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.

• Ended 2025 with 134 core and contender surgeons, a 61% year-over-year increase, and continued to expand commercial leadership and infrastructure.

• Hosted record-breaking educational events, driving a 40% increase in monthly utilization among participating surgeons.

• Launched new products and entered strategic partnerships, notably in robotics, to address unmet needs and expand market coverage.

• Operating and net losses widened due to increased SG&A, R&D, and costs associated with becoming a public company.

Financial highlights

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

• 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; full-year adjusted EBITDA loss was $36.1 million.

• 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.

• Expect strong gross margins to continue, with potential incremental improvements late in 2026.

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

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