Zimmer Biomet Holdings Inc (ZBH) 2023 Q4 法說會逐字稿

Good morning, ladies and gentleman, and welcome to the Zimmer Biomet's Fourth Quarter 2023 Earning's Conference Call. (Operator Instructions) As a reminder, this conference is being recorded today, February 8, 2024. Following today's presentation, there will be a question-and-answer session. (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 年第四季財報電話會議。 （操作員說明）謹此提醒，本次會議將於今天（2024 年 2 月 8 日）進行錄製。在今天的演示之後，將進行問答環節。 （操作員指示）我現在想將會議轉交給首席通訊和行政官 Keri Mattox，請繼續。

Thank you, operator, and good morning everyone. Welcome to Zimmer Biomet's Fourth Quarter 2023 Earning's Conference Call. Joining me today are Ivan Tornos, our President and CEO; and CFO and EVP Finance, Operations and Supply Chain, Suky Upadhyay. Before we get started I would like to remind you that our comments during this call will include forward-looking statements. Actual results may differ materially from those indicated by the forward-looking statements due to a variety of risks and uncertainties. Please note, we assume no obligation to update these looking statements even if the 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.

謝謝接線員，大家早安。歡迎參加 Zimmer Biomet 2023 年第四季財報電話會議。今天加入我的是我們的總裁兼執行長 Ivan Tornos；財務長兼財務、營運和供應鏈執行副總裁 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。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。

Additionally, the discussions on this call will include certain non-GAAP financial measures, some of which are forward-looking non-GAAP financial measures. Reconciliation of these measures to the most directly comparable GAAP financial measures and an explanation of our basis for calculating these measures is included within our Q4 earnings release, which can be found on our website, zimmerbiomet.com. With that, I'll turn the call over to Ivan. Ivan?

此外，本次電話會議的討論將包括某些非公認會計原則財務指標，其中一些是前瞻性非公認會計原則財務指標。這些指標與最直接可比較的 GAAP 財務指標的調整以及我們計算這些指標的基礎的解釋包含在我們的第四季度收益發布中，您可以在我們的網站 zimmerbiomet.com 上找到該資訊。說完，我會把電話轉給伊凡。伊万？

Thank you, Keri, and thanks, everyone, for joining the call here this morning. I'd like to start the way that I typically do, taking a moment to recognize to show my gratitude to the almost 20,000 Zimmer Biomet team members for their dedication, for their commitment, for their strong resilience and for their super performance in 2023. Simply put, 2023 was just a great year for our company. And I want to say thank you.

謝謝 Keri，也謝謝大家今天早上加入我們的電話會議。我想以我通常做的方式開始，花一點時間向近 20,000 名 Zimmer Biomet 團隊成員表示感謝，感謝他們的奉獻、承諾、強大的韌性以及他們在 2023 年的出色表現。簡而言之，2023 年對我們公司來說是偉大的一年。我想說謝謝。

In 2023, we impacted the lives of almost 4 million patients. And along the way, we delivered best-in-class financial performance, growing our constant currency revenue by 7.5%, while adjusted EPS, earnings per share, grew almost 9.5% in the year, that's 200 basis points of leverage between the 7.5% revenue growth and the 9.5% growth in EPS. In the year, we generated almost $1 billion in free cash flow. And that's with some turbulence around inventory management and whatnot.

2023 年，我們影響了近 400 萬名患者的生活。一路走來，我們實現了一流的財務業績，固定貨幣收入增長了7.5%，而調整後每股收益（每股收益）在這一年增長了近9.5%，即7.5% 之間的槓桿率增加了200 個基點收入成長和 EPS 成長 9.5%。這一年，我們產生了近 10 億美元的自由現金流。這是因為庫存管理等方面出現了一些動盪。

So again, strong performance, top to bottom, and I'm just very, very proud of the execution in the year. It's worth noting that this level of execution and performance came in a year in which we still have to deal with fairly complex macro issues, whether it's inflation, FX, geopolitical challenges. I don't think I need to talk much about that and also some micro challenges in the year. We did struggle with some supply challenges throughout some of the periods. I'm happy that's behind, but it was a headwind in many periods in 2023.

再說一遍，從上到下都有強勁的表現，我對今年的執行力感到非常非常自豪。值得注意的是，在這樣的執行和績效水準出現的一年中，我們仍然需要處理相當複雜的宏觀問題，無論是通膨、外匯或地緣政治挑戰。我認為我不需要過多談論這一點以及今年的一些微觀挑戰。在某些時期，我們確實遇到了一些供應挑戰。我很高興這已經落後了，但在 2023 年的許多時期，這都是逆風。

But again, delivering 7.5% in 2023 against some tough comparables, having grown constant currency revenue in 2022, the year before, by 6.6%. So clearly, a great trend in the making, clearly strong performance, and I'm just so grateful and so proud of all of you, the Zimmer Biomet team. At the same time, beyond grateful I'm truly excited as I note that this is just the very beginning when it comes to the level of performance that we can realize here at Zimmer Biomet. And multiple drivers of why I'm confident that this is just the very beginning.

但同樣，與一些艱難的可比較國家相比，2023 年的成長率為 7.5%，而前一年的 2022 年恆定貨幣收入成長了 6.6%。很明顯，這是一個正在形成的偉大趨勢，顯然表現強勁，我非常感激 Zimmer Biomet 團隊的所有人，並為你們感到自豪。同時，除了感激之外，我真的很興奮，因為我注意到，這只是我們在 Zimmer Biomet 可以實現的性能水平的開始。以及為什麼我有信心這只是一個開始的多個驅動因素。

But I'll start with highlighting the bold pipeline that we have in place. The size of our pipeline is twice what it used to be in 2018. We got great new product launches that are happening here early in 2024. We have a stable supply. We've created a stable supply environment. And we've got great commercial execution. We're developing flawless commercial execution as evidenced by these growth rates that I just highlighted. To compound or believe behind this level of excitement ahead is the fact that we have seen and we continue to see a substantial improvement in our end markets. This is not the same market growth profile that we used to have. Patient demand is strong. Procedure volume is very strong given a variety of reasons.

但我將首先強調我們已經建立的大膽管道。我們的管道規模是 2018 年的兩倍。我們將於 2024 年初推出精彩的新產品。我們有穩定的供應。我們創造了穩定的供應環境。我們擁有出色的商業執行力。正如我剛才強調的成長率所證明的那樣，我們正在開發完美的商業執行力。複合或相信這種興奮程度背後的事實是我們已經看到並將繼續看到我們的終端市場的實質改善。這與我們過去的市場成長情況不同。患者需求旺盛。由於多種原因，程序量非常大。

And as the market leader in both knees and hips, being in better markets is just very exciting as we enter 2024. Back 5 years ago, when I joined the company, we used to think of WAMGR, weighted average market growth rates as being somewhere in the 3% range. And today, we pick our WAMGR as being very near if not at 4%. And again, that's a meaningful increase we believe, is sustainable. So we're not going back to the 3% days when it comes to market growth rates. So again, internal and external dynamics gives me -- gives us confidence that the best is truly ahead.

作為膝蓋和臀部的市場領導者，當我們進入2024 年時，進入更好的市場是非常令人興奮的。 早在5 年前，當我加入公司時，我們曾經認為WAMGR（加權平均市場成長率）處於某個位置在3%範圍內。今天，我們認為 WAMGR 即使不是 4%，也非常接近。再說一次，我們相信這是一個有意義的成長，而且是可持續的。因此，就市場成長率而言，我們不會回到 3% 的日子。再說一次，內在和外在的動力給了我信心，讓我們相信最好的就在前方。

When you add to all of these variables, the fact that we have the strongest balance sheet in the history of the company, there is no doubt then that we can claim that our future is nothing short of truly right. So again, very pleased, very proud and very confident. I'd like to thank our investors as well for the support in 2023 and for their confidence in 2024 and beyond. We continue to take biggest strides forward. So we're being a company with a very different growth profile from top to bottom, committing to an expectation to grow at least 100 to 200 basis points above market in revenue with our EPS -- with our earnings per share growing faster than revenue and our free cash flow dollars growing faster than EPS. The guidance that we are providing today for 2024 already reflect such a commitment to this type of financial discipline.

當你添加所有這些變數時，我們擁有公司歷史上最強大的資產負債表這一事實，毫無疑問，我們可以聲稱我們的未來是真正正確的。再次強調，非常高興、非常自豪、非常有自信。我還要感謝我們的投資者在 2023 年的支持以及對 2024 年及以後的信心。我們繼續向前邁出最大的步伐。因此，我們是一家從上到下成長狀況截然不同的公司，我們承諾每股盈餘的成長速度將比市場收入成長至少 100 到 200 個基點——我們的每股盈餘成長速度快於營收成長速度，我們的自由現金流成長速度快於每股盈餘。我們今天提供的 2024 年指導方針已經體現了對此類財務紀律的承諾。

And I'm very much looking forward to our Analyst Day on May 29, when we will provide additional details in terms of our long-range plan, which will illustrate that this is not a 1-year wonder, this is a multiyear commitment. And you will see then that Zimmer Biomet has truly entered our growth stage, and we're no longer in turnaround mode. We're ready to deliver by being laser focus on the 3 strategic imperatives that I highlighted during my very first earnings call as CEO back in November, 3 strategic imperatives that I continue to repeat over and over at every Zimmer Biomet meeting. And frankly, I will continue to repeat because those are the 3 drivers that we know are going to drive our performance. Those being: number one, people and culture; number two, operational excellence; and number three, innovation and diversification.

我非常期待 5 月 29 日的分析師日，屆時我們將提供有關長期計劃的更多細節，這將表明這不是一年的奇蹟，而是一項多年的承諾。那時你會看到 Zimmer Biomet 真正進入了我們的成長階段，我們不再處於週轉模式。我們已準備好透過高度關注我在11 月作為執行長的第一次財報電話會議上強調的3 項戰略要務來實現目標，這3 項戰略要務是我在每次Zimmer Biomet 會議上不斷重複的。坦白說，我將繼續重複，因為我們知道這些是推動我們業績的三個驅動因素。這些是：第一，人民和文化；第二，卓越營運；第三，創新和多元化。

So let's talk about our 2024 commitments, how different initiatives across these 3 strategic imperatives will drive our growth forward. First, in the area of people and culture. And again, I've explained this in the past, what it means, it's about having the right people in the right roles within the right culture. We must make sure that we support team members to act as owners and operators of the business. This means decentralizing decision-making, driving agility and empowering team members at every level across every function around the world. We must become leaner, and we got to be closer to the customer.

那麼，讓我們來談談我們的 2024 年承諾，以及這 3 項策略要務的不同舉措將如何推動我們的成長。首先，在人與文化方面。再說一次，我過去已經解釋過這是什麼意思，就是讓合適的人在合適的文化中擔任合適的角色。我們必須確保支援團隊成員充當企業的所有者和經營者。這意味著分散決策權、提高敏捷性並為全球各個職能部門各個層級的團隊成員提供權力。我們必須變得更加精簡，我們必須更加貼近客戶。

Equally important, we must truly live an environment of pay for performance. And this is something that has already kicked off in a very meaningful way in the fiscal year -- in this fiscal 2024. An example of that is the fact that we're incentivizing free cash flow dollar generation or growth in a much more disciplined way across the enterprise knowing that revenue is also the most durable driver of free cash flow performance. Incentives are also set for revenue growth to meaningfully drive compensation across our firm at every level.

同樣重要的是，我們必須真正生活在一個按績效付費的環境中。這已經在本財年（即 2024 財年）以非常有意義的方式開始了。一個例子是，我們正在以更嚴格的方式激勵自由現金流美元的產生或成長。整個企業都知道收入也是自由現金流績效最持久的驅動力。也為收入成長制定了激勵措施，以有意義地提高我們公司各個層面的薪酬。

So again, we changed the way we pay people, in terms of growing revenue above market. And we changed the way that we pay people, giving a larger percentage of compensation in adherence to the fact that we, as a company, need to grow free cash flow dollars at double-digit rates. In the second area of operational excellence and again, this is about how we think about growing the business top to bottom. You can see already in today's update in the press release that we mean it. It is tough to restructure a company. It's certainly something that we don't take lightly, and you read the press release, we had to do it. It's a tough choice once again that we needed to make operational changes to simplify our structure to deliver greater efficiency and to ensure that we're enhancing investments in the right areas of the business, again, closer to the customer.

因此，我們再次改變了支付員工薪資的方式，使收入高於市場水平。我們改變了支付員工薪資的方式，給予更高比例的薪酬，因為我們作為一家公司需要以兩位數的速度成長自由現金流。在卓越營運的第二個領域，這也是我們如何思考自上而下發展業務的問題。您可以在今天的新聞稿更新中看到我們是認真的。重組一家公司是很困難的。這當然是我們不會掉以輕心的事情，你讀過新聞稿，我們必須這樣做。這再次是一個艱難的選擇，我們需要進行營運變革，以簡化我們的結構，以提供更高的效率，並確保我們在正確的業務領域加強投資，再次更貼近客戶。

So again, not an easy thing to do, but something that we had to do and something that we have done. Beyond the restructuring, other initiatives in the area of operational excellence that are already in full motion, are the new programs that we got in place kicking off how to drastically reduce inventory levels at Zimmer Biomet. This will drive substantial improvement in our free cash flow dollar growth while also reducing our days on hand, DOH by 50 days or more and we'll reduce our excess and obsolescence exposure, which is something that, frankly, we've not done that well in previous years.

再說一遍，這不是一件容易做的事情，而是我們必須做的事情並且我們已經做了。除了重組之外，卓越營運領域的其他措施已經全面啟動，我們實施的新計畫旨在大幅降低 Zimmer Biomet 的庫存水準。這將推動我們的自由現金流美元成長大幅改善，同時也將我們的現有天數（DOH）減少 50 天或更多，我們將減少我們的超額和過時風險，坦白說，我們還沒有這樣做前幾年還好。

Second thing we're doing is the rollout of a global initiative to drive new product launch excellence across the key new product introductions that we have in the year 2024. In simple terms, the 7 or 8 most meaningful product launches, let's make sure we have a cadence of operating mechanisms with proper governance to ensure that we're maximizing these product launches across each key geography. And then the third thing we're doing in operational excellence beyond the restructuring is the integration of the pricing organization under the financial structure, reporting directly to Suky, our CFO, to ensure maximum governance and accountability across the enterprise.

我們正在做的第二件事是推出一項全球計劃，以推動我們在2024 年推出的關鍵新產品中實現卓越的新產品發布。簡單來說，就是7 或8 個最有意義的產品發布，讓我們確保我們擁有適當治理的營運機制，以確保我們在每個關鍵地區最大限度地推出這些產品。除了重組之外，我們在卓越營運方面所做的第三件事是將定價組織整合到財務結構下，直接向我們的財務長 Suky 報告，以確保整個企業的治理和問責制最大化。

While we are pleased with the reduction in price erosion over the last 2 to 3 years, we believe there is a much greater opportunity to drive even better and more durable pricing dynamics. So again, in the area of operational excellence beyond the restructuring is about drastically reducing inventory levels to generate improved free cash flow dollar growth. It's about governance beyond or behind the new product launches. And then thirdly, is around doing better in the area of pricing dynamics.

雖然我們對過去 2 到 3 年價格侵蝕的減少感到高興，但我們相信還有更大的機會來推動更好、更持久的定價動態。再說一次，在卓越營運領域，重組之外的目的是大幅降低庫存水平，以改善自由現金流美元的成長。這是關於新產品發布之外或背後的治理。第三，是在定價動態領域做得更好。

In the third strategic imperative of innovation and diversification, we're going to continue to invest in innovative R&D in customer-centric R&D. We're going to continue to fuel our pipeline with meaningful product launches. We're going to continue to drive our vitality index, which has already expanded very meaningfully over the last 3 years. We're going to make sure that as we continue to launch new products, we also see margin expansion coming from these new products. I'm excited about where we are today. Our pipeline -- the dollar value associated with our pipeline is twice what it was at the end of 2018.

在創新和多元化的第三個策略要務中，我們將繼續投資以客戶為中心的研發創新研發。我們將繼續透過有意義的產品發布來充實我們的產品線。我們將繼續推動我們的活力指數，該指數在過去三年中已經顯著擴大。我們將確保，隨著我們繼續推出新產品，我們也會看到這些新產品帶來的利潤率擴張。我對我們今天的處境感到興奮。我們的管道—與我們的管道相關的美元價值是 2018 年底的兩倍。

And as we enter 2024, we have very meaningful product launches, particularly in the hip area in where we lost market share in the last 2 years, given the lack of products in key categories like surgical impactors, triple taper stems or hip navigation. So again, 2024 is the year in where through very meaningful product launches, we will regain the momentum that we lost. Beyond hips, I'm excited about where we are in shoulder, Identity continues to generate great excitement. We will enter 2024 in full launch mode when it comes to Identity. We're excited about stemless shoulders entering the market, and yes, very excited about being first to market in the category of shoulder robotics with a very highly differentiated offering in robotics for shoulders that will apply for both anatomic and reverse surgeries.

進入 2024 年，我們推出了非常有意義的產品，特別是在髖關節領域，由於手術衝擊器、三錐柄或髖關節導航等關鍵類別的產品缺乏，我們在過去兩年中失去了市場份額。因此，2024 年我們將透過推出非常有意義的產品，重新獲得失去的動力。除了臀部之外，我對肩膀的位置感到興奮，身份繼續產生巨大的興奮。在身分認同方​​面，我們將進入 2024 年全面啟動模式。我們對無柄肩部進入市場感到很興奮，是的，我們也很高興能夠率先進入肩部機器人領域，並提供高度差異化的肩部機器人產品，適用於解剖手術和反向手術。

In the area of knees within the early days of our cementless knee launch, In 2024, we seek to increase our penetration rates drastically. Here in the U.S., our penetration rate in cementless is not even in the 20% range and we are committing to drive the penetration rate into the 50% to 60% range at a very rapid pace. Again, more details to those plans at our Analyst Day, but rest assured that our knee penetration rate in the cementless category is not going to stay in the teens or even the low 20s for long.

在我們推出非骨水泥膝關節產品的初期，我們力求在 2024 年大幅提高膝關節領域的滲透率。在美國，我們的非水泥滲透率甚至不到 20% 的範圍，我們致力於以非常快的速度將滲透率提高到 50% 到 60% 的範圍。再次，我們的分析師日將提供更多有關這些計劃的詳細信息，但請放心，我們在非骨水泥類別中的膝關節滲透率不會長期保持在十幾歲甚至二十幾歲以下。

Beyond cementless, we're excited about next-generation robotics in knee. We are excited about partial cementless knees. We're excited about the fact that in 2024, we're going to be entering the full launch for Persona IQ, the only smart knee in the world that fully integrates data, technology and best-in-class implants in a way that nobody else is doing. In the category of S.E.T., which is 6 different businesses, sports, foot and ankle, restorative therapies, trauma, extremities and CMFT, craniomaxillofacial thoracic, we are seeing great growth already exiting 2023.

除了非骨水泥之外，我們對下一代膝蓋機器人技術感到興奮。我們對部分非骨水泥膝蓋感到興奮。令我們感到興奮的是，我們將在 2024 年全面推出 Persona IQ，這是世界上唯一一款以前所未有的方式完全集成數據、技術和一流植入物的智能膝蓋其他正在做。在 S.E.T. 類別中，有 6 個不同的業務：運動、足部和腳踝、恢復治療、創傷、四肢和 CMFT、顱頜面胸部，我們看到 2023 年已經出現了巨大的增長。

The second semester of 2023, we grew S.E.T. by mid-single digit or above and as we entered 2024 and beyond, the expectation is that S.E.T. will continue to grow mid-single digit or above. And this is something that, as a company, we've not realized ever since the merger in 2015 with exclusion of the post-COVID year given comps.

2023 年第二學期，我們成長了 S.E.T.隨著我們進入 2024 年及以後，預計 S.E.T.將繼續成長中個位數或以上。作為一家公司，自 2015 年合併以來（排除新冠疫情後年份的比較）以來，我們還沒有意識到這一點。

So really excited about the return on the multiple investments we made in S.E.T., particularly in the areas of innovation and commercial execution. There is a great cadence of product launches in S.E.T. I already mentioned some of those and more to come when we do our Analyst Day in -- later in the spring. So excited about S.E.T., excited about innovation as a whole. Our new product development pipeline is strong. We're going to be launching over 40 different new products in the next 24 months or so. Most of them are going to enable category leadership, establishing Zimmer Biomet as the leader or the second position in the category.

我們對 S.E.T. 多項投資的回報感到非常興奮，特別是在創新和商業執行領域。 S.E.T. 的產品發布節奏很快。我已經提到了其中的一些內容以及更多內容，當我們在春季晚些時候舉辦分析師日時。對 S.E.T. 感到非常興奮，對整個創新感到興奮。我們的新產品開發管道很強大。我們將在未來 24 個月左右的時間內推出 40 多種不同的新產品。他們中的大多數將成為該類別的領導者，將 Zimmer Biomet 確立為該類別的領導者或第二個位置。

And virtually, all of them are going to be in market spaces that are growing 4% plus or above. So I like the quantity, I like the quality, and I like the market growth profile in terms of whether innovation is going. I'm also particularly excited about the innovation plans that we have for the ASC here in the U.S., ASC side of care. We've made meaningful investments in innovation during all stages of the episode of care. What happens before surgery, what happens during surgery and what happens after surgery.

事實上，所有這些都將進入成長 4% 以上的市場空間。所以我喜歡數量，喜歡質量，喜歡創新是否正在進行方面的市場成長狀況。我也對我們為美國 ASC 護理方面的 ASC 制定的創新計劃感到特別興奮。我們在護理的各個階段都對創新進行了有意義的投資。手術前會發生什麼，手術期間會發生什麼，手術後會發生什麼。

And relative to the ASC in the intra-op stage of the ASC, we are best-in-class when it comes to solving problems and delivering efficiency, best-in-class outcomes and safety. So again, truly excited about our ASC strategy where we're going relative to this side of care. Diversification of Zimmer Biomet's end markets will happen not just by innovation internally, but will happen through smart M&A, which will remain the #1 category when it comes to capital allocation. With the best-in-class lever ratio and with deep confidence in our free cash flow generating plans over the next few years, our strategy is to make smart M&A the top recipient of our capital.

相對於 ASC 術中階段的 ASC，我們在解決問題和提供效率、一流的結果和安全性方面是一流的。再說一遍，我們對我們的 ASC 策略感到非常興奮，我們將在這方面進行相關的護理。 Zimmer Biomet 終端市場的多元化不僅將透過內部創新實現，還將透過明智的併購實現，這在資本配置方面仍將是第一個類別。憑藉一流的槓桿率以及對未來幾年自由現金流生成計劃的堅定信心，我們的策略是讓明智的併購成為我們資本的最大接受者。

But at the same time, I just love the fact that we have the optionality to continue to do share buybacks as we announced this morning and perhaps at a more meaningful level. So the combination of smart M&A and buybacks can coexist, given the strong free cash flow dollar generation that we are seeing in (technical difficulty) this regard. I'm energized by the very detailed and focused plans that the team has put in place, which I know that upon their execution will position Zimmer Biomet to deliver on the growth profile that we keep recommitting and that is to grow above 100 to 200 basis points.

但同時，我很高興我們可以選擇繼續進行股票回購，正如我們今天早上宣布的那樣，也許是在更有意義的水平上。因此，考慮到我們在這方面（技術難度）看到的強勁的自由現金流美元生成，明智的併購和回購的結合可以共存。我對團隊制定的非常詳細和重點突出的計劃感到鼓舞，我知道這些計劃的執行將使 Zimmer Biomet 實現我們不斷重新承諾的增長概況，即增長超過 100 至 200 基礎點。

So as a minimum point of entry commitment of 5% in the year 2024, with earnings per share always growing faster than revenue, and free cash flow always growing faster than EPS. This is not a 1-year commitment. This is a multiyear commitment. And again, I know based on the very detailed plans we will get there.

因此，2024 年的最低切入點承諾為 5%，每股盈餘的成長速度始終快於營收的成長速度，自由現金流的成長速度始終快於每股盈餘的成長速度。這不是一年的承諾。這是一項多年的承諾。再說一次，我知道根據非常詳細的計劃，我們將實現這一目標。

In closing, we are very excited about where we're at the track record over the last 2 years. And most importantly, we're deeply excited in terms of where we're going to go in 2024 and beyond. The team is ready, we are establishing the right trend, and we're going to continue to drive flawless execution, delivering our commitments. Along the way, we're going to help patients, we're going to create shareholder value, and we will leave our mission of validating pain and improving the quality of life for people around the world. With that, I'll turn the call over to Suky.

最後，我們對過去兩年的業績記錄感到非常興奮。最重要的是，我們對 2024 年及以後的發展方向感到非常興奮。團隊已準備就緒，我們正在建立正確的趨勢，我們將繼續推動完美的執行，兌現我們的承諾。一路走來，我們將幫助患者，我們將創造股東價值，我們將放棄驗證痛苦和改善世界各地人們的生活品質的使命。這樣，我就把電話轉給 Suky。

Thanks, and good morning, everyone. As Ivan mentioned, our fourth quarter results ended a successful year for Zimmer Biomet with full year constant currency revenue growing 7.5% and adjusted earnings growing more than 9.5% on a reported basis, while generating just under $1 billion in free cash flow. Inside of that, our business segments performed well for the year. With global knees constant currency growth of over 10%, hips growth of 5% and S.E.T. growth of almost 4%, all while also expanding adjusted operating margin by almost 100 basis points, the second consecutive year of operating margin expansion in a challenging environment.

謝謝，大家早安。正如Ivan 所提到的，我們第四季的業績為Zimmer Biomet 帶來了成功的一年，全年固定貨幣收入增長7.5%，調整後收益增長超過9.5%（按報告計算），同時產生近10 億美元的自由現金流。其中，我們的業務部門今年表現良好。全球貨幣持續成長超過 10%，髖關節成長 5%，S.E.T.成長近 4%，同時調整後營業利潤率也擴大了近 100 個基點，這是在充滿挑戰的環境下連續第二年實現營業利潤率擴張。

Also, as previously guided, we closed the second half of 2023 with mid-single-digit revenue growth and levered earnings growth, a profile we expect to continue moving forward. Let's dive into the fourth quarter results. Unless otherwise noted, my statements will be about the fourth quarter of 2023 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 in the fourth quarter were $1.94 billion, an increase of 6.3% on a reported basis and an increase of 6.1% on a constant currency basis.

此外，正如先前的指導，我們在 2023 年下半年結束時實現了中等個位數的收入成長和槓桿收益成長，我們預計這種情況將繼續向前發展。讓我們深入了解第四季的業績。除非另有說明，我的陳述將涉及 2023 年第四季及其與 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。第四季淨銷售額為 19.4 億美元，按報告計算成長 6.3%，以固定匯率計算成長 6.1%。

We had a selling day tailwind of about 100 basis points in the quarter. U.S. growth was 4.4% and international growth was 8.7%. As expected, we saw a robust sequential step-up versus the third quarter across all regions. Global knees grew 5.6% in the quarter with the U.S. growing 5.4% and international growing 5.8%. The knee business continues to be driven by our Persona product portfolio, combined with our ROSA robotics platform, and we remain excited about the positive feedback around our recently launched cementless form factor for Persona, OsseoTi. For the full year, global knees grew 10.2%. global hips grew 3.6% in the quarter, with the U.S. growing 4% and international growing 3.2%.

本季我們的銷售日順風順水約 100 個基點。美國成長率為 4.4%，國際成長率為 8.7%。正如預期的那樣，我們看到所有地區與第三季相比都出現了強勁的連續成長。本季全球膝關節成長 5.6%，其中美國成長 5.4%，國際成長 5.8%。膝蓋業務繼續由我們的 Persona 產品組合與 ROSA 機器人平台相結合推動，我們對最近推出的 Persona 無骨水泥外形 OsseoTi 所獲得的積極反饋感到興奮。全年全球膝關節成長 10.2%。本季全球臀部成長 3.6%，其中美國成長 4%，國際成長 3.2%。

We are eager to accelerate performance of this segment with the addition of multiple new product offerings in 2024. For the full year, global hips grew 5.1%. Next, the S.E.T. category grew 6.4% in the quarter, with our key focus areas of sports, CMFT and upper extremities, all growing in the mid-single digit to low double-digit range. The strong growth in these focus areas was partially offset by other subsegments within the category. For the full year, S.E.T. grew. 3.8%, including a step-up to mid-single-digit growth in the second half of the year. Finally, our other category grew 15.9% in the quarter, driven by another strong quarter of global ROSA sales.

我們渴望透過在 2024 年增加多種新產品來加速該細分市場的表現。全年全球髖關節成長 5.1%。接下來，S.E.T.該類別在本季度增長了 6.4%，我們的重點關注領域是體育、CMFT 和上肢，全部增長在中個位數到低兩位數範圍內。這些重點領域的強勁成長被該類別內的其他細分市場部分抵消。全年來看，S.E.T.成長了。 3.8%，其中下半年增幅達到中個位數。最後，在全球 ROSA 銷售又一個強勁季度的推動下，我們的其他類別在本季成長了 15.9%。

Now moving to the P&L. In Q4, we reported GAAP diluted earnings per share of $2.01, compared to GAAP diluted loss per share of $0.62 in the prior year. The increase in GAAP results was driven by higher revenue, a goodwill impairment charge in 2022 that did not repeat favorable onetime tax benefits in 2023 and a lower share count.

現在轉向損益表。第四季度，我們公佈的 GAAP 攤薄每股收益為 2.01 美元，而上一年的 GAAP 攤薄每股虧損為 0.62 美元。 GAAP 業績的成長是由收入增加、2022 年商譽減損費用（未在 2023 年重複享有一次性稅收優惠）以及股份數量減少所推動的。

The details around our financial performance can be found in today's press release. On an adjusted basis, we reported diluted earnings per share of $2.20 compared to $1.88 in the prior year, representing year-over-year reported growth of 17%. The step-up is driven by revenue growth, better gross margins, lower OpEx margin in tandem with a lower tax rate.

有關我們財務業績的詳細資訊可以在今天的新聞稿中找到。調整後的每股攤薄收益為 2.20 美元，而前一年為 1.88 美元，較去年同期成長 17%。這一成長是由收入成長、更高的毛利率、更低的營運支出利潤率以及更低的稅率所推動的。

Our adjusted gross margin was 72.5%, up 80 basis points from the prior year, driven by favorable mix higher volumes and lower royalties. And for the full year, we came in slightly above expectations, representing 90 basis points of year-over-year expansion. Adjusted operating margin was 30.3%, up 200 basis points from the prior year. The year-over-year operating margin step-up was primarily driven by revenue leverage, better gross margin and realized efficiencies across SG&A.

在銷售增加和特許權使用費降低的有利組合推動下，我們調整後的毛利率為 72.5%，比上年增長 80 個基點。就全年而言，我們的業績略高於預期，與去年同期相比擴張 90 個基點。調整後營業利益率為 30.3%，較前一年上升 200 個基點。營業利潤率年增主要是由於收入槓桿、更好的毛利率以及整個銷售、管理和行政管理 (SG&A) 的實現效率。

For the full year, operating margin was slightly ahead of expectations at 28.2%, up 90 basis points year-over-year. Net interest and other adjusted nonoperating expenses were $43 million in the quarter and $194 million for the full year. And our adjusted tax rate was 15.8%, the slightly more favorable tax rate was driven by discrete onetime items in the quarter, bringing our full year tax rate to 16.3% and in line with overall expectations.

全年營業利益率略高於預期，為 28.2%，較去年同期上升 90 個基點。本季淨利息和其他調整後的非營運支出為 4,300 萬美元，全年淨利息和其他調整後非營運支出為 1.94 億美元。我們調整後的稅率為15.8%，稍微優惠的稅率是由本季離散的一次性項目推動的，使我們的全年稅率達到16.3%，符合整體預期。

Turning to cash and liquidity. We generated operating cash flows of $588 million and free cash flow totaled $447 million, and we ended the year with cash and cash equivalents totaling $416 million. As Ivan mentioned earlier, we completed a $500 million share buyback program in early 2024, which is more than required to offset annual dilution. For the full year, we generated operating cash flow of just under $1.6 billion and free cash flow of $979 million. Our balance sheet remains strong, leaving us continued financial flexibility and strategic optionality as we move forward.

轉向現金和流動性。我們的營運現金流為 5.88 億美元，自由現金流總計為 4.47 億美元，年底現金和現金等價物總計為 4.16 億美元。正如伊凡之前提到的，我們在 2024 年初完成了 5 億美元的股票回購計劃，這超出了抵銷年度稀釋所需的金額。全年，我們的營運現金流略低於 16 億美元，自由現金流為 9.79 億美元。我們的資產負債表仍然強勁，使我們在前進的過程中保持持續的財務靈活性和策略選擇性。

Now moving on to our financial outlook for 2024, our outlook takes into account certain key assumptions, including pricing, which is expected to be about 100 to 150 basis points of erosion, but it's a continued step change improvement from historical trends. We expect to see continued strength in our end markets in tandem with new product introductions and continued improvement in product supply. Against that backdrop, we expect 2024 constant currency revenue growth of 5% to 6%, including a foreign currency exchange headwind of approximately 50 basis points, translating to reported growth of 4.5% to 5.5%. Adjusted diluted earnings per share in the range of $8 to $8.15, representing reported growth of 6% to 8%.

現在轉向我們對 2024 年的財務展望，我們的展望考慮了某些關鍵假設，包括定價，預計價格將下降約 100 至 150 個基點，但與歷史趨勢相比，這是一個持續的進步。我們預計，隨著新產品的推出和產品供應的持續改善，我們的終端市場將持續強勁。在此背景下，我們預期 2024 年恆定貨幣收入成長率為 5% 至 6%，其中包括約 50 個基點的外匯逆風，即報告的成長率為 4.5% 至 5.5%。調整後的稀釋每股收益在 8 美元至 8.15 美元之間，報告成長 6% 至 8%。

And currency is expected to have about an $0.08 headwind on EPS based on recent rates and the implementation of Pillar 2 has an $0.18 or about a 250 basis point headwind on earnings per share growth for the year. This implies operating margin expansion of greater than 50 basis points at the EPS guidance midpoint when compared to 2023. We expect slightly lower year-over-year gross margins to be more than offset by efficiency and restructuring programs that were initiated in 2023.

根據最近的匯率，貨幣預計將對每股收益產生約 0.08 美元的阻力，而第二支柱的實施將對今年每股收益的成長產生 0.18 美元或約 250 個基點的阻力。這意味著與 2023 年相比，每股盈餘指引中點的營業利潤率將成長超過 50 個基點。我們預計，年比毛利率略有下降將被 2023 年啟動的效率和重組計畫所抵銷。

Net interest and other nonoperating expenses are expected to be about $205 million. And as previously discussed, our effective tax rate is expected to step up to 18% in conjunction with the implementation of Pillar 2. We expect to end the year with about 207 million shares outstanding, lower than 2023 due to the $500 million share buyback plan that I referenced earlier.

淨利息和其他非營運支出預計約為 2.05 億美元。如同先前所討論的，隨著第二支柱的實施，我們的有效稅率預計將升至18%。由於5 億美元的股票回購計劃，我們預計到年底流通股數約為2.07 億股，低於2023 年的水準我之前提到過。

Finally, we expect our free cash flow to be in the range of $1.05 billion to $1.1 billion or growth of about 10% at the midpoint. As Ivan mentioned, we initiated a global restructuring program along with other cost savings initiatives in late 2023. These programs further streamline our organizational structure, shift select reporting lines, prioritize how we spend across the organization and further above our operational footprint in order to simplify and maximize efficiency.

最後，我們預計我們的自由現金流將在 10.5 億美元至 11 億美元之間，中間值將成長約 10%。正如Ivan 所提到的，我們在2023 年底啟動了一項全球重組計劃以及其他成本節約舉措。這些計劃進一步簡化了我們的組織結構，改變了選擇的報告路線，優先考慮了我們在整個組織中的支出方式，並進一步超越了我們的營運足跡，以簡化並最大限度地提高效率。

This program is expected to result in total cash charges of about $125 million to $150 million over the next 2 years and deliver up to $200 million in run rate savings as we exit 2025, enabling us to invest in priority areas while driving margin expansion and earnings leverage despite a meaningful step-up in tax rate. In terms of cadence through the year, we expect constant currency revenue growth for the first half of the year to be at the lower end of the mid-single digits while the second half will be at the higher end of mid-single digits.

該計劃預計將在未來2 年內產生約1.25 億至1.5 億美元的總現金費用，並在2025 年結束時節省高達2 億美元的運行率，使我們能夠投資於優先領域，同時推動利潤率擴張和盈利儘管稅率大幅提高，但槓桿率仍然很高。就全年節奏而言，我們預計上半年貨幣收入的持續成長將處於中個位數的低端，而下半年將處於中個位數的高端。

Also, quarterly results are expected to be choppy due to billing day impacts. Q1 will be about 150 to 200 basis point headwind and Q2 and Q3 will be a 150 basis point tailwind in each quarter, and Q4 will be a 50 basis point tailwind. Full year impact will be immaterial or less than 50 basis point tailwind. 2024 gross margin is expected to step down slightly versus 2023 due to lower FX hedge gains and the realization of capitalized third-party manufacturing cost increases observed in the second half of 2023.

此外，由於計費日的影響，預計季度業績將出現波動。第一季將是約 150 至 200 個基點的逆風，第二季和第三季將是每季 150 個基點的順風，第四季將是 50 個基點的順風。全年影響將不大或小於 50 個基點的順風。由於外匯對沖收益下降以及 2023 年下半年資本化第三方製造成本增加，預計 2024 年毛利率將較 2023 年略有下降。

From a cadence standpoint, gross margin will be higher in the first half of the year. Additionally, because of the timing of the restructuring program, we expect operating margin will be higher in the second half than in the first half with Q4 being our high watermark, followed by Q2. In summary, 2023 was another strong year for the company, and we expect to maintain that momentum into 2024 and beyond.

從節奏來看，上半年的毛利率將會更高。此外，由於重組計畫的時間安排，我們預計下半年的營業利潤率將高於上半年，其中第四季是我們的高水位線，其次是第二季。總而言之，2023 年是該公司又一個強勁的一年，我們預計將在 2024 年及以後保持這一勢頭。

With that, I'll turn the call back over to Keri for the Q&A.

這樣，我會將電話轉回給 Keri 進行問答。

Thanks Suky. Before we start the Q&A session, just a quick reminder to please limit yourself to a single question and 1 brief 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，請快速提醒您，請限制自己提出一個問題並進行 1 次簡短的跟進，以便我們可以在通話期間解決盡可能多的問題。那麼，接線員，請問第一個問題。

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

我們先去看看富國銀行的 Larry Biegelsen。

Ivan, congratulations on a nice first year here as CEO. I I'd love to ask about the 2024 guidance. Just talk about the key assumptions for the 5% to 6% constant currency growth in '24. What you're assuming for the recon market. And Ivan, talk about your guidance philosophy. Have you incorporated any conservatism in the guidance? What would get you to the high end of the range? And just quickly, Suky, on the buyback, the $500 million, does that imply that it's hard to find good M&A targets? How should we interpret that?

Ivan，恭喜您作為執行長第一年的美好表現。我很想詢問 2024 年的指導意見。就說說24年5%到6%的貨幣恆定成長的關鍵假設吧。您對偵察市場的假設。伊万，談談你的指導理念。您在指導中是否納入了保守主義？什麼能讓您達到該範圍的高端？蘇基，快說，關於回購，5億美元，這是否意味著很難找到好的併購目標？我們該如何解釋呢？

Thank you, Larry. Always great to hear from you. So I'll take the first 2 parts and then Suky can talk about the rest. So embedded in the guidance for 2024, which we're very confident on the 5% to 6% is macro and micro reasons. So from a macro perspective, by now you heard from most of our peers, the markets are very healthy. We believe the -- beyond the backlog, the markets are going to continue to be healthy. You got better patient demographics, younger patients, you got the dynamic of cases moving into an ASC. You got more days of surgery here in the U.S., where it's not just 2 days, it's 3 days. You've seen shorter, better, rehabilitation processes. I can go on and on, but the markets are very healthy.

謝謝你，拉里。很高興收到你的來信。所以我會講前兩部分，然後 Suky 可以談論其餘部分。因此，在 2024 年的指導中，我們對 5% 到 6% 非常有信心，這是宏觀和微觀原因。因此，從宏觀角度來看，到目前為止，您從我們大多數同行那裡聽到，市場非常健康。我們相信，除了積壓之外，市場將繼續健康。您可以獲得更好的患者人口統計、更年輕的患者，以及進入 ASC 的病例動態。在美國，手術時間更長，不是兩天，而是三天。您已經看到了更短、更好的康復過程。我可以繼續說下去，但市場非常健康。

And then from a micro perspective, we got a cadence of new product launches. Most of them are going to be very meaningful as you hit the second semester of the year. We got 3 new product launches in hips early in 2024, which again will be more material later in the year. We're launching ROSA shoulder. We got a cadence of new product introductions in S.E.T., and we're going to continue to increase our penetration in cementless and ROSA.

然後從微觀角度來看，我們有新產品發布的節奏。當你進入今年第二學期時，其中大多數都會非常有意義。 2024 年初，我們推出了 3 款臀部新產品，今年稍後也將推出更多材質產品。我們正在推出 ROSA 肩部。我們在 S.E.T. 中不斷推出新產品，並且我們將繼續提高在非水泥和 ROSA 領域的滲透率。

So again, the combination of new product launches, great commercial execution amplified by the healthier market dynamics gives us confidence on a minimum 5% and the range of 5% to 6%. Relative to my philosophy when it comes to guidance, it's very basic. We make commitments and we don't miss them. So we study the different dynamics, we study what we had. We know that operationally, we're in a better place. We don't have the headwinds that we had in 2023 around supply and whatnot.

因此，新產品的發布、良好的商業執行力和更健康的市場動態相結合，讓我們對至少 5% 和 5% 至 6% 的範圍充滿信心。相對於我的指導哲學，它是非常基本的。我們做出承諾，並且不會錯過它們。所以我們研究不同的動態，我們研究我們所擁有的。我們知道，在營運方面，我們處於更好的位置。我們沒有 2023 年在供應等方面遇到的阻力。

So my guidance represents or exemplifies my philosophy of making commitments and driven on those commitments. I'm not going to comment today on whether there is opportunities to bid and raise throughout the year. I'll just leave at my philosophies to make commitments and deliver commitments, and these are very well-stated commitments. So with that, I'll pass it on to Suky your second question.

因此，我的指導代表或例證了我做出承諾並推動這些承諾的理念。今天我不會評論全年是否有機會投標和籌集資金。我將堅持我的理念，做出承諾並兌現承諾，這些都是非常明確的承諾。那麼，我將把你的第二個問題轉達給Suky。

Yes. Larry, thanks for the question. I'd say, first of all, the $500 million share buyback, I think, demonstrates our confidence in our outlook in the business. And the short answer to your question, does this imply some deterioration in M&A targets. And I would say absolutely not. I think based on where the company is from a firepower perspective, we feel that we've got the balance sheet strength and power as well as the forward-looking results to really do both. We still will prioritize smart M&A, as Ivan has talked about. We still favor tuck-in acquisitions to midsize acquisitions.

是的。拉里，謝謝你的提問。我想說，首先，我認為 5 億美元的股票回購顯示了我們對業務前景的信心。對你的問題的簡短回答是，這是否意味著併購目標有所惡化。我想說絕對不是。我認為，從公司的火力角度來看，我們認為我們擁有真正做到這兩點的資產負債表實力和力量以及前瞻性結果。正如伊万所說，我們仍然會優先考慮明智的併購。我們仍然傾向於中期收購和中型收購。

But even in the backdrop of doing a heightened level of share buyback, we still see very significant M&A firepower to execute that strategy as well. So short answer, again, is no, we don't see this as any type of deterioration in targets.

但即使在增加股票回購力度的背景下，我們仍然看到執行這項策略的強大併購火力。所以簡短的回答是否定的，我們不認為這是目標的任何類型的惡化。

Katie, can we go the next question in the queue?

凱蒂，我們可以討論隊列中的下一個問題嗎？

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

接下來我們將與派珀·桑德勒一起前往馬修·奧布萊恩。

Just maybe start a little bit, Ivan or Suky, on the knee performance in the quarter. It was a little bit below what we were expecting, still better than one of your competitors, but below another one. On a 2-year stack basis, it's not quite 50% of sales, but close to it. So I would anticipate that that's going to need to see very good performance here in '24 in order to hit the guidance range, which I think is maybe being questioned a little bit this morning.

伊凡或蘇基，也許可以從本季的膝蓋表現開始。它比我們的預期稍低一些，但仍然比您的競爭對手要好，但低於另一個競爭對手。以 2 年堆疊為基礎，它還不到銷售額的 50%，但也接近這個比例。因此，我預計 24 年需要看到非常好的表現才能達到指導範圍，我認為今天早上可能會受到一些質疑。

So what is it there specifically between cementless, between robotic, between Persona IQ that gives you the confidence in the knee franchise outside of the macro environment here in '24? And then I do have a quick follow-up.

那麼，在無水泥、機器人、Persona IQ 之間，到底是什麼讓你對 24 年宏觀環境之外的膝蓋特許經營權充滿信心呢？然後我確實進行了快速跟進。

Thanks, Matt. So performance relative to the quarter, we're very pleased with the quarter. We performed in line with our expectations for knees and frankly, for entire business. And for the year, it was a solid year with knees growing double digit, and the entire business growing 7.5% with nice EPS expansion. We really don't pay acute attention to what happens to one quarter. I know that is your job to do that, but we just don't. The 60 to 62 working days in a quarter, there is all kinds of volatility, then you got comps.

謝謝，馬特。因此，相對於本季的表現，我們對該季度非常滿意。我們的表現符合我們對膝蓋的期望，坦白說，對整個業務的期望。今年是穩健的一年，膝蓋增長了兩位數，整個業務增長了 7.5%，每股收益也有不錯的增長。我們確實沒有特別關註四分之一發生的事情。我知道這是你的工作，但我們就是不這麼做。一個季度有 60 到 62 個工作日，有各種波動，然後你就會得到補償。

So when it comes to performance, we look to 8 to 12 quarters. And if you do run the analysis, 8 to 12 quarters, you're talking about knees, but take a look at S.E.T., hips and whatnot, the performance is there. Speaking of volatility in Q4 for knees, we did see in the U.S., we did see some timing of orders, that impacted some of our largest IDMs here. We also had, let's remember, some tougher comps versus Q4 of 2022, particularly in the U.S. where we were at 500 basis points ahead of our strongest competitors in knees.

因此，當談到績效時，我們會關注 8 到 12 個季度。如果你進行 8 到 12 個季度的分析，你談論的是膝蓋，但看看 S.E.T.、臀部等等，表現就在那裡。說到第四季度膝蓋的波動，我們確實在美國看到了一些訂單時機，這影響了我們這裡一些最大的 IDM。讓我們記住，與 2022 年第四季相比，我們也有一些更艱難的比較，特別是在美國，我們在膝蓋方面領先最強競爭對手 500 個基點。

And then again, when you look at Q3, that's the quarter where both in knees and hips, we outperform our competitors in the U.S. So again, given all this volatility, all these ups and downs, we just don't pay any attention to one particular quarter. We look acutely at the trends. And the trends do show that 2, 3 years later, we continue to be the #1 player in knees, and we continue to gain market share.

話又說回來，當你看第三季度時，我們在膝蓋和臀部方面都優於我們在美國的競爭對手。因此，考慮到所有這些波動、所有這些起伏，我們只是不關註一個特定的季度。我們敏銳地觀察趨勢。趨勢確實表明，兩三年後，我們仍然是膝蓋領域的第一名，我們繼續獲得市場份額。

Relative to the second part of your question around 2024, what gives us confidence around the guidance is the fact that we continue to see increases in cementless penetration. We continue to see increases in ROSA penetration, we have solved the backorder challenge that we had in knees, which was a headwind for many periods in 2023. And we've seen this great commercial execution in the ASC. So we're very confident about where we are in knees, and we are very confident around the acceleration in knees going into 2024.

相對於 2024 年左右問題的第二部分，讓我們對指導充滿信心的是，我們繼續看到非水泥滲透率的增加。我們繼續看到 ROSA 滲透率的增長，我們已經解決了膝蓋方面的缺貨挑戰，這在 2023 年的許多時期都是一個逆風。我們在 ASC 中看到了這種偉大的商業執行。因此，我們對膝蓋的狀況非常有信心，並且對進入 2024 年膝蓋的加速也非常有信心。

Appreciate that. Follow-up is just on -- there's a lot of good things coming this year as far as new products, et cetera. But you're trying to lower inventory levels significantly, 50 days is a ton in this space. And then the restructuring as well, are those -- how have you factored in those potential headwinds in '24 and even into '25 in terms of potentially some lost revenues or dislocation you may suffer as a result.

感謝。後續行動才剛開始——今年有很多好東西，例如新產品等等。但您正試圖大幅降低庫存水平，50 天在這個領域已經很長了。然後是重組——你如何考慮24年甚至25年的潛在不利因素，也就是你可能因此遭受的一些收入損失或混亂。

Well, let me just begin with the simple answer. Anything and everything we do in restructuring wise and inventory management wise is embedded in the guidance we've given. So that's part of that. In terms of inventory management or inventory reductions, we're going to be bold, but not reckless. So we're not reducing inventories in the key categories. We actually are making sure that inventory is where it needs to be for those key brands, whether it's Persona, whether it's the key components in hips, whether it's is the key components is S.E.T. This is a lot of the leftover from the integration that we didn't do.

好吧，讓我從簡單的答案開始。我們在重組和庫存管理方面所做的一切都包含在我們給予的指導中。這就是其中的一部分。在庫存管理或庫存削減方面，我們會大膽，但不會魯莽。因此，我們不會減少關鍵類別的庫存。實際上，我們正​​在確保這些關鍵品牌的庫存處於需要的位置，無論是 Persona，無論是臀部的關鍵部件，還是 S.E.T. 的關鍵部件。這是我們沒有進行的整合中的許多剩餘部分。

So the inventory reduction is going to be in noncritical areas, frankly, in noncritical countries. So again, we're doing this thoughtfully. In terms of the restructuring, the reductions that we announced this morning, these are happening in back office. I will tell you, virtually all reductions are noncustomer-facing and again, the changes we make in inventory and people are embedded in the guidance that we've given.

因此，坦白說，庫存減少將在非關鍵領域，在非關鍵國家。再說一遍，我們正在深思熟慮地做這件事。就重組而言，我們今天早上宣布的裁員是在後台進行的。我會告訴你，幾乎所有的削減都是非面向客戶的，而且我們在庫存和人員方面所做的改變都包含在我們給出的指導中。

Katie, can we go to the next question in the queue, please?

凱蒂，我們可以轉到隊列中的下一個問題嗎？

We'll go next to Robbie Marcus with JPMorgan.

接下來我們將與摩根大通一起討論羅比·馬庫斯。

Great. I wanted to ask on S.E.T. and other. Those were the 2 line items that beat versus the Street. I was just hoping you could break out some of the trends there. What did -- well, what might have underperformed, if anything? And how we think about those different line items as part of the guide in 2024? And how much of the strong growth is coming from that versus hips and knees?

偉大的。我想問 S.E.T.和別的。這是擊敗華爾街的兩個項目。我只是希望你能打破那裡的一些趨勢。是什麼——嗯，什麼可能表現不佳（如果有的話）？我們如何看待這些不同的項目作為 2024 年指南的一部分？與臀部和膝蓋相比，強勁增長有多少來自於此？

Thank you, Robbie. So solid quarter for S.E.T., frankly, solid last semester of 2023 for S.E.T. growing around mid-single digits, around 5% and committing to grow in mid-single digit above in 2024. The key drivers are the use of suspects. We continue to do really well with upper extremities, growing upper single digit, double digit in most geographies that's new product launches, that's focusing the ASC, that's stable supply, just great commercial execution.

謝謝你，羅比。 S.E.T. 的季度表現非常出色，坦白說，S.E.T. 2023 年最後一學期的表現也非常出色。成長率約為中個位數，即 5% 左右，並承諾在 2024 年實現中個位數以上的成長。關鍵驅動因素是嫌疑人的使用。我們在上肢方面繼續做得非常好，在大多數地區都在增長個位數、兩位數，這是新產品的發布，重點是 ASC，穩定的供應，以及出色的商業執行力。

Our CMFT business, Craniomaxillofacial thoracic continues to do really well. I recall that we did 2, 3 acquisitions over the last 3 years and those continue to do really well. And again, CMFT is a business where we see upper single digit, double digit. We finally stabilized our Restorative Therapies business here in the U.S. Recall that we had some reimbursement challenges there. And those are behind. So you've seen the biologics restorative therapy business growing at a nice clip now.

我們的 CMFT 業務（顱顏面胸部）繼續表現出色。我記得過去 3 年我們進行了 2、3 次收購，而且這些收購仍然表現出色。再說一次，CMFT 是一個我們看到高個位數、兩位數的業務。我們終於在美國穩定了我們的恢復治療業務。回想一下，我們在那裡遇到了一些報銷挑戰。而那些都在後面。所以你已經看到生物製品恢復治療業務現在正在快速成長。

And in sports, we've done some acquisitions. We have had some challenges, but that continues to perform in line with expectations. So I will tell you, Robbie, out of the 6 businesses within the category, 4 are going really well. Trauma, foot and ankle, we got some work to do. We got some decisions, some strategic considerations to make.

在體育領域，我們進行了一些收購。我們遇到了一些挑戰，但表現仍符合預期。所以我會告訴你，羅比，在該類別的 6 家企業中，有 4 家發展得非常好。腳部和腳踝受傷，我們還有一些工作要做。我們需要做一些決定、一些策略考量。

As we enter 2024, mid-single digit is the point of entry. This has to be the year where we see sales growing mid-single digit. Frankly, in some geographies, I think it's going to be higher than that. We got the innovation, we got the investments in terms of dedicated infrastructure and specialization. Heavy emphasis here in the U.S. in the ASC environment. So again, full confidence in the growth profile that we're going to see moving forward.

當我們進入 2024 年時，中個位數就是切入點。今年我們的銷售額一定會出現中個位數的成長。坦白說，在某些地區，我認為這個數字會更高。我們獲得了創新，我們獲得了專用基礎設施和專業化的投資。美國高度重視 ASC 環境。再次強調，我們對未來的成長前景充滿信心。

Great. Maybe just a quick follow-up for Suky on the guidance and a clarification. The lower end of mid-single digit in the first half and then higher in second half. Is that inclusive or exclusive of the selling day benefit?

偉大的。也許只是 Suky 的指導和澄清的快速跟進。上半場為中個位數的下限，下半場則更高。這是包含還是不含銷售日福利？

That is inclusive of the selling day benefit, Robbie.

這包括銷售日福利，羅比。

Katie, can we go the next question in the queue, please?

凱蒂，我們可以討論隊列中的下一個問題嗎？

We'll go next to Joanne Wuensch with Citi.

接下來我們將與花旗銀行的 Joanne Wuensch 溝通。

Putting in the book right up front, I'm curious why gross margins are expected to be somewhat down year-over-year, what the dynamics are for that? And then my second question has to do with cementless. Can you walk us through the math of what you think moving to 50% to 60% of the knees being cemented -- or cementless excuse me, either way 50%, what the benefit is of that?

首先，我很好奇為什麼毛利率預計會比去年同期下降，其動態是什麼？我的第二個問題與無水泥有關。您能否向我們介紹一下您認為將 50% 到 60% 的膝蓋採用骨水泥固定的數學計算方法，或者抱歉，無論是 50% 還是無骨水泥，這樣做有什麼好處？

Yes. Joanne, it's Suky. I'll start with the gross margin one and then pass it over to Ivan on cementless. Overall, we got a really good year on gross margin in 2023, up 90 basis points year-over-year. drivers of that are really around, we had some FX hedge gains, which we had talked about at length throughout 2023 as well as improved mix and better pricing, still pricing erosive year-over-year, but better than we expected. Overall, generated a pretty nice profile for '23. We had previously communicated that. We had thought that gross margins might get down slightly into '24, primarily driven by the loss of those FX hedge gains. They won't repeat at the same level, in '24 as they did in '23.

是的。喬安妮，是蘇琪。我將從毛利率開始，然後將其交給無水泥公司的伊凡。整體而言，2023 年的毛利率非常好，較去年同期成長 90 個基點。其驅動因素確實存在，我們有一些外匯對沖收益，我們在 2023 年期間詳細討論了這一點，以及改善的組合和更好的定價，定價仍然同比侵蝕，但好於我們的預期。總體而言，為'23 產生了一個相當不錯的設定檔。我們之前已經溝通過這一點。我們曾認為毛利率可能在 24 年略有下降，主要是由於外匯對沖收益的損失。他們不會像 23 年那樣在 24 年重複同樣的水平。

But also, we're seeing in the capitalization of some increased costs in the back end of '23 around third-party manufacturing, which will feather into the P&L towards the back end of 2024. Despite those 2 headwinds, we're able to offset a large component of that. But overall, we do expect to see gross margins down just slightly versus '23 in the backdrop of those headwinds. Now having said that, if you take the midpoint of our EPS guidance, I think that would back you into an implied operating margin of about 29%, which represents about an 80 basis point increase year-over-year.

而且，我們也看到 23 年底圍繞第三方製造的一些成本增加的資本化，這將在 2024 年底進入損益表。儘管存在這 2 個不利因素，但我們能夠抵消了其中很大一部分。但總體而言，在這些不利因素的背景下，我們確實預計毛利率將比 23 年略有下降。話雖如此，如果你採用我們每股收益指引的中點，我認為這將使你的隱含營業利潤率達到約 29%，這意味著同比增長約 80 個基點。

And so while gross margin may step down slightly, you are seeing operating margins increase as we drive better efficiency and revenue growth through the company. So again, there are a lot of puts and calls throughout the P&L. The great thing is we've got optionality where we see headwinds in one area. We can make that up with efficiency and tailwinds in other areas. I think you've seen that now once we deliver '24, 3 years in a row, which, in a challenging environment in all 3 years, we're able to continue to grow operating margin and levered earnings. So thanks for the question.

因此，雖然毛利率可能會略有下降，但隨著我們透過公司提高效率和收入成長，您會看到營業利潤率增加。同樣，損益表中有很多看跌期權和看漲期權。最棒的是，當我們在某個領域看到逆風時，我們有選擇權。我們可以透過其他領域的效率和順風來彌補這一點。我想你現在已經看到，一旦我們連續三年實現「24」目標，在這三年充滿挑戰的環境中，我們就能夠繼續提高營業利潤率和槓桿收益。謝謝你的提問。

And Joanne, relative to your question on cementless, I'll give you as much as I can. So starting with the basic pricing dynamics, we see with cementless Persona, OsseoTi, we see an ASP uplift of around 10% to 15%, frankly, closer to the 15% than the 10%, around 40% to 50% of the time we combo the cementless knee with robotics with ROSA, and that drives additional uplift in revenue in the form of disposals or whatnot. So that's a great dynamic we see in particular in the ASC. Our penetration today on cementless we'll exit in 2023, somewhat near 18% to 20%, with both expectations to get into the 50% to 60% range.

喬安妮，關於你關於非水泥的問題，我會盡可能告訴你。因此，從基本的定價動態開始，我們看到非水泥Persona、OsseoTi 的平均售價上漲約10% 至15%，坦白說，更接近15%，而不是10%，約40% 至50% 的時間我們將非骨水泥膝蓋與 ROSA 機器人技術相結合，這以處置或其他形式推動了收入的額外增長。因此，我們尤其在 ASC 中看到了巨大的活力。我們今天的無水泥滲透率將在 2023 年退出，接近 18% 至 20%，預計將進入 50% 至 60% 的範圍。

And I'm not going to give you a commitment today. But at our Analyst Day, you will see the long-range plans and some of the trending when it comes to getting to 60%. We believe that there's going to be a fairly quick uplift, given the fact that the market is already being developed by some of the work that our peers have done. So again, you should not expect that getting to 50% to 60% is going to be a long journey. All of these dynamics are in the U.S., we're launching in 2024 in other markets outside of the U.S., and I will disclose the pricing dynamics when the time is right, but excited about the launch in Japan in 2024, another key market. So those are the dynamics here when it comes to cementless.

今天我不會對你做出承諾。但在我們的分析師日，您將看到長期計劃和一些達到 60% 的趨勢。我們相信，鑑於我們的同行所做的一些工作已經在開發市場，我們相信將會出現相當快的提升。再次強調，您不應期望達到 50% 到 60% 會是一個漫長的過程。所有這些動態都發生在美國，我們將於 2024 年在美國以外的其他市場推出，我將在適當的時候披露定價動態，但對 2024 年在另一個關鍵市場日本的推出感到興奮。這些就是無水泥的動態。

Katie, can we go the next question in the queue?

凱蒂，我們可以討論隊列中的下一個問題嗎？

We'll go next to Ryan Zimmerman with BTIG.

接下來我們將與 BTIG 一起討論 Ryan Zimmerman。

Following up maybe on Larry's question about guidance. You talked about the WAMGR being at 4%. And clearly, we're in a stronger market environment. And so as I think about the components of guidance, with pricing as a headwind of 100, 150 basis points it suggests product mix is going to contribute 200 to 300 basis points. I just want to see, one, if that's how you're thinking about it? Or if you're thinking about the market contribution to guidance at a higher rate in 2024, and maybe potentially the product mix contribution lower. Maybe just help us flesh a little that out.

也許是在跟進拉里關於指導的問題。您談到 WAMGR 為 4%。顯然，我們正處於一個更強勁的市場環境中。因此，當我考慮指導的組成部分時，定價是 100 到 150 個基點的逆風，這表明產品組合將貢獻 200 到 300 個基點。我只是想看，第一，你是不是這麼想的？或者，如果您正在考慮 2024 年市場對指導的貢獻率更高，而產品組合的貢獻可能會更低。也許只是幫助我們充實一點。

Yes. I'll try to simplify it and Suky, by all means, will elaborate, but we believe the market is around 4% all in. And again, we model this in different ways, but let's call it 4%. I'm not going to quantify the new product contribution, but it's significant. We got 40 new products getting launched in the next 2 years, and these are meaningful products. I mentioned we got 3 large hip products that are going to be launched early in 2024. We got ROSA Shoulder, which we believe is going to be meaningful in the year 2024, giving the fact that it's not a late year launch. We got a lot of products in the S.E.T. category. So again, you should think of new product introductions has a very meaningful contributor to the guidance.

是的。我會嘗試簡化它，Suky 無論如何都會詳細說明，但我們相信市場總體約為 4%。同樣，我們以不同的方式對此進行建模，但我們稱之為 4%。我不會量化新產品的貢獻，但它很重要。未來兩年我們將推出40個新產品，這些都是有意義的產品。我提到我們有 3 款大型臀部產品將於 2024 年初推出。我們有 ROSA Shoulder，我們相信它在 2024 年會有意義，因為它不是年底推出的。我們在 S.E.T. 有很多產品。類別。再次強調，您應該認為新產品的推出對指導有非常有意義的貢獻。

Add to that the fact that we don't have the headwinds that we had in 2023 when it comes to supply, I would say between #1, #2, we got confidence on where we're going. Beyond that, we don't see a headwind when it comes to the shift to the ASC. We actually see that as a tailwind, we're excited about some of the dynamics we hear about when it comes to the movement of shoulders into ASC. That's going to be a contributor. And as I mentioned to Joanne, the uplift that we see on cementless and ROSA which are products that we launched 2 years ago, but not going to get accelerator are the main contributors to the confidence in the guidance.

除此之外，我們在供應方面沒有 2023 年遇到的阻力，我想說在#1、#2 之間，我們對自己的發展方向充滿信心。除此之外，我們沒有看到轉向 ASC 的阻力。實際上，我們將其視為一種順風，當涉及到肩部進入 ASC 的運動時，我們對聽到的一些動態感到興奮。這將是一個貢獻者。正如我向喬安妮提到的，我們在兩年前推出的非水泥和 ROSA 產品上看到的提升，但不會獲得加速器，是對指南信心的主要貢獻者。

I don't know if Suky have anything else here.

不知道Suky這裡還有沒有別的事。

I think that's well said. One of the key points Ryan is that as Ivan said, the pricing erosion is assumed in that 4% WAMGR.

我認為這句話說得很好。 Ryan 的關鍵點之一是，正如 Ivan 所說，假設 4% WAMGR 會導致定價侵蝕。

Right. Okay. That's helpful from both of you. And then just to kind of dovetail on Joanne's question around margins. You talked about gross margin, Suky, clearly, operating margins are doing more heavy lifting this year. And so how much from the restructuring program is benefit, is driving some of that operating margin expansion, how much are you assuming for top line leverage in that 80 basis points or so of expansion? And yes, that's about it.

正確的。好的。這對你們倆都有幫助。然後正好與喬安妮關於利潤的問題相吻合。你談到了毛利率，Suky，顯然，今年的營業利潤率正在發揮更大的作用。那麼，重組計劃帶來的好處有多少，在一定程度上推動了營業利潤率的擴張，您認為在 80 個基點左右的擴張中，頂級槓桿率是多少？是的，就是這樣。

Yes. So the key driver with gross margin being sort of flat to down slightly, it really is coming from revenue leverage and operating margin you could expect overall OpEx as a percentage of sales to drop by about 100 basis points, give or take. And that's even with R&D increasing year-over-year. So the efficiency in the restructuring programs in the near term are really focused on SG&A. However, inside of that full program, we are working on things inside of COGS, to help maintain and keep gross margin stable over time.

是的。因此，毛利率持平或略有下降的關鍵驅動因素實際上來自收入槓桿和營業利潤率，您可以預期整體營運支出佔銷售額的百分比將下降約 100 個基點，無論大小。即使研發規模逐年增加，情況也是如此。因此，短期內重組計劃的效率實際上主要集中在銷售管理費用上。然而，在整個計劃中，我們正在研究銷貨成本內部的事情，以幫助維持毛利率隨著時間的推移保持穩定。

Those are going to be a little bit more midterm in nature and how they get realized, things like SKU rationalization, site optimization, inventory reductions and corresponding E&O reductions. Those are all things that have a little bit longer lead time. Naturally, as you can expect, as you're moving your supply chain around and not wanting to disrupt the ability to supply demand, but they are definitely going to take more of a prominence as we move forward beyond 2024. But for '24, the way you characterize is right. It's primarily revenue-driven and SG&A.

這些本質上是中期的，以及它們如何實現，例如 SKU 合理化、站點優化、庫存減少和相應的 E&O 減少。這些都是交貨時間稍長的事情。當然，正如您所預料的那樣，當您正在移動供應鏈並且不想破壞供應需求的能力時，但隨著我們向 2024 年邁進，它們肯定會變得更加突出。但對於 24 年來說，您所描述的方式是正確的。它主要是收入驅動和SG&A。

Katie, can we go to the next question in the queue?

凱蒂，我們可以轉到隊列中的下一個問題嗎？

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 wanted to ask about the $200 million in cost savings that you guys called out this year. Curious if the plan is for that to kind of drop through to the bottom line? Or are you going to reinvest that and what does that mean for kind of margins beyond this year and longer term?

我想問一下你們今年所說的 2 億美元的成本節省。好奇這個計劃是否會下降到底線？或者你打算將其再投資，這對今年和更長期的利潤率意味著什麼？

Yes. So the way we characterize it was that it would be $200 million run rate as we exit 2025. In year for 2024, we expect that to be about $100 million or about half of the run rate savings that we're predicting over a 2-year period. We're dropping a lot of that to the bottom line as you can see with our implied guidance at the midpoint would suggest about an 80 basis point increase in operating margins.

是的。因此，我們對其進行描述的方式是，當我們退出2025 年時，運行費用將達到2 億美元。到2024 年，我們預計這將達到約1 億美元，或者是我們預測的2 年內運行費用節省的一半左右。年期間。我們將其中很大一部分下降到底線，正如您所看到的，我們在中點的隱含指導建議營業利潤率增加約 80 個基點。

And so we're actually taking a good portion of that dropping it to the bottom, but we're also reinvesting a pretty significant portion back into our priority areas, ensuring that we've got the appropriate amount of sets and instruments for cementless uptake as well as Persona uptake through ROSA, ensuring that we've got the right level of commercialization and execution in our new ROSA shoulder launch, ensuring and ramping up commercialization efforts in our hip franchise around the product launches that we have for hip.

因此，我們實際上將其中的很大一部分投入到了底部，但我們也將相當大的一部分重新投資到我們的優先領域，確保我們擁有適當數量的設備和儀器來進行非水泥應用以及透過ROSA 吸收Persona ，確保我們在新的ROSA 肩部發布中獲得適當的商業化和執行水平，確保並加強我們的時尚特許經營權圍繞我們的時尚產品發布的商業化工作。

So it really is a combination of both, and that's the great thing about this efficiency program. It enables us to reinvest back into our priority areas while dropping pretty significant substantial margin expansion now for the third year in a row.

所以它確實是兩者的結合，這就是這個效率計劃的偉大之處。它使我們能夠重新投資到我們的優先領域，同時連續第三年大幅降低利潤率擴張。

Helpful. And on the new comp plan that you called out, curious if that's going to have an impact on margins or just not material enough to impact margins? And then on M&A., just curious if there's been any change on the 2 years of EPS solution from M&A?

有幫助。關於您提出的新補償計劃，好奇這是否會對利潤率產生影響，或者只是不足以影響利潤率？然後在併購方面，我想知道併購後兩年的 EPS 解決方案是否有任何變化？

Yes. On the comp plan, it's not really going to have any material impact, and it's embedded in our guidance. I think it's more about a mix shift of how that comp plan is designed, right? Whereas previously, it was more focused and biased towards revenue growth. I think now what we're trying to do is get a greater balance between top and bottom line all the way through cash flow.

是的。在補償計劃中，它實際上不會產生任何實質影響，並且它已包含在我們的指導中。我認為這更多的是關於薪酬計劃設計方式的混合轉變，對吧？而以前，它更加關注並偏向收入成長。我認為現在我們正在努力做的是透過現金流在頂線和底線之間取得更大的平衡。

So it's really a mix shift in how we think about comp versus an increase in comp. And again, all of that is embedded into our guidance for '24. Relative to the dilution, we still think about 2 years from a dilution standpoint is reasonable. Of course, we'd like it to be inside of that. But just given where valuations are today as well as the cost of debt, which hopefully is going to come down over time, that's kind of where we see one of our guardrails.

因此，這其實是我們對薪酬與薪酬成長的看法的混合轉變。再說一次，所有這些都已納入我們的 '24 指導方針中。相對於稀釋，我們仍然認為從稀釋的角度來看2年是合理的。當然，我們希望它位於其中。但考慮到目前的估值以及債務成本（預計會隨著時間的推移而下降），這就是我們看到的護欄之一。

Katie, can we go to next question in the queue, please?

凱蒂，我們可以轉到隊列中的下一個問題嗎？

We'll go next to Jeff Johnson with Baird.

我們將和貝爾德一起去傑夫·約翰遜旁邊。

Ivan, maybe you mentioned in passing that shoulder for ROSA is not going to be a late year '24 launch. Just could you dial on that timing anymore. And I'd be interested in hearing about kind of your view on the uptake of ROSA shoulder, obviously, shoulder surgeries replacements technically more challenging. I think some questions about what role robots can initially play in those procedures. So just how does that help the uptake of ROSA and I don't think I heard a ROSA placement number. I think sometimes you give it on kind of an annualized basis. Any updates on kind of exiting '23 where ROSA placements were?

Ivan，也許你在傳遞 ROSA 肩膀時提到不會在 24 年末推出。你能再撥那個時間嗎？我很想聽聽您對 ROSA 肩部採用的看法，顯然，肩部手術置換在技術上更具挑戰性。我想一些關於機器人最初在這些程式中可以扮演什麼角色的問題。那麼這對 ROSA 的採用有什麼幫助，我想我沒有聽說過 ROSA 的安置數字。我認為有時你會按年計算。關於 23 年 ROSA 排名的現有情況有什麼更新嗎？

So I got to be careful what I say about time lines for ROSA Shoulder. I'll just say that I'm very confident that this is not a late 2024 launch. And as I mentioned, I think it's going to be very meaningful. So beyond being first to market, it's a high-quality product. It's going to be applicable for both reverse and anatomic surgeries. It Is going to simplify a very complex procedure. It is going to be fully integrated with the rest of the shoulder ZBH ecosystem. I believe it's going to get great traction in an ASC environment where speed and accuracy matters. And we're going to hopefully demo this next week at the academy meeting, whether it's ready or not, it would be demo there at the academy medium.

所以我在談論 ROSA Shoulder 的時間表時必須小心。我只想說，我非常有信心這不是在 2024 年底發布的。正如我所提到的，我認為這將非常有意義。因此，除了率先上市之外，它還是一款高品質的產品。它將適用於反向手術和解剖手術。它將簡化一個非常複雜的程序。它將與肩部 ZBH 生態系統的其餘部分完全整合。我相信它會在速度和準確性都很重要的 ASC 環境中獲得巨大的吸引力。我們希望在下週的學院會議上進行演示，無論它是否準備好，都會在學院媒體上進行演示。

Relative to your second question on the ROSA placements and the numbers, you should expect us to do around 300 installations per year. You should expect us to drive penetration rates of minimum 5% to 7% at least per year. You should expect that 1/3 of the ROSA -- overall ROSA knee installations are going to go into an ASC environment. And as I mentioned earlier to Joanne, you should expect that in a large percentage of cases, these ROSA installations are going to pull cementless. So again, great momentum with ROSA and I'm very excited about where we are with shoulder.

相對於您關於 ROSA 位置和數量的第二個問題，您應該期望我們每年進行約 300 次安裝。您應該期望我們每年至少將滲透率提高到 5% 至 7%。您應該預期 1/3 的 ROSA（整個 ROSA 膝部安裝）將進入 ASC 環境。正如我之前向喬安妮提到的，您應該預料到，在很大一部分情況下，這些 ROSA 裝置將採用無水泥施工。再說一次，ROSA 勢頭強勁，我對我們在肩膀上的進展感到非常興奮。

And maybe as a follow-up, just as I think about the 5% to 6% constant currency guidance in the 100 to 200 basis points above market, it seems like market is settling in at a good rate. If I think about gross margin, obviously, some of the hedge settlements should normalize as you get into 2025, E&O coming down, pricing getting less bad. So it sounds like gross margin, at least not a big day headwind going forward.

也許作為後續行動，正如我認為高於市場 100 至 200 個基點的 5% 至 6% 固定匯率指導一樣，市場似乎正在以良好的速度穩定下來。如果我考慮毛利率，顯然，隨著進入 2025 年，一些對沖結算應該正常化，E&O 下降，定價變得不那麼糟糕。因此，這聽起來像是毛利率，至少不會是未來的大逆風。

And then, of course, you've got cost savings initiatives here on the SG&A side. If I roll all that together, including the improving balance sheet and cash flow and a commitment to some share buyback, it feels like 10%, 10.5% EPS growth, which is kind of the midpoint of your guidance this year if it were for tax rate and FX headwinds. That sounds like it could be a sustainable kind of target. I'm sure you don't want to lay out an LRP here out of your Analyst Day. But is there anything in my taking there that would say 10%-ish plus or minus is not a reasonable kind of longer-term EPS growth rate to be thinking about?

當然，您也可以在 SG&A 方面採取節省成本的措施。如果我把所有這些綜合起來，包括改善資產負債表和現金流，以及承諾回購一些股票，感覺每股收益增長 10%、10.5%，如果是稅收的話，這就是你們今年指導的中點利率和外匯逆風。聽起來這可能是個可持續的目標。我確信您不想在分析師日期間在此制定 LRP。但我認為 10% 左右的加減不是值得考慮的合理的長期每股盈餘成長率嗎？

Jeff, I think that was actually a really good articulation and summarization of what we're trying to get across. In fact, if you look at our guidance today on reported EPS, it would suggest 6% to 8% at both ends of the range. That's after overcoming about 400 basis points of headwind between nonoperational things like interest expense, FX and tax rate, right?

傑夫，我認為這實際上是對我們想要傳達的內容的非常好的闡述和總結。事實上，如果您查看我們今天公佈的每股盈餘指引，您會發現該範圍的兩端均為 6% 至 8%。那是在克服了利息支出、外匯和稅率等非營運因素之間約 400 個基點的阻力之後，對吧？

So again, that's about a 400 basis point drag that's embedded in that 6% to 8%. So the way you're thinking about it, could we be in that low double-digit ZIP code on EPS in a sustainable durable way. I think, yes.

再說一遍，這大約是 400 個基點的拖累，其中包含在 6% 到 8% 之間。因此，按照您的想法，我們是否可以以可持續持久的方式實現 EPS 的低兩位數郵遞區號。我想是的。

Katie, do you have another question in the queue?

凱蒂，您還有其他問題嗎？

We'll go next to Richard Newitter with Truist Securities.

接下來我們將介紹 Truist 證券公司的 Richard Newitter。

Just with AAOS next week, I was wondering, anything that we should be on the lookout for with respect to Canary or Persona IQ rather and data presentations. I think you had also mentioned on the prior call, you were expecting a GLP-1 kind of data analysis, possibly at AAOS. And then I have a follow-up.

就在下週的 AAOS 上，我想知道我們應該關注 Canary 或 Persona IQ 以及數據演示方面的任何內容。我想您在之前的電話會議中也提到過，您期望進行 GLP-1 類型的數據分析，可能是在 AAOS。然後我有一個後續行動。

So the answer is yes to both, Richard. So we will have some data points on Persona IQ, and we'll have some data on GLP-1. On Persona IQ, we moved from a limited market release in '23 to a full market release in '24. We got the value proposition finalized. We got over 2 billion data points. We understand this is a product that is going to enable clinicians to intervene when needed. We've got data points on how this product will reduce overall complexity in the episode of care, how we can, by intervening soon, reduce costs, especially post surgery when it can be pretty taxing. We done with reimbursement. We spoke about the NTAP, new technology add-on payment, which we got back in October. So that's in full launch mode.

所以答案都是肯定的，理查德。因此，我們將有一些關於 Persona IQ 的數據點，我們將有一些關於 GLP-1 的數據。在 Persona IQ 上，我們從 23 年的有限市場發布轉向了 24 年的全面市場發布。我們最終確定了價值主張。我們獲得了超過 20 億個數據點。我們知道該產品將使臨床醫生能夠在需要時進行幹預。我們已經掌握了有關該產品如何降低護理過程中整體複雜性的數據點，以及我們如何透過快速介入來降低成本，尤其是在手術後可能會非常繁重的情況下。我們已經完成了報銷。我們談到了 NTAP，即新技術附加支付，我們在 10 月收回了它。這是完全啟動模式。

We will submit -- Larry always asks me this question, we will submit for a TPT coming at some point in the spring summer. And we're going to bring some data around some of the experiences that we've seen with Persona IQ at the Cleveland Clinic, HSS and other facilities. So excited in terms of what we have with Persona IQ , more to come by the Academy.

我們將提交——拉里總是問我這個問題，我們將在春夏的某個時候提交 TPT。我們將提供一些關於我們在克利夫蘭診所、HSS 和其他機構使用 Persona IQ 所獲得的一些體驗的數據。我們對 Persona IQ 的成果感到非常興奮，學院也將推出更多內容。

And then for GLP-1s, yes, we're going to be sharing some of the data we've done in conjunction with the Academy. And what I will tell you is that so far, everything we've seen with GLP-1 is that it remains a tailwind. We're actually tracking the number of patients that are using a GLP-1 presurgery, and that number is in the 20% to 30%. So by all means this is not a headwind. And I'm glad that our conversation is being muted.

然後，對於 GLP-1，是的，我們將分享我們與學院合作完成的一些數據。我要告訴你的是，到目前為止，我們所看到的 GLP-1 仍然是一個順風車。我們實際上正在追蹤術前使用 GLP-1 的患者數量，該數字在 20% 到 30% 之間。所以無論如何，這不是一個逆風。我很高興我們的談話被靜音了。

Great. And then just piggybacking off to Jeff's question, even with potential earnings dilution if you're potentially going to be -- or have the potential to be in a low double digit or 10% plus earnings growth range and given your commitment to growing earnings faster than the top line where it sounds like 5% is kind of a sustainable floor, given your end market and your WAMGR. It sounds like no matter what, even with dilution over a 1.5, 2-year period, you feel confident or we should feel confident in a high single-digit earnings growth rate at worst. Is that also a reasonable assumption based on all the different commitments and the commentary that you provided?

偉大的。然後順便回答傑夫的問題，即使有潛在的盈利稀釋，如果你有可能——或者有可能達到低兩位數或 10% 以上的盈利增長範圍，並考慮到你對更快增長盈利的承諾考慮到您的終端市場和WAMGR，聽起來5% 是一個可持續的底線。聽起來無論如何，即使在 1.5 到 2 年的時間內進行稀釋，你也會感到有信心，或者我們應該對最壞情況下的高個位數盈利增長率充滿信心。根據您提供的所有不同承諾和評論，這也是一個合理的假設嗎？

Well, I think what you're asking is, can you still sustain that in a world where you do a sizable M&A transaction if I've gotten that correct? That's really difficult to tell, right? Because no 2 deals are created equal. It's very situational. And so I don't want to get out there front footed to kind of hypothesize theoretically what could happen to EPS inside of sort of Maple Leaf deal.

好吧，我想你要問的是，如果我的答案是正確的話，在進行大規模併購交易的世界中，你還能維持這種狀態嗎？這真的很難說，對吧？因為沒有兩筆交易是平等的。這是非常情況化的。因此，我不想提前從理論上假設楓葉交易中的每股收益可能會發生什麼。

So I think that what you should take away is that from an underlying perspective at 5% to 6% organic growth with the levers that we have operationally, but also with the strength of our balance sheet organically that we can deliver that attractive earnings per share profile.

因此，我認為你應該明白的是，從根本角度來看，透過我們營運上的槓桿，以及我們資產負債表的實力，我們可以實現5% 至6% 的有機成長，從而實現具有吸引力的每股收益輪廓。

Katie, I think we have time for one more question if there's one in the queue.

凱蒂，我想如果隊列中還有問題的話我們還有時間再問一個問題。

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

我們將和雷蒙德詹姆斯一起去傑森貝德福德。

Yes. Sorry about that. I'll be quick. On the supply challenges that you incurred in '23, can you just remind me what was the impact of these challenges on the P&L last year, meaning is there a way to quantify the impact on revenue?

是的。對於那個很抱歉。我會快點的。關於你們在23年遇到的供應挑戰，你能否提醒我這些挑戰對去年損益表的影響是什麼，這意味著有沒有辦法量化對收入的影響？

Jayson, Suky here. It's a bit of more or less to try and say exactly how days on back order really impact sales. Because one, obviously, you have an impact on actual cases. But the more meaningful impact is the ability for our sales reps to go out there and actually hunt for new business, right? They're going to be a little bit hesitant to go shift and make conversions if they don't feel like they can supply. So that's actually probably the bigger impact, but trying to frame that in percentage points is very difficult to do. The way I look at it is as a tailwind from last year. We believe it's part of the -- sorry, it was a headwind for last year. We believe it's part of the tailwind that's going to help give us confidence in delivering that 5% to 6% organic growth for this year.

傑森，蘇基在這裡。或多或少試圖準確說明延期交貨天數對銷售的真正影響。因為，顯然，你對實際案例有影響。但更有意義的影響是我們的銷售代表能夠走出去並實際尋找新業務，對嗎？如果他們覺得自己無法供應，他們會有點猶豫是否要進行轉變和轉換。所以這實際上可能是更大的影響，但試圖用百分比來描述它是非常困難的。我認為這是去年的順風車。我們相信這是——抱歉，這是去年的逆風的一部分。我們相信，這是推動我們今年 5% 至 6% 有機成長的信心的一部分。

We have some internal data points that we don't share. What I will tell you, Jayson, is that new product launches, we had to do limited market releases instead of full market releases Persona OsseoTi, an example. Conversions, as Suky mentioned, we had to prioritize our friends and family customers versus converting accounts. And then the third headwind of supply from a revenue perspective, we couldn't embark on global expansion of these new product launches.

我們有一些不共享的內部數據點。 Jayson，我要告訴你的是，新產品發佈時，我們必須進行有限的市場發布，而不是全面的市場發布 Persona OsseoTi，例如。正如 Suky 所提到的，我們必須優先考慮我們的朋友和家人客戶，而不是轉換帳戶。從收入角度來看，第三個供應逆風是我們無法開始這些新產品發布的全球擴張。

So the example that I used earlier around Japan, second largest market in the world, we could have done things differently. We could have been in other markets. So it is sizable, and it is behind us.

因此，我之前在世界第二大市場日本使用的例子，我們可以採取不同的做法。我們本來可以進入其他市場。所以它很大，而且在我們後面。

Okay. That's helpful. Maybe just along a similar vein, I think you talked about a 50 basis point impact to revenue growth in the second half from Russia. Is Russia a net tailwind as we look to '24?

好的。這很有幫助。也許正是出於類似的原因，我認為您談到了俄羅斯下半年收入成長 50 個基點的影響。當我們展望 24 世紀時，俄羅斯是一個淨順風車嗎？

It is. It is. I would say it's less than 50 basis points, but given that we now have all the licenses secured we need to operate, that will be a tailwind, probably most pronounced in the third quarter because that's when we saw the biggest impact in '23.

這是。這是。我想說，這不到50 個基點，但考慮到我們現在已經獲得了運營所需的所有許可證，這將是一股順風，可能在第三季度最為明顯，因為那是我們在23 年看到最大影響的時候。

I think we're wrapped up with the queue and just hitting 9:30. So I'll turn it over to Ivan for some closing remarks.

我想我們已經排完了隊，現在才 9 點 30 分。所以我將把它交給伊万做一些結束語。

Sure. Thanks, Keri. I'll keep it short. I know we got to get going here. So a minute or less. I want to start -- I want to end the way that I started the call by thanking the team members, the almost 20,000 team members here at Zimmer Biomet, we're doing a remarkable job in executing the plans that we lay forward. So grew 7.5% constant currency in '23 with a nice EPS expansion of 200 basis points, that's after growing 6.6% in 2022.

當然。謝謝，凱裡。我會長話短說。我知道我們必須離開這裡。所以一分鐘或更短。我想以感謝團隊成員開始——我想以感謝 Zimmer Biomet 的近 20,000 名團隊成員來結束我開始通話的方式，我們在執行我們制定的計劃方面做得非常出色。因此，以固定匯率計算，2022 年成長 6.6% 後，2023 年成長了 7.5%，每股盈餘成長了 200 個基點。

And now we're committing to at least 5% revenue growth, 5.5% midpoint with nice EPS expansion and double-digit growth in free cash flow. So very proud of the work that team members are doing. But we're very excited about 2024. We are moving from remediation to -- we have moved from remediation to innovation. I'm excited about the pipeline of products. I'm excited about the financial profile that we're committed to of growing EPS faster than revenue and free cash flow faster than EPS.

現在我們承諾營收成長至少 5%，中間成長 5.5%，每股盈餘成長良好，自由現金流成長兩位數。對團隊成員所做的工作感到非常自豪。但我們對 2024 年感到非常興奮。我們正在從補救轉向創新。我對產品線感到興奮。我對我們致力於每股盈餘成長快於營收、自由現金流成長快於每股盈餘的財務狀況感到興奮。

And so far during the year, everything that we're seeing gives us confidence that is going to be a very solid year for Zimmer Biomet. So thank you for your attention this morning, and thank you, team members at Zimmer Biomet.

今年到目前為止，我們所看到的一切都讓我們充滿信心，這對 Zimmer Biomet 來說將是非常堅實的一年。感謝您今天早上的關注，也感謝 Zimmer Biomet 的團隊成員。

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

感謝您參加今天的電話會議。您現在可以斷開連線。