Consolidation has created a widening gulf between small start-ups with innovative technology and large multi-faceted companies that control sales and distribution channels, making life difficult for mid-sized companies caught in the middle. Nowhere is this more true than in orthopedic devices. Now, some investors are finding opportunities in mid-sized companies by using them as platforms to build more substantial plays. The goal isn't market leadership, but value creation for shareholders, which can be done on a more modest scale.