ORTHOFIX MEDICAL INC., 10-K filed on 2/24/2026
Annual Report
v3.25.4
Document and Entity Information - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Feb. 20, 2026
Jun. 30, 2025
Cover [Abstract]      
Document Type 10-K    
Amendment Flag false    
Document Period End Date Dec. 31, 2025    
Document Fiscal Year Focus 2025    
Document Fiscal Period Focus FY    
Trading Symbol OFIX    
Entity Registrant Name ORTHOFIX MEDICAL INC.    
Entity Central Index Key 0000884624    
Current Fiscal Year End Date --12-31    
Entity Well-known Seasoned Issuer No    
Entity Current Reporting Status Yes    
Entity Voluntary Filers No    
Entity Filer Category Accelerated Filer    
Entity Small Business false    
Entity Emerging Growth Company false    
Entity Shell Company false    
Entity Interactive Data Current Yes    
Entity Common Stock, Shares Outstanding   40,144,397  
Entity Public Float     $ 440.2
Entity File Number 000-19961    
Entity Tax Identification Number 98-1340767    
Entity Address, Address Line One 3451 Plano Parkway    
Entity Address, City or Town Lewisville    
Entity Address, State or Province TX    
Entity Address, Postal Zip Code 75056    
City Area Code 214    
Local Phone Number 937-2000    
Entity Incorporation, State or Country Code DE    
Title of 12(b) Security Common Stock, $0.10 par value    
Security Exchange Name NASDAQ    
Document Annual Report true    
ICFR Auditor Attestation Flag true    
Document Financial Statement Error Correction [Flag] false    
Document Transition Report false    
Auditor Firm ID 42    
Auditor Name Ernst & Young LLP    
Auditor Location Dallas, Texas    
Documents Incorporated by Reference

Certain sections of the registrant’s definitive proxy statement to be filed with the Commission in connection with the Orthofix Medical Inc. 2026 Annual Meeting of Shareholders are incorporated by reference in Part III of this Annual Report.

    
Auditor Opinion [Text Block]

 

We have audited the accompanying consolidated balance sheets of Orthofix Medical Inc. (the Company) as of December 31, 2025 and 2024, the related consolidated statements of operations and comprehensive loss, changes in shareholders' equity and cash flows for each of the three years in the period ended December 31, 2025, and the related notes (collectively referred to as the "consolidated financial statements"). In our opinion, the consolidated financial statements present fairly, in all material respects, the financial position of the Company at December 31, 2025 and 2024, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2025, in conformity with U.S. generally accepted accounting principles.

 

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board (United States) (PCAOB), the Company's internal control over financial reporting as of December 31, 2025, based on criteria established in Internal Control-Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) and our report dated February 24, 2026 expressed an unqualified opinion thereon.

    
v3.25.4
Consolidated Balance Sheets - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Current assets    
Cash and cash equivalents $ 82,025 $ 83,238
Restricted cash 3,090 2,500
Accounts receivable, net of allowances of $8,308 and $7,418, respectively 135,746 134,713
Inventories 172,319 189,452
Prepaid expenses and other current assets 23,667 23,382
Total current assets 416,847 433,285
Property, plant, and equipment, net 129,399 139,804
Intangible assets, net 72,765 98,803
Goodwill 194,934 194,934
Other long-term assets 36,702 26,468
Total assets 850,647 893,294
Current liabilities    
Accounts payable 58,392 48,803
Current portion of long-term debt 0 0
Current portion of finance lease liability 837 755
Other current liabilities 111,253 119,070
Total current liabilities 170,482 168,628
Long-term debt 157,391 157,015
Long-term portion of finance lease liability 17,060 17,835
Other long-term liabilities 55,677 46,692
Total liabilities 400,610 390,170
Contingencies (Note 13)
Shareholders’ equity    
Common shares $0.10 par value; 100,000 shares authorized; 39,834 and 38,486 issued and outstanding as of December 31,2025 and 2024, respectively 3,983 3,849
Additional paid-in capital 813,769 779,718
Accumulated deficit (368,333) (276,141)
Accumulated other comprehensive income (loss) 618 (4,302)
Total shareholders’ equity 450,037 503,124
Total liabilities and shareholders’ equity $ 850,647 $ 893,294
v3.25.4
Consolidated Balance Sheets (Parenthetical) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Statement of Financial Position [Abstract]    
Trade accounts receivable, allowance for doubtful accounts $ 8,308 $ 7,418
Common shares, par value $ 0.10 $ 0.10
Common shares, authorized 100,000,000 100,000,000
Common shares, issued 39,834,000 38,486,000
Common shares, outstanding 39,834,000 38,486,000
v3.25.4
Consolidated Statements of Operations and Comprehensive Loss - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Statement [Abstract]      
Net sales $ 822,312 $ 799,491 $ 746,641
Cost of sales 256,295 253,606 260,368
Gross profit 566,017 545,885 486,273
Sales, general, and administrative 554,329 532,525 530,395
Research and development 65,847 73,643 80,231
Acquisition-related amortization, impairment, and remeasurement (Note 17) 27,269 24,336 14,757
Operating loss (81,428) (84,619) (139,110)
Interest expense, net (17,488) (29,631) (8,631)
Other (expense) income, net 8,106 (9,625) (938)
Loss before income taxes (90,810) (123,875) (148,679)
Income tax expense (1,382) (2,122) (2,716)
Net loss $ (92,192) $ (125,997) $ (151,395)
Net loss per common share:      
Basic $ (2.33) $ (3.30) $ (4.12)
Diluted $ (2.33) $ (3.30) $ (4.12)
Weighted average number of common shares:      
Basic 39,602,345 38,133,684 36,729,258
Diluted 39,602,345 38,133,684 36,729,258
Other comprehensive income (loss), before tax      
Unrealized loss on debt securities     $ (1,334)
Currency translation adjustment $ 4,920 $ (3,009) 1,417
Other comprehensive income (loss), before tax 4,920 (3,009) 83
Other comprehensive income (loss), net of tax 4,920 (3,009) 83
Comprehensive loss $ (87,272) $ (129,006) $ (151,312)
v3.25.4
Consolidated Statements of Changes in Shareholders' Equity - USD ($)
$ in Thousands
Total
Common Shares [Member]
Additional Paid-in Capital [Member]
Retained Earnings (Accumulated Deficit) [Member]
Accumulated Other Comprehensive Income (Loss) [Member]
Beginning Balance at Dec. 31, 2022 $ 336,860 $ 2,016 $ 334,969 $ 1,251 $ (1,376)
Balance, Shares at Dec. 31, 2022   20,162,000      
Net loss (151,395)     (151,395)  
Other comprehensive income (loss), net of tax 83       83
Share-based compensation expense 35,707   35,707    
Common shares issued in connection with SeaSpine merger 376,745 $ 1,605 375,140    
Common shares issued in connection with SeaSpine merger, Shares   16,047,000      
Common shares issued, net 730 $ 96 634    
Common shares issued, net, Shares   956,000      
Ending Balance at Dec. 31, 2023 598,730 $ 3,717 746,450 (150,144) (1,293)
Balance, Shares at Dec. 31, 2023   37,165,000      
Net loss (125,997)     (125,997)  
Other comprehensive income (loss), net of tax (3,009)       (3,009)
Share-based compensation expense 32,455   32,455    
Common shares issued, net 945 $ 132 813    
Common shares issued, net, Shares   1,321,000      
Ending Balance at Dec. 31, 2024 $ 503,124 $ 3,849 779,718 (276,141) (4,302)
Balance, Shares at Dec. 31, 2024 38,486,000 38,486,000      
Net loss $ (92,192)     (92,192)  
Other comprehensive income (loss), net of tax 4,920       4,920
Share-based compensation expense 28,688   28,688    
Common shares issued, net 5,497 $ 134 5,363    
Common shares issued, net, Shares   1,348,000      
Ending Balance at Dec. 31, 2025 $ 450,037 $ 3,983 $ 813,769 $ (368,333) $ 618
Balance, Shares at Dec. 31, 2025 39,834,000 39,834,000      
v3.25.4
Consolidated Statements of Cash Flows - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash flows from operating activities      
Net loss $ (92,192) $ (125,997) $ (151,395)
Adjustments to reconcile net loss to net cash from operating activities      
Depreciation, amortization, and impairment 77,321 60,061 53,063
Inventory reserve expenses 30,825 26,254 27,576
Amortization of inventory fair value step-up   12,188 36,044
Amortization of operating lease assets, debt costs, and other assets 5,934 15,901 7,498
Provision for expected credit losses 2,255 1,999 820
Deferred income taxes 223 1,883 579
Share-based compensation expense 28,688 32,455 35,707
Loss on disposal of fixed assets 1,140 2,025 2,300
Change in valuation of investment securities (48) 7,528 596
Change in fair value of contingent consideration (1,140) 6,900 (2,700)
Other 1,838 3,844 (1,877)
Changes in operating assets and liabilities, net of effects of acquisitions      
Accounts receivable (1,583) (9,526) (10,411)
Inventories (10,748) (5,546) (58,051)
Prepaid expenses and other current assets (3,926) 593 1,760
Accounts payable 2,599 (5,571) 8,642
Other current liabilities (2,268) 9,527 4,069
Contingent consideration milestone payment (1,340)    
Other long-term assets and liabilities (4,231) (8,728) 27
Net cash provided by (used in) operating activities 33,347 25,790 (45,753)
Cash flows from investing activities      
Capital expenditures (34,626) (34,876) (62,050)
Cash acquired in SeaSpine merger     29,419
Sale of investment securities   7,396  
Other investing activities 28 (100) (500)
Net cash used in investing activities (34,598) (27,580) (33,131)
Cash flows from financing activities      
Proceeds from credit facilities   197,600 174,500
Repayment of borrowings from credit facilities   (142,500) (79,000)
Payment of debt acquired from SeaSpine merger     (26,899)
Proceeds from issuance of common shares 5,929 6,257 5,127
Payments related to withholdings for share-based compensation (432) (5,312) (4,397)
Contingent consideration milestone payment (4,990) (1,000) (1,000)
Payments related to finance lease obligation (762) (706) (652)
Payment of debt issuance costs and other financing activities (531) (3,630) (2,357)
Net cash provided by (used in) financing activities (786) 50,709 65,322
Effect of exchange rate changes on cash and restricted cash 1,414 (938) 619
Net change in cash, cash equivalents, and restricted cash (623) 47,981 (12,943)
Cash, cash equivalents, and restricted cash at the beginning of the year 85,738 37,757 50,700
Cash, cash equivalents, and restricted cash at the end of the year 85,115 85,738 37,757
Components of cash, cash equivalents, and restricted cash at the end of the year      
Cash and cash equivalents 82,025 83,238 33,107
Restricted cash 3,090 2,500 4,650
Cash, cash equivalents, and restricted cash at the end of the year $ 85,115 $ 85,738 $ 37,757
v3.25.4
Cybersecurity Risk Management, Strategy and Governance
 12 Months Ended
Dec. 31, 2025
Cybersecurity Risk Management, Strategy, and Governance [Line Items]  
Cybersecurity Risk Management Processes for Assessing, Identifying, and Managing Threats [Text Block]

Item 1C. Cybersecurity

Risk Management and Strategy

We have implemented cybersecurity programs designed to maintain and protect our information technology systems and the confidentiality, integrity, and availability of our data. These programs serve to maintain compliance with applicable laws and regulations governing ethical business practices, including our relationships with suppliers, customers, and business partners.

We maintain formal processes for our cybersecurity program and incident response procedures, which are updated at least annually and reviewed by external legal and cybersecurity advisors. These processes include, among other things, detailed steps on how we assess cyber risks, identify threats, and determine the materiality of cyber incidents. These processes also designate certain roles within the company to execute these policies and certain leadership roles to manage material risk escalation. These processes endeavor to follow the National Institute of Standards and Technology Cybersecurity Framework and are tested at least annually.

Our Information Security team uses automated technology, third-party partners, and direct review of system indicators to monitor and implement the prevention, detection, mitigation, and remediation of cybersecurity incidents, and to stay current with the changing threat landscape. We also leverage encryption technologies and other measures to safeguard systems. We engage third parties as part of our cyber program, including external security firms that provide security technology, conduct regular security audits, and conduct penetration testing. We also engage third parties to conduct regular drills, such as tabletop exercises, to help with our overall preparedness.

We also engage third-party service providers to assist with managing various other aspects of our business. We have implemented processes designed to both assess and maintain oversight of third-party service providers with regards to cybersecurity risks. These service providers are subject to due diligence reviews of their information security programs during our vendor evaluation process.

Our employees are responsible for complying with our data security standards and are required to complete annual training to understand the behaviors and technical requirements necessary to keep data secure. We also require that cybersecurity training be part of the onboarding process for new hires.

As of December 31, 2025, we have not had any known instances of material cybersecurity incidents, including third-party incidents, during any of the prior three fiscal years.

Governance

Cybersecurity is an important component of our enterprise risk management program. While the full Board of Directors has primary responsibility for risk oversight, the Board of Directors utilizes its committees, as appropriate, to monitor and address the risks that may be within the scope of a particular committee’s expertise or charter. The Board of Directors receives updates at quarterly board meetings on committee activities from each committee Chair.

The Audit and Finance Committee has oversight over and regularly reviews our cybersecurity, including information technology ("IT") risks, controls, procedures, and plans to mitigate cybersecurity risks and respond to security incidents. The Audit and Finance Committee receives reports on at least a quarterly basis from the Chief Information Officer and the Vice President, Information Security, on, among other issues, our cyber risks and threats, the status of projects, management’s strategies to strengthen our IT systems, assessments of our security program, third-party assessments and testing, our emerging threat landscape, and the review of our cybersecurity insurance policy. Pursuant to our incident response procedures, material cyber incidents will be reported to the Chair of the Audit and Finance Committee upon a determination of material status. Due to the importance of cybersecurity, the full Board of Directors also receives updates on cybersecurity matters from management at least annually.

Management is responsible for our company’s day-to-day risk management activities. Our cybersecurity program is led by our Chief Information Officer, who is responsible for assessing and managing cybersecurity risks. He has over 25 years of experience in both military and corporate leadership roles, including 14 years of experience in CIO-level leadership roles, including consulting with major firms, covering technology and security operations responsibility.

Our Vice President, Information Security, who reports to our Chief Information Officer, is responsible for cybersecurity program execution, risk management, and oversight of information security staff and consultants. She has over 20 years of experience in IT roles, including 15 years in IT leadership roles and 7 years in cybersecurity program execution and oversight of information security.

Our Manager, Information Security, who reports to our Vice President, Information Security, is responsible for managing our security analyst and engineering team and is also responsible for the tactical execution of security operations. He has over 25 years

of experience in IT roles including 15 years of experience in security leadership. He also has the following certifications: ISC2 CISSP, EC-Council Certified Ethical Hacker, and numerous vendor specific certifications.

As cybersecurity risks arise, our Information Security team executes the incident response procedure and communicates the appropriate details to management in alignment with the escalation steps in the procedure. In addition, our Chief Information Officer, Vice President, Information Security, and Manager, Information Security, conduct monthly cybersecurity program status reviews with the Information Security team that includes key performance indicator tracking, risk assessment, escalation actions, and project status.
Cybersecurity Risk Management Processes Integrated [Flag] true
Cybersecurity Risk Management Processes Integrated [Text Block]

We have implemented cybersecurity programs designed to maintain and protect our information technology systems and the confidentiality, integrity, and availability of our data. These programs serve to maintain compliance with applicable laws and regulations governing ethical business practices, including our relationships with suppliers, customers, and business partners.

Cybersecurity Risk Management Third Party Engaged [Flag] true
Cybersecurity Risk Third Party Oversight and Identification Processes [Flag] true
Cybersecurity Risk Materially Affected or Reasonably Likely to Materially Affect Registrant [Flag] false
Cybersecurity Risk Board of Directors Oversight [Text Block]

Cybersecurity is an important component of our enterprise risk management program. While the full Board of Directors has primary responsibility for risk oversight, the Board of Directors utilizes its committees, as appropriate, to monitor and address the risks that may be within the scope of a particular committee’s expertise or charter. The Board of Directors receives updates at quarterly board meetings on committee activities from each committee Chair.
Cybersecurity Risk Board Committee or Subcommittee Responsible for Oversight [Text Block]

The Audit and Finance Committee has oversight over and regularly reviews our cybersecurity, including information technology ("IT") risks, controls, procedures, and plans to mitigate cybersecurity risks and respond to security incidents. The Audit and Finance Committee receives reports on at least a quarterly basis from the Chief Information Officer and the Vice President, Information Security, on, among other issues, our cyber risks and threats, the status of projects, management’s strategies to strengthen our IT systems, assessments of our security program, third-party assessments and testing, our emerging threat landscape, and the review of our cybersecurity insurance policy. Pursuant to our incident response procedures, material cyber incidents will be reported to the Chair of the Audit and Finance Committee upon a determination of material status. Due to the importance of cybersecurity, the full Board of Directors also receives updates on cybersecurity matters from management at least annually.
Cybersecurity Risk Process for Informing Board Committee or Subcommittee Responsible for Oversight [Text Block] The Board of Directors receives updates at quarterly board meetings on committee activities from each committee Chair.
Cybersecurity Risk Role of Management [Text Block]

Management is responsible for our company’s day-to-day risk management activities. Our cybersecurity program is led by our Chief Information Officer, who is responsible for assessing and managing cybersecurity risks. He has over 25 years of experience in both military and corporate leadership roles, including 14 years of experience in CIO-level leadership roles, including consulting with major firms, covering technology and security operations responsibility.

Our Vice President, Information Security, who reports to our Chief Information Officer, is responsible for cybersecurity program execution, risk management, and oversight of information security staff and consultants. She has over 20 years of experience in IT roles, including 15 years in IT leadership roles and 7 years in cybersecurity program execution and oversight of information security.

Cybersecurity Risk Management Positions or Committees Responsible [Flag] true
Cybersecurity Risk Management Positions or Committees Responsible [Text Block] Our cybersecurity program is led by our Chief Information Officer, who is responsible for assessing and managing cybersecurity risks.
Cybersecurity Risk Management Expertise of Management Responsible [Text Block] He has over 25 years of experience in both military and corporate leadership roles, including 14 years of experience in CIO-level leadership roles, including consulting with major firms, covering technology and security operations responsibility. She has over 20 years of experience in IT roles, including 15 years in IT leadership roles and 7 years in cybersecurity program execution and oversight of information security. He has over 25 years

of experience in IT roles including 15 years of experience in security leadership. He also has the following certifications: ISC2 CISSP, EC-Council Certified Ethical Hacker, and numerous vendor specific certifications.

Cybersecurity Risk Process for Informing Management or Committees Responsible [Text Block] Our Vice President, Information Security, who reports to our Chief Information Officer, is responsible for cybersecurity program execution, risk management, and oversight of information security staff and consultants.Our Manager, Information Security, who reports to our Vice President, Information Security, is responsible for managing our security analyst and engineering team and is also responsible for the tactical execution of security operations.
Cybersecurity Risk Management Positions or Committees Responsible Report to Board [Flag] true
v3.25.4
Pay vs Performance Disclosure - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Pay vs Performance Disclosure      
Net Income (Loss) $ (92,192) $ (125,997) $ (151,395)
v3.25.4
Insider Trading Arrangements
 3 Months Ended
Dec. 31, 2025
Trading Arrangements, by Individual  
Title directors or officers
Rule 10b5-1 Arrangement Adopted false
Non-Rule 10b5-1 Arrangement Adopted false
Rule 10b5-1 Arrangement Terminated false
Non-Rule 10b5-1 Arrangement Terminated false
Rule 10b5-1 Arrangement Modified false
Non-Rule 10b5-1 Arrangement Modified false
v3.25.4
Business and basis of presentation
 12 Months Ended
Dec. 31, 2025
Organization Consolidation And Presentation Of Financial Statements And Unusual Or Infrequent Items Disclosure [Abstract]  
Business and basis of presentation

1. Business and basis of presentation

Description of the Business

Orthofix Medical Inc. (the "Company" or "Orthofix") is a global medical technology company headquartered in Lewisville, Texas. By providing medical technologies that heal musculoskeletal pathologies, the Company delivers exceptional experiences and life-changing solutions to patients around the world. Orthofix offers a comprehensive portfolio of spinal hardware, bone growth therapies, limb reconstruction solutions, biologics and enabling technologies, including the 7D FLASH Navigation System.

Basis of Presentation

The consolidated financial statements include the financial statements of the Company and its wholly owned subsidiaries. All intercompany accounts and transactions are eliminated in consolidation. Information on our accounting policies and methods used in the preparation of our consolidated financial statements are included, where applicable, in the respective footnotes that follow.

Footnote

 

Footnote Reference

Business and basis of presentation

 

1

Significant accounting policies

 

2

Recently adopted accounting standards and recently issued accounting pronouncements

 

3

Mergers, acquisitions, and the discontinuation of the M6 product lines

 

4

Inventories

 

5

Property, plant, and equipment

 

6

Intangible assets

 

7

Goodwill

 

8

Leases

 

9

Other current liabilities

 

10

Indebtedness

 

11

Fair value measurements and investments

 

12

Commitments and contingencies

 

13

Shareholders' equity

 

14

Revenue recognition and accounts receivable

 

15

Business segment information

 

16

Acquisition-related amortization, impairment, and remeasurement

 

17

Share-based compensation

 

18

Defined contribution plans and deferred compensation

 

19

Income taxes

 

20

Earnings per share

 

21

Subsequent events

 

22

Changes in Presentation of Consolidated Financial Statements

Certain prior year balances have been reclassified in the consolidated financial statements to conform to current period presentation.
v3.25.4
Significant accounting policies
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Significant accounting policies

2. Significant accounting policies

The preparation of financial statements in conformity with United States generally accepted accounting principles ("U.S. GAAP") requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities as of the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, the Company evaluates these estimates, including those related to contractual allowances, allowances for expected credit losses, inventories, valuation of intangible assets, goodwill, fair value measurements (including fair value measurements associated with business combinations and/or asset acquisitions), litigation and contingent liabilities, income taxes, and share-based compensation. Estimates are based on historical experience, future expectations, and

other relevant assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results may differ from these estimates.

The following is a discussion of accounting policies and methods used in the consolidated financial statements that are not presented within other footnotes.

Market risk

In the ordinary course of business, the Company is exposed to the impact of changes in interest rates and foreign currency fluctuations. The Company’s objective is to limit the impact of such movements on earnings and cash flows. In order to achieve this objective, the Company seeks to balance its non-U.S. Dollar denominated income and expenditures.

The financial statements for operations outside the U.S. are generally maintained in each subsidiary's respective local currency. All foreign currency denominated balance sheet accounts, except shareholders’ equity, are translated to U.S. Dollars at year end exchange rates, and revenue and expense items are translated at average exchange rates prevailing during the year. Gains and losses resulting from the translation of foreign currency are recorded in the accumulated other comprehensive income (loss) component of shareholders’ equity. Transactional foreign currency gains and losses, including those generated from intercompany operations, are included in other income (expense), net. The Company recorded a gain of $2.9 million, a loss of $4.4 million, and a gain of $1.6 million for the years ended December 31, 2025, 2024, and 2023, respectively, related to these transaction foreign currency gains and losses recorded in other income (expense), net.

Financial instruments and concentration of credit risk

Financial instruments that could subject the Company to a concentration of credit risk consist primarily of cash, cash equivalents, and accounts receivable. Generally, cash is held at large financial institutions. The Company performs ongoing credit evaluations of customers, generally does not require collateral, and maintains a reserve for expected credit losses. The Company believes that a concentration of credit risk related to accounts receivable is limited because customers are geographically dispersed and end users are diversified.

Cash, cash equivalents, and restricted cash

The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents.

In November 2023, following the termination of the Second Amended and Restated Credit Agreement with JPMorgan Chase Bank, N.A., as Administrative Agent, and certain lender parties thereto, Bank of America required collateral of approximately $4.7 million of the Company’s cash as a banking service obligation, which was classified as restricted cash as of December 31, 2023. In March 2024, the Company entered into a Security Agreement with Bank of America to reduce the required collateral to $2.5 million.

In April 2025, following the execution of the lease agreement between Armada Drive Carlsbad LLC and the Company, the Company was required to establish a letter of credit of $0.6 million. The Company opened a letter of credit with Hongkong and Shanghai Banking Corporation ("HSBC"), which was classified as restricted cash as of December 31, 2025.

Investing activities that did not result in cash receipts or cash payments during the years ended December 31, 2025, 2024, and 2023 consisted of the following, which were not included within cash used in investing activities in the Company’s consolidated statements of cash flows:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Supplemental disclosure of cash flow information:

 

 

 

 

 

 

 

 

 

Noncash investing activities:

 

 

 

 

 

 

 

 

 

Changes in accrued capital expenditures

 

$

5,278

 

 

$

(3,040

)

 

$

—

 

Intangible assets acquired in asset acquisitions

 

 

40

 

 

 

—

 

 

 

—

 

Research and development costs, including collaborative arrangements

Expenditures for research and development are expensed as incurred. Expenditures related to the Company’s collaborative arrangement with MTF Biologics ("MTF") are expensed based on the terms of the related agreement. The Company recognized $0.3 million, $0.3 million, and $0.8 million in research and development expense for the years ended December 31, 2025, 2024, and 2023, respectively, related to this arrangement.

v3.25.4
Recently adopted accounting standards and recently issued accounting pronouncements
 12 Months Ended
Dec. 31, 2025
Accounting Changes and Error Corrections [Abstract]  
Recently adopted accounting standards and recently issued accounting pronouncements

3. Recently adopted accounting standards and recently issued accounting pronouncements

Recently Adopted Accounting Standards

Adoption of Accounting Standards Update ("ASU") 2022-03 - Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions

In June 2022, the Financial Accounting Standards Board ("FASB") issued ASU 2022-03, which clarifies the guidance in Topic 820, Fair Value Measurement, when measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale and to introduce new disclosure requirements. The Company adopted this standard effective January 1, 2024, on a prospective basis. Adoption of this standard did not have a material impact on the Company's consolidated balance sheet, statements of operations, or cash flows, but did modify the Company's disclosures related to certain investments. Refer to Note 12 for the Company's updated disclosures on investments in equity securities subject to capital sale restrictions.

Adoption of ASU 2023-07 - Improvements to Reportable Segment Disclosures

In November 2023, the FASB issued ASU 2023-07, which enhances and improves disclosures about operating segment revenues, measures of profit/loss, and expenses to enable investors to better understand an entity's overall performance and assess potential future cash flows. The amendment requires that an entity disclose (i) significant expenses that are regularly provided to the Chief Operating Decision Maker ("CODM"), (ii) other segment items by reportable segment including a description of its composition, (iii) all annual disclosures required by Topic 280, Reporting Measures of Segment Profit or Loss, in interim periods, (iv) additional measures of a segment's profit or loss used by the CODM in assessing segment performance and allocation of resources, and (v) the title and position of the CODM and an explanation of how the CODM uses the reported measure(s) of segment profit or loss. The Company adopted this standard effective January 1, 2024, on a prospective basis. Refer to Note 16 for the Company's business segment disclosures.

Adoption of ASU 2023-09 - Improvements to Income Tax Disclosures

In December 2023, the FASB issued ASU 2023-09, which enhances the transparency and usefulness of income tax disclosures required pursuant to Topic 740, Income Taxes, to provide information to better assess how an entity's operations, tax risks and tax planning, and operational opportunities affect its tax rate and future cash flows. The Company adopted this standard effective January 1, 2025, on a modified retrospective basis. Adoption of this standard did not have a material impact on the Company's consolidated balance sheet, statements of operations, or cash flows. Refer to Note 20 for the Company's updated income tax disclosures.

Adoption of ASU 2025-05 - Measurement of Credit Losses for Accounts Receivable and Contract Assets

In July 2025, the FASB issued ASU 2025-05, which introduced a practical expedient related to applying subtopic 326-20 to current accounts receivable and current contract assets arising from transactions accounted for under Topic 606, Revenue from Contracts with Customers. The Company early adopted this standard effective January 1, 2025, on a prospective basis. Adoption of this standard did not have a material impact on the Company's consolidated balance sheet, statements of operations, or cash flows. Refer to Note 15 for the Company's updated accounts receivable disclosures.

 

Recently Issued Accounting Pronouncements

Topic

 

Description of Guidance

 

Effective Date

 

Status of Company's Evaluation

Disclosure Improvements - Codification Amendments in Response to the SEC's Disclosure Update and Simplification Initiative (ASU 2023-06)

 

Adds interim and annual disclosure requirements to a variety of subtopics in the Accounting Standards Codification, including those focusing on accounting changes, earnings per share, debt, and repurchase agreements. The guidance will be applied prospectively. The effective date will be the date when the SEC's removal of the related disclosure requirement becomes effective, with early adoption prohibited.

 

Various

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Disaggregation of Income Statement Expenses (ASU 2024-03)

 

Improves financial reporting by requiring that public business entities disclose additional information about specific expense categories in the notes to the financial statements at interim and annual reporting periods. The amendments are to be applied prospectively to financial statements issued for reporting periods after the effective date or retrospectively to all prior periods presented in the financial statements.

 

January 1, 2027

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Targeted Improvements to the Accounting for Internal-Use Software (ASU 2025-06)

 

Aligns the accounting for internal-use software with how software is developed to increase the operability of the recognition and capitalization of internal-use software costs in accordance with Subtopic 350-40. Early adoption is permitted as of the beginning of an annual reporting period. The guidance is to be applied prospectively to new software costs incurred as of the beginning of the adoption period for all projects, including in-process projects.

 

January 1, 2028

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Narrow-Scope Requirements for Interim Reporting (ASU 2025-11)

 

Clarifies interim disclosure requirements and applicability of Topic 270, Interim Reporting for events since the end of the last annual reporting period that have a material impact on the entity. Early adoption is permitted and the amendments are to be applied prospectively or retrospectively to any or all periods presented in the financial statements.

 

January 1, 2028

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Other recently issued ASUs, excluding those ASUs which have already been disclosed as adopted or described above, were assessed and determined not applicable, or are expected to have minimal impact on the Company's consolidated financial statements.
v3.25.4
Mergers, acquisitions, and the discontinuation of the M6 product lines
 12 Months Ended
Dec. 31, 2024
Business Combination [Abstract]  
Mergers, acquisitions, and the discontinuation of the M6 product lines

4. Mergers, acquisitions, and the discontinuation of the M6 product lines

Merger with SeaSpine

In January 2023, the Company completed an all-stock merger of equals (the "Merger") with SeaSpine Holdings Corporation ("SeaSpine"). The total fair value of consideration transferred as part of the Merger was $376.7 million. Goodwill attributable to the Merger was assigned to the Global Spine reporting segment and is not deductible for tax purposes.

Certain acquired assets and liabilities assumed were valued utilizing Level 3 inputs and assumptions. The purchase price allocation for the Merger is as follows:

(U.S. Dollars, in thousands)

 

Final Acquisition Date Fair Value

 

 

Assigned Useful Life

Assets acquired:

 

 

 

 

 

Current assets

 

 

 

 

 

Cash and cash equivalents

 

$

29,419

 

 

 

Accounts receivable, net

 

 

35,313

 

 

 

Inventories

 

 

132,636

 

 

 

Prepaid expenses and other current assets

 

 

4,590

 

 

 

Total current assets

 

 

201,958

 

 

 

Property, plant, and equipment, net

 

 

68,863

 

 

 

Customer relationships

 

 

33,100

 

 

13 years

Developed technology

 

 

47,200

 

 

6 - 8 years

In-process research and development ("IPR&D")

 

 

5,750

 

 

Indefinite

Other long-term assets

 

 

20,501

 

 

 

Total identifiable assets acquired

 

$

377,372

 

 

 

 

 

 

 

 

 

Liabilities assumed:

 

 

 

 

 

Current liabilities

 

 

 

 

 

Accounts payable

 

$

21,602

 

 

 

Other current liabilities

 

 

43,521

 

 

 

Total current liabilities

 

 

65,123

 

 

 

Long-term borrowings under SeaSpine credit facility

 

 

26,298

 

 

 

Other long-term liabilities

 

 

32,823

 

 

 

Total liabilities assumed

 

 

124,244

 

 

 

Net identifiable assets acquired

 

$

253,128

 

 

 

Total fair value of consideration transferred

 

 

376,745

 

 

 

Residual goodwill

 

$

123,617

 

 

 

 

Discontinuation of the M6 product lines

In February 2025, the Company announced its plan to discontinue its M6-C artificial cervical disc and M6-L artificial lumbar disc product lines (together, the "M6 artificial discs" or "M6 product lines") in order to allocate associated resources and investment to more profitable growth opportunities. In accordance with FASB Accounting Standards Codification ("ASC") 205, Presentation of Financial Statements, the Company determined that the discontinuation of the M6 artificial disc did not represent a strategic shift that will have a major effect on its consolidated financial results. Therefore, any related financial results were not reported as discontinued operations. Although the M6 product lines did not meet the criteria to be considered a discontinued operation, these assets were determined to meet the criteria to be classified as held for sale as of March 31, 2025, as the Company expected to complete the sale of these assets before December 31, 2025.

During the second quarter of 2025, following several months of marketing and holding the M6 product lines for sale, the Company determined that it is no longer probable that a sale of the M6 product lines will be completed within one year; therefore, the assets no longer qualify to be classified as held for sale. In accordance with this determination, all assets and liabilities associated with the M6 product lines were reclassified from held for sale to held and used during the second quarter of 2025. Further, as a result of this decision, the Company fully impaired all inventories, property, plant, and equipment, and intangible assets related to the M6 product lines that remained in 2025. A summary of impairment charges recognized and the associated financial statement lines in which such costs are recognized are shown in the table below. All such charges are included within the Company's Global Spine reporting segment.

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

Financial Statement Line Item

2025

 

 

2024

 

 

2023

 

Inventory reserve charges

Cost of sales

$

10,862

 

 

$

—

 

 

$

—

 

Impairment of property, plant, and equipment

Operating expenses

 

6,834

 

 

 

—

 

 

 

—

 

Impairment of developed technology intangible asset

Acquisition-related amortization, impairment, and remeasurement

 

14,097

 

 

 

—

 

 

 

—

 

Loss on M6 inventories and long-lived assets

$

31,793

 

 

$

—

 

 

$

—

 
v3.25.4
Inventories
 12 Months Ended
Dec. 31, 2025
Inventory Disclosure [Abstract]  
Inventories

5. Inventories

Inventories are valued at the lower of cost or estimated net realizable value, after provision for excess, obsolete, or impaired items, which is reviewed and updated on a periodic basis by management. For inventory procured or produced internally or through contract manufacturing arrangements at the Company's manufacturing and distribution facilities in the U.S., inventory is valued using a standard-cost method, which is reviewed at least annually, or more often in the event circumstances indicate a change in costs. The Company believes that standard costs, combined with the capitalization and amortization of observed variances versus standards, approximates actual costs on the first-in, first-out method. For inventory procured or produced through contract manufacturing arrangements at the Company's manufacturing facility in Italy, inventory is valued using a weighted-average cost method.

Work-in-process and finished products include material, labor, and production overhead costs. Field and consignment inventory, which represents immediately saleable finished products inventory that is in the possession of the Company’s independent sales representatives or located at third-party customers, such as hospitals, is included within finished products.

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Raw materials

 

$

22,865

 

 

$

27,180

 

Work-in-process

 

 

63,255

 

 

 

56,920

 

Finished products

 

 

86,199

 

 

 

105,352

 

Inventories

 

$

172,319

 

 

$

189,452

 

The Company adjusts the value of its inventory to the extent management determines that the cost cannot be recovered due to obsolescence or other factors. To make these determinations, management uses estimates of future demand for each product to determine the appropriate inventory reserves and to make corresponding adjustments to the carrying value of these inventories to reflect the lower of cost or estimated net realizable value.
v3.25.4
Property, plant and equipment
 12 Months Ended
Dec. 31, 2025
Property, Plant and Equipment [Abstract]  
Property, plant and equipment

6. Property, plant, and equipment

 

Property, plant, and equipment is stated at cost or estimated fair value when acquired as part of a business combination, less accumulated depreciation. Costs include all expenditures necessary to place the asset in service, generally including freight and sales and use taxes. Property, plant, and equipment also includes instrumentation, which is generally used to facilitate the implantation of the Company’s products.

The useful lives of these assets are generally as follows:

 

 

Years

Buildings

 

25 to 33

Plant and equipment

 

1 to 10

Instrumentation

 

3 to 4

Computer software

 

3 to 7

Furniture and fixtures

 

4 to 8

The Company evaluates the useful lives of these assets on an annual basis. Depreciation is computed on a straight-line basis over the useful lives of the assets. Depreciation of leasehold improvements is computed over the shorter of the lease term or the useful life of the asset. Total depreciation expense was $47.3 million, $41.1 million, and $34.2 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Expenditures for maintenance, repairs, and minor renewals and improvements, which do not extend the lives of the respective assets, are expensed as incurred. All other expenditures for renewals and improvements are capitalized. The assets and related accumulated depreciation are adjusted for property retirements and disposals, with the resulting gain or loss included in earnings. Fully depreciated assets remain in the accounts until retired from service.

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Cost

 

 

 

 

 

 

Buildings

 

$

4,400

 

 

$

3,874

 

Plant and equipment

 

 

82,738

 

 

 

76,481

 

Instrumentation

 

 

192,407

 

 

 

176,387

 

Computer software

 

 

44,888

 

 

 

41,396

 

Furniture and fixtures

 

 

11,062

 

 

 

9,832

 

Construction in progress

 

 

23,235

 

 

 

22,693

 

Finance lease assets

 

 

21,406

 

 

 

21,383

 

Property, plant, and equipment, gross

 

 

380,136

 

 

 

352,046

 

Accumulated depreciation

 

 

(250,737

)

 

 

(212,242

)

Property, plant, and equipment, net

 

$

129,399

 

 

$

139,804

 

The Company capitalizes system development costs related to internal-use software during the application development stage. Costs related to preliminary project activities and post-implementation activities are expensed as incurred. Internal-use software is amortized on a straight-line basis over the estimated useful life of the software.

Long-lived assets are evaluated for impairment annually or whenever events or changes in circumstances have occurred that would indicate impairment. For purposes of the evaluation, the Company groups its long-lived assets with other assets and liabilities at the lowest level of identifiable cash flows if the asset does not generate cash flows independent of other assets and liabilities. If the carrying value of the asset or asset group exceeds the undiscounted cash flows expected to result from the use and eventual disposition of the asset group, the Company will write the carrying value down to fair value in the period identified.

The Company generally determines fair value of long-lived assets as the present value of estimated future cash flows. In determining the estimated future cash flows associated with the assets, the Company uses estimates and assumptions about future revenue contributions, cost structures, and remaining useful lives of the asset group. The use of alternative assumptions, including estimated cash flows, discount rates, and alternative estimated remaining useful lives could result in different calculations of impairment.
v3.25.4
Intangible assets
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Intangible assets

7. Intangible assets

Intangible assets are recorded at cost or at estimated fair value when acquired as a part of a business combination, less accumulated amortization. These assets are amortized on a straight-line basis over the useful lives of the assets, which the Company believes is consistent with the pattern of economic benefit provided by the assets.

 

 

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

Weighted Average Amortization Period

 

2025

 

 

2024

 

Cost

 

 

 

 

 

 

 

 

Developed technology

 

7.1 years

 

$

96,364

 

 

$

92,686

 

Patents

 

10.0 years

 

 

49,510

 

 

 

38,329

 

IPR&D

 

Indefinite

 

 

1,023

 

 

 

4,116

 

Customer relationships

 

12.8 years

 

 

49,249

 

 

 

49,145

 

License and other

 

9.9 years

 

 

20,331

 

 

 

18,359

 

Trademarks—finite lived

 

10.0 years

 

 

1,989

 

 

 

1,735

 

 

 

9.8 years

 

$

218,466

 

 

$

204,370

 

Accumulated amortization

 

 

 

 

 

 

 

 

Developed technology

 

 

 

$

(64,357

)

 

$

(40,813

)

Patents

 

 

 

 

(45,645

)

 

 

(35,918

)

Customer relationships

 

 

 

 

(21,221

)

 

 

(17,044

)

License and other

 

 

 

 

(13,352

)

 

 

(10,892

)

Trademarks—finite lived

 

 

 

 

(1,126

)

 

 

(900

)

 

 

 

 

 

(145,701

)

 

 

(105,567

)

Intangible assets, net

 

 

 

$

72,765

 

 

$

98,803

 

Acquired IPR&D represents the fair value assigned to acquired research and development assets that have not reached technological feasibility. In a business combination, the fair value assigned to acquired IPR&D is determined by estimating the remaining costs to develop the acquired technology into commercially viable products, estimating the resulting revenues from the projects, and discounting the net cash flows to present value. The revenue and cost projections used to value acquired IPR&D are, as applicable, reduced based on the probability of success of developing the asset. Additionally, estimated revenues consider the relevant market sizes and growth factors, expected trends in technology, and the nature and expected timing of new product introductions by the Company and its competitors. The rates utilized to discount the net cash flows to their present value are commensurate with the stage of development of the project and uncertainties in the economic estimates used in the projections. Any future costs to further develop the IPR&D subsequent to acquisition are recorded to research and development expense as incurred.

IPR&D assets are considered to be indefinite-lived assets until the completion or abandonment of the associated research and development efforts. During the period the assets are considered indefinite-lived, they are not amortized but tested for impairment. Impairment testing is performed at least annually or when a triggering event occurs that could indicate a potential impairment. If and when development is complete, which generally occurs when regulatory approval to market a product is obtained and becomes available for commercial sale, the associated assets are reclassified to developed technology and are amortized over an assigned useful life that best reflects the economic benefits provided by these assets.

Amortization expense for intangible assets was $30.0 million, $19.0 million, and $18.9 million for the years ended December 31, 2025, 2024, and 2023, respectively. Future amortization expense for intangible assets is estimated as follows:

(U.S. Dollars, in thousands)

 

Amortization

 

2026

 

$

15,175

 

2027

 

 

14,790

 

2028

 

 

12,063

 

2029

 

 

7,660

 

2030

 

 

7,501

 

Thereafter

 

 

14,553

 

Total finite-lived intangible assets, net

 

$

71,742

 

Indefinite-lived intangible assets

 

 

1,023

 

Intangible assets, net

 

$

72,765

 
v3.25.4
Goodwill
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill

8. Goodwill

The Company tests goodwill at least annually for impairment. The Company tests more frequently if indicators are present or changes in circumstances suggest that impairment may exist. These indicators include, among others, declines in sales, earnings, or cash flows, or the development of a material adverse change in the business climate. The Company assesses goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment.

The following table presents the net carrying value of goodwill as of December 31, 2025, and 2024, and a rollforward of such balances from December 31, 2024, by reportable unit:

(U.S. Dollars, in thousands)

 

Balance as of
December 31, 2024

 

 

Impairment

 

 

Currency translation adjustment

 

 

Balance as of
December 31, 2025

 

Global Spine - Gross

 

$

194,934

 

 

$

—

 

 

$

—

 

 

$

194,934

 

Global Spine - Accumulated impairment loss

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Global Spine - Net

 

$

194,934

 

 

$

—

 

 

$

—

 

 

$

194,934

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Global Limb Reconstruction - Gross

 

$

10,765

 

 

$

—

 

 

$

1,447

 

 

$

12,212

 

Global Limb Reconstruction - Accumulated impairment loss

 

 

(10,765

)

 

 

—

 

 

 

(1,447

)

 

 

(12,212

)

Global Limb Reconstruction - Net

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Goodwill, net of accumulated impairment losses

 

$

194,934

 

 

$

—

 

 

$

—

 

 

$

194,934

 

In the third quarter of 2023, the Company announced the termination of its former President and Chief Executive Officer, former Chief Financial Officer, and former Chief Legal Officer, from their respective roles. Immediately following the announcement, the Company’s market capitalization decreased by approximately 30%, indicating that an impairment may exist. As a result, the Company performed an interim quantitative assessment of its goodwill as of September 30, 2023. The Company estimated the fair value of each reporting unit using a weighted average of the fair value derived from both an income approach and a market approach (all Level 3 fair value measurements). Upon performing its assessment, the Company determined its Global Spine reporting unit's fair value exceed its carrying value of net assets as of September 30, 2023.

In the fourth quarter of 2023, the Company performed a qualitative assessment for its annual goodwill impairment analysis, which did not result in an impairment charge. This qualitative analysis considered all relevant factors specific to the reporting units, including macroeconomic conditions, industry and market considerations, overall financial performance, and relevant entity-specific events.

In the fourth quarters of 2024 and 2025, the Company performed qualitative assessments for its annual goodwill impairment analysis, and concluded it was more likely than not that the fair value of its Global Spine reporting unit exceeded its carrying value in each instance. Upon performing the assessments, the Company determined there were no indicators of impairment as of each assessment date. These qualitative assessments considered all relevant factors specific to the reporting units, including macroeconomic conditions, industry and market considerations, overall financial performance, and relevant entity-specific events.

v3.25.4
Leases
 12 Months Ended
Dec. 31, 2025
Leases [Abstract]  
Leases

9. Leases

The Company determines if a contractual arrangement qualifies as a lease at inception. The Company’s leases primarily relate to facilities, vehicles, and equipment. Lease assets represent the Company’s right to use an underlying asset for the lease term, while lease liabilities represent the obligation to make lease payments arising from the lease. Lease assets and liabilities are recognized at the commencement date based on the present value of lease payments over the lease term, with lease assets also adjusted for the impact of any lease prepayments and reduced by the value of any lease incentives. As the Company’s leases do not provide an implicit rate, the Company’s incremental borrowing rate is used as a discount rate, based on the information available at the commencement date, in determining the present value of lease payments.

The Company does not recognize lease liabilities or lease assets on the balance sheet for short-term leases (leases with a lease term of twelve months or less as of the commencement date). Rather, any short-term lease payments are recognized as an expense on a straight-line basis over the lease term. The current period short-term lease expense reasonably reflects the Company's short-term lease commitments.

For all classifications of leases, the Company combines lease and non-lease components to account for them as a single lease component. Variable lease payments are excluded from the lease liability and recognized in the period in which the obligation is incurred. Additionally, lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise the option.

A summary of the Company’s lease portfolio as of December 31, 2025, and 2024, is presented in the table below:

 

 

 

 

December 31,

 

(U.S. Dollars, in thousands, except lease term and discount rate)

 

Classification

 

2025

 

 

2024

 

Assets

 

 

 

 

 

 

 

 

Operating leases

 

Other long-term assets

 

$

22,279

 

 

$

17,238

 

Finance leases

 

Property, plant and equipment, net

 

 

14,442

 

 

 

15,386

 

Total lease assets

 

 

 

$

36,721

 

 

$

32,624

 

Liabilities

 

 

 

 

 

 

 

 

Current

 

 

 

 

 

 

 

 

Operating leases

 

Other current liabilities

 

$

3,147

 

 

$

4,023

 

Finance leases

 

Current portion of finance lease liability

 

 

837

 

 

 

755

 

Long-term

 

 

 

 

 

 

 

 

Operating leases

 

Other long-term liabilities

 

 

25,413

 

 

 

14,084

 

Finance leases

 

Long-term portion of finance lease liability

 

 

17,060

 

 

 

17,835

 

Total lease liabilities

 

 

 

$

46,457

 

 

$

36,697

 

 

 

 

 

 

 

 

 

 

Weighted Average Remaining Lease Term

 

 

 

 

 

 

 

 

Operating leases

 

 

 

8.8 years

 

 

5.4 years

 

Finance leases

 

 

 

14.6 years

 

 

15.6 years

 

 

 

 

 

 

 

 

 

 

Weighted Average Discount Rate

 

 

 

 

 

 

 

 

Operating leases

 

 

 

 

9.9

%

 

 

7.6

%

Finance leases

 

 

 

 

4.4

%

 

 

4.4

%

 

The components of lease costs were as follows:

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Finance lease costs:

 

 

 

 

 

 

 

 

 

Amortization of right-of-use assets

 

$

1,014

 

 

$

1,014

 

 

$

1,013

 

Interest on finance lease liabilities

 

 

805

 

 

 

832

 

 

 

857

 

Operating lease costs

 

 

6,027

 

 

 

5,257

 

 

 

5,015

 

Short-term lease costs

 

 

29

 

 

 

249

 

 

 

313

 

Variable lease costs

 

 

1,753

 

 

 

1,796

 

 

 

1,883

 

Total lease costs

 

$

9,628

 

 

$

9,148

 

 

$

9,081

 

Supplemental cash flow information related to leases was as follows:

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Cash paid for amounts included in the measurement of lease liabilities

 

 

 

 

 

 

 

 

 

Operating cash flows from operating leases

 

$

8,801

 

 

$

8,917

 

 

$

7,682

 

Operating cash flows from finance leases

 

 

801

 

 

 

831

 

 

 

857

 

Financing cash flows from finance leases

 

 

762

 

 

 

706

 

 

 

652

 

Right-of-use assets obtained in exchange for lease obligations

 

 

 

 

 

 

 

 

 

Operating leases

 

 

12,261

 

 

 

1,449

 

 

 

16,688

 

Finance leases

 

 

70

 

 

 

55

 

 

 

—

 

A summary of the Company’s remaining lease liabilities as of December 31, 2025, is included below:

(U.S. Dollars, in thousands)

 

Operating
Leases

 

 

Finance
Leases

 

2026

 

$

5,426

 

 

$

1,607

 

2027

 

 

4,382

 

 

 

1,626

 

2028

 

 

4,438

 

 

 

1,654

 

2029

 

 

4,229

 

 

 

1,672

 

2030

 

 

4,180

 

 

 

1,685

 

Thereafter

 

 

23,687

 

 

 

16,063

 

Total undiscounted value of lease liabilities

 

 

46,342

 

 

 

24,307

 

Less: Interest

 

 

(17,782

)

 

 

(6,410

)

Present value of lease liabilities

 

$

28,560

 

 

$

17,897

 

 

 

 

 

 

 

 

Current portion of lease liabilities

 

$

3,147

 

 

$

837

 

Long-term portion of lease liabilities

 

 

25,413

 

 

 

17,060

 

Total lease liabilities

 

$

28,560

 

 

$

17,897

 

 

On January 15, 2026, the Company executed the Sixth Amendment to Lease Agreement (the "Sixth Amendment") amending the lease agreement for its corporate headquarters in Lewisville, Texas. The Sixth Amendment, among other things, extends the lease term of the lease through October 2040.
v3.25.4
Other current liabilities
 12 Months Ended
Dec. 31, 2025
Payables and Accruals [Abstract]  
Other current liabilities

10. Other current liabilities

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Accrued expenses

 

$

9,857

 

 

$

11,391

 

Salaries, bonuses, employee commissions, severance, and related taxes payable

 

 

27,026

 

 

 

43,899

 

Accrued distributor commissions

 

 

23,542

 

 

 

23,064

 

Accrued litigation and investigation costs

 

 

30,561

 

 

 

11,891

 

Short-term operating lease liability

 

 

3,147

 

 

 

4,023

 

Non-income taxes payable

 

 

3,609

 

 

 

8,414

 

Short-term contingent consideration liability

 

 

4,290

 

 

 

7,100

 

Other payables

 

 

9,221

 

 

 

9,288

 

Other current liabilities

 

$

111,253

 

 

$

119,070

 
v3.25.4
Indebtedness
 12 Months Ended
Dec. 31, 2025
Debt Disclosure [Abstract]  
Indebtedness

11. Indebtedness

The carrying values of the Company’s outstanding debt obligations as of December 31, 2025, and 2024, were as follows:

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Outstanding Term Loans

 

 

 

 

 

 

Principal amount

 

$

160,000

 

 

$

160,000

 

Unamortized original debt discount

 

 

(1,839

)

 

 

(2,327

)

Unamortized debt issuance costs and lenders fees

 

 

(770

)

 

 

(658

)

Total indebtedness from outstanding term loans

 

 

157,391

 

 

 

157,015

 

 

 

 

 

 

 

 

Current portion of long-term debt

 

$

—

 

 

$

—

 

Long-term debt

 

 

157,391

 

 

 

157,015

 

Total indebtedness outstanding

 

$

157,391

 

 

$

157,015

 

The Company paid cash related to interest of $17.3 million, $16.9 million, and $5.8 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Credit Agreement

On November 7, 2024, the Company entered into a $275.0 million secured credit agreement (the "Credit Agreement") with Oxford Finance LLC, as administrative agent and as collateral agent ("Oxford") and certain lenders party thereto, including Oxford, K2 HealthVentures LLC, and HSBC Ventures USA Inc. Certain of our foreign subsidiaries joined the Credit Agreement as guarantors shortly after the signing date. The Credit Agreement provides for a $160.0 million senior secured term loan (the "Initial Term Loan") and a $65.0 million senior secured delayed draw term loan facility (the "Term B Loan"). Draws under the Term B Loan are at the Company’s option from January 1, 2025 through June 30, 2026, subject to, among other conditions, the Company’s continued compliance with a pro-forma total debt-to-EBITDA leverage ratio of less than 4.0x. EBITDA, as defined in the Credit Agreement, is a non-GAAP financial measure which represents earnings before interest income (expense), income taxes, depreciation, amortization, and other negotiated addbacks and adjustments. In addition, at Oxford's discretion, an additional $50.0 million of draw capacity is available through January 1, 2029 (the "Term C Loan" and, together with the Term B Loan, the "Delayed Draw Term Loans" and collectively with the Initial Term Loan, the "Credit Facilities").

The Initial Term Loan and Delayed Draw Term Loans, to the extent ultimately drawn, will each mature in November 2029, following an interest-only payment period ending December 2028, and monthly amortization of principal and accrued interest between January 2029 and November 2029. As of December 31, 2025, the Company had only utilized the Initial Term Loan. However, on January 15, 2026, the Company borrowed $65.0 million via the Term B Loan for working capital purposes.

The Credit Facilities are secured by a perfected first priority lien, or the equivalent security interest in each applicable jurisdiction, on substantially all of the assets of the Company and the applicable guarantors (subject to customary carveouts), including their respective U.S. intellectual property assets.

Borrowings under the Credit Facilities bear interest at a percentage rate equal to the greater of 8.75% or 5.75% plus the one-month term SOFR rate. A facility fee equal to 1.5% of each applicable funded loan tranche is due at the time of funding of such respective tranche, and a 0.5% unused line fee is payable annually on the Term B Loan.

The Credit Agreement contains customary affirmative and negative covenants, including limitations on the Company’s and its subsidiaries’ ability to incur additional debt, grant or permit additional liens, make certain investments and acquisitions, merge or consolidate with others, dispose of certain assets, pay dividends and distributions, pay subordinated indebtedness, and enter into affiliate transactions, as well as financial covenants that the Company (i) possess at least $45.0 million of unrestricted cash at the time the Initial Term Loan is funded and thereafter maintain $15.0 million of unrestricted cash in U.S.-based accounts, and (ii) maintain a maximum total debt-to-EBITDA leverage ratio no greater than 4.0x during the term of the facility.

In conjunction with obtaining the Credit Agreement, the Company paid $1.7 million in debt issuance costs. These costs have been allocated amongst each of the Initial Term Loan, Term B Loan, and Term C Loan and are being amortized over the term of the Credit Agreement. Capitalized debt issuance costs attributable to the Term B Loan and Term C Loan are included in other long-term assets, net of accumulated amortization, whereas capitalized debt issuance costs associated with the Initial Term Loan are recognized as a direct reduction of the outstanding indebtedness. Debt issuance costs associated with all credit facilities, net of accumulated amortization, were $1.3 million and $1.1 million, as of December 31, 2025, and 2024, respectively. Debt issuance costs amortized or expensed totaled $0.3 million, $4.4 million, and $1.3 million for each of the years ended December 31, 2025, 2024, and 2023, respectively.

As of the effective date of the Credit Agreement, the Company had $125.0 million in principal amount of borrowings outstanding under the Company's prior financing agreement with Blue Torch Finance LLC. In connection with entering into the Credit Agreement, the Company repaid in full all amounts outstanding and terminated all commitments under such prior financing agreement.

Prior Financing Agreement

On November 6, 2023, the Company, as borrower, and certain subsidiaries of the Company as guarantors, entered into a Financing Agreement (the "Financing Agreement") with Blue Torch Finance LLC, as administrative agent and collateral agent (the "Agent"), and certain lenders party thereto. The Financing Agreement provided for a $100.0 million senior secured term loan (the "Blue Torch Initial Term Loan"), a $25.0 million senior secured delayed draw term loan facility (the "Delayed Draw Term Loan") which, subject to certain conditions specified in the Financing Agreement, was available to be drawn on or prior to March 30, 2024, and a $25.0 million senior secured revolving credit facility (the "Revolving Credit Facility," and together with the Blue Torch Initial Term Loan and the Delayed Draw Term Loan, the "Blue Torch Credit Facilities"), each of which were scheduled to mature on November 6, 2027. In connection with entering into the Financing Agreement, the Company repaid in full amounts outstanding and terminated all commitments under the Company’s prior $175.0 million senior secured revolving credit facility evidenced by that certain Second Amended and Restated Credit Agreement, dated as of October 25, 2019, among the Company, certain subsidiaries of the Company as borrowers and guarantors, JPMorgan Chase Bank, N.A., as administrative agent, and the lenders party thereto (as amended, supplemented or otherwise modified, the "JPMorgan Credit Agreement"). The Blue Torch Initial Term Loan was fully funded on the effective date of November 6, 2023. As of December 31, 2023, the Company had not made any borrowings under the Delayed Draw Term Loan or the Revolving Credit Facility. However, on January 10, 2024, the Company borrowed $15.0 million under the Revolving Credit Facility, which was fully repaid as of the effective date of the Credit Agreement.

Borrowings under the Financing Agreement were used for, among other things, the repayment in full of the former JPMorgan Credit Agreement, working capital and other general corporate purposes of the Company. Borrowings under the Blue Torch Credit Facilities bore interest at a floating rate, which was, at the Company’s option, either the three-month SOFR rate (subject to a floor of 3.00% and a credit spread adjustment of 0.26161%) (the "Adjusted Term SOFR Rate") plus an applicable margin of 7.25%, or a base rate plus an applicable margin of 6.25%. A revolving unused line fee of 2.00% was payable monthly in arrears based on the average amount of the undrawn portion of each lender’s revolving credit commitments under the Revolving Credit Facility for the preceding month. A delayed draw unused fee equal to the Adjusted Term SOFR Rate plus a margin of 1.00% was payable monthly in arrears based on the average amount of the undrawn portion of each lender’s delayed draw term loan commitments in respect of the Delayed Draw Term Loan for the preceding month.

Certain of the Company’s existing and future material subsidiaries (collectively, the "Guarantors") were required to guarantee the repayment of the Company’s obligations under the Financing Agreement. The obligations of the Company and each of the Guarantors with respect to the Financing Agreement were secured by a pledge of substantially all assets of the Company and each of the Guarantors, including, without limitation, accounts receivable, deposit accounts, intellectual property, investment property, inventory, equipment and equity interests in their respective subsidiaries.

Italian Line of Credit

The Company has an unused available Italian line of credit of €5.5 million ($6.5 million and $5.7 million) at December 31, 2025, and 2024, respectively. This unsecured line of credit provides the Company the option to borrow amounts in Italy at interest rates determined at the time of borrowing.
v3.25.4
Fair value measurements and investments
 12 Months Ended
Dec. 31, 2025
Fair Value Measurements And Investment Disclosure [Abstract]  
Fair value measurements and investments

12. Fair value measurements and investments

Fair value is defined as the price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Non-financial assets and liabilities of the Company measured at fair value include any long-lived assets that are impaired in a currently reported period or equity securities measured at observable prices in orderly transactions. The authoritative guidance also describes three levels of inputs that may be used to measure fair value:

Level 1:

quoted prices in active markets for identical assets and liabilities

 

 

Level 2:

observable inputs other than quoted prices in active markets for identical assets and liabilities

 

 

Level 3:

unobservable inputs in which there is little or no market data available, which require the reporting entity to develop its own assumptions

The Company’s financial instruments include cash equivalents, accounts receivable, accounts payable, long-term secured debt, available for sale debt securities, equity securities, contingent consideration, and deferred compensation plan liabilities. The carrying value of cash equivalents, accounts receivable, and accounts payable approximate fair value due to the short-term maturities of these instruments. The Company’s secured term loan carries a floating rate of interest; therefore, the carrying value of long-term debt is considered to approximate the fair value.

The Company’s available for sale debt securities, equity securities, contingent consideration, and deferred compensation plan liabilities are, or in some cases, were the only financial instruments recorded at fair value on a recurring basis as follows:

(U.S. Dollars, in thousands)

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Balance
December 31,
2025

 

Assets

 

 

 

 

 

 

 

 

 

 

 

 

Neo Medical convertible loan agreement

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Neo Medical preferred equity securities

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Total

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Liabilities

 

 

 

 

 

 

 

 

 

 

 

 

Lattus contingent consideration

 

$

—

 

 

$

—

 

 

$

(7,930

)

 

$

(7,930

)

Deferred compensation plan

 

 

—

 

 

 

(1,720

)

 

 

—

 

 

 

(1,720

)

Total

 

$

—

 

 

$

(1,720

)

 

$

(7,930

)

 

$

(9,650

)

 

(U.S. Dollars, in thousands)

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Balance
December 31,
2024

 

Assets

 

 

 

 

 

 

 

 

 

 

 

 

Neo Medical convertible loan agreement

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Neo Medical preferred equity securities

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Total

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Liabilities

 

 

 

 

 

 

 

 

 

 

 

 

Lattus contingent consideration

 

$

—

 

 

$

—

 

 

$

(15,400

)

 

$

(15,400

)

Deferred compensation plan

 

 

—

 

 

 

(1,703

)

 

 

—

 

 

 

(1,703

)

Total

 

$

—

 

 

$

(1,703

)

 

$

(15,400

)

 

$

(17,103

)

The fair value of the Company’s deferred compensation plan liabilities is determined based on inputs that are readily available in public markets or that can be derived from information available in publicly quoted markets; therefore, the Company has categorized this liability as a Level 2 financial instrument.

Neo Medical Convertible Loan Agreements and Equity Investment

On October 1, 2020, the Company purchased shares of Neo Medical's preferred stock for consideration of $5.0 million and entered into a Convertible Loan Agreement (the "Convertible Loan") pursuant to which Orthofix loaned Neo Medical CHF 4.6 million, or $5.0 million at the date of issuance. In April 2024, the Company converted the Convertible Loan into shares of Neo Medical preferred equity securities. On November 14, 2024, the Company sold and transferred all shares of Neo Medical's preferred equity securities for CHF 6.6 million, or $7.4 million. The Company recorded a realized loss of $5.8 million as a result of the sale, recognized within other expense, net.

The table below presents a reconciliation of the carrying value of the Company’s investment in Neo Medical preferred equity securities for the years ended December 31, 2025, and 2024:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Fair value of Neo Medical preferred equity securities at January 1

 

$

—

 

 

$

4,951

 

Conversion of loan into preferred equity securities

 

 

—

 

 

 

8,224

 

Sale of preferred equity securities

 

 

—

 

 

 

(7,396

)

Realized loss recognized in other expense, net

 

 

—

 

 

 

(5,779

)

Fair value of Neo Medical preferred equity securities at December 31

 

$

—

 

 

$

—

 

Cumulative unrealized gain (loss) on Neo Medical preferred equity securities

 

$

—

 

 

$

—

 

The following table provides a reconciliation of the beginning and ending balances of the Convertible Loan, measured at fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Fair value of Neo Medical Convertible Loans at January 1

 

$

—

 

 

$

6,760

 

Gain recognized in other comprehensive income (loss)

 

 

—

 

 

 

1,671

 

Interest recognized in interest income, net

 

 

—

 

 

 

162

 

Foreign currency remeasurement recognized in other income (expense), net

 

 

—

 

 

 

(629

)

Expected credit loss recognized in other income (expense), net

 

 

—

 

 

 

260

 

Conversion into preferred equity securities

 

 

—

 

 

 

(8,224

)

Fair value of Neo Medical Convertible Loans at December 31

 

$

—

 

 

$

—

 

Lattus Contingent Consideration

In connection with the Merger, the Company assumed a contingent consideration obligation under a purchase agreement between SeaSpine and Lattus Spine LLC ("Lattus") executed in December 2022. Under the terms of the agreement, the Company may be required to make installment payments at certain dates based on future net sales of certain products (the "Lateral Products").

The estimated fair value of the Lattus contingent consideration is determined using a Monte Carlo simulation and a discounted cash flow model requiring significant inputs which are not observable in the market. The significant inputs include assumptions related to the estimated future sales of Lateral Products, revenue risk-adjusted discount rates, revenue volatility, and discount rates matched to the timing of payments. The following table provides a reconciliation of the beginning and ending balances for the Lattus contingent consideration measured at estimated fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Lattus contingent consideration estimated fair value at January 1

 

$

15,400

 

 

$

8,500

 

Change in fair value recognized in acquisition-related amortization, impairment, and remeasurement

 

 

(1,140

)

 

 

6,900

 

Installment payment

 

 

(6,330

)

 

 

—

 

Lattus contingent consideration estimated fair value at December 31

 

$

7,930

 

 

$

15,400

 

 

The following table provides quantitative information related to certain key assumptions utilized within the valuation as of December 31, 2025:

(U.S. Dollars, in thousands)

 

Fair Value as of
 December 31, 2025

 

 

Unobservable inputs

 

Estimate

Lattus contingent consideration

 

$

7,930

 

 

Counterparty discount rate

 

11.8% - 12.0%

 

 

 

 

 

Revenue risk-adjusted discount rate

 

5.7% - 5.9%
v3.25.4
Commitments and Contingencies
 12 Months Ended
Dec. 31, 2025
Commitments and Contingencies Disclosure [Abstract]  
Commitments and Contingencies

13. Commitments and contingencies

Contingencies policy

The Company records accruals for certain outstanding legal proceedings, investigations, or claims when it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. The Company evaluates developments in legal proceedings, investigations, and claims that could affect the amount of any accrual, as well as any developments that would make a loss contingency both probable and reasonably estimable on a quarterly basis. When a loss contingency is not both probable and reasonably estimable, the Company does not accrue the loss. However, if the loss (or an additional loss in excess of the accrual) is at least a reasonable possibility and material, then the Company discloses a reasonable estimate of the possible loss or range of loss, if such reasonable estimate can be made. If the Company cannot make a reasonable estimate of the possible loss, or range of loss, then that is disclosed. In addition, legal fees and other directly related costs are expensed as incurred.

In addition to the matters described in the paragraphs below, in the normal course of its business, the Company is involved in various lawsuits from time to time and may be subject to certain other contingencies. The Company believes any losses related to these matters are individually and collectively immaterial as to a possible loss and range of loss.

Arbitration claims with former executives

In September 2023, the Company's Board of Directors (the “Board“) terminated the employment of Keith Valentine, John Bostjancic, and Patrick Keran, who had served respectively as the Company’s President and Chief Executive Officer, Chief Financial Officer, and Chief Legal Officer (collectively, the “Former Executives”). The Board’s decision followed an investigation conducted by independent outside legal counsel and directed and overseen by a committee of certain of the Company’s independent directors. At the time of termination, the Company notified each of the Former Executives that their respective terminations of employment were being made for “Cause,” as such term is defined in applicable employment-related agreements (including each executive’s respective Change in Control and Severance Agreement, dated June 19, 2023 (the “CIC and Severance Agreements”). The Former Executives subsequently made claims against the Company in arbitration in the State of California, asserting breach of contract because each of them was entitled to the severance payments and other equity-based rights that would be owed to them if their respective termination had been made “without Cause” under the CIC and Severance Agreements, and further asserting damages for purported defamation, false light invasion of privacy, and deceit, as well as indemnification and advancement for attorneys’ fees.

On January 26, 2026, the arbitrator in Mr. Valentine’s matter issued a decision denying Mr. Valentine’s defamation, false light invasion of privacy and deceit claims, and his indemnification of fees claim. Based on the evidence presented during the arbitration process, the arbitrator found that Mr. Valentine’s conduct met the legal definition of “acts of moral turpitude” and that the public statements that the Company made about Mr. Valentine in a press release and filings with the SEC subsequent to the termination of his employment were true. Although Mr. Valentine’s conduct was found to meet the legal definition of “acts of moral turpitude” for purposes of his defamation and other tort claims, and although engaging in “material acts of moral turpitude” would constitute “Cause” under the CIC and Severance Agreement, the arbitrator maintained his preliminary decision issued on October 2, 2025, finding that (i) Mr. Valentine’s conduct prior to his entry into the CIC and Severance Agreement on June 19, 2023 could not be considered for purposes of determining whether “Cause” existed under such agreement, and (ii) his conduct between that date and his termination of employment on September 11, 2023 did not amount to “Cause”. As a result, the arbitrator issued an interim award to Mr. Valentine for breach of contract damages in the amount of $11.8 million, finding such amount to be equivalent to the severance and equity-based rights that Mr. Valentine would have received in a “without Cause” termination. The Company expects the arbitrator’s final order to also include accrued interest, in the approximate amount of $2.7 million.

The Company continues to disagree with the legal claims asserted by the Former Executives in their respective arbitration matters and is vigorously defending them. While the arbitrations for Messrs. Bostjancic and Keran remain pending (and the arbitrators in those proceedings are not bound by the rulings in Mr. Valentine’s arbitration), and certain legal issues related to apportionment of attorneys’ fees remain pending in Mr. Valentine’s matter, the Company is maintaining its accrual in the amount of $18.3 million. The

Company expects a final order from the arbitrator with respect to Mr. Valentine’s matter in the first quarter of 2026. At this time, Messrs. Bostjancic and Keran’s arbitration hearings are currently expected to occur in 2026.

In addition to these arbitration claims, in September 2024 Messrs. Valentine, Bostjancic and Keran filed an action in California State Court against former director and interim CEO Catherine Burzik and current director Wayne Burris, seeking relief for, among other things, alleged defamation, false light invasion of privacy, intentional misrepresentation, false promise, and tortious interference with contract. The Company disagrees with the allegations contained in the action against Ms. Burzik and Mr. Burris and is vigorously defending the asserted claims. The Company currently cannot reasonably estimate a possible loss, or range of loss, that may arise from the action.

Securities class action complaints

On August 21, 2024, a securities class action complaint captioned Bernal v. Orthofix Medical Inc., et al., Case No. 24-cv-00690, was filed in the United States District Court for the Eastern District of Texas (the "Bernal Complaint"). The plaintiff, a purported Company shareholder, alleges through the complaint violations of Sections 10(b) and 20(a) of the Exchange Act, and SEC Rule 10b-5 promulgated thereunder, and names as defendants the Company and the following former Company directors and officers: Jon Serbousek (former director and former President and Chief Executive Officer), Keith Valentine (former director and former President and Chief Executive Officer), John Bostjancic (former Chief Financial Officer), and Patrick Keran (former Chief Legal Officer). The complaint alleges that the Company made, and the named former directors and officers caused the Company to make, materially false and misleading statements between October 11, 2022, and September 12, 2023, that, according to the complaint, falsely assured the market regarding Messrs. Valentine, Bostjancic, and Keran's respective commitments to, among other things, ethical and legal standards and corporate responsibility.

On September 6, 2024, a securities class action complaint captioned O'Hara v. Orthofix Medical Inc., et al., Case No. 24-cv-01593, was filed in the United States District Court for the Southern District of California (the "O'Hara Complaint"). The plaintiff, a purported former shareholder of SeaSpine at the time of the Merger, alleges through the complaint violations of Sections 11, 12 and 15 of the Securities Act, and names most of the same defendants as the Bernal Complaint, as well as certain additional current and/or former Company directors and officers. The complaint makes similar assertions to the Bernal complaint, and alleges that the Company's registration statement on Form S-4 filed in 2022 in connection with the Merger, as well as related written and oral offering materials, contained untrue statements of material fact and material omissions, including, among other things, with respect to the effectiveness of the Company's internal controls. On November 26, 2024, the O'Hara Complaint was transferred to the Eastern District of Texas, and on December 11, 2024, the O'Hara Complaint was consolidated with the Bernal Complaint. On April 17, 2025, the plaintiffs filed an amended complaint in the consolidated action, captioned In re Orthofix Medical Inc. Securities Litigation, with substantially the same allegations contained in the Bernal Complaint and the O'Hara Complaint. The consolidated case is captioned In re Orthofix Medical Inc. Securities Litigation, Case No. 24-cv-00690 and is pending in the Eastern District of Texas. The Company and the individual defendants moved to dismiss the amended complaint on May 15, 2025. On February 18, 2026, the Court held a hearing on the motion to dismiss the amended complaint.

On October 28, 2024, a derivative shareholder complaint was filed against certain of the Company's current and former officers and directors alleging derivative liability for the allegations made in the two complaints noted above. On December 18, 2024, a second derivative shareholder complaint was filed with the same allegations made in the first derivative shareholder complaint. On March 21, 2025, the two derivative shareholder complaints were consolidated into one case.

The Company disagrees with the legal claims asserted in these complaints and is vigorously defending them. Due in part to the preliminary nature of these three matters, the Company currently cannot reasonably estimate a possible loss, or range of loss, that may arise from the respective complaints.

Commitments

As a result of the Merger, the Company became party to agreements with certain distributor partners that provide the Company with an option to purchase, and an option for those partners to require the Company to purchase, the distribution business of those partners at specified future dates. At such time, the Company or distributor may (in certain cases, subject to satisfying certain conditions) submit written notice to the other of its intention to exercise its rights and initiate or require the purchase. Upon receipt of the written notice, the Company and the distributor will work in good faith to consummate the purchase, provided that the distributor meets the required conditions of such purchase option. Under certain of these agreements, the purchase price would be paid in shares of the Company's common stock, whereas for others, the purchase price can be paid in cash or shares, at the Company's option. Based on the closing price of the Company's common stock as of December 31, 2025, assuming the options under all the relevant agreements were exercised, the estimated total number of shares the Company would issue under these agreements was approximately 0.3 million shares for agreements that must be settled in shares of the Company's stock. The Company has received notification from one such distributor, who has notified the Company of its decision to exercise its buyout

option. The Company is currently in negotiations with this distributor with respect to the conditions of a potential acquisition, the consummation of which may be deferred to a future date.

Italian Medical Device Payback ("IMDP")

In 2015, the Italian Parliament introduced rules for entities that supply goods and services to the Italian National Healthcare System. A key provision of the law is a ‘payback’ measure, requiring medical device companies in Italy to make payments to the Italian government if medical device expenditures exceed regional maximum ceilings. Companies are required to make payments equal to a percentage of expenditures exceeding maximum regional caps.

In the third quarter of 2022, the Italian Ministry of Health provided guidelines to the Italian regions and provinces on seeking payback of expenditure overruns relating to the 2015 through 2018 calendar years. Since receiving the guidelines, several regions and provinces have requested payment from affected medical device companies, including the Company. The Company has taken legal action to dispute the legality of such measures. In July 2024, the Italian Constitutional Court issued two judgments following public hearings on the matter held in May 2024. These judgments (i) declared the payback system itself as constitutionally legitimate and (ii) extended previously communicated reductions in the payback liability for certain fiscal years to all medical device companies, regardless of whether or not they had waived their legal claims on the matter.

The Company accounts for the estimated cost of the IMDP as sales, general, and administrative expense and periodically reassesses the liability based upon current facts and circumstances. As a result, the Company recorded expenses of $1.4 million, $1.4 million, and $1.3 million for the years ended December 31, 2025, 2024, and 2023, respectively. As of December 31, 2025, the Company has accrued $10.6 million related to the IMDP, which it has classified within other long-term liabilities; however, the actual liability could be higher or lower than the amount accrued once all legal proceedings are resolved and upon further clarification of the IMDP by the Italian authorities for more recent fiscal years.
v3.25.4
Shareholder's equity
 12 Months Ended
Dec. 31, 2025
Stockholders' Equity Note [Abstract]  
Shareholders' equity

14. Shareholders’ equity

Dividends

The Company has not historically paid dividends to holders of its common stock. Certain subsidiaries of the Company have restrictions on their ability to pay dividends in certain circumstances pursuant to the Credit Agreement. In the event that the Company decides to pay a dividend to holders of its common stock in the future with dividends received from its subsidiaries, the Company may, based on prevailing rates of taxation, be required to pay additional withholding and income tax on such amounts received from its subsidiaries.

Accumulated Other Comprehensive Income (Loss)

Accumulated other comprehensive income (loss) is comprised of foreign currency translation adjustments and unrealized gains (losses) on available for sale debt securities. The Company’s policy is to release income tax effects related to items recognized within accumulated other comprehensive income (loss) using a portfolio approach. The components of and changes in accumulated other comprehensive income (loss) are as follows:

(U.S. Dollars, in thousands)

 

Currency
Translation
Adjustments

 

 

Neo Medical Convertible Loans

 

 

Other Investments

 

 

Accumulated Other
Comprehensive
Income (Loss)

 

Balance at December 31, 2022

 

$

(2,482

)

 

$

1,005

 

 

$

101

 

 

$

(1,376

)

Other comprehensive income (loss)

 

 

1,417

 

 

 

(1,233

)

 

 

(101

)

 

 

83

 

Income taxes

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Balance at December 31, 2023

 

$

(1,065

)

 

$

(228

)

 

$

—

 

 

$

(1,293

)

Other comprehensive income (loss)

 

 

(3,009

)

 

 

1,671

 

 

 

—

 

 

 

(1,338

)

Income taxes

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Reclassification adjustment to:

 

 

 

 

 

 

 

 

 

 

 

 

Other expense, net

 

 

—

 

 

 

(1,671

)

 

 

—

 

 

 

(1,671

)

Balance at December 31, 2024

 

$

(4,074

)

 

$

(228

)

 

$

—

 

 

$

(4,302

)

Other comprehensive income

 

 

4,920

 

 

 

—

 

 

 

—

 

 

 

4,920

 

Income taxes

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Balance at December 31, 2025

 

$

846

 

 

$

(228

)

 

$

—

 

 

$

618

 

 
v3.25.4
Revenue recognition and accounts receivable
 12 Months Ended
Dec. 31, 2025
Revenue Recognition And Accounts Receivable [Abstract]  
Revenue recognition and accounts receivable

15. Revenue recognition and accounts receivable

Revenue Recognition

The Company accounts for a contract when there is (i) approval and commitment from both parties, (ii) the rights of the parties are identified, (iii) payment terms are identified, (iv) the contract has commercial substance, and (v) collectability of consideration is probable. The Company’s contracts may contain one or more performance obligations. If a contract contains more than one performance obligation, the Company allocates the total transaction price to each of the performance obligations based upon the observable standalone selling price of the promised goods or services underlying each performance obligation. The Company recognizes revenue when control of the promised goods or services is transferred to the customer, which typically occurs at a point in time upon shipment, delivery, or utilization, in an amount that reflects the consideration which the Company expects to be entitled to in exchange for the promised goods or services. The consideration for goods or services reflects any fixed amount stated per the contract and estimates for any variable consideration, such as discounts, to the extent that it is probable that a significant reversal of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved.

The following sections discuss the Company’s revenue recognition policies by significant product category:

Bone Growth Therapies

Bone Growth Therapies revenue is largely attributable to the U.S. and is comprised of third-party payor transactions and wholesale revenue.

The largest portion of Bone Growth Therapies revenue is derived from third-party payors. This includes commercial insurance carriers, health maintenance organizations, preferred provider organizations, and governmental payors, such as Medicare. Revenue is recognized when the product is fitted to and accepted by the patient and all applicable documents required by the third-party payor have been obtained. Amounts paid by third-party payors are generally based on fixed or allowable reimbursement rates. These revenues are recorded at the expected or preauthorized reimbursement rates, net of any contractual allowances or adjustments. Certain billings are subject to review by the third-party payors and may be subject to adjustment.

Wholesale revenue is related to the sale of the Company’s bone growth stimulators directly to durable medical equipment suppliers. Wholesale revenues are typically recognized upon shipment and receipt of a confirming purchase order, which is when the customer obtains control of the promised goods.

Biologics

Biologics revenue is largely attributable to the U.S. and is mostly processed from within the Company’s Irvine facility. In addition, the Company has a long-standing collaborative arrangement with MTF that provides exclusive global marketing rights to MTF's Virtuos and Trinity Elite, and exclusive rights to market the FiberFuse tissues in the U.S. Per the terms of the agreement, MTF sources the tissue, processes it to create the allografts, packages, and delivers the tissue to the customer. The Company receives marketing fees from MTF based on sales of products covered under the collaborative arrangement. MTF is considered the principal in these arrangements; therefore, the Company recognizes marketing service fees on a net basis within net sales upon shipment of the product to the customer and receipt of a confirming purchase order.

Spinal Implants and Global Limb Reconstruction (formerly "Global Orthopedics")

Spinal Implants and Global Limb Reconstruction products are distributed world-wide, with U.S. sales largely comprised of commercial revenue and international sales derived from both commercial revenue and stocking distributor arrangements.

Commercial revenue is largely related to the sale of the Company’s Spinal Implants and Global Limb Reconstruction products to hospital customers. The customer obtains control and revenues are recognized when these products have been utilized and a confirming purchase order has been received from the hospital.

Other revenues within the Spinal Implants and Global Limb Reconstruction product categories are derived from stocking distributors, who purchase the Company’s products and then re-sell them directly to customers, such as hospitals. For stocking distributor arrangements, it is the Company’s policy to recognize revenue upon shipment and receipt of a confirming purchase order, which is when the distributor obtains control of the promised goods. The transaction price for revenue recognition is estimated based upon the Company’s historical collection experience with the stocking distributor.

Enabling Technologies

Enabling technologies revenue is primarily comprised of sales of the 7D Flash Navigation Systems and related instruments to hospitals, healthcare providers, and stocking distributors. Revenue is typically recognized from these sales upon installation of the system at the site of the purchasing hospital or upon shipment to a stocking distributor and receipt of a confirming purchase order, as this represents the point in time when the performance obligation has been satisfied.

Product Sales and Marketing Service Fees

The table below presents net sales, which includes product sales and marketing service fees, for each of the years ended December 31, 2025, 2024, and 2023.

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Product sales

 

$

775,396

 

 

$

747,783

 

 

$

693,345

 

Marketing service fees

 

 

46,916

 

 

 

51,708

 

 

 

53,296

 

Net sales

 

$

822,312

 

 

$

799,491

 

 

$

746,641

 

Marketing service fees are received from MTF based on total sales of biologics tissues and relate solely to the Biologics product category within the Global Spine reporting segment, whereas product sales primarily consist of the sale of Bone Growth Therapies, Spinal Implants, non-MTF sourced Biologics, Enabling Technologies, and Global Limb Reconstruction products. Marketing service fees received from MTF were $46.9 million, or approximately 30% of total Biologics revenues, for the year ended December 31, 2025. As MTF is the single supplier for certain allografts in the Company’s Biologics portfolio, derived from deceased donors for their bone grafts and living donors for their amnion grafts, any event or circumstance that would impact MTF’s continued access to donors or the Company’s ability to market these tissues may adversely impact the Company’s financial results.

Revenues exclude any value added or other local taxes, intercompany sales, and trade discounts. Shipping and handling costs for products shipped to customers are included in cost of sales, and were $8.9 million, $9.9 million, and $9.5 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Accounts receivable and related allowances

Payment terms vary by the type and location of the Company’s customers and the products or services offered. The term between invoicing and when payment is due is generally not significant.

The Company’s allowance for expected credit losses represents the portion of the receivable’s amortized cost basis that an entity does not expect to collect over the receivable’s contractual life, considering past events, current conditions, and reasonable and supportable forecasts of future economic conditions.

The process for estimating the ultimate collection of accounts receivable involves certain assumptions and judgments. The determination of the contractual life of accounts receivable, the aging of outstanding receivables, as well as the historical collections, write-offs, and payor reimbursement experience over the estimated contractual lives of such receivables, are integral parts of the estimation process related to reserves for expected credit losses and the establishment of contractual allowances. The Company elected the practical expedient provided within ASU 2025-05, which allows the Company to assume that current macroeconomic conditions as of the balance sheet date persist for the remaining contractual life of current accounts receivable.

Accounts receivable are analyzed on a quarterly basis to assess the adequacy of both reserves for expected credit losses and contractual allowances. Revisions in allowances for expected credit loss estimates are recorded as an adjustment to the Company's provision for expected credit losses within sales, general, and administrative expenses. Revisions to contractual allowances are recorded as an adjustment to net sales. These estimates are periodically tested against actual collection or adjustment experience. In addition, the Company analyzes its receivables by geography and by customer type, where appropriate, in developing estimates for expected credit losses.

The following table provides the detail of changes in the Company’s allowance for expected credit losses for the years ended December 31, 2025, and 2024:

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Allowance for expected credit losses beginning balance

 

$

7,418

 

 

$

7,130

 

Current period provision for expected credit losses

 

 

2,255

 

 

 

1,999

 

Write-offs charged against the allowance and other activity

 

 

(1,764

)

 

 

(1,451

)

Effect of changes in foreign exchange rates

 

 

399

 

 

 

(260

)

Allowance for expected credit losses ending balance

 

$

8,308

 

 

$

7,418

 

The Company will generally sell receivables from certain Italian public hospitals each year to accelerate cash collections. During 2025, 2024, and 2023, the Company sold €8.9 million, €7.9 million, and €9.2 million ($10.3 million, $8.5 million, and $10.0 million) of receivables, respectively. The related fees for 2025, 2024, and 2023, were $0.2 million, $0.3 million, and $0.4 million, respectively, which were recorded as interest expense. Accounts receivable sold without recourse are removed from the balance sheet at the time of sale.

v3.25.4
Business segment information
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Business segment information

16. Business segment information

The Company's operations are managed through two reporting segments: Global Spine and Global Limb Reconstruction. These reporting segments represent the operating segments for which the President and Chief Executive Officer, who is also the Chief Operating Decision Maker ("CODM"), reviews financial information and makes resource allocation decisions among businesses. The primary metric used by the CODM in managing the Company is adjusted earnings before interest, tax, depreciation, and amortization ("adjusted EBITDA", a non-GAAP financial measure). Adjusted EBITDA represents earnings before interest income (expense), income taxes, depreciation and amortization, and excludes the impact of share-based compensation, gains and losses related to changes in foreign exchange rates, charges related to the SeaSpine Merger and other strategic investments, restructuring costs and impairments related to the discontinuation of the M6 product lines, acquisition-related fair value adjustments, gains and/or losses on investments, litigation and investigation charges, succession charges, charges related to initial compliance with regulations set forth by the European Union Medical Device Regulation, and refunds associated with the employee retention credit established by the Coronavirus Aid, Relief, and Economic Security Act.

Corporate activities are comprised of operating expenses not directly identifiable within the two reporting segments, such as human resources, finance, legal, and information technology functions. The Company neither discretely allocates assets, other than goodwill, to its operating segments nor evaluates the operating segments using discrete asset information.

Global Spine

The Global Spine reporting segment offers two primary product categories: (i) Bone Growth Therapies and (ii) Spinal Implants, Biologics, and Enabling Technologies.

The Bone Growth Therapies product category manufactures, distributes, sells, and provides support services for market-leading devices used adjunctively in high-risk spinal fusion procedures and to treat both nonunion and acute fractures in the orthopedic space. These Class III medical devices are indicated as an adjunctive, noninvasive treatment to improve fusion success rates in the cervical and lumbar spine as well as a therapeutic treatment for non-spinal, appendicular fractures, treating both fresh or nonunion fractures. These products are sold almost exclusively in the U.S., using distributors and direct sales representatives to provide these devices to healthcare providers and their patients.

Spinal Implants, Biologics, and Enabling Technologies comprises (i) a broad portfolio of spine fixation implant products used in surgical procedures of the spine, (ii) one of the most comprehensive biologics portfolios in both the demineralized bone matrix and cellular allograft market segments, and (iii) image-guided surgical solutions to facilitate degenerative, minimally invasive, and complex surgical procedures. Spinal Implants, Biologics, and Enabling Technologies products are sold through a network of distributors and sales representatives to hospitals and healthcare providers on a global basis for Spinal Implants and Enabling Technologies, and primarily within the U.S. for Biologics.

Global Limb Reconstruction

The Global Limb Reconstruction reporting segment offers products and solutions for the underserved limb reconstruction market that encompasses four pillars: deformity correction, limb lengthening, complex fracture management, and limb preservation. This reporting segment specializes in the design, development, and marketing of external and internal fixation limb reconstruction products that are coupled with enabling digital technologies to serve the complete patient treatment pathway. The Company sells

these products worldwide through a global network of distributors and sales representatives to hospitals, healthcare organizations, and healthcare providers.

The table below presents net sales by major product category by reporting segment:

 

 

Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

(U.S. Dollars, in thousands)

 

Net Sales

 

 

Percent of
Total Net
Sales

 

 

Net Sales

 

 

Percent of
Total Net
Sales

 

 

Net Sales

 

 

Percent of
Total Net
Sales

 

Bone Growth Therapies

 

$

247,164

 

 

 

30.0

%

 

$

233,405

 

 

 

29.2

%

 

$

212,530

 

 

 

28.5

%

Spinal Implants, Biologics, and Enabling Technologies

 

 

440,491

 

 

 

53.6

%

 

 

441,909

 

 

 

55.3

%

 

 

418,789

 

 

 

56.1

%

Global Spine

 

 

687,655

 

 

 

83.6

%

 

 

675,314

 

 

 

84.5

%

 

 

631,319

 

 

 

84.6

%

Global Limb Reconstruction

 

 

134,657

 

 

 

16.4

%

 

 

124,177

 

 

 

15.5

%

 

 

115,322

 

 

 

15.4

%

Net sales

 

$

822,312

 

 

 

100.0

%

 

$

799,491

 

 

 

100.0

%

 

$

746,641

 

 

 

100.0

%

The following table presents adjusted EBITDA, the primary metric used in managing the Company, by reporting segment:

 

 

Year Ended December 31, 2025

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Limb Reconstruction

 

 

Total

 

Segment revenues

 

$

687,655

 

 

$

134,657

 

 

$

822,312

 

Less:

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

177,585

 

 

 

53,128

 

 

 

230,713

 

Non-GAAP Sales, general, and administrative

 

 

380,659

 

 

 

75,727

 

 

 

456,386

 

Non-GAAP Research and development

 

 

45,570

 

 

 

11,542

 

 

 

57,112

 

Other segment expenses (benefits)

 

 

10,447

 

 

 

(225

)

 

 

10,222

 

Add:

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

39,200

 

 

 

11,772

 

 

 

50,972

 

Segment Adjusted EBITDA

 

$

112,594

 

 

$

6,257

 

 

$

118,851

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

$

32,987

 

Interest expense, net

 

 

 

 

 

 

 

 

17,488

 

Depreciation and amortization

 

 

 

 

 

 

 

 

77,321

 

Share-based compensation expense

 

 

 

 

 

 

 

 

28,688

 

Foreign exchange impact

 

 

 

 

 

 

 

 

(2,910

)

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

6,093

 

Restructuring costs and impairments related to M6 product lines

 

 

 

 

 

 

 

 

17,305

 

Strategic investments

 

 

 

 

 

 

 

 

4,915

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

(1,140

)

Interest and loss on investments

 

 

 

 

 

 

 

 

(48

)

Litigation and investigation costs

 

 

 

 

 

 

 

 

33,788

 

Employee retention credit

 

 

 

 

 

 

 

 

(4,826

)

Loss before income taxes

 

 

 

 

 

 

 

$

(90,810

)

 

 

 

Year Ended December 31, 2024

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Limb Reconstruction

 

 

Total

 

Segment Revenues

 

$

675,314

 

 

$

124,177

 

 

$

799,491

 

Less:

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

183,064

 

 

 

48,638

 

 

 

231,702

 

Non-GAAP Sales, general, and administrative

 

 

368,817

 

 

 

70,185

 

 

 

439,002

 

Non-GAAP Research and development

 

 

58,262

 

 

 

13,154

 

 

 

71,416

 

Other segment expenses (benefits)

 

 

(22

)

 

 

(54

)

 

 

(76

)

Add:

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

42,193

 

 

 

12,367

 

 

 

54,560

 

Segment Adjusted EBITDA

 

$

107,386

 

 

$

4,621

 

 

$

112,007

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

$

44,591

 

Interest expense, net

 

 

 

 

 

 

 

 

29,631

 

Depreciation and amortization

 

 

 

 

 

 

 

 

60,061

 

Share-based compensation expense

 

 

 

 

 

 

 

 

32,455

 

Foreign exchange impact

 

 

 

 

 

 

 

 

4,395

 

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

14,485

 

Strategic investments

 

 

 

 

 

 

 

 

910

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

19,088

 

Interest and loss on investments

 

 

 

 

 

 

 

 

5,120

 

Litigation and investigation costs

 

 

 

 

 

 

 

 

15,770

 

Succession charges

 

 

 

 

 

 

 

 

9,376

 

Loss before income taxes

 

 

 

 

 

 

 

$

(123,875

)

 

 

 

Year Ended December 31, 2023

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Limb Reconstruction

 

 

Total

 

Segment Revenues

 

$

631,319

 

 

$

115,322

 

 

$

746,641

 

Less:

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

166,885

 

 

 

47,928

 

 

 

214,813

 

Non-GAAP Sales, general, and administrative

 

 

355,827

 

 

 

67,815

 

 

 

423,642

 

Non-GAAP Research and development

 

 

56,512

 

 

 

10,726

 

 

 

67,238

 

Other segment expenses (benefits)

 

 

45

 

 

 

(82

)

 

 

(37

)

Add:

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

39,065

 

 

 

11,507

 

 

 

50,572

 

Segment Adjusted EBITDA

 

$

91,115

 

 

$

442

 

 

$

91,557

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

$

45,272

 

Interest expense, net

 

 

 

 

 

 

 

 

8,631

 

Depreciation and amortization

 

 

 

 

 

 

 

 

53,063

 

Share-based compensation expense

 

 

 

 

 

 

 

 

35,707

 

Foreign exchange impact

 

 

 

 

 

 

 

 

(1,581

)

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

36,577

 

Strategic investments

 

 

 

 

 

 

 

 

2,272

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

33,393

 

Interest and loss on investments

 

 

 

 

 

 

 

 

1,781

 

Litigation and investigation costs

 

 

 

 

 

 

 

 

14,453

 

Succession charges

 

 

 

 

 

 

 

 

1,176

 

Medical device regulation

 

 

 

 

 

 

 

 

9,492

 

Loss before income taxes

 

 

 

 

 

 

 

$

(148,679

)

The following table presents depreciation, amortization, and related impairments by reporting segment:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Global Spine

 

$

66,315

 

 

$

49,507

 

 

$

41,213

 

Global Limb Reconstruction

 

 

8,629

 

 

 

7,748

 

 

 

7,158

 

Corporate

 

 

2,377

 

 

 

2,806

 

 

 

4,692

 

Total

 

$

77,321

 

 

$

60,061

 

 

$

53,063

 

 

Geographical information

The table below presents net sales by geographic destination for each reporting segment and for the consolidated Company:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Global Spine

 

 

 

 

 

 

 

 

 

U.S.

 

$

645,139

 

 

$

639,196

 

 

$

591,937

 

International

 

 

42,516

 

 

 

36,118

 

 

 

39,382

 

Total Global Spine

 

 

687,655

 

 

 

675,314

 

 

 

631,319

 

 

 

 

 

 

 

 

 

 

 

Global Limb Reconstruction

 

 

 

 

 

 

 

 

 

U.S.

 

$

38,927

 

 

$

33,620

 

 

$

28,892

 

International

 

 

95,730

 

 

 

90,557

 

 

 

86,430

 

Total Global Limb Reconstruction

 

 

134,657

 

 

 

124,177

 

 

 

115,322

 

 

 

 

 

 

 

 

 

 

 

Consolidated

 

 

 

 

 

 

 

 

 

U.S.

 

$

684,066

 

 

$

672,816

 

 

$

620,829

 

International

 

 

138,246

 

 

 

126,675

 

 

 

125,812

 

Net sales

 

$

822,312

 

 

$

799,491

 

 

$

746,641

 

The following data includes net sales by geographic destination:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

U.S.

 

$

684,066

 

 

$

672,816

 

 

$

620,829

 

Italy

 

 

22,277

 

 

 

21,001

 

 

 

20,060

 

United Kingdom

 

 

13,334

 

 

 

11,183

 

 

 

10,910

 

France

 

 

11,959

 

 

 

13,385

 

 

 

11,096

 

Germany

 

 

9,107

 

 

 

9,004

 

 

 

11,467

 

Brazil

 

 

4,836

 

 

 

5,707

 

 

 

6,452

 

Others

 

 

76,733

 

 

 

66,395

 

 

 

65,827

 

Net sales

 

$

822,312

 

 

$

799,491

 

 

$

746,641

 

The following data includes property, plant, and equipment, net by geographic area:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

U.S.

 

$

114,483

 

 

$

125,541

 

Italy

 

 

9,893

 

 

 

9,472

 

Germany

 

 

1,360

 

 

 

1,904

 

Others

 

 

3,663

 

 

 

2,887

 

Total

 

$

129,399

 

 

$

139,804

 
v3.25.4
Acquisition-Related Amortization, Impairment and Remeasurement
 12 Months Ended
Dec. 31, 2025
Acquisition Related Amortization And Remeasurement [Abstract]  
Acquisition-Related Amortization, Impairment and Remeasurement

17. Acquisition-related amortization, impairment, and remeasurement

Acquisition-related amortization, impairment, and remeasurement consists of (i) the remeasurement of any related contingent consideration arrangement, (ii) amortization related to intangible assets acquired through business combinations or asset acquisitions, and (iii) recognized costs associated with acquired IPR&D assets, which are recognized immediately upon acquisition.

Components of acquisition-related amortization, impairment, and remeasurement for the years ended December 31, 2025, 2024, and 2023, respectively, are as follows:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Changes in fair value of contingent consideration

 

$

(1,140

)

 

$

6,900

 

 

$

(2,700

)

Amortization and impairments of acquired intangibles

 

 

28,409

 

 

 

17,436

 

 

 

17,408

 

Acquired IPR&D

 

 

—

 

 

 

—

 

 

 

49

 

Total

 

$

27,269

 

 

$

24,336

 

 

$

14,757

 

Lattus Contingent Consideration

Under the terms of a contingent consideration obligation in a purchase agreement assumed in the Merger, the Company may be required to make installment payments at certain dates based on future net sales of the Lateral Products. The Company made a payment of $6.3 million under this arrangement during the year ended December 31, 2025. The estimated fair value of the remaining contingent consideration arrangement as of December 31, 2025, was $7.9 million; however, the actual amount ultimately paid could be higher or lower than the estimated fair value of the contingent consideration. As of December 31, 2025, approximately $4.3 million of the remaining contingent consideration liability was classified within other current liabilities and $3.6 million was classified within other long-term liabilities. See Note 12 for further discussion of this arrangement.

IGEA S.p.A Asset Acquisition

In 2021, the Company entered into an Exclusive License and Distribution Agreement (the "License Agreement") with IGEA S.p.A ("IGEA"), an Italian manufacturer and distributor of bone and cartilage stimulation systems. As consideration for the License Agreement, the Company agreed to pay up to $4.0 million, with certain payments contingent upon reaching an FDA milestone. Of this amount, $0.5 million was paid in 2021, which was recognized as acquired IPR&D costs within acquisition-related amortization, impairment, and remeasurement. The Company accounted for this transaction as an asset acquisition. As the transaction was classified as an asset acquisition, the value of the consideration associated with the contingent milestones were recognized at the time that applicable contingencies were resolved and consideration was paid or became payable. The License Agreement also includes certain minimum purchase requirements.

In 2022, the Company achieved FDA approval pertaining to the acquired technology, triggering a contingent consideration milestone obligation of $3.5 million. Of this amount, $1.5 million was paid in 2022, $1.0 million was paid in 2023, and $1.0 million was paid in 2024.
v3.25.4
Share-based compensation
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Share-based compensation

18. Share-based compensation

At December 31, 2025, and 2024, the Company had stock option, award, and stock purchase plans.

Merger with SeaSpine

Pursuant to the Merger Agreement, the equity awards of SeaSpine (including stock options and restricted stock units) outstanding as of immediately prior to the closing of the Merger were converted into equity awards denominated in shares of Orthofix common stock. The Company issued options to purchase 1.9 million shares of Orthofix common stock and 0.5 million shares of time-based vesting restricted stock in connection with the conversion of such awards. The estimated fair value of the portion of the SeaSpine equity awards for which the required service period had been completed at the time of the closing of the Merger was treated as purchase consideration. The remaining estimated fair value is recorded as compensation expense over the remainder of the service period associated with the awards.

In addition, as part of the Merger, the Board determined to treat the transaction as a "Change in Control" under applicable agreements and equity plans. Thus, in January 2023, all outstanding and previously granted performance-based and market-based restricted stock units became time-based restricted stock units with the performance goals deemed achieved at the target level of 100%.

2012 Long Term Incentive Plan

The Board adopted the Amended and Restated 2012 Long-Term Incentive Plan (the "2012 LTIP") on April 23, 2018, which was subsequently approved by shareholder ratification. The 2012 LTIP provides for the grant of options to purchase shares of the Company’s common stock, stock awards (including restricted stock, unrestricted stock, and stock units), stock appreciation rights, performance-based awards, and other equity-based awards. All of the Company’s employees and the employees of the Company’s subsidiaries and affiliates are eligible and may receive awards under the 2012 LTIP. In addition, the Company’s non-employee

directors, consultants, and advisors who perform services for the Company and its subsidiaries and affiliates may receive awards under the 2012 LTIP. Awards granted under the 2012 LTIP expire no later than ten years after the date of grant. At December 31, 2025, the Company reserves a total of 16.3 million shares of common stock for issuance pursuant to the 2012 LTIP, subject to certain adjustments set forth in the 2012 LTIP. At December 31, 2025, there were 2.4 million options outstanding under the 2012 LTIP, of which 1.4 million were exercisable. In addition, there were 2.2 million restricted stock units outstanding, some of which contain performance-based vesting conditions, under the 2012 LTIP as of December 31, 2025.

SeaSpine 2015 Plan

Pursuant to the Merger Agreement, the Company assumed awards outstanding under the SeaSpine Holdings Corporation Amended and Restated 2015 Incentive Award Plan Award Plan (the "SeaSpine 2015 Plan"). The SeaSpine 2015 Plan provides for the grant of options to purchase shares of the Company’s common stock, stock awards (including restricted stock, unrestricted stock, and stock units), stock appreciation rights, performance-based awards and other equity-based awards. All of the Company’s employees and the employees of the Company’s subsidiaries and affiliates are eligible and may receive awards under the SeaSpine 2015 Plan. In addition, the Company’s non-employee directors, consultants, and advisors who perform services for the Company and its subsidiaries and affiliates may receive awards under the SeaSpine 2015 Plan. At December 31, 2025, the Company reserves a total of 3.0 million shares of common stock for issuance pursuant to the SeaSpine 2015 Plan, subject to certain adjustments set forth in the SeaSpine 2015 Plan. At December 31, 2025, there were 0.7 million options outstanding under the SeaSpine 2015 Plan, of which 0.4 million were exercisable. In addition, there were 0.5 million restricted stock units outstanding, some of which contain performance-based vesting conditions, under the SeaSpine 2015 Plan as of December 31, 2025.

Inducement Plans

As an inducement to accept employment, the Company has periodically granted inducement awards to new employees and has also assumed inducement awards that were granted by SeaSpine prior to the Merger. During 2025, there were no inducement awards granted. Under all inducement plans, as of December 31, 2025, there were 1.5 million options outstanding, of which 0.6 million were exercisable, and 1.0 million unvested restricted stock units outstanding, some of which contain performance-based vesting conditions.

Stock Purchase Plan

The Second Amended and Restated Stock Purchase Plan, as Amended (the "Stock Purchase Plan") provides for the issuance of shares of the Company’s common stock to eligible employees and directors of the Company and its subsidiaries that elect to participate in the plan and acquire shares of common stock through payroll deductions (including executive officers).

During each purchase period, eligible employees may designate between 1% and 25% of their compensation to be deducted for the purchase of common stock under the plan (or such other percentage in order to comply with regulations applicable to employees domiciled in or resident of a member state of the European Union). For eligible directors, the designated percentage will be applied to an amount equal to his or her director compensation paid in cash for the current plan period. The purchase price of the shares under the plan is equal to 85% of the fair market value on the first day of the plan period or, if lower, on the last day of the plan period.

Due to the compensatory nature of such plan, the Company records the related share-based compensation expense in the consolidated statement of operations. Compensation expense is estimated using the Black-Scholes valuation model, with such value recognized as expense over the plan period. As of December 31, 2025, the aggregate number of shares reserved for issuance under the Stock Purchase Plan is 4.9 million. As of December 31, 2025, a total of 3.8 million shares had been issued pursuant to the Stock Purchase Plan.

Share-Based Compensation Expense

Share-based compensation expense is recorded in the same line of the consolidated statements of operations as the employee’s cash compensation. The following tables present the detail of share-based compensation expense by line item in the consolidated statements of income as well as by award type, for the years ended December 31, 2025, 2024, and 2023:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Cost of sales

 

$

1,695

 

 

$

2,053

 

 

$

1,901

 

Sales, general, and administrative

 

 

25,418

 

 

 

27,123

 

 

 

29,917

 

Research and development

 

 

1,575

 

 

 

3,279

 

 

 

3,889

 

Total

 

$

28,688

 

 

$

32,455

 

 

$

35,707

 

 

 

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Stock options

 

$

5,245

 

 

$

4,331

 

 

$

6,130

 

Market-based stock options

 

 

2,003

 

 

 

2,118

 

 

 

—

 

Time-based restricted stock awards and stock units

 

 

13,270

 

 

 

18,818

 

 

 

27,290

 

Performance-based / Market-based restricted stock units

 

 

6,353

 

 

 

4,941

 

 

 

227

 

Stock purchase plan

 

 

1,817

 

 

 

2,247

 

 

 

2,060

 

Total

 

$

28,688

 

 

$

32,455

 

 

$

35,707

 

The income tax benefit related to this expense was $5.5 million, $5.8 million, and $5.8 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Stock Options

The fair value of time-based stock options is determined using the Black-Scholes valuation model, with such value recognized as expense over the service period, which is typically three to four years, net of actual forfeitures. A summary of the Company’s assumptions used in determining the fair value of the stock options granted during each of the years ended December 31, 2025, 2024, and 2023, is shown in the following table.

 

 

Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Assumptions:

 

 

 

 

 

 

 

 

 

Expected term (in years)

 

 

4.6

 

 

 

4.5

 

 

 

6.0

 

Expected volatility

 

44.0% – 45.2%

 

 

45.7% – 47.6%

 

 

36.8% – 42.3%

 

Risk free interest rate

 

3.98% – 4.58%

 

 

3.47% – 4.65%

 

 

3.38% – 4.61%

 

Dividend yield

 

 

—

 

 

 

—

 

 

 

—

 

Weighted average grant date fair value

 

$

7.22

 

 

$

5.90

 

 

$

8.43

 

The expected term of the options granted is estimated based on a number of factors, including the vesting and expiration terms of the award, historical employee exercise behavior for both options that are currently outstanding and options that have been exercised or are expired, and an employee’s average length of service. Expected volatility is based on the historical volatility of the Company’s common stock. The risk-free interest rate is determined based upon a constant U.S. Treasury security rate with a contractual life that approximates the expected term of the option.

Certain of the Company's outstanding stock options contain market-based vesting conditions. The fair value of market-based stock options is determined at the date of the grant using the Monte Carlo valuation methodology. The Monte Carlo methodology incorporates into the valuation the possibility that the market condition may not be satisfied. Such value is recognized over the three-year service period, net of actual forfeitures.

A summary of the status of the Company’s time-based stock option plans as of December 31, 2025, and 2024, and changes during the year ended December 31, 2025, is presented below:

(In thousands)

 

Options

 

 

Weighted
Average
Exercise
Price

 

 

Weighted
Average
Remaining
Contractual
Term (Years)

 

Outstanding at December 31, 2024

 

 

3,197

 

 

$

26.15

 

 

 

 

Granted

 

 

1,010

 

 

 

17.00

 

 

 

 

Exercised

 

 

(31

)

 

 

13.23

 

 

 

 

Forfeited or expired

 

 

(405

)

 

 

31.34

 

 

 

 

Outstanding at December 31, 2025

 

 

3,771

 

 

 

23.25

 

 

 

4.6

 

Vested and expected to vest at December 31, 2025

 

 

3,771

 

 

 

23.25

 

 

 

4.5

 

Exercisable at December 31, 2025

 

 

2,280

 

 

 

27.96

 

 

 

3.4

 

 

 

A summary of the status of the Company’s market-based stock option plans as of December 31, 2025, and 2024, and changes during the year ended December 31, 2025, is presented below:

(In thousands)

 

Options

 

 

Weighted
Average
Exercise
Price

 

 

Weighted
Average
Remaining
Contractual
Term (Years)

 

Outstanding at December 31, 2024

 

 

754

 

 

$

13.39

 

 

 

 

Granted

 

 

—

 

 

 

—

 

 

 

 

Exercised

 

 

—

 

 

 

—

 

 

 

 

Forfeited or expired

 

 

—

 

 

 

—

 

 

 

 

Outstanding at December 31, 2025

 

 

754

 

 

 

13.39

 

 

 

5.2

 

Vested and expected to vest at December 31, 2025

 

 

754

 

 

 

13.39

 

 

 

5.2

 

Exercisable at December 31, 2025

 

 

34

 

 

 

12.57

 

 

 

5.5

 

As of December 31, 2025, the unamortized compensation expense relating to options granted and expected to be recognized was $5.3 million. This amount is expected to be recognized through March 2029 over a weighted average period of approximately 1.0 years. The total intrinsic value of options exercised for each of the years ended December 31, 2025, 2024, and 2023 was less than $0.1 million, respectively. For the year ended December 31, 2025, the Company received $0.4 million cash from stock option exercises, and realized less than $0.1 million in tax benefit for the tax deductions from stock option exercises. The aggregate intrinsic value of options outstanding and options exercisable as of December 31, 2025, is calculated as the difference between the exercise price of the underlying options and the market price of the Company’s common stock for options that had exercise prices lower than $15.16, the closing price of the Company’s stock on December 31, 2025. The aggregate intrinsic value of options outstanding was $3.0 million as of December 31, 2025. The aggregate intrinsic value of options exercisable was $0.9 million as of that date.

Time-based Restricted Stock Awards and Stock Units

Compensation expense for time-based restricted stock awards and stock units, which represents the fair value of the stock measured at the market price at the date of grant, is recognized on a straight-line basis over the vesting period, which is typically three to four years, net of actual forfeitures.

The aggregate fair value of time-based restricted stock awards and stock units that vested during the years ended December 31, 2025, 2024, and 2023, was $12.4 million, $13.3 million, and $17.2 million, respectively. Unamortized compensation expense related to time-based restricted stock awards and stock units amounted to $15.3 million at December 31, 2025. This amount is expected to be recognized through December 2028 over a weighted average period of approximately 1.5 years. The aggregate intrinsic value of time-based restricted stock awards and stock units outstanding was $30.1 million as of December 31, 2025.

Performance-based and Market-based Restricted Stock Units

Certain of the Company's outstanding restricted stock units contain performance-based vested conditions or market-based vesting conditions. As previously discussed, in January 2023 all then outstanding performance-based and market-based restricted stock units became time-based restricted stock units with the performance goals deemed achieved at the target level of 100% upon completion of the Merger based on the Board of Directors' determination to treat the transaction as a "Change in Control" under applicable agreements and equity plans.

The fair value of performance-based restricted stock units is calculated based upon the closing stock price at the date of grant. Such value is recognized as expense over the requisite service period beginning in the period in which they are deemed probable to vest, net of actual forfeitures. Vesting probability is assessed based upon forecasted financial metrics or applicable milestones associated with the applicable grant.

The fair value of market-based restricted stock units is determined at the date of the grant using the Monte Carlo valuation methodology, with any discounts for post-vesting restrictions estimated using the Chaffe Model. The Monte Carlo methodology incorporates into the valuation the possibility that the market condition may not be satisfied. Such value is recognized on a straight-line basis over the vesting period, net of actual forfeitures.

The fair value of performance-based and/or market-based restricted stock units that vested and settled during each of the years ended December 31, 2025, 2024, and 2023, totaled less than $0.1 million, respectively. Unamortized compensation expense for performance-based and/or market-based restricted stock units totaled $16.3 million at December 31, 2025, and is expected to be recognized over a weighted average period of approximately 1.5 years. The aggregate intrinsic value of performance-based restricted stock units outstanding was $25.0 million as of December 31, 2025.

A summary of the status of our time-based and performance-based and/or market-based restricted stock units as of December 31, 2025, and 2024, and changes during the year ended December 31, 2025, is presented below:

 

 

 

Time-based Restricted Stock
Awards and Stock Units

 

 

Performance-based and/or Market-based
Restricted Stock Units

 

(In thousands)

 

Shares

 

 

Weighted
Average Grant
Date Fair Value

 

 

Shares

 

 

Weighted
Average Grant
Date Fair Value

 

Outstanding at December 31, 2024

 

 

2,015

 

 

$

18.73

 

 

 

960

 

 

$

16.81

 

Granted

 

 

993

 

 

 

15.58

 

 

 

723

 

 

 

16.98

 

Vested and settled

 

 

(872

)

 

 

21.97

 

 

 

(1

)

 

 

44.00

 

Cancelled

 

 

(153

)

 

 

17.38

 

 

 

(35

)

 

 

17.28

 

Outstanding at December 31, 2025

 

 

1,983

 

 

 

15.83

 

 

 

1,647

 

 

 

16.85

 
v3.25.4
Defined Contribution Plans and deferred compensation
 12 Months Ended
Dec. 31, 2025
Retirement Benefits [Abstract]  
Defined contribution plans and deferred compensation

19. Defined contribution plans and deferred compensation

Defined Contribution Plans

Orthofix sponsors a defined contribution plan (the "401(k) Plan") covering substantially all full-time U.S. employees. The 401(k) Plan allows participants to contribute up to 90% of their pre-tax compensation, subject to certain limitations, with the Company matching 100% of the first 4% of the employee's base compensation. During the years ended December 31, 2025, 2024, and 2023, the Company incurred expenses relating to the 401(k) Plan, including matching contributions, of approximately $6.8 million, $5.9 million, and $4.6 million, respectively.

The Company also operates defined contribution plans for its international employees meeting minimum service requirements. The Company’s expenses for such contributions during each of the years ended December 31, 2025, 2024, and 2023, were $2.0 million, $1.2 million, and $1.1 million, respectively.

Deferred Compensation Plans

Under Italian Law, our Italian subsidiary accrues deferred compensation on behalf of its employees, which is paid on termination of employment. The accrual for deferred compensation is based on a percentage of the employee’s current annual remuneration plus an annual charge. Deferred compensation is also accrued for the leaving indemnity payable to agents in case of dismissal, which is regulated by a national contract and is equal to approximately 4% of total commissions earned from the Company. The Company’s relations with its Italian employees, who represent 15% of total employees at December 31, 2025, are governed by the provisions of a National Collective Labor Agreement setting forth mandatory minimum standards for labor relations in the metal mechanic workers industry. The Company is not a party to any other collective bargaining agreement. The liability is recorded within other long-term liabilities as of December 31, 2025, and 2024, and totaled $1.7 million and $1.7 million, respectively. This represents the amount that would be payable if all the employees and agents had terminated employment at that date.
v3.25.4
Income taxes
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Income taxes

20. Income taxes

Income (loss) before provision for income taxes consisted of the following:

 

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

U.S.

 

$

(93,273

)

 

$

(113,197

)

 

$

(154,794

)

Non-U.S.

 

 

2,463

 

 

 

(10,678

)

 

 

6,115

 

Loss before income taxes

 

$

(90,810

)

 

$

(123,875

)

 

$

(148,679

)

 

 

The provision for income taxes consists of the following:

 

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Current tax expense (benefit)

 

 

 

 

 

 

 

 

 

Federal

 

$

298

 

 

$

(815

)

 

$

(79

)

State & local

 

 

236

 

 

 

225

 

 

 

96

 

Foreign

 

 

625

 

 

 

829

 

 

 

2,120

 

Total current expense

 

 

1,159

 

 

 

239

 

 

 

2,137

 

 

 

 

 

 

 

 

 

 

 

Deferred tax expense (benefit)

 

 

 

 

 

 

 

 

 

Federal

 

 

639

 

 

 

1,355

 

 

 

1,008

 

State & local

 

 

134

 

 

 

217

 

 

 

152

 

Foreign

 

 

(550

)

 

 

311

 

 

 

(581

)

Total deferred expense

 

 

223

 

 

 

1,883

 

 

 

579

 

Income tax expense

 

$

1,382

 

 

$

2,122

 

 

$

2,716

 

 

The differences between the income tax provision at the U.S. federal statutory tax rate and the Company’s effective tax rate for the years ended December 31, 2025, 2024, and 2023, consist of the following:

 

 

 

2025

 

 

2024

 

 

2023

 

(U.S. Dollars, in thousands, except percentages)

 

Amount

 

 

Percent

 

 

Amount

 

 

Percent

 

 

Amount

 

 

Percent

 

U.S. federal statutory rate

 

$

(19,070

)

 

 

21.0

%

 

$

(26,013

)

 

 

21.0

%

 

$

(31,222

)

 

 

21.0

%

State taxes, net of U.S. federal benefit

 

 

300

 

 

 

(0.3

)

 

 

352

 

 

 

(0.3

)

 

 

210

 

 

 

(0.1

)

Foreign tax effects

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Canada

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Valuation allowance

 

 

933

 

 

 

(1.0

)

 

 

2,282

 

 

 

(1.8

)

 

 

1,877

 

 

 

(1.3

)

Other

 

 

(505

)

 

 

0.6

 

 

 

(754

)

 

 

0.6

 

 

 

(659

)

 

 

0.4

 

Other foreign jurisdictions

 

 

(421

)

 

 

0.5

 

 

 

992

 

 

 

(0.8

)

 

 

108

 

 

 

(0.1

)

Effect of changes in tax laws or rates enacted in the current period

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Effects of cross-border tax laws

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GILTI inclusion, net

 

 

786

 

 

 

(0.9

)

 

 

323

 

 

 

(0.3

)

 

 

2,333

 

 

 

(1.6

)

Income from branches

 

 

(702

)

 

 

0.8

 

 

 

(1,525

)

 

 

1.2

 

 

 

(1,078

)

 

 

0.7

 

Tax credits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R&D credit

 

 

64

 

 

 

(0.1

)

 

 

(1,159

)

 

 

0.9

 

 

 

(1,268

)

 

 

0.9

 

Changes in valuation allowance

 

 

14,452

 

 

 

(15.9

)

 

 

23,478

 

 

 

(19.0

)

 

 

21,675

 

 

 

(14.6

)

Nontaxable or nondeductible items

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Merger related deal costs

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

2,547

 

 

 

(1.7

)

Equity compensation

 

 

1,629

 

 

 

(1.8

)

 

 

2,781

 

 

 

(2.2

)

 

 

4,210

 

 

 

(2.8

)

Executive compensation

 

 

3,470

 

 

 

(3.8

)

 

 

2,001

 

 

 

(1.6

)

 

 

3,030

 

 

 

(2.0

)

Other

 

 

417

 

 

 

(0.6

)

 

 

757

 

 

 

(0.5

)

 

 

882

 

 

 

(0.6

)

Changes in unrecognized tax benefits

 

 

29

 

 

 

—

 

 

 

(1,393

)

 

 

1.1

 

 

 

71

 

 

 

—

 

Income tax expense/effective rate

 

$

1,382

 

 

 

(1.5

)%

 

$

2,122

 

 

 

(1.7

)%

 

$

2,716

 

 

 

(1.8

)%

 

State taxes in California and Texas made up the majority (greater than 50%) of the tax effect in this category in 2025 and 2024. State taxes in Texas made up the majority (greater than 50%) of the tax effect in this category in 2023.

The Company’s deferred tax assets and liabilities are as follows:

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Intangible assets and goodwill

 

$

1,331

 

 

$

—

 

Inventories and related reserves

 

 

34,168

 

 

 

34,745

 

Deferred revenue and cost of goods sold

 

 

5,978

 

 

 

5,775

 

Other accruals and reserves

 

 

6,744

 

 

 

5,738

 

Accrued compensation

 

 

15,815

 

 

 

17,216

 

Provision for expected credit losses

 

 

1,897

 

 

 

1,797

 

Accrued interest

 

 

7,864

 

 

 

6,336

 

Net operating loss and tax credit carryforwards

 

 

152,068

 

 

 

132,524

 

Research and development capitalization

 

 

11,127

 

 

 

18,016

 

Lease liabilities

 

 

11,202

 

 

 

8,856

 

Other, net

 

 

6,435

 

 

 

8,456

 

Total deferred tax assets

 

 

254,629

 

 

 

239,459

 

Valuation allowance

 

 

(247,738

)

 

 

(228,724

)

Deferred tax asset, net of valuation allowance

 

$

6,891

 

 

$

10,735

 

Intangible assets and goodwill

 

$

—

 

 

$

(3,557

)

Withholding taxes

 

 

(10

)

 

 

(10

)

Property, plant, and equipment

 

 

(1,359

)

 

 

(3,390

)

Right-of-use lease assets

 

 

(9,729

)

 

 

(7,875

)

Deferred tax liability

 

$

(11,098

)

 

$

(14,832

)

Net deferred tax liabilities

 

$

(4,207

)

 

$

(4,097

)

 

 

 

 

 

 

 

Reported as:

 

 

 

 

 

 

Deferred income tax assets (classified within other long-term assets)

 

$

1,876

 

 

$

1,542

 

Deferred income tax liabilities (classified within other long-term liabilities)

 

 

(6,083

)

 

 

(5,639

)

Net deferred tax liabilities

 

$

(4,207

)

 

$

(4,097

)

The Company historically presented deferred income tax assets as a separate and discrete line item on its consolidated balance sheet; however, as the significance of the asset has decreased as a result of the recognition of valuation allowances, the Company has reclassified this balance to be included within other long-term assets. Deferred income tax liabilities are included in Other Long Term Liabilities.

The Company accounts for income taxes using the asset and liability method, under which deferred tax assets and liabilities are recognized for the expected future tax consequences of temporary differences between the financial reporting and income tax basis of assets and liabilities, and for operating losses and credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates in effect for the years in which those items are expected to be realized. Tax law and rate changes are recorded in the period such changes are enacted. The Company establishes a valuation allowance when it is more likely than not that certain deferred tax assets will not be realized in the foreseeable future. We recognize the tax impact of including certain foreign earnings in US taxable income as a period cost.

The valuation allowance is primarily attributable to net operating loss carryforwards and temporary differences in domestic and certain foreign jurisdictions. The net increase in the valuation allowance of $19.0 million during the year principally relates to recognizing a full valuation allowance against the net deferred tax asset within the Company’s U.S. and Italy operations. The Company considered many factors when assessing the likelihood of future realization of these deferred tax assets, including recent cumulative losses experienced by the subsidiary, expectations of future taxable income or loss, the carryforward periods available to the Company for tax reporting purposes, and other relevant factors. That increase was partially offset by a decrease of valuation allowances on net operating loss carryforwards in other foreign jurisdictions due to expiration, statutory rate changes, and changes

regarding the realizability of net deferred tax assets. It is reasonably possible that the valuation allowance will increase in 2026 due to further losses in certain jurisdictions, offset by decreases related to the expiration of foreign net operating losses.

The Company has federal net operating loss carryforwards of $428.0 million and federal research and development credits of $5.8 million. These federal carryforwards are subject to limitation under the provisions of Internal Revenue Code Section 382 and will continue to expire in 2026. The Company has state net operating loss carryforwards of approximately $292.3 million, principally related to California, Illinois, and Michigan. These carryforwards are subject to limitation under various provisions implemented by each specific state jurisdiction. Additionally, the Company has net operating loss carryforwards in various foreign jurisdictions of approximately $141.3 million, which mainly relate to the Company’s Netherlands, Brazil, Italy, and Canada operations. The majority of the foreign net operating losses do not expire. The Company also has research and development credits in Canada of $1.6 million which begin to expire in 2041.

The Company’s investment in foreign subsidiaries continues to be indefinite in nature; however, the Company may periodically repatriate a portion of these earnings to the extent that it does not incur significant additional tax liability. Quantification of the deferred tax liability, if any, associated with indefinitely reinvested earnings of foreign subsidiaries is not practicable.

The Company records a benefit for uncertain tax positions when the weight of available evidence indicates that it is more likely than not, based on an evaluation of the technical merits, that the tax position will be sustained on audit. The tax benefit is measured as the largest amount that is more than 50% likely to be realized upon settlement. The Company re-evaluates income tax positions periodically to consider changes in facts or circumstances such as changes in or interpretations of tax law, effectively settled issues under audit, and new audit activity. The Company includes interest and any applicable penalties related to income tax issues as part of income tax expense in its consolidated financial statements.

The Company’s unrecognized tax benefit was $1.7 million for both of the years ended December 31, 2025, and 2024, respectively. The Company recorded net interest and penalties expense (benefit) on unrecognized tax benefits of ($0.1) million, $0.2 million, and $0.2 million for the years ended December 31, 2025, 2024, and 2023, respectively, and had approximately $1.0 million and $1.0 million accrued for payment of interest and penalties as of December 31, 2025, and 2024, respectively. The entire amount of unrecognized tax benefits, including interest, would favorably impact the Company's effective tax rate if recognized.

A reconciliation of the gross unrecognized tax benefits (excluding interest and penalties) for the years ended December 31, 2025, and 2024, is shown below:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Balance as of January 1,

 

$

1,723

 

 

$

2,974

 

Additions for current year tax positions

 

 

18

 

 

 

40

 

Increases (decreases) for prior year tax positions

 

 

(23

)

 

 

42

 

Settlements of prior year tax positions

 

 

—

 

 

 

—

 

Expiration of statutes

 

 

(53

)

 

 

(1,333

)

Balance as of December 31,

 

$

1,665

 

 

$

1,723

 

The Company and its subsidiaries file income tax returns in the U.S. federal jurisdiction and in certain state and foreign jurisdictions, including Italy, as well as other jurisdictions where the Company maintains operations. The statute of limitations with respect to federal and state tax filings is closed for years prior to 2022. The statute of limitations with respect to the major foreign tax filing jurisdictions is closed for years prior to 2021. The Company cannot reasonably determine if any state and local or foreign examinations will have a material impact on its financial statements and cannot predict the timing regarding the resolution of these tax examinations.

The Company paid (received or was refunded) cash relating to income taxes totaling $1.6 million, $1.3 million, and $0.9 million for the years ended December 31, 2025, 2024, and 2023, respectively as follows:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

U.S. federal

 

$

2

 

 

$

(154

)

 

$

(640

)

State

 

 

 

 

 

 

 

 

 

California

 

*

 

 

 

(90

)

 

*

 

Massachusetts

 

*

 

 

*

 

 

 

49

 

Texas

 

 

131

 

 

 

85

 

 

 

119

 

All others

 

 

297

 

 

 

197

 

 

 

316

 

Total State

 

 

428

 

 

 

192

 

 

 

484

 

Foreign

 

 

 

 

 

 

 

 

 

Australia

 

 

186

 

 

 

141

 

 

*

 

Brazil

 

*

 

 

 

82

 

 

 

93

 

France

 

 

330

 

 

 

433

 

 

 

521

 

Germany

 

 

171

 

 

*

 

 

 

(164

)

Italy

 

*

 

 

 

85

 

 

 

431

 

Netherlands

 

 

185

 

 

 

236

 

 

 

249

 

Switzerland

 

 

132

 

 

 

102

 

 

*

 

United Kingdom

 

 

101

 

 

 

128

 

 

 

(82

)

All others

 

 

48

 

 

 

56

 

 

 

(12

)

Total Foreign

 

 

1,153

 

 

 

1,263

 

 

 

1,036

 

Total

 

$

1,583

 

 

$

1,301

 

 

$

880

 

* The amount of income taxes paid during the year does not meet the 5% disaggregation threshold.

On July 4, 2025, the One Big Beautiful Bill Act (“OBBBA”) was signed into law, which includes a broad range of tax reform provisions affecting businesses. The OBBBA includes numerous changes to existing tax law including extending or making permanent certain business and international tax measures initially established under the 2017 Tax Cuts and Jobs Act, which were set to expire. Additionally, the OBBBA permanently eliminates the requirement to capitalize and amortize U.S. based research and experimental expenditures over five years, making these expenditures fully deductible in the period incurred. In addition, the OBBBA returns the interest limitation rules under Internal Revenue Code (IRC) Section 163(j) to a tax basis EBITDA calculation as opposed to earnings before interest and taxes (EBIT). The Company has reflected the impact of these provisions in the 2025 income tax provision.
v3.25.4
Earnings per share (EPS)
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
Earnings per share (EPS)

21. Earnings per share (EPS)

The Company uses the treasury stock method of computing basic and diluted EPS. Basic EPS is computed using the weighted average number of common shares outstanding during each of the respective years. Diluted EPS is computed using the weighted average number of common and common equivalent shares outstanding during each of the respective years using the treasury stock method. The difference between basic and diluted shares, if any, largely results from common equivalent shares, which represents the dilutive effect of the assumed exercise of certain outstanding share options, the assumed vesting of restricted stock granted to employees and directors, or the satisfaction of certain necessary conditions for contingently issuable shares (see Note 18).

For each of the three years ended December 31, 2025, 2024, and 2023, no adjustments were made to net income for purposes of calculating basic and diluted EPS. The following is a reconciliation of the weighted average shares used in the diluted EPS computations:

 

 

Year Ended December 31,

 

(In thousands)

 

2025

 

 

2024

 

 

2023

 

Weighted average common shares-basic

 

 

39,602

 

 

 

38,134

 

 

 

36,729

 

Effect of diluted securities:

 

 

 

 

 

 

 

 

 

Unexercised stock options and employee stock purchase plan

 

 

—

 

 

 

—

 

 

 

—

 

Unvested time-based restricted stock units

 

 

—

 

 

 

—

 

 

 

—

 

Weighted average common shares-diluted

 

 

39,602

 

 

 

38,134

 

 

 

36,729

 

 

There were 8.7 million, 7.2 million, and 6.5 million weighted average outstanding options, time-based restricted stock awards and stock units, performance-based stock units, and market-based stock units not included in the diluted earnings per share computation for the years ended December 31, 2025, 2024, and 2023, respectively, because inclusion of these awards was anti-dilutive or, for performance-based stock units and market-based stock units, all necessary conditions had not been satisfied by the end of the respective period.

v3.25.4
Subsequent events
 12 Months Ended
Dec. 31, 2025
Subsequent Events [Abstract]  
Subsequent events

22. Subsequent events

Renewal of Corporate Headquarters Lease

On January 15, 2026, the Company executed the Sixth Amendment amending the lease agreement for its corporate headquarters in Lewisville, Texas. The Sixth Amendment, among other things, extends the lease term of the lease through October 2040. Refer to Note 9 for additional discussion and information on the Company’s lease obligations.

Subsequent Borrowings under the Credit Agreement

Additionally on January 15, 2026, the Company borrowed $65.0 million via the Term B Loan of its Credit Agreement with Oxford for working capital purposes. Refer to Note 11 for additional discussion regarding the Company’s Credit Agreement and information on the Company’s outstanding indebtedness.

Arbitration claims with former executives

On January 26, 2026, the arbitrator overseeing the claim from former CEO Keith Valentine issued a decision denying Mr. Valentine’s claims of defamation, false light invasion of privacy and deceit, and his indemnification of fees claim, and issued an interim award to Mr. Valentine. Refer to Note 13 for additional information regarding the arbitration claims with the Company’s former executives.
v3.25.4
Significant accounting policies (Policies)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Market risk

Market risk

In the ordinary course of business, the Company is exposed to the impact of changes in interest rates and foreign currency fluctuations. The Company’s objective is to limit the impact of such movements on earnings and cash flows. In order to achieve this objective, the Company seeks to balance its non-U.S. Dollar denominated income and expenditures.

The financial statements for operations outside the U.S. are generally maintained in each subsidiary's respective local currency. All foreign currency denominated balance sheet accounts, except shareholders’ equity, are translated to U.S. Dollars at year end exchange rates, and revenue and expense items are translated at average exchange rates prevailing during the year. Gains and losses resulting from the translation of foreign currency are recorded in the accumulated other comprehensive income (loss) component of shareholders’ equity. Transactional foreign currency gains and losses, including those generated from intercompany operations, are included in other income (expense), net. The Company recorded a gain of $2.9 million, a loss of $4.4 million, and a gain of $1.6 million for the years ended December 31, 2025, 2024, and 2023, respectively, related to these transaction foreign currency gains and losses recorded in other income (expense), net.

Financial instruments and concentration of credit risk

Financial instruments and concentration of credit risk

Financial instruments that could subject the Company to a concentration of credit risk consist primarily of cash, cash equivalents, and accounts receivable. Generally, cash is held at large financial institutions. The Company performs ongoing credit evaluations of customers, generally does not require collateral, and maintains a reserve for expected credit losses. The Company believes that a concentration of credit risk related to accounts receivable is limited because customers are geographically dispersed and end users are diversified.
Cash, cash equivalents and restricted cash

Cash, cash equivalents, and restricted cash

The Company considers all highly liquid investments with an original maturity of three months or less to be cash equivalents.

In November 2023, following the termination of the Second Amended and Restated Credit Agreement with JPMorgan Chase Bank, N.A., as Administrative Agent, and certain lender parties thereto, Bank of America required collateral of approximately $4.7 million of the Company’s cash as a banking service obligation, which was classified as restricted cash as of December 31, 2023. In March 2024, the Company entered into a Security Agreement with Bank of America to reduce the required collateral to $2.5 million.

In April 2025, following the execution of the lease agreement between Armada Drive Carlsbad LLC and the Company, the Company was required to establish a letter of credit of $0.6 million. The Company opened a letter of credit with Hongkong and Shanghai Banking Corporation ("HSBC"), which was classified as restricted cash as of December 31, 2025.

Investing activities that did not result in cash receipts or cash payments during the years ended December 31, 2025, 2024, and 2023 consisted of the following, which were not included within cash used in investing activities in the Company’s consolidated statements of cash flows:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Supplemental disclosure of cash flow information:

 

 

 

 

 

 

 

 

 

Noncash investing activities:

 

 

 

 

 

 

 

 

 

Changes in accrued capital expenditures

 

$

5,278

 

 

$

(3,040

)

 

$

—

 

Intangible assets acquired in asset acquisitions

 

 

40

 

 

 

—

 

 

 

—

 
Research and development costs, including collaborative arrangements

Research and development costs, including collaborative arrangements

Expenditures for research and development are expensed as incurred. Expenditures related to the Company’s collaborative arrangement with MTF Biologics ("MTF") are expensed based on the terms of the related agreement. The Company recognized $0.3 million, $0.3 million, and $0.8 million in research and development expense for the years ended December 31, 2025, 2024, and 2023, respectively, related to this arrangement.

Recently adopted accounting standards and recently issued accounting pronouncements

Adoption of Accounting Standards Update ("ASU") 2022-03 - Fair Value Measurement of Equity Securities Subject to Contractual Sale Restrictions

In June 2022, the Financial Accounting Standards Board ("FASB") issued ASU 2022-03, which clarifies the guidance in Topic 820, Fair Value Measurement, when measuring the fair value of an equity security subject to contractual restrictions that prohibit the sale and to introduce new disclosure requirements. The Company adopted this standard effective January 1, 2024, on a prospective basis. Adoption of this standard did not have a material impact on the Company's consolidated balance sheet, statements of operations, or cash flows, but did modify the Company's disclosures related to certain investments. Refer to Note 12 for the Company's updated disclosures on investments in equity securities subject to capital sale restrictions.

Adoption of ASU 2023-07 - Improvements to Reportable Segment Disclosures

In November 2023, the FASB issued ASU 2023-07, which enhances and improves disclosures about operating segment revenues, measures of profit/loss, and expenses to enable investors to better understand an entity's overall performance and assess potential future cash flows. The amendment requires that an entity disclose (i) significant expenses that are regularly provided to the Chief Operating Decision Maker ("CODM"), (ii) other segment items by reportable segment including a description of its composition, (iii) all annual disclosures required by Topic 280, Reporting Measures of Segment Profit or Loss, in interim periods, (iv) additional measures of a segment's profit or loss used by the CODM in assessing segment performance and allocation of resources, and (v) the title and position of the CODM and an explanation of how the CODM uses the reported measure(s) of segment profit or loss. The Company adopted this standard effective January 1, 2024, on a prospective basis. Refer to Note 16 for the Company's business segment disclosures.

Adoption of ASU 2023-09 - Improvements to Income Tax Disclosures

In December 2023, the FASB issued ASU 2023-09, which enhances the transparency and usefulness of income tax disclosures required pursuant to Topic 740, Income Taxes, to provide information to better assess how an entity's operations, tax risks and tax planning, and operational opportunities affect its tax rate and future cash flows. The Company adopted this standard effective January 1, 2025, on a modified retrospective basis. Adoption of this standard did not have a material impact on the Company's consolidated balance sheet, statements of operations, or cash flows. Refer to Note 20 for the Company's updated income tax disclosures.

Adoption of ASU 2025-05 - Measurement of Credit Losses for Accounts Receivable and Contract Assets

In July 2025, the FASB issued ASU 2025-05, which introduced a practical expedient related to applying subtopic 326-20 to current accounts receivable and current contract assets arising from transactions accounted for under Topic 606, Revenue from Contracts with Customers. The Company early adopted this standard effective January 1, 2025, on a prospective basis. Adoption of this standard did not have a material impact on the Company's consolidated balance sheet, statements of operations, or cash flows. Refer to Note 15 for the Company's updated accounts receivable disclosures.

 

Recently Issued Accounting Pronouncements

Topic

 

Description of Guidance

 

Effective Date

 

Status of Company's Evaluation

Disclosure Improvements - Codification Amendments in Response to the SEC's Disclosure Update and Simplification Initiative (ASU 2023-06)

 

Adds interim and annual disclosure requirements to a variety of subtopics in the Accounting Standards Codification, including those focusing on accounting changes, earnings per share, debt, and repurchase agreements. The guidance will be applied prospectively. The effective date will be the date when the SEC's removal of the related disclosure requirement becomes effective, with early adoption prohibited.

 

Various

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Disaggregation of Income Statement Expenses (ASU 2024-03)

 

Improves financial reporting by requiring that public business entities disclose additional information about specific expense categories in the notes to the financial statements at interim and annual reporting periods. The amendments are to be applied prospectively to financial statements issued for reporting periods after the effective date or retrospectively to all prior periods presented in the financial statements.

 

January 1, 2027

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Targeted Improvements to the Accounting for Internal-Use Software (ASU 2025-06)

 

Aligns the accounting for internal-use software with how software is developed to increase the operability of the recognition and capitalization of internal-use software costs in accordance with Subtopic 350-40. Early adoption is permitted as of the beginning of an annual reporting period. The guidance is to be applied prospectively to new software costs incurred as of the beginning of the adoption period for all projects, including in-process projects.

 

January 1, 2028

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Narrow-Scope Requirements for Interim Reporting (ASU 2025-11)

 

Clarifies interim disclosure requirements and applicability of Topic 270, Interim Reporting for events since the end of the last annual reporting period that have a material impact on the entity. Early adoption is permitted and the amendments are to be applied prospectively or retrospectively to any or all periods presented in the financial statements.

 

January 1, 2028

 

The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Other recently issued ASUs, excluding those ASUs which have already been disclosed as adopted or described above, were assessed and determined not applicable, or are expected to have minimal impact on the Company's consolidated financial statements.
Inventories

Inventories are valued at the lower of cost or estimated net realizable value, after provision for excess, obsolete, or impaired items, which is reviewed and updated on a periodic basis by management. For inventory procured or produced internally or through contract manufacturing arrangements at the Company's manufacturing and distribution facilities in the U.S., inventory is valued using a standard-cost method, which is reviewed at least annually, or more often in the event circumstances indicate a change in costs. The Company believes that standard costs, combined with the capitalization and amortization of observed variances versus standards, approximates actual costs on the first-in, first-out method. For inventory procured or produced through contract manufacturing arrangements at the Company's manufacturing facility in Italy, inventory is valued using a weighted-average cost method.
Property, plant and equipment . Costs include all expenditures necessary to place the asset in service, generally including freight and sales and use taxes. Property, plant, and equipment also includes instrumentation, which is generally used to facilitate the implantation of the Company’s products.

The Company evaluates the useful lives of these assets on an annual basis. Depreciation is computed on a straight-line basis over the useful lives of the assets. Depreciation of leasehold improvements is computed over the shorter of the lease term or the useful life of the asset. Total depreciation expense was $47.3 million, $41.1 million, and $34.2 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Expenditures for maintenance, repairs, and minor renewals and improvements, which do not extend the lives of the respective assets, are expensed as incurred. All other expenditures for renewals and improvements are capitalized. The assets and related accumulated depreciation are adjusted for property retirements and disposals, with the resulting gain or loss included in earnings. Fully depreciated assets remain in the accounts until retired from service.

The Company capitalizes system development costs related to internal-use software during the application development stage. Costs related to preliminary project activities and post-implementation activities are expensed as incurred. Internal-use software is amortized on a straight-line basis over the estimated useful life of the software.

Long-lived assets are evaluated for impairment annually or whenever events or changes in circumstances have occurred that would indicate impairment. For purposes of the evaluation, the Company groups its long-lived assets with other assets and liabilities at the lowest level of identifiable cash flows if the asset does not generate cash flows independent of other assets and liabilities. If the carrying value of the asset or asset group exceeds the undiscounted cash flows expected to result from the use and eventual disposition of the asset group, the Company will write the carrying value down to fair value in the period identified.

The Company generally determines fair value of long-lived assets as the present value of estimated future cash flows. In determining the estimated future cash flows associated with the assets, the Company uses estimates and assumptions about future revenue contributions, cost structures, and remaining useful lives of the asset group. The use of alternative assumptions, including estimated cash flows, discount rates, and alternative estimated remaining useful lives could result in different calculations of impairment.
Intangible assets

Intangible assets are recorded at cost or at estimated fair value when acquired as a part of a business combination, less accumulated amortization. These assets are amortized on a straight-line basis over the useful lives of the assets, which the Company believes is consistent with the pattern of economic benefit provided by the assets.
Goodwill

The Company tests goodwill at least annually for impairment. The Company tests more frequently if indicators are present or changes in circumstances suggest that impairment may exist. These indicators include, among others, declines in sales, earnings, or cash flows, or the development of a material adverse change in the business climate. The Company assesses goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment.
Leases

The Company determines if a contractual arrangement qualifies as a lease at inception. The Company’s leases primarily relate to facilities, vehicles, and equipment. Lease assets represent the Company’s right to use an underlying asset for the lease term, while lease liabilities represent the obligation to make lease payments arising from the lease. Lease assets and liabilities are recognized at the commencement date based on the present value of lease payments over the lease term, with lease assets also adjusted for the impact of any lease prepayments and reduced by the value of any lease incentives. As the Company’s leases do not provide an implicit rate, the Company’s incremental borrowing rate is used as a discount rate, based on the information available at the commencement date, in determining the present value of lease payments.

The Company does not recognize lease liabilities or lease assets on the balance sheet for short-term leases (leases with a lease term of twelve months or less as of the commencement date). Rather, any short-term lease payments are recognized as an expense on a straight-line basis over the lease term. The current period short-term lease expense reasonably reflects the Company's short-term lease commitments.

For all classifications of leases, the Company combines lease and non-lease components to account for them as a single lease component. Variable lease payments are excluded from the lease liability and recognized in the period in which the obligation is incurred. Additionally, lease terms may include options to extend or terminate the lease when it is reasonably certain that the Company will exercise the option.
Commitments and contingencies

Contingencies policy

The Company records accruals for certain outstanding legal proceedings, investigations, or claims when it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. The Company evaluates developments in legal proceedings, investigations, and claims that could affect the amount of any accrual, as well as any developments that would make a loss contingency both probable and reasonably estimable on a quarterly basis. When a loss contingency is not both probable and reasonably estimable, the Company does not accrue the loss. However, if the loss (or an additional loss in excess of the accrual) is at least a reasonable possibility and material, then the Company discloses a reasonable estimate of the possible loss or range of loss, if such reasonable estimate can be made. If the Company cannot make a reasonable estimate of the possible loss, or range of loss, then that is disclosed. In addition, legal fees and other directly related costs are expensed as incurred.
Revenue Recognition

Revenue Recognition

The Company accounts for a contract when there is (i) approval and commitment from both parties, (ii) the rights of the parties are identified, (iii) payment terms are identified, (iv) the contract has commercial substance, and (v) collectability of consideration is probable. The Company’s contracts may contain one or more performance obligations. If a contract contains more than one performance obligation, the Company allocates the total transaction price to each of the performance obligations based upon the observable standalone selling price of the promised goods or services underlying each performance obligation. The Company recognizes revenue when control of the promised goods or services is transferred to the customer, which typically occurs at a point in time upon shipment, delivery, or utilization, in an amount that reflects the consideration which the Company expects to be entitled to in exchange for the promised goods or services. The consideration for goods or services reflects any fixed amount stated per the contract and estimates for any variable consideration, such as discounts, to the extent that it is probable that a significant reversal of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved.

The following sections discuss the Company’s revenue recognition policies by significant product category:

Bone Growth Therapies

Bone Growth Therapies revenue is largely attributable to the U.S. and is comprised of third-party payor transactions and wholesale revenue.

The largest portion of Bone Growth Therapies revenue is derived from third-party payors. This includes commercial insurance carriers, health maintenance organizations, preferred provider organizations, and governmental payors, such as Medicare. Revenue is recognized when the product is fitted to and accepted by the patient and all applicable documents required by the third-party payor have been obtained. Amounts paid by third-party payors are generally based on fixed or allowable reimbursement rates. These revenues are recorded at the expected or preauthorized reimbursement rates, net of any contractual allowances or adjustments. Certain billings are subject to review by the third-party payors and may be subject to adjustment.

Wholesale revenue is related to the sale of the Company’s bone growth stimulators directly to durable medical equipment suppliers. Wholesale revenues are typically recognized upon shipment and receipt of a confirming purchase order, which is when the customer obtains control of the promised goods.

Biologics

Biologics revenue is largely attributable to the U.S. and is mostly processed from within the Company’s Irvine facility. In addition, the Company has a long-standing collaborative arrangement with MTF that provides exclusive global marketing rights to MTF's Virtuos and Trinity Elite, and exclusive rights to market the FiberFuse tissues in the U.S. Per the terms of the agreement, MTF sources the tissue, processes it to create the allografts, packages, and delivers the tissue to the customer. The Company receives marketing fees from MTF based on sales of products covered under the collaborative arrangement. MTF is considered the principal in these arrangements; therefore, the Company recognizes marketing service fees on a net basis within net sales upon shipment of the product to the customer and receipt of a confirming purchase order.

Spinal Implants and Global Limb Reconstruction (formerly "Global Orthopedics")

Spinal Implants and Global Limb Reconstruction products are distributed world-wide, with U.S. sales largely comprised of commercial revenue and international sales derived from both commercial revenue and stocking distributor arrangements.

Commercial revenue is largely related to the sale of the Company’s Spinal Implants and Global Limb Reconstruction products to hospital customers. The customer obtains control and revenues are recognized when these products have been utilized and a confirming purchase order has been received from the hospital.

Other revenues within the Spinal Implants and Global Limb Reconstruction product categories are derived from stocking distributors, who purchase the Company’s products and then re-sell them directly to customers, such as hospitals. For stocking distributor arrangements, it is the Company’s policy to recognize revenue upon shipment and receipt of a confirming purchase order, which is when the distributor obtains control of the promised goods. The transaction price for revenue recognition is estimated based upon the Company’s historical collection experience with the stocking distributor.

Enabling Technologies

Enabling technologies revenue is primarily comprised of sales of the 7D Flash Navigation Systems and related instruments to hospitals, healthcare providers, and stocking distributors. Revenue is typically recognized from these sales upon installation of the system at the site of the purchasing hospital or upon shipment to a stocking distributor and receipt of a confirming purchase order, as this represents the point in time when the performance obligation has been satisfied.

Product Sales and Marketing Service Fees

The table below presents net sales, which includes product sales and marketing service fees, for each of the years ended December 31, 2025, 2024, and 2023.

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Product sales

 

$

775,396

 

 

$

747,783

 

 

$

693,345

 

Marketing service fees

 

 

46,916

 

 

 

51,708

 

 

 

53,296

 

Net sales

 

$

822,312

 

 

$

799,491

 

 

$

746,641

 

Marketing service fees are received from MTF based on total sales of biologics tissues and relate solely to the Biologics product category within the Global Spine reporting segment, whereas product sales primarily consist of the sale of Bone Growth Therapies, Spinal Implants, non-MTF sourced Biologics, Enabling Technologies, and Global Limb Reconstruction products. Marketing service fees received from MTF were $46.9 million, or approximately 30% of total Biologics revenues, for the year ended December 31, 2025. As MTF is the single supplier for certain allografts in the Company’s Biologics portfolio, derived from deceased donors for their bone grafts and living donors for their amnion grafts, any event or circumstance that would impact MTF’s continued access to donors or the Company’s ability to market these tissues may adversely impact the Company’s financial results.

Revenues exclude any value added or other local taxes, intercompany sales, and trade discounts. Shipping and handling costs for products shipped to customers are included in cost of sales, and were $8.9 million, $9.9 million, and $9.5 million for the years ended December 31, 2025, 2024, and 2023, respectively.

Accounts receivable and related allowances

Payment terms vary by the type and location of the Company’s customers and the products or services offered. The term between invoicing and when payment is due is generally not significant.

The Company’s allowance for expected credit losses represents the portion of the receivable’s amortized cost basis that an entity does not expect to collect over the receivable’s contractual life, considering past events, current conditions, and reasonable and supportable forecasts of future economic conditions.
Earnings Per Share

The Company uses the treasury stock method of computing basic and diluted EPS. Basic EPS is computed using the weighted average number of common shares outstanding during each of the respective years. Diluted EPS is computed using the weighted average number of common and common equivalent shares outstanding during each of the respective years using the treasury stock method. The difference between basic and diluted shares, if any, largely results from common equivalent shares, which represents the dilutive effect of the assumed exercise of certain outstanding share options, the assumed vesting of restricted stock granted to employees and directors, or the satisfaction of certain necessary conditions for contingently issuable shares (see Note 18).
v3.25.4
Significant accounting policies (Tables)
 12 Months Ended
Dec. 31, 2025
Accounting Policies [Abstract]  
Schedule of Supplemental Disclosure of Cash Flow Information

Investing activities that did not result in cash receipts or cash payments during the years ended December 31, 2025, 2024, and 2023 consisted of the following, which were not included within cash used in investing activities in the Company’s consolidated statements of cash flows:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Supplemental disclosure of cash flow information:

 

 

 

 

 

 

 

 

 

Noncash investing activities:

 

 

 

 

 

 

 

 

 

Changes in accrued capital expenditures

 

$

5,278

 

 

$

(3,040

)

 

$

—

 

Intangible assets acquired in asset acquisitions

 

 

40

 

 

 

—

 

 

 

—

 
v3.25.4
Mergers, acquisitions, and the discontinuation of the M6 product lines (Tables)
 12 Months Ended
Dec. 31, 2025
Business Combination [Abstract]  
Summary of Estimated Fair Values of Assets Acquired and Liabilities Assumed

Certain acquired assets and liabilities assumed were valued utilizing Level 3 inputs and assumptions. The purchase price allocation for the Merger is as follows:

(U.S. Dollars, in thousands)

 

Final Acquisition Date Fair Value

 

 

Assigned Useful Life

Assets acquired:

 

 

 

 

 

Current assets

 

 

 

 

 

Cash and cash equivalents

 

$

29,419

 

 

 

Accounts receivable, net

 

 

35,313

 

 

 

Inventories

 

 

132,636

 

 

 

Prepaid expenses and other current assets

 

 

4,590

 

 

 

Total current assets

 

 

201,958

 

 

 

Property, plant, and equipment, net

 

 

68,863

 

 

 

Customer relationships

 

 

33,100

 

 

13 years

Developed technology

 

 

47,200

 

 

6 - 8 years

In-process research and development ("IPR&D")

 

 

5,750

 

 

Indefinite

Other long-term assets

 

 

20,501

 

 

 

Total identifiable assets acquired

 

$

377,372

 

 

 

 

 

 

 

 

 

Liabilities assumed:

 

 

 

 

 

Current liabilities

 

 

 

 

 

Accounts payable

 

$

21,602

 

 

 

Other current liabilities

 

 

43,521

 

 

 

Total current liabilities

 

 

65,123

 

 

 

Long-term borrowings under SeaSpine credit facility

 

 

26,298

 

 

 

Other long-term liabilities

 

 

32,823

 

 

 

Total liabilities assumed

 

 

124,244

 

 

 

Net identifiable assets acquired

 

$

253,128

 

 

 

Total fair value of consideration transferred

 

 

376,745

 

 

 

Residual goodwill

 

$

123,617

 

 

 
Summary of Impairment Charges A summary of impairment charges recognized and the associated financial statement lines in which such costs are recognized are shown in the table below. All such charges are included within the Company's Global Spine reporting segment.

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

Financial Statement Line Item

2025

 

 

2024

 

 

2023

 

Inventory reserve charges

Cost of sales

$

10,862

 

 

$

—

 

 

$

—

 

Impairment of property, plant, and equipment

Operating expenses

 

6,834

 

 

 

—

 

 

 

—

 

Impairment of developed technology intangible asset

Acquisition-related amortization, impairment, and remeasurement

 

14,097

 

 

 

—

 

 

 

—

 

Loss on M6 inventories and long-lived assets

$

31,793

 

 

$

—

 

 

$

—

 
v3.25.4
Inventories (Tables)
 12 Months Ended
Dec. 31, 2025
Inventory Disclosure [Abstract]  
Schedule of Inventories

Inventories are valued at the lower of cost or estimated net realizable value, after provision for excess, obsolete, or impaired items, which is reviewed and updated on a periodic basis by management. For inventory procured or produced internally or through contract manufacturing arrangements at the Company's manufacturing and distribution facilities in the U.S., inventory is valued using a standard-cost method, which is reviewed at least annually, or more often in the event circumstances indicate a change in costs. The Company believes that standard costs, combined with the capitalization and amortization of observed variances versus standards, approximates actual costs on the first-in, first-out method. For inventory procured or produced through contract manufacturing arrangements at the Company's manufacturing facility in Italy, inventory is valued using a weighted-average cost method.

Work-in-process and finished products include material, labor, and production overhead costs. Field and consignment inventory, which represents immediately saleable finished products inventory that is in the possession of the Company’s independent sales representatives or located at third-party customers, such as hospitals, is included within finished products.

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Raw materials

 

$

22,865

 

 

$

27,180

 

Work-in-process

 

 

63,255

 

 

 

56,920

 

Finished products

 

 

86,199

 

 

 

105,352

 

Inventories

 

$

172,319

 

 

$

189,452

 
v3.25.4
Property, plant and equipment (Tables)
 12 Months Ended
Dec. 31, 2025
Property, Plant and Equipment [Abstract]  
Schedule of Useful Lives of Assets

The useful lives of these assets are generally as follows:

 

 

Years

Buildings

 

25 to 33

Plant and equipment

 

1 to 10

Instrumentation

 

3 to 4

Computer software

 

3 to 7

Furniture and fixtures

 

4 to 8
Schedule of Property, Plant and Equipment The assets and related accumulated depreciation are adjusted for property retirements and disposals, with the resulting gain or loss included in earnings. Fully depreciated assets remain in the accounts until retired from service.

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Cost

 

 

 

 

 

 

Buildings

 

$

4,400

 

 

$

3,874

 

Plant and equipment

 

 

82,738

 

 

 

76,481

 

Instrumentation

 

 

192,407

 

 

 

176,387

 

Computer software

 

 

44,888

 

 

 

41,396

 

Furniture and fixtures

 

 

11,062

 

 

 

9,832

 

Construction in progress

 

 

23,235

 

 

 

22,693

 

Finance lease assets

 

 

21,406

 

 

 

21,383

 

Property, plant, and equipment, gross

 

 

380,136

 

 

 

352,046

 

Accumulated depreciation

 

 

(250,737

)

 

 

(212,242

)

Property, plant, and equipment, net

 

$

129,399

 

 

$

139,804

 
v3.25.4
Intangible assets (Tables)
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of Intangible Assets

Intangible assets are recorded at cost or at estimated fair value when acquired as a part of a business combination, less accumulated amortization. These assets are amortized on a straight-line basis over the useful lives of the assets, which the Company believes is consistent with the pattern of economic benefit provided by the assets.

 

 

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

Weighted Average Amortization Period

 

2025

 

 

2024

 

Cost

 

 

 

 

 

 

 

 

Developed technology

 

7.1 years

 

$

96,364

 

 

$

92,686

 

Patents

 

10.0 years

 

 

49,510

 

 

 

38,329

 

IPR&D

 

Indefinite

 

 

1,023

 

 

 

4,116

 

Customer relationships

 

12.8 years

 

 

49,249

 

 

 

49,145

 

License and other

 

9.9 years

 

 

20,331

 

 

 

18,359

 

Trademarks—finite lived

 

10.0 years

 

 

1,989

 

 

 

1,735

 

 

 

9.8 years

 

$

218,466

 

 

$

204,370

 

Accumulated amortization

 

 

 

 

 

 

 

 

Developed technology

 

 

 

$

(64,357

)

 

$

(40,813

)

Patents

 

 

 

 

(45,645

)

 

 

(35,918

)

Customer relationships

 

 

 

 

(21,221

)

 

 

(17,044

)

License and other

 

 

 

 

(13,352

)

 

 

(10,892

)

Trademarks—finite lived

 

 

 

 

(1,126

)

 

 

(900

)

 

 

 

 

 

(145,701

)

 

 

(105,567

)

Intangible assets, net

 

 

 

$

72,765

 

 

$

98,803

 
Schedule of Future Amortization Expense Future amortization expense for intangible assets is estimated as follows:

(U.S. Dollars, in thousands)

 

Amortization

 

2026

 

$

15,175

 

2027

 

 

14,790

 

2028

 

 

12,063

 

2029

 

 

7,660

 

2030

 

 

7,501

 

Thereafter

 

 

14,553

 

Total finite-lived intangible assets, net

 

$

71,742

 

Indefinite-lived intangible assets

 

 

1,023

 

Intangible assets, net

 

$

72,765

 
v3.25.4
Goodwill (Tables)
 12 Months Ended
Dec. 31, 2025
Goodwill and Intangible Assets Disclosure [Abstract]  
Schedule of Net Carrying Amount of Goodwill

The following table presents the net carrying value of goodwill as of December 31, 2025, and 2024, and a rollforward of such balances from December 31, 2024, by reportable unit:

(U.S. Dollars, in thousands)

 

Balance as of
December 31, 2024

 

 

Impairment

 

 

Currency translation adjustment

 

 

Balance as of
December 31, 2025

 

Global Spine - Gross

 

$

194,934

 

 

$

—

 

 

$

—

 

 

$

194,934

 

Global Spine - Accumulated impairment loss

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Global Spine - Net

 

$

194,934

 

 

$

—

 

 

$

—

 

 

$

194,934

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Global Limb Reconstruction - Gross

 

$

10,765

 

 

$

—

 

 

$

1,447

 

 

$

12,212

 

Global Limb Reconstruction - Accumulated impairment loss

 

 

(10,765

)

 

 

—

 

 

 

(1,447

)

 

 

(12,212

)

Global Limb Reconstruction - Net

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Goodwill, net of accumulated impairment losses

 

$

194,934

 

 

$

—

 

 

$

—

 

 

$

194,934

 
v3.25.4
Leases (Tables)
 12 Months Ended
Dec. 31, 2025
Leases [Abstract]  
Summary of Lease Portfolio A summary of the Company’s lease portfolio as of December 31, 2025, and 2024, is presented in the table below:

 

 

 

 

December 31,

 

(U.S. Dollars, in thousands, except lease term and discount rate)

 

Classification

 

2025

 

 

2024

 

Assets

 

 

 

 

 

 

 

 

Operating leases

 

Other long-term assets

 

$

22,279

 

 

$

17,238

 

Finance leases

 

Property, plant and equipment, net

 

 

14,442

 

 

 

15,386

 

Total lease assets

 

 

 

$

36,721

 

 

$

32,624

 

Liabilities

 

 

 

 

 

 

 

 

Current

 

 

 

 

 

 

 

 

Operating leases

 

Other current liabilities

 

$

3,147

 

 

$

4,023

 

Finance leases

 

Current portion of finance lease liability

 

 

837

 

 

 

755

 

Long-term

 

 

 

 

 

 

 

 

Operating leases

 

Other long-term liabilities

 

 

25,413

 

 

 

14,084

 

Finance leases

 

Long-term portion of finance lease liability

 

 

17,060

 

 

 

17,835

 

Total lease liabilities

 

 

 

$

46,457

 

 

$

36,697

 

 

 

 

 

 

 

 

 

 

Weighted Average Remaining Lease Term

 

 

 

 

 

 

 

 

Operating leases

 

 

 

8.8 years

 

 

5.4 years

 

Finance leases

 

 

 

14.6 years

 

 

15.6 years

 

 

 

 

 

 

 

 

 

 

Weighted Average Discount Rate

 

 

 

 

 

 

 

 

Operating leases

 

 

 

 

9.9

%

 

 

7.6

%

Finance leases

 

 

 

 

4.4

%

 

 

4.4

%

 
Summary of Components of Lease Costs

The components of lease costs were as follows:

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Finance lease costs:

 

 

 

 

 

 

 

 

 

Amortization of right-of-use assets

 

$

1,014

 

 

$

1,014

 

 

$

1,013

 

Interest on finance lease liabilities

 

 

805

 

 

 

832

 

 

 

857

 

Operating lease costs

 

 

6,027

 

 

 

5,257

 

 

 

5,015

 

Short-term lease costs

 

 

29

 

 

 

249

 

 

 

313

 

Variable lease costs

 

 

1,753

 

 

 

1,796

 

 

 

1,883

 

Total lease costs

 

$

9,628

 

 

$

9,148

 

 

$

9,081

 
Summary of Supplemental Cash Flow Information Related to Leases

Supplemental cash flow information related to leases was as follows:

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Cash paid for amounts included in the measurement of lease liabilities

 

 

 

 

 

 

 

 

 

Operating cash flows from operating leases

 

$

8,801

 

 

$

8,917

 

 

$

7,682

 

Operating cash flows from finance leases

 

 

801

 

 

 

831

 

 

 

857

 

Financing cash flows from finance leases

 

 

762

 

 

 

706

 

 

 

652

 

Right-of-use assets obtained in exchange for lease obligations

 

 

 

 

 

 

 

 

 

Operating leases

 

 

12,261

 

 

 

1,449

 

 

 

16,688

 

Finance leases

 

 

70

 

 

 

55

 

 

 

—

 
Summary of Remaining Lease Liabilities

A summary of the Company’s remaining lease liabilities as of December 31, 2025, is included below:

(U.S. Dollars, in thousands)

 

Operating
Leases

 

 

Finance
Leases

 

2026

 

$

5,426

 

 

$

1,607

 

2027

 

 

4,382

 

 

 

1,626

 

2028

 

 

4,438

 

 

 

1,654

 

2029

 

 

4,229

 

 

 

1,672

 

2030

 

 

4,180

 

 

 

1,685

 

Thereafter

 

 

23,687

 

 

 

16,063

 

Total undiscounted value of lease liabilities

 

 

46,342

 

 

 

24,307

 

Less: Interest

 

 

(17,782

)

 

 

(6,410

)

Present value of lease liabilities

 

$

28,560

 

 

$

17,897

 

 

 

 

 

 

 

 

Current portion of lease liabilities

 

$

3,147

 

 

$

837

 

Long-term portion of lease liabilities

 

 

25,413

 

 

 

17,060

 

Total lease liabilities

 

$

28,560

 

 

$

17,897

 
v3.25.4
Other current liabilities (Tables)
 12 Months Ended
Dec. 31, 2025
Payables and Accruals [Abstract]  
Summary of Other Current Liabilities

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Accrued expenses

 

$

9,857

 

 

$

11,391

 

Salaries, bonuses, employee commissions, severance, and related taxes payable

 

 

27,026

 

 

 

43,899

 

Accrued distributor commissions

 

 

23,542

 

 

 

23,064

 

Accrued litigation and investigation costs

 

 

30,561

 

 

 

11,891

 

Short-term operating lease liability

 

 

3,147

 

 

 

4,023

 

Non-income taxes payable

 

 

3,609

 

 

 

8,414

 

Short-term contingent consideration liability

 

 

4,290

 

 

 

7,100

 

Other payables

 

 

9,221

 

 

 

9,288

 

Other current liabilities

 

$

111,253

 

 

$

119,070

 
v3.25.4
Indebtedness (Tables)
 12 Months Ended
Dec. 31, 2025
Debt Disclosure [Abstract]  
Summary of Carrying Values of Outstanding Debt Obligations

The carrying values of the Company’s outstanding debt obligations as of December 31, 2025, and 2024, were as follows:

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Outstanding Term Loans

 

 

 

 

 

 

Principal amount

 

$

160,000

 

 

$

160,000

 

Unamortized original debt discount

 

 

(1,839

)

 

 

(2,327

)

Unamortized debt issuance costs and lenders fees

 

 

(770

)

 

 

(658

)

Total indebtedness from outstanding term loans

 

 

157,391

 

 

 

157,015

 

 

 

 

 

 

 

 

Current portion of long-term debt

 

$

—

 

 

$

—

 

Long-term debt

 

 

157,391

 

 

 

157,015

 

Total indebtedness outstanding

 

$

157,391

 

 

$

157,015

 
v3.25.4
Fair value measurements and investments (Tables)
 12 Months Ended
Dec. 31, 2025
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]  
Schedule of Financial Assets and Liabilities Recorded at Fair Value on Recurring Basis

The Company’s available for sale debt securities, equity securities, contingent consideration, and deferred compensation plan liabilities are, or in some cases, were the only financial instruments recorded at fair value on a recurring basis as follows:

(U.S. Dollars, in thousands)

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Balance
December 31,
2025

 

Assets

 

 

 

 

 

 

 

 

 

 

 

 

Neo Medical convertible loan agreement

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Neo Medical preferred equity securities

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Total

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Liabilities

 

 

 

 

 

 

 

 

 

 

 

 

Lattus contingent consideration

 

$

—

 

 

$

—

 

 

$

(7,930

)

 

$

(7,930

)

Deferred compensation plan

 

 

—

 

 

 

(1,720

)

 

 

—

 

 

 

(1,720

)

Total

 

$

—

 

 

$

(1,720

)

 

$

(7,930

)

 

$

(9,650

)

 

(U.S. Dollars, in thousands)

 

Level 1

 

 

Level 2

 

 

Level 3

 

 

Balance
December 31,
2024

 

Assets

 

 

 

 

 

 

 

 

 

 

 

 

Neo Medical convertible loan agreement

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Neo Medical preferred equity securities

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Total

 

$

—

 

 

$

—

 

 

$

—

 

 

$

—

 

Liabilities

 

 

 

 

 

 

 

 

 

 

 

 

Lattus contingent consideration

 

$

—

 

 

$

—

 

 

$

(15,400

)

 

$

(15,400

)

Deferred compensation plan

 

 

—

 

 

 

(1,703

)

 

 

—

 

 

 

(1,703

)

Total

 

$

—

 

 

$

(1,703

)

 

$

(15,400

)

 

$

(17,103

)
Schedule of Reconciliation of Carrying Value of Investments in Equity Securities

The table below presents a reconciliation of the carrying value of the Company’s investment in Neo Medical preferred equity securities for the years ended December 31, 2025, and 2024:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Fair value of Neo Medical preferred equity securities at January 1

 

$

—

 

 

$

4,951

 

Conversion of loan into preferred equity securities

 

 

—

 

 

 

8,224

 

Sale of preferred equity securities

 

 

—

 

 

 

(7,396

)

Realized loss recognized in other expense, net

 

 

—

 

 

 

(5,779

)

Fair value of Neo Medical preferred equity securities at December 31

 

$

—

 

 

$

—

 

Cumulative unrealized gain (loss) on Neo Medical preferred equity securities

 

$

—

 

 

$

—

 
Schedule of Reconciliation For Contingent Consideration Measured At Fair Value Using Significant Unobservable Inputs The following table provides a reconciliation of the beginning and ending balances for the Lattus contingent consideration measured at estimated fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Lattus contingent consideration estimated fair value at January 1

 

$

15,400

 

 

$

8,500

 

Change in fair value recognized in acquisition-related amortization, impairment, and remeasurement

 

 

(1,140

)

 

 

6,900

 

Installment payment

 

 

(6,330

)

 

 

—

 

Lattus contingent consideration estimated fair value at December 31

 

$

7,930

 

 

$

15,400

 

 
Fair Value, Inputs, Level 3 [Member]  
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]  
Schedule of Reconciliation For Convertible Loans Measured At Fair Value Using Significant Unobservable Inputs

The following table provides a reconciliation of the beginning and ending balances of the Convertible Loan, measured at fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Fair value of Neo Medical Convertible Loans at January 1

 

$

—

 

 

$

6,760

 

Gain recognized in other comprehensive income (loss)

 

 

—

 

 

 

1,671

 

Interest recognized in interest income, net

 

 

—

 

 

 

162

 

Foreign currency remeasurement recognized in other income (expense), net

 

 

—

 

 

 

(629

)

Expected credit loss recognized in other income (expense), net

 

 

—

 

 

 

260

 

Conversion into preferred equity securities

 

 

—

 

 

 

(8,224

)

Fair value of Neo Medical Convertible Loans at December 31

 

$

—

 

 

$

—

 
Schedule of Changes in Valuation of Securities

The following table provides quantitative information related to certain key assumptions utilized within the valuation as of December 31, 2025:

(U.S. Dollars, in thousands)

 

Fair Value as of
 December 31, 2025

 

 

Unobservable inputs

 

Estimate

Lattus contingent consideration

 

$

7,930

 

 

Counterparty discount rate

 

11.8% - 12.0%

 

 

 

 

 

Revenue risk-adjusted discount rate

 

5.7% - 5.9%
v3.25.4
Shareholders' equity (Tables)
 12 Months Ended
Dec. 31, 2025
Stockholders' Equity Note [Abstract]  
Components of Changes in Accumulated Other Comprehensive Income (Loss) The components of and changes in accumulated other comprehensive income (loss) are as follows:

(U.S. Dollars, in thousands)

 

Currency
Translation
Adjustments

 

 

Neo Medical Convertible Loans

 

 

Other Investments

 

 

Accumulated Other
Comprehensive
Income (Loss)

 

Balance at December 31, 2022

 

$

(2,482

)

 

$

1,005

 

 

$

101

 

 

$

(1,376

)

Other comprehensive income (loss)

 

 

1,417

 

 

 

(1,233

)

 

 

(101

)

 

 

83

 

Income taxes

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Balance at December 31, 2023

 

$

(1,065

)

 

$

(228

)

 

$

—

 

 

$

(1,293

)

Other comprehensive income (loss)

 

 

(3,009

)

 

 

1,671

 

 

 

—

 

 

 

(1,338

)

Income taxes

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Reclassification adjustment to:

 

 

 

 

 

 

 

 

 

 

 

 

Other expense, net

 

 

—

 

 

 

(1,671

)

 

 

—

 

 

 

(1,671

)

Balance at December 31, 2024

 

$

(4,074

)

 

$

(228

)

 

$

—

 

 

$

(4,302

)

Other comprehensive income

 

 

4,920

 

 

 

—

 

 

 

—

 

 

 

4,920

 

Income taxes

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

Balance at December 31, 2025

 

$

846

 

 

$

(228

)

 

$

—

 

 

$

618

 

 
v3.25.4
Revenue recognition and accounts receivable (Tables)
 12 Months Ended
Dec. 31, 2025
Revenue Recognition And Accounts Receivable [Abstract]  
Schedule of Net Sales

The table below presents net sales, which includes product sales and marketing service fees, for each of the years ended December 31, 2025, 2024, and 2023.

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Product sales

 

$

775,396

 

 

$

747,783

 

 

$

693,345

 

Marketing service fees

 

 

46,916

 

 

 

51,708

 

 

 

53,296

 

Net sales

 

$

822,312

 

 

$

799,491

 

 

$

746,641

 
Allowances for Expected Credit Losses

The following table provides the detail of changes in the Company’s allowance for expected credit losses for the years ended December 31, 2025, and 2024:

 

 

Year ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Allowance for expected credit losses beginning balance

 

$

7,418

 

 

$

7,130

 

Current period provision for expected credit losses

 

 

2,255

 

 

 

1,999

 

Write-offs charged against the allowance and other activity

 

 

(1,764

)

 

 

(1,451

)

Effect of changes in foreign exchange rates

 

 

399

 

 

 

(260

)

Allowance for expected credit losses ending balance

 

$

8,308

 

 

$

7,418

 
v3.25.4
Business segment information (Tables)
 12 Months Ended
Dec. 31, 2025
Segment Reporting [Abstract]  
Schedule of Net Sales by Major Product Category by Reporting Segment

The table below presents net sales by major product category by reporting segment:

 

 

Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

(U.S. Dollars, in thousands)

 

Net Sales

 

 

Percent of
Total Net
Sales

 

 

Net Sales

 

 

Percent of
Total Net
Sales

 

 

Net Sales

 

 

Percent of
Total Net
Sales

 

Bone Growth Therapies

 

$

247,164

 

 

 

30.0

%

 

$

233,405

 

 

 

29.2

%

 

$

212,530

 

 

 

28.5

%

Spinal Implants, Biologics, and Enabling Technologies

 

 

440,491

 

 

 

53.6

%

 

 

441,909

 

 

 

55.3

%

 

 

418,789

 

 

 

56.1

%

Global Spine

 

 

687,655

 

 

 

83.6

%

 

 

675,314

 

 

 

84.5

%

 

 

631,319

 

 

 

84.6

%

Global Limb Reconstruction

 

 

134,657

 

 

 

16.4

%

 

 

124,177

 

 

 

15.5

%

 

 

115,322

 

 

 

15.4

%

Net sales

 

$

822,312

 

 

 

100.0

%

 

$

799,491

 

 

 

100.0

%

 

$

746,641

 

 

 

100.0

%
Summary of EBITDA by Reporting Segment

The following table presents adjusted EBITDA, the primary metric used in managing the Company, by reporting segment:

 

 

Year Ended December 31, 2025

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Limb Reconstruction

 

 

Total

 

Segment revenues

 

$

687,655

 

 

$

134,657

 

 

$

822,312

 

Less:

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

177,585

 

 

 

53,128

 

 

 

230,713

 

Non-GAAP Sales, general, and administrative

 

 

380,659

 

 

 

75,727

 

 

 

456,386

 

Non-GAAP Research and development

 

 

45,570

 

 

 

11,542

 

 

 

57,112

 

Other segment expenses (benefits)

 

 

10,447

 

 

 

(225

)

 

 

10,222

 

Add:

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

39,200

 

 

 

11,772

 

 

 

50,972

 

Segment Adjusted EBITDA

 

$

112,594

 

 

$

6,257

 

 

$

118,851

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

$

32,987

 

Interest expense, net

 

 

 

 

 

 

 

 

17,488

 

Depreciation and amortization

 

 

 

 

 

 

 

 

77,321

 

Share-based compensation expense

 

 

 

 

 

 

 

 

28,688

 

Foreign exchange impact

 

 

 

 

 

 

 

 

(2,910

)

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

6,093

 

Restructuring costs and impairments related to M6 product lines

 

 

 

 

 

 

 

 

17,305

 

Strategic investments

 

 

 

 

 

 

 

 

4,915

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

(1,140

)

Interest and loss on investments

 

 

 

 

 

 

 

 

(48

)

Litigation and investigation costs

 

 

 

 

 

 

 

 

33,788

 

Employee retention credit

 

 

 

 

 

 

 

 

(4,826

)

Loss before income taxes

 

 

 

 

 

 

 

$

(90,810

)

 

 

 

Year Ended December 31, 2024

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Limb Reconstruction

 

 

Total

 

Segment Revenues

 

$

675,314

 

 

$

124,177

 

 

$

799,491

 

Less:

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

183,064

 

 

 

48,638

 

 

 

231,702

 

Non-GAAP Sales, general, and administrative

 

 

368,817

 

 

 

70,185

 

 

 

439,002

 

Non-GAAP Research and development

 

 

58,262

 

 

 

13,154

 

 

 

71,416

 

Other segment expenses (benefits)

 

 

(22

)

 

 

(54

)

 

 

(76

)

Add:

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

42,193

 

 

 

12,367

 

 

 

54,560

 

Segment Adjusted EBITDA

 

$

107,386

 

 

$

4,621

 

 

$

112,007

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

$

44,591

 

Interest expense, net

 

 

 

 

 

 

 

 

29,631

 

Depreciation and amortization

 

 

 

 

 

 

 

 

60,061

 

Share-based compensation expense

 

 

 

 

 

 

 

 

32,455

 

Foreign exchange impact

 

 

 

 

 

 

 

 

4,395

 

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

14,485

 

Strategic investments

 

 

 

 

 

 

 

 

910

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

19,088

 

Interest and loss on investments

 

 

 

 

 

 

 

 

5,120

 

Litigation and investigation costs

 

 

 

 

 

 

 

 

15,770

 

Succession charges

 

 

 

 

 

 

 

 

9,376

 

Loss before income taxes

 

 

 

 

 

 

 

$

(123,875

)

 

 

 

Year Ended December 31, 2023

 

(U.S. Dollars, in thousands)

 

Global Spine

 

 

Global Limb Reconstruction

 

 

Total

 

Segment Revenues

 

$

631,319

 

 

$

115,322

 

 

$

746,641

 

Less:

 

 

 

 

 

 

 

 

 

Non-GAAP Cost of sales

 

 

166,885

 

 

 

47,928

 

 

 

214,813

 

Non-GAAP Sales, general, and administrative

 

 

355,827

 

 

 

67,815

 

 

 

423,642

 

Non-GAAP Research and development

 

 

56,512

 

 

 

10,726

 

 

 

67,238

 

Other segment expenses (benefits)

 

 

45

 

 

 

(82

)

 

 

(37

)

Add:

 

 

 

 

 

 

 

 

 

Non-GAAP Depreciation, amortization, and share-based compensation expense

 

 

39,065

 

 

 

11,507

 

 

 

50,572

 

Segment Adjusted EBITDA

 

$

91,115

 

 

$

442

 

 

$

91,557

 

 

 

 

 

 

 

 

 

 

 

Reconciling items:

 

 

 

 

 

 

 

 

 

Corporate operating expenses

 

 

 

 

 

 

 

$

45,272

 

Interest expense, net

 

 

 

 

 

 

 

 

8,631

 

Depreciation and amortization

 

 

 

 

 

 

 

 

53,063

 

Share-based compensation expense

 

 

 

 

 

 

 

 

35,707

 

Foreign exchange impact

 

 

 

 

 

 

 

 

(1,581

)

SeaSpine merger-related costs

 

 

 

 

 

 

 

 

36,577

 

Strategic investments

 

 

 

 

 

 

 

 

2,272

 

Acquisition-related fair value adjustments

 

 

 

 

 

 

 

 

33,393

 

Interest and loss on investments

 

 

 

 

 

 

 

 

1,781

 

Litigation and investigation costs

 

 

 

 

 

 

 

 

14,453

 

Succession charges

 

 

 

 

 

 

 

 

1,176

 

Medical device regulation

 

 

 

 

 

 

 

 

9,492

 

Loss before income taxes

 

 

 

 

 

 

 

$

(148,679

)
Schedule of Depreciation and Amortization by Reporting Segment The following table presents depreciation, amortization, and related impairments by reporting segment:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Global Spine

 

$

66,315

 

 

$

49,507

 

 

$

41,213

 

Global Limb Reconstruction

 

 

8,629

 

 

 

7,748

 

 

 

7,158

 

Corporate

 

 

2,377

 

 

 

2,806

 

 

 

4,692

 

Total

 

$

77,321

 

 

$

60,061

 

 

$

53,063

 

 
Summary of Net Sales by Geographic Destination

The table below presents net sales by geographic destination for each reporting segment and for the consolidated Company:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Global Spine

 

 

 

 

 

 

 

 

 

U.S.

 

$

645,139

 

 

$

639,196

 

 

$

591,937

 

International

 

 

42,516

 

 

 

36,118

 

 

 

39,382

 

Total Global Spine

 

 

687,655

 

 

 

675,314

 

 

 

631,319

 

 

 

 

 

 

 

 

 

 

 

Global Limb Reconstruction

 

 

 

 

 

 

 

 

 

U.S.

 

$

38,927

 

 

$

33,620

 

 

$

28,892

 

International

 

 

95,730

 

 

 

90,557

 

 

 

86,430

 

Total Global Limb Reconstruction

 

 

134,657

 

 

 

124,177

 

 

 

115,322

 

 

 

 

 

 

 

 

 

 

 

Consolidated

 

 

 

 

 

 

 

 

 

U.S.

 

$

684,066

 

 

$

672,816

 

 

$

620,829

 

International

 

 

138,246

 

 

 

126,675

 

 

 

125,812

 

Net sales

 

$

822,312

 

 

$

799,491

 

 

$

746,641

 

The following data includes net sales by geographic destination:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

U.S.

 

$

684,066

 

 

$

672,816

 

 

$

620,829

 

Italy

 

 

22,277

 

 

 

21,001

 

 

 

20,060

 

United Kingdom

 

 

13,334

 

 

 

11,183

 

 

 

10,910

 

France

 

 

11,959

 

 

 

13,385

 

 

 

11,096

 

Germany

 

 

9,107

 

 

 

9,004

 

 

 

11,467

 

Brazil

 

 

4,836

 

 

 

5,707

 

 

 

6,452

 

Others

 

 

76,733

 

 

 

66,395

 

 

 

65,827

 

Net sales

 

$

822,312

 

 

$

799,491

 

 

$

746,641

 
Summary of Property, Plant and Equipment, Net of Reporting Segments by Geographic Area

The following data includes property, plant, and equipment, net by geographic area:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

U.S.

 

$

114,483

 

 

$

125,541

 

Italy

 

 

9,893

 

 

 

9,472

 

Germany

 

 

1,360

 

 

 

1,904

 

Others

 

 

3,663

 

 

 

2,887

 

Total

 

$

129,399

 

 

$

139,804

 
v3.25.4
Acquisition-Related Amortization, Impairment and Remeasurement (Tables)
 12 Months Ended
Dec. 31, 2025
Acquisition Related Amortization And Remeasurement [Abstract]  
Components of Acquisition-Related Amortization, Impairment, and Remeasurement

Components of acquisition-related amortization, impairment, and remeasurement for the years ended December 31, 2025, 2024, and 2023, respectively, are as follows:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Changes in fair value of contingent consideration

 

$

(1,140

)

 

$

6,900

 

 

$

(2,700

)

Amortization and impairments of acquired intangibles

 

 

28,409

 

 

 

17,436

 

 

 

17,408

 

Acquired IPR&D

 

 

—

 

 

 

—

 

 

 

49

 

Total

 

$

27,269

 

 

$

24,336

 

 

$

14,757

 
v3.25.4
Share-based compensation (Tables)
 12 Months Ended
Dec. 31, 2025
Share-Based Payment Arrangement [Abstract]  
Schedule of Share-Based Compensation by Line Item in Consolidated Statements of Income The following tables present the detail of share-based compensation expense by line item in the consolidated statements of income as well as by award type, for the years ended December 31, 2025, 2024, and 2023:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Cost of sales

 

$

1,695

 

 

$

2,053

 

 

$

1,901

 

Sales, general, and administrative

 

 

25,418

 

 

 

27,123

 

 

 

29,917

 

Research and development

 

 

1,575

 

 

 

3,279

 

 

 

3,889

 

Total

 

$

28,688

 

 

$

32,455

 

 

$

35,707

 

 

 

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Stock options

 

$

5,245

 

 

$

4,331

 

 

$

6,130

 

Market-based stock options

 

 

2,003

 

 

 

2,118

 

 

 

—

 

Time-based restricted stock awards and stock units

 

 

13,270

 

 

 

18,818

 

 

 

27,290

 

Performance-based / Market-based restricted stock units

 

 

6,353

 

 

 

4,941

 

 

 

227

 

Stock purchase plan

 

 

1,817

 

 

 

2,247

 

 

 

2,060

 

Total

 

$

28,688

 

 

$

32,455

 

 

$

35,707

 
Schedule of Assumptions Used in Determining Fair Value of Stock Options

The fair value of time-based stock options is determined using the Black-Scholes valuation model, with such value recognized as expense over the service period, which is typically three to four years, net of actual forfeitures. A summary of the Company’s assumptions used in determining the fair value of the stock options granted during each of the years ended December 31, 2025, 2024, and 2023, is shown in the following table.

 

 

Year Ended December 31,

 

 

 

2025

 

 

2024

 

 

2023

 

Assumptions:

 

 

 

 

 

 

 

 

 

Expected term (in years)

 

 

4.6

 

 

 

4.5

 

 

 

6.0

 

Expected volatility

 

44.0% – 45.2%

 

 

45.7% – 47.6%

 

 

36.8% – 42.3%

 

Risk free interest rate

 

3.98% – 4.58%

 

 

3.47% – 4.65%

 

 

3.38% – 4.61%

 

Dividend yield

 

 

—

 

 

 

—

 

 

 

—

 

Weighted average grant date fair value

 

$

7.22

 

 

$

5.90

 

 

$

8.43

 
Schedule of Stock Option Plans

A summary of the status of the Company’s time-based stock option plans as of December 31, 2025, and 2024, and changes during the year ended December 31, 2025, is presented below:

(In thousands)

 

Options

 

 

Weighted
Average
Exercise
Price

 

 

Weighted
Average
Remaining
Contractual
Term (Years)

 

Outstanding at December 31, 2024

 

 

3,197

 

 

$

26.15

 

 

 

 

Granted

 

 

1,010

 

 

 

17.00

 

 

 

 

Exercised

 

 

(31

)

 

 

13.23

 

 

 

 

Forfeited or expired

 

 

(405

)

 

 

31.34

 

 

 

 

Outstanding at December 31, 2025

 

 

3,771

 

 

 

23.25

 

 

 

4.6

 

Vested and expected to vest at December 31, 2025

 

 

3,771

 

 

 

23.25

 

 

 

4.5

 

Exercisable at December 31, 2025

 

 

2,280

 

 

 

27.96

 

 

 

3.4

 

 

 

A summary of the status of the Company’s market-based stock option plans as of December 31, 2025, and 2024, and changes during the year ended December 31, 2025, is presented below:

(In thousands)

 

Options

 

 

Weighted
Average
Exercise
Price

 

 

Weighted
Average
Remaining
Contractual
Term (Years)

 

Outstanding at December 31, 2024

 

 

754

 

 

$

13.39

 

 

 

 

Granted

 

 

—

 

 

 

—

 

 

 

 

Exercised

 

 

—

 

 

 

—

 

 

 

 

Forfeited or expired

 

 

—

 

 

 

—

 

 

 

 

Outstanding at December 31, 2025

 

 

754

 

 

 

13.39

 

 

 

5.2

 

Vested and expected to vest at December 31, 2025

 

 

754

 

 

 

13.39

 

 

 

5.2

 

Exercisable at December 31, 2025

 

 

34

 

 

 

12.57

 

 

 

5.5

 
Schedule of Changes in Time-Based and Market-Based Restricted Stock Awards and Stock Units

A summary of the status of our time-based and performance-based and/or market-based restricted stock units as of December 31, 2025, and 2024, and changes during the year ended December 31, 2025, is presented below:

 

 

 

Time-based Restricted Stock
Awards and Stock Units

 

 

Performance-based and/or Market-based
Restricted Stock Units

 

(In thousands)

 

Shares

 

 

Weighted
Average Grant
Date Fair Value

 

 

Shares

 

 

Weighted
Average Grant
Date Fair Value

 

Outstanding at December 31, 2024

 

 

2,015

 

 

$

18.73

 

 

 

960

 

 

$

16.81

 

Granted

 

 

993

 

 

 

15.58

 

 

 

723

 

 

 

16.98

 

Vested and settled

 

 

(872

)

 

 

21.97

 

 

 

(1

)

 

 

44.00

 

Cancelled

 

 

(153

)

 

 

17.38

 

 

 

(35

)

 

 

17.28

 

Outstanding at December 31, 2025

 

 

1,983

 

 

 

15.83

 

 

 

1,647

 

 

 

16.85

 
v3.25.4
Income taxes (Tables)
 12 Months Ended
Dec. 31, 2025
Income Tax Disclosure [Abstract]  
Schedule of Income (Loss) Before Provision for Income Taxes

Income (loss) before provision for income taxes consisted of the following:

 

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

U.S.

 

$

(93,273

)

 

$

(113,197

)

 

$

(154,794

)

Non-U.S.

 

 

2,463

 

 

 

(10,678

)

 

 

6,115

 

Loss before income taxes

 

$

(90,810

)

 

$

(123,875

)

 

$

(148,679

)

 
Schedule of Provision for Income Taxes

The provision for income taxes consists of the following:

 

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

Current tax expense (benefit)

 

 

 

 

 

 

 

 

 

Federal

 

$

298

 

 

$

(815

)

 

$

(79

)

State & local

 

 

236

 

 

 

225

 

 

 

96

 

Foreign

 

 

625

 

 

 

829

 

 

 

2,120

 

Total current expense

 

 

1,159

 

 

 

239

 

 

 

2,137

 

 

 

 

 

 

 

 

 

 

 

Deferred tax expense (benefit)

 

 

 

 

 

 

 

 

 

Federal

 

 

639

 

 

 

1,355

 

 

 

1,008

 

State & local

 

 

134

 

 

 

217

 

 

 

152

 

Foreign

 

 

(550

)

 

 

311

 

 

 

(581

)

Total deferred expense

 

 

223

 

 

 

1,883

 

 

 

579

 

Income tax expense

 

$

1,382

 

 

$

2,122

 

 

$

2,716

 
Schedule of Effective Income Tax Rate Reconciliation for Continuing Operations

The differences between the income tax provision at the U.S. federal statutory tax rate and the Company’s effective tax rate for the years ended December 31, 2025, 2024, and 2023, consist of the following:

 

 

 

2025

 

 

2024

 

 

2023

 

(U.S. Dollars, in thousands, except percentages)

 

Amount

 

 

Percent

 

 

Amount

 

 

Percent

 

 

Amount

 

 

Percent

 

U.S. federal statutory rate

 

$

(19,070

)

 

 

21.0

%

 

$

(26,013

)

 

 

21.0

%

 

$

(31,222

)

 

 

21.0

%

State taxes, net of U.S. federal benefit

 

 

300

 

 

 

(0.3

)

 

 

352

 

 

 

(0.3

)

 

 

210

 

 

 

(0.1

)

Foreign tax effects

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Canada

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Valuation allowance

 

 

933

 

 

 

(1.0

)

 

 

2,282

 

 

 

(1.8

)

 

 

1,877

 

 

 

(1.3

)

Other

 

 

(505

)

 

 

0.6

 

 

 

(754

)

 

 

0.6

 

 

 

(659

)

 

 

0.4

 

Other foreign jurisdictions

 

 

(421

)

 

 

0.5

 

 

 

992

 

 

 

(0.8

)

 

 

108

 

 

 

(0.1

)

Effect of changes in tax laws or rates enacted in the current period

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Effects of cross-border tax laws

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GILTI inclusion, net

 

 

786

 

 

 

(0.9

)

 

 

323

 

 

 

(0.3

)

 

 

2,333

 

 

 

(1.6

)

Income from branches

 

 

(702

)

 

 

0.8

 

 

 

(1,525

)

 

 

1.2

 

 

 

(1,078

)

 

 

0.7

 

Tax credits

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

R&D credit

 

 

64

 

 

 

(0.1

)

 

 

(1,159

)

 

 

0.9

 

 

 

(1,268

)

 

 

0.9

 

Changes in valuation allowance

 

 

14,452

 

 

 

(15.9

)

 

 

23,478

 

 

 

(19.0

)

 

 

21,675

 

 

 

(14.6

)

Nontaxable or nondeductible items

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Merger related deal costs

 

 

—

 

 

 

—

 

 

 

—

 

 

 

—

 

 

 

2,547

 

 

 

(1.7

)

Equity compensation

 

 

1,629

 

 

 

(1.8

)

 

 

2,781

 

 

 

(2.2

)

 

 

4,210

 

 

 

(2.8

)

Executive compensation

 

 

3,470

 

 

 

(3.8

)

 

 

2,001

 

 

 

(1.6

)

 

 

3,030

 

 

 

(2.0

)

Other

 

 

417

 

 

 

(0.6

)

 

 

757

 

 

 

(0.5

)

 

 

882

 

 

 

(0.6

)

Changes in unrecognized tax benefits

 

 

29

 

 

 

—

 

 

 

(1,393

)

 

 

1.1

 

 

 

71

 

 

 

—

 

Income tax expense/effective rate

 

$

1,382

 

 

 

(1.5

)%

 

$

2,122

 

 

 

(1.7

)%

 

$

2,716

 

 

 

(1.8

)%

 
Schedule of Deferred Tax Assets and Liabilities

The Company’s deferred tax assets and liabilities are as follows:

 

 

December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Intangible assets and goodwill

 

$

1,331

 

 

$

—

 

Inventories and related reserves

 

 

34,168

 

 

 

34,745

 

Deferred revenue and cost of goods sold

 

 

5,978

 

 

 

5,775

 

Other accruals and reserves

 

 

6,744

 

 

 

5,738

 

Accrued compensation

 

 

15,815

 

 

 

17,216

 

Provision for expected credit losses

 

 

1,897

 

 

 

1,797

 

Accrued interest

 

 

7,864

 

 

 

6,336

 

Net operating loss and tax credit carryforwards

 

 

152,068

 

 

 

132,524

 

Research and development capitalization

 

 

11,127

 

 

 

18,016

 

Lease liabilities

 

 

11,202

 

 

 

8,856

 

Other, net

 

 

6,435

 

 

 

8,456

 

Total deferred tax assets

 

 

254,629

 

 

 

239,459

 

Valuation allowance

 

 

(247,738

)

 

 

(228,724

)

Deferred tax asset, net of valuation allowance

 

$

6,891

 

 

$

10,735

 

Intangible assets and goodwill

 

$

—

 

 

$

(3,557

)

Withholding taxes

 

 

(10

)

 

 

(10

)

Property, plant, and equipment

 

 

(1,359

)

 

 

(3,390

)

Right-of-use lease assets

 

 

(9,729

)

 

 

(7,875

)

Deferred tax liability

 

$

(11,098

)

 

$

(14,832

)

Net deferred tax liabilities

 

$

(4,207

)

 

$

(4,097

)

 

 

 

 

 

 

 

Reported as:

 

 

 

 

 

 

Deferred income tax assets (classified within other long-term assets)

 

$

1,876

 

 

$

1,542

 

Deferred income tax liabilities (classified within other long-term liabilities)

 

 

(6,083

)

 

 

(5,639

)

Net deferred tax liabilities

 

$

(4,207

)

 

$

(4,097

)
Schedule of Gross Unrecognized Tax Benefits (Excluding Interest and Penalties)

A reconciliation of the gross unrecognized tax benefits (excluding interest and penalties) for the years ended December 31, 2025, and 2024, is shown below:

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

Balance as of January 1,

 

$

1,723

 

 

$

2,974

 

Additions for current year tax positions

 

 

18

 

 

 

40

 

Increases (decreases) for prior year tax positions

 

 

(23

)

 

 

42

 

Settlements of prior year tax positions

 

 

—

 

 

 

—

 

Expiration of statutes

 

 

(53

)

 

 

(1,333

)

Balance as of December 31,

 

$

1,665

 

 

$

1,723

 
Summary of Paid (Received or Was Refunded) Cash Relating to Income Taxes

The Company paid (received or was refunded) cash relating to income taxes totaling $1.6 million, $1.3 million, and $0.9 million for the years ended December 31, 2025, 2024, and 2023, respectively as follows:

 

 

Year Ended December 31,

 

(U.S. Dollars, in thousands)

 

2025

 

 

2024

 

 

2023

 

U.S. federal

 

$

2

 

 

$

(154

)

 

$

(640

)

State

 

 

 

 

 

 

 

 

 

California

 

*

 

 

 

(90

)

 

*

 

Massachusetts

 

*

 

 

*

 

 

 

49

 

Texas

 

 

131

 

 

 

85

 

 

 

119

 

All others

 

 

297

 

 

 

197

 

 

 

316

 

Total State

 

 

428

 

 

 

192

 

 

 

484

 

Foreign

 

 

 

 

 

 

 

 

 

Australia

 

 

186

 

 

 

141

 

 

*

 

Brazil

 

*

 

 

 

82

 

 

 

93

 

France

 

 

330

 

 

 

433

 

 

 

521

 

Germany

 

 

171

 

 

*

 

 

 

(164

)

Italy

 

*

 

 

 

85

 

 

 

431

 

Netherlands

 

 

185

 

 

 

236

 

 

 

249

 

Switzerland

 

 

132

 

 

 

102

 

 

*

 

United Kingdom

 

 

101

 

 

 

128

 

 

 

(82

)

All others

 

 

48

 

 

 

56

 

 

 

(12

)

Total Foreign

 

 

1,153

 

 

 

1,263

 

 

 

1,036

 

Total

 

$

1,583

 

 

$

1,301

 

 

$

880

 

* The amount of income taxes paid during the year does not meet the 5% disaggregation threshold.
v3.25.4
Earnings per share (EPS) (Tables)
 12 Months Ended
Dec. 31, 2025
Earnings Per Share [Abstract]  
Schedule of Reconciliation of Weighted Average Shares Used in the Diluted EPS The following is a reconciliation of the weighted average shares used in the diluted EPS computations:

 

 

Year Ended December 31,

 

(In thousands)

 

2025

 

 

2024

 

 

2023

 

Weighted average common shares-basic

 

 

39,602

 

 

 

38,134

 

 

 

36,729

 

Effect of diluted securities:

 

 

 

 

 

 

 

 

 

Unexercised stock options and employee stock purchase plan

 

 

—

 

 

 

—

 

 

 

—

 

Unvested time-based restricted stock units

 

 

—

 

 

 

—

 

 

 

—

 

Weighted average common shares-diluted

 

 

39,602

 

 

 

38,134

 

 

 

36,729

 

 
v3.25.4
Significant Accounting Policies - Additional Information (Detail) - USD ($)
 1 Months Ended 12 Months Ended
Mar. 31, 2024
Nov. 30, 2023
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Apr. 30, 2025
Summary Of Significant Accounting Policies [Line Items]            
Banking service obligation $ 2,500,000 $ 4,700,000        
Musculoskeletal Transplant Foundation ("MTF") [Member]            
Summary Of Significant Accounting Policies [Line Items]            
Expenditures for other research and development     $ 300,000 $ 300,000 $ 800,000  
Maximum [Member]            
Summary Of Significant Accounting Policies [Line Items]            
Transactional foreign currency gains and (losses), including those generated from intercompany operations     $ 2,900,000 $ (4,400,000) $ 1,600,000  
Letter of Credit [Member]            
Summary Of Significant Accounting Policies [Line Items]            
Line of Credit, Current           $ 600,000
v3.25.4
Significant accounting policies - Schedule of Supplemental Disclosure of Cash Flow Information (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Noncash investing activities:    
Changes in accrued capital expenditures $ 5,278 $ (3,040)
Intangible assets acquired in asset acquisitions $ 40  
v3.25.4
Recently Adopted Accounting Standards and Recently Issued Accounting Pronouncements - Additional Information (Detail)
Dec. 31, 2025
ASU 2020-04 [Member]  
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]  
Change in Accounting Principle, Accounting Standards Update, Adopted [true false] true
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false] true
ASU 2019-12 [Member]  
New Accounting Pronouncements Or Change In Accounting Principle [Line Items]  
Change in Accounting Principle, Accounting Standards Update, Adopted [true false] true
Change in Accounting Principle, Accounting Standards Update, Immaterial Effect [true false] true
v3.25.4
Mergers, acquisitions, and the discontinuation of the M6 product lines - Additional Information (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Business Acquisition [Line Items]      
Net sales $ 822,312 $ 799,491 $ 746,641
Net loss (92,192) (125,997) (151,395)
Pre tax expenses   9,376 1,176
Global Spine [Member]      
Business Acquisition [Line Items]      
Net sales 687,655 $ 675,314 $ 631,319
SeaSpine Holdings Corporation [Member]      
Business Acquisition [Line Items]      
Business Combination, Consideration Transferred, Total $ 376,700    
v3.25.4
Mergers, acquisitions, and the discontinuation of the M6 product lines - Summary of Fair Values of Assets Acquired and Liabilities Assumed (Detail) - USD ($)
$ in Thousands
Jan. 05, 2023
Dec. 31, 2025
Dec. 31, 2024
Current liabilities      
Residual goodwill   $ 194,934 $ 194,934
Assigned Useful Life   9 years 9 months 18 days  
Customer Relationships [Member]      
Current liabilities      
Assigned Useful Life   12 years 9 months 18 days  
Developed Technology [Member]      
Current liabilities      
Assigned Useful Life   7 years 1 month 6 days  
SeaSpine Holdings Corporation [Member]      
Current assets      
Cash and cash equivalents $ 29,419    
Accounts receivable, net 35,313    
Inventories 132,636    
Prepaid expenses and other current assets 4,590    
Total current assets 201,958    
Property, plant, and equipment, net 68,863    
Other long-term assets 20,501    
Total identifiable assets acquired 377,372    
Current liabilities      
Accounts payable 21,602    
Other current liabilities 43,521    
Total current liabilities 65,123    
Long-term borrowings under SeaSpine credit facility 26,298    
Other long-term liabilities 32,823    
Total liabilities assumed 124,244    
Net identifiable assets acquired 253,128    
Total fair value of consideration transferred 376,745    
Residual goodwill 123,617    
SeaSpine Holdings Corporation [Member] | Customer Relationships [Member]      
Current assets      
Finite lived intangible assets, net acquired $ 33,100    
Current liabilities      
Assigned Useful Life 13 years    
SeaSpine Holdings Corporation [Member] | Developed Technology [Member]      
Current assets      
Finite lived intangible assets, net acquired $ 47,200    
SeaSpine Holdings Corporation [Member] | Developed Technology [Member] | Minimum [Member]      
Current liabilities      
Assigned Useful Life 6 years    
SeaSpine Holdings Corporation [Member] | Developed Technology [Member] | Maximum [Member]      
Current liabilities      
Assigned Useful Life 8 years    
SeaSpine Holdings Corporation [Member] | In Process Research and Development [Member]      
Current assets      
Finite lived intangible assets, net acquired $ 5,750    
Current liabilities      
Assigned Useful Life Indefinite    
v3.25.4
Mergers, acquisitions, and the discontinuation of the M6 product lines - Summary of Impairment Charges (Details)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Business Combination [Line Items]  
Loss on M6 inventories and long-lived assets $ 31,793
M6 Product Line [Member] | Cost of Sales [Member]  
Business Combination [Line Items]  
Inventory reserve charges 10,862
M6 Product Line [Member] | Operating Expense [Member]  
Business Combination [Line Items]  
Impairment of property, plant, and equipment 6,834
M6 Product Line [Member] | Acquisition Related Amortization Impairment And Remeasurement [Member]  
Business Combination [Line Items]  
Impairment of developed technology intangible asset $ 14,097
v3.25.4
Inventories - Schedule of Inventories (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Inventory Disclosure [Abstract]    
Raw materials $ 22,865 $ 27,180
Work-in-process 63,255 56,920
Finished products 86,199 105,352
Inventories $ 172,319 $ 189,452
v3.25.4
Property, Plant and Equipment - Schedule of Useful Lives of the Assets (Detail)
Dec. 31, 2025
Minimum [Member] | Buildings [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 25 years
Minimum [Member] | Plant and equipment [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 1 year
Minimum [Member] | Instrumentation [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 3 years
Minimum [Member] | Computer software [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 3 years
Minimum [Member] | Furniture and fixtures [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 4 years
Maximum [Member] | Buildings [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 33 years
Maximum [Member] | Plant and equipment [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 10 years
Maximum [Member] | Instrumentation [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 4 years
Maximum [Member] | Computer software [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 7 years
Maximum [Member] | Furniture and fixtures [Member]  
Property Plant And Equipment [Line Items]  
Useful life, in years 8 years
v3.25.4
Property, Plant and Equipment - Additional Information (Detail) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Property Plant And Equipment [Line Items]      
Depreciation expense $ 47.3 $ 41.1 $ 34.2
Internal-use Software [Member] | Minimum [Member]      
Property Plant And Equipment [Line Items]      
Estimated useful life 3 years    
Internal-use Software [Member] | Maximum [Member]      
Property Plant And Equipment [Line Items]      
Estimated useful life 7 years    
v3.25.4
Property, Plant and Equipment - Schedule of Property, Plant and Equipment (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross $ 380,136 $ 352,046
Accumulated depreciation (250,737) (212,242)
Property, plant, and equipment, net 129,399 139,804
Buildings [Member]    
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross 4,400 3,874
Plant and equipment [Member]    
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross 82,738 76,481
Instrumentation [Member]    
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross 192,407 176,387
Computer software [Member]    
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross 44,888 41,396
Furniture and fixtures [Member]    
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross 11,062 9,832
Construction in progress [Member]    
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross 23,235 22,693
Finance lease assets [Member]    
Property Plant And Equipment [Line Items]    
Property, plant, and equipment, gross $ 21,406 $ 21,383
v3.25.4
Intangible Assets - Schedule of Intangible Assets (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Finite And Indefinite Lived Intangible Assets [Line Items]    
Cost $ 218,466 $ 204,370
Accumulated amortization (145,701) (105,567)
Intangible assets, net $ 72,765 98,803
Weighted Average Amortization Period 9 years 9 months 18 days  
Patents [Member]    
Finite And Indefinite Lived Intangible Assets [Line Items]    
Cost $ 49,510 38,329
Accumulated amortization $ (45,645) (35,918)
Weighted Average Amortization Period 10 years  
Developed Technology [Member]    
Finite And Indefinite Lived Intangible Assets [Line Items]    
Cost $ 96,364 92,686
Accumulated amortization $ (64,357) (40,813)
Weighted Average Amortization Period 7 years 1 month 6 days  
Customer Relationships [Member]    
Finite And Indefinite Lived Intangible Assets [Line Items]    
Cost $ 49,249 49,145
Accumulated amortization $ (21,221) (17,044)
Weighted Average Amortization Period 12 years 9 months 18 days  
Licenses and Other [Member]    
Finite And Indefinite Lived Intangible Assets [Line Items]    
Cost $ 20,331 18,359
Accumulated amortization $ (13,352) (10,892)
Weighted Average Amortization Period 9 years 10 months 24 days  
Trademarks-Finite Lived [Member]    
Finite And Indefinite Lived Intangible Assets [Line Items]    
Cost $ 1,989 1,735
Accumulated amortization $ (1,126) (900)
Weighted Average Amortization Period 10 years  
In-Process Research and Development ("IPR&D") [Member]    
Finite And Indefinite Lived Intangible Assets [Line Items]    
Cost $ 1,023 $ 4,116
Weighted Average Amortization Period Indefinite  
v3.25.4
Intangible Assets - Additional Information (Detail) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Finite And Indefinite Lived Intangible Assets [Abstract]      
Amortization of intangible assets $ 30.0 $ 19.0 $ 18.9
v3.25.4
Intangible Assets - Schedule of Future Amortization Expense (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Goodwill and Intangible Assets Disclosure [Abstract]    
2025 $ 15,175  
2026 14,790  
2027 12,063  
2028 7,660  
2029 7,501  
Thereafter 14,553  
Total finite-lived intangible assets, net 71,742  
Indefinite-lived intangible assets 1,023  
Intangible assets, net $ 72,765 $ 98,803
v3.25.4
Goodwill - Additional Information (Detail) - USD ($)
 3 Months Ended 12 Months Ended
Sep. 30, 2023
Dec. 31, 2025
Goodwill [Line Items]    
Percentage of market capitalization decreased due to termination 30.00%  
Global Spine [Member]    
Goodwill [Line Items]    
Impairment of goodwill   $ 0
v3.25.4
Goodwill - Schedule of Net Carrying Amount of Goodwill (Detail)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
USD ($)
Goodwill [Line Items]  
Goodwill, net Beginning Balance $ 194,934
Goodwill, net Ending Balance 194,934
Global Spine [Member]  
Goodwill [Line Items]  
Goodwill, gross Beginning balance 194,934
Goodwill, gross Ending balance 194,934
Goodwill, net Beginning Balance 194,934
Goodwill, net Ending Balance 194,934
Global Limb Reconstruction [Member]  
Goodwill [Line Items]  
Goodwill, gross Beginning balance 10,765
Goodwill gross, Currency translation adjustment 1,447
Goodwill, gross Ending balance 12,212
Accumulated impairment loss Beginning balance (10,765)
Accumulated impairment loss, Currency translation adjustment (1,447)
Accumulated impairment loss Ending balance $ (12,212)
v3.25.4
Leases - Summary of Lease Portfolio (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Assets    
Operating leases $ 22,279 $ 17,238
Operating lease, right-of-use asset, statement of financial position [Extensible List] Other long-term assets Other long-term assets
Finance leases $ 14,442 $ 15,386
Finance lease, right-of-use asset, statement of financial position [Extensible List] Property, plant and equipment net Property, plant and equipment net
Total lease assets $ 36,721 $ 32,624
Current    
Operating leases $ 3,147 $ 4,023
Operating lease, liability, current, statement of financial position [Extensible List] Other current liabilities Other current liabilities
Finance leases $ 837 $ 755
Long-term    
Operating leases $ 25,413 $ 14,084
Operating lease, liability, noncurrent, statement of financial position [Extensible List] Other long-term liabilities Other long-term liabilities
Finance leases $ 17,060 $ 17,835
Total lease liabilities $ 46,457 $ 36,697
Weighted Average Remaining Lease Term    
Operating leases 8 years 9 months 18 days 5 years 4 months 24 days
Finance leases 14 years 7 months 6 days 15 years 7 months 6 days
Weighted Average Discount Rate    
Operating leases 9.90% 7.60%
Finance leases 4.40% 4.40%
v3.25.4
Leases - Summary of Components of Lease Costs (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Finance lease costs:      
Amortization of right-of-use assets $ 1,014 $ 1,014 $ 1,013
Interest on finance lease liabilities 805 832 857
Operating lease costs 6,027 5,257 5,015
Short-term lease costs 29 249 313
Variable lease costs 1,753 1,796 1,883
Total lease costs $ 9,628 $ 9,148 $ 9,081
v3.25.4
Leases - Summary of Supplemental Cash Flow Information Related to Leases (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Cash paid for amounts included in the measurement of lease liabilities      
Operating cash flows from operating leases $ 8,801 $ 8,917 $ 7,682
Operating cash flows from finance leases 801 831 857
Financing cash flows from finance leases 762 706 652
Right-of-use assets obtained in exchange for lease obligations      
Operating leases 12,261 1,449 $ 16,688
Finance leases $ 70 $ 55  
v3.25.4
Leases - Summary of Remaining Lease Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Operating Leases    
2026 $ 5,426  
2027 4,382  
2028 4,438  
2029 4,229  
2030 4,180  
Thereafter 23,687  
Total undiscounted value of lease liabilities 46,342  
Less: Interest (17,782)  
Present value of lease liabilities 28,560  
Current portion of lease liabilities 3,147 $ 4,023
Long-term portion of lease liabilities 25,413 14,084
Total lease liabilities 28,560  
Finance Leases    
2026 1,607  
2027 1,626  
2028 1,654  
2029 1,672  
2030 1,685  
Thereafter 16,063  
Total undiscounted value of lease liabilities 24,307  
Less: Interest (6,410)  
Present value of lease liabilities 17,897 17,897
Current portion of finance lease liability 837 755
Long-term portion of finance lease liability 17,060 17,835
Total lease liabilities $ 17,897 $ 17,897
v3.25.4
Other Current Liabilities - Summary of Other Current Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Payables and Accruals [Abstract]    
Accrued expenses $ 9,857 $ 11,391
Salaries, bonuses, employee commissions, severance, and related taxes payable 27,026 43,899
Accrued distributor commissions 23,542 23,064
Accrued litigation and investigation costs 30,561 11,891
Short-term operating lease liability 3,147 4,023
Non-income taxes payable 3,609 8,414
Short-term contingent consideration liability 4,290 7,100
Other payables 9,221 9,288
Other current liabilities $ 111,253 $ 119,070
v3.25.4
Indebtedness - Summary of Carrying Values of Outstanding Debt Obligations (Details) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Debt Instrument [Line Items]    
Current portion of long-term debt $ 0 $ 0
Long-term debt 157,391 157,015
Outstanding Term Loans [Member]    
Debt Instrument [Line Items]    
Principal amount outstanding 160,000 160,000
Unamortized original debt discount (1,839) (2,327)
Unamortized debt issuance costs and lenders fees (770) (658)
Total indebtedness from outstanding term loans 157,391 157,015
Revolving Credit Facility [Member]    
Debt Instrument [Line Items]    
Total indebtedness from outstanding term loans $ 157,391 $ 157,015
v3.25.4
Indebtedness- Additional Information (Detail)
 12 Months Ended
Nov. 06, 2023
USD ($)
Dec. 31, 2025
USD ($)
Nov. 07, 2025
Dec. 31, 2024
USD ($)
Dec. 31, 2023
USD ($)
Jan. 15, 2026
USD ($)
Nov. 07, 2024
USD ($)
Sep. 30, 2024
EUR (€)
Jan. 10, 2024
USD ($)
Debt Instrument [Line Items]                  
Borrowings             $ 125,000,000    
Repayment of borrowings       $ 142,500,000 $ 79,000,000        
Debt issuance costs paid   $ 531,000   3,630,000 2,357,000        
Cash paid to interest   17,300,000   16,900,000 5,800,000        
Italy [Member]                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity   6,500,000   5,700,000       € 5,500,000  
Credit Facility [Member]                  
Debt Instrument [Line Items]                  
Debt issuance costs, net of accumulated amortization   1,300,000   1,100,000          
Debt issuance costs amortized or expensed   $ 300,000   4,400,000 $ 1,300,000        
Financing Agreement [Member] | Revolving Credit Facility [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Borrowings       $ 0          
Prior Financing Agreement [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Line of credit facility interest rate description         Borrowings under the Blue Torch Credit Facilities bore interest at a floating rate, which was, at the Company’s option, either the three-month SOFR rate (subject to a floor of 3.00% and a credit spread adjustment of 0.26161%) (the "Adjusted Term SOFR Rate") plus an applicable margin of 7.25%, or a base rate plus an applicable margin of 6.25%.        
Prior Financing Agreement [Member] | Base Rate [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Interest rate 6.25%                
Prior Financing Agreement [Member] | Floor Rate [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Interest rate 3.00%                
Prior Financing Agreement [Member] | Credit Spread Adjustment [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Interest rate 0.26161%                
Prior Financing Agreement [Member] | Adjusted Term SOFR Rate [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Interest rate 7.25%                
Prior Financing Agreement [Member] | Revolving Credit Facility [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity $ 25,000,000                
Maturity date Nov. 06, 2027                
Borrowings                 $ 15,000,000
Repayment of borrowings $ 175,000,000                
Percentage of unused line fee payable 2.00%                
Prior Financing Agreement [Member] | Initial Term Loan [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity $ 100,000,000                
Maturity date Nov. 06, 2027                
Prior Financing Agreement [Member] | Senior Secured Delayed Draw Term Loan [Member] | Blue Torch Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity $ 25,000,000                
Maturity date Nov. 06, 2027                
Percentage of unused line fee payable 1.00%                
New Credit Agreement [Member]                  
Debt Instrument [Line Items]                  
Debt issuance costs             1,700,000    
New Credit Agreement [Member] | Minimum [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Unrestricted Cash             45,000,000    
New Credit Agreement [Member] | Secured Credit Agreement [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity             275,000,000    
Debt Instrument Maturity Period     2029-11            
New Credit Agreement [Member] | Initial Term Loan [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity             160,000,000    
Debt Instrument Maturity Period     2029-11            
New Credit Agreement [Member] | Initial Term Loan [Member] | Minimum [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Unrestricted Cash             15,000,000    
New Credit Agreement [Member] | Term C Loan [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Debt Instrument Maturity Period     2029-11            
Additional borrowing capacity             50,000,000    
New Credit Agreement [Member] | Credit Facility [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Unused Line Fee Percentage     0.50%            
Facility Fee Percentage     1.50%            
Debt Instrument, Frequency of Periodic Payment   annually              
Interest rate     5.75%            
Line of credit facility interest rate description   Borrowings under the Credit Facilities bear interest at a percentage rate equal to the greater of 8.75% or 5.75% plus the one-month term SOFR rate. A facility fee equal to 1.5% of each applicable funded loan tranche is due at the time of funding of such respective tranche, and a 0.5% unused line fee is payable annually on the Term B Loan.              
New Credit Agreement [Member] | Credit Facility [Member] | Minimum [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Interest rate     8.75%            
New Credit Agreement [Member] | Senior Secured Delayed Draw Term Loan [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Maximum borrowing capacity             $ 65,000,000    
Debt Instrument Maturity Period     2029-11            
Line of credit facility interest rate description   Draws under the Term B Loan are at the Company’s option from January 1, 2025 through June 30, 2026, subject to, among other conditions, the Company’s continued compliance with a pro-forma total debt-to-EBITDA leverage ratio of less than 4.0x. EBITDA, as defined in the Credit Agreement, is a non-GAAP financial measure which represents earnings before interest income (expense), income taxes, depreciation, amortization, and other negotiated addbacks and adjustments. In addition, at Oxford's discretion, an additional $50.0 million of draw capacity is available through January 1, 2029 (the "Term C Loan" and, together with the Term B Loan, the "Delayed Draw Term Loans" and collectively with the Initial Term Loan, the "Credit Facilities"). The Initial Term Loan and Delayed Draw Term Loans, to the extent ultimately drawn, will each mature in November 2029, following an interest-only payment period ending December 2028, and monthly amortization of principal and accrued interest between January 2029 and November 2029.              
New Credit Agreement [Member] | Senior Secured Delayed Draw Term Loan [Member] | Subsequent Event [Member] | Oxford Finance LLC [Member]                  
Debt Instrument [Line Items]                  
Borrowings           $ 65,000,000      
v3.25.4
Fair Value Measurements and Investments - Schedule of Financial Assets and Liabilities Recorded at Fair Value on Recurring Basis (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Lattus [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Contingent consideration $ (7,900)  
Fair Value, Measurements, Recurring [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Assets fair value 0 $ 0
Deferred compensation plan, Liabilities (1,720) (1,703)
Liabilities fair value, Total (9,650) (17,103)
Fair Value, Measurements, Recurring [Member] | Lattus [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Liabilities fair value, Total (7,930) (15,400)
Fair Value, Measurements, Recurring [Member] | Convertible Loan Agreements [Member] | Neo Medical [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Assets fair value 0 0
Fair Value, Measurements, Recurring [Member] | Preferred Equity Securities [Member] | Neo Medical [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Assets fair value 0 0
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Assets fair value 0 0
Deferred compensation plan, Liabilities (1,720) (1,703)
Liabilities fair value, Total (1,720) (1,703)
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Preferred Equity Securities [Member] | Neo Medical [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Assets fair value 0 0
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 3 [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Assets fair value 0 0
Liabilities fair value, Total (7,930) (15,400)
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 3 [Member] | Lattus [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Liabilities fair value, Total (7,930) (15,400)
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 3 [Member] | Convertible Loan Agreements [Member] | Neo Medical [Member]    
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]    
Assets fair value $ 0 $ 0
v3.25.4
Fair Value Measurements and Investments - Additional Information (Detail) - Neo Medical [Member]
$ in Thousands, SFr in Millions
 12 Months Ended
Nov. 14, 2024
USD ($)
Nov. 14, 2024
CHF (SFr)
Oct. 01, 2020
USD ($)
Oct. 01, 2020
CHF (SFr)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]            
Sale of preferred equity securities $ 7,400 SFr 6.6 $ 5,000 SFr 4.6 $ (0) $ (7,396)
Realized loss recognized in other expense, net $ 5,800       $ 0 $ (5,779)
Preferred Stock [Member]            
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]            
Amount of Preferred stock consideration     $ 5,000      
v3.25.4
Fair Value Measurements and Investments - Schedule of Reconciliation of Carrying Value of Investments in Equity Securities (Detail) - Neo Medical [Member]
$ in Thousands, SFr in Millions
 12 Months Ended
Nov. 14, 2024
CHF (SFr)
Nov. 14, 2024
USD ($)
Oct. 01, 2020
CHF (SFr)
Oct. 01, 2020
USD ($)
Dec. 31, 2025
USD ($)
Dec. 31, 2024
USD ($)
Fair Value Assets Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]            
Fair value of equity securities beginning balance         $ 0 $ 4,951
Conversion of loan into preferred equity securities         0 8,224
Sale of preferred equity securities SFr 6.6 $ 7,400 SFr 4.6 $ 5,000 (0) (7,396)
Realized loss recognized in other expense, net   $ 5,800     0 (5,779)
Fair value of equity securities Ending balance         0 0
Cumulative unrealized gain (loss) on Neo Medical preferred equity securities         $ 0 $ 0
v3.25.4
Fair Value Measurements and Investments - Schedule of Reconciliation For Contingent Consideration Measured At Fair Value Using Significant Unobservable Inputs (Level 3) (Detail) - Neo Medical [Member] - Fair Value, Inputs, Level 3 [Member] - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]    
Fair value of convertible loans beginning balance $ 0 $ 6,760
Gains (losses) recognized in other comprehensive income (loss) (0) 1,671
Interest recognized in interest income, net 0 162
Foreign currency remeasurement recognized in other income (expense), net (0) (629)
Expected credit loss recognized in other income (expense), net (0) 260
Conversion into preferred equity securities (0) (8,224)
Fair value of convertible loans ending balance $ 0 $ 0
v3.25.4
Fair Value Measurements and Investments - Schedule of Valuation Methodology and Unobservable Inputs for Level 3 Assets and Liabilities Measured at Fair Value (Detail) - Lattus Spine [Member] - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]    
Consideration transferred $ 7,930  
Minimum [Member]    
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]    
Counterparty discount rate 11.80%  
Revenue risk-adjusted discount rate 5.70%  
Maximum [Member]    
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]    
Counterparty discount rate 12.00%  
Revenue risk-adjusted discount rate 5.90%  
Fair Value, Inputs, Level 3 [Member]    
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]    
Contingent consideration estimated fair value $ 15,400 $ 8,500
Change in fair value recognized in acquisition-related amortization and remeasurement (1,140) 6,900
Installment payment (6,330)  
Contingent consideration estimated fair value at December 31 $ 7,930 $ 15,400
v3.25.4
Commitments and Contingencies - Additional Information (Detail) - USD ($)
shares in Millions, $ in Millions
 1 Months Ended 12 Months Ended
Jan. 26, 2026
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Other Commitments [Line Items]        
Accrued other long-term liabilities   $ 10.6    
Estimated sales, general, and administrative expense (benefit)   $ 1.4 $ 1.4 $ 1.3
Subsequent Event [Member]        
Other Commitments [Line Items]        
Contract damages $ 11.8      
Accrued interest 2.7      
Accrual amount of severance and equity based rights $ 18.3      
SeaSpine [Member]        
Other Commitments [Line Items]        
Number of shares issued under acquisition   0.3    
v3.25.4
Shareholders' Equity - Components of Changes in Accumulated Other Comprehensive Income (Loss) (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Accumulated Other Comprehensive Income Loss [Line Items]      
Beginning Balance $ 503,124 $ 598,730 $ 336,860
Ending Balance 450,037 503,124 598,730
Other Investments [Member]      
Accumulated Other Comprehensive Income Loss [Line Items]      
Beginning Balance     101
Other comprehensive income (loss)     (101)
Convertible Loan [Member] | Neo Medical [Member]      
Accumulated Other Comprehensive Income Loss [Line Items]      
Beginning Balance (228) (228) 1,005
Other comprehensive income (loss)   1,671 (1,233)
Other expense, net   (1,671)  
Ending Balance (228) (228) (228)
Currency Translation Adjustments [Member]      
Accumulated Other Comprehensive Income Loss [Line Items]      
Beginning Balance (4,074) (1,065) (2,482)
Other comprehensive income (loss) 4,920 (3,009) 1,417
Income taxes 0 0 0
Other expense, net   0  
Ending Balance 846 (4,074) (1,065)
Accumulated Other Comprehensive Income (Loss) [Member]      
Accumulated Other Comprehensive Income Loss [Line Items]      
Beginning Balance (4,302) (1,293) (1,376)
Other comprehensive income (loss) 4,920 (1,338) 83
Other expense, net   (1,671)  
Ending Balance $ 618 $ (4,302) $ (1,293)
v3.25.4
Revenue Recognition and Accounts Receivable - Schedule of Net Sales (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Revenue Recognition [Abstract]      
Product sales $ 775,396 $ 747,783 $ 693,345
Marketing service fees 46,916 51,708 53,296
Net sales $ 822,312 $ 799,491 $ 746,641
v3.25.4
Revenue Recognition and Accounts Receivable - Additional Information (Detail)
$ in Thousands, € in Millions
 12 Months Ended
Dec. 31, 2025
USD ($)
Dec. 31, 2025
EUR (€)
Dec. 31, 2024
USD ($)
Dec. 31, 2024
EUR (€)
Dec. 31, 2023
USD ($)
Dec. 31, 2023
EUR (€)
Revenue Recognition And Accounts Receivable [Line Items]            
Marketing service fees $ 46,916   $ 51,708   $ 53,296  
Cost of sales 256,295   253,606   260,368  
Sale of receivables 10,300 € 8.9 8,500 € 7.9 10,000 € 9.2
Related fees recorded as interest expense 200   300   400  
Shipping and Handling Costs [Member]            
Revenue Recognition And Accounts Receivable [Line Items]            
Cost of sales 8,900   $ 9,900   $ 9,500  
Biologics [Member]            
Revenue Recognition And Accounts Receivable [Line Items]            
Marketing service fees $ 46,900          
Marketing service fee as percentage of segment revenues 30.00% 30.00%        
v3.25.4
Revenue Recognition and Accounts Receivable - Schedule of Allowance for Expected Credit Losses (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Accounts, Notes, Loans and Financing Receivable [Line Items]    
Allowance for expected credit losses beginning balance $ 7,418 $ 7,130
Current period provision for expected credit losses 2,255 1,999
Write-offs charged against the allowance and other (1,764) (1,451)
Effect of changes in foreign exchange rates 399 (260)
Allowance for expected credit losses ending balance $ 8,308 $ 7,418
v3.25.4
Business Segment Information - Additional Information (Detail)
 12 Months Ended
Dec. 31, 2025
Segment
Segment Reporting [Abstract]  
Number of reporting segments 2
Segment Reporting, CODM, Individual Title and Position or Group Name [Extensible Enumeration] srt:ChiefExecutiveOfficerMember, srt:PresidentMember
Segment Reporting, CODM, Profit (Loss) Measure, How Used, Description The primary metric used by the CODM in managing the Company is adjusted earnings before interest, tax, depreciation, and amortization ("adjusted EBITDA", a non-GAAP financial measure). Adjusted EBITDA represents earnings before interest income (expense), income taxes, depreciation and amortization, and excludes the impact of share-based compensation, gains and losses related to changes in foreign exchange rates, charges related to the SeaSpine Merger and other strategic investments, restructuring costs and impairments related to the discontinuation of the M6 product lines, acquisition-related fair value adjustments, gains and/or losses on investments, litigation and investigation charges, succession charges, charges related to initial compliance with regulations set forth by the European Union Medical Device Regulation, and refunds associated with the employee retention credit established by the Coronavirus Aid, Relief, and Economic Security Act.
v3.25.4
Business Segment Information - Schedule of Net Sales by Major Product Category by Reporting Segment (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Segment Reporting Information [Line Items]      
Net Sales $ 822,312 $ 799,491 $ 746,641
Percent of Total Net Sales 100.00% 100.00% 100.00%
Bone Growth Therapies [Member]      
Segment Reporting Information [Line Items]      
Net Sales $ 247,164 $ 233,405 $ 212,530
Percent of Total Net Sales 30.00% 29.20% 28.50%
Spinal Implants, Biologics, and Enabling Technologies [Member]      
Segment Reporting Information [Line Items]      
Net Sales $ 440,491 $ 441,909 $ 418,789
Percent of Total Net Sales 53.60% 55.30% 56.10%
Global Spine [Member]      
Segment Reporting Information [Line Items]      
Net Sales $ 687,655 $ 675,314 $ 631,319
Percent of Total Net Sales 83.60% 84.50% 84.60%
Global Limb Reconstruction [Member]      
Segment Reporting Information [Line Items]      
Net Sales $ 134,657 $ 124,177 $ 115,322
Percent of Total Net Sales 16.40% 15.50% 15.40%
v3.25.4
Business Segment Information - Summary of EBIDTA by Reporting Segment (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Segment Reporting Information [Line Items]      
Segment Adjusted EBITDA $ 118,851 $ 112,007 $ 91,557
Interest expense, net 17,488 29,631 8,631
Depreciation and amortization 77,321 60,061 53,063
Share-based compensation expense 28,688 32,455 35,707
Foreign exchange impact (2,910) 4,395 (1,581)
SeaSpine merger-related costs 6,093 14,485 36,577
Restructuring costs and impairments related to M6 product lines 17,305    
Strategic investments 4,915 910 2,272
Acquisition-related fair value adjustments (1,140) 19,088 33,393
Interest and loss on investments (48) 5,120 1,781
Litigation and investigation costs 33,788 15,770 14,453
Employee retention credit (4,826)    
Succession charges   9,376 1,176
Medical device regulation     9,492
Loss before income taxes (90,810) (123,875) (148,679)
Global Spine [Member]      
Segment Reporting Information [Line Items]      
Segment Adjusted EBITDA 112,594 107,386 91,115
Global Limb Reconstruction [Member]      
Segment Reporting Information [Line Items]      
Segment Adjusted EBITDA 6,257 4,621 442
Operating Segments [Member]      
Segment Reporting Information [Line Items]      
Segment Adjusted EBITDA 822,312 799,491 746,641
Non-GAAP Cost of sales 230,713 231,702 214,813
Non-GAAP Sales, general, and administrative 456,386 439,002 423,642
Non-GAAP Research and development 57,112 71,416 67,238
Other segment expenses (benefits) 10,222 (76) (37)
Non-GAAP Depreciation, amortization, and share-based compensation expense 50,972 54,560 50,572
Operating Segments [Member] | Global Spine [Member]      
Segment Reporting Information [Line Items]      
Segment Adjusted EBITDA 687,655 675,314 631,319
Non-GAAP Cost of sales 177,585 183,064 166,885
Non-GAAP Sales, general, and administrative 380,659 368,817 355,827
Non-GAAP Research and development 45,570 58,262 56,512
Other segment expenses (benefits) 10,447 (22) 45
Non-GAAP Depreciation, amortization, and share-based compensation expense 39,200 42,193 39,065
Operating Segments [Member] | Global Limb Reconstruction [Member]      
Segment Reporting Information [Line Items]      
Segment Adjusted EBITDA 134,657 124,177 115,322
Non-GAAP Cost of sales 53,128 48,638 47,928
Non-GAAP Sales, general, and administrative 75,727 70,185 67,815
Non-GAAP Research and development 11,542 13,154 10,726
Other segment expenses (benefits) (225) (54) (82)
Non-GAAP Depreciation, amortization, and share-based compensation expense 11,772 12,367 11,507
Corporate, Non-Segment [Member]      
Segment Reporting Information [Line Items]      
Segment Adjusted EBITDA $ 32,987 $ 44,591 $ 45,272
v3.25.4
Business Segment Information - Schedule of Depreciation and Amortization by Reporting Segment (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Segment Reporting Information [Line Items]      
Depreciation and amortization $ 77,321 $ 60,061 $ 53,063
Operating Segments [Member] | Global Spine [Member]      
Segment Reporting Information [Line Items]      
Depreciation and amortization 66,315 49,507 41,213
Operating Segments [Member] | Global Limb Reconstruction [Member]      
Segment Reporting Information [Line Items]      
Depreciation and amortization 8,629 7,748 7,158
Corporate, Non-Segment [Member]      
Segment Reporting Information [Line Items]      
Depreciation and amortization $ 2,377 $ 2,806 $ 4,692
v3.25.4
Business Segment Information - Summary of Net Sales by Geographic Destination for Each Reporting Segment (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales $ 822,312 $ 799,491 $ 746,641
Global Spine [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 687,655 675,314 631,319
Global Limb Reconstruction [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 134,657 124,177 115,322
U.S. [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 684,066 672,816 620,829
U.S. [Member] | Global Spine [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 645,139 639,196 591,937
U.S. [Member] | Global Limb Reconstruction [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 38,927 33,620 28,892
International [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 138,246 126,675 125,812
International [Member] | Global Spine [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 42,516 36,118 39,382
International [Member] | Global Limb Reconstruction [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales $ 95,730 $ 90,557 $ 86,430
v3.25.4
Business Segment Information - Summary of Net Sales by Geographic Destination (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales $ 822,312 $ 799,491 $ 746,641
U.S. [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 684,066 672,816 620,829
Italy [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 22,277 21,001 20,060
United Kingdom [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 13,334 11,183 10,910
France [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 11,959 13,385 11,096
Germany [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 9,107 9,004 11,467
Brazil [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales 4,836 5,707 6,452
Others [Member]      
Revenues from External Customers and Long-Lived Assets [Line Items]      
Net sales $ 76,733 $ 66,395 $ 65,827
v3.25.4
Business Segment Information - Summary of Property, Plant and Equipment, Net of Reporting Segments by Geographic Area (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Revenues from External Customers and Long-Lived Assets [Line Items]    
Property, plant and equipment net $ 129,399 $ 139,804
U.S. [Member]    
Revenues from External Customers and Long-Lived Assets [Line Items]    
Property, plant and equipment net 114,483 125,541
Italy [Member]    
Revenues from External Customers and Long-Lived Assets [Line Items]    
Property, plant and equipment net 9,893 9,472
Germany [Member]    
Revenues from External Customers and Long-Lived Assets [Line Items]    
Property, plant and equipment net 1,360 1,904
Others [Member]    
Revenues from External Customers and Long-Lived Assets [Line Items]    
Property, plant and equipment net $ 3,663 $ 2,887
v3.25.4
Acquisition-Related Amortization, Impairment and Remeasurement - Components of Acquisition-Related Amortization, Impairment, and Remeasurement (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Acquisition Related Amortization And Remeasurement [Abstract]      
Changes in fair value of contingent consideration $ (1,140) $ 6,900 $ (2,700)
Amortization and impairments of acquired intangibles 28,409 17,436 17,408
Acquired IPR&D     49
Total $ 27,269 $ 24,336 $ 14,757
v3.25.4
Acquisition-Related Amortization and Remeasurement - Additional Information (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2025
Dec. 31, 2023
Lattus [Member]        
Research And Development Arrangement Contract To Perform For Others [Line Items]        
Payments for contingent consideration     $ 6.3  
Contingent consideration     7.9  
Contingent consideration other current liabilities     4.3  
Contingent consideration other long-term liabilities     $ 3.6  
License Agreement [Member]        
Research And Development Arrangement Contract To Perform For Others [Line Items]        
Contingent Payment Upon Reaching FDA Milestone   $ 4.0    
Amount Received for the year $ 1.5 $ 0.5    
Contingent consideration milestone obligation 3.5      
License Agreement [Member] | Other Current Liabilities [Member]        
Research And Development Arrangement Contract To Perform For Others [Line Items]        
Contingent consideration accrued $ 1.0     $ 1.0
v3.25.4
Share-based Compensation - Additional Information (Detail) - USD ($)
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Income tax benefit related to expense $ 5,500,000 $ 5,800,000 $ 5,800,000
Exercised stock option amount 400,000    
Realized tax benefit amount $ 100,000    
Closing stock price $ 15.16    
Share-based compensation $ 28,688,000 32,455,000 35,707,000
SeaSpine [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Options outstanding 1,500,000    
Options exercisable 600,000    
Number of shares, Granted 0    
Number of options issued in connection with conversion of awards 1,900,000    
Number of time based RSU issued in exchange for equity awards 500,000    
2012 LTIP Plan [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Award Contractual term 10 years    
Amount of shares reserved for issuance 16,300,000    
Options outstanding 2,400,000    
Options exercisable 1,400,000    
SeaSpine 2015 Plan [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Amount of shares reserved for issuance 3,000,000    
Options outstanding 700,000    
Options exercisable 400,000    
SeaSpine 2015 Plan [Member] | SeaSpine [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Percentage of performance to be achieved 100.00%    
Stock Purchase Plan [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Amount of shares reserved for issuance 4,900,000    
Maximum percentage of compensation eligible employees to be deducted for purchase of common stock 25.00%    
Purchase price of shares equivalent to fair market value 85.00%    
Shares issued under stock purchase plan 3,800,000    
Stock Purchase Plan [Member] | Minimum [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Percentage of compensation eligible employees to be deducted for purchase of common stock 1.00%    
Restricted Stock Units [Member] | SeaSpine [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Unvested restricted stock and stock units outstanding 1,000,000    
Restricted Stock Units [Member] | 2012 LTIP Plan [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Unvested restricted stock and stock units outstanding 2,200,000    
Restricted Stock Units [Member] | SeaSpine 2015 Plan [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Unvested restricted stock and stock units outstanding 500,000    
Market-based Restricted Stock Units [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Unamortized compensation expense $ 16,300,000    
Weighted-average period for unamortized compensation cost expected to be recognized 1 year 6 months    
Market-based Restricted Stock Units [Member] | Maximum [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Share based compensation, fair market value of restricted stock units vested $ 100,000 $ 100,000 100,000
Market-based Stock Option [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Options outstanding 754,000 754,000  
Options exercisable 34,000    
Vesting period 3 years    
Employee Stock Option      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Unamortized compensation expense $ 5,300,000    
Weighted-average period for unamortized compensation cost expected to be recognized 1 year    
Total intrinsic value of options exercised $ 100,000 $ 100,000 100,000
Aggregate intrinsic value of options outstanding 3,000,000    
Aggregate intrinsic value of options exercisable 900,000    
Share-based compensation $ 5,245,000 4,331,000 6,130,000
Time-based Restricted Stock Awards and Stock Units [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Share based compensation grants of restricted stock unit 993,000    
Unamortized compensation expense $ 15,300,000    
Weighted-average period for unamortized compensation cost expected to be recognized 1 year 6 months    
Non-vested shares, vested in period $ 12,400,000 13,300,000 17,200,000
Aggregate intrinsic value of restricted stock outstanding 30,100,000    
Share-based compensation $ 13,270,000 $ 18,818,000 $ 27,290,000
Time-based Restricted Stock Awards and Stock Units [Member] | Maximum [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Vesting period 4 years    
Time-based Restricted Stock Awards and Stock Units [Member] | Minimum [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Vesting period 3 years    
Performance-based Restricted Stock Units [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Aggregate intrinsic value of restricted stock outstanding $ 25,000,000    
Performance-based And Market-based Restricted Stock Units [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Percentage of performance to be achieved 100.00%    
v3.25.4
Share-based Compensation - Schedule of Share-Based Compensation by Line Item in Consolidated Statements of Income (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense $ 28,688 $ 32,455 $ 35,707
Employee Stock Option [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense 5,245 4,331 6,130
Market-based Stock Options [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense 2,003 2,118  
Time-based Restricted Stock Awards and Stock Units [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense 13,270 18,818 27,290
Performance-based / Market-based restricted stock units [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense 6,353 4,941 227
Stock purchase plan [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense 1,817 2,247 2,060
Cost of sales [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense 1,695 2,053 1,901
Sales, general, and administrative [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense 25,418 27,123 29,917
Research and development [Member]      
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]      
Allocated share based compensation expense $ 1,575 $ 3,279 $ 3,889
v3.25.4
Share-based Compensation - Schedule of Assumptions Used in Determining Fair Value of Stock Options Granted (Detail) - $ / shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Share-Based Compensation Arrangement by Share-Based Payment Award, Fair Value Assumptions and Methodology [Abstract]      
Expected term (in years) 4 years 7 months 6 days 4 years 6 months 6 years
Expected volatility, minimum 44.00% 45.70% 36.80%
Expected volatility, maximum 45.20% 47.60% 42.30%
Risk free interest rate, minimum 3.98% 3.47% 3.38%
Risk free interest rate, maximum 4.58% 4.65% 4.61%
Weighted average grant date fair value $ 7.22 $ 5.90 $ 8.43
v3.25.4
Share-based Compensation - Schedule of Stock Option Plans (Detail)
shares in Thousands
 12 Months Ended
Dec. 31, 2025
$ / shares
shares
Time-based Stock Option [Member]  
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]  
Outstanding at the beginning of the period (in shares) | shares 3,197
Granted | shares 1,010
Exercised | shares (31)
Forfeited or expired | shares (405)
Outstanding at the end of the period (in shares) | shares 3,771
Vested and expected to vest | shares 3,771
Exercisable (in shares) | shares 2,280
Outstanding at the beginning of the period (in dollars per share) | $ / shares $ 26.15
Granted | $ / shares 17
Exercised | $ / shares 13.23
Forfeited or expired | $ / shares 31.34
Outstanding at the end of the period (in dollars per share) | $ / shares 23.25
Vested and expected to vest | $ / shares 23.25
Exercisable | $ / shares $ 27.96
Options outstanding, weighted average remaining contractual term 4 years 7 months 6 days
Options vested and expected, weighted average remaining contractual term 4 years 6 months
Options exercisable, weighted average remaining contractual term 3 years 4 months 24 days
Market-based Stock Option [Member]  
Share-Based Compensation Arrangement by Share-Based Payment Award [Line Items]  
Outstanding at the beginning of the period (in shares) | shares 754
Outstanding at the end of the period (in shares) | shares 754
Vested and expected to vest | shares 754
Exercisable (in shares) | shares 34
Outstanding at the beginning of the period (in dollars per share) | $ / shares $ 13.39
Outstanding at the end of the period (in dollars per share) | $ / shares 13.39
Vested and expected to vest | $ / shares 13.39
Exercisable | $ / shares $ 12.57
Options outstanding, weighted average remaining contractual term 5 years 2 months 12 days
Options vested and expected, weighted average remaining contractual term 5 years 2 months 12 days
Options exercisable, weighted average remaining contractual term 5 years 6 months
v3.25.4
Share-based Compensation - Schedule of Changes in Time-Based and Market-Based Restricted Stock Awards and Stock Units (Detail)
shares in Thousands
 12 Months Ended
Dec. 31, 2025
$ / shares
shares
Time-based Restricted Stock Awards and Stock Units [Member]  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]  
Outstanding at December 31, 2024 | shares 2,015
Granted (in shares) | shares 993
Vested and settled (in shares) | shares (872)
Cancelled (in shares) | shares (153)
Outstanding at December 31, 2025 | shares 1,983
Outstanding at December 31, 2024 | $ / shares $ 18.73
Granted (in dollars per share) | $ / shares 15.58
Vested and settled (in dollars per share) | $ / shares 21.97
Cancelled (in dollars per share) | $ / shares 17.38
Outstanding at December 31, 2025 | $ / shares $ 15.83
Performance-based and/or Market-based Restricted Stock Units [Member]  
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]  
Outstanding at December 31, 2024 | shares 960
Granted (in shares) | shares 723
Vested and settled (in shares) | shares (1)
Cancelled (in shares) | shares (35)
Outstanding at December 31, 2025 | shares 1,647
Outstanding at December 31, 2024 | $ / shares $ 16.81
Granted (in dollars per share) | $ / shares 16.98
Vested and settled (in dollars per share) | $ / shares 44
Cancelled (in dollars per share) | $ / shares 17.28
Outstanding at December 31, 2025 | $ / shares $ 16.85
v3.25.4
Defined Contribution Plans and Deferred Compensation - Additional Information (Detail) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Defined Contribution Plan Disclosure [Line Items]      
Amount of deferred compensation payable $ 1.7 $ 1.7  
U.S. [Member]      
Defined Contribution Plan Disclosure [Line Items]      
Employee contribution limit per calendar year (as a percent of compensation) 90.00%    
Employer match of employee contributions of first level of eligible compensation (as a percent) 100.00%    
Percentage of eligible compensation, matched by employer, level one 4.00%    
Expenses incurred for contribution plans $ 6.8 5.9 $ 4.6
Foreign Plan [Member]      
Defined Contribution Plan Disclosure [Line Items]      
Expenses incurred for contribution plans $ 2.0 $ 1.2 $ 1.1
Italy [Member]      
Defined Contribution Plan Disclosure [Line Items]      
Annual deferred compensation provision for leaving indemnity, as a percentage of total commissions earned 4.00%    
Italy [Member] | Labor Force Concentration Risk [Member] | National Collective Labor Agreement [Member]      
Defined Contribution Plan Disclosure [Line Items]      
Number of employees, percentage 15.00%    
v3.25.4
Income Taxes - Schedule of Income (Loss) Before Provision for Income Taxes (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Disclosure [Abstract]      
U.S. $ (93,273) $ (113,197) $ (154,794)
Non-U.S. 2,463 (10,678) 6,115
Loss before income taxes $ (90,810) $ (123,875) $ (148,679)
v3.25.4
Income Taxes - Schedule of Provision for Income Taxes (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Current tax expense (benefit)      
Federal $ 298 $ (815) $ (79)
State & local 236 225 96
Foreign 625 829 2,120
Total current expense 1,159 239 2,137
Deferred tax expense (benefit)      
Federal 639 1,355 1,008
State & local 134 217 152
Foreign (550) 311 (581)
Total deferred expense 223 1,883 579
Income tax expense $ 1,382 $ 2,122 $ 2,716
v3.25.4
Income Taxes - Schedule of Effective Income Tax Rate Reconciliation for Continuing Operations (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Effective Income Tax Rate Reconciliation [Line Items]      
U.S. federal statutory rate $ (19,070) $ (26,013) $ (31,222)
State taxes, net of U.S. federal benefit 300 352 210
Effects of cross-border tax laws      
GILTI inclusion, net 786 323 2,333
Income from branches (702) (1,525) (1,078)
Tax credits      
R&D credit 64 (1,159) (1,268)
Valuation allowance 14,452 23,478 21,675
Nontaxable or nondeductible items      
Merger related deal costs     2,547
Equity compensation 1,629 2,781 4,210
Executive compensation 3,470 2,001 3,030
Other 417 757 882
Changes in unrecognized tax benefits 29 (1,393) 71
Income tax expense $ 1,382 $ 2,122 $ 2,716
U.S. federal statutory rate 21.00% 21.00% 21.00%
State taxes, net of U.S. federal benefit (0.30%) (0.30%) (0.10%)
Effects of cross-border tax laws      
GILTI inclusion, net (0.90%) (0.30%) (1.60%)
Income from branches 0.80% 1.20% 0.70%
Tax credits      
R&D credit (0.10%) 0.90% 0.90%
Valuation allowance (15.90%) (19.00%) (14.60%)
Nontaxable or nondeductible items      
Merger related deal costs     (1.70%)
Equity compensation (1.80%) (2.20%) (2.80%)
Executive compensation (3.80%) (1.60%) (2.00%)
Other (0.60%) (0.50%) (0.60%)
Changes in unrecognized tax benefits 0.00% 1.10% 0.00%
Income tax expense /effective rate (1.50%) (1.70%) (1.80%)
Canada [Member]      
Tax credits      
Valuation allowance $ 933 $ 2,282 $ 1,877
Nontaxable or nondeductible items      
Other $ (505) $ (754) $ (659)
Tax credits      
Valuation allowance (1.00%) (1.80%) (1.30%)
Nontaxable or nondeductible items      
Other 0.60% 0.60% 0.40%
Other Foreign Jurisdictions [Member]      
Effective Income Tax Rate Reconciliation [Line Items]      
Other foreign jurisdictions $ (421) $ 992 $ 108
Nontaxable or nondeductible items      
Other foreign jurisdictions 0.50% (0.80%) (0.10%)
v3.25.4
Income Taxes - Schedule of Deferred Tax Assets and Liabilities (Detail) - USD ($)
$ in Thousands
Dec. 31, 2025
Dec. 31, 2024
Income Tax Disclosure [Abstract]    
Intangible assets and goodwill $ 1,331  
Inventories and related reserves 34,168 $ 34,745
Deferred revenue and cost of goods sold 5,978 5,775
Other accruals and reserves 6,744 5,738
Accrued compensation 15,815 17,216
Provision for expected credit losses 1,897 1,797
Accrued interest 7,864 6,336
Net operating loss and tax credit carryforwards 152,068 132,524
Research and development capitalization 11,127 18,016
Lease liabilities 11,202 8,856
Other, net 6,435 8,456
Total deferred tax assets 254,629 239,459
Valuation allowance (247,738) (228,724)
Deferred tax asset, net of valuation allowance 6,891 10,735
Intangible assets and goodwill   (3,557)
Withholding taxes (10) (10)
Property, plant, and equipment (1,359) (3,390)
Right-of-use lease assets (9,729) (7,875)
Deferred tax liability (11,098) (14,832)
Net deferred tax liabilities (4,207) (4,097)
Reported as:    
Deferred income taxes (classified within other long-term assets) 1,876 1,542
Deferred income tax liabilities (classified within other long-term liabilities) $ (6,083) $ (5,639)
v3.25.4
Income Taxes - Additional Information (Detail) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Components Of Income Tax Expense Benefit [Line Items]      
Tax paid (received or refunded) cash $ 1.6 $ 1.3 $ 0.9
Minimum percentage of income tax benefit 50.00%    
Gross unrecognized tax benefit $ 1.7 1.7  
Net interest and penalties on unrecognized tax benefits (0.1) 0.2 $ 0.2
Accrued interest and penalties related to unrecognized tax benefits 1.0 $ 1.0  
SeaSpine [Member]      
Components Of Income Tax Expense Benefit [Line Items]      
Net increase in valuation allowance 19.0    
State [Member]      
Components Of Income Tax Expense Benefit [Line Items]      
Operating loss carry forwards, net of tax 292.3    
Federal [Member]      
Components Of Income Tax Expense Benefit [Line Items]      
Operating loss carry forwards, net of tax $ 428.0    
Operating loss carryforwards, expiration year 2026    
Research and development credits $ 5.8    
Foreign Tax Authority      
Components Of Income Tax Expense Benefit [Line Items]      
Operating loss carry forwards, net of tax $ 141.3    
Operating loss carryforwards, expiration year 2041    
Research and development credits $ 1.6    
v3.25.4
Income Taxes - Schedule of Gross Unrecognized Tax Benefits (Excluding Interest and Penalties) (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Income Tax Disclosure [Abstract]    
Beginning Balance $ 1,723 $ 2,974
Additions for current year tax positions 18 40
Increases for prior year tax positions   42
Decreases for prior year tax positions (23)  
Expiration of statutes (53) (1,333)
Ending Balance $ 1,665 $ 1,723
v3.25.4
Income Taxes - Summary of Paid (Received or Was Refunded) Cash Relating to Income Taxes (Detail) - USD ($)
$ in Thousands
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Income Tax Paid, by Individual Jurisdiction [Line Items]      
U.S. federal $ 2 $ (154) $ (640)
State 428 192 484
Foreign 1,153 1,263 1,036
Total 1,583 1,301 880
California [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
State   (90)  
Massachusetts [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
State     49
Texas [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
State 131 85 119
All others [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
State 297 197 316
Australia [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign 186 141  
Brazil [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign   82 93
France [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign 330 433 521
Germany [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign 171   (164)
Italy [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign   85 431
Netherlands [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign 185 236 249
Switzerland [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign 132 102  
United Kingdom [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign 101 128 (82)
All others [Member]      
Income Tax Paid, by Individual Jurisdiction [Line Items]      
Foreign $ 48 $ 56 $ (12)
v3.25.4
Earnings Per Share (EPS) - Schedule of Reconciliation of Weighted Average Shares Used in the Diluted EPS (Detail) - shares
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Earnings Per Share [Line Items]      
Weighted average common shares-basic 39,602,345 38,133,684 36,729,258
Effect of diluted securities:      
Weighted average common shares-diluted 39,602,345 38,133,684 36,729,258
v3.25.4
Earnings Per Share (EPS) - Additional Information (Detail) - shares
shares in Millions
 12 Months Ended
Dec. 31, 2025
Dec. 31, 2024
Dec. 31, 2023
Time Based Restricted Stock Awards And Stock Units, Performance Based Stock Units And Market Based Stock Units [Member] | Outstanding Stock Options [Member]      
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]      
Weighted average outstanding options, awards not included in diluted earnings per share 8.7 7.2 6.5
v3.25.4
Subsequent events - Additional Information (Details) - USD ($)
$ in Millions
Jan. 15, 2026
Nov. 07, 2024
Subsequent Event [Line Items]    
Borrowings   $ 125.0
Subsequent Event [Member]    
Subsequent Event [Line Items]    
Lease extended term October 2040  
Delayed Draw Term Loan [Member] | New Credit Agreement [Member] | Oxford Finance LLC [Member] | Subsequent Event [Member]    
Subsequent Event [Line Items]    
Borrowings $ 65.0