Treace Medical Concepts (TMCI) Q4 2025 earnings summary

Executive summary

• Entered a transformational phase in 2025, evolving from a Lapiplasty-focused to a comprehensive bunion solutions company, now addressing all bunion deformity categories with five instrumented systems.

• Fourth quarter 2025 revenue was $62.5 million, down 9% year-over-year; full-year 2025 revenue grew 2% to $212.7 million.

• Achieved elevated case volume growth in the second half of 2025, driven by new product launches and expanded technology offerings.

• Active surgeon base grew 6% to 3,337, representing 33% of estimated U.S. bunion surgeons, with increased product adoption.

• Adjusted EBITDA for Q4 2025 was $6.2 million; full-year adjusted EBITDA loss narrowed to $3.9 million from $11.0 million in 2024.

Financial highlights

• Q4 2025 revenue was $62.5 million, down 9% year-over-year, mainly due to a shift toward lower-priced products.

• Gross margin for Q4 2025 was 80.6%, nearly flat compared to 80.7% in Q4 2024; full-year gross margin was 79.8%.

• Q4 2025 net loss was $9.4 million ($0.15 per share); full-year net loss was $59.0 million ($0.93 per share), slightly higher than 2024.

• Full year 2025 adjusted EBITDA loss improved to $3.9 million from $11.0 million in 2024, a 64% improvement.

• Cash used in 2025 was $27.3 million, a 46% reduction from 2024; cash and equivalents stood at $48.4 million at year-end.

Outlook and guidance

• 2026 revenue guidance is $200–$212 million, representing a decline of 6% to flat versus 2025.

• Revenue declines expected until Q4 2026, when growth is anticipated due to accelerating case volumes and new product launches.

• Adjusted EBITDA loss for 2026 expected in the range of $4–$6 million.

• Cash burn projected to decrease by approximately 50% in 2026 compared to 2025.

• Guidance reflects continued case volume growth, offset by product and price mix headwinds.