Zimmer Biomet has been quietly reving up its M&A engine in the past month, most recently with a deal to acquire A&E Medical for up to $250 million in cash. The Warsaw, IN-based company said it would pay $150 million at closing and $100 million in cash payable in 2021.

A&E Medical has a portfolio of sternal closure devices – including sternal sutures, cable systems, and rigid fixation – along with a range of single-use complementary temporary pacing wire and surgical punch products.

"A&E Medical's high-growth business and innovative products are highly complementary to our current portfolio and will allow us to offer a comprehensive suite of sternal closure products, including rigid fixation, which has the potential to shift the standard of care and address a variety of unmet patient and surgical needs," said Bryan Hanson, president and CEO of Zimmer Biomet. "This deal aligns with our active portfolio management strategy and the ongoing transformation of our business that will position Zimmer Biomet for long-term growth."

The company noted that the global sternal closure business is growing at a high single-digit percentage rate annually. Revenue from the new integrated business will be recognized in Zimmer Biomet's dental, spine and craniomaxillofacial and thoracic (CMFT) product category.

While it hasn't drummed up a lot of fanfare over its recent M&A activity, this deal acqually represents Zimmer Biomet's third recent acquisition. During its third-quarter earnings call, the company noted the acquisition of both Incisive and Relign for $80 million upfront and another $98 million in deferred and milestone payments.

"It's important to note that these acquisitions are consistent with [management] commentary that suggested [Zimmer Biomet] would become more acquisitive as [management] stabilized and turned around the business," Ryan Zimmerman, a medtech analyst at BTIG, said in a report Tuesday. "Further, each acquisition is complementary to existing [Zimmer Biomet] products and businesses and gives [Zimmer Biomet] access to new markets that it had not previously competed in."

Indeed, during that early November call, Hanson talked about M&A being a component of what he referred to as phase 3 of Zimmer Biomet's turnaround story. The CEO said the company would be selective in M&A, prioritizing opportunities that are accretive to Zimmer Biomet's weighted average market growth and aligned to the company's strategy. We could also see some strategic divesting as the company looks to weed out its non-core assets that are financially less attractive, based on Hanson's third-quarter earnings comments.