Treace Medical Concepts (TMCI) 10-Q 9 Aug 23 2023 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares	6 Months Ended
	Jun. 30, 2023	Aug. 04, 2023
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
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		61,544,672

Condensed Balance Sheets

Condensed Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Current assets
Cash and cash equivalents	$ 12,035	$ 19,473
Marketable securities, short-term	127,444	61,779
Accounts receivable	27,232	29,196
Inventories	26,101	19,330
Prepaid expenses and other current assets	5,284	3,624
Total current assets	198,096	133,402
Property and equipment, net	19,435	15,338
Intangible assets, net	9,500	0
Goodwill	12,815	0
Operating lease right-of-use assets	9,651	10,138
Other non-current assets	146	146
Total assets	249,643	159,024
Current liabilities
Accounts payable	8,146	8,668
Accrued liabilities	7,072	6,216
Accrued commissions	5,661	7,356
Accrued compensation	5,368	7,666
Other liabilities	3,775	339
Total current liabilities	30,022	30,245
Long-term debt	52,859	52,711
Operating lease liabilities, net of current portion	16,766	0
Other long-term liabilities	37	0
Total liabilities	99,684	98,495
Commitments and contingencies (Note 8)	0	0
Stockholders’ equity
Common stock, value	62	55
Additional paid-in capital	260,561	145,221
Accumulated deficit	(110,445)	(84,720)
Accumulated other comprehensive (loss) income	(219)	(27)
Total stockholders’ equity	149,959	60,529
Total liabilities and stockholders’ equity	$ 249,643	$ 159,024

Condensed Balance Sheets (Paren

Condensed Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Allowance for doubtful accounts receivable current	$ 707	$ 735
Long term debt unamortized debt discount and issuance costs	$ 1,141	$ 1,289
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	61,528,409	55,628,208
Common stock share outstanding	61,528,409	55,628,208

Condensed Statement of Operatio

Condensed Statement of Operations and Comprehensive Loss - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Income Statement [Abstract]
Revenue	$ 41,953	$ 29,967	$ 84,148	$ 59,014
Cost of goods sold	7,675	5,291	15,714	10,421
Gross profit	34,278	24,676	68,434	48,593
Operating expenses
Sales and marketing	33,773	26,610	67,428	48,909
Research and development	3,526	2,984	6,938	6,036
General and administrative	10,031	7,015	20,896	13,677
Total operating expenses	47,330	36,609	95,262	68,622
Loss from operations	(13,052)	(11,933)	(26,828)	(20,029)
Interest income	1,968	131	3,447	140
Interest expense	(1,282)	(946)	(2,567)	(1,897)
Debt extinguishment loss	0	(4,483)	0	(4,483)
Other income, net	95	(3)	223	(1)
Other non-operating income (expense), net	781	(5,301)	1,103	(6,241)
Net loss	(12,271)	(17,234)	(25,725)	(26,270)
Unrealized losses on marketable securities	(163)	0	(192)	0
Comprehensive loss	$ (12,434)	$ (17,234)	$ (25,917)	$ (26,270)
Net loss per share attributable to common stockholders, basic	$ (0.2)	$ (0.31)	$ (0.43)	$ (0.48)
Net loss per share attributable to common stockholders, diluted	$ (0.2)	$ (0.31)	$ (0.43)	$ (0.48)
Weighted-average common stock outstanding, basic	61,382,514	55,308,273	60,060,483	55,071,368
Weighted-average common stock outstanding, diluted	61,382,514	55,308,273	60,060,483	55,071,368

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, 2021	93,073	$ 45	134,933	(41,905)	0
Balance at Beginning (in Shares) at Dec. 31, 2021		54,181,082
Net loss	(26,270)
Balance at Ending at Jun. 30, 2022	71,712	$ 46	139,841	(68,175)	0
Balance at Ending (in Shares) at Jun. 30, 2022		55,391,309
Balance at Beginning at Mar. 31, 2022	86,818	$ 46	137,713	(50,941)	0
Balance at Beginning (in Shares) at Mar. 31, 2022		55,278,942
Issuance of common stock upon exercise of stock options	165		165
Issuance of common stock upon exercise of stock options, shares		112,367
Share-based compensation expense	1,963		1,963
Net loss	(17,234)			(17,234)
Balance at Ending at Jun. 30, 2022	71,712	$ 46	139,841	(68,175)	0
Balance at Ending (in Shares) at Jun. 30, 2022		55,391,309
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
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
Net loss	(25,725)
Balance at Ending at Jun. 30, 2023	149,959	$ 62	260,561	(110,445)	(219)
Balance at Ending (in Shares) at Jun. 30, 2023		61,528,409
Balance at Beginning at Mar. 31, 2023	157,617	$ 61	255,786	(98,174)	(56)
Balance at Beginning (in Shares) at Mar. 31, 2023		61,280,703
Issuance of common stock upon exercise of stock options	1,180	$ 1	1,179
Issuance of common stock upon exercise of stock options, shares		205,244
Issuance of common stock for vesting of restricted stock units		42,462
Share-based compensation expense	3,596		3,596
Net loss	(12,271)			(12,271)
Unrealized loss on available-for-sale marketable securities	(163)				163
Balance at Ending at Jun. 30, 2023	$ 149,959	$ 62	$ 260,561	$ (110,445)	$ (219)
Balance at Ending (in Shares) at Jun. 30, 2023		61,528,409

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	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Cash flows from operating activities
Net loss	$ (25,725)	$ (26,270)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization expense	2,019	757
(Recovery) provision for allowance for doubtful accounts	78	(45)
Share-based compensation expense	6,288	3,372
Non-Cash Lease Expense	1,264	1,165
Amortization of debt issuance costs	148	95
Recovery of Inventory Obsolescence	0	(197)
Gain on fair value adjustment to derivative liability	0	(173)
Debt extinguishment loss	0	(4,483)
Accretion (amortization) of discount (premium) on marketable securities, net	(663)	0
Other, net	5	0
Net changes in operating assets and liabilities, net of acquisitions:
Accounts Receivable	1,886	2,112
Inventory	(6,704)	(2,410)
Prepaid expenses and other assets	(1,641)	(1,039)
Other non-current assets	0	(134)
Other liabilities	1,072	2,392
Accounts payable	(522)	(957)
Accrued liabilities	(3,137)	(958)
Other, net	38	0
Net cash used in operating activities	(25,594)	(17,807)
Cash flows from investing activities
Purchases of available-for-sale marketable securities	(120,957)	0
Sales and maturities of available-for-sale marketable securities	55,763	0
Purchases of property and equipment	(5,709)	(6,649)
Acquisition, net of cash acquired	(20,000)	0
Net cash used in investing activities	(90,903)	(6,649)
Cash flows from financing activities
Proceeds from interest bearing term debt	0	49,651
Proceeds from interest bearing revolving debt	0	3,850
Debt issuance costs paid to third parties	0	(989)
Repayment of term loan	0	(33,893)
Proceeds from issuance of common stock upon initial public offering, net of issuance costs and underwriting fees of $7.5 million	107,527	0
Proceeds from exercise of employee stock options	1,532	1,537
Net cash provided by financing activities	109,059	20,156
Net (decrease) increase in cash and cash equivalents	(7,438)	(4,300)
Cash and cash equivalents at beginning of period	19,473	105,833
Cash and cash equivalents at end of period	12,035	101,533
Supplemental disclosure of cash flow information:
Cash paid for interest	2,567	1,897
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	(13)	0
Noncash investing activities:
Unrealized losses on marketable securities	$ 192	$ 0

Condensed Statements of Cash _2

Condensed Statements of Cash Flows (Parenthetical) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($)
Statement of Cash Flows [Abstract]
Issuance costs and underwriting fees, net	$ 7.5

Formation and Business of the C

Formation and Business of the Company	6 Months Ended
	Jun. 30, 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 $ 110.4 million as of June 30, 2023. During the six months ended June 30, 2023 and 2022, the Company used $ 25.6 million and $ 17.8 million of cash in its operating activities, respectively. As of June 30, 2023, the Company had cash and cash equivalents of $ 12.0 million and marketable securities available-for-sale of $ 127.4 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	6 Months Ended
	Jun. 30, 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 six months ended June 30, 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 and six months ended June 30, 2022 for $ 0.4 million and $ 0.7 million, respectively 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 valuation of goodwill and intangible assets, contingent earn-out liabilities, 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 June 30, 2023 and December 31, 2022 . Business Combinations The Company allocates the purchase consideration to the identifiable assets and liabilities acquired, including intangible assets at fair value on the date of the acquisition. The excess of the fair value of the purchase consideration over the fair value of the identifiable assets and liabilities, if any, is recorded as goodwill. During the measurement period, which is up to one year from the acquisition date, the Company may adjust initial amounts that were recognized at the acquisition date to reflect new information obtained about facts and circumstances that existed as of the acquisition date. Determining the fair value of assets acquired and liabilities assumed requires significant judgment, including the selection of valuation methodologies including the income approach, the cost approach, and the market approach. Significant assumptions used in those methodologies include the timing and amounts of cash flow projections, including revenue growth rates, obsolescence rates, margins, royalty rates, counterparty risk rates, and other discount rates. Intangibles Definite-life intangible assets are assessed for impairment upon triggering events that indicate that the carrying value of an asset may not be recoverable. Recoverability is measured by a comparison of the carrying amount to future net undiscounted cash flows expected to be generated by the associated asset. If the asset’s carrying value is determined to not be recoverable, the impairment to be recognized is measured by the amount by which the carrying amount exceeds the fair market value of the intangible assets. Goodwill Goodwill represents the excess of the purchase price as compared to the fair value of net assets acquired and liabilities assumed. Goodwill is not amortized but is tested for impairment annually or when indications of impairment exist. The Company can elect to qualitatively assess goodwill for impairment if it is more likely than not that the fair value of a reporting unit exceeds its carrying value. Impairment exists when the carrying amount, including goodwill, of the reporting unit exceeds its fair value, resulting in an impairment charge for this excess (not to exceed the carrying amount of the goodwill). The Company's annual impairment testing date is July 1 . The impairment, if determined, is recorded within operating expenses in the Condensed Statement of Operations and Comprehensive Loss in the period the determination is made. There were no impairments recorded during the periods presented. Contingent Consideration Business combinations may include contingent consideration as part of the purchase price under which the Company will make future payments to the seller upon the achievement of certain milestones. The fair value of the contingent consideration is estimated as of the acquisition date at the present value of the expected contingent payments and is subsequently remeasured at each balance sheet date. The scenario-based model was used and relies on multiple outcomes to estimate the likelihood of future payout of the contingent consideration. The resulting earnout payout is then probability-weighted and discounted at an appropriate risk adjusted rate in order to arrive at the present value of the expected payment. The Company reviews the probabilities of achievement of the earnout milestones to determine impact on the fair value of the contingent consideration on a quarterly basis over the earn-out period. Actual results are compared to the estimates and probabilities of achievement used in its forecasts. The estimated fair value of the contingent consideration liability will increase or decrease, up to the contractual limit, as applicable. Changes in the estimated fair value of the contingent consideration are recorded in operating expenses in the Statement of Operations and Comprehensive Loss and are reflected in the period in which they are identified. Changes in the estimated fair value of the Company's contingent consideration may materially impact or cause volatility in its operating results. 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 the Company holds deposits were to fail or be taken over by the FDIC, such as the takeover of Silicon Valley Bank, where the Company did hold cash as deposits, its 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 June 30, 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 June 30, 2023 and December 31, 2022 , no customer accounted for more than 10 % of accounts receivable. For the six months ended June 30, 2023 and 2022 , there were no customers that represented 10 % or more of revenue.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	6 Months Ended
	Jun. 30, 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 the Company's financial position, results of operations, or its disclosures.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 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 June 30, 2023 and December 31, 2022 (in thousands): June 30, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 9,084 $ — $ — $ 9,084 Short-term marketable securities at fair value U.S. treasury and government agencies 33,733 21,428 — 55,161 Commercial paper — 347 — 347 Corporate debt — 28,384 — 28,384 Asset-backed securities — 30,820 — 30,820 Yankee CD — 12,732 — 12,732 Total assets $ 42,817 $ 93,711 $ — $ 136,528 Liabilities: Contingent consideration $ — $ — $ 2,814 $ 2,814 Total liabilities $ — $ — $ 2,814 $ 2,814 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 assets $ 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 June 30, 2023 and December 31, 2022 .

Business Combination

Business Combination	6 Months Ended
	Jun. 30, 2023
Business Combinations [Abstract]
Business Combination	5. Business Combination On June 12, 2023 ("closing date"), the Company acquired certain assets of MIOS Marketing, LLC d/b/a RedPoint Medical3D (“RPM-3D”), a medical technology company offering pre-operative planning and patient-specific guides designed to deliver accurate surgical correction of deformities tailored to the patient’s unique foot anatomy. RPM-3D’s 22 patent applications further expand and reinforce the Company's global intellectual property portfolio covering technologies for the correction of bunion and related deformities. The Company paid $ 20.0 million in exchange for certain assets used in providing pre-operative planning and patient-specific guides for the surgical correction of foot and ankle deformities. The Company is obligated to make additional payments of up to $ 10.0 million in cash upon completion of certain milestones as follows: $ 3.5 million upon completion of certain transition services at 12 months from the closing date, $ 3.5 million upon completion of certain technological advancement milestones within 12 months of the closing date, and, subject to prior completion of the transition services and the technological advancement milestones, up to $ 3.0 million upon the issuance of certain patent claims. Payments made for the transition services and patent claims require satisfaction of the milestone, as well as the continued service of key individuals and are expensed over the service period of 12 months following the closing date. The milestone payment for technological advancements does not require continued service and is recorded as contingent consideration at fair value in other liabilities at June 30, 2023. The following table summarizes the components of the acquisition-date fair value of consideration transferred (in thousands): Cash $ 20,000 Contingent consideration 2,814 Total $ 22,814 The following table summarizes the preliminary components of the acquisition-date fair value of assets acquired (in thousands): Prepaid expenses and other current assets $ 19 Inventory 67 Property, plant and equipment 413 Intangible assets 9,500 Total identifiable assets acquired 9,999 Goodwill 12,815 Total assets acquired $ 22,814 Identified intangible assets consist of developed technology. The fair value was determined with the assistance of an external valuation specialist using an income approach, in accordance with ASC 805, - Business Combinations. The developed technology is a finite lived intangible asset with a useful life of ten years that is amortized on straight-line basis. There were no other material intangibles from the RPM-3D acquisition. The amortization for the three months and six months ended June 30, 2023 was not material. The purchase consideration was allocated to the identifiable net assets acquired based on estimated fair values at the date of the acquisition. The excess of the fair value of the purchase consideration over the fair value of the identifiable assets and liabilities, if any, was recorded as goodwill. The goodwill is attributable to the expected synergies with the Company’s existing operations. The purchase price allocated to goodwill will be deductible for income tax purposes over a 15-year period. There is no supplemental proforma presentation of operating results of the acquisition of the RPM-3D assets due to the immaterial impact on the Company's operations for the three months and six months ended June 30, 2023 and 2022. No impairment charges were recorded in any of the periods presented.

Balance Sheet Components

Balance Sheet Components	6 Months Ended
	Jun. 30, 2023
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Components	6. Balance Sheet Components Cash and Cash Equivalents The Company’s cash and cash equivalents consisted of the following (in thousands): June 30, December 31, 2023 2022 Cash $ 2,951 $ 3,262 Cash equivalents: Money market funds 9,084 13,141 Commercial paper — 323 Corporate debt — 2,197 Yankee CD — 550 Total cash and cash equivalents $ 12,035 $ 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 June 30, 2023. Marketable Securities The Company's available-for-sale marketable securities consisted of the following (in thousands): June 30, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 55,305 $ — $ ( 144 ) $ 55,161 Commercial paper 347 — — 347 Corporate debt 28,391 22 ( 29 ) 28,384 Asset-backed securities 30,876 20 ( 76 ) 30,820 Yankee CD 12,744 — ( 12 ) 12,732 Total marketable securities - short-term $ 127,663 $ 42 $ ( 261 ) $ 127,444 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): June 30, December 31, 2023 2022 Furniture and fixtures, and equipment $ 1,586 $ 1,577 Construction in progress 3,067 705 Machinery and equipment 2,079 928 Capitalized surgical equipment 11,511 9,248 Computer equipment 697 571 Leasehold improvements 6,351 6,434 Software 138 138 Total property and equipment 25,429 19,601 Less: accumulated depreciation and amortization ( 5,994 ) ( 4,263 ) Property and equipment, net $ 19,435 $ 15,338 Depreciation and amortization expense on property and equipment were $ 1.1 million and $ 0.4 million for the three months ended June 30, 2023 and 2022, respectively. Depreciation and amortization expense on property and equipment were $ 2.0 million and $ 0.8 million for the six months ended June 30, 2023 and 2022, respectively. Accrued liabilities Accrued liabilities consist of the following (in thousands): June 30, December 31, 2023 2022 Accrued royalties expense $ 1,740 $ 2,299 Accrued interest 398 412 Accrued professional services 930 1,727 Other accrued expense 4,004 1,778 Total accrued liabilities $ 7,072 $ 6,216 Other liabilities Other liabilities consist of the following (in thousands): June 30, December 31, 2023 2022 Current portion of operating lease liabilities $ 961 $ 339 Contingent consideration 2,814 — Total other liabilities $ 3,775 $ 339

Long Term Debt

Long Term Debt	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Long Term Debt	7. Long-Term Debt The Company’s long-term debt consisted of the following (in thousands): June 30, 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 ( 1,141 ) ( 1,289 ) Total long-term debt, net $ 52,859 $ 52,711 As of June 30, 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 ( 1,141 ) Total long-term debt, net $ 52,859 MidCap Loan and Revolving Loan Facility On April 29, 2022, the Company entered into a 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 June 30, 2023, the borrowing base allows a total of $ 22.5 million available to the Company under the revolving loan facility. The balance drawn as of June 30, 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 June 30, 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 June 30, 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 June 30, 2023 .

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	. Commitments and Contingencies License and Royalty Commitments As of June 30, 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 $ 1.3 million for the three months ended June 30, 2023 and 2022, respectively, and $ 3.2 million and $ 2.7 million for the six months ended June 30, 2023 and 2022, respectively. For the three months ended June 30, 2023 and 2022, the aggregate royalty rates were 3.7 % and 4.6 % , respectively. For the six months ended June 30, 2023 and 2022, the aggregate royalty rates were 3.8 % and 4.6 % , 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 June 30, 2023 and December 31, 2022 .

Stockholders' Equity

Stockholders' Equity	6 Months Ended
	Jun. 30, 2023
Stockholders' Equity Note [Abstract]
Stockholders' Equity	. Stockholders’ Equity Stock Options During the six months ended June 30, 2023 and 2022, the Company granted stock options to employees to purchase an aggregate of 771,785 and 1,171,175 shares of the Company’s common stock, respectively. The weighted-average grant-date fair value of the employee stock options granted during the six months ended June 30, 2023 and 2022 was $ 10.63 and $ 7.37 per share, respectively. Restricted Stock Units During the three months ended June 30, 2023 and 2022, the Company granted 651,396 and 359,534 restricted st ock units (“RSUs”), respectively. The weighted average grant-date fair value of RSUs granted during the three months ended June 30, 2023 and 2022 was $ 24.26 and $ 18.28 , 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Cost of goods sold $ 53 $ — $ 129 $ — Sales and marketing expense 1,063 690 1,885 1,221 Research and development expense 375 176 632 326 General and administrative expense 2,105 1,097 3,642 1,825 Total $ 3,596 $ 1,963 $ 6,288 $ 3,372

Net Loss Per Share Attributable

Net Loss Per Share Attributable to Common Stockholders	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Net Loss Per Share Attributable to Common Stockholders	. 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 and six months ended June 30, 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Numerator Net loss $ ( 12,271 ) $ ( 17,234 ) $ ( 25,725 ) $ ( 26,270 ) Denominator Weighted-average common stock outstanding, 61,382,514 55,308,273 60,060,483 55,071,368 Net loss per share attributable to common $ ( 0.20 ) $ ( 0.31 ) $ ( 0.43 ) $ ( 0.48 ) 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: June 30, December 31, 2023 2022 Common stock options issued and outstanding 7,529,046 7,150,755 Unvested full value awards 1,107,408 595,048 Total 8,636,454 7,745,803

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 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 six months ended June 30, 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 and six months ended June 30, 2022 for $ 0.4 million and $ 0.7 million, respectively 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 valuation of goodwill and intangible assets, contingent earn-out liabilities, 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 June 30, 2023 and December 31, 2022 .
Business Combinations	Business Combinations The Company allocates the purchase consideration to the identifiable assets and liabilities acquired, including intangible assets at fair value on the date of the acquisition. The excess of the fair value of the purchase consideration over the fair value of the identifiable assets and liabilities, if any, is recorded as goodwill. During the measurement period, which is up to one year from the acquisition date, the Company may adjust initial amounts that were recognized at the acquisition date to reflect new information obtained about facts and circumstances that existed as of the acquisition date. Determining the fair value of assets acquired and liabilities assumed requires significant judgment, including the selection of valuation methodologies including the income approach, the cost approach, and the market approach. Significant assumptions used in those methodologies include the timing and amounts of cash flow projections, including revenue growth rates, obsolescence rates, margins, royalty rates, counterparty risk rates, and other discount rates.
Intangibles	Intangibles Definite-life intangible assets are assessed for impairment upon triggering events that indicate that the carrying value of an asset may not be recoverable. Recoverability is measured by a comparison of the carrying amount to future net undiscounted cash flows expected to be generated by the associated asset. If the asset’s carrying value is determined to not be recoverable, the impairment to be recognized is measured by the amount by which the carrying amount exceeds the fair market value of the intangible assets.
Goodwill	Goodwill Goodwill represents the excess of the purchase price as compared to the fair value of net assets acquired and liabilities assumed. Goodwill is not amortized but is tested for impairment annually or when indications of impairment exist. The Company can elect to qualitatively assess goodwill for impairment if it is more likely than not that the fair value of a reporting unit exceeds its carrying value. Impairment exists when the carrying amount, including goodwill, of the reporting unit exceeds its fair value, resulting in an impairment charge for this excess (not to exceed the carrying amount of the goodwill). The Company's annual impairment testing date is July 1 . The impairment, if determined, is recorded within operating expenses in the Condensed Statement of Operations and Comprehensive Loss in the period the determination is made. There were no impairments recorded during the periods presented.
Contingent Consideration	Contingent Consideration Business combinations may include contingent consideration as part of the purchase price under which the Company will make future payments to the seller upon the achievement of certain milestones. The fair value of the contingent consideration is estimated as of the acquisition date at the present value of the expected contingent payments and is subsequently remeasured at each balance sheet date. The scenario-based model was used and relies on multiple outcomes to estimate the likelihood of future payout of the contingent consideration. The resulting earnout payout is then probability-weighted and discounted at an appropriate risk adjusted rate in order to arrive at the present value of the expected payment. The Company reviews the probabilities of achievement of the earnout milestones to determine impact on the fair value of the contingent consideration on a quarterly basis over the earn-out period. Actual results are compared to the estimates and probabilities of achievement used in its forecasts. The estimated fair value of the contingent consideration liability will increase or decrease, up to the contractual limit, as applicable. Changes in the estimated fair value of the contingent consideration are recorded in operating expenses in the Statement of Operations and Comprehensive Loss and are reflected in the period in which they are identified. Changes in the estimated fair value of the Company's contingent consideration may materially impact or cause volatility in its operating results.
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 the Company holds deposits were to fail or be taken over by the FDIC, such as the takeover of Silicon Valley Bank, where the Company did hold cash as deposits, its 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 June 30, 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 June 30, 2023 and December 31, 2022 , no customer accounted for more than 10 % of accounts receivable. For the six months ended June 30, 2023 and 2022 , there were no customers that represented 10 % or more of revenue.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 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 June 30, 2023 and December 31, 2022 (in thousands): June 30, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 9,084 $ — $ — $ 9,084 Short-term marketable securities at fair value U.S. treasury and government agencies 33,733 21,428 — 55,161 Commercial paper — 347 — 347 Corporate debt — 28,384 — 28,384 Asset-backed securities — 30,820 — 30,820 Yankee CD — 12,732 — 12,732 Total assets $ 42,817 $ 93,711 $ — $ 136,528 Liabilities: Contingent consideration $ — $ — $ 2,814 $ 2,814 Total liabilities $ — $ — $ 2,814 $ 2,814 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 assets $ 26,014 $ 51,976 $ — $ 77,990

Business Combination (Tables)

Business Combination (Tables)	6 Months Ended
	Jun. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Schedule of Acquisition-Date Fair Value Of Consideration Transferred	The following table summarizes the components of the acquisition-date fair value of consideration transferred (in thousands): Cash $ 20,000 Contingent consideration 2,814 Total $ 22,814
Schedule of Acquisition-Date Fair Value Of Assets Acquired	The following table summarizes the preliminary components of the acquisition-date fair value of assets acquired (in thousands): Prepaid expenses and other current assets $ 19 Inventory 67 Property, plant and equipment 413 Intangible assets 9,500 Total identifiable assets acquired 9,999 Goodwill 12,815 Total assets acquired $ 22,814

Balance Sheet Components (Table

Balance Sheet Components (Tables)	6 Months Ended
	Jun. 30, 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): June 30, December 31, 2023 2022 Cash $ 2,951 $ 3,262 Cash equivalents: Money market funds 9,084 13,141 Commercial paper — 323 Corporate debt — 2,197 Yankee CD — 550 Total cash and cash equivalents $ 12,035 $ 19,473
Summary of Available-For-Sale Marketable Securities	The Company's available-for-sale marketable securities consisted of the following (in thousands): June 30, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 55,305 $ — $ ( 144 ) $ 55,161 Commercial paper 347 — — 347 Corporate debt 28,391 22 ( 29 ) 28,384 Asset-backed securities 30,876 20 ( 76 ) 30,820 Yankee CD 12,744 — ( 12 ) 12,732 Total marketable securities - short-term $ 127,663 $ 42 $ ( 261 ) $ 127,444 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): June 30, December 31, 2023 2022 Furniture and fixtures, and equipment $ 1,586 $ 1,577 Construction in progress 3,067 705 Machinery and equipment 2,079 928 Capitalized surgical equipment 11,511 9,248 Computer equipment 697 571 Leasehold improvements 6,351 6,434 Software 138 138 Total property and equipment 25,429 19,601 Less: accumulated depreciation and amortization ( 5,994 ) ( 4,263 ) Property and equipment, net $ 19,435 $ 15,338
Summary of Accrued Liabilities	Accrued liabilities consist of the following (in thousands): June 30, December 31, 2023 2022 Accrued royalties expense $ 1,740 $ 2,299 Accrued interest 398 412 Accrued professional services 930 1,727 Other accrued expense 4,004 1,778 Total accrued liabilities $ 7,072 $ 6,216
Schedule of Other Liabilities	Other liabilities consist of the following (in thousands): June 30, December 31, 2023 2022 Current portion of operating lease liabilities $ 961 $ 339 Contingent consideration 2,814 — Total other liabilities $ 3,775 $ 339

Long Term Debt (Tables)

Long Term Debt (Tables)	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Summary of Long-term Debt Instruments	The Company’s long-term debt consisted of the following (in thousands): June 30, 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 ( 1,141 ) ( 1,289 ) Total long-term debt, net $ 52,859 $ 52,711
Summary of Maturities of Long-term Debt	As of June 30, 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 ( 1,141 ) Total long-term debt, net $ 52,859

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Cost of goods sold $ 53 $ — $ 129 $ — Sales and marketing expense 1,063 690 1,885 1,221 Research and development expense 375 176 632 326 General and administrative expense 2,105 1,097 3,642 1,825 Total $ 3,596 $ 1,963 $ 6,288 $ 3,372

Net Loss Per Share Attributab_2

Net Loss Per Share Attributable to Common Stockholders (Tables)	6 Months Ended
	Jun. 30, 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 and six months ended June 30, 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 June 30, Six Months Ended June 30, 2023 2022 2023 2022 Numerator Net loss $ ( 12,271 ) $ ( 17,234 ) $ ( 25,725 ) $ ( 26,270 ) Denominator Weighted-average common stock outstanding, 61,382,514 55,308,273 60,060,483 55,071,368 Net loss per share attributable to common $ ( 0.20 ) $ ( 0.31 ) $ ( 0.43 ) $ ( 0.48 )
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: June 30, December 31, 2023 2022 Common stock options issued and outstanding 7,529,046 7,150,755 Unvested full value awards 1,107,408 595,048 Total 8,636,454 7,745,803

Formation and Business of the_2

Formation and Business of the Company - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands			6 Months Ended
	Feb. 10, 2023	Apr. 27, 2021	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Formation And Business Of The Company [Line Items]
Company incorporation date of incorporation			Jul. 29, 2013
Offering expenses			$ 7,500
Accumulated deficit			(110,445)		$ (84,720)
Net cash used in operating activities			(25,594)	$ (17,807)
Cash and cash equivalents			12,035		19,473
Marketable securities available for sale			$ 127,444		$ 61,779
IPO [Member]
Formation And Business Of The Company [Line Items]
Sale of stock net consideration received on the transaction		$ 107,600
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
Underwriting discounts and commissions	6,900
Offering expenses	$ 600

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)	3 Months Ended	6 Months Ended		12 Months Ended
	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Summary Of Significant Accounting Policies [Line Items]
Accrued contingent liabilities		$ 0		$ 0
Surgical instrument expense	$ 400,000		$ 700,000
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	Jun. 30, 2023	Dec. 31, 2022
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Operating lease right-of-use assets	$ 9,651	$ 10,138
Operating lease and other liabilities	$ 961	$ 339

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Assets:
Fair Value	$ 127,444	$ 61,779
U.S. treasury and government agencies
Assets:
Fair Value	55,161	16,443
Commercial Paper
Assets:
Fair Value	347
Corporate debt
Assets:
Fair Value	28,384	23,372
Asset-backed securities
Assets:
Fair Value	30,820	13,896
Yankee CD
Assets:
Fair Value	12,732	8,068
Fair Value, Recurring [Member]
Assets:
Total assets	136,528	77,990
Liabilities:
Contingent consideration	2,814
Total	2,814
Fair Value, Recurring [Member] | Money Market Funds
Assets:
Cash equivalents	9,084	13,141
Fair Value, Recurring [Member] | U.S. treasury and government agencies
Assets:
Fair Value	55,161	16,443
Fair Value, Recurring [Member] | Commercial Paper
Assets:
Cash equivalents		323
Fair Value	347
Fair Value, Recurring [Member] | Corporate debt
Assets:
Cash equivalents		2,197
Fair Value	28,384	23,372
Fair Value, Recurring [Member] | Asset-backed securities
Assets:
Fair Value	30,820	13,896
Fair Value, Recurring [Member] | Yankee CD
Assets:
Cash equivalents		550
Fair Value	12,732	8,068
Fair Value, Recurring [Member] | Level 1 [Member]
Assets:
Total assets	42,817	26,014
Fair Value, Recurring [Member] | Level 1 [Member] | Money Market Funds
Assets:
Cash equivalents	9,084	13,141
Fair Value, Recurring [Member] | Level 1 [Member] | U.S. treasury and government agencies
Assets:
Fair Value	33,733	12,873
Fair Value, Recurring [Member] | Level 2 [Member]
Assets:
Total assets	93,711	51,976
Fair Value, Recurring [Member] | Level 2 [Member] | U.S. treasury and government agencies
Assets:
Fair Value	21,428	3,570
Fair Value, Recurring [Member] | Level 2 [Member] | Commercial Paper
Assets:
Cash equivalents		323
Fair Value	347
Fair Value, Recurring [Member] | Level 2 [Member] | Corporate debt
Assets:
Cash equivalents		2,197
Fair Value	28,384	23,372
Fair Value, Recurring [Member] | Level 2 [Member] | Asset-backed securities
Assets:
Fair Value	30,820	13,896
Fair Value, Recurring [Member] | Level 2 [Member] | Yankee CD
Assets:
Cash equivalents		550
Fair Value	12,732	$ 8,068
Fair Value, Recurring [Member] | Level 3 [Member]
Liabilities:
Contingent consideration	2,814
Total	$ 2,814

Business Combination - Addition

Business Combination - Additional Information (Detail) - USD ($) $ in Thousands		6 Months Ended
	Jun. 12, 2023	Jun. 30, 2023
Business Acquisition [Line Items]
Impairment charges		$ 0
Transition Services [Member]
Business Acquisition [Line Items]
Additional payments of milestones	$ 3,500
Technological Advancement Milestones [Member]
Business Acquisition [Line Items]
Additional payments of milestones	3,500
Patent Claims [Member]
Business Acquisition [Line Items]
Additional payments of milestones	3,000
MIOS Marketing, LLC [Member]
Business Acquisition [Line Items]
Cash	20,000
MIOS Marketing, LLC [Member] | Maximum [Member]
Business Acquisition [Line Items]
Additional payments of milestones	$ 10,000

Business Combination - Schedule

Business Combination - Schedule of Acquisition-Date Fair Value Of Consideration Transferred (Details) - MIOS Marketing, LLC [Member] $ in Thousands	Jun. 12, 2023 USD ($)
Asset Acquisition [Line Items]
Cash	$ 20,000
Contingent consideration	2,814
Total	$ 22,814

Business Combination - Schedu_2

Business Combination - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Jun. 30, 2023	Jun. 12, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Goodwill	$ 12,815		$ 0
MIOS Marketing, LLC [Member]
Business Acquisition [Line Items]
Prepaid expenses and other current assets		$ 19
Inventory		67
Property, plant and equipment		413
Intangible assets		9,500
Total identifiable assets acquired		9,999
Goodwill		12,815
Total assets acquired		$ 22,814

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Cash and Cash Equivalents (Detail) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Cash and Cash Equivalents [Line Items]
Cash	$ 2,951	$ 3,262
Total cash and cash equivalents	12,035	19,473
Money Market Funds
Cash and Cash Equivalents [Line Items]
Cash equivalents	9,084	13,141
Commercial Paper
Cash and Cash Equivalents [Line Items]
Cash equivalents	0	323
Corporate debt
Cash and Cash Equivalents [Line Items]
Cash equivalents	0	2,197
Yankee CD
Cash and Cash Equivalents [Line Items]
Cash equivalents	$ 0	$ 550

Balance Sheet Components - Su_2

Balance Sheet Components - Summary of Available-For-Sale Marketable Securities (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Marketable Securities [Line Items]
Amortized Cost	$ 127,663	$ 61,806
Gross Unrealized Gains	42	79
Gross Unrealized Losses	(261)	(106)
Fair Value	127,444	61,779
U.S. treasury and government agencies
Marketable Securities [Line Items]
Amortized Cost	55,305	16,472
Gross Unrealized Gains	0	11
Gross Unrealized Losses	(144)	(40)
Fair Value	55,161	16,443
Commercial Paper
Marketable Securities [Line Items]
Amortized Cost	347
Gross Unrealized Gains	0
Gross Unrealized Losses	0
Fair Value	347
Corporate debt
Marketable Securities [Line Items]
Amortized Cost	28,391	23,376
Gross Unrealized Gains	22	31
Gross Unrealized Losses	(29)	(35)
Fair Value	28,384	23,372
Asset-backed securities
Marketable Securities [Line Items]
Amortized Cost	30,876	13,892
Gross Unrealized Gains	20	27
Gross Unrealized Losses	(76)	(23)
Fair Value	30,820	13,896
Yankee CD
Marketable Securities [Line Items]
Amortized Cost	12,744	8,066
Gross Unrealized Gains	0	10
Gross Unrealized Losses	(12)	(8)
Fair Value	$ 12,732	$ 8,068

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 25,429	$ 19,601
Less: accumulated depreciation and amortization	(5,994)	(4,263)
Property and equipment, net	19,435	15,338
Furniture and Fixtures and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,586	1,577
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	3,067	705
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	2,079	928
Capitalized Surgical Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	11,511	9,248
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	697	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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Cash and Cash Equivalents [Line Items]
Depreciation and amortization expense	$ 1,100	$ 400	$ 2,019	$ 757
Cash	2,951		2,951		$ 3,262
Silicon Valley Bank
Cash and Cash Equivalents [Line Items]
Cash	$ 0		$ 0		$ 900

Balance Sheet Components - Su_4

Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Accrued royalty expense	$ 1,740	$ 2,299
Accrued interest	398	412
Accrued professional services	930	1,727
Other accrued expense	4,004	1,778
Total accrued liabilities	$ 7,072	$ 6,216

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Current Operating Lease Liability and Other Liabilities (Detail) - USD ($) $ in Thousands	Jun. 30, 2023	Dec. 31, 2022
Operating Lease, Liability [Abstract]
Operating lease and other liabilities	$ 961	$ 339
Payable to broker	2,814	0
Total operating lease and other liabilities	$ 3,775	$ 339

Long Term Debt - Additional Inf

Long Term Debt - Additional Information (Detail) - USD ($) $ in Millions		6 Months Ended
	Apr. 29, 2022	Jun. 30, 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 June 30, 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		$ 22.5
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	Jun. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Total term loans	$ 54,000	$ 54,000
Less: Unamortized debt discount and debt issuance costs	(1,141)	(1,289)
Total long-term debt, net	52,859	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	Jun. 30, 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	(1,141)	(1,289)
Total long-term debt, net	$ 52,859	$ 52,711

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Other Commitments [Line Items]
Accrued contingent liabilities	$ 0		$ 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	$ 1,300,000	$ 3,200,000	$ 2,700,000
Royalty as a percentage of net sales for the period	3.70%	4.60%	3.80%	4.60%

Stockholders' Equity (Additiona

Stockholders' Equity (Additional Information) (Detail) - $ / shares	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Employees stock options, shares granted			771,785	1,171,175
Restricted Stock [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares granted	651,396	359,534
Weighted average grant-date fair value	$ 24.26	$ 18.28	$ 24.26	$ 18.28
Employee Stock Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock options, weighted-average grant date fair value			$ 10.63	$ 7.37

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		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	$ 3,596	$ 1,963	$ 6,288	$ 3,372
Cost of goods sold [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	53	0	129	0
Sales and marketing [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	1,063	690	1,885	1,221
Research and development [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	375	176	632	326
General and administrative [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	$ 2,105	$ 1,097	$ 3,642	$ 1,825

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				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Numerator
Net loss	$ (12,271)	$ (13,454)	$ (17,234)	$ (9,036)	$ (25,725)	$ (26,270)
Denominator
Weighted Average Number of Shares Outstanding, Basic	61,382,514		55,308,273		60,060,483	55,071,368
Weighted Average Number of Shares Outstanding, Diluted	61,382,514		55,308,273		60,060,483	55,071,368
Net loss per share attributable to common stockholders, basic	$ (0.2)		$ (0.31)		$ (0.43)	$ (0.48)
Net loss per share attributable to common stockholders, diluted	$ (0.2)		$ (0.31)		$ (0.43)	$ (0.48)

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	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	8,636,454	7,745,803
Common Stock Options Issued and Outstanding [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	7,529,046	7,150,755
Unvested Full Value Awards [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	1,107,408	595,048