GRAND RAPIDS, Mich., May 13, 2026 /PRNewswire/ -- Shoulder Innovations, Inc. (Shoulder Innovations, or the company) (NYSE:SI), a commercial-stage medical technology company exclusively focused on transforming the shoulder surgical care market, today reported financial results for the first quarter ended March 31, 2026.
First Quarter Financial Highlights
Generated net revenue of $16.7 million in the first quarter, a 65% increase over the first quarter of 2025
Achieved gross margin of 77.7% for the first quarter compared to 76.9% for the first quarter of 2025
Increased average selling price of our implant systems to $7,650 in the first quarter, a 9% increase over the first quarter of 2025
Increased full year 2026 net revenue guidance to $65 million to $68 million, representing growth of approximately 37% to 44% over full year 2025 net revenue
Recent Business Highlights
Sold 2,184 total implant systems in the first quarter, a 51% increase over the first quarter of 2025
Initiated full commercial launch of the InSet™ I-135RFX Humeral Stem following a successful limited user release and FDA clearance of additional fracture indications
Expanded commercial organization in the first quarter to support increased business scale
"We are very pleased with our first quarter performance, which reflects accelerating revenue growth and intensifying commercial momentum across our entire organization," said Rob Ball, CEO of Shoulder Innovations. "Net revenue growth of 65%, implant volume growth of 51%, and continued improvement in gross margin demonstrate the strength and efficiency of our rapidly expanding ecosystem."
Mr. Ball continued, "Building on this traction, recent product portfolio milestones, including the full commercial launch of our InSet™ I-135RFX Humeral Stem, meaningfully extend the comprehensive suite of solutions we offer surgeons and their patients. This disciplined financial and operational execution to start the year provides us with increased confidence in the trajectory of the business and enables us to increase our full year 2026 revenue guidance."
First Quarter 2026 Financial ResultsNet revenue in the first quarter of 2026 increased 65% to $16.7 million, compared to $10.1 million in the first quarter of 2025. The increase was due to an increase in the number of implant systems sold, as well as an increase in the number of customers.
Gross margin in the first quarter of 2026 was 77.7%, compared to 76.9% in the first quarter of 2025.
Selling, general and administrative expenses in the first quarter of 2026 increased 73% to $18.2 million, compared to $10.5 million in the first quarter of 2025. The increase was primarily due to investments in the commercial organization, higher variable selling expenses, and increased costs associated with becoming a public company.
Research and development expenses in the first quarter of 2026 increased 137% to $3.8 million, compared to $1.6 million in the first quarter of 2025. The increase was due to investment in new product development efforts, including a milestone payment and development related to the robotic platform strategic partnership.
Operating loss in the first quarter of 2026 was $9.0 million, compared to a loss of $4.3 million in the first quarter of 2025. Net loss in the first quarter of 2026 was $8.4 million, compared to a net loss of $4.7 million in the first quarter of 2025. The increase in operating loss and net loss was primarily related to increased operating expenses.
Adjusted EBITDA in the first quarter of 2026 was a loss of $7.0 million, compared to a loss of $3.5 million in the first quarter of 2025. The increase in loss was primarily due to the aforementioned increased operating expenses.
As of March 31, 2026, cash and cash equivalents, and marketable securities totaled $108.5 million.
2026 Financial OutlookShoulder Innovations expects net revenue for the full year 2026 to be in the range of $65 million to $68 million, representing growth of approximately 37% to 44% over full year 2025 net revenue. This compares to prior guidance of $62 million to $65 million, representing growth of approximately 31% to 37% over full year 2025 net revenue.
Conference CallManagement will host a conference call today, May 13, 2026, at 4:30 p.m. ET / 1:30 p.m. PT to discuss the company's first quarter 2026 financial results. Those interested in listening to the conference call may do so by dialing (877) 407-8216 for domestic callers or (412) 902-1015 for international callers and providing access code 13759613. A live and archived webcast of the event will be available in the "Investor Relations" section of the Shoulder Innovations website at https://ir.shoulderinnovations.com.
Use of Non-GAAP Financial Measures and Key Business MetricsIn addition to our results and measures of performance determined in accordance with U.S. GAAP, we believe that non-GAAP financial measures can be useful in evaluating and comparing our financial and operational performance over multiple periods, identifying trends affecting our business, formulating business plans and making strategic decisions. We use and present Adjusted EBITDA for this purpose. We define Adjusted EBITDA as net loss before interest (income) expense, net, income tax expense, depreciation and amortization, and stock-based compensation expense. We have reconciled our historic non-GAAP financial measures to the applicable most comparable GAAP measures in this press release.
We believe that Adjusted EBITDA, together with a reconciliation to net loss, provides meaningful supplemental information regarding our performance by excluding certain items that may not be indicative of our business, results of operations, or outlook. However, Adjusted EBITDA has limitations as an analytical tool, and you should not consider this measure in isolation or as a substitute for analysis of our financial results as reported under U.S. GAAP. Some of these potential limitations include: (i) other companies, including companies in our industry which have similar business arrangements, may report Adjusted EBITDA, or similarly titled measures but calculate them differently, which reduces their usefulness as comparative measures; (ii) although depreciation and amortization expenses are non-cash charges, the assets being depreciated and amortized may have to be replaced in the future, and Adjusted EBITDA does not reflect cash capital expenditures for such replacements or for new capital expenditure requirements; (iii) Adjusted EBITDA also does not reflect changes in, or cash requirements for, our working capital needs or the potentially dilutive impact of stock-based compensation; and (iv) Adjusted EBITDA does not reflect the interest (income) expense, net, or the cash requirements necessary to service interest or principal payments, on existing or future debt that we may incur. Because of these and other limitations, you should consider Adjusted EBITDA only as supplemental to other GAAP-based financial measures.
In addition, we believe that the number of implant systems sold is a key business metric and a useful indicator of our ability to drive demand for our implant systems, generate net revenue and expand our business. We regularly review a number of operating and financial metrics to evaluate our business, measure our performance, identify trends affecting our business, formulate our business plan and make strategic decisions.
About Shoulder InnovationsShoulder Innovations is a commercial-stage medical technology company exclusively focused on transforming the shoulder surgical care market, with a current offering of advanced implant systems for shoulder arthroplasty. These systems are a core element of Shoulder Innovations' ecosystem, which is designed to improve core components of shoulder surgical care, preoperative planning, implant design and procedural efficiency, to benefit each stakeholder in the care chain. Shoulder Innovations' ecosystem is also comprised of enabling technologies, efficient instrument systems, specialized support and surgeon-to-surgeon collaboration. Together, these elements seek to address the long-standing clinical and operational challenges in the shoulder surgical care market by delivering predictable outcomes, procedural simplicity, and efficiency across ...
