ENOV Enovis Corporation

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$28.62

Enovis Corporation Q3 F2026 Earnings Call Transcript

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Cindy
Conference Operator
Good morning and welcome to the Inovus Third Quarter 2026 Earnings Conference Call. All participants will be in listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by zero. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then one on your telephone keypad. To withdraw your question, Please press star, then two. Please note this event is being recorded. I would now like to turn the conference over to Kyle Rose, VP of Investor Relations. Please go ahead.
Kyle Rose
Vice President of Investor Relations
Good morning, everyone, and thank you for joining us today for our third quarter 2026 earnings conference call. I'm Kyle Rose, Vice President of Investor Relations. Joining me on the call this morning are Damien McDonald, Chief Executive Officer, and Ben Berry, our Chief Financial Officer. Our earnings release was issued earlier this morning and is available in the investor section of our website, anovis.com. We also posted a slide presentation to accompany today's call on our website. Both the audio and the slide presentation of this call will be archived on our website later today. During this call, we'll be making some forward-looking statements about our beliefs and estimates, regarding future events and results, including statements related to our pending acquisition of Essential Robotics. 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. The 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 this call. The accompanying reconciliation information 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
Chief Executive Officer
Thanks, Kyle. Good morning, everyone, and thank you for joining us today. I'll start with an overview of our third quarter results across recon and P&R and give a short update on essential robotics. Ben will then walk through The financials and our outlook for the fourth quarter and the full year before we open the call for questions. In the third quarter, we delivered organic growth of 5% with 6% organic growth in recon and 3% in P&R. In US recon, we grew 5% organically with extremities up 5% and hips and knees up 3%. In extremities, we're now past the anniversary of the ARG launch and ARG continues to be a strong growth opportunity for the future. As planned, Arvis is expanding in shoulder and we build upon the launch that began in Q2. Shoulder remains a healthy market and it's where we have one of our leading share positions globally. In hips and knees, Nebula continues to drive growth with over 80% of new instrumentation sets going to competitive users in the quarter. While we've now annualized the launch of the Nebula in the US, we remain in the early stages of a multi-year product cycle. I'm proud to note that it is now our top-selling stem and we've got a long runway ahead of us. We're competing and winning in both hospital and ASC settings, and the ASC continues to be a good fit for our portfolio. Internationally, Recon grew 8% organically. As we've noted, the Past several quarters, market dynamics in Western Europe remain challenging, and the conflict in the Middle East continues to weigh on growth. Despite these challenges, Shoulder grew double digits and led the international business. We continue to win competitive accounts outside the US, and I'm excited to announce we completed the first Arvis Shoulder cases in Europe last month. On essential robotics, we announced our binding offer to acquire the company on September 1st. Since then, we have completed the Works Council consultation and we expect the deal to close by the end of the year. Integration planning is well underway. Our recon team is working with the essential team in Grenoble on the knee and shoulder programs and the timelines we laid out are unchanged. In fact, through our integration planning, we are making investments to secure the talent and technology required to accelerate our development upon deal close. We expect to bring the knee robot to market within two years and shoulder to follow soon thereafter. Since the announcement, I've spent a lot of time discussing robots with surgeons. What I hear most is how much opportunity there is to develop innovative enabling technology and implant systems which solve known problems and anticipate the evolution of surgical workflows and patient outcomes. This is an exciting inflection point for our recon business and we believe it will be a meaningful contributor to our sustained above-market growth. Now moving to P&R, which grew 3% organically, including 5% organic growth in the US. Global bracing grew 3%, driven by business mix and new products in spine, core, knees and lower extremity bracing segments. Recovery science was driven by double-digit growth in Regen as we accelerate the launch of Manifuse and capitalize on key competitive conversions. Now I'll turn it over to Ben, who will walk through the financial details.
Ben Berry
Chief Financial Officer
Thanks, Damien. Hello, everyone. We reported third quarter sales of $559 million, up 2% versus prior year on a reported basis and up 5% on an organic basis. Reported growth included a 30 basis point headwind from foreign currency, and a 250 basis point headwind related to the divestiture of Dr. Comfort. As a reminder, Q3 is the last quarter in which the Dr. Comfort divestiture affects our year over year comparison. Recon grew 6% organically with extremities up 8% and up 5% in hip and knee. PNR grew 3% organically. The ongoing conflict in the Middle East was 100 basis point headwind to international growth We delivered adjusted gross margins of 60.9%, up 60 basis points, driven by mix and operational productivity. This includes $8 million of tariff refunds, offset by roughly $3 million of inflationary pressure from higher raw material and freight and distribution costs tied to the Middle East conflict. Our teams continue to work on mitigation actions to soften the overall impact of inflation in this dynamic market. Adjusted EBITDA margin was 18.5% of 120 basis points year over year. The third quarter effective tax rate was 23%. Interest expense was $8 million for the quarter versus $9 million in the prior year. Overall, we posted adjusted earnings per share of $0.88 up 17%.
Young Lee
Analyst, Jefferies
versus prior year.
Ben Berry
Chief Financial Officer
Free cash flow in the quarter was 35 million, bringing year-to-date free cash flow to 37 million, up 50 million versus the prior year. We remain confident in our 2026 target of greater than 25% free cash flow conversion. I'm encouraged by the strong demonstrated progress we have made on cash generation, which now gives us more flexibility as we think about capital allocation in the future. We exited the quarter with net leverage of 2.9 times, which is below the goal we set for the year. When the essential transaction closes, leverage will step up about a half turn. While we remain committed to improving our balance sheet and paying down debt, we're also focused on continuing to make capital allocation decisions that we believe will drive long-term growth and shareholder value. To this end, today we announced that our board has authorized a new 200 million share repurchase program. We do not plan to materially waiver from our leverage commitments. However, we plan to use this opportunistically and stay within a range of 2.5 to 3.5 times leverage. We see real value in our long-term growth strategy and share repurchases are another tool we can utilize to create shareholder value. Turning to full year guidance, we are narrowing our revenue range to 2.32 to 2.35 billion. We expect organic growth to be approximately 5%, and we are increasing our adjusted EBITDA range to 428 to 438 million. We are also raising our adjusted earnings per share range to $3.58 to $3.79. As we outlined last quarter, in Q4 we expect modest acceleration in both segments, driven by arvus and shoulder, continued nebula conversions, and new products in P&R. Our outlook assumes the procedural environment we saw in the third quarter holds through year end with typical Q4 seasonality. On the profit side, our updated guidance assumes an incremental $4 million investment in enabling technology R&D talent and a $1 million negative impact from currency. We continue to expect free cash flow conversion of greater than 25% in 2026. To summarize, the third quarter was in line with expectations we set in August in a market that remains dynamic. Cash generation continues to improve. and we are carrying new product momentum in both segments into the fourth quarter.
Young Lee
Analyst, Jefferies
Now I'd like to turn it over to Kyle to start the Q&A. Kyle?
Kyle Rose
Vice President of Investor Relations
Thanks, Ben. In an effort to accommodate everyone in the Q&A session and keep things to a reasonable time, we ask that analysts limit questions to one question and one follow-up. You are welcome to rejoin the queue and we will fit you in if we still have time. With that, we would now like to open up the call to take your questions. Operator?
Cindy
Conference Operator
We will now begin the question and answer session. To ask a question, you may press star then one on your telephone keypad. If you are using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star then two. At this time, we will pause momentarily to assemble our roster. Our first question comes from Ryan Zimmerman of U.S. Bancorp, BTIG. Go ahead, please.
Izzy / Michaela
Analyst representatives for Ryan Zimmerman (BTIG) and Caitlin Roberts (Canaccord)
Hey, good morning, everyone. This is Izzy on for Ryan. Thanks for taking our questions. I just wanted to start on the U.S. recon business specifically with knees and hips. It was a little bit softer than what we saw your growth for both extremities and the international business be. And we've heard some comments from your peers about softness in the large joint market. So I was curious. What your take is on the outlook of the market and what will help get your knee and hip growth back in line or better?
Damien McDonald
Chief Executive Officer
Good morning, Izzy. Thanks for the question. We've been saying since Q1 that the market is more volatile than we'd normally seen, both in the US and internationally. I know there's a lot of swirl about markets, even from those who have much larger perspectives than we do. We're focused on controlling the controllables. It's a dynamic market environment. We think we're building a strong, resilient customer organization. So our focus is really on gaining market share and, candidly, not being a victim to the market.
Izzy / Michaela
Analyst representatives for Ryan Zimmerman (BTIG) and Caitlin Roberts (Canaccord)
Understood. That's helpful. Thank you. And I understand that it's still a little bit on the early side, but I was hoping you could maybe provide some color on your thoughts around 2027. Thanks for taking the questions.
Damien McDonald
Chief Executive Officer
With 2027, we're going to point everyone back to what we outlined in September when we did the essential announcement. Our view hasn't changed since then, and we're going to comment fully in February when we do the Q4 full-year results.
Kyle Rose
Vice President of Investor Relations
Operator, next question, please.
Cindy
Conference Operator
Okay, thank you. Our next question comes from Vijay Kumar of Evercore ISI. Go ahead, please.
Vijay Kumar
Analyst, Evercore ISI
Hi, guys. Thank you for taking my question. I guess my first one, you know, when you look at this recon assumptions, getting back to high singles in Q4, is the bridge between CQ to Q4 just a comp from these headwinds? You know, could you also comment on what's happening within ASCs? You know, what percentage of recon procedures are being done in ASCs and what's the growth rate in ASCs has been?
Ben Berry
Chief Financial Officer
Hey, Vijay, thanks for the question. Yeah, I think as you recall, we get an extra selling day in Q4. So that's going to contribute about 150 basis points, a little bit more than that to the top line growth. So that plus some of the dynamics that we talked about with just normal Q4 seasonality will drive some of the acceleration there. In terms of ASCs, we continue to see movement there. In terms of our knee business, I think what we're seeing is a little over 25% of primary knees going through the ASC. It's about 20% or a little bit more than that in hips. And we're climbing closer to that hip number and shoulder. We're still in the, I'd say, the high teens in terms of percentage of our procedures going through the ASC. So we see the ASC as a continued strategic channel for us and one that we will continue to be focused on in terms of setting our business up for success.
Vijay Kumar
Analyst, Evercore ISI
That's helpful. Then maybe one on free cash. Third quarter was pretty impressive, 68% free cash conversion. Is this a sustainable number for you guys when you think about fiscal 27? I know with the deal coming on, does it impact a free cash conversion or is this a sustainable number?
Ben Berry
Chief Financial Officer
Yeah, thanks, Vijay. Again, we'll point you back to what we talked about in September, where we see a step up to at least 50% free cash flow conversion next year and $100 million of cash generation. So we still see a line of sight to that. We'll try to do better than that. But overall, I'll point you back to that in terms of thinking about next year.
Kyle Rose
Vice President of Investor Relations
Thanks, guys.
Cindy
Conference Operator
The next question comes from Jeff Johnson of Baird. Go ahead, please.
Jeff Johnson
Analyst, Baird
Yeah, thanks. Good morning, guys. Damien, maybe follow up on your comment about controlling the controllable. You know, US hip and knee growth was 3% this quarter. It does seem, as others have said, that the US market, especially for US hips and knees, may have slowed a bit this quarter. Just are you seeing anything, you know, even if you can or can't control, I guess, surgical schedules, higher cancellation rates, extended... Williams, willingness to pay co-pays, deductibles, things like that, so patients slowing down, anything at all there. And Ben, I guess the corollary or follow-up on that is just that you talked about Nebula being one of the drivers of acceleration in 4Q. So if U.S. hip and knee was three this quarter, you pick up the extra day, that's four and a half, and then Nebula on top of that. Should we see U.S. hip and knee growth above the mid-single digits next quarter? Thank you.
Damien McDonald
Chief Executive Officer
Hey, good morning, Jeff. So was there an option D there that was like all of the above? I'd point you to that. I think all of the things you mentioned, we're seeing all of that. It's pretty choppy. And we're, as I said, very focused on market share gain and using EGX to get after the targeting and segmenting, account acquisition, account penetration, being very disciplined on price. And again, making sure we have the best Salesforce. So we're doing a lot on Salesforce training. So The way we're countering all of those things that you mentioned is by focusing on our performance.
Ben Berry
Chief Financial Officer
Yeah, in terms of hip and knee growth in the U.S., Jevin, we don't guide particularly on anatomy level growth given some of the dynamics in the market that Damien talked about. But we see momentum building there. We still see a large opportunity in U.S. hips and knees in terms of ability to take market share as we continue to reinforce the portfolio and build more strength there with enabling tech. So Overall, I think the way you're thinking about it makes sense, but like I said, we don't guide for anatomy level.
Jeff Johnson
Analyst, Baird
Yeah, fair enough. And then just one follow-up. I think last quarter, that low single-digit U.S. shoulder number is what caught a lot of us off guard. I think you explained it well with some of your Arvis shoulder training during the period last quarter, so that all made sense. Encouraging to see that shoulder number get back to high single digits in the U.S. this quarter. But just what can you talk about the competitive environment? You do have a couple of your competitors out there with You know, new shoulder systems, maybe even some robotic applications in shoulders, even though early stage there. Just how to think about the shoulder competitive environment and until you get the robotic option out in a couple years on shoulder. You know, can you sustain market above market growth? How are you thinking about that in the U.S.? Thank you.
Ben Berry
Chief Financial Officer
Yeah, I mean, I think it's definitely a competitive environment. We're pleased with our position in the market. We believe we're continuing to take share. We're the global number three player in shoulder, number two internationally, knocking on the door of being number two globally. We really are encouraged by the portfolio that we've built in the shoulder in terms of the dynamics that we have in terms of products that can be used for different philosophies. That continues to build with new product innovations, things like ARG that are complementing that overall portfolio. You know, putting the Lima and Legacy Inovus portfolios together just adds strength, adds compatibility, gives more options. And what we're really seeing right now is really strong uptake and interest in the Arbus platform. And given where shoulders are in terms of the enabling tech curve, which still needs a lot of development in terms of use cases there, We feel like Arvis will continue to be a player here in terms of giving the surgeons enabling tech tools that really help aid them in a way that makes surgery more efficient in the shoulder. So we're encouraged by the portfolio, the momentum, Arvis' contribution to that, and we would expect that to continue into the future.
Cindy
Conference Operator
Thank you. Our next question comes from Robbie Marcus of JP Morgan.
Cindy
Conference Operator
Go ahead, please.
Lily
Analyst representative for Robbie Marcus, JPMorgan
Hi, everyone. Thanks for taking the question. This is Lily on for Robbie. One on guidance. You beat EPS by about 11 cents, but guidance, by my math, is moving up by five at the midpoint. So hoping you can unpack that a bit more. Why not flow through the full upside, and are there any incremental headwinds or expenses down the P&L we should be baking into the fourth quarter?
Ben Berry
Chief Financial Officer
Hi, Lily. Thanks for the question. As I mentioned in our prepared remarks, we're investing in enabling tech resources, particularly in R&D, to really get ahead of bringing essential into the family. We see lots of opportunities to really de-risk that program and to add some strength with regards to talent within the organization. So that's about $4 million that we're going to make investments in Q4 to support that acquisition. On top of that, currencies moved in a negative way since last quarter. So that's going to hit us for about a million in Q4. So contemplating those two things is really the reason why we didn't flow everything through.
Lily
Analyst representative for Robbie Marcus, JPMorgan
Great. And then just to follow up to that, you delivered pretty significant SG&A leverage this quarter with expense actually down a bit year over year. So What drove that and was there anything one time or timing that drove the greater than expected leverage in the third quarter? Thanks.
Ben Berry
Chief Financial Officer
Yeah, nothing I would point to as one time. Overall, I think it's just phasing of expenses through the year. We generally invest a little bit heavier in the first part of the year. You have the softer Q3 with regards to international markets and that generally reduces expenses in the quarter. Overall, nothing unexpected there, and it's just really phasing.
Kyle Rose
Vice President of Investor Relations
Perfect. Thank you very much.
Cindy
Conference Operator
Our next question comes from Lawrence Beagleson of Wells Fargo.
Cindy
Conference Operator
Go ahead, please.
Ross Osborne
Analyst representative for Larry Biegelsen, Wells Fargo
Hi, good morning. This is Ross Osborne for Larry. Thanks for taking our questions. Starting off, we'd be curious to hear where Lima stands, how much integration spending carries into 27, and how much of the 50 BIPs underlining EBITDA margin expansion comes from Lima Synergies versus improvement elsewhere in the business?
Damien McDonald
Chief Executive Officer
So the integration expense in the quarter. So Lima integration expense?
Ben Berry
Chief Financial Officer
Oh. So yeah, I think we continue to, like we've laid out, this is the third year of integration. on the Lima where we're continuing to finish a lot of that journey with regards to the investments we needed to make to integrate that into the organization. So we're continuing to track to our stated plans there. This will be the last big meaningful year of investments in integration on Lima. And it's going very well in terms of the way that we laid out the plan in terms of executing against that plan. And a lot of what we're doing this year is is cleaning up some things, moving some things from manufacturing to other locations. So that's all continuing to track. In terms of the synergy value, yes, it continues to contribute to our mix and gross margins. We see that as an opportunity to continue to drive improvement there. And that is one of the key drivers as we lay out how do we drive our 50 basis points of improvement every year. So it's a contributor. It's not the contributor. but overall I'd say it's tracking to what our expectations were.
Damien McDonald
Chief Executive Officer
I mean the other one that's stepping down a lot too is the EUMDR, right? So year over year, that's the other step down.
Ross Osborne
Analyst representative for Larry Biegelsen, Wells Fargo
Okay, great. And then on capital deployment and with your leverage within your comfort range and a new $200 million authorization program, is repurchasing shares now a near-term priority or more so optionality? and what capacity remains after essential and how do you rank buyback against debt reduction in M&A?
Ben Berry
Chief Financial Officer
Yeah, thanks, Ross. I mean, we believe that the company's valuation is significantly below where our value lies. You look at where the stock has traded off quite considerably over the last 12 months and it's dislocated given our performance and our outlook for the future. So what we wanted was flexibility to take advantage of this dislocation. and as we think about share buybacks, we're going to be very much opportunistic, disciplined and focused on how we do that. And it's really going to depend on if we feel like the shares are really dislocated from where they should be. And right now, the way that the value that we're trading, we would say that we do see that. So we will use this as a capital allocation tool. But like I said, we'll be disciplined about how we deploy it.
Kyle Rose
Vice President of Investor Relations
Thank you.
Cindy
Conference Operator
Our next question comes from Young Lee of Jefferies. Go ahead, please.
Young Lee
Analyst, Jefferies
All right, great. Thanks for taking the question. I guess to start, just on essential, so, you know, the deal hasn't closed yet, but, you know, what has been the early feedback on that from your customer base as well as from your reps? You know, are there any features essential offers that the customers or reps are more excited about?
Damien McDonald
Chief Executive Officer
Yeah, good morning, Young. I have to say, we've had a great response from our customers, both on the knee side and the shoulder side. In fact, Ben and I just last night were with a group of physicians that we're very close to, and we had a long conversation about this In both therapeutic areas, both anatomies, there's a lot of excitement about what we can bring to the table. And it's not just about the robot. We've always talked about enabling tech, planning, navigation, assistance. And we think the whole ability to bring an ecosystem to an offering for physicians is really key here and meeting the physician where they are. So a lot of people work in Large hospitals and then they also work in small ASC clinics and being able to give them an ecosystem that seamlessly moves between those venues, we view as exciting and so do they. The reps are just excited to be able to compete. In terms of a contractual basis, a lot of accounts require the assistance part of the equation. We've got that now coming into the bag and I think they view that as a really great opportunity to compete. and candidly a lot of shareholders also viewed it as that just being able to compete head-to-head and also shape the direction of where we're going in shoulder with a new form factor is exciting.
Ben Berry
Chief Financial Officer
Yeah, and I'll pile in there, Young. I think that we continue to be very impressed with the essential team, their talent, their ability to collaborate, the speed in which they operate. So overall, we're really excited about This acquisition and what it's going to bring to Inovus in the future.
Young Lee
Analyst, Jefferies
Okay, great. Really helpful. And then I guess one more just on the U.S. extremity side, you know, the shoulders leading the growth there. Can you talk a little bit more about what's going on in the U.S. foot and ankle side? You know, that market is typically viewed as a little bit more deferable, kind of like NEIS. How's that business doing? Any changes in the macro or competitive dynamics you'll call out?
Ben Berry
Chief Financial Officer
Yeah, thanks, Young. I think foot and ankle market continues to be a little bit volatile quarter over quarter. I think underlying performance through the first nine months, we're very pleased with the foot and ankle business. Portfolio continues to get stronger with some of the new innovations that we're launching. We've got some other things coming here. Later this year and into next year that we're really excited about. We still see this as a market that over time is going to grow into the high single digit range. And we're really excited about the portfolio that we're putting together to continue to capitalize on that growth and take share. So overall, I'd say in the quarter itself, it was a little bit softer than what we would have anticipated. Could that have been some deferrals? Maybe. You know, if we look at where it was coming from certain product lines, it Nothing that we're concerned about, and we saw a nice rebound as we stepped into the first month in the fourth quarter there. So overall, I think foot and ankle continues to be a growth driver for us, and we're excited about the portfolio we're building. Quarter over quarter, there could be things that pop up, but overall, if you look at it over the course of time, we expect this business to continue to grow high single digit plus.
Kyle Rose
Vice President of Investor Relations
Thank you.
Cindy
Conference Operator
The next question comes from Caitlin Roberts of Canaccord. Go ahead, please.
Izzy / Michaela
Analyst representatives for Ryan Zimmerman (BTIG) and Caitlin Roberts (Canaccord)
Hey, guys. It's Michaela. I'm for Caitlin. Thanks for taking the question. Just one from us today. We were just wondering if are you seeing any impact from recent competitive dynamics including the new knee launch from one competitor and then the weakness another has called out in HIPS related to the lack of an impactor?
Damien McDonald
Chief Executive Officer
Again, I think we've got a great knee portfolio and we're continuing to take share with that, which is exciting. On the impactor side, we can definitely tell you that having an impactor and by the way, a triple tapered collared stem with Nebula has really made a tremendous impact on our ability to take share and partner with new clinics. So definitively an impactor is a key part of that equation.
Kyle Rose
Vice President of Investor Relations
Awesome, thank you. Next question, operator.
Cindy
Conference Operator
Yes, our next question comes from Vic Chopra of BMO. Go ahead, please.
Vic Chopra
Analyst, BMO
Hey, good morning, and thanks for taking the questions. and apologies if these have been asked. I've been bouncing around. So you said that U.S. hips and knees grew 3% in the quarter. By our math, that's still ahead of the market. I'm just curious what you're seeing in underlying procedural volumes exiting the third quarter and how much of that growth represents share gain versus the market. And I had a quick follow-up.
Ben Berry
Chief Financial Officer
Yeah, I think, Vic, the way that we see it is, yes, we continue to feel positive with regards to our U.S. hip and knee performance as you stack it up versus the overall market. We have seen some nice start to Q4 here. Again, it's still early in the quarter, so we'll have to see how that plays out. But overall, as Damien mentioned, we're excited about the portfolio we're building there. still see a large opportunity for us in growth in terms of our hips and knees, particularly in the U.S. market.
Vic Chopra
Analyst, BMO
Great. Thanks, Ben. You know, you delivered about 5% organic growth in the third quarter. You know, as we look into 2027, maybe just talk at a high level about the biggest drivers and potential offsets to sustaining that 5% or better organic growth. Thank you.
Damien McDonald
Chief Executive Officer
Again, without commenting on 27, I think what gives us confidence about going into the new year in a choppy market, and there's been a lot of talk about that in various forums, we continue to take share in global hip and knee, global shoulder, P&R is growing above the market. So I think our underlying performance and commercial execution is what gives us confidence about how we not only finish off the year but where we're heading into the next year.
Kyle Rose
Vice President of Investor Relations
Operator, next question please.
Cindy
Conference Operator
Yes, our next question comes from Steve Lichtman of William Blair. Go ahead please.
Steve Lichtman
Analyst, William Blair
Thank you, good morning guys. I wanted to ask on the P&R business, it's delivered pretty Steady 3% underlying growth here the last few quarters. Can you give us your latest outlook on the market there and the state of your business overall? So how are you feeling overall about where your P&R business sits today?
Damien McDonald
Chief Executive Officer
Yeah, we're really proud of how that business is shaped. We've talked about the portfolio now that more than 50% of it's growing mid-single digital greater I think the team is really executing in the U.S. You know, really in the prepared remarks region with Manifuse has done a great job of doing competitive conversions and that's really leading the way. But broadly, we've got some great things going on and some tailwinds like the No Pain Act, driving cold therapy and where we're going with the OA portfolio. So I think in the U.S. we're seeing really solid above market performance there. internationally has been challenged and we have a big presence in international and we've talked about markets like France and Germany where by the way we skew towards France and Germany for that portfolio being under pressure but again I think those teams are working hard to counter all of those changes and the dynamics in those markets so overall we're really really pleased with how that group's going.
Steve Lichtman
Analyst, William Blair
Great and then just follow up Ben you highlighted some of the drivers of free cash flow improvement. Sorry if I missed it, but one thing I'm not sure you mentioned was leverage on the CapEx side. Looks like that was down. Is that more of a timing thing or do you see that continuing to run lower year over year and what might be driving that? Thanks.
Ben Berry
Chief Financial Officer
Yeah, thanks, Steve. I think if you look at how we deploy instruments in CapEx, it's generally first half weighted. So we can capitalize on those placements throughout the course of the year and as we build into next year. So I'd point it more towards the phasing of spend versus anything at this point. Overall, I'd say we see capital, CapEx as a percentage of sales to tick down over the next couple years, but it will continue to grow because of the investments that we're making on the recon side of the business.
Kyle Rose
Vice President of Investor Relations
Got it. Thanks, Ben.
Cindy
Conference Operator
The next question comes from Mike Madsen of Needham. Go ahead, please.
Young Lee
Analyst, Jefferies
Hi, guys.
Joseph
Analyst representative for Mike Matson, Needham
This is Joseph for Mike. Maybe just a couple of product ones on P&R. It looks like maybe in the quarter there was some skew rationalization or discontinuing a product maybe in U.S. other P&Rs. Just wondering what that was and maybe the reasons for that. Is it a margin? a problem that was being addressed. And then maybe just Motion ND, you guys called out penetration there in the slide deck. I saw on the website that you guys list some metrics there including maybe 75 integration partners. I'm just wondering in terms of penetration, what's the ceiling there, if you can quantify it at all, and how has growth looked like in that product?
Ben Berry
Chief Financial Officer
Yeah, thanks, Jason. I think what you're referencing is the divestment of Dr. Comfort that we did last year. So this is the last quarter that that's in the comparable, but that is what's driving that down in terms of the rationalization, I believe.
Damien McDonald
Chief Executive Officer
And on MotionMD, we don't declare the metrics broadly, but I will say there's a number of things that are really important for us We have a 99% customer satisfaction rating with the software and the service that's attached to that. And that provides enormous stickiness. Again, without declaring the number of accounts that we service, it's a significant number and growing year on year. And we've got demonstrable ability to show how we can reduce inventory at the clinic level, how we increase the speed of processing of claims. and the return of claims. So we're very, very proud of how that team works and it's a real core competency and I think a differentiator in the P&R space.
Joseph
Analyst representative for Mike Matson, Needham
Okay, great, yeah. And then maybe just on the robotics launch, I guess my assumption for the launch in 2028 would be to target current customers that are already using Astra, Arvis and Portal. But maybe you can touch on that strategy, whether it's more broad-based or targeted. And just based on your initial conversations, if you guys have a good idea, what's maybe your expectation of how many of those Astra customers would be interested in integrating robotics or maybe feel comfortable with just the navigation and planning of Arvis and Portal?
Damien McDonald
Chief Executive Officer
Yeah, that's a whole bunch of questions there. And we don't even own the company yet. So first, we're interested in getting to the close, which we think is on track to be done before year end. Once we do that, we'll start talking about how we are going to frame this up. But I'm definitely not in a position to talk about strategy yet. But we certainly have some great ideas. And again, as I said earlier, The reaction to this from our key customers has been really very positive.
Ben Berry
Chief Financial Officer
Yeah, I'll just weigh in there too. I mean, I think we see an ability here to create a seamless ecosystem between Arvis and the robot. And as we do that, we don't believe there's a one size fits all. So we'll continue to try to leverage this to take as much market share as we can and to really drive Thanks, Jason. Cheers.
Cindy
Conference Operator
The next question comes from Nakula Desai of Freedom Capital Markets. Go ahead, please.
Nakula Desai
Analyst, Freedom Capital Markets
Hey, guys. Good morning. This is Nakula on for Keith. Thanks for taking the question. We have just one quick one. So if we exclude the tariff refund, gross margin was down approximately 80 basis points year over year. So can you Give any color on what the drivers were there and how we should think about gross margin and 4Q and heading into 2027.
Ben Berry
Chief Financial Officer
Yeah, I think the way to really think about it, it's the mix of the business in the third quarter that was really driving that and some of the pressure points that we saw there. So overall, that's the key contributor. Not commenting on guidance in terms of that line for the fourth quarter, but overall, I think we still see gross margin as As the company grows and as Recon becomes a bigger part of the portfolio, we see opportunities to expand gross margins year over year.
Kyle Rose
Vice President of Investor Relations
Thanks so much.
Cindy
Conference Operator
Again, if you have a question, please press star, then one.
Cindy
Conference Operator
This concludes our question and answer session. I would like to turn the conference back over to Damien McDonald, CEO, for any closing remarks.
Damien McDonald
Chief Executive Officer
Thanks, Cindy, and thanks everyone for joining us today. The third quarter played out largely as we expected, and I want to thank our teams for delivering on our commitments and to take share regardless of the challenges posed by the dynamic and volatile markets we faced. We appreciate all of you for your continued interest. Thanks for your support and we look forward to updating you in the fourth quarter and our full year results in February. Thanks everyone.