Orthofix Medical (OFIX) Q1 2026 earnings summary

Executive summary

• Q1 2026 net sales reached $196.7 million, with pro forma net sales up 3% year-over-year on a constant currency basis, reflecting steady execution amid commercial transitions and distributor transitions largely complete in the spine segment.

• Adjusted EBITDA for Q1 2026 was $9.7 million (4.9% of pro forma net sales), down from $11.4 million (6.0%) in Q1 2025, impacted by geography mix and commercial changes.

• Reported net loss was $20.9 million, a significant improvement from $53.1 million in the prior year period.

• Leadership structure in Spine was simplified in April to improve speed, consistency, and commercial focus, with decision-making brought closer to the field.

• Innovation pipeline remains strong, with full-year contributions expected from TrueLok Elevate, Fitbone, and the upcoming launch of Virata in the second half of 2026.

Financial highlights

• Q1 2026 pro forma net sales were $196.4 million, up 2.7% year-over-year on a constant currency basis; reported net sales were $196.7 million.

• Gross margin improved to 70.9% (GAAP), with non-GAAP pro forma adjusted gross margin at 70.7%, up from 70.3% year-over-year.

• Operating loss narrowed to $(14.4) million from $(48.9) million in Q1 2025.

• Cash, cash equivalents, and restricted cash totaled $120.9 million at March 31, 2026, up from $85.1 million at year-end 2025 due to financing activities.

• Free cash flow for Q1 2026 was negative at $(28.3) million, but full-year 2026 is expected to be positive, excluding potential legal settlements.

Outlook and guidance

• Full-year 2026 net sales guidance reaffirmed at $850–$860 million, representing about 5.5% pro forma constant currency growth at the midpoint.

• Non-GAAP adjusted EBITDA projected at $95–$98 million, with about 70 basis points of margin expansion at the midpoint.

• Free cash flow expected to be positive for the full year, excluding potential legal settlements.

• Long-term targets (2026–2028): net sales CAGR of 6.5%–7.5%, mid-teens adjusted EBITDA margin, and ~300 bps gross margin expansion.

• Net sales growth expected at ~5% in 1H and ~6% in 2H 2026.