Confidential | 2026 Mid-year Update Newsletter

Knee preservation stopped being a niche conversation. It became the conversation.

Here's what we've built so far this year, who we've built it with, and where we're headed for the rest of 2026.

Investor team,

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Tom Gamache | CEO & Co-Founder

MARCH •  LOREM IPSUM

MARCH •  AAOS

New Indications
Secured

A wider set of indications for the Dragonfly — with a deliberate choice to go deep on ACL repair first.
Learn more →

JULY •  AOSSM

JULY •  LOREM IPSUM

Native Root Zerofly Fixation Full Launch

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Learn more →

Native Root No-Tie Fixation Full Launch

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Learn more →

ACL Repair
Platform Launched

Tibial Eminence, Prime, and Prime Zero. Three products, one clear message — surgeons finally have the visibility and control this procedure has always deserved.
Learn more →

The Fork in The Road

From Static to Dynamic:
the Next Fixation Category.

For decades, tissue-to-bone repair has meant a trade-off: commit to a tension, seat it in soft cancellous bone, and hope it holds. Native is building the case for something better.

OLD SCHOOL

Lock it once. Live with it.

The Bone
Cancellous — soft, interior bone.

The Tension
Static — set once, no second chances.

The Surgeon’s Moment of Truth
"I hope I got the tension right."

The Risk It Carries
Suture slippage, pullout, blind commitment.

NEW SCHOOL

Optimize until it's right.

The Bone
Cortical — dense, load-bearing bone.

The Tension
Dynamic — adjustable, even after initial placement.

The Surgeon’s Moment of Truth
"I know the repair is right before I leave the OR."

The Risk It Carries
Retensionable control, verified in real time.

Surgeons don't lie awake worrying about anchor materials — they worry about the one thing they can't undo once the case is closed. Native's platform, led by Dragonfly, is built around removing that blind commitment: cortical purchase for strength, dynamic retensioning for certainty.

The numbers tell the same story the surgeons do.

BY THE NUMBERS

100

Surgeon users, adding roughly 10/month

95%

Multi-use rate — surgeons reach for it again

$1M+

In sales, with 30% MoM revenue growth

1,000+

Dragonflies implanted!

Team Spotlights

Great Products Don't
Build Themselves.

Director of Growth

Joined in January 2026, and it didn't take long to feel his impact. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat.

Connor Hay

Joined in Month 2026, Patrick has kept the commercial engine running all year — the kind of steady, relentless work that doesn't always make the highlight reel but shows up in every number above. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat.

Sales Operations Lead

Patrick Schirk

BEHIND THE SCENES

Native In the Wild.

A few frames from the year — in the OR, in the garage, and around the table.

Leadership workshop — full day working session

Faber Prime Zero ACL repair technique dialing in the tension

"Native Orthopaedics has fundamentally changed the way I approach the treatment of knee pathology. Their innovative technology addresses real challenges that orthopedic surgeons face in the operating room, making complex procedures more reproducible and efficient. More importantly, their relentless focus on solving meaningful clinical problems has translated into better surgical options and outcomes for my patients. As someone who has incorporated the technology into my practice, I have seen firsthand the difference thoughtful innovation can make in advancing patient care. I am excited to continue working with Native Orthopaedics as they redefine the future of sports medicine surgery."

Kyle Borque, MD
Native Pioneer

Interview with Dr. Christian Anderson - Founding Surgeon, Native Orthopaedics

We made access easier this year. Procedure packs launched to reduce friction for surgeons — the Dragonfly included as a built-in delighter, not an upsell.

And customers noticed. We're now seeing stocking orders come in regularly — a signal that Native isn't just being tried, it's being relied on.

Business Model Updates

Easier access, deeper reliance.

Every one of them protects the same idea: that anatomy-preserving repair shouldn't be a compromise.

Protecting the idea,
not just the product.

00

secured patents in 2026

00

total patents in 2026

PIPELINE: LOOKING AHEAD

Video Placeholder. Sizzle video — procedure pack unboxing in the OR, immediate impressions from OR staff.

We set out to redefine the Root repair category. We're doing the same for ACL repair — and we're not stopping there. Our sights are set on the broader market this technology touches.

Surgeons who started with layup cases on the Dragonfly are now bringing it into more complex cases. Confidence builds fast when the tool does what you need it to.

IP