Zimmer Holdings Inc (ZMH.N) reported higher quarterly net earnings on Wednesday on stronger sales, mainly outside the United States.

Second-quarter net earnings were $203.8 million, or $1.06 per share, compared with $165.5 million, or 82 cents per share, in the year-earlier period.

Excluding special items, earnings were $1.21 per share. On that basis, analysts on average were expecting $1.19, according to Thomson Reuters I/B/E/S.

Sales rose to $1.14 billion from $1.06 billion.

The orthopedic device maker also revised its outlook for the full year, calling for net income of $4.25 to $4.35 per share and adjusted earnings of $4.70 to $4.80 on a sales increase of 2.5 percent to 3.5 percent.

In April, the company had forecast net income at $4.25 to $4.45 per share and adjusted earnings at $4.60 to $4.80, with a sales increase of 2 percent to 4 percent.