OrthoPediatrics (KIDS) 10-Q 15 May 18 2018 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2018	May 11, 2018
Document And Entity Information [Abstract]
Entity Registrant Name	ORTHOPEDIATRICS CORP
Entity Central Index Key	1,425,450
Current Fiscal Year End Date	--12-31
Entity Filer Category	Non-accelerated Filer
Document Type	10-Q
Document Period End Date	Mar. 31, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q1
Amendment Flag	false
Entity Common Stock, Shares Outstanding		12,772,296

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Current assets:
Cash	$ 34,591	$ 42,582
Accounts receivable - trade, less allowance for doubtful accounts of $131 and $143, respectively	6,838	5,603
Prepaid expenses and other current assets	1,114	831
Total current assets	65,949	69,561
Property and equipment, net	12,280	10,391
Other assets:
Amortizable intangible assets, net	2,154	2,089
Other intangible assets	260	260
Total other assets	2,414	2,349
Total assets	80,643	82,301
Current liabilities:
Accounts payable - trade	7,197	5,495
Accrued compensation and benefits	2,313	2,905
Current portion of long-term debt with affiliate	114	113
Other current liabilities	946	954
Total current liabilities	10,570	9,467
Long-term liabilities:
Long-term debt with affiliate, net of current portion	21,389	21,418
Revolving credit facility with affiliate	3,930	3,921
Total long-term liabilities	25,319	25,339
Total liabilities	35,889	34,806
Commitments and contingencies (Note 11)
Stockholders' equity:
Common stock, $0.00025 par value; 50,000,000 shares authorized; 12,770,796 shares and 12,621,781 shares issued and outstanding as of March 31, 2018 and December 31, 2017	2	2
Additional paid-in capital	152,601	150,424
Accumulated deficit	(108,066)	(103,066)
Accumulated other comprehensive income	217	135
Total stockholders' equity	44,754	47,495
Total liabilities and stockholders' equity	80,643	82,301
United States
Current assets:
Inventories, net	22,004	19,498
International
Current assets:
Inventories, net	$ 1,402	$ 1,047

CONDENSED CONSOLIDATED BALANCE3

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 131	$ 143
Common stock, par value (in dollars per share)	$ 0.00025	$ 0.00025
Common stock, shares authorized	50,000,000	50,000,000
Common stock, shares issued	12,770,796	12,621,781
Common stock, shares outstanding	12,770,796	12,621,781

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Income Statement [Abstract]
Net revenue	$ 12,094	$ 9,762
Cost of revenue	3,175	2,347
Gross profit	8,919	7,415
Operating expenses:
Sales and marketing	6,079	4,192
General and administrative	6,017	3,373
Research and development	1,218	687
Total operating expenses	13,314	8,252
Operating loss	(4,395)	(837)
Other expenses:
Interest expense, net	552	445
Other expense	53	3
Total other expenses	605	448
Net loss	(5,000)	(1,285)
Net loss attributable to common stockholders	$ (5,000)	$ (2,711)
Weighted average common shares - basic and diluted (in shares)	12,073,776	1,744,356
Net loss per share attributable to common stockholders - basic and diluted (in dollars per share)	$ (0.41)	$ (1.55)

CONDENSED CONSOLIDATED STATEME5

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Statement of Comprehensive Income [Abstract]
Net loss	$ (5,000)	$ (1,285)
Other comprehensive income:
Foreign currency translation adjustment	82	0
Other comprehensive income	82	0
Comprehensive loss	$ (4,918)	$ (1,285)

CONDENSED CONSOLIDATED STATEME6

CONDENSED CONSOLIDATED STATEMENT OF STOCKHOLDERS’ EQUITY (Unaudited) - 3 months ended Mar. 31, 2018 - USD ($) $ in Thousands	Total	Common Stock	Additional Paid-in Capital	Accumulated Deficit	Accumulated Other Comprehensive Income
Balance (in shares) at Dec. 31, 2017	12,621,781	12,621,781
Balance at Dec. 31, 2017	$ 47,495	$ 2	$ 150,424	$ (103,066)	$ 135
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	(5,000)			(5,000)
Other comprehensive income	82				82
Restricted stock (in shares)		149,015
Restricted stock	$ 2,177		2,177
Balance (in shares) at Mar. 31, 2018	12,770,796	12,770,796
Balance at Mar. 31, 2018	$ 44,754	$ 2	$ 152,601	$ (108,066)	$ 217

CONDENSED CONSOLIDATED STATEME7

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
OPERATING ACTIVITIES
Net loss	$ (5,000)	$ (1,285)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	681	498
Stock-based compensation	2,177	339
Changes in certain current assets and liabilities:
Accounts receivable - trade	(1,235)	198
Prepaid expenses and other current assets	(283)	(191)
Accounts payable - trade	1,702	2,167
Accrued expenses and other liabilities	(600)	(578)
Other	82	0
Net cash used in operating activities	(5,033)	(5)
INVESTING ACTIVITIES
Purchases of licenses	(159)	(300)
Purchases of property and equipment	(2,771)	(1,332)
Net cash used in investing activities	(2,930)	(1,632)
FINANCING ACTIVITIES
Proceeds from issuance of debt with affiliate	0	2,500
Payments on mortgage notes	(28)	(26)
Net cash (used in) provided by financing activities	(28)	2,474
NET INCREASE (DECREASE) IN CASH	(7,991)	837
Cash, beginning of year	42,582	1,609
Cash, end of period	34,591	2,446
SUPPLEMENTAL DISCLOSURES
Cash paid for interest	552	445
Accretion of redeemable convertible preferred stock	0	1,426
Transfer of instruments from property and equipment to inventory	304	567
United States
Changes in certain current assets and liabilities:
Inventories	(2,202)	(1,360)
International
Changes in certain current assets and liabilities:
Inventories	$ (355)	$ 207

BUSINESS

BUSINESS	3 Months Ended
	Mar. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BUSINESS	BUSINESS OrthoPediatrics Corp., a Delaware corporation, is a medical device company committed to designing, developing and marketing anatomically appropriate implants and devices for children with orthopedic conditions, giving pediatric orthopedic surgeons and caregivers the ability to treat children with technologies specifically designed to meet their needs. We sell our specialized products, including PediLoc ® , PediPlates ® , Cannulated Screws, PediFlex TM nail, PediNail TM , PediLoc ® Tibia, ACL Reconstruction System, Locking Cannulated Blade, Locking Proximal Femur, Spica Tables, RESPONSE Spine, Bandloc and Pediguard, to various hospitals and medical facilities throughout the United States and various international markets. We currently use a contract manufacturing model for the manufacturing of implants and related surgical instrumentation. In 2017, we expanded operations and established legal entities in the United Kingdom, Australia and New Zealand permitting us to sell under an agency model direct to local hospitals in these countries. Operations began in the United Kingdom on April 3, 2017, in Australia on May 1, 2017 and in New Zealand on July 1, 2017. On October 12, 2017, we completed an initial public offering ("IPO") of our common stock, in which we issued and sold 4.6 million shares of common stock at a public offering price of $13.00 per share for aggregate gross proceeds of $59,800 . We received approximately $46,900 in net proceeds after deducting $4,200 of underwriting discounts and commissions, paying approximately $2,700 of offering costs and paying approximately $6,000 of Series B dividends. Our largest investor is Squadron Capital LLC (“Squadron”), a family office firm headquartered near Hartford, Connecticut.

SIGNIFICANT ACCOUNTING POLICIES

SIGNIFICANT ACCOUNTING POLICIES	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
SIGNIFICANT ACCOUNTING POLICIES	SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation The accompanying condensed consolidated financial statements include the accounts of OrthoPediatrics Corp. and its wholly-owned subsidiaries, OrthoPediatrics United States Distribution Corp., OrthoPediatrics EU Limited, OrthoPediatrics AUS PTY LTD and OrthoPediatrics NZ Limited (collectively, the “Company,” “we,” “our” or “us”). All intercompany balances and transactions have been eliminated. Unaudited Interim Consolidated Financial Statements We have prepared the accompanying condensed consolidated financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”). The accompanying condensed consolidated balance sheets as of March 31, 2018 and December 31, 2017 , the condensed consolidated statements of operations for the three months ended March 31, 2018 and 2017 , the condensed consolidated statements of comprehensive loss for the three months ended March 31, 2018 and 2017 , the condensed consolidated statement of stockholders’ equity for the three months ended March 31, 2018 and the condensed consolidated statements of cash flows for the three months ended March 31, 2018 and 2017 are unaudited and should be read in conjunction with the annual consolidated financial statements as of and for the year ended December 31, 2017 and related notes thereto contained in our Annual Report on Form 10-K filed with the Securities and Exchange Commission ("SEC") on March 15, 2018. The financial data and other financial information disclosed in the notes to the accompanying condensed consolidated financial statements are also unaudited. As such, certain information and footnote disclosures normally included in financial statements prepared in accordance with GAAP have been condensed or omitted pursuant to applicable rules and regulations thereunder. The unaudited condensed consolidated financial statements have been prepared on the same basis as the audited consolidated financial statements as of and for the year ended December 31, 2017 and, in management’s opinion, include all adjustments, consisting of only normal recurring adjustments, necessary for the fair presentation of the financial statements for the interim periods. The results of operations for the three months ended March 31, 2018 are not necessarily indicative of the results to be expected for the full fiscal year or for any other period. The accompanying condensed consolidated financial statements have been prepared assuming our Company will continue as a going concern. We have experienced recurring losses from operations since our inception and had an accumulated deficit of $108,066 and $103,066 as of March 31, 2018 and December 31, 2017 , respectively. Effective December 31, 2017, we entered into an amended loan agreement with Squadron to consolidate a majority of our term note into a $20,000 term loan, reestablished a $15,000 revolving credit facility, reduced the interest rate and extended the loan period through January 31, 2023. Management continues to monitor cash flows and liquidity on a regular basis. We believe that our cash balance at March 31, 2018 , expected cash flows from operations for the next twelve months subsequent to the issuance of the condensed consolidated financial statements and the availability under the revolving credit facility are sufficient to enable us to maintain current and essential planned operations for the next twelve months subsequent to the issuance of the condensed consolidated financial statements. Our ability to fund planned operations beyond that date may be substantially dependent upon our ability to obtain sufficient funding at acceptable terms. Use of Estimates Preparation of the condensed consolidated financial statements requires the use of estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses, as of the date of the condensed consolidated financial statements. By their nature, these judgments are subject to an inherent degree of uncertainty. We use historical experience and other assumptions as the basis for our judgments and estimates. Because future events and their effects cannot be determined with precision, actual results could differ significantly from these estimates. Any changes in these estimates will be reflected in the condensed consolidated financial statements. Foreign Currency Transactions We currently bill our international distributors in United States ("U.S.") dollars, resulting in minimal foreign exchange transaction expense. Beginning in the second quarter of 2017, we began selling direct within the United Kingdom, Ireland, Australia and New Zealand and billing using the local currency for each country. The financial statements of our foreign subsidiaries are accounted for and have been translated into U.S. dollars using end-of-period exchange rates for assets and liabilities and average exchange rates during each reporting period for results of operations. Foreign currency translation adjustments have been recorded as a separate component of the condensed consolidated statements of comprehensive loss. Fair Value of Financial Instruments The accounting standards related to fair value measurements define fair value and provide a consistent framework for measuring fair value under the authoritative literature. Valuation techniques are based on observable and unobservable inputs. Observable inputs reflect readily obtainable data from independent sources, while unobservable inputs reflect market assumptions. This guidance only applies when other standards require or permit the fair value measurement of assets and liabilities. The guidance does not expand the use of fair value measurements. A fair value hierarchy was established, which prioritizes the inputs used in measuring fair value into three broad levels: Level 1 – Quoted prices in active markets for identical assets or liabilities; Level 2 – Observable market-based inputs or unobservable inputs that are corroborated by market data; and Level 3 – Significant unobservable inputs that are not corroborated by market data. Generally, these fair value measures are model-based valuation techniques such as, discounted cash flows, and are based on the best information available, including our own data. We do not have any assets or liabilities that are measured on a recurring basis under the presented fair value hierarchy. Revenue from Contracts with Customers The Company adopted ASC 606, " Revenue From Contracts With Customers (ASC 606)", on January 1, 2018 using the modified retrospective method for all contracts not completed as of the date of adoption. The adoption of ASC 606 did not have any impact on the Company’s consolidated historical financial statements. The reported results for 2018 reflect the application of ASC 606 guidance while the reported results for 2017 were prepared under the guidance of "ASC 605, Revenue Recognition (ASC 605)." In accordance with ASC 606, revenue is recognized when a customer obtains control of promised goods or services. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these goods or services, and excludes any sales incentives or taxes collected from a customer which are subsequently remitted to government authorities Revenue Recognition – United States Revenue in the United States is generated primarily from the sale of our implants and, to a much lesser extent, from the sale of our instruments. Sales in the United States are primarily to hospital accounts through independent sales agencies. We recognize revenue when our performance obligations under the terms of a contract with our customer are satisfied. This typically occurs when we transfer control of our products to the customer, generally upon implantation or when title passes upon shipment. The products are generally consigned to our independent sales agencies, and revenue is recognized when the products are used by or shipped to the hospital for surgeries on a case by case basis. On rare occasions, hospitals purchase products for their own inventory, and revenue is recognized when the products are shipped and the title and risk of loss passes to the customer. Pricing for each customer is dictated by a unique pricing agreement, which does not generally include rebates or discounts. Revenue Recognition – International Outside of the United States, we primarily sell our products through independent stocking distributors. Generally, the distributors are allowed to return products, and some are thinly capitalized. Based on our history of collections and returns from international customers, we have concluded that collectability is not reasonably assured at the time of delivery for certain customers who have not evidenced a consistent pattern of timely payment. Accordingly, we do not recognize international revenue and associated cost of revenue at the time title transfers for these customers for whom collectibility has not been deemed probable based on the customer’s history and ability to pay, but rather when cash has been received. Until such payment, cost of revenue is recorded as inventories held by international distributors, net of adjustment for estimated unreturnable inventory, on our balance sheets. For international independent stocking distributors for whom we have determined collectability is probable, based on a history of reliable collections, we have concluded that a contract exists and revenue should be recognized when we transfer control of our products to the customer, generally upon implantation or when title passes upon shipment. In early 2017, we expanded operations and established legal entities in the United Kingdom, Australia and New Zealand permitting us to sell under an agency model direct to local hospitals in these countries. The products are generally consigned to our independent sales agencies, and revenue is recognized when the products are used by or shipped to the hospital for surgeries on a case by case basis. On rare occasions, hospitals purchase products for their own inventory, and revenue is recognized when the products are shipped and the title and risk of loss passes to the customer. Pricing for each customer is dictated by a unique pricing agreement, which does not generally include rebates or discounts. Cash and Cash Equivalents We maintain cash in bank deposit accounts which, at times, may exceed federally insured limits. To date, we have not experienced any loss in such accounts. We consider all highly liquid investments with original maturity of three months or less at inception to be cash equivalents. The carrying amounts reported in the balance sheet for cash are valued at cost, which approximates fair value. Accounts Receivable – United States Domestic accounts receivable are uncollateralized customer obligations due under normal trade terms, generally requiring payment within 30 days from the invoice date. Account balances with invoices over 30 days past due are considered delinquent. No interest is charged on past due accounts. Payments of accounts receivable are applied to the specific invoices identified on the customer's remittance advice or, if unspecified, to the customer's account as an unapplied credit. The carrying amount of domestic accounts receivable is reduced by an allowance that reflects management's best estimate of the amounts that will not be collected, determined principally on the basis of historical experience, management's assessment of the collectability of specific customer accounts and the aging of the accounts receivable. All accounts or portions thereof deemed to be uncollectible or to require an excessive collection cost are written off to the allowance for doubtful accounts. Inventories, net Inventories are stated at the lower of cost or net realizable value, with cost determined using the first-in-first-out method. Inventories, which consist of implants and instruments held in our warehouse or with third-party independent sales agencies or distributors, are considered finished goods and are purchased from third parties. We evaluate the carrying value of our inventories in relation to the estimated forecast of product demand, which takes into consideration the life cycle of the product. A significant decrease in demand could result in an increase in the amount of excess inventory on hand, which could lead to additional charges for excess and obsolete inventory. The need to maintain substantial levels of inventory impacts our estimates for excess and obsolete inventory. Each of our implant systems are designed to include implantable products that come in different sizes and shapes to accommodate the surgeon’s needs. Typically, a small number of the set components are used in each surgical procedure. Certain components within each set may become obsolete before other components based on the usage patterns. We adjust inventory values, as needed, to reflect these usage patterns and life cycle. In addition, we continue to introduce new products, which may require us to take additional charges for excess and obsolete inventory in the future. Property and Equipment, net Property and equipment are carried at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful life of the assets. When assets are retired or otherwise disposed of, costs and related accumulated depreciation are removed from the accounts, and any resulting gain or loss is recognized in operations for the period. Maintenance and repairs that prolong or extend the useful life are capitalized, whereas standard maintenance, replacements, and repair costs are expensed as incurred. Instruments are hand-held devices, specifically designed for use with our implants and are used by surgeons during surgery. Instruments deployed within the United States, United Kingdom, Australia and New Zealand are carried at cost less accumulated depreciation and are recorded in property and equipment, net on the condensed consolidated balance sheets. Sample inventory consists of our implants and instruments, and is maintained to market and promote our products. Sample inventory is carried at cost less accumulated depreciation. Depreciable lives are generally as follows: Building and building improvements 25 to 30 years Furniture and fixtures 5 to 7 years Computer equipment 3 to 5 years Business software 3 years Office and other equipment 5 to 7 years Instruments 5 years Sample inventory 2 years Amortizable Intangible Assets, net Amortizable intangible assets include fees necessary to secure various patents and licenses. Amortization is calculated on a straight-line basis over the estimated useful life of the patents and licenses. Amortization for patents and licenses commences at the time of patent approval and market launch, respectively. Intangible assets are amortized over a 3 to 20 year period. Amortizable intangible assets are assessed for impairment annually or whenever events or changes in circumstances indicate that the carrying value of an asset may not be recoverable. Recoverability is measured by a comparison of the carrying amount to future net undiscounted cash flows expected to be generated by the associated asset. If such assets are determined to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount exceeds the fair market value of the assets. No impairment charges were recorded in any of the periods presented. Other Intangible Assets We have indefinite lived tradename assets that are reviewed for impairment by performing a quantitative analysis, which occurs annually in the fourth quarter or whenever events or changes in circumstances indicate that the carrying value of an asset may not be recoverable. Recoverability is measured by a comparison of the carrying amount to future net undiscounted cash flows expected to be generated by the associated asset. If such assets are determined to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount exceeds the fair market value of the assets. No impairment charges were recorded in any of the periods presented. Cost of Revenue Cost of revenue consists primarily of products purchased from third-party suppliers, excess and obsolete inventory adjustments, inbound freight, and royalties. Our implants and instruments are manufactured to our specifications by third-party suppliers who meet our manufacturer qualifications standards. Our third-party manufacturers are required to meet the standards of the Food and Drug Administration (the “FDA”), and the International Organization for Standardization, as well as other country-specific quality standards. The majority of our implants and instruments are produced in the United States. Sales and Marketing Expenses Sales and marketing expenses primarily consist of commissions to our domestic and select international independent sales agencies and consignment distributors, as well as compensation, commissions, benefits and other related costs for personnel we employ. Commissions and bonuses are generally based on a percentage of sales. Our international independent stocking distributors purchase instrument sets and replenishment stock for resale, and we do not pay commissions or any other sales related costs for international sales to distributors. Advertising Costs Advertising costs consist primarily of print advertising, trade shows, and other related expenses. Advertising costs are expensed as incurred and are recorded as a component of sales and marketing expense. Research and Development Costs Research and development costs are expensed as incurred. Our research and development expenses primarily consist of costs associated with engineering, product development, consulting services, outside prototyping services, outside research activities, materials, development and protection of our intellectual property portfolio, as well as other costs associated with development of our products. Research and development costs also include related personnel and consultants’ compensation expense. Research and development costs were $1,218 and $687 for the three months ended March 31, 2018 and 2017 , respectively. Stock-Based Compensation Prior to our IPO, we maintained an Amended and Restated 2007 Equity Incentive Plan (the “2007 Plan”) that provides for grants of options and restricted stock to employees, directors and associated third-party representatives of our Company as determined by the Board of Directors. The 2007 Plan had authorized 1,585,000 shares for award. Immediately prior to our IPO, we adopted our 2017 Incentive Award Plan (the "2017 Plan") which replaced the 2007 Plan. The 2017 Plan provides for grants of options and restricted stock to officers, employees, consultants or directors of our Company. The 2017 Plan has authorized 1,789,647 shares for award. Options holders, upon vesting, may purchase common stock at the exercise price, which is the estimated fair value of our common stock on the date of grant. Option grants generally vest immediately or over three years . No stock options were granted in any of the periods presented. Restricted stock may not be transferred prior to the expiration of the restricted period. The restricted stock that had been granted under the 2007 Plan had restriction periods that generally last until the earlier of six years from the date of grant, or an IPO or change in control, as defined in the 2007 Plan. All restricted stock granted prior to May 2014 vested upon our IPO and the remaining grants under the 2007 Plan vested six months after the IPO. We recognize the reversal of stock compensation expense when a restricted stock forfeiture occurs as opposed to estimating future forfeitures. We estimate the fair value of stock options and restricted stock at the grant date. Stock-based compensation is recognized ratably over the requisite service period, which is generally the vesting period for stock options and the restriction period for restricted stock. Calculating the fair value of stock-based awards requires that we make highly subjective assumptions. We use the Black-Scholes option pricing model to value our stock options. Use of the valuation methodology requires that we make assumptions as to the volatility of our common stock, the expected term of our stock options and the risk free rate of return for a period that approximates the expected term of our stock options. Because we were a privately-held company with a limited operating history, we utilized the historical stock price volatility from a representative group of comparable industry competitors to estimate expected stock price volatility. Prior to the IPO, in determining the fair value of our common stock at the grant date, which is the basis for the fair value of stock based awards, we used the market approach, which was based on the assumption that the value of an asset is equal to the value of a substitute asset with the same characteristics. In using the market approach, we consider both the guideline public company method and the precedent transaction method. Given the absence of a public trading market for our common stock prior to our IPO, we exercised reasonable judgment and considered a number of objective and subjective factors to determine the best estimate of the fair value of our common stock, including: the preferences and dividends of our redeemable convertible preferred stock relative to those of our common stock; our operating results and financial conditions, including our level of available capital resources; equity market conditions affecting comparable public companies; general U.S. market conditions; and the lack of marketability of our common stock. Prior to our IPO, for restricted stock awards we applied a discount for lack of marketability to the fair value of common shares due to estimate the impact of valuing a minority interest in our Company as a closely held, non-public company with no liquid market for its shares. Following the IPO, we value restricted stock awards using the market value on the grant date. Comprehensive Income Comprehensive income is defined as the change in equity during a period from transactions and other events and circumstances from non-owner sources. Comprehensive income includes foreign currency translation adjustments. Income Taxes We account for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements. Under this method, we determine deferred tax assets and liabilities on the basis of the differences between the financial statement and tax bases of assets and liabilities by using enacted tax rates in effect for the year in which the differences are expected to reverse. The effect of a change in tax rates on deferred tax assets and liabilities is recognized in income in the period that includes the enactment date. We recognize deferred tax assets to the extent that we believe that these assets are more likely than not to be realized. In making such a determination, we consider all available positive and negative evidence. If we determine that we would be able to realize our deferred tax assets in the future in excess of their net recorded amount, we would make an adjustment to the valuation allowance. We record uncertain tax positions on the bases of a two-step process in which (i) we determine whether it is more likely than not that the tax positions will be sustained on the basis of the technical merits of the positions and (ii) for those tax positions that meet the more-likely-than-not recognition threshold, we recognize the largest amount of tax benefit that is more than 50% likely to be realized upon ultimate settlement with the related tax authority. “Emerging Growth Company” Reporting Requirements We qualify as an “emerging growth company” as defined in the Jumpstart Our Business Startups Act (the “JOBS Act”). For as long as a company is deemed to be an emerging growth company, it may take advantage of specified reduced reporting and other regulatory requirements that are generally unavailable to other public companies. Among other things, we are not required to provide an auditor attestation report on the assessment of the internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act of 2002. Section 107 of the JOBS Act also provides that an emerging growth company can delay the adoption of certain accounting standards until those standards would otherwise apply to private companies. We have irrevocably elected not to avail ourselves of this exemption from new or revised accounting standards and, therefore, we will be subject to the same new or revised accounting standards as other public companies that are not emerging growth companies. In April 2017, the SEC adopted new rules that included an inflation-adjusted threshold in the definition of an emerging growth company. Under the new inflation-adjusted threshold, we would cease to be an emerging growth company on the last day of the fiscal year in which our annual gross revenues exceed $1.07 billion or after five years. This is an increase of $70 million from the previous $1 billion threshold. For further information regarding additional criteria to retain our emerging growth company status, see our Annual Report on Form 10-K filed with the SEC on March 15, 2018. Recent Accounting Pronouncements In May 2014, the FASB issued ASU 2014-09 “ Revenue from Contracts with Customers ,” on the recognition of revenue for all contracts with customers designed to improve comparability and enhance financial statement disclosures. The underlying principle of this comprehensive model is that revenue is recognized to depict the transfer of promised goods or services to customers in an amount that reflects the payment to which the company expects to be entitled in exchange for those goods or services. It also requires enhanced disclosures about revenue, provides guidance for transactions that were not previously addressed comprehensively, and improves guidance for multiple-element arrangements. The FASB subsequently issued amendments to ASU No. 2014-09 that have the same effective date and transition date. These standards became effective for us on January 1, 2018. We have performed a review of these new standards as compared to our current accounting policies for revenue recognition. During the fourth quarter of 2017 we finalized our assessments over the impact that these new standards will have on our consolidated results of operations, financial position and disclosures. We elected to apply the modified retrospective approach and as of December 31, 2017, we have not identified any accounting changes that would materially impact the amount of reported revenues and did not record any adjustments on January 1, 2018, related to this new guidance. In February 2016, the FASB issued ASU 2016-02 “ Leases, ” which outlines a comprehensive lease accounting model and supersedes the current lease guidance. The new standard requires lessees to recognize lease liabilities and corresponding right-of-use assets for all leases with lease terms of greater than twelve months. It also changes the definition of a lease and expands the disclosure requirements of lease arrangements. The new standard must be adopted using the modified retrospective approach and will be effective starting in the first quarter of 2019. Early adoption is permitted. We are currently evaluating the impact of this standard, but we do not believe this guidance will have a material effect on our financial position, results of operations or cash flows. In August 2016, the FASB issued ASU No. 2016-15 “Statement of Cash Flows (Topic 230), Classification of Certain Cash Receipts and Cash Payments" which provides guidance intended to reduce diversity in practice in how certain transactions are classified in the statement of cash flows. We adopted ASU 2016-15 effective January 1, 2018. The adoption did not have any impact on our consolidated financial position, results of operations and cash flows. In March 2018, the FASB issued ASU 2018-05 " Income Taxes (Topic 740), Amendments to SEC Paragraphs Pursuant to SEC Staff Accounting Bulletin No. 118 ("SAB No. 118”), to state the income tax accounting implications of the Tax Cuts and Jobs Act (“New Tax Act”)" which clarifies the measurement period time frame, changes in subsequent reporting periods and reporting requirements as a result of the New Tax Act of 2017. In accordance with SAB No. 118, a company must reflect the income tax effects of those aspects of the New Tax Act for which the accounting under ASC 740 is complete. To the extent that a company’s accounting for certain income tax effects of the New Tax Act is incomplete but it is able to determine a reasonable estimate, it must record a provisional estimate in the financial statements. If a company cannot determine a provisional estimate to be included in the financial statements, it should continue to apply ASC 740 on the basis of the provisions of the tax laws that were in effect immediately before the enactment of the New Tax Act. SAB No. 118 provides a measurement period that should not extend beyond one year and it begins in the period that includes the enactment date which was December 22, 2017. We have not completed the accounting for the income tax effects of certain elements of the New Tax Act, which will become effective in future years. When additional guidance and regulations enable us to finalize certain tax positions, we will reflect the impact of this ASU 2018-05 on the tax provision and deferred tax calculation as of December 31, 2018. The Section 382 ownership change analysis will be re–evaluated prior to release of the year-ending December 31, 2018 financial statements to account for equity ownership changes that occur during 2018.

DEBT AND CREDIT ARRANGEMENTS

DEBT AND CREDIT ARRANGEMENTS	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
DEBT AND CREDIT ARRANGEMENTS	DEBT AND CREDIT ARRANGEMENTS Long-term debt consisted of the following: March 31, December 31, 2018 2017 Note payable to Squadron $ 20,000 $ 20,000 Revolving credit facility with Squadron 3,930 3,921 Mortgage payable to affiliate 1,503 1,531 Total debt 25,433 25,452 Less: current maturities 114 113 Long-term debt, net of current maturities $ 25,319 $ 25,339 In May 2014, we entered into the Second Amended and Restated Loan and Security Agreement with Squadron in connection with a restructuring of our debt and equity. The terms of this agreement required monthly interest only payments computed at 10% per annum with all principal and unpaid interest due at maturity in May 2017 or earlier upon a change of control event, as defined in the agreement. The note payable was secured by substantially all of our assets. In November 2015, this agreement was amended to provide a revolving loan commitment of an additional $7,000 . The revolving loan commitment was structured under the same terms and conditions with interest payable monthly computed at 10% per annum and principal due at maturity in May 2017 or earlier upon a change of control event, as defined in the agreement. In April 2017, we entered into the Third Amended and Restated Loan and Security Agreement with Squadron to provide an additional $16,000 revolving loan commitment and extend the maturity date on the note payable and revolving credit facility to May 31, 2019 with an automatic extension to May 31, 2020 if we meet certain revenue goals. The agreement was structured similarly to previous amendments with interest payable monthly computed at 11% per annum and included a $1,000 extension fee payable in three installments on the anniversary date of the agreement. The extension fee was recorded in full upon closing as a deferred financing cost within long-term debt with affiliate, net of current portion, and was to be recognized ratably over the term of the agreement as deferred financing charges within interest expense on the consolidated statements of operations assuming an IPO did not happen. Effective December 31, 2017, we entered into a Fourth Amended and Restated Loan and Security Agreement, or the Loan Agreement, with Squadron. Pursuant to the Loan Agreement, we have consolidated a majority of the term loan amounts into a $20,000 term note and reestablished a $15,000 revolving credit facility. Also, $667 of the extension fee was cancelled as of the completion of our IPO in October 2017. Both facilities include interest only payments and will have an interest rate equal to the greater of (a) three month LIBOR plus 8.61% , or (b) 10.0% . The Loan Agreement also extended the maturity date to January 31, 2023. Borrowings under the Loan Agreement are secured by substantially all of our assets and are unconditionally guaranteed by each of our subsidiaries. The fair value of our note payable to Squadron was estimated based on prices for the same or similar issues and the current interest rates offered for the debt of the same remaining maturities, which are considered level 2 inputs in accordance with ASC Topic 820, “ Fair Value Measurements and Disclosures .” At March 31, 2018 , the fair value approximated the carrying value. In connection with the purchase of our office and warehouse space in Warsaw, Indiana in August 2013, we entered into a mortgage note payable to Tawani Enterprises Inc., an affiliate of Squadron. Pursuant to the terms of the mortgage note, we pay Tawani Enterprises Inc. monthly principal and interest installments of $16 with interest compounded at 5% until maturity in 2028, at which time a final payment of remaining principal and interest is due. The mortgage is secured by the related real estate and building. At December 31, 2017 , the mortgage balance was $1,531 of which current principal due of $113 was included in current portion of long-term debt. At March 31, 2018 , the mortgage balance was $1,503 of which current principal due of $114 was included in current portion of long-term debt. Interest expense relating to notes payable to Squadron and Tawani was $552 and $445 for the three months ended March 31, 2018 and 2017 , respectively.

STRATEGIC ARRANGEMENTS

STRATEGIC ARRANGEMENTS	3 Months Ended
	Mar. 31, 2018
Research and Development [Abstract]
STRATEGIC ARRANGEMENTS	STRATEGIC ARRANGEMENTS Effective December 1, 2007, we entered into a ten -year agreement with Case Western Reserve University (“CASE”) to assist in certain aspects of our research and development. Effective August 2, 2017, we entered into an Amended and Restated License Agreement to account for additional licensed product and extend the agreement for another ten years. The main focus of this research and development involves leveraging our exclusive rights to the Hamann-Todd Collection of the Cleveland National History Museum, the world's largest pediatric osteological collection, to assist in the design of implants which match pediatric bone curvature and structure. In exchange for services, CASE receives certain royalties and up-front fees. The royalties and certain fees are contingent upon our obtaining FDA approval and the launch of our products into the marketplace. CASE receives a minimum annual royalty of $10 or a royalty of 3% of net sales on products, whichever is greater. Additionally, for each new product developed, CASE will receive milestone payments of $5 for FDA approval to sell our products within the United States and $10 for general product launch. Additionally, CASE receives a royalty of 3% of net sales on products fully developed and being sold in the marketplace. The royalty expense recognized related to the CASE agreement is recorded as a component of cost of revenue and was $33 and $38 for the three months ended March 31, 2018 and 2017 , respectively. At March 31, 2018 and December 31, 2017 , $33 and $37 , respectively, was due to CASE.

INCOME TAXES

INCOME TAXES	3 Months Ended
	Mar. 31, 2018
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES For the three month periods ended March 31, 2018 and 2017 , we calculated the provision of income taxes by applying an estimate of the annual effective tax rate for the full fiscal year to the ordinary loss for the reporting period resulting in a zero tax provision consistent with prior periods. The deferred tax assets were fully offset by a valuation allowance at March 31, 2018 and December 31, 2017 , and no income tax benefit has been recognized in our condensed consolidated statements of operations for any of the periods presented. At December 31, 2017 , we had available federal and state tax loss carryforwards of $70,335 and tax credits for federal and state tax purposes of $335 which begin to expire in 2028. Any losses incurred in 2018 and beyond do not expire. An ownership change under Section 382 of the Internal Revenue Code was deemed to occur on May 30, 2014. Given the limitation calculation, we anticipate approximately $16,200 in losses generated prior to the ownership change date will be subject to potential limitation. The estimated annual limitation is $1,062 , which is increased by $2,302 over the first five years as a result of an unrealized built in gain. Management assesses the available positive and negative evidence to estimate whether sufficient future taxable income will be generated to permit use of the existing deferred tax assets. A significant piece of objective negative evidence evaluated was the cumulative loss incurred over the three-year period ended December 31, 2017 and through March 31, 2018. Such objective evidence limits the ability to consider other subjective evidence, such as our projections for future growth.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	3 Months Ended
	Mar. 31, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
STOCKHOLDERS' EQUITY	STOCKHOLDERS’ EQUITY Stock Options The fair value for options granted at the time of issuance were estimated at the date of grant using a Black-Scholes options pricing model. Significant assumptions included in the option value model include the fair value of our common stock at the grant date, weighted average volatility, risk-free interest rate, dividend yield and the forfeiture rate. There were no stock options granted in any of the periods presented. Our stock option activity and related information are summarized as follows: Weighted-Average Contractual Terms Options Exercise Price (in Years) Outstanding at January 1, 2018 176,959 $ 29.42 2.0 Forfeited or expired (36,234 ) 27.61 Outstanding at March 31, 2018 140,725 29.89 2.2 Options generally include a time-based vesting schedule permitting the options to vest ratably over three years. At March 31, 2018 and December 31, 2017 , all options were fully vested. There was no stock-based compensation expense on stock options for the three-month periods ended March 31, 2018 and 2017 , respectively. Restricted Stock Our restricted stock activity and related information are summarized as follows: Weighted-Average Remaining Restricted Contractual Terms Stock (in Years) Outstanding at January 1, 2018 548,005 0.3 Granted 149,350 Forfeited (335 ) Outstanding at March 31, 2018 697,020 0.6 Restricted stock exercisable at March 31, 2018 — At March 31, 2018 , there was $2,964 of unrecognized compensation expense remaining related to our service-based restricted stock awards. The unrecognized compensation cost was expected to be recognized over a weighted average period of 0.6 years or earlier upon an elimination of the restriction period as a result of an IPO or change in control event. Stock-based compensation expense on restricted stock amounted to $2,177 and $339 for the three months ended March 31, 2018 and 2017 , respectively. Due to our limited operating history and lack of marketability, a discount of 15% was applied when estimating the stock-based compensation expense on restricted stock granted in 2017. Total stock-based compensation expense is included as a component of general and administrative expenses in our statement of operations and was $2,177 and $339 for the three months ended March 31, 2018 and 2017 , respectively. Warrants For all periods presented, there were warrants issued and outstanding for the issuance of 44,101 shares of common stock. The warrants were issued at exercise prices ranging from $26.27 to $30.97 per share. The warrants generally have a ten -year term. At March 31, 2018 , no warrants had been exercised. At inception, no fair value was assigned to the warrants.

NET LOSS PER SHARE

NET LOSS PER SHARE	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
NET LOSS PER SHARE	NET LOSS PER SHARE The following is a reconciliation of basic and diluted net loss per share attributable to common stockholders: Three Months Ended March 31, 2018 2017 Net loss $ (5,000 ) $ (1,285 ) Accretion of cumulative dividends of redeemable preferred stock to redemption value — (1,426 ) Net loss attributable to common stockholders - basic and diluted $ (5,000 ) $ (2,711 ) Weighted average number of shares - basic and diluted 12,073,776 1,744,356 Net loss per share attributable to common stockholders - basic and diluted $ (0.41 ) $ (1.55 ) Our basic and diluted net loss per share is computed using the two-class method. The two-class method is an earnings allocation that determines net income per share for each class of common stock and participating securities according to their participation rights in dividends and undistributed earnings or losses. Non-vested restricted stock that includes non-forfeitable rights to dividends are considered participating securities. Prior to the completion of our IPO on October 12, 2017, we had authorized 7,000,000 shares of redeemable convertible preferred stock, of which 5,446,978 were outstanding as of March 31, 2017, designated in series, with the rights and preferences of each series determined by the Board of Directors. Upon completion of our IPO, all of our previously outstanding shares of Series A and B Preferred Stock were converted into common stock on a 1 :1 conversion ratio. As of March 31, 2018 and December 31, 2017, there are no redeemable convertible preferred shares outstanding. Series A and B preferred stock include rights to participate in dividends and distributions to common stockholders on an if-converted basis, and accordingly are also considered participating securities. During periods of undistributed losses however, no effect is given to our participating securities since they are not contractually obligated to share in the losses. Because we have incurred a net loss for all periods presented, diluted net loss per common share is the same as basic net loss per common share. The following contingently issuable and convertible equity shares were excluded from the calculation of diluted net loss per share because their effect would have been anti-dilutive for all periods presented (shares for the redeemable convertible preferred shares for the three-months ended March 31, 2017 were determined based on the applicable conversion ratio of 1 :1): Three Months Ended March 31, 2018 2017 Redeemable convertible preferred stock - Series A — 670,000 Redeemable convertible preferred stock - Series B — 2,979,475 Restricted stock 697,020 676,210 Stock options 140,725 248,871 Warrants 44,101 44,101 881,846 4,618,657

BUSINESS SEGMENT

BUSINESS SEGMENT	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
BUSINESS SEGMENT	BUSINESS SEGMENT Operating segments are defined as components of an enterprise for which separate financial information is available that is evaluated regularly by the chief operating decision maker, or decision making group, in deciding how to allocate resources and in assessing performance. We have one operating and reporting segment, OrthoPediatrics Corp., which designs, develops and markets anatomically appropriate implants and devices for children with orthopedic problems. Our chief operating decision-maker, our Chief Executive Officer, reviews financial information presented on a consolidated basis for purposes of making operating decisions and assessing financial performance, accompanied by disaggregated revenue information by product category. We do not assess the performance of our individual product categories on measures of profit or loss, or other asset-based metrics. Therefore, the information below is presented only for revenue by category and geography. Product sales attributed to a country or region includes product sales to hospitals, physicians and distributors and is based on the final destination where the products are sold. No individual customer accounted for more than 10% of total product sales for any of the periods presented. No customer accounted for more than 10% of consolidated accounts receivable as of March 31, 2018 and December 31, 2017 . Product sales by source were as follows: Three Months Ended March 31, Product sales by geographic location: 2018 2017 U.S. $ 8,653 $ 7,336 International 3,441 2,426 Total $ 12,094 $ 9,762 Three Months Ended March 31, Product sales by category: 2018 2017 Trauma and deformity $ 9,123 $ 7,740 Scoliosis 2,685 1,922 Sports medicine/other 286 100 Total $ 12,094 $ 9,762 No individual country with sales originating outside of the United States accounted for more than 10% of consolidated revenue for the three months ended March 31, 2018 and 2017 .

RELATED PARTY TRANSACTIONS

RELATED PARTY TRANSACTIONS	3 Months Ended
	Mar. 31, 2018
Related Party Transactions [Abstract]
RELATED PARTY TRANSACTIONS	RELATED PARTY TRANSACTIONS In addition to the debt and credit agreements and mortgage with Squadron and its affiliate (see Note 3), we currently use FMI Hansa Medical Products, LLC (“FMI”) and Structure Medical, LLC (“Structure Medical”) as two of our suppliers. Each of these entities is affiliated with Squadron. In 2017, FMI merged with and into Structure Medical. We do not have long-term contracts with either supplier. We made payments to FMI of $0 and $330 for the three months ended March 31, 2018 and 2017 , respectively. We made payments to Structure Medical of $701 and $247 for the three months ended March 31, 2018 and 2017 , respectively.

EMPLOYEE BENEFIT PLAN

EMPLOYEE BENEFIT PLAN	3 Months Ended
	Mar. 31, 2018
Retirement Benefits [Abstract]
EMPLOYEE BENEFIT PLAN	EMPLOYEE BENEFIT PLAN We have a defined-contribution plan, OrthoPediatrics 401(k) Retirement Plan (the “401(k) Plan”), which includes a cash or deferral (Section 401(k)) arrangement. The 401(k) Plan covers those employees who meet certain eligibility requirements and elect to participate. Employee contributions are limited to the annual amounts permitted under the Internal Revenue Code. The 401(k) Plan allows us to make a discretionary matching contribution. Discretionary matching contributions are determined annually by management. Effective January 1, 2018, we have elected to match our employees' 401(k) contributions up to 3% of employees' salary.

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	3 Months Ended
	Mar. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES We are involved with various legal actions arising in the ordinary course of our activities. We accrue for those cases where the potential liability is estimable and probable. From time to time, we are involved in various legal proceedings arising in the ordinary course of our business. On January 20, 2017, K2M, Inc. filed suit against us in the United States District Court for the District of Delaware (K2M, Inc. v. OrthoPediatrics Corp. et al., Case No. 1:17-cv-0061) seeking unspecified damages for alleged infringement of U.S. Patent No. 9,532,816. The complaint was amended on August 21, 2017 to add, among other things, a claim of patent infringement regarding U.S. Patent No. 9,655,664. These patents relate to certain instruments used in our RESPONSE spine systems, which represent a portion of our total scoliosis portfolio. We have denied these claims and responded with counterclaims seeking declaratory relief that the patents in question are both invalid and not infringed. The parties attended a court-ordered mediation on October 24, 2017, which did not resolve the dispute. On January 8 and 22, 2018, we filed our first and second petitions for inter partes review with the United States Patent and Trademark Office to challenge the validity of U.S. Patent No. 9,532,816 (OrthoPediatrics Corp., v. K2M, Inc., Inter Partes Case No. IPR2018-00429 and IPR2018-00521), and we expect to file additional petitions for inter partes review with the United States Patent and Trademark Office to challenge the validity of the above referenced U.S. Patent No. 9,655,664. Although we believe that the suit is without merit and will vigorously defend the claims asserted against us, intellectual property litigation can involve complex factual and legal questions, and an adverse resolution of this proceeding could have a material adverse effect on our business, operating results and financial condition. We are not presently a party to any other legal proceedings the outcome of which, if determined adversely to us, would individually or in the aggregate materially affect our financial position or results of operations or cash flows. As of March 31, 2018, we are contracted to pay royalties to individuals and entities that provide research and development services, which range from 0.5% to 20% of sales. Additionally, we have minimum royalty commitments of $500 annually through 2026. We have products in development that have milestone payments and royalty commitments. In any development project, there are significant variables that will affect the amount and timing of these payments and as of March 31, 2018 , we have not been able to determine the amount and timing of payments. We do not anticipate these future payments will have a material impact on our financial results.

SIGNIFICANT ACCOUNTING POLICI19

SIGNIFICANT ACCOUNTING POLICIES (Policies)	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
Basis of Presentation and Unaudited Interim Consolidated Financial Statements	Basis of Presentation The accompanying condensed consolidated financial statements include the accounts of OrthoPediatrics Corp. and its wholly-owned subsidiaries, OrthoPediatrics United States Distribution Corp., OrthoPediatrics EU Limited, OrthoPediatrics AUS PTY LTD and OrthoPediatrics NZ Limited (collectively, the “Company,” “we,” “our” or “us”). All intercompany balances and transactions have been eliminated. Unaudited Interim Consolidated Financial Statements We have prepared the accompanying condensed consolidated financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”). The accompanying condensed consolidated balance sheets as of March 31, 2018 and December 31, 2017 , the condensed consolidated statements of operations for the three months ended March 31, 2018 and 2017 , the condensed consolidated statements of comprehensive loss for the three months ended March 31, 2018 and 2017 , the condensed consolidated statement of stockholders’ equity for the three months ended March 31, 2018 and the condensed consolidated statements of cash flows for the three months ended March 31, 2018 and 2017 are unaudited and should be read in conjunction with the annual consolidated financial statements as of and for the year ended December 31, 2017 and related notes thereto contained in our Annual Report on Form 10-K filed with the Securities and Exchange Commission ("SEC") on March 15, 2018. The financial data and other financial information disclosed in the notes to the accompanying condensed consolidated financial statements are also unaudited. As such, certain information and footnote disclosures normally included in financial statements prepared in accordance with GAAP have been condensed or omitted pursuant to applicable rules and regulations thereunder. The unaudited condensed consolidated financial statements have been prepared on the same basis as the audited consolidated financial statements as of and for the year ended December 31, 2017 and, in management’s opinion, include all adjustments, consisting of only normal recurring adjustments, necessary for the fair presentation of the financial statements for the interim periods. The results of operations for the three months ended March 31, 2018 are not necessarily indicative of the results to be expected for the full fiscal year or for any other period. The accompanying condensed consolidated financial statements have been prepared assuming our Company will continue as a going concern.
Use of Estimates	Use of Estimates Preparation of the condensed consolidated financial statements requires the use of estimates and assumptions that affect the reported amounts of assets, liabilities, revenues and expenses, as of the date of the condensed consolidated financial statements. By their nature, these judgments are subject to an inherent degree of uncertainty. We use historical experience and other assumptions as the basis for our judgments and estimates. Because future events and their effects cannot be determined with precision, actual results could differ significantly from these estimates. Any changes in these estimates will be reflected in the condensed consolidated financial statements.
Foreign Currency Transactions	Foreign Currency Transactions We currently bill our international distributors in United States ("U.S.") dollars, resulting in minimal foreign exchange transaction expense. Beginning in the second quarter of 2017, we began selling direct within the United Kingdom, Ireland, Australia and New Zealand and billing using the local currency for each country. The financial statements of our foreign subsidiaries are accounted for and have been translated into U.S. dollars using end-of-period exchange rates for assets and liabilities and average exchange rates during each reporting period for results of operations. Foreign currency translation adjustments have been recorded as a separate component of the condensed consolidated statements of comprehensive loss.
Fair Value of Financial Instruments	Fair Value of Financial Instruments The accounting standards related to fair value measurements define fair value and provide a consistent framework for measuring fair value under the authoritative literature. Valuation techniques are based on observable and unobservable inputs. Observable inputs reflect readily obtainable data from independent sources, while unobservable inputs reflect market assumptions. This guidance only applies when other standards require or permit the fair value measurement of assets and liabilities. The guidance does not expand the use of fair value measurements. A fair value hierarchy was established, which prioritizes the inputs used in measuring fair value into three broad levels: Level 1 – Quoted prices in active markets for identical assets or liabilities; Level 2 – Observable market-based inputs or unobservable inputs that are corroborated by market data; and Level 3 – Significant unobservable inputs that are not corroborated by market data. Generally, these fair value measures are model-based valuation techniques such as, discounted cash flows, and are based on the best information available, including our own data. We do not have any assets or liabilities that are measured on a recurring basis under the presented fair value hierarchy.
Revenue Recognition - United States and International	Revenue from Contracts with Customers The Company adopted ASC 606, " Revenue From Contracts With Customers (ASC 606)", on January 1, 2018 using the modified retrospective method for all contracts not completed as of the date of adoption. The adoption of ASC 606 did not have any impact on the Company’s consolidated historical financial statements. The reported results for 2018 reflect the application of ASC 606 guidance while the reported results for 2017 were prepared under the guidance of "ASC 605, Revenue Recognition (ASC 605)." In accordance with ASC 606, revenue is recognized when a customer obtains control of promised goods or services. The amount of revenue recognized reflects the consideration to which the Company expects to be entitled to receive in exchange for these goods or services, and excludes any sales incentives or taxes collected from a customer which are subsequently remitted to government authorities Revenue Recognition – United States Revenue in the United States is generated primarily from the sale of our implants and, to a much lesser extent, from the sale of our instruments. Sales in the United States are primarily to hospital accounts through independent sales agencies. We recognize revenue when our performance obligations under the terms of a contract with our customer are satisfied. This typically occurs when we transfer control of our products to the customer, generally upon implantation or when title passes upon shipment. The products are generally consigned to our independent sales agencies, and revenue is recognized when the products are used by or shipped to the hospital for surgeries on a case by case basis. On rare occasions, hospitals purchase products for their own inventory, and revenue is recognized when the products are shipped and the title and risk of loss passes to the customer. Pricing for each customer is dictated by a unique pricing agreement, which does not generally include rebates or discounts. Revenue Recognition – International Outside of the United States, we primarily sell our products through independent stocking distributors. Generally, the distributors are allowed to return products, and some are thinly capitalized. Based on our history of collections and returns from international customers, we have concluded that collectability is not reasonably assured at the time of delivery for certain customers who have not evidenced a consistent pattern of timely payment. Accordingly, we do not recognize international revenue and associated cost of revenue at the time title transfers for these customers for whom collectibility has not been deemed probable based on the customer’s history and ability to pay, but rather when cash has been received. Until such payment, cost of revenue is recorded as inventories held by international distributors, net of adjustment for estimated unreturnable inventory, on our balance sheets. For international independent stocking distributors for whom we have determined collectability is probable, based on a history of reliable collections, we have concluded that a contract exists and revenue should be recognized when we transfer control of our products to the customer, generally upon implantation or when title passes upon shipment. In early 2017, we expanded operations and established legal entities in the United Kingdom, Australia and New Zealand permitting us to sell under an agency model direct to local hospitals in these countries. The products are generally consigned to our independent sales agencies, and revenue is recognized when the products are used by or shipped to the hospital for surgeries on a case by case basis. On rare occasions, hospitals purchase products for their own inventory, and revenue is recognized when the products are shipped and the title and risk of loss passes to the customer. Pricing for each customer is dictated by a unique pricing agreement, which does not generally include rebates or discounts.
Cash and Cash Equivalents	Cash and Cash Equivalents We maintain cash in bank deposit accounts which, at times, may exceed federally insured limits. To date, we have not experienced any loss in such accounts. We consider all highly liquid investments with original maturity of three months or less at inception to be cash equivalents. The carrying amounts reported in the balance sheet for cash are valued at cost, which approximates fair value.
Accounts Receivable - United States	Accounts Receivable – United States Domestic accounts receivable are uncollateralized customer obligations due under normal trade terms, generally requiring payment within 30 days from the invoice date. Account balances with invoices over 30 days past due are considered delinquent. No interest is charged on past due accounts. Payments of accounts receivable are applied to the specific invoices identified on the customer's remittance advice or, if unspecified, to the customer's account as an unapplied credit. The carrying amount of domestic accounts receivable is reduced by an allowance that reflects management's best estimate of the amounts that will not be collected, determined principally on the basis of historical experience, management's assessment of the collectability of specific customer accounts and the aging of the accounts receivable. All accounts or portions thereof deemed to be uncollectible or to require an excessive collection cost are written off to the allowance for doubtful accounts.
Inventories, net	Inventories, net Inventories are stated at the lower of cost or net realizable value, with cost determined using the first-in-first-out method. Inventories, which consist of implants and instruments held in our warehouse or with third-party independent sales agencies or distributors, are considered finished goods and are purchased from third parties. We evaluate the carrying value of our inventories in relation to the estimated forecast of product demand, which takes into consideration the life cycle of the product. A significant decrease in demand could result in an increase in the amount of excess inventory on hand, which could lead to additional charges for excess and obsolete inventory. The need to maintain substantial levels of inventory impacts our estimates for excess and obsolete inventory. Each of our implant systems are designed to include implantable products that come in different sizes and shapes to accommodate the surgeon’s needs. Typically, a small number of the set components are used in each surgical procedure. Certain components within each set may become obsolete before other components based on the usage patterns. We adjust inventory values, as needed, to reflect these usage patterns and life cycle. In addition, we continue to introduce new products, which may require us to take additional charges for excess and obsolete inventory in the future.
Property and Equipment, net	Property and Equipment, net Property and equipment are carried at cost less accumulated depreciation. Depreciation is computed using the straight-line method over the estimated useful life of the assets. When assets are retired or otherwise disposed of, costs and related accumulated depreciation are removed from the accounts, and any resulting gain or loss is recognized in operations for the period. Maintenance and repairs that prolong or extend the useful life are capitalized, whereas standard maintenance, replacements, and repair costs are expensed as incurred. Instruments are hand-held devices, specifically designed for use with our implants and are used by surgeons during surgery. Instruments deployed within the United States, United Kingdom, Australia and New Zealand are carried at cost less accumulated depreciation and are recorded in property and equipment, net on the condensed consolidated balance sheets. Sample inventory consists of our implants and instruments, and is maintained to market and promote our products. Sample inventory is carried at cost less accumulated depreciation. Depreciable lives are generally as follows: Building and building improvements 25 to 30 years Furniture and fixtures 5 to 7 years Computer equipment 3 to 5 years Business software 3 years Office and other equipment 5 to 7 years Instruments 5 years Sample inventory 2 years
Amortizable Intangible Assets, net	Amortizable Intangible Assets, net Amortizable intangible assets include fees necessary to secure various patents and licenses. Amortization is calculated on a straight-line basis over the estimated useful life of the patents and licenses. Amortization for patents and licenses commences at the time of patent approval and market launch, respectively. Intangible assets are amortized over a 3 to 20 year period. Amortizable intangible assets are assessed for impairment annually or whenever events or changes in circumstances indicate that the carrying value of an asset may not be recoverable. Recoverability is measured by a comparison of the carrying amount to future net undiscounted cash flows expected to be generated by the associated asset. If such assets are determined to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount exceeds the fair market value of the assets.
Other Intangible Assets	Other Intangible Assets We have indefinite lived tradename assets that are reviewed for impairment by performing a quantitative analysis, which occurs annually in the fourth quarter or whenever events or changes in circumstances indicate that the carrying value of an asset may not be recoverable. Recoverability is measured by a comparison of the carrying amount to future net undiscounted cash flows expected to be generated by the associated asset. If such assets are determined to be impaired, the impairment to be recognized is measured by the amount by which the carrying amount exceeds the fair market value of the assets.
Cost of Revenue	Cost of Revenue Cost of revenue consists primarily of products purchased from third-party suppliers, excess and obsolete inventory adjustments, inbound freight, and royalties. Our implants and instruments are manufactured to our specifications by third-party suppliers who meet our manufacturer qualifications standards. Our third-party manufacturers are required to meet the standards of the Food and Drug Administration (the “FDA”), and the International Organization for Standardization, as well as other country-specific quality standards. The majority of our implants and instruments are produced in the United States.
Sales and Marketing Expenses	Sales and Marketing Expenses Sales and marketing expenses primarily consist of commissions to our domestic and select international independent sales agencies and consignment distributors, as well as compensation, commissions, benefits and other related costs for personnel we employ. Commissions and bonuses are generally based on a percentage of sales. Our international independent stocking distributors purchase instrument sets and replenishment stock for resale, and we do not pay commissions or any other sales related costs for international sales to distributors.
Advertising Costs	Advertising Costs Advertising costs consist primarily of print advertising, trade shows, and other related expenses. Advertising costs are expensed as incurred and are recorded as a component of sales and marketing expense.
Research and Development Costs	Research and Development Costs Research and development costs are expensed as incurred. Our research and development expenses primarily consist of costs associated with engineering, product development, consulting services, outside prototyping services, outside research activities, materials, development and protection of our intellectual property portfolio, as well as other costs associated with development of our products. Research and development costs also include related personnel and consultants’ compensation expense.
Stock-Based Compensation	Stock-Based Compensation Prior to our IPO, we maintained an Amended and Restated 2007 Equity Incentive Plan (the “2007 Plan”) that provides for grants of options and restricted stock to employees, directors and associated third-party representatives of our Company as determined by the Board of Directors. The 2007 Plan had authorized 1,585,000 shares for award. Immediately prior to our IPO, we adopted our 2017 Incentive Award Plan (the "2017 Plan") which replaced the 2007 Plan. The 2017 Plan provides for grants of options and restricted stock to officers, employees, consultants or directors of our Company. The 2017 Plan has authorized 1,789,647 shares for award. Options holders, upon vesting, may purchase common stock at the exercise price, which is the estimated fair value of our common stock on the date of grant. Option grants generally vest immediately or over three years . No stock options were granted in any of the periods presented. Restricted stock may not be transferred prior to the expiration of the restricted period. The restricted stock that had been granted under the 2007 Plan had restriction periods that generally last until the earlier of six years from the date of grant, or an IPO or change in control, as defined in the 2007 Plan. All restricted stock granted prior to May 2014 vested upon our IPO and the remaining grants under the 2007 Plan vested six months after the IPO. We recognize the reversal of stock compensation expense when a restricted stock forfeiture occurs as opposed to estimating future forfeitures. We estimate the fair value of stock options and restricted stock at the grant date. Stock-based compensation is recognized ratably over the requisite service period, which is generally the vesting period for stock options and the restriction period for restricted stock. Calculating the fair value of stock-based awards requires that we make highly subjective assumptions. We use the Black-Scholes option pricing model to value our stock options. Use of the valuation methodology requires that we make assumptions as to the volatility of our common stock, the expected term of our stock options and the risk free rate of return for a period that approximates the expected term of our stock options. Because we were a privately-held company with a limited operating history, we utilized the historical stock price volatility from a representative group of comparable industry competitors to estimate expected stock price volatility. Prior to the IPO, in determining the fair value of our common stock at the grant date, which is the basis for the fair value of stock based awards, we used the market approach, which was based on the assumption that the value of an asset is equal to the value of a substitute asset with the same characteristics. In using the market approach, we consider both the guideline public company method and the precedent transaction method. Given the absence of a public trading market for our common stock prior to our IPO, we exercised reasonable judgment and considered a number of objective and subjective factors to determine the best estimate of the fair value of our common stock, including: the preferences and dividends of our redeemable convertible preferred stock relative to those of our common stock; our operating results and financial conditions, including our level of available capital resources; equity market conditions affecting comparable public companies; general U.S. market conditions; and the lack of marketability of our common stock. Prior to our IPO, for restricted stock awards we applied a discount for lack of marketability to the fair value of common shares due to estimate the impact of valuing a minority interest in our Company as a closely held, non-public company with no liquid market for its shares. Following the IPO, we value restricted stock awards using the market value on the grant date.
Comprehensive Income	Comprehensive Income Comprehensive income is defined as the change in equity during a period from transactions and other events and circumstances from non-owner sources. Comprehensive income includes foreign currency translation adjustments.
Income Taxes	Income Taxes We account for income taxes under the asset and liability method, which requires the recognition of deferred tax assets and liabilities for the expected future tax consequences of events that have been included in the financial statements. Under this method, we determine deferred tax assets and liabilities on the basis of the differences between the financial statement and tax bases of assets and liabilities by using enacted tax rates in effect for the year in which the differences are expected to reverse. The effect of a change in tax rates on deferred tax assets and liabilities is recognized in income in the period that includes the enactment date. We recognize deferred tax assets to the extent that we believe that these assets are more likely than not to be realized. In making such a determination, we consider all available positive and negative evidence. If we determine that we would be able to realize our deferred tax assets in the future in excess of their net recorded amount, we would make an adjustment to the valuation allowance. We record uncertain tax positions on the bases of a two-step process in which (i) we determine whether it is more likely than not that the tax positions will be sustained on the basis of the technical merits of the positions and (ii) for those tax positions that meet the more-likely-than-not recognition threshold, we recognize the largest amount of tax benefit that is more than 50% likely to be realized upon ultimate settlement with the related tax authority.
Emerging Growth Company, Reporting Requirements	“Emerging Growth Company” Reporting Requirements We qualify as an “emerging growth company” as defined in the Jumpstart Our Business Startups Act (the “JOBS Act”). For as long as a company is deemed to be an emerging growth company, it may take advantage of specified reduced reporting and other regulatory requirements that are generally unavailable to other public companies. Among other things, we are not required to provide an auditor attestation report on the assessment of the internal control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act of 2002. Section 107 of the JOBS Act also provides that an emerging growth company can delay the adoption of certain accounting standards until those standards would otherwise apply to private companies. We have irrevocably elected not to avail ourselves of this exemption from new or revised accounting standards and, therefore, we will be subject to the same new or revised accounting standards as other public companies that are not emerging growth companies.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In May 2014, the FASB issued ASU 2014-09 “ Revenue from Contracts with Customers ,” on the recognition of revenue for all contracts with customers designed to improve comparability and enhance financial statement disclosures. The underlying principle of this comprehensive model is that revenue is recognized to depict the transfer of promised goods or services to customers in an amount that reflects the payment to which the company expects to be entitled in exchange for those goods or services. It also requires enhanced disclosures about revenue, provides guidance for transactions that were not previously addressed comprehensively, and improves guidance for multiple-element arrangements. The FASB subsequently issued amendments to ASU No. 2014-09 that have the same effective date and transition date. These standards became effective for us on January 1, 2018. We have performed a review of these new standards as compared to our current accounting policies for revenue recognition. During the fourth quarter of 2017 we finalized our assessments over the impact that these new standards will have on our consolidated results of operations, financial position and disclosures. We elected to apply the modified retrospective approach and as of December 31, 2017, we have not identified any accounting changes that would materially impact the amount of reported revenues and did not record any adjustments on January 1, 2018, related to this new guidance. In February 2016, the FASB issued ASU 2016-02 “ Leases, ” which outlines a comprehensive lease accounting model and supersedes the current lease guidance. The new standard requires lessees to recognize lease liabilities and corresponding right-of-use assets for all leases with lease terms of greater than twelve months. It also changes the definition of a lease and expands the disclosure requirements of lease arrangements. The new standard must be adopted using the modified retrospective approach and will be effective starting in the first quarter of 2019. Early adoption is permitted. We are currently evaluating the impact of this standard, but we do not believe this guidance will have a material effect on our financial position, results of operations or cash flows. In August 2016, the FASB issued ASU No. 2016-15 “Statement of Cash Flows (Topic 230), Classification of Certain Cash Receipts and Cash Payments" which provides guidance intended to reduce diversity in practice in how certain transactions are classified in the statement of cash flows. We adopted ASU 2016-15 effective January 1, 2018. The adoption did not have any impact on our consolidated financial position, results of operations and cash flows. In March 2018, the FASB issued ASU 2018-05 " Income Taxes (Topic 740), Amendments to SEC Paragraphs Pursuant to SEC Staff Accounting Bulletin No. 118 ("SAB No. 118”), to state the income tax accounting implications of the Tax Cuts and Jobs Act (“New Tax Act”)" which clarifies the measurement period time frame, changes in subsequent reporting periods and reporting requirements as a result of the New Tax Act of 2017. In accordance with SAB No. 118, a company must reflect the income tax effects of those aspects of the New Tax Act for which the accounting under ASC 740 is complete. To the extent that a company’s accounting for certain income tax effects of the New Tax Act is incomplete but it is able to determine a reasonable estimate, it must record a provisional estimate in the financial statements. If a company cannot determine a provisional estimate to be included in the financial statements, it should continue to apply ASC 740 on the basis of the provisions of the tax laws that were in effect immediately before the enactment of the New Tax Act. SAB No. 118 provides a measurement period that should not extend beyond one year and it begins in the period that includes the enactment date which was December 22, 2017. We have not completed the accounting for the income tax effects of certain elements of the New Tax Act, which will become effective in future years. When additional guidance and regulations enable us to finalize certain tax positions, we will reflect the impact of this ASU 2018-05 on the tax provision and deferred tax calculation as of December 31, 2018. The Section 382 ownership change analysis will be re–evaluated prior to release of the year-ending December 31, 2018 financial statements to account for equity ownership changes that occur during 2018.

SIGNIFICANT ACCOUNTING POLICI20

SIGNIFICANT ACCOUNTING POLICIES (Tables)	3 Months Ended
	Mar. 31, 2018
Accounting Policies [Abstract]
Property and equipment, depreciable lives	Depreciable lives are generally as follows: Building and building improvements 25 to 30 years Furniture and fixtures 5 to 7 years Computer equipment 3 to 5 years Business software 3 years Office and other equipment 5 to 7 years Instruments 5 years Sample inventory 2 years

DEBT AND CREDIT ARRANGEMENTS (T

DEBT AND CREDIT ARRANGEMENTS (Tables)	3 Months Ended
	Mar. 31, 2018
Debt Disclosure [Abstract]
Schedule of long-term debt instruments	Long-term debt consisted of the following: March 31, December 31, 2018 2017 Note payable to Squadron $ 20,000 $ 20,000 Revolving credit facility with Squadron 3,930 3,921 Mortgage payable to affiliate 1,503 1,531 Total debt 25,433 25,452 Less: current maturities 114 113 Long-term debt, net of current maturities $ 25,319 $ 25,339

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	3 Months Ended
	Mar. 31, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of stock option activity	Our stock option activity and related information are summarized as follows: Weighted-Average Contractual Terms Options Exercise Price (in Years) Outstanding at January 1, 2018 176,959 $ 29.42 2.0 Forfeited or expired (36,234 ) 27.61 Outstanding at March 31, 2018 140,725 29.89 2.2
Schedule of restricted stock activity	Our restricted stock activity and related information are summarized as follows: Weighted-Average Remaining Restricted Contractual Terms Stock (in Years) Outstanding at January 1, 2018 548,005 0.3 Granted 149,350 Forfeited (335 ) Outstanding at March 31, 2018 697,020 0.6 Restricted stock exercisable at March 31, 2018 —

NET LOSS PER SHARE (Tables)

NET LOSS PER SHARE (Tables)	3 Months Ended
	Mar. 31, 2018
Earnings Per Share [Abstract]
Reconciliation of basic and diluted net loss per share attributable to common stockholders	The following is a reconciliation of basic and diluted net loss per share attributable to common stockholders: Three Months Ended March 31, 2018 2017 Net loss $ (5,000 ) $ (1,285 ) Accretion of cumulative dividends of redeemable preferred stock to redemption value — (1,426 ) Net loss attributable to common stockholders - basic and diluted $ (5,000 ) $ (2,711 ) Weighted average number of shares - basic and diluted 12,073,776 1,744,356 Net loss per share attributable to common stockholders - basic and diluted $ (0.41 ) $ (1.55 )
Schedule of antidilutive securities excluded from computation of net loss per share	The following contingently issuable and convertible equity shares were excluded from the calculation of diluted net loss per share because their effect would have been anti-dilutive for all periods presented (shares for the redeemable convertible preferred shares for the three-months ended March 31, 2017 were determined based on the applicable conversion ratio of 1 :1): Three Months Ended March 31, 2018 2017 Redeemable convertible preferred stock - Series A — 670,000 Redeemable convertible preferred stock - Series B — 2,979,475 Restricted stock 697,020 676,210 Stock options 140,725 248,871 Warrants 44,101 44,101 881,846 4,618,657

BUSINESS SEGMENT (Tables)

BUSINESS SEGMENT (Tables)	3 Months Ended
	Mar. 31, 2018
Segment Reporting [Abstract]
Schedule of product sales by geographic location	Product sales by source were as follows: Three Months Ended March 31, Product sales by geographic location: 2018 2017 U.S. $ 8,653 $ 7,336 International 3,441 2,426 Total $ 12,094 $ 9,762
Schedule of product sales by category	Three Months Ended March 31, Product sales by category: 2018 2017 Trauma and deformity $ 9,123 $ 7,740 Scoliosis 2,685 1,922 Sports medicine/other 286 100 Total $ 12,094 $ 9,762

BUSINESS - Narrative (Details)

BUSINESS - Narrative (Details) - IPO $ / shares in Units, $ in Thousands, shares in Millions	Oct. 12, 2017USD ($)$ / sharesshares
Common Stock
Class of Stock [Line Items]
Stock issued during period, shares, new issues (in shares) | shares	4.6
Public offering price (usd per share) | $ / shares	$ 13
Gross proceeds on sale of stock	$ 59,800
Net proceeds on sale of stock	46,900
Underwriting discounts and commissions on sale of stock	4,200
Offering costs	2,700
Series B Preferred Stock
Class of Stock [Line Items]
Dividend payments	$ 6,000

SIGNIFICANT ACCOUNTING POLICI26

SIGNIFICANT ACCOUNTING POLICIES - Narrative (Details) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Accounting Policies [Abstract]
Accumulated deficit	$ 108,066,000		$ 103,066,000
Impairment charges, finite-lived	0	$ 0
Impairment charges, indefinite-lived	0	0
Research and development costs	$ 1,218,000	$ 687,000

SIGNIFICANT ACCOUNTING POLICI27

SIGNIFICANT ACCOUNTING POLICIES - Borrowings (Details) - USD ($)	Mar. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Long-term debt	$ 25,433,000	$ 25,452,000
Revolving Credit Facility
Debt Instrument [Line Items]
Revolving credit facility		15,000,000
Note payable to Squadron
Debt Instrument [Line Items]
Long-term debt	$ 20,000,000	$ 20,000,000

SIGNIFICANT ACCOUNTING POLICI28

SIGNIFICANT ACCOUNTING POLICIES - Assets Useful Lives (Details)	3 Months Ended
	Mar. 31, 2018
Minimum
Property, Plant and Equipment [Line Items]
Intangible asset, useful life	3 years
Maximum
Property, Plant and Equipment [Line Items]
Intangible asset, useful life	20 years
Building and building improvements | Minimum
Property, Plant and Equipment [Line Items]
Depreciable lives	25 years
Building and building improvements | Maximum
Property, Plant and Equipment [Line Items]
Depreciable lives	30 years
Furniture and fixtures | Minimum
Property, Plant and Equipment [Line Items]
Depreciable lives	5 years
Furniture and fixtures | Maximum
Property, Plant and Equipment [Line Items]
Depreciable lives	7 years
Computer equipment | Minimum
Property, Plant and Equipment [Line Items]
Depreciable lives	3 years
Computer equipment | Maximum
Property, Plant and Equipment [Line Items]
Depreciable lives	5 years
Business software
Property, Plant and Equipment [Line Items]
Depreciable lives	3 years
Office and other equipment | Minimum
Property, Plant and Equipment [Line Items]
Depreciable lives	5 years
Office and other equipment | Maximum
Property, Plant and Equipment [Line Items]
Depreciable lives	7 years
Instruments
Property, Plant and Equipment [Line Items]
Depreciable lives	5 years
Sample inventory
Property, Plant and Equipment [Line Items]
Depreciable lives	2 years

SIGNIFICANT ACCOUNTING POLICI29

SIGNIFICANT ACCOUNTING POLICIES - Stock-Based Compensation (Details) - shares	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Options granted (in shares)	0	0
Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	3 years
Restricted stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vesting period (in years)	6 years
2007 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for award (in shares)	1,585,000
Vesting period (in years)	6 months
2017 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for award (in shares)	1,789,647

DEBT AND CREDIT ARRANGEMENTS -

DEBT AND CREDIT ARRANGEMENTS - Schedule of Long-term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2018	Dec. 31, 2017
Debt Instrument [Line Items]
Long-term debt	$ 25,433	$ 25,452
Less: current maturities	114	113
Total long-term debt, net of current maturities	25,319	25,339
Note payable to Squadron
Debt Instrument [Line Items]
Long-term debt	20,000	20,000
Revolving credit facility with Squadron | Revolving Credit Facility
Debt Instrument [Line Items]
Long-term debt	3,930	3,921
Mortgage payable to affiliate
Debt Instrument [Line Items]
Long-term debt	1,503	1,531
Less: current maturities	$ 114	$ 113

DEBT AND CREDIT ARRANGEMENTS 31

DEBT AND CREDIT ARRANGEMENTS - Narrative (Details) - USD ($)	Dec. 31, 2017	Apr. 30, 2017	Oct. 31, 2017	Aug. 31, 2013	Mar. 31, 2018	Mar. 31, 2017	Nov. 30, 2015	May 31, 2014
Debt Instrument [Line Items]
Mortgage balance	$ 25,452,000				$ 25,433,000
Current portion of long-term debt with affiliate	113,000				114,000
Note payable to Squadron
Debt Instrument [Line Items]
Interest rate		11.00%					10.00%	10.00%
Additional revolving loan commitment		$ 16,000,000					$ 7,000,000
Deferred financing cost		$ 1,000,000
Extension fee payable period		3 years
Mortgage balance	20,000,000				20,000,000
Debt instrument, extension fee cancelled			$ 667,000
Interest expense					552,000	$ 445,000
Mortgage payable to affiliate
Debt Instrument [Line Items]
Interest rate				5.00%
Mortgage balance	1,531,000				1,503,000
Monthly interest and principal installments				$ 16,000
Current portion of long-term debt with affiliate	113,000				$ 114,000
Revolving Credit Facility
Debt Instrument [Line Items]
Revolving credit facility	$ 15,000,000
Three month LIBOR | Revolving Credit Facility
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate	8.61%
Debt instrument, interest rate, effective percentage	10.00%

STRATEGIC ARRANGEMENTS (Details

STRATEGIC ARRANGEMENTS (Details) - USD ($)	Aug. 02, 2017	Dec. 01, 2007	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Minimum annual royalty payment			$ 500,000
CASE
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Royalty expense			33,000	$ 38,000
Royalty payable			$ 33,000		$ 37,000
Royalty Agreement Terms | CASE
Research and Development Arrangement, Contract to Perform for Others [Line Items]
Royalty agreement period	10 years	10 years
Minimum annual royalty payment		$ 10,000
Royalty agreement percentage		3.00%
Milestone payments for FDA approval to sell our products within the United States		$ 5,000
Milestone payment for general product launch		$ 10,000

INCOME TAXES (Details)

INCOME TAXES (Details) - USD ($)	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Tax provision	$ 0	$ 0
Loss carryforwards			$ 70,335,000
Tax credit carryforward			$ 335,000
Estimated limitation on losses generated prior to ownership change date	16,200,000
Estimated annual limitation of losses	1,062,000
Increase of estimated annual limitation of first five years	$ 2,302,000

STOCKHOLDERS' EQUITY - Stock Op

STOCKHOLDERS' EQUITY - Stock Options (Details) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Granted (in shares)	0	0
Options
Outstanding at period start (in shares)	176,959
Forfeited or expired (in shares)	(36,234)
Outstanding at period end (in shares)	140,725		176,959
Weighted-Average Exercise Price
Outstanding at period start, Weighted-Average Exercise Price (in dollars per share)	$ 29.42
Forfeited or expired, Weighted-Average Exercise Price (in dollars per share)	27.61
Outstanding at period end, Weighted-Average Exercise Price (in dollars per share)	$ 29.89		$ 29.42
Contractual Terms (in years)	2 years 2 months 12 days		2 years
Stock Option
Weighted-Average Exercise Price
Vesting period (in years)	3 years
Stock-based compensation expense	$ 0	$ 0

STOCKHOLDERS' EQUITY - Restrict

STOCKHOLDERS' EQUITY - Restricted Stock (Details) - Restricted stock - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2018	Mar. 31, 2017	Dec. 31, 2017
Restricted Stock
Outstanding at period start (in shares)	548,005
Granted (in shares)	149,350
Forfeited (in shares)	(335)
Outstanding at period end (in shares)	697,020		548,005
Weighted-Average Remaining Contractual Terms (in years)	7 months 6 days		3 months 18 days
Restricted stock exercisable (in shares)	0
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized [Abstract]
Unrecognized compensation expense	$ 2,964
Unrecognized compensation expense, weighted average period of recognition (in years)	7 months 6 days
Stock-based compensation expense	$ 2,177	$ 339
Stock-based compensation expense, discount rate			15.00%
General and Administrative Expense
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized [Abstract]
Stock-based compensation expense	$ 2,177	$ 339

STOCKHOLDERS' EQUITY - Warrants

STOCKHOLDERS' EQUITY - Warrants (Details)	3 Months Ended
	Mar. 31, 2018$ / sharesshares
Class of Warrant or Right [Line Items]
Term of warrants (in years)	10 years
Number of warrants exercised (in shares) | shares	0
Minimum
Class of Warrant or Right [Line Items]
Warrants exercise price (in dollars per share) | $ / shares	$ 26.27
Maximum
Class of Warrant or Right [Line Items]
Warrants exercise price (in dollars per share) | $ / shares	$ 30.97
Common Stock
Class of Warrant or Right [Line Items]
Number of common stock called by warrants (in shares) | shares	44,101

NET LOSS PER SHARE - Reconcilia

NET LOSS PER SHARE - Reconciliation of basic and diluted net loss per share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Earnings Per Share [Abstract]
Net loss	$ (5,000)	$ (1,285)
Accretion of cumulative dividends of redeemable preferred stock to redemption value	0	(1,426)
Net loss attributable to common stockholders - basic	(5,000)	(2,711)
Net loss attributable to common stockholders - diluted	$ (5,000)	$ (2,711)
Weighted average number of shares - basic and diluted	12,073,776	1,744,356
Net loss per share attributable to common stockholders - basic and diluted (in dollars per share)	$ (0.41)	$ (1.55)

NET LOSS PER SHARE - Narrative

NET LOSS PER SHARE - Narrative (Details) - shares	Mar. 31, 2018	Dec. 31, 2017	Oct. 12, 2017	Mar. 31, 2017	Dec. 31, 2016
Temporary Equity [Line Items]
Redeemable convertible preferred stock, authorized (in shares)					7,000,000
Redeemable convertible preferred stock, outstanding (in shares)	0	0		5,446,978
Redeemable Convertible Preferred Stock
Temporary Equity [Line Items]
Conversion ratio			1	1

NET LOSS PER SHARE - Antidiluti

NET LOSS PER SHARE - Antidilutive Securities (Details) - shares	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	881,846	4,618,657
Restricted stock
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	697,020	676,210
Stock options
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	140,725	248,871
Warrants
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	44,101	44,101
Redeemable convertible preferred stock - Series A | Redeemable convertible preferred stock - Series A and Series B
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	0	670,000
Redeemable convertible preferred stock - Series B | Redeemable convertible preferred stock - Series A and Series B
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share	0	2,979,475

BUSINESS SEGMENT - Narrative (D

BUSINESS SEGMENT - Narrative (Details)	3 Months Ended
	Mar. 31, 2018segment
Segment Reporting [Abstract]
Number of operating segments	1
Number of reportable segments	1

BUSINESS SEGMENT - Schedule of

BUSINESS SEGMENT - Schedule of Revenue by Geographical Location (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenues	$ 12,094	$ 9,762
U.S.
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenues	8,653	7,336
International
Revenues from External Customers and Long-Lived Assets [Line Items]
Revenues	$ 3,441	$ 2,426

BUSINESS SEGMENT - Schedule o42

BUSINESS SEGMENT - Schedule of Revenue by Category (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Segment Reporting Information [Line Items]
Revenues	$ 12,094	$ 9,762
Trauma and deformity
Segment Reporting Information [Line Items]
Revenues	9,123	7,740
Scoliosis
Segment Reporting Information [Line Items]
Revenues	2,685	1,922
Sports medicine/other
Segment Reporting Information [Line Items]
Revenues	$ 286	$ 100

RELATED PARTY TRANSACTIONS (Det

RELATED PARTY TRANSACTIONS (Details) - Affiliated Entity $ in Thousands	3 Months Ended
	Mar. 31, 2018USD ($)supplier	Mar. 31, 2017USD ($)
Related Party Transaction [Line Items]
Number of related party suppliers | supplier	2
FMI
Related Party Transaction [Line Items]
Payments to related party	$ 0	$ 330
Structure Medical
Related Party Transaction [Line Items]
Payments to related party	$ 701	$ 247

EMPLOYEE BENEFIT PLAN - Narrati

EMPLOYEE BENEFIT PLAN - Narrative (Details)	Jan. 01, 2018
Retirement Benefits [Abstract]
Employer contribution as a percentage of employees' salary	3.00%

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details)	3 Months Ended
	Mar. 31, 2018USD ($)
Long-term Purchase Commitment [Line Items]
Minimum annual royalty payment	$ 500,000
Minimum
Long-term Purchase Commitment [Line Items]
Royalty agreement percentage	0.50%
Maximum
Long-term Purchase Commitment [Line Items]
Royalty agreement percentage	20.00%