Zimmer Biomet's $1.2B Bet on Foot and Ankle Innovation
2025 M&A is off to a hot start.
In previous weeks, we've covered the acquisition activity of Stryker , 波科 , and Johnson & Johnson MedTech .
Now, it's Zimmer Biomet 's turn
This week, Zimmer Biomet announced that they will acquire Paragon 28 for $1.2B.
Let’s unpack what the deal brings to this orthopedic powerhouse, and dive into the numbers driving the space.
Who is Paragon 28
Founded in 2010, in their own words Paragon 28 “eat, sleep, and breathe foot and ankle”.
The company develops and commercializes an extensive portfolio of surgical implants addressing foot and ankle conditions, including the correction of deformities, fracture, joint replacement, and trauma.
Looking at YoY revenue growth from 2021 to 2022, the company's revenue increased 23%. They repeated this success from 2022 to 2023 with an increase of 19%, reaching $216.4M in total revenue.
As of their most recent quarterly report, it appears the company is poised to post another strong year, with revenue from September 2023 to September 2024 increasing 18.4%.
No doubt, Paragon 28’s commercial success was a compelling factor in Zimmer Biomet’s decision to acquire the company.
The acquisition also consolidates the competitive landscape in one of the orthopedic market’s fastest growing segments — a similar strategy to Zimmer's largest competitor in the industry, Stryker.
In their press release commenting on the acquisition, Zimmer Biomet CEO Ivan Tornos commented that the acquisition enhances the company’s position “in one of the highest growth specialized segments” in orthopedic care.
"This proposed transaction further diversifies Zimmer Biomet's portfolio outside of core orthopedics and positions us well in one of the highest growth specialized segments in musculoskeletal care, while creating cross-selling opportunities in the rapidly growing ASC space," Ivan Tornos , President and CEO, Zimmer Biomet
Exactly how much growth are we looking at for these procedures?
Let’s take a look at the numbers driving Paragon’s success and this acquisition.
The Numbers
According to LSI ’s Global Procedure Volumes (SPV) database, a trusted resource with coverage of 300+ diagnostic and therapeutic procedures in 12 major categories across 37 countries, global Foot and Ankle Arthroplasties (joint replacements) are projected to increase at a CAGR of 5.7%, exceeding 120,000 procedures worldwide by 2029.
These procedures are on track to outpace the growth of hip replacement procedures, which are projected to grow at a CAGR of 5.5% during the same period.
In relation to other major joint replacement procedures, foot and ankle arthroplasties rank beneath knee, shoulder, and elbow, but above hip and other extremities.
However, Paragon 28 is also ingrained in the fracture and trauma space.
Worldwide, these are the second most performed orthopedic procedures, falling slightly behind the 6.96 million upper extremity fracture repair procedures performed in 2024 with an impressive 6.22 million procedures.
These procedures are expected to grow at a healthy CAGR of 4.4% from 2024 to 2029.
Overall, foot and ankle procedures are projected to outpace the overall growth of orthopedic procedures, which we estimate are increasing at a CAGR of 4.6%.
It’s worth noting — fracture volumes are particularly impressive when you multiply by the number of devices used to treat these conditions. In the cases of complex fractures of the foot and ankle, up to 5 devices can be used.
LSI's Global Procedure Volumes Database gives hundreds of startups and multinational companies a competitive edge in answering their most pressing questions and making data-driven decisions.
More Consolidation on the Horizon?
When we evaluate the major joint replacement markets (i.e., hip, knee, shoulder), a significant amount of consolidation has occurred.
There is a substantial amount of work that goes into ensuring a hospital or ASC chooses your company's implants to treat their patients.
Consolidation is an effective means to increase market share, as healthcare providers are less likely to change their implant providers once a relationship is established.
The ASC trend in the U.S., which has effectively increased the number of customers that medtech companies can sell to, further rewards thoughtful acquisitions and consolidations.
Watch List
With M&A wide open in 2025, there are a number of exciting companies that could be value-accretive acquisitions for multinational medtech companies.
Through LSI 's global partnering events ( LSI USA , LSI Europe , LSI Asia ), we have a front row seat to the leading innovators in medtech, and continue to track industry-wide private companies and deals in our Companies & Deals Database.
Below are five companies we're watching closely.
1. Fibioseq Medical Ltd (LSI USA ‘25)
2. Canary Medical Inc. (LSI USA ‘20, ‘21, ‘25 + Europe ‘23, ‘24)
3. Solenic Medical Inc. (LSI USA ‘22-’25 + Europe ‘23-’25 + Asia ‘25)
4. Additive Implants, Inc. (LSI USA ‘25)
5. meduloc (LSI USA ‘25)
What This Means
2024 financial reporting is on the horizon for many of the medtech strategics, including Zimmer Biomet. In 2023, the company reported that foot and ankle products represented only 4% of the company’s $1.75B S.E.T. (Sports Medicine, Extremities, and Trauma) business.
This acquisition adds a company in that market that was doing triple their revenue.
We look forward to seeing how this acquisition, and those that will follow in 2025, continue shaping and reshaping the industry.
More From LSI Market Intelligence
Until next week,
Henry Peck and Nick Talamantes
All data in this article is sourced from LSI's Market Intelligence Team