Zimmer Biomet Holdings (ZBH -0.80%) delivered a sizzling performance in 2019, with shares soaring 44%. But 2020 started off flat -- the medical device stock traded essentially sideways through January.

That could change now. Zimmer Biomet announced its 2019 fourth-quarter and full-year results before the market opened on Tuesday. Here are the highlights from the company's update.

Man holding tablet with numbers projecting out

Image Source: Getty Images.

By the numbers

Zimmer Biomet reported fourth-quarter revenue of $2.13 billion, up 2.6% year over year. That topped analysts' average prediction of $2.11 billion. Net income was $321.4 million, or $1.54 per share, based on generally accepted accounting principles (GAAP). That was a considerable improvement from the GAAP net loss of $902.5 million, or $4.42 per share, in the prior-year period.

The company's adjusted net income was $2.30 per share, up from $2.18 per share in Q4 2018. Zimmer Biomet's adjusted earnings also easily beat the consensus Wall Street estimate of $2.27 per share.

Behind the numbers

Foreign exchange fluctuations hurt Zimmer Biomet somewhat in the fourth quarter. The company stated on a constant currency basis, its revenue climbed 3.2% year over year, well above the reported 2.6% increase.

Over 60% of Zimmer Biomet's total revenue comes from the Americas region, where fourth-quarter sales rose 2.3% to $1.29 billion. The growth picture looked even better in the Asia Pacific region, where sales jumped 9.2% to $367 million. However, Europe was a weak spot  -- sales there slipped by 1.1% to $471 million.

The company reported 4.9% year-over-year sales growth for its knee-replacement products and 3.2% growth for its hip-replacement products. Management noted that sales of the ROSA Knee System  picked up momentum from Q3, and also said that the Q4 launches of the Persona Revision knee system and Avenir Complete hip system went well.

Zimmer Biomet's restructuring initiatives made a big impact. Operating expenses in Q4 were down 37% from the prior-year quarter to $1.79 billion. Those cost reductions combined with revenue growth led to significant improvement on the bottom line.

Looking ahead

Management forecast that revenue will increase by between 2.5% and 3.5% in 2020, and projected adjusted diluted earnings per share of between $8.15 and $8.45.

Some healthcare stocks could experience significant volatility over the next year as the future of the U.S. healthcare system is debated in the presidential campaign. Other companies could run into challenges related to the coronavirus outbreak, with travel restrictions and business shutdowns in China cause problems. The latter could be more of an issue for Zimmer Biomet because of its Asian segment. However, CEO Bryan Hanson said that the company is "operating from a position of strength for 2020 and beyond."