Smith & Nephew PLC (SNN) 2026 Q2 法說會逐字稿

Good morning, everyone. Welcome to the Smith & Nephew Q2 and half one results presentation. I'm Deepak Nath, I'm the Chief Executive Officer; and joined by John Rogers, who's our CFO.

各位早安。歡迎參加 Smith & Nephew 2026 年第二季及上半年業績簡報。我是 Deepak Nath，執行長；與我一同出席的是我們的財務長 John Rogers。

So this quarter, we delivered underlying revenue growth of 1.6%, which was lower than expected. Sports Medicine & ENT performed strongly once again, with consistent delivery across regions and categories, and we saw double-digit growth from many of our key products. However, this was offset by softness in US Orthopaedics and in Advanced Wound Bioactives.

本季我們的基本營收成長為 1.6%，低於預期。運動醫學與耳鼻喉（Sports Medicine & ENT）再次表現強勁，在各地區與各品類均穩定交付，我們多項關鍵產品也呈現兩位數成長。然而，美國骨科與先進傷口生物活性（Advanced Wound Bioactives）的疲弱表現抵銷了上述成長。

In US Orthopaedics, knees remain weak, reflecting similar dynamics to Q1, although we saw a sequential improvement as expected. And we do anticipate further improvement through the remainder of the year. US hips were affected by a delay in CATALYSTEM deployment at a tough comparator, with growth expected to resume as deployment increases during the balance of the year.

在美國骨科方面，膝關節仍然疲弱，反映與第一季相似的動態，不過如預期我們看到環比改善。我們也預期在今年剩餘期間將進一步改善。美國髖關節受到 CATALYSTEM 部署延遲以及高基期影響；隨著今年其餘期間部署增加，預期成長將恢復。

Within Bioactives, SANTYL growth was primarily impacted by strong distributor demand in the prior quarter, which did not repeat. This should normalize over the balance of the year. Despite the slower start on revenue, trading profit was strong at $566 million.

在生物活性（Bioactives）方面，SANTYL 的成長主要受到前一季經銷商需求強勁的影響，而本季未再重現。這在今年其餘期間應會回歸正常。儘管營收起步較慢，交易利潤（trading profit）仍然強勁，達 5.66 億美元。

Excluding M&A, trading profit grew by 9%, supported by stronger-than-expected efficiency savings and tariff refunds that fully offset the forecast tariff headwinds.

排除併購（M&A）影響後，交易利潤成長 9%，主要受惠於高於預期的效率節省，以及關稅退稅，完全抵銷了原先預估的關稅逆風。

Now taking into account revenue performance, we now expect underlying revenue growth of around 4% for 2026.

綜合考量營收表現後，我們目前預期 2026 年基本營收成長約為 4%。

We recognize that Orthopaedics is not where we would want it to be, but we remain focused on delivering better performance as we strengthen the portfolio and build on the margin progress that we have made. We have clear growth drivers across all three business units that support our outlook for the remainder of the year. And importantly, despite the revised revenue outlook, we still expect to deliver our original guidance for profit, trading profit, free cash flow and ROIC.

我們理解骨科表現未達我們期望，但我們仍專注於在強化產品組合的同時，交付更佳表現，並延續我們已取得的毛利率進展。在三個事業單位中，我們都有明確的成長驅動因素，支持我們對今年剩餘期間的展望。更重要的是，儘管我們下修營收展望，我們仍預期可達成原先對利潤、交易利潤、自由現金流與投資資本報酬率（ROIC）的指引。

This includes an additional $50 million in efficiency savings that we identified for 2026, taking our total expected savings from $150 million to $200 million, and a broadly neutral impact from tariffs, net of refunds. The changes that we implemented in our 12-point plan have made the group more resilient and better able to respond to these challenges.

其中包括我們為 2026 年額外辨識出的 5,000 萬美元效率節省，使預期總節省由 1.5 億美元提高至 2 億美元；以及關稅在扣除退稅後整體影響大致中性。我們在 12 點計畫中所推動的變革，使集團更具韌性，也更能因應這些挑戰。

So with that, I'll hand over to John to take you through the financial performance, and I'll come back pretty soon. John?

接下來我把時間交給 John，帶各位回顧財務表現，我很快會再回來。John？

Thank you, Deepak.

謝謝你，Deepak。

Revenue for the quarter was $1.6 billion, representing plus 1.6% underlying growth and 2.8% reported, including 120 basis points tailwind from foreign exchange. Geographically, the US declined by 1.3%, reflecting softer performance in Orthopaedics and Advanced Wound Bioactives.

本季營收為 16 億美元，基本成長 +1.6%，報告成長 2.8%，其中外匯帶來 120 個基點的順風。以地區來看，美國下滑 1.3%，反映骨科與先進傷口生物活性表現較弱。

Other Established Markets grew by 1.7%, with performance led by Canada, on Australia and New Zealand, continuing the good momentum seen in the first quarter. Emerging markets grew 10.6%. Excluding China, group growth was 1.4% on an underlying basis, and we continue to expect China to be broadly neutral to growth for the full year.

其他成熟市場成長 1.7%，表現由加拿大、澳洲與紐西蘭帶動，延續第一季的良好動能。新興市場成長 10.6%。若排除中國，集團基本成長為 1.4%；我們仍預期中國對全年成長的影響大致中性。

Let me now take you through the business units in more detail. I'll start with Sports Medicine & ENT, which had another excellent quarter and grew 8.6%.

接下來我將更詳細說明各事業單位表現。先從運動醫學與耳鼻喉（Sports Medicine & ENT）開始，本季再度表現出色，成長 8.6%。

Within Sports Medicine, the underlying growth drivers remain unchanged, reflecting the continued momentum of our key growth platforms and consistency of performance across the portfolio. Growth was broad-based across regions and joint repair, again, delivered double-digit growth supported by strong demand for Q-FIX KNOTLESS and REGENETEN.

在運動醫學方面，基本成長驅動因素維持不變，反映我們關鍵成長平台的持續動能，以及產品組合表現的一致性。成長在各地區皆為廣泛分布；關節修復再次交出兩位數成長，主要受 Q-FIX KNOTLESS 與 REGENETEN 強勁需求帶動。

In ENT, FASTSEAL and services continue to be the main contributors to growth. In China, after intentionally restricting inventory in the channel at the end of last year and ahead of the implementation of VBP, we saw strong demand for our products during the quarter. We continue to expect VBP to be implemented in the second half.

在耳鼻喉（ENT）方面，FASTSEAL 與服務仍是成長的主要貢獻者。在中國，因我們在去年底並在 VBP 實施前刻意限制通路庫存，本季我們看到產品需求強勁。我們仍預期 VBP 將於下半年實施。

Sports Medicine revenue again exceeded our Recon and Robotics revenue.

運動醫學營收再次超過我們的重建與機器人（Recon and Robotics）營收。

Turning now to ENT. Outside of China, we saw strong growth globally, including double-digit growth in other established markets and emerging markets as well as in our ARIS COBLATION wand for turbinate reduction and our HALO wand for tonsil, adenoid surgeries.

接著談耳鼻喉（ENT）。在中國以外，我們看到全球強勁成長，包括其他成熟市場與新興市場的兩位數成長；同時，我們用於鼻甲縮減的 ARIS COBLATION 探頭，以及用於扁桃腺、腺樣體手術的 HALO 探頭也帶動成長。

In China, we continue to reduce inventory in the channel ahead of VBP implementation, which had a negative impact on our growth. We still expect the profit headwind for China VBP to be around $15 million to $20 million for the full year.

在中國，我們在 VBP 實施前持續降低通路庫存，對成長造成負面影響。我們仍預期中國 VBP 對全年利潤的逆風約為 1,500 萬至 2,000 萬美元。

Let's now look at Advanced Wound Management, which declined by 2.1% in the quarter. Within that, Advanced Wound Care grew 3.7%, with good growth overall, led by US ALLEVYN and strength in our emerging markets. Our ALLEVYN COMPLETE CARE launch is off to a strong start in the US with good early momentum, and we were pleased to launch in Europe in this quarter.

接下來看先進傷口管理（Advanced Wound Management），本季下滑 2.1%。其中，先進傷口照護（Advanced Wound Care）成長 3.7%，整體成長良好，主要由美國 ALLEVYN 與新興市場的強勢表現帶動。我們的 ALLEVYN COMPLETE CARE 在美國上市後開局強勁、早期動能良好；我們也很高興在本季於歐洲推出。

In Bioactives, revenue declined 12.7% for the quarter, driven by the reimbursement change in skin substitutes and the soft quarter for SANTYL. SANTYL benefited from strong distributor demand in Q1, which resulted in a softer Q2.

在生物活性（Bioactives）方面，本季營收下滑 12.7%，主要受皮膚替代物（skin substitutes）給付變更，以及 SANTYL 本季偏弱所致。SANTYL 在第一季受惠於經銷商需求強勁，因此第二季相對偏弱。

We've also seen some impact from one of the payers introducing prior authorization for certain doses of SANTYL. Underlying demand remains healthy, but the change is creating friction in the prescription process, and we're taking action to address this and expect SANTYL to return to growth in the second half.

我們也看到其中一家付款方（payer）針對特定劑量的 SANTYL 導入事前授權（prior authorization），帶來一些影響。基本需求仍然健康，但此變更在處方流程中造成摩擦；我們正採取行動加以因應，並預期 SANTYL 將在下半年恢復成長。

In our skin substitutes business, we continue to face headwinds in the US as a result of CMS reimbursement changes that came into effect at the start of the year. We saw a sequential improvement from the first quarter, driven by hospitals. However, volumes and pricing in nonsurgical settings remained under pressure, particularly in mobile, where we have limited exposure.

在皮膚替代物業務方面，由於 CMS 給付變更自年初生效，我們在美國仍持續面臨逆風。在醫院帶動下，我們較第一季出現環比改善。然而，在非手術場景的量與價仍承壓，尤其是在行動端（mobile），而我們在該領域曝險有限。

The market is adapting more slowly than expected, which continues to affect billing efficiency and inventory levels across the channel. We now expect the trading profit headwind from skin substitutes to be towards the upper end of the previously guided $20 million to $40 million range. We remain confident in the long-term fundamentals of the segment and see opportunities to benefit as the market normalizes.

市場調整速度較預期緩慢，持續影響通路整體的請款效率與庫存水位。我們目前預期皮膚替代物對交易利潤的逆風將接近先前指引 2,000 萬至 4,000 萬美元區間的上緣。我們仍對該細分市場的長期基本面有信心，並看到在市場正常化後受益的機會。

Advanced Wound Devices grew 3.8%. LEAF delivered double-digit growth, reflecting strong demand, both PICO and RENASYS performed very strongly in emerging markets as we continue to expand geographically. PICO sales in other established markets were impacted by doctor strikes in Spain in the surgical sector and the timing of tender offers.

先進傷口裝置（Advanced Wound Devices）成長 3.8%。LEAF 交出兩位數成長，反映需求強勁；隨著我們持續擴大全球布局，PICO 與 RENASYS 在新興市場表現非常強勁。其他成熟市場的 PICO 銷售受到西班牙外科領域醫師罷工，以及標案時點影響。

In the US, sales of RENASYS remained soft in the acute care channel, while performance in the post-acute channel was good.

在美國，RENASYS 在急性照護通路的銷售仍偏弱，但在後急性照護通路的表現良好。

Turning now to Orthopaedics. This declined 1% on an underlying basis, primarily reflecting the ongoing issues in US Knees, ahead of new product launches and temporary headwinds in US Hips.

接著談骨科（Orthopaedics）。基本口徑下滑 1%，主要反映美國膝關節持續存在的問題（在新產品上市前），以及美國髖關節的短期逆風。

Following four consecutive quarters of above market growth in US Hips, we saw softer performance this quarter against a tough comparator. CATALYSTEM continues to grow strongly, but Q2 was impacted by a delay in set deployments and an increasing proportion of existing customer retentions versus competitive conversions. We see a clear path to reacceleration over the remainder of the year as CATALYSTEM set deployment increases.

在美國髖關節業務連續四個季度高於市場的成長之後，本季在高基期比較下表現較為疲弱。CATALYSTEM 仍持續強勁成長，但第二季受到器械組（set）部署延後，以及既有客戶續約占比提高、相較於競品轉換占比上升的影響。隨著 CATALYSTEM 器械組部署增加，我們看到在今年剩餘期間明確的再加速路徑。

As the product moves into its third year post launch, growth should remain strong, albeit at a lower rate than during the initial launch phase.

隨著產品在上市後進入第三年，成長應仍將維持強勁，但增速可能低於初期上市階段。

US Knees remain weak, but we are seeing gradual improvement as expected. The underlying dynamics are unchanged. Deliberate portfolio and capital discipline, combined with an ongoing market shift towards Cementless, continue to influence performance in the near term.

美國膝關節業務仍然疲弱，但如預期般我們正看到逐步改善。基本動態並未改變。審慎的產品組合與資本紀律，加上市場持續轉向無骨水泥（Cementless），在短期內仍將影響表現。

Sequential improvement was driven by strong uptake of LEGION MS and double-digit growth in LEGION CONCELOC, our Cementless offering. LEGION MS now represents almost 20% of our LEGION mix, up from 15% in Q1, and is enhancing the competitiveness of our installed base. We continue to expect improvement through the year, driven by increased LEGION MS set deployments. This will remain the main driver and to LANDMARK launches.

序列性改善主要由 LEGION MS 的強勁採用，以及我們無骨水泥產品 LEGION CONCELOC 的雙位數成長所帶動。LEGION MS 目前約占我們 LEGION 組合的近 20%，高於第一季的 15%，並提升我們既有裝機基礎的競爭力。我們仍預期全年將持續改善，主要由 LEGION MS 器械組部署增加所驅動。這仍將是主要驅動因素，並帶動 LANDMARK 的上市。

Outside of the US, Knees were impacted by a large tender order in the Middle East in the prior year quarter that did not repeat. Hips benefited from the launch of CATALYSTEM in Japan, although we saw some isolated weakness in Australia, where we await regulatory approval of CATALYSTEM.

在美國以外地區，膝關節業務受到去年同期中東一筆大型標案訂單影響，該訂單本期未再出現。髖關節業務受惠於 CATALYSTEM 在日本上市，但澳洲出現一些零星疲弱，我們仍在等待 CATALYSTEM 的法規核准。

Trauma & Extremities performed well overall. We continue to see good growth in EVOS, IM Nails and Shoulder, driven by our AETOS implant. We are seeing the impact of competitor launches in the US, but we expect growth to strengthen in the second half as we launch EVOS, Pelvic, and ramp up TRIGEN MAX.

創傷與四肢（Trauma & Extremities）整體表現良好。在 AETOS 植入物帶動下，我們持續看到 EVOS、IM Nails 與肩部產品的良好成長。我們已看到競品在美國推出新品的影響，但預期隨著我們推出 EVOS、Pelvic，並加速 TRIGEN MAX 放量，下半年成長將轉強。

Finally, Other Recon grew 0.8%. This business can show some quarter-to-quarter volatility as revenue is influenced by contract timing and mix. This was more pronounced in the period given another strong prior year comparator.

最後，其他重建（Other Recon）成長 0.8%。由於營收受合約時點與組合影響，此業務可能呈現季度間波動。在本期，由於去年同期基期同樣強勁，這種波動更為明顯。

That said, we saw double-digit growth in CORI deployments globally, alongside continued growth in utilization and penetration. And we expect growth to accelerate in the second half supported by an easy comparator in Q3, continued strong demand for our robotic platform and good uptake across ASCs and teaching institutions.

儘管如此，我們看到 CORI 在全球的部署呈現雙位數成長，同時使用率與滲透率也持續提升。我們預期在第三季較容易的比較基期、對我們機器人平台的持續強勁需求，以及在日間手術中心（ASCs）與教學機構的良好採用帶動下，下半年成長將加速。

Now I'll move on to the half year financials. For the half year, revenue was $3.1 billion, up 2.3% on an underlying basis and up 4.6% on a reported basis. There was one fewer trading day versus the prior year, with underlying revenue growth of 3.1% on an average daily sales basis.

接下來我將說明上半年財務表現。上半年營收為 31 億美元，以基礎（underlying）口徑成長 2.3%，以報告（reported）口徑成長 4.6%。相較去年少了一個交易日；以平均每日銷售（average daily sales）計算，基礎營收成長為 3.1%。

Consistent with the performance in Q2, we saw strength in Sports Medicine, offset by softness in US Orthopaedics and Advanced Wound Bioactives.

與第二季表現一致，我們看到運動醫學（Sports Medicine）表現強勁，但被美國骨科（US Orthopaedics）與先進傷口生物活性產品（Advanced Wound Bioactives）的疲弱所抵銷。

Moving on to the summary P&L. Underlying gross profit was $2.2 billion, representing a gross margin of 71.1%, up 60 bps year on year. This was driven by greater-than-expected efficiency savings across manufacturing and procurement, which more than offset cost inflation and the headwind from inventory revaluation. Tariff refunds fully offset the forecast tariff headwind to gross margin.

接著看損益表摘要。基礎毛利為 22 億美元，毛利率 71.1%，年增 60 個基點。這主要由製造與採購端高於預期的效率節省所帶動，足以抵銷成本通膨與存貨重估帶來的逆風。關稅退稅（tariff refunds）完全抵銷了原先預估關稅對毛利率的不利影響。

Trading profit increased $43 million, to $566 million, with trading margin expanding 60 bps to 18.3%, reflecting the benefits of higher gross margin and ongoing cost savings.

營業利益（trading profit）增加 4,300 萬美元至 5.66 億美元，營業利益率擴張 60 個基點至 18.3%，反映較高毛利率與持續成本節省的效益。

Moving further down the P&L. IFRS operating profit grew 4.3%, reflecting temporary higher restructuring charges, driven by further optimization of our manufacturing network and higher acquisition costs driven by, of course, our acquisition of Integrity.

再往下看損益表。IFRS 營業利益成長 4.3%，反映重整費用暫時性提高，主要由我們進一步優化製造網絡，以及（當然）收購 Integrity 所帶來較高的併購相關成本所致。

Basic earnings per share grew ahead of this at 6.2%, reflecting the buyback we announced at Q1, and adjusted earnings per share grew by 11% to $0.477. The interim dividend of $0.156 per share is up 4% on half one 2025.

基本每股盈餘（Basic EPS）成長 6.2%，高於上述增幅，反映我們在第一季宣布的庫藏股回購；調整後每股盈餘（adjusted EPS）成長 11% 至 0.477 美元。每股中期股利為 0.156 美元，較 2025 年上半年增加 4%。

I'll now take you through a more detailed bridge of our trading profit growth. We absorbed $119 million of headwinds from cost inflation, inventory revaluation, changes to AWM reimbursement and China VBP, while continuing to invest $33 million in our growth. This was more than offset by $59 million of operating leverage and $128 million of efficiency savings, which I'll discuss in more detail shortly.

接下來我將更詳細說明營業利益成長的橋接分析。我們吸收了 1.19 億美元的逆風，包括成本通膨、存貨重估、AWM 給付（reimbursement）變動以及中國 VBP，同時仍持續投入 3,300 萬美元於成長投資。這些影響被 5,900 萬美元的營運槓桿與 1.28 億美元的效率節省所抵銷；我稍後會更詳細說明。

While we had previously guided to an incremental tariff headwind in 2026, refunds received in the first half meant net tariffs were broadly neutral to profit growth. Foreign exchange also had a broadly neutral impact. As a result, this trading profit growth was 9%, excluding $4 million dilution from the acquisition of Integrity Orthopaedics.

雖然我們先前指引 2026 年將有額外的關稅逆風，但上半年收到的退稅使得淨關稅對獲利成長的影響大致中性。外匯影響亦大致中性。因此，若排除收購 Integrity Orthopaedics 帶來的 400 萬美元稀釋，本次營業利益成長為 9%。

As I said, turning now to efficiency savings, we've delivered around $133 million in the first half, well ahead of expectations. Of this, approximately $50 million came from the 12-point plan and zero-based budgeting initiatives. And as a result, we have now achieved $330 million of cumulative savings since launching these programs, reaching the lower end of the $325 million to $375 million target that we set ourselves at our 2024 interim results, more than a year ahead of schedule.

如我所說，接著談效率節省：我們上半年實現約 1.33 億美元，明顯優於預期。其中約 5,000 萬美元來自 12 點計畫與零基預算（ZBB）倡議。因此，自啟動這些計畫以來，我們累計已達成 3.30 億美元節省，已達到我們在 2024 年中期業績所設定 3.25 億至 3.75 億美元目標區間的下緣，且較原定時程提前一年以上。

We expect further benefits to be realized through the remainder of '26 and into 2027. The remaining $80 million in the first half came from additional opportunities across procurement, manufacturing, sales and marketing and business support functions. We expect a further $70 million of savings in the second half from both the 12-point plan and ZBB and other opportunities.

我們預期在 2026 年剩餘期間以及進入 2027 年仍將持續實現更多效益。上半年其餘 8,000 萬美元來自採購、製造、銷售與行銷，以及業務支援職能的額外機會。我們預期下半年可再節省 7,000 萬美元，來源包括 12 點計畫、ZBB 以及其他機會。

This takes forecast efficiency savings for the year up from around $150 million previously to around $200 million. The additional $50 million is expected to come primarily from manufacturing, including from ongoing footprint optimization as well as procurement and sales and marketing.

這使得我們對全年效率節省的預測，從先前約 1.50 億美元上調至約 2.00 億美元。新增的 5,000 萬美元預期主要來自製造端，包括持續的產能/據點（footprint）優化，以及採購與銷售及行銷。

Our 2026 guidance for trading profit is unchanged. We expect to deliver around 8% reported trading profit growth excluding M&A and around $1.3 billion of trading profit, including the impact of Integrity. We now anticipate that the year-on-year impact of tariffs will be broadly neutral to trading profit net of refunds.

我們對 2026 年營業利益（trading profit）的指引維持不變。我們預期在排除併購（M&A）影響下，報告口徑營業利益成長約 8%；並預期營業利益約 13 億美元（包含 Integrity 的影響）。我們目前預期關稅的年對年影響，在扣除退稅後對營業利益將大致中性。

The headwind from skin substitutes is expected to be towards the upper end of the previously guided $20 million to $40 million range, and there are no changes to our assumptions regarding inventory revaluation or China VBP.

皮膚替代物（skin substitutes）帶來的逆風，預期將落在先前指引 2,000 萬至 4,000 萬美元區間的上緣；我們對存貨重估或中國 VBP 的假設則沒有變更。

As previously disclosed, the acquisition of Integrity Orthopaedics is expected to be marginally dilutive to trading profit in 2026, broadly neutral in 2027 and accretive from 2028.

如先前揭露，收購 Integrity Orthopaedics 預期在 2026 年對營業利益略具稀釋性，2027 年大致中性，並自 2028 年起具增益性（accretive）。

Coming now to trading margin by business units. We saw a 160 bp increase in Sports Medicine & ENT margin to 24.7%, a 10 bp decrease for Wound to 22% and a 30 bp increase in Orthopaedics margin to 13%.

接著看各事業單位的營業利益率（trading margin）。運動醫學與耳鼻喉（Sports Medicine & ENT）利益率上升 160 個基點至 24.7%；傷口（Wound）下降 10 個基點至 22%；骨科（Orthopaedics）上升 30 個基點至 13%。

In Sports Medicine & ENT, margin expansion was driven by operating leverage and efficiency savings.

在運動醫學與耳鼻喉（Sports Medicine & ENT）方面，利益率擴張主要由營運槓桿與效率節省所帶動。

In Wound, the small margin decline reflected the impact of US skin substitute reimbursement changes, largely offset by savings initiatives.

在傷口護理業務中，小幅毛利率下滑反映了美國皮膚替代品給付（報銷）政策變更的影響，但多數已被節省措施所抵銷。

And in Orthopaedics, manufacturing savings from network optimization, ongoing product initiatives and disciplined cost control more than offset the headwind from inventory revaluation and softer revenue growth. We expect further margin expansion over time as we work through the inventory revaluation headwind and benefit from improving revenue growth.

而在骨科業務方面，透過網路優化帶來的製造節省、持續的產品相關措施以及嚴謹的成本控管，已足以抵銷存貨重估與營收成長趨緩所帶來的不利影響。隨著我們逐步消化存貨重估的不利因素並受惠於營收成長改善，我們預期毛利率將隨時間進一步擴張。

The impact of actions already taken to rightsize our manufacturing capacity and our Ortho360 operating model. These results demonstrate the operational excellence we are driving across the business.

這反映了我們已採取的行動所帶來的影響，包括調整製造產能規模以及推動我們的 Ortho360 營運模式。這些成果展現了我們正在全公司推動的卓越營運能力。

As you know, inventory remains a key focus for us, even now that we've completed the 12-point plan. Group DSI, day sales inventory, fell by 72 days, including the reclassification of instrument sets from inventory to PPE and by 40, if you exclude that. The bigger reduction came from Orthopaedics, down 62 days, excluding reclassification, reflecting continued work to reduce the number of units in inventory and a focus on capital efficiency.

如各位所知，即使我們已完成 12 點計畫，存貨仍然是我們的重點關注事項。集團 DSI（存貨銷售天數）下降了 72 天，其中包含將器械組（instrument sets）從存貨重新分類至 PPE 的影響；若排除該重新分類，則下降 40 天。較大的降幅來自骨科業務：若排除重新分類，DSI 下降 62 天，反映我們持續降低存貨單位數量並聚焦資本效率。

We also saw a reduction in Sports Med DSI, albeit to a lesser extent than in Orthopaedics, and no change in Wound DSI, excluding the reclassification. Both Sports and Wound are already much closer to industry benchmark DSIs. We expect to make further progress on inventory in 2026.

我們也看到運動醫學的 DSI 下降，但幅度小於骨科；而傷口護理的 DSI（排除重新分類）則沒有變化。運動醫學與傷口護理兩者的 DSI 已更接近產業基準。我們預期在 2026 年將在存貨方面取得進一步進展。

Right, now moving on to cash flow. Trading cash flow was $437 million in the first half, down $50 million or so year on year. But this reflects a $51 million step-up in CapEx year on year, driven by investments in our new wound manufacturing facility in Melton and in some IT investments. We do not expect this increase to repeat in the second half, and cash generation should improve versus half two, 2025.

接下來談現金流。上半年營運現金流為 4.37 億美元，年減約 5,000 萬美元。但這主要反映資本支出（CapEx）年增 5,100 萬美元，係由我們在 Melton 的新傷口製造設施投資以及部分 IT 投資所帶動。我們預期下半年不會重複出現這樣的增幅，現金創造能力相較於 2025 年下半年應會改善。

Other working capital was higher, largely due to timing of bonus accruals and related cash payments. Cash conversion was 77%, and we anticipate this will improve over the course of the year. Free cash flow was $231 million, down $13 million year on year, again reflecting these factors I've just mentioned, and partially offset by reduced restructuring cash costs.

其他營運資金較高，主要是因獎金應計與相關現金支付的時點所致。現金轉換率為 77%，我們預期其將在今年內逐步改善。自由現金流為 2.31 億美元，年減 1,300 萬美元，同樣反映我剛提到的因素，並部分被較低的重組現金成本所抵銷。

We continue to expect free cash flow in 2026 of around $800 million, driven by profit growth and continued focus on working capital, offset by a modest temporary increase in restructuring costs.

我們仍預期 2026 年自由現金流約為 8 億美元，主要由獲利成長與持續聚焦營運資金所驅動，但會被重組成本的溫和、暫時性上升所抵銷。

Net debt increased over the first half of $3 billion, an increase of $260 million, resulting in a leverage ratio of 1.8 times adjusted EBITDA, within our target of around 2 times. And the increase was driven by our investment in our business, the acquisition of Integrity Orthopaedics, growth in our dividend, and of course, the $500 million buyback we announced in Q1, of which we've actually now completed $260 million as of August 3.

上半年淨負債增加至 30 億美元，增加 2.6 億美元，使槓桿比率為調整後 EBITDA 的 1.8 倍，仍在我們約 2 倍的目標範圍內。淨負債增加主要來自我們對業務的投資、收購 Integrity Orthopaedics、股利增加，當然也包括我們在第一季宣布的 5 億美元庫藏股回購；截至 8 月 3 日，我們實際已完成 2.6 億美元。

This is in line with our capital allocation priorities.

這符合我們的資本配置優先順序。

Before I turn to guidance, I want to highlight the progress we continue to make across margins, working capital, cash flow, and returns. This broad-based improvement reflects stronger operational controls and helps make Smith & Nephew a more resilient business, better positioned to manage through periods of revenue softness or external challenges while maintaining progress against our long-term objectives.

在我談指引之前，我想強調我們在毛利率、營運資金、現金流與報酬方面持續取得的進展。這種全面性的改善反映了更強的營運控管，並有助於使 Smith & Nephew 成為更具韌性的企業，在營收疲弱或外部挑戰期間仍能更好地應對，同時維持我們朝長期目標前進的進度。

Coming now to our updated outlook. Reflecting softer performance in US Orthopaedics and SANTYL, we now expect second half growth to be in the range of 5% to 5.5% and full year growth to be around 4%. Notwithstanding the lower revenue outlook, we are maintaining all other metrics of our guidance.

接著談我們更新後的展望。鑑於美國骨科與 SANTYL 表現較疲弱，我們目前預期下半年成長率將落在 5% 至 5.5% 區間，全年成長率約為 4%。儘管營收展望下修，我們仍維持指引中的其他所有指標不變。

We continue to expect around 8% trading profit growth, excluding M&A for the year. And this translates into approximately $1.3 billion of trading profit, including marginal dilution from the Integrity acquisition. This reflects the step-up in efficiency savings that we are delivering across the business, together with the removal of the forecast tariff headwind.

我們仍預期全年交易營業利益（trading profit）成長約 8%，並排除併購（M&A）影響。換算後，交易營業利益約為 13 億美元，其中包含 Integrity 收購帶來的輕微稀釋。這反映我們在全公司推動的效率節省加速落地，以及移除原先預估的關稅不利因素。

The progress we demonstrated in the first half gives us confidence we can remain disciplined on costs while supporting improved revenue growth in the second half. We also remain on track to deliver around $800 million of free cash flow and a return on invested capital above 10%.

我們在上半年展現的進展，使我們有信心在支持下半年營收成長改善的同時，仍能維持嚴謹的成本紀律。我們也仍按計畫達成約 8 億美元的自由現金流，以及超過 10% 的投入資本報酬率（ROIC）。

Let me finish by outlining why we are confident in a step-up in revenue growth. We expect second half growth of 5% to 5.5%, driven by factors across all three business units.

最後我想說明，為何我們對營收成長加速有信心。我們預期下半年成長 5% 至 5.5%，動能來自三大事業部的多項因素。

In Sports Medicine, we expect continued momentum across segments, including strong growth in REGENETEN and FASTSEAL. In Advanced Wound Management, we expect to see stabilization in US skin substitutes, building on the sequential improvement we saw in Q2 versus Q1.

在運動醫學方面，我們預期各細分領域將延續動能，包括 REGENETEN 與 FASTSEAL 的強勁成長。在先進傷口管理方面，我們預期美國皮膚替代品將趨於穩定，並延續我們在第二季相較第一季所看到的逐季改善。

We also expect to return to growth in SANTYL, further rollout of ALLEVYN COMPLETE CARE in Europe, the ongoing launch of next-generation LEAF and the benefits of greater investment behind PICO.

我們也預期 SANTYL 將恢復成長、ALLEVYN COMPLETE CARE 在歐洲進一步鋪貨推廣、持續推出新一代 LEAF，以及加大對 PICO 投資所帶來的效益。

In Orthopaedics, we expect an improving trajectory in US Knee implants, driven by LEGION MS and the launch of the Cementless version of LANDMARK. We also expect US Hip implants to return to growth as we deploy more CATALYSTEM sets. Of course, we'll also have one extra trading day in fourth quarter.

在骨科方面，我們預期美國膝關節植入物的走勢將改善，主要由 LEGION MS 以及 LANDMARK 無骨水泥版本的上市所帶動。隨著我們部署更多 CATALYSTEM 器械組（sets），我們也預期美國髖關節植入物將恢復成長。當然，第四季也會多出一個交易日。

So with that, I'll hand you back over to Deepak.

那麼，我把時間交回給 Deepak。

Before we conclude, I wanted to spend a few minutes talking about the progress we've made in the first half against each pillar of RISE, which is our strategy for the next three years. These are the actions we are taking to strengthen the business today and position ourselves for sustainable growth over the long term.

在結束之前，我想花幾分鐘談談我們上半年在 RISE 各支柱上的進展；RISE 是我們未來三年的策略。這些是我們正在採取的行動，用以強化當前業務並讓我們在長期具備可持續的成長定位。

In order to reach more patients, we continue to expand access to our technologies through geographic expansion, new product introductions, and important clinical milestones across our portfolio, including completing the first knee and shoulder procedures using our CORI XT handheld robotics platform and the European launches of ALLEVYN COMPLETE CARE and RENASYS EDGE.

為了觸及更多病患，我們持續透過地域擴張、新產品導入，以及在整體產品組合中達成重要臨床里程碑來擴大我們技術的可及性；其中包括完成首例使用 CORI XT 手持式機器人平台的膝關節與肩關節手術，以及 ALLEVYN COMPLETE CARE 與 RENASYS EDGE 在歐洲上市。

To innovate, we advanced our pipeline, strengthened our clinical evidence base and launched a number of new products across all of our business units, including FLOW FLEXTEND and Lens in Sports Medicine & ENT, EVOS pelvic in Orthopaedics and LEAF 3.0 in Advanced Wound Management. And that brings the total number of new products launched so far this year to 9, putting us well on track to launch 16 for the full year.

在創新方面，我們推進研發管線、強化臨床證據基礎，並在所有事業部推出多項新產品，包括運動醫學與耳鼻喉（ENT）領域的 FLOW FLEXTEND 與 Lens、骨科的 EVOS pelvic，以及先進傷口管理的 LEAF 3.0。因此，今年迄今推出的新產品總數達到 9 項，使我們非常有望在全年推出 16 項。

And a key highlight was receiving the FDA approval for TESSA, our spatial surgery system, which I'll come on to shortly.

其中一項關鍵亮點是 TESSA（我們的空間手術系統）獲得 FDA 核准，我稍後會再談到。

To scale, we continue to invest behind our higher priority -- highest priority growth opportunities, including the acquisition of Integrity Orthopaedics has strengthened our leading shoulder repair portfolio, sales force expansion for PICO and continued progress in our new advanced management manufacturing facility in Melton, which remains on track to open actually in 2027.

在擴大規模方面，我們持續加大對更高優先級、最高優先級的成長機會投資；其中包括收購 Integrity Orthopaedics 強化了我們領先的肩部修復產品組合、擴編 PICO 的銷售團隊，以及位於 Melton 的新先進傷口管理製造設施持續取得進展，該設施仍按計畫於 2027 年啟用。

To execute, we remain focused on driving productivity across the group, portfolio simplification and operational excellence, and we're making good progress on streamlining our portfolio, which will allow us to manage significantly fewer SKUs across our value chain and improve our capital efficiency.

在執行方面，我們仍聚焦於推動集團生產力、產品組合精簡與卓越營運；我們在精簡產品組合上進展良好，這將使我們能在價值鏈中管理顯著更少的 SKU，並提升資本效率。

Earlier this quarter, our Advanced Wound Management manufacturing facility in Suzhou, China was recognized with the prestigious Shingo prize, which reflects more than a decade of sustained operational excellence and continuous improvement. Importantly, these aren't just strategic priorities, they are translating into tangible growth platforms that we believe can create value for shareholders for many years to come.

本季稍早，我們位於中國蘇州的先進傷口管理製造工廠榮獲享有盛譽的 Shingo 獎，這反映了十多年來持續的營運卓越與持續改善。重要的是，這些不僅是策略重點，它們正轉化為具體的成長平台，我們相信可在未來多年為股東創造價值。

The clearest example of that is an innovation, where we're building a portfolio of technologies designed to both take share in existing markets and create entirely new growth opportunities.

最明確的例子就是創新：我們正在打造一個技術組合，旨在既能在既有市場中提升市占，也能創造全新的成長機會。

In Sports Medicine, we now have four differentiated growth platforms that we refer to as our big four. REGENETEN continues to perform strongly, delivering around 20% growth in the first half, with significant runway expanding -- remaining to expand penetration in rotator cuff repair and across other tendons and extra-articular ligaments.

在運動醫學領域，我們目前有四個具差異化的成長平台，我們稱之為「四大支柱」。REGENETEN 持續表現強勁，上半年約成長 20%，且仍有顯著的成長跑道——在旋轉袖修補以及其他肌腱與關節外韌帶方面，仍有很大的滲透率提升空間。

Our Integrity acquisition is performing ahead of our expectations, and integration is progressing well as we increase manufacturing capacity and expand our commercial capabilities. With CARTIHEAL AGILI-C, we're continuing to build awareness and adoption in the US ahead of the new reimbursement beginning in January of 2027, while also expanding internationally with our first cases completed in Australia, Italy, and in Belgium.

我們對 Integrity 的收購表現優於預期，隨著我們提升製造產能並擴大商業能力，整合進展順利。就 CARTIHEAL AGILI-C 而言，我們在 2027 年 1 月新給付開始之前，持續在美國提升認知與採用，同時也在國際市場擴張，並已在澳洲、義大利與比利時完成首批病例。

And this quarter, we achieved an important milestone with the FDA approval of TESSA, the first in industry spatial surgery platform. TESSA combines advanced imaging, navigation and AI-enabled assistance to help surgeons perform arthroscopic procedures with greater precision. The initial application is femoral tunnel drilling, but we see a significant long-term opportunity to extend the platform across multiple joints and procedures.

而在本季，我們達成一項重要里程碑：TESSA 獲得 FDA 核准，為業界首個空間手術平台。TESSA 結合先進影像、導航與 AI 輔助，協助外科醫師以更高精準度執行關節鏡手術。初始應用為股骨隧道鑽孔，但我們看到一個重大的長期機會，可將該平台延伸至多個關節與手術項目。

In Advanced Wound Management, ALLEVYN COMPLETE CARE strengthens our position in one of the largest and fastest-growing segments of the wound care market. Initial customer feedback has been encouraging, highlighting meaningful differentiation versus current products that are actually on market today.

在先進傷口管理方面，ALLEVYN COMPLETE CARE 強化了我們在傷口照護市場中最大且成長最快的細分領域之一的地位。初期客戶回饋令人鼓舞，並強調相較於目前市面上的產品具有明顯差異化。

We're also expanding our advanced wound management -- wound market through the recent launch of our recent -- of LEAF 3.0, and by bringing PICO into new care settings and patient populations.

我們也透過近期推出 LEAF 3.0 來擴大我們的先進傷口管理——傷口市場，並將 PICO 帶入新的照護場景與病患族群。

In Orthopaedics, we continue to build a connected ecosystem around CORI, linking planning, execution and outcomes to support more personalized care and better optimized workflows -- clinical workflows. CORI XT provides the foundation for existing robotics platform. We performed our first robotic shoulder procedures on XT in February, the first Knee procedures on it in May, and we remain on track to launch our Hip execution in the first half of 2027.

在骨科方面，我們持續圍繞 CORI 建構互聯生態系，串聯規劃、執行與結果，以支持更個人化的照護與更佳優化的工作流程——臨床工作流程。CORI XT 為既有機器人平台提供基礎。我們於 2 月在 XT 上完成首例機器人肩部手術，5 月完成首例膝部手術，並仍按計畫於 2027 年上半年推出髖部的機器人執行功能。

Alongside robotics, our implant innovation continues to gain traction. CATALYSTEM is growing and becoming an important contributor within Hips, while in Knees, increasing set deployments and supporting broader LEGION MS adoption.

除機器人之外，我們的植入物創新也持續獲得市場動能。CATALYSTEM 持續成長，並在髖關節業務中成為重要貢獻者；而在膝關節方面，套組部署數量增加，並支持更廣泛的 LEGION MS 採用。

We're also looking forward to the launch of LANDMARK in the third quarter, our most robotically enabled implant system that we've developed to date. Overall, the breadth and strength of these innovation platforms give us confidence in our ability to deliver sustainable growth over time through a combination of market expansion, share gains, and new category creation.

我們也期待於第三季推出 LANDMARK，這是我們迄今開發、機器人賦能程度最高的植入物系統。整體而言，這些創新平台的廣度與強度，使我們有信心能透過市場擴張、市占提升與新類別創造的組合，在時間推進下實現可持續成長。

In summary, our second-quarter performance was below our expectation, with the strong momentum in Sports Medicine offset by softness in US Orthopaedics and Advanced Wound Bioactives. That's leading us to reduce our revenue outlook for the year.

總結來說，我們第二季表現低於預期；運動醫學的強勁動能被美國骨科與先進傷口生物活性產品的疲弱所抵銷。因此，我們下調今年的營收展望。

That said, we remain confident that the growth will step up in the second half, and John has given -- taken you through the drivers of all of that across our business units. But importantly, while we are lowering our revenue outlook, we remain on track to deliver our original trading profit guidance, free cash flow, and ROIC.

儘管如此，我們仍有信心下半年成長將加速，而 John 也已帶領各位逐一說明各事業單位的驅動因素。但重要的是，雖然我們下調營收展望，我們仍按計畫達成原先的交易利益（trading profit）指引、自由現金流與 ROIC。

And this is supported by a step-up forecast of efficiency savings, including a further $50 million of savings that we've identified, which helps offset the impact of lower revenue growth.

這也受到效率節省預測上修的支持，其中包括我們額外辨識出的 5,000 萬美元節省，有助於抵銷營收成長較低的影響。

We also continue to build a more resilient and agile business. We're investing behind our growth platforms while driving improvements in margin, cash flow and returns, strengthening our ability to respond effectively to challenges. While Orthopaedics is not where we want it to be, we remain focused on improving execution and delivering better performance.

我們也持續打造更具韌性與敏捷性的企業。我們在推動成長平台投資的同時，也改善毛利率、現金流與報酬，強化我們有效應對挑戰的能力。雖然骨科業務尚未達到我們期望的水準，我們仍專注於提升執行力並交付更佳表現。

At the same time, we are positioning the business to capitalize on the significant opportunities that we see ahead. These include the landmark launch in Knees, robotic execution on CORI in Hips, the big four in Sports Medicine, launching new products and entering new settings in Wound and our broader pipeline of innovation.

同時，我們也在為把握前方可見的重大機會而布局。這些機會包括：膝關節的 LANDMARK 重要上市、CORI 在髖關節的機器人執行、「運動醫學四大支柱」、在傷口照護推出新產品並進入新場景，以及我們更廣泛的創新產品線。

Taken together, these factors reinforce our confidence in the underlying strength of the business and our ability to create long-term value.

綜合而言，這些因素進一步強化我們對業務基本面實力與創造長期價值能力的信心。

So with that, we are ready for your questions.

那麼，我們準備好回答各位的提問。

Jack Reynolds-Clark from Morgan Stanley. Thank you very much for taking the questions. I had three, please.

Morgan Stanley 的 Jack Reynolds-Clark。非常感謝讓我提問。我有三個問題。

First, on US Orthopaedics. Could you run through specifically what went wrong here? How much of it was the market? How much of it was kind of other issues? And what you're seeing so far in Q3? And if it has any impact on your assumptions around midterm margin expansion?

第一個，關於美國骨科。你能否具體說明這裡到底出了什麼問題？其中有多少是市場因素？又有多少是其他類型的問題？以及你們目前在第三季看到的情況如何？另外，這是否會影響你們對中期毛利率擴張的假設？

Then on 2026. So the H2 guide obviously implies a pretty substantial step-up versus H1. Given kind of the comments around VBP delay, where do you see the biggest half-on-half step-up on a segmental basis and kind of really what gives you the confidence in that new guide?

第二個，關於 2026 年。下半年（H2）的指引顯然意味著相較上半年（H1）會有相當顯著的加速。考量你們對 VBP 延遲的評論，你們認為在各事業部/品類層面，最大的上下半年增幅會出現在哪裡？以及究竟是什麼讓你們對這個新指引有信心？

And then lastly, on the midterm guidance, the 4% growth in 2026 is kind of very much below the guidance -- the midterm guidance range. What do you see as stepping up in future years to offset that?

最後，關於中期指引：2026 年 4% 的成長率明顯低於中期指引區間。你們認為未來年度會有哪些因素加速，以抵銷這一點？

Yes, sure. So let me talk about that in turn. So US Ortho, there's some market slowdown (technical difficulty) we are behind the market largely because of the portfolio gap we have. So we're not able to participate in the fastest-growing part of Knees, which is Cementless. We only have that on one half of our installed base.

好的，當然。我依序來談。就美國骨科而言，市場確實有些放緩（技術問題），而我們落後於市場，主要是因為我們的產品組合存在缺口。因此，我們無法參與膝關節中成長最快的部分，也就是無骨水泥（Cementless）。我們目前只在已安裝基礎的一半具備該產品。

And in Q3 when we launched LANDMARK. We'll be better able to retain the market in the other half where we don't have a Cementless offering. By far, that's the biggest factor. It's a challenging thing that we're navigating through. We call that out as a factor in Q1. We continue to see it in Q2, although there was some sequential improvement. And I'll come on to kind of what we see for half-on-half, but that's the fundamental factor that's driving softness in US Ortho.

而在第三季我們推出 LANDMARK 之後，在另一半目前沒有無骨水泥產品的基礎上，我們將更能維持市占。這無疑是最大的因素。這是一個我們正在應對的具挑戰性的課題。我們在第一季就將其列為影響因素。第二季仍持續看到這個影響，儘管環比已有一些改善。我稍後也會談到我們對上下半年變化的看法，但這就是導致美國骨科疲弱的根本因素。

There's a temporary blip in US Hips. CATALYSTEM continue to grow very nicely. But we're in a third full year of launch. We do expect as we go step forward from here at some point, we're going to need to pivot from competitive kind of takeouts to more holding on to our business retention that will happen as we progress through the launch.

美國髖關節業務出現了一個短暫的波動。CATALYSTEM 仍持續非常良好地成長。但我們正處於上市的第三個完整年度。我們確實預期，隨著我們從現在往前推進，在某個時間點，我們將需要從競爭性的「替換/取代」（takeouts）轉向更著重於守住既有業務的留存；這會在我們推進上市進程時發生。

But there was a slower-than-expected deployment of sets. These sets are -- instrument sets are optimized for one or the other products. So for example, if we're trying to take business away from one competitor versus the other competitor, we need to have slightly different instrument sets. So getting that right is a bit challenging. That's what paced our set deployment from the quarter. It's a blip. We expect to regain that in the back half of the year.

但套組的部署速度比預期更慢。這些套組——器械套組是針對某一種或另一種產品進行最佳化的。因此舉例來說，如果我們要從某個競爭對手那裡搶走業務、而不是另一個競爭對手，我們就需要略有不同的器械套組。所以把這件事做對確實有點具挑戰性。這就是本季套組部署進度放緩的原因。這只是個小波動。我們預期在下半年把它追回來。

So those are the two really the fundamental factors, not so much slowdown in procedures, of which there was some.

所以這兩點才是真正的根本因素，並不是手術量的放緩——雖然手術量確實也有一些放緩。

Half on half, fundamentally, what we expect is in Orthopaedics, it's LEGION MS, which strengthens our LEGION offering, right? That's going to be the most material driver. And then as we bring LANDMARK Porous onto market, which we -- largely a Q4 effect, like I said, we'll be able to better retain the business that we have.

從上半年到下半年，從根本來看，我們在骨科方面的預期是 LEGION MS，它會強化我們的 LEGION 產品組合，對吧？這將是最重要的驅動因素。接著，當我們把 LANDMARK Porous 推向市場時——如我所說，這主要會在第四季反映——我們將能更好地留住現有的業務。

And then once we go into 2027 when we have the complete offering with LEGION Cemented as well the end of Q2, we'll be able to go from defense into more of an offensive crouch. So in Orthopaedics, it's LEGION MS and launch of porous.

然後到了 2027 年，當我們在第二季末也推出 LEGION Cemented、形成完整產品組合時，我們就能從防守轉為更具進攻性的姿態。所以在骨科方面，重點是 LEGION MS 以及多孔產品的上市。

In Sports, we'll continue the trend that you have seen quarter on quarter. There hasn't really been a H1, H2 effect in Sports when you take away kind of the China effect, and we expect the same to continue, right, in this year.

在運動醫學方面，我們會延續你們逐季看到的趨勢。在運動醫學上，若排除中國因素，其實並沒有明顯的上半年、下半年效應；我們預期今年也會維持同樣情況。

And in Wound, it's PICO. We're investing behind geographic expansion of PICO. We're starting to see some proof of that in Q2, but we expect to see that build in the back half of the year.

在傷口護理方面，重點是 PICO。我們正在投入資源支持 PICO 的地理擴張。我們在第二季已開始看到一些成效，但預期下半年會持續累積、更加明顯。

And then Skin Subs, which there was sequential improvement Q1 to Q2, as we've said, we're in the upper end of the guidance range that we've given in terms of the impact on reimbursement. But H1 to H2, we expect to see an improvement. So those are the components of H1 to H2 in terms of what accounts for the step-up in growth that we see.

至於皮膚替代物（Skin Subs），如我們所說，從第一季到第二季有連續改善；就償付影響而言，我們目前處在先前給出的指引區間上緣。但從上半年到下半年，我們預期會看到改善。以上就是上半年到下半年、我們所看到成長加速的各項構成因素。

Turning to -- finally, the third question, which is around midterm guidance. Look, we always knew '26 was going to be a challenging year. Obviously, it's proved to be a bit more challenging than we thought. And that's largely on the back of US Knees that we talked about and the prior authorizations that one of our -- one of the larger insurers rolled out this year that's impacting -- there's more friction in the system, but prescription is not end user demand, but it's really the rate which prescriptions get filled.

最後談第三個問題，也就是中期指引。坦白說，我們一直知道 2026 年會是具挑戰的一年。顯然，實際情況比我們原先想的更具挑戰。這主要是因為我們提到的美國膝關節業務，以及我們的一家——其中一家較大型保險公司今年推出的事前授權（prior authorizations），這使系統摩擦增加；但處方量不等於終端需求，而是處方被實際核配/完成的速度。

So that's the reason for why we called down 2026. But the fundamental growth drivers, which are new products, either in existing categories or in creation of new products or creative new categories, those drivers remain well intact, whether it's in Orthopaedics.

這就是我們下修 2026 年預期的原因。但根本的成長驅動因素——也就是新產品，不論是在既有品類中推出，或是創造新產品、開創新類別——這些驅動因素仍然非常完整，無論是在骨科領域。

We talked about LANDMARK launch. We talked about Hip execution on CORI, AETOS, which is on shoulder. And in Trauma, rounding out our EVOS portfolio with the pelvic offering that's new. And then on the Nail part of the portfolio, IM nails continuing to improve. So multiple growth drivers in Orthopaedics we've got to look forward to in 2027.

我們談到了 LANDMARK 的上市。我們談到了在 CORI 上的髖關節執行，以及 AETOS（屬於肩關節）。在創傷（Trauma）方面，則以全新的骨盆產品補齊我們的 EVOS 產品組合。此外在釘（Nail）產品線方面，髓內釘（IM nails）也持續改善。因此在骨科方面，我們在 2027 年有多項成長驅動因素值得期待。

And then in Sports, big four, continued execution on those. And then finally, in Wound. It's PICO. It's building out of RENASYS and normalization of Skin Subs.

接著在運動醫學方面，四大核心（big four）持續推進與執行。最後在傷口護理方面。重點是 PICO。也包括擴建 RENASYS，以及皮膚替代物的正常化。

So these are the growth drivers, as you can see, is multiple of them across all of our business units. It gives us confidence that we are fundamentally a 6% to 7% growth company.

所以如你所見，這些成長驅動因素遍布我們所有事業單位，而且不只一項。這讓我們有信心：從根本來看，我們是一家可達 6% 到 7% 成長的公司。

And maybe just a -- perfect answer. But maybe just a little bit of color on the phasing in terms of the second half. Sort of Q3, Q4, we do expect to see a step-up in Q4 performance versus Q3 performance. So Q3 will improve on Q2, clearly. And then Q4 will be stronger.

也許再補充一點——回答得很完整。但再提供一些關於下半年節奏的說明。大致上在第三季、第四季，我們確實預期第四季表現會比第三季更上一階。所以第三季會明顯優於第二季。而第四季會更強。

And that's not just -- that's not jam tomorrow. That is very clearly because of the timing of investments that we're making, specifically in relation to the launch of LANDMARK.

而這不只是——這不是把好消息推到明天。這非常明確是因為我們投資時點的安排，特別是與 LANDMARK 上市相關的投資時點。

And then in the context of skin substitutes, we're actually starting to lap the impact of last year. Maybe -- like Q4 last year was tough in Skin Substitutes because of the actions that we've been taken by the market in anticipation of the changes to reimbursement. So we've got a much softer comp in Q4 on Skin Subs and therefore, we'd expect that to -- there's not only the continued recovery that we've already seen in Q2 and Q1, we'll see come through in Q3, but we also start to lap in Q4, the impact from last year.

另外在皮膚替代物的脈絡下，我們其實也開始進入與去年影響的對比基期（lap）。也許——去年第四季皮膚替代物很艱難，因為市場為了因應償付變更的預期，我們受到市場採取的行動影響。因此皮膚替代物在第四季的比較基期會更軟，因而我們預期——不僅是我們在第二季與第一季已看到的持續復甦會在第三季延續，到了第四季我們也開始對比去年帶來的影響。

So that will be particularly positive on Skin Subs.

所以這對皮膚替代物會特別正面。

And then, of course, Deepak said, we should also mention that we have got one extra trading day in Q4, which when you add all that up, you'll see a big step up in growth in Q4 versus Q3, just to make that absolutely clear.

當然，正如 Deepak 所說，我們也應該提到第四季會多一個交易日；把這些因素加總起來，你會看到第四季相較第三季的成長會有明顯跳升，我想把這點說得非常清楚。

And then to your point around the headwind on Sports. I mean, you're right. I mean, Deepak's actually spot on, of course, that we're continuing to see the momentum. But we would expect Sports and ENT to be a little bit softer in Q3 than we saw in Q1 and Q2 because of the impact of VBP coming in both of those areas in the second half.

再回到你提到運動醫學的逆風。你的看法沒錯。當然，Deepak 的判斷也非常到位，我們確實持續看到動能。但我們預期運動醫學與耳鼻喉（ENT）在第三季會比第一季與第二季稍微疲弱一些，原因是下半年這兩個領域都會受到 VBP 的影響。

So we factored that into our forecast, and that's fully baked into the expectation of the top-line guidance of the 4% and also the profit guidance as well, which remains unchanged.

因此我們已把這點納入預測，並且已完整反映在 4% 的營收（top-line）指引預期中，也同樣反映在獲利指引中；獲利指引仍維持不變。

That's great. Could I sneak in a cheeky follow-up? If you were to quantify Q3 versus Q4 growth, the phasing there, would you be able to offer any color there?

太好了。我可以再冒昧追問一個小問題嗎？如果要量化第三季相較第四季的成長、也就是那個節奏差異，你能否再提供一些說明？

I could. Look, I think in Q3, we will see growth in the order of -- sort of Q1-type dimensions. So if you remember, in Q1, we were 3.1% growth, 4.7% on an ADS basis. In Q3, we will see growth of a similar level. In Q4, we will see a step-up in that growth. You can work out the math, but it would be -- at a growth level, it will be sort of 6% to 7%.

可以。我認為第三季我們會看到大約——接近第一季那種幅度的成長。如果你還記得，第一季我們成長 3.1%，以 ADS 口徑則是 4.7%。第三季我們會看到類似水準的成長。第四季我們會看到成長再上台階。你可以自行推算，但就成長率而言，大概會在 6% 到 7% 左右。

But actually, on ADS basis, it will be just north of 5% because of the extra trading day. That is a step-up on Q3 in absolute terms, not stripping out the trading day impact. But that is because of the Skin Subs, because of the investments being made in PICO and the timing of those investments and because, of course, of the launch of LANDMARK, which takes place towards the end of Q3.

但其實以 ADS 口徑來看，因為多了一個交易日，會略高於 5%。若不剔除交易日影響、以絕對值來看，這相較第三季是明顯的跳升。而這是因為皮膚替代物、因為對 PICO 的投資及其投資時點，以及當然也因為 LANDMARK 的上市——它發生在第三季末附近。

So those are the reasons why we've got confidence in our ability to deliver that 4% for the full year.

因此，這些就是我們有信心能在全年達成 4% 的原因。

Hassan Al-Wakeel from Barclays. A couple from me on Ortho.

Barclays 的 Hassan Al-Wakeel。我這邊有幾個關於 Ortho 的問題。

So firstly, maybe to ask Jack's question a little differently. We've seen the softness this year. Now we're seeing Hips, which has been really strong before today. You said this isn't market driven. What are you doing differently when it comes to execution? Why shouldn't some of these set delays in Hips weigh on the second half?

首先，或許用稍微不同的方式來問 Jack 的問題。我們今年看到了疲軟。現在我們看到髖關節（Hips），在今天之前一直都很強勁。你說這不是市場驅動的。在執行層面你們做了哪些不同的事情？為什麼髖關節這些器械組（set）的延遲不會拖累下半年？

And then specifically on US Hips, how are you thinking about growth here beyond the next quarter or two as CATALYSTEM matures as a product?

另外，特別針對美國髖關節（US Hips），隨著 CATALYSTEM 作為產品逐漸成熟，除了接下來一兩個季度之外，你們如何看待這裡的成長？

And then secondly, on Robotics, and if you can try and unpack the growth in the quarter and the development in CORI, is it entirely a function of comps? And how should we think about growth in the second half and beyond given the launch of MAKO RPS last month?

第二個問題是關於機器人（Robotics）。如果你能試著拆解本季的成長以及 CORI 的進展，這是否完全是因為比較基期（comps）？考量到上個月推出 MAKO RPS，我們應該如何看待下半年及之後的成長？

Okay. So with Hips, just to emphasize again kind of what I've said around set deployment. So first, there was a comparator, right? So had a strong comparator in Q2, and so that numerically had an impact. When you look at a two-year stack, it's actually not that much of a deceleration in Hips. So it's largely kind of consistent.

好的。關於髖關節（Hips），我再強調一次我先前提到的器械組（set）部署。首先，確實有比較基期，對吧？第二季的比較基期很強，因此在數字上造成了影響。如果看兩年叠加（two-year stack），髖關節其實沒有那麼明顯的減速。所以整體上大致是維持一致。

So with set deployments, just to double-click kind of what I said, largely, it has to do with instrument sets. So when you're trying to take a customer from their existing kind of approach, whether it's one of our legacy products or one of our competitor products. The instrument that you have to deploy to cater to the surgical approach of that particular surgeon has some variability.

至於器械組部署，我再更深入說明一下，主要與器械組（instrument sets）有關。當你試圖把客戶從他們既有的做法轉換過來，不論是我們的舊有產品或競品。你必須部署的器械，需配合該位外科醫師的手術方式，因此會有一些差異。

It's not just some standard instrument that you deploy that works regardless of which legacy platform that they're using. And getting the demand ripe for that instrument, that is a bit tricky because of that variability, right? And so we didn't quite get that right. And so we were somewhat paced by that in Q2, right?

這不是部署一套標準器械就能不管他們使用哪個舊平台都適用。而要讓對該器械的需求成熟到位，因為這種差異性，確實有點棘手，對吧？所以我們沒有完全做到位。因此在第二季我們某種程度上受到這點的節奏限制，對吧？

So the combination of numerically stronger comp plus that -- kind of led to what you saw. We've also said, as we progress through the launch, typically what happens in Orthopaedics launches, certainly the way we approach CATALYSTEM is we targeted competitive surgeons initially, right? And you expect to do that for a period of time.

因此，數字上較強的比較基期再加上這點——就導致你看到的結果。我們也提過，隨著上市推進，骨科產品的上市通常會發生的情況是——至少以我們推動 CATALYSTEM 的方式——我們一開始會先鎖定競品外科醫師，對吧？而你會預期這樣做一段時間。

But eventually, you are going to have to address your base of customers. So that mix of competitive versus retention will start to flip from competitor heavy against retention to more retention heavy, smaller competitors.

但最終，你必須回頭去服務你既有的客戶基礎。因此，競品導入與留存（retention）的組合會開始翻轉：從「以競品導入為主、留存為輔」轉為「以留存為主、競品導入較少」。

So at some point, that will normalize, so we'll get back to, in effect, market levels of growth in Hips. So that's what you should expect as we proceed to the back half of this year and beyond. So hopefully, that explains kind of the blip in kind of instrument deployment that paced Q2, but what you should expect as we go through the launches.

所以在某個時間點，這會回歸正常，我們將回到——實際上——髖關節（Hips）與市場水準一致的成長。因此，這就是你在今年下半年以及之後應該預期看到的。希望這能解釋第二季因器械部署而造成的短暫波動，以及隨著上市推進你應該期待的走勢。

So the second question that you had was in CORI for this quarter and beyond. I think John, you said we had double-digit growth in CORI placements in quarter two and also that got a similar number in first half. So continue to be pleased with the pace at which we're placing CORI, and also we are replacing them, right, hospitals versus ASCs, teaching institutions versus across the mix.

你第二個問題是關於本季以及之後 CORI 的情況。我想 John，你提到我們第二季 CORI 裝機（placements）有雙位數成長，上半年也差不多是同樣的數字。所以我們對 CORI 的裝機速度仍然感到滿意，同時我們也在不同場域推進——醫院相對於 ASC、教學機構等，涵蓋各種組合。

So we're having actually nice impact across a range of care settings. And generally speaking, when I look across the board, we are at least at our market share. That's encouraging.

因此我們在各種照護場景中其實都帶來了不錯的影響。整體而言，當我放眼全局，我們至少達到與自身市佔相符的表現。這令人鼓舞。

But look in the ASC, it's slightly ahead of our market share in terms of CORI replacements within the ASC, not by leaps and balance, but certainly. So what it shows is that we are tracking relative to our share. The strategy we're following is that we're not just placing first and then allowing utilization to catch up. We're placing where we see a demand, where we see a surgeon who wants to integrate it into their practice.

但在 ASC 方面，就 CORI 在 ASC 的替換（replacements）而言，我們略高於自身市佔——不是大幅領先，但確實如此。這顯示我們的進度與市佔相對一致。我們採取的策略不是先大量裝機，然後再讓使用量（utilization）慢慢追上。我們是在看到需求、看到外科醫師希望把它整合進其臨床實務時才進行裝機。

And we're equally monitoring utilization as we are placement, right? We could have followed a different approach, but ours is actually placement and utilization. So I'm actually pleased with not only the headline, but also the texture of the thing.

而且我們對使用量的監測與對裝機的監測同等重視，對吧？我們本可以採取不同做法，但我們的做法是裝機與使用量並重。所以我不只對表面數字滿意，也對其內在結構與質地感到滿意。

You referenced Stryker coming up with their handheld. Look, for me as a headline, there are always questions around, well, is CORI a science experiment? Is this really in a mainstream platform or not? The last reported number was 1,100 that we talked about. We've talked about double-digit growth off of that, you can do the rough math.

你提到 Stryker 推出他們的手持式產品。你看，對我而言，外界一直會問：CORI 是不是只是科學實驗？它到底是不是主流平台？我們上次對外提到的數字是 1,100 台。我們也提到在此基礎上有雙位數成長，你可以大概算一下。

And the fact we're placing in proportion to our shares as CORI is a mainstream product, which it's being accepted by the market. And the fact that there's competitors who are now thinking that they need to have their own handheld platform is validation of our approach.

而我們的裝機與市佔相稱，這代表 CORI 是一個主流產品，市場正在接受它。而且現在有競爭對手也認為他們需要自己的手持式平台，這正是對我們方法的驗證。

It also speaks to the innovation that sets Smith & Nephew at our scale, where we have taken both bets, we could have come up with our handheld rather a fixed arm robot too, but we didn't, right? We have the strength of our conviction to go with a handheld platform, and great that our competitors are following suit.

這也反映了 Smith & Nephew 以我們這樣的規模所具備的創新能力：我們做了兩種押注——我們也可以做手持式，或做固定臂機器人，但我們沒有那麼做，對吧？我們有足夠的信念選擇手持式平台，也很高興看到競爭對手跟進。

But at the end of the day, it's deploying them in the playbook that we've developed, and I feel very confident about how we're doing that. I think those are the questions that you had?

但歸根結底，關鍵在於依照我們建立的作戰手冊去部署，我對我們目前的執行方式非常有信心。我想這就是你問的問題？

Yes. Just to build a little bit on -- just on Deepak's comments. And not withstanding that double-digit growth in placements. Of course, when you place CORI's initially, they start off with low utilization and then slowly ramp up over time.

是的。我再補充一點——延伸 Deepak 的評論。即便裝機有雙位數成長。當然，CORI 一開始裝機時，使用量會偏低，然後隨時間逐步爬升。

So not withstanding that double-digit growth in placements, we continue to see progression on both utilization, which has gone up 4 or 5 percentage points from the end of 2025 and also in penetration, which has gone up about 2 percentage points from the end of 2025.

因此，即便裝機有雙位數成長，我們仍持續看到使用量（utilization）與滲透率（penetration）兩方面的進展：使用量相較 2025 年底提升了 4 到 5 個百分點，滲透率相較 2025 年底提升約 2 個百分點。

So it's -- even not withstanding the dilutive impact of putting out more CORIs there and the buildup curve that those necessitate, we're still continuing to see improving trends in penetration and utilization, which I think is very encouraging.

所以——即便新增更多 CORI 會帶來稀釋效應，且需要相應的爬坡曲線，我們仍持續看到滲透率與使用量的改善趨勢，我認為這非常令人鼓舞。

So I don't betray a leftward bias in my -- who I call on, I'll go to the right part of the room and I'll call on colleagues there, and then I'll hop around.

所以我在點名提問時不會偏向左邊——我會先到會場右側請那邊的同事提問，然後再跳著來。

Seb Jantet with Panmure Liberum. Just a couple of questions then. So just on tariffs. Obviously, you've had -- the guidance has changed, but I remember you were talking about $60 million hit prior to that. I just want to check that the gross and the net numbers haven't changed, so that the refund is still $60 million.

Panmure Liberum 的 Seb Jantet。我有幾個問題。先談關稅（tariffs）。顯然你們的指引（guidance）已經改變，但我記得你們之前提到大約 6,000 萬美元的衝擊。我想確認一下毛額與淨額的數字是否都沒有改變，也就是說退款（refund）仍然是 6,000 萬美元。

And just check the logic that that just shifts as a headwind into '27, rather than '26.

只要檢查一下邏輯，也就是說，那只是把不利因素往後移到 2027 年，而不是 2026 年。

Yes. So you're right. So just to say, it was really, really clear on tariffs. The P&L impact for last year was $15 million. The anticipated P&L impact for this year was $60 million. So it was a $45 million drag. We now expect refunds for this year to be around $50 million.

是的。所以你說得對。所以簡單說，關於關稅這點其實講得非常、非常清楚。去年對損益表（P&L）的影響是 1,500 萬美元。今年預期對損益表（P&L）的影響是 6,000 萬美元。所以是 4,500 萬美元的拖累。我們現在預期今年的退稅金額大約是 5,000 萬美元。

So that's a -- so net-net, when you net all that out, it broadly means that tariffs in total compared to last year is neutral on the P&L. So the refunds effectively offset what would have been the P&L charge.

所以這是——所以淨額來看，當你把這些全部相抵之後，大致上意味著：關稅總體相較去年對損益表（P&L）是中性的。因此，退稅實際上抵銷了原本會計入損益表（P&L）的費用。

And then we'll get the headwind next year effectively?

然後我們明年就會實際上面臨不利因素？

And then you will get the headwind next year. So the cash tariffs is of the order of $15 million. So that's the P&L impact in next year will be circa that quantum. But there's also a little bit of further refunds that will come through likely next year.

然後你明年就會面臨不利因素。所以現金關稅大約是 1,500 萬美元的量級。所以明年對損益表（P&L）的影響大約就是那個規模。但另外也還會有一些進一步的退稅，可能會在明年入帳。

I mean, look, there's a lot of moving parts on tariffs and we still got to see the outcome of the Section 232 review that we probably won't find out about until the back end of this year. So lots of moving parts on tariffs as you always expect, but we would expect a little bit of an offset of the P&L charge next year with some further refunds.

我的意思是，你看，關稅這塊有很多變動因素，我們也還得看第 232 條款（Section 232）審查的結果，而我們大概要到今年下半年末才會知道。所以關稅有很多變動因素，這也一如既往；但我們預期明年的損益表（P&L）費用會有一些進一步退稅來做小幅抵銷。

And we'll -- obviously, we'll provide more guidance on that when we come to our premiums in 20 --

而我們——當然，我們會在談到我們 20——的 premiums 時，提供更多相關指引。

Okay. And then the second question then is just around the kind of the cost savings. And obviously, you've managed to kind of to get some decent kind of momentum in the cost savings. If I heard you correctly, you were saying the extra $50 million is largely coming from manufacturing and things like footprint kind of reduction in that type of area.

好的。那第二個問題是關於成本節省。而且很明顯，你們在成本節省上取得了不錯的動能。如果我沒聽錯，你是說額外的 5,000 萬美元主要來自製造端，以及像是縮減據點（footprint）這類領域。

I'm just wondering how -- I mean, those in my experience, take quite a lot of time to achieve. So how have you managed to kind of find new ones so quickly there?

我只是想知道——我的經驗是，那些通常需要相當長的時間才能達成。所以你們是如何能這麼快就找到新的節省項目？

There's a lot of efficiency savings in the way that we run our facilities. There's some benefit coming through from the changes that were made historically that was better than expected. So it's an element of historical change that has come through -- better than we thought will come through in terms of the way it's flowing through the P&L.

我們在營運設施的方式上有很多效率節省。先前歷史上所做的一些變更帶來的效益也正在顯現，而且比預期更好。所以其中一部分是歷史變更帶來的效益——在流入損益表（P&L）的方式上，比我們原先預期的更好。

But there's also been changes that we've made in how we operate things with -- we've also streamlined our operations, for example, from Austin and also Warwick, which we closed. We put -- we consolidated that into our Memphis facility.

但同時，我們也在營運方式上做了調整——我們也精簡了營運，例如在奧斯汀以及我們已關閉的沃里克。我們把——我們把那些整併到我們的孟菲斯廠。

And we've delivered greater-than-expected efficiency savings. But they're not just -- the efficiency savings are not just in manufacturing. The bulk of them, you're right to say, are in manufacturing, but there's also savings we're seeing in sales and marketing. There's also savings that we're seeing in our business services as well.

而我們交付了超出預期的效率節省。但它們不只是——效率節省不僅在製造端。你說得對，大部分在製造端，但我們也在銷售與行銷看到節省。我們在商務服務（business services）方面也看到節省。

And procurement.

以及採購。

Yes. Thank you, Deepak, yes. So I think it's very exciting. I always -- I think I alluded to, I read back the script to the Q1 or the premium number. And I think I sort of said at the time, $150 million or possibly better. I mean, we always had a little bit of line of sight of being able to beat that $150 million. I think it's very pleasing to be able to talk about the $200 million target today.

是的。謝謝你，Deepak，是的。所以我覺得這非常令人振奮。我一直——我想我曾提到，我回頭讀了第一季（Q1）或 premium 數字的講稿。我想我當時大概說的是 1.5 億美元或可能更好。我的意思是，我們一直對於能夠超越 1.5 億美元有一些能見度。今天能談到 2 億美元的目標，我覺得非常令人欣慰。

But I think it really reflects an ongoing discipline around our cost savings that we built initially through the 12-point plan and then added to with the ZBB program. And today, we're now looking at our next wave, and we're not going to talk too much detail about this, but a lot of the stuff that we're doing, for example, and putting in new systems and also the overlay of AI.

但我認為這確實反映了我們在成本節省上的持續紀律：最初是透過 12 點計畫建立，之後再透過 ZBB（零基預算）計畫加碼。而今天，我們正在看下一波——我們不會談太多細節——但我們正在做的很多事情，例如導入新系統，以及 AI 的疊加應用。

And we're doing a lot of work in the business now to look at how do we fundamentally simplify and streamline our end-to-end processes, which remain quite complex. So we've gone through sort of three phases of cost reduction in our business, the first of which was just to get the P&L in a decent shape to deliver the numbers.

而我們目前在業務中做了大量工作，來檢視我們如何從根本上簡化並精簡端到端流程，而這些流程仍然相當複雜。所以我們的成本削減大致經歷了三個階段，第一個階段只是讓損益表（P&L）處於良好狀態，以交付數字。

The second of which is to basically take our existing processes and take away some of the -- what we call the facts and the cost in those. And the third wave is to fundamentally simplify and automate and streamline our processes. And we're now in that third wave. So we'll -- no doubt, we'll talk more in the future about what the opportunity to come is.

第二個階段基本上是針對我們現有流程，拿掉其中一些——我們所謂的冗餘（facts）與成本。第三波則是從根本上簡化、自動化並精簡我們的流程。而我們現在就在第三波。所以我們——毫無疑問，未來我們會更多談到接下來的機會。

Just two things, one kind of clarification and just more a broader point. Just when we talk about footprint, it's not that we're closing any more factories that we hadn't contemplated. And you're right, like those things take time. It's actually how we're utilizing our current footprint. That's the key driver.

補充兩點，一個是釐清，另一個是更宏觀的觀點。當我們談到據點（footprint）時，並不是說我們要關閉任何比原先規劃更多的工廠。而你說得對，像那樣的事情需要時間。實際上關鍵驅動因素是我們如何運用現有的據點。這才是關鍵驅動因素。

Apart from all of the things that John said, how we use Malaysia versus Memphis in terms of optimizing across our network, for example, in Orthopaedics is one of the contributors to that. We've called out the spirit of continuous improvement as kind of the key, kind of underlying things that enables the strategy to happen. I'm pleased to report that some of those things, the organizations have embraced very, very nicely.

除了 John 所說的所有事情之外，例如我們如何在馬來西亞與孟菲斯之間做配置，以在整個網路中最佳化——以骨科（Orthopaedics）為例——這也是其中一個貢獻因素。我們也點出「持續改善」的精神是促成策略落地的關鍵、底層要素之一。我很高興回報，其中一些事情組織已經非常、非常好地接受並落實。

So the spirit of continuous improvements that lead to these additional savings, it's not a point-in-time activity. It's actually how we are ordering the business this way. And that's what enabled us to hold to a profit target despite the revenue miss.

所以，帶來這些額外節省的持續改善精神，並不是一次性的活動。它其實是我們以這種方式來經營（ordering）業務。而這也讓我們即使營收未達標，仍能維持獲利目標。

Yes, there's not the headwind that we had from tariffs that we expected, but it's more than that, right? It's all of these additional savings that allow us to make -- it's actually that simple statement come true.

是的，確實沒有我們原先預期的關稅不利因素，但不只如此，對吧？是所有這些額外節省讓我們能夠——讓那句看似簡單的說法真正成真。

Charles Weston from RBC. Just to quickly clarify that. How much of that $50 million is sort of brought forward from 2027? And how much of it is incremental, and we should be modeling off that for 2027?

我是 RBC 的 Charles Weston。想快速釐清一下。那 5,000 萬美元當中，有多少是從 2027 年提前到現在？又有多少是增量（incremental），而我們在建模 2027 年時應該以此為基礎？

Do you want to take that or I can?

你要回答，還是我來？

I mean, I think -- the way I think about it is a little bit of the $50 million that's -- I mean, in terms of first half performance, there's -- like there's an element of bringing forward some of the half two into half one. And in terms of the back half of the year, there's an element of bringing in some of the half one '27 into the half two of '26. So there's always shifting everything forward.

我的意思是，我認為——我看待它的方式是：這 5,000 萬美元當中有一部分是——也就是說，就上半年表現而言，確實——例如，有一部分是把原本下半年（H2）的內容提前到上半年（H1）。而就今年下半年而言，也有一部分是把 2027 年上半年（H1 '27）的一些內容提前到 2026 年下半年（H2 '26）。所以總是會把各項內容往前移。

The point I would -- we're not going to sit here and guide now to '27 numbers. But the point I would make is that this is not a one-off exercise, to Deepak's language just now. I mean, deliberately used the word continuous improvement. And I also talked a little bit about some of the savings that we're now driving through things like our ERP program and also AI as well.

我想強調的一點是——我們不會坐在這裡就現在去提供到 '27 的數字指引。但我想說的是，這不是一次性的作業，用 Deepak 剛才的說法。我的意思是，我刻意用了「持續改善」這個詞。而且我也稍微談到一些我們現在正透過像是 ERP 計畫以及 AI 等方式所推動的節省。

So I would say we've got good visibility. And we're not going to set out the guidance now, but we've got good visibility of future opportunities to drive further efficiency savings in this business, and we'll set out that much more clearly, of course, when we give the guidance for '27.

所以我會說我們有很好的能見度。我們現在不會提出指引，但我們對未來進一步推動本業效率節省的機會有很好的能見度；當我們提供 '27 的指引時，當然會把這點講得更清楚。

But I wouldn't -- I would not classify it as robbing Peter to pay Paul in terms of bringing it forward from '27 into '26. There will be plenty more to come in '27.

但我不會——我不會把它歸類為「挪東牆補西牆」，也就是把原本 '27 的內容提前到 '26。'27 還會有更多可以釋出的。

Okay. Sorry, that was a long clarification, but I had two actual questions. One of them on ACA. Have you noticed any changes in terms of either procedure volumes or CapEx sale or CapEx demand from US hospitals?

好的。抱歉，剛才那段澄清有點長，但我其實有兩個問題。其中一個是關於 ACA。你們是否注意到美國醫院在手術量、資本支出（CapEx）銷售或資本支出需求方面有任何變化？

And secondly, just in terms of LANDMARK launch timing, can you just confirm that everything is on track for both Cemented and Cementless. And sort of the typical, I think you said it's a two-quarter ramp to really start meaningfully getting sales from those things.

第二個是關於 LANDMARK 的上市時程，你能否確認 Cemented 與 Cementless 兩者都按計畫進行？以及一般而言，你之前提到大概需要兩個季度的爬坡期，才會開始從這些產品真正有意義地帶來銷售。

Sure. On ACA, we did see some impact of that in terms of procedures. So it's both -- across elective procedures, you have some hospital systems comment on that. And we did see that, but it was not the most pronounced effect, so we didn't overly measure on that. But there is an impact of ACA-related procedures laydown that we are -- that we have seen both across Knees and Hips.

當然。關於 ACA，我們確實看到在手術量方面有一些影響。所以在——涵蓋選擇性手術方面，有些醫院體系對此有所評論。我們也看到了，但影響並不是最顯著的，因此我們沒有過度去量化它。但我們確實看到與 ACA 相關的手術延後（laydown）帶來的影響，涵蓋膝關節與髖關節兩個領域。

But like I said, it's not the dominant factor that explains our performance. In terms of LANDMARK timing, Porous is the very end of Q3, so largely a Q4 effect. And then the Cemented version of LANDMARK is the end of Q2 of 2027. And as you know, Charles, there's a ramp associated with that. You've talked about two quarters. It isn't quite as straightforward is that it depends on competitive dynamics, right?

但如我所說，這不是解釋我們表現的主導因素。至於 LANDMARK 的時程，Porous 會在第三季末推出，因此主要會在第四季反映。然後 LANDMARK 的 Cemented 版本是在 2027 年第二季末。如你所知，Charles，這會伴隨一個爬坡期。你提到兩個季度。但事情並不完全那麼單純，因為這取決於競爭動態，對吧？

But there's a good way and not so good way of introducing these launches, right? When you can throw a lot of capital at it and encourage a lot of trial at a great deal of capital expense, right? But a more methodical and a proper way to do an Orthopaedics launch is to be much more mindful in terms of how you deploy capital in order to encourage trial and then ultimately, adoption.

但推出這些上市案有做得好與做得不好的方式，對吧？你可以砸很多資本，並以很高的資本支出來鼓勵大量試用，對吧？但在骨科領域，更有方法、也更正確的上市方式，是在資本投放上更謹慎，以鼓勵試用，並最終促成採用。

So one of the things that we've gotten much, much better as an organization is around capital discipline and capital efficiency in Orthopaedics business that we did not consistently have. So that does impact top line, right? And we've called that out in previous quarters. But we expect to bring that level of capital discipline and efficiency mindset to the LANDMARK launch.

因此，我們作為一個組織，在骨科業務的資本紀律與資本效率方面已經進步很多、很多，而這是我們過去並非一直具備的。所以這確實會影響營收端（top line），對吧？我們在前幾個季度也點出過這點。但我們預期會把這種資本紀律與效率思維帶到 LANDMARK 的上市。

The consequence of that is a is a more kind of slower ramp, but it'd be, I think, a more durable one and also the more disciplined way to tackle these.

其結果會是較慢的爬坡，但我認為會更具持久性，也是一種更有紀律的做法來推進這些事情。

Okay. One question here, and then we'll go online.

好的。這裡再一個問題，然後我們會轉到線上提問。

Richard Felton from Goldman Sachs. The first one, I want to ask about something that's been coming up a little bit more in our investor conversations, and that is on potential competitive risk for SANTYL. Could you remind us the size of that product today? How revenue split between different care settings? And what you perceive as the key competitive strength of SANTYL?

高盛的 Richard Felton。第一個問題，我想問一個在我們與投資人對話中最近更常被提到的議題，也就是 SANTYL 潛在的競爭風險。你能否提醒我們這個產品目前的規模？營收在不同照護場景之間如何分布？以及你認為 SANTYL 的關鍵競爭優勢是什麼？

And then the second one is on Advanced Wound devices. So I suppose, over the last four quarters, so we've seen a bit of a deceleration from kind of double-digit growth to mid-single-digit growth for that part of the business. What has been driving that? And what is the right way to think about the trajectory for Advance Wound devices going forward?

第二個問題是關於先進傷口（Advanced Wound）裝置。我想在過去四個季度，我們看到這部分業務的成長從雙位數放緩到中個位數。是什麼因素在推動這個變化？以及未來應該如何看待先進傷口裝置的成長軌跡？

Sure. SANTYL, we don't typically give product level detail. It is a multiple hundred million dollar product, right? And to your point, there are kind of -- it's a category where effectively, a large proportion of that market, and there is some competitive activity in that. I just want to emphasize that that's not what's driving our numbers today.

好的。SANTYL 我們通常不提供單一產品層級的細節。它是一個數億美元規模的產品，對吧？如你所說，這個品類基本上——該市場中有相當大一部分，確實存在一些競爭活動。我只想強調，這並不是我們目前數字的驅動因素。

I just want to clearly emphasize that. What -- where we stand out in SANTYL is we don't require refrigeration. So supply chain is simpler. There isn't pain associated with the use of our product, which some of our competitors feature, right? And one of the disadvantages is that it is a slower process -- I mean, it takes time for the product to take effect, right? That's one of the downsides of SANTYL.

我想非常清楚地強調這一點。我們在 SANTYL 的差異化在於不需要冷藏。因此供應鏈更簡單。使用我們產品不會伴隨疼痛，而有些競品則會有這個特徵，對吧？其中一個缺點是它是一個較慢的過程——我的意思是，產品發揮效果需要時間，對吧？這是 SANTYL 的其中一個劣勢。

But having said that, it's got a proven kind of track record and utilization across a range of use cases and across settings, whether it's in an acute setting or when patients get discharged home with a prescription for SANTYL, right? So it is across all of those areas.

但即便如此，它在各種使用情境與不同場域中都有經過驗證的使用紀錄與採用度，不論是在急性照護場域，或是病人出院回家後拿到 SANTYL 處方，對吧？所以它涵蓋所有這些領域。

We feel very good about how we're positioned within that category. We have line of sight obviously to what competitive products are what they offer and how SANTYL continues to be differentiated relative to it. Of course, we're not resting on our laurels there. There is a next-gen product.

我們對自己在該品類中的定位感到非常有信心。我們當然也能清楚掌握競品有哪些、它們提供什麼，以及相較之下 SANTYL 如何持續差異化。當然，我們不會因此自滿。我們有下一代產品。

So we aim to improve upon SANTYL, building upon its advantages around supply chain, its advantages around the level of pain of which there isn't in using the product, but actually have it be faster in terms of how it works. So that's our next gen SANTYL.

因此我們的目標是在 SANTYL 的基礎上再提升，延續它在供應鏈上的優勢、以及使用時不會造成疼痛的優勢，同時讓它在作用速度上更快。這就是我們的下一代 SANTYL。

In terms of AWD, there's two broad categories, so single-use and traditional negative pressure. We also classify LEAF within that. And LEAF has both the device component and the dressing component, just to kind of disaggregate what's in our AWD right? Largely, the deceleration that you see is in our traditional negative pressure category, which is our RENASYS platform.

至於 AWD，大致分成兩大類：一次性（single-use）與傳統負壓（traditional negative pressure）。我們也把 LEAF 歸類在其中。而 LEAF 同時包含裝置（device）組件與敷料（dressing）組件，這裡只是把我們 AWD 的構成稍微拆開來說明，對吧？你看到的放緩主要發生在我們的傳統負壓類別，也就是 RENASYS 平台。

There, as we've highlighted, we're doing well in the post-acute segment. We are not taking share in the acute kind of channel. And the answer to that is actually have a better rounded offering with RENASYS, right, both in terms of the next-gen canister, but actually having a whole assortment of dressings that's fit for purpose for the application, whether it's OB-GYN, whether it's GI procedures, Orthopaedic procedures and the like, and that each one's got a specialized kind of dressing and we've -- we have a narrower range there than the large competitor within that.

在那裡，如我們先前強調的，我們在後急性（post-acute）市場表現不錯。但我們在急性照護（acute）通路並沒有取得市占。原因其實是：我們需要讓 RENASYS 的產品組合更完整，對吧？包括下一代集液罐（canister），但更重要的是要有一整套針對不同應用而設計、適用的敷料組合，不論是婦產科（OB-GYN）、腸胃道（GI）手術、骨科手術等等；每一種都有專門的敷料，而我們在這方面的範圍比該領域的大型競爭對手更窄。

So we obviously have product development to address that, and we'll start to build that out in 2027. So the deceleration is largely within the acute care segment of traditional negative pressure. On the single-use with PICO, that's been a product that's been a growth engine for us for quite some time.

因此，我們顯然會透過產品開發來解決這個問題，並且會在 2027 年開始逐步建置。所以，減速主要發生在傳統負壓治療的急性照護細分市場。至於 PICO 的一次性產品，這款產品長期以來一直是我們的成長引擎。

And in addition to its use across care settings, we're actually invested to drive it into the geographies where we're not present in the same way today. That's part of the investment that we've talked about, and we expect to see the benefits of that come through in Q3 and especially in Q4, right? So we continue to do well there.

而且除了在各種照護場景中的使用之外，我們也實際投入資源，推動它進入我們目前尚未以同樣方式布局的地理市場。這是我們談到的投資的一部分，我們預期其效益會在第三季、尤其是第四季開始顯現，對吧？因此我們在那裡仍持續表現良好。

There's competitor activity within the single-use segment. We feel well positioned within that. But we also have our pipeline there that we expect to, I think we called that out in our Capital Market Day presentation somewhere in the '28, time frame, we expect to come up with our extension PICO.

在一次性細分市場中有競爭對手的活動。我們認為自己在其中具備良好的競爭位置。但我們在那裡也有產品管線；我想我們在資本市場日的簡報中某處提到過，大約在 2028 年的時間框架，我們預期會推出 PICO 的延伸版本。

So hopefully, it gives you a feel for kind of how that segment is categorized and the dynamics within that. So we'll now go online first, and then I'll come back into the room.

希望這能讓你大致了解該細分市場的分類方式以及其中的動態。接下來我們先線上提問，之後我再回到會議室。

(Operator Instructions) Veronika Dubajova, Citi.

(接線員指示) Veronika Dubajova，花旗。

I have two please. One sort of slightly diving into the nitty gritty, but just curious to get your thoughts on what's happening in Trauma & Extremities. Obviously, we had a number of years post the [ATLAsplan] launch really accelerated dramatically year to date. Just curious if you can touch upon the dynamics you're seeing in Trauma versus Extremities, and if there are things you can do to get that growth back into the mid-to-high single digits.

我有兩個問題。第一個稍微深入一些細節，我想了解你們對創傷與四肢（Trauma & Extremities）目前情況的看法。顯然，在 [ATLAsplan] 上市後的幾年裡，我們看到年初至今的成長曾大幅加速。想請你談談你們在創傷相較於四肢所看到的動態，以及是否有什麼作法可以讓成長回到中到高個位數。

And then my second question is a big picture one. I apologize, but I have to come back to the midterm guide. I think even just to hit the low end of the 6% to 7% that you guided for previously. If you are doing 4% this year and you have to do 7% in the other two years, and that would be a pretty dramatic acceleration versus the trend that you'd seen in the last couple of years.

第二個問題是較宏觀的。不好意思，但我必須回到中期指引。我認為即便只是要達到你們先前指引的 6% 到 7% 的低端。如果你們今年做 4%，那接下來兩年就必須做到 7%，相較於過去幾年的趨勢，這會是相當劇烈的加速。

I appreciate there are to headwinds this year, but they were also headwinds to last year and the year before. So I'm just trying to understand the logic for why you are sitting to that 6% to 7%? Is there any way at all in your mind to get anywhere above the low end of that range? And I guess what gives you the confidence at this point in time to maintain that?

我理解今年有一些逆風，但去年和前年也同樣有逆風。所以我想了解的是，你們為什麼仍維持 6% 到 7% 這個區間的邏輯是什麼？在你看來，有沒有任何方式可以達到高於該區間低端的水準？以及在目前這個時間點，是什麼讓你們有信心維持這個指引？

Sure. Thanks, Veronika. So I'll take them in order. So Trauma & Extremities, I'll talk about Trauma and I'll talk about Extremities.

好的。謝謝你，Veronika。我會依序回答。關於創傷與四肢，我會先談創傷，再談四肢。

The Trauma, we're positioned kind of nicely with our EVOS platform. I've talked about pelvic, which is something like 1.5% of the overall pie, but it's an important piece that we're going to launch and do, right? They'll be even fuller now.

在創傷方面，我們以 EVOS 平台的布局相當不錯。我之前提過骨盆（pelvic），它大概只占整體市場的 1.5% 左右，但這是一個重要的部分，我們會推出並推進，對吧？現在會更完整。

Now we've been expecting competitors to launch within that category, and two of our competitors are, in fact, at various stages of launch in the CORI plating category. So there will be some level of trial, some level of adoption as those competitors launch within that category. And we're seeing some impact of that.

我們一直預期競爭對手會在這個類別推出產品，而我們的兩家競爭對手確實正處於 CORI 鋼板（plating）類別不同階段的上市進程中。因此，隨著這些競爭對手在該類別推出產品，會出現一定程度的試用與採用。我們也看到這對我們造成了一些影響。

And that's not a new factor, it's just that's been out there in the market. I think our -- the EVOS compares very, very favorably to competitors' offerings. But over time, as surgeons try those, you'll see some quarterly variations depending on who's trying, who's adopted and so forth, right? But I feel very good about how we're positioned within that category.

這不是新的因素，只是市場上一直存在。我認為我們的 EVOS 與競爭對手的產品相比非常、非常有競爭力。但隨著時間推進，外科醫師會去試用那些產品；你會看到每季因為誰在試用、誰已採用等因素而出現一些波動，對吧？但我對我們在該類別的定位非常有信心。

We do have drivers of our own beyond EVOS, IM nails. We launched that, I guess in Q1, you'll have to remind me, John. But in the recent quarter or two, we launched our own IM nail offering. We hadn't had a new product there in -- my sales force likes to remind me in far too long. But we've got a nice offering there that should expect to kind of drive growth and we called that out in the last quarter.

除了 EVOS 之外，我們也有自身的成長驅動因素，例如髓內釘（IM nails）。我們推出了那個產品，我想是在第一季，你得提醒我一下，John。但在最近一到兩季，我們推出了自家的髓內釘產品。我們在那個領域很久沒有新產品了——我的銷售團隊總愛提醒我，久得太久了。但我們現在有一個不錯的產品組合，應該能帶動成長，我們也在上一季提到過。

So core trauma category, nicely positioned in terms of our products, but there is competitor launches, particularly in plating. On Extremities, our presence now -- we're a relatively small player in Extremities, as you know. And for us, the real call out here is Shoulder with AETOS, right?

因此，在核心創傷類別，我們的產品布局相當到位，但確實有競爭對手的上市動作，尤其是在鋼板方面。至於四肢，我們目前的市場存在感——如你所知，我們在四肢領域仍是相對較小的參與者。對我們而言，這裡真正要強調的是 AETOS 的肩關節（Shoulder），對吧？

And there, again, we are a relatively small player, but we now have more or less the offering we need on the implant side, but actually, importantly, we've got CORI enabled for planning and execution. And there's some real differentiation there within that anatomic, reverse anatomic, glenoid and humeral planning and execution, which is quite a differentiating feature.

在那裡，同樣地，我們仍是相對較小的參與者，但在植入物端我們現在大致具備所需的產品組合；更重要的是，我們已讓 CORI 支援術前規劃與手術執行。在解剖型、反解剖型、盂窩（glenoid）與肱骨（humeral）的規劃與執行方面，這帶來了明顯差異化，是相當具區隔性的特點。

And they're a handheld robot actually is differentiated relative to a fixed arm robot for shoulder surgery. But we are working off of a small base. And we are in the early stages of launch. It will be more group relevant, I would say, '27, '28. We're in that early stages, and they were getting nice traction, not only with surgeons who are trying it, but surgeons who have actually integrated that as part of the routine practice.

而且他們的手持式機器人，相較於用於肩關節手術的固定式機械臂機器人，確實更具差異化。但我們是從一個很小的基礎起步。而且我們仍在上市初期階段。我會說，這在 2027、2028 年會與集團整體更相關。我們目前處於早期階段，且正在取得不錯的進展，不僅是嘗試的外科醫師，還包括已把它整合進日常臨床流程的外科醫師。

So it's -- there is just not as material to the group given the small base. So hopefully, it gives you a bit of texture and color around Trauma & Extremities.

所以——由於基礎規模小，對集團整體的影響還沒有那麼顯著。希望這能讓你對創傷與四肢有更多脈絡與細節。

On the midterm guide, look, as I said, '26 was softer, Veronika, you've done a bit of the numerics around 4% and then 6% to 7%. The reality is we're two quarters into a three-year kind of plan, right? And obviously, we have thought through the numerics ourselves, and we've gone through the fundamentals of what actually drives the 6% to 7%.

關於中期指引，聽著，正如我說的，2026 年較疲弱，Veronika，你也做了一些數字推算，從 4% 到 6% 至 7%。現實是，我們在一個三年計畫中才走到第二季，對吧？而且顯然我們自己也已經把數字想過一遍，並且檢視了真正驅動 6% 到 7% 的基本面因素。

And as I said earlier, once we get through the period today, I mean, what's holding us back this year, why did we actually reduce the guide? One is our position in US Knees and how that's impacting us today with the gap in the portfolio. And the second is SANTYL, right, with the prior authorization that we are having to contend with.

如我先前所說，一旦我們度過目前這段期間——也就是今年是什麼在拖累我們、為什麼我們下修指引？第一是我們在美國膝關節（US Knees）的市場位置，以及產品組合缺口對我們當前造成的影響。第二是 SANTYL，對吧？我們必須應對先前授權（prior authorization）的問題。

And on the Skin Subside, we're on the upper end of the range, but still within the corridor that we guided to. That is in combination, not a great thing to have to navigate in this year because you have a bunch of headwinds and not a whole lot of tailwinds. But as we move into 2027, we expect to normalize the Skin Subs, right? We expect to kind of normalize on the SANTYL, and then we'll have the portfolio complete in the way that allows us to be competitive.

至於 Skin Subs 方面，我們處於區間的上緣，但仍在我們所給出的走廊範圍內。這些因素疊加在一起，使得今年的確不太好走，因為你有一堆逆風，卻沒有太多順風。但當我們進入 2027 年，我們預期 Skin Subs 會回到常態，對吧？我們也預期 SANTYL 會逐步正常化，然後我們的產品組合將以完整的方式到位，使我們能夠具備競爭力。

Now there will be a ramp starting in Q4 this year. Cementless was first and then starting in the back half of next year with Cemented LANDMARK. So there will be a phasing or a pacing in terms of how we become more competitive in Knees.

今年第四季起將會開始放量爬坡。無骨水泥固定（Cementless）會先行，接著在明年下半年推出採用骨水泥固定的 LANDMARK。因此，在我們提升膝關節產品競爭力的過程中，會有一個分階段或節奏上的安排。

But you put all of that together, we feel good about the growth drivers we've got stacked up in Orthopaedics. And I've talked about Knees and Hips. It's about getting execution capability in CORI. We're seeing contracting activity that ties together both Knees and Hips. And I think we'll be able to better compete within that as we have execution ability on CORI as well on the CORI XT platform.

但把這些因素綜合起來看，我們對骨科（Orthopaedics）已經堆疊起來的成長動能感到樂觀。我也談過膝與髖。關鍵在於建立 CORI 的執行能力。我們看到把膝與髖一起綁定的合約簽訂活動。我認為，隨著我們在 CORI 以及 CORI XT 平台上具備執行能力，我們也將能在其中更好地競爭。

And then as I've talked about AETOS becoming more relevant in the '27, '28 period. And then in Sports, we've talked about Big four, and they're very nice growth drivers that are kind of lined up within that business unit.

接著如我所說，AETOS 在 2027、2028 年期間會變得更具相關性。另外在運動醫學（Sports）方面，我們談到「四大」項目，它們是相當不錯的成長動能，且大致已在該事業單位內排好時程。

And then in Wound, beyond the normalization of Skin Subs, you've got new product launches coming in the traditional negative pressure category where we have given up ground, and I've previously commented on the fact that, that's one part of the 12-point plan that didn't work as well, right?

再來在傷口照護（Wound）方面，除了皮膚替代物（Skin Subs）的常態化之外，你還有新產品即將在傳統負壓治療類別推出；在那個類別我們曾經失去一些市占，而我先前也評論過，那是 12 點計畫中表現沒那麼好的一部分，對吧？

The growth rates were great, but when you looked at the placements of RENASYS, we were behind on that. But we have addressed that. We understand the reasons why. But as we turn into 2027, that will become a growth driver together with the investments we've made in LEAF and NextGen PICO.

成長率很亮眼，但當你看 RENASYS 的裝機/佈點（placements）時，我們在那方面落後。但我們已經處理了這個問題。我們也理解原因。隨著我們邁入 2027 年，這將成為一項成長動能，並與我們在 LEAF 與 NextGen PICO 上的投資相互加乘。

So you stack all of that up, that gives us the confidence that at the end of the day, we are 6% to 7% growth company, despite the challenges we're navigating through in '26. Yes. We'll come back into the room and then back online.

所以把這些都加總起來，讓我們有信心：最終而言，儘管我們在 2026 年正面臨各種挑戰，我們仍是一家年成長 6% 到 7% 的公司。是的。我們會回到會議室，然後再回到線上。

It's Kane Slutzkin, Deutsche. John, just a quick one for you on the savings. Can you give us some comfort that -- I guess none of what's been done over the last few years or still to be done sort of is at the detriment of growth down the line. Often, we do see these sort of situations where you could cut too close to the bone?

我是德意志銀行（Deutsche）的 Kane Slutzkin。John，我想就節省（savings）快速問一題。你能否讓我們放心——我想是說，過去幾年已做的、或仍待完成的這些措施，不會在未來損害成長。我們常看到這種情況：可能會砍得太貼近骨頭（cut too close to the bone）？

And then just for Deepak, just quickly coming back to the US environment. You mentioned sort of some of it is a slower growth. Your bigger peers have kind of pushed back -- seemed to push back at a sort of view that the market is weakening. There was one smaller peer suggesting that we go back to pre-COVID sort of growth rates.

另外也想請 Deepak 簡短回到美國市場環境。你提到其中一部分是成長較慢。你們較大的同業似乎反駁了「市場正在走弱」的看法。有一家較小的同業則表示，我們會回到 COVID 之前那種成長率。

Just wondering if you have any thoughts on that with a view to obviously try to launch?

想請問你對此有沒有什麼看法，尤其是考量到你們顯然也正準備推出（launch）？

You want to take the first one?

你要先回答第一題嗎？

Yes. Yes, just to be -- I think we can be categorically clear that we're not sort of strengthening the business vis-a-vis growth. In fact, we're very, very deliberately investing in growth in the business. So we've been very conscious about how do we deliver cost and efficiency savings and how do we actually invest in our growth, so much so that we actually split it out in the bridge that we give you. So we really see the transparency.

好的。是的，先把話說清楚——我認為我們可以非常明確地說，我們並不是以犧牲成長為代價來強化業務。事實上，我們非常、非常刻意地在業務中投資成長。因此，我們一直很有意識地思考：如何實現成本與效率節省，以及如何實際投資於成長；以至於我們在提供給你們的那張橋接表（bridge）中把它拆分出來。所以我們確實提供了透明度。

So you see the savings in that bridge and you see the sort of $33 million investment that we're making in growth. What does that look like in practice? Very simply, I mean, if you look at it just purely in head count terms, and I'm massively in favor of cutting head count where we can.

你會在那張橋接表中看到節省，也會看到我們投入成長的約 3,300 萬美元投資。實務上那是什麼樣子？很簡單，如果只用人力編制（headcount）的角度來看，而且我非常支持在可行之處削減人力。

But actually, over the last 12 months or so, we've actually increased our headcount. But the areas where we -- we've actually reduced our headcount, permanent head count in those areas where we can drive efficiency savings.

但其實在過去大約 12 個月，我們的員工人數是增加的。不過，我們確實在那些可以帶來效率節省的領域，降低了永久編制（permanent headcount）。

So for example, manufacturing and operations, we've actually reduced our overall permanent headcount. And we've actually increased our head count almost singularly in Sports and Wound, where we see very specific opportunities to grow our business.

例如在製造與營運方面，我們降低了整體永久編制。而我們幾乎是單一地把人力增加在運動醫學（Sports）與傷口照護（Wound），因為我們在那裡看到非常明確的業務成長機會。

And so obviously, the Sports story is very clear and Deepak's talked about the four opportunities we have across CARTIHEAL and TESSA and REGENETEN and et cetera, et cetera. So that's very clear. And in Wound, we have the opportunities in PICO and ACC and Skin Subs.

因此，運動醫學的故事非常清楚，Deepak 也談到我們在 CARTIHEAL、TESSA、REGENETEN 等等方面的四個機會，諸如此類。所以那非常清楚。而在傷口照護方面，我們在 PICO、ACC 與皮膚替代物（Skin Subs）上有機會。

And if you actually look at the increase in our headcount, all of it comes into Wound and Sport, and at least 75% of that increase comes in the front line, in other words, into sales, into medical education, into customer service. So we're not adding to the back office.

而如果你看我們人力增加的部分，全部都投入在傷口照護與運動醫學；而且其中至少 75% 的增量是在第一線，也就是銷售、醫學教育與客戶服務。所以我們不是在增加後勤辦公室（back office）。

So I can be absolutely clear that we are recycling resource. We are taking resources away from things like the back office functions where we're streamlining and taking cost out, and we're reinvesting into the front line to drive that top line growth.

因此我可以非常明確地說，我們是在重新配置資源。我們把資源從後勤職能等正在精簡、降低成本的地方移出，並再投資到第一線，以推動營收端（top line）的成長。

Now we won't see a return on that investment within '26. The $33 million I say that we're investing in that growth. But to Deepak's earlier comments about what gives us confidence in our ability to deliver, why do we think we're a 6% to 7% growth company, because we're investing in that growth.

不過，我們不會在 2026 年內看到這項投資的回報。我所說投入成長的 3,300 萬美元。但呼應 Deepak 先前對我們為何有信心能交付、為何認為我們是一家 6% 到 7% 成長公司的評論，原因就在於我們正在投資成長。

So we're being very deliberate. And we're spelling that out for you as well. It's not sort of assumed in one lump in the bridge. We're very clearly separating out the cost savings from the investment piece.

所以我們做得非常刻意。我們也把這點清楚地說明給你們。它不是在那張橋接表中以一筆總額被假設進去。我們非常清楚地把成本節省與投資部分分開呈現。

Just a couple of builds on it. As we navigated the 12-point plan journey, I'll tell you, with all the margin pressures we faced, it would have been easy for us to kind of meet the targets, particularly within the years, the interim years by cutting R&D.

再補充幾點。在我們推進 12 點計畫的過程中，我可以告訴你，面對所有的毛利壓力，我們其實很容易透過削減研發（R&D）來達成目標，尤其是在各年度、過渡年度要達標時。

I mean, I can tell you that, that was a place we could have gone, although we more or less got there at the end of the three-year period. You'll remember the periods in '23, '24, where there's tremendous margin pressure and there's all the questions whether we're going to get to kind of what we set out.

我的意思是，我可以告訴你，那確實是我們可以走的一條路，雖然我們在三年期結束時或多或少也達到了。你會記得在 2023、2024 年期間，毛利壓力非常大，大家也一直在問我們是否能達到當初設定的目標。

But we resisted the urge to do that, right? We maintain the level of investment in R&D in order to fuel the growth, and we're starting to see the benefits of that, and it will come even as we go through the next three years. So it's a very conscious -- life's a balancing act.

但我們克制了那種衝動，對吧？我們維持研發投資水準以驅動成長，我們也開始看到其效益，而且在接下來三年中仍會持續顯現。所以這是非常有意識的——人生就是一種平衡。

But what we have actually held on to is to not cut the things that position this business for sustainable kind of growth over the longer term. John's talked about the trade-offs there in manufacturing and commercial investments, but particularly in R&D as well. We've made sure that we have ring-fenced or protected the things that really drive long-term business -- long term growth in this business.

但我們真正堅持的是：不去削減那些能讓這個業務在更長期具備可持續成長定位的事項。John 談到了在製造與商業投資上的取捨，但尤其是在研發方面也是如此。我們確保把真正驅動這個業務長期成長的事項加以圈定（ring-fenced）或保護。

In terms of your question on US procedure, I assume it's primarily in Orthopaedics. Believe it or not, it's actually harder to get at what the market is doing that you might think, right? Third-party data sources in this space are not as robust as it is in other areas. So we're all trying to parse based on limited data points kind of what the market actually is doing, right?

就您關於美國手術量的問題而言，我假設主要是在骨科領域。信不信由你，要掌握市場實際在做什麼，其實比你想像的更難，對吧？這個領域的第三方數據來源不像其他領域那麼健全。所以我們都在嘗試根據有限的數據點去解讀市場實際在做什麼，對吧？

And I have been somewhat loath to comment on the market because we've had performance challenges in the US. So I've been less front fitted and commenting on the market historically.

而且我一直有點不太願意評論市場，因為我們在美國的表現面臨挑戰。所以過去我比較少站到前面、也比較少就市場發表評論。

Now our performance still is challenged, but it's not necessarily all because of commercial execution. They've got a little bit more visibility into kind of what's going on in the market. So when I tell you, there's a little bit of a market effect, it's based on what we can see.

現在我們的表現仍然有挑戰，但不一定全都是商業執行的問題。他們對市場上發生的事情有更高一些的能見度。所以當我告訴你市場有一些影響時，是基於我們所能看到的情況。

And I wouldn't have been able to say that even last year -- never mind, two years ago. So against that backdrop of market is not as robust third-party doses to call it. I do believe when you look -- it's an exercise of triangulation. So what are those things you look at? First is look at reimbursement, right?

而這點即使在去年我都未必能這麼說——更不用說兩年前了。所以在這樣的背景下，市場缺乏足夠健全的第三方數據（姑且這麼說）。我確實認為，當你去看——這是一個「三角驗證」的練習。那你會看哪些東西？第一個是看給付（reimbursement），對吧？

And those are public, and you can see what's happening to how procedures, Knees and Hips get reimbursement -- reimbursed in various care settings, right? And you can see what that -- what that's done in the past was is projected to do in 2027. That's one data point.

而這些是公開資訊，你可以看到膝關節與髖關節等手術在不同照護場域的給付——如何被給付，對吧？你也可以看到這些在過去造成了什麼影響，以及預計到2027年會如何發展。這是一個數據點。

The second data point you've got is the shift in site of care, right? As you go from a hospital setting into an ASC, the reimbursements are lower. There's an impact on ASPs as you go through that, right? And that's a very dynamic thing, but there's impact around that.

第二個數據點是照護場域的轉移，對吧？當你從醫院場域轉到ASC（門診手術中心），給付會更低。在這個過程中，對ASP（平均售價）會有影響，對吧？而這是非常動態的事情，但確實會帶來影響。

Against that, you've got other factors like mix, right, and the shift from Cemented to Cementless, you have a mixed benefit that runs counter to the things that I've talked about. So you put all of these pieces together, working out what the market is doing in revenue terms and what it's doing in volume terms can be trickier.

在此之外，還有其他因素，例如產品組合（mix），對吧？以及從有骨水泥（Cemented）轉向無骨水泥（Cementless），你會得到一個組合上的利多，與我剛才談到的那些因素形成對沖。所以把這些拼圖全部放在一起，要推算市場在營收面與量（volume）面到底在做什麼，就會更棘手。

And then you've got the ACA impact that you asked about earlier, which is not only patients who are coming off of the ACA roles as they lose subsidies. But also what's really happening to those who are in commercial programs that are not necessarily recipients of those subsidies, but they're out of pocket.

然後還有你先前問到的ACA影響，不僅是那些因補貼取消而退出ACA名冊的病患。也包括那些在商業保險方案中的人——他們不一定是補貼的受益者，但他們需要自付。

Out-of-pocket proportion -- fees have gone up. The premiums have gone up and how that impacts their desire or their willingness or ability to undertake elective procedures is also another factor into this. So you put all of this in, what I see and what I've seen in Q2 is a slow down. But I'm not going there to explain our performance in the quarter.

自付比例——費用已經上升。保費也上升了，而這如何影響他們進行選擇性手術的意願、意圖或能力，也是另一個因素。所以把這些都納入後，我看到、也在第二季看到的是放緩。但我不會用這個來解釋我們本季的表現。

So hopefully, it gives you a bit of color around market, the position that I've taken, why I've taken it based on what I see. Back to the calls, yes.

希望這能讓你對市場有一些更具體的理解，包括我採取的立場、以及我為什麼基於所見而採取這個立場。回到提問，是的。

Caitlin Cronin, Canaccord.

Caitlin Cronin，Canaccord。

Maybe just starting with skin subs. How are you thinking about recovery of this business that you noted it is taking longer for the market to adapt and could this weakness bleed into 2027? And are there any efforts that you're making to really help the market adopt these changes?

也許先從皮膚替代物（skin subs）開始。你們如何看待這項業務的復甦？你提到市場適應需要更長時間，這種疲弱是否可能延續到2027年？另外，你們是否有任何作為來真正協助市場採用這些變化？

Right. I didn't get your name. I think it's Caitlin. So on Skin Subs, so what's happening there? So first, there's the utilization of Skin Sub across settings. It's in the hospital setting, it's in physician offices. It's in HOPD setting, so hospital outpatient settings as in mobile, right? So what we're talking about here in terms of impact is greatest in the mobile setting, followed by physician office and hospital outpatient.

好的。我沒有聽清楚你的名字。我想是Caitlin。那關於Skin Subs，目前發生了什麼？首先，是Skin Sub在不同場域的使用。它在住院醫院場域、也在醫師診所。也在HOPD場域，也就是醫院門診場域，以及行動（mobile）場域，對吧？所以我們這裡談到的影響，最大的是在行動場域，其次是醫師診所與醫院門診。

By and large, in-hospital users have been impacted by the change in reimbursement. The second thing that we're talking about is what products get used right? And you've got new entrants that have products that don't have a lot of clinical data supporting them, and then you've got players like us and a couple of others who've been in the market for a long period of time.

整體而言，院內使用者已受到給付變更的影響。第二個我們在談的是使用哪些產品，對吧？你會看到一些新進者的產品缺乏大量臨床數據支持；同時也有像我們以及其他少數公司，已在市場上深耕很長一段時間。

We got products that's withstood the test of time and we've got a great deal of clinical data supporting the appropriate use in the clinic for those products. So what is happening this year now is as the change in reimbursement has gotten implemented, folks in -- the mobile is where we expected the greatest impact, and that's what we're seeing.

我們的產品經得起時間考驗，並且有大量臨床數據支持其在臨床上的適當使用。所以今年發生的情況是，隨著給付變更落地實施，在——行動場域是我們預期影響最大的地方，而我們也確實看到如此。

We, Smith & Nephew, have had the least exposure in the mobile segment. So we've had exposure in the physician office and HOPD and in the physician office. And we previously detailed that out. You can go back to our previous releases to see how we've parsed that, right? So generally speaking, that impact on mobile office is playing out as we thought.

我們Smith & Nephew在行動細分市場的曝險最小。我們主要曝險在醫師診所與HOPD，也在醫師診所。而我們之前已經詳細說明過。你可以回去看我們先前的公告，了解我們如何拆解這些，對吧？所以整體來說，行動診所端的影響正如我們所預期地在發生。

In the physician office, how they get reimbursed has changed. I mean, does the mechanics of how you build for it, whether it's per application or per episode of care. And that has changed, right? And so as physician offices have adopted to the new ways of billing, that's introduced friction into the system, right?

在醫師診所端，他們的給付方式已經改變。也就是計費機制：是按每次使用（per application）計費，還是按每個照護療程（per episode of care）計費。這已經改變了，對吧？因此當醫師診所採用新的計費方式時，系統中就產生了摩擦，對吧？

And that part has taken time. The reimbursement part of it has also been slower and there are about four max within the US that have gone through or currently covered under the [Wiser] model, which you've heard about either through -- from us or from other disclosures, where there's an AI-based algorithm for how claims are reimbursed.

而這部分需要時間。給付本身的調整也比較慢；美國大約有四個MAC（Medicare行政承包商）已經納入或目前在[Wiser]模型下覆蓋——你可能透過我們或其他揭露聽過——其中理賠給付是透過AI演算法來決定。

And there's been friction associated with that, right? And so what are we doing about it? We had always expected that the parts of our portfolio that -- we've always had uptake based on the clinical data and everything else will get robust utilization, and we're seeing that. In fact, our OASIS product line is growing by leaps and bounds, right? And that's been great.

而這也帶來了相關摩擦，對吧？那我們在做什麼？我們一直預期，我們產品組合中那些——一向因臨床數據與其他因素而被採用的部分，會維持強勁的使用量，而我們也確實看到如此。事實上，我們的OASIS產品線正在大幅成長，對吧？這非常好。

And as we move into 2027, where all of this administrative friction that I'm talking about, whether in terms of how claims get submitted or how claims gest processed and how physicians then adapt their care to which products they use, all of that we expect to settle out in 2027 as the new calendar year, the new fiscal year in the United States kind of turns over.

而當我們邁向2027年，我所說的這些行政摩擦——不論是理賠如何提交、理賠如何處理、以及醫師如何調整其照護並選用哪些產品——我們預期在2027年會逐步消化並趨於穩定，因為美國新的曆年、新的財政年度會在那時完成切換。

And that's -- and in that new world, we expect to be very well positioned because we've got a product portfolio that's very, very relevant to that category. We've got a price point that works within the reimbursement level that the government has set at $127 per square centimeter.

而在那個新環境下，我們預期會處於非常有利的位置，因為我們擁有與該類別高度相關的產品組合。我們也有一個能在政府設定的每平方公分127美元給付水準內運作的價格點。

And we've got the clinical evidence for the products that we aim to use. So it's a great category growing at double digit when products are used appropriately, right, when it's relevant for a clinical setting, and we're very well positioned within that. So it's really about navigating this year, that's been a challenge.

而且我們已經具備我們計畫使用之產品的臨床證據。因此，這是一個在產品適當使用時以雙位數成長的優質品類，對吧，當其適用於臨床場景時，而我們在其中的布局非常到位。所以，重點其實在於應對今年的情況，而這一直是個挑戰。

And we've -- based on taking all of these factors into account, we provided a range of something like $20 million to $40 million, right? We're navigating to the upper end of that range, but we're still within that corridor that we had provided all of these dynamics.

而且我們——在把所有這些因素都納入考量後——給出了一個大約2,000萬美元到4,000萬美元的區間，對吧？我們正朝該區間的上緣推進，但仍在我們所提供、涵蓋這些動態因素的區間範圍內。

Within that, we had also called for sequential improvement or normalization from first half to the second half. We have seen sequential improvement from Q1 to Q2, and we expect that trend from the first half to second half.

在此之內，我們也曾預期從上半年到下半年會出現逐季改善或回歸正常。我們已看到從第一季到第二季的逐季改善，並且預期這個趨勢會從上半年延續到下半年。

So hopefully, that unpacks the Skin Subs topic. Anything you want to add?

所以，希望這能把皮膚替代物（Skin Subs）這個主題說清楚。你還想補充什麼嗎？

I mean, just a little bit of color just on the numbers because you remember at the beginning of the year, we said that revenues will be down 15% to 20%, and that was driven by a 20% to 25% reduction in price, offset by a slight positive on volumes. And that's what got us to the $20 million $40 million range.

我的意思是，就數字再補充一點背景，因為你記得年初我們說營收會下滑15%到20%，主要是由於價格下調20%到25%，並由銷量略為正向所抵銷。而這就是我們得出2,000萬到4,000萬美元區間的原因。

And actually, we were flat bang in the middle of that range, hence why we said $20 million to $40 million. What we've actually seen in practice is that actually, revenues in the first half were off about 20% or so, so towards the upper end of that range. And that's, broadly speaking, what we're now forecasting for the full year.

而且實際上，我們正好落在該區間的正中間，因此我們才說是2,000萬到4,000萬美元。我們在實務上看到的是，上半年營收實際下滑約20%左右，因此更接近該區間的上緣。而這大致上就是我們目前對全年所做的預測。

But we're not expecting the price impact, the 20% to 25% that we've previously called out to be quite harsh. So the price impact will be less than that. And equally, the converse, we're not necessarily expecting the volume to be as flat to positive. We are expecting there to be a slight decline in the volume.

但我們不預期價格影響——也就是我們先前提到的20%到25%——會那麼嚴重。因此，價格影響會小於那個幅度。同樣地，反過來說，我們也不一定預期銷量會像先前那樣持平到略為正向。我們預期銷量會有小幅下滑。

So volumes are a little bit worse than we thought. Price, a little bit better than we thought. The net-net is that we're up towards the upper end of that $20 million to $40 million range. But it's not 1 million miles from where we thought we would be. What's really important is Deepak's point that sequentially, we think Q2 is better than Q1.

所以銷量比我們原先想的稍差一些。價格則比我們原先想的稍好一些。綜合下來，我們會更接近2,000萬到4,000萬美元區間的上緣。但距離我們原先預期的位置並沒有差太多。真正重要的是Deepak的觀點：就逐季而言，我們認為第二季優於第一季。

So we are seeing the market change just a little bit slower when we first forecast.

所以我們看到市場的變化速度比我們最初預測的稍微慢一些。

Right, should we come back to the room? David? You've had your hand up for a while.

好，我們回到現場提問？David？你舉手有一段時間了。

David Adlington from JPMorgan. Sorry, John, just to come back on tariffs. The net amount, I think, was $5 million in the first half, but I just wonder what the gross was, was it all $50 million received in the first half and how you expect that to play out through the second half?

我是摩根大通（JPMorgan）的David Adlington。抱歉，John，我想再回到關稅的問題。淨額我記得上半年是500萬美元，但我想知道毛額是多少——上半年是否收到了全部5,000萬美元？以及你預期這在下半年會如何發展？

And then just wondering how that was spread across the three businesses?

另外也想了解這在三個事業之間是如何分攤的？

It's slightly focused towards Orthopaedics. And then a little bit more so on Sports with Wound being the least impacted is roughly the way it trades at. But it's not as massively differentiated across all businesses. And then the -- basically, we saw a net benefit in the first half between tariffs and the refunds of $5 million or so.

影響稍微偏向骨科（Orthopaedics）。其次是運動醫學（Sports），而傷口照護（Wound）受影響最小，大致上是這樣的分布。但在各事業之間的差異並沒有大到非常明顯。然後——基本上，我們在上半年在關稅與退稅之間看到約500萬美元左右的淨受益。

We're expecting to see a net benefit in the second half between the tariffs and the refunds of about $1 million or so. And so for the overall year, it will be plus or minus $4 million, $5 million or something of that nature. But effectively, in both halves, the refund is effectively offsetting the -- from -- on a year-on-year basis, the refund is effectively offsetting the tariff headwind.

我們預期下半年在關稅與退稅之間會看到約100萬美元左右的淨受益。因此就全年而言，將會是正負4百萬、5百萬美元左右，或類似的水準。但實際上，在兩個半年期中，從年對年角度來看，退稅基本上是在抵銷關稅的不利影響。

So just to be absolutely clear, we still expect to see a net tariff cost in the year. But we saw it -- last year, we saw a net tariff cost of $15 million. This year, we expect to see a net tariff cost of $10 million. The delta is the $5 million positive. Makes sense?

所以為了完全說清楚，我們仍預期全年會有淨關稅成本。但去年我們看到的淨關稅成本是1,500萬美元。今年我們預期淨關稅成本是1,000萬美元。差額就是正向的500萬美元。這樣合理嗎？

Okay. I think we'll draw this to a close.

好的。我想我們就到此結束。

Just to summarize then, well, our revenue performance in the first half was, of course, below our expectations. We did deliver strong profit performance and in doing that, we demonstrate the inherent resilience in our business that we've built. We do remain confident of the actions we are taking to drive better performance more consistently over time.

那麼簡要總結一下，我們上半年的營收表現當然低於我們的預期。我們確實交出了強勁的獲利表現，而在做到這一點的同時，我們也展現了我們所打造之業務內在的韌性。我們仍對我們正在採取的行動充滿信心，這些行動將推動我們隨時間推進更一致地達成更佳表現。

And I just want to take the moment to thank you for joining us today. I appreciate the engagement and the support and your questions, and we do look forward to coming back and updating you on progress as we move forward. So thank you very much.

我也想藉此機會感謝各位今天的參與。我很感謝各位的互動、支持與提問，我們也期待在未來推進的過程中再回來向各位更新進展。非常感謝。