Shoulder Innovations

What Shoulder Innovations does

Shoulder Innovations, Inc. is a commercial-stage medical device company that designs, manufactures, and sells shoulder arthroplasty implant systems built around its proprietary InSet glenoid technology. Founded in 2009 by orthopedic surgeon Dr. Stephen Gunther with venture backing from EDF Ventures, and headquartered in Michigan, the company completed its initial public offering on the New York Stock Exchange (ticker: SI) in 2025. Its product portfolio spans the InSet Total Shoulder System (including the InSet Glenoid, InSet Plus Augmented Glenoid, I-70, I-95, and I-135RFX humeral stems, a short stem, and a stemless system), the InSet Reverse Shoulder Arthroplasty system, the InSet Tray System (a one-tray TSA / two-tray RSA instrument configuration), and the ProVoyance Shoulder Planning Software — an FDA-approved AI/ML tool that converts CT imaging into 3D bone reconstructions and was the first pre-operative planning software cleared under the FDA's new AI/ML approval pathway. The core technical differentiator is the InSet glenoid design, which positions the implant within a rim of sclerotic bone rather than on the bone surface, with finite element analysis demonstrating an 87% reduction in "rocking horse" stresses and clinical data showing 1.3% glenoid loosening at five years. The company is also partnered with Interventional Systems to co-develop a micro-robotic platform for shoulder arthroplasty.

The company sells exclusively through a direct U.S. field-sales organization targeting orthopedic shoulder surgeons at hospitals and ambulatory surgery centers (ASCs), with 134 core and contender surgeons as of end-2025 (a 61% year-on-year increase) and 2,184 implant systems sold in Q1 2026. Average selling price per implant system was $7,650 in Q1 2026, up 9% year-over-year, and gross margin was 76.7% in Q1 2026 and 77.5% for full-year 2025 — consistent with a premium specialty implant pricing model. FY2025 net revenue was $47.3 million (+50% YoY) and management has guided to $65–68 million for FY2026 (37–44% growth). The company holds multiple U.S. patents covering InSet glenoid fixation, augmented glenoid designs, reverse shoulder systems, the K-Coat porous coating, and the ProVoyance software. Capital structure is well-funded: $108.5 million in cash and marketable securities as of March 31, 2026, supplemented by a $50 million credit facility with Stifel Venture Banking (June 2026) consisting of a $15 million term loan, a $30 million undrawn revolver, and a $5 million accordion.

Customers are orthopedic shoulder surgeons and the hospitals/ASCs where they practice, with a primary focus on the United States and no disclosed international revenue. The company was founded in 2009, has 11–50 employees, and is led by CEO and Executive Chairman Robert Ball (in role since October 2020, board chair since April 2015) with CFO Jeffrey Points (since September 2023, previously CFO of Cardiovascular Systems), COO Matthew Ahearn, and Chief Customer Experience Officer David Blue. The board includes representatives of lead investors U.S. Venture Partners (Casey Tansey) and Lightstone Ventures (Michael Carusi), with medtech operator-directors including Paul Buckman (former LivaNova and Coventus CEO), Kevin Sidow (former Moximed CEO), and Drew Hykes (former Inari Medical CEO, acquired by Stryker).

Name

Shoulder Innovations

Legal name

Shoulder Innovations, Inc.

Website

https://shoulderinnovations.com

Company type

Public

Founded year

2009

Operating status

Operating

Headcount range

11–50 employees

Short description

Shoulder Innovations is a U.S. medical device company that designs and sells InSet shoulder arthroplasty implant systems and the ProVoyance AI surgical planning software, sold directly to orthopedic surgeons at hospitals and ambulatory surgery centers, generating $47.3M in 2025 revenue.

Ownership category

akta.pro rank

Product category

Shoulder Arthroplasty Implants

NAICS

Surgical Appliance and Supplies Manufacturing (339113), Surgical and Medical Instrument Manufacturing (339112)

SIC

Orthopedic, Prosthetic & Surgical Appliances & Supplies (3842)

akta.pro primary industry

Orthopedic Joint Reconstruction Implants (Hip/Knee/Shoulder/Elbow/Ankle) (HLAHAEAA)

Keywords

• Shoulder arthroplasty implants
• Orthopedic medical devices
• Glenoid fixation systems
• Reverse shoulder replacement
• Surgical planning software

Headquarters

HQ city

Holland

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Hardware or Manufacturing

Cost components

Technology or R&D, Personnel, Marketing or Sales, Operations, Infrastructure, Supply Chain

Revenue model

1. Implant System Sales: Sale of shoulder arthroplasty implant systems including InSet glenoid components, humeral stems (short stem, stemless, I-70, I-95, I-135RFX), and reverse shoulder systems. Revenue is generated through direct commercial organization to hospitals and ASCs. Average selling price increased 9% to $7,650 in Q1 2026.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels7 records

Core offering

Shoulder Innovations designs, manufactures, and commercializes shoulder arthroplasty implant systems built around its proprietary InSet glenoid technology, which positions the glenoid implant within a pocket of sclerotic bone to reduce mechanical stress and the rocking horse effect. The product portfolio includes anatomic and reverse shoulder replacement systems, multiple humeral stem options (short stem, stemless, I-70, I-95, I-135RFX), augmented glenoid components, streamlined surgical tray instrumentation, and the FDA-approved ProVoyance AI/ML-based pre-operative planning software.

Product overview

Shoulder Innovations offers a comprehensive ecosystem of shoulder arthroplasty solutions centered on the proprietary InSet® implant technology. The portfolio includes the InSet® Total Shoulder System (featuring glenoid and multiple humeral stem options), InSet® Reverse Shoulder Arthroplasty, and the InSet® Tray System for procedural efficiency. Key product variants include the InSet® Glenoid (standard and PLUS augmented), InSet® 70 Humeral Stem, InSet® 95 Humeral Stem, InSet™ I-135RFX Humeral Stem, Stemless, and Short Stem options. The ecosystem is enhanced by ProVoyance® Shoulder Planning Software—an FDA-approved AI/ML-powered 3D surgical planning tool—and streamlined one-tray (TSA) / two-tray (RSA) instrument systems. The InSet® technology addresses glenoid loosening by positioning implants within sclerotic bone, demonstrating 87% reduction in rocking horse stresses.

Differentiator

Problem solved

Functional benefit

Brands

• InSet®: The company's flagship implant technology platform for shoulder arthroplasty, including Total Shoulder Arthroplasty, Reverse Shoulder Arthroplasty, and various humeral stem options.
• ProVoyance®
• InSet® Tray System

Products and services

• InSet® Total Shoulder System Comprehensive shoulder arthroplasty system featuring the InSet® Glenoid designed to address glenoid loosening through mechanical stability, with multiple humeral stem options including short stem, stemless, and 70mm/95mm variants. The flagship system for orthopedic surgeons performing total shoulder arthroplasty procedures at hospitals and ASCs.
• InSet® Glenoid Implant Glenoid implant designed to sit within a rim of sclerotic bone, demonstrating 87% reduction in rocking horse stresses and significantly reduced implant displacement compared to traditional onlay designs. For use in total shoulder arthroplasty procedures by orthopedic surgeons.
• InSet® PLUS Augmented Glenoid Augmented glenoid offering 5 or 10 degree correction options for glenoid defects, featuring flat-back design for 100% backside coverage and standard surgical technique compatibility. Designed for shoulder arthroplasty procedures requiring correction of glenoid bone loss.
• InSet® 70 Humeral Stem 70mm canal-sparing stem available in five sizes, designed to better match patient anatomy while preserving bone and improving alignment. Minimizes canal preparation to reduce blood loss and post-operative pain. For use in total shoulder arthroplasty procedures.
• InSet® 95 Humeral Stem Humeral stem with unique 2-fin design for superior rotational control and robust fixation with aggressive proximal coating. Features convertible design enabling seamless transition between TSA and RSA configurations. For orthopedic shoulder surgeons.
• InSet™ I-135RFX Humeral Stem Third addition to the I-Series humeral stem product line, enabled for all primary, revision, and fracture total shoulder arthroplasty procedures following FDA 510(k) clearance. Built on exclusive InSet lateral-lateral implant philosophy. For orthopedic surgeons performing fracture-indicated shoulder procedures.
• InSet® Reverse Shoulder Arthroplasty Reverse total shoulder replacement system featuring lateralized-lateralized design for better range of motion with fewer complications. Supports treatment of large rotator cuff tears, cuff tear arthropathy, and complex shoulder fractures. For orthopedic shoulder surgeons.
• InSet® Stemless Shoulder Replacement System Stemless implant system offering highest level of intra-operative flexibility with 23% greater axial pullout strength and 21% greater torque-out strength than leading linear finned stemless implants. Single sterilization tray contains all instrumentation. For orthopedic surgeons preferring bone-preserving stemless options.
• InSet® Short Stem Low profile humeral stem with proprietary K-Coat porous coated curved fins designed to maximize rotational stability and fixation while preserving bone. Supports wide range of Subscapularis repair techniques. For orthopedic surgeons performing total shoulder arthroplasty.
• InSet® Tray System Economically efficient streamlined tray design available in one-tray TSA and two-tray RSA configurations, reducing operating room instrument footprint, turnover times, and sterilization costs. Specifically designed for hospital and ASC settings performing shoulder arthroplasty.
• ProVoyance® Shoulder Planning Software AI-powered pre-operative surgical planning software that converts CT imaging into detailed 3D bone reconstructions. First pre-operative planning software approved through FDA's new AI/ML approval process. Available to all shoulder surgeons regardless of implant system use. Built on gaming platform for enhanced user experience.

Quantifiable outcome

• 87% reduction in rocking horse stresses and implant displacement compared to traditional onlay glenoid
• +5 more outcomes

Named customers6 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability3 records

Feature6 records

Partnerships

Two partnerships are on record, tiered core.

• Interventional Systems (INS)coreStrategic or Co-development Partner · 3 December 2025Strategic partnership to develop a micro-robotic system for shoulder arthroplasty. Collaboration aims to enhance surgical precision, workflow efficiency, and address challenges of robotic surgery including costs and technical complexity. INS is described as a small, flexible company well-suited to the ASC environment.
• Genesis Innovation GroupcoreStrategic or Co-development Partner · 1 January 2009Genesis acquired a position in Shoulder Innovations in 2014 after EDF Ventures contacted them about the technology. Genesis provides medical device development and commercialization expertise. CEO Rob Ball serves as Chairman of Genesis Innovation.

Scale indicators14 records

Recent moves7 records

Expansion highlights6 records

Broad incumbents

• Smith+Nephew: Global medtech with a sports medicine and shoulder arthroplasty portfolio. Competes in shoulder replacement and is an established alternative for surgeons considering switching systems.
• Stryker: Global orthopedic and medical device leader with a large shoulder arthroplasty franchise inherited from Wright Medical (Tornier). Operates across multiple orthopedic segments and is the largest direct competitor to Shoulder Innovations in shoulder replacement.
• Zimmer Biomet: Major orthopedic medical device company offering the Comprehensive shoulder arthroplasty system. Competes across joint reconstruction broadly, including shoulder, and has scale advantages in hospital contracting and surgeon relationships.
• Arthrex: Privately held sports medicine and orthopedic surgical implant leader. Strong in shoulder arthroscopy and an emerging competitor in shoulder arthroplasty, leveraging its dominant sports medicine sales channel to surgeons.
• Enovis (DJO): Medical device company with shoulder arthroplasty systems (AltiVate, MatchPoint) and a broader orthopedic and bracing portfolio. Direct competitor in shoulder reconstruction implants.

Emerging players

• Ignite Orthopedics: Early-stage orthopedic company developing shoulder and other joint replacement solutions. Emerging competitor with overlapping product roadmap in shoulder arthroplasty.
• Arthrosurface: Orthopedic implant company focused on joint preservation and hemiarthroplasty solutions for the shoulder. Adjacent competitor with overlapping surgeon customer base and clinical indications.

Direct peers

• Catalyst OrthoScience: Smaller specialty orthopedic company focused exclusively on shoulder arthroplasty. Direct niche competitor with targeted shoulder replacement systems competing for the same surgeon accounts as Shoulder Innovations.
• Exactech: Specialty orthopedic implant company focused on joint replacement including shoulder arthroplasty (Equinoxe system). Closest direct peer in terms of size and specialization; targets similar shoulder surgeon customer base.

Regional players

• FX Shoulder Solutions: Shoulder arthroplasty specialist with strong presence in Europe and selective US distribution. Comparable product portfolio focused exclusively on shoulder replacement.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/shoulder-innovations

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Funding overview

Funding rounds9 records

Investors19 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Shoulder Innovations