Shoulder Innovations (NYSE:SI) is targeting high-volume shoulder surgeons with its implant system and planning technology while developing a portable surgical robot and considering expansion into soft-tissue procedures, CEO Rob Ball said during a discussion with UBS MedTech’s Patrick Wood.
Ball said the company’s customer acquisition pace accelerated in the first half of the year, though he also noted an increase in patient-related surgical cancellations during the summer. He said he could not determine whether insurance or other factors were responsible for the cancellations.
Shoulder Innovations doubled its pace of new customer additions in the first quarter compared with the prior year and exceeded that pace in the second quarter, Ball said. The third-quarter pace fell short of the second quarter but was close, he added.
Implants and surgical workflow
Ball said the company focuses on approximately 1,800 high-volume surgeons among the roughly 15,000 who may perform a shoulder replacement in a given year. Shoulder Innovations defines a high-volume surgeon as one who performs more than 35 shoulder arthroplasties annually, he said.
The company’s InSet Glenoid implant addresses a longstanding challenge in anatomic shoulder replacement: keeping the implant attached to the shoulder blade over time. Ball said the company has published clinical literature showing 100% survivorship out to almost nine years. He described the evidence as a factor that helps surgeons become comfortable using the device.
Shoulder Innovations also sells an integrated system for anatomic and reverse shoulder replacements that uses two trays of loaned surgical instruments, Ball said. He estimated that leading competitors bring six to 10 trays into an operating room, adding that the smaller footprint can be valuable as procedures move to ambulatory surgery centers.
More than 30% of the company’s procedures now take place in such centers, Ball said. He also highlighted ProVoyance, a CT-based, AI-enabled planning tool that lets surgeons reconstruct a patient’s anatomy in three dimensions and plan a procedure before entering the operating room.
For reverse shoulder replacement, Ball said the company has nearly 1,000 patients in a clinical registry and hopes to publish initial findings. He said the company hopes the research will show low rates of certain complications alongside strong range-of-motion results, but noted that some surgeons are waiting for data before adopting the technology.
Robotics and expansion plans
Shoulder Innovations plans to file a 510(k) submission in the first half of 2027 for a portable robotic system designed specifically for shoulder replacement, Ball said. The planned system is intended to assist with accurate placement while offering an economic model suited to ambulatory surgery centers.
Ball said the company expects a gradual rollout and does not anticipate that robotics will transform its business in 2027. He expects setup to take approximately 10 to 15 minutes and said the existing commercial team should eventually be able to support the system without substantial changes to its workflow.
Beyond shoulder replacement, Ball identified rotator cuff repair as a potential area for expansion. He said surgeons sometimes use another company’s products to repair a rotator cuff during a shoulder replacement, and that Shoulder Innovations could pursue opportunities in the area through a combination of internal development and external technologies.
Ball estimated the combined U.S. market for shoulder soft-tissue and arthroplasty procedures at approximately $5 billion. He said the company is currently focused on arthroplasty but sees room to serve more of the same surgeons’ practices over time.
About Shoulder Innovations (NYSE:SI)
Shoulder Innovations, Inc. is a medical technology company focused on developing and commercializing products for shoulder replacement surgery. Its offerings are designed for orthopedic surgeons treating patients with shoulder conditions that may require joint replacement. The company’s product portfolio includes shoulder implant systems such as its InSet glenoid and Catalyst reverse shoulder technologies, along with related surgical instruments. These products support different approaches to shoulder arthroplasty, including procedures that replace or reconstruct parts of the shoulder joint.
