Zimmer Biomet Holdings Inc (ZBH) 2023 Q1 法說會逐字稿

Good morning, ladies and gentlemen, and welcome to the Zimmer Biomet First Quarter 2023 Earnings Conference Call. (Operator Instructions) I would now like to turn the conference over to Keri Mattox, Chief Communications Officer. Please go ahead.

女士們先生們，早上好，歡迎參加 Zimmer Biomet 2023 年第一季度收益電話會議。 （操作員說明）我現在想將會議轉交給首席傳播官 Keri Mattox。請繼續。

Thank you, operator, and good morning, everyone. We're joining you from our Warsaw, Indiana headquarters and are happy to be with you today. Welcome to Zimmer Biomet's First Quarter 2023 Earnings Conference Call. Joining me are Bryan Hanson, our Chairman, President and CEO, EVP and CFO, Suketu Upadhyay and COO, 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.

謝謝接線員，大家早上好。我們將從印第安納州華沙總部與您會面，今天很高興與您在一起。歡迎來到 Zimmer Biomet 的 2023 年第一季度收益電話會議。加入我的是 Bryan Hanson，我們的董事長、總裁兼首席執行官、執行副總裁兼首席財務官 Suketu Upadhyay 和首席運營官 Ivan Tornos。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。

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.

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 comparable GAAP financial measures is included within our Q1 earnings release, which can be found on our website, zimmerbiomet.com. With that, I'll turn the call over to Bryan. Bryan?

此外，本次電話會議的討論將包括某些非 GAAP 財務指標。這些措施與可比的 GAAP 財務措施的對賬包含在我們的第一季度收益發布中，可以在我們的網站 zimmerbiomet.com 上找到。有了這個，我會把電話轉給布萊恩。布萊恩？

All right. Thanks,Keri, and thanks to everyone for joining us on the call this morning. Hey, we don't get the opportunity to do this too often. So I'm going to take advantage of it. And I'm just going to start the call by simply saying this was a phenomenal quarter where pretty much everything went better than expected. And importantly, as a result of that momentum, we are significantly raising our full year top and bottom-line outlook, which Suky is going to talk about in just a minute. With that said, and maybe taking a step back. For today's call, I'll talk more about our Q1 performance and the drivers of that performance. And then Suky will get into more details for the quarter and importantly, also our financial guidance for the rest of the year.

好的。謝謝 Keri，也感謝大家今天早上加入我們的電話會議。嘿，我們很少有機會這樣做。所以我要好好利用它。我只是想通過簡單地說這是一個非凡的季度開始通話，幾乎所有事情都比預期的要好。重要的是，由於這種勢頭，我們顯著提高了全年的最高和最低預期，Suky 將在一分鐘內談到這一點。話雖如此，也許退後一步。在今天的電話會議上，我將更多地討論我們第一季度的表現以及該表現的驅動因素。然後 Suky 將詳細介紹本季度的更多細節，重要的是，還有我們今年剩餘時間的財務指導。

And then we'll make sure that we save plenty of time for your questions, which we look forward to addressing. But before we do any of that, I just want to take a minute to speak directly and personally to the ZB team and really truly say thank you for yet again, you have delivered beyond our expectations. And I'm very proud of what this team is doing to navigate an environment that, while improving, there's no question it's improving, it is still fluid. And it presents us with challenges that, quite frankly, seen like daily challenges. And it is truly impressive how you're navigating that environment right now. And I'm very proud of the dedication, the resilience and the innovative thinking that you're bringing to your roles each and every day. It is truly making a difference.

然後我們確保為您的問題節省大量時間，我們期待著解決這些問題。但在我們做任何這些之前，我只想花一分鐘時間直接和 ZB 團隊親自交談，再次真誠地感謝你們，你們的表現超出了我們的預期。我為這個團隊在環境中所做的努力感到非常自豪，在改善的同時，毫無疑問它正在改善，它仍然是流動的。它向我們提出了挑戰，坦率地說，這些挑戰被視為日常挑戰。你現在如何在那個環境中航行真是令人印象深刻。我為你們每天為自己的角色帶來的奉獻精神、韌性和創新思維感到非常自豪。這確實有所作為。

But I'm most proud of how together and I do mean together, we are living the ZB mission to alleviate pain and improve the quality of life for people around the world. And as we know, we do that every 8 seconds, 24 hours a day, 7 days a week, which is really what it's all about in the first place. So thank you. Thank you for what you do for ZB. Thank you for what you do for our customers and most of all, and most importantly, what you do for our patients, the patients that we serve every day.

但我最自豪的是我們在一起，我的意思是在一起，我們正在履行 ZB 的使命，為世界各地的人們減輕痛苦，提高生活質量。正如我們所知，我們每週 7 天、每天 24 小時每 8 秒執行一次，這首先就是真正的意義所在。所以謝謝。感謝您為ZB所做的一切。感謝您為我們的客戶所做的一切，最重要的是，最重要的是，感謝您為我們每天服務的患者所做的一切。

Okay. So let's take a look now at the first quarter. And as some of you may recall, coming into the year, our guidance assumed that Q1 would have the easiest comp of the year. But would also experience some headwinds from both staffing and COVID-related challenges that we felt would put pressure on elective procedures during the quarter. We also assumed that there would be a pretty high level of supply pressure in the first quarter. Our assumptions also believed that all 3 of these headwind variables would then improve throughout the year, providing less impact to the business. But then outside of the easy comp, Q1 would be pretty bumpy. Okay. So what actually happened in the quarter and why was it considerably stronger than we expected? Well, first and foremost, procedure recovery was much better than we anticipated, really having almost no material or meaningful impact from COVID or staffing challenges in the quarter. And second, we manage the supply constrained environment better than we originally anticipated.

好的。現在讓我們來看看第一季度。正如你們中的一些人可能還記得的那樣，進入今年，我們的指導假設第一季度將是今年最簡單的組合。但也會遇到一些來自人員配置和 COVID 相關挑戰的不利因素，我們認為這會給本季度的選修程序帶來壓力。我們還假設第一季度會有相當高的供應壓力。我們的假設還認為，所有這 3 個逆風變量將在全年得到改善，對業務的影響較小。但是在簡單的競爭之外，Q1 會非常坎坷。好的。那麼本季度實際發生了什麼，為什麼它比我們預期的要強得多？好吧，首先，程序恢復比我們預期的要好得多，實際上幾乎沒有受到本季度 COVID 或人員配置挑戰的實質性或有意義的影響。其次，我們比我們原先預期的更好地管理供應受限的環境。

Make no mistake, supply is a real problem and it's putting pressure on the business. But this team has done an excellent job managing that environment, probably leveraging some muscle memory from the past. And then third, and I think really importantly, our team's execution and traction with our new product innovation is even stronger than we anticipated. And that's important because it's going to continue to provide benefit to the rest of the year. And so because of this, we saw another quarter of very positive year-over-year momentum in large joints. With our global hip and knee businesses growing approximately 13% and 18% on an ex-FX basis. Our overall SET category grew more than 6%. Driven by strong low double-digit performance in our growth drivers in set, which we've talked about before, being sports, CMFT and upper extremities. And then this was partially offset, as expected, from headwinds from our Restorative Therapies business, where these headwinds will anniversary. And as you remember, these are reimbursement change headwinds that we have in that business, they should anniversary by the back half of this year.

毫無疑問，供應是一個真正的問題，它給企業帶來了壓力。但是這個團隊在管理該環境方面做得非常出色，可能利用了過去的一些肌肉記憶。然後是第三，我認為非常重要的是，我們團隊對新產品創新的執行力和吸引力比我們預期的還要強大。這很重要，因為它將繼續為今年剩餘時間帶來好處。因此，我們在大型關節中看到了另一個季度非常積極的同比增長勢頭。我們的全球髖關節和膝關節業務在不含外彙的基礎上分別增長了約 13% 和 18%。我們的整體 SET 類別增長超過 6%。在我們之前討論過的增長驅動因素中，強勁的低兩位數表現推動了運動、CMFT 和上肢。然後，正如預期的那樣，這部分抵消了我們恢復性療法業務的逆風，這些逆風將在周年紀念日出現。正如你記得的那樣，這些是我們在該業務中遇到的報銷變更逆風，它們應該在今年下半年周年紀念。

And then finally, our other category grew 11% in the quarter. So needless to say, it was a pretty strong quarter. The momentum is real in this business, and our confidence is extremely high. And there's good reason for this confidence. If we just think about this quarter alone, we officially launched our new cementless knee form factor at Persona OsseoTi and this is adding to the Persona family and really strategically rounding out that portfolio. And this new Kel-design tray is extremely versatile. It's anatomic because it is the Persona family, and it's stable. And it's the only need that you could do a cemented or cementless procedure with an interoperative decision possible for the surgeon. And that's a big deal. We believe that this will enhance the potential for cementless penetration because surgeons can go into a questionable bone quality procedure with the intent to use cementless, but then they have the ability to pivot back to cemented at the bone quality isn't there. And for this reason and a lot of other reasons, customer feedback so far has been extremely positive as we've launched this product.

最後，我們的其他類別在本季度增長了 11%。不用說，這是一個非常強勁的季度。這項業務的勢頭是真實的，我們的信心非常高。這種信心是有充分理由的。如果我們只考慮本季度，我們在 Persona OsseoTi 正式推出了我們新的非骨水泥膝關節形狀因子，這將增加 Persona 系列，並真正從戰略上完善該產品組合。這款全新的 Kel 設計托盤用途極為廣泛。它是解剖學的，因為它是 Persona 家族，而且它很穩定。並且這是您可以進行骨水泥或非骨水泥手術的唯一需要，外科醫生可以在手術間做出決定。這是一件大事。我們相信這將提高非骨水泥穿透的潛力，因為外科醫生可能會為了使用非骨水泥而進行有問題的骨質量手術，但隨後他們有能力在骨質量不存在時轉回使用骨水泥。由於這個原因和許多其他原因，到目前為止，我們推出該產品時，客戶的反饋非常積極。

And as you may know, our cementless penetration is already in the mid-teens, but we believe that this can get to 50% or higher penetration. And we're excited about that. And we truly do believe that this premium product can accelerate that growth for ZB and is already doing so. It's still early days. Our full launch is planned for the middle of this year as more sets become available.

正如您所知，我們的非水泥滲透率已經在十幾歲左右，但我們相信這可以達到 50% 或更高的滲透率。我們對此感到興奮。我們確實相信這款優質產品可以加速 ZB 的增長，而且已經在這樣做了。現在還為時尚早。隨著更多套裝的推出，我們計劃於今年年中全面推出。

Make no mistake, this is a real driver for not just our knee franchise but for the overall company. So we're very excited. As you remember, back in February, we also closed our acquisition of Embody, which is providing access to differentiated products and an innovative pipeline for our sports medicine business. And this investment helps expand ZB's presence in this very attractive high-growth market while also in that market, serving our customers and our patients better. And this, combined with a very strong innovation pipeline that we have in sports and the dedicated commercial channel that we put into place gives us continued confidence in our global sports franchise.

別搞錯了，這不僅是我們膝蓋特許經營權的真正推動力，也是整個公司的真正推動力。所以我們非常興奮。如您所知，早在 2 月份，我們還完成了對 Embody 的收購，這為我們的運動醫學業務提供了差異化產品和創新渠道。這項投資有助於擴大 ZB 在這個極具吸引力的高增長市場中的影響力，同時也在該市場中更好地為我們的客戶和患者提供服務。而這一點，再加上我們在體育領域擁有的非常強大的創新渠道和我們建立的專用商業渠道，使我們對我們的全球體育特許經營權充滿信心。

And if you were the AAOS meeting, you would have seen that we previewed our HAMR product, which is designed to ensure consistent and reproducible compaction for hip procedures while allowing the surgeon to dial up or dial back the force of the strike depending on the individual patient need. And this ability to be more personalized, actually differentiates HAMR versus other compaction devices on the market.

如果你是參加 AAOS 會議的人，你會看到我們預覽了我們的 HAMR 產品，該產品旨在確保髖關節手術的壓實一致且可重複，同時允許外科醫生根據個人情況調高或調低打擊力病人需要。這種更加個性化的能力實際上使 HAMR 與市場上的其他壓實設備區分開來。

So needless to say, we're excited about this differentiated product. We believe this could actually increase not only the consistency for surgeons, but also the procedure efficiency, which is really important right now and our current expectation is to launch HAMR in the third quarter of this year. And if you just look at these combined products, this is actually building on other launches that we've talked about, the Persona iQ, Hip Insights, the Identity shoulder system. And in total, we've introduced more than 50, 5-0 new products from 2018 through the end of 2022, with the majority of those products coming in markets growing 4% or faster.

不用說，我們對這種與眾不同的產品感到興奮。我們相信這實際上不僅可以提高外科醫生的一致性，還可以提高手術效率，這在目前非常重要，我們目前的預期是在今年第三季度推出 HAMR。如果你只看這些組合產品，這實際上是建立在我們已經討論過的其他產品的基礎上的，Persona iQ、Hip Insights、Identity 肩部系統。從 2018 年到 2022 年底，我們總共推出了 50 多種 5-0 的新產品，其中大多數產品的市場增長率為 4% 或更快。

And we're geared to continue that momentum. It doesn't stop here. with another 40, 4-0 planned product launches between this year and the end of 2025, again, with the majority of those products to be launched in 4%-plus growth markets. And this shift not only continues the transformation of our product portfolio, it gives us short-term revenue growth, but it also improves our weighted average market growth.

我們準備繼續保持這種勢頭。它不止於此。從今年到 2025 年底，計劃再推出 40 個 4-0 產品，其中大部分產品將在 4% 以上的增長市場推出。這種轉變不僅繼續了我們產品組合的轉型，它給我們帶來了短期收入增長，而且還提高了我們的加權平均市場增長。

And ultimately, as a result of that gives us more confidence that our markets and our portfolio mix positions the company for sustainable mid-single-digit growth. And with this kind of traction around our product pipeline, increasing strength of our balance sheet and our team members' ability to execute, ZB continues to be well positioned to deliver value today and in the future and achieve our mission as a company. And with that, I'm going to turn the call over to Suky to take a closer look at Q1 and our latest expectations for 2023. Okay, Suky?

最終，這讓我們更有信心相信我們的市場和我們的投資組合將使公司實現可持續的中個位數增長。憑藉圍繞我們產品線的這種牽引力、我們資產負債表實力的增強和我們團隊成員執行能力的增強，ZB 繼續處於有利地位，可以在今天和未來創造價值，並實現我們作為一家公司的使命。有了這個，我將把電話轉給 Suky 來仔細研究第一季度和我們對 2023 年的最新預期。好的，Suky？

Thanks, and good morning, everyone. As Bryan mentioned, we had an excellent quarter with better-than-expected results. As a result of continued market normalization and the strength of our performance, we are increasing and narrowing our full year financial outlook. With that, let's turn to our results and updated full year guidance.

謝謝，大家早上好。正如布萊恩所說，我們有一個出色的季度，結果好於預期。由於市場持續正常化和我們的業績強勁，我們正在增加和縮小我們的全年財務展望。有了這個，讓我們轉向我們的結果和更新的全年指導。

Unless otherwise noted, my statements will be about the first quarter and how it compares to the same period in 2022, and my commentary will be on a constant currency and adjusted operating basis. Net sales were $1.831 billion, an increase of 10.1% on a reported basis and an increase of 13.2%, excluding the impact of foreign currency. As we noted on our last call, we had a selling day tailwind of about 100 basis points this quarter. Overall, the business benefited from faster-than-expected recovery of elective procedures, driven by the easing of staffing-related headwinds on normalization of cancellation rates and some backlog recapture.

除非另有說明，否則我的陳述將是關於第一季度的，以及它與 2022 年同期相比如何，我的評論將以不變貨幣和調整後的運營為基礎。淨銷售額為 18.31 億美元，較報告基礎增長 10.1%，剔除外匯影響後增長 13.2%。正如我們在上次電話會議中指出的那樣，本季度我們的賣出日順風約為 100 個基點。總體而言，該業務受益於選擇性程序恢復速度快於預期，這是由於與取消率正常化和一些積壓重新獲取相關的人員配置相關不利因素有所緩解。

Also, we benefited from lighter comps, strong commercial and supply chain execution and new product uptake. While we continue to face macro supply headwinds, our teams have been doing a great job mitigating these challenges. U.S. growth of 12.7% was well ahead of our expectations with elective procedure volumes recovering and procedure cancellation rates returning to pre-pandemic levels.

此外，我們還受益於更輕的組合、強大的商業和供應鏈執行以及新產品的採用。雖然我們繼續面臨宏觀供應逆風，但我們的團隊在緩解這些挑戰方面做得很好。美國 12.7% 的增長率遠超我們的預期，選擇性手術量正在恢復，手術取消率也恢復到大流行前的水平。

International sales grew 14% and with EMEA growing ahead of expectations driven by faster recovery and strength across both developed and emerging markets. And in APAC, we saw some pressure in China as anticipated, but results were generally in line with our expectations. Turning to business category performance. Global Knees grew 18.2%, with U.S. growing 18.1% and international growth at 18.2% Specifically, we saw a strong uptake across the full Persona product portfolio and traction in all regions. We now have the Persona primary partial revision and OsseoTi cementless options rounding out our full product line. And we are seeing very encouraging results across that new cement form factor. This full Persona product line not only improves and enhances our product mix benefit, but also supports the continued utilization of ROSA and associated pull-through.

國際銷售額增長 14%，歐洲、中東和非洲地區的增長超出預期，這得益於發達市場和新興市場更快的複蘇和實力。在亞太地區，正如預期的那樣，我們在中國看到了一些壓力，但結果總體上符合我們的預期。轉向業務類別性能。全球膝蓋增長 18.2%，其中美國增長 18.1%，國際增長 18.2% 具體來說，我們看到整個 Persona 產品組合的強勁增長以及在所有地區的吸引力。我們現在擁有 Persona 主要部分修訂版和 OsseoTi 非骨水泥選項，完善了我們的完整產品線。我們在新的水泥形狀因素上看到了非常令人鼓舞的結果。這一完整的 Persona 產品線不僅改善和增強了我們的產品組合優勢，而且還支持 ROSA 的持續利用和相關的 pull-through 。

Global Hips grew 12.9% with U.S. hips up 12.3% and international up 13.5%, driven by continued traction across the Avenir and G7 product lines, along with ongoing uptake of ROSA hip. And we are encouraged by the early impact of the Hip Insight launch. The SET category grew 6.4%, driven by continued strong performance across our key focus areas of CMFT, sports medicine and upper extremities, all of which grew in the teens.

全球臀部增長 12.9%，其中美國臀部增長 12.3%，國際增長 13.5%，這得益於 Avenir 和 G7 產品線的持續牽引力，以及 ROSA 臀部的持續採用。我們對 Hip Insight 發布的早期影響感到鼓舞。 SET 類別增長了 6.4%，這得益於我們在 CMFT、運動醫學和上肢等主要重點領域的持續強勁表現，所有這些領域都在青少年中增長。

This was partially offset by lower growth in other parts of SET, which includes the reimbursement changes in restorer therapies that will anniversary mid this year. Finally, our other category grew 11.1%, partially driven by some larger orders in surgical products, which may not repeat over time.

這部分被 SET 其他部分的較低增長所抵消，其中包括今年年中周年紀念日的恢復療法的報銷變化。最後，我們的其他類別增長了 11.1%，部分原因是外科產品的一些較大訂單，隨著時間的推移可能不會重複。

Moving to the P&L. For the quarter, we reported GAAP diluted earnings per share of $1.11 compared to our GAAP diluted earnings per share of $0.35 in the prior year. While investments in R&D and commercial infrastructure increased, net earnings were higher this quarter, driven by revenues, improved gross margins and losses in the prior year related to XMD. On an adjusted basis, diluted earnings per share of $1.89 represents a 17% increase from $1.61 in the first quarter of 2022. Adjusted gross margin was 72.8%, up 220 basis points from the prior year.

轉到損益表。本季度，我們報告的 GAAP 攤薄後每股收益為 1.11 美元，而去年我們的 GAAP 攤薄後每股收益為 0.35 美元。雖然對研發和商業基礎設施的投資有所增加，但本季度的淨收益有所增加，這是受收入、毛利率提高以及與 XMD 相關的上一年虧損的推動。在調整後的基礎上，攤薄後每股收益為 1.89 美元，比 2022 年第一季度的 1.61 美元增長 17%。調整後的毛利率為 72.8%，比上年增長 220 個基點。

These results were positively impacted by favorable mix related to large joints performance and foreign currency hedge gains. Excluding these items, underlying gross margin was broadly in line with our expectations. Related to inflation, we are seeing some incremental pressure from spot buying and contract manufacturing pricing. But overall, inflationary pressure has largely stabilized. Our adjusted operating margin for the first quarter was 28.4%, up 200 basis points, primarily driven by revenue, better gross margin and continued discipline around our investment profile. Interest and non-operating expenses of $46 million and our adjusted tax rate of 16.3% were broadly in line with our expectations.

這些結果受到與大型聯合業績和外匯對沖收益相關的有利組合的積極影響。排除這些項目，基礎毛利率大致符合我們的預期。與通貨膨脹相關，我們看到現貨購買和合同製造定價帶來了一些增量壓力。但總體而言，通脹壓力已基本穩定。我們第一季度調整後的營業利潤率為 28.4%，上升了 200 個基點，這主要是由於收入、毛利率提高以及我們對投資狀況的持續約束。 4600 萬美元的利息和營業外支出以及我們調整後的 16.3% 的稅率基本符合我們的預期。

Turning to cash and liquidity. Operating cash flows were $308 million and free cash flow totaled $178 million. We ended the quarter with cash and cash equivalents of approximately $330 million. Now moving to our updated financial outlook for 2023. Based on strong Q1 results and our ongoing strong execution, we are raising and narrowing our full year 2023 outlook. Constant currency revenue growth is now expected to be 6% to 7% versus 2022.

轉向現金和流動性。經營現金流為 3.08 億美元，自由現金流總計 1.78 億美元。本季度末，我們的現金和現金等價物約為 3.3 億美元。現在轉向我們更新的 2023 年財務展望。基於強勁的第一季度業績和我們持續的強勁執行力，我們正在提高和縮小 2023 年全年展望。現在預計與 2022 年相比，貨幣收入的恆定增長率為 6% 至 7%。

And with an expected foreign currency exchange headwind of 100 basis points. We are also updating our adjusted EPS guidance range, now expecting $7.40 to $7.50. While we initially gave color that adjusted operating margin would be flat to slightly better in 2023, our Q1 results in tandem with an improved rest of year outlook gives us the confidence that we will expand operating margins this year. We continue to expect interest and other nonoperating expenses, along with our tax rate to be in line with our previous commentary. Finally, we now expect free cash flow for the year to increase to a range of $1 billion to $1.1 billion.

預計外幣匯率將面臨 100 個基點的逆風。我們還更新了調整後的每股收益指導範圍，現在預計為 7.40 美元至 7.50 美元。雖然我們最初給出的顏色是調整後的營業利潤率將在 2023 年持平或略有改善，但我們的第一季度業績以及今年剩餘時間前景的改善讓我們有信心今年將擴大營業利潤率。我們繼續預計利息和其他非營業費用，以及我們的稅率將與我們之前的評論一致。最後，我們現在預計今年的自由現金流將增加到 10 億至 11 億美元。

In terms of quarterly cadence throughout the year, our expectations remain unchanged. Q1 will be the highest revenue growth quarter followed by Q4, which should benefit from improving supply and contribution from new and innovative products. As well as a selling day tailwind of about 100 basis points. Q2 and Q3 are expected to be lighter growth quarters given tougher comps and a net selling day headwind of about 100 basis points. Again, selling days will have a net neutral impact for the full year. We expect adjusted operating margin to largely follow revenue with second half operating margin being slightly better than the first half.

就全年的季度節奏而言，我們的預期保持不變。第一季度將是收入增長最快的季度，緊隨其後的是第四季度，這將受益於新產品和創新產品的供應和貢獻的改善。以及約 100 個基點的賣出日順風。鑑於更艱難的競爭和約 100 個基點的淨銷售日逆風，預計第二季度和第三季度將是較輕的增長季度。同樣，銷售天數將對全年產生淨中性影響。我們預計調整後的營業利潤率將在很大程度上跟隨收入，下半年營業利潤率略好於上半年。

In summary, we delivered excellent top line results beating internal expectations in nearly every category, while posting very strong adjusted earnings performance. Our business is executing well. Our pipeline is delivering, and our momentum is real. We feel very confident as we move forward. With that, I'll turn the call back over to Keri to start the Q&A.

總而言之，我們幾乎在每個類別中都取得了超出內部預期的優異業績，同時公佈了非常強勁的調整後收益表現。我們的業務執行良好。我們的管道正在交付，我們的勢頭是真實的。我們在前進的過程中感到非常自信。有了這個，我會把電話轉回 Keri 開始問答。

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

謝謝，蘇基。在我們開始問答環節之前，請快速提醒一下，請將自己限制在一個問題和一個後續問題上，這樣我們就可以在通話期間解決盡可能多的問題。那麼，接線員，我們可以問第一個問題嗎？

We'll take our first question from Steve Lichtman with Oppenheimer.

我們將從 Steve Lichtman 和 Oppenheimer 提出我們的第一個問題。

Congratulations on the quarter. I guess, first one, I want to start on the knee and hip market. Obviously, very strong for ZB and for the market. As you noted comps play a part. I was wondering if you could talk about what you think sort of underlying market growth here is and maybe talk a little bit about procedure growth and where sort of pricing stands as well?

祝賀這個季度。我想，首先，我想從膝蓋和臀部市場開始。顯然，對於中幣和市場來說，都是非常強大的。正如您所指出的，補償發揮了作用。我想知道你是否可以談談你認為這裡的潛在市場增長是什麼，也許可以談談程序增長以及定價的立場？

Sure, Steve. Thanks for the question. This is Suky and let everyone on the call. The first thing I'd just step back, overall, we had a very good first quarter, as you can see from the results. And it was really across all of our business segments, including all of our regions, and that flowed through all the way through the P&L. So really happy about the quality and the execution of the entire team. We did always think that Q1 would be our strongest growth quarter.

當然，史蒂夫。謝謝你的問題。我是 Suky，讓大家接聽電話。首先我要退後一步，總的來說，我們第一季度表現非常好，正如你從結果中看到的那樣。它確實跨越了我們所有的業務部門，包括我們所有的地區，並且一直貫穿於損益表。對整個團隊的素質和執行力感到非常高興。我們一直認為第一季度將是我們最強勁的增長季度。

We talked about that when we gave our initial guidance for the year. That was really 2 key drivers. One is you had a strong comp benefit versus the first quarter of 2022. Clearly, we were still dealing with Omicron back in 2022. Secondly, we talked about a day rate tailwind of 100 basis points. So we knew year-over-year that we would see strong growth. But we achieved better than that and really across every one of our business segments, as I pointed out earlier.

我們在給出今年的初步指導意見時談到了這一點。這確實是 2 個關鍵驅動因素。一是與 2022 年第一季度相比，您獲得了強勁的補償收益。顯然，我們在 2022 年仍在與 Omicron 打交道。其次，我們談到了 100 個基點的日利率順風。所以我們知道年復一年我們會看到強勁的增長。但正如我之前指出的那樣，我們取得了比這更好的成績，而且確實跨越了我們的每一個業務部門。

But recall where our expectations were before. We thought we would continue to see some procedural volume challenges and staffing challenges and also supply chain headwinds. So that underpinned our previous guide. But we actually overachieved relative to those macro factors. Where we just didn't see as much staffing or COVID pressure. We also saw some backlog come into the marketplace. And so from a macro standpoint, it was better than we expected.

但回想一下我們之前的期望是什麼。我們認為我們將繼續看到一些程序量挑戰和人員配置挑戰以及供應鏈逆風。因此，這鞏固了我們之前的指南。但相對於這些宏觀因素，我們實際上超額完成了。我們只是沒有看到那麼多的人員配備或 COVID 壓力。我們還看到一些積壓訂單進入市場。所以從宏觀的角度來看，它比我們預期的要好。

And then also our execution was incredibly strong. Our innovation was very strong across commercial but also supply chain. So really happy with where everybody sort of executed for the quarter. And we think that, that store will going forward.

然後我們的執行力也非常強大。我們的創新在商業和供應鏈上都非常強大。對每個人在本季度的執行情況感到非常滿意。我們認為，那家商店會繼續發展。

Relative to your specific question on the overall market growth rates, I would just say, we're not yet in normal market growth. You clearly continue to have some choppy comp comparisons versus the prior year. We do still think we're going to continue to face some headwinds relative to staffing and of course, supply chain continues to be a very real challenge out there, partially offset by some backlog tailwinds. So again, the markets, I think, are anything but normal yet.

關於你關於整體市場增長率的具體問題，我只想說，我們還沒有進入正常的市場增長。你顯然繼續與前一年進行一些不穩定的比較。我們仍然認為我們將繼續面臨與人員配置相關的一些不利因素，當然，供應鏈仍然是一個非常現實的挑戰，部分被積壓的不利因素所抵消。因此，我認為，市場仍然不正常。

But I would say they're very strong they're improving and normalizing, and we're very encouraged about where they're going. Pricing in the quarter was a little bit, I would say, kind of in line with where we expected it to be. We always talked about this year being a bit better than the traditional 200 to 300 basis points that we've seen historically. And at 140 basis points of erosion that was right in line with where we expected to be.

但我會說他們非常強大，他們正在改進和正常化，我們對他們的發展方向感到非常鼓舞。我想說，本季度的定價有點符合我們的預期。我們總是說今年比我們歷史上看到的傳統 200 到 300 個基點要好一些。在 140 個基點的侵蝕下，這正好符合我們的預期。

And one product on the new side that is yet benefiting you is on a Persona IQ. I was wondering if you could give us your updated thoughts on that, how the limited launch is going and maybe your latest thoughts on the outlook for that product, particularly after the NTAP proposal.

Persona IQ 是一種新的產品，它仍然使您受益。我想知道您是否可以向我們提供您對此的最新想法、有限發布的進展情況以及您對該產品前景的最新想法，尤其是在 NTAP 提案之後。

Thank you, Steve, Ivan here. So lots of excitement as of late on Persona IQ. As of late, obviously, we got the NTAP indication that we're kicking October of 2023, were featured in the Wall Street Journal that got a lot of attention. We've signed additional contracts all over the U.S. with advancing rapidly in our limited market release, which as we said in the past, is more clinical in nature than commercial. We got now north of 500 million data points. And again, that's gained a lot of excitement.

謝謝史蒂夫，這裡是伊万。 Persona IQ 最近令人興奮不已。很明顯，最近，我們得到了 NTAP 的指示，表明我們將於 2023 年 10 月開始，這在華爾街日報上得到了廣泛關注。我們在美國各地簽署了額外的合同，並在我們有限的市場發布中迅速推進，正如我們過去所說，這在本質上比商業更重要。我們現在獲得了超過 5 億個數據點。再一次，這引起了很多興奮。

In terms of where we are, I'll tell you nothing has changed. We believe we'll be in a position to launch speed product by the end of 2023. We're working on 4 key things when it comes to this limited market release. #1 is understanding the clinical value proposition as well as the commercial value proposition. What do we do with all this data? What is the best way to position this product in the marketplace. #2, as you can imagine, with the data component, there is a bit of a back-and-forth ownership, how do we utilize it, how do we make the best out of all this data. So we can act on it. And I would say with that tends a lot in this regard. Number 3 is making sure that, overall, the customer experience is seamless.

就我們所處的位置而言，我會告訴你什麼都沒有改變。我們相信我們將能夠在 2023 年底之前推出速度產品。我們正在為這個有限的市場發布做 4 件關鍵的事情。 #1 是理解臨床價值主張和商業價值主張。我們如何處理所有這些數據？在市場上定位該產品的最佳方式是什麼。 #2，正如您想像的那樣，對於數據組件，存在一些來回所有權，我們如何利用它，我們如何充分利用所有這些數據。所以我們可以採取行動。我會說在這方面有很多傾向。第三是確保總體上客戶體驗是無縫的。

This involves patient education; this involves caregiver education. We're going to make sure that this is a best-in-class experience. And then number 4 is how do we monetize the device. So in those 4 key areas, we've made tremendous advancements. And I do believe we're going to be in a position to launch at the end of the year.

這涉及患者教育；這涉及照顧者教育。我們將確保這是一流的體驗。然後第 4 點是我們如何通過設備獲利。因此，在這 4 個關鍵領域，我們取得了巨大進步。而且我相信我們將能夠在今年年底推出。

The NTAP is not going to impact every single patient, but it's a sizable amount of patients that are going to benefit from the additional reimbursement. And again, it's just another reminder that this is breakthrough technology, first to market, new to market that will make a difference. So the exigent is high, and we look forward to updating you guys down the road.

NTAP 不會影響每一位患者，但有相當數量的患者將從額外的報銷中受益。再一次，這只是另一個提醒，這是突破性的技術，首先推向市場，新的市場將產生影響。所以緊急情況很高，我們期待著在路上更新你們。

Thanks so much, Steve. Operator, can we go to the next question?

非常感謝，史蒂夫。接線員，我們可以轉到下一個問題嗎？

We'll go next to Shagun Singh with RBC.

我們將與 RBC 一起去 Shagun Singh。

Congratulations on a really strong print here. I guess just a question around guidance and Q2 trends. So your guidance is about 6% to 7% ex FX in 2023. Can you just walk us through expectations around cadence, perhaps shed some light on April trends for your business? how you expect that to stack up versus Q2. I think prior to the call, consensus was looking for sales and EPS of 1.79 and 1.77, respectively, your guidance obviously implies strength beyond Q1. So any color there? And then longer term, what does it mean for the growth profile for Zimmer going forward really versus consensus? I believe for 2024 is around 4.5%. So any color there would be great.

祝賀你在這裡打印出非常強大的打印效果。我想這只是一個關於指導和第二季度趨勢的問題。因此，您的指導意見是 2023 年除外匯外匯率約為 6% 至 7%。您能否向我們介紹一下圍繞節奏的預期，或許可以闡明您的業務在 4 月份的趨勢？你期望它與第二季度相比如何。我認為在電話會議之前，一致認為銷售額和每股收益分別為 1.79 和 1.77，您的指導顯然意味著超過第一季度的實力。那麼有什麼顏色嗎？然後從長遠來看，這對 Zimmer 未來的增長狀況與共識相比意味著什麼？我相信 2024 年約為 4.5%。所以任何顏色都會很棒。

Yes. Shagun, it's Suky. Thank you for the question. We definitely saw a very good quarter in the year in the first quarter, and we're expecting that momentum to carry through. And I think you would see that in our rest of year guide coming up to 6% to 7% ex FX. From a quarterly cadence standpoint, I would expect the overall growth rates in each quarter from here to step down from the first quarter.

是的。 Shagun，是 Suky。感謝你的提問。今年第一季度，我們確實看到了一個非常好的季度，我們預計這種勢頭會持續下去。我想你會在我們今年剩餘時間的指南中看到 6% 到 7% ex FX。從季度節奏的角度來看，我預計每個季度的整體增長率將從第一季度開始下降。

And it really goes back to that one that comp benefit I talked about in the first quarter on Steve's question, but also, we have that day rate tailwind of about 100 basis points in the first quarter. So that you should think about, again, the first quarter being the highest fourth quarter being the second highest from a growth perspective and the second and third being a little bit lighter just based on tougher comps and a net day rate headwind. And so that's how you should think about cadence.

這真的可以追溯到我在第一季度就史蒂夫的問題談到的那個補償收益，而且，我們在第一季度有大約 100 個基點的日利率順風。因此，您應該再次考慮，從增長的角度來看，第一季度是最高的，第四季度是第二高的，而第二和第三季度是基於更嚴格的補償和淨日利率逆風而稍微輕一些。這就是你應該如何考慮節奏。

But definitely, we're lifting our guidance by more than just the first quarter outperformance. We're actually pulling that momentum through the rest of the year as part of that raise. Maybe Bryan, do you want to talk about the underlying growth as we move forward.

但可以肯定的是，我們不僅僅是通過第一季度的出色表現來提升我們的指導。作為加薪的一部分，我們實際上在今年餘下的時間里拉動了這種勢頭。也許布萊恩，你想談談我們前進時的潛在增長嗎？

I mean, we've stated it before. And obviously, just based on our performance today, our confidence level is even higher. We do believe that we're 4-plus percent grower in a normal market. is not exactly normal right now, as Suky talked about before, but our confidence continues to grow that we're in the right markets. We continue to build scale in more attractive submarkets and our confidence design.

我的意思是，我們之前已經說過了。顯然，僅根據我們今天的表現，我們的信心水平就更高了。我們確實相信，在正常市場中，我們的增長率超過 4%。正如 Suky 之前所說，現在並不完全正常，但我們對自己處於正確市場的信心不斷增強。我們繼續在更具吸引力的子市場和我們的信心設計中建立規模。

And just any color on April trends?

4 月流行趨勢的任何顏色？

I would say, continue to support our increase in guidance. So things continue to -- our guidance initially showed or had an assumption of improvement throughout the year. Our current increase in guide assumes that as well in the early days in April continuing to prove that out.

我會說，繼續支持我們增加指導。所以事情繼續 - 我們的指導最初顯示或假設全年都會有所改善。我們當前增加的指南假設以及在 4 月初繼續證明這一點。

Thanks shagun. Operator, can we go to the next question?

謝謝沙根。接線員，我們可以轉到下一個問題嗎？

We'll go next to Matt Taylor with Jefferies.

我們將與 Jefferies 一起去 Matt Taylor 旁邊。

You hear me, okay?

你聽我說，好嗎？

We can.

我們可以。

Great. So Suky, I want to ask you a question about margins. Because to your point, you're fortunate now you have this maybe excess growth. We don't know exactly. But that gives you a lot of margin to work with. And so I think, ultimately, that's what people care about is how our margin is going to progress. And I know you've talked a lot about it. But if you enjoy this excess growth for a while, how are you going to use that? Are you going to reinvest? Or are you going to let it drop through? What are you thinking about in terms of how to use the excess margin?

偉大的。 Suky，我想問你一個關於利潤率的問題。因為就你的觀點而言，你很幸運，現在你有這種可能的過度增長。我們不確切知道。但這給了你很大的工作餘地。所以我認為，最終，人們關心的是我們的利潤率將如何增長。我知道你已經談了很多了。但是，如果你暫時享受這種超額增長，你將如何利用它？你打算再投資嗎？或者你打算讓它通過嗎？關於如何使用超額保證金，您有什麼想法？

Yes. I'd say the first thing is that it feels good to be in a position where you have the optionality, right, of deciding where you're going to put that additional growth in the margin or the profitability upside that comes from that. We continue to have a very strong, robust and innovative pipeline. We're going to continue to invest against the business in the right way, in a disciplined way. We're going to continue to be focused and make choices about, continue to expand in faster-growth submarkets that have good profitability profiles.

是的。我要說的第一件事是，處於一個你有選擇權的位置感覺很好，對，決定你要把額外的利潤增長或由此產生的盈利能力提高到哪裡。我們繼續擁有非常強大、穩健和創新的渠道。我們將繼續以正確的方式、有紀律的方式對業務進行投資。我們將繼續關注並做出選擇，繼續在具有良好盈利能力的快速增長的子市場中擴張。

We believe we can do that while still expanding margins over time. And that really comes from the strength and the discipline of the overall team in driving efficiency and mix shift in that investment profile to make sure that we're growing the top line while still growing the bottom-line. So we think we can do both over time.

我們相信我們可以做到這一點，同時隨著時間的推移仍在擴大利潤率。這真的來自整個團隊在提高效率和投資組合轉變方面的實力和紀律，以確保我們在增加收入的同時仍在增加利潤。所以我們認為我們可以隨著時間的推移做到這兩點。

Great. And one follow-up. So no one quite knows what's going to happen here, right? But it seems like there may be some excess demand for a while. And the best type of margin is that, that comes from excess organic growth, right? And so you may have that for a while. So how are you thinking about that? You talk about yourself as a 4% grower, but I mean clearly, you just outperformed that by a lot. And I guess, a, how long can that last? And then b, if it does last longer, then how does that change how you run the business?

偉大的。和一個後續行動。所以沒有人完全知道這裡會發生什麼，對吧？但似乎在一段時間內可能會有一些過剩的需求。最好的利潤類型是來自過度的有機增長，對吧？所以你可能會有一段時間。那你怎麼想的？你說自己是一個 4% 的種植者，但我的意思很明確，你的表現要好很多。我想，a，這能持續多久？然後 b，如果它確實持續更長時間，那麼這將如何改變您經營業務的方式？

Just going back to your point there, remember the comp benefit in Q1 was a key driver beyond underpinning that large overperformance relative to sort of that 4% to 5% we've been talking about. So just want to make sure that we've got good clarity around that. Having said that, as Bryan talked about, we do think and have even more confidence now based on our execution, based on the normalization of markets based on our pipeline, that 4 to 5 is a durable number, and we'd be disappointed again if we weren't able to achieve that in normalized markets. So we think that, that's sustainable over time. And then as we talked about, if that provides profitability upside that can be reinvested back into the business while still driving margin expansion. I mean that's where we want to be, right? That was the story underpinning our margin expansion all the way back to the beginning a few years ago, which is to be able to do this through revenue leverage, and do it in a high-quality way while investing back to the business.

回到你的觀點，請記住第一季度的競爭優勢是一個關鍵驅動因素，而不是支撐相對於我們一直在談論的 4% 到 5% 的大幅超額表現。所以只想確保我們對此有很好的了解。話雖如此，正如布萊恩所說，基於我們的執行，基於基於我們管道的市場正常化，我們確實認為並且現在更有信心，4 到 5 是一個持久的數字，我們會再次失望如果我們無法在正常化市場中實現這一目標。所以我們認為，隨著時間的推移，這是可持續的。然後正如我們所討論的那樣，如果這提供了可以重新投資回業務的盈利能力，同時仍然推動利潤率增長。我的意思是那是我們想要的地方，對吧？這就是支撐我們利潤率擴張的故事，一直追溯到幾年前，也就是能夠通過收入槓桿來做到這一點，並在投資回業務的同時以高質量的方式做到這一點。

Thank you so much.Operator, can we go to the next question?

非常感謝，接線員，我們可以進入下一個問題嗎？

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

我們將接受來自 Evercore ISI 的 Vijay Kumar 的下一個問題。

Congrats on really strong. I'll start here. My first one here, Bryan, there is some debate on perhaps demand being pulled forward here. Do you see this also in market growth as perhaps a catch-up of backlog as against a pull forward of demand and do you feel like with your product portfolio that you have, is Zimmer now gaining share in the market versus the industry?

恭喜真強。我將從這裡開始。我在這裡的第一個，布萊恩，這裡有一些關於也許需求被推進的爭論。您是否也認為這在市場增長中可能是對積壓的追趕而不是需求的拉動？您是否覺得您擁有的產品組合，Zimmer 現在是否在市場和行業中獲得份額？

Well, maybe I'll just quickly talk about what I see from a market standpoint, us versus market. And then maybe you could speak to, which I think when you say pull forward you talked about backlog consumption. So maybe you could talk about backlog, Suky. From us versus market perspective, it felt pretty good in the quarter. Obviously, we look at this on a year-over-year basis, a stack basis, a sequential basis versus our key competitors.

好吧，也許我會快速談談我從市場的角度來看，我們與市場的對比。然後也許你可以談談，我認為當你說向前推進時你談到了積壓消費。所以也許你可以談談積壓，Suky。從我們與市場的角度來看，本季度感覺相當不錯。顯然，我們是在逐年、堆棧、順序的基礎上與我們的主要競爭對手進行比較的。

But we try not to get overexuberant about any specific order or too depressed about any specific quarter. What we do look at, as I've always talked about, is an 8-quarter trend across those 3 vectors. If I go all the way back to Q2 of 2020, and I look at that consistent order trend, I feel very good about our position versus market. And I truly believe we're just getting started. So from us versus market perspective, I feel good, and I think it will only get better over time. If you think about the backlog, maybe you could speak to what we saw in the quarter.

但我們盡量不要對任何特定訂單過於樂觀或對任何特定季度過於沮喪。正如我一直在談論的那樣，我們所關注的是這 3 個向量的 8 個季度趨勢。如果我一直追溯到 2020 年第二季度，並且看到一致的訂單趨勢，我對我們相對於市場的地位感到非常滿意。我真的相信我們才剛剛開始。因此，從我們與市場的角度來看，我感覺很好，而且我認為隨著時間的推移它只會變得更好。如果你考慮積壓，也許你可以談談我們在本季度看到的情況。

Yes. So there are a lot of factors inside the quarter that drove the outsized performance. I talked about year-over-year our original expectations, but we were above that, again, for a number of variables, including less pressure than we expected. We saw some backlog. I talked about, and we were able to navigate supply chain and good commercial execution. I would say backlog was probably the smaller component of the overall change our performance relative to expectations in Q1.

是的。因此，本季度有很多因素推動了超額業績。我談到了與去年同期相比我們最初的預期，但我們再次超出了一些變量，包括低於我們預期的壓力。我們看到了一些積壓。我談到，我們能夠駕馭供應鍊和良好的商業執行。我想說，相對於第一季度的預期，積壓可能是我們業績整體變化的較小組成部分。

We do expect that to continue for the rest of the year. That's built into our guidance as we move forward. And so yes, it's good to have that a bit of an offset or tailwind relative to some of the other challenges we're seeing in the marketplace.

我們確實希望在今年餘下的時間裡繼續這種情況。在我們前進的過程中，這已納入我們的指導方針。所以是的，相對於我們在市場上看到的其他一些挑戰，有一點抵消或順風是件好事。

Understood. And Suky, one on margins for you. gross margins up 100 basis points sequentially. Can you just remind us on what was the impact of inflation, China BP, et cetera, in Q1? And what drove this sequential gross margin expansion? And when I look at your guidance, revenue raised by 250 basis points at the midpoint, EPS up by 6%. Clearly, that implies operating margin expansion I think, north of 50 basis points. Is it all coming from gross margins versus operating leverage?

明白了。還有 Suky，一個給你的利潤。毛利率環比上升 100 個基點。你能提醒我們一季度通脹、中國BP等的影響是什麼嗎？是什麼推動了這種連續的毛利率擴張？當我查看您的指引時，收入在中點提高了 250 個基點，每股收益增長了 6%。顯然，這意味著我認為營業利潤率擴大了 50 個基點以上。是否全部來自毛利率與經營槓桿？

Yes. So thanks for the question -- second question here, Vijay. The first thing is I'm just going to step back a little bit. As part of the overall margin expansion story, the Zimmer Biomet, we talked about ability to stabilize gross margins from '22 out for the next few years. Side of that on better revenue growth, we would leverage SG&A, which would give us the platform to then expand margins increase our earnings balance as a company. So that continues to be the strategy and story, and I think you're just seeing that play out here to 2023. Remember, as we came into '23, we talked about 100 basis points roughly of inflationary pressure in '22. That was going to capitalize in our P&L this year. That still remains true. In fact, probably seeing a little bit of additional incremental pressure on some areas of supply chain and inflation.

是的。謝謝你提出這個問題——這裡是第二個問題，Vijay。首先，我要退後一步。作為整體利潤率擴張故事的一部分，Zimmer Biomet，我們談到了在未來幾年從 22 年開始穩定毛利率的能力。在更好的收入增長方面，我們將利用 SG&A，這將為我們提供平台，然後擴大利潤率，增加我們作為一家公司的收益平衡。因此，這仍然是戰略和故事，我認為你只是看到這種情況一直持續到 2023 年。請記住，當我們進入 23 年時，我們在 22 年大致談到了 100 個基點的通脹壓力。這將利用我們今年的損益表。這仍然是正確的。事實上，供應鍊和通貨膨脹的某些領域可能會看到一些額外的增量壓力。

I talked about contract manufacturing supply prices. We're still doing some spot buys for certain raw materials. It's putting a modest amount of incremental pressure. Nothing significant, but something we just want to keep our eyes on for the rest of this year and into 2024. But again, inflation has largely stabilized. So that 100 basis points is definitely coming in year-over-year.

我談到了合同製造供應價格。我們仍在為某些原材料進行一些現貨採購。它施加了適度的增量壓力。沒什麼大不了的，但我們只想在今年餘下時間和 2024 年繼續關注。但同樣，通貨膨脹已基本穩定。因此，這 100 個基點肯定會同比增長。

But despite that, we said that 22% on gross margins would be relatively in line, excuse me, '23 versus 2022, right? So the teams are going to be able to find a way to offset that incremental headwind and we've largely done that. Now in the first quarter, we did see exceptional growth sequentially, but also year-over-year. There are a number of variables that drive that. But I'd say the 3 biggest are around volume gains, right, that led us year-over-year but also versus expectation. Saw some FX hedge gains in the quarter and also a pretty pronounced mix benefit, especially given the outsized performance of our large joints versus our SET and other category and also U.S. versus the rest of the world. So those are kind of the 3 dynamics that are going on.

但儘管如此，我們說 22% 的毛利率相對符合，對不起，23 年與 2022 年，對吧？因此，團隊將能夠找到一種方法來抵消這種不斷增加的逆風，而我們基本上已經做到了。現在在第一季度，我們確實看到了連續的超常增長，但也是同比的。有許多變量在驅動它。但我想說 3 個最大的是圍繞銷量增長，對，這導致我們同比增長但也低於預期。本季度看到了一些外匯對沖收益，並且還有相當明顯的混合收益，特別是考慮到我們的大型聯合公司與我們的 SET 和其他類別以及美國與世界其他地區相比表現出色。所以這些是正在發生的 3 種動態。

In the first quarter, we -- as we go through the rest of the year, we still expect those 3 variables to play a positive impact, but not at the same level, okay? So the way to think about this is gross margin for the rest of the year will step down versus Q1, but still for the overall year will be higher than it was in 2022. So you should think about it on an underlying basis, '23 being still in line with 2022, okay?

在第一季度，我們 - 在今年剩餘時間裡，我們仍然預計這 3 個變量會產生積極影響，但不是在同一水平上，好嗎？因此，考慮這一點的方式是，今年剩餘時間的毛利率將低於第一季度，但全年的毛利率仍將高於 2022 年。所以你應該從根本上考慮，'23仍然符合 2022 年，好嗎？

So gross margin is definitely a tailwind, underlying still consistent with prior year. The operating margin that you're implying off of our EPS guide is I think the directionally right way to think about that, and that upside is coming primarily from gross margin. So those are some of the building blocks that underpin our EPS raise for the year.

因此，毛利率絕對是順風，基本仍與上一年一致。你從我們的 EPS 指南中暗示的營業利潤率是我認為正確的方向思考方式，而這種上行空間主要來自毛利率。因此，這些是支撐我們今年 EPS 增長的一些基石。

Operator, can we have the next question?

接線員，我們可以有下一個問題嗎？

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。

Great. Thanks for the question, and congrats on a nice quarter. Maybe to start, I was hoping maybe you could dive into some of the drivers behind the knee growth rate. It was really impressive, definitely better than market growth and was just hoping you could help us understand how much is coming from robotics, from mix of new products and really dive into some of the growth drivers there?

偉大的。感謝您提出問題，並祝賀您度過了一個愉快的季度。也許首先，我希望你能深入了解膝蓋增長率背後的一些驅動因素。這真的令人印象深刻，絕對比市場增長好，只是希望你能幫助我們了解有多少來自機器人技術，來自新產品的組合，並真正深入了解那裡的一些增長動力？

Thank you, Robbie. Good talking to you this morning. I will probably bucket the performance in 2 key areas: commercial execution and innovation. And maybe I'll start with Slide #2, and I won't break down all the details on what's driving what. But clearly, new product introductions had to do a lot with the performance. As you know, during Las Vegas, we launched Persona OsseoTi, that is our cementless new form factor platform, and that is gaining traction.

謝謝你，羅比。今天早上很高興和你交談。我可能會在兩個關鍵領域表現出色：商業執行和創新。也許我會從幻燈片 #2 開始，我不會分解有關驅動因素的所有細節。但顯然，新產品的推出對性能有很大影響。如您所知，在拉斯維加斯期間，我們推出了 Persona OsseoTi，這是我們的非水泥新外形平台，並且越來越受歡迎。

I'll tell you, roughly 1/3 of all customers for Persona OsseoTi are competitive accounts. We've seen that with Persona OsseoTi with increasing also the penetration robotics. And again, I won't break down the size of that increase. But we've seen an increase in robotic cases done in combination, personas and ROSA. So definitely a driver there. Persona iQ, obviously, too early but ROSA overall, with Persona primary is gaining traction across the globe. The ecosystem, the interconnectivity of implants and CV is gaining momentum. And that's the momentum whether you hit in the U.S. or you're in Europe or Asia Pacific. So again, a lot to unpack when it comes to innovation. On commercial execution, we navigated supply challenges, I think, very effectively, very proud of what the team has done in that regard.

我告訴你，Persona OsseoTi 的所有客戶中大約有 1/3 是競爭客戶。我們已經看到 Persona OsseoTi 也增加了穿透機器人技術。再說一遍，我不會詳細說明增長的規模。但是我們已經看到結合角色和 ROSA 完成的機器人案例有所增加。所以肯定是那裡的司機。顯然，Persona iQ 還為時過早，但總的來說，ROSA 和 Persona primary 正在全球範圍內獲得關注。生態系統、植入物和 CV 的互連性正在獲得動力。無論你是在美國，還是在歐洲或亞太地區，這都是勢頭。因此，在創新方面，還有很多東西需要拆解。在商業執行方面，我認為我們非常有效地應對了供應挑戰，對團隊在這方面所做的工作感到非常自豪。

And we're executing flawlessly. We got new incentive plans in place in '23 that were not around in 2022. Around making sure that people are growing in knees and hips, while pulling asset. We have new incentives in other geographies around EMEA and APAC. And I would say, again, the commercial execution is going very well.

我們正在完美地執行。我們在 23 年制定了新的激勵計劃，這些計劃在 2022 年沒有出現。圍繞確保人們的膝蓋和臀部在增長，同時拉動資產。我們在 EMEA 和亞太地區的其他地區有新的激勵措施。我要說的是，商業執行進展順利。

The last thing I'll talk about is the ASC. This is one area where in the past, we're not doing other grade. We have 3 major gaps, people, contracts and portfolio. The portfolio is definitely there. We added a lot of people in our contracting group and the number of people they're thinking about ASCs in the hundreds. So today, around 10% to 15% of our sales come from the ASC and that's growing very nicely. So again, commercial execution and innovation are the 2 key buckets when it comes to this level of performance.

我要談的最後一件事是 ASC。這是過去我們不做其他年級的一個領域。我們有 3 個主要差距，人員、合同和投資組合。投資組合肯定在那裡。我們在我們的承包團隊中增加了很多人，他們正在考慮數百人的 ASC。所以今天，我們大約 10% 到 15% 的銷售額來自 ASC，而且增長非常好。因此，商業執行和創新再次成為這一績效水平的兩個關鍵因素。

Really helpful. And maybe for Bryan and Suky, we've heard you talk in the past about using M&A to maybe diversify into faster-growing parts of the market. There's a lot of talk from your competitors about M&A, some of them more specific than others. I thought it would be great to just get your latest thoughts on M&A for Zimmer, how you're thinking about it in terms of size and ability to diversify away from your core markets and your thoughts on valuations out there right now.

真的很有幫助。也許對於 Bryan 和 Suky，我們聽過你們過去談論過使用併購來實現多元化，進入增長更快的市場部分。您的競爭對手就併購進行了很多討論，其中一些比其他的更具體。我認為如果能了解你對 Zimmer 併購的最新想法，你是如何考慮它的規模和從核心市場多元化的能力，以及你現在對估值的想法，那就太好了。

Yes. So maybe just quickly before I get into our focus areas. I'd say in valuations, I still think -- see things as being pretty expensive. I look at assets that are out there today. We're not seeing as much downward pressure on valuations as we certainly were hoping for. Maybe a little better recently, but not as good as we would have expected. And then that, combined with the fact that capital is a little more expensive to come by is not necessarily a great combination. That said, we still think there's opportunities that we're going to try to pursue. We are absolutely in Phase III of the transformation. As we said many times, Phase III is focused on portfolio transformation using capital to be able to acquire technologies that are attractive to the organization.

是的。所以也許在我進入我們的重點領域之前很快。我會說在估值方面，我仍然認為——認為事情非常昂貴。我看看今天的資產。我們沒有看到我們當然希望的那麼大的估值下行壓力。也許最近好一點，但沒有我們預期的那麼好。然後，再加上資本成本稍高的事實，不一定是一個很好的組合。話雖如此，我們仍然認為我們會嘗試抓住機會。我們絕對處於轉型的第三階段。正如我們多次說過的，第三階段的重點是利用資本進行投資組合轉型，以獲得對組織有吸引力的技術。

And we're very focused on this and extremely disciplined, number one, we're not going to look at a target if it's not mission centric. That's very important to the organization. We are a mission-driven organization, and that target needs to move our mission forward. We need to see a path to leadership at some point if we move into that space or we're already in that space. We need to see a WAM accretion, so increasing our weighted average market growth and as a result of that, our revenue growth and then ultimately helping us drive faster EPS growth. So those are the types of deals.

我們非常專注於此並且非常有紀律，第一，如果目標不是以任務為中心，我們就不會考慮它。這對組織來說非常重要。我們是一個使命驅動的組織，這個目標需要推動我們的使命向前發展。如果我們進入那個領域或者我們已經進入那個領域，我們需要在某個時候看到通往領導力的道路。我們需要看到 WAM 的增加，從而增加我們的加權平均市場增長，並因此增加我們的收入增長，然後最終幫助我們推動更快的 EPS 增長。這些就是交易的類型。

And then inside of that, we're looking at enhancing our position through acquisitions in fast growth subcategories of recon, which may not seem super exciting, but the fact is there's some fast growth subcategories that we want to build scale in so that we can grow faster than the overall market in a consistent way. And then we're also going to look to diversify.

然後在其中，我們正在考慮通過收購快速增長的偵察子類別來增強我們的地位，這可能看起來並不令人興奮，但事實上我們希望在一些快速增長的子類別中建立規模，以便我們能夠以一致的方式比整體市場增長更快。然後我們還將尋求多元化。

So looking at acquisitions, which we've already shown in other parts of orthopedics that are faster growth, that's mainly in our set category for us. eventually looking to diversify outside of orthopedics to diversify outside of electric procedures and give us other forms of opportunity to grow the business again outside of orthopedics. And we would say most likely in the near term, we would look at smaller to midsized deals, and we would kind of quantify that to say about $1 billion in revenue or less would put us in that category.

因此，看看收購，我們已經在其他骨科領域展示了增長更快的收購，這主要是我們的固定類別。最終尋求在骨科以外的領域實現多元化，以實現電手術以外的多元化，並為我們提供其他形式的機會，在骨科以外的領域再次發展業務。我們會說最有可能在短期內，我們會考慮中小型交易，我們會量化說大約 10 億美元或更少的收入將使我們屬於這一類。

And we would probably stay a little closer to the vest in Orthopedics in the near term. So that's the way we're thinking about it right now. Anything else you want to add to that?

在短期內，我們可能會更接近骨科的背心。這就是我們現在考慮的方式。你還有什麼要補充的嗎？

I would just say all the hard work that the team has done in improving financial performance, paying down debt over the last few years, even through a challenging period to COVID. We've really strengthened the balance sheet. And so the great thing is our capital structure can support everything that Brian spoke about. Right now, we're traveling somewhere around the mid- to high 2s from a net debt to leverage ratio perspective.

我只想說團隊在過去幾年裡在改善財務業績、償還債務方面所做的所有努力，甚至度過了 COVID 的挑戰時期。我們確實加強了資產負債表。因此，最棒的是我們的資本結構可以支持布賴恩所說的一切。目前，從淨債務與槓桿率的角度來看，我們正處於中高 2 左右的某個位置。

So if you took 1 turn, 1.5 turns on that relative to $2 billion to $2.5 billion of adjusted EBITDA, you would see that there's a substantial amount of M&A firepower available to us. And those numbers would only be augmented by the EBITDA from a target. So a long way of saying that we've got the capital structure, we've got the balance sheet to support what Bryan talked about.

因此，如果相對於 20 億至 25 億美元的調整後 EBITDA，你轉 1、1.5 轉，你會發現我們有大量的併購火力。這些數字只會因目標的 EBITDA 而增加。所以說我們有資本結構的方式很長，我們有資產負債表來支持布萊恩所說的。

And what's key about that, we were very disciplined about this. It's who we put phases into the organization transformation. We wanted to make sure that the base business was humming. That the organization was executing just like Ivan spoke to, we have. Our confidence level is very high. So not only do we have the balance sheet to move into that Phase III transformation. We now are ready to do it. We have the capability. We have the right team in place, and we have the execution of the base business. So we're excited about Phase III.

關鍵是，我們對此非常自律。這是我們在組織轉型中分階段進行的工作。我們想確保基礎業務蓬勃發展。該組織的執行就像伊万所說的那樣，我們已經做到了。我們的信心水平非常高。因此，我們不僅擁有進入第三階段轉型的資產負債表。我們現在準備好了。我們有能力。我們有合適的團隊，我們有基礎業務的執行。所以我們對第三階段感到興奮。

Thanks [Robert].Thanks for the question.

謝謝[羅伯特]。謝謝你的問題。

Operator, can we have the next question?

接線員，我們可以有下一個問題嗎？

We'll go next to Matthew O'Brien with Piper Sandler.

我們將和 Piper Sandler 一起去 Matthew O'Brien 旁邊。

Brian and Ivan, you talked a lot about new product introductions. And I think you said 40 through the next 3 years. How does that compare to the number of products you've introduced over the past 3 years? And then I know you've got your competitors listening probably don't want to give us too much. But just can you give us a general sense of where those are going to go? Are they going to go into set specifically? And are you going to start touching maybe some areas kind of outside your traditional power alleys, I guess, with those new product introductions.

Brian 和 Ivan，你們談了很多關於新產品介紹的話題。我想你說的是未來 3 年 40 年。這與您過去 3 年推出的產品數量相比如何？然後我知道你已經讓你的競爭對手傾聽了，他們可能不想給我們太多信息。但是，您能否讓我們大致了解一下這些產品的去向？他們會專門進入片場嗎？我想，隨著這些新產品的推出，你是否會開始觸及傳統權力範圍之外的某些領域。

So first things first, it's not just the quantity, it's also the quality. Not every new product is created equal. But I think we referenced in the past, we launched around 50 new products from 18 through 22. And the commitment is to do at least 40 new product launches over the next 36 months. And again, what excites me about this launch is, Matthew, is the type of products that they are. They're differentiated. In many instances, they are first to market. And most of them are in growth areas that are going to drive WinGuard accretion for that, so 4% or above. In terms of where they're going, it will take me about an hour to go through everything in the pipeline.

所以首先，重要的不僅僅是數量，還有質量。並非每個新產品都是平等的。但我認為我們過去提到過，我們從 18 日到 22 日推出了大約 50 種新產品。我們承諾在未來 36 個月內至少推出 40 種新產品。再一次，馬修，這次發布讓我興奮的是它們的產品類型。他們是有區別的。在許多情況下，它們是最先上市的。他們中的大多數都在將推動 WinGuard 增長的增長領域，因此增長 4% 或更高。就他們的去向而言，我將花費大約一個小時的時間來完成管道中的所有內容。

I'll keep it to maybe 3 minutes or less, but I'll tell you excited about where we are in is with a full portfolio, things that are already -- we already spoke about cementless or Persona OsseoTi new to market as of 2, 3 months ago is getting up on traction. Our cementless penetration is at 15%, 1-5. We deserve to be in the 50% range, and that is definitely the goal. Excited about ROSA partial or robotic parcel system that is next generation is getting relaunched summer of 2023.

我會把它保持在 3 分鐘或更短的時間，但我會告訴你我們對我們所處的位置感到興奮，因為我們擁有完整的產品組合，已經存在的東西——我們已經談到了 2 時新上市的無水泥或 Persona OsseoTi , 3 個月前開始牽引。我們的非水泥滲透率為 15%，1-5。我們應該在 50% 的範圍內，這絕對是目標。對下一代 ROSA 部分或機器人包裹系統感到興奮，該系統將於 2023 年夏季重新推出。

Persona IQ , I think, we spoke plenty about that. As you look at the next 12 to 14 months, we will have (inaudible) in the U.S. That is a legacy product that has gained a ton of markets in Europe. Persona revision, [I didn't] comment on do when Robbie as Cabani performance in Q1 percent revision saw tremendous growth again. That is a product that is only available in the U.S. I can hardly wait for 2024 when it gets into all U.S. markets.

Persona IQ，我想，我們就此談了很多。展望未來 12 到 14 個月，我們將在美國（聽不清）這是一種傳統產品，已在歐洲贏得了大量市場。 Persona 修訂，[我沒有] 評論 do 當 Robbie 作為 Cabani 在第一季度的業績百分比修訂再次看到巨大的增長時。那是一種只在美國有售的產品。我迫不及待地想等到 2024 年它進入所有美國市場。

Shifting to hips, we launched ROSA Hip on the direct interior category, posterior to come at some point. Already market, we are the only mixed reality company with hip insights. That is something that is gaining tremendous traction. You can see the hologram of a patient anatomy. It drives efficiency and accuracy in a case with a lower instrumentation. Bryan, in the opening remarks spoke about HAMR or surgical impact. That is also a device that is driving efficiency in an operating room, frankly, taking an existing product.

轉向臀部，我們在直接內飾類別上推出了 ROSA Hip，稍後會推出。已經上市，我們是唯一一家具有時尚洞察力的混合現實公司。這是正在獲得巨大吸引力的東西。您可以看到患者解剖結構的全息圖。它在儀器較少的情況下提高了效率和準確性。布萊恩在開場白中談到了 HAMR 或手術影響。這也是一種提高手術室效率的設備，坦率地說，採用現有產品。

Product that is in market and making it better. It drives variable energy control. It's got better accuracy. It has the ability of actual implanting the cap. Again, I can spend an hour in that regard. On recon, we got a set amount of products in set through acquisitions and organic. We recently announced that we closed the Embody deal. That is giving us a competitive advantage in soft tissue repair. Whether it's tendon injury or whether it's rotator cap, that is performing very well. We got everything that we need in Sports medtech. We have a new product introduction in Shoulder. Again, I think 3 minutes are almost done, but I will tell you, there is a lot that is happening and it's happening both from an implant standpoint happening from a technology data solutions standpoint. So we look forward to updating you at an upcoming product fair, but I will tell you, innovation is truly now a competitive advance seat at Zimmer Biomet.

已上市並正在改進的產品。它驅動可變能量控制。它有更好的準確性。它具有實際植入帽的能力。同樣，我可以在這方面花一個小時。在偵察中，我們通過收購和有機獲得了一定數量的產品。我們最近宣布完成了與 Embody 的交易。這使我們在軟組織修復方面具有競爭優勢。無論是肌腱損傷還是肩周炎，它的表現都非常好。我們獲得了運動醫療技術所需的一切。我們在 Shoulder 中有一個新產品介紹。再一次，我認為 3 分鐘快結束了，但我會告訴你，有很多事情正在發生，而且從植入的角度和技術數據解決方案的角度來看，它都在發生。因此，我們期待在即將舉行的產品展覽會上為您提供最新信息，但我會告訴您，創新現在確實是 Zimmer Biomet 的競爭優勢。

Thank you can hear the enthusiasm there. I appreciate it. A question for Suky. On the pricing side, I think you said down 140 bps in Q1. You had a competitor report last night, and they said more like neutral this year, they're more diversified. I know it's a little different. But are you guys a little bit more on the stream side as far as pricing concessions at this point in the marketplace? Is that part of the strategy? And can pricing actually be a little less of a headwind for you guys over the next maybe year or 2 versus what you've seen historically?

謝謝你可以聽到那裡的熱情。我很感激。有一個問題要問 Suky。在定價方面，我想你說第一季度下降了 140 個基點。昨晚你有一份競爭對手報告，他們說今年更像是中性，他們更加多元化。我知道這有點不同。但是，就目前市場上的定價優惠而言，你們在流方面有更多的優勢嗎？這是戰略的一部分嗎？與歷史上所見相比，在接下來的一年或兩年內，定價對你們來說真的能減少一點阻力嗎？

Yes. Matt, so I definitely think that pricing will be less of a headwind than we've seen historically. I do think that pricing pressure in the overall market will remain it could potentially intensify over time. But I will tell you, our performance, so idiosyncratic to Zimmer Biomet is that we're putting things in place to ensure that we don't have pricing erosion at the same level that we've had historically. Even if the market worsens. So we think that we can continue to travel less than 200 basis points here in 2023 and at least for the near term beyond that.

是的。馬特，所以我絕對認為定價不會像我們歷史上看到的那樣不利。我確實認為整個市場的定價壓力將持續存在，並且可能會隨著時間的推移而加劇。但我會告訴你，我們的表現對 Zimmer Biomet 如此特殊，我們正在採取措施確保我們不會像歷史上那樣出現價格侵蝕。即使市場惡化。因此，我們認為我們可以在 2023 年繼續以不到 200 個基點的速度運行，至少在短期內如此。

Thanks Matt. Can we go the next question please?

謝謝馬特。我們可以進入下一個問題嗎？

We'll take our next question from Joanne Wuensch with Citi.

我們將接受來自花旗銀行的 Joanne Wuensch 的下一個問題。

And very nice quarter. Just summing back just a little bit. I don't think anyone expects these kind of growth rates to go on forever that it's a new normal. But it does give you what I would call, breathability to make some strategic decisions as you get these really strong quarters on a cash flow basis and on a revenue basis. What changes and maybe the way you approach your strategy given it?

非常好的季度。只是總結一下。我認為沒有人期望這種增長率會永遠持續下去，因為這是一種新常態。但它確實給了你我所說的，當你在現金流和收入的基礎上獲得這些非常強勁的季度時，可以做出一些戰略決策。有什麼變化，也許是您處理策略的方式？

Yes. Probably no major change, to be honest. To your point, it will create some headroom and it gives us that optionality as referenced before to let it flow through, which, as you can tell by our guide, we're going to let some of this flow through, but also to invest, and we are highly focused on driving revenue growth. We've done a lot of research in the med tech space. And it's very clear that those companies that are consistently top quartile performers in TSR, grow faster than those companies that aren't. And the second leading thing behind that is EPS growth. So make no mistake, when we get this headroom, we're going to be focused, first and foremost, on investing in the business to continue to drive sustained revenue growth that ultimately as a result of that drives EPS growth as well.

是的。老實說，可能沒有重大變化。就您的觀點而言，它將創造一些餘量，並為我們提供了之前提到的可選性以讓它流過，正如您從我們的指南中了解到的那樣，我們將讓其中的一些流過，但也會投資，我們高度專注於推動收入增長。我們在醫療技術領域做了很多研究。很明顯，那些在 TSR 方面始終處於前四分之一表現的公司比那些不是的公司增長得更快。其次是每股收益的增長。所以不要誤會，當我們獲得這個空間時，我們將首先關注業務投資，以繼續推動持續的收入增長，最終也因此推動每股收益增長。

So it's going to be the balance that we've always had with maybe a little more optionality than we would have otherwise.

因此，這將是我們一直擁有的平衡，可能比我們在其他情況下擁有更多的選擇權。

And then as my follow-up. You did mention that there are some, we'll call it, niggling supply chain issues that are out there. Is there a way to put some color around that, what those issues may be? Are they easing? Or are they staying the same, intensifying and just sort of maybe give us a line of sight on what would make those go away.

然後作為我的後續行動。你確實提到有一些，我們稱之為，瑣碎的供應鏈問題。有什麼辦法可以解決這個問題，這些問題可能是什麼？他們在放鬆嗎？或者他們是否保持不變，加強並且可能讓我們了解是什麼讓這些消失。

Absolutely. I wish I will tell you when they are going to go away. What I will say is that we're navigating those very effectively. There are 3 key areas that I would say, account for 90% of the problem: Material shortage, labor issues an sterilization issues. On the materials situation is better. We have validated second sources. We've come out with new materials. So I would say that it's probably better than it was, let's say, 6 to 12 months ago.

絕對地。我希望我能告訴你他們什麼時候離開。我要說的是，我們正在非常有效地駕馭這些。我要說的 3 個關鍵領域佔問題的 90%：材料短缺、勞動力問題和消毒問題。物資上的情況要好一些。我們已經驗證了第二個來源。我們推出了新材料。所以我想說它可能比 6 到 12 個月前更好。

On the labor here in Warsaw, we constantly continue to hire people. So again, I would say we're in a much better position than we were 6, 12 months ago. Sterilization is also getting better, but make no mistake, it is a bottleneck. We could definitely be in a much better position. It will have more sterilization capabilities. That said, as reflected in the quarter, supply has been what it needed to be. It's put us in a position that we can continue to manage the business and grow the business. In terms of when this goes away, I have no idea. But I do think that it's well managed as of today.

在華沙這裡的勞動力方面，我們不斷地繼續僱用人員。所以，我要說的是，我們的處境比 6 個月、12 個月前要好得多。殺菌也越來越好，但別搞錯了，這是一個瓶頸。我們絕對可以處於更好的位置。它將具有更多的殺菌能力。也就是說，正如本季度所反映的那樣，供應一直是它所需要的。它使我們能夠繼續管理業務並發展業務。至於什麼時候消失，我不知道。但我確實認為它在今天得到了很好的管理。

Yes. The other factor that's impacting it is you've got all these negative pressures that Ivan just referenced. And then, of course, our demand is going up pretty substantially. So the demand signal is coming in much higher than we expected in the face of that environment that's pretty challenging.

是的。影響它的另一個因素是你有 Ivan 剛才提到的所有這些負面壓力。然後，當然，我們的需求正在大幅上升。因此，面對極具挑戰性的環境，需求信號的出現比我們預期的要高得多。

And I just want to -- again, I know I said it in my prepared remarks, but I want to compliment the team. I've been with the commercial teams around the globe. And they're just doing an excellent job. These guys are really fighting 24 hours a day to make sure that we get product to the cases where they're needed. And trust me, it's a lot of work. It's a lot of effort. It's a lot of frustration I'm positive of that, but the team is doing a wonderful job. -- indeed.

我只是想——再一次，我知道我在準備好的發言中說過了，但我想稱讚團隊。我一直在全球的商業團隊工作。他們只是做得很好。這些人真的一天 24 小時都在戰鬥，以確保我們將產品送到需要他們的地方。相信我，這是很多工作。這是很大的努力。我對此很樂觀，但團隊做得非常出色。 - 的確。

Joanne, thanks for the question.

喬安妮，謝謝你的提問。

We'll take our next question from Lawrence Biegelsen with Wells Fargo.

我們將從富國銀行的 Lawrence Biegelsen 那裡回答下一個問題。

I'll echo my congratulations. A really nice quarter here. Just one for Ivan person, one big picture, one for Bryan. So Ivan, on Persona IQ , can you put the NTAP into context for us into context for us, what percent of knee patients are Medicare. What do you see happening with reimbursement for commercial payers? Do you expect them to follow? And have you guys filed for a pass-through payment in the outpatient setting? And I had one follow-up for Brian.

我會回應我的祝賀。這裡是一個非常好的季度。一張給 Ivan 人，一張大圖，一張給 Bryan。所以 Ivan，在 Persona IQ 上，你能把 NTAP 放到我們的上下文中嗎？有多少膝關節患者是 Medicare。您如何看待商業付款人的報銷？你希望他們跟進嗎？你們有沒有在門診環境中申請轉手付款？我對布賴恩進行了一次跟進。

Thank you. I'll keep it short, so you can continue with Bryan. But first things first. NTAP, new technology add-on payment enables an additional payment of around $150 per additional knee, so up to $1,700 for both knee. The decision kicks in, in October or actually the indication. The approval kicks in, in October '23 and the last for 30 years. So it's pretty material. In terms of -- and by the way, it's not done.

謝謝。我會保持簡短，這樣你就可以繼續講布萊恩了。但首先是第一件事。 NTAP 是一項新技術附加付款，每增加一個膝蓋就可以額外支付大約 150 美元，因此雙膝的費用最高為 1,700 美元。該決定將在 10 月或實際指示中生效。批准於 23 年 10 月開始，也是 30 年來的最後一次。所以它很重要。就- 順便說一句，它還沒有完成。

So we're going to be requesting these additional payments for the base station and other components. So there may be some additional upside to these numbers that I just quoted. In terms of the percentage of patients, this is for Medicare inpatient. We estimate that to be between 15% to 20%, 15% to 20%.

因此，我們將要求為基站和其他組件支付這些額外費用。因此，我剛才引用的這些數字可能還有一些額外的好處。就患者百分比而言，這是針對 Medicare 住院患者。我們估計在 15% 到 20% 之間，15% 到 20% 之間。

Relative to the second part of the question, do we think that commercial payers will follow. I think that comes down to the data to the clinical data. As we expand the number of patients that benefit from this technology, we're able to validate the clinical claims that we think that we're going to able to validate, of course, this will become a new standard of care, and this will impact not just Medicare patients, but also commercial patients. So I think you I had a follow-up question for Brian.

相對於問題的第二部分，我們認為商業支付方會跟進嗎？我認為這歸結為臨床數據的數據。隨著我們擴大受益於這項技術的患者數量，我們能夠驗證我們認為我們將能夠驗證的臨床聲明，當然，這將成為一種新的護理標準，這將不僅影響 Medicare 患者，還影響商業患者。所以我想你有一個後續問題要問布賴恩。

And just Ivan, on the outpatient setting, did you file for pass-through payment?

只是伊万，在門診設置中，你是否申請了轉嫁付款？

We're in the process of evaluating that, but we have not done that as of right now, no, we don't have any.

我們正在對此進行評估，但我們現在還沒有這樣做，不，我們沒有。

Okay. And Bryan, people have asked this question. I'm going to ask a similar question in a different way. So the recon market is clearly running hot now, 13% by our math in Q1. Pre-COVID, the recon market grew 2% to 3%. So A, do you expect the recon market to eventually return to its historical growth rate at some point in the future? I'm not asking you for a date. And B, does that create more urgency for you to do some M&A to increase your [anger] and diversify while things are good.

好的。布萊恩，人們問過這個問題。我將以不同的方式問一個類似的問題。因此，偵察市場現在顯然很火爆，根據我們的計算，第一季度為 13%。在 COVID 之前，偵察市場增長了 2% 至 3%。那麼 A，您是否預計偵察市場最終會在未來某個時候恢復到歷史增長率？我不是要你約會。 B，這是否會讓你更加緊迫地進行一些併購，以增加你的 [憤怒] 並在情況良好時實現多元化。

Yes. I think it's important to go back to the first quarter and just say, hey, that's not indicative of recon market. That is an easy comp for everybody, not just us, but across the board. So you have to look at that outsized performance and kind of haircut it by the comp. But even without that, it's a very hot market, to your point right now. And there are certain things about that, that you might think would be for just a period of time. Backlog recovery should be here for a while. But that will eventually go away.

是的。我認為重要的是回到第一季度，然後說，嘿，這並不表示偵察市場。這對每個人來說都是一個簡單的組合，不僅僅是我們，而是對所有人來說。所以你必須看看那種超凡的表現，並通過比賽來剪掉它。但即使沒有它，它也是一個非常熱門的市場，就你現在的觀點而言。並且有一些關於那的事情，你可能認為只會持續一段時間。積壓的恢復應該在這裡有一段時間了。但這最終會消失。

But there are some things associated with Recon that we think are sustainable. And we've talked about these in the past. I don't know that everybody connects with what we're saying. But here's what I see. If I think about market in total, there's a pretty significant technology shift that's occurring in Orthopedics at a very rapid pace. And by the way, we're just really getting started with that technology shift. That has a mixed benefit associated with it. So you don't need one new patient. You just need that technology to come in and that lifts the overall market growth and creates because of the innovation, better pricing stability. So the combination of those 2 things, in my view, is durable and sustainable to elevate the overall recon market growth, and we're certainly going to take advantage of that.

但我們認為有些與 Recon 相關的東西是可持續的。我們過去也談過這些。我不知道每個人都能理解我們所說的。但這就是我所看到的。如果我從整體上考慮市場，那麼骨科領域正在以非常快的速度發生非常重大的技術轉變。順便說一句，我們才真正開始進行技術轉變。這有一個與之相關的混合好處。所以你不需要一個新病人。您只需要引入該技術即可提升整體市場增長並因創新而創造更好的定價穩定性。因此，在我看來，這兩件事的結合是持久和可持續的，可以提升整體偵察市場的增長，我們當然會利用這一點。

The other benefit that we have in this area for us specifically is that we're investing very disciplined in areas in recon that are faster growth. So our weighted average market growth will be better than the overall market growth in Recon. That creates more sustainability for fast growth and above-market growth for the company. And then outside of that and specific to us, as Suky said, we're doing a much better job on pricing. And that's a big benefit.

我們在這一領域為我們帶來的另一個好處是，我們在快速增長的偵察領域進行了非常有紀律的投資。因此，我們的加權平均市場增長將優於 Recon 的整體市場增長。這為公司的快速增長和高於市場的增長創造了更多的可持續性。然後除此之外，正如 Suky 所說，我們在定價方面做得更好。這是一個很大的好處。

So if we can stay below our historical average in pricing, that does also elevate our Recon business. And then finally, if I think about our innovation, we do believe it's differentiated. So we have an opportunity to also take market share through that innovation. So we really do believe Recon is attractive and sustainable. It's not going to be first quarter type of growth. That's abnormal because of the comp. But we do believe it could be elevated.

因此，如果我們能夠將定價保持在歷史平均水平以下，那也確實會提升我們的 Recon 業務。最後，如果我考慮我們的創新，我們確實相信它是與眾不同的。因此，我們也有機會通過該創新獲得市場份額。所以我們確實相信 Recon 具有吸引力和可持續性。這不會是第一季度的增長。這是不正常的，因為 comp。但我們確實相信它可以提升。

We're also looking into some patient behavior potential changes that we're seeing through COVID. This is early days. We're kind of analyzing it right now, but the feedback is that there's really 3 things that may be changing the perspective of a patient on whether they do or don't get a procedure. Which would be positive for us because we think that we're going to make the decision to get the procedure.

我們還在研究我們通過 COVID 看到的一些患者行為的潛在變化。這是早期。我們現在正在對其進行分析，但反饋是，實際上有 3 件事可能會改變患者對是否接受手術的看法。這對我們來說是積極的，因為我們認為我們將做出接受手術的決定。

The first one is the technology advancements are giving people confidence that the outcome of the procedure is going to be good. A lot of people don't get the procedure because they're afraid the procedure is not going to do what they wanted to do. If that fear goes away, you may see more people enter the funnel. The second is that you're getting out of the hospital or the ASC faster. So that turnaround for the procedures 24 hours a lot of times used to be dates. So that also then is less inconvenient for the patient. And then the ASC setting by itself is attractive. I mean we don't want to go to a hospital to get a knee procedure where a bunch of sick people are. The ASC setting is less overwhelming, feel safer. And I think people are more attracted to it.

第一個是技術進步讓人們相信手術的結果會很好。很多人沒有接受這個程序，因為他們擔心這個程序不會做他們想做的事情。如果這種恐懼消失，您可能會看到更多人進入漏斗。第二個是您可以更快地離開醫院或 ASC。因此，24 小時的程序周轉時間過去常常是日期。這樣對於患者來說也就更少了不便。然後 ASC 設置本身就很有吸引力。我的意思是我們不想去醫院做膝關節手術，那裡有一群病人。 ASC 設置不那麼壓倒性，感覺更安全。而且我認為人們更喜歡它。

And the final thing is you've got flexwork right now. That's pretty rampant out there. And so people feel more comfortable, more confident rehabbing and also staying in work. So we think those 3 things really have the opportunity to continue to elevate the recon market. And we're going to continue to look at it and take advantage of it.

最後一件事是你現在有彈性工作。那裡很猖獗。因此，人們在康復和繼續工作時會感到更舒適、更有信心。所以我們認為這三件事真的有機會繼續提升偵察市場。我們將繼續研究並利用它。

I think we have time for one more question in the queue.

我想我們還有時間在隊列中回答另一個問題。

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 guess I hear you on all the strong momentum to carry through post Q1 and improvement throughout the year. And so maybe given the funky comps on Q1. Maybe think about Q2 in dollars, like hips and knees before the pandemic were typically flat to slightly down. And so I don't know if you think on a dollar basis, Q2 hips and needs would still be flat or if it can actually go up sequentially. Just kind of thinking about the momentum you have going through the year?

我想我聽到了你在 Q1 後進行和全年改進的所有強勁勢頭。因此，也許考慮到第一季度的時髦組合。也許想想第二季度的美元，就像大流行之前的臀部和膝蓋通常持平或略有下降。所以我不知道你是否認為以美元為基礎，第二季度的臀部和需求仍然持平，或者它是否真的可以連續上升。只是想一想你這一年的勢頭？

Yes. I think on an absolute dollar standpoint, you should expect to see a step down in Q2. That's typical seasonality. So growth rates yet are going to be wonky sequentially or year-over-year between 1Q and 2Q, but you should expect to see the traditional sort of historic step down in absolute dollars for Q2.

是的。我認為從絕對美元的角度來看，你應該期望看到第二季度的降幅。這是典型的季節性。因此，在第一季度和第二季度之間，增長率仍將連續或同比不穩定，但你應該期望看到第二季度絕對美元的傳統歷史性下降。

Okay. Appreciate that clarity. And then I did want some clarification. I think I heard you say gross margin for the full year would still be flat year-over-year. I wanted to make sure I understood why it was still flat every year given the momentum on Q1. And then it looks like you bought back $268 million of stock in the quarter. I don't know if there was any color on that, if that's kind of a new use of capital for you.

好的。欣賞這種清晰度。然後我確實想要一些澄清。我想我聽到你說全年的毛利率仍將同比持平。考慮到第一季度的勢頭，我想確保我理解為什麼它每年仍然持平。然後看起來你在本季度回購了 2.68 億美元的股票。我不知道那是否有任何顏色，如果這對你來說是一種新的資本用途。

Thanks for the question on gross margin, Travis, because actually, I intended to say that gross margin would be higher this year versus 2022, primarily driven by that mix component and FX hedge gains. But if you thought about neutralizing those because they may not continue beyond 2023 at the same level, the underlying gross margin will be equivalent to 22%. But in absolute terms, it will be higher this year versus last year on gross margin. I just want to make sure that's clear.

感謝 Travis 提出毛利率問題，因為實際上，我打算說今年的毛利率會比 2022 年更高，這主要是受混合成分和外匯對沖收益的推動。但如果你考慮抵消這些，因為它們可能不會在 2023 年後繼續保持在同一水平，那麼基礎毛利率將相當於 22%。但就絕對值而言，今年的毛利率將高於去年。我只是想確保這一點很清楚。

Very perceptive on the share buyback. We did buy back, I think, about $250 million of shares this year, $150 million in Q4 of last year. That gets split between the Embody transaction, where we structured that with some equity to be advantageous from a deal structuring standpoint. So we bought those shares back, so to avoid any dilution on that deal. from shares. And then the second is our more normal cadence going forward will be to buy back equity dilution from annual brands.

對股票回購非常敏感。我認為，我們今年確實回購了大約 2.5 億美元的股票，去年第四季度回購了 1.5 億美元。這在 Embody 交易之間被分開，我們從交易結構的角度來看，我們用一些股權來構建它是有利的。所以我們回購了這些股票，以避免對該交易造成任何稀釋。從股票。其次，我們未來更正常的節奏是從年度品牌中回購股權稀釋。

Thanks so much for the question. Yes. And I think that wraps us up through the queue, and we're at 9:30. So thanks, everyone, for your comments and your questions. The IR team is obviously available today, and we'll continue the conversations as we go through the day. Please feel free to reach out with any others.

非常感謝你的問題。是的。我認為這使我們排完隊，現在是 9:30。謝謝大家的意見和問題。 IR 團隊顯然今天有空，我們將在當天繼續進行對話。請隨時與任何其他人聯繫。

Thank you again for participating on 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。