Q2 2026 Shoulder Innovations Inc Earnings Call

August 6, 2026

Speaker #1: Please stand by. Welcome, ladies and gentlemen, to the first quarter 2026 earnings conference call for SHOULDER INNOVATIONS. At this time, all participants will be placed on listen-only mode.

Operator: Please stand by. Welcome, ladies and gentlemen, to the Q1 2026 earnings conference call for Shoulder Innovations. At this time, all participants will be placed on a listen-only mode. At the end of the company's prepared remarks, we will conduct a question-and-answer session. Please note that this conference is being recorded and will be available on the company's website for replay shortly. I would now like to turn the call over to Sam Bentzinger, Investor Relations at Gilmartin Group, for a few introductory comments. Please go ahead.

Speaker #1: At the end of the company's prepared remarks, we will conduct a question-and-answer session. Please note that this conference is being recorded and will be available on the company's website for replay shortly.

Speaker #1: I would now like to turn the call over to Sam Benzinger, Investor Relations at Gilmartin Group, for a few introductory comments. Please go ahead.

Speaker #2: Good afternoon, and thank you for participating in today's call. Joining me from Shoulder Innovations are Rob Ball, Chief Executive Officer, and Jeff Poynts, Chief Financial Officer.

Sam Bentzinger: Good afternoon, thank you for participating in today's call. Joining me from Shoulder Innovations are Rob Ball, Chief Executive Officer, Jeff Points, Chief Financial Officer. Earlier today, Shoulder Innovations issued a press release announcing financial results for the Q2 ended 30 June 2026. A copy of the press release is available on the investor relations section of the company's website. Before we begin, I'd like to remind you that management will make remarks during this call that constitute forward-looking statements within the meaning of federal securities laws, that these are being made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that relate to expectations or predictions of future events, results, or performance are forward-looking statements.

Speaker #2: Earlier today, SHOULDER INNOVATIONS issued a press release announcing financial results for the second quarter ended June 30, 2026. A copy of the press release is available on the investor relations section of the company's website.

Speaker #3: Before we begin, I'd like to remind you that management will make remarks during this call that constitute forward-looking statements within the meaning of federal securities laws, and that these are being made pursuant to the safe harbor provisions of the private securities litigation reform act of 1995.

Sam Bentzinger: Before we begin, I'd like to remind you that management will make remarks during this call that constitute forward-looking statements within the meaning of federal securities laws, that these are being made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that relate to expectations or predictions of future events, results, or performance are forward-looking statements.

Speaker #3: Any statements contained in this call that relate to expectations or predictions of future events, results, or performance are forward-looking statements. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward-looking statements.

Sam Bentzinger: These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward-looking statements. Accordingly, you should not place undue reliance on these statements. For a listing of descriptions of the risks and uncertainties associated with our business, please refer to the Risk Factors section of our most recent annual report on Form 10-K and in our other filings with the Securities and Exchange Commission. Additionally, during this conference call, the company will discuss certain financial measures that have been prepared in accordance with GAAP. This non-GAAP information should not be considered in isolation or as a substitute for, or superior to, results prepared in accordance with GAAP. Please refer to the tables in our earnings release for a reconciliation of these measures to the most directly comparable GAAP financial measure.

Speaker #3: Accordingly, you should not place undue reliance on these statements. For our listing descriptions of the risks and uncertainties associated with our business, please refer to the risk factors section of our most recent annual report on Form 10-K and in our other filings with the Securities and Exchange Commission.

Speaker #3: Additionally, during this conference call, the company will discuss certain financial measures that have been prepared in accordance with GAAP. This non-GAAP information should not be considered in isolation, or as a substitute for, or superior to, results prepared in accordance with GAAP.

Sam Bentzinger: Additionally, during this conference call, the company will discuss certain financial measures that have been prepared in accordance with GAAP. This non-GAAP information should not be considered in isolation or as a substitute for, or superior to, results prepared in accordance with GAAP. Please refer to the tables in our earnings release for a reconciliation of these measures to the most directly comparable GAAP financial measure.

Speaker #3: Please refer to the tables in our earnings release for a reconciliation of these measures to the most directly comparable GAAP financial measure. This conference call contains time-sensitive information and is accurate only as of the live broadcast today, August 6, disclaims any intention or obligation except as required by law to update or revise any financial projections or forward-looking statements, whether because of new information, future events, or otherwise.

Sam Bentzinger: This conference call contains time-sensitive information and is accurate only as of the live broadcast today, 6 August 2026. Shoulder Innovations disclaims any intention or obligation, except as required by law, to update or revise any financial projections or forward-looking statements, whether because of new information, future events, or otherwise. With that, I'll now turn the call over to Rob.

Speaker #3: With that, I'll now turn the call over to Rob.

Speaker #2: Thanks, Sam. Good afternoon, everyone, and welcome to our second quarter earnings call. We have several noteworthy updates today across our future results and growth strategies, particularly with respect to our innovation pipeline and so we're excited to share those with you.

Rob Ball: Thanks, Sam. Good afternoon, everyone, and welcome to our Q2 earnings call. We have several noteworthy updates today across our future results and growth strategies, particularly with respect to our innovation pipeline. We're excited to share those with you. At a high level, I'm pleased to report that our organization continued to demonstrate remarkable strength through the Q2. Following a very strong Q1 start to 2026, we again delivered year-over-year and sequential revenue growth in Q2 as we rapidly onboarded new surgeons, deepening utilization within our existing customer base, and made steady progress in several key product initiatives. This performance enabled us to deliver Q2 net revenue of $17.2 million, an increase of 56% year-over-year. Q2 gross margins was also strong at 78.3%, up both year-over-year and sequentially.

Speaker #2: At a high level, I'm pleased to report that our organization continued to demonstrate remarkable strength through the second quarter. Following a very strong first quarter start to 2026, we again delivered year-over-year and sequential revenue growth in Q2 as we rapidly onboarded new surgeons, deepened utilization within our existing customer base, and made steady progress in several key product initiatives.

Speaker #2: This performance enabled us to deliver second quarter net revenue of $17.2 million, an increase of 56% year-over-year. Q2 gross margins was also strong at 78.3%, up both year-over-year and sequentially.

Rob Ball: This performance enabled us to deliver Q2 net revenue of $17.2 million, an increase of 56% year-over-year. Q2 gross margins was also strong at 78.3%, up both year-over-year and sequentially.

Speaker #2: These improvements reflect ongoing operational efficiency, and we expect further gross margin expansion from several additional cost-reduction initiatives that Jeff will cover shortly. Given these results, our growing scale, and the expanding efficiency of our commercial organization, we are raising our full-year 2026 net revenue guidance to $69 million, representing growth of 42% to 46% over 2025.

Rob Ball: These improvements reflect ongoing operational efficiency, and we expect further gross margin expansions from several additional cost reduction initiatives Jeff will cover shortly. Given these results, our growing scale, and the expanding efficiency of our commercial organization, we are raising our full year 2026 net revenue guidance today to a range of $67 to 69 million, representing growth of 42% to 46% over 2025. This compares to our prior range of $65 to 68 million, or 37% to 44% growth. Our guidance reflects our continued expectation for a normal degree of orthopedic seasonality that began as expected in June and will continue into the Q3, consistent with patterns we've experienced in the past. Customer activity and our pipeline remain robust, giving us high conviction in this guidance.

Speaker #2: This compares to our prior range of $65 to $68 million, or 37 to 44 percent growth. Our guidance reflects our continued expectation for a normal degree of orthopedic seasonality that began as expected in June and will continue into the third quarter, consistent with patterns we've experienced in the past.

Rob Ball: Our guidance reflects our continued expectation for a normal degree of orthopedic seasonality that began as expected in June and will continue into the Q3, consistent with patterns we've experienced in the past. Customer activity and our pipeline remain robust, giving us high conviction in this guidance.

Speaker #2: Customer activity and our pipeline remain robust, giving us high conviction in this guidance. Our ability to deliver this growth in 2026 and beyond is grounded in the same three strategic priorities we've discussed during our last few calls, which include: driving adoption among new surgeons, increasing penetration in our existing customer surgeon base to increase procedural volume, and adding products to our portfolio to address the unmet needs of patients and surgeons.

Rob Ball: Our ability to deliver this growth in 2026 and beyond is grounded in the same three strategic priorities we've discussed during our last few calls, which include driving adoption among new surgeons, increasing penetration in our existing customer surgeon base to increase procedural volume, and adding products to our portfolio to address the unmet needs of patients and surgeons. Beginning with new surgeon adoptions, we maintained our high pace of new customer additions through Q2 following our very strong start to the year. As a reminder, in Q1, we grew new customer additions at more than double the pace of the prior year, and in Q2, we added even more new customers than we did in Q1, an acceleration on top of an already strong start.

Speaker #2: Beginning with new surgeon adoptions, we maintained our high pace of new customer additions through the second quarter, following our very strong start to the year.

Speaker #2: As a reminder, in the first quarter, we grew new customer additions at more than double the pace of the prior year, and then the second quarter, we added even more new customers than we did in Q1, and acceleration on top of an already strong start.

Rob Ball: As a reminder, in Q1, we grew new customer additions at more than double the pace of the prior year, and in Q2, we added even more new customers than we did in Q1, an acceleration on top of an already strong start.

Speaker #2: Our W-2 commercial leadership organization is focused on targeting the roughly 1,800 high-volume surgeon specialists in the US, and that approach is translating into rapid growth in our customer base.

Rob Ball: Our W2 commercial leadership organization is focused on targeting the roughly 1,800 high-volume surgeon specialists in the US, that approach is translating into rapid growth in our customer base. We are encouraged by these trends and expect that momentum to be durable for the balance of the year. To further capitalize on this sustained momentum, we again accelerated commercial expansion plans and added the top talent to our commercial leadership team in Q2 following our investment in this area in Q1. Just as our H1 performance has benefited from the accelerating productivity gains within the W2 commercial leadership cohort hired in 2025, we expect these newly hired team members to be a growth driver in future quarters as they ramp and build deeper relationships within their territories.

Speaker #2: We are encouraged by these trends and expect that momentum to be durable for the balance of the year. To further capitalize on this sustained momentum, we again accelerated commercial expansion plans and added to top talent to our commercial leadership team in Q2, following our investment in this area in Q1.

Speaker #2: Just as our first half performance has benefited from the accelerating productivity gains within the W-2 commercial leadership cohort hired in 2025, we expect these newly hired team members to be a growth driver in future quarters as they ramp and build deeper relationships within their focused execution from our commercial leadership team is supported by our proprietary business intelligence platform, which has proven to be a true differentiator in our ability to execute on top of strong fundamentals.

Rob Ball: Just as our H1 performance has benefited from the accelerating productivity gains within the W2 commercial leadership cohort hired in 2025, we expect these newly hired team members to be a growth driver in future quarters as they ramp and build deeper relationships within their territories.

Rob Ball: As always, the focused execution from our commercial leadership team is supported by our proprietary business intelligence platform, which has proven to be a true differentiator in our ability to execute on top of strong fundamentals. We also continue to invest in our surgeon-to-surgeon education programs, which we view as central to our commercial strategy. Our CME team has carried out more than 90 surgeon engagement events so far this year, touching hundreds of surgeons, the organic peer advocacy these events foster remains a key differentiator for our commercial model. In April, we hosted our national symposium in Napa, the largest such event in SI's history by surgeon attendance. In the three months since, we've already seen a tangible increase in procedural volumes among attending surgeons as compared to before the event, further evidence of the power of our education program.

Speaker #2: We also continue and invest in our surgeon-to-surgeon education commercial strategy. Our CEME team has carried out more than 90 surgeon engagement events so far this year, touching hundreds of surgeons, and the organic peer advocacy these events foster remains a key differentiator for our commercial model.

Speaker #2: In April, we hosted our national symposium in Napa, the largest such event SI's history

Speaker #1: By surge in attendance and the three months since , we've already seen a tangible increase in procedural volumes among attending surgeons as compared to before the event .

Speaker #1: Further evidence of the power of our education program. Turning to our second strategic priority of increasing utilization and procedural growth within our customer base.

Rob Ball: Turning to our second strategic priority of increasing utilization and procedural growth within our customer base. In Q2, total implant volume across our core contender and prospect customers increased approximately 50% year over year to 2,238 units. This growth volume is strong on its own, what stands out even more is the composition behind it. The vast majority of our implant volume growth this quarter was derived from our core surgeon category, with core surgeons also carrying out more procedures, meaning our growth is coming from core on both a physician and unit basis, exactly as our customer base is designed to progress. Surgeons frequently enter the funnel as prospect, move to contender, then grow to become core. Those first two categories remain consistent across quarters, while our core category only continues to grow.

Speaker #1: In the second quarter , total implant volume across our core contender and prospect customers increased approximately 50% year over year to 2238 units .

Speaker #1: This growth volume is strong on its own , but what stands out even more is the composition behind it . The vast majority of our implant volume growth this quarter was derived from our core surgeon category , with core surgeons also carrying out more procedures , meaning our growth is coming from core on both a physician and unit basis .

Speaker #1: Exactly as our customer base is designed to progress. Surgeons frequently enter the funnel as prospects, move to contender, and then grow to become core. Those first two categories remain consistent across quarters, while our core category only continues to grow. This trend, combined with the sequential increase of new surgeon adds to the funnel.

Rob Ball: This trend, combined with sequential increase of new surgeon adds to the funnel this quarter, gives us a highly encouraging outlook on the current trajectory of our customer base. Importantly, we are seeing these utilization increases broadly across all our territories. In Q2, each of our territories grew year-over-year, and the majority demonstrating more than 80% growth year-over-year. We also continue to enter new markets and deepen our presence in the current ones. For instance, we recently expanded our commercial presence within two highly prominent hospital systems and now have full access at both centers. Even as we continue to make progress activating new markets across the US, we believe there is a significant greenfield opportunity remaining for our expanded commercial leadership team to target.

Speaker #1: This quarter gives us a highly encouraging outlook on the current trajectory of our customer base. Importantly, we're seeing these utilization increases broadly across all our territories in the second quarter.

Speaker #1: Each of our territories grew year over year , and the majority demonstrating more than 80% growth year over year . We also continue to enter new markets and deepen our presence in the current ones .

Speaker #1: For instance, we recently expanded our commercial presence within two highly prominent hospital systems and now have full access at both centers. Even as we continue to make progress activating new markets across the US.

Speaker #1: We believe there is a significant greenfield opportunity remaining for our expanded commercial leadership team to target to ensure we continually equip surgeons with the best in class product portfolio .

Rob Ball: To ensure we continually equip surgeons with the best-in-class product portfolio, we also remain focused on our third strategic priority of developing and launching new technologies to address the unmet needs of patients and surgeons. 2026 has been an active year on this front. I want to start with three recent product introductions and then walk through updates on our enabling technology platform, our robotic program, and four additional pipeline projects. First, on recent progress, we transitioned our I-135RFX Humeral Stem to full commercial launch last quarter following receipt of expanded clearance from FDA to include more complex fractures. Full launch progressed through Q2 in line with our expectations, and we are pleased with the consistent surgeon feedback across both anatomic and reverse shoulder arthroplasty configurations. Second, we recently moved our N22 Glenosphere into full launch since debuting it earlier this year.

Speaker #1: We also remain focused on our third strategic priority of developing and launching new technologies to address the unmet needs of patients and surgeons. 2026 has been an active year on this front. I want to start with three recent product introductions and then walk through updates on our enabling technology platform.

Speaker #1: Our robotic program , and for additional pipeline projects First , on recent progress , we transitioned our I135 RF humeral stem to full commercial launch last quarter .

Speaker #1: Following receipt of expanded clearance from FDA to include more complex fractures , full launch progressed through the second quarter in line with our expectations , and we're pleased with the consistent surgeon feedback across both Anatomic and reverse shoulder arthroplasty configurations Second , we recently moved our N-22 Glennis gear into full launch .

Speaker #1: Since debuting it earlier this year, this product is the first introduction of our new line of technologies designed for patients with metal hypersensitivity and represents an incremental addressable market for us.

Rob Ball: This product is the first introduction of our new line of technologies designed for patients with metal hypersensitivity and represents an incremental addressable marker for us. Third, we fully rolled out our new titanium plasma spray, or TPS, reverse base plate as a product line extension, which provides an additional option for surgeons to match implant selection to patient need. We are seeing early success across each of these products. In fact, a growing portion of our total procedures year-to-date have involved the use of one of these new products, and all three have contributed to our recent uplift in average selling price. Beyond these recent introductions, we are also committed to further extending our technology advantage and have significantly advanced several programs across enabling technology and new product development.

Speaker #1: And third , we fully rolled out our new titanium plasma Spray , or TPS reverse base plate as a product line extension , which provides an additional option for surgeons to match implant selection to patient needs We're seeing early success across each of these products .

Speaker #1: In fact , a growing portion of our total procedures year to date have involved the use of one of these new products . In all , three have contributed to our recent uplift in average selling price Beyond these recent introductions , we are also committed to further extending our technology advantage and have significantly advanced several programs across enabling technology and new product development .

Speaker #1: As I've shared on recent calls , the integration of robotic surgery into our ecosystem has unlocked a renewed innovation cycle within our technical and clinical teams , and I want to outline a few initiatives that have taken clear shape over the past several quarters and represent meaningful opportunities in the near future .

Rob Ball: As I have shared on recent calls, the integration of robotic surgery into our ecosystem has unlocked a renewed innovation cycle within our technical and clinical teams, and I want to outline a few initiatives that have taken clear shape over the past several quarters and represent meaningful opportunities in the near future. At the center of this innovation cycle and overarching across each of our pipeline project is a technological revamp of our ProVoyance enabling technology platform. We are building upon the platform's strong existing foundation to better align with each surgeon's unique needs while delivering a substantial step up from a software perspective in terms of available information and functionality.

Speaker #1: At the center of this innovation cycle and overarching across each of our pipeline projects is a technological revamp of our province , enabling technology platform We're building upon the platform's strong existing foundation to better align with each surgeon's unique needs .

Speaker #1: While delivering a substantial step up from a software perspective in terms of available information and functionality based on surgeon feedback . To date , we believe strongly that this platform is the main engagement center for our customers and that when paired with the innovation programs , I'll describe next , will drive an important shift in how shoulder surgery is planned and executed .

Rob Ball: Based on surgeon feedback to date, we believe strongly that this platform is the main engagement center for our customers and that when paired with the innovation programs I'll describe next, will drive an important shift in how shoulder surgery is planned and executed. We believe this advancement will further expand our competitive advantage, creating an environment where innovation for improved care happens through a software advancement, and that is a shift that will benefit all stakeholders through improved care, lower costs, and lower capital requirements. We're also developing this next-generation software platform to be fully compatible with our upcoming shoulder-specific micro robotic solution for shoulder arthroplasty, which will enable us to offer a comprehensive integrated enabling technology suite. The purpose of enabling technology is to support more accurate, effective surgery.

Speaker #1: We believe this advancement will further expand our competitive advantage , creating an environment where innovation for improved care happens through a software advancement .

Speaker #1: And that is a shift that will benefit all stakeholders through improved care , lower costs and lower capital requirements We're also developing this next generation software platform to be fully compatible with our upcoming shoulder specific micro robotic solution for shoulder arthroplasty , which will enable us to offer a comprehensive , integrated enabling technology suite .

Speaker #1: The purpose of enabling technology is to support more accurate, effective surgery. However, rapid and sustainable uptake requires the simplest possible adjustment to existing surgical technique, delivering predictable, consistent procedure.

Rob Ball: However, rapid and sustainable uptake requires the simplest possible adjustment to existing surgical technique, delivering predictable, consistent procedure times in the OR and an economic proposition that is value accretive for all clinical partners. We believe this approach will deliver better outcomes at a lower economic burden across all sites of care, particularly the ambulatory surgery center. Since announcing our strategic partnership with INS in December, we've made tangible progress each quarter with product development running almost a full year ahead of our initial internal forecasts. We remain incredibly excited with the mid and longer-term economic and competitive opportunities associated with this technology. Officially, the robotic technology will be known as InSET Neo and we are planning FDA submission in H1 2027. We'll provide additional details on product features and filing timelines over the coming quarters.

Speaker #1: Times in the O.R. and an economic proposition that is value accretive for all clinical partners. We believe this approach will deliver better outcomes at a lower economic burden across all sites of care, particularly the ambulatory surgery center.

Speaker #1: Since announcing our strategic partnership with Inhs in December , we've made tangible progress each quarter with product development running almost a full year ahead of our initial internal forecasts , and we remain incredibly excited with the mid and longer term economic and competitive opportunities associated with this technology Officially , the robotic technology will be known as inset neo , and we are planning FDA submission in the first half of 2027 .

Speaker #1: We'll provide additional details on product features and filing timelines over the coming quarters . Alongside the filing . We are also anticipate kicking off a robotic training program in early Q1 of next year , which will enlist the expertise of our current surgeons , consistent with our broader philosophy surrounding peer to peer medical education .

Rob Ball: Alongside the filing, we also anticipate kicking off a robotic training program in early Q1 of next year, which will enlist the expertise of our current surgeons. Consistent with our broader philosophy surrounding peer-to-peer medical education, we believe this train-the-trainer approach will be effective in creating a scalable way to share knowledge and drive surgeon engagement at a rapid pace. Our revamped enabling technology suite is also fundamental to several initiatives across new product development. First, we've spent the last several quarters working to improve the transferability of preoperative planning information into the operating room through a simple reusable solution. With limited available starting in Q3, our new InSET CLUTCH guide system for anatomic and reverse glenoid procedures will allow surgeons to more effectively transfer and execute the intended surgical plan in the OR. We also expect this solution to provide a modest uplift to average selling price.

Speaker #1: We believe this train , the trainer approach will be effective in creating a scalable way to share knowledge and drive surgeon engagement at a rapid pace .

Speaker #1: Our revamped enabling technology suite is also fundamental to several initiatives across new product development First , we've spent the last several quarters working to improve the transferability of preoperative planning information into the operating room through a simple , reusable solution with limited available starting in Q3 .

Speaker #1: Our new inset clutch guide system for anatomic and reverse glenoid procedures will allow surgeons to more effectively transfer and execute the intended surgical plan in the O.R.

Speaker #1: . We also expect this solution to provide a modest uplift uplift to average selling price Second , we've developed a new concept for reverse procedures branded inset one offering a highly unique solution purpose built for our risk based approach in preoperative planning Born out of our next generation , enabling technology platform .

Rob Ball: Second, we've developed a new concept for reverse procedures branded InSET ONE, offering a highly unique solution purpose-built for our risk-based approach in preoperative planning. Born out of our next-generation enabling technology platform, InSET ONE will enable surgeons to formulate a patient-matched, additively manufactured iteration of our InSET reverse solution, leveraging expansive data set and highly optimized decision algorithms to treat challenging and complex patient indications, improving upon existing market designs. We also believe that over the midterm, paired with our robotic solution, InSET ONE can represent a lower cost, higher margin procedure for the majority of patients, enabling even lower capital costs than our current small trade platform. We're targeting FDA submission for this product in 2027. Third, we expect to commence a limited user release in Q3 of this year for our new subscapularis-sparing technique initiatives.

Speaker #1: Inset one will enable surgeons to formulate a patient match additively manufactured iteration of our inset reverse solution , leveraging expansive data set and highly optimized optimized decision algorithms to treat challenging and complex patient indications .

Speaker #1: Improving upon existing market designs . We also believe that over the mid-term , paired with our robotic solution inset , one can represent a lower cost , higher margin procedure for the majority of patients , enabling enabling even lower capital costs .

Speaker #1: In our current small trade platform . We're targeting FDA submission for this product in 2027 . Third , we expect to commence a limited user release in Q3 of this year for our new Subscapularis sparing technique initiatives .

Speaker #1: Failure of the Subscapularis tendon remains a persistent post-operative complication , particularly across anatomic shoulder arthroplasty , where shoulder innovations inset platform has a marked advantage due to the structure of our unique implant designs .

Rob Ball: Failure of the subscapularis tendon remains a persistent postoperative complication, particularly across anatomic shoulder arthroplasty, where Shoulder Innovations' InSet platform has a marked advantage due to the structure of our unique implant designs. Together with a group of innovative surgeons, our engineering and clinical teams have developed instrumentation to more effectively enable surgery where takedown of the subscap tendon can be avoided, which may materially reduce the risk of this complication. This technique can also have a significant impact on postoperative protocols, pain, and simplicity of patient recovery. Last, certainly not least, we're looking forward to the first surgical cases for our next generation InSet anatomic glenoid implant in early Q4 of this year. Branded InSET GO, we expect this solution to further streamline the OR experience by further reducing the surgical steps. We expect this innovation will save up to 10 minutes per procedure.

Speaker #1: Together with a group of innovative surgeons, our engineering and clinical teams have developed instrumentation to more effectively enable surgery where takedown of the subscap tendon can be avoided, which may materially reduce the risk of this complication.

Speaker #1: This technique can also have a significant impact on post-operative protocols . Pain and simplicity of patient recovery . And last , but certainly not least , we're looking forward to the first surgical cases for our next generation .

Speaker #1: Inset anatomic glenoid implant in early Q4 of this year. Branded Inset Go. We expect this solution to further streamline the OR experience by further reducing the surgical steps.

Speaker #1: We expect this innovation will save up to ten minutes per procedure . The inset and inset plus glenoid implants are a foundational technology for shoulder innovations , and this next generation product builds on our heritage of published and recognized clinical success in deploying experience and know how inaccessible to any other competitor external to our own pipeline .

Rob Ball: The InSet and InSet Plus glenoid implants are a foundational technology for Shoulder Innovations, and this next-generation product builds on our heritage of published and recognized clinical success in deploying experience and know-how inaccessible to any other competitor. External to our own pipeline, we also continue to generate incremental interest from additional strategic partners who see the value in accessing the shoulder surgical care market through our platform. Our enhanced brand awareness has been a meaningful positive development for SI since our IPO last year. To that end, we are pleased to announce a new exclusive collaboration with a leader in additive manufacturing devices for the treatment of severe deformity, where no other solution currently exists and cases frequently involve challenging revisions or other complicated circumstances.

Speaker #1: We also continue to generate incremental interest from additional strategic partners who see the value in accessing the shoulder surgical care market through our platform Our enhanced brand awareness has been a meaningful , positive development for Sy since our IPO last year , and to that end , we are pleased to announce a new exclusive collaboration with a leader in additive manufacturing devices for the treatment of severe deformity , where no other solution currently exists , and cases frequently involved challenging revisions or other complicated circumstances .

Speaker #1: We expect this partnership will enable us to offer improved bespoke solutions for highly complex revision cases, bolstering our broad array of offerings to the shoulder surgical care market.

Rob Ball: We expect this partnership will enable us to offer improved bespoke solution for highly complex revision cases, bolstering our broader way of offerings to the shoulder surgical care market. To be clear, these are cases where surgeons may not perceive our current solutions to be optimal for the patient condition, and this relationship will enable further expansion into these complex cases. We've also spoken before about the broader opportunity in adjacent indications, particularly soft tissue procedures. While we're bringing the same rigor to this market as we did with arthroplasty, an opportunity has emerged for faster, more immediate impact. We're pleased to announce a new relationship with a soft tissue device manufacturer that we expect will enable us to begin commercializing several of these devices before year-end.

Speaker #1: To be clear , these are cases where surgeons may not perceive our current solutions to be optimal for the patient condition , and this relationship will enable further expansion into these complex cases We've also spoken before about the broader opportunity in adjacent indications , particularly soft tissue procedures While we'll bring the same rigor to this market as we did with arthroplasty and opportunity has emerged for faster , more immediate impact , we're pleased to announce a new relationship with the soft tissue device manufacturer that we expect will enable us to begin commercializing several of these devices before year end .

Speaker #1: We don't expect material 2026 revenue from this partnership , but it marks an important starting point that should yield strategic advantages . As our commercial organization continues to grow Before turning the call over to Jeff , I have one final update on the clinical evidence front .

Rob Ball: We don't expect material 2026 revenue from this partnership, it marks an important starting point that should yield strategic advantages as our commercial organization continues to grow. Before turning the call over to Jeff, I have one final update on the clinical evidence front. As we've shared previously, we are actively building a database of real-world evidence for our clinical data registry. Clinical data collection efforts within the registry are ahead of our expectations. While still preliminary, our initial review suggests improvements in postoperative acromial fractures, reduced complications related to instability, advances in patient range of motion, and materially favored aesthetic outcomes. Furthermore, we've recently identified the opportunity to accelerate our ability to publish a more thorough report of these results through partnerships with centers that hold large bodies of retrospective data.

Speaker #1: As we've shared previously , we are actively building a database of real world evidence for our clinical data registry Clinical data collection efforts within the registry are ahead of our expectations .

Speaker #1: While still preliminary , our initial review suggests improvements in post-operative acromial fractures reduced complications related to instability , advances in patient range of motion , and materially favored aesthetic outcomes Furthermore , we've recently identified the opportunity to accelerate our ability to publish a more thorough report of these results through partnerships with centers that hold large bodies of retrospective data .

Speaker #1: While a modest investment will be required to enable the advancement , we're encouraged by these early signals and are confident this improved approach can accelerate our pathway to publication of these results by several quarters I'm excited that each of these innovation and clinical opportunities remain central to our existing clinical focus within shoulder surgical care , and we expect them to accelerate the efficiency of our commercial engine as we continue to scale .

Rob Ball: While a modest investment will be required to enable the advancement, we are encouraged by these early signals and are confident this improved approach can accelerate our pathway to publication of these results by several quarters. I am excited that each of these innovation and clinical opportunities remain central to our existing clinical focus within shoulder surgical care, and we expect them to accelerate the efficiency of our commercial engine as we continue to scale. We look forward to providing additional updates on each of these as we progress. With that, I will now turn the call over to Jeff to review our full Q2 results and discuss our updated full year 2026 outlook in more detail.

Speaker #1: We look forward to providing additional updates on each of these as we progress . And with that , I'll now turn the call over to Jeff to review our full second quarter results and discuss our updated full year 2026 outlook in more detail Thanks , Rob , and good .

Jeff Points: Thanks, Rob, and good afternoon, everyone. As Rob mentioned, net revenue for Q2 2026 was $17.2 million, a 56% increase from $11 million in the prior year. Our unique commercial model and proprietary business intelligence capabilities drove continued commercial expansion in Q2, resulting in increased adoption of our implant systems across new and existing surgeons. Gross margin for Q2 2026 was 78.3%, compared to 76.2% in the prior year. The improvement was driven by continued strong ASPs, along with benefits from negotiated cost reduction programs across our product lines. Selling, general, and administrative expenses in Q2 2026 were $20.1 million, compared to $12.8 million in the prior year. The increase in SG&A expenses was primarily driven by increased headcount in the commercial organization, higher variable selling expenses, and increased costs associated with becoming a public company.

Speaker #1: afternoon , everyone As Rob mentioned , net revenue for the second quarter of 2026 was 17.2 million , a 56% increase from 11 million in the prior year Our unique commercial model and proprietary business intelligence capabilities drove continued commercial expansion in the second quarter , resulting in increased adoption of our implant systems across new and existing surgeons .

Speaker #1: Gross margin for the second quarter of 2026 was 78.3% , compared to 76.2% in the prior year The improvement was driven by continued strong ASPs , along with benefits from negotiated cost reduction programs across our product lines Selling , general and administrative expenses in the second quarter of 2026 were 20.1 million , compared to 12.8 million in the prior year .

Speaker #1: The increase in expenses was primarily driven by increased headcount in the commercial organization , higher variable selling expenses and increased costs associated with becoming a public company Excluding public company costs .

Jeff Points: Excluding public company costs, we delivered operating leverage across SG&A during the quarter as compared to the prior year. Research and development expenses in Q2 2026 were $3.4 million, compared to $1.4 million in the prior year. The increase was primarily driven by investment in new product development efforts, including substantial work related to the robotics platform. Net loss in Q2 2026 was $10.2 million, compared to a loss of $19.2 million in the prior year. The adjusted EBITDA loss in Q2 2026 was $8 million, compared to a loss of $18.1 million in the prior year. The decrease in both net loss and the adjusted EBITDA loss were primarily related to a significant prior year charge related to changes in the fair value of the company's preferred stock, warrant liability, and Series E purchase option.

Speaker #1: We delivered operating leverage across a during the quarter as compared to the prior year . Research and development expenses in the second quarter of 2026 were 3.4 million , compared to 1.4 million in the prior year .

Speaker #1: The increase was primarily driven by investment in new product development efforts , including substantial work related to the robotics platform . Net loss in the second quarter of 2026 was 10.2 million , compared to a loss of 19.2 million in the prior year .

Speaker #1: Prior year . The adjusted EBITDA loss in the second quarter of 2026 was 8 million , compared to a loss of $18.1 million in the prior year .

Speaker #1: The decrease in both net loss and the adjusted EBITDA loss were primarily related to a significant prior year charge . Related to changes in the fair value of the company's preferred stock warrant liability , and series E purchase option .

Speaker #1: Our cash and cash equivalents and marketable securities as of June 30th , 2026 , were 99 million . As expected , our cash burn improved to improved in Q2 compared to Q1 , primarily due to a lower level of asset and instrument purchases , along with other working capital improvements Looking ahead , we expect improvements in cash burn during the second half of the year as compared to the first half .

Jeff Points: Our cash and cash equivalents and marketable securities as of 30 June 2026 were $99 million. As expected, our cash burn improved in Q2 compared to Q1, primarily due to a lower level of asset and instrument purchases, along with other working capital improvements. Looking ahead, we expect improvements in cash burn during H2 as compared to H1, as we proactively increased our inventory and asset purchases in Q1 and Q2. We remain confident in our balance sheet and our ability to fund our growth plans with cash on hand. During the quarter, we also announced the closing of two new debt facilities for an aggregate amount of up to $50 million with Stifel Venture Banking, consisting of a fully funded term loan to refinance our existing credit facility and a separate undrawn line of credit.

Speaker #1: As we proactively increased our inventory and asset purchases in Q1 and Q2 , we remain confident in our balance sheet and our ability to fund our growth plans with cash on hand during the quarter , we also announced the closing of two new debt facilities for an aggregate amount of up to $50 million , with Steeple Venture Banking consisting of a fully funded term loan to refinance our existing credit facility and a separate undrawn line of credit This refinancing represents an important step in strengthening our financial foundation as we continue to rapidly scale , providing material future cost savings on our existing debt structure .

Jeff Points: This refinancing represents an important step in strengthening our financial foundation as we continue to rapidly scale, providing material future cost savings on our existing debt structure while enabling financial flexibility. In the near future, we expect to file a shelf registration statement on Form S-3 as we recently became eligible following the one-year anniversary of our IPO. This is standard corporate housekeeping, and we have no imminent plan to raise capital through a primary offering. The filing will also register shares held by certain pre-IPO investors and insiders, satisfying registration rights granted in our March 2025 financing. This is a procedural step to meet those contractual obligations. It is not a sale of stock, and we have no visibility into if or when any holder might choose to sell. Turning now to our guidance and outlook for 2026.

Speaker #1: While enabling financial flexibility in the near future . We expect to file a shelf registration statement on form S-3 , as we recently became eligible following the one year anniversary of our IPO This is standard corporate housekeeping , and we have no imminent plan to raise capital through a primary offering .

Speaker #1: The following the filing will also register shares held by certain pre-IPO investors and insiders , satisfying registration rights granted in our March 2025 financing .

Speaker #1: This is a procedural step to meet those contractual obligations . It's not a sale of stock , and we have no visibility into if or when any holder might choose to sell Turning now to our guidance and outlook for 2026 on the top line , we now expect full year 2026 net revenue to range from 67 to 69 million , representing growth of 42 to 46% .

Jeff Points: On the top line, we now expect full-year 2026 net revenue to range from $67 to 69 million, representing growth of 42% to 46%. This guidance reflects our continued high degree of conviction in our ability to deliver industry-leading growth by driving adoption among new surgeons, increasing penetration in our existing surgeon customer base, and through commercial launches of new products. In addition, guidance accounts for seasonal dynamics that are typical in our industry, specifically lower sequential volumes in Q3 and a shift in procedure mix during H2, which typically lowers our percentage of reverse procedures and correspondingly impacts ASPs. Regarding gross margins, we are very pleased with our progress on margin improvement and expect similar margins for the balance of 2026, noting there could be some quarter-to-quarter fluctuations based on product mix and ASP.

Speaker #1: This guidance reflects our continued high degree of conviction in our ability to deliver industry leading growth by driving adoption among new surgeons , increasing penetration in our existing surgeon customer base and through commercial launches of new products in addition , guidance accounts for seasonal dynamics that are typical in our industry Specifically , lower sequential volumes in Q3 and a shift in procedure mix during the second half of the year , which typically lowers our percentage of reverse procedures and correspondingly impacts ASPs Regarding gross margins , we are very pleased with our progress on margin improvement and expect similar margins for the balance of 2026 , noting there could be some quarter and quarter fluctuations based on product mix and ASP Looking ahead , we recently filed a five 10-K with FDA related to additive manufacturing of certain products .

Jeff Points: Looking ahead, we recently filed a 510 with FDA related to additive manufacturing of certain products. This 510 is separate from the additive manufactured products that Rob discussed earlier and will add additional capability to our supply chain, providing incremental cost reductions of up to 30% on certain products beginning sometime in 2027. Cost down initiatives remain a key focus. We are confident they will continue driving gross margin improvement as we scale. At our current full-year revenue guidance, we expect SG&A expenses in Q3 as a percentage of revenue to increase from Q2 before declining in Q4. As our conviction around business growth increases, we will continue to identify and invest in greenfield opportunities across new geographic areas for commercial team footprint expansion. Finally, with currently contemplated innovation programs, we expect R&D expenses as a percentage of revenue to moderate late in 2026.

Speaker #1: This five 10-K is separate from the Additive manufactured products that Rob discussed earlier and will add additional capability to our supply chain , providing incremental cost reductions of up to 30% on certain products beginning sometime in 2027 .

Speaker #1: Cost down initiatives remain a key focus , and we're confident they'll continue driving gross margin improvement as we scale at our current full year revenue guidance , we expect sG&A expenses in Q3 as a percentage of revenue to increase from Q2 before declining in Q4 .

Speaker #1: As our conviction around business growth increases, we will continue to identify and invest in greenfield opportunities across new geographic areas for commercial team footprint expansion. Finally, with currently contemplated innovation programs, we expect our expenses as a percentage of revenue to moderate late in 2026.

Speaker #1: With that, I'll turn the call back to Rob for a few closing remarks. Thanks, Jeff. In sum, the second quarter reflected strength across every dimension of our business.

Jeff Points: With that, I turn the call back to Rob for a few closing remarks.

Rob Ball: Thanks, Jeff. In sum, the Q2 reflected strength across every dimension of our business. We continued to rapidly onboard new surgeons against a large under-penetrated market opportunity, deepening utilization within our existing customer base, and advancing a broad and increasingly differentiated product pipeline from the continued ramp of our I-135RFX and N22 launches to the next generation of our enabling technology suite to the accelerating progress we're making on our robotic platform. At the same time, the growing external interest we're seeing from external partners is a testament to the position we've built in the shoulder surgical market, and we believe these relationships will meaningfully expand what we're able to offer surgeons and patients over time.

Speaker #1: We continued to rapidly onboard new surgeons against a large under-penetrated market opportunity , deepening utilization within our existing customer base and advancing a broad and increasingly differentiated product pipeline from the continued ramp of our I135 RF and M22 launches to the next generation of our next .

Speaker #1: Our enabling technology suite to the accelerating progress we're making on our robotic platform At the same time , the growing external interest we were seeing from external partners is a testament to the position we built in the shoulder surgical market , and we believe these relationships will be meaningfully expand .

Speaker #1: What we're able to offer surgeons and patients over time This quarter also marked just a year since our IPO and reflecting on everything our team has accomplished in that time , the growth we've delivered and the products we brought to the market in relationships we've built across the surgeon and partner community , our confidence in what lies ahead is very strong .

Rob Ball: This quarter also marked just a year since our IPO and reflecting on everything our team has accomplished in that time, the growth we've delivered and the products we've brought to the market and relationships we've built across the surgeon and partner community, our confidence in what lies ahead is very strong. The commercial organization we've built continues to perform. Our pipeline has never been deeper, and our conviction in the team's ability to execute has never been higher. We believe Shoulder Innovations remains in the very early stages of what we can accomplish in transforming shoulder surgical care, and we look forward to demonstrating that in the H2 of 2026 and beyond. With that, I'll now turn the call over to the operator for Q&A. Operator?

Speaker #1: The commercial organization we built continues to perform our pipeline has never been deeper , and our conviction in the team's ability to execute has never been higher .

Speaker #1: We believe shoulder remains in the very early stages of what we can accomplish in transforming shoulder surgical care , and we look forward to demonstrating that in the back half of 2026 and beyond With that , I'll now turn the call over to the operator for Q&A Operator .

Speaker #2: Thank you . At this time , we'll be conducting a question and answer session . If you'd like to ask a question , please press star one on your telephone keypad The confirmation tone will indicate your line is in the question queue .

Operator: Thank you. At this time, we'll be conducting a question and answer session. If you'd like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you'd like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment, please, while we poll for questions. Our first question comes from Matthew O'Brien with Piper Sandler. Please proceed with your question.

Speaker #2: You may press star two if you'd like to remove your question from the queue for participants using speaker equipment , it may be necessary to pick up your handset before pressing the star keys .

Speaker #2: One moment please , while we pull for questions Our first question comes from Matthew O'Brien with Piper Sandler Please proceed with your question

Speaker #1: Great . Thanks for taking the questions . Maybe for starters , on the guidance side of things , if you look at the .

Matthew O'Brien: Great. Thanks for taking the question. Maybe for starters, on the guidance side of things, if you look at the, it's good to see a bump up in the H2 of the year, and I understand seasonality and mix changes, but this time last year, you saw a pretty meaningful bump up H2 of the year versus the H1. This year, it's essentially flat H1 versus H2, and I know you want to be conservative, but I'm just curious about any other dynamics we should be aware of, especially competitively. I know one of your competitors has a new robotic system in shoulder, and they seem to be chatting that up a little bit. Just anything like that you can point to as far as the H2 guide goes, and then I do have a follow-up.

Speaker #1: It's good to see a bump up in the back half of the year, and I understand seasonality and mix changes. But you know, this time last year, you saw a pretty meaningful bump up in the second half of the year versus the first half.

Speaker #1: This this year , it's essentially flat first half versus second half . And I know you want to be conservative , but I'm just curious about any other dynamics we should be aware of , especially competitively .

Speaker #1: I know one of your competitors has a new robotic system in shoulder , and they seem to be chatting that up a little bit .

Speaker #1: So just anything like that that you can point to as far as the back half guide goes . And then I do have a follow up Yeah .

Rob Ball: Yeah. Matt, appreciate the question very much, thanks for pointing that out. I'd characterize a couple things remain factually true that I shared in the prepared remarks. One, our pace of new customer adds has done nothing but accelerate relative to last year. We feel really confident and excited about the progress that we've developed here in Q1 and Q2. There's nothing that we're remarking about or considering as it relates to any changes in the market dynamics in H2 of the year. I'd characterize that, like all quarters that we've reported on so far, we've presented numbers that we consider to be very high conviction numbers. It's no more complicated than that, Matt.

Speaker #3: Matt , I appreciate the question very much . And thanks for pointing that out . You know , I characterize a couple of things remain factually true that I shared in that prepared remarks .

Speaker #3: One , our pace of new customer adds has done nothing but accelerate relative to last year . We feel really confident and excited about the progress that we've developed here in , in Q1 and Q2 .

Speaker #3: You know , there's there's nothing that we remarking about or considering as it relates to any changes in the market dynamics in the second half of the year .

Speaker #3: And I'd characterize that like , like all quarters that we've reported on so far , we have we've presented numbers that we consider to be very high conviction numbers .

Speaker #3: And, you know, it's no more complicated than that. Matt,

Speaker #1: Got it . And then on the robotics side , you know , great news to hear that things have accelerated . And the submission the first half of next year .

Matthew O'Brien: Got it. Then on the robotics side, great news to hear that things have accelerated and the submission in H1 of next year. Can you talk about, I know it's a little early here, but just plans for that system, selling it ASPs, I'm sure you're going to get some kind of ASP bump on the implant side of things from it. Just anything you can frame up for us as we think about the impact of that system next year. Thanks.

Speaker #1: Can you talk about you know , I know it's a little early here , but just just plans for that . That system selling it ASPs and then , you know , I'm sure you're going to get some kind of ASP bump on the implant side of things from it .

Speaker #1: Just anything you can, you can frame up for us as we think about the impact of that system next year.

Speaker #1: Thanks .

Speaker #3: Yeah , I appreciate that . It's a great question , Matt . You know , kind of we're not in a position yet to share with the market our strategy as it relates to economic relationships .

Rob Ball: Yeah, I appreciate that. It's a great question, Matt. We're not in a position yet to share with the market our strategy as it relates to economic relationships we might build with operating centers. I think what I've shared on the last couple of calls is what we believe is very differentiated about our platform, is the structure and the portability of our platform puts us in a very, very unique position as it relates to the types of economic relationships we can build with centers, both ambulatory surgery centers and inpatient hospitals. I think that puts us in a position where we can build pricing into the implant, we can build pricing into actual capital purchase of the robot itself, and frankly, everything in between that.

Speaker #3: We might build with operating centers . But I think what I've shared in the last couple calls is what we believe is , is very differentiated about our platform is the structure and the portability of our platform puts us in a very , very unique position as it relates to the types of economic relationships we can build with centers , both ambulatory surgery centers and inpatient hospitals and , and I think that puts us in a position where we can build pricing into the implant .

Speaker #3: We can build pricing into actual capital purchase of the robot itself . And frankly , everything in between . Matt . We know we will start with a careful and pensive , limited user release to ensure we get everything right the first time .

Rob Ball: We know we will start with a careful and pensive limited user release to ensure we get just everything right the first time. We're extremely excited about what we're achieving from an outcome standpoint in 2027. I think we're in a very advantaged position relative to, I'll say, competitors as it relates to the relationships that we can build. Now, having said all of that, we do believe there will clearly be economic benefit to the company for deployment of that technology commensurate with the clinical benefit that we're providing for both hospitals and patients. We're excited about what that can be, and we believe it will be quite meaningful for Shoulder Innovations on a go-forward basis.

Speaker #3: And we're extremely excited about what we're achieving from an outcome standpoint . In 2027 . But , you know , I think I think we're in a very advantaged position relative to , let's say , competitors as it relates to the relationships that we can build .

Speaker #3: Now , having said all of that , we do believe there will clearly be economic benefit to the company for deployment of that technology commensurate with the with the clinical benefit that we're providing for both hospitals and patients .

Speaker #3: So , you know , we we're excited about kind of what that can be . And we believe it will be quite meaningful for SHOULDER INNOVATIONS, INC. go forward basis .

Speaker #1: Understood . Thank you .

Matthew O'Brien: Understood. Thank you.

Speaker #3: Yep .

Rob Ball: Yep.

Speaker #2: Our next question comes from Patrick Wood with UBS . Please proceed with your question .

Operator: Our next question comes from Patrick Wood with UBS. Please proceed with your question.

Speaker #4: Amazing . Thanks , guys . I've got two maybe the first one on insect go . You know , ten minutes is a is a pretty material saving in terms of surgery time .

Patrick Wood: Amazing. Thanks, guys. I've got two. Maybe the first one on InSET GO. 10 minutes is a pretty material saving in terms of surgery time. OR time, $40, $50 a minute is pretty meaningful. Do you think the bigger opportunity here is to use that as a way to break into new accounts to get utilization per surgeon up? Or is this also something where you can say, Hey, look, I'm probably saving you minimum $500 of absorbed overhead per case and include a little bit of pricing? Or is it a bit of both? How are you thinking about angling it?

Speaker #4: I mean , you know , all time 4050 bucks a minute . It's pretty meaningful . Do you think the bigger opportunity here is to use that as a way to break into new accounts , to get utilization per , you know , surgeon up ?

Speaker #4: Or is this also something where you can say, hey, look, I'm probably saving you a minimum of $500 of absorbed overhead per case and include a little bit of pricing?

Speaker #4: Or is it a bit of both ? How you're thinking about angling it ?

Speaker #3: I think interactions with surgeon customers in that context are commonly less about the minute-by-minute cost. It's more about, can I fit an additional surgery into my surgery day?

Rob Ball: I think interactions with surgeon customers, in that context, is commonly less about the minute-by-minute costs. It's more about can I fit an additional surgery into my surgery day? That's where the economic benefit can really be gained. I think when you reach times like 10 minutes, that can be possible. I'll put it that way. Won't always be common just based on surgery schedule, but it is, as you mentioned, Patrick, a material amount of time and can enable that. I'll highlight a recent anecdote. Because of the efficiency we've enabled in our system, we recently, at a major hospital center, did 8 surgeries in 1 day at a major inpatient hospital setting. A remarkable achievement that we were really delighted with, and it is a function of the efficiency that we present.

Speaker #3: That's where the economic benefit can really be gained . And I think when you reach times like ten minutes , that that can be possible , I'll put it that way won't always be be common just based on surgery schedule .

Speaker #3: But it is as you , as you mentioned , Patrick , a material amount of time and can enable that . I'll just I'll highlight a recent anecdote because of the efficiency we've we've enabled in our system .

Speaker #3: We recently at a major hospital center did eight surgeries in one day in a major inpatient hospital setting . So a remarkable achievement that we were kind of really delighted with .

Speaker #3: And it is a function of the efficiency that we present . And I'll just characterize that it's not just a surgeon that responds positively .

Rob Ball: I'll just characterize that it's not just a surgeon that responds positively, it's the entire staff. We had found over time that everything we can do to simplify the procedure is constructive for both the surgeon and their team broadly and is frankly a positive advantage for us.

Speaker #3: It's the entire staff . And so we have found over time that that everything we can do to simplifies the procedure is , is , is constructive for both the surgeon and their team broadly .

Speaker #3: and is, frankly, a positive advantage for us. So,

Patrick Wood: Makes sense. No, I completely get it. I guess the other one is obviously the core surgeon utilization is in a good spot. Maybe this is a strange question, but what do you find typically per surgeon triggers them to really drive utilization up? Is it a few months in, they've done a few InSet Glenoids, and then they suddenly begin to transition more of their book over? Is there like a triggering point of comfort with the system that you found recently that's getting them to adopt it much faster? What's that moment that kind of gets them to buy in, if that makes sense?

Speaker #4: And I completely get it . I guess the other one is obviously the core surgeon utilization is in a good spot . You know , maybe this is a strange question , but what do you find typically per surgeon triggers , you know them to really drive utilization up .

Speaker #4: Is it , you know , a few months in , they've done a few insect bites and then , you know , they suddenly begin to transition more of their book over .

Speaker #4: And is there , is there like a triggering point of comfort with the system that you found recently that's getting them to adopt it much faster ?

Speaker #4: Like , what's that moment that kind of gets them to buy in , if that makes sense ?

Speaker #3: Well , I wish that every surgeon was the same and we just had a recipe we could deploy . And on some level , you know , kind of we have to manage , you know , each , each interaction according to the particular surgeon's needs .

Rob Ball: Well, I wish that every surgeon was the same, and we just had a recipe we could deploy. On some level, we have to manage each interaction according to the particular surgeon's needs. That's what's very helpful about the level of experience we have in our W2 commercial leadership team. They can navigate that, I'll just call it complexity, if you will. I'd say, having said that, one thing that has been remarkable in the perceived change of how our customers view us as we have materially moved from the InSet Glenoid company to the InSet platform company. What I mean by that is surgeons recognize the significant technological benefits of our lateral kinematics in our reverse platform.

Speaker #3: And that's , you know , kind of that that's what's very helpful about the level of experience we have in our W-2 commercial leadership team .

Speaker #3: They can they can navigate that . I'll just call it complexity , if you will . You know , I'd say having said that , one thing that has been remarkable in the perceived change of how our customers view us as we have materially moved from the insect glenoid company to the insect platform company .

Speaker #3: What I mean by that is surgeons recognize the significant technological benefits of our lateral lateral kinematics in our reverse platform , and so as we've grown and matured as a company , we've seen surgeons become starters with our reverse platform more commonly than was the case historically as compared to our anatomic platform .

Rob Ball: As we've grown and matured as a company, we've seen surgeons become starters with our reverse platform more commonly than was the case historically as compared to our anatomic platform. I think the immediate outcome results are more evident in reverse for our company, for our technology as it relates to the anatomic. That's been quite remarkable. What we find, Patrick, is when surgeons leverage our reverse, we tend to build quite a bit of loyalty pretty quickly.

Speaker #3: And I think the immediate outcome results are more evident in reverse for our company , for our technology as it relates to anatomic .

Speaker #3: And so that's been quite remarkable . So what we find , Patrick , is when surgeons leverage our reverse , we tend to build quite a bit of loyalty pretty quickly .

Speaker #4: Nice one . Great to see . Thanks guys .

Patrick Wood: Excellent. Great to see you. Thanks, guys.

Speaker #3: Yeah . Thank you . Thank you .

Rob Ball: Yep. Thank you.

Speaker #2: As a reminder , if you'd like to ask a question , please press star one on your telephone keypad . One moment please .

Operator: As a reminder, if you'd like to ask a question, please press star one on your telephone keypad. One moment please while we poll for questions. Our next question comes from Ryan Zimmerman with US Bank. Please proceed with your question.

Speaker #2: While we wait for questions, our next question comes from Ryan Zimmerman with U.S. Bank. Please proceed with your question.

Speaker #5: Thank you , and congrats on a nice quarter here . I want to ask I mean , you know , I've listened to some of your peers talk over the last week during their earnings calls .

Ryan Zimmerman: Thank you, and congrats on a nice quarter here. I want to ask. I've listened to some of your peers talk over the last week during their earnings calls. One of the things that struck me is their US extremities numbers were maybe a little lower than I thought they would be. In that vein, Rob, I'm wondering if you could talk about, your core contender growth is impressive. In that context, do you see yourself taking share from existing players in the market? Do you see these core contender surgeons as they move up that curve in terms of utilization, growing the market? And what are your thoughts about that trade-off between market growth accelerating versus share gains potentially?

Speaker #5: And one of the things that struck me is , you know , their U.S. extremities numbers were maybe a little lower than I than I thought they would be .

Speaker #5: And so , you know , in that in that vein , Rob , I'm wondering if you could talk about I mean , your core contender growth is , impressive .

Speaker #5: And so in that context , do you see yourself taking share from existing players in the market ? Do you see these core contender surgeons as they , you know , move up that curve in terms of utilization , growing the market ?

Speaker #5: And you know , what are your thoughts about kind of that trade off between market growth accelerating versus , you know , share gains potentially ?

Speaker #3: Yeah . Thank you . Ryan , appreciate the question . You know , kind of I would say I don't I can't quantify the ratio , but a vast majority of the growth that we're driving is indeed taking share from larger market incumbents .

Rob Ball: Thank you, Ryan. Appreciate the question. I would say I can't quantify the ratio, but a vast majority of the growth that we're driving is indeed taking share from larger market incumbents. As time has gone by and we've penetrated further into the market, and particularly into centers with fellowship programs, you can consider a growth of the market can be in part developed by graduating fellows with shoulder specialty training. As we've grown, we've been able to capture more of those, but we're in the very early innings. What that means is, for sure there is a portion of market that we're capturing, call it 90/10, if you understand, Ryan. A very small portion related to expanding the market. A vast majority of that is just capture of existing market share from competitors.

Speaker #3: We as time has gone by and we've penetrated further into the market , and particularly into centers with fellowship programs , you can consider a growth of the market can be in part developed by graduating fellows with shoulder specialty training .

Speaker #3: And as we've grown , we've been able to capture more of those . But we're in the very early innings . So what that means is for sure , there is a portion of market that we're capturing , you know , call it 9010 .

Speaker #3: If you understand , Ryan , you know , kind of very small portion related to expanding the market , a vast majority of that is just capture of , of existing market share from , from competitors .

Speaker #5: Understood . And , you know , I was struck by , you know , you have a lot going on in the pipeline .

Ryan Zimmerman: Understood. I was struck by, you have a lot going on in the pipeline, Rob. You laid a lot out on the table this afternoon. When I think about ProVoyance today versus where you want to take it, how do you make that transition smooth, and how are you thinking about the impact of that playing through the business as you integrate these new programs, as you advance software, as you add potentially robotics in 2027 at some point? Help us think through what that means for the existing ProVoyance user base.

Speaker #5: Rob you , you laid a lot out on the table . This to this afternoon . When I think about , you know , Prévoyance today versus where you want to take it .

Speaker #5: I mean , how do you make that transition ? You know , smooth and how are you thinking about , you know , the impact of that , you know , playing through the business as you integrate these new programs , as you advance software , as you add , you know , potentially robotics , you know , in 27 at some point , you know , help us think through what that means for the existing Prévoyance user base .

Speaker #3: Yeah , it's a great question , Ryan . You know , so as you know , Prévoyance has been a very much an enabler for the relationships we've built with our , our core surgeons today and the way those surgeons typically become familiar and excited about Prévoyance is , frankly , training from other surgeons .

Rob Ball: It's another great question, Ryan. As you know, ProVoyance has been very much an enabler for the relationships we've built with our core surgeons today. The way those surgeons typically become familiar and excited about ProVoyance is frankly training from other surgeons. We have a number of surgeons that we've enlisted that are just experts on how to apply it into their clinical practice and have a very loud and effective voice in helping other surgeons to leverage it in the same way. As we expand the utility of ProVoyance, we would expect to use that same surgeon-to-surgeon communication basis as the primary driver.

Speaker #3: We have a number of surgeons that we've enlisted that are , are just experts on how to apply it into their clinical practice and have a , a quite , very loud and effective voice in helping other surgeons to , to leverage it in the same way .

Speaker #3: And as we expand the utility of Prévoyance , we would expect to , to , to use that same surgeon to surgeon communication basis as the primary driver .

Speaker #3: Now , as it relates to what do we think the impact . Is on the business on a go forward basis , you know , I would think about it , you know , in these terms , as we move into a more enabled technology environment in shoulder surgical care , the goal or the vision is that what happens in the operating room is more and more a preconceived resolution of what you have already planned in preoperative planning .

Rob Ball: Now, as it relates to what do we think the impact is on the business on a go-forward basis, I would think about it in these terms: as we move into a more enabled technology environment in shoulder surgical care, the goal or the vision is that what happens in the operating room is more and more a preconceived resolution of what you have already planned in preoperative planning. As time goes by, we will care for more and more of the risks and take more and more of the decision-making at the software level and less of that decision-making happening in the operating room. What happens in the operating room is just a function of what you've already conceived in the software.

Speaker #3: So as time goes by , we will care for more and more of the risks and take more and more of the decision making at the software level , and less of that decision making happening in the operating room .

Speaker #3: So what happens in the operating room is a is just a function of what you've already conceived in the software . We think that will provide for a more rapid pace of innovation in that we can provide better and better decision making tools more quickly at the software level .

Rob Ball: We think that will provide for a more rapid pace of innovation in that we can provide better and better decision-making tools more quickly at the software level. Number two, we think that enables us to put ourselves in a position where we have a very rich and sticky, for lack of a better term, environment that is very hard for surgeons to leave. We think it can be quite effective for driving loyalty on a go-forward basis.

Speaker #3: And number two , we think that enables us to put ourselves in a position where we have a very rich in , in , in sticky , for lack of a better term , environment that it's very hard for surgeons to leave .

Speaker #3: So we think it can be quite effective for , for driving loyalty on a go forward basis .

Speaker #5: Very helpful . Thank you . Look forward to it .

Ryan Zimmerman: Very helpful. Thank you. Look forward to it.

Speaker #6: Yep

Rob Ball: Yep.

Speaker #2: We have reached the end of the question and answer session . I would now like to turn the call over to management for closing remarks .

Operator: We have reached the end of the question and answer session. I would now like to turn the call over to management for closing remarks.

Speaker #7: I appreciate everybody's engagement today. Obviously, we're excited.

Rob Ball: Appreciate everybody's engagement today. Obviously, we're excited about the results that we have produced and excited about the future for the company. We have a ton of new innovation that we think is going to have a meaningful impact on a go-forward basis. Very much appreciate everyone's engagement today, and have a great afternoon.

Speaker #3: About the results that we have produced and excited about the future for the company . We have a ton of new innovation that we think is going to have a meaningful impact on a go forward basis .

Speaker #3: So very much appreciate everyone's engagement today and have a great afternoon .

Operator: This concludes today's conference. You may disconnect your lines at this time, and we thank you for your participation.

Q2 2026 Shoulder Innovations Inc Earnings Call

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