Tenon Medical (TNON) Q4 2025 Earnings Transcript

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Thursday, March 19, 2026 at 4:30 p.m. ET
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Steven Foster: Thank you, Shamali, and good afternoon to everyone. I'm pleased to welcome you to today's fourth quarter and full year 2025 financial results and corporate update conference call for Tenon Medical. Our fourth quarter and full year 2025 results demonstrate continued momentum in executing our strategic growth initiatives within our unique structure. We achieved record full year revenue of $3.9 million, a 20% increase compared to 2024, driven by strong second half momentum with fourth quarter revenue of $1.5 million, representing a 92% increase over the prior year period.
The increase in revenue for the year was primarily driven by growth in surgical procedures across both the Catamaran and SImmetry+ platforms in the back half of 2025, led by new physician users. To support that clinical engagement, we hosted 24 physicians and targeted training sessions for both platforms during the fourth quarter alone. Importantly, alongside top line expansion, we leveraged operational effectiveness initiatives to achieve a reduction in cost of sales, reflecting improved operational efficiencies, better field productivity and greater leverage within our commercial infrastructure. We believe these gains underscore the effectiveness of our execution strategy alongside growing market awareness of our differentiated technologies.
During the quarter, Tenon achieved several significant milestones that meaningfully strengthened our competitive position and lay the groundwork for continued growth in the coming year. Most notably, we received FDA 510(k) clearance for the next-generation SImmetry+ SI-Joint Fusion System, expanding our portfolio to include a complementary lateral approach alongside Catamaran. This milestone enhances our ability to serve a broader range of surgeon preferences and patient anatomies. We also successfully initiated and completed early clinical cases with SImmetry+, marking an important step in the system's commercial rollout. These procedures performed at leading Centers of Excellence, validate the system's readiness for broader market adoption and provide valuable real-world feedback as we scale development.
To support these strategic enhancements, we strengthened our balance sheet through a $2.85 million At-The-Market PIPE financing that provides flexibility to expand our commercial organization, support our product rollout initiatives, advance clinical programs and continue building operational infrastructure. Subsequent to quarter end, we further strengthened our financial position by closing a private placement of senior convertible notes for gross proceeds of $4.3 million. Net proceeds will fund continued commercial expansion, upcoming product launches, clinical studies, working capital and general corporate purposes. Collectively, these accomplishments demonstrate disciplined execution across regulatory, clinical and financial fronts.
With an expanded product offering, growing clinical validation and enhanced financial flexibility, we believe that Tenon exited the quarter and year well positioned to accelerate adoption, deepen our market penetration and drive sustained growth in the quarters and years ahead. We also expanded our intellectual property portfolio subsequent to quarter end, receiving notices of allowance from the U.S. Patent and Trademark Office for multiple applications expected to issue in 2026. This brings our global estate to 29 issued U.S. patents, 9 international patents and 31 pending applications, further reinforcing the defensibility of our platform around both the Catamaran and SImmetry technologies.
Looking ahead, we remain firmly committed to advancing our strong market position with increased adoption across our expanding portfolio, now bolstered by the recent FDA 510(k) clearance of the SImmetry+ SI-Joint Fusion System. With this expanded product portfolio and growing clinical validation, we are leveraging both regulatory and market momentum to drive broader commercial uptake and deepen physician engagement. Building on strong execution in Q4, we are optimizing our cost structure and scaling operations to extend our market reach more efficiently. As we continue to refine our go-to-market strategy and capitalize on multiple surgical approaches across the SI-Joint Fusion landscape, we intend to accelerate revenue growth and deliver sustained value in the quarters ahead.
With that, I'll turn the call over to Kevin to discuss our financials.
Kevin Williamson: Thank you, Steve. I will now provide a summarized review of our financial results. A full breakdown is available in our press release that crossed the wire this afternoon. Revenue for the fourth quarter of 2025 was $1.5 million, an increase of 92% compared to $0.8 million in the fourth quarter of 2024. Revenue for the 12 months ended December 31, 2025, was $3.9 million, an increase of 20% from $3.3 million during the prior year period. The increase in the fourth quarter was primarily due to growth in surgical procedure volume across both the Catamaran and SImmetry+ platforms, driven primarily by new physician adoption.
The increase in revenue for the year was driven by sales growth and momentum we saw in the back half of the year, which we expect to continue throughout 2026. Gross profit was $1 million or 69% of revenue in the fourth quarter of 2025 compared to $0.4 million or 46% of revenue in the prior year quarter, an increase of 188% and a 23 percentage point improvement in gross margin. For the 12 months ended December 31, 2025, gross profit was $2.4 million or 60% of revenue, compared to $1.7 million or 52% of revenue for the previous year's period, a 38% increase and an 8 percentage point improvement in gross margin.
The gross margin improvement for the quarter and full year was primarily driven by higher revenue and the further absorption of fixed costs within our cost of goods sold. We expect gross margin to continue to improve with further revenue growth. Operating expenses totaled $3.9 million for the fourth quarter of 2025, up from $3.5 million in the prior year quarter. For the 12-months ended December 31, 2025, operating expenses totaled $15.2 million compared to $15.5 million in the prior year period.
The increase in the fourth quarter was primarily due to higher variable expenses within sales and marketing, driven by increased revenue in the period, while the decrease in the year ended December 31, 2025, was due to reduced general and administrative expenses, partially offset by increased sales and marketing investments to support increased sales and continued commercial expansion. Net loss for the fourth quarter was $2.8 million or $0.29 per share compared to a net loss of $3.1 million or $0.98 per share in the fourth quarter of 2024. For the 12 months ended December 31, 2025, net loss was $12.6 million or $1.70 per share compared to $13.7 million or $11.26 per share in the same year ago period.
The year-over-year improvement in both periods, was largely driven by increased revenue as well as reduced general and administrative expenses, which together improved operating leverage across the business. We ended the quarter with $3.8 million in cash and cash equivalents compared to $6.5 million as of December 31, 2024. The company had no outstanding debt as of quarter end. Subsequent to quarter end, we closed a $4.3 million private placement of senior convertible notes, which provides additional runway to fund our commercial and clinical priorities deep into 2026.
Overall, we believe the financial and strategic actions implemented both this quarter and throughout the year have positioned Tenon to drive continued growth in 2026 while sustaining a streamlined and disciplined cost base. I'll now hand the call back to Steve for closing comments.
Steven Foster: Thank you, Kevin. In summary, we believe that the fourth quarter and full year of 2025 served as a pivotal inflection point for our company, delivering meaningful progress across our key priorities, including record top line performance, the commercial debut of SImmetry+ and the advancement of important regulatory and clinical programs. These achievements created a strong platform for continued execution. Building on that foundation, we have entered the current quarter with increased traction across our commercial channels and tighter operational discipline through optimizing our expense base and driving efficiencies throughout the organization.
With expanding engagement from physicians and continued progress across our pipeline, we believe this strengthening momentum supports sustainable growth and long-term value creation for patients, providers and shareholders alike. I thank you all for attending. And now I'd like to hand the call over to our operator to begin our question-and-answer session with covering analysts. Shamali?
Operator: [Operator Instructions] Our first question comes from the line of Scott Henry with Alliance Global Partners.
Scott Henry: Really strong results for the fourth quarter. So just had a couple of questions on that. First, on the expense line, the operating expenses were down sequentially even with the addition of the other business. How representative do you think the Q4 rate is for 2026? Sometimes there's timing or seasonality issues, but just trying to get a sense of that $3.9 million in Q4 '25. Should we think about that as a baseline going forward? Or are there some unique situations that come into play?
Kevin Williamson: Yes. Thank you, Scott, for the question. This is Kevin. Happy to answer that. So I think we talked about this a little bit last quarter as well. And I think, yes, this becomes a better baseline in Q4 moving forward into '26 for an expense line, total operating expense. And I think you're seeing two things there. Some higher integration and deal-related costs that were in Q3 that increased that operating line, those falling out in Q4, but then seeing a little bit higher variable expense around higher revenue to offset some of that, ultimately landing you though at a better run rate here in Q4 and moving forward.
So it's a good metric to use to look at the business moving into '26.
Scott Henry: Okay. Great. And then on the revenue side, $1.5 million in the quarter, annualizing at $6 million. I guess two questions. How do you think about 2026 relative to that $6 million run rate? And specifically first quarter, which only has about 11 days left, how do we think about that sequentially from fourth quarter?
Steven Foster: Scott, this is Steve Foster. I'll comment just quickly. While we don't give future projections at this point, given our early stage, we're really excited about two things. One, the adoption momentum out there. We set records in all aspects, every metric of our business with incremental users with total surgeries done, our SImmetry+ alpha, these early surgeries to make sure the technology was meeting physician expectations, exceeded all expectations. The adoption rate was really high, a lot of enthusiasm about that product as well. And then lastly, I'll point to a very, very engaged and active pipeline.
The transaction we did with SiVantage last year not only loaded what we're capable of selling at that moment, but perhaps more importantly, loaded technologies into our development pipeline, and those things are moving through quite efficiently. And we really do think once these things start hitting in 2026, they can have a meaningful impact on what we're able to achieve in 2026. So lots of excitement within the organization and confidence that we can meet and exceed expectations in '26.
Kevin Williamson: Sorry, Scott. I'll go ahead and add a couple of points there, maybe to think about -- yes, as you look at revenue throughout the year in '26. So as you recall, we launched SImmetry+ in Q4, and that was right in the middle of Q4, November time frame. So a successful alpha there. We'll be commercializing SImmetry+ throughout the year here in '26. As Steve mentioned, some products in the pipeline that we plan to launch here in '26 will also be catalysts as well. So when you look at the momentum we built in the back half of the year, and you saw the incremental increase there between Q3 and Q4, we feel good about that momentum continuing.
And then you bake-in the initiatives we have throughout the year. I think when you look at the year in general, you're typically going to see a higher Q4 as revenue increases, especially as those initiatives bake throughout the year. So likely on that track, but we feel good about taking that $6 million run rate that we're now on, as you mentioned, Scott, into Q1 here and then driving revenue through the catalyst throughout the year.
Scott Henry: Okay. Great. And just the final question, just kind of qualitatively, when you look out to 2026, what do you see as your key driver for this revenue growth? Because you have a lot of things going on. You have SImmetry+, we've got the Catamaran SE launch, you've got SiVantage. Is there anything that kind of jumps out as leading the way in your opinion?
Steven Foster: Yes, I'll take it real quick and then Kevin jump in if you'd like. Yes, what jumps to me is, look, we now have built a multiproduct portfolio that can address a ton of variables, whether it's approach to the anatomy variables, whether it's patient variables, et cetera. And physicians are seeing now that, that tool bag that they have that Tenon Medical provides is not only diverse, but it's backed by data. It's something they can count on. And so now that we've built that foundation, it really is for us about commercial expansion and execution in 2026. So what are you going to feed into that? You mentioned them, Scott, with Catamaran SE with SImmetry+, et cetera.
But we also have other launches of new product, which we'll talk about here very shortly as they sort of come into view and as we prepare for FDA submissions and what have you, that we also think are going to continue to be very compelling for our physician customers. They're looking for solutions for the patients. We want to be there for them for every aspect of the sacropelvic challenges that they deal with. So that's how I would comment. Kevin, do you have anything to add there?
Kevin Williamson: No, well said, Steve.
Operator: Our next question comes from the line of Anthony Vendetti with Maxim Group.
Anthony Vendetti: Yes. Steve, I was wondering if you could just talk a little bit about the launch of SImmetry+. And then maybe just what the physicians are saying now that you have a broader portfolio? Is that helping you gain access to more prospective physicians or medical centers? So maybe we'll start with that.
Steven Foster: Yes, Anthony, thank you. It does. So when we were a single product organization, Catamaran got attention, people were excited about i