Stock Ratings / Health Care / SI / options

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Shoulder Innovations Inc. (SI) Options Positioning, Max Pain & Unusual Sweeps

$20.44 +4.93% NYSE • Live Quote vs Prior Daily Close (Synced Snapshot)

Shoulder Innovations Inc. (SI) carries a Roarable Rating of D- (Sell) with 42/100 RQD Confidence due to weak cash-flow efficiency and sensitivity to current interest rates. Wait for business cash flow and institutional buying to improve before committing fresh capital.

ROARABLE D- • SELL / AVOID Cap $425.5M

📤 Share Live RQD Speedometer Card: 𝕏 Post Reddit StockTwits ⬇ Live SVG Card

INTERACTIVE SCENARIO DECK:

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RQD QUANT TACHOMETERSELL / AVOID • D-

2-of-3 JEV AI Jury Bearish Warning

Cash

SEC

Whale

Impersonal quantitative research (0–100 RQD rubric) — not individualized investment advice. Past performance does not guarantee future results. Full Disclaimer

5-PILLAR SNOWFLAKE RADARRw D- · Rk D

Each axis scored 0–20

12M PRICE TARGET CONE-7.2% Base Target

WHALE OPTIONS SNAPSHOT: — (No Active Options Snapshot on file for SI)Realized 20D OHLCV Swing Band: ±11.3%

CALL VS. PUT WHALE SHARE

— (No Active Options Snapshot)

Put/Call Ratio: — (No Active Options Snapshot)

MAX-PAIN EXPIRATION MAGNET

— (No Active Options Snapshot)

No active options chain max-pain snapshot on file

HISTORICAL 20D VOLATILITY SWING

±11.3%

Derived from 20D OHLCV bars (No Active Options Snapshot)

Active Strike Call vs. Put Concentration Ladder (SI)

— (No Active Options Snapshot) — No unusual CBOE strike concentration anomalies recorded in the current database snapshot for SI.

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Red-Light Warning Desk: Spotting SEC Cash-Flow & Dilution Risks Before Downgrades (Featuring SI)

✓Walkthrough of SI's RQD Radar, SEC cash-conversion gap & downside invalidation levels
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SI // CANDLESTICK & AUTO-TRENDLINE WORKSTATION6M: +59.81%▲ RESISTANCE BREAKOUT

2026-10-30O $20.50H $20.74L $19.05C $20.44VOL 119.0K

RES: $19.99SUP: $15.11SMA50: $19.18SMA200: $17.01

PRIMARY-SOURCE FORENSICS, SECOND-ORDER LINKS & AI ANALYST DESK

SI Dilution Monitor, Expectations Hurdle, Butterfly Connections & Policy Exposure

🦋 SI Butterfly Map → + Track SI →

Share Count & Dilution Monitor (#25)

Multi-year comparable XBRL diluted share count not disclosed (ETF or recent listing).

Reverse-DCF Expectations Hurdle (#30)

8.0%/yr Implied 5Y Growth

vs. +49.6% actual YoY revenue growth (assuming 9.25% cost of equity & 16.5x terminal multiple).

Ellis Vennor Setup Ledger (#33)

No active Ellis Vennor swing setup published on SI today. View full Setup Ledger →

🦋 Documented & Second-Order Butterfly Connections Open Graph →

No direct multi-tier Butterfly edges indexed yet for SI. Explore sector supply chains on /butterfly.

AI Analyst Theses, Washington Policy & Company Video

🎬 No recent verified company-specific video clip queued for SI today (we never pad ticker pages with unrelated generic clips). Browse Macro Video Desk →

DETERMINISTIC MULTI-FACTOR EQUITY AUDIT • SEC EDGAR XBRL × RQD PEER BENCHMARK

📊 Quantitative Sector Peer Comparison, SEC Filing Delta & Investment FAQ (SI)

Health Care Rank #572 of 1016 ⚔️ CARL vs SI Full Matrix →

1. Head-to-Head Health Care Peer Comparison (SI vs. CARL, OFIX, NPCE, SSII)

Industry: Medical/Dental Instruments (120 Tracked Issuers)

Across 1016 tracked Health Care securities in the Roarable RQD universe, Shoulder Innovations Inc. (SI) ranks #572 by composite RQD confidence (42/100, grade D-) and #471 by equity capitalization ($425.5M). Within this direct 5-issuer industry benchmark cohort, SI leads on earnings valuation at N/A trailing P/E, while OFIX leads on capital efficiency and profitability with -12.2% ROIC and 68.8% gross margin. OFIX currently holds the highest overall quantitative score in the immediate peer group at 55/100 (D+) compared with SI at 42/100 (D-).

Ticker / Company	Roarable Grade	RQD Score	Trailing P/E	Gross Margin	ROIC	1D Change	Market Cap	Head-to-Head
SI ACTIVE Shoulder Innovations Inc.	D-	42/100	—	76.5%	-16.1%	+4.93%	$425.5M	Benchmark Subject
CARL Carlsmed Inc.	D-	39/100	—	75.3%	-35.0%	+3.01%	$430.6M	/carl-vs-si →
OFIX Orthofix Medical Inc.	D+	55/100	—	68.8%	-12.2%	+1.99%	$417.1M	/ofix-vs-si →
NPCE Neuropace Inc.	E	30/100	—	77.2%	-23.0%	+0.62%	$446.6M	/npce-vs-si →
SSII SS Innovations International Inc.	D-	39/100	—	46.0%	-18.5%	-2.46%	$477.2M	/ssii-vs-si →

2. Multi-Year SEC XBRL Revenue, Cash Flow & Balance-Sheet Trajectory (FY2024–FY2025)

SEC EDGAR 10-K • FILED 2025-12-31 • CIK 0001699350

In its most recent audited fiscal period (FY2025, filed 2025-12-31), Shoulder Innovations Inc. (SI) reported GAAP revenue of $47.3M (+49.6% vs. FY2024 revenue of $31.6M ) , GAAP net income of -$40.4M, operating cash flow of -$28.6M, and free cash flow of -$36.0M (-98.4% YoY). On the balance sheet, SI closed FY2025 with $169.9M in total assets against $14.9M in total debt (Altman Z-Score: 8.73, Piotroski F-Score: 5/9).

Fiscal Period	Filing Date	Revenue	Net Income	Operating Cash Flow	Free Cash Flow	Total Assets	Total Debt
FY2025 (FY)	2025-12-31	$47.3M	-$40.4M	-$28.6M	-$36.0M	$169.9M	$14.9M
FY2024 (FY)	2024-12-31	$31.6M	-$15.6M	-$14.1M	-$18.2M	$43.1M	$14.7M

3. SI Data-Verified Investor FAQ (RQD Rating, Sector Peers, SEC Forensics & Technicals)

✓ SCHEMA.ORG FAQPAGE JSON-LD ENABLED

Is SI stock a Buy, Hold, or Sell right now according to Roarable's RQD model?

As of 2026-11-01, Shoulder Innovations Inc. (NYSE: SI) is rated D- (Sell / SELL) by Roarable's 5-pillar RQD engine with a composite confidence score of 42/100 at a spot price of $20.44 (+4.93% 1D, market cap $425.5M). Pillar breakdown: Fundamental Cash Engine 9/20, Institutional 13F & Options Flow 11/20, Executive Insider Alignment 11/20, FRED Macro Regime Fit 8/20, and SEC Balance-Sheet Forensics 3/20. Across 1016 tracked Health Care issuers, SI ranks #572 in composite RQD confidence.

How does SI compare to CARL and OFIX in the Health Care sector?

Within the Health Care sector (Medical/Dental Instruments), SI carries a Roarable D- (42/100 RQD), trailing P/E of N/A, gross margin of 76.5%, and ROIC of -16.1%. By comparison, CARL (Carlsmed Inc.) holds a D- grade (39/100 RQD, P/E N/A, ROIC -35.0%, cap $430.6M) and OFIX (Orthofix Medical Inc.) posts a D+ grade (55/100 RQD, P/E N/A, ROIC -12.2%, cap $417.1M). Among the 5-stock peer group, SI leads on earnings multiple (N/A) while OFIX leads on capital efficiency (-12.2% ROIC).

What are the biggest fundamental strengths and SEC risk factors for SI?

Per SI's SEC EDGAR XBRL 10-K filing (FY2025, filed 2025-12-31, CIK 0001699350), Shoulder Innovations Inc. generated $47.3M in revenue (+49.6% YoY), -$40.4M in net income, and -$36.0M in free cash flow against $169.9M in total assets and $14.9M in total debt. Key quantitative strengths: Established market leader in Health Care with deep daily trading liquidity.. Primary risk factors monitored: Company executives have done more routine share selling than personal cash buying lately.. Institutional options positioning shows a 50% call / 50% put premium split.

Where is SI trading relative to its 50-day, 200-day, and 52-week technical levels?

SI last traded at $20.44 (+4.93% on volume of 144,839 shares), positioning the stock +6.57% above its 50-day simple moving average ($19.18) and +20.16% above its 200-day simple moving average ($17.01). Across its 52-week range of $10.92 to $24.60, SI sits at the 69.6% percentile with a 14-day RSI of 50.8 (NEUTRAL RANGE) and an implied next-earnings move of ±11.3% ($18.13 to $22.75).

SI Investor FAQ & Complete 8-Part Research Index

100% OPEN ACCESS • SEC EDGAR × CBOE × FRED

What is SI's options positioning and volatility profile?

Roarable tracks verified CBOE unusual options sweeps, put/call ratios, and OHLCV realized volatility bands for SI.

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