J&J's aggressive moves in orthopedics has industry executives nervous, most recently about its purchases of artificial disk maker Waldemar Link and biomaterials expert Orquest. The Link valuation (J&J is paying $325 million upfront, plus earn-outs) isn't quite as high as some earlier orthopedics deals, but it is still comparatively substantial. With Link and Orquest under its roof, J&J is poised to assume market leadership in the traditional orthopedics markets and also in spine.

The once consolidating orthopedic implant business is, if anything, going in the opposite direction, given the decisions this week by parents of two of the leading companies to create stand-alone companies of their orthopedic businesses. Bristol-Myers confirmed what had been rumored for months: that it will spin off its Zimmer orthopedics business into a public company rather than sell the company to some other player. Earlier, Sulzer announced that it plans to spin off its medical device business, Sulzer Medica, in response to pressure from a large investor who was concerned about the industrial giant's declining stock performance. But these individual deals also represent a surprising industry turnaround--the consolidation of two years ago has largely stabilized pricing, allowing independent companies to thrive once again.

Orthobiologics are now on the horizon, driving suppliers to increase R&D spending. The goal is to develop high-margin products that will actively promote bone formation. Has the slow progress to commercialization of the first two products--bone morphogenic proteins developed by the collaborations of Stryker Corp/Creative Biomolecules and Genetics Institute/Sofamor Danek--helped prime the market to accept a new technology? Or has the perception of delay dampened enthusiasm and scared off some of the big orthopedics players?

Technology innovation and product differentiation are the keys to success in medical devices, says Dan Lemaitre, Global Sector Head, Health Care, for SG Cowen Securities Corp. and one of the device industry's leading experts. From implantable cardiac defibrillators to cardiovascular stents, Lemaitre argues, the record is clear: the winners are those companies that can develop new technology with meaningful clinical benefits. The losers not only lose their technological edge, but often resort, futilely, to pricing strategies to try to hold their markets.