OrthoPediatrics (KIDS) 10-Q 6 Aug 24 2024 Q2 Quarterly report Financial data

COVER

COVER - shares	6 Months Ended
	Jun. 30, 2024	Aug. 02, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2024
Document Transition Report	false
Entity File Number	001-38242
Entity Registrant Name	OrthoPediatrics Corp
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	26-1761833
Entity Address, Address Line One	2850 Frontier Drive
Entity Address, City or Town	Warsaw
Entity Address, State or Province	IN
Entity Address, Postal Zip Code	46582
City Area Code	574
Local Phone Number	268-6379
Title of Each Class	Common Stock, $0.00025 par value per share
Trading Symbol(s)	KIDS
Name of each exchange on which registered	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		24,214,426
Document Fiscal Year Focus	2024
Document Fiscal Period Focus	Q2
Amendment Flag	false
Entity Central Index Key	0001425450
Current Fiscal Year End Date	--12-31

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 28,927	$ 31,055
Restricted cash	1,963	1,972
Short-term investments	0	49,251
Accounts receivable - trade, net of allowances of $1,026 and $1,373, respectively	42,028	34,617
Inventories, net	116,366	105,851
Prepaid expenses and other current assets	4,499	3,750
Total current assets	193,783	226,496
Property and equipment, net	53,482	41,048
Other assets:
Amortizable intangible assets, net	67,848	69,275
Goodwill	90,512	83,699
Other intangible assets	18,669	15,287
Other non-current assets	6,467	2,940
Total other assets	183,496	171,201
Total assets	430,761	438,745
Current liabilities:
Accounts payable - trade	17,002	12,649
Accrued compensation and benefits	12,616	11,325
Current portion of long-term debt with affiliate	156	152
Current portion of acquisition installment payable	1,304	10,149
Other current liabilities	8,491	7,391
Total current liabilities	39,569	41,666
Long-term liabilities:
Acquisition installment payable, net of current portion	2,371	3,551
Deferred income taxes	4,739	5,483
Other long-term liabilities	3,007	1,112
Total long-term liabilities	19,899	20,054
Total liabilities	59,468	61,720
Stockholders' equity:
Common stock, $0.00025 par value; 50,000,000 shares authorized; 24,216,738 shares and 23,378,408 shares issued as of June 30, 2024 and December 31, 2023, respectively	6	6
Additional paid-in capital	593,087	580,287
Accumulated deficit	(211,576)	(197,742)
Accumulated other comprehensive loss	(10,224)	(5,526)
Total stockholders' equity	371,293	377,025
Total liabilities and stockholders' equity	430,761	438,745
Nonrelated Party
Long-term liabilities:
Long-term debt, net of current portion	9,250	9,297
Related Party
Long-term liabilities:
Long-term debt, net of current portion	$ 532	$ 611

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Unaudited) (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Statement of Financial Position [Abstract]
Allowance for doubtful accounts	$ 1,026	$ 1,373
Common stock, par value (in dollars per share)	$ 0.00025	$ 0.00025
Common stock, shares authorized (in shares)	50,000,000	50,000,000
Common stock, shares issued (in shares)	24,216,738	23,378,408

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Income Statement [Abstract]
Net revenue	$ 52,802	$ 39,559	$ 97,487	$ 71,147
Cost of revenue	12,003	9,534	24,514	17,561
Gross profit	40,799	30,025	72,973	53,586
Operating expenses:
Sales and marketing	16,593	13,533	30,762	26,082
General and administrative	27,329	19,112	52,059	36,269
Research and development	2,543	2,966	5,541	5,412
Total operating expenses	46,465	35,611	88,362	67,763
Operating loss	(5,666)	(5,586)	(15,389)	(14,177)
Other expense (income):
Interest expense, net	261	294	898	84
Fair value adjustment of contingent consideration	0	(2,304)	0	(2,974)
Other expense (income), net	120	(289)	96	(620)
Total other expense (income), net	381	(2,299)	994	(3,510)
Loss before income taxes	(6,047)	(3,287)	(16,383)	(10,667)
Provision for income taxes (benefit)	(18)	(401)	(2,549)	(975)
Net loss	$ (6,029)	$ (2,886)	$ (13,834)	$ (9,692)
Weighted average shares outstanding - basic (in shares)	23,145,064	22,704,723	22,982,921	22,587,022
Weighted average shares outstanding for diluted (in shares)	23,145,064	22,704,723	22,982,921	22,587,022
Net loss per share - basic (in dollars per share)	$ (0.26)	$ (0.13)	$ (0.60)	$ (0.43)
Net loss per share - diluted (in dollars per share)	$ (0.26)	$ (0.13)	$ (0.60)	$ (0.43)

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS (Unaudited) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Statement of Comprehensive Income [Abstract]
Net loss	$ (6,029)	$ (2,886)	$ (13,834)	$ (9,692)
Other comprehensive loss:
Foreign currency translation adjustment	(3,263)	(1,858)	(4,689)	(2,820)
Unrealized gain (loss) on short-term investments	0	(7)	109	610
Adjustment for realized gain on securities	0	0	(118)	(301)
Other comprehensive loss, net of tax	(3,263)	(1,865)	(4,698)	(2,511)
Comprehensive loss	$ (9,292)	$ (4,751)	$ (18,532)	$ (12,203)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (Unaudited) - USD ($) $ in Thousands	Total	Medtech	ApiFix Ltd	Common Stock	Common Stock Medtech	Common Stock ApiFix Ltd	Additional Paid-in Capital	Additional Paid-in Capital Medtech	Additional Paid-in Capital ApiFix Ltd	Accumulated Deficit	Accumulated Other Comprehensive Loss
Beginning balance at Dec. 31, 2022	$ 378,648			$ 6			$ 560,810			$ (176,768)	$ (5,400)
Beginning balance (in shares) at Dec. 31, 2022				22,877,962
Increase (Decrease) in Stockholders' Equity
Net loss	(6,806)									(6,806)
Other comprehensive loss	(646)										(646)
Restricted stock (in shares)				264,156
Restricted stock	1,959						1,959
Ending balance at Mar. 31, 2023	373,155			$ 6			562,769			(183,574)	(6,046)
Ending balance (in shares) at Mar. 31, 2023				23,142,118
Beginning balance at Dec. 31, 2022	378,648			$ 6			560,810			(176,768)	(5,400)
Beginning balance (in shares) at Dec. 31, 2022				22,877,962
Increase (Decrease) in Stockholders' Equity
Net loss	(9,692)
Other comprehensive loss	(2,511)
Ending balance at Jun. 30, 2023	380,312			$ 6			574,677			(186,460)	(7,911)
Ending balance (in shares) at Jun. 30, 2023				23,340,463
Beginning balance at Mar. 31, 2023	373,155			$ 6			562,769			(183,574)	(6,046)
Beginning balance (in shares) at Mar. 31, 2023				23,142,118
Increase (Decrease) in Stockholders' Equity
Net loss	(2,886)									(2,886)
Other comprehensive loss	(1,865)										(1,865)
Stock portion of MedTech acquisition (in shares)					43,751
Stock portion of MedTech anniversary payment		$ 2,274						$ 2,274
Stock portion of ApiFix anniversary installment (in shares)						140,003
Stock portion of ApiFix anniversary installment			$ 6,178						$ 6,178
Restricted stock (in shares)				14,591
Restricted stock	3,456						3,456
Ending balance at Jun. 30, 2023	380,312			$ 6			574,677			(186,460)	(7,911)
Ending balance (in shares) at Jun. 30, 2023				23,340,463
Beginning balance at Dec. 31, 2023	377,025			$ 6			580,287			(197,742)	(5,526)
Beginning balance (in shares) at Dec. 31, 2023				23,378,408
Increase (Decrease) in Stockholders' Equity
Net loss	(7,805)									(7,805)
Other comprehensive loss	(1,435)										(1,435)
Restricted stock (in shares)				162,003
Restricted stock	2,799						2,799
Ending balance at Mar. 31, 2024	370,584			$ 6			583,086			(205,547)	(6,961)
Ending balance (in shares) at Mar. 31, 2024				23,540,411
Beginning balance at Dec. 31, 2023	377,025			$ 6			580,287			(197,742)	(5,526)
Beginning balance (in shares) at Dec. 31, 2023				23,378,408
Increase (Decrease) in Stockholders' Equity
Net loss	(13,834)
Other comprehensive loss	(4,698)
Ending balance at Jun. 30, 2024	371,293			$ 6			593,087			(211,576)	(10,224)
Ending balance (in shares) at Jun. 30, 2024				24,216,738
Beginning balance at Mar. 31, 2024	370,584			$ 6			583,086			(205,547)	(6,961)
Beginning balance (in shares) at Mar. 31, 2024				23,540,411
Increase (Decrease) in Stockholders' Equity
Net loss	(6,029)									(6,029)
Other comprehensive loss	(3,263)										(3,263)
Stock portion of ApiFix anniversary installment (in shares)					4,288	245,812
Stock portion of ApiFix anniversary installment		$ 133	$ 6,929					$ 133	$ 6,929
Restricted stock (in shares)				426,227
Restricted stock	2,939						2,939
Ending balance at Jun. 30, 2024	$ 371,293			$ 6			$ 593,087			$ (211,576)	$ (10,224)
Ending balance (in shares) at Jun. 30, 2024				24,216,738

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023
OPERATING ACTIVITIES
Net loss	$ (13,834)	$ (9,692)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization	9,807	7,928
Stock-based compensation	5,738	5,415
Fair value adjustment of contingent consideration	0	(2,974)
Accretion of acquisition installment payable	537	812
Deferred income taxes	(2,955)	(975)
Changes in certain operating assets and liabilities:
Accounts receivable - trade	(4,583)	(8,964)
Inventories, net	(10,420)	(11,860)
Prepaid expenses and other current assets	(403)	72
Accounts payable - trade	4,150	9,724
Accrued expenses and other liabilities	959	1,325
Other	(1,778)	(1,645)
Net cash used in operating activities	(12,782)	(10,834)
INVESTING ACTIVITIES
Acquisition of Boston O&P, net of cash acquired	(20,693)	0
Acquisition of MedTech	0	(3,097)
Sale of short-term marketable securities	49,855	72,347
Purchase of short-term marketable securities	0	(44,600)
Purchases of property and equipment	(13,144)	(10,563)
Net cash provided by investing activities	16,018	14,087
FINANCING ACTIVITIES
Payments on acquisition note	(928)	0
Payment of debt issuance costs	(343)	0
Payments on mortgage notes	(71)	(71)
Net cash used in financing activities	(4,842)	(2,071)
Effect of exchange rate changes on cash, cash equivalents and restricted cash	(531)	(335)
NET (DECREASE) INCREASE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH	(2,137)	847
Cash, cash equivalents and restricted cash, beginning of year	33,027	10,462
Cash, cash equivalents and restricted cash, end of period	30,890	11,309
SUPPLEMENTAL DISCLOSURES
Cash paid for interest	760	11
Transfer of instruments between property and equipment and inventory	281	367
Right-of-use assets obtained in exchange for lease liabilities	0	293
Debt issuance costs not yet paid	67	0
ApiFix Ltd
FINANCING ACTIVITIES
Installment payment for ApiFix	(2,250)	(2,000)
SUPPLEMENTAL DISCLOSURES
Issuance of common shares in acquisition	6,929	6,178
Medtech
FINANCING ACTIVITIES
Installment payment for ApiFix	(1,250)	0
SUPPLEMENTAL DISCLOSURES
Issuance of common shares in acquisition	$ 133	$ 2,274

BUSINESS

BUSINESS	6 Months Ended
	Jun. 30, 2024
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, instruments, and specialized braces 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 TM Spine, BandLoc Duo ® , Pediatric Nailing Platform | Femur, Devise Rail, Orthex ® , The Fassier-Duval Telescopic Intramedullary System ® , SLIM TM Nail, The GAP Nail TM , The Free Gliding SCFE Screw System TM , GIRO ® Growth Modulation System, PNP Tibia System, ApiFix ® Mid-C System and Mitchell Ponseti ® specialized bracing products 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 while our orthopedic bracing products are manufactured in-house plus clinical services.

SUMMARY OF SIGNIFICANT ACCOUNTI

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	6 Months Ended
	Jun. 30, 2024
Accounting Policies [Abstract]
SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES	SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES Basis of Presentation The accompanying condensed consolidated financial statements include the accounts of OrthoPediatrics Corp. and its wholly-owned subsidiaries (collectively, the “Company,” “we,” “our” or “us”). All intercompany balances and transactions have been eliminated. Unaudited Interim Condensed 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 financial statements are unaudited and should be read in conjunction with the annual consolidated financial statements as of and for the year ended December 31, 2023 and related notes thereto contained in our Annual Report on Form 10-K filed with the Securities and Exchange Commission ("SEC") o n March 8, 2024. 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, 2023 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 and six months ended June 30, 2024 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 $211,576 and $197,742 as of June 30, 2024 and December 31, 2023, respectively. Management continues to monitor cash flows and liquidity on a regular basis. We believe that our cash balance at June 30, 2024 and expected cash flows from operations for the next twelve months subsequent to the issuance of the accompanying condensed consolidated financial statements, are sufficient to enable us to maintain current and essential planned operations for more than the next twelve months. Use of Estimates Preparation of our 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 our consolidated financial statements. Significant Accounting Policies There have been no changes in the Company's significant accounting polices as disclosed in Note 2 to the audited consolidated financial statements included in the 2023 Annual Report on Form 10-K. Reclassification In the condensed consolidated financial statements, the Company has reclassified stock-based compensation to conform to the current period presentation. All stock-based compensation was previously recorded within general and administrative expenses, and such costs have now been allocated between general and administrative expenses, research and development expenses and sales and marketing expenses. The current presentation results in stock-based compensation expense being recorded in the same manner in which the award recipient's payroll costs are classified. This reclassification did not affect previously reported total operating expenses, loss before income taxes, or net loss in the condensed consolidated statements of operations. The following tables present the impact of the reclassification on our condensed consolidated statements of operations: Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 Sales and marketing (prior presentation) $ 13,165 $ 25,381 Reclassification 368 701 Sales and marketing (new presentation) $ 13,533 $ 26,082 Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 General and administrative (prior presentation) $ 19,654 $ 37,320 Reclassification (542) (1,051) General and administrative (new presentation) $ 19,112 $ 36,269 Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 Research and development (prior presentation) $ 2,792 $ 5,062 Reclassification 174 350 Research and development (new presentation) $ 2,966 $ 5,412 Financial Instruments and Concentration of Credit Risk Financial instruments that could subject the Company to credit risk consist primarily of cash, cash equivalents, short-term investments and accounts receivable. We consider all highly liquid investments with original maturity of three months or less at inception to be cash equivalents.The Company performs ongoing credit evaluations of customers and maintains a reserve for expected credit losses. The Company believes the risk of credit losses associated with accounts receivable is low given the history of collections and customer base. Additionally, the Company considers the risk for credit losses associated with short-term investments to be low given the types of investments which primarily include Certificates of Deposits and Treasury Bonds. Recent Accounting Pronouncements In October 2023, the FASB issued ASU No. 2023-06 " Disclosure Improvements - Codification Amendments in Response to SEC's Disclosure Update and Simplification Initiative". This amendment modifies the disclosure or presentation requirements of a variety of Topics in the Codification. Certain of the amendments represent clarifications to or technical corrections of the current requirements. For entities subject to the SEC's existing disclosure requirements and entities required to file or furnish financial statements with or to the SEC in preparation for the sale of or for purposes of issuing securities that are not subject to contractual restrictions on transfer, the effective date for each amendment will be the date on which the SEC's removal of that related disclosure from Regulation S-X or Regulation S-K becomes effective, with early adoption prohibited. For all other entities, the amendments will be effective two years later. Amendments in this Update should be applied prospectively. The Company continues to analyze this ASU. The update is specific to disclosures and, therefore, is not expected to have a material impact to the condensed consolidated financial statements. In November 2023, the FASB issued ASU No. 2023-07, " Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures ." The standard requires disclosure of significant segment expenses that are regularly provided to the chief operating decision maker ("CODM") and included within each reported measure of segment profit or loss, an amount and description of its composition for other segment items to reconcile to segment profit or loss, and the title and position of the entity's CODM. The amendments in this update also expand the interim segment disclosure requirements. This authoritative guidance will be effective for us in fiscal 2024 for annual periods and in the first quarter of fiscal 2025 for interim periods, with early adoption permitted. We are currently evaluating the effect of this new guidance on our consolidated financial statements and disclosures. In December 2023, the FASB issued ASU No. 2023-09, " Income Taxes (Topic 740): Improvements to Income Tax Disclosures

BUSINESS COMBINATIONS AND ASSET

BUSINESS COMBINATIONS AND ASSET ACQUISITIONS	6 Months Ended
	Jun. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
BUSINESS COMBINATIONS AND ASSET ACQUISITIONS	BUSINESS COMBINATIONS AND ASSET ACQUISITIONS Boston Brace International, Inc. On January 5, 2024, the Company purchased all of the issued and outstanding share capital of Boston Brace International, Inc., a Massachusetts corporation ("Boston O&P"). Boston O&P has developed and manufactures pediatric orthotic and prosthetic devices, including non-surgical scoliosis treatment options, and provides related clinical services. Under the terms of the stock purchase agreement, the Company paid to the shareholders of Boston O&P consideration of $22,000 in cash, subject to customary adjustments related to net working capital, transaction expenses, and funded indebtedness. Additionally, certain employees and executives of Boston O&P also received awards of restricted stock of the Company which will vest in three years subject to continuous service. The Restricted Stock Award Agreements were to approximately 170 individuals for an aggregate of approximately 83,000 shares representing approximately $2,500 (based on a share price of $30.12, which was the average closing price during the four-month period ending on January 4, 2024) and were granted pursuant to the Company’s 2017 Incentive Award Plan. The restricted stock units are not considered part of the purchase consideration. The following table summarizes the total consideration paid for Boston O&P and the preliminary allocation of purchase price to the estimated fair value of the assets acquired and liabilities assumed at the acquisition date: Fair value of estimated total acquisition consideration $ 22,000 Assets Cash 1,307 Accounts receivable - trade 2,876 Inventories 1,093 Prepaid expenses and other current assets 378 Property and equipment 4,360 Amortizable intangible assets 3,720 Other intangible assets 3,650 Other non-current assets 2,038 Total assets 19,422 Liabilities Accounts payable-trade 581 Other current liabilities 1,630 Long-term debt, including current portion 1,157 Deferred tax liability 2,268 Other non-current liabilities 1,003 Total liabilities 6,639 Less: total net assets 12,783 Goodwill $ 9,217 The fair value of identifiable intangible assets and certain long-lived assets were based on valuations using a combination of the income and cost approach, inputs which would be considered Level 3 under the fair value hierarchy. The estimated fair value and useful life of identifiable intangible assets are as follows: Amount Remaining Economic Useful Life Trademarks / Names $ 3,650 Indefinite Customer Relationships & Other 3,720 12 years $ 7,370 The following table represents the pro forma net revenue and net loss assuming the acquisition of Boston O&P occurred on January 1, 2023. Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net revenue $ 52,802 $ 45,837 $ 97,918 $ 84,272 Net loss $ (6,029) $ (2,770) $ (13,809) $ (9,460) Rhino Pediatric Orthopedic Designs, Inc. On July 1, 2023, the Company completed an acquisition of assets, including inventory and certain intangible assets, of Rhino Pediatric Orthopedic Designs, Inc. ("Rhino"). Rhino's product portfolio included several pediatric orthopedic products in the bracing and soft goods space, including the Cruiser TM , Kicker TM , and Rhino Stomper TM . The Company paid $1,024 in total consideration for the assets which was comprised of $546 of cash, including $46 of transactions costs, and 11,133 shares of the Company’s common stock, par value $0.00025 per share, representing approximately $478 (based on closing price of $42.91 on July 1, 2023). Medtech Concepts LLC On May 1, 2023, the Company purchased all of the issued and outstanding membership interest of Medtech Concepts LLC, a Delaware limited liability company (“MedTech”). MedTech has developed an early-stage, pre-commercial enabling technology platform designed to increase efficiency in the perioperative environment. The solution combines hardware, software, and data analytics to help streamline operative care and support better decision making in the operating room. In the future, the Company believes this enabling technology platform will provide valuable intraoperative resources for surgeons that will improve decision making, drive operating room efficiency, and ultimately improve healthcare for children. The Company also expects that the acquisition will further support future market share gains for its implant systems, similar to what the Company has experienced with the FIREFLY ® Technology and the 7D Surgical FLASH TM Navigation platform. No revenue was recorded from this platform in 2023, and the Company does not anticipate material revenue contributions from the platform in 2024. The sellers of MedTech are being paid a purchase price of approximately $15,274 in the following manner: (i) cash in the aggregate amount of $3,000 was paid on May 1, 2023, the transaction closing date (the “Closing Date”); (ii) 43,751 unregistered shares of the Company’s common stock, par value $0.00025 per share, representing approximately $2,274 (based on a closing share price of $51.98 on May 1, 2023), were issued on the Closing Date; and (iii) an aggregate of $2,500 payable 50% in cash and 50% in shares of unregistered common stock, will be paid on each of the first four anniversaries of the Closing Date, all subject to the conditions set forth in the Membership Interest Purchase Agreement (the "Purchase Agreement"), as amended, relating to the transaction. The Company concluded that the business acquired did not comprise an integrated set of activities that meet the definition of a business and therefore did not result in the acquisition of a business. Instead, the Company accounted for the transaction as an asset acquisition for accounting purposes. Under the Purchase Agreement, a number of future payments in the form of common stock are contingent on continued service through each applicable payment anniversary date. As such, these amounts have been excluded from measuring the cost of the acquisition. The result is $4,500 of stock compensation which is being recognized on a straight-line basis over the four year service period. Future cash payments and stock issuances that are not contingent on continuous service are included in the calculation of consideration. The total consideration is $10,043 after discounting the future guaranteed fixed payments to their present value. Additionally, since this was treated as an asset acquisition, the Company included $97 of transaction costs in the total consideration. The table below reconciles the payments and issuances to total consideration transferred after discounting the future payments to present value. Consideration Present Value Cash consideration $ 3,000 $ 3,000 Issuance of common stock 2,274 2,274 Anniversary payments 5,500 4,672 Transaction costs 97 97 Total consideration transferred $ 10,871 $ 10,043 As result of this asset acquisition, the Company recorded a trademark asset in the amount of $520 with an indefinite useful life and an intellectual property asset relating to software acquired of $9,523 which is being amortized over a useful life of ten years. During the three and six months ended June 30, 2024, the Company paid the first anniversary payment consisting of $1,250 in cash and issued 4,288 of the Company's common stock approximating $133 which reduced the amount of the acquisition installment payable on our balance sheet. In addition, we issued 38,594 shares of our common stock to one individual on the first anniversary date in exchange for their continued service through the vesting date which had been accounted for as stock based compensation expense in the post-combination consolidated financial statements. Kevin Unger, a member of the Company’s Board of Directors (the “Board”) through April 28, 2023, was one of the sellers in the transaction. As a result, the Board formed a special committee comprised of independent and disinterested directors (the “Special Committee”) with the exclusive authority to review, evaluate, and negotiate, or reject, the potential MedTech acquisition. The Purchase Agreement and the transactions contemplated thereby were approved by both the Special Committee and the full Board (with Mr. Unger abstaining).

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS	6 Months Ended
	Jun. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
GOODWILL AND INTANGIBLE ASSETS	GOODWILL AND INTANGIBLE ASSETS Goodwill Changes in the carrying amount of goodwill for the six months ended June 30, 2024 were as follows: Total Goodwill at January 1, 2024 $ 83,699 Boston O&P acquisition 9,217 Foreign currency translation impact (2,404) Goodwill at June 30, 2024 $ 90,512 Intangible Assets As of June 30, 2024, the balances of amortizable intangible assets were as follows: Weighted-Average Amortization Period Gross Intangible Assets Accumulated Amortization Net Intangible Assets Patents 10.7 years $ 44,328 $ (12,215) $ 32,113 Intellectual Property & Capitalized Software 8.6 years 16,027 (3,296) 12,731 Customer Relationships & Other 11.9 years 22,294 (4,070) 18,224 License Agreements 3.4 years 10,733 (5,953) 4,780 Total amortizable assets $ 93,382 $ (25,534) $ 67,848 As of December 31, 2023, the balances of amortizable intangible assets were as follows: Weighted-Average Amortization Period Gross Intangible Assets Accumulated Amortization Net Intangible Assets Patents 11.2 years $ 45,646 $ (11,008) $ 34,638 Intellectual Property & Capitalized Software 9.1 years 16,026 (2,524) 13,502 Customer Relationships & Other 12.4 years 18,862 (3,270) 15,592 License Agreements 3.8 years 10,733 (5,190) 5,543 Total amortizable assets $ 91,267 $ (21,992) $ 69,275 Licenses are tied to product launches and do not begin amortizing until the product is launched to the market. Trademarks are non-amortizing intangible assets which were $18,669 and $15,287 as of June 30, 2024 and December 31, 2023, respectively. Trademarks are recorded in Other intangible assets on the condensed consolidated balance sheets. The change in balance during the six months ended June 30, 2024 was driven by foreign currency translation adjustments and the Boston O&P acquisition.

FAIR VALUE OF FINANCIAL INSTRUM

FAIR VALUE OF FINANCIAL INSTRUMENTS	6 Months Ended
	Jun. 30, 2024
Fair Value Disclosures [Abstract]
FAIR VALUE OF FINANCIAL INSTRUMENTS	FAIR VALUE OF FINANCIAL INSTRUMENTS The Company measures certain financial assets and liabilities at fair value. The accounting standards related to fair value measurements define fair value and provide a consistent framework for measuring fair value under the authoritative literature. 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. The following table summarizes the assets and liabilities measured at fair value on a recurring basis as of December 31, 2023. The balance of short-term investments was zero at June 30, 2024. December 31, 2023 Level 1 Level 2 Level 3 Total Financial Assets Short-term investments Certificates of Deposit $ — $ 25,792 $ — $ 25,792 Exchange Trade Mutual Funds $ 5,015 $ — $ — $ 5,015 Treasury Bonds $ 18,235 $ — $ — $ 18,235 Other $ 207 $ — $ — $ 207 The Company's Level 1 assets consist of short-term, liquid investments with original maturity of three months or less at inception and other short-term investments which are comprised of exchange traded mutual funds and marketable securities with a maturity date greater than 3 months. The Company's Level 2 assets pertain to certain asset-backed securities, collateralized by non-mortgage-related consumer debt, or certificates of deposit. These securities are predominately priced by third parties, either by a pricing vendor or dealer with significant inputs observable in active markets.

DEBT AND CREDIT ARRANGEMENTS

DEBT AND CREDIT ARRANGEMENTS	6 Months Ended
	Jun. 30, 2024
Debt Disclosure [Abstract]
DEBT AND CREDIT ARRANGEMENTS	DEBT AND CREDIT ARRANGEMENTS Long-term debt consisted of the following as of the dates indicated: June 30, 2024 December 31, 2023 Term loan and final payment $ 10,300 $ 10,300 Mortgage payable to affiliate 688 763 Acquisition note payable 229 — Total debt 11,217 11,063 Less: debt discount and issuance costs 1,279 1,003 Less: current maturities 156 152 Long-term debt, net of current maturities $ 9,782 $ 9,908 On December 29, 2023, the Company entered into an $80 million Credit, Security and Guaranty Agreement (the “Credit Agreement”) by and among (i) the Company and other borrowers party to the Credit Agreement (collectively, the “Borrowers”), (ii) MidCap Funding IV Trust, as Agent (“Agent”), (iii) MidCap Financial Trust, as Term Loan Servicer (“Servicer”), and (iv) the financial institutions or other entities from time to time party thereto as Lenders (collectively, “Lenders”). Under the terms of the Credit Agreement, the Lenders have provided to Borrowers a term loan in an aggregate principal amount that will not exceed $30 million available in three tranches of $10 million each subject to certain draw conditions (the “Term Loan”) and a revolving loan in an aggregate principal amount that will not exceed $50 million (the “Revolving Loan”). Borrowings are available subject to certain levels of working capital for the Revolving Loan. As of June 30, 2024, the borrowing availability under the Revolving Loan was approximately $19.0 million. The second tranche of the Term Loan is eligible to be drawn between July 1, 2024 through June 30, 2025. The third tranche of the Term Loan is eligible to be drawn between January 1, 2025 through June 30, 2025. The Company must meet certain cash usage requirements at the time of each draw to be eligible to access these term loans. Interest on the Term Loan will accrue at the greater of (a) One Month Term SOFR plus 6.50% or (b) 9.0% and interest on the Revolving Loan will accrue at the greater of (a) One Month Term SOFR plus 4.0% or (b) 6.50% (the “Applicable Rate”) and will be payable monthly by the Borrowers. The Term Loans may be prepaid in full through December 29, 2024 with payment of a 3.00% prepayment premium, after which they may be prepaid in full through December 29, 2025 with payment of a 2.00% prepayment premium, after which they may be prepaid in full through December 29, 2026 with payment of a 1.00% prepayment premium, after which they may be prepaid in full with no prepayment premium. An additional final payment of 3.00% ("Final Payment") of the amount of the Terms Loans advanced by the Lenders will be due upon prepayment or repayment of the Terms Loans in full, and is accounted for as debt discount. The first tranche of $10 million was issued under the Term Loan upon execution. Payments of principal and all accrued but unpaid interest will be due and payable upon the earlier of: (i) December 1, 2028; (ii) the occurrence of any transaction or series of transactions pursuant to which any person or entity in the aggregate acquire(s) 35% or more of the voting capital stock of the Company; (iii) a change in the majority of the Company’s Board of Directors over a 12-month period; (iv) the Company ceases to own directly or indirectly, 100% of the capital stock of any of its subsidiaries (with the exception of any subsidiaries permitted to be dissolved, merged or otherwise disposed of by the Credit Agreement), or (v) the occurrence of a change in control, fundamental change, deemed liquidation event or terms of similar import under any document or instrument governing or relating to debt of or equity interests of the Company. The loans under the Credit Agreement are secured by a security interest in the Company’s and other Borrowers' assets. The Credit Agreement provides for customary events of default. If an event of default is not cured within the time periods specified (if any), the Lenders and Agent have the right to accelerate the Company’s payment of principal and interest in addition to other rights and remedies. The Credit Agreement includes certain customary non-financial covenants, and also include certain financial covenants related to the Company achieving minimum revenu e targets over a trailing twelve month period and maintaining minimum liquidity of $10 million. The Credit Agreement was amended on May 3, 2024 to clarify the inputs into the financial covenant calculations. No other changes were made to the Credit Agreement. The Company was in compliance with all covenants under the Credit Agreement, as amended, as of June 30, 2024 a nd December 31, 2023. The debt facilities available under the Credit Agreement replace the Fourth Amended and Restated Loan and Security Agreement with Squadron Capital, LLC ("Squadron"), (as amended, the “Squadron Loan Agreement”), which provided the Company with a $50 million revolving credit facility. During the year ended December 31, 2023, there was no indebtedness outstanding under the Squadron Loan Agreement and it was terminated in connection with the Credit Agreement. Borrowings under the Squadron Loan Agreement accrued interest at an annual rate equal to the greater of (a) six month SOFR plus 8.69% and (b) 10.0%, and the Company was permitted to make interest only payments on amounts outstanding. Prior to December 31, 2021, the interest rate on the facility had been equal to the greater of (a) three month LIBOR plus 8.61% and (b) 10.0%. The Company paid Squadron an unused commitment fee in an amount equal to the per annum rate of 0.50% (computed on the basis of a year of 360 days and the actual number of days elapsed) times the daily unused portion of the revolving credit commitment. The unused commitment fee was payable quarterly in arrears. Borrowings under the Squadron Loan Agreement were made under a Second Amended and Restated Revolving Note, dated June 13, 2022 (the “Amended Revolving Note”), payable, jointly and severally, by the Company and each of its subsidiaries party thereto. The Amended Revolving Note matured at the earlier of: (i) the date on which any person or persons acquire (x) capital stock of the Company possessing the voting power to elect a majority of the Company’s Board of Directors (whether by merger, consolidation, reorganization, combination, sale or transfer), or (y) all or substantially all of the Company’s assets, determined on a consolidated basis; and (ii) January 1, 2024. Borrowings under the Squadron Loan Agreement were secured by substantially all of the Company's assets and were unconditionally guaranteed by each of its subsidiaries with the exception of Vilex in Tennessee, Inc. ("Vilex"). There were no traditional financial covenants associated with the Squadron Loan Agreement. However, there were negative covenants that prohibited us from, among other things, transferring any of our material assets, merging with or acquiring another entity, entering into a transaction that would result in a change of control, incurring additional indebtedness, creating any lien on our property, making investments in third parties and redeeming stock or paying dividends, in each case subject to certain exceptions. 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% unt il maturity in 2028, at which time a final payment of remaining principal and interest is due. At June 30, 2024, the mortgage balance was $688 of which current principal of $156 was included in the current portion of long-term debt. As of December 31, 2023, the mortgage balance was $763 of which current principal due of $152 was included in the current portion of long-term debt. The aggregate interest expense relating to the notes payable to Squadron, the mortgage note payable to Tawani Enterprises Inc. and the term loan with MidCap was $421 and $11 for the three months ended June 30, 2024 and 2023, respectively, and $760 and $22 for the six months ended June 30, 2024 and 2023, respectively.

INCOME TAXES

INCOME TAXES	6 Months Ended
	Jun. 30, 2024
Income Tax Disclosure [Abstract]
INCOME TAXES	INCOME TAXES The Company utilizes an estimated annual effective tax rate to determine its provision or benefit for income taxes for interim periods. The income tax provision or benefit is computed by multiplying the estimated annual effective tax rate by the year-to-date pre-tax book income (loss). For the six months ended June 30, 2024, the income tax benefit was $2,549 compared to $975 for the six months ended June 30, 2023. Our effective income tax rate was 15.6% and 9.1% for the six months ended June 30, 2024 and 2023, respectively. The higher effective rate compared to the prior period is from the remeasurement of the valuation allowance subsequent to recording the deferred tax liability as a result of the purchase accounting from the Boston O&P acquisition. The deferred tax assets were fully offset by a valuation allowance at June 30, 2024 and December 31, 2023, with the exception of certain deferred tax liabilities recognized in a foreign jurisdiction as a result of fair value adjustments recorded upon the acquisition of ApiFix, Ltd. and Pega Medical. The Company has recorded a tax benefit for losses generated in Israel and a tax expense for income generated in Canada during the period ended June 30, 2024.

STOCKHOLDERS' EQUITY

STOCKHOLDERS' EQUITY	6 Months Ended
	Jun. 30, 2024
Share-Based Payment Arrangement [Abstract]
STOCKHOLDERS' EQUITY	STOCKHOLDERS’ EQUITY Restricted Stock Our restricted stock activity and related information are summarized as follows: Weighted-Average Weighted-Average Restricted Remaining Restricted Remaining Stock Contractual Terms Stock Contractual Terms Awards (in Years) Units (in Years) Outstanding at January 1, 2024 592,453 1.6 13,851 1.7 Granted 556,109 7,900 Forfeited (6,473) (100) Vested (95,116) — Outstanding at June 30, 2024 1,046,973 2.0 21,651 1.7 On June 11, 2024, we granted an aggregate of 345,985 shares of restricted stock to eight members of management. The restricted stock was granted pursuant to the Company's 2024 Incentive Award Plan. While restricted stock awards generally vest over three years, these restricted stock awards provide for a vesting period ending on March 15, 2027 in order to align the vesting dates with the vesting dates of other restricted stock awards held by members of management. At June 30, 2024, there was $25,764 of unrecognized compensation expense remaining related to our service-based restricted stock awards and restricted stock units. The unrecognized compensation cost is expected to be recognized over a weighted-average period of 2.0 years or earlier upon an elimination of the restriction period as a result of a change in control event.

NET LOSS PER SHARE

NET LOSS PER SHARE	6 Months Ended
	Jun. 30, 2024
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: Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Net loss $ (6,029) $ (2,886) $ (13,834) $ (9,692) Weighted average shares outstanding for basic and diluted 23,145,064 22,704,723 22,982,921 22,587,022 Net loss per share - basic and diluted $ (0.26) $ (0.13) $ (0.60) $ (0.43) Our basic and diluted net loss per share is computed using the two-class method. For purposes of our equity disclosures and calculation of weighted average shares for basic earnings per share calculations, 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. For the periods presented with a net loss, the weighted average shares outstanding remained consistent between basic and diluted as the effect of any outstanding common stock equivalents would have been anti-dilutive. The contingently issuable shares in the paragraph above do not include shares of our common stock associated with our obligation to issue a variable number of our common shares as a result of our recent acquisitions of Pega Medical, ApiFix or MedTech. See Note 3 for additional information regarding our commitment to issue future equity under the MedTech acquisition. Additionally, as a component of the acquisition of ApiFix, the Company is obligated to make anniversary installment payments on the second, third and fourth anniversary of the acquisition date. These payments included a minimum cash component with the remaining settled in common stock. See Note 3 under Item 8 in the Company's Annual Report on Form 10-K for additional information regarding this business combination. During the three and six months ended June 30, 2024, the final anniversary payment was made to ApiFix and no additional shares of common stock are issuable under the ApiFix acquisition.

BUSINESS SEGMENT

BUSINESS SEGMENT	6 Months Ended
	Jun. 30, 2024
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 reportable segment, 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 determined that disaggregating revenue into these categories achieves the disclosure objective of illustrating the differences in the nature, timing and uncertainty of our revenue streams. 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 the three and six months ended June 30, 2024 or 2023. No individual customer accounted for more than 10% of consolidated accounts receivable as of June 30, 2024 and December 31, 2023. Product sales by source were as follows: Three Months Ended June 30, Six Months Ended June 30, Product sales by geographic location: 2024 2023 2024 2023 U.S. $ 41,249 $ 29,587 $ 75,554 $ 53,388 International 11,553 9,972 21,933 17,759 Total $ 52,802 $ 39,559 $ 97,487 $ 71,147 Three Months Ended June 30, Six Months Ended June 30, Product sales by category: 2024 2023 2024 2023 Trauma and deformity $ 37,771 $ 27,514 $ 71,073 $ 50,909 Scoliosis 13,682 10,893 23,886 17,966 Sports medicine/other 1,349 1,152 2,528 2,272 Total $ 52,802 $ 39,559 $ 97,487 $ 71,147

RELATED PARTY TRANSACTIONS

RELATED PARTY TRANSACTIONS	6 Months Ended
	Jun. 30, 2024
Related Party Transactions [Abstract]
RELATED PARTY TRANSACTIONS	RELATED PARTY TRANSACTIONS In addition to the expired debt and credit agreements and mortgage with Squadron (the Company's largest investor) and its affiliate (see Note 6), we currently use Structure Medical, LLC (“Structure

EMPLOYEE BENEFIT PLAN

EMPLOYEE BENEFIT PLAN	6 Months Ended
	Jun. 30, 2024
Retirement Benefits [Abstract]
EMPLOYEE BENEFIT PLAN	EMPLOYEE BENEFIT PLANWe 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. We have elected to match our employees' 401(k) contributions up to 4% of employees' salary. Additionally, employees of MD Ortho receive contribution matches up to 3% of their salary.

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	6 Months Ended
	Jun. 30, 2024
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES Leases As of June 30, 2024, the Company has recorded a lease liability of $4,162 and corresponding right-of-use asset of $4,539 on its condensed consolidated balance sheet Legal Proceedings From time to time, we are involved in various legal proceedings arising in the ordinary course of our business. IMED Surgical - Software Ownership Dispute On October 16, 2020, the Company, its wholly-owned subsidiary, Orthex, LLC (“Orthex”), the Company’s largest investor, Squadron, and certain other defendants, were named in a lawsuit filed by IMED Surgical, LLC, a New Jersey company ("IMED"), in Broward County, Florida Circuit Court. In the lawsuit, IMED claims, among other things, that it is the rightful owner of certain patented point-and-click planning software being used by the Company, Orthex and Squadron (specifically, U.S. Patent No. 10,258,377 (titled “Point and click alignment method for orthopedic surgeons, and surgical and clinical accessories and devices,” issued on April 16, 2019) (hereinafter, the “’377 Patent”). In June 2019, the Company purchased all the issued and outstanding units of membership interests in Orthex, and all the issued and outstanding shares of stock of Vilex in Tennessee, Inc. for $60,000 in total consideration. Vilex and Orthex are primarily manufacturers of foot and ankle surgical implants, including cannulated screws, fusion devices, surgical staples and bone plates, as well as the Orthex Hexapod technology, a system of rings, struts, implants, hardware accessories, and the Point & Click Software used to treat congenital deformities and limb length discrepancies. On December 31, 2019, the Company divested substantially all of the assets relating to Vilex's adult product offerings to a wholly-owned subsidiary of Squadron, in exchange for a $25,000 reduction in a term note owed to Squadron in connection with the initial acquisition. As part of the sale, the Company also executed an exclusive license arrangement with Squadron providing for perpetual access to certain intellectual property, including the ‘377 Patent. According to the lawsuit, the other defendants, who are unrelated to the Company, assigned the ‘377 Patent to Orthex in violation of certain agreements with IMED. IMED, among other things, requests that the defendants be ordered to convey and assign to IMED all of their rights, title and interests in and to the ’377 Patent and seeks certain compensatory, consequential and unjust enrichment damages from Orthex and the unrelated defendants. On May 13, 2021, the Court ordered the lawsuit stayed pending arbitration. To the extent IMED desires to further pursue the matter, it must first do so through a separate arbitration proceeding. In mid-November 2021, IMED initiated an arbitration proceeding; however, IMED failed to pay the fees it was required to pay for the arbitration to continue, resulting in the arbitration panel terminating the arbitration proceedings in mid-October 2022. In connection with the stay order, the Court also ordered the Company, Orthex and Squadron to give notice to IMED before any attempt to dispose, assign, sell or otherwise encumber the ‘377 Patent. The Company, Orthex and Squadron filed an appeal of this component of the order, but the appellate court affirmed the lower court’s decision. The Company, Orthex and Squadron have not sought to further pursue an appeal of the subject order. On February 3, 2023, the Court partially lifted the stay in this case for the sole purpose of, as clarified by the Court's order on March 7, 2023, "permitting any party to argue any motion challenging the events that occurred which led to the arbitration panel's termination order." No filing was made in response to that order. No further filings were made in this case until October 30, 2023, when defendants filed a motion to dismiss. On December 12, 2023, the Court ordered IMED has until March 13, 2024, to appear before the Court and show cause why this case should not be dismissed for failure to pursue arbitration consistent with the Court’s orders. On March 13, 2024, a hearing took place to discuss the status of IMED’s effort to re-initiate arbitration. Thereafter, on March 25, 2024, the court ordered, if, by April 27, 2024, IMED has not begun arbitration, resolved this case, or substantiated (in the form of an attorney and client declaration) that it has executed an agreement with a litigation funder to pay for arbitration proceedings, to pay the balance due to the subject arbitration association and to re-instate the arbitration, the Court will dismiss this case without prejudice. On April 26, 2024, IMED informed the Court it has executed an agreement with a litigation funder to pay for arbitration proceedings, to pay the balance due to the subject arbitration association, and to reinstate the arbitration, and is in the final stages of resolving the balance due to the subject arbitration association. However, as of June 30, 2024, IMED has not re-initiated arbitration. Although we believe the Company has strong defenses to the IMED lawsuit and we intend to vigorously defend the claims asserted against us, arbitration and litigation can involve complex factual and legal questions, and an adverse resolution of such proceedings could have a material adverse effect on our business, operating results and financial condition. Boston O&P Litigation This lawsuit arises from the alleged wrongful death of a patient following his January 2016, tracheal and laryngeal resection procedure at Boston Children’s Hospital, which was performed by two physicians named as defendants in the suit. The Plaintiffs allege that as a result of the patient’s post-operative care, which included placing his neck in a position of flexion in a modified brace provided by Boston O&P, the patient was paralyzed, and years later, he died due to complications caused by his paralysis. The Company acquired all of the outstanding shares of Boston O&P on January 5, 2024 as described more fully under Note 3 - Business Combinations and Asset Acquisitions. The lawsuit commenced in December 2018, in Suffolk Superior Court in Boston, Massachusetts. The Plaintiffs assert counts of negligence against each individual defendant, lack of informed consent against the physician defendants, failure to warn, breach of warranty and alleged improper use against Boston O&P, and loss of consortium against all defendants. Trial is currently scheduled to begin in December 2025. Although we believe Boston O&P has strong defenses to this lawsuit and we intend to vigorously defend the claims asserted against us, litigation can involve complex factual and legal questions, and an adverse resolution of such proceedings 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. Purchase Obligations and Performance Requirements As a result of entering into a license agreement for the exclusive distribution of the 7D Surgical FLASH TM Navigation platform during 2021, the Company agreed to a minimum purchase commitment for the first twelve months of that agreement. Additionally, the contract requires future purchase commitments based upon a percentage of historical purchases. As a result and as of June 30, 2024, the remaining purchase commitment under the agreement was $1,092 for the year ended December 31, 2024 and $1,456 for the year ended December 31, 2025. On July 20, 2021, we entered into an amended license agreement, resulting in a five-year extension of our exclusive distribution rights of the FIREFLY Technology. As a component of the agreement the Company is required to meet minimum performance metrics, measured by the number of spine procedures in the fiscal year which used the FIREFLY products against the annual requirement in the agreement. This includes any scheduled surgeries whereby the Company has committed to payment of the product. The number of required surgeries varies each year of the agreement. The Company analyzes its projected achievement of these performance metrics and accrues for any estimated shortfall. During the six months ended June 30, 2024, the Company recorded an expense of $976 based on current estimates. The Company recorded $576 of expense for the six months ended June 30, 2023. Royalties As of June 30, 2024, 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.

SUBSEQUENT EVENT

SUBSEQUENT EVENT	6 Months Ended
	Jun. 30, 2024
Subsequent Events [Abstract]
SUBSEQUENT EVENT	SUBSEQUENT EVENT Term Loan Agreement On August 5, 2024 (the “Signing Date”), the Company and its wholly owned domestic subsidiaries, as borrowers (collectively, the “Credit Parties”), entered into that certain Credit Agreement and Guaranty (the “Term Loan Agreement”), by and among the Credit Parties, any additional borrowers from time to time party thereto, any guarantors from time to time party thereto, one or more funds managed by Braidwell LP (“Braidwell”), as lenders, the other lenders from time to time party thereto (together with Braidwell, the “Term Lenders”), and Wilmington Trust, National Association, as agent (the “Term Agent”). The Term Loan Agreement provides for (i) an initial term loan facility in the initial principal amount of $25.0 million, which will be funded in its entirety on the Closing Date (as defined therein) and (ii) a delayed draw term loan facility (the “DDTL”) in an aggregate principal amount not to exceed $25.0 million, which, subject to certain conditions set forth in the Term Loan Agreement, may be drawn until the date that is 12 months after the Signing Date. Loans borrowed pursuant to the Term Loan Agreement (the “Term Loans”) bear interest at a rate per annum equal to SOFR Interest Rate (as defined in the Term Loan Agreement and with a floor of 3.25%) plus 6.50%. The Company has the option to make a payment-in-kind interest payment equal to 1.00% per annum of the interest rate. The Term Loans do not amortize and will be interest-only until the August 5, 2029 maturity date, at which time all unpaid principal and accrued and unpaid interest, fees and expenses due under the Term Loan Agreement will become due and payable. The Company is obligated to pay certain upfront fees and agency fees in connection with the Term Loan Agreement. The Company may pay all or a portion of the outstanding principal and accrued and unpaid interest under the Term Loan Agreement at any time upon prior notice to the Term Lenders subject to (i) a repayment fee schedule of, depending on when the repayment is made, 3.00% of the principal amount of any such repayment during the first 12 months of the Term Loan Agreement or applicable DDTL funding date, 2.00% of the principal amount of any such repayment during months 13 through 24 of the Term Loan Agreement or applicable DDTL funding date, 1.00% of the principal amount of any such repayment during months 25 through 36 of the Term Loan Agreement or applicable DDTL funding date, and 0.00% thereafter and (ii) an exit fee equal to 2.00% of the principal amount of any such repayment. The Term Loan Agreement contains customary mandatory prepayment provisions. Once repaid or prepaid, the Term Loans may not be reborrowed. The Term Loan Agreement includes customary conditions to borrowing, representations and warranties and covenants, including affirmative covenants and negative covenants that restrict the Credit Parties’ and their subsidiaries’ ability to, among other things, incur indebtedness, grant liens, merge or consolidate, make investments, dispose of assets, make acquisitions, pay dividends or make distributions, repurchase stock and enter into certain transactions with affiliates, in each case subject to certain exceptions. The Term Loan Agreement also has financial covenants requiring the Credit Parties to (i) maintain at all times unrestricted cash held in US accounts subject to Lenders’ first priority lien equal to at least 25% of the aggregate principal amount of any outstanding Term Loans and (ii) maintain certain minimum net product sales as set forth therein. The Term Loan Agreement also contains customary events of default, including among other things, the Credit Parties’ failure to make any principal or interest payments when due, the occurrence of certain bankruptcy or insolvency events, or the Credit Parties’ breach of the covenants under the Term Loan Agreement. Upon the occurrence of an event of default, the Term Lenders may, among other things, accelerate the Credit Parties’ obligations under the Term Loan Agreement. As security for their obligations under the Term Loan Agreement, the Credit Parties granted the Term Agent a continuing first priority security interest in substantially all of their assets (including intellectual property), subject to certain customary exceptions. Proceeds from the Term Loans will be used to pay existing debt, transaction fees incurred in connection with the Term Loan Agreement and the Notes (as defined below), up to $5.0 million to repurchase shares of the Company’s common stock, and for working capital needs and general corporate purposes of the Credit Parties. Indenture and Convertible Notes On August 5, 2024, the Company also entered into a Purchase Agreement (the “Purchase Agreement”) with Braidwell Transaction Holdings LLC – Series 10 (the “Purchaser”), whereby the Purchaser has agreed to purchase $50.0 million in aggregate principal amount of the Company’s 4.75% Convertible Senior Notes due February 15, 2030 (the “Notes”). The Notes will be issued pursuant to, and will governed by, an indenture (the “Indenture”), to be dated as of the closing date of the issue and sale of the Notes, between the Company and U.S. Bank Trust Company, National Association, as trustee (the “Trustee”). The Notes will be the Company’s senior, unsecured obligations and will be (i) equal in right of payment with the Company’s existing and future senior, unsecured indebtedness; (ii) senior in right of payment to the Company’s existing and future indebtedness that is expressly subordinated to the Notes; and (iii) effectively subordinated to the Company’s existing and future secured indebtedness, to the extent of the value of the collateral securing that indebtedness. The Notes will accrue interest at a rate of 4.75% per annum, payable quarterly in arrears on February 15, May 15, August 15, and November 15 of each year, beginning on November 15, 2024. The Notes will mature on February 15, 2030, unless earlier repurchased, redeemed, or converted. Before November 15, 2029, noteholders will have the right to convert their Notes only upon the occurrence of certain events, including, but not limited to, the Company’s common stock trading above 130% of the conversion price for a specified period, the Notes per $1,000 in principal amount trading below 98% of the product of the trading price of the Company’s common stock and the conversion rate, and certain fundamental changes to corporate structure. From and after November 15, 2029, noteholders may convert their Notes at any time at their election until the close of business on the second scheduled trading day immediately before the maturity date. The Company will settle conversions by paying or delivering, as applicable, cash, shares of its common stock, or a combination of cash and shares of its common stock, at the Company’s election. The initial conversion rate is 24.4021 shares of common stock per $1,000 principal amount of Notes, which represents an initial conversion price of approximately $40.98 per share of common stock. The conversion rate and conversion price will be subject to customary adjustments upon the occurrence of certain events. In addition, if certain corporate events that constitute a “Make-Whole Fundamental Change” (as defined in the Indenture) occur, then the conversion rate will, in certain circumstances, be increased for a specified period of time. The Notes will be redeemable, in whole or in part, at the Company’s option at any time, and from time to time, on or after February 21, 2028 and on or before the 30th scheduled trading day immediately before the maturity date, at a cash redemption price equal to the principal amount of the Notes to be redeemed, plus accrued and unpaid interest, if any, to, but excluding, the redemption date, but only if (i) the Notes are Freely Tradable (as defined in the Indenture) and any accrued and unpaid additional interest pursuant to the Notes has been paid as of the redemption date, and (ii) the last reported sale price per share of the Company’s common stock exceeds 140% of the conversion price on (1) each of at least 20 trading days, whether or not consecutive, during the 30 consecutive trading days ending on, and including, the trading day immediately before the date the Company sends the related redemption notice; and (2) the trading day immediately before the date the Company sends such notice. In addition, calling any Note for redemption will constitute a Make-Whole Fundamental Change with respect to that Note, in which case the conversion rate applicable to the conversion of that Note will be increased in certain circumstances if it is converted after it is called for redemption. If certain corporate events that constitute a “Fundamental Change” (as defined in the Indenture) occur, then, subject to a limited exception for certain cash mergers, noteholders may require the Company to repurchase their Notes at a cash repurchase price equal to the principal amount of the Notes to be repurchased, plus accrued and unpaid interest, if any, to, but excluding, the fundamental change repurchase date. The definition of Fundamental Change includes certain business combination transactions involving the Company and certain de-listing events with respect to the Company’s common stock. The Notes will have customary provisions relating to the occurrence of “Events of Default” (as defined in the Indenture), which include the following: (i) certain payment defaults on the Notes (which, in the case of a default in the payment of interest on the Notes, will be subject to a 30-day cure period); (ii) the Company’s failure to send certain notices under the Indenture within specified periods of time; (iii) the Company’s failure to comply with certain covenants in the Indenture relating to the Company’s ability to consolidate with or merge with or into, or sell, lease, or otherwise transfer, in one transaction or a series of transactions, all or substantially all of the assets of the Company and its subsidiaries, taken as a whole, to another person; (iv) a default by the Company in its obligation to convert a note in accordance with the Indenture upon the exercise of the conversion right with respect thereto, if not cured within two business days after its occurrence; (v) a default by the Company in its other obligations or agreements under the Indenture or the Notes if such default is not cured or waived within 60 days after notice is given in accordance with the Indenture; (vi) certain defaults by the Company or any of its significant subsidiaries with respect to indebtedness for borrowed money of at least $25.0 million; (vii) the rendering of certain judgments against the Company or any of its significant subsidiaries for the payment of at least $25.0 million where such judgments are not discharged or stayed within 60 days after the date on which the right to appeal has expired or on which all rights to appeal have been extinguished; and (viii) certain events of bankruptcy, insolvency, and reorganization involving the Company or any of the Company’s significant subsidiaries. If an Event of Default involving bankruptcy, insolvency, or reorganization events with respect to the Company (and not solely with respect to a significant subsidiary of the Company) occurs, then the principal amount of, and all accrued and unpaid interest on, all of the Notes then outstanding will immediately become due and payable without any further action or notice by any person. If any other Event of Default occurs and is continuing, then, the Trustee, by notice to the Company, or noteholders of at least 25% of the aggregate principal amount of Notes then outstanding, by notice to the Company and the Trustee, may declare the principal amount of, and all accrued and unpaid interest on, all of the Notes then outstanding to become due and payable immediately. However, notwithstanding the foregoing, the Company may elect, at its option, that the sole remedy for an Event of Default relating to certain failures by the Company to comply with certain reporting covenants in the Indenture consists exclusively of the right of the noteholders to receive special interest on the Notes for up to 180 days at a specified rate per annum not exceeding 0.50% on the principal amount of the Notes. Proceeds from the Notes will be used to pay existing debt of approximately $10.0 million, transaction fees (including original issue discount, prepayment penalties, advisor fees, trustee/agent fees and attorney fees) incurred in connection with the Purchase Agreement, Indenture and Notes of approximately $6.5 million, and for working capital needs and general corporate purposes of the Company and its subsidiaries. Stock Repurchase Program In connection with its approval of the Term Loan Agreement, Purchase Agreement, the Indenture and Notes, on August 2, 2024, the Board of Directors of the Company also approved a stock repurchase program of up to $5.0 million in aggregate investment of the Company’s outstanding common stock, contingent upon the closing of the Term Loan and the Notes. On a share basis using the closing price of the Company’s common stock on August 2, 2024 of $29.56, the amount of common stock subject to the repurchase program represents approximately 0.7% of the Company’s outstanding common stock. The stock repurchases may, at the discretion of management, be made from time to time, through solicited or unsolicited transactions in the open market, in privately negotiated transactions or pursuant to a Rule 10b5-1 plan all as effected in accordance with Rule 10b-18 under the Securities Exchange Act of 1934, as amended. The Company is not obligated to purchase any shares under the program, and the program may be discontinued at any time. The actual timing, number, and share price of shares purchased under the repurchase program will be determined by the Company at its discretion and will depend upon such factors as the market price of the stock, general market and economic conditions, and applicable legal requirements.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Pay vs Performance Disclosure
Net loss	$ (6,029)	$ (7,805)	$ (2,886)	$ (6,806)	$ (13,834)	$ (9,692)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Jun. 30, 2024 shares
Trading Arrangements, by Individual
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false
Greg Odle [Member]
Trading Arrangements, by Individual
Material Terms of Trading Arrangement	On May 31, 2024, Mr. Greg Odle, the Company's President of Scoliosis, adopted a trading
Name	Greg Odle
Title	President
Rule 10b5-1 Arrangement Adopted	true
Adoption Date	August 29, 2024
Expiration Date	August 28, 2025
Arrangement Duration	364 days
Aggregate Available	7,500

SUMMARY OF SIGNIFICANT ACCOUN_2

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)	6 Months Ended
	Jun. 30, 2024
Accounting Policies [Abstract]
Basis of Presentation and Unaudited Interim Condensed Consolidated Financial Statements	Basis of Presentation The accompanying condensed consolidated financial statements include the accounts of OrthoPediatrics Corp. and its wholly-owned subsidiaries (collectively, the “Company,” “we,” “our” or “us”). All intercompany balances and transactions have been eliminated. Unaudited Interim Condensed 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 financial statements are unaudited and should be read in conjunction with the annual consolidated financial statements as of and for the year ended December 31, 2023 and related notes thereto contained in our Annual Report on Form 10-K filed with the Securities and Exchange Commission ("SEC") o n March 8, 2024. 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, 2023 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 and six months ended June 30, 2024 are not necessarily indicative of the results to be expected for the full fiscal year or for any other period.
Use of Estimates	Use of Estimates
Reclassification	Reclassification
Financial Instruments	Financial Instruments and Concentration of Credit Risk
Concentration of Credit Risk	Financial Instruments and Concentration of Credit Risk
Recent Accounting Pronouncements	Recent Accounting Pronouncements In October 2023, the FASB issued ASU No. 2023-06 " Disclosure Improvements - Codification Amendments in Response to SEC's Disclosure Update and Simplification Initiative". This amendment modifies the disclosure or presentation requirements of a variety of Topics in the Codification. Certain of the amendments represent clarifications to or technical corrections of the current requirements. For entities subject to the SEC's existing disclosure requirements and entities required to file or furnish financial statements with or to the SEC in preparation for the sale of or for purposes of issuing securities that are not subject to contractual restrictions on transfer, the effective date for each amendment will be the date on which the SEC's removal of that related disclosure from Regulation S-X or Regulation S-K becomes effective, with early adoption prohibited. For all other entities, the amendments will be effective two years later. Amendments in this Update should be applied prospectively. The Company continues to analyze this ASU. The update is specific to disclosures and, therefore, is not expected to have a material impact to the condensed consolidated financial statements. In November 2023, the FASB issued ASU No. 2023-07, " Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures ." The standard requires disclosure of significant segment expenses that are regularly provided to the chief operating decision maker ("CODM") and included within each reported measure of segment profit or loss, an amount and description of its composition for other segment items to reconcile to segment profit or loss, and the title and position of the entity's CODM. The amendments in this update also expand the interim segment disclosure requirements. This authoritative guidance will be effective for us in fiscal 2024 for annual periods and in the first quarter of fiscal 2025 for interim periods, with early adoption permitted. We are currently evaluating the effect of this new guidance on our consolidated financial statements and disclosures. In December 2023, the FASB issued ASU No. 2023-09, " Income Taxes (Topic 740): Improvements to Income Tax Disclosures

SUMMARY OF SIGNIFICANT ACCOUN_3

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)	6 Months Ended
	Jun. 30, 2024
Accounting Policies [Abstract]
Schedule of Reclassifications	The following tables present the impact of the reclassification on our condensed consolidated statements of operations: Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 Sales and marketing (prior presentation) $ 13,165 $ 25,381 Reclassification 368 701 Sales and marketing (new presentation) $ 13,533 $ 26,082 Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 General and administrative (prior presentation) $ 19,654 $ 37,320 Reclassification (542) (1,051) General and administrative (new presentation) $ 19,112 $ 36,269 Three Months Ended June 30, 2023 Six Months Ended June 30, 2023 Research and development (prior presentation) $ 2,792 $ 5,062 Reclassification 174 350 Research and development (new presentation) $ 2,966 $ 5,412

BUSINESS COMBINATIONS AND ASS_2

BUSINESS COMBINATIONS AND ASSET ACQUISITIONS (Tables)	6 Months Ended
	Jun. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the total consideration paid for Boston O&P and the preliminary allocation of purchase price to the estimated fair value of the assets acquired and liabilities assumed at the acquisition date: Fair value of estimated total acquisition consideration $ 22,000 Assets Cash 1,307 Accounts receivable - trade 2,876 Inventories 1,093 Prepaid expenses and other current assets 378 Property and equipment 4,360 Amortizable intangible assets 3,720 Other intangible assets 3,650 Other non-current assets 2,038 Total assets 19,422 Liabilities Accounts payable-trade 581 Other current liabilities 1,630 Long-term debt, including current portion 1,157 Deferred tax liability 2,268 Other non-current liabilities 1,003 Total liabilities 6,639 Less: total net assets 12,783 Goodwill $ 9,217
Schedule of Indefinite-Lived Intangible Assets Acquired as Part of Business Combination	The fair value of identifiable intangible assets and certain long-lived assets were based on valuations using a combination of the income and cost approach, inputs which would be considered Level 3 under the fair value hierarchy. The estimated fair value and useful life of identifiable intangible assets are as follows: Amount Remaining Economic Useful Life Trademarks / Names $ 3,650 Indefinite Customer Relationships & Other 3,720 12 years $ 7,370
Schedule of Business Acquisition, Pro Forma Information	The following table represents the pro forma net revenue and net loss assuming the acquisition of Boston O&P occurred on January 1, 2023. Three Months Ended June 30, Six Months Ended June 30, 2024 2023 2024 2023 Net revenue $ 52,802 $ 45,837 $ 97,918 $ 84,272 Net loss $ (6,029) $ (2,770) $ (13,809) $ (9,460)
Schedule of Total Consideration Transferred after Discounting Future Payments	The table below reconciles the payments and issuances to total consideration transferred after discounting the future payments to present value. Consideration Present Value Cash consideration $ 3,000 $ 3,000 Issuance of common stock 2,274 2,274 Anniversary payments 5,500 4,672 Transaction costs 97 97 Total consideration transferred $ 10,871 $ 10,043

GOODWILL AND INTANGIBLE ASSETS

GOODWILL AND INTANGIBLE ASSETS (Tables)	6 Months Ended
	Jun. 30, 2024
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	Changes in the carrying amount of goodwill for the six months ended June 30, 2024 were as follows: Total Goodwill at January 1, 2024 $ 83,699 Boston O&P acquisition 9,217 Foreign currency translation impact (2,404) Goodwill at June 30, 2024 $ 90,512
Schedule of the Balances of Amortizable Intangible Assets	As of June 30, 2024, the balances of amortizable intangible assets were as follows: Weighted-Average Amortization Period Gross Intangible Assets Accumulated Amortization Net Intangible Assets Patents 10.7 years $ 44,328 $ (12,215) $ 32,113 Intellectual Property & Capitalized Software 8.6 years 16,027 (3,296) 12,731 Customer Relationships & Other 11.9 years 22,294 (4,070) 18,224 License Agreements 3.4 years 10,733 (5,953) 4,780 Total amortizable assets $ 93,382 $ (25,534) $ 67,848 As of December 31, 2023, the balances of amortizable intangible assets were as follows: Weighted-Average Amortization Period Gross Intangible Assets Accumulated Amortization Net Intangible Assets Patents 11.2 years $ 45,646 $ (11,008) $ 34,638 Intellectual Property & Capitalized Software 9.1 years 16,026 (2,524) 13,502 Customer Relationships & Other 12.4 years 18,862 (3,270) 15,592 License Agreements 3.8 years 10,733 (5,190) 5,543 Total amortizable assets $ 91,267 $ (21,992) $ 69,275

FAIR VALUE OF FINANCIAL INSTR_2

FAIR VALUE OF FINANCIAL INSTRUMENTS (Tables)	6 Months Ended
	Jun. 30, 2024
Fair Value Disclosures [Abstract]
Schedule of Fair Value, Assets and Liabilities Measured on Recurring Basis	The following table summarizes the assets and liabilities measured at fair value on a recurring basis as of December 31, 2023. The balance of short-term investments was zero at June 30, 2024. December 31, 2023 Level 1 Level 2 Level 3 Total Financial Assets Short-term investments Certificates of Deposit $ — $ 25,792 $ — $ 25,792 Exchange Trade Mutual Funds $ 5,015 $ — $ — $ 5,015 Treasury Bonds $ 18,235 $ — $ — $ 18,235 Other $ 207 $ — $ — $ 207

DEBT AND CREDIT ARRANGEMENTS (T

DEBT AND CREDIT ARRANGEMENTS (Tables)	6 Months Ended
	Jun. 30, 2024
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	Long-term debt consisted of the following as of the dates indicated: June 30, 2024 December 31, 2023 Term loan and final payment $ 10,300 $ 10,300 Mortgage payable to affiliate 688 763 Acquisition note payable 229 — Total debt 11,217 11,063 Less: debt discount and issuance costs 1,279 1,003 Less: current maturities 156 152 Long-term debt, net of current maturities $ 9,782 $ 9,908

STOCKHOLDERS' EQUITY (Tables)

STOCKHOLDERS' EQUITY (Tables)	6 Months Ended
	Jun. 30, 2024
Share-Based Payment Arrangement [Abstract]
Schedule of Restricted Stock Activity	Our restricted stock activity and related information are summarized as follows: Weighted-Average Weighted-Average Restricted Remaining Restricted Remaining Stock Contractual Terms Stock Contractual Terms Awards (in Years) Units (in Years) Outstanding at January 1, 2024 592,453 1.6 13,851 1.7 Granted 556,109 7,900 Forfeited (6,473) (100) Vested (95,116) — Outstanding at June 30, 2024 1,046,973 2.0 21,651 1.7

NET LOSS PER SHARE (Tables)

NET LOSS PER SHARE (Tables)	6 Months Ended
	Jun. 30, 2024
Earnings Per Share [Abstract]
Schedule of 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: Three Months Ended Six Months Ended June 30, June 30, 2024 2023 2024 2023 Net loss $ (6,029) $ (2,886) $ (13,834) $ (9,692) Weighted average shares outstanding for basic and diluted 23,145,064 22,704,723 22,982,921 22,587,022 Net loss per share - basic and diluted $ (0.26) $ (0.13) $ (0.60) $ (0.43)

BUSINESS SEGMENT (Tables)

BUSINESS SEGMENT (Tables)	6 Months Ended
	Jun. 30, 2024
Segment Reporting [Abstract]
Schedule of Product Sales by Geographic Location	Product sales by source were as follows: Three Months Ended June 30, Six Months Ended June 30, Product sales by geographic location: 2024 2023 2024 2023 U.S. $ 41,249 $ 29,587 $ 75,554 $ 53,388 International 11,553 9,972 21,933 17,759 Total $ 52,802 $ 39,559 $ 97,487 $ 71,147
Schedule of Product Sales by Category	Three Months Ended June 30, Six Months Ended June 30, Product sales by category: 2024 2023 2024 2023 Trauma and deformity $ 37,771 $ 27,514 $ 71,073 $ 50,909 Scoliosis 13,682 10,893 23,886 17,966 Sports medicine/other 1,349 1,152 2,528 2,272 Total $ 52,802 $ 39,559 $ 97,487 $ 71,147

SUMMARY OF SIGNIFICANT ACCOUN_4

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Basis of Presentation (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Accounting Policies [Abstract]
Accumulated deficit	$ 211,576	$ 197,742

SUMMARY OF SIGNIFICANT ACCOUN_5

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES - Schedule of Reclassifications (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Reclassification [Line Items]
Sales and marketing	$ 16,593	$ 13,533	$ 30,762	$ 26,082
General and administrative	27,329	19,112	52,059	36,269
Research and development	$ 2,543	2,966	$ 5,541	5,412
Previously Reported
Reclassification [Line Items]
Sales and marketing		13,165		25,381
General and administrative		19,654		37,320
Research and development		2,792		5,062
Reclassification
Reclassification [Line Items]
Sales and marketing		368		701
General and administrative		(542)		(1,051)
Research and development		$ 174		$ 350

BUSINESS COMBINATIONS AND ASS_3

BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Narrative (Details) $ / shares in Units, $ in Thousands					3 Months Ended	6 Months Ended
	Jun. 11, 2024	Jan. 05, 2024 USD ($) individual $ / shares shares	Jul. 01, 2023 USD ($) $ / shares shares	May 01, 2023 USD ($) $ / shares shares	Jun. 30, 2024 USD ($) $ / shares shares	Jun. 30, 2024 USD ($) $ / shares shares	Jun. 30, 2023 USD ($)	Dec. 31, 2023 $ / shares
Business Acquisition
Cash paid to acquire						$ 20,693	$ 0
Common stock, par value (in dollars per share) | $ / shares					$ 0.00025	$ 0.00025		$ 0.00025
Rhino Pediatric Orthopedic Designs, Inc.
Business Acquisition
Total consideration transferred			$ 1,024
Cash consideration			546
Asset acquisition			46
Issuance of common stock			$ 478
Medtech Concepts LLC
Business Acquisition
Total consideration transferred				$ 15,274
Cash consideration				3,000
Asset acquisition				97
Issuance of common stock				$ 2,274
Business combination, consideration paid In cash (as a percent)				50%
Stock based compensation capitalized				$ 4,500
Stock based compensation service period (in years)				4 years
Total consideration transferred				$ 10,871
Asset acquisition, contingent consideration cash consideration					$ 1,250	$ 1,250
Asset acquisition, contingent consideration (in shares) | shares					4,288	4,288
Asset acquisition, contingent consideration, value					$ 133	$ 133
Medtech Concepts LLC | Present Value
Business Acquisition
Cash consideration				3,000
Asset acquisition				97
Issuance of common stock				2,274
Total consideration transferred				10,043
Restricted Stock
Business Acquisition
Vesting period (in years)	3 years
Share-Based Payment Arrangement | Medtech Concepts LLC
Business Acquisition
Asset acquisition, contingent consideration (in shares) | shares					38,594
Intellectual Property & Capitalized Software | Medtech Concepts LLC
Business Acquisition
Finite-lived intangible assets acquired				$ 9,523
Intangible asset, useful life (in years)				10 years
Trademarks | Medtech Concepts LLC
Business Acquisition
Indefinite-lived intangible assets acquired				$ 520
Common Stock | Rhino Pediatric Orthopedic Designs, Inc.
Business Acquisition
Asset acquisition, consideration (in shares) | shares			11,133
Common stock, par value (in dollars per share) | $ / shares			$ 0.00025
Asset acquisition, acquisition price (per share) | $ / shares			$ 42.91
Common Stock | Medtech Concepts LLC
Business Acquisition
Asset acquisition, consideration (in shares) | shares				43,751
Common stock, par value (in dollars per share) | $ / shares				$ 0.00025
Asset acquisition, acquisition price (per share) | $ / shares				$ 51.98
Aggregate value of equity consideration				$ 2,500
Business combination, consideration of unregistered common stock (as a percent)				50%
Boston Brace International, Inc.
Business Acquisition
Cash paid to acquire		$ 22,000
Issuance of common stock		$ 2,500
Boston Brace International, Inc. | Restricted Stock
Business Acquisition
Vesting period (in years)		3 years
Business combination, number of individuals received restricted stock awards | individual		170
Consideration for acquisition (in shares) | shares		83,000
Share acquisition price (in dollars per share) | $ / shares		$ 30.12

BUSINESS COMBINATIONS AND ASS_4

BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Jan. 05, 2024	Jun. 30, 2024	Dec. 31, 2023
Liabilities
Goodwill		$ 90,512	$ 83,699
Boston Brace International, Inc.
Business Acquisition
Fair value of estimated total acquisition consideration	$ 22,000
Assets
Cash	1,307
Accounts receivable - trade	2,876
Inventories	1,093
Prepaid expenses and other current assets	378
Property and equipment	4,360
Amortizable intangible assets	3,720
Other intangible assets	3,650
Other non-current assets	2,038
Total assets	19,422
Liabilities
Accounts payable-trade	581
Other current liabilities	1,630
Long-term debt, including current portion	1,157
Deferred tax liability	2,268
Other non-current liabilities	1,003
Total liabilities	6,639
Less: total net assets	12,783
Goodwill	$ 9,217

BUSINESS COMBINATIONS AND ASS_5

BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Indefinite-Lived Intangible Assets Acquired as Part of Business Combination (Details) - Boston Brace International, Inc. $ in Thousands	Jan. 05, 2024 USD ($)
Business Acquisition
Other intangible assets	$ 3,650
Amortizable intangible assets	3,720
Fair value of identifiable intangible assets	7,370
Customer Relationships & Other
Business Acquisition
Amortizable intangible assets	$ 3,720
Remaining economic useful life (in years)	12 years
Trademarks / Names
Business Acquisition
Other intangible assets	$ 3,650

BUSINESS COMBINATIONS AND ASS_6

BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Business Acquisition, Pro Forma Information (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
Net revenue	$ 52,802	$ 45,837	$ 97,918	$ 84,272
Net loss	$ (6,029)	$ (2,770)	$ (13,809)	$ (9,460)

BUSINESS COMBINATIONS AND ASS_7

BUSINESS COMBINATIONS AND ASSET ACQUISITIONS - Schedule of Discounting the Future Payments (Details) - Medtech Concepts LLC $ in Thousands	May 01, 2023 USD ($)
Business Acquisition
Cash consideration	$ 3,000
Issuance of common stock	2,274
Anniversary payments	5,500
Transaction costs	97
Total consideration transferred	10,871
Present Value
Business Acquisition
Cash consideration	3,000
Issuance of common stock	2,274
Anniversary payments	4,672
Transaction costs	97
Total consideration transferred	$ 10,043

GOODWILL AND INTANGIBLE ASSET_2

GOODWILL AND INTANGIBLE ASSETS - Changes in Goodwill (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2024 USD ($)
Goodwill
Goodwill, beginning balance	$ 83,699
Boston O&P acquisition	9,217
Foreign currency translation impact	(2,404)
Goodwill, ending balance	$ 90,512

GOODWILL AND INTANGIBLE ASSET_3

GOODWILL AND INTANGIBLE ASSETS - Amortizable Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Finite-Lived Intangible Assets, Net [Abstract]
Gross Intangible Assets	$ 93,382	$ 91,267
Accumulated Amortization	(25,534)	(21,992)
Net Intangible Assets	$ 67,848	$ 69,275
Patents
Finite-Lived Intangible Assets, Net [Abstract]
Weighted-Average Amortization Period	10 years 8 months 12 days	11 years 2 months 12 days
Gross Intangible Assets	$ 44,328	$ 45,646
Accumulated Amortization	(12,215)	(11,008)
Net Intangible Assets	$ 32,113	$ 34,638
Intellectual Property & Capitalized Software
Finite-Lived Intangible Assets, Net [Abstract]
Weighted-Average Amortization Period	8 years 7 months 6 days	9 years 1 month 6 days
Gross Intangible Assets	$ 16,027	$ 16,026
Accumulated Amortization	(3,296)	(2,524)
Net Intangible Assets	$ 12,731	$ 13,502
Customer Relationships & Other
Finite-Lived Intangible Assets, Net [Abstract]
Weighted-Average Amortization Period	11 years 10 months 24 days	12 years 4 months 24 days
Gross Intangible Assets	$ 22,294	$ 18,862
Accumulated Amortization	(4,070)	(3,270)
Net Intangible Assets	$ 18,224	$ 15,592
License Agreements
Finite-Lived Intangible Assets, Net [Abstract]
Weighted-Average Amortization Period	3 years 4 months 24 days	3 years 9 months 18 days
Gross Intangible Assets	$ 10,733	$ 10,733
Accumulated Amortization	(5,953)	(5,190)
Net Intangible Assets	$ 4,780	$ 5,543

GOODWILL AND INTANGIBLE ASSET_4

GOODWILL AND INTANGIBLE ASSETS - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2024	Jun. 30, 2024	Dec. 31, 2023
Business Acquisition
Other intangible assets		$ 18,669	$ 15,287
Trademarks
Business Acquisition
Other intangible assets		$ 18,669	$ 15,287
Trademarks | ApiFix Ltd
Business Acquisition
Trademark impairment	$ 985

FAIR VALUE OF FINANCIAL INSTR_3

FAIR VALUE OF FINANCIAL INSTRUMENTS - Schedule of Assets and Liabilities Measured at Fair Value (Details) - Fair Value, Recurring - USD ($)	Jun. 30, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments	$ 0
Certificates of Deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		$ 25,792,000
Exchange Trade Mutual Funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		5,015,000
Treasury Bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		18,235,000
Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		207,000
Level 1 | Certificates of Deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		0
Level 1 | Exchange Trade Mutual Funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		5,015,000
Level 1 | Treasury Bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		18,235,000
Level 1 | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		207,000
Level 2 | Certificates of Deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		25,792,000
Level 2 | Exchange Trade Mutual Funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		0
Level 2 | Treasury Bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		0
Level 2 | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		0
Level 3 | Certificates of Deposit
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		0
Level 3 | Exchange Trade Mutual Funds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		0
Level 3 | Treasury Bonds
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		0
Level 3 | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Short-term investments		$ 0

DEBT AND CREDIT ARRANGEMENTS -

DEBT AND CREDIT ARRANGEMENTS - Schedule of Long-term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2024	Dec. 31, 2023
Debt Instrument
Long term debt	$ 11,217	$ 11,063
Less: debt discount and issuance costs	1,279	1,003
Less: current maturities	156	152
Long-term debt, net of current maturities	9,782	9,908
Revolving Credit Facility | Term Loan
Debt Instrument
Long term debt	10,300	10,300
Mortgage payable to affiliate
Debt Instrument
Long term debt	688	763
Less: current maturities		152
Acquisition note payable | Acquisition note payable
Debt Instrument
Long term debt	$ 229	$ 0

DEBT AND CREDIT ARRANGEMENTS _2

DEBT AND CREDIT ARRANGEMENTS - Narrative (Details)			3 Months Ended		6 Months Ended
	Dec. 29, 2023 USD ($) tranche	Jun. 13, 2022	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Dec. 31, 2023 USD ($)
Debt Instrument
Long term debt			$ 11,217,000		$ 11,217,000		$ 11,063,000
Current portion of long-term debt with affiliate			156,000		156,000		152,000
Interest expense			$ 421,000	$ 11,000	$ 760,000	$ 22,000
Mortgage payable to affiliate
Debt Instrument
Interest rate (as a percent)			5%		5%
Monthly interest and principal installments					$ 16,000
Long term debt			$ 688,000		688,000		763,000
Current portion of long-term debt with affiliate							152,000
Revolving Credit Facility | Security and Guaranty Agreement
Debt Instrument
Long term debt face amount	$ 80,000,000
Debt instrument, maximum distribution per tranche	$ 30,000,000
Debt instrument, number of tranches | tranche	3
Debt instrument, liquidity requirement			10,000,000		10,000,000
Line of Credit Facility, Remaining Borrowing Capacity			19,000,000		19,000,000
Revolving Credit Facility | Term Loan
Debt Instrument
Debt instrument, maximum distribution per tranche	$ 10,000,000
Proceeds from lines of credit	$ 10,000,000
Debt instrument, debt repayment trigger, as a basis of capital stock ownership (percent)	35%
Long term debt			10,300,000		10,300,000		$ 10,300,000
Revolving Credit Facility | Revolving Loan
Debt Instrument
Debt instrument, maximum distribution per tranche	$ 50,000,000
Percentage of prepayment of facility (percent)	3%
Revolving Credit Facility | Revolving Loan | Option One
Debt Instrument
Interest rate (as a percent)	9%
Revolving Credit Facility | Revolving Loan | Option Two
Debt Instrument
Applicable debt rate (percent)	6.50%
Revolving Credit Facility | Revolving Loan | Option Three
Debt Instrument
Debt prepayment premium (percent)	3%
Revolving Credit Facility | Revolving Loan | Option Four
Debt Instrument
Debt prepayment premium (percent)	2%
Revolving Credit Facility | Revolving Loan | Option Five
Debt Instrument
Debt prepayment premium (percent)	1%
Revolving Credit Facility | Revolving Loan | SOFR | Option One
Debt Instrument
Debt instrument, basis spread on variable rate (as a percent)	6.50%
Revolving Credit Facility | Revolving Loan | SOFR | Option Two
Debt Instrument
Debt instrument, basis spread on variable rate (as a percent)	4%
Revolving Credit Facility | Fourth Amended Loan Agreement
Debt Instrument
Interest rate (as a percent)		10%
Revolving credit facility			$ 50,000,000		$ 50,000,000
Unused commitment fee percentage (as a percent)		0.50%
Revolving Credit Facility | Fourth Amended Loan Agreement | SOFR
Debt Instrument
Debt instrument, basis spread on variable rate (as a percent)		8.69%
Revolving Credit Facility | Fourth Amended Loan Agreement | Three Month LIBOR
Debt Instrument
Debt instrument, basis spread on variable rate (as a percent)		8.61%

INCOME TAXES (Details)

INCOME TAXES (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Income Tax Disclosure [Abstract]
Income tax benefit	$ 18	$ 401	$ 2,549	$ 975
Effective income tax rate (as a percent)			(15.60%)	(9.10%)

STOCKHOLDERS' EQUITY - Restrict

STOCKHOLDERS' EQUITY - Restricted Stock (Details) - shares		6 Months Ended	12 Months Ended
	Jun. 11, 2024	Jun. 30, 2024	Dec. 31, 2023
Restricted Stock
Restricted Stock
Outstanding at period start (in shares)		592,453
Granted (in shares)	345,985	556,109
Forfeited (in shares)		(6,473)
Vested (in shares)		(95,116)
Outstanding at period end (in shares)		1,046,973	592,453
Weighted-Average Remaining Contractual Terms (in Years)
Weighted-average remaining contractual terms (in years)		2 years	1 year 7 months 6 days
Restricted Stock Units (RSUs)
Restricted Stock
Outstanding at period start (in shares)		13,851
Granted (in shares)		7,900
Forfeited (in shares)		(100)
Vested (in shares)		0
Outstanding at period end (in shares)		21,651	13,851
Weighted-Average Remaining Contractual Terms (in Years)
Weighted-average remaining contractual terms (in years)		1 year 8 months 12 days	1 year 8 months 12 days

STOCKHOLDERS' EQUITY - Narrativ

STOCKHOLDERS' EQUITY - Narrative (Details) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
	Jun. 11, 2024	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Share-based Compensation Arrangement by Share-based Payment Award
Stock-based compensation				$ 5,738	$ 5,415
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award
Granted (in shares)	345,985			556,109
Unrecognized compensation expense		$ 25,764		$ 25,764
Unrecognized compensation expense, weighted average period of recognition (in years)				2 years
Vesting period (in years)	3 years
Stock-based compensation		$ 2,939	$ 3,456	$ 5,738	$ 5,415

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				6 Months Ended
	Jun. 30, 2024	Mar. 31, 2024	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2024	Jun. 30, 2023
Earnings Per Share [Abstract]
Net loss	$ (6,029)	$ (7,805)	$ (2,886)	$ (6,806)	$ (13,834)	$ (9,692)
Weighted average shares outstanding for basic (in shares)	23,145,064		22,704,723		22,982,921	22,587,022
Weighted average shares outstanding for diluted (in shares)	23,145,064		22,704,723		22,982,921	22,587,022
Net loss per share - basic (in dollars per share)	$ (0.26)		$ (0.13)		$ (0.60)	$ (0.43)
Net loss per share - diluted (in dollars per share)	$ (0.26)		$ (0.13)		$ (0.60)	$ (0.43)

BUSINESS SEGMENT - Narrative (D

BUSINESS SEGMENT - Narrative (Details)	6 Months Ended
	Jun. 30, 2024 segment
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		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Revenues from External Customers and Long-Lived Assets
Total	$ 52,802	$ 39,559	$ 97,487	$ 71,147
U.S.
Revenues from External Customers and Long-Lived Assets
Total	41,249	29,587	75,554	53,388
International
Revenues from External Customers and Long-Lived Assets
Total	$ 11,553	$ 9,972	$ 21,933	$ 17,759

BUSINESS SEGMENT - Schedule o_2

BUSINESS SEGMENT - Schedule of Revenue by Category (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023
Segment Reporting Information
Total	$ 52,802	$ 39,559	$ 97,487	$ 71,147
Trauma and deformity
Segment Reporting Information
Total	37,771	27,514	71,073	50,909
Scoliosis
Segment Reporting Information
Total	13,682	10,893	23,886	17,966
Sports medicine/other
Segment Reporting Information
Total	$ 1,349	$ 1,152	$ 2,528	$ 2,272

RELATED PARTY TRANSACTIONS (Det

RELATED PARTY TRANSACTIONS (Details) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Jun. 30, 2024 USD ($) supplier	Jun. 30, 2023 USD ($)
Structure Medical, LLC | Supplier
Related Party Transaction
Payments to related party | $	$ 141	$ 149	$ 523	$ 395
Affiliated Entity
Related Party Transaction
Number of related party suppliers | supplier			1

EMPLOYEE BENEFIT PLAN (Details)

EMPLOYEE BENEFIT PLAN (Details)	6 Months Ended
	Jun. 30, 2024
Business Acquisition
Employer contribution as a percentage of employees' salary (as a percent)	4%
MD Orthopaedics
Business Acquisition
Employer contribution as a percentage of employees' salary (as a percent)	3%

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details) - USD ($) $ in Thousands			1 Months Ended	3 Months Ended		6 Months Ended
	Jul. 20, 2021	Dec. 31, 2019	Jun. 30, 2019	Jun. 30, 2024	Jun. 30, 2023	Jun. 30, 2024	Jun. 30, 2023	Dec. 31, 2023
Long-term Purchase Commitment
Operating lease liability				$ 4,162		$ 4,162
Operating lease, right-of-use asset				$ 4,539		$ 4,539
Operating Lease, Liability, Current, Statement of Financial Position				Other long-term liabilities		Other long-term liabilities		Other long-term liabilities
Operating Lease, Right-of-Use Asset, Statement of Financial Position				Assets, Noncurrent, Excluding Property, Plant And Equipment		Assets, Noncurrent, Excluding Property, Plant And Equipment		Assets, Noncurrent, Excluding Property, Plant And Equipment
Purchase obligation, to be paid, remainder of fiscal year				$ 1,092		$ 1,092
Purchase obligation, to be paid, year one				1,456		1,456
Cost of revenue				12,003	$ 9,534	$ 24,514	$ 17,561
Minimum
Long-term Purchase Commitment
Royalty agreement percentage (as a percent)						0.50%
Maximum
Long-term Purchase Commitment
Royalty agreement percentage (as a percent)						20%
Firefly Technology | License Agreements
Long-term Purchase Commitment
Finite lived intangible asset useful life extension period (in years)	5 years
Cost of revenue						$ 976
Trademark impairment							$ 576
Squadron Capital LLC | Team Note B | Affiliated Entity
Long-term Purchase Commitment
Repayments of related party debt		$ 25,000
Boston O&P
Long-term Purchase Commitment
Operating lease, right-of-use asset				$ 1,579		$ 1,579
Vilex and Orthex
Long-term Purchase Commitment
Fair value of estimated total acquisition consideration			$ 60,000

SUBSEQUENT EVENT (Details)

SUBSEQUENT EVENT (Details)		6 Months Ended
	Aug. 05, 2024 USD ($) $ / shares	Jun. 30, 2024 USD ($)	Jun. 30, 2023 USD ($)	Aug. 02, 2024 USD ($) $ / shares
Subsequent Event
Payment of debt issuance costs		$ 343,000	$ 0
Subsequent Event | Scenario, Plan
Subsequent Event
Payment of debt issuance costs	$ 10,000,000
Repayments of debt	6,500,000
Subsequent Event | Term Loan Agreement
Subsequent Event
Share repurchase program, authorized, amount				$ 5,000,000
Share price | $ / shares				$ 29.56
Authorized shares as a percentage of outstanding stock (percent)				0.70%
Subsequent Event | Term Loan Agreement | Scenario, Plan
Subsequent Event
Long term debt face amount	$ 25,000,000
Interest rate (as a percent)	6.50%
Payment in kind interest rate per annum (percent)	1%
Debt instrument, exit fee (percent)	2%
Debt covenant, required cash on hand as a percentage of outstanding debt (percent)	25%
Share repurchase program, authorized, amount	$ 5,000,000
Subsequent Event | Term Loan Agreement | Scenario, Plan | Period One
Subsequent Event
Debt instrument early repayment fee (percent)	3%
Subsequent Event | Term Loan Agreement | Scenario, Plan | Period Two
Subsequent Event
Debt instrument early repayment fee (percent)	2%
Subsequent Event | Term Loan Agreement | Scenario, Plan | Period Three
Subsequent Event
Debt instrument early repayment fee (percent)	1%
Subsequent Event | Term Loan Agreement | Scenario, Plan | Period Four
Subsequent Event
Debt instrument early repayment fee (percent)	0%
Subsequent Event | Term Loan Agreement | Scenario, Plan | Minimum
Subsequent Event
Debt instrument, basis spread on variable rate (as a percent)	3.25%
Subsequent Event | Delayed Draw Term Loan Facility | Scenario, Plan
Subsequent Event
Revolving credit facility	$ 25,000,000
Subsequent Event | 4.75% Convertible Senior Notes | Scenario, Plan
Subsequent Event
Interest rate (as a percent)	4.75%
Proceeds from the issuance of convertible debt	$ 50,000,000
Debt conversion price (percent)	130%
Debt covenant, percentage trigger for conversion, as a percentage of principal (percent)	98%
Debt instrument, convertible, conversion ratio	0.0244021
Debt instrument, convertible, conversion price (in dollars per share) | $ / shares	$ 40.98
Debt covenant, debt conversion trigger as a percentage of conversion price (percent)	140%
Debt covenant, default trigger	$ 25,000,000
Debt covenant, percentage of debt in default that would trigger recall (percent)	25%
Debt covenant, special interest rate upon debt default (percent)	0.50%