Q3 FY2026
Filed Nov 9, 2026Orthofix reports Q3 2026 net sales of $207.9 million (+1.1% reported) and a $6.1 million net loss, and cuts FY2026 pro forma net sales and adjusted EBITDA guidance
Q3 reported net sales rose 1.1% and adjusted EBITDA rose to $26.0 million from $24.6 million, with the reported net loss narrowing to $(6.1) million from $(22.8) million. Offsetting this, U.S. Spine weakness is driving a cut to full-year pro forma net sales guidance to $825 million to $830 million from $845 million to $855 million, and adjusted EBITDA guidance to $86 million to $88 million from $95 million to $98 million. Free cash flow for the nine months was negative and cash declined in the quarter.
Key metrics
shortened, hover for the filing’s print| Metric | Value | q/q | y/y |
|---|---|---|---|
| Q3 2026 Reported net salesGAAP | $207.9M | – | 1.1% |
| Q3 2026 Pro forma net salesnon-GAAP | $207.8M | – | 2.2% |
| Q3 2026 Net sales (statement of operations)GAAP | $207.9M | – | – |
| Q3 2026 Cost of salesGAAP | $61.32M | – | – |
| Q3 2026 Gross profitGAAP | $146.5M | – | – |
| Q3 2026 GAAP gross marginGAAP | 70.5% | – | – |
| Q3 2026 Adjusted gross profitnon-GAAP | $146.9M | – | – |
| Q3 2026 Adjusted gross margin (as % of reported net sales)non-GAAP | 70.7% | – | – |
| Q3 2026 Sales, general and administrativeGAAP | $125.3M | – | – |
| Q3 2026 Sales, general and administrative, as adjustednon-GAAP | $122.6M | – | – |
| Q3 2026 Research and developmentGAAP | $15.28M | – | – |
| Q3 2026 Research and development, as adjustednon-GAAP | $14.63M | – | – |
| Q3 2026 Acquisition-related amortization, impairment and remeasurementGAAP | $4.39M | – | – |
| Q3 2026 Operating income (loss)GAAP | $1.54M | – | – |
| Q3 2026 Interest expense, netGAAP | −$5.89M | – | – |
| Q3 2026 Other income (expense), netGAAP | −$904K | – | – |
| Q3 2026 Loss before income taxesGAAP | −$5.25M | – | – |
| Q3 2026 Income tax expenseGAAP | −$826K | – | – |
| Q3 2026 Net lossGAAP | −$6.07M | – | – |
| Q3 2026 Diluted net loss per shareGAAP | $(0.15) | – | – |
| Q3 2026 Adjusted EBITDAnon-GAAP | $26.04M | – | – |
| Q3 2026 Adjusted EBITDA as % of reported net salesnon-GAAP | 12.5% | – | – |
| Q3 2026 Adjusted EBITDA as % of pro forma net salesnon-GAAP | 12.5% | – | – |
| Q3 2026 Adjusted net incomenon-GAAP | $7.47M | – | – |
| 9M 2026 Net sales (statement of operations)GAAP | $615.5M | – | – |
| 9M 2026 Cost of salesGAAP | $179.7M | – | – |
| 9M 2026 Gross profitGAAP | $435.8M | – | – |
| 9M 2026 Adjusted gross profitnon-GAAP | $437.0M | – | – |
| 9M 2026 Adjusted gross margin (as % of reported net sales)non-GAAP | 71.0% | – | – |
| 9M 2026 Sales, general and administrativeGAAP | $398.3M | – | – |
| 9M 2026 Sales, general and administrative, as adjustednon-GAAP | $385.5M | – | – |
| 9M 2026 Research and developmentGAAP | $46.54M | – | – |
| 9M 2026 Research and development, as adjustednon-GAAP | $45.09M | – | – |
| 9M 2026 Operating lossGAAP | −$21.02M | – | – |
| 9M 2026 Interest expense, netGAAP | −$17.64M | – | – |
| 9M 2026 Other income (expense), netGAAP | −$2.42M | – | – |
| 9M 2026 Net lossGAAP | −$42.78M | – | – |
| 9M 2026 Diluted net loss per shareGAAP | $(1.05) | – | – |
| 9M 2026 Adjusted EBITDAnon-GAAP | $55.87M | – | – |
| 9M 2026 Adjusted EBITDA as % of reported net salesnon-GAAP | 9.1% | – | – |
| 9M 2026 Adjusted net incomenon-GAAP | $5.77M | – | – |
| 9M 2026 Net cash provided by (used in) operating activitiesGAAP | −$23.47M | – | – |
| 9M 2026 Capital expendituresnon-GAAP | −$37.81M | – | – |
| 9M 2026 Free cash flownon-GAAP | −$61.28M | – | – |
| Cash, cash equivalents and restricted cash at September 30, 2026GAAP | $86.9M | – | – |
Segments
| Segment | Revenue | q/q | y/y |
|---|---|---|---|
| Therapeutic SolutionsNet sales rose 4.5% (pro forma, reported and constant currency) against $61.2 million in Q3 2025. The release highlights describe this as a 4% increase. The company credits growth in Limb Reconstruction and Therapeutic Solutions with helping offset weaker Spine performance. | $64M | – | 4.5% |
| Spinal Implants, Biologics and Enabling TechnologiesPro forma net sales declined 1.1% against $108.6 million in Q3 2025, excluding the M6 product lines. The release does not give a further driver for this line. | $107.4M | – | (1.1%) |
| Global SpinePro forma net sales rose 0.9% against $169.8 million in Q3 2025, both excluding the M6 product lines. Spine Fixation net sales rose 1% on a reported and constant currency basis. The CEO describes weaker Spine performance, and the company ties the guidance cut to U.S. Spine execution, instrument set availability and asset productivity. | $171.4M | – | 0.9% |
| Global Limb ReconstructionNet sales rose 8.5% on a reported basis and 9.4% on a constant currency basis against $33.6 million in Q3 2025. The release highlights describe the increase as 8% reported and 9% constant currency. The CEO cites continued growth in Limb Reconstruction as helping offset Spine weakness. | $36.4M | – | 8.5% (9.4% constant currency) |
FY2026 (revised in this release) outlook
- RevenuePro forma net sales $825 million to $830 million (prior guidance $845 million to $855 million, as printed in this release)
- NoteNon-GAAP adjusted EBITDA $86 million to $88 million (prior guidance $95 million to $98 million, as printed in this release)
- NoteBoth guidance ranges assume current foreign currency exchange rates
- NoteThe company is unable to provide a forward GAAP net income (loss) reconciliation to adjusted EBITDA
Capital returns
- No share repurchases or dividends are reported in the filing.
- Common shares issued and outstanding rose to 40,749 thousand at September 30, 2026 from 39,834 thousand at December 31, 2025, as printed on the balance sheet.
What drove it
- The company states that the year-over-year increase in adjusted EBITDA primarily reflected continued cost discipline and resource alignment initiatives.
- The company states that the adjusted EBITDA increase was partially offset by lower Spine revenue, unfavorable geographic mix and the related reduction in operating leverage.
- Reported SG&A fell to $125,330 thousand from $148,102 thousand in Q3 2025, while Q3 2025 included litigation and investigation costs of $21,548 thousand in the non-GAAP reconciliation.
- The company states that the guidance revision reflects third-quarter performance and the anticipated fourth quarter impact of actions to improve U.S. Spine execution, instrument set availability and asset productivity.
- The company states that the actions focus resources on its highest-performing distributor partners, products and market opportunities.
Concerns
- Full-year pro forma net sales guidance was cut by $20 million at the midpoint, from $845 million to $855 million to $825 million to $830 million, and adjusted EBITDA guidance was cut from $95 million to $98 million to $86 million to $88 million.
- Nine-month free cash flow was $(61,281) thousand, compared with $(18,099) thousand in the prior year period, and nine-month operating cash flow was $(23,471) thousand.
- Long-term debt rose to $221,847 thousand from $157,391 thousand at December 31, 2025.
- Pro forma net sales in Spinal Implants, Biologics and Enabling Technologies declined 1.1% in Q3.
- Q3 reported net loss was $(6,074) thousand, with interest expense, net of $(5,889) thousand in the quarter.
What to watch
- Execution of the U.S. Spine actions: commercial execution, instrument set supply and allocation, and asset productivity, as referenced in the guidance revision.
- Whether the fourth quarter delivers the implied sales and adjusted EBITDA needed to reach the revised ranges of $825 million to $830 million and $86 million to $88 million.
- Reversal of the cash decline and the negative nine-month free cash flow of $(61,281) thousand.
- Trend in Spinal Implants, Biologics and Enabling Technologies, which declined 1.1% pro forma in Q3.
- Growth in Global Limb Reconstruction, which rose 8.5% on a reported basis, and Therapeutic Solutions, which rose 4.5%.
Balance sheet and cash flow
- Cash and cash equivalents: $86,322 thousand at September 30, 2026 vs $82,025 thousand at December 31, 2025. Restricted cash: $598 thousand vs $3,090 thousand.
- Long-term debt: $221,847 thousand at September 30, 2026 vs $157,391 thousand at December 31, 2025.
- Total assets: $855,761 thousand at September 30, 2026 vs $850,647 thousand at December 31, 2025.
- Total shareholders' equity: $429,567 thousand at September 30, 2026 vs $450,037 thousand at December 31, 2025.
- Inventories: $190,357 thousand at September 30, 2026 vs $172,319 thousand at December 31, 2025.
- Nine-month net cash used in investing activities was $(37,664) thousand (2025: $(23,727) thousand). Net cash provided by financing activities was $63,228 thousand (2025: $(3,163) thousand).
- The company states that the quarter-over-quarter cash decline primarily reflected working capital timing.
Analysis
Orthofix reported third-quarter 2026 reported net sales of $207.9 million, up 1.1% on a reported basis and 2.3% on a pro forma constant currency basis, against $205.6 million a year earlier. Pro forma net sales, which exclude the discontinued M6 product lines, were $207.8 million, up 2.2%. The mix was uneven. Global Limb Reconstruction grew 8.5% to $36.4 million (9.4% constant currency), Therapeutic Solutions rose 4.5% to $64.0 million, and Global Spine rose 0.9% to $171.4 million. Spinal Implants, Biologics and Enabling Technologies declined 1.1% to $107.4 million. The CEO attributes the offset of Spine weakness to growth in Limb Reconstruction and Therapeutic Solutions.
Profitability improved on the cost side. GAAP gross margin was 70.5% and adjusted gross margin was 70.7%, against an adjusted 71.4% in Q3 2025. GAAP SG&A fell to $125,330 thousand from $148,102 thousand, and the prior-year period included litigation and investigation costs of $21,548 thousand in the non-GAAP reconciliation. GAAP operating income was $1,545 thousand, compared with an operating loss of $(17,046) thousand. The reported net loss narrowed to $(6,074) thousand, or $(0.15) per diluted share, from $(22,795) thousand, or $(0.57). Non-GAAP adjusted EBITDA rose to $26,036 thousand, or 12.5% of pro forma net sales, from $24,582 thousand, or 12.1%. The company attributes the EBITDA increase primarily to cost discipline and resource alignment initiatives, partially offset by lower Spine revenue, unfavorable geographic mix and the related reduction in operating leverage. Interest expense, net rose to $(5,889) thousand from $(4,681) thousand.
For the nine months, reported net sales were $615,503 thousand against $602,401 thousand, the net loss narrowed to $(42,780) thousand from $(89,970) thousand, and adjusted EBITDA was $55,868 thousand against $56,657 thousand. Nine-month free cash flow was $(61,281) thousand, compared with $(18,099) thousand, reflecting operating cash flow of $(23,471) thousand and capital expenditures of $(37,810) thousand. Cash, cash equivalents and restricted cash were $86.9 million at September 30, 2026, down from $104.4 million at June 30, 2026. The company states that the quarterly decline primarily reflected working capital timing. Long-term debt increased to $221,847 thousand from $157,391 thousand at December 31, 2025, and total shareholders' equity declined to $429,567 thousand from $450,037 thousand.
The guidance revision is the central event. Full-year 2026 pro forma net sales guidance moved to $825 million to $830 million from $845 million to $855 million, and non-GAAP adjusted EBITDA guidance moved to $86 million to $88 million from $95 million to $98 million, both assuming current foreign currency rates. The company ties the cut to third-quarter performance and the expected fourth-quarter effect of actions in U.S. Spine execution, instrument set availability and asset productivity. The filing does not quantify those actions' costs or timing beyond that statement. The figures that deserve the most attention are the sharp reduction in the EBITDA range, the negative nine-month free cash flow, the rise in long-term debt, and the Spinal Implants, Biologics and Enabling Technologies decline.
Management, verbatim
Continued growth in Limb Reconstruction and Therapeutic Solutions helped offset weaker Spine performance. In U.S. Spine, we are accelerating actions to strengthen commercial execution, improve instrument set supply and allocation, and increase asset productivity by focusing resources on our highest-performing distributor partners, products and market opportunities. Our revised guidance reflects third-quarter performance and the near-term impact of these actions, which are intended to build a stronger foundation for sustainable growth, profitability and cash generation.
Massimo Calafiore, President and Chief Executive Officer
Not in the filing
stated, not guessed- Previous release OUTLOOK section was not supplied as a separate input, so vs_prior_guidance is empty. The prior guidance ranges are printed in this release and are shown in guidance.
- Q3 2025 GAAP gross margin is not printed, so prior_year for the Q3 2026 GAAP gross margin is null.
- Year-over-year changes for GAAP and non-GAAP dollar lines are not printed for Q3 or nine months, so yoy_change is null for those rows.
- Quarterly operating cash flow and free cash flow for Q3 alone are not printed. Only nine-month figures are given.
- Prior-quarter (Q2 2026) operating figures are not printed, so qoq_change is null throughout.
- Analyst consensus estimates, expectations and any share-price reaction are not included in the filing.
- Constant currency change for pro forma net sales (2.3%) is printed on a different basis and is recorded in the analysis text rather than in yoy_change.
- Driver for the decline in Spinal Implants, Biologics and Enabling Technologies is not stated in the filing.
- Quantified costs, timing and expected benefits of the U.S. Spine actions are not disclosed.
Written by an AI language model from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure is checked against the filing text, and a metric the filing does not print, or whose value, prior period and change do not add up, is dropped from the metrics. The model can still misread a table, in the metrics or in the text, so check a number in the filing before you rely on it. Consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.