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Solving Real Problems

Innovation in orthoapedics has been slow and inefficient. Large interdependent, oligopolistic companies are not incentivized to innovate and dominate the market with implants that are almost indistinguishable.

36%

Survey: 36% of TKA patients would not have undergone the surgery knowing what it did for them (10 years later)

1 in 5

1 in 5 patients are not satisfied with the results of their total knee replacement

LEADING PREVENTABLE SURGICAL RE-ADMISSION:
21%
Dislocation
9.1%
Periprosthetic Fracture
8.6%
Mechanical Loosening
Hips

Rate of re-admission:

8%-13%.

Approximately 50%-75% are surgical.

Knees

Rate of re-admission:

7%-8%.

Our Products

Implants Designed for Stability

Monogram implants are smaller, less invasive, and more stable.

Leading Generic

Poor fixation by design
VS

Monogram

Optimized fixation

Monogram Results

Orthopedic implants are generic and indistinguishable.  The industry is using the same implant and instrument ideology that it has been for the past 50 years.  It's time to use technology to change the game.

up to 270%
more stable than generic equivalent
Independent micromotion testing conducted by leading orthopedic labs at UCLA and UNMC.

Robotic Surgical Assistants

Monogram’s navigated surgical robot features several enhancements that will improve surgical experiences including:

Better Vision

Tracking cameras directly mounted to the robot to mitigate line-of-sight issues.

Increased Range of Motion

Seven degrees-of-freedom (used to measure range of motion) with control algorithms that leverage the kinematic redundancy to avoid interoperative boundaries and optimize execution.

Soft Tissue Tracking

Our robot will utilize complex tracking capabilities for soft tissue avoidance.

Disrupting the Joint Replacement Market

$27.2 B

Joint Replacement Market
in the US.

700,000

Knee replacements in the US every year

300,000

Hip replacements in the US every year.

The Technology Platform

The Monogram technology platform is a series of algorithms that auto-segments images and auto-generates implants that will be integrated into a navigated robotic system for surgery. This process automates the design and insertion of high conforming implants from the raw images using automated digital image analysis algorithms. The navigated robot will then execute optimized auto-generated cut paths that surgically prepare the corresponding cavities to facilitate insertion of the implant.

The Robotics

Monogram’s navigated robot features several enhancements that will improve user experience compared to robots currently in use. Specifically, the Monogram robot will feature tracking cameras mounted directly on the robot to mitigate line-of-sight issues. The robot will feature seven degrees-of-freedom (used to measure range of motion) with control algorithms that leverage kinematic redundancy to avoid inoperative boundaries and optimize surgical execution. The robot will also utilize complex tracking capabilities for soft-tissue avoidance.

Our Implants

Monogram implants are designed such that cortical contact and stability are maximized while remaining insertable and designed to reconstruct the native patient anatomy as closely as possible. Monogram will commercialize the first patient specific hip and knee to address the primary clinical shortcomings of their generic counterparts.

The leading generic knee had up to 270% more micromotion in some orientations than the Monogram implants.
The leading generic hip had an average of 630% more micromotion  than the Monogram implants.
Leading orthopedic labs at UCLA (for hip) and UNMC (for knee) conducted the testing.

Developmental Milestones

Monogram is building the future of orthopedics one step at a time

1st

Foundational patent filed

2017

634%

improved hip micromotion from UCLA Ortho Lab testing

2018

5

Additional filed patents

2019

$4.5M

Series A

2020

FDA

target submission implants

2021

Target robotic

FDA submission

2022

Our goal is to combine state-of-the-art software with world class hardware to deliver a robotic system that addresses the major clinical concerns today - cost, time, and a lack of control or real-time adjustment.

Robotic Milling Cavity Technology

Monogram is taking the capabilities of surgical robotics to the next level. We start with the surgical plan which is run through an optimization and simulation engine to make sure the cuts are being executed as safely and time-efficiently as possible. But we don’t stop there. Rather than relying solely on a pre-operative surgical plan Monogram leverages the kinematic redundancy of the robot to allow for intraoperative obstacle avoidance and real-time tissue tracking. With the ability to simultaneously track 6 objects in real time Monogram allows for the integration of “smart tools” into the surgical theater. What was once an ordinary retractor is now a virtual boundary.

Monogram’s software solution is constantly re-optimizing to real world scenarios. The system is designed for hyper-efficiency down to the fine details. Rather than relying on conventional, cart based optical navigation, Monogram is exploring robot mounted camera systems that eliminate line of site issues and reduce cost and portability issues.

Our Plan

We believe that precision implants with precision insertion are the future of orthopaedics. Monograms principal competitive advantage will be our ability to produce customized, robotically inserted orthopaedic implants rapidly and at scale. The product solution architecture we are developing enables rapid fabrication and mass personalization of robotically inserted, patient specific orthopaedic implants.  

Currently, Monogram is the only orthopaedic company to broadly offer robotic technology in combination with surgical navigation for the insertion of patient specific orthopaedic implants. Monogram is designing additively manufactured (AM) patient matched titanium hip stems and tibial knee implants that will require robotically milled complementary cavities.

Our monetizatible products will include:

Surgical robotic system

Cutting tools and navigation consumables

Software licensing of clinical modules

Patient specific reconstructive implants

Meet the Team

Monogram was started in 2016 by Dr. Douglas Unis, an attending orthopaedic surgeon for the Mount Sinai Health System, after being awarded a $30k grant from the prestigious ELabNYC biotech startup incubator. Dr. Unis has a deep passion for patient well-being. After years of consulting with several strategic companies, Dr. Unis grew frustrated by the slow pace of innovation and a lack of focus on implant design. Dr. Unis realized that surgical readmissions and implant failures were only in part driven by the surgical method. The implants themselves had significant design limitations that could be vastly improved with new manufacturing methods and robotic insertion.

With an unassailable belief that the answer lies in in the thoughtful synthesis of machine learning (AI), robotics, and 3D printing, Dr. Unis recruited a team of highly energized engineers, medtech, and entrepreneurs to realize his vision.

Executive Leadership Team

Douglas Unis, Md

Founder & Chief Medical Officer

Dr. Unis is a board-certified attending orthopedic surgeon for the Mount Sinai Health System and Chief of Quality Improvement for Mount Sinai West.

Benjamin Sexson - CEO

CFA, Chief Executive Officer

Prior to joining Monogram, Mr. Sexson served as the Director of R&D and Business Development at Pro-dex (ticker: PDEX). Mr. Sexson graduated with honors from Caltech in Mechanical Engineering and is a CFA Charterholder.

Paul Riss

CPA, MBA, Interim CFO

Experienced executive with a demonstrated history of completing SEC filings, focusing on the Securities Exchange Act of 1934 and Section 4(a)(6) of the Securities Act of 1933.  Currently serves as a Director for NetCapital and was a CPA with Ernst & Young.

Engineering Leadership Team

Sherif Aly, P.hD.

VP Engineering

Sherif was instrumental to the development of the Mako Orthopedic Robot and Implant systems.  After the Mako acquisition, he was the Sr Director of Robotics Development Program Management, reporting to the VP of Robotics R&D, and was responsible for managing all Stryker Joint Replacement robotics development programs (over 250 engineers at 7 sites worldwide). Most recently, Sherif was the VP of Engineering and Regulatory Affairs at Xenex Disinfection Systems. 

Christopher Scifert, P.hD.

Director of Product Development Implants and Instruments

Chris was the Director of Engineering for Orchid Design, a division of Orchid Orthopedic Solutions, a market-leading outsourced medical services. Chris has held various engineering management roles at Medtronic and Smith & Nephew and obtained a Ph.D. in Biomedical Engineering from the University of Iowa.

Scientific Advisory Board

Sophia Sangiorgio, PhD

Director, Orthopaedic Institute for Children

Laura Gilmour

Global Medical B. Development Manager at EOS NA

Matt DiCicco, M.S.

Robotics, MIT

Benjamin Sexson - CEO

Douglas Unis, Md

Monogram Orthopedics Investment Thesis Video

Benjamin Sexson - CEO

Douglas Unis, Md

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06:00 PM Eastern Time (US and Canada), GMT - 5
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