Treace Medical Concepts NASDAQ: TMCI reaffirmed its full-year 2026 revenue outlook after reporting a first-quarter revenue decline, as management said new product adoption is helping drive procedure volume momentum despite pricing and mix headwinds.
On the company’s first-quarter earnings call, Chief Executive Officer John Treace said the company has “evolved beyond its foundation in Lapiplasty into a comprehensive bunion solutions company,” citing multiple new procedure innovations launched in 2025 and additional planned launches in 2026.
Treace reported first-quarter revenue of $47.2 million, down 10% from the prior year. Chief Financial Officer Mark Hair said the decline was mainly driven by a revenue mix shift toward lower-priced minimally invasive products and lower volume of bunion procedure kits sold.
Gross margin was 79.3% in the quarter, compared with 79.7% in the first quarter of 2025. Operating expenses were $54.6 million, down from $57.5 million a year earlier. The company’s net loss was $18 million, or $0.28 per share, compared with a net loss of $15.9 million, or $0.25 per share, in the year-ago period. Adjusted EBITDA was a loss of $5.5 million, compared with a loss of $3.8 million in the first quarter of 2025.
Company Maintains 2026 Outlook
Treace reaffirmed its full-year 2026 revenue guidance of $202 million to $212 million, representing a decline of 5% to flat compared with 2025. The company had raised that outlook when it announced preliminary operating results on April 9.
Management said it expects revenue declines to continue until the fourth quarter, which it described as the company’s seasonally strongest period. Treace expects fourth-quarter revenue growth to be supported by accelerating case volumes, the anniversary of the product mix shift that has pressured average selling prices, and contributions from planned 2026 product launches.
The company also reaffirmed its expectation for a full-year adjusted EBITDA loss of $4 million to $6 million, compared with an adjusted EBITDA loss of $3.9 million in 2025. Hair said Treace expects cash usage to decline by approximately 50% in 2026 compared with 2025. Cash, cash equivalents and marketable securities totaled $51.9 million as of March 31, up from $48.4 million at year-end 2025.
New Bunion Systems Drive Adoption, But Pressure ASPs
Treace’s management said its 2025 product launches remain central to the company’s growth strategy. The company highlighted three new bunion systems: Nanoplasty, Percuplasty 3D MIS and SpeedMTP. Treace said the products are intended to broaden its addressable market beyond Lapiplasty alone.
John Treace said Nanoplasty and Percuplasty expand the company’s reach into the osteotomy segment, which he said represents about 70% of the estimated 450,000 annual U.S. bunion procedures. He also said SpeedMTP targets the roughly 20% of bunion patients with an arthritic great toe or metatarsophalangeal joint, as well as non-bunion patients with isolated arthritic MTP joints.
As of the first quarter, about 35% of Treace’s Lapiplasty surgeon user base had incorporated at least one of the three new bunion systems since launch, up from 25% reported in the fourth quarter of 2025. Treace also said approximately 30% of new surgeons who initially became customers through one of the three new bunion systems had also used Lapiplasty technology.
Hair said the new products have been adopted by a large portion of the surgeon base but carry lower average selling prices, creating a temporary headwind. He said the company expects that dynamic to continue until it begins to anniversary the launch period in the third quarter.
“We feel like the strategy is working,” Hair said in response to an analyst question. “We’re getting these new products to our surgeons. They’re utilizing them, and that’s just gonna have a temporary headwind in the first part of this year, but that will change in the back half of this year.”
Lapiplasty Updates and Portfolio Expansion
Treace said it remains focused on expanding adoption of Lapiplasty, which addresses the Lapidus fusion segment. John Treace said Lapidus fusion represents about 30% of the 450,000 annual U.S. bunion procedures and described it as a category in which the company is the recognized leader.
The company said it remains on track to commercialize its next-generation Lapiplasty platform, called Lapiplasty Lightning, later in 2026. Management said the system includes next-generation 3D correction instrumentation and new SpeedTMT implants. Treace also pointed to IntelliGuide PSI, a patented preoperative planning and patient-specific cut guide system for bunion and midfoot correction.
Beyond bunion procedures, the company discussed its broader foot and ankle portfolio, including SpeedPlate implants, sterile instruments and biologics offerings. Treace also highlighted its SuperBite variable pitch compression screw system, which it said had initial surgeries in April, and the forthcoming SpeedXM Fusion System.
John Treace said SuperBite is designed to reduce or eliminate the need to pre-drill before implanting a screw because of its self-drilling design. He said the product can help Treace reduce the need for a competitor’s product in its cases while expanding access to forefoot, midfoot, hindfoot and ankle procedures.
Treace expects full commercialization of SuperBite and SpeedXM during the third quarter. The company said the products collectively expand its total addressable market by approximately $300 million and provide access to higher average selling price midfoot and hindfoot procedures.
Management Discusses Market Conditions and Competitive Trends
During the question-and-answer session, analysts asked about the company’s product mix, adoption trends and broader market conditions. John Treace said the company continues to see strong adoption of the new products among existing customers and is working to increase the number of surgeons using multiple Treace systems.
Hair said management does not view the new product options as simply replacing Lapiplasty procedures. Instead, he said they provide additional choices for surgeons to address patient needs.
Asked about the broader market environment, John Treace said the company entered the year expecting macro headwinds and consumer sentiment-related impacts on elective procedures to continue. He said the first quarter played out within expectations, with no major surprises in patient flow or surgeon activity.
On competitive positioning, John Treace said adoption initially came more from existing customers, but the company has seen more competitive conversions as products have become more broadly supplied and surgeons have been trained. He said Treace is seeing displacement of competitors in minimally invasive systems and in SpeedMTP.
Management said it remains focused on increasing surgeon training, expanding new account activity and improving utilization of its broader product portfolio as it works toward returning to revenue growth in the fourth quarter.
About Treace Medical Concepts NASDAQ: TMCI
Treace Medical Concepts, Inc is a medical technology company specializing in the development and commercialization of innovative surgical solutions for foot and ankle conditions. The company's flagship product, the Lapiplasty 3D Bunion Correction System, addresses the underlying joint instability that causes bunion deformity through a patented, multi-plane correction approach. The system combines proprietary instrumentation, fixation plates, and a comprehensive surgical protocol designed to improve patient outcomes and reduce recurrence rates.
The Lapiplasty System has received clearance from the U.S.
Featured Stories
This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to contact@marketbeat.com.
Before you consider Treace Medical Concepts, you'll want to hear this.
MarketBeat keeps track of Wall Street's top-rated and best performing research analysts and the stocks they recommend to their clients on a daily basis. MarketBeat has identified the five stocks that top analysts are quietly whispering to their clients to buy now before the broader market catches on... and Treace Medical Concepts wasn't on the list.
While Treace Medical Concepts currently has a Reduce rating among analysts, top-rated analysts believe these five stocks are better buys.
View The Five Stocks Here
Looking to profit from the electric vehicle mega-trend? Click the link to see our list of which EV stocks show the most long-term potential.
Get This Free Report
