Treace Medical Concepts Stifel 2026 Healthcare Conference

No, great. Thanks for having us again. Sixth year here. It's a pleasure and honor. As I look through the progression of Treace Medical, it started with a real innovation in the bunion space. How do you fix this problem that's very prevalent, affects 65 million Americans, and recurrence rates are anywhere between 20% and up to 80% in the clinical literature? We developed Lapiplasty to be a comprehensive solution, fix all three planes of the bunion correction. We drove that into the marketplace successfully, IPO'd in mid-2021, got access to more funds, and started to look at where do we go next with our product development. We were beginning to see this trend of minimally invasive osteotomies becoming more popular in the marketplace for treating bunions. We were also seeing more need for MTP fusion.

As the baby boomer population was aging, those bunion patients had more arthritic toe joints.

More surgeons were starting to shift these procedure preferences around a bit. With the funds from the IPO, we were able to invest in an innovation pipeline, and that spit out the three new bunion solutions we brought into the market in Q3 of 2025. What we've been doing up until now is driving those deep into our base of 3,300-plus surgeon customers. If you look at from a broader perspective, with Lapiplasty, as successful as it was and as user-friendly as it was and as great as the outcomes were, we were only getting about 25% of our overall surgeons' bunion business. Those three bunion solutions were made to go after the other 75% and address those preference shifts. Q4 of last year, after launching them in Q3, they were in the hands of about 25% of our overall surgeon customer base.

As we sat in Q3, we announced we had them in 45%. 45% of our customer base had used one or more of those three new bunion systems in their practice, and that is up from, we have been sequentially increasing about 5% over the last few quarters. We are making really good progress there. That was wave two, I would say. Lapiplasty, wave one, the three new bunion systems, wave two. How do we go after the big volume? 70% of the bunion volume were in the space that those three new bunion systems served. Now we recently announced the launch of several new technologies targeting the midfoot and the hindfoot, and more broadly allowing us to access procedures throughout the foot and ankle, that TAM expansion of $700 million that we talked about. All of that is building our case volumes.

We announced a double-digit case volume growth in the third quarter. We were more like single digits in the low single digits in the first quarter, second quarter, high single digits. Now we are double digits, and we are translating that to positive top-line growth as we enter Q4. Maybe a little longer answer than you wanted, but wanted to give you the whole rundown. It is a great position to be in. We are really excited. We are also excited about the enhancements in our profitability. adjusted EBITDA positive for the first time ever in a Q3.

We are typically in Q4. 50% reduction in our cash, broadened portfolio, and our salespeople are more productive. They are in more cases. We are doing more procedures than ever, and we are excited to return to top-line growth in Q4.

We feel great about it, actually. The products we've introduced at the 2026 launches, we announced on that third quarter call, we're tapping into the same customer base, and typically they're going to be the same procedures that occur the same day as the bunion surgeries our sales reps are already in.

I see. They occur within the same week.

So they all have, we believe, best-in-class features and bring real benefits, whether it's time savings to the case, saving steps, or making the outcomes more predictable. So they all have those nuances that Treace Medical's been known for. Whenever we launch something, surgeons know it's going to be worth looking at.