When Tauranga local Jacob* was 21 years old, he was crushed under the weight of a collapsed tree.
The damage was so severe that doctors had to rebuild his hip with a complex surgical implant over the course of numerous surgeries, which ultimately gave him the ability to return to kite surfing and the other outdoor activities he had long enjoyed.
But, this state of normality didn't last forever. After 20 years of wear and tear, the bone of Jacob's hip had started to deteriorate and grow abnormally under the pressure. The problem was that the degradation was so dire that doctors didn't believe a generic off-the-shelf implant would return him to the lifestyle he had grown accustomed to.
Fortunately, in the 20 years it had taken for his hip to degrade, the technology behind implants had come a long way.
At the forefront of this evolution was a Kiwi tech firm called Ossis which specialises in the development of custom-made implants that are an exact match to the requirements of the patient. It was exactly the kind of technology Jacob's doctor felt could make a long-lasting difference to his patient.
Ossis engineers set about designing Jacob's implant using 3D tech to closely match his existing skeleton based on computer modelling of his hip anatomy. This meant that Jacob would eventually receive an implant that perfectly matched the requirements of his body.
The strategy worked. And now, six years later, he enjoys an active lifestyle that still incorporates the odd touch of kitesurfing.
Over the course of an hour-long chat, this is only one of the many patient stories Ossis managing directors Kelvin Hyland and Paul Morrison tell the Herald.
The company has, since its inception 12 years ago, seen 220 successful surgeries incorporate its implant technology.
"Importantly, there have been no implant revisions to date," says Morrison, pointing out that a major advantage of this technology is that it ensures patients don't have to go through numerous corrective surgeries to get the implant right.
"The medical industry is evolving rapidly. Technology, attitudes, the way people are paid, the way insurance companies are involved, everything is changing. And this whole idea of 'my medicine' or 'my treatment' is getting more and more customised."
This extends well beyond implants and also applies to medicine people are taking, Morrison says. Society is steadily moving away from the notion that one dose or one implant is suitable for everyone.
At a time when developed societies are ageing, the custom implant market also presents a huge financial opportunity and is expected to grow from a value of US$47 billion this year to US$75 billion by 2023.
Morrison isn't under the illusion that every customer in need of an implant will need a custom version.
He says Ossis is really trying to provide assistance to those patients with difficult problems and few alternative options to have a high quality of life.
He also makes the point that Ossis specialises on the pelvis, largely because of how difficult it can be to get this right. While knees and other joints are simpler to replace, pelvic damage has long been seen as a challenging repair job.
"It's a difficult space. If we were just making a medical product, we wouldn't have a business. It's about getting a bio-engineer to solve a complex problem."
Morrison says the final product is simply the end result of a surgeon working closely with an engineer to help a patient that otherwise wouldn't have any options without the assistance of this technology.
"It's the whole process of pre-op planning and then the follow-up after the surgery," says Morrison.
While the service offered by Ossis might seem more expensive than the generic alternative, Morrison makes the point that it beats paying multiple times when things go wrong.
"It's more economical to deal with a complex case in its entirety rather than patching the patient up and seeing if it works."
Pointing to a recent example of a patient who had to get four corrective surgeries before finally opting for a custom implant from Ossis.
"They said to us, 'we should have contacted you earlier'. And that isn't their fault. It's because we're just a typical Kiwi business with its head down, getting on with it."
Morrison says that in the last two years he's noticed a shift in the perception among doctors, who were once reluctant to trust custom implants.
"The world has started to open up to the technology," Morrison says.
"Three or four years ago, I'd stand in front of surgeons and they'd go, 'ah no, custom implants always fall out'."
But after 12 years and more than 200 patients, Ossis has collected a series of compelling stories that help to win over doctors who prefer to err on the side of caution.
Building a strong reputation was incredibly important during these initial 12 years, says Morrison. If anything went wrong with any of the early patients, the surgeon community would have immediately lost faith in what Ossis was offering. With any medical device, it takes time to build trust.
"Our market is only starting to appear and mature now," Morrison says, pointing to the fact that more than a decade of groundwork has laid the foundation for the products to now be scaled up.
"Our experience has given us a level of maturity to know who to be working with and how to play the game."
"Before that, we were just the geeks, but now we're more mainstream."
Hyland believes the industry is on the cusp of widespread acceptance, but this doesn't mean the race is over.
"All of this has got us to the starting line, and now the gun's about to go off," Hyland says.
"We need to be right on the front foot. Which is why we're partnering with some big global players, who have reach and scale. A big thing for us is the expansion in Europe and the US."
Hyland explains getting approval to sell in the US is particularly important because it accounts for half of the global orthopaedic market.
"We've met with a consulting firm that helps companies get regulatory approval in the US, we've shown them our strategy and approach, and they've come back saying they love it," he says.
So far the business has largely been funded through government grants, but Ossis now has its eye on a capital raise from private funders.
"We're very confident we can get that funding complete and head on," he says.
"The idea is to be the first to market in the United States."
*Jacob's full name has been withheld to protect his identity.