Shoulder Innovations, Inc. (SI) AI Stock Analysis

• Market Cap: $297.53M
• Dividend Yield: N/A
• Average Volume (3M): 130.13K
• Price to Earnings (P/E): ―
• Beta (1Y): >-0.01
• Revenue Growth: 39.97%
• EPS Growth: -148.57%
• Country: US
• Employees: 300
• Sector: Healthcare
• Sector Strength: 45
• Industry: Medical - Specialties
• EPS (TTM): -0.38
• Shares Outstanding: 20,647,526
• 10 Day Avg. Volume: 53,279
• 30 Day Avg. Volume: 130,135
• PEG Ratio: 30.92
• Price to Book (P/B): 800.45
• Price to Sales (P/S): 2621.17
• P/FCF Ratio: -3.44K
• Enterprise Value/Market Cap: 0.96
• Enterprise Value/Revenue: 6.04
• Enterprise Value/Gross Profit: 7.89
• Enterprise Value/Ebitda: -7.48
• 1Y Price Target: $21.25
• Price Target Upside: 46.15% Upside
• Rating Consensus: Strong Buy
• Number of Analyst Covering: 4
• EPS Forecast (FY): -1.33
• Revenue Forecast (FY): $65.38M

• Rating: 51 Neutral
• Price Target: $14.00 ▼(-3.71% Downside)
• Action: Reiterated Date: 03/12/26
• Date: Action: Reiterated 03/12/26

The score is held back primarily by worsening losses and accelerating cash burn despite strong revenue growth and high gross margins. Technicals are modestly supportive with price above key moving averages, while valuation remains unfavorable due to negative earnings and no dividend. Positive corporate events (guidance, product/partnership progress, and board strengthening) provide an offset but do not remove near-term funding and profitability risks.

Positive Factors

Revenue Growth & Surgeon Adoption

Sustained double-digit topline growth and a rapid increase in surgeon adoption indicate durable market demand and successful commercial penetration. Over the next 2–6 months this expanding user base supports recurring procedure volume, strengthens sales channels, and underpins future scale economies.

High Gross Margins / Unit Economics

Consistently high gross margins point to differentiated product economics and pricing power versus peers. Durable margin strength provides capacity to fund R&D and commercial investments while improving the potential for eventual operating leverage as revenue scales and fixed costs are absorbed.

Product & Strategic Partnership Momentum

New product introductions plus a robotic partnership and experienced board addition represent structural progress in commercialization and clinical integration. These moves deepen product portfolio, advance procedural differentiation, and bolster execution capability across regulatory, clinical and go-to-market functions.

Negative Factors

Accelerating Cash Burn

Significant and worsening negative operating and free cash flow increases financing risk and limits runway for organic scaling. Over the medium term the company may need external capital to sustain investments, which can dilute shareholders or constrain strategy if markets tighten.

Large Net Losses / Negative Returns

Deep and expanding net losses are consuming equity and suppressing returns, signaling the business has not yet converted strong unit economics into operating profit. Persistent negative margins impair reinvestment capacity and make the path to sustainable profitability uncertain without tighter cost control or faster revenue scale.

Operating Expense Growth Outpacing Revenue

Expenses rising faster than revenues undermines operating leverage and delays breakeven. If SG&A and R&D scale ahead of demand, profitability targets slip and the company may be forced to re-prioritize investments, slowing commercial expansion and prolonging dependence on external funding.

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 makes money primarily by selling its shoulder arthroplasty products to healthcare providers (e.g., hospitals and ambulatory surgery centers) for use in surgical procedures. Revenue is generated from the sale of implant components and associated surgical instruments/ancillary items used to perform shoulder replacement surgeries. Additional details on pricing, contractual arrangements, service/recurring revenue (if any), or specific distribution/strategic partnerships are null.

Shoulder Innovations, Inc. Financial Statement Overview

Summary

Strong top-line growth and consistently high gross margins support the business model, and leverage appears manageable. However, profitability deteriorated (wider operating and net losses) and cash burn accelerated with meaningfully negative operating and free cash flow, keeping overall financial quality risk-tilted.

Income Statement

Revenue is scaling quickly (2025 revenue up ~44% year over year), and gross margin is consistently strong (~76–79%), suggesting attractive unit economics. However, profitability deteriorated in 2025: operating losses widened (EBITDA loss roughly -56% margin) and net loss expanded materially (net margin ~-85%), indicating operating expense growth is outpacing revenue growth. Overall, the model shows strong top-line momentum and gross profitability, but still lacks cost discipline and path-to-profit visibility based on the latest year.

Balance Sheet

Leverage looks manageable in 2025 with low debt relative to equity (debt-to-equity ~0.10), which provides financial flexibility. Total equity and assets increased sharply versus prior years, strengthening the capital base. The key weakness is returns: equity returns remain deeply negative due to ongoing losses, so balance-sheet strength is currently being used to fund operating deficits rather than compounding shareholder value.

Cash Flow

Cash generation remains a clear pressure point: operating cash flow and free cash flow are meaningfully negative across all three years, and cash burn accelerated in 2025 (operating cash flow about -$28.6M; free cash flow about -$36.0M). While cash outflows are consistent with a growth phase, the worsening burn alongside larger net losses increases funding risk if capital markets tighten. A modest positive note is that free cash flow has generally tracked net losses in direction (i.e., losses are not being masked by cash inflows), but the company has not yet demonstrated self-funding operations.

Breakdown	Dec 2025	Dec 2024	Dec 2023
Income Statement
Total Revenue	47.32M	31.62M	19.27M
Gross Profit	36.20M	24.34M	15.27M
EBITDA	-26.30M	-12.11M	-10.25M
Net Income	-40.36M	-15.62M	-12.65M
Balance Sheet
Total Assets	169.91M	43.08M	54.29M
Cash, Cash Equivalents and Short-Term Investments	124.31M	15.04M	32.81M
Total Debt	15.02M	14.73M	14.46M
Total Liabilities	14.96M	97.78M	94.03M
Stockholders Equity	154.94M	19.78M	34.74M
Cash Flow
Free Cash Flow	-36.02M	-18.16M	-15.89M
Operating Cash Flow	-28.61M	-14.14M	-13.14M
Investing Cash Flow	-95.60M	13.96M	-28.97M
Financing Cash Flow	144.96M	66.00K	44.73M

Shoulder Innovations, Inc. Peers Comparison

Name	Overall Rating	Market Cap	P/E Ratio	ROE	Dividend Yield	Revenue Growth	EPS Growth
LMAT	78 Outperform	$2.46B	31.80	15.58%	0.95%	13.07%	27.98%
MMSI	68 Neutral	$4.05B	40.58	8.52%	―	11.49%	-2.89%
VCEL	66 Neutral	$1.65B	110.29	5.17%	―	14.05%	241.86%
ICUI	57 Neutral	$3.21B	4,802.44	0.04%	―	-0.81%	93.27%
Sector *	51 Neutral	$7.86B	-0.30	-43.30%	2.27%	22.53%	-2.21%
SI	51 Neutral	$297.53M	-3,073.07	-89.55%	―	39.97%	-148.57%
ATEC	51 Neutral	$1.84B	-22.02	-1760.45%	―	27.11%	17.66%

Shoulder Innovations, Inc. Corporate Events

Shoulder Innovations Reports Transformational 2025 Growth and Guidance

Shoulder Innovations reported that 2025 was a transformational year, with net revenue rising 50% to $47.3 million on strong adoption of its implant systems and a 61% increase in core and contender surgeons, despite a wider full-year net loss of $40.4 million driven by higher operating expenses and valuation-related charges. For the fourth quarter ended December 31, 2025, revenue grew 65% to $14.4 million with gross margins holding above 76%, while the company invested heavily in R&D, launched new humeral stem and metal-sensitive humeral head products, formed a robotic shoulder arthroplasty partnership, added former Inari Medical CEO Drew Hykes to its board, issued 2026 revenue guidance of $62–$65 million, and disclosed that director Michael Carusi will not stand for re-election at the 2026 annual meeting, though his departure is not tied to any disagreement with management.

The most recent analyst rating on (SI) stock is a Sell with a $12.50 price target. To see the full list of analyst forecasts on Shoulder Innovations, Inc. stock, see the SI Stock Forecast page.

Shoulder Innovations Adds Medtech Veteran Drew Hykes to Board

On March 2, 2026, Shoulder Innovations announced that medtech veteran Drew Hykes joined its Board of Directors and Compensation Committee, effective February 26, 2026, while Independent Director Geoff Pardo resigned. The move signals a governance refresh as the company continues scaling adoption of its novel shoulder arthroplasty portfolio in a competitive orthopedic devices market.

Hykes brings more than 25 years of medical device operating experience, including senior leadership roles at Okami Medical, Inari Medical, Sequent Medical, and Medtronic, with a track record spanning commercialization, clinical and regulatory affairs, and investor relations. His appointment is expected to bolster Shoulder Innovations’ strategic execution and commercial capabilities as it seeks to expand access to its differentiated platform and strengthen its position in the shoulder surgical care segment.

The most recent analyst rating on (SI) stock is a Sell with a $12.50 price target. To see the full list of analyst forecasts on Shoulder Innovations, Inc. stock, see the SI Stock Forecast page.