Revenue Growth (Q1 2026)
Worldwide revenue of $52.6M, up 11.2% year-over-year; U.S. revenue $49.3M, up ~10%; international revenue $3.3M, up 33.9%.
Raised Full-Year Guidance
Full-year 2026 revenue guidance increased to $230.0M–$233.0M, implying ~14%–16% year-over-year growth (midpoint ~15%).
Strong Gross Margins
Gross profit $41.9M (+11.3%); gross margin ~79.8% for the quarter (flat year-over-year) and full-year gross margin target raised ~100 bps to ~79%.
Improving Profitability
Adjusted EBITDA of $2.5M in Q1, representing over 440% improvement vs $0.5M in Q1 2025; net loss narrowed to $4.3M ($0.10 per diluted share) from $6.5M ($0.15).
Operating Leverage / Controlled OpEx
Operating expenses grew ~4.1%, significantly below revenue growth (~11.2%), reflecting ~2.5x operating leverage and disciplined spend on commissions, training and pipeline investments.
Cash and Liquidity Position
Exited Q1 with $144.7M in cash and marketable securities, providing runway for R&D, launches, and commercial expansion.
Free Cash Flow Improvement
Free cash flow was negative $3.4M in Q1, a 50.7% improvement versus the prior-year period (seasonality noted due to commission true-ups and bonuses).
Physician Engagement and Commercial Productivity
Record 1,650 active physicians in the quarter (+17% year-over-year); 20 consecutive quarters of double-digit physician growth; 14 consecutive quarters of double-digit territory productivity growth; revenue per territory $2.2M (+11% YoY) with 89 quota-carrying territory managers.
Product Launches and Pipeline Momentum
Launched Intra TI in Q1; introduced TNT TORQ in Europe and TORQ in Australia; third Breakthrough Device progressing with V&V nearly complete, targeting 510(k) filing in early Q3 and commercial launch in Q4.
Strategic Partnership with Smith & Nephew
Completed first phase of field rollout with Smith & Nephew in April; training and capacity rollout expected substantially complete by end of Q2; revenue contribution anticipated to begin in Q3 and accelerate into Q4.
Favorable Reimbursement Developments
CMS proposed new DRG families for extensive/complex spinal fusion procedures (including cases that use Granite), potentially increasing average hospital payment by up to ~$50K per procedure if finalized (effective Oct 1, 2026), which could materially support Granite adoption.
International Commercial Traction
International revenue growth of 33.9% driven by accelerating demand for iFuse TORQ across Europe and Australia and early enthusiasm for TNT in Europe; international now tracking as an accretive growth contributor.