4 stories this morning, for surgeons and the people who support them.
- SI-BONE Q3 2026: revenue $55.7M (+14.5%), U.S. $52.8M (+13.9%) on ~19.5% procedure growth offset by lower ASP from mix and office/ASC INTRA demand; 1,770 active U.S. physicians (+~16%); adjusted EBITDA $3.0M; FY26 revenue guidance of $231-233M reaffirmed; iFuse Granite Onyx in alpha launch — SI-BONE reported third-quarter 2026 results on November 2 (8-K Exhibit 99.1): worldwide revenue $55.7M, up 14.5%; U.S. $52.8M, up 13.9%, with ~19.5% procedure volume growth partly offset by lower average selling price from procedure mix and interventional spine demand for iFuse INTRA in office and ASC settings; gross margin 79.3% (vs 79.8%); net loss $3.6M; adjusted EBITDA $3.0M; cash $146.3M. 1,770 active U.S. physicians (+~16%). FY26 revenue guidance reaffirmed at $231-233M, operating expense growth trimmed to ~10.5% from ~12%. iFuse Granite Onyx (510(k) September 2026) is in alpha launch; the company says the October MS-DRGs for complex fusion with Bedrock Granite raise average inpatient payment by up to ~$50,000 per qualifying case. Context: Xenix Medical's Riva Anchor spinopelvic implant cleared in September (covered 2026-09-23). Source
- Medartis says U.S. adoption of the TOUCH CMC 1 thumb prosthesis is accelerating: more than 2,000 U.S. procedures by October and about 3,000 expected in 2026; expects to beat its 17-19% organic core growth guidance — Medartis Holding AG issued an ad hoc (inside information) release on November 2, 2026: U.S. momentum has increased since half-year results, with more than 2,000 TOUCH procedures performed in the U.S. by October and about 3,000 expected for full-year 2026; it expects to exceed its 17-19% organic core sales growth guidance (constant currency) if demand holds, with core EBITDA margin at the upper end of its high-teens range; full-year results March 2, 2027. FDA approved the TOUCH CMC 1 Prosthesis (Keri Medical SA) by PMA P240020 on July 10, 2025, for primary first CMC total joint arthroplasty in symptomatic Eaton-Littler stage II-III OA; openFDA lists it as the only PMA under product code SFA (https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P240020). Medartis then acquired the remaining 53% of KeriMedical; a 163-patient U.S. post-approval study is enrolling (NCT07405983). Source
- Br J Anaesth RCT, Samsung Medical Center: remimazolam-based TIVA with flumazenil reversal noninferior to propofol-based TIVA for postoperative delirium after elective neurovascular surgery (12.8% vs 10.8%, 686 patients), with less hypotension and more extubation in the OR (85.2% vs 67.3%) — Single-centre, double-blind randomised noninferiority trial (NCT06115031), published online October 29, 2026, in adults undergoing aneurysm clipping, AVM resection, microvascular decompression or STA-MCA bypass, both arms with remifentanil. Postoperative delirium within 5 days (CAM-ICU or 3D-CAM): 44/344 (12.8%) remimazolam vs 37/342 (10.8%) propofol, risk difference 1.97 points (95% CI -2.85 to 6.80) against a 10-point margin. Hypotensive burden below MAP 65 mmHg median 0 vs 7.5 mmHg-min; extubation in the OR 85.2% vs 67.3%. Authors caution delirium incidence was lower than anticipated when the margin was set. In the U.S., remimazolam (Byfavo) is labeled only for procedural sedation of 30 minutes or less (FDA label via openFDA). Source
- Bone Joint J meta-analysis of 22 RCTs (28,112 patients): DOACs lowered VTE vs LMWH after elective THA (OR 0.62); overall bleeding higher (OR 1.19) but no difference with UK-licensed agents and doses (OR 1.06); no difference in reoperation or mortality — Systematic review and meta-analysis from Queen Mary University of London, Oxford, Imperial and Keele (Mohammad, Murray, Griffin et al.), November 2026 issue, of RCTs comparing DOACs with LMWH for VTE prophylaxis after elective THA, searched to December 13, 2025. VTE OR 0.62 (95% CI 0.47-0.82), driven by DVT (OR 0.60); bleeding OR 1.19 (1.03-1.38) overall, 1.06 (0.95-1.18) for UK-licensed agents and doses; reoperation OR 1.21 and mortality OR 1.03, both nonsignificant. Authors estimate switching would save the NHS about GBP 8.6 million a year and call for new trials with modern rehabilitation protocols. Aspirin was not among the comparisons. Source
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