From startup to health tech leader – one entrepreneur shares his scale-up success

“Growing up with an orthopaedic surgeon for a father, there was always a motivation to go into medicine,” Armen Bakirtzian recalls while discussing his decision to sidestep medical school to pursue his passion for technology and engineering. Bakirtzian may have taken a different route into the medical world from his dad, but his mark on orthopaedics has been nothing less than groundbreaking.

Bakirtzian is the CEO and co-founder of Intellijoint Surgical Inc., Canada’s fastest growing tech company in 2020 according to Deloitte Canada. Their flagship product, Intellijoint HIP, is a computer navigation system that assists orthopaedic surgeons with implant size selection and positioning during total hip replacement (THR) surgery. The miniature optical camera provides accurate, real-time measurements while compensating for intraoperative patient movement, which is routine during THR. Today, Intellijoint HIP has been used by surgeons worldwide, including Bakirtzian’s father, in more than 15,000 hip replacement surgeries.

From startup to the operating room

The idea for Intellijoint HIP came from Bakirtzian’s final year capstone design assignment at the University of Waterloo. He needed an innovative engineering project and was inspired by a frank discussion he had with his dad.

“He was forthcoming that surgeons have to rely on their training and their judgement to make decisions during surgery, and that in some cases, patients will have to undergo more costly and involved revision surgery,” Bakirtzian says. “That was the motivation for us to create a technology to help deliver better outcomes for patients.”

After graduation, Bakirtzian and his classmates, now co-founders, Andre Hladio and Richard Fanson, worked closely with surgeons to design a prototype that would inform decision making in the operating room in real-time. But developing a solution to a real-world problem may have been the easiest part of the journey.

“A startup is about getting your problem identified, understanding your customer and developing your prototype,” Bakirtzian says. “Our goal from the beginning was to graduate from a startup and become a real medical technology company.”

For Bakirtzian, that meant making the leap beyond a prototype to produce a real product. The largest hurdle to commercialization was converting the prototype into a regulated medical device which included turning Intellijoint into a certified ISO13485 Medical Device Manufacturer and getting a license from Health Canada and clearance from the U.S. Food and Drug Administration.

With very few medical technology companies in Canada to lean on for expertise, Bakirtzian knew he needed to import knowledge to help him scale.

“Engineering school teaches you how to learn, and we needed to learn from others how to build a medical product,” Bakirtzian says. “We worked with experts from the United States to learn how to turn our prototype into a medical device.”

Remarkably, it took just three years for Intellijoint HIP to go from prototype to being used in its first live surgery — a hip replacement performed at Mt. Sinai Hospital in Toronto. Now ten years old, Intellijoint Surgical is celebrating the launch of their second product, Intellijoint KNEE, offering real-time navigation for knee replacement surgery.

Scaling in Waterloo Region

“Waterloo’s ecosystem is designed for startups. We are here today because of the University — allowing us to pursue work that was interesting and to own the IP [Intellectual Property] so we could commercialize it,” Bakirtzian says. “The difference at the University of Waterloo is its creator-owned IP policy. It is the start of entrepreneurship — generating ideas and owning patents.”

Bakirtzian is betting on the University to continue to generate the skilled talent, bold ideas and IP that make Waterloo Region home to one of the largest concentrations of startups in the world, second only to Silicon Valley. In 2019, he founded the Medical Innovation Xchange (MIX), Canada’s first industry-led hub for medical technology startups that are looking to convert their tested prototype into a product.

Intellijoint founders Armen Bakirtzian, Andre Hladio (left) and Richard Fanson (right).

“As Intellijoint has grown smarter and larger, we feel it is our role to pay that expertise forward,” Bakirtzian says. “There is an opportunity for our company to be a leader in this ecosystem and help smaller, domestic companies successfully navigate the transition from startup to scale-up.”

MIX is filling the expertise void that Bakirtzian encountered early in his journey. With more and more medical technology companies getting their start at Waterloo, Bakirtzian is now able to share his scale-up experience with other MIX Resident founders, extending a valuable service to complement Waterloo’s entrepreneurship ecosystem.

Bakirtzian says, “MIX can be the commercial arm of the research and innovation happening at the University because we have proven we can commercialize medical technology — and do it right here in Kitchener-Waterloo.”

Investing in future talent

With many businesses currently facing economic challenges, Intellijoint continues to invest in future talent, recognizing the significant contributions students can make in the workforce.

“Co-ops have been key contributors to the growth of Intellijoint over the past decade. They have always met and often exceeded our expectations - some even coming back as full-time employees upon graduation. As a local, scale-up medical technology company that continues to grow during this challenging time, we have actually increased our work with Waterloo co-ops.”

Bakirtzian sees Waterloo’s co-op program as a pipeline to talent, adding, “They are our future employees and future leaders. We want to continue investing in this pipeline by providing students with hands-on experience and enabling their development of key skills that will help determine their career path."