Shoulder Innovations Raises 2026 Revenue Outlook Again

The Tip Desk · November 11, 2026 · 3 min read

The company now expects full-year 2026 net revenue of $68 million to $70 million after third-quarter sales of $16.2 million.

Shoulder Innovations, Inc. (SI), a commercial-stage medical technology company focused on shoulder surgical care, raised its full-year 2026 net revenue outlook to $68 million to $70 million after a third quarter in which year-over-year growth cooled for a second consecutive period.

The new range represents growth of approximately 44% to 48% over full-year 2025 net revenue. Prior guidance, issued after the second quarter, was $67 million to $69 million. After the first quarter, the company had guided to $65 million to $68 million.

Net revenue in the third quarter ended September 30, 2026, was $16.2 million, up 38% from $11.8 million a year earlier. That followed 56% year-over-year growth in the second quarter and 65% in the first quarter. The company said the increase was primarily due to more implant systems sold, driven by new surgeon customers and higher utilization among existing customers, as well as a higher average selling price.

Implant systems sold were 2,126, an approximate 34% increase over the third quarter of 2025, after approximately 50% volume growth in the second quarter and 51% in the first. Average selling price was $7,616, a 2% increase from a year earlier, after a 5% increase in the second quarter and a 9% increase in the first.

Gross margin was 78.5%, compared with 76.2% a year earlier. The company attributed the increase to higher average selling prices and benefits from cost reduction programs. Selling, general and administrative expenses rose 14% to $17.1 million from $15.1 million a year earlier, after a 56% increase in the second quarter and a 73% increase in the first. The company said the increase was primarily due to investments in the commercial organization and higher variable selling expenses, partially offset by lower legal expenses. Research and development expenses were $3.2 million, up 107% from $1.5 million a year earlier, which the company said reflected investment in new product development, including work on the InSet Neo robotic platform.

Operating loss was $7.6 million, essentially unchanged from a year earlier, after a $10.0 million operating loss in the second quarter and a $9.0 million operating loss in the first. The company said higher gross profit was offset by increased operating expenses. Net loss was $7.0 million, or $0.34 a share, compared with a net loss of $8.7 million, or $0.64 a share, a year earlier. The company said the decrease was primarily due to changes in the fair value of preferred stock warrant liability and convertible notes in the prior year. Adjusted EBITDA was a loss of $5.5 million.

Cash and cash equivalents and marketable securities totaled $92.3 million as of September 30, 2026.

The company completed the first surgical cases with InSet Go, its next-generation anatomic glenoid implant, received FDA 510(k) clearance for and launched the N-22 humeral head, and announced an exclusive partnership with ALM Ortho to develop additively manufactured solutions for severe deformity and complex revision cases. It also announced a settlement with Catalyst OrthoScience Inc. to resolve outstanding patent litigation. Chief Executive Rob Ball said the quarter reflected the consistency of the commercial model, with new surgeons added ahead of plan and volume growth within the existing customer base. The company said it promoted Jon Osborne to Chief Commercial Officer and continued to expand the commercial leadership organization.

Ball said the company looks forward to finishing 2026 and building on that momentum into 2027, including a planned FDA submission of InSet Neo.