Dave Turkaly: Got it. And the update that you put out on the triangular broach, the patent, I imagine that’s – that refers to the core the 3D implants, but I just wanted to get your thoughts on sort of what that means from your intellectual property and the runway that you have?
Laura Francis: Yes. Another good question. So our – we have been able to actually extend our patents on the shape and the trajectory through the end of 2025. But what’s unique about this extension is that it actually will take those patents and extend them further into 2034. So the broach, just to remind you on the procedure, the broach is a triangular shape and it creates the channel in order for the surgeon to actually place the triangular implant and this is something that’s required for the surgeon to do in order to place a triangular implant. And so by receiving this new patents for the broach instrument, it’s extending our patents into 2034.
Dave Turkaly: That’s a long time. Thank you.
Laura Francis: Thank you.
Operator: Thank you. Our next question comes from the line of William Plovanic of Canaccord.
Caitlin Cronin: This is Caitlin on for Bill. And congrats on a great quarter. I was hoping to dig a little bit into the ASP. Can you really talk about your expectations for the rest of the year? How much of a dynamic do you think using a second point of fixation for Granite will be on the ASP going forward? And aside from this kind of product mix dynamic, can you continue your success in maintaining price at ASCs?
Anshul Maheshwari: Yes, I’m happy to take that, Caitlin. So from an ASP standpoint, our procedure ASP varies depending on the type of procedure and the surgeons preference. So when you think about SI joint fusion cases, surgeons generally tend to use three implants. And deformity cases to the pelvis or pelvic fixation cases, we generally see the use of two points of fixation. So three to four implants are used in that case. And then within the degen space with Granite or in the trauma space, you generally see two implants used. So what you’re seeing is just the continued evolution of the portfolio as we continue to penetrate these markets on different use cases. And with the increase in our surgical capacity in the third quarter, in addition to the strong demand for Granite within deformity, we also were able to capture a lot more of the short construct degenerative spine procedures to the sacrum and that’s what impacted the ASP.
And if you recall in our second quarter, we had mentioned sort of that low single-digit decline in ASP, so it played out just the way we expected. As we think about it from a planning standpoint, we generally tend to assume a low to mid-single-digit ASP decline in cost of the procedures, because of just healthcare cost and then we focus on executing to come out ahead of that.
Caitlin Cronin: Got it. And then just to touch a little bit more on competition. It seems like SI joint dysfunction is kind of a growing area – given all of your work on establishing reimbursement in the space, what are you really seeing from a competitive landscape and kind of any new products some companies have seen increased competition from even with your IP extension there?
Laura Francis: Yes, I mean it’s become clear that we’re the market leader in this space. If we look at the market, our estimate when we went public is that our market share was in the high 50% range and we think we’re significantly higher than that at this point in time and I think it’s because of the fact that our name has become synonymous with sacropelvic procedures number one, but also it’s the innovative products. The discussion we just had around patents, I think it’s an important one. Innovative patent-protected products that we have, the clinical evidence that we have provided for this particular space, the educational efforts that we make around these sorts of very specific procedures, and then the reimbursement support that we have here too.
So if you look in our slide deck, that’s on our website, you can get more information on the competitive environment and how we’ve been able to lead the way here. So it’s not just about putting out an SI joint product, it’s about differentiated products, clinical evidence, education and reimbursement support which are – what we pride ourselves on. And then in addition to that, we’re building from there with our pelvic fixation business and with our fragility fracture business.
Caitlin Cronin: Great. Thanks for taking the questions.
Laura Francis: Thank you.
Operator: Thank you. Our next question comes from the line of Samuel Brodovsky of Truist Securities.
Samuel Brodovsky: Hi, thanks for squeezing us in here, and congrats again on a solid quarter. I just wanted to start off with what you saw in 3Q. I know you’re probably are going to break down growth rates by, by product, but did you see the sequential strength in the core SI joint fusion market as well? Was that up from 2Q or was the strength more from Granite and TORQ? And I guess, more broadly, are you seeing any underlying acceleration of momentum in that SI joint fusion market?
Laura Francis: Yes, Sam. Thanks for the question. So as I stated earlier, I really am very pleased with our Q3 performance. It’s another record quarter at 30% – 34% growth in U.S. volume. It just continues to show how strongly we’re performing. And I want to reiterate that we saw strong growth across all of our products. And certainly Granite has been a strong driver of the business. TORQ has been a strong driver of the business as well, but our core business is absolutely critical to showing the sorts of results that we showed in the third quarter. And so I think if you, if you look forward and you think about the underlying drivers that we have for the business, that sort of performance is not limited to the current quarter.
It just really shows the level of execution that we’ve shown here with product differentiation, surgeon education and engagement. The fact that we built a very significant commercial infrastructure with a direct sales force as well as a significant agent force as well. And I also just want to highlight that we continue to increase our surgical capacity to support demand, especially for some of those new products that you mentioned. So our conviction in the, in the demand momentum is reflected in the guidance that we provided for this year. So finishing between $136 million to $137 million which is 28% to 29% growth. So that’s up from the previous guidance of $132 million to $134 million, which was growth of 24% to 26%. So I think, I think that it was a great quarter.
And I think that we have reflected our expectations to finish the year strong in our increase in guidance.
Samuel Brodovsky: Great. That’s helpful, and then just as we think about the short construct opportunity, can you just give us any color on sort of the logistics of how that’s going to happen? Is that going to require new sets and how quickly you should we think about existing Granite users being able to have access to a short construct option in ’24? Thanks.
Laura Francis: Yes, it’s a great question. First of all, no new instrument tray. So to be very clear, it will not require a new instrument tray. And what we’re really trying to do here is to capture the opportunity in pelvic fixation for short construct, also I had mentioned this S1 trajectory when surgeons are performing pelvic fixation, they usually, typically use an S2 trajectory or an S1 trajectory and 60% are S2 and that’s where our current Granite product is being used. The S1 trajectory is where the line extension will be used [technical difficulty]. So it’s a big increase in the ability to fully capture the opportunity in pelvic fixation and also specifically in the degen part of the market. So short construct two to four level constructs where surgeons may want to include pelvic fixation.
