Improving Patient Outcomes


Innovative Medical Device Start Up Intellijoint Surgical Takes the Fast Track to Success


In the United States alone, more than 850,000 people will undergo hip and knee replacement surgery in any given year, with the average surgeon performing around 30 or less of these surgeries annually. While total joint replacement can bring back quality of life to patients, and for many, an escape from chronic pain, this surgery is not without its risks. In hip replacement surgery, for example, nearly two–thirds of patients will experience a lengthening of their operated leg. This situation requires further non– surgical intervention and treatment. And in 7 percent of cases, complications related to hip surgery are far more severe ––requiring the surgery be repeated within 90 days.

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The more surgeries performed, the more accomplished the surgeon and the better the patient outcome. But to this day, when performing any kind of joint surgery, most orthopedic surgeons operate without the support of technology, relying upon professional judgment and visual alignment to select and place an implant properly into a patient’s body. And as the statistics show, patient outcomes for this type of surgery can be improved.

It was 2007 when Armen Bakirtzian entered the OR to watch his father, an orthopedic surgeon, perform a hip replacement surgery for the first time. Bakirtzian was entering his final year of the University of Waterloo Mechatronics Engineering program, and was on the lookout for a subject for his fourth year project. He and his team needed to design and construct a mechatronic system, and they were intrigued with the idea of creating a medical device.

As Armen watched on, his dad explained the problem orthopedic surgeons face when performing joint replacement and the consequences of poor alignment. He asked Armen if he could design something to help. While he didn’t realize it at the time, that simple question set Armen and his co–founders on an entrepreneurial path that now has them at the helm of Intellijoint, one of the most exciting medical device start ups to emerge on the Canadian landscape.

As Armen and his classmates, Intellijoint co–founders Richard Fanson and Andre Hladio, began investigating the problem framed out by Armen’s dad that day in surgery.

Armen explains. “The deeper we looked, the more our excitement grew. We realized there really was no fast, simple, and cost effective technology available to assist in joint replacement. The problem was also very widespread. Lots of surgeons had the same problem. The existing navigation technologies we found were overly complex and significantly increased surgery time. So no orthopedic surgeons were using them – if they even knew about them. They were also really expensive, about $250,000 to buy and another $600 every time they used it. The average hospital does about 30 hip replacements a year. It is hard for them to justify having a quarter million dollar piece of equipment sitting in the OR gathering dust.”

The guys determined that when it came to hip surgery there were two ends of the spectrum – by eye, or highly complex. “There just had to be a middle ground,” says Armen. “So we began mapping out an idea to create a miniature smart tool to get surgeons the result they wanted without over complicating things. We wanted to create a tool that was cost effective, easy to use, and fast.”

And that’s exactly what they built. By the end of their fourth year, Bakirtzian, Fanson and Hladio had their first prototype for PelvAssist™ (now called Intellijoint HIP™).

But they weren’t quite ready to embark on life as a start up. “We didn’t even know the word entrepreneur,” Armen reminisces. “Sure we had a cool idea that we figured could solve the problem. But we were just three guys right out of University. All we knew was school.”

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So back into the academic world they went, each pursing Masters degrees, Armen in biomedical engineering, Richard in medical robotics, and Andre in electrical engineering.

“We were all studying completely different stuff, but we still kept coming back to our fourth year project. We’d get together and work on it on weekends, and when we had spare time,” says Richard. And still the three weren’t certain the entrepreneurial life was where they’d end up.

“We really needed the validation from the market and orthopaedic surgeons to get the confidence we required to take that next step,” says Armen.

That arrived in 2010, when the guys on a bit of a lark decided to enter Ontario’s Next Young Entrepreneur contest at OCE Discovery. They cleaned up, winning the competition and $18,000 in seed capital. Even more importantly, they were introduced to Mount Sinai Hospital in Toronto, an event that in retrospect became a tipping point for the fledging company.

“Suddenly we had a mission,” says Andre Hladio. “We were told by one of our OCE advisors that if we were going to fail, we should do it as early as possible and move on to something else. We really took that advice to heart. We wanted to be darned sure our idea would work.”

The team worked in two months sprints, aggressively seeking to poke holes in their idea. They talked to as many orthopedic surgeons as they could. And in the summer of 2010, they met Dr. Allan Gross, an orthopedic surgeon at Mount Sinai, who would eventually become the chairman of Intellijoint’s Scientific–Medical Advisory Board.

“Dr. Gross had never used a navigation technology in his surgeries. He was skeptical, but he loved our idea. And he wanted to be involved. He helped us meet other orthopedic surgeons, and helped guide our discovery,” says Armen.

It was now the fall of 2010 and while the guys were hammering at their idea to find the holes, the concept of a simple, affordable smart tool for joint replacement was holding up. Armen, Richard and Andre now had the confidence they needed to become entrepreneurs. They incorporated the company and moved into the Accelerator Centre, an award winning incubation facility located within the David Johnston R+T Park.

The next three years saw various iterations of the Intellijoint HIP™ device, many design iterations, and countless more conversations with a host of orthopedic surgeons. But the focused, disciplined effort was worth it. In the summer of 2013, Intellijoint received its ISO 13485 certification, and in November received its Health Canada Medical Device License in addition to closing $6 million in investment.

“For a medical device company to accomplish all of these milestones in just a three year period is really significant,” says Armen. “It’s also a testament to the strength of our team, and to our determination to surround ourselves with excellence.”

At the time of writing, the Intellijoint HIP™ device has been used in 30 surgeries at Mount Sinai and Grand River Hospitals, and use of the device is expanding, with 2 more hospitals coming on line in the next few weeks.

Word about the Intellijoint HIP™ device is circulating among patients as well. The founders have received several letters from individuals inquiring if Intellijoint HIP™ can be used in their upcoming surgery.

“Patients today are a lot more informed, and are actively taking ownership of their health care. They are out there looking for technologies that have the potential to improve their outcomes. It’s really quite gratifying to know that they are interested in our device and wanting to be part of our story,” says Armen.

Any entrepreneur will tell you that it is a journey filled with twists and turns, and tricks of fate. And yet the team at Intellijoint was able to channel each of the events that came their way to their advantage, starting with that day 6 years ago when Armen Bakirtzian joined his dad in the operating room. “Funny how things happen,” he muses. “I wonder where we’d all be today if I hadn’t taken my dad up on his offer.”