Zimmer Biomet Holdings Inc (ZBH) 2022 Q4 法說會逐字稿

Good morning, ladies and gentlemen, and welcome to the Zimmer Biomet Fourth Quarter 2022 Earnings Conference Call. (Operator Instructions) As a reminder, this conference is being recorded today, February 3, 2023. (Operator Instructions) I would now like to turn the conference over to Keri Mattox, Senior Vice President, Chief Communications and Administration Officer. Please go ahead.

女士們先生們，早上好，歡迎來到 Zimmer Biomet 2022 年第四季度收益電話會議。 （操作員說明）提醒一下，本次會議將於今天 2023 年 2 月 3 日錄製。（操作員說明）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 Fourth 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 年第四季度收益電話會議。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 Q4 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 財務指標。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四季度收益發布中，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？

All right. Great. Thanks, Kerri, and thanks to all of you for joining us this morning for the call. We've really got 3 sections for the call this morning. First, I'm going to talk briefly about our fourth quarter performance and spend a few minutes on our teams, what I would just define as solid execution as well as our innovation and drivers for continued strong performance.

好的。偉大的。謝謝 Kerri，也感謝大家今天早上加入我們的電話會議。今天早上的電話會議實際上有 3 個部分。首先，我將簡要談談我們第四季度的表現，並在我們的團隊上花幾分鐘時間，我將其定義為可靠的執行以及我們的創新和持續強勁表現的驅動力。

And then for the second section, as usual, Suky will provide more detail on the quarter itself and very importantly, our 2023 guidance and expectations. And then, of course, we'll close things out by addressing any questions that you might have.

然後對於第二部分，像往常一樣，Suky 將提供有關本季度本身的更多細節，非常重要的是，我們的 2023 年指導和預期。然後，當然，我們將通過解決您可能遇到的任何問題來結束一切。

Before we get started, I want to take a minute to thank really the ZB team, just the full ZB team, not only for their work in making Q4 another successful quarter, but also for their resilience, the innovative thinking and dedication to getting the job done throughout all of 2022, even in the face of very real adversity.

在我們開始之前，我想花一點時間真正感謝 ZB 團隊，感謝整個 ZB 團隊，不僅感謝他們使第四季度成為另一個成功的季度，而且感謝他們的韌性、創新思維和致力於獲得完成整個 2022 年的工作，即使面對非常真實的逆境。

There's no doubt in my mind that this team is the engine that is driving us forward. So again, thank you, and I can tell you that I'm very proud to be on this journey with you. And now as we turn to Q4 results, I know that each and every one of you made the quarter happen. And I can tell you, it was a solid quarter.

毫無疑問，這支球隊是推動我們前進的引擎。再次感謝你，我可以告訴你，我很自豪能和你一起踏上這段旅程。現在，當我們轉向第四季度的結果時，我知道你們每個人都讓這個季度成為現實。我可以告訴你，這是一個穩定的季度。

We again saw better-than-expected growth driven by continued procedure recovery, strong execution and a solid momentum with our new innovation. And as expected, we also benefited from some favorable comps in the quarter. Inside of this, we saw another quarter of positive year-over-year momentum in large joints, with our overall global hip and knee business growing more than 8% and 10% on an ex FX basis.

在持續的程序恢復、強大的執行力和我們新創新的強勁勢頭的推動下，我們再次看到了好於預期的增長。正如預期的那樣，我們也從本季度的一些有利競爭中受益。其中，我們在大型關節領域又看到了一個季度的積極同比增長勢頭，我們的全球髖關節和膝關節業務整體增長超過 8% 和 10%（不含外匯）。

And our overall S.E.T category grew in the high single digits, driven by strong performance in our business growth drivers, which as we've said before, are sports, CMFT and upper extremities as well as the expected tailwind from BVP comps in our Trauma business.

我們的整體 S.E.T 類別以高個位數增長，這得益於我們業務增長驅動力的強勁表現，正如我們之前所說，運動、CMFT 和上肢以及我們創傷業務中 BVP comps 的預期順風.

With that said, we are clearly seeing overall market stabilization, but our fourth quarter execution and procedure recovery is still set against a macro backdrop that is challenging and fluid. Foreign currency has improved, but remains a challenge and supply, inflation and staffing pressures continue.

話雖如此，我們清楚地看到整體市場穩定，但我們第四季度的執行和程序恢復仍處於充滿挑戰和流動性的宏觀背景下。外匯有所改善，但仍然是一個挑戰，供應、通貨膨脹和人員配置壓力仍在繼續。

In fourth quarter, our team was once again able to navigate these challenges, flexing what I would just define as a muscle memory that I think fortunately or unfortunately, is a bit unique to ZB and has served us well over the past year, during 2022.

在第四季度，我們的團隊再次能夠應對這些挑戰，展示了我剛剛定義為肌肉記憶的東西，我認為幸運或不幸的是，這對 ZB 來說有點獨特，並且在過去的一年中為我們提供了很好的服務，在 2022 年期間.

But make no mistake, the challenges are real and they're ongoing. But regardless of this environment, with COVID mainly in the rearview mirror, I have confidence that the ZB team will continue to deliver. Our culture, our strategy, innovation and execution are coalescing right now, driving tangible momentum and importantly, belief from the team.

但別搞錯了，挑戰是真實存在的，而且還在持續。但不管這種環境如何，COVID 主要在後視鏡中，我相信 ZB 團隊將繼續交付。我們的文化、我們的戰略、創新和執行現在正在融合，推動了切實的動力，更重要的是，推動了團隊的信念。

And as a result, confidence in our business continues to grow. Let me just give a few examples from Q4. In the quarter, we announced the approval of our new cementless knee form factor, which is adding to our Persona family and strategically rounding out that portfolio.

因此，對我們業務的信心不斷增強。讓我舉幾個第四季度的例子。在本季度，我們宣布批准我們新的無骨水泥膝關節形狀係數，這將增加我們的 Persona 系列並從戰略上完善該產品組合。

The first procedures have been completed with this new keel design and the feedback, as expected, has been very positive. We continue to believe that our cementless knee penetration will grow significantly, and at this differentiated premium product can really accelerate that growth. It's early days, with full launch planned for the middle of the year, but make no mistake, this is a real growth driver for our knee franchise.

這種新龍骨設計的第一批程序已經完成，正如預期的那樣，反饋非常積極。我們仍然相信我們的非骨水泥膝關節滲透率將顯著增長，而這種差異化的優質產品可以真正加速這種增長。現在還處於早期階段，計劃在今年年中全面推出，但請不要誤會，這是我們膝蓋特許經營權的真正增長動力。

This launch builds on other recent product launches like HipInsights and our Identity Shoulder System introductions, bringing now our total to more than 50 new product launches from 2018 through 2022. And importantly, the largest majority of these launches came in markets we see growing in the mid-single digits or better.

此次發佈建立在其他近期產品發布的基礎上，例如 HipInsights 和我們的 Identity Shoulder System 介紹，使我們從 2018 年到 2022 年的新產品發布總數達到 50 多個。重要的是，這些發布中的絕大部分來自我們認為正在增長的市場中個位數或更好。

That's really important, being launched in markets that we see growing in the mid-single digits or better. This strategic prioritization and output from our innovation pipeline has helped ZB more than double our vitality index over that time, and very importantly, increase our revenue in faster-growth markets and submarkets which, of course, drives positive increases in our weighted average market growth.

這非常重要，在我們看到以中個位數或更好的速度增長的市場推出。這種戰略優先次序和我們創新渠道的產出幫助 ZB 在此期間將我們的活力指數提高了一倍多，而且非常重要的是，增加了我們在增長更快的市場和子市場的收入，這當然會推動我們加權平均市場增長的正增長.

And that momentum continues. We expect to launch another 40-plus products between now and the end of 2025, once again with the majority of those launches in 4% plus growth markets. This will drive further increases in our vitality index and weighted average market growth and most importantly, bring real and meaningful innovation to the patients and customers that we serve.

而且這種勢頭還在繼續。我們預計從現在到 2025 年底將再推出 40 多種產品，其中大部分將再次在 4% 以上的增長市場推出。這將進一步推動我們的活力指數和加權平均市場增長，最重要的是，為我們服務的患者和客戶帶來真正有意義的創新。

So what I know for sure is that our current momentum, a very robust new product pipeline and our strengthening balance sheet, focused on accelerating our portfolio transformation positions ZB well for the future. And as a result, I feel increasingly confident about ZB's ability to transform our business, drive growth, deliver value and achieve our mission to alleviate pain and improve the quality of life for people around the world.

因此，我可以肯定的是，我們目前的勢頭、非常強勁的新產品線和我們不斷加強的資產負債表，專注於加速我們的投資組合轉型，使 ZB 為未來做好準備。因此，我越來越相信 ZB 有能力轉變我們的業務、推動增長、創造價值並實現我們為全世界人民減輕痛苦和改善生活質量的使命。

And with that, I'll turn the call over to Suky for a closer look at Q4, and again, our expectations for 2023. Okay, Suky?

有了這個，我會把電話轉給 Suky 來仔細看看第四季度，然後再一次，我們對 2023 年的期望。好吧，Suky？

Thanks, and good morning, everyone. For today's call, I'm going to focus on 3 topics. First, our fourth quarter results; second, how that performance in recent macro trends translates into our 2023 financial guidance; and third, I'll provide a brief update on our long-term financial priorities.

謝謝，大家早上好。對於今天的電話會議，我將重點討論 3 個主題。首先，我們的第四季度業績；其次，近期宏觀趨勢的表現如何轉化為我們的 2023 年財務指南；第三，我將簡要介紹一下我們的長期財務重點。

With that, I'll turn to the fourth quarter results. Unless otherwise noted, my statements will be about the fourth quarter of 2022 and how it compares to the same period in 2021, and my commentary will be on a constant currency and adjusted continuing operations basis.

有了這個，我將轉向第四季度的結果。除非另有說明，否則我的陳述將是關於 2022 年第四季度及其與 2021 年同期的比較，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 fourth quarter were $1.825 billion, an increase of 2.7% on a reported basis and an increase of 8.3% on a constant currency basis. Previously noted, we had a selling day headwind of 150 to 200 basis points that impacted each category at about the same level.

第四季度淨銷售額為 18.25 億美元，按報告基礎增長 2.7%，按固定匯率計算增長 8.3%。之前指出，我們遇到了 150 到 200 個基點的銷售日逆風，對每個類別的影響大致相同。

U.S. sales grew 6.2%, driven by strong elective procedure recovery and commercial execution, especially in our knee and hip businesses. In addition, the U.S. business saw strength across our 3 priority areas within S.E.T.

美國的銷售額增長了 6.2%，這得益於強勁的擇期手術恢復和商業執行，尤其是在我們的膝蓋和臀部業務中。此外，美國業務在 S.E.T. 的 3 個優先領域看到了優勢。

International sales grew 11.1%, driven by strong procedure volumes across most markets in EMEA and APAC in tandem with later comps and continued strong commercial execution. EMEA performance was driven by recovery in developed markets and continued strength in emerging markets.

國際銷售額增長了 11.1%，這得益於 EMEA 和亞太地區大多數市場的強勁手術量，以及後期的治療和持續強勁的商業執行。歐洲、中東和非洲地區的業績受到發達市場復甦和新興市場持續走強的推動。

APAC was impacted by COVID-19 surges and lockdowns in China that were broadly offset by strength in other markets. Now turning to our business category performance. Global Knees grew 10.2% with U.S. Knees up 10.8% and International Knees up 9.3%, with strong performance driven by knee procedure recovery across most regions and an easier comp outside of the U.S.

亞太地區受到中國 COVID-19 激增和封鎖的影響，這些影響在很大程度上被其他市場的強勁所抵消。現在轉向我們的業務類別表現。全球膝關節增長 10.2%，美國膝關節增長 10.8%，國際膝關節增長 9.3%，大部分地區的膝關節手術恢復情況強勁，美國以外的地區更容易進行治療。

Continued global traction for our Persona Knee system, including both Persona Primary and Revision in the U.S. and continued increase in ROSA procedure penetration and pull-through.

我們的 Persona Knee 系統在全球範圍內持續受到關注，包括美國的 Persona Primary 和 Revision 以及 ROSA 程序滲透和拉通的持續增加。

Global Hips grew 8.4% with U.S. Hips up 5.9% and International Hips up 10.8%, driven by strong international procedure recovery and easier comps outside the U.S. continued traction across Hip products , including the G7 revision system and Avenir Complete primary hip, which is focused on the direct anterior surgical approach.

全球髖關節增長 8.4%，美國髖關節增長 5.9%，國際髖關節增長 10.8%，這得益於強大的國際程序恢復和美國以外更容易的補償持續推動髖關節產品，包括 G7 翻修系統和 Avenir Complete 初級髖關節，這是重點關於直接前路手術入路。

And lastly, continued solid ROSA pull-through in the Hip category, especially in the U.S. The Sports Extremity and Trauma category grew 7.6% and was impacted by continued strong performance across our key focus areas of CMFT, Sports Medicine and Upper Extremities.

最後，在臀部類別中，尤其是在美國，運動肢體和創傷類別增長了 7.6%，並受到 CMFT、運動醫學和上肢等關鍵重點領域持續強勁表現的影響。

S.E.T. was also impacted by a comp tailwind from China VBP that was partially offset by reimbursement changes in restorative therapies.

放。也受到來自中國 VBP 的補償順風的影響，這部分被恢復性療法的報銷變化所抵消。

Finally, our Other category grew 1.3%.

最後，我們的其他類別增長了 1.3%。

Moving to the P&L. For the quarter, we reported GAAP diluted loss per share of $0.62 compared to GAAP diluted loss per share of $0.40 in the fourth quarter of 2021. The change was driven by higher revenues, partially offset by a goodwill impairment in EMEA as a result of macro factors.

轉到損益表。本季度，我們報告的 GAAP 攤薄每股虧損為 0.62 美元，而 2021 年第四季度的 GAAP 攤薄每股虧損為 0.40 美元。這一變化是由更高的收入推動的，部分被歐洲、中東和非洲地區因宏觀經濟造成的商譽減值所抵消因素。

On an adjusted basis, diluted earnings per share of $1.88 represented an increase from $1.79 in the fourth quarter of '21. Adjusted gross margin was 71.7%, bringing full year gross margin of 71.2% or about in line with full year 2021 despite significant headwinds from inflationary pressure.

在調整後的基礎上，每股攤薄收益為 1.88 美元，高於 2021 年第四季度的 1.79 美元。調整後的毛利率為 71.7%，使全年毛利率達到 71.2%，或與 2021 年全年基本持平，儘管通脹壓力帶來巨大阻力。

Our adjusted operating expenses were $791 million, an increase versus the prior year due to inflationary pressures in tandem with higher investments into R&D and commercial infrastructure to support new products.

我們調整後的運營費用為 7.91 億美元，較上年有所增加，原因是通貨膨脹壓力以及對研發和商業基礎設施的更高投資以支持新產品。

For the year, overall OpEx was flat to 2021 with an increase in R&D and lower SG&A. We remain disciplined in realizing efficiencies while investing in our priority areas and offsetting headwinds. Adjusted operating profit margin for the quarter was 28.3%, up slightly from the prior year, bringing total year operating margin to 27.3%, ahead of full year 2021 despite macro headwinds.

今年，總體運營支出與 2021 年持平，研發增加，SG&A 降低。我們在實現效率方面保持紀律，同時投資於我們的優先領域和抵消逆風。儘管存在宏觀逆風，但本季度調整後的營業利潤率為 28.3%，略高於上年同期，使全年營業利潤率達到 27.3%，比 2021 年全年提前。

The adjusted tax rate was 16.9% in the quarter, slightly higher than our expectations due to certain onetime discrete tax items. For the full year, the adjusted tax rate was 16.5% and in line with our full year guidance.

本季度調整後的稅率為 16.9%，由於某些一次性的離散稅項，略高於我們的預期。全年，調整後的稅率為 16.5%，符合我們的全年指引。

Turning to cash and liquidity. Operating cash flows were $244 million and free cash flow totaled $115 million for the quarter, bringing our total free cash flow for the full year to $910 million.

轉向現金和流動性。本季度的運營現金流為 2.44 億美元，自由現金流總計 1.15 億美元，使我們全年的自由現金流總額達到 9.1 億美元。

We continue to reduce our net debt by approximately $150 million in the fourth quarter, excluding the effects of foreign currency and ended the quarter with cash and cash equivalents of approximately $375 million.

我們在第四季度繼續減少約 1.5 億美元的淨債務，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 3.75 億美元。

Moving to our financial outlook for 2023. We based our projections on the following key assumptions: we expect to experience procedure cancellations and staffing challenges, but the impact will be less acute than what we experienced in 2022.

轉向我們 2023 年的財務展望。我們的預測基於以下關鍵假設：我們預計會經歷程序取消和人員配備挑戰，但影響不會像 2022 年那樣嚴重。

Supply chain headwinds will continue throughout the year, but with improvement in the second half of '23. Pricing headwinds are expected to be slightly better than our historic average of 200 to 300 basis points.

供應鏈逆風將全年持續，但在 23 年下半年有所改善。定價逆風預計將略好於我們 200 至 300 個基點的歷史平均水平。

Inflationary pressure will remain stable to 2022 exit and an expected adjusted EPS dilution of about $0.05 to $0.10 due to our acquisition of Embody in the first quarter of 2023. Against this backdrop, our expectations for the full year '23 financial outlook are reported revenue growth in the range of 1.5% to 3.5% versus 2022, and expected foreign currency exchange headwind of approximately 150 basis points, resulting in revenue growth of 3% to 5% on a constant currency basis, and adjusted diluted earnings per share in the range of $6.95 to $7.15.

由於我們在 2023 年第一季度收購了 Embody，通脹壓力將在 2022 年之前保持穩定，預計調整後的每股收益攤薄約為 0.05 美元至 0.10 美元。在此背景下，我們對 23 年全年財務前景的預期是收入增長與 2022 年相比在 1.5% 至 3.5% 的範圍內，預計外匯逆風約為 150 個基點，導致收入在固定匯率基礎上增長 3% 至 5%，調整後的攤薄每股收益在6.95 美元至 7.15 美元。

Inside of that guidance, at our midpoint, we expect adjusted operating profit margins to be flat to slightly up compared to 2022 levels. We also expect net interest and other nonoperating expenses will be about $190 million, primarily due to higher interest rates.

在該指引內，我們預計調整後的營業利潤率與 2022 年的水平相比持平或略有上升。我們還預計淨利息和其他非運營費用將約為 1.9 億美元，這主要是由於較高的利率。

Our adjusted tax rate should be broadly in line with 2022 and total shares outstanding are expected to remain in line with full year 2022 average fully diluted shares outstanding.

我們調整後的稅率應與 2022 年基本一致，已發行股票總數預計將與 2022 年全年平均完全攤薄已發行股票一致。

Finally, we expect our free cash flow to be in the range of $925 million to $1.025 billion. In terms of cadence through the year, we expect that constant currency revenue growth rate for the first half will be slightly higher than the growth rate in the second half, and we do expect choppiness by quarter.

最後，我們預計我們的自由現金流將在 9.25 億美元至 10.25 億美元之間。就全年節奏而言，我們預計上半年的固定貨幣收入增長率將略高於下半年的增長率，我們確實預計每個季度都會出現波動。

Q1 is projected to be our highest growth quarter due to easier comps and will be followed by the fourth quarter, driven by improved supply and innovation building throughout the year.

由於比較容易，預計第一季度將是我們增長最快的季度，隨後是第四季度，這將受到全年供應和創新建設改善的推動。

Q2 and Q3 will be lighter quarters given tougher comps. And lastly, we don't expect any material day rate impact on full year results. However, Q1 and Q4 will benefit by about 100 basis points of tailwind that will be offset by headwinds in Q2 and Q3.

考慮到更強硬的組合，第二季度和第三季度將是更輕鬆的季度。最後，我們預計日費率不會對全年業績產生任何重大影響。然而，第一季度和第四季度將受益於約 100 個基點的順風，這將被第二季度和第三季度的不利因素所抵消。

In summary, we delivered accelerated growth in 2022 with a margin profile that is better than '21, as we overcame headwinds while investing in our priority areas. We navigated a number of macro challenges and delivered on our commitments to all of our stakeholders. As we look forward to 2023, while the environment remains dynamic, we see a path to delivering solid growth and earnings performance with robust free cash flow.

總而言之，我們在 2022 年實現了加速增長，利潤率優於 21 年，因為我們克服了逆風，同時投資於我們的優先領域。我們應對了許多宏觀挑戰，並兌現了對所有利益相關者的承諾。展望 2023 年，雖然環境仍然充滿活力，但我們看到了一條通過強勁的自由現金流實現穩健增長和盈利表現的途徑。

To close out, let me make a few comments about our financial priorities moving forward. We've made significant progress over the past few years in strengthening our balance sheet through improved financial performance and ongoing reductions in debt.

最後，讓我對我們未來的財務優先事項發表一些評論。過去幾年，我們通過改善財務業績和持續減少債務，在加強資產負債表方面取得了重大進展。

This ultimately provides ZB with greater strategic flexibility as we look to transform our portfolio with a focus on increasing our WAMGR and driving improved long-term growth. We remain committed to our investment-grade rating, and we'll continue to look at ways to accelerate profitable growth with a focus on achieving our mission.

這最終為 ZB 提供了更大的戰略靈活性，因為我們希望轉變我們的投資組合，重點是增加我們的 WAMGR 和推動改善的長期增長。我們仍然致力於我們的投資級評級，我們將繼續尋找加速盈利增長的方法，重點是實現我們的使命。

I'm so very proud of the ZB team for their perseverance and dedication throughout 2022, and I'm excited about what we can accomplish in 2023. With that, I'll turn the call back over to Keri.

我為 ZB 團隊在整個 2022 年的堅持不懈和奉獻精神感到非常自豪，我對我們在 2023 年取得的成就感到興奮。有了這個，我會把電話轉回 Keri。

Thanks, Suky. (Operator Instructions) With that, operator, may we have the first question, please?

謝謝，蘇基。 （操作員說明）這樣，操作員，我們可以問第一個問題嗎？

We'll go to Ryan Zimmerman with BTIG.

我們將與 BTIG 一起去 Ryan Zimmerman。

All right. Can you hear me okay?

好的。你能聽到我說話嗎？

Yes, we can hear you.

是的，我們能聽到你的聲音。

Bryan, starting with guidance. If I think back to third quarter, you were asked whether 4% organic growth was an appropriate way to think about '23? And -- at the time, you said '23 -- you didn't see '23 as normal. But then in January, you said we're in a better place, procedures are kind of normal, and we'd expect that to continue in '23.

布萊恩，從指導開始。如果我回想第三季度，有人問你 4% 的有機增長是否是思考 23 年的合適方式？而且——當時，你說的是 23 歲——你並不認為 23 歲是正常的。但是在 1 月份，你說我們處在一個更好的地方，程序有點正常，我們預計這種情況會在 23 年繼續。

And so as we sit here today with guidance that 4% at constant currency at the midpoint, just help us understand kind of that shift that's occurred in the fourth quarter that gives you a more optimistic view of the year ahead?

因此，當我們今天坐在這裡，以中點不變匯率計算 4% 的指導時，只是幫助我們了解第四季度發生的那種轉變，讓你對未來一年有更樂觀的看法？

And really, the key to my question is this 4%, do you view that as a floor, do you view that as realistic or aspirational? And just help us kind of characterize kind of where you're sitting in guidance in the year ahead?

真的，我的問題的關鍵是這 4%，你認為這是一個底線，你認為它是現實的還是理想的？只是幫助我們描述一下你在未來一年的指導中所處的位置？

Got it. Thanks for the question, Ryan. Maybe what I'll do is, Suky, you can provide color around the way we're thinking about guidance because there's a lot that goes into it. We still don't believe it's a normal year, obviously, there's a lot of puts and takes on either side of the equation, but you could walk through those perhaps. And then I will give you some color around what we're seeing so far in January and how that's making us feel as well. But why don't you go ahead and start?

知道了。謝謝你的問題，瑞安。也許我要做的是，Suky，你可以圍繞我們考慮指導的方式提供顏色，因為其中涉及很多內容。我們仍然不認為這是正常的一年，顯然，等式的兩邊都有很多看跌期權，但你也許可以通過這些。然後我會給你一些關於我們在 1 月份到目前為止所看到的事情的顏色，以及這如何讓我們感受到。但你為什麼不繼續開始呢？

Yes. So Ryan, thank you for the question. Good to be with everyone. First of all, I'd say we had a really good close to the year. We ended topline, bottom line and free cash flow at the top end of our third quarter guidance. So a really strong finish. There's a number of variables behind that, but the key one is really about execution.

是的。瑞安，謝謝你提出這個問題。很高興和大家在一起。首先，我想說我們在這一年結束時非常好。我們在第三季度指引的頂端結束了收入、利潤和自由現金流。所以一個非常強大的完成。這背後有很多變數，但關鍵是執行。

So I feel really good about the momentum that we have. As we move into 2023, some of the key variables that underpin our guidance. I talked a little bit about them on our -- in the scripted remarks. The first is around stabilization related to case cancellations, staffing shortages and things of that nature. We expect that to continue to improve throughout 2023.

所以我對我們擁有的勢頭感覺非常好。隨著我們進入 2023 年，一些支撐我們指導的關鍵變量。我在我們的 - 在腳本評論中談了一些關於他們的事情。首先是圍繞與案件取消、人員短缺和類似性質的事情相關的穩定性。我們預計這一情況將在整個 2023 年繼續改善。

We're not completely at normal markets. There are still some underlying dynamics impacting the overall market, but things are definitely improving, we expect that to continue to work through the rest of this year.

我們並不完全處於正常市場。仍有一些潛在的動力影響著整個市場，但情況肯定在改善，我們預計今年餘下時間將繼續發揮作用。

So procedure recovery for sure, '23. The other thing we have to think though, to balance that out is we're continuing to see supply challenges. We saw those in the fourth quarter. Our supply chain team as well as our commercial team responded incredibly well to those challenges. But we're assuming that those supply challenges remain, at least through the first half of this year and begin to improve in the second part of this year. But as we put all that together, we've got a lot of confidence against our full guidance range. We're optimistic about where trends are going. And like I said, we're really excited about where the business is headed. So I don't know, Bryan, if you want to talk a little bit about sort of what we're seeing so far?

所以程序恢復肯定，'23。不過，我們必須考慮的另一件事是，要平衡這一點，我們將繼續面臨供應挑戰。我們在第四季度看到了這些。我們的供應鏈團隊以及我們的商業團隊對這些挑戰的反應非常好。但我們假設這些供應挑戰仍然存在，至少在今年上半年仍然存在，並在今年下半年開始改善。但當我們把所有這些放在一起時，我們對我們的全部指導範圍充滿信心。我們對趨勢的走向持樂觀態度。就像我說的，我們對業務的發展方向感到非常興奮。所以我不知道，布萊恩，你是否想談談我們目前所看到的一些事情？

Yes. I mean, clearly, a lot of variables that are still moving. But if I just think about the kind of the here and now, and just look at what we've already accomplished in January, I'd just say it was a really strong start to the year.

是的。我的意思是，很明顯，很多變量仍在變化。但如果我只是想一想此時此地的情況，看看我們在 1 月份已經取得的成就，我會說這是今年一個非常強勁的開端。

Again, we're still looking at those variables. But when I think about the things that we can control, things around execution and innovation. They're going in the direction we want. When I think about the things we can't control, it's procedural recovery and supply chain challenges, those are also coalescing in a nice way.

同樣，我們仍在研究這些變量。但是當我想到我們可以控制的事情時，圍繞執行和創新的事情。他們正朝著我們想要的方向前進。當我想到我們無法控制的事情時，它是程序恢復和供應鏈挑戰，它們也以一種很好的方式結合在一起。

And so I guess suffice to say, based on those things, the momentum right now, and it's early days, but the momentum right now in 2023 is feeling really good. So again, we'll continue to monitor those other variables, but we feel pretty good about how we're starting.

因此，我想可以說，基於這些事情，現在的勢頭還為時尚早，但 2023 年的勢頭感覺非常好。同樣，我們將繼續監控其他變量，但我們對我們的開始方式感到非常滿意。

Very helpful. And then if I could ask a follow-up? Suky, The Street's margin expectations going into today -- for operating margins were essentially flat, maybe up 10 basis points, so really in line with your guidance. But just maybe walk us through kind of the levers that you think are at your disposal here on the operating margin line that could maybe move that up a little bit higher than where we're starting today?

很有幫助。然後我是否可以詢問後續行動？ Suky，華爾街對今天的利潤率預期——因為營業利潤率基本持平，可能上升 10 個基點，所以真的符合你的指導。但是也許可以讓我們了解一下您認為在營業利潤線上可以使用的槓桿，這些槓桿可能會使它比我們今天開始的位置高一點？

Yes. I think one of the key drivers is obviously going to be revenue growth, right? So if we continue to navigate the challenges around supply as we have been and as we saw in the fourth quarter, if we continue to see stabilization in the market and start to trend towards the upper half of the range, clearly, that will help drive some margin expansion as we continue to leverage our overall cost base.

是的。我認為關鍵驅動因素之一顯然是收入增長，對吧？因此，如果我們像第四季度那樣繼續應對供應方面的挑戰，如果我們繼續看到市場穩定並開始趨向於區間的上半部分，顯然，這將有助於推動隨著我們繼續利用我們的整體成本基礎，利潤率有所擴大。

Beyond that, there's still normal block and tackling that this company has gotten accustomed to over the last 4 or 5 years. We're going to continue to drive sourcing improvements around site optimization, Six Sigma, procurement.

除此之外，這家公司在過去 4 或 5 年中已經習慣了正常的障礙和解決方法。我們將繼續推動圍繞站點優化、六西格碼和採購的採購改進。

I'll tell you the commercial team has really stepped up. I've never seen a focus on mix, on simplification of the supply chain and the SKU rationalization on pricing that I've -- before in the company's history. So I think we've made really good strides from a commercial perspective, which I think could be some levers to potential upside.

我會告訴你商業團隊真的加強了。在公司歷史上，我從未見過像我這樣專注於混合、簡化供應鍊和 SKU 定價合理化。所以我認為從商業角度來看我們已經取得了很大的進步，我認為這可能是潛在上行的一些槓桿。

And then across SG&A, we're still in the early innings of fully leveraging our shared service operating model, which we started through the pandemic. So I think we have a number of things at our disposal that can help either expand margins or derisk our margin aspirations in a downturn. So feeling really good about what the overall team has been able to accomplish and where we can go with this.

然後在整個 SG&A 中，我們仍處於充分利用我們通過大流行開始的共享服務運營模型的早期階段。因此，我認為我們有很多可以使用的東西，可以幫助擴大利潤率或降低我們在經濟低迷時期的利潤率願望。因此，對整個團隊能夠完成的工作以及我們可以實現的目標感到非常滿意。

Ryan, thanks so much for the question.

瑞安，非常感謝你提出這個問題。

We'll go next to Mike Matson with Needham.

我們將和 Needham 一起去 Mike Matson 旁邊。

I guess, I'll start with the Recon market. It looks like it grew about 8% in 2022, and this is well above the 3% to 4%, we were seeing prior to COVID. What do you think is driving this above-normal growth? It seems like it's got to be the COVID backlog because I don't think pricing has been all that strong. But maybe you could comment on that? And do you think that this type of high single-digit market growth can you carry into 2023?

我想，我將從 Recon 市場開始。看起來它在 2022 年增長了約 8%，這遠高於我們在 COVID 之前看到的 3% 至 4%。您認為是什麼推動了這種高於正常水平的增長？似乎它必須是 COVID 積壓，因為我認為定價並沒有那麼強勁。但也許你可以對此發表評論？你認為這種高個位數的市場增長能延續到 2023 年嗎？

Yes. So I would say that probably the biggest reason that you're seeing that outsized growth overall, I wouldn't define it as backlog consumption, I don't believe we've started to consume the backlog.

是的。所以我想說，這可能是你看到整體超額增長的最大原因，我不會將其定義為積壓消費，我不相信我們已經開始消耗積壓。

I would define it more as comps. You just had easier comps. Maybe you call that procedure recovery versus the prior year. So that, to me, is not something that's necessarily sustainable, but it was just easier comps being that we had more pressure last year.

我會將其定義為 comps。你只是有更簡單的伴奏。也許您將該程序稱為與上一年相比的恢復。所以，對我來說，這不一定是可持續的，但由於去年我們承受了更大的壓力，所以比較容易。

Pricing was better, though, across the board, whether it's our company or other companies, we did a better job in pricing as a group. And as a result of that, that buoyed us as well. And Suky has talked before about what our expectations are in pricing as we move into 2023, but I'm sure we'll get another question around that.

不過，無論是我們公司還是其他公司，整體定價都更好，我們作為一個整體在定價方面做得更好。因此，這也鼓舞了我們。 Suky 之前曾談到我們在進入 2023 年時對定價的期望，但我相信我們會圍繞這個問題提出另一個問題。

So those are probably the 2 biggest things that wouldn't be as sustainable. But make no mistake, I feel like the market is strong. And some of the things that we look to that can buoy sustainably the market growth is innovation and innovation adoption right now in orthopedics is really promising.

所以這些可能是最不可持續的兩件事。但別搞錯了，我覺得市場很強勁。我們認為可以持續推動市場增長的一些事情是創新，目前在骨科領域採用創新確實很有前途。

Not just the typical innovation, but technology innovation that absolutely can drive up the share of wallet or mix benefit you get with that new innovation.

不僅是典型的創新，而且技術創新絕對可以提高錢包份額或混合您從新創新中獲得的收益。

We'll go to Larry Biegelsen with Wells Fargo.

我們將與 Wells Fargo 一起去 Larry Biegelsen。

Congrats on a nice finish to the year here. Suky, FX of negative 1.5%, can you tell us the rate you're using, that seems a little high and the EPS flow through?

祝賀您在這裡度過了美好的一年。 Suky，負 1.5% 的外匯，你能告訴我們你使用的利率，這似乎有點高，EPS 流過嗎？

Yes. Sure, Larry. It's good to be with you today. So you're right, we pegged FX as a headwind year-over-year and 150 basis points. That's an improvement from our original commentary back on our third quarter call. Originally, we were thinking 300 basis points. And so we did see some moderation of the dollar at the very back end of 2022 and early part of '23.

是的。當然，拉里。今天很高興和你在一起。所以你是對的，我們將外匯視為同比逆風和 150 個基點。這是我們對第三季度電話會議的原始評論的改進。最初，我們考慮的是 300 個基點。因此，我們確實看到美元在 2022 年底和 23 年初有所放緩。

So that drove the improvement. The way to think about it is we use recent rates. We look at the full cadre of all of our foreign currency exposures. One of the things to recall or remember is that about 40% of our revenues foreign currency exposed, half of that is euro and yen, right? So the other half is a lot of other currencies that you have to take into consideration.

所以這推動了改進。考慮它的方法是我們使用最近的利率。我們查看所有外匯敞口的全部幹部。要回憶或記住的一件事是，我們大約 40% 的收入外幣暴露，其中一半是歐元和日元，對嗎？所以另一半是你必須考慮的許多其他貨幣。

So when we aggregate all that, we're at 150 basis points. Now hopefully, we see -- continue to see things improve throughout this year and things turn favorable. But for right now, that's our latest estimate.

因此，當我們匯總所有這些時，我們處於 150 個基點。現在希望，我們看到 - 繼續看到今年的情況有所改善，情況變得有利。但就目前而言，這是我們的最新估計。

The flow-through on that, we expect it to be about 20% to 30% down to earnings, that's a little bit less than what we said last year. And as I said last year, when we quoted 30%, there are a lot of variables that can affect that, but it's still a reasonable drop-through to historical norm. So again, 150 basis points based on recent rates, euro and yen , making up about half of our foreign currency exposure and the flow-through being about 20% to 30%.

我們預計收益將下降約 20% 至 30%，這比我們去年所說的要少一些。正如我去年所說，當我們引用 30% 時，有很多變量會影響它，但這仍然是一個合理的歷史標準。因此，基於近期利率、歐元和日元的 150 個基點，約占我們外匯敞口的一半，流通量約為 20% 至 30%。

That's helpful. And then on S.E.T., it was about 2% in 2022. Can you help us think about the growth that's embedded in the 4% constant currency at the midpoint? And how you're thinking about the different subsegments there?

這很有幫助。然後在 S.E.T.，它在 2022 年約為 2%。你能幫助我們考慮一下中點 4% 的固定貨幣所包含的增長嗎？您如何看待那裡的不同細分市場？

Yes. So if we think about overall S.E.T., I think what you're asking, Larry, is how we view that business in an undisturbed market going forward. Is that kind of what you're asking?

是的。因此，如果我們考慮整體 S.E.T.，我想你問的是，拉里，我們如何看待未來不受干擾的市場中的業務。這就是你要問的嗎？

Yes. And certainly for '23, Bryan?

是的。當然是 23 年，布萊恩？

Yes. Yes. So when we come into 2023, even though it's not going to be a normal market, what we're still thinking about S.E.T. as being able to be a mid-single-digit grower. That's the way we're looking at that and in an undisturbed market, we would think the same thing.

是的。是的。所以當我們進入 2023 年時，即使這不會是一個正常的市場，我們仍然在考慮 S.E.T.能夠成為中等個位數的種植者。這就是我們看待這個問題的方式，在一個不受干擾的市場中，我們也會有同樣的想法。

Remember, in the first half, though, we're going to be a bit pressured still by the Restorative Therapies Group and that change in reimbursement. But even with that, throughout the year, we believe that, that segment can grow in the mid-single digits. And the key drivers for that because we don't treat all the businesses the same from an investment standpoint would be our growth drivers, which would be upper extremities for us, our sports business and in certain portions of our CMFT business.

請記住，在上半年，儘管如此，我們仍然會受到恢復性療法小組和報銷變化的壓力。但即便如此，我們相信，在全年中，該細分市場可以以中個位數增長。因為從投資的角度來看，我們沒有對所有業務一視同仁，所以關鍵驅動力將是我們的增長動力，這對我們來說是上肢，我們的體育業務和我們 CMFT 業務的某些部分。

Thanks, Larry.

謝謝，拉里。

We'll go next to Travis Steed with Bank of America.

接下來我們將與美國銀行的 Travis Steed 會面。

Congrats on a nice quarter. I wanted to ask about the robotic shoulder opportunity. I think before you said you'd be first or second to market now that Stryker has given more definitive timelines, I wonder if you can kind of clarify if you will be first or second or kind of timing there and how you're thinking about the opportunity and from a mix and share perspective?

祝賀一個不錯的季度。我想問一下機器人肩膀的機會。我想在你說你會是第一個或第二個進入市場之前，現在 Stryker 已經給出了更明確的時間表，我想知道你是否可以澄清一下你是第一個還是第二個或某種時間安排，以及你是如何考慮的機會以及從混合和共享的角度來看？

Travis, good morning. Ivan here. So I don't know where they are. We don't pay attention to where competitors are. We pay attention to where we are in the process. I'll tell you, frankly, I'll be very surprised we're not first to market, given where we are in the development cycle.

特拉維斯，早上好。伊万在這裡。所以我不知道他們在哪裡。我們不關注競爭對手在哪裡。我們注意我們在這個過程中所處的位置。我會告訴你，坦率地說，考慮到我們處於開發週期的哪個階段，我會感到非常驚訝我們沒有首先進入市場。

So my expectation remains that we're going to be ahead. The most important part is not just the speed in the actual launch. It is the quality, the features and benefits that we have in the platform. And given the mix of developers that we have involved in the project, I do think it's going to be a transformation on that platform. So that would be my answer.

所以我的期望仍然是我們會領先。最重要的部分不僅僅是實際發射的速度。這是我們在平台中擁有的質量、功能和優勢。考慮到我們參與該項目的開發人員組合，我確實認為這將是該平台上的一次轉型。這就是我的答案。

Okay. And then -- that's fair. And then a quick clarification on the 3% to 5% constant currency growth. How much of the revenue is coming from Embody in that? And then -- and Brian, a question for you on M&A. Just kind of curious what your willingness is in 2023, now that markets are a little more diversified beyond electives or is 2023 is more of a tuck-in year from an M&A perspective?

好的。然後——這很公平。然後快速澄清 3% 至 5% 的恆定貨幣增長。其中有多少收入來自 Embody？然後 - Brian，有一個關於併購的問題。只是有點好奇你在 2023 年的意願是什麼，既然市場比選修課更加多樣化，或者從併購的角度來看，2023 年更像是一個收斂的一年？

Yes. Sure, sure. May be I'll just start with the Embody thing. Then it's a relatively small acquisition. I would probably think more about that as a product launch. So it's not overly material, but it's a very attractive subspace of Sports.

是的。一定一定。可能我會從 Embody 開始。那麼這是一個相對較小的收購。我可能會更多地考慮將其作為產品發布。所以它並不過分物質，但它是體育的一個非常有吸引力的子空間。

And as we're building out that commercial channel, it's one of those things you really need in your bag to attract talent to that commercial channel. And so it's important to us but I wouldn't look at that as a significant or material impact to the year, only in the sense that we're going to be able to bring that channel in place and get good momentum in Sports overall.

在我們建立商業渠道的過程中，這是您真正需要的東西之一，可以吸引人才進入該商業渠道。因此，這對我們很重要，但我不會將其視為對今年的重大或實質性影響，只是從某種意義上說，我們將能夠將該渠道落實到位並在整體體育領域獲得良好勢頭。

From an M&A standpoint, yes, we are clearly in Phase III of the transformation of the company, which I've clearly talked about looks at portfolio transformation focused on getting more revenue and faster growth markets in its simplest form. And that's exactly what we're going to concentrate on. The fact is, as our balance sheet continues to strengthen, our flexibility, your strategic flexibility goes up.

從併購的角度來看，是的，我們顯然處於公司轉型的第三階段，我已經清楚地談到了著眼於以最簡單的形式獲得更多收入和更快增長市場的投資組合轉型。而這正是我們要關注的。事實是，隨著我們的資產負債表不斷加強，我們的靈活性，您的戰略靈活性也會提高。

And we will look at acquiring technologies that make sense from a mission standpoint for the company, that we see a path to leadership in, that we think will increase our weighted average market growth because that's important for sustainability and we see a path to be able to increase the growth rate in EPS.

我們將著眼於收購從公司使命的角度來看有意義的技術，我們看到了通往領導地位的道路，我們認為這將增加我們的加權平均市場增長，因為這對可持續發展很重要，我們看到了一條能夠實現的道路以提高每股收益的增長率。

And I've said before, there are 3 areas that we'll look at for acquisitions, mainly kind of smaller to midsized deals, but we look at things that would enhance our position in recon in those faster-growth submarkets that could be robotics data or the ASC settings. In orthopedic areas diversification that would be in vast growth subsegments like Sports or CMFT or Extremities. And then as you said, those things that might be outside of orthopedics that would help us diversify the business away from elected procedures, but also in vast growth markets.

我之前說過，我們會在 3 個領域考慮收購，主要是中小型交易，但我們會考慮能夠增強我們在機器人技術等增長更快的子市場中的偵察地位的東西數據或 ASC 設置。在骨科領域，多元化將出現在巨大的增長子領域，如運動或 CMFT 或四肢。然後正如你所說，那些可能在骨科之外的東西將幫助我們使業務多樣化，遠離選舉程序，但也在廣闊的增長市場中。

All those things are on the table right now. And again, as our balance sheet strengthens, our ability to action that obviously also increases. We're going to stay disciplined. There's no question about it, but we are clearly on the hunt for targets that make sense in those ways.

所有這些事情現在都擺在桌面上了。而且，隨著我們資產負債表的增強，我們採取行動的能力顯然也在增強。我們要保持紀律。毫無疑問，但我們顯然正在尋找在這些方面有意義的目標。

Thanks for the question, Travis.

謝謝你的問題，特拉維斯。

We'll go next to Drew Ranieri with Morgan Stanley.

我們將與摩根士丹利一起去 Drew Ranieri。

Maybe, Bryan, just to start for a question for you. You've talked about your confidence in the business, and I understand that your thinking is this year is not normal relative to prepandemic times, but just it's been a while since you kind of last discussed long-term plans.

也許，布萊恩，只是開始問你一個問題。你談到了你對企業的信心，我知道你的想法是今年相對於大流行前的時期來說是不正常的，但自從你上次討論長期計劃以來已經有一段時間了。

I'm just curious how you're thinking about the business longer term and your confidence in gross margin expansion opportunities ahead. Just anything that you could help frame investors with in terms of thinking about the business from a margin or growth perspective?

我只是好奇您如何看待業務的長期發展以及您對未來毛利率擴張機會的信心。在從利潤率或增長的角度考慮業務方面，您可以幫助構建投資者的任何東西嗎？

Yes. Yes. So maybe I'll start and Suky, I'll pass it you on the margin side. Yes, my -- I would say, not mine, our team's confidence is as high as it's ever been, quite frankly. I just think about that in the short term. It is not a normal environment.

是的。是的。所以也許我會開始，Suky，我會把它傳給你。是的，我的 - 我會說，不是我的，坦率地說，我們團隊的信心和以往一樣高。我只是在短期內考慮這一點。這不是一個正常的環境。

There are a lot of challenges that we're having to deal with from a supply chain standpoint. But I do go back to what I said in the prepared remarks, I have a lot of confidence in this team because of the muscle memory we have over the last 5 years in dealing with a lot of adversity.

從供應鏈的角度來看，我們必須應對許多挑戰。但我確實要回到我在準備好的發言中所說的話，我對這支球隊充滿信心，因為我們在過去 5 年中處理過很多逆境的肌肉記憶。

And so just in this moment of a non-normal environment, I would rather have this team than any other team because I believe they can fight to those challenges, and they've proven it. That's number one.

因此，就在這個非正常環境的時刻，我寧願擁有這支球隊，也不願擁有任何其他球隊，因為我相信他們能夠應對這些挑戰，而且他們已經證明了這一點。這是第一。

Number two, outside of those challenges, we're just hitting our stride. From a momentum standpoint, we've had a lot of kickoff meetings here recently. I'd love to go to those meetings and get a real sense for how people are feeling, just having a conversation with sales reps, that's where it all starts.

第二，在這些挑戰之外，我們剛剛邁出大步。從勢頭的角度來看，我們最近在這裡舉行了很多啟動會議。我很想參加那些會議，真正了解人們的感受，與銷售代表交談，這就是一切的開始。

And the momentum there, the confidence there, the belief there is as good as I've ever seen it. So all those things add up to me that say, particularly in a normal environment, we're in a good place. And I feel confident that we can continue to deliver the innovation and drive real revenue growth. We -- I don't want to give too many views of what the future revenue growth of the company will be, but know this, as we increase the weighted average market growth of the company, as we get to a 4%, that's organic, that we can commit to and sustain, that won't be good enough.

那裡的動力，那裡的信心，那裡的信念和我見過的一樣好。所以所有這些加起來對我來說就是說，特別是在正常環境中，我們處在一個好地方。我相信我們可以繼續提供創新並推動實際收入增長。我們——我不想對公司未來的收入增長給出太多看法，但要知道，隨著我們增加公司的加權平均市場增長，當我們達到 4% 時，那就是有機的，我們可以承諾和維持的，這還不夠好。

We'll continue to look at portfolio transformation to drive it north of that. But right now, I feel really good. I feel really good about the confidence that the team has, and I feel really confident about the team's ability to drive the results that we've just guided to in 2023.

我們將繼續研究投資組合轉型，以推動它向北發展。但是現在，我感覺真的很好。我對團隊的信心感到非常滿意，我對團隊在 2023 年實現我們剛剛指導的結果的能力充滿信心。

Maybe you want to talk more about the margin expansion?

也許你想多談談利潤率的擴張？

Yes. I'll actually level up from margin expansion, talk a bit more about how we think about it, which is earnings power inside the company. And our goal is to drive a leveraged P&L, right? And what do I mean by that? So we're looking for earnings growing faster than revenue.

是的。實際上，我將從利潤率擴張中提高水平，更多地談談我們如何看待它，這是公司內部的盈利能力。我們的目標是推動槓桿損益，對嗎？那是什麼意思？因此，我們正在尋找收入增長快於收入的增長。

And as we approach those revenue kind of outlook that Bryan just talked about, we see a very clear path to being able to do that. Now margin expansion will be a key building block in that, but it's not the only one, right? Obviously, sales leverage and then our ability to continue to leverage our interest rate as well as tax.

當我們接近布賴恩剛剛談到的那些收入前景時，我們看到了一條非常明確的實現這一目標的途徑。現在利潤率擴張將是其中的一個關鍵組成部分，但它不是唯一的，對吧？顯然，銷售槓桿以及我們繼續利用我們的利率和稅收的能力。

There are a number of levers at our disposal to drive that earnings power higher than revenue. Inside of that for margin, we continue to have the same variables that I've been talking about for quite some time, and the companies continue to show improvement on all those fronts, whether it's pricing, manufacturing and simplification, cost improvement, SG&A improvement.

我們可以使用許多槓桿來推動盈利能力高於收入。在利潤率方面，我們繼續擁有我已經討論了很長一段時間的相同變量，公司繼續在所有這些方面表現出改進，無論是定價、製造和簡化、成本改進、SG&A 改進.

I mean just look at our SG&A this year, we've been flat year-over-year while driving expansion in a number of areas in commercial infrastructure. So we've shown that we can do this. I'm confident we can continue to do it forward, and we start to really see that durable revenue expansion that Brian talked about, I'm very confident we can drive earnings power faster than revenue.

我的意思是看看我們今年的 SG&A，我們在推動商業基礎設施許多領域的擴張的同時，同比持平。所以我們已經證明我們可以做到這一點。我有信心我們可以繼續前進，我們開始真正看到布賴恩談到的持久收入擴張，我非常有信心我們可以比收入更快地推動盈利能力。

Great. And just as another question. We had a survey out with hospital CFOs, and they kind of pointed to orthopedic robotics being kind of a key capital spending category for this year. Just curious what you're seeing in the environment in terms of both hospital purchases? And it would be great to really kind of hear where you're seeing or having the most success in ROSA, whether it's greenfield placements or multisystem orders, hospital versus ASC and maybe what your share shift has been within ROSA accounts and cementless mix?

偉大的。就像另一個問題一樣。我們對醫院的首席財務官進行了一項調查，他們指出骨科機器人技術是今年的一個關鍵資本支出類別。只是想知道您在醫院購買方面在環境中看到了什麼？真的很高興聽到您在 ROSA 中看到或取得最大成功的地方，無論是綠地安置還是多系統訂單，醫院與 ASC 以及您在 ROSA 賬戶和無水泥組合中的份額轉移是什麼？

I'm happy to take that, Andrew. I'll tell you, Q4 was solid, both from ROSA installation and purchasing standpoint. I'm not aware of any deal that we've lost, what is here in the U.S. or U.S. relative to capital.

我很樂意接受，安德魯。我會告訴你，無論是從 ROSA 安裝還是採購的角度來看，第四季度都很可靠。我不知道我們失去了任何交易，美國或美國相對於資本的情況。

We also do small capital deals in the surgical business, and those were on track as well. So sequentially, Q3 to Q4 of 2022 was solid. Because of comps, obviously is a lower number than a year ago. But so far so good when it comes to capital. So nothing that I've seen so far leads me to believe that we're going to have a challenge when it comes to robotics.

我們還在外科業務中進行小額資本交易，這些交易也都在進行中。因此，2022 年第三季度至第四季度表現穩定。由於 comps，顯然比一年前的數字要低。但到目前為止，在資本方面一切都很好。所以到目前為止，我所看到的一切都沒有讓我相信我們在機器人技術方面會遇到挑戰。

Yes. And I think we do a really nice job of not just getting individual deals, but also getting multiple placements in the same account. You do typically have hybrid accounts where you've got us in there with robotics and potentially another competitor, but it's not just greenfield. It is existing accounts where you've gone to the point where you don't have enough capacity for that robotic system and they want to buy another system. So it's a combination of those 2 things.

是的。而且我認為我們做得非常好，不僅獲得了個人交易，而且還獲得了同一賬戶中的多個展示位置。你通常有混合賬戶，在那裡你讓我們與機器人技術和潛在的另一個競爭對手一起進入，但這不僅僅是綠地。現有帳戶已經到了您沒有足夠的容量用於該機器人系統並且他們想購買另一個系統的地步。所以這是這兩件事的結合。

Thanks for the question, Drew. Sorry, cementless mix, is that part of the question as a follow on?

謝謝你的問題，德魯。抱歉，無水泥混合，這部分問題是後續問題嗎？

Can you repeat the question? We didn't catch this now, I'm sorry?

你能重複這個問題嗎？對不起，我們現在沒看到這個？

What was your cementless mix in Knees?

你在 Knees 中使用的非骨水泥組合是什麼？

Yes, I can take that as well. So we've been in the low-teens, as we've been disclosing. That's obviously prior to the launch of Persona OsseoTi, which is now in the market. It's been around for 2 weeks. So the expectation is that number is going to dramatically increase.

是的，我也可以接受。正如我們所披露的那樣，我們一直處於十幾歲的低水平。這顯然是在 Persona OsseoTi 推出之前，後者現已投放市場。它已經存在了 2 週。所以預計這個數字會急劇增加。

And as you know, Drew, in combination with robotics, you're going to see a collateral effect. You're going to see increase of cementless mix and you're going to see increase of robotic penetration. So we're very bullish about what we're going to end at the end of the year. We don't disclose that externally. But you should expect something fairly aggressive.

正如你所知，德魯，結合機器人技術，你會看到附帶效應。你會看到無水泥混合的增加，你會看到機器人滲透的增加。所以我們非常看好我們將在年底結束的事情。我們不會對外透露。但是你應該期待一些相當激進的事情。

Just to make sure no one's confused that Persona OsseoTi, we've not used the name before, but that is the new form factor for cementless for Persona.

只是為了確保沒有人對 Persona OsseoTi 感到困惑，我們之前沒有使用過這個名稱，但這是 Persona 無骨水泥的新外形。

Yes. Thanks, Drew.

是的。謝謝，德魯。

We'll go next to Josh Jennings with Cowen.

我們將和 Cowen 一起去 Josh Jennings 旁邊。

I was hoping, Bryan, to ask you, you teed up the question for us on price and Suky and just maybe a recap of how you fared in '22? And I'm not sure if you quantify pricing assumptions and guidance topline for '23. But maybe if you could also just directionally help us out to think about the difference in terms of the pricing environment in the U.S. versus Europe and Asia Pac?

Bryan，我希望問你，你為我們提出了價格和 Suky 的問題，也許只是回顧一下你在 22 年的表現？而且我不確定你是否量化了 23 年的定價假設和指導底線。但也許你也可以定向幫助我們思考美國與歐洲和亞太地區在定價環境方面的差異？

Sure. I'll take that. So first of all, thanks for the question, Josh. On pricing, we had a really good fourth quarter. If you look at our disclosure in our press release, you'd actually see that pricing was positive in the fourth quarter. Now I would say, on an underlying basis, pricing was -- had erosion of about 100 to 150 basis points.

當然。我會接受的。首先，感謝喬希的提問。在定價方面，我們第四季度的表現非常好。如果您查看我們在新聞稿中的披露，您實際上會發現第四季度的定價是積極的。現在我要說的是，在基本的基礎上，定價是 - 侵蝕了大約 100 到 150 個基點。

We benefited by some year-over-year comps due to VBP and we also had some onetime rule adjustments that were favorable in the quarter, that drove us to be positive in the fourth quarter. But on an underlying basis, I would still think about it as 100 to 150 basis points erosion, which is still incredibly good versus our historical average of 200 to 300 basis points.

由於 VBP，我們受益於一些同比比較，我們也有一些在本季度有利的一次性規則調整，這促使我們在第四季度保持積極。但在基礎上，我仍然認為這是 100 到 150 個基點的侵蝕，與我們 200 到 300 個基點的歷史平均水平相比，這仍然非常好。

We ended the year at about 150 basis points of erosion, right, again, so a pretty clear step change to where we've been historically. I talked about in my scripted remarks, we expect next year -- or this year, I should say, 2023, to be slightly better than that annual average that we had before 2022.

我們以大約 150 個基點的侵蝕結束了這一年，對，再次，所以我們已經向歷史水平邁出了非常明顯的一步。我在照本宣科的發言中談到，我們預計明年——或者今年，我應該說，2023 年，將略好於 2022 年之前的年平均水平。

So maybe not as good as '22, but definitely better than where we've historically been. There are a number of drivers inside that. Some of them are transitional, some are more structural in nature. The ones that I'm more excited about are the structural improvements that we've made.

所以也許不如 22 年那麼好，但絕對比我們歷史上的水平要好。裡面有很多驅動程序。其中一些是過渡性的，一些本質上更具結構性。令我更興奮的是我們所做的結構改進。

We've made a lot of investments around capabilities, around systems, around analytics. We've got better governance. We've got better discipline. It's an area we the Santa Fe source off of now. So there are a host of things that structurally are improving our price performance as we move to 2023, and that's sticking in part of our guide. If you think about the dynamics between U.S. and EMEA and Asia Pacific, maybe I'll let Ivan talk a little bit about what he's seeing.

我們圍繞能力、系統和分析進行了大量投資。我們有更好的治理。我們有更好的紀律。這是我們 Santa Fe 現在的來源地。因此，隨著我們邁向 2023 年，有很多事情在結構上正在改善我們的價格表現，這在我們的指南中得到了體現。如果你考慮美國、歐洲、中東和非洲以及亞太地區之間的動態，也許我會讓伊万談談他所看到的。

Yes. Well, so far -- thanks, Suky. So far, we've not seen the performance when it comes to pricing being a single region, frankly, 2022, all 3 regions, a bit of expectations when it comes to pricing.

是的。好吧，到目前為止——謝謝，Suky。到目前為止，我們還沒有看到在單一區域定價方面的表現，坦率地說，2022 年，所有 3 個區域，在定價方面有點期望。

And the most important part, I do think that is sustainable and in line with the guidance that we've given for 2023. The role of innovation also is a critical component of the sustainability of the pricing, as you think about bundled deals, as you think about bring innovation that is going to drive mix, and in some cases, price -- better price performance.

最重要的是，我確實認為這是可持續的，並且符合我們為 2023 年提供的指導。創新的作用也是定價可持續性的重要組成部分，就像您考慮捆綁交易一樣，你考慮帶來將推動組合的創新，在某些情況下，價格 - 更好的性價比。

Maybe just a follow-up. I think we -- entire team has been tracking share for in large joints in the United States more effectively than international. But I was hoping maybe you could just help us understand where you think you had success capturing share in Knees and Hips in Europe and Asia Pac? And just where that stands and how you're thinking about share capture in those markets with international markets in '23?

也許只是一個跟進。我認為我們 - 整個團隊一直在跟踪美國大型聯合體的份額，而不是國際。但我希望你能幫助我們了解你認為你在歐洲和亞太地區成功奪取膝蓋和臀部份額的地方？在 23 年的國際市場中，您如何看待這些市場的份額捕獲？

Yes. So it's first of all, and I think it's really important, we never really pay a whole lot of attention to any individual quarter. Obviously, this quarter is a pretty strong one for us globally and in the U.S. But we don't try to over index on that. We do an 8-quarter trend and we look at how we're trending versus market. And I even try to stay away from specific competitors, but just the overall market growth, looking at the largest players.

是的。所以首先，我認為這非常重要，我們從來沒有真正關注任何一個季度。顯然，本季度對我們在全球和美國來說是一個非常強勁的季度，但我們不會試圖對此進行過度索引。我們做一個 8 季度的趨勢，我們看看我們的趨勢與市場的關係。我什至試圖遠離特定的競爭對手，而只是關注整體市場的增長，著眼於最大的參與者。

And I would tell you in that 8-quarter trend as that continues to roll, we're seeing good performance versus market in large joints, both hip and knee probably more in knee than hip. But overall, we're feeling pretty good. I mean you got to go back to before Q2 2020 as you probably remember, we had 20 straight quarters of being below market in every quarter, so 5 years below market in Large Joints.

我會告訴你，在 8 季度的趨勢中，隨著它繼續滾動，我們看到大關節的市場表現良好，臀部和膝蓋可能更多的是膝蓋而不是臀部。但總的來說，我們感覺很好。我的意思是，你必須回到 2020 年第二季度之前，你可能還記得，我們每個季度都有 20 個季度低於市場，所以大型關節低於市場 5 年。

And so we definitely have seen a sea change in our ability to perform at or above market in Large Joints which, as you know, is our biggest business. So that's the way we think about it, and we break it in a bunch of different ways. Year-over-year, we look at it on a stack basis, we look at it sequentially, but in all those areas, when we look at that a 8-quarter trend, we're feeling good about where we are.

因此，我們肯定已經看到我們在大型接頭市場上或高於市場的能力發生了翻天覆地的變化，正如你所知，這是我們最大的業務。所以這就是我們思考它的方式，我們以多種不同的方式打破它。年復一年，我們在堆棧的基礎上查看它，我們按順序查看它，但在所有這些領域，當我們查看 8 個季度的趨勢時，我們對自己所處的位置感覺良好。

Thanks, Josh.

謝謝，喬希。

We'll go next to Robbie Marcus with JPMorgan.

我們將與摩根大通的羅比馬庫斯一起去。

Congrats on good quarter. Maybe to start. In the script, you talked about improving supply moving throughout the year, but you also talked about it as benefiting fourth quarter sales. What are the products that are supply limited right now? And how should we think about the potential benefit to sales from improving supply?

祝賀好季度。也許開始。在腳本中，您談到改善全年的供應流動，但您也談到它有利於第四季度的銷售。現在限購的產品有哪些？我們應該如何考慮改善供應給銷售帶來的潛在好處？

Yes. So maybe I'll start off on a broad-based basis because there's really 2 factors that you talked about, Suky, and being able to drive performance in the fourth quarter. One, would be supply challenges alleviating, but also the innovation building because those almost 2 separate things.

是的。所以也許我會從一個廣泛的基礎開始，因為你談到了兩個因素，Suky，以及能夠在第四季度推動業績。一是緩解供應挑戰，二是創新建設，因為這幾乎是兩件獨立的事情。

So we'll make sure that we talk about both of those and Ivan, maybe talk about some of the innovation. For us, when we think about the supply challenges, it really comes down to material shortages that we're seeing, that we think are going to get better as we move in through the year, labor shortages that we think are going to get better as we move into the year.

因此，我們將確保我們談論這兩者和 Ivan，也許談論一些創新。對我們來說，當我們考慮供應挑戰時，它實際上歸結為我們所看到的材料短缺，我們認為隨著我們進入這一年會變得更好，我們認為勞動力短缺會變得更好隨著我們進入這一年。

And then sterilization capacity, which everybody is dealing with right now that I do believe is going to catch up at some point. So that's why we think supply challenges are going to get better, but it's pretty broad-based. I can't look at supply challenges and say, it's just this product or that product because it's in packaging.

然後是每個人現在都在處理的消毒能力，我相信在某個時候會趕上來。所以這就是為什麼我們認為供應挑戰會變得更好，但它的基礎相當廣泛。我不能看著供應挑戰說，這只是這個產品或那個產品，因為它在包裝中。

It's in resins. It's almost everything that we're dealing with has some form of supply challenges like sterilization, for instance. And so I wouldn't isolate the supply challenges to a product or product set, it's just a broad-based pressure that we're feeling. Outside of that, it's around innovation that's going to be building and maybe you can talk to some of the things you're excited about there?

它在樹脂中。我們正在處理的幾乎所有事物都存在某種形式的供應挑戰，例如滅菌。因此，我不會將供應挑戰孤立於產品或產品集，這只是我們感受到的廣泛壓力。除此之外，它圍繞著將要建立的創新，也許你可以談談你在那裡感到興奮的一些事情？

Yes, sure. Good to talk to you here today, Robbie. So innovation, as we discussed at JPMorgan earlier in the year, could be a 3-hour conversation. So I'm going to try to keep it more or less (inaudible) but I will tell you, I truly do believe today, innovation is a key competitive advantage.

是的，當然。羅比，今天很高興在這里和你交談。因此，正如我們今年早些時候在摩根大通討論的那樣，創新可能是一次 3 小時的對話。所以我會或多或少地嘗試保持它（聽不清），但我會告訴你，我今天真的相信，創新是一個關鍵的競爭優勢。

And true data points rather the (inaudible) that I mentioned, our vitality index, the percentage of sales coming from new products, that's more than double over the last 3 years, and we expect the number to increase dramatically over the strategic horizon.

真正的數據點而不是我提到的（聽不清），我們的活力指數，來自新產品的銷售額百分比，在過去 3 年中翻了一番以上，我們預計這個數字在戰略範圍內會急劇增加。

And in the second part, we filed in 2022, the highest number of 510(k)s in the history of the company. And actually, we got the largest number of approvals, public information when it comes to the peer group. Breaking down innovation in 3 or 4 buckets when it comes to Knees, I already mentioned Persona OsseoTi, that is the new cementless form factor device that we got here at Zimmer Biomed.

在第二部分，我們在 2022 年提交了公司歷史上最多的 510(k)s。實際上，我們獲得了最多的批准，公開信息涉及同行組。當涉及到膝蓋時，將創新分為 3 或 4 個桶，我已經提到了 Persona OsseoTi，這是我們在 Zimmer Biomed 獲得的新型無骨水泥外形設備。

The clinical data that we got on that product is compelling. We believe it's highly stable, when it comes to the mechanical and biological fixation. It's extremely versatile. You can all the way to the end of the surgery, decide whether you want to go cemented or cementless. It has used the Persona technology, so it's highly anatomic.

我們獲得的有關該產品的臨床數據令人信服。我們相信它在機械和生物固定方面非常穩定。它用途廣泛。您可以一直到手術結束，決定是使用骨水泥還是非骨水泥。它使用了 Persona 技術，因此具有高度的解剖學特徵。

You can customize the device to any kind of anatomy. We've got the broadest size of ranges. I'm excited with Persona Smart, we don't talk much about it because we still are in the limited market trials. But I like where this is going.

您可以根據任何類型的解剖結構自定義設備。我們有最廣泛的範圍。我對 Persona Smart 感到很興奮，我們沒有談論太多，因為我們仍處於有限的市場試驗中。但我喜歡它的發展方向。

I like the opportunity that we have with Personal Smart especially later in the year. When it comes to Hips, in the prepared remarks, Bryan talked about HipInsight. It's the world's first and only mix reality digital surgery platform for hip arthroplasty.

我喜歡我們與 Personal Smart 的機會，尤其是在今年晚些時候。說到 Hips，在準備好的發言稿中，Bryan 談到了 HipInsight。它是世界上第一個也是唯一一個用於髖關節置換術的混合現實數字手術平台。

This is making procedures faster. This is increasing accuracy in the actual procedure. When you come to the median in Vegas at the academy, I think you'll be impressed. It has effectively give the surgeon x-ray vision over the anatomy of the patient, the instrument, the implants. You're going to get more accuracy, faster procedures.

這使程序更快。這在實際過程中提高了準確性。當你在學院來到拉斯維加斯的中位數時，我想你會印象深刻。它有效地為外科醫生提供了患者、儀器和植入物解剖結構的 X 射線視野。您將獲得更高的準確性、更快的程序。

It is going to be transformational. I like the momentum we had with both ROSA in Hips and Knees. We got strong portfolio when it comes to Shoulder. We talk about Identity, the transformational launch that we did at the end of 2022. That is followed by a cadence of launches on Glenoids on Signature ONE planning, I can spend an hour on that. And then through organic and inorganic means, I think we have a best-in-class portfolio in sports med.

這將是變革性的。我喜歡 ROSA 在 Hips 和 Knees 方面的勢頭。在 Shoulder 方面，我們擁有強大的產品組合。我們談論 Identity，這是我們在 2022 年底進行的轉型發布。接下來是在 Glenoids 上發布 Signature ONE 計劃的節奏，我可以花一個小時在上面。然後通過有機和無機手段，我認為我們在運動醫學領域擁有一流的產品組合。

So I guess it will be my 3-minute summary on all of the things that are happening from an innovation standpoint. But I'll close it by saying, again, I do believe this is a true competitive advantage for Zimmer Biomet.

所以我想這將是我從創新的角度對所有正在發生的事情進行的 3 分鐘總結。但最後我要再次聲明，我相信這是 Zimmer Biomet 真正的競爭優勢。

Yes. And Robbie, just back to your question around supply chain, our comments on Q4 and then 2023. Look, we did see pressure in the fourth quarter around supply chain. I think you've heard us comment on that and not inconsistent with what you're hearing around the sector. We expect those challenges to continue into 2023.

是的。羅比，回到你關於供應鏈的問題，我們對第四季度和 2023 年的評論。看，我們確實看到了第四季度圍繞供應鏈的壓力。我認為您已經聽到我們對此發表評論，並且與您在該行業聽到的內容並不矛盾。我們預計這些挑戰將持續到 2023 年。

The commentary on Q4 is just to provide a little color that we think that our group did a really nice job in navigating that. The situation continues to be dynamic into '23, but our expectation is that we're going to continue to navigate that really well.

關於 Q4 的評論只是為了提供一點顏色，我們認為我們的團隊在導航方面做得非常好。這種情況在 23 年繼續保持動態，但我們的期望是我們將繼續很好地導航。

Great. And you touched on inorganic, you did Embody in the business line. How should we think about overall inorganic in your view at Zimmer Biomet in '23 and beyond? And how should we think about the size of deals you're looking to do and how fast you're looking to move to take the own inorganic and help expand the WAMGR higher?

偉大的。而你談到了無機物，你在業務線做了體現。在您看來，23 世紀及以後的 Zimmer Biomet 我們應該如何看待整體無機？我們應該如何考慮您希望進行的交易規模以及您希望以多快的速度採取自己的無機業務並幫助將 WAMGR 擴展得更高？

Yes. Yes, we're ready now. And again, the balance sheet is moving in a place that allows us to have even more strategic flexibility than we've had in the past, which is a good thing. And as I said, it's probably more of those smaller to midsized deals that would be a bit closer to the best for now. In other words, closer to the orthopedic space that we are already in.

是的。是的，我們現在準備好了。再一次，資產負債表的變化使我們擁有比過去更多的戰略靈活性，這是一件好事。正如我所說，目前可能更多的是那些更接近最佳交易的中小型交易。換句話說，更接近我們已經身處的骨科領域。

But we're ready, we're definitely ready. Now it comes down to opportunistically finding the right target at the right price and the right returns. But we are ready to move into phase III of the transformation, for sure.

但我們準備好了，我們絕對準備好了。現在歸結為機會主義地以合適的價格和合適的回報找到合適的目標。但我們已經準備好進入轉型的第三階段，這是肯定的。

Robbie, thanks so much for the question.

羅比，非常感謝你提出這個問題。

We'll go next to Jayson Bedford with Raymond James.

我們將和雷蒙德·詹姆斯一起去傑森·貝德福德旁邊。

Just a couple. Clarification on the growth cadence in '23. I think you said that organic growth would be the highest in the first and fourth quarter, but I think those are your toughest comp quarters. So I'm just wondering why 2Q and 3Q are a bit softer from a relative growth perspective? Is it simply the day rate dynamic?

只是一對。澄清 23 年的增長節奏。我想你說過第一季度和第四季度的有機增長將是最高的，但我認為那是你最艱難的季度。所以我只是想知道為什麼從相對增長的角度來看 2Q 和 3Q 有點疲軟？僅僅是日費率動態嗎？

Yes. Let me take that one. So you heard us correctly. First half will be stronger than the second half from a growth rate perspective, topline ex FX. First quarter will be the strongest followed by the fourth quarter and then the second and third quarter.

是的。讓我拿那個。所以你沒聽錯。從增長率的角度來看，上半年將強於下半年，收入不包括外匯。第一季度將是最強的，其次是第四季度，然後是第二和第三季度。

Let me go into a little bit more detail. On the first quarter, that will be our strongest one, primarily due to procedural recovery. Remember, we're comparing against the first quarter of 2022 which had omicron in it. And therefore, you you've got a nice comp benefit.

讓我更詳細一點。在第一季度，這將是我們最強勁的季度，主要是由於程序恢復。請記住，我們正在與其中包含 omicron 的 2022 年第一季度進行比較。因此，您將獲得不錯的補償。

In the fourth quarter, that's generally from a seasonality perspective from growth, usually one of our strongest quarters -- and we're assuming a nice benefit from the innovation, the momentum of innovation build throughout the year from new products and execution. So that's why we characterize that as our second largest quarter.

在第四季度，這通常是從增長的季節性角度來看，通常是我們最強勁的季度之一——我們假設創新會帶來很好的好處，全年創新的勢頭都會從新產品和執行中獲得。所以這就是為什麼我們將其描述為我們的第二大季度。

And then inside of that, the second and third quarter will actually have tougher comps because that's when you began to see some recovery last year relative to Omicron. The day rate impact, you're right, we said 100 basis points for each of Q1 and Q4, that's a tailwind, which will be offset by headwinds in Q2 and Q3. So you've got it largely right there.

然後在其中，第二和第三季度實際上會有更艱難的競爭，因為那時你開始看到去年相對於 Omicron 有所復甦。日利率影響，你是對的，我們說第一季度和第四季度各有 100 個基點，這是順風，將被第二季度和第三季度的逆風所抵消。所以你基本上就在那裡。

Okay. Maybe just on M&A, the $0.05 to $0.10 dilution tied to the Embody deal is a bit heavier than we expected. Can you just talk about the return profile there? And when can this be additive or at least neutral to earnings?

好的。也許就併購而言，與 Embody 交易相關的 0.05 美元至 0.10 美元的稀釋比我們預期的要重一些。你能談談那裡的回報情況嗎？這什麼時候可以增加或至少對收益保持中立？

Yes. We would see this as breakeven to positive in the first 24 months. So it's very attractive from a margin profile, from an earnings accretion profile. As Bryan said, it's more or less like a product launch right now. But as that begins to ramp up from a revenue standpoint and begins to cover some of the investments we're making in a very important sector in sports and extremities, we feel good about the return profile. It meets all of our hurdles from an NPV, IRR, ROIC metric perspective. And so again, it's just early days, but again, neutral within the first 24 months.

是的。我們認為這是前 24 個月的盈虧平衡。因此，從利潤率和收益增長情況來看，它非常有吸引力。正如 Bryan 所說，它現在或多或少更像是一次產品發布。但隨著從收入的角度來看，這開始增加，並開始涵蓋我們在運動和四肢這個非常重要的領域所做的一些投資，我們對回報情況感到滿意。從 NPV、IRR、ROIC 指標的角度來看，它滿足了我們所有的障礙。同樣，這只是早期階段，但在前 24 個月內再次保持中立。

Jayson, thanks for the questions.

傑森，謝謝你的提問。

We'll go next to Kyle Rose with Canaccord.

我們將與 Canaccord 一起去 Kyle Rose 旁邊。

Great. Just wondering and apologies if I missed it, I wondered if you could give us a little more insight into where you're at from an inflationary perspective into 2023? I think previously you talked about being at the higher end of the range of 50 to 100 bps. I just wanted to see if that was the way to think about inflationary impact in the P&L in '23? And then maybe update us on the actual headwinds you did see in 2022?

偉大的。只是想知道如果我錯過了它並道歉，我想知道你是否可以讓我們更深入地了解你從通貨膨脹的角度到 2023 年所處的位置？我想你之前談到過處於 50 到 100 個基點範圍的高端。我只是想看看這是否是考慮通貨膨脹對 23 年損益表影響的方式？然後也許向我們介紹您在 2022 年看到的實際逆風？

Yes. So you're right, we did point to the higher end of our range back in '22 of 50 to 100 basis points flowing into '23. We're actually seeing that come through year-over-year as a headwind to gross margin. I could say, though, I'm very pleased with how the commercial and supply chain teams have reacted to that.

是的。所以你是對的，我們確實指出了 22 年流入 23 年的 50 到 100 個基點的範圍的高端。實際上，我們看到這是毛利率的逆風。不過，我可以說，我對商業和供應鏈團隊對此的反應非常滿意。

And we believe we're going to be in a position to offset all of that and pretty much hold gross margin flat year-over-year. And that's coming from a number of variables. But again, we're really proud of what the team has done to offset that.

而且我們相信我們將能夠抵消所有這些並且幾乎保持毛利率同比持平。這是來自許多變量。但同樣，我們為團隊為抵消這一點所做的努力感到非常自豪。

And the impact that we saw in 2022 was, I would say, about 100 basis points as well. And if you actually look at gross margin performance, it was flat to 2021. So again, the team did a really nice job in offsetting those headwinds. So once again, we're demonstrating and showing that we can be disciplined, we can offset these headwinds and help our earnings growth over time.

我想說，我們在 2022 年看到的影響也約為 100 個基點。如果你真的看一下毛利率表現，它到 2021 年持平。因此，團隊在抵消這些不利因素方面做得非常好。因此，我們再次證明並表明我們可以遵守紀律，我們可以抵消這些不利因素並幫助我們的收入隨著時間的推移而增長。

Great. That's helpful. And then overall in the commercial channel, you talked a lot about historically about making investments in specialized sales forces and investing alongside your distributors to support some of the higher-growth market segments. Just wondered, can you help us understand how these initiatives are trending?

偉大的。這很有幫助。然後在整個商業渠道中，您在歷史上談到了很多關於對專業銷售隊伍進行投資並與您的分銷商一起投資以支持一些更高增長的細分市場的問題。只是想知道，您能幫助我們了解這些舉措的趨勢嗎？

And then any potential updates in kind of where you stand from a distributor versus a direct model across some of those higher growth segments?

然後，在某些高增長細分市場中，您從分銷商到直接模式的立場是否有任何潛在的更新？

Maybe I can take that one, Kyle. So first thing first, on the 3 segments, we think there are growth drivers, sports med, Upper Extremities and CMFT. We have double, if not triple, the number of people dedicated to these specialties.

凱爾，也許我可以接受那個。首先，在這三個領域，我們認為有增長動力、運動醫學、上肢和 CMFT。我們有兩倍（如果不是三倍）致力於這些專業的人數。

The sports med expansion is very real, now that we have the portfolio. So the number of dedicated to specialized people has dramatically increased in these 3 categories.

既然我們有了產品組合，運動醫學的擴張是非常真實的。因此，在這 3 個類別中，專門為專業人士服務的人數急劇增加。

In tandem, we also increased the number of people that are fully dedicated to the ASC environment. And that's because these procedures, for the most part, do take place in that space, but that goes beyond sales reps. It also touches on the contracting of the organization.

同時，我們還增加了完全致力於 ASC 環境的人員數量。那是因為這些程序在大多數情況下確實發生在那個空間，但超出了銷售代表的範圍。它還涉及組織的承包。

As far as your second question, the percentage of direct or indirect, I don't think that we disclose that externally. We like where we are. We like the mix that we have direct, indirect. We just left our sales meeting in Denver, nearly 2,000 people were there. And I'll tell you the mood is very solid, whether you're an indirect or direct territory leader. I think people feel it's a good time to be a part of the company, but I don't think we break down the percentages externally.

至於你的第二個問題，直接或間接的百分比，我認為我們不會對外披露。我們喜歡我們所在的位置。我們喜歡直接和間接的混合。我們剛剛結束在丹佛舉行的銷售會議，當時有將近 2,000 人參加。我會告訴你情緒非常穩定，無論你是間接還是直接區域領導者。我認為人們覺得現在是加入公司的好時機，但我認為我們不會從外部分解百分比。

All right. Kyle, yes, thanks so much for the questions.

好的。凱爾，是的，非常感謝你提出問題。

We'll take our next question from Chris Pasquale with Nephron.

我們將接受來自 Nephron 的 Chris Pasquale 的下一個問題。

Just a quick one first. I was hoping you could give us an update on the ROSA installed base exiting '22?

只是一個快速的第一個。我希望您能向我們提供有關退出 22 年的 ROSA 安裝基礎的更新？

Yes. I'll keep it short and sweet here. In any year, we expect to do no less than 300 installations, and we exceeded that expectation across all 3 regions. And as you think about the future, '23-'24 and whatnot, that's frankly the point of entry.

是的。我會在這裡保持簡短和甜蜜。在任何一年，我們預計都會進行不少於 300 次安裝，並且我們在所有 3 個地區都超出了這一預期。當您考慮未來時，'23-'24 等等，坦率地說，這是切入點。

I would be disappointed, maybe even jobless if we don't exceed a number given the new applications in shoulder next-generation and other technologies coming in, but we so far exceeding those expectations.

鑑於肩負下一代和其他技術的新應用，如果我們沒有超過一個數字，我會感到失望，甚至可能失業，但我們到目前為止超出了這些預期。

Okay. And then, Bryan, I thought your comment that you had not started to work through the COVID backlog yet was interesting. It certainly felt like the market had some pent-up demand benefit last year, but I understand your point that the comps weren't exactly normal. My question is, if you haven't started to make progress on the backlog yet, do you think you ever will? And are you assuming any progress on that front in '23?

好的。然後，布萊恩，我認為你關於你還沒有開始處理 COVID 積壓工作的評論很有趣。去年確實感覺市場有一些被壓抑的需求收益，但我理解你的觀點，即補償並不完全正常。我的問題是，如果你還沒有開始在積壓工作上取得進展，你認為你會嗎？您是否假設 23 年在這方面取得任何進展？

That is the question that I think we're all grappling with. There's clearly backlog. You might call it as longer waiting list backlog, you can define it the way you want, but the fact is there's pent-up demand for these procedures.

這是我認為我們都在努力解決的問題。有明顯的積壓。您可以將其稱為更長的等待列表積壓，您可以按照自己的方式定義它，但事實是這些程序存在被壓抑的需求。

The rate limiting factor is really capacity at the provider level. You could -- because of the supply challenge environment, maybe even capacity constraints, at the company level. But I think the bigger capacity constraint at this point is at the provider level.

速率限制因素實際上是提供商級別的容量。你可以——因為供應挑戰環境，甚至可能是公司層面的產能限制。但我認為此時更大的容量限制是在供應商層面。

We actually had a third-party run this analysis for us because we really wanted to get in tune to what is the size of the backlog based on a third party's view. And then also when they believe the backlog would start coming through and at what pace.

實際上，我們有第三方為我們運行此分析，因為我們真的很想根據第三方的觀點了解積壓的大小。然後，當他們認為積壓工作將以何種速度開始處理時。

And what we found in that is that, number one, they came back with -- there is a very sizable backlog in orthopedics. Actually, it was their analysis came back smaller than what we expected, but still very material. And they said that when we start to work through it, it would be constrained again because of the capacity.

我們從中發現的是，第一，他們回來了——骨科領域有大量積壓。實際上，是他們的分析結果比我們預期的要小，但仍然非常重要。他們說，當我們開始處理它時，由於容量的原因，它會再次受到限制。

And it was a relatively minor impact, tailwind for sure, but impact to the overall market growth, just given the capacity constraints you're going to have in the provider for some period of time.

這是一個相對較小的影響，肯定是順風，但對整體市場增長的影響，只是考慮到供應商在一段時間內的容量限制。

The good news about that, I guess, is when we start to digest the backlog, it will come as a positive tailwind likely for years and it wouldn't be overly material in any given year, but it would be a tailwind for multiple years.

我想，關於這一點的好消息是，當我們開始消化積壓時，它可能會在未來幾年成為積極的順風，並且在任何一年都不會過於重要，但它會成為多年的順風.

So that's the analysis that we have. And we just, again, just doing the math, we don't believe that we're into that backlog yet. Hopefully, we'll see some of that come in 2023, but we're not depending on that when you look at the center of our guidance range.

這就是我們的分析。我們只是，再次，只是做數學，我們不相信我們已經進入積壓工作。希望我們能在 2023 年看到其中的一些，但當您查看我們指導範圍的中心時，我們並不依賴於此。

All right. Katie, I think we have time for just 1 final question.

好的。凱蒂，我想我們只有最後一個問題的時間。

We'll take our next question from Rick Wise with Stifel.

我們將接受來自 Stifel 的 Rick Wise 的下一個問題。

Can you hear me now? Sorry about that.

你能聽到我嗎？對於那個很抱歉。

Yes.

是的。

Great. Two questions. I'll just have them right up front. First, I don't think you commented on China, Bryan, it seems like the latest COVID surge is subsiding. We're seeing sort of mostly negative, but sort of mixed results, some doing a little better.

偉大的。兩個問題。我會把它們放在前面。首先，我認為你沒有對中國發表評論，布萊恩，最近的 COVID 浪潮似乎正在消退。我們看到的結果大多是負面的，但結果喜憂參半，有些情況好一些。

How are you thinking about China factoring it in to the first quarter and to the full year? And a quick one for Suky. Suky, Bryan asked me to ask you about the shared services initiatives. You're in the early innings. He said, why isn't it moving faster? Just kidding Suky, just kidding.

您如何看待中國將其計入第一季度和全年？給 Suky 一個快速的。 Suky，Bryan 讓我問你有關共享服務計劃的問題。你在早期局。他說，為什麼它不移動得更快？開玩笑的，Suky，開玩笑的。

That's a great question. That's a great question. Rick, he really knows me.

這是一個很好的問題。這是一個很好的問題。瑞克，他真的了解我。

Yes. So we're seeing China and COVID surges clearly start to stabilize in the first quarter. It was pretty acute there in the fourth quarter. Fortunately, we were able to offset it with strength in other markets. So overall, China wasn't as big a factor in the fourth quarter.

是的。因此，我們看到中國和 COVID 的激增在第一季度明顯開始趨於穩定。第四季度那裡的情況非常嚴重。幸運的是，我們能夠用其他市場的實力來抵消它。所以總的來說，中國在第四季度並不是一個重要的因素。

And we don't see it as a material mover at least from a COVID standpoint in the first quarter. We do see China as a very attractive market for overall growth in '23 and beyond, especially now that we've moved through all of the pain and noise of BVP, which is now sunset and behind us. So really feeling good about where that market is. And now that team can start to position towards not only growing the business but start to really work on the margin structure of China as a whole coming out of BVP. So again, feel very optimistic about where we are there.

至少從第一季度的 COVID 角度來看，我們並不認為它是一個實質性的推動者。我們確實認為中國是 23 世紀及以後整體增長的一個非常有吸引力的市場，特別是現在我們已經經歷了 BVP 的所有痛苦和喧囂，現在已經落日和身後。所以對那個市場在哪裡真的感覺很好。現在，該團隊不僅可以開始定位於發展業務，而且可以開始真正致力於從 BVP 中脫穎而出的整個中國的利潤率結構。因此，再次對我們所處的位置感到非常樂觀。

Yes. On the -- what a way to end a call on a good quarter and good outlook with shared services. But I love your ambition, and I'm going to share that with the leadership team that we've got to move faster. So thanks for the question.

是的。關於 - 通過共享服務結束良好季度和良好前景的電話的方式。但我喜歡你的雄心壯志，我將與領導團隊分享這一點，我們必須加快步伐。所以謝謝你的問題。

Thanks, Rick, and thanks for all the questions. I'll turn it over to Bryan just to close out the call.

謝謝，里克，也謝謝你提出的所有問題。我會把它交給 Bryan 來結束通話。

Just a couple of thoughts. First of all, thanks for joining us this morning. And I would say I hope it's clear that the phase I and phase II of the transformation of this company are well on track, and we're feeling very good about where we stand. And I can tell you, because of those 2 phases, I feel that we'll at least take our fair share of the markets that we play in. We certainly hope to do more than that.

只是幾個想法。首先，感謝您今天早上加入我們。我想說的是，我希望這家公司轉型的第一階段和第二階段進展順利，我們對自己的立場感到非常滿意。我可以告訴你，由於這兩個階段，我覺得我們至少會在我們所參與的市場中佔據公平的份額。我們當然希望做得更多。

Now we're moving on to phase III, and that really is the portfolio transformation of our company, looking at changing the mix of our revenue to make sure that we have more of that mix in high-growth markets. And we're going to do that in 3 ways, which is kind of a combination phase II, phase III.

現在我們正在進入第三階段，這實際上是我們公司的投資組合轉型，著眼於改變我們的收入組合，以確保我們在高增長市場中擁有更多的收入組合。我們將以三種方式做到這一點，這是第二階段和第三階段的組合。

The first one is innovation. We're going to invest in innovation in the right areas, in faster growth markets so that we build more revenue through that innovation in those attractive markets, gives you real-time revenue growth, but it also makes it sustainable by increasing the weighted average market growth of the company. The second is investment in the commercial channel. You've got to have the commercial channel and capability to drive that innovation and make it real.

第一個是創新。我們將投資於正確領域的創新，在增長更快的市場中，以便我們通過在那些有吸引力的市場中的創新創造更多收入，為您提供實時收入增長，但它也通過增加加權平均數使其可持續公司的市場增長。二是商業渠道的投入。您必須擁有商業渠道和能力來推動創新並使其成為現實。

And the third is portfolio -- active portfolio management, really looking at moving things into the organization and out of the organization that can drive our weighted average market growth rate up. So we are clearly in that phase. We have a better balance sheet right now that we're going to be able to leverage in that part of the transformation.

第三是投資組合——積極的投資組合管理，真正著眼於將事物移入組織和移出組織，以推動我們的加權平均市場增長率上升。所以我們顯然處於那個階段。我們現在擁有更好的資產負債表，我們將能夠在轉型的那一部分中加以利用。

Make no mistake, we feel very confident about phase I, phase II and now phase III, given that balance sheet freedom that we're going to have going forward. And with that, I think we'll go ahead and end the call.

毫無疑問，我們對第一階段、第二階段和現在的第三階段非常有信心，因為我們將擁有資產負債表的自由度。有了這個，我想我們會繼續並結束通話。

Yes. Thanks, everyone, for joining us. I'm sure we'll talk today. And of course, if you have questions, please don't hesitate to reach out to the IR team. Have a great day.

是的。謝謝大家加入我們。我相信我們今天會談。當然，如果您有任何疑問，請隨時聯繫 IR 團隊。祝你有美好的一天。

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。