Shoulder Innovations (SI) investor relations material

Market and procedure trends

• U.S. shoulder surgical care TAM, including soft- and hard-tissue procedures, estimated at ~$5B; current focus is shoulder arthroplasty and high-volume specialists.

• Shoulder and knee pain visits are similar in volume, but fewer shoulder surgeries are performed; reverse arthroplasty addresses patients with both arthritis and rotator cuff deficiency.

• Reverse procedures now represent ~70% of shoulder arthroplasty unit volume, with the reverse/anatomic mix stabilizing near 70/30 over the past 3–5 years.

• Patient triggers for surgery include loss of desired arm function and pain severe enough to disrupt sleep.

Implant and procedural technology

• InSet Glenoid addresses fixation challenges in anatomic arthroplasty; published clinical literature extends to almost 9 years with 100% survivorship.

• Integrated instrumentation supports both anatomic and reverse procedures in two trays, versus 6–10 trays cited for larger competitors; lower equipment burden supports ASC use.

• More than 30% of procedures are performed in ASCs; a leading competitor was described as being in the high teens, and the ASC transition pace has roughly doubled.

• ProVoyance uses CT scans and AI-enabled 3D reconstruction for preoperative planning, allowing surgeons to virtually plan procedures before entering the OR.

• A clinical registry includes almost 1,000 patients; initial findings are expected to assess range of motion alongside rates of subluxation and acromial fracture.

Commercial model and growth

• Commercial focus is ~1,800 high-volume surgeons among ~15,000 who may perform shoulder arthroplasty annually; a core surgeon performs >35 cases per year, measured on a rolling 90-day basis.

• The pace of moving surgeons into the core category increased each year from 2023 through 2026.

• This year, 160 surgeon education events were held; two annual national symposiums use surgeon-written agendas and clinically focused content.

• New customer adds doubled their prior-year pace in Q1, exceeded that pace in Q2, and came close to the Q2 level in Q3.

• Arthroplasty accounts currently represent less than half of surgeons' total surgical volume; rotator cuff repair was identified as a potential adjacent market, with both internal development and external technology additions possible.