Injuries may be inevitable. Recovery shouldn't be a gamble.
In a single moment, everything changes. Your comeback starts here.
An injury strikes and everything stops: the training, the routine, the plan. Frustration, isolation, and anxiety creep in, along with the two questions every athlete asks.
"How long until I can return?"
"Will I perform the same?"
Too often, scar tissue stands in the way. Temple OrthoBio is developing TX-33, an investigational WADA1 compliant therapeutic designed to prevent scar tissue from forming after joint surgery or injury.
$3.7T
global sports economy by 2030, and athletes are its biggest asset. When they're injured, ticket sales, media rights, and sponsorships take the hit.
Nearly 1 in 32
young athletes suffer a second ACL injury within two years of returning to sport.
65%3
of athletes return to their pre-injury level of sport after ACL reconstruction. Only 55% return to competitive sport.
1 WADA: Dr. Olivier Rabin, Director, Science and Medicine, World Anti-Doping Agency, September 1, 2026.
$3.7T: Oliver Wyman and World Economic Forum, global sports market forecast for 2030.
2 Paterno MV et al., Am J Sports Med, 2014;42(7):1567-73 (PMID 24753238). 29.5% of athletes aged 10-25; female athletes had more than four times the rate of healthy peers.
3 Ardern CL et al., Br J Sports Med, 2014;48(21):1543-52. Meta-analysis of 69 studies, 7,556 athletes.
The problem
Why is scar tissue after surgery or injury such a problem?
Scar tissue that forms after surgery or injury can delay or derail recovery, increase the risk of re-injury, and leave athletes short of peak performance. Joints stiffen. Range of motion shrinks. Careers get shorter. No FDA-approved drug prevents it. That's the gap TX-33 is designed to fill.
Healthy joint tissue
- Strong ligaments and tendons built to carry load
- Resists tearing
- Glides freely through full range of motion
Scar tissue in the joint
- Weaker, and never fully the same as the original4
- More prone to tearing again4
- Excess collagen forms adhesions that stiffen the joint, limit motion and cause pain5
The Human Cost
Tap a button to read each story.
4 years
of training for one Games. One cut, one pop, and the Games go on without you. After an ACL injury, depressive symptoms appear most severe in elite athletes, with the highest risk in the first six weeks after surgery.
Source: Piussi R et al., Orthop J Sports Med, 2022;10(1):23259671211066493
Off the team
For many young athletes, the team is where their closest friends are. An injury can take away the game, the friendships and the sense of who they are. The more a young athlete identifies with their sport, the harder the blow may land.
Source: McGinley J et al., Front Psychol, 2022;13:906300
10 days
of bed rest cost healthy adults in their 60s nearly 1 kg of leg muscle, more than younger adults lost in 28 days. Senior pickleball injuries seen in U.S. emergency rooms have climbed to match tennis. And when the court is where your friends are, an injury sidelines your social life too.
Sources: Kortebein P et al., JAMA, 2007;297(16):1772-4; Weiss H et al., Inj Epidemiol, 2021;8:34; Deck S et al., Front Sports Act Living, 2021;3:653590
The Recovery Science Gap
Zero
FDA-approved drugs designed to prevent scar tissue inside joints after surgery. Treatments exist for symptoms. Nothing targets the root biological cause.
"Fibrosis causes significant pain and dysfunction, and we've never had an easy-to-use drug to prevent it in muscles and joints. TX-33 has the potential to improve outcomes in millions of patients with chronic, acute, and surgical conditions."
Dr. Vinod Dasa, Orthopedic Surgeon, Vice Chair of Academic Affairs, LSU Health. Medical Advisor, Temple OrthoBioAthletes Are Assets
€1,922
a minute. That is what injuries cost clubs in Europe's top five men's football leagues in 2023/24.
No athlete, no product. Protect their health and performance, and you protect the economics.
Source: Howden, Men's European Football Injury Index 2023/24
More athletes, more at stake
16.6 million women and girls play organized football worldwide, up nearly 25% since 2019.
$3B+ in women's elite sports revenue expected in 2026, up 340% since 2022.
Sources: FIFA Women's Football Survey, 2023; Deloitte, April 2026
4 Leong NL et al., J Orthop Res, 2020;38(1):7-12.
5 Usher KM et al., Bone Research, 2019;7:9.
The approach
How does TX-33 work?
An investigational therapeutic, delivered into the joint after injury or surgery, designed to promote normal tissue and stop scar tissue before it forms.
The biological shot clock
Right molecule. Right place. Before time runs out.
The moment a joint is injured or operated on, healing starts a countdown of up to five days. The key to preventing scar tissue is delivering the right molecule to the right area before the biological shot clock runs out. TX-33 is designed to act inside that window.
Robertson LM et al., Reprod Sci, 2019;26(6):724-33; Ghosh N, Guzman R et al., CNS Neurol Disord Drug Targets, 2023;22(5):761-73.
01
Injury triggers healing
Left unchecked, repair overshoots into scar tissue that stiffens the joint.
02
TX-33 acts in the window
An anti-fibrotic compound in a biomaterial, released locally in the joint.
03
Prevention, not treatment
Designed to stop scar tissue before it forms, not treat it after.
04
Back with confidence
Aimed at full range of motion, paired with physical therapy.
The evidence so far
- Tested in peopleIn a double-blind, placebo-controlled trial after abdominal and pelvic surgery, 93%† of patients given TX-33's active compound had no adhesions, vs. 41% on placebo.
- Peer-reviewedPublished in the European Journal of Obstetrics & Gynecology and Reproductive Biology, 2023.
- Now: orthopedicsBeing engineered for the knee, shoulder, and elbow.
† The 93% figure (no adhesions at any abdominal site) comes from a post hoc analysis. The trial met its primary endpoint of reduced adhesions (p = 0.046): adhesions improved in 15 of 15 patients (100%) given the active compound, vs. 5 of 17 on placebo. No serious adverse events were reported, and safety measures did not differ between groups.
Chizen DR et al., Eur J Obstet Gynecol Reprod Biol, 2023;284:180-8. doi:10.1016/j.ejogrb.2023.03.032
"TX-33 is a game changer. I see it being used in every surgery we do."
Leadership
Who is building TX-33?
TX-33 is led by five co-founders across medicine, science, and business. Three of them:
Sanj Singh, MBA
Co-Founder & CEO
More than 20 years of C-suite leadership in biotech and life sciences, and co-founder of three biotech companies. Leads strategy, partnerships, and the I'm Back!™ brand.
Riley J. Williams III, MD
Co-Founder · Chief, HSS Sports Medicine Institute
Chief, HSS Sports Medicine Institute. Orthopedic surgeon at Hospital for Special Surgery. Professor at Weill Cornell. Team physician for USA Basketball, the Brooklyn Nets, NY Liberty, and NY Red Bulls. Served as FIFA 2026 Venue Medical Officer.
Jens Thies, PhD, MBI
Co-Founder & CSO
Scientist and inventor with more than 20 years in radical innovation and 36+ patent families in advanced biomaterials, medical devices, and drug delivery. Former global lead biomedical scientist at DSM Biomedical.
I'm Back!™
Where does the name I'm Back!™ come from?
The questions start before anyone else asks them. Will I play again? Will I be the same? Will my body hold, or give out the moment I trust it? Every day of rehab, the doubt is louder than any crowd I have played in front of.
Then the day comes. I walk back onto the pitch, the court, the field. I take the first step. The first cut. The first jump. The first pivot. The first burst. And I don't feel anything. I know: I'm Back!™
"You practice all your life, and in one second, you cannot do it anymore."
"Just a lot of disappointment. Staying patient has been the most difficult. Can't have it all right now. Committed to the process to get back."
"When you feel good, you see yourself capable of doing many things, but the reality is your knee is healing, scarring, and controlling the thoughts is the most difficult part. Really miss playing, and I want to come back better than before."
Athlete quotes are taken from publicly available interviews and are shown for illustrative purposes only. The athletes quoted are not affiliated with Temple OrthoBio, have not been compensated, and do not endorse Temple OrthoBio or TX-33.
Follow the work
TX-33 is in active development. Get updates on where things stand, or reach out directly.