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Text: For today's call, I will provide opening comments, followed by Preston with an update on the Wright Medical integration.
Glenn will then provide additional details regarding our quarterly results before opening the call to Q&A.
For the quarter, we posted organic sales growth of 9.3%, reflecting growth versus 2019 for all our major businesses.
This strong result was driven by standout performances from Neurovascular, Mako, emergency care, sports medicine and our U.S. shoulder and total ankle products.
Each of these posted very strong double-digit growth.
International organic growth outpaced the U.S. at 14.2% despite COVID challenges in some countries.
We posted double-digit growth in most regions, including excellent results in South Pacific, China, Canada, South Korea and many countries in Western Europe.
We were also pleased to see the continued rebound in elective procedures as both hips and knees saw quarter-over-quarter sequential improvement and both returned to growth.
Also, now that we have a fuller appreciation of Wright Medical, we are delighted to have it within the Stryker family.
With our first half organic growth of 7.1%, combined with continued recovery of electric procedures, a strong order book across our capital businesses and new product innovations, we have increased confidence in the full year outlook.
This is reflected in our upward narrowing of organic sales guidance to 9% to 10% compared to 2019.
Our sales performance carried through the rest of our results with strong margin performance and adjusted earnings per share growth and cash flow conversion of over 100% in the quarter.
Through the remainder of the year, we do expect a disciplined increase in spending to support our future growth expectations.
Our bullish sales outlook, combined with ongoing execution on margins and continued progress on Wright Medical integration has resulted in a raised full year adjusted earnings per share guidance of $9.25 to $9.40 a share.
I continue to be impressed with the resiliency of our people and culture, which positions us well for a successful 2021 and beyond.
My comments today will focus on the second quarter performance of our combined Trauma and Extremities business, including an update on the ongoing integration of Wright Medical.
During the quarter, our combined worldwide Trauma and Extremities business, including Wright Medical had a strong performance, growing 7% compared to 2019.
The performance in the quarter was driven by double-digit growth in our U.S. Trauma and Upper Extremities businesses.
U.S. businesses were benefited by the recovery from COVID-related restrictions, which continues to outpace the rest of the world as well as the ongoing execution of the U.S. selling integration.
The Trauma business unit was positively impacted by the reopening of economies and the continued strong performance of key products, including T2 Alpha, and the mini-frag plating system.
Our U.S. upper extremities business, which remains number one in shoulder arthroplasty, grew strong double digits in the quarter behind continued strength within reverse ARPA plastic portfolio with Perform reverse and revision driving the growth.
The upper extremities performance in the quarter was enhanced by the continued adoption of our BLUEPRINT planning software with approximately 50% of total shoulder cases completed using BLUEPRINT.
As a result of the strong performance of our Trauma and Extremities business, which grew approximately 5% in the first half of the year, we are confident in the combined business to grow at least 6% for the full year when compared to 2019.
We are now about nine months into the integration of Wright Medical and we remain very pleased with the progress and efficiency at which the team is moving through the integration.
The U.S. integration is pacing ahead of our expectations and cross-selling has begun in a limited capacity.
We expect to continue to execute on our cross-selling priorities during the second half of the year as we work to fortify the supply chain and processes to support cross-selling activities.
Outside the U.S., the teams have successfully executed integration plans in several key markets, including the U.K., Germany, France, Japan and China with further countries to follow into 2022.
In addition to the commercial activities, we are also executing on the integration of other operational areas, including the consolidation of distribution and sales offices, harmonization of key operational processes and executing on our manufacturing site strategy.
Within R&D, the team also continues to make progress on aligning the long-term portfolio, pipeline strategies and harmonized design processes.
While the team has moved through the integration, they have also remained focused on executing the critical existing projects in the pipeline.
This includes the recent launch of the new Tornier Perform humeral system, which offers clinical solutions for the simplest and most complex arthroplasty procedures and delivers on our mission to make healthcare better for surgeons and the patients they serve.
Today, I will focus my comments on our second quarter financial results and the related drivers.
As a reminder, we are providing our comments in comparison to 2019 as it is a more normal baseline given the variability throughout 2020.
Our organic sales growth was 9.3% in the quarter.
The second quarter included the same number of selling days as Q2 2019 and Q2 2020.
Compared to 2019, pricing in the quarter was unfavorable, 0.6% versus Q2 2020, pricing was 5% unfavorable.
Foreign currency had a favorable 1.5% impact on sales.
During the quarter, we saw a recovery ramp of elective procedures and accelerated sales momentum as the impact of the COVID-19 pandemic has eased in most geographies.
However, the recovery ramp of elective procedures continues to be variable by region and geography and has a more pronounced impact on our orthopedic and spine implant businesses.
For the quarter, U.S. organic sales increased by 7.5%, reflecting the recovery of our procedural business and continued strong demand for Mako, medical products and neurovascular products.
During the quarter, we had strong sequential improvement in all our U.S. businesses.
International organic sales showed strong growth of 14.2%.
Our adjusted quarterly earnings per share of $2.25 increased 13.6% from 2019, reflecting sales growth and operating margin expansion, partially offset by higher interest charges resulting from the Wright Medical acquisition and a somewhat higher quarterly effective tax rate.
Our second quarter earnings per share was positively impacted from foreign currency by $0.04.
Now I will provide some highlights around our segment performance.
Orthopaedics had constant currency sales growth of 26% and an organic sales growth of 6.7%, including an organic growth of 8% in the U.S.
This reflects a ramp-up in elective procedures, especially in knees and trauma and extremities.
Our knees business grew 7.5% in the U.S., reflecting the strong bounce back as the COVID-related restrictions were lifted.
Other Orthopaedics grew 26.5% in the U.S., primarily reflecting strong demand for our Mako robotic platform, partially offset by declines in bone cement.
Internationally, Orthopaedics grew 4% organically, which reflects sequential improvement as the COVID-19 impacts have started to ease in Europe, strong momentum in Mako internationally and strong performances in Australia.
For the quarter, our Trauma and Extremities business, which includes Wright Medical, delivered 7% growth on a comparable basis.
In the U.S., comparable growth was 12.5%, and which included double-digit growth in our Upper Extremities and Trauma businesses.
In the quarter, MedSurg had constant currency and organic sales growth of 8.3%, which included 6.4% growth in the U.S. Instruments had a U.S. organic sales growth of 0.9%, primarily related to growth in smoke evacuation, lighted instruments and skin closure products partially offset by slower growth in power tools.
As a reminder, during the second quarter of 2019, Instruments had a very strong growth of approximately 19%.
Endoscopy had U.S. organic sales growth of 6%, reflecting strong performances in our Sports Medicine, general surgery and video products.
The Medical division had U.S. organic growth of 13.4%, reflecting continued double-digit performance in our emergency care business.
Internationally, MedSurg had organic sales growth of 15.9% and reflecting strong growth in the Endoscopy, Instruments and Medical businesses across Europe, Canada and Australia.
Neurotechnology and Spine had organic growth of 15.5%.
This growth reflects double-digit performances in all four of our Neurotech businesses: CMF, Neurovascular, Neurosurgical and ENT.
It also reflects very strong growth in our neurovascular business of approximately 30%.
Our U.S. Neurotech business posted an organic growth of 17.3% and highlighted by strong product growth in Sonopet IQ, bipolar forceps, max space, cryotherapy and nasal implants.
Additionally, our U.S. Neurovascular business had significant growth in all categories of our products, including hemorrhagic, flow diversion and ischemic.
Internationally, Neurotechnology and Spine had organic growth of 28.8%.
This performance was driven by strong demand in China and other emerging markets as well as Europe and Australia.
Now I will focus on operating highlights in the second quarter.
Our adjusted gross margin of 66% was a favorable approximately 15 basis points from second quarter 2019 compared to the second quarter in 2019, gross margin was primarily impacted by business mix and acquisitions, primarily offset by price.
Adjusted R&D spending was 6.6% of sales, reflecting our continued focus on innovation.
Our adjusted SG&A was 33.4% of sales, which was slightly better than the second quarter of 2019.
The reflects our continued cost discipline and fixed cost leverage, offset by the impact of the Wright Medical acquisition.
In summary, for the quarter, our adjusted operating margin was 25.9% of sales, which is five basis points improvement over the second quarter of 2019.
This performance primarily resulted from our positive sales momentum combined with the disciplined ramp-up in costs offset by the dilutive impact of acquisitions.
Based on our positive momentum, we continue to reiterate our op margin guidance for the year of 30 to 50 basis points improvement over 2019, excluding the impact of Wright Medical.
Related to other income and expense, as compared to the second quarter in 2019, we saw a decline in investment income earned on deposits and an increase in interest expense resulting from the additional debt outstanding for the funding of the Wright Medical acquisition.
Our second quarter had an adjusted effective tax rate of 17% and was impacted by our mix of U.S. non-U.S. income and some adverse discrete tax items included in our provision to return adjustments.
Our year-to-date effective tax rate is 15.2%.
For the full year, we expect an adjusted effective tax rate of 15% to 15.5% with some variability in the remaining quarters, including a slightly lower rate in the third quarter and a more normalized rate in the fourth quarter.
Focusing on the balance sheet, we ended the first quarter with $2.3 billion of cash and marketable securities and total debt of $12.7 billion.
During the quarter, we fully repaid the $400 million of term loan debt related to the borrowings incurred for the acquisition of Wright Medical.
Year-to-date, we have paid down $1.15 billion of debt.
Turning to cash flow.
Our year-to-date cash from operations was approximately $1.3 billion.
This performance reflects the results of earnings and continued focus on working capital management.
And now I will provide a summary of our revised guidance.
Based on our performance in sales ramp in the second quarter as well as our capital orders pipeline, we expect 2021 organic net sales growth to be in the range of 9% to 10%.
As it relates to sales expectations for Wright Medical, we now expect comparable growth for Trauma and Extremities to be at least 6% for the full year when compared to the combined results for 2019.
If foreign currency exchange rates hold near current levels, we expect net sales in the full year will be positively impacted by approximately 1%.
Consistent with the upper range of our previous guidance, net earnings per diluted share will be positively impacted by foreign exchange by approximately $0.10 in the full year, and this is included in our revised guidance range.
Based on our performance in the first six months and including consideration of our improved full year Wright Medical performance impact, controlled spend ramp to facilitate growth and continued positive recovery outlook, we now expect adjusted net earnings per diluted share to be in the range of $9.25 to $9.40.
And now we will open up the call up for Q&A.

user
q2 adjusted earnings per share $2.25.
expect 2021 organic net sales growth to be in range of 9% to 10% from 2019.
expect 2021 adjusted net earnings per diluted share to be in range of $9.25 to $9.40.
expect continued unfavorable price reductions of approximately 1% in 2021.
stryker - if foreign currency exchange rates hold near current levels, expect earnings per share will be positively impacted by approximately $0.10 for full year.

assistant