Earnings Call Transcript - ENOV Q2 2025

Kyle William Rose, VP, Investor Relations

Good morning, everyone. Thank you for joining us today for our second quarter 2025 results conference call. I'm Kyle Rose, Enovis' Vice President of Investor Relations. Joining me on the call this morning are Damien McDonald, Chief Executive Officer; and Ben Berry, Chief Financial Officer. Our earnings release was issued earlier this morning and is available in the Investors section of our website, enovis.com. We will be using a slide presentation in today's call, which can also be found on our website. Both the audio and the slide presentation of this call will be archived on the website later today. During this call, we'll be making some forward-looking statements about our beliefs and estimates regarding future events and results. These forward-looking statements are subject to risks and uncertainties, including those set forth in the safe harbor language in today's earnings release and in our filings with the SEC. Actual results might differ materially from any forward-looking statements that we make today. These forward-looking statements speak only as of today, and we do not assume any obligation or intend to update them, except as required by law. For further details regarding any non-GAAP financial measures referenced during the call today, the accompanying reconciliation information relating to those measures can be found in our earnings press release and in the appendix of today's slide presentation. With that, let me turn it over to Damien.

Damien McDonald, CEO

Thank you, Kyle. Good morning, everyone, and thank you for joining us today for our second quarter earnings call and my first as CEO of Enovis. Before we walk you through the quarter, I want to take a moment to speak directly to our investors and shareholders. I recognize the trust you place in this company and in me as its new leader. Your confidence and support are what make our growth possible. I stepped into this role with a deep sense of responsibility to our patients, to our healthcare partners, to our employees, and to you. I look forward to engaging with you and earning your confidence with our results. I've been at Enovis for just over 90 days, and I would like to share with you my observations on the company and the opportunities ahead of us as well as begin to outline our near-term priorities. I started in my role shortly after the third anniversary of the spin-off that created Enovis, a medical technology company with an unmatched portfolio spanning surgical solutions, bracing, and rehabilitation. All technologies that align with our orthopedic continuum of care needed by patients and their providers. In those 3 years, we bought more than 10 companies into our portfolio. Our transformation has been notable, scaling from $1.4 billion to $2.2 billion in revenues, from 56% to 60% in gross margins, and from 14% to close to 18% in adjusted EBITDA margins. This growth has been deliberate and driven by organic expansion, portfolio shaping, and targeted acquisitions that align with our strategy to globalize our business toward faster-growing, higher-margin end markets. It's clear that we've got a strong foundation and an unmatched diverse portfolio of solutions. But to realize our full potential, we must maximize the power of what we have built. There are opportunities to improve the durability and consistency of our organic growth, margin expansion, and cash flow generation. Each of these improvement opportunities will be supported by disciplined capital allocation. In my first 3 months, I've been out in the field and actively listening and engaging with our global stakeholders who are key to our success. This included visiting customers, hospitals, and medical centers, and meeting key physician partners. It was encouraging to hear how highly they regard our portfolio of products and their views on the opportunity we have to gain share. I've also been busy internally connecting with our senior leaders and spending meaningful time with our teams around the world. It's been incredibly energizing to witness firsthand our passion for restoring motion and improving patients' lives. Having toured all our major manufacturing sites and corporate offices, I'm now concluding comprehensive reviews of each of our business segments, functional teams, and sales regions to inform a multiyear road map centered on profitable, capital-efficient growth in order to improve patient outcomes, become a talent magnet, and deliver outsized shareholder returns. In the near term, I intend to focus the organization on three key priorities: commercial execution and innovation, operational excellence, and financial discipline. In terms of commercial execution, Enovis operates in attractive, sizable markets and competes against some of the strongest and most financially capable technologies in med tech. We have and we will need to always bring our A-game to every customer-facing activity. I know that there have been instances where complex integrations and rapid product launches have stretched our teams. The opportunity lies in further embedding and expanding disciplined commercial practices across the enterprise. With respect to innovation, we must use size to our advantage and reinforce our ability to be nimble by quickly identifying and addressing key market trends and making focused investments in those areas with the highest differentiation and market potential. An immediate priority for our team will be accelerating our product pipeline with a particular focus on enabling technologies that improve clinical outcomes and surgical efficiency. Regarding operational excellence, a large part of my experience in this area centers on focused business system philosophies to deliver exceptional long-term financial outcomes. High teens EBITDA margins are not sufficient to achieve our company's goals and ambitions. To that end, we are developing detailed plans to optimize resources, augment gross and operating margin, improve cash flow, and address leverage directly, while continuing investments in customer-facing and R&D activities that promise differentiation and profitability. Additionally, while EGX is central to our operating philosophy, its implementation remains in varying stages of maturity, largely following the successful acquisitions over the last 5 years. I believe the accelerated application of this business system will improve capital allocation and operating efficiencies. And I am confident we will see tangible improvements in cash generation, leverage, and productivity in the near term. And third, with multiple operating companies under our umbrella, it is important to further embed organization-wide financial discipline to expand margins, improve working capital and CapEx efficiency, and significantly reduce integration-related costs. As our foundation gets stronger, we will create the flexibility for broader capital allocation decisions in the future. Finally, under my leadership, Enovis will build on our strong culture of thoughtful speed, transparent accountability, and collaborative empowerment. Our employees remain central to achieving our mission, and we are actively investing in their development, fostering an open high-performance environment, and encouraging cross-team collaboration to get better every day. Now let's turn to our second quarter results. In the second quarter, we delivered reported growth of 7% and 5% on an organic constant currency basis. We delivered strong earnings growth and positive cash in the quarter while managing tariff headwinds. Our teams have made good progress on new product launches, and we have clear line of sight into a multiyear cadence of meaningful NPI. In Recon, we delivered organic growth of 8%, including U.S. growth of 6% and international growth of 10%. Growth in U.S. Extremities was 10%, driven by strong double-digit growth of shoulders led by the launch of our augmented reverse glenoid system. U.S. hip and knee growth was flat, reflecting the impact of fewer selling days and headwinds in capital sales as customers deferred orders in anticipation of our next-generation hardware launch. Underlying implant growth in hip and knee was mid-single digit, and we expect acceleration in the second half of the year as new products ramp. Early commercial feedback on the Nebula system and the OrthoDrive surgical impactor has been encouraging with a positive reception from surgeons and sales teams. Our launch activities to date have been controlled as we scale inventory and ramp surgeon training. Outside the U.S., we benefited from our recent geographical expansion and continue to take share in a resilient market. Our Optimys Stem and RM Cup continue to drive competitive share gains in international hip. Similarly, our SMR and Prima shoulder portfolios continue to be a highlight as we integrate and capitalize on cross-selling opportunities. A consistent theme in my conversations with our commercial teams and surgeons is the growing conviction that enabling technologies are key to having a comprehensive portfolio. Our entry and key platform in this space is Arvis, an augmented reality platform that delivers real-time intraoperative intelligence, guidance, and navigation. Arvis stands out in the market because it is simple, portable, and scalable, enhancing surgical precision without adding complexity to the workflow. It fits seamlessly into both inpatient and outpatient settings regardless of the reimbursement model, delivering real value where it matters most. Our next-generation platform builds on this foundation with a lighter, more complex headset, improved visualization, faster registration, and enhanced tracking. These upgrades also enable future expansion into real-time soft tissue balancing for knee procedures and differentiated shoulder applications. All important steps towards building a broader, more versatile multi-anatomy ecosystem. The addition of these features has extended our commercial timeline. We're now about 6 months behind where we expected to be, but the excitement we're seeing with surgeons gives us confidence that the enhancement will be a meaningful addition to our global portfolio. In P&R, 3% organic growth reflects a stable market environment and disciplined execution. Overall, this business is performing in line with our strategic plan and will benefit from the ManaFuse LIPUS technology launch and several key new bracing products in the coming quarters. Adjusted EBITDA margins in P&R improved 130 basis points year-over-year as we continue to use EGX tools to drive consistent productivity improvements and proactively shape the portfolio for profitable capital-efficient growth. I've been in the medical industry for more than 30 years, and I'm passionate about its power to improve people's lives and longevity. I'm grateful I've been given this opportunity to bring my experience to Enovis and lead the company into its next chapter of growth. Since joining, my initial optimism about the potential has only grown stronger, and I am confident in the near-term strategic objectives and commitments we've made to investors, including our updated guidance that Ben will outline shortly. As I mentioned, my immediate priority is reinforcing organic growth and margin expansion while also unlocking capital efficiencies across the business. I look forward to sharing a detailed multiyear road map in the future. And now I'll turn it over to Ben to take you through the P&L details.

Phillip Benjamin Berry, CFO

Thanks, Damien, hello, everyone. We are pleased to report second quarter sales of $565 million, up 7% versus prior year and 5% on an organic basis. The quarter included approximately 200 basis points of positive currency tailwinds, offset by roughly 200 basis point headwind from selling days. Overall, our Recon business saw organic growth of 8%, led by high single-digit growth in Global Extremities and mid-single-digit growth in Global Hips and Knees. Our growth in P&R continues to be stable at 3% in the quarter. For the first half of the year, organic growth was 8% at the Enovis level, 10% in Recon and 5% in P&R. We are encouraged with the momentum building in both segments and believe the diversity in the portfolio produces durability of growth as we continue to navigate ever-evolving end markets. Adjusted gross margins improved 90 basis points in the quarter and 200 basis points year-to-date. This expansion is driven by favorable segment and product mix, and in-flight productivity programs in manufacturing and supply chain. Second quarter adjusted EBITDA was flat versus prior year at 17.2%, primarily a result of the phasing of expenses and increased investments in R&D. Year-to-date, we have expanded our adjusted EBITDA margins by 75 basis points. Second quarter effective tax rate was 23%. Interest expense was $9 million for the quarter versus $17 million in 2024. Overall, we delivered adjusted earnings per share of $0.79, an increase of 27% versus prior year. First half adjusted EPS grew 42%, driven by margin expansion and reduced interest expenses. We are pleased with the financial progress we've made so far in 2025 and are excited about the value creation opportunities in front of us as we continue to execute. With this in mind, we are raising our guidance. We are increasing our revenue range by $25 million to $2.245 billion to $2.275 billion. This is driven by an improved currency outlook, particularly strength in the euro and organic growth execution. We expect foreign currency to be a slight tailwind in 2025. This compares to our prior expectation of flat versus 2024. For organic growth, we are raising our constant currency growth guidance to 6.25% to 6.75%, an increase of 25 basis points versus the prior range. We continue to expect high single-digit growth in Recon and low single-digit growth in P&R. We are also raising our guidance for margins and earnings. On margins, we are raising our adjusted EBITDA range to $392 million to $402 million. This is a $7 million increase versus our prior guidance and reflective of our updated view on tariffs, which improved versus our prior guidance due to the 90-day pause on the elevated tariff rate in China. The tariff situation remains very fluid. We paid $6 million in tariffs in Q2, mostly related to P&R. As the new costs have worked their way through inventory, as we've previously outlined, we will begin feeling the impact in the P&L starting in Q3 as we expect our mitigation efforts to accelerate through the balance of the year. No adjustments have been made to our outlook for depreciation, interest, tax rate, or share count. Considering these changes, we are increasing our adjusted earnings per share range by $0.10 to $3.05 to $3.20. Lastly, we reiterate our expectation for positive free cash flow in 2025, and are focused on using generated cash to pay down debt and reduce leverage as we exit the year. To summarize, the first 6 months of 2025 demonstrated the strength of our platform and the intentional diversification we have built into our business. We are pleased with our improving business mix and are excited about the new product innovations that should continue to ramp over the second half of 2025. The underlying fundamentals of the business remain strong and robust, and we are poised to manage the business responsibly through this dynamic environment and maintain progress towards our strategic goals and financial commitments.

Kyle William Rose, VP, Investor Relations

Thanks, Ben. Before we begin the Q&A session, in an effort to accommodate everyone on the call, we ask that analysts keep the questions to one question and one follow up. You are welcome to rejoin the queue if we have time. With that, operator, please open the call to questions.

Vijay Muniyappa Kumar, Analyst

Damian, congratulations and welcome to your first earnings call. I'd like to start with a question regarding the delay in the Arvis launch. The U.S. hip and knee segments were relatively flat. As we consider the expected acceleration in the second half for Recon, what are your projections for Arvis? With its launch now pushed back by six months, are there any other new products anticipated to drive growth in the second half?

Damien McDonald, CEO

Thank you for the question. There are several key points regarding Recon in the latter half of the year. The Nebula hip is just starting to enter the market. We've been in a limited release phase, and as I mentioned earlier, the feedback has been outstanding. We're eager to make it more widely available in the later part of Q3 and Q4. Similarly, the ARG for shoulder presents a strong opportunity for us in the U.S., as we've also received positive responses. During my time in Europe with the international team, I've observed their growing success with cross-selling in extremities. The Prima/SMR cross-selling initiative is effectively increasing our market share in shoulders. Overall, I see significant potential with our emerging portfolio, and as I stated earlier, enhancing our commercial operations, especially in the U.S., is a promising opportunity for us.

Vijay Muniyappa Kumar, Analyst

Understood. And maybe, Ben, one for you. I want to ask on the guidance, but maybe more focused on adjusted EBITDA and free cash. I think a recent report raised some questions on adjusted EBITDA reconciliation. I think some of the points raised were the warranty agreements and whether that's a period expense that's being non-GAAP and inventory step-up costs. So I'm curious on your comfort around the adjusted EBITDA metrics that you report. And I think a lot of these debates would end if free cash flows normalize, right? So I know you said free cash positive for fiscal '25. When do we get back to 70% to 80% of net income and free cash conversion for the company?

Phillip Benjamin Berry, CFO

Yes. Thanks for the question, Vijay. Let me just reiterate our commitment to maintaining high standards of transparency, accounting controls, reporting and compliance with all the rules and regulations. I mean, we're confident that we've represented the company in the right way and continue to make the right calls with regards to how we're representing the business. So overall, if you think about where we are in our cycle, we are in a period here where we've been heavily integrating Lima over the past 2 years. And with that, we've been spending a lot of efforts to make sure that we're getting the right momentum of that company coming into Enovis. And we've shown some of that with the growth that we've been able to continue to demonstrate as we've been integrating it. When it comes to the royalty piece, I mean, we talked a little bit about this on the Q1 call. This was a shift in our model to essentially remove some bias in terms of the innovation cycle with some of our key surgeon partners. So it was onetime in nature. It was noncash. It's over a 7- to 9-year period. So there's no clear, I'd say, benefit that rolls through the P&L here. If anything, it's relatively neutralized with regards to the shift in the model that we've just executed. But your point is the right one with regards to the focus on free cash flow. I think you saw progress that we've made in free cash flow in the second quarter, particularly with the pressure that we felt on tariffs. I think you heard in my prepared remarks that we took $6 million of payments of tariffs in the second quarter, but still posted positive free cash flow. So you're seeing some of those adjusted costs neutralize a little bit as we're completing more of the integration, and we're reducing the burden there due to that. So we feel very strong about our ability to continue to incrementally make progress on cash flow throughout the course of this year. And then as we step into next year, we're very much entitled to see step-ups, particularly as the European medical device regulation spend significantly diminishes and the Lima integration costs significantly step down. So that entitlement right there puts us on the pathway towards the 70% to 80% conversion and a very clear line of sight for us to continue to step up towards those levels over the coming years.

Vikramjeet Singh Chopra, Analyst

Congrats on a nice quarter. Damian, welcome. Two questions for me, maybe one, a more high level one, for Damian. Maybe just talk about some of the lessons learned from your previous company that you think you can apply at Enovis. And then I had a follow-up, please.

Damien McDonald, CEO

Well, I think there's some tremendous things. So thanks for the question, Vik. In terms of growth, I think we've got huge opportunities of applying discipline to the way we think about customer segmentation and targeting, account acquisition, and account penetration, and really driving innovation. So I think bringing some of the things that I learned in my previous role around pipeline development and execution is really key. I think also the fact that the DNA of Enovis has EGX in it is really a great opportunity for us. I've had a lot of experience with that business system mentality. And what I'm excited about is the fact that we have it and people use it, but the real opportunity is expanding that across the entire business. And making it applicable to not just the ops groups, but the carpet land, as sometimes it's referred. So we've got great opportunity to really use that, again, to focus on capital efficiency and generating more cash and really thinking about how we get leverage down.

Vikramjeet Singh Chopra, Analyst

Great. Thank you for that answer. A follow-up question is, how should we think about your M&A strategy post-Lima? And maybe just talk about how you're thinking about balancing debt paydown with doing tuck-in deals in 2025?

Damien McDonald, CEO

Yes. So let's be very clear, and I think I alluded to this in my opening comments. The capital allocation priority right now is debt reduction. And Ben and I have spent a lot of time talking about this and also with the Board. So our intention is to be very focused on debt reduction. Look, when our foundation is stronger, we'd look at either opportunistic share buybacks or focused M&A. But in the near term, you should think about our capital allocation priority as debt reduction.

Xuyang Li, Analyst

Welcome, Damian, and looking forward to working with you. We'll probably hear a lot more about this as you spend more time with the business, but I wanted to hear a little bit more about your early impressions of the business and key near-term focuses and priorities. I'm sure we'll hear more about your long-term views later. And in particular, I wanted to hear a little bit more about your comment on focusing on enabling technologies to drive faster growth. Where does robotics fit in that framework? And also your thoughts on the portfolio management in general?

Damien McDonald, CEO

Thank you, Young. There’s a lot to discuss regarding that question. To start, I’ve been following Colfax, and later Enovis, for many years. As my discussions with the Board progressed, I became very interested in the product portfolio that has been built, as well as the emerging development pipeline. The chance to collaborate with the team to generate value through careful execution was particularly appealing. Our immediate goals include focusing on our organic growth, emphasizing commercial execution and innovation, enhancing operational excellence, and improving capital efficiency and margins along with maintaining financial discipline. Ben and I have discussed CapEx, cost management, and shared service utilization at length, and our near-term efforts will prioritize those three areas. Regarding enabling technology and robotics, we’ve recognized that enabling technology is essential for a comprehensive global portfolio. Our initial solution aims at planning and navigation. When considering planning, navigation, and assistance, we're still assessing the cost-effectiveness of large-format robots and their potential to improve patient outcomes, along with the appropriateness of entering the market at this time. We have resources focused on exploring all viable avenues, and I’m actively involved with that team already. The Avis situation presents us with a chance to expand in that sector. We plan to launch our next-generation product with a simultaneous hardware and software update. We've conducted valuable research and gathered customer feedback, which has enhanced our understanding of the software that needs to be included in the next generation release, leading to a delay. Our current focus is on working with the team to maximize the potential of that product and drive greater implant growth. The important aspect here is not just the capital, but our goal of increasing implant growth, which remains a primary focus in our discussions on commercial execution and innovation.

Xuyang Li, Analyst

All right. Very helpful. I guess on the extremities business, the 10% growth, it sounds like shoulders did better than foot and ankle. Maybe if you can provide us a little bit more color on the growth and performance of each of the segments and the key products and initiatives to drive faster growth.

Damien McDonald, CEO

Why don't I do shoulders and you do foot and ankle. So the shoulder thing, I think, is two things. Firstly, in the U.S. with the release of ARG, the Altivate Reverse Glenoid, we've been, again, in limited commercial release there. It's progressing really well. Our opportunity is later in Q3 and Q4 to really expand that. Internationally, speaking with the team and spending time with them, the cross-selling is really the great opportunity there. We had a Prima system that is more about simple procedures and the SMR system that really comes out of like a fracture mentality. And the ability of the team now to firstly be trained and competent and capable to talk about those 2 different philosophies and then take either Prima customers and introduce SMR or SMR customers who were doing complex cases and bring Prima to their portfolio has really been what's driving the international growth. So I see it as really, again, back to this focus on commercial execution, and I think that team is doing a tremendous job.

Phillip Benjamin Berry, CFO

Yes. And on foot and ankle, Young, I think we're still very bullish on the capabilities of the product lines that we've put together there and what the end market potential is. And we would expect that, that business continues to contribute to our growth algorithm as we think about the strength in extremities. Second quarter for foot and ankle was a little bit softer from a market volume standpoint. As we look at it, it was more volume procedural driven than it was anything that we think was disruptions in our business. But we're launching some new products, getting new inventory out in the field, which we'll expect some acceleration in the second half. So overall, we still feel comfortable that we'll be well within our guidance with regards to what we've set expectations around and see some acceleration in foot and ankle in the back half.

Joseph Scott Conway, Analyst

This is Joseph on for Mike. Welcome, Damian. Nice to meet you over the phone. Apologies if you guys noted this in the prepared remarks, but the guidance increase in revenue, was that due to currency? Or was this more outperformance of Core Enovis? And then the acquisition revenue in P&R, I don't know if you guys had announced that. It looks small. I was just curious where that was coming from.

Damien McDonald, CEO

Joseph, on the guidance piece, it's a combination of currency and organic performance. So we shifted up the range, $25 million with a combination of that coming from slightly better currency than what we expected as we went into the last call and then taking our organic growth range up 25 basis points. So it's a little bit of a combination there. If you think about what that acquisition was on the P&R side, very, very small, little bolt-on thing that we did to reinforce our leadership position outside the U.S. So relatively immaterial in terms of the size of that thing, but it was an acquisition that was completed in the quarter.

Joseph Scott Conway, Analyst

It was great to see the expansion in gross margin on both a GAAP and non-GAAP basis. However, I'm curious about the flow-through, as it appears we’re expecting more to impact the EBITDA margin. It seems flat year-over-year, so I’d like to know what factors contributed to that lack of flow-through.

Damien McDonald, CEO

Yes. Again, I think we're pleased with the performance that we've seen against the expectations that we set, especially through the first half. Second quarter, yes, I think you're seeing some positive mix elements that are continuing to work in our favor with regards to gross margins. And from an expense side, in my prepared remarks, I talked a little bit about some of the phasing and investments in R&D on the operating expense side. So overall, again, I think we're well in line with what our expectations were that we set for the year, especially through the first half, and we are still bullish in terms of our ability to continue to expand our margins with the evolving business mix that we have as a company.

Caitlin Cronin, Analyst

Just to start on the Arvis shoulder launch. Just any updates on how that's going? And then how important will kind of the next-gen updates to Arvis be to this ongoing shoulder launch?

Damien McDonald, CEO

Thank you for your question; I'm eager to work together. Recently, I had the opportunity to meet with a large group of shoulder surgeons in Madrid, and the response to Arvis in the shoulder space has been exceptional. When comparing large-format robots to a portable, scalable tool for shoulder procedures, it’s clear why we believe Arvis is promising. People were particularly enthusiastic about the next-generation version of Arvis, which we showcased and allowed attendees to test in a lab setting. The lighter headset and enhanced visualization are significant advancements. Additionally, the software development, along with the feedback we received from key opinion leaders during its development, has been impactful. I'm truly excited about what Arvis can achieve for shoulder surgeries and how it will help us increase our market share in that area.

Phillip Benjamin Berry, CFO

Yes. Thanks, Damian. Yes, if you recall, the EU MDR costs are really the remediation of tech files to be able to continue selling products on the market in Europe. So we've completed the vast majority of that remediation. So this would be the last meaningful year of spend with regards to that remediation.

Danielle Joy Antalffy, Analyst

Damian, it's great to work with you. I have two questions. First, regarding the shoulder market dynamics, I've noticed it has become more competitive. I understand that you are one of the market leaders. As you assess the competitive landscape, what strategy do you have to maintain Enovis as the market share leader? Secondly, I have a follow-up question on P&R.

Damien McDonald, CEO

Danielle, it's a pleasure to collaborate with you. First, I want to express my excitement about being recognized as a market leader, which is our goal. I believe we have the momentum to achieve that. This will involve a multifaceted approach to commercial execution. First and foremost are the relationships we’ve developed. I just spent time with an excellent group of shoulder surgeons in Madrid who are enthusiastic about our product offerings and committed to educating the next generation of surgeons. In my view, it all begins with strong relationships and focusing on patient needs. Second, we need to enhance our commercial execution by making our products more accessible and relevant to our current customers. We're performing well in Europe, and I see significant opportunities being realized there. Additionally, the cross-selling of our Prima and SMR portfolios is showing great potential. We have established trust with customers who are eager to utilize our systems in various cases, whether complex or straightforward. Lastly, we are excited about launching new products. For instance, our ARG product has received an excellent response in the U.S. market. We are taking a layered approach to remain competitive. Moreover, as we discussed, our next-generation Arvis technology is crucial for shoulder applications. The key element is not just having a robotic arm but also effective planning and navigation.

Phillip Benjamin Berry, CFO

Yes. I'll just pile in there a little bit too, Danielle, with regards to how important the Lima acquisition was to unlock our ability to really lean into shoulder growth. Not only from the robustness of portfolio and innovation capabilities that we got with the acquisition, but then the market access that it unlocks with regards to our ability to leverage this broader portfolio around the world. So we're really excited about what's happening in shoulder. The ARG was coming at a critical time, and we think that there's some really good momentum that's being created here in terms of our shoulder performance around the world.

Danielle Joy Antalffy, Analyst

Got you. Okay. That makes a lot of sense. Damian, we hear the same thing regarding the implant being much more significant than a robot. I have a question about P&R. That business is currently undergoing a turnaround. I'm curious about how you would describe where we are in that turnaround and your thoughts on the future potential of that business.

Damien McDonald, CEO

I'll talk a little bit about what I've seen, and why don't you jump in with the future. I really have a lot of faith in the ability of this team to continue to execute well. We know the markets are lower growth markets, but I think this team executes really well in multiple spaces, and they're very focused on financial discipline and really continuing to do that. And you saw that in the margin expansion. But even right now, there's a President's Kaizen going on in Dallas with the team to really look at how they get more capital efficient. And so I like this team in terms of its focus and execution. But I also like the fact that we're continuing to invest in bringing new products to market like the ManaFuse launch, which I think is going to be meaningful. And that's a tremendous product and has a huge unmet need. So a combination of great discipline and continuing to invest in new product launches, I think, is a great opportunity for us.

Phillip Benjamin Berry, CFO

Yes. I think what you've seen from us there, Danielle, on P&R is it's been much more consistent. I mean if you look past at the last 8 to 12 quarters, I think it's in that low single-digit growth, around that 3% to 4% range, and we were even a little bit north of that here in the first half of the year. So if you think about where we are in P&R, it's really a story around how do we continue to shape and improve it. So we've been looking at how do we continue to do that. Damien mentioned one with some new products that we're launching, but we're really trying to up the frequency of new product launches, and you're starting to see some of that play through with some of the choices that we've made from a shaping standpoint as well. So overall, we feel like this business is continuing to perform in that level that it has consistently. I think our expectations will be that it will continue to do that. We're continuing to look at how do we make it even better. But right now, I wouldn't propose to give any updated guidance other than to say I think we see it continuing to be consistent in terms of growth.

Dane M. Reinhardt, Analyst

Welcome, Damian. My first question is about end markets. Your U.S. hip and knee growth, even when normalized to mid-single digits, appears to be a bit lighter than the high single-digit growth from last quarter. Can you provide any updates on the evolution of end markets as we move through the summer months? One of your larger competitors mentioned a slowdown in June, so I'm interested in what you're observing both in the U.S. and internationally and how that has progressed so far in July.

Phillip Benjamin Berry, CFO

Yes. Thanks, Dane. I mean I think what we're seeing really is the post-COVID norm really. I mean you have ebbs and flows in terms of the market. So like we had said, we got off to a nice solid start in the first part of the second quarter. I think we did see some of that with regards to vacation schedules, especially as we ended our quarter on the 4th of July. So I think there's some of that. But again, if you look at our performance, I think Damien outlined it within hip and knee. One, we're still in that controlled launch phase of the Stem and Impactor. We had the headwind of capital with regards to delays with getting Arvis out. And then you had some days pressure in the U.S. as well with Good Friday and 4th of July that were impacting the U.S. market a little bit more heavily in the quarter. So overall, I mean, it's not where we want to be from a growth in the hip and knee standpoint. But as we think about the underlying performance of it, implants are still performing pretty well, and we think that the new products coming and some of the commercial execution efforts that Damian also outlined will help us to accelerate in the second half. Yes. So I'll take the tariffs. So yes, I mean, I think what we saw, Dane, is that the tariff rate for China paused the 90-day given that was 75% of our total exposure was a helpful thing for us. Now the question mark is a lot of these trade deals still aren't completed. So there's still a lot of uncertainty with regards to what gets actually agreed to here as we go through the balance of the year. So we improved our EBITDA guidance for the year. That's primarily, I would say, because we're seeing some favorability there, but we're still being a bit conservative because of the uncertainties that still exist. And as you think about how that plays through, I mean, we're taking a little bit of that through now, as I mentioned, with the cash flow impacts in the second quarter, it works its way through inventory to where we start to feel the effects here. in the third quarter in the P&L. We've started to work the mitigation actions. Most of those really scale in the fourth quarter to drive offsets. And what we had committed to everyone when we outlined the tariff exposure plan was that we will make sure that next year's impacts are less than what we feel this year. So overall, still a pretty dynamic situation. We're monitoring it. I'd say we're cautiously optimistic that it can get better. We've given a little bit back now, but hopefully, we'll be able to continue to see improvements here as these deals get executed.

Damien McDonald, CEO

So with respect to R&D, you saw a slight uptick in the quarter. I would characterize it like this. As I said, we're reviewing all the programs, and that's not just on the SG&A side. It's also on the R&D side. I'd consider this more about a shift in resource allocation than an expansion in spend. Our OpEx is healthy to say the least. And as I mentioned, we're looking to really understand our capital efficiency and the way we spend. So I wouldn't say that we're looking to increase spend. What I'm looking for is a change in allocation through this review of all the programs, looking at our effectiveness and focus. Not all programs are created equal. And there are some that I think have more near-term impact and ability to execute, some that are critical for our longer term. And then there are always projects that I think maybe should be re-examined. And so, again, don't look at this as a signal that we're increasing overall OpEx. I think about this as a shift in resource allocation.

Kyle William Rose, VP, Investor Relations

This concludes our question-and-answer session. I would like to turn the conference back over to Damien McDonald for any closing remarks.

Damien McDonald, CEO

Well, thank you. Let me just say I appreciate the welcome from all of you, and you have my commitment to be open, engaged, and visible. And if you need access, please make sure you reach out. I know we're on a start of a new journey together, and it's an important part of how we're going to build trust and a relationship. On behalf of the Enovis team and the Board of Directors, I'd like to thank you all for joining this morning, and we look forward to sharing our third quarter results with you in November.

Operator, Operator

Thank you. The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.