$103M Revenue, 93% Margins, EBITDA Up 86% - And the Stock Dropped 25%
The Q4 update on a surgical pure-play the market still hasn't caught up to.
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In early January, we published a deep-dive on a surgical products company with 93% gross margins, 22% revenue growth, and a pipeline product with FDA Breakthrough designation that the market wasn’t pricing.
The thesis was straightforward: you were getting a profitable, growing surgical business at half the peer multiple, with a first-of-its-kind bone adhesive as free optionality.
Then Q4 earnings dropped. And the stock kept falling.
Revenue grew just 5% year-over-year.
Operating income missed estimates by 66%.
A noncash impairment charge hit the P&L.
And the debt balance - which the original thesis expected to come down - went up instead.
The stock is now $18, down roughly 25% from our initial coverage.
But here’s the thing about optically messy quarters - sometimes the headline hides the progress.
Full-year revenue crossed $100 million for the first time - $103.1 million, up 19%.
Gross margins at 93%.
Adjusted EBITDA nearly doubled to $17 million.
Operating cash flow swung from essentially zero to $6.8 million.
The money-losing THP segment is officially dead.
And the company just secured a Vizient contract that opens 1,800 new facilities for its fastest-growing product.
The Q4 comp was distorted by a hurricane. The debt increase has a reason behind it.
And 2026 guidance of 13-17% growth - while decelerating - still represents the first formal revenue guidance in the company’s history.
The stock is cheaper today than it was when I wrote the thesis.
The question is whether it’s cheaper for the right reasons or the wrong ones.
Let me walk through what happened, what changed, and where the thesis stands...