Twenty-Five Years of Global Private Investment in Pediatric Orthopaedic Start-ups

BACKGROUND: New drugs, devices, and other tools are essential to improving children's orthopaedic care. An often underappreciated aspect of new products is the amount of time and money needed to bring them to the bedside. While grants and other seed money have a role very early in the development of technology by start-ups, the bulk of the expense of such development is borne by private investors. METHODS: We examined a quarter century of early-stage investments in pediatric orthopaedic start-ups and compared them with similar investments in adult-focused orthopaedic companies. RESULTS: Investor backing of pediatric enterprises was much less common, representing only 10% of investments in the field of orthopaedics. Yet, when pediatric companies were supported, the rate at which they acquired subsequent capital and the total amount of capital they raised were comparable with those of adult-focused companies. CONCLUSIONS: Investments in new pediatric orthopaedic innovations from 2000 to 2024 were far less common than adult orthopaedic investments. Our data underscore the unmet challenges of backing start-ups in the field and provide benchmark data against which founders and investors can judge their financial performance. CLINICAL RELEVANCE: The availability of new orthopaedic tools is tied to capital investment in the field's youngest companies. A more complete understanding of long-term trends in the private financing of pediatric orthopaedic start-ups is essential for founders, investors, and policymakers.