On a recent regional tour of Northeast Indiana’s medtech industry, we stopped off at Nextremity Solutions, a company headquartered in Warsaw, IN, a town known as The Orthopedic Capital. Founded in 2008 by a couple surgeons from Lennox Hill Hospital in New York City, Nextremity has been dedicated from the beginning to introducing innovative new products for foot and ankle care.
This product focus was motivated by the fact that large ortho firms have been channeling the majority of their resources into hip and knee devices. Simpler, cheaper products that address the needs of a more limited population have been overlooked and left to smaller firms to develop. The two surgeons that founded the firm saw the discrepancy in progress of hip and knees products compared to foot and ankle devices, and realized an opportunity to be the ones to close the gap.
Originally based in New Jersey, the firm moved about three years ago to Warsaw. Though the original management team was in New Jersey, there was a clear understanding that there’s a need to be close to the supply houses and synergies available in Indiana if the firm is to be able to roll out new products at a healthy rate. Factors, such as availability of qualified specialists to hire and personal access to engineers and executives of partner firms, played an important part in the decision making. Rod Mayer, the President and CEO of Nextremity, explaining the decision making the move to Indiana quoted Lee Iacoca, former head of Chrysler, that “business, after all, is nothing more than a bunch of human relationships.” As an example, he pointed to working with a nearby company that makes orthopedic models for Nextremity that are used in product development, marketing, and education. It’s only four miles away from Nextremity, so when the company wants to make a small change, they can always just take a quick drive to their partner’s headquarters and talk in person how to make that happen. Since development of new products can take many months and even years, being able to speed up the process can provide a significant competitive advantage.
The actual process of product development at Nextremity starts with surgeons putting forth new ideas. Working off an idea, the company builds an appropriate design strategy and brings the proposal to another group of surgeons who are qualified to evaluate and comment on the new idea. Once the idea is confirmed as being beneficial for patients and surgeons, the engineering team takes over to actually produce a device that will have the benefits and characteristics that the surgeons intended.
There’s still a great deal of room for new innovations in the foot and ankle space, and because this market is growing at about 12% per year Nextremity plans to continue being dedicated to this ortho niche. As an example of the potential for growth, Rod Mayer, the CEO, mentioned that in 1977 the entire ortho market was less than $1 billion while now it is about $45 billion in size. Foot and ankle space being about $2.5 billion right now, considering a 12% annual growth rate points to some potential for companies in this space to make serious money.
Rod showed off some of Nextremity’s products and noted that women, because they tend to like to show off their feet while often wearing shoes that ruin those very feet, are a very large part of the market. Forefoot procedures, such as bunyon and hammertoe treatments, are mostly performed on women. But because most women seem to not bring up these conditions with their doctors, many are not even aware that there are treatment options out there. This means that the potential customer base is considerably larger than it is now, and that a good deal of education will be required to familiarize people with hammertoes and similar conditions to what is possible in the way of treatment options.
All of Nextremity’s products come packaged in sterile kits that include all the necessary tools to complete the procedure. Once done, the remaining components are simply chucked away so no time wasting on on-site sterilization is necessary. A lot of the designs of these products are patent protected, which means Nextremity has unique advantages over its competitors. Since it doesn’t produce essentially existing “me too” products, all of what they make has a good deal of innovation baked right in. We’d love to explain how these products work, but Nextremity has a product page with videos that will do a better job showing both the implants and how they’re delivered.
Overall we were left quite fascinated by Nextremity Solutions, the speed of the firm’s growth, and how it innovates in what already seems like a pretty competitive marketplace. It found its niche and thanks to that focus is able to deliver products essentially overlooked by the bigger guys. We wish them the best and hope they’ll continue offering new solutions for foot and ankle conditions, allowing more people to walk in comfort and show off their sexy feet.