OrthoPediatrics Corp (KIDS) 2023 Q4 法說會逐字稿

Good morning, and welcome to OrthoPediatrics Corporation's Fourth Quarter and Full Year 2023 earnings conference call. (Operator Instructions) As a reminder, this call is being recorded for replay purposes.

早上好，歡迎參加 OrthoPediatrics Corporation 的 2023 年第四季和全年收益電話會議。（操作員說明）謹此提醒，此通話正在錄音以供重播之用。

I would now like to turn the call over to Chip Taylor from the Gilmartin Group for a few enter 3Com's.

我現在想將電話轉給 Gilmartin Group 的 Chip Taylor，以獲取一些進入 3Com 的資訊。

Thank you for joining today's call. With me from the Company are David Bailey, President and Chief Executive Officer; and Fred Hite, Chief Operating and Financial Officer.

感謝您參加今天的電話會議。和我在一起的有公司總裁兼執行長 David Bailey；營運長和財務長 Fred Hite。

Before we begin today, let me remind you that the company's remarks include forward-looking statements within the meaning of the federal securities laws, including the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. And these forward-looking statements are subject to numerous risks and uncertainties and the Company's actual results may differ materially. For a discussion of risk factors, I encourage you to review the company's most recent annual report on Form 10 K, which will be filed with the SEC in the near future.

在今天開始之前，讓我提醒您，該公司的言論包括聯邦證券法含義內的前瞻性陳述，包括 1995 年《私人證券訴訟改革法案》的安全港條款。這些前瞻性陳述面臨眾多風險和不確定性，公司的實際結果可能有重大差異。為了討論風險因素，我鼓勵您查看該公司最新的 10 K 表格年度報告，該報告將在不久的將來向 SEC 提交。

During the call today, management will also discuss certain non-GAAP financial measures, which are supplemental measures of performance. The company believes these measures provide useful information for investors in evaluating its operations period-over-period. Each non-GAAP financial measure referenced on this call. The company has included a reconciliation of the non-GAAP financial measures to the most directly comparable GAAP financial measures in its earnings.

在今天的電話會議上，管理階層還將討論某些非公認會計準則財務指標，這些指標是績效的補充指標。該公司認為，這些措施為投資者評估其同期營運狀況提供了有用的信息。本次電話會議引用的每項非公認會計準則財務指標。該公司已將非公認會計原則財務指標與最直接可比較的公認會計原則財務指標的調節表納入其收益中。

Please note that these non-GAAP financial measures have limitations as analytical tools and should not be considered in isolation or as a substitute for OrthoPediatrics financial results prepared in accordance with GAAP. In addition, the content of this conference call contains time-sensitive information that is accurate only as of the date of this live broadcast. Today, March seventh, 2024. Except as required by law, the Company undertakes no obligation to revise or update any statements to reflect events or circumstances taking place after the date of this call.

請注意，這些非公認會計原則財務指標作為分析工具有其局限性，不應單獨考慮或取代根據公認會計原則編制的骨兒科財務結果。此外，本次電話會議的內容包含時效性訊息，僅截至本次直播之日準確。今天，2024 年 3 月 7 日。除法律要求外，本公司不承擔修改或更新任何聲明以反映本次電話會議之後發生的事件或情況的義務。

With that, I'd like to turn the call over to David Bailey, President and Chief Executive Officer.

接下來，我想將電話轉給總裁兼執行長 David Bailey。

Thanks Tripp. Good morning, everyone, and thank you for joining us on our fourth quarter and full year 2023 conference call. As we start our earnings call, I'd like to begin by highlighting that we helped over 82,000 kids in 2023 a new record for OrthoPediatrics. Since inception, we've helped over 710,000 kids and including Boston O&P, our combined organizations have helped more than 1 million kids. This continues to be the most important metric of success for OrthoPediatrics and each year, we strive to increase our impact and benefit markets.

謝謝特里普。大家早安，感謝您參加我們的 2023 年第四季和全年電話會議。當我們開始財報電話會議時，我首先要強調的是，我們在 2023 年幫助了超過 82,000 名兒童，創下了骨科兒科的新紀錄。自成立以來，我們已幫助了超過 71 萬名兒童，包括 Boston O&P，我們的聯合組織已幫助了超過 100 萬名兒童。這仍然是衡量 OrthoPediatrics 成功的最重要指標，每年我們都努力提高我們的影響力和利益市場。

In line with our pre-announcement from early January for the fourth quarter of 2023, we generated quarterly revenue of $37.6 million, representing growth of 21% compared to the fourth quarter of 2022 for the full year of 2023, we generated record revenue of $148.7 million, representing growth of 22% compared to the full year of 2022, driven by favorable leverage in the cash portion of G&A, disciplined expense management, strong margins and healthy revenue growth. We are excited to report that we outperformed our original adjusted EBITDA expectations, producing a record adjusted EBITDA of $5 million in 2023. In addition, we are thrilled to see our prior acquisitions fully integrated and performing well with robust top line revenue contributions and profitability.

根據我們從1 月初發布的2023 年第四季的預先公告來看，我們的季度營收為3,760 萬美元，與2022 年第四季相比成長了21%。的收入148.7 美元。我們很高興地報告，我們的表現超出了最初的調整後 EBITDA 預期，2023 年調整後 EBITDA 達到創紀錄的 500 萬美元。此外，我們很高興看到我們先前的收購完全整合並表現良好，具有強勁的收入貢獻和盈利能力。

Looking closer at the quarter, revenue and surgery scheduling was strong throughout except during the final two weeks of December when we started to experience lighter surgical volumes due to an uptick in RSV. After RSV rates rose rapidly at the end of December and extended into early January, volumes quickly returned to more normalized levels hospitals appear to be managing their spikes of the respiratory season better and mitigating the impact on case schedules. Altogether, volumes and staffing continued to improve month over month.

仔細觀察本季度，除 12 月最後兩週外，整個季度的收入和手術安排都表現強勁，當時由於 RSV 上升，手術量開始減少。RSV 發病率在 12 月底迅速上升並延續到 1 月初後，數量迅速恢復到更正常的水平，醫院似乎更好地管理了呼吸道季節的高峰，並減輕了對病例安排的影響。總而言之，數量和人員配備逐月持續改善。

And while still not running full tilt, we are encouraged. Recovery in the environment is tracking our expectations for modest sequential improvement. Overall, we feel this headwind is lessening and we will remain cautious until we see further normalization. The diverse nature of our business continued to benefit OrthoPediatrics in the quarter. Global trauma and deformity domestic scoliosis and OPSB. business were very strong offset by lower growth in international scoliosis.

雖然仍未全力以赴，但我們受到了鼓舞。環境的復甦符合我們對適度連續改善的預期。總體而言，我們認為這種阻力正在減弱，我們將保持謹慎，直到看到進一步的正常化。我們業務的多元化性質在本季繼續使骨科受益。全球創傷和畸形國內脊椎側彎和OPSB。業務非常強勁，但被國際脊椎側彎成長放緩所抵消。

Fourth quarter global T&E was very strong at 23%, with growth led by sales of Pega products. Pnp Femur, early sales of PNP tibia and growth within the LPSB. franchise. US Scoliosis revenue bounced back aggressively in the fourth quarter with 35% growth despite a very slow few weeks at the end of December, new scoliosis users continued to increase significantly across the response and EpiFix product lines. Overall, global scoliosis growth was slightly muted by a continuation of slower than expected ordering in our Latin and South American business, resulting in a 31% reduction in OUS scoliosis sales and negatively impacting overall growth.

第四季全球 T&E 成長強勁，達到 23%，其中 Pega 產品銷售帶動了成長。PNP 股骨、PNP 脛骨的早期銷售和 LPSB 內的增長。特許經營權。儘管 12 月底的幾週增長非常緩慢，但第四季度美國脊柱側彎收入大幅反彈，增長了 35%，響應和 EpiFix 產品線的新脊柱側彎用戶繼續顯著增加。總體而言，由於我們的拉丁美洲和南美業務訂單持續慢於預期，全球脊椎側彎成長略有放緩，導致 OUS 脊椎側彎銷售額下降 31%，並對整體成長產生負面影響。

We expect O-US scoliosis to rebound in 2024 and to act as a tailwind for the full year, beginning as early as Q1 with multiple opportunities, including continuing legacy product growth. Several key new organic product launches, Pega sales mix mentioned normalization of international markets positive longer term as fixed data publications, a newly formed and rapidly expanding specialty bracing business, OPSB. and at an early start in digital health care, we are confident in our growth prospects for 2024 and beyond. Importantly, we remain in an extremely secure financial position and are confident that our current balance sheet enables us to execute our long-term strategy without additional equity capital.

我們預計 O-US 脊椎側彎將在 2024 年反彈，並成為全年的推動力，最早從第一季開始，帶來多種機會，包括傳統產品的持續成長。幾個重要的新有機產品發布、Pega 銷售組合提到了國際市場的正常化，從長遠來看，固定數據出版物、新成立且快速擴張的專業支撐業務 OPSB 都是積極的。由於數位醫療保健還處於起步階段，我們對 2024 年及以後的成長前景充滿信心。重要的是，我們仍然保持著極其安全的財務狀況，並且相信我們目前的資產負債表使我們能夠在不增加股本的情況下執行我們的長期策略。

Therefore, we are reiterating our revenue guidance for the full year 2024 of $197 million to $200 million, including Boston LMP historical revenue of $25 million, representing overall growth of 32% to 34%. We are also issuing our full year EBITDA guidance of $8 million to $9 million and our expectation for SET deployments of less than $20 million as we continue to focus on improving profitability and reducing cash usage.

因此，我們重申 2024 年全年營收指引為 1.97 億美元至 2 億美元，其中波士頓 LMP 歷史營收為 2,500 萬美元，整體成長 32% 至 34%。我們還發布了 800 萬至 900 萬美元的全年 EBITDA 指導，並預計 SET 部署將低於 2000 萬美元，因為我們將繼續專注於提高盈利能力和減少現金使用。

We closed 2023 on an extremely high note, we achieved a record number of children helped, record revenue and generated record adjusted EBITDA. We continue to balance top line revenue growth with improved profitability on our way to cash flow breakeven sooner, the trend we expect to carry into 2024.

我們以極高的成績結束了 2023 年，我們幫助的兒童數量創歷史新高，收入創歷史新高，調整後 EBITDA 創歷史新高。我們繼續在收入成長和獲利能力提高之間取得平衡，以更快地實現現金流收支平衡，我們預計這一趨勢將延續到 2024 年。

Moving to our revenue segments in the fourth quarter of 2023, we generated total trauma and deformity revenue of $27.1 million, representing growth of 23% compared to the prior year period. Strong performances from Pega products, trauma, XE6 and OPSB. led revenue growth in the quarter, we saw continued record Pega product performance with substantial growth of 59% in the US and 32% outside of the US sales are going to continue to be better than we ever expected. And as we more deeply penetrate our U.S. accounts with the full Pega product portfolio and ran international sales. We believe Pega growth will continue to be very strong globally in 2024 and beyond.

轉向 2023 年第四季的收入部門，我們的創傷和畸形總收入為 2,710 萬美元，較上年同期成長 23%。Pega 產品、創傷、XE6 和 OPSB 表現強勁。在引領本季營收成長的同時，我們看到 Pega 產品業績持續創紀錄，在美國大幅成長 59%，在美國以外地區成長 32%，銷售額將繼續優於我們的預期。隨著我們透過完整的 Pega 產品組合更深入地滲透我們的美國客戶並進行國際銷售。我們相信，2024 年及以後，Pega 在全球的成長將持續強勁。

Elsewhere in T&D, we continue to take share across our entire T&D portfolio, a trend we expect to maintain for several years. We enjoy a leading share position and then T and D franchise within the U.S. children's hospitals and we plan to continue to execute our market. Dominant strategy was set deployment, new product development and superior service. On the R&D side, we received FDA approval and beta launched the PNP tibia system in Q three and performed more cases than we expected in Q4. Initial surgeries have gone extremely well so far. The surgeon usage rate has been higher than we forecasted which bodes well for our full market launch of the PNP tibia scheduled to start in the first half of 2024.

在輸配電領域的其他領域，我們繼續在整個輸配電產品組合中佔據份額，我們預計這一趨勢將維持數年。我們在美國兒童醫院中享有領先的市場份額以及 T 和 D 特許經營權，我們計劃繼續開拓我們的市場。主導策略是集約部署、新產品開發和優質服務。在研發方面，我們獲得了 FDA 的批准，並在第三季度推出了 PNP 脛骨系統的測試版，並在第四季度執行了比我們預期更多的案例。到目前為止，初步手術進展非常順利。外科醫生的使用率高於我們的預測，這對我們計劃在 2024 年上半年開始全面上市的 PNP 脛骨來說是個好兆頭。

We expect PMP to be that to be an important growth driver in 2024 and for the next several years and expect the full release of the new packet Gyro product to make a positive impact as well, driven by continued execution of our key account conversion strategy. We have seen an increase in the number of customers and the quantity of product use now with more high-technology products coming to the market and a robust pipeline that was strengthened by the Pega acquisition.

我們預計 PMP 將成為 2024 年及未來幾年的重要成長動力，並預計在我們大客戶轉換策略持續執行的推動下，新分組陀螺儀產品的全面發布也將產生積極影響。隨著更多高科技產品進入市場，我們看到客戶數量和產品使用量不斷增加，並且透過收購 Pega 加強了強大的產品線。

Our T&D business is positioned to deliver sustainable growth over the next several years as we execute our long-term strategy to capture greater than 50% market share. We also have several prominent R&D projects in process within the surgical side of the T&B business. We're making great progress on the development of our entirely new pediatric plating platform for P3 project, which we expect will be world-class and spawn further share-taking opportunities for us within our plating franchise.

我們的輸配電業務定位於在未來幾年實現永續成長，因為我們執行長期策略以佔領超過 50% 的市場份額。我們也在 T&B 業務的外科領域開展了幾個著名的研發項目。我們在 P3 項目的全新兒科電鍍平台開發方面取得了巨大進展，我們預計該平台將達到世界一流水平，並為我們在電鍍特許經營範圍內帶來更多的分享機會。

We're also making solid strides on new external fixation devices that will continue the growth trajectory of our export franchise. Further, we expect numerous new EU MDR approved products that we'll be launching in the EU market in the coming year to be impactful. Our OrthoPediatrics nonsurgical specialty bracing business, our OPSB continues to perform extremely well. And I'd like to spend a little more time today outlining this significant opportunity that we have here, we recently announced the official OrthoPediatrics specialty bracing brand, or LPSB, featuring a new website that incorporates the full MDL club foot and Rhino product portfolio, along with several new products as well as the acquisition of Boston O&P.

我們還在新的外部固定裝置方面取得了堅實的進展，這將繼續我們的出口特許經營的成長軌跡。此外，我們預計明年我們將在歐盟市場推出的眾多歐盟 MDR 批准的新產品將產生影響。我們的骨骼兒科非手術專業支架業務 OPSB 繼續表現出色。今天我想花更多時間概述我們在這裡擁有的這一重要機會，我們最近宣布了官方骨骼兒科專業支架品牌(LPSB)，該品牌推出了一個新網站，其中包含完整的MDL 馬蹄足和Rhino產品組合，隨著一些新產品的推出以及對 Boston O&P 的收購。

We believe the OPSV franchise represents a large new source of capital friendly revenue growth. It's estimated that 80% of the pediatric orthopedic care happens before and after surgery. And we're extremely excited to now be better positioned to address this important segment, we estimate the US non-surgical specialty bracing market is at minimum $775 million in total and conservatively $500 million of opportunity in the top 300 children's hospitals. Importantly, these customers at prices do not require the upfront capital investment in consigned inventory or instrument sets. It has always been our aspiration to surround the pediatric orthopedic surgeon with all the products they need to treat children.

我們相信 OPSV 特許經營權代表了資本友善收入成長的一個重要新來源。據估計，80% 的兒科骨科護理發生在手術前後。我們非常高興現在能夠更好地解決這個重要細分市場，我們估計美國非手術專業支架市場總額至少為 7.75 億美元，保守地說，前 300 家兒童醫院的機會為 5 億美元。重要的是，這些客戶不需要在寄售庫存或儀器組上進行前期資本投資。我們一直希望為兒科骨科醫生提供治療兒童所需的所有產品。

And we're thrilled about this opportunity to provide our surgeon customers with more of the products they use to treat their patients every day. Boston orthotics and prosthetics is the only sizable company with an exclusive focus on pediatric orthotics management offering leading custom Bryson orthotics and prosthetics technology for the nonoperative treatment of children whose lives have been impacted by scoliosis play geo supply and various neuromuscular disorders, their portfolio of some of the most advanced individualized braces available to treat pediatric orthopedic conditions includes custom pediatric specific, often bracing for scoliosis, lower limb or ptosis and dynamic movement orthos as DMO as well as the Boston band for play geo separately, partnering with world-class medical facilities, including Boston Children's Hospital, Children's Hospital of Philadelphia and Nationwide Children's Hospital on Columbus, Ohio and Phoenix Children's Hospital, just to name a few.

我們很高興有機會為我們的外科醫生客戶提供更多他們每天用來治療患者的產品。波士頓矯正器和義肢是唯一一家專注於兒科矯正器管理的大型公司，提供領先的客製化Bryson 矯正器和義肢技術，用於對生活受到脊柱側凸、遊戲地理供應和各種神經肌肉疾病影響的兒童進行非手術治療，他們的產品組合包括一些可用於治療兒科骨科疾病的最先進的個人化支架包括定制的兒科專用支架，通常用於脊柱側彎、下肢或上瞼下垂的支架和動態運動矯正器，如DMO 以及波士頓樂隊與世界一流的醫療機構合作的play geo 單獨產品，包括波士頓兒童醫院、費城兒童醫院、俄亥俄州哥倫布市全國兒童醫院以及菲尼克斯兒童醫院等。

Boston O&P maintains 26 patient care clinics, primarily concentrated in the Northeast Boston OMP's annual historical revenue is approximately $25 million. As we mentioned on our previous calls, we continue to successfully execute a build aggressively strategy in OPSB. and anticipate it to grow very rapidly in the coming several years. We see many of the same characteristics in the OPSB. opportunity that we witnessed when we started OP 17 years ago. These include a large $775 million US TAM, $500 million of which is in the top 300 U.S. children's hospitals, very limited competition, a general lack of ongoing innovation and the opportunity to provide elite level of customer service and support clinical education and training.

Boston O&P 擁有 26 家病患照護診所，主要集中在波士頓東北部。正如我們在先前的電話會議中提到的，我們繼續在 OPSB 中成功執行積極建構策略。並預計在未來幾年將快速成長。我們在 OPSB 中看到了許多相同的特徵。 17 年前我們開始 OP 時就見證了這個機會。其中包括 7.75 億美元的美國 TAM，其中 5 億美元來自美國排名前 300 的兒童醫院，競爭非常有限，普遍缺乏持續創新以及提供精英水平的客戶服務和支持臨床教育和培訓的機會。

We also see an opportunity for strong margins, healthy profits and the potential to build a large business in a very capital friendly manner. Beyond all of that, non-surgical specialty bracing fits with our goal of providing our customers with all of the products they need to treat children with orthopedic conditions and building further brand loyalty across our entire surgical and nonsurgical portfolio. We do not plan to just scratched the surface of this segment of the pediatric orthopedic market. And we believe the Boston O&P acquisition makes that it's very clear.

我們還看到了高利潤率、健康利潤的機會以及以非常資本友好的方式建立大型業務的潛力。除此之外，非手術專業支架符合我們的目標，即為客戶提供治療患有骨科疾病的兒童所需的所有產品，並在我們的整個手術和非手術產品組合中進一步建立品牌忠誠度。我們不打算只觸及兒童骨科市場這一細分市場的表面。我們相信波士頓 O&P 的收購讓這一點變得非常清楚。

This is another market dominance play where we plan to be very aggressive and to scale this business rapidly until we are the clear-cut market leader. This has been a historically fragmented market and we are able to leverage our current channel to increase access and most importantly, provide service required to achieve optimal patient outcomes in a way that allows us to increase the partnership with all of our customers. While the integration of Boston OMB will happen throughout 2024, we expect the rest of LPSB. franchise to organically grow aggressively this year once integrated, our strategy to aggressively grow.

這是另一個市場主導地位的遊戲，我們計劃非常積極地並迅速擴大這項業務，直到我們成為明確的市場領導者。這是一個歷史上分散的市場，我們能夠利用我們目前的管道來增加准入，最重要的是，提供實現最佳患者結果所需的服務，使我們能夠加強與所有客戶的合作夥伴關係。雖然波士頓 OMB 的整合將在 2024 年進行，但我們預計 LPSB 的其餘部分將進行整合。一旦整合，特許經營權今年將積極有機成長，這是我們積極成長的策略。

Boston will produce many years of future growth. Our strategy for the OPSB. business is rooted in three core initiatives that we believe will enable OrthoPediatrics to deliver outsized growth. These include sales force expansion to drive adoption and scale usage, product development to build a competitive and comprehensive portfolio and the addition of new clinics to enhance profitability or we're in the early innings of this growth journey. We believe we are well on our way to growing this business to be in excess of $100 million in the coming years.

波士頓將帶來未來多年的成長。我們的 OPSB 策略。業務植根於三項核心舉措，我們相信這些舉措將使 OrthoPediatrics 實現大幅成長。其中包括擴大銷售隊伍以推動採用和規模使用、開發產品以建立有競爭力和全面的產品組合以及增加新診所以提高盈利能力，或者我們正處於這一增長之旅的早期階段。我們相信，我們將在未來幾年內將這項業務發展到超過 1 億美元。

Turning to the first initiative of sales force expansion in anticipation of the Boston O&P acquisition and to support the OPSB. business as a whole we have been preemptively recruiting OPSB. specific sales representatives that will be integrated into our existing agency sales network. We continue to actively recruit and train new associates and so far, we are pleased with the types of people we're attracting with our pre-existing customer relationships. We expect to see rapid organic revenue ramp in each territory where our new OPSB. reps are partnering with our existing surgical sales team.

談到收購 Boston O&P 並支持 OPSB 時的第一個銷售團隊擴張計劃。就整個業務而言，我們一直在搶先招募 OPSB。特定的銷售代表將被整合到我們現有的代理銷售網路中。我們繼續積極招募和培訓新員工，到目前為止，我們對透過現有客戶關係吸引的人員類型感到滿意。我們預計新 OPSB 所在的每個地區的有機收入都會快速成長。代表正在與我們現有的外科銷售團隊合作。

Regarding the second initiative, product development within the MDO. team in Iowa, the OPSB. team in Warsaw and now the Boston L and P team at our OPSB. headquarters in Boston, we are now staffed to deliver our aspiration to launch four to five new products every year, beginning in 2024. This cadence, along with the launch of several products in 2023, such as the MP. Light & P plus the move bar DS. two, the Rhino Cruiser and the oral medical levity device set us up nicely for strong growth. Beyond these product launches and partnerships, there will be several more in the coming months and quarters supporting our thesis that we can build a scaled business in this space in the coming years.

關於第二項舉措，MDO 內的產品開發。愛荷華州的 OPSB 團隊。華沙團隊，現在是我們 OPSB 的波士頓 L 和 P 團隊。我們的總部位於波士頓，現在配備了員工來實現我們的願望，從 2024 年開始，每年推出四到五種新產品。這一節奏以及 2023 年 MP 等多款產品的推出。Light & P 加上移動桿 DS。第二，Rhino Cruiser 和口腔醫療浮動裝置為我們的強勁成長奠定了良好的基礎。除了這些產品發布和合作夥伴關係之外，未來幾個月和幾季還將有更多產品支持我們的論點，即我們可以在未來幾年在這個領域建立規模化的業務。

Looking at the third initiative over the last several years, we have completed multiple acquisitions and partnerships, all of which we have successfully grown and will continue to grow, but never have. We seen such a favorable response for our customers as when we announced our partnership with Boston O&P in early January. This is a true testament to the legacy of amazing service products and patient care that Boston O&P has provided our customers through their 26 clinics, largely in the upper upper New England.

看看過去幾年的第三項舉措，我們已經完成了多次收購和合作，所有這些我們都已經成功發展並將繼續發展，但從未實現過。當我們在一月初宣布與 Boston O&P 建立合作關係時，我們看到了客戶的正面反應。這是 Boston O&P 透過其 26 家診所（主要位於新英格蘭上北部）為客戶提供的令人驚嘆的服務產品和患者護理傳統的真實證明。

Our customers' feedback makes clear their desire to have a true partner in the nonsurgical treatment of their patients and validates the large unmet need in the nonsurgical support of their patients. In addition, it signifies our customer support of our growth strategy to scale Boston O&P to the rest of our 300 children's hospitals around the U.S. and in certain international markets. It will take us a little time, but we feel this is an important first step that will open a larger opportunity for our company.

我們客戶的回饋清楚地表明他們希望在患者的非手術治療中擁有一個真正的合作夥伴，並證實了患者在非手術支持方面存在大量未滿足的需求。此外，這也表明我們的客戶支持我們的成長策略，即將 Boston O&P 擴展到美國各地和某些國際市場的其餘 300 家兒童醫院。這將花費我們一些時間，但我們認為這是重要的第一步，將為我們公司帶來更大的機會。

Importantly, the operating economics for each of our existing clinics and future clinics is favorable for OrthoPediatrics. Generally speaking, we expect modest setup costs with limited initial capital outlay, consisting mainly of leased office space, Limited, build out and staffing orthodontists growing with the scale of the opportunity consistent with Boston LPs historical revenue, we expect each new clinic while the capacity to generate between $1 million and $3 million in revenue and produce a profit rapidly once fully operational. Again, it will take us some time for us to integrate Boston OMP and ramp the strategy, but we are already working to build a large funnel of opportunity and expect this to have a material contribution to revenue growth as early as 2025.

重要的是，我們每個現有診所和未來診所的營運經濟效益對骨兒科都是有利的。一般來說，我們預計初始資本支出有限，設置成本適中，主要包括租賃辦公空間、有限的擴建和配備正畸醫生，機會規模與波士頓有限合夥人的歷史收入一致，我們預計每個新診所的容量都會增加產生 100 萬至 300 萬美元的收入，並在全面運作後迅速產生利潤。同樣，我們需要一些時間來整合波士頓 OMP 並提升策略，但我們已經在努力建立一個巨大的機會漏斗，並預計這最早將在 2025 年對收入成長做出實質貢獻。

Moving to the scoliosis business, in the fourth quarter of 2023, we generated revenue of $9.7 million, representing global growth of 20% compared to the prior year. This global growth was led by an extremely strong domestic performance of 35% growth and muted by a few slower weeks in the back of December due to RSV rates and a slower quarter internationally, fourth quarter international sales declined by 31% and were lighter due to continued shopping ordering patterns from a few large international stocking distributors in Latin and South America. Despite this, we started to see a rebound across the international scoliosis business, and we expect improved international scoliosis in 2024. As we lap these difficult comparables, Latin and South America and ordering improves and new revenue growth opportunities materialize as we launch scoliosis in Europe. We're very proud of the way this business has rebound and have a clear line of sight into continued improvement for the coming year.

轉向脊椎側彎業務，2023 年第四季度，我們營收 970 萬美元，全球較上年增長 20%。全球成長主要由極其強勁的國內業績 35% 的成長帶動，但由於 RSV 率和國際季度放緩，導致 12 月後幾週的成長放緩，第四季國際銷售下降 31%，並且由於繼續從拉丁美洲和南美洲的一些大型國際庫存經銷商購買訂購模式。儘管如此，我們開始看到國際脊椎側彎業務反彈，我們預計國際脊椎側彎業務將在 2024 年得到改善。當我們完成這些困難的可比性時，拉丁美洲和南美的訂單量有所改善，並且隨著我們在歐洲推出脊椎側彎產品，新的收入成長機會成為現實。我們對這項業務的反彈方式感到非常自豪，並對來年的持續改進有著清晰的願景。

A highlight in the quarter is the success of our US scoliosis business, which outpaced a rebounding international business. The fourth quarter saw strong U.S. growth of 35%, driven from more users of response and Apotex and the successful execution of new launches this year. In addition, we're pleased to report that the surgeons from the three largest sites to transition to new practice locations are now settled in and have ramped up to speed starting to perform more cases and returning to more normalized levels. This significant growth in U.S. scoliosis is representative of both the strength of this business and the opportunity we have for the future. We are bullish on 2024 scoliosis growth as we exit 2023 with 25% more total users of response and EpiFix, several new products that were launched in 2023, such as response, cannulated screws and response power, strengthening EpiFix data, a robust pipeline of 70 placements and an improving international outlook.

本季度的一大亮點是我們美國脊椎側彎業務的成功，超過了國際業務的反彈。第四季美國市場成長了 35%，這得益於更多的 response 和 Apotex 用戶以及今年新產品發布的成功執行。此外，我們很高興地報告說，來自三個最大站點的外科醫生現在已經安頓下來，並已加快速度開始執行更多病例並恢復到更正常的水平。美國脊椎側彎的顯著成長既代表了該業務的實力，也代表了我們未來的機會。我們看好2024 年脊椎側彎的成長，因為到2023 年，response 和EpiFix 的總用戶增加了25%，這是2023 年推出的幾款新產品，例如response、空心螺絲和response power，加強了EpiFix 數據，擁有70 種強大的產品線安置和不斷改善的國際視野。

Further, the 2024 of R&D pipeline is rich with extremely novel technologies that solve major unmet needs for our customers, specifically for patients with early onset scoliosis, an area historically, we've never had products. We recently announced the FDA approval and beta launch of our first U.S. product response Ribbon pelvic and expect to have the new verticalized growing Spine System FDA approved in 2024. Beyond that, we'll launch our new rod reduction instrumentation and 24 and 2024 that will support both the Rosemont Spine System and our new Fusion system currently in development.

此外，2024 年的研發管道充滿了極其新穎的技術，可以解決我們客戶未滿足的主要需求，特別是針對早發性脊椎側彎患者，這是我們歷史上從未有過產品的領域。我們最近宣布 FDA 批准並推出我們的第一個美國產品響應 Ribbon 骨盆，並預計新的垂直生長脊柱系統將於 2024 年獲得 FDA 批准。除此之外，我們將在 24 和 2024 年推出新的桿復位儀器，該儀器將支援 Rosemont 脊椎系統和目前正在開發的新 Fusion 系統。

Lastly, we continue progress on the development of our electromechanical growing rod, although its launch will be a few more years. Notably, U.S. surgery scheduling trends strengthened late in Q3 and continued into Q4, but for a few weeks at the end of the year. We expect this strength to continue into 2024 as the elective market normalizes.

最後，我們在機電生長桿的開發方面繼續取得進展，儘管它的推出還需要幾年時間。值得注意的是，美國的手術安排趨勢在第三季末有所加強，並持續到第四季度，但在年底僅持續了幾週。我們預計隨著選修市場的正常化，這種強勁勢頭將持續到 2024 年。

Moving on to international in the fourth quarter of 2023, we generated international revenue of $9.3 million, delivering 13% growth on top of 67% growth in the fourth quarter of 2022. Fourth quarter 2023 growth was led by extremely solid performance with our T&E products, offset by slow scoliosis sales to stocking distributors in South America. We're pleased to see a continuation of the rebound in our international business in the fourth quarter and expect it to continue throughout 2024.

2023 年第四季度，我們的國際營收達到 930 萬美元，在 2022 年第四季成長 67% 的基礎上，成長了 13%。2023 年第四季的成長得益於我們的 T&E 產品極其穩健的業績，但被南美庫存分銷商的脊椎側彎銷售緩慢所抵消。我們很高興看到我們的國際業務在第四季度繼續反彈，並預計這種情況將持續到 2024 年。

International Agency market sales continue to be particularly strong, both in trauma and deformity and scoliosis. Progress in our German direct sales model continues to track favorably and should produce good growth in 2024. We have onboarded several new users and we look forward to increasing penetration in the German market. We expect strong tech and product sales to continue into 2024 and likely 2025 as we deploy inventory and train our sales team despite the scoliosis softness we experienced from Latin and South America. We're making great progress launching scoliosis in Europe. We're performing first surgeries in new markets and with new surgeon customers.

國際代理市場銷售持續特別強勁，無論是在創傷、畸形或脊椎側彎方面。我們的德國直銷模式持續順利進展，並應在 2024 年產生良好的成長。我們已經吸引了一些新用戶，我們期待提高在德國市場的滲透率。儘管我們在拉丁美洲和南美洲經歷了脊椎側彎的問題，但我們預計強勁的技術和產品銷售將持續到 2024 年，並可能持續到 2025 年，因為我們將部署庫存並培訓我們的銷售團隊。我們在歐洲開展脊椎側彎運動方面取得了巨大進展。我們正在新市場和新外科醫生客戶中進行首次手術。

Additionally, we're making good headway in growing Australia and entering New Zealand as we have had added cases and leadership in support of our long-standing agency partner and we are starting cases in Canada following recent approvals and launch. Overall, we've got a really nice setup for our international business, and we believe that 2024 will show great improvement beginning as early as Q1. That brings us to surgeon training and education.

此外，我們在發展澳洲和進入紐西蘭方面取得了良好進展，因為我們已經增加了案例和領導力來支持我們的長期代理合作夥伴，並且在最近獲得批准和啟動後，我們正在加拿大啟動案例。總體而言，我們的國際業務已經有了非常好的設置，我們相信 2024 年最早從第一季開始就會出現巨大的進步。這給我們帶來了外科醫生的培訓和教育。

In Q4, we hosted 98 unique training experiences for over 2,600 health care professionals among these events, our premier sponsorship of the Accurin resident review course, and the annual international Pediatric Orthopedic Society meeting I posed, which takes place in Orlando every December and 2023, we unveiled a new sponsorship level for a Pediatric Orthopedic Society of North America apartments. And I see those as the first ever Emerald level sponsor, our presence in IPOs, this year was marked by multiple hands-on workshops featuring five sessions, including one for our new specialty braking business and the DF. to brace for kids with femur fractures.

在第四季度，我們為2,600 多名醫療保健專業人員舉辦了98 場獨特的培訓體驗，其中包括我們對Accurin 住院醫師審查課程的首要贊助，以及我提出的每年12 月和2023 年在奧蘭多舉行的年度國際兒童骨科協會會議，我們為北美小兒骨科協會公寓推出了新的贊助等級。我認為這些是有史以來第一個翡翠級贊助商，我們今年在IPO 中的表現是舉辦了多個實踐研討會，其中包括五場會議，其中一場是關於我們新的專業煞車業務和DF的。為患有股骨骨折的孩子提供支撐。

Full year 2023 saw record numbers of educational moments for pediatric orthopedic surgeons and other allied health professionals globally, we advanced our partnership with multiple surgical societies, including the European Pediatric Orthopedic Society as well as special spot scoliosis meetings in the UK and Germany, each posting several hundred European surgeons. We conducted a total of 391 learning experiences for our surgeon customers, thus advancing our ongoing commitment to training the next-generation of pediatric orthopedic surgeons and leading innovation in our subspecialty around the world.

2023 年全年，全球兒科整形外科醫生和其他專職醫療專業人員的教育時刻數量創歷史新高，我們推進了與多個外科學會的合作夥伴關係，包括歐洲兒科骨科協會以及在英國和德國舉行的特別現場脊椎側彎會議，每個會議都發布了數百名歐洲外科醫生。我們為外科醫生客戶提供了總共 391 次學習體驗，從而推進了我們對培訓下一代兒科骨科醫生並引領全球專科創新的持續承諾。

Lastly, continued focus on our people is a critical part of our competitive advantage, which is why it's so important that we recently announced for the eighth time OrthoPediatrics was named as one of the best places to work in the state of Indiana, and we are committed to fostering a culture that is positive, engaging and allows our associates to do their best work. This important culture allows us to further our mission and successfully help more kids all over the world.

最後，持續關注我們的員工是我們競爭優勢的關鍵部分，這就是為什麼我們最近第八次宣布 OrthoPediatrics 被評為印第安納州最佳工作場所之一如此重要，而且我們致力於培育一種積極、有吸引力的文化，讓我們的員工能夠盡最大努力工作。這種重要的文化使我們能夠進一步推進我們的使命，並成功地幫助世界各地更多的孩子。

With that, I'd like to turn the call over to Fred to provide more detail on our financial results. Fred?

因此，我想將電話轉給 Fred，以提供有關我們財務業績的更多詳細資訊。弗雷德？

Thanks, Dave, our fourth quarter 2023 worldwide revenue of $37.6 million increased 21% compared to the fourth quarter of 2022. Growth in the quarter was driven primarily by the strong performance across global trauma and deformity domestic scoliosis and the OPSB. US revenue of $28.3 million a 24% increase from the fourth quarter of 2022. Growth in the quarter was primarily driven by our Trauma and Deformity product lines, scoliosis and OPSB.

謝謝戴夫，我們 2023 年第四季的全球營收為 3,760 萬美元，比 2022 年第四季成長了 21%。本季的成長主要得益於全球創傷和畸形、國內脊椎側彎和 OPSB 的強勁表​​現。美國營收為 2,830 萬美元，較 2022 年第四季成長 24%。本季的成長主要是由我們的創傷和畸形產品線、脊椎側彎和 OPSB 所推動的。

We generated total international revenue of $9.3 million, representing growth of 13% compared to the fourth quarter of 2022, which grew by 67%. Growth in the quarter was primarily driven by trauma and deformity, offset by lower scoliosis sales to stocking distributors in South America. In the fourth quarter of 2023, trauma and deformity global revenue of $27.1 million increased 23% compared to the prior year period. Growth in the quarter was driven primarily by share gain across our entire portfolio with strong contributions from Pega products, trauma experts and OPSB.

我們的國際總營收為 930 萬美元，比 2022 年第四季成長 67%，成長 13%。本季的成長主要是由創傷和畸形推動的，但被南美洲庫存分銷商的脊柱側彎銷售下降所抵消。2023年第四季，創傷和畸形全球收入為2,710萬美元，較上年同期成長23%。本季度的成長主要是由我們整個產品組合的份額成長推動的，其中 Pega 產品、創傷專家和 OPSB 做出了巨大貢獻。

In the fourth quarter of 2023, Scoliosis revenue of $9.7 million increased 20% compared to the prior year period. Growth was primarily driven by increased US growth of 35%, partially offset by canceled cases in late December from RSV and lower than expected orders in Latin and South America.

2023 年第四季度，脊椎側彎收入為 970 萬美元，比去年同期成長 20%。成長主要受到美國 35% 成長的推動，但部分被 RSV 12 月底取消的訂單以及拉丁美洲和南美訂單低於預期所抵消。

Finally, sports medicine other revenue in the fourth quarter of 2023 was $0.9 million compared to $0.9 million in the prior year period.

最後，2023 年第四季運動醫學其他收入為 90 萬美元，而去年同期為 90 萬美元。

Turning to set deployment, $5.9 million of sets were consigned in the fourth quarter of 2023 compared to $6.3 million in the fourth quarter of 2022. For the full year of 2023, we deployed $22.0 million compared to $20.1 million in 2022. The increase was driven by significant new product development deployments, SIGNIFICANT Pega deployments as well as multiple consigned 70 units.

在設備部署方面，2023 年第四季交付的設備價值為 590 萬美元，而 2022 年第四季為 630 萬美元。2023 年全年，我們部署了 2,200 萬美元，而 2022 年為 2,010 萬美元。這一成長是由重要的新產品開發部署、重要的 Pega 部署以及多個委託的 70 台設備所推動的。

Touching briefly on a few key metrics for the fourth quarter of 2023 gross profit margin was 71.0% compared to 68.5% for the fourth quarter of 2022. The slight increase in gross profit margin was driven primarily by lower set sales to international stocking distributors.

簡單談談幾個關鍵指標，2023 年第四季的毛利率為 71.0%，而 2022 年第四季為 68.5%。毛利率小幅成長主要是由於國際庫存分銷商的套裝銷售下降。

Total operating expenses increased $5.2 million or 18% to $34.8 million in the fourth quarter of 2023. The increase was mainly driven by increased volume related commissions as well as incremental personnel required to support the growth in the Company. Sales and marketing expenses increased $1.5 million or 14% to $12.4 million in the fourth quarter of 2023. The increase was primarily driven by increased sales, commission expenses.

2023 年第四季總營運費用增加 520 萬美元，或 18%，達到 3,480 萬美元。這一增長主要是由於與交易量相關的佣金增加以及支持公司成長所需的人員增加所致。2023 年第四季銷售和行銷費用增加 150 萬美元，成長 14%，達到 1,240 萬美元。這一增長主要是由銷售額和佣金費用的增加所推動的。

General and administrative expenses increased $3.0 million or 18% to $19.6 million in the fourth quarter of 2023. The increase was driven primarily by the addition of personnel and resources to support the continued expansion of the business and an increase in depreciation and amortization expense.

2023 年第四季一般及管理費用增加 300 萬美元，或 18%，達到 1,960 萬美元。這一增長主要是由於支持業務持續擴張而增加的人員和資源以及折舊和攤銷費用的增加所致。

Research and development expenses increased $0.7 million or 35% to $2.7 million in the fourth quarter of 2023, driven by additional resources as well as increased payments to third party providers. Total other income was $1.2 million for the fourth quarter of 2023 compared to $0.4 million for the same period last year. Adjusted EBITDA was $1.3 million in the fourth quarter of 2023. This compares to a loss of $2.2 million in the fourth quarter of 2022. This increase was driven by incremental revenue combined with cost controls across the organization.

受額外資源以及向第三方提供者付款增加的推動，2023 年第四季的研發費用增加了 70 萬美元，即 35%，達到 270 萬美元。2023 年第四季的其他收入總額為 120 萬美元，而去年同期為 40 萬美元。2023 年第四季調整後 EBITDA 為 130 萬美元。相比之下，2022 年第四季虧損 220 萬美元。這一成長是由收入增量和整個組織的成本控制所推動的。

Net loss for the full year of 2023 was $21.0 million compared to a net income of $1.3 million last year. Fair value adjustment of contingent consideration for the total year 2023 was a favorable $3 million compared to a favorable $26 million in 2022. Adjusted EBITDA for the full year of 2023 was $5.0 million compared to $0.2 million for the full year of 2022.

2023 年全年淨虧損為 2,100 萬美元，而去年的淨收入為 130 萬美元。2023 年全年或有對價的公允價值調整為有利的 300 萬美元，而 2022 年為有利的 2600 萬美元。2023 年全年調整後 EBITDA 為 500 萬美元，而 2022 年全年調整後 EBITDA 為 20 萬美元。

We ended the fourth quarter with $82.3 million in cash, short-term investments and restricted cash. As of December 31, 2023, $10.0 million had been drawn on our new term loan with MidCap post-closing, the Boston O&P acquisition in January of 2024, our cash and restricted cash balance was approximately $60 million.

截至第四季末，我們擁有 8,230 萬美元的現金、短期投資和限制性現金。截至 2023 年 12 月 31 日，我們已從 MidCap 的新定期貸款（2024 年 1 月收購 Boston O&P）中提取了 1000 萬美元，我們的現金和限制性現金餘額約為 6000 萬美元。

With our current cash position as well as our new debt facility. We are well capitalized to continue to execute on our strategy. Given our strong balance sheet, positive adjusted EBITDA, our line of sight to cash flow breakeven and our recent acquisitions, we are in a position of tremendous strength.

憑藉我們目前的現金狀況以及新的債務融資。我們資本充足，可以繼續執行我們的策略。鑑於我們強勁的資產負債表、正調整後的 EBITDA、我們對現金流盈虧平衡的視野以及我們最近的收購，我們處於巨大的優勢地位。

Turning to guidance, we are reiterating our expectation for full year 2020 for revenue to be in the range of $197 million to $200 million, representing year-over-year growth of 32% to 34%. Additionally, we now expect to generate between $8.0 million to $9.0 million of adjusted EBITDA in 2024. We expect less than $20 million of new set deployed in 2024, representing our continued focus on driving the business to cash flow breakeven sooner rather than later.

在指導方面，我們重申對 2020 年全年營收的預期為 1.97 億美元至 2 億美元，年增 32% 至 34%。此外，我們現在預計 2024 年調整後 EBITDA 將達到 800 萬至 900 萬美元。我們預計 2024 年部署的新設備數量將少於 2,000 萬美元，這表明我們將繼續致力於推動業務早日實現現金流收支平衡。

Lastly, our S-3 shelf registration filed in 2020 was fully sold in 2022 and keeping up with good corporate housekeeping, we will likely establish another universal shelf in 2024. As discussed previously, we have no need or plans to raise capital in the near term, but we believe maintaining shelf is consistent with good corporate practices.

最後，我們在 2020 年提交的 S-3 貨架註冊已於 2022 年全部售出，並保持良好的企業內務管理，我們可能會在 2024 年建立另一個通用貨架。正如前面所討論的，我們沒有必要或計劃在短期內籌集資金，但我們相信維持貨架符合良好的企業實踐。

I'll now turn the call back over to Dave for closing remarks.

現在我將把電話轉回給戴夫，讓他作結束語。

Things, Fred, as we look back on 2023, we're proud of all that we've achieved and are confident that we have the right growth drivers in place for continued success in 2024, we expect positive trends in the business to continue, including robust top line revenue growth and continued profitability growth as we move toward cash flow breakeven earlier than anticipated.

Fred，當我們回顧 2023 年時，我們對所取得的一切成就感到自豪，並相信我們擁有正確的成長動力，可以在 2024 年繼續取得成功，我們預計業務的積極趨勢將持續下去，包括強勁的營收成長和持續的獲利成長，因為我們比預期更早實現現金流收支平衡。

In addition, in 2023, we launched eight new cross including RESPONSE power scoliosis, the Gyro growth modulation system, Pediatric Nailing Platform, tibial system, the DF. to brace mutual funds, 30 plus bar and the levity device. We continue to expect strong performance from our legacy products as a result of our heavy investment in S.E.T. deployments in 2022 and 2023.

此外，2023年，我們推出了RESPONSE動力脊椎側彎、陀螺生長調節系統、小兒釘平台、脛骨系統、DF等八款新產品。支持共同基金、30 加欄和槓桿裝置。由於我們對 S.E.T. 的大量投資，我們仍然預計我們的傳統產品將表現強勁。 2022 年和 2023 年部署。

However, our recent acquisitions, along with Apotex and Orthex and our most recent organic product launches such as PNP Femur, tibia, drive rail and DEF to require less capital deployment to drive growth due to a faster return on invested capital. This combined with the launch and the growth of the OPSB. franchise, ensure we can maintain our high rate of growth are using less cash for inventory deployment thus ensuring we drive to cash flow breakeven much sooner than earlier anticipated.

然而，我們最近的收購以及 Apotex 和 Orthex 以及我們最近推出的 PNP 股骨、脛骨、傳動軌和 DEF 等有機產品，由於投資資本回報更快，需要更少的資本部署來推動成長。這與 OPSB 的推出和發展相結合。特許經營權，確保我們能夠保持高成長率，使用更少的現金進行庫存部署，從而確保我們比之前預期更快地實現現金流收支平衡。

All of our long-term plans, including profitability growth, are supported by our robust balance sheet, strong cash position and access to debt. I've been with OP for nearly 17 years now, and I'm not sure I've ever been more excited. We are in an extremely strong position with all the tools in place to help more children than ever before. And I think our customers feel the same way together our OP associates, our customers and our shareholders are building something special and that is having a profound impact on the lives of children. The future is bright for OrthoPediatrics, and we are just getting started.

我們所有的長期計劃，包括獲利能力成長，都得到我們穩健的資產負債表、強勁的現金狀況和債務管道的支持。我在 OP 工作已近 17 年了，我不確定自己是否曾經如此興奮過。我們處於極其有利的地位，所有工具都已到位，可以幫助比以往更多的兒童。我認為我們的客戶也有同樣的感受，我們的 OP 員工、客戶和股東正在共同打造一些特別的東西，並對兒童的生活產生深遠的影響。骨兒科的未來是光明的，而我們才剛開始。

In closing, I'd like to thank our search partners my o associates, our investors and all the innovators in pediatric health care for standing together to help kids.

最後，我要感謝我們的搜尋合作夥伴、我的同事、我們的投資者以及兒科醫療保健領域的所有創新者，感謝你們共同努力幫助孩子們。

Operator, let's open the call for Q&A.

接線員，讓我們開始問答通話。

Matthew O'Brien, Piper Sandler.

馬修·奧布萊恩，派珀·桑德勒。

Morning. Can you hear me?

早晨。你聽得到我嗎？

Yes, excellent. So just maybe starting obviously with the Boston O&P commentary, first of all, and so it's going to be a multipart. Is that going to split out separately spread? You're saying this morning clearly, you know, you're not going to need additional capital because you have plenty of funding for that and to build out these facilities, I don't think they're that expensive.

是的，非常好。所以，首先，可能首先從波士頓 O&P 的評論開始，所以這將是一個多部分的內容。那是不是要分開分開傳播呢？你今天早上明確表示，你知道，你不需要額外的資金，因為你有足夠的資金來建造這些設施，我認為它們不會那麼昂貴。

And then how do we model this growth going forward off of this base that you have today as you're adding new clinics across the US?

那麼，當你們在美國各地增加新診所時，我們如何在現有的基礎上對這種增長進行建模？

Yes. So good questions. Boston is approximately 30% scoliosis bracing, custom braces and the other 70% is deformity correction. And so that's how the sales will show up in those two segments going forward.

是的。這麼好的問題。波士頓約 30% 是脊椎側彎支架、訂製支架，另外 70% 是畸形矯正。這就是未來這兩個細分市場的銷售情況。

The business has a different seasonality than our typical business they don't have the big summer selling season. The way we do it in our scoliosis in the formative Correction business and their fourth quarter is a few points a few percentage points higher than the other quarters. And typically their first quarter is a few percentage points lower. The middle quarters are roughly 25% of the year.

業務的季節性與我們典型的業務不同，他們沒有夏季銷售旺季。我們在脊椎側彎形成矯正業務和第四季的做法比其他季度高了幾個百分點。通常他們的第一季會下降幾個百分點。中間季度約佔全年的 25%。

The growth of this business. Obviously, we're still working on that for 2025, but we would expect this to grow faster than the overall business. And as the sales force becomes effective as new products are introduced and we are looking to open new clinics starting next year. That does take some time to get the hospital to approve it to find the facility to get the OBVIOUSLY specialists trained in the pediatric space. But overall, I would say that this segment is going to grow much faster than the overall business for the next several years.

這項業務的成長。顯然，我們仍在努力實現 2025 年的目標，但我們預計其成長速度將快於整體業務的成長速度。隨著新產品的推出，銷售團隊變得高效，我們希望從明年開始開設新診所。確實需要一些時間才能讓醫院批准它找到設施來讓顯然的專家接受兒科領域的培訓。但總的來說，我想說，未來幾年該細分市場的成長速度將遠遠快於整體業務。

Yeah. Matt. And I think what we're trying to signal here is the clinic side kind of as I walk through the three-point strategy, we expect no question as we add sales reps and we've already done that. We expect the sales of the OPSB. franchise, which is still inclusive, obviously of MD, orthopedics and Rhino and Aura and the organic products that we launched last year, DF2 and the new stuff we're going to launch this year. We would expect that business to continue to grow well in excess of 20%. That's kind of what we've what it's done ever since we acquired MDO. and then started adding products to that. I think what we're saying here is it's going to take a little bit of time on the clinic side, obviously to get that side of the Boston business ramp. But we're definitely expecting growth in the rest of the business again as we've seen for the last couple of years.

是的。馬特。我認為我們在這裡試圖發出的信號是診所方面的信號，當我介紹三點策略時，我們預計在我們增加銷售代表時不會有任何問題，而且我們已經做到了這一點。我們預計 OPSB 的銷量。特許經營權，顯然仍然具有包容性，包括醫學博士、骨科、Rhino 和 Aura 以及我們去年推出的有機產品、DF2 以及我們今年將推出的新產品。我們預計該業務將繼續成長超過 20%。這就是我們收購 MDO 以來所做的事情。然後開始在其中添加產品。我認為我們在這裡所說的是，在診所方面需要一些時間，顯然是為了獲得波士頓業務的成長。但正如我們過去幾年所看到的那樣，我們肯定預計其他業務將再次成長。

Okay. And just on the on the upfront cost side, can you just comment a little bit there? And then I'll just ask my second question here. Just expectations for EpiFix this year and is that going to start to be a bigger contributor? Or is it more still the kind of 25 Yes.

好的。在前期成本方面，您能稍微評論一下嗎？然後我會在這裡問第二個問題。只是對今年 EpiFix 的期望，這會開始成為更大的貢獻者嗎？或者說還是25是的那種。

I think our view our view on Apple fixes, the data continues to get stronger. There's no question. And as the data gets stronger, we expect this to continue to go up and to the right. I think we we've kind of come off this position that there's going to be some quarter or some specific moment where it's this watershed a moment where every surgeon agrees that this is the right treatment. But there's no question that the entire on non-fusion segment of pediatric spine is super interesting. It's still embryonic. It's still generally growing a lot of questions. We think we're answering those questions with the data, and that would generally we expect EpiFix to continue to outpace the growth of our fusion business and that's kind of how we're modeling it for 2024 and specifically on the cost.

我認為我們對蘋果的看法已經修正，數據繼續變得更強。毫無疑問。隨著數據變得更強，我們預計這一數字將繼續上升並向右。我認為我們已經擺脫了這樣的立場，即將在某個季度或某個特定時刻，這是一個分水嶺，每個外科醫生都同意這是正確的治療方法。但毫無疑問，兒科脊椎的整個非融合部分非常有趣。它仍處於萌芽階段。總的來說，仍然存在很多問題。我們認為我們正在用數據回答這些問題，通常我們預計 EpiFix 將繼續超過我們融合業務的成長，這就是我們為 2024 年建模的方式，特別是在成本方面。

So today, Boston, at 26 clinics, they're all leased facilities. So really the cost, if we were to open a new facility is minimal upfront. It's just building out of the space, hiring and training on the actual clinicians and then hiring more clinicians as the volume ramp. So I don't know million dollars, I would say Max to open one of these, maybe less. And then the revenue starts coming in pretty quick because we're not going to open one unless we have commitments from the surgeons at the hospitals that obviously they're going to be used in the clinic.

所以今天，波士頓有 26 家診所，它們都是租賃設施。因此，如果我們要開設新工廠，前期成本確實是最低的。它只是在空間之外進行建設，僱用和培訓實際的臨床醫生，然後隨著數量的增加僱用更多的臨床醫生。所以我不知道一百萬美元，我會說麥克斯開其中一個，也許更少。然後收入很快就開始增加，因為除非我們得到醫院外科醫生的承諾，顯然它們將在診所中使用，否則我們不會開設一家診所。

Got it. Very helpful. Thank you so much.

知道了。很有幫助。太感謝了。

Thanks, Matt.

謝謝，馬特。

Rick Wise, Stifel.

瑞克懷斯，史蒂菲爾。

I'm sorry, there was a glitch here on the mine.

抱歉，礦井故障了。

Thank you. The start of a big picture question, if I'm hearing you correctly, it sounds like a lot of the headwinds that you've experienced over the last year or so. Our either going away or gone away are sort of resolved on the staffing front on the RFP front on a variety of things. And so I mean, that sounds very encouraging.

謝謝。這是一個大問題的開始，如果我沒聽錯的話，聽起來你在過去一年左右經歷了很多逆風。我們要么離開，要么離開，在 RFP 方面的人員配備方面已經解決了很多問題。所以我的意思是，這聽起來非常令人鼓舞。

But I think that we are yet another quarter into this improvement, and I think we're seeing that improvement here in Q1 as well. And so yes, I think what we have said for a while here is we think that this is probably something that's behind us, let's say, by midyear we're a little cautious just because we recognize the June, July, August. These are obviously are big months on the surgical side. So until we see that and June, July and August I don't know that we're going to declare victory, but it's certainly encouraging that we're seeing this come through. It's also encouraging that as the business further diversifies on the specialty bracing side that a lot of the headwinds that we saw in the in the OR setting, we don't see on the specialty bracing side. And so as that big business becomes bigger It enables us to kind of mitigate some of the risks associated with the environmental, the environmental risks that we saw over the last few years. And I think that's also encouraging us that overall, the business should be less affected by those types of environmental abnormalities that we've experienced over the last few years.

但我認為我們已經進入了這項改進的另一個季度，我認為我們在第一季也看到了這種改進。所以，是的，我想我們在這裡所說的一段時間是，我們認為這可能是我們身後的事情，比方說，到年中我們會有點謹慎，只是因為我們認識到六月、七月、八月。這顯然是外科手術方面的重要月份。因此，在我們看到這一點以及六月、七月和八月之前，我不知道我們是否會宣布勝利，但我們看到這一切的實現無疑令人鼓舞。同樣令人鼓舞的是，隨著業務在專業支撐方面進一步多元化，我們在手術室環境中看到的許多逆風，我們在專業支撐方面沒有看到。因此，隨著大企業變得更大，它使我們能夠減輕與環境相關的一些風險，即我們在過去幾年中看到的環境風險。我認為這也鼓勵我們，總體而言，業務應該較少受到過去幾年我們經歷的那些類型的環境異常的影響。

Got you. And Fred, did you help us think through the quarterly setup for the year, it went by quickly. I wasn't sure if you I thought at one point maybe was relative to a product and not overall, I think you were talking about maybe sequentially better first quarter revenues overall, but help us level set the right place to start thinking about the first quarter and especially given the Boston O&P mix in there now. And thank you for the specific guidance that you gave about it in terms of their quarters. But how should we think about the flow of quote the new on the pediatrics quarterly flow overall for the '24 year? Thank you.

明白你了。弗雷德，你有沒有幫助我們思考今年的季度設置，一切都過得很快。我不確定你是否認為在某一點上可能與產品有關，而不是與整體有關，我認為你在談論第一季度總體收入可能會連續好轉，但請幫助我們設定正確的位置來開始考慮第一個季度季度，特別是考慮到波士頓 O&P 組合現在在那裡。感謝您就他們的宿舍給予的具體指導。但我們應該如何看待 24 年兒科季度流量的新報價流量？謝謝。

Yes, absolutely. So traditionally, the pre COVID, in particular, because the last several years have been so unusual the first quarter is typically around five or 6% lower than the fourth quarter. And so if you think about the of the legacy business and those factors, the first quarter revenue would come down. However, with the addition of Boston that is going to generate a first quarter revenue number that are actually higher that then the fourth quarter and I would bet or I would assume that it's probably in that $41.5 million to $42 million range.

是的，一點沒錯。傳統上，特別是在新冠疫情爆發之前，因為過去幾年的情況非常不尋常，第一季的房價通常比第四季低 5% 或 6% 左右。因此，如果考慮到遺留業務和這些因素，第一季的收入將會下降。然而，隨著波士頓的加入，第一季的收入數字實際上會高於第四季度，我打賭或假設它可能在 4,150 萬美元到 4,200 萬美元的範圍內。

So definitely a nice increase over the third quarter -- over the fourth quarter, [37.6]

因此，與第三季相比，與第四季相比，絕對是一個不錯的成長，[37.6]

Growth and some of the past have you broken the overall Company quarters by as a percentage of sales. So you're guiding us to that $197 million to $200 million range. How would you frame the as a percentage of sales in rough terms the flow of the quarters as you contemplate 2024?

成長和過去的一些情況已經打破了公司整體季度銷售額的百分比。所以你引導我們達到 1.97 億美元到 2 億美元的範圍。在您考慮 2024 年時，您將如何粗略地描述季度流量佔銷售額的百分比？

Yes, I mean Boston is still right, $25 million out of $200 million. So it's not going to have a dramatic 1st year impact on changing the overall metrics of the third quarter, we still would anticipate is by far the largest and followed by the second quarter and then the fourth quarter and the first quarter obviously be the smallest number. So I think it's going to be pretty similar, honestly, to historical with a slight change with Boston, but not not much.

是的，我的意思是波士頓仍然是對的，2 億美元中的 2500 萬美元。因此，這不會對第三季度總體指標的變化產生巨大的第一年影響，我們仍然預計是迄今為止最大的，其次是第二季度，然後第四季度和第一季度顯然是最小的數字。因此，老實說，我認為這將與歷史非常相似，只是與波士頓略有不同，但變化不大。

I'm going to squeeze in one more if you don't mind, I know you don't guide to gross margins, but if I'm hearing you correctly, Boston is going to be above average. Also, you've got new products launching. You've got on recovery. A variety of other things. Help us understand a little more clearly, the again, the cadence and how we should be thinking about gross margin in '24 and put that in perspective relative to the as always, seasonally slow of fourth quarter performance, given the mix of business typically? Thank you.

如果你不介意的話，我會再擠進去一個，我知道你不會指導毛利率，但如果我沒聽錯的話，波士頓將高於平均水平。此外，您也推出了新產品。你已經康復了。還有各種各樣的其他事情。幫助我們更清楚地了解一下，節奏，以及我們應該如何考慮 24 年的毛利率，並考慮到通常的業務組合，相對於一如既往的季節性緩慢的第四季度業績？謝謝。

Yes, absolutely. So on the fourth quarter of 2023 gross margin at 71%, obviously lower than the third quarter, which is always our highest revenue and highest gross margin quarter. And the 71% was an improvement year over year versus the 68.5 we saw in the fourth quarter previously. And so the gross margin in 2024, I would expect to continue to follow the sales. So it's going to be highest in the third quarter, a little lower in the second quarter, come down again in the fourth quarter and a little softer in the first quarter. I think overall, the business was under 75% in 2023, and we would expect to see a similar type of result between 74.5%, 75% for 2024.

是的，一點沒錯。所以2023年第四季的毛利率為71%，明顯低於第三季度，而第三季一直是我們營收最高、毛利率最高的季度。與我們之前第四季看到的 68.5 相比，71% 年比有所改善。因此，我預計 2024 年的毛利率將繼續跟隨銷售額的變化。因此，第三季將達到最高，第二季會稍低，第四季再次下降，第一季會稍軟。我認為總體而言，2023 年該業務的成長率低於 75%，我們預計 2024 年將在 74.5% 至 75% 之間看到類似的結果。

The Boston business, gross margin, it's good. If you think about it, it's really two businesses in one cell manufacturing business. And so we get the manufacturing margin from their products they manufacture and it's a retail business in the clinics. So we're getting the retail pricing and the margins associated with that. And so overall, very strong US similar gross margins to our overall business. But historically, they've had very little sales commissions, if you will. So the contribution margin from that business is very strong, better than our legacy business and even adding some sales force into that to grow higher revenue, the contribution margin is still very strong in that business, which is very attractive, obviously, to the bottom line for us.

波士頓業務的毛利率還不錯。如果你仔細想想，這實際上是一項電池製造業務中的兩項業務。因此，我們從他們製造的產品中獲得製造利潤，這是診所的零售業務。所以我們得到了零售價格和與之相關的利潤。整體而言，美國的毛利率與我們的整體業務相似，非常強勁。但從歷史上看，如果你願意的話，他們的銷售佣金很少。因此，該業務的邊際貢獻非常強勁，比我們的傳統業務更好，甚至增加一些銷售人員以增加更高的收入，該業務的邊際貢獻仍然非常強勁，這顯然對底部非常有吸引力為我們排隊。

That's wonderful perspective. Thanks for all the color.

這是一個很棒的視角。感謝所有的顏色。

Thank you.

謝謝。

Thanks, Rick.

謝謝，瑞克。

Ryan Zimmerman, BTIG.

瑞安·齊默爾曼，BTIG。

Good morning. Thanks for taking the questions. I wanted to follow up a couple of questions for me. A lot of a lot already been asked in the past known piece just first of Dave, the last few weeks to the summer. Any any quantification there to think about and that impact on the flows and potentially the first quarter as it was?

早安.感謝您提出問題。我想為我跟進幾個問題。在戴夫的第一篇已知文章中，也就是夏天的最後幾週，已經問了很多很多問題。是否有任何量化需要考慮，以及對流量和第一季可能產生的影響？

Okay, yes, good question. So I guess what I would say is that we were we were really really doing well throughout the entirety of the quarter, and we saw that kind of a screeching halt in the last two weeks. Last two weeks are traditionally two of the largest weeks for us. These are weeks when kids are out of school. And so it was a pretty steep drop off and kind of and all of a sudden and it did extend into the early part of January. And so, you know, maybe, Ryan, it's a couple of points, probably of total top line revenue growth for us. And it was a bit bit unfortunate, but not a lot we can do about it. What we did see though in the quarter. So is this quarter now is that obviously after with the hospital systems were hit, seems like handling that much better, particularly on the elective surgical side and seen a really nice rebound in Q1. It seems like cases that were scheduled are starting to get put back on and get done. And so I think that's why you hear fairly bullish commentary about the way the hospitals are handling the situation, how rapidly it went up, affected us and came back down here in the first quarter and things seems to be really normal going forward.

好吧，是的，好問題。所以我想我想說的是，我們在整個季度都表現得非常好，但在過去兩週我們看到了這種急煞車。過去兩週傳統上是我們最重要的兩週。這是孩子失學的幾週。所以這是一個相當陡峭的下降，有點突然，而且確實延續到了一月初。所以，瑞安，你知道，這可能是我們總收入成長的幾個點。這有點不幸，但我們對此無能為力。我們在本季確實看到了什麼。現在這個季度也是如此，顯然在醫院系統受到打擊之後，似乎處理得更好，特別是在選擇性手術方面，並且在第一季度看到了非常好的反彈。似乎預定的案件開始重新開始並完成。所以我認為這就是為什麼你會聽到關於醫院處理這種情況的方式相當樂觀的評論，它上升的速度有多快，影響了我們，並在第一季度又回到了這裡，而且未來的情況似乎真的很正常。

Okay. That's helpful. And then just you're going to build out like more of OPSB. sales force. We already started doing that when I think about kind of all the head NFTs that are dedicated to Ortho. I'm just kind of wondering if you could kind of size and scale what that is relative to the existing sales force as your distributors and dedicated sales agents kind of ramp up?

好的。這很有幫助。然後你就可以像 OPSB 一樣進行建置。銷售隊伍。當我想到所有致力於 Ortho 的頭部 NFT 時，我們已經開始這樣做了。我只是想知道，隨著您的經銷商和專門的銷售代理商的增加，您是否可以確定相對於現有銷售隊伍的規模和規模？

Sure. Good question. So we've already factored some of those heads and obviously, we started some of the hiring here in Q4 and early in Q1. So just to be clear, the expense associated with that is captured in our guide of the $8 million to $9 million in EBITDA and I think orders of magnitude you might expect over the year for us to add or have or have maybe 20 people or so in the US that are focusing more heavily or exclusively on the OPSB. side of the business.

當然。好問題。因此，我們已經考慮了其中一些負責人，顯然，我們在第四季和第一季初就開始了一些招募。因此，需要明確的是，與此相關的費用已在我們 800 萬至 900 萬美元 EBITDA 的指南中得到體現，我認為您可能期望我們在這一年中增加或擁有 20 名左右的員工在美國，他們更重視或專門關注OPSB。業務的一面。

And obviously, that's up from zero this time last year. So we that's why we're pretty bullish about it, that sales force has capacity to help us drive revenue with the MO. products and Rhino and our and all the of VF to all the things that we've come out with in the last year. But if you remember that these people aren't spending time standing in the operating room, right? And so it doesn't take as many people to cover the geographies that we want to cover. We also have obviously, really strong relationships with our surgeons in the operating room.

顯然，去年這個時候這個數字是零。這就是為什麼我們非常看好它，銷​​售人員有能力幫助我們透過 MO 增加收入。產品和 Rhino 以及我們的所有 VF 以及我們去年推出的所有產品。但如果你還記得這些人並沒有花時間站在手術室裡，對嗎？因此，不需要那麼多人來涵蓋我們想要涵蓋的地區。顯然，我們與手術室的外科醫師也有著非常牢固的關係。

And when you partner these OPSB. salesforce with our existing sales force and our existing sales force so far has been really great about receiving these people in and working as a team. We just think the combination of of the great people we have in the field already in the 200 plus strong OR based sales reps that we have combined with 20 or so of these more clinical-based sales reps is a real tonic for us us to grow. And Ryan, over the course of the next several years, we'll see maybe that sales force grows out of larger, but we're not committing that at this point.

當您與這些 OPSB 合作時。 salesforce 與我們現有的銷售團隊以及我們現有的銷售團隊到目前為止在接納這些人員並作為一個團隊工作方面確實非常出色。我們只是認為，我們已經在該領域擁有 200 多名強大的 OR 銷售代表，再加上 20 名左右這些更多基於臨床的銷售代表，這對我們的成長來說是真正的補品。瑞安，在接下來的幾年裡，我們可能會看到銷售團隊不斷壯大，但目前我們還沒有做出承諾。

Okay. Just real quick one quick modeling question for Fred. You already gave the split between Kali and deformity correction on the Boston on PBS and it's all U.S. based though.

好的。弗雷德的一個快速建模問題非常快。您已經在 PBS 的波士頓節目中對 Kali 和畸形矯正進行了區分，但這都是美國的。

Fred, I mean, is there any international revenue there is just from a modeling, make sure.

弗雷德，我的意思是，是否有任何國際收入僅來自建模，請確保。

Yes, a great question. We haven't clarified that. It is 100% domestic as of today, but that in '25, '26, '27 Up may be an opportunity for us to enhance the growth of that business as well.

是的，一個很好的問題。我們還沒有澄清這一點。截至目前，它已 100% 國內化，但在 25 年、26 年、27 年，這可能也是我們促進該業務成長的機會。

Okay. Thank you, guys. That's it for me of it.

好的。感謝你們。對我來說就是這樣。

Thanks.

謝謝。

Mike Matson, Needham & Co.

麥克‧馬特森，李約瑟公司

Hey, guys. This is Joseph on for Mike. It just so you guys have a lot of growth prospects moving for international expansion, Pega X6, ramping new product launches. But I guess the comments today if you know, it seems like OrthoPediatrics has shifted its strategy to favoring maybe growth and profitability or profitability over growth. So I guess maybe could you just give you a little bit more color a little bit more of your thoughts on maybe the shift in the strategy and why that good moving forward?

大家好。這是麥克的約瑟夫。這只是為了讓你們有很大的成長前景，進行國際擴張，Pega X6，增加新產品的發布。但我想如果你知道的話，今天的評論似乎是 OrthoPediatrics 已經將其戰略轉變為有利於增長和盈利能力，或者盈利能力超過增長。所以我想也許你可以給你多一點色彩，多一點你對策略轉變的想法，以及為什麼要向前邁進？

Yeah, Joe. So I don't think I would characterize our strategy as a focus of profit over growth. We are we're heads down focusing on growth and but also recognizing that balancing growth with profitability with the aspiration to get to cash flow breakeven is probably a more prudent or rational course, particularly in the current financial environment. And so this is not a new I guess I don't view this as a new thing for us this over the last three years has been our aspiration to continue to focus more heavily on top line revenue growth.

是的，喬。因此，我認為我不會將我們的策略描述為注重利潤而非成長。我們正專注於成長，但也認識到，平衡成長與獲利能力以及實現現金流收支平衡的願望可能是一個更加謹慎或理性的做法，特別是在當前的金融環境下。因此，這並不是什麼新鮮事，我想我不認為這對我們來說是新鮮事，在過去三年裡，我們一直渴望繼續更加關注收入成長。

And I think that was one of the reasons why we were we're excited about the OPSV. side and all the product launches going on on the legacy side and all the assets that we've deployed over the last two years. And we think all of those are going to generate really nice growth for the business for the next several years. But we also think that the growth is going to come be more profitable growth and the cash usage associated with that is going to be lower, which is kind of what we've been trying to get to over the course of the last three years, and I think we're well positioned to do it. So we still see this as a young, aggressive top-line growth strategy.

我認為這就是我們對 OPSV 感到興奮的原因之一。方面以及遺留方面正在進行的所有產品發布以及我們在過去兩年中部署的所有資產。我們認為所有這些都將為未來幾年的業務帶來非常好的成長。但我們也認為成長將是更有利可圖的成長，與之相關的現金使用量將會更低，這正是我們在過去三年中一直努力實現的目標，我認為我們有能力做到這一點。因此，我們仍然認為這是一項年輕、積極的營收成長策略。

There's no question about that. We just think that it's a bit unique in that this is like an aggressive top-line growth strategy that's also going to be profitable and it generate its own cash and I think that's pretty unique right now in the marketplace.

毫無疑問。我們只是認為它有點獨特，因為這就像一個積極的營收成長策略，它也會獲利並產生自己的現金，我認為這在目前的市場上是相當獨特的。

Okay. Yes, that's super helpful. Maybe just touch on that a little bit more. We estimate your organic growth to be mid 10s or so for the last two years. But do you think you can maybe get back to the 20%, what's number or do you think mid 10s is more of a real expert realistic expectation for organic growth moving forward?

好的。是的，這非常有幫助。也許再稍微談談這一點。我們估計過去兩年您的有機成長約為 10 左右。但你認為你可以回到 20%，這個數字是多少，還是你認為 10% 更能代表專家對未來有機成長的現實預期？

Yes. So obviously, the guide implies mid 10s. And I think, you know, we everything we're doing here internally and the setup, particularly on the LPSB. and the legacy product launch is pointing us towards driving top-line revenue growth in excess of mid 10s. But yes, I think as we model as we guide, we're not going to get ahead of ourselves here. And so that's what you see in the guide. But you can rest assured that our team is aligned around a growth rate that's in excess of 20%. Now obviously, with the acquisition, it's in excess of 30 for 2024.

是的。很明顯，該指南暗示了 10 左右。我想，你知道，我們在內部所做的一切和設置，特別是在 LPSB 上。傳統產品的推出預示著我們將推動營收成長超過 10 %。但是，是的，我認為當我們按照指導進行建模時，我們不會在這裡超前。這就是您在指南中看到的內容。但您可以放心，我們的團隊會以超過 20% 的成長率為目標。現在顯然，透過收購，到 2024 年這一數字將超過 30 個。

So we're putting the drivers in place and I think, again, one IOPSB. side or PoC, trying to put a driver in place that we have really low share, really good competitive opportunities here and a really big TAM for us. And we see that as a catalyst to hopefully get to where we're at. We're achieving higher in the upper 10s or maybe bridging back over the 20s. And yes, that's a real feat when you're a business that's much larger now and in the future than we have been when we were consistently grow in 2022%. It's our aspiration to continue to do that or we're just not going to guide to that at this stage.

因此，我們正在將驅動程式安裝到位，我再次認為是 IOPSB。側面或 PoC，試圖將一個驅動因素放在適當的位置，我們的份額非常低，這裡有很好的競爭機會，並且對我們來說有一個非常大的 TAM。我們認為這是一種催化劑，有希望達到我們現在的目標。我們在 10 多歲的範圍內取得了更高的成績，或者可能在 20 多歲的範圍內取得了進步。是的，當您的企業現在和未來的規模比我們在 2022% 持續成長時要大得多時，這確實是一項壯舉。我們希望繼續這樣做，否則現階段我們不會引導這樣做。

Okay. Makes sense. Thanks very much for taking the questions.

好的。說得通。非常感謝您提出問題。

Thanks.

謝謝。

Dave Turkaly, Citizen's JMP.

Dave Turkaly，公民 JMP。

Hey, good morning, guys. How liquid You announced the BOP deal, the $22 million upfront. I was just curious if you might comment on any on milestones or sales-related targets. Is that the all in price or is there additional payments?

嘿，早上好，夥計們。流動性如何 你宣布了 BOP 交易，預付款為 2200 萬美元。我只是好奇您是否可以對里程碑或銷售相關目標發表評論。這是總價還是需要額外付款？

Yes, that is the all in right, there are no contingent additional pain fabric and frequency of use and the sales base debit.

是的，這就是全部權利，沒有任何額外的痛苦面料和使用頻率以及銷售基礎借方。

So again, thanks for all the detail on the business to follow up on I think it was Ryan's question about the scope of the business, the RSV., the impact maybe be in a couple of points. And when you look at the lower sales to stocking distributors in South America and maybe the lower than expected orders in Latin and South America. I mean, is that another point? Or I guess I'm trying to quantify that you grew 20% in squalene. You had kind of three things you called out. I don't know. Maybe it's even more than a couple of points.

再次感謝您提供有關業務的所有詳細信息，我認為這是 Ryan 關於業務範圍、RSV 的問題。當你看到南美洲庫存分銷商的銷售額下降以及拉丁美洲和南美洲的訂單可能低於預期。我的意思是，這是另一點嗎？或者我想我正在嘗試量化你的角鯊烯含量增加了 20%。你提到了三件事。我不知道。也許這不僅僅是幾個點。

Yes, certainly the situation that we've had in the last few quarters in Latin America, a fairly unexpected ocean, and it had a pretty a pretty big impact. It was a pretty big headwind on the scope of growth overall and on the Company's growth overall, and it's disappointing to see. But I think at this stage, we feel good about that being behind us and them and being able to diversify our scoliosis business now that we're in markets like Canada and the rest of Europe, again, that's small segment right now, but it's going to grow and it's going to be all peer growth for us in 2024 because it essentially gross up a zero base. And so yes, I think that's behind us. I don't know if we call it a couple of points on we were yes, we haven't really quantified it, but we don't expect it to continue. And I have pretty good line of sight into that as we head into this now, as we're in 2024, we expect that to be a tailwind for our business, not a headwind.

是的，當然是過去幾季我們在拉丁美洲所遇到的情況，這是一個相當出乎意料的海洋，它產生了相當大的影響。這對整體成長範圍和公司整體成長來說是一個相當大的阻力，令人失望。但我認為在現階段，我們對我們和他們的支持感到高興，並且能夠使我們的脊椎側彎業務多樣化，因為我們進入了加拿大和歐洲其他地區等市場，再說一遍，目前這只是一小部分，但它是到 2024 年，我們的成長將全部是同業成長，因為它基本上是零基數。是的，我認為這已經過去了。我不知道我們是否稱之為幾點，我們是的，我們還沒有真正量化它，但我們不希望它繼續下去。當我們現在進入 2024 年時，我對此有很好的看法，我們預計這將成為我們業務的順風，而不是逆風。

And just one last one if I could, the OB. and P., you mentioned gross margin. I think you said the profile's pretty similar, but it operating margin wise. I'm just curious if that's higher than sort of where you stand today. And I know the EBITDA guide of eight to nine was higher than the Street seven, I think. And some of that's coming from that acquisition but any comments sort of on the bottom line contribution? Is that scale? Thanks.

如果可以的話，就說最後一位，OB。 P.，你提到了毛利率。我想你說的情況非常相似，但它的營業利潤率是明智的。我只是好奇這是否比你今天的立場還要高。我知道八到九的 EBITDA 指南高於七街，我認為。其中一些來自那次收購，但對底線貢獻有什麼評論嗎？是這個規模嗎？謝謝。

Yes, absolutely. So very similar to MDO when we bought it, this business of Boston is profitable. It's positive adjusted EBITDA and positive net income, positive cash flow. And however, however, historically hadn't been growing tremendously fast. And so we will be investing a little bit of money into that business, obviously the sales force. But yes, you are correct in assuming that that business is more profitable than others, then our overall business was in 2023. That is correct. And we would expect that to continue going forward.

是的，一點沒錯。所以和我們買的MDO很相似，波士頓的這個業務是獲利的。調整後的 EBITDA 為正，淨利為正，現金流為正。然而，從歷史上看，成長速度並不快。因此，我們將向該業務（顯然是銷售團隊）投資一點錢。但是，是的，你假設該業務比其他業務更有利可圖，那麼我們的整體業務是在 2023 年，這是正確的。那是對的。我們預計這種情況將持續下去。

Great. Thank you.

偉大的。謝謝。

Thank you.

謝謝。

Sam Brodovsky, Truist Securities.

薩姆·布羅多夫斯基 (Sam Brodovsky)，Truist 證券公司。

Hey, good morning, guys. Thanks for taking my question. One more on Boston to start off, I think you'd mentioned a $1 million to $3 million revenue number per clinic and 26 clinics implies a pretty nice opportunity to ramp revenue there or going to or without adding new clinics as well, something we should think about being able to achieve quickly sort of after the integration is completed? Or is that going to be a steady ramp over time as new product?

嘿，早上好，夥計們。感謝您提出我的問題。再從波士頓開始，我想你提到了每個診所100 萬至300 萬美元的收入數字，26 家診所意味著一個很好的機會來增加那裡的收入，或者也可以增加或不增加新診所，這是我們應該做的想一想整合完成後能夠快速實現排序嗎？或者說，隨著時間的推移，新產品的銷售量會穩定上升嗎？

Yes, that's a good question. So it definitely is an opportunity for us to drive the efficiency of the existing clinics and that kind of flow of patients through the existing clinics as well as the products used at the existing clinics with the added sales channel. It's not something we've modeled aggressively yet because it's so new. But I do think you're right, it's probably probably an opportunity there. And part of the reason that that is such is that these clinics are primarily surrounded around Boston around Philadelphia, kind of upper Northeast, which are major major population centers as well as major hospitals that are using Boston's products.

是的，這是一個好問題。因此，這對我們來說絕對是一個機會，可以提高現有診所的效率、現有診所的患者流量以及現有診所使用的產品以及增加的銷售管道。這還不是我們積極建模的東西，因為它太新了。但我確實認為你是對的，這可能是一個機會。造成這種情況的部分原因是，這些診所主要圍繞著費城周圍的波士頓周圍，即東北部北部，是主要的人口中心以及使用波士頓產品的主要醫院。

And so it takes a few maybe more clinics in those areas where patients are coming from longer distance because of their catchment. And so maybe some of those clients are doing a little less than they would if there were fewer, it is our intent to consolidate, but it is our intent to drive more volume through the existing. So that is a possibility. But I also think you've got this right though, when you think about our capacity over the course of the next several years, and our intent is to scale this to every major Children's Hospital jurisdiction in the United States and then some internationally.

因此，在那些患者來自較遠距離的地區，由於其聚集地，需要更多的診所。因此，也許其中一些客戶做得比他們做得更少時要少一些，我們的目的是進行整合，但我們的目的是透過現有的業務來推動更多的業務量。所以這是有可能的。但我也認為，當你考慮我們在未來幾年的能力時，你是對的，我們的目的是將其擴展到美國的每個主要兒童醫院轄區，然後是國際上的一些兒童醫院。

And when you start thinking about those 26 clinics, we think they're serving, give or take 15 children's hospitals right now. I mean, think about the math there is a really big opportunity for us to too, to scale this into the other 285 children's hospitals that aren't active users or don't have active Boston clinics in their area. So yes, that's obviously why we're one of the reasons why we think we should be pretty excited about the opportunity here.

當你開始考慮這 26 家診所時，我們認為他們現在正在為 15 家兒童醫院提供服務、提供或接管。我的意思是，想想數學，我們也有一個非常大的機會，可以擴展到其他 285 家非活躍用戶或在其所在地區沒有活躍的波士頓診所的兒童醫院。所以，是的，這顯然就是我們認為我們應該對這裡的機會感到非常興奮的原因之一。

Great, thanks. And then just switching to guidance, can you just remind us what's factored in in terms of sort of respiratory illness season? As I know I think coming into 23 infected in a pretty worst case scenario. Is that how we should be thinking about it this year? And then just philosophically, it's a pretty pretty tight range, especially given the given the acquisition coming into revenue, just how do you settle out of the range and we think about that?

萬分感謝。然後轉向指導，您能否提醒我們呼吸道疾病季節的影響因素是什麼？據我所知，我認為感染人數達到 23 人是最糟糕的情況。今年我們該這樣思考嗎？從哲學上講，這是一個相當狹窄的範圍，特別是考慮到收購將帶來收入，那麼你如何擺脫這個範圍，我們會考慮這一點？

Yes. So similar to last year, 2024 guidance assumes that we will see a similar RSV. environment in the fourth quarter of 2024 that we saw in 2023. So we're not assuming that it goes away. We're not assuming it's worse. And as far as the guidance goes, it's a tight range and we have a pretty good line of sight on the core business as well as Boston coming into this, and it is kind of what it is, I guess. So I don't have any philosophy of why it's as tight as this, but we're pretty confident in in those numbers.

是的。與去年類似，2024 年指導假設我們將看到類似的 RSV。我們在 2023 年看到的 2024 年第四季的環境。所以我們並不假設它會消失。我們並不認為情況會更糟。就指導而言，這是一個狹窄的範圍，我們對核心業務以及波士頓進入這一領域有很好的視野，我想這就是它的本質。所以我不知道為什麼會這麼嚴格，但我們對這些數字非常有信心。

Thanks for taking my questions.

感謝您回答我的問題。

Thanks.

謝謝。

And thank you.

謝謝你。

There are no further questions. I'd like to turn the call back over to David Bailey or any closing remarks.

沒有其他問題了。我想將電話轉回給大衛貝利或做結束語。

Thanks, operated. Well, I appreciate you all joining us today on the call today's call a little bit longer, just wanting to make sure that we can fully explain the Boston acquisition and the opportunity we have on OPSB. combined with everything else that's going on. So thanks for your time today and look forward to seeing you all at meetings in the next several months. Have a great day.

謝謝，已操作。好吧，我感謝大家今天加入我們的電話會議，今天的電話會議時間稍微長一點，只是想確保我們能夠充分解釋波士頓的收購以及我們在 OPSB 上擁有的機會。與正在發生的其他一切結合。感謝您今天抽出寶貴的時間，並期待在接下來幾個月的會議上見到大家。祝你有美好的一天。

Thank you for your participation. This does conclude the program. You may now disconnect. Good day.

感謝您的參與。這確實結束了該程式。您現在可以斷開連線。再會。