Treace Medical Concepts (TMCI) Q2 FY26 earnings call: guidance and Q&A

What were the quarter-over-quarter improvements in volume and pricing, and how have new products impacted these dynamics? How should investors think about Q3 and Q4 revenue pacing given the full-year guidance?

Case volume growth accelerated to high single digits in Q2 due to greater penetration of new bunion systems and contributions from SuperBite. Management expects continued improvement in case volumes and new product contributions in H2, with Q3 revenue stepping up from Q2, leading into a seasonally strongest Q4.

“Within the quarter, what we saw was greater penetration of our three new bunion systems that we launched in Q3 of last year. We went from 35% of our 3,300 surgeon base using those products last quarter to 40%. So that was nice to see. We also saw some contributions from our limited market release of our SuperBite screw system, and that penetrated some new procedures, so when you combine those two together, we accelerated our case volume growth. We talked about mid single digits over the last couple of quarters. We were in the high single digits this quarter.”

asked by Iseult McMahon · answered by John Treace

Can you share the addressable market sizes for Great Release and CardiBlaster? Do Lapoplasty surgeons gravitate towards specific new offerings, and who are you displacing?

The combination of SuperBite, HyperPlate XM, CardiBlaster, and Great Release XM expands the U.S. TAM by approximately $300 million in the midfoot and hindfoot. Surgeon preference for new bunion systems varies (e.g., Nanoplasty vs. Percuplasty based on burr use), while Speed MTP sees strong adoption. The company is capturing the 75% of bunion volume not previously addressed by Lapoplasty.

“What we've talked about is when you look at the combination of SuperByte, the HyperPlate XM, and the CardiBlaster, the Great Release XM platform, I think that expands our TAM by about $300 million on the US side. That's eyes of that opportunity that we're going after in this kind of midfoot and hindfoot port.”

asked by Benjamin Haynor · answered by John Treace

What competitive response are you seeing to your innovations? What is the quarterly OPEX run rate, and how does it impact the goal of adjusted EBITDA breakeven in 2027?

No notable shift in the competitive landscape. Treace differentiates through high-performing products, medical education, specialized sales teams, and a high pace of innovation. The company continues to seek efficiencies, with Q2 OPEX at $50.6M. Management is confident in continued adjusted EBITDA improvements, expecting positive adjusted EBITDA in Q4 2026 and into 2027.

“I guess at a high level, we haven't seen a notable shift on the competitive landscape since last quarter. As you know, we have numerous companies that participate in the bunion space, some very large companies and a lot of smaller players. The way we see it, we just have these very high performing products in the segments that we play in.”

asked by Frederick Wise · answered by John Treace

What are you seeing in the elective procedure market, especially regarding fears of slowdowns or ACA subsidy expirations? Is there any reason why a high single-digit growth trajectory wouldn't be sustainable in 2027?

Underlying trends track assumptions, and no material impact from elective procedure slowdown fears has been observed on their commercially insured patient demographic. Summer seasonality is normal. While not guiding for 2027, management expects a much stronger growth trajectory exiting 2026 and going into 2027, with continued improvements in adjusted EBITDA.

“To date, I would say the underlying trends have kind of tracked with our assumptions that were built into our 2026 guidance. And then with, you know, more new products coming and impacting things in the back half of the year, like SuperBite and the new products we talked about, we can tap into incrementally more elective cases that are outside, you know, what is going on in the bunion market specifically.”

asked by Richard Newitter · answered by John Treace

How does the mix shift towards lower ASP MIS products, combined with new product additions, affect the average procedure price moving forward? How far along are you in the ASP headwind from new MIS osteotomy products?

The ASP mix dynamic is expected to play through Q3. New products like SuperBite can be add-on sales to existing procedures ($500-$1,500) or standalone ($500-$2,000). Combined with other technologies for mid/hindfoot cases, they can lead to $5,000-$15,000 cases. This blend is expected to strengthen the portfolio and increase sales rep engagement.

“As we launch things like SuperBite, you have two different places those go. Sometimes SuperBite screws go into our existing lapoplasty, adductoplasty procedures where they're an add-on sale and They may be a $500 or $1,000 or $1,500 addition to a case like that. can be used standalone, and that may be a case that varies between $500 and, you know, call it $2,000. When you get into cases more in the back of the foot, sometimes these combine multiple technologies. So you have SuperBite screws, you have our Speedplates or our forthcoming Hyperplate, you have some of our Biologics involved, and these can be $5,000, $10,000, even $15,000 cases.”

asked by Lilia-Celine Lozada · answered by John Treace