Shoulder Innovations, Inc.

First-quarter 2026 net revenue was $16.7 million, up 65% from $10.1 million a year ago and 16% sequentially. Gross margin was 77.7% versus 76.9% in the prior year. SG&A was $18.2 million versus $10.5 million, R&D was $3.8 million versus $1.6 million, net loss was $8.4 million versus $4.7 million, and adjusted EBITDA loss was $7.0 million versus $3.5 million. Cash and cash equivalents were $108.5 million at March 31, 2026. Full-year 2026 net revenue guidance was raised to $65 million-$68 million, implying 37% to 44% growth, with management expecting similar gross margins for the rest of 2026, Q3 seasonally lower, and a Q4 step-up.

Rob Ball said the quarter showed strong execution across the organization, driven by new surgeon adoption, deeper utilization in the existing base, and product milestones. He emphasized that the company is still early in building a shoulder-specific platform, not just a product, and highlighted durable momentum in its core and contender surgeon funnel. His tone was confident and upbeat, especially around market opportunity, commercialization, and the potential of the robotic and product pipeline.

Jeff Points detailed the financial drivers behind the quarter: revenue of $16.7 million, gross margin of 77.7%, SG&A of $18.2 million, R&D of $3.8 million, net loss of $8.4 million, and adjusted EBITDA loss of $7.0 million. He said margin improvement came from higher ASPs and cost reduction programs, while cash burn was elevated because the company proactively increased inventory and asset purchases and invested in growth. He expects significantly lower cash burn starting in Q2, similar gross margins for the rest of 2026, SG&A as a percentage of revenue to rise slightly from Q1, and R&D to moderate later in the year.

Analysts pressed on what drove the Q1 inflection, whether the raised guidance was conservative, and how durable the higher ASPs and volume gains might be. Management said Q1 strength came from new customer growth, higher volume from existing surgeons, and higher ASPs, and that the annual guide reflects an early-year, balanced view rather than concern about business deterioration. Questions also focused on robotics and profitability; management said the robotic platform is time-transparent, portable, and intended to be a robotics-as-a-service model, while declining to give a timeline for EBITDA profitability but saying they are balancing investment with long-term profitability.