Form 4 for SI SHOULDER INNOVATIONS, INC.

Accepted 2025-08-05 00:00:00 ET · period of report 2025-08-01 · accession 0001641172-25-022248 · SEC index · Original document

Summary rows

Aggregated the way they appear in lists: one row per insider, transaction code and security table.

X	Filed	Traded	Ticker	Insider	Title	Type	Price	Qty	Owned	ΔOwn	Value
D	2025-08-05	2025-08-01	SI	Ahearn Matthew Fraser	COO, Dir	C - Cnv Deriv	—	+67.2K	108.0K	+165%	—
DM	2025-08-05	2025-08-01	SI	Ahearn Matthew Fraser	COO, Dir	C - Cnv Deriv	—	-1.28M	0	-100%	—

Purchase Sale Sale after option exercise All abbreviations

#	Table	Security	Date	Code	A/D	Shares	Price	Owned after	Own	Exercise / expiry	Underlying	Footnotes
1	Common	Common Stock	2025-08-01	C	A	67,242	—	108,035	D	—	—	(F1) Immediately prior to the closing of the Issuer's initial public offering, the shares of preferred stock of the Issuer automatically converted into shares of Common Stock on a one-for-0.052410901 basis.
2	Derivative	Series A Convertible Preferred Stock	2025-08-01	C	D	814,093	—	0	D	— · — to —	42,667 Common Stock	(F1) Immediately prior to the closing of the Issuer's initial public offering, the shares of preferred stock of the Issuer automatically converted into shares of Common Stock on a one-for-0.052410901 basis.
3	Derivative	Series B Convertible Preferred Stock	2025-08-01	C	D	218,217	—	0	D	— · — to —	11,436 Common Stock	(F1) Immediately prior to the closing of the Issuer's initial public offering, the shares of preferred stock of the Issuer automatically converted into shares of Common Stock on a one-for-0.052410901 basis.
4	Derivative	Series Seed Convertible Preferred Stock	2025-08-01	C	D	250,710	—	0	D	— · — to —	13,139 Common Stock	(F1) Immediately prior to the closing of the Issuer's initial public offering, the shares of preferred stock of the Issuer automatically converted into shares of Common Stock on a one-for-0.052410901 basis.