LeMaitre Vascular (LMAT) 10-K 12 Mar 21 2020 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2020	Mar. 02, 2021	Jun. 30, 2020
Document Information [Line Items]
Entity Central Index Key	0001158895
Entity Registrant Name	LEMAITRE VASCULAR INC
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	FY
Document Fiscal Year Focus	2020
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2020
Document Transition Report	false
Entity File Number	001-33092
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-2825458
Entity Address, Address Line One	63 Second Avenue
Entity Address, City or Town	Burlington
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01803
City Area Code	781
Local Phone Number	221-2266
Title of 12(b) Security	Common stock, $0.01 par value
Trading Symbol	LMAT
Security Exchange Name	NASDAQ
Entity Well-known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Public Float			$ 289,244,419
Entity Common Stock, Shares Outstanding		20,527,451

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Assets
Cash and cash equivalents	$ 26,764	$ 11,786
Short-term marketable securities	214	20,895
Accounts receivable, net of allowances of $623 at December 31, 2020, and $522 at December 31, 2019	19,552	16,572
Inventory and other deferred costs	45,115	39,527
Prepaid expenses and other current assets	2,618	3,312
Total current assets	94,263	92,092
Property and equipment, net	15,036	14,854
Right-of-use leased assets	16,066	15,208
Goodwill	65,945	39,951
Other intangibles, net	58,905	24,893
Deferred tax assets	1,686	1,084
Other assets	909	259
Total assets	252,810	188,341
Liabilities and stockholders’ equity
Current portion of long-term debt	2,500	0
Revolving line of credit	0	0
Accounts payable	2,394	2,604
Accrued expenses	17,525	14,014
Acquisition-related obligations	772	2,476
Lease liabilities - short-term	1,954	1,757
Total current liabilities	25,145	20,851
Long-term debt, net	35,532	0
Lease liabilities - long-term	14,791	13,955
Deferred tax liabilities	127	1,179
Other long-term liabilities	4,643	4,215
Total liabilities	80,238	40,200
Stockholders’ equity:
Preferred stock, $0.01 par value; authorized 3,000,000 shares; none outstanding	0	0
Common stock, $0.01 par value; authorized 37,000,000 shares; issued 22,061,554 shares at December 31, 2020, and 21,678,927 shares at December 31, 2019	221	217
Additional paid-in capital	114,924	105,934
Retained earnings	70,554	57,029
Accumulated other comprehensive loss	(1,525)	(4,007)
Treasury stock, at cost; 1,538,572 shares at December 31, 2020 and 1,522,035 shares at December 31, 2019	(11,602)	(11,032)
Total stockholders’ equity	172,572	148,141
Total liabilities and stockholders’ equity	$ 252,810	$ 188,341

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parentheticals) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Accounts receivable, allowances	$ 623	$ 522
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	3,000,000	3,000,000
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	37,000,000	37,000,000
Common stock, shares issued (in shares)	22,061,554	21,678,927
Treasury stock, at cost (in shares)	1,538,572	1,522,035

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Net sales	$ 129,366	$ 117,232	$ 105,568
Cost of sales	44,748	37,379	31,629
Gross profit	84,618	79,853	73,939
Sales and marketing	23,700	30,339	27,318
General and administrative	22,501	19,055	17,689
Research and development	10,099	9,276	8,197
Gains on sales of assets and acquisitions	(470)	0	(7,474)
Total operating expenses	55,830	58,670	45,730
Income from operations	28,788	21,183	28,209
Other income (expense):
Interest income	207	698	631
Interest expense	(1,310)	0	(2)
Foreign currency loss	(329)	(202)	(394)
Income before income taxes	27,356	21,679	28,444
Provision for income taxes	6,136	3,745	5,501
Net income	$ 21,220	$ 17,934	$ 22,943
Earnings per share of common stock:
Basic (in dollars per share)	$ 1.05	$ 0.91	$ 1.18
Diluted (in dollars per share)	$ 1.04	$ 0.88	$ 1.13
Weighted-average shares outstanding:
Basic (in shares)	20,246	19,813	19,426
Diluted (in shares)	20,479	20,326	20,242
Cash dividends declared per common share (in dollars per share)	$ 0.38	$ 0.34	$ 0.28

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Net income	$ 21,220	$ 17,934	$ 22,943
Other comprehensive income (loss):
Foreign currency translation adjustment, net	2,468	(234)	(1,626)
Unrealized gain (loss) on short-term marketable securities	14	127	15
Total other comprehensive income (loss)	2,482	(107)	(1,611)
Comprehensive income	$ 23,702	$ 17,827	$ 21,332

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Treasury Stock [Member]	Total
Balance (in shares) at Dec. 31, 2017	20,745,041				1,480,101
Balance at Dec. 31, 2017	$ 207	$ 93,127	$ 28,333	$ (2,289)	$ (9,608)	$ 109,770
Net income			22,943			22,943
Other comprehensive income (loss)				(1,611)		(1,611)
Issuance of common stock for stock options exercised (in shares)	303,379
Issuance of common stock for stock options exercised	$ 4	2,966				2,970
Vested restricted stock units (in shares)	61,804
Vested restricted stock units	$ 0	0				0
Stock-based compensation expense		2,349				2,349
Repurchase of common stock at cost (in shares)					21,410
Repurchase of common stock at cost					$ (741)	(741)
Common stock cash dividend paid			(5,445)			(5,445)
Balance (in shares) at Dec. 31, 2018	21,110,224				1,501,511
Balance at Dec. 31, 2018	$ 211	98,442	45,831	(3,900)	$ (10,349)	130,235
Net income			17,934			17,934
Other comprehensive income (loss)				(107)		(107)
Issuance of common stock for stock options exercised (in shares)	509,693
Issuance of common stock for stock options exercised	$ 6	4,850				4,856
Vested restricted stock units (in shares)	59,010
Vested restricted stock units	$ 0	0				0
Stock-based compensation expense		2,642				2,642
Repurchase of common stock at cost (in shares)					20,524
Repurchase of common stock at cost					$ (683)	(683)
Common stock cash dividend paid			(6,736)			(6,736)
Balance (in shares) at Dec. 31, 2019	21,678,927				1,522,035
Balance at Dec. 31, 2019	$ 217	105,934	57,029	(4,007)	$ (11,032)	148,141
Net income			21,220			21,220
Other comprehensive income (loss)				2,482		$ 2,482
Issuance of common stock for stock options exercised (in shares)	331,958					331,958	[1]
Issuance of common stock for stock options exercised	$ 3	5,968				$ 5,971
Vested restricted stock units (in shares)	50,669
Vested restricted stock units	$ 1	0				1
Stock-based compensation expense		3,022				3,022
Repurchase of common stock at cost (in shares)					16,537
Repurchase of common stock at cost					$ (570)	(570)
Common stock cash dividend paid			(7,695)			(7,695)
Balance (in shares) at Dec. 31, 2020	22,061,554				1,538,572
Balance at Dec. 31, 2020	$ 221	$ 114,924	$ 70,554	$ (1,525)	$ (11,602)	$ 172,572
[1]	The aggregate intrinsic value of shares exercised represents the difference between the exercise price and the closing price of our stock on the date of exercise.

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Operating activities
Net income	$ 21,220	$ 17,934	$ 22,943
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	8,395	5,416	4,324
Stock-based compensation	3,022	2,642	2,349
Fair value adjustments to contingent consideration obligations	182	171	(29)
Provision for doubtful accounts and allowances	293	388	264
Provision for inventory write-downs	1,523	747	671
Provision (benefit) for deferred income taxes	(328)	824	(2,152)
Gains on sale of building, acquisitions and divestitures	(470)	0	(7,474)
Foreign currency transaction gain	100	(57)	259
Changes in operating assets and liabilities:
Accounts receivable	(939)	(1,301)	(1,283)
Inventory and other deferred costs	(2,609)	(11,335)	(4,262)
Prepaid expenses and other assets	89	(654)	(418)
Accounts payable and other liabilities	4,322	(596)	4,314
Net cash provided by operating activities	34,800	14,179	19,506
Investing activities
Purchases of property and equipment	(2,982)	(3,761)	(3,054)
Proceeds from sale of building	2,023	0	0
Payments related to acquisitions	(72,627)	(21,240)	(12,282)
Purchases of short-term marketable securities	(2,205)	(22,699)	(19,619)
Proceeds from sales of marketable securities	22,900	23,600	20,500
Proceeds from divestitures	0	0	7,400
Net cash used in investing activities	(52,891)	(24,100)	(7,055)
Financing activities
Payment of deferred acquisition consideration	(2,800)	(2,059)	(1,199)
Proceeds from revolving line of credit	25,000	0	0
Proceeds from issuance of long-term debt	40,000	0	0
Payments of revolving line of credit	(25,000)	0	0
Payments of long-term debt	(1,000)	0	0
Payment of deferred debt issuance costs	(1,751)	0	0
Proceeds from issuance of common stock	5,971	4,856	2,969
Purchase of treasury stock	(570)	(683)	(741)
Common stock cash dividend paid	(7,695)	(6,736)	(5,445)
Net cash provided by (used in) financing activities	32,155	(4,622)	(4,416)
Effect of exchange rate changes on cash and cash equivalents	914	11	(813)
Net increase (decrease) in cash and cash equivalents	14,978	(14,532)	7,222
Cash and cash equivalents at beginning of year	11,786	26,318	19,096
Cash and cash equivalents at end of year	$ 26,764	$ 11,786	$ 26,318

Note 1 - Significant Accounting

Note 1 - Significant Accounting Policies and Related Matters	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Significant Accounting Policies [Text Block]	1. Description of Business Unless the context requires otherwise, references to LeMaitre, LeMaitre Vascular, we, our, and us refer to LeMaitre Vascular, Inc. and our subsidiaries. We develop, manufacture, and market medical devices and implants used primarily in the field of vascular surgery. We also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. We operate in a single segment in which our principal product lines include the following: anastomotic clips, angioscopes, biologic vascular and dialysis grafts, biologic vascular and cardiac patches, carotid shunts, embolectomy catheters, occlusion catheters, powered phlebectomy devices, radiopaque marking tape, remote endarterectomy devices, surgical glue, synthetic vascular grafts and valvulotomes. Our offices and production facilities are located in Burlington, Massachusetts; Fox River Grove, Illinois; North Brunswick, New Jersey (Note 2 Consolidation and Basis of Presentation Our consolidated financial statements include the accounts of LeMaitre Vascular and the accounts of our wholly-owned subsidiaries, LeMaitre Vascular GmbH, LeMaitre Vascular GK, Vascutech Acquisition LLC, LeMaitre Acquisition LLC, LeMaitre Vascular SAS, LeMaitre Vascular S.r.l., LeMaitre Vascular Spain SL, LeMaitre Vascular Switzerland GmbH, LeMaitre Vascular ULC, LeMaitre Vascular AS, LeMaitre Vascular Pty Ltd, Bio Nova International Pty Ltd, LeMaitre Vascular, Ltd., LeMaitre Medical Technology (Shanghai) Co. Ltd, LeMaitre Cardial SAS and LeMaitre Vascular Singapore Pte Ltd. All significant intercompany accounts and transactions have been eliminated in consolidation. Foreign Currency Translation Balance sheet accounts of foreign subsidiaries are translated into U.S. dollars at year-end exchange rates. Operating accounts are translated at average exchange rates for each year. Net translation gains or losses are adjusted directly to a separate component of other comprehensive income (loss) within stockholders’ equity. Foreign exchange transaction gains (losses), substantially all of which relate to intercompany activity between us and our foreign subsidiaries, are included in other income (expense) in the accompanying consolidated statements of operations. Estimates The preparation of financial statements in conformity with U.S. generally accepted accounting principles (GAAP) requires management to make estimates and assumptions that affect the amounts reported in in our consolidated financial statements and accompanying notes. Due to the COVID- 19 19 not March 12, 2021, 10 19. Revenue Recognition Our revenue is derived primarily from the sale of disposable or implantable devices used during vascular surgery. We sell primarily directly to hospitals and to a lesser extent to distributors, as described below, and, during the periods presented in our consolidated financial statements, entered into consigned inventory arrangements with either hospitals or distributors on a limited basis. With the acquisition of the RestoreFlow allograft business, we also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. These revenues are recognized when services have been provided and the tissue has been shipped to the customer, provided all other revenue recognition criteria discussed in the succeeding paragraph have been met. We record revenue under the provisions of ASU 2014 09, Revenue from Contracts with Customers (Topic 606 606 Step 1: Step 2: Step 3: Step 4: Step 5: Revenue is recognized when or as a company satisfies a performance obligation by transferring a promised good or service to a customer (which is when the customer obtains control of that good or service). In instances in which shipping and handling activities are performed after a customer takes control of the goods (such as when title passes upon shipment from our dock), we have made the policy election allowed under Topic 606 not We generally reference customer purchase orders to determine the existence of a contract. Orders that are not one not We record revenue, net of allowances for returns and discounts, fees paid to group purchasing organizations, and any sales and value added taxes required to be invoiced, which we have elected to exclude from the measurement of the transaction price as allowed by the standard, at the time of shipment (taking into consideration contractual shipping terms), or in the case of consigned inventory, when it is consumed. Shipment is the point at which control of the product and title passes to our customers, and at which LeMaitre has a present right to receive payment for the goods. Below is a disaggregation of our revenue by major geographic area, which is among the primary categorizations used by management in evaluating financial performance, for the periods indicated (in thousands): Year ended December 31, 2020 2019 Americas $ 81,470 $ 69,359 Europe, Middle East and Africa 39,193 39,480 Asia/Pacific Rim 8,703 8,393 Total $ 129,366 $ 117,232 We do not no not no Customers returning products may 18 twelve 30 not not Research and Development Expense Research and development costs, principally salaries, laboratory testing, and supplies, are expensed as incurred and also include royalty payments associated with licensed and acquired intellectual property. Shipping and Handling Costs Shipping and handling fees paid by customers are recorded within net sales, with the related expense recorded in cost of sales. Advertising Costs Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows: Year ended December 31, 2020 2019 2018 (in thousands) Advertising expense $ 216 $ 286 $ 299 Cash and Cash Equivalents We consider all highly liquid instruments purchased with maturity dates of 90 Short-term Marketable Securitie Our short-term marketable securities are available-for-sale securities carried at fair value, with unrealized gains and losses recorded in other comprehensive income. Concentrations of Credit Risk Our financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. Cash equivalents represent highly liquid investments with maturities of 90 $250,000. December 31, 2020. Our accounts receivable are with customers based in the United States and internationally. Accounts receivable generally are due within 30 90 may 90 240 We closely monitor outstanding receivables for potential collection risks, including those that may may December 31, 2020 December 31, 2020, may not may We write off accounts receivable when they become uncollectible. Such credit losses have historically been within our expectations and allowances. The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable. We review our allowance for doubtful accounts on a monthly basis and all past due balances are reviewed individually for collectability. The provision for the allowance for doubtful accounts is recorded in general and administrative expenses. The following is a summary of our allowance for doubtful accounts and sales returns: Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2020 $ 522 $ 293 $ 192 $ 623 Year ended December 31, 2019 399 388 265 522 Year ended December 31, 2018 349 264 214 399 Fair Value of Financial Instruments Our financial instruments include cash and cash equivalents, short-term marketable securities, accounts receivable and trade payables. The fair value of these instruments approximates their carrying value based upon their short-term nature or variable rates of interest. Unrealized gains and losses on our short-term marketable securities are recorded in other comprehensive income and were not December 31, 2020. Inventory and Other Deferred Costs Inventory and Other Deferred Costs consists of finished products, work-in-process, raw materials and costs deferred in connection with human tissue cryopreservation services of our RestoreFlow allograft business. We value inventory and other deferred costs at the lower of cost or market value. Cost includes materials, labor and manufacturing overhead and is determined using the first first may not may Property and Equipment Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows: Description Useful Life Computers and equipment 3–5 years Machinery and equipment 3–10 years Leasehold improvements The shorter of its useful life or lease term Expenditures for maintenance and repairs are charged to operations when incurred, while additions and betterments are capitalized. When assets are retired or disposed, the asset’s original cost and related accumulated depreciation are eliminated from the accounts and any gain or loss is reflected in the statement of operations. Valuation of Business Combinations We assign the value of the consideration transferred to acquire a business to the tangible assets and identifiable intangible assets acquired and liabilities assumed on the basis of their fair values at the date of acquisition. We assess the fair value of assets, including intangible assets, using a variety of methods and are usually performed by an independent appraiser who measures fair value from the perspective of a market participant. Acquisitions have been accounted for using the acquisition method, and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. Acquisition transaction costs have been recorded in general and administrative expenses, and are expensed as incurred. Allocation of the purchase price for acquisitions is based on estimates of the fair value of the net assets acquired and, for acquisitions completed within the past year, is subject to adjustment upon finalization of the purchase price allocation. Our acquisitions have historically been made at prices above the fair value of the acquired assets, resulting in goodwill, due to expectations of synergies of combining the businesses. These synergies include use of our existing commercial infrastructure to expand sales of the acquired businesses’ products, use of the commercial infrastructure of the acquired businesses to cost-effectively expand sales of our products, and the elimination of redundant facilities, functions and staffing. Contingent Consideration Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income. Impairment of Long-lived Assets We review our long-lived assets (primarily property and equipment and intangible assets) subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may not Goodwill Goodwill represents the amount of consideration paid in connection with business acquisitions in excess of the fair value of assets acquired and liabilities assumed. Goodwill is evaluated for impairment annually or more frequently if indicators of impairment are present or changes in circumstances suggest that an impairment may December 31 single not” two not” 50 December 31, 2020, 2019 2018. Other Intangible Assets Other intangible assets consist primarily of patents, trademarks, technology licenses, and customer relationships acquired in connection with business acquisitions and asset acquisitions and are amortized over their estimated useful lives, ranging from 2 to 16 years. Stock-based Compensation We recognize, as expense, the estimated fair value of stock options to employees which is determined using the Black-Scholes option pricing model. Share-based compensation charges are recorded across the consolidated statement of operations based upon the grantee’s primary function. We have elected to recognize the compensation cost of all share-based awards on a straight-line basis over the vesting period of the award. In periods that we grant stock options, fair value assumptions are based on volatility, interest, dividend yield, and expected term over which the stock options will be outstanding. The computation of expected volatility is based on the historical volatility of the company’s stock. The interest rate for periods within the contractual life of the award is based on the U.S. Treasury risk-free interest rate in effect at the time of grant. Historical data on exercise patterns is the basis for estimating the expected life of an option. The expected annual dividend rate was calculated by dividing our annual dividend, based on the most recent quarterly dividend rate, by the closing stock price on the grant date. We also issue restricted stock units (RSUs) as an additional form of equity compensation to our employees, officers, and directors, pursuant to our stockholder-approved 2006 no Commitments and Contingencies In the normal course of business, we are subject to proceedings, lawsuits, and other claims and assessments for matters related to, among other things, patent infringement, business acquisitions, employment, commercial matters and product recalls. We assess the likelihood of any adverse judgments or outcomes to these matters as well as potential ranges of probable losses. A determination of the amount of reserves required, if any, for these contingencies is made after careful analysis of each individual issue. The required reserves may December 31, 2020, 2019 2018, not Sales of medical devices outside the U.S. are subject to international regulatory requirements that vary from country to country. These requirements and the amount of time required for approval may no Income Taxes We account for income taxes under the asset and liability method of accounting for income taxes. Under the asset and liability method, deferred taxes are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. The provision for income taxes includes taxes currently payable and deferred taxes resulting from the tax effects of temporary differences between the financial statement and tax bases of assets and liabilities. We maintain valuation allowances where it is more likely than not not We recognize, measure, present and disclose in our financial statements, uncertain tax positions that we have taken or expect to take on a tax return. We recognize in our financial statements the impact of tax positions that meet a “more likely than not” fifty Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense. Comprehensive Income Comprehensive income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than reported net income, comprehensive income includes foreign currency translation adjustments, which are disclosed in the accompanying consolidated statements of comprehensive income. There were no reclassifications out of comprehensive income for the years ended December 31, 2020, 2019 2018. Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $1.6 million and $4.0 million as of December 31, 2020 2019, Restructuring We record restructuring charges incurred in connection with consolidation or relocation of operations, exited business lines, reductions in force, or distributor terminations. These restructuring charges, which reflect our commitment to a termination or exit plan that will begin within twelve Earnings per Share We compute basic earnings per share by dividing net income available for common stockholders by the weighted average number of shares outstanding during the year. Except where the result would be anti-dilutive to net income per share, diluted earnings per share has been computed using the treasury stock method and reflects the potential vesting of restricted common stock and the potential exercise of stock options, as well as their related income tax effects. The computation of basic and diluted net income per share is as follows: Year ended December 31, 2020 2019 2018 (in thousands, except per share data) Basic: Net income available for common stockholders $ 21,220 $ 17,934 $ 22,943 Weighted average shares outstanding 20,246 19,813 19,426 Basic earnings per share $ 1.05 $ 0.91 $ 1.18 Diluted: Net income available for common stockholders $ 21,220 $ 17,934 $ 22,943 Weighted-average shares outstanding 20,246 19,813 19,426 Common stock equivalents, if dilutive 233 513 816 Shares used in computing diluted earnings per common share 20,479 20,326 20,242 Diluted earnings per share $ 1.04 $ 0.88 $ 1.13 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 483 468 230 Recent Accounting Pronouncements In June 2016, 2016 13 326 January 1, 2020. not In August 2018, 2018 13 820 January 1, 2020, not In January 2017, 2017 04 350 2” not January 1, 2020, not In December 2019, 2019 12 740 740 740. January 1, 2021, not

Note 2 - Acquisitions and Dives

Note 2 - Acquisitions and Divestitures	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Business Combination Disclosure [Text Block]	2. Acquisitions are accounted for using the acquisition method and the acquired businesses’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. In each case for the acquisitions disclosed below, pro forma information assuming the acquisition had occurred at the beginning of the earliest period presented is not Our acquisitions have historically been made at prices above the fair value of the acquired identifiable assets, resulting in goodwill, due to expectations of synergies that will be realized by combining businesses. These synergies include the use of our existing sales channel to expand sales of the acquired businesses’ products, consolidation of manufacturing facilities, and the leveraging of our existing administrative infrastructure. The fair market valuations associated with these transactions fall within Level 3 13 Artegraft Biologic Grafts On June 22, 2020, December 31, 2021 Three earn-out payments of $5,833,333 ● $5.8 million upon final determination that 20,000 units of Product have been sold to third January 1, 2021 December 31, 2021; ● $5.8 million upon final determination that 24,000 units of Product have been sold to third January 1, 2022 December 31, 2022; ● $5.8 million upon final determination that 28,800 units of Product have been sold to third January 1, 2023 December 31, 2023. The Artegraft APA includes a catch-up feature on the earn-outs such that, at the end of the three three three On the date of acquisition, the Company allocated the consideration given to the individual assets acquired and the liabilities assumed based on a preliminary estimate of their fair values. During the three September 30, 2020, Allocated Fair Value (in thousands) Inventory $ 3,859 Accounts receivable 1,789 Equipment and supplies 1,140 Accounts payable and other (53 ) Intangible assets 39,056 Goodwill 27,115 Purchase price $ 72,906 The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 years. The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Allocated Estimated Fair Value Useful Life (Years) (in thousands) Customer relationships $ 20,310 15.0 Intellectual property 16,449 10.0 Non-compete agreement 104 5.0 Tradenames 2,193 10.0 Total intangible assets $ 39,056 The weighted-average amortization period of the acquired intangible assets was 12.6 years. The results of operations of the Artegraft biologic graft business have been included in the results of operations of LeMaitre since the date of acquisition of June 22, 2020. December 31, 2020 December 31, 2020 2019 2019. not 2019, Unaudited Pro Forma Financial Information Year ended December 31, 2020 2019 ($ in thousands) Net sales $ 137,450 $ 131,915 Net income 20,041 15,045 Net income per share Basic $ 0.99 $ 0.76 Diluted $ 0.98 $ 0.74 CardioCel and VascuCel Biologic Patches On October 11, 2019 ( three December 31, 2019 Under the APA we agreed to pay Anteris a total of up to $15.3 million for the purchase of substantially all of its biologic patch business assets, other than specifically identified Excluded Assets, plus $8.0 million for the technology licenses. The acquired assets (in combination with the license) included inventory, intellectual property, permits and approvals, data and records, and customer and supplier information, as well as a small amount of machinery and equipment. At closing, $14.2 million of the purchase price was paid to Anteris. Shortly thereafter another $0.3 million was paid in connection with delivery of audited financial statements of the acquired business to LeMaitre. Additional payments of $0.7 million are due within 15 first third first October 2020. may ● $2.0 million (the Third Holdback) within 15 ● $2.5 million if revenues in the first 12 $20 first 12 $15 not no ● $2.5 million if revenues in the second 12 $30 second 12 $22.5 ● $0.5 million if by the first 36 60 not no This contingent consideration of $7.5 million was initially valued in total at $2.3 million and is being re-measured each reporting period until the payment requirement ends, with any adjustments reported in income from operations. During the quarter ended September 30, 2020, Allocated Fair Value (in thousands) Inventory and other $ 1,343 Intangible assets 8,725 Goodwill 7,344 Purchase price $ 17,412 The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships $ 5,562 12.0 Intellectual property 2,335 8.0 Non-compete agreement 361 5.0 Tradenames 467 8.0 Total intangible assets $ 8,725 The weighted-average amortization period of the acquired intangible assets was 10.4 years. Tru-Incise Valve Cutter On July 12, 2019, December 31, 2019 The purchase price for the acquired assets, which included inventory, machinery and equipment, intellectual property, and customer and supplier information, was $8.0 million. Of this amount, $6.8 million was paid at closing, with three second third no may first July 2020. The following table summarizes the preliminary purchase price allocation: Allocated Fair Value (in thousands) Inventory $ 276 Equipmentand supplies 70 Intangible assets 4,844 Goodwill 2,748 Purchase price $ 7,938 The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships $ 3,945 13.0 Intellectual property 563 7.0 Non-compete agreement 233 5.0 Tradenames 103 7.0 Total intangible assets $ 4,844 The weighted-average amortization period of the acquired intangible assets was 11.8 years. Cardial On October 22, 2018, The purchase price for the acquired assets, including the land and building, inventory, machinery and equipment, intellectual property, permits and approvals, data and records, and customer and supplier information, was €2.0 €1.1 €0.5 €0.4 two twelve eighteen first two not second April 2020, The following table summarizes the purchase price allocation: Allocated Fair Value (in thousands) Inventory € 2,419 Land and building 750 Equipment and supplies 94 Intangible assets 623 Bargain purchase gain (1,946 ) Purchase price € 1,940 The bargain purchase gain was recorded to reflect the excess of the net assets acquired over the purchase price. We recorded deferred taxes on this gain of €0.5 €1.4 The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships € 250 16.0 Intellectual property 237 5.0 Non-compete agreement 46 5.0 Tradenames 90 5.0 Total intangible assets € 623 The weighted-average amortization period of the acquired intangible assets was 9.4 years. Applied Medical On September 20, 2018, twelve not The purchase price for the acquired assets, which included inventory, machinery and equipment, intellectual property, permits and approvals, data and records, and customer and supplier information, was $14.2 million. Of this amount, $11.0 million was paid at closing, another $2.0 million was paid 12 24 The following table summarizes the purchase price allocation. The purchase accounting is complete: Allocated Fair Value (in thousands) Inventory $ 739 Equipment and supplies 416 Intangible assets 6,527 Goodwill 6,361 Purchase price $ 14,043 The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 years. The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships $ 4,475 16.0 Intellectual property 1,316 7.0 Non-compete agreement 530 5.0 Tradenames 206 7.0 Total intangible assets $ 6,527 The weighted-average amortization period of the acquired intangible assets was 13.0 years. Reddick Divestiture On April 5, 2018, two six Allocated Fair Value (in thousands) Inventory $ 308 Deferred revenue - transition services agreement 1,081 Goodwill 135 Gain on divestiture 5,876 Consideration received $ 7,400 Under the terms of the TSA, we agreed to manufacture the Reddick products for the buyer at prices at or in some cases below our cost. We allocated a portion of the consideration received to this agreement to reflect it at fair value and recorded it as deferred revenue. As the products were sold to the buyer, we amortized a portion of the deferred revenue to adjust the gross margin on the sale to fair value on a specific identification basis. Additionally, as the Reddick product lines that were divested constituted a business, we allocated a portion of our goodwill to this divestiture based on the fair value of the business sold in relation to the fair value of the business retained.

Note 3 - Inventory and Other De

Note 3 - Inventory and Other Deferred Costs	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Inventory and Other Deferred Costs Disclosure [Text Block]	3. Inventory and other deferred costs consists of the following: December 31, 2020 December 31, 2019 (in thousands) Raw materials $ 5,044 $ 5,359 Work-in-process 6,004 6,238 Finished products 28,117 23,032 Other deferred costs 5,950 4,898 Total inventory and other deferred costs $ 45,115 $ 39,527 We had inventory on consignment at customer sites of $2.1 million and $1.9 million as of December 31, 2020 2019, In connection with our RestoreFlow allograft business, other deferred costs include costs incurred for the preservation of human vascular tissues available for shipment, tissues currently in active processing, and tissues held in quarantine pending release to implantable status. By federal law, human tissues cannot be bought or sold. Therefore, the tissues we preserve are not

Note 4 - Property and Equipment

Note 4 - Property and Equipment	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	4. Property and equipment consists of the following: As of December 31, 2020 2019 (in thousands) Computers and equipment $ 5,046 $ 4,623 Machinery and equipment 17,266 16,245 Building and leasehold improvements 12,809 11,758 Gross property and equipment 35,121 32,626 Less accumulated depreciation (20,085 ) (17,772 ) Property and equipment, net $ 15,036 $ 14,854 During the years ended December 31, 2020, 2019 2018 Depreciation expense is as follows: Year ended December 31, 2020 2019 2018 (in thousands) Depreciation expense $ 3,181 $ 2,979 $ 2,564

Note 5 - Goodwill and Other Int

Note 5 - Goodwill and Other Intangibles	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	5. Goodwill consists of the following: As of December 31, 2020 2019 Balance at beginning of year $ 39,951 $ 29,868 Additions for acquisitions 27,115 10,092 Purchase accounting adjustments (1,345 ) - Effects of currency exchange 224 (9 ) Balance at end of year $ 65,945 $ 39,951 During the quarter ended September 30, 2020, Other intangibles consist of the following: December 31, 2020 December 31, 2019 Gross Net Gross Net Carrying Accumulated Carrying Carrying Accumulated Carrying Value Amortization Value Value Amortization Value (in thousands) Product technology and intellectual property $ 29,951 $ 7,947 $ 22,004 $ 13,502 $ 5,722 $ 7,780 Trademarks, tradenames and licenses 4,000 1,094 2,906 1,807 702 1,105 Customer relationships 38,525 5,424 33,101 18,215 3,364 14,851 Other intangible assets 1,767 873 894 1,725 568 1,157 Total identifiable intangible assets $ 74,243 $ 15,338 $ 58,905 $ 35,249 $ 10,356 $ 24,893 These assets are being amortized over useful lives ranging from 2 to 16 years. The weighted-average amortization period for these intangibles as of December 31, 2020, Year ended December 31, 2020 2019 2018 (in thousands) Amortization expense $ 5,043 $ 2,437 $ 1,760 During the year ended December 31, 2019 five December 31, 2020, Year ended December 31, 2021 2022 2023 2024 2025 (in thousands) Amortization expense $ 6,179 $ 5,975 $ 5,902 $ 5,706 $ 5,467

Note 6 - Revolving Line of Cred

Note 6 - Revolving Line of Credit and Long-term Debt	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Debt Disclosure [Text Block]	6. In connection with the acquisition of the Artegraft biologic graft business, we incurred debt in the amount of $65 million under a senior secured credit facility with a group of banks. This credit arrangement included a $25 million revolving credit line, which was fully drawn at inception, as well as a $40 million five December 31, 2020 December 31, 2020 December 31, 2020 (in thousands) Five-year term loan, net of unamortized debt issuance costs of $968 $ 38,032 Less current portion (2,500 ) $ 35,532 The following table summarizes the maturities or our long-term debt under the term loan agreement: Year ending December 31, 2021 $ 2,500 2022 3,000 2023 3,500 2024 4,000 2025 26,000 Total before unamortized issuance costs 39,000 Less unamortized issuance costs (968 ) Less current portion of long-term bebt (2,500 ) Total long-term debt $ 35,532 The loans bear interest at a rate per annum of, at our option, either (i) the Base Rate plus an applicable margin of from 1.25% to 1.75% depending on our consolidated leverage ratio, or (ii) the Eurodollar Rate plus an applicable margin of from 2.25% to 2.75% depending on our consolidated leverage ratio. Base Rate is defined in the credit agreement as a fluctuating rate per annum of the Federal Funds rate plus 0.5%, or the prime rate of interest established from time to time by KeyBank National Association. At December 31, 2020 not five December 31, 2020 The term of the revolving line of credit is five June 22, 2025. September 30, 2020 March 31, 2025, June 22, 2025. We must comply with various financial and non-financial covenants, which are set forth in the Credit Agreement. The primary financial covenant consists of a maximum consolidated leverage ratio. The lenders are entitled to accelerate repayment of the loans and terminate the revolving credit commitment upon the occurrence of any of various events of default as described in the Credit Agreement. We were in compliance with the covenants as of December 31, 2020. Borrowings under the secured credit facility are secured by 100% of the stock of our domestic subsidiaries, portions of the stock of certain of our foreign subsidiaries, and substantially all of our and our subsidiaries’ other property and assets, in each case subject to various exceptions. We are required to make mandatory prepayments of the term loans and any revolving credit loans in various amounts if we have Excess Cash Flow (as defined in the Credit Agreement, and commencing in respect of our fiscal year ending December 31, 2021 may

Note 7 - Accrued Expenses and O

Note 7 - Accrued Expenses and Other Long-term Liabilities	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Accounts Payable, Accrued Liabilities, and Other Liabilities Disclosure, Noncurrent [Text Block]	7. Accrued expenses consist of the following: December 31, 2020 December 31, 2019 (in thousands) Compensation and related taxes $ 8,675 $ 8,550 Income and other taxes 2,394 1,003 Professional fees 39 40 Other 6,417 4,421 Total $ 17,525 $ 14,014 Other long-term liabilities consist of the following: December 31, 2020 December 31, 2019 (in thousands) Acquisition-related liabilities $ 3,700 $ 3,268 Income taxes 813 781 Other 130 166 Total $ 4,643 $ 4,215

Note 8 - Commitments and Contin

Note 8 - Commitments and Contingencies	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	8. Leases We conduct the majority of our operations in leased facilities, all of which are accounted for as operating leases, as they do not five five December 2030. August 2023. two five October 2029. five February 2023. September May, twelve None None no December 31, 2020. We also lease automobiles under operating leases in the U.S. as well as certain other countries. The terms of these leases are generally three As discussed above under Recent Accounting Pronouncements, on January 1, 2019 No. 2016 02, Leases (Topic 842 2018 11, Leases (Topic 842 Our most significant judgment involved in determining the amounts to initially record as lease liabilities and right-of-use assets was the selection of a discount rate; because we had no no 2020 Additional information with respect to our leases is as follows: Year ended Year ended December 31, December 31, 2020 2019 (in thousands) (in thousands) Lease cost Operating lease cost $ 1,912 $ 1,756 Short-term lease cost 192 291 Total lease cost $ 2,104 $ 2,047 Other information Cash paid for amounts included in the measurement of operating lease liabilities $ 2,404 $ 1,858 Right-of-use assets obtained in exchange for new operating lease liabilities $ 2,770 $ 10,571 Weighted average remaining lease term - operating leases (years) 7.8 8.3 Weighted average discount rate - operating leases 5.02 % 5.25 % At December 31, 2020, one Year ending December 31, 2021 $ 2,763 2022 2,447 2023 2,064 2024 1,866 2025 1,916 Thereafter 9,920 Adjustment to net present value as of December 31, 2020 (4,230 ) Minimum noncancelable lease liability $ 16,746 Purchase Commitments As part of our normal course of business, we have commitments to purchase $5.2 million of inventory through 2021. not

Note 9 - Income Taxes

Note 9 - Income Taxes	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Income Tax Disclosure [Text Block]	9. Income (loss) before income taxes is as follows: Year ended December 31, 2020 2019 2018 (in thousands) United States $ 25,308 $ 17,989 $ 22,256 Foreign 2,048 3,690 6,188 Total $ 27,356 $ 21,679 $ 28,444 Certain of our foreign subsidiaries are included in the U.S. tax return as branches but are included as foreign for purposes of the table above. The provision (benefit) for income taxes is as follows: Year ended December 31, 2020 2019 2018 (in thousands) Current: Federal $ 4,594 $ 1,501 $ 4,262 State 806 304 673 Foreign 1,064 1,116 2,718 6,464 2,921 7,653 Deferred: Federal (397 ) 538 (1,512 ) State (48 ) 144 (145 ) Foreign 117 142 (495 ) (328 ) 824 (2,152 ) Provision for income taxes $ 6,136 $ 3,745 $ 5,501 We have reviewed the tax positions taken, or to be taken, in our tax returns for all tax years currently open to examination by a taxing authority. As of December 31, 2020, may twelve December 31, 2021. 2020 2013 2016 2028. 2020 2019 2018 (in thousands) Unrecognized tax benefits at the beginning of year $ 848 $ 711 $ 525 Additions for tax positions of current year - 74 73 Additions for tax positions of prior years 37 63 113 Reductions for settlements with taxing authorities. (65 ) - - Reductions for lapses of the applicable statutes of limitations - - - Unrecognized tax benefits at the end of the year $ 820 $ 848 $ 711 Deferred taxes are attributable to the following temporary differences: As of December 31, 2020 2019 (in thousands) Deferred tax assets: Inventory $ 1,629 $ 840 Net operating loss carryforwards 1,348 1,289 Tax credit carryforwards 1,019 944 Capital loss carryforwards 521 277 Reserves and accruals 994 787 Operating lease liabilities 3,664 3,343 Intangible assets 4,386 2,764 Stock options 359 342 Other 105 20 Total deferred tax assets 14,025 10,606 Deferred tax liabilities: Property and equipment (1,831 ) (1,520 ) Goodwill (4,055 ) (3,459 ) Operating lease right-of-use assets (3,503 ) (3,224 ) Foreign branch deferred offset (954 ) (923 ) Other (299 ) (187 ) Total deferred tax liabilities (10,642 ) (9,313 ) Net deferred tax assets before valuation allowance 3,383 1,293 Valuation allowance (1,824 ) (1,388 ) Net deferred tax liabiltity $ 1,559 $ (95 ) Deferred tax classification Long-term deferred tax asset $ 1,686 $ 1,084 Long-term deferred tax liability (127 ) (1,179 ) Net long-term deferred tax liability $ 1,559 $ (95 ) In 2019, 2020, As of December 31, 2020, not may Realization of our deferred tax assets is dependent on our generating sufficient taxable income in future periods. Although we believe it is more likely than not not may As of December 31, 2020, not not not not not 2021, In December 2018, no no not A reconciliation of the U.S. federal statutory rate to our effective tax rate is as follows: 2020 2019 2018 Federal statutory rate 21.0 % 21.0 % 21.0 % State tax, net of federal benefit 2.2 % 1.9 % 1.4 % Effect of foreign taxes 1.1 % 2.1 % 3.8 % Federal tax on foreign income 0.4 % 0.8 % 1.4 % Valuation allowance 1.4 % 0.6 % (3.2 %) Foreign deferred tax liability offset (0.2 %) (0.4 %) (0.3 %) Manufacturing deduction 0.0 % 0.0 % 0.0 % Research & development tax credits (0.6 %) (1.2 %) (0.7 %) Stock options (2.3 %) (8.8 %) (3.3 %) Uncertain tax positions 0.3 % 1.0 % 0.8 % Other permanent differences (0.6 %) 0.5 % (0.7 %) Change in tax laws 0.0 % 0.0 % 0.0 % Deferred tax remeasurement 0.0 % 0.0 % 0.0 % Other (0.3 %) (0.2 %) (0.9 %) Effective tax rate 22.4 % 17.3 % 19.3 % In August 2018, 2013 2016. 2020 not As of December 31, 2020, United States 2017 Foreign 2013 Supplemental disclosures of cash flow information are as follows: Year ended December 31, 2020 2019 2018 (in thousands) Cash paid for income taxes, net $ 4,470 $ 4,817 $ 5,521

Note 10 - Stockholders' Equity

Note 10 - Stockholders' Equity	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Stockholders' Equity Note Disclosure [Text Block]	10. Equity Authorized Shares Our certificate of incorporation, as amended and restated from time to time, authorizes the issuance of up to 37,000,000 shares of common stock and up to 3,000,000 shares of undesignated preferred stock. Under the terms of our certificate of incorporation, our board of directors is authorized to issue shares of the preferred stock in one Stock Award Plans In May 2006 2006 2006 2006 not four five no ten 2006 no 2006 may 2006 December 31, 2020. We have computed the fair value of employee stock options granted each year using the following weighted average assumptions: 2020 2019 2018 Dividend yield 1.02 % 0.96 % 1.20 % Volatility 47.3 % 42.8 % 41.3 % Risk-free interest rate 0.3 % 1.7 % 2.7 % Weighted average expected option term (in years) 4.9 4.7 4.8 Weighted average fair value per share of options granted $ 13.24 $ 12.51 $ 8.28 A summary of option activity as of December 31, 2020 Weighted Weighted Average Aggregate Number Average Remaining Intrinsic of Shares Exercise Price Contractual Term Value (in years) Balance outstanding at December 31, 2019 (1) 1,047,094 $ 23.19 4.31 $ 13,366,595 Granted 222,110 $ 36.67 Exercised (2) (331,958 ) $ 17.99 $ 5,413,197 Canceled / Expired (5,406 ) $ 27.49 Balance outstanding at December 31, 2020 (3) 931,840 $ 28.22 4.49 $ 11,442,240 Vested and exercisable at December 31, 2020 (4) 274,411 $ 23.08 3.50 $ 4,780,656 Expected to vest at December 31, 2020 657,429 $ 30.37 4.93 Total 931,840 ( 1 December 31, 2019, ( 2 ( 3 December 31, 2020, ( 4 December 31, 2020, Restricted Stock Units A summary of our RSU activity is as follows: Weighted Average Grant Date Shares Fair Value Balance outstanding at December 31, 2019 188,681 $ 26.14 Granted 46,146 $ 36.86 Vested (1) (50,669 ) $ 22.76 Canceled (37,143 ) $ 27.88 Balance outstanding at December 31, 2020 147,015 $ 30.24 ( 1 2020, 2019 2018 We repurchase shares of our common stock in order to cover any minimum tax withholding liability associated with RSU vestings. A summary of our repurchases is as follows: 2020 2019 Shares of common stock repurchased 16,537 20,524 Average per share repurchase price $ 34.47 $ 33.28 Aggregage purchase price (in thousands) $ 570 $ 683 Stock-based Compensation The components of stock-based compensation expense included in the consolidated statements of operations are as follows: 2020 2019 2018 (in thousands) Stock option awards $ 1,938 $ 1,580 $ 1,457 Restricted stock units 1,084 1,062 892 Total stock-based compensation $ 3,022 $ 2,642 $ 2,349 Stock-based compensation is included in our statements of operations as follows: 2020 2019 2018 (in thousands) Cost of sales $ 333 $ 310 $ 272 Sales and marketing 516 544 529 General and administrative 1,883 1,509 1,293 Research and development 290 279 255 Total stock-based compensation $ 3,022 $ 2,642 $ 2,349 We expect to record the unamortized portion of share-based compensation expense of $10.8 million for existing stock options and RSUs outstanding at December 31, 2020, Stock Repurchase Plans On February 23, 2021, February 22, 2022. may not Dividends In February 2011, Record Date Payment Date Per Share Amount Dividend Payment (in thousands) Fiscal Year 2020 March 3, 2020 March 19, 2020 $ 0.095 $ 1,917 May 20, 2020 June 4, 2020 $ 0.095 $ 1,917 August 27, 2020 September 10, 2020 $ 0.095 $ 1,925 November 19, 2020 December 3, 2020 $ 0.095 $ 1,936 Fiscal Year 2019 March 22, 2019 April 5, 2019 $ 0.085 $ 1,672 May 22, 2019 June 6, 2019 $ 0.085 $ 1,672 August 21, 2019 September 5, 2019 $ 0.085 $ 1,691 November 20, 2019 December 5, 2019 $ 0.085 $ 1,701 On February 23, 2021, March 25, 2021 March 9, 2021 ,

Note 11 - Profit-sharing Plan

Note 11 - Profit-sharing Plan	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Compensation and Employee Benefit Plans [Text Block]	11. We offer a 401 may six 2020, 2019 2018,

Note 12 - Segment and Enterpris

Note 12 - Segment and Enterprise-wide Disclosures	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	12. The FASB establishes standards for reporting information regarding operating segments in financial statements. Operating segments are identified as components of an enterprise that engage in business activities for which separate, discrete financial information is available and is regularly reviewed by the chief operating decision-maker in making decisions on how to allocate resources and assess performance. We view our operations and manage our business as one operating segment. No Most of our revenues are generated in the United States, Germany, and other European countries, Canada, the United Kingdom and Japan, and substantially all of our assets are located in the United States, Germany and France. Net sales to unaffiliated customers by country were as follows: Year ended December 31, 2020 2019 2018 (in thousands) United States $ 75,222 $ 63,130 $ 59,078 Germany 12,365 12,400 12,445 Other countries 41,779 41,702 34,045 Net sales $ 129,366 $ 117,232 $ 105,568 Total long-term assets by country, including property and equipment, net and right-of-use leased assets were as follows: As of December 31, 2020 2019 (in thousands) United States $ 27,660 $ 24,885 Australia 115 1,499 France 1,140 1,089 Germany 1,138 1,405 Other countries 1,049 1,184 Total long-term assets $ 31,102 $ 30,062

Note 13 - Fair Value Measuremen

Note 13 - Fair Value Measurements	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Fair Value Disclosures [Text Block]	13. The fair value accounting guidance requires that assets and liabilities carried at fair value be classified and disclosed in one three • Level 1 • Level 2 1, not • Level 3 no Level 1 December 31, 2020 We had no 2 December 31, 2020. As discussed in Notes 1 2, 3 2020 2, first three During 2019, first 12 24 November 2019 first 12 not The following table provides a rollforward of the fair value of these liabilities, as determined by Level 3 Year ended December 31, 2020 2019 2018 (in thousands) Beginning balance $ 1,764 $ 72 $ 1,300 Additions 406 1,989 - Payments - (309 ) (1,199 ) Change in fair value included in earnings 70 12 (29 ) Ending balance $ 2,240 $ 1,764 $ 72

Note 14 - Accumulated Other Com

Note 14 - Accumulated Other Comprehensive Income (Loss)	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Comprehensive Income (Loss) Note [Text Block]	14. Year ended December 31, 2020 2019 2018 (in thousands) Beginning balance $ (4,007 ) $ (3,900 ) $ (2,289 ) Other comprehensive income (loss) before reclassifications 2,482 (107 ) (1,611 ) Amounts reclassified from accumulated other comprehensive loss - - - Ending Balance $ (1,525 ) $ (4,007 ) $ (3,900 ) Changes to our accumulated other comprehensive loss consisted primarily of foreign currency translation for the years ended December 31, 2020, 2019 2018.

Note 15 - Quarterly Financial D

Note 15 - Quarterly Financial Data (Unaudited)	12 Months Ended
	Dec. 31, 2020
Notes to Financial Statements
Quarterly Financial Information [Text Block]	15. Three months ended 2020 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 30,551 $ 24,851 $ 36,416 $ 37,548 Gross profit 20,483 17,029 22,704 24,402 Income (loss) from operations 4,353 4,872 10,018 9,545 Net income 3,174 3,500 7,513 7,033 Earnings per share Basic $ 0.16 $ 0.17 $ 0.37 $ 0.35 Diluted $ 0.16 $ 0.17 $ 0.37 $ 0.34 Three months ended 2019 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 28,479 $ 29,483 $ 29,100 $ 30,170 Gross profit 19,464 20,315 20,166 19,908 Income (loss) from operations 4,435 5,915 5,905 4,928 Net income 3,513 4,624 5,184 4,613 Earnings per share Basic $ 0.18 $ 0.23 $ 0.26 $ 0.23 Diluted $ 0.17 $ 0.23 $ 0.25 $ 0.23

Significant Accounting Policies

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2020
Accounting Policies [Abstract]
Concentration Risk, Credit Risk, Policy [Policy Text Block]	Concentrations of Credit Risk Our financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. Cash equivalents represent highly liquid investments with maturities of 90 $250,000. December 31, 2020. Our accounts receivable are with customers based in the United States and internationally. Accounts receivable generally are due within 30 90 may 90 240 We closely monitor outstanding receivables for potential collection risks, including those that may may December 31, 2020 December 31, 2020, may not may We write off accounts receivable when they become uncollectible. Such credit losses have historically been within our expectations and allowances. The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable. We review our allowance for doubtful accounts on a monthly basis and all past due balances are reviewed individually for collectability. The provision for the allowance for doubtful accounts is recorded in general and administrative expenses. The following is a summary of our allowance for doubtful accounts and sales returns: Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2020 $ 522 $ 293 $ 192 $ 623 Year ended December 31, 2019 399 388 265 522 Year ended December 31, 2018 349 264 214 399
Fair Value of Financial Instruments, Policy [Policy Text Block]	Fair Value of Financial Instruments Our financial instruments include cash and cash equivalents, short-term marketable securities, accounts receivable and trade payables. The fair value of these instruments approximates their carrying value based upon their short-term nature or variable rates of interest. Unrealized gains and losses on our short-term marketable securities are recorded in other comprehensive income and were not December 31, 2020.
Inventory and Other Deferred Costs [Policy Text Block]	Inventory and Other Deferred Costs Inventory and Other Deferred Costs consists of finished products, work-in-process, raw materials and costs deferred in connection with human tissue cryopreservation services of our RestoreFlow allograft business. We value inventory and other deferred costs at the lower of cost or market value. Cost includes materials, labor and manufacturing overhead and is determined using the first first may not may
Property, Plant and Equipment, Policy [Policy Text Block]	Property and Equipment Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows: Description Useful Life Computers and equipment 3–5 years Machinery and equipment 3–10 years Leasehold improvements The shorter of its useful life or lease term Expenditures for maintenance and repairs are charged to operations when incurred, while additions and betterments are capitalized. When assets are retired or disposed, the asset’s original cost and related accumulated depreciation are eliminated from the accounts and any gain or loss is reflected in the statement of operations.
Business Combinations Policy [Policy Text Block]	Valuation of Business Combinations We assign the value of the consideration transferred to acquire a business to the tangible assets and identifiable intangible assets acquired and liabilities assumed on the basis of their fair values at the date of acquisition. We assess the fair value of assets, including intangible assets, using a variety of methods and are usually performed by an independent appraiser who measures fair value from the perspective of a market participant. Acquisitions have been accounted for using the acquisition method, and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. Acquisition transaction costs have been recorded in general and administrative expenses, and are expensed as incurred. Allocation of the purchase price for acquisitions is based on estimates of the fair value of the net assets acquired and, for acquisitions completed within the past year, is subject to adjustment upon finalization of the purchase price allocation. Our acquisitions have historically been made at prices above the fair value of the acquired assets, resulting in goodwill, due to expectations of synergies of combining the businesses. These synergies include use of our existing commercial infrastructure to expand sales of the acquired businesses’ products, use of the commercial infrastructure of the acquired businesses to cost-effectively expand sales of our products, and the elimination of redundant facilities, functions and staffing.
Contingent Consideration [Policy Text Block]	Contingent Consideration Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income.
Impairment or Disposal of Long-Lived Assets, Policy [Policy Text Block]	Impairment of Long-lived Assets We review our long-lived assets (primarily property and equipment and intangible assets) subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may not
Goodwill and Intangible Assets, Goodwill, Policy [Policy Text Block]	Goodwill Goodwill represents the amount of consideration paid in connection with business acquisitions in excess of the fair value of assets acquired and liabilities assumed. Goodwill is evaluated for impairment annually or more frequently if indicators of impairment are present or changes in circumstances suggest that an impairment may December 31 single not” two not” 50 December 31, 2020, 2019 2018.
Goodwill and Intangible Assets, Intangible Assets, Policy [Policy Text Block]	Other Intangible Assets Other intangible assets consist primarily of patents, trademarks, technology licenses, and customer relationships acquired in connection with business acquisitions and asset acquisitions and are amortized over their estimated useful lives, ranging from 2 to 16 years.
Share-based Payment Arrangement [Policy Text Block]	Stock-based Compensation We recognize, as expense, the estimated fair value of stock options to employees which is determined using the Black-Scholes option pricing model. Share-based compensation charges are recorded across the consolidated statement of operations based upon the grantee’s primary function. We have elected to recognize the compensation cost of all share-based awards on a straight-line basis over the vesting period of the award. In periods that we grant stock options, fair value assumptions are based on volatility, interest, dividend yield, and expected term over which the stock options will be outstanding. The computation of expected volatility is based on the historical volatility of the company’s stock. The interest rate for periods within the contractual life of the award is based on the U.S. Treasury risk-free interest rate in effect at the time of grant. Historical data on exercise patterns is the basis for estimating the expected life of an option. The expected annual dividend rate was calculated by dividing our annual dividend, based on the most recent quarterly dividend rate, by the closing stock price on the grant date. We also issue restricted stock units (RSUs) as an additional form of equity compensation to our employees, officers, and directors, pursuant to our stockholder-approved 2006 no
Commitments and Contingencies, Policy [Policy Text Block]	Commitments and Contingencies In the normal course of business, we are subject to proceedings, lawsuits, and other claims and assessments for matters related to, among other things, patent infringement, business acquisitions, employment, commercial matters and product recalls. We assess the likelihood of any adverse judgments or outcomes to these matters as well as potential ranges of probable losses. A determination of the amount of reserves required, if any, for these contingencies is made after careful analysis of each individual issue. The required reserves may December 31, 2020, 2019 2018, not Sales of medical devices outside the U.S. are subject to international regulatory requirements that vary from country to country. These requirements and the amount of time required for approval may no
Income Tax, Policy [Policy Text Block]	Income Taxes We account for income taxes under the asset and liability method of accounting for income taxes. Under the asset and liability method, deferred taxes are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. The provision for income taxes includes taxes currently payable and deferred taxes resulting from the tax effects of temporary differences between the financial statement and tax bases of assets and liabilities. We maintain valuation allowances where it is more likely than not not We recognize, measure, present and disclose in our financial statements, uncertain tax positions that we have taken or expect to take on a tax return. We recognize in our financial statements the impact of tax positions that meet a “more likely than not” fifty Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense.
Comprehensive Income, Policy [Policy Text Block]	Comprehensive Income Comprehensive income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than reported net income, comprehensive income includes foreign currency translation adjustments, which are disclosed in the accompanying consolidated statements of comprehensive income. There were no reclassifications out of comprehensive income for the years ended December 31, 2020, 2019 2018. Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $1.6 million and $4.0 million as of December 31, 2020 2019,
Costs Associated with Exit or Disposal Activities or Restructurings, Policy [Policy Text Block]	Restructuring We record restructuring charges incurred in connection with consolidation or relocation of operations, exited business lines, reductions in force, or distributor terminations. These restructuring charges, which reflect our commitment to a termination or exit plan that will begin within twelve
Earnings Per Share, Policy [Policy Text Block]	Earnings per Share We compute basic earnings per share by dividing net income available for common stockholders by the weighted average number of shares outstanding during the year. Except where the result would be anti-dilutive to net income per share, diluted earnings per share has been computed using the treasury stock method and reflects the potential vesting of restricted common stock and the potential exercise of stock options, as well as their related income tax effects. The computation of basic and diluted net income per share is as follows: Year ended December 31, 2020 2019 2018 (in thousands, except per share data) Basic: Net income available for common stockholders $ 21,220 $ 17,934 $ 22,943 Weighted average shares outstanding 20,246 19,813 19,426 Basic earnings per share $ 1.05 $ 0.91 $ 1.18 Diluted: Net income available for common stockholders $ 21,220 $ 17,934 $ 22,943 Weighted-average shares outstanding 20,246 19,813 19,426 Common stock equivalents, if dilutive 233 513 816 Shares used in computing diluted earnings per common share 20,479 20,326 20,242 Diluted earnings per share $ 1.04 $ 0.88 $ 1.13 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 483 468 230
New Accounting Pronouncements, Policy [Policy Text Block]	Recent Accounting Pronouncements In June 2016, 2016 13 326 January 1, 2020. not In August 2018, 2018 13 820 January 1, 2020, not In January 2017, 2017 04 350 2” not January 1, 2020, not In December 2019, 2019 12 740 740 740. January 1, 2021, not

Note 1 - Significant Accounti_2

Note 1 - Significant Accounting Policies and Related Matters (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Disaggregation of Revenue [Table Text Block]	Year ended December 31, 2020 2019 Americas $ 81,470 $ 69,359 Europe, Middle East and Africa 39,193 39,480 Asia/Pacific Rim 8,703 8,393 Total $ 129,366 $ 117,232
Schedule of Advertising Expenses [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) Advertising expense $ 216 $ 286 $ 299
Financing Receivable, Allowance for Credit Loss [Table Text Block]	Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2020 $ 522 $ 293 $ 192 $ 623 Year ended December 31, 2019 399 388 265 522 Year ended December 31, 2018 349 264 214 399
Schedule of Property, Plant and Equipment Estimated Useful Lives [Table Text Block]	Description Useful Life Computers and equipment 3–5 years Machinery and equipment 3–10 years Leasehold improvements The shorter of its useful life or lease term
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands, except per share data) Basic: Net income available for common stockholders $ 21,220 $ 17,934 $ 22,943 Weighted average shares outstanding 20,246 19,813 19,426 Basic earnings per share $ 1.05 $ 0.91 $ 1.18 Diluted: Net income available for common stockholders $ 21,220 $ 17,934 $ 22,943 Weighted-average shares outstanding 20,246 19,813 19,426 Common stock equivalents, if dilutive 233 513 816 Shares used in computing diluted earnings per common share 20,479 20,326 20,242 Diluted earnings per share $ 1.04 $ 0.88 $ 1.13 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 483 468 230

Note 2 - Acquisitions and Div_2

Note 2 - Acquisitions and Divestitures (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]	Allocated Fair Value (in thousands) Inventory $ 3,859 Accounts receivable 1,789 Equipment and supplies 1,140 Accounts payable and other (53 ) Intangible assets 39,056 Goodwill 27,115 Purchase price $ 72,906 Allocated Fair Value (in thousands) Inventory and other $ 1,343 Intangible assets 8,725 Goodwill 7,344 Purchase price $ 17,412 Allocated Fair Value (in thousands) Inventory $ 276 Equipmentand supplies 70 Intangible assets 4,844 Goodwill 2,748 Purchase price $ 7,938 Allocated Fair Value (in thousands) Inventory € 2,419 Land and building 750 Equipment and supplies 94 Intangible assets 623 Bargain purchase gain (1,946 ) Purchase price € 1,940 Allocated Fair Value (in thousands) Inventory $ 739 Equipment and supplies 416 Intangible assets 6,527 Goodwill 6,361 Purchase price $ 14,043
Schedule of Finite-Lived Intangible Assets Acquired as Part of Business Combination [Table Text Block]	Allocated Estimated Fair Value Useful Life (Years) (in thousands) Customer relationships $ 20,310 15.0 Intellectual property 16,449 10.0 Non-compete agreement 104 5.0 Tradenames 2,193 10.0 Total intangible assets $ 39,056 Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships $ 5,562 12.0 Intellectual property 2,335 8.0 Non-compete agreement 361 5.0 Tradenames 467 8.0 Total intangible assets $ 8,725 Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships $ 3,945 13.0 Intellectual property 563 7.0 Non-compete agreement 233 5.0 Tradenames 103 7.0 Total intangible assets $ 4,844 Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships € 250 16.0 Intellectual property 237 5.0 Non-compete agreement 46 5.0 Tradenames 90 5.0 Total intangible assets € 623 Weighted Allocated Average Fair Value Useful Life (Years) (in thousands) Customer relationships $ 4,475 16.0 Intellectual property 1,316 7.0 Non-compete agreement 530 5.0 Tradenames 206 7.0 Total intangible assets $ 6,527
Business Acquisition, Pro Forma Information [Table Text Block]	Unaudited Pro Forma Financial Information Year ended December 31, 2020 2019 ($ in thousands) Net sales $ 137,450 $ 131,915 Net income 20,041 15,045 Net income per share Basic $ 0.99 $ 0.76 Diluted $ 0.98 $ 0.74
Disposal Groups, Including Discontinued Operations [Table Text Block]	Allocated Fair Value (in thousands) Inventory $ 308 Deferred revenue - transition services agreement 1,081 Goodwill 135 Gain on divestiture 5,876 Consideration received $ 7,400

Note 3 - Inventory and Other _2

Note 3 - Inventory and Other Deferred Costs (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Inventory, Current [Table Text Block]	December 31, 2020 December 31, 2019 (in thousands) Raw materials $ 5,044 $ 5,359 Work-in-process 6,004 6,238 Finished products 28,117 23,032 Other deferred costs 5,950 4,898 Total inventory and other deferred costs $ 45,115 $ 39,527

Note 4 - Property and Equipme_2

Note 4 - Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Property, Plant and Equipment [Table Text Block]	As of December 31, 2020 2019 (in thousands) Computers and equipment $ 5,046 $ 4,623 Machinery and equipment 17,266 16,245 Building and leasehold improvements 12,809 11,758 Gross property and equipment 35,121 32,626 Less accumulated depreciation (20,085 ) (17,772 ) Property and equipment, net $ 15,036 $ 14,854
Depreciation Expense [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) Depreciation expense $ 3,181 $ 2,979 $ 2,564

Note 5 - Goodwill and Other I_2

Note 5 - Goodwill and Other Intangibles (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Goodwill [Table Text Block]	As of December 31, 2020 2019 Balance at beginning of year $ 39,951 $ 29,868 Additions for acquisitions 27,115 10,092 Purchase accounting adjustments (1,345 ) - Effects of currency exchange 224 (9 ) Balance at end of year $ 65,945 $ 39,951
Schedule of Finite-Lived Intangible Assets [Table Text Block]	December 31, 2020 December 31, 2019 Gross Net Gross Net Carrying Accumulated Carrying Carrying Accumulated Carrying Value Amortization Value Value Amortization Value (in thousands) Product technology and intellectual property $ 29,951 $ 7,947 $ 22,004 $ 13,502 $ 5,722 $ 7,780 Trademarks, tradenames and licenses 4,000 1,094 2,906 1,807 702 1,105 Customer relationships 38,525 5,424 33,101 18,215 3,364 14,851 Other intangible assets 1,767 873 894 1,725 568 1,157 Total identifiable intangible assets $ 74,243 $ 15,338 $ 58,905 $ 35,249 $ 10,356 $ 24,893
Finite-lived Intangible Assets Amortization Expense [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) Amortization expense $ 5,043 $ 2,437 $ 1,760
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	Year ended December 31, 2021 2022 2023 2024 2025 (in thousands) Amortization expense $ 6,179 $ 5,975 $ 5,902 $ 5,706 $ 5,467

Note 6 - Revolving Line of Cr_2

Note 6 - Revolving Line of Credit and Long-term Debt (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Debt [Table Text Block]	December 31, 2020 (in thousands) Five-year term loan, net of unamortized debt issuance costs of $968 $ 38,032 Less current portion (2,500 ) $ 35,532
Schedule of Maturities of Long-term Debt [Table Text Block]	Year ending December 31, 2021 $ 2,500 2022 3,000 2023 3,500 2024 4,000 2025 26,000 Total before unamortized issuance costs 39,000 Less unamortized issuance costs (968 ) Less current portion of long-term bebt (2,500 ) Total long-term debt $ 35,532

Note 7 - Accrued Expenses and_2

Note 7 - Accrued Expenses and Other Long-term Liabilities (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Accrued Liabilities [Table Text Block]	December 31, 2020 December 31, 2019 (in thousands) Compensation and related taxes $ 8,675 $ 8,550 Income and other taxes 2,394 1,003 Professional fees 39 40 Other 6,417 4,421 Total $ 17,525 $ 14,014
Other Noncurrent Liabilities [Table Text Block]	December 31, 2020 December 31, 2019 (in thousands) Acquisition-related liabilities $ 3,700 $ 3,268 Income taxes 813 781 Other 130 166 Total $ 4,643 $ 4,215

Note 8 - Commitments and Cont_2

Note 8 - Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Lease, Cost [Table Text Block]	Year ended Year ended December 31, December 31, 2020 2019 (in thousands) (in thousands) Lease cost Operating lease cost $ 1,912 $ 1,756 Short-term lease cost 192 291 Total lease cost $ 2,104 $ 2,047 Other information Cash paid for amounts included in the measurement of operating lease liabilities $ 2,404 $ 1,858 Right-of-use assets obtained in exchange for new operating lease liabilities $ 2,770 $ 10,571 Weighted average remaining lease term - operating leases (years) 7.8 8.3 Weighted average discount rate - operating leases 5.02 % 5.25 %
Lessee, Operating Lease, Liability, Maturity [Table Text Block]	Year ending December 31, 2021 $ 2,763 2022 2,447 2023 2,064 2024 1,866 2025 1,916 Thereafter 9,920 Adjustment to net present value as of December 31, 2020 (4,230 ) Minimum noncancelable lease liability $ 16,746

Note 9 - Income Taxes (Tables)

Note 9 - Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) United States $ 25,308 $ 17,989 $ 22,256 Foreign 2,048 3,690 6,188 Total $ 27,356 $ 21,679 $ 28,444
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) Current: Federal $ 4,594 $ 1,501 $ 4,262 State 806 304 673 Foreign 1,064 1,116 2,718 6,464 2,921 7,653 Deferred: Federal (397 ) 538 (1,512 ) State (48 ) 144 (145 ) Foreign 117 142 (495 ) (328 ) 824 (2,152 ) Provision for income taxes $ 6,136 $ 3,745 $ 5,501
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block]	2020 2019 2018 (in thousands) Unrecognized tax benefits at the beginning of year $ 848 $ 711 $ 525 Additions for tax positions of current year - 74 73 Additions for tax positions of prior years 37 63 113 Reductions for settlements with taxing authorities. (65 ) - - Reductions for lapses of the applicable statutes of limitations - - - Unrecognized tax benefits at the end of the year $ 820 $ 848 $ 711
Schedule of Deferred Tax Assets and Liabilities [Table Text Block]	As of December 31, 2020 2019 (in thousands) Deferred tax assets: Inventory $ 1,629 $ 840 Net operating loss carryforwards 1,348 1,289 Tax credit carryforwards 1,019 944 Capital loss carryforwards 521 277 Reserves and accruals 994 787 Operating lease liabilities 3,664 3,343 Intangible assets 4,386 2,764 Stock options 359 342 Other 105 20 Total deferred tax assets 14,025 10,606 Deferred tax liabilities: Property and equipment (1,831 ) (1,520 ) Goodwill (4,055 ) (3,459 ) Operating lease right-of-use assets (3,503 ) (3,224 ) Foreign branch deferred offset (954 ) (923 ) Other (299 ) (187 ) Total deferred tax liabilities (10,642 ) (9,313 ) Net deferred tax assets before valuation allowance 3,383 1,293 Valuation allowance (1,824 ) (1,388 ) Net deferred tax liabiltity $ 1,559 $ (95 ) Deferred tax classification Long-term deferred tax asset $ 1,686 $ 1,084 Long-term deferred tax liability (127 ) (1,179 ) Net long-term deferred tax liability $ 1,559 $ (95 )
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]	2020 2019 2018 Federal statutory rate 21.0 % 21.0 % 21.0 % State tax, net of federal benefit 2.2 % 1.9 % 1.4 % Effect of foreign taxes 1.1 % 2.1 % 3.8 % Federal tax on foreign income 0.4 % 0.8 % 1.4 % Valuation allowance 1.4 % 0.6 % (3.2 %) Foreign deferred tax liability offset (0.2 %) (0.4 %) (0.3 %) Manufacturing deduction 0.0 % 0.0 % 0.0 % Research & development tax credits (0.6 %) (1.2 %) (0.7 %) Stock options (2.3 %) (8.8 %) (3.3 %) Uncertain tax positions 0.3 % 1.0 % 0.8 % Other permanent differences (0.6 %) 0.5 % (0.7 %) Change in tax laws 0.0 % 0.0 % 0.0 % Deferred tax remeasurement 0.0 % 0.0 % 0.0 % Other (0.3 %) (0.2 %) (0.9 %) Effective tax rate 22.4 % 17.3 % 19.3 %
Schedule of Cash Flow, Supplemental Disclosures [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) Cash paid for income taxes, net $ 4,470 $ 4,817 $ 5,521

Note 10 - Stockholders' Equity

Note 10 - Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	2020 2019 2018 Dividend yield 1.02 % 0.96 % 1.20 % Volatility 47.3 % 42.8 % 41.3 % Risk-free interest rate 0.3 % 1.7 % 2.7 % Weighted average expected option term (in years) 4.9 4.7 4.8 Weighted average fair value per share of options granted $ 13.24 $ 12.51 $ 8.28
Share-based Payment Arrangement, Option, Activity [Table Text Block]	Weighted Weighted Average Aggregate Number Average Remaining Intrinsic of Shares Exercise Price Contractual Term Value (in years) Balance outstanding at December 31, 2019 (1) 1,047,094 $ 23.19 4.31 $ 13,366,595 Granted 222,110 $ 36.67 Exercised (2) (331,958 ) $ 17.99 $ 5,413,197 Canceled / Expired (5,406 ) $ 27.49 Balance outstanding at December 31, 2020 (3) 931,840 $ 28.22 4.49 $ 11,442,240 Vested and exercisable at December 31, 2020 (4) 274,411 $ 23.08 3.50 $ 4,780,656 Expected to vest at December 31, 2020 657,429 $ 30.37 4.93 Total 931,840
Share-based Payment Arrangement, Restricted Stock Unit, Activity [Table Text Block]	Weighted Average Grant Date Shares Fair Value Balance outstanding at December 31, 2019 188,681 $ 26.14 Granted 46,146 $ 36.86 Vested (1) (50,669 ) $ 22.76 Canceled (37,143 ) $ 27.88 Balance outstanding at December 31, 2020 147,015 $ 30.24
Accelerated Share Repurchases [Table Text Block]	2020 2019 Shares of common stock repurchased 16,537 20,524 Average per share repurchase price $ 34.47 $ 33.28 Aggregage purchase price (in thousands) $ 570 $ 683
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]	2020 2019 2018 (in thousands) Stock option awards $ 1,938 $ 1,580 $ 1,457 Restricted stock units 1,084 1,062 892 Total stock-based compensation $ 3,022 $ 2,642 $ 2,349 2020 2019 2018 (in thousands) Cost of sales $ 333 $ 310 $ 272 Sales and marketing 516 544 529 General and administrative 1,883 1,509 1,293 Research and development 290 279 255 Total stock-based compensation $ 3,022 $ 2,642 $ 2,349
Schedule of Dividends Payable [Table Text Block]	Record Date Payment Date Per Share Amount Dividend Payment (in thousands) Fiscal Year 2020 March 3, 2020 March 19, 2020 $ 0.095 $ 1,917 May 20, 2020 June 4, 2020 $ 0.095 $ 1,917 August 27, 2020 September 10, 2020 $ 0.095 $ 1,925 November 19, 2020 December 3, 2020 $ 0.095 $ 1,936 Fiscal Year 2019 March 22, 2019 April 5, 2019 $ 0.085 $ 1,672 May 22, 2019 June 6, 2019 $ 0.085 $ 1,672 August 21, 2019 September 5, 2019 $ 0.085 $ 1,691 November 20, 2019 December 5, 2019 $ 0.085 $ 1,701

Note 12 - Segment and Enterpr_2

Note 12 - Segment and Enterprise-wide Disclosures (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Revenue from External Customers Attributed to Foreign Countries by Geographic Area [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) United States $ 75,222 $ 63,130 $ 59,078 Germany 12,365 12,400 12,445 Other countries 41,779 41,702 34,045 Net sales $ 129,366 $ 117,232 $ 105,568
Schedule of Revenue from External Customers and Long-Lived Assets, by Geographical Areas [Table Text Block]	As of December 31, 2020 2019 (in thousands) United States $ 27,660 $ 24,885 Australia 115 1,499 France 1,140 1,089 Germany 1,138 1,405 Other countries 1,049 1,184 Total long-term assets $ 31,102 $ 30,062

Note 13 - Fair Value Measurem_2

Note 13 - Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) Beginning balance $ 1,764 $ 72 $ 1,300 Additions 406 1,989 - Payments - (309 ) (1,199 ) Change in fair value included in earnings 70 12 (29 ) Ending balance $ 2,240 $ 1,764 $ 72

Note 14 - Accumulated Other C_2

Note 14 - Accumulated Other Comprehensive Income (Loss) (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Schedule of Accumulated Other Comprehensive Income (Loss) [Table Text Block]	Year ended December 31, 2020 2019 2018 (in thousands) Beginning balance $ (4,007 ) $ (3,900 ) $ (2,289 ) Other comprehensive income (loss) before reclassifications 2,482 (107 ) (1,611 ) Amounts reclassified from accumulated other comprehensive loss - - - Ending Balance $ (1,525 ) $ (4,007 ) $ (3,900 )

Note 15 - Quarterly Financial_2

Note 15 - Quarterly Financial Data (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2020
Notes Tables
Quarterly Financial Information [Table Text Block]	Three months ended 2020 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 30,551 $ 24,851 $ 36,416 $ 37,548 Gross profit 20,483 17,029 22,704 24,402 Income (loss) from operations 4,353 4,872 10,018 9,545 Net income 3,174 3,500 7,513 7,033 Earnings per share Basic $ 0.16 $ 0.17 $ 0.37 $ 0.35 Diluted $ 0.16 $ 0.17 $ 0.37 $ 0.34 Three months ended 2019 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 28,479 $ 29,483 $ 29,100 $ 30,170 Gross profit 19,464 20,315 20,166 19,908 Income (loss) from operations 4,435 5,915 5,905 4,928 Net income 3,513 4,624 5,184 4,613 Earnings per share Basic $ 0.18 $ 0.23 $ 0.26 $ 0.23 Diluted $ 0.17 $ 0.23 $ 0.25 $ 0.23

Note 1 - Significant Accounti_3

Note 1 - Significant Accounting Policies and Related Matters (Details Textual) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2020	Dec. 31, 2020USD ($)	Dec. 31, 2019USD ($)	Dec. 31, 2018USD ($)
Accounts Receivable, after Allowance for Credit Loss, Current, Total		$ 19,552	$ 16,572
Number of Operating Segments	1	1
Goodwill, Impairment Loss		$ 0
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax		0	0	$ 0
Accumulated Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Net of Tax, Ending Balance		1,600	$ 4,000
ITALY
Accounts Receivable, after Allowance for Credit Loss, Current, Total		900
SPAIN
Accounts Receivable, after Allowance for Credit Loss, Current, Total		600
Geographic Distribution, Foreign [Member]
Cash, Ending Balance		$ 13,700
Minimum [Member]
Period of Payments Received from Customers (Day)		30 days
Finite-Lived Intangible Asset, Useful Life (Year)		2 years
Maximum [Member]
Period of Payments Received from Customers (Day)		60 days
Finite-Lived Intangible Asset, Useful Life (Year)		16 years

Note 1 - Organization and Basis

Note 1 - Organization and Basis for Presentation - Disaggregation of Revenue by Major Geographic Area (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Revenue	$ 129,366	$ 117,232
Americas [Member]
Revenue	81,470	69,359
EMEA [Member]
Revenue	39,193	39,480
Asia Pacific [Member]
Revenue	$ 8,703	$ 8,393

Note 1 - Significant Accounti_4

Note 1 - Significant Accounting Policies and Related Matters - Summary of Advertising Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Advertising expense	$ 216	$ 286	$ 299

Note 1 - Significant Accounti_5

Note 1 - Significant Accounting Policies and Related Matters - Allowance for Doubtful Accounts and Sales Returns (Details) - Allowance for Doubtful Accounts and Sales Returns [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Balance	$ 522	$ 399	$ 349
Additions (recoveries) charged to income	293	388	264
Deductions from reserves	192	265	214
Balance	$ 623	$ 522	$ 399

Note 1 - Significant Accounti_6

Note 1 - Significant Accounting Policies and Related Matters - Summary of Property and Equipment (Details)	12 Months Ended
	Dec. 31, 2020
Computers and Equipment [Member] | Minimum [Member]
Useful life (Year)	3 years
Computers and Equipment [Member] | Maximum [Member]
Useful life (Year)	5 years
Machinery and Equipment [Member] | Minimum [Member]
Useful life (Year)	3 years
Machinery and Equipment [Member] | Maximum [Member]
Useful life (Year)	10 years
Leasehold Improvements [Member] | Minimum [Member]
Estimated useful life	The shorter of its useful life or lease term
Leasehold Improvements [Member] | Maximum [Member]
Estimated useful life	The shorter of its useful life or lease term

Note 1 - Significant Accounti_7

Note 1 - Significant Accounting Policies and Related Matters - Computation of Basic and Diluted Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Basic:
Net income available for common stockholders	$ 7,033	$ 7,513	$ 3,500	$ 3,174	$ 4,613	$ 5,184	$ 4,624	$ 3,513	$ 21,220	$ 17,934	$ 22,943
Weighted average shares outstanding (in shares)									20,246	19,813	19,426
Basic earnings per share (in dollars per share)	$ 0.35	$ 0.37	$ 0.17	$ 0.16	$ 0.23	$ 0.26	$ 0.23	$ 0.18	$ 1.05	$ 0.91	$ 1.18
Diluted:
Net income available for common stockholders	$ 7,033	$ 7,513	$ 3,500	$ 3,174	$ 4,613	$ 5,184	$ 4,624	$ 3,513	$ 21,220	$ 17,934	$ 22,943
Weighted average shares outstanding (in shares)									20,246	19,813	19,426
Common stock equivalents, if dilutive (in shares)									233	513	816
Shares used in computing diluted earnings per common share (in shares)									20,479	20,326	20,242
Diluted earnings per share (in dollars per share)	$ 0.34	$ 0.37	$ 0.17	$ 0.16	$ 0.23	$ 0.25	$ 0.23	$ 0.17	$ 1.04	$ 0.88	$ 1.13
Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive (in shares)									483	468	230

Note 2 - Acquisitions and Div_3

Note 2 - Acquisitions and Divestitures (Details Textual) € in Millions

Jun. 22, 2020USD ($)

Oct. 11, 2019USD ($)

Jul. 12, 2019USD ($)

Oct. 22, 2018USD ($)

Oct. 22, 2018EUR (€)

Sep. 20, 2018USD ($)

Apr. 05, 2018USD ($)

Sep. 30, 2020USD ($)

Dec. 31, 2019USD ($)

Jun. 30, 2018USD ($)

Dec. 31, 2020USD ($)

Dec. 31, 2020USD ($)

Dec. 31, 2019USD ($)

Oct. 22, 2018EUR (€)

Goodwill, Purchase Accounting Adjustments

$ (1,345,000)

$ 0

Reddick Divestiture [Member]

Proceeds from Sale of Productive Assets, Total

$ 7,400,000

Long-term Purchase Commitment, Period (Year)

2 years

Gain (Loss) on Disposition of Assets for Financial Service Operations, Total

$ 5,900,000

Artegraft Inc [Member]

Payments to Acquire Businesses, Gross

$ 72,500,000

Escrow Deposit Disbursements Related to Property Acquisition

$ 7,500,000

Business Combination, Contingent Consideration, Liability, Total

$ 400,000

400,000

Business Acquisition, Purchase Price Allocation, Goodwill Expected Tax Deductible, Period (Year)

15 years

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)

12 years 7 months 6 days

Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual

11,100,000

Artegraft Inc [Member] | First Earn-out [Member]

Business Combination, Contingent Consideration, Liability, Total

$ 5,800,000

Business Combination, Contingent Consideration, Unit Sales

20,000

Artegraft Inc [Member] | Second Earn-out [Member]

Business Combination, Contingent Consideration, Liability, Total

$ 5,800,000

Business Combination, Contingent Consideration, Unit Sales

24,000

Artegraft Inc [Member] | Third Earn-out [Member]

Business Combination, Contingent Consideration, Liability, Total

$ 5,800,000

Business Combination, Contingent Consideration, Unit Sales

28,800

Artegraft Inc [Member] | Catch-Up Payment [Member]

Business Combination, Contingent Consideration, Liability, Total

$ 400,000

Business Combination, Contingent Consideration, Minimum Unit Sales in Three Years

58,240

Business Combination, Contingent Consideration, Minimum Unit Sales in Three Years, Percent of Combined Individual Year Targets

80.00%

Business Combination, Contingent Consideration, Before Multiplied by Fraction

$ 17,500,000

Business Combination, Contingent Consideration, Denominator, Less Amount Paid

72,800

Artegraft Inc [Member] | Maximum [Member]

Business Combination, Consideration Transferred, Total

$ 90,000,000

CardioCel and VascuCel Biologic Patches [Member]

Payments to Acquire Businesses, Gross

$ 14,200,000

Business Combination, Contingent Consideration, Liability, Total

7,500,000

$ 2,300,000

$ 2,300,000

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)

10 years 4 months 24 days

Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual

$ 1,400,000

Goodwill, Purchase Accounting Adjustments

$ (1,300,000)

Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Assets

$ 1,300,000

CardioCel and VascuCel Biologic Patches [Member] | Technology Licenses [Member]

Business Combination, Consideration Transferred, Total

8,000,000

CardioCel and VascuCel Biologic Patches [Member] | Achieving Audited Financial Statements of Acquired Business [Member]

Payments to Acquire Businesses, Gross

300,000

CardioCel and VascuCel Biologic Patches [Member] | First Holdback [Member]

Business Combination, Contingent Consideration, Liability, Total

700,000

CardioCel and VascuCel Biologic Patches [Member] | Third Holdback [Member]

Business Combination, Contingent Consideration, Liability, Total

2,000,000

CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Twenty Million in the First Twelve Month Period After Closing Date [Member]

Business Combination, Contingent Consideration, Liability, Total

2,500,000

CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Fifteen Million in the First Twelve Month Period After Closing Date [Member]

Business Combination, Contingent Consideration, Liability, Total

1,200,000

CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Thirty Million in the Second Twelve Month Period After Closing Date [Member]

Business Combination, Contingent Consideration, Liability, Total

2,500,000

CardioCel and VascuCel Biologic Patches [Member] | Revenues Exceeding Twenty-Two and a Half Million in the First Twelve Month Period After Closing Date [Member]

Business Combination, Contingent Consideration, Liability, Total

1,200,000

CardioCel and VascuCel Biologic Patches [Member] | Extension of Product Shelf Life from 36 Months to 60 Months in the First Anniversary of Closing Date [Member]

Business Combination, Contingent Consideration, Liability, Total

500,000

CardioCel and VascuCel Biologic Patches [Member] | Maximum [Member] | Biological Patch Business Assets [Member]

Business Combination, Consideration Transferred, Total

$ 15,300,000

Tru-Incise Valve Cutter [Member]

Business Combination, Consideration Transferred, Total

$ 8,000,000

Payments to Acquire Businesses, Gross

$ 6,800,000

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)

11 years 9 months 18 days

Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual

$ 800,000

Business Combination, Deferred Purchase Consideration, Installment Payment

$ 400,000

Business Combination, Deferred Purchase Consideration

1,200,000

Acquisition Date Fair Value

$ 1,100,000

Business Combination ,Fair Value Inputs, Discount Rate

4.19%

Cardial [Member]

Business Combination, Consideration Transferred, Total

$ 2,300,000

€ 2

Payments to Acquire Businesses, Gross

$ 1,300,000

€ 1.1

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)

9 years 4 months 24 days

9 years 4 months 24 days

Business Combination, Deferred Purchase Consideration

$ 400,000

€ 0.4

Business Combination, Consideration Transferred, Liabilities Incurred

500,000

€ 0.5

Deferred Tax Assets, Business Combinations

600,000

€ 0.5

Business Combination, Bargain Purchase, Gain Recognized, Amount

$ 1,600,000

€ 1.4

Applied Medical [Member]

Business Combination, Consideration Transferred, Total

$ 14,200,000

Business Acquisition, Purchase Price Allocation, Goodwill Expected Tax Deductible, Period (Year)

15 years

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life (Year)

13 years

Acquisition Date Fair Value

$ 3,000,000

Business Combination ,Fair Value Inputs, Discount Rate

3.75%

Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed Current Assets Deferred Costs

$ 3,200,000

Applied Medical [Member] | Closing Date [Member]

Business Combination, Consideration Transferred, Total

11,000,000

Applied Medical [Member] | 12 Months Following the Closing Date [Member]

Business Combination, Consideration Transferred, Total

2,000,000

Applied Medical [Member] | 24 Months Following the Closing Date [Member]

Business Combination, Consideration Transferred, Total

$ 1,200,000

Balloon Supply Agreement [Member] | Reddick Divestiture [Member]

Long-term Purchase Commitment, Period (Year)

6 years

Note 2 - Acquisitions and Div_4

Note 2 - Acquisitions and Divestitures - Assets Acquired and Liabilities Assumed (Details) € in Thousands, $ in Thousands	Dec. 31, 2020USD ($)	Jun. 22, 2020USD ($)	Dec. 31, 2019USD ($)	Oct. 11, 2019USD ($)	Jul. 12, 2019USD ($)	Dec. 31, 2018USD ($)	Oct. 22, 2018EUR (€)	Sep. 20, 2018USD ($)
Goodwill	$ 65,945		$ 39,951			$ 29,868
Artegraft Inc [Member]
Inventory		$ 3,859
Accounts receivable		1,789
Equipment and supplies		1,140
Accounts payable and other		53
Intangible assets		39,056
Goodwill		27,115
Purchase price		$ 72,906
CardioCel and VascuCel Biologic Patches [Member]
Intangible assets				$ 8,725
Goodwill				7,344
Purchase price				17,412
Inventory and other				$ 1,343
Tru-Incise Valve Cutter [Member]
Inventory					$ 276
Equipment and supplies					70
Intangible assets					4,844
Goodwill					2,748
Purchase price					$ 7,938
Cardial [Member]
Inventory | €							€ 2,419
Equipment and supplies | €							94
Intangible assets | €							623
Purchase price | €							1,940
Land and building | €							750
Bargain purchase gain | €							€ (1,946)
Applied Medical [Member]
Inventory								$ 739
Equipment and supplies								416
Intangible assets								6,527
Goodwill								6,361
Purchase price								$ 14,043

Note 2 - Acquisitions and Div_5

Note 2 - Acquisitions and Divestitures - Acquired Intangible Assets and Related Estimated Useful Lives (Details) € in Thousands, $ in Thousands	Jun. 22, 2020USD ($)	Oct. 11, 2019USD ($)	Jul. 12, 2019USD ($)	Oct. 22, 2018EUR (€)	Sep. 20, 2018USD ($)	Dec. 31, 2020
Artegraft Inc [Member]
Allocated Fair Value	$ 39,056
Weighted Average Useful Life (Year)	12 years 7 months 6 days
Artegraft Inc [Member] | Customer Relationships [Member]
Allocated Fair Value	$ 20,310
Weighted Average Useful Life (Year)	15 years
Artegraft Inc [Member] | Intellectual Property [Member]
Allocated Fair Value	$ 16,449
Weighted Average Useful Life (Year)	10 years
Artegraft Inc [Member] | Noncompete Agreements [Member]
Allocated Fair Value	$ 104
Weighted Average Useful Life (Year)	5 years
Artegraft Inc [Member] | Trade Names [Member]
Allocated Fair Value	$ 2,193
Weighted Average Useful Life (Year)	10 years
CardioCel and VascuCel Biologic Patches [Member]
Allocated Fair Value		$ 8,725
Weighted Average Useful Life (Year)						10 years 4 months 24 days
CardioCel and VascuCel Biologic Patches [Member] | Customer Relationships [Member]
Allocated Fair Value		$ 5,562
Weighted Average Useful Life (Year)		12 years
CardioCel and VascuCel Biologic Patches [Member] | Intellectual Property [Member]
Allocated Fair Value		$ 2,335
Weighted Average Useful Life (Year)		8 years
CardioCel and VascuCel Biologic Patches [Member] | Noncompete Agreements [Member]
Allocated Fair Value		$ 361
Weighted Average Useful Life (Year)		5 years
CardioCel and VascuCel Biologic Patches [Member] | Trade Names [Member]
Allocated Fair Value		$ 467
Weighted Average Useful Life (Year)		8 years
Tru-Incise Valve Cutter [Member]
Allocated Fair Value			$ 4,844
Weighted Average Useful Life (Year)			11 years 9 months 18 days
Tru-Incise Valve Cutter [Member] | Customer Relationships [Member]
Allocated Fair Value			$ 3,945
Weighted Average Useful Life (Year)			13 years
Tru-Incise Valve Cutter [Member] | Intellectual Property [Member]
Allocated Fair Value			$ 563
Weighted Average Useful Life (Year)			7 years
Tru-Incise Valve Cutter [Member] | Noncompete Agreements [Member]
Allocated Fair Value			$ 233
Weighted Average Useful Life (Year)			5 years
Tru-Incise Valve Cutter [Member] | Trade Names [Member]
Allocated Fair Value			$ 103
Weighted Average Useful Life (Year)			7 years
Cardial [Member]
Allocated Fair Value | €				€ 623
Weighted Average Useful Life (Year)				9 years 4 months 24 days
Cardial [Member] | Customer Relationships [Member]
Allocated Fair Value | €				€ 250
Weighted Average Useful Life (Year)				16 years
Cardial [Member] | Intellectual Property [Member]
Allocated Fair Value | €				€ 237
Weighted Average Useful Life (Year)				5 years
Cardial [Member] | Noncompete Agreements [Member]
Allocated Fair Value | €				€ 46
Weighted Average Useful Life (Year)				5 years
Cardial [Member] | Trade Names [Member]
Allocated Fair Value | €				€ 90
Weighted Average Useful Life (Year)				5 years
Applied Medical [Member]
Allocated Fair Value					$ 6,527
Weighted Average Useful Life (Year)					13 years
Applied Medical [Member] | Customer Relationships [Member]
Allocated Fair Value					$ 4,475
Weighted Average Useful Life (Year)					16 years
Applied Medical [Member] | Intellectual Property [Member]
Allocated Fair Value					$ 1,316
Weighted Average Useful Life (Year)					7 years
Applied Medical [Member] | Noncompete Agreements [Member]
Allocated Fair Value					$ 530
Weighted Average Useful Life (Year)					5 years
Applied Medical [Member] | Trade Names [Member]
Allocated Fair Value					$ 206
Weighted Average Useful Life (Year)					7 years

Note 2 - Acquisitions and Div_6

Note 2 - Acquisitions and Divestitures - Pro Forma Financial Information (Details) - Artegraft Inc [Member] - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Net sales	$ 137,450	$ 131,915
Net income	$ 20,041	$ 15,045
Basic (in dollars per share)	$ 0.99	$ 0.76
Diluted (in dollars per share)	$ 0.98	$ 0.74

Note 2 - Acquisitions and Div_7

Note 2 - Acquisitions and Divestitures - Asset Purchase Agreement (Details) - Reddick Divestiture [Member] $ in Thousands	Apr. 05, 2018USD ($)
Inventory	$ 308
Deferred revenue - transition services agreement	1,081
Goodwill	135
Gain on divestiture	5,876
Consideration received	$ 7,400

Note 3 - Inventory and Other _3

Note 3 - Inventory and Other Deferred Costs (Details Textual) - USD ($) $ in Millions	Dec. 31, 2020	Dec. 31, 2019
Other Inventory, Materials, Supplies and Merchandise under Consignment, Gross	$ 2.1	$ 1.9

Note 3 - Inventory and Other _4

Note 3 - Inventory and Other Deferred Costs - Summary of Inventories and Other Deferred Costs (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Raw materials	$ 5,044	$ 5,359
Work-in-process	6,004	6,238
Finished products	28,117	23,032
Other deferred costs	5,950	4,898
Total inventory and other deferred costs	$ 45,115	$ 39,527

Note 4 - Property and Equipme_3

Note 4 - Property and Equipment (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Impairment of Long-Lived Assets Held-for-use	$ 0.6	$ 0.5	$ 1

Note 4 - Property and Equipme_4

Note 4 - Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Gross property and equipment	$ 35,121	$ 32,626
Less accumulated depreciation	(20,085)	(17,772)
Property and equipment, net	15,036	14,854
Computers and Equipment [Member]
Gross property and equipment	5,046	4,623
Machinery and Equipment [Member]
Gross property and equipment	17,266	16,245
Building and Leasehold Improvements [Member]
Gross property and equipment	$ 12,809	$ 11,758

Note 4 - Property and Equipme_5

Note 4 - Property and Equipment - Depreciation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Depreciation expense	$ 3,181	$ 2,979	$ 2,564

Note 5 - Goodwill and Other I_3

Note 5 - Goodwill and Other Intangibles (Details Textual) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Sep. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Goodwill, Purchase Accounting Adjustments		$ (1,345)	$ 0
Impairment of Intangible Assets, Finite-lived			$ 4,500
Minimum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		2 years
Maximum [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		16 years
Weighted Average [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		11 years 8 months 12 days
CardioCel and VascuCel Biologic Patches [Member]
Goodwill, Purchase Accounting Adjustments	$ (1,300)
Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed, Deferred Tax Assets	$ 1,300

Note 5 - Goodwill and Other I_4

Note 5 - Goodwill and Other Intangibles - Schedule of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Balance at beginning of year	$ 39,951	$ 29,868
Additions for acquisitions	27,115	10,092
Purchase accounting adjustments	(1,345)	0
Effects of currency exchange	224	(9)
Balance at end of year	$ 65,945	$ 39,951

Note 5 - Goodwill and Other I_5

Note 5 - Goodwill and Other Intangibles - Components of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Gross carrying value	$ 74,243	$ 35,249
Accumulated amortization	15,338	10,356
Net carrying value	58,905	24,893
Product Technology and Intellectual Property [Member]
Gross carrying value	29,951	13,502
Accumulated amortization	7,947	5,722
Net carrying value	22,004	7,780
Trademarks, Tradenames and Licenses [Member]
Gross carrying value	4,000	1,807
Accumulated amortization	1,094	702
Net carrying value	2,906	1,105
Customer Relationships [Member]
Gross carrying value	38,525	18,215
Accumulated amortization	5,424	3,364
Net carrying value	33,101	14,851
Other Intangible Assets [Member]
Gross carrying value	1,767	1,725
Accumulated amortization	873	568
Net carrying value	$ 894	$ 1,157

Note 5 - Goodwill and Other I_6

Note 5 - Goodwill and Other Intangibles - Amortization Expense Included in General and Administrative Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Amortization expense	$ 5,043	$ 2,437	$ 1,760

Note 5 - Goodwill and Other I_7

Note 5 - Goodwill and Other Intangibles - Estimated Amortization Expense for Each of Five Succeeding Fiscal Years (Details) $ in Thousands	Dec. 31, 2020USD ($)
2021	$ 6,179
2022	5,975
2023	5,902
2024	5,706
2025	$ 5,467

Note 6 - Revolving Line of Cr_3

Note 6 - Revolving Line of Credit and Long-term Debt (Details Textual) - Senior Secured Credit Facility [Member] - USD ($) $ in Thousands	Jun. 22, 2020	Dec. 31, 2020
Debt Instrument, Face Amount	$ 65,000
Debt Instrument, Interest Rate, Effective Percentage		4.20%
Debt Issuance Costs, Net, Total	$ 1,800
Interest Paid, Including Capitalized Interest, Operating and Investing Activities, Total		$ 900
Debt Instrument, Collateral, Percentage of Stock of Domestic Subsidiaries	100.00%
Term Loan [Member]
Debt Instrument, Face Amount	$ 40,000
Debt Instrument, Term (Year)	5 years
Repayments of Long-term Debt, Total		$ 1,000
Debt Instrument, Interest Rate, Effective Percentage		3.50%
Debt Issuance Costs, Net, Total		$ 968
Term Loan [Member] | Minimum [Member]
Debt Instrument, Periodic Payment, Total	$ 500
Term Loan [Member] | Maximum [Member]
Debt Instrument, Periodic Payment, Total	$ 1,000
Term Loan [Member] | Base Rate [Member] | Minimum [Member]
Debt Instrument, Basis Spread on Variable Rate	1.25%
Term Loan [Member] | Base Rate [Member] | Maximum [Member]
Debt Instrument, Basis Spread on Variable Rate	1.75%
Term Loan [Member] | Eurodollar [Member] | Minimum [Member]
Debt Instrument, Basis Spread on Variable Rate	2.25%
Term Loan [Member] | Eurodollar [Member] | Maximum [Member]
Debt Instrument, Basis Spread on Variable Rate	2.75%
Term Loan [Member] | Fed Funds Effective Rate Overnight Index Swap Rate [Member]
Debt Instrument, Basis Spread on Variable Rate	0.50%
Revolving Credit Facility [Member]
Line of Credit Facility, Maximum Borrowing Capacity	$ 25,000
Debt Instrument, Term (Year)	5 years
Revolving Credit Facility [Member] | Other Assets [Member]
Debt Issuance Costs, Line of Credit Arrangements, Net, Total	$ 700

Note 6 - Revolving Line of Cr_4

Note 6 - Revolving Line of Credit and Long-term Debt - Five Year Term Loan (Details) - USD ($)	Dec. 31, 2020	Dec. 31, 2019
Five-year term loan, net of unamortized debt issuance costs of $968	$ 38,032
Less current portion	(2,500,000)	$ 0
Secured Long-term Debt, Noncurrent	35,532,000	$ 0
Term Loan [Member] | Senior Secured Credit Facility [Member]
Less current portion	(2,500,000)
Secured Long-term Debt, Noncurrent	$ 35,532,000

Note 6 - Revolving Line of Cr_5

Note 6 - Revolving Line of Credit and Long-term Debt - Five Year Term Loan (Details) (Parentheticals)	Jun. 22, 2020
Term Loan [Member] | Senior Secured Credit Facility [Member]
Term (Year)	5 years

Note 6 - Revolving Line of Cr_6

Note 6 - Revolving Line of Credit and Long-term Debt - Long-term Debt Maturities (Details) - Senior Secured Credit Facility [Member] - USD ($) $ in Thousands	Dec. 31, 2020	Jun. 22, 2020
Less unamortized issuance costs		$ (1,800)
Term Loan [Member]
2021	$ 2,500
2022	3,000
2023	3,500
2024	4,000
2025	26,000
Total before unamortized issuance costs	39,000
Less unamortized issuance costs	(968)
Less current portion of long-term bebt	(2,500)
Total long-term debt	$ 35,532

Note 7 - Accrued Expenses and_3

Note 7 - Accrued Expenses and Other Long-term Liabilities - Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Compensation and related taxes	$ 8,675	$ 8,550
Income and other taxes	2,394	1,003
Professional fees	39	40
Other	6,417	4,421
Total	$ 17,525	$ 14,014

Note 7 - Accrued Expenses and_4

Note 7 - Accrued Expenses and Other Long-term Liabilities - Other Long-term Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Acquisition-related liabilities	$ 3,700	$ 3,268
Income taxes	813	781
Other	130	166
Total	$ 4,643	$ 4,215

Note 8 - Commitments and Cont_3

Note 8 - Commitments and Contingencies (Details Textual) $ in Thousands	Dec. 31, 2020USD ($)ft²
Finance Lease, Right-of-Use Asset | $	$ 0
Lessee, Operating Lease, Discount Rate	5.25%
Recorded Unconditional Purchase Obligation, Total | $	$ 5,200
Leased Automobiles [Member]
Lessee, Operating Lease, Term of Contract (Year)	3 years
North Brunswick, New Jersey [Member] | Artegraft Inc [Member]
Area of Real Estate Property (Square Foot)	16,732
CANADA
Lessee, Operating Lease, Renewal Term (Year)	5 years
Principal Worldwide Executive, Distribution, and Manufacturing Operations Facilities [Member] | Massachusetts [Member]
Area of Real Estate Property (Square Foot)	109,354
International Operations Headquarter Facility [Member] | GERMANY
Area of Real Estate Property (Square Foot)	16,470
Lessee, Operating Lease, Renewal Term (Year)	5 years
United Kingdom Sales and Distribution Business [Member] | Hereford, England [Member]
Area of Real Estate Property (Square Foot)	2,258

Note 8 - Commitments and Cont_4

Note 8 - Commitments and Contingencies - Additional Lease Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Operating lease cost	$ 1,912	$ 1,756
Short-term lease cost	192	291
Total lease cost	2,104	2,047
Cash paid for amounts included in the measurement of operating lease liabilities	2,404	1,858
Right-of-use assets obtained in exchange for new operating lease liabilities	$ 2,770	$ 10,571
Weighted average remaining lease term - operating leases (years) (Year)	7 years 9 months 18 days	8 years 3 months 18 days
Weighted average discount rate - operating leases	5.02%	5.25%

Note 8 - Commitments and Cont_5

Note 8 - Commitments and Contingencies - Minimum Rental Commitments (Details) $ in Thousands	Dec. 31, 2020USD ($)
2021	$ 2,763
2022	2,447
2023	2,064
2024	1,866
2025	1,916
Thereafter	9,920
Adjustment to net present value as of December 31, 2020	(4,230)
Minimum noncancelable lease liability	$ 16,746

Note 9 - Income Taxes (Details

Note 9 - Income Taxes (Details Textual) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Unrecognized Tax Benefits, Ending Balance	$ 820	$ 848	$ 711	$ 525
Deferred Tax Assets, Valuation Allowance, Total	1,824	1,388
Deferred Tax Assets, Operating Loss Carryforwards, Total	1,348	1,289
Deferred Tax Assets, Capital Loss Carryforwards	521	277
Foreign Tax Authority [Member] | AUSTRALIA
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount	400	$ 100
Deferred Tax Assets, Operating Loss Carryforwards, Total	1,500
Deferred Tax Assets, Capital Loss Carryforwards	1,700
Foreign Tax Authority [Member] | FRANCE
Deferred Tax Assets, Operating Loss Carryforwards, Total	2,500
Foreign Tax Authority [Member] | SPAIN
Deferred Tax Assets, Operating Loss Carryforwards, Total	900
Foreign Tax Authority [Member] | NORWAY
Deferred Tax Assets, Operating Loss Carryforwards, Total	100
State and Local Jurisdiction [Member]
Tax Credit Carryforward, Amount	$ 1,600

Note 9 - Income Taxes - Income

Note 9 - Income Taxes - Income (Loss) Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
United States	$ 25,308	$ 17,989	$ 22,256
Foreign	2,048	3,690	6,188
Total	$ 27,356	$ 21,679	$ 28,444

Note 9 - Income Taxes - The Pro

Note 9 - Income Taxes - The Provision (Benefit) for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Current:
Federal	$ 4,594	$ 1,501	$ 4,262
State	806	304	673
Foreign	1,064	1,116	2,718
Current Income Tax Expense (Benefit), Total	6,464	2,921	7,653
Deferred:
Federal	(397)	538	(1,512)
State	(48)	144	(145)
Foreign	117	142	(495)
Deferred Income Tax Expense (Benefit), Total	(328)	824	(2,152)
Provision for income taxes	$ 6,136	$ 3,745	$ 5,501

Note 9 - Income Taxes - Reconci

Note 9 - Income Taxes - Reconciliation of Beginning and Ending Amount of Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Unrecognized tax benefits at the beginning of year	$ 848	$ 711	$ 525
Additions for tax positions of current year	0	74	73
Additions for tax positions of prior years	37	63	113
Reductions for settlements with taxing authorities.	(65)	0	0
Reductions for lapses of the applicable statutes of limitations	0	0	0
Unrecognized tax benefits at the end of the year	$ 820	$ 848	$ 711

Note 9 - Income Taxes - Deferre

Note 9 - Income Taxes - Deferred Taxes (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Deferred tax assets:
Inventory	$ 1,629	$ 840
Net operating loss carryforwards	1,348	1,289
Tax credit carryforwards	1,019	944
Capital loss carryforwards	521	277
Reserves and accruals	994	787
Operating lease liabilities	3,664	3,343
Intangible assets	4,386	2,764
Stock options	359	342
Other	105	20
Total deferred tax assets	14,025	10,606
Deferred tax liabilities:
Property and equipment	(1,831)	(1,520)
Goodwill	(4,055)	(3,459)
Operating lease right-of-use assets	(3,503)	(3,224)
Foreign branch deferred offset	(954)	(923)
Other	(299)	(187)
Total deferred tax liabilities	(10,642)	(9,313)
Net deferred tax assets before valuation allowance	3,383	1,293
Valuation allowance	(1,824)	(1,388)
Net deferred tax asset	1,559	95
Net deferred tax liabiltity	(1,559)	(95)
Deferred tax classification
Deferred tax assets	1,686	1,084
Long-term deferred tax liability	(127)	(1,179)
Net long-term deferred tax liability	1,559	95
Net long-term deferred tax asset	$ (1,559)	$ (95)

Note 9 - Income Taxes - Recon_2

Note 9 - Income Taxes - Reconciliation of the Federal Statutory Rate to Effective Tax Rate (Details)	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Federal statutory rate	21.00%	21.00%	21.00%
State tax, net of federal benefit	2.20%	1.90%	1.40%
Effect of foreign taxes	1.10%	2.10%	3.80%
Federal tax on foreign income	0.40%	0.80%	1.40%
Valuation allowance	1.40%	0.60%	(3.20%)
Foreign deferred tax liability offset	(0.20%)	(0.40%)	(0.30%)
Manufacturing deduction	0.00%	0.00%	0.00%
Research & development tax credits	(0.60%)	(1.20%)	(0.70%)
Stock options	(2.30%)	(8.80%)	(3.30%)
Uncertain tax positions	0.30%	1.00%	0.80%
Other permanent differences	(0.60%)	0.50%	(0.70%)
Change in tax laws	0.00%	0.00%	0.00%
Deferred tax remeasurement	0.00%	0.00%	0.00%
Other	(0.30%)	(0.20%)	(0.90%)
Effective tax rate	22.40%	17.30%	19.30%

Note 9 - Income Taxes - Schedul

Note 9 - Income Taxes - Schedule of Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Cash paid for income taxes, net	$ 4,470	$ 4,817	$ 5,521

Note 10 - Stockholders' Equit_2

Note 10 - Stockholders' Equity (Details Textual) - USD ($) $ / shares in Units, $ in Millions	Feb. 23, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Common Stock, Shares Authorized (in shares)		37,000,000	37,000,000
Preferred Stock, Shares Authorized (in shares)		3,000,000	3,000,000
Preferred Stock, Shares Outstanding, Ending Balance (in shares)		0	0
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized (in shares)		5,500,000
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period (Year)		10 years
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in shares)		7,118,003
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant (in shares)		860,847
Share Price (in dollars per share)		$ 40.50	$ 35.95
Common Stock, Dividends, Per Share, Declared (in dollars per share)		$ 0.38	$ 0.34	$ 0.28
Subsequent Event [Member]
Common Stock, Dividends, Per Share, Declared (in dollars per share)	$ 0.11
Dividends Payable	$ 2.2
Dividends Payable, Date to be Paid	Mar. 25, 2021
Dividends Payable, Date of Record	Mar. 9, 2021
Common Stock [Member]
Treasury Stock, Shares, Acquired (in shares)
Stock Repurchase Program [Member] | Common Stock [Member]
Treasury Stock, Shares, Acquired (in shares)		0
Stock Repurchase Program [Member] | Common Stock [Member] | Subsequent Event [Member]
Stock Repurchase Program, Authorized Amount	$ 15
Share-based Payment Arrangement, Option [Member] | Share-based Payment Arrangement, Tranche One [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)		4 years
Share-based Payment Arrangement, Option [Member] | Share-based Payment Arrangement, Tranche Two [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period (Year)		5 years
Restricted Stock Units (RSUs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value		$ 1.8	$ 2.1	$ 1.9
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total		$ 10.8
Share-based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)		3 years 7 months 6 days

Note 10 - Stockholders' Equit_3

Note 10 - Stockholders' Equity - Weighted Average Assumptions (Details) - Share-based Payment Arrangement, Option [Member] - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Dividend yield	1.02%	0.96%	1.20%
Volatility	47.30%	42.80%	41.30%
Risk-free interest rate	0.30%	1.70%	2.70%
Weighted average expected option term (Year)	4 years 10 months 24 days	4 years 8 months 12 days	4 years 9 months 18 days
Weighted average fair value per share of options granted (in dollars per share)	$ 13.24	$ 12.51	$ 8.28

Note 10 - Stockholders' Equit_4

Note 10 - Stockholders' Equity - Summary of Option Activity (Details) - USD ($)		12 Months Ended				24 Months Ended
		Dec. 31, 2020		Dec. 31, 2019	[1]	Dec. 31, 2020
Outstanding (in shares)	[1]	1,047,094
Outstanding, weighted average exercise price (in dollars per share)	[1]	$ 23.19
Outstanding, weighted average contractual term (Year)		4 years 5 months 26 days	[2]	4 years 3 months 21 days
Outstanding, aggregate intrinsic value		$ 11,442,240	[2]	$ 13,366,595		$ 11,442,240	[2]
Granted (in shares)		222,110
Granted, weighted average exercise price (in dollars per share)		$ 36.67
Exercised (in shares)	[3]	(331,958)
Exercised, weighted average exercise price (in dollars per share)	[3]	$ 17.99
Exercised, aggregate intrinsic value	[3]					$ 5,413,197
Canceled / Expired (in shares)		(5,406)
Canceled / Expired, weighted average exercise price (in dollars per share)		$ 27.49
Outstanding (in shares)		931,840	[2]	1,047,094		931,840	[2]
Outstanding, weighted average exercise price (in dollars per share)		$ 28.22	[2]	$ 23.19		$ 28.22	[2]
Vested and exercisable (in shares)	[4]	274,411				274,411
Vested and exercisable, weighted average exercise price (in dollars per share)	[4]	$ 23.08				$ 23.08
Vested and exercisable, weighted average contractual term (Year)	[4]	3 years 6 months
Vested and exercisable, aggregate intrinsic value	[4]	$ 4,780,656				$ 4,780,656
Expected to vest (in shares)		657,429				657,429
Expected to vest, weighted average exercise price (in dollars per share)		$ 30.37				$ 30.37
Expected to vest, weighted average contractual term (Year)		4 years 11 months 4 days
Total (in shares)		931,840
[1]	The aggregate intrinsic value represents the difference between the exercise price and $23.64, the closing price of our stock on December 31, 2018, for all in-the-money options outstanding.
[2]	The aggregate intrinsic value represents the difference between the exercise price and $40.50, the closing price of our stock on December 31, 2020, for all in-the-money options outstanding.
[3]	The aggregate intrinsic value of shares exercised represents the difference between the exercise price and the closing price of our stock on the date of exercise.
[4]	The aggregate intrinsic value represents the difference between the exercise price and $35.95, the closing price of our stock on December 31, 2019, for all in-the-money options vested and exercisable as of that date.

Note 10 - Stockholders' Equit_5

Note 10 - Stockholders' Equity - Summary of RSU Activity (Details) - Restricted Stock Units (RSUs) [Member]	12 Months Ended
	Dec. 31, 2020$ / sharesshares
Outstanding (in shares) | shares	188,681
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 26.14
Granted (in shares) | shares	46,146
Granted, weighted average grant date fair value (in dollars per share) | $ / shares	$ 36.86
Vested (in shares) | shares	(50,669)	[1]
Vested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 22.76	[1]
Canceled (in shares) | shares	(37,143)
Canceled, weighted average grant date fair value (in dollars per share) | $ / shares	$ 27.88
Outstanding (in shares) | shares	147,015
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 30.24
[1]	The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements. The fair values of the RSUs that vested during 2020, 2019 and 2018 were $1.8 million, $2.1 million, and $1.9 million, respectively.

Note 10 - Stockholders' Equit_6

Note 10 - Stockholders' Equity - Summary of Repurchases (Details) - Restricted Stock Units (RSUs) [Member] - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019
Shares of common stock repurchased (in shares)	16,537	20,524
Average per share repurchase price (in dollars per share)	$ 34.47	$ 33.28
Aggregage purchase price (in thousands)	$ 570	$ 683

Note 10 - Stockholders' Equit_7

Note 10 - Stockholders' Equity - Stock-based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Stock-based compensation	$ 3,022	$ 2,642	$ 2,349
Cost of Sales [Member]
Stock-based compensation	333	310	272
Sales [Member]
Stock-based compensation	516	544	529
General and Administrative Expense [Member]
Stock-based compensation	1,883	1,509	1,293
Research and Development Expense [Member]
Stock-based compensation	290	279	255
Share-based Payment Arrangement, Option [Member]
Stock-based compensation	1,938	1,580	1,457
Restricted Stock Units (RSUs) [Member]
Stock-based compensation	$ 1,084	$ 1,062	$ 892

Note 10 - Stockholders' Equit_8

Note 10 - Stockholders' Equity - Dividend Activity (Details) - $ / shares	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Per share amount (in dollars per share)	$ 0.38	$ 0.34	$ 0.28
Quarterly Dividends 1 [Member]
Record date	Mar. 19, 2020	Apr. 5, 2019
Per share amount (in dollars per share)	$ 1,917	$ 1,672
Quarterly Dividends 2 [Member]
Record date	Jun. 4, 2020	Jun. 6, 2019
Per share amount (in dollars per share)	$ 1,917	$ 1,672
Quarterly Dividends 3 [Member]
Record date	Sep. 10, 2020	Sep. 5, 2019
Per share amount (in dollars per share)	$ 1,925	$ 1,691
Quarterly Dividends 4 [Member]
Record date	Dec. 3, 2020	Dec. 5, 2019
Per share amount (in dollars per share)	$ 1,936	$ 1,701

Note 11 - Profit-sharing Plan (

Note 11 - Profit-sharing Plan (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Defined Contribution, Plan Employers Matching Contribution, Annual Vesting Period (Year)	6 years
Deferred Profit Sharing [Member]
Defined Contribution Plan, Employer Discretionary Contribution Amount	$ 0.3	$ 0.4	$ 0.3

Note 12 - Segment and Enterpr_3

Note 12 - Segment and Enterprise-wide Disclosures (Details Textual)	6 Months Ended	12 Months Ended
	Jun. 30, 2020	Dec. 31, 2020
Number of Operating Segments	1	1

Note 12 - Segment and Enterpr_4

Note 12 - Segment and Enterprise-wide Disclosures - Net Sales to Unaffiliated Customers by Geography (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Net sales	$ 37,548	$ 36,416	$ 24,851	$ 30,551	$ 30,170	$ 29,100	$ 29,483	$ 28,479	$ 129,366	$ 117,232	$ 105,568
UNITED STATES
Net sales									75,222	63,130	59,078
GERMANY
Net sales									12,365	12,400	12,445
Other Countries [Member]
Net sales									$ 41,779	$ 41,702	$ 34,045

Note 12 - Segment and Enterpr_5

Note 12 - Segment and Enterprise-wide Disclosures - Long-term Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019
Long-term Assets	$ 31,102	$ 30,062
UNITED STATES
Long-term Assets	27,660	24,885
AUSTRALIA
Long-term Assets	115	1,499
FRANCE
Long-term Assets	1,140	1,089
GERMANY
Long-term Assets	1,138	1,405
Other Countries [Member]
Long-term Assets	$ 1,049	$ 1,184

Note 13 - Fair Value Measurem_3

Note 13 - Fair Value Measurements (Details Textual) - USD ($) $ in Thousands	Dec. 31, 2020	Dec. 31, 2019	Oct. 11, 2019
Artegraft Inc [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	$ 17,500
Business Combination, Contingent Consideration, Liability, Total	400
CardioCel and VascuCel Biologic Patches [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High		$ 7,800
Business Combination, Contingent Consideration, Liability, Total	2,300		$ 7,500
CardioCel and VascuCel Biologic Patches [Member] | Audited Carve-Out Financial Statements of the Acquired Business [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High		300
CardioCel and VascuCel Biologic Patches [Member] | Third Holdback [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High		2,000
Business Combination, Contingent Consideration, Liability, Total			2,000
CardioCel and VascuCel Biologic Patches [Member] | Extension of Product Shelf Life from 36 Months to 60 Months in the First Anniversary of Closing Date [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High		500
Business Combination, Contingent Consideration, Liability, Total			500
CardioCel and VascuCel Biologic Patches [Member] | Achievement of Specified Levels of Revenues [Member]
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High		$ 5,000
Fair Value, Inputs, Level 2 [Member] | Fair Value, Recurring [Member]
Assets, Fair Value Disclosure	$ 0
Fair Value, Inputs, Level 3 [Member] | CardioCel and VascuCel Biologic Patches [Member]
Business Combination, Contingent Consideration, Liability, Total			$ 2,300

Note 13 - Fair Value Measurem_4

Note 13 - Fair Value Measurements - Rollforward of the Fair Value as Determined by Level 3 (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Beginning balance	$ 1,764	$ 72	$ 1,300
Additions	406	1,989	0
Payments	0	(309)	(1,199)
Change in fair value included in earnings	70	12	(29)
Ending balance	$ 2,240	$ 1,764	$ 72

Note 14 - Accumulated Other C_3

Note 14 - Accumulated Other Comprehensive Income (Loss) - Schedule of Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Balance	$ 148,141	$ 130,235	$ 109,770
Balance	172,572	148,141	130,235
AOCI Attributable to Parent [Member]
Balance	(4,007)	(3,900)	(2,289)
Other comprehensive income (loss) before reclassifications	2,482	(107)	(1,611)
Amounts reclassified from accumulated other comprehensive loss	0	0	0
Balance	$ (1,525)	$ (4,007)	$ (3,900)

Note 15 - Quarterly Financial_3

Note 15 - Quarterly Financial Data (Unaudited) - Quarterly Financial Data (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2020	Sep. 30, 2020	Jun. 30, 2020	Mar. 31, 2020	Dec. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Total net sales	$ 37,548	$ 36,416	$ 24,851	$ 30,551	$ 30,170	$ 29,100	$ 29,483	$ 28,479	$ 129,366	$ 117,232	$ 105,568
Gross profit	24,402	22,704	17,029	20,483	19,908	20,166	20,315	19,464	84,618	79,853	73,939
Income (loss) from operations	9,545	10,018	4,872	4,353	4,928	5,905	5,915	4,435	28,788	21,183	28,209
Net income	$ 7,033	$ 7,513	$ 3,500	$ 3,174	$ 4,613	$ 5,184	$ 4,624	$ 3,513	$ 21,220	$ 17,934	$ 22,943
Basic:
Basic (in dollars per share)	$ 0.35	$ 0.37	$ 0.17	$ 0.16	$ 0.23	$ 0.26	$ 0.23	$ 0.18	$ 1.05	$ 0.91	$ 1.18
Diluted (in dollars per share)	$ 0.34	$ 0.37	$ 0.17	$ 0.16	$ 0.23	$ 0.25	$ 0.23	$ 0.17	$ 1.04	$ 0.88	$ 1.13
Total net sales	$ 37,548	$ 36,416	$ 24,851	$ 30,551	$ 30,170	$ 29,100	$ 29,483	$ 28,479	$ 129,366	$ 117,232	$ 105,568
Gross profit	24,402	22,704	17,029	20,483	19,908	20,166	20,315	19,464	84,618	79,853	73,939
Income (loss) from operations	9,545	10,018	4,872	4,353	4,928	5,905	5,915	4,435	28,788	21,183	28,209
Net income	$ 7,033	$ 7,513	$ 3,500	$ 3,174	$ 4,613	$ 5,184	$ 4,624	$ 3,513	$ 21,220	$ 17,934	$ 22,943