史賽克 (SYK) 2024 Q4 法說會逐字稿

Welcome to the fourth quarter 2024 Stryker earnings call. My name is Luke, and I'll be your operator for today's call. (Operator Instructions) This conference call will be recorded for replay purposes. For your planning purposes, and given the amount of content we have to cover, in the event the call runs long, we plan to end the call no later than 6:00 PM EST.

歡迎參加 Stryker 2024 年第四季財報電話會議。我叫盧克，我是今天電話的接線生。（操作員說明）本次電話會議將被錄音以供重播。出於您的規劃目的，並考慮到我們必須涵蓋的內容量，如果通話時間較長，我們計劃在美國東部時間下午 6:00 之前結束通話。

Before we begin, I'd 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 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.

在我們開始之前，我想提醒您，本次電話會議期間的討論將包括前瞻性陳述。最近向 SEC 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，討論還將包括某些非公認會計準則財務措施。在今天的新聞稿中可以找到與最直接可比較的 GAAP 財務指標的調節表，該新聞稿是 Stryker 今天向 SEC 提交的 8-K 表格當前報告的展示。

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

我現在想將電話轉給董事長兼執行長 Kevin Lobo 先生。您可以繼續了，先生。

Welcome to Stryker's fourth quarter earnings call. Joining me today are Glenn Boehnlein, Stryker's CFO; Andy Pierce, Group President, MedSurg on Neurotechnology; and Jason Beach, Vice President of Finance and Investor Relations. For today's call, I'll provide open comments followed by Andy, who will expand on our strategic rationale for the pending Inari acquisition. Jason will then follow with the trends we saw during the quarter and some product updates. Finally, Glenn will offer further details on our 2024 results and 2025 guidance as well as financial elements Inari Medical and Spine before we open the call to Q&A.

歡迎參加 Stryker 第四季財報電話會議。今天加入我的是 Stryker 財務長 Glenn Boehnlein； Andy Pierce，MedSurg 神經技術集團總裁；以及財務和投資者關係副總裁 Jason Beach。在今天的電話會議中，我將發表公開評論，隨後安迪將詳細闡述我們對即將進行的 Inari 收購的策略理由。然後 Jason 將關注我們在本季看到的趨勢和一些產品更新。最後，在我們開始問答環節之前，格倫將提供有關我們 2024 年業績和 2025 年指導以及 Inari Medical 和 Spine 財務要素的更多詳細資訊。

First, as you saw in our press release, Glenn Fogel has decided to retire from Stryker effective April 1, after a very successful nine-year tenure as our CFO. He will be replaced by Preston Wells who most of you know from his time in the Investor Relations role. I would like to thank Glenn for his outstanding leadership and great partnership with me and Stryker leaders as we grew the company significantly, delivered consistent strong financial results and have positioned it very well for the future.

首先，正如您在我們的新聞稿中看到的那樣，Glenn Fogel 在擔任我們的 CFO 九年非常成功的任期後，決定從 4 月 1 日起從 Stryker 退休。他將由普雷斯頓威爾斯 (Preston Wells) 接替，你們大多數人都在擔任投資者關係職務時認識他。我要感謝 Glenn 的傑出領導力以及與我和 Stryker 領導者的良好合作關係，我們使公司取得了顯著發展，實現了持續強勁的財務業績，並為公司的未來做好了良好的定位。

Now let's move to our 2024 results, which were excellent, both for Q4 and the full year. Against double-digit comparatives from a year ago, organic sales growth exceeded 10% for both Q4 and the full year. Globally, for the full year, our instruments, endoscopy, medical, neuro cranial and trauma and extremities businesses all delivered double-digit organic sales growth. Full year US organic sales growth was an impressive 10.6% and international organic sales growth was 8.8%.

現在讓我們來看看 2024 年的業績，無論是第四季還是全年，業績都非常出色。與去年同期兩位數的比較相比，第四季和全年的有機銷售額成長均超過 10%。在全球範圍內，我們的儀器、內視鏡、醫療、神經顱腦、創傷和四肢業務全年均實現了兩位數的有機銷售成長。全年美國有機銷售額成長 10.6%，國際有機銷售額成長 8.8%，令人印象深刻。

International results were led by strong performances in Canada, emerging markets in Europe. International continues to represent a significant opportunity for both our legacy businesses and recent acquisitions. We also had excellent earnings performance, including the dilutive impacts from the seven acquisitions that we completed in 2024, we exceeded our adjusted operating margin goals, delivering an improvement of 200 basis points in Q4 and 110 basis points for the full year versus 2023.

國際業績主要由加拿大和歐洲新興市場的強勁表現帶動。國際業務持續為我們的傳統業務和最近的收購帶來重大機會。我們也擁有出色的獲利表現，包括我們在2024 年完成的七項收購的稀釋影響，我們超越了調整後的營業利潤率目標，與2023 年相比，第四季度提高了200 個基點，全年提高了110 個基點。

Our quarterly and full year adjusted EPS of $4.01 and $12.19 represents 16% growth for Q4 and 15% growth compared to the full year of 2023. This comprehensive performance demonstrates the durability of our high-growth offense, driven by organic innovation, focused M&A and terrific commercial execution as well as strong earnings power.

我們的季度和全年調整後每股收益分別為 4.01 美元和 12.19 美元，這意味著第四季度增長 16%，與 2023 年全年相比增長 15%。這項綜合表現證明了我們在有機創新、專注的併購、出色的商業執行力以及強大的獲利能力的推動下，高成長業務的持久性。

We have momentum entering 2025 and expect to continue delivering sales growth at the high end of med tech, which is reflected in our full year 2025 guidance of organic sales growth of 8% to 9%. This growth, combined with continuing operating margin expansion translate to an adjusted EPS of $13.45, $13.70 per share before considering the impact of Inari Medical, which Glenn will cover.

進入 2025 年，我們勢頭強勁，預計將繼續實現高端醫療技術的銷售成長，這反映在我們 2025 年全年有機銷售成長 8% 至 9% 的指導中。這一增長加上持續的營業利潤率擴張，調整後每股收益為 13.45 美元，在考慮格倫將負責的 Inari Medical 的影響之前，每股收益為 13.70 美元。

We also announced an agreement to sell our Spinal Implants business, which has faced challenges in achieving our performance expectations. This sale will place the Spinal Implants business in the hands of new owners that have extensive experience in the spine market, and it allows us to better align our resources.

我們還宣布了一項出售脊椎植入物業務的協議，該業務在實現我們的業績預期方面面臨著挑戰​​。此次出售將使脊椎植入物業務交到在脊椎市場擁有豐富經驗的新所有者手中，這使我們能夠更好地調整我們的資源。

We continue to be excited about Interventional Spine, which is one of our fastest-growing businesses and was bolstered by the recent acquisition of Vertos Medical. Additionally, we remain committed to enabling technologies for the spine market, including our Q Guidance System, Copilot and Mako Spine. These portfolio decisions reflect a continuation of our strategy to drive category leadership in attractive, high-growth end markets.

我們仍然對介入脊椎感到興奮，這是我們成長最快的業務之一，並受到最近收購 Vertos Medical 的支持。此外，我們仍然致力於為脊椎市場提供支援技術，包括我們的 Q Guidance System、Copilot 和 Mako Spine。這些投資組合決策反映了我們在有吸引力的高成長終端市場中推動品類領導地位的策略的延續。

I will now turn the call over to Andy.

我現在會把電話轉給安迪。

Thanks, Kevin. Our entry into the peripheral vascular market is a logical adjacency to our Neurovascular division given their complementary product portfolios and parallel sites of service. With the acquisition of Inari, Stryker will be a leading player in the fast-growing area of chemical thrombectomy treatment for venous thromboembolism or VTE. Mechanical thrombectomy for represents a $15 billion addressable opportunity with the US comprising the $6 billion of that opportunity.

謝謝，凱文。鑑於我們的神經血管部門具有互補的產品組合和平行的服務地點，我們進入周邊血管市場是順理成章的。透過收購 Inari，Stryker 將成為快速成長的靜脈血栓栓塞或 VTE 化學血栓切除治療領域的領導者。機械血栓切除術代表著 150 億美元的可利用機會，其中美國佔 60 億美元。

Today, less than 1/5 of treatments for VTE are with mechanical thrombectomy. And we, therefore, believe this opportunity will expand over time as hospitals and clinicians look to elevate the standard of care for VTE. We believe Inari Solutions, which are supported by clinical research demonstrating their effectiveness, representing significant opportunity for our portfolio. Since bringing its ClotTriever and flow treater products to market in 2017, Inari has seen tremendous revenue growth in excess of 20% annually with a gross margin profile of approximately 85%.

如今，不到 1/5 的 VTE 治療採用機械血栓切除術。因此，我們相信隨著時間的推移，隨著醫院和臨床醫生尋求提高 VTE 的護理標準，這個機會將會擴大。我們相信 Inari Solutions 的有效性得到了臨床研究的支持，為我們的產品組合帶來了重大機會。自 2017 年將 ClotTriever 和流量處理器產品推向市場以來，Inari 的收入每年大幅增加超過 20%，毛利率約為 85%。

In addition to its treatments for VTE, Inari has invested in four exciting therapies to address unmet needs in other patient populations. These emerging therapies include chronic venous disease, dialysis access management, acute limb ischemia and chronic limb-threatening ischemia. Together, they represent over $5 billion of incremental market segment opportunity globally. We believe Stryker's international presence can help Inari more rapidly into global markets.

除了 VTE 治療外，Inari 還投資了四種令人興奮的療法，以滿足其他患者群體未滿足的需求。這些新興療法包括慢性靜脈疾病、透析通路管理、急性肢體缺血和慢性肢體威脅性缺血。它們合計代表了全球超過 50 億美元的增量細分市場機會。我們相信 Stryker 的國際影響力可以幫助 Inari 更快進入全球市場。

In recent years, Inari has made strides globally and is currently helping improve patient outcomes in over 30 markets, primarily in Europe and certain parts of Asia. Its international business is approximately 7% of sales. Stryker has long been a global leader in interventional neurovascular procedures. And with the addition of Inari, we will be equipped with a more comprehensive interventional endovascular portfolio. By launching the R&D and clinical capabilities of both organizations, we will have a greater opportunity to accelerate innovation and meet customer needs.

近年來，Inari 在全球取得了長足進步，目前正在幫助改善 30 多個市場（主要是歐洲和亞洲某些地區）的患者治療效果。其國際業務約佔銷售額的7%。史賽克長期以來一直是介入神經血管手術的全球領導者。而隨著Inari的加入，我們將擁有更全面的介入性血管內產品組合。透過啟動兩個組織的研發和臨床能力，我們將有更大的機會加速創新並滿足客戶需求。

From a commercial perspective, we are excited about the great synergies that exist between our teams. Inari brings significant operational infrastructure, which includes a commercial organization with attractive call points, including interventional radiologists, vascular surgeons and interventional cardiologists. Inari's strong commercial model and patient-focused mission aligns well with Stryker's culture and our go-to-market strategy in Neurovascular.

從商業角度來看，我們對我們團隊之間存在的巨大協同效應感到興奮。Inari 帶來了重要的營運基礎設施，其中包括一個具有有吸引力的呼叫點的商業組織，其中包括介入放射科醫生、血管外科醫生和介入性心臟病專家。Inari 強大的商業模式和以患者為中心的使命與 Stryker 的文化和我們在神經血管領域的進入市場策略非常契合。

Finally, I would like to thank and recognize Drew Hikes and the entire Inari leadership team for building a strong mission-driven company that is improving patient lives. Inari has done an incredible job establishing this segment and driving adoption through extensive clinical studies and commercial excellence over the last 10-plus years.

最後，我要感謝並認可 Drew Hikes 和整個 Inari 領導團隊，他們建立了一家強大的使命驅動型公司，致力於改善患者的生活。Inari 在過去 10 多年來透過廣泛的臨床研究和卓越的商業成就，在建立這個細分市場並推動採用方面做出了令人難以置信的工作。

I'd also like to thank the Stryker team for their tremendous efforts in bringing together our two companies. With our track record in M&A, we have conviction in our ability to drive a successful integration, deliver innovative solutions to our customers and create significant shareholder value. With our long history of investing in customer-focused technologies, we look forward to achieving best-in-class performance through a world-class sales force, a highly complementary and clinically compelling product portfolio and an exciting pipeline to ensure we continue on this segment.

我還要感謝 Stryker 團隊為合併我們兩家公司所做的巨大努力。憑藉我們在併購方面的業績記錄，我們堅信自己有能力推動成功整合、為客戶提供創新解決方案並創造顯著的股東價值。憑藉我們投資以客戶為中心的技術的悠久歷史，我們期待透過世界一流的銷售隊伍、高度互補且具有臨床吸引力的產品組合以及令人興奮的產品線來實現一流的業績，以確保我們繼續在這一領域發展。

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

現在，我將把電話轉給傑森。

Thanks, Andy. My comments today will focus on providing an update on the current environment as well as Mako, an update on product launches and an adjustment to our external reporting. Procedural volumes remained healthy in the fourth quarter, and we continue to expect the markets will remain strong in 2025, underscored by the continued adoption in robotic-assisted surgery, favorable demographics and healthy levels of patient activity.

謝謝，安迪。我今天的評論將重點介紹當前環境和 Mako 的最新情況、產品發布的最新情況以及我們外部報告的調整。第四季的手術量保持健康，我們繼續預計 2025 年市場將保持強勁，機器人輔助手術的持續採用、有利的人口統計和健康的患者活動水平都強調了這一點。

Additionally, demand for our capital products remained robust with strong organic growth in medical, Instruments and Endoscopy in the quarter and double-digit growth for the full year across all three businesses. Hospital CapEx budgets are healthy and our capital order book remains elevated as we enter 2025.

此外，對我們資本產品的需求依然強勁，本季醫療、儀器和內視鏡業務強勁有機成長，所有三項業務全年均實現兩位數成長。進入 2025 年，醫院資本支出預算保持健康，我們的資本訂單簿仍保持在較高水準。

Next, specific to Mako, we had another record quarter and year of installations in the US and worldwide. The progress of our Mako offense, including our direct-to-consumer campaign, has resulted in strong growth of our installed base alongside continued increases in utilization. In the US, we are approaching 2/3 of knees and 1/3 of hips performed using Mako as we exited the year. Globally, we exited the year with just over 45% of knees and approximately 20% of hips performed using Mako.

接下來，具體到 Mako，我們在美國和全球範圍內的安裝量再次創下季度和年度記錄。我們的 Mako 攻勢（包括我們的直接面向消費者的活動）的進展導致我們的安裝基礎強勁增長，同時利用率持續提高。在美國，今年年底，我們已經接近 2/3 的膝蓋和 1/3 的臀部使用 Mako 進行。在全球範圍內，今年結束時，我們有超過 45% 的膝蓋和大約 20% 的臀部使用 Mako 進行了手術。

We have momentum and significant opportunities remain as Mako adoption increases. Mako Spine completed its first cases in October, and we received excellent surgeons feedback. We will continue to progress through our limited market release and remain on track for full US commercial launch in the second half of the year.

隨著 Mako 採用率的增加，我們仍然擁有動力和重大機會。Mako Spine 於 10 月完成了第一批病例，我們收到了外科醫生的良好回饋。我們將繼續在有限的市場發布中取得進展，並繼續在今年下半年在美國全面商業發布。

Next, we received approval from the FDA for our Mako shoulder application, and we're able to perform our first cases in December. We are excited to now offer a complete ecosystem for shoulders, which includes blueprint, our preplanning software, Mako Shoulder and a leading portfolio of shoulder implants. As a reminder, 2025 will also be a limited launch year for Mako shoulder as we carefully gain clinical experience. We expect a full launch in the US by Q1 of 2026.

接下來，我們的 Mako 肩部應用獲得了 FDA 的批准，我們能夠在 12 月進行第一批病例。我們很高興現在能夠提供完整的肩部生態系統，其中包括藍圖、我們的預先規劃軟體、Mako Shoulder 和領先的肩部植入物產品組合。提醒一下，隨著我們認真累積臨床經驗，2025 年也將是 Mako 肩部的有限推出年。我們預計將於 2026 年第一季在美國全面推出。

We have continued to see positive momentum driven by our recent product launches. Our Pangia plating system has seen robust customer interest since its launch, driving strong sales growth. Additionally, our LIFEPAK 35 defibrillator and monitor continues to draw interest driving meaningful sales performance in the quarter, along with a robust order book. Lastly, we have adjusted our external reporting to better align with how we are organized internally and to reflect the pending divestiture of the spinal implants business.

我們持續看到近期產品推出所帶來的正面動能。我們的 Pangia 電鍍系統自推出以來就引起了客戶的濃厚興趣，推動了銷售的強勁成長。此外，我們的 LIFEPAK 35 除顫器和監視器繼續引起人們的興趣，推動了本季度有意義的銷售業績以及強勁的訂單。最後，我們調整了外部報告，以更好地與我們的內部組織方式保持一致，並反映即將剝離的脊椎植入物業務。

Effective in the fourth quarter, our Spine enabling technologies results are reported as part of other orthopedics and Interventional Spine results are reported as part of neurocrine. As a result, spinal implants is now reported separately within orthopedics.

從第四季度開始，我們的脊椎支持技術結果將作為其他骨科的一部分進行報告，介入脊椎結果將作為神經分泌的一部分進行報告。因此，脊椎植入物現在在骨科中單獨報告。

With that, I will now turn the call over to Glenn.

現在，我將把電話轉給格倫。

Thanks, Jason. Today, I will focus my comments on our fourth quarter financial results and the related drivers. Our detailed financial results have been provided in today's press release. Our organic sales growth was 10.2% in the quarter compared to 11.4% in the fourth quarter of 2023. This quarter had one more selling day than 2023.

謝謝，傑森。今天，我將重點放在我們第四季的財務表現和相關驅動因素。我們詳細的財務業績已在今天的新聞稿中提供。本季我們的有機銷售額成長率為 10.2%，而 2023 年第四季為 11.4%。本季比 2023 年多了 1 個銷售日。

We had a 1.1% favorable impact from pricing with both MedSurg and Neurotechnology and Orthopaedic segments contributing positive pricing for the quarter. Foreign currency had a 0.5% unfavorable impact on sales.

定價對我們產生了 1.1% 的有利影響，醫療外科、神經技術和骨科部門為本季度貢獻了積極的定價。外幣對銷售產生了 0.5% 的不利影響。

In the quarter, US organic sales growth was 10.9%. International organic sales growth was 7.9% and was led by positive sales momentum in Canada, Europe and our emerging markets. For the year, our organic sales growth was also 10.2% against a very strong comparable of 11.5% last year. US full year organic growth was [10.6%] and international growth was 8.8%. For the full year, the impact from price is favorable 1.1%. Foreign currency had a 0.5% unfavorable impact and 2024 had one more selling day than 2023.

本季度，美國有機銷售額成長 10.9%。國際有機銷售額成長 7.9%，主要得益於加拿大、歐洲和新興市場的積極銷售動能。今年，我們的有機銷售額成長率也達到 10.2%，而去年的成長率為 11.5%。美國全年有機成長率為 [10.6%]，國際成長率為 8.8%。全年來看，價格影響有利1.1%。外幣帶來了 0.5% 的不利影響，2024 年比 2023 年多了 1 個銷售日。

Our fourth quarter adjusted EPS was $4.01 was up 15.9% from 2023, driven by higher gross margins and the continued expansion of operating margins. Foreign currency translation had an unfavorable impact of $0.05. Our full year adjusted EPS of $12.19 was up 15% from 2023, reflecting the favorable impact of sales growth and operating margin expansion partially offset by the unfavorable impact of foreign currency exchange translation of $0.13.

受毛利率上升和營業利潤率持續擴張的推動，第四季度調整後每股收益為 4.01 美元，較 2023 年增長 15.9%。外幣換算產生了 0.05 美元的不利影響。我們全年調整後每股收益為 12.19 美元，較 2023 年增長 15%，反映出銷售成長和營業利潤率擴張的有利影響，部分被外幣兌換帶來的 0.13 美元不利影響所抵消。

Now I will provide some more highlights around our quarterly segment performance. In the quarter, MedSurg and Neurotechnology had constant currency sales growth of 11.1% and organic sales growth of 10.1%, which included 11.5% of US organic growth and 5.8% of international organic growth. Instruments had US organic sales growth of 8.8% with healthy growth in both the Surgical Technologies and orthopedic implants businesses. From a product perspective, sales growth was led by smoke evacuation, waste management, power tools and SteriShield.

現在我將提供有關我們季度業績的更多亮點。本季度，MedSurg 和 Neurotechnology 的固定匯率銷售額成長 11.1%，有機銷售額成長 10.1%，其中美國有機成長 11.5%，國際有機成長 5.8%。Instruments 在美國的有機銷售額成長了 8.8%，外科技術和骨科植入業務都健康成長。從產品角度來看，排煙、廢棄物管理、電動工具和 SteriShield 引領了銷售成長。

Endoscopy had US organic sales growth of 12.9%, led by strong growth across all businesses. Growth in the quarter was fueled by robust demand for our OR infrastructure and renovations and the continued success of our 1788 video platform and sports medicine shoulder products. Medical had US organic sales growth of 11.1%, driven by double-digit performances in the emergency care and Sage businesses. From a product perspective, the medical business was led by strong sales growth in beds, Sage products, transport capital and defibrillators.

在所有業務的強勁成長帶動下，內視鏡的美國有機銷售額成長了 12.9%。本季的成長得益於對手術室基礎設施和翻新的強勁需求以及 1788 視訊平台和運動醫學肩部產品的持續成功。在緊急護理和 Sage 業務兩位數業績的推動下，醫療器材在美國的有機銷售額增長了 11.1%。從產品角度來看，醫療業務由病床、Sage 產品、運輸資本和除顫器的強勁銷售成長所帶動。

LIFEPAK 35 continues to drive excitement in the market with a strong and accelerating order pipeline. Neurovascular had US organic sales growth of 12%, reflecting a strong performance in our hemorrhagic business and improvement against competitive pressures in our ischemic business. And finally, neurocranial had US organic sales growth of 13.3%, led by strong growth in our bone mill, high-speed drills, bipolar forceps, craniomaxillofacial and interventional spine products.

LIFEPAK 35 憑藉強勁且不斷加速的訂單管道持續推動市場興奮。神經血管業務在美國的有機銷售額成長了 12%，反映出我們的出血業務的強勁表現以及我們的缺血業務的競爭壓力的改善。最後，在骨磨機、高速鑽頭、雙極鉗、顱顏面和介入性脊椎產品強勁成長的帶動下，神經顱在美國的有機銷售量成長了 13.3%。

As a reminder, our growth numbers now reflect the changes that Jason discussed earlier, with interventional spine now reported as part of our neurocranial division. Internationally, MedSurg & Neurotechnology had organic sales growth of 5.8%, led by growth in our Instruments and Endoscopy businesses. Geographically, this included strong performances in Canada and the United Kingdom.

提醒一下，我們的生長數字現在反映了傑森之前討論的變化，介入脊椎現在被報告為我們神經顱部門的一部分。在國際範圍內，MedSurg & Neurotechnology 的有機銷售額增長了 5.8%，這主要得益於我們的儀器和內視鏡業務的成長。從地域上看，加拿大和英國的表現強勁。

Orthopaedics had constant currency sales growth of 11.3% and organic sales growth of 10.2%, which included organic growth of 10% in the US and 10.5% internationally. Our knee business grew 8.5% organically, reflecting our market-leading position in robotic-assisted knee procedures and momentum from the continued strength of our new Mako installations. Our US hips business grew 7.1% organically, fueled by the continued success of our Cigna hip stem and momentum of our Mako robotic hip platform.

骨科的貨幣銷售額穩定成長 11.3%，有機銷售額成長 10.2%，其中美國有機成長 10%，國際有機成長 10.5%。我們的膝關節業務有機成長了 8.5%，反映了我們在機器人輔助膝關節手術方面的市場領先地位以及新 Mako 裝置的持續強勁勢頭。在 Cigna 髖關節桿的持續成功和 Mako 機器人髖關節平台的強勁推動下，我們的美國髖關節業務有機增長了 7.1%。

Our US Trauma and Extremities business grew 16.2% organically with very strong double-digit sales growth in our core trauma and upper extremities businesses. The performance of Pangea continues to ramp amid robust interest and adoption of this differentiated plating portfolio.

我們的美國創傷和四肢業務有機成長了 16.2%，核心創傷和上肢業務的銷售額實現了非常強勁的兩位數成長。由於對這種差異化電鍍產品組合的強烈興趣和採用，Pangea 的業績持續上升。

Our US spinal implants business grew [2.3%] organically in the quarter. Our US other ortho business, which now includes Enabling Technologies, grew 1.3% organically, primarily driven by Mako deal mix and a decline in bone cement. Internationally, Orthopaedics grew 10.5% organically, including strong performances in our emerging markets, Australia, New Zealand, Europe and Canada.

我們的美國脊椎植入物業務本季有機成長 [2.3%]。我們的美國其他骨科業務（現在包括 Enabling Technologies）有機成長了 1.3%，這主要是受到 Mako 交易組合和骨水泥業務下降的推動。在國際上，骨科有機成長 10.5%，其中在澳洲、紐西蘭、歐洲和加拿大等新興市場表現強勁。

Now I will focus on operating highlights in the fourth quarter. Our adjusted gross margin of 65.3% was favorable by 140 basis points compared to the fourth quarter of 2023. This improvement was primarily driven by positive pricing, manufacturing cost improvements and mix. Adjusted R&D spending was 5.3% of sales, which was 30 basis points lower than the fourth quarter of 2023. Our adjusted SG&A was 30.8% of sales, which was 20 basis points lower than the fourth quarter of 2023.

下面我將重點介紹一下第四季的經營亮點。與 2023 年第四季相比，我們的調整後毛利率為 65.3%，提高了 140 個基點。這種改善主要是由積極的定價、製造成本的改善和組合所推動的。調整後的研發支出佔銷售額的5.3%，比2023年第四季低30個基點。調整後的 SG&A 佔銷售額的 30.8%，比 2023 年第四季低 20 個基點。

In summary, for the quarter, our adjusted operating margin was 29.2% of sales which was 200 basis points favorable to the fourth quarter of 2023. For the full year, our adjusted operating margin was 25.3%, which was a 110 basis point increase over 2023. Adjusted other income expense of $51 million for the quarter was $20 million higher than 2023, driven by a full quarter of higher interest expense related to our September 2024 debt issuance. For 2025, excluding the impact from the pending acquisition of Inari, we expect our full year other income and expense to be approximately $260 million driven primarily by the full year impact of additional interest expense from our September 2024 debt issuance.

總而言之，本季調整後的營業利潤率為銷售額的 29.2%，比 2023 年第四季有利 200 個基點。全年調整後營業利益率為 25.3%，比 2023 年成長 110 個基點。該季度調整後的其他收入支出為 5,100 萬美元，比 2023 年高出 2,000 萬美元，這是由於與我們 2024 年 9 月發行債券相關的整個季度利息支出增加所致。對於 2025 年，排除即將收購 Inari 的影響，我們預計全年其他收入和支出約為 2.6 億美元，這主要是由於我們 2024 年 9 月發行債券的額外利息支出對全年的影響。

Our fourth quarter and full year had an adjusted effective tax rate of 15.4% and 14.8%, respectively, reflecting the impact of geographic mix and certain discrete tax items. For 2025, we expect our full year effective tax rate to be in the range of 15% to 16%. Focusing on the balance sheet. We ended the year with $4.5 billion of cash, marketable securities and short-term investments. Total debt was approximately $13.6 billion and includes approximately $3 billion from our bond offerings in September 2024, of which a portion of the proceeds were used to pay down debt of $1.5 billion during the fourth quarter.

我們第四季和全年的調整後有效稅率分別為 15.4% 和 14.8%，反映了地理組合和某些離散稅項的影響。2025 年，我們預計全年有效稅率將在 15% 至 16% 之間。重點關注資產負債表。年底，我們擁有 45 億美元的現金、有價證券和短期投資。債務總額約為 136 億美元，其中包括 2024 年 9 月發行的債券中的約 30 億美元，其中部分收益用於償還第四季 15 億美元的債務。

Turning to cash flow. Our full year 2024 cash from operations was $4.2 billion, an increase of $531 million from 2023, driven mainly by higher earnings and improvements in inventory and accounts payable. For 2025, we anticipate that capital spending will be in the range of $800 million to $850 million. We do not anticipate any share buybacks.

轉向現金流。2024 年全年我們的營運現金為 42 億美元，比 2023 年增加 5.31 億美元，這主要是由於收益增加以及庫存和應付帳款改善所致。2025 年，我們預計資本支出將在 8 億至 8.5 億美元之間。我們預計不會進行任何股票回購。

And now I will provide full year 2025 guidance. Based on our momentum exiting 2024, a sustained level of procedural volumes strong demand for our capital products and our presence in healthy end markets, we expect organic net sales growth to be in the range of 8% to 9% for 2025, and expect adjusted net earnings per share to be in the range of $13.45 to $13.70, before considering the impact of Inari. This guidance assumes a full year adjusted operating margin of 26.3%, which is in line with our previous assertion to improve op margin to pre-COVID levels.

現在我將提供 2025 年全年指導。基於我們2024 年退出的勢頭、程序數量的持續水平、對我們資本產品的強勁需求以及我們在健康的終端市場中的存在，我們預計2025 年有機淨銷售額增長將在8% 至9% 的範圍內，並預計調整後的在考慮 Inari 的影響之前，每股淨利潤將在 13.45 美元至 13.70 美元之間。本指引假設全年調整後營業利益率為 26.3%，這與我們先前將營業利益率提高至新冠疫情前水準的主張一致。

Our sales guidance reflects our expectation that the full year impact of price is modestly favorable. Additionally, if foreign exchange rates hold near current levels, we anticipate sales will be unfavorably impacted approximately 1% for the full year and that adjusted earnings per share will be negatively impacted in the range of $0.10 to $0.15, both of which are reflected in our guidance. Compared to 2024, we will have one fewer selling day in the first quarter of 2025. The remaining quarters of this year will have the same number of selling days as 2024.

我們的銷售指引反映了我們對全年價格影響適度有利的預期。此外，如果匯率保持在當前水準附近，我們預計全年銷售額將受到約 1% 的不利影響，調整後每股收益將受到 0.10 美元至 0.15 美元的負面影響，這兩者都反映在我們的指導。與 2024 年相比，2025 年第一季的銷售天數將減少。今年剩餘季度的銷售天數將與 2024 年相同。

Finally, while we did quarterly guidance, we do expect the seasonality of our sales, op margin expansion and related earnings to be similar to 2024. As it relates to the pending close of the Inari acquisition, we expect to fund the $4.9 billion purchase price to a mix of cash on hand and new debt and anticipate closing this transaction towards the end of February.

最後，雖然我們做出了季度指導，但我們確實預計我們的銷售、營運利潤率擴張和相關收益的季節性將與 2024 年類似。由於這與即將完成的 Inari 收購有關，我們預計將以手頭現金和新債務的形式為 49 億美元的收購價格提供資金，並預計在 2 月底完成此項交易。

For the approximately 10-month period ending in December 2025, we expect Inari to deliver approximately $590 million of sales on a constant currency basis and have a dilutive impact on adjusted op margin of 0 to 20 basis points and $0.20 to $0.30 on adjusted EPS. As it relates to the divestiture of our spine implants business, we expect that the impact of this transaction will be absorbed into the above guidance for net sales growth, adjusted operating margin and adjusted EPS.

在截至2025 年12 月的大約10 個月期間，我們預計Inari 將在固定匯率基礎上實現約5.9 億美元的銷售額，並對調整後的營運利潤率產生0 至20 個基點的攤薄影響，對調整後的每股盈餘產生0.20 至0.30 美元的稀釋影響。由於它涉及剝離我們的脊椎植入物業務，我們預計此次交易的影響將被吸收到上述淨銷售成長、調整後營業利潤率和調整後每股收益的指引中。

With that, I will now open the call up for Q&A.

現在，我將開始問答徵集。

(Operator Instructions) Larry Biegelsen, Wells Fargo.

（操作說明）Larry Biegelsen，富國銀行。

Congrats on the strong finish to the year. Kevin, I just wanted to start on the spine sale. Just -- and first, also, congratulations to both Glenn and Preston. So Kevin, on the spine sale, just talk about why this was the right time? How much of that $700 million is going to BB, just the economics of the deal, sale price and how you're offsetting any dilution from the deal? And I had one follow-up.

祝賀今年圓滿成功。凱文，我只是想開始銷售脊柱。只是——首先，恭喜格倫和普雷斯頓。那麼凱文，關於脊椎銷售，請談談為什麼這是正確的時間？這 7 億美元中有多少會歸 BB 所有，只是交易的經濟性、銷售價格以及如何抵消交易帶來的股權稀釋？我有一個後續行動。

Yes, sure. Thanks, Larry. Why is now the time? As you know, we've been looking at this market for a long time, and we've been trying to make improvements in our Spine business. We are excited about the enabling tech with Copilot and Mako Spine, but fundamentally, just have better opportunities to invest our funds in other businesses.

是的，當然。謝謝，拉里。為什麼現在是時候？如您所知，我們長期以來一直關注這個市場，並且一直在努力改進我們的 Spine 業務。我們對 Copilot 和 Mako Spine 的支援技術感到興奮，但從根本上說，我們有更好的機會將我們的資金投資於其他業務。

And the VEB Brothers have a lot of experience in spine. They're going to provide the follow-on innovation that's required in the implant side of the business. As you saw in the press release, we will be partnering together. So we will be providing the enabling tech. They will be providing the implants.

VEB 兄弟在脊椎方面擁有豐富的經驗。他們將提供植入業務所需的後續創新。正如您在新聞稿中看到的，我們將共同合作。因此，我們將提供支援技術。他們將提供植入物。

The entire $700 million is expected to be divested to them. And so the remaining portions that we're keeping have been moved into other -- the IVS into neurocranial and the enabling technology being moved into other orthopedics. It's just one of those things where we've moved into so many other faster-growing spaces. And this is really where we'd like to spend our time and our energy. It's, as you know, a very competitive market on the implant side of the business where we just haven't had the same degree of innovation that we've had in other parts of our portfolio.

預計這 7 億美元全部將被剝離給他們。因此，我們保留的剩餘部分已轉移到其他領域——IVS 轉移到神經顱科，而支援技術則轉移到其他骨科。這只是我們進入許多其他快速成長領域的事情之一。這確實是我們願意花時間和精力的地方。如您所知，在植入業務方面，這是一個競爭非常激烈的市場，我們只是沒有像我們產品組合的其他部分那樣具有相同程度的創新。

So this felt like the right time. We feel like we've got a really great partner. The business will be in good hands. Our employees will be in good hands and so are our customers.

所以這感覺是正確的時間。我們覺得我們有一個非常好的合作夥伴。生意將會得到良好的照顧。我們的員工和我們的客戶都會得到良好的照顧。

And then just a follow-up on Inari, maybe for Andy or for Glenn. Just talk about maybe some of the deal assumptions. By our math, the return on invested capital seems relatively low in year five. How do you see ROIC in five years? And when does this deal turn accretive?

然後是伊納裡的後續行動，也許是安迪或格倫的。只是談談可能的一些交易假設。根據我們的計算，第五年的投資資本報酬率似乎相對較低。您如何看待五年後的投入資本報酬率？這筆交易何時會帶來增值？

Yes, Larry, thanks. We don't really guide on ROIC or talk about it too much, but we generally target to get back to whack sometime between five and seven years. And I would say Inari fits squarely in that sort of model as we looked at our own modeling on this. We're super excited about their sales growth and the accretion of that to our sales growth, especially once we hit the one-year comparable mark on it. And honestly, from an operating income standpoint, we feel there are a lot of opportunities for us to partner with them.

是的，拉里，謝謝。我們並沒有真正指導投資回報率，也沒有過多談論它，但我們通常目標是在五到七年的某個時間恢復正常。我想說，當我們研究我們自己的模型時，伊納裡完全適合這種模型。我們對他們的銷售成長以及對我們銷售成長的貢獻感到非常興奮，特別是當我們達到一年可比目標時。老實說，從營業收入的角度來看，我們覺得我們有很多與他們合作的機會。

And obviously, we have the normal public company synergies that will be in our favor. And then when you work your way down to EPS, most of the impact will result from additional borrowings and the interest expense related to that in terms of the dilution we'll feel at the EPS level.

顯然，我們擁有正常的上市公司協同效應，這對我們有利。然後，當你逐步降低每股盈餘時，大部分影響將來自額外的借款以及與我們在每股盈餘水準上感受到的稀釋度相關的利息支出。

Robbie Marcus, JPMorgan.

羅比馬庫斯，摩根大通。

Congratulations on a really nice quarter. Glenn, we wish you the best in retirement. It was great working with you. Maybe a follow-up on Larry's questions and ask another way, and this is more of a P&L focus. It's really impressive that you could sell probably one of your lowest growth businesses and still be able to absorb it in the existing range that people expected and the guidance you provided on operating margins.

恭喜您度過了一個非常美好的季度。格倫，我們祝你退休後一切順利。和你一起工作真是太好了。也許可以跟進拉里的問題並以另一種方式提問，這更多的是損益表的焦點。令人印象深刻的是，您可以出售可能是成長最低的業務之一，並且仍然能夠在人們預期的現有範圍和您提供的營業利潤率指導範圍內吸收它。

So maybe just -- we got a good look at where your margin structure was and how you were planning to get there at the Analyst Day a little over a year ago. But as you sit here today, and there's a lot of moving pieces from that time to today, what is it that helps you get that 100-plus basis points expansion this year before Inari dilution? And what's still left to go afterwards? And any color into the building blocks would be really helpful.

所以也許只是 - 我們在一年多前的分析師日上仔細了解了您的利潤結構以及您計劃如何實現這一目標。但當你今天坐在這裡時，從那時到今天有很多變化，是什麼幫助你今年在伊納裡稀釋之前實現了 100 多個基點的擴張？之後還剩下什麼？構建塊中的任何顏色都會非常有幫助。

Yes, sure. Thanks, Robbie. Gosh, there's so many opportunities still as I think through sort of how we look at our structure, how we look at our P&L, how we look at our manufacturing footprint. I would tell you that our GQO group is very excited about purchasing opportunities. We're very excited about expanding sort of our low-cost manufacturing footprint. And we've recently opened up facilities in Poland. We have Tijuana facility. So there really are still a lot of robust opportunities as we think about how do we streamline.

是的，當然。謝謝，羅比。天哪，透過我們如何看待我們的結構、我們如何看待我們的損益表、我們如何看待我們的製造足跡，我認為仍然有很多機會。我想告訴您，我們的 GQO 團隊對購買機會感到非常興奮。我們對擴大我們的低成本製造足跡感到非常興奮。我們最近在波蘭開設了工廠。我們有蒂華納工廠。因此，當我們思考如何簡化流程時，確實仍然存在著許多強大的機會。

Moving on down the income statement, if I look at operating expenses, we really -- we have scratched pretty hard, the shared services sort of aspect of back office and transactional services. But I would say there is room to go for sure. We look at our worldwide facilities in Asia, in Poland and in Costa -- and there -- first of all, they are some of the fastest-growing facilities we have.

繼續看損益表，如果我看一下營運費用，我們真的——我們在後台和交易服務的共享服務方面做得相當努力。但我想說肯定還有空間。讓我們來看看我們在亞洲、波蘭和科斯塔的全球工廠——首先，它們是我們擁有的成長最快的工廠之一。

And so there are really some opportunities to even sort of push more transactional type activities down to there. Even if we look at sort of leveraging R&D and using our India Tech Center more often, it just from a cost standpoint, we really have an opportunity to drive additional cost savings there, too.

因此，確實有一些機會可以將更多的交易類型活動推向那裡。即使我們更頻繁地考慮利用研發和使用我們的印度技術中心，僅從成本的角度來看，我們確實有機會在那裡節省額外的成本。

And then honestly, a couple of my favorite ways to drive up margin. We are continuing to be very successful in gaining price. And it's not just price in the US, it's priced on a worldwide basis. And then lastly, the way our formula works, we get a lot of natural leverage just by growing sales 8% to 9%, and that model will work, and that model will deliver what we need for 2025.

老實說，我最喜歡的幾種提高利潤率的方法。我們在獲得價格方面繼續非常成功。這不僅是美國的價格，也是全球的價格。最後，按照我們公式的運作方式，只需將銷售額增長 8% 到 9%，我們就能獲得大量自然槓桿，並且該模型將會發揮作用，並且該模型將滿足我們 2025 年的需求。

Great. Maybe a follow-up. If I had some my takeaways coming out of our health care conference as it relates to your business from your competitors. So is that the ortho markets remain healthy and stable, volumes are robust, less negative pricing and capital equipment markets remain healthy around the world. I wanted to see if you agree with that outlook. You always have great insights and any other color if there's a difference in geography that you want to add?

偉大的。也許是後續行動。如果我從我們的醫療保健會議中獲得一些收穫，因為它與您的競爭對手的業務相關。全球正畸市場維持健康穩定，銷售強勁，負面定價減少，資本設備市場維持健康。我想看看你是否同意這種觀點。您總是有深刻的見解，如果您想添加地理上的差異，還有其他顏色嗎？

Robbie, it's Jason. I'll take this one. I would say well said across the board on the commentary there. I think we're very well aligned with that and feel really good as we enter 2025 really across all three of those.

羅比，我是傑森。我要這個。我想說那裡的評論說得很好。我認為我們對此非常一致，當我們進入 2025 年時，我們在所有這三個方面都感覺非常好。

Travis Steed, Bank of America.

特拉維斯·斯蒂德，美國銀行。

Congrats, Preston. I look forward to working with you again. I wanted to ask about kind of the M&A. You guys used to have kind of five things on the list and kind of checked one of those off of Inari. So maybe kind of talk about, Kevin, some of your new prioritized list of like focus areas for M&A.

恭喜，普雷斯頓。我期待再次與您合作。我想問一下併購的類型。你們過去常常在清單上列出五件事，然後從伊納裡（Inari）檢查其中一項。凱文，也許可以談談您的一些新的併購重點領域優先事項清單。

And is this going to be a period of kind of digestion or is this going to be a period of continued M&A? And I assume that some of the proceeds in the client business will help pay down debt. So you can kind of get back on the offense on M&A sooner if that's the right?

這將是消化時期還是持續併購時期？我認為客戶業務的部分收益將有助於償還債務。那麼如果這是正確的話，你可以更快地重新發動併購攻擊嗎？

Yes. Listen, what I'd say is even with the debt to purchase Inari, even before any proceeds from spine, we still -- it takes our debt equity to around 3x. So that we still have capacity to continue to do tuck-in deals. And as a reminder, over the last 12 years, the majority of the deals we do are tuck-ins. And they can range inside most of them are small and medium-sized, occasionally, we do a large tuck-in.

是的。聽著，我想說的是，即使有購買 Inari 的債務，即使在沒有從脊柱獲得任何收益之前，我們仍然 - 它使我們的債務股本增加到大約 3 倍。這樣我們仍然有能力繼續進行內購交易。提醒一下，在過去 12 年裡，我們所做的大部分交易都是折價交易。它們的範圍可以很大，大部分都是中小型的，偶爾我們也會做一個大的折邊。

But we're still on offense and looking at acquisitions. I don't necessarily think that we'll do necessarily as big as Inari in the near term. But the adjacencies continue to be the ones that I've talked about, Peripheral Vascular, obviously, I've mentioned that in the past, and we're very excited to be able to consummate that deal. And the other spaces, like I've talked about urology, I've talked about Neuromodulation. I talked about soft tissue robotics.

但我們仍在進攻​​並考慮收購。我並不認為我們在短期內一定會做像伊納裡那麼大的事。但鄰接仍然是我談論過的，週邊血管，顯然，我過去曾提到過，我們很高興能夠完成這筆交易。在其他領域，就像我談到泌尿科一樣，我談到了神經調節。我談到了軟組織機器人。

I've talked about health care IT. Those all remain very interesting spaces for us, but that's in addition to all of the tuck-ins. Every single business is out looking for deals. And you saw the seven that we did last year were all within our existing businesses, and that will continue to be the majority of the deals that we do. Those bring tremendous ROIC return because we already have existing sales forces and call points. And once Inari is integrated into Stryker, we'll also continue to love it in that peripheral space for follow-on acquisitions just as we do with all our businesses.

我已經談到了醫療保健 IT。這些對我們來說仍然是非常有趣的空間，但這是除了所有的折疊空間之外的。每個企業都在尋找優惠。你看到我們去年做的七筆交易都在我們現有的業務範圍內，這將繼續成為我們所做交易的大部分。這些帶來了巨大的投資回報率回報，因為我們已經擁有現有的銷售團隊和呼叫點。一旦 Inari 整合到 Stryker 中，我們也將繼續喜歡它在外圍領域的後續收購，就像我們對所有業務所做的那樣。

Great. And I wanted to ask on the revenue guidance of 7% to 9% there, kind of another year of above normal growth. And I guess five years now above normal growth, it's probably kind of a new normal of higher growth. And so I wanted to think about like the sustainability of this kind of higher revenue, you gotten LIFEPAK going and several of the pipeline products. So just kind of talk about the sustainability of this growth rate that you've gotten and the confidence in the revenue guidance for 2025.

偉大的。我想詢問 7% 至 9% 的收入指導，這又是高於正常成長的一年。我想現在比正常成長五年了，這可能是更高成長的新常態。所以我想考慮這種更高收入的可持續性，你得到了 LIFEPAK 和一些管道產品。因此，請談談您所獲得的這一增長率的可持續性以及對 2025 年收入指導的信心。

Yes. Thanks. Listen, just to clarify, the guidance was 8% to 9% organic. And so on the low end, it's a little bit higher than it was last year. So we feel even less risk on the bottom end of the range.

是的。謝謝。聽著，澄清一下，指導是 8% 到 9% 的有機率。所以在低端，它比去年高一些。因此，我們認為該範圍底部的風險較小。

And look, we're feeling very bullish. If you look at all of our businesses, they all have robust pipelines and they're constantly following on with innovations. Our commercial offenses are extremely strong. Just a lot of time with our sales forces in the month of January at our kickoff meetings, and I could tell you the morale and the spirit has never been better. There are big impacts such as Pangea and LIFEPAK 35, those big launches, but there's a series of smaller product launches that are occurring across our portfolio.

看，我們感覺非常樂觀。如果您觀察我們所有的業務，您會發現它們都擁有強大的管道，並且不斷追求創新。我們的商業犯罪非常嚴重。一月份我們在啟動會議上花了很多時間與我們的銷售人員在一起，我可以告訴你，士氣和精神從未如此好過。Pangea 和 LIFEPAK 35 等大型產品的發布具有重大影響，但我們的產品組合中也有一系列較小的產品發布。

And so by now, I would hope everyone thinks and knows that it's durable. We're doing it year after year after year, and I don't see that slowing down anytime soon.

所以到目前為止，我希望每個人都認為並知道它是耐用的。我們年復一年地這樣做，而且我認為這種情況不會很快放緩。

David Roman, Goldman Sachs.

大衛羅曼，高盛。

I want to just follow up maybe on a couple of strategic questions here. I think on the last call, you had cited that the acquisitions you completed in 2024 were expected to contribute about $300 million this year. Can you maybe just give us an update on how that's progressing? How you're thinking about commercial strategy there? And any updates that you serve have observed since you've been able to close these deals?

我想在這裡跟進幾個戰略問題。我想在上次電話會議上，您提到您在 2024 年完成的收購預計今年將貢獻約 3 億美元。您能否向我們介紹一下進展？您如何考慮那裡的商業策略？自從您能夠完成這些交易以來，您所提供的服務有哪些更新？

Yes, sure. First of all, I'd tell you, I'm extremely excited about the deals. All of the acquisitions are actually at or above the deal model, kind of unusual for us. Normally, you'd have one or two that are a little bit below the model, but they've all taken off really, really well. And so that $300 million, we feel very confident about achieving or surpassing.

是的，當然。首先，我要告訴你，我對這些交易感到非常興奮。所有收購實際上都達到或高於交易模式，這對我們來說有點不尋常。通常情況下，你會有一兩個比模型稍低一點的，但它們都非常非常好。因此，我們對實現或超越這 3 億美元充滿信心。

The integrations, frankly, are very simple on these deals because they tuck into existing call points in existing business units of the company. In some cases, we've actually added some specialized sales forces, just additional specialized people in the case of certainly of Vertos, we've added some additional sales feet on the street. And that some of them came obviously with the company, and we've decided to add some. But adding sales feet on the street is something we do every year.

坦白說，這些交易的整合非常簡單，因為它們融入了公司現有業務部門的現有通話點。在某些情況下，我們實際上增加了一些專門的銷售隊伍，只是額外的專門人員，以 Vertos 為例，我們在街上增加了一些額外的銷售人員。其中一些顯然是公司自備的，我們決定添加一些。但在街上增加銷售人員是我們每年都會做的事情。

All of our businesses are constantly looking to split territories, to split sales forces or parts of sales forces. And we've created a number of small new sales forces across the company and continue to add salespeople, but it's quite an easy integration when you tuck it into an existing business with --

我們所有的業務都在不斷尋求分割區域、分割銷售團隊或部分銷售團隊。我們在整個公司創建了一些小型的新銷售隊伍，並繼續增加銷售人員，但當你將其融入現有業務中時，這是一個相當容易的整合--

And then maybe just a follow-up on the Mako Shoulder rollout. I think as your competitor is also coming out with the robotic shoulder solution as described similarly a measured and gradual rollout. Maybe you could just help us understand some of the dynamics in the shoulder market, how we should think about the addressable market here? The pace of adoption if knees, hips was a good proxy? And how the robotic shoulder market should kind of evolve in your view over the next maybe one to three years?

然後也許只是 Mako Shoulder 推出的後續行動。我認為你的競爭對手也推出了機器人肩膀解決方案，正如所描述的那樣，是一種有計劃的、逐步的推出。也許您可以幫助我們了解肩部市場的一些動態，我們應該如何考慮這裡的潛在市場？通過膝蓋、臀部的速度是一個很好的指標嗎？在您看來，機器人肩膀市場在未來一到三年內該如何發展？

Listen, I'm extremely excited about Mako Shoulder. It's a very difficult procedure to do. And the harder the procedure is, the more the robot brings value. And in our case, we're doing bone preparation with haptics with our robot in a tight space. So the surgeon feedback -- early feedback is extremely exciting, at least as exciting in knees, if not more.

聽著，我對 Mako Shoulder 感到非常興奮。這是一個非常困難的過程。過程越困難，機器人帶來的價值就越大。在我們的案例中，我們正在狹小的空間內使用機器人透過觸覺進行骨骼準備。因此，外科醫生的回饋——早期回饋非常令人興奮，至少在膝蓋方面同樣令人興奮，甚至更多。

Now it does require a lot of change management, and we learned that through the new launch that sometimes you have to go a little slow at the beginning, so they can go fast later on. And so this year is going to be really getting the training protocols well-defined and established, and we'll really start to see more acceleration in 2026 and beyond.

現在它確實需要大量的變更管理，我們透過新的發布了解到，有時你必須在開始時走得慢一點，這樣他們以後才能走得快。因此，今年將真正明確並建立培訓協議，我們將在 2026 年及以後真正開始看到更多的加速。

So not much of an impact commercially, but our shoulder business doesn't really need it. It's growing strong double digits. It's been doing that since we acquired Wright Medical and had a fantastic year in 2024, and we'll have another great year in '25 even without the act of Mako. But this will take it to another whole other level. And as you know, as you've seen with knees, our robotic solution is clearly compelling and will be very differentiating.

所以商業上影響不大，但我們的肩部業務並不真正需要它。它正在以兩位數的強勁增長。自從我們收購 Wright Medical 以來，我們一直在這樣做，並在 2024 年度過了美好的一年，即使沒有 Mako 的影響，我們也會在 25 年度過另一個美好的一年。但這將把它帶到另一個完全不同的水平。如您所知，正如您在膝蓋上所看到的那樣，我們的機器人解決方案顯然引人注目，並且將非常與眾不同。

Pito Chickering, Deutsche Bank.

皮托·奇克林，德意志銀行。

Glenn, thanks for all the years in press and looking forward to working with you again. On spine divestitures, like I know the there's no color here on the economics around this transaction. But from a modeling perspective, with the deal closed in the first half of the year, how should we think about EPS seasonality this year? Does the transaction change the normal EPS seasonality Stryker?

格倫，感謝您多年來的報道，並期待再次與您合作。關於脊椎資產剝離，據我所知，圍繞這項交易的經濟學沒有任何色彩。但從建模的角度來看，隨著上半年交易完成，我們該如何看待今年 EPS 的季節性？該交易是否會改變 Stryker 的正常 EPS 季節性？

Yes, Pito. Yes. Honestly, when we pull spine out, it's -- first of all, it's not really material to the overall numbers that we're delivering. And so I would say the seasonality that you saw in 2024 will generally carry forward to 2025 in terms of the cadence of sales, op margin expansion and EPS.

是的，皮托。是的。老實說，當我們把脊椎拉出來時，首先，它對我們提供的總體數字並不重要。因此，我想說，就銷售節奏、營運利潤率擴張和每股盈餘而言，您在 2024 年看到的季節性通常會延續到 2025 年。

All right. Great. And then in '24, Medical had a huge year, does never get to the near time as the other divisions. How should we think about growth there for 2025? And sort of what are the big growth drivers in medical for this year?

好的。偉大的。然後在 24 年，醫療部門度過了重要的一年，但從未像其他部門一樣達到最近的時間。我們該如何看待 2025 年的成長？今年醫療領域的主要成長動力是什麼？

Yes, I've said this many times, I think it's the most underappreciated division within our company. And you should expect another year of double-digit growth in Medical. They have a tremendous number of growth drivers, tremendous momentum across whether it's Sage, emergency care, acute care, beds, wireless stretchers, Vocera, it's just -- there's just a series of tremendous opportunities across the portfolio. So they're posting double-digit -- on top of double-digit growth years and I expect another year of double-digit growth in 2025.

是的，我已經說過很多次了，我認為這是我們公司內最被低估的部門。您應該預期醫療領域又將出現兩位數成長。他們擁有大量的成長動力，無論是 Sage、緊急護理、急診、病床、無線擔架、Vocera，或是整個投資組合中都有一系列巨大的機會。因此，除了兩位數成長年份之外，他們還將實現兩位數成長，我預計 2025 年將再次實現兩位數成長。

Vijay Kumar, Evercore ISI.

維傑·庫馬爾，Evercore ISI。

Glenn, wishing you the best, and Preston, congratulations, well deserve. I guess my first question and just a guidance clarification. Inari is the maximum dilution impacts your 20 basis points, Glenn, is that what you're saying? And spine, I think the comment you made was spine will be absorbed in the current guidance does mean the EPS of $13.45 to $13.70 that's intact given that Spine?

格倫，祝你一切順利，普雷斯頓，恭喜你，當之無愧。我想我的第一個問題只是一個指導說明。Inari 是最大稀釋影響你的 20 個基點，格倫，你是這麼說的嗎？脊柱，我認為你所說的脊柱將被吸收到當前的指導中，這是否意味著 13.45 美元至 13.70 美元的每股收益是完好無損的？

You heard it right. in will be maximum 20 basis points dilutive to our op margin expansion. And Spine will be absorbed in the EPS guidance that we gave of $13.45 to $13.70.

你沒聽錯。我們的營運利潤率擴張最多將稀釋 20 個基點。Spine 將吸收我們給出的 13.45 美元至 13.70 美元的 EPS 指導。

Understood. And then maybe one related question here on -- with fine below corporate margin, is that sort of aiding margins here? Inari, Kevin, this is a fairly good deal close time. Sometimes we do have sales force disruption when deals were announced. But given the fairly quick turnaround time, I'm assuming that should be minimal here. Is that a fair assumption? And how do you guys get comfortable? I know there was some noise around a DOJ investigation. If you could just clarify on how you got comfortable that it would be helpful.

明白了。然後也許還有一個相關的問題——在低於公司利潤率的情況下，這是否有助於提高利潤率？伊納裡、凱文，這是一個相當不錯的交易時間。有時，當交易宣佈時，我們的銷售人員確實會受到干擾。但考慮到週轉時間相當快，我認為這裡應該是最小的。這是一個公平的假設嗎？你們如何感到舒服？我知道司法部的調查存在一些噪音。如果你能澄清一下你是如何感到舒服的，那將會很有幫助。

Vijay, I'm going to Andy to answer that since he's here in the room with us. Go ahead, Andy.

維傑，我要請安迪回答這個問題，因為他和我們一起在房間裡。繼續吧，安迪。

Sure, Vijay. The timing of the deal close, we do anticipate, as noted, to be by the end of February, and we got pretty comfortable around that based on regulatory filings and other customary closing conditions. And we feel like we're going to be in pretty good shape there. . And then secondarily to your question around the CID.

當然，維傑。如前所述，我們確實預計交易完成時間為 2 月底，並且根據監管文件和其他慣例成交條件，我們對此感到非常滿意。我們覺得我們在那裡會保持良好的狀態。。其次是關於 CID 的問題。

Of course, that was an area where we did go deep into in gaining our understanding what the risk was with the CID. And as you see, of course, we went through with transaction.

當然，我們確實深入了解了這個領域，以了解 CID 的風險。正如你所看到的，當然，我們完成了交易。

Matthew O'Brien, Piper Sandler.

馬修·奧布萊恩，派珀·桑德勒。

Maybe this one is for Andy specifically. But just based on my math of the $560 million, thinking about the annual contribution from Inari, it looks like it's about $670 million. So roughly about $40 million, $50 million of lost sales, I think that you're factoring in versus what -- the Street had been modeling. So that's about 11% growth. So kind of well below market.

也許這是專門為安迪準備的。但僅根據我對 5.6 億美元的計算，考慮到 Inari 每年的貢獻，看起來大約是 6.7 億美元。因此，我認為您所考慮的因素是大約 4000 萬美元、5000 萬美元的銷售損失，而華爾街一直在建模。所以這大約是 11% 的成長。遠低於市場水準。

Andy, do you think you can get this business back to market growth? Or do you need to full in other technologies to be able to do that type of growth in the future, be it aspiration, et cetera?

安迪，您認為您能讓這項業務恢復市場成長嗎？或者你需要充分利用其他技術才能在未來實現這種類型的成長，無論是願望等等？

Let me be really clear. This is only for 10 months' worth of sales. We are assuming high double-digit growth in this business. So not very far off from the growth rate they have. We are not assuming any falloff.

讓我說得非常清楚。這僅相當於 10 個月的銷售額。我們預計該業務將實現兩位數的高成長。因此，與他們的成長率相差不遠。我們不假設任何衰退。

And you can follow up with Jason, afterwards, it was $590 million, not $560 million, and it's only for 10 months of the year, not 12 months of the year. So we are not assuming fall off. We think the sales force is going to stay very engaged. There isn't any overlap with our business.

你可以跟傑森跟進一下，事後，這是5.9億美元，而不是5.6億美元，而且只適用於一年中的10個月，而不是一年中的12個月。所以我們不假設會脫落。我們認為銷售人員將保持高度參與。與我們的業務沒有任何重疊。

So there's not -- we're not going to have the sales force integration challenges that we have had with overlap deals. This plug us right alongside our existing business, and we plan to continue to make this business sing just the way they have as an independent company.

因此，我們不會遇到重疊交易那樣的銷售團隊整合挑戰。這使我們與現有業務並駕齊驅，我們計劃繼續讓這項業務像獨立公司一樣發展。

Got it. Got it. I'll do math one of these days. And then, Kevin, for you specifically, I know it's early in the year, but just the top line guide of 8% to 9%. And you're trying to be, I'm sure somewhat conservative, but just getting even to the low end of that range, just given the momentum in trauma and extremities looks unbelievably good.

知道了。知道了。有一天我會做數學。然後，凱文，具體來說，我知道現在還處於今年年初，但只是 8% 到 9% 的頂線指導。我敢肯定，你試圖變得有點保守，但只是達到該範圍的低端，考慮到創傷和四肢的勢頭看起來令人難以置信的好。

Medical, you just talked about double digits well above average on the new side of things. I just guess what would get you down to the 8%-ish range versus midpoint or even higher, just given, again, all the momentum that we see in the business?

醫療方面，您剛剛談到了新方面遠高於平均水平的兩位數。我只是猜測，考慮到我們在業務中看到的所有動力，什麼會讓你的成長率下降到 8% 左右的範圍（相對於中點甚至更高）？

Yes. Listen, I feel really good about the business. Look, it's early in the year. And so the activity levels, procedure levels, capital, we have good visibility, at least for the first six, seven, eight months, but that's not a full year, and things can change. So obviously, every quarter, we're going to continue to update our guidance.

是的。聽著，我對這項業務感覺非常好。看看，現在已經是年初了。因此，活動水準、程序水準、資本，我們有很好的可見性，至少在前六、七、八個月是這樣，但這不是一整年，事情可能會改變。顯然，每個季度我們都會繼續更新我們的指導。

And last year, you saw us steadily move up our guidance. I'm not going to predict what will happen this year. But assume that we're going to continue to be playing offense. And we're going to continue to launch products. Those have to continue to go smoothly as they have in the past.

去年，您看到我們穩步提高了指導值。我不會預測今年會發生什麼事。但假設我們將繼續進攻。我們將繼續推出產品。這些必須像過去一樣繼續順利進行。

And if everything goes to plan, we could expect another very strong year towards the upper end of our guidance or potentially moving it up. But I certainly don't feel risk on the downside. And I'm hopeful that if we continue the momentum the way it is that we'll be able to deliver above where we're currently guiding. That remains to be seen.

如果一切按計劃進行，我們預計又一個非常強勁的一年將達到我們指導的上限，或者有可能上調。但我當然不認為有下行風險。我希望，如果我們繼續保持這種勢頭，我們將能夠實現高於當前指導目標的目標。這還有待觀察。

Shagun Singh, RBC.

沙貢辛格，加拿大皇家銀行。

Congratulations to both Glenn and Preston here. I was just wondering if we should expect any shift in priorities given this transition. And then, Kevin, a question for you on the LRP. Your algorithm growth algorithm has been 5% weighted average market growth, but another 200 to 300 basis points of outperformance, gets you to 7%. You have exceeded those levels in recent years, including 2024.

在這裡祝賀格倫和普雷斯頓。我只是想知道，鑑於這一轉變，我們是否應該期待優先事項發生任何變化。然後，Kevin，有一個關於 LRP 的問題。你的演算法成長演算法是 5% 的加權平均市場成長，但另外 200 到 300 個基點的表現優異，可以讓你達到 7%。近年來，包括 2024 年，您已經超過了這些水平。

How -- and you've made some deals here as well. So how should we think about that weighted average market growth going forward? And then just similarly on margins, you guys had previously said at least 30 basis points annually beyond 2025, how do you think about peak levels?

怎麼——你也在這裡達成了一些交易。那我們該如何看待未來的加權平均市場成長呢？同樣，在利潤率方面，你們之前曾表示，2025 年之後每年至少增長 30 個基點，您如何看待峰值水平？

Yes. Thanks, Shagun. We're going to have an Analyst Day later this year. And so we'll update at that time, kind of the growth algorithm for the future years beyond 2025. Clearly, we're moving into faster-growing markets.

是的。謝謝，沙貢。今年晚些時候我們將舉辦分析師日。因此，我們將在那時更新 2025 年之後的未來幾年的成長演算法。顯然，我們正在進入成長更快的市場。

So that weighted average market growth rate has moved up as we increase our exposure to faster-growing end markets. And as it relates to operating margin expansion, you saw we had a terrific year -- in 2024. We're planning on another strong year. We believe we have this operating margin power in the company, which is why we're absorbing Spine, which is why even for the Inari acquisition, we're not planning to give up much in the way of dilution at the operating margin level. But in terms of getting beyond that, I think we'll do that later on in the year at the Analyst Day.

因此，隨著我們增加對成長更快的終端市場的投資，加權平均市場成長率有所上升。就營業利潤率擴張而言，您可以看到我們在 2024 年度過了輝煌的一年。我們正計劃迎來另一個強勁的一年。我們相信我們公司擁有這種營業利潤率能力，這就是我們吸收 Spine 的原因，這就是為什麼即使對於 Inari 收購，我們也不打算在營業利潤率水平上放棄太多稀釋方式。但就超越這一點而言，我認為我們將在今年稍後的分析師日上做到這一點。

Sorry, as it with second to your question. Sorry, there were many parts to your questions. The -- as it relates to priorities, I've been with me sitting in the Chair CEO with Preston having been in the company, both in the IR capacity and as the Head of Finance for Orthopaedics and Spine, you shouldn't expect any change in terms of our priorities.

抱歉，這是你的問題的第二個。抱歉，您的問題有很多部分。因為這與優先事項有關，我一直和我一起擔任首席執行官，普雷斯頓也曾在公司任職，無論是擔任 IR 職務，還是骨科和脊柱財務主管，你不應該期望任何我們的優先事項發生變化。

Matt Miksic, Barclays.

馬特·米克西奇，巴克萊銀行。

Great. And congrats to everyone who's moving in and out of interest looking forward to working with you again as everyone said. I know the conversation has been around spine. There are a ton of questions. I don't think anybody saw this coming, but it does make a lot of sense for what it's worth.

偉大的。恭喜每一位加入和退出感興趣的人，正如大家所說，期待再次與您合作。我知道談話是圍繞著脊椎進行的。有很多問題。我認為沒有人預見到這一點，但它的價值確實很有意義。

I just had one question maybe around some of the other businesses that have been doing so well with many product launches that we spent a good part of the last year talking about. So camera, defibrillator, even things like, I don't know, powered instruments and base management. Just the basic question is, these are all punching kind of above double digits. How many -- maybe if you could dig through any of them that are going to start to kind of hit the other side of these refresh and product cycle by the end of the year? Or do all these carry into '26?

我只是有一個問題，可能是關於其他一些企業，這些企業在許多產品發布方面表現出色，我們去年花了很大一部分時間討論這些產品。所以相機、除顫器，甚至像是我不知道的動力儀器和基地管理之類的東西。基本問題是，這些數字都在兩位數以上。有多少——也許如果你能深入挖掘其中任何一個，它們將在今年年底開始影響這些更新和產品週期的另一邊？或者這一切都會延續到26年嗎？

Any kind of color you could give on sustainability would be great. Then I have one quick follow-up.

你可以為永續性賦予任何一種顏色都很棒。然後我會進行快速跟進。

Yes. Thanks, Matt. As you rightly say, we have a whole lot of businesses that are really firing on all cylinders. I thanks for mentioning the camera because I think a year ago at this time, there was a lot of speculation that we would be impacted by the DR5 and that's clearly not the case. Looking at our tremendous performance in cameras.

是的。謝謝，馬特。正如您所說，我們有很多業務真正在全速運轉。我感謝您提到相機，因為我認為一年前的這個時候，有很多猜測我們會受到 DR5 的影響，但事實顯然並非如此。看看我們在相機方面的出色表現。

There's plenty of room for both companies to grow. The way we do our launches is just before you start to see the business start to the Peter of the new product as it comes on the scene. And so we have that all locked and loaded. The pipelines are still -- we're still investing healthy rates in R&D. So you shouldn't expect really any material slowdown in any of those businesses in 2025, and we will restock the funnel and be able to launch products before you start to see that.

兩家公司都有很大的發展空間。我們發布產品的方式是在您開始看到新產品出現時的業務開始之前。所以我們已經將所有內容鎖定並加載。管道仍在—我們仍在研發方面進行健康的投資。因此，你不應該期望 2025 年這些業務會出現任何實質放緩，我們將在通路中補充庫存，並能夠在你開始看到這種情況之前推出產品。

In the old days of Stryker, if you go back 10 years, you sort of have a bit of a gap sometimes. And in that gap year, you would have lower growth. But as you've noticed, in the last five, six, seven years, before the product starts to flag in terms of its growth, another System 8 goes to System 9, we'll go to System 10. We have the R&D products teed up to be able to insulate against that. So I'm feeling very good about '25.

在 Stryker 的過去，如果你回到 10 年前，有時會有點差距。在那個間隔年，你的成長率會較低。但正如您所注意到的，在過去的五年、六年、七年裡，在產品的成長開始放緩之前，另一個系統 8 會轉向系統 9，我們將轉向系統 10。我們的研發產品能夠抵禦這種情況。所以我對25歲感覺很好。

And then again, we'll have an Analyst Day later in the year, and we'll talk about the outlook in the future.

再說一次，我們將在今年稍後舉辦分析師日，我們將討論未來的前景。

Great. And then just a quick follow-up on the Shoulder. I know focus on the robot as being an important catalyst here and one of your competitors is out there wrong. Could you give us a sense is not just the implants and the robot, right? I mean there's a fair amount of other enabling technology.

偉大的。然後對肩膀進行快速跟進。我知道重點關注機器人作為這裡的重要催化劑，而你的競爭對手之一是錯誤的。您能否給我們一種感覺，不僅僅是植入物和機器人，對吧？我的意思是還有相當多的其他支援技術。

If you could give us a sense of maybe how that's contributing to growth with the uptake or adoption has been like there? And what other enabling technology solutions besides the robot you see as contributing to growth for Shoulder in the next day, I don't know, 12 weeks a month?

您能否讓我們了解一下這如何透過吸收或採用來促進成長？除了機器人之外，您認為還有哪些其他支援技術解決方案有助於肩部在接下來的一天（我不知道）每月 12 週的增長？

Yes. Well, first of all, we have an incredible ecosystem with our Blueprint software and market-leading implants like absolutely terrific implants, stemless, short stem, anatomic, reverse, perform funeral system, which is totally modern and outstanding. And BluePrint provides AI guidance to the surgeon and actually it's the surgical plan with which type of implant should be implemented. And that Blueprint software has been integrated with the robot. So the same software that the surgeons used to using to plan their procedure will be the same software they're using on Mako.

是的。首先，我們擁有一個令人難以置信的生態系統，包括Blueprint 軟體和市場領先的植入物，例如絕對出色的植入物、無柄、短柄、解剖型、反向、執行葬禮系統，這是完全現代且出色的。BluePrint 為外科醫生提供人工智慧指導，實際上是應實施哪種類型的植入物的手術計劃。該藍圖軟體已與機器人整合。因此，外科醫生用來規劃手術的軟體將與他們在 Mako 上使用的軟體相同。

And so it's -- that has been the formula for the Tornier system under ride Medical and now under Stryker, to have market leading growth for years and we continue that progress forward. And Mako is just added benefit, but it hasn't been like we've needed the robot. And initially, our robot is going to come out and start off with the reverse, which is about 2/3 of the procedure. So that, by far, the most procedures are reversed. And then eventually, we move to other parts of the procedure.

因此，這就是在 Ride Medical 和現在在 Stryker 旗下的 Tornier 系統多年來保持市場領先成長的公式，我們將繼續向前邁進。Mako 只是額外的好處，但我們並不需要機器人。最初，我們的機器人會出來並從相反的方向開始，這大約是整個過程的 2/3。因此，到目前為止，大多數程序都是相反的。最後，我們轉向該程式的其他部分。

But as we saw with hips and knees, not all robots are equal. And we love our Mako shoulder application, and you'll start to hear a surgeon feedback about it. We'll be showing it at Academy. If you're at AOS, you'll get a chance to see it. It's really compelling.

但正如我們在臀部和膝蓋上看到的那樣，並非所有機器人都是一樣的。我們喜歡 Mako 肩部應用，您會開始聽到外科醫生對此的反饋。我們將在學院展示它。如果您在 AOS，您將有機會親眼目睹。實在是太有說服力了。

We think it's going to be very powerful. But again, it's not as if the shoulder business really even needs this. Because of the high growth that they already have with market-leading implants and Blueprint software, which is the best-in-class SAR system to navigate and plan your shoulder. And not to mention that we have shoulder ID, which is a custom patient match glenoid. Glenoid as was the trickiest part of the anatomy.

我們認為它將會非常強大。但同樣，肩部業務似乎並不真正需要這個。因為他們已經透過市場領先的植入物和 Blueprint 軟體實現了高速成長，這是用於導航和規劃肩部的一流 SAR 系統。更不用說我們有肩部 ID，這是一個定制的患者匹配關節盂。關節盂是解剖學中最棘手的部分。

And we are actually just starting to expand that personalized solution, which surgeons find absolutely fantastic, save some time. It doesn't -- you don't have to put an augments in the shoulder. So that -- there's a series of other product launches that we have that are pretty exciting. And longer term, I can imagine mixed reality will play into this. But that's sort of looking at '26, '27 and beyond.

實際上，我們剛開始擴展個人化解決方案，外科醫生認為這絕對很棒，可以節省一些時間。事實並非如此——你不必在肩膀上放置增強物。因此，我們推出了一系列非常令人興奮的其他產品。從長遠來看，我可以想像混合現實將發揮作用。但這是在考慮 26 年、27 年及以後的情況。

Mike Matson, Needham & Company, Inc.

麥克‧馬森 (Mike Matson)，李約瑟公司

So with the spine divestiture, just wanted to ask about how the Mako and enabling technologies will sort of work? I know one of your competitors try to be something similar when they spun out their buying business, and it didn't really seem to work in the end. Is there still the same type of revenue opportunity here from the Mako spine robot?

因此，隨著脊椎剝離，我只是想問一下 Mako 和支援技術將如何運作？我知道您的一位競爭對手在剝離採購業務時試圖採取類似的做法，但最終似乎並沒有真正發揮作用。Mako 脊椎機器人是否仍存在相同類型的收入機會？

Yes. Listen, the Mako spine robot is going to be compelling because it's Mako and the brand is extremely strong and the initial cases we've done have gone very well. The surgeons who are using our Eximiuspine implants will now be obviously served by similar salespeople. That will be part of the Spine business. So there won't be a lot of change in that respect.

是的。聽著，Mako 脊椎機器人將會很引人注目，因為它是 Mako，這個品牌非常強大，而且我們所做的最初案例進展順利。使用我們的 Eximiuspine 植入物的外科醫生現在顯然將由類似的銷售人員提供服務。這將成為 Spine 業務的一部分。所以在這方面不會有太大的改變。

It will just be the same rep in the operating room using Mako and the same implant they've been using today. And then the VB Spine team will obviously go out and try to attract other surgeons to join the business. So we already operated in two different worlds. We had capital salespeople providing Mako and our Mako plastic specialists and then we had the implant business. So it's -- instead of that being Stryker's problem, it's now VB spine.

手術室中的同一名代表將使用 Mako 和他們今天使用的相同植入物。然後 VB Spine 團隊顯然會出去嘗試吸引其他外科醫生加入該行業。所以我們已經在兩個不同的世界中運作。我們有提供 Mako 的資本銷售人員和我們的 Mako 塑膠專家，然後我們有了植入物業務。所以這不是 Stryker 的問題，而是 VB 的問題。

So it's not really for the customer a big difference. We have a little bit more work to do because it's a third party. So when we're doing contracts, we have to contract together with a third party. But I'm not expecting it to be really a big difference versus what we have. What does change is we're not going to be investing in all the innovation on implants and having to deal with the management of the implant business, which, to be frank, we have not done a great goal over the past 10, 12 years.

所以對客戶來說這並不是什麼大的差別。我們還有更多工作要做，因為它是第三方。所以我們在做合約的時候，必須和第三方一起簽約。但我並不認為它與我們現有的有很大區別。改變的是我們不會投資所有植入物創新，也不必處理植入物業務的管理問題，坦白說，我們在過去 10 年、12 年並沒有實現一個偉大的目標。

It's a tough competitive market, which the VB Brothers know very well. They've been in this business a long time. They know this business. And I think they're going to be laser-focused on it. Whereas for us, we have a lot of other areas of investment that we put a bit more focus on.

這是一個競爭激烈的市場，VB 兄弟對此非常了解。他們從事這個行業已經很久了。他們了解這個行業。我認為他們會全神貫注於此。而對我們來說，我們還有很多其他投資領域值得我們更關注。

So -- but to the customer in the short term, at least, it's not going to be much of an impact. And we do -- what we thought we could do with Mako Spine in terms of the revenue isn't much different with this partner. They're going to be exclusive at least for the first few years, and then we'll see weapons beyond that, whether it stays exclusive or whether it becomes a more open system. But I'm hoping that it stays exclusive and that we -- that they do really, really well, and we do alongside.

所以，但至少在短期內，這不會對客戶造成太大影響。我們確實做到了——我們認為在收入方面我們可以與 Mako Spine 一起做的事情與這個合作夥伴沒有太大不同。至少在最初幾年，它們將是排他性的，然後我們將看到除此之外的武器，無論它保持排他性還是成為一個更開放的系統。但我希望它保持排他性，並且我們——他們做得非常非常好，我們也一起做得很好。

Okay. Got it. And then just in terms of -- I know you mean that you've got a plant in Mexico. There's talk of potential tariffs on Mexico and Canada. So how much of your manufacturing is coming from either of those two countries? And how much flexibility do you have to move production elsewhere if we do end up seeing some tariffs there this weekend?

好的。知道了。然後就——我知道你的意思是說你在墨西哥有一家工廠。有傳言稱可能對墨西哥和加拿大徵收關稅。那麼你們的製造業有多少是來自這兩個國家？如果我們最終在本週末看到一些關稅，那麼您有多大的靈活性將生產轉移到其他地方？

Yes. Yes, it's a good question. I think, first of all, just you got to keep in mind the scale here. We have roughly 40 manufacturing plants around the world, and we have 1 in Mexico. It does assembly of some of our products.

是的。是的，這是一個好問題。我認為，首先，你必須記住這裡的規模。我們在全球擁有約 40 家製造工廠，其中 1 家位於墨西哥。它負責組裝我們的一些產品。

So right now, we are looking at this closely. We're following the discussions. It's a little early to really evaluate what the possibility of that might be and the impact to us or even maybe the potential follow-on impact to customers. So right now, I would say we're like most companies, especially medical companies that may be excluded at some level from a certain level of tariffs, we're watching and sort of seeing which way this develops. But keep in mind, it's 1 plant out of 40.

所以現在，我們正在密切關注這一點。我們正在關注討論。現在真正評估這種情況的可能性以及對我們的影響，甚至可能對客戶的潛在後續影響還為時過早。所以現在，我想說，我們像大多數公司一樣，尤其是可能在某種程度上被排除在一定水平關稅之外的醫療公司，我們正在觀察並了解這種情況的發展方式。但請記住，這只是 40 株植物中的 1 株。

Caitlin Cronin, Canaccord Genuity.

凱特琳·克羅寧，Canaccord Genuity。

Congrats on a great quarter and congrats to Glenn and Preston as well. I guess just to start off, with these new Mako launches in spine and shoulder, have you seen any momentum increased interest from hospitals and SC the excitement of just having one-stop shop for the Mako solution, as you kind of touched on before?

恭喜這個季度的出色表現，也恭喜格倫和普雷斯頓。我想首先，隨著這些新的Mako 在脊椎和肩部的推出，您是否看到醫院和SC 的興趣增加了，就像您之前提到的那樣，為Mako 解決方案提供一站式服務而感到興奮？

Yes. It's a bit early still, right? We're just kind of in limited launch on both of these, and we're gaining experience and we're -- we're not out actively -- certainly on shoulder, not actively promoting it. ASC -- we're going to stay in a limit number of sites to make sure we get all our training protocols done. There is excitement.

是的。現在還有點早，對吧？我們在這兩個方面的推出都有限，我們正在累積經驗，但我們並沒有積極參與其中，當然也沒有積極地推廣它。ASC－我們將留在有限數量的地點，以確保我們完成所有的培訓方案。有興奮。

The Mako brand is a strong brand, certainly because of our success with knees and hips. And so I do expect that we asked about it, but it's early days still. I would say stay tuned. We'll update you in future quarters as the launches proceed. Spine will move a little bit more quickly than shoulder, there's less change management involved for the surgeon. So that will move to a quicker launch. So we'll probably be able to tell you more about spine probably at the end of Q3.

Mako 品牌是一個強大的品牌，當然是因為我們在膝蓋和臀部方面取得了成功。所以我確實希望我們會問這個問題，但現在還為時過早。我想說請繼續關注。隨著發布的進行，我們將在未來幾季向您通報最新情況。脊椎的移動速度比肩膀快一點，外科醫生涉及的變更管理較少。因此，這將導致更快的啟動。因此，我們可能會在第三季末告訴您更多有關脊椎的資訊。

Got it. And then just a strong extremities number. You didn't really mention Foot & Ankle in the commentary. How did that business far into Q4? And any commentary on the market environment going into 2025?

知道了。然後只是一個強而有力的四肢數字。你在評論中並沒有真正提到腳和腳踝。該業務進入第四季進度如何？對 2025 年的市場環境有何評論？

Yes. You recall the first couple of quarters of the year, the Foot & Ankle market was very soft. It did start picking up kind of around September and fourth quarter certainly was better for the market overall, and our business did improve. But the real story around an unbelievable fourth quarter for trauma and extremities, it was really powered by our shoulder business and our core trauma. Core trauma business had an exceptional quarter it was partly Pangea, but not just Pangea, just amazing sales force execution in that business, and Pangea has created a halo impact around the entire business. And I expect trauma extremities to have a terrific year again. in 2025.

是的。您還記得今年的前幾季度，足部和腳踝市場非常疲軟。它確實在九月左右開始回升，第四季對整個市場來說肯定更好，我們的業務也確實有所改善。但關於令人難以置信的第四季度創傷和四肢的真實故事，它確實是由我們的肩部業務和我們的核心創傷所推動的。核心創傷業務有一個出色的季度，部分是 Pangea，但不僅僅是 Pangea，只是該業務中令人驚嘆的銷售人員執行力，Pangea 為整個業務創造了光環影響。我預計四肢創傷將再次迎來美好的一年。 2025年。

Richard Newitter, Truist Securities.

理查德紐特 (Richard Newitter)，Truist 證券公司。

Congrats, Preston and good luck, Glenn. Just going back to the CapEx environment question, I think someone asked earlier. I'm just curious you guys obviously have great insight into conversations at the hospital C-suite level. Just with all the rhetoric going on out there about potential health care policy changes coming, some of the uncertainty that must be brewing with some of your customers. I'm just curious, are you starting to see maybe in the 2025 fiscal years and budget. But are there any behavior changes that are going on? Or how are your customers, if at all, expressing any potential emerging anxiety?

恭喜普雷斯頓，祝你好運，格倫。回到資本支出環境問題，我想有人之前問過。我只是很好奇你們顯然對醫院高層的對話有深刻的洞察力。儘管關於潛在的醫療保健政策變化的各種言論不斷湧現，但您的一些客戶肯定正在醞釀一些不確定性。我只是好奇，您是否開始看到 2025 財政年度和預算的情況。但行為是否正在改變？或者，您的客戶（如果有的話）如何表達任何潛在的新出現的焦慮？

Rich, it's Jason. I won't try to speculate on any policy potentially coming in the future. But what I would say is similar to what I said earlier on the call, which is, as we look at kind of the capital environment as we ended 2024 and frankly, early days here in 2025, very positive for us, and we feel good about the environment, certainly. And don't have any reason to believe as we go throughout this year, it'd be any different at this point.

里奇，是傑森。我不會試著猜測未來可能出台的任何政策。但我想說的與我之前在電話會議上所說的類似，即當我們審視 2024 年結束時的資本環境時，坦率地說，2025 年初期，這對我們來說非常積極，我們感覺很好當然是關於環境的。沒有任何理由相信今年的情況會有所不同。

Okay. That's very encouraging to hear. And maybe just one more Inari in the process. We all had access to the proxy, and I think I read it right, but it looked like the -- it looked like you guys got access to the financials and whatnot in early December. It feels like a pretty quick turnaround to diligence, I guess, one, is that -- was I reading that right? And can you give any color on how much work had been done prior to that? Or how you got comfortable with the diligence on this end market and the company so fast?

好的。聽到這個消息非常令人鼓舞。也許這個過程中又多了一個伊納裡。我們都可以訪問代理，我想我沒看錯，但看起來你們在 12 月初就可以訪問財務數據之類的了。我想，這感覺就像是一個很快的轉變，我猜對了，是這樣嗎？您能否說明在此之前已經完成了多少工作？或者你是如何如此快速地適應這個終端市場和公司的勤奮工作的？

Yes. Listen, it's a publicly traded company. That is a very typical due diligence period you have for publicly traded companies. There's a lot of information that was publicly available, and we had done our homework, frankly, prior to the start of this. As you know, I've mentioned Peripheral Vascular many, many times.

是的。聽著，這是一家上市公司。這是上市公司的一個非常典型的盡職調查期。有很多資訊是公開的，坦白說，我們在開始之前就已經做好了功課。如您所知，我已經多次提到週邊血管。

So we were absolutely prepared and done all of our homework on everything public. And then when we got a chance to go in and look at things and go into our due diligence, we knew exactly where to look, what to look for and including the R&D line and felt very good about what we saw with the team that we sent there. So this is not atypical for a public company deal, and we feel like we had a really sufficient amount of due diligence, we feel comfortable moving forward.

因此，我們完全做好了準備，並完成了所有公開內容的所有功課。然後，當我們有機會進入並進行盡職調查時，我們確切地知道該去哪裡尋找、尋找什麼，包括研發線，並對我們在團隊中所看到的感到非常滿意。因此，這對於上市公司交易來說並不罕見，我們覺得我們已經進行了足夠的盡職調查，我們對繼續前進感到放心。

Josh Jennings, TD Cowen.

喬許·詹寧斯，TD·考恩。

Congrats to Glenn and Preston. Kevin, I was hoping to just touch on the continued kind of build-out of the ASC infrastructure in the US, it's been a tailwind Stryker is best positioned. I think most think about procedure volume increases as being the biggest boost, but many of your businesses are levered to this continuing year-over-year of increase in the number of ASCs in the US. So I guess the question is really one, what inning are we in, in this ASC infrastructure buildout in the US? And two, can you just help us think about which business is because I think there are a lot, maybe it's too long to answer, but that are benefiting from this tailwind? And how long do you expect this to last?

恭喜格倫和普雷斯頓。Kevin，我希望談談美國 ASC 基礎設施的持續建設，這是 Stryker 處於最佳位置的順風車。我認為大多數人都認為手術量的增加是最大的推動力，但您的許多企業都受益於美國 ASC 數量的持續逐年增加。所以我想問題實際上是一個，在美國 ASC 基礎設施建設中，我們處於哪一局？第二，您能否幫助我們思考哪些業務是因為我認為有很多（也許回答太長）但受益於這種順風？您預計這種情況會持續多久？

Yes. Listen, I still think we're in early innings, and it's very exciting for us at Stryker. So I love this trend because we have many businesses that play in the ASC. And most of the deals that we do, especially new construction and builds and big renovations, they involve at least six of our business units and sometimes more, and which is really exciting. So obviously, the ones that you think about automatically are hips and knees, but it also involves our orthopedic instruments, it can involve Foot & Ankle.

是的。聽著，我仍然認為我們還處於早期階段，這對 Stryker 的我們來說非常令人興奮。所以我喜歡這個趨勢，因為我們有很多企業參與 ASC。我們所做的大多數交易，特別是新建、建造和大型翻修，都涉及我們至少六個業務部門，有時甚至更多，這確實令人興奮。顯然，您自動想到的是臀部和膝蓋，但它也涉及我們的矯形器械，它可能涉及腳和腳踝。

It always involves sports medicine, communications, booms and lights, sometimes you have stretchers, so there's a suite of businesses and everyone is customized. So every ASC deal is unique because of the number of RRs, varies and the types of procedures that they choose to do also varies. But normally, you always have sports, you have hips, and you have knees and then you have potentially other procedures around that interventional spine and on and on. So we love the way things are moving, even E&T. But what I'd say is, if you think about just hips and knees as kind of like the sort of the biggest change that's occurred in the last four or five years.

它總是涉及運動醫學、通訊、吊桿和燈光，有時你還有擔架，所以有一套業務，每個人都是客製化的。因此，每筆 ASC 交易都是獨一無二的，因為 RR 的數量各不相同，而且他們選擇執行的程序類型也各不相同。但通常情況下，你總是會進行運動，你有臀部，你有膝蓋，然後你可能會在介入脊椎周圍進行其他手術等等。所以我們喜歡事物的發展方式，甚至是 E&T。但我想說的是，如果你只考慮臀部和膝蓋，就像過去四、五年來發生的最大變化。

In this fourth quarter, we hit a high for both hips and knees in the US ASC market. Knees, there were 17% of our knees were done in the ASC and 14% of our hips. And that's just been, I'll call it, a steady climb quarter after quarter, it's not sort of inflecting, but it's just a steady increase. And I think the only gating factor is construction of new ASCs, which will take time.

在第四季度，我們在美國 ASC 市場上的臀部和膝蓋產品都創下了新高。膝蓋，我們有 17% 的膝蓋在 ASC 中完成，14% 的臀部在 ASC 中完成。我稱之為，一個季度又一個季度的穩定攀升，這並不是某種變化，但只是穩定成長。我認為唯一的限制因素是建立新的 ASC，這需要時間。

So this is not something that I see kind of changing the ramp of -- The curve is just going to continue kind of on its current linear trajectory. I don't think it's going to inflect because capacity just isn't easy to bring on stream in large, large, large quantities. So I think it will just be a continuation. And I don't see an end in sight because -- and patients have a great experience. The surgeons love it.

所以我認為這不會改變斜坡——曲線只會繼續其當前的線性軌跡。我不認為它會發生變化，因為產能不容易大量投產。所以我認為這只是一個延續。我看不到結束的跡象，因為——病人有很好的體驗。外科醫生喜歡它。

And healthy people should be going to these places to get procedures and don't have a risk of getting contracting illnesses when they're there, and sick people go to hospitals and health, or people are going to go to ASC. So I don't see this slowing down, but it will be gradual progression over time.

健康的人應該去這些地方接受手術，並且在那裡沒有感染疾病的風險，生病的人應該去醫院和健康中心，或者人們會去 ASC。因此，我認為這種情況不會放緩，但會隨著時間的推移而逐漸進展。

Appreciate that. And then just a follow-up on the answer to the acquisition strategy post Inari, getting that weighted average market growth rate higher there are many high-growth cardiovascular segments, and you're now in peripheral vascular. Should we consider this kind of initial breast into in the peripheral vascular kind of opening the door to other high-growth cardiovascular sectors as well for Stryker?

很欣賞這一點。然後是對伊納裡收購策略的回答的後續行動，讓加權平均市場成長率更高，有許多高成長的心血管領域，而你現在處於週邊血管領域。我們是否應該考慮將這種最初的乳房納入周邊血管，為史賽克打開通往其他高成長心血管領域的大門？

Yes. Thanks for the question. At least initially, let's integrate this, and we'll look to probably add within the peripheral space. Beyond that, we'll see longer term, but I don't expect that we'll, in the near term, kind of make a jump into cardiovascular. I think we have to get to our homework here, get this integrated and frankly, build around these call points that we're in right now.

是的。謝謝你的提問。至少在最初，讓我們將其整合起來，我們將考慮在外圍空間中添加。除此之外，我們還會看到更長期的情況，但我不認為我們會在短期內進入心血管領域。我認為我們必須在這裡做好功課，將其整合起來，坦白說，圍繞著我們現在所處的這些呼叫點進行構建。

There's a lot more room within even Peripheral Vascular for them to play. And those emerging technologies are really exciting. We want to those on fire and be able to realize those businesses. And we also have a lot of other mouths to feed across Stryker. A lot of business that are sort of spinning up deals. And so I think we're going to pay attention to those at least for the rest of this year.

甚至週邊血管內也有更多的空間供它們發揮作用。這些新興技術確實令人興奮。我們希望那些火起來並能夠實現這些業務。我們還有很多其他人需要透過史賽克來餵食。很多業務都在促成交易。所以我認為我們至少在今年剩下的時間裡會關注這些問題。

Danielle Antalffy, UBS.

丹妮爾·安塔菲，瑞銀集團。

And Glenn, congrats to you, enjoy retirement. Preston, really looking forward working with you again. Just a question on R&D and productivity there. I mean you saw a pretty healthy growth in R&D in 2024. I mean this plays into the super cycle of new products you have, and it also helps on the pricing front.

格倫，恭喜你，享受退休生活。普雷斯頓，非常期待再次與您合作。只是關於研發和生產力的問題。我的意思是，2024 年研發工作將實現相當健康的成長。我的意思是，這會影響新產品的超級週期，並且在定價方面也有所幫助。

I mean, how do we think about R&D spend going forward? I appreciate you guys for 2025 has given some goalpost there. But -- just at a high level and what you're seeing from an R&D productivity perspective and really how the focus might be changing there, if at all, to ensure you continue to get at least some modest price benefit and sustain this level of growth based on what is a very steady cadence of new product launches?

我的意思是，我們如何看待未來的研發支出？我感謝你們為 2025 年提供了一些目標。但是，只是在較高的層面上，以及您從研發生產力的角度所看到的情況，以及重點可能會如何改變（如果有的話），以確保您繼續獲得至少一些適度的價格優勢並維持這一水平成長基於什麼是非常穩定的新產品發布節奏？

Yes. Thanks, Danielle. And honestly, thanks for your question on R&D. It gives us a chance to talk about the amazing job that our teams are doing in R&D. And lining up pipelines of products and new product launches and feature enhancements.

是的。謝謝，丹妮爾。老實說，感謝您提出有關研發的問題。它讓我們有機會談論我們的團隊在研發方面所做的出色工作。並排列產品管道、新產品發布和功能增強。

And so honestly, that innovation engine is a giant engine of Stryker, and -- we generally target anywhere between 6% to 7% of sales as sort of a rough number to make sure that we're investing in R&D. It receives a very high priority in terms of as we go through our budgeting or our strategic planning process. We don't plan on backing down from that in any which way. We're very excited to take on the innovation of Inari and have those teams fold into our current innovation engine and feel like there'll be great synergies with our neurovascular business on there.

老實說，創新引擎是 Stryker 的一個巨大引擎，而且——我們通常將銷售額的 6% 到 7% 作為一個粗略數字，以確保我們對研發進行投資。當我們進行預算或策略規劃過程時，​​它受到非常高的優先順序。我們不打算以任何方式放棄這一點。我們非常高興能夠接受 Inari 的創新，並將這些團隊融入我們目前的創新引擎中，我們感覺到這將與我們的神經血管業務產生巨大的協同效應。

So honestly, I don't see that strategy really changing just in terms of the kind of spend we prioritize there. I think we're looking at -- where we look to drive better efficiencies might be where we're doing the R&D or building up centers of excellence around software programming or AI or do any of those things. But honestly, I think in the 6% to 7% range, I think that's probably where you'll continue to see us stay.

老實說，我認為該策略並沒有真正改變我們優先考慮的支出類型。我認為我們正在考慮——我們希望提高效率的地方可能是我們正在進行研發或圍繞軟體程式設計或人工智慧建立卓越中心或做任何這些事情。但老實說，我認為在 6% 到 7% 的範圍內，我認為我們可能會繼續保持這個水平。

Michael Polark, Wolfe Research.

邁克爾·波拉克，沃爾夫研究中心。

I just have one final follow-up on the guidance, the organic revenue growth guidance as it relates to the Spine. So I just want to be very clear, the full year for the full company has guided 8% to 9% you're saying, that includes Spine, which is doing math, assuming the 1H closed, it's kind of 150 to 250 basis points of impact. So if I look at the 8.5%, plus 2 (inaudible) is as real kind of RemainCo organic revenue growth guidance for '25?

我只是對該指南進行最後的跟進，即與脊椎相關的有機收入增長指南。所以我只想說得很清楚，整個公司的全年業績指引是你所說的 8% 到 9%，其中包括 Spine，它正在做數學計算，假設 1H 關閉，那就是 150 到 250 個基點的影響。因此，如果我看一下 8.5%，再加上 2（聽不清楚），這就是真正的 RemainCo 25 年有機收入成長指引嗎？

Yes. Michael, I think this is something maybe you can follow up with Jason offline. Despite 8% to 9% organic, we'll get some benefit when Spine is divested because Spine is growing at a lower rate. But it's pretty small, the impact on the overall Stryker business. And Jason can follow up with you off-line on that.

是的。邁克爾，我想你可以在線下與傑森跟進這件事。儘管有 8% 到 9% 的有機增長，但當 Spine 被剝離時，我們會得到一些好處，因為 Spine 的增長速度較低。但這對整個 Stryker 業務的影響非常小。Jason 可以離線跟進您的情況。

But we're going to -- that will give us a slight benefit, probably not that similar to the headwind we're going to get by having one less day in next year than we do this year. So those two kind of more or less offset. So the 8% to 9% is a pretty good guide, a pretty healthy guide, and spine doesn't give us this massive benefit just given its size. But again, Jason can follow up with you off-line on that.

但我們將會——這會為我們帶來一點好處，可能與明年比今年少一天所帶來的逆風不太相似。所以這兩種或多或少都是抵消的。所以 8% 到 9% 是一個非常好的指南，一個非常健康的指南，而脊椎並不能只考慮到它的大小給我們帶來如此巨大的好處。但同樣，傑森可以離線與您跟進。

There are no further questions. I'll now turn the call over to Kevin Lobo for closing remarks.

沒有其他問題了。現在我將把電話轉給凱文·洛博（Kevin Lobo）做總結發言。

Thank you all for joining our call. I want to thank Glenn once again for a great nine years and also for building a great pipeline of talent and finance. We're obviously Preston, but the entire finance organization. We have terrific people all over the company just as we do in our commercial organizations. We've, over time, built extremely strong functions at Stryker that support our businesses and line up behind our business to help them succeed.

感謝大家加入我們的通話。我要再次感謝格倫度過了美好的九年，也感謝他建立了一個偉大的人才和財務管道。我們顯然是普雷斯頓，但我們是整個財務組織。正如我們在商業組織中一樣，我們公司各處都有出色的人才。隨著時間的推移，我們在 Stryker 建立了極其強大的職能部門，為我們的業務提供支持，並為我們的業務提供支持，幫助他們取得成功。

And we look forward to sharing our Q1 results with you in early May. Thank you.

我們期待在五月初與您分享我們的第一季業績。謝謝。