Zimmer Biomet Holdings Inc (ZBH) 2022 Q2 法說會逐字稿

Good morning, ladies and gentlemen, and welcome to the Zimmer Biomet Second Quarter 2022 Earnings Conference Call. (Operator Instructions). As a reminder, this conference is being recorded today, August 2, 2022. (Operator Instructions).

女士們，先生們，早上好，歡迎參加 Zimmer Biomet 2022 年第二季度收益電話會議。 （操作員說明）。提醒一下，本次會議將於 2022 年 8 月 2 日錄製。（操作員說明）。

I would now like to turn the conference over to Keri Mattox, Senior Vice President, Chief Communications and Administration Officer. Please go ahead.

我現在想將會議轉交給高級副總裁兼首席通信和行政官 Keri Mattox。請繼續。

Thank you, operator, and good morning, everyone. I hope you are all well and safe. Welcome to Zimmer Biomet's Second Quarter 2022 Earnings Conference Call. Joining me today are Bryan Hanson, our Chairman, President and CEO; and EVP and CFO, Suky Upadhyay; and COO, Ivan Tornos.

謝謝接線員，大家早上好。我希望你們一切安好。歡迎參加 Zimmer Biomet 的 2022 年第二季度收益電話會議。今天加入我的是我們的董事長、總裁兼首席執行官 Bryan Hanson；執行副總裁兼首席財務官 Suky Upadhyay；和首席運營官 Ivan Tornos。

Before we get started, I'd like to remind you that our comments during this call will include forward-looking statements. Actual results may differ materially from those indicated by the forward-looking statements due to a variety of risks and uncertainties. Please note, we assume no obligation to update these forward-looking statements even if actual results or future expectations change materially. Please refer to our SEC filings for a detailed discussion of these risks and uncertainties in addition to the inherent limitations of such forward-looking statements. Additionally, the discussions on this call will include certain non-GAAP financial measures. Reconciliation of these measures to the most directly comparable GAAP financial measures is included within our Q2 earnings release, which can be found on our website, zimmerbiomet.com.

在我們開始之前，我想提醒您，我們在本次電話會議期間的評論將包括前瞻性陳述。由於各種風險和不確定性，實際結果可能與前瞻性陳述所表明的結果存在重大差異。請注意，即使實際結果或未來預期發生重大變化，我們也不承擔更新這些前瞻性陳述的義務。除此類前瞻性陳述的固有限制外，請參閱我們向美國證券交易委員會提交的文件，詳細討論這些風險和不確定性。此外，本次電話會議的討論將包括某些非公認會計原則的財務措施。這些措施與最直接可比的 GAAP 財務措施的對賬包含在我們的第二季度收益發布中，可在我們的網站 zimmerbiomet.com 上找到。

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

有了這個，我會把電話轉給布萊恩。布萊恩?

All right. Great. Thanks, Keri, and thanks to all of you for joining us this morning for the call. We've got 3 sections for the call this morning. The first section, I'll talk briefly about our Q2 performance from an overall perspective and how a combination of strong execution and COVID recovery have actually enabled us to revise our expectations up again for the full year. And that's in the face of some pretty significant macro pressures, especially around FX.

好的。偉大的。謝謝，Keri，感謝大家今天早上加入我們的電話。今天早上我們有 3 個部分的電話會議。第一部分，我將從整體角度簡要談談我們第二季度的表現，以及強勁的執行力和 COVID 復甦的結合如何實際上使我們能夠再次上調全年的預期。這是面對一些相當大的宏觀壓力，尤其是在外匯方面。

I'll also spend a few minutes talking about ZB innovation. That's a primary contributor to our performance today and certainly our performance in the future. So we want to make sure we touch upon that. And for the second section, I'll switch it to Suky, and Suky will obviously provide details on Q2, but I think even more importantly and probably more interesting is to talk about 2022 guidance and our updates there.

我還將花幾分鐘時間談論 ZB 創新。這是我們今天表現的主要貢獻者，當然也是我們未來表現的主要貢獻者。所以我們要確保我們觸及到這一點。對於第二部分，我將切換到 Suky，Suky 顯然會提供 Q2 的詳細信息，但我認為更重要且可能更有趣的是談論 2022 年的指導和我們在那裡的更新。

And then for our favorite section of the call, we'll close things out by addressing any questions you might have, either on Q2 or any other topic. So let's go ahead and get started with Q2. And I'll start this section by saying that despite some very real and what I would define as universal challenges in our sector, I'm very proud of the fact that the team delivered again another solid quarter that actually was above our internal expectations. And I think this speaks to the teams -- I'm just going to define it as muscle memory associated with effectively managing through challenging times, and that's exactly what we have right now. With the supply concerns that are out there, it is a challenging time, and it's great to know that our team has that muscle memory to manage through it effectively. And they continue to show that.

然後對於我們最喜歡的電話部分，我們將通過解決您在第二季度或任何其他主題上可能遇到的任何問題來結束事情。因此，讓我們繼續開始第二季度。我將在本節開始時說，儘管在我們的行業中存在一些非常真實且我將其定義為普遍挑戰的挑戰，但我為團隊再次交付了另一個實際上超出我們內部預期的穩健季度而感到非常自豪。而且我認為這對團隊來說 - 我只是將其定義為與有效管理充滿挑戰的時期相關的肌肉記憶，而這正是我們現在所擁有的。由於存在供應問題，這是一個充滿挑戰的時期，很高興知道我們的團隊擁有強大的記憶力來有效地管理它。他們繼續證明這一點。

The primary reason for the overachievement was stronger than anticipated COVID recovery for sure, which happened in the quarter, but also just really solid and focused execution from the team across our regions and all of our business segments. From a procedure volume standpoint, the momentum that we saw in Q1, particularly at the end of Q1, actually continued through April and May, but we did see a bit of a slowdown in June, and that has actually carried over through to July. The recovery pace was different, depending on where you were in the world in Q2, it was strong everywhere, but it was really strong outside the U.S., where we saw strong performance pretty much across the board in all of our areas, OUS. And inside of this, we saw solid momentum again in Knees and Hips. I'm really pleased to see another strong quarter in large joints and excited that we continue to get traction for our innovation in this area.

超額完成的主要原因肯定是比預期的 COVID 復甦要強，這發生在本季度，但也只是我們地區和所有業務部門的團隊真正紮實而專注地執行。從手術量的角度來看，我們在第一季度看到的勢頭，特別是在第一季度末，實際上一直持續到 4 月和 5 月，但我們確實看到 6 月有所放緩，並且實際上一直延續到 7 月。復甦的速度是不同的，這取決於你在第二季度的世界各地，它在所有地方都很強勁，但在美國以外的地方確實很強勁，我們在所有地區（OUS）都看到了幾乎全面的強勁表現。在這其中，我們再次看到膝蓋和臀部的強勁勢頭。我真的很高興看到大型關節又一個強勁的季度，並對我們繼續在該領域的創新獲得牽引力感到興奮。

The momentum in large joints was then offset by some expected pressure in our set businesses and our other category, and Suky will provide more detail here in a minute. I think it's pretty clear for all of us, actually the foreign currency is a challenge. Supply challenges are very real. Inflationary pressures are with us right now. And those hurt us in Q2, all of these did. They're going to continue to pressure us through the back half of '22 and potentially beyond. But just given our business momentum thus far into the year, our new product innovation and the traction we're getting there with our customers and COVID recovery, at least a profile today, our overall confidence in 2022 has actually gotten better.

然後，大型關節的勢頭被我們固定業務和其他類別的一些預期壓力所抵消，Suky 將在一分鐘內提供更多細節。我認為我們所有人都非常清楚，實際上外匯是一個挑戰。供應挑戰是非常現實的。通脹壓力現在就在我們身邊。那些在第二季度傷害了我們，所有這些都傷害了我們。他們將在 22 年下半年甚至更久之後繼續向我們施壓。但是，鑑於我們今年迄今為止的業務勢頭、我們的新產品創新以及我們與客戶的合作以及 COVID 恢復，至少從今天的情況來看，我們對 2022 年的總體信心實際上已經變得更好。

And as a result of that, we are raising our full year guidance for revenue, operating margin and earnings per share. And I think this should be a solid indication that our strategy is working. And our team is executing, really just getting it done and our underlying business is gaining strength. And a big part of that, the big part of this momentum is our new product innovation and continuing to deliver in delighting our customers. And in Q2, we debuted another element of our ZBEdge ecosystem. This is an AI technology within our Omni Suite smart OR system. That focuses on optimizing surgical workflow and increasing procedure efficiency. And I'd say that's important right now. It's really important because of the capacity constraints that our customers have.

因此，我們正在提高對收入、營業利潤率和每股收益的全年指導。我認為這應該是我們的戰略正在奏效的可靠跡象。我們的團隊正在執行，真的只是完成它，我們的基礎業務正在增強。其中很大一部分，這種勢頭的很大一部分是我們的新產品創新，並繼續提供讓我們的客戶滿意的服務。在第二季度，我們推出了 ZBEdge 生態系統的另一個元素。這是我們 Omni Suite 智能手術室系統中的一項人工智能技術。這側重於優化手術工作流程和提高手術效率。我會說這現在很重要。由於我們客戶的容量限制，這非常重要。

Separate from that, from a ROSA perspective, ROSA robotics momentum continued in both Knee and Hip for the quarter, and our placement pipeline remains extremely strong. And while it's still in limited launch in very early days, the feedback and interest in Persona iQ is positive, and we're focused on collecting as much early data as quickly as we possibly can with an eye toward clearly establishing clinical use benefits. So when we move into full launch in 2023, we're as prepared as possible. And all of these innovations and our broader ZBEdge Suite highlight the possibilities around data collection and integration on the patient and customer experience, and that's really our focus.

除此之外，從 ROSA 的角度來看，本季度 ROSA 機器人在膝關節和髖關節領域的勢頭持續，我們的安置渠道仍然非常強勁。雖然它在早期仍處於有限發布階段，但對 Persona iQ 的反饋和興趣是積極的，我們專注於盡快收集盡可能多的早期數據，著眼於明確建立臨床使用效益。因此，當我們在 2023 年全面啟動時，我們會盡可能做好準備。所有這些創新和我們更廣泛的 ZBEdge 套件突出了圍繞患者和客戶體驗收集和集成數據的可能性，這確實是我們的重點。

In addition to the strength of our existing product portfolio, our new product pipeline is just as exciting. We have additional product launches planned for the second half of 2022, especially across our Knee and set portfolios. In Knee, our soon-to-be launched Persona cementless form factor will complement our current form factor and provide additional momentum for cementless conversions, particularly as we get into 2023. And in our S.E.T. businesses, I'm very excited about our identity shoulder system launch. This is going to be a much more customizable shoulder for a more personalized feel for the patient that should optimize movement in the shoulder.

除了我們現有產品組合的實力外，我們的新產品線同樣令人興奮。我們計劃在 2022 年下半年推出更多產品，尤其是在我們的膝關節和套裝產品組合中。在 Knee，我們即將推出的 Persona 無水泥外形將補充我們當前的外形，並為無水泥轉換提供額外動力，特別是在我們進入 2023 年時。在我們的 S.E.T.企業，我對我們的身份肩部系統推出感到非常興奮。這將是一個更加可定制的肩部，為患者提供更加個性化的感覺，從而優化肩部的運動。

We're also continuing to reshape our business and accelerate ZB's transformation. We've made significant progress in streamlining and modernizing our operating model, but we've also really focused on making ZB a best and preferred place to work as well as a trusted partner, which are 2 of our strategic pillars for the company.

我們還將繼續重塑我們的業務並加速 ZB 的轉型。我們在精簡和現代化運營模式方面取得了重大進展，但我們也真正專注於使 ZB 成為最佳和首選的工作場所以及值得信賴的合作夥伴，這是我們公司的兩個戰略支柱。

In Q2, Zimmer Biomet was certified by Great Place to Work. This is a global authority on workplace culture. The U.S. certification was based on direct survey feedback from our team members, which I think makes it even more compelling. We also established a new function for refining and driving our environmental, social and governance strategy but also the commitments and actions we're taking in this area as well. We have already seen significant improvements across almost every element of ESG. And truly, we're just getting started. We see this as an important responsibility as a company, for sure, but also something we believe is critically important to our team members, our customers and our investors. You'll be hearing more from us on the ESG front as we make further progress and as we continue to enhance our reporting in this area. So in summary, even though there are real macro headwinds that our team is managing, the recovery shift in COVID continues and the execution of our strategy is making a difference.

在第二季度，Zimmer Biomet 獲得了 Great Place to Work 的認證。這是工作場所文化的全球權威。美國認證是基於我們團隊成員的直接調查反饋，我認為這使其更具吸引力。我們還設立了一項新職能，以完善和推動我們的環境、社會和治理戰略，以及我們在該領域所採取的承諾和行動。我們已經看到 ESG 的幾乎所有要素都有顯著改善。真的，我們才剛剛開始。作為一家公司，我們當然認為這是一項重要的責任，但也是我們認為對我們的團隊成員、客戶和投資者至關重要的事情。隨著我們取得進一步進展並繼續加強我們在該領域的報告，您將在 ESG 方面收到更多消息。因此，總而言之，儘管我們的團隊正在應對真正的宏觀逆風，但 COVID 的複蘇轉變仍在繼續，我們戰略的執行正在發揮作用。

We'll need to stay close to the headwinds into the recovery, in the last couple of years have proven that things are fluid. But I do feel confident in our team's ability to navigate the path forward, and I'm excited about where ZB is going. And with that, I'm going to turn the call over to Suky for a deeper dive into Q2. And again, I look at our revised expectations for the year. Okay. Suky?

我們需要在復蘇中保持逆風，在過去的幾年中證明事情是不穩定的。但我確實對我們團隊前進道路的能力充滿信心，我對 ZB 的發展方向感到興奮。有了這個，我將把電話轉給 Suky，以便更深入地了解第二季度。再一次，我看看我們對這一年的修訂預期。好的。蘇基？

Thanks, and good morning, everyone. Overall, we had a good quarter, driven by strong execution and faster-than-expected recovery of elective procedures across most markets. While we continue to face heightened headwinds and challenges related to foreign currency, inflation and supply chain disruptions, our second quarter performance gives us the confidence to raise our full year revenue and EPS outlook.

謝謝，大家早上好。總體而言，我們有一個良好的季度，這得益於強大的執行力和大多數市場的選修程序恢復速度快於預期。儘管我們繼續面臨與外匯、通貨膨脹和供應鏈中斷相關的更大阻力和挑戰，但我們第二季度的表現使我們有信心提高全年收入和每股收益前景。

With that, I'll turn to our second quarter results and how that translates into our updated full year financial guidance. Unless otherwise noted, my statements will be about the second quarter of 2022 and how it compares to the same period in 2021. And my commentary will be on a constant currency or adjusted continuing operations basis. Net sales in the second quarter were $1.782 billion, up 1% on a reported and 6% on a constant currency basis.

有了這個，我將轉向我們的第二季度業績以及如何將其轉化為我們更新的全年財務指導。除非另有說明，否則我的陳述將是關於 2022 年第二季度以及與 2021 年同期相比的情況。我的評論將基於不變貨幣或調整後的持續運營。第二季度淨銷售額為 17.82 億美元，按報告增長 1%，按固定匯率計算增長 6%。

As Bryan mentioned, strong procedure volume recovery extended from the first quarter, especially as we moved into April and May with moderation of recovery in June. U.S. sales grew 1.3%, driven by strong recovery in execution as COVID cases subsided and elected procedures returned, especially in Knee and Hips. This was partially offset by lower S.E.T. growth and declines in the other category. International sales grew 12.2%, driven by strong procedural volume across most markets in EMEA and APAC. EMEA experienced rapid uptake in the second quarter across developed and emerging markets with a generally lighter comp versus 2021. Asia Pacific overall grew in line with expectations with China performing largely as projected and Japan growing better than anticipated.

正如 Bryan 所說，強勁的手術量恢復從第一季度開始延續，尤其是當我們進入 4 月和 5 月時，6 月的複蘇有所緩和。美國的銷售額增長了 1.3%，這是由於隨著 COVID 案件的平息和選舉程序的恢復，執行力強勁復甦，尤其是在膝蓋和臀部。這被較低的 S.E.T. 部分抵消。其他類別的增長和下降。國際銷售額增長了 12.2%，這得益於歐洲、中東和非洲和亞太地區大多數市場的強勁程序量。與 2021 年相比，歐洲、中東和非洲地區在第二季度的發達市場和新興市場快速增長。亞太地區整體增長符合預期，中國的表現基本符合預期，日本的增長好於預期。

Turning to our business category performance. Global Knees grew 11.2% and with U.S. Knees up 4.5% and international Knees up 20.1%. These results were driven by easy comparisons [OUS], along with strong Knee procedure recovery across most regions, continued global traction for our Persona Knee system, especially with Persona Revision in the U.S. and ROSA penetration and pull-through.

轉向我們的業務類別表現。全球膝關節指數增長 11.2%，美國膝關節指數增長 4.5%，國際膝關節指數增長 20.1%。這些結果是由簡單的比較 [OUS] 驅動的，以及大多數地區的膝關節手術恢復強勁，我們的 Persona 膝關節系統在全球範圍內持續受到關注，特別是在美國的 Persona Revision 以及 ROSA 的滲透和推動下。

Global Hips grew 8.6%, with U.S. Hips up 2.6% and international Hips up 14.9%, driven by easier comparisons OUS in tandem with strong international procedure recovery. We also saw continued traction across key hip products, including our Arcos and G7 system for Revision and our Avenir Complete primary hip, which is focused on the direct anterior surgical approach. And lastly, we continue to see solid ROSA pull-through in the hip category.

全球髖關節增長 8.6%，美國髖關節增長 2.6%，國際髖關節增長 14.9%，這得益於更容易比較的 OUS 以及強勁的國際手術恢復。我們還看到關鍵髖關節產品的持續牽引力，包括我們的 Arcos 和 G7 系統修訂和我們的 Avenir Complete 初級髖關節，專注於直接前路手術方法。最後，我們繼續在臀部類別中看到穩固的 ROSA。

Fourth, extremities and trauma category increased 0.1% and was impacted by a tough comp in 2021 and expected pressure in trauma due to VBP implementation as well as expected pressure in restorative therapies due to a reimbursement shift for our GEL-One product. Within the category, we continue to deliver strong performance across our key focus areas of CMFT, sports medicine and upper extremities. Finally, our other category declined 6.1%, driven by tough comps and expected lower capital sales related to a higher mix of ROSA placements versus upfront sales in the quarter.

第四，四肢和創傷類別增長了 0.1%，並受到 2021 年艱難的競爭和由於 VBP 實施導致的預期創傷壓力以及由於我們的 GEL-One 產品的報銷轉移而導致的恢復性治療的預期壓力的影響。在該類別中，我們繼續在 CMFT、運動醫學和上肢等關鍵重點領域取得強勁表現。最後，我們的其他類別下降了 6.1%，這是由於艱難的業績以及與本季度 ROSA 配售與前期銷售的較高組合相關的預期資本銷售下降。

Moving to the P&L. We reported GAAP diluted earnings per share of $0.73 compared to our GAAP diluted earnings per share of $0.68 in the second quarter of 2021.

轉到損益表。我們報告的 GAAP 攤薄後每股收益為 0.73 美元，而 2021 年第二季度我們的 GAAP 攤薄後每股收益為 0.68 美元。

Higher revenue and lower IP R&D charges more than offset restructuring costs and mark-to-market losses on our retained ZimVie stake. On an adjusted basis, diluted earnings per share of $1.82 represented an increase from $1.51 in the second quarter of '21. Higher sales in tandem with lower IP R&D in the quarter more than offset lower year-over-year gross margins.

更高的收入和更低的 IP 研發費用抵消了我們保留的 Zimvie 股份的重組成本和按市值計價的損失。經調整後，每股攤薄收益為 1.82 美元，較 21 年第二季度的 1.51 美元有所增加。本季度較高的銷售額與較低的 IP 研發同時抵消了較低的同比毛利率。

Adjusted gross margin was 71.6%, slightly ahead of expectations due primarily to better mix and lower pricing erosion. As a note, we expect heightened inflation to temper our observed second quarter favorability as we move through the rest of the year. We continue to project full year gross margin to be slightly down when compared to full year 2021 gross margin. And as we've said, increasing inflationary pressure will pull through into 2023, and we now expect about 50 to 100 basis points of headwind from inflation in 2023 versus our previous estimate of about 50 basis points.

調整後的毛利率為 71.6%，略高於預期，主要是由於更好的組合和更低的定價侵蝕。需要注意的是，隨著我們在今年餘下時間的推移，我們預計通脹加劇將緩和我們觀察到的第二季度的好感度。與 2021 年全年毛利率相比，我們繼續預計全年毛利率將略有下降。正如我們所說，通脹壓力的增加將持續到 2023 年，我們現在預計 2023 年的通脹壓力約為 50 至 100 個基點，而我們之前的估計約為 50 個基點。

Our adjusted operating expenses were $777 million, lower than the prior year, primarily due to the 2021 IP R&D charges referenced earlier. Our adjusted operating margin for the quarter was 28%, up from the prior year. As previously noted, full year margins will be pressured versus the prior year due to inflation, supply chain headwinds and China VBP, with partial offset by the ongoing realization of our efficiency programs. Despite these ongoing headwinds, we expect those efficiency programs to drive improved second half operating margins versus the first half of the year. The adjusted tax rate was 16.5% in the quarter and in line with our expectations.

我們調整後的運營費用為 7.77 億美元，低於上一年，主要是由於前面提到的 2021 年 IP 研發費用。我們本季度調整後的營業利潤率為 28%，高於去年同期。如前所述，由於通貨膨脹、供應鏈逆風和中國 VBP，全年利潤率將比上一年承壓，部分被我們正在實施的效率計劃所抵消。儘管存在這些持續的不利因素，但我們預計這些效率計劃將推動下半年的營業利潤率與上半年相比有所提高。本季度調整後的稅率為 16.5%，符合我們的預期。

Operating cash flows were $346 million and free cash flow totaled $240 million for the quarter. We paid down about $100 million of debt in the second quarter and ended with cash and cash equivalents of about $390 million. Our improving financial performance in tandem with ongoing reductions in debt, continue to strengthen our balance sheet for greater strategic flexibility.

本季度的經營現金流為 3.46 億美元，自由現金流為 2.4 億美元。我們在第二季度償還了約 1 億美元的債務，最終獲得了約 3.9 億美元的現金和現金等價物。我們在不斷減少債務的同時不斷改善財務業績，繼續加強我們的資產負債表，以實現更大的戰略靈活性。

And now moving to our updated financial outlook for the full year 2022. We're raising our financial guidance based on the following key assumptions: COVID and customer staffing pressures will continue through 2022, but with a lesser impact than previously anticipated. Supply chain and inflationary pressures stabilize at current levels and foreign currency will be a 500 basis point headwind in '22 versus our previous projection of 350 basis points. Also, we assume about a 30% flow-through of FX-related revenue headwinds falls to EPS and that the FX headwinds applies to the full range of EPS guidance.

現在轉向我們更新的 2022 年全年財務展望。我們正在根據以下關鍵假設提高我們的財務指導：COVID 和客戶人員配置壓力將持續到 2022 年，但影響小於先前預期。供應鍊和通脹壓力穩定在當前水平，外幣在 22 年將是 500 個基點的逆風，而我們之前的預測為 350 個基點。此外，我們假設與外匯相關的收入逆風中約有 30% 流向每股收益，並且外匯逆風適用於整個每股收益指引。

Against this backdrop, I'll walk through our updated financial guidance for the year. Constant currency revenue growth is now expected to be 4% to 6% versus '21. With an expected foreign currency headwind of 500 basis points. This means that reported revenue growth is expected to be in the range of negative 1% to positive 1% versus 2021. We're raising adjusted operating margin by 25 basis points to the range of 26.75% to 27.75%. Adjusted tax rate guidance remains in the range of 16% to 16.5%. Adjusted diluted earnings per share is now expected to be higher at $6.70 to $6.90. And free cash flow is now expected to improve to $800 million to $900 million. And lastly, net interest expense and nonoperating expense will be modestly higher than the $160 million we anticipated earlier this year due to higher interest rates in foreign currency.

在這種背景下，我將介紹我們今年更新的財務指導。與 21 年相比，固定貨幣收入增長現在預計為 4% 至 6%。預計外匯逆風為 500 個基點。這意味著與 2021 年相比，報告的收入增長預計將在負 1% 至正 1% 的範圍內。我們將調整後的營業利潤率提高 25 個基點至 26.75% 至 27.75% 的範圍。調整後的稅率指引保持在 16% 至 16.5% 的範圍內。調整後的每股攤薄收益現在預計將更高，為 6.70 美元至 6.90 美元。現在預計自由現金流將提高到 8 億至 9 億美元。最後，由於外幣利率較高，淨利息支出和營業外支出將略高於我們今年早些時候預期的 1.6 億美元。

We expect to see typical seasonality in the back half of the year, which would suggest stronger revenue dollars in Q4 than in Q3. Additionally, we expect Q4 revenue growth to be higher than Q3 growth, in part due to the easier fourth quarter comp related to China VBP headwinds we observed in the fourth quarter of 2021. Operating margins are expected to follow a similar trend as revenue.

我們預計下半年會出現典型的季節性變化，這表明第四季度的收入將高於第三季度。此外，我們預計第四季度的收入增長將高於第三季度的增長，部分原因是我們在 2021 年第四季度觀察到的與中國 VBP 逆風相關的第四季度比較容易。預計營業利潤率將遵循與收入類似的趨勢。

In summary, while there are macro challenges and headwinds, our team is navigating these challenges and executing well. We are raising our '22 financial guidance due to better-than-expected COVID recovery, the strength of our execution and our confidence in ZB's underlying business fundamentals. With that, I'll turn the call back over to Keri.

總之，雖然存在宏觀挑戰和逆風，但我們的團隊正在應對這些挑戰並執行良好。由於好於預期的 COVID 復甦、我們的執行力以及我們對 ZB 基本業務基本面的信心，我們正在提高我們的 '22 財務指導。有了這個，我會把電話轉回給 Keri。

Thanks, Suky. Before we start the Q&A session, just a quick reminder, please limit yourself to a single question and one follow-up so that we can get through as many questions as possible during the call. With that, operator, may we have the first question, please.

謝謝，蘇基。在我們開始問答環節之前，請快速提醒一下，請將自己限制在一個問題和一個後續問題上，以便我們能夠在通話過程中解決盡可能多的問題。有了這個，接線員，請問第一個問題。

(Operator Instructions) We will begin with Rick Wise with Stifel.

（操作員說明）我們將從 Rick Wise 和 Stifel 開始。

Bryan, maybe I'll start off with your commentary about the outlook for the second half from a couple of perspectives. Bryan, you talked about the April-May strengthening, maybe some softening in June and continuing. Help us understand where you're seeing it. What do you think is happening and maybe better understand what you've dialed into the second half? We recently did a survey of 50 orthopedic surgeons who were cautious about the second quarter, but the most -- exuberant about their volume expectations for the second half of any doctor group we surveyed. I'm confused about how we sort of reconcile those 2 points of view?

布萊恩，也許我會從你對下半年前景的評論開始，從幾個角度開始。布萊恩，你談到了 4 月至 5 月的增強，可能在 6 月有所減弱並繼續。幫助我們了解您在哪裡看到它。你認為正在發生什麼，也許更好地理解你在下半場打了什麼？我們最近對 50 位骨科醫生進行了一項調查，他們對第二季度持謹慎態度，但在我們調查的任何醫生群體中，他們對下半年的數量預期最為樂觀。我對我們如何調和這兩種觀點感到困惑？

Yes. Thanks for the question, Rick. So what I would tell you is that what we experienced, and of course, we talked to a lot of our customers as well as you would imagine, but what we experienced is in June and then carried through to July, not fewer procedures, but more cancellations of those procedures. And most of that was driven by either one, the staff member having COVID or testing positive for COVID or the patient testing positive for COVID. And as a result of that, they could not carry on with the procedure.

是的。謝謝你的問題，瑞克。所以我要告訴你的是，我們所經歷的，當然，我們與很多客戶進行了交談，正如你想像的那樣，但我們經歷的是在六月，然後一直延續到七月，不是更少的程序，而是更多取消這些程序。其中大部分是由感染 COVID 或 COVID 檢測呈陽性的工作人員或 COVID 檢測呈陽性的患者之一驅動的。結果，他們無法繼續進行該程序。

And what we're saying is that we believe that could continue. We believe that could continue until we see a shift we're going to assume it will continue at least through the third quarter. That's just what we're experiencing. The good news is when I think about the quarter, we had a really strong quarter. And the business momentum, the underlying business momentum is real, and we believe that's going to continue. But outside of that, I don't know if you want to speak more, Suky, to just on our second half view.

我們要說的是，我們相信這種情況會繼續下去。我們相信這種情況可能會持續下去，直到我們看到我們假設它至少會持續到第三季度的轉變。這正是我們正在經歷的。好消息是當我想到這個季度時，我們有一個非常強勁的季度。商業動力，潛在的商業動力是真實的，我們相信這將繼續下去。但除此之外，我不知道你是否想多說一些，Suky，就我們的下半場觀點而言。

Yes. So Rick, good to be with you today. So if you look at our implied guidance, in second half at the midpoint versus what we did in the first half, you'd get about 4% operational ex-FX growth for revenue. And really what interpin that is 3 key assumptions we've made inside that. One, you've got tougher comps in the second half than you saw in the first half. You see that, especially with EMEA, if you just think about the second quarter growth we just posted, but it really translates to other markets as well, so tougher comps.

是的。所以瑞克，很高興今天和你在一起。因此，如果您查看我們的隱含指導，在中點與我們在上半年所做的相比，您將獲得約 4% 的運營前外匯收入增長。實際上，我們在其中做出了 3 個關鍵假設。一，你在下半場的比賽比上半場更艱難。如果您只考慮我們剛剛發布的第二季度增長，您會看到，尤其是在歐洲、中東和非洲地區，但它確實也適用於其他市場，因此更加艱難。

Two, we have one less selling day in the second half of the year. So we've accounted for that. And third, as Bryan talked about, we're just taking a prudent view on COVID, especially given our index to elective procedures. We did see some softening of procedures due to those cancellations as we exited the second quarter. And we're assuming that, that continues into the third quarter with a step-up or improvement in COVID in the fourth quarter.

二是下半年我們少了一個銷售日。所以我們已經考慮到了這一點。第三，正如 Bryan 所說，我們只是對 COVID 持謹慎態度，特別是考慮到我們對選修程序的索引。當我們退出第二季度時，由於這些取消，我們確實看到了一些程序的軟化。我們假設這種情況會持續到第三季度，隨著第四季度 COVID 的升級或改善。

Now I would say if we don't see that pressure continue all the way through the third quarter, that would likely take us to the top end of our range. So those are some of the big building blocks that we've assumed in our second half growth rate. But as Bryan said, we feel really confident about the execution of the team where our pipeline is going and our ability to execute on our recent product launches. So feeling really good about the second half.

現在我想說，如果我們沒有看到這種壓力一直持續到第三季度，那可能會將我們帶到我們範圍的頂端。因此，這些是我們在下半年增長率中假設的一些重要組成部分。但正如 Bryan 所說，我們對我們管道所在團隊的執行能力以及我們最近產品發布的執行能力充滿信心。所以下半場感覺很好。

That's great. And maybe just as a follow-up to follow-on to some of these thoughts. Maybe, Suky, and this is always -- I know your -- just kind of favorite question on calls like this at this time of the year. Talk about the setup for '23. Just hearing some of the factors you're talking about improved internal execution, major new products being launching. The positive impact of your efficiency programs, it would seem like I'm leaving this feeling more encouraged about that setup for the next year than I might have appreciating that the many uncertainties as well.

那太棒了。也許只是作為對其中一些想法的後續跟進。也許，Suky，這總是 - 我知道你的 - 只是每年這個時候在這樣的電話中最喜歡的問題。談論'23的設置。剛剛聽到您談論的一些因素，即改進內部執行，主要新產品正在推出。您的效率計劃的積極影響，看起來我對明年的設置感到更加鼓舞，而不是我可能會欣賞許多不確定性。

Yes. So I'm glad you're feeling encouraged because we're feeling encouraged as well about the outlook. As we -- we're not going to get into guidance, obviously, for '23, there's still a lot more to play out in '22. But as we think about a normalized market and normal market dynamics, we would expect revenue at a 4%. And inside of that, based on all the operational efficiencies, the team has been very successful in making and things that we've got planned for next year. We believe we can offset the headwinds that we're seeing this year related to inflationary pressures, and we believe we're in a position where we can expand margins into 2023.

是的。所以我很高興你感到鼓舞，因為我們也對前景感到鼓舞。正如我們——我們不會進入指導，顯然，對於 23 年，22 年還有很多事情要做。但當我們考慮正常化的市場和正常的市場動態時，我們預計收入為 4%。其中，基於所有運營效率，團隊在製作和我們明年計劃的事情方面非常成功。我們相信我們可以抵消今年與通脹壓力相關的不利因素，我們相信我們可以將利潤率擴大到 2023 年。

Now I mean it won't be as great a margin expansion as you would have -- we didn't have these inflationary pressures this year, but we still feel confident that we can expand margins with that type of top line growth profile into next year.

現在我的意思是，利潤率不會像你想像的那麼大——我們今年沒有這些通脹壓力，但我們仍然有信心，我們可以通過這種類型的頂線增長情況將利潤率擴大到下一個年。

Yes. I'll just maybe make an additional comment on that. I would agree. I think that the execution of the business and the team is very real. The momentum in the business is real. The product pipeline that we have is very strong that we haven't even launched yet. So for all those things coming together in a normal market, I would be very disappointed if we didn't deliver at least a 4% growth rate. And that said, that's not where we're going to stop, right? We clearly have a little more cash flexibility and that opens up options for us from an acquisition standpoint, and we're going to be looking to add accretive WAMGR acquisition to potentially diversifying acquisitions to bolster that growth rate over time.

是的。我可能會對此發表額外評論。我會同意的。我認為業務和團隊的執行是非常真實的。業務的勢頭是真實的。我們擁有的產品線非常強大，我們甚至還沒有推出。因此，對於所有這些東西在一個正常的市場中融合在一起，如果我們不能實現至少 4% 的增長率，我會非常失望。也就是說，這不是我們要停下來的地方，對吧？我們顯然有更多的現金靈活性，從收購的角度來看，這為我們提供了選擇，我們將尋求在可能的多元化收購中增加增值 WAMGR 收購，以隨著時間的推移提高增長率。

We will hear from Pito Chickering with Deutsche Bank.

我們將收到來自德意志銀行的 Pito Chickering 的消息。

Looking at your 2022 guidance on the margin side, can you help us understand the increase of inflationary pressures and the FX headwinds and how that's offset by stronger revenue growth and margin leverage then you usually have around positive price or mix in your updated guidance for the year?

查看您在利潤率方面的 2022 年指導，您能否幫助我們了解通脹壓力的增加和外匯逆風，以及這如何被更強的收入增長和利潤率槓桿所抵消，那麼您通常會有大約正價格或混合您的更新指導年？

Yes. Pito, this is Suky. So I'll start with the operating margin guide. So inside of that gross margin, we do expect to step down in the second half versus the first half. We are experiencing greater headwinds due to inflationary pressures. That's baked into our operating margin guide. And that's increased in the second quarter from our first quarter call. And what we now see is where we originally anticipated about 50 basis points of that incremental inflationary pressure landing in 2023, we now think it's closer to 50 to 100 basis points. But again, we've completely included that in our new operating margin and gross margin guide or expectations for the rest of this year. And I would say, inside of that, our assumption is that inflationary pressures stay relatively stable to where we exited the second quarter as we think about the rest of the year. If you take that operating margin, you would expect perhaps a bigger EPS flow-through. But as you're seeing with -- across the sector, FX has been a significant headwind taking our number up from 350 basis points of headwind now to 500 basis points of headwind. And so if you think about our EPS guide and our raise, the way to think about it is while we're increasing our ex-FX or operational growth by 200 basis points, our reported growth at the midpoint is only going up by 50 basis points.

是的。皮托，這是蘇基。因此，我將從營業利潤率指南開始。因此，在毛利率範圍內，我們確實預計下半年會比上半年下降。由於通脹壓力，我們正面臨更大的阻力。這已納入我們的營業利潤率指南。這比我們第一季度的電話會議在第二季度有所增加。我們現在看到的是，我們最初預計 2023 年增量通脹壓力下降約 50 個基點，我們現在認為它接近 50 到 100 個基點。但同樣，我們已將其完全包含在我們新的營業利潤率和毛利率指南或今年剩餘時間的預期中。我想說的是，在此之內，我們的假設是，在我們考慮今年剩餘時間時，通脹壓力相對於我們退出第二季度的水平保持相對穩定。如果您採用該營業利潤率，您可能會期望更大的每股收益流動。但正如你所看到的——在整個行業中，外匯一直是一個重大的逆風，使我們的數字從現在的 350 個基點上升到 500 個基點。因此，如果您考慮我們的每股收益指南和我們的加薪，那麼考慮它的方式是，當我們將外匯前或運營增長提高 200 個基點時，我們報告的中點增長僅增長 50 個基點點。

And so if you take that 50 basis points, that translates to about an incremental $35 million in revenue, including Q2 performance. And if you flow that through, that would get you to about $0.05. And so that helps support or help to give the big building blocks around the $0.05 raise that we just put in there. So hopefully, that gets to your questions, but happy to take any follow-ons you might have.

因此，如果您將這 50 個基點計算在內，這意味著大約增加了 3500 萬美元的收入，包括第二季度的業績。如果你把它通過，那會讓你得到大約 0.05 美元。因此，這有助於支持或幫助提供我們剛剛投入的 0.05 美元左右的籌碼。所以希望這能解決你的問題，但很高興接受你可能有的任何後續行動。

Just one more quick follow-up here. So on the 2023 commentary. With this sort of 5% FX hit you're seeing, assuming that these were comps out next year. Can you just refresh us how that would flow through the P&L in 2023?

這裡只是一個快速跟進。所以在 2023 年的評論中。假設這些是明年的補償，你會看到這種 5% 的 FX 命中率。你能告訴我們這將如何在 2023 年通過損益表嗎？

Yes. So right now, we're assuming that FX is flowing through to net income at about 30%. And that's inclusive of any natural hedges we have plus any FX gains and losses. Now I would say that 30% can vary over time for a number of variables. It can vary based on mix of regional profit. It could vary because of timing of foreign currency changes. It could vary because of the timing of FX gains and losses. But right now, our best estimate is 30%. And as that changes over time, we'll keep you updated.

是的。所以現在，我們假設外匯流入淨收入的比例約為 30%。這包括我們擁有的任何自然對沖以及任何外匯收益和損失。現在我會說 30% 可以隨時間變化，因為許多變量。它可以根據區域利潤的組合而有所不同。它可能會因外幣變化的時間而有所不同。由於外匯收益和損失的時間，它可能會有所不同。但現在，我們最好的估計是 30%。隨著時間的推移，這種情況會發生變化，我們會及時通知您。

We will now move to Larry Biegelsen with Wells Fargo.

我們現在將搬到富國銀行的拉里·比格爾森。

Congratulations on a really nice quarter here. Bryan or Suky, I just want to confirm that international was really strong for Hips and Knees. I just want to confirm, there was nothing kind of onetime no catch-up there. And then in just S.E.T. and other, maybe just some color on what accelerates those 2 businesses? Is it the new shoulder in S.E.T.? When does that happen? And the outlook for other given some of your comments, more ROSA, rentals or lease agreements. What's the outlook there?

祝賀這裡有一個非常好的季度。 Bryan 或 Suky，我只是想確認國際化對於 Hips 和 Knees 來說真的很強大。我只是想確認一下，那裡沒有什麼曾經沒有追趕過的東西。然後在 S.E.T.和其他，也許只是對加速這兩項業務的一些顏色？是 S.E.T. 的新肩膀嗎？什麼時候發生？鑑於您的一些評論、更多 ROSA、租賃或租賃協議，其他人的前景。那裡的前景如何？

Sure. And thanks, Larry. So what I would tell you is that there was nothing other than some easy comps, obviously, that we had OUS. There was no onetime event that buoyed the quarter that somehow skewed the quarter. It was just the factors that we referenced already that came together and allowed for a very strong quarter OUS. So that's the first answer. I'll hit that and then maybe Suky, if you could talk about other or Ivan, you can as well.

當然。謝謝，拉里。所以我要告訴你的是，很明顯，除了一些簡單的組合，我們有 OUS。沒有任何一次事件會以某種方式扭曲該季度，從而提振該季度。正是我們已經參考的因素結合在一起，形成了非常強勁的季度 OUS。所以這是第一個答案。我會打那個，然後也許是 Suky，如果你可以談論其他人或 Ivan，你也可以。

So on the S.E.T. side, I think it's probably good to just take a step back because we don't talk about the subcategories that often have S.E.T. and just kind of reorient everybody. We have 6 businesses underneath S.E.T. We have our CMFT, which is our Craniomaxillofacial and thoracic business, sports med, upper extremities, foot and ankle, trauma and restorative therapies. And I would say in the quarter, we saw a very strong performance in our 3 focus areas, upper extremities, CMFT and sports. With upper extremities and CMFT, both growing double digits in the quarter, and we think that's sustainable. In Sports Medicine growing mid-single digits even with a pretty tough comp in that area. That was offset by expected pressure from Asia Pacific and trauma.

所以在 S.E.T.另一方面，我認為退後一步可能會很好，因為我們不談論經常有 S.E.T. 的子類別。只是重新定位每個人。我們在 S.E.T. 旗下有 6 家企業。我們有我們的 CMFT，這是我們的顱頜面和胸部業務、運動醫學、上肢、足踝、創傷和恢復療法。我想說，在本季度，我們在 3 個重點領域——上肢、CMFT 和運動——的表現非常強勁。上肢和 CMFT 在本季度都增長了兩位數，我們認為這是可持續的。在運動醫學中，即使在該領域的競爭非常激烈，也能保持中個位數的增長。這被來自亞太地區的預期壓力和創傷所抵消。

And to be very clear, we expect that to continue that pressure in Asia Pacific to continue through Q3, but then reverse itself in Q4. And then in the U.S., we saw pressure in restorative therapies. This is due, as Suky had already mentioned, because of a reimbursement change in GEL-One. But what's important on this is that's going to accelerate into Q3 and continue through about mid-2023 and then it will annualize out, okay?

非常清楚的是，我們預計亞太地區的壓力將持續到第三季度，但隨後會在第四季度逆轉。然後在美國，我們看到了恢復療法的壓力。正如 Suky 已經提到的，這是由於 GEL-One 的報銷變化。但重要的是，這將加速到第三季度並持續到 2023 年年中左右，然後每年都會結束，好嗎？

So just net-net, I would expect S.E.T. to stay pressured in Q3 and then improve in Q4. And again, we feel pretty confident that we're going to continue to see momentum in our focus areas. And maybe, Ivan, you could speak to some of the innovation and some of the things that give you confidence about those areas.

所以只是 net-net，我希望 S.E.T.在第三季度保持壓力，然後在第四季度有所改善。再一次，我們非常有信心，我們將繼續在我們的重點領域看到勢頭。也許，伊万，你可以談談一些創新和一些讓你對這些領域充滿信心的事情。

Sure. Thanks, Larry. Thanks, Bryan. So you mentioned shoulder, whether it's just one device that is driving the growth. And I think the answer, Larry, is that that's not the case. It's more than one product. You are familiar with sort of a Signature ONE Planner and Guides. We launched that about 2 years ago that today, about 50% of all procedures are done using this technology. And the feedback continues to be really compelling around accuracy around the simple interface with a surgeon, the integration of the workflow and just the fact that the surgery is in control. Nano or stemless shoulder was also launched and is getting great momentum. The big launch that I think you're talking about hasn't happened yet or identity launch, which is going to be our biggest shoulder launch in the last 5 years is about to get launched and that is going to be a spacing centric as it gets. Truly a personalized solution. It has the ability of doing Inlay and Onlay reconstruction. I can spend an hour talking about it. I know you're a product guy. What I will tell you is going to be transformational.

當然。謝謝，拉里。謝謝，布萊恩。所以你提到了肩膀，它是否只是推動增長的一種設備。我認為答案，拉里，事實並非如此。它不止一種產品。您對 Signature ONE Planner 和 Guides 很熟悉。我們大約在 2 年前推出了這項技術，今天大約 50% 的程序都是使用這項技術完成的。圍繞與外科醫生的簡單界面的準確性、工作流程的集成以及手術在控制中這一事實，反饋仍然非常引人注目。 Nano 或無柄肩部也已推出，並且勢頭強勁。我認為您正在談論的大型發布尚未發生，或者身份發布，這將是我們在過去 5 年中最大的肩部發布，即將發布，這將是一個以空間為中心的發布得到。真正的個性化解決方案。它具有進行Inlay和Onlay重建的能力。我可以花一個小時談論它。我知道你是個產品人。我要告訴你的將是變革性的。

But beyond shoulder, Sports Med we have filled the portfolio very quickly, still integrating Relign, the acquisition that we did about 12 months ago. It is an all-in-one arthroscopic surgical platform. The feedback continues to be great both on the capital and consumable side. We got new products on Anchors. And again, I can continue to go on an on, but I would say that our portfolio in Sports Med today has everything that we need to have.

但除肩之外，Sports Med 我們已經很快填補了投資組合，仍在整合 Relign，這是我們大約 12 個月前進行的收購。它是一個一體化的關節鏡手術平台。在資本和消耗品方面的反饋仍然很好。我們在 Anchors 上獲得了新產品。再說一次，我可以繼續繼續下去，但我想說的是，我們今天在 Sports Med 的投資組合擁有我們需要的一切。

And then lastly, on CMFT, as Bryan referenced, that is a double-digit growth business with a combination of organic and organic place. We launched new products on thoracic and neuro. We're about to launch as many as 6 to 7 different products in the next 12 to 18 months, and we're making a lot of investments in that business. So it's not 1 product. It's not 1 category. At least 3 categories are growing really strongly globally. And then on top of that, I would say our commercial execution is best-in-class. When it comes to the focus, specialization, incentive plan, and our contracting capabilities. So really excited about the S.E.T. and the momentum that we got, Larry.

最後，在 CMFT 上，正如 Bryan 所提到的，這是一個兩位數的增長業務，結合了有機和有機的地方。我們推出了胸部和神經方面的新產品。我們將在未來 12 到 18 個月內推出多達 6 到 7 種不同的產品，並且我們正在對該業務進行大量投資。所以它不是 1 個產品。它不是 1 類。在全球範圍內，至少有 3 個類別的增長非常強勁。最重要的是，我想說我們的商業執行是一流的。談到重點、專業化、激勵計劃和我們的承包能力。對 S.E.T. 感到非常興奮。以及我們得到的動力，拉里。

Great. Thanks, Ivan. Maybe Suky can just speak quickly on other.

偉大的。謝謝，伊万。也許 Suky 可以快速地談論其他人。

Yes. So you had 2 other questions in there, Larry. One was on the quarter for Knee and Hip and anything that we saw in there. But I would say it's a very clean quarter. We really didn't see anything material or meaningful relative to shifts in timing on tenders or anything. It was pretty straightforward on both, well, on recon in Total.

是的。所以你還有兩個問題，拉里。一個是膝關節和髖關節以及我們在那裡看到的任何東西的四分之一。但我會說這是一個非常乾淨的季度。我們真的沒有看到任何與招標時間變化或任何事情相關的實質性或有意義的事情。兩者都非常簡單，好吧，在Total中進行偵察。

And then relative to other, it was down primarily driven by the mix of ROSA. I would say the installments continue to be very strong as a company. We're very happy with how that -- the continued uptake of ROSA and the utilization increases we're seeing. But the mix of placements versus sales was different than the prior year where we saw this year more placements of this quarter, more placements than we saw absolute dollars in sales. And then -- we did see just a little bit a modest level of pressure in surgical capital within our other business. So again, that was the -- those are the 2 key drivers to the year-over-year declines in the quarter.

然後相對於其他，它主要是由 ROSA 的混合驅動的。我想說的是，作為一家公司，分期付款仍然非常強勁。我們對此感到非常滿意——ROSA 的持續採用和我們看到的利用率增加。但是展示位置與銷售額的組合與去年不同，我們今年看到本季度的展示位置更多，展示位置比我們看到的絕對銷售額還要多。然後 - 我們確實在我們的其他業務中看到了手術資本的適度壓力。再說一次，這就是 - 這些是本季度同比下降的兩個關鍵驅動因素。

We will now hear from Josh Jennings with Cowen.

我們現在將聽取 Josh Jennings 和 Cowen 的來信。

Bryan, wanted to just ask about competitive wins in joints and what you think is driving in the marketplace, decision-making by our certain customers, robotics was provided an edge at one point. Now all the big 4 have the robotic systems commercialized. Do you think that surgeons are shifting back to making decisions in terms of what brand based on implant? Or is robotics still driving competitive wins? And just in the same vein, just what -- how should we think about the evolution of ROSA from here and we're -- but I'm sure it's probably a combination of implant and the robotic system. But what is Zimmer doing to evolve the ROSA system and anything that's -- any software updates that you guys have implemented so far in 2022? I just have one follow-up.

Bryan，想問一下關節的競爭優勢以及您認為在市場上的推動力，我們某些客戶的決策，機器人技術在某一時刻被提供了優勢。現在所有四大都將機器人系統商業化。您是否認為外科醫生正在轉向基於植入物的品牌來做出決定？還是機器人技術仍在推動競爭勝利？同樣，我們應該如何考慮 ROSA 的演變，而我們現在是 - 但我確信它可能是植入物和機器人系統的結合。但是 Zimmer 正在做些什麼來改進 ROSA 系統以及其他任何東西——你們在 2022 年迄今為止實施的任何軟件更新？我只有一個跟進。

Yes. Thanks, Josh, for the question. I would say that it's always been a combination of the implant and the value of the implant to the surgeon and will always be that way in concert with the technology you bring that surrounds the implant. That could be robotics, it could be mymobility, it could be our entire ecosystem that surrounds the implant. So it's always been a combination of those 2 things. When I look at our performance is those things are now coming together in a cleaner market than we've had in the past.

是的。謝謝喬希的問題。我會說它始終是植入物和植入物對外科醫生的價值的結合，並且將始終與您帶來的圍繞植入物的技術相一致。這可能是機器人技術，可能是我的移動性，也可能是我們圍繞植入物的整個生態系統。所以它一直是這兩件事的結合。當我看到我們的表現時，這些東西現在正在一個比過去更清潔的市場中融合在一起。

And so the underlying strength we've had as a business has been masked by some external things. As those clouds begin to move, I think you're going to see the real performance of the business come out. With that said, obviously, Ivan is here, he's much closer to it even than I am. So maybe you could speak to what you're seeing out there.

因此，我們作為一家企業所擁有的潛在實力被一些外部事物所掩蓋。隨著這些烏雲開始移動，我認為您將看到業務的真實表現。話雖如此，顯然，伊万在這裡，他甚至比我更接近它。所以也許你可以談談你在外面看到的東西。

Yes, absolutely. So on question #1, Josh, I concur with Bryan. The physician is clearly the decision maker. But the role of the provider and the payer is also very, very important. And obviously, we target those decision makers as well. Relative to ROSA, I'll tell you, Josh, what makes ROSA unique is not that it is one product. It is a part of an ecosystem that consolidates a lot of different parts of pieces. It's fully integrated with a lot of pre-op staff, our partnership with Apple and mymobility or planning software. The fact that you can use ROSA with the #1 in the world, Persona. The connectivity with has some data points in also Intel data platforms and obviously, Persona iQ at some point. So I think it's more of an integrated solution than just one product that is driving those decision-makers to come our way.

是的，一點沒錯。所以關於問題#1，喬希，我同意布萊恩的觀點。醫生顯然是決策者。但是提供者和支付者的角色也非常非常重要。顯然，我們也針對那些決策者。相對於 ROSA，喬希，我會告訴你，使 ROSA 與眾不同的並不是它是一種產品。它是整合了許多不同部分的生態系統的一部分。它與許多術前工作人員、我們與 Apple 的合作夥伴關係以及 mymobility 或規劃軟件完全集成。事實上，您可以將 ROSA 與世界第一的 Persona 一起使用。與英特爾數據平台的連接也有一些數據點，顯然，Persona iQ 在某些時候。因此，我認為它更像是一種集成解決方案，而不僅僅是一種產品，它推動那些決策者走上我們的道路。

If you go ahead and ask physicians why or payors for the matter, why are they choosing ROSA other than the outcomes and the technology at play, they like the efficiency. They like the fact that our preplanning is easier. They're seeing the outcomes. And I think those are the reasons why we're seeing the great momentum with ROSA. So hopefully, that answers your question.

如果您繼續詢問醫生為什麼或付款人，他們為什麼選擇 ROSA，而不是結果和發揮作用的技術，他們喜歡效率。他們喜歡我們的預先計劃更容易的事實。他們正在看到結果。我認為這就是我們看到 ROSA 勢頭強勁的原因。所以希望這能回答你的問題。

And Bryan, I just wanted to ask about if there's any opportunities you see for maybe product line pruning or even if you're working through any product line obsolescence that could -- you could drop some maybe anchor product lines and help catalyze some stronger growth at your different business units. .

布賴恩，我只是想問一下，您是否看到了任何可能進行產品線修剪的機會，或者即使您正在解決任何可能的產品線過時問題——您可能會放棄一些可能的錨定產品線並幫助催化一些更強勁的增長在您的不同業務部門。 .

It's a great question. And it's interesting because when I first started at Zimmer Biomet, I made the mistake one time on an earnings call talking about the fact that we were going to reduce SKUs and the stock just tanked because normally what happens when you do that, there's risk associated with revenue. What we've done then is just to be kind of quiet about it, but we've also been doing it. So we've had dramatic decreases in SKUs over the past 4 years, dramatic.

這是一個很好的問題。這很有趣，因為當我第一次在 Zimmer Biomet 開始工作時，我在一次財報電話會議上犯了一個錯誤，談到我們將減少 SKU 並且股票剛剛暴跌的事實，因為通常情況下你這樣做時會發生相關的風險與收入。我們當時所做的只是對此保持沉默，但我們也一直在這樣做。因此，在過去的 4 年中，我們的 SKU 數量急劇下降，非常驚人。

And we're going to continue to focus on that because there's a lot of inefficiencies in orthopedics, if you have multiple product lines you're trying to cover. And it reduces focus in the field. So we really are trying to focus on the main brands push from an incentive standpoint, our teams to focus on those brands and rationalize categories that are just not as important to us. So again, we've been doing that very quietly but very effectively over the last 4.5 years.

我們將繼續關注這一點，因為骨科存在很多效率低下的問題，如果您要覆蓋多個產品線。並且它減少了對該領域的關注。所以我們真的試圖從激勵的角度關注主要品牌的推動，我們的團隊專注於那些品牌並合理化對我們來說不那麼重要的類別。因此，在過去的 4.5 年裡，我們一直在非常安靜但非常有效地做到這一點。

Our next question will come from Jayson Bedford with Raymond James.

我們的下一個問題將來自 Jayson Bedford 和 Raymond James。

Congrats on the progress. Just a couple of quick ones. In response to Rick's question earlier, Suky, you mentioned margin expansion in '23. I was just a little unclear. Was that in reference to gross margin, op margin or both?

祝賀進展。只是幾個快速的。在回答 Rick 早些時候的問題時，Suky，您提到了 23 年的利潤率擴張。我只是有點不清楚。這是指毛利率、營業利潤率還是兩者兼而有之？

Yes, Jayson, great question. Good clarification. It's really more about operating margin expansion. As I said, we've got some inflationary pressure this year that's going to capitalize into next year, which is going to put some headwinds into gross margins year-over-year. I don't want to get into exactly where we think gross margins are going to end, but just know that year-over-year, as a starting point, you've got 50 to 100 basis points working against you because of things that happened this year. Having said that, quite excited about all the progress the team is making to help offset those. We're doing some really good things around pricing, which is improving our profile. You saw that in this quarter. We expect to see some of those more strategic and tactical levers continue to play through for the rest of this year and into next year.

是的，傑森，好問題。很好的澄清。這實際上更多是關於營業利潤率的擴大。正如我所說，今年我們面臨一些通脹壓力，這些壓力將在明年發揮作用，這將給毛利率同比帶來一些阻力。我不想確切地了解我們認為毛利率將結束的確切位置，但要知道，作為起點，你有 50 到 100 個基點對你不利，因為一些事情今年發生了。話雖如此，對於團隊為幫助抵消這些而取得的所有進展感到非常興奮。我們在定價方面做了一些非常好的事情，這正在改善我們的形象。你在本季度看到了這一點。我們預計，在今年剩餘時間和明年，其中一些更具戰略性和戰術性的槓桿將繼續發揮作用。

Really happy about what the supply chain and commercial teams are doing relative to site optimization and cost down in manufacturing, even in the backdrop of a very dynamic supply chain market and the challenges with trying to get product and packaging materials and logistics all sorted out in a very, again, volatile market. And then it's beyond that in SG&A, we're going to continue to look at improvements in our go-to-market models, commercial models across the world. We've already implemented a number of those, for instance, in Europe, where we've looked to restructure and rethink how we go to market in lower-margin markets as well as lower-margin business categories. And then the Global Business Services operating model that we created growing the pandemic is ripe for further leverage, and we think that we can continue to drive efficiencies by putting more of our activities into those service centers.

真的很高興供應鍊和商業團隊在場地優化和製造成本下降方面所做的事情，即使在供應鏈市場非常活躍的背景下，以及試圖將產品、包裝材料和物流全部整理好所面臨的挑戰一個非常，再次，動蕩的市場。然後在 SG&A 之外，我們將繼續關注我們的上市模式和全球商業模式的改進。我們已經實施了其中的一些，例如在歐洲，我們希望重組和重新思考我們如何在利潤率較低的市場以及利潤率較低的業務類別中進入市場。然後，我們為應對大流行而創建的全球商業服務運營模式已經成熟，可以進一步利用，我們認為我們可以通過將更多活動投入這些服務中心來繼續提高效率。

So we feel really good that despite ongoing gross margin pressure because of these inflationary headwinds that we can -- we see a clear path to operating margin expansion into '23. So hopefully, that gives you a little bit more color and clarification on where we expect to see it.

因此，儘管由於這些通脹逆風，我們可以看到持續的毛利率壓力，但我們感覺非常好——我們看到了一條通往 23 年營業利潤率擴張的清晰道路。所以希望這能給你更多的色彩和澄清我們希望在哪裡看到它。

Yes. That's very helpful. Just as a bit of an unrelated follow-up. In terms of patient backlog, I thought it was somewhat refreshing that you didn't talk about hospital staffing issues. So my question is, what do you think is posing the biggest hurdle to kind of unleashing that backlog? Is it just patient reluctance to come in, whether it be COVID or economic reasons? Or is it still hospital staffing?

是的。這很有幫助。就像一個無關緊要的後續行動。在病人積壓方面，我認為你沒有談論醫院人員配備問題有點令人耳目一新。所以我的問題是，你認為釋放積壓的最大障礙是什麼？只是患者不願意進來，無論是COVID還是經濟原因？還是仍然是醫院的人員配備？

Yes. I think it's a good question. I would say it's a bit balanced, it's multifactorial. I would say that even in the quarter, in the second quarter, we didn't talk about backlog much, but I do believe in certain areas where you had capacity capabilities, we did see some backlog come through. Unfortunately, what we continue to see is also an offset typically of that in other areas that have either COVID or staffing pressure that then drive the numbers down. So I've kind of continue to see this kind of offsetting of areas that can drive forward and pick up backlog in other areas that are probably building backlog. I don't know when that's going to stop. It's hard to predict.

是的。我認為這是一個很好的問題。我會說它有點平衡，它是多因素的。我想說的是，即使在第二季度，我們也沒有過多地談論積壓，但我確實相信在您有能力的某些領域，我們確實看到了一些積壓。不幸的是，我們繼續看到的情況通常也抵消了其他領域的抵消，這些領域要么有 COVID 要么有人員壓力，然後導致數字下降。所以我有點繼續看到這種區域的抵消，這些區域可以推動並在其他可能正在積壓的區域中增加積壓。我不知道什麼時候會停止。很難預測。

But the good news is that what we're seeing now anyway is very strong procedure growth. We're just seeing cancellations being the thing we're concentrating on. So we're not seeing COVID driving ICU beds in the wrong direction or capacity of ICU beds being a challenge. It just is a patient wants to come in, the procedures being scheduled, either the patient or the staff member gets COVID and they can't conduct the procedure. That's what we're seeing, and that's what we saw more in June and July so far.

但好消息是，無論如何，我們現在看到的是非常強勁的程序增長。我們只是看到取消是我們專注的事情。因此，我們沒有看到 COVID 將 ICU 病床推向錯誤的方向或 ICU 病床的容量是一個挑戰。只是患者想進來，程序正在安排中，患者或工作人員感染了 COVID，他們無法進行程序。這就是我們所看到的，也是迄今為止我們在 6 月和 7 月看到的更多。

We'll hear from Kyle Rose with Canaccord.

我們將聽到凱爾·羅斯和 Canaccord 的消息。

I just -- Suky, you made some comments on the last question, just about pricing updates. I wonder if we could just take that at one level deeper? Where are you seeing the biggest success, I guess, in price pressures near term? And then when you think about strategically over the long term, I mean, where do you see pricing power and opportunities to potentially flex from a pricing perspective longer term.

我只是——Suky，你對最後一個問題發表了一些評論，只是關於定價更新。我想知道我們是否可以更深入地了解這一點？我猜，你認為近期價格壓力最大的成功在哪裡？然後，當您從長遠角度進行戰略思考時，我的意思是，您在哪裡看到定價能力和從定價角度長期靈活調整的機會。

Yes. Thanks for the question. I'll actually turn it over to Ivan. He's probably the closest and doing the day-to-day content on this.

是的。謝謝你的問題。我實際上會把它交給伊万。他可能是最接近這一點的人，並且每天都在做這方面的內容。

Yes, absolutely. Thanks. So I'll tell you, when I joined this business 4 years ago, the normal price erosion was 300, even 400 basis points per year, in some categories, 500 basis points. That's not where we are. That's not what we're going to be. I would be extremely disappointed. It was not at the low end of the range of 2% -- and that is in a bad day, if you ask me, 200 basis points of price erosion. Relative to what are we doing, what are we seeing in success?

是的，一點沒錯。謝謝。所以我會告訴你，當我 4 年前加入這個業務時，正常的價格侵蝕是每年 300 甚至 400 個基點，在某些類別中是 500 個基點。那不是我們所在的地方。這不是我們要成為的樣子。我會非常失望。它不在 2% 範圍的低端——如果你問我，那是糟糕的一天，200 個基點的價格侵蝕。相對於我們正在做什麼，我們在成功中看到了什麼？

First of all, I'll define the journey as a 3-stage journey: tactical, number one; strategic, number two; transformation, number three. We completed #1. We've done a lot of tactical staff, raising price for non-core products, raising price in non-core markets, thinking differently about different customers based on segmentation. All of that has been done, and we're getting great success. Stage #2 strategic, I would say we're probably at midpoint in that stage. It's about category contracting. We have a #1 position in Hips and Knees in many different accounts around the world.

首先，我將旅程定義為 3 個階段的旅程：戰術，第一；戰略，第二；轉型，第三。我們完成了#1。我們做了很多戰術人員，為非核心產品提高價格，在非核心市場提高價格，根據細分對不同的客戶進行不同的思考。所有這些都已經完成，我們正在取得巨大的成功。第 2 階段戰略，我想說我們可能處於該階段的中點。這是關於類別承包的。我們在全球許多不同客戶的臀部和膝蓋方面排名第一。

We've not done a good job in leveraging that position to bring S.E.T. and other categories that is happening. Now that we have truly an ecosystem of solutions. We are bundling. I don't like the word, but that's the one that comes to mind, our ecosystem and contracting across the entire episode of care. We're doing a lot of things in terms of thinking ASCs. We incorporate a ton of people in our contracting group that are thinking more strategically about those relationships, line extensions and whatnot.

我們在利用這一職位帶來 S.E.T. 方面做得併不好。和其他正在發生的類別。現在我們有了真正的解決方案生態系統。我們正在捆綁。我不喜歡這個詞，但這是我們腦海中浮現的詞，我們的生態系統和整個護理過程中的收縮。我們在思考 ASC 方面做了很多事情。我們在我們的承包團隊中加入了很多人，他們對這些關係、產品線擴展等進行了更具戰略性的思考。

And then at some point, we'll get into the transformation stage and that is how do we leverage all this data that we're getting to do risk sharing agreements. Now that we launch product platforms like WalkAI, we're able to engage in predictive analytics, how we're going to leverage that to really understand what happens 3, 6 months after surgery is done.

然後在某個時候，我們將進入轉型階段，這就是我們如何利用所有這些數據來達成風險分擔協議。現在我們推出了像 WalkAI 這樣的產品平台，我們能夠參與預測分析，我們將如何利用它來真正了解手術完成後 3、6 個月會發生什麼。

So 3 different stages, I would say, again, we're in stage #2. And if we are now at least or at worst at 2% price erosion, we're not doing our job.

所以 3 個不同的階段，我要再說一遍，我們處於第 2 階段。如果我們現在至少或最壞的情況是 2% 的價格侵蝕，我們就沒有做好我們的工作。

That's very helpful. And then just one follow-up on ROSA. Maybe just talk a little bit about utilization you're seeing in some of the positives. And then I'll take a stab, but overall installed base and percent of Knees and Hips flowing through that would be very helpful.

這很有幫助。然後只是對 ROSA 的一項後續行動。也許只是談談你在一些積極方面看到的利用率。然後我會試一試，但總體安裝基數和膝關節和髖關節的百分比會非常有幫助。

I think you've always got to try to take a stab at those 2 things, but we're just not going to provide it. But I do want, Ivan, if you could just talk about the momentum. I mean, we're seeing really strong momentum in ROSA. It was a little off from the other category given the mix, as Suky referenced before, we sold less than we did the prior year, but the placements were still strong. and the pull-through on those placements are also still strong, but maybe you can speak to...

我認為您總是必須嘗試對這兩件事進行嘗試，但我們只是不打算提供。但我確實想要，伊万，如果你能談談勢頭。我的意思是，我們在 ROSA 看到了非常強勁的勢頭。正如 Suky 之前提到的那樣，考慮到混合情況，它與其他類別略有不同，我們的銷量低於前一年，但展示位置仍然強勁。並且這些展示位置的成功率仍然很高，但也許您可以與...交談

Yes, absolutely. I'll tell you, I'm really proud of the work that the team has done globally. We are now in 40 countries with ROSA over the last 3 years. But I'm even more energized about what's happening or what's going to happen over the next 3 years. But to throw some colors, I won't disclose the number of placements Bryan has done there in the past. I won't talk about penetration, but I will tell you that it's double digit here in the U.S.

是的，一點沒錯。我會告訴你，我為團隊在全球範圍內所做的工作感到非常自豪。在過去的 3 年裡，我們現在在 40 個國家擁有 ROSA。但我對正在發生的事情或未來 3 年將要發生的事情更加充滿活力。但是為了拋出一些顏色，我不會透露布萊恩過去在那裡做過的展示次數。我不會談論滲透率，但我會告訴你，在美國這裡是兩位數。

We had a solid Q2. Sequentially, we grew both on sales and placements overall installments, Q2 2022 versus Q1 of 2022 versus last year comes was a headwind. We continue to see a nice mix in terms of the installations in an inpatient unit and in an ASC unit. I mentioned earlier that the feedback from customers is very compelling when it comes to efficiency. And today, about 30% of all installations are happening in the ASC. So that's a great leading indicator to what's going to happen here, given the migration into that setting.

我們有一個穩健的第二季度。隨後，我們在銷售和展示位置的整體分期付款方面都實現了增長，2022 年第二季度與 2022 年第一季度相比，去年是逆風。在住院病房和 ASC 病房的安裝方面，我們繼續看到一個很好的組合。我之前提到過，客戶的反饋在效率方面非常引人注目。而今天，大約 30% 的安裝都發生在 ASC 中。因此，考慮到遷移到該環境，這是一個很好的領先指標，預示著這裡將會發生什麼。

From a competitive standpoint, we track that obviously very closely about 40% to 50% of installations are happening in competitive accounts. And again, the number of returns and the feedback has been very, very positive in that space as well. So really excited about what we are. It's a global business, continue to see penetration in the right direction. And as I think about the next 3 years with as many as 9 indications coming, I would say that we're in the really, really early innings of this game.

從競爭的角度來看，我們很明顯地跟踪到大約 40% 到 50% 的安裝發生在競爭賬戶中。同樣，退貨數量和反饋在該領域也非常非常積極。對我們是什麼感到非常興奮。這是一項全球業務，繼續看到正確方向的滲透。當我想到未來 3 年有多達 9 個跡像出現時，我會說我們正處於這場比賽的非常非常早期的一局中。

Next, we will hear from Jason Wittes with Loop Capital.

接下來，我們將聽取 Loop Capital 的 Jason Wittes 的來信。

Maybe a follow-up on which you -- appreciate the detail on ROSA. Curious on the competitive accounts that you're getting in with ROSA. Are they using multiple robots? Or is it usually just a single robot that's ROSA? Or how would you characterize those competitive inroads?

也許是你的後續行動——欣賞 ROSA 的細節。對您通過 ROSA 獲得的競爭性帳戶感到好奇。他們是否使用多個機器人？或者它通常只是一個單一的機器人，即 ROSA？或者你會如何描述這些競爭性的進場？

Absolutely, Jason. Thank you. It really depends. We are in a lot of teaching institutions. And as you can imagine, when you're talking to HSS, Hospital for Special Surgery in New York or the Clinic in Mayo, they do like to have wide array of different robotic solutions. So it's not uncommon to see 2 or even 3 robotic systems there. So that comes to mind when it comes to selection.

絕對的，傑森。謝謝你。這真的取決於。我們在很多教學機構。正如您可以想像的那樣，當您與 HSS、紐約特殊外科醫院或梅奧診所交談時，他們確實喜歡擁有各種不同的機器人解決方案。因此，在那裡看到 2 個甚至 3 個機器人系統並不少見。因此，在選擇時會想到這一點。

As you look at other savings, it really does depend. It depends on the preference. When you have high-volume surgeons that they used to use in Persona, then they tend to gravitate towards ROSA because it does integrate Persona and it drives a different level of efficiency. So it does depend on the volume of the surgeon, teaching institution, nonteaching institution. But yes, we do have examples in the U.S. and globally, where you have as many as 2 or even 3 robots in an account.

當您查看其他儲蓄時，它確實取決於。這取決於偏好。當您擁有他們曾經在 Persona 中使用的大批量外科醫生時，他們往往會傾向於 ROSA，因為它確實集成了 Persona，並且它推動了不同水平的效率。所以它確實取決於外科醫生、教學機構、非教學機構的數量。但是，是的，我們在美國和全球都有例子，一個賬戶裡有多達 2 個甚至 3 個機器人。

Yes. And it's not surprising that, that occurs. Even if you just look at the implants, even in a very strong account that we would have. Usually, it's not homogeneous with 1 implant. You typically have some competitive implants in there as well. So it would follow suit that if you're going to move into robotics, you likely will have more than 1 robotic system.

是的。發生這種情況也就不足為奇了。即使你只看植入物，即使是我們會擁有的非常強大的帳戶。通常，它與 1 個種植體不均勻。你通常也有一些有競爭力的植入物。因此，如果你要進入機器人領域，你可能會擁有超過 1 個機器人系統。

Okay. Okay. I appreciate that detail. And then a follow-up on Persona iQ. I know you mentioned you're kind of working out or building up the case for the value proposition. I assume that's going to be a premium priced product. And it sounds like you're ready to fully launch that in 2023. How do we think about that in terms -- I mean, is it in terms of the price and the value proposition for the patient in the hospital?

好的。好的。我很欣賞這個細節。然後是 Persona iQ 的後續行動。我知道你提到你正在為價值主張制定或建立案例。我認為這將是一個高價產品。聽起來您已準備好在 2023 年全面推出該產品。我們如何看待這一點——我的意思是，是從價格和醫院患者的價值主張方面考慮嗎？

You're absolutely right. It is going to be -- it is today, and it will be a premium priced product. It is one of those opportunities for share of wallet, just like you would see in robotics disposables, you would see in mymobility, you would see in a cementless uptick in price point. And that's why we're sprinting right now to be able to collect data to prove out the value proposition, as I said in my prepared remarks. But Ivan, obviously, you're very close to the launch. Maybe you could speak to that as well.

你是絕對正確的。它將是 - 它是今天，它將是一個高價產品。這是分享錢包的機會之一，就像你在機器人一次性用品中看到的那樣，你會在 mymobility 中看到，你會在價格點的無水泥上漲中看到。這就是為什麼我們現在正在衝刺以能夠收集數據以證明價值主張，正如我在準備好的評論中所說的那樣。但伊万，顯然，你離發射很近了。也許你也可以談談。

Yes. I'm not sure, Jason, that we're ready to commit to a launch date. We knew early on when we acquired this technology when we partnered with Canary in this technology, that this was going to be a limited market release, and it will take 6, 12 or even 18 months, depends on the level of data that we're getting. We knew that this LMR was more of a clinical exercise than a commercial exercise.

是的。 Jason，我不確定我們是否準備好承諾發布日期。當我們與 Canary 合作開發這項技術時，我們很早就知道，這將是一個有限的市場發布，需要 6、12 甚至 18 個月，這取決於我們的數據水平。重新獲得。我們知道，這種 LMR 更像是一種臨床練習，而不是商業練習。

We are on track with the things we want to get. Really, the LMR has 3 stages. Number 1 is validation of the value proposition. And again, we're getting millions and I'm talking millions of data points so far in this LMR. Anything from what happens in resection, gap balancing, the level of alignment, the cutting, what happens post op in terms of range of motion, in terms of a gait, speed and all kinds of things. With all these data points, we need to understand what is the true value proposition for that patient, that provider and that physician.

我們正在實現我們想要得到的東西。實際上，LMR 有 3 個階段。第一是價值主張的驗證。再說一次，我們正在獲得數百萬個數據點，到目前為止，我正在談論這個 LMR 中的數百萬個數據點。從切除術中發生的任何事情、間隙平衡、對齊水平、切割、術後在運動範圍、步態、速度和各種事情方面發生的事情。借助所有這些數據點，我們需要了解對於該患者、該提供者和該醫生的真正價值主張是什麼。

The second part is how do we -- once we really do launch the product, how do we make this efficient. What's the pathway towards activating sites at a faster speed? How do we train surgeons? How do we deal with the data questions around privacy and whatnot? And the number 3 is really what's next. We don't want to be just a smart knee company, want to be a smart solutions company. So we got a pathway to get into hip. We got a pathway to get into shoulder. We understand both cemented and cementless knees, different platforms and to that end, is a lot of data we get into to understand what is we're going to do from a portfolio standpoint.

第二部分是我們如何——一旦我們真正推出了產品，我們如何提高效率。以更快的速度激活站點的途徑是什麼？我們如何培訓外科醫生？我們如何處理圍繞隱私之類的數據問題？數字 3 真的是下一個。我們不想只是一家聰明的膝蓋公司，而是想成為一家聰明的解決方案公司。所以我們有一條進入臀部的途徑。我們有一條進入肩膀的途徑。我們了解水泥和非水泥膝蓋，不同的平台，為此，我們需要大量數據來了解我們將從投資組合的角度做什麼。

So I'm not going to commit to a date for launch, but I will tell you we're on track in terms of gathering all the data and the roadmap ahead.

所以我不會承諾發布日期，但我會告訴你，我們在收集所有數據和未來的路線圖方面正在走上正軌。

And maybe -- that's helpful. And just maybe just one quick conceptually question here. And is the market ready to pay up for these AI technologies, these planning technologies I mean, traditionally, the market has been very focused on implants, implant costs. So this is a bit of a shift. Has the market been receptive? Do you think they're receptive? You think, 2023, they are receptive to paying these types of premiums for these sort of new take on technologies?

也許——這很有幫助。這裡可能只是一個快速的概念性問題。市場是否準備好為這些人工智能技術、這些規劃技術買單？我的意思是，傳統上，市場一直非常關注植入物和植入物成本。所以這有點轉變。市場接受了嗎？你覺得他們能接受嗎？您認為，到 2023 年，他們願意為這些新技術的新技術支付這些類型的溢價嗎？

I'll answer it in a couple of ways. I think first, I look at data points that would suggest that the market is ready, and I just look at ROSA, I look at robotics in general. It wasn't that long ago that there was an assumption that orthopedics would not pay a premium to bring robotics into play. I think we're finding that's changing very rapidly. I really do believe robotics will become a standard of care at some point. I think it's the same thing. This is the next leg of the stool. I really do believe that data collection and the informatics capability as a result of that will be something that people will desire and pay for.

我會從幾個方面回答。我認為首先，我查看表明市場已準備就緒的數據點，我只查看 ROSA，我查看一般的機器人技術。不久前，人們還假設骨科不會支付額外費用來讓機器人發揮作用。我認為我們發現這種情況變化非常迅速。我真的相信機器人技術會在某個時候成為一種護理標準。我認為這是同一件事。這是凳子的下一條腿。我真的相信，數據收集和由此產生的信息學能力將是人們渴望並為此付出代價的東西。

We have to prove it. We have to collect the data, create the data lake, create the insights as a result of that and give guidance to surgeons from that data. Once that occurs, and we can then predict things ahead of time and change care as a result of that, there's value in that. There's no question.

我們必須證明這一點。我們必須收集數據，創建數據湖，由此產生洞察力，並根據這些數據為外科醫生提供指導。一旦發生這種情況，我們就可以提前預測事情並因此改變護理，這是有價值的。沒有問題。

Remember, there's still a large percentage of patients, somewhere in the neighborhood of 20% to get a knee procedure that are not happy for whatever reason. And when you talk to surgeons, even really good surgeons, they don't always know why. They'll say, hey, I had the best surgery day. The x-ray looks fantastic. That patient is not happy. I do not know why. We don't either. But I'm pretty confident with the data that we're collecting, we'll be able to predict it in the future and then change the care for that patient. And that's really good for the patient, and that's why we're doing it.

請記住，仍然有很大比例的患者，大約 20% 的患者接受了膝蓋手術，無論出於何種原因都不滿意。當你與外科醫生交談時，即使是非常優秀的外科醫生，他們並不總是知道為什麼。他們會說，嘿，我有最好的手術日。 X 光片看起來很棒。那個病人不高興。我不知道為什麼。我們也不。但我對我們收集的數據非常有信心，我們將能夠在未來預測它，然後改變對該患者的護理。這對患者來說真的很好，這就是我們這樣做的原因。

I'll just maybe quickly add that in addition to the example of ROSA, which I think is a great example of the market being ready to pay for technology. We already have thousands of patients in our mymobility by Apple platform. So it's another example of when you do provide the right data, people will pay for it. There's 2 questions that every day we are trying to solve with the payers and providers. Can we lower the length of the stay in a hospital for surgery can we lower readmission rates. And if we can do that through data and technology, the market will pay for that. And we're making bold base that we're going to be able to do both of those.

除了 ROSA 的例子之外，我可能會很快補充一下，我認為這是市場準備為技術付費的一個很好的例子。我們的 mymobility by Apple 平台已經有數千名患者。所以這是另一個例子，當你提供正確的數據時，人們會為此付費。我們每天都在嘗試與付款人和提供者一起解決兩個問題。我們能否縮短手術住院時間，能否降低再入院率？如果我們能通過數據和技術做到這一點，市場就會為此買單。我們正在建立大膽的基礎，我們將能夠做到這兩點。

And we'll hear from Chris Pasquale with Nephron.

我們將聽取 Chris Pasquale 和 Nephron 的消息。

Just following up on the Persona iQ question. Can you give us a sense for the scope of what you're collecting? And is this something we should expect at the AAOS meeting in the spring? Or is the timing not going to line up with that?

只是跟進 Persona iQ 問題。你能告訴我們你所收集的範圍嗎？這是我們應該在春季的 AAOS 會議上期待的嗎？還是時間不會與此一致？

Well, I'll tell you, I could expand an hour to talking about the things that we're collecting, but from preop to intra-op to post-op through different devices were collecting data. Now with the Persona iQ, which is obviously intra-op and post-op, we're looking at things such as resection data, gap balancing, the accuracy on cuts, the overall alignment, the range of motion expectations. We're looking at post-op asymmetry of the actual implant, the step length, what else gait of speed, how well are you doing physical therapy post surgery. Again, I can go on and on.

好吧，我會告訴你，我可以延長一個小時來討論我們正在收集的東西，但是從術前到術中到術後，通過不同的設備正在收集數據。現在有了 Persona iQ，它顯然是術中和術後的，我們正在研究諸如切除數據、間隙平衡、切割精度、整體對齊、運動預期範圍等內容。我們正在研究實際植入物的術後不對稱性、步長、其他速度步態、術後物理治療的情況。再說一次，我可以繼續說下去。

In addition to those patient-centric measures, we're looking at how to design products in a better way based on how those implants are functioning post surgery. But I think in the economy, you'll see much more in this space. And again, the idea going back to value proposition is out of all these multiple data points, what are the 2 or 3 that are going to drive the premium and the willingness to pay. I'm looking forward to showing that in academy.

除了這些以患者為中心的措施外，我們還在研究如何根據這些植入物在手術後的功能以更好的方式設計產品。但我認為在經濟方面，你會在這個領域看到更多。再次，回到價值主張的想法來自所有這些多個數據點，將推動溢價和支付意願的 2 或 3 個是什麼。我期待在學院展示這一點。

Yes. And I think it's important because you said it's not just IQ. It is an ecosystem of capability that allows us to collect data across all areas of the procedure before, during and after. And it's a combination of those things that will create that data lake that is just too vast for us to make any sense of. But with machine learning, we can look for patterns in this data and ultimately provide insights as a result of it.

是的。我認為這很重要，因為你說這不僅僅是智商。這是一個能力生態系統，使我們能夠在手術之前、期間和之後收集整個過程的所有領域的數據。正是這些東西的結合，將創建一個對我們來說太大而無法理解的數據湖。但是通過機器學習，我們可以在這些數據中尋找模式並最終提供洞察力。

Got you. And then I just wanted to clarify on the pricing commentary. You guys used to give the impact of price by business went away from that this year. But if I look back over the past 7 or 8 years, the average impact was just a little bit over 2%. So I'm a little confused by the 3- to 4-point comment and how much of an improvement we should really expect if 2% is a target going forward. Maybe you could just clarify that.

得到你。然後我只想澄清定價評論。你們過去常常用業務來衡量價格的影響，今年已經不復存在了。但如果我回顧過去 7 或 8 年，平均影響僅略高於 2%。因此，我對 3 到 4 點的評論以及如果 2% 是未來的目標，我們應該真正期待多少改進感到有些困惑。也許你可以澄清一下。

Yes. I'll take that one. So overall, on a consolidated basis, you're right, it was somewhere in the 200 to 300 range. But if you deconstructed that and actually look by category, and we did provide that level of data. You would see that knee and hip or recon was higher on price erosion than the overall consolidated. And you saw generally lower than that average in S.E.T., so that was your offset. I don't know, Ivan...

是的。我會拿那個。所以總的來說，在綜合的基礎上，你是對的，它在 200 到 300 的範圍內。但是，如果您將其解構並實際按類別查看，我們確實提供了該級別的數據。您會看到膝蓋和臀部或偵察在價格侵蝕方面高於整體合併。而且你看到的 S.E.T. 的平均值普遍低於平均水平，所以這就是你的抵消。我不知道，伊万...

Just to be clear on the 300 to 400 basis points that is large joints in the U.S. So when you look at the overall category might have been different. But yes, it was not unusual to see 300, 400, even higher than 400 basis points in the U.S. given the way that we contract than historical factors.

只是要清楚 300 到 400 個基點是美國的大關節。所以當你查看整體類別時可能會有所不同。但是，是的，鑑於我們收縮的方式比歷史因素，在美國看到 300、400 甚至高於 400 個基點並不罕見。

We'll hear from Steve Lichtman with Oppenheimer.

我們將聽取史蒂夫·利希特曼和奧本海默的消息。

Follow-up on S.E.T. You talked about the pipeline you have coming in your focus areas. As you think about overall S.E.T. versus WAMGR for those markets, do you see a pathway to improved foot and ankle growth versus that market either through internal innovation or M&A, your overall thoughts on your foot and ankle from here?

S.E.T. 的後續行動您談到了您在重點領域的管道。當您考慮整體 S.E.T.與這些市場的 WAMGR 相比，您是否看到通過內部創新或併購來改善足部和踝部增長的途徑？

Yes. So I'd tell you is, again, all 6 of the categories we have in S.E.T. are interesting and attractive categories. There's no question. We do bias our investment in our focus areas, which are the ones that I referenced, CMFT, Sports and upper extremities, mainly because those businesses have either been able to acquire a full portfolio have a full portfolio, and we see a cleaner path to leadership in those spaces. And so they get disproportionate amount of investment. And as a result of that, we expect above-market growth in those spaces. In the other categories, they still get investment, they're still important to us. We just expect a different performance because the investment level is different. Now if any one of those businesses comes back with a pathway through acquisition or otherwise, that would also show a clear path of leadership that could become a focus area as well. I don't know if you want to add anything...

是的。所以我要告訴你的是，我們在 S.E.T. 中擁有的所有 6 個類別。是有趣和有吸引力的類別。沒有問題。我們確實偏向於我們的重點領域，即我提到的 CMFT、體育和上肢領域的投資，主要是因為這些企業要么能夠獲得完整的投資組合，要么擁有完整的投資組合，而且我們看到了一條更清潔的途徑在這些領域的領導地位。因此，他們獲得了不成比例的投資。因此，我們預計這些領域的增長將高於市場。在其他類別中，他們仍然獲得投資，他們對我們仍然很重要。我們只是期待不同的表現，因為投資水平不同。現在，如果這些企業中的任何一個通過收購或其他方式回歸，那也將顯示出一條清晰的領導路徑，這也可能成為一個重點領域。不知道你要不要補充...

I'll just keep it very succinct, and say we have not given up on foot and ankle. I would say, a meaningful amount of R&D that is going into that space. We recently closed the buyout of an extremity, which was a partner of ours in foot and ankle. We now have a more complete offering in forefoot, mid-foot and hindfoot. We got some biologic solutions that we're launching as we speak. We got a partnership with our Sports Medicine group on sutures. So there is a compelling portfolio will labeling that we think that we're going to be able to launch here.

我會保持非常簡潔，並說我們沒有放棄腳和腳踝。我想說的是，大量的研發正在進入該領域。我們最近完成了對一個肢體的收購，它是我們在腳和腳踝方面的合作夥伴。我們現在在前足、中足和後足提供更完整的產品。在我們發言時，我們正在推出一些生物解決方案。我們與我們的運動醫學小組在縫合線方面建立了合作夥伴關係。因此，我們認為我們將能夠在這裡推出一個引人注目的產品組合。

Got it. Okay. And then -- and Bryan, you said before that as you guys moved into Phase 3 of your transformation. M&A got crimped obviously by COVID. The impact there from a procedure volume basis has ebbed, but obviously, there are some other macro headwinds, your balance sheet is in good shape. But how do you feel overall about the environment for Zimmer to go out and do some deals here over the next 12 to 18 months?

知道了。好的。然後——還有布萊恩，你們之前說過，你們進入轉型的第三階段。併購顯然受到 COVID 的影響。以程序量為基礎的影響已經減弱，但顯然，還有其他一些宏觀不利因素，您的資產負債表狀況良好。但是，您對 Zimmer 在未來 12 到 18 個月內走出去並在這裡做一些交易的總體感覺如何？

Well, I'd tell you a lot better now than I did before. That's for sure. The fact is our financial flexibility is improving. The balance sheet looks strong. And we've earned -- the right now to be able to truly increase our focus in this area. Don't get me wrong, all along, since we've been in Phase 3, we've been looking at the market, looking for assets that we could pursue. But now our ability to execute this phase of our transformation is more real.

好吧，我現在會比以前更好地告訴你。這是肯定的。事實上，我們的財務靈活性正在提高。資產負債表看起來很強勁。我們已經贏得了——現在能夠真正增加我們在這一領域的關注度。不要誤會我的意思，一直以來，自從我們進入第三階段以來，我們一直在關注市場，尋找我們可以追求的資產。但現在我們執行這一階段轉型的能力更加真實。

And just to give you some color there, we truly will be looking at mission-centric targets because that's the #1 criteria. We're also going to be looking for places where we believe our spaces where we believe we can get a path to leadership at least at some point. We're always going to be looking for WAMGR accretive assets, and then those things that as a result of that can drive faster growth and faster EPS growth over time. To size it, we're probably looking more small- to medium-sized deals, and it would be across 3 areas. Number 1 would be to diversify in our faster growth orthopedic markets like extremity sports, CMFT and even settings like ASC, but also secondly, to diversify our revenue outside of traditional orthopedics with an eye towards those things that are a little less elective in nature. And then inside of recon, we're actually looking to enhance our position in those faster-growth submarkets of recon, so we can bring our WAMGR up there as well, things like data and robotics. So that's where we're going to focus. And we've been at Phase 3 for a while. We've got a lot of things that we're interested in. And now we have a little more financial flexibility to move in that direction.

只是為了給你一些顏色，我們真的會關注以任務為中心的目標，因為這是#1標準。我們還將尋找我們相信我們的空間的地方，我們相信我們至少可以在某個時候獲得通往領導力的道路。我們一直在尋找 WAMGR 增值資產，然後是那些可以隨著時間推移推動更快增長和更快每股收益增長的東西。為了確定它的規模，我們可能正在尋找更多的中小型交易，它將跨越 3 個領域。第一是在我們快速增長的骨科市場（如極限運動、CMFT 甚至像 ASC 等設置）中實現多元化，但其次是在傳統骨科之外實現我們的收入多樣化，著眼於那些本質上選擇性較少的事情。然後在偵察內部，我們實際上正在尋求提高我們在那些快速增長的偵察子市場中的地位，因此我們也可以將我們的 WAMGR 帶到那裡，比如數據和機器人技術。所以這就是我們要關注的地方。我們已經處於第 3 階段有一段時間了。我們有很多我們感興趣的事情。現在我們有更多的財務靈活性可以朝著這個方向前進。

Yes. And Jake, we probably have to end there. I know we're a little bit above 9:30 here. But thanks for all the questions. All great from the queue. Bryan, I don't know if there's any closing remarks that you'd make to round out the call.

是的。傑克，我們可能不得不到此為止。我知道我們現在比 9:30 多一點。但感謝所有的問題。隊列中的一切都很棒。布賴恩，我不知道你是否有任何結束髮言來結束這次電話會議。

Yes. I think when I said, it was a strong quarter, but it's just a quarter. The fact is the momentum has been there for a long time. And I'm just really happy that finally, with some of the clouds being removed, you can actually see the performance that the team is actually delivering.

是的。我認為當我說，這是一個強勁的季度，但它只是一個季度。事實上，這種勢頭已經存在了很長時間。最後，我真的很高興，隨著一些雲被移除，你可以真正看到團隊實際交付的性能。

I think I do want to make sure that we're clear. As we think about that concept of we should at least do a 4% growth rate, it's going to be choppy for a while. The fact is it's not a clean market, it's not an undisturbed market and it's not going to be for a while. So you could expect quarters that might be above that 4%, you might expect to see quarters that are below that 4%, just given all that noise in the market. Make no mistake, the business momentum is real. The team is executing right now flawlessly, and our product pipeline is really, really strong. So our confidence is high, even though it's going to be choppy for a while, our confidence is very high.

我想我確實想確保我們清楚。當我們考慮我們應該至少實現 4% 的增長率的概念時，它會在一段時間內波動。事實是它不是一個乾淨的市場，它不是一個不受干擾的市場，而且不會持續一段時間。因此，考慮到市場上的所有噪音，您可以預期可能會高於 4% 的季度，您可能會期望看到低於 4% 的季度。毫無疑問，業務勢頭是真實的。團隊現在執行得很完美，我們的產品線非常非常強大。所以我們的信心很高，雖然會有一段時間波濤洶湧，但我們的信心很高。

Okay. Thanks, everyone, for the questions. Of course, if you have others, please don't hesitate to reach out to the team today, and I'm sure we'll talk soon. Thanks for joining.

好的。謝謝大家的提問。當然，如果你還有其他人，請不要猶豫，今天就與團隊聯繫，我相信我們很快就會談。感謝您的加入。

And this concludes the Zimmer Biomet quarterly earnings call. Thank you for your participation.

Zimmer Biomet 季度財報電話會議到此結束。感謝您的參與。