SI-BONE, Inc., a medical device company, develops implantable devices used to solve musculoskeletal disorders of the sacropelvic anatomy in the United States and internationally. It offers iFuse, a minimally invasive surgical implant system to address sacroiliac joint dysfunction and degeneration, adult deformity, and pelvic ring traumatic fractures. The company also provides iFuse-3D, a titanium implant that combines the triangular cross-section of the iFuse implant with the proprietary 3D-printed porous surface and fenestrated design; and iFuse-TORQ, a set of 3D-printed threaded implants designed to treat fractures of the pelvis and for minimally invasive sacroiliac joint fusion. It markets its products primarily with a direct sales force, as well as through distributors. The company was incorporated in 2008 and is headquartered in Santa Clara, California.
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Here are 1-3 brief analogies for SI-BONE (SIBN):
Think of it as the Zimmer Biomet for the sacroiliac (SI) joint, exclusively focused on minimally invasive implants for that specific joint.
It's like a highly specialized medical device company, akin to a focused orthopedic division of Stryker or Medtronic, but dedicated solely to developing solutions for SI joint pain.
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- iFuse Implant System: A minimally invasive surgical (MIS) device used to fuse the sacroiliac (SI) joint for patients experiencing chronic SI joint pain.
- iFuse-TORQ Implant System: A next-generation implant system designed for minimally invasive sacroiliac joint fusion, featuring improved fixation capabilities.
- iFuse-3D Implant System: A 3D-printed titanium implant designed for minimally invasive SI joint fusion, promoting bone ingrowth due to its porous surface.
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SI-BONE (SIBN) is a medical device company that develops and markets products for the treatment of sacroiliac (SI) joint disorders. As such, the company primarily sells its products to healthcare providers, which can be categorized as follows:
- Hospitals: These are institutional customers that purchase SI-BONE's devices for use in surgical procedures performed on patients within their facilities.
- Ambulatory Surgical Centers (ASCs): These are specialized outpatient facilities that also acquire SI-BONE's products for minimally invasive surgical procedures performed on an outpatient basis.
Due to the nature of the medical device industry, SI-BONE's customer base is highly diversified across a large number of these healthcare institutions in the United States and through distributors internationally. The company typically does not have a few "major customer companies" (e.g., individual hospital systems or corporate chains) that account for a significant portion of its revenue, nor does it publicly disclose the names of specific major institutional customers. Therefore, it is not possible to list specific named customer companies or their public symbols.
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Laura Francis, Chief Executive Officer
Ms. Francis has served as SI-BONE's Chief Executive Officer and a Director since April 2021. She joined SI-BONE in May 2015 as Chief Financial Officer and became Chief Operating Officer in July 2019, playing a fundamental role in taking the company public in October 2018. Prior to SI-BONE, Ms. Francis held executive and leadership roles with other public and private life science companies, including Auxogyn (now part of Progyny), Promega Corporation, and Bruker Corporation. As CFO of Auxogyn, she was with a venture-backed life science start-up. At Promega, a privately held life sciences company, she led multiple acquisitions of businesses. As CFO of Bruker BioSciences Corporation, a publicly traded life science company, she led their post-IPO merger and secondary offering. Earlier in her career, she was an Engagement Manager with McKinsey & Company and an Audit Manager with PricewaterhouseCoopers. She also serves as a Board Member of Shockwave Medical, Inc.
Anshul Maheshwari, Chief Financial Officer
Mr. Maheshwari joins SI-BONE with over 15 years of experience in corporate finance, banking, treasury, and strategy. Most recently, he served as Vice President of Finance, Investor Relations and Treasurer for Varian Medical Systems. Prior to Varian, he was Assistant Treasurer for Bechtel Corporation. He spent the majority of his early career at Bank of America in corporate and investment banking.
Anthony Recupero, President, Commercial Operations
Mr. Recupero was named President, Commercial Operations by SI-BONE in April 2021, having joined the company in 2016 as Chief Commercial Officer. In his current role, he leads all aspects of SI-BONE's commercial operations, including sales, marketing, reimbursement, medical affairs, and international markets. He has prior experience in the orthopedic space, notably serving as the VP of sales at Kyphon, where he helped grow sales from zero to $250 million.
Michael Pisetsky, Chief Business & Legal Affairs Officer
Mr. Pisetsky serves as the Chief Business & Legal Affairs Officer for SI-BONE.
Scott Yerby, PhD, Senior Vice President of Engineering and Chief Technology Officer
Dr. Yerby was named Senior Vice President of Engineering and Chief Technology Officer by SI-BONE in April 2021. In this role, he is responsible for developing and bringing to market innovative solutions that help treat sacropelvic conditions.
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The key risks to SI-BONE's business include:
- Reimbursement and Coverage: SI-BONE's ability to maintain favorable reimbursement for procedures using its products is a significant risk. This encompasses decisions made by Medicare Administrative Contractors and private payors. Any challenges in securing or sustaining adequate reimbursement and insurance coverage could materially impact the company's growth and profitability.
- Product Adoption and Commercialization of New Products: The company faces risks related to the continued adoption of its existing products, such as the iFuse Implant System, and its capacity to successfully introduce and commercialize new products and indications. A slowdown in adoption rates or difficulties in expanding its physician base could negatively affect SI-BONE's growth trajectory.
- Economic Conditions and Elective Procedures: Economic downturns or general deterioration in economic conditions pose a risk, as they can influence patients' financial ability and willingness to undergo elective procedures that utilize SI-BONE's products.
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SI-BONE (SIBN) operates primarily in the market for sacropelvic disorders, with its main products addressing sacroiliac (SI) joint dysfunction, pelvic trauma, and spinal stability.
The company estimates its total addressable market for its procedures to be nearly 500,000 procedures. This market size is primarily for the U.S.
For pelvic fracture fixation, which includes acute, nonacute, and nontraumatic types such as pelvic fragility and pelvic insufficiency fractures, the combined market potential for SI-BONE's iFuse-TORQ system is estimated to be approximately USD 300 million. While not explicitly stated, this figure is provided within reports predominantly discussing the global market with a strong emphasis on the U.S. and North America.
More broadly, the global sacroiliac joint fusion market, where SI-BONE's iFuse Implant System holds a significant share, was estimated at USD 721.2 million in 2023 and is projected to reach USD 2490.0 million by 2030. Other estimates place the global market at USD 764.57 million in 2024, expected to grow to USD 858.42 million in 2025, and USD 1,910.34 million by 2032. Another source indicates the global market size was US$ 620 million in 2022 and is likely to reach US$ 3,900 million by 2032.
North America is a dominant region in the sacroiliac joint fusion market, accounting for the largest share in 2023 and expected to hold over 35.1% of the market share in 2025. The U.S. specifically accounted for the largest share of the sacroiliac joint fusion market within North America in 2023.
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SI-BONE (SIBN) is expected to drive future revenue growth over the next 2-3 years through several key strategies:
- Expansion of Product Offerings and Innovation: SI-BONE plans to launch new products, including a next-generation technology in the first quarter of 2026, building on its existing portfolio like iFuse TORQ and iFuse Bedrock Granite. The company has an extensive pipeline of novel technologies aimed at addressing poor bone quality, with several solutions anticipated over the next five years. Recent product introductions, such as iFuse TORQ TNT for pelvic fragility fractures (cleared in August 2024), are also expected to contribute to growth.
- Market Expansion and Increased Commercial Footprint: The company is focused on expanding its market presence by increasing the number of territories to 100 within the next 12-18 months. This includes geographical expansion, particularly the successful commercialization of iFuse TORQ in European markets following regulatory approval in June 2025. SI-BONE is also expanding into adjacent markets such as adult deformity, sacropelvic fixation, and pelvic trauma.
- Growing Physician Adoption and Procedure Volume: SI-BONE has seen a significant increase in its active U.S. physician base, growing by 27% year-over-year, and strong U.S. procedure volume growth of over 22% in Q3 2025. The company's expanding procedure platform is attracting new physicians and deepening engagement with existing ones, making physician density an increasingly important growth driver.
- Favorable Reimbursement Enhancements: New Technology Add-on Payments (NTAP) for procedures involving iFuse TORQ TNT, effective October 1, 2025, are expected to provide over $4,100 in reimbursement, thereby enhancing procedure affordability and potentially driving adoption. Analysts also anticipate favorable reimbursement changes in 2026 to further impact growth.
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Here's a summary of SI-BONE's (SIBN) capital allocation decisions over the last 3-5 years:
Share Issuance
- The number of common shares outstanding for SI-BONE has increased significantly, from 28,384,633 shares as of March 6, 2020, to 42,453,116 shares by February 20, 2025, and further to 43,391,254 shares as of November 4, 2025.
- Shares have been issued through employee benefit plans, with increases in shares reserved for issuance under the 2018 Employee Incentive Plan (EIP) in January 2019 and January 2020.
Inbound Investments
- SI-BONE refinanced a $36 million Term Loan in the third quarter of 2024, which reduced overall borrowing costs and extended the maturity date to 2029.
Capital Expenditures
- The company's gross margin was impacted in 2023 by higher depreciation from instrument trays and depreciation associated with a second facility in Santa Clara, indicating capital investments in these areas.
- Capital requirements are driven by new surgical systems, which necessitate investments in instrument tray and implant inventory to support product deployment and revenue opportunities.
- Operating expenses include research and development investments dedicated to the development and rollout of future products.