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| Statement |
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| The additional capacity positions us well for the current quarter, historically, our seasonally strongest of the year |
| This elevated level of surgeon interest and engagement is a great forward-looking indicator and underscores the long-term growth trajectory of our business |
| And I've said it many times, but with nearly $0.5 million targeted annual procedures in the ultra-state, I firmly believe we're positioned to drive sustainable long-term and profitable revenue growth |
| The strength of the business is reflected in our impressive year-to-date performance and the increase in guidance for the third time this year |
| This robust revenue growth also translated into continued improvement in adjusted EBITDA loss and cash outflow and moved us closer to our profitability and cash flow breakeven goals |
| We also achieved a major surgeon milestone in the third quarter with the number of active surgeons in the quarter exceeding 1,000 for the first time in the Company's history, performing nearly 3,900 procedures |
| So very excited about the impending launch |
| We saw strong growth across all of our different procedures and we certainly are benefiting from the rollout of the additional Granite and TORQ surgical capacity, which does set us up very well for our seasonally strongest fourth quarter as well as 2024 |
| And I think that we have reflected our expectations to finish the year strong in our increase in guidance |
| So I think, I think that it was a great quarter |
| And certainly Granite has been a strong driver of the business |
| territory of over $1.5 million, representing a 38% productivity gain over the comparable trailing 12-month period |
| It really just shows you that we're in a really strong position here proceeding forward |
| The market reception in the pace of adoption underscores Granite's success and reaffirms our belief that it is becoming the standard of care for a long construct procedures to the pelvis |
| And I want to reiterate that we saw strong growth across all of our products |
| This was the 11th consecutive quarter of double-digit year-over-year growth in our U.S |
| We're proud of this milestone, which is the outcome of years of focus on driving surgeon awareness through education, building the best clinical evidence, and expanding our portfolio of solutions to address our surgeons unmet needs |
| So, for us that bodes very well for the business in the future with three different procedure types going forward and really just at the start in every one of these markets |
| It just shows our execution delivering another record quarter and outperformance and it's really energizing for our team to deliver these strong results despite typical seasonality that you see in the summer time |
| So I am thrilled with our Q3 performance |
| And I mentioned it in your last question, but with around $0.5 million procedures still untapped, it puts us into a great position going forward |
| With regards to our Q4 guide, as we've demonstrated throughout this year, we've consistently outperformed versus our own guidance just because of our execution and the strong demand that we're seeing |
| procedure volume trends confirm that with iFuse 3D, iFuse-TORQ and now iFuse Bedrock Granite, the value of our innovative, versatile, and complementary product portfolio has positioned us as the top choice for surgeons looking for sacropelvic solutions |
| It's another record quarter at 30% - 34% growth in U.S |
| So as I stated earlier, I really am very pleased with our Q3 performance |
| It has also been a key driver of new surgeon engagement, as well as successful conversion of surgeons using competitive products when performing minimally invasive SI joint fusion procedures |
| If we look at the market, our estimate when we went public is that our market share was in the high 50% range and we think we're significantly higher than that at this point in time and I think it's because of the fact that our name has become synonymous with sacropelvic procedures number one, but also it's the innovative products |
| At a recent Orthopedic Trauma Association's event in October, there was tremendous excitement around our solution to address insufficiency fractures |
| And with the increase in our surgical capacity in the third quarter, in addition to the strong demand for Granite within deformity, we also were able to capture a lot more of the short construct degenerative spine procedures to the sacrum and that's what impacted the ASP |
| But as I said, we're really excited about the revenue potential for the expansion of the Granite implant system |
| Statement |
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| So just talking about the P&L, so gross margin came in a little bit lower than we were expecting and then supposed to step down, or you said it is going to step down again in Q4 |
| Our net loss was $10 million for the quarter or $0.25 per diluted share |
| And if you recall in our second quarter, we had mentioned sort of that low single-digit decline in ASP, so it played out just the way we expected |
| These risks include SI-BONE's ability to introduce and commercialize new products and indications, SI-BONE's ability to maintain favorable reimbursement for its products and procedures, the impact of potential economic weakness on the ability and desire of patients to undergo elective procedures, SI-BONE's ability to manage risks to its supply chain, the impact of future capital requirements driven by new product introductions, and risks to the continued re-normalization of the healthcare operating environment |
| Compared to a net loss of $14.2 million or $0.41 per diluted share in the prior year |
| 2018 study in the Spine Journal by [indiscernible] of 244 adult spinal deformity patients indicated that BMI greater than 35 was associated with significantly worse peri-operative outcomes and higher cost compared to non-obese patients |
| This high BMI cause spinal degeneration or does the painful spinal condition tend to correlate with a sedentary lifestyle an elevated BMI? Against this data backdrop, it is in our opinion, not likely that widespread adoption of GLP-1 therapy and a resulting decrease in average BMI in the American population would have a significant impact on the incidents of SI joint dysfunction, trauma or deformity that would meaningfully impact demand for our products in the near or immediate term |
| While it would be premature to predict the long term implications of GLP-1, if any, on our musculoskeletal degeneration, in the intermediate term, there is the potential for lower population average BMI to increase the number of surgery eligible patients |
| I guess the comments from spine surgeons that lower BMI patients can fall back into the funnel |
| Representing a 29% reduction in net loss |
| and the question of the impact of GLP-1 |
| Before I hand the call over to Anshul, I'd like to provide some background on drivers of sacroiliac joint pain incidents in the U.S |
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