Month: March 2022

Exactech Celebrates 15 Years of Clinical Use: Equinoxe® Reverse Shoulder

The Equinoxe® reverse prosthesis is a groundbreaking implant that has served as the platform for several additional innovations in reverse shoulder arthroplasty.

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Exactech Equinoxe Shoulder System

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GAINESVILLE, Fla. (March 31, 2022) – Exactech, a developer and producer of innovative implants, instrumentation, and smart technologies for joint replacement surgery, commemorates today the 15th anniversary of the launch of the Equinoxe® reverse prosthesis, a groundbreaking implant that has improved clinical outcomes and reduced complication rates1 relative to published meta-analyses2– and has served as the platform for several additional innovations in reverse shoulder arthroplasty.

One of the first systems to utilize a platform humeral stem, the Equinoxe reverse builds off all of the Equinoxe humeral stems, providing intraoperative flexibility and enabling surgeons to convert a well-fixed stem to a reverse without stem removal. From a biomechanical standpoint, this system was designed to lateralize the deltoid through the humerus to increase the deltoid moment arm length and create a more deltoid wrapping around the greater tuberosity, which aids stability, and better tensions the remaining cuff, to improve active rotation.3,4

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...Now our shoulder team is using what we’ve learned to develop new products, such as innovative new options for proximal humeral bone loss, machine learning technologies that pull from the vast collection of data gathered over 10+ years, and new Active Intelligence® solutions such as ExactechGPS® navigation and preoperative planning for the humeral and glenoid sides...
Joseph Zuckerman, MDA founding shoulder design team surgeon
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“The Equinoxe reverse system was designed the right way from the very beginning,” said Joseph Zuckerman, MD, a founding shoulder design team surgeon. “Biomechanically, it has performed so well that the original design is still in clinical use, and it has helped more than 140,000 patients. Exactech’s focus is on solving unmet clinical challenges, and the Equinoxe system is a perfect example of that. Now our shoulder team is using what we’ve learned to develop new products, such as innovative new options for proximal humeral bone loss, machine learning technologies that pull from the vast collection of data gathered over 10+ years, and new Active Intelligence® solutions such as ExactechGPS® navigation and preoperative planning for the humeral and glenoid sides.”

The team designed the Equinoxe reverse prosthesis beginning in 2005 by first optimizing Dr. Paul Grammont’s reverse shoulder prostheses using some novel computer modelling techniques.5 By independently adjusting humeral neck angle, glenosphere center of rotation, glenosphere thickness, glenosphere offset, and humeral liner constraint, the Equinoxe design team was able to identify the combinations of parameters that minimized scapular impingement, maximized range of motion, and maximized stability – all while maintaining a medialized center of rotation near the glenoid face.5 This new Equinoxe design leveraged Dr. Grammont’s revolutionary medialized center of rotation fixed-fulcrum design concept.

“After 15 years of clinical experience, I am exceedingly proud of the positive outcomes that this product has achieved, which are well documented in 180+ published peer-reviewed journal articles,” said Chris Roche, Sr. Vice President, Extremities. “Because of these successes, we have continued to advance the art of innovation and science, by expanding our product offering over the past 15 years to build a complete line of shoulder arthroplasty solutions for straightforward to challenging cases. We were the first to offer several other products – reverse augments, a biomechanically designed humeral reconstruction system, the first platform shoulder navigation system, and a machine learning-based patient-specific outcome predictor. Congratulations to the surgeon team and product development group for this significant milestone.”

Key research highlights include:

  • Low instability rate of <1.0%.1
  • Low aseptic glenoid loosening rate of <1.0%.1,6
  • Very low aseptic humeral loosening rate of <0.5%.1,6
  • Acromial/scapular fracture rates of 1.8% at 2-year minimum follow-up.1,7
  • Scapular notching rates <15% at 5-year minimum follow-up.8
  • 78% convertibility from anatomic to reverse shoulder.9 >34% of patients achieve ceiling scores with the Simple Shoulder Test.10
  • 80% of rTSA patients achieve internal rotation to the sacrum or higher.11
  • 97.3% clinical survivorship at 8-year follow-up.12

Visit exac.com/15years for more information.

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About Exactech

Exactech is a global medical device company that develops and markets orthopaedic implant devices, related surgical instruments and the Active Intelligence® platform of smart technologies to hospitals and physicians. Headquartered in Gainesville, Fla., Exactech markets its products in the United States, in addition to more than 30 markets in Europe, Latin America, Asia and the Pacific. Visit staging.exac.com for more information and connect with us on LinkedIn, VuMedi, YouTube, Twitter and Instagram.

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  1. Aibinder, W. et al. Risk Factors for Complications and Revision Surgery after Anatomic and Reverse Total Shoulder Arthroplasty. J Shoulder Elbow Surg. 2021 Nov;30(11):e689-e701. doi: 10.1016/j.jse.2021.04.029.
  2. Zumstein MA, et al. Problems, complications, reoperations, and revisions in reverse total shoulder arthroplasty: a systematic review. J Shoulder Elbow Surg. 2011 Jan;20(1):146-57.
  3. Roche, C. et al. Impact of Inferior Glenoid Tilt, Humeral Retroversion and Bone Grafting on Muscle Length and Deltoid Wrapping in Reverse Shoulder Arthroplasty. Bulletin for the Hospital for Joint Diseases. Vol. 71(4):284-93. 2013.*
  4. Routman, H. et al. Reverse Shoulder Arthroplasty Prosthesis Design Classification System. Bulletin for the Hospital for Joint Diseases. Vol. 73: S5-14. 2015.*
  5. Roche, C. et al. An Evaluation of the Relationships between Reverse Shoulder Design Parameters and Clinical Failure Modes. J Shoulder Elbow Surg. Vol. 18: 734-741. 2009.*
  6. Parada, S. et al. Comparison of Complication Types and Rates Associated with Anatomic and Reverse Total Shoulder Arthroplasty. J Shoulder Elbow Surg. 2021 Apr;30(4):811-818. doi: 10.1016/j.jse.2020.07.028.
  7. Routman, H.D. et al. Acromial and Scapular Fractures After Reverse Total Shoulder Arthroplasty with a Medialized Glenoid and Lateralized Humeral Implant: An Analysis of Outcomes and Risk Factors. J Bone Joint Surg Am. 2020 Oct 7;102(19):1724-1733. doi: 10.2106/JBJS.19.00724.
  8. Simovitch R, et al. Impact of scapular notching on reverse total shoulder arthroplasty midterm outcomes: 5-year minimum follow-up. J Shoulder Elbow Surg. 2019 Dec;28(12):2301-2307. doi: 10.1016/j.jse.2019.04.042.
  9. Crosby, L. et al. Conversion to reverse total shoulder arthroplasty with and without humeral stem retention: the role of a convertible platform stem. J Bone Joint Surg Am. 2017 May 3;99(9):736-742.
  10. Schoch, B. et al. Characteristics of Anatomic and Reverse Total Shoulder Arthroplasty Patients Who Achieve Ceiling Scores with 3 Common Patient Reported Outcome Measures. JSES. In press. 2022.
  11. Rohman, E. et al. Factors Associated with Improvement or Loss of Internal Rotation After Reverse Shoulder Arthroplasty. JSES. In press. 2022.
  12. Flurin PH, et al. Comparison of survivorship and performance of a platform shoulder system in anatomic and reverse total shoulder arthroplasty. JSES Int. 2020 Jul 27;4(4):923-928. doi: 10.1016/j.jseint.2020.07.001.

*In vitro (bench) test results may not necessarily be indicative of clinical performance.

ExactechGPS, Equinoxe Planning App and Predict+ are developed by Blue Ortho, an Exactech subsidiary, and distributed by Exactech, Inc.

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Media contact

Nancy Walsh
Director, Marketing Communications
nancy.walsh@exac.com

Exactech Announces Key Leadership Changes

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GAINESVILLE, Fla. (March 30, 2022) – Exactech, a developer and producer of innovative implants, instrumentation, and smart technologies for joint replacement surgery, today announced it has formed a new leadership structure. Jeffrey R. Binder, Exactech’s Chairman of the Board, has been appointed Chief Executive Officer of the company. Darin Johnson will continue in the role of President. The changes, which are effective immediately, bring additional depth and expertise to Exactech’s executive leadership team to position the company for continued growth. Binder and Johnson will remain on Exactech’s board of directors.

Binder joined Exactech’s board in 2018. He is a 30-year veteran of the medical device and diagnostics industry, having served in several executive roles, including CEO of orthopaedic product developer Biomet and CEO of transfusion and transplantation diagnostics company Immucor. As CEO of Exactech, Binder will work closely with Johnson and the executive leadership team to drive overall business strategy and introduce new innovations in clinical care. In his capacity as President, Johnson will leverage his nearly 20 years of experience at Exactech to oversee the company’s business units, as well as its Human Resources and Information Technologies functions.

“Following the disruption caused by the COVID-19 pandemic, the orthopaedics market is on strong footing and ripe for solutions that help surgeons improve patients’ lives,” Binder said. “Today’s leadership changes will better position Exactech to address this demand. It’s a privilege to assume the role of CEO, and I’m excited to work with Darin and team, the board, and our partners at TPG to further Exactech’s market leadership.”

“Over the past several years, we have continued to strengthen our position as the innovation leader in shoulder while expanding our product and technology platforms through important product launches across our businesses,” Johnson said. “Throughout my nearly two decades at the company, I have seen this organization evolve, innovate, and grow, always in the pursuit of benefiting our employees and physician partners, as well as the patients we serve. I look forward to working with Jeff and the team to capitalize on the opportunities ahead.”

Exactech has recently launched several important new products. Earlier in March, Exactech announced the issuance of a patent for its Newton™ Knee, a dynamic platform of cutting-edge technology used with forward-thinking implants that are designed to provide optimal balance in a reproducible way. During last week’s American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting, the company featured several new products, technologies and upcoming launches, including the Laser Cage Glenoid, Predict+ and Humeral Augmented Tray, as well as the Spartan Hip Stem, a next-generation, direct anterior hybrid stem.

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About Exactech

Exactech is a global medical device company that develops and markets orthopaedic implant devices, related surgical instruments and the Active Intelligence® platform of smart technologies to hospitals and physicians. Headquartered in Gainesville, Fla., Exactech markets its products in the United States, in addition to more than 30 markets in Europe, Latin America, Asia and the Pacific. Visit staging.exac.com for more information and connect with us on LinkedIn, VuMedi, YouTube, Twitter and Instagram.

*Spartan Hip Stem is manufactured by Signature Orthopaedics and distributed by Exactech, Inc. Predict+ is developed by Blue Ortho, an Exactech subsidiary, and distributed by Exactech, Inc.

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Media contact

Nancy Walsh
Director, Marketing Communications
nancy.walsh@exac.com

New Blog Post: Leveraging Data in Shoulder Arthroplasty

Leveraging Data to Determine Risks for Shoulder Arthroplasty

In our latest blog post by Moby Parsons, MD, he reviews a study regarding the risk factors for complications after TSA and rTSA and how leveraging data can help mitigate the risks for those complications. Click the button below to learn more.

Share this blog post with your surgeons and read others on the Innovations Blog page of our website.

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Leveraging Data in Shoulder Arthroplasty

Leveraging Data to Determine Risk for Complications and Revisions in Shoulder Arthroplasty

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[us_iconbox icon=”fas|fas fa-user-md-chat” style=”circle” size=”20px” iconpos=”left” title=”Contributor” title_size=”20px” title_tag=”h3″ alignment=”left” css=”%7B%22default%22%3A%7B%22font-family%22%3A%22Roboto%22%7D%7D”]Moby Parsons, MD
The Knee Hip and
Shoulder Center
Portsmouth, NH[/us_iconbox][us_separator]

The goal of shoulder arthroplasty is to improve comfort and function for a variety of degenerative conditions. Over the past two decades, the prevalence of shoulder arthroplasty has increased dramatically, and the proportion of reverse shoulder replacements has now surpassed anatomic shoulder replacements accounting for 70-80% of the market.

As the indications for shoulder replacement have evolved and the implants have been engineered to address common modes of failure, so too has the profile of potential complications, both short-term and long-term, that may afflict patients undergoing these procedures.

Shoulder surgeons who engage an increasingly complex array of clinical problems must understand the factors that may negatively impact results and lead to a higher risk of complications. A better understanding of risk factors will help not only educate patients about potential adverse outcomes, but it also leads to improved ways to mitigate complications by addressing the root cause(s) where possible.

A better understanding of risk factors will help to educate patients about potential adverse outcomes and leads to improved ways to mitigate complications by addressing the root cause(s) when possible.
Moby Parsons, MDThe Knee Hip and Shoulder Center
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The Data

Aibinder and colleagues were able to leverage the data from a large multinational clinical registry of anatomic and reverse shoulder arthroplasty to determine risk factors for complications and revision surgery.1 Although based on a single implant design, this registry uses a standardized data collection method across centers and provides long-term follow-up on large cohorts that provide for robust analysis of both patient-specific and implant-specific risk factors for intraoperative or post-operative complications.

Interestingly, while intraoperative complication rates did not differ between ATSA and RTSA, post-operatively ATSA patients had nearly double the revision rate of 5.7% vs 2.4%. Principle complications for ASTA included subscapularis failure and aseptic glenoid loosening, while those for RTSA included acromial/scapular spine fracture reactions and instability.

Risk factors for complications intraoperatively included female gender and prior shoulder replacement surgery, while those for post-operative complications included younger age, prior shoulder surgery, and inflammatory arthritis. Implant-related risk factors for revision shoulder replacement surgery included increased retroversion, larger humeral liner offset, and larger glenosphere.

Key Findings

These findings may indicate more difficult underlying pathology that required implant configurations creating more lateralization and distalization to achieve stability.  The use of augmented baseplates and glenoids was associated with greater intraoperative complications as was increased operative time. All of these suggest that as the complexity of the case increases, so too do the potential risks for adverse outcomes.

A key finding across this study, and one that has been reported in other outcome studies of RTSA, is the association of prior surgery with risk poor outcomes.1 In the current study, prior surgery was an independent risk factor for intraoperative and post-operative complications and revision surgery. This suggests that surgeons must carefully consider this variable when counseling patients about arthroplasty and consider the implications of the prior surgery on the reconstruction complexity both with regard to bone and soft tissue.

Another key finding of this study, though one that requires longer term follow-up to confirm, is that the revision rate of RTSA is now less than that of ATSA which is counter to what people initially predicted as RTSA started increasing in utilization. While this is a testament to the utility and durability of RTSA, it must also be noted that the specific complications of acromial/scapular spine fractures and instability can be very difficult to treat.

*Read complete study: Risk factors for complications and revision surgery after anatomic and reverse total shoulder arthroplasty

Leveraging Data

As our planning and navigation tools become ever more sophisticated and may eventually be able to include information on bone density and fracture risk, the hope is that we will be able to reduce the incidence of these problems by leveraging data to improve patient outcomes.

 

Reference:

  1. Aibinder W, Schoch B, Parsons M, Watling J, Ko JK, Gobbato B, Throckmorton T, Routman H, Fan W, Simmons C, Roche C. Risk factors for complications and revision surgery after anatomic and reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2021 Nov;30(11):e689-e701. doi: 10.1016/j.jse.2021.04.029. Epub 2021 May 5.

 

Moby Parsons, MD, practices at the Knee, Hip and Shoulder Center in Portsmouth, N.H., and is a member of the ExactechGPS® design team. He trained at the University of Pittsburgh where he performed a research fellowship in shoulder surgery; his clinical research on tendon transfers won the Neer Award. Dr. Parsons received fellowship training at the University of Washington and University of New South Wales. He is a founding member of the New England Shoulder and Elbow Surgeons and a regional leader in shoulder surgery, including outpatient shoulder arthroplasty.

Further Reading

For additional content on leveraging data for shoulder arthroplasty, read our blog post titled The Power of Data Collection. To access our library of resources for tools and techniques that can improve patient outcomes, visit the landing page of our Innovations Blog.

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Exactech Announces New Patent, Strengthening Company’s Position in Joint Replacement Soft Tissue Management

Exactech Newton Knee

GAINESVILLE, Fla. (March 22, 2022) – Exactech, a developer and producer of innovative implants, instrumentation, and smart technologies for joint replacement surgery, announced today that the United States Patent and Trademark Office (USPTO) has issued U.S. Patent #11,278,338 for the Newton™ Knee, a dynamic platform of cutting-edge technology used with forward-thinking implants that are designed to provide optimal balance in a reproducible way.

“The patent allowance supports the uniqueness of Newton and its ability to maintain a force-controlled environment regardless of the joint gap through antagonist sub-mechanisms,” said Laurent Angibaud, Vice President of Advanced Surgical Technologies at Exactech. “While initially dedicated to total knee arthroplasty, Newton has the potential to be applied to other joints where proper soft tissue management is of paramount importance.”

The patent recognizes Newton’s sophisticated approach to providing critical soft tissue data that helps orthopaedic surgeons execute a total knee replacement with precision. Newton is unique in that it captures active balance data through the entire arc of motion with the patella in place and seamlessly integrates with ExactechGPS® to allow surgeons the ability to visualize a predictive plan through quantifiable insights. This results in a powerful system that is designed for a dynamic, patient-specific and reproducible outcome.

“This recognition is a significant achievement for Exactech,” said Darin Johnson, Exactech President and CEO. “The patent not only protects the commercial potential of the Newton Knee, but it also demonstrates our unwavering commitment to protecting innovation around our entire Active Intelligence® suite of technologies.”

The Newton Knee is in pilot release with limited launch planned for later this year. For more information on Newton and the Active Intelligence portfolio, visit www.AIExactech.com.

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About Exactech

Exactech is a global medical device company that develops and markets orthopaedic implant devices, related surgical instruments and the Active Intelligence® platform of smart technologies to hospitals and physicians. Headquartered in Gainesville, Fla., Exactech markets its products in the United States, in addition to more than 30 markets in Europe, Latin America, Asia and the Pacific. Visit staging.exac.com for more information and connect with us on LinkedIn, VuMedi, YouTube, Twitter and Instagram.

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Media contact

Courtney Adkins
Senior Marketing Communications Manager
media@exac.com

Exactech to Showcase New Technology and Product Innovations at AAOS 2022 Annual Meeting, Booth #3014

Surgeon attendees will be able to experience all the innovations through product demonstrations and an immersive experience in the technology suite.

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GAINESVILLE, Fla. (March 21, 2022) – Exactech, a developer and producer of innovative implants, instrumentation, and smart technologies for joint replacement surgery, announced today the new product innovations and Active Intelligence® technologies to be showcased at the company’s educational exhibit, Booth #3014, at the American Academy of Orthopaedic Surgeons (AAOS) 2022 Annual Meeting, March 22-26, in Chicago, Il. Surgeon attendees will be able to experience all the innovations through product demonstrations and an immersive experience in the technology suite.

“We are pleased to showcase an exciting array of transformative products and technologies this year,” said Exactech President and CEO Darin Johnson. “With our newest products and smart solutions, Exactech is continuing to advance orthopaedics with a rich portfolio of technologies that are designed to help improve patient outcomes throughout the continuum of care.”

Key highlights include:

  • Equinoxe® Planning App (v. 2.0), including the recently 510(k)-cleared humeral preoperative planning feature, which helps augment a surgeon’s decision-making on the humeral side of the joint, and assess range of motion and impingement
  • Newton™ Knee, a dynamic platform of cutting-edge technology with forward-thinking implants designed to provide optimal balance in a reproducible way
  • exacCoach™, a new patient text messaging service that helps surgeons connect with patients before surgery through rehabilitation
  • Spartan Hip Stem, a next-generation, direct anterior hybrid stem, and Logical Cup, a comprehensive hip cup and liner platform system
  • The Vantage® Ankle PSI 3D-printed tibia and talar cutting guides, designed for patients’ unique anatomies and allowing surgeons to pre-plan their cases
  • ExactechGPS® navigation for knee and shoulder arthroplasty, delivering reproducibility through real-time intraoperative instrument guidance1-4
  • Predict+®, a clinical decision support tool that uses machine learning to provide predictions of individual patient outcomes after shoulder replacement surgery
  • Exactech’s Chime mobile application for clinical exchange between surgeons around the world
  • VERASENSE™ wireless humeral load sensor, which helps shoulder surgeons make informed decisions on load magnitude and center of load location in real time

Visit staging.exac.com/Academy for more product information.

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  1. Angibaud, LD et al. Evaluation of the Accuracy and Precision of a Next Generation Computer-Assisted Surgical System. Clin Orthop Surg. 2015.*
  2. Cip J et al. Conventional versus computer-assisted technique for computer-assisted technique for total knee arthroplasty: a minimum of 5-year follow-up of 200 patients in a prospective randomized comparative trial. J Arthroplasty. 2014 Sept.
  3. Alexander T. Greene, Matthew A. Hamilton, PhD, Sandrine V. Polakovic, Nicole J. Mohajer, Ari R. Youderian, MD, Thomas W. Wright, MD, Ira M. Parsons, MD; Paul D. Saadi, MD, Emilie V. Cheung, MD, Richard B. Jones, MD. Navigated vs. non-navigated results of a CT based computer assisted shoulder arthroplasty system in 30 cadavers. Presented at ISTA 2018.*
  4. Piyush S. Nashikkar, MS, DNB, Corey J. Scholes, PhD, Mark D. Haber, FRACS. Computer navigation re-creates planned glenoid placement and reduces correction variability in total shoulder arthroplasty: an in vivo case-control study. Article in Press. J Shoulder Elbow Surg (2019) -, 1–12.

* In vitro (bench) test results may not necessarily be indicative of clinical performance.

Spartan Hip Stem and Logical Cup are manufactured by Signature Orthopaedics and distributed by Exactech, Inc. The Vantage Ankle PSI is manufactured by 3D Systems, Inc., and distributed in the U.S. only by Exactech, Inc. ExactechGPS, Equinoxe Planning App and Predict+ are developed by Blue Ortho, an Exactech subsidiary, and distributed by Exactech, Inc. VERASENSE is manufactured by OrthoSensor and distributed by Exactech, Inc.

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About Exactech

Exactech is a global medical device company that develops and markets orthopaedic implant devices, related surgical instruments and the Active Intelligence® platform of smart technologies to hospitals and physicians. Headquartered in Gainesville, Fla., Exactech markets its products in the United States, in addition to more than 30 markets in Europe, Latin America, Asia and the Pacific. Visit staging.exac.com for more information and connect with us on LinkedIn, VuMedi, YouTube, Twitter and Instagram.

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Media contact

Courtney Adkins
Senior Marketing Communications Manager
media@exac.com

Exactech Powers New Ways for Surgeons to Connect with Patients Through ExacCoach™

Automated patient text messaging service that helps surgeons easily communicate with their total joint patients from surgical preparation through rehabilitation.

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exacCoach Patient Text Messaging Service

GAINESVILLE, Fla. (March 16, 2022) – Exactech, a developer and producer of innovative implants, instrumentation, and smart technologies for joint replacement surgery, announced the initial release of exacCoach™ with an automated patient text messaging service that helps surgeons easily communicate with their total joint patients from surgical preparation through rehabilitation. Powered by Active Intelligence®, the exacCoach suite is designed to decrease office workload and improve patient satisfaction through its robust platform of smart communication technologies and future integrations.

An exacCoach initial adopter, Chris Christensen, MD, of Bluegrass Orthopaedics, commented, “One of my patients, who was about to undergo her second hip replacement told me how much she loved the new communication. She felt confident this was going to be the new way of the future because patients had pertinent, timely reminders that were easy to understand and easy to follow. It makes me incredibly optimistic for the future of the program.”

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...She felt confident this was going to be the new way of the future because patients had pertinent, timely reminders that were easy to understand and easy to follow...
Chris Christensen, MD Bluegrass Orthopaedics
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The exacCoach message stream is designed to inform patients and their caregivers about what to expect before and after their surgical procedure, including words of encouragement, helpful videos, and exercise recommendations. The automated technology can be fully customized to meet the needs of each surgeon and their practice.

“The introduction of exacCoach is an exciting example of Exactech’s efforts to partner with surgeons in ways to make them more efficient, while still prioritizing and elevating the surgeon-patient experience,” Exactech President and CEO Darin Johnson said. “The text messaging platform allows surgeons more time to meet increasing demands, while providing a personalized experience for their patients every step of the way through the journey of care.”

exacCoach is in its initial pilot release with future expansion and integrations planned for later this year. For more information, visit www.exacCoach.com.

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About Exactech

Exactech is a global medical device company that develops and markets orthopaedic implant devices, related surgical instruments and the Active Intelligence® platform of smart technologies to hospitals and physicians. Headquartered in Gainesville, Fla., Exactech markets its products in the United States, in addition to more than 30 markets in Europe, Latin America, Asia and the Pacific. Visit staging.exac.com for more information and connect with us on LinkedIn, VuMedi, YouTube, Twitter and Instagram.

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Media contact

Courtney Adkins
Senior Marketing Communications Manager
media@exac.com