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Portfolio Update: Monogram Orthopaedics Explores a Public Listing

Portfolio Update: Monogram Orthopaedics Explores a Public Listing
By Teddy Lyons
Date August 18, 2022

We recommended Monogram Orthopaedics to you back in 2019 and again in 2021. The company is developing advanced robotics technology combined with 3D printing to disrupt the joint replacement industry. We recently caught up with Monogram CEO Benjamin Sexson to learn more about the company’s progress and future plans.

Public Listing 

One of the advantages of crowdfunding is that once a company raises on a platform like Republic, StartEngine or Wefunder (among many others), the company satisfies many requirements for listing on a public exchange. 

Monogram recognizes this and has begun taking tangible steps toward a public listing. The company has engaged an investment bank to explore the possibility of an initial public offering (IPO) via Regulation A (Reg A). This would be a potential liquidity event for those of you who invested in Monogram’s previous crowdfunding rounds. Of course, nothing is confirmed or certain yet. However, the fact that Monogram is starting to explore a public listing is very exciting. 

If the company does end up going through with a public offering, it would look to raise up to $75 million. The company would also file paperwork for a shelf offering to raise additional funds during the lockup period. 

The beauty of a Reg A IPO is that a company can go public without anchor institutional investors (aka qualified institutional investors). While Monogram could try to find an institutional investor, it does not necessarily need one for a public listing and would theoretically be able to complete a successful IPO with just retail investors. 

Strategic Interest

With that being said, Monogram is still open to entertaining interest from larger companies in the joint replacement space. One of the big issues Monogram has run into from a partnership/acquisition perspective is that 82% of the knee replacement market is dominated by four companies: Stryker, OMNllife science, Smith & Nephew and THINK Surgical. All of these firms have spent hundreds of millions of dollars attempting to develop their own novel robotics solutions for knee and/or hip replacements, but with limited success to date. With so much internal money already spent, these legacy players have been too focused on their own projects to pursue a relationship with Monogram. 

To help get the attention of these companies, Monogram conducted a livestream of a robotic knee replacement surgery that took place in the company’s cadaver lab. This livestream was a resounding success and caught the eye of many players in the orthopedic community. Many of them now show keen interest in Monogram and its technology. Whether an acquisition from one of these companies ever materializes remains to be seen. However, the livestream certainly had its intended effect of getting Monogram on the radar of these major players.

Future Plans

In addition to exploring funding options, Monogram is also making progress in its pursuit of FDA approval. The company is scheduled to have a pre-submission meeting with the FDA in October. This meeting will be used to determine whether the FDA will accept Monogram’s predicate technology or if the company needs more clinical data to prove its safety and efficacy. A regulatory consulting firm specializing in orthopedics recently assessed Monogram’s data, and it doesn’t think that the company will need more clinical data. While there’s still a risk of a long and expensive clinical trial, this is positive news for Monogram in its pursuit of FDA approval.

Overall, things are looking extremely bright for Monogram. The company has continued to develop its technology and take steps to fund its growth. And with an FDA pre-submission meeting on the books, the company will soon have further clarity on what the next 12 to 18 months will look like. 

If Monogram ends up pursuing a public listing next year, we will be sure to update you with more information on official deal terms, lockup period and any other pertinent information.

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