The 2026 Shark Tank Winners Rethinking Surgical Imaging

What if the C-arm you already own could show you the entire pelvis — in real time, with less radiation? The winners of the 2026 AHF Shark Tank believe it can, and they built the system to prove it.

Dr. Dean Cole, an orthopedic trauma surgeon with roughly 40 patents and designs licensed across the industry, and Scott Banks, PhD, who has spent nearly four decades quantifying how joints actually move under fluoroscopy across more than 200 published papers, join Joe Schwab to tell the story of Orthopedic Driven Imaging (ODI) — the company born from a 2022 cold call — and SODI, their FDA-cleared imaging platform that retrofits the GE OEC C-arms already sitting in an estimated 22,000 operating rooms.

The conversation traces both founders' paths: Dean's trauma training under Jeff Mast and a lifetime of problem-solving inherited from a space-program father; Scott's route from pre-med engineer to Mako-era implant design and a career asking how knees and hips really move. Together they explain why surgical planning and postoperative confirmation have advanced dramatically while the middle of the operation stayed fuzzy — and what a full-field-of-view detector changes for anterior approach hip replacement: pelvis alignment from a video camera in the collimator, fewer scout shots, less radiation, and femoral offset you can actually measure.

They also get practical about adoption: what they'd say to the surgeon who trusts their current imaging, why anterior hip and spine come first while the joint-kinematics vision matures, and what they're looking for from early-adopter surgeons (orthodriven.com).

⏱️ Chapters:
00:00 Introduction: the AHF Shark Tank winners
01:35 Pitching surgeons live at AHF 2026
04:33 Dean Cole: trauma, Jeff Mast, and 40 patents
07:12 Scott Banks: an engineer's toolbox for medicine
09:02 What we still can't see about joint motion
11:31 The 2022 phone call that started ODI
15:33 A founding team built by serendipity
18:13 Two decades of C-arms, nav, and robotics
21:30 What robotics does well — and the ill-defined target
26:56 Full field of view, less radiation, same workflow
30:55 Retrofitting the C-arm you already own
34:16 What early ODI cases taught Dean
36:11 Why anterior hip (and spine) come first
38:29 To the surgeon who trusts their current setup
40:09 Hip replacement five years from now
41:16 What ODI wants from early adopters
44:08 Taking risks late in a career
49:50 Advice for surgeon-innovators in training
53:06 What they hope patients never have to know

Listen to the AHF Podcast on your preferred platform:
Buzzsprout: https://ahfpodcast.buzzsprout.com
Apple Podcasts: https://podcasts.apple.com/us/podcast/ahf-podcast/id1749521487
Spotify: https://open.spotify.com/show/5CrGJyvRiQFTCU3FFFVvHc
LinkedIn: https://www.linkedin.com/showcase/ahf-podcast
YouTube: https://www.youtube.com/@anteriorhipfoundation
Homepage: https://anteriorhipfoundation.com
Guest company: https://orthodriven.com

This podcast is intended for educational and informational purposes only.

The content discussed does not constitute medical advice and should not be used as a substitute for professional judgment. Clinicians should rely on their own training, experience, and clinical decision-making when applying information from this discussion.

#AnteriorHipFoundation #AHFPodcast #TotalHipArthroplasty #THA #AnteriorApproach #HipReplacement #Fluoroscopy #SurgicalImaging #OrthopedicInnovation #SharkTank #DeanCole #ScottBanks #ODI #OrthopedicSurgery

Transcript

Joseph M. Schwab 0:21

Hello and welcome to the AHF Podcast. I'm your host, Joe Schwab. If you were at AHF 2026 in Nashville, you may have caught the Shark Tank competition. It's surgeons mostly pitching innovation to a panel of judges live in front of a room full of their peers. Well, today I'm sitting down with the two men who won that competition. Dr. Dean Cole is an orthopedic surgeon with designs licensed to just about every major player in the industry, and Scott Banks is a PhD who has spent years studying how joints actually move under fluoroscopy. He has over 200 published papers. Together, they founded Orthopedic Driven Imaging, ODI, and they've developed SODI, an FDA-cleared real-time imaging system that runs on the GEC arm you probably already have in your OR. And in many ways, they're starting this with anterior hip replacement. Dean, Scott, welcome to the AHF Podcast

Scott Banks 1:32

Me

Dean Cole 1:32

Aiko Joe

Scott Banks 1:33

Glad to be here

Joseph M. Schwab 1:35

So the reason we're here together, you two just won the Shark Tank competition at this year's meeting. For anyone who's never seen it live, um, paint a picture for me. What's it actually like standing up in front of that panel and pitching your company to a room full of surgeons?

Scott Banks 1:53

Sure. For, for me it was, uh, exciting. Uh, I have a couple decades experience standing in front of a classroom or in front of a g- you know, an audience of, of surgeons talking about implant design and, and that sort of thing. So the, the, the venue was not unfamiliar. Um, but this was the first time that we'd had the opportunity to share in an audience like that what we're doing as ODI. And, and so it was definitely exciting. I think the room probably had... It, it appeared maybe 300 or 400 surgeons in a, a fairly big ballroom. And then of course, uh, to our left where we were standing was the, the four sharks and Stefan Kreutzer as the moderator. So, um, you know, our, our colleagues up there ready to, you know, to dig into our, our prospects

Joseph M. Schwab 2:51

Was there a moment, um, or maybe a question from the judges where you thought, "Okay, they're, they're actually kind of getting what it is that we've built"?

Scott Banks 3:06

Yeah. For me, uh, and, and I, I don't remember which judge it was, but they said, "I'm-- we're really excited about the vision and joint kinematics," and all of the sort of trajectory that we, we presented. But they said, "But we're gonna focus on the anterior hip thing." And, and so in that statement, uh, it, it seemed like we had successfully communicated the broad scope of, of what we are seeking to accomplish, uh, and then getting back to today's business, you know, for the Anterior Hip Foundation.

Joseph M. Schwab 3:38

And looking back at it now, w- what do you think it was about ODI specifically that won the room over?

Dean Cole 3:49

I think we offered a very practical solution to a problem that, uh, the audience was well aware of and, uh, frankly, you know, should've been done a long time ago. Uh, we have been taught with, uh, direct anterior hip, uh, approach, uh, through Joel Matta, the importance of, uh, X-ray. As a traumatologist, uh, you know, certainly part of my OR, and so to have it in the operating room and to optimize its use, uh, was certainly just common sense. Having a full, uh, field of view, uh, concerning the object that we were operating on, again, just something that needed to be done

Joseph M. Schwab 4:33

Hmm. And Dean, I wanna stay with you for a minute because, so you've been, you are an orthopedic surgeon, and you've been one for over 40 years, and a lot of that work seems to be in trauma and deformity correction and non-unions, malunions. What drew you to that kind of work in the first place?

Dean Cole 4:53

Yeah, pretty simple answer. I had the opportunity as a resident, a young resident, to work with, uh, Dr. Jeff Mast, who took myself and Brett Bohoffner under his arm and, uh, taught us, uh, principles, uh, indirect reduction methods, and the importance of operating re- with principles, understanding biology, anatomy, and then applying that to, uh, things that honestly were, were fun and easy to be enthusiastic about. So it was that association that, uh, you know, uh, when after working with, uh, Dr. Mast for a week, uh, you know, I knew I wanted to do trauma. Uh, that's, you know, where I got that

Joseph M. Schwab 5:32

Well, and a-apart from that type of work, you've got, I think it's somewhere around 40 patents to your name. Um, and like we, I sort of mentioned in the intro, your designs have ended up with companies like DePuy and Zimmer Biomet and Stryker and Smith+Nephew. What is it that makes a surgeon start thinking about building his or her own tools instead of just using what already is around and available to you?

Dean Cole 6:02

Yeah, that dates back really to my young year, young years. My, uh, dad was an electrical engineer with the space program, so I can remember him and his friends talking mainly in acronyms, so I didn't quite understand, but with problems with the Gemini, Apollo, space shuttle, uh, working out problems, finding solutions was just, you know, part of, uh, their being. But-- And then I also grew up in a small town and had two mentors that, again, were very innovative and very, uh, helpful in just overcoming fears associated with it. It was just a, a way of life, uh, for them, Rodney Thompson and Ben Story. Rodney was, uh-- owned a boat, uh, uh, manufacturing company, shrimping. He designed, uh, how to, uh, clean rock shrimp. So he was always solving problems. Uh, nothing got in his way. And I learned also about failure through them and how to overcome that, how to think differently about failure as an opportunity to learn. So an open mind, uh, and the mentors that, you know, I had in life certainly just made it, you know, part of a career

Joseph M. Schwab 7:12

Hmm. Scott, I want to ask you, 'cause your path into ODI looks, uh, I would say in some ways completely different from, from Dean's. Um, you came at it from research and engineering. What pulled you towards that path?

Scott Banks 7:30

Yeah. So it, it, it started as an interest in medicine, you know, as, as a, a kid in school. And, uh, I went to undergraduate as a pre-med engineer and enjoyed a lot of the pre-medical classes, the biology, the chemistry, all, all of that. Got to organic chemistry, hated it, and it hated me. And so it, it-- that basically foreclosed my, uh, my medical career. But at the same time, as an engineer, I had already begun working in research labs that were doing biomedical applications, and saw that as an engineer, I could contribute to that medical enterprise just with a different toolbox. And, and so that's basically the path that I've been on since, uh, I s- I joined that lab in 1984 and, and have, you know, really had that as a mission of, you know, trying to have a positive impact on, on patients through the, the, the providers like Dean, um, you know, using my engineer's toolbox to, to effect positive change and, and outcomes.

Joseph M. Schwab 8:45

So after all these years of kind of watching knees and hips move on a screen, is, is there something about how a joint behaves or works or functions that still surprises you? Or do you feel like you know everything you need to know?

Scott Banks 9:02

Yeah, I, I wish that were true. Uh, I, I think the-- So we've been imaging joints for-- since the late '80s using dynamic fluoroscopy, us and, and many others, and in that entire history, we've probably looked at a couple thousand humans. Um, you know, so, uh, just a, a, an infinitesimal sliver of humanity. And so do we understand kind of the big picture? Probably. Uh, but, you know, think of what we know about joints is looking through frosted glass. You know, we can tell, oh yeah, that's a knee, uh, that's a shoulder. Uh, but being able to understand how that joint is working in a patient that's suffering from some kind of disease process, um, we can't predict that with any accuracy. And, and that, in part, is what really drove, um, you know, Dean and I to get together was, uh, you know, he called me in the spring of twenty twenty-two. Uh, we had not previously met, and I, I'm driving home from campus and, and, uh, I get this call from Dean Cole, who of course I knew about, uh, but we, we hadn't previously met, and he's like, "I, I, I wanna, I wanna be able to measure the kinematics in, in my knee patients because I'm making all these measurements intraoperatively, and I don't have a way to quantify what's going on postoperatively to, to close the loop." And, uh, we just couldn't find a way in my role at the University of Florida to do that kind of fee-for-service thing. Um, and, and what it made clear was, was that if, if we're actually going to, um, really move the needle on here's what's going on in a patient, here's how the treatment affected their function, that we need the ability to take all of this stuff out of the, the research enterprise and be able to re-engineer it so it scales, right? Doing a couple thousand people over decades is not gonna get us where we need to go. We need to be able to do this routinely on thousands of patients a day in order to get the kind of precision care that I think we're all moving to, to wanna deliver. So, so that, that was-- It's Dean's fault that we're here

Joseph M. Schwab 11:31

Well, d- and Dean, that, that sort of leads me to ask, was there a case in your career that sort of prompted this call, uh, to Scott specifically? Was there, was there something that you experienced during a case that helped you decide that, that you needed to actually see how the joint was sort of moving in real time to understand the kinem- kinematics of it?

Dean Cole 11:58

Well, certainly there was inconsistency in outcomes, uh, that led to that, but I cannot say that there was one case. But, you know, the understanding that I gained really about what I did not know, uh, you know, I have Scott to credit. You read his work, I thought, you know, I l- I certainly learned a lot, but also learned that I knew a lot less than I should if I'm going to be responsible for, uh, the patient's outcome. So that, that led to, you know, getting up the nerve to contact the professor, uh, that you, you read about. Uh, that was, uh, uh, probably the biggest hurdle. After that, it's, uh, been great and I can't imagine working without him, so in, in reality, we see plenty of, uh, patients that are unhappy with their knees. I, I still, you know, am able to see patients from other docs, and, and, uh, you see, uh, that we could-- we should do better. Uh, they're frequently told, uh, "Well, your X-ray looks great. I did a good job," and that's it. But, uh, you know, Scott and I know it's a lot different than that and know that we really need to make kinematic analysis part of the routine follow-up of patients to understand why they're happy or why they're unhappy and to improve our ability to, uh, obtain good outcomes.

Joseph M. Schwab 13:22

So Scott, just going off of that, does this sort of line up with what you were thinking about in terms of, um, going into engineering and actually providing sort of service to the medical community? W- Is this the same thing that you were sort of seeing from the research side at the same time, that there was a better way we could be treating patients?

Scott Banks 13:46

I, I mean, it, it, the start, no, I had no idea. Uh, you know, back in, in the college years, I j- I just wanted to, you know, I aspired to do something useful. Uh, when I began my doctorate with a, a surgeon named Andy Hodge at Mass General, uh, he said, "I really wanna know how knees move after I put them in." And that i- is, that was 1988. Uh, that's when this particular quest, uh, got underway, and it, it, you know, it started off with just answering questions of, of how does, how do things move, and do they move the way they were designed, and that sort of thing. I think we, we learned a lot, and that mission, uh, has expanded over time from what's going on to how do we optimize. And, uh, you know, in, in my transition from university faculty to now, you know, startup founder, it's exactly the same mission. It, it's just a different vehicle, uh, to, to have that impact, uh, you know, that I, I think both Dean and I share is, is, uh, you know, we want patients to, to benefit from the treatments they get, uh, to the maximum amount, and so how do we do that?

Joseph M. Schwab 15:12

So, uh, you, you mentioned, you know, kind of moving into this founding role, and, uh, you d- the two of you represented ODI at the AHF. But my understanding is that your founding group is larger than just the two of you. You've got a few other members of that founding group. Can you tell me a little bit about that and how, how that group came together?

Scott Banks 15:33

Yeah, you bet. So, uh, yeah, th-this is, uh, serendipity at its best. So i-in the, in the fall of, of '22, uh, I had, I had made the decision that I was gonna leave the university and, and, uh, see if we could, uh, you know, do something, uh, with, with Dean that, that would let us, you know, get to this clinically practical, uh, examination. And a buddy of mine, John Cox, uh, he's a PhD, um, nuclear engineer who'd been in the, the X-ray imaging business for 40 years, uh, out of the blue, I get a voice message: "Hey, we should get together for lunch." And, uh, we did, and the conversation is basically boiled down to me saying, "Yeah, I think I'm gonna leave the university and, and figure out how to make joint kinematics measurements practical." And John says, "Oh, my partner George Decote and I started a imaging company here in Gainesville in 2019, and we have an FDA-approved all-digital image chain that might be useful." And, and so, uh, you know, it was like, holy cow. And so, so there's, uh, you know, amongst our founding group, um, the, the hardware experts were already here in Gainesville, uh, with FDA-approved image chains that we have subsequently adapted, uh, to work on the, the C-arm and the, and the orthopedic, um, application space that we're interested in. And then on the business side, I had, in a separate project, uh, been working on a gait modification therapy, so basically very funky shoes, um, that, uh, we had, uh, gotten together with a couple of, of industry veterans, uh, Don Running and Dan Justin, who had a company called Exodus New Ventures, uh, and they had been involved in, um, you know, helping us form and fund and, and get that company going. And so when we conceived of doing ODI, I said, "Hey, Dan and Don, take a look at this, and any interest in that?" And, and, you know, yes. And, and so that's, that's kind of the folks that you see on the masthead today is, uh, you know, the imaging side, the business side, and then, you know, Dean and I providing the, the need and, and some of the ideas on how to do things.

Joseph M. Schwab 18:13

Hmm. So before the two of you built ODI, you, my understanding is, had spent, uh, the better part of, uh, you know, two decades, um, reviewing or kind of, uh, studying sort of every major imaging or navigation system out there, from standard C-arms, robotics platforms, navigation systems. Um, e- either one of you who wants to address this, can you walk me through that journey a little bit and help me understand what kind of made you move on from one system to the next sort of over and over?

Dean Cole 18:53

Well, certainly from a surgeon's end, it's easy. Uh, just the inadequacies, the, uh, failures that occur, uh, from what we had to work with. Uh, limited field of view, trying to make that work, uh, one led to more radiation, uh, than you'd like, uh, and, uh, a lot of, uh, guesswork. I added nav to that, and then I ended up with, uh, dueling inputs and trying to make a decision on which one was right, uh, which one to trust. Uh, even, uh, used, uh, robotics didn't really appreciate the, uh, real change in footprint in the operating room with that device and believe that, uh, 2D imaging is, uh, what we need for doing, uh, accurate, uh, hip replacements. Uh, so in the gist, uh, just, uh, the failures that occur with what we had to, uh, work with at that time

Joseph M. Schwab 19:51

And, and Scott, you worked with Mako specifically, um, in the robotic space, is that correct?

Scott Banks 19:59

Yeah. So, uh, uh, w- shortly after I joined the University of Florida, uh, it was either late 2004 or two-- early 2005, uh, I had, uh, Roni Abovitz and Denny Hagag, so the two founders in my office on campus opening a laptop and saying, "Here's our vision, and, uh, can you get involved with us on, on the implant design side of this?" So I was not involved in the, the robotics development part of it. I was there to contribute, uh, knee arthroplasty design, uh, input. Uh, but that was, you know, the folks that remember the original all-black robot arm, uh, you know, it was, it was that era, uh, that, uh, that we got involved and then, uh, you know, through that worked with their surgeon, uh, designers, guys like, uh, Martin Roche, uh, Stefan Kreutzer, and, uh, who have been friends and, and collaborators for, you know, since. Um, but that was a great experience. And, uh, I, I also had the ability to work with other companies, uh, because of our ability to, to do these kinematic analyses. Uh, I, I was able to work with a lot of companies to document how their implant designs were working in various patient groups, and in some cases that led to opportunities to contribute to other knee replacement designs as well

Joseph M. Schwab 21:30

And so Dean mentioned sort of moving from one system to another because of its inadequacies, but I, I know a lot of our listeners, uh, are very familiar with Mako as a system. And so I, I wanna ask you, Scott, what does a system like that do really well?

Scott Banks 21:50

Yeah. So I think it, i- that and, you know, there's a, there's a whole myriad of, of other systems that probably are, um, similar in, in what they offer. I, I think they offer the ability to do exquisite planning. So many systems that are based on three-dimensional imaging preoperative, uh, allow you to, uh, do a great job capturing the geometry of, of that joint, uh, whether it's a, a shoulder, knee, or a hip, uh, and to plan a procedure that then the robotic side allows you to execute very accurately. Uh, and w- today the, the planning side is probably advanced e-even more, um, than was possible, you know, when we, when we started with, with just the, uh, the 3D imaging. Um, but what we consistently heard from the, uh, you know, from that robotic experiences is that the planning's great, the nav and, and the cutting is great, but we don't know what target to aim at. And, and so what was lacking there is the, the, the demonstrated relationship between what you have in the OR on the table as you're putting that arthroplasty in and how that patient performs a year post, right? So, so our, our, our ability to achieve a target was really excellent, uh, with those systems, but the target was ill-defined. And, and so that, that really feeds into the, you know, ODI's desire to contribute on the characterization side of here's how a patient is, um, you know, how that joint is performing during daily activities preoperatively, and then with our system or others measure what you do intraoperatively and then characterize postoperatively and, and hopefully through that set of objective quantitative information, uh, you can really learn how to optimize for that patient phenotype and, and, and achieve, you know, those uniformly good outcomes.

Joseph M. Schwab 24:13

So I, I do wanna move a little bit to the product specifically, but bef- right before we do that, you, um, uh, the way I remember you framing your pitch at the Shark Tank at AHF is that kind of a little bit of what you're saying right now. Surgeons plan the surgery well, and they can confirm the results afterwards with imaging, but that middle step of actually doing the surgery is where picture maybe gets a little fuzzy. No, no pun intended, I suppose. Um, why do you think, uh, that that middle step has been the hardest one to crack? And, and Dean, maybe I'll ask you

Dean Cole 24:56

No, I think execution of a plan, and sometimes that plan is in 3D that you've obtained from a CT and a planning program. But the ability to execute it, uh, requires accuracy that's hard to perform with a, a smaller, uh, field of view. So having that larger field of view, I think is very important. But there's some other additions that, uh, also are important part of that product. One, we decrease the amount of radiation necessary by having a video camera in the collimator so our X-ray tech can accurately align the pelvis through a grid on the bottom of the table, or he's using video to line that up. So we have a perfect, uh, positioned, uh, pelvis each time. So instead of taking the normal three to five shots, uh, to get that alignment, uh, that's not necessary. So instead of pushing the limits and, uh, accepting a AP pelvis not operating in the anterior pelvic plane, uh, we don't have to do that. Also, the increased field of view allows alignment of the femurs in a manner that we can accurately depict offset. Femoral offset is impossible to, uh, measure with a small field of view accurately. So that opens up the ability to not only be more efficient with radiation, but also to be more accurate. And with that accuracy comes the workflow. We don't have to change the workflow. We have a C-arm that's normal footprint that doesn't interfere with that at all in the operating room as well. So you hit all four categories that we would like to as far as a device that can help you with surgery, not slow you down, but offer your patients, uh, more accurate, more reproducible, uh, outcomes.

Scott Banks 26:57

you know, the, The reason this hasn't happened before, I think in, in large measure is because it's really hard to change the imaging equipment itself, right? If, if you look across the, the, the marketplace of, of surgical C-arms, uh, there's, you know, nine-inch image intensifiers, 12-inch image intensifiers, and now there's 12-inch square flat panel detectors. Um, and I, I think it's fair to characterize that most of those systems are optimized for vascular work. That's the biggest part o- of the C-arm market and, and that the, uh, the needs of the orthopedic surgeon for things like anterior hip arthroplasty, those voices weren't loud enough or economically consequential enough to move the, the big players into providing the same size imaging that's used in the clinic. And, and so for our, our mission to do kinematics, having a big detector was st- w- was absolutely a requirement because we wanna see joints in motion. You need a lot of real estate to do that. And, uh, when we started this, uh, you know, there, there was a lot of excitement, you know, "Yeah, we're gonna do kinematics," and that kind of stuff. And, and, and I think, you know, Dean more or less said, "We'll get there, but I want that detector in my OR for anterior hips tomorrow." And, and so he immediately realized that, that, you know, this, this componentry that we were putting together for the longer term vision could have immediate value, uh, for procedures he was doing now. Um, and it was because we were really changing the imaging chain that gave us the opportunity to do that

Joseph M. Schwab 28:58

And you base this, I mean, y-y... the, the hip guide software that comes with the ODI, the 1.0 software, I think got its FDA clearance and you started shipping it, uh, a-almost a year- or just a little over a year ago. Is that right?

Scott Banks 29:16

That was last fall. Yeah

Joseph M. Schwab 29:18

And so after so many years of your work sort of culminating towards this and putting a, a product out on the market like that, um, w- what is, what does getting there actually feel like?

Scott Banks 29:37

I, I'll, I'll let Dean, uh, give his impression. For me, it's, it's very incremental. Uh, it, it, you know, it, it's, it, it-- wh-when you get your first journal paper published, right? It's like, "Yeah." and, and, and, and, and I think this is, at least in my mind, quite analogous, is it's a step. You're really glad to be, uh, you know, at that step. Uh, but you realize how far there is to go that, you know, the, the celebration is pretty brief, and you just get back to work

Joseph M. Schwab 30:10

Is that your experience, Dean?

Dean Cole 30:13

Yeah, I would say it's a small bridge that then opens you up to a very new and bigger frontier as w- uh, it, uh, has its own challenges and new challenges. Uh, that's the way I would look at it. We have a, a long way to go. The, the best part about it for me is the, uh, the journey, uh, not so much the destination. But to be able to work with a team, uh, with Scott and, uh, some journeymen from Scott, uh, to, uh, uh, solve a, a good problem, I, I think is, you know, just a great opportunity and, uh, great, uh, for my, uh, career and wellbeing

Joseph M. Schwab 30:55

So I kind of mentioned this detail at the beginning in the introduction, but I think this is something that a lot of surgeons are gonna care about, which is your SODI platform is really built to work on the very standard GEC arm imaging equipment that's in a ton of operating rooms, uh, certainly around the US. It's not a whole new machine, as you talked about, that they have to buy. And was that what-- You mentioned some of the advantages of that, which is understandable. Was that a deliberate call from the beginning, or was that something that you came to over a period of time, trial and error maybe?

Scott Banks 31:36

Yeah. It, it was fr-from the very beginning, uh, a decision that we made, first of all, because our, our hardware partners, you know, John and George, uh, had a company called Imaging Engineering. Uh, they already knew how to do these retrofit imaging systems, um, in the special procedures rooms, the, the radiology and fluoroscopy rooms, the R and F rooms. Um, so that model already existed. When we said, "Hey, we wanna do stuff in the orthopedic space," and with a, a imaging system that has novel capabilities, you look at, okay, a fully de novo set of, uh, you know, imaging systems is millions and millions of dollars and factories and years to develop and, and get through regulatory, uh, uh, approvals. Whereas we could leverage the fact that there's an existing model of retrofitting and that our target market is served by, as you mentioned, uh, there's-- we estimate 22,000, 23,000, uh, of these OEC 9800, 9900s, um, many of which are, are being determined as end of life. So the, uh, the platform for us to build on a-as our first product, right? So S-ODI, surgical ODI, um, is, uh, an opportunity for us to get our imaging system, our software and capabilities into the surgeon's hands as quickly as possible. You know, that, that allows ODI to do this as a company, um, with a, a pretty modest, uh, investment, uh, to, to get there and, and to get commercial. So it, it was a, a path where all these things came together that said, this is, uh, you know, a, a good way to go. And, and so, you know, that's, that's how we've started. We have, uh, initial designs of completely novel systems, uh, in, in the works that we hope people will have learned about ODI as, "Oh, they upgraded my old OEC, uh, and let me see what they have, you know, that they've created, uh, brand new." Um, but we thought that that trajectory, uh, would, would be beneficial for everybody. Get the products out there, uh, become a, a going concern as a company, um, and, and then build into those, those larger capital outlays of, of novel equipment.

Joseph M. Schwab 34:16

So Dean, is there something that actually operating with this product in early cases has sort of taught you about what you do that maybe data from the lab, Scott's lab, um, couldn't have shown you?

Dean Cole 34:33

Oh, I think so. Just the practical aspect, uh, the ability to be confident that, uh, the X-ray, if positioned right, is the ground truth. It's the best way I'm gonna follow the, uh, surgery. Uh, so I can plan, I can execute, and then I can confirm that all in the operating room. It's a, a very good feeling as a surgeon leaving the operating room knowing that, uh, you know, you've got it just right. Uh, and, and being consistent about that, uh, knowing where your offset is, your length, your acetabular inclination, center of acetabulum, inversion, all those things are, are knowns. Uh, and you feel, you know, I, I think from that, then you're looking for more challenges. So the next is femoral version. What do we need to know about that? What do we need to know its equation and combined version? So it opens up new avenues to explore. Uh, the-- is another, you know, way to look at it. Efficiency and accuracy all improve, less radiation. But, uh, to me, uh, I'm most excited about new areas that I can concentrate on now that, uh, the basics are, uh, a given

Joseph M. Schwab 35:49

And so you kind of mentioned, you know, this whole conversation sort of started around knee kinematics, but really the first procedures you're targeting, anterior hip is one, and some spine surgery it sounds like. Um, why, why start there? Why start with anterior hip and spine as opposed to, say, knee replacement or shoulder replacement?

Scott Banks 36:11

Yeah. So the, the ultimate trajectory, clinical ODI units, pre and post kinematics, all that kind of thing, we are excited about and committing to-- committed to getting there. But there's-- that's not standard of care today. And, and so, you know, there's not necessarily billing codes and, and, and the whole, you know, practice infrastructure for doing that. And, and so-- and it was Dean's insight that said, "Hey, we can contribute in a meaningful way to anterior hips today with these imaging capabilities we're putting together." And so that was-- it was kind of a no-brainer, um, you know, to focus there first as the means to develop this ecosystem and the capabilities and, and bring the team together with anterior hip as essentially our first suite of projects and products with, you know, knowing that, that the ultimate vision i-is, is to get to some of these other spaces. Um, one of the, the next pieces, uh, that we hope to implement on our imaging platforms is the ability, for example, to do very quick, uh, cone beam CT reconstructions, and in doing it in a way that is, uh, very workflow friendly, which we think, to your point, will be advantageous in cases where 3D imaging is commonly used in the surgical milieu today, so spine surgery. Um, and all of these tools that are part of our ultimate trajectory, we hope to deploy them where and when they can be used productively as soon as they're available. And, and so even though, you know, my office is filled with knee stuff, because that's really my passion, um, you know, with this vision in mind of the pieces that we're putting together, the, the software capabilities, the analytical capabilities, the hardware capabilities that along the way we think we can do a lot of nice contributions to various procedures, um, you know, starting with the anterior hip

Joseph M. Schwab 38:29

Hmm. So w-we have a big enough audience, um, of surgeons that I'm certain, completely certain, there's a surgeon listening right now who says to him or herself, "You know, I really trust the imaging I already use, and I'm not really convinced a new system is worth the extra time, hassle, whatever, in the operating room." What would you say to that surgeon?

Dean Cole 39:01

Um, I would say, uh, right away that the efficiency gained by a full field of view is, uh, certainly worth, uh, the change. Uh, also that it's not going to affect the workflow, uh, that if a surgeon is good at reading X-rays, understands the way to position, has a team with him that, uh, can do that, that again, he's just gonna be more accurate and quicker. The other thing to emphasize is the decrease in radiation and decrease in time necessary to get a g- well-positioned X-ray. It opens up the avenue for more accuracy, but also you're al- more efficient, uh, with that. So for me, I, I think it's really easy, uh, to see the difference, um, when you view the full pelvis. Um, that, uh, that will attract, uh, surgeons enough to, uh... Again, all we're talking about is, uh, modifying a, uh, imaging device they already have

Joseph M. Schwab 40:09

And, and speaking of that, so if everything goes the way you want it to over the next five years, what does a hip replacement look like at that point that it doesn't look like today?

Dean Cole 40:23

I think planning will be driven by, uh, patient, uh, parameters, uh, maybe in gait, uh, analysis that somebody has a long femoral neck, uh, will have a different, uh, solution. I think also in the operating room, uh, I think we might as well face that we're gonna have less help and less qualified help, so we're gonna need to lean on technology. So patient positioning that's coordinated with our X-ray imaging, I think is gonna be a big part of that in direct anterior hip, uh, because accuracy demands, uh, some fluoroscopic guidance. So for that reason, I, I think that, uh, you know, we're gonna grow, we're gonna get better, but, uh, we're gonna have less help to accomplish that, so technology better catch up, and I think that's a, a driving factor

Joseph M. Schwab 41:16

When I, I wanna go back to Shark Tank for just a moment, because when you pitched your company at Shark Tank, companies that participate in that do it for all sorts of reasons. Um, some are looking for feedback, some are looking for financing, some are looking for, um, all, all sorts of things. You weren't really there looking for financing so much as you were looking for surgeons who were sort of interested in becoming early adopters or maybe partners who would be willing to help you develop this further. Um, I mean, we've got an audience of surgeons, too. What can they do to help? What are you looking for in your customer base at this point?

Scott Banks 42:00

Yeah. We, we want to get our systems out there. We wanna learn how, uh, different surgeons operate different workflows and, and, and thank Anterior Hip Foundation, we've already gotten a fair amount of incoming interest because of Shark Tank, so thank you. Uh, and we, we really appreciate that. But i-in, in our early deployments, uh, with our system beyond, you know, Orlando Health and, and Dean and his colleagues, uh, we've already seen, uh, differences in workflow, differences in how the staff are utilized intraoperatively. Um, and so a whole bunch of learning is going on that, uh, will allow us to customize the product to work in, in various and, and varied environments better, um, how to train that, y- you know, basically get the, the potential of these tools realized in a, a way that, that is, um, you know, can be broadly distributed and, and beneficial. So if surgeons are interested in this, you know, uh, www.orthodriven.com, scott@orthodriven.com, uh, we are eager to engage, uh, and see what the interests are and hopefully provide, uh, capabilities that allows surgeons to treat their patients with, with better accuracy and, and get better results

Joseph M. Schwab 43:37

And I can make sure that we put, um, orthodriven.com in the description below this video or as part of this audio podcast, um, so our, our users can certainly find it. Um, I, I do have a few kinda closing questions for you guys, um, because at, at your stage in your careers, um, many people are just trying to protect what they've already built, not necessarily risking what they've built on something new. So you both, um, sort of fall into that category. What does it actually feel like personally to maybe take that risk?

Dean Cole 44:22

Well, for me, it's been a part of life. Uh, yeah, no, I'm happy to start, Scott. It's certainly been a part of my life from, uh, the beginning of my career and even before that, uh, uh, since high school, actually, developing things. So, um, uh, you know, I picked a mate that was, uh, open with that idea as well. I, I think, you know, so my life has been set up for that. Uh, so it's not, uh, probably a usual type of, uh, career or life, uh, choice, but, uh, that's what's happened. So to me, I'm just doing what I've always done. Look for problems. You fail sometimes Sometimes you find solutions, uh, sometimes you fall flat on your face, but, um, I haven't changed

Joseph M. Schwab 45:12

Scott, how about you?

Scott Banks 45:13

And, and, uh, for me, it, it's-- it, it's... My career has been about the mission. And a-as I, uh, you know, Dean called me in 2022, that's the year that I turned 60. Uh, I had not really thought much, taken stock per se, about, you know, what do I wanna do when I grow up sort of thoughts. And, uh, that-that's when I decided that, uh, to really, you know, pursue the mission and, and have the impact that, that maybe is possible, that changing the vehicle, you know, leaving the, leaving the university, starting a company, um, would be the best way to achieve that mission. And so I, I think for neither Dean nor I, the idea of, "Oh, I'm, I'm, I'm a particular age, I should slow down or do something like that," is really part of the calculus. Uh, I, I think as, as long as we have the ability to, um, express ideas and explore them, that that's where you're gonna find us. Uh, I, I mean, on Thursday, so today's Saturday morning, uh, we were in the lab together on Thursday, uh, cadaver lab, uh, with the ODI system, doing all kinds of new things, and really excited about what we saw, how it might be useful in, you know, day in, day out surgeries and, and, uh, where we might fit that in the product roadmap. So I, I think, you know, you'll, you'll see here and, and representative of our, our enterprise, um, you know, just in-in-in intense enthusiasm for, "Hey, I think we can make this better. Let's go."

Joseph M. Schwab 47:10

Hmm. Hmm. If there-- And, and Scott, I wanna stay with you for a moment. If, if there-- if you could go back, um, and talk to yourself at the start of all of this decades ago, uh, not the 2022 start, but the, the decades ago start, what's, what's one thing that you know now that you wish you would've known then?

Scott Banks 47:34

Yeah, I, I think I, I've fallen into the, the realization that sometimes you have to, um, follow your mission, which means changing jobs. So I've done that twice, and, and I've been happy, uh, about both. I, I started running a, a research lab at a hospital, and then I moved to a faculty job, and more recently moved, uh, to, to do a startup. Um, and, and i-in the context of a kid that grew up in the, in the '60s, I, I think that vision that you're gonna make fundamental changes in your career path along the way, uh, was not something that was, uh, culturally expected then, and now I think is, is, is a lot more usual. Um, the other piece that has really, uh, been prominent in my, uh, my life of late is I've been involved in the, the medical device world and, and doing implant designs and things now for decades. Uh, I'd always appreciated the, uh, the regulatory environment and, and all of the work that needed to be done in that regulated medical device space. But it always been, um, I, I guess, uh, separate from that. I, I got to contribute ideas and concepts, and I didn't have to do the real hard work. And I, I think now that I'm in that role and seeing the magnitude of, of effort that it takes to take an idea, implement it, do the verification, validation, documentation, and work in this regulated industry, uh, I have a huge appreciation for that, uh, much bigger than in my ivory tower days. Um, and, and I think in terms of my engagement and what I would, uh, counsel students to learn along the way probably would have reflected more and more of that, um, you know, the, the industrial reality as opposed to just, you know, get the math right and, and, uh, y-you know, kind of the technical side.

Joseph M. Schwab 49:50

you, 'cause there are young surgeons and residents listening to this show, uh, fellows, what's a piece of advice that you would give them about combining clinical practice, um, with engineering, genuinely building something new?

Dean Cole 50:15

Uh, I can go on and on about that, but I think it is important, uh, for your career. I think you start with the basics. Uh, you need-- Before ideas are going to amount to much, you really do need to understand the basics of anatomy, biology, and mechanics, and how they work with wha- how they apply to the problems that you're trying to solve. I think that's number one. I think that's, you know, in my day, it was Index Medicus, and, you know, we, we did not do things very rapidly. Uh, nowadays, it's, uh, it's a lot different, so there's, uh, I think you've have some more efficiency to gain basic knowledge. After that, it's an open mind, uh, just, uh, being honest with yourself, being critical of your outcomes, uh, being willing to see the patients, being willing to listen to their problems, uh, being able to put yourself in the hot seat. What should I have done different, uh, for that, uh, particular situation? So I think an openness and understanding, and then you have to take some risk. A lot of things have to be aligned to have a successful product or have an idea, and some of that is patience, but, uh, it's also knowing when to pull the plug that's important. So advice from mentors, I think is helpful, uh, to, uh, help shorten those, uh, that learning curve. But, uh, it takes, uh, a real commitment, uh, and a lot of things have to be aligned just right, uh, with industry too. Uh, you know, the whole-- If you could have a good idea, and if it's not the right time, it's, it's not gonna sail. Uh, so that, that's important, uh, as well. I happen to work in an environment now that is just, uh, ideal for innovation, and as a result of that, I have five new products in the last, uh, couple of years that are, you know, getting ready to commercialize, and part of that is the environment set up from the leadership there, that they're willing to invest in their surgeons. I have a great lab to work in, good staff to work in that environment. Uh, so the-- it's more efficient for me to look at surgical problems and develop, uh, ideas and then to get that, uh, developed, uh, further, uh, through that system. So the system that you work in, if it's important, I think nowadays that will, uh, allow you to get to that point of success a lot quicker. And do understand that as a young surgeon, that you're gonna need to collaborate. Uh, just on your own, it's probably you're not gonna go that far. You need the engineering help. You need, uh, support. The financial side of it is important. A good patent attorney. There's, there's a lot to it, uh, that, uh, are important steps that hard to learn by hard knocks

Joseph M. Schwab 53:06

You- you've both been really generous with your time. I have one last question, and I, I want both of you to, to answer this. Dean, I'm gonna have you answer it first. Um, most of the patients who are gonna benefit from what you guys are putting together probably won't ever know your names or probably won't even know the name of the technology, right? Years from now, um, what's the one thing you want to have actually changed for those patients?

Dean Cole 53:39

Yeah, I think it's very true that from my experience with, uh, good techniques or good devices that I developed, it's, it's 20 years before they're accepted. So, you know, I'm, I'm planting a, a small tree, and I know I'm not gonna benefit from its shade. So that's, uh, you know, I think that understanding is, is unique at, uh, at this age. But, uh, overall, I think to me, the biggest thing that we could help with is, uh, the knee and that, uh, kinematic assessment is a routine part of that evaluation. We need that feedback as surgeons to drive better outcomes. Uh, the number of patients that aren't happy, uh, as a result of going through a major surgery like that is, is too much. Uh, even though there's been very smart people involved in it, I, I think the problem is that it's, uh, difficult to quantify a good outcome and that we're on the right path to that. So we won't see that, um, in our lifetime, I don't think. Uh, we'll have-- I, I guess we'll have some experience with it. Uh, but as far as acceptance, that's probably not gonna happen. But, uh, just the drive is there. We're, we're on our way, and, uh, I think, uh, you know, we're gonna work together until it's done.

Joseph M. Schwab 55:02

Scott, how about you?

Scott Banks 55:05

Yeah, so, so I, I have had the good fortune of standing with people who have a widget that I designed in them, and the feedback that you get, you know, "This thing changed my life," for example, is just so incredibly motivating, uh, that y- you only need a couple of those to basically launch a, a quest. And, uh, you know, I've been fortunate to have that. I, I think with what we're doing with ODI, the, the ideal outcome years from now is, you know, a patient goes, "Yeah, I had, I had a really bad hip or knee or shoulder. I wish I could remember which one it was." That's what we want

Joseph M. Schwab 55:52

That's fantastic. Well, uh, Dean Scott, um, first of all, congratulations on, um, your product, your presentation at the AHF Shark Tank, your victory at the AHF Shark Tank, and, uh, and thank you, um, not only for doing what you do for patients, but for joining me today on the AHF Podcast

Scott Banks 56:16

Our pleasure, Joe. Thanks for the opportunity

Dean Cole 56:18

great

Joseph M. Schwab 56:20

Thank you for joining me for this episode of the AHF Podcast. As always, please take a moment to like and subscribe so we can keep the lights on and keep sharing great content and conversations just like this. Please also drop any topic ideas or feedback in the comments below. You can find the AHF Podcast on Apple Podcasts, Spotify, or in any of your favorite podcast apps, as well as in video form on YouTube/@anteriorhipfoundation, all one word. Episodes of the AHF Podcast come out on Fridays. I'm your host, Joe Schwab, asking you to keep those hips happy, healthy, and imaged