Interview with Dr. Brad Estes: 3D Woven Bone

Dr. Brad Estes received his Ph.D. from Duke University in Biomedical Engineering with an emphasis in chondrogenesis of fat-derived stem cells. Before earning his Ph.D., Brad served as the Manager of Research and Development in the spinal orthopedic division of Medtronic, where he oversaw the commercialization of medical devices from conception to market, including the achievement of regulatory approval for class III medical devices. He was also integrally involved in seeking intellectual property protection for the innovative products Medtronic was producing. In addition, Dr. Estes has acted as a consultant for both small and large medical device companies. In total, he has over 25 years of industry experience and holds 55 patents associated with medical devices. In his current role, Brad oversees all aspects of CytexOrtho operations, focusing on growth and success. In this position, he provides strategic leadership and sets the vision and direction for the company. His responsibilities include guiding research and development efforts, forging strategic partnerships, securing funding, and ensuring regulatory compliance. Additionally, he plays a hands-on role in fostering a collaborative and dynamic work culture, driving motivation and creativity among the tight-knit team at CytexOrtho. Brad is a speaker at the Bioprinting Biofabrication for Musculoskeletal Event.

When was the first encounter you had with 3D printing? What was that experience like? What were you thinking at that moment?

Brad: I was a product development engineer working for a large medical device company, and we purchased one of the early Stratasys machines. This couldn’t be ultra-precise, so we printed many parts at 2x and even 3x scale, mainly as an initial feasibility tool for design work. I remember being inspired by the ability to have something to touch and feel as it jumped from the CAD screen to the printer, never thinking that we would be using 3D printing in manufacturing in a relatively short time frame. 

What inspired you to start your journey?

Brad: The cornerstone or the secret sauce to our technology isn’t actually 3D printing; it’s a 3D woven textile. That textile structure was the foundation of CytexOrtho. Still, early in our journey we realized that we had this ideal structure for repairing and regenerating cartilage, but to be successful, we had to add a component to our implant that could repair and regenerate bone. Given the intricate contours of our implant and the need for customizable bone structures, we turned to 3D printing to add this component. It took us a while to find the right 3D printing technology and then develop it, but it turned out to be a perfect solution for our implant to repair diseased and arthritic joints.

Who inspired you the most along this journey?

Brad: This one is easy. It’s Dr. Farsh Guilak. Farsh was my PhD advisor in grad school. Everything I learned about cells, tissues, tissue engineering, regenerative medicine, cartilage, grants (the list could go on…), I learned from him, and I count it a privilege to have been able to work alongside him over the years. Farsh is also why CytexOrtho exists – Farsh’s ability to see the big picture is amazing, and he was the one who connected the dots from what we were doing with research and the potential for translating those basic science ideas in the lab to something that could help millions of patients. He always dreams big, never shies away from challenges, and constantly achieves goals and receives incredible accolades for his contributions to science. He also has an uncanny way of motivating people and promoting excellence – those fortunate enough to be around him constantly strive for it and push boundaries to achieve lofty objectives. Farsh inspired me over 20 years ago to leave a job in industry and do basic science research and continues to inspire the whole team at CytexOrtho today as we reach clinical trials and continue our push to the clinic.

What motivates you the most for your work? 

Brad: The patients. If we look at the US market alone, there are over a million patients under the age of 65 suffering from hip disease without any solutions. Their proposition is to wait many years (on average 7-8 years) struggling with chronic pain and increasing disability until they either can’t stand it anymore or have reached an age where they’re not as active so that a total joint replacement is better indicated. We get calls and messages all the time from patients such as, “I am 37 putting off hip replacements as long as possible. I will be first in line to try this if allowed.” These patients need a better solution, and we’re trying to give it to them.

What is/are the biggest obstacle(s) in your line of work? If you have conquered them, what were your solutions? 

Brad: I hate to say it, but it’s fundraising. Working on a Class III medical device that faces the hardest regulatory path for medical devices (which adds a significant amount of time before any revenue) that’s also in orthopedics and cartilage repair, a sector that has experienced numerous failures over the past two decades, is an obstacle to a lot of investors. Our solution has been to bootstrap it with grant funding, and we’ve done so successfully to the tune of $19M. Grants can only take you so far, though, and we will of course need investment funds to push this over the finish line. To solve this, we are actively seeking investors to join in our current Series A raise, as we are anticipating reaching our next milestone of gathering clinical data the second half of this year.

What do you think is (are) the biggest challenge(s) in 3D Printing/bio-printing? What do you think the potential solution(s) is (are)?

Brad: There are several issues, but I think one of the big ones is cost and scalability. Even with what we’re doing at CytexOrtho, scaling the technology appears doable but expensive. Quality control during the printing process will also play a role in manufacturing success at scale and add to the expense to ensure mechanical robustness, consistency, and repeatability. Better printing technology and more affordable printers will undoubtedly be part of the solution. Fortunately, this field is rapidly changing, and due to the number of great companies and intelligent engineers and scientists (including our own!) working on the problem, successes will happen. Building on these successes and a better, more affordable supply chain will enable us to solve this problem. Necessity will also play a role – if our technology succeeds in the clinic, as an example, we will overcome this obstacle and scale the technology.

If you were granted three wishes by a higher being, what would they be?

Brad:

  • The first wish would be the eradication of disease. So much suffering comes from disease—we see it up close and personal at our company, working on treatments for osteoarthritis. It’s hard to imagine a world without disease, but it sounds amazing!
  • In a world with easy communication, it seems like we’re further apart than ever. I wish for a universal means of communication that’s not so divisive and one that transcends language barriers, enabling people from different cultures and backgrounds to understand and connect with each other.
  • One would be for wisdom. Knowing what to do, say, and act on, not to mention what not to say, not to do, and not to act on, is constantly challenging. Having great wisdom would be a luxury!  

What advice would you give to a smart driven college student in the “real world”? What bad advice you heard should they ignore?

Brad:

  • Telling someone they can be whoever or whatever they want to be is bad advice. While the sentiment sounds nice and that it meshes with an ideal, it’s just not true. It disregards the person’s unique talents, passions, and values and could imply that they should conform to societal expectations or pursue goals that may not align with their true interests, values, and/or strengths. Instead, I would tell them to figure out what they are passionate about, what sorts of things they like to do, and what makes them tick – and do those things!
  • Related to that, once you figure out what you do like, pursue it like crazy. To do that, network even while you’re in school and take every opportunity to learn more about what you’re passionate about. People you meet will see your passion, and most will be more than happy to help you on your journey. You just have to ask. Fifteen seconds of courage to ask is all you need, and you’ll be glad you put yourself out there.

What’s your favorite book you read this year and why? Alternatively, what’s your favorite book of all times you read and why?

Brad: I’m always reading a few books, both fiction and non-fiction, but I’ll focus on a couple that I just finished reading. One is the late Tim Keller’s book, “Prayer – Experiencing Awe and Intimacy with God.” It was a rich walk through a historical understanding of prayer through the eyes of many theological giants like Augustine, Luther, and Calvin. That might sound a bit boring, but it was so well-written that it wasn’t at all. it was just thought-provoking, encouraging, practical, insightful, and a joy to read.

The other book that I recently finished was Patrick Radden Keefe’s, “Say Nothing: A True Story of Murder and Memory in Northern Ireland.” This was a spellbinding read of the violent conflict in Northern Ireland. The book’s strength lies in Keefe’s exceptional storytelling, underpinned by his meticulous research. Keefe has the profound ability to humanize such a brutal part of the Northern Ireland history, which made me empathize with the real people and not just focus on the “big picture.” Overall, the book does a fantastic job of exposing the grim realities of the conflict while preserving the memories of many of the people who were involved in the conflict. It is harrowing and enlightening at the same time – a great read!

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