Treace Medical Concepts (TMCI) 10-Q 7 May 24 2024 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares	3 Months Ended
	Mar. 31, 2024	May 01, 2024
Cover [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2024
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q1
Document Quarterly Report	true
Document Transition Report	false
Entity Registrant Name	Treace Medical Concepts, Inc.
Entity File Number	001-40355
Entity Tax Identification Number	47-1052611
Entity Address, Address Line One	100 Palmetto Park Place
Entity Address, City or Town	Ponte Vedra
Entity Address, Postal Zip Code	32081
City Area Code	904
Local Phone Number	373-5940
Entity Central Index Key	0001630627
Current Fiscal Year End Date	--12-31
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Incorporation, State or Country Code	DE
Entity Address, State or Province	FL
Entity Filer Category	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		62,008,135

Condensed Balance Sheets (unaud

Condensed Balance Sheets (unaudited) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Current assets
Cash and cash equivalents	$ 9,334	$ 12,982
Marketable securities, short-term	100,672	110,216
Accounts receivable, net of allowance for doubtful accounts of $1,076 and $980 as of March 31, 2024 and December 31, 2023, respectively	30,083	38,063
Inventories	35,860	29,245
Prepaid expenses and other current assets	11,448	7,853
Total current assets	187,397	198,359
Property and equipment, net	24,517	22,298
Intangible assets, net of accumulated amortization of $713 and $475 as of March 31, 2024 and December 31, 2023, respectively	8,787	9,025
Goodwill	12,815	12,815
Operating lease right-of-use assets	9,064	9,264
Other non-current assets	146	146
Total assets	242,726	251,907
Current liabilities
Accounts payable	21,149	11,835
Accrued liabilities	15,155	10,458
Accrued commissions	5,527	10,759
Accrued compensation	4,196	7,549
Other liabilities	1,022	4,432
Total current liabilities	47,049	45,033
Long-term debt, net of discount of $917 and $992 as of March 31, 2024 and December 31, 2023, respectively	53,083	53,008
Operating lease liabilities, net of current portion	16,166	15,891
Other long-term liabilities	37	37
Total liabilities	116,335	113,969
Commitments and contingencies (Note 7)
Stockholders’ equity
Preferred stock, $0.001 par value,5,000,000 shares authorized as of March 31, 2024 and December 31,2023 ;0 shares issued and outstanding as of March 31,2024 and December 31, 2023	0	0
Common stock, $0.001 par value, 300,000,000 shares authorized; 61,948,776 and 61,749,654 issued, and 61,929,172 and 61,749,654 outstanding as of March 31, 2024 and December 31, 2023, respectively	62	62
Additional paid-in capital	279,433	271,973
Accumulated deficit	(152,923)	(134,247)
Accumulated other comprehensive (loss) income	69	163
Treasury stock,at cost; 19,604 and 1,218 shares as of March 31, 2024 and December31, 2023,respectively	(250)	(13)
Total stockholders’ equity	126,391	137,938
Total liabilities and stockholders’ equity	$ 242,726	$ 251,907

Condensed Balance Sheets (Paren

Condensed Balance Sheets (Parenthetical) (unaudited) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Allowance for doubtful accounts receivable current	$ 1,076	$ 980
Intangible assets, accumulated amortization	713	475
Long term debt unamortized debt discount and issuance costs	$ 917	$ 992
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	61,948,776	61,749,654
Common stock share outstanding	61,929,172	61,749,654
Treasury stock (in shares)	19,604	1,218

Condensed Statements of Operati

Condensed Statements of Operations and Comprehensive Loss (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Income Statement [Abstract]
Revenue	$ 51,108	$ 42,195
Cost of goods sold	10,127	8,039
Gross profit	40,981	34,156
Operating expenses
Sales and marketing	40,328	33,655
Research and development	5,259	3,412
General and administrative	14,362	10,865
Total operating expenses	59,949	47,932
Loss from operations	(18,968)	(13,776)
Interest income	1,535	1,479
Interest expense	(1,317)	(1,285)
Other income, net	74	128
Other non-operating income (expense), net	292	322
Net loss	(18,676)	(13,454)
Unrealized gain (loss) on marketable securities	(94)	(29)
Comprehensive loss	$ (18,770)	$ (13,483)
Net loss per share attributable to common stockholders, basic	$ (0.3)	$ (0.23)
Net loss per share attributable to common stockholders, diluted	$ (0.3)	$ (0.23)
Weighted-average shares used in computing net loss per share attributable to common stockholders, basic	61,792,788	58,723,760
Weighted-average shares used in computing net loss per share attributable to common stockholders, diluted	61,792,788	58,723,760

Condensed Statement of Stockhol

Condensed Statement of Stockholders' Equity (unaudited) - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Income [Member]	Treasury stock [Member]
Balance at Beginning at Dec. 31, 2022	$ 60,529	$ 55	$ 145,221	$ (84,720)	$ (27)	$ 0
Balance at Beginning (in Shares) at Dec. 31, 2022		55,628,208
Issuance of common stock upon exercise of stock options	352		352
Issuance of common stock upon exercise of stock options, shares		125,890
Issuance of common stock for vesting of restricted stock units		50,415
Share-based compensation expense	2,692		2,692
Issuance of common stock from public offering, net of issuance costs and underwriting discount of $7.5 million	107,527	$ 6	107,521
Issuance of common stock from public offering, net of issuance costs and underwriting discount of $7.5 million, shares		5,476,190
Net Income (Loss)	(13,454)			(13,454)
Unrealized loss on available-for-sale marketable securities	(29)				(29)
Balance at Ending at Mar. 31, 2023	157,617	$ 61	255,786	(98,174)	(56)	0
Balance at Ending (in Shares) at Mar. 31, 2023		61,280,703
Balance at Beginning at Dec. 31, 2023	137,938	$ 62	271,973	(134,247)	163	(13)
Balance at Beginning (in Shares) at Dec. 31, 2023		61,749,654
Issuance of common stock upon exercise of stock options	52		52
Issuance of common stock upon exercise of stock options, shares		20,294
Issuance of common stock for vesting of restricted stock units		177,610
Share-based compensation expense	7,408		7,408
Net Income (Loss)	(18,676)			(18,676)
Unrealized loss on available-for-sale marketable securities	(94)				(94)
Shares Directly Withheld From Employees For Tax Payment	(237)					(237)
Shares directly withheld from employees for tax payment shares		(18,386)
Balance at Ending at Mar. 31, 2024	$ 126,391	$ 62	$ 279,433	$ (152,923)	$ 69	$ (250)
Balance at Ending (in Shares) at Mar. 31, 2024		61,929,172

Condensed Statement of Stockh_2

Condensed Statement of Stockholders' Equity (Parenthetical) (unaudited) $ in Millions	3 Months Ended
	Mar. 31, 2023 USD ($)
Statement of Stockholders' Equity [Abstract]
Issuance cost and underwriting discount	$ 7.5

Condensed Statements of Cash Fl

Condensed Statements of Cash Flows (unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Cash flows from operating activities
Net loss	$ (18,676)	$ (13,454)
Adjustments to reconcile net loss to net cash used in operating activities
Depreciation and amortization expense	1,909	924
Provision for allowance for doubtful accounts	159	38
Share-based compensation expense	7,408	2,692
Non-cash lease expense	592	626
Amortization of debt issuance costs	75	74
Recovery of loss reserve for surgical instruments	0	(23)
Accretion (amortization) of discount (premium) on marketable securities, net	(335)	(297)
Other, net	90	0
Net changes in operating assets and liabilities, net of acquisitions:
Accounts receivable	7,821	3,793
Inventory	(6,615)	(3,189)
Prepaid expenses and other assets	(1,495)	(963)
Other non-current assets	0	(69)
Payable to broker for unsettled marketable security purchases	0	710
Operating lease liabilities	(657)	(478)
Accounts payable	9,314	(3,592)
Accrued liabilities	(6,918)	(4,076)
Other, net	107	25
Net cash used in operating activities	(7,221)	(17,259)
Cash flows from investing activities
Purchases of available-for-sale marketable securities	(28,711)	(99,550)
Sales and maturities of available-for-sale marketable securities	36,396	20,548
Purchases of property and equipment	(3,927)	(1,478)
Net cash provided by (used in) investing activities	3,758	(80,480)
Cash flows from financing activities
Proceeds from issuance of common stock from public offering, net of issuance costs and underwriting discount of $7.5 million and $10.6 million	0	107,527
Proceeds from exercise of employee stock options	52	352
Taxes from withheld shares	(237)	0
Net cash provided by (used in) financing activities	(185)	107,879
Net increase (decrease) in cash and cash equivalents	(3,648)	10,140
Cash and cash equivalents at beginning of period	12,982	19,473
Cash and cash equivalents at end of period	9,334	29,613
Supplemental disclosure of cash flow information:
Cash paid for interest	1,317	1,285
Operating lease right-of-use asset and lease liability adjustment due to lease incentive	0	(35)
Noncash investing activities:
Unrealized (gains) losses, net on marketable securities	94	29
Unsettled matured marketable security and receivable from broker	$ 2,100	$ 0

Condensed Statements of Cash _2

Condensed Statements of Cash Flows (Parenthetical) (unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Statement of Cash Flows [Abstract]
Issuance costs and underwriting fees, net	$ 7.5	$ 10.6

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ (18,676)	$ (13,454)

Insider Trading Arrangements

Insider Trading Arrangements - Sean Scanlan [Member]	3 Months Ended
	Mar. 31, 2024 shares
Trading Arrangements, by Individual
Name	Sean Scanlan
Title	Chief Innovation Officer
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	March 15, 2024
Rule 10b5-1 Arrangement Terminated	true
Termination Date	March 15, 2025
Arrangement Duration	365 days
Aggregate Available	80,000

Formation and Business of the C

Formation and Business of the Company	3 Months Ended
	Mar. 31, 2024
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 $ 107.6 million from the IPO. O n February 10, 2023, the Company completed a follow-on offering that resulted in net proceeds of $ 107.5 million. Acquisition of RedPoint Medical3D 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 and agreed to make additional payments upon completion of certain milestones. The original terms are 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 advancements milestone within 12 months of the closing date, and, subject to prior completion of the transition services and the technological advancements milestone, 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. In the first quarter of 2024, the Company and RPM-3D evaluated the status of the three milestones and amended the original terms associated with the milestone payments. The maximum amount to be paid upon the achievement of the milestone payments has been reduced from $ 10.0 million to $ 8.1 million and is subject to successful completion of the transition services milestone at the first anniversary date of the acquisition. Upon successful completion of the transition services milestone, the payments are scheduled as follows: $ 6.0 million on July 15, 2024 and $ 2.1 million on January 15, 2025. No milestone payments would be made if the transition services milestone is not achieved by the acquisition anniversary date.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies The Company prepared the unaudited interim condensed financial statements included in this report in accordance with U.S. generally accepted accounting principles ("GAAP") for interim financial information and the rules and regulations of the Securities and Exchange Commission ("SEC") related to quarterly reports on Form 10-Q. Basis of Presentation The condensed financial statements have been prepared on the same basis as the Company’s annual financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023, filed with the SEC on February 27, 2024. The condensed financial statements included herein reflect all adjustments, including normal recurring adjustments, which are, in the opinion of management, necessary for a fair presentation of the financial position, results of operations and cash flows for the periods presented. The results of operations for the three months ended March 31, 2024 are not necessarily indicative of the results that may be expected for future quarters or for the fiscal year ending December 31, 2024. Any reference in these notes to applicable guidance is meant to refer to the authoritative GAAP as found in the Accounting Standards Codification ("ASC") and Accounting Standards Updates ("ASU") of the Financial Accounting Standards Board ("FASB"). Use of Estimates The preparation of 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 valuation of intangible assets and goodwill, reserves and write-downs related to accounts receivable, inventories, the recoverability of long-term assets, deferred tax assets and related valuation allowances, contingencies, and stock-based compensation . The Company had no accrued contingent liabilities as of March 31, 2024 and December 31, 2023 . Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents, marketable securities, and accounts receivable. The Company maintains its cash and cash equivalents balances with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation ("FDIC") insured limits. The Company's available-for-sale securities portfolio primarily consists of U.S. treasury and agency securities, money market funds, commercial paper, Yankee CDs, high credit quality asset-backed securities and corporate debt securities. The Company's investment policy requires its available-for-sale securities to meet certain criteria including investment type, credit ratings, and a maximum portfolio duration of one year. If any of the financial institutions where the Company holds deposits were to fail or be taken over by the FDIC, its access to these accounts could be temporarily unavailable or permanently lost for the amounts in excess of the FDIC insured limits. The Company did no t have material cash deposits in excess of the FDIC insured limits at March 31, 2024. 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. On March 31, 2024 and December 31, 2023 , no customer accounted for more than 10 % of accounts receivable. For the three months ended March 31, 2024 and 2023 , there were no customers that represented 10 % or more of revenue. Accounts receivable as of March 31, 2024 includes $ 2.0 million, prior to an allowance for credit losses, due from a customer that has filed for bankruptcy in May 2024. The Company is assessing the impact of the bankruptcy filing related to this accounts receivable and its relationship with this customer. While the Company maintains an allowance for doubtful accounts, there can be no assurance that this receivable will be timely collected, if at all, or that the current allowance for doubtful accounts will be adequate to offset the credit risk related to this matter, and no assurance that the Company will have an ongoing relationship with this customer.

Recent Accounting Pronouncement

Recent Accounting Pronouncements	3 Months Ended
	Mar. 31, 2024
Accounting Standards Update and Change in Accounting Principle [Abstract]
Recent Accounting Pronouncements	3. Recent Accounting Pronouncements 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	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Fair Value Measurements	4. Fair Value Measurements Assets and liabilities recorded at fair value in the condensed financial statements are categorized based upon the level of judgment associated with the inputs used to measure their fair value. Hierarchical levels which are directly related to the amount of subjectivity associated with the inputs to the valuation of these assets or liabilities are as follows: Level 1—Inputs are unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access as of the measurement date. Level 2—Inputs are observable, unadjusted quoted prices in active markets for similar assets or liabilities, unadjusted quoted prices for identical or similar assets or liabilities in markets that are not active or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the related assets or liabilities. Level 3—Unobservable inputs for the asset or liability only used when there is little, if any, market activity for the asset or liability at the measurement date. This hierarchy requires the Company to use observable market data, when available, and to minimize the use of unobservable inputs when determining fair value. Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis – The following assets and liabilities are measured at fair value on a recurring basis as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 4,562 $ — $ — $ 4,562 Short-term marketable securities at fair value U.S. treasury and government agencies 19,779 5,275 — 25,054 Commercial paper — 1,933 — 1,933 Corporate debt — 44,486 — 44,486 Asset-backed securities — 23,042 — 23,042 Yankee CD — 6,157 — 6,157 Total assets $ 24,341 $ 80,893 $ — $ 105,234 December 31, 2023 Level 1 Level 2 Level 3 Total Assets: Cash and 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 The carrying amounts of the Company's money market funds classified as cash and cash equivalents, accounts receivable, accounts payable, and accrued liabilities, approximate their fair value due to the short-term nature of these assets and liabilities. Based on the borrowing rates currently available to the Company for debt with similar terms and consideration of default and credit risk, the carrying value of the term loan approximates fair value. 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. Fair value as of December 31, 2023 $ 2,977 Change in fair value prior to contract modification 53 Reclassification of contingent consideration due to contract modification ( 3,030 ) Fair value as of March 31, 2024 $ - Contingent consideration is included in other liabilities on the Condensed Balance Sheets. As of December 31, 2023, the balance was classified as current due to the timing of the expected payment and the change in fair value for the contingent consideration related to the technological advancements milestone payment was classified as research and development expense within the Condensed Statements of Operations and Comprehensive Loss. The Company has made no cash payments for contingent consideration since the acquisition date. During the first quarter of 2024, the Company renegotiated with RPM-3D the terms for payment of the technological advancements milestone that was initially accounted for as contingent consideration. The renegotiated contract specifies that the technological advancements milestone payment will not be paid unless the transition services milestone is achieved. The technological advancements milestone payment is now tied to the continued service of key individuals from the date of the new contract until the transition services milestone determination date (which is the first anniversary date of the acquisition). Therefore, the Company is no longer accounting for the technological advancements milestone payment as contingent consideration at fair value, but rather as research and development expense over the remaining service period. The Company expects to pay the full amount for the technological advancements milestone of $ 3.5 million. See Note 1, "Formation and Business of the Company," of the Notes to Condensed Financial Statements for additional information on the acquisition of RPM-3D. There were no assets or liabilities measured at fair value on a nonrecurring basis as of March 31, 2024 and December 31, 2023 .

Balance Sheet Components

Balance Sheet Components	3 Months Ended
	Mar. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Balance Sheet Components	5. Balance Sheet Components Cash and Cash Equivalents The Company’s cash and cash equivalents consisted of the following (in thousands): March 31, December 31, 2024 2023 Cash $ 4,772 $ 9,822 Cash equivalents: Money market funds 4,562 3,160 Total cash and cash equivalents $ 9,334 $ 12,982 Marketable Securities The Company's available-for-sale marketable securities consisted of the following (in thousands): March 31, 2024 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 25,069 $ 2 $ ( 17 ) $ 25,054 Commercial paper 1,933 - - 1,933 Corporate debt 44,438 73 ( 25 ) 44,486 Asset-backed securities 23,007 54 ( 19 ) 23,042 Yankee CD 6,156 2 ( 1 ) 6,157 Total marketable securities - short-term $ 100,603 $ 131 $ ( 62 ) $ 100,672 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 As of March 31, 2024, 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 March 31, 2024 and December 31, 2023. As of March 31, 2024, 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. For the three months ended March 31, 2024 and 2023, there were no material gains or losses from sales of available-for-sale securities. As of March 31, 2024 and December 31, 2023, accrued interest of $ 1.0 million and $ 1.0 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 Condensed Balance Sheets. As of March 31, 2024, 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): March 31, December 31, 2024 2023 Furniture and fixtures, and equipment $ 2,564 $ 2,494 Construction in progress 388 1,115 Machinery and equipment 2,711 2,423 Capitalized surgical equipment 17,726 14,253 Computer equipment 1,055 1,020 Leasehold improvements 10,097 9,425 Software 395 316 Total property and equipment 34,936 31,046 Less: accumulated depreciation and amortization ( 10,419 ) ( 8,748 ) Property and equipment, net $ 24,517 $ 22,298 Depreciation and amortization expense on property and equipment was $ 1.7 million and $ 0.9 million for the three months ended March 31, 2024 and 2023, respectively. The Company did no t record impairment charges for its property and equipment, net for the three months ended March 31, 2024 and 2023. Accrued liabilities Accrued liabilities consist of the following (in thousands): March 31, December 31, 2024 2023 Accrued royalties expense $ 1,860 $ 2,305 Accrued interest 425 417 Accrued professional services 774 424 Accrued compensation expense for RPM-3D earn-out 7,602 3,340 Other accrued expense 4,494 3,972 Total accrued liabilities $ 15,155 $ 10,458 Other liabilities Other liabilities consist of the following (in thousands): March 31, December 31, 2024 2023 Current portion of operating lease liabilities $ 864 $ 1,404 Contingent consideration — 2,977 Other 158 51 Total other liabilities $ 1,022 $ 4,432 Due to renegotiated terms, the Company is no longer classifying the technological advancements milestone as contingent consideration. See discussion of RPM3-D renegotiation in Note 4, "Fair Value Measurements," of the Notes to Condensed Financial Statements.

Long Term Debt

Long Term Debt	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Long Term Debt	6. Long-Term Debt The Company’s long-term debt consisted of the following (in thousands): March 31, December 31, 2024 2023 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 ( 917 ) ( 992 ) Total long-term debt, net $ 53,083 $ 53,008 As of March 31, 2024, 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 ( 917 ) Total long-term debt, net $ 53,083 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 a term loan facility and a $ 30.0 million revolving loan facility. The term loan facility provides for a 60-month term loan up to $ 120.0 million in borrowing capacity to the Company, over four tranches. At 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 tranches. The revolving loan facility provides up to $ 30.0 million in borrowing capacity to the Company based on the borrowing base. The borrowing base is calculated based on certain accounts receivable and inventory assets. On March 31, 2024, the borrowing base allows a total of $ 20.2 million available to the Company under the revolving loan facility. The balance drawn as of March 31, 2024 is $ 4.0 million under the revolving loan facility. The Company may request an increase in the revolving loan facility up to $ 20.0 million for a total commitment of up to $ 50.0 million. The Company is required to either (i) maintain a minimum drawn balance under the revolving loan facility or (ii) pay a minimum balance fee that is equal to the amount of the minimum balance deficit multiplied by the applicable interest rate during the period. If the outstanding balance under the revolving loan facility exceeds the lesser of (i) 50 % of the revolving borrowing capacity or (ii) 50 % of the borrowing base, or the Company is in default, MidCap will apply funds collected from the Company's lockbox account to reduce the outstanding balance of the revolving loan facility ("Lockbox Deductions"). As of March 31, 2024, 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 and the revolving loan facility are accruing interest as of March 31, 2024 at the capped interest rates of 9 % and 7 %, respectively. The Company is obligated to pay interest only for the first 48 months and straight-line amortization for the remaining 12 months, subject to the Company’s election to extend the initial interest-only period by 12 months to 60 months total if the Company’s trailing twelve-month revenue is at or above certain levels. If the term loan is repaid before the maturity date or the revolving loan facility is terminated before the end of its term, the prepayment fees are 3.0 % of the amount repaid in the first year, 2.0 % in the second year and 1.0 % in the third year and thereafter, and a final payment fee of 3.0 % of the amount borrowed is due under the term loan. The revolving loan facility prepayment fees are based on the revolving loan commitment amount. The loans are secured by substantially all of the Company’s assets, including intellectual property. The loan agreements and other ancillary documents contain customary representations and warranties and affirmative and negative covenants. Under the loan agreements, the Company is not required to meet any minimum level of revenue if liquidity (defined as unrestricted cash plus undrawn availability under the revolving loan agreement) is greater than the outstanding balance under the term loan. If liquidity falls below such outstanding balance, then the Company is subject to a minimum trailing twelve-month revenue covenant. The Company is not subject to this covenant on March 31, 2024 .

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	7. Commitments and Contingencies License and Royalty Commitments The Company has entered into product development and fee for service agreements with members of its Surgeon Advisory Board 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 such consultant's contributions to the product are novel, significant and innovative. 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 March 31, 2024 and 2023, 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 royalty expense of $ 1.7 million and $ 1.6 million for the three months ended March 31, 2024 and 2023, respectively, resulting in an aggregate royalty rate of 3.4 % and 3.9 % , for the three months ended March 31, 2024 and 2023, respectively. Contingencies From time to time, the Company may be a party to various litigation claims in the normal course of business. Legal fees and other costs associated with such actions are expensed as incurred. The Company assesses, in conjunction with legal counsel, the need to record a liability for litigation and contingencies. Accrual estimates are recorded when and if it is determinable that such a liability for litigation and contingencies are both probable and reasonably estimable. There were no accrued contingent liabilities as of March 31, 2024 and December 31, 2023 .

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2024
Stockholders' Equity Note [Abstract]
Stockholders' Equity	8. Stockholders’ Equity Stock Options During the three months ended March 31, 2024 and 2023, the Company granted stock options to employees to purchase an aggregate o f 619,400 and 727,650 shares of the Company’s common stock, respectively. The weighted-average grant-date fair value of the employee stock options granted during the three months ended March 31, 2024 and 2023 was $ 5.98 and $ 10.58 per share, respectively. Restricted Stock Units During the three months ended March 31, 2024 and 2023, the Company granted 1,426,015 and 571,565 restricted st ock units ("RSUs"), respectively. The weighted average grant-date fair value of RSUs granted during the three months ended March 31, 2024 and 2023 was $ 13.39 and $ 24.07 , respectively. Performance Share Units The Company granted performance-based restricted stock unit ("PSU") awards in the first quarter of 2024 subject to market and service vesting conditions to certain executives under the Company's 2021 Incentive Award 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 three years . The grant date value of each target PSU award was determined using a Monte Carlo valuation model. Over the full three-year performance period, 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 200 % of target PSUs. During the three months ended March 31, 2024 the Company granted 453,375 target PSUs. The weighted average grant-date fair value of the PSUs granted during the three months ended March 31, 2024 was $ 18.89 . Share-Based Compensation Expense Share-based compensation expense is reflected in operating expenses in the Condensed Statements of Operations and Comprehensive Loss as follows (in thousands): Three Months Ended March 31, 2024 2023 Cost of goods sold $ 90 $ 76 Sales and marketing expense 1,697 822 Research and development expense 1,006 257 General and administrative expense 4,615 1,537 Total $ 7,408 $ 2,692

Net Loss Per Share Attributable

Net Loss Per Share Attributable to Common Stockholders	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Net Loss Per Share Attributable to Common Stockholders	9. Net Loss Per Share Attributable to Common Stockholders The following table sets forth the computation of basic and diluted net loss per share attributable to common stockholders which is computed by dividing the net loss attributable to common stockholders by the weighted-average number of shares of common stock outstanding for the period. As the Company reported a net loss for the three months ended March 31, 2024 and 2023, basic net loss per share attributable to common stockholders was the same as diluted net loss per share attributable to common stockholders as the inclusion of potentially dilutive shares would have been antidilutive if included in the calculation (in thousands, except share and per share amounts): Three Months Ended March 31, 2024 2023 Numerator Net loss $ ( 18,676 ) $ ( 13,454 ) Denominator Weighted-average common stock outstanding, 61,792,788 58,723,760 Net loss per share attributable to common $ ( 0.30 ) $ ( 0.23 ) The following potentially dilutive securities outstanding have been excluded from the computation of diluted weighted average shares outstanding because such securities have an antidilutive impact due to the Company’s net loss, in common stock equivalent shares: As of March 31, 2024 2023 Common stock options issued and outstanding 7,949,702 7,717,414 Unvested full value awards 2,545,925 1,086,697 Contingently issuable PSU shares 906,750 — Total 11,402,377 8,804,111

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The condensed financial statements have been prepared on the same basis as the Company’s annual financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2023, filed with the SEC on February 27, 2024. The condensed financial statements included herein reflect all adjustments, including normal recurring adjustments, which are, in the opinion of management, necessary for a fair presentation of the financial position, results of operations and cash flows for the periods presented. The results of operations for the three months ended March 31, 2024 are not necessarily indicative of the results that may be expected for future quarters or for the fiscal year ending December 31, 2024. Any reference in these notes to applicable guidance is meant to refer to the authoritative GAAP as found in the Accounting Standards Codification ("ASC") and Accounting Standards Updates ("ASU") of the Financial Accounting Standards Board ("FASB").
Use of Estimates	Use of Estimates The preparation of 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 valuation of intangible assets and goodwill, reserves and write-downs related to accounts receivable, inventories, the recoverability of long-term assets, deferred tax assets and related valuation allowances, contingencies, and stock-based compensation . The Company had no accrued contingent liabilities as of March 31, 2024 and December 31, 2023 .
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that potentially subject the Company to concentrations of risk consist principally of cash, cash equivalents, marketable securities, and accounts receivable. The Company maintains its cash and cash equivalents balances with established financial institutions and, at times, such balances with any one financial institution may be in excess of the Federal Deposit Insurance Corporation ("FDIC") insured limits. The Company's available-for-sale securities portfolio primarily consists of U.S. treasury and agency securities, money market funds, commercial paper, Yankee CDs, high credit quality asset-backed securities and corporate debt securities. The Company's investment policy requires its available-for-sale securities to meet certain criteria including investment type, credit ratings, and a maximum portfolio duration of one year. If any of the financial institutions where the Company holds deposits were to fail or be taken over by the FDIC, its access to these accounts could be temporarily unavailable or permanently lost for the amounts in excess of the FDIC insured limits. The Company did no t have material cash deposits in excess of the FDIC insured limits at March 31, 2024. 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. On March 31, 2024 and December 31, 2023 , no customer accounted for more than 10 % of accounts receivable. For the three months ended March 31, 2024 and 2023 , there were no customers that represented 10 % or more of revenue. Accounts receivable as of March 31, 2024 includes $ 2.0 million, prior to an allowance for credit losses, due from a customer that has filed for bankruptcy in May 2024. The Company is assessing the impact of the bankruptcy filing related to this accounts receivable and its relationship with this customer. While the Company maintains an allowance for doubtful accounts, there can be no assurance that this receivable will be timely collected, if at all, or that the current allowance for doubtful accounts will be adequate to offset the credit risk related to this matter, and no assurance that the Company will have an ongoing relationship with this customer.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2024
Fair Value Disclosures [Abstract]
Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis	Assets and Liabilities Measured and Recorded at Fair Value on a Recurring Basis – The following assets and liabilities are measured at fair value on a recurring basis as of March 31, 2024 and December 31, 2023 (in thousands): March 31, 2024 Level 1 Level 2 Level 3 Total Assets: Cash equivalents Money market funds $ 4,562 $ — $ — $ 4,562 Short-term marketable securities at fair value U.S. treasury and government agencies 19,779 5,275 — 25,054 Commercial paper — 1,933 — 1,933 Corporate debt — 44,486 — 44,486 Asset-backed securities — 23,042 — 23,042 Yankee CD — 6,157 — 6,157 Total assets $ 24,341 $ 80,893 $ — $ 105,234 December 31, 2023 Level 1 Level 2 Level 3 Total Assets: Cash and 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
Summary of the Changes in the Fair Value	Fair value as of December 31, 2023 $ 2,977 Change in fair value prior to contract modification 53 Reclassification of contingent consideration due to contract modification ( 3,030 ) Fair value as of March 31, 2024 $ -

Balance Sheet Components (Table

Balance Sheet Components (Tables)	3 Months Ended
	Mar. 31, 2024
Balance Sheet Related Disclosures [Abstract]
Summary of Cash and Cash Equivalents	The Company’s cash and cash equivalents consisted of the following (in thousands): March 31, December 31, 2024 2023 Cash $ 4,772 $ 9,822 Cash equivalents: Money market funds 4,562 3,160 Total cash and cash equivalents $ 9,334 $ 12,982
Summary of Available-For-Sale Marketable Securities	The Company's available-for-sale marketable securities consisted of the following (in thousands): March 31, 2024 Amortized Cost Gross Unrealized Gains Gross Unrealized Losses Fair Value Marketable securities - short-term U.S. treasury and government agencies $ 25,069 $ 2 $ ( 17 ) $ 25,054 Commercial paper 1,933 - - 1,933 Corporate debt 44,438 73 ( 25 ) 44,486 Asset-backed securities 23,007 54 ( 19 ) 23,042 Yankee CD 6,156 2 ( 1 ) 6,157 Total marketable securities - short-term $ 100,603 $ 131 $ ( 62 ) $ 100,672 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
Summary of Property and Equipment, Net	The Company’s property and equipment, net consisted of the following (in thousands): March 31, December 31, 2024 2023 Furniture and fixtures, and equipment $ 2,564 $ 2,494 Construction in progress 388 1,115 Machinery and equipment 2,711 2,423 Capitalized surgical equipment 17,726 14,253 Computer equipment 1,055 1,020 Leasehold improvements 10,097 9,425 Software 395 316 Total property and equipment 34,936 31,046 Less: accumulated depreciation and amortization ( 10,419 ) ( 8,748 ) Property and equipment, net $ 24,517 $ 22,298
Summary of Accrued Liabilities	Accrued liabilities consist of the following (in thousands): March 31, December 31, 2024 2023 Accrued royalties expense $ 1,860 $ 2,305 Accrued interest 425 417 Accrued professional services 774 424 Accrued compensation expense for RPM-3D earn-out 7,602 3,340 Other accrued expense 4,494 3,972 Total accrued liabilities $ 15,155 $ 10,458
Schedule of Other Liabilities	Other liabilities consist of the following (in thousands): March 31, December 31, 2024 2023 Current portion of operating lease liabilities $ 864 $ 1,404 Contingent consideration — 2,977 Other 158 51 Total other liabilities $ 1,022 $ 4,432

Long Term Debt (Tables)

Long Term Debt (Tables)	3 Months Ended
	Mar. 31, 2024
Debt Disclosure [Abstract]
Summary of Long-term Debt Instruments	The Company’s long-term debt consisted of the following (in thousands): March 31, December 31, 2024 2023 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 ( 917 ) ( 992 ) Total long-term debt, net $ 53,083 $ 53,008
Summary of Maturities of Long-term Debt	As of March 31, 2024, 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 ( 917 ) Total long-term debt, net $ 53,083

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2024
Stockholders' Equity Note [Abstract]
Summary of Share-Based Compensation Expense is Reflected in Operating Expense in the Condensed Statements of Operations and Comprehensive Loss	Share-based compensation expense is reflected in operating expenses in the Condensed Statements of Operations and Comprehensive Loss as follows (in thousands): Three Months Ended March 31, 2024 2023 Cost of goods sold $ 90 $ 76 Sales and marketing expense 1,697 822 Research and development expense 1,006 257 General and administrative expense 4,615 1,537 Total $ 7,408 $ 2,692

Net Loss Per Share Attributab_2

Net Loss Per Share Attributable to Common Stockholders (Tables)	3 Months Ended
	Mar. 31, 2024
Earnings Per Share [Abstract]
Schedule of Net Loss Per Share Attributable to Common Stockholders, Basic and Diluted	As the Company reported a net loss for the three months ended March 31, 2024 and 2023, basic net loss per share attributable to common stockholders was the same as diluted net loss per share attributable to common stockholders as the inclusion of potentially dilutive shares would have been antidilutive if included in the calculation (in thousands, except share and per share amounts): Three Months Ended March 31, 2024 2023 Numerator Net loss $ ( 18,676 ) $ ( 13,454 ) Denominator Weighted-average common stock outstanding, 61,792,788 58,723,760 Net loss per share attributable to common $ ( 0.30 ) $ ( 0.23 )
Summary of Potentially Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares Outstanding	The following potentially dilutive securities outstanding have been excluded from the computation of diluted weighted average shares outstanding because such securities have an antidilutive impact due to the Company’s net loss, in common stock equivalent shares: As of March 31, 2024 2023 Common stock options issued and outstanding 7,949,702 7,717,414 Unvested full value awards 2,545,925 1,086,697 Contingently issuable PSU shares 906,750 — Total 11,402,377 8,804,111

Formation and Business of the_2

Formation and Business of the Company - Additional Information (Detail) $ in Millions						3 Months Ended
	Jan. 15, 2025 USD ($)	Jul. 15, 2024 USD ($)	Jun. 12, 2023 USD ($)	Feb. 10, 2023 USD ($)	Apr. 27, 2021 USD ($)	Mar. 31, 2024 USD ($) Milestones
Formation And Business Of The Company [Line Items]
Company incorporation date of incorporation						Jul. 29, 2013
Number of milestones | Milestones						3
Transition Services [Member]
Formation And Business Of The Company [Line Items]
Additional payments of milestones			$ 3.5			$ 0
Transition Services [Member] | Maximum [Member]
Formation And Business Of The Company [Line Items]
Reduction of payment on achievement of milestone						10
Transition Services [Member] | Minimum [Member]
Formation And Business Of The Company [Line Items]
Reduction of payment on achievement of milestone						8.1
Transition Services [Member] | Forecast [Member]
Formation And Business Of The Company [Line Items]
Additional payments of milestones	$ 2.1	$ 6
Technological Advancement Milestones [Member]
Formation And Business Of The Company [Line Items]
Additional payments of milestones			3.5			$ 3.5
Patent Claims [Member]
Formation And Business Of The Company [Line Items]
Additional payments of milestones			3
MIOS Marketing, LLC [Member]
Formation And Business Of The Company [Line Items]
Cash			$ 20
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]
Proceeds from sale of shares				$ 107.5

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Detail) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Summary Of Significant Accounting Policies [Line Items]
Accrued contingent liabilities	$ 0		$ 0
Accounts receivable, prior to an allowance for credit losses	2,000,000
material cash deposits	$ 0
Minimum [Member] | Revenue Benchmark [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	10%	10%
Maximum [Member] | Accounts Receivable [Member] | Customer Concentration Risk [Member]
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, percentage	10%		10%

Recent Accounting Pronounceme_2

Recent Accounting Pronouncements - Additional Information (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]
Operating lease right-of-use assets	$ 9,064	$ 9,264
Operating lease and other liabilities	$ 864	$ 1,404

Fair Value Measurements - Summa

Fair Value Measurements - Summary of Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Assets:
Fair Value	$ 100,672	$ 110,216
U.S. Treasury and Government Agencies [Member]
Assets:
Fair Value	25,054	29,369
Commercial Paper [Member]
Assets:
Fair Value	1,933	2,895
Corporate Debt [Member]
Assets:
Fair Value	44,486	46,586
Asset-Backed Securities [Member]
Assets:
Fair Value	23,042	24,756
Yankee CD [Member]
Assets:
Fair Value	6,157	6,610
Fair Value, Recurring [Member]
Assets:
Total assets	105,234	113,376
Liabilities:
Contingent consideration		2,977
Total		2,977
Fair Value, Recurring [Member] | Money Market Funds [Member]
Assets:
Cash and cash equivalents	4,562	3,160
Fair Value, Recurring [Member] | U.S. Treasury and Government Agencies [Member]
Assets:
Fair Value	25,054	29,369
Fair Value, Recurring [Member] | Commercial Paper [Member]
Assets:
Fair Value	1,933	2,895
Fair Value, Recurring [Member] | Corporate Debt [Member]
Assets:
Fair Value	44,486	46,586
Fair Value, Recurring [Member] | Asset-Backed Securities [Member]
Assets:
Fair Value	23,042	24,756
Fair Value, Recurring [Member] | Yankee CD [Member]
Assets:
Fair Value	6,157	6,610
Fair Value, Recurring [Member] | Level 1 [Member]
Assets:
Total assets	24,341	17,165
Fair Value, Recurring [Member] | Level 1 [Member] | Money Market Funds [Member]
Assets:
Cash and cash equivalents	4,562	3,160
Fair Value, Recurring [Member] | Level 1 [Member] | U.S. Treasury and Government Agencies [Member]
Assets:
Fair Value	19,779	14,005
Fair Value, Recurring [Member] | Level 2 [Member]
Assets:
Total assets	80,893	96,211
Fair Value, Recurring [Member] | Level 2 [Member] | U.S. Treasury and Government Agencies [Member]
Assets:
Fair Value	5,275	15,364
Fair Value, Recurring [Member] | Level 2 [Member] | Commercial Paper [Member]
Assets:
Fair Value	1,933	2,895
Fair Value, Recurring [Member] | Level 2 [Member] | Corporate Debt [Member]
Assets:
Fair Value	44,486	46,586
Fair Value, Recurring [Member] | Level 2 [Member] | Asset-Backed Securities [Member]
Assets:
Fair Value	23,042	24,756
Fair Value, Recurring [Member] | Level 2 [Member] | Yankee CD [Member]
Assets:
Fair Value	$ 6,157	6,610
Fair Value, Recurring [Member] | Level 3 [Member]
Liabilities:
Contingent consideration		2,977
Total		$ 2,977

Fair Value Measurements - Sum_2

Fair Value Measurements - Summary of the Changes in the Fair value (Detail) - Fair Value, Inputs, Level 3 [Member] $ in Thousands	3 Months Ended
	Mar. 31, 2024 USD ($)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value as of December 31, 2023	$ 2,977
Change in fair value prior to contract modification	53
Reclassification of contingent consideration due to contract modification	(3,030)
Fair value as of March 31, 2024	$ 0

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Thousands		3 Months Ended
	Jun. 12, 2023	Mar. 31, 2024
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Cash payments for contingent consideration		$ 0
Technological Advancement Milestones [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Additional payments of milestones	$ 3,500	$ 3,500

Business Combination - Schedule

Business Combination - Schedule of Acquisition-Date Fair Value Of Consideration Transferred (Details) $ in Millions	Jun. 12, 2023 USD ($)
MIOS Marketing, LLC [Member]
Asset Acquisition [Line Items]
Cash	$ 20

Business Combination - Schedu_2

Business Combination - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Business Acquisition [Line Items]
Goodwill	$ 12,815	$ 12,815

Balance Sheet Components - Summ

Balance Sheet Components - Summary of Cash and Cash Equivalents (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Cash and Cash Equivalents [Line Items]
Cash	$ 4,772	$ 9,822
Total cash and cash equivalents	9,334	12,982
Money Market Funds [Member]
Cash and Cash Equivalents [Line Items]
Cash equivalents	$ 4,562	$ 3,160

Balance Sheet Components - Su_2

Balance Sheet Components - Summary of Available-For-Sale Marketable Securities (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2024	Dec. 31, 2023
Marketable Securities [Line Items]
Amortized Cost	$ 100,603	$ 110,053
Gross Unrealized Gains	131	196
Gross Unrealized Losses	(62)	(33)
Fair Value	100,672	110,216
U.S. Treasury and Government Agencies [Member]
Marketable Securities [Line Items]
Amortized Cost	25,069	29,377
Gross Unrealized Gains	2	8
Gross Unrealized Losses	(17)	(16)
Fair Value	25,054	29,369
Commercial Paper [Member]
Marketable Securities [Line Items]
Amortized Cost	1,933	2,893
Gross Unrealized Gains	0	2
Gross Unrealized Losses	0	0
Fair Value	1,933	2,895
Corporate Debt [Member]
Marketable Securities [Line Items]
Amortized Cost	44,438	46,467
Gross Unrealized Gains	73	123
Gross Unrealized Losses	(25)	(4)
Fair Value	44,486	46,586
Asset-Backed Securities [Member]
Marketable Securities [Line Items]
Amortized Cost	23,007	24,712
Gross Unrealized Gains	54	56
Gross Unrealized Losses	(19)	(12)
Fair Value	23,042	24,756
Yankee CD [Member]
Marketable Securities [Line Items]
Amortized Cost	6,156	6,604
Gross Unrealized Gains	2	7
Gross Unrealized Losses	(1)	(1)
Fair Value	$ 6,157	$ 6,610

Balance Sheet Components - Su_3

Balance Sheet Components - Summary of Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 34,936	$ 31,046
Less: accumulated depreciation and amortization	(10,419)	(8,748)
Property and equipment, net	24,517	22,298
Furniture and Fixtures and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	2,564	2,494
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	388	1,115
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	2,711	2,423
Capitalized Surgical Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	17,726	14,253
Computer Equipment [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,055	1,020
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	10,097	9,425
Software [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 395	$ 316

Balance Sheet Components - Addi

Balance Sheet Components - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Cash and Cash Equivalents [Line Items]
Depreciation and amortization expense	$ 1,700,000	$ 900,000
Impairment, Long-Lived Asset, Held-for-Use, Total	0	$ 0
Cash	4,772,000		$ 9,822,000
Prepaid Expenses And Other Current Assets [Member]
Cash and Cash Equivalents [Line Items]
Accrued Interest	$ 1,000,000		$ 1,000,000

Balance Sheet Components - Su_4

Balance Sheet Components - Summary of Accrued Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Balance Sheet Related Disclosures [Abstract]
Accrued royalty expense	$ 1,860	$ 2,305
Accrued interest	425	417
Accrued professional services	774	424
Accrued compensation expense for RPM-3D earn-out	7,602	3,340
Other accrued expense	4,494	3,972
Total accrued liabilities	$ 15,155	$ 10,458

Balance Sheet Components - Sche

Balance Sheet Components - Schedule of Current Operating Lease Liability and Other Liabilities (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
Operating Lease, Liability [Abstract]
Current portion of operating lease liabilities	$ 864	$ 1,404
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Total other liabilities	Total other liabilities
Contingent consideration	$ 0	$ 2,977
Other	158	51
Total other liabilities	$ 1,022	$ 4,432

Long Term Debt - Additional Inf

Long Term Debt - Additional Information (Detail) - USD ($) $ in Millions		3 Months Ended
	Apr. 29, 2022	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Line of credit facility, borrowing capacity description	The Company is required to either (i) maintain a minimum drawn balance under the revolving loan facility or (ii) pay a minimum balance fee that is equal to the amount of the minimum balance deficit multiplied by the applicable interest rate during the period. If the outstanding balance under the revolving loan facility exceeds the lesser of (i) 50% of the revolving borrowing capacity or (ii) 50% of the borrowing base, or the Company is in default, MidCap will apply funds collected from the Company's lockbox account to reduce the outstanding balance of the revolving loan facility ("Lockbox Deductions").
Revolving borrowing capacity percentage	50%
Line of credit, interest description	The loans bear interest at an annual rate based on a 30-day forward looking secured overnight financing rate plus 0.10% (subject to a floor of 1.0% and a cap of 3.0% for both loan agreements) plus (i) 6.0% under the term loan agreement and (ii) 4.0% under the revolving loan facility.
Term loan repayment term	Interest is payable monthly in arrears on the first day of each month and on the maturity of the loan agreements. The term loan and the revolving loan facility are accruing interest as of March 31, 2024 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%
MidCap Financial Trust [Member]
Debt Instrument [Line Items]
Term loan tenure	5 years
Line of credit	$ 150
Revolving borrowing capacity percentage	50%
Debt instrument, face amount	$ 120
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Borrowings	50
Remaining borrowing capacity	30
Increase in credit facility	$ 20
Debt instrument interest rate, percentage	0.10%
Debt instrument interest rate	4%
Capped interest rates		7%
Line of credit current borrowing capacity		$ 20.2
Current portion of long-term line of credit drawn		$ 4
Debt instrument, face amount	$ 30
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
Tranche Two[Member]
Debt Instrument [Line Items]
Borrowings			$ 30
Tranche Four [Member]
Debt Instrument [Line Items]
Borrowings	$ 120
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
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	Mar. 31, 2024	Dec. 31, 2023
Debt Instrument [Line Items]
Total term loans	$ 54,000	$ 54,000
Less: Unamortized debt discount and debt issuance costs	(917)	(992)
Total long-term debt, net	53,083	53,008
Mid Cap Revolving Loan Facility
Debt Instrument [Line Items]
Total term loans	4,000	4,000
Term Loans [Member] | MidCap Term Loan Facility
Debt Instrument [Line Items]
Total term loans	$ 50,000	$ 50,000

Long Term Debt - Summary of Mat

Long Term Debt - Summary of Maturities of Long-term Debt (Detail) - USD ($) $ in Thousands	Mar. 31, 2024	Dec. 31, 2023
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	(917)	(992)
Total long-term debt, net	$ 53,083	$ 53,008

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($)	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023	Dec. 31, 2023
Other Commitments Line Items
Accrued contingent liabilities	$ 0		$ 0
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	$ 1,700,000	$ 1,600,000
Royalty as a percentage of net sales for the period	3.40%	3.90%
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%

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - $ / shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Restricted Stock [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares granted	1,426,015	571,565
Weighted average grant-date fair value	$ 13.39	$ 24.07
Employee Stock Option
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Stock options, weighted-average grant date fair value	$ 5.98	$ 10.58
Employees stock options, shares granted	619,400	727,650
Performance Share Units [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Shares granted	453,375
Vesting period	3 years
Weighted average grant-date fair value	$ 18.89
Performance Share Units [Member] | Maximum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting rights percentage of PSU	200%
Performance Share Units [Member] | Minimum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]
Vesting rights percentage of PSU	0%

Stockholders' Equity - Summary

Stockholders' Equity - Summary of Share-Based Compensation Expense is Reflected in Operating expenses in the Condensed Statements of Operations and Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Employee Service Share Based Compensation Allocation Of Recognized Period Costs Line Items
Stock-based compensation expense	$ 7,408	$ 2,692
Cost of goods sold [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs Line Items
Stock-based compensation expense	90	76
Sales and marketing [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs Line Items
Stock-based compensation expense	1,697	822
Research and development expense [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs Line Items
Stock-based compensation expense	1,006	257
General and administrative expense [Member]
Employee Service Share Based Compensation Allocation Of Recognized Period Costs Line Items
Stock-based compensation expense	$ 4,615	$ 1,537

Net Loss Per Share Attributab_3

Net Loss Per Share Attributable to Common Stockholders - Schedule of Net Loss Per Share Attributable to Common Stockholders, Basic and Diluted (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Numerator
Net Income (Loss)	$ (18,676)	$ (13,454)
Denominator
Weighted-average common stock outstanding, basic	61,792,788	58,723,760
Weighted-average common stock outstanding, diluted	61,792,788	58,723,760
Net loss per share attributable to common stockholders, basic	$ (0.3)	$ (0.23)
Net loss per share attributable to common stockholders, diluted	$ (0.3)	$ (0.23)

Net Loss Per Share Attributab_4

Net Loss Per Share Attributable to Common Stockholders - Summary of Potentially Dilutive Securities Excluded from Computation of Diluted Weighted Average Shares Outstanding (Detail) - shares	3 Months Ended
	Mar. 31, 2024	Mar. 31, 2023
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	11,402,377	8,804,111
Common Stock Options Issued and Outstanding [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	7,949,702	7,717,414
Unvested Full Value Awards [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	2,545,925	1,086,697
Contingently Issuable PSU Shares [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Diluted weighted average shares outstanding	906,750	0