Shoulder Innovations (SI) Q4 2025 earnings summary

Executive summary

• Achieved transformational growth in 2025, with accelerated adoption of advanced implant systems and expansion of surgeon customer base, solidifying leadership in shoulder arthroplasty.

• Fourth quarter net revenue grew 65% year-over-year to $14.4 million, driven by higher implant system sales and new customer additions.

• Added 134 core and contender surgeons by year-end, a 61% increase year-over-year, with both new and existing surgeons driving growth.

• Hosted record-setting educational events, including national symposiums, which significantly increased surgeon engagement and utilization.

• Strategic milestones included new product launches, a robotic platform partnership, and board expansion.

Financial highlights

• Q4 2025 revenue reached $14.4 million, up 65% year-over-year and 23% sequentially; full-year revenue was $47.3 million, up 50% over 2024.

• Q4 gross margin was 76.7%; full-year gross margin was 76.5%.

• Q4 net loss was $7.8 million (vs. $3.8 million prior year); full-year net loss was $40.4 million (vs. $15.6 million prior year).

• Adjusted EBITDA loss for Q4 was $7 million (vs. $2.6 million prior year); full-year adjusted EBITDA loss was $36.1 million (vs. $11.4 million prior year).

• Cash and cash equivalents at year-end were $124.3 million.

Outlook and guidance

• 2026 revenue guidance set at $62–$65 million, representing 31%–37% year-over-year growth.

• Gross margins expected to remain strong with potential incremental improvements late in 2026.

• Operating expenses and SG&A as a percentage of revenue expected to remain stable, with further leverage anticipated in Q4 2026.

• R&D expenses to remain at approximately 22% of revenue for the next several quarters, driven by investment in robotics.

• Cash burn expected to remain flat through most of 2026, with improvement later in the year.