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Introduction & Market Context
Si-Bone Inc (NASDAQ:SIBN), a medical device company focused on sacropelvic disorders, presented its Q1 2025 corporate overview on May 5, 2025, highlighting strong financial performance and continued market expansion. The company’s stock surged 12.98% in aftermarket trading following the release of better-than-expected quarterly results, closing at $16.10.
The presentation emphasized Si-Bone’s position as a market leader in the sacropelvic space, addressing a total U.S. addressable market exceeding $3.5 billion with proprietary technologies that have received multiple FDA Breakthrough Device designations.
Quarterly Performance Highlights
Si-Bone reported impressive first-quarter results, with worldwide revenue reaching $47.3 million, representing a 24.9% year-over-year increase. U.S. revenue grew even faster at 26.6% to $44.8 million, while U.S. procedure volume increased by approximately 27% to 5,100 procedures.
As shown in the following chart of quarterly revenue and procedure growth:
The company also achieved a gross margin of 79.7%, an improvement of 80 basis points compared to the same period last year. This performance contributed to Si-Bone’s second consecutive quarter of positive adjusted EBITDA, reaching $0.5 million in Q1 2025.
The company’s adjusted EBITDA has shown consistent improvement over the past five quarters:
Si-Bone reported strong liquidity with $144.4 million in cash and equivalents, which the company expects to sustain operations through 2025.
Physician Engagement and Commercial Execution
A key driver of Si-Bone’s growth has been its success in expanding its physician base. The company reported a 27% year-over-year increase in U.S. active physicians to 1,400, marking the 17th consecutive quarter of double-digit growth in this metric. Notably, Si-Bone added a record 300 U.S. physicians in Q1 and reported a 43% increase in physicians performing multiple procedures.
The following graph illustrates this physician adoption trend:
Laura, the company’s CEO, emphasized during the earnings call that "The future has never been brighter for SI BONE," highlighting the company’s optimistic outlook on continued physician adoption and market penetration.
Product Innovation and Market Opportunity (SO:FTCE11B)
Si-Bone’s presentation detailed its differentiated product portfolio addressing three key market segments: SI Joint Dysfunction ($2.4 billion market), Sacropelvic Fixation ($1.0 billion market), and Pelvic Trauma ($0.3 billion market). The company estimates these markets represent approximately 470,000 target U.S. annual procedures, with current penetration below 10%.
The company’s addressable markets are illustrated in this breakdown:
Si-Bone highlighted its innovative product platform, which includes iFuse INTRA, iFuse TORQ, iFuse 3D, and iFuse Bedrock Granite. Each product addresses specific clinical needs within the sacropelvic space:
A significant development is the iFuse TORQ TNT, which received FDA Breakthrough Device Designation and is designed for pelvic fragility fracture fixation. The device has been proposed for a New Technology Add-On Payment (NTAP) of up to $3,960 for FY2026:
The company’s iFuse Bedrock Granite, another Breakthrough Device, targets the adult spinal deformity and degenerative spine market with advanced fixation technology:
Forward-Looking Statements and Guidance
Si-Bone raised its 2025 revenue guidance to $193.5-$197.5 million, representing year-over-year growth of approximately 16-18%. The company also improved its gross margin guidance to approximately 78% and expects operating expenses to be around 10% of revenue.
The updated guidance is visualized in this chart showing the company’s revenue trajectory:
Anshul, the company’s CFO, emphasized during the earnings call the company’s financial strategy, noting that "Our ability to convert over 50% of the growth revenue dollars to adjusted EBITDA dollars... is illustrative of the longer-term leverage potential for our business."
Si-Bone outlined its long-term business drivers focused on innovation, physician engagement, commercial execution, and operational excellence. The company is preparing for the Q1 2026 launch of a new SI joint fusion solution, which could further strengthen its market position.
The company’s differentiated portfolio and fundamentals are summarized in this overview:
Competitive Positioning
Si-Bone emphasized its leadership position in the sacropelvic space, supported by extensive clinical evidence including 160+ published papers and 4 randomized controlled trials. The company has built significant intellectual property protection with 67 worldwide patents and 47 pending patents.
The company’s market leadership is highlighted in this summary:
Si-Bone’s iFuse technology demonstrates superior performance compared to competitors, with 6x resistance, 3x strength, and a low complication rate of 3.5%:
With over 120,000 procedures performed by more than 4,500 treating physicians worldwide, Si-Bone continues to build on its established position as a pioneer in sacropelvic solutions while addressing significant unmet clinical needs in this specialized market segment.
Full presentation:
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