Welcome to Stryker's Third Quarter 2014 Earnings Conference Call. My name is Adrian and I will be your operator for today's call. At this time, all participants are in a listen-only mode. Following the conference, we will conduct a question-and-answer session. (Operator Instructions). This conference call is being recorded for replay purposes. Before we begin, I'd like to remind you that discussions during this conference call will include forward-looking statements. Factors that could cause actual results to differ materially are discussed in the company's most recent filings with the SEC. Also the discussions will include certain non-GAAP financial measures. Reconciliation to the most directly comparable GAAP financial measures can be found in today's press release, that is an exhibit to Stryker's current report on Form 8-K filed today with the SEC. I will now turn the call over to Mr. Kevin Lobo, President and Chief Executive Officer. You may proceed sir.

Good afternoon everyone and welcome to Stryker's third quarter 2014 earnings call. Joining me today are Bill Jellison, our CFO; and Katherine Owen, Vice President of Strategy and Investor Relations. Following my opening comments, Katherine will provide an update on our M&A activity. Bill will then offer details on our quarterly reports, before turning it to Q&A. Our top line performance strengthened in Q3, with organic revenue growth of 8%, which did include the benefit from one extra selling day, that contributed roughly 1%. These results reflect solid year-over-year growth for all three business segments; Reconstructive, MedSurg, and Neurotechnology and Spine, while also being balanced geographically. Within Reconstructive, trauma and extremities continued its lengthy string of double digit increases and U.S. hip implants were also a standout. MedSurg's impressive gains in instruments were bolstered by acceleration in Neptune sales, and in medical we are seeing early signs of a strengthening in the CapEx environment. Our Neurotechnology and Spine Group reported double digit growth in the neuro businesses, partly offset by lower growth in spinal implants. From a geographic perspective, both the U.S. and international delivered high single digit year-over-year organic growth. Europe continues to gain traction, and our strong performance in emerging markets reinforces our view of this segment's long term potential to contribute meaningfully to our growth goals. Overall, the strength of our diverse revenue base, enabled us to offset some challenges and achieve impressive growth. As Katherine will discuss, we are working to drive greater momentum with MAKO, and while sales are pacing below our target, the pipeline development is encouraging as is our clinical progress. Gross margin was similar to Q2, as we are seeing the impact of a modestly tougher pricing environment, coupled with the negative effect of mix with existing products and acquisitions. Shifting to SG&A, our focus on reducing costs is evident, as we continue to drive this down as a percent of sales. We realize additional P&L leverage, as the benefits from our recently opened European Regional Headquarters contributed to a lower tax rate. With the strong pipeline, reduction in operating expenses and the lower tax rate, offset by meaningful investments in R&D, we delivered adjusted EPS of $1.15 a share, up 10.6% year-over-year. For the full year, we are confident in our ability to achieve organic sales growth of 5% to 6%. We expect adjusted EPS to come in at the low end of our $4.75 to $4.80 range, owing to the tougher foreign exchange environment that Bill will elaborate on. Also, the creation of our European Headquarters will enable us to repatriate approximately $2 billion of O-U.S. cash over the course of 2015. With that, I will now turn the call over to Katherine.

Thanks Kevin. The focus of my comments today will be on providing an update on the performance of our recent key acquisitions. Encouragingly, the acquisitions of Trauson, Berchtold and Patient Safety Technology, which we reviewed in detail on our Q2 call, all continue to track with our expectations, while Pivot is running slightly ahead, as we leverage the strength of our considerable endoscopy sales channel. Shifting to MAKO, overall we are encouraged by the progress we are making, while recognizing some challenges. Our capital sales are pacing behind our initial targets, but we have made progress each quarter, with a total of eight robots sold in Q3. We are confident that the market for robots is improving, as we have a strong pipeline of deals we are working on closing. We expect continued sequential improvement in Q4 and into next year for several reasons. Firstly, we are in the final stages of the integration of the MAKO selling organization into our recon sales force, and the development of sales coordination between the MAKO capital sales reps and our very large recon implant sales force. The first stage was completed in April, as we move the MAKO selling and service organization into our recon division and under recon management and establish near term incentives. We continue to work toward full integration into a single implant and selling organization. Gaining near term sale synergies has proven to be more challenging than we anticipated, but we are encouraged by the recent momentum. Secondly, we have developed and are expanding our flexible financing offering that we believe a number of hospitals will find attractive, as we look to leverage our considerable expertise in this area. On the clinical front, we have completed enrolment in our total knee trial and continue to target FDA approval in 2015. Turning to SBI, we are very pleased with the early integration, with sales tracking ahead of our initial expectations. We have trained over 100 Stryker reps on the STAR ankle and various products. By the time the training is complete, we will have over 200 reps trained and selling the STAR Ankle and over 400 reps trained in selling SBI's various upper extremity products. Its important to note that the STAR Ankle is a fourth generation design with over 28,000 total ankles implanted globally. There are now well over 100 clinical studies on the STAR Ankle, with one of the newest published by Dr. Michael Kaufman [ph], where he reported 94% survivorship at an average of 12.6 years. We believe these favorable long term results are helping to differentiate the STAR Ankle from our competitors, and reinforce the benefits of three-piece mobile bearing technology. With that, I will now turn the call over to Bill.

Thanks Katherine. Sales growth was positive by 11.1% in the third quarter, including a negative 0.2% impact from foreign exchange translation. Constant currency sales increased 11.3%, which includes organic growth of 7.8%. We had a positive impact from one more selling day in the quarter, which had a positive impact on growth of approximately 1%. Earnings per share on a GAAP basis for the third quarter were $0.16 per share versus $0.27 per share last year, while adjusted earnings per share were $1.15 for the quarter versus $1.04 last year. This quarter's earning per share includes a negative impact of approximately $0.01 per share from foreign exchange due to currency movements later in the quarter. If foreign exchange rates stay on current levels, this year will be negatively impacted by approximately $0.12 compared to last year, or approximately $0.04 per share worse than what we anticipated at the end of the second quarter. Based on the current volatility of foreign exchange rates, we would expect 2015 to be negatively impacted by roughly $0.10 to $0.12 per share. This negative impact is largely driven by the translational component of foreign exchange, which we do not hedge. The transactional impact of foreign exchange on earnings is being mostly offset by both natural and real hedges, which we continue to layer into our operations. The most significant non-GAAP adjustment in the quarter relates to tax expense, associated with both the transfer of intellectual property to the Netherlands from some of our other European locations and for planned tax payments associated with approximately $2 billion of cash repatriation associated with this transfer. I will discuss both of these items a little more, when I discuss our tax rate. Also in the quarter, we incurred a charge of approximately $25 million associated with the voluntary…

(Operator Instructions). And your first question comes from Mike Weinstein from JPMorgan. Please go ahead.

Thanks for taking the question. So I wanted to talk about really two items. One was the MedSurg performance this morning. I was hoping you could discuss the environment and how you think it evolved in the quarter, both the U.S. and in Europe. And then second Bill, it looks like the gross margin came in lighter than you were baking, maybe a month ago, and I assume part of that is mix, maybe part of it is FX, I was hoping you could tease that out for us a little bit. Thanks.

Mike, I will take the first part, in terms of the MedSurg performance, and I am overall, really pleased with what we saw in the quarter. I would say for the higher ticket capital products that are predominantly in our medical business, although to a lesser degree, in endo, we are seeing signs of strengthening. How strong that ends up being tough to tell, because this is really the first quarter where we feel comfortable commenting that it feels that the CapEx environment has strengthened. Instruments is really hitting on all cylinders. Clearly, the Neptune relaunch continues to gain traction. But as mentioned, even excluding that, we had solid double digit growth. So its really across the board. Endo really benefited from the acquisition, as we mentioned before, they had challenging year-over-year comparisons. So I think overall, we feel good about the environment, and feel like there has been very strong momentum going into the fourth quarter, which as you know, is typically -- a particularly strong quarter as it relates to CapEx.

Mike, then on the gross margin rate, as far as our expectation. Actually the margin rates for the quarter came in relatively close to what we were expecting. We were expecting, as I mentioned before that this was going to be our toughest gross margin comp quarter. I'd say that pricing was incrementally a little bit worse than what we expected, so it did have a little bit of additional impact on the rate, but not much in relationship to what we were expecting. We expect it to be relatively close to the rates that we ran at in the second quarter, and as I mentioned, that's pretty consistent with our expectations moving into the fourth quarter this year and as I also mentioned, that should be more in line with kind of the rates that we were running last year in the fourth quarter as well.

Okay. If I can just ask one follow-up. So Bill, at the analyst meeting, you made some comments just relative to the ability to drive operating leverage in 2015. Can you just, with this quarter now behind you and you have kind of seen what the gross margin progression looks like, is that -- are you still confident in your ability to drive operating leverage next year?

I think our broader based comments, first just talking about rate improvements in future periods. We generally talk about that over the next few years, but we are absolutely focused on targeting improvements in operating margin rates, not gross margin rates, but operating margin rates on average over time. we did state though however for next year that because of our investments with some of the tax benefits that half of those tax benefits would be actually reinvested directly in our business, and that will also obviously add pressure associated with the rate in that period.

So Mike, its Kevin, just to add. So obviously we will give guidance in January, and you should expect to see leveraged earnings. We obviously don't spike out the guidance specifically in every line of our P&L. The last two years on an operational basis, we were able to have gross margin gains over the last couple of years. Clearly, our mix of our business has changed, based on both our acquisitions as well as MedSurg growing, but we do have our GQ&O efforts clearly focused on driving improvement in our comps. But with price now tracking more towards a 2% range, its certainly an area of extreme focus for us. But you will see, when we give our guidance in January, the degree of leverage that we will be delivering in 2015.

And our next question comes from David Lewis from Morgan Stanley. You may proceed.

Good afternoon. First question, Katherine, just based on some of your comments on MAKO. Just a few things I was wondering you could elaborate on; one was, you talked about sales synergies being a little more challenging than you expected, and then also new financing options for customers, and I guess in light of the CapEx improvement, very curious in terms of what does that mean? Are you experimenting with sort of lease type models, reagent rental type models, so those two dynamic sales and financing options for customers regarding MAKO and then I have one follow-up?

Okay. So to take the second part, we have offered through our Flex Financial Group financing options, because of the capital components that exists within many of our MedSurg businesses. So we have been in that financing area for a number of years. What we are doing, is expanding that and leveraging that expertise over to the recon side, where the MAKO capital fits, and really helping them work with some of the budget limitations that exists between capital and operating budgets within a hospital. So a variety of different options that we are looking at, but its clearly a skill we have, and something that MAKO couldn't, at their point in their trajectory offer to customers. In terms of the integration, I think the most challenging part, and I think its fair to say, we underestimated the complexity of it, but feel very comfortable with the trajectory we are on. Its just integrating a capital salesforce alongside a very large implant salesforce, and going through the necessary training and coordination that has to take place in existing accounts. So its nothing truly unique, its just, it’s a big job to do, given how large our salesforce is. So we are making really good headway, very excited about the pipeline we are seeing and our ability to continue to drive sequential acceleration in robot sales.

Okay. That's very helpful. And then Bill, just a question on the balance sheet; obviously with their [indiscernible] event, your balance sheet is going to expand in size here over the next six months. And Stryker is in this interesting position right now, where you basically are the most underlevered company in all large cap med-tech and there is an increasing trend largely to M&A increase that relative rate of leverage. But I am just sort of wondering, given that increase in cash over the short term, which is going to be quite rapid, can you think about the spread between your cash interest and what you can get in the credit markets, that spread is actually pretty narrow. So you start thinking about different level of capital structure that's appropriate for Stryker, given your cash balance is going to expand here rapidly in the next six months?

Well I think its fair to say that we definitely believe that our balance sheet is very strong across the board and has been. And so we always want to make sure that we are putting the broader based assets that we have to work as efficiently and effectively as we can. I think as Kevin mentioned multiple times, we are absolutely first and foremost focused on acquisitions, but dividends and stock buybacks are also a key part of our overall cash structure strategy. Just keep in mind as well too, that as we move forward here, we have been booking and accruing an amount on our Rejuvenate claims, at some point, those will potentially be paid out. So we have to make sure that we are covered for that situation. But also on the cash repatriation side, also keep in mind that as I mentioned, most of that cash won't occur actually until the back half of 2015. But you can be assured that we are actively looking at how to best utilize that cash moving forward.

And our next question comes from Kristen Stewart from Deutsche Bank. Please proceed.

Hi, congrats. Hear me okay?

Yeah, hi Kristen.

Okay perfect. Thanks. Sorry about that. I just wanted to ask a question just kind of, if you can give us your broad I guess view on just the overall recon market, and in particular, your performances in Europe or within international markets seems to be improving nicely. Maybe just walk us through I guess, what you are seeing if you're seeing underlying improvement, if you would expect to continue to see improvements going forward sequentially, seasonality, and I think you do have a, one last selling day in the fourth quarter as well, I just wanted to confirm that?

Yeah. We do have one last selling day in the fourth quarter, and I would say that, it’s a little bit geographic dependent, but clearly the momentum we are seeing in Europe continues, and that's helping that O-U.S. growth, recognizing as we mentioned, we did have some very difficult comps, particularly on the hip side. Japan, with the price cuts have been challenging and also, we have been working through, and largely are past that now, but there were implications tied to the ERP implementation that we talked about previously. But overall, feel pretty good about the environment.

Okay. And then on the U.S. side, any comments there, in particular?

Yeah I mean, a little tough, because obviously we don't have all the numbers in yet, but in terms of hips, we feel pretty comfortable that we are growing ahead of the market, even after adjusting for MAKO. These for the past eight quarters, we have kept pace with the market. We may be a little trailing in that this quarter, but we will have to wait and see as everybody else's numbers come in. It does seem like overall, this is a year where the hip market is stronger than the knee market. Seasonality, I think you're going to see a similar dynamic recognizing that was exceptionally strong in the fourth quarter last year, so its really difficult to predict if we are going to have that healthy of a seasonality effect. But clearly, Q4 is going to see the benefit of that seasonality.

And our next question comes from David Turkaly from JMP Securities. Please go ahead.

Thanks. Just quickly, I think you said that U.S., the knee pricing was stable. Did you guys quantify that in terms of a percent, the pricing impact on those two lines?

No. What we said was, in the U.S., hip and knee pricing was consistent with what we saw in the second quarter of this year's -- approximately in that mid single digit range.

So mid single digit range for both?

Yes.

And I guess, given the better CapEx environment you guys talked about, I am curious if you guys have any comment on sort of utilization or overall procedural volume or sort of surgeon backlog here. Any thoughts or any updated thoughts on that, post this quarter?

No. I don't think we have any real insights to offer there. It does seem like the CapEx environment did modestly improve. But again its one quarter, and its tough to know, if that is a trend that's going to be indicative of accelerating unit volume. So overall, feel good about the momentum we are seeing, but we don't really have any insight, as it relates to physician volumes or [indiscernible] and the like.

And our next question comes from Matt Miksic from Piper Jaffray. Please go ahead.

Hi. Just following to hospital capitals, one follow-up there on strength. You talked about it potentially improving here towards the end of a seasonally strong fourth quarter. You mentioned last year I think Kevin, you had spoken quite a bit about this sort of collaborative approach across to this line, but they are sort of customized flexible financing approach, this contracting with hospitals, based on capital or operating pricing; [indiscernible] capital business lines; what you're seeing in your estimation seasonal and sort of market improvements or to what degree do you think you're taking share because of some of the programs you've put in place? And I have one follow-up.

Okay Matt, first of all for the follow-up, if you are on speaker, I'd appreciate if you could just get off the speaker, because we had a little trouble hearing you. But I think I got the gist of the question, and so clearly, we do have a lot of flexible programs, we are collaborating across our divisions. But I would say at this stage of that work, its really more about our teams executing directly with our customers, and we clearly saw a nice performance in medical last quarter, and the second quarter, and that also accelerated very dramatically in the third quarter. So part of it is, the market is improving. We can see conditions in the market improving, and part of it is our execution. Really difficult for me to parse, which one of those two, and when more people report this quarter, we will have a better sense on how much of it is growing with the market, versus how much is taking shares. My sense is, we are probably growing a little faster, but I can't dimensionalize that for you just yet. I would say, our collaboration efforts, its still early, we were getting some wins, but I wouldn't attribute the bulk of our success to that. Its really more about our -- our team is really performing well in the market.

Thanks for that. The follow-up maybe for Katherine on MAKO. You had mentioned adjusting for hips, and we certainly have heard more interest on the hip side. As you complete this integration and head into the end of the year, is there something that you can give us that we might view as sort of capital as heading into next year. And to what degree is the hip emerging as sort of an important application whereas maybe a year or two ago, kind of view it as sort of maybe a less interesting opportunity than the knee side?

So thanks. I think there is a couple of things. I would go back to all the products we highlighted, the Stryker products that we are going to be putting on the robot, targeting for 2015. On the hip side, where they obviously have an indication, and we would agree, we are seeing increasing interest there, and then clearly, our expectation to get approval with triathlon on the robot in 2015. So those are probably the two major triggers. Now keep in mind, we are going to have to do training and software upgrades and there is going to be work to be done and make sure this launch is executed in such a way that we can achieve our goals, and that's why we continue to point to -- think about 2016 as the year when we are really going to be on a trajectory where its indicative of us taking meaningful market share gains.

What I would add is, Matt, just to add one comment. The hip application, we were certainly excited about it, the software improvements and the last version that was done just prior to our acquisition, and made a big improvement. But surgeons for the most part are pretty happy with our hips, so this requires really a change management with surgeons, to really get to try it and have a good experience and having our implants of course that will help dramatically with that. But we still see the total knee as a much bigger opportunity. There is less overall satisfaction with patients and the perception of improvement we think is far greater than total knee. So there is certainly going to be growth in both areas, but the knee still for us is the biggest opportunity.

And our next question comes from Raj Denhoy from Jefferies. Please go ahead.

Hi. Good afternoon. I wondered if I could just ask on the pricing environment in the United States. One of your competitors earlier this week talked about worsening pricing, particularly on the hip side, and you are talking about a much more stable environment, and just curious if you have any thoughts around why we would be seeing this dichotomy or this diversion in pricing in the market?

I think we are actually experiencing some very similar pricing phenomenon, and so the characterization is last year versus this year, or how things are going from quarter-to-quarter this year. So certainly versus the prior year, we are seeing a moderate acceleration in price pressure, or prices have certainly declined. When we characterize it as stable, its really over the course of this year. But when you compare the prior year, certainly, we are seeing an acceleration, and that's why we are now modeling for total company price decrease of roughly 2%.

Okay, that's helpful. Maybe I could ask one about MAKO as well. I think as you outlined at the analyst meeting, I mean, one of the interesting things about that now for you, is that you seem to broaden the offering in a sense to -- for hospitals in terms of not only offering better potential patient outcomes, but also looking at things like efficiency and infections and other sorts of benefits you might be able to get from the robot? And I guess the question is when we might start to see some of that data, so that you can present the much more compelling case to the hospitals to adopt it?

I would say that we are obviously continuing to analyze and look at data. I wouldn't point you to anything near term on the data front. I think this is really going to be getting this in the hands of Stryker and other physicians, leveraging the breadth of our product offering and then seeing, just as they did with [indiscernible] the benefits of having the consistency of results, reproducability, better patient experience, all those things that they will get a feel for, as they start to use the robot. I think long term, to think about this becoming more of a standard of care, that's when we are going to have to really look to start to have more clinical data. But I wouldn't point you to anything at the podiums or anything near term.

And we have Matthew O'Brien next with a question. Please proceed.

Afternoon. Thanks for taking the questions. Was hoping we can start on the extremity side of things. Kevin, this is an area that just continues to kind of boggle the mind as far as your growth rates go. I think you are about doubling the market in foot and ankle. Can you just give us a sense of -- is that share coming from some of the larger multinationals that are playing there, or coming from some of the more extremities focused companies at this point? And then with the integration of SBI, is there any reason to think you can't, even though you have more difficult comparisons coming up, grow somewhere around the 30%, maybe mid-20s level going forward?

Well certainly, I am not going to speculate on the growth going forward, because certainly, they define my expectations thus far. So when you're entering a new market, its really hard to predict. Obviously, when you're in an existing market, its much more easy to predict what the volume will be. I would say, most of the growth is really coming from expanding the market. We are calling on new surgeons that weren't putting in implants before. That has been really the engine of growth. Obviously, new products that we have been launching as well. The STAR ankle really fills a very important gap in the product portfolio. So we are really excited about that. And frankly we see, in a new market like this, continued opportunity for growth. So we are growing the market primarily. We are obviously taking some share as well. But at this point, I think we see robust growth going into the future. But what exactly robust will be, will remain to be seen. But we are extremely pleased with the performance, the dedicated business unit model is working. The certain segmentation that we created is working, and we are very-very pleased with the performance.

Thanks. And as my follow-up, the neuro business which seems to get overlooked here, looks like it improved sequentially here in the third quarter, which historically has not done. Can you talk a little bit about what some of the growth drivers there? It sounds like, I think from last quarter, you mentioned hemorrhagic is the primary growth driver. Is the momentum in that business strengthening at this point?

We have three business units within our Neurotechnology business and all three businesses are performing very well. In fact, in this quarter, the neuro-powered instruments was really the strongest growth of the three. But neurovascular, which is really just the coils [ph] for neuro, also grew very-very well, as did our craniomaxillofacial business. That CMF business has been sort of a double digit growth business as well. Growing very well, with custom cranial implants and a number of other new products. So all three business contributing very evenly to the nice double digit performance.

Thank you.

And our next question comes from Bruce Nudell from Credit Suisse. Please go ahead.

Good afternoon. Kevin and Katherine, to my recollection, minus five or --

Bruce sorry, can you just speak up a little bit? We are having trouble hearing you.

Yeah, I am sorry. To my recollection, could you hear me now?

Better. But if you can speak loudly please.

Yes. To my recollection, mid-single digit negative price in hips and knees in the U.S. is kind of at the high end of historical levels. Has there been a secular change and what might be driving that, and is it reversible?

I would say, what we see -- there is nothing new in terms of the trends, whether its physicians becoming employees of hospitals and greater alignment there or transparency around patient pricing, and also keep in mind, product cycles. Accolade II for example, we got a nice price premium for that, but you do anniversary those from a couple of years into the launch. The product cycles definitely see an impact. So while it has declined, I wouldn't say, we are seeing a step function change. Mid single digits is in the 3% to 5% range. So again, nothing really significantly different, and clearly stable -- and are largely stable through the first three quarters of this year.

Okay. And my follow-up Kevin is, clearly you guys --

Bruce I am losing you. I am sorry Bruce.

I am sorry. You didn't expect to have Stryker implants on MAKO this year. What is surprising you about the difficulty of MAKO robot placements?

I think the biggest thing is just the pace of the integration, and we were probably a bit -- we weren't probably, we were overly optimistic on how quickly we could integrate and do all the coordination that's required between the capital reps and our very large Stryker implant reps, and there is a lot of coordination, particularly when you get into individual accounts. Certain regions have embraced it, they understand the differences in implant sales versus the CapEx sales and how to partner, and there we are seeing great success and uptick in utilization. But we are only a couple of quarters in and its going to take some time here to really leverage that breadth of combining those two sales forces. So nothing that's significant or really different. It was really just us being overly optimistic about the pace of managing that integration.

Yeah Bruce. The other thing I'd add is, there were certain parts of the country, where some of our customers wanted better use of their robots. So there was a bulk buy that you may have heard about, that HMA had done. CHS bought HMA as a big chain, and they weren't really pleased with the performance of some of their robots. So we actually went about transferring, and went through a big process to actually transfer and move about six or seven robots to [indiscernible] high performing locations. That look a lot of effort on the capital sales team that’s normally focused on selling, to actually shift and transfer. That will pay dividends for us going forward, but its obviously tied up a lot of activity. So when you integrate a company, you have to go through these kinds of stumbles I would say. It certainly hasn't taken away any of our enthusiasm. The robot sales force is still intact, and the funnel is really nice and filling up very nicely. So we are excited about being able to continue to improve. But those are some of the stumbles we had to kind of go through. Relationships are everything and building relationships for the big recon sales force is time consuming. And so its below our expectations, but certainly the promise is every bit as exciting as we thought when we did the acquisition.

And our next question comes from Glenn Novarro from RBC Capital Markets. You may proceed.

Hi. Good afternoon Two follow-up questions on pricing. One, the mid single digit knee and hips pricing in the U.S., does that include or exclude mix? Or maybe the question should be, are you getting any mix in this environment? And then a question on spine, I think you called that out as pricing getting a little worse. Can you quantify what the spine pricing was, and provide some commentary why the spine pricing got worse? Thank you.

Yeah. So that is pure price. We are getting some mix, which is partly offsetting that, and that's what we report in a combined volume mix number being north of 10%. So a little bit of price, but it does not fully offset what we are seeing on the overall pure pricing side. In terms of spine, pricing there is challenging and that's part of the year-over-year decline in our pricing, to the 2.3% as Bill referenced. Part of it is just the mix of our businesses and greater pressure on certain types of products. But we are managing through that. Really excited about some of the new products and the leadership team that we have got in place there. So we expect to see some improvement going forward, but that's probably the key part that we would highlight.

And our next question comes from Bill Plovanic from Canaccord. Please go ahead.

Great. Thanks, good evening. So if I could just leverage off of Glenn's question and switch it over to the trauma. You mentioned pricing pressure on trauma. Maybe I have been paying attention, but historically that hasn't been an area that we have seen a lot of pressure, and I am just wondering, if you could give us more granularity on that? Then I have one follow-up.

So when we say pressure, its certainly a different type of pressure than you see in hips and knees. So its very low single digit. But trauma has historically been sort of flat. Sometimes we are going to be able to get a little bit in price, but if you look year-over-year, certainly, we did have a bit of single digit decline in price. Low single digit, it’s a change, its nothing dramatic, but obviously if you look at how much market share we have taken over the last few years, and we are starting to get a little bit of pushback from some of our competitors, caused a small amount of price erosion, nothing that's concerning. If you look at the overall growth of our trauma business, it hasn't hampered our growth, and not something that we are overly worried about.

Okay. And then just in terms of SBI, it’s a more specific question, but you closed on the international component of that. I mean what -- Katherine, what type of contribution should we expect from them in the quarter's going forward?

We haven't broken out the acquisition contribution by the individual pieces. I mean, clearly MAKO is the largest piece and we do have to go through the integration process with SBI. But I think with that group, with the foot and ankle up 30% without it, and then leveraging this product, we would expect a pretty healthy acceleration, obviously continuing to be in that double digit vicinity.

And our next question comes from Jeff Johnson from Robert W. Baird. Please proceed.

Thank you. Good evening guys. Wondered if I could start just one question on the spine side of the business, especially on the implant side, you know that has been kind of bumping along in the U.S. here, plus or minus a couple of points every quarter. We are starting to hear more and more pods or pod participation reversing in that. Any signs of that showing up, it doesn't seem like it in your numbers, but are you hearing anything out in the field along those lines?

No, it really hasn't changed. For every pod that goes away and new pods seems to pop up, it seems to be pretty stable overall. The fact that there is some prosecution, will hopefully turn that tide. We haven't seen that trend turn yet. For our business, obviously we had some challenges in the first quarter, we highlighted around some sales force disruptions. We are working our way through those challenges. We are also focused on upgrading our portfolio to have much more MIS products in our mix. Katherine just mentioned, we had spent some time with the spine team this week and very excited about the leadership. We have made some new leadership changes at spine, and exciting portfolio of products that we are going to start to see since the beginning of next year, which will hopefully make us less immune to the kind of price pressure that they have on the core spinal endpoint.

Fair enough. Thanks Kevin. And then Bill, just a follow-up question for you; you mentioned the $0.10 to $0.12 kind of incremental hit, or at least a $0.10 to $0.12 hit from currency in 2015 at current rates. Is that incremental to how you're thinking about it, maybe in the second quarter, is all that from the movements just over the past three months, and I know you haven't guided 2015 yet, but would you kind of take a look at our 2015 numbers and whatever we were thinking last quarter, maybe take that dime out at this point, or how should we think about that?

Sure. I think, one of the ways to kind of broadly take a look at that Jeff, that you should always be kind of watching. And it is definitely since the second quarter, in fact its really the changes that occurred really since the middle of August, on the rate side of the equation. So when rates move that much, and rates have generally moved about five to six percentage points across almost all the key currencies, we have got roughly 35% of our business is international. So think of in the kind of 2% range on our total earnings, just from the translation related impact. So that kind of should help kind of guide you to the level of impact that we would see on the overall operations. As we move forward, we don't know where rates are going to be as we move through, in the fourth quarter and into next year, right. So as we get a better look on it, we will obviously be giving better visibility when we give our broader guidance for 2015.

Plus we are obviously in the process of working through our budget for next year, and whether we will be able to offset any negative pricing is something we will provide more clarity to, in January.

And our next question comes from Richard Newitter from Leerink. You may proceed.

Hi. Thanks for taking the question. Maybe I could just ask on the capital spending environment. Can you parse out where or what kind of products in the capital equipment domain, within your MedSurg division are -- where you think things are getting better. And is this kind of also applying for bigger ticket items; because it sounded like MAKO, you didn't necessarily have much of a pickup on placing systems, but obviously the lower ticket items within your MedSurg division are -- is that the right characterization?

No. I would say MAKO is somewhat unique, because yes its capital, but really what we are focused on right now is the integration and the training and driving the coordination between our selling organizations and working with hospitals on the value proposition and the like. That's a little bit insulated or separate right now from the general hospital CapEx trends. I would say, if you look at our medical growth, clearly, very healthy, and that tends to be our larger ticket and more deferrable hospital capital equipment, and we are seeing good momentum and as we mentioned, early signs of an acceleration, recognizing its one quarter. So we will see how the fourth quarter plays out, but we are pretty optimistic about the momentum there. And then if you look at instruments, which has a lower component and a lower ticket CapEx, but still there, clearly whether its Neptune or excluding Neptune, they are seeing very healthy growth, which I think speaks more to the strength of the selling organization and the product portfolio and the value that Neptune brings, less so than a change that we are seeing in the hospital capital environment.

Okay. Thanks for that. And then just a quick follow-up on the pricing. I just want to make sure I heard correctly. I think you said spine pricing net of mix was down 10%, is that right? And then two, is there anything specific that you saw in the last kind of three, four, five months, on kind of spine pricing contracts coming out or a big contract coming up?

No. We didn't quote that number on spine pricing pressure. We are seeing pricing pressure in spine, and that really has to do partly with the product mix and some of the core spine fusion products. So we do think its going to improve going forward. Its clearly one of the contributors to the overall 2.3% pricing pressure we are seeing.

As it relates to contracts, they go through different cycles at different periods of time. So there isn't one overall contract that we'd point to. And if you've seen the spine market really, frankly over the last couple of years, a mid single digit decline in prices is what we generally see over a number of quarters.

And our next question comes from David Roman from Goldman Sachs. Please go ahead.

Thank you for taking the question. I wanted to come back to the gross margin. And I think the explanation around the trajectory is quite clear on what we have seen thus far. But as you look forward, as you add up the headwinds and tailwinds, at least the way I am thinking about, the headwinds are obviously product mix. In the near term, you have the impact of M&A and then pricing currency. But on the tailwind side, it seems like over time, some of those acquisition headwinds probably abate. You have the GQ&O efforts and then neuro seems to be doing pretty well, as is trauma and extremity. So can we --- what does it take to neutralize some of those forces around the gross margin line and flatten that out on a go forward basis.

So let me just hit on a couple of the ones that you just talked about. So from an acquisition perspective, absolutely. Acquisitions impacted in a period only, right. Once it anniversaries itself, now its part of our base, and also keep in mind, as we move into the end of the integration of acquisitions, that's actually a piece that helps us improve margin rates over time, because we can ultimately leverage some of the benefits of our broader operations to the GQ&O team to help those acquisitions improve. So its really just the one year, where it wasn't in the base, but its in kind of the current numbers. As far as for the product side of the mix, the general product mix, the large part of that is driven really by how strong our equipment growth and instruments growth has been broadly in this quarter. And at 16% this quarter, that was very strong. So I think we are still expecting to see good instrument strength, and MedSurg growth as we move into the fourth quarter, especially since we have not fully anniversaried kind of the relaunch of our Neptune product. But over time, we would think that that balance would be a little bit more in line with some of our historical related averages. And then, as it relates to pricing; pricing is incrementally a little bit stronger here, and that is something that our broader based GQ&O team is focused on, knowing that we need to be working hard at our broad based cost improvement initiatives to help offset those types of costs.

Okay, that's helpful. And maybe just a follow-up for Kevin or Katherine; as you think about the organic growth rate, at the Analyst Day, kind of one of the things that you tried to stress was the company's ability to sustain an above [indiscernible] growth rate, which obviously, based on the results today you're tracking well ahead of. But if you think, on a going forward basis, whether its in the context of the 5% to 6% that you're offering, what are the factors that lead things to be upside relative to either the current run rate, or what you're targeting here? Is it MAKO -- how much would have to come from the MAKO environment, versus anything you can do on the individual product side or share gain initiative?

So we're really obviously a growth oriented company, both in terms of the acquisitions that we pursue, as well as if you look at our R&D spend over the last few years. We are spending at a pretty healthy rate in R&D, and our new product cycle across all the division, which I get a chance to visit and do business reviews, are very exciting. So a combination of both internally developed products, as well as acquisitions, will continue to fuel, what Stryker has really been known for, for years and years and years, which are incredibly strong and talented sales organizations, that can really deliver results. And you're seeing that. You're seeing us perform above the market over quarter after quarter after quarter, and with the pipeline of products coming in and feeding into these really specialized dedicated sales forces, we see this as a sustainable engine for continued strong growth.

And our next question comes from Bob Hopkins from Bank of America. Please proceed.

Hi thanks. Can you hear me okay?

Yes we can. Hi Bob.

Hi great. Good afternoon. So two things, first on the repatriation opportunity, I think this is an obviously question, but I just want to be clear. So that opportunity is an opportunity to bring cash back to the United States, without paying a tax penalty, correct?

So the tax penalty that we are talking about, would be relatively minor, and actually, part of the tax hit that you see in this quarter, include the cost of bringing back those funds. So once we, in essence, make a decision that we are ultimately going to be bringing back funds from O-U.S., which we actually did this quarter, we have to actually book that U.S. tax in our GAAP numbers right upfront once we make that decision, because the specific action associated with, on an expectation of how we are going to utilize that cash. So that's already reflected, and we would not expect to book any additional tax charge when we repatriate that, but we would then have the cash outflow of the tax that we have already accrued now.

So Bob, so obviously the tax charge we have has two components. So it’s a moving of the IP, as well as repatriation. But the repatriation is in the 5% kind of range, its similar to the tax that we paid when we had those holidays to bring back cash, a very-very nominal rate [indiscernible] bring back. If we try to bring back further dollars, then we would have to pay a much higher rate, which is not interesting to us.

Okay. I will want to understand the mechanism of that a little better. But I will save that for a later time. The other quick question I wanted to ask was just, back on pricing and the -- I understand the comment about sort of sequentially seeing a stability in the rate of change versus what you've seen over the last couple of quarters. But Kevin as you look forward, just maybe express your confidence that you can maintain relative stability in the level of decline in pricing versus where you're right now, as we again look forward into, not just Q4, but thinking about 2015. I think that's a hot button issue for a lot of investors, and we'd just love to hear reviews on how confident you are, that that can remain stable.

Well Bob, obviously I don't have a crystal ball to know exactly what the future is going to hold. I would say there are no new dynamics at play. So these are the same dynamics we have been saying over the last couple of years around physician-hospital alignment, around contracting, the pressure that hospitals are feeling. So its similar dynamics. We are seeing stability over the course of the last couple of quarters. It is a little bit more under pressure than it was in the prior year. But if we saw a new catalyst that would be something that I'd be more worried about. But its really the same catalyst and contracts sort of come and go. There is different cycles that are underway, and as MAKO ramps and as we start to place robots, we really believe that as a fantastic differentiator for us, and something that we will be able -- for Stryker at least, to insulate us from some of the price pressure going forward. So that for us is one of the key advantages. But the marketplace hasn't fundamentally changed. There are no new catalysts. If there were, then that would be -- it would create a lot more uncertainty for me, and what we are seeing right now. We are seeing pretty good discipline among the competitive players in the marketplace. So from that standpoint, there will be some consolidation pending in the industry. I think that's also a catalyst for more stability generally, if you look at other industries and what's happening in other industries.

And our next question comes from Rick Wise from Stifel Nicolaus. Please go ahead.

Hi. Good afternoon everybody. Couple of questions; SG&A clearly going down as a percentage of sales. Trying to understand, where do we go from here? How sustainable is this directionally? Is this is a onetime one year, major stepdown or with [indiscernible] charges are a lot more to come. Just help us think about that, if you would?

So on the SG&A side of the equation, we have been averaging about roughly 1.5% of improvement as a percent of sales this year. This last quarter, obviously a little bit stronger again than that. But I'd say, when we can grow at the levels that we just grew at, we can absolutely get additional leverage from our broader based operations, and that's what we are generally driving throughout all the goals and expectations for each of the different divisions. We on top of that, obviously have a number of different cost initiatives to try and make sure that we are focused on taking costs out of the organization, where it makes sense. So I'd say that we made good progress on a number of fronts over the last couple of years, and I'd say that we still believe that there is some good progress yet to be made. So I don't think we talk about an endpoint, but I would say that, if we continually can grow north of kind of the 5% range in general, that we can typically get some good leverage off of that, moving forward.

Yeah, specifically related to G&A. So on the selling side, we have taken out quite a bit of expense on the selling line this year, and some in the G&A area. But in G&A, we still have significant room for savings, by driving more shared services, where we have just a couple of small pockets in Stryker right now, that have moved to shared services. We have not generalized that across the corporation, and that's something we will be pushing forward in the next couple of years.

I just want to emphasize, this European headquarters was a massive undertaking. So you're seeing the side of the benefits related to repatriation of cash and tax improvements. But to actually provide system changes and to remap all of our transactions involved, hundreds of people across our organization over the last year to put this change into effect. So we will see those benefits, but those resources were burning a lot of energy on this project. We are now going to turn their focus and their attention on driving more shared services. And so we see room to continue to drive efficiency and leverage.

That's great Kevin. And my follow-up, again I don't know if I should put these in the same sentence, but the $2 billion repatriation and the comment about reinvesting 50% of the tax savings etc, could this potentially help you offset some of the clearly obvious FX headwinds in some way, could you reinvest a smaller amount of the tax savings or be more aggressive. Are these levers we should believe or assume that you're reflecting on as you put together your 2015 plan?

There are a lot of dynamics and a lot of variables as we put together a plan. So a lot of what you say will be things that we will think through and will provide clear guidance in January and characterize those elements for you in a very clear manner.

And our next question comes from Larry Biegelsen from Wells Fargo. Please go ahead.

Good afternoon. Thanks for taking the question. Bill, I wanted to focus on the tax rate. I think you said, if I heard correctly, that you expect it to be down sequentially in Q4, but you still expect to come in at about 22% for the full year, and that the R&D tax credit would be reflected in Q4. I guess, did I hear correctly and that would seem to get you down to about 21%. So maybe if you could help clarify my misunderstanding?

Sure. Yeah, that's a little bit of a misunderstanding there. But we are expecting -- we have got a year-to-date adjusted operating effective tax rate of about 22% so far year-to-date. That's actually the rate that we are expecting for the full year, which would imply that the fourth quarter will be relatively close to that rate. As we move forward though into 2015, we do expect to reduce our average tax rate from 14 to 15 by about two full percentage points. So if we average roughly 22 this year, you should be thinking in the neighborhood of around 20% next year, as you are looking at 2015.

Got it. So that means, if the -- sorry, go ahead.

Just maybe one other point of clarification which was around the tax extender comment. So the tax extenders are currently in our year end forecast. So if those don't come, then obviously that puts a little bit additional pressure on this year's tax, but hopefully at the end of the day, if it doesn't come this year, we would sure expect it to come next year and may have like a double year benefit, as we did back in 2012.

Got it. That's helpful. And then the Q4 implied guidance, if my math is correct, is 3% to 7%. I understand you have one less selling day in Q4, but is there any reason that you would be towards the low end of the guidance, given the strength and momentum we saw this quarter? Thanks.

Fourth quarter is pretty volatile as we have seen in the past, and certainly capital equipment is a big thrust in the fourth quarter, and is inherently volatile. So based on how we close this quarter, I wouldn't think we'd be expecting to be at the low end of the range. But it’s a range, and there is unknowns that could happen. But we are certainly feeling -- at this point, we are feeling pretty good, but its always inherently volatile.

And our next question comes from Joanne Wuensch from BMO Capital Markets. Please go ahead.

Can you hear me okay?

We can now Joanne.

Thanks and good evening. Thanks for taking the question. We have heard on a couple of calls say for about O-U.S. weakness, it has ranged from problem in Europe to problems in the Middle East and other areas. Could you please comment if you are experiencing any of this?

Yeah. So for us it’s a little different given the makeup of our business. So in Europe, we have a smaller business that we have really strengthened over the last couple of years. We had a strong quarter in Europe, again in the third quarter. And so, we may not be indicative of the overall broad market based on our presence. China, we had extremely strong growth, well north of 20%. India was very strong. Now look at all the emerging markets, we were very strong double digit growth. Even if I look at our EMEA, our region had a good performance. So clearly, Russia and Turkey are two areas that are problematic. But beyond those two areas, the rest of our international -- and we feel pretty good about our performance, and the markets are holding up well. The challenges that we had in Japan are I would say more Stryker specific challenges, beyond obviously the price cuts, that everyone experienced. We have some of our own challenges. But international for us is a bright spot, and we are feeling -- our organic growth was very strong in Q3, and the overall negatives that I have heard as well, haven't really applied as much to Stryker. It could be based on our market presence, and the momentum that we have in those regions.

That's helpful. And as a follow-up question, the two points that you will experience in tax reduction in 2015, does that become status quo, or is there still more room for you to move it down? Thank you.

That's a loaded question. I think that you can assume that we have a number of different areas that we want to continue to focus on, and ultimately can see opportunities for improvement, but also keep in mind that worldwide, pressures within different municipalities around the world, both in the U.S. and other European and international countries, are all looking for ways to increase their broader based revenue. So while we have opportunities on improvement, there is also the broader pressure on areas where governments or different areas are trying to help or reduce kind of those levels, from at least the impact on their overall tax rate. So we are absolutely focused on it, and we are going to continue to make efforts there. But as far as projecting it, we aren't projecting anything in Jan 2015.

If you look at the last 10 years in Stryker's performance on this line, it has been pretty steady and pretty meaningful improvements; and this is a big change which required a -- it was a big project. But you shouldn't assume that we are content and that we are going to just sit still.

And our next question comes from Matt Taylor from Barclays. Please go ahead.

Hi, couple of questions. So you had a really nice quarter on your capital business and talk about this improving environment; that's a little inconsistent with some of the other results we have seen and what hospitals are talking about. So I am just curious if there is anything to do with new products or big orders or you really think that they are opening up for whatever reason, is it ACA or some factor in Europe that we are not seeing, because a lot of other things that we have seen so far, seem to point to relatively weak capital market?

I would go back to our comments which were -- we are seeing signs of a moderate improvement in the capital environment. Its very difficult for us to know how much of that is just us executing better than competitors, versus an overall strengthening in the market. But just looking at our medical results and looking at our pipeline and thinking about the momentum we are seeing really across our MedSurg businesses on the implant and the capital side, that's what we are seeing now. Again its just one quarter, and we don't want to get too far ahead of ourselves, but we feel pretty good about sings of at least a moderate improvement in the overall environment.

And then on ortho, are you seeing any disruption from other big deals that are going on in the space? Is that something you could take advantage of, and what are you doing well in hips and knees that your competitors aren't doing that?

So I'd say, related to consolidation and disruption, we are not really seeing much in the way of disruption yet. As we saw with the previous big acquisition, the disruption really didn't occur sort of post implementation. Once implementation begins and people really understand what does this mean to me, that's when we really start to see disruption. So I would say its sort of business as usual right now, and we are seeing a pretty stable marketplace, at least at this point, once the companies integrate, that's usually when we see -- tend to see more turmoil. As it relates to our performance, the story on hips is not a new story, somewhat like trauma. Trauma of course, double digits, and continued sustained performance; in hips, if you go back 12 quarters, we have been growing faster than the market, at a pretty steady rate. A combination of some new products like Accolade II, as well as really strong execution in the field; and then on the knee business, we have just been performing with the market, which is a very good performance, given that we had two large competitive launches, that we have been able to perform well. So our field sales organization has done really an excellent job, and we feel we are in a very good position.

And our next question comes from Mike Weinstein from JPMorgan. Please go ahead.

I think I had everything answered. Thanks guys.

Thank you, Mike.

And our next question comes from Kristen Stewart with Deutsche Bank. Please go ahead.

Hi, thanks for the follow-up. I just wanted to confirm two things, I guess; one on the FX, the $0.10 to $0.12 that is incremental to what you would expect to finish 2014 at?

That's correct. That's the year-over-year impact that we would see next year.

That's if exchange rates stay at their current levels.

Based on current rates, right.

And this year, what is the total FX included within your forecast roughly?

The FX that we are talking about in 2014 is now up to about $0.12 negative impact for us, and that's about $0.04 worse than what we expected at the end of the second quarter. Most of that $0.04 differential is occurring in the fourth quarter.

Yeah. So Bill mentioned before, once that hit us in the third quarter, if the rates stay where they are now, there would be a $0.03 additional hit in the fourth quarter. So its just coincidental that that $0.12 would be similar to next year.

Okay. And then just a bigger picture I guess, if we look at the overall pricing dynamics of hips and knees down in the mid single digits. We are still seeing really strong, obviously sales growth and I don't suspect mix is contributing all that much, so its really implying you got unit volume growth probably somewhere in the mid to high single digits. How long do you think you can seek kind of this high single digit volume growth, really sustain itself, and what would be a more normalized unit growth environment?

I think its fair to say that your statements are correct mix. It has just been a modest benefit, nowhere near offsetting price, and the unit volume growth is very healthy. Certainly in the case of hips, we think that is also reflective of consistent market share gains. And its difficult to know exactly what the market is going to grow at on a go forward basis. We have been talking about it being largely stable. We don't see any reason really to move away from that. What we are really focused on though, is how do we drive market share gains, whether its with our existing portfolio and products like Accolade II, or obviously getting into next year and beyond leveraging the MAKO. So its really all about market share being our focus. Its 5:45, I think we are going to wrap the call up operator.

There are no further questions at this time. I will now turn the conference over to Mr. Kevin Lobo for any closing remarks.

So thank you all for joining our call. Our conference call for the fourth quarter 2014 results will be held on January 27, 2015. Thank you.