Cover Page
Cover Page - shares | 3 Months Ended | |
Mar. 31, 2023 | May 01, 2023 | |
Cover [Abstract] | ||
Document Type | 10-Q | |
Amendment Flag | false | |
Document Period End Date | Mar. 31, 2023 | |
Document Fiscal Year Focus | 2023 | |
Document Fiscal Period Focus | Q1 | |
Document Quarterly 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, $0.001 par value | |
Trading Symbol | TMCI | |
Security Exchange Name | NASDAQ | |
Entity Common Stock, Shares Outstanding | 61,331,465 |
Condensed Balance Sheets
Condensed Balance Sheets - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Current assets | ||
Cash and cash equivalents | $ 29,613 | $ 19,473 |
Marketable securities, short-term | 141,049 | 61,779 |
Accounts receivable | 25,365 | 29,196 |
Inventories | 22,519 | 19,330 |
Prepaid expenses and other current assets | 4,587 | 3,624 |
Total current assets | 223,133 | 133,402 |
Property and equipment, net | 15,915 | 15,338 |
Operating lease right-of-use assets | 9,907 | 10,138 |
Other non-current assets | 215 | 146 |
Total assets | 249,170 | 159,024 |
Current liabilities | ||
Accounts payable | 5,076 | 8,668 |
Accrued liabilities | 7,971 | 6,216 |
Accrued commissions | 5,891 | 7,356 |
Accrued compensation | 3,300 | 7,666 |
Operating lease and other liabilities | 1,058 | 339 |
Total current liabilities | 23,296 | 30,245 |
Long-term debt | 52,785 | 52,711 |
Operating lease liabilities, net of current portion | 15,447 | 15,539 |
Other long-term liabilities | 25 | 0 |
Total liabilities | 91,553 | 98,495 |
Commitments and contingencies (Note 7) | ||
Stockholders’ equity | ||
Preferred stock, value | 0 | 0 |
Common stock, value | 61 | 55 |
Additional paid-in capital | 255,786 | 145,221 |
Accumulated deficit | (98,174) | (84,720) |
Accumulated other comprehensive (loss) income | (56) | (27) |
Total stockholders’ equity | 157,617 | 60,529 |
Total liabilities and stockholders’ equity | $ 249,170 | $ 159,024 |
Condensed Balance Sheets (Paren
Condensed Balance Sheets (Parenthetical) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Allowance for doubtful accounts receivable current | $ 677 | $ 735 |
Long term debt unamortized debt discount and issuance costs | $ 1,215 | $ 1,289 |
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 | 61,280,703 | 55,628,208 |
Common stock share outstanding | 61,280,703 | 55,628,208 |
Condensed Statement of Operatio
Condensed Statement of Operations and Comprehensive Loss - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Income Statement [Abstract] | ||
Revenue | $ 42,195 | $ 29,047 |
Cost of goods sold | 8,039 | 5,130 |
Gross profit | 34,156 | 23,917 |
Operating expenses | ||
Sales and marketing | 33,655 | 22,299 |
Research and development | 3,412 | 3,052 |
General and administrative | 10,865 | 6,662 |
Total operating expenses | 47,932 | 32,013 |
Loss from operations | (13,776) | (8,096) |
Interest income | 1,479 | 9 |
Interest expense | (1,285) | (951) |
Other income, net | 128 | 2 |
Other non-operating income (expense), net | 322 | (940) |
Net loss | (13,454) | (9,036) |
Unrealized losses on marketable securities | (29) | 0 |
Comprehensive loss | $ (13,483) | $ (9,036) |
Net loss per share attributable to common stockholders, basic | $ (0.23) | $ (0.16) |
Net loss per share attributable to common stockholders, diluted | $ (0.23) | $ (0.16) |
Weighted-average common stock outstanding, basic | 58,723,760 | 54,827,665 |
Weighted-average common stock outstanding, diluted | 58,723,760 | 54,827,665 |
Condensed Statement of Stockhol
Condensed Statement of Stockholders' Equity - USD ($) $ in Thousands | Total | Common Stock [Member] | Additional Paid-in Capital [Member] | Accumulated Deficit [Member] | Accumulated Other Comprehensive Income [Member] |
Balance at Beginning at Dec. 31, 2021 | $ 93,073 | $ 45 | $ 134,933 | $ (41,905) | $ 0 |
Balance at Beginning (in Shares) at Dec. 31, 2021 | 54,181,082 | ||||
Issuance of common stock upon exercise of stock options | 1,372 | $ 1 | 1,371 | ||
Issuance of common stock upon exercise of stock options, shares | 1,097,860 | ||||
Share-based compensation expense | 1,409 | 1,409 | |||
Net loss | (9,036) | (9,036) | |||
Balance at Ending at Mar. 31, 2022 | 86,818 | $ 46 | 137,713 | (50,941) | 0 |
Balance at Ending (in Shares) at Mar. 31, 2022 | 55,278,942 | ||||
Balance at Beginning at Dec. 31, 2022 | 60,529 | $ 55 | 145,221 | (84,720) | (27) |
Balance at Beginning (in Shares) at Dec. 31, 2022 | 55,628,208 | ||||
Issuance of common stock upon exercise of stock options | 352 | 352 | |||
Issuance of common stock upon exercise of stock options, shares | 125,890 | ||||
Issuance of common stock for vesting of restricted stock units | 50,415 | ||||
Share-based compensation expense | 2,692 | 2,692 | |||
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount of $7.5 million | 107,527 | $ 6 | 107,521 | ||
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount of $7.5 million, shares | 5,476,190 | ||||
Net loss | (13,454) | (13,454) | |||
Unrealized loss on available-for-sale marketable securities | (29) | (29) | |||
Balance at Ending at Mar. 31, 2023 | $ 157,617 | $ 61 | $ 255,786 | $ (98,174) | $ (56) |
Balance at Ending (in Shares) at Mar. 31, 2023 | 61,280,703 |
Condensed Statement of Stockh_2
Condensed Statement of Stockholders' Equity (Parenthetical) $ in Millions | 3 Months Ended |
Mar. 31, 2023 USD ($) | |
Statement of Stockholders' Equity [Abstract] | |
Issuance cost and underwriting discount | $ 7.5 |
Condensed Statements of Cash Fl
Condensed Statements of Cash Flows - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Cash flows from operating activities | ||
Net loss | $ (13,454) | $ (9,036) |
Adjustments to reconcile net loss to net cash used in operating activities | ||
Depreciation and amortization expense | 924 | 334 |
Provision for allowance for doubtful accounts | 38 | 30 |
Share-based compensation expense | 2,692 | 1,409 |
Non-Cash Lease Expense | 626 | 336 |
Amortization of debt issuance costs | 74 | 45 |
Recovery of loss reserve for surgical instruments | (23) | 0 |
Gain on fair value adjustment to derivative liability | 0 | (90) |
Accretion (amortization) of discount (premium) on marketable securities, net | (297) | 0 |
Net changes in operating assets and liabilities: | ||
Accounts Receivable | 3,793 | 2,542 |
Inventory | (3,189) | (551) |
Prepaid expenses and other assets | (963) | 1,233 |
Other non-current assets | 69 | 134 |
Payable to broker for unsettled marketable security purchases | 710 | 0 |
Operating lease liabilities | (478) | (133) |
Accounts payable | (3,592) | (607) |
Accrued liabilities | (4,076) | (2,619) |
Other, net | 25 | 0 |
Net cash used in operating activities | (17,259) | (7,241) |
Cash flows from investing activities | ||
Purchases of available-for-sale marketable securities | (99,550) | 0 |
Maturities of available-for-sale marketable securities | 20,548 | 0 |
Purchases of property and equipment | (1,478) | (1,481) |
Net cash used in investing activities | (80,480) | (1,481) |
Cash flows from financing activities | ||
Proceeds from issuance of common stock upon initial public offering, net of issuance costs and underwriting fees of $0.6 million | 107,527 | 0 |
Proceeds from exercise of employee stock options | 352 | 1,372 |
Net cash provided by financing activities | 107,879 | 1,372 |
Net (decrease) increase in cash and cash equivalents | 10,140 | (7,350) |
Cash and cash equivalents at beginning of period | 19,473 | 105,833 |
Cash and cash equivalents at end of period | 29,613 | 98,483 |
Supplemental disclosure of cash flow information: | ||
Cash paid for interest | 1,285 | 951 |
Operating lease right-of-use assets obtained in exchange for new lease liabilities | 0 | 15,300 |
Operating lease right-of-use asset and lease liability adjustment due to lease incentive | (35) | 0 |
Unrealized losses on marketable securities | $ 29 | $ 0 |
Condensed Statements of Cash _2
Condensed Statements of Cash Flows (Parenthetical) - USD ($) | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Statement of Cash Flows [Abstract] | ||
Issuance costs and underwriting fees, net | $ 7,500 | $ 7,500 |
Formation and Business of the C
Formation and Business of the Company | 3 Months Ended |
Mar. 31, 2023 | |
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 and Follow-on Offering On April 27, 2021, the Company completed its initial public offering ("IPO). The Company received net proceeds of $ 107.6 million from the IPO. On February 10, 2023, the Company completed a follow-on 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. The February 2023 offering resulted in net proceeds of $ 107.5 million after deducting underwriting discounts and commissions of $ 6.9 million and offering expenses payable by the Company of $ 0.6 million. Liquidity and Capital Resources The Company has incurred operating losses to date and has an accumulated deficit of $ 98.2 million as of March 31, 2023. During the three months ended March 31, 2023 and 2022 , the Company used $ 17.3 million and $ 7.2 million of cash in its operating activities, respectively. As of March 31, 2023, the Company had cash and cash equivalents of $ 29.6 million and marketable securities available-for-sale of $ 141.0 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 interim condensed financial statements. |
Summary of Significant Accounti
Summary of Significant Accounting Policies | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Summary of Significant Accounting Policies | 2. Summary of Significant Accounting Policies The Company prepared the unaudited interim condensed financial statements included in this report in accordance with U.S. generally accepted accounting principles ("GAAP") for interim financial information and the rules and regulations of the Securities and Exchange Commission related to quarterly reports on Form 10-Q. Basis of Presentation The condensed financial statements have been prepared on the same basis as the Company’s annual financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, filed with the SEC on March 8, 2023, with the exception of the reclassification as discussed below. The unaudited condensed financial statements included herein reflect all adjustments, including normal recurring adjustments, which are, in the opinion of management, necessary for a fair presentation of the financial position, results of operations and cash flows for the periods presented. The results of operations for the three months ended March 31, 2023 are not necessarily indicative of the results that may be expected for future quarters or for the fiscal year ending December 31, 2023. An adjustment has been made to the Statement of Operations for the three months ended March 31, 2022 for $ 0.4 million to reclassify surgical instrument expense from cost of goods sold to sales and marketing expense, to conform with the current year's presentation. This reclassification had no effect on the Company's net loss. Any reference in these notes to applicable guidance is meant to refer to the authoritative GAAP as found in the Accounting Standards Codification (“ASC” ) and Accounting Standards Updates (“ASU”) of the Financial Accounting Standards Board (“FASB”). Use of Estimates The preparation of condensed 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 condensed financial statements and the reported amounts of revenues and expenses during the reporting periods. 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, stock-based compensation, deferred tax assets and related valuation allowances and impact of contingencies. The Company had no accrued contingent liabilities as of March 31, 2023 and December 31, 2022 . 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 and cash equivalents balances 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. If any of the financial institutions where we hold deposits were to fail or be taken over by the FDIC, such as the recent takeover of Silicon Valley Bank, where we did hold cash as deposits, our access to these accounts could be temporarily unavailable or permanently lost for the amounts in excess of the FDIC insured limits. The Company did no t have material cash deposits at Silicon Valley bank at the time of the FDIC takeover or as of March 31, 2023. 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. On March 31, 2023 and December 31, 2022 , no customer accounted for more than 10 % of accounts receivable. For the three months ended March 31, 2023 and 2022 , there were no customers that represented 10 % or more of revenue. |
Recent Accounting Pronouncement
Recent Accounting Pronouncements | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Standards Update and Change in Accounting Principle [Abstract] | |
Recent Accounting Pronouncements | 3. Recent Accounting Pronouncements Recently Adopted Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses . This guidance requires financial instruments measured at amortized cost, and trade accounts receivable to be presented at the net amount expected to be collected. The model requires an entity to estimate credit losses based on historical information, current conditions and reasonable and supportable forecasts of future economic conditions. In November 2019, the FASB issued ASU 2019-10, which provides that this standard is effective for the Company for fiscal years beginning after December 15, 2022, and interim periods within that fiscal year. The Company adopted the new standard as of January 1, 2023. Adoption of the standard did not have a material impact on our financial position, results of operations, or our disclosures. |
Fair Value Measurements
Fair Value Measurements | 3 Months Ended |
Mar. 31, 2023 | |
Fair Value Disclosures [Abstract] | |
Fair Value Measurements | 4. Fair Value Measurements Assets and liabilities recorded at fair value in the condensed 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 March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 12,289 $ — $ — $ 12,289 Commercial paper — 998 — 998 Corporate debt — 8,358 — 8,358 Yankee CD — 4,502 — 4,502 Short-term marketable securities at fair value U.S. treasury and government agencies 33,544 23,221 — 56,765 Commercial paper — 2,550 — 2,550 Corporate debt — 33,570 — 33,570 Asset-backed securities — 29,845 — 29,845 Yankee CD — 18,319 — 18,319 Total $ 45,833 $ 121,363 $ — $ 167,196 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 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. 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 fair value. There were no assets or liabilities measured at fair value on a nonrecurring basis as of March 31, 2023 and December 31, 2022 . |
Balance Sheet Components
Balance Sheet Components | 3 Months Ended |
Mar. 31, 2023 | |
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): March 31, December 31, 2023 2022 Cash $ 3,466 $ 3,262 Cash equivalents: Money market funds 12,289 13,141 Commercial paper 998 323 Corporate debt 8,358 2,197 Yankee CD 4,502 550 Total cash and cash equivalents $ 29,613 $ 19,473 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 March 31, 2023. Marketable Securities The Company's available-for-sale marketable securities consisted of the following (in thousands): March 31, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 56,730 $ 54 $ ( 19 ) $ 56,765 Commercial paper 2,550 1 ( 1 ) 2,550 Corporate debt 33,651 10 ( 91 ) 33,570 Asset-backed securities 29,854 17 ( 26 ) 29,845 Yankee CD 18,320 4 ( 5 ) 18,319 Total marketable securities - short-term $ 141,105 $ 86 $ ( 142 ) $ 141,049 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): March 31, December 31, 2023 2022 Furniture and fixtures, and equipment $ 1,577 $ 1,577 Construction in progress 671 705 Machinery and equipment 1,729 928 Capitalized surgical equipment 9,886 9,248 Computer equipment 639 571 Leasehold improvements 6,351 6,434 Software 138 138 Total property and equipment 20,991 19,601 Less: accumulated depreciation and amortization ( 5,076 ) ( 4,263 ) Property and equipment, net $ 15,915 $ 15,338 Depreciation and amortization expense on property and equipment were $ 0.9 million and $ 0.3 million f or the three months ended March 31, 2023 and 2022, respectively. Accrued liabilities Accrued liabilities consist of the following (in thousands): March 31, December 31, 2023 2022 Accrued royalties expense $ 1,827 $ 2,299 Accrued interest 412 412 Accrued professional services 2,083 1,727 Other accrued expense 3,649 1,778 Total accrued liabilities $ 7,971 $ 6,216 Operating lease and other liabilities The Company's current operating lease liability and other liabilities consisted of the following (in thousands): March 31, December 31, 2023 2022 Current portion of operating lease liabilities $ 348 $ 339 Payable to broker 710 — Total operating lease and other liabilities $ 1,058 $ 339 The Company's available for sale securities are accounted for on a trade date basis. Purchases of securities that have traded but not settled as of the balance sheet date are recorded as either cash and cash equivalents or marketable securities with a corresponding amount payable to broker as noted above. These investment transactions normally settle in one to three days. |
Long Term Debt
Long Term Debt | 3 Months Ended |
Mar. 31, 2023 | |
Debt Disclosure [Abstract] | |
Long Term Debt | 6. Long-Term Debt The Company’s long-term debt consisted of the following (in thousands): March 31, December 31, 2023 2022 Revolving line of credit MidCap revolving loan facility $ 4,000 $ 4,000 Term loans MidCap term loan facility 50,000 50,000 Total term and revolving loans 54,000 54,000 Less: debt discount and issuance costs ( 1,215 ) ( 1,289 ) Total long-term debt, net $ 52,785 $ 52,711 As of March 31, 2023, 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 ( 1,215 ) Total long-term debt, net $ 52,785 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 loan facility 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 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 tranches. 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. On March 31, 2023, the borrowing base allows a total of $ 21.5 million available to the Company under the revolving loan facility. The balance drawn as of March 31, 2023 is $ 4.0 million under the revolving loan facility. The Company may request an increase in the revolving loan facility 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 March 31, 2023, 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 March 31, 2023 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 substantially all of the Company’s assets, including intellectual property. The loan agreements and other ancillary 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 on March 31, 2023. |
Commitments and Contingencies
Commitments and Contingencies | 3 Months Ended |
Mar. 31, 2023 | |
Commitments and Contingencies Disclosure [Abstract] | |
Commitments and Contingencies | 7. Commitments and Contingencies License and Royalty Commitments As of March 31, 2023 and December 31, 2022, the Company has royalty agreements with certain members of its surgeon advisory board. The Company recognized royalty expense under these agreements of $ 1.6 million and $ 1.4 million for the three months ended March 31, 2023 and 2022, respectively. For the three months ended March 31, 2023 and 2022, the aggregate royalty rates were 3.9 % and 4.8 % 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 March 31, 2023 and December 31, 2022 . |
Stockholders' Equity
Stockholders' Equity | 3 Months Ended |
Mar. 31, 2023 | |
Stockholders' Equity Note [Abstract] | |
Stockholders' Equity | 8. Stockholders’ Equity Stock Option Plans During the three months ended March 31, 2023 and 2022, the Company granted stock options to employees to purchase an aggregate of 727,650 and 963,800 shares of the Company’s common stock, respectively. The weighted-average grant-date fair value of the employee stock options granted during the three months ended March 31, 2023 and 2022 was $ 10.58 and $ 7.50 per share, respectively. Restricted Stock Units During the three months ended March 31, 2023 and 2022, the Company granted 571,565 and 201,580 restricted st ock units (“RSUs”), respectively. The weighted average grant-date fair value of RSUs granted during the three months ended March 31, 2023 and 2022 was $ 24.07 and $ 20.13 , respectively. Share-Based Compensation Expense Share-based compensation expense is reflected in operating expenses in the condensed statements of operations and comprehensive loss as follows (in thousands): Three Months Ended March 31, 2023 2022 Cost of goods sold $ 76 $ — Sales and marketing expense 822 531 Research and development expense 257 150 General and administrative expense 1,537 728 Total $ 2,692 $ 1,409 |
Net Loss Per Share Attributable
Net Loss Per Share Attributable to Common Stockholders | 3 Months Ended |
Mar. 31, 2023 | |
Earnings Per Share [Abstract] | |
Net Loss Per Share Attributable to Common Stockholders | 9. 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 three months ended March 31, 2023 and 2022, 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): Three Months Ended March 31, 2023 2022 Numerator Net loss $ ( 13,454 ) $ ( 9,036 ) Denominator Weighted-average common stock outstanding, 58,723,760 54,827,665 Net loss per share attributable to common $ ( 0.23 ) $ ( 0.16 ) 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: As of March 31, 2023 2022 Common stock options issued and outstanding 7,717,414 7,205,037 Unvested full value awards 1,086,697 211,580 Total 8,804,111 7,416,617 |
Summary of Significant Accoun_2
Summary of Significant Accounting Policies (Policies) | 3 Months Ended |
Mar. 31, 2023 | |
Accounting Policies [Abstract] | |
Basis of Presentation | Basis of Presentation The condensed financial statements have been prepared on the same basis as the Company’s annual financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022, filed with the SEC on March 8, 2023, with the exception of the reclassification as discussed below. The unaudited condensed financial statements included herein reflect all adjustments, including normal recurring adjustments, which are, in the opinion of management, necessary for a fair presentation of the financial position, results of operations and cash flows for the periods presented. The results of operations for the three months ended March 31, 2023 are not necessarily indicative of the results that may be expected for future quarters or for the fiscal year ending December 31, 2023. An adjustment has been made to the Statement of Operations for the three months ended March 31, 2022 for $ 0.4 million to reclassify surgical instrument expense from cost of goods sold to sales and marketing expense, to conform with the current year's presentation. This reclassification had no effect on the Company's net loss. Any reference in these notes to applicable guidance is meant to refer to the authoritative GAAP as found in the Accounting Standards Codification (“ASC” ) and Accounting Standards Updates (“ASU”) of the Financial Accounting Standards Board (“FASB”). |
Use of Estimates | Use of Estimates The preparation of condensed 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 condensed financial statements and the reported amounts of revenues and expenses during the reporting periods. 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, stock-based compensation, deferred tax assets and related valuation allowances and impact of contingencies. The Company had no accrued contingent liabilities as of March 31, 2023 and December 31, 2022 . |
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 and cash equivalents balances 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. If any of the financial institutions where we hold deposits were to fail or be taken over by the FDIC, such as the recent takeover of Silicon Valley Bank, where we did hold cash as deposits, our access to these accounts could be temporarily unavailable or permanently lost for the amounts in excess of the FDIC insured limits. The Company did no t have material cash deposits at Silicon Valley bank at the time of the FDIC takeover or as of March 31, 2023. 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. On March 31, 2023 and December 31, 2022 , no customer accounted for more than 10 % of accounts receivable. For the three months ended March 31, 2023 and 2022 , there were no customers that represented 10 % or more of revenue. |
Fair Value Measurements (Tables
Fair Value Measurements (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
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 March 31, 2023 and December 31, 2022 (in thousands): March 31, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 12,289 $ — $ — $ 12,289 Commercial paper — 998 — 998 Corporate debt — 8,358 — 8,358 Yankee CD — 4,502 — 4,502 Short-term marketable securities at fair value U.S. treasury and government agencies 33,544 23,221 — 56,765 Commercial paper — 2,550 — 2,550 Corporate debt — 33,570 — 33,570 Asset-backed securities — 29,845 — 29,845 Yankee CD — 18,319 — 18,319 Total $ 45,833 $ 121,363 $ — $ 167,196 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 |
Balance Sheet Components (Table
Balance Sheet Components (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Balance Sheet Related Disclosures [Abstract] | |
Summary of Cash and Cash Equivalents | The Company’s cash and cash equivalents consisted of the following (in thousands): March 31, December 31, 2023 2022 Cash $ 3,466 $ 3,262 Cash equivalents: Money market funds 12,289 13,141 Commercial paper 998 323 Corporate debt 8,358 2,197 Yankee CD 4,502 550 Total cash and cash equivalents $ 29,613 $ 19,473 |
Summary of Property and Equipment, Net | The Company’s property and equipment, net consisted of the following (in thousands): March 31, December 31, 2023 2022 Furniture and fixtures, and equipment $ 1,577 $ 1,577 Construction in progress 671 705 Machinery and equipment 1,729 928 Capitalized surgical equipment 9,886 9,248 Computer equipment 639 571 Leasehold improvements 6,351 6,434 Software 138 138 Total property and equipment 20,991 19,601 Less: accumulated depreciation and amortization ( 5,076 ) ( 4,263 ) Property and equipment, net $ 15,915 $ 15,338 |
Summary of Accrued Liabilities | Accrued liabilities consist of the following (in thousands): March 31, December 31, 2023 2022 Accrued royalties expense $ 1,827 $ 2,299 Accrued interest 412 412 Accrued professional services 2,083 1,727 Other accrued expense 3,649 1,778 Total accrued liabilities $ 7,971 $ 6,216 |
Schedule of Current Operating lease liability and Other liabilities | The Company's current operating lease liability and other liabilities consisted of the following (in thousands): March 31, December 31, 2023 2022 Current portion of operating lease liabilities $ 348 $ 339 Payable to broker 710 — Total operating lease and other liabilities $ 1,058 $ 339 |
Long Term Debt (Tables)
Long Term Debt (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Debt Disclosure [Abstract] | |
Summary of Long-term Debt Instruments | The Company’s long-term debt consisted of the following (in thousands): March 31, December 31, 2023 2022 Revolving line of credit MidCap revolving loan facility $ 4,000 $ 4,000 Term loans MidCap term loan facility 50,000 50,000 Total term and revolving loans 54,000 54,000 Less: debt discount and issuance costs ( 1,215 ) ( 1,289 ) Total long-term debt, net $ 52,785 $ 52,711 |
Summary of Maturities of Long-term Debt | As of March 31, 2023, 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 ( 1,215 ) Total long-term debt, net $ 52,785 MidCap Loan and Revolving Loan Facility |
Operating Leases (Tables)
Operating Leases (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Operating Lease, Liability [Abstract] | |
Summary of Available-For-Sale Marketable Securities | The Company's available-for-sale marketable securities consisted of the following (in thousands): March 31, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 56,730 $ 54 $ ( 19 ) $ 56,765 Commercial paper 2,550 1 ( 1 ) 2,550 Corporate debt 33,651 10 ( 91 ) 33,570 Asset-backed securities 29,854 17 ( 26 ) 29,845 Yankee CD 18,320 4 ( 5 ) 18,319 Total marketable securities - short-term $ 141,105 $ 86 $ ( 142 ) $ 141,049 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 |
Balance Sheet Components | 5. Balance Sheet Components Cash and Cash Equivalents The Company’s cash and cash equivalents consisted of the following (in thousands): March 31, December 31, 2023 2022 Cash $ 3,466 $ 3,262 Cash equivalents: Money market funds 12,289 13,141 Commercial paper 998 323 Corporate debt 8,358 2,197 Yankee CD 4,502 550 Total cash and cash equivalents $ 29,613 $ 19,473 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 March 31, 2023. Marketable Securities The Company's available-for-sale marketable securities consisted of the following (in thousands): March 31, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 56,730 $ 54 $ ( 19 ) $ 56,765 Commercial paper 2,550 1 ( 1 ) 2,550 Corporate debt 33,651 10 ( 91 ) 33,570 Asset-backed securities 29,854 17 ( 26 ) 29,845 Yankee CD 18,320 4 ( 5 ) 18,319 Total marketable securities - short-term $ 141,105 $ 86 $ ( 142 ) $ 141,049 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): March 31, December 31, 2023 2022 Furniture and fixtures, and equipment $ 1,577 $ 1,577 Construction in progress 671 705 Machinery and equipment 1,729 928 Capitalized surgical equipment 9,886 9,248 Computer equipment 639 571 Leasehold improvements 6,351 6,434 Software 138 138 Total property and equipment 20,991 19,601 Less: accumulated depreciation and amortization ( 5,076 ) ( 4,263 ) Property and equipment, net $ 15,915 $ 15,338 Depreciation and amortization expense on property and equipment were $ 0.9 million and $ 0.3 million f or the three months ended March 31, 2023 and 2022, respectively. Accrued liabilities Accrued liabilities consist of the following (in thousands): March 31, December 31, 2023 2022 Accrued royalties expense $ 1,827 $ 2,299 Accrued interest 412 412 Accrued professional services 2,083 1,727 Other accrued expense 3,649 1,778 Total accrued liabilities $ 7,971 $ 6,216 Operating lease and other liabilities The Company's current operating lease liability and other liabilities consisted of the following (in thousands): March 31, December 31, 2023 2022 Current portion of operating lease liabilities $ 348 $ 339 Payable to broker 710 — Total operating lease and other liabilities $ 1,058 $ 339 The Company's available for sale securities are accounted for on a trade date basis. Purchases of securities that have traded but not settled as of the balance sheet date are recorded as either cash and cash equivalents or marketable securities with a corresponding amount payable to broker as noted above. These investment transactions normally settle in one to three days. |
Stockholders' Equity (Tables)
Stockholders' Equity (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
Stockholders' Equity Note [Abstract] | |
Summary of Share-Based Compensation Expense is Reflected in operating expense in the Condensed Statements of Operations and Comprehensive Loss | Share-based compensation expense is reflected in operating expenses in the condensed statements of operations and comprehensive loss as follows (in thousands): Three Months Ended March 31, 2023 2022 Cost of goods sold $ 76 $ — Sales and marketing expense 822 531 Research and development expense 257 150 General and administrative expense 1,537 728 Total $ 2,692 $ 1,409 |
Net Loss Per Share Attributab_2
Net Loss Per Share Attributable to Common Stockholders (Tables) | 3 Months Ended |
Mar. 31, 2023 | |
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 three months ended March 31, 2023 and 2022, 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): Three Months Ended March 31, 2023 2022 Numerator Net loss $ ( 13,454 ) $ ( 9,036 ) Denominator Weighted-average common stock outstanding, 58,723,760 54,827,665 Net loss per share attributable to common $ ( 0.23 ) $ ( 0.16 ) |
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: As of March 31, 2023 2022 Common stock options issued and outstanding 7,717,414 7,205,037 Unvested full value awards 1,086,697 211,580 Total 8,804,111 7,416,617 |
Formation and Business of the_2
Formation and Business of the Company - Additional Information (Detail) - USD ($) | 3 Months Ended | ||||
Feb. 10, 2023 | Apr. 27, 2021 | Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Formation And Business Of The Company [Line Items] | |||||
Company incorporation date of incorporation | Jul. 29, 2013 | ||||
Offering expenses | $ 7,500 | $ 7,500 | |||
Accumulated deficit | (98,174,000) | $ (84,720,000) | |||
Net cash used in operating activities | (17,259,000) | $ (7,241,000) | |||
Cash and cash equivalents | 29,613,000 | 19,473,000 | |||
Marketable securities available for sale | $ 141,049,000 | $ 61,779,000 | |||
IPO [Member] | |||||
Formation And Business Of The Company [Line Items] | |||||
Sale of stock net consideration received on the transaction | $ 107,600,000 | ||||
Public Offering [Member] | |||||
Formation And Business Of The Company [Line Items] | |||||
Stock issued during the period shares new issues | 5,476,190 | ||||
Share Price | $ 21 | ||||
Proceeds from sale of shares | $ 107,500,000 | ||||
Underwriting discounts and commissions | 6,900,000 | ||||
Offering expenses | $ 600,000 |
Summary of Significant Accoun_3
Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($) | 3 Months Ended | 12 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Summary Of Significant Accounting Policies [Line Items] | |||
Accrued contingent liabilities | $ 0 | $ 0 | |
Surgical instrument expense | $ 400,000 | ||
material cash deposits | $ 0 | ||
Minimum [Member] | Revenue Benchmark [Member] | Customer Concentration Risk [Member] | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Concentration risk, percentage | 10% | 10% | |
Maximum [Member] | Accounts Receivable [Member] | Customer Concentration Risk [Member] | |||
Summary Of Significant Accounting Policies [Line Items] | |||
Concentration risk, percentage | 10% | 10% |
Recent Accounting Pronounceme_2
Recent Accounting Pronouncements - Additional Information (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
New Accounting Pronouncements Or Change In Accounting Principle [Line Items] | ||
Operating lease right-of-use assets | $ 9,907 | $ 10,138 |
Operating lease and other liabilities | $ 348 | $ 339 |
Fair Value Measurements - Summa
Fair Value Measurements - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Assets: | ||
Fair Value | $ 141,049 | $ 61,779 |
Commercial Paper | ||
Assets: | ||
Fair Value | 2,550 | |
U.S. treasury and government agencies | ||
Assets: | ||
Fair Value | 56,765 | 16,443 |
Corporate debt | ||
Assets: | ||
Fair Value | 33,570 | 23,372 |
Asset-backed securities | ||
Assets: | ||
Fair Value | 29,845 | 13,896 |
Yankee CD | ||
Assets: | ||
Fair Value | 18,319 | 8,068 |
Fair Value, Recurring [Member] | ||
Assets: | ||
Total | 167,196 | 77,990 |
Fair Value, Recurring [Member] | Money Market Funds | ||
Assets: | ||
Cash equivalents | 12,289 | 13,141 |
Fair Value, Recurring [Member] | Commercial Paper | ||
Assets: | ||
Cash equivalents | 998 | 323 |
Fair Value | 2,550 | |
Fair Value, Recurring [Member] | U.S. treasury and government agencies | ||
Assets: | ||
Fair Value | 56,765 | 16,443 |
Fair Value, Recurring [Member] | Corporate debt | ||
Assets: | ||
Cash equivalents | 8,358 | 2,197 |
Fair Value | 33,570 | 23,372 |
Fair Value, Recurring [Member] | Asset-backed securities | ||
Assets: | ||
Fair Value | 29,845 | 13,896 |
Fair Value, Recurring [Member] | Yankee CD | ||
Assets: | ||
Cash equivalents | 4,502 | 550 |
Fair Value | 18,319 | 8,068 |
Fair Value, Recurring [Member] | Level 1 [Member] | ||
Assets: | ||
Total | 45,833 | 26,014 |
Fair Value, Recurring [Member] | Level 1 [Member] | Money Market Funds | ||
Assets: | ||
Cash equivalents | 12,289 | 13,141 |
Fair Value, Recurring [Member] | Level 1 [Member] | U.S. treasury and government agencies | ||
Assets: | ||
Fair Value | 33,544 | 12,873 |
Fair Value, Recurring [Member] | Level 2 [Member] | ||
Assets: | ||
Total | 121,363 | 51,976 |
Fair Value, Recurring [Member] | Level 2 [Member] | Commercial Paper | ||
Assets: | ||
Cash equivalents | 998 | 323 |
Fair Value | 2,550 | |
Fair Value, Recurring [Member] | Level 2 [Member] | U.S. treasury and government agencies | ||
Assets: | ||
Fair Value | 23,221 | 3,570 |
Fair Value, Recurring [Member] | Level 2 [Member] | Corporate debt | ||
Assets: | ||
Cash equivalents | 8,358 | 2,197 |
Fair Value | 33,570 | 23,372 |
Fair Value, Recurring [Member] | Level 2 [Member] | Asset-backed securities | ||
Assets: | ||
Fair Value | 29,845 | 13,896 |
Fair Value, Recurring [Member] | Level 2 [Member] | Yankee CD | ||
Assets: | ||
Cash equivalents | 4,502 | 550 |
Fair Value | $ 18,319 | $ 8,068 |
Balance Sheet Components - Summ
Balance Sheet Components - Summary of Cash and Cash Equivalents (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Cash and Cash Equivalents [Line Items] | ||
Cash | $ 3,466 | $ 3,262 |
Total cash and cash equivalents | 29,613 | 19,473 |
Money Market Funds | ||
Cash and Cash Equivalents [Line Items] | ||
Cash equivalents | 12,289 | 13,141 |
Commercial Paper | ||
Cash and Cash Equivalents [Line Items] | ||
Cash equivalents | 998 | 323 |
Corporate debt | ||
Cash and Cash Equivalents [Line Items] | ||
Cash equivalents | 8,358 | 2,197 |
Yankee CD | ||
Cash and Cash Equivalents [Line Items] | ||
Cash equivalents | $ 4,502 | $ 550 |
Balance Sheet Components - Su_2
Balance Sheet Components - Summary of Available-For-Sale Marketable Securities (Detail) - USD ($) $ in Thousands | 3 Months Ended | 12 Months Ended |
Mar. 31, 2023 | Dec. 31, 2022 | |
Marketable Securities [Line Items] | ||
Amortized Cost | $ 141,105 | $ 61,806 |
Gross Unrealized Gains | 86 | 79 |
Gross Unrealized Losses | (142) | (106) |
Fair Value | 141,049 | 61,779 |
U.S. treasury and government agencies | ||
Marketable Securities [Line Items] | ||
Amortized Cost | 56,730 | 16,472 |
Gross Unrealized Gains | 54 | 11 |
Gross Unrealized Losses | (19) | (40) |
Fair Value | 56,765 | 16,443 |
Commercial Paper | ||
Marketable Securities [Line Items] | ||
Amortized Cost | 2,550 | |
Gross Unrealized Gains | 1 | |
Gross Unrealized Losses | (1) | |
Fair Value | 2,550 | |
Corporate debt | ||
Marketable Securities [Line Items] | ||
Amortized Cost | 33,651 | 23,376 |
Gross Unrealized Gains | 10 | 31 |
Gross Unrealized Losses | (91) | (35) |
Fair Value | 33,570 | 23,372 |
Asset-backed securities | ||
Marketable Securities [Line Items] | ||
Amortized Cost | 29,854 | 13,892 |
Gross Unrealized Gains | 17 | 27 |
Gross Unrealized Losses | (26) | (23) |
Fair Value | 29,845 | 13,896 |
Yankee CD | ||
Marketable Securities [Line Items] | ||
Amortized Cost | 18,320 | 8,066 |
Gross Unrealized Gains | 4 | 10 |
Gross Unrealized Losses | (5) | (8) |
Fair Value | $ 18,319 | $ 8,068 |
Balance Sheet Components - Su_3
Balance Sheet Components - Summary of Property and Equipment, Net (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | $ 20,991 | $ 19,601 |
Less: accumulated depreciation and amortization | (5,076) | (4,263) |
Property and equipment, net | 15,915 | 15,338 |
Furniture and Fixtures and Equipment [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 1,577 | 1,577 |
Construction in Progress [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 671 | 705 |
Machinery and Equipment [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 1,729 | 928 |
Capitalized Surgical Equipment [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 9,886 | 9,248 |
Computer Equipment [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 639 | 571 |
Leasehold Improvements [Member] | ||
Property, Plant and Equipment [Line Items] | ||
Total property and equipment | 6,351 | 6,434 |
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 | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Cash and Cash Equivalents [Line Items] | |||
Depreciation and amortization expense | $ 924 | $ 334 | |
Cash | 3,466 | $ 3,262 | |
Silicon Valley Bank | |||
Cash and Cash Equivalents [Line Items] | |||
Cash | $ 0 | $ 900 |
Balance Sheet Components - Su_4
Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Balance Sheet Related Disclosures [Abstract] | ||
Accrued royalty expense | $ 1,827 | $ 2,299 |
Accrued interest | 412 | 412 |
Accrued professional services | 2,083 | 1,727 |
Other accrued expense | 3,649 | 1,778 |
Total accrued liabilities | $ 7,971 | $ 6,216 |
Balance Sheet Components - Sche
Balance Sheet Components - Schedule of Current Operating Lease Liability and Other Liabilities (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Operating Lease, Liability [Abstract] | ||
Operating lease and other liabilities | $ 348 | $ 339 |
Payable to broker | 710 | 0 |
Total operating lease and other liabilities | $ 1,058 | $ 339 |
Long Term Debt - Additional Inf
Long Term Debt - Additional Information (Detail) - USD ($) $ in Millions | 3 Months Ended | |
Apr. 29, 2022 | Mar. 31, 2023 | |
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 March 31, 2023 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% | |
SOFR [Member] | Interest Rate Floor [Member] | ||
Debt Instrument [Line Items] | ||
Debt instrument variable interest rate spread percentage | 1% | |
SOFR [Member] | Interest Rate Cap [Member] | ||
Debt Instrument [Line Items] | ||
Debt instrument variable interest rate spread percentage | 3% | |
Tranche One [Member] | ||
Debt Instrument [Line Items] | ||
Borrowings | $ 50 | |
Tranche Four [Member] | ||
Debt Instrument [Line Items] | ||
Borrowings | $ 120 | |
MidCap Financial Trust [Member] | ||
Debt Instrument [Line Items] | ||
Term loan tenure | 5 years | |
Line of credit | $ 150 | |
Revolving borrowing capacity percentage | 50% | |
Debt Instrument, Face Amount | $ 120 | |
Early Repayment Year Two[Member] | ||
Debt Instrument [Line Items] | ||
Debt instrument repayment fee percentage for second year | 2% | |
Term Loans [Member] | ||
Debt Instrument [Line Items] | ||
Remaining borrowing capacity | $ 70 | |
Debt Instrument Interest Rate | 6% | |
Capped interest rates | 9% | |
Revolving Loan Facility [Member] | ||
Debt Instrument [Line Items] | ||
Current portion of long-term line of credit drawn | $ 4 | |
Line of credit current borrowing capacity | $ 21.5 | |
Borrowings | $ 50 | |
Remaining borrowing capacity | 30 | |
Increase in credit facility | $ 20 | |
Debt Instrument Interest Rate, Percentage | 0.10% | |
Debt Instrument, Face Amount | $ 30 | |
Debt Instrument Interest Rate | 4% | |
Capped interest rates | 7% |
Long Term Debt - Summary of Lon
Long Term Debt - Summary of Long-term Debt Instruments (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Debt Instrument [Line Items] | ||
Total term loans | $ 54,000 | $ 54,000 |
Less: Unamortized debt discount and debt issuance costs | (1,215) | (1,289) |
Total long-term debt, net | 52,785 | 52,711 |
Mid Cap Revolving Loan Facility | ||
Debt Instrument [Line Items] | ||
Total term loans | 4,000 | 4,000 |
Term Loans [Member] | MidCap Term loan facility | ||
Debt Instrument [Line Items] | ||
Total term loans | $ 50,000 | $ 50,000 |
Long Term Debt - Summary of Mat
Long Term Debt - Summary of Maturities of Long-term Debt (Detail) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Debt Disclosure [Abstract] | ||
2023 | $ 0 | |
2024 | 0 | |
2025 | 0 | |
2026 | 33,333 | |
2027 | 20,667 | |
Total principal payments | 54,000 | $ 54,000 |
Less: Unamortized debt discount and debt issuance costs | (1,215) | (1,289) |
Total long-term debt, net | $ 52,785 | $ 52,711 |
Commitments and Contingencies -
Commitments and Contingencies - Additional Information (Detail) - USD ($) | 3 Months Ended | ||
Mar. 31, 2023 | Mar. 31, 2022 | Dec. 31, 2022 | |
Other Commitments [Line Items] | |||
Accrued contingent liabilities | $ 0 | $ 0 | |
Royalty Agreement With Certain Members Of The Surgeon Advisory Board [Member] | Ten Years From The First Sale Of The Commercial Product Member [Member] | |||
Other Commitments [Line Items] | |||
Royalty expenses | $ 1,600,000 | $ 1,400,000 | |
Royalty as a percentage of net sales for the period | 3.90% | 4.80% |
Operating Leases - Summary of F
Operating Leases - Summary of Future Minimum Lease Payments and Maturity Analysis of Operating Lease Liabilities (Details) - USD ($) $ in Thousands | Mar. 31, 2023 | Dec. 31, 2022 |
Operating Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract] | ||
Less: Current portion of lease liability | $ 348 | $ 339 |
Operating lease liabilities, net of current portion | $ 15,447 | $ 15,539 |
Stockholders' Equity (Additiona
Stockholders' Equity (Additional Information) (Detail) - $ / shares | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | ||
Employees stock options, shares granted | 727,650 | 963,800 |
Restricted Stock [Member] | ||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | ||
Shares granted | 571,565 | 201,580 |
Weighted average grant-date fair value | $ 24.07 | $ 20.13 |
Employee Stock Option [Member] | ||
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items] | ||
Stock options, weighted-average grant date fair value | $ 10.58 | $ 7.50 |
Stockholders' Equity - Summary
Stockholders' Equity - Summary of Share-Based Compensation Expense is Reflected in Operating expenses in the Condensed Statements of Operations and Comprehensive Loss (Detail) - USD ($) $ in Thousands | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||
Stock-based compensation expense | $ 2,692 | $ 1,409 |
Cost of goods sold [Member] | ||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||
Stock-based compensation expense | 76 | 0 |
Sales and marketing [Member] | ||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||
Stock-based compensation expense | 822 | 531 |
Research and development [Member] | ||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||
Stock-based compensation expense | 257 | 150 |
General and administrative [Member] | ||
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items] | ||
Stock-based compensation expense | $ 1,537 | $ 728 |
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 | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Numerator | ||
Net loss | $ (13,454) | $ (9,036) |
Denominator | ||
Weighted Average Number of Shares Outstanding, Basic | 58,723,760 | 54,827,665 |
Weighted Average Number of Shares Outstanding, Diluted | 58,723,760 | 54,827,665 |
Net loss per share attributable to common stockholders, basic | $ (0.23) | $ (0.16) |
Net loss per share attributable to common stockholders, diluted | $ (0.23) | $ (0.16) |
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 | 3 Months Ended | |
Mar. 31, 2023 | Mar. 31, 2022 | |
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||
Diluted weighted average shares outstanding | 8,804,111 | 7,416,617 |
Common Stock Options Issued and Outstanding [Member] | ||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||
Diluted weighted average shares outstanding | 7,717,414 | 7,205,037 |
Unvested Full Value Awards [Member] | ||
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items] | ||
Diluted weighted average shares outstanding | 1,086,697 | 211,580 |