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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2020	Apr. 27, 2020
Cover [Abstract]
Entity Incorporation, State or Country Code	NY
Entity Registrant Name	CONMED CORPORATION
City Area Code	315
Local Phone Number	797-8375
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Central Index Key	0000816956
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity Filer Category	Large Accelerated Filer
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Small Business	false
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Amendment Flag	false
Title of 12(b) Security	Common Stock, $0.01 par value
Entity Common Stock, Shares Outstanding		28,528,214
Entity File Number	001-39218
Entity Tax Identification Number	16-0977505
Entity Address, Address Line One	525 French Road
Entity Address, City or Town	Utica,
Entity Address, State or Province	NY
Entity Address, Postal Zip Code	13502
Trading Symbol	CNMD
Security Exchange Name	NYSE

Consolidated Condensed Statements of Comprehensive Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net sales	$ 214,010	$ 218,378
Cost of sales	94,851	96,940
Gross profit	119,159	121,438
Selling and administrative expense	95,867	99,226
Research and development expense	10,120	10,575
Operating expenses	105,987	109,801
Income from operations	13,172	11,637
Interest expense	9,592	9,369
Other expense	89	4,225
Income (loss) before income taxes	3,491	(1,957)
Benefit from income taxes	(2,436)	(2,978)
Net income	5,927	1,021
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	$ (1,121)	$ 1,096
Per share data:
Basic (in dollars per share)	$ 0.21	$ 0.04
Diluted (in dollars per share)	$ 0.20	$ 0.04
Weighted average common shares:
Basic (shares)	28,478	28,173
Diluted (shares)	29,707	29,034

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 24,309	$ 25,856
Accounts receivable, net	166,504	189,097
Inventories	174,538	164,616
Prepaid expenses and other current assets	27,816	17,794
Total current assets	393,167	397,363
Property, plant and equipment, net	114,234	118,883
Goodwill	615,682	618,042
Other intangible assets, net	525,022	532,800
Other assets	102,867	108,007
Total assets	1,750,972	1,775,095
Current liabilities:
Current portion of long-term debt	13,571	13,596
Accounts payable	57,379	55,968
Accrued compensation and benefits	34,827	53,690
Other current liabilities	54,227	64,833
Total current liabilities	160,004	188,087
Long-term debt	772,630	755,211
Deferred income taxes	72,327	74,488
Other long-term liabilities	44,376	46,842
Total liabilities	1,049,337	1,064,628
Commitments and contingencies
Shareholders' equity:
Preferred stock, par value $.01 per share; authorized 500,000 shares; none outstanding	0	0
Common stock, par value $.01 per share; 100,000,000 shares authorized; 31,299,194 shares issued in 2020 and 2019, respectively	313	313
Paid-in capital	374,620	379,324
Retained earnings	471,068	470,844
Accumulated other comprehensive loss	(66,325)	(59,277)
Less: 2,780,667 and 2,876,729 shares of common stock in treasury, at cost in 2020 and 2019, respectively	(78,041)	(80,737)
Total shareholders’ equity	701,635	710,467
Total liabilities and shareholders’ equity	$ 1,750,972	$ 1,775,095

Consolidated Condensed Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Preferred stock, par value (dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	500,000	500,000
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	31,299,194	31,299,194
Treasury stock, shares (in shares)	2,780,667	2,876,729

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Loss	Treasury Stock
Balance at period start (shares) at Dec. 31, 2018		31,299
Balance at period start at Dec. 31, 2018	$ 662,270	$ 313	$ 341,738	$ 464,851	$ (55,737)	$ (88,895)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans	1,748		(769)			2,517
Stock-based compensation	2,703		2,703
Dividends on common stock ($0.20 per share)	(5,643)			(5,643)
Convertible notes discount (net of income tax expense)	39,145		39,145
Convertible notes hedge, (net of income tax benefit)	(38,829)		(38,829)
Issuance of warrants	30,567		30,567
Comprehensive income (loss):
Foreign currency translation adjustments	(578)				(578)
Pension liability, net of income tax	547				547
Cash flow hedging gain (loss), net of income tax	106				106
Net income	1,021			1,021
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	1,096
Balance at period end (shares) at Mar. 31, 2019		31,299
Balance at period end at Mar. 31, 2019	693,057	$ 313	374,555	460,229	(55,662)	(86,378)
Balance at period start (shares) at Dec. 31, 2019		31,299
Balance at period start at Dec. 31, 2019	710,467	$ 313	379,324	470,844	(59,277)	(80,737)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans	(5,040)		(7,736)			2,696
Stock-based compensation	3,032		3,032
Dividends on common stock ($0.20 per share)	(5,703)			(5,703)
Comprehensive income (loss):
Foreign currency translation adjustments	(9,988)				(9,988)
Pension liability, net of income tax	535				535
Cash flow hedging gain (loss), net of income tax	2,405				2,405
Net income	5,927			5,927
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	(1,121)
Balance at period end (shares) at Mar. 31, 2020		31,299
Balance at period end at Mar. 31, 2020	$ 701,635	$ 313	$ 374,620	$ 471,068	$ (66,325)	$ (78,041)

Consolidated Condensed Statements of Shareholders' Equity (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Dividends per share of common stock (in dollars per share)	$ 0.20	$ 0.20

Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Cash flows from operating activities:
Net income	$ 5,927	$ 1,021
Adjustments to reconcile net income to net cash provided by (used in) operating activities:
Depreciation	4,646	4,442
Amortization of debt discount	2,264	1,510
Amortization of deferred debt issuance costs	819	697
Amortization	13,776	12,208
Stock-based compensation	3,032	2,703
Deferred income taxes	(2,742)	(4,699)
Loss on early extinguishment of debt	0	300
Increase (decrease) in cash flows from changes in assets and liabilities:
Accounts receivable	19,057	13,733
Inventories	(12,313)	(11,971)
Accounts payable	1,705	(1,776)
Accrued compensation and benefits	(18,397)	(13,695)
Other assets	(7,260)	(10,047)
Other liabilities	(6,793)	1,654
Adjustments to Reconcile Net Income (Loss) to Cash Provided by (Used in) Operating Activities	(2,206)	(4,941)
Net cash provided by (used in) operating activities	3,721	(3,920)
Cash flows from investing activities:
Purchases of property, plant and equipment	(2,825)	(4,022)
Payments related to business and asset acquisitions, net of cash acquired	(3,852)	(364,928)
Net cash used in investing activities	(6,677)	(368,950)
Cash flows from financing activities:
Payments on term loan	(3,313)	(144,375)
Proceeds from term loan	0	265,000
Payments on revolving line of credit	(41,000)	(342,000)
Proceeds from revolving line of credit	59,000	299,000
Proceeds from convertible notes	0	345,000
Payments related to contingent consideration	(1,133)	(2,859)
Payments related to debt issuance costs	0	(16,210)
Dividends paid on common stock	(5,683)	(5,626)
Purchases of convertible notes hedges	0	(51,198)
Proceeds from issuance of warrants	0	30,567
Other, net	(5,132)	1,655
Net cash provided by financing activities	2,739	378,954
Effect of exchange rate changes on cash and cash equivalents	(1,330)	(188)
Net increase (decrease) in cash and cash equivalents	(1,547)	5,896
Cash and cash equivalents at beginning of period	25,856	17,511
Cash and cash equivalents at end of period	24,309	23,407
Non-cash investing and financing activities:
Dividends payable	$ 5,703	$ 5,643

Operations	3 Months Ended
Operations	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Operations	Operations CONMED Corporation (“CONMED”, the “Company”, “we” or “us”) is a medical technology company that provides surgical devices and equipment for minimally invasive procedures. The Company’s products are used by surgeons and physicians in a variety of specialties including orthopedics, general surgery, gynecology, neurosurgery, thoracic surgery and gastroenterology.

Interim Financial Information	3 Months Ended
Interim Financial Information	Mar. 31, 2020
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Interim financial information	Interim Financial Information The accompanying unaudited consolidated condensed financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for annual financial statements. The information herein reflects all normal recurring material adjustments, which are, in the opinion of management, necessary to fairly present the results for the periods presented. The consolidated condensed financial statements herein consist of all wholly-owned domestic and foreign subsidiaries with all significant intercompany transactions eliminated. Results for the period ended March 31, 2020 are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. The consolidated condensed financial statements and notes thereto should be read in conjunction with the consolidated financial statements and notes for the year ended December 31, 2019 included in our Annual Report on Form 10-K. Use of Estimates Preparation of the consolidated condensed financial statements in conformity with 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 at the date of the consolidated condensed financial statements and the reported amounts of revenue and expenses during the reporting period. Due to the COVID-19 pandemic, there has been uncertainty and disruption in the global economy and financial markets. We are not aware of any specific event or circumstance that would require an update to our estimates or judgments or a revision of the carrying value of our assets or liabilities as of April 30, 2020, the date of issuance of this Quarterly Report on Form 10-Q. These estimates may change, as new events occur and additional information is obtained. Actual results could differ materially from these estimates under different assumptions or conditions.

Business Acquisition

3 Months Ended

Mar. 31, 2020

Business Combinations [Abstract]

Business Acquisition

On February 11, 2019 we acquired Buffalo Filter, LLC and all of the issued and outstanding common stock of Palmerton Holdings, Inc. from Filtration Group FGC LLC (the "Buffalo Filter Acquisition") for approximately $365 million in cash. Buffalo Filter develops, manufactures and markets smoke evacuation technologies that are complementary to our general surgery offering. The business combination was funded through a combination of cash on hand and long-term borrowings.

The unaudited pro forma information for the three months ended March 31, 2019, assuming the Buffalo Filter Acquisition occurred as of January 1, 2018 are presented below. This information has been prepared for comparative purposes only and does not purport to be indicative of the results of operations which actually would have resulted had the Buffalo Filter Acquisition occurred on the dates indicated, or which may result in the future.



	Three Months Ended March 31,
	2019
Net sales	$	223,397
Net income	8,745

These pro forma results include certain adjustments, primarily due to increases in amortization expense due to fair value

adjustments of intangible assets, increases in interest expense due to additional borrowings incurred to finance the acquisition and amortization of debt issuance costs incurred to finance the transaction, and acquisition related costs including transaction costs such as legal, accounting, valuation and other professional services as well as integration costs such as severance and retention.

Acquisition related costs excluded from the determination of pro forma net income for the three months ended March 31, 2019 included $0.7 million in cost of goods sold and $7.2 million in selling and administrative expense on the consolidated condensed statement of comprehensive income.

Net sales associated with Buffalo Filter of $6.1 million have been recorded in the consolidated condensed statement of comprehensive income for the three months ended March 31, 2019. It is impracticable to determine the earnings recorded in the consolidated condensed statement of comprehensive income for the three months ended March 31, 2019 as these amounts are not separately measured.

In conjunction with the December 2019 acquisition of a distributor, we paid $3.3 million during the three months ended March 31, 2020.

Revenues

3 Months Ended

Mar. 31, 2020

Revenue from Contract with Customer [Abstract]

Revenues

The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition:



	Three Months Ended						Three Months Ended
	March 31, 2020						March 31, 2019
	Orthopedic Surgery		General Surgery		Total		Orthopedic Surgery		General Surgery		Total
Primary Geographic Markets
United States	$	37,039	$	81,808	$	118,847	$	45,256	$	71,770	$	117,026
Americas (excluding the United States)	15,802		7,979		23,781		15,042		7,462		22,504
Europe, Middle East & Africa	25,907		16,615		42,522		30,402		15,930		46,332
Asia Pacific	20,535		8,325		28,860		22,737		9,779		32,516
Total sales from contracts with customers	$	99,283	$	114,727	$	214,010	$	113,437	$	104,941	$	218,378

Timing of Revenue Recognition
Goods transferred at a point in time	$	90,553	$	113,901	$	204,454	$	104,739	$	104,425	$	209,164
Services transferred over time	8,730		826		9,556		8,698		516		9,214
Total sales from contracts with customers	$	99,283	$	114,727	$	214,010	$	113,437	$	104,941	$	218,378

Contract liability balances related to the sale of extended warranties to customers are as follows:



	March 31, 2020		December 31, 2019

Contract liability	$	14,550	$	14,276

Revenue recognized during the three months ended March 31, 2020 and March 31, 2019 from amounts included in contract liabilities at the beginning of the period were $3.0 million and $2.3 million, respectively. There were no material contract assets as of March 31, 2020 and December 31, 2019.

Comprehensive Income

3 Months Ended

Mar. 31, 2020

Equity [Abstract]

Comprehensive Income

Comprehensive income consists of the following:



	Three Months Ended March 31,
	2020			2019
Net income	$	5,927		$	1,021

Other comprehensive income (loss):
Pension liability, net of income tax (income tax expense of $170 and $173 for the three months ended March 31, 2020 and 2019, respectively)	535			547
Cash flow hedging gain, net of income tax (income tax expense of $766 and $34 for the three months ended March 31, 2020 and 2019, respectively)	2,405			106
Foreign currency translation adjustment	(9,988		)	(578		)

Comprehensive income (loss)	$	(1,121	)	$	1,096

Accumulated other comprehensive loss consists of the following:



	Cash Flow Hedging Gain (Loss)			Pension Liability			Cumulative Translation Adjustments			Accumulated Other Comprehensive Income (Loss)
Balance, December 31, 2019	$	493		$	(31,691	)	$	(28,079	)	$	(59,277	)

Other comprehensive income (loss) before reclassifications, net of tax	3,257			—			(9,988		)	(6,731		)
Amounts reclassified from accumulated other comprehensive income (loss) before tax^a	(1,124		)	705			—			(419		)
Income tax	272			(170		)	—			102

Net current-period other comprehensive income (loss)	2,405			535			(9,988		)	(7,048		)

Balance, March 31, 2020	$	2,898		$	(31,156	)	$	(38,067	)	$	(66,325	)



	Cash Flow Hedging Gain (Loss)			Pension Liability			Cumulative Translation Adjustments			Accumulated Other Comprehensive Income (Loss)
Balance, December 31, 2018	$	4,085		$	(31,718	)	$	(28,104	)	$	(55,737	)

Other comprehensive income (loss) before reclassifications, net of tax	1,318			—			(578		)	740
Amounts reclassified from accumulated other comprehensive income (loss) before tax^a	(1,598		)	720			—			(878		)
Income tax	386			(173		)	—			213

Net current-period other comprehensive income (loss)	106			547			(578		)	75

Balance, March 31, 2019	$	4,191		$	(31,171	)	$	(28,682	)	$	(55,662	)

(a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.

Fair Value of Financial Instruments

3 Months Ended

Mar. 31, 2020

Fair Value Disclosures [Abstract]

Fair Value of Financial Instruments

We enter into derivative instruments for risk management purposes only. We operate internationally and, in the normal course of business, are exposed to fluctuations in interest rates, foreign exchange rates and commodity prices. These fluctuations can increase the costs of financing, investing and operating the business. We use forward contracts, a type of derivative instrument, to manage certain foreign currency exposures.

By nature, all financial instruments involve market and credit risks. We enter into forward contracts with major investment grade financial institutions and have policies to monitor the credit risk of those counterparties. While there can be no assurance, we do not anticipate any material non-performance by any of these counterparties.

Foreign Currency Forward Contracts. We hedge forecasted intercompany sales denominated in foreign currencies through the use of forward contracts. We account for these forward contracts as cash flow hedges. To the extent these forward contracts meet hedge accounting criteria, changes in their fair value are not included in current earnings but are included in accumulated other comprehensive loss. These changes in fair value will be recognized into earnings as a component of sales or cost of sales when the forecasted transaction occurs.

We also enter into forward contracts to exchange foreign currencies for United States dollars in order to hedge our currency transaction exposures on intercompany receivables designated in foreign currencies. These forward contracts settle each month at month-end, at which time we enter into new forward contracts. We have not designated these forward contracts as hedges and have not applied hedge accounting to them.

The following table presents the notional contract amounts for forward contracts outstanding:



		As of
	FASB ASC Topic 815 Designation	March 31, 2020		December 31, 2019
Forward exchange contracts	Cash flow hedge	$	156,229	$	156,818
Forward exchange contracts	Non-designated	37,819		33,867

The remaining time to maturity as of March 31, 2020 is within two years for hedge designated foreign exchange contracts and approximately one month for non-hedge designated forward exchange contracts.

Statement of comprehensive income presentation

Derivatives designated as cash flow hedges

Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) and net earnings on our consolidated condensed statements of comprehensive income and our consolidated condensed balance sheets:



	Amount of Gain Recognized in AOCI				Consolidated Condensed Statements of Comprehensive Income					Amount of Gain (Loss) Reclassified from AOCI
	Three Months Ended March 31,					Three Months Ended March 31,				Three Months Ended March 31,
						Total Amount of Line Item Presented
Derivative Instrument	2020		2019		Location of amount reclassified	2020		2019		2020			2019

Foreign exchange contracts	$	4,295	$	1,738	Net Sales	$	214,010	$	218,378	$	1,201		$	1,497
					Cost of Sales	94,851		96,940		(77		)	101
Pre-tax gain	$	4,295	$	1,738						$	1,124		$	1,598
Tax expense	1,038		420							272			386
Net gain	$	3,257	$	1,318						$	852		$	1,212

At March 31, 2020, $2.7 million of net unrealized gains on forward contracts accounted for as cash flow hedges, and included in accumulated other comprehensive loss, are expected to be recognized in earnings in the next twelve months.

Derivatives not designated as cash flow hedges

Net losses from derivative instruments not accounted for as hedges and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income were:



		Three Months Ended March 31,
Derivative Instrument	Location on Consolidated Condensed Statements of Comprehensive Income	2020			2019

Net loss on currency forward contracts	Selling and administrative expense	$	(245	)	$	(181	)
Net loss on currency transaction exposures	Selling and administrative expense	$	(191	)	$	(229	)

Balance sheet presentation

We record these forward foreign exchange contracts at fair value. The following tables summarize the fair value for forward foreign exchange contracts outstanding at March 31, 2020 and December 31, 2019:



March 31, 2020	Location on Consolidated Condensed Balance Sheet	Asset Fair Value		Liabilities Fair Value			Net Fair Value
Derivatives designated as hedged instruments:
Foreign exchange contracts	Prepaids and other current assets	$	5,329	$	(1,790	)	$	3,539
Foreign exchange contracts	Other long-term assets	1,190		(907		)	283
		$	6,519	$	(2,697	)	$	3,822

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	25		(255		)	(230		)

Total derivatives		$	6,544	$	(2,952	)	$	3,592



December 31, 2019	Location on Consolidated Condensed Balance Sheet	Asset Fair Value		Liabilities Fair Value			Net Fair Value
Derivatives designated as hedged instruments:
Foreign exchange contracts	Prepaids and other current assets	$	2,307	$	(1,341	)	$	966
Foreign exchange contracts	Other long-term liabilities	38		(353		)	(315		)
		$	2,345	$	(1,694	)	$	651

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	22		(159		)	(137		)

Total derivatives		$	2,367	$	(1,853	)	$	514

Our forward foreign exchange contracts are subject to a master netting agreement and qualify for netting in the consolidated condensed balance sheets.

Fair Value Disclosure. FASB guidance defines fair value and establishes a framework for measuring fair value and related disclosure requirements. This guidance applies when fair value measurements are required or permitted. The guidance indicates, among other things, that a fair value measurement assumes that the transaction to sell an asset or transfer a liability occurs in the principal market for the asset or liability or, in the absence of a principal market, the most advantageous market for the asset or liability. Fair value is defined based upon an exit price model.

Valuation Hierarchy. A valuation hierarchy was established for disclosure of the inputs to the valuations used to measure fair value. This hierarchy prioritizes the inputs into three broad levels as follows. Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets in markets that are not active, inputs other than quoted prices that are observable for the asset or liability, including interest rates, yield curves and credit risks, or inputs that are derived principally from or corroborated by observable market data through correlation. Level 3 inputs are unobservable inputs based on our own assumptions used to measure assets and liabilities at fair value. A financial asset or liability’s classification within the hierarchy is determined based on the lowest level input that is significant to the fair value measurement. There have been no significant changes in the assumptions.

Valuation Techniques. Assets and liabilities carried at fair value and measured on a recurring basis as of March 31, 2020 consist of forward foreign exchange contracts. The Company values its forward foreign exchange contracts using quoted

prices for similar assets. The most significant assumption is quoted currency rates. The value of the forward foreign exchange contract assets and liabilities were valued using Level 2 inputs and are listed in the table above.

The carrying amounts reported in our consolidated condensed balance sheets for cash and cash equivalents, accounts receivable, accounts payable and long-term debt approximate fair value.

Inventories

3 Months Ended

Mar. 31, 2020

Inventory Disclosure [Abstract]

Inventories

Inventories consist of the following:



	March 31, 2020		December 31, 2019
Raw materials	$	54,003	$	51,103
Work-in-process	15,062		15,142
Finished goods	105,473		98,371
Total	$	174,538	$	164,616

Earnings Per Share

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Earnings Per Share

Basic earnings per share (“basic EPS”) is computed by dividing net income by the weighted average number of common shares outstanding for the reporting period. Diluted earnings per share (“diluted EPS”) gives effect to all dilutive potential shares outstanding resulting from employee stock options, restricted stock units, performance share units and stock appreciation rights ("SARs") during the period.

The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2020 and 2019:



	Three Months Ended March 31,
	2020		2019
Net income	$	5,927	$	1,021

Basic – weighted average shares outstanding	28,478		28,173

Effect of dilutive potential securities	1,229		861

Diluted – weighted average shares outstanding	29,707		29,034

Net income (per share)
Basic	$	0.21	$	0.04
Diluted	0.20		0.04

The shares used in the calculation of diluted EPS exclude options and SARs to purchase shares where the exercise price was greater than the average market price of common shares for the period and the effect of the inclusion would be anti-dilutive. Such shares aggregated approximately 1.1 million for the three months ended March 31, 2020 and 0.3 million for the three months ended March 31, 2019. Our 2.625% convertible notes due in 2024 (the “Notes”) are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The calculation of diluted EPS would include potential diluted shares upon conversion of the Notes when the average market price per share of our common stock for the period, is greater than the conversion price of the Notes of $88.80. We intend to settle in cash the principal outstanding and use the treasury stock method when calculating their potential dilutive effect, if any. We have entered into convertible notes hedge transactions to increase the effective conversion price of the Notes to $114.92. However, our convertible notes hedges are not included when calculating potential dilutive shares since their effect is always anti-dilutive.

During the three months ended March 31, 2020, our average share price exceeded the conversion price of the Notes and we included 0.1 million shares assumed to be issued if the Notes were converted in our diluted share count. During the three months ended March 31, 2019, our average share price had not exceeded the conversion price of the Notes; therefore, under the net share settlement method, there were no potential shares issuable under the Notes to be used in the calculation of diluted EPS.

Goodwill and Other Intangible Assets

3 Months Ended

Mar. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangible Assets

The changes in the net carrying amount of goodwill for the three months ended March 31, 2020 are as follows:



Balance as of December 31, 2019	$	618,042

Goodwill adjustment resulting from business acquisition	(1,009		)

Foreign currency translation	(1,351		)

Balance as of March 31, 2020	$	615,682

Assets and liabilities of acquired businesses are recorded at their estimated fair values as of the date of acquisition. Goodwill represents costs in excess of fair values assigned to the underlying net assets of acquired businesses. During the three months ended March 31, 2020, the Company recorded a measurement period adjustment related to a prior business combination.

Other intangible assets consist of the following:



	March 31, 2020						December 31, 2019
	Weighted Average Amortization Period (Years)	Gross Carrying Amount		Accumulated Amortization			Gross Carrying Amount		Accumulated Amortization
Intangible assets with definite lives:

Customer and distributor relationships	24	$	342,359	$	(120,072	)	$	342,568	$	(115,311	)

Sales representation, marketing and promotional rights	25	149,376		(49,500		)	149,376		(48,000		)

Patents and other intangible assets	15	71,582		(47,066		)	70,646		(46,456		)

Developed technology	16	106,604		(14,805		)	106,604		(13,171		)

Intangible assets with indefinite lives:

Trademarks and tradenames		86,544		—			86,544		—

	22	$	756,465	$	(231,443	)	$	755,738	$	(222,938	)

Customer and distributor relationships, trademarks and tradenames, developed technology and patents and other intangible assets primarily represent allocations of purchase price to identifiable intangible assets of acquired businesses. Sales representation, marketing and promotional rights represent intangible assets created under our agreement with Musculoskeletal Transplant Foundation (“MTF”).

Amortization expense related to intangible assets which are subject to amortization totaled $8.5 million and $7.4 million in the three months ended March 31, 2020 and 2019, respectively, and is included as a reduction of revenue (for amortization related to our sales representation, marketing and promotional rights) and in selling and administrative expense (for all other

intangible assets) in the consolidated condensed statements of comprehensive income. Included in developed technology is $6.4 million of earn-out consideration that is considered probable as of March 31, 2020 associated with a prior asset acquisition. This is recorded in other current liabilities at March 31, 2020.

The estimated intangible asset amortization expense remaining for the year ending December 31, 2020 and for each of the five succeeding years is as follows:



	Amortization included in expense		Amortization recorded as a reduction of revenue		Total
Remaining, 2020	$	21,055	$	4,500	$	25,555
2021	27,453		6,000		33,453
2022	26,299		6,000		32,299
2023	25,443		6,000		31,443
2024	24,705		6,000		30,705
2025	24,957		6,000		30,957

Long Term Debt

3 Months Ended

Mar. 31, 2020

Debt Disclosure [Abstract]

Long Term Debt

Long-Term Debt

Long-term debt consists of the following:



	March 31, 2020		December 31, 2019
Revolving line of credit	$	238,000	$	220,000
Term loan, net of deferred debt issuance costs of $1,428 and $1,528 in 2020 and 2019, respectively	250,322		253,535
2.625% convertible notes, net of deferred debt issuance costs of $6,807 and $7,252 in 2020 and 2019, respectively, and unamortized discount of $41,048 and $43,312 in 2020 and 2019, respectively	297,145		294,436
Financing leases	734		836
Total debt	786,201		768,807
Less: Current portion	13,571		13,596
Total long-term debt	$	772,630	$	755,211

On February 7, 2019 we entered into a sixth amended and restated senior credit agreement consisting of: (a) a $265.0 million term loan facility and (b) a $585.0 million revolving credit facility. The revolving credit facility will terminate and the loans outstanding under the term loan facility will expire on the earlier of (i) February 7, 2024 or (ii) 91 days prior to the earliest scheduled maturity date of the 2.625% convertible notes due in 2024 described below, (if, as of such date, more than $150.0 million in aggregate principal amount of such convertible notes (or any refinancing thereof) remains outstanding). The term loan facility is payable in quarterly installments increasing over the term of the facility. Proceeds from the term loan facility and borrowings under the revolving credit facility were used to repay the then existing senior credit agreement and in part to finance the acquisition of Buffalo Filter. Interest rates were at LIBOR plus an interest rate margin of 1.50% (2.50% at March 31, 2020). For those borrowings where we elected to use the alternate base rate, the initial base rate was the greatest of (i) the Prime Rate, (ii) the Federal Funds Rate plus 0.50% or (iii) the one-month Eurocurrency Rate plus 1.00%, plus, in each case, an interest rate margin.

There were $251.8 million in borrowings outstanding on the term loan facility as of March 31, 2020. There were $238.0 million in borrowings outstanding under the revolving credit facility as of March 31, 2020. Our available borrowings on the revolving credit facility at March 31, 2020 were $344.5 million with approximately $2.5 million of the facility set aside for outstanding letters of credit.

The sixth amended and restated senior credit agreement is collateralized by substantially all of our personal property and assets. The sixth amended and restated senior credit agreement contains covenants and restrictions which, among other things, require the maintenance of certain financial ratios and restrict dividend payments and the incurrence of certain indebtedness and other activities, including acquisitions and dispositions. We were in full compliance with these covenants and restrictions as of March 31, 2020. We are also required, under certain circumstances, to make mandatory prepayments from net cash proceeds from any issuance of equity and asset sales.

On April 17, 2020, we amended our sixth amended and restated senior credit agreement to suspend our normal leverage ratios for up to four quarters as a result of the potential impact from the COVID-19 pandemic (as further described in Note 17). Under the terms of the amendment, there are certain minimum liquidity and fixed charge coverage ratio requirements. Interest rates are also adjusted so that the applicable margin for base rate loans is 2.50% per annum and for Eurocurrency rate loans is 3.50% per annum, and the applicable commitment fee rate for the revolving credit facility is 0.50%. Following the suspension period, the applicable margin will depend upon CONMED’s consolidated senior secured leverage ratio, using the pricing grid set forth in the amendment.

On January 29, 2019, we issued $345.0 million in 2.625% convertible notes due in 2024 (the "Notes"). Interest is payable semi-annually in arrears on February 1 and August 1 of each year, commencing August 1, 2019. The Notes will mature on February 1, 2024, unless earlier repurchased or converted. The Notes represent subordinated unsecured obligations and are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The Notes may be converted at an initial conversion rate of 11.2608 shares of our common stock per $1,000 principal amount of Notes (equivalent to an initial conversion price of approximately $88.80 per share of common stock). Holders of the Notes may convert the Notes at their option at any time on or after November 1, 2023 through the second scheduled trading day preceding the maturity date. Holders of the Notes will also have the right to convert the Notes prior to November 1, 2023, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of the net proceeds from the offering of the Notes were used as part of the financing for the Buffalo Filter acquisition and $21.0 million were used to pay the cost of certain convertible notes hedge transactions as further described below.

Our effective borrowing rate for nonconvertible debt at the time of issuance of the Notes was estimated to be 6.14%, which resulted in $51.6 million of the $345.0 million aggregate principal amount of Notes issued, or $39.1 million after taxes, being attributable to equity. For the three months ended March 31, 2020 and 2019, we have recorded interest expense related to the amortization of debt discount on the Notes of $2.3 million and $1.5 million, respectively, at the effective interest rate of 6.14%. The debt discount on the Notes is being amortized through February 2024. For the three months ended March 31, 2020 and 2019, we have recorded interest expense on the Notes of $2.3 million and $1.6 million, respectively, at the contractual coupon rate of 2.625%.

In connection with the offering of the Notes, we entered into convertible note hedge transactions with a number of financial institutions (each, an “option counterparty”). The convertible note hedge transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the Notes, the number of shares of our common stock underlying the Notes. Concurrently with entering into the convertible note hedge transactions, we also entered into separate warrant transactions with each option counterparty whereby we sold to such option counterparty warrants to purchase, subject to customary anti-dilution adjustments, the same number of shares of our common stock.

The convertible note hedge transactions are expected generally to reduce the potential dilution upon conversion of the Notes and/or offset any cash payments we are required to make in excess of the principal amount of converted Notes, as the case may be, in the event that the market price per share of our common stock, as measured under the terms of the convertible note hedge transactions, is greater than the strike price ($114.92) of the convertible note hedge transactions, which initially corresponds to the conversion price of the Notes and is subject to anti-dilution adjustments substantially similar to those applicable to the conversion rate of the Notes. If, however, the market price per share of our common stock, as measured under the terms of the warrant transactions, exceeds the strike price of the warrants, there would nevertheless be dilution to the extent that such market price exceeds the strike price of the warrants.

The scheduled maturities of long-term debt outstanding at March 31, 2020 are as follows:



Remaining 2020	$	9,937
2021	18,219
2022	24,844
2023	436,750
2024	345,000

Guarantees

3 Months Ended

Mar. 31, 2020

Guarantees [Abstract]

Guarantees

We provide warranties on certain of our products at the time of sale and sell extended warranties. The standard warranty period for our capital equipment is generally one year and our extended warranties typically vary from one to three years. Liability under service and warranty policies is based upon a review of historical warranty and service claim experience. Adjustments are made to accruals as claim data and historical experience warrant.

Changes in the carrying amount of service and product standard warranties for the three months ended March 31, are as follows:



	2020			2019
Balance as of January 1,	$	2,186		$	1,585

Provision for warranties	355			486
Claims made	(363		)	(343		)

Balance as of March 31,	$	2,178		$	1,728

Costs associated with extended warranty repairs are recorded as incurred and amounted to $1.5 million and $1.4 million for the three months ended March 31, 2020 and 2019, respectively.

Pension Plan

3 Months Ended

Mar. 31, 2020

Retirement Benefits [Abstract]

Pension Plan

Net periodic pension cost consists of the following:



	Three Months Ended March 31,
	2020			2019
Service cost	$	179		$	253

Interest cost on projected benefit obligation	639			782

Expected return on plan assets	(1,255		)	(1,181		)

Net amortization and deferral	705			720

Net periodic pension cost	$	268		$	574

We do not expect to make any pension contributions during 2020. Non-service cost of $0.1 million and $0.3 million are included in other expense in the consolidated condensed statements of comprehensive income for the three months ended March 31, 2020 and 2019, respectively.

Acquisition and Other Expense

3 Months Ended

Mar. 31, 2020

Acquisition and Other Expense [Abstract]

Acquisition and Other Expense [Text Block]

Acquisition and Other Expense

Acquisition and other expense consists of the following:



	Three Months Ended March 31,
	2020		2019

Manufacturing consolidation costs	$	1,785	$	—
Acquisition and integration costs	805		660
Acquisition and other expense included in cost of sales	$	2,590	$	660

Acquisition and integration costs included in selling and administrative expense	$	754	$	7,245

Debt refinancing costs included in other expense	$	—	$	3,904

During the three months ended March 31, 2020, we incurred $1.8 million in costs related to the consolidation of certain manufacturing operations which were charged to cost of sales. These costs related to winding down operations at certain locations and moving production lines to other facilities.

In conjunction with the consolidation of our manufacturing operations, our Buffalo, New York facility is currently held for sale and classified in prepaid expenses and other current assets in the consolidated condensed balance sheet. The net book value of this facility at March 31, 2020 was $3.0 million.

During the three months ended March 31, 2020 and 2019, we incurred costs for inventory adjustments and other costs of $0.8 million related to a previous acquisition and $0.7 million associated with the acquisition of Buffalo Filter as further described in Note 3, respectively. These costs were charged to cost of sales.

During the three months ended March 31, 2020, we incurred $0.8 million in severance and integration costs mainly related to the Buffalo Filter acquisition. During the three months ended March 31, 2019, we incurred $7.2 million in investment banking fees, consulting fees, legal fees and integration related costs associated with the February 11, 2019 acquisition of Buffalo Filter as further described in Note 3. These costs were included in selling and administrative expense.

During the three months ended March 31, 2019, we incurred a $3.6 million charge related to commitment fees paid to certain of our lenders, which provided a financing commitment for the Buffalo Filter acquisition and recorded a loss on the early extinguishment of debt of $0.3 million in conjunction with the sixth amended and restated senior credit agreement.

Business Segments

3 Months Ended

Mar. 31, 2020

Segment Reporting [Abstract]

Business Segments

Business Segment

We are accounting and reporting for our business as a single operating segment entity engaged in the development, manufacturing and sale on a global basis of surgical devices and related equipment. Our chief operating decision maker (the CEO) evaluates the various global product portfolios on a net sales basis and evaluates profitability, investment, cash flow metrics and allocates resources on a consolidated worldwide basis due to shared infrastructure and resources. Our product lines consist of orthopedic surgery and general surgery. Orthopedic surgery consists of sports medicine instrumentation and small bone, large bone and specialty powered surgical instruments as well as imaging systems for use in minimally invasive surgery procedures including 2DHD and 3DHD vision technologies and fees related to the sales representation, promotion and marketing of sports medicine allograft tissue. General surgery consists of a complete line of endo-mechanical instrumentation for minimally invasive laparoscopic and gastrointestinal procedures, a line of cardiac monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales are as follows:



	Three Months Ended March 31,
	2020		2019
Orthopedic surgery	$	99,283	$	113,437
General surgery	114,727		104,941
Consolidated net sales	$	214,010	$	218,378

Legal Proceedings	3 Months Ended
Legal Proceedings	Mar. 31, 2020
Commitments and Contingencies Disclosure [Abstract]
Legal Proceedings	Legal Proceedings From time to time, the Company may receive an information request or subpoena from a government agency such as the Securities and Exchange Commission, Department of Justice, Equal Employment Opportunity Commission, the Occupational Safety and Health Administration, the United States Food and Drug Administration, the Department of Labor, the Treasury Department or other federal and state agencies or foreign governments or government agencies. These information requests or subpoenas may or may not be routine inquiries, or may begin as routine inquiries and over time develop into enforcement actions of various types. Likewise, if we receive reports of alleged misconduct from employees and third parties, we investigate as appropriate. Manufacturers of medical devices have been the subject of various enforcement actions relating to interactions with health care providers domestically or internationally whereby companies are claimed to have provided health care providers with inappropriate incentives to purchase their products. Similarly, the Foreign Corrupt Practices Act ("FCPA") imposes obligations on manufacturers with respect to interactions with health care providers who may be considered government officials based on their affiliation with public hospitals. The FCPA also requires publicly listed manufacturers to maintain accurate books and records, and maintain internal accounting controls sufficient to provide assurance that transactions are accurately recorded, lawful and in accordance with management's authorization. The FCPA poses unique challenges both because manufacturers operate in foreign cultures in which conduct illegal under the FCPA may not be illegal in local jurisdictions, and because, in some cases, a United States manufacturer may face risks under the FCPA based on the conduct of third parties over whom the manufacturer may not have complete control. While CONMED has not experienced any material enforcement action to date, there can be no assurance that the Company will not be subject to a material enforcement action in the future, or that the Company will not incur costs including, in the form of fees for lawyers and other consultants, that are material to the Company’s results of operations in the course of responding to a future inquiry or investigation. Manufacturers of medical products may face exposure to significant product liability claims, as well as patent infringement and other claims incurred in the ordinary course of business. To date, we have not experienced any claims that have been material to our financial statements or financial condition, but any such claims arising in the future could have a material adverse effect on our business, results of operations or cash flows. We currently maintain commercial product liability insurance of $30 million per incident and $30 million in the aggregate annually, which we believe is adequate. This coverage is on a claims-made basis. There can be no assurance that claims will not exceed insurance coverage, that the carriers will be solvent or that such insurance will be available to us in the future at a reasonable cost. Our operations are subject, and in the past have been subject, to a number of environmental laws and regulations governing, among other things, air emissions; wastewater discharges; the use, handling and disposal of hazardous substances and wastes; soil and groundwater remediation and employee health and safety. Likewise, the operations of our suppliers and sterilizers are subject to similar environmental laws and regulations. In some jurisdictions, environmental requirements may be expected to become more stringent in the future. In the United States, certain environmental laws can impose liability for the entire cost of site restoration upon each of the parties that may have contributed to conditions at the site regardless of fault or the lawfulness of the party’s activities. While we do not believe that the present costs of environmental compliance and remediation are material, there can be no assurance that future compliance or remedial obligations would not have a material adverse effect on our financial condition, results of operations or cash flows. In 2014, the Company acquired EndoDynamix, Inc. The agreement governing the terms of the acquisition provides that, if various conditions are met, certain contingent payments relating to the first commercial sale of the products (the milestone payment), as well as royalties based on sales (the revenue based payments), are due to the seller. In 2016, we notified the seller that there was a need to redesign the product, and that, as a consequence, the first commercial sale had been delayed. Consequently, the payment of contingent milestone and revenue-based payments were delayed. On January 18, 2017, the seller provided notice ("the Notice") seeking $12.7 million, which essentially represents the seller's view as to the sum of the projected contingent milestone and revenue-based payments on an accelerated basis. CONMED responded to the Notice denying that there was any basis for acceleration of the payments due under the acquisition agreement. On February 22, 2017, the representative of the former shareholders of EndoDynamix filed a complaint in Delaware Chancery Court claiming breach of contract with respect to the duty to commercialize the product and seeking the contingent payments on an accelerated basis. We believe that there was a substantive contractual basis to support the Company's decision to redesign the product, such that there was no legitimate basis for seeking the acceleration of the contingent payments at that time. In the third quarter of 2018, the Company decided to halt the development of the EndoDynamix clip applier. We previously recorded a charge to write off assets and released a previously accrued contingent consideration liability. A non-jury trial is now scheduled to take place in December 2020. We expect to defend the claims asserted by the sellers of EndoDynamix in the Delaware Court, although there can be no assurance that we will prevail in the litigation. We record reserves sufficient to cover probable and estimable losses associated with any such pending claims. We do not expect that the resolution of any pending claims, investigations or reports of alleged misconduct will have a material adverse effect on our financial condition, results of operations or cash flows. There can be no assurance, however, that future claims or investigations, or the costs associated with responding to such claims, investigations or reports of misconduct, especially claims and investigations not covered by insurance, will not have a material adverse effect on our financial condition, results of operations or cash flows.

New Accounting Pronouncements	3 Months Ended
New Accounting Pronouncements	Mar. 31, 2020
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards In June 2016, the FASB issued ASU No. 2016-13 Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, along with subsequent amendments issued in 2019. This ASU requires instruments measured at amortized cost, including accounts receivable, to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments. This ASU is effective for fiscal years beginning after December 31, 2019 and the Company adopted the new standard on January 1, 2020. We adopted this ASU by applying historical loss rates to our accounts receivable aging schedule to estimate expected credit losses. We further adjusted expected credit losses for specifically identified and forecasted credit losses. This update did not have a material impact on our net income, earnings per share or cash flows. In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement, which modifies the disclosure requirements on fair value measurements. This ASU is effective for fiscal years beginning after December 15, 2019 and early adoption is permitted. We adopted this update as of January 1, 2020 and it did not have a material impact on our net income, earnings per share or cash flows. Recently Issued Accounting Standards, Not Yet Adopted In August 2018, the FASB issued ASU 2018-14, Compensation-Retirement Benefits-Defined Benefit Plans-General (Topic 715-20): Disclosure Framework-Changes to the Disclosure Requirements for Defined Benefit Plans, which modifies the disclosure requirements for defined benefit pension plans and other postretirement plans. This ASU is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes, which results in the removal of certain exceptions to the general principles of ASC 740 and simplifies other aspects of the accounting for income taxes. This ASU is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2020. The Company has not adopted the ASU as of March 31, 2020 and will continue to assess the impact of this guidance on our consolidation financial statements.

COVID-19 (Notes)	3 Months Ended
COVID-19 (Notes)	Mar. 31, 2020
COVID-19 [Abstract]
COVID-19 [Text Block]	COVID-19 We experienced lower sales for the three months ended March 31, 2020 as a result of the emergence of the COVID-19 virus, which was first identified in Wuhan, China in December 2019 and then spread throughout Asia before emerging in the United States, Europe and elsewhere. Our sales were negatively impacted first in the Asia Pacific geography and later in the United States, Europe and elsewhere as lockdown measures were implemented and hospitals and surgery centers postponed many non-urgent surgical procedures in order to minimize the risk of infection with COVID-19. We believe the deferral of non-urgent procedures has had a greater impact on our Orthopedic product lines compared to General Surgery as a result of the nature of the products and the procedures in which they are used. In compliance with various governmental lockdown orders, beginning in March we restricted access to our main facilities to only essential personnel required to be onsite (primarily manufacturing and distribution) with substantially all other personnel working remotely. As a medical device manufacturer, we were designated as an “essential business” by the relevant authorities in New York, Florida, Georgia and Mexico and have maintained production or distribution at our facilities in these locations. We expect to continue to experience materially lower sales for as long as the lockdown and deferral of surgeries continues, which we anticipate will materially impact the results of operations for the quarter ended June 30, 2020. As a result, on April 17, 2020 we amended our sixth amended and restated senior credit agreement to suspend our normal leverage ratios (the "Existing Covenants") for up to four quarters. Under the terms of the amendment, we will have certain minimum liquidity and fixed charge coverage ratio requirements. We were in full compliance with our Existing Covenants as of March 31, 2020. We are forecasting that sales and earnings will be sufficient to remain in compliance with the liquidity and fixed charge coverage ratio requirements under the terms of the amendment and we will have sufficient availability under our revolving credit facility to meet our liquidity needs. We have undertaken steps to reduce our spending and expenses in light of our expectation that our revenues will be depressed over the next several months. While we expect that we will be well positioned when surgeries begin to return to their pre-pandemic levels, we are unable to predict with certainty how long the COVID-19 pandemic will last, or how severe its economic impact will be. Even after the COVID-19 pandemic and government responses thereto have subsided, residual economic and other effects may have an impact on the demand for post-pandemic surgery levels that are difficult to predict. If the downturn is more severe and prolonged than we currently expect, we may need to take further steps to reduce our costs, or to refinance our debt. Additionally, the Coronavirus Aid, Relief, and Economic Security (CARES) Act was signed into law on March 27, 2020 to provide economic relief in the early wake of the COVID-19 pandemic. The CARES Act includes many measures to assist companies, including temporary changes to income and non-income-based tax laws. Income tax relief includes temporary favorable changes to net operating loss and interest expense annual deduction limitations. These provisions are not expected to result in any material impact to our financial results.

Subsequent Events	3 Months Ended
Subsequent Events	Mar. 31, 2020
Subsequent Events [Abstract]
Subsequent Events [Text Block]	Subsequent Events On April 17, 2020, we amended our sixth amended and restated senior credit agreement to suspend our normal leverage ratios for up to four quarters as a result of the potential impact from the COVID-19 pandemic. Under the terms of the amendment, there are certain minimum liquidity and fixed charge coverage ratio requirements. Refer to Note 10 for further details.

New Accounting Pronouncements (Policies)	3 Months Ended
New Accounting Pronouncements (Policies)	Mar. 31, 2020
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards In June 2016, the FASB issued ASU No. 2016-13 Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, along with subsequent amendments issued in 2019. This ASU requires instruments measured at amortized cost, including accounts receivable, to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments. This ASU is effective for fiscal years beginning after December 31, 2019 and the Company adopted the new standard on January 1, 2020. We adopted this ASU by applying historical loss rates to our accounts receivable aging schedule to estimate expected credit losses. We further adjusted expected credit losses for specifically identified and forecasted credit losses. This update did not have a material impact on our net income, earnings per share or cash flows. In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement, which modifies the disclosure requirements on fair value measurements. This ASU is effective for fiscal years beginning after December 15, 2019 and early adoption is permitted. We adopted this update as of January 1, 2020 and it did not have a material impact on our net income, earnings per share or cash flows. Recently Issued Accounting Standards, Not Yet Adopted In August 2018, the FASB issued ASU 2018-14, Compensation-Retirement Benefits-Defined Benefit Plans-General (Topic 715-20): Disclosure Framework-Changes to the Disclosure Requirements for Defined Benefit Plans, which modifies the disclosure requirements for defined benefit pension plans and other postretirement plans. This ASU is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In December 2019, the FASB issued ASU 2019-12, Income Taxes (Topic 740): Simplifying the Accounting for Income Taxes, which results in the removal of certain exceptions to the general principles of ASC 740 and simplifies other aspects of the accounting for income taxes. This ASU is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2020. The Company has not adopted the ASU as of March 31, 2020 and will continue to assess the impact of this guidance on our consolidation financial statements.

Business Acquisition (Tables)

3 Months Ended

Mar. 31, 2020

Business Combinations [Abstract]

Business Acquisition, Pro Forma Information



	Three Months Ended March 31,
	2019
Net sales	$	223,397
Net income	8,745

Revenues (Tables)

3 Months Ended

Mar. 31, 2020

Revenue from Contract with Customer [Abstract]

Disaggregation of Revenue

The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition:



	Three Months Ended						Three Months Ended
	March 31, 2020						March 31, 2019
	Orthopedic Surgery		General Surgery		Total		Orthopedic Surgery		General Surgery		Total
Primary Geographic Markets
United States	$	37,039	$	81,808	$	118,847	$	45,256	$	71,770	$	117,026
Americas (excluding the United States)	15,802		7,979		23,781		15,042		7,462		22,504
Europe, Middle East & Africa	25,907		16,615		42,522		30,402		15,930		46,332
Asia Pacific	20,535		8,325		28,860		22,737		9,779		32,516
Total sales from contracts with customers	$	99,283	$	114,727	$	214,010	$	113,437	$	104,941	$	218,378

Timing of Revenue Recognition
Goods transferred at a point in time	$	90,553	$	113,901	$	204,454	$	104,739	$	104,425	$	209,164
Services transferred over time	8,730		826		9,556		8,698		516		9,214
Total sales from contracts with customers	$	99,283	$	114,727	$	214,010	$	113,437	$	104,941	$	218,378

Contract with Customer, Asset and Liability

Contract liability balances related to the sale of extended warranties to customers are as follows:



	March 31, 2020		December 31, 2019

Contract liability	$	14,550	$	14,276

Comprehensive Income (Tables)

3 Months Ended

Mar. 31, 2020

Equity [Abstract]

Schedule of Comprehensive Income

Comprehensive income consists of the following:



	Three Months Ended March 31,
	2020			2019
Net income	$	5,927		$	1,021

Other comprehensive income (loss):
Pension liability, net of income tax (income tax expense of $170 and $173 for the three months ended March 31, 2020 and 2019, respectively)	535			547
Cash flow hedging gain, net of income tax (income tax expense of $766 and $34 for the three months ended March 31, 2020 and 2019, respectively)	2,405			106
Foreign currency translation adjustment	(9,988		)	(578		)

Comprehensive income (loss)	$	(1,121	)	$	1,096

Schedule of Accumulated Other Comprehensive Loss

Accumulated other comprehensive loss consists of the following:



	Cash Flow Hedging Gain (Loss)			Pension Liability			Cumulative Translation Adjustments			Accumulated Other Comprehensive Income (Loss)
Balance, December 31, 2019	$	493		$	(31,691	)	$	(28,079	)	$	(59,277	)

Other comprehensive income (loss) before reclassifications, net of tax	3,257			—			(9,988		)	(6,731		)
Amounts reclassified from accumulated other comprehensive income (loss) before tax^a	(1,124		)	705			—			(419		)
Income tax	272			(170		)	—			102

Net current-period other comprehensive income (loss)	2,405			535			(9,988		)	(7,048		)

Balance, March 31, 2020	$	2,898		$	(31,156	)	$	(38,067	)	$	(66,325	)



	Cash Flow Hedging Gain (Loss)			Pension Liability			Cumulative Translation Adjustments			Accumulated Other Comprehensive Income (Loss)
Balance, December 31, 2018	$	4,085		$	(31,718	)	$	(28,104	)	$	(55,737	)

Other comprehensive income (loss) before reclassifications, net of tax	1,318			—			(578		)	740
Amounts reclassified from accumulated other comprehensive income (loss) before tax^a	(1,598		)	720			—			(878		)
Income tax	386			(173		)	—			213

Net current-period other comprehensive income (loss)	106			547			(578		)	75

Balance, March 31, 2019	$	4,191		$	(31,171	)	$	(28,682	)	$	(55,662	)

Fair Value of Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2020

Fair Value Disclosures [Abstract]

Schedule of Notional Amounts of Outstanding Derivative Positions

The following table presents the notional contract amounts for forward contracts outstanding:



		As of
	FASB ASC Topic 815 Designation	March 31, 2020		December 31, 2019
Forward exchange contracts	Cash flow hedge	$	156,229	$	156,818
Forward exchange contracts	Non-designated	37,819		33,867

Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)



	Amount of Gain Recognized in AOCI				Consolidated Condensed Statements of Comprehensive Income					Amount of Gain (Loss) Reclassified from AOCI
	Three Months Ended March 31,					Three Months Ended March 31,				Three Months Ended March 31,
						Total Amount of Line Item Presented
Derivative Instrument	2020		2019		Location of amount reclassified	2020		2019		2020			2019

Foreign exchange contracts	$	4,295	$	1,738	Net Sales	$	214,010	$	218,378	$	1,201		$	1,497
					Cost of Sales	94,851		96,940		(77		)	101
Pre-tax gain	$	4,295	$	1,738						$	1,124		$	1,598
Tax expense	1,038		420							272			386
Net gain	$	3,257	$	1,318						$	852		$	1,212

Derivatives Not Designated as Hedging Instruments

Net losses from derivative instruments not accounted for as hedges and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income were:



		Three Months Ended March 31,
Derivative Instrument	Location on Consolidated Condensed Statements of Comprehensive Income	2020			2019

Net loss on currency forward contracts	Selling and administrative expense	$	(245	)	$	(181	)
Net loss on currency transaction exposures	Selling and administrative expense	$	(191	)	$	(229	)

Schedule of Fair Value for Forward Foreign Exchange Contracts

The following tables summarize the fair value for forward foreign exchange contracts outstanding at March 31, 2020 and December 31, 2019:



March 31, 2020	Location on Consolidated Condensed Balance Sheet	Asset Fair Value		Liabilities Fair Value			Net Fair Value
Derivatives designated as hedged instruments:
Foreign exchange contracts	Prepaids and other current assets	$	5,329	$	(1,790	)	$	3,539
Foreign exchange contracts	Other long-term assets	1,190		(907		)	283
		$	6,519	$	(2,697	)	$	3,822

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	25		(255		)	(230		)

Total derivatives		$	6,544	$	(2,952	)	$	3,592



December 31, 2019	Location on Consolidated Condensed Balance Sheet	Asset Fair Value		Liabilities Fair Value			Net Fair Value
Derivatives designated as hedged instruments:
Foreign exchange contracts	Prepaids and other current assets	$	2,307	$	(1,341	)	$	966
Foreign exchange contracts	Other long-term liabilities	38		(353		)	(315		)
		$	2,345	$	(1,694	)	$	651

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	22		(159		)	(137		)

Total derivatives		$	2,367	$	(1,853	)	$	514

Inventories (Tables)

3 Months Ended

Mar. 31, 2020

Inventory Disclosure [Abstract]

Schedule of inventory

Inventories consist of the following:



	March 31, 2020		December 31, 2019
Raw materials	$	54,003	$	51,103
Work-in-process	15,062		15,142
Finished goods	105,473		98,371
Total	$	174,538	$	164,616

Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2020

Earnings Per Share [Abstract]

Schedule of calculation of basic and diluted earnings per share

The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2020 and 2019:



	Three Months Ended March 31,
	2020		2019
Net income	$	5,927	$	1,021

Basic – weighted average shares outstanding	28,478		28,173

Effect of dilutive potential securities	1,229		861

Diluted – weighted average shares outstanding	29,707		29,034

Net income (per share)
Basic	$	0.21	$	0.04
Diluted	0.20		0.04

Goodwill and Other Intangible Assets (Tables)

3 Months Ended

Mar. 31, 2020

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

The changes in the net carrying amount of goodwill for the three months ended March 31, 2020 are as follows:



Balance as of December 31, 2019	$	618,042

Goodwill adjustment resulting from business acquisition	(1,009		)

Foreign currency translation	(1,351		)

Balance as of March 31, 2020	$	615,682

Schedule of Finite-Lived and Indefinite-Lived Intangible Assets

Other intangible assets consist of the following:



	March 31, 2020						December 31, 2019
	Weighted Average Amortization Period (Years)	Gross Carrying Amount		Accumulated Amortization			Gross Carrying Amount		Accumulated Amortization
Intangible assets with definite lives:

Customer and distributor relationships	24	$	342,359	$	(120,072	)	$	342,568	$	(115,311	)

Sales representation, marketing and promotional rights	25	149,376		(49,500		)	149,376		(48,000		)

Patents and other intangible assets	15	71,582		(47,066		)	70,646		(46,456		)

Developed technology	16	106,604		(14,805		)	106,604		(13,171		)

Intangible assets with indefinite lives:

Trademarks and tradenames		86,544		—			86,544		—

	22	$	756,465	$	(231,443	)	$	755,738	$	(222,938	)

Schedule of Estimated Amortization Expense

The estimated intangible asset amortization expense remaining for the year ending December 31, 2020 and for each of the five succeeding years is as follows:



	Amortization included in expense		Amortization recorded as a reduction of revenue		Total
Remaining, 2020	$	21,055	$	4,500	$	25,555
2021	27,453		6,000		33,453
2022	26,299		6,000		32,299
2023	25,443		6,000		31,443
2024	24,705		6,000		30,705
2025	24,957		6,000		30,957

Long Term Debt (Tables)

3 Months Ended

Mar. 31, 2020

Debt Disclosure [Abstract]

Schedule of Long-term Debt

Long-term debt consists of the following:



	March 31, 2020		December 31, 2019
Revolving line of credit	$	238,000	$	220,000
Term loan, net of deferred debt issuance costs of $1,428 and $1,528 in 2020 and 2019, respectively	250,322		253,535
2.625% convertible notes, net of deferred debt issuance costs of $6,807 and $7,252 in 2020 and 2019, respectively, and unamortized discount of $41,048 and $43,312 in 2020 and 2019, respectively	297,145		294,436
Financing leases	734		836
Total debt	786,201		768,807
Less: Current portion	13,571		13,596
Total long-term debt	$	772,630	$	755,211

Schedule of Maturities of Long-term Debt

The scheduled maturities of long-term debt outstanding at March 31, 2020 are as follows:



Remaining 2020	$	9,937
2021	18,219
2022	24,844
2023	436,750
2024	345,000

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
-URI http://asc.fasb.org/extlink&oid=6877327&loc=d3e13212-122682

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 1A
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28541-108399

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 6
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21506-112644

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08.(e),(f))
-URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690

Reference 5: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=114775744&loc=d3e28551-108399

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
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-Section 50
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21521-112644

Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
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-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21538-112644

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
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-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=75038535&loc=d3e64711-112823

Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
-SubTopic 30
-Section 55
-Paragraph 8
-URI http://asc.fasb.org/extlink&oid=114775985&loc=d3e28878-108400

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=109259400&loc=d3e21475-112644

+ Details

Guarantees (Tables)

3 Months Ended

Mar. 31, 2020

Guarantees [Abstract]

Changes in the carrying amount of service and product warranties

Changes in the carrying amount of service and product standard warranties for the three months ended March 31, are as follows:



	2020			2019
Balance as of January 1,	$	2,186		$	1,585

Provision for warranties	355			486
Claims made	(363		)	(343		)

Balance as of March 31,	$	2,178		$	1,728

Pension Plan (Tables)

3 Months Ended

Mar. 31, 2020

Retirement Benefits [Abstract]

Schedule of net benefit cost

Net periodic pension cost consists of the following:



	Three Months Ended March 31,
	2020			2019
Service cost	$	179		$	253

Interest cost on projected benefit obligation	639			782

Expected return on plan assets	(1,255		)	(1,181		)

Net amortization and deferral	705			720

Net periodic pension cost	$	268		$	574

Acquisition and Other Expense (Tables)

3 Months Ended

Mar. 31, 2020

Acquisition and Other Expense [Abstract]

Schedule of Acquisition and Other Operating Expense [Table Text Block]

Acquisition and other expense consists of the following:



	Three Months Ended March 31,
	2020		2019

Manufacturing consolidation costs	$	1,785	$	—
Acquisition and integration costs	805		660
Acquisition and other expense included in cost of sales	$	2,590	$	660

Acquisition and integration costs included in selling and administrative expense	$	754	$	7,245

Debt refinancing costs included in other expense	$	—	$	3,904

Business Segments (Tables)

3 Months Ended

Mar. 31, 2020

Segment Reporting [Abstract]

Schedule of net sales information by product line

These product lines' net sales are as follows:



	Three Months Ended March 31,
	2020		2019
Orthopedic surgery	$	99,283	$	113,437
General surgery	114,727		104,941
Consolidated net sales	$	214,010	$	218,378

Business Acquisition (Details) - USD ($) $ in Thousands		3 Months Ended
Business Acquisition (Details) - USD ($) $ in Thousands	Feb. 11, 2019	Mar. 31, 2020	Mar. 31, 2019
Business Acquisition [Line Items]
Net sales			$ 223,397
Net income			8,745
Net sales		$ 214,010	218,378
Payments to acquire businesses, gross	$ 365,000	$ 3,300
Buffalo Filter LLC
Business Acquisition [Line Items]
Net sales			6,100
Pro Forma \| Acquisition-related Costs \| Cost of Sales
Business Acquisition [Line Items]
Business acquisition costs			700
Pro Forma \| Acquisition-related Costs \| Selling and Administrative Expenses
Business Acquisition [Line Items]
Business acquisition costs			$ 7,200

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Disaggregation of Revenue [Line Items]
Net Sales	$ 214,010	$ 218,378
Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	204,454	209,164
Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	9,556	9,214
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	99,283	113,437
Orthopedic Surgery \| Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	90,553	104,739
Orthopedic Surgery \| Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	8,730	8,698
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	114,727	104,941
General Surgery \| Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	113,901	104,425
General Surgery \| Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	826	516
United States
Disaggregation of Revenue [Line Items]
Net Sales	118,847	117,026
United States \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	37,039	45,256
United States \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	81,808	71,770
Americas (excluding the United States)
Disaggregation of Revenue [Line Items]
Net Sales	23,781	22,504
Americas (excluding the United States) \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	15,802	15,042
Americas (excluding the United States) \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	7,979	7,462
Europe, Middle East & Africa
Disaggregation of Revenue [Line Items]
Net Sales	42,522	46,332
Europe, Middle East & Africa \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	25,907	30,402
Europe, Middle East & Africa \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	16,615	15,930
Asia Pacific
Disaggregation of Revenue [Line Items]
Net Sales	28,860	32,516
Asia Pacific \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	20,535	22,737
Asia Pacific \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	$ 8,325	$ 9,779

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Revenue from Contract with Customer [Abstract]
Contract liability	$ 14,550		$ 14,276
Revenue recognized	$ 3,000	$ 2,300

Comprehensive Income (Details) - USD ($) $ in Thousands	3 Months Ended
Comprehensive Income (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
Equity [Abstract]
Net income	$ 5,927	$ 1,021
Pension liability, net of income tax	535	547
Cash flow hedging gain (loss), net of income tax	2,405	106
Foreign currency translation adjustments	(9,988)	(578)
Comprehensive Income (Loss), Net of Tax, Including Portion Attributable to Noncontrolling Interest	(1,121)	1,096
Pension liability, tax	170	173
Cash flow hedging gain (loss), tax	$ 766	$ 34

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Comprehensive Income (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($)
$ in Thousands

3 Months Ended

Mar. 31, 2020

Mar. 31, 2019

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

$ (59,277)

Accumulated Other Comprehensive Income (Loss), Net of Tax

(66,325)

Accumulated Other Comprehensive Loss

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

(59,277)

$ (55,737)

Other comprehensive income (loss) before reclassifications, net of tax

(6,731)

740

Amounts reclassified from other accumulated comprehensive income (loss) before tax

^[1]

(419)

(878)

Reclassification from AOCI, Current Period, Tax

102

213

Net current-period other comprehensive income (loss)

(7,048)

Accumulated Other Comprehensive Income (Loss), Net of Tax

(66,325)

(55,662)

Cash Flow Hedging Gain (Loss)

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

493

4,085

Other comprehensive income (loss) before reclassifications, net of tax

3,257

1,318

Amounts reclassified from other accumulated comprehensive income (loss) before tax

^[1]

(1,124)

(1,598)

Reclassification from AOCI, Current Period, Tax

272

386

Net current-period other comprehensive income (loss)

2,405

106

Accumulated Other Comprehensive Income (Loss), Net of Tax

2,898

4,191

Pension Liability

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

(31,691)

(31,718)

Other comprehensive income (loss) before reclassifications, net of tax

Amounts reclassified from other accumulated comprehensive income (loss) before tax

^[1]

705

720

Reclassification from AOCI, Current Period, Tax

(170)

(173)

Net current-period other comprehensive income (loss)

535

547

Accumulated Other Comprehensive Income (Loss), Net of Tax

(31,156)

(31,171)

Cumulative Translation Adjustments

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

(28,079)

(28,104)

Other comprehensive income (loss) before reclassifications, net of tax

(9,988)

(578)

Amounts reclassified from other accumulated comprehensive income (loss) before tax

^[1]

Reclassification from AOCI, Current Period, Tax

Net current-period other comprehensive income (loss)

(9,988)

(578)

Accumulated Other Comprehensive Income (Loss), Net of Tax

$ (38,067)

$ (28,682)

[1]	The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.

Fair Value of Financial Instruments (Amounts Recorded In and Reclassified From AOCI) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Derivative Instruments, Gain (Loss) [Line Items]
Net sales	$ 214,010	$ 218,378
Cost of sales	94,851	96,940
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	4,295	1,738
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	1,038	420
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	3,257	1,318
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	1,124	1,598
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	272	386
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	852	1,212
Revenues
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	1,201	1,497
Cost of Sales
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	$ (77)	$ 101

Fair Value of Financial Instruments (Foreign Currency Forward Contracts) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Derivative [Line Items]
Foreign Currency Transaction Gain (Loss), before Tax	$ (191)	$ (229)
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	6,544		$ 2,367
Liabilities Fair Value	(2,952)		(1,853)
Net Fair Value	3,592		514
Foreign Currency Forward Contracts
Derivative [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	(245)	$ (181)
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	6,519		2,345
Liabilities Fair Value	(2,697)		(1,694)
Net Fair Value	3,822		651
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Prepaids and other current assets
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	5,329		2,307
Liabilities Fair Value	(1,790)		(1,341)
Net Fair Value	3,539		966
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Other Noncurrent Assets [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	1,190
Liabilities Fair Value	(907)
Net Fair Value	283
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Other Noncurrent Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value			38
Liabilities Fair Value			(353)
Net Fair Value			(315)
Derivatives not designated as hedging instruments: \| Foreign Currency Forward Contracts
Derivative [Line Items]
Notional amount of cash flow hedges	37,819		33,867
Derivatives not designated as hedging instruments: \| Foreign Currency Forward Contracts \| Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	25		22
Liabilities Fair Value	(255)		(159)
Net Fair Value	$ (230)		(137)
Cash flow hedge \| Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge	2 years
Notional amount of cash flow hedges	$ 156,229		$ 156,818
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 2,700
Derivatives not designated as hedging instruments: \| Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge	1 month

Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Inventory Disclosure [Abstract]
Raw materials	$ 54,003	$ 51,103
Work-in-process	15,062	15,142
Finished goods	105,473	98,371
Total inventory	$ 174,538	$ 164,616

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Earnings Per Share [Abstract]
Net income	$ 5,927	$ 1,021
Basic-weighted average shares outstanding (in shares)	28,478	28,173
Effect of dilutive potential securities (in shares)	1,229	861
Diluted- weighted average shares outstanding (in shares)	29,707	29,034
Basic (in dollars per share)	$ 0.21	$ 0.04
Diluted (in dollars per share)	$ 0.20	$ 0.04
Antidilutive securities excluded from computation of earnings per share (in shares)	1,100	300
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities	100

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 944
-SubTopic 220
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(19))
-URI http://asc.fasb.org/extlink&oid=116637232&loc=SL114874131-224263

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 260
-SubTopic 10
-Section 45
-Paragraph 7
-URI http://asc.fasb.org/extlink&oid=117326831&loc=d3e1337-109256

Reference 3: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 260
-SubTopic 10
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+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References

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+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details

Earnings Per Share - Convertible Notes (Details) - Convertible Notes Payable - 2.625 Percent Convertible Notes Due 2024 [Member]	3 Months Ended
	Mar. 31, 2020 $ / shares
Debt Instrument [Line Items]
Interest rate, stated percentage	2.625%
Conversion price (in dollars per share)	$ 88.80
Option indexed to issuer's equity, strike price (in dollars per share)	$ 114.92

Goodwill and Other Intangible Assets (Goodwill) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2020 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 618,042
Goodwill adjustment resulting from business acquisition	(1,009)
Foreign currency translation	(1,351)
Ending balance	$ 615,682

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Accumulated amortization	$ (231,443)		$ (222,938)
Intangible assets, Gross carrying amount	756,465		755,738
Amortization expense	8,500	$ 7,400
Future amortization expense [Abstract]
Remaining, 2020	25,555
2021	33,453
2022	32,299
2023	31,443
2024	30,705
2025	30,957
Amortization included in expense
Future amortization expense [Abstract]
Remaining, 2020	21,055
2021	27,453
2022	26,299
2023	25,443
2024	24,705
2025	24,957
Amortization recorded as a reduction of revenue
Future amortization expense [Abstract]
Remaining, 2020	4,500
2021	6,000
2022	6,000
2023	6,000
2024	6,000
2025	6,000
Trademarks & tradenames
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Unamortized intangible assets, Gross carrying amount	86,544		86,544
Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	342,359		342,568
Intangible assets, Accumulated amortization	(120,072)		(115,311)
Sales representation, marketing and promotional rights
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	149,376		149,376
Intangible assets, Accumulated amortization	(49,500)		(48,000)
Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	71,582		70,646
Intangible assets, Accumulated amortization	(47,066)		(46,456)
Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	106,604		106,604
Intangible assets, Accumulated amortization	(14,805)		$ (13,171)
Asset acquisition, contingent consideration liability	$ 6,400
Weighted Average
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	22 years
Weighted Average \| Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	24 years
Weighted Average \| Sales representation, marketing and promotional rights
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	25 years
Weighted Average \| Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	15 years
Weighted Average \| Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	16 years

Long Term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Dec. 31, 2019
Debt Instrument [Line Items]
Long-term Debt and Lease Obligation, Including Current Maturities	$ 786,201	$ 768,807
Finance Lease, Liability	734	836
Current portion of long-term debt	13,571	13,596
Long-term debt	772,630	755,211
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt	238,000	220,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt	250,322	253,535
Unamortized Debt Issuance Expense	1,428	1,528
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Convertible Debt	297,145	294,436
Debt Instrument, Unamortized Discount	41,048	43,312
Unamortized Debt Issuance Expense	$ 6,807	$ 7,252

Long Term Debt Additional Information (Details) - USD ($)		3 Months Ended
	Apr. 17, 2020	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Debt Instrument [Line Items]
Amortization of debt discount		$ 2,264,000	$ 1,510,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross		251,800,000
Long-term Debt		250,322,000		$ 253,535,000
Term Loan Facility [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount		265,000,000.0
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt		238,000,000		$ 220,000,000
Line of Credit Facility, Remaining Borrowing Capacity		344,500,000
Line of Credit [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity		585,000,000.0
Letter of Credit [Member]
Debt Instrument [Line Items]
Letters of Credit Outstanding, Amount		2,500,000
Convertible Notes Payable [Member] \| 2.625 Percent Convertible Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount		345,000,000.0
Debt Instrument, Convertible, Carrying Amount of Equity Component		39,100,000
Amortization of debt discount		$ 2,300,000	1,500,000
Interest rate, stated percentage		2.625%
Credit Agreement Expiration Trigger Requirement, Convertible Note Outstanding Balance		$ 150,000,000.0
Debt Instrument, Interest Rate, Effective Percentage		6.14%
Interest Expense, Debt		$ 2,300,000	$ 1,600,000
Debt Instrument, Convertible, Gross Amount of Equity Component		$ 51,600,000
Debt Instrument, Convertible, Initial Conversion Rate		11.2608
Conversion price (in dollars per share)		$ 88.80
Option indexed to issuer's equity, strike price (in dollars per share)		$ 114.92
Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage		2.50%
London Interbank Offered Rate (LIBOR) [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		1.50%
Fed Funds Effective Rate Overnight Index Swap Rate [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		0.50%
Eurodollar [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		1.00%
Call Option [Member]
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid		$ 21,000,000.0
Subsequent Event [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Commitment Fee Percentage	0.50%
Subsequent Event [Member] \| London Interbank Offered Rate (LIBOR) [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	2.50%
Subsequent Event [Member] \| Eurodollar [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate	3.50%

Long Term Debt Maturities of Long Term Debt (Details) $ in Thousands	Mar. 31, 2020 USD ($)
Maturities of Long-term Debt [Abstract]
Remaining, 2020	$ 9,937
2021	18,219
2022	24,844
2023	436,750
2024	$ 345,000

Guarantees (Details) - USD ($) $ in Thousands	3 Months Ended
Guarantees (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
Guarantees [Abstract]
Standard warranty period (in years)	1 year
Movement in Standard Product Warranty Accrual [Roll Forward]
Balance as of January 1,	$ 2,186	$ 1,585
Provision for warranties	355	486
Claims made	(363)	(343)
Balance as of March 31,	2,178	1,728
Extended Product Warranty Disclosure [Abstract]
Product extended warranty expense	$ 1,500	$ 1,400

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended
Pension Plan (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
Retirement Benefits [Abstract]
Service cost	$ 179	$ 253
Interest cost on projected benefit obligation	639	782
Expected return on plan assets	(1,255)	(1,181)
Net amortization and deferral	705	720
Net periodic pension cost	268	574
Defined Benefit Plan, Non-service cost	$ 100	$ 300

Acquisition and Other Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Acquisition and Other Expense [Line Items]
Assets Held-for-sale, Not Part of Disposal Group	$ 3,000
Debt related commitment fees and debt issuance costs		$ 3,600
Other expense	89	4,225
Loss on early extinguishment of debt	0	300
Cost of Sales
Acquisition and Other Expense [Line Items]
Manufacturing consolidation costs	1,785	0
Acquisition and integration costs	805	660
Acquisition and other expense included in cost of sales	2,590	660
Selling and Administrative Expenses
Acquisition and Other Expense [Line Items]
Acquisition and integration costs	754	7,245
Debt
Acquisition and Other Expense [Line Items]
Other expense	$ 0	$ 3,904

Business Segments (Details) - USD ($) $ in Thousands	3 Months Ended
Business Segments (Details) - USD ($) $ in Thousands	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
Net sales	$ 214,010	$ 218,378
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales	99,283	113,437
General Surgery
Segment Reporting Information [Line Items]
Net sales	$ 114,727	$ 104,941

Legal Proceedings (Details) - USD ($) $ in Millions	Jan. 18, 2017	Mar. 31, 2020
Loss Contingencies [Line Items]
Product liability insurance, amount per incident		$ 30.0
Product liability insurance, aggregate annual amount		$ 30.0
Pending Litigation \| EndoDynamix, Inc.
Loss Contingencies [Line Items]
Loss Contingency, Damages Sought, Value	$ 12.7