Financial Data and Key Metrics Changes - Revenue in Q4 2025 was $62.5 million, a decrease of 9% compared to the prior year period, primarily due to a shift in revenue mix towards lower-priced products [21] - Gross margin was 80.6% in Q4 2025, slightly down from 80.7% in Q4 2024 [21] - The net loss for Q4 2025 was $9.4 million, or $0.15 per share, compared to a net loss of $0.5 million, or $0.01 per share, in Q4 2024 [22] - Full year 2025 adjusted EBITDA loss was $3.9 million, a 64% improvement over the prior year [22] - Cash usage for the full year 2025 was $27.3 million, a 46% reduction compared to $50.5 million in 2024 [23] Business Line Data and Key Metrics Changes - The company has expanded its bunion procedure offerings, now addressing virtually 100% of surgeons' technique preferences with five best-in-class instrumented systems [5] - The new bunion systems launched in 2025 have already been adopted by over 25% of the surgeon base, contributing to increased procedure volume growth [13] - The company expects to continue to reduce cash burn by approximately 50% in 2026 compared to 2025 [9] Market Data and Key Metrics Changes - The overall foot and ankle market was reported to be unusually soft in 2025, with elective procedures experiencing declines [27] - The company anticipates that case volume growth will improve in 2026, particularly in the fourth quarter, driven by new product launches and an increase in case volumes [8][19] Company Strategy and Development Direction - The company is focused on leveraging its existing customer base to drive adoption of new bunion products and expanding its product offerings to grow wallet share [10] - The introduction of new technologies, such as the Lapiplasty Lightning and SpeedTMT, is expected to attract new surgeons and enhance the company's competitive position [15][19] - The company plans to continue its emphasis on medical education and training for surgeons to ensure successful integration of new products [18] Management's Comments on Operating Environment and Future Outlook - Management noted that while there are ongoing headwinds related to economic conditions and consumer sentiment, they remain confident in their strategies to restore revenue growth [7] - The outlook for full year 2026 revenue is projected to be in the range of $200 million to $212 million, reflecting a decline of 6% to 0% compared to 2025 [8][23] - Management expressed optimism about the potential for market share gains and improved profitability through disciplined investments and strategic initiatives [19] Other Important Information - The company has expanded its active surgeon base from nearly 1,300 users in 2020 to over 3,300 users in 2025, indicating strong growth in customer engagement [18] - The company has entered the biologics market with new offerings, which are expected to enhance revenue without negatively impacting margins [16] Q&A Session Summary Question: Insights on the softness in the foot and ankle market - Management acknowledged that 2025 was a softer year for elective procedures, but noted an increase in Q4 case volumes, indicating market share gains despite the overall market conditions [27] Question: Impact of the biologics portfolio on operating margins - Management expressed confidence that the expansion into biologics would provide additional revenue without negatively impacting margins [30] Question: Development timeline and surgeon feedback on new products - Management confirmed that new products like SuperBite screws and SpeedXM have been in development for about 18 months and received positive feedback from surgeons during testing [35] Question: Guidance assumptions for 2026 - Management indicated that guidance includes assumptions for the uptake of new products and the performance of existing offerings, with a focus on achieving reasonable and achievable targets [82] Question: Strategy for penetrating the market - Management emphasized the strategy of deepening engagement with the existing surgeon base while also attracting new surgeons through innovative product offerings [88]

Financial Data and Key Metrics Changes - The company reported third quarter revenues of $50.2 million, representing an 11% growth over the third quarter of 2024 and a 49% improvement in adjusted EBITDA compared to the prior year [4][17] - Gross margin decreased to 79.1% in Q3 2025 from 80.1% in Q3 2024 [17] - The net loss for the third quarter was $16.3 million, or $0.26 per share, which is a 6% increase in net loss compared to $15.4 million, or $0.25 per share, in Q3 2024 [18] - Year-to-date net loss decreased by 10% to $49.6 million compared to $55.2 million for the same period in 2024 [18] - Total liquidity as of September 30, 2025, was $80.6 million, down from $90.7 million at the end of Q2 [19] Business Line Data and Key Metrics Changes - The company has expanded its product portfolio to include three new bunion correction systems, aiming to address nearly 100% of surgeon preferences for bunion correction [5][6] - Case volume growth was mid-single digits compared to the prior year, but below original expectations, largely driven by new bunion systems with lower average selling prices (ASPs) [10] - Sales to a limited number of stocking distributors contributed approximately $6 million in the third quarter, which is not expected to recur at the same levels in future quarters [12] Market Data and Key Metrics Changes - A survey indicated that surgeon customers reported a 7% decrease in bunion surgical volumes year-to-date through October compared to the same period last year [11] - Broader economic conditions and softer consumer sentiment have led to deferrals of elective bunion procedures, impacting case volumes [8][11] Company Strategy and Development Direction - The company is transitioning from a single technology focus to a comprehensive bunion solutions provider, with plans to capture market share in minimally invasive osteotomies and MTP fusion markets [5][9] - The strategy includes enhancing the sales team's capabilities and expanding the product portfolio to drive market share gains and improve profitability [13][15] Management's Comments on Operating Environment and Future Outlook - Management expressed disappointment in the current growth trajectory and revised the full-year revenue outlook to $211 million-$213 million, reflecting only 1%-2% growth compared to 2024 [8][20] - The company plans to continue focusing on training existing customers and onboarding new surgeons to drive adoption of new products [13][22] Other Important Information - The company is taking actions to control costs and improve profitability, with a focus on reducing cash burn in 2026 [16][20] - The company has appointed a new Chief Commercial Officer and expanded its sales team to enhance market presence [6] Q&A Session Summary Question: Can you talk about the softness in the core Lapiplasty business? - Management acknowledged a trend towards minimally invasive osteotomies but emphasized the importance of Lapiplasty for significant bunion deformities, stating efforts to capture market share in this area [24][25] Question: What does the guidance imply for Q4 and 2026? - Management refrained from providing specific guidance for 2026 but expressed optimism about case volume growth and the reception of new products [26][27] Question: Has there been an acceleration in the shift away from Lapiplasty? - Management confirmed a trend towards minimally invasive procedures but highlighted ongoing efforts to capture market share with new technologies [30][31] Question: How will the company recoup deferred procedures next year? - Management indicated that improved consumer sentiment and enhanced engagement with new products would help capture a larger share of patients returning for surgery [38]