Xtant Medical (NYSEAMERICAN:XTNT) raised its full-year 2026 revenue guidance after announcing a distribution agreement that moves the company into the hemostatic agent market, while first-quarter revenue declined from the prior-year period following divestitures and the loss of certain license revenue.
President and Chief Executive Officer Sean Browne said on the company’s first-quarter earnings call that Xtant now expects 2026 revenue of $101 million to $105 million. He attributed the higher outlook to the addition of HEMOBLAST Bellows through a Dilon Technologies agreement and growth in the company’s base business.
Dilon deal expands biologics portfolio
In April, Xtant acquired exclusive U.S. distribution rights to Dilon Technologies’ HEMOBLAST Bellows product, which Browne described as a high-performance hemostasis product for use following certain surgical procedures. He said the agreement gives Xtant entry into an estimated $2 billion global addressable market for hemostatic products.
Browne said HEMOBLAST is differentiated as “the only hemostat containing collagen, human-derived thrombin, and bovine-derived chondroitin sulfate,” and noted that it is indicated across minimal, mild and moderate bleeding types and requires no preparation before use.
As part of the agreement, Xtant hired Dilon’s team of 21 sales professionals. Browne said the company also has doubled the number of regional sales representatives in the field in 2026 and plans to add resources to its national accounts team.
During the question-and-answer portion of the call, Browne said HEMOBLAST’s existing business has been primarily in general surgery, with additional call points including trauma and urology. He said Xtant sees an opportunity to bring the product into spine, which he described as the largest market within the hemostatic market.
Browne said the Dilon sales team will initially focus on HEMOBLAST and will also receive access to complementary Xtant product lines, including collagen and amnio products. “Eventually they’ll get the entire bag,” he said, but added that this would occur later.
Chief Financial Officer Scott Neils said the addition of 21 mostly seasoned representatives is expected to add “at least $2.5 million quarterly” in sales and marketing expense, including compensation, travel and marketing expense.
Revenue declines from prior year on divestitures, amnio headwinds
Xtant reported first-quarter 2026 revenue of $20.9 million, compared with $32.9 million in the first quarter of 2025. Neils said first-quarter 2025 revenue was $23.9 million on a pro forma basis, excluding revenue from non-core products and businesses sold to Companion Spine and license revenue that did not repeat in 2026.
Neils said the decline from the pro forma 2025 period was driven mainly by headwinds in amnio product revenue tied to the advanced wound care market. Browne said the company expects amnio business in both surgical and advanced wound care to “start to see some pickup again in the second half of this year.”
Gross margin was 57.3% in the first quarter, down from 61.5% a year earlier. Neils said the decline was primarily due to the end of Q-code license revenue from amniotic membrane agreements that terminated at the end of 2025 because of reimbursement changes, partially offset by improvements in product mix.
In response to an analyst question, Neils said low-60% gross margin remains the right way to view the business, adding that first-quarter margin was affected by additional excess and obsolete expense and product mix. He said the company expects margin to improve in the third and fourth quarters.
Costs fall after Companion Spine transaction
Operating expenses were $14.9 million in the first quarter, compared with $19.2 million in the prior-year period. Neils said the decrease was primarily due to the December 2025 sale of non-core Coflex and CoFix assets and an international hardware business to Companion Spine.
General and administrative expenses fell to $6.3 million from $7.5 million, while sales and marketing expenses declined to $8.2 million from $11.2 million. Neils said about $2.5 million of the sales and marketing decrease came from the Companion Spine divestitures, with the remainder primarily due to lower independent agent commissions and reduced professional fees. Research and development expenses were essentially flat at $435,000.
Xtant posted a first-quarter net loss of $3.1 million, or $0.02 per basic and diluted share, compared with net income of $58,000, or break-even per share, in the first quarter of 2025. Adjusted EBITDA was a loss of $1.6 million, compared with positive adjusted EBITDA of about $3 million in the same period in 2025, according to Neils.
Debt reduced following asset sales
Browne said Xtant received the final $10.7 million from Companion Spine in March related to Companion Spine’s purchase of Xtant’s non-core Coflex assets and Paradigm OUS businesses in December 2025. The total purchase price for the divestitures was $21.4 million.
The company used proceeds to reduce borrowings and strengthen its cash position. Browne said Xtant reduced total indebtedness by $13.3 million in the first quarter, including a $10.4 million reduction in amounts outstanding under its revolving line of credit and a $2.8 million reduction in its term loan balance.
As of March 31, Xtant had $12.2 million in cash and cash equivalents, total indebtedness of $12.2 million and $11.8 million of availability under its revolving credit facility. That compared with $17.3 million in cash, $25.4 million in total indebtedness and $3.8 million of revolver availability at the end of 2025.
New products remain a focus
Xtant also highlighted the commercial launch of Trivium Shaped, an extension of its Trivium Bone Graft portfolio. Browne said the product is offered in pre-shaped configurations, including blocks and strips, to support handling, preparation and placement across surgical applications.
Browne said Trivium Shaped builds on the Trivium sculptable format launched in April 2025 and gives surgeons “ready-to-use graft forms” intended to improve consistency and handling in the operating room.
Asked about orthobiologic growth, Browne said recent product introductions, including OsteoFactor Pro and Trivium product lines, have performed well. He said the company saw some softness in stem cell products during the first quarter, partly due to the “lumpy” nature of OEM business, but said it remains one of Xtant’s largest product lines and is expected to perform well through the year.
About Xtant Medical (NYSEAMERICAN:XTNT)
Xtant Medical, Inc is a medical technology company focused on the development, manufacturing and distribution of bone graft, spine biologics and related implantable medical devices. The company’s product portfolio is designed to address critical needs in spinal fusion, orthopedics and trauma surgery by providing a range of solutions that promote bone growth, structural support and patient recovery.
The company’s offerings include an array of bone graft substitutes – such as demineralized bone matrix putties and fibers – interbody fusion devices, spinal fixation systems and biologic agents.
