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Fresh off the 2024 Musculoskeletal New Ventures Conference, we have a notebook full of investor advice, regulatory updates and exciting new ideas for orthopedic care. Below are some initial thoughts and highlights from this year’s conference.
Investor Advice for Orthopedic Start-Ups
It can be hard to find a pitch at MNVC that doesn’t include massive target addressable market estimates and hockey stick growth projections.
Healthpoint Capital Manager Partner Mike Mogul said a survey of start-up pitches over the last seven years showed that no company achieved better than 40% of its pitch revenue projection, with many coming in far below.
The ubiquity of multi-billion dollar TAM estimates belies the realities of reimbursement and adoption. Investors are more interested in viewing adoption on an individual account or surgeon basis. They want to know how you’ll drive cases per month and get multiple surgeons per account to use your technology.
“With financial investors, be as thoughtful and honest as you can be in your presentation,” said Mr. Mogul. “When one slide is out of whack, it calls into question every other slide you have. It needs to have challenges, and we need to know you understand what those challenges are.”
Investors and regulatory experts also offered these best practices and insights:
- Clinical evidence is a great differentiator and creates value for potential strategic buyers who lack the risk tolerance or patience to gather the data.
- Spend money on high-quality regulatory and intellectual property advice.
- There is hope on the horizon for companies wrestling with EU MDR as lawmakers review it. However, it’s still probably not worth it for small companies.
- Biocompatibility is an increasingly important regulatory issue globally, but especially in the U.S., leading many companies into a doom loop of back-and-forth with FDA.
- With the continuing emergence of enabling technology, cyber security will be the next major regulatory issue.
Using Tech to Improve Decision Making
During the OMTEC® 2023 keynote, Dr. Nitin Goyal lamented the crude methods still in use for making clinical decisions
“Today, if someone potentially needs a revision surgery, a surgeon will line up x-rays looking for lines and changes,” Dr. Goyal said. “Isn’t that crazy? From a consumer standpoint, I would look at that and laugh. Can’t someone tell me if it’s loose or changed position? Your eyes have to identify that? Boy.”
Several companies that pitched at MNVC this year are trying to change that by introducing more precision and objectivity to the process.
Since its 2021 Breakthrough Device Designation, MY01’s Continuous Compartmental Pressure Monitor has found early commercial success in its quest to provide real-time, predictive trauma care. Likewise, TESA Medical hopes to provide precise and reproducible tension and fixation for ACL repair with its single-use, ASC-focused system. Robossis is in the early stages of tackling long bone fracture repair malalignment issues with what would be the first trauma robot.
Two other throughlines we noted across multiple pitches:
- Companies like Onkos Surgical and Osteal Therapeutics are taking on the cancer-like mortality rate and monumental economic burden of periprosthetic joint infection.
- Strategic buyers are looking for platform technologies, but smart several startups are staying focused on initial indications. Early in day one, RevBio coined the oft-repeated phrase “pipeline behind the pipeline.”
Eye Opening Technology: VISIE
VISIE (formerly Advanced Scanners) is a growth company developing optical scanners for robotic and navigated orthopedic and spine procedures.
“When I think about the patient, I actually think about my father,” said Doug Fairbanks, CEO of VISIE. “I took my dad to get his robotic uni knee done, and he said, ‘Doug, what kind of surgeon did you take me to? He operated on my thigh and my ankle. Why couldn’t he find my knee?’ We laughed, but I realized that’s a pretty terrible patient experience. It’s also a bad surgeon experience.”
Earlier this month, the company successfully demonstrated Continuous Anatomic Auto Tracking (CAAT) for robotic-assisted total knee arthroplasty. CAAT could lead to pinless robotic surgery, the holy grail within the space that could greatly accelerate the adoption of orthopedic robotics.
Fresh off the 2024 Musculoskeletal New Ventures Conference, we have a notebook full of investor advice, regulatory updates and exciting new ideas for orthopedic care. Below are some initial thoughts and highlights from this year’s conference.
Investor Advice for Orthopedic Start-Ups
It can be hard to find a pitch at MNVC that doesn’t...
Fresh off the 2024 Musculoskeletal New Ventures Conference, we have a notebook full of investor advice, regulatory updates and exciting new ideas for orthopedic care. Below are some initial thoughts and highlights from this year’s conference.
Investor Advice for Orthopedic Start-Ups
It can be hard to find a pitch at MNVC that doesn’t include massive target addressable market estimates and hockey stick growth projections.
Healthpoint Capital Manager Partner Mike Mogul said a survey of start-up pitches over the last seven years showed that no company achieved better than 40% of its pitch revenue projection, with many coming in far below.
The ubiquity of multi-billion dollar TAM estimates belies the realities of reimbursement and adoption. Investors are more interested in viewing adoption on an individual account or surgeon basis. They want to know how you’ll drive cases per month and get multiple surgeons per account to use your technology.
“With financial investors, be as thoughtful and honest as you can be in your presentation,” said Mr. Mogul. “When one slide is out of whack, it calls into question every other slide you have. It needs to have challenges, and we need to know you understand what those challenges are.”
Investors and regulatory experts also offered these best practices and insights:
- Clinical evidence is a great differentiator and creates value for potential strategic buyers who lack the risk tolerance or patience to gather the data.
- Spend money on high-quality regulatory and intellectual property advice.
- There is hope on the horizon for companies wrestling with EU MDR as lawmakers review it. However, it’s still probably not worth it for small companies.
- Biocompatibility is an increasingly important regulatory issue globally, but especially in the U.S., leading many companies into a doom loop of back-and-forth with FDA.
- With the continuing emergence of enabling technology, cyber security will be the next major regulatory issue.
Using Tech to Improve Decision Making
During the OMTEC® 2023 keynote, Dr. Nitin Goyal lamented the crude methods still in use for making clinical decisions
“Today, if someone potentially needs a revision surgery, a surgeon will line up x-rays looking for lines and changes,” Dr. Goyal said. “Isn’t that crazy? From a consumer standpoint, I would look at that and laugh. Can’t someone tell me if it’s loose or changed position? Your eyes have to identify that? Boy.”
Several companies that pitched at MNVC this year are trying to change that by introducing more precision and objectivity to the process.
Since its 2021 Breakthrough Device Designation, MY01’s Continuous Compartmental Pressure Monitor has found early commercial success in its quest to provide real-time, predictive trauma care. Likewise, TESA Medical hopes to provide precise and reproducible tension and fixation for ACL repair with its single-use, ASC-focused system. Robossis is in the early stages of tackling long bone fracture repair malalignment issues with what would be the first trauma robot.
Two other throughlines we noted across multiple pitches:
- Companies like Onkos Surgical and Osteal Therapeutics are taking on the cancer-like mortality rate and monumental economic burden of periprosthetic joint infection.
- Strategic buyers are looking for platform technologies, but smart several startups are staying focused on initial indications. Early in day one, RevBio coined the oft-repeated phrase “pipeline behind the pipeline.”
Eye Opening Technology: VISIE
VISIE (formerly Advanced Scanners) is a growth company developing optical scanners for robotic and navigated orthopedic and spine procedures.
“When I think about the patient, I actually think about my father,” said Doug Fairbanks, CEO of VISIE. “I took my dad to get his robotic uni knee done, and he said, ‘Doug, what kind of surgeon did you take me to? He operated on my thigh and my ankle. Why couldn’t he find my knee?’ We laughed, but I realized that’s a pretty terrible patient experience. It’s also a bad surgeon experience.”
Earlier this month, the company successfully demonstrated Continuous Anatomic Auto Tracking (CAAT) for robotic-assisted total knee arthroplasty. CAAT could lead to pinless robotic surgery, the holy grail within the space that could greatly accelerate the adoption of orthopedic robotics.
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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.
