# TMCI earnings call intelligence

LOPJLB CallCard / temporal rollup · freemium · [stock page](https://www.lopjlb.com/stock/TMCI) · [Earnings tab](https://www.lopjlb.com/stock/TMCI?tab=earnings)

Updated: 2026-08-07T08:15:03

Quarters analyzed: 8

## Cross-quarter narrative

Across the eight TMCI earnings calls, the company moved from reaffirming 2024 guidance and modest Q2 growth to cutting FY25 revenue expectations in Q3 2025 and further lowering FY26 guidance in early 2026. The driver of the downward revisions is a mix shift toward lower‑priced minimally invasive osteotomy products, elective procedure deferrals, and a 7% YoY dip in bunion case volumes. Despite these pressures, TMCI continued to roll out its product pipeline: three bunion correction systems were delivered in Q3 2025, while a suite of MIS platforms—including Lapiplasty Lightning, Percuplasty, Nanoplasty, SpeedMTP, IntelliGuide and SuperBite—remained on‑track through Q1 2026. Gross margins slipped modestly in Q3 2025 (‑100 bps) but stabilized around 79% in Q1 2026. Operating expenses rose in late‑2025 due to training, restructuring and litigation, yet fell YoY in Q1 2026 as the firm trimmed spend and targeted a 50% reduction in cash burn. Case‑volume growth stayed in the mid‑single‑digit range, but the overall revenue trajectory turned negative, with a projected 5‑10% decline for FY26. Macro demand pressure, ASP headwinds, competitive dynamics in MIS osteotomy, and the early adoption curve for new products emerged as recurring concerns.

## Latest CallCard · Q1

**Guidance:** maintained — Reaffirmed full year 2026 revenue guidance of $202M-$212M (decline of 5% to 0% vs 2025) and adjusted EBITDA loss of $4M-$6M, both previously raised on April 9 pre-announcement. Expect revenue growth returning in Q4. Expect ~50% reduction in cash usage for full year 2026 vs 2025. No formal 2027 guidance provided.

**Tone:** mgmt 0.2 · Q&A pressure 0.4 · divergence 0.2

Management acknowledges macro headwinds and 10% Q1 revenue decline but emphasizes strategic progress: 35% surgeon adoption of new products (up from 25%), mid-single-digit case volume growth, competitive conversions accelerating, and clear path to Q4 growth inflection. Language balances realism ('not satisfied', 'lot of work to do') with confidence in controllable levers.

### Demand visibility

Macro pressures on elective procedures persist; mid-single-digit case volume growth in Q1; expect improvement through 2026 with Q4 growth inflection.

Management states macro headwinds (consumer sentiment impacting elective procedures) continue into 2026 and played out as expected in Q1 with no surprises in patient flow or surgeon activity. Mid-single-digit case volume momentum observed in Q1. Revenue decline of ~10% in Q1 driven by mix shift to lower-priced MIS products and lower bunion kit volumes. Expect revenue declines to improve through the year with growth returning in seasonally strong Q4, supported by case volume growth, lapping of ASP mix shift, and 2026 product launch contributions. No independent market data yet for overall bunion/foot & ankle elective trends in Q1.

### Margins / costs

Gross margin stable at 79.3%; operating expenses down $2.9M YoY; adjusted EBITDA loss widened to $5.5M; targeting 50% cash usage reduction for FY26.

Q1 2026 gross margin 79.3% vs 79.7% in Q1 2025. Total operating expenses $54.6M vs $57.5M prior year. Net loss $18M ($0.28/share) vs $15.9M ($0.25/share). Adjusted EBITDA loss $5.5M vs $3.8M loss prior year. Cash, equivalents and marketable securities $51.9M as of March 31, 2026, up $3.5M from Dec 31, 2025. Full year 2026 adjusted EBITDA loss guided $4M-$6M vs $3.9M loss in 2025. Expect ~50% reduction in cash usage for full year 2026 vs 2025. Progressing toward cash flow breakeven.

### Capital allocation

Cash increased $3.5M to $51.9M; investing in sales force expansion, surgeon training, new product launches; targeting 50% cash burn reduction FY26; no buybacks/dividends mentioned.

Cash, cash equivalents and marketable securities totaled $51.9M as of March 31, 2026, up ~$3.5M from $48.4M at Dec 31, 2025. Q1 2025 cash increase was only ~$0.4M. Management highlights 'controllable levers' including strengthening sales team, launching product innovations, adding new accounts and surgeons. New sales reps ramping in back half of 2026. Full commercialization of SuperBite and SpeedXM expected in Q3. No mention of share repurchases, dividends, or M&A. Balance sheet described as 'strong and flexible' to execute strategic initiatives.

### Milestones

- **Nanoplasty 3D MIS System** [on_track]: Launched 2025; part of 3 new bunion systems; 35% of Lapiplasty surgeon base adopted at least one new system as of Q1 2026 (up from 25% in Q4 2025).
- **Percuplasty 3D MIS System** [on_track]: Launched 2025; part of 3 new bunion systems; targets high-volume osteotomy segment (~70% of 450k annual US bunion procedures).
- **SpeedMTP Great Toe Fusion System** [on_track]: Launched 2025; targets ~20% of bunion patients with arthritic MTP joint plus non-bunion MTP arthritis; seeing competitive conversions and higher ASP than MIS products.
- **Lapiplasty Lightning (next-gen platform)** [on_track]: On track for commercialization later in 2026; includes Lightning Instrumentation (faster procedure, enhanced 3D correction) and SpeedTMT implants (faster fixation).
- **IntelliGuide PSI Technology** [on_track]: Advancing preoperative planning and patient-specific cut guide system; patented; complementary to Lightning and SpeedTMT.
- **SuperBite Variable Pitch Compression Screw System** [on_track]: Initial surgeries in April 2026; full commercialization expected Q3 2026; novel self-drilling design reduces OR time; expands access to forefoot through ankle procedures.
- **SpeedXM Fusion System** [on_track]: Forthcoming launch; leverages SpeedPlate hybrid technology for midfoot/hindfoot fusions; full commercialization expected Q3 2026; complementary with SuperBite and biologics.
- **SpeedPlate Implants, Sterile Instruments, Biologics** [delivered]: Added to portfolio in 2025; enabling sales force to support broader surgeon needs and adjacent procedures.

### Fears / risks

- **Macro demand pressure**: Consumer sentiment impacts on elective procedures expected to continue through 2026; no independent market data yet for Q1 bunion/foot & ankle trends.
- **ASP/mix shift headwinds**: Revenue decline driven by shift to lower-priced MIS products and lower bunion kit volumes; ASP headwinds expected to persist until Q4 lapping.
- **Competitive dynamics in MIS osteotomy**: Going head-to-head with established ortho players in MIS osteotomy; adoption initially from existing base but competitive conversions increasing; sustained displacement uncertain.
- **New product adoption curve**: 3 new 2025 systems only 3 quarters into full launch; 35% surgeon adoption of at least one system; pull-through to Lapiplasty early and numbers not large yet.
- **Revenue decline trajectory**: Q1 revenue down ~10% YoY; full year guidance implies 5-0% decline; growth not expected until Q4; execution risk on new product contributions.
- **Cash burn and profitability timeline**: Adjusted EBITDA loss widened to $5.5M in Q1; full year loss guided $4-6M vs $3.9M loss in 2025; cash flow breakeven timeline not specified despite 50% cash usage reduction target.
- **Dependence on 2026 launches for growth recovery**: Q4 growth inflection heavily reliant on SuperBite, SpeedXM, Lightning, SpeedTMT contributions; supply, training, and adoption execution risks

## Quarter one-liners

- **2026 Q1:** —
- **2025 Q4:** TMCI guides 2026 revenue down 6-0% to $200-212M amid mix shift headwinds, but sees accelerating procedure volumes from new MIS osteotomy and MTP fusion products, targeting
- **2025 Q3:** Treace Medical cut 2025 revenue guidance to 1-2% growth ($211-213M) as Lapiplasty volumes face MIS osteotomy shift and elective deferrals; new product portfolio driving case volume growth but lower ASPs; Q3 revenue $50.2M (+11%), adj EBITDA loss narrowed 49%.
- **2025 Q2:** —
- **2025 Q1:** TMCI Q1 revenue $52.6M (+3%, +4.5% adj), maintained FY25 guidance $224-230M (7-10% growth), three new bunion systems launching Q3 targeting 100% of surgeon cases, adj EBITDA loss improved 54% YoY, targeting breakeven adj EBITDA FY25.','tone': {'mgmt': 0.7, 'mgmt_rationale': 'Management expresses hig
- **2024 Q4:** —
- **2024 Q3:** —
- **2024 Q2:** Treace Medical reaffirms 2024 guidance after 6% Q2 growth, plans limited MIS osteotomy launch in Q4, and sees CMS reimbursement boost for Lapidus procedures.','tone': {'mgmt': 0.3, 'mgmt_rationale': 'Management highlights progress on new MIS osteotomy platforms, pipeline of >10 products, and CMS rei

## Theme arcs

- **Revenue guidance trajectory** (deteriorating): Guidance cut from stable 2024 outlook to FY25 1‑2% growth and FY26 down 0‑6%.
- **Product launch pipeline** (improving): Multiple new bunion and MIS systems delivered or on‑track.
- **Gross margin pressure** (stable): Margins down 100bps in Q3 2025 then held near 79%.
- **Operating expenses and cash burn** (improving): Expenses rose in late‑2025 then fell YoY in Q1 2026 with cash‑burn reduction targets.
- **Case volume trends** (deteriorating): Mid‑single‑digit growth offset by ~7% bunion volume decline.
- **ASP/mix shift** (deteriorating): Shift to lower‑priced MIS products eroding revenue.
- **Competitive dynamics in MIS osteotomy** (new): Increasing competition noted in 2026 Q1.

## Fear persistence

- **Macro demand pressure** [recurring]: Elective deferrals noted in 2025 Q3 and macro pressure in 2026 Q1.
- **ASP/mix shift headwinds** [recurring]: Lower ASPs and mix shift cited in 2025 Q3 and reiterated in 2026 Q1.
- **Competitive dynamics in MIS osteotomy** [new]: Competitive pressure highlighted in 2026 Q1.
- **New product adoption curve** [new]: Adoption rates and pull‑through discussed in 2026 Q1.
- **Revenue decline trajectory** [recurring]: Revenue decline trend noted from 2025 Q3 through 2026 Q1.

## Guidance path

2024 Q2:vague → 2024 Q3:vague → 2024 Q4:vague → 2025 Q1:vague → 2025 Q2:vague → 2025 Q3:lowered → 2025 Q4:vague → 2026 Q1:maintained

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