Robert Ball, Shoulder Innovations - Innovative Solutions for Shoulder Arthroplasty | LSI USA '24

Robert Ball  0:03  
Hi, I'm Rob Ball, Shoulder innovations, as you mentioned, and thanks for for joining today. I appreciate the opportunity to present the company to we are a pure play shoulder arthroplasty company. We've been focused on this market since 2009 we introduced our first implant into humans in 2016 and have been and what that was our insect glenoid solution, really solving the primary difficulty with anatomic shoulder arthroplasty. We've now built a comprehensive product line of shoulder arthroplasty products covering about 85% of arthroplasty procedures happen in the marketplace. We're running along here about a $30 million run rate, so growing very nicely in a very healthy market, and are enjoying great success and momentum at this point. I like to start with our management team. We've had a long history of success, specifically in this market. We began at depewed prior to it being debut synthesis, but built the shoulder arthroplasty product line there, and that's what really made shoulder arthroplasty a relevant product line in the orthopedic space. A number of our team members built a company called DVO and built what was the simplicity implant. That was the first US stemless shoulder arthroplasty device is now the market leader worldwide, and we built a product line for tornier, which subsequently became bright medical and then was further acquired by Stryker. Of course, that's now the leading market share leader worldwide for shoulder arthroplasty. So we've had a pretty meaningful impact in this market. A couple of my team members are here with us, and we've just enjoyed a great opportunity over the last decade or so, really now, to build a spectacular company, the market is very healthy. It's about a $1.5 billion market in the United States today, about half that, in addition, also outside the United States, we only operate in the US marketplace today. We just have a lot of headroom and a lot of capacity to enjoy a lot of growth sticking with the US market, and it enjoys the same demographic changes that are driving much of the rest of the growth in the orthopedic market and aging population, really, that expects much, much higher activity levels, including further specialization by surgeons focusing on specific markets Like shoulder arthroplasty, notably at January one of this year, CMS did render a payment decision to award payment for a shoulder arthroplasty and standalone surgery centers. You know, surgeon owned surgery center. So that's a new dynamic in the market that we were particularly well prepared for. You can see down here in the lower left, excuse me, the lower right, we've built a product line that's tuned to fit into two trays of instrumentation, which is very unique in the marketplace. And so our entire product line fits there. And so when you think about an ambulatory surgery center setting, we are extremely efficient as it relates to them being successful executing these procedures in a surgery center in the upper left. We started with our what we call our insect glenoid. That's what we're really known for. From a branding position in the marketplace today, we solved what's known as the problem of glenoid loosening, or the main problem in anatomic shoulder arthroplasty. I explain that more here in just a moment. We're also doing a great job taking advantage of a major shift that's happening in the shoulder arthroplasty marketplace, which is kind of twofold. One, a transition from anatomic shoulder arthroplasty, where the ball's on the humeral side, to reverse shoulder arthroplasty, where the ball is on the scapular side. And we've learned a lot about that technique over the last call it 20 years. And now we're transitioning to a new type of reverse shoulder arthroplasty, where that ball is still on the on the scapular side, but we we change the way that ball interfaces with the interface, and that transition, excuse me, with the humerus, and that transition is happening today, and we're right in the middle of that transition and leading in that technology space. And that's what's indeed playing a big role in giving a share. All of our products are extremely minimally invasive. I'm very confident in saying we take less bone than any other competitor in the market, and our surgeons recognize this for that fact. So you can see, there we are, the lower left the two circles, the lower left, that's our instrument tray, and the upper right is our little box of implants. According to the same procedure with a competitive company, you can see they've got nine trays of instruments and quite a few more implants, and just puts this in a very much advantaged position, from an efficiency, from a cost saving standpoint, and from just a distribution and logistics standpoint, as we enter that ambulatory surgery center market that just frankly cannot handle the presentation of metal and plastic that our competitors today are presenting to them. This is our suite of products in the lower left is indeed that insect glenoid that was released in 2016 and 2020 we released an augmented version of that for kind of particular wear of the scapular glenoid. We released our humeral stem in 2019 our reverse in the lower right in 2021 And then in late 22 reintroduced our stemless device, all of those products flow through what we call our, excuse me prove preoperative planning solution was actually the first musculoskeletal application that went through FDA, qih code for artificial intelligence enabled software applications. So we're proud of that, and that all of those products then flow through that true to tray instrumentation system. So very much a world class product, leading differentiating technology in a very, very efficient package. This is that provoiance package. It's really a very much a gamified preoperative planning solution, as I mentioned, AI enabled analysis of CT scans into a three dimensional structure that patients, excuse me, surgeons can indeed preoperatively plan that solution, the insect glenoid you can see in the lower left just very quickly solves that glenoid loosening problem by actually setting the implant down into bone. That eliminates what's called rocking horse motion, which is the main cause of shoulder arthroplasty loosening. And so we've we've proven that that indeed, now does solve that problem. You don't have to take my word for it. We've got multiple peer reviewed publication proving indeed that's the case, and including a nine year follow up with no loosening, no radiographic finding. So very successful demonstration. Our humoral stem came in 2019 which is an extremely unique device stands alone. It's what we call a convertible device, that means you can implant it as an anatomic implant, and then later, with tissue failure, for example, convert that to reverse shoulder arthroplasty, which is effectively a necessity in today's marketplace. We do that in a very differentiated in special way that is shown here. So you can see that implant curving into the humerus that gives us a very special advantage, allowing us to have an inlay reverse dynamics, as opposed to onlay reverse dynamics. And what I mean by that, as you can see here on the right, the onlay arthroplasty, you have a large space, that large blue line, the large space between the sphere and the and the humerus bone on the left, those two are very close together, and that transitioning is happening in the marketplace today. Indeed, you can see our competitor reverse, which is inlay, and ours is inlay as well on the left. And so we've demonstrated to the market at this point that we have a great inlay solution, and the market is learning about why this is important, and indeed provides greater motion for patients very soon postoperatively. And so we're in a very much advantaged position of taking advantage of that transition, and we're seeing that with our momentum in the marketplace today. And of course, our stemmed and stemless devices work in exactly the same way. They can be implanted in a reverse dynamic in exactly the same way. So the stemless is not yet cleared in the US. The the stemmed is cleared in the us all, all supported by a very robust patent portfolio. Very much of our art is already published, excuse me, already issued, really. And so we're in a great position. We've got technology out into the 30s and 40s from a from a lifetime standpoint, we raised a $42 million series D last year, and much of that is going into our sales and marketing team. And we built out a spectacular warehouse in the Grand Rapids, Michigan area, and are enjoying a great activity, you know, kind of distributing from there, and have built, really a supply chain platform in a warehouse that supports about $100 million in revenue today. So we started with very much a micro commercialization model, spent very little capital, and so now we're in the phase of a very rapid commercialization, and what we're really focused on today is building that commercial team. We've literally tripled the size of our commercial organization in the last last 12 months alone, really, and so we began to really scale revenue in 21 we've doubled in 2122 and in 23 we expect to about double this year. As I mentioned, we're running along about a $30 million run rate today and enjoying spectacular margins in the range of 80% so that's that's the story. Thanks for your time today. You.