史賽克 (SYK) 2022 Q2 法說會逐字稿

Welcome to the Second Quarter 2022 Stryker Earnings Call. My name is Hannah, and I will be your operator for today's call. (Operator Instructions) This conference call is being recorded for replay purposes.

歡迎來到 Stryker 2022 年第二季度財報電話會議。我的名字是漢娜，今天我將擔任您的接線員。 （操作員說明）正在錄製此電話會議以供重播。

Before we begin, I would like to remind you that discussions during this conference call will include forward-looking statements. Factors that could cause actual results to differ materially are discussed in the company's most recent filings with the SEC. Also, the discussions will include certain non-GAAP financial measures. Reconciliations to the most directly comparable GAAP financial measures can be found in today's press release that is an exhibit to Stryker's current report on Form 8-K filed today with the SEC.

在開始之前，我想提醒您，本次電話會議期間的討論將包括前瞻性陳述。該公司最近向美國證券交易委員會提交的文件中討論了可能導致實際結果出現重大差異的因素。此外，討論將包括某些非公認會計原則的財務措施。與最直接可比的 GAAP 財務指標的對賬可以在今天的新聞稿中找到，該新聞稿是 Stryker 今天向美國證券交易委員會提交的關於表格 8-K 的當前報告的展示。

I will now turn the call over to Mr. Kevin Lobo, our Chair and Chief Executive Officer. You may proceed.

我現在將把電話轉給我們的主席兼首席執行官 Kevin Lobo 先生。你可以繼續。

Welcome to Stryker's second quarter earnings call. Joining me today are Glenn Boehnlein, Stryker's CFO; and Jason Beach, Vice President of Investor Relations.

歡迎參加 Stryker 第二季度財報電話會議。今天加入我的是 Stryker 的首席財務官 Glenn Boehnlein；和投資者關係副總裁 Jason Beach。

For today's call, I'll provide opening comments, followed by Jason with the trends we saw during the quarter and updates on Mako and Vocera. Glenn will then provide additional details regarding our quarterly results before opening the call to Q&A.

對於今天的電話會議，我將提供開場評論，然後是 Jason，介紹我們在本季度看到的趨勢以及 Mako 和 Vocera 的更新。然後，格倫將在打開問答電話之前提供有關我們季度業績的更多詳細信息。

For the quarter, organic sales growth was 6% with high single-digit growth from our MedSurg and Neurotechnology businesses, led by endoscopy, instruments and neurocranial. Our hip and knee businesses delivered high single-digit growth in the face of tough compares from 2021.

本季度，我們的 MedSurg 和神經技術業務的有機銷售額增長了 6%，實現了高個位數增長，其中內窺鏡檢查、儀器和神經顱內窺鏡處於領先地位。面對 2021 年的艱難比較，我們的髖關節和膝關節業務實現了高個位數增長。

Internationally, we posted high single-digit organic growth with strength in Canada, Europe and Japan as well as double-digit organic growth in emerging markets despite the China COVID-related slowdowns.

在國際上，儘管與中國 COVID 相關的放緩，我們在加拿大、歐洲和日本實現了強勁的個位數有機增長以及新興市場的兩位數有機增長。

During the quarter, we continue to have robust demand for our capital products. However, we had meaningful shipment delays as a result of ongoing product supply challenges mostly affecting our large capital businesses. As a reminder, less than 10% of our revenue is large capital with about 15% of our revenue being smaller operating capital that drives revenue for hospitals.

在本季度，我們對資本產品的需求繼續強勁。然而，由於持續的產品供應挑戰主要影響我們的大型資本業務，我們的發貨延遲很明顯。提醒一下，我們不到 10% 的收入是大額資本，我們約 15% 的收入是推動醫院收入的較小運營資本。

For the quarter, we delivered adjusted EPS of $2.25 as we faced increasing negative impacts from foreign exchange as well as inflationary pressures and significant premiums on inventory spot buys. We expect these pressures to continue in the back half of the year. However, the supply situation is improving.

在本季度，我們實現了 2.25 美元的調整後每股收益，因為我們面臨來自外匯以及通脹壓力和庫存現貨購買顯著溢價的日益增加的負面影響。我們預計這些壓力將在今年下半年繼續存在。不過，供應情況正在改善。

Given the higher input costs, we've begun to take a series of pricing actions across our portfolio. These will take time to be reflected in our results given the phasing of contract renewals in many areas of our business.

鑑於較高的投入成本，我們已開始在我們的投資組合中採取一系列定價措施。鑑於我們許多業務領域的合同續簽分階段進行，這些將需要時間才能反映在我們的業績中。

We continue to invest in R&D at a healthy ratio of sales, demonstrating our continued focus on new product pipelines. We remain confident in the outlook of our business and expect to continue to deliver sales growth at the high end of med tech. However, even with disciplined spending, the worsened foreign exchange situation and other pressures will prevent us from delivering leverage to earnings in 2022.

我們繼續以健康的銷售額比例投資於研發，表明我們對新產品管道的持續關注。我們對我們的業務前景仍然充滿信心，並期望繼續在醫療技術的高端實現銷售增長。然而，即使有紀律的支出，惡化的外匯形勢和其他壓力也將阻止我們在 2022 年為收益提供槓桿作用。

With half of the year behind us and a very strong order book, we now expect full year organic sales growth of 8% to 9%. And due largely to foreign currency exchange, we now expect adjusted earnings per share to be in the range of $9.30 to $9.50 per share. Overall, our team has shown good resiliency and we are on track for another strong year of sales growth. Our employee engagement remains very high, and we continue to win awards as a Great Place to Work, most recently as a Great Place to Work for Millennials by Fortune.

由於我們已經過去了半年，並且訂單非常強勁，我們現在預計全年有機銷售額增長 8% 至 9%。而且主要由於外匯兌換，我們現在預計調整後的每股收益將在每股 9.30 美元至 9.50 美元之間。總體而言，我們的團隊表現出良好的彈性，我們有望迎來又一個強勁的銷售增長年。我們的員工敬業度仍然很高，我們繼續贏得最佳工作場所獎，最近被《財富》評為千禧一代最佳工作場所。

We are also gearing up for some exciting new product launches in 2023 and look forward to an improved supply chain picture. Through the many challenges that we had faced since 2020, we feel optimistic about how we are positioning ourselves for the future.

我們還準備在 2023 年推出一些令人興奮的新產品，並期待改善供應鏈狀況。自 2020 年以來，我們面臨著許多挑戰，我們對如何為未來定位感到樂觀。

I will now turn the call over to Jason.

我現在將把電話轉給傑森。

Thanks, Kevin. My comments today will focus on providing an update on the current environment, including the procedural and geographic trends during the quarter. In addition, I will provide an update on the integration progress of the Vocera business.

謝謝，凱文。我今天的評論將集中在提供當前環境的更新，包括本季度的程序和地理趨勢。此外，我將提供 Vocera 業務整合進展的最新情況。

Procedural volumes continued to recover throughout the second quarter in most countries. While we are seeing volumes recover, hospital staffing pressures have continued, impacting the ability to reduce procedural backlog in a meaningful way. These challenges will likely continue, meaning the tailwind of pent-up demand will be more moderate but last longer.

大多數國家的程序量在整個第二季度持續回升。雖然我們看到數量有所回升，但醫院人員配置壓力仍然存在，影響了以有意義的方式減少程序積壓的能力。這些挑戰可能會繼續存在，這意味著被壓抑的需求的順風將更加溫和，但持續時間更長。

Geographically, procedural volumes steadily improved during the quarter in the United States, Europe and Latin America. Procedural trends in parts of Asia and Australia have been more volatile due to ongoing COVID-related impacts. In addition to the continued procedural recovery, we had a strong quarter of Mako installations, up 19% versus 2021. However, as we are balancing customer purchasing preferences, the mix of these deals has resulted in less revenue per quarter. We are pleased with how the growing installation base continues to fuel market-leading implant growth.

從地域上看，本季度美國、歐洲和拉丁美洲的程序量穩步提高。由於持續的與 COVID 相關的影響，亞洲和澳大利亞部分地區的程序趨勢更加不穩定。除了持續的程序恢復之外，我們的 Mako 安裝量在一個季度表現強勁，與 2021 年相比增長了 19%。但是，由於我們正在平衡客戶的購買偏好，這些交易的組合導致每季度的收入減少。我們對不斷增長的安裝基礎如何繼續推動市場領先的植入物增長感到高興。

The order book remains strong for Mako and the percentage of implants using the robot continues to increase. We will update you on our installations and utilization metrics at the end of the year.

Mako 的訂單保持強勁，使用機器人的植入物百分比繼續增加。我們將在年底向您更新我們的安裝和利用率指標。

Demand for our capital products remained very strong in the quarter. While we experienced solid customer order performance from our capital businesses, the sales growth was restricted because of ongoing headwinds, which included raw material shortages primarily related to electronic components and installation delays in parts of our business due to hospital staffing challenges.

本季度對我們的資本產品的需求仍然非常強勁。雖然我們的資本業務的客戶訂單表現穩健，但由於持續的不利因素，銷售增長受到限制，其中包括主要與電子元件相關的原材料短缺以及由於醫院人員配備挑戰導致我們部分業務的安裝延遲。

The raw material shortages continue to be most impactful in our medical business, both within our acute care and emergency care business units. Based on our current supply outlook, we expect medical to have a strong second half.

原材料短缺繼續對我們的醫療業務產生最大影響，無論是在我們的急症護理和急診護理業務部門中。根據我們目前的供應前景，我們預計醫療行業下半年將表現強勁。

Now to our key integration activities. We continue to be pleased with the momentum of the Vocera integration. Since acquiring the company, we have seen double-digit growth in the first and second quarter versus the same period in 2021. We are already starting to realize synergies and remain excited about the potential this product will create for both Stryker and the customers we serve.

現在到我們的關鍵集成活動。我們繼續對 Vocera 整合的勢頭感到滿意。自收購公司以來，與 2021 年同期相比，我們在第一季度和第二季度實現了兩位數的增長。我們已經開始實現協同效應，並對這款產品將為 Stryker 和我們服務的客戶創造的潛力感到興奮.

In summary, while the macroeconomic environment remains volatile, procedural volumes are improving and the underlying demand for our products remain strong, which gives us confidence in our ability to continue to drive strong growth.

總而言之，儘管宏觀經濟環境依然動盪，但程序量正在改善，對我們產品的潛在需求依然強勁，這讓我們對繼續推動強勁增長的能力充滿信心。

With that, I'll turn the call over to Glenn.

有了這個，我會把電話轉給格倫。

Thanks, Jason. Today, I will focus my comments on our second quarter financial results and the related drivers. Our detailed financial results have been provided in today's press release.

謝謝，傑森。今天，我將把我的評論集中在我們的第二季度財務業績和相關驅動因素上。我們的詳細財務業績已在今天的新聞稿中提供。

Our organic sales growth was 6.1% in the quarter. The second quarter's average selling days were in line with 2021. The impact from pricing in the quarter was unfavorable 1.4%. Foreign currency had a 3% unfavorable impact on sales. Despite a challenging comparable versus 2021, our organic sales growth has been solid and was led by double-digit performances in our endoscopy and instruments businesses as well as strong growth in our international businesses. Our sales growth has been somewhat constrained by the continued supply chain challenges and electronic component shortages especially impacting the capital products in our MedSurg businesses, primarily in our medical business.

本季度我們的有機銷售增長為 6.1%。第二季度的平均銷售天數與 2021 年一致。該季度定價的不利影響為 1.4%。外幣對銷售產生了 3% 的不利影響。儘管與 2021 年相比具有挑戰性，但我們的有機銷售增長一直穩健，並由我們的內窺鏡和儀器業務的兩位數表現以及我們的國際業務的強勁增長引領。我們的銷售增長在一定程度上受到持續的供應鏈挑戰和電子元件短缺的限制，尤其是影響了我們 MedSurg 業務的資本產品，主要是我們的醫療業務。

Our capital order book continues to be very robust as demand from our customers continues to be strong. In the quarter, U.S. organic sales growth was 4.7%. International organic sales growth was 9.7%, impacted by positive sales momentum across most of our international markets, specifically emerging markets, Canada, Japan and Europe, somewhat offset by lingering COVID impacts in Australia and China.

由於客戶的需求持續強勁，我們的資本訂單繼續非常強勁。本季度，美國有機銷售額增長 4.7%。國際有機銷售額增長 9.7%，受我們大部分國際市場，特別是新興市場、加拿大、日本和歐洲的積極銷售勢頭的影響，在一定程度上被澳大利亞和中國揮之不去的 COVID 影響所抵消。

Our adjusted EPS of $2.25 in the quarter was in line with 2021 driven by our sales momentum and favorable adjusted tax rate, offset by gross margin challenges and the impact of foreign currency exchange. Our second quarter EPS was negatively impacted by foreign currency exchange of $0.05 versus 2021.

在我們的銷售勢頭和有利的調整後稅率的推動下，我們本季度調整後的每股收益為 2.25 美元，與 2021 年一致，但被毛利率挑戰和外匯兌換的影響所抵消。與 2021 年相比，我們第二季度的每股收益受到 0.05 美元的外匯匯率的負面影響。

Now I will provide some highlights around our segment performance. In the quarter, MedSurg and Neurotechnology had constant currency sales growth of 10.6% with organic sales growth of 7.9%, which included 7.2% of U.S. organic growth and 9.9% of international organic growth.

現在，我將圍繞我們的細分市場表現提供一些亮點。本季度，MedSurg 和 Neurotechnology 的固定貨幣銷售額增長 10.6%，有機銷售額增長 7.9%，其中包括美國有機增長的 7.2% 和國際有機增長的 9.9%。

Instruments had U.S. organic sales growth of 12.1%, led by double-digit growth in our orthopedic instruments and surgical technology businesses. From a product perspective, sales growth was highlighted by double-digit growth in power tools, surg account, irrigation, smoke evacuation and Steri-Shield.

Instruments 在美國的有機銷售額增長了 12.1%，這得益於我們的骨科器械和外科技術業務的兩位數增長。從產品角度來看，電動工具、浪湧賬戶、灌溉、排煙和 Steri-Shield 的兩位數增長突顯了銷售增長。

Endoscopy had U.S. organic sales growth of 15.4%, reflecting very strong performances across all of their portfolio, including video products and double-digit growth of our communications and sports medicine businesses.

內窺鏡在美國的有機銷售額增長了 15.4%，反映了其所有產品組合的強勁表現，包括視頻產品以及我們的通信和運動醫學業務的兩位數增長。

Medical, which includes our recently acquired Vocera business, had a U.S. organic sales decline of 2.4% driven by the aforementioned supply chain challenges primarily impacting our emergency care products. Medical Sage and acute care businesses boosted double-digit organic growth. During the quarter, we also saw significant growth in orders for our beds and emergency care products driven by very strong customer demand.

醫療（包括我們最近收購的 Vocera 業務）在美國的有機銷售額下降了 2.4%，原因是上述供應鏈挑戰主要影響了我們的緊急護理產品。 Medical Sage 和急症護理業務推動了兩位數的有機增長。在本季度，由於客戶需求非常強勁，我們的床和緊急護理產品的訂單也顯著增長。

Our U.S. neurovascular business posted an organic decline of 1.8% driven by a strong double-digit comparable in 2021 as well as competitive pressures, disruptions due to hospital staffing shortages and softer market conditions in part because of supply shortages of contrast use in procedures. The U.S. neurocranial business posted organic sales growth of 9.4%, which included solid growth in our ENT navigation, balloon dilation and neuro products.

我們的美國神經血管業務錄得 1.8% 的有機下降，原因是 2021 年可比強勁的兩位數，以及競爭壓力、醫院人員短缺造成的中斷以及市場條件疲軟，部分原因是手術中對比劑使用的供應短缺。美國腦腦業務有機銷售額增長 9.4%，其中包括我們的耳鼻喉導航、球囊擴張和神經產品的穩健增長。

Internationally, MedSurg and Neurotechnology had organic sales growth of 9.9%, reflecting double-digit growth in the endoscopy, neurovascular and neurocranial businesses, somewhat offset by medical. Geographically, this included strong performances in Japan and emerging markets.

在國際上，MedSurg 和 Neurotechnology 的有機銷售額增長了 9.9%，反映了內窺鏡、神經血管和神經顱業務的兩位數增長，但在一定程度上被醫療所抵消。從地域上看，這包括日本和新興市場的強勁表現。

Orthopaedics and Spine had both constant currency and organic sales growth of 3.9%, which included organic growth of 1.6% in the U.S. and 9.5% internationally. This reflects the impact of strong international growth and solid growth in our hip, knee and extremity businesses.

骨科和脊柱的固定匯率和有機銷售額均增長 3.9%，其中美國有機增長 1.6%，國際有機增長 9.5%。這反映了強勁的國際增長和我們的髖關節、膝關節和四肢業務穩健增長的影響。

Our U.S. hips business grew 4.5% organically, reflecting strong primary hip growth reflected by the recent launch of our Insignia Hip Stem and continued procedural growth. Our U.S. knee business grew 5.3% organically, reflecting our market-leading position in robotic knee procedures.

我們的美國臀部業務有機增長 4.5%，反映了我們最近推出的 Insignia Hip Stem 的強勁初級臀部增長和持續的程序增長。我們的美國膝關節業務有機增長 5.3%，反映了我們在機器人膝關節手術方面的市場領先地位。

Our U.S. trauma and extremities business grew 3.1% organically against a significant comparable in 2021. This growth was led by double-digit growth in our upper extremities, somewhat offset by softness in the trauma market.

我們的美國創傷和四肢業務有機增長 3.1%，與 2021 年的顯著可比增長相比。這一增長是由我們的上肢兩位數增長帶動的，但在一定程度上被創傷市場的疲軟所抵消。

Our U.S. spine business declined 3.6% organically, reflecting a slightly slower scoliosis season, partially offset by solid performance in our enabling technology business.

我們的美國脊柱業務有機下降 3.6%，反映出脊柱側彎季節略有放緩，部分被我們的賦能技術業務的穩健表現所抵消。

Our U.S. other ortho declined organically by 13.8% primarily driven by the impact related to the aforementioned deal mix changes of Mako installations in the quarter.

我們的美國其他鄰域有機下降 13.8%，主要是受上述 Mako 裝置交易組合變化相關的影響。

Internationally, Orthopaedics and Spine grew 9.5% organically, which reflects the strong momentum in Europe as procedural volumes improved as well as strong performances in Japan, Canada and India, somewhat offset by COVID-related volatility in Australia and Korea.

在國際上，骨科和脊柱有機增長了 9.5%，這反映了歐洲的強勁勢頭，因為手術量的改善以及日本、加拿大和印度的強勁表現，在一定程度上被澳大利亞和韓國與 COVID 相關的波動所抵消。

Now I will focus on operating highlights in the second quarter. Our adjusted gross margin of 63.3% was unfavorable, approximately 270 basis points from the second quarter of 2021. Compared to 2021, our gross margin was adversely impacted by the purchases of electronic components at premium prices on the spot market and other inflationary pressures primarily related to labor, steel and transportation costs as well as operational efficiencies due to component shortages.

現在我將重點介紹第二季度的運營亮點。我們的調整後毛利率為 63.3%，較 2021 年第二季度下降約 270 個基點。與 2021 年相比，我們的毛利率受到在現貨市場以高價購買電子元件和其他主要與通脹壓力相關的不利影響勞動力、鋼材和運輸成本以及由於組件短缺導致的運營效率。

We expect these adverse impacts to continue throughout 2022. We expect Q3 gross margin to be similar to Q2. Q4 should see some improvement and the full year gross margin compared to 2021 will be negatively impacted by approximately 200 basis points.

我們預計這些不利影響將持續到 2022 年。我們預計第三季度的毛利率將與第二季度相似。第四季度應該會有所改善，全年毛利率與 2021 年相比將受到約 200 個基點的負面影響。

Adjusted R&D was 7.2% of sales, which represents a 60 basis point increase from 2021. This reflects our continued commitment to innovation funding and the related future growth it will provide. Our adjusted SG&A was 32.4% of sales, which was 100 basis points lower than 2021. This reflects continued cost discipline, somewhat offset by the ramping of certain prioritized expenses and hiring that support future growth.

調整後的研發佔銷售額的 7.2%，比 2021 年增加了 60 個基點。這反映了我們對創新資金的持續承諾以及它將提供的相關未來增長。我們調整後的 SG&A 佔銷售額的 32.4%，比 2021 年低 100 個基點。這反映了持續的成本紀律，但在一定程度上被某些支持未來增長的優先支出和招聘的增加所抵消。

In summary, for the quarter, our adjusted operating margin was 23.7% of sales, which was approximately 220 basis points unfavorable to the second quarter of 2021. This performance is primarily driven by the aforementioned inflationary impacts resulting in gross margin challenges and the net negative impact resulting from foreign currency.

總而言之，本季度，我們調整後的營業利潤率為銷售額的 23.7%，比 2021 年第二季度不利約 220 個基點。這一表現主要是由上述通脹影響導致的毛利率挑戰和淨負外幣帶來的影響。

Adjusted other income and expense decreased from 2021 primarily resulting from an equity investment gain and favorable interest income. We anticipate a normalized run rate of adjusted OI&E to be approximately $70 million per quarter for the remainder of 2022.

調整後的其他收入和費用自 2021 年起減少，主要是由於股權投資收益和有利的利息收入。我們預計，在 2022 年剩餘時間內，調整後的 OI&E 的正常運行率約為每季度 7000 萬美元。

Our second quarter had an adjusted effective tax rate of 13.9%, reflecting the impact of geographic mix and certain discrete tax items. We now expect our full year adjusted effective tax rate to be in the range of 14.5% to 15%, which is consistent with the ETR performance we experienced in 2021.

我們第二季度的調整後有效稅率為 13.9%，反映了地域組合和某些離散稅項的影響。我們現在預計全年調整後的有效稅率將在 14.5% 至 15% 之間，這與我們在 2021 年的 ETR 表現一致。

Focusing on the balance sheet. We ended the second quarter with $1.1 billion of cash and marketable securities and total debt of $13.4 billion. Approximately $450 million of debt was paid down in the quarter.

專注於資產負債表。我們在第二季度結束時擁有 11 億美元的現金和有價證券，總債務為 134 億美元。本季度償還了約 4.5 億美元的債務。

Turning to cash flow. Our year-to-date cash from operations is $732 million. This performance reflects the results of net earnings and continued focus on working capital management, partially offset by the impact of higher costs for certain electronic components and pre-buying certain other critical raw material inventory.

轉向現金流。我們年初至今的運營現金為 7.32 億美元。這一業績反映了淨收益的結果和對營運資金管理的持續關注，部分被某些電子元件成本上升和預購某些其他關鍵原材料庫存的影響所抵消。

Considering our second quarter results, the strong order book for capital equipment and the sales momentum in our implant businesses, we now expect full year 2022 organic sales growth to be in the range of 8% to 9%. This performance assumes that the market environment experienced in Q2 continues to improve throughout the rest of the year with supply chain disruptions easing in the back half of the year.

考慮到我們第二季度的業績、資本設備的強勁訂單以及我們植入業務的銷售勢頭，我們現在預計 2022 年全年有機銷售增長將在 8% 至 9% 之間。這一業績假設第二季度經歷的市場環境在今年剩餘時間內繼續改善，供應鏈中斷在下半年有所緩解。

If foreign currency exchange rates hold near current levels, we expect net sales in the full year to be adversely impacted by approximately 2% to 3% and adjusted net earnings per diluted share to be adversely impacted by approximately $0.25 to $0.30 in the full year, which is included in our revised earnings guidance range.

如果外匯匯率保持在當前水平附近，我們預計全年淨銷售額將受到約 2% 至 3% 的不利影響，調整後每股攤薄淨收益全年受到約 0.25 美元至 0.30 美元的不利影響，這包含在我們修訂後的收益指導範圍內。

Based on our performance in the second quarter, including consideration of the continued supply chain challenges and the inflationary environment, together with our increased sales guidance and continued financial discipline, and most significantly, the anticipated future impact related to foreign currency, we now expect adjusted earnings per share to be in the range of $9.30 to $9.50. The low end of this guidance range assumes that the continued macroeconomic volatility persists, including procedural disruptions and worsening of the electronic component availability.

根據我們在第二季度的表現，包括考慮到持續的供應鏈挑戰和通貨膨脹環境，以及我們增加的銷售指導和持續的財務紀律，以及最重要的是與外匯相關的預期未來影響，我們現在預計調整每股收益在 9.30 美元至 9.50 美元之間。該指導範圍的低端假設持續的宏觀經濟波動持續存在，包括程序中斷和電子元件可用性的惡化。

We will continue to evaluate the changing environment, and we'll provide updates to our guidance as necessary. And now I will open up the call for Q&A.

我們將繼續評估不斷變化的環境，並在必要時更新我們的指導。現在我將打開問答電話。

(Operator Instructions) The first question is from the line of Robbie Marcus with JPMorgan.

（操作員說明）第一個問題來自摩根大通的 Robbie Marcus。

Maybe I'd start on second half. It's sort of like a tale of 2 cities where you have this really strong top line and somewhat of a pressured bottom line. And moving organic sales guidance up 100 basis points is great to see. But it does look like roughly 2/3 of EPS down move is currency, a little bit from operations.

也許我會從下半場開始。這有點像一個關於 2 個城市的故事，在這些城市中，您擁有非常強大的頂線和有些壓力的底線。將有機銷售指導上調 100 個基點非常值得一看。但看起來每股收益下降的大約 2/3 是貨幣，有點來自運營。

So maybe just walk us through -- it sounds like medical is going to get a good chunk better in the second half. Maybe just give us a little color of how you get the confidence to raise the top line and where exactly you're seeing the softening operating margin constant currency.

所以也許只是引導我們完成——聽起來醫療在下半年會變得更好。也許只是給我們一點顏色，說明您如何有信心提高收入，以及您在哪裡看到營業利潤率不變貨幣的疲軟。

Yes. Sure, Robbie, this is Kevin. I'll take that. So first of all, I feel very good about the momentum that we have across all of our businesses. Medical for sure is going to have a much better second half. They were the division that was most affected by the shortages. We do have a line of sight towards the supply of key electronic components, and we're going to ramp up as fast as we can to meet that demand.

是的。當然，羅比，這是凱文。我會接受的。因此，首先，我對我們所有業務的發展勢頭感到非常滿意。醫療肯定會有更好的下半年。他們是受短缺影響最大的部門。我們確實對關鍵電子元件的供應有一定的看法，我們將盡可能快地增加以滿足這一需求。

But we also have softer comps. This second quarter was by far the most difficult comparative from the prior year. So we have softer comps across, frankly, all of our businesses in Q3 and Q4. And the order book, not just for medical, but if I look at the other MedSurg businesses like instruments and endoscopy, which both had terrific Q2, they're going to continue to have strong growth in Q3, Q4.

但我們也有更柔和的組合。與去年相比，第二季度是迄今為止最困難的比較。因此，坦率地說，我們在第三季度和第四季度的所有業務中都有較軟的組合。還有訂單，不僅僅是醫療，如果我看看其他 MedSurg 業務，如儀器和內窺鏡檢查，它們在第二季度都表現出色，它們將在第三季度和第四季度繼續強勁增長。

So we obviously feel very good about the demand from our hospital customers. That gives us the confidence to raise our sales growth. We exited the first half at 7.5% with a very tough Q2 comp. So we feel pretty good about getting to the 8% to 9% on the top line.

因此，我們顯然對醫院客戶的需求感到非常滿意。這讓我們有信心提高我們的銷售增長。我們以 7.5% 的比例退出了上半年，第二季度的表現非常艱難。因此，我們對達到 8% 到 9% 的收入感覺非常好。

On the bottom line, as you can see, based on the change in our guidance from last quarter, $0.15, if you look at the midpoint of our range, $0.15 of our drop is due to foreign currency. So that's the majority the adjustment on the EPS line. And we're really fighting through significant supply chain challenges and inflationary pressures. And right now, obviously, taking it on the chin for our customers, at least for this year. But we are taking -- obviously starting to take pricing actions. Those -- we won't see a lot of that in this year. It will start to roll kind of more into next year. But I'd say the majority of our takedown is due to foreign currency but obviously, very significant supply chain pressures that we're dealing with but a very strong demand situation overall.

正如您所看到的，最重要的是，根據我們上個季度的指導變化 0.15 美元，如果您查看我們範圍的中點，我們下降的 0.15 美元是由於外幣。所以這是EPS線上的大部分調整。我們真的在與重大的供應鏈挑戰和通脹壓力作鬥爭。而現在，顯然，至少在今年，我們的客戶會接受它。但我們正在採取 - 顯然開始採取定價行動。那些——今年我們不會看到很多。它將開始在明年推出更多。但我想說，我們的大部分撤資是由於外匯，但顯然，我們正在應對的供應鏈壓力非常大，但總體需求情況非常強勁。

Great. Maybe as a quick follow-up, Kevin or Glenn. I'm getting a little greedy here, but I'm already looking out to next year. And we've heard from a number of companies that have reported so far to use 2022 as a base year. Don't treat it as a onetime easy comp. And I look at sell-side numbers for next year, and it's about 100 basis points of operating margin expansion.

偉大的。也許作為快速跟進，凱文或格倫。我在這裡有點貪心，但我已經在期待明年了。到目前為止，我們已經收到許多公司報告稱將 2022 年作為基準年。不要把它當作一次性的簡單組合。我查看了明年的賣方數據，營業利潤率大約增加了 100 個基點。

So I know nobody is good enough to forecast next year yet. But do you have any early thoughts on 2023 margins? Are you committed to growing margins next year? And just if you have any color on your interpretation of the -- where the sell-side sits right now?

所以我知道沒有人足夠好來預測明年。但是你對 2023 年的利潤率有什麼早期的想法嗎？您是否致力於明年提高利潤率？如果你對你對賣方現在所處位置的解釋有任何看法？

Yes. Thanks, Robbie. As you can imagine, a lot has changed in the last 6 months. A lot could change in the next 6 months. And as you know, we always give guidance in January, which we'll do. But what I will say is the spot buy situation has been pretty significant. It's been a big part of our gross margin negative story for this year. That is starting to abate. I would hope that, that gets better next year. But obviously, we'll update you in January in terms of the overall outlook.

是的。謝謝，羅比。可以想像，在過去的 6 個月裡發生了很多變化。未來 6 個月內可能會發生很多變化。如您所知，我們總是在一月份提供指導，我們會這樣做。但我要說的是現貨購買情況非常重要。這是我們今年毛利率負增長的重要組成部分。這種情況開始減弱。我希望，明年會變得更好。但顯然，我們將在 1 月份就整體前景向您更新。

I would not call this year an easy year from the top line comparative. Driving organic growth of 8% to 9% is pretty heavy, but we do have a lot of very exciting launches next year. We have System 9 for power tools, 1788 camera launch, a LIFEPAK defibrillator launch, a Neptune S which is a smaller version of Neptune for GI in ASC. Those are all really outstanding launches.

從頂線比較來看，我不會稱今年是輕鬆的一年。推動 8% 到 9% 的有機增長是相當沉重的，但我們明年確實有很多非常令人興奮的發布。我們有用於電動工具的 System 9、1788 相機啟動、LIFEPAK 除顫器啟動、Neptune S，它是 ASC 中用於 GI 的 Neptune 的較小版本。這些都是非常出色的發布。

So I do expect that the top line will continue to hum for Stryker next year. The bottom line, we're going to work through these challenges, and we'll have more to talk about in January.

因此，我確實預計明年 Stryker 的收入將繼續增長。歸根結底，我們將克服這些挑戰，我們將在一月份討論更多內容。

The next question is from Lawrence Biegelsen with Wells Fargo.

下一個問題來自富國銀行的勞倫斯·比格爾森。

Just wanted to follow up on the capital environment comments. Kevin, maybe just a little more color on what you're seeing with the large and small capital. And your comments on the Mako deal mix changes, I assume that's because hospitals are preferring volume-based agreements. So why do you think that behavior is changing? I mean I think people on the call might -- that may give people a concern that there is some change in the hospital capital environment. And I have one follow-up.

只是想跟進資本環境評論。凱文，也許只是對你所看到的大小資本多一點色彩。你對 Mako 交易組合變化的評論，我認為這是因為醫院更喜歡基於數量的協議。那麼為什麼你認為這種行為正在改變呢？我的意思是，我認為電話會議上的人可能——這可能會讓人們擔心醫院資本環境會發生一些變化。我有一個後續行動。

Yes. Larry, first of all, on the Mako side, what I would tell you is this is not a new trend. This has been happening over the past kind of 6 months where we're seeing more deals being financed versus outright purchased and actually a move towards more rental agreements. And if you have a rental agreement, you can't recognize all the revenue upfront.

是的。拉里，首先，在 Mako 方面，我要告訴你的是，這不是一個新趨勢。在過去的 6 個月裡，這種情況一直在發生，我們看到更多的交易是通過融資而不是直接購買，實際上是在朝著更多的租賃協議邁進。而且，如果您有租賃協議，則無法預先確認所有收入。

Even in some of our overall finance deals, we could recognize more of the revenue upfront. In a rental, the customer has the right to return the product. And so you can't record all the revenue upfront, and that's what our competitors are also offering. We're not really worried because we've had virtually no returns of our product once we get our products in. And you can tell by our utilization of Mako, which again, we'll report on at the end of the year, we have highly utilized machines.

即使在我們的一些整體金融交易中，我們也可以預先確認更多的收入。在租賃中，客戶有權退回產品。因此，您無法預先記錄所有收入，而這也是我們的競爭對手提供的。我們並不真正擔心，因為一旦我們收到我們的產品，我們的產品幾乎沒有退貨。你可以通過我們對 Mako 的使用來判斷，我們將在今年年底再次報告，我們擁有高利用率的機器。

And so -- but that's really -- that's a shift that's been ongoing. It was a new factor this quarter. We're really pleased with the number of installations. But the revenue per unit that we can recognize upfront is lower. And we'll be able to recognize more of this revenue over the life of the contracts.

所以——但那是真的——這是一個一直在進行的轉變。這是本季度的一個新因素。我們對安裝數量感到非常滿意。但是我們可以預先確認的每單位收入較低。我們將能夠在合同有效期內確認更多的收入。

And then as it relates to the rest of the capital equipment environment, what I'd tell you is we wouldn't be taking up our sales if we felt that the capital environment was softening in any way, shape or form. The small capital is needed to be able to do procedures. Power tools, worn-out cameras need to be replaced. And the medical business is continuing to get fantastic order growth whether it's on the defibrillator or power cots as well as our ProCuity bed. The orders are continuing to really pour in.

然後，由於它與資本設備環境的其他部分有關，我要告訴你的是，如果我們認為資本環境以任何方式、形狀或形式在軟化，我們就不會承擔我們的銷售。需要小資金才能辦手續。電動工具、破舊的相機需要更換。無論是除顫器、電動嬰兒床還是我們的 ProCuity 床，醫療業務的訂單量都在繼續獲得驚人的增長。訂單繼續真正湧入。

We're not seeing hospital construction projects being halted at all. And just look at our communications business, which is a large capital business. They had a terrific quarter in the second quarter and their order book is continuing to grow. So the timing of construction may get delayed a quarter or so, but no one's canceling these projects. Nobody is canceling any of our orders. So we're feeling, at least through the end of this year, feeling pretty bullish about the overall environment.

我們根本沒有看到醫院建設項目停止。看看我們的通信業務，這是一項大型資本業務。他們在第二季度有一個了不起的季度，他們的訂單繼續增長。所以建設時間可能會推遲四分之一左右，但沒有人取消這些項目。沒有人取消我們的任何訂單。因此，至少到今年年底，我們對整體環境感到非常樂觀。

Hospital liquidity is still strong. Now of course, they're feeling pressure on their profits but their liquidity is in a healthy position. And that's really where the source of funding comes for capital.

醫院流動性依然強勁。當然，他們現在感受到利潤壓力，但他們的流動性處於健康狀態。這就是資金來源的真正來源。

That's very helpful. And Glenn, thanks for the color on the gross margin. Kind of plugging the numbers into the model, it implies that OpEx growth is -- let's call it mid-single digits year-over-year in 2022 on a reported basis. I don't know if my math is right. But how do you do that in an inflationary environment where you're growing sales 8% to 9% organically?

這很有幫助。還有格倫，感謝毛利率的顏色。將數字插入模型中，這意味著 OpEx 的增長是——讓我們稱其為 2022 年的中個位數同比增長。我不知道我的數學是否正確。但是，在通貨膨脹環境中，您如何實現銷售額有機增長 8% 到 9% 的情況呢？

Yes. Larry, that was quick with the model. A couple of things to keep in mind. We are seeing really good performance in our operating expenses, especially SG&A. Single biggest driver in SG&A is really sort of hiring and how prudent are we being about our hiring and the related costs that come along with every time we add a new employee.

是的。拉里，這個模型很快。有幾件事要記住。我們在運營費用方面看到了非常好的表現，尤其是 SG&A。 SG&A 中最大的單一驅動因素實際上是招聘，以及我們對招聘的謹慎程度以及每次增加新員工時所帶來的相關成本。

So we've positioned ourselves pretty well relative to that halfway through the year here and feel confident that we'll be able to drive sort of meaningful leverage within our SG&A. I mean that being said, we are also mindful that we need to invest in R&D to make sure that we can hit a lot of these key product launches that we're lined up for, for next year.

因此，相對於今年中途，我們已經很好地定位了自己，並相信我們將能夠在我們的 SG&A 中推動某種有意義的影響力。我的意思是說，我們也注意到我們需要在研發方面進行投資，以確保我們能夠在明年推出很多我們排隊等待的關鍵產品。

And then honestly, too, if you move on down the rest of the P&L, I think I kind of gave you a little bit of guidance on OI&E. And we're also seeing favorable performance in our ETR, which helps at the bottom as well.

老實說，如果你繼續看損益表的其餘部分，我想我給了你一些關於 OI&E 的指導。我們也看到我們的 ETR 表現良好，這也有助於底部。

Our next question is from the line of Vijay Kumar with Evercore.

我們的下一個問題來自與 Evercore 的 Vijay Kumar。

Congrats on a good [prints] here. Maybe Kevin, one on the guidance here. So the organic was raised by 50 basis points versus the prior guidance. I think the press release had some commentary about the guide raise was based on strong capital orders. Is the guide assuming the capital sales trends to improve in the back half as the supply chain improves? Or are we still looking at perhaps a constrained supply chain environment in the back half? And you did mention implant strength. I couldn't help but notice the hip strength and you had new product launched in hips. Are we seeing share gains within hips?

恭喜這裡取得了良好的 [打印]。也許凱文，這裡的指導之一。因此，與之前的指導相比，有機指數提高了 50 個基點。我認為新聞稿有一些關於指導性加薪是基於強勁的資本訂單的評論。該指南是否假設隨著供應鏈的改善，後半部分的資本銷售趨勢會改善？或者我們是否仍在關注後半部分可能受限的供應鏈環境？你確實提到了植入強度。我不禁注意到臀部的力量，你在臀部推出了新產品。我們看到臀部的份額增加了嗎？

Well, let me start with the hips. We're feeling really great about our hip business. And as you know, the Insignia launch was -- is a very big launch. It's not actually even fully launched. So we are still deploying sets out in the field. But the customer feedback has been overwhelmingly positive.

好吧，讓我從臀部開始。我們對我們的時尚業務感覺非常好。如您所知，Insignia 的發布是 - 是一個非常大的發布。它實際上甚至還沒有完全啟動。所以我們仍在現場部署佈景。但客戶的反饋非常積極。

And that also is compatible with the Mako robot. The Mako robot utilization for hips is also increasing pretty significantly, which is exciting. That's due in part to the Hip 4.0 software that we launched, I guess, about 2 or 3 quarters ago. That new software, combined with this Hip Stem, I believe will position us for growing above the market in hips. Not everybody has reported yet, so let's see how that plays out this quarter. But we're really only getting started with that Stem launch and very excited about the hip business. What was the first part of the question?

這也與 Mako 機器人兼容。 Mako 機器人對臀部的利用率也在顯著增加，這令人興奮。這部分歸功於我們大約在 2 或 3 個季度前推出的 Hip 4.0 軟件。那個新軟件，加上這個 Hip Stem，我相信會讓我們在臀部市場上成長。並不是每個人都報告過，所以讓我們看看本季度的情況如何。但我們真的只是剛剛開始推出 Stem 並且對時尚業務感到非常興奮。問題的第一部分是什麼？

Capital.

首都。

Yes. So on the first part of your question was on capital. So clearly, medical is going to improve in the second half versus their performance. They were down organically in the first half of the year. They're going to be up pretty significantly in the second half of the year because they were the most affected by the shortages of electronics.

是的。所以你問題的第一部分是關於資本的。很明顯，與他們的表現相比，醫療將在下半場有所改善。他們在今年上半年有機地下降了。它們將在下半年大幅上漲，因為它們受電子產品短缺的影響最大。

We still -- even though we're guiding to this 8% to 9%, that doesn't assume that we completely bleed everything. We're still living in a bit of a tough environment out there. And so there is that risk ongoing that might move us towards the lower end of the range or move us up to the higher end of the range.

我們仍然 - 即使我們正在指導這 8% 到 9%，但這並不假設我們完全流血了一切。我們仍然生活在一個有點艱難的環境中。因此，風險持續存在，可能會將我們推向范圍的低端或將我們推向范圍的高端。

On the implant side, we're feeling pretty good about procedures are largely back to normal in most parts of the world. And really, it's about the hospital staffing. If that staffing gets better, then obviously, there's a lot of pent-up demand for procedures. And we're feeling very good about our position in those businesses.

在植入物方面，我們對世界大部分地區的手術基本恢復正常感到非常滿意。真的，這是關於醫院的人員配備。如果人員配備變得更好，那麼顯然，對程序有很多被壓抑的需求。我們對我們在這些業務中的地位感到非常滿意。

That's helpful comments, Kevin. Maybe one for Glenn here. I think your updated guidance assumes 200 basis points of gross margin impact. I think the prior guide was 100 basis points. That's almost an incremental, I think, if I'm doing the math right, $0.35 to $0.40 impact. Along with FX impact of $0.15, it's almost incremental $0.50 that Stryker is eating.

這是有用的評論，凱文。也許在這裡給格倫一個。我認為你更新的指導假設毛利率影響 200 個基點。我認為之前的指南是 100 個基點。我認為，如果我計算正確的話，這幾乎是一個增量，影響為 0.35 到 0.40 美元。加上 0.15 美元的外匯影響，Stryker 吃掉的幾乎是 0.50 美元。

Are you holding back, Glenn, on the expenses? And is that enough to sustain the 8% to 9% growth? Or maybe just talk about within the P&L, were you comfortable toggling the model? You can still achieve the sales growth metrics?

格倫，你對費用有所保留嗎？這足以維持 8% 到 9% 的增長嗎？或者只是在損益表中談論，你是否願意切換模型？您仍然可以實現銷售增長指標嗎？

Yes. I think a couple of things. First of all, this backlog of orders really gives us a lot of confidence that we have the sales in place to deliver on this increased sales guidance as a baseline. It also implies that we've spent a lot of money on these spot buys and electronic components and prebuying other inventories so that we feel confident and comfortable that we actually have the right sort of supply and raw materials in place to deliver on these future sales.

是的。我認為有幾件事。首先，這種積壓的訂單確實讓我們非常有信心，我們有足夠的銷售來交付這個增加的銷售指導作為基準。這也意味著我們在這些現貨採購和電子元件以及預購其他庫存上花費了大量資金，因此我們對我們實際上擁有合適的供應和原材料來交付這些未來的銷售感到自信和放心.

I mean that being said, we are mindful in being a good steward of the operating expenses and not letting that get away from us. I think that's prudent just given the current environment and given the environment that we might be heading into. And so we haven't really taken our foot off of that pedal in terms of controlling that at all for the whole year. And so I don't expect that, that will change in the back half of the year.

我的意思是說，我們注意成為運營費用的好管家，而不是讓它遠離我們。我認為考慮到當前環境和我們可能進入的環境，這是謹慎的做法。因此，就整年的控製而言，我們並沒有真正從踏板上移開。所以我不認為這種情況會在今年下半年發生變化。

If you look at like sales force hiring, it almost universally occurs for the most part in literally the first month of the year for every single division. They fill out their sales forces at that point in time. So I don't feel like there's a big gap that I'm staring down that can't really deliver on the sales growth.

如果你看一下銷售人員招聘，它幾乎普遍發生在每個部門的一年中的第一個月。他們在那個時間點填補了他們的銷售隊伍。所以我不覺得有一個很大的差距，我盯著看，不能真正實現銷售增長。

I think the name of the game is really going to be delivering for our customers these finished products based on what we have in our supply chain and what we currently have in inventories. And that's going to really drive that sales growth number.

我認為遊戲的名稱實際上是為我們的客戶提供這些成品，這些成品基於我們在供應鏈中所擁有的以及我們目前在庫存中所擁有的。這將真正推動銷售增長數字。

The next question is from the line of Pito Chickering with Deutsche Bank.

下一個問題來自德意志銀行的 Pito Chickering。

Nice execution in pretty tough markets. You've been crystal clear on this call that CapEx demand remains very robust. But a lot of large not-for-profit health systems have a September 30 year-end. And because of the margin pressure facing hospitals due to labor, we've heard some discussions around CapEx reductions beginning with our fiscal '23 budgets, which began in the fourth quarter. So do you assume any changes of the macro CapEx environment when hospitals update their CapEx plans for this calendar fourth quarter?

在相當艱難的市場中表現出色。您在這次電話會議上非常清楚，資本支出需求仍然非常強勁。但許多大型非營利性衛生系統都有 9 月 30 日的年終。而且由於勞動力因醫院面臨的利潤率壓力，我們從第四季度開始的 23 財年預算開始聽到一些關於削減資本支出的討論。那麼，當醫院更新本日曆第四季度的資本支出計劃時，您是否假設宏觀資本支出環境發生任何變化？

Yes. Right now, we're not baking in any major changes. Certainly, if you look at prior situations where hospitals were under fire, we really didn't see much of an impact at all in the small capital area. The one area you could see some impact would be in the larger capital. But of course, a lot of our business, we do have financing through Stryker Flex Financial, which does help with offsetting the kind of pressures that the hospital has in terms of overall capital.

是的。現在，我們沒有進行任何重大更改。當然，如果你看看以前醫院受到攻擊的情況，我們真的沒有看到在小首都地區受到太大影響。您可以看到一些影響的一個領域將是更大的首都。但當然，我們的很多業務，我們確實通過 Stryker Flex Financial 獲得融資，這確實有助於抵消醫院在整體資本方面的壓力。

And as I mentioned earlier, coming out of the -- out of 2020 with CARES Act funding, liquidity of hospitals is actually pretty good right now. So with our portfolio mix, I think we're in good shape. If you think about something like Mako, it's still early in the cycle and hospitals are really anxious to get that product. It's not like they have old Makos that they're trying to upgrade and change. They're looking at increasing adoption early in the cycle.

正如我之前提到的，從 2020 年開始，有了 CARES 法案的資金，醫院的流動性現在實際上相當不錯。因此，憑藉我們的投資組合組合，我認為我們的狀況良好。如果您考慮像 Mako 這樣的產品，那麼它仍處於週期的早期階段，醫院真的急於獲得該產品。他們並沒有試圖升級和改變舊的 Makos。他們正在考慮在周期早期增加採用率。

So I think our portfolio lends itself very well to what hospitals need. And they're going to prioritize our capital and potentially not prioritize other people's capital. You could say that's an optimistic outlook but just the way orders are continuing to stream in -- and we haven't had really any orders canceled. And we don't have a history of that in our company.

所以我認為我們的產品組合非常適合醫院的需求。他們將優先考慮我們的資本，而可能不會優先考慮其他人的資本。你可以說這是一個樂觀的前景，但只是訂單繼續流入的方式——而且我們還沒有真正取消任何訂單。我們公司沒有這樣的歷史。

So do I have great visibility into the second half of next year? No. Do I have really good visibility through the end of this year and probably into the early part of next year? Yes, I think we do.

那麼我對明年下半年有很好的了解嗎？不。我在今年年底和明年年初的知名度真的很高嗎？是的，我認為我們有。

Okay. Fair enough. On the same topic of hospitals under pressure just from labor. Like you talked to us you're getting some price increases versus normal decreases. I'm just curious -- and I do understand it takes time for contracts to sort of roll off. But are you seeing any RFP sort of today or in the last sort of few months, which is showing confidence that hospitals are willing to absorb these price increases to offset your increased inflationary pressures?

好的。很公平。關於醫院在勞動力壓力下的同一主題。就像您與我們交談的那樣，您的價格上漲與正常下跌相比有所上漲。我只是很好奇——而且我確實理解合同的結束需要時間。但是，您是否在今天或最近幾個月看到任何 RFP，這表明醫院願意吸收這些價格上漲以抵消您增加的通脹壓力？

Yes. Peter, it's Jason. So I'd say a couple of things. I mean we're not, for competitive reasons, going to get into the various tactics around pricing and those things. But I will say we see some shoots of confidence, if you will, in terms of customers willing to take price. And they understand the environment that we're working in, right? So it's going to look, to your point, very different depending on the business that we're talking to.

是的。彼得，是傑森。所以我想說兩句。我的意思是，出於競爭的原因，我們不會圍繞定價和那些事情採取各種策略。但我會說，我們看到了一些信心的萌芽，如果你願意的話，就願意接受價格的客戶而言。他們了解我們工作的環境，對嗎？因此，根據您的觀點，根據我們正在與之交談的業務，它看起來會非常不同。

On the implant side, you've got the contract cycles in some of those things. But then there's also the MedSurg side that has historically gotten price, right? And we continue to expect that we will as we move forward.

在植入物方面，您已經在其中一些事情中獲得了合同周期。但是還有歷史上已經獲得價格的 MedSurg 方面，對嗎？我們繼續期待我們會繼續前進。

The next question is from the line of Matthew O'Brien with Piper Sandler.

下一個問題來自 Matthew O'Brien 和 Piper Sandler。

I think this question is for Glenn. Glenn, you've got a bunch of different acute situations happening right now with FX and wages going up and raw materials and freight. It's clear you're going to carry a lot of those extra costs throughout this year. But do you think we can start to see -- we're starting to see an easing of some of those things right now? We can start to see somewhat of a snapback in the first half of next year in earnings? Or just given your inventory levels and cost structure, is it something that's likely going to persist into the first half of next year and maybe get better or more like second half of next year on the earnings side?

我想這個問題是給格倫的。格倫，隨著外彙和工資上漲以及原材料和運費的上漲，您現在遇到了許多不同的緊急情況。很明顯，您將在今年全年承擔大量額外費用。但是你認為我們可以開始看到 - 我們現在開始看到其中一些事情的緩和嗎？我們可以在明年上半年開始看到收益的回升嗎？或者僅僅考慮到您的庫存水平和成本結構，它是否可能會持續到明年上半年，並且在收益方面可能會變得更好或更接近明年下半年？

Okay, Matt. Without giving 2023 guidance, what I will say is the spot buy and the chip situation in the electronic component situation, we are seeing some easing of that. And we are seeing examples of where we are going to our regular suppliers and they are supplying us these components based on our negotiated contract pricing. So we're not necessarily having to [only] spot markets for everything.

好的，馬特。在沒有給出 2023 年指導的情況下，我要說的是電子元件情況中的現貨購買和芯片情況，我們看到這種情況有所緩解。我們看到了我們去往我們的常規供應商的例子，他們根據我們協商的合同定價向我們提供這些組件。因此，我們不一定必須 [only] 為所有事物提供現貨市場。

That being said, some of these other costs that are really driven by inflation and they're commodity oriented for metals, for plastics, for transportation, some of those, I think, are going to linger for a while for sure. And I would expect to see those bleed into next year. Certainly, the first half of next year. But I am hopeful that the spot buy kind of premium things that we have experienced pretty severely in this quarter and in Q1 will actually start to abate.

話雖如此，其中一些真正由通貨膨脹驅動的其他成本，它們以商品為導向，用於金屬、塑料、運輸，我認為其中一些成本肯定會持續一段時間。我希望看到那些流血到明年。當然，明年上半年。但我希望現貨購買我們在本季度和第一季度經歷的非常嚴重的溢價商品實際上會開始減弱。

Got it. That's very helpful. And then the instruments and endoscopy numbers were really strong. I would just love to hear about durability of that -- of those products are not the most sexy products, I guess, for lack of a better term, I guess, across med tech. So just talk about the durability there. And then Kevin, I think you said last quarter that neurovascular had some competitive pressures in ischemic. Is that still the case today?

知道了。這很有幫助。然後儀器和內窺鏡檢查的數量非常強大。我很想听聽它的耐用性——我想，這些產品並不是最性感的產品，因為我想，在整個醫療技術領域都沒有更好的術語。所以只談那裡的耐用性。然后凱文，我想你上個季度說過神經血管在缺血性方面有一些競爭壓力。今天還是這樣嗎？

Yes. Yes. First of all, I actually think instruments and endoscopy are pretty sexy businesses. But really, this is really about having terrific products. Our power tools are market-leading. Our Flyte helmets are market-leading. Procedures are picking up. And if procedures pick up, every time you do an orthopedic procedure using our Flyte helmet, you're using our -- if you're using cement, you're using our cement mixers. You're using our power tools. In the general surgery area, you're using our cameras. And they go through the autoclave and then they break down and then they've got to be replaced.

是的。是的。首先，我實際上認為儀器和內窺鏡是非常性感的行業。但實際上，這真的是關於擁有出色的產品。我們的電動工具是市場領先的。我們的 Flyte 頭盔是市場領先的。手續正在加快。如果手術恢復，每次您使用我們的 Flyte 頭盔進行骨科手術時，您都在使用我們的 - 如果您使用水泥，那麼您就在使用我們的水泥攪拌機。您正在使用我們的電動工具。在普通外科領域，您正在使用我們的相機。它們經過高壓滅菌器，然後分解，然後必須更換。

And so we have obviously the leading imaging system. And so -- and our sports medicine business has just been on fire, right? It's growing strong double digits. And our ASC offense, we had a fabulous second quarter in ASC. We have a couple of new shoulder products with our InSpace balloon as well as our AlphaVent PEEK anchors.

因此，我們顯然擁有領先的成像系統。所以——我們的運動醫學業務剛剛火了，對吧？它正在增長強勁的兩位數。而我們的 ASC 進攻，我們在 ASC 的第二節表現出色。我們的 InSpace 氣球和 AlphaVent PEEK 錨點有一些新的肩部產品。

And so we have a lot of strength across those 2 businesses. And they always have been kind of consistent growers for Stryker, if you go back over the last 15 years. And so they're going to continue their momentum. They have been a really great engine of R&D and new products. And both power tools and cameras have new launches coming up next year. So I think it's absolutely -- they're absolutely durable.

因此，我們在這兩項業務中擁有強大的實力。如果你回顧過去的 15 年，他們一直是 Stryker 的穩定種植者。所以他們將繼續他們的勢頭。他們一直是研發和新產品的真正偉大引擎。電動工具和相機都將在明年推出新產品。所以我認為這絕對是——它們絕對是耐用的。

What was the second part, sorry?

第二部分是什麼，對不起？

NV.

內華達州。

Yes. So neurovascular, look, the market has been a bit soft in the U.S. Just keep in mind, the U.S. is certainly smaller in NV. They actually have more of their sales outside of the United States. It's a little different than the rest of the Stryker portfolio. But the market has been a bit softer. And on the aspiration side, there have been a lot of competitive entrants in the United States. A lot of new aspiration products, which when the new products are launched, it does take surgeon attention. They want to try them out. And so there's been a bit of a factor there that has touched that business.

是的。所以神經血管，看，美國的市場有點疲軟。請記住，美國的 NV 肯定更小。他們實際上在美國以外有更多的銷售。它與 Stryker 的其他產品組合略有不同。但市場有所疲軟。在抱負方面，美國有很多競爭激烈的進入者。很多新的願望產品，當新產品推出時，它確實引起了外科醫生的注意。他們想嘗試一下。因此，有一個因素影響了該業務。

But overall, I still feel very good about the neurovascular business. It's still going to -- we're still treating just a small fraction of the patients that need to be served. And over time, we're sure that, that business will pick up, not just outside the U.S. but also inside the U.S.

但總的來說，我對神經血管業務仍然感覺很好。它仍然會 - 我們仍然只治療一小部分需要服務的患者。隨著時間的推移，我們確信，這項業務將會回升，不僅在美國以外，而且在美國境內。

The next question is from the line of Joanne Wuensch with Citi.

下一個問題來自花旗的 Joanne Wuensch。

I want to talk a little bit about the pricing environment, both the headwinds that you experienced in the quarter. And then it sounds like you're going contract by contract and trying to right-size some of that to reflect inflation.

我想談談定價環境，以及您在本季度遇到的不利因素。然後聽起來你正在逐個合同地簽訂合同，並試圖調整其中的一些規模以反映通貨膨脹。

Yes. I think, Joanne, in terms of Q2, we did experience some of the pricing difficulties that you felt in the pricing number, the 1.4% negative that we disclosed. I will say that that's pretty consistent with the range that we feel in normal years. I do think that we have a very big focus with our sales teams on pricing and with our customers. And we actually saw positive pricing performance related to our U.S. MedSurg and Neurotechnology business, which is a good indicator that we are starting to enter these conversations with our customers.

是的。我認為，喬安妮，就第二季度而言，我們確實遇到了您在定價數字中感受到的一些定價困難，即我們披露的 1.4% 的負數。我會說這與我們在正常年份感受到的範圍非常一致。我確實認為我們的銷售團隊非常關注定價和客戶。我們實際上看到了與我們的美國 MedSurg 和神經技術業務相關的積極定價表現，這是我們開始與客戶進行這些對話的一個很好的指標。

Our customers are doing their diligence. They understand that just like with their staffing, with their nursing, that prices are going up and that's impacting us, too. And so we are having the conversations. Although given the contracting nature of some of our business, it just takes time for some of these things to stick. And so I do think that we are beginning to really lay the groundwork to really impact pricing over the future well into next year. And so I'm confident that we're laying the processes in place now to make sure that we work with our customers to implement price increases.

我們的客戶正在盡職盡責。他們明白，就像他們的人員配備和護理一樣，價格正在上漲，這也影響了我們。所以我們正在進行對話。儘管考慮到我們某些業務的合同性質，但其中一些事情需要時間才能堅持下去。因此，我確實認為我們正在開始真正奠定基礎，以真正影響明年的未來定價。因此，我相信我們現在正在製定流程，以確保我們與客戶合作實施價格上漲。

Yes. And keep in mind, Joanne, like some of the contracts have rebate clauses. And so you see those rebates do show up in our price number and that's a bit of a lag effect, right? So they earn the rebate and then the rebate flows through. So that's another part of this timing issue where it will take time for this to show up even as we negotiate higher prices for our products.

是的。請記住，喬安妮，有些合同有回扣條款。所以你看到這些回扣確實出現在我們的價格數字中，這有點滯後效應，對吧？所以他們賺取回扣，然後回扣流過。所以這是這個時間問題的另一部分，即使我們為我們的產品協商更高的價格，也需要時間才能顯示出來。

I appreciate that clarification. As a second question, are some of the pipeline products, maybe even for next year, including other applications of the robot? Maybe finally, shoulder or spine?

我很欣賞這一澄清。作為第二個問題，是否有一些管道產品，甚至可能在明年，包括機器人的其他應用？也許最後，肩膀或脊椎？

Joanne, could you repeat that for us? Sorry, we had a little trouble here.

喬安妮，你能為我們重複一遍嗎？抱歉，我們在這裡遇到了一點麻煩。

Sure. No problem. The question has to do with your pipeline products and the timing of other applications for robots for applications such as spine and/or shoulder applications.

當然。沒問題。這個問題與您的管道產品和機器人其他應用的時間有關，例如脊柱和/或肩部應用。

Yes. Joanne, it's Jason. So at this point, we don't have anything further to announce. Obviously, as we get closer to launch time, we'll do that but nothing further at this point.

是的。喬安妮，是傑森。所以在這一點上，我們沒有任何進一步的宣布。顯然，隨著我們接近發佈時間，我們會這樣做，但此時不會再做進一步的事情了。

Yes. The one thing I'd tell you is the spine team is pretty excited about -- but just separate from Mako, Joanne, I would say the spine team is pretty excited about Q Guidance, which received approval, okay. It's not a full robotic solution, but it is a pretty exciting offering within enabling technologies. We now have the spinal application approved and the cranial application is sitting with the FDA. But that should give them a bit of a lift in the second half.

是的。我要告訴你的一件事是脊椎團隊非常興奮——但與 Mako 分開，喬安妮，我想說脊椎團隊對 Q Guidance 感到非常興奮，它獲得了批准，好吧。它不是一個完整的機器人解決方案，但它是支持技術中的一個非常令人興奮的產品。我們現在已經批准了脊柱應用程序，而顱腦應用程序正在與 FDA 合作。但這應該在下半場給他們一點動力。

Our next question is from Josh Jennings with Cowen.

我們的下一個問題來自 Josh Jennings 和 Cowen。

Kevin, I was hoping to just ask about staffing shortages and impact on the implant business. I think we kind of felt that they may have peaked during the Omicron surge. And absenteeism contributed to the staffing shortage pressuring like the procedure volumes. But do you feel -- I know it's probably hard to quantify, but staffing shortages have improved gradually over the last few months? Or are we -- has it kind of stalled? And are you expecting within your updated organic revenue guidance that staffing shortages will improve? It sounded like in one of your previous answers that wasn't the case but just wanted to clarify that.

凱文，我只是想問一下人員短缺和對植入物業務的影響。我認為我們有點覺得它們可能在 Omicron 激增期間達到頂峰。曠工導致人員短缺，就像程序量一樣造成壓力。但你覺得——我知道這可能很難量化，但在過去幾個月裡，人員短缺情況逐漸改善？還是我們——它已經停滯不前了？您是否期望在更新的有機收入指南中人員短缺會有所改善？聽起來在您之前的一個答案中並非如此，但只是想澄清一下。

Yes. Certainly, we saw choppiness in the second quarter. That's kind of the word I would use. And it could be related to staffing challenges, just hiring staff and having consistent staff that actually know the procedure, so you can do the same number of procedures that you used to do in a day, and COVID, which affected, frankly, some of the nurses as well as patients who had to delay their procedure because they got -- contracted COVID.

是的。當然，我們在第二季度看到了波動。這就是我會用的詞。這可能與人員配備方面的挑戰有關，只需僱用員工並擁有真正了解程序的穩定員工，因此您可以執行與過去相同數量的程序，坦率地說，COVID 影響了一些那些因為感染了新冠病毒而不得不推遲手術的護士和病人。

So that type of choppiness is actually still lingering right now as we speak. But we've seen a nice uptick in procedural volumes, and we do expect that uptick to gradually improve. We're not calling it -- calling for a giant spike. But we are calling for this kind of environment to continue and see gradual improvement from where we were in the second quarter through the rest of the year.

所以在我們說話的時候，這種波濤洶湧的情緒實際上仍然揮之不去。但是我們已經看到程序量有了很好的增長，我們確實希望這種增長會逐漸改善。我們不叫它——叫一個巨大的峰值。但我們呼籲這種環境繼續下去，並看到從第二季度到今年剩餘時間的逐步改善。

Understood. And maybe just a follow-up on just the spine business. And I know there was some scolio softness, it sounds like Glenn called out. Is there anything to highlight just with the market recovery in spine relative to other ortho procedure categories? Or do you think the 2Q performance was more Stryker-specific?

明白了。也許只是對脊柱業務的跟進。而且我知道有一些脊柱側彎，聽起來格倫在呼喚。與其他正畸手術類別相比，脊柱市場復甦有什麼需要強調的嗎？還是您認為第二季度的表現更適合史賽克？

Yes. It's Jason. I don't think at this point there's anything more to highlight. I mean obviously, we're early in the earnings cycle as well. So tough to tell how we compare to the rest of market but I'd say nothing else to add at this point.

是的。是傑森。我不認為在這一點上還有什麼要強調的。我的意思很明顯，我們也處於盈利週期的早期。很難說我們與其他市場相比如何，但我現在沒有什麼要補充的了。

Our next question is from the line of Kyle Rose with Canaccord.

我們的下一個問題來自於 Canaccord 的 Kyle Rose。

I wanted to touch on the Mako dynamics. And you talked about some different ordering patterns. Is that more indicative of maybe going into competitive accounts where you haven't been historically and they want to rent before they fully commit? And then I do have a follow-up.

我想談談 Mako 的動態。你談到了一些不同的訂購模式。這是否更能表明您可能進入了您歷史上沒有過的競爭性賬戶並且他們想在他們完全承諾之前租用？然後我確實有後續行動。

Yes. It's not that we're showing up anywhere differently. It's just that if your competitor offers a rental option, the customer says, "Do you have a rental option?" And so the idea is, look, we're not going to let our prior contracting approach stop us from competing. And so we've introduced a rental option and started to promote that just to make sure that that's not one of the barriers and that we let the technologies fight head-to-head and let the best technology win.

是的。這並不是說我們在任何地方都以不同的方式出現。只是如果你的競爭對手提供租賃選項，客戶會說，“你有租賃選項嗎？”所以這個想法是，看，我們不會讓我們之前的承包方式阻止我們競爭。所以我們引入了租賃選項並開始推廣它，以確保這不是障礙之一，我們讓技術正面交鋒，讓最好的技術獲勝。

So it's more of a response to what has been happening in the marketplace, not so much that we're going into different accounts. We've always been active in competitive accounts as well as active in -- with surgeons that use Stryker products. We're really pretty agnostic. Whoever wants to use robotics, we want to make sure that we show up and that they're able to try our technologies, and we believe we have the best system in the market.

因此，這更多是對市場上正在發生的事情的回應，而不是我們要進入不同的賬戶。我們一直積極參與競爭性客戶，並積極參與使用 Stryker 產品的外科醫生。我們真的很不可知論。無論誰想使用機器人技術，我們都希望確保我們出現並且他們能夠嘗試我們的技術，並且我們相信我們擁有市場上最好的系統。

Great. And then historically, you've talked about trends in the ASC market and putting together one sales team into the ASC. Maybe just touch on what trends you're seeing in the ASC and how that focused sales approach is playing out commercially.

偉大的。然後從歷史上看，您談到了 ASC 市場的趨勢，並將一個銷售團隊整合到 ASC 中。也許只需談談您在 ASC 中看到的趨勢，以及這種專注的銷售方式在商業上的表現如何。

Yes. Look, I'm really excited about our success in the ASC market. One of the ways you can gauge that is just our sports medicine business, which is normally involved in those deals and has been a big beneficiary of the overall Stryker offense and also Mako. So with the Mako, sales in the ASC has continued to increase. So if you look at the percentage of Makos in ASCs versus hospitals, that ratio has been gradually increasing. It increased again in the second quarter.

是的。看，我對我們在 ASC 市場的成功感到非常興奮。您可以衡量的方法之一就是我們的運動醫學業務，該業務通常參與這些交易，並且一直是 Stryker 整體進攻和 Mako 的一大受益者。因此，有了 Mako，ASC 的銷售額持續增長。因此，如果您查看 ASC 與醫院中 Makos 的百分比，該比例一直在逐漸增加。第二季度再次增加。

So the ASC is a place that Stryker can really play well given that we're so deep in the orthopedic service line with capital equipment as well as implants and disposables.

因此，鑑於我們在骨科服務線中的資本設備以及植入物和一次性用品如此深入，因此 ASC 是 Stryker 真正可以發揮出色的地方。

The next question is from the line of Chris Pasquale with Nephron Research.

下一個問題來自 Nephron Research 的 Chris Pasquale。

I wanted to ask 2 here upfront. First, if you could just go into some more detail on what's holding back trauma, whether that's a product portfolio issue or a market issue, that would be great. And then Kevin, you mentioned a couple of times being excited about the pipeline. You want to just highlight maybe 2 or 3 products that you guys have coming in the next 6 to 12 months that we should be paying attention to?

我想提前在這裡問2。首先，如果你能更詳細地了解阻礙創傷的因素，無論是產品組合問題還是市場問題，那就太好了。然后凱文，你提到過幾次對管道感到興奮。你想強調一下你們在未來 6 到 12 個月內推出的 2 或 3 款我們應該關注的產品嗎？

Yes. First of all, I think there's nothing holding back our trauma business. I would tell you that we had a massive comp from the prior year. If you go back to the prior year second quarter, we had pretty massive comparative. We have a great trauma business, whether it's the upper extremities business, which grew double digits again and will continue to grow double digits for the rest of the year.

是的。首先，我認為沒有什麼能阻礙我們的創傷業務。我會告訴你，我們從前一年有大量的補償。如果你回到去年第二季度，我們有相當大的比較。我們有一個很好的創傷業務，無論是上肢業務，它再次增長了兩位數，並將在今年剩餘時間繼續增長兩位數。

I think foot and ankle, the total ankle had another really strong quarter in the second quarter. It was a little bit soft on the sort of the forefoot procedures. And then the overall sort of underlying core trauma business, the market was a little bit softer. That happens from quarter-to-quarter, right? So whether it's weather, whether it's who knows what, it's not unusual. But I have 0 worries about our trauma and extremities business. We are wildly excited about the way Wright Medical is integrated into our business. And we have a business, as you've seen over the past 5 years, that performs very, very well. And so there's nothing holding that business back. I'm pretty bullish on that business for the future. Was there a second part?

我認為腳和腳踝，總腳踝在第二節又一個非常強勁的季度。前腳掌手術有點軟。然後是整體潛在的核心創傷業務，市場有點疲軟。這種情況每季度都會發生，對吧？所以無論是天氣，無論是誰知道，這並不罕見。但我對我們的創傷和四肢業務的擔憂為零。我們對 Wright Medical 融入我們業務的方式感到非常興奮。正如您在過去 5 年中看到的那樣，我們有一家業務表現非常非常好。因此，沒有什麼能阻止這項業務。我非常看好該業務的未來。有第二部嗎？

Pipeline.

管道。

Well, product pipeline. I think I mentioned before that we're really entering a pretty exciting period going into next year with System 9 and next-generation power tools; 1788 camera, the next-generation camera; LIFEPAK defibrillator, which is the big -- sort of the big, large complex defibrillator; and then the Neptune S, which is a smaller version of Neptune that will get us into procedure areas that we're not currently in today, especially GI, which is a very, very high-volume procedure.

好吧，產品管道。我想我之前提到過，明年我們將進入一個非常激動人心的時期，使用 System 9 和下一代電動工具； 1788相機，下一代相機； LIFEPAK 除顫器，它是大的——某種大型的複雜除顫器；然後是 Neptune S，它是 Neptune 的一個較小版本，它將讓我們進入我們目前不在的手術領域，尤其是 GI，這是一個非常非常高容量的手術。

An amazing feature of this product is the ability to be able to capture the polyp. And if you have to watch what they have to do today to find polyps within the waste that they have to sort through, it's not very pretty. And this is a very, very elegant solution with this innovation. And so something we're very excited about being able to launch. It will get us, frankly, into brand new markets where we don't even play today.

該產品的一個驚人功能是能夠捕獲息肉。如果你必須看看他們今天必須做什麼才能在他們必須分類的廢物中找到息肉，這不是很漂亮。這是一個非常非常優雅的創新解決方案。因此，我們對能夠發布感到非常興奮。坦率地說，它將使我們進入我們今天甚至沒有參與的全新市場。

So those are some of the launches. I'm sure I'm missing a few from some of the other divisions. But those are big launches. And as you know, when we launch those big -- when we have these big launches, they really do drive growth and they have historically.

所以這些是一些發射。我確定我在其他一些部門中缺少一些。但這些都是重大發布。如你所知，當我們推出這些大型產品時——當我們推出這些大型產品時，它們確實推動了增長，而且它們在歷史上一直如此。

Our next question is from the line of Steve Lichtman with Oppenheimer.

我們的下一個問題來自史蒂夫·利希特曼（Steve Lichtman）和奧本海默（Oppenheimer）的觀點。

Glenn, on the increased headwind you're building in for inflation this year, I was wondering versus your assumptions on the 1Q call where the biggest deltas were. Was it the persistence of spot buying at elevated prices that maybe are going on longer? Is it higher base assumption on input and labor costs? Just wondering if one stood out or if it was just across the board.

格倫，鑑於今年通脹面臨的逆風增加，我想知道與你在第一季度電話會議上的假設相比，最大的三角洲在哪裡。是不是以高價購買現貨的持續時間可能會持續更長時間？投入和勞動力成本的基礎假設是否更高？只是想知道一個是否脫穎而出，或者它是否只是全面的。

Yes. I think probably the single biggest thing was the spot buy and the premiums. I think as we entered into Q2 and exited Q1, we saw that, that was happening. But who could imagine the demand that was out there relative to us competing with car companies and a whole bunch of different kind of competitors that we never really had before with those vendors.

是的。我認為最大的可能是現貨購買和溢價。我認為，當我們進入第二季度並退出第一季度時，我們看到了這一點，這正在發生。但是誰能想像相對於我們與汽車公司和一大堆不同類型的競爭對手競爭的需求，我們以前從未真正與這些供應商競爭。

And so I would say that those premiums that we paid just so that we could make sure that we were serving our customers and could deliver them products were the single biggest thing that maybe changed from guidance last time to guidance this time.

所以我想說，我們支付的那些溢價只是為了確保我們為客戶提供服務並可以向他們交付產品，這可能是從上次指導到這次指導的最大變化。

I think the other though persistent thing that we're seeing is just because the supply chain has been so spotty, we also are just -- we're feeling inefficiencies in our processes in how we manage our manufacturing across the globe with sort of inconsistencies of when we'll have raw materials available for teams to work on.

我認為我們看到的另一件持續存在的事情僅僅是因為供應鏈如此參差不齊，我們也只是——我們在管理全球製造的過程中感到效率低下，並存在某種不一致什麼時候我們可以為團隊工作提供原材料。

So I do say it's probably spot buys is the one big thing that really sticks out. But a lot of these little nits on inflation are also impacting us as well.

所以我確實說，現貨購買可能是真正突出的一件大事。但是很多這些關於通貨膨脹的小問題也對我們產生了影響。

Got it. And then just secondly, on China. I know obviously not a big business for you, and you grew emerging markets solidly in the quarter. But just wondering what you saw there specifically in the second quarter? And any easing of pressures in China as we exited the quarter?

知道了。其次，關於中國。我知道對你來說顯然不是什麼大生意，而且你在本季度穩健地發展了新興市場。但只是想知道你在第二季度具體看到了什麼？當我們退出本季度時，中國的壓力是否有所緩解？

Yes. Look, China, it was a tough quarter, and I think anybody you talk to would say that just given the lockdowns and all the challenges. So we certainly had negative growth in China in the quarter. But our other emerging markets were pretty fantastic. And that growth was able to offset the negative that we had in China.

是的。看，中國，這是一個艱難的季度，我想任何與你交談的人都會這麼說，只是考慮到封鎖和所有的挑戰。因此，我們在本季度肯定在中國出現了負增長。但我們的其他新興市場非常棒。這種增長能夠抵消我們在中國的負面影響。

It's looking like it's starting to get better. But we didn't fare, I don't think, any better than our competitors. It was definitely a tough quarter, Q2 in China. We do have some businesses that were -- like our neurovascular business continue to do very well in China. They were a little less impacted, just the nature of that type of procedure. But the rest of our businesses felt the same pressure as everybody else.

看起來它開始好轉了。但我認為，我們的表現並不比我們的競爭對手好。這絕對是一個艱難的季度，中國的第二季度。我們確實有一些業務——比如我們的神經血管業務在中國繼續做得很好。他們受到的影響較小，只是這種程序的性質。但我們的其他企業也感受到了與其他人一樣的壓力。

The next question is from Rich Newitter with Truist.

下一個問題來自 Rich Newitter 和 Truist。

Kevin, I was wondering if you could maybe give us a little historical perspective on the capital spending situation. We're all looking forward and the prospect of recession is obviously there. At what point historically for your capital mix of businesses have you seen -- what have you seen as the leading indicator for when replacement cycles do, in fact, elongate? Clearly, you're not seeing it yet, but is there a point at which we should be braced for that happening?

凱文，我想知道你是否可以給我們一些關於資本支出情況的歷史觀點。我們都在展望未來，經濟衰退的前景顯然就在那裡。您在歷史上的什麼時候看到過您的企業資本組合——您認為什麼是替代周期實際上延長的領先指標？顯然，您還沒有看到它，但是我們是否應該為這種情況做好準備？

Well, I think, look, the recession would have to be pretty prolonged. We always have a delayed reaction across our portfolio, whether it's more elective procedures or whether it's capital equipment. We tend to get affected much later in the cycle versus other parts of the health care system. So it would have to be prolonged, which I think the economists for now are not really calling for kind of a prolonged recession.

好吧，我認為，看，經濟衰退將不得不相當長。我們總是對我們的投資組合做出延遲反應，無論是更多的選擇性程序還是資本設備。與醫療保健系統的其他部分相比，我們往往會在周期的後期受到影響。所以它必須延長，我認為現在的經濟學家並沒有真正呼籲一種長期的衰退。

The other factor is really hospital liquidity. That's a big factor. So if you go back to the financial meltdown, it wasn't just that there was a recession, right? There was a liquidity crisis. And when that happens, that's when you see -- you saw our medical business, the large capital business, really get impacted. But we don't see a liquidity crisis today. The hospital balance sheets are actually quite strong, so that gives us some confidence.

另一個因素是醫院的流動性。這是一個很大的因素。所以如果你回到金融危機，不僅僅是經濟衰退，對吧？出現了流動性危機。當這種情況發生時，你就會看到——你看到我們的醫療業務，大型資本業務，真的受到了影響。但我們今天沒有看到流動性危機。醫院的資產負債表實際上相當強勁，這給了我們一些信心。

And plus, look, Stryker is a different company than it was. Back in the financial meltdown, large capital was a big part of our company. We've diversified dramatically in the past decade, so much so that it's less than 10% of our overall sales. So even if there was an impact, it's certainly not going to hurt us anywhere near the way it would have hurt us a decade ago.

而且，看，Stryker 是一家不同的公司。回到金融危機時，大筆資金是我們公司的重要組成部分。在過去的十年中，我們的多元化程度非常高，以至於它不到我們總銷售額的 10%。因此，即使有影響，它肯定不會像十年前那樣傷害我們。

That's really helpful. And then maybe just one more on Mako, like big-ticket capital. It sounds like the message was there was no real change in buying or demand for robotic reprioritization of hip and knee, Mako robotics, per se. But maybe there was just some revenue mix and some changes in the revenue recognition. Is that right that the actual in-quarter demand, not just the order book, but the in-quarter demand for Mako was pretty much unchanged and strong?

這真的很有幫助。然後也許只有一個關於 Mako 的，比如大票資本。聽起來好像信息是購買或需求沒有真正的變化，對髖關節和膝關節的機器人重新排序，Mako 機器人本身。但也許只是一些收入組合和收入確認的一些變化。實際的季度需求，不僅是訂單，而且對 Mako 的季度需求幾乎沒有變化並且強勁，這對嗎？

Yes, it was strong. I mean I think Jason mentioned in his prepared remarks, it was -- we were up 19% versus the prior year. Now a good part of that was international. But even in the U.S., we had growth versus the prior year, and that's actually starting to pick up in the U.S.

是的，它很強大。我的意思是，我認為傑森在他準備好的講話中提到，我們比去年增長了 19%。現在其中很大一部分是國際化的。但即使在美國，我們也比前一年有所增長，而且這實際上在美國開始回升。

So demand is very strong. So you have to remember where we are in the cycle of robotics, right? We're in the early stages, in the early cycle of robotic surgery adoption. And I think if we were in a later cycle, might be a bit of a different story. But because it's robotics, it's still early. There are still people who are anxious to get their hands on robots. And we're now very active in all the teaching hospitals. And the residents are coming out and they want a robot. And when they go into their new facility and the facility doesn't have a robot, they put a lot of pressure on their hospital to adopt it.

所以需求非常旺盛。所以你必須記住我們在機器人循環中的位置，對嗎？我們正處於早期階段，處於機器人手術採用的早期階段。而且我認為，如果我們處於較晚的周期中，可能會有所不同。但因為它是機器人技術，現在還為時尚早。仍然有人急於接觸機器人。我們現在在所有教學醫院都非常活躍。居民們出來了，他們想要一個機器人。當他們進入他們的新設施並且該設施沒有機器人時，他們向醫院施加了很大的壓力來採用它。

Now how they choose to pay for it, what type of contracting arrangements they get into, that's a whole other story. But facilities are buying their fourth and their fifth and their sixth robots. And so they're doing that because they absolutely believe in the value of robotics. That has nothing to do with marketing. It's all about really trying to provide best value for their customers and for their patients.

現在他們如何選擇支付，他們進入什麼類型的合同安排，這完全是另一回事。但設施正在購買他們的第四個、第五個和第六個機器人。所以他們這樣做是因為他們絕對相信機器人技術的價值。這與營銷無關。這一切都是為了真正努力為他們的客戶和他們的病人提供最大的價值。

The next question is from the line of Travis Steed with Bank of America.

下一個問題來自美國銀行的 Travis Steed。

Glenn, I'd love a little bit more clarification on the 200 basis point margin headwind you called out. How much of that is actually coming from some of the more acute spot buying that you mentioned versus the other inflationary things like plastics, metals and travel? Is it roughly half and half? Or is it 75-25? Just any directional color would be helpful.

格倫，我想對你所說的 200 個基點的保證金逆風做更多的澄清。與塑料、金屬和旅行等其他通脹因素相比，其中有多少實際上來自您提到的一些更激烈的現貨購買？大概是一半一半吧？還是75-25？任何方向性的顏色都會有所幫助。

Yes. Sure. I think as you look at sort of that basket of costs, the spot buys certainly are significant, maybe approaching half of that basket of costs. I mean that being said, keep in mind that as we made those spot buy purchases, the underlying inventory goes on the balance sheet. And then it bleeds out into our P&L over the utilization period. So it's not something that goes away from us in the short term.

是的。當然。我認為，當您查看一攬子成本時，現貨購買肯定是重要的，可能接近該籃子成本的一半。我的意思是說，請記住，當我們進行這些現貨購買時，基礎庫存會出現在資產負債表上。然後它會在使用期間流入我們的損益表。因此，這不會在短期內遠離我們。

The other basket of costs, though, we do feel that inflation. We feel it in labor. We feel it in transportation. We're seeing it in commodities. And that's something that I'm not necessarily expecting will necessarily go away for us over the longer term.

然而，另一籃子成本，我們確實感受到了通貨膨脹。我們在勞動中感受到它。我們在運輸中感受到它。我們在大宗商品中看到了這一點。從長遠來看，我不一定期望這對我們來說一定會消失。

No, that's really helpful as we kind of think about our models for the next year. So that's helpful. And I guess on pricing, do you think that you could see it going flattish next year? Or could it be something that goes positive? And then I don't know if you have any other quick comments on the sports medicine market and smoke evacuation, that would be helpful as well. Appreciate it.

不，當我們考慮明年的模型時，這真的很有幫助。所以這很有幫助。我猜在定價方面，你認為明年你會看到它持平嗎？或者它可能是積極的事情？然後我不知道您是否對運動醫學市場和排煙有任何其他快速評論，這也會有所幫助。欣賞它。

Yes. Travis, it's Jason. Just really quickly on the pricing piece, and then I'll hand it over to Glenn on the sports med. But relative to guiding on price, we're not going to guide on price for next year. And when we get closer to 2023 earnings season, you'll hear more, but nothing to guide there.

是的。特拉維斯，是傑森。只是很快就定價，然後我會把它交給運動醫學的格倫。但相對於價格指導，我們不打算對明年的價格進行指導。當我們接近 2023 年財報季時，您會聽到更多消息，但沒有什麼可指導的。

Yes. On your question on smoke evac and sports medicine. First of all, smoke evac continues to be very high growth. There are 6 states that are mandating smoke-free ORs. There are 7 other states that have legislation that's pending. And so you can see the momentum around smoke-free operating rooms is absolutely increasing. And we're in a great position and we had fantastic growth in smoke evacuation. That should continue.

是的。關於你關於菸霧疏散和運動醫學的問題。首先，Smoke Evac 繼續保持非常高的增長。有 6 個州強制要求無菸手術室。還有其他 7 個州的立法正在等待中。因此，您可以看到無菸手術室的勢頭正在絕對增加。我們處於有利地位，我們在排煙方面取得了驚人的增長。那應該繼續。

And then on sports med, this is about our company and we are now becoming -- we're fast becoming a leader in sports medicine, which obviously wasn't the case a decade ago. First, we started off with our hip portfolio with the Pivot acquisition and some -- and really becoming the leader in hip arthroscopy. We already had a decent knee offering. And shoulder had been our weakness, and we've really bolstered our shoulder portfolio. So in all the key areas, we now have very compelling product opportunities.

然後在運動醫學方面，這是關於我們公司的，我們現在正在成為——我們正在迅速成為運動醫學領域的領導者，這顯然不是十年前的情況。首先，我們從收購 Pivot 開始我們的髖關節產品組合——並真正成為髖關節鏡檢查領域的領導者。我們已經提供了不錯的膝蓋產品。肩膀一直是我們的弱點，我們確實加強了我們的肩膀組合。因此，在所有關鍵領域，我們現在都有非常引人注目的產品機會。

And we're absolutely growing faster than the market and have been for the last couple of years. But I think the ASC shift has put an accelerator on our sports medicine business. And I think you know that sits within our endoscopy division. But that business has a fabulous outlook for the future. I mentioned the InSpace balloon for massive rotator cuff repair. The AlphaVent product has just recently launched, which really addresses gaps that we had in the sort of smaller rotator cuff repair part of the sports medicine business. So I'm extremely bullish about sports medicine for the future.

而且我們的增長速度絕對比市場快，而且在過去的幾年裡一直如此。但我認為 ASC 的轉變加速了我們的運動醫學業務。我想你知道這屬於我們的內窺鏡部門。但該業務的未來前景非常好。我提到了用於大規模肩袖修復的 InSpace 氣球。 AlphaVent 產品最近剛剛推出，它真正解決了我們在運動醫學業務中較小的肩袖修復部分存在的差距。所以我非常看好運動醫學的未來。

Our next question is from the line of Drew Ranieri with Morgan Stanley.

我們的下一個問題來自摩根士丹利的 Drew Ranieri。

Kevin, just to go back to one of your comments about the trauma market. And I think specifically, it was on foot and ankle. You mentioned there was some softness on forefoot procedures. Just curious if that was the overall market or if there's anything else that you were seeing there.

凱文，回到你對創傷市場的評論之一。我特別想，它是在腳和腳踝上。你提到前足程序有一些柔軟。只是好奇這是整個市場還是您在那裡看到的其他任何東西。

And then second, just on ProCuity, you've talked about it being just a strong launch. Curious kind of what you're thinking in terms of the durability there. And are you taking competitive share? Or is it really growth really all driven by replacements at this point?

其次，就在 ProCuity 上，您已經談到它只是一個強大的發布。就那裡的耐用性而言，你在想什麼很奇怪。你是否在搶占競爭份額？或者，在這一點上，增長真的都是由替代驅動的嗎？

Yes. Look, the orders are continuing to pile up on ProCuity, and it's not just in friendly shops. So we are clearly winning competitive business. This is an absolutely fantastic product. The challenge that we have is there are a lot of microchips used in that product. And so we're really constrained on being able to ship to meet the demand. That is going to get better in the second half and into next year. But it's really -- it's a terrific product, and that's going to continue to drive growth.

是的。看，ProCuity 上的訂單繼續堆積，而且不僅僅是在友好的商店裡。因此，我們顯然正在贏得有競爭力的業務。這是一款絕對出色的產品。我們面臨的挑戰是該產品中使用了很多微芯片。因此，我們在運送以滿足需求方面確實受到了限制。這將在下半年和明年變得更好。但它真的是——它是一個了不起的產品，它將繼續推動增長。

It's kind of year 2 of the product launch and if we weren't so supply constrained, we'd be shipping a lot more of those products. But beds don't sort of ramp as quickly in terms of the buying cycle as a power tool or as a camera. So I would expect the next, let's call it, 2 years to be really, really strong for ProCuity. And what was the second thing?

這是產品發布的第 2 年，如果我們沒有受到供應限制，我們會運送更多這些產品。但就購買週期而言，床並沒有電動工具或相機那麼快。所以我預計下一個，讓我們稱之為，2 年對 ProCuity 來說非常非常強大。第二件事是什麼？

On foot and ankle, look, we'll have to see what happens when everybody else reports and kind of see what's happening in the marketplace. It was a little bit softer for us on the forefoot side but strong on the total ankle side. And let's just -- we'll have to see how that plays out. I really -- it's a little premature for us to know kind of how we're doing. I would say we're pretty excited about -- we have a number of forefoot launches. We had some supply challenges in getting those launches activated. But like the EasyClip launch, for example -- or EasyFuse, we call it, sorry, it looks like a staple, a terrific product for forefoot procedures.

在腳和腳踝方面，看，我們將不得不看看當其他人報告時會發生什麼，並看看市場上正在發生什麼。對我們來說，前掌側稍微柔軟一點，但整個腳踝側很結實。讓我們 - 我們將不得不看看它是如何發揮作用的。我真的 - 我們現在知道我們在做什麼還為時過早。我想說我們非常興奮——我們有許多前腳掌發布。在啟動這些發射時，我們遇到了一些供應挑戰。但是就像 EasyClip 的發布，例如，或者 EasyFuse，我們稱之為，對不起，它看起來像一個主食，一個非常適合前足手術的產品。

But we stumbled a little bit in -- just because of supply chain challenges in getting these new launches for MIS forefoot. Those launches will -- I just mentioned one of those is EasyFuse. But there's about 5 of these products, which we'll start to see the impact of those in the second half of the year. So I'm feeling optimistic going forward, but that's -- the second quarter was a little bit choppy. Nothing that's overly concerning though.

但是我們偶然發現了一點——只是因為在為 MIS 前腳推出這些新產品時面臨供應鏈挑戰。這些發布將——我剛剛提到其中之一是 EasyFuse。但是其中大約有 5 種產品，我們將在下半年開始看到這些產品的影響。所以我對未來感到樂觀，但那是 - 第二季度有點波濤洶湧。不過沒有什麼過分擔心的。

Our next question is from Michael Matson with Needham & Company.

我們的下一個問題來自 Needham & Company 的 Michael Matson。

Yes. Just had 2 questions, I guess, I'll just go ahead and give them to you both to you here. So the -- with the System 9 and the 1788 coming up next year, is there any risk that we're going to see a slowdown in those businesses? I know how important those product lines are to instruments in endoscopy.

是的。我想只有 2 個問題，我會繼續把它們給你們兩個給你們。那麼——隨著明年 System 9 和 1788 的問世，我們會看到這些業務放緩的風險嗎？我知道這些產品線對於內窺鏡檢查儀器的重要性。

And then the second question would just be around R&D. It's 7.2% in the first half. Looking back at my model, that's up almost 200 basis points over the past 10 years. Is this the new normal? Or could it keep going higher from here?

然後第二個問題是關於研發的。上半年為7.2%。回顧我的模型，在過去的 10 年裡，它上升了近 200 個基點。這是新常態嗎？或者它會從這裡繼續走高嗎？

Well, let me start with the product launches. When we do these new launches, we have sales forces that know how to kind of drive revenue. And these are products that do wear out and do need to be replaced. And so I'm not expecting any slowdown whatsoever. If anything, you should see growth continue and then gradually increase. And sometimes, it's not the first year that you see the spike. You sort of see it -- you certainly see it by the second year.

好吧，讓我從產品發布開始。當我們進行這些新發佈時，我們的銷售人員知道如何增加收入。這些產品確實會磨損並需要更換。因此，我預計不會出現任何放緩。如果有的話，你應該看到增長繼續，然後逐漸增加。有時，這不是您看到峰值的第一年。你會看到它——你肯定會在第二年看到它。

So to me, this is just a continuation of -- it will continue a very, very good trend. Look, R&D has gone up and part of it is because of the mix of our businesses. If you think about neurovascular, it's a little more thirsty because of the clinicals that are required. We are launching a lot of new products, so our spend has increased.

所以對我來說，這只是一個延續——它將繼續一個非常非常好的趨勢。看，研發已經上升，其中一部分是因為我們的業務組合。如果您考慮神經血管，由於需要進行臨床檢查，因此會更加口渴。我們正在推出許多新產品，因此我們的支出增加了。

And look, we were over 7% of sales, I think, for the full year. I don't know that we'll stay over 7% but we'll be in kind of in that neighborhood as a percentage of sales. I don't know that it goes a lot higher from here. I think that's a pretty healthy level of R&D. But look, that fuels our growth and growth doesn't come for free.

看，我們全年的銷售額超過 7%。我不知道我們會保持在 7% 以上，但我們會在那個區域內佔銷售額的百分比。我不知道它比這里高得多。我認為這是一個相當健康的研發水平。但是看，這推動了我們的成長，而成長並不是免費的。

So you do have to invest in innovation if you want to continue to grow. But I think this is probably a good level. And we'll kind of stay at this level unless our portfolio drastically changes. We are doing more in the world of digital. That does cost some money. In Mako, we're pursuing different applications. That is a bit thirsty for R&D. But I would say that this is a pretty good level.

因此，如果您想繼續增長，就必須投資於創新。但我認為這可能是一個很好的水平。除非我們的投資組合發生巨大變化，否則我們將保持在這個水平。我們在數字世界中做得更多。那確實要花一些錢。在 Mako，我們追求不同的應用。這對研發有點渴望。但我會說這是一個相當不錯的水平。

Our next question is from the line of Jeff Johnson with Baird.

我們的下一個問題來自 Jeff Johnson 和 Baird。

Maybe just a couple of clarifying questions. First, on pricing. You sound pretty good on pricing going forward. Is that largely driven by the strong new product cycle coming in MedSurg and you typically can get a little price on new MedSurg products? Or do you -- would you expect in MedSurg to take bigger than normal price increases on these new products?

也許只是幾個澄清的問題。首先，關於定價。你對未來的定價聽起來不錯。這主要是由 MedSurg 強勁的新產品週期推動的嗎？您通常可以在新 MedSurg 產品上獲得一點價格嗎？或者您是否希望 MedSurg 對這些新產品的價格上漲幅度超過正常水平？

And then on the implant side, have you had any tangible conversations with hospitals yet about maybe less bad pricing dynamics in contracts over the next couple of years? Or is that just still a hope at this point but nothing tangible yet to talk about?

然後在植入物方面，您是否與醫院進行過任何切實的對話，但關於未來幾年合同中可能不那麼糟糕的定價動態？或者，在這一點上，這只是一個希望，但還沒有什麼具體可談的？

Yes. On the first question, I want to be really clear here that whenever we do launch new products, whatever price -- we normally will raise the price. But you won't see that in the price line of our quarterly results. So price -- the way we report price is like-for-like.

是的。關於第一個問題，我想在這裡非常清楚，每當我們推出新產品時，無論價格如何——我們通常都會提高價格。但你不會在我們季度業績的價格線上看到這一點。所以價格——我們報告價格的方式是相似的。

So as the System 9, if it comes in at a higher price for the first year, that will show up in mix and volume. It will not show up in the price line. So in the second year, that like-for-like will start to show up. So just to be clear about that, we always -- ProCuity is a good example. The ProCuity price is higher than our [S3] beds. But that -- in the first year of that launch, you don't see that showing up in the price line. It shows up in volume mix. So I hope I'm clear on that.

因此，對於 System 9，如果它在第一年的價格更高，那麼它將在混合和數量上體現出來。它不會出現在價格行中。因此，在第二年，這種類似將開始出現。所以為了澄清這一點，我們總是—— ProCuity 是一個很好的例子。 ProCuity 價格高於我們的 [S3] 床。但是——在發布的第一年，你看不到它出現在價格線上。它出現在音量混合中。所以我希望我清楚這一點。

But obviously, that's going to be part of our strategy. As we launch new products, we're going to be able to raise prices. As it relates to implants, early days yet. We've had a couple of early conversations, and they've gone reasonably well. But it is way too early for me to be able to give you a sign of what is going to come in the future. And we'll have more to share on future calls.

但顯然，這將成為我們戰略的一部分。隨著我們推出新產品，我們將能夠提高價格。由於它與植入物有關，還處於早期階段。我們已經進行了幾次早期的對話，而且進展相當順利。但是，我現在無法告訴你未來會發生什麼，還為時過早。我們將在未來的電話會議上分享更多內容。

All right. That's helpful. And then, Glenn, just one more on gross margin. Just it sounds like about 100 basis points of that headwind is on the spot buy heightened costs this year and that. If those spot prices do come down over the next 6 months as it seems like you think they could, is that 30 to 60 days to work that into the product and turn that over onto the P&L? So that tends to be a short cycle, where those benefits could show up quickly?

好的。這很有幫助。然後，格倫，毛利率再增加一個。只是聽起來大約 100 個基點的逆風是在現場購買今年和那個時候增加的成本。如果這些現貨價格在接下來的 6 個月內確實像您認為的那樣下跌，那麼是否需要 30 到 60 天才能將其轉化為產品並將其轉入損益表？所以這往往是一個短週期，這些好處可能會很快顯現出來？

And then maybe on the implant side, where that is getting capitalized to the balance sheet right now, those higher costs, is there a significantly greater headwind next year, another 100 basis points that's being capitalized on to the balance sheet right now that hasn't yet come through this year? So we have to think maybe an incremental 100 basis point headwind there, that could get offset by the short-cycle spot buy pricing coming down next year and net-net, those could offset? Or just conceptually, maybe how do we think about those 2 moving parts?

然後也許在植入方面，現在正在資產負債表中資本化，那些更高的成本，明年是否會有更大的逆風，另外100個基點現在正在資產負債表上資本化今年還過不去嗎？因此，我們必須考慮可能會增加 100 個基點的逆風，這可能會被明年下降的短週期現貨購買價格和淨淨值所抵消，這些可能會抵消嗎？或者只是在概念上，也許我們如何看待這兩個活動部分？

Yes. Without getting too granular about next year, the way these bleed out, it's not necessarily short term in terms of how they bleed out. We worked pretty diligently to secure the kind of supply that was available when we could get it. And so that has a longer tail in terms of when we'll feel the bleed out into our P&L. And that would apply to either site implants or the MedSurg businesses.

是的。在沒有對明年過於細化的情況下，這些流血的方式，就它們如何流血而言不一定是短期的。我們非常努力地工作，以確保我們能夠獲得可用的供應。因此，就我們何時會感覺到損益表的流失而言，它的尾巴更長。這將適用於網站植入或 MedSurg 業務。

Our next question is from the line of Shagun Singh with RBC.

我們的下一個問題來自 RBC 的 Shagun Singh。

I'll just keep it to one. Just on M&A, how are you thinking about the current M&A environment? Your appetite for deals at the moment given valuations where they are, are you more or less likely to do one? And do you -- should we expect you to continue to focus on tuck-ins versus larger deals given the recent Vocera acquisition?

我只保留一個。就併購而言，您如何看待當前的併購環境？鑑於目前的估值，您對交易的興趣，您或多或少可能會這樣做？考慮到最近的 Vocera 收購，我們是否應該期望您繼續專注於大宗交易而不是更大的交易？

Yes. Thanks for the question. Certainly, we are focused on tuck-ins, not just given Vocera but also Wright Medical. So we did Wright Medical not so long ago and then we did Vocera. As Glenn mentioned, we paid $450 million of debt down in the last quarter.

是的。謝謝你的問題。當然，我們專注於折疊，不僅提供 Vocera，還提供 Wright Medical。所以不久前我們做了 Wright Medical，然後我們做了 Vocera。正如格倫所說，我們在上個季度償還了 4.5 億美元的債務。

So right now, given our balance sheet situation, our focus is really on tuck-ins. We have all of our businesses are actively pursuing these kind of tuck-ins. But you should expect that that's kind of in our near term, let's say, through at least the end of this year, our focus will be much more on the tuck-ins.

所以現在，考慮到我們的資產負債表情況，我們的重點實際上是收緊。我們所有的企業都在積極追求這種折衷方案。但是你應該期望這在我們的近期內，比如說，至少到今年年底，我們的重點將更多地放在折疊上。

And obviously, valuations are down. That doesn't mean that the companies that have these lower valuations are excited to sell at these new values. I think it's going to take a little time for that to set in before we're going to see a lot of those companies want to sell.

顯然，估值下降了。這並不意味著估值較低的公司樂於以這些新價值出售。我認為在我們看到很多公司想要出售之前，這需要一點時間。

So I don't think that we're going to miss a window, so to speak, just because we're focused on the tuck-ins. But we do need to digest the acquisitions. We do need to fortify our balance sheet, but we will continue to pursue tuck-ins.

所以我不認為我們會錯過一個窗口，可以這麼說，只是因為我們專注於折疊。但我們確實需要消化這些收購。我們確實需要加強我們的資產負債表，但我們將繼續追求折中。

The last question is from the line of Ryan Zimmerman with BTIG.

最後一個問題來自 BTIG 的 Ryan Zimmerman。

I'll try and be quick on my questions. Number one, I just want to ask the pricing question in a different way. And as they think about price and the ability to take it, I mean I know you're not going to give us what kind of pricing it's going to take. But how do you think about inflation? And what persists over the next 6 months or into next year in terms of how much that you can carry through? So is inflation versus an 8% is a reasonable thing we can push through a similar type price increase into next year?

我會盡量快速回答我的問題。第一，我只是想以不同的方式提出定價問題。當他們考慮價格和接受它的能力時，我的意思是我知道你不會告訴我們它將採取什麼樣的定價。但是你如何看待通貨膨脹？在接下來的 6 個月或明年，您可以承擔多少？那麼通脹與 8% 相比是否合理，我們可以將類似的價格上漲推到明年？

And then the follow-up question is just around Mako dynamics and the shift to either a rent or a lease type model. We see with Intuitive, 40-plus percent in the last quarter. Is that the right level to think about for where this shakes out and settles out in terms of Mako adoption and the business model?

然後接下來的問題是圍繞 Mako 動態以及向租金或租賃類型模型的轉變。我們在上個季度看到了 40% 以上的 Intuitive。在 Mako 的採用和商業模式方面，這是正確的考慮水平嗎？

Ryan, I'll handle the pricing/inflation one first. I do think some of the normal things that you think about relative to the inflationary environment we're in and we're feeling will persist and will live on into next year. We see labor increases. We see increases in these commodities. I do think it will take a while before transportation and freight settles down to a more, what I'll call, normal cadence in terms of ocean freight versus air freight.

瑞安，我會先處理定價/通貨膨脹。我確實認為你認為與我們所處的通脹環境相關的一些正常事情會持續存在，並將持續到明年。我們看到勞動力增加。我們看到這些商品價格上漲。我確實認為運輸和貨運需要一段時間才能穩定下來，我稱之為海運與空運的正常節奏。

And so I think that will take a while to settle out. And in fact, where we enter into conversations with our customers about sort of what our cost makeup looks like and we're very frank with them, there are no surprises to them in terms of where we're seeing real increase in the real kind of raw materials and components that go into our products. And those are the kind of discussions that customers may not want to have, but they know and they expect it's coming. And so when we lead to go after price, we lead with details and with information so that they understand that underneath our pricing increase, we are feeling real increases in the components that go into our products.

所以我認為這需要一段時間才能解決。事實上，當我們與客戶就我們的成本構成進行對話時，我們對他們非常坦率，就我們看到真實類型的真正增長而言，他們並不感到意外進入我們產品的原材料和組件。這些是客戶可能不想進行的討論，但他們知道並且他們期望它即將到來。因此，當我們開始追求價格時，我們以細節和信息為主導，以便他們了解在我們的價格上漲之下，我們感受到了進入我們產品的組件的真正增加。

Ryan, it's Jason. In terms of the Mako question, I guess what I would say is in terms of the right mix, I think what's important here is we think about the different options. We're trying to be flexible with the customer to ultimately drive the installed base to then get to continue market-leading growth on the implant side, right? So that's really what's important for us and less about kind of that mix as we think about finance, direct purchase, et cetera.

瑞恩，是傑森。關於 Mako 的問題，我想我想說的是正確的組合，我認為這裡重要的是我們考慮不同的選擇。我們正在努力與客戶保持靈活性，以最終推動安裝基礎，然後在植入物方面繼續保持市場領先的增長，對嗎？所以這對我們來說真的很重要，而不是當我們考慮金融、直接購買等時那種組合。

So we're excited where we're headed with Mako as I said in my opening remarks with the 19% install increase year-on-year. And so I'll just kind of leave it there as we're thinking about Mako.

因此，正如我在開場白中所說的那樣，我們對 Mako 的發展感到興奮，安裝量同比增長 19%。因此，當我們在考慮 Mako 時，我將把它留在那裡。

There are no additional questions waiting at this time. So I will now turn the call over to Kevin Lobo for closing remarks.

目前沒有其他問題在等待。所以我現在將把電話轉給 Kevin Lobo 來做結束語。

Great. Well, thank you all for joining our call, and thank you for all your questions. We look forward to sharing our third quarter results with you in October. Thank you.

偉大的。好吧，感謝大家加入我們的電話，並感謝您提出的所有問題。我們期待在 10 月份與您分享我們的第三季度業績。謝謝你。

That concludes today's call. Thank you for your participation. You may now disconnect your lines.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開線路。