SHOULDER INNOVATIONS, INC. Q4 FY2025 earnings call

Rob mentioned 2025 was transformational, with accelerated new surgeon customer addition, rapid commercial adoption of implant systems. Efforts to drive new surgeon adoption, including commercial model with distributors and BI platform. Increased existing surgeon utilization, with implant volume up in Q4 and full year. Progress on new product development like strategic partnership with Interventional Systems and limited releases of new products. Also, clinical data registry enrollment progress.

Fourth quarter of 2025 revenue was $14.4 million, an increase of 65% year - over - year and 23% sequentially. Full year 2025 revenue totaled $47.3 million, an increase of 50% over 2024. Q4 gross margin was 76.7% and full year 2025 gross margin was 76.5%.

Initiated full year 2026 revenue guidance of $62 to $65 million, growth of 31 to 37% year - over - year. Expect strong gross margins with potential incremental improvements later, SG&A and R&D as percentage of revenue to stay consistent, and quarterly cash burn to be relatively flat with improvement later in 2026.

Refer to risk factors section of most recent annual report on Form 10 - K and other SEC filings.

Q: About surgeon side programs and adoption curve acceleration, what's driving it?

A: Leveraging business intelligence platform, national symposiums and labs with surgeon - to - surgeon interactions.

Q: On new product front, update on progress and 2026 outlook?

A: I - 135 and N - 22 in limited commercial release phase, working towards covering all angles, robotic strategy with portable device and time - transparent technology.

Q: On core contender surgeons and utilization curve, how is it?

A: Growth from new and existing surgeons, both contributing.

Q: On SG&A spend and OPEX, how is it?

A: Expect SG&A and R&D as percentage of revenue to stay similar, Q4 R&D percentage to remain similar.

Q: On ASC utilization and drivers?

A: Instrumentation platform adapted to ASC, CMS payment change helped, trend continues.

Q: On guidance assumptions and risks?

A: Execution and units key, no major macro risks currently.