Revenue grew 56% year-over-year to $17.2 million in 2026Q2 with gross margin at 78.3%, but SG&A of $20.1 million (roughly 117% of revenue) widened the operating loss to $10.0 million, indicating that expense scaling still outpaces top-line gains.
Shoulder Innovations, Inc. (SI) annual income statement — 3-year revenue, gross profit & net income history
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 |
|---|
| Sales/Revenue | 64.49M | 47.32M | 31.62M | 19.27M |
| Revenue Growth % | 54.93% | 49.63% | 64.07% | - |
| Cost of Goods Sold | 14.3M | 11.12M | 7.28M | 4M |
| COGS % of Revenue | - | 23.49% | 23.03% | 20.77% |
| Gross Profit | 50.19M | 36.2M | 24.34M | 15.27M |
| Gross Margin % | 77.82% | 76.51% | 76.97% | 79.23% |
| Gross Profit Growth % | - | 48.73% | 59.4% | - |
| Operating Expenses | 85.3M | 62.5M | 38.99M | 26.13M |
| OpEx % of Revenue | - | 132.09% | 123.31% | 135.59% |
| Selling, General & Admin | 71.77M | 54.77M | 34.51M | 23.11M |
| SG&A % of Revenue | - | 115.75% | 109.11% | 119.92% |
| Research & Development | 13.53M | 7.73M | 4.49M | 3.02M |
| R&D % of Revenue | - | 16.34% | 14.2% | 15.67% |
| Other Operating Expenses | 0 | 0 | 0 | 0 |
| Operating Income | -35.11M | -26.3M | -14.65M | -10.86M |
| Operating Margin % | -54.44% | -55.58% | -46.34% | -56.37% |
| Operating Income Growth % | - | -79.47% | -34.88% | - |
| EBITDA | -31.86M | -23.09M | -12.46M | -9.22M |
| EBITDA Margin % | -49.41% | -48.8% | -39.39% | -47.85% |
| EBITDA Growth % | -67.97% | -85.35% | -35.06% | - |
| D&A (Non-Cash Add-back) | 3.25M | 3.21M | 2.2M | 1.64M |
| EBIT | -27.33M | -40.29M | -14.3M | -11.89M |
| Net Interest Income | 1.7M | -70K | -1.32M | -761K |
| Interest Income | 673K | 0 | 0 | 0 |
| Interest Expense | -1.6M | 70K | 1.32M | 761K |
| Other Income/Expense | 1.76M | -14.06M | -966K | -1.79M |
| Pretax Income | -33.35M | -40.36M | -15.62M | -12.65M |
| Pretax Margin % | -51.72% | -85.29% | -49.39% | -65.66% |
| Income Tax | 0 | 0 | 0 | 0 |
| Effective Tax Rate % | 0% | 0% | 0% | 0% |
| Net Income | -33.35M | -40.36M | -15.62M | -12.65M |
| Net Margin % | -51.72% | -85.29% | -49.39% | -65.66% |
| Net Income Growth % | 8.32% | -158.4% | -23.42% | - |
| Net Income (Continuing) | -33.35M | -40.36M | -15.62M | -12.65M |
| Discontinued Operations | 0 | 0 | 0 | 0 |
| Minority Interest | 0 | 0 | 0 | 0 |
| EPS (Diluted) | -1.60 | -1.96 | -0.77 | -0.63 |
| EPS Growth % | 10% | -154.55% | -22.22% | - |
| EPS (Basic) | - | -1.96 | -0.77 | -0.63 |
| Diluted Shares Outstanding | 20.84M | 20.63M | 19.92M | 19.92M |
| Basic Shares Outstanding | 20.84M | 20.63M | 19.92M | 19.92M |
| Dividend Payout Ratio | - | - | - | - |
Quick answers to the most common questions about buying SI stock.
For fiscal year 2025, Shoulder Innovations, Inc. (SI) reported total revenue of $47.3M. This represents a 145.5% increase compared to $19.3M in 2023.
Shoulder Innovations, Inc. (SI) reported a net loss of $40.4M for the fiscal year ending 2025.
Shoulder Innovations, Inc. (SI) reported an operating income of $-26.3M, resulting in an operating profit margin of -55.6%. This margin reflects the operational efficiency of the business before interest and taxes.
Shoulder Innovations, Inc. (SI) generated $36.2M in gross profit for the year, representing a gross profit margin of 76.5%. This demonstrates the company's core pricing power and production efficiency.
Key Metrics
Top Statement Risk
SG&A growth outpacing revenue
Metrics are mathematically derived from official filings.
Revenue Nearly Doubles on Commercial Scale-Up
Revenue at Shoulder Innovations has nearly doubled over six quarters, from $10.1 million in 2025Q1 to $17.2 million in 2026Q2, with year-over-year growth above 56% in each of the last four quarters, as shown in the company's reported income statements.
The growth profile appears consistent with a commercial-stage orthopedic platform still early in penetration, as sequential revenue gains of roughly 6-19% per quarter have compounded steadily without a visible deceleration into the $17 million range. However, the reported data does not decompose volume versus price or flag acquisitions, so the durability of this trajectory hinges on commercial coverage expansion that investors should confirm against unit and procedure-level disclosures. The fact that the most recent quarter posted 56% year-over-year growth versus 65% in 2025Q1 suggests the base effect is beginning to matter, though the absolute growth rate remains exceptional relative to the 8-25% posted by listed spine and orthopedic peers.
Gross Margin Expansion Outruns Specialty Peers
Gross margin at Shoulder Innovations expanded roughly 860 basis points over six quarters, from 69.7% to 78.3%, exceeding the 67-70% posted by scaled spine peers Globus Medical and Alphatec, according to company filings and peer comparative data.
COGS grew only modestly, from $3.0 million to $3.7 million, while revenue rose 70%, implying meaningful absorption of fixed manufacturing overhead and favorable product mix rather than aggressive cost cutting, which is a structurally healthier margin driver than pricing alone. At 78.3%, SI's gross margin now sits above Globus Medical (67.4%) and Alphatec (69.6%), which may indicate premium implant pricing or a favorable mix of higher-value constructs, though this premium positioning could face pressure if competitive tenders or hospital group purchasing intensify as volume scales. The widening gap between gross margin expansion (up 860bps) and operating margin (down to -58.4%) signals that unit economics at the product level are sound, but the commercial model consuming them is not yet efficient.
Operating Leverage Missing as Opex Doubles
Operating losses at Shoulder Innovations widened to $10.0 million in 2026Q2 despite revenue growth, as SG&A reached $20.1 million, roughly 117% of quarterly revenue, versus $9.8 million or 97% a year earlier, based on reported quarterly statements.
Combined R&D and SG&A have grown 106% over the period, from $11.4 million to $23.5 million, while gross profit rose from $7.1 million to $13.4 million, meaning the incremental gross profit generated has been more than fully absorbed by incremental overhead. R&D intensity also jumped sharply, from 15.8% of revenue in 2025Q1 to 19.8% in 2026Q2, with a pronounced step-up in 2025Q4, which suggests a development program or launch cost cycle is underway rather than a steady-state spend profile. On this operating leverage trajectory, breakeven would require quarterly revenue of roughly $30 million at current gross margins and flat opex, an inference that investors should test against management's forward spend guidance, which is not disclosed in the data provided.
SBC and Non-Operating Items Depress EPS
Stock-based compensation at Shoulder Innovations rose roughly 8.7-fold from $127K in 2025Q1 to $1.1 million in 2026Q2, now about 6.4% of revenue, while the 2025Q2 net loss of $19.2 million far exceeded the $5.9 million operating loss, per reported filings.
The rapid growth in SBC, accelerating from $298K to $1.1 million in just three quarters, indicates equity-linked compensation is scaling alongside headcount, and at $1.1 million per quarter it now represents a meaningful drag that raw operating margins understate. The dilution burden appears to be compounding into per-share results: the diluted loss per share deteriorated from $0.41 in 2025Q1 to $0.49 in 2026Q2 even as revenue grew 70%, though share count data is unavailable to fully quantify this effect. The $13.3 million gap between the 2025Q2 operating loss and net loss points to material non-operating charges in that period, the nature of which is not disclosed in the data provided and warrants further investigation into the company's filings.
Q4 2025 Marks Spend-Driven Inflection
2025Q4 appears to mark the operational inflection for Shoulder Innovations, with revenue jumping 22% sequentially to $14.4 million and gross margin stepping up 50 basis points to 76.7%, alongside a 114% sequential increase in R&D to $3.2 million, as reported in the income statement.
That quarter combined a revenue step-change with a structural gross margin break above the 70% level the company had held for three quarters, while R&D more than doubled sequentially, which may indicate the start of a new product development cycle or launch preparation phase. The lasting impact is visible in the quarters since: revenue has continued to compound toward $17.2 million, but the operating loss base has been reset higher, from -$7.6 million in 2025Q3 to -$10.0 million in 2026Q2, so the inflection appears to have accelerated scale without yet bending the profitability curve. Investors should watch whether the R&D spend initiated in late 2025 converts into revenue-bearing products, as the data provided does not disclose pipeline milestones.
Path to Breakeven Remains Distant
Shoulder Innovations' operating deficit widened from $8.5 million in 2025Q4 to $10.0 million in 2026Q2 even as quarterly revenue grew 19%, implying expense scaling continues to outpace top-line gains; net loss per share also deteriorated from $0.38 to $0.49, based on reported figures.
The strongest bear case rests on the arithmetic that current quarterly opex of $23.5 million exceeds gross profit of $13.4 million by 75%, meaning SI would need roughly 74% more revenue at today's gross margin just to cover its existing cost base, a substantial doubling that is not evidenced by the current growth trend alone. Peer precedent cuts both ways: Alphatec grows at 25% with a -10.7% operating margin, so the sector tolerates losses, but Globus Medical and Xtant demonstrate that scaled orthopedic platforms do eventually convert high gross margins into positive operating leverage, and SI has shown no such conversion in ten quarters of data. Compounding the concern, stock-based compensation has risen nearly nine-fold over the period while per-share losses have widened, which suggests that even if the company reaches nominal operating breakeven, the equity dilution already embedded may leave shareholders with a smaller share of an improving business than headline margin improvements imply.