Exhibit 21.1
Subsidiaries
| Entity Name | State or Other Jurisdiction of Incorporation or Organization | |
| Bacterin International, Inc. | Nevada | |
| Surgalign SPV, Inc. | Delaware | |
| X-spine Systems, Inc. | Ohio | |
| Xtant Medical, Inc. | Delaware | |
| RTI Surgical Holdings Luxembourg SARL | Luxembourg | |
| RTI Surgical – Singapore Pte. Ltd. | Singapore | |
| Fourth Dimension Spine GmbH | Germany | |
| RTI Surgical GmbH(1) | Germany | |
| Pioneer Surgical Technology B.V.(1) | Netherlands |
| (1) | RTI Surgical GmbH and Pioneer Surgical Technology B.V. are wholly owned subsidiaries of RTI Surgical Holdings Luxembourg SARL and, therefore, are indirectly owned by Xtant Medical Holdings, Inc. |