Zimmer Biomet Holdings Inc (ZBH) 2023 Q3 法說會逐字稿

Good morning, ladies and gentlemen, and welcome to the Zimmer Biomet Third Quarter 2023 Earnings Conference Call. (Operator Instructions) As a reminder, this conference is being recorded today, November 7. (Operator Instructions) I would now like to turn the conference over to Keri Mattox Chief Communications and Administration Officer. Please go ahead.

早安，女士們、先生們，歡迎參加 Zimmer Biomet 2023 年第三季財報電話會議。 （操作員指示）謹此提醒，本次會議將於今天（11 月 7 日）進行錄製。（操作員指示）我現在想將會議轉交給 Keri Mattox 首席通訊和行政官。請繼續。

Thank you, operator, and good morning, everyone. Welcome to Zimmer Biomet's Third Quarter 2023 Earnings Conference Call. Joining me today are Ivan Tornos, our President and CEO; and EVP and CFO, Suky Upadhyay. Before we get started, I'd like to remind you that our comments during this call will include forward-looking statements.

謝謝接線員，大家早安。歡迎參加 Zimmer Biomet 2023 年第三季財報電話會議。今天加入我的是我們的總裁兼執行長 Ivan Tornos；執行副總裁兼財務長 Suky Upadhyay。在我們開始之前，我想提醒您，我們在本次電話會議中的評論將包括前瞻性陳述。

Actual results may differ materially from those indicated by the forward-looking statements due to a variety of risks and uncertainties. Please note, we assume no obligation to update these forward-looking statements, even if actual results or future expectations change materially. Please refer to our SEC filings for a detailed discussion of these risks and uncertainties in addition to the inherent limitations of such forward-looking statements. Additionally, the discussions on this call will include certain non-GAAP financial measures.

由於各種風險和不確定性，實際結果可能與前瞻性陳述所示的結果有重大差異。請注意，即使實際結果或未來預期發生重大變化，我們也不承擔更新這些前瞻性聲明的義務。除了此類前瞻性陳述的固有限制之外，請參閱我們向 SEC 提交的文件，詳細討論這些風險和不確定性。此外，本次電話會議的討論將包括某些非公認會計準則財務措施。

Reconciliation of these measures to the most directly comparable GAAP financial measures is included within our Q3 earnings release, which can be found on our website, zimmerbiomet.com. With that, I'll turn the call over to Ivan. Ivan?

這些指標與最直接可比較的 GAAP 財務指標的調整包含在我們的第三季財報中，您可以在我們的網站 zimmerbiomet.com 上找到該報告。說完，我會把電話轉給伊凡。伊万？

Thank you very much, Keri, and good morning, and greetings everyone from Warsaw Indiana, the orthopedic capital of the world. Welcome to our Q3 earnings call. In my first call as the CEO of this amazing organization, really grateful that all of you are joining us here this morning. I'd like to begin by saying how truly excited I am to be in the new role, what I deem to be a very inspiring time not just in musculoskeletal health, which it is, but also in Medtech in general.

非常感謝你，克里，早安，並向來自世界骨科之都華沙印第安納的大家致以問候。歡迎參加我們的第三季財報電話會議。作為這個令人驚嘆的組織的首席執行官，我第一次打電話，非常感謝大家今天早上加入我們。首先，我想說的是，我對擔任新角色感到非常興奮，我認為這是一個非常鼓舞人心的時刻，不僅在肌肉骨骼健康方面，而且在整個醫療技術領域也是如此。

Simply put, the space is not what it used to be just so 5 years ago. When you look at orthopedics, when you look at the entire category, it's changed. It changed a lot. Groundbreaking technologies are shaping how procedures are done. Beyond the backlog and continued favorable demographics, global demand for treatment is higher than it has historically been. This is driven by better clinically reported outcomes. This is driven by shorter episodes of care. This is driven by better and more comfortable ways to do physical therapy. This is driven by greater ways to approach different disease states. And this is driven by [subtle] treatment migrations that you always see here in the U.S. with the rapid shift of cases moving to an ASC, while also preserving what are very compelling volume levels, in the traditional inpatient and outpatient savings.

簡而言之，這個空間已經不再是五年前的樣子了。當你看骨科時，當你看整個類別時，它發生了變化。它改變了很多。突破性的技術正在改變手術的完成方式。除了積壓的病例和持續有利的人口統計數據之外，全球對治療的需求比歷史上任何時候都高。這是由更好的臨床報告結果所推動的。這是由較短的護理時間所推動的。這是由更好、更舒適的物理治療方法所推動的。這是由應對不同疾病狀態的更佳方法所推動的。這是由[微妙的]治療遷移推動的，這種情況在美國隨處可見，病例迅速轉移到 ASC，同時在傳統住院和門診節省中也保持了非常引人注目的數量水平。

So in plain English, healthy market, great patient dynamics, new technology, disruptive innovation, a lot has changed, and I don't see us going back to 4, 5 years ago. So again, a very inspiring time to be in musculoskeletal health and orthopedics in general. All of these markets accelerating trends are opening new doors for countless patients to benefit from what we do here at CV, which is to drive life change in solutions. We do that every single day for countless patients. And the best part about it, we're just getting started.

簡而言之，健康的市場、良好的患者動態、新技術、顛覆性創新，很多事情都發生了變化，我不認為我們會回到四、五年前。再說一次，對於肌肉骨骼健康和骨科來說，這是一個非常鼓舞人心的時刻。所有這些市場加速趨勢都為無數患者打開了新的大門，使他們能夠從我們在 CV 所做的事情中受益，即透過解決方案推動生活的改變。我們每天都為無數患者這樣做。最棒的是，我們才剛開始。

So I could not be more excited to be here in my new role. With this encouraging market dynamics, sustainable trends and building on the solid track record of execution that the CV team has enabled. It's great to be here today to report what it is another solid quarter of a strong performance while strongly reaffirming our year-end guidance for the year 2023. Even more exciting, as I look forward to our future, I'm more convinced than ever that Zimmer Biomet will continue to lead the way on customer-centric innovation, already a competitive advantage and solid commercial execution, enabling not just the delivery of our mission but also improving on our other key value creation drivers, those regaining and sustaining top quartile performance. And again, this is something that we treat with a lot of rigor and something that is a mandate for the organization. We must regain and sustain top quartile performance.

因此，我對能夠擔任新職務感到無比興奮。憑藉著令人鼓舞的市場動態、永續發展趨勢以及 CV 團隊所取得的良好執行記錄。很高興今天能夠在這裡報告又一個強勁表現的堅實季度，同時強烈重申我們對 2023 年的年終指引。更令人興奮的是，當我展望我們的未來時，我比以往任何時候都更有信心Zimmer Biomet 將繼續引領以客戶為中心的創新，這已經具有競爭優勢和紮實的商業執行力，不僅能夠實現我們的使命，而且還能改善我們其他關鍵價值創造驅動因素，即重新獲得併維持前四分之一的業績。再說一次，我們非常嚴格地對待這件事，也是組織的任務。我們必須重新獲得並維持最高四分之一的業績。

For today's call, I want to first share my thoughts on my first 2 months as CEO of Zimmer Biomet, while also providing key insights into what I have learnt, how my learning has shaped, what are going to be my 3 key priorities as the new CEO of the enterprise. This would answer the question of what is fundamentally going to change around here in the next chapter of our transformation.

在今天的電話會議上，我想先分享我作為Zimmer Biomet 執行長的頭兩個月的想法，同時也提供關於我所學到的東西、我的學習如何形成的、我作為Zimmer Biomet 的3個關鍵優先事項的重要洞見。企業新任CEO。這將回答我們轉型的下一章將從根本上發生什麼變化的問題。

After that, I'm going to talk about the key drivers behind the solid Q3 performance. Next Suky will take over, and will discuss the financials for the quarter as well as the expectations for the rest of the year and then our favorite part of the call Q&A. Before we move into these updates, I do want to take a moment to thank the global Zimmer Biomet team for their unwavering commitment to our purpose, to our plans. I want to thank them for the sense of urgency in driving [some] execution. I want to thank them for everything that they do. This is a highly engaged and focused team that has been operating at a very rapid speed and is eagerly deciding to do even more, more for patients, more for customers, more for the team, more for each other, more for the company, more for the communities where we work and live, like right here in Warsaw and frankly, far more for the shareholders.

之後，我將討論第三季穩健表現背後的關鍵驅動因素。接下來 Suky 將接手，並將討論本季的財務狀況以及今年剩餘時間的預期，然後是我們最喜歡的電話問答部分。在我們進行這些更新之前，我確實想花點時間感謝全球 Zimmer Biomet 團隊對我們的目標和計劃的堅定承諾。我要感謝他們在推動[某些]執行上的迫切感。我要感謝他們所做的一切。這是一個高度投入和專注的團隊，一直在以非常快的速度運作，並熱切地決定做更多的事情，為患者做更多的事情，為客戶做更多的事情，為團隊做更多的事情，為彼此做更多的事情，為公司做更多的事情，對於我們工作和生活的社區，例如在華沙，坦白說，對於股東來說，更重要。

This is team that has gone through a lot, and a lot is a lot. This team has done a lot of heavy lifting. And now with a heavy lifting behind from a remediation standpoint. It's great to be in a different stage. And it's great to be able to show to the world what the Zimmer Biomet team can do and will do. I'm beyond proud of the organization, and I'm generally inspired by what they do each and every day.

這是一支經歷了很多事情的團隊，而且很多就是很多。這個團隊做了很多繁重的工作。從補救的角度來看，現在還有一項艱鉅的任務要做。處於不同的階段真是太好了。很高興能夠向世界展示 Zimmer Biomet 團隊可以做什麼和會做什麼。我為這個組織感到無比自豪，而且他們每天所做的事情通常都激勵著我。

We do this for a while around the world, and I can truthfully tell you I have never worked with a better team than the one we have here at Zimmer Biomet. And again, I can hardly wait to showcase our results in quarters to come. So thank you. I also want to thank Bryan Hanson for all the Bryan did to bring Zimmer Biomet to this moment. We are grateful and we're stronger because of his leadership. So thank you, Bryan.

我們在世界各地這樣做已經有一段時間了，我可以誠實地告訴您，我從未與比 Zimmer Biomet 更好的團隊合作過。我再次迫不及待地想展示我們在未來幾季的成果。所以謝謝。我還要感謝 Bryan Hanson 為將 Zimmer Biomet 帶到這一刻所做的一切。我們很感激，並且因為他的領導而變得更加強大。所以謝謝你，布萊恩。

Now let me share some perspective as the new CEO of Zimmer Biomet. During my first 11 weeks or 77 days in the job, I've spent significant time with team members, customers, analysts, investors or Board, my peers, health care executives across Medtech and government officials and other key stakeholders in health care, so that I could listen, I could learn and I could get the property insights. I've been in every Zimmer Biomet region around the globe. I've interacted with every key manufacturing facility. I have visited hundreds of decision makers across every major continent, and I have collected countless pages of feedback and recommendations.

現在讓我作為 Zimmer Biomet 新任執行長分享一些觀點。在工作的前11 週或77 天中，我花了很多時間與團隊成員、客戶、分析師、投資者或董事會、我的同事、醫療技術領域的醫療保健高管以及政府官員和醫療保健領域的其他主要利害關係人打交道，因此我可以傾聽，我可以學習，我可以獲得對房地產的見解。我去過全球每個 Zimmer Biomet 地區。我與每個主要製造工廠進行了互動。我拜訪了各大洲的數百位決策者，收集了無數頁的回饋和建議。

Most critically, obvious this reflection time, to ensure that we, at Zimmer Biomet are boldly prioritizing what needs to get done. And this, I can assure you, will be a trademark of my time as CEO of Zimmer Biomet, having the courage to say no to several things so that we can become truly great in those things that will drive the most value for the enterprise and our key stakeholders. These key priorities are purpose and people, number one. We have a winning culture. We have the absolute best talent in the industry.

最關鍵的是，這個反思時間很明顯，以確保我們 Zimmer Biomet 大膽地確定需要完成的工作的優先順序。我可以向您保證，這將成為我擔任 Zimmer Biomet 執行長期間的標誌，有勇氣對一些事情說不，以便我們能夠在那些為企業帶來最大價值的事情上變得真正偉大，我們的主要利益相關者。這些關鍵優先事項是目的和人員是第一位的。我們擁有獲勝的文化。我們擁有業界絕對最優秀的人才。

It has been a foundational priority for CV and will continue to be critical under my leadership. People, purpose, talent, culture, with a very data-centric organization, we use the same level of data centricity to track how it is that we're doing with our human capital. To that end, we track level of engagement, development, DEI, engagement across different segments and geographies, high potential ratings and everything in between.

這是簡歷的一個基本優先事項，並且在我的領導下將繼續發揮重要作用。人員、目標、人才、文化，在一個以數據為中心的組織中，我們使用相同程度的資料中心來追蹤我們如何利用我們的人力資本。為此，我們追蹤參與度、發展、DEI、不同細分市場和地區的參與度、高潛力評級以及介於兩者之間的一切。

I'm really excited to report that our most recent engagement survey, which we completed about 6 weeks ago deliver the absolute best scores in the history of the company. Let me say that again, the latest engagement score for organization, close to 20,000 employees showcase the absolute best scores in the history of the organization, frankly, going up across every single category.

我非常高興地向大家報告，我們大約 6 週前完成的最新敬業度調查得出了公司歷史上絕對最好的分數。讓我再說一遍，組織的最新敬業度分數顯示，近 20,000 名員工展示了該組織歷史上絕對最好的分數，坦白說，每個類別都在上升。

This tells me that the team is energized. This tells me that the team is ready. And this tells me that the team is about to unleash a lot of greatness for the organization. The second priority is to create and sustain a framework of operational excellence across the board. Simply put, it's about being great when it comes to running the business. This means simplifying what we do, where we play and how we play.

這告訴我，團隊充滿活力。這告訴我團隊已經準備好了。這告訴我，團隊即將為組織釋放許多偉大的力量。第二個優先事項是創建並維持全面的卓越營運框架。簡而言之，就是在經營業務方面表現出色。這意味著簡化我們的工作、比賽地點和比賽方式。

This means being courageous and bold about the choices that we make. It starts with being intention about driving sustainable revenue growth. We know this is the #1 driver of top quartile performance. And we also know that innovation -- customer-centric innovation and commercial execution are the 2 key drivers of sustainable revenue growth. So we will accelerate that. But at the same time, we're not going to forget that we can and will do better across the entirety of the P&L.

這意味著我們要勇敢、大膽地做出選擇。首先是致力於推動永續收入成長。我們知道這是排名前四分之一的性能的第一大驅動因素。我們也知道，創新——以客戶為中心的創新和商業執行是永續收入成長的兩個關鍵驅動力。所以我們將加快這一進程。但同時，我們不會忘記，我們可以而且將會在整個損益表上做得更好。

We're going to drive a culture of ownership by every single employee across the globe with all of us waking up every single day acting as key investors in the business and thinking of time and money as the key currencies of the organization. This means continuing to align our incentives with an even greater emphasis on best-in-class performance from both top and bottom.

我們將在全球每一位員工中推動一種主人翁文化，我們所有人每天醒來都充當業務的主要投資者，並將時間和金錢視為組織的關鍵貨幣。這意味著我們將繼續調整我們的激勵措施，並更加重視從上到下的一流績效。

By delivering on operational excellence as a mandate or mindset for the organization, we're going to enable, number one, revenue growth of at least 100 to 200 basis points of our market while growing earnings faster than revenue and free cash flow growing faster than the rate of earnings. Number two, operational excellence will enable best-in-class supply and operational outcomes by simplifying a rather complex operations at manufacturing footprint. And then thirdly, operational excellence as a mandate is going to enable an agile, nimble and simplified company that can anticipate, can be proactive in successfully navigating market trends.

透過將卓越營運視為組織的使命或理念，我們將實現第一，我們市場的收入成長至少 100 到 200 個基點，同時獲利成長速度快於收入成長速度，自由現金流成長速度快於營收成長速度。收益率。第二，卓越營運將透過簡化製造足跡中相當複雜的營運來實現一流的供應和營運成果。第三，卓越營運作為一項任務將使公司變得敏捷、敏捷和簡化，能夠預測並積極主動地成功駕馭市場趨勢。

So again, operational excellence and mindset is going to deliver revenue growth of at least 100 to 200 basis points of a market while growing earnings faster than revenue and free cash flow faster than the rate of earnings while enabling best-in-class supply and operational outcomes by making Zimmer Biomet agile, nimble and a very simplified company that is proactive in what it does.

因此，卓越的營運和心態將帶來市場收入成長至少 100 到 200 個基點，同時獲利成長速度快於收入成長速度，自由現金流快於獲利速度，同時實現一流的供應和營運透過使Zimmer Biomet 成為一家敏捷、靈活、非常簡單、積極主動的公司，並取得了成果。

Based on where we are as we close the year 2023, and based on our latest guidance, we're already on track to deliver the metrics that I mentioned above around revenue, earnings and free cash flow, the way we run the company, but we expect to do it again with even greater rigor in 2024. To that end, we look forward to hosting an Analyst Day. It's something we've not done ever since we merged with 2 companies.

根據我們在 2023 年結束時的情況，以及根據我們的最新指導，我們已經有望實現我上面提到的關於收入、盈利和自由現金流的指標，這些指標是我們運營公司的方式，但是我們預計在2024 年會更嚴格地再次進行這項工作。為此，我們期待舉辦分析師日活動。自從我們與兩家公司合併以來，這是我們從未做過的事情。

And at the Analyst Day, we're going to be sharing more details on this thought that I have highlighted and the specific drivers of these goals. So this becomes truly the DNA of Zimmer Biomet. Third priority is about innovating and diversifying Zimmer Biomet into high-growth markets, table stakes. We must enter higher growth markets. We do need to diversify our portfolio. And we will do that. We're going to do it through organic and inorganic means. We're going to do it through innovation and M&A.

在分析師日，我們將分享有關我強調的這一想法的更多細節以及這些目標的具體驅動因素。因此，這真正成為 Zimmer Biomet 的 DNA。第三個優先事項是 Zimmer Biomet 的創新和多元化，進入高成長市場和賭注。我們必須進入更高成長的市場。我們確實需要使我們的投資組合多樣化。我們會這麼做的。我們將透過有機和無機手段來做到這一點。我們將透過創新和併購來實現這一目標。

On the innovation front, we're going to innovate by continuing to boldly invest in the right segments of R&D. So that is new product development, so that we always think customer problems and bringing solutions to those products. We're going to make sure that those projects are in attractive growth areas that are mission-centric but also are in the right markets. And by bringing those solutions, we're going to become and remain market leaders in these categories where we choose to play, aided by more product and solutions launches that will enable category leadership for Zimmer Biomet.

在創新方面，我們將透過持續大膽投資於正確的研發領域來進行創新。這就是新產品開發，因此我們始終思考客戶的問題並為這些產品提供解決方案。我們將確保這些項目位於有吸引力的成長領域，以任務為中心，但也位於正確的市場。透過提供這些解決方案，我們將成為並保持在我們選擇參與的這些類別中的市場領導者地位，並透過更多產品和解決方案的發布來幫助 Zimmer Biomet 實現類別領導地位。

We're going to be relentless about the CytoCare opportunities, namely the ASC opportunity here in the U.S., where we're already growing in the strong double-digit rates, but we know we're far from realizing our true potential. This journey, by the way, innovation journey has already started. We then try to launch over 40 new products over the next 36 months, and the value -- the dollar value of our pipeline today it's twice the dollar value that we had back in 2018.

我們將不懈地抓住 CytoCare 機會，即美國的 ASC 機會，我們已經在以兩位數的速度強勁增長，但我們知道我們還遠遠沒有實現我們的真正潛力。順便說一句，這趟旅程，創新之旅已經開始了。然後，我們嘗試在接下來的 36 個月內推出 40 多種新產品，而我們今天的產品線的美元價值是 2018 年美元價值的兩倍。

So a lot of new exciting technologies are about to get launched here at Zimmer Biomet. In addition, 80% of our products in our pipeline, we study markets that are growing at least 4% many in areas that are growing more than 4%. Equally viral, we're going to ensure that our innovation journey accelerates value creation through making sure that we're monitoring not just the revenue associated with these launches, the vitality index, but also what we call our innovation, profitability index or IPI.

因此，Zimmer Biomet 即將推出許多令人興奮的新技術。此外，我們在管道中的 80% 產品中，研究了成長至少 4% 的市場，許多領域的成長超過 4%。同樣，我們將確保我們的創新之旅加速價值創造，不僅要監控與這些產品發布相關的收入、活力指數，還要監控我們所謂的創新、獲利指數或 IPI。

And thus the gross margin dollars coming from new products. We've got to make sure that these new products are driving margin accretion to the overall margin profile of the organization. So again, it's about innovation and it's about value creation at the same time. Mission and margin expansion will coexist and will coexist as part of our innovation journey. To materially change our portfolio, we're going to also leverage the strength of our balance sheet, which is stronger than ever. We will do M&A. We're going to be thoughtful and disciplined about the spaces we prioritize.

因此，毛利率來自新產品。我們必須確保這些新產品能夠推動組織整體利潤狀況的利潤成長。再說一次，這與創新有關，同時也與價值創造有關。使命和利潤擴張將共存，並將作為我們創新之旅的一部分共存。為了實質地改變我們的投資組合，我們還將利用比以往任何時候都更強大的資產負債表的優勢。我們將進行併購。我們將對我們優先考慮的空間進行深思熟慮並遵守紀律。

We're going to ensure that the spaces are mission-centric. And at the same time, these spaces are the areas where Zimmer Biomet has the right to win. We focus on opportunities that are going to hit strategic thresholds, but also hit financial thresholds. We're going to make sure that these acquisitions drive strong returns and create long-term shareholder value.

我們將確保這些空間以任務為中心。同時，這些空間也是 Zimmer Biomet 有權獲勝的領域。我們關注那些將達到策略門檻和財務門檻的機會。我們將確保這些收購帶來強勁回報並創造長期股東價值。

It is worth noting that this diversification of our business has started already. Yes, we have bolder and we will be bolder but it has already started. In the last 2, 3 years, we have shifted our portfolio already into mid-single-digit or above market environment, and our weighted average market growth rates have already increased from 50 basis points, and this happens through thoughtful resource allocation and some of the active portfolio management we've done.

值得注意的是，我們業務的多元化已經開始。是的，我們已經更加大膽，我們將會更加大膽，但它已經開始了。在過去的兩三年裡，我們的投資組合已經進入中個位數或以上的市場環境，我們的加權平均市場成長率已經從50個基點上升，這是透過深思熟慮的資源配置和一些我們所做的主動投資組合管理。

Again, we're going to be bolder, but the journey has already started. I'm excited about where we can and will do across these 3 priorities. It's about, first and foremost, people, human capital, having a best-in-class culture. Secondly, it's about delivering operational excellence as a company mindset or mandate and fairly is about making sure that we diversify and innovate in a far bolder way through organic and inorganic means.

同樣，我們將更加大膽，但旅程已經開始。我對我們能夠並且將會在這三個優先事項上做的事情感到很興奮。首先，最重要的是人、人力資本以及一流的文化。其次，它是將卓越營運作為公司的心態或使命，公平地是確保我們透過有機和無機手段以更大膽的方式實現多元化和創新。

Those are the 3 priorities. So now that you got a better sense of our priorities, I want to talk about Q3. And again, I want to reiterate that we're really excited about the performance that we saw in the quarter. Performance that was driven by continued execution, especially in the key areas where we've been investing.

這是三個優先事項。現在您對我們的優先事項有了更好的了解，我想談談第三季。我想再次重申，我們對本季的表現感到非常興奮。績效是由持續執行推動的，尤其是在我們一直投資的關鍵領域。

In particular, I want to talk about Knees, it was a great quarter for Knees, where we delivered a broad market performance in key markets around the world. We also grew in areas that are mission-critical within SET, upper extremity CMFT as well as Sports Medicine. We had solid performance in the ASC environment, and we saw a revenue generation coming strongly from our data, technology and solutions platform, primarily within ROSA and mymobility. In Knees persona OsseoTi are highly are differentiated cementless platform, continues to perform above our expectations. I was recently in Dallas at the hip and knee society, and the feedback continues to be superb. I can't wait until we continue to bring this technology to other geographies. ROSA had a strong quarter. I continue to see great adoption. We've seen a lot of ROSA adoption happening in the ASC setting, where speed we're dealing with higher volumes, that's matter.

我特別想談談 Knees，對於 Knees 來說，這是一個偉大的季度，我們在全球主要市場上取得了廣泛的市場表現。我們也在 SET、上肢 CMFT 以及運動醫學等關鍵任務領域中取得了發展。我們在 ASC 環境中表現穩定，我們看到我們的數據、技術和解決方案平台（主要是 ROSA 和 mymobility）帶來了強勁的收入。在膝關節中，OsseoTi 是高度差異化的非骨水泥平台，持續表現超越我們的預期。我最近在達拉斯參加了髖關節和膝關節協會，回饋仍然非常好。我迫不及待地想繼續將這項技術帶到其他地區。 ROSA 的季度表現強勁。我繼續看到它的廣泛採用。我們已經看到在 ASC 環境中大量採用 ROSA，在這種情況下，我們處理更高容量的速度很重要。

In the ASC, we continue to see growth in the teams, and we're executing contracts daily or portfolios second to none, and we're benefiting from the recent acquisitions we've done, such as Embody and ReLine. Against the backdrop of this strong execution, medtech sector stocks have been facing pressure related to GLP-1 drugs and their impact or their perceived impact on obesity and this was a long-term perspective.

在 ASC，我們繼續看到團隊的成長，我們每天執行的合約或投資組合都是首屈一指的，並且我們從最近完成的收購（例如 Embody 和 ReLine）中受益。在這種強勁執行力的背景下，醫療科技板塊的股票一直面臨著與 GLP-1 藥物及其對肥胖的影響或感知影響相關的壓力，這是一個長期的觀點。

We're mission-centric pace in the bore organization, so if this drug class truly does accelerate and improves patient health. And if these drugs truly do become the end of the obesity pandemic around the world, that is great news for everyone, as long as truly, this is sustainable in the long term. What I can tell you that we spend a lot of time researching GLP-1 drugs, engaging third parties, engaging thought partners and key opinion leaders across every major market and these GLP-1 drugs today become a tailwind for us. The [step up framing] the root causes of osteoarthritis, a disease which impacts 528 million people around the world according to the World Health organization. The top osteoarthritis factors are ranking order, age, genetics and joint injury.

我們在無聊的組織中以任務為中心，所以如果這種藥物確實能夠加速並改善患者的健康。如果這些藥物確實能夠終結世界範圍內的肥胖大流行，那麼這對每個人來說都是個好消息，只要這確實是長期可持續的。我可以告訴您的是，我們花了大量時間研究GLP-1 藥物、與第三方合作、與每個主要市場的思想合作夥伴和關鍵意見領袖合作，而這些GLP-1 藥物今天成為我們的順風車。 [加強框架]骨關節炎的根本原因，據世界衛生組織稱，這種疾病影響著全世界 5.28 億人。最重要的骨關節炎因素是排名順序、年齡、遺傳和關節損傷。

Obesity certain accelerator of the disease and certainly is an element of the disease or a driver of the disease, but let's not forget that once the cartilage is damaged, there is no recovery. Once you get osteoarthritis you will not get rid of osteoarthritis. And drop in weight is not going to cure osteoarthritis. Again, this is a generative and non-tenable disease that we're talking about.

肥胖是疾病的一定加速器，當然也是疾病的因素或驅動因素，但我們不要忘記，軟骨一旦受損，就無法恢復。一旦患有骨關節炎，您將無法擺脫骨關節炎。體重下降並不能治癒骨關節炎。再說一遍，我們正在談論的是一種無法持續的生殖疾病。

If anything, obesity is a blocker today to join surgery as many surgeons are uncomfortable operating on patients with a BMI greater than 40 (inaudible) or even above the 30 thresholds in some locations. So why could GLP-1s then be a tailwind for orthopedics, 3 compelling reasons. First, if you can lower the patient's BMI below a certain threshold 40 or 30 some cases, these patients now become eligible for surgery.

如果有什麼不同的話，那就是肥胖是當今參與手術的障礙，因為許多外科醫生對 BMI 大於 40（聽不清楚）甚至在某些地方超過 30 閾值的患者進行手術感到不舒服。那麼為什麼 GLP-1 能夠成為骨科的順風車，有 3 個令人信服的原因。首先，在某些情況下，如果可以將患者的 BMI 降低到某個閾值 40 或 30 以下，這些患者現在就有資格接受手術。

And all the data points that we're getting in primary markets like the U.S. is that there is a large percentage of patients who today are not going through surgery because their BMI is too high. Secondly, if a patient does lose the weight -- and I would say this is pretty logical. And they do become more active, there would be a greater risk for additional joint procedures because there will be injury.

我們在美國等主要市場獲得的所有數據都表明，目前有很大比例的患者因為體重指數太高而沒有接受手術。其次，如果患者確實體重減輕了——我會說這是非常合乎邏輯的。而且他們確實變得更加活躍，進行額外的關節手術的風險也會更大，因為會受傷。

And third, if a patient loses weight, they are likely to live longer. Again, expanding the patient final for an orthopedic procedure. A great example of this fact is Japan, the second largest market in the world for osteoarthritis with Minimal obesity rates but very, very long life expectancy dynamics. We don't see any near-term impact from GLP-1s, and we've seen the long-term impact would be a positive one for orthopedics and Zimmer Biomet. We've engaged independent third parties to perform surgeon surveys. I have gathered U.S.-based claims data. we're still early in the process. We are very excited about the initial findings, and we look forward to sharing them.

第三，如果患者體重減輕，他們的壽命可能會更長。再次，擴大患者最終進行骨科手術的範圍。日本是這一事實的一個很好的例子，它是世界上第二大骨關節炎市場，其肥胖率極低，但預期壽命非常非常長。我們沒有看到 GLP-1 產生任何短期影響，而且我們看到長期影響將對骨科和 Zimmer Biomet 產生積極影響。我們聘請了獨立的第三方來進行外科醫生調查。我收集了美國的索賠數據。我們還處於這個過程的早期階段。我們對初步發現感到非常興奮，並期待與大家分享。

So in a nutshell, more of a tailwind. We'll be sharing data very soon. We think that the logic will prevail, and this will be the end of what has been so far a rather emotional argument that is not being fact-based. In closing, I hope you can tell that I'm very confident about the future of this organization. I'm very excited to be here.

簡而言之，更多的是順風。我們很快就會共享數據。我們認為邏輯將會佔上風，這將是迄今為止一場相當情緒化、不以事實為基礎的爭論的結束。最後，我希望您能看出我對這個組織的未來充滿信心。我很高興來到這裡。

Our end markets have never been stronger, and we believe that this market beyond the backlog is sustainable. Our execution is strong and is also sustainable. We've been delivering consistently for a while, and we'll continue to do so with even greater focus and speed. We know what we need to do.

我們的終端市場從未如此強大，我們相信這個超出積壓的市場是可持續的。我們的執行力很強，而且可持續。一段時間以來，我們一直在持續交付，並且我們將繼續以更專注和更快的速度這樣做。我們知道我們需要做什麼。

The strategy is clear, and we will execute on the strategy. We have financial flexibility to invest in higher growth markets, and we are going to continue to shift our portfolio mix and diversify our business. I generally believe this is the time for Zimmer Biomet. I'm proud of what we've done and even more proud of the work that we're going to be doing ahead.

戰略是明確的，我們將執行該戰略。我們擁有財務靈活性，可以投資於更高成長的市場，並且我們將繼續改變我們的投資組合並使我們的業務多元化。我總體認為現在是 Zimmer Biomet 的時代。我為我們所做的事情感到自豪，也為我們接下來要做的工作感到自豪。

This is why I'm excited to be the CEO and even more excited to be a proud Zimmer Biomet shareholder as I believe that now is the time for real value creation. With that, I'll turn the call over to Suky for a run-through of our Q3 financials. Suky?

這就是為什麼我很高興成為首席執行官，更興奮的是成為一名自豪的 Zimmer Biomet 股東，因為我相信現在是創造真正價值的時候。接下來，我將把電話轉給 Suky，讓他詳細介紹我們第三季的財務狀況。蘇基？

Thanks, and good morning. I'd like to start my prepared remarks today by welcoming Ivan to his first earnings call as the Zimmer Biomet CEO. Ivan has been a constant force and a driver within the organization for several years, and I'm proud to work with him, and I'm excited by the partnership. As Ivan noted, we had another strong quarter driven by healthy and improving end markets, and continued strong execution across the organization. Overall, we remain on track to deliver mid-single-digit constant currency revenue growth and adjusted operating margin expansion in the back half of the year just as we committed to on our second quarter call.

謝謝，早安。我今天首先要歡迎 Ivan 作為 Zimmer Biomet 執行長參加他的第一次財報電話會議。多年來，伊凡一直是組織內的一股持續力量和驅動力，我很自豪能與他合作，我對這種夥伴關係感到興奮。正如伊凡指出的那樣，在健康和不斷改善的終端市場以及整個組織持續強勁的執行力的推動下，我們又迎來了一個強勁的季度。總體而言，正如我們在第二季電話會議上所承諾的那樣，我們仍有望在今年下半年實現中個位數的恆定貨幣收入成長和調整後的營業利潤率擴張。

Moving to results. Unless otherwise noted, my statements will be about the third 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 $1.754 billion, an increase of 5% on a reported basis and an increase of 4.7%, excluding the impact of foreign currency. Additionally, we had a selling day headwind of about 150 basis points that impacted all regions and product categories at about the same level.

轉向結果。除非另有說明，我的陳述將涉及第三季以及與 2022 年同期的比較。我的評論將基於固定匯率和調整後的營運基礎。淨銷售額為 17.54 億美元，按報告計算成長 5%，剔除外匯影響後成長 4.7%。此外，我們的銷售日逆風約為 150 個基點，對所有地區和產品類別的影響大致相同。

Excluding the selling day impact, consolidated ex FX sales would have grown just over 6%. U.S. growth was 6% and international growth was 2.9%. In the U.S., our strong year-over-year results were driven by Recon and a step-up in our SET category in tandem with strong capital sales. Outside of the U.S., we saw more moderated growth across Europe and Asia, driven by tough comps and geopolitical headwinds, which I'll discuss in our product category section.

排除銷售日的影響，除外匯外的綜合銷售額將成長略高於 6%。美國成長率為 6%，國際成長率為 2.9%。在美國，我們強勁的年比業績是由 Recon 和我們的 SET 類別的提升以及強勁的資本銷售所推動的。在美國以外，在艱難的競爭和地緣政治逆風的推動下，我們看到歐洲和亞洲的成長更為溫和，我將在我們的產品類別部分討論這一點。

Global Knees grew 7.3% with the U.S. growing 6.1% and international growing 9.1%. The strong performance in Knees was driven by continued uptake from our Persona product portfolio, combined with the benefits of our ROSA robotics platform. Global Hips declined by 60 basis points with the U.S. growing 3% and international declining by 4.2%.

全球膝蓋成長 7.3%，其中美國成長 6.1%，國際成長 9.1%。 Knees 的強勁表​​現得益於我們 Persona 產品組合的持續採用，以及我們 ROSA 機器人平台的優勢。全球髖關節指數下降 60 個基點，其中美國成長 3%，國際水準下降 4.2%。

Tough comps in China and headwinds in Russia disproportionately impacted our OUS hip business. Excluding these impacts, our international hip business grew in the low single digits. Looking ahead, portfolio expansion will continue to support growth in our hips business. Next, the SET category grew 2.8%. Again, as a reminder, there was about 150 basis point selling day headwind across all categories and regions.

中國的艱難競爭和俄羅斯的逆風對我們的 OUS 時尚業務產生了不成比例的影響。排除這些影響，我們的國際時尚業務以較低的個位數成長。展望未來，投資組合擴張將繼續支持我們臀部業務的成長。接下來，SET 類別成長了 2.8%。再次提醒大家，所有類別和地區的銷售日均存在約 150 個基點的逆風。

Our key focus areas within SET, including sports, upper extremities and CMFT, continued to post double-digit growth which was partially offset by other subsegments within the category. We remain confident that SET will grow in the mid-single digits in the fourth quarter. Finally, our other category grew 16.4%, driven by ROSA sales. Now moving on to the P&L. In Q3, we reported GAAP diluted earnings per share of $0.77 compared to GAAP diluted earnings per share of $0.92 in the prior year. While we had higher year-over-year revenue and higher pretax operating profits, post-tax income was lower due to a favorable tax settlement in 2022 that did not repeat this year.

我們在 SET 內的主要關注領域，包括體育、上肢和 CMFT，繼續實現兩位數成長，但部分被該類別內的其他細分市場所抵消。我們仍然相信 SET 在第四季將實現中個位數成長。最後，在 ROSA 銷售的推動下，我們的其他類別成長了 16.4%。現在轉向損益表。第三季度，我們公佈的 GAAP 攤薄每股收益為 0.77 美元，而上一年的 GAAP 攤薄每股收益為 0.92 美元。雖然我們的年收入和稅前營業利潤較高，但由於 2022 年的有利稅收結算今年沒有重複，稅後收入較低。

On an adjusted basis, we reported diluted earnings per share of $1.65 compared to adjusted diluted earnings per share of $1.58 in the prior year. The step-up is primarily driven by revenue growth in the quarter, partially offset by higher operating expenses and higher interest costs. Our adjusted gross margin was 70.9%, up 20 basis points from the prior year, primarily driven by favorable mix. Adjusted operating margin was 26.4% and up slightly versus the prior year.

在調整後的基礎上，我們報告的稀釋後每股收益為 1.65 美元，而上一年調整後稀釋後每股收益為 1.58 美元。這一增長主要是由本季度收入增長推動的，但部分被較高的營運費用和較高的利息成本所抵消。我們的調整後毛利率為 70.9%，比上年增長 20 個基點，這主要是受到有利組合的推動。調整後營業利益率為 26.4%，較上年略為上升。

Better gross margin and savings from efficiencies across SG&A were partially offset by higher R&D expenses that will support upcoming product launches, ultimately driving a continued increase in our Vitality Index. Net interest and other adjusted nonoperating expenses of $48 million was higher than the prior year due to certain foreign currency exposures as well as higher interest rates. And our adjusted tax rate was 16.7% in the quarter.

更好的毛利率和整個 SG&A 效率帶來的節省被更高的研發費用所部分抵消，這將支持即將推出的產品，最終推動我們活力指數的持續成長。由於某些外幣風險以及較高的利率，淨利息和其他調整後的非營運支出比去年增加了 4,800 萬美元。本季調整後的稅率為 16.7%。

Turning to cash and liquidity. We had operating cash flows of $338 million and free cash flow of $189 million in the quarter. We ended with cash and cash equivalents totaling just under $300 million. Our balance sheet remains strong, providing us financial flexibility and strategic optionality as we move forward. Now regarding our outlook. Overall, for 2023, the outlook remains largely unchanged from the prior quarter, implying over 7% constant currency revenue growth and 9% EPS growth at the midpoint of our range.

轉向現金和流動性。本季我們的營運現金流為 3.38 億美元，自由現金流為 1.89 億美元。最終我們的現金和現金等價物總額接近 3 億美元。我們的資產負債表依然強勁，為我們的前進提供了財務靈活性和策略選擇性。現在談談我們的展望。總體而言，2023 年的前景與上一季基本保持不變，這意味著恆定貨幣收入增長超過 7%，每股收益增長 9%，處於我們範圍的中點。

We expect reported growth for the full year to be 6% to 6.5% and are maintaining our ex FX growth expectations for the year of 7% to 7.5%. Inside of that, the U.S. dollar has strengthened, so we are increasing our outlook for foreign currency to be about a 100 basis point headwind to revenue growth for the full year. Additionally, we are reiterating our EPS guidance of $7.47 to $7.57 for the full year despite the strengthening dollar, which we project to be about a $0.04 headwind to fourth quarter earnings.

我們預計全年報告成長率為 6% 至 6.5%，並維持全年 7% 至 7.5% 的除外匯成長預期。其中，美元走強，因此我們將外匯展望調高，預計全年營收成長將受到約 100 個基點的阻力。此外，儘管美元走強，我們仍重申全年每股收益指引為 7.47 至 7.57 美元，預計第四季度收益將受到約 0.04 美元的阻力。

This guidance implies that we will increase full year operating margins by about 100 basis points in the backdrop of a challenging environment. In addition to our formal guidance ranges, I will reiterate that there is no material impact from selling days on the full year revenue growth expectations. However, we do expect about a 100 basis point tailwind in the fourth quarter. Additionally, our expectations for interest and other nonoperating expenses as well as tax rate and shares outstanding remain unchanged.

這項指引意味著，在充滿挑戰的環境背景下，我們將把全年營業利潤率提高約 100 個基點。除了我們的正式指導範圍外，我將重申，銷售天數對全年收入成長預期沒有重大影響。然而，我們確實預計第四季將出現約 100 個基點的順風車。此外，我們對利息和其他非營業費用以及稅率和已發行股票的預期保持不變。

We expect free cash flow for the year to be between $950 million and $1 billion. In summary, we delivered another excellent quarter on both the top and bottom lines. We remain confident in our 2023 expectations and are excited about the next year with revenue growing in the mid-single digits and earnings growing faster than the top line. With that, I'll turn the call back over to Keri.

我們預計今年的自由現金流將在 9.5 億美元至 10 億美元之間。總而言之，我們在營收和利潤方面又實現了出色的季度表現。我們對 2023 年的預期仍然充滿信心，並對明年的營收成長中個位數和獲利成長速度快於營收的情況感到興奮。這樣，我會將電話轉回給 Keri。

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

謝謝，蘇基。 （操作員指示） 那麼，操作員，請問第一個問題。

We'll go first to Robbie Marcus with JPMorgan.

我們先請摩根大通的羅比·馬庫斯。

Great. I'll ask both upfront as they're kind of interrelated. Ivan and Suky, I was hoping you could address just the health of the ortho market. You talked to it, but we see your results and we see your peer results, and most of them were in line to slightly below in the quarter. So one, how you're thinking about the health of the market? And then second, you touched last quarter and then this quarter as well on longer-range guidance for '24.

偉大的。我會預先詢問兩者，因為它們是相互關聯的。 Ivan 和 Suky，我希望你們能夠解決正骨市場的健康問題。您與之交談過，但我們看到了您的結果，我們看到了您的同行結果，其中大多數與本季度的結果一致或略低於。那麼，您如何看待市場的健康狀況呢？其次，您談到了上個季度和本季以及 24 年的長期指引。

You talked newer guidance this time about 100 to 200 basis points above your end market growth. I think last quarter, it was implying something like 4% plus. Is that a change? And how do we think about margins for next year? I think previously, it was slightly up.

這次您談到的新指引比您的終端市場成長高出約 100 到 200 個基點。我認為上個季度，這意味著 4% 以上。這是一個改變嗎？我們如何看待明年的利潤率？我認為之前，它略有上升。

Thank you, Robbie. I'll start. I'll talk about the market dynamics and briefly a comment on '24. I'll pass it on to Suky to provide more color on '24 and maybe discuss what he can discuss at this point when it comes to the margin profile. But I'll start with the market dynamics.

謝謝你，羅比。我開始吧。我將談論市場動態並簡要評論 '24。我會將其傳遞給 Suky，以提供有關 24 年的更多信息，並可能討論他此時可以討論的利潤概況。但我將從市場動態開始。

We are the fourth company to report in Q3. So by now, everybody sees that the markets are healthy. And quite frankly, I won't match about Q4, but so far, so good. So this is not a one quarter type of market dynamic. The reasons behind the market profile, the market growth profile and why I continue to say this market is different than 4, 5 years ago is the things that I alluded to in my prepared remarks.

我們是第四家在第三季報告的公司。所以到目前為止，每個人都看到市場是健康的。坦白說，我不會匹配第四季度，但到目前為止，一切都很好。所以這不是一個季度的市場動態。市場概況、市場成長概況以及為什麼我繼續說這個市場與四五年前不同的原因是我在準備好的發言中提到的。

The explosion of ASCs, the movement, the set to ASC is real. That means new ASCs are opening in the U.S. That means Ee ratio surgery are happening. Demographics around the world play a factor. We continue to track data in terms of the age for someone to get a hip or a knee. And these are younger patients. In the U.S., we're also see more days of surgery. And I don't think this is just a backlog dynamic.

ASC 的爆炸、運動、ASC 的設定都是真實的。這意味著新的 ASC 正在美國開業，這意味著 Ee 比率手術正在進行。世界各地的人口統計數據都是一個因素。我們繼續追蹤某人獲得髖關節或膝關節的年齡數據。這些都是年輕的患者。在美國，我們也看到手術天數更長。我不認為這只是積壓動態。

Pricing, you see what every single one of us is reporting these days is not the same pricing dynamic that we had in the past. And beyond that, the technology. We are driving disruptive innovation. We got more efficient solutions surgeries are shorter and the episodes are getting shorter. So we're dealing with the patients, the final patients with more efficiency.

定價，你看我們每個人現在報告的定價動態與我們過去的定價動態不同。除此之外，還有技術。我們正在推動顛覆性創新。我們得到了更有效的解決方案，手術時間更短，發作時間也更短。所以我們在與病人打交道時，最終的病人效率更高。

Again, this is a durable trend. It's happening in Q3. As I think like Q4, nothing is really changing. As we look into 2024, every early indicator suggests that things are not going to change. And relative to performance, well, look, in the background of these healthy market dynamics in the U.S., we gained share in Q3 in both categories, really proud of being #1 in knees for the quarter. We don't pay a lot of attention to any given quarter but that is a fact that we're the fastest-growing company in the quarter.

再次強調，這是一個持久的趨勢。這發生在第三季。我認為就像第四季度一樣，沒有什麼真正改變。當我們展望 2024 年時，每項早期指標都顯示情況不會改變。相對於業績，好吧，看看，在美國市場健康發展的背景下，我們在第三季度在這兩個類別中都獲得了份額，對於本季度膝蓋排名第一感到非常自豪。我們不會過多關注任何特定季度，但事實是我們是該季度成長最快的公司。

And then globally, net of a couple of one-timers, both in Russia and China when it comes to hips, our performance was in line with hips, and knees was very strong. And then as we get to 2024, I'll let Suky comment, but we will be mid-single digit. That's the point of entry. And nothing has really changed. It's just getting closer to the end of the year and realizing that these market trends are sustainable. And the innovation pipeline that we have will drive the type of growth. But I'll pass it on to Suky to comment on all the drivers.

然後在全球範圍內，除去俄羅斯和中國的幾個一次性運動員，在臀部方面，我們的表現與臀部一致，膝蓋也非常強壯。然後，當我們到達 2024 年時，我會讓 Suky 發表評論，但我們將達到中個位數。這就是切入點。一切都沒有真正改變。距離年底越來越近，我們意識到這些市場趨勢是可持續的。我們擁有的創新管道將推動這種成長。但我會把它轉給 Suky 來評論所有的司機。

Robbie, thanks for the question. The first thing I'd say is, starting with the back half of this year, we committed to mid-single-digit ex FX growth for the second half of the year with operating margin expansion, both sequentially and year-over-year. Q3 was a really another strong validation proof point of that, and we feel confident in that profile.

羅比，謝謝你的提問。我要說的第一件事是，從今年下半年開始，我們致力於在下半年實現中個位數的除外匯增長，同時營業利潤率連續增長和同比增長。第三季確實是另一個強而有力的驗證點，我們對此充滿信心。

The reason I mentioned that is I think it gives us a running start as we go into 2024. And so I do want to talk a little bit about '24 back to your question. First, we've already provided a lot of color, I think, on '24 more than most of our peers, but we feel that being transparent, giving you guys a robust view of what we're going to do not only this year but into the future is really important. But let me talk a little bit about the headwinds and tailwinds as we see it going into '24.

我提到這一點的原因是我認為它為我們進入 2024 年提供了一個良好的開端。所以我確實想在回答你的問題時談談 24 年。首先，我認為，我們已經在 24 週年慶典上提供了比大多數同行更多的色彩，但我們認為保持透明可以讓大家對我們不僅今年要做的事情有一個清晰的認識但展望未來確實很重要。但讓我談談我們在 24 世紀所看到的逆風和順風。

And some things have modestly changed. First, I'll start with the headwinds. One, we do see a higher tax rate into next year because of the OECD's Pillar 2. Secondly, based on where FX rates are today, we see some additional pressure from a foreign currency perspective into next year. Again, both of these are more macro versus execution, right? There are things that are outside of our control, but we're going to contend with them, we're going to deal with them. I'll tell you a little bit about how.

有些事情已經發生了適度的改變。首先，我將從逆風開始。首先，由於經合組織的第二個支柱，我們確實預計明年的稅率會更高。其次，根據目前的匯率，我們看到明年從外匯角度來看會面臨一些額外的壓力。同樣，這兩者都更宏觀而不是執行，對嗎？有些事情是我們無法控制的，但我們會與之抗爭，我們會處理它們。我會告訴你一些如何做。

On the tailwind side, I would say, yes, we are more confident in our outlook for revenue next year. Our end markets are stronger than they've ever been. Our portfolio and new product launches have been executing extremely well in some areas above our expectation. Our performance relative to market has been very strong, and that's consistent and durable.

在順風方面，我想說，是的，我們對明年的收入前景更有信心。我們的終端市場比以往任何時候都更強大。我們的產品組合和新產品發佈在某些領域的表現非常好，超出了我們的預期。我們相對於市場的表現非常強勁，而且是一致且持久的。

And quite frankly, we're seeing a more moderated pricing environment still erosion, but much more moderated than what we've seen historically. All of those elements give us confidence that we're going to be able to close to mid-single-digit growth top line, ex FX into 2024. And then despite those sort of P&L headwinds I talked about, we do believe that we're going to be able to grow earnings faster than revenue. I talked about gross margin next year stepping down because of the FX hedge gains from this year, not repeating at the same level. That will still happen, but we're going to be able to offset some of that.

坦白說，我們看到更溫和的定價環境仍在受到侵蝕，但比我們歷史上看到的要溫和得多。所有這些因素都讓我們有信心，我們將能夠在 2024 年實現接近中個位數的增長（扣除外匯因素）。然後，儘管我談到了這些損益不利因素，但我們確實相信我們「我們將能夠以比收入更快的速度成長收入。我談到明年的毛利率會因為今年的外匯對沖收益而下降，而不是在同一水平上重複。這種情況仍然會發生，但我們將能夠抵消其中的一些影響。

The operations and manufacturing team has been working really hard at efficiency. And so we feel more optimistic about where our gross margin is going into next year. Secondly, as I said, we've already got a running start and a lot of SG&A efficiency programs in the back half of this year that are going to run into next year.

營運和製造團隊一直在努力提高效率。因此，我們對明年的毛利率持更樂觀的態度。其次，正如我所說，我們已經有了一個良好的開端，並在今年下半年實施了許多 SG&A 效率計劃，這些計劃將持續到明年。

So when you combine those 2 elements together, again, we feel really confident that we're going to be able to do that mid-single-digit top line growth next year as well as earnings growing faster than revenues.

因此，當你將這兩個因素再次結合在一起時，我們非常有信心明年我們將能夠實現中個位數的營收成長，並且獲利成長速度快於收入成長速度。

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

接下來我們將與摩根士丹利一起討論德魯·拉涅利。

just maybe on '24 also, you haven't talked about backlog much at recent conferences. You kind of pointed out that you think it's going to carry through '24. But just maybe help us a bit more of how you're factoring that into your mid-single-digit directional guide for next year. I know it's not -- I know your growth is not all dependent on backlog. But just how do you think about that helping to support the orthopedic market growth? And maybe just talk to us about your ability to capture a disproportional amount of share of that backlog?

也許在 24 日，您在最近的會議上也沒有太多談論積壓問題。你有點指出你認為它會持續到 24 年。但也許可以幫助我們更多地了解您如何將其納入明年的中位數方向指南中。我知道不是——我知道你們的成長並不完全依賴積壓。但您如何看待這有助於支持骨科市場的成長？也許只是和我們談談您是否有能力從積壓的訂單中獲取不成比例的份額？

Yes. And first things first, you should be in your honeymoon considering that you got married recently. So I'm disappointed you're here. Look, I'm going to keep this short and sweet. We don't see backlog as a major driver in our growth profile for the next year. So when Suky and I said on mid-single digit, we're not assuming any real meaningful backlog. So not a key driver. We believe we spent other time going back on for some backlog that is going to remain here throughout the end of '24 at least, but we are not a backlog depending -- backlog dependent type of company. So we don't have our focus on that. What we're tracking is innovation, the pipeline that we have. What we're tracking is the investments we made in the ASC, we're tracking is commercial execution and in the background, just sustainable pricing dynamics. So no backlog.

是的。首先，考慮到您最近結婚了，您應該正在度蜜月。所以你在這裡我很失望。聽著，我會保持這個簡短而甜蜜。我們不認為積壓是我們明年成長的主要動力。因此，當蘇基和我談到中個位數時，我們並沒有假設有任何真正有意義的積壓。所以不是關鍵驅動因素。我們相信我們花了其他時間來處理一些積壓的訂單，這些積壓的訂單至少會在 24 世紀末保留在這裡，但我們不是一家依賴積壓訂單的公司。所以我們沒有把重點放在這上面。我們追蹤的是創新，也就是我們擁有的管道。我們追蹤的是我們在 ASC 中所做的投資，我們追蹤的是商業執行，而在後台，我們追蹤的是可持續的定價動態。所以沒有積壓。

And just a second, as a follow-up, your commentary was very strong that you're expecting mid-single-digit SET growth into next year. But just remind us about what's it going to take to really accelerate SET? And maybe just talk a bit more about the lift on the organic side and maybe what you're thinking about in terms of M&A to get that growth rate higher and more sustainable?

作為後續行動，您的評論非常強烈，您預計 SET 明年將實現中個位數的成長。但請提醒我們，要真正加速 SET 需要什麼？也許只是多談談有機方面的提升，以及您在併購方面的想法，以使增長率更高、更可持續？

Yes, absolutely. Great question. First things first, Q3 SET was in line as we move into Q4, we're actually going to be a mid-single-digit grower. I'm not going to talk about a dynamics for '24. We'll do that coming guidance, but very excited in terms of where we are. We integrated a couple of companies within Sports Med, those are performing very well or upper extremity, so their business is growing in the mid- to upper single digits in most regions. When you look at our CMFT, craniomaxillofacial thoracic, which is part of -- as said, it has been performing very well. It continues to perform very well. So again, lots of reasons to believe that as we get in '24, you should expect a sustainable performance in SET.

是的，一點沒錯。很好的問題。首先，第三季的 SET 與我們進入第四季的情況一致，我們實際上將成為一個中等個位數的種植者。我不會談論 24 年的動態。我們將在未來提供指導，但對我們所處的位置感到非常興奮。我們整合了 Sports Med 內的幾家公司，這些公司表現非常好或上肢，因此他們的業務在大多數地區都在中上個位數成長。當你觀察我們的 CMFT（顱顏面胸椎）時，如前所述，它的表現一直非常好。它繼續表現得很好。再說一次，有很多理由相信，當我們進入 24 年時，您應該期待 SET 的可持續表現。

In terms of M&A, again, we'll comment more on that later, but it remains the #1 recipient of capital allocation. We haven't changed in that regard. And you have said this one category that is very attractive given higher market growth dynamics or position in this space. So you should assume that this is one area where we're going to be focusing from an M&A standpoint. But again, net of M&A already delivering mid-single-digit growth entering Q4 strongly and really excited about 2024.

在併購方面，我們稍後會對此進行更多評論，但它仍然是資本配置的第一大接受者。在這方面我們沒有改變。您說過，鑑於較高的市場成長動力或在該領域的地位，這個類別非常有吸引力。因此，您應該假設，從併購的角度來看，這是我們將重點關注的領域。但同樣，進入第四季度，扣除併購後的成長已經實現了中個位數成長，並且對 2024 年感到非常興奮。

We'll go next to Matt Taylor with Jefferies.

接下來我們將與傑弗里斯一起前往馬特泰勒。

Congrats on a good quarter. I was curious about your outlook comments for 2024, and I was hoping you could specifically address the concern I think investors have about growth especially in the first half of the year with a new air quotes on this, but tough comps, especially in Q1. So maybe you could address how you think you can grow throughout the year and address investor concerns about those tough comps in the first half?

恭喜季度表現良好。我對您對2024 年展望的評論感到好奇，我希望您能具體解決我認為投資者對增長的擔憂，特別是在今年上半年，對此有新的空氣報價，但比較艱難，尤其是在第一季。那麼，也許您可以談談您認為如何在全年實現成長，並解決投資者對上半年艱難的業績的擔憂？

Yes. I'll start, Matt, and again, Suky, maybe want to chime in here. But we're confident about 2024 because the market dynamics are sustainable. There's been a lot of back and forth in terms of what's going to happen once the backlog is out and all that, first, the backlog. We don't think it's going to be out anytime soon. And then pricing is sustainable. And all the things that I mentioned -- my answer to Robbie are here, they move to ASC the shorter episodes of care, more [diesel] surgery. So macro-wise, every data point we get, Matt, is very compelling. And then on the micro, we are seeing a bolus of innovation being launched. We've got 40 new products that we're going to be launching over the next 36 months. Some of these products are very compelling.

是的。我先開始，馬特，蘇基，也許想插話。但我們對 2024 年充滿信心，因為市場動態是可持續的。關於積壓訂單結束後會發生什麼，我們進行了很多來回討論，首先是積壓訂單。我們認為它不會很快發布。然後定價是可持續的。我提到的所有事情 - 我對羅比的回答都在這裡，他們轉移到 ASC 護理時間較短，更多的[柴油]手術。因此，從宏觀角度來看，馬特，我們獲得的每個數據點都非常引人注目。然後在微觀上，我們看到大量創新正在啟動。我們將在未來 36 個月內推出 40 種新產品。其中一些產品非常引人注目。

We launched our Persona OsseoTi, which is a cementless construct earlier in '23. That is going to be a full -- truly full market release in the U.S. in '24 with right amount of SETs and that's high growth. As we enter the first semester of '24, to your point, there's another 2 or 3 very meaningful product launches, some in robotics, some within Rico, some in SET said, that's very compelling. The integration of embody, the integration of ReLine continues to generate revenue.

我們在 23 年初推出了 Persona OsseoTi，它是一種無水泥結構。這將是 24 年在美國全面、真正全面的市場發布，並有適當數量的 SET，而且成長速度很快。當我們進入24 年第一學期時，就你的觀點而言，還有另外2 到3 個非常有意義的產品發布，有些是機器人領域的，有些是Rico 的，有些是SET 的，據說，這非常引人注目。體現在，ReLine的整合持續產生收入。

I could spend an hour, but I will tell you that is the balance of really sustainable macro dynamics and solid innovation. And then on top of that, you got great commercial execution with a highly engaged sales force. So I'm not -- we're not deeply concerned about the comps.

我可以花一個小時，但我會告訴你，這是真正可持續的宏觀動力和紮實的創新之間的平衡。最重要的是，您透過高度敬業的銷售團隊獲得了出色的商業執行力。所以我不是——我們不太關心比賽。

Yes. I think just building on that, remember, the first half of this year, which was very strong, was more about comps versus 2021 -- or excuse me, versus 2022 than it was something about abnormal market growth. So again, just building off what Ivan said, we feel confident in that. Now we're not, of course, giving specific guidance, and we're certainly not giving quarterly guidance into next year. So as always, quarters can be choppy or driven by seasonality mix changes. But overall, we're confident in that position.

是的。我認為在此基礎上，請記住，今年上半年非常強勁，更多的是與 2021 年相比的比較，或者對不起，與 2022 年相比，而不是異常的市場增長。再說一次，只是以伊万所說的為基礎，我們對此充滿信心。當然，現在我們不會提供具體的指導，而且我們當然不會提供明年的季度指導。與往常一樣，季度可能會波動或受到季節性組合變化的影響。但總的來說，我們對這立場充滿信心。

Maybe one last comment here, Matt, quickly, and then we move on. Don't forget that the first semester of 23, while we had very solid comps also had pretty challenging dynamics from a supply standpoint. So as we think about 2024, that we believe is going to be a tailwind.

馬特，也許是最後一個評論，很快，然後我們繼續。不要忘記，23 年的第一學期，雖然我們有非常穩定的比較，但從供應的角度來看，也有相當具有挑戰性的動態。因此，當我們思考 2024 年時，我們相信這將是一個順風車。

We'll go next to Shagun Singh with RBC Capital Markets.

接下來我們將與 RBC Capital Markets 的 Shagun Singh 進行對話。

I'm just going to try to ask the Q4 implied in 2024 guide in a different way. Your Q4 implied guidance assumes a deceleration from Q3. And your commentary seems pretty positive. It implies a deceleration even on a back to year basis, which has just become. So should we just assume that it's conservatism. And then if you look at growth on an underlying basis adjusted for China VBP selling days and all onetime items, I think you did plus 6% in '22, you're looking to do 7% to 7.5% in '23 guidance -- sorry, consensus looking for about 4.5% growth in '24. I know, Ivan, one of your targets is to drive that revenue growth acceleration. You've indicated that you will not be satisfied with 4% to 5% growth for the company. So just what is your reaction to that 4.5%? Does it look conservative to you in the context of the comments that you made?

我只是想嘗試以不同的方式詢問 2024 年指南中隱含的第四季。您的第四季隱含指導假設較第三季減速。你的評論看起來很正面。這意味著即使與去年同期相比也會出現減速，而這只是成為現實。所以我們應該假設這是保守主義嗎？然後，如果你看看根據中國 VBP 銷售天數和所有一次性商品調整後的基本增長，我認為你在 22 年確實增長了 6％，你希望在 23 年指導中增長 7％ 至 7.5％ -抱歉，共識預計2024 年成長率約4.5%。我知道，伊万，您的目標之一是推動收入加速成長。您曾表示您不會滿足於公司 4% 至 5% 的成長。那麼您對這 4.5% 有何反應？從您發表的評論來看，您認為它看起來保守嗎？

Sure. Shagun, this is Suky. So just first on the fourth quarter, I'll just keep going back to -- we don't give quarterly guidance. And obviously, with our implied, you can pretty much squeeze into the last quarter of the year. We talked about mid-single-digit growth. Margins expanded in the back half of this year, and we're going to deliver on that. We have a range around our guidance, obviously, to the downside, geopolitical factors continue to be erosive or supply doesn't continue to -- that very positive trend has been on, then you're towards the bottom end.

當然。沙岡，這是蘇基。因此，首先在第四季度，我將繼續回到——我們不提供季度指導。顯然，根據我們的暗示，你幾乎可以擠到今年最後一個季度。我們討論了中等個位數的成長。今年下半年利潤率有所擴大，我們將實現這一目標。顯然，我們的指引有一個下行區間，地緣政治因素繼續侵蝕或供應不再繼續——非常積極的趨勢一直存在，那麼你就接近底部了。

However, that supply picks up and it remediates even faster than it's already been improving, then as well as better execution on our new products, we could be at the upper end. So there's a range around that. And so I'll just leave it at that. But overall, we feel really good about where we're ending in the second half of this year and where our end markets are. As we look into next year, I think you've seen a bit of a pivot where our commentary was before anchoring quarter 4, maybe even better to now where we're saying mid-single digit. And I think that reflects the momentum that we've seen, to your point in '22 and '23.

然而，供應量的增加和修復速度甚至比已經改善的速度還要快，然後以及我們新產品的更好執行，我們可能處於高端。所以有一個範圍。所以我就這樣吧。但總的來說，我們對今年下半年的結局以及我們的終端市場狀況感到非常滿意。當我們展望明年時，我認為您已經看到了我們的評論在第四季度之前的一些轉折點，也許現在更好，我們說的是中個位數。我認為這反映了我們在 22 年和 23 年所看到的勢頭。

Got it. And if I could just ask a question on M&A...

知道了。如果我可以問一個關於併購的問題...

Go ahead. Yes. Go ahead, Shagun.

前進。是的。加油吧，沙岡。

Okay. Great. Just on M&A, Ivan, if you could just elaborate a little bit more in your thinking of tuck-ins versus larger deals, high-growth adjacencies that may allow you to diversify outside of elective procedures? And then I'm most interested about ASCs. A lot of your business is moving to ASC. That is a growth driver. What do you need to further succeed that you need a broader bag or more depth?

好的。偉大的。就併購而言，伊万，您是否可以詳細闡述您對大筆交易和高成長鄰接的思考，這些可以讓您在選擇性程序之外實現多元化？然後我對 ASC 最感興趣。您的許多業務正在轉移到 ASC。這是一個成長動力。為了進一步取得成功，你需要什麼，你需要更寬的包還是更深的深度？

Yes, absolutely. So on M&A, as I already mentioned, and it was in my prepared remarks as well, it will remain our top strategic priority from a capital allocation standpoint. So that's not changing. And we're excited about the opportunities that we have in front of us. We're going to continue to focus on growth markets or areas that are not only mission-centric but offer an exciting growth profile. And that is 3 things: no rank in order, 3 key areas, segments within Recon that are growing faster than our WAMGR or collected -- our collective market growth rates. And there's a lot in there. You got navigation, you've got data, technology elements of weaker really attractive.

是的，一點沒錯。因此，在併購方面，正如我已經提到的，也是在我準備好的發言中，從資本配置的角度來看，這仍然是我們的首要策略重點。所以這並沒有改變。我們對擺在我們面前的機會感到興奮。我們將繼續關注成長型市場或領域，這些市場或領域不僅以任務為中心，而且提供令人興奮的成長概況。這就是三件事：排名不分先後，Recon 內的 3 個關鍵領域和細分市場的成長速度快於我們的 WAMGR 或收集的數據——我們的集體市場成長率。裡面有很多東西。你有導航，你有數據，較弱的技術元素確實很有吸引力。

True is a set, as we've done already buying things in Sportsmed, buying things in CMFT, and then looking at other categories that I don't want to get into for competitive dynamics, but again, optionality there. And the ASC is also one attractive area. It's one area where we have dedicated resources. We're growing in the teens. We have currently 10% to 15% of our sales in that space and there is opportunities there to acquire things.

True 是一個集合，就像我們已經在 Sportsmed 中購買東西、在 CMFT 中購買東西一樣，然後查看其他我不想進入的競爭動態類別，但同樣，那裡有選擇性。 ASC 也是一個有吸引力的領域。這是我們擁有專用資源的領域之一。我們正在成長為青少年。目前我們 10% 到 15% 的銷售額來自該領域，並且那裡有機會收購東西。

So that's a bit of the strategic summary of where we've gone from an M&A perspective. In terms of financials, we're not changing the story. We like to do things up to $2 billion in acquisition price. And again, that gives you a lot of options. You can do a midsize deal. You can do some tuck-ins, combination of different things. We want these deals to be EPS neutral within 2 years. And we spoke about high single-digit ROIC within 5 years. So that's a bit of a strategic and our financial profile.

這就是我們從併購角度進行的策略總結。就財務而言，我們不會改變這個故事。我們喜歡收購價格高達 20 億美元的事。再說一次，這給了你很多選擇。您可以進行中型交易。你可以做一些折邊運動，將不同的事情組合起來。我們希望這些交易在兩年內能達到每股收益中立。我們談到了 5 年內高個位數的投資報酬率。這是我們的策略和財務狀況。

As we look into the next 3 or 5 years, we spent a lot of time -- Suky and I have spent a lot of time looking at the strap plan, what is the growth profile? The great news is that we convinced that the free cash flow generation is solid. So we're going to be able to do M&A and potentially do other stuff when it comes to capital allocation. So that's the answer to your first question. On ASC. look, I don't think we need to do much more.

當我們展望未來 3 到 5 年時，我們花了很多時間——Suky 和我花了很多時間研究錶帶計劃，成長概況如何？好消息是我們確信自由現金流的產生是穩定的。因此，在資本配置方面，我們將能夠進行併購，並可能做其他事情。這就是你第一個問題的答案。在ASC上。聽著，我認為我們不需要做更多的事情。

We're growing in the strong teams already here in the U.S. in the ASC. I mentioned 10% to 15% of our sales are there. We got the right portfolio. This is not where we were, let's say, 3, 4 years ago. We got the rig robotic platform for the ASC. We got a great cementless need that is gaining share very quickly. We got a full bag in sports and across it. We got best-in-class technologies. So the portfolio is great. We got dedicated resources, which we very much need in an ASC environment. We have a dedicated sales force. We've got simple contracting -- simplify contracting. Look, what we don't have organically, we partner with others. So whether it's sterilization, booms and lights or other staff, we've got the right partnerships. So very, very confident that we're going to continue to perform in the ASC environment.

我們在美國 ASC 的強大團隊中不斷成長。我提到我們銷售額的 10% 到 15% 都在那裡。我們得到了正確的投資組合。這不是我們三、四年前的處境。我們為 ASC 配備了鑽孔機機器人平台。我們對非水泥的需求很大，而且這種需求正在迅速擴大。我們在運動方面得到了滿滿的收穫。我們擁有一流的技術。所以這個投資組合很棒。我們擁有專用資源，這在 ASC 環境中非常需要。我們擁有一支敬業的銷售團隊。我們有簡單的合約——簡化合約。看，我們有機地沒有什麼，我們與其他人合作。因此，無論是消毒、吊桿和燈光或其他工作人員，我們都擁有正確的合作關係。我們對繼續在 ASC 環境中表現非常非常有信心。

We'll go next to Josh Jennings with TD Cowen.

接下來我們將與 TD Cowen 一起討論 Josh Jennings。

One to just follow up on your ASC comments. I wanted to ask about the migration of total joint surgeries to ASCs. Any back-the-envelope assumptions you would have us use just in terms of where the penetration or the migration for knees and hips has been? What percentage of cases for each category is reported in ASCs currently here at the end of '23 versus 2022? And then any metrics you can share just with ROSA penetration in ASCs and then any pricing dynamics for Total Joyce as this migration is occurring, that's a multipart question, but I appreciate you taking it.

一個只是跟進您的 ASC 評論。我想問全聯合手術遷移到ASC的情況。您是否希望我們使用膝蓋和臀部的穿透或遷移的任何粗略假設？截至 23 年底與 2022 年相比，目前 ASC 報告的每個類別的病例百分比是多少？然後，您可以與 ASC 中的 ROSA 滲透率分享的任何指標，以及遷移發生時 Total Joyce 的任何定價動態，這是一個由多個部分組成的問題，但我很感謝您接受它。

All right. Let's see if my memory is as good as I think it is. So starting with ASC, macro-wise, we believe that roughly between 40% to 60% of cases in the next 5 years are going to move to ASC. And I will say that a large portion of cases are already moving to the ASC. What we like about this dynamic is that as cases are moving to the ASC, other cases are coming to inpatient and patients. So it's a little bit of a double dip happening there, Josh. But yes, the number is 40% to 60% over the next 3 to 5 years, and I would say a good percentage has already moved.

好的。讓我們看看我的記憶力是否像我想像的那麼好。因此，從 ASC 開始，從宏觀角度來看，我們認為未來 5 年內約 40% 到 60% 的病例將轉移到 ASC。我要說的是，很大一部分案件已經轉移到 ASC。我們喜歡這種動態的一點是，隨著病例轉移到 ASC，其他病例也會轉移到住院病人和病人。所以，喬什，那裡正在發生一點雙底衰退。但是，是的，未來 3 到 5 年這個數字將達到 40% 到 60%，而且我想說很大一部分已經改變了。

We are growing in the upper teens when it comes to ASC. And today, around 10% to 15% repeating myself or cases or revenue, rather, of Zimmer Biomet comes from the ASC. I will tell you that it's pretty equal in terms of both hips and Knees. So we don't see one category being above the other. And I like the fact that given the recent CMS changes, you're going to see shoulder cases also accelerating the ASC.

當談到 ASC 時，我們正處於十幾歲的成長階段。如今，Zimmer Biomet 大約 10% 到 15% 的重複性案例或收入來自 ASC。我會告訴你，就臀部和膝蓋而言，它是相當相等的。因此，我們不認為某一類別高於另一類別。我喜歡這樣一個事實：考慮到最近 CMS 的變化，你會看到肩包也會加速 ASC。

We believe that's a great opportunity for us here at Zimmer Biomet. So that's the answer on ASC. In terms of ROSA dynamics, I think we've been very transparent in terms of 1/3, roughly 1/3 of all of our installations are happening in the ASC. That's a trend that has been happening for a few quarters. And that's a trend that we continue to see happen in the next quarters.

我們相信這對 Zimmer Biomet 來說是一個很好的機會。這就是ASC 上的答案。就 ROSA 動態而言，我認為我們在 1/3 方面非常透明，大約 1/3 的安裝都發生在 ASC 中。這種趨勢已經持續了幾個季度。我們將在接下來的幾個季度繼續看到這種趨勢。

In an ASC environment, speed matters, not having to get engaged in complex preplanning matters. Efficiency does matter. And having a need that you are confident it's going to be the right need does matter. And those dynamics are driving ROSA penetration in ASC. And then outside of ASC, ROSA continues to perform.

在 ASC 環境中，速度很重要，而不必參與複雜的預先規劃事務。效率確實很重要。擁有一個你確信它是正確的需求的需求確實很重要。這些動態正在推動 ROSA 在 ASC 中的滲透。然後在 ASC 之外，ROSA 繼續表演。

We are selling and placing ROSA frankly, at a rapid pace. You see in the other category, we saw a nice increase that was driven by ROSA. And we are on track to at least install 300 units at the end of the year 2023 when it comes to ROSA. So really satisfied. And that's before we launched next-generation ROSA across Recon and delivered the first shoulder robotic platform. So excited about both ASC and ROSA.

我們正在快速銷售和銷售 ROSA。您可以看到，在其他類別中，我們看到了 ROSA 推動的良好成長。就 ROSA 而言，我們預計在 2023 年底前至少安裝 300 台。所以真的很滿意。那是在我們在 Recon 上推出下一代 ROSA 並交付第一個肩部機器人平台之前。對 ASC 和 ROSA 都很興奮。

We'll go next to Larry Biegelsen with Wells Fargo.

接下來我們將與富國銀行一起去拉里·比格爾森 (Larry Biegelsen)。

I have enjoyed watching your post on LinkedIn, looks like you've traveled around the world literally since you've taken over as CEO. I wanted to ask, Suky, you start on the margins. You're going to end '23 with an operating margin of about 20.5%, which is towards the high end of Medtech. Where -- what do you see as peak margins for Zimmer? I mean 5, 10 years ago, the margins were in the low 30s. Is that still realistic? And I have one follow-up.

我很喜歡在 LinkedIn 上看你的帖子，看起來自從你接任執行長以來，你已經環遊世界了。我想問，Suky，你是從邊緣開始的。到 23 年末，營業利潤率約為 20.5%，接近醫療技術的高端水準。您認為 Zimmer 的最高利潤率在哪裡？我的意思是 5、10 年前，利潤率只有 30 多歲。這仍然現實嗎？我還有一個後續行動。

Yes, sure. So Larry, thanks for noticing. It's actually 2 years in a row where we've expanded margins in the backdrop of a really challenging environment. By the way, while also accelerating revenue. I think in '22, we expanded margins, operating margins by about 40 to 50 bps. And this year, you're right, the implied is about 100 basis points.

是的，當然。拉里，感謝您的關注。事實上，在充滿挑戰的環境背景下，我們已經連續兩年擴大了利潤。順便說一下，同時也加速了收入。我認為在 22 年，我們擴大了利潤率、營業利潤率約 40 至 50 個基點。今年，你是對的，隱含的利率約為 100 個基點。

So again, really proud of what the ZB team has done collectively. Again, in the backdrop of still investing for growth, which we've been able to demonstrate. As we move into next year, I think we've been pretty front-footed in our ability to continue to grow margins in '24, quite frankly, we're going to do that in every year after 2024 and continue to deliver a profile where earnings are growing faster than revenue.

再說一遍，我對 ZB 團隊集體所做的事情感到非常自豪。同樣，在仍然投資成長的背景下，我們已經能夠證明這一點。當我們進入明年時，我認為我們在 24 年繼續提高利潤率的能力方面已經相當領先，坦率地說，我們將在 2024 年之後的每一年都這樣做，並繼續提供一個概況收入增長速度快於收入增長的地方。

I'm not going to go out and put a marker out there as to where we think it can get to. But historical levels, we'll look for over time to definitely beat and exceed those. So I'll just leave it there. Again, really happy with where the team has performed over the last couple of years,very confident in what we're going to do next year, quite excited about our outlook in the longer term.

我不會出去在我們認為它可以到達的地方做一個標記。但隨著時間的推移，我們將尋找歷史水平，以明確擊敗和超越這些水平。所以我就把它留在那裡。再說一次，我們對團隊在過去幾年的表現感到非常滿意，對我們明年要做的事情非常有信心，對我們的長期前景感到非常興奮。

Yes. The other category was obviously very strong. We heard you talk about ROSA sales in the quarter. What was the change in the quarter that drove that strength and how sustainable is that?

是的。另一類顯然非常強大。我們聽說您談論了本季 ROSA 的銷售情況。本季度的哪些變化推動了這種強勁勢頭？這種變化的可持續性如何？

Yes. I don't think there is anything changing really. There's not a change of strategy. It's we continue with ROSA, we continue to show strong clinical efficacy. We continue to demonstrate time neutrality after a few cases. We continue to see great adoption in an ASC environment. We have 3 ROSA indications today with Enrico. So total knee, partial and heal. We've done a lot of podium presence. If you attended the Dallas meeting this last weekend, there was a lot of noise around posters and whatnot. So I think we're just getting the right adoption is moving quickly. And then a driver, I will tell you, has been tremendous. A lot of these cases that are done in the ASC do like or do one, a lot of surgeons in an ASC on the combination of robotics and cementless. In the past, we didn't have the right cementless construct. We do now with Persona OsseoTi. So I think there's been a bit of a tailwind. But I wouldn't say it's a major change of strategy. It's just the fact that it's been 2, 3 years in market now and just trying to see the data. So really excited in terms of what we are.

是的。我認為沒有什麼真正改變。策略沒有改變。正是我們繼續ROSA，我們繼續展現出強大的臨床療效。在幾個案例之後，我們繼續展示時間中立性。我們繼續看到 ASC 環境中的廣泛採用。今天我們與 Enrico 討論了 3 個 ROSA 適應症。所以全膝、部分膝都癒合了。我們已經多次登上頒獎台。如果您參加了上週末的達拉斯會議，您會發現海報等周圍有很多噪音。所以我認為我們正在迅速採取正確的做法。我會告訴你，一名車手非常出色。在 ASC 中完成的許多此類病例確實類似於 ASC 中的許多外科醫生將機器人技術和非骨水泥技術相結合。過去，我們沒有合適的無水泥結構。我們現在用 Persona OsseoTi 來做。所以我認為有一點順風。但我不會說這是戰略的重大變化。事實上，它已經上市兩三年了，只是想看看數據。就我們而言，我們真的很興奮。

And Larry, just to get back -- Larry, just to get back to your original question, just to make sure I'm completely clear. I do see getting back to historic margins are better over time, absolutely a definable objective for us. Now having greater insight and taking over for ops and supply chain, I would say this is an area where we can certainly do better. We're going to do better going forward.

拉里，只是為了回來——拉里，只是為了回到你最初的問題，只是為了確保我完全清楚。我確實認為隨著時間的推移，回到歷史利潤水平會更好，這對我們來說絕對是一個明確的目標。現在有了更深入的洞察力並接管了營運和供應鏈，我想說這是我們當然可以做得更好的領域。今後我們會做得更好。

And I can tell you that the company's focus on not just revenue growth but operating profit and free cash flow generation has been more acutely stronger than it's ever been. So I think we've got the pathway. We've got the culture we've got the levers to get there over time.

我可以告訴你，該公司不僅關注收入成長，還關注營業利潤和自由現金流的產生，比以往任何時候都更強烈。所以我認為我們已經找到了途徑。我們擁有文化，我們擁有隨著時間的推移實現這一目標的槓桿。

Larry, thank you for being my warm follower on LinkedIn. The whole time I tell was my wife and disappointing, appreciate it.

Larry，感謝您在 LinkedIn 上成為我的熱情追隨者。我一直告訴我的妻子，令人失望，很感激。

We'll go next to Chris Pasquale with Nephron.

接下來我們將與 Nephron 一起前往克里斯·帕斯誇萊 (Chris Pasquale)。

I just wanted to follow up real quickly on Larry's ROSA question. Was the mix of sales versus placements different in 3Q than what we saw in the first half of the year? Just trying to figure out whether that played a role or the acceleration in other sales was really driven by volume.

我只想快速跟進 Larry 的 ROSA 問題。第三季的銷售與投放情況與我們上半年看到的情況是否有所不同？只是想弄清楚這是否發揮了作用，或者其他銷售的加速是否真的是由銷量推動的。

Yes. Thank you, Chris, for the follow-up. We did see more sales. We haven't changed the strategy. So it's reflective of the fact that there is capital in the hospital systems across the world. And we saw people wanting to buy them, and we sold the units. It's not a fundamental change. It's not a change in strategy. We've settled along that we prefer placing given the annuity factor and whatnot. But yes, capital is strong, and we did do some deals in some ASCs and in some of the systems. And that's why you see the other category growing.

是的。謝謝克里斯的跟進。我們確實看到了更多的銷量。我們沒有改變策略。因此，這反映了世界各地的醫院系統都有資本的事實。我們看到人們想購買它們，我們就賣掉了這些單位。這不是根本性的改變。這不是策略的改變。我們已經達成共識，考慮到年金等因素，我們更喜歡放置。但是，是的，資本很強大，我們確實在一些 ASC 和一些系統中進行了一些交易。這就是為什麼你會看到其他類別正在成長。

That's helpful. And then on SET, is the strategy there to lean into these focused categories that are already growing pretty well? And then hope that the overall performance improves. Is that becoming a bigger part of the mix? Or do you see an opportunity to reinvigorate areas like lower extremities that maybe aren't on that list today?

這很有幫助。那麼在 SET 上，是否有策略向這些已經發展良好的重點類別傾斜？然後希望整體表現有所提升。這是否會成為其中更重要的一部分？或者您看到了重振下肢等今天可能不在該清單中的區域的機會？

Yes. Let me start with the second part. We really don't do hope here. So we do have plans to drive better performance in the 3 areas that so far have not been that compelling because being restorative therapies for an ankle and trauma. What I will tell you is that we start the therapies, biologics, the issue there was a reimbursement change a year ago, that's been resolved. So that's not a concern moving forward. And then [food] and ankle, lower extremity is something that we're looking at. It may require some organic, inorganic place.

是的。讓我從第二部分開始。我們真的不抱希望。因此，我們確實有計劃在這三個領域取得更好的表現，但到目前為止，這三個領域還沒有那麼引人注目，因為它們是腳踝和創傷的恢復療法。我要告訴你的是，我們開始治療、生物製劑，一年前報銷變化的問題已經解決。所以這不是一個值得關注的問題。然後[食物]和腳踝、下肢是我們正在關注的東西。它可能需要一些有機、無機的地方。

But given the space, we're paying close attention to what is that we need to do. And in trauma, for many markets continues to be very attractive. We own some smaller tuck-ins. So I would expect that the declines that we have seen in the past are going to disappear. So again, not really doing hope there. We got plans to remediate and to get back to growth in those 3 categories. That said, the 3 most compelling priorities within SET, remain upper extremity solder, sports medicine and CMFT, and those 3 are performing very nicely.

但考慮到空間，我們正在密切關注我們需要做什麼。而在創傷方面，對許多市場來說仍然非常有吸引力。我們擁有一些較小的折邊。因此，我預計我們過去看到的下降將會消失。再說一次，我並沒有真正抱持希望。我們計劃進行補救並恢復這三個類別的成長。也就是說，SET 中最引人注目的 3 個優先事項仍然是上肢焊接、運動醫學和 CMFT，而這 3 個領域表現非常好。

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

接下來我們將與美國銀行聯繫特拉維斯·斯蒂德 (Travis Steed)。

I guess a quick follow-up on M&A. Any way to frame how much margin or EPS dilution you're willing to take in years 1 and 2 realize, you said neutral by year 3, but curious kind of what the framework is on year 1 and 2. And when you think about bid-ask spreads, is it a deal something you think you could get done this year? Or is it probably more something for 2024?

我想是對併購的快速跟進。任何方式來框架你願意在第一年和第二年採取多少利潤或每股收益稀釋意識到，你說在第三年是中性的，但很好奇第一年和第二年的框架是什麼。當你考慮出價時-詢問利差，您認為今年可以完成這項交易嗎？還是 2024 年可能會發生更多事情？

Travis, this is Suky. I'm not sure I completely got that second question. Can you repeat that?

崔維斯，這是蘇基。我不確定我是否完全理解了第二個問題。你可以再說一次嗎？

Yes. In terms of like when you think about like bid-as spreads and the progress on your conversations, is a deal happening in 2023, a possibility? Or is it probably something that we need to wait 2024 to see M&A?

是的。當您考慮出價價差和對話進度時，2023 年是否有可能達成交易？或者我們可能需要等到 2024 年才能看到併購？

So first of all, on your first question around earnings per share dilution, that's really going to depend on the type of asset that we acquire, the size of the transaction, what markets in where it is and its journey and its life cycle. It's a product that's just launched or something that's very mature in marketplace.

首先，關於每股盈餘稀釋的第一個問題，這實際上取決於我們收購的資產類型、交易規模、所在市場以及其旅程和生命週期。這是一個剛推出的產品或是市場上非常成熟的產品。

So I'm not going to sort of give a guide post on year 1 or year 2 because I think that would be premature because it is going to be very situation dependent. But what we will commit to is that we're going to look for break even by at least 24 months, if not sooner than that. So that's the profile that we look for in our M&A relative to bid-ask and timing, of course, for a variety of reasons, mostly proprietary. We're not going to get into the timing of any specific deal.

因此，我不會在第一年或第二年發表指導性文章，因為我認為這還為時過早，因為這將非常取決於具體情況。但我們將承諾的是，我們將尋求至少 24 個月（甚至更早）實現收支平衡。這就是我們在併購中尋找的相對於買賣和時機的概況，當然，出於多種原因，其中大部分是專有的。我們不會討論任何具體交易的時間安排。

As you know, those are often opportunistic situation based. So here's what I would say is that we've got a lot of strategic flexibility on the balance sheet in the strongest position it's been since the merger of Zimmer Biomet, we feel really good about the optionality we have going forward.

如您所知，這些通常是基於機會主義的情況。因此，我想說的是，我們的資產負債表具有很大的策略靈活性，處於 Zimmer Biomet 合併以來的最強位置，我們對未來的選擇感到非常滿意。

And we think we can deploy capital to continue to accelerate our growth profile and diversify the company, but I'm not going to get any specific timing. I'm sure you can appreciate that. But thank you for the question.

我們認為我們可以部署資本來繼續加速我們的成長並使公司多元化，但我不會得到任何特定的時間表。我相信你會欣賞這一點。但謝謝你的提問。

Yes. That's fair. And a couple of housekeeping questions. The OUS onetime stop in hips this quarter, does that get better in Q4? And when you think about tax rate next year, I heard your comments, but curious if that being less than 100 basis points or more than 100 basis points on tax rate. And when you think about the interest line, you've got, I think, $850 million of debt coming due. So is interest of a headwind or a tailwind next year?

是的。這還算公平。還有一些家事問題。 OUS 本季一度停步，第四季情況會好轉嗎？當你考慮明年的稅率時，我聽到了你的評論，但很好奇稅率是低於 100 個基點還是超過 100 個基點。當你考慮利息額度時，我認為你有 8.5 億美元的債務到期。那麼明年的興趣是順風還是逆風呢？

I'll briefly comment on Q4, I'll keep it simple. It does go away. So this is a one timer. And in Q4, we get back to growth in terms of the tax and interest, Suky, do you want to want to comment on that?

我將簡要評論第四季度，我會保持簡單。它確實消失了。所以這是一個單一計時器。在第四季度，我們在稅收和利息方面恢復了成長，Suky，您想對此發表評論嗎？

Yes. So on the interest expense line, right now, we're not going to give full guidance on that. So we'll unveil that. I think the one thing you want to keep in the backdrop is we do believe we can grow earnings, we will grow earnings faster than revenue. On the tax rate, right now, our best estimate is that it will be about 150 basis point increase off of our full year 2023 tax rate.

是的。因此，在利息支出方面，目前我們不會給予全面的指導。所以我們將揭曉這一點。我認為你想要保留的一件事是我們確實相信我們可以增加收入，我們的收入成長速度將快於收入成長。關於稅率，目前我們最好的估計是，它將比 2023 年全年稅率增加約 150 個基點。

I think we have time for maybe one last question. Katy, is there one in the queue.

我想我們還有時間回答最後一個問題。凱蒂，隊列裡有人嗎？

We'll go next to Vijay Kumar with Evercore ISI.

接下來我們將與 Evercore ISI 一起討論 Vijay Kumar。

Maybe just one question from me. This OUS hips, I think you called out Russian headwinds. Is that done within fiscal '23, should that continue into fiscal '24? And I think you did speak about M&A. Can you comment on your hurdle rates you've given current interest rate environment for deals?

也許只是我的一個問題。這個 OUS 臀部，我想你呼喚了俄羅斯的逆風。這是在 23 財年完成的嗎？是否應該持續到 24 財年？我認為您確實談到了併購。您能否評論一下當前交易利率環境下的最低門檻利率？

Yes. Sure. Vijay, it's good to hear from you. So on the OUS hip headwind, specifically to Russia. If you go back to last quarter's call, second quarter, I talked about Russia being about a 50 basis point headwind in the back half of 2023, that estimate is still largely true, and most of that occurred in the third quarter.

是的。當然。維傑，很高興收到你的來信。因此，美國的逆風，特別是俄羅斯。如果你回到上個季度的電話會議，即第二季度，我談到俄羅斯在2023 年下半年將面臨約50 個基點的逆風，這一估計在很大程度上仍然是正確的，而且大部分發生在第三季。

So we're going to see a little bit of pressure in the fourth quarter, but it's largely behind us. We don't see that as being a headwind at this time into 2024. And I'm sorry, Vijay, can you repeat your question around...

因此，我們將在第四季度看到一些壓力，但基本上已經過去了。我們不認為這會成為 2024 年的阻力。很抱歉，Vijay，你能重複一下你的問題嗎…

Sorry, on Deals. M&A, given current interest rate environment, can you talk about your hurdle rates for deals?

抱歉，關於優惠。併購方面，考慮到當前的利率環境，您能談談您的交易最低門檻嗎？

Yes. So look, we would still look at debt financing over equity financing all day long, even though it's 2x of where it was a year ago, it's still versus historical rates still a pretty attractive source of capital. It has become marginally more difficult to make the deal economics work at these interest rates. So it just means that we've got to be that much more disciplined on our valuation and our purchase price. And so that's how we view things right now.

是的。因此，我們仍然會整天專注於債務融資而不是股權融資，儘管它是一年前的兩倍，但與歷史利率相比，它仍然是一個相當有吸引力的資本來源。在這樣的利率下，讓交易經濟學發揮作用變得更加困難。所以這只是意味著我們必須對我們的估值和購買價格更加嚴格。這就是我們現在看待事物的方式。

Thanks, Vijay and thanks, everyone, for the questions. Yes, absolutely. I think now we're probably nearing the end of the call. I'll turn it back over to Ivan just for any closing remarks.

謝謝維傑，也謝謝大家提出的問題。是的，一點沒錯。我想現在我們的通話可能已經接近尾聲了。我會將其轉回伊万以供結束語。

Yes. Thank you, Keri, and I'll give it to 2 minutes or less here, so we can close on time. But couple of things here. Number one, really, really pleased with the progress here at Zimmer Biomet. I'm really proud of the team and the work that they have done, they are doing and most importantly, they were that now that we are going to continue to do. Excited about the markets, lots of questions on market dynamics.

是的。謝謝你，Keri，我會在這裡給它 2 分鐘或更短的時間，這樣我們就可以準時結束。但這裡有幾件事。第一，對 Zimmer Biomet 的進展非常非常滿意。我真的為這個團隊以及他們已經完成的、正在做的工作感到自豪，最重要的是，我們現在將繼續這樣做。對市場感到興奮，對市場動態有很多疑問。

Every data point suggests that they're healthy markets, they're durable markets. No, we're not concerned about GLP-1, and I'll say that with utmost respect and humility. But every data point shows that this is not something we should be concerned about. The performance is strong, and it's going to continue to get there.

每個數據點都顯示它們是健康的市場，是持久的市場。不，我們不關心 GLP-1，我會以最大的尊重和謙遜的態度這麼說。但每一個數據點都顯示這不是我們該關心的事情。表現很強勁，並且會持續達到這個目標。

We saw a great Q3 performance in Recon, net of the hip OUS. It was solid. I like where we are with both Hips and Knees here in the U.S., in the largest market. I like the fact that we've seen SET being in line now. I like the profile as we enter Q4 and as we get into 2024, I believe this will be the year for SET. And I like the optionality that we got around M&A. So healthy market, solid portfolio, a great opportunity to leverage the balance sheet, I do think is a different place, a different environment.

我們在 Recon 的第三季度看到了出色的表現，並扣除了時髦的 OUS。它很堅固。我喜歡我們在美國這個最大市場的臀部和膝蓋的現狀。我喜歡我們現在看到 SET 排隊的事實。我喜歡進入第四季時的情況，進入 2024 年，我相信今年將是 SET 的一年。我喜歡我們在併購方面的選擇性。如此健康的市場、穩健的投資組合、槓桿資產負債表的絕佳機會，我確實認為這是一個不同的地方、不同的環境。

So really hard to be here. Look forward to leading this great team and look forward to answering more questions in quarters to come. Thank you for your time today.

來到這裡真的很難。期待領導這個偉大的團隊，並期待在未來幾季回答更多問題。感謝您今天抽出時間。

Thanks, everyone, for joining us. The IR team will be in touch, of course. And if you have questions or comments, please feel free to reach out.

謝謝大家加入我們。當然，IR 團隊會與您聯繫。如果您有任何疑問或意見，請隨時與我們聯繫。

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。您現在可以斷開連線。