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v3.26.3
Operations (Details) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended 9 Months Ended
Jun. 30, 2026
Mar. 31, 2026
Sep. 30, 2026
Sep. 30, 2026
Sep. 30, 2025
Organization, Consolidation and Presentation of Financial Statements [Abstract]          
Proceeds from sale of product offerings $ 14,000 $ 7,000   $ 22,313 $ 0
(Gain) /loss on sale of product offerings, net $ 4,400 $ (3,900)   $ (1,824) $ 0
(Gain) on sale of a product offering, additional gain     $ (2,200)    
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v3.26.3
Business Segment (Tables)
9 Months Ended
Sep. 30, 2026
Segment Reporting [Abstract]  
Schedule of Net Sales Information by Product Line These product lines' net sales are as follows:
Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Orthopedic surgery$148,834 $138,193 $448,810 $417,216 
General surgery186,723 199,733 547,280 584,310 
Consolidated net sales$335,557 $337,926 $996,090 $1,001,526 
Segment Reporting The following table includes significant segment expenses:
Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Net sales
$335,557 $337,926 $996,090 $1,001,526 
Cost of sales(a)
146,409 171,807 426,038 469,336 
Salesforce and commission expense
56,903 59,404 174,268 175,760 
Marketing expense
18,859 16,915 56,151 49,782 
Distribution expense
13,860 13,085 41,283 38,270 
General and administrative expense
30,112 31,941 93,649 97,609 
Stock-based compensation expense
5,911 4,585 16,643 23,352 
Amortization expense
7,247 7,233 21,745 21,597 
Non-cash adjustments to fair value of contingent consideration liability605 1,341 1,215 3,504 
Research and development expense(b)
15,588 13,901 47,421 40,985 
Interest expense
11,135 7,606 26,078 23,716 
Other (income)/expense— — (2,825)418 
Provision for income taxes
6,213 1,414 19,016 11,548 
Other segment items(c)
2,919 5,835 18,713 15,333 
Net income
$19,796 $2,859 $56,695 $30,316 
(a)Cost of sales in 2026 includes a charge for inventory, equipment, and tooling related to the discontinuation of certain products for the nine months ended September 30, 2026 and a net benefit for the early termination of our distribution agreement with W.L. Gore & Associates, Inc for the nine months ended September 30, 2026. Cost of sales in 2025 includes the write off of inventory, equipment, tooling and patents related to the cancellation of planned new product lines and discontinuation of certain catalog numbers as a result of our operational optimization consultation and internal review for the three and nine months ended September 30, 2025. In addition, the Company incurred costs related to the engagement of a consulting firm to evaluate and propose improvements to our manufacturing operations which are included in cost of sales for the three and nine months ended September 30, 2025.

(b)Research and development expense includes costs to comply with the European Union's Medical Device Regulations in the three and nine months ended September 30, 2026.

(c)Other segment items consist of (i) consulting fees, legal fees, and other costs related to operational optimization in the three and nine months ended September 30, 2026 and 2025; (ii) cash compensation costs related to advisory services provided by our former Chief Financial Officer and Chief Executive
Officer in the nine months ended September 30, 2026 and 2025, respectively; (iii) loss from the sale of additional assets related to the gastroenterology product offerings which was recorded as a sale of a business in the nine months ended September 30, 2026; (iv) a gain from the sale of certain assets related to gastroenterology products in the three and nine months ended September 30, 2026; (v) third party services pertaining to the review of potential issues with certain royalty payments to surgeons involved in design teams in three and nine months ended September 30, 2025; and (vi) gain on the sale of a product offering in the nine months ended September 30, 2025.
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v3.26.3
Consolidated Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / shares
Sep. 30, 2026
Dec. 31, 2025
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) 1,429,841 328,097
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3 Months Ended
Sep. 30, 2025
Jun. 30, 2025
Mar. 31, 2025
Statement of Stockholders' Equity [Abstract]      
Dividends per share of common stock (in dollars per share) $ 0.20 $ 0.20 $ 0.20
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Aggregate dividends declared during the period for each share of common stock outstanding.

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Guarantees (Tables)
9 Months Ended
Sep. 30, 2026
Guarantees [Abstract]  
Changes in the Carrying Amount of Service and Product Warranties
Changes in the liability for standard warranties for the nine months ended September 30, are as follows:

20262025
Balance as of January 1,$1,323 $1,445 
Provision for warranties935 415 
Claims made(692)(530)
Balance as of September 30,$1,566 $1,330 
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Earnings Per Share (Tables)
9 Months Ended
Sep. 30, 2026
Earnings Per Share [Abstract]  
Schedule of Calculation of Basic and Diluted Earnings Per Share
The following tables set forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2026 and 2025:

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2026202520262025
Net income
$19,796 $2,859 $56,695 $30,316 
Basic weighted average shares outstanding
29,926 30,955 30,178 31,027 
Stock-based awards
199 95 75 118 
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30,125 31,050 30,253 31,145 
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Basic
$0.66 $0.09 $1.88 $0.98 
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0.66 0.09 1.87 0.97 
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Comprehensive Income (Details) - USD ($)
$ in Thousands
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Sep. 30, 2026
Jun. 30, 2026
Mar. 31, 2026
Sep. 30, 2025
Jun. 30, 2025
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Pension liability, net of income tax 213     268     640 805
Foreign currency translation adjustments 1,031     (256)     (1,929) 15,595
Comprehensive income 18,992 $ 24,386 $ 15,436 6,605 $ 25,835 $ 7,501 58,814 39,941
Cash flow hedging gain (loss), tax (655)     1,195     1,091 (2,168)
Pension liability, tax $ 68     $ 86     $ 206 $ 257
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Product Lines (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Segment Reporting [Line Items]        
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Orthopedic Surgery        
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General Surgery        
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v3.26.3
Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Cash flows from operating activities:    
Net income $ 56,695 $ 30,316
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation 12,234 13,077
Amortization of deferred debt issuance costs 2,940 4,107
Amortization 44,832 42,354
Stock-based compensation 16,643 23,352
Deferred income taxes 8,281 2,711
Gain on sale of product offerings, net (1,824) 0
Non-cash adjustments to fair value of contingent consideration liability 1,215 3,504
(Gain) loss on early extinguishment of debt, net (4,597) 363
Increase (decrease) in cash flows from changes in assets and liabilities:    
Accounts receivable 12,977 20,310
Inventories (15,600) (15,242)
Accounts payable 3,862 3,863
Accrued compensation and benefits (5,362) 8,990
Other assets (29,946) (12,934)
Other liabilities (2,372) (417)
Net cash provided by operating activities 99,978 124,354
Cash flows from investing activities:    
Proceeds from sale of product offerings 22,313 0
Purchases of property, plant and equipment (8,510) (14,695)
Other 0 850
Net cash provided by (used in) investing activities 13,803 (13,845)
Cash flows from financing activities:    
Payments on term loan (5,625) (79,821)
Proceeds from term loan 450,000 25,234
Payments on revolving line of credit (583,000) (508,432)
Proceeds from revolving line of credit 763,000 508,432
Repurchases of common stock (49,423) 0
Payments to repurchase convertible notes (637,176) 0
Payments related to contingent consideration (40,679) (22,577)
Payments related to debt issuance costs (3,562) (2,897)
Dividends paid on common stock 0 (18,555)
Other, net 721 166
Net cash used in financing activities (105,744) (98,450)
Effect of exchange rate changes on cash and cash equivalents (882) 2,411
Net increase in cash and cash equivalents 7,155 14,470
Cash and cash equivalents at beginning of period 40,817 24,459
Cash and cash equivalents at end of period 47,972 38,929
Non-cash financing activities:    
Dividends payable $ 0 $ 6,191
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v3.26.3
Fair Value Measurement
9 Months Ended
Sep. 30, 2026
Fair Value Disclosures [Abstract]  
Fair Value Measurement Fair Value Measurement
 
 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 DesignationSeptember 30, 2026December 31, 2025
Forward exchange contractsCash flow hedge$258,729 $239,588 
Forward exchange contractsNon-designated67,769 49,459 

The remaining time to maturity as of September 30, 2026 is within two years for hedge designated foreign exchange contracts and approximately one month for non-hedge designated forward exchange contracts.
Statement of comprehensive income presentation

Derivatives designated as cash flow hedges

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

Amount of Gain (Loss) Recognized in AOCI
Consolidated Condensed Statements of Comprehensive Income
Amount of Gain (Loss) Reclassified from AOCI
Three Months Ended September 30,
Total Amount of Line Item Presented
Derivative Instrument20262025Location of amount reclassified2026202520262025
Foreign exchange contracts$(1,670)$4,387 Net Sales$335,557 $337,926 $(30)$(653)
Cost of Sales146,409 171,807 1,063 112 
Pre-tax gain (loss)
$(1,670)$4,387 $1,033 $(541)
Tax expense (benefit)
(405)1,063 250 (131)
Net gain (loss)
$(1,265)$3,324 $783 $(410)

Amount of Gain (Loss) Recognized in AOCI
Consolidated Condensed Statements of Comprehensive Income
Amount of Gain (Loss) Reclassified from AOCI
Nine Months Ended September 30,
Total Amount of Line Item Presented
Derivative Instrument20262025Location of amount reclassified2026202520262025
Foreign exchange contracts$6,178 $(9,219)Net Sales$996,090 $1,001,526 $(1,300)$505 
Cost of Sales426,038 469,336 2,979 (781)
Pre-tax gain (loss)
$6,178 $(9,219)$1,679 $(276)
Tax expense (benefit)
1,498 (2,235)407 (67)
Net gain (loss)
$4,680 $(6,984)$1,272 $(209)

At September 30, 2026, $2.2 million of net unrealized gain 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 loss from derivative instruments not accounted for as hedges and gain (loss) on our intercompany receivables on our consolidated condensed statements of comprehensive income were:

Three Months Ended September 30,Nine Months Ended September 30,
Derivative Instrument
Location on Consolidated Condensed Statements of Comprehensive Income
2026202520262025
Net loss on currency forward contracts
Selling and administrative expense$(1,950)$(150)$(2,913)$(2,230)
Net gain (loss) on currency transaction exposures
Selling and administrative expense$1,243 $(690)$458 $653 

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 September 30, 2026 and December 31, 2025:

September 30, 2026Location on Consolidated Condensed Balance SheetAsset Fair ValueLiabilities Fair ValueNet
Fair
Value
Derivatives designated as hedged instruments:
Foreign exchange contracts
Prepaid expenses and other current assets
$5,053 $(2,188)$2,865 
Foreign exchange contracts
Other assets
891 (454)437 
$5,944 $(2,642)$3,302 
Derivatives not designated as hedging instruments:
Foreign exchange contractsOther current liabilities4 (249)(245)
Total derivatives$5,948 $(2,891)$3,057 

December 31, 2025Location on Consolidated Condensed Balance SheetAsset Fair ValueLiabilities Fair ValueNet
Fair
Value
Derivatives designated as hedged instruments:
Foreign exchange contracts
Other current liabilities
$4,389 $(5,223)$(834)
Foreign exchange contracts
Other long-term liabilities
46 (407)(361)
$4,435 $(5,630)$(1,195)
Derivatives not designated as hedging instruments:
Foreign exchange contracts
Other current liabilities
— (307)(307)
Total derivatives$4,435 $(5,937)$(1,502)
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 September 30, 2026 consist of forward foreign exchange contracts and contingent consideration. 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 Company values contingent consideration from its acquisitions of In2Bones, Global Inc. ("In2Bones") and Biorez, Inc. ("Biorez") using Level 3 inputs. The contingent consideration was recorded at fair value at the date of acquisition based on the consideration expected to be transferred, estimated as the probability-weighted future cash flows, discounted back to present value. The fair value of contingent consideration was measured using projected payment dates, discount rates, revenue volatilities and projected revenues. The earn-out periods for In2Bones and Biorez ended on June 30, 2026 and September 30, 2026, respectively.

Adjustments to the fair value of contingent consideration for In2Bones were driven principally by the level of In2Bones revenue resulting in the elimination of the liability upon the completion of the earn-out period at June 30, 2026. Adjustments to the fair value of contingent consideration for Biorez mainly relate to the passage of time. Changes in the fair value of contingent consideration liabilities for the nine months ended September 30, 2026 and 2025 are as follows:

In2BonesBiorez
2026202520262025
Balance as of January 1,$2,160 $11,196 $59,248 $61,021 
Payments
— — (40,679)(22,577)
Changes in fair value of contingent consideration(2,160)(8,828)3,375 12,332 
Balance as of September 30,$— $2,368 $21,944 $50,776 
    
Contingent consideration of $21.9 million and $61.4 million is included in other current liabilities in the consolidated condensed balance sheet at September 30, 2026 and December 31, 2025, respectively.
The carrying amounts reported in our consolidated condensed balance sheets for cash and cash equivalents, accounts receivable, accounts payable and variable long-term debt approximate fair value.
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v3.26.3
Long Term Debt (Details) - USD ($)
$ in Thousands
Sep. 30, 2026
Dec. 31, 2025
Debt Instrument [Line Items]    
Finance Lease, Liability $ 734 $ 1,233
Long-term Debt and Lease Obligation, Including Current Maturities 815,866 834,942
Current portion of long-term debt 180,109 712
Long-term debt 635,757 834,230
Line of Credit    
Debt Instrument [Line Items]    
Long-term Debt 180,000 0
2.250 Percent Convertible Notes Due 2027 | Convertible Notes Payable    
Debt Instrument [Line Items]    
Convertible Debt 154,182 793,927
Unamortized Debt Issuance Expense 576 6,073
Term A-1 Loan | Term Loan Facility    
Debt Instrument [Line Items]    
Long-term Debt 39,842 39,782
Unamortized Debt Issuance Expense 158 218
Term A-2 Loan | Term Loan Facility    
Debt Instrument [Line Items]    
Long-term Debt 441,108 $ 0
Unamortized Debt Issuance Expense $ 3,267  
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v3.26.3
Revenues
9 Months Ended
Sep. 30, 2026
Revenue from Contract with Customer [Abstract]  
Revenues 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 EndedThree Months Ended
September 30, 2026September 30, 2025
Orthopedic SurgeryGeneral SurgeryTotalOrthopedic SurgeryGeneral SurgeryTotal
Primary Geographic Markets
United States$51,538 $121,167 $172,705 $52,456 $141,523 $193,979 
Europe, Middle East & Africa35,029 32,590 67,619 30,935 27,746 58,681 
Asia Pacific37,733 22,648 60,381 33,765 20,061 53,826 
Americas (excluding the United States)24,534 10,318 34,852 21,037 10,403 31,440 
Total sales from contracts with customers$148,834 $186,723 $335,557 $138,193 $199,733 $337,926 
Timing of Revenue Recognition
Goods transferred at a point in time$136,521 $185,836 $322,357 $126,763 $197,069 $323,832 
Services transferred over time12,313 887 13,200 11,430 2,664 14,094 
Total sales from contracts with customers$148,834 $186,723 $335,557 $138,193 $199,733 $337,926 

Nine Months EndedNine Months Ended
September 30, 2026September 30, 2025
Orthopedic SurgeryGeneral SurgeryTotalOrthopedic SurgeryGeneral SurgeryTotal
Primary Geographic Markets
United States$159,123 $362,022 $521,145 $157,158 $411,195 $568,353 
Europe, Middle East & Africa113,818 99,085 212,903 101,730 88,404 190,134 
Asia Pacific105,131 54,364 159,495 94,624 54,995 149,619 
Americas (excluding the United States)70,738 31,809 102,547 63,704 29,716 93,420 
Total sales from contracts with customers$448,810 $547,280 $996,090 $417,216 $584,310 $1,001,526 
Timing of Revenue Recognition
Goods transferred at a point in time$415,444 $540,532 $955,976 $383,693 $576,651 $960,344 
Services transferred over time33,366 6,748 40,114 33,523 7,659 41,182 
Total sales from contracts with customers$448,810 $547,280 $996,090 $417,216 $584,310 $1,001,526 
Contract liability balances related to the sale of extended warranties to customers are as follows:

September 30, 2026December 31, 2025
Contract liability$24,025 $21,967 
    
Revenue recognized during the nine months ended September 30, 2026 and September 30, 2025 from amounts included in contract liabilities at the beginning of the periods were $12.7 million and $12.2 million, respectively. There were no material contract assets as of September 30, 2026 and December 31, 2025.
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v3.26.3
Guarantees
9 Months Ended
Sep. 30, 2026
Guarantees [Abstract]  
Guarantees Guarantees
We provide warranties on certain of our products at the time of sale and sell extended warranties. The standard warranty period for our capital equipment is generally one year and our extended warranties typically vary from one to three years. Liability under service and warranty policies is based upon a review of historical warranty and service claim experience. Adjustments are made to accruals as claim data and historical experience warrant.

Changes in the liability for standard warranties for the nine months ended September 30, are as follows:

20262025
Balance as of January 1,$1,323 $1,445 
Provision for warranties935 415 
Claims made(692)(530)
Balance as of September 30,$1,566 $1,330 
 
Costs associated with extended warranty repairs are recorded as incurred and amounted to $3.6 million and $3.2 million for the nine months ended September 30, 2026 and 2025, respectively.
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v3.26.3
Goodwill and Other Intangible Assets (Tables)
9 Months Ended
Sep. 30, 2026
Intangible Asset, Goodwill and Other [Abstract]  
Goodwill
The changes in the net carrying amount of goodwill for the nine months ended September 30, 2026 are as follows:

Balance as of December 31, 2025$807,011 
Goodwill allocated to the sale of a business(9,778)
Foreign currency translation(306)
Balance as of September 30, 2026$796,927 
Intangible Asset, Finite-Lived
Other intangible assets consist of the following:

September 30, 2026December 31, 2025
Weighted Average Amortization Period (Years)Gross
Carrying
Amount
Accumulated
Amortization
Gross
Carrying
Amount
Accumulated
Amortization
Intangible assets with definite lives:22
Customer and distributor relationships24$365,093 $(228,920)$370,068 $(221,904)
Sales representation, marketing and promotional rights25149,376 (88,500)149,376 (84,000)
Developed technology18317,904 (73,531)317,904 (65,281)
Patents and other intangible assets1586,125 (57,061)87,029 (57,685)
Intangible assets with indefinite lives:
Trademarks and tradenames86,144 — 86,544 — 
$1,004,642 $(448,012)$1,010,921 $(428,870)
Intangible Asset, Indefinite-Lived
Other intangible assets consist of the following:

September 30, 2026December 31, 2025
Weighted Average Amortization Period (Years)Gross
Carrying
Amount
Accumulated
Amortization
Gross
Carrying
Amount
Accumulated
Amortization
Intangible assets with definite lives:22
Customer and distributor relationships24$365,093 $(228,920)$370,068 $(221,904)
Sales representation, marketing and promotional rights25149,376 (88,500)149,376 (84,000)
Developed technology18317,904 (73,531)317,904 (65,281)
Patents and other intangible assets1586,125 (57,061)87,029 (57,685)
Intangible assets with indefinite lives:
Trademarks and tradenames86,144 — 86,544 — 
$1,004,642 $(448,012)$1,010,921 $(428,870)
Schedule of Estimated Amortization Expense
The estimated intangible asset amortization expense remaining for the year ending December 31, 2026 and for each of the five succeeding years is as follows:
 
Amortization included in expenseAmortization recorded as a reduction of revenueTotal
Remaining, 2026
$7,472 $1,500 $8,972 
202730,430 6,000 36,430 
202833,912 6,000 39,912 
202933,106 6,000 39,106 
203034,586 6,000 40,586 
203136,017 6,000 42,017 
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v3.26.3
Business Segment (Details)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
USD ($)
Sep. 30, 2025
USD ($)
Sep. 30, 2026
USD ($)
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Segment Reporting [Abstract]        
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Number of Operating Segments | operating_segments     1  
Segment Reporting [Line Items]        
Net sales $ 335,557 $ 337,926 $ 996,090 $ 1,001,526
Cost of sales 146,409 171,807 426,038 469,336
Stock-based compensation     16,643 23,352
Amortization expense 8,800 8,700 26,200 26,100
Non-cash adjustments to fair value of contingent consideration liability     1,215 3,504
Research and development expense 15,588 13,901 47,421 40,985
Interest expense 11,135 7,606 26,078 23,716
Other (income) / expense 0 0 (2,825) 418
Provision for income taxes 6,213 1,414 19,016 11,548
Net income 19,796 2,859 56,695 30,316
Single Reportable Segment        
Segment Reporting [Line Items]        
Net sales 335,557 337,926 996,090 1,001,526
Cost of sales 146,409 171,807 426,038 469,336
Salesforce and commission expense 56,903 59,404 174,268 175,760
Marketing expense 18,859 16,915 56,151 49,782
Distribution expense 13,860 13,085 41,283 38,270
General and administrative expense 30,112 31,941 93,649 97,609
Stock-based compensation 5,911 4,585 16,643 23,352
Non-cash adjustments to fair value of contingent consideration liability 605 1,341 1,215 3,504
Research and development expense 15,588 13,901 47,421 40,985
Interest expense 11,135 7,606 26,078 23,716
Other (income) / expense 0 0 (2,825) 418
Provision for income taxes 6,213 1,414 19,016 11,548
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Net income 19,796 2,859 56,695 30,316
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v3.26.3
Inventories
9 Months Ended
Sep. 30, 2026
Inventory Disclosure [Abstract]  
Inventories Inventories
Inventories consist of the following:

September 30,
2026
December 31,
2025
Raw materials$118,652 $109,630 
Work-in-process38,501 33,263 
Finished goods205,676 212,651 
Total$362,829 $355,544 
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v3.26.3
Long Term Debt Additional Information (Details)
$ / shares in Units, $ in Thousands
3 Months Ended 9 Months Ended 12 Months Ended
Jun. 15, 2026
USD ($)
Jun. 12, 2026
USD ($)
Jun. 06, 2022
USD ($)
$ / shares
Sep. 30, 2026
USD ($)
Sep. 30, 2025
USD ($)
Sep. 30, 2026
USD ($)
Sep. 30, 2025
USD ($)
Dec. 31, 2025
USD ($)
May 27, 2026
USD ($)
Jun. 10, 2025
USD ($)
Jan. 29, 2019
Debt Instrument [Line Items]                      
Repayments of Senior Debt           $ 5,625 $ 79,821        
Payments to repurchase convertible notes           637,176 0        
Term Loan Facility | Term A-1 Loan                      
Debt Instrument [Line Items]                      
Debt instrument, face amount                   $ 100,000  
Repayments of Senior Debt     $ 90,000         $ 60,000      
Long-term Debt, Gross       $ 40,000   40,000          
Long-term Debt       39,842   39,842   39,782      
Term Loan Facility | Term A-2 Loan                      
Debt Instrument [Line Items]                      
Debt instrument, face amount                 $ 450,000    
Debt Instrument, Increase (Decrease), Net   $ 450,000                  
Long-term Debt, Gross       444,400   444,400          
Long-term Debt       441,108   441,108   0      
Line of Credit                      
Debt Instrument [Line Items]                      
Long-term Debt       180,000   180,000   $ 0      
Line of Credit | Amended and Restated Senior Credit Agreement                      
Debt Instrument [Line Items]                      
Line of Credit Facility, Maximum Borrowing Capacity                   $ 650,000  
Line of Credit Facility, Remaining Borrowing Capacity       468,500   468,500          
Letters of Credit Outstanding, Amount       1,500   1,500          
Convertible Notes Payable | 2.250 Percent Convertible Notes Due 2027                      
Debt Instrument [Line Items]                      
Debt instrument, face amount     $ 800,000                
Interest rate, stated percentage     2.25%                
Debt Instrument, Convertible, Conversion Ratio     6.8810                
Conversion price (in dollars per share) | $ / shares     $ 145.33                
Gain (Loss) on Extinguishment of Debt, before Debt Issuance Cost Writeoff           8,100          
Extinguishment of Debt, Amount $ 645,200                    
Payments to repurchase convertible notes $ 637,200                    
Deferred Debt Issuance Cost, Writeoff           3,500          
Professional Fees           1,800          
Interest Expense, Debt       900 $ 4,500 9,300 $ 13,500        
Debt Instrument, Fair Value Disclosure       $ 151,700   $ 151,700          
Convertible Notes Payable | 2.250 Percent Convertible Notes Due 2027 | Warrant                      
Debt Instrument [Line Items]                      
Option indexed to issuer's equity, strike price (in dollars per share) | $ / shares     $ 251.53                
Convertible Notes Payable | 2.625 Percent Convertible Notes Due 2024                      
Debt Instrument [Line Items]                      
Interest rate, stated percentage                     2.625%
Long-term Debt | Term A-1 Loan and Revolving Credit Facility                      
Debt Instrument [Line Items]                      
Term SOFR Interest Rate       3.938%   3.938%          
Effective Interest Rate       5.438%   5.438%          
Long-term Debt | Term A-1 Loan and Revolving Credit Facility | Secured Overnight Financing Rate (SOFR)                      
Debt Instrument [Line Items]                      
Debt Instrument, Basis Spread on Variable Rate           1.50%          
Long-term Debt | Term A-1 Loan and Revolving Credit Facility | Alternate Base Rate Spread, New York Federal Reserve Bank Rate                      
Debt Instrument [Line Items]                      
Debt Instrument, Basis Spread on Variable Rate           0.50%          
Long-term Debt | Term A-1 Loan and Revolving Credit Facility | Alternate Base Rate Spread, Secured Overnight Financing Rate (SOFR)                      
Debt Instrument [Line Items]                      
Debt Instrument, Basis Spread on Variable Rate           1.00%          
Long-term Debt | Term A-2 Loan                      
Debt Instrument [Line Items]                      
Adjusted Term SOFR Interest Rate       3.813%   3.813%          
Effective Interest Rate       5.563%   5.563%          
Long-term Debt | Term A-2 Loan | Secured Overnight Financing Rate (SOFR)                      
Debt Instrument [Line Items]                      
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Call Option | Convertible Notes Payable | 2.250 Percent Convertible Notes Due 2027                      
Debt Instrument [Line Items]                      
Hedge and warrant transactions, net cash paid     $ 115,600                
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Fair Value Measurement (Amounts Recorded In and Reclassified From AOCI) (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Derivative Instruments, Gain [Line Items]        
Net sales $ 335,557 $ 337,926 $ 996,090 $ 1,001,526
Cost of sales 146,409 171,807 426,038 469,336
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), before Reclassification and Tax (1,670) 4,387 6,178 (9,219)
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), before Reclassification, Tax (405) 1,063 1,498 (2,235)
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax (1,265) 3,324 4,680 (6,984)
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), Reclassification, before Tax 1,033 (541) 1,679 (276)
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), Reclassification, Tax 250 (131) 407 (67)
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), Reclassification, after Tax 783 (410) 1,272 (209)
Income Statement Location [Axis]: us-gaap:CostOfGoodsAndServicesSold        
Derivative Instruments, Gain [Line Items]        
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), Reclassification, before Tax 1,063 112 2,979 (781)
Income Statement Location [Axis]: us-gaap:Revenues        
Derivative Instruments, Gain [Line Items]        
Other Comprehensive Income, Cash Flow Hedge, Gain (Loss), Reclassification, before Tax $ (30) $ (653) $ (1,300) $ 505
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v3.26.3
Legal Proceedings
9 Months Ended
Sep. 30, 2026
Commitments and Contingencies Disclosure [Abstract]  
Legal Proceedings Legal Proceedings
In the ordinary course of business, we are involved in various legal actions involving product liability, employment, intellectual property and commercial disputes, stockholder related matters, environmental proceedings, tax disputes, and governmental proceedings and investigations. 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, investigations, or reports of alleged misconduct, or the costs associated with responding to such claims, investigations or reports of alleged misconduct, especially when not covered by insurance, will not have a material adverse effect on our financial condition, results of operations or cash flows.

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For further description of our legal proceedings, reference is made to Note 13, “Legal Proceedings” in the Notes to the Consolidated Financial Statements in our Annual Report on Form 10-K for the year ended December 31, 2025.
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$ in Thousands
3 Months Ended 9 Months Ended
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Mar. 31, 2026
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v3.26.3
Business Segment
9 Months Ended
Sep. 30, 2026
Segment Reporting [Abstract]  
Business Segment Business Segment
We operate and report 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. The Company derives revenue globally and manages the business on a consolidated basis due to shared infrastructure and resources. Our chief operating decision maker ("CODM"), the President and Chief Executive Officer, 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.
Our product lines consist of orthopedic surgery and general surgery. Orthopedic surgery consists of sports medicine and lower extremities instrumentation and implants, small bone, large bone and specialty powered surgical instruments as well as imaging systems for use in minimally invasive surgical procedures and fees related to 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 procedures, clinical insufflation, smoke evacuation devices, a line of patient monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales are as follows:
Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Orthopedic surgery$148,834 $138,193 $448,810 $417,216 
General surgery186,723 199,733 547,280 584,310 
Consolidated net sales$335,557 $337,926 $996,090 $1,001,526 
The following table includes significant segment expenses:
Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Net sales
$335,557 $337,926 $996,090 $1,001,526 
Cost of sales(a)
146,409 171,807 426,038 469,336 
Salesforce and commission expense
56,903 59,404 174,268 175,760 
Marketing expense
18,859 16,915 56,151 49,782 
Distribution expense
13,860 13,085 41,283 38,270 
General and administrative expense
30,112 31,941 93,649 97,609 
Stock-based compensation expense
5,911 4,585 16,643 23,352 
Amortization expense
7,247 7,233 21,745 21,597 
Non-cash adjustments to fair value of contingent consideration liability605 1,341 1,215 3,504 
Research and development expense(b)
15,588 13,901 47,421 40,985 
Interest expense
11,135 7,606 26,078 23,716 
Other (income)/expense— — (2,825)418 
Provision for income taxes
6,213 1,414 19,016 11,548 
Other segment items(c)
2,919 5,835 18,713 15,333 
Net income
$19,796 $2,859 $56,695 $30,316 
(a)Cost of sales in 2026 includes a charge for inventory, equipment, and tooling related to the discontinuation of certain products for the nine months ended September 30, 2026 and a net benefit for the early termination of our distribution agreement with W.L. Gore & Associates, Inc for the nine months ended September 30, 2026. Cost of sales in 2025 includes the write off of inventory, equipment, tooling and patents related to the cancellation of planned new product lines and discontinuation of certain catalog numbers as a result of our operational optimization consultation and internal review for the three and nine months ended September 30, 2025. In addition, the Company incurred costs related to the engagement of a consulting firm to evaluate and propose improvements to our manufacturing operations which are included in cost of sales for the three and nine months ended September 30, 2025.

(b)Research and development expense includes costs to comply with the European Union's Medical Device Regulations in the three and nine months ended September 30, 2026.

(c)Other segment items consist of (i) consulting fees, legal fees, and other costs related to operational optimization in the three and nine months ended September 30, 2026 and 2025; (ii) cash compensation costs related to advisory services provided by our former Chief Financial Officer and Chief Executive
Officer in the nine months ended September 30, 2026 and 2025, respectively; (iii) loss from the sale of additional assets related to the gastroenterology product offerings which was recorded as a sale of a business in the nine months ended September 30, 2026; (iv) a gain from the sale of certain assets related to gastroenterology products in the three and nine months ended September 30, 2026; (v) third party services pertaining to the review of potential issues with certain royalty payments to surgeons involved in design teams in three and nine months ended September 30, 2025; and (vi) gain on the sale of a product offering in the nine months ended September 30, 2025.
Total assets for the Company's single operating segment are the same as presented on the Company's consolidated balance sheet, which is used to measure segment performance.
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v3.26.3
Consolidated Condensed Balance Sheets (Unaudited) - USD ($)
$ in Thousands
Sep. 30, 2026
Dec. 31, 2025
Current assets:    
Cash and cash equivalents $ 47,972 $ 40,817
Accounts receivable, net 233,913 247,830
Inventories 362,829 355,544
Prepaid expenses and other current assets 37,325 28,669
Total current assets 682,039 672,860
Property, plant and equipment, net 108,768 113,331
Goodwill 796,927 807,011
Other intangible assets, net 556,630 582,051
Other assets 160,098 150,496
Total assets 2,304,462 2,325,749
Current liabilities:    
Current portion of long-term debt 180,109 712
Accounts payable 98,495 93,648
Accrued compensation and benefits 76,619 82,139
Other current liabilities 103,740 138,542
Total current liabilities 458,963 315,041
Long-term debt 635,757 834,230
Deferred income taxes 88,962 79,530
Other long-term liabilities 60,861 63,851
Total liabilities 1,244,543 1,292,652
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 2026 and 2025, respectively 313 313
Paid-in capital 518,448 503,200
Retained earnings 645,461 588,766
Accumulated other comprehensive loss (44,176) (46,295)
Less: 1,429,841 and 328,097 shares of common stock in treasury, at cost, in 2026 and 2025, respectively (60,127) (12,887)
Total shareholders’ equity 1,059,919 1,033,097
Total liabilities and shareholders’ equity $ 2,304,462 $ 2,325,749
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v3.26.3
Comprehensive Income
9 Months Ended
Sep. 30, 2026
Equity [Abstract]  
Comprehensive Income Comprehensive Income
Comprehensive income consists of the following:
 
Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Net income
$19,796 $2,859 $56,695 $30,316 
Other comprehensive income (loss):
Cash flow hedging gain (loss), net of income tax (income tax expense (benefit) of $(655) and $1,195 for the three months ended September 30, 2026 and 2025, respectively, and $1,091 and $(2,168) for the nine months ended September 30, 2026 and 2025, respectively)
(2,048)3,734 3,408 (6,775)
Pension liability, net of income tax (income tax expense of $68 and $86 for the three months ended September 30, 2026 and 2025, respectively, and $206 and $257 for the nine months ended September 30, 2026 and 2025, respectively)
213 268 640 805 
Foreign currency translation adjustment1,031 (256)(1,929)15,595 
Comprehensive income
$18,992 $6,605 $58,814 $39,941 

Accumulated other comprehensive loss consists of the following:

Cash Flow
Hedging
Gain (Loss)
Pension
Liability
Cumulative
Translation
Adjustments
Accumulated
Other
Comprehensive
Loss
Balance, December 31, 2025$(905)$(14,287)$(31,103)$(46,295)
Other comprehensive income (loss) before reclassifications, net of tax4,680 — (1,929)2,751 
Amounts reclassified from accumulated other comprehensive income (loss) before taxa
(1,679)846 — (833)
Income tax 407 (206)— 201 
Net current-period other comprehensive income (loss)
3,408 640 (1,929)2,119 
Balance, September 30, 2026$2,503 $(13,647)$(33,032)$(44,176)
Cash Flow
Hedging
Gain (Loss)
Pension
Liability
Cumulative
Translation
Adjustments
Accumulated
Other
Comprehensive
Loss
Balance, December 31, 2024$4,297 $(16,880)$(46,274)$(58,857)
Other comprehensive gain (loss) before reclassifications, net of tax
(6,984)— 15,595 8,611 
Amounts reclassified from accumulated other comprehensive income (loss) before taxa
276 1,062 — 1,338 
Income tax (67)(257)— (324)
Net current-period other comprehensive income (loss)
(6,775)805 15,595 9,625 
Balance, September 30, 2025$(2,478)$(16,075)$(30,679)$(49,232)
(a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive loss components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.
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-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.7-04(19))
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v3.26.3
Consolidated Condensed Statements of Shareholders' Equity (Unaudited) - USD ($)
shares in Thousands, $ in Thousands
Total
Common Stock
Paid-in Capital
Retained Earnings
Accumulated Other Comprehensive Loss
Treasury Stock
Balance at period start (in shares) at Dec. 31, 2024   31,299        
Balance at period start at Dec. 31, 2024 $ 962,681 $ 313 $ 476,575 $ 560,277 $ (58,857) $ (15,627)
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Common stock issued under employee plans (223)   (1,340)     1,117
Stock-based compensation 13,863   13,863      
Dividends on common stock ($0.20 per share) (6,186)     (6,186)    
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax         (3,669)  
Pension liability, net of income tax         268  
Foreign currency translation adjustments         4,866  
Net income       6,036    
Comprehensive income 7,501          
Balance at period end (in shares) at Mar. 31, 2025   31,299        
Balance at period end at Mar. 31, 2025 977,636 $ 313 489,098 560,127 (57,392) (14,510)
Balance at period start (in shares) at Dec. 31, 2024   31,299        
Balance at period start at Dec. 31, 2024 962,681 $ 313 476,575 560,277 (58,857) (15,627)
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax (6,775)          
Pension liability, net of income tax 805          
Foreign currency translation adjustments 15,595          
Net income 30,316          
Comprehensive income 39,941          
Balance at period end (in shares) at Sep. 30, 2025   31,299        
Balance at period end at Sep. 30, 2025 1,008,263 $ 313 498,672 572,027 (49,232) (13,517)
Balance at period start (in shares) at Mar. 31, 2025   31,299        
Balance at period start at Mar. 31, 2025 977,636 $ 313 489,098 560,127 (57,392) (14,510)
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Common stock issued under employee plans 685   36     649
Stock-based compensation 4,903   4,903      
Dividends on common stock ($0.20 per share) (6,189)     (6,189)    
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax         (6,840)  
Pension liability, net of income tax         268  
Foreign currency translation adjustments         10,986  
Net income       21,421    
Comprehensive income 25,835          
Balance at period end (in shares) at Jun. 30, 2025   31,299        
Balance at period end at Jun. 30, 2025 1,002,870 $ 313 494,037 575,359 (52,978) (13,861)
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Common stock issued under employee plans 394   50     344
Stock-based compensation 4,585   4,585      
Dividends on common stock ($0.20 per share) (6,191)     (6,191)    
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax 3,734       3,734  
Pension liability, net of income tax 268       268  
Foreign currency translation adjustments (256)       (256)  
Net income 2,859     2,859    
Comprehensive income 6,605          
Balance at period end (in shares) at Sep. 30, 2025   31,299        
Balance at period end at Sep. 30, 2025 1,008,263 $ 313 498,672 572,027 (49,232) (13,517)
Balance at period start (in shares) at Dec. 31, 2025   31,299        
Balance at period start at Dec. 31, 2025 1,033,097 $ 313 503,200 588,766 (46,295) (12,887)
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Common stock issued under employee plans 1,025   (208)     1,233
Stock-based compensation 5,502   5,502      
Repurchases of common stock (a) (37,387)         (37,387)
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax         3,061  
Pension liability, net of income tax         213  
Foreign currency translation adjustments         (1,666)  
Net income       13,828    
Comprehensive income 15,436          
Balance at period end (in shares) at Mar. 31, 2026   31,299        
Balance at period end at Mar. 31, 2026 1,017,673 $ 313 508,494 602,594 (44,687) (49,041)
Balance at period start (in shares) at Dec. 31, 2025   31,299        
Balance at period start at Dec. 31, 2025 1,033,097 $ 313 503,200 588,766 (46,295) (12,887)
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax 3,408          
Pension liability, net of income tax 640          
Foreign currency translation adjustments (1,929)          
Net income 56,695          
Comprehensive income 58,814          
Balance at period end (in shares) at Sep. 30, 2026   31,299        
Balance at period end at Sep. 30, 2026 1,059,919 $ 313 518,448 645,461 (44,176) (60,127)
Balance at period start (in shares) at Mar. 31, 2026   31,299        
Balance at period start at Mar. 31, 2026 1,017,673 $ 313 508,494 602,594 (44,687) (49,041)
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Common stock issued under employee plans 362   (264)     626
Stock-based compensation 5,230   5,230      
Repurchases of common stock (a) (6,265)         (6,265)
Settlement of convertible notes hedge transactions 12   12      
Settlement of warrants (8)   (8)      
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax         2,394  
Pension liability, net of income tax         213  
Foreign currency translation adjustments         (1,292)  
Net income       23,071    
Comprehensive income 24,386          
Balance at period end (in shares) at Jun. 30, 2026   31,299        
Balance at period end at Jun. 30, 2026 1,041,390 $ 313 513,464 625,665 (43,372) (54,680)
Increase (Decrease) in Stockholders' Equity [Roll Forward]            
Common stock issued under employee plans (110)   (927)     817
Stock-based compensation 5,911   5,911      
Repurchases of common stock (a) (6,264)         (6,264)
Comprehensive income:            
Cash flow hedging gain (loss), net of income tax (2,048)       (2,048)  
Pension liability, net of income tax 213       213  
Foreign currency translation adjustments 1,031       1,031  
Net income 19,796     19,796    
Comprehensive income 18,992          
Balance at period end (in shares) at Sep. 30, 2026   31,299        
Balance at period end at Sep. 30, 2026 $ 1,059,919 $ 313 $ 518,448 $ 645,461 $ (44,176) $ (60,127)
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v3.26.3
Long Term Debt
9 Months Ended
Sep. 30, 2026
Debt Disclosure [Abstract]  
Long-Term Debt Long-Term Debt
Long-term debt consists of the following:

September 30, 2026December 31, 2025
Revolving line of credit$180,000 $— 
Term A-1 Loan, net of deferred debt issuance costs of $158 and $218 in 2026 and 2025, respectively
39,842 39,782 
Term A-2 Loan, net of deferred debt issuance costs of $3,267 in 2026
441,108 — 
2.250% convertible notes, net of deferred debt issuance costs of $576 and $6,073 in 2026 and 2025, respectively
154,182 793,927 
Finance leases
734 1,233 
Total debt815,866 834,942 
Less:  Current portion180,109 712 
Total long-term debt$635,757 $834,230 

Eighth Amended and Restated Senior Credit Agreement

On June 10, 2025, we entered into an eighth amended and restated senior credit agreement consisting of: (a) a $100.0 million term loan facility ("Term A-1 Loan") and (b) a $650.0 million revolving credit facility. On May 27, 2026, we entered into the first amendment to the eighth amended and restated senior credit agreement to obtain additional commitments for a senior secured delayed draw term loan facility of $450 million ("Term A-2 Loan"). The revolving credit facility will terminate and the loans outstanding under both term loan facilities will expire on June 10, 2030.

The Term A-1 Loan was payable in quarterly installments increasing over the term of the facility with the remaining outstanding balance due at maturity. During 2025, we made $60 million in prepayments on the Term A-1 Loan facility resulting in the elimination of such quarterly payments. Proceeds from the Term A-1 Loan facility and borrowings under the revolving credit facility were used to repay the then existing senior credit agreement. On June 12, 2026, we borrowed $450.0 million under the Term A-2 Loan. The Term A-2 Loan is payable in quarterly installments increasing over the term of the facility with the remaining outstanding balance due at maturity. Proceeds from the Term A-2 Loan facility and borrowings under the revolving credit facility were used to repurchase a portion of the 2.250% convertible notes (the "2.250% Notes").

Interest rates are at the Term Secured Overnight Financing Rate ("SOFR") (3.938% at September 30, 2026) plus an interest rate margin of 1.500% (5.438% at September 30, 2026) for the Term A-1 Loan and revolving credit facility. For borrowings where we elect to use the alternate base rate, the initial base rate is the greatest of (i) the Prime Rate, (ii) the New York Federal Reserve Bank Rate plus 0.50% or (iii) the one-month Term SOFR plus 1.00%, plus, in each case, an interest rate margin. For the Term A-2 Loan, the interest rate is at an adjusted Term Secured Overnight Financing Rate (3.813%) plus an interest rate margin of 1.750% (5.563% at September 30, 2026).
There were $40.0 million in borrowings outstanding on the Term A-1 Loan and $444.4 million in borrowings outstanding on the Term A-2 Loan as of September 30, 2026. There were $180.0 million in borrowings outstanding under the revolving credit facility as of September 30, 2026. Our available borrowings on the revolving credit facility at September 30, 2026 were $468.5 million with approximately $1.5 million of the facility set aside for outstanding letters of credit. The carrying amounts of the term loan and revolving credit facility approximate fair value due to the variable interest rates on our outstanding debt.
    
The eighth amended and restated senior credit agreement is collateralized by substantially all of our property and assets. The eighth 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 September 30, 2026. We are also required, under certain circumstances, to make mandatory prepayments with net cash proceeds from the incurrence of certain additional indebtedness, certain asset sales, or insurance proceeds or condemnation awards, in each case, subject to certain exceptions and reinvestment rights.

2.250% Convertible Notes

On June 6, 2022, we issued $800.0 million aggregate principal amount of 2.250% Notes. Interest is payable semi-annually in arrears on June 15 and December 15 of each year, commencing December 15, 2022. The 2.250% Notes will mature on June 15, 2027, unless earlier repurchased or converted. The 2.250% 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, with the principal required to be paid in cash. The 2.250% Notes may be converted at an initial conversion rate of 6.8810 shares of our common stock per $1,000 principal amount of the 2.250% Notes (equivalent to an initial conversion price of approximately $145.33 per share of common stock). Holders of the 2.250% Notes may convert the 2.250% Notes at their option at any time on or after March 15, 2027 through the second scheduled trading day preceding the maturity date. Holders of the 2.250% Notes will also have the right to convert the 2.250% Notes prior to March 15, 2027, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of these proceeds were used to repurchase a portion of our then-outstanding 2.625% Convertible Notes (the "2.625% Notes"), pay off our then outstanding balance on our revolving line of credit, pay down of $90.0 million of our then outstanding term loan and partially pay for the In2Bones Global, Inc. acquisition. In addition, approximately $115.6 million of the proceeds were used to pay the cost of certain convertible notes hedge transactions related to the 2.250% Notes.

On June 15, 2026, the Company repurchased $645.2 million principal amount of the 2.250% Notes for cash consideration of $637.2 million. During the nine months ended September 30, 2026, the Company recorded a gain on extinguishment of $8.1 million to other income. We also recorded to other expense a write-off of unamortized debt issuance costs related to the 2.250% Notes of $3.5 million and professional fees of $1.8 million.

For the three months ended September 30, 2026 and 2025, we have recorded interest expense on the 2.250% Notes of $0.9 million and $4.5 million, respectively, and for the nine months ended September 30, 2026 and 2025 we have recorded interest expense on the 2.250% Notes of $9.3 million and $13.5 million, respectively, at the contractual coupon rate of 2.250%.

The estimated fair value of the remaining 2.250% Notes was approximately $151.7 million as of September 30, 2026 based on a market approach which represents a Level 2 valuation in the fair value hierarchy. The estimated fair value was determined based on the estimated or actual bids and offers of the 2.250% Notes in an over-the-counter market transaction on the last business day of the period.

Convertible Notes Hedge Transactions

In connection with the offering of the 2.250% Notes, we entered into convertible notes hedge transactions with a number of financial institutions (each, an “option counterparty”). The convertible notes hedge transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the 2.250% Notes, the number of shares of our common stock underlying the 2.250% Notes. Concurrent with entering into the convertible notes 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.

In connection with the repurchase of $645.2 million principal amount of the 2.250% Notes, the Company entered into agreements with the option counterparties to terminate a corresponding portion of the hedges and warrants on the 2.250%
Notes. The transactions had an immaterial net fair value due to the Company which was recorded as an adjustment to Paid-in Capital.

The convertible notes hedge transactions are expected generally to reduce the potential dilution upon conversion of the 2.250% Notes and/or offset any cash payments we are required to make in excess of the principal amount of converted 2.250% 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 notes hedge transactions, is greater than the strike price of the convertible notes hedge transactions, which initially corresponds to the conversion price of the 2.250% Notes and is subject to anti-dilution adjustments substantially similar to those applicable to the conversion rate of the 2.250% 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 ($251.53) of the warrants, there would nevertheless be dilution to the extent that such market price exceeds the strike price of the warrants, unless we elect to settle the warrants in cash.

The scheduled maturities of long-term debt outstanding at September 30, 2026 are as follows:

Remaining, 2026
$5,625 
2027
182,883 
2028
39,375 
2029
45,000 
2030
546,250 
The above amounts exclude deferred debt issuance costs and finance leases.
We believe that our existing cash and cash equivalents, cash flows generated from operations, and borrowing capacity available under the eighth amended and restated senior credit agreement will be sufficient to meet our future cash requirements for at least the next twelve months from the filing of this quarterly report on Form 10-Q.
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v3.26.3
New Accounting Pronouncements
9 Months Ended
Sep. 30, 2026
Accounting Standards Update and Change in Accounting Principle [Abstract]  
New Accounting Pronouncements New Accounting Pronouncements
    
Recently Issued Accounting Standards, Not Yet Adopted
    
In September 2025, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2025-06 - Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. The standard removes all references to software development stages. It also requires that an entity capitalizes software when both: (1) management has authorized and committed funding to the project and (2) it is probable that the project will be completed and the software is used to perform the intended function. This ASU may be adopted prospectively, retrospectively, or on a modified transition approach based on the status of the project and whether software costs were capitalized before the date of adoption. It is effective for annual periods beginning after December 15,
2027 and interim periods within fiscal years beginning after December 15, 2027 with early adoption permitted. We are currently evaluating the impact this ASU will have on our consolidated financial statements.

In November 2024, the FASB issued ASU 2024-03 - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40) as clarified by ASU 2025-01. The standard requires disaggregation of certain expense captions into specified categories in disclosures within the footnotes on an annual and interim basis. Any relevant expense caption presented on the face of the income statement within continuing operations are required to be disaggregated by the following natural expense categories: (1) purchases of inventory, (2) employee compensation, (3) depreciation, and (4) intangible asset amortization. This ASU can be adopted prospectively or retrospectively and is effective for annual periods beginning after December 15, 2026 and interim periods within fiscal years beginning after December 15, 2027. We expect this ASU to only impact our disclosures.
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v3.26.3
Interim Financial Information
9 Months Ended
Sep. 30, 2026
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 state 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 periods ended September 30, 2026 are not necessarily indicative of the results that may be expected for the year ending December 31, 2026.

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, 2025 included in our Annual Report on Form 10-K.

Use of Estimates

The preparation of the consolidated condensed financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and judgments which affect the reported amounts of assets, liabilities and related disclosures of contingent assets and liabilities at the date of the consolidated condensed financial statements and the reported amount of revenue and expenses during the reporting period. While 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 October 28, 2026, 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.
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v3.26.3
Goodwill and Other Intangible Assets
9 Months Ended
Sep. 30, 2026
Intangible Asset, Goodwill and Other [Abstract]  
Goodwill and Other Intangible Assets Goodwill and Other Intangible Assets
The changes in the net carrying amount of goodwill for the nine months ended September 30, 2026 are as follows:

Balance as of December 31, 2025$807,011 
Goodwill allocated to the sale of a business(9,778)
Foreign currency translation(306)
Balance as of September 30, 2026$796,927 
Assets and liabilities of acquired businesses are recorded at their estimated fair values as of the date of acquisition.  Goodwill represents costs in excess of fair values assigned to the underlying net assets of acquired businesses. 

During the quarter ended June 30, 2026, the Company completed the sale of additional assets, which constituted a business, related to the gastroenterology product offerings for $14.0 million. As this transaction was determined to be the sale of a business, we allocated $9.8 million of goodwill to the business based on its relative fair value, which resulted in a $4.4 million loss on the sale recorded to selling and administrative expense.

Other intangible assets consist of the following:

September 30, 2026December 31, 2025
Weighted Average Amortization Period (Years)Gross
Carrying
Amount
Accumulated
Amortization
Gross
Carrying
Amount
Accumulated
Amortization
Intangible assets with definite lives:22
Customer and distributor relationships24$365,093 $(228,920)$370,068 $(221,904)
Sales representation, marketing and promotional rights25149,376 (88,500)149,376 (84,000)
Developed technology18317,904 (73,531)317,904 (65,281)
Patents and other intangible assets1586,125 (57,061)87,029 (57,685)
Intangible assets with indefinite lives:
Trademarks and tradenames86,144 — 86,544 — 
$1,004,642 $(448,012)$1,010,921 $(428,870)

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.

Amortization expense related to intangible assets which are subject to amortization totaled $8.8 million and $8.7 million for the three months ended September 30, 2026 and 2025, respectively, and $26.2 million and $26.1 million for the nine months ended September 30, 2026 and 2025, 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.
 
The estimated intangible asset amortization expense remaining for the year ending December 31, 2026 and for each of the five succeeding years is as follows:
 
Amortization included in expenseAmortization recorded as a reduction of revenueTotal
Remaining, 2026
$7,472 $1,500 $8,972 
202730,430 6,000 36,430 
202833,912 6,000 39,912 
202933,106 6,000 39,106 
203034,586 6,000 40,586 
203136,017 6,000 42,017 
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Inventories (Tables)
9 Months Ended
Sep. 30, 2026
Inventory Disclosure [Abstract]  
Schedule of Inventory
Inventories consist of the following:

September 30,
2026
December 31,
2025
Raw materials$118,652 $109,630 
Work-in-process38,501 33,263 
Finished goods205,676 212,651 
Total$362,829 $355,544 
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v3.26.3
Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Dec. 31, 2025
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Intangible assets, Gross carrying amount $ 1,004,642   $ 1,004,642   $ 1,010,921
Intangible assets, Accumulated amortization (448,012)   (448,012)   (428,870)
Amortization expense 8,800 $ 8,700 26,200 $ 26,100  
Future amortization expense [Abstract]          
Remaining, 2026 8,972   8,972    
2027 36,430   36,430    
2028 39,912   39,912    
2029 39,106   39,106    
2030 40,586   40,586    
2031 42,017   42,017    
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2028 6,000   6,000    
2029 6,000   6,000    
2030 6,000   6,000    
2031 6,000   6,000    
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Remaining, 2026 7,472   7,472    
2027 30,430   30,430    
2028 33,912   33,912    
2029 33,106   33,106    
2030 34,586   34,586    
2031 36,017   36,017    
Trademarks & tradenames          
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Unamortized intangible assets, Gross carrying amount 86,144   86,144   86,544
Customer and distributor relationships          
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Amortized intangible assets, Gross carrying amount 365,093   365,093   370,068
Intangible assets, Accumulated amortization (228,920)   (228,920)   (221,904)
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   149,376
Intangible assets, Accumulated amortization (88,500)   (88,500)   (84,000)
Developed technology          
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Amortized intangible assets, Gross carrying amount 317,904   317,904   317,904
Intangible assets, Accumulated amortization (73,531)   (73,531)   (65,281)
Patents and other intangible assets          
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Amortized intangible assets, Gross carrying amount 86,125   86,125   87,029
Intangible assets, Accumulated amortization $ (57,061)   $ (57,061)   $ (57,685)
Weighted Average          
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Finite-lived intangible asset useful life (in years) 22 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   24 years    
Weighted Average | Sales representation, marketing and promotional rights          
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Finite-lived intangible asset useful life (in years) 25 years   25 years    
Weighted Average | Developed technology          
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Finite-lived intangible asset useful life (in years) 18 years   18 years    
Weighted Average | Patents and other intangible assets          
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]          
Finite-lived intangible asset useful life (in years) 15 years   15 years    
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v3.26.3
Pension Plan
9 Months Ended
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Retirement Benefits [Abstract]  
Pension Plan Pension Plan
Net periodic pension cost consists of the following: 

Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Service cost$123 $164 $369 $492 
Interest cost on projected benefit obligation818 882 2,454 2,646 
Expected return on plan assets(1,154)(1,091)(3,462)(3,273)
Net amortization and deferral282 354 846 1,062 
Net periodic pension cost$69 $309 $207 $927 
 
We do not expect to make any pension contributions during 2026. Non-service pension cost/(benefit) was immaterial for the three and nine months ended September 30, 2026 and 2025.
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Fair Value Measurement (Contingent Consideration) (Details) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Dec. 31, 2025
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]      
Non-cash adjustments to fair value of contingent consideration liability $ 1,215 $ 3,504  
Business Combination, Contingent Consideration, Liability, Current 21,900   $ 61,400
In2Bones Global Inc      
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]      
Balance as of January 1, 2,160 11,196  
Payments 0 0  
Non-cash adjustments to fair value of contingent consideration liability (2,160) (8,828)  
Balance as of September 30, 0 2,368  
Biorez Inc      
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]      
Balance as of January 1, 59,248 61,021  
Payments (40,679) (22,577)  
Non-cash adjustments to fair value of contingent consideration liability 3,375 12,332  
Balance as of September 30, $ 21,944 $ 50,776  
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v3.26.3
Comprehensive Income (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Accumulated other comprehensive income (loss) [Roll Forward]    
Balance at period start $ 1,033,097 $ 962,681
Balance at period end 1,059,919 1,008,263
Accumulated Other Comprehensive Loss    
Accumulated other comprehensive income (loss) [Roll Forward]    
Balance at period start (46,295) (58,857)
Other comprehensive income (loss) before reclassifications, net of tax 2,751 8,611
Amounts reclassified from accumulated other comprehensive income (loss) before tax [1] (833) 1,338
Reclassification from AOCI, Current Period, Tax 201 (324)
Net current-period other comprehensive income (loss) 2,119 9,625
Balance at period end (44,176) (49,232)
Accumulated Gain (Loss), Net, Cash Flow Hedge, Parent    
Accumulated other comprehensive income (loss) [Roll Forward]    
Balance at period start (905) 4,297
Other comprehensive income (loss) before reclassifications, net of tax 4,680 (6,984)
Amounts reclassified from accumulated other comprehensive income (loss) before tax [1] (1,679) 276
Reclassification from AOCI, Current Period, Tax 407 (67)
Net current-period other comprehensive income (loss) 3,408 (6,775)
Balance at period end 2,503 (2,478)
Pension Liability    
Accumulated other comprehensive income (loss) [Roll Forward]    
Balance at period start (14,287) (16,880)
Other comprehensive income (loss) before reclassifications, net of tax 0 0
Amounts reclassified from accumulated other comprehensive income (loss) before tax [1] 846 1,062
Reclassification from AOCI, Current Period, Tax (206) (257)
Net current-period other comprehensive income (loss) 640 805
Balance at period end (13,647) (16,075)
Cumulative Translation Adjustments    
Accumulated other comprehensive income (loss) [Roll Forward]    
Balance at period start (31,103) (46,274)
Other comprehensive income (loss) before reclassifications, net of tax (1,929) 15,595
Amounts reclassified from accumulated other comprehensive income (loss) before tax [1] 0 0
Reclassification from AOCI, Current Period, Tax 0 0
Net current-period other comprehensive income (loss) (1,929) 15,595
Balance at period end $ (33,032) $ (30,679)
[1] The cash flow hedging gain (loss) and pension liability accumulated other comprehensive loss components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.
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v3.26.3
Operations
9 Months Ended
Sep. 30, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Operations Operations
CONMED Corporation (“CONMED”, the “Company”, “we” or “us”) is a medical technology company that provides devices and equipment for surgical procedures.  The Company’s products are used by surgeons and other healthcare professionals in a variety of specialties including orthopedics, general surgery, gynecology, and thoracic surgery.

During the quarter ended March 31, 2026, the Company sold certain assets related to our gastroenterology product offerings for $7.0 million and we recorded a gain of $3.9 million on this asset sale to selling and administrative expense. During the subsequent quarters, we recorded additional gains of $2.2 million to selling and administrative expense.

During the quarter ended June 30, 2026, the Company completed the sale of additional assets related to our gastroenterology product offerings for $14.0 million. This sale was accounted for as a sale of a business which resulted in a $4.4 million loss as further described in Note 9.
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v3.26.3
Long Term Debt Maturities of Long Term Debt (Details)
$ in Thousands
Sep. 30, 2026
USD ($)
Maturities of Long-term Debt [Abstract]  
Remaining, 2026 $ 5,625
2027 182,883
2028 39,375
2029 45,000
2030 $ 546,250
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v3.26.3
Revenues (Tables)
9 Months Ended
Sep. 30, 2026
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 EndedThree Months Ended
September 30, 2026September 30, 2025
Orthopedic SurgeryGeneral SurgeryTotalOrthopedic SurgeryGeneral SurgeryTotal
Primary Geographic Markets
United States$51,538 $121,167 $172,705 $52,456 $141,523 $193,979 
Europe, Middle East & Africa35,029 32,590 67,619 30,935 27,746 58,681 
Asia Pacific37,733 22,648 60,381 33,765 20,061 53,826 
Americas (excluding the United States)24,534 10,318 34,852 21,037 10,403 31,440 
Total sales from contracts with customers$148,834 $186,723 $335,557 $138,193 $199,733 $337,926 
Timing of Revenue Recognition
Goods transferred at a point in time$136,521 $185,836 $322,357 $126,763 $197,069 $323,832 
Services transferred over time12,313 887 13,200 11,430 2,664 14,094 
Total sales from contracts with customers$148,834 $186,723 $335,557 $138,193 $199,733 $337,926 

Nine Months EndedNine Months Ended
September 30, 2026September 30, 2025
Orthopedic SurgeryGeneral SurgeryTotalOrthopedic SurgeryGeneral SurgeryTotal
Primary Geographic Markets
United States$159,123 $362,022 $521,145 $157,158 $411,195 $568,353 
Europe, Middle East & Africa113,818 99,085 212,903 101,730 88,404 190,134 
Asia Pacific105,131 54,364 159,495 94,624 54,995 149,619 
Americas (excluding the United States)70,738 31,809 102,547 63,704 29,716 93,420 
Total sales from contracts with customers$448,810 $547,280 $996,090 $417,216 $584,310 $1,001,526 
Timing of Revenue Recognition
Goods transferred at a point in time$415,444 $540,532 $955,976 $383,693 $576,651 $960,344 
Services transferred over time33,366 6,748 40,114 33,523 7,659 41,182 
Total sales from contracts with customers$448,810 $547,280 $996,090 $417,216 $584,310 $1,001,526 
Contract with Customer, Asset and Liability
Contract liability balances related to the sale of extended warranties to customers are as follows:

September 30, 2026December 31, 2025
Contract liability$24,025 $21,967 
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Interim Reporting (Policies)
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Sep. 30, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]  
Use of Estimates
Use of Estimates
The preparation of the consolidated condensed financial statements in conformity with accounting principles generally accepted in the United States of America requires management to make estimates and judgments which affect the reported amounts of assets, liabilities and related disclosures of contingent assets and liabilities at the date of the consolidated condensed financial statements and the reported amount of revenue and expenses during the reporting period.
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v3.26.3
Fair Value Measurement (Foreign Currency Forward Contracts) (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Dec. 31, 2025
Derivative [Line Items]          
Net gain (loss) on currency transaction exposures $ 1,243 $ (690) $ 458 $ 653  
Derivative Assets and Liabilities at Fair Value [Abstract]          
Asset Fair Value 5,948   5,948   $ 4,435
Liabilities Fair Value (2,891)   (2,891)   (5,937)
Net Fair Value 3,057   3,057   (1,502)
Foreign Currency Forward Contracts          
Derivative [Line Items]          
Net loss on currency forward contracts (1,950) $ (150) (2,913) $ (2,230)  
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts          
Derivative Assets and Liabilities at Fair Value [Abstract]          
Asset Fair Value 5,944   5,944   4,435
Liabilities Fair Value (2,642)   (2,642)   (5,630)
Net Fair Value 3,302   3,302   (1,195)
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Derivative Assets and Liabilities at Fair Value [Abstract]          
Asset Fair Value 891   891    
Liabilities Fair Value (454)   (454)    
Net Fair Value 437   437    
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Derivative Assets and Liabilities at Fair Value [Abstract]          
Asset Fair Value         4,389
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Net Fair Value         (834)
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Derivative Assets and Liabilities at Fair Value [Abstract]          
Asset Fair Value 5,053   5,053    
Liabilities Fair Value (2,188)   (2,188)    
Net Fair Value 2,865   $ 2,865    
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts          
Derivative [Line Items]          
Cash Flow Hedge, Hedging Exposure, Maximum Period     1 month    
Notional amount of cash flow hedges 67,769   $ 67,769   49,459
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts | Balance Sheet Location [Axis]: us-gaap:OtherLiabilitiesCurrent          
Derivative Assets and Liabilities at Fair Value [Abstract]          
Asset Fair Value 4   4   0
Liabilities Fair Value (249)   (249)   (307)
Net Fair Value (245)   $ (245)   (307)
Cash flow hedge | Foreign Currency Forward Contracts          
Derivative [Line Items]          
Cash Flow Hedge, Hedging Exposure, Maximum Period     2 years    
Notional amount of cash flow hedges 258,729   $ 258,729   $ 239,588
Foreign Currency Cash Flow Hedge Gain to be Reclassified During Next 12 Months $ 2,200   $ 2,200    
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v3.26.3
Earnings Per Share (Details) - USD ($)
$ / shares in Units, shares in Thousands, $ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Earnings Per Share [Abstract]        
Net income $ 19,796 $ 2,859 $ 56,695 $ 30,316
Basic-weighted average shares outstanding (in shares) 29,926 30,955 30,178 31,027
Stock-based awards 199 95 75 118
Diluted- weighted average shares outstanding (in shares) 30,125 31,050 30,253 31,145
Basic (in dollars per share) $ 0.66 $ 0.09 $ 1.88 $ 0.98
Diluted (in dollars per share) $ 0.66 $ 0.09 $ 1.87 $ 0.97
Antidilutive securities excluded from computation of earnings per share (in shares) 3,700 4,000 4,300 3,900
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v3.26.3
Revenues (Disaggregated Revenues) (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Disaggregation of Revenue [Line Items]        
Net Sales $ 335,557 $ 337,926 $ 996,090 $ 1,001,526
Goods transferred at a point in time        
Disaggregation of Revenue [Line Items]        
Net Sales 322,357 323,832 955,976 960,344
Services transferred over time        
Disaggregation of Revenue [Line Items]        
Net Sales 13,200 14,094 40,114 41,182
Orthopedic Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 148,834 138,193 448,810 417,216
Orthopedic Surgery | Goods transferred at a point in time        
Disaggregation of Revenue [Line Items]        
Net Sales 136,521 126,763 415,444 383,693
Orthopedic Surgery | Services transferred over time        
Disaggregation of Revenue [Line Items]        
Net Sales 12,313 11,430 33,366 33,523
General Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 186,723 199,733 547,280 584,310
General Surgery | Goods transferred at a point in time        
Disaggregation of Revenue [Line Items]        
Net Sales 185,836 197,069 540,532 576,651
General Surgery | Services transferred over time        
Disaggregation of Revenue [Line Items]        
Net Sales 887 2,664 6,748 7,659
United States        
Disaggregation of Revenue [Line Items]        
Net Sales 172,705 193,979 521,145 568,353
United States | Orthopedic Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 51,538 52,456 159,123 157,158
United States | General Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 121,167 141,523 362,022 411,195
Americas (excluding the United States)        
Disaggregation of Revenue [Line Items]        
Net Sales 34,852 31,440 102,547 93,420
Americas (excluding the United States) | Orthopedic Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 24,534 21,037 70,738 63,704
Americas (excluding the United States) | General Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 10,318 10,403 31,809 29,716
Europe, Middle East & Africa        
Disaggregation of Revenue [Line Items]        
Net Sales 67,619 58,681 212,903 190,134
Europe, Middle East & Africa | Orthopedic Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 35,029 30,935 113,818 101,730
Europe, Middle East & Africa | General Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 32,590 27,746 99,085 88,404
Asia Pacific        
Disaggregation of Revenue [Line Items]        
Net Sales 60,381 53,826 159,495 149,619
Asia Pacific | Orthopedic Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales 37,733 33,765 105,131 94,624
Asia Pacific | General Surgery        
Disaggregation of Revenue [Line Items]        
Net Sales $ 22,648 $ 20,061 $ 54,364 $ 54,995
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Guarantees (Details) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Guarantees [Abstract]    
Product Warranty Obligation, Term 1 year  
Movement in Standard Product Warranty Accrual [Roll Forward]    
Balance as of January 1, $ 1,323 $ 1,445
Provision for warranties 935 415
Claims made (692) (530)
Balance as of September 30, 1,566 1,330
Extended Product Warranty Disclosure [Abstract]    
Product extended warranty expense $ 3,600 $ 3,200
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v3.26.3
New Accounting Pronouncements (Policies)
9 Months Ended
Sep. 30, 2026
Accounting Standards Update and Change in Accounting Principle [Abstract]  
New Accounting Pronouncements
Recently Issued Accounting Standards, Not Yet Adopted
    
In September 2025, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2025-06 - Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software. The standard removes all references to software development stages. It also requires that an entity capitalizes software when both: (1) management has authorized and committed funding to the project and (2) it is probable that the project will be completed and the software is used to perform the intended function. This ASU may be adopted prospectively, retrospectively, or on a modified transition approach based on the status of the project and whether software costs were capitalized before the date of adoption. It is effective for annual periods beginning after December 15,
2027 and interim periods within fiscal years beginning after December 15, 2027 with early adoption permitted. We are currently evaluating the impact this ASU will have on our consolidated financial statements.

In November 2024, the FASB issued ASU 2024-03 - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40) as clarified by ASU 2025-01. The standard requires disaggregation of certain expense captions into specified categories in disclosures within the footnotes on an annual and interim basis. Any relevant expense caption presented on the face of the income statement within continuing operations are required to be disaggregated by the following natural expense categories: (1) purchases of inventory, (2) employee compensation, (3) depreciation, and (4) intangible asset amortization. This ASU can be adopted prospectively or retrospectively and is effective for annual periods beginning after December 15, 2026 and interim periods within fiscal years beginning after December 15, 2027. We expect this ASU to only impact our disclosures.
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v3.26.3
Earnings Per Share
9 Months Ended
Sep. 30, 2026
Earnings Per Share [Abstract]  
Earnings Per Share 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.

The following tables set forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2026 and 2025:

Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Net income
$19,796 $2,859 $56,695 $30,316 
Basic weighted average shares outstanding
29,926 30,955 30,178 31,027 
Stock-based awards
199 95 75 118 
Diluted weighted average shares outstanding
30,125 31,050 30,253 31,145 
Net income (per share)
Basic
$0.66 $0.09 $1.88 $0.98 
Diluted
0.66 0.09 1.87 0.97 

The shares used in the calculation of diluted EPS exclude stock options, stock appreciation rights, restricted stock units, and performance share units 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 3.7 million and 4.3 million for the three and nine months ended September 30, 2026, respectively, and 4.0 million and 3.9 million for the three and nine months ended September 30, 2025, respectively.
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v3.26.3
Comprehensive Income (Tables)
9 Months Ended
Sep. 30, 2026
Equity [Abstract]  
Schedule of Comprehensive Income
Comprehensive income consists of the following:
 
Three Months Ended September 30,Nine Months Ended September 30,
2026202520262025
Net income
$19,796 $2,859 $56,695 $30,316 
Other comprehensive income (loss):
Cash flow hedging gain (loss), net of income tax (income tax expense (benefit) of $(655) and $1,195 for the three months ended September 30, 2026 and 2025, respectively, and $1,091 and $(2,168) for the nine months ended September 30, 2026 and 2025, respectively)
(2,048)3,734 3,408 (6,775)
Pension liability, net of income tax (income tax expense of $68 and $86 for the three months ended September 30, 2026 and 2025, respectively, and $206 and $257 for the nine months ended September 30, 2026 and 2025, respectively)
213 268 640 805 
Foreign currency translation adjustment1,031 (256)(1,929)15,595 
Comprehensive income
$18,992 $6,605 $58,814 $39,941 
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
Loss
Balance, December 31, 2025$(905)$(14,287)$(31,103)$(46,295)
Other comprehensive income (loss) before reclassifications, net of tax4,680 — (1,929)2,751 
Amounts reclassified from accumulated other comprehensive income (loss) before taxa
(1,679)846 — (833)
Income tax 407 (206)— 201 
Net current-period other comprehensive income (loss)
3,408 640 (1,929)2,119 
Balance, September 30, 2026$2,503 $(13,647)$(33,032)$(44,176)
Cash Flow
Hedging
Gain (Loss)
Pension
Liability
Cumulative
Translation
Adjustments
Accumulated
Other
Comprehensive
Loss
Balance, December 31, 2024$4,297 $(16,880)$(46,274)$(58,857)
Other comprehensive gain (loss) before reclassifications, net of tax
(6,984)— 15,595 8,611 
Amounts reclassified from accumulated other comprehensive income (loss) before taxa
276 1,062 — 1,338 
Income tax (67)(257)— (324)
Net current-period other comprehensive income (loss)
(6,775)805 15,595 9,625 
Balance, September 30, 2025$(2,478)$(16,075)$(30,679)$(49,232)
(a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive loss components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.
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v3.26.3
Long Term Debt (Tables)
9 Months Ended
Sep. 30, 2026
Debt Disclosure [Abstract]  
Schedule of Long-Term Debt
Long-term debt consists of the following:

September 30, 2026December 31, 2025
Revolving line of credit$180,000 $— 
Term A-1 Loan, net of deferred debt issuance costs of $158 and $218 in 2026 and 2025, respectively
39,842 39,782 
Term A-2 Loan, net of deferred debt issuance costs of $3,267 in 2026
441,108 — 
2.250% convertible notes, net of deferred debt issuance costs of $576 and $6,073 in 2026 and 2025, respectively
154,182 793,927 
Finance leases
734 1,233 
Total debt815,866 834,942 
Less:  Current portion180,109 712 
Total long-term debt$635,757 $834,230 
Schedule of Maturities of Long-Term Debt
The scheduled maturities of long-term debt outstanding at September 30, 2026 are as follows:

Remaining, 2026
$5,625 
2027
182,883 
2028
39,375 
2029
45,000 
2030
546,250 
The above amounts exclude deferred debt issuance costs and finance leases.
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v3.26.3
Consolidated Condensed Statements of Comprehensive Income (Unaudited) - USD ($)
shares in Thousands, $ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Sep. 30, 2026
Sep. 30, 2025
Statement of Comprehensive Income [Abstract]        
Net sales $ 335,557 $ 337,926 $ 996,090 $ 1,001,526
Cost of sales 146,409 171,807 426,038 469,336
Gross profit 189,148 166,119 570,052 532,190
Selling and administrative expense 136,416 140,339 423,667 425,207
Research and development expense 15,588 13,901 47,421 40,985
  Operating expenses 152,004 154,240 471,088 466,192
Income from operations 37,144 11,879 98,964 65,998
Interest expense 11,135 7,606 26,078 23,716
Other (income) / expense 0 0 (2,825) 418
Income before income taxes 26,009 4,273 75,711 41,864
Provision for income taxes 6,213 1,414 19,016 11,548
Net income 19,796 2,859 56,695 30,316
Comprehensive income $ 18,992 $ 6,605 $ 58,814 $ 39,941
Per share data:        
Basic (in dollars per share) $ 0.66 $ 0.09 $ 1.88 $ 0.98
Diluted (in dollars per share) $ 0.66 $ 0.09 $ 1.87 $ 0.97
Weighted average common shares:        
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Diluted (in shares) 30,125 31,050 30,253 31,145
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v3.26.3
Fair Value Measurement (Tables)
9 Months Ended
Sep. 30, 2026
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 DesignationSeptember 30, 2026December 31, 2025
Forward exchange contractsCash flow hedge$258,729 $239,588 
Forward exchange contractsNon-designated67,769 49,459 
Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)
Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) ("AOCI") and net earnings on our consolidated condensed statements of comprehensive income and our consolidated condensed balance sheets:

Amount of Gain (Loss) Recognized in AOCI
Consolidated Condensed Statements of Comprehensive Income
Amount of Gain (Loss) Reclassified from AOCI
Three Months Ended September 30,
Total Amount of Line Item Presented
Derivative Instrument20262025Location of amount reclassified2026202520262025
Foreign exchange contracts$(1,670)$4,387 Net Sales$335,557 $337,926 $(30)$(653)
Cost of Sales146,409 171,807 1,063 112 
Pre-tax gain (loss)
$(1,670)$4,387 $1,033 $(541)
Tax expense (benefit)
(405)1,063 250 (131)
Net gain (loss)
$(1,265)$3,324 $783 $(410)

Amount of Gain (Loss) Recognized in AOCI
Consolidated Condensed Statements of Comprehensive Income
Amount of Gain (Loss) Reclassified from AOCI
Nine Months Ended September 30,
Total Amount of Line Item Presented
Derivative Instrument20262025Location of amount reclassified2026202520262025
Foreign exchange contracts$6,178 $(9,219)Net Sales$996,090 $1,001,526 $(1,300)$505 
Cost of Sales426,038 469,336 2,979 (781)
Pre-tax gain (loss)
$6,178 $(9,219)$1,679 $(276)
Tax expense (benefit)
1,498 (2,235)407 (67)
Net gain (loss)
$4,680 $(6,984)$1,272 $(209)

Derivatives Not Designated as Hedging Instruments
Net loss from derivative instruments not accounted for as hedges and gain (loss) on our intercompany receivables on our consolidated condensed statements of comprehensive income were:

Three Months Ended September 30,Nine Months Ended September 30,
Derivative Instrument
Location on Consolidated Condensed Statements of Comprehensive Income
2026202520262025
Net loss on currency forward contracts
Selling and administrative expense$(1,950)$(150)$(2,913)$(2,230)
Net gain (loss) on currency transaction exposures
Selling and administrative expense$1,243 $(690)$458 $653 
Schedule of Fair Value for Forward Foreign Exchange Contracts The following tables summarize the fair value for forward foreign exchange contracts outstanding at September 30, 2026 and December 31, 2025:
September 30, 2026Location on Consolidated Condensed Balance SheetAsset Fair ValueLiabilities Fair ValueNet
Fair
Value
Derivatives designated as hedged instruments:
Foreign exchange contracts
Prepaid expenses and other current assets
$5,053 $(2,188)$2,865 
Foreign exchange contracts
Other assets
891 (454)437 
$5,944 $(2,642)$3,302 
Derivatives not designated as hedging instruments:
Foreign exchange contractsOther current liabilities4 (249)(245)
Total derivatives$5,948 $(2,891)$3,057 

December 31, 2025Location on Consolidated Condensed Balance SheetAsset Fair ValueLiabilities Fair ValueNet
Fair
Value
Derivatives designated as hedged instruments:
Foreign exchange contracts
Other current liabilities
$4,389 $(5,223)$(834)
Foreign exchange contracts
Other long-term liabilities
46 (407)(361)
$4,435 $(5,630)$(1,195)
Derivatives not designated as hedging instruments:
Foreign exchange contracts
Other current liabilities
— (307)(307)
Total derivatives$4,435 $(5,937)$(1,502)
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation Changes in the fair value of contingent consideration liabilities for the nine months ended September 30, 2026 and 2025 are as follows:
In2BonesBiorez
2026202520262025
Balance as of January 1,$2,160 $11,196 $59,248 $61,021 
Payments
— — (40,679)(22,577)
Changes in fair value of contingent consideration(2,160)(8,828)3,375 12,332 
Balance as of September 30,$— $2,368 $21,944 $50,776 
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v3.26.3
Revenues (Customer Liability) (Details) - USD ($)
$ in Thousands
9 Months Ended
Sep. 30, 2026
Sep. 30, 2025
Dec. 31, 2025
Revenue from Contract with Customer [Abstract]      
Contract liability $ 24,025   $ 21,967
Revenue recognized $ 12,700 $ 12,200  
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Amount of obligation to transfer good or service to customer for which consideration has been received or is receivable.

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