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Introduction & Market Context
SI-BONE, Inc. (NASDAQ:SIBN), a medical device company focused on sacropelvic disorders, released its Q2 2025 corporate presentation on August 4, 2025, highlighting strong financial performance and continued market expansion. The company, which positions itself as the market leader in the sacropelvic space, reported significant revenue growth and its third consecutive quarter of positive adjusted EBITDA.
The presentation comes after SI-BONE’s stock closed at $17.39 on August 4, representing a 2.93% increase for the day. The company’s shares have been trading in a 52-week range of $11.70 to $20.05, indicating a recovery from previous lows.
Quarterly Performance Highlights
SI-BONE reported worldwide revenue of $48.6 million for Q2 2025, representing a 21.7% increase compared to the same period in 2024. U.S. revenue, which accounts for the vast majority of the company’s business, grew by 22.8% to $46.4 million.
As shown in the following chart of quarterly revenue and procedure volume growth:
The company’s gross margin improved to 79.8%, an increase of 80 basis points year-over-year, demonstrating enhanced operational efficiency. SI-BONE also reported $1.0 million in positive adjusted EBITDA, marking its third consecutive profitable quarter on this basis, and generated $1.1 million in net cash.
The key financial highlights from the quarter demonstrate SI-BONE’s continued momentum:
The company’s adjusted EBITDA has shown consistent improvement over the past five quarters, transitioning from negative territory to sustained profitability:
Physician Engagement and Commercial Execution
A key driver of SI-BONE’s growth has been its expanding physician base. The company reported a 25% increase in its U.S. active physician base, growing from 1,150 in Q2 2024 to 1,440 in Q2 2025. This represents the 18th consecutive quarter of double-digit growth in active physicians.
The following chart illustrates this physician engagement trend:
The company also noted a 24% increase in physicians performing procedures across multiple modalities, suggesting deeper adoption of SI-BONE’s product portfolio. Territory productivity reached $2.1 million on a trailing 12-month basis, a 23% improvement that reflects the company’s effective commercial execution strategy.
Updated 2025 Guidance
Based on its strong performance, SI-BONE raised its full-year 2025 revenue guidance to $195-$198 million, up from its previous guidance of $193.5-$197.5 million mentioned in its Q1 earnings report. This represents projected year-over-year growth of approximately 17-18%.
The updated guidance and historical revenue trajectory are illustrated in the following chart:
The company also increased its gross margin guidance to 78.5-79.0%, up from the previous estimate of approximately 78.0%, while maintaining its projection for operating expense growth of around 10%.
Product Innovation and Market Opportunity (SO:FTCE11B)
SI-BONE continues to target a large, underpenetrated market with significant growth potential. The company estimates its total U.S. addressable market at $3.5 billion, comprising approximately 470,000 annual procedures across three key segments: SI Joint Dysfunction, Sacropelvic Fixation, and Pelvic Trauma.
The company’s differentiated product portfolio addresses these market segments:
SI-BONE’s proprietary iFuse Technology offers significant advantages over competing products, including 6x greater resistance to rotation compared to competitive screws and a 3.5% four-year revision rate:
Clinical evidence supporting the company’s products continues to accumulate, with the SALLY prospective clinical trial demonstrating strong 5-year outcomes for the iFuse 3D implant:
Financial Position and Outlook
SI-BONE maintains a strong financial position with $145.5 million in cash and equivalents as of June 30, 2025. This robust liquidity provides the company with flexibility to continue investing in growth initiatives while maintaining its path to profitability.
The company’s long-term business strategy focuses on four key drivers:
Looking ahead, SI-BONE appears well-positioned to continue its growth trajectory, with multiple catalysts including expanding physician adoption, increasing procedure volumes, and ongoing product innovation. The company’s ability to deliver three consecutive quarters of positive adjusted EBITDA suggests it is successfully balancing growth with improved operational efficiency.
As the company continues to penetrate its large addressable market, which remains less than 10% penetrated according to management, SI-BONE’s focus on innovation, physician engagement, commercial execution, and operational excellence should support its long-term growth objectives.
Full presentation:
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