Treace Medical Concepts (TMCI) 10-K 8 Mar 23 2022 FY Annual report Financial data

Cover Page

Cover Page - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Feb. 28, 2023	Jun. 30, 2022
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2022
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	FY
Document Annual Report	true
Document Transition Report	false
Entity Registrant Name	TREACE MEDICAL CONCEPTS, INC.
Entity File Number	001-40355
Entity Tax Identification Number	47-1052611
Entity Address, Address Line One	100 Palmetto Park Place
Entity Address, City or Town	Ponte Vedra
Entity Address, Postal Zip Code	32081
City Area Code	904
Local Phone Number	373-5940
Entity Central Index Key	0001630627
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Entity Address, State or Province	FL
Entity Filer Category	Non-accelerated Filer
Entity Shell Company	false
Entity Small Business	true
Entity Emerging Growth Company	true
Entity Ex Transition Period	false
Title of 12(b) Security	Common stock, $0.001 par value
Trading Symbol	TMCI
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		61,156,070
Entity Public Float			$ 526.2
ICFR Auditor Attestation Flag	false
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Portions of the registrant’s definitive proxy statement relating to its 2023 annual meeting of stockholders (the “2023 Proxy Statement”) are incorporated by reference into Part III of this Annual Report on Form 10-K where indicated. The 2023 Proxy Statement will be filed with the U.S. Securities and Exchange Commission within 120 days after the end of the fiscal year to which this Annual Report on Form 10-K relates.
Auditor Firm ID	248
Auditor Name	GRANT THORNTON LLP
Auditor Location	Jacksonville, FL

Balance Sheets

Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Current assets
Cash and cash equivalents	$ 19,473	$ 105,833
Marketable securities, short-term	61,779	0
Accounts receivable, net of allowance for doubtful accounts of $735 and $414 as of December 31, 2022 and 2021, respectively	29,196	18,568
Inventories	19,330	10,561
Prepaid expenses and other current assets	3,624	3,010
Total current assets	133,402	137,972
Property and equipment, net	15,338	2,849
Operating lease right-of-use assets	10,138	0
Other non-current assets	146	0
Total assets	159,024	140,821
Current liabilities
Accounts payable	8,668	4,056
Accrued liabilities	6,216	4,518
Accrued commissions	7,356	5,181
Accrued compensation	7,666	4,455
Operating lease liabilities	339	0
Total current liabilities	30,245	18,210
Derivative liability on term loan	0	173
Long-term debt, net of discount of $1,289 and $635 as of December 31, 2022 and 2021, respectively	52,711	29,365
Operating lease liabilities, net of current portion	15,539	0
Total liabilities	98,495	47,748
Commitments and contingencies (Note 7)
Stockholders’ equity
Preferred stock, value	0	0
Common stock, value	55	45
Additional paid-in capital	145,221	134,933
Accumulated deficit	(84,720)	(41,905)
Accumulated other comprehensive (loss) incom	(27)	0
Total stockholders’ equity	60,529	93,073
Total liabilities and stockholders’ equity	$ 159,024	$ 140,821

Balance Sheets (Parenthetical)

Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Allowance for doubtful accounts receivable current	$ 735	$ 414
Long term debt unamortized debt discount and issuance costs	$ 1,289	$ 635
Preferred stock, par or stated value per share	$ 0.001	$ 0.001
Preferred stock shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par or stated value per share	$ 0.001	$ 0.001
Common stock shares authorized	300,000,000	300,000,000
Common stock share issued	55,628,208	54,181,082
Common stock share outstanding	55,628,208	54,181,082

Statements of Operations and Co

Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Statement [Abstract]
Revenue	$ 141,838	$ 94,419	$ 57,365
Cost of goods sold	27,523	17,826	12,470
Gross profit	114,315	76,593	44,895
Operating expenses
Sales and marketing	102,576	64,467	31,654
Research and development	13,584	10,204	5,847
General and administrative	32,999	18,432	6,539
Total operating expenses	149,159	93,103	44,040
Income (loss) from operations	(34,844)	(16,510)	855
Interest and other income (expense), net	910	18	(1,746)
Interest expense	(4,398)	(4,060)	(2,777)
Debt extinguishment loss	(4,483)	0	0
Other expense, net	(7,971)	(4,042)	(4,523)
Net loss	(42,815)	(20,552)	(3,668)
Convertible preferred stock cumulative and undeclared dividends	0	(196)	(640)
Net loss attributable to common stockholders	(42,815)	(20,748)	(4,308)
Other comprehensive income (loss):
Unrealized losses on marketable securities	(27)	0	0
Comprehensive loss	$ (42,842)	$ (20,748)	$ (4,308)
Net loss per share attributable to common stockholders, basic	$ (0.77)	$ (0.43)	$ (0.12)
Net loss per share attributable to common stockholders, diluted	$ (0.77)	$ (0.43)	$ (0.12)
Weighted-average shares used in computing net loss per share attributable to common stockholders, basic	55,276,834	48,415,679	37,068,965
Weighted-average shares used in computing net loss per share attributable to common stockholders, diluted	55,276,834	48,415,679	37,068,965

Statements of Stockholders' Equ

Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Convertible preferred stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Loss [Member]
Balance at Beginning at Dec. 31, 2019	$ 3,161	$ 7,935	$ 28	$ 12,883	$ (17,685)
Balance at Beginning (in Shares) at Dec. 31, 2019		6,687,475	37,031,840
Common stock issued upon exercise of stock options	364			364
Common stock issued upon exercise of stock options, shares			335,025
Share-based compensation expense	919			919
Net loss	(3,668)				(3,668)
Balance at Ending at Dec. 31, 2020	776	$ 7,935	$ 28	14,166	(21,353)	$ 0
Balance at Ending (in Shares) at Dec. 31, 2020		6,687,475	37,366,865
Common stock issued upon exercise of stock options	1,830		$ 2	1,828
Common stock issued upon exercise of stock options, shares			2,368,705
Issuance of restricted stock awards, shares			24,895
Share-based compensation expense	3,409			3,409
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount of $10.6 million	107,610		$ 7	107,603
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount of $10.6 million, shares			6,953,125
Issuance of common stock upon net exercise of warrants			$ 1	(1)
Issuance of common stock upon net exercise of warrants, shares			621,570
Conversion of convertible preferred stock and accrued dividends on convertible preferred stock into common stock		$ (7,935)	$ 7	7,928
Conversion of convertible preferred stock and accrued dividends on convertible preferred stock into common stock, shares		(6,687,475)	6,845,922
Net loss	(20,552)				(20,552)
Balance at Ending at Dec. 31, 2021	93,073	$ 0	$ 45	134,933	(41,905)	0
Balance at Ending (in Shares) at Dec. 31, 2021		0	54,181,082
Common stock issued upon exercise of stock options	$ 2,187		$ 10	2,177
Common stock issued upon exercise of stock options, shares	1,444,626		1,444,626
Common stock issued for vesting of stock units			2,500
Share-based compensation expense	$ 8,111			8,111
Net loss	(42,815)				(42,815)
Unrealized loss on available-for-sale marketable securities	(27)					(27)
Balance at Ending at Dec. 31, 2022	$ 60,529	$ 0	$ 55	$ 145,221	$ (84,720)	$ (27)
Balance at Ending (in Shares) at Dec. 31, 2022		0	55,628,208

Statements of Stockholders' E_2

Statements of Stockholders' Equity (Parenthetical) $ in Millions	12 Months Ended
	Dec. 31, 2021 USD ($)
Statement of Stockholders' Equity [Abstract]
Issuance cost and underwriting discount	$ 10.6

Statements of Cash Flows

Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash flows from operating activities
Net loss	$ (42,815)	$ (20,552)	$ (3,668)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization expense	2,133	685	1,210
Provision for allowance for doubtful accounts	411	144	216
Share-based compensation expense	8,111	3,409	919
Non-cash lease expense	2,522	0	0
Amortization of debt issuance costs	244	176	220
Impairment of capitalized surgical instruments	0	0	144
Gain on fair value adjustment to derivative liability	(173)	(72)	0
Debt extinguishment loss	4,483	0	639
Loss on impairment of long-lived assets	346	0	0
Accretion (amortization) of discount (premium) on marketable securities, net	(126)	0	0
Other, net	25	0	0
Net changes in operating assets and liabilities:
Accounts Receivable	(11,039)	(4,226)	(4,290)
Inventory	(8,769)	(2,741)	(2,258)
Prepaid expenses and other assets	(668)	(2,417)	(103)
Other non-current assets	(146)	0	0
Operating lease liabilities	3,076	0	0
Accounts payable	4,612	1,791	1,334
Accrued liabilities	7,125	6,610	1,143
Net cash used in operating activities	(30,648)	(17,193)	(4,494)
Cash flows from investing activities
Purchases of available-for-sale marketable securities	(63,409)	0	0
Maturities of available-for-sale marketable securities	1,729	0	0
Purchases of property and equipment	(14,838)	(2,705)	(1,069)
Net cash used in investing activities	(76,518)	(2,705)	(1,069)
Cash flows from financing activities
Proceeds from interest bearing debt	49,651	0	29,530
Proceeds from interest bearing revolving debt	3,850	0	0
Payments on interest bearing debt	(33,893)	0	(20,000)
Proceeds from PPP Loan	0	0	1,788
Payments on PPP Loan	0	(1,788)	0
Proceeds from issuance of common stock upon initial public offering, net of issuance costs and underwriting fees of $10.6 million	0	107,610	0
Debt issuance costs	(989)	0	(179)
Proceeds from exercise of employee stock options	2,187	1,830	364
Net cash provided by financing activities	20,806	107,652	11,503
Net increase (decrease) in cash and cash equivalents	(86,360)	87,754	5,940
Cash and cash equivalents at beginning of period	105,833	18,079	12,139
Cash and cash equivalents at end of period	19,473	105,833	18,079
Supplemental disclosure of cash flow information:
Cash paid for interest	4,398	3,900	1,146
Operating lease right-of-use assets obtained in exchange for new lease liabilities	15,300	0	0
Operating lease right-of-use asset and lease liability adjustment due to lease incentive	3,615	0	0
Unrealized losses on marketable securities	27	0	0
Noncash financing activities:
Issuance of common stock upon exercise of warrants	0	1	0
Conversion of convertible preferred stock and accrued dividends on convertible preferred stock into common stock	0	7,935	0
Initial fair value of derivative liability	$ 0	$ 0	$ 245

Statements of Cash Flows (Paren

Statements of Cash Flows (Parenthetical) $ in Millions	12 Months Ended
	Dec. 31, 2022 USD ($)
Statement of Cash Flows [Abstract]
Issuance costs and underwriting fees, net	$ 10.6

Formation and Business of the C

Formation and Business of the Company	12 Months Ended
	Dec. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Formation and Business of the Company	1. Formation and Business of the Company The Company Treace Medical Concepts, LLC was formed on July 29, 2013 , as a Florida limited liability company. Effective July 1, 2014, the entity converted to a Delaware corporation and changed its name to Treace Medical Concepts, Inc. (the "Company"). The Company is a medical technology company with the goal of advancing the standard of care for the surgical management of bunion and related midfoot deformities. The Company received 510(k) clearance for the Lapiplasty System in March 2015 and began selling its surgical medical devices in September 2015. The Company has pioneered the proprietary Lapiplasty 3D Bunion Correction System – a combination of instruments, implants and surgical methods designed to surgically correct all three planes of the bunion deformity and secure the unstable joint, addressing the root cause of the bunion. In addition, the Company offers other advanced instrumentation and implants for use in the Lapiplasty Procedure or other ancillary procedures performed in high frequency with bunion surgery. In 2021, the Company expanded its offerings with the Adductoplasty™ Midfoot Correction System, designed for reproducible correction of the midfoot to provide further support to hallux valgus patients. The Company operates from its corporate headquarters located in Ponte Vedra, Florida. Initial Public Offering On April 27, 2021, the Company completed its initial public offering ("IPO") of 12,937,500 shares of its common stock, which included the exercise in full of the underwriters’ option to purchase additional shares. As part of the IPO, 6,953,125 shares of common stock were issued and sold by the Company (inclusive of 703,125 shares pursuant to the exercise of the underwriters’ option) and 5,984,375 shares of common stock that were sold by the selling stockholders named in the prospectus (inclusive of 984,375 shares pursuant to the exercise of the underwriters’ option), at a price to the public of $ 17.00 per share. The Company received net proceeds of approximately $ 107.6 million, after deducting underwriting discounts and commissions of $ 8.3 million and offering expenses payable by the Company of $ 2.3 million. The Company did no t receive any proceeds from the sale of the shares by the selling stockholders. Upon the completion of the IPO, all 6,687,475 shares of Series A convertible preferred stock then outstanding were converted into shares of common stock on a one-to-one basis plus 158,447 shares of common stock were issued to pay accrued cumulative dividends on Series A convertible preferred stock of $ 2.5 million. Forward Stock Split On April 16, 2021, in connection with the IPO, the Company filed an Amended and Restated Certificate of Incorporation with the Delaware Secretary of State to implement a 1.3375 -for-1 forward stock split (the "Forward Stock Split"), effective on April 16, 2021, whereby each 1.0 share of Class A common stock issued and outstanding was reclassified as 1.3375 shares of Class A common stock and each 1.0 share of Series A convertible preferred stock (each a "Preferred Share") issued and outstanding was reclassified as 1.3375 Preferred Shares. In connection with the Forward Stock Split, the total number of shares of all classes of stock which the Company is authorized to issue was adjusted to 73,562,500 , divided into 66,875,000 shares of Class A common stock and 6,687,500 Preferred Shares. There was no adjustment to the par value of $ 0.001 per share. All share and per share amounts in the accompanying financial statements for the prior periods have been retroactively adjusted to reflect the Forward Stock Split. In lieu of issuing fractional shares in connection with the Forward Stock Split, the Company paid cash in an amount equal to the fair value of such fractional shares (as determined in good faith by the Company’s board of directors). Liquidity and Capital Resources The Company has incurred operating losses to date and has an accumulated deficit of $ 84.7 million as of December 31, 2022. During the years ended December 31, 2022, 2021 and 2020, the Company used $ 30.6 million, $ 17.2 million and $ 4.5 million of cash in its operating activities, respectively. As of December 31, 2022, the Company had cash and cash equivalents of $ 19.5 million and marketable securities available for sale of $ 61.8 million. Management believes that the Company’s existing cash, cash equivalents, and marketable securities will allow the Company to continue its planned operations for at least the next 12 months from the date of the issuance of these financial statements. Coronavirus Pandemic The coronavirus (COVID-19) pandemic has had, and we expect that it will continue to have intermittent impacts on our business, operations, and financial results and condition. Among other impacts, COVID-19 and its variants have slowed our revenue growth by decreasing or delaying elective procedures, such as the Lapiplasty Procedure, during various phases of the pandemic, including in particular from March through May 2020 when governmental “shelter in place” orders restricted elective procedures and in the second half of 2021 when COVID-19 variants affected patient demand for elective procedures and limited hospital staffing and capacity. While it is difficult to determine with certainty, we believe that COVID-19 did not have a significant impact on our 2022 operations and financial results. However, there is still uncertainty around the potential impacts related to COVID-19 especially if potentially more contagious and virulent variants of the virus emerge. If states implement shelter-in-place rules again, medical facilities implement restrictions on elective surgeries as a result of COVID-19 surges, or other pandemic disruptions occur, we may be required to adjust our operations as well as our forecasted revenues and operating results. We cannot assure you that we will not experience additional negative impacts associated with COVID-19 in the future, which could be significant.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Basis of Presentation The accompanying financial statements are prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). Certain prior year amounts have been reclassified for consistency with the current year presentation. These reclassifications had no effect on the reported results of operations. An adjustment has been made to the Statements of Cash Flow for the fiscal years ended December 31, 2021 and December 31, 2020, for $ 0.3 million and $ 1.1 million, respectively, to reclassify non cash expense for inventory obsolescence to net changes in operating assets for inventory. This classification change does not change previously reported cash flows from operating activities in the Statements of Cash Flows. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the periods presented. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, actual results may ultimately materially differ from these estimates and assumptions. Significant estimates and assumptions include reserves and write-downs related to accounts receivable, inventories, the recoverability of long-term assets, valuation of equity instruments, valuation of common stock, stock-based compensation, deferred tax assets and related valuation allowances and impact of contingencies. The Company had no accrued contingent liabilities as of December 31, 2022 and 2021 . Segments The Company operates and manages its business as one reportable and operating segment, which is the business of designing, manufacturing, and marketing medical devices for physicians, surgeons, ambulatory surgery centers and hospitals. The Company’s chief executive officer, who is the chief operating decision maker, reviews financial information on an aggregate basis for purposes of allocating and evaluating financial performance. All long-lived assets are maintained in the United States. Cash and Cash Equivalents The Company considers all highly liquid investments with an original or remaining maturity at the time of purchase of 90 days or less to be cash equivalents. All of the Company's cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits, the balances of which at times may exceed federally insured limits. Marketable Securities The Company considers its debt securities and Yankee certificate of deposits ("Yankee CDs") to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term marketable securities. The Company's marketable securities are classified as current assets based on their availability for sale to meet current operating requirements. Available-for-sale securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in fair value judged to be other-than-temporary are included in the Company’s statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s consolidated statements of operations and comprehensive loss for the years ended December 31, 2022, 2021, or 2020. Accounts Receivable and Allowances Accounts receivable are generally from hospitals and ambulatory surgery centers and are stated at amounts billed less allowances for doubtful accounts. The Company continually monitors customer payments and maintains an allowance for losses resulting from a customer’s inability to make required payments. The Company considers factors such as historical experience, credit quality, age of the accounts receivable balances, geographic related risks and economic conditions that may affect a customer’s ability to pay. Accounts receivable are written off when individual balances are no longer collectible. As of December 31, 2022 and 2021, accounts receivable are presented net of an allowance for doubtful accounts of $ 0.7 mi llion and $ 0.4 million, respectively. For the years ended December 31, 2022, 2021 and 2020, the Company recorded provisions for bad debts of $ 0.4 million , $ 0.1 million and $ 0.2 mill ion, respectively. Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents, marketable securities, and accounts receivable. The Company maintains its cash with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation ("FDIC") insured limits. The Company's available for sale securities portfolio primarily consists of U.S. treasury and agency securities, money market funds, commercial paper, Yankee CDs, high credit quality asset-backed securities and corporate debt securities. The Company's investment policy requires its available for sale securities to meet certain criteria including investment type, credit ratings, and a maximum portfolio duration of one year. The Company earns revenue from the sale of its products to customers such as hospitals and ambulatory surgery centers. The Company’s accounts receivable is derived from revenue earned from customers. The Company performs ongoing credit evaluations of its customers’ financial condition and generally requires no collateral from its customers and independent sales agencies. At December 31, 2022 and 2021 , no customer accounted for more than 10 % of accounts receivable. For the years ended December 31, 2022, 2021 and 2020 , there were no customers that represented 10 % or more of revenue. Leases The Company determines whether an arrangement is or contains a lease at the inception of the arrangement and whether such a lease is classified as a financing lease or an operating lease at the commencement date of the lease. Lease liabilities and their corresponding right-of-use assets are recorded based on the present value of lease payments over the expected lease term. The Company determines the commencement date of a lease to be the date on which a lessor makes an underlying asset available for use by the Company. Leases with a term greater than one year are recognized on the balance sheet as operating lease right-of-use assets, operating lease liabilities and operating lease liabilities, net of current portion. The Company elected not to recognize right-of-use assets and lease liabilities for leases with terms of 12 months or less (short-term leases). As the interest rates implicit in our lease contracts are not readily determinable, the Company utilizes its incremental borrowing rate based on the information available at the commencement date to determine the present value of lease payments. Certain adjustments to the right-of-use asset may be required for items such as initial direct costs paid, incentives received, or impairment charges if the Company determines the right-of-use asset is impaired. In the fourth quarter of 2022, the Company recorded an impairment to the right-of-use asset associated with the lease on its previous corporate headquarters. See Note 5 for further details of the impairment. The Company considers the lease term to be the noncancelable period that the Company has the right to use the underlying asset, together with any periods where it is reasonably certain the Company will exercise an option to extend (or not terminate) the lease. Rent expense for operating leases is recognized on a straight-line basis over the lease term and is presented in operating expenses on the statements of operations and comprehensive loss. The Company has elected to not separate lease and non-lease components for its real estate leases and instead accounts for each separate lease component and the non-lease components associated with that lease component as a single lease component. Variable lease payments are recognized as lease expense as incurred and are recorded in operating expenses on the statements of operations and comprehensive loss. The Company has no finance leases. Inventories Inventories consist primarily of surgical kits and components as finished goods and are stated at the lower of cost or net realizable value. Cost is determined based on an average cost method which approximates the first-in, first-out basis and includes primarily outsourced manufacturing costs and direct manufacturing overhead costs. The Company reviews inventory for obsolescence and writes down inventory, as necessary. For the years ended December 31, 2022, 2021 and 2020 , the Company recorded a provision to cost of goods sold of $ 0.1 million , $ 0.3 million and $ 1.1 mil lion, respectively, for obsolete inventory. Property and Equipment, Net Property and equipment are recorded at cost. Depreciation of property and equipment is recorded using the straight-line method over the following estimated useful lives as follows: Years Furniture, fixtures and equipment 7 Machinery and equipment 3 Capitalized surgical instruments 3 Computer equipment 3 Leasehold improvements Lesser of estimated useful life or lease term Software 3 Long-lived assets are evaluated whenever a change in circumstances indicates that the carrying amount of an asset may not be recoverable. If assets are considered to be impaired, a charge is recorded for an amount that the carrying value exceeds the fair value. Beginning January 1, 2021, the Company adjusted the useful life of its capitalized instruments from 18 months to 36 months to align with the expected life of the instruments. The change in useful life was made as a prospective adjustment and resulted in a decrease of depreciation expense o f $ 0.3 mil lion during the year ended December 31, 2021 and no material impact on earnings per share. The change in useful life is not expected to significantly impact annual depreciation expense. Revenue Recognition The Company generates revenue through the sale of its primary product, the Lapiplasty System, the Adductoplasty and Lapiplasty Mini-Incision Systems and ancillary products. The Lapiplasty and Adductoplasty Systems are comprised of single-use implant kits and reusable instrument trays. Implant kits and ancillary products are sold in the United States through a combination of a direct employee sales force and independent sales agencies. The Company invoices hospitals and ambulatory surgery centers for the implant kits and ancillary products and pays commissions to the sales representatives and independent sales agencies. The Company has no international sales. For shipments to customers, the Company offers the right to return the product within 30 days for a full refund, and for returns between 30 and 90 days, the Company offers a full refund less 15% restocking fee. The Company does not have a history of product returns for refund. Customer invoices are generally payable within 30 days. The Company’s products are generally sold with a limited standard warranty to the original purchaser of the products against defects in workmanship and materials for 180 days. The Company’s liability is limited to providing, at the Company’s option, a full refund or credit of the purchase price, or repairing or replacing the product, provided that the customer returns the defective product within 180 days from the purchase date. To date, the Company has had negligible returns of any products alleged to be defective. On January 1, 2019 , the Company adopted ASC 606, Revenue from Contracts with Customers , using the modified retrospective method for all contracts not completed as of the date of adoption. In connection with the adoption of ASC 606, the Company also adopted the related amendments that impact the accounting for the incremental costs of obtaining a contract. Adoption of ASC 606 did not have any impact on the financial statements, except changes in the disclosures. Under ASC 606, revenue is recognized when the customer obtains control of promised goods or services, in an amount that reflects consideration which the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606, the Company performs the following five steps as prescribed by ASC 606: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies performance obligations. A contract with a customer exists when (i) the Company enters into a legally enforceable contract with a customer that defines each party’s rights regarding the products to be transferred and identifies the payment terms related to these products, (ii) the contract has commercial substance, and (iii) the Company determines that collection of substantially all consideration for its products that are transferred is probable based on the customer’s intent and ability to pay the promised consideration. The Company considers signed agreements and purchase orders as a customer’s contract. The Company identifies performance obligations based on the terms of the contract and customary business practices, which include products that are distinct, or a series of distinct goods that are substantially the same and that have the same pattern of transfer to the customer. The Company’s Lapiplasty System products are distinct performance obligations. The Company does not have any contracts with customers that contain multiple performance obligations. The transaction price in the Company’s customer contracts includes fixed consideration to be contractually billed to the customer while variable consideration includes the right of return. The Company does not allocate the transaction price or any variable consideration to the right of return. The Company did no t recognize a refund liability as of December 31, 2022 and 2021 and there were negligible returns during the year ended December 31, 2022 and no product returns during the years ended December 31, 2021 and 2020. Revenue for products is recognized when a customer obtains control of the promised products, which is generally when the customer has the ability to (i) direct its use and (ii) obtain substantially all of the remaining benefits from it. Revenue recognition occurs when control of the product transfers to the customer which is generally at the time the product is used in surgery. When a customer purchases products directly from us before the time of surgery, revenue is recognized based upon the shipment terms. Contract Costs The Company applies the practical expedient to recognize the incremental costs of obtaining a contract as expense when incurred if the amortization period would be one year or less. These incremental costs include sales commissions paid to the Company’s independent sales agencies or employee sales representatives. Cost of Goods Sold Cost of goods sold consists primarily of costs for the purchase of the Company’s Lapiplasty and Adductoplasty Systems as well as ancillary products from third-party manufacturers. Direct costs from the Company’s third-party manufacturers include costs for raw materials plus the markup for the assembly of the components. Cost of goods sold also includes royalties, allocated overhead for indirect labor, depreciation, certain direct costs such as those incurred for shipping our products and personnel costs. The Company expenses all inventory provisions for excess and obsolete inventories as cost of goods sold. The Company records adjustments to its inventory valuation for estimated excess, obsolete and non-sellable inventories based on assumptions about future demand, past usage, changes to manufacturing processes and overall market conditions. Research and Development Expenses Research and development ("R&D") expenses consist primarily of engineering, product development, clinical studies to develop and support the Company’s products, regulatory expenses, and other costs associated with products and technologies that are in development. These expenses include compensation for personnel, including salaries, bonuses, benefits and stock-based compensation, supplies, consulting, prototyping, testing, materials, travel expenses, depreciation and an allocation of facility overhead expenses. For the fiscal years ended December 31, 2022, 2021 and 2020, the Company's research and development costs wer e $ 13.6 million, $ 10.2 million, and $ 5.8 million, respectively. Shipping and Handling The Company has elected to account for shipping and handling activities as fulfillment activities. As such, the Company does not evaluate shipping and handling as promised services to its customers. The Company may bill customers for shipping and handling costs. Amounts billed for shipping and handling are included in revenue. Shipping and handling costs incurred by the Company are included in sales and marketing expense. Shipping and handling costs totaled $ 0.8 million, $ 0.5 million, and $ 0.3 million, for the years ended 2022, 2021, and 2020, respectively. Advertising Costs Advertising costs are expensed as incurred and are included as a component of marketing and sales expenses. Advertising expense includes the cost of advertising across the various mediums we employ, including print, digital, radio and television. Advertising costs totaled approximately $ 15.0 million, $ 13.0 million and $ 3.1 million, for the years ended 2022, 2021 and 2020 , respectively. Income Taxes The Company accounts for income taxes under the liability method, whereby deferred tax assets and liabilities are determined based on the difference between the financial statements and tax bases of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to affect taxable income. A valuation allowance is established when necessary to reduce deferred tax assets when management estimates, based on available objective evidence, that it is more likely than not that the benefit will not be realized for the deferred tax assets. The Company also follows the provisions of ASC 740-10, Accounting for Uncertainty in Income Taxes . ASC 740-10, which prescribes a comprehensive model for the recognition, measurement, presentation and disclosure in financial statements of any uncertain tax positions that have been taken or expected to be taken on a tax return. No liability related to uncertain tax positions is recorded in the financial statements. It is the Company’s policy to include penalties and interest expense related to income taxes as part of the provision for income taxes. Product Liability The Company believes it carries adequate insurance for possible product liability claims. Accruals for product liability claims and legal defense costs in excess of insured amounts are recorded if it is probable that a liability has been incurred and the amount of any liability can be reasonably estimated. No accruals for product liability claims had been recorded as of December 31, 2022 and 2021. Debt Debt issuance costs and discount are amortized to interest expense u sing the effective interest method. Stock-Based Compensation The Company accounts for stock-based compensation arrangements with employees in accordance with ASC 718, Compensation—Stock Compensation, using a fair-value based method. The Company determines the fair value of stock options on the date of grant using the Black-Scholes option pricing model. The fair value for RSAs and RSUs awards is the fair value of the stock at the grant date. The fair value of time-based awards is recognized over the period during which an award holder is required to provide services in exchange for the award, known as the requisite service period, which is typically the vesting period using the straight-line method. The Company accrues for estimated forfeitures on share-based awards and adjusts stock-based compensation cost to actual as forfeitures occur. The estimated forfeitures are based on a historical analysis of actual forfeitures of awards. The Company estimates the fair value of the stock-based awards using the Black-Scholes option-pricing model, which requires the input of highly subjective assumptions. The assumptions are as follows: • Expected Term . The expected term represents the period that the stock options are expected to remain outstanding. Prior to the closing of the IPO, the Company was using the probabilities of the anticipated timing of potential liquidity events to determine the expected term. After the closing of the IPO, the Company is using the "simplified" method, which is the simple average of the vesting period and the contractual term. • Expected Volatility . The expected volatility is derived from the historical stock volatilities of comparable publicly listed peers over a period approximately equal to the expected term of the options as the Company does not have sufficient trading history to determine the volatility of its common stock. • Risk-Free Interest Rate . The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the date of grant for zero-coupon U.S. Treasury notes with maturities approximately equal to the stock-based awards’ expected term. • Expected Dividend Yield . The expected dividend yield is zero as the Company has not paid nor anticipates paying any dividends on the common stock in the foreseeable future. • Fair Market Value of Common Stock. Prior to the IPO, the fair market value of the common stock was determined by the board of directors with assistance from management and external valuation experts. The Company’s approach to estimating the fair market value of its common stock was consistent with the methods outlined in the American Institute of Certified Public Accountants’ Practice Aid, Valuation of Privately-Held-Company Equity Securities Issued as Compensation . Following our IPO, the fair market value of the common stock is based on its closing price on NASDAQ as reported on the date of grant. The Company continues to use judgment in evaluating the expected volatility and expected terms utilized for the stock-based compensation calculations on a prospective basis. As the Company continues to accumulate additional data, the Company may make refinements to the assumptions, which could materially impact the future stock-based compensation expense. Comprehensive Loss The Company is required to report all components of comprehensive loss, including net loss, in the financial statements in the period in which they are recognized. Comprehensive loss is defined as a change in equity of a business enterprise during a period, resulting from transactions and other events and circumstances from non-owner sources. Comprehensive loss equaled $ 42.8 million for the year end December 31, 2022. Comprehensive loss equaled net loss for the years ended December 31, 2021 and 2020 . Net Loss Per Share Attributable to Common Stockholders Basic net loss per share attributable to common stockholders is calculated by dividing the net loss attributable to common stockholders, by the weighted-average number of common shares outstanding during the period, without consideration for potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss by the weighted-average number of common shares and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, common stock options, unvested restricted stock units and restricted stock awards are considered to be potentially dilutive securities. Because the Company has reported a net loss for the years ended December 31, 2022, 2021 and 2020 , diluted net losses per common share were the same as basic net losses per common share for these periods. Derivative Liability The Company evaluates its financial instruments for embedded features and bifurcates embedded features from the host instrument that meet the definition of a derivative and if (i) the economic characteristics and risks of the embedded feature are not clearly and closely related to the host instrument, (ii) the hybrid instrument that embodies both the embedded feature and the host contract is not remeasured at fair value under otherwise applicable generally accepted accounting principles with changes in fair value reported in earnings as they occur and (iii) a separate instrument with the same terms as the embedded feature would be considered a derivative instrument subject to the accounting requirements of derivative instruments. The Company uses judgment in determining the fair value of embedded features that are bifurcated from the host instrument and accounted for as derivative instruments at the date of issuance and at every balance sheet date thereafter. The valuation method used in the determination of fair value is based on the type of derivative instrument. At each balance sheet date, the Company remeasures its derivative instruments at fair value with adjustments to fair value recognized within other expense, net.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	12 Months Ended
	Dec. 31, 2022
Accounting Standards Update and Change in Accounting Principle [Abstract]
Recent Accounting Pronouncements	3. Recent Accounting Pronouncements Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) ("ASC 842"). The update establishes principles for recognition, measurement, presentation, and disclosure intended to increase transparency and comparability for the accounting of lease transactions. The standard requires lessees to recognize leases with terms greater than 12 months on the balance sheet and disclose key information about leasing arrangements. ASC 842 is effective for the Company for fiscal years beginning after December 15, 2021 and early application is permitted. The Company adopted the new standard as of January 1, 2022, using the required modified retrospective approach. Comparative periods were not adjusted and continue to be presented under the previous accounting guidance. The Company elected the package of practical expedients permitted under the ASC 842 transition guidance, which among other things, allowed it to carry forward the historical lease classification. The impact of adoption was the recognition of right-of-use assets and lease liabilities of $ 1.9 million for real estate operating leases at January 1, 2022. In addition, ASC 842 requires new disclosures for lease transactions. Refer to Note 8, "Operating Leases", for new lease disclosures. Recent Accounting Pronouncements Not Yet Adopted In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses . This new guidance will require financial instruments to be measured at amortized cost, and trade accounts receivable to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments. In November 2019, the FASB issued ASU 2019-10, that is effective for fiscal years beginning after December 15, 2022, and interim periods within that fiscal year. The Company adopted the standard on January 1, 2023. The adoption of this guidance did not have a material impact on the Company's financial statements.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	4. Fair Value Measurements Assets and liabilities recorded at fair value in the financial statements are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Hierarchical levels which are directly related to the amount of subjectivity associated with the inputs to the valuation of these assets or liabilities are as follows: Level 1—Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date. Level 2—Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities. Level 3—Unobservable inputs for the asset or liability only used when there is little, if any, market activity for the asset or liability at the measurement date. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis – The following assets and liabilities are measured at fair value on a recurring basis as of December 31, 2022 and December 31, 2021: December 31, 2022 Level 1 Level 2 Level 3 Total Assets: Cash and cash equivalents Money market funds $ 13,141 $ — $ — $ 13,141 Commercial paper — 323 — 323 Corporate debt — 2,197 — 2,197 Yankee CD — 550 — 550 Short-term marketable securities at fair value U.S. treasury and government agencies 12,873 3,570 — 16,443 Corporate debt — 23,372 — 23,372 Asset-backed securities — 13,896 — 13,896 Yankee CD — 8,068 — 8,068 Total $ 26,014 $ 51,976 $ — $ 77,990 December 31, 2021 Level 1 Level 2 Level 3 Total Assets: Money market funds $ 105,220 $ — $ — $ 105,220 Total $ 105,220 $ — $ — $ 105,220 Liabilities: Derivative liability $ — $ — $ 173 $ 173 Total $ — $ — $ 173 $ 173 The carrying amounts of the Company’s money market funds classified as cash and cash equivalents, accounts receivable, accounts payable, and accrued liabilities, approximate their fair value due to the short-term nature of these assets and liabilities. The derivative liability is carried at fair value based on unobservable market inputs. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates their fair value. The Company's available for sale securities portfolio consists of investments in U.S. treasury and government agency securities, commercial paper, corporate debt securities, asset-backed securities, and Yankee CDs. Yankee CDs are certificates of deposit issued in the United States by a branch of a foreign bank and are denominated in U.S. dollars. The fair value of level 1 securities is determined on trade prices in active markets for identical assets. The fair value of level 2 securities is determined using valuation models using inputs that are observable either directly or indirectly, such as quoted prices for similar assets, interest rates, yield curves, credit spreads, default rates, loss severity, broker and dealer quotes, as well as other relevant economic measures. As discussed in Note 6, in July 2020, the Company entered into a term loan facility with CR Group LP ("CRG") and accounted for embedded features in the agreement as a derivative liability with an initial fair value of $ 0.2 million that was a level 3 valuation. The derivative liability was accounted for at fair value using the income approach and inputs consisting of (i) the probability of events occurring that trigger an event of default of the Company’s term loans under the CRG term loan facility, ranging from 1 % to 2 %, (ii) the prepayment premium payable upon early redemption, and (iii) additional interest payable upon an event of defau lt. The change in fair value of the derivative liability was $ 0.2 million and $ 0.1 million in the years ended December 31, 2022 and 2021, respectively, and was recorded as a component of other expense, net in the statements of operations and comprehensive loss. Th ere was no adjustment to the fair value of the derivative liability recognized in net loss for the year ended December 31, 2020. The following table sets forth a summary of the changes in the fair value of the Company’s Level 3 financial instruments (in thousands): Derivative liability Fair value as of January 1, 2021 $ 245 Change in fair value included in other expense, net ( 72 ) Fair value as of December 31, 2021 173 Change in fair value included in other expense, net ( 173 ) Fair value as of December 31, 2022 $ — There were no assets or liabilities measured at fair value on a nonrecurring basis as of December 31, 2022 and December 31, 2021 .

Balance Sheet Components

Balance Sheet Components	12 Months Ended
	Dec. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Components	5. Balance Sheet Components Cash and Cash Equivalents The Company’s cash and cash equivalents consisted of the following (in thousands): December 31, 2022 2021 Cash $ 3,262 $ 613 Cash equivalents: Money market funds 13,141 105,220 Commercial paper 323 — Corporate debt 2,197 — Yankee CD 550 — Total cash and cash equivalents $ 19,473 $ 105,833 Included in cash as of December 31, 2022 is $ 0.9 million pledged to Silicon Valley Bank (“SVB”) as collateral for the Company's corporate credit card program and is restricted from use by the Company. There was no cash pledged to SVB as of December 31, 2021. Marketable Securities The Company’s available-for-sale marketable securities consisted of the following (in thousands): December 31, 2022 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 16,472 $ 11 $ ( 40 ) $ 16,443 Corporate debt 23,376 31 ( 35 ) 23,372 Asset-backed securities 13,892 27 ( 23 ) 13,896 Yankee CD 8,066 10 ( 8 ) 8,068 Total marketable securities - short-term $ 61,806 $ 79 $ ( 106 ) $ 61,779 Property and Equipment, Net The company’s property and equipment, net consisted of the following (in thousands): December 31, 2022 2021 Furniture and fixtures, and equipment $ 1,577 $ 180 Construction in progress 705 126 Machinery and equipment 928 274 Capitalized surgical equipment 9,248 4,442 Computer equipment 571 160 Leasehold improvements 6,434 268 Software 138 138 Total property and equipment 19,601 5,588 Less: accumulated depreciation and amortization ( 4,263 ) ( 2,739 ) Property and equipment, net $ 15,338 $ 2,849 Depreciation and amortization expense was $ 2.1 million, $ 0.7 million and $ 1.2 million for the years ended December 31, 2022, 2021 and 2020, respectively. In the fourth quarter of 2022, the Company recognized a $ 0.3 million impairment on a group of assets consisting of $ 0.2 million of property and equipment and $ 0.1 million related to the right-of-use asset associated with the lease of its previous corporate headquarters. The impairment loss is presented as a component of interest and other income, net in the statements of operations and comprehensive loss. The Company did no t record impairment charges for its property and equipment, net for the years ended December 31, 2021 and 2020. Accrued Liabilities Accrued liabilities consist of the following (in thousands): December 31, 2022 2021 Accrued royalties expense $ 2,299 $ 1,522 Accrued interest 412 975 Accrued professional services 1,727 941 Other accrued expense 1,778 1,080 Total accrued liabilities $ 6,216 $ 4,518

Long Term Debt

Long Term Debt	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Long Term Debt	6. Long Term Debt The Company’s debt consisted of the following (in thousands): December 31, 2022 2021 Revolving line of credit MidCap revolving loan facility $ 4,000 $ — Term loans CRG term loan facility — 30,000 MidCap term loan facility 50,000 — Total term and revolving loans 54,000 30,000 Less: debt discount and issuance costs ( 1,289 ) ( 635 ) Total long-term debt, net $ 52,711 $ 29,365 As of December 31, 2022, future payments of long-term debt were as follows (in thousands): Fiscal Year 2023 $ — 2024 — 2025 — 2026 33,333 2027 20,667 Total principal payments 54,000 Less: Unamortized debt discount and debt issuance costs ( 1,289 ) Total long-term debt, net $ 52,711 MidCap Loan and Revolving Loan Facility On April 29, 2022, the Company entered into a new five-year $ 150.0 million loan facility with entities affiliated with MidCap Financial Trust ("MidCap"), providing up to $ 120.0 million in term loans and a $ 30.0 million revolving loan facility. The term loan facility provides for a 60-month term loan up to $ 120.0 million in borrowing capacity to the Company, over four tranches. At term loan closing, the Company drew $ 50.0 million under tranche one. The remaining tranches provide up to an additional $ 70.0 million in borrowing capacity in the aggregate, subject to the achievement of certain revenue targets for the third and fourth tranche. The revolving loan facility provides up to $ 30.0 million in borrowing capacity to the Company based on the borrowing base. The borrowing base is calculated based on certain accounts receivable and inventory assets. As of December 31, 2022, the borrowing base allows a total of $ 24.5 million available to the Company under the revolving loan facility. The balance drawn as of December 31, 2022 is $ 4.0 million under the revolving loan facility. The Company may request an increase in the revolving loan facility in an amount up to $ 20.0 million for a total commitment of up to $ 50.0 million. The Company is required to either (i) maintain a minimum drawn balance under the revolving loan facility or (ii) pay a minimum balance fee that is equal to the amount of the minimum balance deficit multiplied by the applicable interest rate during the period. If the outstanding balance under the revolving loan facility exceeds the lesser of (i) 50 % of the revolving borrowing capacity or (ii) 50 % of the borrowing base, or the Company is in default, MidCap will apply funds collected from the Company's lockbox account to reduce the outstanding balance of the revolving loan facility (“Lockbox Deductions”). As of December 31, 2022, the Company's borrowing level has not activated the Lockbox Deductions, nor is it expected to for the next 12 months; therefore, the Company has determined that the revolving loan balance is long-term debt. The loans bear interest at an annual rate based on a 30-day forward looking secured overnight financing rate plus 0.10 % (subject to a floor of 1.0 % and a cap of 3.0 % for both loan agreements) plus (i) 6.0 % under the term loan agreement and (ii) 4.0 % under the revolving loan facility. Interest is payable monthly in arrears on the first day of each month and on the maturity of the loan agreements. The term loan agreement and the revolving loan facility are accruing interest as of December 31, 2022 at the capped interest rates of 9 % and 7 %, respectively. The Company is obligated to pay interest only for the first 48 months and straight-line amortization for the remaining 12 months, subject to the Company’s election to extend the initial interest-only period by 12 months to 60 months total if the Company’s trailing twelve-month revenue is at or above certain levels. If the term loan is repaid before the maturity date or the revolving loan facility is terminated before the end of its term, the prepayment fees are 3.0 % of the amount repaid in the first year, 2.0 % in the second year and 1.0 % in the third year and thereafter, and a final payment fee of 3.0 % of the amount borrowed is due under the term loan. The revolving loan facility prepayment fees are based on the revolving loan commitment amount. The loans are secured by all of the Company’s assets, including intellectual property. The loan agreements and other ancillary loan documents contain customary representations and warranties and affirmative and negative covenants. Under the loan agreements, the Company is not required to meet any minimum level of revenue if liquidity (defined as unrestricted cash plus undrawn availability under the revolving loan agreement) is greater than the outstanding balance under the term loan. If liquidity falls below such outstanding balance, then the Company is subject to a minimum trailing twelve-month revenue covenant. The Company is not subject to this covenant at December 31, 2022. CRG Term Loan Facility On July 31, 2020, the Company entered into a term loan facility with CRG Group L.P ("CRG"), which provided up to $ 50.0 million in financing over three tranches to be advanced no later than December 31, 2021. Principal amounts totaling $ 30.0 million were borrowed as of December 31, 2021 and until April 29, 2022, when the facility was repaid as part of the refinancing with MidCap. The CRG term loan facility provided for a maturity date as of June 30, 2025 , and permitted the Company to elect to make quarterly interest-only payments or to pay interest in-kind through December 31, 2020 . The Company was not required to make any principal payments until the maturity of the CRG term loan facility and all outstanding principal and accrued interest were due upon the maturity of the CRG term loan facility. Interest under the CRG term loan facility was applied to outstanding principal and accrued interest at a rate of 13.00 % per annum and would increase by 4.0 % if an event of default had occurred. The loan agreement provided that if the Company repaid the CRG term loan within one year of the borrowing date, the Company was required to pay a premium of 20.00 % of the aggregated outstanding principal amount of the loans that was repaid. If the Company repaid the CRG term loan between one and two years from the borrowing date, it was required to pay a premium of 11.00 % of the aggregated outstanding principal amount of the loans that it repaid. The CRG term loan facility did not require a prepayment premium for loans being prepaid after two years from the initial borrowing date. Under the terms of the CRG term loan facility, the Company granted first priority liens and security interests in substantially all of the Company’s assets as collateral (including the Company’s intellectual property), provided that the priority of such liens was subject to an intercreditor agreement between CRG and SVB. The CRG term loan facility also contained certain representations and warranties, indemnification provisions in favor of CRG, affirmative and negative covenants and events of default. The Company paid $ 0.5 million in fees to CRG and $ 0.2 million in fees to third parties in connection with the CRG term loan facility. The fees were recorded as debt issuance costs and classified as contra-debt. In addition, the Company recognized $ 0.2 million as debt discount on borrowings under the CRG term loan facility due to embedded features contained in the agreement which resulted in a derivative liability (Note 4). The CRG term loan facility was repaid in the second quarter of 2022 as part of the refinancing with MidCap. The Company incurred a $ 4.5 million loss on extinguishment of debt related to terminating its previously outstanding borrowing agreements. During the years ended December 31, 2022, 2021, and 2020 , the Company recognized $ 4.4 million, $ 4.1 million and $ 2.7 million, respectively, in interest expense related to the borrowings under the MidCap agreements and the CRG loan facility. During the years ended December 31, 2022 and 2021 , amortization of the debt discount was $ 0.2 million. During the year ended December 31, 2020 amortization of the debt discount was $ 0.1 million.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	7. Commitments and Contingencies License and Royalty Commitments The Company has entered into product development and fee for service agreements with members of its Surgeon Advisory Board that specify the terms under which the member is compensated for his or her consulting services and grants the Company rights to the intellectual property created by the member in the course of such services. As products are commercialized with the assistance of members of the Surgeon Advisory Board, the Company may agree to enter into a royalty agreement if the member’s contributions to the product are novel, significant and innovative. As of December 31, 2022 and 2021 , the Company has royalty agreements with certain members of its Surgeon Advisory Board providing for royalties based on each individual’s level of contribution. Each royalty agreement: (i) confirms the irrevocable transfer to the Company of all pertinent intellectual property rights; (ii) sets the applicable royalty rate; (iii) sets the period of time during which royalties are payable; (iv) is for a term of three years , renewable by the parties, and may be terminated by either party on 90 days ’ notice for convenience (provided that if terminated by the Company for convenience the obligation to pay royalties is not affected); and (v) prohibits the payment of royalties on products sold to entities and/or individuals with whom the surgeon advisor or any other surgeon advisor entitled to royalties is affiliated. Each of the royalty agreements may be subsequently amended to add the license of additional intellectual property covering new products, and as a result, multiple royalty rates and duration of royalty payments may be included in one royalty agreement. As of December 31, 2022 and 2021, the Company’s royalty agreements provide for (i) royalty payments for 10 years from first commercial sale of the relevant product and (ii) a royalty rate for each such agreement ranging fr om 0.4 % to 3.0 % of net sales for the particular product to which the surgeon contributed. The Company recognized royalties expense of $ 6.5 million, $ 4.3 million and $ 2.4 million for the years ended December 31, 2022, 2021 and 2020, respectively, resulting in an aggregate royalty rate of 4.6 %, 4.6 % and 4.1 %, for the years ended December 31, 2022, 2021 and 2020, respectively. Contingencies From time to time, the Company may be a party to various litigation claims in the normal course of business. Legal fees and other costs associated with such actions are expensed as incurred. The Company assesses, in conjunction with legal counsel, the need to record a liability for litigation and contingencies. Accrual estimates are recorded when and if it is determinable that such a liability for litigation and contingencies are both probable and reasonably estimable. There were no accrued contingent liabilities as of December 31, 2022 and 2021 .

Operating Leases

Operating Leases	12 Months Ended
	Dec. 31, 2022
Operating Lease, Liability [Abstract]
Operating Leases	8. Operating Leases The Company’s leases consist of real estate leases in Ponte Vedra, Florida. On February 9, 2022, the Company entered into a 10-year operating lease for a new corporate headquarters building in Ponte Vedra, Florida, with a lease commencement date of March 1, 2022. The Company's obligation to make cash payments for the new headquarters building started in the third quarter of 2022. The Company’s leases contain various options to renew, none of which the Company is reasonably certain to exercise. The lease agreements do not contain any residual value guarantees or restrictive covenants. For the new headquarters lease, the Company is provided a tenant improvement allowance for the construction of leasehold improvements. In exchange for construction management and supervision services related to these improvements, the Company paid the lessor a fee equal to one and a half percent ( 1.5 %) of total construction costs. In addition to base rent, the Company will pay variable costs related to its share of operating expenses under certain of its lease arrangements. These variable costs are recorded as lease expense as incurred and presented as operating expenses in the statements of operations and comprehensive loss. Variable lease costs were $ 0.2 million for the twelve months ended December 31, 2022. Rent expense was $ 0.6 and $ 0.2 for the twelve months ended December 31, 2021 and 2020, respectively. Operating lease cost was $ 2.3 million for the twelve months ended December 31, 2022. During the twelve months ended December 31, 2022, cash paid for amounts included in operating lease liabilities of $ 1.2 million was included in cash flows from operating activities on the condensed statements of cash flows. Additional information related to operating leases is as follows: December 31, 2022 Weighted average remaining lease term (years) 9.1 Weighted average discount rate 9.1 % The following table summarizes future minimum lease payments on operating leases as of December 31, 2021 (in thousands): Fiscal Year 2022 $ 627 2023 444 2024 458 2025 472 2026 321 Total $ 2,322 The following table summarizes a maturity analysis of operating lease liabilities showing the aggregate lease payments as of December 31, 2022 (in thousands): Fiscal Year 2023* $ 138 2024 2,932 2025* 1,398 2026 3,338 2027 3,097 Thereafter 14,998 Total undiscounted lease payments 25,901 Less: imputed interest ( 10,023 ) Total discounted lease payments 15,878 Less: Current portion of lease liability ( 339 ) Noncurrent portion of lease liability $ 15,539 * Amount presented is net of allowance for tenant improvements.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Income Taxes	9. Income Taxes The Company has no t recorded an income tax provision for years ended December 31, 2022, 2021 and 2020 due to its operating losses. All losses before income taxes were generated in the United States. Reconciliation of the statutory federal income tax to the Company’s effective tax is as follows: December 31, 2022 2021 2020 Income tax at the statutory rate ( 21 )% ( 21 )% ( 21 )% Stock-based and other compensation ( 5 ) ( 8 ) — State taxes, net of federal benefit ( 1 ) ( 6 ) ( 4 ) Research and development credits ( 1 ) ( 1 ) ( 4 ) Change in valuation allowance 26 32 28 Other 2 4 1 Effective tax rate 0 % 0 % 0 % The tax effects of temporary differences and carryforwards that give rise to significant portions of deferred tax assets and deferred tax liabilities were as follows (in thousands): December 31, 2022 2021 Deferred income tax assets Net operating loss carryforwards $ 15,979 $ 8,264 Interest expense 1,785 1,025 Stock option compensation expense 1,590 456 Accrued bonus 1,184 726 Research and development expenses 1,032 717 Research and development credits 954 — Operating lease liabilities 3,539 — Other 698 753 Gross deferred income tax assets 26,761 11,941 Less: valuation allowance ( 22,864 ) ( 11,941 ) Net deferred tax assets $ 3,897 $ — Deferred income tax liabilities Property and equipment $ ( 1,537 ) $ — Operating lease right-of-use assets ( 2,331 ) — Other ( 29 ) — Gross deferred income tax liabilities $ ( 3,897 ) — Net deferred tax liabilities $ — $ — In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax asset will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers the scheduled reversal of deferred tax assets, projected future taxable income, and tax planning strategies in making this assessment. Due to the Company’s history of net losses, the net, deferred tax assets have been fully offset by a full valuation allowance of $ 22.9 million and $ 11.9 million as of December 31, 2022 and December 31, 2021, respectively. The Company’s changes in the deferred tax asset valuation allowance for the years ended December 31, 2022 and 2021, were $ 10.9 million and $ 6.4 million, respectively. The Company had unused federal and state net operating loss carryforwards of approximately $ 71.2 million and $ 34.0 m illion, respectively as of December 31, 2022 , and federal and state net operating loss carryforwards of approximately $ 35.4 million and $ 17.2 million, respectively, as of December 31, 2021. The net operating loss carryforwards begin to expire in 2034 . The Company's research and development tax credit carryforwards were $ 1.0 million and $ 0.7 million as of December 31, 2022 and 2021, respectively, and begin to expire in 2037 . The federal and state net operating loss carryforwards and credits may be subject to significant limitations under Section 382 and Section 383 of the Internal Revenue Code and similar provisions under state law. The Tax Reform Act contains provisions that limit the federal net operating loss carryforwards that may be used in any given year in the event of special occurrences, including significant ownership changes. A Section 382 "ownership change" generally occurs if one or more stockholders or groups of stockholders, who own at least 5% of the Company’s stock, increase their ownership by more than 50 percentage points over their lowest ownership percentage within a rolling three-year period. The Company may have previously experienced, and may in the future experience, one or more Section 382 "ownership changes," including in connection with the Company’s initial public offering. If so, the Company may lose some or all of the tax benefits of its carryforwards and credits. Management has reviewed and evaluated the relevant technical merits of each of its tax positions in accordance with accounting principles generally accepted in the United States of America for accounting for uncertainty in income taxes and determined that there are no uncertain tax positions that would have a material impact on the financial statements of the Company. The Company is not subject to U.S. Federal and state income tax examinations by tax authorities for tax years before 2017.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2022
Stockholders' Equity Note [Abstract]
Stockholders' Equity	10. Stockholders’ Equity Series A Convertible Preferred Stock Immediately before the completion of the IPO, all outstanding shares of Series A convertible preferred stock were converted into shares of the Company’s common stock. Accordingly, no shares of Series A convertible preferred stock were outstanding as of December 31, 2022 or 2021. Upon the closing of the IPO in April 2021, the Company issued 158,447 shares of common stock, to settle accrued and unpaid Series A convertible preferred stock dividends of $ 2.5 million. At December 31, 2020, the Company had accrued and unpaid dividends of $ 2.3 million on the Series A convertible preferred stock outstanding. Preferred Stock Upon the closing of the IPO, the Company is authorized to issue 5,000,000 shares of preferred stock. As of December 31, 2022 , and December 31, 2021, no shares of preferred stock were outstanding. Common Stock On April 27, 2021, the Company amended and restated its Certificate of Incorporation, which became effective upon the closing of the IPO. The Company is authorized to issue 300,000,000 shares of common stock. Warrants for Class A Common Stock On April 28, 2021, Silicon Valley Bank exercised their warrants in a cashless net exercise using the closing price of the Company’s common stock on the prior business day of $ 31.27 as permitted by the warrant agreement. Accordingly, the transaction resulted in 621,570 shares of the Company’s common stock being issued to the warrant holders. The Company issued these warrants in 2019 to Silicon Valley Bank in connection with the terms of its debt agreement. Shares Reserved for Future Issuance The Company has reserved shares of common stock for future issuances as follows: December 31, 2022 2021 Common stock options issued and outstanding 7,150,755 7,464,580 Shares available for future awards granted under the 2021 Plan 4,769,842 3,766,337 Unvested restricted stock units under the 2021 Plan 582,248 10,000 Common stock available for Employee Stock Purchase Plan 1,046,437 504,627 Total 13,549,282 11,745,544 Share-based Incentive Plans In April 2021, prior to the IPO closing, the Company’s board of directors and stockholders approved the 2021 Incentive Award Plan ("2021 Plan"), which became effective upon the IPO closing. The Company initially reserved 5,046,278 shares of common stock for issuance of share-based compensation awards, including stock options, restricted stock ("RSA"), restricted stock units ("RSU") and other stock-based awards. The number of shares initially reserved for issuance or transfer pursuant to awards under the 2021 Plan will be increased by (i) the number of shares represented by awards outstanding under the Company’s 2014 Stock Option Plan ("2014 Plan") and collectively with the 2021 Plan, the "Stock Plans") that become available for issuance under the terms of the 2021 Plan and (ii) an annual increase on the first day of each fiscal year beginning in 2022 and ending in 2031, equal to the lesser of (i) 5.0 % of the shares of stock outstanding (on an as converted basis) on the last day of the immediately preceding fiscal year and (ii) such smaller number of shares of stock as determined by the Company's board of directors; provided, however, that no more than 37,847,090 shares of stock may be issued upon the exercise of incentive stock options. Prior to the IPO, the Company was authorized to issue stock purchase rights and to grant options to purchase Class A common stock to employees, directors, and consultants under the 2014 Plan. Stock options under the 2014 Plan have a term of no more than ten years from the date of grant and vest in equal installments over a maximum of five years . No future awards can be granted under the 2014 Plan. The shares underlying outstanding and unexercised options granted to employees, directors and consultants under the 2014 Plan may become available for issuance under the 2021 Plan as follows: (i) to the extent that such an option award terminates, expires or lapses for any reason or is settled in cash without the delivery of shares, any shares subject to the award at such time will be available for future grants under the 2021 Plan; (ii) to the extent shares are tendered or withheld to satisfy the grant, exercise price or tax withholding obligation with respect to any award under the 2014 Plan, such tendered or withheld shares will be available for future grants under the 2021 Plan; and (iii) to the extent that the Company repurchases the shares prior to vesting so that shares are returned to the Company, such shares will be available for future grants under the 2021 Plan. At December 31, 2022 , 4,769,842 shares of common stock remain available for issuance as awards under the 2021 Plan. In January 2023, the number of shares of common stock available for issuance under the 2021 Plan was increased by 2,781,410 shares as a result of the automatic increase provision in the 2021 Plan. Stock Options Options under the 2021 Plan may be granted for periods of up to 10 years at exercise prices no less than the fair market value of the Company's common stock on the date of grant; provided, however, that the exercise price of an incentive stock option granted to a 10 % stockholder may not be less than 110 % of the fair market value of the shares on the date of grant and such option may not be exercisable after the expiration of five years from the date of grant. Stock options granted vest ratably over four years . Stock option activity under the Stock Plans is set forth below: Outstanding Options Number of Weighted- Weighted- Balance, December 31, 2021 7,464,580 6.89 $ 6.36 Options granted 1,346,553 19.39 Options exercised ( 1,444,626 ) 1.50 Options canceled ( 215,752 ) 13.82 Balance, December 31, 2022 7,150,755 7.03 $ 9.57 Options vested and expected to vest at December 31, 2022 6,608,140 6.90 $ 8.97 Options vested and exercisable at December 31, 2022 3,728,683 5.79 $ 4.50 The aggregate intrinsic value of options exercised during the years ended December 31, 2022, 2021 and 2020 was $ 25.9 million, $ 39.1 million and $ 1.9 million, respectively. The aggregate intrinsic value is calculated as the difference between the exercise price of the underlying stock options and the fair value of the Company’s common stock for stock options that were in-the-money as of year-end. Aggregate intrinsic values of options outstanding, options vested and expected to vest, and options exercisable were $ 98.7 million, $ 94.9 million and $ 69.6 million as of December 31, 2022, respectively. Restricted Stock Units and Awards Full value award activity under the Stock Plans is set forth below: Full Value Awards RSUs Weighted-Average Grant Date Fair Value RSAs Weighted-Average Grant Date Fair Value Unvested as of December 31, 2021 10,000 $ 22.13 19,023 $ 31.50 Shares or units granted 592,778 19.04 — — Shares or units vested ( 2,500 ) 22.13 ( 6,223 ) 31.50 Shares or units forfeited ( 18,030 ) 18.92 — — Unvested as of December 31, 2022 582,248 $ 19.08 12,800 $ 31.50 RSUs and RSAs granted under the 2021 Plan generally vest annually over 4 years in equal installments. The total fair value of RSUs and RSAs vested during 2021 was not material. The Company did no t grant RSAs and RSUs during the year ended December 31, 2020, and had no unvested RSAs and RSUs as of December 31, 2020. Employee Share Purchase Plan In April 2021, the Company’s board of directors and stockholders approved the 2021 Employee Stock Purchase Plan ("ESPP"). The Company initially reserved 504,627 shares of common stock for purchase under the ESPP. The number of shares of common stock reserved for issuance under the ESPP will be automatically increased each year for ten calendar years beginning in 2022 by the number of shares equal to the lesser of 1 % of the total number of shares of common stock outstanding as of the last day of the immediately preceding fiscal year or such number of shares as may be determined by the Company's board of directors; provided that the maximum number of shares that may be issued under the ESPP is 7,064,790 shares. Each offering to the employees to purchase stock under the ESPP will begin on a date to be determined by the Company’s Compensation Committee and will end no later than six months thereafter. The ESPP allows an eligible employee to purchase shares of the Company's common stock at a discount through payroll deductions of up to 15 % of the employee’s eligible compensation. At the end of each offering period, employees are able to purchase shares at 85 % of the lower of the fair market value of its common stock at the beginning of the offering period or at the end of each applicable offering period. The occurrence and duration of offering periods under the ESPP are subject to the determinations of the Company’s Compensation Committee, in its sole discretion. The Company has not yet commenced any enrollment periods under the ESPP. In January 2023, the number of shares of common stock available for issuance under the ESPP was increased by 556,282 to 1,602,719 shares as a result of the automatic increase provision in the ESPP. Stock-Based Compensation The weighted-average grant date fair values of the stock options granted were $ 7.52 , $ 6.19 and $ 2.26 per share for the years ended December 31, 2022, 2021 and 2020, respectively. The Company uses the Black-Scholes option pricing model to determine the fair value of stock options at the grant dates with the following assumptions for options granted during 2022, 2021 and 2020 fiscal years: December 31, 2022 2021 2020 Expected term (in years) 6.25 2.1 - 6.25 2.7 - 3.3 Expected volatility 36.05 % - 37.08 % 35.57 % - 55.60 % 37.09 % - 51.29 % Risk-free interest rate 1.64 % - 4.34 % 0.08 % - 1.39 % 0.18 % - 1.53 % Expected dividend yield 0.00 % 0.00 % 0.00 % Stock-based compensation expense is reflected in the statements of operations and comprehensive loss as follows (in thousands): Years Ended December 31, 2022 2021 2020 Sales and marketing expense $ 2,928 $ 1,231 $ 479 Research and development expense 697 475 199 General and administrative expense 4,486 1,703 241 Total $ 8,111 $ 3,409 $ 919 As of December 31, 2022 , there was $ 12.8 million of unrecognized stock-based compensation expense related to common stock options , which the Company expects to recognize over a weighted-average period of 2.3 years. As of December 31, 2022 , there was $ 7.8 million of unrecognized stock-based compensation expense related to RSAs and RSUs , which the Company expects to recognize over a weighted-average period of 3.3 years. The total grant date fair value of shares vested during the years ended December 31, 2022, 2021 and 2020 were $ 5.3 million, $ 2.0 million and $ 0.9 million, respectively.

Employee Benefit Plan

Employee Benefit Plan	12 Months Ended
	Dec. 31, 2022
Retirement Benefits [Abstract]
Employee Benefit Plan	11. Employee Benefit Plan Effective as of January 2021, the Company began sponsoring a 401(k) profit sharing plan trust for its employees who satisfy certain eligibility requirements. An employee will be eligible to become a participant in the plan for purposes of (i) elective deferrals and matching contributions after completing 3 consecutive months of service beginning on the employee’s date of hire and (ii) employer profit sharing contributions after completing 1 year of service. The Company matches employee contributions to the 401(k) plan at a rate equal to 100 % of the first 3 % of the employee’s pre-tax salary contributed and 50 % of any additional contributions, including and up to 5 % of the employee’s pre-tax salary. Participants vest in their Company matching contributions after 90 days of service and in any potential future nonelective contributions by the Company on a one -to- six year graded vesting schedule. Employer contributions under this plan were $ 1.0 million and $ 0.7 million for the years ended December 31, 2022 and 2021 , respectively.

Net Loss Per Share Attributable

Net Loss Per Share Attributable to Common Stockholders	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Net Loss Per Share Attributable to Common Stockholders	12. Net Loss Per Share Attributable to Common Stockholders The following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders which is computed by dividing the net loss attributable to common stockholders by the weighted- average number of shares of common stock outstanding for the period. As the Company reported a net loss for the years ended December 31, 2022, 2021 and 2020, respectively, basic net loss per share attributable to common stockholders was the same as diluted net loss per share attributable to common stockholders as the inclusion of potentially dilutive shares would have been antidilutive if included in the calculation (in thousands, except share and per share amounts): Years Ended December 31, 2022 2021 2020 Numerator Net loss $ ( 42,815 ) $ ( 20,552 ) $ ( 3,668 ) Adjust: Convertible preferred stock cumulative — ( 196 ) ( 640 ) Net loss attributable to common stockholders ( 42,815 ) ( 20,748 ) ( 4,308 ) Denominator Weighted-average common stock outstanding, 55,276,834 48,415,679 37,068,965 Net loss per share attributable to common $ ( 0.77 ) $ ( 0.43 ) $ ( 0.12 ) The following potentially dilutive securities outstanding have been excluded from the computation of diluted weighted average shares outstanding because such securities have an antidilutive impact due to the Company’s net loss, in common stock equivalent shares: December 31, 2022 2021 2020 Series A convertible preferred stock outstanding — — 6,687,475 Warrants to purchase Class A common stock — — 713,330 Common stock options issued and outstanding 7,150,755 7,464,580 8,081,828 Unvested full value awards 595,048 29,024 — Total 7,745,803 7,493,604 15,482,633

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2022
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent Events On February 10, 2023, the Company completed a public offering of 5,476,190 shares of its common stock, which included the exercise in full of the underwriters' option to purchase additional shares, at a price to the public of $ 21.00 per share. This offering resulted in net proceeds of approximately $ 107.5 million after deducting underwriting discounts and commissions of $ 6.9 million and offering expenses payable by the Company of approximately $ 0.6 million.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying financial statements are prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). Certain prior year amounts have been reclassified for consistency with the current year presentation. These reclassifications had no effect on the reported results of operations. An adjustment has been made to the Statements of Cash Flow for the fiscal years ended December 31, 2021 and December 31, 2020, for $ 0.3 million and $ 1.1 million, respectively, to reclassify non cash expense for inventory obsolescence to net changes in operating assets for inventory. This classification change does not change previously reported cash flows from operating activities in the Statements of Cash Flows.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the periods presented. Although these estimates are based on the Company’s knowledge of current events and actions it may undertake in the future, actual results may ultimately materially differ from these estimates and assumptions. Significant estimates and assumptions include reserves and write-downs related to accounts receivable, inventories, the recoverability of long-term assets, valuation of equity instruments, valuation of common stock, stock-based compensation, deferred tax assets and related valuation allowances and impact of contingencies. The Company had no accrued contingent liabilities as of December 31, 2022 and 2021 .
Segments	Segments The Company operates and manages its business as one reportable and operating segment, which is the business of designing, manufacturing, and marketing medical devices for physicians, surgeons, ambulatory surgery centers and hospitals. The Company’s chief executive officer, who is the chief operating decision maker, reviews financial information on an aggregate basis for purposes of allocating and evaluating financial performance. All long-lived assets are maintained in the United States.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with an original or remaining maturity at the time of purchase of 90 days or less to be cash equivalents. All of the Company's cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in bank deposits, the balances of which at times may exceed federally insured limits.
Marketable Securities	Marketable Securities The Company considers its debt securities and Yankee certificate of deposits ("Yankee CDs") to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term marketable securities. The Company's marketable securities are classified as current assets based on their availability for sale to meet current operating requirements. Available-for-sale securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees’ financial condition and the Company’s intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in fair value judged to be other-than-temporary are included in the Company’s statements of operations and comprehensive loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company’s consolidated statements of operations and comprehensive loss for the years ended December 31, 2022, 2021, or 2020.
Accounts Receivable and Allowances	Accounts Receivable and Allowances Accounts receivable are generally from hospitals and ambulatory surgery centers and are stated at amounts billed less allowances for doubtful accounts. The Company continually monitors customer payments and maintains an allowance for losses resulting from a customer’s inability to make required payments. The Company considers factors such as historical experience, credit quality, age of the accounts receivable balances, geographic related risks and economic conditions that may affect a customer’s ability to pay. Accounts receivable are written off when individual balances are no longer collectible. As of December 31, 2022 and 2021, accounts receivable are presented net of an allowance for doubtful accounts of $ 0.7 mi llion and $ 0.4 million, respectively. For the years ended December 31, 2022, 2021 and 2020, the Company recorded provisions for bad debts of $ 0.4 million , $ 0.1 million and $ 0.2 mill ion, respectively.
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents, marketable securities, and accounts receivable. The Company maintains its cash with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation ("FDIC") insured limits. The Company's available for sale securities portfolio primarily consists of U.S. treasury and agency securities, money market funds, commercial paper, Yankee CDs, high credit quality asset-backed securities and corporate debt securities. The Company's investment policy requires its available for sale securities to meet certain criteria including investment type, credit ratings, and a maximum portfolio duration of one year. The Company earns revenue from the sale of its products to customers such as hospitals and ambulatory surgery centers. The Company’s accounts receivable is derived from revenue earned from customers. The Company performs ongoing credit evaluations of its customers’ financial condition and generally requires no collateral from its customers and independent sales agencies. At December 31, 2022 and 2021 , no customer accounted for more than 10 % of accounts receivable. For the years ended December 31, 2022, 2021 and 2020 , there were no customers that represented 10 % or more of revenue.
Leases	Leases The Company determines whether an arrangement is or contains a lease at the inception of the arrangement and whether such a lease is classified as a financing lease or an operating lease at the commencement date of the lease. Lease liabilities and their corresponding right-of-use assets are recorded based on the present value of lease payments over the expected lease term. The Company determines the commencement date of a lease to be the date on which a lessor makes an underlying asset available for use by the Company. Leases with a term greater than one year are recognized on the balance sheet as operating lease right-of-use assets, operating lease liabilities and operating lease liabilities, net of current portion. The Company elected not to recognize right-of-use assets and lease liabilities for leases with terms of 12 months or less (short-term leases). As the interest rates implicit in our lease contracts are not readily determinable, the Company utilizes its incremental borrowing rate based on the information available at the commencement date to determine the present value of lease payments. Certain adjustments to the right-of-use asset may be required for items such as initial direct costs paid, incentives received, or impairment charges if the Company determines the right-of-use asset is impaired. In the fourth quarter of 2022, the Company recorded an impairment to the right-of-use asset associated with the lease on its previous corporate headquarters. See Note 5 for further details of the impairment. The Company considers the lease term to be the noncancelable period that the Company has the right to use the underlying asset, together with any periods where it is reasonably certain the Company will exercise an option to extend (or not terminate) the lease. Rent expense for operating leases is recognized on a straight-line basis over the lease term and is presented in operating expenses on the statements of operations and comprehensive loss. The Company has elected to not separate lease and non-lease components for its real estate leases and instead accounts for each separate lease component and the non-lease components associated with that lease component as a single lease component. Variable lease payments are recognized as lease expense as incurred and are recorded in operating expenses on the statements of operations and comprehensive loss. The Company has no finance leases.
Inventories	Inventories Inventories consist primarily of surgical kits and components as finished goods and are stated at the lower of cost or net realizable value. Cost is determined based on an average cost method which approximates the first-in, first-out basis and includes primarily outsourced manufacturing costs and direct manufacturing overhead costs. The Company reviews inventory for obsolescence and writes down inventory, as necessary. For the years ended December 31, 2022, 2021 and 2020 , the Company recorded a provision to cost of goods sold of $ 0.1 million , $ 0.3 million and $ 1.1 mil lion, respectively, for obsolete inventory.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are recorded at cost. Depreciation of property and equipment is recorded using the straight-line method over the following estimated useful lives as follows: Years Furniture, fixtures and equipment 7 Machinery and equipment 3 Capitalized surgical instruments 3 Computer equipment 3 Leasehold improvements Lesser of estimated useful life or lease term Software 3 Long-lived assets are evaluated whenever a change in circumstances indicates that the carrying amount of an asset may not be recoverable. If assets are considered to be impaired, a charge is recorded for an amount that the carrying value exceeds the fair value. Beginning January 1, 2021, the Company adjusted the useful life of its capitalized instruments from 18 months to 36 months to align with the expected life of the instruments. The change in useful life was made as a prospective adjustment and resulted in a decrease of depreciation expense o f $ 0.3 mil lion during the year ended December 31, 2021 and no material impact on earnings per share. The change in useful life is not expected to significantly impact annual depreciation expense.
Revenue Recognition	Revenue Recognition The Company generates revenue through the sale of its primary product, the Lapiplasty System, the Adductoplasty and Lapiplasty Mini-Incision Systems and ancillary products. The Lapiplasty and Adductoplasty Systems are comprised of single-use implant kits and reusable instrument trays. Implant kits and ancillary products are sold in the United States through a combination of a direct employee sales force and independent sales agencies. The Company invoices hospitals and ambulatory surgery centers for the implant kits and ancillary products and pays commissions to the sales representatives and independent sales agencies. The Company has no international sales. For shipments to customers, the Company offers the right to return the product within 30 days for a full refund, and for returns between 30 and 90 days, the Company offers a full refund less 15% restocking fee. The Company does not have a history of product returns for refund. Customer invoices are generally payable within 30 days. The Company’s products are generally sold with a limited standard warranty to the original purchaser of the products against defects in workmanship and materials for 180 days. The Company’s liability is limited to providing, at the Company’s option, a full refund or credit of the purchase price, or repairing or replacing the product, provided that the customer returns the defective product within 180 days from the purchase date. To date, the Company has had negligible returns of any products alleged to be defective. On January 1, 2019 , the Company adopted ASC 606, Revenue from Contracts with Customers , using the modified retrospective method for all contracts not completed as of the date of adoption. In connection with the adoption of ASC 606, the Company also adopted the related amendments that impact the accounting for the incremental costs of obtaining a contract. Adoption of ASC 606 did not have any impact on the financial statements, except changes in the disclosures. Under ASC 606, revenue is recognized when the customer obtains control of promised goods or services, in an amount that reflects consideration which the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606, the Company performs the following five steps as prescribed by ASC 606: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies performance obligations. A contract with a customer exists when (i) the Company enters into a legally enforceable contract with a customer that defines each party’s rights regarding the products to be transferred and identifies the payment terms related to these products, (ii) the contract has commercial substance, and (iii) the Company determines that collection of substantially all consideration for its products that are transferred is probable based on the customer’s intent and ability to pay the promised consideration. The Company considers signed agreements and purchase orders as a customer’s contract. The Company identifies performance obligations based on the terms of the contract and customary business practices, which include products that are distinct, or a series of distinct goods that are substantially the same and that have the same pattern of transfer to the customer. The Company’s Lapiplasty System products are distinct performance obligations. The Company does not have any contracts with customers that contain multiple performance obligations. The transaction price in the Company’s customer contracts includes fixed consideration to be contractually billed to the customer while variable consideration includes the right of return. The Company does not allocate the transaction price or any variable consideration to the right of return. The Company did no t recognize a refund liability as of December 31, 2022 and 2021 and there were negligible returns during the year ended December 31, 2022 and no product returns during the years ended December 31, 2021 and 2020. Revenue for products is recognized when a customer obtains control of the promised products, which is generally when the customer has the ability to (i) direct its use and (ii) obtain substantially all of the remaining benefits from it. Revenue recognition occurs when control of the product transfers to the customer which is generally at the time the product is used in surgery. When a customer purchases products directly from us before the time of surgery, revenue is recognized based upon the shipment terms.
Contract Costs	Contract Costs The Company applies the practical expedient to recognize the incremental costs of obtaining a contract as expense when incurred if the amortization period would be one year or less. These incremental costs include sales commissions paid to the Company’s independent sales agencies or employee sales representatives.
Cost of Goods Sold	Cost of Goods Sold Cost of goods sold consists primarily of costs for the purchase of the Company’s Lapiplasty and Adductoplasty Systems as well as ancillary products from third-party manufacturers. Direct costs from the Company’s third-party manufacturers include costs for raw materials plus the markup for the assembly of the components. Cost of goods sold also includes royalties, allocated overhead for indirect labor, depreciation, certain direct costs such as those incurred for shipping our products and personnel costs. The Company expenses all inventory provisions for excess and obsolete inventories as cost of goods sold. The Company records adjustments to its inventory valuation for estimated excess, obsolete and non-sellable inventories based on assumptions about future demand, past usage, changes to manufacturing processes and overall market conditions.
Research and Development Expenses	Research and Development Expenses Research and development ("R&D") expenses consist primarily of engineering, product development, clinical studies to develop and support the Company’s products, regulatory expenses, and other costs associated with products and technologies that are in development. These expenses include compensation for personnel, including salaries, bonuses, benefits and stock-based compensation, supplies, consulting, prototyping, testing, materials, travel expenses, depreciation and an allocation of facility overhead expenses. For the fiscal years ended December 31, 2022, 2021 and 2020, the Company's research and development costs wer e $ 13.6 million, $ 10.2 million, and $ 5.8 million, respectively.
Shipping and Handling	Shipping and Handling The Company has elected to account for shipping and handling activities as fulfillment activities. As such, the Company does not evaluate shipping and handling as promised services to its customers. The Company may bill customers for shipping and handling costs. Amounts billed for shipping and handling are included in revenue. Shipping and handling costs incurred by the Company are included in sales and marketing expense. Shipping and handling costs totaled $ 0.8 million, $ 0.5 million, and $ 0.3 million, for the years ended 2022, 2021, and 2020, respectively.
Advertising Costs	Advertising Costs Advertising costs are expensed as incurred and are included as a component of marketing and sales expenses. Advertising expense includes the cost of advertising across the various mediums we employ, including print, digital, radio and television. Advertising costs totaled approximately $ 15.0 million, $ 13.0 million and $ 3.1 million, for the years ended 2022, 2021 and 2020 , respectively.
Income Taxes	Income Taxes The Company accounts for income taxes under the liability method, whereby deferred tax assets and liabilities are determined based on the difference between the financial statements and tax bases of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to affect taxable income. A valuation allowance is established when necessary to reduce deferred tax assets when management estimates, based on available objective evidence, that it is more likely than not that the benefit will not be realized for the deferred tax assets. The Company also follows the provisions of ASC 740-10, Accounting for Uncertainty in Income Taxes . ASC 740-10, which prescribes a comprehensive model for the recognition, measurement, presentation and disclosure in financial statements of any uncertain tax positions that have been taken or expected to be taken on a tax return. No liability related to uncertain tax positions is recorded in the financial statements. It is the Company’s policy to include penalties and interest expense related to income taxes as part of the provision for income taxes.
Product Liability	Product Liability The Company believes it carries adequate insurance for possible product liability claims. Accruals for product liability claims and legal defense costs in excess of insured amounts are recorded if it is probable that a liability has been incurred and the amount of any liability can be reasonably estimated. No accruals for product liability claims had been recorded as of December 31, 2022 and 2021.
Debt	Debt Debt issuance costs and discount are amortized to interest expense u sing the effective interest method.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for stock-based compensation arrangements with employees in accordance with ASC 718, Compensation—Stock Compensation, using a fair-value based method. The Company determines the fair value of stock options on the date of grant using the Black-Scholes option pricing model. The fair value for RSAs and RSUs awards is the fair value of the stock at the grant date. The fair value of time-based awards is recognized over the period during which an award holder is required to provide services in exchange for the award, known as the requisite service period, which is typically the vesting period using the straight-line method. The Company accrues for estimated forfeitures on share-based awards and adjusts stock-based compensation cost to actual as forfeitures occur. The estimated forfeitures are based on a historical analysis of actual forfeitures of awards. The Company estimates the fair value of the stock-based awards using the Black-Scholes option-pricing model, which requires the input of highly subjective assumptions. The assumptions are as follows: • Expected Term . The expected term represents the period that the stock options are expected to remain outstanding. Prior to the closing of the IPO, the Company was using the probabilities of the anticipated timing of potential liquidity events to determine the expected term. After the closing of the IPO, the Company is using the "simplified" method, which is the simple average of the vesting period and the contractual term. • Expected Volatility . The expected volatility is derived from the historical stock volatilities of comparable publicly listed peers over a period approximately equal to the expected term of the options as the Company does not have sufficient trading history to determine the volatility of its common stock. • Risk-Free Interest Rate . The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the date of grant for zero-coupon U.S. Treasury notes with maturities approximately equal to the stock-based awards’ expected term. • Expected Dividend Yield . The expected dividend yield is zero as the Company has not paid nor anticipates paying any dividends on the common stock in the foreseeable future. • Fair Market Value of Common Stock. Prior to the IPO, the fair market value of the common stock was determined by the board of directors with assistance from management and external valuation experts. The Company’s approach to estimating the fair market value of its common stock was consistent with the methods outlined in the American Institute of Certified Public Accountants’ Practice Aid, Valuation of Privately-Held-Company Equity Securities Issued as Compensation . Following our IPO, the fair market value of the common stock is based on its closing price on NASDAQ as reported on the date of grant. The Company continues to use judgment in evaluating the expected volatility and expected terms utilized for the stock-based compensation calculations on a prospective basis. As the Company continues to accumulate additional data, the Company may make refinements to the assumptions, which could materially impact the future stock-based compensation expense.
Comprehensive Loss	Comprehensive Loss The Company is required to report all components of comprehensive loss, including net loss, in the financial statements in the period in which they are recognized. Comprehensive loss is defined as a change in equity of a business enterprise during a period, resulting from transactions and other events and circumstances from non-owner sources. Comprehensive loss equaled $ 42.8 million for the year end December 31, 2022. Comprehensive loss equaled net loss for the years ended December 31, 2021 and 2020 .
Net Loss Per Share Attributable to Common Stockholders	Net Loss Per Share Attributable to Common Stockholders Basic net loss per share attributable to common stockholders is calculated by dividing the net loss attributable to common stockholders, by the weighted-average number of common shares outstanding during the period, without consideration for potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss by the weighted-average number of common shares and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, common stock options, unvested restricted stock units and restricted stock awards are considered to be potentially dilutive securities. Because the Company has reported a net loss for the years ended December 31, 2022, 2021 and 2020 , diluted net losses per common share were the same as basic net losses per common share for these periods.
Derivative Liability	Derivative Liability The Company evaluates its financial instruments for embedded features and bifurcates embedded features from the host instrument that meet the definition of a derivative and if (i) the economic characteristics and risks of the embedded feature are not clearly and closely related to the host instrument, (ii) the hybrid instrument that embodies both the embedded feature and the host contract is not remeasured at fair value under otherwise applicable generally accepted accounting principles with changes in fair value reported in earnings as they occur and (iii) a separate instrument with the same terms as the embedded feature would be considered a derivative instrument subject to the accounting requirements of derivative instruments. The Company uses judgment in determining the fair value of embedded features that are bifurcated from the host instrument and accounted for as derivative instruments at the date of issuance and at every balance sheet date thereafter. The valuation method used in the determination of fair value is based on the type of derivative instrument. At each balance sheet date, the Company remeasures its derivative instruments at fair value with adjustments to fair value recognized within other expense, net.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2022
Accounting Policies [Abstract]
Summary of Property and Equipment Depreciation Estimated Useful Lives	Property and equipment are recorded at cost. Depreciation of property and equipment is recorded using the straight-line method over the following estimated useful lives as follows: Years Furniture, fixtures and equipment 7 Machinery and equipment 3 Capitalized surgical instruments 3 Computer equipment 3 Leasehold improvements Lesser of estimated useful life or lease term Software 3

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis	Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis – The following assets and liabilities are measured at fair value on a recurring basis as of December 31, 2022 and December 31, 2021: December 31, 2022 Level 1 Level 2 Level 3 Total Assets: Cash and cash equivalents Money market funds $ 13,141 $ — $ — $ 13,141 Commercial paper — 323 — 323 Corporate debt — 2,197 — 2,197 Yankee CD — 550 — 550 Short-term marketable securities at fair value U.S. treasury and government agencies 12,873 3,570 — 16,443 Corporate debt — 23,372 — 23,372 Asset-backed securities — 13,896 — 13,896 Yankee CD — 8,068 — 8,068 Total $ 26,014 $ 51,976 $ — $ 77,990 December 31, 2021 Level 1 Level 2 Level 3 Total Assets: Money market funds $ 105,220 $ — $ — $ 105,220 Total $ 105,220 $ — $ — $ 105,220 Liabilities: Derivative liability $ — $ — $ 173 $ 173 Total $ — $ — $ 173 $ 173
Summary of the Changes in the Fair Value of the Companies Level 3 Financial Instruments	The following table sets forth a summary of the changes in the fair value of the Company’s Level 3 financial instruments (in thousands): Derivative liability Fair value as of January 1, 2021 $ 245 Change in fair value included in other expense, net ( 72 ) Fair value as of December 31, 2021 173 Change in fair value included in other expense, net ( 173 ) Fair value as of December 31, 2022 $ —

Balance Sheet Components (Table

Balance Sheet Components (Tables)	12 Months Ended
	Dec. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Summary of Cash and Cash Equivalents	The Company’s cash and cash equivalents consisted of the following (in thousands): December 31, 2022 2021 Cash $ 3,262 $ 613 Cash equivalents: Money market funds 13,141 105,220 Commercial paper 323 — Corporate debt 2,197 — Yankee CD 550 — Total cash and cash equivalents $ 19,473 $ 105,833
Summary of Available-For-Sale Marketable Securities	The Company’s available-for-sale marketable securities consisted of the following (in thousands): December 31, 2022 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 16,472 $ 11 $ ( 40 ) $ 16,443 Corporate debt 23,376 31 ( 35 ) 23,372 Asset-backed securities 13,892 27 ( 23 ) 13,896 Yankee CD 8,066 10 ( 8 ) 8,068 Total marketable securities - short-term $ 61,806 $ 79 $ ( 106 ) $ 61,779
Summary of Property and Equipment, Net	The company’s property and equipment, net consisted of the following (in thousands): December 31, 2022 2021 Furniture and fixtures, and equipment $ 1,577 $ 180 Construction in progress 705 126 Machinery and equipment 928 274 Capitalized surgical equipment 9,248 4,442 Computer equipment 571 160 Leasehold improvements 6,434 268 Software 138 138 Total property and equipment 19,601 5,588 Less: accumulated depreciation and amortization ( 4,263 ) ( 2,739 ) Property and equipment, net $ 15,338 $ 2,849
Summary of Accrued Liabilities	Accrued liabilities consist of the following (in thousands): December 31, 2022 2021 Accrued royalties expense $ 2,299 $ 1,522 Accrued interest 412 975 Accrued professional services 1,727 941 Other accrued expense 1,778 1,080 Total accrued liabilities $ 6,216 $ 4,518

Long Term Debt (Tables)

Long Term Debt (Tables)	12 Months Ended
	Dec. 31, 2022
Debt Disclosure [Abstract]
Summary of Long-term Debt Instruments	The Company’s debt consisted of the following (in thousands): December 31, 2022 2021 Revolving line of credit MidCap revolving loan facility $ 4,000 $ — Term loans CRG term loan facility — 30,000 MidCap term loan facility 50,000 — Total term and revolving loans 54,000 30,000 Less: debt discount and issuance costs ( 1,289 ) ( 635 ) Total long-term debt, net $ 52,711 $ 29,365
Summary of Maturities of Long-term Debt	As of December 31, 2022, future payments of long-term debt were as follows (in thousands): Fiscal Year 2023 $ — 2024 — 2025 — 2026 33,333 2027 20,667 Total principal payments 54,000 Less: Unamortized debt discount and debt issuance costs ( 1,289 ) Total long-term debt, net $ 52,711 MidCap Loan and Revolving Loan Facility

Operating Leases (Tables)

Operating Leases (Tables)	12 Months Ended
	Dec. 31, 2022
Operating Lease, Liability [Abstract]
summary of operating leases	Additional information related to operating leases is as follows: December 31, 2022 Weighted average remaining lease term (years) 9.1 Weighted average discount rate 9.1 %
Summary of future minimum lease payments and maturity analysis of operating lease liabilities	The following table summarizes future minimum lease payments on operating leases as of December 31, 2021 (in thousands): Fiscal Year 2022 $ 627 2023 444 2024 458 2025 472 2026 321 Total $ 2,322 The following table summarizes a maturity analysis of operating lease liabilities showing the aggregate lease payments as of December 31, 2022 (in thousands): Fiscal Year 2023* $ 138 2024 2,932 2025* 1,398 2026 3,338 2027 3,097 Thereafter 14,998 Total undiscounted lease payments 25,901 Less: imputed interest ( 10,023 ) Total discounted lease payments 15,878 Less: Current portion of lease liability ( 339 ) Noncurrent portion of lease liability $ 15,539 * Amount presented is net of allowance for tenant improvements.

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2022
Income Tax Disclosure [Abstract]
Summary of Reconciliation of Statutory Federal Income Tax to Effective Tax	Reconciliation of the statutory federal income tax to the Company’s effective tax is as follows: December 31, 2022 2021 2020 Income tax at the statutory rate ( 21 )% ( 21 )% ( 21 )% Stock-based and other compensation ( 5 ) ( 8 ) — State taxes, net of federal benefit ( 1 ) ( 6 ) ( 4 ) Research and development credits ( 1 ) ( 1 ) ( 4 ) Change in valuation allowance 26 32 28 Other 2 4 1 Effective tax rate 0 % 0 % 0 %
Summary of Tax Effects of Temporary Differences and Carryforwards to Significant Portions of Deferred Tax Assets and Deferred Tax Liabilities	The tax effects of temporary differences and carryforwards that give rise to significant portions of deferred tax assets and deferred tax liabilities were as follows (in thousands): December 31, 2022 2021 Deferred income tax assets Net operating loss carryforwards $ 15,979 $ 8,264 Interest expense 1,785 1,025 Stock option compensation expense 1,590 456 Accrued bonus 1,184 726 Research and development expenses 1,032 717 Research and development credits 954 — Operating lease liabilities 3,539 — Other 698 753 Gross deferred income tax assets 26,761 11,941 Less: valuation allowance ( 22,864 ) ( 11,941 ) Net deferred tax assets $ 3,897 $ — Deferred income tax liabilities Property and equipment $ ( 1,537 ) $ — Operating lease right-of-use assets ( 2,331 ) — Other ( 29 ) — Gross deferred income tax liabilities $ ( 3,897 ) — Net deferred tax liabilities $ — $ —

Warrants for Class A Common Sto

Warrants for Class A Common Stock (Tables)	12 Months Ended
	Dec. 31, 2022
Class of Warrant or Right [Line Items]
Summary of Company Determined the Fair Value of Warrants using Black-Scholes Option Pricing Model	The Company uses the Black-Scholes option pricing model to determine the fair value of stock options at the grant dates with the following assumptions for options granted during 2022, 2021 and 2020 fiscal years: December 31, 2022 2021 2020 Expected term (in years) 6.25 2.1 - 6.25 2.7 - 3.3 Expected volatility 36.05 % - 37.08 % 35.57 % - 55.60 % 37.09 % - 51.29 % Risk-free interest rate 1.64 % - 4.34 % 0.08 % - 1.39 % 0.18 % - 1.53 % Expected dividend yield 0.00 % 0.00 % 0.00 %

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2022
Stockholders' Equity Note [Abstract]
Summary of the Company has Reserved Shares of Common Stock for Future Issuances	The Company has reserved shares of common stock for future issuances as follows: December 31, 2022 2021 Common stock options issued and outstanding 7,150,755 7,464,580 Shares available for future awards granted under the 2021 Plan 4,769,842 3,766,337 Unvested restricted stock units under the 2021 Plan 582,248 10,000 Common stock available for Employee Stock Purchase Plan 1,046,437 504,627 Total 13,549,282 11,745,544
Summary of Stock Option Activity under Stock Plans	Stock option activity under the Stock Plans is set forth below: Outstanding Options Number of Weighted- Weighted- Balance, December 31, 2021 7,464,580 6.89 $ 6.36 Options granted 1,346,553 19.39 Options exercised ( 1,444,626 ) 1.50 Options canceled ( 215,752 ) 13.82 Balance, December 31, 2022 7,150,755 7.03 $ 9.57 Options vested and expected to vest at December 31, 2022 6,608,140 6.90 $ 8.97 Options vested and exercisable at December 31, 2022 3,728,683 5.79 $ 4.50
Summary of Full Value Award Activity Under Stock Plans	Full value award activity under the Stock Plans is set forth below: Full Value Awards RSUs Weighted-Average Grant Date Fair Value RSAs Weighted-Average Grant Date Fair Value Unvested as of December 31, 2021 10,000 $ 22.13 19,023 $ 31.50 Shares or units granted 592,778 19.04 — — Shares or units vested ( 2,500 ) 22.13 ( 6,223 ) 31.50 Shares or units forfeited ( 18,030 ) 18.92 — — Unvested as of December 31, 2022 582,248 $ 19.08 12,800 $ 31.50
Summary of Company Determined the Fair Value of Warrants using Black-Scholes Option Pricing Model	The Company uses the Black-Scholes option pricing model to determine the fair value of stock options at the grant dates with the following assumptions for options granted during 2022, 2021 and 2020 fiscal years: December 31, 2022 2021 2020 Expected term (in years) 6.25 2.1 - 6.25 2.7 - 3.3 Expected volatility 36.05 % - 37.08 % 35.57 % - 55.60 % 37.09 % - 51.29 % Risk-free interest rate 1.64 % - 4.34 % 0.08 % - 1.39 % 0.18 % - 1.53 % Expected dividend yield 0.00 % 0.00 % 0.00 %
Summary of Share-Based Compensation Expense is Reflected in the Statements of Operations and Comprehensive Loss	Stock-based compensation expense is reflected in the statements of operations and comprehensive loss as follows (in thousands): Years Ended December 31, 2022 2021 2020 Sales and marketing expense $ 2,928 $ 1,231 $ 479 Research and development expense 697 475 199 General and administrative expense 4,486 1,703 241 Total $ 8,111 $ 3,409 $ 919

Net Loss Per Share Attributab_2

Net Loss Per Share Attributable to Common Stockholders (Tables)	12 Months Ended
	Dec. 31, 2022
Earnings Per Share [Abstract]
Schedule of Net Loss Per Share Attributable to Common Stockholders, Basic and Diluted	As the Company reported a net loss for the years ended December 31, 2022, 2021 and 2020, respectively, basic net loss per share attributable to common stockholders was the same as diluted net loss per share attributable to common stockholders as the inclusion of potentially dilutive shares would have been antidilutive if included in the calculation (in thousands, except share and per share amounts): Years Ended December 31, 2022 2021 2020 Numerator Net loss $ ( 42,815 ) $ ( 20,552 ) $ ( 3,668 ) Adjust: Convertible preferred stock cumulative — ( 196 ) ( 640 ) Net loss attributable to common stockholders ( 42,815 ) ( 20,748 ) ( 4,308 ) Denominator Weighted-average common stock outstanding, 55,276,834 48,415,679 37,068,965 Net loss per share attributable to common $ ( 0.77 ) $ ( 0.43 ) $ ( 0.12 )
Summary of Potentially Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares Outstanding	The following potentially dilutive securities outstanding have been excluded from the computation of diluted weighted average shares outstanding because such securities have an antidilutive impact due to the Company’s net loss, in common stock equivalent shares: December 31, 2022 2021 2020 Series A convertible preferred stock outstanding — — 6,687,475 Warrants to purchase Class A common stock — — 713,330 Common stock options issued and outstanding 7,150,755 7,464,580 8,081,828 Unvested full value awards 595,048 29,024 — Total 7,745,803 7,493,604 15,482,633

Formation and Business of the_2

Formation and Business of the Company - Additional Information (Detail)			12 Months Ended
	Apr. 27, 2021 USD ($) $ / shares shares	Apr. 16, 2021 $ / shares shares	Dec. 31, 2022 USD ($) $ / shares shares	Dec. 31, 2021 USD ($) $ / shares shares	Dec. 31, 2020 USD ($)
Formation And Business Of The Company [Line Items]
Company incorporation date of incorporation			Jul. 29, 2013
Stock issued during the period shares including sale by the existing shareholders	12,937,500
Sale of stock issue price per share | $ / shares	$ 17
Underwriting discounts and commissions | $	$ 8,300,000
Adjustment to additional paid in capital stock issuance costs | $	$ 2,300,000
Preferred stock shares outstanding converted into equity shares	6,687,475
Stock split ratio		1.3375
Common stock shares authorized	300,000,000		300,000,000	300,000,000
Preferred stock shares authorized	5,000,000		5,000,000	5,000,000
Common stock, par or stated value per share | $ / shares		$ 0.001	$ 0.001	$ 0.001
Preferred stock, par or stated value per share | $ / shares		$ 0.001	$ 0.001	$ 0.001
Accumulated deficit | $			$ (84,720,000)	$ (41,905,000)
Net cash used in operating activities | $			(30,648,000)	(17,193,000)	$ (4,494,000)
Cash and cash equivalents | $			19,473,000	$ 105,833,000
Marketable securities available for sale | $			61,779,000
Forward Stock Split [Member]
Formation And Business Of The Company [Line Items]
Shares authorized preferred and common stock		73,562,500
Common stock shares authorized		66,875,000
Preferred stock shares authorized		6,687,500
IPO [Member]
Formation And Business Of The Company [Line Items]
Stock issued during the period shares new issues	6,953,125
Sale of stock by the existing shareholders	5,984,375
Sale of stock net consideration received on the transaction | $	$ 107,600,000
Over-Allotment Option [Member]
Formation And Business Of The Company [Line Items]
Stock issued during the period shares new issues	703,125
Sale of stock by the existing shareholders	984,375
Selling Stockholders [Member]
Formation And Business Of The Company [Line Items]
Proceeds from sale of shares | $			$ 0
Common Class A [Member]
Formation And Business Of The Company [Line Items]
Stock split ratio		1.3375
Series A Convertible Preferred Stock [Member]
Formation And Business Of The Company [Line Items]
Stock shares issued during the period shares dividends	158,447
Stock shares issued during the period value dividends | $	$ 2,500,000
Stock split ratio		1.3375

Summary of Significant Accoun_4

Summary of Significant Accounting Policies -Additional Information (Detail)	12 Months Ended
	Dec. 31, 2022 USD ($) Segment	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Net changes in operating assets for inventory		$ 300,000	$ 1,100,000
Accrued contingent liabilities	$ 0	0
Number of reportable segment | Segment	1
Net of an allowance for doubtful accounts	$ 700,000	400,000
Provision for bad debts	411,000	144,000	216,000
Revenue recognition international sales	$ 0
Revenue recognition shipments to customers right to return description	shipments to customers, the Company offers the right to return the product within 30 days for a full refund, and for returns between 30 and 90 days, the Company offers a full refund less 15% restocking fee. The Company does not have a history of product returns for refund. Customer invoices are generally payable within 30 days. The Company’s products are generally sold with a limited standard warranty to the original purchaser of the products against defects in workmanship and materials for 180 days. The Company’s liability is limited to providing, at the Company’s option, a full refund or credit of the purchase price, or repairing or replacing the product, provided that the customer returns the defective product within 180 days from the purchase date. To date, the Company has had negligible returns of any products alleged to be defective.
Contract with customer, refund liability	$ 0	0
Contract with customer, product returns		0	0
Practical expedient, incremental cost of obtaining contract	true
Research and development costs	$ 13,584,000	10,204,000	5,847,000
Shipping and handling costs	800,000	500,000	300,000
Advertising costs	15,000,000	13,000,000	$ 3,100,000
Liability related to uncertain tax positions	0
Accruals for product liability	$ 0	$ 0
Expected dividend yield	0%	0%	0%
Comprehensive loss	$ (42,842,000)	$ (20,748,000)	$ (4,308,000)
Capitalized Surgical Instruments [Member]
Summary Of Significant Accounting Policies [Line Items]
Useful life of its capitalized instruments	3 years
Decrease in depreciation expense		300,000
ASC 606 [Member]
Summary Of Significant Accounting Policies [Line Items]
Change in accounting principle, accounting standards update, adoption date	Jan. 01, 2019
Change in accounting principle, accounting standards update, adopted	true
Change in accounting principle, accounting standards update, immaterial effect	true
Obsolescence [Member]
Summary Of Significant Accounting Policies [Line Items]
Provision for inventory obsolescence	$ 100,000	$ 300,000	$ 1,100,000
Maximum [Member] | Capitalized Surgical Instruments [Member]
Summary Of Significant Accounting Policies [Line Items]
Useful life of its capitalized instruments		36 months
Maximum [Member] | Accounts Receivable [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	10%	10%
Minimum [Member] | Capitalized Surgical Instruments [Member]
Summary Of Significant Accounting Policies [Line Items]
Useful life of its capitalized instruments			18 months
Minimum [Member] | Revenue Benchmark [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	10%	10%	10%

Summary of Property and Equipme

Summary of Property and Equipment Depreciation Estimated Useful Lives (Detail)	12 Months Ended
	Dec. 31, 2022
Furniture Fixtures and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	7 years
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Capitalized Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Leasehold improvements	Lesser of estimated useful life or lease term
Software [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Jan. 01, 2022	Dec. 31, 2021
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Operating lease liability	$ 15,878
Operating lease right-of-use assets	$ 10,138	$ 1,900	$ 0
ASC 842 Topic [Member] | Minimum [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Lessee, operating lease, term of contract	12 months

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Assets:
Fair Value	$ 61,779
Liabilities:
Derivative liability	200
US Treasury and Government Agencies
Assets:
Fair Value	16,443
Corporate Debt
Assets:
Fair Value	23,372
Asset-Backed Securities
Assets:
Fair Value	13,896
Yankee CD
Assets:
Fair Value	8,068
Fair Value, Recurring [Member]
Assets:
Money market funds		$ 105,220
Total	77,990	$ 105,220
Liabilities:
Derivative Liability, Statement of Financial Position [Extensible Enumeration]		Liabilities
Derivative liability		$ 173
Total		173
Fair Value, Recurring [Member] | Money Market Funds [Member]
Assets:
Cash and cash equivalents	13,141
Fair Value, Recurring [Member] | Commercial Paper [Member]
Assets:
Cash and cash equivalents	323
Fair Value, Recurring [Member] | US Treasury and Government Agencies
Assets:
Fair Value	16,443
Fair Value, Recurring [Member] | Corporate Debt
Assets:
Cash and cash equivalents	2,197
Fair Value	23,372
Fair Value, Recurring [Member] | Asset-Backed Securities
Assets:
Fair Value	13,896
Fair Value, Recurring [Member] | Yankee CD
Assets:
Cash and cash equivalents	550
Fair Value	8,068
Fair Value, Recurring [Member] | Level 1 [Member]
Assets:
Money market funds		105,220
Total	26,014	$ 105,220
Fair Value, Recurring [Member] | Level 1 [Member] | Money Market Funds [Member]
Assets:
Cash and cash equivalents	13,141
Fair Value, Recurring [Member] | Level 1 [Member] | US Treasury and Government Agencies
Assets:
Fair Value	12,873
Fair Value, Recurring [Member] | Level 2 [Member]
Assets:
Total	51,976
Fair Value, Recurring [Member] | Level 2 [Member] | Commercial Paper [Member]
Assets:
Cash and cash equivalents	323
Fair Value, Recurring [Member] | Level 2 [Member] | US Treasury and Government Agencies
Assets:
Fair Value	3,570
Fair Value, Recurring [Member] | Level 2 [Member] | Corporate Debt
Assets:
Cash and cash equivalents	2,197
Fair Value	23,372
Fair Value, Recurring [Member] | Level 2 [Member] | Asset-Backed Securities
Assets:
Fair Value	13,896
Fair Value, Recurring [Member] | Level 2 [Member] | Yankee CD
Assets:
Cash and cash equivalents	550
Fair Value	$ 8,068
Fair Value, Recurring [Member] | Level 3 [Member]
Liabilities:
Derivative Liability, Statement of Financial Position [Extensible Enumeration]		Liabilities
Derivative liability		$ 173
Total		$ 173

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Derivative liability	$ 200
Other Expense [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Change in fair value	$ 200	$ 100	$ 0
Minimum [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Probability of default	1%
Maximum [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Probability of default	2%

Fair Value Measurements - Sum_2

Fair Value Measurements - Summary of the Changes in the Fair Value of the Company's Financial Instruments (Detail) - Derivative [Member] - Level 3 [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fair value, beginning balance	$ 173	$ 245
Change in fair value included in other expense, net	$ (173)	$ (72)
Fair Value, Liability, Recurring Basis, Unobservable Input Reconciliation, Gain (Loss), Statement of Income or Comprehensive Income [Extensible Enumeration]	Other Nonoperating Income (Expense)	Other Nonoperating Income (Expense)
Fair value, ending balance	$ 0	$ 173

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Cash and Cash Equivalents (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Cash and Cash Equivalents [Line Items]
Cash	$ 3,262	$ 613
Total cash and cash equivalents	19,473	105,833
Money Market Funds [Member]
Cash and Cash Equivalents [Line Items]
Cash equivalents	13,141	105,220
Commercial Paper [Member]
Cash and Cash Equivalents [Line Items]
Cash equivalents	323	0
Corporate Debt
Cash and Cash Equivalents [Line Items]
Cash equivalents	2,197	0
Yankee CD
Cash and Cash Equivalents [Line Items]
Cash equivalents	$ 550	$ 0

Balance Sheet Components - Su_2

Balance Sheet Components - Summary of Available-For-Sale Marketable Securities (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2022 USD ($)
Marketable Securities [Line Items]
Amortized Cost	$ 61,806
Gross Unrealized Gains	79
Gross Unrealized Losses	(106)
Fair Value	61,779
US Treasury and Government Agencies
Marketable Securities [Line Items]
Amortized Cost	16,472
Gross Unrealized Gains	11
Gross Unrealized Losses	(40)
Fair Value	16,443
Corporate Debt
Marketable Securities [Line Items]
Amortized Cost	23,376
Gross Unrealized Gains	31
Gross Unrealized Losses	(35)
Fair Value	23,372
Asset-Backed Securities
Marketable Securities [Line Items]
Amortized Cost	13,892
Gross Unrealized Gains	27
Gross Unrealized Losses	(23)
Fair Value	13,896
Yankee CD
Marketable Securities [Line Items]
Amortized Cost	8,066
Gross Unrealized Gains	10
Gross Unrealized Losses	(8)
Fair Value	$ 8,068

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 19,601	$ 5,588
Less: accumulated depreciation and amortization	(4,263)	(2,739)
Property and equipment, net	15,338	2,849
Furniture and Fixtures, and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,577	180
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	705	126
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	928	274
Capitalized Surgical Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	9,248	4,442
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	571	160
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	6,434	268
Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 138	$ 138

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Cash and Cash Equivalents [Line Items]
Depreciation and amortization expense	$ 2,133	$ 685	$ 1,210
Cash	3,262	613
Asset impairment charges	300
Imapairment charges, property and equipment	$ 200	0	$ 0
Impairment, Long-Lived Asset, Held-for-Use, Statement of Income or Comprehensive Income [Extensible Enumeration]	Investment Income, Net
Impairment charges, right-of-use asset associated with the lease	$ 100
Silicon Valley Bank
Cash and Cash Equivalents [Line Items]
Cash	$ 900	$ 0

Balance Sheet Components - Su_4

Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Balance Sheet Related Disclosures [Abstract]
Accrued royalties expense	$ 2,299	$ 1,522
Accrued interest	412	975
Accrued professional services	1,727	941
Other accrued expense	1,778	1,080
Total accrued liabilities	$ 6,216	$ 4,518

Long Term Debt - Additional Inf

Long Term Debt - Additional Information (Detail) - USD ($) $ in Thousands			3 Months Ended	12 Months Ended
	Apr. 29, 2022	Jul. 31, 2020	Jun. 30, 2022	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Line Of Credit Facility, Borrowing Capacity Description	The Company is required to either (i) maintain a minimum drawn balance under the revolving loan facility or (ii) pay a minimum balance fee that is equal to the amount of the minimum balance deficit multiplied by the applicable interest rate during the period. If the outstanding balance under the revolving loan facility exceeds the lesser of (i) 50% of the revolving borrowing capacity or (ii) 50% of the borrowing base, or the Company is in default, MidCap will apply funds collected from the Company's lockbox account to reduce the outstanding balance of the revolving loan facility (“Lockbox Deductions”).
Revolving borrowing capacity percentage	50%
Line of credit, interest description	The loans bear interest at an annual rate based on a 30-day forward looking secured overnight financing rate plus 0.10% (subject to a floor of 1.0% and a cap of 3.0% for both loan agreements) plus (i) 6.0% under the term loan agreement and (ii) 4.0% under the revolving loan facility.
Term loan repayment term	Interest is payable monthly in arrears on the first day of each month and on the maturity of the loan agreements. The term loan agreement and the revolving loan facility are accruing interest as of December 31, 2022 at the capped interest rates of 9% and 7%, respectively. The Company is obligated to pay interest only for the first 48 months and straight-line amortization for the remaining 12 months, subject to the Company’s election to extend the initial interest-only period by 12 months to 60 months total if the Company’s trailing twelve-month revenue is at or above certain levels.
Debt instrument repayment fee percentage for first year	3%
Debt instrument repayment fee percentage for third year	1%
Debt instrument repayment fee percentage final	3%
Payment of debt issuance costs				$ 989	$ 0	$ 179
Interest and other income (expense), net				910	18	$ (1,746)
Long term debt fixed rate of interest						13%
Long term debt net of unamortized debt issuance costs and discount				52,711	29,365
Amortization of debt discount				200	200	$ 100
SVB Credit Facility And CRG Credit Facility [Member]
Debt Instrument [Line Items]
Interest expenses				$ 4,400	4,100	2,700
Midcap Financial Trust [Member]
Debt Instrument [Line Items]
Term loan tenure	5 years
Line of credit	$ 150,000
Revolving borrowing capacity percentage	50%
Debt Instrument, Face Amount	$ 120,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Borrowings	50,000
Remaining borrowing capacity	30,000
Increase in credit facility	$ 20,000
Debt Instrument Interest Rate, Percentage	0.10%
Debt Instrument Interest Rate	4%
Capped interest rates				7%
Line of credit current borrowing capacity				$ 24,500
Current portion of long-term line of credit drawn				$ 4,000
Debt Instrument, Face Amount	$ 30,000
Early Repayment Year Two [Member]
Debt Instrument [Line Items]
Debt instrument repayment fee percentage for second year	2%
Tranche One [Member]
Debt Instrument [Line Items]
Borrowings	$ 50,000
Tranche Four [Member]
Debt Instrument [Line Items]
Borrowings	$ 120,000
Interest Rate Floor [Member] | SOFR [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate spread percentage	1%
Interest Rate Cap [Member] | SOFR [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate spread percentage	3%
Term Loans [Member]
Debt Instrument [Line Items]
Remaining borrowing capacity	$ 70,000
Debt Instrument Interest Rate	6%
Capped interest rates				9%
CRG Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt, Maturity Date		Jun. 30, 2025
Debt Instrument, Face Amount		$ 50,000
Proceeds from long term loan from the bank					$ 30,000
Long term debt terms of interest payment		quarterly interest-only payments or to pay interest in-kind through December 31, 2020
Long term debt default rate of interest		4%
Debt discount gross						200
Loss on extinguishment of previously outstanding borrowing			$ 4,500
CRG Term Loan Facility [Member] | Third Party [Member]
Debt Instrument [Line Items]
Debt issuance costs gross						500
CRG Term Loan Facility [Member] | CRG [Member]
Debt Instrument [Line Items]
Debt issuance costs gross						$ 200
CRG Term Loan Facility [Member] | Early Repayment Within One Year [Member]
Debt Instrument [Line Items]
Long term debt prepayment premium percentage						20%
CRG Term Loan Facility [Member] | Early Repayment => 1Year But Within 2 Years [Member]
Debt Instrument [Line Items]
Long term debt prepayment premium percentage						11%

Long Term Debt - Summary of Lon

Long Term Debt - Summary of Long-term Debt Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Total term loans	$ 54,000	$ 30,000
Less: Unamortized debt discount and debt issuance costs	(1,289)	(635)
Total long-term debt, net	52,711	29,365
Mid Cap Revolving Credit Facility
Debt Instrument [Line Items]
Total term loans	4,000	0
Term Loans [Member] | CRG Term Loan Facility [Member]
Debt Instrument [Line Items]
Total term loans	0	30,000
Term Loans [Member] | MidCap Term Loan Facility
Debt Instrument [Line Items]
Total term loans	$ 50,000	$ 0

Long Term Debt - Summary of Mat

Long Term Debt - Summary of Maturities of Long-term Debt (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
2023	$ 0
2024	0
2025	0
2026	33,333
2027	20,667
Total principal payments	54,000	$ 30,000
Less: Unamortized debt discount and debt issuance costs	(1,289)	(635)
Total long-term debt, net	$ 52,711	$ 29,365

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Other Commitments [Line Items]
Accrued contingent liabilities	$ 0	$ 0
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member]
Other Commitments [Line Items]
Period over which the royalties are payable	3 years	3 years
Notice period for termination of agreement	90 days	90 days
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member] | 10 Years from the First Sale of the Commercial Product [Member]
Other Commitments [Line Items]
Royalty expenses	$ 6,500,000	$ 4,300,000	$ 2,400,000
Royalty as a percentage of net sales for the period	4.60%	4.60%	4.10%
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member] | 10 Years from the First Sale of the Commercial Product [Member] | Maximum [Member]
Other Commitments [Line Items]
Royalty as a percentage of net sales	3%	3%
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member] | 10 Years from the First Sale of the Commercial Product [Member] | Minimum [Member]
Other Commitments [Line Items]
Royalty as a percentage of net sales	0.40%	0.40%

Operating Leases - Additional I

Operating Leases - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Operating Lease, Liability [Abstract]
Operating lease term	10 years
Percentage of construction cost paid as fee to lessor	(1.50%)
Variable lease costs	$ 0.2
Rent expense		$ 0.6	$ 0.2
Operating lease cost	2.3
Cash paid for operating lease liabilities	$ 1.2

Operating Leases - Summary of O

Operating Leases - Summary of Operating Leases (Detail)	Dec. 31, 2022
Operating Lease, Liability [Abstract]
Weighted-average remaining lease term (years)	9 years 1 month 6 days
Weighted average discount rate	9.10%

Operating Leases - Summary of F

Operating Leases - Summary of Future Minimum Lease Payments and Maturity Analysis of Operating Lease Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2022		Dec. 31, 2021
Operating Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]
2022			$ 627
2023	$ 138	[1]	444
2024	2,932		458
2025	1,398	[1]	472
2026	3,338		321
2027	3,097
Thereafter	14,998
Total undiscounted lease payments	25,901		2,322
Less: imputed interest	(10,023)
Total discounted lease payments	15,878
Less: Current portion of lease liability	(339)		0
Noncurrent portion of lease liability	$ 15,539		$ 0
[1] Amount presented is net of allowance for tenant improvements.

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Line Items]
Income tax provision	$ 0	$ 0	$ 0
Valuation allowance offsetting deferred tax assets	22,864,000	11,941,000
Change in the deferred tax asset valuation allowance	$ 10,900,000	6,400,000
Net operating loss carryforwards expiration year	2034
Liability related to uncertain tax positions	$ 0
Research and Development [Member]
Income Tax Disclosure [Line Items]
Tax credit carryforwards	$ 1,000,000	700,000
Tax credit carryforwards expiration year	2037
Federal [Member]
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 71,200,000	35,400,000
State [Member]
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 34,000,000	$ 17,200,000

Income Taxes - Summary of Recon

Income Taxes - Summary of Reconciliation of Statutory Federal Income Tax to Effective Tax (Detail)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Disclosure [Abstract]
Income tax at the statutory rate	(21.00%)	(21.00%)	(21.00%)
Stock-based and other compensation	(5.00%)	(8.00%)	0%
State taxes, net of federal benefit	(1.00%)	(6.00%)	(4.00%)
Research and development credits	(1.00%)	(1.00%)	(4.00%)
Change in valuation allowance	26%	32%	28%
Other	2%	4%	1%
Effective tax rate	0%	0%	0%

Income Taxes - Summary of Tax E

Income Taxes - Summary of Tax Effects of Temporary Differences and Carryforwards to Significant Portions of Deferred Tax Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2022	Dec. 31, 2021
Deferred income tax assets
Net operating loss carryforwards	$ 15,979	$ 8,264
Interest expense	1,785	1,025
Stock option compensation expense	1,590	456
Accrued bonus	1,184	726
Research and development expenses	1,032	717
Research and development credits	954	0
Operating lease liabilities	3,539	0
Other	698	753
Gross deferred income tax assets	26,761	11,941
Less: valuation allowance	(22,864)	(11,941)
Net deferred tax assets	3,897	0
Deferred income tax liabilities
Property and equipment	(1,537)	0
Operating lease right-of-use assets	(2,331)	0
Other	(29)	0
Gross deferred income tax liabilities	(3,897)	0
Net deferred tax liabilities	$ 0	$ 0

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions			1 Months Ended		12 Months Ended
	Apr. 28, 2021	Apr. 27, 2021	Jan. 31, 2023	Apr. 30, 2021	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020	Apr. 21, 2021
Class Of Stock [Line Items]
Preferred shares outstanding					0	0
Preferred shares authorized		5,000,000			5,000,000	5,000,000
Common stock shares authorized		300,000,000			300,000,000	300,000,000
Shares of common stock reserved for issuance					13,549,282	11,745,544
Stock options, weighted-average grant date fair value					$ 7.52	$ 6.19	$ 2.26
Method used to determine the grant date fair value of warrants					Black-Scholes option pricing model	Black-Scholes option pricing model	Black-Scholes option pricing model
Unvested unrecognized stock-based compensation expense					$ 12.8
Grant date fair value of shares vested					$ 5.3	$ 2	$ 0.9
Revolving Credit Facility [Member]
Class Of Stock [Line Items]
Prior business day closing price of share	$ 31.27
IPO [Member]
Class Of Stock [Line Items]
Common stock, shares, issued		6,953,125
2021 Incentive Award Plan [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance					4,769,842	3,766,337		5,046,278
Percentage of shares of stock outstanding on an as converted basis								5%
Shares of stock may be issued upon the exercise								37,847,090
Percentage of incentive stock option granted to stockholder					10%
Stock option, Expiration period					5 years
Vesting period					4 years
2021 Incentive Award Plan [Member] | Maximum [Member]
Class Of Stock [Line Items]
Stock options, Terms					10
Percentage of fair market value of stock options					110%
2021 Incentive Award Plan [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Number of common stock available for issuance increased			2,781,410
2014 Plan [Member]
Class Of Stock [Line Items]
Stock options, Terms					ten years
Vesting period					5 years
Stock Plan grant awards authorized					0
Aggregate intrinsic value of options exercised					$ 25.9	$ 39.1	$ 1.9
Aggregate intrinsic values of options outstanding					98.7
Aggregate intrinsic values of options vest and option exercisable					94.9
Aggregate intrinsic values of options exercisable					$ 69.6
Restricted Stock
Class Of Stock [Line Items]
Vesting period					4 years
Shares granted							0
Shares outstanding					12,800	19,023	0
Weighted average grant-date fair value					$ 31.50	$ 31.50
Weighted-average period of recognition					3 years 3 months 18 days
Unvested unrecognized stock-based compensation expense, Other than options					$ 7.8
Restricted Stock Units [Member]
Class Of Stock [Line Items]
Vesting period					4 years
Shares granted					592,778		0
Shares outstanding					582,248	10,000	0
Weighted average grant-date fair value					$ 19.08	$ 22.13
Weighted-average period of recognition					3 years 3 months 18 days
Unvested unrecognized stock-based compensation expense, Other than options					$ 7.8
Employee Share Purchase Plan [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance								504,627
Maximum subscription rate					15%
Common stock, Price per share percentage					85%
Employee Share Purchase Plan [Member] | Maximum [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance								7,064,790
Employee Share Purchase Plan [Member] | Subsequent Event [Member] | Maximum [Member]
Class Of Stock [Line Items]
Number of common stock available for issuance increased			1,602,719
Employee Share Purchase Plan [Member] | Subsequent Event [Member] | Minimum [Member]
Class Of Stock [Line Items]
Number of common stock available for issuance increased			556,282
2021 ESPP [Member]
Class Of Stock [Line Items]
Increase in shares of common stock reserved for issuance period					10 years
2021 ESPP [Member] | Maximum [Member]
Class Of Stock [Line Items]
Number of shares of common stock reserved increase percentage by annual of common stock outstanding					1%
Employee Stock Option [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance					7,150,755	7,464,580
Weighted-average period of recognition					2 years 3 months 18 days
Common Stock [Member]
Class Of Stock [Line Items]
Common stock, shares, issued						6,953,125
Common Stock [Member] | Revolving Credit Facility [Member] | Warrant [Member]
Class Of Stock [Line Items]
Number of shares issued for conversion of warrants	621,570
Common Stock [Member] | IPO [Member]
Class Of Stock [Line Items]
Common stock, shares, issued				158,447
Series A Convertible Preferred Stock [Member]
Class Of Stock [Line Items]
Preferred shares outstanding					0	0
Preferred shares dividends unpaid					$ 2.5		$ 2.3

Stockholders' Equity - Summary

Stockholders' Equity - Summary of the Company had Reserved Shares of Common Stock for Future Issuances (Detail) - shares	Dec. 31, 2022	Dec. 31, 2021	Apr. 21, 2021
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	13,549,282	11,745,544
Common stock options issued and outstanding [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	7,150,755	7,464,580
2021 Incentive Award Plan [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	4,769,842	3,766,337	5,046,278
Unvested restricted stock units under 2021 Plan [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	582,248	10,000
Common stock available for Employee Stock Purchase Plan [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	1,046,437	504,627

Stockholders' Equity - Summar_2

Stockholders' Equity - Summary of Stock Option Activity under Stock Plans (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares Outstanding Options of Beginning Balance	7,464,580
Number of Shares Outstanding of Option Granted	1,346,553
Number of Shares Outstanding of Options Exercised	(1,444,626)
Number of Shares Outstanding of Options Canceled	(215,752)
Number of Shares Outstanding of Ending Balance	7,150,755	7,464,580
Number of Shares Options vested and expected to vest at December 31, 2022	6,608,140
Number of Shares Options vested and exercisable at December 31, 2022	3,728,683
Outstanding Options Weighted-Average Remaining Contractual Term	7 years 10 days	6 years 10 months 20 days
Options vested and expected to vest at December 31, 2022	6 years 10 months 24 days
Options vested and exercisable at December 31, 2022	5 years 9 months 14 days
Weighted-Average Exercise Price Beginning Balance	$ 6.36
Weighted-Average Exercise Price, Options granted	19.39
Weighted-Average Exercise Price, Options exercised	1.50
Weighted-Average Exercise Price, Options canceled	13.82
Weighted-Average Exercise Price, Ending Balance	9.57	$ 6.36
Weighted-Average Exercise Price, Options vested and expected to vest at December 31, 2022	8.97
Weighted-Average Exercise Price, Options vested and exercisable at December 31, 2022	$ 4.50

Stockholders' Equity - Summar_3

Stockholders' Equity - Summary of Full Value Award Activity Under Stock Plans (Detail) - $ / shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2020
Restricted Stock Units (RSUs) [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unvested, Number of shares outstanding, Beginning Balance	10,000
Unvested, Number of shares or units granted	592,778	0
Unvested, Number of shares or units vested	(2,500)
Unvested, Number of shares or units forfeited	(18,030)
Unvested, Number of shares outstanding, Ending Balance	582,248	0
Unvested, Weighted Average Grant Date Fair Value, Beginning Balance	$ 22.13
Unvested, Weighted Average Grant Date Fair ValueWeighted Average, Shares or units granted	19.04
Unvested, Weighted-Average Grant Date Fair Value, Shares or units vested	22.13
Unvested, Weighted-Average Grant Date Fair Value, Shares or units forfeited	18.92
Unvested, Weighted Average Grant Date Fair Value, Ending Balance	$ 19.08
Restricted Stock [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unvested, Number of shares outstanding, Beginning Balance	19,023
Unvested, Number of shares or units granted		0
Unvested, Number of shares or units vested	(6,223)
Unvested, Number of shares outstanding, Ending Balance	12,800	0
Unvested, Weighted Average Grant Date Fair Value, Beginning Balance	$ 31.50
Unvested, Weighted-Average Grant Date Fair Value, Shares or units vested	31.50
Unvested, Weighted Average Grant Date Fair Value, Ending Balance	$ 31.50

Stockholders' Equity - Summar_4

Stockholders' Equity - Summary of Company uses the Black-Scholes Option Pricing Model to Determine the Fair Value of Stock Options at the Grant (Detail)	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)	6 years 3 months
Expected volatility (Minimum)	36.05%	35.57%	37.09%
Expected volatility (Maximum)	37.08%	55.60%	51.29%
Risk-free interest rate (Minimum)	1.64%	0.08%	0.18%
Risk-free interest rate (Maximum)	4.34%	1.39%	1.53%
Expected dividend yield	0%	0%	0%
Minimum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)		2 years 1 month 6 days	2 years 8 months 12 days
Maximum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)		6 years 3 months	3 years 3 months 18 days

Stockholders' Equity - Summar_5

Stockholders' Equity - Summary of Share-Based Compensation Expense is Reflected in the Statements of Operations and Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	$ 8,111	$ 3,409	$ 919
Sales and marketing expenses [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	2,928	1,231	479
Research and development expenses [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	697	475	199
General and administrative expenses [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	$ 4,486	$ 1,703	$ 241

Employee Benefit Plan - Additio

Employee Benefit Plan - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021
Defined Contribution Plan Disclosure [Line Items]
Defined contribution plan, percent of match	100%
Employees matching pre tax salary contribution percent	3%
Employees matching additional contribution percent	50%
Employees pre tax salary maximum matching contribution percent	5%
Elective deferrals and matching contributions eligibility period	3 months
Employer profit sharing contributions eligibility service period	1 year
Description of employee contributions to 401(K) plan	Effective as of January 2021, the Company began sponsoring a 401(k) profit sharing plan trust for its employees who satisfy certain eligibility requirements. An employee will be eligible to become a participant in the plan for purposes of (i) elective deferrals and matching contributions after completing 3 consecutive months of service beginning on the employee’s date of hire and (ii) employer profit sharing contributions after completing 1 year of service.
Participants vest matching contributions period	90 days
Contribution to retirement plans	$ 1	$ 0.7
Minimum [Member]
Defined Contribution Plan Disclosure [Line Items]
Graded vesting schedule period	1 year
Maximum [Member]
Defined Contribution Plan Disclosure [Line Items]
Graded vesting schedule period	6 years

Net Loss Per Share Attributab_3

Net Loss Per Share Attributable to Common Stockholders - Schedule of Net Loss Per Share Attributable to Common Stockholders, Basic and Diluted (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Numerator
Net loss	$ (42,815)	$ (20,552)	$ (3,668)
Adjust: Convertible preferred stock cumulative and undeclared dividends	0	(196)	(640)
Net loss attributable to common stockholders	$ (42,815)	$ (20,748)	$ (4,308)
Denominator
Weighted-average common stock outstanding, basic	55,276,834	48,415,679	37,068,965
Weighted-average common stock outstanding, diluted	55,276,834	48,415,679	37,068,965
Net loss per share attributable to common stockholders, basic	$ (0.77)	$ (0.43)	$ (0.12)
Net loss per share attributable to common stockholders, diluted	$ (0.77)	$ (0.43)	$ (0.12)

Net Loss Per Share Attributab_4

Net Loss Per Share Attributable to Common Stockholders - Summary of Potentially Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares Outstanding (Detail) - shares	12 Months Ended
	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	7,745,803	7,493,604	15,482,633
Series A Convertible Preferred Stock Outstanding [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding			6,687,475
Warrants to Purchase Class A Common Stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding			713,330
Common Stock Options Issued and Outstanding [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	7,150,755	7,464,580	8,081,828
Unvested Full Value Awards [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	595,048	29,024

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) - USD ($)		12 Months Ended
	Feb. 10, 2023	Dec. 31, 2022
Subsequent Event [Line Items]
Offering expenses		$ 10,600,000
Subsequent Event [Member] | Public Offering [Member]
Subsequent Event [Line Items]
Common stock, shares, issued	5,476,190
Share Price	$ 21
Proceeds from issuance of stock	$ 107,500
Underwriting discounts and commissions	6,900,000
Offering expenses	$ 600,000