Episode #92 | Nanochon: Joint Repair Layer by Layer

Cartilage injuries sideline millions every year, yet current treatments often fail to restore long-term function. In this episode, Dr. Nathan Castro and Dr. Ben Holmes, co-founders of Nanochon, explain how they are tackling this challenge with a 3D-printed implant designed not only to replace damaged tissue but to help it regrow. What began as a collaboration in a graduate lab has grown into a company now preparing for its first human clinical trial.

Their journey began at George Washington University in Dr. Grace Zhong’s tissue engineering lab, where the freedom to explore outside of strict grant-funded projects encouraged bold experimentation. Nathan even purchased specialized materials with his own money to expedite early tests. That investment in curiosity became the foundation for a technology that could change how orthopedic surgeons treat cartilage damage.

Nanochon’s implant blends strength with biology. It pairs a smooth articular surface with a porous lattice that integrates directly with surrounding tissue. Traditional approaches, Nathan explains, can be “like filling a pothole with jelly.” By contrast, their device provides stability without the need for sutures or pins. Despite being less than half the thickness of conventional implants, it requires two to three times more force to dislodge, which may result in shorter recovery times for patients.

From there, the company advanced step by step. They began with small animal studies in rats, progressed to goats, and finally proved the implant’s strength and integration in horses. These results not only built regulatory confidence but also convinced investors. With Health Canada’s approval for its first-in-human trial, Nanochon stands on the edge of translating a decade of persistence into clinical impact.

Ben and Nathan also reveal the realities of building a medical device startup, including raising funds during tight markets, meeting ISO 13485 quality standards, and learning to manage external contractors. This conversation is a rare look behind the curtain of medtech entrepreneurship. It shows how innovation happens in steady layers, built one on top of another, much like 3D printing itself.

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Episode Transcript

Speaker 1 (00:01):
Welcome to the pod.
Today we're joined by twopioneering voices at the
forefront of orthopedicinnovation Dr Nathan Castro and
Dr Ben Holmes, co-founders ofNanoCon, a company transforming
joint repair through 3D printedcartilage implants.
Castro, a biomedical engineerwith a PhD in tissue engineering

(00:29):
, brings deep expertise indevice design, regulatory
strategy and clinicaltranslation.
As CTO, he's leading NanoCon'seffort from early stage
development to commercialization.
Ceo Dr Ben Holmes complimentsthis with his leadership in
company formation, fundraisingand executive management.
Together, their work bridgesadvanced biomaterial science

(00:51):
with scalable medtech businessmodels, pushing the limits of
what's possible in regenerativeorthopedics.
Whether you're in healthcare,biotech or venture capital, this
episode offers powerful insightinto building the future of
joint care, layer by layer.
Enjoy.
Please listen to the disclaimerat the end of this podcast.

(01:15):
Hello, hello, welcome to thepod.
This is episode number 92,believe it or not, you wonder
where the previous 90 episodeswent.
But anyways, welcome to the pot, ben and Nathan.
Thank you so much for joiningus.
And as a team, I think I'venever done actually a team

(01:38):
interview before.
So this is going to be excitingbecause we have both the CEO
and CTO of NanoCom, a veryexciting startup focusing on
restoring cartilage using 3Dprinting.
So with that context, I alludedthat we want to talk about the
origin of the company.
You know the very beginning,how did you guys cross paths,

(02:01):
and you know what was thefunding story for nano con so
I'm curious, jenny, do you wantto do like?

Speaker 2 (02:09):
uh, I'll tell my version, and then nathan tells
his version and we see, uh, youknow, see what reality is, or?

Speaker 1 (02:15):
uh, I don't know I, I would say you know, I think,
whoever wants to take a firststep, um, but ben, why don't you
start?
And n Nathan, if there are someshocking facts that you didn't
know about that you can let usknow.

Speaker 2 (02:29):
Sure, yeah, I mean.
So Nathan and I met in thetissue engineering lab at the
George Washington University,still headed by Grace Chong, I
think I had a strong interest inbiomaterials and regenerative
medicine and basically had noreal background in it other than

(02:51):
some classes I had taken as anundergrad, and so you know it's
an interesting experience too,because Nathan correct me if I'm
wrong we were also the firsttwo PhDs in the lab.
I don't think anybody else wasa PhD at the time.

Speaker 3 (03:07):
Yeah, actually, grace started about two semesters
before I joined the lab.
So I joined the lab in fall of2011.
She had joined as an assistantprofessor tenure track, I
believe in fall of 2010.
Her tenure track, I believe infall of 2010.
So she had actually had onehigher PhD student who, you know

(03:29):
, for lack of a better word,didn't really pan out.
So if you were to ask Grace,she would probably say the same
thing that she would.
You know, consider me as herfirst PhD student and then Ben
as her second.
But collectively, yeah, youknow we yeah, I would say,

(03:50):
between Ben and myself andobviously students that were
supportive we really built thelab to where, to where it is now
, and the Promenade started,started doing Well, that sounds
like the first risk you guystook in your career.
It was, yeah, being proactiveand, I dare say, entrepreneurial

(04:11):
was kind of the culture inGrace's lab for sure you know,
I'm sure Ben had to kind ofthink about his own personal
trajectory and whether or notgoing back to grad school really

(04:31):
fit.
Much like myself, you know,prior to GW I was working at the
University of Texas at El Pasowhere I did my undergrad and my
master's, and I'm sure we'll getinto a deeper dive into our
respective backgrounds.
But I think Ben and I are bothcut from the same cloth in

(04:55):
regards to being risk-takers,looking for opportunities, as
well as having that inherententrepreneurial spirit.
So I think what GW afforded uswas the ability to cross paths
in that lab and to really setthe foundation for what we built

(05:16):
with Madam Connie.

Speaker 2 (05:18):
Yeah, absolutely Very well said.
And I'll say too, as long asdid high quality work and got

(05:43):
stuff published.
You know, it wasn't it wasn'tsome material that was built
into one of our grant fundedprojects or something that grace
had brought from her, herprevious um labs, it was.
It was just something thatseemed interesting and it was
kind of, you know, it was anenvironment where we were
encouraged to have the freedomto kind of pull on threads like
that.

(06:03):
If we ever came acrosssomething that that's, that
seemed kind of cool and outsidethe box.

Speaker 3 (06:07):
Yeah yeah, definitely , and you know that really came
out from as a sort of as aproduct of Ben and my
participation in the NSF I-Corpsprogram.
Participation in the NSFI-Corps program, so, where they

(06:30):
really instilled the importanceof customer discovery to follow
that lean startup approach.
So that really had me thinkingthat, from what I was personally
involved with during my PhD,which is focused on additive
manufacturing, of which isfocused on additive
manufacturing of soft mattermaterials like hydrogenolism,
even complementing some of ourpostdocs that joined the lab in

(06:51):
some of their work, it justdidn't seem like a viable option
that could translate from benchto bedside.
And you know, what we werelooking at into the course of
both Ben's interviews and my owninterviews and his stellar
performance in the I-Corpsprogram is that you know we

(07:13):
actually had participatedseparately because we had two
different technologies that wewere trying to kind of, you know
, vet through the technologytransfer office.

Speaker 1 (07:26):
So this was before Nanocom was funded.

Speaker 2 (07:28):
Yeah, this was maybe like 2012 or 2013.

Speaker 1 (07:33):
I see.
So most PhD students don't haveany business experience Before
founding Nanocom.
Did you guys have any kind ofbusiness experiences already?
It sounds like you did Good.
You sound like you did?

Speaker 2 (07:49):
I'm happy to answer that first because it's a short
answer.
No, I didn't really.
You know, between undergrad andgrad school I worked for two
and a half years in industry,but not in the medical field.
I was a mechanical engineer bytraining and I knew I had an
interest in biomedicalengineering and medical devices.

(08:10):
But after four years ofundergrad I was really needing a
break from school.
So a lot of mechanicalengineers are able to get jobs
in design, build, construction,that kind of work.
So I went to work for basicallya company that builds like big
office buildings, officecampuses, infrastructure
projects, work.
That is interesting andchallenging.

(08:32):
But I immediately knew itwasn't for me.
So for me it was just having areal interest and a curiosity in
biomedical research.
But what I will say is, eventhough it was only a few years,
that experience of working inthe construction industry, I got
a lot of exposure to projectmanagement and it's funny

(08:57):
because I think a lot of what Ido now, even though it's many,
many years later, a lot of thestuff that I do now as the CEO
of the company, are things I cantrace all the way back to that
short period of time where I wasworking in an industry not the
orthopedics industry, but justany industry where it's
complicated, there's a lot ofregulation, it's very capital

(09:20):
intensive.
I think there's a lot ofparallels in managing those
types of large constructionprojects that are very similar
to how you build a medicalproduct.

Speaker 1 (09:30):
Definitely, they're very translatable, these
business skills.
What about you, nathan?
Did you have any lemonadeselling experiences and stuff
like?

Speaker 3 (09:37):
that before.
Yeah, yeah, I mean, actuallyboth my paternal and my maternal
grandfathers were smallbusiness owners.
My maternal grandfather, afterhe returned from the Korean War,
set up a neighborhood grocerystore.
So you know he catered to thewants and the needs of the local

(10:02):
neighborhood and my paternalgrandfather, as well as my
father, had their own business.
So my father, when I was born,was a shoe salesman at a major
department store and you know,through that experience, you

(10:24):
know he because it was partlycommission-based, he would get a
lot of and we're talking backin El Paso, texas, so right on
the border of the US and Mexico.
So there was a lot of industryand a lot of people coming into
the US to purchase goods andthings of that nature.

(10:45):
But sometimes you know, hewould have a big sale and then a
week later the customer wouldcome and return the items and
because it was department storepolicy that they couldn't
reshelf and resell the shoes,that got my dad inquiring.
I said, okay, well, whathappens to those shoes after you

(11:05):
know they're?
You know, quote unquote used.
So, long story short, he didinvestigative work, he found
where those shoes resided andthen when I, you know, as a
young child, I would join him atthe weekend flea markets and we
would sell partially worn shoes, like designer shoes and
athletic shoes and, uh, you knowmy that was one, one aspect of

(11:30):
my dad's business and then mydad had a storefront where he
would sell, you know, um schoolsupplies and school uniforms to
cater to the local, uh, publicschools who are transitioning to
a uniform-based dress code andyou know that was able to

(11:51):
sustain our family during theschool year.
And then in the summers he and Iwould travel around the region,
so Texas, New Mexico, arizona,arizona and we would do
basically festivals.
So each town would have liketheir community festival.
So we would go there and wewould.

(12:12):
We would sell, like you know,toys, knickknack items, and then
when, even when I would go backto elementary school, I would
personally go and sell schoolsupplies to my colleagues and my
classmates.
So, yeah, I've always beenexposed to entrepreneurship.

(12:33):
I have sort of that inherentupbringing to be driven and also
to be very dynamic in theproduct that you're trying to
sell.
But more directly related toNanocon, I've suffered from knee

(12:54):
injuries my entire childhood.
So it's very personal whatwe're doing, because I feel like
I'm addressing a need that Ieventually will require, but
also having the guidance frommore experienced people to

(13:18):
really help mold and direct thatdesire.
Direct that desire, so I mean,without the network of support
system and mentors that I'vebeen able to establish
throughout my life andthroughout my academic and
professional life, I don't thinkI would find myself personally

(13:43):
where I am now.
So you know, I really and it'ssomething that I enjoy paying
forward to and you know, I'msure Ben can, you know, give
examples to what I'm saying whenwe were in Grace's lab, you
know he and I were the primarystudents lab.

(14:03):
You know he and I were theprimary students and I was the
de facto lab manager because Ihad already had experience in
biomedical engineering andbiomedical research, so from an
earlier, from my undergrad yearsand throughout my master's.
So I think Grace really feltcomfortable handing me reins to

(14:26):
oversee the day-to-dayactivities of the lab and that
included mentoring students bothfrom GW as undergraduates, and
one of the papers that Ipublished during my PhD was
actually with a high schoolstudent that I mentored over the
summer, that I mentored overthe summer.
So really wanting to share thatexperience of mentorship and

(14:49):
that transfer of knowledge toyounger people was, you know I
think, part of my core values.

Speaker 2 (14:55):
Yeah, and I think that's something that Nathan and
I both really share.
You know, I would say one justbecause I consider you know,
nathan, someone who mentored meearly on in the lab and really
kind of got me up to speed onwhat this bioengineering thing
is all about.
But also I think that we sharethat same passion for kind of

(15:19):
giving back, I think, as Nathansaid, and sort of sharing the
knowledge we've gained, I think,as Nathan said, and sort of
sharing the knowledge we'vegained but also recognizing that
we have benefited tremendouslyfrom mentorship, especially
going through I-Corpsno-transcript.

(15:57):
And then he was really intriguedby what we were doing, wanted
to help us basically just givingfreely of his time and then
eventually coming on asessentially an
equity-compensated advisor.
So for anybody who's listeningto this just wondering, how do I
even start a company, you findpeople like that that are, you
know, knowledgeable, generous,good people.
You give them a little bit of astake in the company to kind of
keep them engaged.
But you know, I think what'salso really great about

(16:20):
mentorship is it can also end upcoming back around.
You never know how someone isgoing to fit into the story of
your career or the story of yourcompany if it's a startup.
We just hired our firstfull-time employee who's not a
C-level executive or Nathan or I, so like a true employee of the

(16:41):
company, and he's somebody thatI mentored when we were in
Grace's lab.
He was one of the undergraduatementors and you know we stayed
in touch all through hisacademic career.
And then you know we wereneeding to hire somebody because
we just moved to this newmanufacturing space in Baltimore
and it just so happened he wasgraduating and looking for
something.
So you know, I think it's also,you know, generosity and, um,

(17:07):
you know, just really taking areal interest in people and
valuing people is how you buildthese networks.
You know it's um, I think itreally does take a human touch.
I think people really forgetthat.
Or there's so many storiesabout people being successful in
business because they're soruthless or, uh, because they're
so self-interested.
But you know, I think that somuch effort from so many

(17:31):
different types of people, somany different types of
expertise, it's just I'll.
I'll quote a medical device VCthat I really respect and I
heard him say this on podcastthis is not an industry for
assholes and, generally speaking, the assholes don't actually
have real, real success and I Ithink about that a lot actually.

Speaker 1 (17:53):
Especially long-term success.
Yeah, that's right, AbsolutelyNow going back, just dialing
back a little bit so that we canhave a more concrete story of
how NanoCon was.
What is the conception of now?
We've studied a lot about 3Dprinting and muscular skeleton,
studied a lot aboutnanomaterials, and what is the

(18:17):
moment like when you guysdecided, okay, this is a great
time to start a Delaware orstart a company?
Does it take like a year toreally kind of stew on it?
Or was it like overnight idea?
What was that like?
Or was it like overnight idea?

Speaker 3 (18:35):
What was that like?
I mean, I can speak to like theexperimental work and the
realization for me.
So, as Ben mentioned earlier,you know, with Grace's lab, she

(19:01):
gave us the flexibility toexplore and expand our
understanding, understanding ofthe of the space, intellectually
.
So you know, as I mentionedbefore, we were doing hydrogels,
which I felt was a difficulthurdle to transition from bench
to bedside, and so that kind ofgot us thinking okay, okay.
Well, you know, we're trying toaddress cartilage in the knee,
which experiences a lot ofstress and impact, and you know,

(19:25):
an analogy that we like to usequite often is the cartilage
defect is like a pothole on thestreet.
What most people are doing isfilling that pothole with jelly
or jello, something soft,something that's not
mechanically matched to thesurrounding area, something

(19:46):
that's not going to be veryrobust, not very robust.
So you know that got meexploring kind of the greater
commercial space and saying,okay, is there a material that
one has the ability to be 3Dprinted which falls in line with
what our lab was doing?
And two, does it have the youknow kind of the mechanics that

(20:13):
we would consider appropriate?
So then I found have themechanics that we would consider
appropriate.
So then I found a group ofCanada materials, and I
purchased them on my own.

Speaker 1 (20:24):
On your own money, not grant money.

Speaker 3 (20:26):
Wow.
It's something that Ipersonally kind of like to.
It's kind of like a behavioralthing for me, and the I guess
the model that kind ofencapsulates this sort of, you

(20:51):
know, behavior is it's easier toask for forgiveness than to ask
for permission.
So for me, from a researchstandpoint, and also from like a
business standpoint, you know,the cost to purchase these
materials wasn't that great,albeit, you know, a PhD salary

(21:13):
is not that high.

Speaker 1 (21:16):
So any little thing, it's like a week's of dinner.
A week's meals are gone,basically.

Speaker 3 (21:25):
Especially in DC where you're paying a premium.
But yeah, it was essentiallythe way I approached.
It was the best way to convincesomebody that an idea works is
to have empirical data toillustrate your idea.
So that's what I did in Grace'slab and that's kind of what I

(21:48):
carried over through all mymultiple postdocs after, before
getting fully onboarded withNanoconon.
So what I did is I purchasedthe materials on my own, I
printed some samples and then Idid the initial cellular
cellular studies, like lookingat adhesion, proliferation,

(22:09):
things on nature, just to kindof see one whether or not these,
whether or not cells, like thematerial.
Because at the end of the day,right, if the cells for any
implantable device, if theycause an adverse reaction, then
it's, you know, it's pretty mucha no-go thereafter and you need

(22:30):
to go through a lot of otheroptimizations or, you know,
surface treatments or things ofthat nature which further
complicate it.
Right, what I was reallylooking for is just the cleanest
, simplest way to address theproblem and thankfully, one of
you know at least one of thematerials that I purchased

(22:53):
showed glimpses of that.
So then, you know, after theI-Corps program, ben and I
collectively came together andsaid, okay, well, instead of,
you know, pursuing our separatepathways.
What about if we just merge?
You know, come together andform a single entity and then,

(23:15):
you know, essentially build atechnology up.
You know, come together andform a single entity and then,
you know, essentially build atechnology up.
You know, together and withwhat I did experimentally and
then with us coming together isreally what established Nanocon
as the entity.
And we did it, you know, fairlyquickly and actually we filed
some initial IP with the help ofone of our other students that

(23:38):
we had mentored in the past, whohad gone on to do some legal
work.
So we've definitely created anetwork of people with different
skill sets that have comethrough the lab and have gone
their own way, always stay incontact and, you know, create
this mutually beneficialsymbiosis to help build up the

(24:03):
company.
So after we formed the company,you know, thankfully, ben was
able to dedicate a large amountof his time, a large amount of
his time at the, in the earlydays, to really promote the
technology, really, you know,pursue some additional funding,
um, whereas I had to, you know,basically sustain myself.

(24:25):
So then I had to go to thepostdoctoral route, which, you
know, um exposed me to otherways of thinking in other
countries like Australia.

Speaker 1 (24:40):
I know they go all the way across the ocean.

Speaker 2 (24:44):
Yes, yeah, but I do Nathan's, the real Mr Worldwide.

Speaker 1 (24:51):
I do want to mention that you guys are very generous.
Every time I introduce anybodyto you guys, Ben never said no,
always very generously offer histime and insights to whoever
which is rare towards you guysfor wanting to, and also being

(25:16):
able to, mentor people who arein needs in this space.
So thank you very much for thatNow that you have founded this
company but that was like almost10 years ago, wasn't that right
?

Speaker 2 (25:28):
Almost yeah.
Nanocon turns 10 next year.

Speaker 1 (25:32):
Exactly.
I mean, were you guysanticipating this long of a
journey?

Speaker 2 (25:38):
Yeah, so I'll answer that anecdotally.
Like a lot of medtech companies, we've been through a handful
of funding rounds now and we hada seed two round last year.
So I actually got the chance togo back and pitch an investor
that I pitched way back at thebeginning of the company I think
it was somebody I'd pitched at2017.

(25:58):
And they kind of came backaround, they saw me in the news
or something.
They invited me back to theirgroup and they asked me oh, can
you dig up the pitch deck thatyou did in 2017?
And make sure that your currentpitch deck, you know, shows
progress, which in and of itself, is almost kind of a laughable
thing to request.
But I did it and I believe inthat pitch deck.

(26:20):
I said we were going to beexiting the company in 2022.

Speaker 3 (26:25):
Oh, is that right?

Speaker 2 (26:27):
Well, but yes, but you know, at the same time, you
know I said we were going to bea five, 10 K I think.
I said it was going to take usmaybe like $7 million to get to
commercialization.
I also said that we were onlygoing to exit the company for
like 50 to $60 million, which wehaven't exited yet.
But I think what's what'sinteresting is that you know one

(26:52):
.
Yes, this has taken way longerthan I think we initially
thought it would.
But I also think that theopportunities, the size of the
market, the clinical impact thatwe're positioning ourselves to
have are also very different,and I think that sometimes you
can sell yourself short bysaying, oh, I need the fastest

(27:12):
possible path to getting to anexit.
If you really think diligentlyabout what it's going to take to
create value, there can be muchbigger opportunities
acquisition comps from ourindustry and, specifically

(27:33):
looking at our indication, othercompanies that have developed
some type of device to address acartilage defect in the knee.
The exit range is like $400 to$500 billion.
So again, it's taking a lotmore work, but I also think the
opportunity is much larger thanwe thought it was originally.

Speaker 1 (27:56):
Absolutely.
I think the game has changedbasically for you guys over time
.
I mean, there are somecompanies who wanted a quick ROI
, a quick turnaround.
You know, I see dozens ofimplant companies that can turn
out different designs andindications, you know, within
three to five years.
But this is I guess this isconsidered biologic right.
This is in a biologic categoryin terms of Well, from a
regulatory perspective, it isnot.

Speaker 2 (28:18):
It's actually very much considered a medical device
because, even though it's aunique material and a 3D printed
structure that are designed tobe bioactive and work with
biology, there's really nothingin it that the FDA considers a
biologic or a drug, because it'snot eluding a molecule, it's

(28:39):
not facilitating some moleculebinding interaction, anything
that would be consideredpharmacological or biologic.
So I think that's also aninteresting nuance that even
though it's designed to have abiological effect, it's not
considered biologic by the FDA,which again also really changes
our path.

Speaker 1 (28:59):
And since we're on the subject, I'd like to just
dive a little bit deeper on thetechnology of NanoComm, so that
people who don't know NanoCommyet can have a full
understanding of what you guysare proposing.

Speaker 3 (29:21):
Yeah, so our core technology revolves around a
proprietary filament that iscompounded of two components.
Both components are wellcharacterized and well
documented, both in the regularspace as well as in literature.
But we, you know, we, as it were, developed the process to

(29:42):
homogeneously extrude it andcompound it.
As well, as you know, inaddition to the material itself,
we also have unique designfeatures which leverage additive
manufacturing technologies forthe manufacture of our implant.

(30:02):
So our technology of choice isfused element fabrication or
fused deposition modeling, as ismore commonly known.
And so, you know, with thatkind of, with that mindset, you
know we have the inherentrelative quickness of iterative

(30:28):
design due to the presence andthe use of the rapid prototyping
presence and the use of therapid prototyping, but also we
have the ability to scale and tomanufacture quite quickly using
that technology.
So we have our material, wehave our implant designs and

(30:49):
then, subsequent to that, wealso have processes that we
condition the final implant tobe more analogous to the native
tissue in situ performance thatwe've seen at multiple scales,

(31:18):
from the in vitro cellular workthat initially did, to the small
and medium-sized animals thatBen was able to secure funding
to support, and, most recently,our large animal models, which
you know regulatory consultantshave said is the most extreme,
worst case scenario that you cantest your implant in and that
has just shown, you know, Iwould say, spectacular results.

Speaker 1 (31:44):
Yeah, and thanks for submitting that beautiful photo
of your latest implantable kit.
So basically, for those whodon't know what the Chondrograph
look like, it basically lookslike a little weaved,
waffle-shaped implant.
It's very tiny, so I guess thesurgeon has to dig a hole first
in the area of your diseasedcartilage and then put this

(32:05):
little waffle in.

Speaker 3 (32:08):
Yes, yeah, so our, you know, our design for the
human patient population is, asyou described, takes the core
elements of the chondrographthat we've developed over time.
There's, you know, the latticewhich is, you know, apropos to
the that's right.
I'm sorry I went this way.

(32:31):
Yes, we are using alattice-like structure in our
implant design.

Speaker 1 (32:37):
Yeah.

Speaker 3 (32:41):
But one of our other major differentiating factors is
we're really, really strongproponents about tissue
preservation and only removingthe defective tissue or damaged
tissue.
So we did our third generationimplant design and we coupled

(33:03):
that with our own customarthroscopic instrumentation.
So, as you alluded to, yes, youhave to prepare the defect site
to essentially mirror imagewhat the implant design is and
allows for it to be self-fixing.
So you know, unlike otherimplantable devices which

(33:30):
require suturing, nails or pins,bioresorbables or
semi-permanents, we're prettymuch eliminating the need for
any of that.
Our implant is just a one-stepprocess where you prepare the
defect and then we essentiallyuse a specialized tool to insert

(33:51):
the implant into that perfectlysized and mated pocket and
press fit that in.

Speaker 1 (34:00):
Do you have to anchor it with anything?
No, wow, so I would assume theexisting procedure, which is
allograft, right?
So that's what we're comparingto typically for this kind of
process, does that needanchoring?
I mean, how do you compare withallograft?

Speaker 2 (34:20):
Yeah, allograft is interesting because sometimes
people will anchor it with asingle dart.
Sometimes people will anchor itwith like a single dart or if
it's purely a cartilage graft,they'll suture it.
As Nathan was mentioning, mostof the time it's an ostracondral

(34:41):
sample which can be press fit.
But one of the things that wedid in the course of our design
is we wanted to make sure wewere at least matching the
performance that a press fitosteochondral plug gets.
Uh, and so you know, we wereable to pull numbers from
literature.
It's been pretty thoroughlytested and then we did, you know
, pull out um tests on the benchand we actually were able to
show that our unique design andour material take roughly twice

(35:04):
the force to unseat the implantum compared tosterkond or
Allograft.
And you know, I'll kind of turnit back over to Nathan to
comment on a little bit more.
But one of the additional thingsthat 3D printing has allowed us
to do, in addition to justcreating a bioactive matrix out
of our material, is it's allowedus to incorporate these very
fine features which kind ofcreate like a interference when

(35:28):
you press the implant into place.
And it's not so much that it'sreally difficult to push the
implant in, but it creates thiskind of like interference fit
where you get a little bit ofextra force holding the implant
into place, which right now,with Ostracon or Allograft or
even some of the otheroff-the-shelf implants that are
on the market, the surgeonsactually have to go out of their

(35:48):
way to ensure that there is nofriction when the implant is
pressed in place.
But 3D printing and ourmaterial have allowed us to kind
of flip that in a nuanced wayto get better performance.

Speaker 3 (36:01):
Yeah, so our comparator for our mechanical
testing was a 10 centimeterosteochondral plug, so roughly
two and a half times as deep asour implant.

Speaker 1 (36:16):
That's like almost entire like.
That's like half of the knee,10 centimeter.

Speaker 3 (36:21):
Sorry, 10 millimeter.

Speaker 1 (36:22):
Okay.

Speaker 3 (36:24):
Yeah, we don't want to take off the entire condyle,
that's way bigger yeah.
Okay, 10 millimeter.
Okay, all right, 10 millimeter,all right Sounds good, yeah, so
the traditional OC plugs are 10millimeter.
Our implant is only fourmillimeters in thickness but, as
Ben mentioned, we're able toproduce or we illustrate that it

(36:48):
requires roughly two to threetimes the amount of force to
dislodge or implant it.
That's amazing.
And we've done both benchtesting and simulated bone
blocks.
We've also done cadaveric workin human tissue as well as in

(37:10):
animal tissue, and it showsconsistent performance across
the board.
And the other caveat that wealso have as part of our design
is that we also are offering ourimplant in different size
ranges, primarily in thediameter dimension, so from 10

(37:32):
millimeter diameter to 20millimeter diameter.
So we can really look toaddress not only small focal
defects but larger wearabrasions that are maybe not as
uniform but also can beaddressed by a larger surface

(37:53):
area implant.
And because our material, as Imentioned, is malleable, we're
able to press fit it in, it'sable to maintain contact around
the periphery of the implant.
So what we've seen in ourpreclinical studies is that we

(38:15):
have in-growth from the edges,where it's in intimate contact
with the neighboring maturetissue, but also from the
underside.
Also from the underside where,you know, as part of our
surgical preparation, we debridethe cartilage, the defective
cartilage, we create a you know,I would consider it a

(38:37):
subchondral hematoma, and ourimplant is designed to protect
that hematoma and prevent andminimize inflex and inflex of
synovium, which has been shownto aid in chondrogenesis, but

(38:58):
also give it that robustness tobe able to be almost time zero,
stable from a mechanicalstandpoint to allow for
subsequent ambulation.
So our end goal is that, or the, I would say the dream and most

(39:19):
bookmakers will probably agreewith this is that a patient
comes into the office they gettheir knee scoped, or they come
in already with, you know,pre-vetted, with a chondro-V-vet
that's able to be addressedwith our technology.
They close up the joint and thepatient is able to walk out

(39:39):
right afterwards, wow.
Or with, you know, limitedencumbrance to mobility as they
heal.

Speaker 1 (39:49):
Well, that brings up yeah go ahead, ben.

Speaker 2 (39:52):
All I was going to say is I think that's a really
important point of what makesour Not just what makes our
technology intriguing, but whatreally makes our product highly
differentiated.
It's something that can act asa replacement, but also act as
that kind of biologic catalystfor, you know, regeneration.

(40:12):
So we see this, you know, notjust being a better, a better
solution with better longevity,but also something that
dramatically improves thepatient experience, which is
which is really critical.
Again, even even some of thesenext generation things that have
come on the market can't dothat, and I've had people tell
me anecdotally that they'veturned down those treatments
because you know they can'tafford to be off their knee for

(40:34):
eight months.
Yeah, you know, it's really,it's really significant.
So I think, just another reasonwhy we're really excited about
the potential our product has.

Speaker 1 (40:43):
Yeah, that brings up a question I have is the
recovery time, because you knowwe're joking about.
Nathan made a mistake talkingabout 10 centimeter versus 10
millimeter, but a 10 millimeteris pretty thick in terms of
defect and so, if your productcan allow for a thinner defect,
have you guys ever done acomparison study of what's the I

(41:04):
guess, theoretical recoverytime difference between the
traditional method and yourmethod?

Speaker 2 (41:10):
Yeah, you know that's .
We're about to do our firsthuman clinical study in.
Canada so we will be at leastlooking at basically planning a
recovery process that lookssimilar to osteochondralograft.
So it typically takes six monthsto be considered fully
recovered from anosteochondralograft, and there
typically takes six months to beconsidered fully recovered from
an osteochondralograft andthere's a period of two weeks

(41:31):
where you have protectedprogressive weight bearing.
So for people who are not in theorthopedics industry, that
basically just means you startout in a leg brace, maybe
putting a little bit of weighton your leg, and you kind of
work up to full body weight overa two to three week period.
So that's kind of a conservativestarting point.
But one thing that we builtinto the protocol is that if

(41:53):
patients are doing very well,the surgery can accelerate them
and then I think, assuming thathappens, that's something we'll
be able to build into a moreaggressive recovery protocol
which we can use in therandomized trial.
Uh, you know, in a year or so,which would be the larger trial
that actually would be to get astep to approval.

(42:13):
Um, but for anyone listeningwho's not intimately familiar,
you know the standard of care isstill this this surgery called
microfracture, where nothing'sbeing implanted into the, into
the damaged cartilage, but thesurgeon goes in, they clean out
the diseased cartilage, thepothole.
Essentially they make a cleanhole and then they drill little
holes in the bone, and sosurgeons have been doing that

(42:36):
now for about 35 years.
Right, I mean it was 25 yearsago, 10 years ago but now
they're still doing it.
That's how fast things happenin medical fields.
Yeah, well, and what I think isinteresting too is that, you
know, sometimes knowledgeoutpaces our ability to address
the problem.
You know, it's still the mostwidely done because, frankly,

(42:59):
it's quick and easy to do.
I mean, if you have a patientwho's not far, you know, not far
enough along to need a kneereplacement, who's not far
enough along to need a kneereplacement which is a
tremendous amount of people, butalso not even severe enough to
need an osteochondralograft,because it's really hard to get
that tissue they might just do amicrofracture because they know

(43:19):
, okay, I'm going to buy thepatient one to two more years
before they need a more invasivesurgery.
The problem, though, is thatthere's been some interesting
clinical evidence published inthe last three or four years
that patients who did notundergo any treatment at the
time of getting one of thesecartilage defects diagnosed had

(43:43):
better outcomes thanmicrofracture patients.
And the problem is that, eventhough microfracture temporarily
alleviates the pain, it doesn'tstop the spread of
osteoarthritis.
And I would even argueanecdotally that if people don't
have pain, but they have ajoint that is structurally,
biologically diseased andthey're doing a bunch of
activity on it, that's justgoing to accelerate the damage.

(44:06):
So, um, you know, we know thatmicrofracture, um, frankly, is
doing harm to people.
Uh, and if in the last coupleyears, at any of the sports
medicine society conferences,it's all the surgeons can talk
about us, we need, we need to dosomething else.
Um, and patients?

(44:26):
I think it's also interesting.
Unlike a lot of areas ofmedicine, patients are very
highly educated.
Um, you know, about orthopedics, people will, because, again it
just to put it bluntly, youknow, if you have a heart attack
and you need to have, like youknow, one of the arteries in
your heart stented, you're notgoing to shop around for
cardiologists, probably maybethere maybe there's a small

(44:47):
percentage of people that aregoing to do that, but I think
most people are not going to dothat.
But in orthopedics, especiallyin sports medicine, where, okay,
my knee hurts, I can't run asmuch but I've got time to
research what are the bestsports medicine surgeons in my
area.
Research, you know, what arethe best sports medicine

(45:08):
surgeons you know in my area?
Maybe I'm a train ride awayfrom the next city.
Who are the good sportsmedicine surgeons there, if I'm
really willing to travel?
You know these are literallystories I hear from people.

Speaker 1 (45:16):
Oh, no, it makes sense.
I would.

Speaker 2 (45:19):
Yeah, yeah, honestly, and, like you know, friends of
mine, friends of my family, havereally gone out of their way to
, you know, seek treatment forthese types of problems.
And you know we have, inaddition to our email, we just
have like an info at nanocomaccount, kind of set up as a
catch-all email address.
That account probably getsanywhere from like a dozen to 25

(45:43):
people a month emailing itasking if NanoCon is available.
Yet you know, I live in thisstate, I live in this country.
You know, even sometimes peoplewill, will attach their MRIs and
be like, can you refer me to adoctor who does it?
I just have to politely say,unfortunately we're still
investigational.
You know, we might, might,maybe a clinical trial might be

(46:04):
coming in the next couple ofyears.
That you, that you, butpatients are really actively
seeking new and bettertreatments and I think that's
again that's really powerful.
It creates a powerful incentivefor the surgeons as well,
Because in this particularsegment, doing new and

(46:26):
innovative treatments as a wayto attract these patients,
because they're clearly takingthe time to look for them.

Speaker 1 (46:31):
Absolutely.
Yeah, I mean myself.
I have knee problems, so maybeI'll sign up for your clinical
trial when it's ready.

Speaker 3 (46:39):
We'd be happy to have you.
Yeah, and I'd like to add thatyou know, because of the
proprietary nature of you know,this industry as well as
analogous to other industries.
There's that 20-year windowwhere not much is publicly
available being able to addresswhat previous prior technologies

(47:07):
or prior generations oftechnologies were inferior in,
as well as other companies whomay have encountered some
adverse effects over the courseof their clinical trials.
They're not going to compromisetheir availability to go to

(47:28):
market by publishing somethingthat's compromising.
So it's really you know, inaddition to what Ben was saying
with the micro-threats, you knowthere's just this long delay in
getting publicly available datato at least leverage and to vet

(47:51):
your technology against.
So you know, I don't knowexactly how that could be
resolved or expedited, but yeah,I mean, there's a science,
there's innovation, discovery,and there's also deployment
problem, right?

Speaker 1 (48:07):
So I think the startup field is where founders
tackle that deployment challenge.
Now, if you guys alreadyconducted the small animal and
large animal trials, preclinicaltrials, what did you guys learn
from those preclinical data sofar?

Speaker 2 (48:30):
Nathan, I'll let you take it.

Speaker 3 (48:33):
I mean, I think initially what we found is that,
you know, the material is quiteimpressive, both from its
original source as well as ourcurrent source.
So you know, the materialbehaves uniformly spectacular

(48:54):
across all species and all sizes, as well as different designs.
So, our small animal, becausewe were doing it in a rat, we
couldn't really create a latticestructure per se at the scale
that would fit into a rat femur.

Speaker 1 (49:09):
Yeah, I can't imagine how big of a hole you have to
create or how small that hole isgoing to be.

Speaker 3 (49:15):
Yeah, we were actually able to print a one
millimeter diameter, essentiallyosteochondral plug equivalent.

Speaker 2 (49:22):
Yeah, and this was when Nathan was in Australia.
So he's like working up theseSTLs and then he's emailing them
to me.
So I'd wake up in the morningand I'd have like the day's STLs
and then I'd 3d print and so,yeah, I mean to nathan's point,
the implants we ended up usingin this rodent study were, yeah,

(49:54):
I think they were onemillimeter in diameter and they
were maybe like three or fourmillimeters long.
They kind of looked, they kindof looked like a piece of a
really fine gauge screwessentially, and they didn't
really have a true lattice, butthey had this kind of
interesting, you know they.
They ended up having a porosity, sort of as like a, like a or

(50:15):
like a surface texture, um, asan artifact of the printing, um.
And in that first rodent studywe were able to really
essentially see something whichis very hard to observe with
these types of biomaterials isthe interaction between multiple
tissue types.
So that original study, youknow, showed integration with,

(50:36):
with the cartilage layer, but italso showed integration with
bone and this is in the samematerial which, which I think is
, is really powerful and andsignificant clinically, because
that's that, even even again,with things that are being
developed now, that's an ongoingchallenge.
Can you, can you make somethingthat integrates well with both
tissues?
Um so, so again, just another,another breakthrough that I

(50:59):
think we had early on.
Uh, and so that that rodentstudy was where we learned, okay
, what is at a, a baseline, likewhat's the biological response
to this material?
Uh, and then I'll turn it backover to nathan to kind of keep
talking about how we keptiterating yeah.

Speaker 3 (51:17):
Then we went to to a goat model.
So we were able to, you know,create a more of a, more of a
structure akin to what our firstand second generation implant,
which was essentially a, youknow, a one millimeter wafer
with a lattice structure with no, no articulating top layer.

(51:41):
So our current design just kindof break it down at a high
level essentially composed ofthree major components One we
have the joint-facing articularsurface, which is near solid not
100% solid to allow for influxand deflux of synovium as well
as to protect the underlyinghematoma.

(52:02):
We have the lattice, which issimilar to the thickness of the
cartilage, which will allow forholistic integration from the
core, from the inside as well asfrom the perimeter.
And then we have essentially amirrored, what we like to
describe as kind of like abottle cap feature.

(52:23):
So our instrumentation createsa negative mole image of that.
So we have, we basically createwhat is what we call a bone
pedestal.
So we go in with our customreamer.
The reamer debrides all of theentire volume down to the

(52:44):
subchondral bone, and then itundercuts and creates a trough
around a pedestal of bone.
That's that's been deemed to behealthy and non-uncompromised,
and then our implant sits onthat.
So it not only does it havecircumferential pressure on the

(53:08):
outside walls of the surroundingbone but also, through the
course of creating that pedestal, we induce the bone bleeding
which fills the inner volume ofour implant, both the inner
walls of the bone fixationaspect but also the underside of
that lattice to allow forinfiltration and oxidation of

(53:33):
the marrow space milieu thatgoes into it.
So that's the embodiment ofwhat the human clinical implant
looks like.
But it was definitely aniterative design, from the rat
model to the thin wafer with noarticular surface, to a wafer

(53:54):
with an articular surface.
And then when we went into theequine model, the horse model,
you know, our initial pilotstudy was looking at depth of
placement.
Because we were still dealingwith just a single one
millimeter wafer and becauseit's difficult to fully
immobilize a horse for any givenamount of time, we had to

(54:19):
essentially use third-partyfixators to ensure that the
implant, or to give us thehighest probability that the
implant would stay in place,that the implant, or to give us
the highest probability that theimplant would stay in place.
So we ended up usingcommercially available PLA,
bioreservable PIMs.

Speaker 1 (54:37):
Makes sense.
Now we're going to talk aboutthe exciting news that you guys
want to share, which is you areentering into your first human
trial in Canada.
You want to share someinformation about that.

Speaker 2 (54:50):
Yeah, absolutely.
So, you know, tremendouslyexcited.
This is the first clinical useof the device and, as we've
talked about over the last 55minutes, years and years of our
lives and tremendous effort havegone into getting to this point
, so we're super excited.
It's going to be a small study,so really still designed to

(55:12):
evaluate safety 10 patients.
We're going to track those 10patients, uh, for 12 months, but
we're going to do interim uhcheck-ins at three months, six
uh sorry, six weeks, threemonths and six months.
So we'll have a nice sort oflike progressive build of how
people are healing.
Um, the primary way that youstill evaluate clinical success

(55:36):
is pain and function.
So we're going to be literallygiving people a survey to ask
them how they're feeling.
Uh, it's a little bit morecomplicated, that's just a long
survey with a lot of differentways to ask that question.
But we we are also doing MRIsat every checkpoint.
So you wouldn't typicallythat's not standard of care to
do so many MRIs after theprocedure and even in like a

(55:56):
large clinical trial, you mightnot do that, but with a small
cohort of patients, you know, itadds a lot of value to be able
to actually visually see how theimplant's integrating and you
can also if you have a powerfulenough magnet.
We're doing 3T, we're mandatinga 3T magnet for the MRIs so
we'll be able to do Mokarscoring, which is basically a

(56:18):
radiologist I know you know this, jenny, but for those who are
not radiologists, people canlook at the MRI image and
actually quantitatively assess.
You know how good the tissuehealing is.
So we'll be doing all of that.
And then our hope is that youknow the study goes well, we
could take that to the US FDAand get approval to do that

(56:40):
larger randomized study.
You know we're hoping to treatthe first patient in the next
eight weeks roughly and if wecan enroll pretty quickly, you
know we're hoping to treat thefirst patient in the next eight
weeks roughly and if we canenroll pretty quickly, you know
we can be wrapping up this studyby the end of next year and
looking at starting thatrandomized trial, you know, in
the first half of 2027.

Speaker 1 (57:00):
Now, who can just quickly, who can qualify for
your clinical trial?
Since we're on the pot, youmight as well just tell who's
qualified?

Speaker 2 (57:07):
you have to be canadian uh well, you don't have
to be canadian, although youhave to be willing to travel to
the toronto metro area to havethe surgery and then you'd have
to go every couple months forthese checkups.
So that might be difficult.
But you know, if you live inlike niagara falls or something
you just drive across the border.
Um, you know, we arerestricting it on age for this

(57:29):
first one.
So 22 to 60 is the age rangefor this first trial.
We might expand that in the inthe later trial.
That's what it is now.
Um, there's also somethingcalled the kelvin lawrence scale
, which is how the severity ofosteoarthritis in a cartilage
injury is presenting.

(57:49):
So just as an example, like ifyou are running and you fall or
you're playing soccer, you fall,you tear something that's still
considered a KL0 because atthat point it's a trauma.
There's no sign of degeneration, but the degeneration can
progress.
So it's evaluated from a scaleof zero to four.
Four is like your knee is sobadly damaged that you

(58:13):
absolutely need a kneereplacement and then there's
some nuance in between that.
So in addition to the agerestriction, we're also
restricting it to KL zero tothree.
Kl zero to three.
Uh, we also have some otherrestrictions, like you can't
have had another procedure toyour knee within six months.
So you know, if you had an ACLtear a month ago, you can't be

(58:36):
in our study.
But if you had an ACL tear ayear ago, you can be in our
study.
Uh, and then, beyond that, it'sjust, it's the typical stuff,
right, like you can't beseverely overweight, you can't
be diabetic, you can't be asmoker.
These are things that aretypical in any certainly any
implant trial.
I think they're things that arealso very typical in drug
trials.
So yeah, really just justtrying to make sure that the

(58:57):
date you can cleanly see fromthe data what the safety and
efficacy of our devices Right,you want to remove all the
confounding factors.

Speaker 1 (59:06):
But one big congratulations to your team,
because I know how hard it wasto get to this point today.
So big shout out.
Now I know we're kind ofreaching the end of our
interview, but we have so muchmore that I prepared.
I wanted to discuss.
One thing is hustling okay,because you've been hustling for
almost a decade and I would sayit's a success in itself that

(59:31):
the company has survived and andprospering.
Um, just if you can sum it upquickly and I know it's, it's a
kind of a disservice to reallysum it up quickly about this
like um, tell us, just sharesome experience, because you, a
lot of people right now, arehustling and the environment of
funding and startup in medtechis not great.

Speaker 2 (59:54):
Yeah, yeah, I guess I'll give my perspective as the
one who does all the investorfundraising.
Nathan, at this point, managesall of our non-diluted funding,
so he can give a differentperspective on that too.
But I think A lot of people arestruggling, yes, and I think
that the environment has stillnot completely corrected since

(01:00:16):
2023.
But I kind of feel like thingslike what we're doing and where
it's an implant, it's a very newtechnology, it's very high risk
.
I mean, we always faced a lotof challenges fundraising.
I mean, nobody was throwingmoney at you know, a PMA
cartilage implant.

Speaker 1 (01:00:33):
Yeah, money at a PMA cartilage implant headed by two.

Speaker 2 (01:00:35):
PhD students in 2016.
We really had to build value,and so I think that it's
important to talk to investorsearly on.
But I think you need tounderstand that not all
investors are the same and youneed to talk to a lot of them to
understand.
What do different types ofinvestors look for, when do
different types of investorswant to come in and what's going

(01:00:58):
to convince them to come in.
And I think that by just I meantruly being willing to pitch
anybody who would talk to me.
I was able to kind of startfiguring that out and kind of
figure out okay, you know, thenext thing we need to do is this
small animal study.
No one's going to give us themoney to do that.
We need to target these typesof grants.
What do we need to do afterthat?

(01:01:19):
What do we need to do to theproduct?
What do we need to get surgeonsto tell us to be able to put
into a business plan?
So it's just like thoseconversations with investors
when you do enough of them,you'll start to learn what do I
need to do to make my companyinvestable?
So I think I always tell peopledon't get discouraged by the
no's, because you're stilllearning from the experience.

(01:01:40):
If you're doing it right, andonce you talk to enough people,
you start to see those patterns.

Speaker 3 (01:01:46):
Yeah, and I would say from all the lessons that Ben's
learned from the technical sideof things, the operational side
of things, right, being verymindful of what are the most
value-added experiments and datathat you need, to be most
efficient with the funding thatyou do have and also what are

(01:02:10):
the milestones that people arelooking for to unlock those
doors for the next tranche offunding.
So we've been very, verydiligent and very good, both
involuntarily and voluntarily,of being very lean and very
mindful with what are theexperiments we're going to, what

(01:02:30):
data is needed, how are wegoing to fund it?
Who are we going to work withto actually get that data in a
timely fashion?
Because you know we ourselvesdon't have a lab that I.
You know that I or Ben oranybody affiliated with MediCon
can just go in and do all theexperimental work, as we did

(01:02:51):
when we were PhD students.
Right Now, as we, you knowyou've grown into industry.
Do you have to outsource itthrough a contract work from a
service provider, or you have todevelop, you know, relations
with, you know, either academicinstitutions or private labs
that want to partner with you toactually build up that data set

(01:03:14):
.
So you know, being able to bemindful and be diligent about
what your expenditures are, andalso vetting the service
providers and the suppliers thatyou're working with is also
critically important, becauseone misstep can put you back

(01:03:35):
months, if not a couple of years.
So my approach is you know, asI've engaged with various
service providers for the sameproject is really sussing out
their level of expertise, theirfamiliarity with not only our
technology but the greater scopeof the indication that we're

(01:03:58):
looking to address and what thelead times are to actually get
the work done in a timelinethat's beneficial to us with our
target goals of maintainingprogress towards, you know, the

(01:04:20):
next funding milestone.

Speaker 1 (01:04:23):
Yeah, I mean this kind of echoes what you guys
said earlier, which is that thisis really a human business.
Human business One is you found, you guys found each other,
people who has incredible amountof grit, which I can, I can say
that.
I can say that I cannot do whatyou do, ben, I see, I see you
out there.
I do not think I can go to allthese conferences just period.

(01:04:46):
I know for certain.
And number two is that you dohave to manage all the
relationships you have withthese contractors and people who
are providing the service sothat, like you said, you have to
be really focused and effective.
So it's mostly people businessactually, because the technology
is already there and now youjust have to manage the people,

(01:05:07):
which is the hardest part.
For everything.
We can do a whole other hour,yes.

Speaker 2 (01:05:12):
Yeah, sometimes.
For sure, I'm going to inviteyou back because we have so much
more we haven't talked about.
We can do a whole other hour.

Speaker 1 (01:05:15):
Yes, yeah, sometimes for sure I'm going to invite you
back because we have so muchmore we haven't talked about, so
let's just wrap it up here.
I asked you guys to give someadvice to the next generation of
founders, and maybe evenstudents in school who are
thinking about entrepreneurship.
What kind of advice would yougive them?

Speaker 2 (01:05:48):
I'll let Ben go first get funding.
You know, don't get discouragedabout you know stories about
the federal funding gettingdisrupted or drying up.
You know.
I think the reality is that youknow if you're doing something
in our field, broadly speaking,you know medicine, human health.
You know those needs and thoseproblems are not going away and

(01:06:11):
they're not going to just goaway because of you know an
administration or because of howinvestors are behaving.
You know the opportunities todramatically improve human
health are always going to bethere and I think that you know
there's always going to becustomers.
What really kept me going veryearly on?

(01:06:32):
was going through those customerdiscovery programs and talking
to surgeons and just hearingover and over and over how much
they wanted something like whatwe were proposing.
So you know, I think, stayengaged with your customer, if
nothing else, to kind of, youknow, keep perspective and keep
motivation, because ultimatelythat's what you're doing it for.
I mean, yes, we're buildingthis thing to get a return for

(01:06:53):
our investors, but ultimatelywe're building something that's
going to live on past the lifeof the company and is going to
be a product that is improvingpatients' lives and is improving
surgeons' lives.

Speaker 1 (01:07:06):
That's really well said.
I agree 100%.
What about you, Nathan?

Speaker 3 (01:07:10):
What about you, nathan?
I mean, I would say from anidea perspective, don't be
afraid to think outside the box,don't be afraid to, as it were,
fail fast.
It's better to fail fast andprove or disprove an idea rather
than to be afraid of actuallyventuring down that path.

(01:07:33):
Rather than to be afraid ofactually venturing down that
path, which is, you know,apropos for my way of
approaching not only you knowcommercial potential products,
but you know other aspects of mylife and you know again,
sometimes and I'm not advocatingit, but in certain situations

(01:07:57):
it's easier to ask forforgiveness than to ask for
permission.
So if that permission meansshowing your idea works and has
value to someone who is a keydecision maker for you to
realize that end goal ofstarting up a company, starting
anything, don't be afraid totake that initial step and to at

(01:08:24):
least present somebody withyour idea, as opposed to try to
ask, convince somebody that youridea works.
For me, data and numbers andhard facts will trump anything
else.

Speaker 1 (01:08:43):
Wow, amazing.
And this is a good reminder formyself, because I used to be
like Jenny you got to take alittle bit of risk every day and
I have forgotten about thatover time.
This is a good reminder and Iwant to encourage everybody to
take some risk every day.
I'm not breaking law, okay, andI have forgotten about that
over time.
This is a good reminder and Iwant to encourage everybody to
take some risk every day.
I'm not breaking law, okay.
I'm not asking you to break law, but just take a little bit of
risk every day.

(01:09:03):
Yeah, so that's a reallywonderful conclusion from
everybody.
Thank you so much for joiningour pod today and I certainly
want to invite you guys back inthe near future, thank you.
Thank you for having me today.

(01:09:29):
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