0000816956-21-000008 | 10-Q | XBRL Viewer

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Document and Entity Information - shares	3 Months Ended
Document and Entity Information - shares	Mar. 31, 2021	Apr. 26, 2021
Cover [Abstract]
Entity Registrant Name	CONMED CORPORATION
Document Quarterly Report	true
Document Type	10-Q
Document Period End Date	Mar. 31, 2021
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2021
Entity File Number	001-39218
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	16-0977505
Entity Address, Address Line One	11311 Concept Blvd
Entity Address, City or Town	Largo,
Entity Address, State or Province	FL
Entity Address, Postal Zip Code	33773
City Area Code	727
Local Phone Number	392-6464
Entity Central Index Key	0000816956
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	CNMD
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Document Transition Report	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		29,092,141
Amendment Flag	false

Consolidated Condensed Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Statement of Comprehensive Income [Abstract]
Net sales	$ 232,677	$ 214,010
Cost of sales	104,228	94,851
Gross profit	128,449	119,159
Selling and administrative expense	98,340	95,867
Research and development expense	10,027	10,120
Operating expenses	108,367	105,987
Income from operations	20,082	13,172
Interest expense	10,351	9,592
Other expense	0	89
Income before income taxes	9,731	3,491
Benefit from income taxes	(129)	(2,436)
Net income	9,860	5,927
Comprehensive income (loss)	$ 10,743	$ (1,121)
Per share data:
Basic (in dollars per share)	$ 0.34	$ 0.21
Diluted (in dollars per share)	$ 0.31	$ 0.20
Weighted average common shares:
Basic (shares)	28,972	28,478
Diluted (shares)	31,378	29,707

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 36,769	$ 27,356
Accounts receivable, net	163,954	177,152
Inventories	205,797	194,868
Prepaid expenses and other current assets	17,849	17,278
Total current assets	424,369	416,654
Property, plant and equipment, net	109,379	111,407
Goodwill	618,104	618,440
Other intangible assets, net	493,905	501,537
Other assets	100,855	103,635
Total assets	1,746,612	1,751,673
Current liabilities:
Current portion of long-term debt	20,076	18,415
Accounts payable	55,780	53,310
Accrued compensation and benefits	40,908	50,171
Other current liabilities	65,391	68,305
Total current liabilities	182,155	190,201
Long-term debt	725,320	735,221
Deferred income taxes	56,593	57,875
Other long-term liabilities	56,974	59,338
Total liabilities	1,021,042	1,042,635
Commitments and contingencies
Shareholders' equity:
Preferred stock, par value $.01 per share; authorized 500,000 shares; none outstanding	0	0
Common stock, par value $0.01 per share; 100,000,000 shares authorized; 31,299,194 shares issued in 2021 and 2020, respectively	313	313
Paid-in capital	388,959	382,628
Retained earnings	461,464	457,417
Accumulated other comprehensive loss	(62,798)	(63,681)
Less: 2,222,233 and 2,410,045 shares of common stock in treasury, at cost in 2021 and 2020, respectively	(62,368)	(67,639)
Total shareholders’ equity	725,570	709,038
Total liabilities and shareholders’ equity	$ 1,746,612	$ 1,751,673

Consolidated Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2021	Dec. 31, 2020
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)	2,222,233	2,410,045

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, 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):
Cash flow hedging gain, net of income tax	2,405				2,405
Pension liability, net of income tax	535				535
Foreign currency translation adjustments	(9,988)				(9,988)
Net income	5,927			5,927
Comprehensive income (loss)	(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)
Balance at period start (shares) at Dec. 31, 2020		31,299
Balance at period start at Dec. 31, 2020	709,038	$ 313	382,628	457,417	(63,681)	(67,639)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans	8,215		2,944			5,271
Stock-based compensation	3,387		3,387
Dividends on common stock ($0.20 per share)	(5,813)			(5,813)
Comprehensive income (loss):
Cash flow hedging gain, net of income tax	3,926				3,926
Pension liability, net of income tax	631				631
Foreign currency translation adjustments	(3,674)				(3,674)
Net income	9,860			9,860
Comprehensive income (loss)	10,743
Balance at period end (shares) at Mar. 31, 2021		31,299
Balance at period end at Mar. 31, 2021	$ 725,570	$ 313	$ 388,959	$ 461,464	$ (62,798)	$ (62,368)

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
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, 2021	Mar. 31, 2020
Cash flows from operating activities:
Net income	$ 9,860	$ 5,927
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	4,757	4,646
Amortization of debt discount	2,503	2,264
Amortization of deferred debt issuance costs	1,058	819
Amortization	13,519	13,776
Stock-based compensation	3,387	3,032
Deferred income taxes	(2,688)	(2,742)
Increase (decrease) in cash flows from changes in assets and liabilities:
Accounts receivable	11,957	19,057
Inventories	(11,638)	(12,313)
Accounts payable	2,804	1,705
Accrued compensation and benefits	(8,955)	(18,397)
Other assets	(6,002)	(7,260)
Other liabilities	1,782	(6,793)
Net cash provided by operating activities	22,344	3,721
Cash flows from investing activities:
Purchases of property, plant and equipment	(3,109)	(2,825)
Payments related to business and asset acquisitions, net of cash acquired	0	(3,852)
Net cash used in investing activities	(3,109)	(6,677)
Cash flows from financing activities:
Payments on term loan	(3,313)	(3,313)
Payments on revolving line of credit	(72,000)	(41,000)
Proceeds from revolving line of credit	64,000	59,000
Payments related to contingent consideration	0	(1,133)
Dividends paid on common stock	(5,775)	(5,683)
Other, net	8,216	(5,132)
Net cash provided by (used in) financing activities	(8,872)	2,739
Effect of exchange rate changes on cash and cash equivalents	(950)	(1,330)
Net increase (decrease) in cash and cash equivalents	9,413	(1,547)
Cash and cash equivalents at beginning of period	27,356	25,856
Cash and cash equivalents at end of period	36,769	24,309
Non-cash investing and financing activities:
Dividends payable	$ 5,813	$ 5,703

Operations	3 Months Ended
Operations	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Operations	OperationsCONMED 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 other healthcare professionals in a variety of specialties including orthopedics, general surgery, gynecology, thoracic surgery and gastroenterology.

Interim Financial Information	3 Months Ended
Interim Financial Information	Mar. 31, 2021
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, 2021 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. 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, 2020 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 29, 2021, 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.

Revenues

3 Months Ended

Mar. 31, 2021

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, 2021						March 31, 2020
	Orthopedic Surgery		General Surgery		Total		Orthopedic Surgery		General Surgery		Total
Primary Geographic Markets
United States	$	37,131	$	86,812	$	123,943	$	37,039	$	81,808	$	118,847
Europe, Middle East & Africa	26,052		18,544		44,596		25,907		16,615		42,522
Asia Pacific	26,602		12,662		39,264		20,535		8,325		28,860
Americas (excluding the United States)	17,381		7,493		24,874		15,802		7,979		23,781
Total sales from contracts with customers	$	107,166	$	125,511	$	232,677	$	99,283	$	114,727	$	214,010

Timing of Revenue Recognition
Goods transferred at a point in time	$	97,690	$	124,394	$	222,084	$	90,553	$	113,901	$	204,454
Services transferred over time	9,476		1,117		10,593		8,730		826		9,556
Total sales from contracts with customers	$	107,166	$	125,511	$	232,677	$	99,283	$	114,727	$	214,010

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


	March 31, 2021		December 31, 2020

Contract liability	$	15,231	$	13,666

Revenue recognized during the three months ended March 31, 2021 and March 31, 2020 from amounts included in contract liabilities at the beginning of the period were $3.4 million and $3.0 million, respectively. There were no material contract assets as of March 31, 2021 and December 31, 2020.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-URI http://asc.fasb.org/topic&trid=49130388

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 10
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130551-203045

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130556-203045

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 9
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130550-203045

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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-Section 50
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-Subparagraph (e)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (d)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 15
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130558-203045

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 606
-SubTopic 10
-Section 50
-Paragraph 12
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=121604090&loc=SL49130554-203045

+ Details

Comprehensive Income (Loss)

3 Months Ended

Mar. 31, 2021

Equity [Abstract]

Comprehensive Income (Loss)

Comprehensive income (loss) consists of the following:


	Three Months Ended March 31,
	2021		2020
Net income	$	9,860	$	5,927

Other comprehensive income (loss):
Cash flow hedging gain, net of income tax (income tax expense of $1,250 and $766 for the three months ended March 31, 2021 and 2020, respectively)	3,926		2,405
Pension liability, net of income tax (income tax expense of $201 and $170 for the three months ended March 31, 2021 and 2020, respectively)	631		535
Foreign currency translation adjustment	(3,674)		(9,988)

Comprehensive income (loss)	$	10,743	$	(1,121)

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, 2020	$	(5,945)	$	(36,620)	$	(21,116)	$	(63,681)

Other comprehensive income (loss) before reclassifications, net of tax	2,725		—		(3,674)		(949)
Amounts reclassified from accumulated other comprehensive income (loss) before taxa	1,584		832		—		2,416
Income tax	(383)		(201)		—		(584)

Net current-period other comprehensive income (loss)	3,926		631		(3,674)		883

Balance, March 31, 2021	$	(2,019)	$	(35,989)	$	(24,790)	$	(62,798)


	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 taxa	(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)

(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 5 and Note 11, respectively, for further details.

Fair Value of Financial Instruments

3 Months Ended

Mar. 31, 2021

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, 2021		December 31, 2020
Forward exchange contracts	Cash flow hedge	$	164,562	$	154,504
Forward exchange contracts	Non-designated	45,545		42,380

The remaining time to maturity as of March 31, 2021 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 (loss) 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 (loss) and our consolidated condensed balance sheets:


	Amount of Gain (Loss) Recognized in AOCI				Consolidated Condensed Statements of Comprehensive Income (Loss)					Amount of Gain (Loss) Reclassified from AOCI
	Three Months Ended March 31,
						Total Amount of Line Item Presented
Derivative Instrument	2021		2020		Location of amount reclassified	2021		2020		2021		2020

Foreign exchange contracts	$	3,593	$	4,295	Net Sales	$	232,677	$	214,010	$	(1,849)	$	1,201
					Cost of Sales	104,228		94,851		265		(77)
Pre-tax gain (loss)	$	3,593	$	4,295						$	(1,584)	$	1,124
Tax expense (benefit)	868		1,038							(383)		272
Net gain (loss)	$	2,725	$	3,257						$	(1,201)	$	852

At March 31, 2021, $2.3 million of net unrealized losses 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 gains and losses from derivative instruments not accounted for as hedges and gains and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income (loss) were:


		Three Months Ended March 31,
Derivative Instrument	Location on Consolidated Condensed Statements of Comprehensive Income (Loss)	2021		2020

Net gain (loss) on currency forward contracts	Selling and administrative expense	$	458	$	(245)
Net loss on currency transaction exposures	Selling and administrative expense	$	(1,123)	$	(191)

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, 2021 and December 31, 2020:


March 31, 2021	Location on Consolidated Condensed Balance Sheet	Asset Fair Value		Liabilities Fair Value		Net Fair Value
Derivatives designated as hedged instruments:
Foreign exchange contracts	Other current liabilities	$	1,557	$	(4,592)	$	(3,035)
Foreign exchange contracts	Other long-term assets	709		(337)		372
		$	2,266	$	(4,929)	$	(2,663)

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	8		(179)		(171)

Total derivatives		$	2,274	$	(5,108)	$	(2,834)


December 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	Other current liabilities	$	1,500	$	(8,826)	$	(7,326)
Foreign exchange contracts	Other long-term liabilities	23		(535)		(512)
		$	1,523	$	(9,361)	$	(7,838)

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	25		(150)		(125)

Total derivatives		$	1,548	$	(9,511)	$	(7,963)

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, 2021 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, 2021

Inventory Disclosure [Abstract]

Inventories

Inventories consist of the following:


	March 31, 2021		December 31, 2020
Raw materials	$	73,654	$	71,807
Work-in-process	18,429		15,864
Finished goods	113,714		107,197
Total	$	205,797	$	194,868

Earnings Per Share

3 Months Ended

Mar. 31, 2021

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") as well as the Notes and related hedge transactions during the period.

The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2021 and 2020:


	Three Months Ended March 31,
	2021		2020
Net income	$	9,860	$	5,927

Basic – weighted average shares outstanding	28,972		28,478

Effect of dilutive potential securities	2,406		1,229

Diluted – weighted average shares outstanding	31,378		29,707

Net income (per share)
Basic	$	0.34	$	0.21
Diluted	0.31		0.20

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 0.3 million and 1.1 million for the three months ended March 31, 2021 and 2020, respectively. 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 following is intended to describe the impact of the Notes and related hedge transactions on the calculation of diluted EPS. Additional shares to be issued pursuant to the terms of the Notes and related hedge transactions, if any, would occur at maturity.

The calculation of diluted EPS includes 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.

During the three months ended March 31, 2021 and 2020, our average share price exceeded the conversion price of the Notes and we included in our diluted share count 1.0 million and 0.1 million shares, respectively, assumed to be issued if the Notes were converted.

We previously 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.

Concurrently with entering into the hedge transactions, we also previously entered into warrant transactions under which we agreed to sell shares of our common stock at $114.92.

The calculation of diluted EPS also includes potential diluted shares to be issued under the warrants when the average market price per share of our common stock for the period is greater than $114.92. During the three months ended March 31, 2021, our average share price exceeded $114.92 and we therefore included in our diluted share count an additional 0.2 million shares assumed to be issued under the warrants.

Goodwill and Other Intangible Assets

3 Months Ended

Mar. 31, 2021

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, 2021 are as follows:


Balance as of December 31, 2020	$	618,440



Foreign currency translation	(336)

Balance as of March 31, 2021	$	618,104

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.

Other intangible assets consist of the following:


	March 31, 2021					December 31, 2020
	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	$	342,531	$	(139,243)	$	342,639	$	(134,555)

Sales representation, marketing and promotional rights	25	149,376		(55,500)		149,376		(54,000)

Developed technology	16	106,604		(21,358)		106,604		(19,705)

Patents and other intangible assets	16	74,307		(49,356)		73,516		(48,882)

Intangible assets with indefinite lives:

Trademarks and tradenames		86,544		—		86,544		—

	22	$	759,362	$	(265,457)	$	758,679	$	(257,142)

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 $8.3 million and $8.5 million in the three months ended March 31, 2021 and 2020, 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 (loss). Included in developed technology is $6.0 million of earn-out consideration that is considered probable as of March 31, 2021 associated with a prior asset acquisition. This is recorded in other current and other long-term liabilities at March 31, 2021.

The estimated intangible asset amortization expense remaining for the year ending December 31, 2021 and for each of the five succeeding years is as follows:


	Amortization included in expense		Amortization recorded as a reduction of revenue		Total
Remaining, 2021	$	20,620	$	4,500	$	25,120
2022	26,426		6,000		32,426
2023	25,646		6,000		31,646
2024	24,836		6,000		30,836
2025	25,058		6,000		31,058
2026	24,529		6,000		30,529

Long Term Debt

3 Months Ended

Mar. 31, 2021

Debt Disclosure [Abstract]

Long-term Debt

Long-Term Debt

Long-term debt consists of the following:


	March 31, 2021		December 31, 2020
Revolving line of credit	$	199,000	$	207,000
Term loan, net of deferred debt issuance costs of $1,520 and $1,668 in 2021 and 2020, respectively	236,980		240,145
2.625% convertible notes, net of deferred debt issuance costs of $5,031 and $5,475 in 2021 and 2020, respectively, and unamortized discount of $31,117 and $33,620 in 2021 and 2020, respectively	308,850		305,904
Financing leases	566		587
Total debt	745,396		753,636
Less: Current portion	20,076		18,415
Total long-term debt	$	725,320	$	735,221

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 mature 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. On April 17, 2020, we amended our sixth amended and restated senior credit agreement to suspend our required leverage ratios for up to four quarters as a result of the potential impact from the COVID-19 pandemic. On November 20, 2020, we entered into a third amendment under our senior credit agreement to lower the applicable margin on the loans and lower the interest floor on Eurocurrency loans agreed upon in April 2020. On April 15, 2021, we terminated the suspension period, thus reinstating our required leverage ratios. Interest rates are adjusted so that the applicable margin for base rate loans is 2.00% per annum and for Eurocurrency rate loans is 3.00% 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. Interest rates were at LIBOR (subject to 0.50% floor) plus an interest rate margin of 3.00% (3.50% at March 31, 2021).

There were $238.5 million in borrowings outstanding on the term loan facility as of March 31, 2021. There were $199.0 million in borrowings outstanding under the revolving credit facility as of March 31, 2021. Our available borrowings on the revolving credit facility at March 31, 2021 were $383.4 million with approximately $2.6 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, 2021. We are also required, under certain circumstances, to make mandatory prepayments from net cash proceeds from any issuance of equity and asset sales.

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, 2021 and 2020, we have recorded interest expense related to the amortization of debt discount on the Notes of $2.5 million and $2.3 million, respectively, at the effective interest rate of 6.14%. The debt discount on the Notes is being amortized through February 2024. For both the three months ended March 31, 2021 and 2020, we have recorded interest expense on the Notes of $2.3 million 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 as noted in Note 7, unless we elect to settle the warrants in cash.

The scheduled maturities of long-term debt outstanding at March 31, 2021 are as follows:


Remaining 2021	$	14,906
2022	24,844
2023	397,750
2024	345,000
2025	—

The above amounts exclude debt discount, deferred debt issuance costs and financing leases.

Guarantees

3 Months Ended

Mar. 31, 2021

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 warranty policies is based upon a review of historical claim experience. Adjustments are made to accruals as claim data and historical experience warrant.

Changes in the liability for standard warranties for the three months ended March 31, are as follows:


	2021		2020
Balance as of January 1,	$	1,826	$	2,186

Provision for warranties	291		355
Claims made	(206)		(363)

Balance as of March 31,	$	1,911	$	2,178

Costs associated with extended warranty repairs are recorded as incurred and amounted to $1.6 million and $1.5 million for the three months ended March 31, 2021 and 2020, respectively.

Pension Plan

3 Months Ended

Mar. 31, 2021

Retirement Benefits [Abstract]

Pension Plan

Net periodic pension cost consists of the following:


	Three Months Ended March 31,
	2021		2020
Service cost	$	248	$	179

Interest cost on projected benefit obligation	451		639

Expected return on plan assets	(1,289)		(1,255)

Net amortization and deferral	832		705

Net periodic pension cost	$	242	$	268

We do not expect to make any pension contributions during 2021. Non-service cost of $0.1 million for the three months ended March 31, 2020 is included in other expense in the consolidated condensed statements of comprehensive income (loss). Non-service pension cost was immaterial for the three months ended March 31, 2021.

- Definition

The entire disclosure for retirement benefits.

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+ Details

Acquisition and Other Expense

3 Months Ended

Mar. 31, 2021

Acquisition and Other Expense [Abstract]

Acquisition and Other Expense

Acquisition and other expense consist of the following, which are included in cost of sales or selling and administrative expense depending on the nature of the charge:


	Three Months Ended March 31,
	2021		2020





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


Restructuring and related costs	$	414	$	—

Acquisition and integration costs	—		754
Acquisition and other expense included in selling and administrative expense	$	414	$	754

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.

During the three months ended March 31, 2020, we incurred costs for inventory step-up adjustments and other costs of $0.8 million related to a previous acquisition, which 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, which were included in selling and administrative expense.

During the three months ended March 31, 2021, we recorded a charge of $0.4 million related to the restructuring of our sales force which was charged to selling and administrative expense. The charges for sales force restructuring consisted

primarily of termination payments to Orthopedic distributors made in exchange for ongoing assistance to transition to employee-based sales representatives and severance.

Business Segment

3 Months Ended

Mar. 31, 2021

Segment Reporting [Abstract]

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 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, smoke evacuation devices, 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,
	2021		2020
Orthopedic surgery	$	107,166	$	99,283
General surgery	125,511		114,727
Consolidated net sales	$	232,677	$	214,010

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

Legal Proceedings	3 Months Ended
Legal Proceedings	Mar. 31, 2021
Commitments and Contingencies Disclosure [Abstract]
Legal Proceedings	Legal Proceedings From time to time, the Company may receive an information request, subpoena or warrant 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, subpoenas or warrants 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 under a liquidated damages clause, 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 liquidated damages. 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. In a pre-trial filing the Plaintiffs claim to seek liquidated damages, as well as additional damages up to $24.8 million. A non-jury trial in the Delaware Chancery Court commenced on March 18, 2021, and testimony concluded on April 7, 2021. We expect the parties to submit post-trial briefs in the second quarter of 2021, with the Court to hear oral arguments at a hearing scheduled for July 22, 2021, and the Court to issue a ruling at some point thereafter. The Company has not recorded any expense related to potential damages in connection with this matter because the Company does not believe any potential loss is probable. We expect to defend the claims asserted by the sellers of EndoDynamix, although there can be no assurance that we will prevail in the trial and/or any resulting appeals. 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, 2021
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Issued Accounting Standards, Not Yet Adopted 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, 2022. The Company has not adopted this ASU as of March 31, 2021, however will continue to monitor the impact of reference rates and will elect to apply this guidance in our consolidated financial statements in the event that we are impacted by reference rate reform. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity, which simplifies the accounting for convertible instruments by removing certain separation models requiring separate accounting for embedded conversion features which will result in more convertible debt instruments accounted for as a single liability. The ASU eliminates certain settlement conditions that are required for equity classification to qualify for the derivative scope exception. The ASU addresses how convertible instruments are accounted for in the calculation of diluted earnings per share by using the if-converted method. The ASU is effective for fiscal years beginning after December 15, 2021, with early adoption permitted no earlier than fiscal years beginning after December 15, 2020. The Company is currently assessing the impact of this guidance on our consolidated financial statements.

- Definition

The entire disclosure for change in accounting principle. Includes, but is not limited to, nature, reason, and method of adopting amendment to accounting standards or other change in accounting principle.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Interim Reporting (Policies)	3 Months Ended
Interim Reporting (Policies)	Mar. 31, 2021
Quarterly Financial Information Disclosure [Abstract]
Use of Estimates, Policy	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.

New Accounting Pronouncements (Policies)	3 Months Ended
New Accounting Pronouncements (Policies)	Mar. 31, 2021
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Issued Accounting Standards, Not Yet Adopted 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, 2022. The Company has not adopted this ASU as of March 31, 2021, however will continue to monitor the impact of reference rates and will elect to apply this guidance in our consolidated financial statements in the event that we are impacted by reference rate reform. In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity, which simplifies the accounting for convertible instruments by removing certain separation models requiring separate accounting for embedded conversion features which will result in more convertible debt instruments accounted for as a single liability. The ASU eliminates certain settlement conditions that are required for equity classification to qualify for the derivative scope exception. The ASU addresses how convertible instruments are accounted for in the calculation of diluted earnings per share by using the if-converted method. The ASU is effective for fiscal years beginning after December 15, 2021, with early adoption permitted no earlier than fiscal years beginning after December 15, 2020. The Company is currently assessing the impact of this guidance on our consolidated financial statements.

Revenues (Tables)

3 Months Ended

Mar. 31, 2021

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, 2021						March 31, 2020
	Orthopedic Surgery		General Surgery		Total		Orthopedic Surgery		General Surgery		Total
Primary Geographic Markets
United States	$	37,131	$	86,812	$	123,943	$	37,039	$	81,808	$	118,847
Europe, Middle East & Africa	26,052		18,544		44,596		25,907		16,615		42,522
Asia Pacific	26,602		12,662		39,264		20,535		8,325		28,860
Americas (excluding the United States)	17,381		7,493		24,874		15,802		7,979		23,781
Total sales from contracts with customers	$	107,166	$	125,511	$	232,677	$	99,283	$	114,727	$	214,010

Timing of Revenue Recognition
Goods transferred at a point in time	$	97,690	$	124,394	$	222,084	$	90,553	$	113,901	$	204,454
Services transferred over time	9,476		1,117		10,593		8,730		826		9,556
Total sales from contracts with customers	$	107,166	$	125,511	$	232,677	$	99,283	$	114,727	$	214,010

Contract with Customer, Asset and Liability

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


	March 31, 2021		December 31, 2020

Contract liability	$	15,231	$	13,666

Comprehensive Income (Loss) (Tables)

3 Months Ended

Mar. 31, 2021

Equity [Abstract]

Schedule of Comprehensive Income (Loss)

Comprehensive income (loss) consists of the following:


	Three Months Ended March 31,
	2021		2020
Net income	$	9,860	$	5,927

Other comprehensive income (loss):
Cash flow hedging gain, net of income tax (income tax expense of $1,250 and $766 for the three months ended March 31, 2021 and 2020, respectively)	3,926		2,405
Pension liability, net of income tax (income tax expense of $201 and $170 for the three months ended March 31, 2021 and 2020, respectively)	631		535
Foreign currency translation adjustment	(3,674)		(9,988)

Comprehensive income (loss)	$	10,743	$	(1,121)

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, 2020	$	(5,945)	$	(36,620)	$	(21,116)	$	(63,681)

Other comprehensive income (loss) before reclassifications, net of tax	2,725		—		(3,674)		(949)
Amounts reclassified from accumulated other comprehensive income (loss) before taxa	1,584		832		—		2,416
Income tax	(383)		(201)		—		(584)

Net current-period other comprehensive income (loss)	3,926		631		(3,674)		883

Balance, March 31, 2021	$	(2,019)	$	(35,989)	$	(24,790)	$	(62,798)


	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 taxa	(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)

Fair Value of Financial Instruments (Tables)

3 Months Ended

Mar. 31, 2021

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, 2021		December 31, 2020
Forward exchange contracts	Cash flow hedge	$	164,562	$	154,504
Forward exchange contracts	Non-designated	45,545		42,380

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


	Amount of Gain (Loss) Recognized in AOCI				Consolidated Condensed Statements of Comprehensive Income (Loss)					Amount of Gain (Loss) Reclassified from AOCI
	Three Months Ended March 31,
						Total Amount of Line Item Presented
Derivative Instrument	2021		2020		Location of amount reclassified	2021		2020		2021		2020

Foreign exchange contracts	$	3,593	$	4,295	Net Sales	$	232,677	$	214,010	$	(1,849)	$	1,201
					Cost of Sales	104,228		94,851		265		(77)
Pre-tax gain (loss)	$	3,593	$	4,295						$	(1,584)	$	1,124
Tax expense (benefit)	868		1,038							(383)		272
Net gain (loss)	$	2,725	$	3,257						$	(1,201)	$	852

Derivatives Not Designated as Hedging Instruments


		Three Months Ended March 31,
Derivative Instrument	Location on Consolidated Condensed Statements of Comprehensive Income (Loss)	2021		2020

Net gain (loss) on currency forward contracts	Selling and administrative expense	$	458	$	(245)
Net loss on currency transaction exposures	Selling and administrative expense	$	(1,123)	$	(191)

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, 2021 and December 31, 2020:


March 31, 2021	Location on Consolidated Condensed Balance Sheet	Asset Fair Value		Liabilities Fair Value		Net Fair Value
Derivatives designated as hedged instruments:
Foreign exchange contracts	Other current liabilities	$	1,557	$	(4,592)	$	(3,035)
Foreign exchange contracts	Other long-term assets	709		(337)		372
		$	2,266	$	(4,929)	$	(2,663)

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	8		(179)		(171)

Total derivatives		$	2,274	$	(5,108)	$	(2,834)


December 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	Other current liabilities	$	1,500	$	(8,826)	$	(7,326)
Foreign exchange contracts	Other long-term liabilities	23		(535)		(512)
		$	1,523	$	(9,361)	$	(7,838)

Derivatives not designated as hedging instruments:
Foreign exchange contracts	Other current liabilities	25		(150)		(125)

Total derivatives		$	1,548	$	(9,511)	$	(7,963)

Inventories (Tables)

3 Months Ended

Mar. 31, 2021

Inventory Disclosure [Abstract]

Schedule of inventory

Inventories consist of the following:


	March 31, 2021		December 31, 2020
Raw materials	$	73,654	$	71,807
Work-in-process	18,429		15,864
Finished goods	113,714		107,197
Total	$	205,797	$	194,868

Earnings Per Share (Tables)

3 Months Ended

Mar. 31, 2021

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, 2021 and 2020:


	Three Months Ended March 31,
	2021		2020
Net income	$	9,860	$	5,927

Basic – weighted average shares outstanding	28,972		28,478

Effect of dilutive potential securities	2,406		1,229

Diluted – weighted average shares outstanding	31,378		29,707

Net income (per share)
Basic	$	0.34	$	0.21
Diluted	0.31		0.20

Goodwill and Other Intangible Assets (Tables)

3 Months Ended

Mar. 31, 2021

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, 2021 are as follows:


Balance as of December 31, 2020	$	618,440



Foreign currency translation	(336)

Balance as of March 31, 2021	$	618,104

Schedule of Finite-Lived Intangible Assets

Other intangible assets consist of the following:


	March 31, 2021					December 31, 2020
	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	$	342,531	$	(139,243)	$	342,639	$	(134,555)

Sales representation, marketing and promotional rights	25	149,376		(55,500)		149,376		(54,000)

Developed technology	16	106,604		(21,358)		106,604		(19,705)

Patents and other intangible assets	16	74,307		(49,356)		73,516		(48,882)

Intangible assets with indefinite lives:

Trademarks and tradenames		86,544		—		86,544		—

	22	$	759,362	$	(265,457)	$	758,679	$	(257,142)

Schedule of Indefinite-Lived Intangible Assets

Other intangible assets consist of the following:


	March 31, 2021					December 31, 2020
	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	$	342,531	$	(139,243)	$	342,639	$	(134,555)

Sales representation, marketing and promotional rights	25	149,376		(55,500)		149,376		(54,000)

Developed technology	16	106,604		(21,358)		106,604		(19,705)

Patents and other intangible assets	16	74,307		(49,356)		73,516		(48,882)

Intangible assets with indefinite lives:

Trademarks and tradenames		86,544		—		86,544		—

	22	$	759,362	$	(265,457)	$	758,679	$	(257,142)

Schedule of Estimated Amortization Expense

The estimated intangible asset amortization expense remaining for the year ending December 31, 2021 and for each of the five succeeding years is as follows:


	Amortization included in expense		Amortization recorded as a reduction of revenue		Total
Remaining, 2021	$	20,620	$	4,500	$	25,120
2022	26,426		6,000		32,426
2023	25,646		6,000		31,646
2024	24,836		6,000		30,836
2025	25,058		6,000		31,058
2026	24,529		6,000		30,529

Long Term Debt (Tables)

3 Months Ended

Mar. 31, 2021

Debt Disclosure [Abstract]

Schedule of Long-term Debt

Long-term debt consists of the following:


	March 31, 2021		December 31, 2020
Revolving line of credit	$	199,000	$	207,000
Term loan, net of deferred debt issuance costs of $1,520 and $1,668 in 2021 and 2020, respectively	236,980		240,145
2.625% convertible notes, net of deferred debt issuance costs of $5,031 and $5,475 in 2021 and 2020, respectively, and unamortized discount of $31,117 and $33,620 in 2021 and 2020, respectively	308,850		305,904
Financing leases	566		587
Total debt	745,396		753,636
Less: Current portion	20,076		18,415
Total long-term debt	$	725,320	$	735,221

Schedule of Maturities of Long-term Debt

The scheduled maturities of long-term debt outstanding at March 31, 2021 are as follows:


Remaining 2021	$	14,906
2022	24,844
2023	397,750
2024	345,000
2025	—

The above amounts exclude debt discount, deferred debt issuance costs and financing leases.

- 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
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+ Details

Guarantees (Tables)

3 Months Ended

Mar. 31, 2021

Guarantees [Abstract]

Changes in the carrying amount of service and product warranties

Changes in the liability for standard warranties for the three months ended March 31, are as follows:


	2021		2020
Balance as of January 1,	$	1,826	$	2,186

Provision for warranties	291		355
Claims made	(206)		(363)

Balance as of March 31,	$	1,911	$	2,178

Pension Plan (Tables)

3 Months Ended

Mar. 31, 2021

Retirement Benefits [Abstract]

Schedule of net benefit cost

Net periodic pension cost consists of the following:


	Three Months Ended March 31,
	2021		2020
Service cost	$	248	$	179

Interest cost on projected benefit obligation	451		639

Expected return on plan assets	(1,289)		(1,255)

Net amortization and deferral	832		705

Net periodic pension cost	$	242	$	268

Acquisition and Other Expense (Tables)

3 Months Ended

Mar. 31, 2021

Acquisition and Other Expense [Abstract]

Schedule of Acquisition and Other Operating Expense

Acquisition and other expense consist of the following, which are included in cost of sales or selling and administrative expense depending on the nature of the charge:


	Three Months Ended March 31,
	2021		2020





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


Restructuring and related costs	$	414	$	—

Acquisition and integration costs	—		754
Acquisition and other expense included in selling and administrative expense	$	414	$	754

Business Segment (Tables)

3 Months Ended

Mar. 31, 2021

Segment Reporting [Abstract]

Schedule of net sales information by product line

These product lines' net sales are as follows:


	Three Months Ended March 31,
	2021		2020
Orthopedic surgery	$	107,166	$	99,283
General surgery	125,511		114,727
Consolidated net sales	$	232,677	$	214,010

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Disaggregation of Revenue [Line Items]
Net Sales	$ 232,677	$ 214,010
Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	222,084	204,454
Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	10,593	9,556
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	107,166	99,283
Orthopedic Surgery \| Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	97,690	90,553
Orthopedic Surgery \| Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	9,476	8,730
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	125,511	114,727
General Surgery \| Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	124,394	113,901
General Surgery \| Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	1,117	826
United States
Disaggregation of Revenue [Line Items]
Net Sales	123,943	118,847
United States \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	37,131	37,039
United States \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	86,812	81,808
Americas (excluding the United States)
Disaggregation of Revenue [Line Items]
Net Sales	24,874	23,781
Americas (excluding the United States) \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	17,381	15,802
Americas (excluding the United States) \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	7,493	7,979
Europe, Middle East & Africa
Disaggregation of Revenue [Line Items]
Net Sales	44,596	42,522
Europe, Middle East & Africa \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	26,052	25,907
Europe, Middle East & Africa \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	18,544	16,615
Asia Pacific
Disaggregation of Revenue [Line Items]
Net Sales	39,264	28,860
Asia Pacific \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	26,602	20,535
Asia Pacific \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	$ 12,662	$ 8,325

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Contract liability	$ 15,231		$ 13,666
Revenue recognized	$ 3,400	$ 3,000

Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Equity [Abstract]
Net income	$ 9,860	$ 5,927
Cash flow hedging gain, net of income tax	3,926	2,405
Pension liability, net of income tax	631	535
Foreign currency translation adjustments	(3,674)	(9,988)
Comprehensive income (loss)	10,743	(1,121)
Pension liability, tax	201	170
Cash flow hedging gain, tax	$ 1,250	$ 766

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

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

+ References

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+ Details

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

3 Months Ended

Mar. 31, 2021

Mar. 31, 2020

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

$ (63,681)

Accumulated Other Comprehensive Income (Loss), Net of Tax

(62,798)

Accumulated Other Comprehensive Loss

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

(63,681)

$ (59,277)

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

(949)

(6,731)

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

^[1]

2,416

(419)

Reclassification from AOCI, Current Period, Tax

(584)

102

Net current-period other comprehensive income (loss)

883

(7,048)

Accumulated Other Comprehensive Income (Loss), Net of Tax

(62,798)

(66,325)

Cash Flow Hedging Gain (Loss)

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

(5,945)

493

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

2,725

3,257

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

^[1]

1,584

(1,124)

Reclassification from AOCI, Current Period, Tax

(383)

272

Net current-period other comprehensive income (loss)

3,926

2,405

Accumulated Other Comprehensive Income (Loss), Net of Tax

(2,019)

2,898

Pension Liability

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

(36,620)

(31,691)

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

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

^[1]

832

705

Reclassification from AOCI, Current Period, Tax

(201)

(170)

Net current-period other comprehensive income (loss)

631

535

Accumulated Other Comprehensive Income (Loss), Net of Tax

(35,989)

(31,156)

Cumulative Translation Adjustments

Accumulated other comprehensive income (loss) [Roll Forward]

Accumulated Other Comprehensive Income (Loss), Net of Tax

(21,116)

(28,079)

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

(3,674)

(9,988)

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

^[1]

Reclassification from AOCI, Current Period, Tax

Net current-period other comprehensive income (loss)

(3,674)

(9,988)

Accumulated Other Comprehensive Income (Loss), Net of Tax

$ (24,790)

$ (38,067)

[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 5 and Note 11, 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, 2021	Mar. 31, 2020
Derivative Instruments, Gain (Loss) [Line Items]
Net sales	$ 232,677	$ 214,010
Cost of sales	104,228	94,851
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	3,593	4,295
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	868	1,038
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	2,725	3,257
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	(1,584)	1,124
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	(383)	272
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	(1,201)	852
Revenues
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	(1,849)	1,201
Cost of Sales
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	$ 265	$ (77)

Fair Value of Financial Instruments (Foreign Currency Forward Contracts) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Derivative [Line Items]
Foreign Currency Transaction Gain (Loss), before Tax	$ (1,123)	$ (191)
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	2,274		$ 1,548
Liabilities Fair Value	(5,108)		(9,511)
Net Fair Value	(2,834)		(7,963)
Foreign Currency Forward Contracts
Derivative [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	458	$ (245)
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	2,266		1,523
Liabilities Fair Value	(4,929)		(9,361)
Net Fair Value	(2,663)		(7,838)
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Other Noncurrent Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value			23
Liabilities Fair Value			(535)
Net Fair Value			(512)
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	1,557		1,500
Liabilities Fair Value	(4,592)		(8,826)
Net Fair Value	(3,035)		(7,326)
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Other Noncurrent Assets [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	709
Liabilities Fair Value	(337)
Net Fair Value	$ 372
Derivatives not designated as hedging instruments: \| Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge	1 month
Notional amount of cash flow hedges	$ 45,545		42,380
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	8		25
Liabilities Fair Value	(179)		(150)
Net Fair Value	$ (171)		(125)
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	$ 164,562		$ 154,504
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ (2,300)

Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials	$ 73,654	$ 71,807
Work-in-process	18,429	15,864
Finished goods	113,714	107,197
Total inventory	$ 205,797	$ 194,868

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Earnings Per Share [Abstract]
Net income	$ 9,860	$ 5,927
Basic-weighted average shares outstanding (in shares)	28,972	28,478
Effect of dilutive potential securities (in shares)	2,406	1,229
Diluted- weighted average shares outstanding (in shares)	31,378	29,707
Basic (in dollars per share)	$ 0.34	$ 0.21
Diluted (in dollars per share)	$ 0.31	$ 0.20
Antidilutive securities excluded from computation of earnings per share (in shares)	300	1,100
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities	1,000	100
Incremental Common Shares Attributable to Dilutive Effect of Call Options and Warrants	200

Earnings Per Share - Convertible Notes (Details) - Convertible Notes Payable - 2.625 Percent Convertible Notes Due 2024 [Member]	Jan. 29, 2019 $ / shares
Debt Instrument [Line Items]
Interest rate, stated percentage	2.625%
Conversion price (in dollars per share)	$ 88.80
Hedge transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)	114.92
Warrant transactions
Debt Instrument [Line Items]
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, 2021 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 618,440
Foreign currency translation	(336)
Ending balance	$ 618,104

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020	Dec. 31, 2020
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Gross carrying amount	$ 759,362		$ 758,679
Intangible assets, Accumulated amortization	(265,457)		(257,142)
Amortization expense	8,300	$ 8,500
Future amortization expense [Abstract]
Remaining, 2021	25,120
2022	32,426
2023	31,646
2024	30,836
2025	31,058
2026	30,529
Amortization included in expense
Future amortization expense [Abstract]
Remaining, 2021	20,620
2022	26,426
2023	25,646
2024	24,836
2025	25,058
2026	24,529
Amortization recorded as a reduction of revenue
Future amortization expense [Abstract]
Remaining, 2021	4,500
2022	6,000
2023	6,000
2024	6,000
2025	6,000
2026	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	342,531		342,639
Intangible assets, Accumulated amortization	(139,243)		(134,555)
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	(55,500)		(54,000)
Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	74,307		73,516
Intangible assets, Accumulated amortization	(49,356)		(48,882)
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	(21,358)		$ (19,705)
Asset acquisition, contingent consideration liability	$ 6,000
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)	16 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, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Long-term Debt and Lease Obligation, Including Current Maturities	$ 745,396	$ 753,636
Finance Lease, Liability	566	587
Current portion of long-term debt	20,076	18,415
Long-term debt	725,320	735,221
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt	199,000	207,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt	236,980	240,145
Unamortized Debt Issuance Expense	1,520	1,668
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Convertible Debt	308,850	305,904
Debt Instrument, Unamortized Discount	31,117	33,620
Unamortized Debt Issuance Expense	$ 5,031	$ 5,475

Long Term Debt Additional Information (Details)		3 Months Ended
Long Term Debt Additional Information (Details)	Jan. 29, 2019 USD ($) $ / shares	Mar. 31, 2021 USD ($)	Mar. 31, 2020 USD ($)	Dec. 31, 2020 USD ($)	Feb. 07, 2019 USD ($)
Debt Instrument [Line Items]
Amortization of debt discount		$ 2,503,000	$ 2,264,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross		238,500,000
Long-term Debt		236,980,000		$ 240,145,000
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		199,000,000		$ 207,000,000
Line of Credit Facility, Remaining Borrowing Capacity		383,400,000
Letters of Credit Outstanding, Amount		2,600,000
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
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		2,500,000	2,300,000
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	$ 2,300,000
Debt Instrument, Convertible, Gross Amount of Equity Component	$ 51,600,000
Conversion price (in dollars per share) \| $ / shares	$ 88.80
Debt Instrument, Convertible, Conversion Ratio	11.2608
Convertible Notes Payable [Member] \| 2.625 Percent Convertible Notes Due 2024 [Member] \| Hedge transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) \| $ / shares	$ 114.92
Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Commitment Fee Percentage		0.50%
Debt Instrument, Interest Rate, Effective Percentage		3.50%
LIBOR Interest Rate Floor		0.50%
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		3.00%
Eurodollar [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		3.00%
Base Rate [Member] \| Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		2.00%
Call Option [Member] \| Convertible Notes Payable [Member] \| 2.625 Percent Convertible Notes Due 2024 [Member]
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid	$ 21,000,000.0

Long Term Debt Maturities of Long Term Debt (Details) $ in Thousands	Mar. 31, 2021 USD ($)
Maturities of Long-term Debt [Abstract]
Remaining, 2021	$ 14,906
2022	24,844
2023	397,750
2024	345,000
2025	$ 0

Guarantees (Details) - USD ($) $ in Thousands	3 Months Ended
Guarantees (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Mar. 31, 2020
Guarantees [Abstract]
Standard warranty period (in years)	1 year
Movement in Standard Product Warranty Accrual [Roll Forward]
Balance as of January 1,	$ 1,826	$ 2,186
Provision for warranties	291	355
Claims made	(206)	(363)
Balance as of March 31,	1,911	2,178
Extended Product Warranty Disclosure [Abstract]
Product extended warranty expense	$ 1,600	$ 1,500

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended
Pension Plan (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Mar. 31, 2020
Retirement Benefits [Abstract]
Service cost	$ 248	$ 179
Interest cost on projected benefit obligation	451	639
Expected return on plan assets	(1,289)	(1,255)
Net amortization and deferral	832	705
Net periodic pension cost	$ 242	268
Defined Benefit Plan, Non-service cost		$ 100

Acquisition and Other Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2021	Mar. 31, 2020
Cost of Sales
Acquisition and Other Expense [Line Items]
Manufacturing consolidation costs	$ 0	$ 1,785
Acquisition and integration costs	0	805
Acquisition and other expense	0	2,590
Selling and Administrative Expenses
Acquisition and Other Expense [Line Items]
Restucturing and related costs	414	0
Acquisition and integration costs	0	754
Acquisition and other expense	$ 414	$ 754

Business Segment (Details) - USD ($) $ in Thousands	3 Months Ended
Business Segment (Details) - USD ($) $ in Thousands	Mar. 31, 2021	Mar. 31, 2020
Segment Reporting Information [Line Items]
Net sales	$ 232,677	$ 214,010
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales	107,166	99,283
General Surgery
Segment Reporting Information [Line Items]
Net sales	$ 125,511	$ 114,727

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
-SubTopic 10
-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=75031198&loc=d3e14064-108612

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8933-108599

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8736-108599

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 40
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9031-108599

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-Section 50
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-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e8906-108599

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 41
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9038-108599

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 42
-URI http://asc.fasb.org/extlink&oid=120311839&loc=d3e9054-108599

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
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-Section S99
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-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e23780-122690

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 235
-Section S99
-Paragraph 1
-Subparagraph (SX 210.9-05(b)(2))
-URI http://asc.fasb.org/extlink&oid=120399901&loc=d3e537907-122884

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
-SubTopic 10
-Section S99
-Paragraph 2
-Subparagraph (SX 210.5-03(1))
-URI http://asc.fasb.org/extlink&oid=120395209&loc=SL114868664-224227

+ Details

Legal Proceedings (Details) - USD ($) $ in Millions	Jan. 18, 2017	Mar. 31, 2021
Loss Contingencies [Line Items]
Product liability insurance, amount per incident		$ 30.0
Product liability insurance, aggregate annual amount		$ 30.0
Pending Litigation \| EndoDynamix, Inc. \| Liquidated Damages
Loss Contingencies [Line Items]
Loss Contingency, Damages Sought, Value	$ 12.7
Pending Litigation \| EndoDynamix, Inc. \| Additional Damages
Loss Contingencies [Line Items]
Loss Contingency, Damages Sought, Value	$ 24.8