Treace Medical Concepts, Inc.

Good day and thank you for standing by. Welcome to the Treece Medical Concepts first quarter 2026 earnings conference call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there'll be a question and answer session. To ask a question during the session, you'll need to press star 1-1 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 1-1 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Tripp Taylor. Please go ahead.

Good morning everyone and welcome to our first quarter 2026 earnings conference call. Participating from the company today will be John Treese, Chief Executive Officer, and Mark Hare, Chief Financial Officer. John and Mark will discuss our first quarter financial results in 2026 Outlook. We will then host a question and answer session following our prepared remarks. Our press release can be found in the investor relations section of our website at investors.treese.com. This call is being recorded and will be archived in the investor section of our website. Before we begin, we would like to remind you that it is our intent that all forward looking statements made during today's call will be protected under the Private Securities Litigation Reform Act of 1995. Any statements that relate to expectations or predictions of future events, market trends, as well as our estimated results or performance are forward looking statements. All forward looking statements are based upon our current estimates and various assumptions. These statements involve material risks and uncertainties that could cause actual results or events to materially differ from those anticipated or implied by these forward looking statements. All forward-looking statements are based upon currently available information, and Treece Medical assumes no obligation to update these statements. Accordingly, you should not place undue reliance on these statements. please refer to our SEC filings, including our 2025 Form 10-K and our Form 10-Q for the first quarter of 2026, filed before the market opens today, May 8th, which can be found in the investor relations section of our website at investors.treese.com for a detailed presentation of risks. With that, I will now turn the call over to John.

Thank you, Tripp. Good morning, everyone, and thank you for joining us on our first quarter 2026 earnings conference call. Entering 2026, Treece Medical has evolved beyond its foundation in lapoplasty into a comprehensive bunion solutions company. Building on the strategic progress made in 2025, we've expanded our portfolio with multiple new procedure innovations, which we believe position us to address a broad spectrum of surgeon and patient preferences across all Bunyan clients. This breadth of offerings will support accelerated growth in procedure volume, increased wallet share, and a meaningfully expanded serviceable market opportunity. We are encouraged by our first quarter performance, but remain focused on driving further improvement. We continue to execute on controllable levers, including continuing to strengthen our sales team, launching meaningful product innovations, and adding new accounts and surgeons. Importantly, the sustained mid-single-digit case volume momentum to start the year reinforces our confidence in our strategy to expand market penetration and improve top-line growth as we move through 2026. At the same time, we also meaningfully reduce cash burn as we progress towards cash flow breakeven. I do want to note the dynamics that impacted 2025, including macro pressures on procedure demand and portfolio mix shifts, remain present. We reported revenue declines of approximately 10% in Q1, and we believe this trend will improve over time as we annualize the launch of the new products we launched in 2025. And we believe we're well positioned to navigate these factors and drive long-term growth. As such, we're reaffirming our outlook for full year 2026 revenue, which was raised when we pre-announced our results on April 9th, to be in the range of $202 million to $212 million, representing a decline of 5% to 0% compared to full year 2025. We expect revenue declines to improve through the rest of the year, with revenue growth returning in our seasonally strongest fourth quarter. As mentioned, we expect fourth quarter revenue growth will largely be supported by case volume growth, the lapping of the ASP mix shift dynamics, as well as the contributions from our planned 2026 product launches. Now I'd like to turn to our three strategic initiatives to drive top line growth and the progress we've made on these initiatives in the first quarter of 2026. First, leveraging our large existing customer base to drive adoption of the three new bunion systems that we commercialized in 2025. Second, continuing to build upon our leadership position with Laplacide by launching new technologies that can appeal to new surging users. And third, expanding our product offerings to grow wallet share and tap into new TAM-expanding procedural adjacencies. First, let me begin with an overview on the Bunyan technologies we introduced in 2025, including their strategic relevance and early market reception. We believe these three new systems more than double our accessible market relative to lapoplasty alone, making their successful commercialization and deeper market penetration an important priority as we look to drive incremental growth. Our nanoplasty and percuplasty 3D MIS systems expand our reach into the high-volume osteotomy segment, which represents approximately 70% of the estimated 450,000 annual U.S. funding procedures. Today, we believe only around 15% of metatarsal osteotomies are effectively being performed using MIS approaches, largely due to steep learning curves, variability in outcomes, and limited correction of the third frontal plane of the deformity, which is associated with higher recurrence rates. Our two 3D minimally invasive osteotomy systems are designed to address these challenges with more reproducible, instrumented procedures that can be easier to adopt and are designed to correct all three planes of the bunion deformity. We believe this position is well to expand adoption and drive greater penetration over time across the estimated 4.4 million annual US bunion sufferers. Now speaking to our SPEED MTP great toe fusion system. SPEED MTP targets the roughly 20% of bunion patients who have developed an arthritic great toe or MTP joint. Additionally, SPEED MTP addresses a separate population of non-bunion patients who suffer from an isolated arthritic MTP joint. This is a large and strategically important market segment for trees to participate and to innovate in, given that MTP fusion is among the most common foot and ankle procedures performed. Across our growing base of over 3,300 insurgent customers, we estimate lapoplasty currently captures about 25% of their bunion-related procedure volume. These three new systems are intended to target the remaining 75%, representing a significant opportunity for continued penetration and growth. Market penetration with these three products is increasing. While just three quarters into our full launch, we continue to see a strong uptake of our new systems and a corresponding acceleration in our procedure volumes, resulting in market share gains. As of Q1, approximately 35% of our lapoplasty surgeon user base has incorporated at least one of these three new bunion systems into their practice since launch. This represents an increase over the 25% that we reported in the fourth quarter of 2025. We're also encouraged to see that approximately 30% of our new surgeons who became Treece customers by initially using one of the three new bunion systems have also used lapoplasty technology, which we believe indicates a pull through to lapoplasty technologies. Second, at the same time, we remain highly focused on advancing our leadership in lapoplasty and expanding its appeal and adoption across a broader surgeon audience. Lapidus fusion represents approximately 30% of the 450,000 annual US bunion procedures and is the largest segment where we are the recognized category leader. And we remain on track to commercialize our next generation lapoplasty platform known as Lapoplasty Lightning later this year. This system offers next generation 3D correction instrumentation and new speed TMT implants. Lightning instrumentation is designed to deliver a faster procedure by reducing procedure steps while also offering enhanced precision and enhanced control for the 3D correction. while speed TMT implants, as the name indicates, are designed to provide faster fixation application. Expanding surgeon interest and uptake of lapoplasty also includes advancing our Intelliguide PSI technology, the first patented preoperative planning and patient-specific cut guide system for bunion and MIG foot correction in the U.S., Together with Lapoplasty Lightning and Speed TMT, we believe these three core innovations position us well to extend our category leadership and drive further adoption in 2026 and beyond. Now turning to our third initiative, expanding our offerings to more broadly serve our growing customer base. In addition to our three new bunion systems, we expanded our portfolio with the addition of new speed plate implants, new sterile instruments, and we introduced our first biologics offerings. These additions are designed to enable our sales force to more comprehensively support their surgeons' needs while also increasing access to additional procedures. With this expanded portfolio, not only are we seeing growth in bunion-related adjacent procedures, but our sales team is now servicing some of their customers' incremental procedures outside of bunions as well. Building on this trend, in 2026, we are launching new technologies aimed at both increasing wallet share and expanding our access to incremental procedure volumes. Our SuperBite variable pitch compression screw system represents another differentiated technology from Treece. Compression screws are a fundamental fixation technology utilized in foot and ankle surgery. And without this high volume fixation offering in our portfolio, competitive sales reps have supplied these products where needed in Treece cases. We announced initial surgeries with our SuperBite screws in April, and we're hearing positive early responses from surgeon users and high enthusiasm from our sales reps in our early commercial experience. Not only are SuperBite screws built with advanced features based on the latest MIS customer preferences, but they're also designed to save OR time by reducing or eliminating altogether the need to pre-drill before implanting the screw due to their novel self-drilling design. The strategic addition of SuperBite to our portfolio not only reduced the need for a competitor in our cases, but importantly, they equip our sales force to gain access to a broader range of procedures ranging from the forefoot to the midfoot to the hindfoot and to the ankle. And, complementing our expanded procedure access with SuperBite, we will target improving outcomes for challenging midfoot and hindfoot fusion procedures with our forthcoming SpeedXM fusion system launch. SpeedXM leverages our novel speed plate hybrid technology, delivering the benefits of dynamic compression and locking screw stability in a specialized anatomic design to address fusions of the larger bones of the midfoot and the hindfoot. SpeedXM plates are highly complementary with SuperBite screws and our biologics as these technologies are often used in these larger bone fusion procedures. Importantly, these new products are serving procedures already performed by our existing surgeon customers in the same setting of care and often on the same day as our surgeons' bunion cases. These new offerings leverage our sales force's presence and expertise and we believe can drive greater selling efficiency and impact. We expect full commercialization of both SuperByte and SpeedXM during Q3, collectively expanding our total addressable market by approximately $300 million and providing access to attractive high ASP midfoot and hindfoot procedures where multiple trees technologies are often needed. Our strategy to build a comprehensive best-in-class bunion solutions platform is gaining traction, supported by encouraging early indicators across the business. We continue to expand our active surgeon base while increasing utilization as adoption of our broader portfolio grows, driving mid-single-digit procedure volume growth in the first quarter, which we believe supports our approach. Looking ahead, we believe we have a path to accelerating procedure growth and increasing wallet share as we drive deeper penetration with our broadened product portfolio and continue to more comprehensively service our great surgeon customers' product and procedure needs. Combined with disciplined investment, these efforts position us to deliver sustained market share gains, improve profitability, and long-term shareholder value. With that, now let me turn the call over to Mark to review our financial performance. Mark?