Sports medicine is one segment of the device industry that may fare well in the post-health care reform world. New treatments aimed at preserving joint structures may protect young athletes from more invasive procedures down the road.

2006's most intriguing Series As reflect VCs' continued emphasis on risk reduction through reprofiling in biotech, and big gains in funding for diagnostics and device start-ups.

The $4.6 billion worldwide market for knee arthroplasty is technologically mature, but it is underpenetrated today and it's still growing at a robust 14% annual rate. Furthermore, changes in demographics and patient expectations have created a large, unmet clinical need: the 50-something year old with unbearable knee pain. Today, that is the focus of a great deal of technological innovation-most of it incremental-on the part of large companies that seek to increase the longevity of devices with wear-resistant materials, and technologies that improve device fit, or the precision of placement and the accuracy of alignment of implants. But recently, and somewhat surprisingly, venture-backed start-ups have also begun to enter joint reconstruction with their own technological solutions. Four new companies believe they've staked out spaces ranging from operating alongside multi-billion dollar companies without facing crushing competition from them, to taking a more head-on competitive posture, and in each case, to make a clinical difference.

In Vivo briefly summarizes the technologies of these recently founded companies: Cerenis Therapeutics, iBalance Medical, NABsys, Pharmaxon, Synthetic Genomics, Theraclion.