Zimmer Biomet Holdings Inc (ZBH) 2022 Q3 法說會逐字稿

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

女士們先生們，早上好，歡迎參加 Zimmer Biomet 2022 年第三季度收益電話會議。 （操作員說明）提醒一下，本次會議將於今天 2022 年 11 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傳播和行政官 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 Third Quarter 2022 Earnings Conference Call. Joining me today are Bryan Hanson, our Chairman, President and CEO; 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。歡迎來到 Zimmer Biomet 的 2022 年第三季度收益電話會議。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；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.

在我們開始之前，我想提醒您，我們在本次電話會議中發表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，我們也沒有義務更新這些前瞻性陳述。請參閱我們向美國證券交易委員會提交的文件，以詳細討論這些風險和不確定性以及此類前瞻性陳述的固有局限性。

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 Q3 earnings release, which can be found on our website, zimmerbiomet.com.

此外，本次電話會議的討論將包括某些非 GAAP 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三季度收益發布中，可以在我們的網站 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？

Thanks, Keri, and thanks for joining us for the call this morning. We've got 3 sections of the call. First, I'm going to briefly talk about our Q3 performance and really the momentum that we saw in Q3 that has allowed us to increase our outlook for the year and doing so even in the face of some pretty meaningful macro pressures that we're certainly still facing. I also want to spend time talking about our ZB innovation. This is clearly the driver of our continued strong performance and will be the driver as we go forward.

謝謝 Keri，也感謝今天早上加入我們的電話會議。我們有 3 個通話部分。首先，我將簡要談談我們第三季度的表現，以及我們在第三季度看到的真正勢頭，這讓我們能夠提高對今年的展望，即使面對一些非常有意義的宏觀壓力，我們也會這樣做肯定還在面對。我還想花時間談談我們ZB的創新。這顯然是我們持續強勁表現的驅動力，並將成為我們前進的驅動力。

And for the second section, Suky will provide more detail on the quarter, but probably more importantly, our 2022 guidance update. And then we'll close things out by addressing any questions you might have.

對於第二部分，Suky 將提供有關本季度的更多詳細信息，但可能更重要的是，我們的 2022 年指導更新。然後我們通過解決您可能會遇到的任何問題來結束事情。

Before I get started on Q3, I just want to make sure that I take a minute to say thank you. Thank you to the ZB team members that I know are listening. I know a lot of you listen to the call, and I appreciate that. Your continued strong performance is -- it's just built on day in and day out execution. You're just focused on driving results. And I know you're showing up and facing some very, very real macro challenges right now, and I appreciate it. The fact is, I'm just really proud that even in the face of these challenges, you're delivering results for our customers, you're delivering results for our patients and for our shareholders, and you're moving the mission of this company forward every single day. I know it's not easy, but I promise you, it is much appreciated.

在我開始 Q3 之前，我只想確保我花一分鐘時間說聲謝謝。感謝我認識的正在傾聽的 ZB 團隊成員。我知道你們中的很多人都在聽電話，對此我表示感謝。你持續的強勁表現是——它只是建立在日復一日的執行之上的。你只是專注於推動結果。而且我知道你現在出現並面臨一些非常非常真實的宏觀挑戰，我很感激。事實上，我真的很自豪，即使面對這些挑戰，您仍在為我們的客戶提供成果，為我們的患者和我們的股東提供成果，並且您正在推動這個使命公司每天都在前進。我知道這並不容易，但我向你保證，非常感謝。

Okay. So turning to the third quarter. Although the beginning of the quarter was a bit choppy when it comes to procedure cancellations, we did see very nice improvement throughout the quarter, and we finished strong. And that execution and recovery occurred in all of our regions, but especially in our o U.S. regions, with both EMEA and APAC performing better than our expectations. Inside of this, we saw good momentum in our large Joints business, with our Knee Franchise growing in the high single digits and our Hip business growing just above 10%. And as you've seen, this was somewhat offset by the telegraphed and expected pressure in our S.E.T. business and our other category.

好的。所以轉向第三季度。儘管本季度初在程序取消方面有點起伏不定，但我們確實在整個季度看到了非常好的改善，而且我們表現強勁。這種執行和恢復發生在我們所有的地區，尤其是在我們的美國地區，EMEA 和 APAC 的表現都好於我們的預期。其中，我們看到了大型關節業務的良好勢頭，我們的膝關節業務以高個位數增長，我們的髖關節業務增長略高於 10%。正如你所看到的，這在某種程度上被我們 S.E.T. 中的電報和預期壓力所抵消。業務和我們的其他類別。

Now although we did see the strength in the quarter, we continue to face significant challenges across foreign currency, supply, inflation and staffing. That said, the team has been able to navigate these challenges and mitigate their impact. You can't completely eliminate them, but they've certainly mitigated their impact. And they've done this through operational and commercial discipline as well as driving our innovation in the field. And as a result, our confidence continues to grow, and you see that reflected in our updated financial guidance.

現在，雖然我們確實看到了本季度的實力，但我們繼續面臨外匯、供應、通貨膨脹和人員配置方面的重大挑戰。也就是說，該團隊已經能夠應對這些挑戰並減輕其影響。你不能完全消除它們，但它們肯定減輕了它們的影響。他們通過運營和商業紀律以及推動我們在該領域的創新來做到這一點。因此，我們的信心不斷增強，您會在我們更新的財務指南中看到這一點。

In short, our underlying business is clearly strong, and I truly do believe it's getting stronger. Just as an example, when we look at the quarter, we announced a first-of-its-kind 3-year agreement with Hospital for Special Surgery, or HSS. The partnership creates HSS, Zimmer Biomet innovation center for artificial intelligence and robotic joint replacement. We're focused here with HSS to develop new tools that will be powered by AI to provide data-driven recommendations or insights to surgeons for robotic-assisted joint surgery.

簡而言之，我們的基礎業務顯然很強大，而且我真的相信它會越來越強大。舉個例子，當我們查看本季度時，我們宣布了與特殊外科醫院 (HSS) 簽訂的首個為期 3 年的協議。該合作夥伴關係創建了 HSS，Zimmer Biomet 人工智能和機器人關節置換創新中心。我們專注於 HSS 開發新工具，這些工具將由 AI 提供支持，為機器人輔助關節手術的外科醫生提供數據驅動的建議或見解。

It's really -- it's a big deal. It's -- we're clearly very excited about it. We really do believe, this is a future of medicine opportunity, and we're excited to be involved with HSS.

這真的 - 這很重要。這是 - 我們顯然對此感到非常興奮。我們真的相信，這是一個未來的醫學機會，我們很高興能參與 HSS。

In our Q3, our new product pipeline continue to deliver as well. While it's early, we're definitely excited about the launch of HipInsight. This is the first FDA-cleared mixed-reality navigation system for total hip replacement. HipInsight is the latest addition to our OptiVu portfolio, and it further expands our ZBEdge suite of solutions. Additionally, we announced the FDA clearance of our Identity Shoulder System. This is a technology that has proprietary capability of aligning each surgeon's approach to an individual patient's anatomy. All of this with the goal, first and foremost, of alleviating pain, but also optimizing the range of motion for that patient.

在我們的第三季度，我們的新產品線也繼續交付。雖然現在還早，但我們對 HipInsight 的發布感到非常興奮。這是第一個獲得 FDA 批准的用於全髖關節置換術的混合現實導航系統。 HipInsight 是我們 OptiVu 產品組合的最新成員，它進一步擴展了我們的 ZBEdge 解決方案套件。此外，我們還宣布了我們的 Identity Shoulder System 已獲得 FDA 批准。這是一項具有專有能力的技術，可以使每個外科醫生的方法與個體患者的解剖結構保持一致。所有這一切的首要目標是減輕疼痛，同時優化患者的活動範圍。

And I got to tell you, our existing product portfolio kept up the momentum as well. Demand continues for ROSA, both in knee and hip. Persona Revision traction in the U.S. remained strong, and our limited launch of Persona iQ is driving positive feedback and interest. And we're focused on aggressive data collection so that we can establish clinical use benefits. And we expect to build on this momentum with new product launches in the coming months, including, as we've talked about, our new Persona cementless form factor, additional launches in our S.E.T. category and a hip product launch that we're excited about in early 2023.

我得告訴你，我們現有的產品組合也保持了勢頭。膝蓋和臀部對 ROSA 的需求仍在繼續。 Persona Revision 在美國的吸引力依然強勁，我們有限推出的 Persona iQ 正在推動積極的反饋和興趣。我們專注於積極的數據收集，以便我們可以建立臨床使用效益。我們希望在未來幾個月推出新產品，以此推動這一勢頭，包括，正如我們所談到的，我們新的 Persona 非水泥外形，我們的 S.E.T. 中的額外發布。 2023 年初我們興奮的產品類別和時尚產品發布。

And I can tell you that all of these product innovations, coupled with our ongoing efforts to reshape our business, and accelerate ZB's transformation position us very well for future growth. We continue to strive to be a best and preferred place to work for our team members, and we continue to strive to be a top quartile performer for our shareholders and to be a trusted partner to all of our stakeholders but in particular, our customers and our patients.

我可以告訴你，所有這些產品創新，加上我們不斷努力重塑我們的業務，並加速 ZB 的轉型，我們為未來的增長做好了準備。我們繼續努力成為我們團隊成員的最佳和首選工作場所，我們繼續努力成為我們股東表現最好的四分之一，並成為我們所有利益相關者值得信賴的合作夥伴，尤其是我們的客戶和我們的病人。

Just in summary, we're navigating and really managing through some very real macro headwinds that are definitely muting our growth. But we're also seeing an offset via COVID recovery, very strong execution from the team and meaningful innovation in the field. And against that backdrop, our team continues to execute our strategy, and I feel increasingly confident about our future as a company.

總而言之，我們正在通過一些非常真實的宏觀逆風進行導航和真正管理，這些逆風肯定會抑制我們的增長。但我們也看到了通過 COVID 恢復、團隊非常強大的執行力以及該領域有意義的創新所帶來的抵消。在這種背景下，我們的團隊繼續執行我們的戰略，我對我們公司的未來越來越有信心。

And with that, I'm going to turn it to Suky to talk more in depth about Q3 and give you an outlook for 2022 guidance. Okay, Suky.

就此，我將請 Suky 更深入地討論第三季度，並為您提供 2022 年指導展望。好的，蘇基。

Thanks, Bryan, and good morning. Overall, we delivered another good quarter, driven by strong execution and continued recovery of elective procedures. While we continue to navigate challenges, our third quarter performance gives us the confidence to raise our full year financial guidance. With that, I'll turn to our third quarter results. Unless otherwise noted, my statements will be about the third quarter of 2022 and how it compares to the same period in '21. And my commentary will be on a constant currency and adjusted continuing operations basis.

謝謝，布萊恩，早上好。總體而言，在強大的執行力和選擇性程序的持續恢復的推動下，我們又交付了一個不錯的季度。在我們繼續應對挑戰的同時，我們第三季度的業績讓我們有信心提高全年財務指導。有了這個，我將轉向我們的第三季度業績。除非另有說明，否則我的陳述將是關於 2022 年第三季度以及與 21 年同期相比的情況。我的評論將以不變貨幣和調整後的持續經營為基礎。

Net sales in the third quarter were $1.67 billion, a decrease of 0.9% on a reported basis and an increase of 5% on a constant currency basis. U.S. sales grew 3.2%, driven by strong elective procedure recovery and commercial execution, especially in our Knee and Hip businesses. This was partially offset by expected declines in the S.E.T. and other categories.

第三季度淨銷售額為 16.7 億美元，按報告基準下降 0.9%，按固定匯率計算增長 5%。美國銷售額增長 3.2%，這主要得益於強勁的擇期手術恢復和商業執行，尤其是在我們的膝關節和髖關節業務方面。這部分被 S.E.T. 的預期下降所抵消。和其他類別。

International sales grew 7.3%, driven by strong procedure volumes across most markets in EMEA and APAC, in tandem with lighter comps and continued strong commercial execution. EMEA performed better than expected, driven by recovery in developed markets and continued strength in emerging markets, and APAC performed better than expected, with China largely in line with expectations and strength in Japan.

受 EMEA 和 APAC 大部分市場手術量強勁的推動，國際銷售額增長了 7.3%，同時伴隨著更輕的 comps 和持續強勁的商業執行。在發達市場復甦和新興市場持續走強的推動下，歐洲、中東和非洲地區表現好於預期，亞太地區表現好於預期，其中中國基本符合預期且日本表現強勁。

Turning to our business category performance. Global Knees grew 7.2%, with U.S. Knees up 7.3% and International Knees up 7%. The strong performance was driven by knee procedure recovery across most regions and easier comps, along with continued global traction of our Persona Knee System, especially with Persona Revision in the U.S., and continue to increase in ROSA procedure penetration and pull-through.

轉向我們的業務類別表現。全球膝關節增長 7.2%，美國膝關節增長 7.3%，國際膝關節增長 7%。強勁的表現是由大多數地區的膝關節手術恢復和更容易的補償，以及我們的 Persona 膝關節系統在全球範圍內的持續牽引力，特別是美國的 Persona Revision，以及 ROSA 手術滲透率和牽引力的持續增加所推動的。

Global Hips grew 10.5%, with U.S. Hips up 5.3% and International Hips up 15.5%, driven by strong international procedure recovery and an easier comp outside of the U.S. Continued traction across key Hip products, including the G7 Revision System, and Avenir Complete Primary Hip, which is focused on the direct interior surgical approach. And lastly, continued solid ROSA pull-through in the hip category, especially in the U.S.

全球髖關節增長 10.5%，其中美國髖關節增長 5.3%，國際髖關節增長 15.5%，這得益於強勁的國際程序恢復和美國以外更容易的競爭。關鍵髖關節產品的持續牽引力，包括 G7 修訂系統和 Avenir Complete Primary髖關節，專注於直接內部手術方法。最後，在臀部類別中繼續穩固的 ROSA 拉動，特別是在美國

The sports extremities and trauma category declined 2.1% and was impacted by a tough comp in 2021 and the expected pressure around VBP, which is expected to reverse in Q4, and reimbursement headwinds in U.S. restorative therapies that will anniversary in mid-2023. Within the category, we continued to deliver strong performance across our key focus areas of CMFT, sports medicine and upper extremities. Finally, our other category declined 0.4%, driven by tough comps and expected lower capital sales related to a higher mix of ROSA placements versus upfront sales.

運動四肢和創傷類別下降了 2.1%，並受到 2021 年的艱難競爭和圍繞 VBP 的預期壓力（預計將在第四季度逆轉）以及將於 2023 年年中周年的美國恢復性療法的報銷逆風的影響。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 0.4%，這是由於 ROSA 配售與前期銷售的較高組合導致的艱難補償和預期的較低資本銷售。

Moving to the P&L. For the quarter, we reported GAAP diluted earnings per share of $0.92 compared to GAAP diluted earnings per share of $0.77 in the third quarter of 2021. The increase was driven by a decline in litigation-related expenses and a tax benefit in the quarter from a favorable tax liability outcome. On an adjusted basis, diluted earnings per share of $1.58 represents a decrease from $1.71 in the third quarter of 2021.

轉到損益表。本季度，我們報告 GAAP 攤薄後每股收益為 0.92 美元，而 2021 年第三季度 GAAP 攤薄後每股收益為 0.77 美元。這一增長是由於訴訟相關費用的下降以及本季度的稅收優惠所推動的有利的納稅義務結果。在調整後的基礎上，每股攤薄收益為 1.58 美元，低於 2021 年第三季度的 1.71 美元。

Adjusted gross margin was 70.7%, in line with expectations. As previously discussed, heightened inflationary pressure will drive full year gross margins to be slightly down when compared to the prior year. As previously noted, increasing input costs from this year will pull through into 2023, and we now expect the headwind from inflation in 2023 to be at the upper end of our previously communicated 50 to 100 basis point range.

調整後毛利率為 70.7%，符合預期。如前所述，與上一年相比，通脹壓力加劇將推動全年毛利率略有下降。如前所述，從今年開始增加的投入成本將持續到 2023 年，我們現在預計 2023 年通脹帶來的逆風將處於我們之前公佈的 50 至 100 個基點範圍的上限。

Our adjusted operating expenses were $742 million, an increase versus the prior year due to inflationary pressures and higher investments into R&D to support future product launches. Our adjusted operating margin for the quarter was 26.3%, a 200-basis point decline from the prior year and largely driven by increased inflationary pressures and continued investments into the pipeline and product portfolio.

我們調整後的運營費用為 7.42 億美元，較上年有所增加，原因是通脹壓力和研發投資增加以支持未來的產品發布。我們本季度調整後的營業利潤率為 26.3%，比上年下降 200 個基點，這主要是由於通脹壓力增加以及對管道和產品組合的持續投資。

Despite ongoing macro headwinds, we continue to expect our efficiency programs to drive improved second half operating margins versus the first half of the year, with a step-up in the fourth quarter in tandem with higher revenue. The adjusted tax rate was 16.3% in the quarter, in line with our expectations.

儘管存在持續的宏觀逆風，但我們繼續預計我們的效率計劃將推動下半年營業利潤率與上半年相比有所提高，第四季度將隨著收入的增加而提高。本季度調整後的稅率為 16.3%，符合我們的預期。

Turning to cash and liquidity. Operating cash flows were $451 million and free cash flow totaled $332 million for the quarter. We reduced our debt by about $160 million in the third quarter, excluding the effects of foreign currency, and ended the quarter with cash and cash equivalents of about $545 million. On a related note, despite a higher interest rate environment in 2022, interest expense is expected to be broadly in line with our previous expectations for the year. However, we would expect a step-up of interest expense into 2023.

轉向現金和流動性。本季度運營現金流為 4.51 億美元，自由現金流總計 3.32 億美元。我們在第三季度減少了約 1.6 億美元的債務，不包括外彙的影響，並在本季度結束時現金和現金等價物約為 5.45 億美元。與此相關的是，儘管 2022 年的利率環境較高，但預計利息支出將與我們此前對這一年的預期基本一致。但是，我們預計到 2023 年利息支出會增加。

We have made significant progress in strengthening our balance sheet through improved financial performance and ongoing debt reduction, ultimately providing greater strategic flexibility for the company.

通過改善財務業績和持續削減債務，我們在加強資產負債表方面取得了重大進展，最終為公司提供了更大的戰略靈活性。

Moving on to our updated financial outlook for the year. Constant currency revenue growth is now expected to be 5.5% to 6.5% versus 2021, with an expected foreign currency exchange headwind based on recent spot rates of 550 basis points versus our previous assumption of 500 basis points. This means that reported revenue growth will be in the range of 0% to 1% versus 2021.

繼續我們今年更新的財務展望。目前預計與 2021 年相比，固定貨幣收入增長 5.5% 至 6.5%，根據近期即期匯率 550 個基點與我們之前假設的 500 個基點相比，預計外匯匯率逆風。這意味著與 2021 年相比，報告的收入增長將在 0% 到 1% 之間。

Also related to revenue, based on the recent spot rates, we estimate that the strengthening of the dollar through 2022 will create about a 300-basis point headwind to revenue growth in 2023. Additionally, we are tightening our expected adjusted diluted EPS range to $6.80 to $6.90. All other metrics in our '22 financial guidance remain unchanged from our second quarter update.

同樣與收入相關，根據最近的即期匯率，我們估計到 2022 年美元走強將對 2023 年的收入增長造成約 300 個基點的逆風。此外，我們將調整後的稀釋後每股收益預期範圍收緊至 6.80 美元至 6.90 美元。我們 22 年財務指南中的所有其他指標與我們的第二季度更新保持不變。

As a reminder, we expect Q4 revenue growth to be slightly higher than the third quarter due in part to a tailwind related to Q4 2021 VBP charges that will be partially offset by about a 1-day selling day headwind.

提醒一下，我們預計第四季度的收入增長將略高於第三季度，部分原因是與 2021 年第四季度 VBP 費用相關的順風將被大約 1 天的銷售日逆風部分抵消。

In summary, we had another solid quarter, underpinned by market recovery and good execution, and we are pleased to again raise our full year outlook. While we expect to have to continue to navigate a number of persistent macro headwinds, ongoing market recovery in tandem with strong execution and an attractive product pipeline leaves us confident about our future. And lastly, I'm extremely proud of and want to thank our broader ZB team for all that they do.

總而言之，在市場復甦和良好執行的支持下，我們又迎來了一個穩健的季度，我們很高興再次上調全年展望。雖然我們預計必須繼續應對一些持續的宏觀逆風，但持續的市場復甦加上強勁的執行力和有吸引力的產品線讓我們對未來充滿信心。最後，我非常自豪並要感謝我們更廣泛的 ZB 團隊所做的一切。

With that, I'll turn the call back over to Keri. Thank you.

有了這個，我會把電話轉回 Keri。謝謝你。

Thanks, Suky. Before we start the Q&A session, (Operator Instructions) 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，（操作員說明）那麼，操作員，我們可以問第一個問題嗎？

We'll take our first question from Shagun Singh with RBC.

我們將接受來自 RBC 的 Shagun Singh 的第一個問題。

Congratulations on a strong print here despite a pretty challenging environment. So Bryan and Suky, I was just wondering if you can elaborate a little bit more on 2023. Just on the top line, how should we think about the durability of growth? I think last quarter, you talked about a 4% floor, but it looks like you have stronger momentum going into next year with a 6% exit rate. And then on margins, given the incremental impact you called out from FX and inflation, do you still believe you can drive operating margin expansion next year? Or is that going to be more challenging? And then I have a follow-up.

儘管環境非常具有挑戰性，但還是要祝賀這裡的打印效果很好。所以 Bryan 和 Suky，我只是想知道你們是否可以詳細說明 2023 年。最重要的是，我們應該如何考慮增長的持久性？我想上個季度，你談到了 4% 的下限，但看起來你進入明年的勢頭更強勁，退出率為 6%。然後關於利潤率，考慮到您從外彙和通貨膨脹中提出的增量影響，您是否仍然相信您可以推動明年的營業利潤率增長？或者這會更具挑戰性嗎？然後我有一個後續行動。

Okay. Two really good questions right out of the gate. So maybe, Suky, I'll start with the revenue side of that equation, and then you could answer on the margin side. And certainly, any color you want to provide that I might miss, feel free to do that. Maybe just to make it simple, I'll just start with the end of the story, and then I'll get into some of the details around variables that I think are important to consider.

好的。兩個非常好的問題就在門外。所以也許，Suky，我將從該等式的收入方面開始，然後你可以在保證金方面回答。當然，如果您想提供我可能會錯過的任何顏色，請隨意這樣做。也許只是為了簡單起見，我將從故事的結尾開始，然後我將介紹我認為需要考慮的重要變量的一些細節。

But just going to the end of the story. We said that in an undisturbed market, we would be disappointed if we couldn't grow 4%. Now I would tell you that we do not see 2023 as a normal market or not a straight market. There's just too many variables moving, but we do see -- we still do see a pathway to 4% growth. So that's kind of the end of the story. Now let's take a look at some of the puts and takes that we have to look at that could either benefit or detract from that.

但只是到故事的結尾。我們說過，在一個不受干擾的市場中，如果我們不能增長 4%，我們會感到失望。現在我要告訴你，我們不認為 2023 年是一個正常的市場，也不是一個直接的市場。變化的變量太多了，但我們確實看到了——我們仍然看到了實現 4% 增長的途徑。所以這就是故事的結尾。現在讓我們看一下我們必須考慮的一些看跌期權和看跌期權，它們可能會從中受益或減損。

On the positive side of the equation, I'm going to start first with those things that are controllable by our company. There are really 3 major things that I look at that give me confidence and should give you confidence. Number one, it's around innovation. I'm just going to call it the innovation flywheel here at ZB is really moving in the right direction and it's creating a solid pipeline that importantly is translating into moving our Vitality Index north, and that continues to move north for us and we expect to continue to do that on a go-forward basis. So innovation is a really big part of our confidence.

從等式的積極方面來看，我將首先從我們公司可以控制的那些事情開始。我確實看到了 3 件主要的事情，這些事情給我信心，也應該給你信心。第一，它圍繞創新。我只想稱它為 ZB 的創新飛輪，它確實在朝著正確的方向前進，它正在創造一個堅實的管道，重要的是轉化為將我們的活力指數向北移動，並且繼續為我們向北移動，我們期望在前進的基礎上繼續這樣做。因此，創新是我們信心的重要組成部分。

The team is executing. Really strong execution right now and hitting a stride which is important for momentum in the business. And the third one is around a continued focus from this organization on moving our weighted average market growth north through very disciplined portfolio decisions. I'm talking about not just active portfolio management, but truly looking at the way we spend in research and development, commercial infrastructure, the way we compensate our people, the way we actively move things out of the portfolio that are not helping our (inaudible) and move things into the portfolio to do. That has allowed us to increase our weighted average market growth, and we're continuing to do so.

團隊正在執行。現在執行力非常強，並且邁出了一大步，這對業務發展勢頭很重要。第三個是圍繞該組織繼續關注通過非常有紀律的投資組合決策將我們的加權平均市場增長向北移動。我說的不僅僅是積極的投資組合管理，而是真正審視我們在研發、商業基礎設施方面的支出方式，我們對員工的薪酬方式，我們積極將無益於我們的投資組合中的東西移出的方式（聽不見）並將事情轉移到投資組合中去做。這使我們能夠提高加權平均市場增長率，並且我們將繼續這樣做。

So those are the positives, coming into 2023. From a macro standpoint, we have a couple of positives as well. I really look at the backlog of patients in orthopedics as being real. I can't put a number to it, but it's hard to size. It's hard to say when it's going to be impacting the markets, the pace that's going to impact the markets. But at some point, this has got to begin to work its way through the system, and that could provide a tailwind to 2023. And then comps as well in 2023. It's going to be choppy. We've got choppy comps, you're going to see differences in growth rates by quarter. But the fact is, when I look at the full year, we should look at comps as a slight positive to 2023.

所以這些都是積極因素，進入 2023 年。從宏觀角度來看，我們也有一些積極因素。我真的把骨科病人的積壓看成是真實的。我不能給它一個數字，但很難確定它的大小。很難說它何時會影響市場，影響市場的速度。但在某些時候，這必須開始在整個系統中發揮作用，這可能會為 2023 年提供順風。然後在 2023 年也會出現。這將是波濤洶湧的。我們有起伏不定的公司，你會看到每個季度的增長率差異。但事實是，當我回顧全年時，我們應該將 comps 視為對 2023 年的輕微積極影響。

And on the negative side, it's the stuff that everybody is talking about, unfortunately. We do have a very constrained supply challenge situation. And we're managing through it, but it's a tough road. And that's going to continue throughout 2022 -- 2023, we believe. And then staffing and our capacity has continued -- is not as difficult as it was, but that's going to remain a headwind for us in 2023. And then we also look at recession risk on elective procedures, particularly if it impacts unemployment.

從消極的方面來說，不幸的是，這是每個人都在談論的事情。我們確實面臨非常有限的供應挑戰。我們正在通過它進行管理，但這是一條艱難的道路。我們相信，這將持續到 2022 年 - 2023 年。然後人員配備和我們的能力繼續 - 不像以前那麼困難，但這將在 2023 年對我們來說仍然是一個逆風。然後我們還關注選舉程序的衰退風險，特別是如果它影響失業。

But all that to say, 2023 is not a normal year given all these variables. There's a lot to manage, a lot to think through and lot to contemplate in the way that we set up our guidance range. But based on what I'm seeing today, I expect there to be a 4 handle in that range, which may or may not sound like a lot to people looking at medtech, but to us, knowing where we started, that's a pretty significant step-up from where we started the journey, and we're proud of it. And again, we're just getting started. So that gives you a sense for revenue components and our view on revenue as we come into 2023. And then Suky, I'll pass it to you on the margin side.

但綜上所述，考慮到所有這些變數，2023 年不是正常的一年。在我們建立指導範圍的方式中，有很多事情需要管理，需要思考很多，需要考慮很多。但根據我今天所看到的情況，我預計該範圍內會有 4 個句柄，這對於關注醫療技術的人來說可能聽起來很多，但對我們來說，知道我們從哪裡開始，這是一個非常重要的從我們開始旅程的地方開始，我們為此感到自豪。再一次，我們才剛剛開始。因此，當我們進入 2023 年時，這可以讓您了解收入組成部分以及我們對收入的看法。然後 Suky，我會把它傳遞給您。

Yes. Thanks, Bryan. Shagun, thanks for the question. On the margin side, you're right. The macro environment has become incrementally more challenging here in the back half than we originally assumed. That's been reflected in our rest-of-year outlook. And despite those challenges, we've been able to raise the back end of our year. So we're pretty proud of that, and the team is doing a great job.

是的。謝謝，布萊恩。沙根，謝謝你的提問。在保證金方面，你是對的。後半段的宏觀環境比我們原先假設的更具挑戰性。這反映在我們對今年餘下時間的展望中。儘管存在這些挑戰，我們還是能夠提高年底的收入。所以我們為此感到非常自豪，團隊做得很好。

As that rolls into next year, it has become incrementally more challenging, but we still see a path to maintaining or slightly improving our operating margin versus 2022 despite some of these headwinds. And that assumes current market conditions. If things erode or if things improve, we'll revisit that. But where we are today and assume stability on some of those headwinds, that's how we're thinking about 2023.

隨著明年的到來，它變得越來越具有挑戰性，但儘管存在一些不利因素，我們仍然看到了與 2022 年相比保持或略微提高營業利潤率的途徑。這是假設當前的市場條件。如果情況惡化或情況有所改善，我們將重新考慮。但我們今天所處的位置並假設其中一些不利因素保持穩定，這就是我們對 2023 年的看法。

The biggest move for us really has been around FX. So as you know, we increased our full year outlook by 50 basis points to 550. That means we're exiting the year at 600 basis points of headwind on revenue. That translates to about 300 basis points of headwind into next year. So that's got a pretty significant impact on the top line in absolute dollars. And of course, there's a flow-through to margin and to earnings on that. But despite that pretty big drag, again, we believe, there is a pathway, and we're committed to maintaining or growing margins into next year.

對我們來說最大的舉措確實是圍繞外匯。如您所知，我們將全年展望提高了 50 個基點，達到 550 個基點。這意味著我們將以 600 個基點的收入逆風結束這一年。這意味著明年將面臨約 300 個基點的逆風。因此，這對絕對美元的頂線產生了相當大的影響。當然，利潤率和收益也有流動性。但是，儘管存在很大的阻力，但我們再次相信，有一條道路，我們致力於在明年保持或增加利潤率。

The other major area you touched on was inflation. Our previous estimate was that we'd have 50 to 100 basis points capitalized out of '22 into '23. We're now at the top end of that, but still within our overall purview that we gave earlier this year. The real driver of that increase has been less about supply and raw material costs, and less about wage and inflation, which were the bigger areas, and it's more about higher freight costs right now trending higher as well as energy costs, especially in Europe. But again, at least on the bigger components of that, we're starting to see some stabilization. So hopefully, that's a positive light towards the end of the tunnel.

您提到的另一個主要領域是通貨膨脹。我們之前的估計是，從 22 年到 23 年，我們將資本化 50 到 100 個基點。我們現在處於最高端，但仍在我們今年早些時候給出的總體權限範圍內。這種增長的真正驅動因素不是供應和原材料成本，也不是工資和通貨膨脹，這是更大的領域，而且更多的是更高的運費成本和能源成本，目前呈上升趨勢，尤其是在歐洲。但同樣，至少在更大的組成部分上，我們開始看到一些穩定。因此，希望這是通往隧道盡頭的積極曙光。

And then interest expense. Again, just recognizing the higher interest rate environment we're in, we would expect overall interest expense to be modestly higher next year, so just making sure that folks have that as an update to their model. But look, we're continuing to address our efficiency programs. We're going deeper and faster. I really want to commend the overall ZB team for embracing these challenges and hitting them head on. They've done a fantastic job. And again, just based on that execution and assuming current market conditions hold into 2023, we think we've got a pathway to maintain or slightly improved.

然後是利息支出。同樣，只要認識到我們所處的利率較高的環境，我們預計明年的整體利息支出將略有增加，因此只需確保人們將其作為模型的更新即可。但是看，我們正在繼續解決我們的效率計劃。我們走得更深、更快。我真的很想讚揚整個 ZB 團隊迎接這些挑戰並直面挑戰。他們做得非常出色。再一次，僅基於這種執行並假設當前的市場狀況持續到 2023 年，我們認為我們有一條途徑可以維持或略有改善。

That's really helpful. Thank you so much for the color. Just as a follow-up, I was just curious to get your thoughts on portfolio management in the context shift of procedures to the ASC setting. We are hearing about 60% of recon procedures could be done in the ASC setting by 2028 or, let's say, even by the end of the decade. Any thoughts on that? And are you still under-indexed in that setting?

這真的很有幫助。非常感謝你的顏色。作為後續行動，我只是想知道您在將程序轉移到 ASC 設置的背景下對投資組合管理的想法。我們聽說到 2028 年，或者說，甚至到本世紀末，大約 60% 的偵察程序可以在 ASC 環境中完成。對此有什麼想法嗎？在那種情況下，你的索引仍然不足嗎？

Yes. And maybe I'll start off with that and then, Ivan, if you want to weight in, feel free to do so. We clearly still see the ASC as an attractive submarket of our recon business and also clearly other parts of our S.E.T. business. It's one of the faster-growth submarkets, and we're clearly increasing our focus and spend in that area. And we're doing it in a couple of ways.

是的。也許我會從那開始，然後，伊万，如果你想加入，請隨意。我們顯然仍然將 ASC 視為我們偵察業務的一個有吸引力的子市場，也顯然是我們 S.E.T. 的其他部分。商業。它是增長較快的子市場之一，我們顯然正在增加對該領域的關注和支出。我們正在以幾種方式做到這一點。

Number one, we're putting infrastructure in place. We've got dedicated commercial teams that focus only on the ASC. And that's important because you've got to have contracting prowess in that space, and we've done that over the last couple of years and really getting good traction as a result of it. Additionally, we're making sure that we scale up in the product categories that the ASC is looking for. We wouldn't have purchased a booms and light company if we didn't want to have that infrastructure for the ASC. Not to take anything away from booms and lights, but it's not an area that we would have waited into if it wouldn't have given us scale in the ASC marketplace.

第一，我們正在建立基礎設施。我們擁有專注於 ASC 的專門商業團隊。這很重要，因為你必須在那個領域擁有承包能力，而我們在過去幾年中已經做到了這一點，並因此真正獲得了良好的牽引力。此外，我們確保我們在 ASC 正在尋找的產品類別中擴大規模。如果我們不想為 ASC 提供基礎設施，我們就不會購買吊桿和照明公司。不要從繁榮和燈光中拿走任何東西，但如果它不會給我們在 ASC 市場上的規模，我們不會等待進入這個領域。

Same thing in sports acquisitions that we've done in other parts of our business. So we're really doing it 2 ways: commercial infrastructure, product portfolio, so that we have a broad-based contracting opportunity in the ASC, and we're seeing traction as a result of that. We do expect the ASC to continue to move north relative to the number of procedures being done in the ASC versus the hospital. I don't know that I would agree with the numbers you stated. But certainly, we believe that it's going to continue to move north, and we want to make sure that we're taking advantage of that. So Ivan, I don't know if you had anything else you want to add.

我們在其他業務領域所做的體育收購也是如此。因此，我們確實以兩種方式進行：商業基礎設施、產品組合，以便我們在 ASC 中擁有廣泛的承包機會，因此我們看到了牽引力。我們確實希望 ASC 相對於醫院進行的手術數量繼續向北移動。我不知道我會同意你所說的數字。但可以肯定的是，我們相信它會繼續向北移動，我們希望確保我們正在利用這一點。 Ivan，我不知道你是否還有其他要補充的內容。

Yes, I wanted to but I think you covered pretty much everything, Bryan. But I do think one of the drivers of having a complete portfolio now is that we have best-in-class contracting. So there were contracts back in '20 and '21 that were not a part of Zimmer Biomet, was not a part of, we're a part of today. So indeed, the portfolio that has been remediated the dedicated structure working. And while we don't disclose the specifics in terms of growth, we are growing double digit. In the ASC category here in the U.S., we believe will continue to grow at double-digit rates.

是的，我想，但我認為你涵蓋了幾乎所有內容，布萊恩。但我確實認為，現在擁有完整產品組合的驅動因素之一是我們擁有一流的承包服務。因此，20 世紀 20 年代和 21 世紀的合同不屬於 Zimmer Biomet，不屬於我們今天的一部分。因此，確實，已經修復的專用結構工作的投資組合。雖然我們沒有透露增長方面的具體細節，但我們正在以兩位數的速度增長。在美國的 ASC 類別中，我們相信將繼續以兩位數的速度增長。

We'll take Steven Lichtman with Oppenheimer & Company.

我們將邀請 Steven Lichtman 與 Oppenheimer & Company。

I was wondering if you could talk about the strength you're seeing in the hip side of your business, particularly as it relates to ROSA pull-through. What are you seeing as it relates to surgeon interest on the hip side with ROSA and would you say you're still in the early days in terms of that being a tailwind?

我想知道您是否可以談談您在業務的時尚方面看到的力量，特別是與 ROSA 拉動相關的力量。你看到了什麼，因為它與外科醫生對 ROSA 的臀部興趣有關，你會說你還處於順風的早期階段嗎？

Yes. I'll probably pass the -- just that its product related more than anything, I'll probably pass it to Ivan to speak to the hip performance. And also, Ivan, maybe speak to some of the things that, without too much specificity, that we're predicting in the future to help the hip business as well.

是的。我可能會通過 - 只是它的產品相關性比任何東西都重要，我可能會把它傳遞給 Ivan 來談論臀部表現。而且，伊万，也許可以談談我們預測未來也會幫助時尚行業的一些事情，但不要太具體。

Absolutely. Thank you. Steve, I will just summarize the Hip performance so far when it comes to robotics at above expectations. We like the fact that this is the only pin-less robotic system in the world. We like the fact that it remains CT scan-less, which is a great advantage for the ASC setting that we're talking about. We've seen, versus conventional hip procedures, at similar level in a higher level of accuracy in the procedure. So for all the clinical reasons that I'm alluding to, it continues to be a best-in-class product launch. It's going to continue to scale up. We are right now placing, installing about 30% of all robotics, including hips in ASC settings, so in a major advantage in settings where time and efficiency makes sense.

絕對地。謝謝你。史蒂夫，當談到超出預期的機器人技術時，我將總結到目前為止的髖關節表現。我們喜歡這樣一個事實，即這是世界上唯一的無針機器人系統。我們喜歡它仍然不需要 CT 掃描，這對於我們正在談論的 ASC 設置來說是一個很大的優勢。我們已經看到，與傳統的髖關節手術相比，該手術在相似水平上具有更高的準確性。因此，出於我提到的所有臨床原因，它仍然是一流的產品發布。它將繼續擴大規模。我們現在正在放置、安裝大約 30% 的機器人，包括 ASC 設置中的臀部，因此在時間和效率有意義的設置中具有主要優勢。

Beyond robotics, beyond hip robotics, also excited about other product launches. We have on Hip, I think you might have heard from Bryan in the opening remarks, we've got a partnership in mixed reality with a company called Surgical Planning Associates, that enables Zimmer Biomet to be the only FDA-approved mixed reality platform in hips in the U.S. What we saw through mixed reality? We get better visibility in hip surgery. We get better accuracy. And overall, better efficiency. This is some of the technologies that we're going to be explaining that this week, as hip as well as mixed reality HipInsight, but it's a CAGR of other products that continue to have momentum. Continue to perform strongly globally with having a complete -- we believe that we have the best robotic platform with G7 and Arcos. So again, multiple examples of innovation that are gaining some traction, both here in the U.S. and globally.

除了機器人技術，除了臀部機器人技術，我們還對其他產品的發布感到興奮。我們有 Hip，我想你可能在開場白中聽過 Bryan，我們與一家名為 Surgical Planning Associates 的公司建立了混合現實合作夥伴關係，這使 Zimmer Biomet 成為唯一獲得 FDA 批准的混合現實平台臀部在美國。我們通過混合現實看到了什麼？我們在髖關節手術中獲得了更好的知名度。我們得到更好的準確性。總體而言，效率更高。這是我們本週將要解釋的一些技術，如時尚和混合現實 HipInsight，但它是繼續保持勢頭的其他產品的複合年增長率。繼續在全球範圍內表現強勁，擁有一個完整的——我們相信我們擁有最好的機器人平台 G7 和 Arcos。因此，無論是在美國還是在全球範圍內，創新的多個例子都獲得了一定的吸引力。

Great. And then, Suky, just a follow-up. Thanks for the color on the 2023 inflationary headwinds. Just wondering if you could talk about offsets. You mentioned some of the internal efficiency programs. But what about on pricing, are you seeing any progress on pricing initiatives? Any color you can provide on that and what potential impact they may -- that might have on the offset side?

偉大的。然後，Suky，只是跟進。感謝 2023 年通脹逆風的顏色。只是想知道你是否可以談談抵消。你提到了一些內部效率計劃。但在定價方面，您是否看到定價舉措有任何進展？您可以提供的任何顏色以及它們可能對抵消側產生的潛在影響是什麼？

Yes. Thanks for the question, Steve. So we have so far this year seen an improvement in overall pricing erosion at the company level. Our historic pricing erosion was in the 200 to 300 basis points per year, coming into 2022. And so far, this year, we're tracking about 100 to 150 basis points. So there's been some marked improvement. We've been making investments around data and analytics systems, better governance. We've hired additional capabilities. Ivan talked a little bit about contracting. All of these are contributing strategically and tactically to that improved price.

是的。謝謝你的問題，史蒂夫。因此，今年到目前為止，我們已經看到公司層面的整體定價侵蝕有所改善。到 2022 年，我們歷史性的定價侵蝕是每年 200 到 300 個基點。到目前為止，今年我們追踪了大約 100 到 150 個基點。所以有一些顯著的改進。我們一直在圍繞數據和分析系統、更好的治理進行投資。我們僱用了額外的能力。伊万談到了一些關於承包的事情。所有這些都在戰略和戰術上為提高價格做出了貢獻。

As we move into next year, we do expect there to continue to be pricing erosion, but we would hope that and expect it to be at the lower end of our historic average, if not, better. So while we do expect it to be better than where we've been for the last several years, it will still be a headwind year-over-year. Now having said that, there are a number of other efficiency programs that we're targeting to help offset some of these headwinds. Like our new global business services or shared services operating model that we created through the pandemic. We're taking a much more targeted look at country profitability.

隨著我們進入明年，我們確實預計價格會繼續下降，但我們希望並預計它會處於我們歷史平均水平的低端，如果不是，會更好。因此，儘管我們確實預計它會比過去幾年更好，但與去年同期相比仍將是一個逆風。話雖如此，我們的目標還有許多其他效率計劃，以幫助抵消其中的一些不利因素。就像我們通過大流行創造的新的全球商業服務或共享服務運營模式。我們正在更有針對性地審視國家/地區的盈利能力。

The product portfolio, active portfolio management that Bryan spoke about, looking at products that have lower margin, lower growth opportunities and thinking differently about those investment profiles, these are all things that are going to help contribute to offset those headwinds.

Bryan 談到的產品組合、積極的投資組合管理，著眼於利潤率較低、增長機會較低的產品以及對這些投資概況的不同思考，這些都將有助於抵消這些不利因素。

We'll take our next caller from Vijay Kumar with Evercore ISI.

我們將接聽 Evercore ISI 的 Vijay Kumar 的下一位來電。

Bryan, maybe my first one on your 4% for fiscal '23 as a starting point. I'm curious, where is that floor assuming? It looks like there is no backlog. Pricing still continues to be a headwind. And it looked like you sounded pretty bullish on new products, but I'm assuming that 4% -- is assuming minimal contribution from new products. Could you just go through the assumptions, please?

布萊恩，也許我的第一個關於你 23 財年 4% 的起點。我很好奇，那層樓假設在哪裡？看起來沒有積壓。定價仍然是一個不利因素。看起來你聽起來很看好新產品，但我假設 4%——假設新產品的貢獻很小。能否請您先完成這些假設？

Yes. I think you've kind of laid them out already. When I think about the go-forward-looking revenue growth, you're going to have puts and takes. The things that we know are going to be positive for our business will absolutely be innovation. So when I think about the calculus on revenue growth going forward, there's no question that we've included innovation. We're spending a lot of money and a lot of focus in research and development. We're bringing great products to the market, and we absolutely expect that to buoy our revenue growth. That's part of reason why we gain from a 0% growth business in 2017, 2018, and now we're predicting we can get to 4%. So that's been a big part of that movement.

是的。我想你已經把它們佈置好了。當我考慮前瞻性的收入增長時，你會有所顧慮。我們所知道的對我們的業務有積極影響的事情絕對是創新。因此，當我考慮未來收入增長的計算時，毫無疑問我們已經包括了創新。我們在研發上投入了大量資金和精力。我們正在將優質產品推向市場，我們絕對希望這能提振我們的收入增長。這就是為什麼我們從 2017 年、2018 年的 0% 增長業務中獲益的部分原因，現在我們預測我們可以達到 4%。所以這是該運動的重要組成部分。

The execution of our team is another part of it. There's no question. I know that it's hard to put a dollar amount on momentum in an organization, but momentum does matter, and we have it right now. And the other big one is that weighted average market growth. We have moved our weighted average market growth north during the last 5 years. So as we get closer, for our weighted average market growth to that 4%. It gives us more confidence that without share taking, we can deliver the 4% in a consistent way.

我們團隊的執行力是其中的另一部分。毫無疑問。我知道很難用金錢來衡量一個組織的勢頭，但勢頭確實很重要，我們現在就有了。另一個重要的是加權平均市場增長。在過去的 5 年中，我們已將加權平均市場增長向北移動。因此，隨著我們越來越接近，我們的加權平均市場增長率將達到 4%。這讓我們更有信心，無需股份，我們就能以一致的方式交付 4%。

Now certainly, we wouldn't stop there. Active portfolio management is Phase 3 of this organization, and we're going to have more financial flexibility going forward. We're going to continue to change that weighted average market growth rate up. But getting to the 4% to start is a good thing. The negatives against that because you're saying, "Okay, we've got all these positive and why isn't it more than that?" We still have real challenges around supply, and that is a distractor for growing your business. And so we're going to have to manage through that as we get through 2023. We believe at least through the middle of 2023, potentially beyond.

當然，我們不會就此止步。積極的投資組合管理是該組織的第 3 階段，我們將在未來擁有更多的財務靈活性。我們將繼續提高加權平均市場增長率。但是達到 4% 是一件好事。反對它的負面因素是因為你在說，“好吧，我們有所有這些積極因素，為什麼不比這更多呢？”我們在供應方面仍然面臨真正的挑戰，這會干擾您發展業務。因此，我們將不得不在 2023 年之前解決這個問題。我們相信至少要到 2023 年中期，甚至可能更久。

And even though staffing in our capacity isn't as acute as it was before, it's no question that this is going to be a headwind for us going forward. And of course, we have to calculate some potential risk associated with the recession, if that does occur. So I think it's all those things combined in concert with this concept of having some backlog that we're hoping we can count on in 2023. But as of yet, we haven't seen it. Even Q3, which was a great quarter, we still don't believe backlog was consumed. We certainly might have had some backlog in certain areas consumed, but it was offset by some of these negative headwinds that we actually think backlog built in Q3. So those are the variables that we're looking at as we think about 2023 and beyond.

儘管我們的人員配備不像以前那麼嚴重，但毫無疑問，這將成為我們前進的逆風。當然，如果確實發生，我們必須計算與衰退相關的一些潛在風險。所以我認為所有這些都與我們希望在 2023 年可以指望的一些積壓的概念相結合。但到目前為止，我們還沒有看到它。即使是第三季度，這是一個很好的季度，我們仍然不相信積壓訂單被消耗掉了。我們當然可能在某些領域有一些積壓消耗，但它被我們實際上認為積壓在第三季度建立的一些負面逆風所抵消。因此，這些是我們考慮 2023 年及以後時正在考慮的變量。

That's helpful, Bryan. And Suky, one for you on your free cash flows year-to-date. It's really been impressive, up year-on-year free cash conversion north of 80%. You're probably one of a few medtech companies to have free cash flows up. Is that a timing impact or anything else going on in the free cash flow line item?

這很有幫助，布萊恩。還有 Suky，一個關於你今年迄今為止的自由現金流量的。這確實令人印象深刻，同比自由現金轉換率超過 80%。您可能是少數自由現金流量增加的醫療技術公司之一。這是時間影響還是自由現金流行項目中發生的任何其他事情？

Yes, Vijay, we did -- we have posted a really good 9 months here. I would say there is some timing benefit in the third quarter that will reverse in the fourth quarter. It has to do with some payments around VBP as well as some tax payments that normally would fall in the third quarter, but now land in the fourth quarter. All in all, I think you nailed it. We're having a pretty good year in cash, and we feel confident in our overall range for this year.

是的，Vijay，我們做到了——我們在這裡發布了非常好的 9 個月。我想說的是，第三季度有一些時間上的好處將在第四季度逆轉。它與 VBP 周圍的一些付款以及通常會在第三季度下降但現在在第四季度下降的一些稅收有關。總而言之，我認為你做到了。我們今年的現金收入相當不錯，我們對今年的整體範圍充滿信心。

We'll take our next question from Travis Steed with Bank of America.

我們將接受來自美國銀行的 Travis Steed 的下一個問題。

I wanted to follow up a little bit more on the 2023 comments. I think before you said EPS to grow faster than revenue growth. And so now that was with op margins up, now margins are kind of flat to slightly improving. So I'm just curious how we should think about EPS growth now versus the 4% constant currency growth if EPS is still up, but probably less than 4%? And I did want to clarify on the interest expense. You had a higher interest expense, but I think you have no floating debt. So just kind of curious what's driving the higher interest expense.

我想對 2023 年的評論進行更多跟進。我想在你說每股收益增長快於收入增長之前。所以現在運營利潤率上升了，現在利潤率有點持平到略有改善。所以我很好奇，如果 EPS 仍然上升但可能低於 4%，我們應該如何考慮現在的 EPS 增長與 4% 的恆定貨幣增長？我確實想澄清一下利息支出。你有更高的利息支出，但我認為你沒有浮動債務。所以有點好奇是什麼導致了更高的利息支出。

Sure. So Bryan, I'll go ahead and take those. So the one thing to remember on the EPS line is, I talked about 300 basis points of headwind on revenue into next year. And so as Bryan thinks -- talks about, that 4% on an XFX basis, you need to take into consideration the foreign currency headwind that matriculates into next year. So having said that, with the margins kind of being relatively in line, maybe slightly up, and with interest expense up year-over-year, which I'll talk about in a moment, you would expect on a reported basis to see EPS kind of travel in line with overall reported revenue.

當然。所以布萊恩，我會繼續接受那些。因此，在 EPS 線上要記住的一件事是，我談到明年的收入逆風 300 個基點。因此，正如 Bryan 所想的那樣——談到以 XFX 為基礎的 4%，你需要考慮到明年的外幣逆風。所以話雖如此，由於利潤率相對一致，可能略有上升，利息支出同比上升，我稍後會談到，你會期望在報告的基礎上看到每股收益一種符合整體報告收入的旅行。

So hopefully, that gives you a little bit more color. Again, that's our best view right now. Things can obviously change between now and when we finally give guidance for 2023 in the first quarter of next year. On your question related to interest expense, you're right, we are on face value in fixed debt, but we also do and have done some previous strategies to swap out our fixed to floating. So it's really the interest burden on those swaps that create that higher interest expense.

所以希望這能給你多一點色彩。再一次，這是我們現在最好的觀點。從現在到我們最終在明年第一季度給出 2023 年的指導，情況顯然會發生變化。關於與利息支出有關的問題，你是對的，我們是固定債務的面值，但我們也做了並且已經做了一些以前的策略來將我們的固定債務換成浮動債務。因此，真正造成更高利息支出的是那些互換的利息負擔。

Okay. No, that's helpful color. And then -- and Bryan, I wanted to ask on M&A. Like you kind of always talked about getting more aggressive with M&A once the market stabilize, which it seems like 2023 is a year where we're in a much more, I quote, "almost a normal market". So that's -- willing us to do something on M&A that can maybe move the needle a bit more and more adjacent to the portfolio versus some of the things you've been doing historically, with your more smaller private stuff in S.E.T.?

好的。不，那是有用的顏色。然後 - 布萊恩，我想問一下併購問題。就像你總是談論一旦市場穩定下來就更積極地進行併購，我引用的話，似乎 2023 年是我們處於“幾乎正常市場”的一年。所以這就是——我們是否願意在併購方面做一些事情，這可能會使針頭越來越接近投資組合，而不是你過去一直在做的一些事情，在 S.E.T. 中使用你更小的私人東西？

Yes. So first of all, I want to be careful what I say because it's a pretty competitive space right now. We don't want to telegraph too much what we want to do. But clearly, we, as an organization, are squarely in the Phase 3 of our transformation. And we, Travis, have been very clear that Phase 3 is all around active portfolio management, to transform the portfolio, shifting toward more WAMGR accretive markets and diversifying our business. So that's kind of a broad-based way of looking at what Phase 3 is all about for our company. And we've already made some changes here. I know you're saying there's been smaller acquisitions that we've done, but we haven't had as much firepower, obviously. But we have spun businesses out as well that have helped in this strategy.

是的。所以首先，我要小心我說的話，因為現在這是一個競爭非常激烈的領域。我們不想傳達太多我們想做的事情。但顯然，作為一個組織，我們正處於轉型的第 3 階段。我們 Travis 非常清楚，第 3 階段圍繞積極的投資組合管理，轉變投資組合，轉向更多 WAMGR 增值市場並使我們的業務多樣化。因此，這是一種廣泛的方式來看待我們公司的第 3 階段的全部內容。我們已經在這裡做了一些改變。我知道你是說我們已經完成了較小的收購，但顯然我們沒有那麼多的火力。但我們也分拆了有助於實施這一戰略的業務。

That said, COVID is getting behind us. There's no question. And as a result, just exactly the way you're saying, we would expect to have more strategic flexibility going forward. What I'd probably be willing to say, and maybe not give any more detail, is that we're going to look at vetting assets across a few metrics outside of the typical financial metrics. We look at mission centricity. We've got to make sure that we're acquiring something that can move the mission. We want absolutely something that can drive WAMGR accretion for our organization, and it's going to translate into revenue growth that's accretive. Because just because you're in a fast-growth market, if you don't have a good asset, you don't necessarily get the growth rate out of it, and it's got to accelerate our EPS growth over time, because that's kind of the vetting.

也就是說，COVID 正在落後於我們。毫無疑問。因此，正如你所說的那樣，我們希望未來有更多的戰略靈活性。我可能願意說的，也許不會提供更多細節的是，我們將通過典型財務指標之外的幾個指標來審查資產。我們著眼於以任務為中心。我們必須確保我們正在獲得可以推動任務的東西。我們絕對想要一些可以推動我們組織的 WAMGR 增長的東西，它將轉化為增加的收入增長。因為僅僅因為你處於一個快速增長的市場，如果你沒有好的資產，你不一定能從中獲得增長率，而且隨著時間的推移它必須加速我們的 EPS 增長，因為那很好的審查。

And then the categories that we're going to look at would be, first and foremost, probably closest to the best, would be vast growth subcategories of recon. So that would be things like data, robotics or building more scale in the ASC setting, like we were talking about just a minute ago. It would be faster growth areas outside of recon, but still in orthopedics, and that would be mainly in our S.E.T. category. So that diversifies our business away from just recon in those faster-growth subcategories of orthopedics.

然後，我們首先要研究的類別可能最接近最佳類別，將是偵察的巨大增長子類別。因此，這將是數據、機器人技術或在 ASC 環境中建立更大規模的東西，就像我們一分鐘前談論的那樣。這將是偵察以外增長更快的領域，但仍在骨科領域，而且主要是在我們的 S.E.T.類別。因此，這使我們的業務多樣化，而不僅僅是在那些增長較快的骨科子類別中進行偵察。

And then to your point, attractive white spaces that are completely out of orthopedics, less selective in nature and provide more diversification, again, out of orthopedics. I don't want to say which of those we're going to prioritize, but just know that all of those vectors are on the table, and we're looking at a number of assets in each of those categories.

然後就您的觀點而言，有吸引力的白色空間完全不屬於骨科領域，本質上選擇性較低，並且提供了更多的多樣化，同樣，在骨科領域之外。我不想說我們將優先考慮哪些，但只知道所有這些向量都在桌面上，我們正在研究每個類別中的許多資產。

We'll take our next question from Robbie Marcus with JPMorgan.

我們將接受 JPMorgan 的羅比馬庫斯的下一個問題。

Congrats on a good quarter. Maybe to start, Bryan, I'd love to hear a little bit more about what you're seeing on the capital equipment environment. I know it's a smaller overall component for Zimmer Biomet. But you talked about lower capital sales in the quarter. It sounded like it was a bit more placement versus upfront sales. But any color on ROSA, what you're seeing if it's different U.S. versus U.S.? And how you expect that to trend going forward over the next 12, 18 months?

祝賀一個好的季度。也許首先，布萊恩，我想多聽聽你在資本設備環境中看到的情況。我知道這是 Zimmer Biomet 的一個較小的整體組件。但是你談到了本季度較低的資本銷售。聽起來它更多的是展示位置而不是前期銷售。但是 ROSA 上的任何顏色，如果美國與美國不同，您會看到什麼？您預計未來 12、18 個月的趨勢如何？

Yes. I'll make some comments and then Ivan can correct anything I say incorrectly. But no, clearly, capital is not as big a component for us. So I almost don't like talking about the capital market because I don't want to say anything that's going to hurt those businesses that depend more on the capital market. But from our perspective, where we do focus on it, it hasn't been a major barrier for us. Again, we really focus on, from a ROSA perspective, trying to place through agreements that allow for payment for the ROSA system through commitments and increased business. Consider a leasing arrangement, but the leasing payment is actually a commitment of business. That is what we focus on, and we did more of those in the quarter, and that's a good thing for our business. But we do have opportunities to continue to sell, and we do not feel, at this point anyway, serious constraints in the capital market when it comes to ROSA. But maybe, Ivan, if you've got any further color to provide around that, you can help as well.

是的。我會發表一些評論，然後 Ivan 可以糾正我說的不正確的地方。但不，很明顯，資本對我們來說並不是一個重要的組成部分。所以我幾乎不喜歡談論資本市場，因為我不想說任何會傷害那些更依賴資本市場的企業的話。但從我們的角度來看，在我們確實關注它的地方，它並不是我們的主要障礙。同樣，從 ROSA 的角度來看，我們真正專注於嘗試通過允許通過承諾和增加業務來支付 ROSA 系統的協議。考慮租賃安排，但租賃付款實際上是企業的承諾。這就是我們關注的重點，我們在本季度做了更多的事情，這對我們的業務來說是一件好事。但我們確實有機會繼續出售，無論如何，在這一點上，我們並不覺得資本市場對 ROSA 有嚴重的限制。但也許，伊万，如果你有任何進一步的顏色可以提供，你也可以提供幫助。

Absolutely, Bryan. I'm pretty sure that correcting my boss publicly is a bad career move. So I'm not going to correct him. Mr. Bryan, your answer is very right. The only thing I'll add is that it is really a global performance. So 50% of the installations are in the U.S., 50% are o U.S., as I referenced earlier, around 30% of are robots are going to the ASC and that segment is growing, and we've seen exciting momentum with the hip software. So I would say, all in all, our robotic installations placement sales are in line. They continue to move in the right direction. And as we enter Q4, we're very excited about where we are from a ROSA standpoint.

當然，布萊恩。我很確定公開糾正我的老闆是一個糟糕的職業舉動。所以我不打算糾正他。布賴恩先生，您的回答非常正確。我唯一要補充的是，它確實是一場全球表演。因此，50% 的安裝在美國，50% 在美國以外，正如我之前提到的，大約 30% 的機器人將進入 ASC，並且該部分正在增長，我們已經看到了時髦軟件令人興奮的勢頭.所以我想說，總而言之，我們的機器人安裝安置銷售符合要求。他們繼續朝著正確的方向前進。當我們進入第四季度時，從 ROSA 的角度來看，我們對我們所處的位置感到非常興奮。

Great. Maybe as a follow-up, I think, Bryan, you said last quarter, extremities grew double digits. This -- a little less visibility in this line item. Anything you could give us on extremities? I know sports medicine has the HA reimbursement changes, so that there's some pressure there. But any color on what we're seeing in extremities versus trauma and sports and how that might shake out U.S., APAC, EMEA?

偉大的。也許作為後續行動，我認為，布萊恩，你上個季度說過，四肢增長了兩位數。這 - 在此行項目中的可見度稍低。關於四肢，你能給我們什麼嗎？我知道運動醫學有 HA 報銷變化，所以那裡有一些壓力。但是我們在四肢與創傷和運動中看到的任何顏色以及這可能如何撼動美國、亞太地區、歐洲、中東和非洲？

Yes, no problem. So maybe just as a quick reminder for everybody. When we think about our S.E.T. businesses, and there's really no proxy for S.E.T. in other businesses, because we have different categories in it than others would probably consider. We have the upper extremities business inside of S.E.T. trauma; CMFT, which is our craniomaxillofacial and thoracic business; sports; separate from sports would be restorative therapies; and then foot and ankle. Those are the categories that we manage across the S.E.T. categories. The pressure that you were talking about in restorative therapies would be separate from sports, but it's still in the S.E.T. categories.

是沒有問題。所以也許只是對每個人的快速提醒。當我們想到我們的 S.E.T.企業，而且真的沒有 S.E.T. 的代理人。在其他業務中，因為我們的類別與其他人可能會考慮的不同。我們在 S.E.T. 內部有上肢業務。創傷; CMFT，這是我們的顱頜面和胸部業務；運動的;與運動分開的是恢復療法；然後是腳和腳踝。這些是我們在整個 S.E.T. 管理的類別。類別。你所說的恢復療法中的壓力與運動是分開的，但它仍然存在於 S.E.T.類別。

The pressure that you were talking about in restorative therapies would be separate from sports, but it's still in the S.E.T. category. On areas that we really focus and invest in our growth drivers would be upper extremities, CMFT and sports. It doesn't mean the other businesses aren't important, they just don't get the same level of resourcing at this point. And those 3 that we do concentrate on, did have another good quarter. And if I look at all 3 of them, without giving specifics, I would say they ranged anywhere from mid-single digits to double-digit growth again this quarter. So in the areas where we're concentrating, there's no question that we're getting the performance in the field. A lot of that has to do with commercial infrastructure and then the incremental support that we're giving in research and development to those areas. And of course, the acquisitions that we've been tucking in to drive a more fulsome portfolio.

你所說的恢復療法中的壓力與運動是分開的，但它仍然存在於 S.E.T.類別。我們真正關注並投資於我們增長動力的領域是上肢、CMFT 和運動。這並不意味著其他業務不重要，他們只是在這一點上沒有獲得同等水平的資源。而我們關注的那三個，確實有另一個好的季度。如果我看一下這 3 個，但沒有給出具體細節，我會說本季度它們的增長范圍從中等個位數到兩位數。因此，在我們專注的領域，毫無疑問我們正在獲得該領域的表現。這在很大程度上與商業基礎設施有關，然後是我們在這些領域的研發中提供的增量支持。當然，我們一直在進行收購以推動更豐富的投資組合。

What you're seeing relative to pressure in the quarter for the global S.E.T. business, it really has more to do with what Suky said in the prepared remarks around Asia Pacific pressure and trauma, mainly associated with VBP, which we'll reverse next quarter. And then that restored therapies pressure from a reimbursement change in G1. And unfortunately, that will carry through to the middle of 2023 or so.

您所看到的與本季度全球 S.E.T. 壓力相關的情況業務，這實際上與 Suky 在準備好的有關亞太地區壓力和創傷的評論中所說的更多有關，主要與 VBP 有關，我們將在下個季度扭轉這一局面。然後恢復了 G1 報銷變化帶來的治療壓力。不幸的是，這將持續到 2023 年中期左右。

We'll go next to Joanne Wuensch with Citibank.

接下來我們將去花旗銀行的 Joanne Wuensch。

I wonder if you can step back a little bit and talk about the orthopedics markets, what you're viewing as maybe changes or no changes in the competitive landscape, maybe something in physician practices, pricing. Or generally, what you think of as sort of the state of the union.

我想知道你是否可以退後一步談談骨科市場，你所看到的競爭格局可能發生變化或沒有變化，也許是醫生實踐和定價方面的變化。或者一般來說，你認為的某種工會狀況。

That's a great question. It's an interesting question. I think what I'll probably do is, again, maybe start off on some of the things that I'm seeing that I think are interesting. And then Ivan, Suky, Keri, anybody who wants to add anything, because I think it's a really interesting question. It's a good one. My view in part the thing that I like the most that I'm seeing, kind of state of the union that you're saying, is just the rapid adoption in open arms that I'm seeing from an orthopedics customer perspective to technology.

這是一個很好的問題。這是一個有趣的問題。我想我可能會做的是，再一次，也許從我看到的一些我認為有趣的事情開始。然後是 Ivan、Suky、Keri，還有任何想補充的人，因為我認為這是一個非常有趣的問題。這是一個很好的。我的部分觀點是我最喜歡看到的東西，你所說的那種聯盟狀態，只是我從骨科客戶的角度到技術看到的張開雙臂的迅速採用。

There was a lot of question marks in my mind coming over to orthopedics on whether or not that transition could truly occur. We saw it with Mako obviously in robotics, but we're bringing a lot of other technologies to bear. And I've been very excited to see all companies kind of doubling down on the technology front, robotics and data. We're all moving in that direction. And I'm hearing from our customer base that they're looking for it and, very importantly, willing to pay for the value that it brings.

關於這種轉變是否真的會發生，我的腦海裡有很多問號轉向骨科。我們顯然在機器人技術中看到了 Mako，但我們正在引入許多其他技術。我很高興看到所有公司都在技術前沿、機器人技術和數據方面加倍努力。我們都在朝著那個方向前進。我從我們的客戶群那裡聽說他們正在尋找它，而且非常重要的是，他們願意為它帶來的價值付出代價。

That's really important because if that type of innovation comes into a marketplace, particularly in medtech, it usually doesn't leave. And when you do bring that kind of technology, it is more sticky than previous technology, and it does have the ability to impact pricing dynamics. Because the more technology that has stickiness to it, the longer the term contracts and the better stability you have in pricing. And you also get this benefit of increased, let's call it, share of wallet or mix for every procedure. So if you can bring technology in to the very same procedure you had yesterday, you get more revenue for that procedure.

這真的很重要，因為如果這種類型的創新進入市場，特別是在醫療技術領域，它通常不會離開。當你真正引入那種技術時，它比以前的技術更具粘性，而且它確實有能力影響定價動態。因為對它有粘性的技術越多，合同期限越長，定價的穩定性就越好。而且您還可以獲得增加的好處，讓我們稱之為，錢包份額或每個程序的組合。因此，如果您可以將技術引入與昨天完全相同的程序中，您將從該程序中獲得更多收入。

And as we see that adoption continue to move up of things like robotics and data or cementless technologies in knee, that actually allows a mix benefit for the entire market, and that could buoy the overall market growth rate. Taking pricing stability, moving that forward, bringing more revenue per procedure, that has a real positive effect for the overall orthopedic space. And so that's a dynamic that's happening real time, that's pretty exciting in my view anyway. But I'll open it up to anyone else if you want to add anything.

正如我們所看到的那樣，機器人和數據或無骨水泥技術在膝蓋中的採用率繼續上升，這實際上為整個市場帶來了混合效益，這可能會提振整體市場增長率。保持定價穩定，向前推進，為每個手術帶來更多收入，這對整個骨科領域具有真正的積極影響。所以這是一種實時發生的動態，無論如何在我看來這非常令人興奮。但如果您想添加任何內容，我會向其他人開放。

Maybe quickly here, Bryan, I'll just recap some of what you said in 4 bullet points here. Number one, as it was mentioned earlier, the shift of care on to the ASC and frankly, in some cases, something getting on a home like physical therapy, is real. No longer it's all about the inpatient unit, there's a real shift of care again to ASC. And then post-surgery, some of the stuff getting down a home. So that's number one.

也許很快，Bryan，我將在這裡用 4 個要點重述你所說的一些內容。第一，正如前面提到的，將護理轉移到 ASC 上，坦率地說，在某些情況下，像物理治療這樣的事情在家裡進行是真實的。不再只是住院病房，真正的護理再次轉移到 ASC。然後是手術後，一些東西被帶回家了。所以這是第一。

Number two, clearly, the decision maker is not just the physician or the provider. The patient plays a role, that's why we're excited the best technologies that we're launching that directly target consumers, patients. So it's not only just the physician and provider, it's basically physician, provider and payer. Some of the data and the technology that Bryan is talking about becomes really a powerful tool for us to engage payers in demonstrating that we are not just a solid clinical value proposition, but also an economic value proposition.

第二，很明顯，決策者不僅僅是醫生或提供者。患者扮演著重要角色，這就是為什麼我們對我們推出的直接針對消費者和患者的最佳技術感到興奮。所以它不僅僅是醫生和提供者，它基本上是醫生、提供者和付款人。 Bryan 談論的一些數據和技術確實成為我們吸引付款人證明我們不僅是一個可靠的臨床價值主張，而且還是一個經濟價值主張的強大工具。

Number three, and I think this is aligned with the pricing story, there is an emphasis in discussing value just as much as pricing. Some of the discussions that we're having today around length of stay, reducing length of stay, some of the discussions we're having around lowering readmission rates, increasing patient satisfaction, having a shorter surgery with the same outcomes were not discussions that were happening maybe 3 years ago, and they're happening right now.

第三，我認為這與定價故事是一致的，重點是討論價值和定價一樣多。我們今天圍繞住院時間、縮短住院時間進行的一些討論，我們圍繞降低再入院率、提高患者滿意度、縮短手術時間並獲得相同結果進行的一些討論都不是討論可能發生在 3 年前，現在正在發生。

And then number four, the role of innovation. I've been in medtech for 28 years. I was working in orthopedics 15 years ago. When I rejoined or when I joined orthopedics again 4 years ago, I would say that things were pretty much the same, net of a couple of robotic introductions. Over the last 3, 4 years, we've seen a lot of innovation coming to orthopedics in mixed reality, in infection management, in bringing in machine learning, really thinking about the entire (inaudible). So I would say those are the 4 key things that we pay attention to, and we think we'll have a competitive advantage in those areas.

然後是第四，創新的作用。我在醫療技術領域工作了 28 年。 15 年前我在骨科工作。當我重新加入或當我 4 年前再次加入骨科時，我會說事情幾乎是一樣的，只是引入了幾個機器人。在過去的 3、4 年裡，我們看到骨科在混合現實、感染管理、引入機器學習方面有很多創新，真正考慮到整個（聽不清）。所以我想說這些是我們關注的 4 個關鍵問題，我們認為我們將在這些領域擁有競爭優勢。

We'll take our next question from Richard Newitter with Truist Securities.

我們將從 Truist Securities 的 Richard Newitter 那裡回答我們的下一個問題。

I wanted to just follow up, first, Bryan, on what you were talking about on kind of some of the pricing opportunities you mentioned with new technology. Mixed reality, smart implants, I'm curious, within the buckets of mixed, the ability just to preserve your pricing as contracts roll off,and discrete opportunities to charge for some of these newer areas, particularly on that third bucket, can you give some examples of where these new technologies might be able to fall into that third category? Or which of those buckets should we expect more of the pricing impact from?

首先，布萊恩，我想跟進你所說的關於你提到的新技術的一些定價機會。混合現實，智能植入，我很好奇，在混合的範圍內，隨著合同的結束而保持定價的能力，以及對這些新領域中的一些，特別是第三個領域收費的離散機會，你能給這些新技術可能屬於第三類的一些例子？或者我們應該期待哪些桶的價格影響更大？

Yes. It's -- make sure that I understand your question specifically. But when I think about the innovation that we're bringing -- and not just us, by the way. That's what I like about it, there's momentum across the entire orthopedic space and all the major players moving in this direction. I think, in certain areas, we're ahead. But make no mistake, everyone is moving in this direction. So if I just take a couple of examples and hopefully this will answer the question that you're asking.

是的。它是-- 確保我明確理解你的問題。但是，當我想到我們正在帶來的創新時——順便說一句，不僅僅是我們。這就是我喜歡它的地方，整個骨科領域都有動力，所有主要參與者都朝著這個方向前進。我認為，在某些領域，我們領先。但不要誤會，每個人都在朝著這個方向前進。所以，如果我只舉幾個例子，希望這會回答你問的問題。

Think about mymobility, for instance, which is one of the first launches that we had in data collection, leveraging the relationship that we have with Apple. This uses an Apple Watch to collect data and then ultimately uses machine learning to be able to do some predictive analysis. And we're actually now looking at that through an opportunity to tell a surgeon and the patient when they're falling out of the norm for recovery, okay? So that's the type of thing that we're able to do. And we do sell that. So there's an opportunity to monetize that application.

例如，考慮一下 mymobility，這是我們在數據收集方面的首批發布之一，利用了我們與 Apple 的關係。這使用 Apple Watch 收集數據，然後最終使用機器學習來進行一些預測分析。實際上，我們現在正在通過一個機會來了解這一點，告訴外科醫生和患者他們何時不符合恢復標準，好嗎？這就是我們能夠做的事情。我們確實賣掉了。所以有機會通過該應用程序獲利。

So it's not just giving it to them and getting pull-through of implants, it certainly is getting the pull-through of implants because you get that natural gravitational pull once you bring technology in, but there's also a discrete way of making money or monetizing that mymobility application. So that's one example. Another example is robotics. I mean robotics comes in, you get that natural gravitational pull for competitive surgeons to come over, but you also get an uplift every time they use a robotic procedure because you get the uptick in disposable value. So that procedure now cost more for the account to do, but you get the benefit of robotics inside of that. So it's a fair trade.

所以這不僅僅是給他們並獲得植入物的拉動，它肯定是獲得植入物的拉動，因為一旦你引入技術，你就會獲得自然的引力，但也有一種獨立的賺錢或貨幣化方式mymobility 應用程序。這就是一個例子。另一個例子是機器人。我的意思是機器人技術的出現，你會得到自然引力讓有競爭力的外科醫生過來，但每次他們使用機器人手術時你也會得到提升，因為你的一次性價值增加了。因此，該程序現在需要花費更多的帳戶來完成，但您可以從中獲得機器人技術的好處。所以這是一個公平的交易。

Those are 2 examples of the way technology is leaning in, in that way. Same thing with Persona iQ. That's the first smart implant that will be on the market. It's collecting data in a very compliant way because you can't take it off, right? They're nonstop for the patient. And that will also drive a premium in the marketplace. So if you're going to use Persona IQ, you're going to pay discretely for that, that sensor capability, and that's the way we're monetizing this.

這些是技術以這種方式傾斜的兩個例子。 Persona iQ 也是如此。這是第一個將投放市場的智能植入物。它以一種非常合規的方式收集數據，因為你無法將其取下，對吧？他們不間斷地為病人服務。這也將推動市場溢價。因此，如果你打算使用 Persona IQ，你將為此支付離散費用，即傳感器功能，這就是我們將其貨幣化的方式。

So you could see a combination of things where we monetize the technology or sometimes it just brings value that is unique to us, that would allow us to pull in additional implants. But it's some combination of those 2 things. And again, Ivan, if you wanted to add anything else, or Suky or anybody else.

所以你可以看到我們將技術貨幣化的事情的組合，或者有時它只是為我們帶來獨特的價值，這將使我們能夠引入額外的植入物。但它是這兩件事的某種組合。再說一次，Ivan，如果你想添加任何其他內容，或者 Suky 或其他任何人。

I think you've done a very good job, Bryan. We can get our next question.

我認為你做得很好，布賴恩。我們可以得到下一個問題。

Great. And just on Persona IQ, it seems like the infection prevention capability or the ability to detect the infection before it occurs, that's probably going to be the killer app for a product like that, that will allow you to get that kind of premium. I guess, what should we think of timelines on the data collection to be able to get an approval for infection prevention indication?

偉大的。就 Persona IQ 而言，它似乎具有感染預防能力或在感染髮生之前檢測到感染的能力，這可能會成為此類產品的殺手級應用，讓您獲得那種溢價。我想，我們應該如何看待數據收集的時間表才能獲得感染預防適應症的批准？

What I've learned over the years is committing to timelines in a situation like this is always a bad idea. What I can say is that we are absolutely sprinting and using our limited launch focused on getting users that will use significant quantities and be able to collect data with us so that we can ultimately look for different ways of providing insights that will matter to our customers. The things that we want to focus on first would be, what are those things that we could predict that will obviously be good for the patient, but also derail the cost associated with caring for the patients, so reduce the cost of caring for the patients.?

多年來我學到的是，在這種情況下遵守時間表總是一個壞主意。我能說的是，我們絕對是衝刺並使用我們有限的發布，專注於讓用戶大量使用並能夠與我們一起收集數據，以便我們最終可以尋找不同的方式來提供對我們的客戶重要的見解.我們首先要關注的事情是，我們可以預測哪些事情顯然對患者有好處，但也會降低與照顧患者相關的成本，從而降低照顧患者的成本.?

And in infection is great. If you could get there, that's fantastic. If we could predict a risk of infection before it occurs, that would be fantastic. Certainly, something that we're going to be looking to do, but it doesn't happen very often. So you just think about the power, the number of patients you're going to have to have and the amount of data, it's going to take us a little longer to get there. What we're also going to be looking at though is just loosening, which also happens. Can we predict loosening before it happens? You're looking at stiffening. There are certain things you've got to do from a stiffening perspective that if we can get out ahead of, we can reduce the amount of care that needs to be provided to the patient.

而且感染力很大。如果你能到達那裡，那就太棒了。如果我們能夠在感染髮生之前預測到感染風險，那就太好了。當然，這是我們想要做的事情，但它不會經常發生。所以你只要想想力量，你必須擁有的患者數量和數據量，我們需要更長的時間才能到達那裡。不過，我們還將關注的只是放鬆，這也會發生。我們能在鬆動發生之前預測它嗎？你正在看硬化。從僵硬的角度來看，您必須做一些事情，如果我們能夠提前行動，我們就可以減少需要為患者提供的護理量。

So there's a lot of other things that we're looking at to try to predict that will derail the cost or reduce the cost of caring for the patient and make sure for better outcomes for the patient. So I don't want people to get hyper focused on infection. It's something that we're going to pursue. It will take longer. But the real goal right now is to be able to look at the data that we're collecting, which is significant already and then be able to derive those insights that will change the way we care for our patient. Once we get to those, we can define those, that will really begin to bolster that value proposition that we have for the product and be able to support a higher price point for Persona iQ.

因此，我們正在研究許多其他事情，試圖預測這些事情會降低成本或降低患者護理成本，並確保為患者帶來更好的結果。所以我不希望人們過分關注感染。這是我們要追求的東西。這將需要更長的時間。但現在真正的目標是能夠查看我們正在收集的數據，這些數據已經很重要，然後能夠得出那些將改變我們護理患者方式的見解。一旦我們得到這些，我們就可以定義它們，這將真正開始支持我們對產品的價值主張，並能夠支持更高的 Persona iQ 價格點。

We'll take our next question from Jeff Johnson with Baird.

我們將與 Baird 一起接受 Jeff Johnson 的下一個問題。

Bryan, maybe even building further out on this pricing discussion. I think it's all interesting stuff. And the premiums you can get on new technologies, on sensor-based technologies, moving that mix higher and all that, that all makes sense. I'm more interested or equally interested, I guess, I should say, on kind of your base business. I don't know what your Vitality Index is right now, but let's say, 70% or 80% of your revenue is generated on products that are a few years or older in the portfolio, where are hospitals that in understanding that they can't keep extracting 2 or 3 points of price even out of those base products every single year, if you're going to continue to invest and develop this new technology in that? Or are those conversations with hospitals improving at all in this -- especially in this inflationary environment?

布賴恩，甚至可能進一步討論這個定價討論。我認為這都是有趣的事情。你可以從新技術、基於傳感器的技術中獲得溢價，將混合技術提高等等，這一切都是有道理的。我想，我應該說，我對你的基本業務更感興趣或同樣感興趣。我不知道你現在的活力指數是多少，但假設你的收入的 70% 或 80% 來自產品組合中幾年或更早的產品，哪裡有醫院了解他們可以如果你打算繼續投資和開發這項新技術，每年都不會從這些基礎產品中提取 2 或 3 個點的價格嗎？或者在這方面與醫院的對話是否有所改善——尤其是在這種通貨膨脹的環境中？

Yes. Probably what I'll do is, I'll turn this one over to Suky because we don't look at pricing just through one vector, one lens. There's multiple variables that we have in that equation that we think are going to benefit the company going forward. But maybe, Suky, you could talk about the variables that we do look at when we think about pricing, and I know, Ivan, probably have some color as well you want to provide.

是的。我可能會做的是，我會把這個交給 Suky，因為我們不會僅僅通過一個向量、一個鏡頭來考慮定價。我們在這個等式中有多個變量，我們認為這些變量將使公司向前發展。但也許，Suky，你可以談談我們在考慮定價時確實考慮的變量，我知道，Ivan，你可能也想提供一些顏色。

Yes. So we do think overall that this can help pricing discussions. They're becoming much more strategic in nature and more centered around value. We're not completely there where we want to be, but we're starting the dialogue more around value versus just straight price and transactions. But maybe, Ivan, do you want to talk a little bit because I know you've got some real-world experience.

是的。因此，我們確實認為總體而言，這有助於定價討論。它們在本質上變得更具戰略性，並且更加以價值為中心。我們還沒有完全達到我們想要達到的目標，但我們開始更多地圍繞價值而不是直接的價格和交易展開對話。但也許，伊万，你想談談嗎，因為我知道你有一些現實世界的經驗。

Yes, absolutely. It's a real discussion. It's happening, Jeff, in pretty much every country. As you think about our Vitality Index, there is a direct correlation between improvements in Vitality Index, percentage of sales coming from new products and stability around price. And it may not be mixed, the product launch itself that you launch in a given year. But as you launch, as an example, Persona iQ, that creates a category contracting opportunity where we contract that for the rest of the portfolio in Knees, they've got to keep a certain price. And again, that is a real discussion, one very real example of how we think about it. We do that in Knees. We do that in Hips, across the board. So again, a very direct correlation between new product introductions, Vitality Index and keeping the price premiums for the product a couple of years later, but also for the category of products in a given space.

是的，一點沒錯。這是一場真正的討論。傑夫，幾乎每個國家都在發生這種情況。當您考慮我們的活力指數時，活力指數的改善、來自新產品的銷售額百分比和價格穩定性之間存在直接關聯。而且它可能不會混合，您在給定年份推出的產品會自行推出。但是當你推出時，例如，Persona iQ，它創造了一個類別承包機會，我們為 Knees 的其餘投資組合承包，他們必須保持一定的價格。再一次，這是一場真實的討論，是我們如何思考它的一個非常真實的例子。我們在膝蓋中這樣做。我們在 Hips 全面這樣做。因此，新產品推出、活力指數與幾年後保持產品價格溢價之間存在非常直接的相關性，而且與給定空間中的產品類別也存在非常直接的相關性。

Yes, that's helpful. And then maybe just a follow-up, and I think Suky, it's probably for you. But as I think about this placement strategy with ROSA, kind of how the market has shifted over the last 6 to 12 months to more of a placement strategy, and it sounds like that's probably going to continue at least for the foreseeable future. When do we get that crossover where the minimum purchase commitments, maybe the minimum price points, things like that, that are guaranteed in those contracts, those start to outweigh on the good guy side, versus I'm sure, which are some upfront costs you're having to eat here on this placement strategy, and it's probably not helpful in the very short run on the margins, things like that? So just when does that crossover happen that the longer tail of those positives really start to kick in?

是的，這很有幫助。然後可能只是跟進，我想 Suky，這可能是給你的。但當我考慮 ROSA 的這種安置策略時，市場在過去 6 到 12 個月內如何轉變為更多的安置策略，這聽起來至少在可預見的未來可能會持續下去。我們什麼時候才能獲得最低購買承諾的交叉點，也許是最低價格點，諸如此類，在這些合同中得到保證，這些合同開始超過好人方面，我敢肯定，這是一些前期成本您不得不在這裡吃這個放置策略，它可能在很短的時間內沒有幫助，諸如此類？那麼這種交叉是什麼時候發生的，那些積極因素的長尾真正開始發揮作用呢？

I'll start with it and turn over to Ivan. You're thinking about it the right way, right? Upfront here, there is some investment relative to those placements because we start that depreciation, and you really haven't ramped up that overall growth commitment. We're still in the early innings on that. But maybe, Ivan, do you want to talk a little bit?

我將從它開始，然後交給 Ivan。你正在以正確的方式思考它，對吧？在這裡，有一些與這些配售相關的投資，因為我們開始貶值，而你真的沒有提高整體增長承諾。我們仍處於早期階段。但也許，伊万，你想談談嗎？

I would say, the governance when it comes to robotics is second to none. So when we do install place our robotic unit in any center globally, there is a minimum commitment of cases that the center has to perform where we take the unit back. One reason is financial. The other reason, perhaps more important, is from a compliance standpoint, giving fair market value exchanges, we cannot have capital equipment in centers that are not delivering on the contracted number of cases. That's why we keep talking about, how we prefer to place units versus semi units, so we get the annuity.

我想說，機器人技術的治理是首屈一指的。因此，當我們在全球任何中心安裝我們的機器人單元時，中心必須執行的案例最少，我們將單元取回。一個原因是財務上的。另一個可能更重要的原因是，從合規的角度來看，給予公平的市場價值交換，我們不能在沒有交付合同規定的案件數量的中心擁有資本設備。這就是為什麼我們一直在談論，我們更喜歡放置單位而不是半單位，所以我們得到了年金。

On the other side of the question, as we think about those cases, there is also a governance around disposables. There is 0 latitude when it comes to pricing discounts on the disposables, the peripheral items that are part of that robotic case. So again, I would say that the robotic governance is second to none, and really early innings here in terms of where we are in the journey.

在問題的另一方面，當我們考慮這些案例時，也存在圍繞一次性用品的治理。在一次性用品（屬於機器人外殼的外圍物品）的定價折扣方面，沒有任何自由度。所以，我要說的是，機器人治理是首屈一指的，而且就我們在旅程中所處的位置而言，這裡確實處於早期階段。

Yes. Thanks for the question. Yes, I think operator we have time for maybe one more.

是的。謝謝你的問題。是的，我認為接線員我們還有時間再談一次。

We'll take our next question from Matthew O'Brien with Piper Sandler.

我們將與 Piper Sandler 一起接受 Matthew O'Brien 的下一個問題。

Just -- and maybe I'll just stick with one. And Bryan, I just want to put a finer point on this top line number that you're talking about for next year. First of all, is that 4% kind of the floor that you're thinking about for the business next year? And just as I think about the components that you're talking about between VBP and pricing and ASCs, et cetera, it just seems like the environment for Hips and Knees specifically is going to get more robust or really levered 2 Hips and Knees. So why wouldn't 4% be the floor? And is there potential for some meaningful upside to that as we head into next year?

只是 - 也許我會堅持使用一個。布萊恩，我只想對你談論的明年的這個頂線數字提出一個更好的觀點。首先，您明年為業務考慮的底線是 4% 嗎？正如我在考慮您在 VBP 和定價以及 ASC 等之間談論的組件一樣，似乎 Hips 和 Knees 的環境特別會變得更加穩健或真正槓桿化 2 個 Hips 和 Knees。那麼，為什麼 4% 不是最低限度呢？當我們進入明年時，是否有可能對此產生一些有意義的好處？

The positive news is that's the question I'm getting, not a question of whether we could deliver the 4%. So we're making progress there. I would say that I still think that, as I talked about before, there are a lot of headwinds that we have to pay attention to. And so I don't want to say that -- first of all, we're giving more color than we would ever give in a normal year, just given all the challenges that everybody is facing, trying to help you out here. But I would say, 4% is a number that I'm saying is doable, we see a pathway to 4%. But make no mistake that there are challenges that are out in the market, macro challenges, not things that are internal to our own organization, that could stress that. And there are opportunities from a macro perspective that we just talked about that could also help that.

好消息是，這就是我得到的問題，而不是我們是否可以交付 4% 的問題。所以我們正在那裡取得進展。我要說的是，我仍然認為，正如我之前所說，我們必須注意很多不利因素。所以我不想這麼說——首先，我們提供了比正常年份更多的顏色，只是考慮到每個人都面臨的所有挑戰，試圖在這裡幫助你。但我要說的是，4% 是一個可行的數字，我們看到了達到 4% 的途徑。但請不要誤會，市場上存在挑戰，宏觀挑戰，而不是我們自己組織內部的挑戰，這可能會強調這一點。從我們剛才談到的宏觀角度來看，也有機會可以幫助實現這一目標。

So we're trying to take a balanced view of what could happen, positive or negative, to what we think organically we can do in 2023. And that's the reason why, I would say for, 4% you should not consider a floor. 4%, you should consider a good way to look at, all things considered, a fair way to look at growth in 2023. And by the way, if 2023 was just a normal year and we didn't have all these noises, we believe that 4% is about the right way to think about our business. Given all the portfolio moves that we've made, the WAMGR improvements that we've made, the innovation flywheel that we're now moving, we believe that's what we deserve.

因此，我們正試圖平衡地看待我們認為 2023 年可以做的事情，無論是積極的還是消極的。這就是為什麼我要說 4% 的人不應該考慮下限。 4%，你應該考慮一個很好的方式來看待，所有的事情都考慮到，一個公平的方式來看待 2023 年的增長。順便說一下，如果 2023 年只是一個正常的年份並且我們沒有所有這些噪音，我們相信 4% 是思考我們業務的正確方式。考慮到我們所做的所有投資組合舉措、我們所做的 WAMGR 改進、我們現在正在推動的創新飛輪，我們相信這是我們應得的。

Could we do more than that? Certainly. Particularly as we start to continue to move our active portfolio management strategy, we have more financial flexibility, and we continue to move that weighted average market growth rate north. But I don't want people thinking that I mean 4% as a floor. I didn't mean to attend that.

我們還能做更多嗎？當然。特別是當我們開始繼續推進我們積極的投資組合管理策略時，我們擁有更大的財務靈活性，並且我們繼續將加權平均市場增長率向北移動。但我不希望人們認為我的意思是 4% 作為底線。我不是故意要參加那個的。

All right. Operator, I think we're a little past 9:30, unless there's any closing remarks. So Bryan, anything you'd add, we're probably good to end the call.

好的。接線員，我想我們已經過了 9:30 了，除非有任何結束語。所以布萊恩，無論你添加什麼，我們都可以結束通話。

Yes. I'd probably just add, I think I want people to continue to focus on the transformation that has occurred at Zimmer Biomet. We've been extremely disciplined in our portfolio decisions. And portfolio to me is in all aspects of the business. We are biasing our spend, whether it be research and development, commercial infrastructure, the way we compensate people in active portfolio management through M&A, on ensuring that we're increasing the weighted average market growth of our business and diversifying our business over time.

是的。我可能只是補充說，我想我希望人們繼續關注 Zimmer Biomet 發生的轉變。我們在投資組合決策方面一直非常自律。對我來說，投資組合涉及業務的各個方面。我們正在調整我們的支出，無論是研發、商業基礎設施，還是我們通過併購補償積極投資組合管理人員的方式，以確保我們增加我們業務的加權平均市場增長並隨著時間的推移使我們的業務多樣化。

That is happening. It has already happened and more of it will happen on a go-forward basis. And I keep talking about that innovation flywheel, but that was nonexistent just a few years ago. The Vitality Index is moving in the right direction in a rapid way, and we expect that to continue. All of that, combined with the execution that we're seeing from the field, is putting us in a good place in a very challenging market. So I guess I'll leave it with that, Keri.

那正在發生。它已經發生了，更多的將在前進的基礎上發生。我一直在談論那個創新飛輪，但就在幾年前，它還不存在。活力指數正朝著正確的方向快速發展，我們預計這種趨勢將繼續下去。所有這一切，再加上我們在現場看到的執行力，使我們在一個極具挑戰性的市場中處於有利地位。所以我想我會保留它，Keri。

All right. Thanks so much, Bryan. And thanks, everyone, for joining the call this morning. Of course, if you have questions, please feel free to reach out to the IR team. I know we'll speak to many of you today. So thanks for joining.

好的。非常感謝，布萊恩。感謝大家今天早上加入電話會議。當然，如果您有任何疑問，請隨時聯繫 IR 團隊。我知道我們今天將與你們中的許多人交談。感謝您的加入。

Thank you again for participating in today's conference call. You may now disconnect.

再次感謝您參加今天的電話會議。您現在可以斷開連接。