Paragon 28 Inc (FNA) 2023 Q2 法說會逐字稿

Good afternoon, and welcome to Paragon 28's Second Quarter 2023 Earnings Conference Call. (Operator Instructions)As a reminder, this call is being recorded for replay purposes.

下午好，歡迎參加 Paragon 28 2023 年第二季度收益電話會議。 （操作員說明）謹此提醒，此通話正在錄音以供重播之用。

And now I would like to hand the conference over to your host today, Mr. Matthew Brinckman, Senior Vice President of Strategy and Investor Relations. Mr. Brinckman, please go ahead.

現在我想把會議交給你們今天的東道主，戰略和投資者關係高級副總裁 Matthew Brinckman 先生。布林克曼先生，請繼續。

Good afternoon, and thank you for joining Paragon 28's Second Quarter 2023 Financial Results and Earnings Call. Presenting on today's call are Albert DaCosta, Chairman and Chief Executive Officer; and Steve Deitsch, Chief Financial Officer.

下午好，感謝您參加 Paragon 28 的 2023 年第二季度財務業績和收益電話會議。出席今天電話會議的有董事長兼首席執行官阿爾伯特·達科斯塔 (Albert DaCosta)；和首席財務官 Steve Deitsch。

Before we begin, I would like to remind you that management will make statements during this call that include forward-looking statements within the meaning of federal securities laws, which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include statements made as to the company's or management's intentions, hopes, beliefs, expectations or predictions of future events, results or performance. These forward-looking statements are subject to a number of risks, uncertainties, estimates and assumptions that may cause actual results to differ materially from these forward-looking statements. All forward-looking statements are based upon current available information, and Paragon 28 assumes no obligation, except as required by law, to update these statements. Additional information concerning certain risks and uncertainties that may impact these forward-looking statements is contained from time to time in the company's SEC filings and in the press release that was issued earlier today.

在我們開始之前，我想提醒您，管理層將在本次電話會議期間發表聲明，其中包括聯邦證券法含義內的前瞻性聲明，這些聲明是根據1995 年《私人證券訴訟改革法案》的安全港條款制定的. 前瞻性陳述包括有關公司或管理層對未來事件、結果或業績的意圖、希望、信念、期望或預測的陳述。這些前瞻性陳述受到許多風險、不確定性、估計和假設的影響，可能導致實際結果與這些前瞻性陳述存在重大差異。所有前瞻性陳述均基於當前可用信息，除法律要求外，Paragon 28 不承擔更新這些陳述的義務。有關可能影響這些前瞻性陳述的某些風險和不確定性的更多信息，不時包含在該公司向 SEC 提交的文件和今天早些時候發布的新聞稿中。

During this presentation, we will refer to the non-GAAP financial measure of adjusted EBITDA and constant currency net revenue growth. A reconciliation to the most comparable GAAP financial measure, net income and reported net revenue growth is contained in our press release issued earlier today.

在本演示中，我們將參考調整後 EBITDA 和恆定貨幣淨收入增長的非 GAAP 財務指標。我們今天早些時候發布的新聞稿中包含了與最具可比性的公認會計準則財務指標、淨利潤和報告的淨收入增長的對賬。

And with that, I will turn the call over to Albert.

這樣，我會將電話轉給艾伯特。

Thanks, Matt. Good afternoon, and thank you for joining us for our second quarter 2023 earnings call. I will kick the call off with a business update and then pass things over to Steve to provide an overview of our financial results and give an update on our 2023 financial guidance.

謝謝，馬特。下午好，感謝您參加我們的 2023 年第二季度財報電話會議。我將首先介紹業務更新情況，然後將事情轉交給 Steve，以概述我們的財務業績並提供 2023 年財務指導的最新信息。

To start things off, we are extremely pleased with the work our team has done, continuing to grow our global business at a great pace and well above the overall foot and ankle market growth rate. Paragon 28 is all about changing the world of foot and ankle and helping improve patients' lives, and I see the passion, tenacity and commitment to that mission from our team every day. That collective effort and enthusiasm is really what drives our success and is why we win in so many ways.

首先，我們對我們團隊所做的工作感到非常滿意，我們的全球業務繼續以驚人的速度增長，遠高於足部和腳踝市場的整體增長率。 Paragon 28 致力於改變足部和腳踝的世界並幫助改善患者的生活，我每天都看到我們團隊對這一使命的熱情、堅韌和承諾。這種集體努力和熱情確實是我們成功的動力，也是我們在很多方面取得勝利的原因。

With that, I will turn to some updates on the business and our performance this year. Total revenue for the first half of the year was $103 million, representing constant currency growth of 24% year-over-year. Both our U.S. business and international business had strong first half 2023 performances. The U.S. grew 20% and international grew 51% constant currency, and all our segments grew double digits year-to-date. Our resilient team, combined with our balanced business model, delivered growth at over 3x the broader foot and ankle market growth rate despite industry-wide supply chain challenges. Both our U.S. and international businesses had strong performances in the second quarter as well, with global net revenue totaling $51 million, representing constant currency growth of 21% year-over-year.

接下來，我將談談今年業務和業績的一些最新情況。上半年總收入為 1.03 億美元，按固定匯率計算同比增長 24%。我們的美國業務和國際業務在 2023 年上半年均表現強勁。按固定匯率計算，美國增長了 20%，國際增長了 51%，今年迄今為止，我們所有的業務部門都實現了兩位數增長。儘管全行業的供應鏈面臨挑戰，但我們堅韌的團隊與平衡的業務模式相結合，實現了足部和腳踝市場增長率超過 3 倍的增長。我們的美國和國際業務在第二季度也表現強勁，全球淨收入總計 5100 萬美元，按固定匯率計算同比增長 21%。

Our U.S. revenue performance in the quarter was once again led by our innovative and comprehensive product portfolio, which continues to attract new surgeons and sales reps to Paragon 28. During the quarter, we increased our U.S. surgeon customer base by 12% to a record 2,047 surgeons. We finished the quarter with an increase in the number of producing sales reps to 250 while also increasing the average revenue per producing sales rep. Our international business also did very well during the quarter with sizable growth contributions coming from our key markets.

我們本季度美國的收入表現再次由我們創新和全面的產品組合引領，該產品組合繼續吸引新的外科醫生和銷售代表來到Paragon 28。本季度，我們的美國外科醫生客戶群增加了12%，達到創紀錄的2,047 名外科醫生。本季度結束時，我們將生產銷售代表的數量增加到 250 名，同時還增加了每個生產銷售代表的平均收入。我們的國際業務在本季度也表現出色，主要市場對增長做出了巨大貢獻。

Turning to our product portfolio. In the second quarter, we fully launched 2 new systems, including the Phantom Met Shortening System and the Gorilla Supramalleolar Osteotomy, or SMO plating system. We also have a few products on beta launch that we are thrilled to bring to market later this year. The Phantom Met Shortening System is a novel approach in to prevent metatarsalgia and floating toe pathologies associated with various forefoot procedures.

轉向我們的產品組合。第二季度，我們全面推出了兩個新系統，包括 Phantom Met 縮短系統和大猩猩上踝截骨術（SMO 電鍍系統）。我們還有一些正在測試版的產品，我們很高興能在今年晚些時候將其推向市場。 Phantom Met 縮短系統是一種新穎的方法，可預防與各種前腳手術相關的蹠骨痛和浮趾病變。

The introduction of our met shortening system addresses an unmet need in foot and ankle and will help catalyze our growth in the forefoot segment. The Gorilla SMO plating system includes a state-of-the-art bone graft kit that offers surgeons a streamlined, customized and reproducible way of addressing ankle deformities. This system is highly synergistic with existing products in our ankle franchise, including total ankle replacement.

我們的met縮短系統的推出解決了足部和腳踝未滿足的需求，並將有助於促進我們在前足部分的增長。 Gorilla SMO 電鍍系統包括最先進的骨移植套件，為外科醫生提供了一種簡化、定制和可重複的方法來解決腳踝畸形。該系統與我們腳踝特許經營中的現有產品（包括全腳踝置換術）具有高度協同作用。

As a reminder, we've launched nearly 20 products since the start of 2021, and our pipeline boasts over 25 active new products under development across all of the subsegments within foot and ankle. Perhaps as important as new product introductions and our exciting pipeline, we continue to experience substantial growth from our legacy products, including our plating systems, screw systems and bone wedges, which span multiple segments and indications.

提醒一下，自 2021 年初以來，我們已經推出了近 20 種產品，我們的產品線擁有超過 25 種正在開發的活躍新產品，涵蓋足部和腳踝內的所有細分市場。也許與新產品的推出和令人興奮的產品線同樣重要的是，我們的傳統產品繼續實現大幅增長，包括我們的電鍍系統、螺釘系統和骨楔，這些產品跨越多個細分市場和適應症。

Foot and ankle is a gem within the orthopedic market, and we feel so lucky to be in such a dynamic, high-growth space where we can contribute in a meaningful way. Our passion and singular focus on this market motivates us every day and drives our success. We continue to perform well and take share across each subsegment and geography, a compelling testament to the balance and strength of our overall business and team.

足部和腳踝是骨科市場中的瑰寶，我們很幸運能夠身處這樣一個充滿活力、高增長的領域，我們可以以有意義的方式做出貢獻。我們對這個市場的熱情和專注每天都激勵著我們，推動著我們的成功。我們繼續表現良好，並在每個細分市場和地區佔據份額，這有力地證明了我們整體業務和團隊的平衡和實力。

And with that, I will now turn it over to Steve.

現在，我將把它交給史蒂夫。

Thank you, Albert. Paragon 28's second quarter 2023 net revenue was $51 million, representing 20% and 21% reported and constant currency growth, respectively. Gross profit margin was 82.6% for the second quarter of 2023 compared to 82% last year. We continue to make important investments in research and development as R&D was $7.7 million or 15% of revenue for the second quarter of 2023.

謝謝你，艾伯特。 Paragon 28 2023 年第二季度淨收入為 5100 萬美元，按報告匯率和固定匯率計算分別增長 20% 和 21%。 2023 年第二季度毛利率為 82.6%，而去年為 82%。我們繼續在研發方面進行重要投資，2023 年第二季度研發費用為 770 萬美元，佔收入的 15%。

During the quarter, we made additional investments in our robust and innovative product pipeline, ongoing clinical studies and regulatory and quality initiatives. We continue to leverage our past investments in selling, general and administrative expense, which totaled $43.8 million for the second quarter of 2023, representing a 330 basis point year-over-year margin improvement. Total SG&A expense has been consistent for the last 3 consecutive quarters.

本季度，我們對穩健和創新的產品線、正在進行的臨床研究以及監管和質量舉措進行了額外投資。我們繼續利用過去在銷售、一般和管理費用方面的投資，2023 年第二季度的投資總額為 4,380 萬美元，利潤率同比提高了 330 個基點。銷售、管理及行政費用總額在過去連續三個季度保持穩定。

Adjusted EBITDA for the second quarter of 2023 improved by 17% to a $2.6 million loss. Second quarter adjusted EBITDA included approximately $2 million of onetime expenses, composed of investments in our organizational structure and other growth initiatives. On a year-to-date basis, our adjusted EBITDA improved by 38% to a $4 million loss. We continue to expect 2023 adjusted EBITDA to improve by $5 million to $10 million as compared to the $10.7 million loss in 2022.

2023 年第二季度調整後 EBITDA 改善 17%，虧損 260 萬美元。第二季度調整後的 EBITDA 包括約 200 萬美元的一次性費用，包括對我們的組織結構和其他增長計劃的投資。年初至今，我們調整後的 EBITDA 改善了 38%，虧損 400 萬美元。我們仍然預計 2023 年調整後 EBITDA 將比 2022 年 1,070 萬美元的虧損增加 500 萬美元至 1,000 萬美元。

Turning to cash flow and liquidity. During the second quarter and 6 months ended 2023, P28 had $6.4 million and $11.4 million of operating cash used after normalizing for nonrecurring legal settlement payments. These year-over-year operating cash flow improvements were in excess of 50% despite higher-than-normal levels of inventory on hand at June 30, 2023. Beyond the inventory growth requirements to support new product launches and our expanded commercial footprint, increased supplier lead times have significantly contributed to our inventory growth. Specifically, these longer lead times have required us to increase our power levels of inventory. Our inventory balance also includes a higher-than-normal level of incomplete kits or work in process inventory awaiting delivery of final components to complete sets that otherwise would have been deployed to our sales force, contributing to revenue in the quarter.

轉向現金流和流動性。在截至 2023 年的第二季度和 6 個月內，P28 在非經常性法律和解付款正常化後使用了 640 萬美元和 1140 萬美元的運營現金。儘管截至 2023 年 6 月 30 日的庫存水平高於正常水平，但運營現金流量同比改善超過 50%。除了支持新產品發布和擴大商業足蹟的庫存增長要求之外，供應商的交貨時間對我們的庫存增長做出了重大貢獻。具體來說，較長的交貨時間要求我們提高庫存能力。我們的庫存餘額還包括高於正常水平的不完整套件或在製品庫存，等待最終組件交付以完成套件，否則這些套件將被部署到我們的銷售人員，從而為本季度的收入做出貢獻。

Turning to liquidity. We ended the second quarter of 2023 with approximately $117 million of total liquidity, including $57 million of cash and short-term investments and up to $60 million of cash available via our senior credit facility. Considering our anticipated future revenue growth and improvements to adjusted EBITDA and free cash flow, we remain comfortable with our liquidity position, which we continue to expect will enable us to reach cash flow breakeven.

轉向流動性。截至 2023 年第二季度末，我們的流動資金總額約為 1.17 億美元，其中包括 5700 萬美元的現金和短期投資，以及通過我們的高級信貸安排提供的最多 6000 萬美元的現金。考慮到我們預期的未來收入增長以及調整後 EBITDA 和自由現金流的改善，我們對我們的流動性狀況仍然感到滿意，我們仍然期望這將使我們能夠實現現金流收支平衡。

Now turning to our 2023 net revenue guidance. P28 continues to see tremendous demand for our innovative products, and our commercial momentum and execution is very strong going into the second half of the year. For the full year of 2023, we are reaffirming our previous net revenue guidance of $214 million to $218 million. On a constant currency basis, the midpoint of our revenue guidance range implies 20% year-over-year growth. Our net revenue guidance also assumes foreign currency translation rates remain consistent with current translation rates. That is the end of our prepared remarks.

現在轉向我們的 2023 年淨收入指導。 P28 繼續看到對我們創新產品的巨大需求，進入下半年我們的商業勢頭和執行力非常強勁。對於 2023 年全年，我們重申之前的淨收入指引為 2.14 億美元至 2.18 億美元。按固定匯率計算，我們收入指導範圍的中點意味著同比增長 20%。我們的淨收入指引還假設外幣換算率與當前換算率保持一致。我們準備好的發言到此結束。

(Operator Instructions) And your first question will come from Craig Bijou with Bank of America.

（操作員說明）您的第一個問題將來自美國銀行的 Craig Bijou。

Just -- I guess I wanted to start with some of the supply chain challenges. And maybe if you can go into a little bit more detail of what exactly they were, maybe quantify the impact and if it hits certain products more than others.

只是——我想我想從一些供應鏈挑戰開始。也許如果你能更詳細地了解它們到底是什麼，也許可以量化影響，以及它是否對某些產品的影響大於其他產品。

Thanks, Craig. It's Steve. Good question. And the supply chain headwinds that we've been facing along with the rest of the industry have been out there for really a couple plus years since COVID, and our teams have done a really good job of navigating through that. Our ops teams and commercial teams have been really resilient.

謝謝，克雷格。是史蒂夫。好問題。自新冠疫情以來，我們與行業其他公司一起面臨的供應鏈逆風已經存在了好幾年了，我們的團隊在應對這一問題方面做得非常好。我們的運營團隊和商業團隊非常有彈性。

During the second quarter, we did experience what I would call a higher number of stockouts on certain products that we primarily sell in our U.S. market, and those would be products that are sterile packaged. And so we've seen our lead times in some of those products go from 8 months to 22 months. And so a lot of our new product categories are experiencing some stockouts because of that. So that's an area that definitely had an impact on the second quarter, particularly in the U.S. But despite these challenges, our business is up 20% year-to-date in the U.S.

在第二季度，我們確實經歷了我所說的主要在美國市場銷售的某些產品的大量缺貨，這些產品是無菌包裝的產品。因此，我們發現其中一些產品的交貨時間從 8 個月延長到 22 個月。因此，我們的許多新產品類別都出現了缺貨的情況。因此，這個領域肯定會對第二季度產生影響，尤其是在美國。儘管面臨這些挑戰，我們的美國業務今年迄今仍增長了 20%。

And also, we expect -- and beginning in July, we actually started to see some relief on some of those products actually getting in the door. So we're really optimistic that, that's going to improve over time, particularly as we roll through the second half of this year.

而且，我們預計，從 7 月開始，我們實際上開始看到其中一些產品真正上市的情況有所緩解。因此，我們非常樂觀地認為，隨著時間的推移，情況將會有所改善，特別是在今年下半年。

Got it. That's helpful, Steve. And then if I -- maybe just your reaffirmed guidance, I would love to hear if the split between U.S. and international, obviously, international is doing -- did well in the quarter, has done well thus far this year. The U.S. side, as you just talked about, some supply challenges. So maybe just talk about how we should think about the U.S. and international contribution to your reaffirmed guidance.

知道了。這很有幫助，史蒂夫。然後，如果我——也許只是你重申的指導，我很想听聽美國和國際之間的分歧，顯然，國際之間的分歧是否在本季度表現良好，今年迄今為止表現良好。美方，正如你剛才談到的，供應方面存在一些挑戰。因此，也許只是談談我們應該如何考慮美國和國際對您重申的指導方針的貢獻。

Yes. And maybe before I do that, Albert actually punched me under the table and said that it was 8 weeks to 22 weeks, not months. So it's felt like months to me, so I'm sure to our sales team. So I just wanted to clarify that. So as we go forward, we do expect our businesses to continue to contribute on a pretty similar basis as we go forward. We expect our U.S. business to continue to be a terrific driver of growth for us as it has been for the first half of the year. And then our international business also has a lot of momentum, as you can see by our year-to-date results and also prior to that.

是的。也許在我這樣做之前，阿爾伯特實際上在桌子底下打了我一拳，說這是 8 周到 22 週，而不是幾個月。所以對我來說這感覺就像幾個月一樣，所以我對我們的銷售團隊很確定。所以我只是想澄清這一點。因此，隨著我們的前進，我們確實希望我們的業務能夠繼續在非常相似的基礎上做出貢獻。我們預計我們的美國業務將繼續成為我們增長的巨大推動力，就像今年上半年一樣。然後，我們的國際業務也有很大的發展勢頭，正如您從我們今年迄今以及之前的業績中看到的那樣。

One thing to think about as we go into 3Q, our international business typically has the highest level of seasonality because of the concentration of revenue in the European markets there. So you do typically see a step-down in international contribution during the third quarter. So those -- that's the way I would think about the reaffirmation of guidance.

進入第三季度時需要考慮的一件事是，由於收入集中在歐洲市場，我們的國際業務通常具有最高的季節性。因此，您通常會看到第三季度的國際貢獻有所下降。這就是我思考重申指導意見的方式。

And when we think about reaffirming our guidance, our business has enormous demand for our products. We're maintaining our guidance really just to be prudent about the supply chain situation and other uncertainties relating to the economic conditions we all operate within.

當我們考慮重申我們的指導時，我們的業務對我們的產品有巨大的需求。我們維持我們的指導實際上只是為了對供應鏈狀況以及與我們所處的經濟條件相關的其他不確定性保持謹慎。

Got it. If I can just squeeze on the guidance cadence. Any thoughts on how we should think about Q3 versus Q4 with respect to the guidance?

知道了。如果我能緊跟指導節奏就好了。關於我們應該如何考慮第三季度和第四季度的指導意見，有什麼想法嗎？

Yes. No, happy to answer that. And this year, we actually have a couple less billing days in the third quarter as compared to last year. So that will have a headwind of 300 basis points or so. So we'll have a greater concentration of revenue in the fourth quarter as compared to the third quarter when you look at our previous historical levels. So we expect our third quarter to be the lowest growth quarter of the year because of that factor and then ramping back up again in terms of growth into the fourth quarter.

是的。不，很高興回答這個問題。今年，我們第三季度的計費天數實際上比去年少了幾個。因此，這將帶來 300 個基點左右的阻力。因此，當你查看我們之前的歷史水平時，與第三季度相比，我們第四季度的收入將更加集中。因此，由於這一因素，我們預計第三季度將成為今年增長最低的季度，然後第四季度的增長將再次回升。

The other thing we have this year that in terms of 3Q comparison is last year, we grew 30% in the third quarter. So that's our toughest comp of the year as well. So when you're doing your modeling and thinking about our business, 3Q had some unusual factors that will make the growth level the lowest of the year on a quarterly basis.

今年我們的另一件事是，與去年第三季度相比，我們第三季度增長了 30%。所以這也是我們今年最艱難的比賽。因此，當您進行建模並思考我們的業務時，第三季度有一些不尋常的因素，這些因素將使季度增長水平成為今年的最低水平。

Your next question comes from Mike Matson with Needham & Company.

您的下一個問題來自 Needham & Company 的 Mike Matson。

Yes. Just wondering if you could maybe give us an update on some of your surgeon training in the quarter. I don't know if you're willing to share any numbers or anything like that, but...

是的。只是想知道您是否可以向我們介紹本季度外科醫生培訓的最新情況。我不知道你是否願意分享任何數字或類似的東西，但是......

Yes, Mike, happy to. We continue to have very strong training momentum, training again over 600 surgeons. The mobile lab was really effective for us again, training hundreds of surgeons for us in the second quarter. So we're continuing to touch and train both new surgeons on our products but also importantly, as we've mentioned before, we also train existing surgeons on a lot of our new product offerings. So it's a double benefit for us. And then another benefit as well is just getting to have our sales representatives and other commercial team members also have opportunities to train alongside these surgeons.

是的，邁克，很高興。我們繼續保持非常強勁的培訓勢頭，再次培訓了 600 多名外科醫生。移動實驗室再次對我們非常有效，在第二季度為我們培訓了數百名外科醫生。因此，我們將繼續接觸和培訓新外科醫生使用我們的產品，但同樣重要的是，正如我們之前提到的，我們還對現有外科醫生進行許多新產品的培訓。所以這對我們來說是雙重好處。另一個好處是我們的銷售代表和其他商業團隊成員也有機會與這些外科醫生一起接受培訓。

Okay. And then the international growth was particularly strong this quarter. I mean I know it's a smaller dollar amount, it does kind of [botch out] a little. But I was just wondering, is there something going on there? Or is it just kind of maybe like a more procedural recovery in some of those markets? Or is it just kind of a random thing that happened?

好的。本季度的國際增長尤其強勁。我的意思是我知道這是一個較小的金額，它確實有點[搞砸]。但我只是想知道，那裡發生了什麼事嗎？或者這只是某些市場的更程序性複蘇？或者這只是隨機發生的事情？

We've really been really pleased with the growth in the markets outside the United States. And the teams there have done a nice job of training new surgeons or training existing surgeons on our products. Our medical education programs really have driven a lot of new customers to us. And our existing markets, such as the U.K., they're just absolutely killing it right now. And our Australian market is doing very, very well. And then we have a new market in Spain that is really starting to drive a lot of growth for us. And just really starting to hit across all of our major markets, and we've been doing that. I think we've reported record sequential quarters for the last 8 quarters or so. So -- but 2Q was particularly strong, and it's just I think a lot of the investments we've been making really paying off. And as we move into 3Q, we get a little bit of seasonality coming back. But 2Q, we are very pleased with.

我們對美國以外市場的增長感到非常滿意。那裡的團隊在培訓新外科醫生或現有外科醫生使用我們的產品方面做得很好。我們的醫學教育計劃確實為我們帶來了很多新客戶。而我們現有的市場，比如英國，現在絕對是在扼殺牠。我們的澳大利亞市場表現非常非常好。然後我們在西班牙有了一個新市場，它確實開始為我們帶來大量增長。我們才真正開始衝擊我們所有的主要市場，而且我們一直在這樣做。我認為我們在過去 8 個季度左右的連續季度報告中創下了紀錄。所以，但第二季度特別強勁，我認為我們所做的很多投資確實得到了回報。當我們進入第三季度時，我們會看到一些季節性的回歸。但2Q，我們非常滿意。

And your next question comes from Matthew O'Brien with Piper Sandler.

你的下一個問題來自馬修·奧布萊恩和派珀·桑德勒。

Can we just start again on the U.S. performance and specifically, the supply chain, Albert or Steve. Just was it specifically on the side of things, there are certain components to the set that you weren't getting so you couldn't get sets out the door, especially on the new product side of things? So you still put up really good growth, just more legacy products, but the new products weren't seeing as much traction. And do those cases get delayed into Q3 because they are elective and you start to see the benefits of that? Or are they just kind of lost sales because of the supply chain issue?

我們能否重新開始關注美國的表現，特別是供應鏈，阿爾伯特或史蒂夫。只是在事情方面，有一些你沒有得到的組件，所以你無法把套裝拿出來，特別是在新產品方面？因此，您仍然實現了非常好的增長，只是更多的傳統產品，但新產品並沒有看到那麼大的吸引力。這些案件是否會被推遲到第三季度，因為它們是選擇性的，並且您開始看到這樣做的好處？或者他們只是因為供應鏈問題而導致銷售損失？

Yes, Matt. So as we mentioned, I would say that probably 2/3 of the lost cases or deferred cases in the U.S. were related to products that are sterile packed for us. And I think when you listen to some of the other larger joint orthopedic companies talking about their increases in volumes over the last couple of quarters, most of their products are sterile packed as well. So we've been competing with space on the manufacturing lines with some of these very large hip and knee companies that have had unusual levels of high growth coming out of post-COVID era. And it just happens that a number of our new products that we've launched over the last 24, 36 months are sterile packed.

是的，馬特。正如我們提到的，我想說，在美國，可能有 2/3 的丟失病例或延期病例與為我們無菌包裝的產品有關。我認為，當你聽到其他一些較大的聯合骨科公司談論過去幾個季度銷量的增長時，你會發現他們的大多數產品也是無菌包裝的。因此，我們一直在與一些非常大的髖關節和膝關節公司競爭生產線的空間，這些公司在後新冠時代取得了不同尋常的高增長水平。碰巧的是，我們在過去 24、36 個月內推出的許多新產品都是無菌包裝的。

So that has been a big element of the deferred or loss cases, you might call it. I don't think they're lost, but we certainly maintained relationships with physicians. They get moved out in some cases. We've done a really nice job of maintaining relationships and selling other products to physicians if we may not have a particular product that's sterile packed. So we're looking forward to 3Q and into 4Q. We've started to see improvements in the supply of those products moving forward.

因此，這是延期或損失案件的一個重要因素，你可以稱之為。我不認為他們迷失了，但我們確實與醫生保持著關係。在某些情況下，他們會被搬出去。如果我們沒有無菌包裝的特定產品，我們在維持關係和向醫生銷售其他產品方面做得非常好。所以我們期待第三季度和第四季度。我們已經開始看到這些產品的供應有所改善。

But it's also beyond that, there's an element of just completing kits or waiting on certain components beyond just sterile packed so that we can get the product out into the field for the new reps that we've added and the record number of customers that are using Paragon today.

但還不止於此，除了無菌包裝之外，還有一個要素是完成套件或等待某些組件，以便我們可以將產品送到現場，供我們添加的新代表以及創紀錄的客戶數量使用。今天使用Paragon。

Got it. So I'll ask my second question, it's got two parts to it, but I'll ask them together. So the supply issue, do you think that's largely behind you exiting Q3? Or is it more into '24, you expect to be -- have this largely behind you?

知道了。所以我會問第二個問題，它有兩個部分，但我會一起問。那麼供應問題，您認為這在很大程度上是您退出第三季度的原因嗎？或者是更接近 24 世紀了，你預計這一切已經基本過去了嗎？

And then that extra $2 million investment that you made, I think you said in Q2, just alone, where was that? Was that medical education? Was it more reps, more advertising? Where was that investment? Because I know that's an area that gets pushed back or get some pushback from investors for P28 not spending enough, not being aggressive enough to really to drive the top line more than you already are.

然後，您額外進行的 200 萬美元投資，我想您在第二季度就說過，那是在哪裡？那是醫學教育嗎？是更多的代表、更多的廣告嗎？這筆投資在哪裡？因為我知道這個領域會因為 P28 支出不夠、不夠激進而無法真正推動營收增長而受到推遲或受到投資者的一些抵制。

Yes. Starting with the supply chain. We think by the time we exit this year, we'll be pretty much back in sync with the sterilized product supply. We've seen some relief already on that in 3Q, but we won't be back to normal until likely exiting 4Q, but we will get better over the next 2 quarters.

是的。從供應鏈開始。我們認為，到今年退出時，我們將基本上恢復與滅菌產品供應同步。我們在第三季度已經看到了一些緩解，但直到第四季度結束時我們才會恢復正常，但在接下來的兩個季度我們會變得更好。

So -- but as I mentioned earlier, we have had these headwinds before. We just started to see it peak in the second quarter, and we think it's going to improve. We know it's going to improve from here out based upon the delivery schedules we have commitments for. So that's regarding your supply chain question.

所以——但正如我之前提到的，我們以前也遇到過這些阻力。我們剛剛開始看到它在第二季度達到頂峰，我們認為它會有所改善。我們知道，根據我們承諾的交付時間表，從現在開始，情況將會有所改善。這就是關於你的供應鏈問題。

And then with respect to the investments, there -- you're right, there has been continued investments in medical education and sales force expansion. That's not really what I was referring to in terms of the onetime costs. We made a number of enhancements to our organizational structure, some of our directors and senior directors and vice presidents, bringing in new folks, transitioning out some older folks and really just looking for folks that we believe are going to take us to $500 million plus in revenue in a reasonable period of time.

然後就投資而言，你是對的，在醫學教育和銷售隊伍擴張方面持續進行投資。這並不是我所說的一次性成本。我們對我們的組織結構、我們的一些董事、高級董事和副總裁進行了許多改進，引入了新員工，淘汰了一些老員工，實際上只是在尋找那些我們相信能夠幫助我們實現5 億美元以上目標的員工。在合理的時間內產生收入。

So some headhunter costs, some transition costs. And then we also spent some money to accelerate EU MDR initiatives relating to getting some of our products approved faster for movement into the European Union. So a number of investments that are setting us well for continued growth.

所以一些獵頭成本，一些過渡成本。然後，我們還花費了一些資金來加速歐盟 MDR 計劃，以便更快地批准我們的一些產品進入歐盟。因此，許多投資為我們的持續增長奠定了良好的基礎。

Your next question will come from Neil Chatterji with B. Riley.

您的下一個問題將由 Neil Chatterji 和 B. Riley 提出。

Maybe just on just the sales force. I want to say -- I think you said you were up to 250 producing reps. Just kind of curious, one, just on the productivity kind of ramp benefit kind of in the quarter and then kind of that in the second half. And any plans for further sales force expansion?

也許只是銷售人員。我想說——我想你說過你有多達 250 名生產代表。只是有點好奇，第一，生產率在本季度有所提高，然後在下半年有所提高。有進一步擴大銷售隊伍的計劃嗎？

Yes. And thanks for the question. I'll start off by saying our momentum has been fantastic with building out our sales force really since we've gone public. And I think with the launch of each new piece of technology, we see some excited folks out there. And so it's inspired both surgeons attending medical education, but it's really inspired a lot of great conversations with sales reps that might have some experience. So we continue to have a really good momentum there. And maybe, Steve, do you want to comment a little bit on the productivity?

是的。謝謝你的提問。首先我要說的是，自從我們上市以來，我們在銷售隊伍建設方面的勢頭確實非常強勁。我認為隨著每一項新技術的推出，我們都會看到一些興奮的人。因此，它激勵了兩位參加醫學教育的外科醫生，但它確實激勵了與可能有一些經驗的銷售代表進行很多精彩的對話。因此，我們在那裡繼續保持著良好的勢頭。也許，史蒂夫，你想對生產力發表一些評論嗎？

Yes. No, it's exactly right, and it's the number of reps. We continue to expand. We get a lot of inbound interest, continue to get a lot of inbound interest from very qualified folks who want to carry the Paragon bag. But at the same time, we continue to increase the productivity of our producing reps, which is -- we're particularly proud of that when we're growing the number of reps by 12% during the quarter that we're able to increase productivity as well. Because when you put more reps into the equation that are newer to Paragon 28, it has a natural impact of bringing down the revenue per rep statistics, and we still increased it year-over-year despite adding 12% more reps. So both growth levers are intact and doing really well for us.

是的。不，完全正確，就是重複次數。我們繼續擴張。我們得到了很多入境興趣，繼續從那些想要攜帶 Paragon 包的非常合格的人那裡得到很多入境興趣。但與此同時，我們繼續提高生產代表的生產力，當我們在本季度將代表數量增加 12% 時，我們感到特別自豪生產力也是如此。因為當您將更多的代表放入 Paragon 28 更新的方程中時，它自然會降低每個代表的收入統計數據，儘管增加了 12% 的代表，但我們仍然逐年增加了收入。因此，這兩個增長槓桿都完好無損，並且對我們來說效果非常好。

Great. And just one quick follow-up. So I did notice you had kind of held the AOFAS resident training at your headquarters. Just kind of curious, maybe just more generally, how much of your training is kind of focused on that kind of resident and fellow kind of next generation?

偉大的。只需一個快速跟進。我確實注意到你們在總部舉辦了 AOFAS 駐場培訓。只是有點好奇，也許更一般地說，您的培訓有多少集中在那種居民和下一代的同類身上？

Yes. I would say we were really excited to finally get to support the industry in that way. We've built a pretty amazing facility here for medical education. It's kind of the center of our building, and it's really been one of the key pillars of success for Paragon. And to be able to utilize the facility for AOFAS to use for some of their incoming residents was honestly, it's pretty awesome to see and experience, and we hope to do a lot more of that in the future. I can tell you that supporting people at every stage of their career is really important for us. And I think that's been one of the really nice aspects of having the mobile app, where we can bring this really to their backyard and we can have residents, fellows, attendings. We can have a pretty wide variety of folks come into the mobile app and really tailor their education to whatever it is their interests are. So the mobile app has really facilitated our ability to get to people at all the different stages of their career.

是的。我想說，我們真的很高興終於能夠以這種方式支持這個行業。我們在這裡建造了一個非常令人驚嘆的醫學教育設施。它是我們大樓的中心，也是 Paragon 成功的關鍵支柱之一。老實說，能夠利用 AOFAS 的設施為一些新來的居民使用，看到和體驗到的感覺真是太棒了，我們希望將來能做更多這樣的事情。我可以告訴您，為人們職業生涯的每個階段提供支持對我們來說非常重要。我認為這是擁有移動應用程序的真正好處之一，我們可以將其真正帶到他們的後院，我們可以有居民、研究員、護理人員。我們可以讓各種各樣的人進入移動應用程序，並真正根據他們的興趣定制他們的教育。因此，移動應用程序確實促進了我們接觸處於職業生涯不同階段的人們的能力。

Your next question will come from Dave Turkaly with JMP Securities.

您的下一個問題將由 JMP 證券公司的 Dave Turkaly 提出。

Just a rep question again, I appreciate the year-over-year. Sequentially, I think it's something like 3. And as we look at this year, I was wondering, do you have a plan that you might want to share with us or maybe a number even if it's going to be a little uneven in terms of how they're at it? But where do you think you could take that in 2023?

再次只是一個代表問題，我很欣賞這一年的表現。依次來說，我認為大概是 3。當我們回顧今年時，我想知道，您是否有一個可能想要與我們分享的計劃，或者可能是一個數字，即使它在方面會有點不平衡。他們怎麼樣？但您認為 2023 年您能把它帶到哪裡呢？

In terms of producing reps, Dave? Sorry, you went...

在生產代表方面，戴夫？對不起，你去了...

Sorry, yes. I was talking about the 250 reps from last quarter. I think I had 247, and so I was just trying to get an idea of where that might wind up by the end of the year.

抱歉，是的。我說的是上個季度的 250 次代表。我想我有 247 個，所以我只是想知道到今年年底可能會出現什麼結果。

That's a little less than what we had.

這比我們擁有的要少一點。

We haven't really talked about specifics by quarter or by year, but we have said that we expect that number to double over time. And it won't always be perfectly linear because sometimes, the opportunities don't present themselves that way. As we have the opportunity to add reps, it certainly we take them whenever they come. And from a seasonality perspective, we see a lot more productivity, particularly in the fourth quarter.

我們還沒有真正討論過按季度或按年度的具體情況，但我們已經說過，我們預計這個數字會隨著時間的推移而增加一倍。而且它並不總是完全線性的，因為有時機會並不以這種方式出現。由於我們有機會增加代表，因此我們當然會在他們來的時候接受他們。從季節性角度來看，我們看到生產率提高了很多，特別是在第四季度。

So we would expect that producing rep number to go higher as more of our reps who aren't productive in terms of the definition become producing reps in the fourth quarter. So that number is going to keep growing as we move forward, and we expect it to double over time.

因此，我們預計生產代表數量會更高，因為更多在定義方面效率不高的代表在第四季度成為生產代表。因此，隨著我們的前進，這個數字將繼續增長，並且我們預計它會隨著時間的推移而翻倍。

Got it. And then sort of your enabling technology initiatives. I think you've said that you expected to have pre-op planning tools, commercial sometime in the back half of this year. I'm just curious if there's any update there or anything you'd like to share in those areas.

知道了。然後對您的支持技術計劃進行排序。我想您已經說過，您希望在今年下半年的某個時候擁有術前規劃工具並進行商業化。我只是好奇這些領域是否有任何更新或您想分享的內容。

That was right. We're expecting later this year to have a limited launch of one of the first modules of really what is the Disior introduction. We're pretty excited about that. As we mentioned on previous calls, we've been very effective utilizing that technology in our internal development process. It's really sped up certain aspects of that. So it's been very useful as a tool for us really since day 1, but we are expecting to introduce into the market later this year, early next year, really one of the first modules that I think will give you a great representation of what that tool could mean.

沒錯。我們預計今年晚些時候將限量推出 Disior 介紹的首批模塊之一。我們對此感到非常興奮。正如我們在之前的電話會議中提到的，我們在內部開發過程中非常有效地利用了該技術。它確實加快了某些方面的速度。因此，從第一天起，它作為一個工具對我們來說就非常有用，但我們預計將在今年晚些時候、明年初引入市場，這實際上是第一個模塊，我認為它將為您提供一個很好的展示。工具可能意味著。

And overall, just generally speaking, I think I've said this before, we really feel like SMART 28 initiative could be one of the most significant opportunities to improve outcomes for patients and give surgeons visibility really to the deformity, the planning and even the tracking postoperatively. So we've got a lot of energy around that, and we're still pretty excited about what that could mean.

總的來說，一般來說，我想我之前已經說過了，我們真的覺得SMART 28 計劃可能是改善患者治療效果的最重要機會之一，並使外科醫生能夠真正了解畸形、計劃甚至手術情況。術後追踪。因此，我們對此投入了大量精力，而且我們仍然對這可能意味著什麼感到非常興奮。

Your next question comes from Kyle Rose with Canaccord.

您的下一個問題來自 Canaccord 的 Kyle Rose。

So a lot has been asked, but the one thing I wanted to talk about through the first half of the year is really on the gross margin line. Strong gross margins, particularly when we consider first half '23 relative to the second half '22. And then normally, when we hear things about supply chain challenges and increasing lead times, there's always some sort of increased cost associated with that. So I guess I'm just trying to understand how should we think about gross margins through the first half of the year? Is that how we should really be thinking about them through the second half of the year? Or is there anything that we should be calling out there?

問了很多，但今年上半年我想談的一件事實際上是毛利率。毛利率強勁，尤其是當我們將 23 年上半年與 22 年下半年相比時。通常，當我們聽到有關供應鏈挑戰和交貨時間增加的事情時，總會有某種與之相關的成本增加。所以我想我只是想了解我們應該如何看待上半年的毛利率？這真的是我們下半年應該如何思考的嗎？或者有什麼我們應該在那裡呼籲的嗎？

Kyle, thanks. And one of the things we've been pretty consistent about saying is think about our business as an 80%-plus gross margin business, and we have continued to perform above that, in an 82% to 83% range, which we think really reflects the value of our products and the price that we're getting them for or selling them for and the price we're procuring it for. We haven't seen any significant impact at this point in time in terms of the actual procurement cost year-over-year. Our supply team has done a terrific job of managing that. Where we have some extra costs is just carrying the additional inventory on our balance sheet today. We're buying products that are all valid and good products. We just have more than we normally would have given the longer lead times.

凱爾，謝謝。我們一直非常一致地說的一件事是將我們的業務視為毛利率超過 80% 的業務，並且我們的表現繼續高於該水平，在 82% 到 83% 的範圍內，我們認為這確實反映了我們產品的價值以及我們購買或出售產品的價格以及我們採購產品的價格。目前我們還沒有看到實際採購成本同比受到任何重大影響。我們的供應團隊在管理方面做得非常出色。我們有一些額外成本的地方只是今天我們的資產負債表上有額外的庫存。我們購買的產品都是有效且優質的產品。我們只是擁有比通常情況下更長的交貨時間更多的東西。

So we expect, as we move forward, that we won't -- as these lead times decrease, that we'll be able to work through this inventory and get back to a more normalized level of days of inventory on hand. And then further, as we also complete sets and replenish existing sets and get them back out into the field where we've had back orders, we expect that to drive more revenue. And so it will have the benefit of more revenue in the future as we move forward and complete those sets. And we also expect that inventory balance to come down.

因此，隨著我們的前進，我們預計，隨著交貨時間的縮短，我們將能夠處理掉這些庫存，並恢復到更正常的現有庫存天數水平。此外，由於我們還完成了套件並補充了現有套件，並將它們帶回到我們有延期交貨訂單的領域，我們預計這將帶來更多收入。因此，隨著我們繼續前進並完成這些系列，它將在未來帶來更多收入。我們還預計庫存餘額將會下降。

So 80%, I think, or thereabouts is the right way to model our gross margins. And if we continue to do well on our pricing of our products and manage supply chain to get the products at the right price, we can potentially do better than that like we have the last several quarters.

所以我認為 80% 左右是對毛利率進行建模的正確方法。如果我們繼續在產品定價方面做得很好，並管理供應鏈，以合適的價格提供產品，我們有可能做得比過去幾個季度更好。

Okay. Great. And then just 2 products I'd love to get an update on. You made a big focus on putting out some innovative soft tissue products as well as the total ankle spend a big investment. I just wonder if you could talk about how those are being received by both the growing sales force as well as all of the new physicians you're adding. Just kind of the overall growth there would be helpful.

好的。偉大的。然後只有 2 個我想了解最新情況的產品。你們非常注重推出一些創新的軟組織產品，並且在整個腳踝上花費了大量投資。我只是想知道您是否可以談談不斷增長的銷售隊伍以及您添加的所有新醫生如何接受這些內容。只是整體增長會有幫助。

Yes. Thanks for the question, Kyle. I would tell you, we really -- since honestly, 2020, right around COVID time, we launched a couple of key products really in the ankle arena, whether it's ankle fusion or ankle nail and our ankle fusion plating in addition to our total ankle. We also launched last year a couple of significant products in the Ex Fix category and some of the early products in our soft tissue portfolio. Those are crushing it. The market reception has been pretty awesome. And the complementary effect that have had to our -- the rest of our portfolio has been pretty powerful.

是的。謝謝你的提問，凱爾。我想告訴你，我們真的- 老實說，從2020 年開始，就在新冠疫情期間，我們在腳踝領域推出了幾款真正的關鍵產品，無論是腳踝融合器還是腳踝釘，以及我們的腳踝融合板以及全腳踝。去年，我們還推出了 Ex Fix 類別中的一些重要產品以及我們軟組織產品組合中的一些早期產品。那些正在壓垮它。市場反響非常好。我們的其他投資組合的互補效應非常強大。

So we're seeing a lot of great momentum from those products. It's inspiring a lot of conversation around medical education. So the demand is pretty hot there. And this year, I think we're going to add a couple more soft tissue products that are going to be pretty complementary. We've also launched a couple of key products already this year. So we're really excited not only about what we've launched and the momentum we're seeing those products generate. But in addition to that, our pipeline is as strong as ever. We've got well over 20 projects actively being developed.

因此，我們看到這些產品帶來了巨大的動力。它激發了許多有關醫學教育的討論。所以那裡的需求非常火爆。今年，我認為我們將添加更多的軟組織產品，這些產品將非常互補。今年我們還推出了一些關鍵產品。因此，我們不僅對我們推出的產品以及我們看到這些產品產生的勢頭感到非常興奮。但除此之外，我們的管道一如既往地強大。我們有超過 20 個項目正在積極開發中。

That's kind of the story for P28. It's consistent, consistent moving forward as well. So that's my sweet spot. It gets me excited every day, and I think it's really inspiring us here at Paragon 28 as well.

這就是 P28 的故事。它是一致的，一致的前進。這就是我的最佳點。這讓我每天都感到興奮，我認為這也確實激勵了 Paragon 28 的我們。

And Kyle, it's Steve. I would just add to that, that a number of those products that Albert mentioned, they are sterile packaged. So we would like more of those products to come in to meet the demand that we have. It's intense level of demand for a lot of those products, and we're just working to get more of a sterile packaged goods in faster so we can get it out back into the field.

凱爾，是史蒂夫。我想補充一點，阿爾伯特提到的許多產品都是無菌包裝的。因此，我們希望有更多此類產品進入以滿足我們的需求。對許多此類產品的需求量很大，我們正在努力更快地獲得更多無菌包裝產品，以便我們可以將其帶回現場。

Your next question comes from George Sellers with Stephens Inc.

您的下一個問題來自 Stephens Inc. 的 George Sellers。

And I apologize if I missed that. I've been jumping around between calls a little bit, but -- so I apologize if I'm repeating something that's already been asked. But I wanted to dig in a little bit on the international revenue. This was a really strong quarter for international and relative to our expectations as well. So just curious if you could peel back some layers there and give us some additional color on what was driving the outperformance in international. Any specific devices or subsegments that were really outperforming expectations?

如果我錯過了，我深表歉意。我在兩次通話之間來回切換，但是——所以如果我重複已經被問到的問題，我深表歉意。但我想深入了解一下國際收入。對於國際市場來說，這是一個非常強勁的季度，也相對於我們的預期而言。因此，我很好奇您是否可以剝開一些層，並為我們提供一些額外的信息，以了解推動國際表現出色的因素。有哪些特定設備或細分市場的表現確實超出了預期？

George, it's Steve. I would tell you that I would say it's the culmination of a lot of investments that have been being made over the last 12 to 18 months in some key markets for us, in some key new markets. So I mentioned earlier, our U.K. business, I believe we had a record second quarter in terms of total dollars of revenue. Our Australian foot business performed very well again. And those are 2 markets where we've focused a lot of energy on and in many ways, added a number of new very talented people and augmented the teams.

喬治，是史蒂夫。我想說的是，這是我們過去 12 到 18 個月在一些關鍵市場、一些關鍵新市場進行的大量投資的結晶。所以我之前提到過，我們的英國業務，我相信我們第二季度的總收入創下了紀錄。我們的澳洲足部業務再次表現出色。我們在這兩個市場上投入了大量精力，並通過多種方式增加了一些非常有才華的新人才並擴充了團隊。

We've also -- despite some of the sterile packed problems and challenges that we've been working through the headwinds, we've also been able to get more kits over some of our core legacy products to our international markets, and that's helped. We also have some new markets like Spain that have done really well for us and are really just getting going. So lots of opportunities in the existing big 3, which in addition to Australia and the U.K. includes South Africa, but also some emerging growth drivers in Spain and Germany and Italy. We expect to increasingly contribute more as we move forward.

我們還——儘管我們在逆風中遇到了一些毫無意義的問題和挑戰，但我們也能夠向國際市場提供比我們的一些核心傳統產品更多的套件，這對我們有幫助。我們還有一些新市場，比如西班牙，這些市場對我們來說表現非常好，而且剛剛開始發展。現有的三大經濟體中存在很多機會，除了澳大利亞和英國之外，還包括南非，而且西班牙、德國和意大利也有一些新興的增長動力。我們期望隨著我們的前進，做出更多的貢獻。

Okay. That's really helpful context. And then maybe on the guidance, and again, I apologize if I missed this earlier, but the guidance seems to assume that there's going to be a bit of a slowdown in the second half relative to the first half in terms of growth. I'm just curious what some of the puts and takes there. Is that predominantly seasonality? Or what's sort of going into that?

好的。這確實是很有幫助的背景。然後也許是關於指導，如果我之前錯過了這一點，我再次表示歉意，但指導似乎假設下半年相對於上半年的增長會有所放緩。我只是好奇那裡的一些看跌期權和拿走的是什麼。主要是季節性嗎？或者說這是怎麼回事？

Yes, George, it's a couple of things. You mentioned seasonality. I think this is the first year we've had a normal seasonality. So 2 and 3Q have just generally less procedures as compared to last year when we had higher levels of procedures coming out of an Omicron-impacted first quarter. So that's one element.

是的，喬治，有幾件事。你提到了季節性。我認為這是我們有正常季節性的第一年。因此，與去年相比，第二季度和第三季度的程序普遍較少，去年受 Omicron 影響的第一季度我們的程序水平較高。這就是其中一個要素。

Another element just candidly is our 30% growth quarter last year in the third quarter. That's our toughest comp of the year, 30% growth in 3Q last year. And we also have 2 less billing days in the U.S. this year in the third quarter so -- and a similar number of billing days in the fourth quarter. So you lose a little bit of growth there.

坦率地說，另一個因素是我們去年第三季度增長了 30%。這是我們今年最艱難的業績對比，去年第三季度增長了 30%。今年第三季度美國的計費天數也減少了 2 個，第四季度的計費天數也類似。所以你會失去一點增長。

And then I think we've just continued to be prudent on our guidance for the full year, incorporating uncertainties related to the supply chain issues that we're turning the corner on and started to see improvements in July, but also just the uncertainties in the economic environment in the U.S. and around the world. So that's the thinking on the guidance.

然後我認為我們對全年的指導繼續保持謹慎，考慮到與供應鏈問題相關的不確定性，我們正在扭轉局面，並在7 月份開始看到改善，但也只是考慮到供應鏈問題的不確定性。美國和世界各地的經濟環境。這就是指導意見的想法。

This concludes Paragon 28's Second Quarter 2023 Earnings Call and Q&A. I will now hand the call back over to Albert for closing remarks.

Paragon 28 的 2023 年第二季度收益電話會議和問答到此結束。我現在將把電話轉回阿爾伯特以作結束語。

Thank you again for your time today. We look forward to seeing many of you at future investor and industry conferences, including next week in Boston at the Canaccord Genuity Annual Growth Conference on August 9. Have a great day.

再次感謝您今天抽出時間。我們期待在未來的投資者和行業會議上見到你們，包括下週 8 月 9 日在波士頓舉行的 Canaccord Genuity 年度增長會議。祝您有美好的一天。

This concludes today's conference call. You may now disconnect.

今天的電話會議到此結束。您現在可以斷開連接。