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Spine and Joint Lead Investor Interest in 1H15

Funds raised in the first half of 2015 show continued interest in support of the spine and joint reconstruction segments: of the $135 million we’ve reported thus far, both claim over 28 percent of the whole. Orthobiologic companies, whose products have application across different segments, account for 18 percent.

          It’s important to note, however, that the $135 million does not include funding sought and not yet raised—most notably, the IPO expected for ConforMIS, developer of customized knee replacement systems (and hips, to come). The company just priced its offering of 9 million shares in the range of $14 to $16, for potential proceeds up to $144 million.

          The fact that most of these companies are not new to you or to us affirms an observation from this time last year, that investors remain primarily focused on growth-stage companies vs. start-ups. Where available, we’ve noted how much the companies have raised to date and how they’ve raised it.

Atlas Spine
Plans to raise $5MM in Series B Financing

  • To support existing business and monetization of spinal implant products through licensing/royalty model
  • Portfolio includes 7 product systems on the market and 27 products in various stages of development, focusing on MIS and interbody fusion devices
  • Since formation in 2001, raised $8.5MM (most recently, $3.5MM venture capital in 2011)

Aurora Spine
Non-brokered private placement of common shares, issuing ~0.5MM shares at $1.35/share

  • Aggregate gross proceeds ~CDN $0.68MM (~US $0.58MM) will support general working capital
  • In 2Q, launched MIS VOX™ Lateral Interbody System, featuring TiNano® titanium spray coating, as well as 1st U.S. and international surgical implantations of the ZIP 51™ MIS Interspinous Implant
  • Since 2014, raised $2.1MM in venture capital

Bone Biologics
Completed $2MM round of seed funding

  • Will support ongoing development of Nell-1 recombinant human protein in preparation for human clinical trials to validate the technology in bone regeneration
  • In large animal studies, Nell-1 exhibited no side effects associated with other bone growth factors, such as ectopic/extraneous bone growth or cyst formation
  • Company formed following a reverse merger with AFH Acquisition; Musculoskeletal Transplant Foundation remains its largest shareholder

Bone Therapeutics
Plans to launch an IPO in Europe

  • Funds will support clinical trials, research & development, manufacturing scale, etc.
  • PREOB® autologous bone cell therapeutic product is in pivotal Phase IIb/III clinical study for osteonecrosis and nonunion fractures; ALLOB® in Phase II for delayed union fractures and lumbar fusion
  • Established Bone Therapeutics USA in early 2Q, the 1st step in support of its U.S. clinical trial program
  • In 2013, raised €7.7MM (~$10.4MM) in Series D funding

Closed $14MM round of funding

  • Will support global sales/marketing, expansion of CERAMENT™ platform into new drug delivery products and market opportunities; presently used to treat fragility fractures
  • Most recent CE Mark received in early 2Q for CERAMENT|V, injectable vancomycin-eluting bone substitute indicated to promote and protect bone healing in the management of osteomyelitis
  • In late 2014, entered co-development agreement with Orthocell for bone repair products based on Celgro™ collagen scaffold and CERAMENT to create a product that will not only support damaged bone, but induce growth of new bone
  • From 2006, raised $64.1MM in venture capital rounds

In 1H15, secured $8.5MM in an oversubscribed Series D financing

  • Will fund through premarket approval of Synthetic Cartilage Implant (SCI), as well as post-510(k)-clearance clinical evaluations of ProxiFuse Hammertoe Correction System and GRIP Study evaluating Cartiva SCI in the treatment of thumb base OA
  • In mid-2Q15, submitted final PMA application module for SCI to FDA and in late 2Q, announced 1st human implant of ProxiFuse
  • Since 2013, raised $15.8MM in Series A and D financing, debt financing and venture capital

Ceterix Orthopaedics
Term loan agreement to secure up to $35MM of available borrowing capacity

  • Will support product development and clinical research
  • Developed tools to treat soft tissue injuries, e.g. tears of the meniscus, hip and shoulder labrum, rotator cuff, etc.
  • Recently sponsored a study that found meniscus surgery to be associated with an increased relative risk of failure, yet also leading to substantial reductions in subsequent incidence of OA and TKR; clinical benefit and cost-effectiveness further improved with longer follow-up
  • Since 2014, raised $53MM via Series B and debt financing

Filed with SEC to raise up to $144MM in an IPO

  • Plans to submit application for FDA clearance of iTotal customized hip replacement in 2015
  • Since 2009, has raised over $240MM in Series D, E and grant funding
  • Offering customized knee implants designed to restore the natural shape of a patient’s knee; sold >30,000 knee implants in U.S. and EU to date

CyMedica Orthopedics
Closed extension to its $11.5MM Series A financing

  • Will support sales and continued rollout of QB1™ neuromuscular electrical stimulation system for treatment of quadriceps muscle atrophy
  • Since mid-2013, has offered just over $12.9MM and sold just under $6MM

Flower Orthopedics
Completed $4.5MM Series C equity raise

  • Will support working capital and growth strategies
  • Markets FlowerCube™, a standardized, single-use bone fixation concept housing all requisite implants and instruments for a fracture procedure, sterile packaged (most recent configuration launched is Distal Radius FlowerCube™)
  • Since 2014, raised $9.2MM in Series C and venture rounds

Intellirod Spine
Secured undisclosed amount of additional equity financing in 1H15

  • To support commercialization of LOADPRO intra-operative sensor technologies and lumbar fusion implants
  • Submitted 510(k) application for sensor’s use in rod strain balance during surgery and completed preclinical testing in support of FDA application for ACCUVISTA™, implantable version to monitor post-op strain in rods employed in fusion to treat degenerative disc disease
  • Since 2009, operating as OrthoData, has offered $0.57MM and sold just over $0.35MM
  • Additionally, since 2013, has secured debt financing of $1.6MM from the Ohio Third Frontier’s Commercial Acceleration Loan Fund, received a $1.1MM Series A funding led by The Kentucky Seed Capital Fund, a $1.1MM investment from Akron BioInvestment Funds and a $250,000 investment commitment from JumpStart

Raised $19.7MM of a potential $37.6MM round of funding

  • Developer of KineSpring® joint-sparing partial load absorber, designed to reduce knee joint load by up to 13 kg (500 implanted worldwide at end of 2013)
  • Four clinical trials ongoing
  • Since 2011, raised $80.6MM in Series A & B, venture capital (largest was $45.8MM Series A in 2011)

Ortho Kinematics
Closed a ~$9.6MM Series C equity financing

  • Will support sales, marketing, R&D for Vertebral Motion Analysis (VMA) product for radiographic assessment of spinal motion and instability
  • At end of 1Q14,  >1,000 patients tested with VMA since limited commercial launch in late 2013
  • In 4Q14, entered into agreement granting Medtronic rights to promote VMA to spine surgeons
  • Since 2009, raised $27.4MM via Series A-C rounds, debt financing and venture capital


  • Completed an $8MM financing transaction, including investment from Smith & Nephew (In 3Q13, ArthroCare made a small investment in OrthoSpace and obtained distribution rights to InSpace in certain ex-U.S. markets)
  • Will support market adoption, clinical study and entry into emerging markets for InSpace, disruptive biodegradable balloon technology for treatment of severe rotator cuff tears; product is CE Marked
  • In 2011, raised ILS 2.6MM (~US $0.7MM) in funding

Raised US $19MM in a private placement of Series C Preferred Stock

  • Will support development and commercialization of VERASENSE™ sensor-assisted total knee replacement instrument
  • Has partnerships with Biomet, Smith & Nephew, Stryker and Zimmer on use of product with various knee systems
  • Since 2008, raised $92MM from combination of Series A-C funding, convertible note (largest $21MM Series B in 2011)

Closed a $21MM round of growth capital financing during 1H15

  • Will support further U.S. and EU expansion in anticipation of increased demand in the minimally invasive surgical SI joint fusion market, as well as entry into the Middle East, Asia and South America
  • Since 2009, has raised a total of $82.1MM via Series A, B and venture capital financing
  • North American Spine Society recommended coverage for percutaneous SI joint fusion when certain criteria are met; this evidence-based coverage policy based primarily on 19 SI-BONE iFuse® published clinical studies
  • As of 3Q15, >15,000 iFuse procedures performed worldwide, using >44,000 iFuse implants

Closed a €1.6MM (~US $1.8MM) private placement capital increase and launched a €1.8MM (~US $2.0MM) public offering (the latter later cancelled due to poor market conditions)

  • Completed additional equity round of €0.9MM (~US $1.0MM), bringing new equity funds raised in 2Q15 to €2.8MM (~$3.1MM), comprising equity rounds and PACEO™ equity line draws
  • Will support market launch of SpineGuard’s “smart screws” for use in spine surgery
  • Within 2015, entered into co-development partnerships with Neuro France Implants and U.S.-based Zavation to integrate Dynamic Surgical Guidance technology into pedicle screw systems
  • In 2009 and 2011, raised $10.2MM total in Series A and B financings

Trice Medical
Raised $6.5MM in a Series B financing

  • Founded to improve orthopaedic diagnostics through camera-enabled technologies that support instant diagnosis of orthopaedic injuries
  • Will support clinical trials of mi-eye™ single-use visualization device, comprising camera-enabled needle and light source to perform diagnostic arthroscopy in physician’s office
  • Since 2014, raised $18.1MM in Series B funding

Vertos Medical
In 1H15, raised ~$6MM of $12MM offering

  • Developer of mild®, a minimally invasive, fluoroscopically-guided outpatient treatment for lumbar spinal stenosis that requires no general anesthesia, implants or stitches
  • In 2Q15, completed enrollment and treatment for its 27-site MiDAS ENCORE randomized controlled study to examine long-term benefits for ~300 patients who received either mild or epidural steroid injections to treat lumbar spinal stenosis
  • Since 2006, raised $82.7MM in a combination of Series A-D rounds, venture capital, convertible notes and debt financing (largest venture round $23MM in 2013)

Raised $2.4MM in capital

  • Will support expansion of “Smart Patient Navigation” software for orthopaedic surgery patients, adding spinal and other specialties; platform transmits videos, articles and interactive content in distinct steps as part of patient’s care plan
  • Since 2013, raised $4.2MM in Series A and venture capital