Medacta International reported first-half 2026 revenue of EUR368 million, up from EUR344 million a year earlier and representing 9.7% growth in constant currency. Adjusted EBITDA came in at EUR97 million on a reported basis, or EUR104.4 million on a constant-currency basis, down slightly from EUR98.8 million in H1 2025.
Net profit fell to EUR42 million, or EUR41.9 million, from EUR60 million a year earlier. The prior-year figure included a one-off bargain purchase gain tied to the Parcus Medical acquisition. On a comparable basis excluding one-time items, net profit rose to EUR49 million from EUR46 million.
Gross profit edged up to EUR240 million from EUR235 million, but gross margin contracted sharply to 65.2% from 68.3%, a decline of 310 basis points. Operating cash flow dropped to EUR56 million from EUR73 million, and free cash flow turned negative at minus EUR18.6 million compared with a positive EUR8.5 million a year ago.
Capital expenditure totalled EUR74 million, up from EUR64 million, driven by EUR42 million spent on instruments and EUR22 million on other tangible assets including the new facility site in Ticino, Switzerland. Net debt to adjusted EBITDA rose to 1.2 times at the end of H1 2026 from 0.9 times at year-end 2025; the five-year average stands at 0.9 times.
Revenue was split across regions, with EMEA accounting for EUR184.7 million or 50% of total sales and growing 10.0% in constant currency. Headwinds included French price cuts implemented in September 2025 and public-sector strikes in Spain. North America contributed EUR102.1 million (28%) with 6.6% constant-currency growth, while the US joint replacement market slowed to roughly 3% expansion from a post-COVID pace of 5% to 5.5%. Asia-Pacific grew 13.1% to EUR73.1 million and Latin America rose 16.4% to EUR8.3 million.
By business line, knee products generated EUR154.1 million (42% of sales) with 10.8% constant-currency growth, led by the GMK SpheriKA system and efficiency single-use instruments. Hip products accounted for EUR145 million (39%) and grew 8.1%, supported by early cases with the NextAR Hip system in the US and Australia and the full US release of the Mfinity hip stem. Extremities revenues, including shoulder and sports medicine, reached EUR40.4 million (11%) with 15.9% growth, bolstered by the first US revision shoulder arthroplasty using NextAR Shoulder and the launch of the SecureFix All-Inside Meniscal Repair System. The spine segment contributed EUR28.7 million (8%) and grew 4.5% despite a sales channel transition in North America and the launch of NextAR Spine 2.0.
CEO Francesco Siccardi described the period as "probably our worst semester in the last five years after COVID," contrasting it with what he called "the best semester of Medacta history" in H1 2025. On the trade-off between organic investment and acquisitions, he said: "Every time I look at price points paid for M&A, for technology, for products, the return on invested capital when we do it internally is incredibly better."
For the full year, Medacta maintained its revenue growth target of 10% to 14% in constant currency and outlined an adjusted EBITDA margin expansion of roughly 50 basis points compared with the prior year's 27.9% in constant currency. Its mid-term outlook for 2024–2027 calls for a revenue compound annual growth rate of 12% to 15% in constant currency with gradual EBITDA margin improvement relative to 2025.
Shares fell 3.43% to $118.40 following the announcement. The stock trades within a 52-week range of $116.40 to $177.20.
