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] - Total operating expenses increased to $56.3 million in Q4 2025 from $55.7 million in Q4 2024, reflecting restructuring charges and increased litigation expenses [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] - Adjusted EBITDA for Q4 was $6.2 million, down from $11.1 million in Q4 2024, while the full year 2025 Adjusted EBITDA loss was $3.9 million, a 64% improvement over the prior year [22][23] - 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 for bunion correction [5] - New bunion systems launched in 2025 are expected to significantly increase market penetration and procedure volume growth [10][19] - Over 25% of the surgeon base has incorporated one or more of the new bunion systems into their practice, with Q4 procedure volume growth exceeding mid-single-digit rates [13][19] Market Data and Key Metrics Changes - The overall foot and ankle market was reported to be soft in 2025, with deferrals of elective procedures impacting case volumes [27] - The company anticipates that case volume growth will continue to be offset by product ASP mix-related headwinds in the first half of 2026 [28] - The company expects to capture a larger share of the market with new product launches and improved sales strategies [19][28] Company Strategy and Development Direction - The company is focused on leveraging its existing customer base to drive adoption of new products and expand its serviceable total addressable market (TAM) [10] - Plans for 2026 include launching new products that are expected to enhance market share and profitability [16][19] - The company aims to continue improving its profitability and reducing cash burn, with a target of a 50% reduction in cash usage for 2026 compared to 2025 [23][24] Management's Comments on Operating Environment and Future Outlook - Management noted that broader economic conditions and softer consumer sentiment continue to impact the business environment [7] - The outlook for full year 2026 revenue is projected to be in the range of $200 million to $212 million, representing a decline of 6% to 0% compared to 2025 [8][23] - Management expressed confidence in the strategies in place to restore top-line revenue growth and improve profitability [6][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 [18] - The company has entered the biologics market with new offerings, which are expected to enhance revenue without negatively impacting margins [31] Q&A Session Summary Question: Market conditions and growth outlook - Management acknowledged that the foot and ankle market was soft in 2025, with case deferrals impacting overall surgical volume, but noted an increase in Q4 case volumes [27][28] Question: Impact of biologics on operating margins - Management indicated that the expansion into biologics is expected to provide additional revenue without negatively impacting margins [31] Question: Product development timelines and surgeon feedback - Management confirmed that new products like SuperBite and SpeedXM have been in development for about 18 months and received positive feedback from surgeons [36][38] Question: Balancing sales force focus with new product offerings - Management emphasized that the sales force remains focused on bunion-related products while also addressing adjacent procedures to meet surgeon demand [54][55] Question: Cash flow outlook and cost management - Management detailed initiatives to reduce cash burn and improve profitability, including lower operating expenses and capital expenditures in 2026 [64][66]

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 [19] - Gross margin was 80.6% in Q4 2025, slightly down from 80.7% in Q4 2024 [19] - Total operating expenses increased to $56.3 million in Q4 2025 from $55.7 million in Q4 2024, reflecting restructuring charges and increased litigation expenses [19] - 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 [20] - Full year 2025 Adjusted EBITDA loss was $3.9 million, a 64% improvement over the prior year [20] - Cash usage for the full year 2025 was $27.3 million, a 46% reduction compared to $50.5 million in 2024 [21] Business Line Data and Key Metrics Changes - The company has transitioned from a Lapiplasty-focused company to a comprehensive bunion solutions provider, launching multiple new bunion procedure innovations [4] - The new bunion systems are expected to effectively double the accessible market, targeting a significant portion of the 450,000 annual bunion procedures in the U.S. [9] - Over 25% of the surgeon base has incorporated one or more of the new bunion systems into their practice, with Q4 procedure volume growth increasing over mid-single-digit rates achieved in Q3 [11][18] Market Data and Key Metrics Changes - The foot and ankle market was reported to be unusually soft in 2025, with deferrals of cases impacting overall bunion surgical volume [26] - The company expects to capture market share despite the softness, with an anticipated increase in case volume in 2026 [26] - The outlook for full year 2026 revenue is projected to be in the range of $200 million-$212 million, representing a decline of 6%-0% compared to full year 2025 [21] Company Strategy and Development Direction - The company aims to leverage its existing customer base to drive adoption of new bunion product launches and expand its product offerings to grow wallet share [8] - The strategy includes advancing the Lapiplasty technology and introducing new products like the Lapiplasty Lightning and SpeedTMT implants [12][14] - The company plans to expand its biologics market presence with new offerings, which are expected to enhance revenue without negatively impacting margins [15][30] Management's Comments on Operating Environment and Future Outlook - Management acknowledged ongoing headwinds related to broader economic conditions and softer consumer sentiment, which are expected to persist into 2026 [5] - The company anticipates a reduction in cash usage of approximately 50% for full year 2026 compared to 2025, supported by a strong balance sheet [22] - Management expressed confidence in the strategies in place to drive market share gains and improve profitability [18] 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 [17] - The company plans to launch additional products in 2026 that are expected to expand its total addressable market by an estimated $300 million [16] Q&A Session Summary Question: Thoughts on the softness in the foot and ankle market - Management noted that 2025 was a softer year due to case deferrals, but they are seeing an increase in Q4 case volumes, indicating market share gains [26] Question: Impact of biologics portfolio on operating margins - Management expressed optimism that the expansion of the biologics portfolio would provide additional revenue without negatively impacting margins [30] Question: Details on new products and their development - The SuperBite screws and SpeedXM midfoot plating system have been in development for about 18 months and are expected to enhance the product offering significantly [35][36] Question: How to balance the focus of the sales force with new products - Management emphasized that the sales force is trained to focus on the bunion segment while also addressing adjacent procedures, ensuring they meet customer demands [54] Question: Long-term growth expectations - Management believes that with the expanded product portfolio and focus on the bunion market, they can achieve at least mid-single-digit growth, potentially higher with market share gains [73]

Financial Data and Key Metrics Changes - Fourth quarter revenue was $68.7 million, representing a 10.4% growth over the fourth quarter of 2023, at the top-end of previously announced preliminary results [22][27] - Full-year 2024 revenue was $209.4 million, a 12% increase over 2023, also at the top-end of prior guidance [28] - Gross margin for the fourth quarter was 80.7%, down from 81.6% in the fourth quarter of 2023, while full-year gross margin was 80.4%, compared to 81.2% in 2023 [28][29] - Fourth quarter net loss was $0.5 million or $0.01 per share, compared to a net loss of $6.3 million or $0.10 per share in the fourth quarter of 2023 [30] - Adjusted EBITDA for the fourth quarter was $11.1 million, an improvement of 322% compared to the fourth quarter of 2023 [30] Business Line Data and Key Metrics Changes - The growth was driven by a product mix shift, increased adoption of newer technologies such as Adductoplasty and SpeedPlate, and an increase in active surgeon users [22][28] - The company aims to capture a larger share of the remaining 75% of bunion procedures performed by its surgeon customers [20] Market Data and Key Metrics Changes - The company has a growing base of over 3,100 surgeon customers, representing a ready audience for its expanding suite of technologies [10] - The company estimates that around 10% to 15% of all metatarsal osteotomies today are being performed with minimally invasive approaches, indicating a significant growth opportunity [14] Company Strategy and Development Direction - The company focuses on expanding its portfolio of innovative solutions to address all four classes of bunions, aiming to maximize market share [20][26] - The strategy includes making procedures less invasive, which is expected to appeal to a larger portion of the 4.4 million Americans seeking medical attention for bunions each year [11] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the setup for 2025, expecting revenue guidance of $224 million to $230 million, reflecting a 7% to 10% increase over 2024 [24][32] - The company anticipates break-even adjusted EBITDA for full-year 2025 and a 50% decrease in cash burn compared to 2024 [32] Other Important Information - The company has introduced new technologies such as Mini-Adductoplasty and SpeedMTP, which are expected to ramp availability and revenue impact in the back half of 2025 [21][19] - The company is monitoring reimbursement trends following significant increases in material reimbursement for CPT code 28297, associated with Lapiplasty procedures [23] Q&A Session Summary Question: Thoughts on revenue pacing through 2025 - Management acknowledged that Q1 will be a tougher comp but expects higher growth rates in Q2, Q3, and Q4 [38] Question: Impact of new products on ASPs and unit volumes - Management indicated that the focus will be on procedure volume rather than significant shifts in blended ASP [44] Question: Profitability and leverage components - Management highlighted natural leverage from a more experienced sales force and reduced aggressive hiring [52][54] Question: Early feedback on new products and competitive dynamics - Early feedback on new products has been positive, with some surgeons returning to Lapiplasty after trying competitors [58] Question: Thoughts on the Zimmer-Paragon deal - Management stated they are focused on growing their product line and will observe the market effects of the acquisition [66] Question: Clinical outcomes of new osteotomy solutions - Management emphasized the importance of three-plane correction in their osteotomy approach, which they believe will lead to better long-term outcomes [72] Question: Q1 revenue expectations - Management confirmed that Q1 is expected to show low-single digit growth rates year-over-year [76] Question: Targeting new surgeons with broader product offerings - Management aims to add approximately 200 new surgeons to their customer base in 2025 [84] Question: Future opportunities in foot and ankle market - Management indicated a robust pipeline of products and a focus on penetrating the bunion and midfoot markets [90][92] Question: Utilization of new osteotomy offerings - Initial adopters of the new osteotomy systems are high utilizers of minimally invasive techniques [98] Question: Update on SpeedPlate attach rates - SpeedPlate has grown to over 50% of the overall fixation mix, with expectations for continued growth [108]