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Shoulder Innovations, Inc.
(NYSE:SI)
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Rating:55Neutral
Price Target:
$21.00
▲(2.89% Upside)
Action:Reiterated
Date:08/10/26
The score is held back primarily by weak cash flow and worsening losses despite strong revenue growth and high gross margins. Technicals are modestly supportive with a longer-term uptrend but neutral current momentum, while valuation remains constrained by ongoing losses (negative P/E). The earnings call improves the outlook due to raised revenue guidance and continued strong gross margin profile, tempered by elevated operating spend and near-term cash burn.
Positive Factors
Strong revenue growth and surgeon adoption
Rapid, repeatable adoption by surgeons and accelerating implant volume indicate true commercial traction in an underpenetrated shoulder market. Durable top-line momentum across channels supports scaling revenue as new customers convert and utilization deepens, giving a multi-quarter runway for sustained growth.
Negative Factors
Accelerating negative operating and free cash flow
Persistent, sizable cash burn increases reliance on external capital and elevates funding risk if markets tighten. Negative operating and free cash flow mean current operations do not self-fund growth, pressuring runway and forcing prioritization between scale investments and liquidity preservation over coming quarters.
Read all positive and negative factors
Positive Factors
Negative Factors
Strong revenue growth and surgeon adoption
Rapid, repeatable adoption by surgeons and accelerating implant volume indicate true commercial traction in an underpenetrated shoulder market. Durable top-line momentum across channels supports scaling revenue as new customers convert and utilization deepens, giving a multi-quarter runway for sustained growth.
Read all positive factors
Shoulder Innovations, Inc. (SI) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$408.68M
Dividend YieldN/A
Average Volume (3M)130.31K
Price to Earnings (P/E)―
Beta (1Y)-0.46
Revenue Growth60.90%
EPS Growth-7.99%
CountryUS
Employees74
SectorGeneral
Sector StrengthN/A
IndustryMedical - Specialties
Share Statistics
EPS (TTM)-1.71
Shares Outstanding20,818,956
10 Day Avg. Volume85,080
30 Day Avg. Volume130,306
Financial Highlights & Ratios
PEG Ratio-0.05
Price to Book (P/B)1.90
Price to Sales (P/S)6.23
P/FCF Ratio-8.19
Enterprise Value/Market Cap<0.01
Enterprise Value/Revenue<0.01
Enterprise Value/Gross Profit<0.01
Enterprise Value/Ebitda>-0.01
Forecast
1Y Price Target
$24.75Price Target Upside21.26% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering4
EPS Forecast (FY)-1.71
Revenue Forecast (FY)$67.28M
Shoulder Innovations, Inc. Business Overview & Revenue Model
Company Description
Shoulder Innovations, Inc. manufactures medical devices. It has developed a shoulder replacement system. The company was founded by Stephen B. Gunther and Michael DeVries in 2009 and is headquartered in Grand Rapids, MI....
How the Company Makes Money
SI primarily makes money by selling shoulder arthroplasty products (implant systems and related surgical instruments/ancillary components) to healthcare providers (e.g., hospitals and ambulatory surgery centers) that perform shoulder replacement p...
Shoulder Innovations, Inc. Earnings Call Summary
Earnings Call Date:May 13, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Nov 17, 2026
Earnings Call Sentiment Positive
The call presented a strong operating and commercial momentum: sizable revenue and volume growth, improving gross margins, accelerating surgeon adoption and meaningful product and technology milestones (I-135 full launch, N22 limited release, >500 patients in registry, and a progressing robotic partnership). These positives were offset by increased operating expenses and larger net and adjusted EBITDA losses as the company invests to scale, a Q1 cash burn driven by inventory and working capital, and some seasonality and ASP/mix variability risk embedded in the updated guidance. Overall, management expressed high conviction in the trajectory and raised full-year guidance while noting near-term investment-related impacts.Positive Updates
Strong Top-Line Growth
Net revenue of $16.7M in Q1 2026, up 65% year-over-year and 16% sequentially, driven by new surgeon adoption, increased utilization and higher ASPs.
Negative Updates
Widening Operating Losses
Net loss increased to $8.4M in Q1 2026 from $4.7M a year earlier; adjusted EBITDA loss rose to $7.0M from $3.5M, primarily driven by higher SG&A and R&D investments.
Read all updates
Q1-2026 Updates
Positive
Negative
Strong Top-Line Growth
Net revenue of $16.7M in Q1 2026, up 65% year-over-year and 16% sequentially, driven by new surgeon adoption, increased utilization and higher ASPs.
Read all positive updates
Company Guidance
Management raised full‑year 2026 net revenue guidance to $65–68 million (growth of 37%–44% vs. 2025; prior range $62–65M or 31%–37%) after a strong Q1: net revenue $16.7M (+65% YoY, +16% sequential), total implant volume 2,184 units (+51% YoY) and gross margin 77.7% (vs. 76.9% a year ago). Q1 operating metrics included SG&A $18.2M (vs. $10.5M prior year) with variable selling expense down from 128% of revenue in Q3 2025 to 109% in Q1 2026, R&D $3.8M (vs. $1.6M), net loss $8.4M, adjusted EBITDA loss $7.0M, and cash & equivalents $108.5M at 3/31/26. Guidance assumes similar gross margins for the balance of 2026 (subject to quarter‑to‑quarter product‑mix and ASP variability), typical seasonality (lighter Q3, step‑up in Q4), a modest rise in SG&A as a percent of revenue in Q2–Q3 to fund greenfield expansion before declining in Q4, and R&D as a percent of revenue moderating late in the year; management also noted increased inventory/asset purchases in H1 but expects significantly lower cash burn starting in Q2 and believes current cash can support the path to cash‑flow breakeven.Shoulder Innovations, Inc. Financial Statement Overview
Summary
Income Statement
46
Neutral
Balance Sheet
66
Positive
Cash Flow
34
Negative
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 |
|---|---|---|---|---|
Income Statement | ||||
| Total Revenue | 60.05M | 47.32M | 31.62M | 19.27M |
| Gross Profit | 46.45M | 36.20M | 24.34M | 15.27M |
| EBITDA | -33.03M | -37.08M | -12.11M | -10.25M |
| Net Income | -35.03M | -40.36M | -15.62M | -12.65M |
Balance Sheet | ||||
| Total Assets | 152.01M | 169.91M | 43.08M | 54.29M |
| Cash, Cash Equivalents and Short-Term Investments | 98.99M | 124.31M | 15.04M | 32.81M |
| Total Debt | 14.85M | 15.02M | 14.73M | 14.46M |
| Total Liabilities | 27.68M | 14.96M | 97.78M | 94.03M |
| Stockholders Equity | 124.33M | 154.94M | 19.78M | 34.74M |
Cash Flow | ||||
| Free Cash Flow | -47.08M | -36.02M | -18.16M | -15.89M |
| Operating Cash Flow | -37.09M | -28.61M | -14.14M | -13.14M |
| Investing Cash Flow | -72.40M | -95.60M | 13.96M | -28.97M |
| Financing Cash Flow | 106.89M | 144.96M | 66.00K | 44.73M |
Shoulder Innovations, Inc. Risk Analysis
Shoulder Innovations, Inc. disclosed 79 risk factors in its most recent earnings report. Shoulder Innovations, Inc. reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Shoulder Innovations, Inc. Peers Comparison
UnderperformOutperform
Sector (55)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
77 Outperform | $5.44B | 37.22 | 9.07% | ― | 10.51% | 20.67% | |
75 Outperform | $1.89B | 28.32 | 16.42% | 0.94% | 11.85% | 38.09% | |
74 Outperform | $2.27B | 93.19 | 6.91% | ― | 22.95% | 228.76% | |
65 Neutral | $4.55B | 149.45 | 1.41% | ― | -8.84% | ― | |
62 Neutral | $1.45B | -13.38 | -818.99% | ― | 19.47% | 36.87% | |
55 Neutral | $6.65B | 3.83 | -15.92% | 6.20% | 10.91% | 7.18% | |
55 Neutral | $408.68M | -11.31 | -24.36% | ― | 60.90% | -7.99% |
* General Sector Average
SI
Shoulder Innovations, Inc.
19.34
6.20
47.18%
VCEL
Vericel
44.73
6.80
17.93%
ATEC
Alphatec Holdings
9.63
-6.17
-39.05%
ICUI
ICU Medical
179.34
65.21
57.14%
LMAT
Lemaitre Vascular
82.13
-12.15
-12.89%
MMSI
Merit Medical Systems
91.20
5.05
5.86%
Shoulder Innovations, Inc. Corporate Events
Business Operations and StrategyExecutive/Board Changes
Shoulder Innovations Promotes Jon Osborne to Commercial Chief
Positive
Aug 10, 2026
On August 10, 2026, Shoulder Innovations, Inc. announced that it had promoted Jon Osborne to Chief Commercial Officer, effective August 6, 2026, expanding his responsibilities to lead all aspects of the company’s commercial organization. Osb...
Business Operations and StrategyPrivate Placements and Financing
Shoulder Innovations Secures New Loan and Credit Facilities
Positive
Jun 29, 2026
On June 26, 2026, Shoulder Innovations, Inc. entered into a new Loan and Security Agreement with Stifel Bank, securing a $15 million senior secured term loan and a $30 million senior secured asset-based revolving credit facility, expandable by $5 ...
Executive/Board ChangesShareholder Meetings
Shoulder Innovations Stockholders Elect Directors, Ratify Auditor
Positive
Jun 26, 2026
On June 26, 2026, Shoulder Innovations, Inc. held its 2026 Annual Meeting of Stockholders virtually, with 16,424,584 shares of common stock represented, constituting a quorum for business. Stockholders voted on the election of two Class I director...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.