Hi, good morning. How's everyone doing? Okay? I appreciate you taking a few minutes out of your very busy schedule to hear about SINTX. We are a medical device company, we have found the secret of material science in medical devices. I don't know how many of you are familiar with typical materials that are used in long-term implantable medical devices, there are really only two that are most popularly used in most implants, titanium and PEEK. PEEK is a high-performance polymer. I'll just pause right there to let you know a little bit about my background. I came from the company that invented PEEK. They're called Victrex. It's a British corporation, and I was responsible for the biomaterials division there. I know a little bit about biomaterials as an engineer and leader of that business.
One thing that we always were reticent about is being able to share with our customers the foibles and the shortcomings of PEEK. Both titanium and PEEK have some shortcomings. Titanium likes to be with bone. Bone likes to grow onto titanium, it doesn't do particularly well in cases where patients have active infections. That's a big deal. If you have an infection, the implant is going to loosen, it's ultimately going to fail. PEEK doesn't do well with infection, it also doesn't do well with bone on growth or osteoinductive properties. We've really got this new material that we've created, I'm skipping a little bit too far ahead there, called silicon nitride.
It's a ceramic, it's not like PEEK, and it's not like titanium in that what silicon nitride can do is actually resist the infection when it's put into the surgical site. What happens are ammonium particles or nitrogen molecules are eluted from this material, and they actually perform differently depending upon if the cell is a single-celled organism, like a virus or bacteria, versus a eukaryotic cell, or an animal or plant cell. In a single-celled organism, the ammonium or nitrogen molecules will actually go in, penetrate that cell membrane, and cause the cell to lyse or burst. What's the term I'm trying to find here? When you go to the doctor and you try to get something for a bacterial infection, he'll get you an antibiotic. Silicon nitride is not an antibiotic. It doesn't work in the same mechanism.
You don't have antibiotic resistance that can build up in your body as a result of it being planted with silicon nitride, it's still capable of killing bacteria and viruses, just as an antibiotic is. The other thing that silicon nitride can do in animal cells is it actually goes in and stimulates mitochondria to grow. In wound healing, we believe this is going to lead to some pretty dramatic incidents of reduced inflammation and increased wound healing. In bone type applications, we've actually shown a lot of data that we show increased osteoblast activity, which osteoblasts are the precursor cells to bone, and we see that it actually attracts those osteoblasts at a much higher level than titanium does, and PEEK really elicits no osteoblast activity.
This slide is just here as a takeaway for you to see how silicon nitride compares with PEEK and titanium. We've essentially decided to create a business around silicon nitride because we feel it's essentially the world's ideal biomaterial. Now, we offer silicon nitride, and it can be used to create implants in a number of different forms. On the far left, you see something called monolithic ceramic. This is the purest form of silicon nitride that comes 100% with no compounding, no mixture with any other materials, okay? That obviously means that it's in its purest essence. If we were trying to maximize the bone on-growth properties or the properties of antibacterial, you would want to use a monolithic ceramic, a monolithic silicon nitride. The next one over is silicon nitride composites. There are some applications that will perform better if you don't have a stiff ceramic.
Any kind of application that it's in tensile or stretching or torsion or rotation doesn't perform as well in a ceramic. We've actually invented something called silicon nitride-PEEK. You remember in the last slide, I was talking about PEEK. PEEK is actually very good in the fact that it has the same modulus of elasticity or the mechanical properties of human bone. When we're able to supercharge PEEK with silicon nitride, we get the best of both worlds. We get that mechanical modulus of PEEK with the outstanding biologic properties of silicon nitride. The third one, there will be some medical devices that just can't work in either silicon nitride or in PEEK, and those have to be continued to be made in metal or maybe titanium or cobalt-chrome.
In those, we've developed coating technology where we can place the silicon nitride over the top in a variety of different forms. Now, when we began to survey the landscape of the market and decide which markets we wanted to serve, we just did an overview, and you can see that some of them look really attractive. The spine market, for example, is quite highly valued. The problem with spine is that the growth rate right now is very poor. What we wanted to do with the first product lines that we developed is target a high growth, highly disruptive segment of the med tech market, and we've chosen extremities. Extremities is growing right now at around 7.5%-8% CAGR on a global basis, and we see procedure volumes growing at around that 7-10 as well.
There's also a very specific form of products that have exploded within extremities called patient-specific implants, and they're used to treat things like patients with extreme trauma or osteosarcoma, which is a type of bone cancer. If you were unfortunate enough to have osteosarcoma in one of your long bones, like your femur or your tibia or even maybe in your arm, large sections of your bone have to be removed. Sometimes that results in amputation of the limb. What we and some other companies are looking to do is salvage those limbs by being able to put in custom-made implants that fit exactly the right anatomy that was taken out when the surgeon performed his operation. If you look at the far left, we've highlighted in orthopedics, there's a number of different choices from which we've got to choose.
We've chosen to start with foot and ankle, I'll explain to you about our first product that we've just received FDA approval on last fall. At the far right, you can see that that vertical patient-specific implants there, where we talk about orthopedics, specifically orthopedic extremities to start. The middle bucket, where you see something called textiles, we'll talk to you about that.
It's a little bit further out for us in the technology landscape, but we believe that just as I mentioned in the beginning, where silicon nitride has the ability to positively influence wound-healing characteristics, by us creating a braided suture from silicon nitride and other polymers, we can actually resist the growth of infections in those sites, while also helping to aid in wound healing without the problem that comes associated with the triclosan, the current Ethicon suture, which is an antibiotic that can cause antibiotic-resistant bacteria. As a matter of fact, we were just at dinner last night, one of our friends passed along a World Health Organization update that actually was discouraging the use of triclosan or that Ethicon-based antibiotic suture because of the danger of increased antibiotic resistance. We feel we've got something very special there as well.
I mentioned starting in foot and ankle. This is a release from the fall where we announced the 510 or FDA clearance for our foot and ankle wedge system. This is that foot and ankle wedge system, and you can see that it is a pure 100% silicon nitride foot and ankle wedge. If you remember back to the earlier slides where we talked about the different forms, we've started with the purest form and foot and ankle surgeons, those are either podiatrists or orthopedic surgeons, they really love silicon nitride for this application because there is a high incidence of bacterial infection that can cause problems in foot and ankle surgery. This is where we've begun.
Our chief commercial officer has a history with a company called Paragon 28, which was just recently acquired by Zimmer Biomet, which is one of the top three orthopedic companies in the world. Paragon 28 had a very large line of foot and ankle products and patient-specific implants that our chief commercial officer helped to launch. She moved on to another company called restor3d. I'd encourage you to look at both of those companies because they're really the only two other companies besides SINTX that are going to be capable of launching patient-specific implants for the extremities. That's it. Only three companies in the world.
We have that technology. This is an overview of the limited user release for our foot and ankle wedge system, and you can see some logos of big hospital systems. Unfortunately, not too many in California because the reimbursements here are very poor. We've deliberately chosen other areas where either on the East Coast, where we have a lot of university-based medicine, where we get a lot of publications, a lot of volume.
Reimbursements aren't great there either. We do get a lot of volume. The Midwest and the Southeast, we get better reimbursements. Of course, in the Central West or the mountain region, that's also where we'll get some really good reimbursements. This reflects the 15 surgeons that have been identified now to help us with the design of our foot and ankle wedge system. The next one expands out. You can see a much wider picture of the surgeons that have been chosen for our full launch. In gold, the gold crosses are representative of the same slide as we just looked at. Those are the designing surgeons for the foot and ankle wedge system. The blue, the purple, the gray, the green reflect the rest.
It's about 71 surgeons in total that we've hand selected that have given us a verbal commitment that they want to use the product when it's available, and we'll be going into full launch for the Evans, Cotton, and Subtalar Wedges by the fourth quarter of this year. I will say that so far, we did our first case in March. It's still very early, but cases are getting booked all of the time. It's a very limited user release. Again, by the end of this year, we'll scale up. That's only the first product that we plan to offer. In targeting the extremity segment, we're going to need to do more if we want to do patient-specific implants than just foot and ankle wedges. The foot and ankle wedge, though, was chosen because it's a relatively easy-to-do procedure. It's used every day.
Foot and ankle surgeons put this in very commonly to restore flat foot deformity or other types of foot and ankle issues. When we want to increase the value of our implant offering, that's when we start getting into the lower and upper extremities. I mentioned those before as either treatments for osteosarcoma. All right, for cancer, oncology, or for severe trauma. When we start looking at the lower extremity focus, we're talking about the femur and the tibia. We talk about upper extremity focus, we talk about the arm. No joints right now. In the first couple of years, as we're looking at this midterm commercial strategy, we're looking at producing patient-specific and custom implants for large bone segmental defects.
Those are these large pieces of bone that have to be surgically removed, and we'll put those back in with a silicon nitride-PEEK or silicon nitride-based implant. Right along together with the implant, we're able to also sell custom instrumentation that helps the surgeon to make the accurate cutting guide. If you want to put in an implant, it helps to actually have a pattern. I don't know if you have any woodworkers in here, but it's very difficult to freehand a cut if you're a surgeon and make it absolutely precise at the right angle. Surgeons now really like to have patient-specific cutting guides to guide the oscillating saw that's used before they place the implant. We're going to be selling those also, and they're single use, so we can bill the hospital for those in addition to the implant. Okay. Keep going.
I did mention restor3d and Paragon 28. There are a few others on this list that you could see as the competitors that we're seeking to go after. The one thing that you'll not see anywhere on this is anyone that's using a unique biomaterial like silicon nitride. One of the value propositions, obviously, that we're targeting in this group is the use of our implant in active infection, and not restor3d or MedCAD or OPM. No one can sell their products now for that type of an indication because it's contraindicated. FDA hasn't approved it for that application. Because we have the ability with silicon nitride to fight bacteria and viruses, we can actually make that claim. That'll be one thing that we'll be able to sell as a niche application.
The other thing that these companies are struggling with right now is producing their implants on time. Lead time is a big deal, and we want a good customer experience in business. These companies are struggling to deliver their implants within eight weeks. Eight weeks for a patient that is undergoing severe trauma or cancer is very problematic, as you can tell. It's also a problem for the hospital to stabilize the patient for that long and incur incredible expense. If we can reduce that lead time, which we believe we can get it down to about two weeks because of the simplified nature in which we can print silicon nitride-PEEK or silicon nitride, we don't have to go through the same external suppliers that these folks do in printing metal. Metal is a very different process than printing ceramics or polymers that we can.
We're quite confident that we'll be able to not only deliver an improved biomaterial that's going to give better patient outcomes, but also an improved lead time that can save the hospitals money and deliver a better customer experience. I'll introduce you to our facility. We're located in Salt Lake City, and the bottom here, you can see some of the equipment that we have proprietarily built into the system to make our ceramic. We're the only company on planet Earth that has figured out a way to make a medical grade silicon nitride.
Silicon nitride's been used in automotive and in aerospace applications for quite some time, but no one realized the biologic benefits until SINTX actually began to study these materials, and after doing a lot of in vitro testing, they realized, hey, there's something really special here about the way it interacts with both bone, soft tissue, as well as bacteria and viruses. We've invested quite a bit of money. We have a very robust patent portfolio where no one else is going to be able to take the silicon nitride and make excuse me, to make a medical grade. We feel very good about there being a pretty high barrier to entry for any of the competitors that might want to progress this technology in parallel. Yep. This is just talking a little bit more about that robust patent portfolio.
Do you remember in the beginning when I talked about silicon nitride and PEEK, and I've kind of referred to silicon nitride-PEEK a couple of times. To make a compound, silicon nitride-PEEK, it's a polymer, PEEK, combined with our ceramic powder. It's not easy to do that. We had to find the right partner who would be interested in validating the SINTX technology, first of all, and then saying, "Yeah, we will make that for you." Evonik is a multi-billion dollar polymers and chemicals corporation located out of Europe in Belgium, and they've actually become really excited because they see this not only as an opportunity to get us as a customer. They can resell to us our compounded materials and make those for us, but they're also really excited about reselling these materials to their customers.
We're not going to get rich about Evonik selling our customers, but what it does do is it validates that this very large behemoth biomaterials company sees something very special in our material and something that they feel validates our value proposition, which we're very excited about that. Aside from the orthopedic and musculoskeletal applications, which I spoke about a little bit earlier, this is talking more about that anti-pathogenic fibrous material, suture, wound dressing that we feel really bullish about as well. Not to put down, I guess, the musculoskeletal applications, but this is a very large market where there is only one technology on the market right now which addresses antibacterial concerns in suture or wound healing. You just heard me say that it's actually becoming a little bit of a problem because of antibacterial resistance.
We have plans to make our own suture and wound dressings and then find distribution partners for those, and the first step of that is to perform an animal study which validates all of our in vitro or laboratory data. We've got a lot of data in the lab that shows this is very good at attracting the right types of cells for healing. It's very good at resisting bacteria. We now need to take that to the next step. This summer, we're going to be embarking upon an animal study to test both suture and wound dressing. Once we have that data, we'll be able to go to FDA, have a 510 or a license to market our product, and then we'll be seeking distribution partners.
I mean, Ethicon could be one example of a suture company that would be a great partner for us to distribute our product. I can turn it over now to our chief investment officer, Gregg Honigblum, who can answer any questions for you at the end and talk to you about the investment.
Since I'm a midget, I'm going to stand over here. Thanks. I'm an investment banker by occupation, and this was one of my early portfolio companies. Raised the first $100 million of equity for this company in the early stage development. Helped build the manufacturing facility, get all the intellectual property. I was approached by the former board of directors about 18 months ago to come back in the company to help restructure it because they'd kind of lost their way to focus on specifically the medical device applications for silicon nitride. We've been very fortunate to recruit people like Ryan to come in as the president of the company, developing the distribution channels. We obviously are FDA approved for the foot and ankle. We've got a stellar team, a management team. We've also came in and restructured the board of directors.
Chris Lyons was part of M&A for Medtronic for years. Bob Mitchell was a senior executive at Cook Medical, and Mark Anderson ran a billion-dollar division for Boston Scientific. These are luminaries that have been very creative in our development of the next stage of our technology. Our cap table is very simple. It's been very closely held by very long-term investors. There hasn't been a lot of selling. There's about 65% of the stock is in very close hands. We've got some strong institutional ownership. We just actually had a very well-known institution buy 4.7% of the stock last week that we're really excited about. Ran a $20 billion fund for a major private equity group. We have no debt. We have the availability of about $5.1 million of an ATM.
We also have warrant coverage too that we feel that could get exercised due to the fact that we've got some nice catalytic announcements over the next coming quarters and months as our ramp for our revenue increases, we're in a great shot. We pioneered the use of silicon nitride for the use of medical implants. We're the only ones in the world that can make it. We've got all the IP around it. We've got the great management team. We're executing flawlessly now, and you'll see a nice uptick of our financials on both the revenue and profitability side as we move along into these coming quarters. I'd like to open it up for any questions. Yeah.
Surgeons have to have special training to use this. Is that what you explained from Matt? It's a great question. No, they don't. The implants that are used are actually the same shape and size as metal or PEEK implants, so they can use the same surgical technique that they would've otherwise used with another material. They can just put this implant in and, yeah, it's the same surgical technique. Yeah, great question. Yeah.
You mentioned the foot and ankle wedge.
Two other companies are direct competitors in that space.
It's about a $50 million-$60 million market for just foot and ankle wedges. There are several companies. Stryker has them, a lot of people have them. I think what we're trying to do is, Lisa Marie, our Chief Commercial Officer you saw on the slide, she has the relationships with about 71 surgeons that she was working with in her former role as the sales director for Paragon 28, as well as for restor3d. We're starting with a simple product. They've all agreed to use it, but that's just the benchmark from which we're going to grow. It's an easy one to get into the hospitals because it's so different.
You do need to get hospital approval, and that's not easy for something that's just a me too product, but something that's quite unique where the hospital see an opportunity for them to be able to resist maybe additional infections, it's going to save them money. It's also going to be an improved outcome that they can demonstrate to payers and say, "Look, we're showing an increased rate of success with lower infection," and they can negotiate better reimbursement rates from payers as well. That's ultimately where we're trying to go with the data set. Yeah. Yeah.
I have a question. You mentioned you have 5.1 million in cash?
No, 5.1 million on the ATM. Okay. We just announced our Q last week. We can't really go into it, but we're in a really advantageous place from a capital formation standpoint. If you'd like to have a more substantive conversation, we could. We have access to the ATM, which was tapped last week by a major institution that wanted to just buy the stock in the market and hold it long term. We have access to warrants that could be exercised throughout some catalytic events that we feel will have an impact on the stock, I believe.
What's your cash burn currently?
Cash burn right now, it's about 800,000 a month, but it's getting ready to diminish as we have some also legacy industrial business that we work with Champion, GE, and Fralock, three of the large companies that we had previous contracts with, and we've recently renegotiated those contracts, which they want us to make these parts for them, and we do it in our manufacturing facility and doesn't cause any disruption from making our medical implants. That is becoming a very lucrative business for us that you'll see in the coming quarters.
One thing Gregg and I were just joking about on the way to dinner last night was if I was in your shoes sitting out here in the audience and what would I want to hear as a potential investor about a new company? The first thing is it's a very unique biomaterial that no one else has. The second thing is the medium by which we're introducing these implants is very disruptive in 3D printed patient-specific implants, and we've targeted a market that's poised for continued very strong growth. The last thing is we've got a growth projection. Our three-year projections puts us at cash positive by year three.
Because of the relationships that Lisa Marie, our Chief Commercial Officer has, and because of the high price of each of these implants, we feel that we've got a very good chance of getting to around that $22 million range by year three.
Thank you.
Yeah. Thank you very much.