Q4 and 2025 Financial Results
February 24, 2026
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Q4 & 2025 Business Highlights and 2026 Goals
Michael Dale
President and
Chief Executive Officer
Agenda
Q4 and 2025 Business Highlights and 2026 Goals
Michael Dale, President and Chief Executive Officer
Q4 and 2025 Financials and 2026 Guidance
Lindsey Hartley, Chief Financial Officer
Q&A
Michael Dale, Lindsey Hartley, Jens Kemp, Chief Marketing Officer
Rick Ditto, VP Global Health Economic, Reimbursement & Policy
Strategic Priorities
01 GROWTH
15-20% Revenue CAGR + Operating Leverage03 COMMERCIAL EXPANSION
Infrastructure and Sales Force expansion02 MARKET DEVELOPMENT
Elective & Planned Procedures + Prostate market development04 COMMERCIAL EXCELLENCE
Continuous business model and customer creation process optimization by market
05 STANDARD OF CARE
Clinical evidence generation for societal support, standard of care & coverage requirements
06 INNOVATION
Product development to drive better benefit versus risk profiles in nerve care6
2025 Business Highlights
Strategic Priorities
0 1 G R O W T H
15-20% Revenue CAGR + Operating Leverage
Q4 Revenue
$59.9M, +21.3% YoY
Full-Year Revenue
$225.2M, +20.2% YoY
Capital Structure
Raised $133.3M; retired $69.7M term loan
2026
Target
Disciplined profitable growth; improving margins
0 2 M A R K E T D E V E L O P M E N T
Elective & Planned + Prostate
Extremities
Solid traumatic & chronic growth; most mature market
OMF / H&N
High double-digit growth; quality-of-life recognition growing
Breast
Fast-growing; accelerating Resensation adoption
Prostate
100+ procedures; 10 sites; surgical technique standardized
2026
Prostate
Meaningful clinical signals expected in 2H 2026
0 3 C O M M E R C I A L E X P A N S I O N
Infrastructure + Sales Force Growth
Breast
21 reps, 2 regional directors
Extremities
117 reps, 15 regional directors
OMF / H&N
3 field-based market development managers
Prostate
Added 3 clinical development managers and 1 director
2026 Breast / Ext.
Grow to ~30 breast reps; ~130 extremity reps
2025 Business Highlights
Strategic Priorities
0 4 C O M M E R C I A L E X C E L L E N C E
HiPo Accounts, Productivity & Education
HiPo Revenue
61% of growth from HiPo accounts
Productivity
+21% avg. HiPo account productivity
Active Accounts
679 HiPo accounts; +131 active surgeons
Education
Exceeded surgeon training targets across all markets
HiPo & Training
2026 60% growth from HiPo; +18% productivity; 100+ new surgeons
0 5 S T A N D A R D O F C A R E
Evidence, Coverage & Avance® FDA BLA
Avance® BLA Approved
First & only FDA-approved biologic for peripheral nerve repair
Exclusivity
12 years of U.S. market exclusivity
Societies
AAHS & ASRM recognize allograft as standard of care (1)
Coverage
+19.8M lives added; commercial coverage now above 65%
Payer & Coverage
2026 Pursue near-universal US coverage (est. 2H 2028)
0 6 I N N O V A T I O N
R&D + Therapeutic Reconstruction
Ease of Coaptation
R&D focused on faster, more consistent nerve coaptation
Chronic Injuries
Advancing non-transected and chronic nerve repair solutions
Therapeutic Reconstruction
Next-gen technologies to improve nerve regeneration
Clinical Studies
BLA enables prioritized breast & mixed/motor nerve studies
Program Updates
2026 Detailed updates on individual R&D programs in 2H 2026
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(1) The American Association of Hand Surgery ("AAHS") and the American Society for Reconstructive Microsurgery ("ASRM") released official position statements recognizing nerve allograft as a standard medical practice option for the treatment of peripheral nerve defects during the third quarter of 2025.
Q4 & 2025 Financials and 2026 Guidance Discussion
Lindsey Hartley
Chief Financial Officer
Q4 & 2025 Financial Performance
$240.0
$200.0
$160.0
$120.0
$80.0
$40.0
$-
Q4 & 2025 Revenue ($ in millions)
$187.3 $59.9 $49.4+21.3%
+20.2%
$225.2Q4 Annual
Q4 & 2025 Gross Margin %(1)
76.5%
76.1% 75.8%74.3%
74.1%-2pp
-1.5pp
76.0%
75.5%
75.0%
74.5%
74.0%
73.5%
73.0%
2024 2025Q4 Annual
2024 2025(1) Q4 2025 and full-year 2025 include $1.9M of one-time costs, of which $1.3M is non-cash stock-based compensation, related to the U.S. Food and Drug Administration ("FDA") Biologics License Application ("BLA") approval of Avance®, impacting gross margin by -3.3% and -0.9%, respectively.
Q4 & 2025 Financial Performance
Gaining operating leverage with topline growth
($ in millions)
Q4 2025 | Q4 2024 | 2025 | 2024 | |
Revenues | $59.9 | $49.4 | $225.2 | $187.3 |
Sales and marketing expenses | $27.2 | $20.1 | $97.7 | $78.5 |
Research and development expenses | 12.4 | 6.7 | 32.9 | 27.8 |
General and administrative expenses | 14.6 | 8.9 | 44.6 | 39.0 |
Total costs and expenses (1) | $54.2 | $35.6 | $175.2 | $145.3 |
YoY change % | 52.0% | 20.6% |
Change as a % of revenue (2) 18.3% 0.3%
(1) Q4 2025 and full-year 2025 total costs and expenses include $7.2M of non-cash, one-time stock-based compensation costs related to the FDA BLA approval for Avance® ($0.7M in sales and marketing, $4.6M in research and development, and $1.9M in general and administrative expenses).
(2) One-time stock-based compensation costs related to the FDA BLA approval for Avance® impacted Q4 2025 and full-year 2025 operating margin by approximately -12.1% and -3.2%, respectively.
Q4 & 2025 Financial Performance
Q4 2025
Q4 2024
2025
2024
($ in millions, except per share data)
Net (loss) income | $(13.2) | $0.5 | $(15.7) | $(10.0) |
Diluted EPS | $(0.28) | $0.01 | $(0.34) | $(0.23) |
Adjusted net income* | $3.5 | $3.5 | $14.4 | $5.9 |
Adjusted Diluted EPS* | $0.07 | $0.07 | $0.29 | $0.13 |
Adjusted EBITDA* | $6.5 | $6.7 | $27.9 | $19.8 |
Adjusted EBITDA margin* | 10.9% | 13.6% | 12.4% | 10.6% |
* Excludes stock-based compensation. See non-GAAP reconciliations included in Appendix.
Q4 and 2025 Financial Performance
Operating cash flow
($ in millions)
+$6.0
+$5.7
$45.5
Operational cash*
2025 Change
Q4 Change
December 31, 2025
* Cash, cash equivalents, restricted cash, and investments.
Guidance for the Full-Year 2026
Revenue growth of at least 18% or $265.7 million
Gross margin of 74% to 76%
Net free cash flow positive
Q&A
Michael Dale
President and
Chief Executive Officer
Jens Kemp
Chief Marketing Officer
Lindsey HartleyChief Financial Officer
Rick Ditto
VP, Global Health Economics, Reimbursement & Policy
Thank youAppendix
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Non-GAAP Reconciliations: Three Months Ended December 31, Years Ended December 31, (in thousands, except share and per share amounts) 2025 2024 2025 2024 | ||||||||
Net (loss) income | $ | (13,156) | $ | 450 | $ (15,703) | $ | (9,964) | |
Depreciation and amortization expense | 1,727 | 1,700 | 6,975 | 6,734 | ||||
Investment income | (352) | (325) | (1,168) | (1,141) | ||||
Income tax expense | - | 21 | 4 | 97 | ||||
Interest expense | 1,718 | 1,801 | 7,702 | 8,206 | ||||
EBITDA - non-GAAP | $ | (10,063) | $ | 3,647 | $ | (2,190) | $ | 3,932 |
EBITDA margin - non-GAAP | (16.8)% | 7.4 % | (1.0)% | 2.1 % | ||||
Noncash stock-based compensation expense | 16,611 | 3,076 | 30,112 | 15,906 | ||||
Adjusted EBITDA - non-GAAP | $ | 6,548 | $ | 6,723 | $ | 27,922 | $ | 19,838 |
Adjusted EBITDA margin - non-GAAP | 10.9 % | 13.6 % | 12.4 % | 10.6 % |
Net (loss) income | $ | (13,156) | $ | 450 | $ (15,703) | $ | (9,964) | |
Noncash stock-based compensation expense | 16,611 | 3,076 | 30,112 | 15,906 | ||||
Adjusted net income - non-GAAP | $ | 3,455 | $ | 3,526 | $ 14,409 | $ | 5,942 | |
Weighted average common shares outstanding -diluted GAAP | 46,929,309 | 48,064,916 | 46,050,266 | 44,257,754 | ||||
Weighted average common shares outstanding -diluted non-GAAP (1) | 52,230,508 | 48,064,916 | 49,812,186 | 46,197,934 | ||||
Net (loss) income per common share - diluted - GAAP | $ | (0.28) | $ | 0.01 | $ | (0.34) | $ | (0.23) |
Noncash stock-based compensation expense | 0.35 | 0.06 | 0.65 | 0.36 | ||||
Adjusted net income per common share - diluted - non-GAAP (1) | $ | 0.07 | $ | 0.07 | $ | 0.29 | $ | 0.13 |
(1) Due to a GAAP net loss, antidilutive securities are excluded from GAAP diluted weighted average common shares outstanding for the three months ended December 31, 2025 and the years ended December 31, 2025 and 2024. However, considering the adjusted net income position for the three months ended December 31, 2025 and the years ended December 31, 2025 and 2024, adjusted diluted weighted average common shares outstanding incorporates securities that would have been dilutive for GAAP.
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