This Note (i) amends and restates the Amended and Restated Secured Promissory Note of the Company dated June 30, 2014 (the “ Prior Note ”), which is cancelled by renewal, and (ii) incorporates (x) amounts due under Section 2.04(a)(iii) of that certain Asset Purchase Agreement dated June 30, 2014 (the “ Asset Purchase Agreement ”) by and among the Company, the Holder and Stryker Corporation (“ Stryker Corp. ”) and (y) interest accrued through the date hereof in respect of amounts due under the Prior Note and Section 2.05(e)(vii) of the Asset Purchase Agreement.