Dive Brief:

• Stryker's Mako robotic surgery systems in use worldwide number close to 800 after the Kalamazoo, Michigan-based medtech sold 51 during the third quarter, the company reported Tuesday, up from 44 sold last quarter and 37 the year prior.
• More than three-quarters of the joint replacement platforms are in the U.S., with Japan and China being Stryker's near-term geographic priorities for expanding Mako, CEO Kevin Lobo told investors. Having won regulatory approval for the Mako total knee application in Japan during the quarter, Stryker sold four robots there.
• Despite the full launch of Zimmer Biomet's Rosa total knee option earlier this year, pricing for the Mako robot "remains extremely stable," Katherine Owen, vice president of strategy and investor relations, said.

Dive Insight:

Adoption of Mako helped Stryker hit 8.6% organic net sales growth (a slight sequential slowdown from last quarter, analysts said), and management lifted full-year expectations "toward the higher end" of the previously guided 7.5% to 8% range.

Hip replacement procedures in the U.S. using the robot were up approximately 40% year over year. Total knee procedures, where Stryker now competes with Zimmer, rose 60%.

"On the competitive front, the numbers and feedback suggest that Zimmer's Rosa launch has had little impact on MAKO momentum out of the gate but also that the shift to robotics will likely prove to be more a rising tide rather than a zero sum game," analysts at Jefferies wrote to investors Wednesday. Zimmer Biomet is set to report earnings Nov. 5.

Lobo, who in March was named chairman of trade association AdvaMed, also weighed in on the status of the currently suspended 2.3% medical device excise tax. AdvaMed is "not optimistic" a repeal will happen, Lobo said, but the group will continue to lobby for a continued multi-year suspension. "There are a number of vehicles that we are hopeful, we can attach this to between now and the end of the year," he said.

Stryker management also touted the up to $500 million acquisition, closed last week, of sister companies Mobius Imaging, which makes a mobile CT scanner, and surgical and interventional radiology robotics developer Cardan Robotics. The additions are part of an effort to offer "complete procedural solutions," Owen said, which is "increasingly a trend we're seeing in spine."

Stifel analysts wrote to investors following the earnings call that "still-underwhelming spine results were the only real 3Q negative."

CFO Glenn Boehnlein said in prepared remarks Tuesday "U.S. sales softness and price erosion" dented the business' results, as did slower than expected salesforce integration related to the acquisition of K2M completed last November. Despite drag from core spine offerings, strength in interventional spine offerings helped the neurotechnology and spine unit hit 7.6% organic growth, Boehnlein said.

Stryker is ultimately hoping to bring a spine robot to market. Executives declined to clarify to analysts on the earnings call whether an offering from Cardan could beat a Mako spine robot to market.

"We do think there is some complementary technology for our ultimate goal of Mako spine robotics system, but it's just too early" to get into details, Owen said.