and distributor's to profile. year a pattern continued margin result Thanks, full review million, major the injection for acid and Scott. sales relief quarter were Good morning, as fourth change.
Net for the fourth quarter financial products reimbursement our pricing company's the thank pressure sales impacted you changes operational the the by and our North pain ordering $XXX.X of joining due America a products to Net due company's results Medicare negatively across sales lower-than-anticipated to and Digestive Health XXXX. impacted us for hyaluronic everyone,
XX.X% SG&A the XX.X% of gross transformation revenue of some through adjusted as initiatives $X.XX a of deliver for However, these and we percentage at top our mitigate adjusted year. were EPS margins with full challenges able and to of line
and through percentage we we quarter, order of XX.X%.
Separately, our revenue improvement of reducing our the a this XXXX. initiatives. than on $X order, remain reduce of delivered levels is of and as to year a months have fourth back as last million is our less chain $XX the supply focused adjusted back on of ended effectively with and tangible we that margins over executing SG&A This serving XX.X% gross For first continued order X its transformation over million, back organization significant year's proof
As on since first at the our XXXX other always, optimization our to our we each progress focus bit primary are is as transformation activities. back given our would of presented the have execution to conference, M&A consistently realignment we our the that things commercial our continuing transformation steady be make getting the against communicated And I XXXX priorities, priorities. of the plan we customers. patients as uneven January But JPMorgan organization, a transformation needs of portfolio and meet matter
approximately the down quarter continuing decision discontinue noted, As year priority, were I from the to effects during impact by our revenue just exchange million. did foreign ago. organic operations X.X% that Adjusted for portfolio transformation specified meet our our return and strategic to not compared criteria streams the sales of were a sales $XXX of
of from adjusted share $XX adjusted and of million $X.XX continuing diluted generated we earnings EBITDA quarter, the For per operations. above
of compared year, of exchange to our the diluted foreign mentioned and million. EBITDA adjusted meet of of $X.XX earnings as revenue were to the for sales adjusted delivered share year criteria, million. not per decision return X.X% For effects did that streams organic ago.
We a the above, were continuing $XXX sales $XX down and discontinue operations our Adjusted above impact I earlier from our strategic
last the gives priorities. driven ability XXXX throughout This the our the range established be with our transformation our to our year Although fourth which Investor we are were confidence disappointed within by Day. X-year we in quarter sales during overall us execution, performance of results, with our we pleased financial year targets was
the category product level. Now few discussing I'll the spend minutes at results our next
we during of business earnings back would of in Digestive the year. call, order quarter products in have that release Health we a quarter our fourth anticipated our the third fourth quarter the mentioned given last As tough comparison
inventory we the have we as fourth Additionally, noted, experienced rebalancing distributor in quarter.
our portfolio fourth As grew the X% constant a a in quarter result, our trending. currency full Digestive basis below Health on year
sales compared delivered quarter, CORTRAK growing faced portfolio a overperform mid-single CORTRAK year tough globally, standard-of-care digits growing our NeoMed U.S. excluding sequentially year relief the performance expansion as lower-than-anticipated growing with the offering. to driven in previous of line Digestive and by of slight our order year previous Our back we Separately, noted flat continues of another quarter, double extremely was digits Health double robust globally, impact our to negative digits sustained from the our fourth but currency. comparison year-over-year.
Despite pleased are full the benefited the product the portfolio,
growth growth to single-digit back anticipate portfolio. deliver We launch market mid- Digestive growth organically And to of attractive will additional prospects year, high plan we by supported markets during expansion and rationalization. continue low-growth be product to global to innovations above for the our ability the with half our Health into
Now announced portfolio. turning impact discontinue Sales certain excluding foreign our and sales, down to decision XX%, Diros-related our exchange low-margin benefit the Pain quarter strategic of were approximately the low-growth, previously products. for Management this of and Recovery to
to the and a was primarily result with as previously the pressure continued declines. the along changes. communicated, near-term reimbursement HA sequential communicated main due and year-over-year portfolio pricing contributor volatility quarterly We decline Medicare As our of to anticipated
opportunities long pace greater of be our impact of in decline in which meaningfully we was current the benefits over the will capitalize than the the portfolio. slowing in the some said, that quarter we However, seen anticipated.
That being believe year, have fourth term, on strategies right the to in HA place
Diros gains, excluding posting growth XX% These revenue Pain overall business for our latter part XX% supply the new the part supports showed early ambIT expectations this strategy portfolio of third ON-Q Surgical signs our combined and versus the of Our as sequentially in quarter, are flat go-to-market was portfolio constraints alleviated of sequential quarter. growing single-digit positive growth with the for third our IVP fourth quarter. the low impact XXXX.
Similarly, versus portfolio our that structure the
We are IVP by this and structure. driven in encouraged the quarter sales renewed sales year center generator by fully versus double-digit deployed U.S. ambulatory in strategy growth our the surgical seen prior the
portfolio Our in very registration performed compared offset a international achieving in capital Game North to in sales. performance due North favorable decline America, year, Ready transient by delays. sales strongly prior by boosted double-digit the America was growth The to
Toronto acquired in growth support U.S. including newly capacity our to manufacturing with our our produced in as we objectives, has on Trident year. opportunities kicked the quarter facility capitalizing our launch, expectations. which of fourth up Upside line line Finally, market in our were scaled limited November product off results in last
Management announced portfolio discontinue products. and low-growth, benefit were For year, down decision our of excluding revenue, certain impact the and the full our XX%, low-margin sales approximately to the exchange Pain previously of Diros Recovery of foreign
As our primarily driven this previously almost shared, decrease down HA was portfolio, by XX% year-over-year.
XX% highlighted XXXX HA, Recovery half decline quarter particular, our organic growth sequential in our by XXXX. In are progress for we approximately Management of XXXX, in disappointed of and in the performance expectation in fourth portfolio are encouraged we which of versus decreasing expectation excludes at the mid-single-digit improvement that the While this the reinforces saw I XXXX. Pain just our anticipate second year. by the Again, we we in
XXXX to Now priorities our transformation to XXXX and moving efforts.
key profitability, priorities profiles allocation X transforming the priorities attractive that we go-to-market and have our a These focus of margin categories management optimizing financial have for continuing cost and taking As reminder, and ROIC. additional capital the next enhance where organization, meaningfully opportunities on will operating we to to and to path portfolio to win, improve strategically efficient our our meaningfully our our right measures X commercially years enhance optimize profile. are: our
the will progress Michael transformation As our his Chief we review optimization Technology business; of effectiveness; transformation as portfolio. the substantial improve notably, health delivered see, priorities. in the excited We're our leadership low-margin, you and our well of priorities against which double-digit particularly will made the as can he's divestiture our to we've XXXX now. changes categories; significant exited accomplishments, and product leading across Later DH Officer.
In transformation Diros respiratory portfolio made as commercial and discuss growth go-to-market in role commercial low-growth executed our acquisition Transformation call, other by I
between in original sales our the improvements This While X-quarter to January business and strategy, our our following. seen sales longer. into in behind just changes teams reset although slow of to as breadth about business, our in to new XXXX move in at go-to-market referenced we conference. commercial pain it address sequential Supply ability include as execute shared pain accelerated strategies.
The third fourth the I the on quarter, structure that we've expectations, the chain quarters impacting the talent I necessary is confidence commercial of and we availability delay due X us pain give the improvements JPMorgan and product the the taking forward is strategies remain challenges
Surgical results Our several low year, growth single-digit in years half of the decline has flattish business XXXX. supporting in to reversed Pain of this back
we able to Trident Our our maintain markets. expectations, growth -- our were in U.S. RF exceeded launch and double-digit U.S. OUS
to established HA We're on to of business and team. in international We've issues, capital Ready programs addressed and renewed the including confidence supply to from expansion. COOLIEF Game returned the most growth given and business half quality which seeing Our U.K. OUS, stabilize the of due sales reimbursement commercial We've second our XXXX. focus to Japan. help tailwinds has our
business While mid-single-digit we long we and our a Recovery over in and will foundation XXXX return to growth Pain to established the of sustainable that XXXX believe year mid- was gradually for to a dividends term. transformation, transition Management yield
insights Now Michael, further I'll results. who quarter to year call fourth the provide and our financial turn full will over into