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In 2020, Enovis embarked on a rapid entry into the foot and ankle space by acquiring the STAR total ankle from Stryker. Since then, the company’s foot and ankle business unit has grown rapidly and is on the cusp of generating $100 million in annual sales. We chatted with Gary Justak, President of Enovis’ Foot and Ankle business, about R&D focus, managing integrations and long-term goals. Our conversation is excerpted below.
How have you fielded such a competitive foot and ankle business so fast?
Gary Justak: We’ve been extremely aggressive, going from a business unit that did not exist at Enovis to being on track to be a hundred-million-dollar business unit by the end of next year. We’ve done that through heavy M&A. We’ve folded in five companies, three between late 2020 and early 2021 and two just recently here in July.
At the same time, we’ve been focused on internal product development. Integrations are a heavy lift, but what we were focused on was building out a strong R&D team. We probably have more engineers than most other businesses in the foot and ankle space. Last year we spent more, as a percentage of revenue, on R&D than any other dedicated foot and ankle company in the space.
What about Enovis’ growing foot and ankle portfolio excites you most?
Gary Justak: I’m most excited about the products we’ve brought to market and launched. One of the most exciting products that we have is the DynaNail Helix. It’s been on the market since late last year and is one of the most tremendous pieces of technology I’ve seen.
DynaNail has been on the market for ten years, but taking that nitinol technology and expanding the indications of active adaptive to smaller applications that are really in underserved segments, you think about the areas that have higher non-union rates and lower fusion rates like subtalar fusion. We’re thinking about the application of nitinol and the benefits of compression as the body resorbs and heals. We’re starting to push that technology moving forward.
Enovis has been doing a lot of work on STAR. Where do things stand with that product?
Gary Justak: We’ve been very hard at work on revolutionizing STAR. As you know, we got STAR in 2020 as the divestiture from Stryker and Wright Medical. It’s a Class III device, so it’s a PMA and comes with many regulatory hurdles and work that we need to do. We worked hard to build our teams and focus on some big projects.
We just brought patient-specific instruments to STAR for the first time. That will simplify a complicated procedure. We’re working on vitamin E poly. That’s in the 180-day review with FDA, and we hope to get it approved by the end of the year.
Orthopedic integrations are notoriously complex. Enovis has an effective playbook for post-merger integrations, but what has the day-to-day management of those deals been like?
Gary Justak: Listen, I had a full head of hair when we started this. As you can imagine, we live it day in and day out. I try to get to the simplest perspective: start with the end in mind. For us, having a firm view of our end game and developing one cohesive strategy as a business was the first thing we had to do. For us, for our sellers and our internal employees, it’s less about the companies that you came from; it’s more about the vision of the business we’re building together.
The goal is to be a top three player dedicated in foot and ankle over time. Our end goal is to have differentiated technology that will improve outcomes. I know there’s a lot of companies out there that say that, but if you look at how we’re backing that up with the data and the science and very strategically with the acquisitions we’ve done, there’s a story behind that.
Where does Enovis foot and ankle go from here?
Gary Justak: The first milestone for us is $100 million. We said two years ago we wanted to be a $100 million foot and ankle business. People laughed at that, saying, oh, how are you going to do that? Well, we’ve been very aggressive in how we did that, and we’ve been aggressive in how we’ve expanded our global position as well.
You’re going to see the same amount of aggressiveness for us. I’ve always said getting to your first a hundred million is hard. It gets a lot easier to get from $100 million to $200 million. It’s the scale; it’s the mass. You have a commercial engine. You can feed that beast, right? So, if you’ve got an R&D flywheel working nonstop and a great marketing and medical education team, then the field just needs innovative products. That matters, especially when sellers are looking for opportunities in the space.
You will see our entrepreneurial-minded spirit. Enovis allows us to do that. We get to run our business as a startup, and have that energy and excitement. It requires an investment in innovation, point blank. Organic or acquisition, it’s going to be founded in differentiated technology. And then you’re going to see scale and mass, and ultimately, you’ll see us aggressively push to $200 million over the next three to five years and long-term goal to the top three.
In 2020, Enovis embarked on a rapid entry into the foot and ankle space by acquiring the STAR total ankle from Stryker. Since then, the company’s foot and ankle business unit has grown rapidly and is on the cusp of generating $100 million in annual sales. We chatted with Gary Justak, President of Enovis’ Foot and Ankle business, about R&D...
In 2020, Enovis embarked on a rapid entry into the foot and ankle space by acquiring the STAR total ankle from Stryker. Since then, the company’s foot and ankle business unit has grown rapidly and is on the cusp of generating $100 million in annual sales. We chatted with Gary Justak, President of Enovis’ Foot and Ankle business, about R&D focus, managing integrations and long-term goals. Our conversation is excerpted below.
How have you fielded such a competitive foot and ankle business so fast?
Gary Justak: We’ve been extremely aggressive, going from a business unit that did not exist at Enovis to being on track to be a hundred-million-dollar business unit by the end of next year. We’ve done that through heavy M&A. We’ve folded in five companies, three between late 2020 and early 2021 and two just recently here in July.
At the same time, we’ve been focused on internal product development. Integrations are a heavy lift, but what we were focused on was building out a strong R&D team. We probably have more engineers than most other businesses in the foot and ankle space. Last year we spent more, as a percentage of revenue, on R&D than any other dedicated foot and ankle company in the space.
What about Enovis’ growing foot and ankle portfolio excites you most?
Gary Justak: I’m most excited about the products we’ve brought to market and launched. One of the most exciting products that we have is the DynaNail Helix. It’s been on the market since late last year and is one of the most tremendous pieces of technology I’ve seen.
DynaNail has been on the market for ten years, but taking that nitinol technology and expanding the indications of active adaptive to smaller applications that are really in underserved segments, you think about the areas that have higher non-union rates and lower fusion rates like subtalar fusion. We’re thinking about the application of nitinol and the benefits of compression as the body resorbs and heals. We’re starting to push that technology moving forward.
Enovis has been doing a lot of work on STAR. Where do things stand with that product?
Gary Justak: We’ve been very hard at work on revolutionizing STAR. As you know, we got STAR in 2020 as the divestiture from Stryker and Wright Medical. It’s a Class III device, so it’s a PMA and comes with many regulatory hurdles and work that we need to do. We worked hard to build our teams and focus on some big projects.
We just brought patient-specific instruments to STAR for the first time. That will simplify a complicated procedure. We’re working on vitamin E poly. That’s in the 180-day review with FDA, and we hope to get it approved by the end of the year.
Orthopedic integrations are notoriously complex. Enovis has an effective playbook for post-merger integrations, but what has the day-to-day management of those deals been like?
Gary Justak: Listen, I had a full head of hair when we started this. As you can imagine, we live it day in and day out. I try to get to the simplest perspective: start with the end in mind. For us, having a firm view of our end game and developing one cohesive strategy as a business was the first thing we had to do. For us, for our sellers and our internal employees, it’s less about the companies that you came from; it’s more about the vision of the business we’re building together.
The goal is to be a top three player dedicated in foot and ankle over time. Our end goal is to have differentiated technology that will improve outcomes. I know there’s a lot of companies out there that say that, but if you look at how we’re backing that up with the data and the science and very strategically with the acquisitions we’ve done, there’s a story behind that.
Where does Enovis foot and ankle go from here?
Gary Justak: The first milestone for us is $100 million. We said two years ago we wanted to be a $100 million foot and ankle business. People laughed at that, saying, oh, how are you going to do that? Well, we’ve been very aggressive in how we did that, and we’ve been aggressive in how we’ve expanded our global position as well.
You’re going to see the same amount of aggressiveness for us. I’ve always said getting to your first a hundred million is hard. It gets a lot easier to get from $100 million to $200 million. It’s the scale; it’s the mass. You have a commercial engine. You can feed that beast, right? So, if you’ve got an R&D flywheel working nonstop and a great marketing and medical education team, then the field just needs innovative products. That matters, especially when sellers are looking for opportunities in the space.
You will see our entrepreneurial-minded spirit. Enovis allows us to do that. We get to run our business as a startup, and have that energy and excitement. It requires an investment in innovation, point blank. Organic or acquisition, it’s going to be founded in differentiated technology. And then you’re going to see scale and mass, and ultimately, you’ll see us aggressively push to $200 million over the next three to five years and long-term goal to the top three.
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ME
Mike Evers is a Senior Market Analyst and writer with over 15 years of experience in the medical industry, spanning cardiac rhythm management, ER coding and billing, and orthopedics. He joined ORTHOWORLD in 2018, where he provides market analysis and editorial coverage.
