Quarterly Revenue and Organic Growth
Q4 revenue of $158 million, a 3% increase year-over-year, with 10% organic growth after adjusting for the Advanced Rehabilitation divestiture; management highlighted a year-over-year acceleration in the second half of 2025 driven by Pain Treatments and Restorative Therapies.
Adjusted EBITDA and Margin Expansion
Adjusted EBITDA of $37 million in Q4, up $8 million (+30% YoY); adjusted EBITDA margin expanded to 23%, an increase of approximately 490 basis points year-over-year. For the full year, adjusted EBITDA margin expanded nearly 150 basis points versus 2024, surpassing the company target to expand margin by 100 basis points.
Record Cash From Operations and Free Cash Flow Momentum
Quarterly cash from operations of approximately $38 million (record for a quarter); full-year cash from operations nearly $75 million, representing a 92% increase year-over-year. 2026 guidance projects cash from operations of $82–$87 million (approximately +10% to +17%).
Strong Gross Margin and Bottom-Line Improvement
Adjusted gross margin of 76% in Q4, up 180 basis points versus prior year. Adjusted operating income of $33 million (+$7 million YoY) and adjusted net income of $20 million (+$1 million YoY). Adjusted EPS of $0.24 in Q4; 2026 adjusted EPS guidance of $0.73–$0.77, with management expecting earnings growth to outpace revenue growth.
Balance Sheet Progress and Interest Savings
Ended the quarter with $51 million cash on hand and $294 million outstanding debt; debt decreased by $29 million during the quarter after revolving borrowings were repaid. Net leverage declined to below 2.5x with management targeting below 2.0x by the end of 2026. Term loan refinancing is expected to drive ongoing interest expense savings.
Successful Pilot Launches and Targeted Investment Program
Pilot launches for peripheral nerve stimulation (PNS) and platelet-rich plasma (PRP) received positive physician and patient feedback. Management reaffirmed a minimum combined contribution of 200 basis points to growth from PNS and PRP in 2026 and plans approximately $13 million of incremental investment across PNS, PRP, ultrasonics and international expansion in 2026.
Above-Market Segment Performance and International Momentum
Company delivered above-market organic revenue growth across all three businesses in 2025. Restorative Therapies recorded the highest organic growth in seven years, and the International segment grew 11% organically for the year.
Clear 2026 Targets and Growth Strategy
Management set 2026 net sales guidance of $600–$610 million, intends to maintain ~20% adjusted EBITDA margin while increasing investment in growth drivers, and articulated a framework to accelerate revenue growth, further expand margins (expected to resume expansion in 2027) and continue deleveraging.