Orthofix Medical Inc. (OFIX) Earnings Call Transcript & Summary

November 10, 2021

NASDAQ US Health Care Health Care Equipment and Supplies conference_presentation 39 min

Earnings Call Speaker Segments

Matthew Miksic

analyst
#1

Okay. I think we're ready to get started. Thanks, everyone, for joining us this afternoon. Very, very happy to have with us today at Orthofix, Jon Serbousek, President and CEO; and Doug Rice, CFO. My name is Matt Miksic, I cover medical devices here at Credit Suisse. So thank you, gentlemen, for joining us.

Jon Serbousek

executive
#2

Matt, thanks for having us. Appreciate the invite.

Doug Rice

executive
#3

Thanks, Matt.

Matthew Miksic

analyst
#4

Pleasure is all ours.

Matthew Miksic

analyst
#5

So I thought it might be helpful just to maybe frame for folks a little less familiar with Orthofix? How -- you certainly have a fair amount again fine business, but you've got some other elements of the business that sort of make up this portfolio differentiates you a little bit from the standard, sort of, I should say, standard, but pure-play spine midcap. So maybe, Jon, if you could just provide a little bit of an overview of those businesses, and maybe we can dive into each one a little bit and get a sense of growth trajectory, opportunity, and that kind of stuff?

Jon Serbousek

executive
#6

Yes, Matt, I'm happy to do that. And one thing I might -- throughout there is an opportunity as we just had our earnings release this past Friday, and there's a couple of highlights that may help that for those that are on the call, if you'd like me to start with that, and then I'll jump into your questions.

Matthew Miksic

analyst
#7

Sure. Okay.

Jon Serbousek

executive
#8

Okay. So we did just have earnings this past Friday. And throughout Q3, which is a little bit tumultuous for most device companies, we posted net sales of $112 million, which is an increase of 1.3% over prior year and delivering 11% adjusted EBITDA margin. We've also posted double-digit growth in our Spinal Implants business and our Global Orthopedics business. And we had a number of key milestones for us as far as we'll get into more details on these of the products, I'm sure, but we had trained our 1,000 surgeon on M6-C artificial cervical disc, and it just passed to 60,000 implantation of M6-C globally. We also had a nice milestone with our Excel stem, new addition, where we put a PMA application in for bone healing or fresh fracture healing. And with kind of putting a finer point on it, we put -- we are on target for our guidance -- mid-level guidance of $462 million, which implies a mid-single-digit growth coming out of Q4. So that kind of frames some of the financial performance of the company, and we can jump right into the question you put pros, if that's okay, if you?

Matthew Miksic

analyst
#9

Well, thanks, Jon. Dealers' choice, I guess, what would you like to start maybe with the biggest business first? And how is that?

Jon Serbousek

executive
#10

Sure. Well, so we're not just a spine company as many of our peers are. And so we have in Orthopedics business as well, which focuses on deformity correction in both pediatrics, Charcot foot and ankle and also especially trauma. And we have a pretty significant and unique regenerative technology offering, one framed by our Biologics business, which is founded on our cellular-based allografts, and we've been expanding that business. And we just announced the launch of our first synthetic osteoconductive product with OPUS MG SET and is fulfilling bone voids and structural gaps during surgery. And then in the second quarter, we launched -- we further expanded that product to the launch of Fiber strip, which is our fiber family, which performs an allograft for consisting of mineralized can cells and demineralized cortical bone for procedures and adapting solutions in both not only spine, but orthopedics. And then in addition to that, in the areas we have our bone growth therapies market, or BGT, as we call it, which has been over 30 years of experience in healing patients for bone healing activities. And our bone growth therapy devices are #1 as far as prescribed bone growth stimulators in the U.S. and a key business and within the Orthofix business. And then we plan to continue expanding our existing platform in regenerative technologies as well as our future technology, we highlighted with AccelStim to provide further value creation in the business going to large. So we start -- I started out there, Matt, with one of our first categories of regenerative technologies, but also we have our spine implant business in our basically Orthopedics business, but I'm going to take a pause here to make sure I stay where you want to go with this discussion.

Matthew Miksic

analyst
#11

Yes. Well, I think it would be interesting maybe to talk a little bit about what some of the end market growth rates, if we look at BGT as a business line? What's the end market growth that you're targeting? Maybe what are some of your advantages and expectations to grow above that and then we can maybe talk about like contribution to cash and margins and because these businesses are very current and complementary in different ways? So look, maybe that's a good way to start.

Jon Serbousek

executive
#12

Sure. Within our BGT business, and I'll let Doug count some of the other financial aspects that you get to hear from both of us. But that is one of our largest businesses at 40% of our business, of our top line. Over the last years, it has been a slower growing business than we preferred to be. And much to the reason why we did our deal this last spring, where we licensed in technologies from a European company to further focus on our bone growth stimulation business. With that, we did announce the PMA submission for a new fresh fracture indication, which expands the markets we're going to be playing in. And with a successful PMA, it will open up another $100-plus millions of market opportunity for us in that area. And when there's really only one other competitor in that space that is generating significant results. So we look at that. And then we also, in our regenerative technologies, our bone growth, our BGT area, we focused in -- we've announced that we do -- we have another active as far as for doing rotator cuff repair. And it's an area where we did preclinical work, we found substantial signal. And so we implemented a prospective randomized double-blinded study which would open us up into an assisting in the repair of rotator cuffs, which has a significant upside. We're over in the U.S., over 600,000 rotator cuff repaired part each year. And there's also a fairly significant post-surgery failure rate in that market as well. And so that's the reason for the drive in the study, and we're progressing nicely, and we start to accelerate enrollment. It slowed a little bit before I got here. So we're accelerating enrollment there because you can imagine at an ASP of around $4,000 in that area with 600,000 opportunities. And let's suggest that there's a 20% failure rate in the rotator cuffs. You just do the math about how people would want to basically adopt that. It's a sizable market size up for us. So that's in the BGT areas we're looking at. And Doug can handle some of the margin contributions as far as in that business as well, which is pretty significant for us from a business.

Matthew Miksic

analyst
#13

Go ahead, Doug.

Doug Rice

executive
#14

If you look at Orthofix from just a margin profile perspective, it's clear that some product categories have higher margins than others. Our regenerative businesses, which we consider bone growth therapies and biologics have much higher margins than our traditional metals-based businesses around our fixation and motion preservation products. But overall, we blend in sort of at a gross margin profile of somewhere in the upper 70% range. And it's very mix dependent as we grow in certain areas, but strong margin profile. And in Q3, you saw us have it trickle all the way down to the adjusted EBITDA margin of about 11% for the quarter. So I'll pause there.

Matthew Miksic

analyst
#15

Great. Great. And I would imagine maybe not quite so kind of cash heavy in terms of working capital in the channel and screws and rods and both different shape sizes of everything that titanium repair that comes with being in the business of orthopedics that Jon so familiar with?

Jon Serbousek

executive
#16

Well, I'd say it's a very interesting market. It's actually one that I see great opportunity for because of the things you talk about. It's also they're nonsurgical. It's postsurgical in many cases. If you're dealing with nonunions, you can offer a patient obviously can go back to the OR and have that nonunion cared for or have it with an external device, which is essentially not operative, palliative, but also has a high efficacy rate as well. And so we see that -- and that's the reason why we're investing heavily in this area as far as we see not only the potential growth opportunity, but also the margin opportunity and also lends well because it works across both of our businesses. We have our PhysioStim in our orthopedic area, which are nonunions. We have our SpinalStim, which is in our spinal business. So we get to leverage both of those channels with one business. And that's the other series on why we're focused on only BGT but also our biologic portfolio because they share very similar attributes. We're leveraging both channels and we got to grow that regenerative technology business even faster.

Matthew Miksic

analyst
#17

Great. And so absent this shoulder rotator cuff opportunity, which is exciting and -- but a bit of a -- it's still -- it's going to be an R&D project for until you get the evidence that you need, I would imagine and get to approvals and so on. But absent that for a second, the core business because it's sort of servicing adjacent to intermingled with things like orthopedics and trauma. Is it fair to say like the volume growth is in that kind of low to mid-single-digit growth rate absent any share gains that you're driving? Is that a fair way to think about the kind of baseline business, not last year, obviously, was going forward?

Jon Serbousek

executive
#18

I would say it's a fair assessment of existing businesses that goes. However, 11% EBITDA contribution is really in a heavily invested environment. And so what we're doing is we're investing in the BGT channel, not only in the sales and service side, but fill both in the spine and the physio channel. And with the approval of a PMA for AccelStim, which will get us into a completely new market, we expect those growth rates to be higher. That's the reason why we made the investment with to acquire that technology for the U.S. and Canada. And so while we your assessment is correct today with the investments we expect there to be a different outcome in the year post approval of the cell for sure.

Matthew Miksic

analyst
#19

Got it. And then along with that, I guess, growth and leverage and EBITDA line, which you characterized now as sort of an investment mode, is that fair?

Jon Serbousek

executive
#20

Yes.

Matthew Miksic

analyst
#21

Great. And I guess the other good thing about this business is have a lot of company at the moment. There's not that many companies out there with this technology that are sort of established and familiar to and used by orthopedics or maybe orthopedics and spine surgeons. If you could talk a little bit about the competitive landscape and modes and so on?

Jon Serbousek

executive
#22

Yes. On the competitive landscape, there are very few competitors in this space. And Orthofix has really been a leader as far as introducing this in the market. As a matter of fact, we're the only one that has an FDA PMA approval for cervical applications in spine. And so you take that with just the PEM technology that we have that really excels in deep wound healing as far as for rollback and lumbar areas. We have a very unique position there. On top of that, with the sales channel, we have a very -- we're #1 market share position. So we have that. We also have a very large number of covered lives. We have over 300 million covered lives with this technology and so in contracting. And so you have the regulatory, you have the reimbursement side of it, you have the -- also the order-to-cash area that we set up this is a DME, be CMS directly with this in some cases. So we have an order to cash. And we have our innovation pipeline that where we're coming into. So we think we're well positioned, not only in the base business of spine and physio but also with the future applications for fresh fracture. And then as we're fortunate now we're running, I think, a really clean study to get into the rotator count really brings forward a whole business. And I would -- one of the things that I'm looking to do is to change this rather than to be just a product. This is really a regenerative technologies company coming forward. And so I think you and I've had that conversation and it comes down, it really makes sense that many people think of this as a STIM. But really, we're modulating tissues, whether it be hard tissues like bone or soft tissues like rotator cuff. And I think that we take and explore that even further. has other technologies that they've been working on in cartilage and other soft tissues. So that's weighs down the road, and we know that's really kind of 1 of those Holy Grails for orthopedics, but those are the ways we -- that's one of the ways we look at the business.

Matthew Miksic

analyst
#23

So steady growth, established coverage, I guess, not a very crowded market and a pipeline and to regenerative medicine versus, I don't know, reconstructive implant. It's not that the naming wrong with that. So -- yes. That's helpful background on that. And anything else that you'd add, Jon?

Jon Serbousek

executive
#24

I'd add in that, that it's not either reconstructive implants or BGC. I think it's the combination thereof. And much like in the trauma side, the orthopedic side is not their fixed -- that fixation product, it's the fixation product with BGT and get accelerated healing and it's good patient care. And patients that get back to their normal daily lives quicker. So we look forward to that as well.

Matthew Miksic

analyst
#25

No. I get it. I've spent my fair share of time out in Warsaw. I would never know the great business of implants and reconstructive. It's just -- it is nice to have this sort of differentiated elements of the portfolio, I think, and interesting. So maybe with that, moving on to what's next spine or ortho?

Jon Serbousek

executive
#26

Well, let's go to spine. I think that we -- it's our second largest segment. It's about 25% of our revenue. And with that, we've got a comprehensive offering. It was a historical offering, but we are spending a fair amount of time reinventing that. And so as we -- as I joined the organization, it was all about creating great -- pulling together the correct team. There's a really good group of people here, but is also expanding it to basically making a more comprehensive view towards the spine market. We had a really great entry with our M6-C artificial cervical disc, which I highlighted, but also a base of business that we can build from. And so what we've really focused on are key areas, not only near term, midterm but long term. And 2 our real key near-term areas are with M6-C but also redeveloping our overall interbody portfolio. And with regards to our interbody portfolio, we believe we have the most comprehensive offerings in the industry today. We have not only a peak material or a polymer material, we have a peak titanium composite material for an implant. We also have a titanium expandable, which seems to be the preference in many cases, especially TLIF and PLIF. And then we also have now a full 3D printed titanium material. And we -- and we'll get more into some of the other technologies we use 3D have printed in, but that is also incorporates an innovative technology called Nanova which helps activate the fusion of that procedure around those implants. And so with a market opportunity of around $800 million in interbody devices, and our market share, which is rather low, we're a small player in that area. We have significant upside when you just look at the comprehensive nature of that technology. I mentioned other areas that we use 3D printed in. We also do it in our SI Fusion, our Firebird SI Fusion system, which we do 3D printed titanium and it's a very novel device which also helps fuse across the painful SI joint when it has it. And there's a really rapidly growing market there. Served is around $120 million -- $130 million, but there seems to be significant upside in that market as well. So those are just a couple of highlights. I know you know this business well, and we've got a comprehensive area that we can talk about from pedicle screws to interbodies and other things, but I want to pause there to see where we'd like to take it.

Matthew Miksic

analyst
#27

Sure. So I think investors maybe know spine as being a business that sort of maybe segmented into things like MIS and into robotics now and some capital consumable strategies that seem to probe the NAS meeting this past September. So I guess and maybe deformity or scoliosis, where do you feel like you play there? Where do you want to -- where do you want to move to get stronger across those different segments? If you think about it that was cervical, I guess I should obviously have leaving out a big one there, especially with M6. But where do you think you're focused? Where do you want to move to -- can move everywhere, obviously, strategy?

Jon Serbousek

executive
#28

No. I think that -- so we're going to continue to drive hard into the motion preservation area with SXC. But what that allows us to do, and you highlighted cervical, is that I'll suggest, all even claim that we have the broadest cervical offering of any spine company out there. And I should probably explain that because we have a very competitive interbody, a really exceptional ACDF for our anterior cervical discounting infusion plate. So that's the mainstay of manage that, as you know. But then again, we also have all the biologics offering that we can do, whether they'd be from allogeneic or synthetic. And then we have a poster cervical offering. And then on top of that, we have the only approved STEM device for cervical. So if you think about anybody that has the broadest cervical portfolio, it's Orthofix. And we're not stopping there. We're actually investing in new areas where we think that there's future opportunity to, for example, in posterior cervical. Posterior cervical has not changed a lot in the last 15 years. So we think there's some MIS approaches to go after there as well as some comprehensive thoracic docs opportunities in that space. So that being cervical, we think we're well positioned with not only existing but new innovations. We've actually gathered a team of world-class innovators and key opinion leaders to help guide us in that area to create a completely new comprehensive posterior cervical system. And so we do that in cervical, but also you have to have -- in spine, you have to have at least a broad enough portfolio so that you can go in and basically address the surgeon's needs as they did go through low back and deformity. So we do have investments in development for MIS, low-back MIS, and we also have it for anterior or A-lift activities. And then we actually have a deformity system. Why do we do that? Because with the team that we brought together, the leadership we brought together, we had access to really the top innovators, the top KOLs in the industry. And so we've populated those programs with that. So not only do we get the innovation and the design, we also get the execution and the market adoption in that area. So those programs are ongoing right now, and those are the midterm programs we talked about as we execute short term.

Matthew Miksic

analyst
#29

Okay. That's helpful. And maybe just on M6. I know I want to get at how -- what's happening in that market with LDR sort of, I guess, took a pretty good leadership position in the market and -- but now you've got you got simplify joining the market. How do you think about share? How do you think about size? How do you talk about that market opportunity in the near term and say, the long term?

Jon Serbousek

executive
#30

Yes. We look at the cervical market today, both fusion and motion in the U.S. around 300,000 procedures a year. And we believe that there's only about 12% or 13% of that is penetrated with motion right now. And so with all the competitors. And as we look forward, we're told by a number of our surgeons and advisers that there's probably 30% to 40% of that market that could be motion in the cervical side. And so we look at it that way. And we continue to train, and we continue to basically expand the market. And so that's why I gave you the highlight of order of 1,000 surgeons trained because the surgeons that know how to do the procedure, they look at the differences between motion and fusion will try motion. They'll continue to expand more to more motion, but they also hold back some of their ACDF cases or cervical fusion cases. So really, we're about expanding the market bringing more of those fusions into motion as well as at the same time where competitors will basically take market share and we capped to, and we're doing quite well in the U.S. with the first 24 months of M16 in the marketplace.

Matthew Miksic

analyst
#31

Great. So call it, but -- is that $250 million, $300 million market currently, something like that, in that neighborhood?

Jon Serbousek

executive
#32

I would say it's that neighborhood for sure. Absolutely.

Matthew Miksic

analyst
#33

And I don't know if to push you too much on how big the money, but are you really north of 10% share in that market yet in the U.S.?

Jon Serbousek

executive
#34

We look at -- it's pretty dynamic right now. In fact, we're doing quite well. We haven't really published where we're at as far as our market share, but we talk about how we continue to grow sequentially quarter-over-quarter and quarter-to-quarter and quarter-over-quarter, year-to-year. And so we're not pushing that number out there right now, but it's a good business for us, and we'll continue to focus on it, not only just in the U.S. but also outside the U.S. M6 has been implanted since -- for almost 15 years now. And so we -- with 60,000 implanted, a good portion of those are in Europe. And we look at basically continue to invest not only with our training and education, but also with our clinical data collection, we've started a 2-level study in the last quarter, and we're going to continue to do that for not only getting good clinical data for knowing how well our product works but also market access. And then we're also starting a real-world evidence data collection to mine some of that data that's in Europe and basically bring forward some of that longer-term data, the 10-year data, which is really important because it brings confidence to the surgeons as they adopt that. And so if you classically do a PMA in the U.S., you may have 250 to 400 patients total that you move forward. With M6, it was in Europe or pilot longer before we even did the PMA. So we have this wealth of information that we're going to basically adopt. And it's investment dollars, but we think it's helpful for market development and market expansion dollars as well. And so that's part of further commitment on M6 to grow the business and to grow the market.

Matthew Miksic

analyst
#35

Well, it's a super exciting product and category. And so at the risk of sort of keeping out about it too much with you, I'd love to hear -- I thought didn't ask you -- you highlighted a couple of points that you felt were interesting in terms of differentiating yourself from the other products. And we're accustomed to something being like the best and then like the second and then the third best. But in this case, it struck me that there were some elements of the design that maybe were just more qualitatively and thematically appealing to surgeons and patients maybe than the other devices are lucky to give a quick second on that.

Jon Serbousek

executive
#36

Yes, Matt, you've called it out correctly. We can't stand here and geek out, but we'll do it a little bit, okay? Because I think it's worthwhile, okay? Now that's why we're in this business because we enjoy it, and we want to make sure that the technologies transfer into good patient care, so people get back to mobility, and that's what we're about. But one thing about M6 is that it's the only technology that actually mimics the natural disc. It has 6 degrees of motion. It also has a compressive nature of it as far as the dynamic core, and it has progressive resistance. So the fact is most of the designs are either a classic ball and socket unrestricted. So there will be a 3-part design with a couple of 2 end plates and in center course of that nature or to end plates with the core balances. And that's classic. We've been in the orthopedic business a while, so we get that. But the M6 replicates the natural kinematics as well, so not only the motion profile of the native disc. And we have great biomechanics testing that shows that natural progression between a natural motion of the M6 is in direct comparison with a native disk. It's also -- this serves actually -- it basically resonates with them. When you show it to them, it has an end plated. It has an annulus, it has a core. It has the fibers of a natural disc. And so you tie that out with the biomechanical testing and the 15 years of in-market experience. And it's something that is naturally appealing to the surgeons. There are many surgeons that use other devices and they make them work. But as you look at just the natural appeal to this in the mechanics, the biomechanics of it, it certainly does appeal to the surgeons at large.

Matthew Miksic

analyst
#37

Great. Well, not a third run product or for a third ranked product, it's really differentiates, so congrats on all that. So now we've got that out of the way. You probably should maybe get back to sort of growth and margins and zooming out a bit, you stepped in, Jon and into a situation that needed a bit of kind of turning around, I think. And maybe talk about what the plans are what you've accomplished so far? Obviously, the pandemic has been no picnic for anybody and not for someone who's trying to turn things around. But what are the next steps and key initiatives that -- and results that investors should look for, say, in early 2022 and throughout 2020 in terms of growth and margins?

Jon Serbousek

executive
#38

Thank you. And so -- to take a step back, and Doug was at the business when I got here. And so there are -- when I arrived, I saw a company that was really ready to basically reposition and go for growth. And so it had been a little bit underinvested I'll use that term. But it had a great back office, had a core finance, legal, compliance was all done. The hard -- many times the hard things to basically get right were already done. So it's left for a commercial and basically a developmental innovative in the channel funding. So we set 4 areas to go after. One was resetting the leadership in the commercial area. The other one was new product innovation and differentiation. The other item was rebuilding our distribution channels and then also operational execution and redeveloping the supply chain. So we've really been focused in those 4 areas. We completed all the structure and leadership in 2020. And that gave lights effective now going to work on the distribution channel, and we can talk about that. It has -- obviously, you can't go anywhere out of great channel. And then also retooling and refreshing the product areas, the product categories, probably refreshing the existing but expanding those categories with either organic or inorganic activities and then the supply chain. And so we've been active in those 3 areas. The good news about through 2020, we're able to continue to make progress in all those areas, and it certainly was no picnic operating in a COVID environment. I've never seen sales go to from 100 to 20 in such a fast period of time, about like 1.5 weeks in 2020. And so -- but the reality is that the team we assembled went to work, and we just continue to build value. And what we talk about on a daily basis is that everything we do should build long-term value or -- and so if we're not -- if you can't say it's building value, you shouldn't be doing it. Some of the things we brought from private equity and some other things have done as far as for value creation. So that's the key focus. We also took from a standpoint of margins, I'll let Doug talk a little bit more about this, is that we told everybody to what -- we told the Street and the investors in 2020 that we were going to delever our EBITDA so that we could basically do this work and position the company as a growth company, not as a value, not as a low single-digit company but as a growth company. And so everything we do is focusing on building that platform so that we can become a growth company. And so that's the -- that's what we're focused on doing. And then we've talked about products. We can talk more about channel and the supply chain, but that's where it's at. So we purposely delevered that EBITDA contribution to where we were highlighting, where we're marketing it now as we do our work and be prepared for much higher growth activity. And really, we're looking forward to the day when we just have good clean quarters without COVID, so that we can execute our plan that we have in place to attain those growth numbers. But I'll pause there. Doug, do you have anything you'd like to weigh in on that question?

Doug Rice

executive
#39

No, I think you covered it really well, Jon. I mean our cash flow and strong margins and cash position, as Matt pointed out, are strong. We've been able to balance sheet fund our organic initiatives as well as our inorganic initiatives from acquisitions like FITBONE to our investment in Neo Medical and single-use instruments, for example, to our and AccelStim investment in our BTT product category. So we'll maintain that discipline going forward. But we've got a lot of firepower with an untapped credit facility and the cash position that we have. So we're constantly evaluating strategically how we want to grow and our margin profile, as Jon mentioned, we did intentionally delever. And we think as we scale, there's certainly room to improve that in the future. But right now, it's about making sure that we grow at the right rates, and we exit this year, if everything plays out the way we think it's going to in mid-single digits, and that will be good momentum heading into 2022.

Matthew Miksic

analyst
#40

Okay. So maybe -- and just everybody loves getting the 2022 questions when they haven't yet formulated the guidance for '22, but one helpful way to think about a business or a company for investors just like what the major businesses can do? Or what the combined business on an underlying basis could do absent some of the product launches you talked about, absent the variability of COVID and so on? So is this -- do you think at the current run rate, and it's hard to kind of disaggregate all the macro factors and stuff? Is this a low to mid-single-digit grower now? Is it a mid-single grower now on a basis given the room to operate, Jon?

Jon Serbousek

executive
#41

Yes. One of the things that -- and we've not given our '22 guidance, so thank you very much for question. But when you look at Orthofix, Orthofix is different than other styles of companies that we compare to pure-play buying companies. So we -- the reason we're intently focused on BGT is to get that growth driver going up. Because if you look at ask -- I mean, last quarter, we had double-digit growth in our spine implant business, and we had double-digit growth in our orthopedic business. So we can do -- so when you ask that question about are we low mid-singles or high singles is that, it depends on how fast we execute on that BGT areas. So that's the area that we're we talked a lot about that today and why we're focused in that area because we must get that accelerated growth to be able to bring the entire company up from its current growth rate. And so it's -- Right now, we are double-digit growth in spinal implants. We are double-digit growth in orthopedics. And if you compare it against some of those pure-play spine companies, that might be an example to use, but we don't get measured that way in the marketplace because of who we are in the totality of us. And so that's why we're focused in those areas and not only BGT but also biologics. Last quarter, our biologics were down. And it was because we're heavily reliant on our or large or multi-level spinal fixation, big applications, those didn't go out as much as they had in previous quarters. So we're taking a rather than having a single product or a dual product, we're having a portfolio so that we get a much broader application and we get lift in that whole business to get in that single and mid- and high single-digit growth rate. because it's -- we know it's all possible, but we have to do that work. I just effectively almost didn't answer your question, so I want to be respectful of that. But it's a different -- we look at us differently. And that's for the investors out there, as you look at us as a company, there's a couple of key segments that you want to focus on and where we're driving growth and what we're executing on because we've not always done double-digit orthopedics. We've not always done double-digit spinal implants. That's a result of the team's effort that's gone forward here, bringing those bringing the existing products but also bringing new products into the marketplace to take that. So that's our playbook, and we're going to continue to work it through BGT and the biologics portfolio as we continue to take more energies into the spinal implants in the Orthopedics business.

Matthew Miksic

analyst
#42

I think that's helpful. You have effectively not answered it, but you provided a lot of helpful color, Jon.

Jon Serbousek

executive
#43

So we'll do that in Q1. We have our guidance out about that.

Matthew Miksic

analyst
#44

That's perfect. But thanks again for taking the time. We're just about at time here. So we should call it. But I appreciate you joining us. Jon and Doug, thanks so much, and look forward to keeping you.

Jon Serbousek

executive
#45

Matt, thanks -- special thanks. We appreciate you allowing us to come and share our story and I appreciate the dialogue we've had over the years. It's always helpful to hear what's going on in the industry, and we hope we've provided some information for the investor group to think more about Orthofix. And not only where we're at, but where we're going and the value creation that we're putting forward is not only spine, orthopedics, but also in our regenerative technologies position in the marketplace segments today. So thank you.

Matthew Miksic

analyst
#46

Thank you.

Jon Serbousek

executive
#47

All right.

Doug Rice

executive
#48

Thanks, Matt.

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