A Look Outside the Top 10: Orthopedic Startups Making a Mark

Orthopedic Design & Technology’s Top 10 issue highlights giants in the industry, providing insight into the successes and pitfalls experienced by the companies in orthopedic technology that bring in the most money. On the opposite end of the spectrum are the emerging companies that are revolutionizing their own fields in numerous small and not-so-small ways. With an aging population and new technology that allows for more customizable, niche products, more people that need specialized medical technology now are able to receive good care to solve unique problems from startups catering to specific needs. For instance, San Francisco, Calif.-based startup Standard Cyborg is making a 3-D printed, customized waterproof leg for amputees that’s reportedly 28 times cheaper than a normal walking prosthetic leg; and Rochester, N.Y.-based Balance Engineering Inc. is commercializing a technology that has already helped football players and college athletes improve their balance after concussive trauma.

Let’s take a look at some of the small companies making big splashes:
Standard Cyborg was founded by engineer Jeff Huber, who also is an amputee. For most of his life, Huber has used a prosthetic leg. He was born with a congenital birth defect that left him without a fully formed fibula. As a growing child, Huber would get a new leg every nine months or so, a familiar and expensive problem for children who need prosthetics. Once he became an adult, insurance only would cover a new leg every three to five years. His current leg costs $23,000; for patients who are above-the-leg amputees, it can cost double. In his own Emeryville, Calif., work space, Huber started tinkering with 3-D printers and various different plastics including ABS and PLA. One of the materials was promising, but wasn’t quite strong enough until he found the perfect blend of traditional techniques to form a plastic covered with carbon fiber.

“The process has this interesting blend of human and machine labor,” he told TechCrunch in February. “What’s interesting is how the machines help us print the legs. But the machines couldn’t design this on their own.”

All of Standard Cyborg’s prosthetics are custom-made; the final lamination process takes two hours and is done by hand. Even with the more labor-intensive portion, Huber’s techniques allow him to sell these prosthetics at just $799 a piece. The company is backed by the seed fund Y Combinator. Huber remains the founder and currently is the sole employee.

Intellirod Spine (formerly OrthoData Inc.), which received its first round of funding in 2008, was founded by spine surgeon Rolando M. Puno, M.D., and professors from the University of Louisville in Kentucky. The company is developing a wireless implantable microelectronic spinal rod strain sensor meant to allow spine surgeons to objectively assess the strain on implanted spinal fusion rods postoperatively. After years of work and funding, the company received $1.9 million last year to accelerate commercialization of the sensor and related lumbar fusion implants. The company has now submitted a 510(k) clearance application to the U.S. Food and Drug Administration for the Loadpro intra-operative sensor for use in achieving rod strain balance during surgery. The system gives the surgeon new information for improving surgical technique and avoiding post-operative adverse hardware related events. The company currently is establishing alpha clinical sites for Loadpro in Louisville, Ky.; and in Cincinnati, Columbus and Cleveland, Ohio. Not only does the technology promise to help surgeons do their job better; it also holds the promise of reducing costs associated with postoperative complications.

Inspired by his daughter who runs a dance studio, serial Rochester, N.Y., entrepreneur Jack Schickler started Balance Engineering in 2009 to create software that can measure human balance. Six years later, the company is now starting a funding round to expand sales of a product that can diagnose and treat people with concussions and other balance issues.

The tool, Equilibrate, has been in development since the company’s founding, and has been used to treat professional football players, orthopedic surgery patients and college athletes. The software tool combines real time objective upper and lower body measures with the judgment and experience of a clinical professional to improve patient outcomes. A patient stands on adjustable, static force plates while wearing a lightweight vest with imaging targets placed at specific anatomical landmarks. Receiving input from the force plates and cameras, Equilibrate senses minute shifts in central body force, positions, directions and frequencies of motion from individual areas of the body and provides quantitative scores of dynamic alignment and sway, as well as the integration of combined effects across the whole body in an overall score for total balance.