olivlawolivlaw

olivLaw · US equity research

Shoulder Innovations, Inc. SI

Surgical & Medical Instruments & Apparatus · SIC 3841 · Vertical: Surgical & Medical Instruments & Apparatus (SIC 3841)

21.01USD+6.00% · 1 dayClose 04 Nov 2026

Shoulder Innovations is a medical technology company focused exclusively on shoulder surgery, offering implant systems for shoulder arthroplasty and a surgical ecosystem that includes AI-based preoperative planning. In 2026 it reported rapid sales growth, helped by the shift of procedures to outpatient centers, but it still runs operating losses.

At the close of 04 Nov 2026, Shoulder Innovations, Inc. (SI) stock was 21.01 USD (+6.00% on the day), with market capitalisation 437.4 m USD, beta 0.48, 52-week range 11.01–24.25 USD. Latest reported quarter (Q2 2026): revenue of 17.2 m USD (+56.0% YoY), net income of -10.2 m USD, diluted EPS -0.49 USD.

Data as of · AI analysis dated · Source: SEC filings and closing prices, computed by olivLaw.

Market cap
437.4 m USD
shares as of 30 Jul 2026
P/E (TTM)
unavailable
Diluted EPS TTM -1.92 · TTM to 30 Jun 2026
E/P (TTM)
-9.13%
TTM to 30 Jun 2026
Dividend yield
unavailable
Beta (2y)
0.48
Volatility (1y) 65%
52-week range
11.0124.25

Price history

Loading chart…

Technical reading

RSI (14)
64.2
strong (55–70)
Bollinger (20, 2)
17.28 – 20.75
above the upper band · %B 1.07 · band width 18.3%
SMA 50 / 200
19.06 / 17.10
uptrend (price > SMA50 > SMA200)
MACD (12, 26, 9)
0.35 / 0.17
MACD above signal

Indicators describe past prices; on their own they do not predict direction. On our history the RSI ≤ 40 filter added no return (see the signals methodology).

Performance

CompanyS&P 500vs S&P 500Vertical median
1 month+7.2%−1.1%+8.3 pp—
3 months−7.0%−0.5%−6.6 pp—
6 months+63.0%+4.4%+58.6 pp—
Year to date+46.9%+12.3%+34.6 pp—
1 year+88.1%+13.5%+74.6 pp−3.6%
3 yearsunavailable+76.4%unavailable−16.1%
5 yearsunavailable+63.7%unavailable—
Max drawdown (1y)
−29.9%
28 Jul 2026 → 25 Sept 2026
Max drawdown (5y)
−31.3%
02 Sept 2025 → 10 Nov 2025
Compound annual growth (5y)
unavailable
S&P 500 +10.4%

Price returns, dividends excluded.

Quarterly results

Latest quarter: Q2 2026 · 30 Jun 2026

Revenue
17.2 m USD
+56.0% YoY
Net income
-10.2 m USD
unavailable YoY
Diluted EPS
-0.49
unavailable YoY
net / operating
-59.1% / -58.4%

Quarterly margins

Quarterly statements · USD

Fiscal yearQ3 '24Q4 '24Q1 '25Q2 '25Q3 '25Q4 '25Q1 '26Q2 '26
Revenue7.5 m8.7 m10.1 m11.0 m11.8 m14.4 m16.7 m17.2 m
Cost of revenue1.8 m2.0 m2.3 m2.6 m2.8 m3.4 m3.7 m3.7 m
Gross profit5.7 m6.8 m7.8 m8.4 m9.0 m11.1 m13.0 m13.4 m
Research & development1.1 m1.2 m1.6 m1.4 m1.5 m3.2 m3.8 m3.4 m
SG&A8.5 m9.1 m10.5 m12.8 m15.1 m16.3 m18.2 m20.1 m
Operating income-3.9 m-3.5 m-4.3 m-5.9 m-7.6 m-8.5 m-9.0 m-10.0 m
Interest expense316.0 k391.0 k367.0 k216.0 k78.0 k-591.0 k-436.0 k-673.0 k
Pre-tax income-4.1 m-3.8 m-4.7 m-19.2 m-8.7 m-7.8 m-8.4 m-10.2 m
Income tax00000000
Net income-4.1 m-3.8 m-4.7 m-19.2 m-8.7 m-7.8 m-8.4 m-10.2 m
Diluted EPS-68.31-45.20 ≈-52.13-165.53-0.64-0.38 ≈-0.41-0.49
Operating cash flow-4.9 m ≈-3.3 m-6.5 m-4.8 m ≈-8.6 m ≈-8.8 m-12.4 m-7.4 m ≈
Capex887.0 k ≈1.0 m843.0 k1.5 m ≈2.8 m ≈2.3 m2.7 m2.2 m ≈

≈ derived quarter (cumulative difference / share-days average)

E/P over time

E/P = trailing-12-month diluted EPS / price at quarter end. E/P is the inverse of P/E and stays defined when earnings are negative.

Fiscal years

Fiscal year20242025
Revenue31.6 m47.3 m
Revenue YoYunavailable+49.6%
Net income-15.6 m-40.4 m
Net income YoYunavailableunavailable
Diluted EPS-242.04-4.65
Diluted EPS YoYunavailableunavailable
net %-49.4%-85.3%
Free cash flow-18.2 m-36.0 m

Reported results vs expectations

Loading…

Balance sheet & financial health

Fiscal year 2025 · 31 Dec 2025

Cash
26.9 m USD
Financial debt
14.9 m USD
Net debt
-12.0 m USD
Equity
140.8 m USD
Total assets
169.9 m USD
Debt / equity
0.11x
Current ratio
11.07x
ROE
unavailable
ROA
-37.9%
FCF margin
-76.1%

Financial statements (source on every figure)

Revenue and net income (USD)

Margins

Income statement · USD

Revenue
2024
31.6 m
2025
47.3 m

SEC (XBRL)· 10 Mar 2026verified

Cost of revenue
2024
7.3 m
2025
11.1 m

SEC (XBRL)· 10 Mar 2026verified

Gross profit
2024
24.3 m
2025
36.2 m

SEC (XBRL)· 10 Mar 2026verified

Research & development
2024
4.5 m
2025
7.7 m

SEC (XBRL)· 10 Mar 2026verified

SG&A
2024
34.5 m
2025
54.8 m

SEC (XBRL)· 10 Mar 2026verified

Operating income
2024
-14.7 m
2025
-26.3 m

SEC (XBRL)· 10 Mar 2026verified

Interest expense
2024
1.3 m
2025
70.0 k

SEC (XBRL)· 10 Mar 2026verified

Pre-tax income
2024
-15.6 m
2025
-40.4 m

SEC (XBRL)· 10 Mar 2026verified

Income tax
2024
0
2025
0

SEC (XBRL)· 10 Mar 2026verified

Net income
2024
-15.6 m
2025
-40.4 m

SEC (XBRL)· 10 Mar 2026verified

Diluted EPS
2024
-242.04
2025
-4.65

SEC (XBRL)· 10 Mar 2026verified

Weighted average diluted shares
2024
64.5 k
2025
8.7 m

SEC (XBRL)· 10 Mar 2026verified

Balance sheet · USD

Cash
2024
6.1 m
2025
26.9 m

SEC (XBRL)· 10 Mar 2026verified

Receivables
2024
5.1 m
2025
8.3 m

SEC (XBRL)· 10 Mar 2026verified

Inventories
2024
14.0 m
2025
21.6 m

SEC (XBRL)· 10 Mar 2026verified

Current assets
2024
35.1 m
2025
157.2 m

SEC (XBRL)· 10 Mar 2026verified

Property, plant & equipment, net
2024
7.5 m
2025
12.5 m

SEC (XBRL)· 10 Mar 2026verified

Intangibles (excl. goodwill)
2024
400.0 k
2025
100.0 k

SEC (XBRL)· 10 Mar 2026verified

Total assets
2024
43.1 m
2025
169.9 m

SEC (XBRL)· 10 Mar 2026verified

Accounts payable
2024
4.9 m
2025
8.9 m

SEC (XBRL)· 10 Mar 2026verified

Long-term debt
2024
14.7 m
2025
14.9 m

SEC (XBRL)· 10 Mar 2026verified

Current liabilities
2024
7.6 m
2025
14.2 m

SEC (XBRL)· 10 Mar 2026verified

Total liabilities
2024
23.3 m
2025
29.2 m

SEC (XBRL)· 10 Mar 2026verified

Equity
2024
-54.7 m †
2025
140.8 m †

SEC (XBRL)· 10 Mar 2026verified

Cash flow · USD

Operating cash flow
2024
-14.1 m
2025
-28.6 m

SEC (XBRL)· 10 Mar 2026verified

Capex
2024
4.0 m
2025
7.4 m

SEC (XBRL)· 10 Mar 2026verified

Free cash flow
2024
-18.2 m ≈
2025
-36.0 m ≈

SEC (XBRL)· 10 Mar 2026derived

Investing cash flow
2024
14.0 m
2025
-95.6 m

SEC (XBRL)· 10 Mar 2026verified

Financing cash flow
2024
66.0 k
2025
145.0 m

SEC (XBRL)· 10 Mar 2026verified

Computed indicators

Growth

Revenue growth (YoY)
49.6%
computed by olivLawFY 2025
Revenue CAGR 3Y
unavailable
input data missing
Revenue CAGR 5Y
unavailable
input data missing
EBIT growth (YoY)
unavailable
the base of the ratio is not positive
Net income growth (YoY)
unavailable
the base of the ratio is not positive
Net income CAGR 3Y
unavailable
input data missing
Net income CAGR 5Y
unavailable
input data missing
EPS growth (YoY)
unavailable
the base of the ratio is not positive
EPS CAGR 3Y
unavailable
input data missing
EPS CAGR 5Y
unavailable
input data missing
FCF growth (YoY)
unavailable
the base of the ratio is not positive

Profitability

Gross margin
77.3%
computed by olivLawTTM to 30 Jun 2026
EBITDA margin
unavailable
input data missing
EBIT margin
-58.5%
computed by olivLawTTM to 30 Jun 2026
Net margin
-58.3%
computed by olivLawTTM to 30 Jun 2026
FCF margin
-78.4%
computed by olivLawTTM to 30 Jun 2026

Returns

ROE
-151.9%
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
ROA
-30.5%
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
ROIC
-243.9%
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
ROCE
-25.3%
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
Payout ratio (EPS)
unavailable
input data missing
Payout ratio (FCF)
unavailable
input data missing

Balance sheet

Net debt
-9.6 m USD
computed by olivLawbalance sheet at 30 Jun 2026
Net debt / EBITDA
unavailable
input data missing
Debt / equity
0.1x
computed by olivLawbalance sheet at 30 Jun 2026
Interest coverage
-21.7x
computed by olivLawTTM to 30 Jun 2026

Liquidity

Current ratio
10.7x
computed by olivLawbalance sheet at 30 Jun 2026
Quick ratio
8.9x
computed by olivLawbalance sheet at 30 Jun 2026
Cash ratio
1.9x
computed by olivLawbalance sheet at 30 Jun 2026

Cash

Operating cash flow
-37.1 m USD
computed by olivLawTTM to 30 Jun 2026
Capital expenditure
10.0 m USD
computed by olivLawTTM to 30 Jun 2026
Free cash flow
-47.1 m USD
computed by olivLawTTM to 30 Jun 2026
FCF conversion
unavailable
insufficient data
Cash conversion
unavailable
input data missing

Efficiency

Days sales outstanding
54 days
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
Days inventory outstanding
536 days
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
Days payables outstanding
161 days
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
Cash conversion cycle
430 days
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026

Market and valuation

Market capitalisation
437.4 m USD
computed by olivLawbalance sheet at 30 Jun 2026
Enterprise value
427.8 m USD
computed by olivLawbalance sheet at 30 Jun 2026
Market cap / net income TTM
unavailable
insufficient data
P/E (TTM)
unavailable
insufficient data
Earnings yield
-9.1%
computed by olivLawTTM to 30 Jun 2026
P/B
3.5x
computed by olivLawbalance sheet at 30 Jun 2026
P/S
7.3x
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
EV/EBITDA
unavailable
input data missing
EV/EBIT
unavailable
insufficient data
EV/Sales
7.1x
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
P/FCF
unavailable
the base of the ratio is not positive
FCF yield
-10.8%
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
Dividend yield
unavailable
no dividend in the structured statements; a missing line is not a confirmed zero
Shareholder yield (distributions)
unavailable
input data missing

1 indicators that do not apply to the sector.

Valuation

olivLaw classification

Insufficient data
What is missing
  • indicators available: 5 of at least 6
  • score weight coverage: 35.4% of at least 60%
  • valuation methods computed: 0 of at least 1

A scoring methodology on indicators and valuation, not investment advice.

Closing price

21.01 USD

04 Nov 2026Source: olivLaw, closing series

Market cap: 437.4 m USD

Key indicators

Market capitalisation
437.4 m USD
computed by olivLawbalance sheet at 30 Jun 2026
P/E (TTM)
unavailable
insufficient data
P/B
3.5x
computed by olivLawbalance sheet at 30 Jun 2026
EV/EBITDA
unavailable
input data missing
ROE
-151.9%
computed by olivLawTTM to 30 Jun 2026 · balance sheet at 30 Jun 2026
Net margin
-58.3%
computed by olivLawTTM to 30 Jun 2026
Revenue growth (YoY)
49.6%
computed by olivLawFY 2025
Dividend yield
unavailable
no dividend in the structured statements; a missing line is not a confirmed zero

Coverage and freshness

29/37 reporting lines present
Latest full fiscal year: 2025
Latest reported period: 30 Jun 2026
Latest balance sheet date: 30 Jun 2026
Share count (cover of the latest filing), as of: 30 Jul 2026
Source: SEC (XBRL)published 06 Aug 2026
verified 317derived 28

Score by group

35% · Insufficient data

Estimated value range

unavailable — no valuation method could be computed

Valuation assumptions are editorial choices, not measured; beta is not measured.

Valuation methods

  • DCF (discounted cash flow)unavailable · the base of the ratio is not positive
  • Peers: EV/EBITDAunavailable · input data missing
  • Peers: P/Eunavailable · the base of the ratio is not positive
  • Dividend discount (DDM)unavailable · the company pays no dividend: a dividend model needs an explicit initiation assumption

no valuation method could be computed

Multiple comparisons use the SIC vertical: Surgical & Medical Instruments & Apparatus (SIC 3841)

Classification (SIC) comparables group by industry code, not by economic activity; the direct group is an editorial selection by activity. Members' multiples are on their own trailing twelve months, at their own latest close.

Assumptions (illustrative, editorial)

Risk-free rate
4.3%
Equity risk premium
5.0%
Beta (default)
1.00
Cost of equity
9.3%
Terminal growth
2.5%

Factor scorecard

Insufficient data

Minimum-evidence gate: indicators available: 5 of at least 6; score weight coverage: 35.4% of at least 60%; valuation methods computed: 0 of at least 1

FactorValueScoreWeight used
ROIC · Quality-243.9%0 (vs peers)29%
Net margin · Quality-58.3%19 (vs peers)18%
FCF conversion · Qualityunavailableunavailable—
Revenue CAGR 3Y · Growthunavailableunavailable—
EPS CAGR 3Y · Growthunavailableunavailable—
Net debt / EBITDA · Balance sheetunavailableunavailable—
Interest coverage · Balance sheet-21.7x0 (on a fixed band)18%
Current ratio · Balance sheet10.7x100 (on a fixed band)12%
P/E (TTM) · Valuationunavailableunavailable—
EV/EBITDA · Valuationunavailableunavailable—
FCF yield · Valuation-10.8%0 (on a fixed band)24%
Shareholder yield (distributions) · Returnsunavailableunavailable—
Payout ratio (FCF) · Returnsunavailableunavailable—

Factors without a value were dropped; the remaining weights were renormalised.

Score groups

  • Balance sheet40/100 · 2/3 factors with a value
  • Growth· partialunavailable · 0/2 factors with a value
  • Quality7/100 · 2/3 factors with a value
  • Returns· partialunavailable · 0/2 factors with a value
  • Valuation· partial0/100 · 1/3 factors with a value

A «partial» group is computed from under half of its weight or from one factor: it is not a full assessment of the group.

Memo

SHOULDER INNOVATIONS, INC. (SI). Latest full fiscal year: 2025; data up to 2026-06-30.

Figures computed from the financial statements: revenue 47.3 m USD in 2025; YoY growth 49.6%; net margin -58.3%; ROE -151.9%.

Valuation cannot be computed from the available data.

Insufficient data for a verdict (indicators available: 5 of at least 6; score weight coverage: 35.4% of at least 60%; valuation methods computed: 0 of at least 1).

Text generated deterministically from the figures shown; no language model. Not investment advice.

What supports the thesis

  • Current ratio: 10.7x

What contradicts it

  • ROIC: -243.9%
  • Net margin: -58.3%
  • Interest coverage: -21.7x
  • FCF yield: -10.8%

Not assessed (insufficient data or a ratio without meaning): FCF conversion, Revenue CAGR 3Y, EPS CAGR 3Y, Net debt / EBITDA, P/E (TTM), EV/EBITDA, Shareholder yield (distributions), Payout ratio (FCF).

Versus the vertical median

Surgical & Medical Instruments & Apparatus (SIC 3841) · same industry (4-digit SIC) · compared with 39 companies

Multiples and returns vs the median

P/E
—
vertical median 34.8x
EV/EBITDA
—
vertical median 18.6x
P/S
7.3x
vertical median 5.1x
above median (+42.8%)
P/B
3.5x
vertical median 3.3x
above median (+6.7%)
ROE
-151.9%
vertical median -12.2%
below median
Net margin
-58.3%
vertical median -6.2%
below median
EBIT margin
-58.5%
vertical median -3.3%
below median
Revenue YoY
49.6%
vertical median 10.5%
above median (+372.4%)
Net debt/EBITDA
—
vertical median 1.7x
Dividend yield
—
vertical median 1.0%

Price rebased to 100 (monthly, 5 years)

Companies in the vertical

Market capP/EROENet marginRevenue YoY1A / 3A
SYKStryker Corp129.3 bn36.216.0%13.8%+11.2%−8% / +15%
MMM3m Company100.2 bn28.980.8%14.0%+1.5%+13% / +134%
BSXBoston Scientific Corporation66.4 bn19.414.3%16.6%+19.9%−55% / −18%
BDXBecton, Dickinson And Company57.0 bn63.23.8%4.0%+8.2%+37% / +13%
RMDResMed Inc.33.8 bn21.926.4%27.8%+9.9%−6% / +52%
DXCMDexcom, Inc.33.0 bn34.837.7%19.4%+15.6%+39% / −23%
WSTWest Pharmaceutical Services, Inc.28.5 bn45.921.2%18.8%+6.3%+47% / +17%
GKOSGLAUKOS Corp14.6 bn—-22.8%-24.6%+32.3%+132% / +286%
BAXBaxter International Inc.13.7 bn—-10.5%-6.2%+5.7%+41% / −27%
PODDInsulet Corporation11.4 bn26.928.9%13.4%+30.7%−50% / −13%
TFXTeleflex Incorporated6.4 bn—-28.9%-45.8%+17.2%+31% / −34%
HAEHaemonetics Corporation5.8 bn62.311.2%7.1%−2.0%+57% / +58%
ICUIIcu Medical Inc4.3 bn144.21.4%1.4%−6.3%+16% / +97%
LMATLemaitre Vascular, Inc.2.0 bn30.916.8%25.0%+13.5%+6% / +67%
KMTSKestra Medical Technologies, Ltd.1.8 bn—-73.7%-140.4%+59.0%+13% / unavailable
IARTIntegra Lifesciences Holdings Corp1.2 bn88.31.2%0.8%+1.5%+13% / −62%
SIBNSi-Bone, Inc.1.1 bn—-7.7%-6.2%+20.2%+28% / +32%
MDXGMimedx Group, Inc.467.0 m—-8.5%-6.3%+20.0%−53% / −59%
CARLCarlsmed, Inc.439.3 m—-6,196.9%-57.4%+85.9%−1% / unavailable
BWAYBrainsway Ltd.439.0 m224.25.6%7.1%+29.0%+28% / +258%
SIShoulder Innovations, Inc.437.4 m—-151.9%-58.3%+49.6%+88% / unavailable
OFIXOrthofix Medical Inc.395.9 m—-13.9%-7.4%+2.9%−40% / −12%
CTSOCytosorbents Corporation286.6 m—-336.2%-48.9%+4.1%−72% / −81%
UTMDUtah Medical Products, Inc.230.6 m22.18.8%29.0%−5.8%+29% / −14%
LUNGPulmonx Corporation123.2 m—-90.3%-47.9%+8.0%+75% / −74%

1- and 3-year price returns: for SI from daily closes (the same as the performance table), for the other companies from month-end closes.

olivLaw engine forecast

The world engine ran after the company's latest material disclosure. Probabilities are of TOUCHING a level within the horizon (not closing there) and sit next to the random walk (p_rw), the no-information benchmark.

The engine has no published run for this company yet.

Valuation scenarios (editable assumptions)

Illustrative scenarios

Illustrative: not forecasts and without probabilities. Each case is one coherent set of assumptions, computed on today's figures.

Bear
Allowed range: -50 … 50%
Allowed range: -100 … 100%
Allowed range: 0 … 100
Allowed range: -10 … 20%
Allowed range: 0 … 100%
Base
Allowed range: -50 … 50%
Allowed range: -100 … 100%
Allowed range: 0 … 100
Allowed range: -10 … 20%
Allowed range: 0 … 100%
Bull
Allowed range: -50 … 50%
Allowed range: -100 … 100%
Allowed range: 0 … 100
Allowed range: -10 … 20%
Allowed range: 0 … 100%
Nothing is saved.

Estimated price (USD)

Estimated priceBearBaseBull
1 years
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
3 years
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
5 years
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
insufficient data
Total return unavailable · Per year unavailable
What moves the 3-year price the most

    AI analysis

    AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.

    In brief

    Shoulder Innovations is a medical technology company focused exclusively on shoulder surgery, offering implant systems for shoulder arthroplasty and a surgical ecosystem that includes AI-based preoperative planning. In 2026 it reported rapid sales growth, helped by the shift of procedures to outpatient centers, but it still runs operating losses.

    SWOT

    Strengths

    • The company is exclusively focused on shoulder surgery, which allows a specialised offering and a dedicated commercial team.
    • Recent sales growth and a high gross margin show real demand for the two-tray system.
    • Published clinical evidence for the InSet Glenoid and integration of ProVoyance planning support the company's positioning.

    Weaknesses

    • The company remains unprofitable, with operating losses and negative adjusted EBITDA in 2025 and 2026.
    • Commercial and R&D spending is rising quickly, which pressures operating margins.
    • Manufacturing is outsourced to third parties, creating dependence on manufacturing partners.

    Opportunities

    • The shift of procedures to ambulatory surgery centers could accelerate adoption of the two-tray system.
    • Expansion into sports medicine and shoulder trauma could enlarge the addressable market.
    • International markets and the InSet Neo robot, if approved, could open new revenue sources.

    Threats

    • Pricing pressure in the healthcare system could reduce margins in the future.
    • Competitors with more mature solutions could limit gains in market share.
    • Debt obligations secured by the company's assets could restrict financial flexibility if results fall short of guidance.

    Risks

    • Persistent losseshigh

      The company has incurred net losses every year since inception and expects to keep losing money for an extended period 1.

    • Debt and covenantsmedium

      The Trinity loan is secured by substantially all assets, and a covenant breach could lead to foreclosure on the collateral 1.

    • Reliance on third-party suppliersmedium

      Implant manufacturing is outsourced, and quality or supply problems could delay deliveries 1.

    • Managing growthmedium

      Rapid growth demands more resources and stronger internal controls, and poor management could affect execution of the plan 1.

    Investment thesis

    What would need to be true (bull case)

    • Sales growth and the raised guidance point to strong commercial momentum, and a high gross margin suggests a favourable cost structure if volumes keep rising.
    • The refinancing and new credit lines reduce near-term liquidity risk, and available cash gives time to execute.
    • The shift of operations to ambulatory surgery centers, where the two-tray system is advantageous, could support longer-term growth.

    What would break the thesis

    • Persistent operating losses and rising expenses could prevent profitability within the visible horizon.
    • Debt secured by the company's assets could limit flexibility if sales slow down.
    • Reliance on third-party manufacturers and pressure on healthcare prices could reduce margins if problems arise.

    What to watch

    • Trend in implant sales volume and gross marginQ3 2026
    • Delivery against the 2026 revenue guidance2026
    • FDA submission timing for InSet Neofirst half 2027
    • Development of operating loss and commercial spendingnext 10-K

    Products, market & competition

    AI-generatedAI-generated analysis (Claude) from cited public sources; it may contain errors. Not investment advice. As of 27 Oct 2026 · Model: claude-haiku-5-5.

    The business

    Shoulder Innovations is a commercial-stage medical technology company exclusively focused on transforming shoulder surgical care. Its current offering includes advanced implant systems for shoulder arthroplasty, including aTSA and rTSA variants, complemented by the ProVoyance planning platform that uses AI and ML to turn CT images into 3D renderings. The company built its ecosystem around an instrument system with just two trays, versus six to nine trays used by other offerings 1.

    Recent quarterly results show the scale of growth: net revenue in the second quarter of 2026 reached 17.2 million dollars, up 56% from the same quarter of 2025, with a gross margin of 78.3% 3. The company raised its 2026 guidance to 67-69 million dollars, which would represent growth of roughly 42-46% over 2025 3.

    The company is not yet profitable: its 2025 net loss was 40,359 thousand dollars, and principal outstanding under the Trinity loan was about 15,000 thousand dollars at December 31, 2025 1. In 2026 it refinanced debt through credit facilities of up to 50 million dollars, and at June 30, 2026 it held 99.0 million dollars in cash and marketable securities 23.

    Segments

    Shoulder arthroplasty implant systems

    The core segment includes aTSA and rTSA implants built on InSet Glenoid technology and humeral stems. Revenue comes from implants sold, at an average price of 7,273 dollars in 2025 1. Implant units sold rose from 1,443 in the first quarter of 2025 to 2,238 in the second quarter of 2026 2.

    ProVoyance preoperative planning

    ProVoyance is an AI and ML preoperative planning platform cleared by the FDA for shoulder planning. According to the company, virtually all surgeries using its implants use ProVoyance, which points to its integration into surgeon workflow 1.

    Market context

    The company estimates that about 250,000 shoulder arthroplasty procedures were performed in the United States in 2025, a market of roughly 1.7 billion dollars, with annual growth expected at about 11% through 2029 1. Adding the international market brings the global estimate to about 2.7 billion dollars 1. The growing weight of ambulatory surgery centers is an important factor, since Medicare added total shoulder arthroplasty to its ASC covered list effective 2024 1.

    Demand is also affected by seasonality: the company expects lower demand in the months around the third calendar quarter, linked to summer 1. Market size depends on the company's internal estimates, which are not independently verified in the sources.

    Trends

    • Shift of procedures to ambulatory surgery centerstailwind

      Growth in ASC procedures, where costs are lower, could support demand for the company's two-tray system. Medicare added total shoulder arthroplasty to the ASC list in 2024 1.

    • Pricing pressure in healthcareheadwind

      Industry trends have increased downward pricing pressure on medical products; the company has not yet seen a material impact but cannot rule out that this could change 1.

    • Innovation and range expansionmixed

      Launches such as the I-Series stem line, implants for metal-sensitive patients and the InSet Neo robot could widen the addressable market if clinicians and regulators accept them 2.

    • Dependence on financingmixed

      Persistent operating losses make access to capital and credit important; the 2026 refinancing reduces near-term risk, but obligations remain 3.

    Competitive position

    The analysed sources do not name competitors. The company says it differentiates through its ecosystem, its two-tray instrument system and clinical data on the InSet Glenoid, which has a mean follow-up of 8.7 years 1.

    Competition comes from traditional arthroplasty solutions that use six to nine instrument trays and may be harder to run in ASCs 1. The company argues that it addresses the limitations of legacy implants.

    • Traditional shoulder implant makers

      Legacy arthroplasty solutions with more instrument trays are the direct competition described in the filing.

    • Systems requiring six to nine instrument trays

      Alternatives that need more trays are the comparison point the company invokes.

    • Hospital-based shoulder surgery

      Hospitals are a competing site of care, though they are also a place where procedures are performed.

    • Other preoperative planning providers

      The sources do not name providers; planning technology is cited only as a differentiator.

    News & filings

    In the press

    No news in our archive over the last 180 days.

    SEC filings

    • Current report08 Oct 2026
      Regulation FD disclosure · Financial statements and exhibits
    • Current report10 Aug 2026
      Regulation FD disclosure · Financial statements and exhibits
    • Quarterly report06 Aug 2026
    • Current report06 Aug 2026
      Results of operations · Financial statements and exhibits
    • Current report29 Jun 2026
      Material agreement · Termination of a material agreement · Creation of a direct financial obligation · Regulation FD disclosure · Financial statements and exhibits
    • Current report26 Jun 2026
      Shareholder vote
    • Quarterly report13 May 2026
    • Current report13 May 2026
      Results of operations · Financial statements and exhibits
    • Proxy statement29 Apr 2026
    • Current report27 Apr 2026
      Regulation FD disclosure · Financial statements and exhibits

    Sources

    1. [1] Form 10-K, fiscal year ended 2025-12-31 · SEC / Shoulder Innovations, Inc. · 10 Mar 2026
    2. [2] Form 10-Q, quarter ended 2026-06-30 · SEC / Shoulder Innovations, Inc. · 06 Aug 2026
    3. [3] Form 8-K, results release (exhibit 99.1) · SEC / Shoulder Innovations, Inc. · 06 Aug 2026

    Figures computed by olivLaw from SEC filings and closing prices; the qualitative analysis is AI-generated from cited sources. Not investment advice.