Treace Medical Concepts (TMCI) 10-K 27 Feb 24 2023 FY Annual report Financial data

Cover Page

Cover Page - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Feb. 22, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2023
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Document Annual Report	true
Document Transition Report	false
Entity Registrant Name	TREACE MEDICAL CONCEPTS, INC.
Entity File Number	001-40355
Entity Tax Identification Number	47-1052611
Entity Address, Address Line One	100 Palmetto Park Place
Entity Address, City or Town	Ponte Vedra
Entity Address, Postal Zip Code	32081
City Area Code	904
Local Phone Number	373-5940
Entity Central Index Key	0001630627
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Entity Address, State or Province	FL
Entity Filer Category	Large Accelerated Filer
Entity Shell Company	false
Entity Small Business	false
Entity Emerging Growth Company	false
Title of 12(b) Security	Common stock, $0.001 par value
Trading Symbol	TMCI
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		61,755,146
Entity Public Float			$ 1,223.6
ICFR Auditor Attestation Flag	true
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Document Financial Statement Error Correction [Flag]	false
Documents Incorporated by Reference	DOCUMENTS INCORPORATED BY REFERENCE Portions of the registrant's definitive proxy statement relating to its 2024 annual meeting of stockholders (the "2024 Proxy Statement") are incorporated by reference into Part III of this Annual Report on Form 10-K where indicated. The 2024 Proxy Statement will be filed with the U.S. Securities and Exchange Commission within 120 days after the end of the fiscal year to which this Annual Report on Form 10-K relates.
Auditor Firm ID	248
Auditor Name	GRANT THORNTON LLP
Auditor Location	Jacksonville, FL

Balance Sheets

Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Current assets
Cash and cash equivalents	$ 12,982	$ 19,473
Marketable securities, short-term	110,216	61,779
Accounts receivable, net of allowance for doubtful accounts of $980 and $735 as of December 31, 2023 and 2022, respectively	38,063	29,196
Inventories	29,245	19,330
Prepaid expenses and other current assets	7,853	3,624
Total current assets	198,359	133,402
Property and equipment, net	22,298	15,338
Intangible assets, net of accumulated amortization of $475 and $0 as of December 31, 2023 and December 31, 2022, respectively	9,025	0
Goodwill	12,815	0
Operating lease right-of-use assets	9,264	10,138
Other non-current assets	146	146
Total assets	251,907	159,024
Current liabilities
Accounts payable	11,835	8,668
Accrued liabilities	10,458	6,216
Accrued commissions	10,759	7,356
Accrued compensation	7,549	7,666
Other liabilities	4,432	339
Total current liabilities	45,033	30,245
Long-term debt, net of discount of $992 and $1,289 as of December 31, 2023 and 2022, respectively	53,008	52,711
Operating lease liabilities, net of current portion	15,891	15,539
Other long-term liabilities	37	0
Total liabilities	113,969	98,495
Stockholders’ equity
Preferred stock, $0.001 par value, 5,000,000 shares authorized as of December 31,2023 and December 31, 2022; 0 shares issued and outstanding as of December 31,2023 and December 31, 2022	0	0
Common stock, $0.001 par value, 300,000,000 shares authorized; 61,749,654 issued and outstanding as of December 31, 2023; 300,000,000 shares authorized; 55,628,208 issued and outstanding as of December 31, 2022	62	55
Additional paid-in capital	271,973	145,221
Accumulated deficit	(134,247)	(84,720)
Accumulated other comprehensive (loss) incom	163	(27)
Treasury stock, at cost; 1,218 and 0 shares as of December 31, 2023 and December 31, 2022	(13)	0
Total stockholders’ equity	137,938	60,529
Total liabilities and stockholders’ equity	$ 251,907	$ 159,024

Balance Sheets (Parenthetical)

Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Allowance for doubtful accounts receivable current	$ 980	$ 735
Intangible assets, accumulated amortization	475	0
Long term debt unamortized debt discount and issuance costs	$ 992	$ 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	61,749,654	55,628,208
Common stock share outstanding	61,749,654	55,628,208
Treasury stock (in shares)	1,218	0

Statements of Operations and Co

Statements of Operations and Comprehensive Loss - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Revenue	$ 187,118	$ 141,838	$ 94,419
Cost of goods sold	35,181	25,532	16,888
Gross profit	151,937	116,306	77,531
Operating expenses
Sales and marketing	140,894	104,567	65,405
Research and development	15,440	13,584	10,204
General and administrative	47,031	32,999	18,432
Total operating expenses	203,365	151,150	94,041
Loss from operations	(51,428)	(34,844)	(16,510)
Interest income	6,726	1,313	17
Interest expense	(5,167)	(4,398)	(4,060)
Debt extinguishment loss	0	(4,483)	0
Other income, net	342	(403)	1
Other non-operating income (expense), net	1,901	(7,971)	(4,042)
Net loss	(49,527)	(42,815)	(20,552)
Convertible preferred stock cumulative and undeclared dividends	0	0	(196)
Net loss attributable to common stockholders	(49,527)	(42,815)	(20,748)
Other comprehensive income (loss):
Unrealized gain (loss) on marketable securities	190	(27)	0
Comprehensive loss	$ (49,337)	$ (42,842)	$ (20,748)
Net loss per share attributable to common stockholders, basic	$ (0.81)	$ (0.77)	$ (0.43)
Net loss per share attributable to common stockholders, diluted	$ (0.81)	$ (0.77)	$ (0.43)
Weighted-average shares used in computing net loss per share attributable to common stockholders, basic	60,852,153	55,276,834	48,415,679
Weighted-average shares used in computing net loss per share attributable to common stockholders, diluted	60,852,153	55,276,834	48,415,679

Statements of Stockholders' Equ

Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Convertible preferred stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Loss [Member]	Treasury Stock [Member]
Balance at Beginning at Dec. 31, 2020	$ 776	$ 7,935	$ 28	$ 14,166	$ (21,353)	$ 0	$ 0
Balance at Beginning (in Shares) at Dec. 31, 2020		6,687,475	37,366,865
Issuance of common stock upon exercise of stock options	1,830		$ 2	1,828		0	0
Issuance of common stock upon exercise of stock options, shares			2,368,705
Issuance of restricted stock awards, shares			24,895
Share-based compensation expense	3,409			3,409
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount	107,610		$ 7	107,603
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount			6,953,125
Issuance of common stock upon net exercise of warrants			$ 1	(1)
Issuance of common stock upon net exercise of warrants, shares			621,570
Conversion of convertible preferred stock and accrued dividends on convertible preferred stock into common stock		$ (7,935)	$ 7	7,928
Conversion of convertible preferred stock and accrued dividends on convertible preferred stock into common stock, shares		(6,687,475)	6,845,922
Net loss	(20,552)				(20,552)
Balance at Ending at Dec. 31, 2021	93,073	$ 0	$ 45	134,933	(41,905)	0	0
Balance at Ending (in Shares) at Dec. 31, 2021		0	54,181,082
Issuance of common stock upon exercise of stock options	2,187		$ 10	2,177			0
Issuance of common stock upon exercise of stock options, shares			1,444,626
Common stock issued for vesting of stock units			2,500
Share-based compensation expense	8,111			8,111
Net loss	(42,815)				(42,815)
Unrealized loss on available-for-sale marketable securities	(27)	$ 0
Unrealized loss on available-for-sale marketable securities						(27)
Balance at Ending at Dec. 31, 2022	60,529	$ 0	$ 55	145,221	(84,720)	(27)	0
Balance at Ending (in Shares) at Dec. 31, 2022		0	55,628,208
Issuance of common stock upon exercise of stock options	$ 1,869		$ 1	1,868
Issuance of common stock upon exercise of stock options, shares	495,337		495,337
Common stock issued for vesting of stock units			149,919
Share-based compensation expense	$ 17,363			17,363
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount	107,527		$ 6	107,521
Issuance of common stock from initial public offering, net of issuance costs and underwriting discount			5,476,190
Net loss	(49,527)				(49,527)
Unrealized loss on available-for-sale marketable securities	190					190
Shares directly withheld from employees for tax payment	(13)						(13)
Balance at Ending at Dec. 31, 2023	$ 137,938	$ 0	$ 62	$ 271,973	$ (134,247)	$ 163	$ (13)
Balance at Ending (in Shares) at Dec. 31, 2023		0	61,749,654

Statements of Stockholders' E_2

Statements of Stockholders' Equity (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2021
Statement of Stockholders' Equity [Abstract]
Issuance cost and underwriting discount	$ 7.5	$ 10.6

Statements of Cash Flows

Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash flows from operating activities
Net loss	$ (49,527)	$ (42,815)	$ (20,552)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization expense	5,352	2,133	685
Provision for allowance for doubtful accounts	434	411	144
Share-based compensation expense	17,352	8,111	3,409
Non-cash lease expense	2,461	2,522	0
Amortization of debt issuance costs	297	244	176
Gain on fair value adjustment to derivative liability	0	(173)	(72)
Debt extinguishment loss	0	4,483	0
Loss on impairment of long-lived assets	0	346	0
Accretion (amortization) of discount (premium) on marketable securities, net	(1,406)	(126)	0
Other, net	205	25	0
Net changes in operating assets and liabilities, net of acquisitions:
Accounts Receivable	(9,301)	(11,039)	(4,226)
Inventory	(9,848)	(8,769)	(2,741)
Prepaid expenses and other assets	(1,210)	(668)	(2,417)
Other non-current assets	0	(146)	0
Other liabilities	(119)	3,076	0
Accounts payable	3,167	4,612	1,791
Accrued liabilities	7,528	7,125	6,610
Other, net	40	0	0
Net cash used in operating activities	(34,575)	(30,648)	(17,193)
Cash flows from investing activities
Purchases of available-for-sale marketable securities	(169,865)	(63,409)	0
Sales and maturities of available-for-sale marketable securities	120,024	1,729	0
Purchases of property and equipment	(11,458)	(14,838)	(2,705)
Acquisition, net of cash acquired	(20,000)	0	0
Net cash used in investing activities	(81,299)	(76,518)	(2,705)
Cash flows from financing activities
Proceeds from interest bearing term debt	0	49,651	0
Proceeds from interest bearing revolving debt	0	3,850	0
Debt issuance costs	0	(989)	0
Payments on interest bearing debt	0	(33,893)	0
Payments on PPP Loan	0	0	(1,788)
Proceeds from issuance of common stock from public offering, net of issuance costs and underwriting discount of $7.5 million and $10.6 million	107,527	0	107,610
Proceeds from exercise of employee stock options	1,869	2,187	1,830
Taxes from withheld shares	(13)	0	0
Net cash provided by financing activities	109,383	20,806	107,652
Net decrease in cash and cash equivalents	(6,491)	(86,360)	87,754
Cash and cash equivalents at beginning of period	19,473	105,833	18,079
Cash and cash equivalents at end of period	12,982	19,473	105,833
Supplemental disclosure of cash flow information:
Cash paid for interest	5,167	4,398	3,900
Operating lease right-of-use assets obtained in exchange for new lease liabilities	0	15,300	0
Operating lease right-of-use asset and lease liability adjustment due to lease incentive	(22)	3,615	0
Noncash investing activities and financing activities:
Unrealized (gains) losses on marketable securities	(190)	27	0
Unsettled matured marketable security and receivable from broker	3,000	0	0
Noncash portion of internally developed software	(11)	0	0
Issuance of common stock upon exercise of warrants	0	0	1
Conversion of convertible preferred stock and accrued dividends on convertible preferred stock into common stock	$ 0	$ 0	$ 7,935

Statements of Cash Flows (Paren

Statements of Cash Flows (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Statement of Cash Flows [Abstract]
Issuance costs and underwriting fees, net	$ 7.5	$ 10.6

Formation and Business of the C

Formation and Business of the Company	12 Months Ended
	Dec. 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 advanced instrumentation and implants for use in other procedures performed in high frequency with bunion surgery. 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 approximately $ 107.6 million from the IPO. O n February 10, 2023, the Company completed a follow-on 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.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Basis of Presentation The accompanying financial statements are prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). The financial statements presented have been prepared on a consistent basis with the exception of the following item. An adjustment has been made to the Statement of Operations and Comprehensive Loss for the years ended 2022 and 2021 for $ 2.0 million and $ 0.9 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. The Company evaluated events or transactions that may have occurred after the balance sheet date for potential recognition or disclosure through the date the financial statements were issued. No subsequent events or transactions requiring recognition or disclosure were identified. Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the 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 write-downs related to accounts receivable, reserves and inventories, valuation of intangible assets and goodwill, the recoverability of long-term assets, deferred tax assets and related valuation allowances, contingencies, earn-out liabilities, and stock-based compensation. 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 that may include the income approach, the cost approach, or 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 Statements 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 the 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. Segments The Company operates and manages its business as one operating and reportable segment, which is the business of designing, manufacturing, and marketing medical devices for physicians, surgeons, ambulatory surgery centers and hospitals related to the surgical management of bunion and related midfoot deformities. The Company's chief executive officer, who is the chief operating decision maker, reviews financial information on an aggregate basis for purposes of allocating resources and evaluating financial performance. All long-lived assets are maintained in the United States. Cash and Cash Equivalents The Company considers all highly liquid investments with an original or remaining maturity at the time of purchase of 90 days or less to be cash equivalents. All of the Company's cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in money market funds and bank deposits, the balances of which at times may exceed federally insured limits. Marketable Securities The Company considers its debt securities and Yankee certificate of deposits ("Yankee CDs") to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term marketable securities. Marketable securities classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders' equity (deficit) until their disposition or maturity. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company's current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Premiums and discounts are amortized and accreted, respectively, using the effective interest method. Refer to Note 4, "Fair Value Measurements," for fair value disclosures for cash equivalents and short-term marketable securities. Available-for-sale securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees' financial condition and the Company's intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in fair value judged to be other-than-temporary are included in the Company's Statements of Operations and Comprehensive Loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company's Statements of Operations and Comprehensive Loss for the years ended December 31, 2023 or 2022 . Accounts Receivable and Allowances Accounts receivable are generally from hospitals and ambulatory surgery centers and are stated at amounts billed less allowances for doubtful accounts. The Company continually monitors customer payments and maintains an allowance for losses resulting from a customer's inability to make required payments. The Company considers factors such as historical experience, credit quality, age of the accounts receivable balances, geographic related risks and economic conditions that may affect a customer's ability to pay. Accounts receivable are written off when individual balances are no longer collectible. As of December 31, 2023 and 2022, accounts receivable are presented net of an allowance for doubtful accounts of $ 1.0 million and $ 0.7 million, respectively. For the years ended December 31, 2023, 2022, and 2021, the Company recorded provisions for bad debts of $ 0.4 million, $ 0.4 million, and $ 0.1 million, respectively. Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents, marketable securities, and accounts receivable. The Company maintains its cash with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation ("FDIC") insured limits. The Company's available-for-sale securities portfolio primarily consists of U.S. treasury and agency securities, money market funds, commercial paper, Yankee CDs, high credit quality asset-backed securities and corporate debt securities. The Company's investment policy requires its available for sale securities to meet certain criteria including investment type, credit ratings, and a maximum portfolio duration of one year. The Company earns revenue from the sale of its products to customers such as hospitals and ambulatory surgery centers. The Company's accounts receivable is derived from revenue earned from customers. The Company performs ongoing credit evaluations of its customers' financial condition and generally requires no collateral from its customers. At December 31, 2023 and 2022 , no customer accounted for more than 10 % of accounts receivable. For the years ended December 31, 2023, 2022, and 2021 , there were no customers that represented 10 % or more of revenue. Leases The Company determines whether an arrangement is or contains a lease at the inception of the arrangement and whether such a lease is classified as a financing lease or an operating lease at the commencement date of the lease. Lease liabilities and their corresponding right-of-use assets are recorded based on the present value of lease payments over the expected lease term. The Company determines the commencement date of a lease to be the date on which a lessor makes an underlying asset available for use by the Company. Leases with a term greater than one year are recognized on the Balance Sheets as operating lease right-of-use assets, Operating lease liabilities and Operating lease liabilities, net of current portion. The Company elected not to recognize right-of-use assets and lease liabilities for leases with terms of 12 months or less (short-term leases). As the interest rates implicit in our lease contracts are not readily determinable, the Company utilizes its incremental borrowing rate based on the information available at the commencement date to determine the present value of lease payments. Certain adjustments to the right-of-use asset may be required for items such as initial direct costs paid, incentives received, or impairment charges if the Company determines the right-of-use asset is impaired. In the fourth quarter of 2022, the Company recorded an impairment to the right-of-use asset associated with the lease on its previous corporate headquarters. See Note 6, "Balance Sheet Components," for further details of the impairment. The Company considers the lease term to be the noncancelable period that the Company has the right to use the underlying asset, together with any periods where it is reasonably certain the Company will exercise an option to extend (or not terminate) the lease. Rent expense for operating leases is recognized on a straight-line basis over the lease term and is presented in operating expenses on the Statements of Operations and Comprehensive Loss. The Company has elected to not separate lease and non-lease components for its real estate leases and instead accounts for each separate lease component and the non-lease components associated with that lease component as a single lease component. Variable lease payments are recognized as lease expense as incurred and are recorded in operating expenses on the Statements of Operations and Comprehensive Loss. The Company has no finance leases. Inventories Inventories consist primarily of surgical kits and components as finished goods and are stated at the lower of cost or net realizable value. Cost is determined based on an average cost method which approximates the first-in, first-out basis and includes primarily outsourced manufacturing costs and direct manufacturing overhead costs. The Company reviews inventory for excess, obsolescence, and field losses and writes down inventory, as necessary. For the years ended December 31, 2023, 2022, and 2021, the Company recorded a provision to cost of goods sold of $ 0.9 million, $ 0.1 million, and $ 0.3 million, respecti vely, for excess, obsolete, and field related losses to inventory. Property and Equipment, Net Property and equipment are recorded at cost. Depreciation of property and equipment is recorded using the straight-line method over the following estimated useful lives as follows: Years Furniture, fixtures and equipment 7 Machinery and equipment 3 or 5 Capitalized surgical instruments 3 Computer equipment 3 Leasehold improvements Lesser of estimated useful life or lease term Software 3 Long-lived assets are evaluated whenever a change in circumstances indicates that the carrying amount of an asset may not be recoverable. If assets are considered to be impaired, a charge is recorded for an amount that the carrying value exceeds the fair value. The Company capitalized $ 0.2 million of software development costs that will be depreciated over a period of three years. Revenue Recognition The Company generates revenue from the sale of its proprietary Lapiplasty System and its minimally invasive variations, Adductoplasty System, Hammertoe PEEK Fixation System, SpeedPlate Implant Fixation Platform, single use osteotomes and release instruments, and other implanted ancillary products. The Company receives payment for all these products that are consumed during the surgery and does not receive separate consideration for the use of the instrument tray furnished by the Company for the surgeon's use. The Company identifies the instrument trays as a lease component and the implants and other single use products as a non-lease component in its arrangements with its customers. The Company concluded that the non-lease component is predominant, and as such, elected the practical expedient to not separate the lease and non-lease components. Therefore, the overall arrangement is accounted for under ASC 606. Implant kits, single use instruments, and other ancillary products are sold in the United States through a combination of a direct employee sales force and independent sales agencies. The Company invoices hospitals and ambulatory surgery centers for the implant kits and other products and pays commissions to the sales representatives and independent sales agencies. The Company has no international sales. Under ASC 606, revenue is recognized when the customer obtains control of promised goods or services, in an amount that reflects consideration which the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606, the Company performs the following five steps as prescribed by ASC 606: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies performance obligations. A contract with a customer exists when (i) the Company enters into a legally enforceable contract with a customer that defines each party's rights regarding the products to be transferred and identifies the payment terms related to these products, (ii) the contract has commercial substance, and (iii) the Company determines that collection of substantially all consideration for its products that are transferred is probable based on the customer's intent and ability to pay the promised consideration. The Company considers signed agreements and purchase orders as a customer's contract. Sales prices are specified in either the customer contract or agreed price list, which is executed prior to the transfer of control to the customer. The Company identifies performance obligations based on the terms of the contract and customary business practices, which include products that are distinct, or a series of distinct goods that are substantially the same and that have the same pattern of transfer to the customer. The transfer of the Company's products to the customer are distinct performance obligations. The Company does not have any material performance obligations other than the transfer of the products to the customer. The transaction price in the Company's customer contracts includes fixed consideration to be contractually billed to the customer while variable consideration includes the right of return. The Company does not allocate the transaction price or any variable consideration to the right of return. The Company did no t recognize a refund liability as of December 31, 2023 and 2022 , and there were negligible returns during the years ended December 31, 2023 and 2022 and no product returns during the year ended December 31, 2021. The Company has elected to exclude from the measurement of the transaction price all taxes (e.g., sales, use, value-added) assessed by government authorities and collected from a customer. For shipments to customers, the Company offers the right to return the product within 30 days for a full refund, and for returns between 30 and 90 days, the Company offers a full refund less a 15% restocking fee. The Company does not have a history of product returns for refund. Customer invoices are generally payable within 30 days. The Company's products are generally sold with a limited standard warranty to the original purchaser of the products against defects in workmanship and materials for 180 days. The Company's liability is limited to providing, at the Company's option, a full refund or credit of the purchase price, or repairing or replacing the product, provided that the customer returns the defective product within 180 days from the purchase date. To date, the Company has had negligible returns of any products alleged to be defective. Revenue for products is recognized when a customer obtains control of the promised products, which is generally when the customer has the ability to (i) direct its use and (ii) obtain substantially all of the remaining benefits from it. Revenue recognition occurs for the majority of our sales when control of the product transfers to the customer, which is generally at the time the product is used in surgery. The Company also generates a small percentage of total revenues from the sale of products when the products are ordered in advance of a surgery procedure. The performance obligation is the delivery of the products and therefore, revenue is recognized either at shipment or upon receipt by the customer depending upon the contractual terms of the purchase and when the risk of ownership transfers to the customer. Contract Costs The Company applies the practical expedient to recognize the incremental costs of obtaining a contract as expense when incurred if the amortization period would be one year or less. These incremental costs include sales commissions paid to the Company's independent sales agencies or employee sales representatives. Cost of Goods Sold Cost of goods sold consists primarily of costs for the purchase of the Company's products from third-party manufacturers. Direct costs from the Company's third-party manufacturers include costs for raw materials plus the markup for the assembly of the components. Cost of goods sold also includes royalties, allocated overhead for indirect labor, certain direct costs such as those incurred for shipping our products and personnel costs. The Company expenses all inventory provisions for excess and obsolete inventories as cost of goods sold. The Company records adjustments to its inventory valuation for estimated excess, obsolete, field loss rate, and non-sellable inventories based on assumptions about future demand, past usage, changes to manufacturing processes and overall market conditions. Research and Development Expenses Research and development ("R&D") expenses consist primarily of engineering, product development, clinical studies to develop and support the Company's products, regulatory expenses, and other costs associated with products and technologies that are in development. These expenses include compensation for personnel, including salaries, bonuses, benefits and stock-based compensation, supplies, consulting, prototyping, testing, materials, travel expenses, depreciation and an allocation of facility overhead expenses. Shipping and Handling The Company has elected to account for shipping and handling activities as fulfillment activities. As such, the Company does not evaluate shipping and handling as promised services to its customers. The Company may bill customers for shipping and handling costs. Amounts billed for shipping and handling are included in revenue. Shipping and handling costs incurred by the Company are included in sales and marketing expense. Shipping and handling costs totaled $ 1.3 million, $ 0.8 million, and $ 0.5 million, for the years ended December 31, 2023, 2022, and 2021 , respectively. Advertising Costs Advertising costs are expensed as incurred and are included as a component of marketing and sales expenses. Advertising expense includes the cost of advertising across the various mediums we employ, including print, digital, radio and television. Advertising costs totaled approximately $ 16.1 million , $ 15.0 million, and $ 13.0 million, for the years ended December 31, 2023, 2022, and 2021 , respectively. Income Taxes The Company accounts for income taxes under the liability method, whereby deferred tax assets and liabilities are determined based on the difference between the financial statements and tax bases of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to affect taxable income. A valuation allowance is established when necessary to reduce deferred tax assets when management estimates, based on available objective evidence, that it is more likely than not that the benefit will not be realized for the deferred tax assets. The Company also follows the provisions of ASC 740-10, Accounting for Uncertainty in Income Taxes . ASC 740-10, which prescribes a comprehensive model for the recognition, measurement, presentation and disclosure in financial statements of any uncertain tax positions that have been taken or expected to be taken on a tax return. No liability related to uncertain tax positions is recorded in the financial statements. It is the Company's policy to include penalties and interest expense related to income taxes as part of the provision for income taxes. Product Liability The Company believes it carries adequate insurance for possible product liability claims. Accruals for product liability claims and legal defense costs in excess of insured amounts are recorded if it is probable that a liability has been incurred and the amount of any liability can be reasonably estimated. No accruals for product liability claims had been recorded as of December 31, 2023 and 2022 . Debt Debt issuance costs and discount are amortized to interest expense u sing the effective interest method. Stock-Based Compensation The Company accounts for stock-based compensation arrangements with employees in accordance with ASC 718, Compensation-Stock Compensation, using a fair-value based method. The Company determines the fair value of stock options and performance-based restricted stock awards units ("PSUs") on the date of grant. The fair value for restricted stock and restricted stock units awards is the fair value of the stock at the grant date. The fair value of time-based awards is recognized over the period during which an award holder is required to provide services in exchange for the award, known as the requisite service period, which is typically the vesting period using the straight-line method. The Company accrues for estimated forfeitures on share-based awards and adjusts stock-based compensation cost to actual as forfeitures occur. The estimated forfeitures are based on a historical analysis of actual forfeitures of awards. The Company estimates the fair value of the stock-based awards using the Black-Scholes option-pricing model, which requires the input of highly subjective assumptions. The assumptions are as follows: • Expected Term . The expected term represents the period that the stock options are expected to remain outstanding. The Company is using the "simplified" method, which is the simple average of the vesting period and the contractual term. • Expected Volatility . The expected volatility is derived from the historical stock volatilities of comparable publicly listed peers over a period approximately equal to the expected term of the options as the Company does not have sufficient trading history to determine the volatility of its common stock. • Risk-Free Interest Rate . The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the date of grant for zero-coupon U.S. Treasury notes with maturities approximately equal to the stock-based awards' expected term. • Expected Dividend Yield . The expected dividend yield is zero as the Company has not paid nor anticipates paying any dividends on the common stock in the foreseeable future. • Fair Market Value of Common Stock. The fair market value of the common stock is based on its closing price as reported on the date of grant. The Company continues to use judgment in evaluating the expected volatility and expected terms utilized for the fair value of stock options on a prospective basis. The Company used the simplified method to determine the expected term for options due to the lack employee exercise history since our IPO. As the Company continues to accumulate additional data, the Company may make refinements to the assumptions, which could materially impact the future stock-based compensation expense. The Company estimates the fair value of PSUs awards using the Monte Carlo model, which requires the input of several assumptions. The assumptions are as follows: • Beginning Average Stock Price. Includes the stock price for the Company and each peer company within the index for the measurement period prior to the grant date assuming dividends distributed during the period were reinvested for additional shares on the ex-dividend date. • Valuation Date Stock Price. The closing price for the Company and each peer company on the grant date. • Expected Volatility . The expected volatility is the historical stock volatilities for the Company and each peer company within the index over the period of time that is consistent with the measurement period for the awards. • Correlation Coefficients. The correlation coefficients are derived from the price data used to calculate expected volatility and are used to model the way in which each entity's stock price tends to move in relation to the peer company group. • Risk-Free Interest Rate . The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the date of grant with maturities equal to the PSU awards performance period. • Expected Dividend Yield For Modeling Total Stockholder Return . The total stockholder return for the Company and each peer company in the index is calculated assuming dividends distributed from the start of the measurement period are reinvested on the ex-dividend date in the underlying company's stock. Comprehensive Loss The Company is required to report all components of comprehensive loss, including net loss, in the financial statements in the period in which they are recognized. Comprehensive loss is defined as a change in equity of a business enterprise during a period, resulting from transactions and other events and circumstances from non-owner sources. Comprehensive loss equaled $ 49.3 million and 42.8 million for the years ended December 31, 2023 and 2022, respectively. Comprehensive loss equaled net loss for the year ended December 31, 2021 . Net Loss Per Share Attributable to Common Stockholders Basic net loss per share attributable to common stockholders is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of common shares outstanding during the period, without consideration for potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss by the weighted-average number of common shares and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, common stock options, unvested restricted stock units and restricted stock awards are considered to be potentially dilutive securities. Because the Company has reported a net loss for the years ended December 31, 2023, 2022, and 2021 , diluted net losses per common share were the same as basic net losses per common share for these periods.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	12 Months Ended
	Dec. 31, 2023
Accounting Standards Update and Change in Accounting Principle [Abstract]
Recent Accounting Pronouncements	3. Recent Accounting Pronouncements Recently Adopted Accounting Pronouncements In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) ("ASC 842"). The update establishes principles for recognition, measurement, presentation, and disclosure intended to increase transparency and comparability for the accounting of lease transactions. The standard required lessees to recognize leases with terms greater than 12 months on the balance sheet and disclose key information about leasing arrangements. ASC 842 was effective for the Company for fiscal years beginning after December 15, 2021. The Company adopted the new standard as of January 1, 2022, using the required modified retrospective approach. Comparative periods were not adjusted and continue to be presented under the previous accounting guidance. The Company elected the package of practical expedients permitted under the ASC 842 transition guidance, which among other things, allowed it to carry forward the historical lease classification. The impact of adoption was the recognition of right-of-use assets and lease liabilities of $ 1.9 million for real estate operating leases at January 1, 2022. In addition, ASC 842 required new disclosures for lease transactions. Refer to Note 9, "Operating Leases," for new lease disclosures. In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses . This guidance required financial instruments to be measured at amortized cost, and trade accounts receivable to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments. In November 2019, the FASB issued ASU 2019-10, that was effective for fiscal years beginning after December 15, 2022, and interim periods within that fiscal year. The Company adopted the standard on January 1, 2023. The adoption of this guidance did not have a material impact on the Company's financial statements. Recent Accounting Pronouncements Not Yet Adopted In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280) ("ASC 280") . The update requires all public business entities to identify their reportable segments, including the basis of organization, types of products and services from which each reportable segment derives its revenues, and the title and position of the individual or the name of the group or committee identified as the chief operating decision maker ("CODM") and an explanation of how the CODM uses the reported measure(s) of segment profit or loss in assessing segment performance and deciding how to allocate resources. Public entities shall disclose on an annual and interim basis for each reportable segment including entities that only have one reportable segment, certain significant expense categories and amounts that are regularly provided to the CODM and included in reported segment profit or loss. ASC 280 is applied retrospectively to all prior periods presented in the financial statements. This new guidance is effective for fiscal years beginning after December 15, 2023, and interim periods within fiscal years beginning after December 15, 2024. Early adoption is permitted. The Company is currently evaluating the impact of the new standard on its financial statements and related disclosures. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740) ("ASC 740") . The update requires all public business entities on an annual basis to (1) disclose specific categories in the rate reconciliation and (2) provide additional information for reconciling items that meet a quantitative threshold and an explanation, if not otherwise evident, of the individual reconciling items disclosed, such as the nature, effect, and underlying causes of the reconciling items and the judgment used in categorizing the reconciling items. In addition, the update requires certain new disclosures of the amount of income taxes paid (net of refunds received) disaggregated by federal, state, and foreign taxes and the amount of income taxes paid (net of refunds received) disaggregated by individual jurisdictions in which income taxes paid is equal to or greater than five percent of total income taxes paid (net of refunds received). Other new disclosures required include income (or loss) from continuing operations before income tax expense (or benefit) disaggregated between domestic and foreign and income tax expense (or benefit) from continuing operations disaggregated by federal, state, and foreign. The new guidance is effective for annual periods beginning after December 15, 2024. Early adoption is permitted. The amendments are to be applied on a prospective basis, with retrospective application permitted. The Company is currently evaluating the impact of the new standard on its financial statements and related disclosures.

Fair Value Measurements

Fair Value Measurements	12 Months Ended
	Dec. 31, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	4. Fair Value Measurements Assets and liabilities recorded at fair value in the financial statements are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Hierarchical levels which are directly related to the amount of subjectivity associated with the inputs to the valuation of these assets or liabilities are as follows: Level 1—Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date. Level 2—Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities. Level 3—Unobservable inputs for the asset or liability only used when there is little, if any, market activity for the asset or liability at the measurement date. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis – The following assets and liabilities are measured at fair value on a recurring basis as of December 31, 2023 and December 31, 2022 (in thousands): December 31, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 3,160 $ — $ — $ 3,160 Short-term marketable securities at fair value U.S. treasury and government agencies 14,005 15,364 — 29,369 Commercial paper — 2,895 — 2,895 Corporate debt — 46,586 — 46,586 Asset-backed securities — 24,756 — 24,756 Yankee CD — 6,610 — 6,610 Total assets $ 17,165 $ 96,211 $ — $ 113,376 Liabilities: Contingent consideration $ — $ — $ 2,977 $ 2,977 Total liabilities $ — $ — $ 2,977 $ 2,977 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 their fair value. The Company's available-for-sale securities portfolio consists of investments in U.S. treasury and government agency securities, commercial paper, corporate debt securities, asset-backed securities, and Yankee CDs. Yankee CDs are certificates of deposit issued in the United States by a branch of a foreign bank and are denominated in U.S. dollars. The fair value of Level 1 securities is determined on trade prices in active markets for identical assets. The fair value of Level 2 securities is determined using valuation models using inputs that are observable either directly or indirectly, such as quoted prices for similar assets, interest rates, yield curves, credit spreads, default rates, loss severity, broker and dealer quotes, as well as other relevant economic measures. The Level 3 contingent consideration was recorded at fair value on the date of the acquisition and thereafter based on the consideration expected to be transferred on the projected payment date estimated as the probability weighted future cash flows, discounted back to the present value. This calculation uses unobservable inputs that reflect the Company's own assumptions as to the ability of the acquired business to meet the targeted benchmarks and the discount rate used in the determination of fair value. The following table sets forth a summary of the changes in the fair value of the Company's Level 3 financial instruments (in thousands): Fair value as of December 31, 2022 $ - Contingent consideration from acquisition 2,814 Change in fair value 163 Fair value as of December 31, 2023 $ 2,977 Contingent consideration is included in other liabilities on the Balance Sheets. As of December 31, 2023 , the entire balance is classified as current due to the timing of the expected payment. The change in fair value for the contingent consideration related to the technological advancements milestone payment is classified as research and development expense within the Statements of Operations and Comprehensive Loss. We made no cash payments for contingent consideration during the twelve months ended December 31, 2023. See Note 5, "Business Combination," for more information on the technological advancements milestone payment. There were no assets or liabilities measured at fair value on a nonrecurring basis as of December 31, 2023 and December 31, 2022 .

Business Combination

Business Combination	12 Months Ended
	Dec. 31, 2023
Business Combinations [Abstract]
Business Combination	5. Business Combination On June 12, 2023 (the "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 such milestones, 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 December 31, 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 Topic 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 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 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. The intangible assets balance as of December 31, 2023 consisted of the following (in thousands): Gross Carrying Amount Accumulated Amortization Net Carrying Amount Developed technology $ 9,500 $ 475 $ 9,025 The intangible amortization for the twelve months ended December 31, 2023 and 2022 was $ 0.5 million and $ 0 , respectively. Estimated intangible amortization expense as of December 31, 2023 for the next five years is as follows (in thousands): 2024 $ 950 2025 950 2026 950 2027 950 2028 950 The goodwill balance as of December 31, 2023 is as follows (in thousands): Balance as of December 31, 2022 $ - Acquisitions 12,815 Balance as of December 31, 2023 $ 12,815 No impairment charges for finite lived intangibles or goodwill were recorded in any of the periods presented. 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 twelve months ended December 31, 2023 and 2022.

Balance Sheet Components

Balance Sheet Components	12 Months Ended
	Dec. 31, 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): December 31, December 31, 2023 2022 Cash $ 9,822 $ 3,262 Cash equivalents: Money market funds 3,160 13,141 Commercial paper — 323 Corporate debt — 2,197 Yankee CD — 550 Total cash and cash equivalents $ 12,982 $ 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. During the twelve months ended December 31, 2023 , $ 0.9 million of pledged cash was released by SVB. Marketable Securities The Company's available-for-sale marketable securities consisted of the following (in thousands): December 31, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 29,377 $ 8 $ ( 16 ) $ 29,369 Commercial paper 2,893 2 - 2,895 Corporate debt 46,467 123 ( 4 ) 46,586 Asset-backed securities 24,712 56 ( 12 ) 24,756 Yankee CD 6,604 7 ( 1 ) 6,610 Total marketable securities - short-term $ 110,053 $ 196 $ ( 33 ) $ 110,216 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 As of December 31, 2023, there were no available-for-sale securities with unrealized losses greater than 12 months. There was not an allowance for credit losses required as of December 31, 2023 and 2022. As of December 31, 2023, the Company had no plans to sell securities with unrealized losses, and believes it is more likely than not that it would not be required to sell such securities before recovery of their amortized cost. As of December 31, 2023 and 2022, there were no material gains or losses from sales of available-for-sale securities. As of December 31, 2023 and 2022, accrued interest of $ 1.1 million and $ 0.4 million, respectively, is excluded from the amortized cost basis of available-for-sale securities in the tables above and is recorded in prepaid expenses and other current assets on the Balance Sheets. As of December 31, 2023 all marketable securities mature within two years, except for asset-backed securities. Asset-backed securities are not due at a single maturity date. As such, these securities were not included. Property and Equipment, Net The Company's property and equipment, net consisted of the following (in thousands): December 31, December 31, 2023 2022 Furniture and fixtures, and equipment $ 2,494 $ 1,577 Construction in progress 1,115 705 Machinery and equipment 2,423 928 Capitalized surgical equipment 14,253 9,248 Computer equipment 1,020 571 Leasehold improvements 9,425 6,434 Software 316 138 Total property and equipment 31,046 19,601 Less: accumulated depreciation and amortization ( 8,748 ) ( 4,263 ) Property and equipment, net $ 22,298 $ 15,338 Depreciation and amortization expense for property and equipment was $ 4.9 million, $ 2.1 million, and $ 0.7 million for the years ended December 31, 2023, 2022, and 2021, respectively. In the fourth quarter of 2022, the Company recognized a $ 0.3 million impairment on a group of assets consisting of $ 0.2 million of property and equipment and $ 0.1 million related to the right-of-use asset associated with the lease of its previous corporate headquarters. The impairment loss is presented as a component of other income, net in the Statements of Operations and Comprehensive Loss. The Company did no t record impairment charges for its property and equipment, net for the years ended December 31, 2023 and 2021. Accrued Liabilities Accrued liabilities consist of the following (in thousands): December 31, December 31, 2023 2022 Accrued royalties expense $ 2,305 $ 2,299 Accrued interest 417 412 Accrued professional services 424 1,727 Accrued compensation expense for RPM-3D earn-out 3,340 — Other accrued expense 3,972 1,778 Total accrued liabilities $ 10,458 $ 6,216 Other liabilities Other liabilities consist of the following (in thousands): December 31, December 31, 2023 2022 Current portion of operating lease liabilities $ 1,404 $ 339 Contingent consideration 2,977 — Other 51 — Total other liabilities $ 4,432 $ 339

Long Term Debt

Long Term Debt	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Long Term Debt	7. Long Term Debt The Company's debt consisted of the following (in thousands): December 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 ( 992 ) ( 1,289 ) Total long-term debt, net $ 53,008 $ 52,711 As of December 31, 2023, future payments of long-term debt were as follows (in thousands): Fiscal Year 2024 — 2025 — 2026 33,333 2027 20,667 Total principal payments 54,000 Less: Unamortized debt discount and debt issuance costs ( 992 ) Total long-term debt, net $ 53,008 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 loans and a $ 30.0 million revolving loan facility. The term loan facility provides for a 60-month term loan up to $ 120.0 million in borrowing capacity to the Company, over four tranches. At term loan closing, the Company drew $ 50.0 million under tranche one. At December 31, 2023 , tranche two for $ 30.0 million expired. The remaining tranches provide up to an additional $ 40.0 million in borrowing capacity in the aggregate, subject to the achievement of certain revenue targets for the third and fourth tranche. The revolving loan facility provides up to $ 30.0 million in borrowing capacity to the Company based on the borrowing base. The borrowing base is calculated based on certain accounts receivable and inventory assets. As of December 31, 2023, the borrowing base allows a total of $ 26.0 million available to the Company under the revolving loan facility. The balance drawn as of December 31, 2023 is $ 4.0 million under the revolving loan facility. The Company may request an increase in the revolving loan facility in an amount up to $ 20.0 million for a total commitment of up to $ 50.0 million. The Company is required to either (i) maintain a minimum drawn balance under the revolving loan facility or (ii) pay a minimum balance fee that is equal to the amount of the minimum balance deficit multiplied by the applicable interest rate during the period. If the outstanding balance under the revolving loan facility exceeds the lesser of (i) 50 % of the revolving borrowing capacity or (ii) 50 % of the borrowing base, or the Company is in default, MidCap will apply funds collected from the Company's lockbox account to reduce the outstanding balance of the revolving loan facility ("Lockbox Deductions"). As of December 31, 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 December 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 all of the Company's assets, including intellectual property. The loan agreements and other ancillary loan documents contain customary representations and warranties and affirmative and negative covenants. Under the loan agreements, the Company is not required to meet any minimum level of revenue if liquidity (defined as unrestricted cash plus undrawn availability under the revolving loan agreement) is greater than the outstanding balance under the term loan. If liquidity falls below such outstanding balance, then the Company is subject to a minimum trailing twelve-month revenue covenant. The Company is not subject to this covenant at December 31, 2023. During the years ended December 31, 2023, 2022, and 2021 , the Company recognized $ 5.2 million, $ 4.4 million, and $ 4.1 million, respectively, in interest expense related to debt agreements. During the years ended December 31, 2023, 2022, and 2021 amortization of the debt discount was $ 0.3 million, $ 0.2 million, and $ 0.2 million.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	8. Commitments and Contingencies License and Royalty Commitments The Company has entered into product development and fee for service agreements with members of its Surgeon Advisory Board and other surgeon consultants that specify the terms under which the consultant is compensated for his or her consulting services and grants the Company rights to the intellectual property created by the consultant in the course of such services. As products are commercialized with the assistance of members of the Surgeon Advisory Board and other surgeon consultants, the Company may agree to enter into a royalty agreement if the consultant's contributions to the product are novel, significant and innovative. As of December 31, 2023 and 2022 , the Company has royalty agreements with certain members of its Surgeon Advisory Board and other surgeon consultants providing for royalties based on each individual's level of contribution. Each royalty agreement: (i) confirms the irrevocable transfer to the Company of all pertinent intellectual property rights; (ii) sets the applicable royalty rate; (iii) sets the period of time during which royalties are payable; (iv) is for a term of three years , renewable by the parties, and may be terminated by either party on 90 days ' notice for convenience (provided that if terminated by the Company for convenience the obligation to pay royalties is not affected); and (v) prohibits the payment of royalties on products sold to entities and/or individuals with whom the surgeon advisor or any other surgeon advisor entitled to royalties is affiliated. Each of the royalty agreements may be subsequently amended to add the license of additional intellectual property covering new products, and as a result, multiple royalty rates and duration of royalty payments may be included in one royalty agreement. As of December 31, 2023 and 2022, the Company's royalty agreements provide for (i) royalty payments for 10 years from first commercial sale of the relevant product and (ii) a royalty rate for each such agreement ranging from 0.4 % to 3.0 % of ne t sales for the particular product to which the surgeon contributed. The Company recognized royalties expense of $ 6.9 million, $ 6.5 million, and $ 4.3 m illion for the years ended December 31, 2023, 2022, and 2021, respectively, resulting in an aggregate royalty rate of 3.7 % , 4.6 % , and 4.6 %, for the years ended December 31, 2023, 2022, and 2021, 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 liabilities related to litigation and contingencies as of December 31, 2023 and 2022 .

Operating Leases

Operating Leases	12 Months Ended
	Dec. 31, 2023
Operating Lease, Liability [Abstract]
Operating Leases	9. Operating Leases The Company's leases consist of real estate leases in Ponte Vedra, Florida. On February 9, 2022, the Company entered into a 10-year operating lease for a new corporate headquarters building in Ponte Vedra, Florida, with a lease commencement date of March 1, 2022. The Company's obligation to make cash payments for the new headquarters building started in the third quarter of 2022. The Company's leases contain options to renew, none of which the Company is reasonably certain to exercise. The lease agreements do not contain any residual value guarantees or restrictive covenants. For the new headquarters lease, the Company is provided a tenant improvement allowance for the construction of leasehold improvements, of which $ 2.0 million is remaining as of December 31, 2023 . In exchange for construction management and supervision services related to these improvements, the Company paid the lessor a fee equal to one and a half percent ( 1.5 %) of total construction costs. In addition to base rent, the Company pays variable costs related to its share of operating expenses under certain of its lease arrangements. These variable costs are recorded as lease expense as incurred and presented as operating expenses in the Statements of Operations and Comprehensive Loss. Variable lease costs were $ 0.7 million, $ 0.2 million, and $ 0 for the twelve months ended December 31, 2023, 2022, and 2021, respectively. Rent expense was $ 0.6 f or the twelve months ended December 31, 2021. Operating lease cost was $ 2.4 million and $ 2.3 million for the twelve months ended December 31, 2023 and 2022, respectively. During the twelve months ended December 31, 2023, cash paid for amounts included in operating lease liabilities of $ 2.2 million was included in cash flows from operating activities on the Statements of Cash Flows. Additional information related to operating leases is as follows: December 31, 2023 Weighted average remaining lease term (years) 8.2 Weighted average discount rate 9.2 % The following table summarizes a maturity analysis of operating lease liabilities showing the aggregate lease payments as of December 31, 2023 (in thousands): Fiscal Year 2024 $ 2,905 2025* 1,398 2026 3,339 2027 3,097 2028 3,159 Thereafter 11,839 Total undiscounted lease payments 25,737 Less: imputed interest ( 8,442 ) Total discounted lease payments 17,295 Less: Current portion of lease liability ( 1,404 ) Noncurrent portion of lease liability $ 15,891 * Amount presented is net of allowance for tenant improvements. In 2023, the Company entered into subleases for a portion of its former headquarter space as a lessor. The lease is classified as an operating lease. The Company recorded rental income of $ 0.3 million for years ended December 31, 2023.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Income Taxes	10. Income Taxes The Company has no t recorded an income tax provision for years ended December 31, 2023, 2022, and 2021 due to its operating losses. All losses before income taxes were generated in the United States. Reconciliation of the statutory federal income tax to the Company's effective tax is as follows: December 31, 2023 2022 2021 Income tax at the statutory rate ( 21 )% ( 21 )% ( 21 )% Stock-based and other compensation ( 1 ) ( 5 ) ( 8 ) State taxes, net of federal benefit ( 3 ) ( 1 ) ( 6 ) Research and development credits ( 1 ) ( 1 ) ( 1 ) Change in valuation allowance 25 26 32 Other 1 2 4 Effective tax rate 0 % 0 % 0 % The tax effects of temporary differences and carryforwards that give rise to significant portions of deferred tax assets and deferred tax liabilities were as follows (in thousands): December 31, 2023 2022 Deferred income tax assets Net operating loss carryforwards $ 22,947 $ 15,979 Interest expense 2,618 1,785 Stock-based compensation expense 3,538 1,590 Accrued bonus 1,092 1,184 Research and development expenses 2,368 1,032 Research and development credits 1,273 954 Operating lease liabilities 4,015 3,539 Other 1,178 698 Gross deferred income tax assets 39,029 26,761 Less: valuation allowance ( 35,211 ) ( 22,864 ) Net deferred tax assets $ 3,818 $ 3,897 Deferred income tax liabilities Property and equipment $ ( 1,573 ) $ ( 1,537 ) Operating lease right-of-use assets ( 2,217 ) ( 2,331 ) Other ( 28 ) ( 29 ) Gross deferred income tax liabilities ( 3,818 ) ( 3,897 ) Net deferred tax liabilities $ — $ — In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax asset will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers the scheduled reversal of deferred tax assets, projected future taxable income, and tax planning strategies in making this assessment. Due to the Company's history of net losses, the deferred tax assets have been fully offset by a full valuation allowance of $ 35.2 million and $ 22.9 million as of December 31, 2023 and December 31, 2022, respectively. The Company's changes in the deferred tax asset valuation allowance for the years ended December 31, 2023 and 2022, wer e $ 12.3 million and $ 10.9 milli on, respectively. The Company had unused federal and state net operating loss carryforwards of approximately $ 99.6 million and $ 53.0 m illion, respectively as of December 31, 2023, and federal and state net operating loss carryforwards of approximately $ 71.2 million and $ 34.0 million, respectively, as of December 31, 2022. The net operating loss carryforwards begin to expire in 2034 . The Company's research and development tax credit carryforwards wer e $ 1.3 million and $ 1.0 million as of December 31, 2023 and 2022, respectively, and begin to expire in 2037 . The federal and state net operating loss carryforwards and credits may be subject to significant limitations under Section 382 and Section 383 of the Internal Revenue Code and similar provisions under state law. The Tax Reform Act contains provisions that limit the federal net operating loss carryforwards that may be used in any given year in the event of special occurrences, including significant ownership changes. A Section 382 "ownership change" generally occurs if one or more stockholders or groups of stockholders, who own at least 5% of the Company's stock, increase their ownership by more than 50 percentage points over their lowest ownership percentage within a rolling three-year period. The Company may have previously experienced, and may in the future experience, one or more Section 382 "ownership changes," including in connection with the Company's initial public offering. If so, the Company may lose some or all of the tax benefits of its carryforwards and credits. Management has reviewed and evaluated the relevant technical merits of each of its tax positions in accordance with accounting principles generally accepted in the United States of America for accounting for uncertainty in income taxes and determined that there are no uncertain tax positions that would have a material impact on the financial statements of the Company. The Company is not subject to U.S. Federal and state income tax examinations by tax authorities for tax years before 2017.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2023
Stockholders' Equity Note [Abstract]
Stockholders' Equity	11. Stockholders' Equity Preferred Stock The Company is authorized to issue 5,000,000 shares of preferred stock. As of December 31, 2023, and December 31, 2022 , no shares of preferred stock were outstanding. Common Stock On April 27, 2021, the Company amended and restated its Certificate of Incorporation, which became effective upon the closing of the IPO. The Company is authorized to issue 300,000,000 shares of common stock. Shares Reserved for Future Issuance The Company has reserved shares of common stock for future issuances as follows: December 31, 2023 2022 Common stock options issued and outstanding 7,377,017 7,150,755 Shares available for future awards granted under the 2021 Plan 4,635,615 4,769,842 Unvested restricted stock units under the 2021 Plan 1,351,542 582,248 Common stock available for Employee Stock Purchase Plan 1,602,719 1,046,437 Total 14,966,893 13,549,282 Share-based Incentive Plans In April 2021, prior to the IPO closing, the Company's board of directors and stockholders approved the 2021 Incentive Award Plan ("2021 Plan"), which became effective upon the IPO closing. The Company initially reserved 5,046,278 shares of common stock for issuance of share-based compensation awards, including stock options, restricted stock ("RSA"), restricted stock units ("RSU") and other stock-based awards. The number of shares initially reserved for issuance or transfer pursuant to awards under the 2021 Plan will be increased by (i) the number of shares represented by awards outstanding under the Company's 2014 Stock Option Plan ("2014 Plan") and collectively with the 2021 Plan, the "Stock Plans") that become available for issuance under the terms of the 2021 Plan and (ii) an annual increase on the first day of each fiscal year beginning in 2022 and ending in 2031, equal to the lesser of (i) 5.0 % of the shares of stock outstanding (on an as converted basis) on the last day of the immediately preceding fiscal year and (ii) such smaller number of shares of stock as determined by the Company's board of directors; provided, however, that no more than 37,847,090 shares of stock may be issued upon the exercise of incentive stock options. Prior to the IPO, the Company was authorized to issue stock purchase rights and to grant options to purchase Class A common stock to employees, directors, and consultants under the 2014 Plan. Stock options under the 2014 Plan have a term of no more than ten years from the date of grant and vest in equal installments over a maximum of five years . No future awards can be granted under the 2014 Plan. The shares underlying outstanding and unexercised options granted to employees, directors and consultants under the 2014 Plan may become available for issuance under the 2021 Plan as follows: (i) to the extent that such an option award terminates, expires or lapses for any reason or is settled in cash without the delivery of shares, any shares subject to the award at such time will be available for future grants under the 2021 Plan; (ii) to the extent shares are tendered or withheld to satisfy the grant, exercise price or tax withholding obligation with respect to any award under the 2014 Plan, such tendered or withheld shares will be available for future grants under the 2021 Plan; and (iii) to the extent that the Company repurchases the shares prior to vesting so that shares are returned to the Company, such shares will be available for future grants under the 2021 Plan. At December 31, 2023, 4,635,615 shares of common stock remain available for issuance as awards under the 2021 Plan. In January 2024, the number of shares of common stock available for issuance under the 2021 Plan was increased by 3,087,482 shares as a result of the automatic increase provision in the 2021 Plan. Stock Options Options under the 2021 Plan may be granted for periods of up to 10 years at exercise prices no less than the fair market value of the Company's common stock on the date of grant; provided, however, that the exercise price of an incentive stock option granted to a 10 % stockholder may not be less than 110 % of the fair market value of the shares on the date of grant and such option may not be exercisable after the expiration of five years from the date of grant. Stock options granted vest ratably over four years . The Company uses the Black-Scholes option pricing model to determine the fair value of stock options at the grant dates with the following assumptions for options granted during 2023, 2022, and 2021 fiscal years: December 31, 2023 2022 2021 Expected term (in years) 6.25 6.25 2.1 - 6.25 Expected volatility 37.43 % - 37.61 % 36.05 % - 37.08 % 35.57 % - 55.60 % Risk-free interest rate 3.75 % - 4.44 % 1.64 % - 4.34 % 0.08 % - 1.39 % Expected dividend yield 0.00 % 0.00 % 0.00 % Stock option activity for 2023 under the Stock Plans is set forth below: Number of Weighted- Weighted- Aggregate Intrinsic Value Outstanding as of December 31, 2022 7,150,755 7.03 $ 9.57 Options granted 877,910 23.67 Options exercised ( 495,337 ) 3.77 Options canceled ( 156,311 ) 17.33 Outstanding as of December 31, 2023 7,377,017 6.48 $ 11.47 $ 38,409 Options vested and expected to vest at December 31, 2023 7,009,511 6.39 $ 6.03 $ 38,158 Options vested and exercisable at December 31, 2023 4,592,722 5.48 $ 3.65 $ 35,388 The aggregate intrinsic value of options exercised during the years ended December 31, 2023, 2022, and 2021 was $ 8.3 million, $ 25.9 million, and $ 39.1 million, respectively. Restricted Stock Units and Awards Full value award activity for 2023 under the Stock Plans is set forth below: Full Value Awards RSUs Weighted-Average Grant Date Fair Value RSAs Weighted-Average Grant Date Fair Value Unvested as of December 31, 2022 582,248 $ 19.08 12,800 $ 31.50 Shares or units granted 1,020,836 20.76 — — Shares or units vested or released ( 149,919 ) 18.94 ( 6,222 ) 31.50 Shares or units forfeited ( 101,623 ) 21.05 — — Unvested as of December 31, 2023 1,351,542 $ 20.22 6,578 $ 31.50 RSUs and RSAs granted under the 2021 Plan generally vest annually over 4 years in equal installments. Performance Share Units The Company granted performance-based restricted stock unit ("PSU") awards in the third quarter of 2023 subject to market and service vesting conditions to certain executives under the Company's 2021 Plan. The actual number of PSUs that will vest at the end of the measurement period is determined based on the Company's total stockholder return ("TSR") ranking relative to the TSR of a published index of the Company's peers. The measurement period is two years . The grant date value of each target PSU award was determined using a Monte Carlo valuation model. If the service vesting conditions are met, the actual number of PSUs earned may vary from zero , if performance thresholds are not met, to as much as 250 % of target PSUs. The table below summarizes the assumptions used to estimate the grant date fair value of the PSUs granted: Year Ended December 31, 2023 Weighted average expected volatility of common stock 61.12 % Expected volatility of peer index 21.61 % to 95.93 % Correlation coefficient of peer index 0.08 to 1 Weighted average risk-free interest rate 4.76 % Dividend yield 0 % PSU activity for 2023 under the Stock Plans is set forth below: Number of Shares Weighted Average Granted Date Fair Value Unvested as of December 31, 2022 - $ - Granted 509,600 30.90 Vested - - Canceled or forfeited - - Unvested as of December 31, 2023 509,600 $ 30.90 Share-Based Compensation Expense Stock-based compensation expense is reflected in the Statements of Operations and Comprehensive Loss as follows (in thousands): Year Ended December 31, 2023 2022 2021 Cost of goods sold $ 228 $ — $ — Sales and marketing expense 4,556 2,928 1,231 Research and development expense 2,053 697 475 General and administrative expense 10,515 4,486 1,703 Total $ 17,352 $ 8,111 $ 3,409 The weighted-average grant date fair values of the stock options granted were $ 12.75 , $ 7.52 , and $ 6.19 p er share for the years ended December 31, 2023, 2022, and 2021, respectively. The total grant date fair value of shares vested during the years ended December 31, 2023, 2022, and 2021 were $ 10.1 million, $ 5.3 million, and $ 2.0 million, respectively. As of December 31, 2023, there was $ 13.6 million of unrecognized stock-based compensation expense related to stock options, which the Company expects to recognize over a weighted-average period of 2.1 years. As of December 31, 2023, there was $ 18.3 million of unrecognized stock-based compensation expense related to RSAs and RSUs, which the Company expects to recognize over a weighted-average period of 3.1 years. As of December 31, 2023, unrecognized compensation expense for PSUs was $ 11.4 million; the expense is expected to be recognized over the weighted-average period of 1.6 years. Employee Share Purchase Plan In April 2021, the Company's board of directors and stockholders approved the 2021 Employee Stock Purchase Plan ("ESPP"). The Company initially reserved 504,627 shares of common stock for purchase under the ESPP. The number of shares of common stock reserved for issuance under the ESPP will be automatically increased each year for ten calendar years beginning in 2022 by the number of shares equal to the lesser of 1 % of the total number of shares of common stock outstanding as of the last day of the immediately preceding fiscal year or such number of shares as may be determined by the Company's board of directors; provided that the maximum number of shares that may be issued under the ESPP is 7,064,790 shares. Each offering to the employees to purchase stock under the ESPP will begin on a date to be determined by the Company's Compensation Committee and will end no later than six months thereafter. The ESPP allows an eligible employee to purchase shares of the Company's common stock at a discount through payroll deductions of up to 15 % of the employee's eligible compensation. At the end of each offering period, employees are able to purchase shares at 85 % of the lower of the fair market value of its common stock at the beginning of the offering period or at the end of each applicable offering period. The occurrence and duration of offering periods under the ESPP are subject to the determinations of the Company's Compensation Committee, in its sole discretion. The Company has not yet commenced any enrollment periods under the ESPP. In January 2024, the number of shares of common stock available for issuance under the ESPP was increased by 617,497 to 2,220,216 shares as a result of the automatic increase provision in the ESPP.

Employee Benefit Plan

Employee Benefit Plan	12 Months Ended
	Dec. 31, 2023
Retirement Benefits [Abstract]
Employee Benefit Plan	12. Employee Benefit Plan Effective as of January 2021, the Company began sponsoring a 401(k) profit sharing plan trust for its employees who satisfy certain eligibility requirements. An employee will be eligible to become a participant in the plan for purposes of (i) elective deferrals and matching contributions after completing three consecutive months of service beginning on the employee's date of hire and (ii) employer profit sharing contributions after completing one year of service. The Company matches employee contributions to the 401(k) plan at a rate equal to 100 % of the first 3 % of the employee's pre-tax salary contributed and 50 % of any additional contributions, including and up to 5 % of the employee's pre-tax salary. Participants vest in their Company matching contributions after 90 days of service and in any potential future nonelective contributions by the Company on a one -to- six year graded vesting schedule. Employer contributions under this plan were $ 1.6 million, $ 1.0 million, and $ 0.7 million for the years ended December 31, 2023, 2022, and 2021 , respectively.

Net Loss Per Share Attributable

Net Loss Per Share Attributable to Common Stockholders	12 Months Ended
	Dec. 31, 2023
Earnings Per Share [Abstract]
Net Loss Per Share Attributable to Common Stockholders	13. Net Loss Per Share Attributable to Common Stockholders The following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders which is computed by dividing the net loss attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. As the Company reported a net loss for the years ended December 31, 2023, 2022, and 2021, respectively, basic net loss per share attributable to common stockholders was the same as diluted net loss per share attributable to common stockholders as the inclusion of potentially dilutive shares would have been antidilutive if included in the calculation (in thousands, except share and per share amounts): Year Ended December 31, 2023 2022 2021 Numerator Net loss $ ( 49,527 ) $ ( 42,815 ) $ ( 20,552 ) Adjust: Convertible preferred stock cumulative — — ( 196 ) Net loss attributable to common stockholders ( 49,527 ) ( 42,815 ) ( 20,748 ) Denominator Weighted-average common stock outstanding, 60,852,153 55,276,834 48,415,679 Net loss per share attributable to common $ ( 0.81 ) $ ( 0.77 ) $ ( 0.43 ) The following potentially dilutive securities outstanding have been excluded from the computation of diluted weighted average shares outstanding because such securities have an antidilutive impact due to the Company's net loss, in common stock equivalent shares: December 31, December 31, 2023 2022 Common stock options issued and outstanding 7,377,017 7,150,755 Unvested full value awards 1,358,120 595,048 Total 8,735,137 7,745,803

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The accompanying financial statements are prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). The financial statements presented have been prepared on a consistent basis with the exception of the following item. An adjustment has been made to the Statement of Operations and Comprehensive Loss for the years ended 2022 and 2021 for $ 2.0 million and $ 0.9 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. The Company evaluated events or transactions that may have occurred after the balance sheet date for potential recognition or disclosure through the date the financial statements were issued. No subsequent events or transactions requiring recognition or disclosure were identified.
Use of Estimates	Use of Estimates The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the 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 write-downs related to accounts receivable, reserves and inventories, valuation of intangible assets and goodwill, the recoverability of long-term assets, deferred tax assets and related valuation allowances, contingencies, earn-out liabilities, and stock-based compensation.
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 that may include the income approach, the cost approach, or 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 Statements 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 the 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.
Segments	Segments The Company operates and manages its business as one operating and reportable segment, which is the business of designing, manufacturing, and marketing medical devices for physicians, surgeons, ambulatory surgery centers and hospitals related to the surgical management of bunion and related midfoot deformities. The Company's chief executive officer, who is the chief operating decision maker, reviews financial information on an aggregate basis for purposes of allocating resources and evaluating financial performance. All long-lived assets are maintained in the United States.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with an original or remaining maturity at the time of purchase of 90 days or less to be cash equivalents. All of the Company's cash equivalents have liquid markets and high credit ratings. The Company maintains its cash in money market funds and bank deposits, the balances of which at times may exceed federally insured limits.
Marketable Securities	Marketable Securities The Company considers its debt securities and Yankee certificate of deposits ("Yankee CDs") to be available-for-sale securities. Available-for-sale securities are classified as cash equivalents or short-term marketable securities. Marketable securities classified as available-for-sale are measured at fair value with temporary unrealized gains and losses reported in other comprehensive loss, and as a component of stockholders' equity (deficit) until their disposition or maturity. The Company reviews all available-for-sale securities at each period end to determine if they remain available-for-sale based on the Company's current intent and ability to sell the security if it is required to do so. Realized gains and losses from the sale of marketable securities, if any, are calculated using the specific-identification method. Premiums and discounts are amortized and accreted, respectively, using the effective interest method. Refer to Note 4, "Fair Value Measurements," for fair value disclosures for cash equivalents and short-term marketable securities. Available-for-sale securities are subject to a periodic impairment review. The Company may recognize an impairment charge when a decline in the fair value of investments below the cost basis is determined to be other-than-temporary. In determining whether a decline in market value is other-than-temporary, various factors are considered, including the cause, duration of time and severity of the impairment, any adverse changes in the investees' financial condition and the Company's intent and ability to hold the security for a period of time sufficient to allow for an anticipated recovery in market value. Declines in fair value judged to be other-than-temporary are included in the Company's Statements of Operations and Comprehensive Loss. The Company did not record any other-than-temporary impairments related to marketable securities in the Company's Statements of Operations and Comprehensive Loss for the years ended December 31, 2023 or 2022 .
Accounts Receivable and Allowances	Accounts Receivable and Allowances Accounts receivable are generally from hospitals and ambulatory surgery centers and are stated at amounts billed less allowances for doubtful accounts. The Company continually monitors customer payments and maintains an allowance for losses resulting from a customer's inability to make required payments. The Company considers factors such as historical experience, credit quality, age of the accounts receivable balances, geographic related risks and economic conditions that may affect a customer's ability to pay. Accounts receivable are written off when individual balances are no longer collectible. As of December 31, 2023 and 2022, accounts receivable are presented net of an allowance for doubtful accounts of $ 1.0 million and $ 0.7 million, respectively. For the years ended December 31, 2023, 2022, and 2021, the Company recorded provisions for bad debts of $ 0.4 million, $ 0.4 million, and $ 0.1 million, respectively.
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents, marketable securities, and accounts receivable. The Company maintains its cash with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation ("FDIC") insured limits. The Company's available-for-sale securities portfolio primarily consists of U.S. treasury and agency securities, money market funds, commercial paper, Yankee CDs, high credit quality asset-backed securities and corporate debt securities. The Company's investment policy requires its available for sale securities to meet certain criteria including investment type, credit ratings, and a maximum portfolio duration of one year. The Company earns revenue from the sale of its products to customers such as hospitals and ambulatory surgery centers. The Company's accounts receivable is derived from revenue earned from customers. The Company performs ongoing credit evaluations of its customers' financial condition and generally requires no collateral from its customers. At December 31, 2023 and 2022 , no customer accounted for more than 10 % of accounts receivable. For the years ended December 31, 2023, 2022, and 2021 , there were no customers that represented 10 % or more of revenue.
Leases	Leases The Company determines whether an arrangement is or contains a lease at the inception of the arrangement and whether such a lease is classified as a financing lease or an operating lease at the commencement date of the lease. Lease liabilities and their corresponding right-of-use assets are recorded based on the present value of lease payments over the expected lease term. The Company determines the commencement date of a lease to be the date on which a lessor makes an underlying asset available for use by the Company. Leases with a term greater than one year are recognized on the Balance Sheets as operating lease right-of-use assets, Operating lease liabilities and Operating lease liabilities, net of current portion. The Company elected not to recognize right-of-use assets and lease liabilities for leases with terms of 12 months or less (short-term leases). As the interest rates implicit in our lease contracts are not readily determinable, the Company utilizes its incremental borrowing rate based on the information available at the commencement date to determine the present value of lease payments. Certain adjustments to the right-of-use asset may be required for items such as initial direct costs paid, incentives received, or impairment charges if the Company determines the right-of-use asset is impaired. In the fourth quarter of 2022, the Company recorded an impairment to the right-of-use asset associated with the lease on its previous corporate headquarters. See Note 6, "Balance Sheet Components," for further details of the impairment. The Company considers the lease term to be the noncancelable period that the Company has the right to use the underlying asset, together with any periods where it is reasonably certain the Company will exercise an option to extend (or not terminate) the lease. Rent expense for operating leases is recognized on a straight-line basis over the lease term and is presented in operating expenses on the Statements of Operations and Comprehensive Loss. The Company has elected to not separate lease and non-lease components for its real estate leases and instead accounts for each separate lease component and the non-lease components associated with that lease component as a single lease component. Variable lease payments are recognized as lease expense as incurred and are recorded in operating expenses on the Statements of Operations and Comprehensive Loss. The Company has no finance leases.
Inventories	Inventories Inventories consist primarily of surgical kits and components as finished goods and are stated at the lower of cost or net realizable value. Cost is determined based on an average cost method which approximates the first-in, first-out basis and includes primarily outsourced manufacturing costs and direct manufacturing overhead costs. The Company reviews inventory for excess, obsolescence, and field losses and writes down inventory, as necessary. For the years ended December 31, 2023, 2022, and 2021, the Company recorded a provision to cost of goods sold of $ 0.9 million, $ 0.1 million, and $ 0.3 million, respecti vely, for excess, obsolete, and field related losses to inventory.
Property and Equipment, Net	Property and Equipment, Net Property and equipment are recorded at cost. Depreciation of property and equipment is recorded using the straight-line method over the following estimated useful lives as follows: Years Furniture, fixtures and equipment 7 Machinery and equipment 3 or 5 Capitalized surgical instruments 3 Computer equipment 3 Leasehold improvements Lesser of estimated useful life or lease term Software 3 Long-lived assets are evaluated whenever a change in circumstances indicates that the carrying amount of an asset may not be recoverable. If assets are considered to be impaired, a charge is recorded for an amount that the carrying value exceeds the fair value. The Company capitalized $ 0.2 million of software development costs that will be depreciated over a period of three years.
Revenue Recognition	Revenue Recognition The Company generates revenue from the sale of its proprietary Lapiplasty System and its minimally invasive variations, Adductoplasty System, Hammertoe PEEK Fixation System, SpeedPlate Implant Fixation Platform, single use osteotomes and release instruments, and other implanted ancillary products. The Company receives payment for all these products that are consumed during the surgery and does not receive separate consideration for the use of the instrument tray furnished by the Company for the surgeon's use. The Company identifies the instrument trays as a lease component and the implants and other single use products as a non-lease component in its arrangements with its customers. The Company concluded that the non-lease component is predominant, and as such, elected the practical expedient to not separate the lease and non-lease components. Therefore, the overall arrangement is accounted for under ASC 606. Implant kits, single use instruments, and other ancillary products are sold in the United States through a combination of a direct employee sales force and independent sales agencies. The Company invoices hospitals and ambulatory surgery centers for the implant kits and other products and pays commissions to the sales representatives and independent sales agencies. The Company has no international sales. Under ASC 606, revenue is recognized when the customer obtains control of promised goods or services, in an amount that reflects consideration which the entity expects to receive in exchange for those goods or services. To determine revenue recognition for arrangements that an entity determines are within the scope of ASC 606, the Company performs the following five steps as prescribed by ASC 606: (i) identify the contract(s) with a customer; (ii) identify the performance obligations in the contract; (iii) determine the transaction price; (iv) allocate the transaction price to the performance obligations in the contract; and (v) recognize revenue when (or as) the entity satisfies performance obligations. A contract with a customer exists when (i) the Company enters into a legally enforceable contract with a customer that defines each party's rights regarding the products to be transferred and identifies the payment terms related to these products, (ii) the contract has commercial substance, and (iii) the Company determines that collection of substantially all consideration for its products that are transferred is probable based on the customer's intent and ability to pay the promised consideration. The Company considers signed agreements and purchase orders as a customer's contract. Sales prices are specified in either the customer contract or agreed price list, which is executed prior to the transfer of control to the customer. The Company identifies performance obligations based on the terms of the contract and customary business practices, which include products that are distinct, or a series of distinct goods that are substantially the same and that have the same pattern of transfer to the customer. The transfer of the Company's products to the customer are distinct performance obligations. The Company does not have any material performance obligations other than the transfer of the products to the customer. The transaction price in the Company's customer contracts includes fixed consideration to be contractually billed to the customer while variable consideration includes the right of return. The Company does not allocate the transaction price or any variable consideration to the right of return. The Company did no t recognize a refund liability as of December 31, 2023 and 2022 , and there were negligible returns during the years ended December 31, 2023 and 2022 and no product returns during the year ended December 31, 2021. The Company has elected to exclude from the measurement of the transaction price all taxes (e.g., sales, use, value-added) assessed by government authorities and collected from a customer. For shipments to customers, the Company offers the right to return the product within 30 days for a full refund, and for returns between 30 and 90 days, the Company offers a full refund less a 15% restocking fee. The Company does not have a history of product returns for refund. Customer invoices are generally payable within 30 days. The Company's products are generally sold with a limited standard warranty to the original purchaser of the products against defects in workmanship and materials for 180 days. The Company's liability is limited to providing, at the Company's option, a full refund or credit of the purchase price, or repairing or replacing the product, provided that the customer returns the defective product within 180 days from the purchase date. To date, the Company has had negligible returns of any products alleged to be defective. Revenue for products is recognized when a customer obtains control of the promised products, which is generally when the customer has the ability to (i) direct its use and (ii) obtain substantially all of the remaining benefits from it. Revenue recognition occurs for the majority of our sales when control of the product transfers to the customer, which is generally at the time the product is used in surgery. The Company also generates a small percentage of total revenues from the sale of products when the products are ordered in advance of a surgery procedure. The performance obligation is the delivery of the products and therefore, revenue is recognized either at shipment or upon receipt by the customer depending upon the contractual terms of the purchase and when the risk of ownership transfers to the customer.
Contract Costs	Contract Costs The Company applies the practical expedient to recognize the incremental costs of obtaining a contract as expense when incurred if the amortization period would be one year or less. These incremental costs include sales commissions paid to the Company's independent sales agencies or employee sales representatives.
Cost of Goods Sold	Cost of Goods Sold Cost of goods sold consists primarily of costs for the purchase of the Company's products from third-party manufacturers. Direct costs from the Company's third-party manufacturers include costs for raw materials plus the markup for the assembly of the components. Cost of goods sold also includes royalties, allocated overhead for indirect labor, certain direct costs such as those incurred for shipping our products and personnel costs. The Company expenses all inventory provisions for excess and obsolete inventories as cost of goods sold. The Company records adjustments to its inventory valuation for estimated excess, obsolete, field loss rate, and non-sellable inventories based on assumptions about future demand, past usage, changes to manufacturing processes and overall market conditions.
Research and Development Expenses	Research and Development Expenses Research and development ("R&D") expenses consist primarily of engineering, product development, clinical studies to develop and support the Company's products, regulatory expenses, and other costs associated with products and technologies that are in development. These expenses include compensation for personnel, including salaries, bonuses, benefits and stock-based compensation, supplies, consulting, prototyping, testing, materials, travel expenses, depreciation and an allocation of facility overhead expenses.
Shipping and Handling	Shipping and Handling The Company has elected to account for shipping and handling activities as fulfillment activities. As such, the Company does not evaluate shipping and handling as promised services to its customers. The Company may bill customers for shipping and handling costs. Amounts billed for shipping and handling are included in revenue. Shipping and handling costs incurred by the Company are included in sales and marketing expense. Shipping and handling costs totaled $ 1.3 million, $ 0.8 million, and $ 0.5 million, for the years ended December 31, 2023, 2022, and 2021 , respectively.
Advertising Costs	Advertising Costs Advertising costs are expensed as incurred and are included as a component of marketing and sales expenses. Advertising expense includes the cost of advertising across the various mediums we employ, including print, digital, radio and television. Advertising costs totaled approximately $ 16.1 million , $ 15.0 million, and $ 13.0 million, for the years ended December 31, 2023, 2022, and 2021 , respectively.
Income Taxes	Income Taxes The Company accounts for income taxes under the liability method, whereby deferred tax assets and liabilities are determined based on the difference between the financial statements and tax bases of assets and liabilities using the enacted tax rates in effect for the year in which the differences are expected to affect taxable income. A valuation allowance is established when necessary to reduce deferred tax assets when management estimates, based on available objective evidence, that it is more likely than not that the benefit will not be realized for the deferred tax assets. The Company also follows the provisions of ASC 740-10, Accounting for Uncertainty in Income Taxes . ASC 740-10, which prescribes a comprehensive model for the recognition, measurement, presentation and disclosure in financial statements of any uncertain tax positions that have been taken or expected to be taken on a tax return. No liability related to uncertain tax positions is recorded in the financial statements. It is the Company's policy to include penalties and interest expense related to income taxes as part of the provision for income taxes.
Product Liability	Product Liability The Company believes it carries adequate insurance for possible product liability claims. Accruals for product liability claims and legal defense costs in excess of insured amounts are recorded if it is probable that a liability has been incurred and the amount of any liability can be reasonably estimated. No accruals for product liability claims had been recorded as of December 31, 2023 and 2022 .
Debt	Debt Debt issuance costs and discount are amortized to interest expense u sing the effective interest method.
Stock-Based Compensation	Stock-Based Compensation The Company accounts for stock-based compensation arrangements with employees in accordance with ASC 718, Compensation-Stock Compensation, using a fair-value based method. The Company determines the fair value of stock options and performance-based restricted stock awards units ("PSUs") on the date of grant. The fair value for restricted stock and restricted stock units awards is the fair value of the stock at the grant date. The fair value of time-based awards is recognized over the period during which an award holder is required to provide services in exchange for the award, known as the requisite service period, which is typically the vesting period using the straight-line method. The Company accrues for estimated forfeitures on share-based awards and adjusts stock-based compensation cost to actual as forfeitures occur. The estimated forfeitures are based on a historical analysis of actual forfeitures of awards. The Company estimates the fair value of the stock-based awards using the Black-Scholes option-pricing model, which requires the input of highly subjective assumptions. The assumptions are as follows: • Expected Term . The expected term represents the period that the stock options are expected to remain outstanding. The Company is using the "simplified" method, which is the simple average of the vesting period and the contractual term. • Expected Volatility . The expected volatility is derived from the historical stock volatilities of comparable publicly listed peers over a period approximately equal to the expected term of the options as the Company does not have sufficient trading history to determine the volatility of its common stock. • Risk-Free Interest Rate . The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the date of grant for zero-coupon U.S. Treasury notes with maturities approximately equal to the stock-based awards' expected term. • Expected Dividend Yield . The expected dividend yield is zero as the Company has not paid nor anticipates paying any dividends on the common stock in the foreseeable future. • Fair Market Value of Common Stock. The fair market value of the common stock is based on its closing price as reported on the date of grant. The Company continues to use judgment in evaluating the expected volatility and expected terms utilized for the fair value of stock options on a prospective basis. The Company used the simplified method to determine the expected term for options due to the lack employee exercise history since our IPO. As the Company continues to accumulate additional data, the Company may make refinements to the assumptions, which could materially impact the future stock-based compensation expense. The Company estimates the fair value of PSUs awards using the Monte Carlo model, which requires the input of several assumptions. The assumptions are as follows: • Beginning Average Stock Price. Includes the stock price for the Company and each peer company within the index for the measurement period prior to the grant date assuming dividends distributed during the period were reinvested for additional shares on the ex-dividend date. • Valuation Date Stock Price. The closing price for the Company and each peer company on the grant date. • Expected Volatility . The expected volatility is the historical stock volatilities for the Company and each peer company within the index over the period of time that is consistent with the measurement period for the awards. • Correlation Coefficients. The correlation coefficients are derived from the price data used to calculate expected volatility and are used to model the way in which each entity's stock price tends to move in relation to the peer company group. • Risk-Free Interest Rate . The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the date of grant with maturities equal to the PSU awards performance period. • Expected Dividend Yield For Modeling Total Stockholder Return . The total stockholder return for the Company and each peer company in the index is calculated assuming dividends distributed from the start of the measurement period are reinvested on the ex-dividend date in the underlying company's stock.
Comprehensive Loss	Comprehensive Loss The Company is required to report all components of comprehensive loss, including net loss, in the financial statements in the period in which they are recognized. Comprehensive loss is defined as a change in equity of a business enterprise during a period, resulting from transactions and other events and circumstances from non-owner sources. Comprehensive loss equaled $ 49.3 million and 42.8 million for the years ended December 31, 2023 and 2022, respectively. Comprehensive loss equaled net loss for the year ended December 31, 2021 .
Net Loss Per Share Attributable to Common Stockholders	Net Loss Per Share Attributable to Common Stockholders Basic net loss per share attributable to common stockholders is calculated by dividing the net loss attributable to common stockholders by the weighted-average number of common shares outstanding during the period, without consideration for potentially dilutive securities. Diluted net loss per share is computed by dividing the net loss by the weighted-average number of common shares and potentially dilutive securities outstanding for the period. For purposes of the diluted net loss per share calculation, common stock options, unvested restricted stock units and restricted stock awards are considered to be potentially dilutive securities. Because the Company has reported a net loss for the years ended December 31, 2023, 2022, and 2021 , diluted net losses per common share were the same as basic net losses per common share for these periods.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2023
Accounting Policies [Abstract]
Summary of Property and Equipment Depreciation Estimated Useful Lives	Property and equipment are recorded at cost. Depreciation of property and equipment is recorded using the straight-line method over the following estimated useful lives as follows: Years Furniture, fixtures and equipment 7 Machinery and equipment 3 or 5 Capitalized surgical instruments 3 Computer equipment 3 Leasehold improvements Lesser of estimated useful life or lease term Software 3

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 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 December 31, 2023 and December 31, 2022 (in thousands): December 31, 2023 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 3,160 $ — $ — $ 3,160 Short-term marketable securities at fair value U.S. treasury and government agencies 14,005 15,364 — 29,369 Commercial paper — 2,895 — 2,895 Corporate debt — 46,586 — 46,586 Asset-backed securities — 24,756 — 24,756 Yankee CD — 6,610 — 6,610 Total assets $ 17,165 $ 96,211 $ — $ 113,376 Liabilities: Contingent consideration $ — $ — $ 2,977 $ 2,977 Total liabilities $ — $ — $ 2,977 $ 2,977 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
Summary of the Changes in the Fair Value of the Companies Level 3 Financial Instruments	The following table sets forth a summary of the changes in the fair value of the Company's Level 3 financial instruments (in thousands): Fair value as of December 31, 2022 $ - Contingent consideration from acquisition 2,814 Change in fair value 163 Fair value as of December 31, 2023 $ 2,977

Business Combination (Tables)

Business Combination (Tables)	12 Months Ended
	Dec. 31, 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
Schedule Of Intangible Assets Balance	The intangible assets balance as of December 31, 2023 consisted of the following (in thousands): Gross Carrying Amount Accumulated Amortization Net Carrying Amount Developed technology $ 9,500 $ 475 $ 9,025
Schedule Of Estimated Intangible Amortization Expense	Estimated intangible amortization expense as of December 31, 2023 for the next five years is as follows (in thousands): 2024 $ 950 2025 950 2026 950 2027 950 2028 950
Schedule of Goodwill	The goodwill balance as of December 31, 2023 is as follows (in thousands): Balance as of December 31, 2022 $ - Acquisitions 12,815 Balance as of December 31, 2023 $ 12,815

Balance Sheet Components (Table

Balance Sheet Components (Tables)	12 Months Ended
	Dec. 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): December 31, December 31, 2023 2022 Cash $ 9,822 $ 3,262 Cash equivalents: Money market funds 3,160 13,141 Commercial paper — 323 Corporate debt — 2,197 Yankee CD — 550 Total cash and cash equivalents $ 12,982 $ 19,473
Summary of Available-For-Sale Marketable Securities	The Company's available-for-sale marketable securities consisted of the following (in thousands): December 31, 2023 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 29,377 $ 8 $ ( 16 ) $ 29,369 Commercial paper 2,893 2 - 2,895 Corporate debt 46,467 123 ( 4 ) 46,586 Asset-backed securities 24,712 56 ( 12 ) 24,756 Yankee CD 6,604 7 ( 1 ) 6,610 Total marketable securities - short-term $ 110,053 $ 196 $ ( 33 ) $ 110,216 December 31, 2022 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 16,472 $ 11 $ ( 40 ) $ 16,443 Corporate debt 23,376 31 ( 35 ) 23,372 Asset-backed securities 13,892 27 ( 23 ) 13,896 Yankee CD 8,066 10 ( 8 ) 8,068 Total marketable securities - short-term $ 61,806 $ 79 $ ( 106 ) $ 61,779
Summary of Property and Equipment, Net	The Company's property and equipment, net consisted of the following (in thousands): December 31, December 31, 2023 2022 Furniture and fixtures, and equipment $ 2,494 $ 1,577 Construction in progress 1,115 705 Machinery and equipment 2,423 928 Capitalized surgical equipment 14,253 9,248 Computer equipment 1,020 571 Leasehold improvements 9,425 6,434 Software 316 138 Total property and equipment 31,046 19,601 Less: accumulated depreciation and amortization ( 8,748 ) ( 4,263 ) Property and equipment, net $ 22,298 $ 15,338
Summary of Accrued Liabilities	Accrued liabilities consist of the following (in thousands): December 31, December 31, 2023 2022 Accrued royalties expense $ 2,305 $ 2,299 Accrued interest 417 412 Accrued professional services 424 1,727 Accrued compensation expense for RPM-3D earn-out 3,340 — Other accrued expense 3,972 1,778 Total accrued liabilities $ 10,458 $ 6,216
Schedule of Other Liabilities	Other liabilities consist of the following (in thousands): December 31, December 31, 2023 2022 Current portion of operating lease liabilities $ 1,404 $ 339 Contingent consideration 2,977 — Other 51 — Total other liabilities $ 4,432 $ 339

Long Term Debt (Tables)

Long Term Debt (Tables)	12 Months Ended
	Dec. 31, 2023
Debt Disclosure [Abstract]
Summary of Long-term Debt Instruments	The Company's debt consisted of the following (in thousands): December 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 ( 992 ) ( 1,289 ) Total long-term debt, net $ 53,008 $ 52,711
Summary of Maturities of Long-term Debt	As of December 31, 2023, future payments of long-term debt were as follows (in thousands): Fiscal Year 2024 — 2025 — 2026 33,333 2027 20,667 Total principal payments 54,000 Less: Unamortized debt discount and debt issuance costs ( 992 ) Total long-term debt, net $ 53,008

Operating Leases (Tables)

Operating Leases (Tables)	12 Months Ended
	Dec. 31, 2023
Operating Lease, Liability [Abstract]
summary of operating leases	Additional information related to operating leases is as follows: December 31, 2023 Weighted average remaining lease term (years) 8.2 Weighted average discount rate 9.2 %
Summary of future minimum lease payments and maturity analysis of operating lease liabilities	The following table summarizes a maturity analysis of operating lease liabilities showing the aggregate lease payments as of December 31, 2023 (in thousands): Fiscal Year 2024 $ 2,905 2025* 1,398 2026 3,339 2027 3,097 2028 3,159 Thereafter 11,839 Total undiscounted lease payments 25,737 Less: imputed interest ( 8,442 ) Total discounted lease payments 17,295 Less: Current portion of lease liability ( 1,404 ) Noncurrent portion of lease liability $ 15,891 * Amount presented is net of allowance for tenant improvements. In 2023, the Company entered into subleases for a portion of its former headquarter space as a lessor. The lease is classified as an operating lease. The Company recorded rental income of $ 0.3 million for years ended December 31, 2023.

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2023
Income Tax Disclosure [Abstract]
Summary of Reconciliation of Statutory Federal Income Tax to Effective Tax	Reconciliation of the statutory federal income tax to the Company's effective tax is as follows: December 31, 2023 2022 2021 Income tax at the statutory rate ( 21 )% ( 21 )% ( 21 )% Stock-based and other compensation ( 1 ) ( 5 ) ( 8 ) State taxes, net of federal benefit ( 3 ) ( 1 ) ( 6 ) Research and development credits ( 1 ) ( 1 ) ( 1 ) Change in valuation allowance 25 26 32 Other 1 2 4 Effective tax rate 0 % 0 % 0 %
Summary of Tax Effects of Temporary Differences and Carryforwards to Significant Portions of Deferred Tax Assets and Deferred Tax Liabilities	The tax effects of temporary differences and carryforwards that give rise to significant portions of deferred tax assets and deferred tax liabilities were as follows (in thousands): December 31, 2023 2022 Deferred income tax assets Net operating loss carryforwards $ 22,947 $ 15,979 Interest expense 2,618 1,785 Stock-based compensation expense 3,538 1,590 Accrued bonus 1,092 1,184 Research and development expenses 2,368 1,032 Research and development credits 1,273 954 Operating lease liabilities 4,015 3,539 Other 1,178 698 Gross deferred income tax assets 39,029 26,761 Less: valuation allowance ( 35,211 ) ( 22,864 ) Net deferred tax assets $ 3,818 $ 3,897 Deferred income tax liabilities Property and equipment $ ( 1,573 ) $ ( 1,537 ) Operating lease right-of-use assets ( 2,217 ) ( 2,331 ) Other ( 28 ) ( 29 ) Gross deferred income tax liabilities ( 3,818 ) ( 3,897 ) Net deferred tax liabilities $ — $ —

Warrants for Class A Common Sto

Warrants for Class A Common Stock (Tables)	12 Months Ended
	Dec. 31, 2023
Class of Warrant or Right [Line Items]
Summary of Company Determined the Fair Value of Warrants using Black-Scholes Option Pricing Model	The Company uses the Black-Scholes option pricing model to determine the fair value of stock options at the grant dates with the following assumptions for options granted during 2023, 2022, and 2021 fiscal years: December 31, 2023 2022 2021 Expected term (in years) 6.25 6.25 2.1 - 6.25 Expected volatility 37.43 % - 37.61 % 36.05 % - 37.08 % 35.57 % - 55.60 % Risk-free interest rate 3.75 % - 4.44 % 1.64 % - 4.34 % 0.08 % - 1.39 % Expected dividend yield 0.00 % 0.00 % 0.00 %

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Summary of the Company has Reserved Shares of Common Stock for Future Issuances	The Company has reserved shares of common stock for future issuances as follows: December 31, 2023 2022 Common stock options issued and outstanding 7,377,017 7,150,755 Shares available for future awards granted under the 2021 Plan 4,635,615 4,769,842 Unvested restricted stock units under the 2021 Plan 1,351,542 582,248 Common stock available for Employee Stock Purchase Plan 1,602,719 1,046,437 Total 14,966,893 13,549,282
Summary of Stock Option Activity under Stock Plans	Stock option activity for 2023 under the Stock Plans is set forth below: Number of Weighted- Weighted- Aggregate Intrinsic Value Outstanding as of December 31, 2022 7,150,755 7.03 $ 9.57 Options granted 877,910 23.67 Options exercised ( 495,337 ) 3.77 Options canceled ( 156,311 ) 17.33 Outstanding as of December 31, 2023 7,377,017 6.48 $ 11.47 $ 38,409 Options vested and expected to vest at December 31, 2023 7,009,511 6.39 $ 6.03 $ 38,158 Options vested and exercisable at December 31, 2023 4,592,722 5.48 $ 3.65 $ 35,388
Summary of Company Determined the Fair Value of Warrants using Black-Scholes Option Pricing Model	The Company uses the Black-Scholes option pricing model to determine the fair value of stock options at the grant dates with the following assumptions for options granted during 2023, 2022, and 2021 fiscal years: December 31, 2023 2022 2021 Expected term (in years) 6.25 6.25 2.1 - 6.25 Expected volatility 37.43 % - 37.61 % 36.05 % - 37.08 % 35.57 % - 55.60 % Risk-free interest rate 3.75 % - 4.44 % 1.64 % - 4.34 % 0.08 % - 1.39 % Expected dividend yield 0.00 % 0.00 % 0.00 %
Summary of Assumptions Used to Estimate the Grant Date Fair Value of the PSUs Granted	The table below summarizes the assumptions used to estimate the grant date fair value of the PSUs granted: Year Ended December 31, 2023 Weighted average expected volatility of common stock 61.12 % Expected volatility of peer index 21.61 % to 95.93 % Correlation coefficient of peer index 0.08 to 1 Weighted average risk-free interest rate 4.76 % Dividend yield 0 %
Summary of Share-Based Compensation Expense is Reflected in the Statements of Operations and Comprehensive Loss	Stock-based compensation expense is reflected in the Statements of Operations and Comprehensive Loss as follows (in thousands): Year Ended December 31, 2023 2022 2021 Cost of goods sold $ 228 $ — $ — Sales and marketing expense 4,556 2,928 1,231 Research and development expense 2,053 697 475 General and administrative expense 10,515 4,486 1,703 Total $ 17,352 $ 8,111 $ 3,409
RSUs and RSAs [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Summary of Full Value Award Activity Under Stock Plans	Full value award activity for 2023 under the Stock Plans is set forth below: Full Value Awards RSUs Weighted-Average Grant Date Fair Value RSAs Weighted-Average Grant Date Fair Value Unvested as of December 31, 2022 582,248 $ 19.08 12,800 $ 31.50 Shares or units granted 1,020,836 20.76 — — Shares or units vested or released ( 149,919 ) 18.94 ( 6,222 ) 31.50 Shares or units forfeited ( 101,623 ) 21.05 — — Unvested as of December 31, 2023 1,351,542 $ 20.22 6,578 $ 31.50
Performance Share Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Summary of Full Value Award Activity Under Stock Plans	PSU activity for 2023 under the Stock Plans is set forth below: Number of Shares Weighted Average Granted Date Fair Value Unvested as of December 31, 2022 - $ - Granted 509,600 30.90 Vested - - Canceled or forfeited - - Unvested as of December 31, 2023 509,600 $ 30.90

Net Loss Per Share Attributab_2

Net Loss Per Share Attributable to Common Stockholders (Tables)	12 Months Ended
	Dec. 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 years ended December 31, 2023, 2022, and 2021, respectively, basic net loss per share attributable to common stockholders was the same as diluted net loss per share attributable to common stockholders as the inclusion of potentially dilutive shares would have been antidilutive if included in the calculation (in thousands, except share and per share amounts): Year Ended December 31, 2023 2022 2021 Numerator Net loss $ ( 49,527 ) $ ( 42,815 ) $ ( 20,552 ) Adjust: Convertible preferred stock cumulative — — ( 196 ) Net loss attributable to common stockholders ( 49,527 ) ( 42,815 ) ( 20,748 ) Denominator Weighted-average common stock outstanding, 60,852,153 55,276,834 48,415,679 Net loss per share attributable to common $ ( 0.81 ) $ ( 0.77 ) $ ( 0.43 )
Summary of Potentially Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares Outstanding	The following potentially dilutive securities outstanding have been excluded from the computation of diluted weighted average shares outstanding because such securities have an antidilutive impact due to the Company's net loss, in common stock equivalent shares: December 31, December 31, 2023 2022 Common stock options issued and outstanding 7,377,017 7,150,755 Unvested full value awards 1,358,120 595,048 Total 8,735,137 7,745,803

Formation and Business of the_2

Formation and Business of the Company - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions			12 Months Ended
	Feb. 10, 2023	Apr. 27, 2021	Dec. 31, 2023	Dec. 31, 2022
Formation And Business Of The Company [Line Items]
Company incorporation date of incorporation			Jul. 29, 2013
Offering expenses			$ 7.5	$ 10.6
IPO [Member]
Formation And Business Of The Company [Line Items]
Sale of stock net consideration received on the transaction		$ 107.6
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	$ 107.5
Underwriting discounts and commissions	6.9
Offering expenses	$ 0.6

Summary of Significant Accoun_4

Summary of Significant Accounting Policies -Additional Information (Detail)	12 Months Ended
	Dec. 31, 2023 USD ($) Segment	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Summary Of Significant Accounting Policies [Line Items]
Surgical instrument expense		$ 2,000,000	$ 900,000
Number of reportable segment | Segment	1
Net of an allowance for doubtful accounts	$ 1,000,000	700,000
Provision for bad debts	434,000	411,000	144,000
Capitalized software development cost	200,000
Revenue recognition international sales	$ 0
Revenue recognition shipments to customers right to return description	shipments to customers, the Company offers the right to return the product within 30 days for a full refund, and for returns between 30 and 90 days, the Company offers a full refund less a 15% restocking fee. The Company does not have a history of product returns for refund. Customer invoices are generally payable within 30 days. The Company's products are generally sold with a limited standard warranty to the original purchaser of the products against defects in workmanship and materials for 180 days. The Company's liability is limited to providing, at the Company's option, a full refund or credit of the purchase price, or repairing or replacing the product, provided that the customer returns the defective product within 180 days from the purchase date. To date, the Company has had negligible returns of any products alleged to be defective.
Contract with customer, refund liability	$ 0	0
Contract with customer, product returns			0
Practical expedient, incremental cost of obtaining contract	true
Shipping and handling costs	$ 1,300,000	800,000	500,000
Advertising costs	16,100,000	15,000,000	$ 13,000,000
Liability related to uncertain tax positions	0
Accruals for product liability	$ 0	$ 0
Expected dividend yield	0%	0%	0%
Comprehensive loss	$ (49,337,000)	$ (42,842,000)	$ (20,748,000)
Obsolescence [Member]
Summary Of Significant Accounting Policies [Line Items]
Provision for inventory obsolescence	$ 900,000	$ 100,000	$ 300,000
Maximum [Member] | Accounts Receivable [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	10%	10%
Minimum [Member] | Revenue Benchmark [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	10%	10%	10%

Summary of Property and Equipme

Summary of Property and Equipment Depreciation Estimated Useful Lives (Detail)	Dec. 31, 2023
Furniture Fixtures and Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	7 years
Machinery and Equipment [Member] | Maximum [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	5 years
Machinery and Equipment [Member] | Minimum [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Capitalized Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Leasehold improvements	us-gaap:UsefulLifeShorterOfTermOfLeaseOrAssetUtilityMember
Software [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022	Jan. 01, 2022
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Operating lease right-of-use assets	$ 9,264	$ 10,138	$ 1,900
ASC 842 Topic [Member] | Minimum [Member]
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Lessee, operating lease, term of contract	12 months

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Assets:
Fair Value	$ 110,216	$ 61,779
US Treasury and Government Agencies
Assets:
Fair Value	29,369	16,443
Commercial Paper
Assets:
Fair Value	2,895
Corporate Debt
Assets:
Fair Value	46,586	23,372
Asset-Backed Securities
Assets:
Fair Value	24,756	13,896
Yankee CD
Assets:
Fair Value	6,610	8,068
Fair Value, Recurring [Member]
Assets:
Total asset	113,376	77,990
Liabilities:
Contingent consideration	2,977
Total	2,977
Fair Value, Recurring [Member] | Money Market Funds [Member]
Assets:
Cash and cash equivalents	3,160	13,141
Fair Value, Recurring [Member] | US Treasury and Government Agencies
Assets:
Fair Value	29,369	16,443
Fair Value, Recurring [Member] | Commercial Paper
Assets:
Cash and cash equivalents		323
Fair Value	2,895
Fair Value, Recurring [Member] | Corporate Debt
Assets:
Cash and cash equivalents		2,197
Fair Value	46,586	23,372
Fair Value, Recurring [Member] | Asset-Backed Securities
Assets:
Fair Value	24,756	13,896
Fair Value, Recurring [Member] | Yankee CD
Assets:
Cash and cash equivalents		550
Fair Value	6,610	8,068
Fair Value, Recurring [Member] | Level 1 [Member]
Assets:
Total asset	17,165	26,014
Fair Value, Recurring [Member] | Level 1 [Member] | Money Market Funds [Member]
Assets:
Cash and cash equivalents	3,160	13,141
Fair Value, Recurring [Member] | Level 1 [Member] | US Treasury and Government Agencies
Assets:
Fair Value	14,005	12,873
Fair Value, Recurring [Member] | Level 2 [Member]
Assets:
Fair Value		23,372
Total asset	96,211	51,976
Fair Value, Recurring [Member] | Level 2 [Member] | US Treasury and Government Agencies
Assets:
Fair Value	15,364	3,570
Fair Value, Recurring [Member] | Level 2 [Member] | Commercial Paper
Assets:
Cash and cash equivalents		323
Fair Value	2,895
Fair Value, Recurring [Member] | Level 2 [Member] | Corporate Debt
Assets:
Cash and cash equivalents		2,197
Fair Value	46,586
Fair Value, Recurring [Member] | Level 2 [Member] | Asset-Backed Securities
Assets:
Fair Value	24,756	13,896
Fair Value, Recurring [Member] | Level 2 [Member] | Yankee CD
Assets:
Fair Value	6,610	8,068
Fair Value, Recurring [Member] | Level 3 [Member]
Liabilities:
Contingent consideration	2,977
Total	$ 2,977
Fair Value, Recurring [Member] | Level 3 [Member] | Yankee CD
Assets:
Cash and cash equivalents		$ 550

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash payments for contingent consideration	$ 0

Fair Value Measurements - Sum_2

Fair Value Measurements - Summary of the Changes in the Fair Value of the Company's Financial Instruments (Detail) - Level 3 [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fair value as of December 31,2022	$ 0
Change in fair value	163
Fair value, as of December 31, 2023	2,977
Mios Marketing Llc Member
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Contingent consideration from acquisition	$ 2,814

Business Combination - Addition

Business Combination - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Jun. 12, 2023	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Amortization of intangible assets		$ 500	$ 0
Impairment charges		$ 0	$ 300
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 (Detail) - 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	Dec. 31, 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	12,815	$ 0
Total assets acquired		$ 22,814

Business Combination -Schedule

Business Combination -Schedule of Intangible Assets Balance (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition [Line Items]
Accumulated Amortization	$ 475	$ 0
MIOS Marketing, LLC [Member] | Developed Technology [Member]
Business Acquisition [Line Items]
Gross Carrying Amount	9,500
Accumulated Amortization	475
Net Carrying Amount	$ 9,025

Business Combination - Schedu_3

Business Combination - Schedule of Estimated Intangible Amortization Expense (Detail) - MIOS Marketing, LLC [Member] $ in Thousands	Dec. 31, 2023 USD ($)
Acquired Indefinite-Lived Intangible Assets [Line Items]
2024	$ 950
2025	950
2026	950
2027	950
2028	$ 950

Business Combination - Schedu_4

Business Combination - Schedule of Goodwill (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($)
Goodwill [Line Items]
Balance as of December 31, 2022	$ 0
Balance as of December 31, 2023	12,815
MIOS Marketing, LLC [Member]
Goodwill [Line Items]
Balance as of December 31, 2022	0
Acquisitions	12,815
Balance as of December 31, 2023	$ 12,815

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Cash and Cash Equivalents (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Cash and Cash Equivalents [Line Items]
Cash	$ 9,822	$ 3,262
Total cash and cash equivalents	12,982	19,473
Money Market Funds [Member]
Cash and Cash Equivalents [Line Items]
Cash equivalents	3,160	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	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Marketable Securities [Line Items]
Amortized Cost	$ 110,053	$ 61,806
Gross Unrealized Gains	196	79
Gross Unrealized Losses	(33)	(106)
Fair Value	110,216	61,779
US Treasury and Government Agencies
Marketable Securities [Line Items]
Amortized Cost	29,377	16,472
Gross Unrealized Gains	8	11
Gross Unrealized Losses	(16)	(40)
Fair Value	29,369	16,443
Commercial Paper
Marketable Securities [Line Items]
Amortized Cost	2,893
Gross Unrealized Gains	2
Gross Unrealized Losses	0
Fair Value	2,895
Corporate Debt
Marketable Securities [Line Items]
Amortized Cost	46,467	23,376
Gross Unrealized Gains	123	31
Gross Unrealized Losses	(4)	(35)
Fair Value	46,586	23,372
Asset-Backed Securities
Marketable Securities [Line Items]
Amortized Cost	24,712	13,892
Gross Unrealized Gains	56	27
Gross Unrealized Losses	(12)	(23)
Fair Value	24,756	13,896
Yankee CD
Marketable Securities [Line Items]
Amortized Cost	6,604	8,066
Gross Unrealized Gains	7	10
Gross Unrealized Losses	(1)	(8)
Fair Value	$ 6,610	$ 8,068

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 31,046	$ 19,601
Less: accumulated depreciation and amortization	(8,748)	(4,263)
Property and equipment, net	22,298	15,338
Furniture and Fixtures, and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	2,494	1,577
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,115	705
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	2,423	928
Capitalized Surgical Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	14,253	9,248
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,020	571
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	9,425	6,434
Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 316	$ 138

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash and Cash Equivalents [Line Items]
Depreciation and amortization expense	$ 4,900	$ 2,100	$ 700
Cash	9,822	3,262
Asset impairment charges	0	300
Imapairment charges, property and equipment	0	$ 200	$ 0
Impairment, Long-Lived Asset, Held-for-Use, Statement of Income or Comprehensive Income [Extensible Enumeration]		Investment Income, Net
Impairment charges, right-of-use asset associated with the lease		$ 100
Prepaid Expenses And Other Current Assets
Cash and Cash Equivalents [Line Items]
Accrued Interest	1,100	400
Silicon Valley Bank
Cash and Cash Equivalents [Line Items]
Cash	$ 900	$ 900

Balance Sheet Components - Su_4

Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Balance Sheet Related Disclosures [Abstract]
Accrued royalties expense	$ 2,305	$ 2,299
Accrued interest	417	412
Accrued professional services	424	1,727
Accrued Compensation Expense	3,340	0
Other accrued expense	3,972	1,778
Total accrued liabilities	$ 10,458	$ 6,216

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Current Operating Lease Liabilities and Other Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Operating Lease, Liability [Abstract]
Current portion of operating lease liabilities	$ 1,404	$ 339
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Total operating lease and other liabilities	Total operating lease and other liabilities
Contingent consideration	$ 2,977	$ 0
Other	51	0
Total operating lease and other liabilities	$ 4,432	$ 339

Long Term Debt - Additional Inf

Long Term Debt - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Apr. 29, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Line Of Credit Facility, Borrowing Capacity Description	The Company is required to either (i) maintain a minimum drawn balance under the revolving loan facility or (ii) pay a minimum balance fee that is equal to the amount of the minimum balance deficit multiplied by the applicable interest rate during the period. If the outstanding balance under the revolving loan facility exceeds the lesser of (i) 50% of the revolving borrowing capacity or (ii) 50% of the borrowing base, or the Company is in default, MidCap will apply funds collected from the Company's lockbox account to reduce the outstanding balance of the revolving loan facility ("Lockbox Deductions").
Revolving borrowing capacity percentage	50%
Line of credit, interest description	The loans bear interest at an annual rate based on a 30-day forward looking secured overnight financing rate plus 0.10% (subject to a floor of 1.0% and a cap of 3.0% for both loan agreements) plus (i) 6.0% under the term loan agreement and (ii) 4.0% under the revolving loan facility.
Term loan repayment term	Interest is payable monthly in arrears on the first day of each month and on the maturity of the loan agreements. The term loan agreement and the revolving loan facility are accruing interest as of December 31, 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%
Payment of debt issuance costs		$ 0	$ 989	$ 0
Interest and other income (expense), net		6,726	1,313	17
Long term debt net of unamortized debt issuance costs and discount		53,008	52,711
Amortization of debt discount		300	200	200
SVB Credit Facility And CRG Credit Facility [Member]
Debt Instrument [Line Items]
Interest expenses		$ 5,200	$ 4,400	$ 4,100
Midcap Financial Trust [Member]
Debt Instrument [Line Items]
Term loan tenure	5 years
Line of credit	$ 150,000
Revolving borrowing capacity percentage	50%
Debt Instrument, Face Amount	$ 120,000
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Borrowings	50,000
Remaining borrowing capacity	30,000
Increase in credit facility	$ 20,000
Debt Instrument Interest Rate, Percentage	0.10%
Debt Instrument Interest Rate	4%
Capped interest rates		7%
Line of credit current borrowing capacity		$ 26,000
Current portion of long-term line of credit drawn		4,000
Debt Instrument, Face Amount	$ 30,000
Early Repayment Year Two [Member]
Debt Instrument [Line Items]
Debt instrument repayment fee percentage for second year	2%
Tranche One [Member]
Debt Instrument [Line Items]
Borrowings	$ 50,000
Tranche Two[Member]
Debt Instrument [Line Items]
Borrowings		30,000
Tranche Four [Member]
Debt Instrument [Line Items]
Borrowings	$ 120,000
Interest Rate Floor [Member] | SOFR [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate spread percentage	1%
Interest Rate Cap [Member] | SOFR [Member]
Debt Instrument [Line Items]
Debt instrument variable interest rate spread percentage	3%
Term Loans [Member]
Debt Instrument [Line Items]
Remaining borrowing capacity		$ 40,000
Debt Instrument Interest Rate	6%
Capped interest rates		9%

Long Term Debt - Summary of Lon

Long Term Debt - Summary of Long-term Debt Instruments (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Total term loans	$ 54,000	$ 54,000
Less: Unamortized debt discount and debt issuance costs	(992)	(1,289)
Total long-term debt, net	53,008	52,711
Mid Cap Revolving Credit 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	Dec. 31, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
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	(992)	(1,289)
Total long-term debt, net	$ 53,008	$ 52,711

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Other Commitments [Line Items]
Accrued liabilities related to litigation and contingencies	$ 0	$ 0
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member]
Other Commitments [Line Items]
Period over which the royalties are payable	3 years	3 years
Notice period for termination of agreement	90 days	90 days
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member] | 10 Years from the First Sale of the Commercial Product [Member]
Other Commitments [Line Items]
Royalty expenses	$ 6,900,000	$ 6,500,000	$ 4,300,000
Royalty as a percentage of net sales for the period	3.70%	4.60%	4.60%
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member] | 10 Years from the First Sale of the Commercial Product [Member] | Maximum [Member]
Other Commitments [Line Items]
Royalty as a percentage of net sales	3%	3%
Royalty Agreement with Certain Members of the Surgeon Advisory Board [Member] | 10 Years from the First Sale of the Commercial Product [Member] | Minimum [Member]
Other Commitments [Line Items]
Royalty as a percentage of net sales	0.40%	0.40%

Operating Leases - Additional I

Operating Leases - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating Lease, Liability [Abstract]
Operating lease term	10 years
Leasehold improvements	$ 2
Percentage of construction cost paid as fee to lessor	(1.50%)
Variable lease costs	$ 0.7	$ 0.2	$ 0
Rent expense			$ 0.6
Operating lease cost	2.4	$ 2.3
Cash paid for operating lease liabilities	2.2
Rental income	$ 0.3

Operating Leases - Summary of O

Operating Leases - Summary of Operating Leases (Detail)	Dec. 31, 2023
Operating Lease, Liability [Abstract]
Weighted-average remaining lease term (years)	8 years 2 months 12 days
Weighted average discount rate	9.20%

Operating Leases - Summary of F

Operating Leases - Summary of Future Minimum Lease Payments and Maturity Analysis of Operating Lease Liabilities (Details) - USD ($) $ in Thousands		Dec. 31, 2023	Dec. 31, 2022
Operating Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]
2024		$ 2,905
2025	[1]	1,398
2026		3,339
2027		3,097
2028		3,159
Thereafter		11,839
Total undiscounted lease payments		25,737
Less: imputed interest		(8,442)
Total discounted lease payments		17,295
Less: Current portion of lease liability		$ (1,404)	$ (339)
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]		Operating Lease and Other Liabilities	Operating Lease and Other Liabilities
Noncurrent portion of lease liability		$ 15,891	$ 15,539
[1] Amount presented is net of allowance for tenant improvements. In 2023, the Company entered into subleases for a portion of its former headquarter space as a lessor. The lease is classified as an operating lease. The Company recorded rental income of $ 0.3 million for years ended December 31, 2023.

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Line Items]
Income tax provision	$ 0	$ 0	$ 0
Valuation allowance offsetting deferred tax assets	35,211,000	22,864,000
Change in the deferred tax asset valuation allowance	$ 12,300,000	10,900,000
Net operating loss carryforwards expiration year	2034
Liability related to uncertain tax positions	$ 0
Research and Development [Member]
Income Tax Disclosure [Line Items]
Tax credit carryforwards	$ 1,300,000	1,000,000
Tax credit carryforwards expiration year	2037
Federal [Member]
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 99,600,000	71,200,000
State [Member]
Income Tax Disclosure [Line Items]
Net operating loss carryforwards	$ 53,000,000	$ 34,000,000

Income Taxes - Summary of Recon

Income Taxes - Summary of Reconciliation of Statutory Federal Income Tax to Effective Tax (Detail)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Income tax at the statutory rate	(21.00%)	(21.00%)	(21.00%)
Stock-based and other compensation	(1.00%)	(5.00%)	(8.00%)
State taxes, net of federal benefit	(3.00%)	(1.00%)	(6.00%)
Research and development credits	(1.00%)	(1.00%)	(1.00%)
Change in valuation allowance	25%	26%	32%
Other	1%	2%	4%
Effective tax rate	0%	0%	0%

Income Taxes - Summary of Tax E

Income Taxes - Summary of Tax Effects of Temporary Differences and Carryforwards to Significant Portions of Deferred Tax Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2023	Dec. 31, 2022
Deferred income tax assets
Net operating loss carryforwards	$ 22,947	$ 15,979
Interest expense	2,618	1,785
Stock-based compensation expense	3,538	1,590
Accrued bonus	1,092	1,184
Research and development expenses	2,368	1,032
Research and development credits	1,273	954
Operating lease liabilities	4,015	3,539
Other	1,178	698
Gross deferred income tax assets	39,029	26,761
Less: valuation allowance	(35,211)	(22,864)
Net deferred tax assets	3,818	3,897
Deferred income tax liabilities
Property and equipment	(1,573)	(1,537)
Operating lease right-of-use assets	(2,217)	(2,331)
Other	(28)	(29)
Gross deferred income tax liabilities	(3,818)	(3,897)
Net deferred tax liabilities	$ 0	$ 0

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	1 Months Ended	12 Months Ended
	Jan. 31, 2024	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Apr. 27, 2021	Apr. 21, 2021
Class Of Stock [Line Items]
Preferred shares outstanding		0	0
Preferred shares authorized		5,000,000	5,000,000		5,000,000
Common stock shares authorized		300,000,000	300,000,000		300,000,000
Shares of common stock reserved for issuance		14,966,893	13,549,282
Stock options, weighted-average grant date fair value		$ 12.75	$ 7.52	$ 6.19
Grant date fair value of shares vested		$ 10.1	$ 5.3	$ 2
Unvested unrecognized stock-based compensation expense		$ 13.6
2021 Incentive Award Plan [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance		4,635,615	4,769,842			5,046,278
Percentage of shares of stock outstanding on an as converted basis						5%
Shares of stock may be issued upon the exercise						37,847,090
Percentage of incentive stock option granted to stockholder		10%
Stock option, Expiration period		5 years
Vesting period		4 years
2021 Incentive Award Plan [Member] | Maximum [Member]
Class Of Stock [Line Items]
Stock options, Terms		10
Percentage of fair market value of stock options		110%
2021 Incentive Award Plan [Member] | Subsequent Event [Member]
Class Of Stock [Line Items]
Number of common stock available for issuance increased	3,087,482
2014 Plan [Member]
Class Of Stock [Line Items]
Stock options, Terms			ten years
Vesting period		5 years
Stock Plan grant awards authorized		0
Aggregate intrinsic value of options exercised		$ 8.3	$ 25.9	$ 39.1
Restricted Stock
Class Of Stock [Line Items]
Vesting period		4 years
Restricted Stock Units [Member]
Class Of Stock [Line Items]
Vesting period		4 years
Performance Share Units [Member]
Class Of Stock [Line Items]
Vesting period		2 years
Unvested unrecognized stock-based compensation expense		$ 11.4
Weighted-average period of recognition		1 year 7 months 6 days
Performance Share Units [Member] | Maximum [Member]
Class Of Stock [Line Items]
Vesting rights percentage of PSU		250%
Performance Share Units [Member] | Minimum [Member]
Class Of Stock [Line Items]
Vesting rights percentage of PSU		0%
RSUs and RSAs [Member]
Class Of Stock [Line Items]
Weighted-average period of recognition		3 years 1 month 6 days
Unvested unrecognized stock-based compensation expense, Other than options		$ 18.3
Employee Share Purchase Plan [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance						504,627
Maximum subscription rate		15%
Common stock, Price per share percentage		85%
Employee Share Purchase Plan [Member] | Maximum [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance						7,064,790
Employee Share Purchase Plan [Member] | Subsequent Event [Member] | Maximum [Member]
Class Of Stock [Line Items]
Number of common stock available for issuance increased	2,220,216
Employee Share Purchase Plan [Member] | Subsequent Event [Member] | Minimum [Member]
Class Of Stock [Line Items]
Number of common stock available for issuance increased	617,497
2021 ESPP [Member]
Class Of Stock [Line Items]
Increase in shares of common stock reserved for issuance period		10 years
2021 ESPP [Member] | Maximum [Member]
Class Of Stock [Line Items]
Number of shares of common stock reserved increase percentage by annual of common stock outstanding		1%
Employee Stock Option [Member]
Class Of Stock [Line Items]
Shares of common stock reserved for issuance		7,377,017	7,150,755
Weighted-average period of recognition		2 years 1 month 6 days

Stockholders' Equity - Summary

Stockholders' Equity - Summary of the Company had Reserved Shares of Common Stock for Future Issuances (Detail) - shares	Dec. 31, 2023	Dec. 31, 2022	Apr. 21, 2021
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	14,966,893	13,549,282
Common stock options issued and outstanding [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	7,377,017	7,150,755
2021 Incentive Award Plan [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	4,635,615	4,769,842	5,046,278
Unvested restricted stock units under 2021 Plan [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	1,351,542	582,248
Common stock available for Employee Stock Purchase Plan [Member]
Shares Reserved For Future Issuance [Line Items]
Common stock available for future issuance	1,602,719	1,046,437

Stockholders' Equity - Summar_2

Stockholders' Equity - Summary of Company uses the Black-Scholes Option Pricing Model to Determine the Fair Value of Stock Options at the Grant (Detail)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)	6 years 3 months	6 years 3 months
Expected volatility (Minimum)	37.43%	36.05%	35.57%
Expected volatility (Maximum)	37.61%	37.08%	55.60%
Risk-free interest rate (Minimum)	3.75%	1.64%	0.08%
Risk-free interest rate (Maximum)	4.44%	4.34%	1.39%
Expected dividend yield	0%	0%	0%
Minimum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)			2 years 1 month 6 days
Maximum [Member]
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Expected term (in years)			6 years 3 months

Stockholders' Equity - Summar_3

Stockholders' Equity - Summary of Stock Option Activity under Stock Plans (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Number of Shares Outstanding Options of Beginning Balance	7,150,755
Number of Shares Outstanding of Option Granted	877,910
Number of Shares Outstanding of Options Exercised	(495,337)
Number of Shares Outstanding of Options Canceled	(156,311)
Number of Shares Outstanding of Ending Balance	7,377,017	7,150,755
Number of Shares Options vested and expected to vest at December 31, 2023	7,009,511
Number of Shares Options vested and exercisable at December 31, 2023	4,592,722
Outstanding Options Weighted-Average Remaining Contractual Term	6 years 5 months 23 days	7 years 10 days
Options vested and expected to vest at December 31, 2023	6 years 4 months 20 days
Options vested and exercisable at December 31, 2023	5 years 5 months 23 days
Weighted-Average Exercise Price Beginning Balance	$ 9.57
Weighted-Average Exercise Price, Options granted	23.67
Weighted-Average Exercise Price, Options exercised	3.77
Weighted-Average Exercise Price, Options canceled	17.33
Weighted-Average Exercise Price, Ending Balance	11.47	$ 9.57
Weighted-Average Exercise Price, Options vested and expected to vest at December 31, 2023	6.03
Weighted-Average Exercise Price, Options vested and exercisable at December 31, 2023	$ 3.65
Aggregate intrinsic values of options outstanding	$ 38,409
Aggregate Intrinsic Value, Options vested and expected to vest at December 31, 2023	38,158
Aggregate Intrinsic Value, Options vested and exercisable at December 31, 2023	$ 35,388

Stockholders' Equity - Summar_4

Stockholders' Equity - Summary of Full Value Award Activity Under Stock Plans (Detail)	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Restricted Stock Units (RSUs) [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unvested, Number of shares outstanding, Beginning Balance | shares	582,248
Unvested, Number of shares or units granted | shares	1,020,836
Unvested, Number of shares or units vested or released | shares	(149,919)
Unvested, Number of shares or units forfeited | shares	(101,623)
Unvested, Number of shares outstanding, Ending Balance | shares	1,351,542
Unvested, Weighted Average Grant Date Fair Value, Beginning Balance | $ / shares	$ 19.08
Unvested, Weighted Average Grant Date Fair ValueWeighted Average, Shares or units granted | $ / shares	20.76
Unvested, Weighted-Average Grant Date Fair Value, Shares or units vested or released | $ / shares	18.94
Unvested, Weighted-Average Grant Date Fair Value, Shares or units forfeited | $ / shares	21.05
Unvested, Weighted Average Grant Date Fair Value, Ending Balance | $ / shares	$ 20.22
Restricted Stock [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unvested, Number of shares outstanding, Beginning Balance | shares	12,800
Unvested, Number of shares or units granted | shares	0
Unvested, Number of shares or units vested or released | shares	(6,222)
Unvested, Number of shares or units forfeited | shares	0
Unvested, Number of shares outstanding, Ending Balance | shares	6,578
Unvested, Weighted Average Grant Date Fair Value, Beginning Balance | $ / shares	$ 31.5
Unvested, Weighted Average Grant Date Fair ValueWeighted Average, Shares or units granted | $ / shares	0
Unvested, Weighted-Average Grant Date Fair Value, Shares or units vested or released | $ / shares	31.5
Unvested, Weighted-Average Grant Date Fair Value, Shares or units forfeited | $ / shares	0
Unvested, Weighted Average Grant Date Fair Value, Ending Balance | $ / shares	$ 31.5
Performance Share Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Unvested, Number of shares outstanding, Beginning Balance | shares	0
Unvested, Number of shares or units granted | shares	509,600
Unvested, Number of shares or units vested or released | shares	0
Unvested, Number of shares or units forfeited | shares	0
Unvested, Number of shares outstanding, Ending Balance | shares	509,600
Unvested, Weighted Average Grant Date Fair Value, Beginning Balance | $ / shares	$ 0
Unvested, Weighted Average Grant Date Fair ValueWeighted Average, Shares or units granted | $ / shares	30.9
Unvested, Weighted-Average Grant Date Fair Value, Shares or units vested or released | $ / shares	0
Unvested, Weighted-Average Grant Date Fair Value, Shares or units forfeited | $ / shares	0
Unvested, Weighted Average Grant Date Fair Value, Ending Balance | $ / shares	$ 30.9

Stockholders' Equity - Summar_5

Stockholders' Equity - Summary of Assumptions Used to Estimate the Grant Date Fair Value of the PSUs Granted (Detail)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Dividend yield	0%	0%	0%
Performance Share Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Weighted average expected volatility of common stock	61.12%
Weighted average risk-free interest rate	4.76%
Dividend yield	0%
Performance Share Units [Member] | Maximum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected volatility of peer index	95.93%
Correlation coefficient of peer index	1%
Performance Share Units [Member] | Minimum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Expected volatility of peer index	21.61%
Correlation coefficient of peer index	0.08%

Stockholders' Equity - Summar_6

Stockholders' Equity - Summary of Share-Based Compensation Expense is Reflected in the Statements of Operations and Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	$ 17,352	$ 8,111	$ 3,409
Cost of goods sold
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	228	0	0
Sales and marketing expenses [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	4,556	2,928	1,231
Research and development expenses [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	2,053	697	475
General and administrative expenses [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs [Line Items]
Stock-based compensation expense	$ 10,515	$ 4,486	$ 1,703

Employee Benefit Plan - Additio

Employee Benefit Plan - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Defined Contribution Plan Disclosure [Line Items]
Defined contribution plan, percent of match	100%
Employees matching pre tax salary contribution percent	3%
Employees matching additional contribution percent	50%
Employees pre tax salary maximum matching contribution percent	5%
Elective deferrals and matching contributions eligibility period	3 months
Employer profit sharing contributions eligibility service period	1 year
Description of employee contributions to 401(K) plan	Effective as of January 2021, the Company began sponsoring a 401(k) profit sharing plan trust for its employees who satisfy certain eligibility requirements. An employee will be eligible to become a participant in the plan for purposes of (i) elective deferrals and matching contributions after completing three consecutive months of service beginning on the employee's date of hire and (ii) employer profit sharing contributions after completing one year of service.
Participants vest matching contributions period	90 days
Contribution to retirement plans	$ 1.6	$ 1	$ 0.7
Minimum [Member]
Defined Contribution Plan Disclosure [Line Items]
Graded vesting schedule period	1 year
Maximum [Member]
Defined Contribution Plan Disclosure [Line Items]
Graded vesting schedule period	6 years

Net Loss Per Share Attributab_3

Net Loss Per Share Attributable to Common Stockholders - Schedule of Net Loss Per Share Attributable to Common Stockholders, Basic and Diluted (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Numerator
Net loss	$ (49,527)	$ (42,815)	$ (20,552)
Adjust: Convertible preferred stock cumulative and undeclared dividends	0	0	(196)
Net loss attributable to common stockholders	$ (49,527)	$ (42,815)	$ (20,748)
Denominator
Weighted-average common stock outstanding, basic	60,852,153	55,276,834	48,415,679
Weighted-average common stock outstanding, diluted	60,852,153	55,276,834	48,415,679
Net loss per share attributable to common stockholders, basic	$ (0.81)	$ (0.77)	$ (0.43)
Net loss per share attributable to common stockholders, diluted	$ (0.81)	$ (0.77)	$ (0.43)

Net Loss Per Share Attributab_4

Net Loss Per Share Attributable to Common Stockholders - Summary of Potentially Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares Outstanding (Detail) - shares	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	8,735,137	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	7,377,017	7,150,755
Unvested Full Value Awards [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	1,358,120	595,048

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions		12 Months Ended
	Feb. 10, 2023	Dec. 31, 2023	Dec. 31, 2022
Subsequent Event [Line Items]
Offering expenses		$ 7.5	$ 10.6
Public Offering [Member]
Subsequent Event [Line Items]
Common stock, shares, issued	5,476,190
Share Price	$ 21
Proceeds from issuance of stock	$ 107.5
Underwriting discounts and commissions	6.9
Offering expenses	$ 0.6