Orthofix Medical (OFIX) 2026 CG Musculoskeletal Conference summary

Operational and financial performance

• Achieved strong growth and momentum across all business segments in Q4, with continued expansion in Bone Growth Therapies and U.S. Limb Reconstruction, and improved performance in spine following distributor transitions.

• Delivered eighth consecutive quarter of EBITDA margin expansion and strong positive free cash flow, highlighting scalability and financial discipline.

• Guidance for 2026 includes 5.5% pro forma growth at midpoint, 70 basis points of adjusted EBITDA margin expansion, and positive free cash flow.

• Net sales growth expected at 5% in H1 and 6% in H2, with Q1 impacted by one less selling day and CMS pilot program.

• Since 2023, EBITDA has more than doubled, with free cash flow positivity expected in 2026 after significant cash use two years prior.

Segment strategies and growth drivers

• Bone Growth Therapies expected to outperform the market, with minimal impact from CMS pilot after Q1.

• U.S. Limb Reconstruction to return to double-digit growth in H2 after sunsetting non-core products.

• Spine segment shows improved performance, with channel upgrades completed and momentum building.

• 7D technology is shifting from capital sales to an earn-out model, supporting spine fixation growth.

Channel optimization and commercial alignment

• Long-range plan goals extended from 2027 to 2028 to fully realize benefits of spine channel optimization.

• Over 75% of business now with top 30 distributors, up from less than 50% in 2024, reflecting significant channel consolidation.

• New IDN accounts signed at year-end, setting up for strong performance in 2026 and beyond.