MiMedx (MDXG) 10-Q 30 Oct 24 2024 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2024	Oct. 21, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
Document Transition Report	false
Entity File Number	001-35887
Entity Registrant Name	MIMEDX GROUP, INC.
Entity Incorporation, State or Country Code	FL
Entity Tax Identification Number	26-2792552
Entity Address, Address Line One	1775 West Oak Commons Ct NE
Entity Address, City or Town	Marietta
Entity Address, State or Province	GA
Entity Address, Postal Zip Code	30062
City Area Code	770
Local Phone Number	651-9100
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	MDXG
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		146,946,213
Entity Central Index Key	0001376339
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 88,801	$ 82,000
Accounts receivable, net	54,030	53,871
Inventory	24,249	21,021
Prepaid expenses	2,907	5,624
Other current assets	2,152	1,745
Total current assets	172,139	164,261
Property and equipment, net	6,451	6,974
Right of use asset	2,843	2,132
Deferred tax asset, net	30,636	40,777
Goodwill	19,441	19,441
Intangible assets, net	11,201	5,257
Other assets	1,180	205
Total assets	243,891	239,047
Current liabilities:
Current portion of long term debt	1,000	1,000
Accounts payable	6,924	9,048
Accrued compensation	20,170	22,353
Accrued expenses	8,396	9,361
Current portion of Profit Share Payments (Note 12)	2,860	0
Current liabilities of discontinued operations	0	1,352
Other current liabilities	2,591	2,894
Total current liabilities	41,941	46,008
Long term debt, net	18,018	48,099
Other liabilities	2,924	2,223
Total liabilities	62,883	96,330
Commitments and contingencies (Note 12)
Stockholders' equity
Common stock; $0.001 par value; 250,000,000 shares authorized; 146,962,812 issued and outstanding at September 30, 2024 and 146,227,639 issued and outstanding at December 31, 2023	147	146
Additional paid-in capital	279,558	276,249
Accumulated deficit	(98,697)	(133,678)
Total stockholders' equity	181,008	142,717
Total liabilities and stockholders’ equity	$ 243,891	$ 239,047

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	250,000,000	250,000,000
Common stock, shares issued (in shares)	146,962,812	146,227,639
Common stock, shares outstanding (in shares)	146,962,812	146,227,639

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Net sales	$ 84,057	$ 81,712	$ 255,972	$ 234,645
Cost of sales	15,322	14,790	43,164	40,792
Gross profit	68,735	66,922	212,808	193,853
Operating expenses:
Selling, general and administrative	53,516	52,571	164,044	156,773
Research and development	2,918	3,075	8,770	10,232
Investigation, restatement and related	649	(38)	(8,741)	4,652
Amortization of intangible assets	192	190	572	570
Impairment of intangible assets	298	0	352	0
Operating income	11,162	11,124	47,811	21,626
Other expense, net
Interest income (expense), net	278	(1,680)	(1,409)	(4,864)
Other expense, net	(21)	(11)	(357)	(42)
Income from continuing operations before income tax provision	11,419	9,433	46,045	16,720
Income tax provision from continuing operations	(3,541)	(591)	(11,485)	(569)
Net income from continuing operations	7,878	8,842	34,560	16,151
Income (loss) from discontinued operations, net of tax	217	(308)	421	(11,400)
Net income	8,095	8,534	34,981	4,751
Net income available to common stockholders from continuing operations	$ 7,878	$ 7,069	$ 34,560	$ 10,967
Basic net income per common share:
Continuing operations - basic (in dollars per share)	$ 0.05	$ 0.06	$ 0.24	$ 0.09
Discontinued operations - basic (in dollars per share)	0	0	0	(0.09)
Basic net income per common share (in dollars per share)	0.05	0.06	0.24	0
Diluted net income per common share:
Continuing operations - diluted(in dollars per share)	0.05	0.06	0.23	0.09
Discontinued operations - diluted (in dollars per share)	0	0	0	(0.09)
Diluted net income per common share (in dollars per share)	$ 0.05	$ 0.06	$ 0.23	$ 0
Weighted average common shares outstanding - basic (in shares)	146,958,986	116,298,146	147,008,732	115,528,067
Weighted average shares outstanding - diluted (in shares)	148,373,631	149,773,706	148,964,788	116,893,270

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY - USD ($) $ in Thousands	Total	Common Stock Issued	Additional Paid - In Capital	Treasury Stock	Accumulated Deficit
Balance beginning of period (in shares) at Dec. 31, 2022		113,705,447
Balance, beginning of period at Dec. 31, 2022	$ (17,988)	$ 114	$ 173,804	$ 0	$ (191,906)
Treasury stock, beginning balance (in shares) at Dec. 31, 2022				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	12,793		12,793
Employee stock purchase plan (in shares)		444,809
Employee stock purchase plan	1,368		1,368
Exercise of stock options (in shares)		45,567		(17,032)
Exercise of stock options	406		294	$ 112
Issuance of restricted stock	0	$ 2	(268)	$ 266
Issuance of restricted stock (in shares)		2,163,925		(73,335)
Restricted stock shares canceled/forfeited	0		378	$ (378)
Restricted stock canceled/forfeited (in shares)				90,367
Net income	4,751				4,751
Balance end of period (in shares) at Sep. 30, 2023		116,359,748
Balance, end of period at Sep. 30, 2023	1,330	$ 116	188,369	$ 0	(187,155)
Treasury stock, ending balance (in shares) at Sep. 30, 2023				0
Balance beginning of period (in shares) at Jun. 30, 2023		116,109,125
Balance, beginning of period at Jun. 30, 2023	(12,666)	$ 116	182,907	$ 0	(195,689)
Treasury stock, beginning balance (in shares) at Jun. 30, 2023				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	4,388		4,388
Employee stock purchase plan (in shares)		209,390
Employee stock purchase plan	688		688
Exercise of stock options (in shares)		41,233		(17,032)
Exercise of stock options	386		274	$ 112
Issuance of restricted stock	0		(73)	$ 73
Issuance of restricted stock (in shares)				(11,080)
Restricted stock shares canceled/forfeited	0		185	$ (185)
Restricted stock canceled/forfeited (in shares)				28,112
Net income	8,534				8,534
Balance end of period (in shares) at Sep. 30, 2023		116,359,748
Balance, end of period at Sep. 30, 2023	$ 1,330	$ 116	188,369	$ 0	(187,155)
Treasury stock, ending balance (in shares) at Sep. 30, 2023				0
Balance beginning of period (in shares) at Dec. 31, 2023	146,227,639	146,227,639
Balance, beginning of period at Dec. 31, 2023	$ 142,717	$ 146	276,249	$ 0	(133,678)
Treasury stock, beginning balance (in shares) at Dec. 31, 2023				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	12,240		12,240
Employee stock purchase plan (in shares)		245,640
Employee stock purchase plan	1,583		1,583
Issuance of restricted stock, net (in shares)		1,481,847
Issuance of restricted stock, net	(2,611)	$ 2	(2,613)
Exercise of stock options (in shares)		207,686
Exercise of stock options	1,398		1,398
Shares received in settlement of litigation (in shares)		(1,200,000)
Shares received in settlement of litigation	(9,300)	$ (1)	(9,299)
Net income	$ 34,981				34,981
Balance end of period (in shares) at Sep. 30, 2024	146,962,812	146,962,812
Balance, end of period at Sep. 30, 2024	$ 181,008	$ 147	279,558	$ 0	(98,697)
Treasury stock, ending balance (in shares) at Sep. 30, 2024				0
Balance beginning of period (in shares) at Jun. 30, 2024		146,749,402
Balance, beginning of period at Jun. 30, 2024	168,040	$ 147	274,685	$ 0	(106,792)
Treasury stock, beginning balance (in shares) at Jun. 30, 2024				0
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Share-based compensation expense	3,810		3,810
Employee stock purchase plan (in shares)		123,857
Employee stock purchase plan	785		785
Issuance of restricted stock, net (in shares)		27,887
Issuance of restricted stock, net	(109)		(109)
Exercise of stock options (in shares)		61,666
Exercise of stock options	387		387
Net income	$ 8,095				8,095
Balance end of period (in shares) at Sep. 30, 2024	146,962,812	146,962,812
Balance, end of period at Sep. 30, 2024	$ 181,008	$ 147	$ 279,558	$ 0	$ (98,697)
Treasury stock, ending balance (in shares) at Sep. 30, 2024				0

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities:
Net income (loss) from continuing operations	$ 34,560	$ 16,151
Adjustments to reconcile net income (loss) from continuing operations to net cash flows provided by operating activities from continuing operations:
Share-based compensation	12,240	12,573
Fair value of shares received in settlement of litigation (Note 12)	(9,300)	0
Change in deferred income taxes	10,142	0
Depreciation	1,715	2,054
Loss on extinguishment of debt	1,401	0
Amortization of intangible assets	1,336	570
Non-cash lease expenses	972	959
Impairment of intangible assets	352	0
Amortization of deferred financing costs	219	373
Bad debt expense	141	737
Other	430	70
Increase (decrease) in cash resulting from changes in:
Accounts receivable	(299)	(6,659)
Inventory	(2,797)	(5,885)
Prepaid expenses	2,717	4,361
Other assets	(521)	1,024
Accounts payable	(2,123)	716
Accrued compensation	(600)	1,932
Accrued expenses	(931)	(2,268)
Other liabilities	(1,307)	(1,041)
Net cash flows provided by operating activities from continuing operations	48,347	25,667
Net cash flows used in operating activities from discontinued operations	(931)	(9,149)
Net cash flows provided by operating activities	47,416	16,518
Cash flows from investing activities:
Consideration paid pursuant to TELA APA (Note 12)	(5,366)	0
Purchases of equipment	(1,420)	(1,560)
Patent application costs	(30)	(114)
Net cash flows used in investing activities	(6,816)	(1,674)
Cash flows from financing activities:
Proceeds from Citizens Revolving Credit Facility	30,000	0
Proceeds from Citizens Term Loan Facility	19,783	0
Prepayment premium on Hayfin term loan	(500)	0
Deferred financing cost	(1,101)	0
Repayment of Hayfin term loan	(50,000)	0
Repayment of Citizens Revolving Credit Facility	(30,000)	0
Principal payments on Citizens Term Loan Facility	(750)	0
Proceeds from exercise of stock options	1,398	406
Stock repurchased for tax withholdings on vesting of restricted stock	(2,611)	0
Principal payments on finance lease	(18)	(36)
Net cash flows (used in) provided by financing activities	(33,799)	370
Net change in cash	6,801	15,214
Cash and cash equivalents, beginning of period	82,000	65,950
Cash and cash equivalents, end of period	$ 88,801	$ 81,164

Nature of Business

Nature of Business	9 Months Ended
	Sep. 30, 2024
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business	Nature of Business MiMedx Group, Inc. (together with its subsidiaries, except where the context otherwise requires, “MIMEDX,” or the “Company” ) is a pioneer and leader focused on helping humans heal. With more than a decade of helping clinicians manage chronic and other hard-to-heal wounds, MIMEDX is dedicated to providing a leading portfolio of products for applications in the wound care, burn, and surgical sectors of healthcare. The Company’s vision is to be the leading global provider of healing solutions through relentless innovation to restore quality of life. All of the Company’s products sold in the United States are regulated by the United States Food and Drug Administration ( “FDA” ). The Company’s product portfolio and product development focuses on Wound and Surgical markets. The Company’s business is focused primarily on the United States, but the Company also has an emerging commercial presence in several international locations, including Japan.

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies Please see Note 2, Significant Accounting Policies , to the Company’s Consolidated Financial Statements included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 (the “ 2023 Form 10-K ”), filed with the Securities and Exchange Commission (“ SEC ”) on February 28, 2024 for a description of all significant accounting policies. Basis of Presentation The unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three and nine months ended September 30, 2024 and 2023 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2023 was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2023 Form 10-K. Reclassifications Current portion of long term debt of $1.0 million as of December 31, 2023, which was presented in other current liabilities in previously-issued financial statements, has been reclassified to be presented in a separate line item, still within current liabilities, in the September 30, 2024 balance sheet presentation. Principles of Consolidation The condensed consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation. Use of Estimates GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported condensed consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment, estimates of impairment for goodwill and intangible assets, estimates of useful lives for intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, estimates of fair value of and the probable achievement of performance conditions associated with share-based payment awards, estimates of returns and allowances, estimate of fair value of Profit Share Payments (as defined below), and valuation of deferred tax assets. Intangible Assets, Net Intangible assets are assets which lack physical substance and (a) grant the Company with a legal right or (b) are capable of being separated and sold. Intangible assets acquired outside of a business combination are capitalized based on the cost to acquire the assets, allocated pro rata based on the fair value of the individual assets acquired. Any contingent consideration issued in connection with the acquisition of assets is capitalized at the time at which all contingencies regarding its payment are resolved. The Company amortizes the capitalized cost of finite-lived intangible assets over a period generally reflective of the anticipated contributions to cash flow generation. Amortization of intangible assets is recorded as part of cost of sales or operating expenses in the unaudited condensed consolidated statements of operations depending on the nature of the underlying intangible asset and its use in the Company’s operations. Recently Issued Accounting Standards Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“ FASB ”) issued Accounting Standards Update (“ ASU ”) 2023-07, “ Segment Reporting: Improvements to Reportable Segment Disclosures (Topic 280) ”. The standard improves disclosures about a public entity’s reportable segments and addresses requests from investors for additional, more detailed information about a reportable segment’s expenses. Additionally, ASU 2023-07 extends the disclosure requirements under Accounting Standards Codification (“ ASC ”) Topic 280 to entities with a single reportable segment. ASU 2023-07 is effective for annual reporting periods beginning after December 15, 2023, and interim periods in fiscal years beginning after December 15, 2024. As of September 30, 2024, the Company is evaluating the impact of this standard on its consolidated financial statements. In December 2023, the FASB issued ASU 2023-09, “ Improvement to Income Tax Disclosures (Topic 740) ”, which requires additional disclosures for income tax rate reconciliations, income taxes paid, and certain other tax disclosures. ASU 2023-09 is intended to enhance the transparency and decision usefulness of income tax disclosures. The amendments in ASU 2023-09 address investor requests for enhanced income tax information primarily through changes to the rate reconciliation and income taxes paid information. Adoption is required for annual periods beginning after December 15, 2024. The Company is currently evaluating the impact of this standard on its consolidated financial statements and related disclosures.

Accounts Receivable, Net

Accounts Receivable, Net	9 Months Ended
	Sep. 30, 2024
Receivables [Abstract]
Accounts Receivable, Net	Accounts Receivable, Net Accounts receivable, net, consisted of the following (in thousands): September 30, 2024 December 31, 2023 Accounts receivable, gross $ 56,797 $ 57,015 Less: allowance for doubtful accounts (2,767) (3,144) Accounts receivable, net $ 54,030 $ 53,871 Activity related to the Company’s allowance for doubtful accounts for the three months ended September 30, 2024 and 2023 were as follows (in thousands): 2024 2023 Balance at July 1 $ 3,269 $ 2,196 Bad debt (reversal) expense (279) 447 Write-offs (223) (69) Balance at September 30 $ 2,767 $ 2,574 Activity related to the Company’s allowance for doubtful accounts for the nine months ended September 30, 2024 and 2023 were as follows (in thousands): 2024 2023 Balance at January 1 $ 3,144 3,783 Bad debt expense 141 737 Write-offs (518) (1,946) Balance at September 30 $ 2,767 $ 2,574

Inventory

Inventory	9 Months Ended
	Sep. 30, 2024
Inventory Disclosure [Abstract]
Inventory	Inventory Inventory consisted of the following (in thousands): September 30, 2024 December 31, 2023 Raw materials $ 781 $ 825 Work in process 9,279 8,521 Finished goods 14,189 11,675 Inventory $ 24,249 $ 21,021

Property and Equipment, Net

Property and Equipment, Net	9 Months Ended
	Sep. 30, 2024
Property, Plant and Equipment [Abstract]
Property and Equipment, Net	Property and Equipment, Net Property and equipment, net, consisted of the following (in thousands): September 30, 2024 December 31, 2023 Laboratory and clean room equipment $ 15,568 $ 13,954 Furniture and equipment 1,972 1,989 Leasehold improvements 8,199 8,141 Construction in progress 910 1,791 Asset retirement cost 881 938 Finance lease right-of-use asset 189 189 Property and equipment, gross 27,719 27,002 Less: accumulated depreciation and amortization (21,268) (20,028) Property and equipment, net $ 6,451 $ 6,974

Intangible Assets, Net

Intangible Assets, Net	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible Assets, Net	Intangible Assets, Net Intangible assets, net, are summarized as follows (in thousands): September 30, 2024 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 10,207 $ (8,307) $ 1,900 $ 10,039 $ (7,818) $ 2,221 Licenses 1,000 (92) 908 1,000 (54) $ 946 Distribution rights 7,659 (765) 6,894 — — — Total amortized intangible assets $ 18,866 $ (9,164) $ 9,702 $ 11,039 $ (7,872) $ 3,167 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 491 491 1,082 1,082 Total intangible assets $ 20,365 $ 11,201 $ 13,129 $ 5,257 The Company recognized $0.3 million and $0.4 million of impairment of intangible assets during the three and nine months ended September 30, 2024, respectively, related to abandoned patents. Expected future amortization of intangible assets as of September 30, 2024, is as follows (in thousands): Year ending December 31, Estimated 2024 (excluding the nine months ended September 30, 2024) $ 577 2025 1,912 2026 1,757 2027 1,757 2028 1,755 Thereafter 1,944 Total amortized intangible assets $ 9,702

Accrued Expenses

Accrued Expenses	9 Months Ended
	Sep. 30, 2024
Payables and Accruals [Abstract]
Accrued Expenses	Accrued Expenses Accrued expenses consisted of the following (in thousands): September 30, 2024 December 31, 2023 Commissions to sales agents $ 3,154 $ 4,136 Accrued rebates 1,806 745 Estimated sales returns 912 1,096 Legal and settlement costs 756 834 Accrued group purchasing organization fees 688 1,338 Accrued travel 587 433 Other 493 779 Accrued expenses $ 8,396 $ 9,361

Long Term Debt, Net

Long Term Debt, Net	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Long Term Debt, Net	Long Term Debt, Net Citizens Credit Agreement On January 19, 2024 (the “ Closing Date ”), the Company entered into a Credit Agreement (the “ Citizens Credit Agreement ”) with certain lenders party thereto, and Citizens Bank, N.A., as administrative agent (the “ Agent ”). The Citizens Credit Agreement provides for senior secured credit facilities in an aggregate principal amount of up to $95.0 million consisting of: (i) a $75.0 million senior secured revolving credit facility (the “ Revolving Credit Facility ”) with a $10.0 million letter of credit sublimit and a $10.0 million swingline loan sublimit, and (ii) a $20.0 million senior secured term loan facility (the “ Term Loan Facility ” and, together with the Revolving Credit Facility, the “ Credit Facilities ”). All obligations are required to be paid in full on January 19, 2029 (the “ Maturity Date ”). The Company has the option to obtain one or more incremental Term Loan Facilities and/or increase the commitments under the Revolving Credit Facility in an aggregate principal amount equal to the greater of (i) $50.0 million and (ii) 1.00 times the Company’s Consolidated EBITDA (as defined therein), each subject to the existing or any new lenders’ election to extend additional term loans or revolving commitments. At the Company’s option, borrowings under the Citizens Credit Agreement (other than any swingline loan) will bear interest at a rate per annum equal to (i) the Alternate Base Rate, as defined therein, or (ii) a Term SOFR as defined therein, in each case plus an applicable margin ranging from 1.25% and 2.50% with respect to Alternate Base Rate borrowings and 2.25% and 3.50% for Term SOFR borrowings, plus a fallback provision of 0.1%. Swingline loans will bear interest at a rate per annum equal to one-month Term SOFR plus the applicable margin. The applicable margin will be determined based on the Company’s consolidated total net leverage ratio. The Company is required to pay a quarterly commitment fee on any unused portion of the Revolving Credit Facility, letter of credit fees, and other customary fees to the Agent and the Lenders. The Term Loan Facility will amortize on a quarterly basis at 1.25% (for year one and two), 1.88% (for year three and four), and 2.5% (for year five) based on the aggregate principal amount outstanding under the Term Loan Facility on the Closing Date, with the remainder due on the Maturity Date. The Company must make mandatory prepayments in connection with certain asset dispositions and casualty events, subject in each case to customary reinvestment rights. The Company may prepay borrowings under the Credit Facilities at any time, without premium or penalty, and may, at its option, reduce the aggregate unused commitments under the Revolving Credit Facility in whole or in part, in each case subject to the terms of the Credit Agreement. The Company must also comply with certain financial covenants, including a maximum total net leverage ratio and a minimum consolidated fixed charge coverage ratio, as well as other customary restrictive covenants. As of September 30, 2024, the Company is in compliance with all financial covenants under the Citizens Credit Agreement. On the Closing Date, the Company borrowed $30.0 million under the Revolving Credit Facility and $20.0 million under the Term Loan Facility. Proceeds from the initial drawings under the Credit Facilities together with cash on hand were used to repay in full the $50.0 million principal amount and other outstanding obligations under the Company’s prior senior secured term loan with Hayfin (the “Hayfin Term Loan ”) and to pay related fees, premiums, costs and expenses. The Company recorded a loss on extinguishment of debt of $1.4 million. This amount is reflected as a part of interest expense, net on the unaudited condensed consolidated statement of operations for the nine months ended September 30, 2024. The composition of the loss on extinguishment of debt was as follows (amounts in thousands): January 19, 2024 Unamortized deferred financing costs $ 781 Unamortized original issue discount 120 Prepayment premium 500 Loss on extinguishment of debt $ 1,401 In addition, on February 27, 2024, the Company repaid the initial $30.0 million drawing under the Revolving Credit Facility and had no outstanding borrowings under this facility as of September 30, 2024. Deferred financing costs and original issue discount allocated to the Revolving Credit Facility are amortized straight-line through the expiration of the commitment term. The Revolving Credit Facility is currently subject to a commitment fee of 0.25% per annum of the amount undrawn, which is recognized as interest expense. Original issue discount and deferred financing costs incurred as part of the Credit Facilities were allocated between the Term Loan Facility and the Revolving Credit Facility on the basis of the maximum potential principal outstanding permitted under the Citizens Credit Agreement. The allocation of the deferred financing costs and original issue discount between the Term Loan Facility and the Revolving Credit Facility were as follows (in thousands): January 19, 2024 Term Loan Facility Revolving Credit Facility Total Long term debt, net Other assets Original issue discount $ 224 $ 839 $ 1,063 Deferred financing costs 54 202 256 The balances of the Term Loan Facility as of September 30, 2024 and the Hayfin Term Loan as of December 31, 2023 were as follows (in thousands): September 30, 2024 December 31, 2023 Current portion of long term debt Long term debt, net Current portion of long term debt Long term debt, net Outstanding principal $ 1,000 $ 18,250 $ 1,000 $ 49,000 Deferred financing costs — (42) — (781) Original issue discount — (190) — (120) Long term debt, net $ 1,000 $ 18,018 $ 1,000 $ 48,099 The Term Loan Facility bears interest at a rate per annum equal to (i) the Alternate Base Rate, as defined therein, or (ii) a Term SOFR, as defined therein, in each case plus an applicable margin ranging from 1.25% and 2.50% with respect to Alternate Base Rate borrowings and 2.25% and 3.50% for Term SOFR borrowings, plus a fallback provision of 0.1%. The applicable margin is determined based on the Company’s consolidated total net leverage ratio. The Term Loan Facility carried an interest rate of 7.9% as of September 30, 2024. Interest expense related to the Term Loan Facility and the Hayfin Term Loan included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Stated interest $ 393 $ 1,554 1,451 $ 4,498 Amortization of deferred financing costs 5 111 38 323 Accretion of original issue discount 12 17 36 50 Interest expense $ 410 $ 1,682 $ 1,525 $ 4,871 Interest expense related to the Revolving Credit Facility included in Interest income (expense), net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2024 Commitment fee $ 47 $ 125 Amortization of deferred financing costs 16 47 Accretion of original issue discount 42 126 Interest expense $ 105 $ 298 A summary of principal payments due on the Term Loan Facility, by year, from September 30, 2024 through maturity are as follows (in thousands): Year ending December 31, Principal 2024 (excluding the nine months ended September 30, 2024) $ 250 2025 1,000 2026 1,500 2027 1,500 2028 2,000 Thereafter 13,000 Outstanding principal $ 19,250 As of September 30, 2024, the fair value of the Term Loan Facility was $19.7 million. This valuation was calculated based on a series of Level 2 and Level 3 inputs, including a discount rate based on the credit risk spread of debt instruments of similar risk character in reference to U.S. Treasury instruments with similar maturities, with an incremental risk premium for risk factors specific to the Company. Fair value was calculated by discounting the remaining cash flows associated with the Term Loan Facility to September 30, 2024 using this discount rate.

Net Income Per Common Share

Net Income Per Common Share	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Net Income Per Common Share	Net Income Per Common Share Net income per common share is calculated using two methods: basic and diluted. Basic Net Income Per Common Share The following table provides a reconciliation of net income from continuing operations and calculation of basic net income (loss) per common share for each of the three and nine months ended September 30, 2024 and 2023 (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Net income from continuing operations $ 7,878 $ 8,842 $ 34,560 $ 16,151 Income (loss) from discontinued operations, net of tax 217 (308) 421 (11,400) Net income 8,095 8,534 34,981 4,751 Accumulated dividend on previously converted Series B Preferred Stock — 1,773 — 5,184 Net income available to common stockholders from continuing operations $ 7,878 $ 7,069 $ 34,560 $ 10,967 Weighted average common shares outstanding 146,958,986 116,298,146 147,008,732 115,528,067 Basic net income (loss) per common share: Continuing operations $ 0.05 $ 0.06 $ 0.24 $ 0.09 Discontinued operations 0.00 (0.00) 0.00 (0.09) Basic net income per common share $ 0.05 $ 0.06 $ 0.24 $ 0.00 Diluted Net Income Per Common Share The following table sets forth the computation of diluted net income per common share (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Net income available to common stockholders from continuing operations $ 7,878 $ 7,069 $ 34,560 $ 10,967 Adjustments: Dividends on Series B Preferred Stock — 1,773 — 5,184 Less: antidilutive adjustments — — — (5,184) Total adjustments — 1,773 — — Numerator Net income available to common stockholders from continuing operations 7,878 8,842 34,560 10,967 Income (loss) from discontinued operations, net of tax 217 (308) 421 (11,400) Weighted average shares outstanding 146,958,986 116,298,146 147,008,732 115,528,067 Adjustments: Potential common shares (a) Series B Preferred Stock — 30,445,997 — — Restricted stock unit awards 881,237 1,845,832 1,433,335 1,219,776 Outstanding stock options 394,767 1,131,410 450,168 107,897 Performance stock unit awards 114,050 35,441 57,629 13,425 Employee stock purchase plan 24,591 1,113 14,924 372 Restricted stock awards — 15,767 — 23,733 Total adjustments 1,414,645 33,475,560 1,956,056 1,365,203 Weighted average shares outstanding adjusted for potential common shares 148,373,631 149,773,706 148,964,788 116,893,270 Diluted net income (loss) per common share: Continuing operations $ 0.05 $ 0.06 $ 0.23 $ 0.09 Discontinued operations 0.00 (0.00) $ 0.00 (0.09) Diluted net income per common share $ 0.05 $ 0.06 $ 0.23 $ 0.00 (a) Weighted average common shares outstanding for the calculation of diluted net income per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented. Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Series B Preferred Stock — — — 29,559,946

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes On a continuing operations basis, the effective tax rates for the Company were 31.0% and 6.3% for the three months ended September 30, 2024 and 2023, respectively. On a continuing operating basis, the effective tax rates for the Company were 24.9% and 3.4% for the nine months ended September 30, 2024 and 2023, respectively. Effective tax rates for the three and nine months ended September 30, 2023 were impacted by a full valuation allowance against the Company’s deferred tax assets. During the fourth quarter of 2023, the Company concluded that it was no longer in a cumulative three-year loss on a continuing operations basis, after excluding the effects of permanent book-tax differences. The absence of such negative evidence, coupled with its expectations for future taxable income generation, led to a change in the Company’s assessment of the realizability of its deferred tax assets. Consequently, effective tax rates for the three and nine months ended September 30, 2024 were not influenced by a valuation allowance.

Supplemental Disclosure of Cash

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	9 Months Ended
	Sep. 30, 2024
Supplemental Cash Flow Elements [Abstract]
Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Nine Months Ended September 30, 2024 2023 Cash paid for interest $ 2,297 $ 4,496 Cash paid for income taxes 4,833 210 Non-cash activities: Fair value of shares received in settlement of litigation 9,300 — Minimum Profit Share Payments pursuant to TELA APA 2,731 — Right of use assets arising from operating lease liabilities 1,820 — Issuance of shares pursuant to employee stock purchase plan 1,583 1,368 Purchases of equipment in accounts payable — 126

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies TELA and Regenity Agreements On March 15, 2024, the Company entered into an Asset Purchase Agreement (the “ TELA APA ”) with TELA Bio, Inc. ( “TELA” ) to obtain exclusive rights to sell and market a 510(k)-cleared collagen particulate xenograft product in the United States. TELA held these rights pursuant to a Manufacturing and Supply Agreement (the “TELA-Regenity Supply Agreement” ) between TELA and Regenity Biosciences, Inc. (“ Regenity ”), which retains all intellectual property rights and regulatory clearances related to the product. Pursuant to the TELA APA, the Company paid $5.0 million of initial consideration to TELA; additionally, the Company paid $0.4 million to acquire TELA’s remaining product inventory, and will be required to make additional payments (the “ Profit Share Payments ”) of between a minimum of $3.0 million and a maximum of $7.0 million based on MIMEDX’s net sales of the product over the two years following its commercialization of the product, which occurred during the second quarter of 2024. In connection with the execution of the TELA APA, the Company was able to renegotiate the terms of the TELA-Regenity Supply Agreement, ultimately replacing it with a new Manufacturing and Supply Agreement (the “ Supply Agreement ”) with Regenity. The Supply Agreement maintains MIMEDX’s exclusive right to sell and market the product in the United States. The transaction was accounted for as an acquisition of assets, as substantially all the fair value of the acquired assets was concentrated in the acquired exclusive distribution rights. The cost to acquire the assets on the transaction date was $8.1 million, reflecting the $5.0 million of initial consideration, $0.4 million to acquire inventory, and $2.7 million, which represented the fair value of the minimum amount of the Profit Share Payments. These costs were allocated amongst the assets acquired. The Company assigned $7.6 million to the distribution rights acquired and $0.5 million to inventory. The amount ascribed to the distribution rights will be amortized over five years, generally reflective of the period of time over which the distribution rights are anticipated to contribute to cash flow generation. Any Profit Share Payments exceeding the $3.0 million minimum will be capitalized in the period incurred as a part of the acquired assets and amortized over the remaining life of such assets. Litigation and Regulatory Matters In the ordinary course of business, the Company and its subsidiaries may be a party to pending and threatened legal, regulatory, and governmental actions and proceedings (including those described below). In view of the inherent difficulty of predicting the outcome of such matters, particularly where the plaintiffs or claimants seek very large or indeterminate damages or where the matters present novel legal theories or involve a large number of parties, the Company generally cannot predict what the eventual outcome of the pending matters will be, what the timing of the ultimate resolution of these matters will be, or what the eventual recovery, loss, fines or penalties related to each pending matter may be. The Company's unaudited condensed consolidated balance sheet as of September 30, 2024 reflects the Company's current best estimate of probable losses associated with these matters, including costs to comply with various settlement agreements, where applicable. For more information regarding the Company’s legal proceedings, refer to Note 16, “ Commitments and Contingencies ” in the 2023 Form 10-K. The Company has no accrual for potential losses related to legal matters as of September 30, 2024. The Company made $0.6 million payments toward the resolution of legal matters involving the Company during the nine months ended September 30, 2024. The Company paid $0.2 million toward the resolution of legal matters during the nine months ended September 30, 2023. In addition, in the quarter ended June 30, 2024, the Company received 1.2 million shares of its own common stock in the settlement of certain legal matters. The Company accounted for the repayment of shares as a loss recovery, as the repayment related to the recoupment of legal fees previously incurred, but not in excess of the amount originally recorded. The Company recorded $9.3 million, reflecting the fair value of the returned shares on the date of the prevailing agreement, as a reduction to investigation, restatement and related expense on the unaudited condensed consolidated statements of operations, where the legal fees to which this recovery originally related were recorded as they were incurred, for the nine months ended September 30, 2024. The following is a description of certain litigation and regulatory matters to which the Company is a party: AXIOFILL

Revenue

Revenue	9 Months Ended
	Sep. 30, 2024
Revenue from Contract with Customer [Abstract]
Revenue	Revenue Net Sales by Site of Service MIMEDX has three main sites of service for its products (1) Hospital settings and wound care clinics, which are stable reimbursement settings in which products are used for both wound and surgical applications, (2) Private offices, which generally represents doctors and practitioners with independent operations treating wound patients, and (3) Other, which includes federal facilities, international sales, and other sites of service using products for both wound and surgical applications. Below is a summary of net sales by site of service (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Hospital $ 46,034 $ 47,350 $ 137,174 $ 136,108 Private Office 25,585 22,951 82,874 68,188 Other 12,438 11,411 35,924 30,349 Total $ 84,057 $ 81,712 $ 255,972 234,645 Net Sales by Product Category MIMEDX has two product categories: (1) Wound, which reflects products typically used in Advanced Wound Care settings, including the treatment of chronic, non-healing wounds, and (2) Surgical, which reflects products principally used in surgical settings, including the closure of acute wounds or to protect and reinforce tissues and/or regions of interest. The Company manages its product portfolio and pipeline based upon opportunities in each of these settings. Below is a summary of net sales by product line (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Wound $ 55,052 $ 51,156 $ 169,647 $ 149,681 Surgical 29,005 30,556 86,325 84,964 Total $ 84,057 $ 81,712 $ 255,972 $ 234,645 The Company did not have significant foreign operations or a single external customer from which 10% or more of revenues were derived during the three or nine months ended September 30, 2024 or 2023.

Discontinued Operations

Discontinued Operations	9 Months Ended
	Sep. 30, 2024
Discontinued Operations and Disposal Groups [Abstract]
Discontinued Operations	Discontinued Operations Disbanding of Regenerative Medicine Business Unit In the second quarter of 2023, the Company announced the disbanding of its Regenerative Medicine reportable segment and the suspension of its Knee Osteoarthritis clinical trial program. The announcement reflected the abandonment of the Company’s efforts to pursue a Biological License Application for its micronized dehydrated human amnion chorion membrane product and a major definitive strategic shift in the Company’s focus towards its continuing commercial pipeline as its primary source of value creation. The Company completed the regulatory obligations associated with the clinical trial during the fourth quarter of 2023, at which time material run-off operations had ceased and Regenerative Medicine met the criteria for presentation as a discontinued operation. Financial Statement Impact of Discontinued Operations The income and expenses of the discontinued operation have been classified as income (loss) from discontinued operations in the consolidated statements of operations for the three and nine months ended September 30, 2024 and 2023 as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Selling, general and administrative expense $ (217) $ — $ (221) $ — Research and development expense — 100 (200) 7,937 Restructuring expense — 208 — 3,463 Income (loss) from discontinued operations $ 217 $ (308) $ 421 $ (11,400)

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net Income (Loss)	$ 8,095	$ 8,534	$ 34,981	$ 4,751

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation	Basis of Presentation The unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“ GAAP ”) for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by GAAP for complete financial statements. In the opinion of management, all adjustments considered necessary for a fair presentation of the results of operations for the periods presented have been included. The operating results for the three and nine months ended September 30, 2024 and 2023 are not necessarily indicative of the results that may be expected for the full fiscal year. The balance sheet as of December 31, 2023 was derived from the audited consolidated financial statements at that date, but does not include all of the information and footnotes required by GAAP for complete financial statements. These unaudited condensed consolidated financial statements should be read in conjunction with the historical consolidated financial statements of the Company included in the 2023 Form 10-K.
Reclassifications	Reclassifications Current portion of long term debt of $1.0 million as of December 31, 2023, which was presented in other current liabilities in previously-issued financial statements, has been reclassified to be presented in a separate line item, still within current liabilities, in the September 30, 2024 balance sheet presentation.
Principles of Consolidation	Principles of Consolidation The condensed consolidated financial statements include the accounts of MiMedx Group, Inc. and its wholly-owned subsidiaries. All intercompany balances and transactions have been eliminated upon consolidation.
Use of Estimates	Use of Estimates GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the condensed consolidated financial statements and the reported condensed consolidated statements of operations during the reporting period. Actual results could differ from those estimates. Significant estimates include estimated useful lives and potential impairment of property and equipment, estimates of impairment for goodwill and intangible assets, estimates of useful lives for intangible assets, estimates of loss for contingent liabilities, estimate of allowance for doubtful accounts, estimates of fair value of and the probable achievement of performance conditions associated with share-based payment awards, estimates of returns and allowances, estimate of fair value of Profit Share Payments (as defined below), and valuation of deferred tax assets.
Intangible Assets, Net	Intangible Assets, Net Intangible assets are assets which lack physical substance and (a) grant the Company with a legal right or (b) are capable of being separated and sold. Intangible assets acquired outside of a business combination are capitalized based on the cost to acquire the assets, allocated pro rata based on the fair value of the individual assets acquired. Any contingent consideration issued in connection with the acquisition of assets is capitalized at the time at which all contingencies regarding its payment are resolved. The Company amortizes the capitalized cost of finite-lived intangible assets over a period generally reflective of the anticipated contributions to cash flow generation. Amortization of intangible assets is recorded as part of cost of sales or operating expenses in the unaudited condensed consolidated statements of operations depending on the nature of the underlying intangible asset and its use in the Company’s operations.
Recently Issued Accounting Standards Not Yet Adopted	Recently Issued Accounting Standards Not Yet Adopted In November 2023, the Financial Accounting Standards Board (“ FASB ”) issued Accounting Standards Update (“ ASU ”) 2023-07, “ Segment Reporting: Improvements to Reportable Segment Disclosures (Topic 280) ”. The standard improves disclosures about a public entity’s reportable segments and addresses requests from investors for additional, more detailed information about a reportable segment’s expenses. Additionally, ASU 2023-07 extends the disclosure requirements under Accounting Standards Codification (“ ASC ”) Topic 280 to entities with a single reportable segment. ASU 2023-07 is effective for annual reporting periods beginning after December 15, 2023, and interim periods in fiscal years beginning after December 15, 2024. As of September 30, 2024, the Company is evaluating the impact of this standard on its consolidated financial statements. In December 2023, the FASB issued ASU 2023-09, “ Improvement to Income Tax Disclosures (Topic 740) ”, which requires additional disclosures for income tax rate reconciliations, income taxes paid, and certain other tax disclosures. ASU 2023-09 is intended to enhance the transparency and decision usefulness of income tax disclosures. The amendments in ASU 2023-09 address investor requests for enhanced income tax information primarily through changes to the rate reconciliation and income taxes paid information. Adoption is required for annual periods beginning after December 15, 2024. The Company is currently evaluating the impact of this standard on its consolidated financial statements and related disclosures.

Accounts Receivable, Net (Table

Accounts Receivable, Net (Tables)	9 Months Ended
	Sep. 30, 2024
Receivables [Abstract]
Schedule of Accounts Receivable	Accounts receivable, net, consisted of the following (in thousands): September 30, 2024 December 31, 2023 Accounts receivable, gross $ 56,797 $ 57,015 Less: allowance for doubtful accounts (2,767) (3,144) Accounts receivable, net $ 54,030 $ 53,871
Schedule of Activity Related to the Allowance for Doubtful Accounts	Activity related to the Company’s allowance for doubtful accounts for the three months ended September 30, 2024 and 2023 were as follows (in thousands): 2024 2023 Balance at July 1 $ 3,269 $ 2,196 Bad debt (reversal) expense (279) 447 Write-offs (223) (69) Balance at September 30 $ 2,767 $ 2,574 Activity related to the Company’s allowance for doubtful accounts for the nine months ended September 30, 2024 and 2023 were as follows (in thousands): 2024 2023 Balance at January 1 $ 3,144 3,783 Bad debt expense 141 737 Write-offs (518) (1,946) Balance at September 30 $ 2,767 $ 2,574

Inventory (Tables)

Inventory (Tables)	9 Months Ended
	Sep. 30, 2024
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventory consisted of the following (in thousands): September 30, 2024 December 31, 2023 Raw materials $ 781 $ 825 Work in process 9,279 8,521 Finished goods 14,189 11,675 Inventory $ 24,249 $ 21,021

Property and Equipment, Net (Ta

Property and Equipment, Net (Tables)	9 Months Ended
	Sep. 30, 2024
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment, net, consisted of the following (in thousands): September 30, 2024 December 31, 2023 Laboratory and clean room equipment $ 15,568 $ 13,954 Furniture and equipment 1,972 1,989 Leasehold improvements 8,199 8,141 Construction in progress 910 1,791 Asset retirement cost 881 938 Finance lease right-of-use asset 189 189 Property and equipment, gross 27,719 27,002 Less: accumulated depreciation and amortization (21,268) (20,028) Property and equipment, net $ 6,451 $ 6,974

Intangible Assets, Net (Tables)

Intangible Assets, Net (Tables)	9 Months Ended
	Sep. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets Activity Summary - Indefinite-lived	Intangible assets, net, are summarized as follows (in thousands): September 30, 2024 December 31, 2023 Gross Carrying Amount Accumulated Amortization Net Carrying Amount Gross Carrying Amount Accumulated Amortization Net Carrying Amount Amortized intangible assets Patents and know-how $ 10,207 $ (8,307) $ 1,900 $ 10,039 $ (7,818) $ 2,221 Licenses 1,000 (92) 908 1,000 (54) $ 946 Distribution rights 7,659 (765) 6,894 — — — Total amortized intangible assets $ 18,866 $ (9,164) $ 9,702 $ 11,039 $ (7,872) $ 3,167 Unamortized intangible assets: Tradenames and trademarks $ 1,008 $ 1,008 $ 1,008 $ 1,008 Patents in Process 491 491 1,082 1,082 Total intangible assets $ 20,365 $ 11,201 $ 13,129 $ 5,257
Schedule of Estimated Future Amortization Expense for Intangible Assets	Expected future amortization of intangible assets as of September 30, 2024, is as follows (in thousands): Year ending December 31, Estimated 2024 (excluding the nine months ended September 30, 2024) $ 577 2025 1,912 2026 1,757 2027 1,757 2028 1,755 Thereafter 1,944 Total amortized intangible assets $ 9,702

Accrued Expenses (Tables)

Accrued Expenses (Tables)	9 Months Ended
	Sep. 30, 2024
Payables and Accruals [Abstract]
Schedule of Accrued Liabilities	Accrued expenses consisted of the following (in thousands): September 30, 2024 December 31, 2023 Commissions to sales agents $ 3,154 $ 4,136 Accrued rebates 1,806 745 Estimated sales returns 912 1,096 Legal and settlement costs 756 834 Accrued group purchasing organization fees 688 1,338 Accrued travel 587 433 Other 493 779 Accrued expenses $ 8,396 $ 9,361

Long Term Debt, Net (Tables)

Long Term Debt, Net (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Schedule of Extinguishment of Debt	The composition of the loss on extinguishment of debt was as follows (amounts in thousands): January 19, 2024 Unamortized deferred financing costs $ 781 Unamortized original issue discount 120 Prepayment premium 500 Loss on extinguishment of debt $ 1,401
Schedule of Original Discount and Deferred Financing Costs	Original issue discount and deferred financing costs incurred as part of the Credit Facilities were allocated between the Term Loan Facility and the Revolving Credit Facility on the basis of the maximum potential principal outstanding permitted under the Citizens Credit Agreement. The allocation of the deferred financing costs and original issue discount between the Term Loan Facility and the Revolving Credit Facility were as follows (in thousands): January 19, 2024 Term Loan Facility Revolving Credit Facility Total Long term debt, net Other assets Original issue discount $ 224 $ 839 $ 1,063 Deferred financing costs 54 202 256
Schedule of the Balances of the Loan Facility and Agreement	The balances of the Term Loan Facility as of September 30, 2024 and the Hayfin Term Loan as of December 31, 2023 were as follows (in thousands): September 30, 2024 December 31, 2023 Current portion of long term debt Long term debt, net Current portion of long term debt Long term debt, net Outstanding principal $ 1,000 $ 18,250 $ 1,000 $ 49,000 Deferred financing costs — (42) — (781) Original issue discount — (190) — (120) Long term debt, net $ 1,000 $ 18,018 $ 1,000 $ 48,099
Schedule of Interest Expense	Interest expense related to the Term Loan Facility and the Hayfin Term Loan included in interest expense, net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Stated interest $ 393 $ 1,554 1,451 $ 4,498 Amortization of deferred financing costs 5 111 38 323 Accretion of original issue discount 12 17 36 50 Interest expense $ 410 $ 1,682 $ 1,525 $ 4,871 Interest expense related to the Revolving Credit Facility included in Interest income (expense), net in the unaudited condensed consolidated statements of operations, was as follows (amounts in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2024 Commitment fee $ 47 $ 125 Amortization of deferred financing costs 16 47 Accretion of original issue discount 42 126 Interest expense $ 105 $ 298
Schedule of Principal Payments for the Term Loan Facility	A summary of principal payments due on the Term Loan Facility, by year, from September 30, 2024 through maturity are as follows (in thousands): Year ending December 31, Principal 2024 (excluding the nine months ended September 30, 2024) $ 250 2025 1,000 2026 1,500 2027 1,500 2028 2,000 Thereafter 13,000 Outstanding principal $ 19,250

Net Income Per Common Share (Ta

Net Income Per Common Share (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Basic Net Income Per Common Share	The following table provides a reconciliation of net income from continuing operations and calculation of basic net income (loss) per common share for each of the three and nine months ended September 30, 2024 and 2023 (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Net income from continuing operations $ 7,878 $ 8,842 $ 34,560 $ 16,151 Income (loss) from discontinued operations, net of tax 217 (308) 421 (11,400) Net income 8,095 8,534 34,981 4,751 Accumulated dividend on previously converted Series B Preferred Stock — 1,773 — 5,184 Net income available to common stockholders from continuing operations $ 7,878 $ 7,069 $ 34,560 $ 10,967 Weighted average common shares outstanding 146,958,986 116,298,146 147,008,732 115,528,067 Basic net income (loss) per common share: Continuing operations $ 0.05 $ 0.06 $ 0.24 $ 0.09 Discontinued operations 0.00 (0.00) 0.00 (0.09) Basic net income per common share $ 0.05 $ 0.06 $ 0.24 $ 0.00
Diluted Net Income Per Common Share	The following table sets forth the computation of diluted net income per common share (in thousands, except share and per share amounts): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Net income available to common stockholders from continuing operations $ 7,878 $ 7,069 $ 34,560 $ 10,967 Adjustments: Dividends on Series B Preferred Stock — 1,773 — 5,184 Less: antidilutive adjustments — — — (5,184) Total adjustments — 1,773 — — Numerator Net income available to common stockholders from continuing operations 7,878 8,842 34,560 10,967 Income (loss) from discontinued operations, net of tax 217 (308) 421 (11,400) Weighted average shares outstanding 146,958,986 116,298,146 147,008,732 115,528,067 Adjustments: Potential common shares (a) Series B Preferred Stock — 30,445,997 — — Restricted stock unit awards 881,237 1,845,832 1,433,335 1,219,776 Outstanding stock options 394,767 1,131,410 450,168 107,897 Performance stock unit awards 114,050 35,441 57,629 13,425 Employee stock purchase plan 24,591 1,113 14,924 372 Restricted stock awards — 15,767 — 23,733 Total adjustments 1,414,645 33,475,560 1,956,056 1,365,203 Weighted average shares outstanding adjusted for potential common shares 148,373,631 149,773,706 148,964,788 116,893,270 Diluted net income (loss) per common share: Continuing operations $ 0.05 $ 0.06 $ 0.23 $ 0.09 Discontinued operations 0.00 (0.00) $ 0.00 (0.09) Diluted net income per common share $ 0.05 $ 0.06 $ 0.23 $ 0.00 (a) Weighted average common shares outstanding for the calculation of diluted net income per common share does not include the following adjustments for potential common shares below because their effects were determined to be antidilutive for the periods presented.
Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share	Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Series B Preferred Stock — — — 29,559,946

Supplemental Disclosure of Ca_2

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities (Tables)	9 Months Ended
	Sep. 30, 2024
Supplemental Cash Flow Elements [Abstract]
Schedule of Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities	Selected cash payments, receipts, and non-cash activities are as follows (in thousands): Nine Months Ended September 30, 2024 2023 Cash paid for interest $ 2,297 $ 4,496 Cash paid for income taxes 4,833 210 Non-cash activities: Fair value of shares received in settlement of litigation 9,300 — Minimum Profit Share Payments pursuant to TELA APA 2,731 — Right of use assets arising from operating lease liabilities 1,820 — Issuance of shares pursuant to employee stock purchase plan 1,583 1,368 Purchases of equipment in accounts payable — 126

Revenue (Tables)

Revenue (Tables)	9 Months Ended
	Sep. 30, 2024
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	Below is a summary of net sales by site of service (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Hospital $ 46,034 $ 47,350 $ 137,174 $ 136,108 Private Office 25,585 22,951 82,874 68,188 Other 12,438 11,411 35,924 30,349 Total $ 84,057 $ 81,712 $ 255,972 234,645 Below is a summary of net sales by product line (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Wound $ 55,052 $ 51,156 $ 169,647 $ 149,681 Surgical 29,005 30,556 86,325 84,964 Total $ 84,057 $ 81,712 $ 255,972 $ 234,645

Discontinued Operations (Tables

Discontinued Operations (Tables)	9 Months Ended
	Sep. 30, 2024
Discontinued Operations and Disposal Groups [Abstract]
Schedule of Assets And Liabilities of the Discontinued Operations	The income and expenses of the discontinued operation have been classified as income (loss) from discontinued operations in the consolidated statements of operations for the three and nine months ended September 30, 2024 and 2023 as follows (in thousands): Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Selling, general and administrative expense $ (217) $ — $ (221) $ — Research and development expense — 100 (200) 7,937 Restructuring expense — 208 — 3,463 Income (loss) from discontinued operations $ 217 $ (308) $ 421 $ (11,400)

Significant Accounting Polici_3

Significant Accounting Policies (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Other current liabilities	$ (2,591)	$ (2,894)
Current portion of long term debt	$ 1,000	1,000
Revision of Prior Period, Reclassification, Adjustment
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Other current liabilities		1,000
Current portion of long term debt		$ 1,000

Accounts Receivable, Net - Sche

Accounts Receivable, Net - Schedule of Accounts Receivable (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Jun. 30, 2024	Dec. 31, 2023	Sep. 30, 2023	Jun. 30, 2023	Dec. 31, 2022
Receivables [Abstract]
Accounts receivable, gross	$ 56,797		$ 57,015
Less: allowance for doubtful accounts	(2,767)	$ (3,269)	(3,144)	$ (2,574)	$ (2,196)	$ (3,783)
Accounts receivable, net	$ 54,030		$ 53,871

Accounts Receivable, Net - Sc_2

Accounts Receivable, Net - Schedule of Activity Related to the Allowance for Doubtful Accounts (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Allowance for Doubtful Accounts
Beginning balance	$ 3,269	$ 2,196	$ 3,144	$ 3,783
Bad debt (reversal) expense	(279)	447	141	737
Write-offs	(223)	(69)	(518)	(1,946)
Ending balance	$ 2,767	$ 2,574	$ 2,767	$ 2,574

Inventory (Details)

Inventory (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Inventory Disclosure [Abstract]
Raw materials	$ 781	$ 825
Work in process	9,279	8,521
Finished goods	14,189	11,675
Inventory	$ 24,249	$ 21,021

Property and Equipment, Net - S

Property and Equipment, Net - Schedule of Property and Equipment (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Property, Plant and Equipment [Line Items]
Finance lease right-of-use asset	$ 189	$ 189
Property and equipment, gross	27,719	27,002
Less: accumulated depreciation and amortization	(21,268)	(20,028)
Property and equipment, net	6,451	6,974
Laboratory and clean room equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	15,568	13,954
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, gross	1,972	1,989
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property and equipment, gross	8,199	8,141
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, gross	910	1,791
Asset retirement cost
Property, Plant and Equipment [Line Items]
Property and equipment, gross	$ 881	$ 938

Intangible Assets, Net - Schedu

Intangible Assets, Net - Schedule of Intangible Assets Activity Summary - Indefinite-lived (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 18,866	$ 11,039
Accumulated Amortization	(9,164)	(7,872)
Total amortized intangible assets	9,702	3,167
Indefinite-lived Intangible Assets [Line Items]
Intangible assets, gross carrying amount	20,365	13,129
Intangible assets, net carrying amount	11,201	5,257
Tradenames and trademarks
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	1,008	1,008
Patents in Process
Indefinite-lived Intangible Assets [Line Items]
Gross carrying value, indefinite lived	491	1,082
Patents and know-how
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	10,207	10,039
Accumulated Amortization	(8,307)	(7,818)
Total amortized intangible assets	1,900	2,221
Licenses
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,000	1,000
Accumulated Amortization	(92)	(54)
Total amortized intangible assets	908	946
Distribution rights
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	7,659	0
Accumulated Amortization	(765)	0
Total amortized intangible assets	$ 6,894	$ 0

Intangible Assets, Net - Narrat

Intangible Assets, Net - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Impairment of intangible assets	$ 298	$ 0	$ 352	$ 0

Intangible Assets, Net - Sche_2

Intangible Assets, Net - Schedule of Estimated Future Amortization Expense for Intangible Assets (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Estimated future amortization expense [Abstract]
2024 (excluding the nine months ended September 30, 2024)	$ 577
2025	1,912
2026	1,757
2027	1,757
2028	1,755
Thereafter	1,944
Total amortized intangible assets	$ 9,702	$ 3,167

Accrued Expenses (Details)

Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Dec. 31, 2023
Payables and Accruals [Abstract]
Commissions to sales agents	$ 3,154	$ 4,136
Accrued rebates	1,806	745
Estimated sales returns	912	1,096
Legal and settlement costs	756	834
Accrued group purchasing organization fees	688	1,338
Accrued travel	587	433
Other	493	779
Accrued expenses	$ 8,396	$ 9,361

Long Term Debt, Net - Narrative

Long Term Debt, Net - Narrative (Details)			9 Months Ended
	Feb. 27, 2024 USD ($)	Jan. 19, 2024 USD ($) term_loan	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)
Debt Instrument [Line Items]
Proceeds from revolving credit facility			$ 30,000,000	$ 0
Proceeds from term loan			19,783,000	0
Repayments of term loan			50,000,000	0
Loss on extinguishment of debt		$ 1,401,000	1,401,000	0
Repayments of initial line of credit draw			30,000,000	$ 0
Citizens Credit Agreement | Line of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 95,000,000
Citizens Credit Agreement | Line of Credit | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		1.25%
Citizens Credit Agreement | Line of Credit | Minimum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.25%
Citizens Credit Agreement | Line of Credit | Maximum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.50%
Citizens Credit Agreement | Line of Credit | Maximum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		3.50%
Citizens Credit Agreement | Line of Credit | Letter of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 10,000,000
Citizens Credit Agreement | Line of Credit | Revolving Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity		75,000,000
Line of credit facility, optional increase		$ 50,000,000
Line of credit facility, optional increase, EBITDA multiplier		1
Proceeds from revolving credit facility		$ 30,000,000
Repayments of initial line of credit draw	$ 30,000,000
Undrawn commitment fee percentage	0.25%
Citizens Credit Agreement | Line of Credit | Bridge Loan
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 10,000,000
Citizens Credit Agreement | Line of Credit | Bridge Loan | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		0.10%
Citizens Credit Agreement | Line of Credit | Term Loan
Debt Instrument [Line Items]
Maximum borrowing capacity		$ 20,000,000
Options to obtain incremental term loan, number | term_loan		1
Proceeds from term loan		$ 20,000,000
Fair value of term loan			$ 19,700,000
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year One
Debt Instrument [Line Items]
Interest rate		1.25%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Two
Debt Instrument [Line Items]
Interest rate		1.25%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Three
Debt Instrument [Line Items]
Interest rate		1.88%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Four
Debt Instrument [Line Items]
Interest rate		1.88%
Citizens Credit Agreement | Line of Credit | Term Loan | Debt Amortization, Year Five
Debt Instrument [Line Items]
Interest rate		2.50%
Citizens Credit Agreement | Line of Credit | Term Loan | SOFR Fallback Provision
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		0.10%
Citizens Credit Agreement | Line of Credit | Term Loan | Minimum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		1.25%
Citizens Credit Agreement | Line of Credit | Term Loan | Minimum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.25%
Interest rate, effective percentage (percent)			7.90%
Citizens Credit Agreement | Line of Credit | Term Loan | Maximum | Base Rate
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		2.50%
Citizens Credit Agreement | Line of Credit | Term Loan | Maximum | SOFR
Debt Instrument [Line Items]
Basis spread on variable rate (percent)		3.50%
Hayfin Loan Agreement Term Loan | Term loan
Debt Instrument [Line Items]
Repayments of term loan		$ 50,000,000

Long Term Debt, Net - Schedule

Long Term Debt, Net - Schedule of Extinguishment of Debt (Details) - USD ($) $ in Thousands		9 Months Ended
	Jan. 19, 2024	Sep. 30, 2024	Sep. 30, 2023
Debt Disclosure [Abstract]
Unamortized deferred financing costs	$ 781
Unamortized original issue discount	120
Prepayment premium on Hayfin term loan	500
Loss on extinguishment of debt	$ 1,401	$ 1,401	$ 0

Long Term Debt, Net - Schedul_2

Long Term Debt, Net - Schedule of Term Loan Facility Balances (Details) - Line of Credit - Citizens Credit Agreement - USD ($) $ in Thousands	Sep. 30, 2024	Jan. 19, 2024
Long term debt, net
Original issue discount		$ 1,063
Deferred financing costs		256
Term Loan
Long term debt, net
Original issue discount, noncurrent	$ 190	224
Deferred financing costs, noncurrent	42	54
Current portion of long term debt
Original issue discount, current	0
Deferred financing costs, current	$ 0
Revolving Credit Facility
Current portion of long term debt
Original issue discount, current		839
Deferred financing costs, current		$ 202

Long Term Debt, Net - Schedul_3

Long Term Debt, Net - Schedule of Term Loan Balances (Details) - USD ($) $ in Thousands	Sep. 30, 2024	Jan. 19, 2024	Dec. 31, 2023
Current portion of long term debt
Long term debt, net	$ 1,000		$ 1,000
Long term debt, net
Long term debt, net	18,018		48,099
Line of Credit | Citizens Credit Agreement | Term Loan
Current portion of long term debt
Outstanding principal	1,000
Deferred financing costs	0
Original issue discount	0
Long term debt, net	1,000
Long term debt, net
Outstanding principal	18,250
Deferred financing costs	(42)	$ (54)
Original issue discount	(190)	$ (224)
Long term debt, net	$ 18,018
Term loan | Hayfin Loan Agreement Term Loan
Current portion of long term debt
Outstanding principal			1,000
Deferred financing costs			0
Original issue discount			0
Long term debt, net			1,000
Long term debt, net
Outstanding principal			49,000
Deferred financing costs			(781)
Original issue discount			(120)
Long term debt, net			$ 48,099

Long Term Debt, Net - Schedul_4

Long Term Debt, Net - Schedule of Interest Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Term loan | Term Loan Facility and Hayfin Loan Agreement
Debt Instrument [Line Items]
Stated interest	$ 393	$ 1,554	$ 1,451	$ 4,498
Amortization of deferred financing costs	5	111	38	323
Accretion of original issue discount	12	17	36	50
Interest expense	410	$ 1,682	1,525	$ 4,871
Line of Credit | Citizens Credit Agreement | Revolving Credit Facility
Debt Instrument [Line Items]
Amortization of deferred financing costs	16		47
Accretion of original issue discount	42		126
Commitment fee	47		125
Interest expense	$ 105		$ 298

Long Term Debt, Net - Schedul_5

Long Term Debt, Net - Schedule of Principal Payments for the Term Loan Facility (Details) - Term Loan - Citizens Credit Agreement - Line of Credit $ in Thousands	Sep. 30, 2024 USD ($)
Debt Instrument [Line Items]
2024 (excluding the nine months ended September 30, 2024)	$ 250
2025	1,000
2026	1,500
2027	1,500
2028	2,000
Thereafter	13,000
Outstanding principal	$ 19,250

Net Income Per Common Share - S

Net Income Per Common Share - Schedule of Basic Net Income Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Net income from continuing operations	$ 7,878	$ 8,842	$ 34,560	$ 16,151
Income (loss) from discontinued operations, net of tax	217	(308)	421	(11,400)
Net income	8,095	8,534	34,981	4,751
Accumulated dividend on previously converted Series B Preferred Stock	0	1,773	0	5,184
Net income available to common stockholders from continuing operations	$ 7,878	$ 7,069	$ 34,560	$ 10,967
Weighted average common shares outstanding (in shares)	146,958,986	116,298,146	147,008,732	115,528,067
Basic net income (loss) per common share:
Continuing operations - basic (in dollars per share)	$ 0.05	$ 0.06	$ 0.24	$ 0.09
Discontinued operations - basic (in dollars per share)	0	0	0	(0.09)
Basic net income per common share (in dollars per share)	$ 0.05	$ 0.06	$ 0.24	$ 0

Net Income Per Common Share -_2

Net Income Per Common Share - Schedule of Diluted Net Income Per Common Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Net income available to common stockholders from continuing operations	$ 7,878	$ 7,069	$ 34,560	$ 10,967
Adjustments:
Dividends on Series B Preferred Stock	0	1,773	0	5,184
Less: antidilutive adjustments	0	0	0	(5,184)
Total adjustments	0	1,773	0	0
Numerator
Net income available to common stockholders from continuing operations	7,878	8,842	34,560	10,967
Income (loss) from discontinued operations, net of tax	$ 217	$ (308)	$ 421	$ (11,400)
Weighted average shares outstanding (in shares)	146,958,986	116,298,146	147,008,732	115,528,067
Potential common shares
Total adjustments (in shares)	1,414,645	33,475,560	1,956,056	1,365,203
Weighted average shares outstanding adjusted for potential common shares (in shares)	148,373,631	149,773,706	148,964,788	116,893,270
Diluted net income (loss) per common share:
Continuing operations - diluted(in dollars per share)	$ 0.05	$ 0.06	$ 0.23	$ 0.09
Discontinued operations - diluted (in dollars per share)	0	0	0	(0.09)
Diluted net income per common share (in dollars per share)	$ 0.05	$ 0.06	$ 0.23	$ 0
Series B Preferred Stock
Potential common shares
Stock-based awards (in shares)	0	30,445,997	0	0
Restricted stock unit awards
Potential common shares
Stock-based awards (in shares)	881,237	1,845,832	1,433,335	1,219,776
Outstanding stock options
Potential common shares
Stock-based awards (in shares)	394,767	1,131,410	450,168	107,897
Performance stock unit awards
Potential common shares
Stock-based awards (in shares)	114,050	35,441	57,629	13,425
Diluted net income (loss) per common share:
Diluted net income per common share (in dollars per share)	$ 0.05	$ 0.06	$ 0.23	$ 0
Employee stock purchase plan
Potential common shares
Stock-based awards (in shares)	24,591	1,113	14,924	372
Restricted stock awards
Potential common shares
Stock-based awards (in shares)	0	15,767	0	23,733

Net Income Per Common Share -_3

Net Income Per Common Share - Schedule of Antidilutive Securities Excluded from Computation of Earnings Per Share (Details) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Series B Preferred Stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential common shares (in shares)	0	0	0	29,559,946

Income Taxes (Details)

Income Taxes (Details)	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Effective tax rate	31%	6.30%	24.90%	3.40%

Supplemental Disclosure of Ca_3

Supplemental Disclosure of Cash Flow and Non-cash Investing and Financing Activities (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Supplemental Cash Flow Elements [Abstract]
Cash paid for interest			$ 2,297	$ 4,496
Cash paid for income taxes			4,833	210
Non-cash activities:
Fair value of shares received in settlement of litigation			9,300	0
Minimum Profit Share Payments pursuant to TELA APA			2,731	0
Right of use assets arising from operating lease liabilities			1,820	0
Issuance of shares pursuant to employee stock purchase plan	$ 785	$ 688	1,583	1,368
Purchases of equipment in accounts payable			$ 0	$ 126

Commitments and Contingencies (

Commitments and Contingencies (Details) - USD ($) $ in Thousands, shares in Millions			9 Months Ended
	Sep. 30, 2024	Mar. 15, 2024	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2024
Asset Acquisition [Line Items]
Initial consideration paid			$ 5,366	$ 0
Fair value of minimum contingent consideration			2,731	0
Legal and settlement expense	$ 0		0
Payments for legal settlements			600	200
Fair value of shares received in settlement of litigation			9,300	$ 0
Settled Litigation
Asset Acquisition [Line Items]
Litigation settlement, share-based payment arrangement, number of shares received (in shares)					1.2
Fair value of shares received in settlement of litigation			$ 9,300
TELA APA
Asset Acquisition [Line Items]
Initial consideration paid		$ 5,000
Future payments for remaining product inventory		$ 400
Net sales over the period		2 years
Consideration transferred		$ 8,100
Fair value of minimum contingent consideration	$ 2,800	2,700
Asset acquisition, inventory		500
TELA APA | Distribution rights
Asset Acquisition [Line Items]
Finite-lived intangible assets acquired		$ 7,600
Estimated useful life (in years)		5 years
TELA APA | Minimum
Asset Acquisition [Line Items]
Contingent consideration		$ 3,000
TELA APA | Maximum
Asset Acquisition [Line Items]
Contingent consideration		$ 7,000

Revenue - Narrative (Details)

Revenue - Narrative (Details)	9 Months Ended
	Sep. 30, 2024 product_line service_site
Revenue from Contract with Customer [Abstract]
Number of sites of service | service_site	3
Number of product lines | product_line	2

Revenue - Schedule of Revenue b

Revenue - Schedule of Revenue by Site Of Service (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenue, Major Customer [Line Items]
Total	$ 84,057	$ 81,712	$ 255,972	$ 234,645
Hospital
Revenue, Major Customer [Line Items]
Total	46,034	47,350	137,174	136,108
Private Office
Revenue, Major Customer [Line Items]
Total	25,585	22,951	82,874	68,188
Other
Revenue, Major Customer [Line Items]
Total	$ 12,438	$ 11,411	$ 35,924	$ 30,349

Revenue - Schedule of Revenue_2

Revenue - Schedule of Revenue by Product Type (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Revenue, Major Customer [Line Items]
Total	$ 84,057	$ 81,712	$ 255,972	$ 234,645
Wound
Revenue, Major Customer [Line Items]
Total	55,052	51,156	169,647	149,681
Surgical
Revenue, Major Customer [Line Items]
Total	$ 29,005	$ 30,556	$ 86,325	$ 84,964

Discontinued Operations - Sched

Discontinued Operations - Schedule Of Disposal Groups Including Discontinued Operations Income Statement (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income (loss) from discontinued operations, net of tax	$ 217	$ (308)	$ 421	$ (11,400)
Regenerative Medicine | Disbanded
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Selling, general and administrative expense	(217)	0	(221)	0
Research and development expense	0	100	(200)	7,937
Restructuring expense	0	208	0	3,463
Income (loss) from discontinued operations, net of tax	$ 217	$ (308)	$ 421	$ (11,400)