Shoulder Innovations (SI) investor relations material

Executive summary

• Net revenue for Q1 2026 reached $16.7 million, up 65% year-over-year, driven by higher implant system sales, customer growth, and strong surgeon adoption.

• Gross margin improved to 77.7% from 76.9% in Q1 2025, reflecting higher ASPs, operational efficiencies, and cost reduction initiatives.

• Operating loss widened to $9.0 million due to increased investments in commercial expansion and R&D.

• Adjusted EBITDA loss was $7.0 million, compared to $3.5 million in Q1 2025.

• Strategic priorities include expanding surgeon adoption, increasing procedural volume, launching new products, and leveraging outpatient and ASC market growth.

Financial highlights

• Q1 2026 net revenue: $16.7 million (up from $10.1 million in Q1 2025).

• Gross profit: $13.0 million, up 66.7% year-over-year.

• Operating expenses: $22.0 million, up 81.7% year-over-year, mainly from higher SG&A and R&D.

• Net loss: $8.4 million (vs. $4.7 million prior year); adjusted EBITDA loss: $7.0 million (vs. $3.5 million prior year).

• Cash and cash equivalents plus marketable securities: $108.5 million as of March 31, 2026.

Outlook and guidance

• Full-year 2026 net revenue guidance raised to $65–$68 million, up from prior $62–$65 million, representing 37%–44% growth over 2025.

• Guidance reflects confidence in continued growth, with expected seasonal volume dip in Q3 and rebound in Q4.

• SG&A as a percentage of revenue expected to rise in Q2/Q3, then decline in Q4; R&D as a percentage of revenue to moderate late in 2026.

• Cash burn expected to decrease significantly from Q2 onward; sufficient liquidity projected for at least 12 months.

• Investments in R&D and commercial infrastructure are expected to continue, impacting near-term profitability.