Why research is the foundation of this medtech start-up

25 Jul 2024

Loci Orthopaedics co-founder and executive chair Dr Brendan Boland. Image: Andrew Downes/Xposure

Dr Brendan Boland of Loci Orthopaedics explains the benefits and challenges of hands-on research in a medtech start-up.

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The road to success is different for every start-up, but those in certain sectors have a longer route to becoming major businesses.

For some founders, they can come to investors with a working product ready to go, requiring money to improve and scale up. But for some – such as deep-tech or medtech start-ups – they may require large amounts of investment to make a research concept a reality.

Even with a potentially transformative idea, there is also a long regulatory route for medtechs before they can create a commercially viable product. This requires clinical studies to prove the validity of a medical product, requiring more funding.

One start-up leader who knows about this long journey is Dr Brendan Boland, the co-founder and executive chair of Loci Orthopaedics. This Galway-based start-up has developed an implant for the treatment of thumb base joint arthritis and is currently working to get regulatory approval for this device.

Before co-founding the start-up, Boland spent seven years practicing medicine in Ireland and got the opportunity to focus his research skills in 2013 when he joined the BioInnovate Ireland fellowship programme.

“I count myself very lucky in that I’ve been able to work in clinical medicine or improving the lives of patients or developing and researching new concepts to improve the life of patients for my career,” Boland said.

Research foundations

Loci Orthopaedics was founded in 2017 as a “tri-university spinout”, with its roots in the University of Galway, University College Cork and KU Leuven in Belgium. But Boland said the real origins of the start-up were in a 10-month BioInnovate Fellowship, which began with a 10-week clinical immersion to delve deeper into existing medical issues and potential solutions.

“We were looking at orthopaedics, so we looked at everything from spinal surgery, sport surgery, knee implants, occupational therapy, physiotherapy,” Boland said. “We spent 10 weeks in an absolute deep clinical immersion, looking at all potential unmet clinical needs in orthopaedics.

“After that, we spent another eight months researching all of these unmet clinical needs. We applied a filtering process to really distil down the unmet clinical needs that we felt that we were able to make a big difference on.”

Eventually, the team that would go on to found Loci Orthopaedics set their sights on thumb base joint arthritis, a common condition in older people that can cause severe pain, swelling, decreased strength and decreased range of motion, making it difficult to do simple tasks. Boland said the existing surgical options “just aren’t great”.

“So this is where we said, there has to be a better way,” he said. “We spent quite a bit of time looking back in terms of the biomechanical, anatomical and physiological research of the thumb-based joint.”

It was during this fellowship programme that Boland and his team stumbled upon research that identified the thumb-based joint as a “dual axis joint”. He described this discovery as a key moment for the eventual creation of Loci Orthopaedics.

“Which was really the kind of eureka moment for us to say, if all of the implant designs to date have been single-axis joints … being put into a double-axis joint, of course they’re not going to work,” he said. “So that led us then to develop the first evidence-based solution for this common and disabling condition.”

The importance of a research fellowship

Fast forward to 2024 and Loci Orthopaedics has managed to raise significant amounts of funding, including €8m in grant and equity funding from the European Innovation Council in 2022.

Last week, the start-up managed to raised €12.8m to boost the development of its thumb arthritis implant and to expand its team by 20 in the near future.

But Boland said he is not sure if this journey would have been possible without an entity like the BioInnovate fellowship, as it gave the team a significant amount of time to “research and identify” potential areas to work on.

“You get to really do a deep dive into the important and key elements of an unmet clinical need or even identifying the unmet clinical need,” Boland said.

But another key aspect that boosted the creation of Loci Orthopaedics was the fact the BioInnovate fellowship helped put a “multidisciplinary team together”.

“I was the clinician on the team, my co-founder, Gerry Clarke, an engineer, and then our other two team members, another one was an engineer, another one was in biotech,” Boland said. “So to be able to work with a multidisciplinary team across different professional areas is extremely important because the research that you do is then informed and elevated by the inputs across different areas.”

The long road to commercialisation

Boland noted the challenges that can exist for medtech start-ups trying to raise funding – from having to prove the feasibility of a design concept to the expenses that stem from clinical research, preclinical research, bench testing and more.

“The company has to not only research the product, demonstrate to its customers and its end users the viability of that product, but then in terms of getting that product to market, we have the additional step of all of the research, development and innovation that’s required in order to be able to meet the requirements of the US FDA or a notified body in Europe, which, obviously, is more time-consuming and it’s more expensive.”

While the journey can be difficult, Boland said there is always hope that the journey is worth it, both from a commercial success standpoint and in creating something that provides a “meaningful benefit to patients affected with any given condition”.

“I think Ireland is somewhat fortunate in that it has good funders that understand medtech,” he added. “So by that, I mean a good network of angel investors, as well as governmental supporters such as Enterprise Ireland and WDC, who have been prepared to make early-stage investments in medtech. They understand that pathway.”

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Leigh Mc Gowran is a journalist with Silicon Republic

editorial@siliconrepublic.com