Top 10 Companies: Insights from 2024 and What May Unfold in 2026
To view this article on the Orthopedic Design & Technology Magazine, click here.
ODT’s July/August issue featured the annual Top 10 orthopedic device companies list, an analysis of the industry’s leading players. The appraisal is extremely useful, as most high-level executives have a keen interest in these companies’ business affairs because their actions tend to drive the overall dynamics for smaller players and OEM suppliers.
Every new Top 10 list reflects interesting changes from the previous version(s). However, this year’s list was surprising due to some key dynamics at the top. While it’s not unusual for major industry players to utilize divestitures and acquisitions to manage their portfolio, it is rare for a market leader (in this case, Stryker Corp.) to withdraw from an entire industry segment—as it did with its spine business.
Certainly, some reshuffling of power is to be expected. In previous years, for example, Globus Medical acquired Nuvasive Inc., Orthofix Medical Inc. merged with SeaSpine Holdings Corporation, and Zimmer Biomet Holdings divested its spine unit.
The 2025 Top 10 list confirms what many OMTEC and AAOS attendees discovered: scale is winning, enabling technology is no longer “ancillary,” and portfolio pruning remains in fashion. Nine of the Top 10 companies posted growth, with Stryker stretching its lead and two mid-pack contenders breaking the $2 billion ceiling.
Hence, the following recap/analysis of the orthopedic industry’s top leaders, the factors that landed them in the Top 10, and a prognosis on where the list might change in 2026.
The Leadership Board
The 2025 Top 10 roster (based on latest fiscal year revenue) includes, in order: Stryker ($22.6 billion), Johnson & Johnson MedTech ($9.2 billion), Zimmer Biomet ($7.7 billion), Smith+Nephew ($5.8 billion), Medtronic ($5 billion), Arthrex ($3.2 billion), Globus Medical ($2.5 billion), Enovis ($2.1 billion), Embla Medical (Össur’s new parent name; $855 million), and Orthofix ($799.5 million). All but one grew year-over-year.
For context, the 2024 list contained the same companies but smaller tallies, reflecting broad-based momentum for the industry. Notable moves from key players include:
1. Stryker—Owned headlines by doing two things at once—buying growth and trimming where it didn’t fit the plan. On the buy side, it closed the Vertos Medical acquisition to expand interventional pain for lumbar spinal stenosis; completed deals for Artelon (soft-tissue fixation), mfPHD (OR infrastructure), SERF SAS (hip), MOLLI Surgical (breast localization), NICO (neuro tumor/ICH access), and—big swing—Inari Medical to enter high-growth peripheral vascular.
Then Stryker did something unusual for a relentless acquirer: It sold its U.S. spinal implants business to the Viscogliosi Brothers as part of the newly formed company VB Spine. The deal was inked in January and closed April 1.
Net effect: Despite divesting a chunk of legacy spine revenue, Stryker’s orthopedic top line still climbed to $22.6 billion—proof that its bolt-on and adjacency strategy continues to outrun pruning.
2. J&J MedTech—It was a relatively uneventful year for J&J and it seems the company liked it that way. There were no major dramas, only consistent growth and presence across large joint and trauma. And, notably, J&J MedTech is finally growing its footprint in robotics and enabling technologies.
3. Zimmer Biomet—Expanding its portfolio to further penetrate the extremities markets, Zimmer Biomet snatched up Paragon 28 to broaden its capabilities in a fast-growing sub-segment. While the near-term cost and tariff overhang trimmed 2025 guidance (it’s since improved), the strategic logic is sound: diversify beyond large joint with a branded, innovation-heavy foot/ankle portfolio.
4. Smith+Nephew—While always the subject of M&A speculation (who will buy it?), S&N simply continued forward with stable growth and steady execution—no movie-plot moves, just market share staying power (for now).
5. Medtronic—Contrary to recurring speculation, Medtronic kept its spine business in-house and instead chose to separate its Diabetes unit, with plans to list the new company—MiniMed—within roughly 18 months. That move sharpens its focus on higher-margin core segments while giving diabetes a purpose-built, consumer-oriented path.
6. Arthrex—The stealth locomotive—private, product-driven, and locked in at $3.2 billion (estimated in 2024 and 2025). With a deep sports medicine/new procedure pipeline and ASC-friendly economics, the company’s “under the radar, over the benchmark” operating model remains intact.
7. Globus Medical—Continuing its transition from spine pure-play to musculoskeletal platform, Globus finished integrating NuVasive (closed in 2023) and then leaped into neuromodulation by acquiring Nevro Corp. in April. That combination pushed Globus past $2 billion in annual revenue for the first time, thanks to the NuVasive integration and enabling technology momentum. Globus is no longer solely a spine company now—it’s a spine-first musculoskeletal platform with neuromodulation and advanced navigation/robotics capabilities as growth multipliers.
8. Enovis—Having closed the LimaCorporate S.p.A. deal on Jan. 3, 2024, the company now generates more than $2 billion in orthopedic sales, significantly more than a year ago. In April 2025, Enovis named former LivaNova chief executive Damien McDonald as CEO, succeeding Matt Trerotola (retiring). Enovis’ strategic north star remains the same—build a balanced reconstructive/extremities engine with a runway for above-market growth.
9. Össur/Embla Medical—ODT’s No. 9 spot looks new only by name. Össur reorganized under Embla Medical—an Iceland-anchored parent brand—without changing the fundamentals of its bracing/prosthetics business. Revenue rose from $786 million to $855 million, enough to keep the Top 10’s last two rungs competitive.
10. Orthofix—After a messy 2023 leadership scandal, Orthofix is back on track. The company reset its C-suite, installing Massimo Calafiore as CEO in January 2024 and Julie Andrews as CFO shortly afterwards. The result was renewed growth—revenues increased from $747 million in 2023 to just under $800 million in 2024. The SeaSpine merger synergies are still being harvested but the direction is better, even if execution remains under the microscope (for good reason).
Now for some insights on the Top 10 class for 2026. It’s quite possible the ice could crack for some—perhaps quietly at the bottom and more loudly in the middle.
1. Slots 7-9 could bunch up. If Globus extracts more from Nevro Corp. and NuVasive while Enovis drives LimaCorporate synergy into reconstruction and extremities, the 7 and 8 rankings may pull away considerably from number 9. Embla is growing, but the prosthetics/bracing cadence naturally expands by mid-single-digits; a healthy pipeline won’t match platform-plus-M&A compounding growth elsewhere.
2. ZB’s foot/ankle bet matters. Paragon 28 gives ZB extremities credibility where it was desperately needed. However, integration and ASC channel execution will decide whether that translates into sustained out-performance relative to the rest of the top five.
3. Tariffs could pinch, timing-wise. ZB already trimmed its 2025 guidance, citing tariff headwinds but updated estimates showed a less considerable impact. If trade frictions and dollar exchange rate fluctuations persist into 2026, gross margin pressure could shave points off growth investments across multiple Top 10 organizations. That won’t reshuffle the top three, but it could compress deltas in the middle and bottom.
4. Stryker’s stamina: A win is certain with a continued focus on portfolio execution and pure volume. And that doesn’t include any new deals that may occur. While divesting U.S. spine implants trimmed one mature revenue stream, adding Inari Medical, Vertos Medical, plus neurological and reconstruction feeders keeps Stryker’s growth engine in the high-single-digit to low-double-digit zone. There’s no credible challenger to the top unless a megamerger rewires the leaderboard.
5. Medtronic’s spin creates a cleaner story. Spinning diabetes into MiniMed should boost Medtronic’s margins and focus—good for orthopedics allocation. If the newco IPO completes on time, a crisper capital deployment into spine/enabling technology will take place. Don’t expect a rank jump, but expect better operating leverage. And perhaps some M&A.
6. Orthofix’s next 12 months are decisive. With leadership stable, the path to 2026 is about sequential wins—share gains in biologics, navigated spine, and deformity correction; continuous quality calm; and a “clean house.” With that noted, there’s a likely upside to hold
No. 10 with some room to spare.
For 2026, the “podium” is safe, but the real sparks may fly in the mid- to bottom tier.
About the Authors:
Florence Joffroy-Black, CM&AA, is a longtime marketing and M&A expert with significant experience in the medical technology industry, including working for multi-national corporations based in the United States, Germany, and Israel. She currently is CEO at MedWorld Advisors and can be reached at florencejblack@medworldadvisors.com.
Dave Sheppard, CM&AA, is a former medical technology Fortune 500 executive and is now focused on M&A as a managing director at MedWorld Advisors. He can be reached at davesheppard@medworldadvisors.com.
To view this article on the Orthopedic Design & Technology Magazine, click here.
