Statement of Changes in Beneficial Ownership (Form 4)

FORM 4 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940

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(Print or Type Responses)

1. Name and Address of Reporting Person * Gilde Healthcare Holding B.V. 2. Issuer Name and Ticker or Trading Symbol SHOULDER INNOVATIONS, INC. [SI] 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) _____ Director __X__ 10% Owner _____ Officer (give title below) _____ Other (specify below) (Last) (First) (Middle) STADSPLATEAU 36 3. Date of Earliest Transaction (Month/Day/Year) 07/30/2026 (Street) UTRECHT 3521 AZ 4. If Amendment, Date Original Filed (Month/Day/Year) 6. Individual or Joint/Group Filing (Check Applicable Line) _X_ Form filed by One Reporting Person ___ Form filed by More than One Reporting Person (City) (State) (Zip) Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1.Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4) Code V Amount (A) or (D) Price Common Stock 07/30/2026 S 28,245 D $23.36(1) 2,352,237 I(2) See Footnote(2) Common Stock 07/31/2026 S 20,034 D $22.73(3) 2,332,203 I(2) See Footnote(2)

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security (Instr. 3)

2. Conversion or Exercise Price of Derivative Security

3. Transaction Date (Month/Day/Year)

3A. Deemed Execution Date, if any (Month/Day/Year)

4. Transaction Code (Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5)

6. Date Exercisable and Expiration Date (Month/Day/Year)

7. Title and Amount of Underlying Securities (Instr. 3 and 4)

8. Price of Derivative Security (Instr. 5)

9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)

10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)

11. Nature of Indirect Beneficial Ownership (Instr. 4)

Code

V

(A)

(D)

Date Exercisable

Expiration Date

Title

Amount or Number of Shares

Reporting Owners

Reporting Owner Name / Address	Relationships
	Director	10% Owner	Officer	Other
Gilde Healthcare Holding B.V. STADSPLATEAU 36 UTRECHT 3521 AZ		X

Signatures

Gilde Healthcare Holding B.V., By: /s/ Edwin de Graaf, Managing Director		08/03/2026
**Signature of Reporting Person		Date
Gilde Healthcare V Management B.V., By: /s/ Edwin de Graaf, Managing Director		08/03/2026
**Signature of Reporting Person		Date
Cooperatieve Gilde Healthcare V U.A., By: /s/ Edwin de Graaf, Managing Director		08/03/2026
**Signature of Reporting Person		Date

Explanation of Responses:

*	If the form is filed by more than one reporting person, see Instruction 4(b)(v).
**	Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
(1)	This figure is the weighted average sales price of multiple trades ranging from $23.00 to $23.73 per share. The Reporting Person undertakes to provide the Staff of the Securities and Exchange Commission, Shoulder Innovations, Inc. or any security holder of Shoulder Innovations, Inc. full information about the number of shares sold at each separate price upon request.
(2)	Held directly by Cooperatieve Gilde Healthcare V U.A. ("Gilde"). Gilde Healthcare V Management B.V. is the managing director of Gilde and has sole voting and dispositive power with respect to the shares held by Gilde. Gilde Healthcare V Management B.V. is owned by Gilde Healthcare Holding B.V. The managing partners of Gilde Healthcare Holding B.V. are Manapouri B.V. (of which Edwin de Graaf is the owner and managing director) and Martemanshurk B.V. (of which Pieter van der Meer is the owner and managing director). Geoff Pardo is a partner at Gilde and may be deemed to share voting and dispositive power with respect to the shares held of record by Gilde. Mr. Pardo disclaims beneficial ownership of such holdings, except to the extent of his pecuniary interest in the shares.
(3)	This figure is the weighted average sales price of multiple trades ranging from $22.60 to $23.00 per share. The Reporting Person undertakes to provide the Staff of the Securities and Exchange Commission, Shoulder Innovations, Inc. or any security holder of Shoulder Innovations, Inc. full information about the number of shares sold at each separate price upon request.

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