SI-BONE's Q2 2025: Navigating Contradictions in Growth Strategy and Margin Guidance

Product adoption and growth strategy, gross margin guidance, gross margin expectations, and growth drivers and product momentum are the key contradictions discussed in SI-BONE's latest 2025Q2 earnings call.



Revenue and Volume Growth:
- SI-BONE reported revenue growth of 22.8% in the U.S. for Q2 2025, with a 25% increase in procedure volumes.
- This growth was driven by broad-based demand across all target markets and a significant increase in the number of physicians performing SI joint dysfunction procedures.

International Market Expansion:
- The company achieved revenue growth of 21.7% worldwide, with international revenue reaching $2.2 million.
- The launch of iFuse TORQ in Europe and its strong regulatory approval are expected to accelerate growth in international markets, although Q2 growth was impacted by later-than-expected regulatory clearance.

Operational and Financial Performance:
- SI-BONE reported a gross margin of 79.8%, expanding by 80 basis points year-over-year, and achieved positive adjusted EBITDA for the third consecutive quarter.
- Operational improvements in manufacturing and supply chain efficiencies contributed to this strong financial performance, along with disciplined cost management and strategic pricing.

Cash Flow and Liquidity:
- The company achieved cash flow breakeven in Q2, with a cash and marketable securities balance of $145.5 million.
- This milestone was driven by efficient revenue growth management, disciplined operating expenses, and strategic investment in product innovation and capacity.