But rest assured that, that is the engine of growth for our company.
Shagun Chadha: Got it. That’s helpful. And just as a quick follow-up. Can you just remind us how you define Stryker’s performance at the high end of med tech. So how do you define that growth range?
Kevin Lobo: Yes. Historically, we’ve said 200 to 300 basis points higher than the market, Shagun. I would say, right now, it’s tracking more towards 300 basis points faster. The market has improved clearly versus where it was a few years ago. but we continue to outperform it at that kind of level.
Operator: The next question comes from the line of Ryan Zimmerman with BTIG.
Ryan Zimmerman: I want to dovetail on Shagun’s Cajuns question and also Larry’s earlier question on ’24 and asking the way, I appreciate you guys have always been at the higher end of med tech. But Kevin, when you think about some of the puts and takes that you’ve outlined, be it robust orthopedic demand, offset by some of the staffing issues that we’re seeing in hospitals. Do you anticipate ’24 to be at a growth rate similar to kind of what we think of as historical net debt growth rates in that 4% to 5% range.
Jason Beach: Ryan, it’s Jason. I’ll just jump in here and then we’ll open it up for your follow-up. But as we think about 2024, obviously, we will get into that more in January. I can give you a little bit more detail. But at this point, we won’t comment any further in terms of how we’re thinking about the top line.
Ryan Zimmerman: Okay. I had to try it in a different way. So I appreciate it. All right. I’ll turn — I’ll shift directions then. And just ask, your head of your knee business just gave an interview actually yesterday that I thought was really interesting. And you disclosed that there’s about 300 robots from Mako that is in ASCs today. And I’m wondering where you see that market topping out at or where you see from a socket perspective? I mean if there’s 12,000 ASCs in the U.S. today, I mean there’s no way that all of them can own a robot, although that would be nice to think I guess I’m curious kind of as we thought — as we’ve seen the ramp of Mako, I mean, initially, it was maybe 2,000 hospitals and then it was potentially all 5,000 hospitals in the U.S. it’s early days in ASC, but where do you think that can go over time as you sit here today?
Kevin Lobo: Yes. Listen, Mako is performing extremely well in the ASC. And just as a reminder, right now, at our hip and knees procedures roughly, call it, 12% of those are being done in ASCs. That number is growing dramatically and will continue to grow dramatically. And as surgeons move their business to the ASC, they do not want to suffer. They want the best technology, they want Mako. So I see tremendous upside in Makos in the ASC because they want to be able to do it, it lends itself very well. There’s less instruments, which means less pressure on sterilization, which is a major bottleneck within ASCs. They don’t have the same room for sterilization that hospitals do. So it’s actually a very, very effective product to have in the ASC.
And so as that percentage of 12% moves and based on different pundits, it’s somewhere between 30%, 40%, as that goes higher, you’re going to see more and more robots being installed in these ASCs. So there is a significant upside in front of us here in the United States. And frankly, ASCs, now they’re starting to talk about it in multiple countries in Europe. In Switzerland, they’re talking about it in Germany, they’re talking about and in the U.K. They’re starting to figure out that this model is actually a good model for the delivery of health care. Good for surgeons, good for staff. Staff, frankly, nurses love going to ASCs. We’re having less issues on staffing and surgery centers than we are in hospitals and good for the patients. Patients actually like going to a place where there aren’t sick people and where there’s easy parking and where you can go home the same day.
Operator: The next question comes from the line of Matthew O’Brien with Piper Sandler.
Matthew O’Brien: Kevin, that Mako line this quarter was pretty eye-popping. So I’m kind of wondering, J&J launched the system at WS this year. I’m not sure it’s all that great. But — but Zimmer was pushing as well. Did you see a pause in the market with some of those dynamics? And then that’s kind of behind you now and you’re winning a disproportionate share of Mako sales placements? And then specifically within there, are you getting more of those placements into competitive accounts that you have historically? Or is it still kind of a reasonable mix between existing shrinker accounts and then competitive.
Kevin Lobo: Yes. We’re not really seeing much of a change in the mix between competitive and, let’s call it, Stryker-friendly accounts. It’s pretty similar as it’s been, frankly, throughout the launch. There really hasn’t — it’s really people who want technology, and are really looking for the best that they can get. And what we saw with the competitive products came on the market is we saw a little bit of a slowdown as they evaluated side-by-side different companies. But it was pretty modest. And I would say now, really, we’re not concerned about comparison side by side. We frankly encourage that, that they look at the product side by side. We really believe we have the best solution for hip and knee replacement in the same robot. And then, of course, look forward to adding other applications, again, to the same robot with the spine and shoulder in the coming periods.
Matthew O’Brien: It makes sense. And then Kevin, again, you touched on this at the beginning, but GLP is a dominated a conversation for all of us on this call. There’s some Shanghai data out there about a big reduction in knee replacements in that study, although I’m not sure that study is all that robust. There’s another OA study coming out fairly soon that we’re all looking at. I’m just curious what Stryker looked at internally that gives you that comfort that you can tell investors confidently that this is not going to be an issue, not necessarily now, but in 2, 3, 5 years from now, and then I don’t know if you can talk a little bit about some of these near-term benefits that you’re seeing in terms of some patients that have lost weight that are now eligible get a knee or hip replacement.
