Shoulder Innovations Q1 Earnings Call Highlights
Shoulder Innovations (NYSE:SI) reported a sharp increase in first-quarter revenue and raised its full-year sales outlook, citing new surgeon adoption, higher utilization among existing customers and progress across its product pipeline.
Chief Executive Officer Rob Ball said 2026 was “off to a strong start,” with the company rapidly onboarding new surgeons, increasing use within its customer base and reaching several product milestones. For the first quarter ended March 31, 2026, Shoulder Innovations reported net revenue of $16.7 million, up 65% from the prior year and 16% sequentially. Gross margin was 77.7%.
Based on the quarter’s performance, the company raised its 2026 net revenue guidance to a range of $65 million to $68 million, representing growth of 37% to 44% over 2025. Its prior outlook called for revenue of $62 million to $65 million, or growth of 31% to 37%.
Surgeon Adoption and Utilization Drive Growth
Ball said the company’s growth strategy remains centered on three priorities: adding new surgeons, increasing penetration among existing surgeon customers and expanding its product portfolio to address unmet needs. He said Shoulder Innovations’ commercial organization continues to focus on roughly 1,800 high-volume shoulder specialists in the U.S.
The company ended 2025 with 134 “core and contender” surgeons, up 61% year over year, and Ball said Shoulder Innovations will update that figure annually. He added that the company is seeing momentum from brand awareness, its proprietary business intelligence platform and productivity gains from commercial leadership hires made in 2025.
Shoulder Innovations also continued to invest in surgeon education. Ball said the company’s Customer Experience and Medical Education team conducted 44 company-sponsored educational events in the first quarter, excluding industry meetings. In April, the company hosted a national symposium in Napa Valley, with surgeon attendance up more than 70% from the prior year’s event, making it the largest symposium since the program began four years ago.
Ball said the educational programs are translating into commercial activity. Among attending surgeons at the Napa course who were not already core or contender customers, more than 70% had either performed their first case with the company’s system, committed to their first case or committed to increasing volume within a few weeks of the meeting.
Total implant volume across core, contender and prospect customers increased 51% year over year in the first quarter to 2,184 units. Ball said the company more than doubled the number of new customers entering its funnel compared with the first quarter of 2025. He also said the core surgeon category was the company’s fastest-growing segment both year over year and sequentially.
Product Milestones Include i135 Launch and N22 Limited Release
Shoulder Innovations advanced several product initiatives during the quarter. Ball said the company began a limited user release of its i135 RFX products early in the first quarter, later expanded the product’s indication to include more complex fractures and recently moved the InSet 135 RFX humeral stem into full commercial launch following expanded clearance from the U.S. Food and Drug Administration.
With the broader label, Ball said the i135 addresses primary, revision and fracture total shoulder arthroplasty cases. He said the product helps the company support nearly the full spectrum of shoulder arthroplasty procedures performed by its surgeon customers in both operating rooms and ambulatory surgery settings.
The company also began a limited user release of its N22 Glenosphere in the first quarter. Ball described N22 as the first product in a new line intended for patients with metal hypersensitivity who may experience adverse reactions associated with metal implants. He said the company views the product as an incremental addressable market and expects to provide more detail on full launch plans in future updates.
Ball also pointed to the company’s clinical data registry, which has enrolled more than 500 patients across anatomic and reverse shoulder arthroplasty configurations. He said the company believes the registry will help build evidence to support its position with surgeons, health systems and patients over time.
Robotics Program Targets 2027 FDA Submission
Shoulder Innovations also updated investors on its robotic surgery initiative with Interventional Systems. Ball said the robotic solution is being designed to integrate with the company’s ProVoyance preoperative planning platform, creating a connected workflow from planning through intraoperative execution.
In March, the company conducted another cadaver lab that Ball said reinforced management’s conviction in the technology for robotic shoulder arthroplasty. He said the session included the full procedure, beginning with a CT scan through ProVoyance and ending with robotic placement of the device in a cadaveric specimen.
Ball said development of the robotic solution is running “slightly ahead of schedule,” with a 510(k) submission targeted for 2027.
During the Q session, Jefferies analyst Matt Taylor asked how the robotic system could contribute to customer stickiness or share gains. Ball said the company is focused on a platform that is “time-transparent” and uses the same surgical techniques surgeons use today. He also said Shoulder Innovations expects to offer a different economic model, describing it as “Robotics as a Service” rather than a capital acquisition. Ball said the robotic system is intended to be portable and provided on an event-by-event basis in a case about the size of a carry-on suitcase.
Margins Improve as Expenses Rise
Chief Financial Officer Jeff Points said first-quarter revenue rose to $16.7 million from $10.1 million a year earlier, driven by commercial expansion and increased adoption of implant systems across new and existing surgeons. Gross margin improved to 77.7% from 76.9%, which Points attributed to improved average selling prices and cost reduction programs.
Selling, general and administrative expenses increased to $18.2 million from $10.5 million in the prior year. Points said the increase was primarily driven by commercial headcount, higher variable selling expenses and professional service fees tied to the company’s transition to being public. However, SG expenses declined as a percentage of revenue from 128% in the third quarter of 2025 to 109% in the first quarter of 2026.
Research and development expenses rose to $3.8 million from $1.6 million a year earlier, mainly due to new product development, including a second milestone payment and development costs related to the robotics partnership.
The company reported a net loss of $8.4 million, compared with a loss of $4.7 million in the prior-year period. Adjusted EBITDA loss was $7.0 million, compared with a loss of $3.5 million a year earlier. Shoulder Innovations had $108.5 million in cash and cash equivalents as of March 31, 2026.
Management Cites Confidence but Notes Seasonality
Points said the updated full-year revenue guidance reflects confidence in continued growth from surgeon adoption, deeper penetration with existing customers and new product launches. He also said the outlook accounts for typical industry seasonality, including lower sequential volumes in the third quarter of 2026.
In response to questions from Goldman Sachs analyst David Roman about whether the guidance was conservative given the first-quarter performance, Points said the company sets annual guidance with “high conviction.” Ball added that management does not see marketplace factors that would fundamentally change its view of the business trajectory.
BTIG analyst Ryan Zimmerman asked about average selling prices. Ball said Shoulder Innovations has focused on improving pricing by targeting centers where the company can achieve higher prices and by improving the commercial team’s ability to navigate negotiations. He said new products made a small contribution to first-quarter average selling prices and could contribute more meaningfully in future years. Points said he expects average selling prices to remain “in this neighborhood” through the rest of the year, while noting some variation is possible.
Ball closed the call by saying the first quarter reflected strength across the business, including revenue growth, margin expansion, surgeon onboarding, increased utilization and product progress. He said the company believes its commercial organization is performing and that the U.S. shoulder market remains large and underpenetrated.
About Shoulder Innovations (NYSE:SI)
Shoulder Innovations (NYSE:SI) is a medical device company focused on the design, development and commercialization of shoulder implant systems and related surgical instruments for orthopedic surgery. The company’s product portfolio includes modular shoulder prostheses, humeral and glenoid components, and instrumentation kits designed to facilitate both primary and revision shoulder arthroplasty procedures. Emphasizing a patient-centric approach, Shoulder Innovations works to offer implant solutions that aim to restore mobility and reduce post-operative complications.
In addition to its core implant offerings, Shoulder Innovations provides comprehensive clinical support and training programs for surgeons and operating room teams.
This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to [email protected].
Where Should You Invest $1,000 Right Now?
Before you make your next trade, you'll want to hear this.
MarketBeat keeps track of Wall Street's top-rated and best performing research analysts and the stocks they recommend to their clients on a daily basis.
Our team has identified the five stocks that top analysts are quietly whispering to their clients to buy now before the broader market catches on... and none of the big name stocks were on the list.
They believe these five stocks are the five best companies for investors to buy now...
Source MarketBeat
