CONMED (CNMD) 10-Q 5 May 22 2022 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2022	May 02, 2022
Cover [Abstract]
Entity Registrant Name	CONMED CORPORATION
Document Quarterly Report	true
Document Type	10-Q
Document Period End Date	Mar. 31, 2022
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2022
Entity File Number	001-39218
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	16-0977505
Entity Address, Address Line One	11311 Concept Blvd
Entity Address, City or Town	Largo,
Entity Address, State or Province	FL
Entity Address, Postal Zip Code	33773
City Area Code	727
Local Phone Number	392-6464
Entity Central Index Key	0000816956
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	CNMD
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Document Transition Report	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		29,526,009
Amendment Flag	false

Consolidated Condensed Statemen

Consolidated Condensed Statements of Comprehensive Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement of Comprehensive Income [Abstract]
Net sales	$ 242,327	$ 232,677
Cost of sales	106,336	104,228
Gross profit	135,991	128,449
Selling and administrative expense	102,875	98,340
Research and development expense	10,672	10,027
Operating expenses	113,547	108,367
Income from operations	22,444	20,082
Interest expense	4,998	10,351
Income before income taxes	17,446	9,731
Provision for (benefit from) income taxes	2,471	(129)
Net income	14,975	9,860
Comprehensive income	$ 16,415	$ 10,743
Per share data:
Basic (in dollars per share)	$ 0.51	$ 0.34
Diluted (in dollars per share)	$ 0.47	$ 0.31
Weighted average common shares:
Basic (shares)	29,428	28,972
Diluted (shares)	35,155	31,378

Consolidated Condensed Balance

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 24,864	$ 20,847
Accounts receivable, net	183,248	183,882
Inventories	253,729	231,644
Prepaid expenses and other current assets	26,459	23,750
Total current assets	488,300	460,123
Property, plant and equipment, net	108,526	108,863
Goodwill	617,534	617,528
Other intangible assets, net	463,421	471,049
Other assets	107,943	108,454
Total assets	1,785,724	1,766,017
Current liabilities:
Current portion of long-term debt	12,231	12,249
Accounts payable	67,458	58,197
Accrued compensation and benefits	45,423	60,488
Other current liabilities	62,485	65,712
Total current liabilities	187,597	196,646
Long-term debt	703,542	672,407
Deferred income taxes	63,226	68,537
Other long-term liabilities	41,813	42,992
Total liabilities	996,178	980,582
Commitments and contingencies
Shareholders' equity:
Preferred stock, par value $.01 per share; authorized 500,000 shares; none outstanding	0	0
Common stock, par value $0.01 per share; 100,000,000 shares authorized; 31,299,194 shares issued in 2022 and 2021, respectively	313	313
Paid-in capital	365,555	396,771
Retained earnings	526,472	496,605
Accumulated other comprehensive loss	(52,763)	(54,203)
Less: 1,782,667 and 1,925,893 shares of common stock in treasury, at cost in 2022 and 2021, respectively	(50,031)	(54,051)
Total shareholders’ equity	789,546	785,435
Total liabilities and shareholders’ equity	$ 1,785,724	$ 1,766,017

Consolidated Condensed Balanc_2

Consolidated Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Mar. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Preferred stock, par value (dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	500,000	500,000
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	31,299,194	31,299,194
Treasury stock, shares (in shares)	1,782,667	1,925,893

Consolidated Condensed Statem_2

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands		Total	Common Stock	Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Loss	Treasury Stock
Balance at period start (shares) at Dec. 31, 2020			31,299
Balance at period start at Dec. 31, 2020		$ 709,038	$ 313	$ 382,628	$ 457,417	$ (63,681)	$ (67,639)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		8,215		2,944			5,271
Stock-based compensation		3,387		3,387
Dividends on common stock ($0.20 per share)		(5,813)			(5,813)
Comprehensive income (loss):
Cash flow hedging gain, net		3,926				3,926
Pension liability, net of income tax		631				631
Foreign currency translation adjustments		(3,674)				(3,674)
Net income		9,860			9,860
Comprehensive income		10,743
Balance at period end (shares) at Mar. 31, 2021			31,299
Balance at period end at Mar. 31, 2021		725,570	$ 313	388,959	461,464	(62,798)	(62,368)
Balance at period start (shares) at Dec. 31, 2021			31,299
Balance at period start at Dec. 31, 2021		785,435	$ 313	396,771	496,605	(54,203)	(54,051)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		6,252		2,232			4,020
Stock-based compensation		4,463		4,463
Dividends on common stock ($0.20 per share)		(5,899)			(5,899)
Comprehensive income (loss):
Cash flow hedging gain, net		1,082				1,082
Pension liability, net of income tax		521				521
Foreign currency translation adjustments		(163)				(163)
Net income		14,975			14,975
Comprehensive income		$ 16,415
Accounting Standards Update [Extensible Enumeration]		Accounting Standards Update 2020-06
Balance at period end (shares) at Mar. 31, 2022			31,299
Balance at period end at Mar. 31, 2022		$ 789,546	$ 313	365,555	526,472	$ (52,763)	$ (50,031)
Balance at period end (Accounting Standards Update 2020-06) at Mar. 31, 2022	[1]	$ (17,120)		$ (37,911)	$ 20,791
[1]	(1) We recorded the cumulative impact of adopting ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity in 2022. Refer to Note 3 for further detail.

Consolidated Condensed Statem_3

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) (Parenthetical) - $ / shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement of Stockholders' Equity [Abstract]
Dividends per share of common stock (in dollars per share)	$ 0.20	$ 0.20

Consolidated Condensed Statem_4

Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows from operating activities:
Net income	$ 14,975	$ 9,860
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	4,032	4,757
Amortization of debt discount	0	2,503
Amortization of deferred debt issuance costs	880	1,058
Amortization	12,799	13,519
Stock-based compensation	4,463	3,387
Deferred income taxes	177	(2,688)
Increase (decrease) in cash flows from changes in assets and liabilities:
Accounts receivable	(163)	11,957
Inventories	(21,857)	(11,638)
Accounts payable	9,205	2,804
Accrued compensation and benefits	(14,966)	(8,955)
Other assets	(6,129)	(6,002)
Other liabilities	(3,088)	1,782
Net cash provided by operating activities	328	22,344
Cash flows from investing activities:
Purchases of property, plant and equipment	(3,687)	(3,109)
Net cash used in investing activities	(3,687)	(3,109)
Cash flows from financing activities:
Payments on term loan	(2,981)	(3,313)
Payments on revolving line of credit	(99,000)	(72,000)
Proceeds from revolving line of credit	110,000	64,000
Payments related to contingent consideration	(798)	0
Dividends paid on common stock	(5,874)	(5,775)
Other, net	6,142	8,216
Net cash provided by (used in) financing activities	7,489	(8,872)
Effect of exchange rate changes on cash and cash equivalents	(113)	(950)
Net increase in cash and cash equivalents	4,017	9,413
Cash and cash equivalents at beginning of period	20,847	27,356
Cash and cash equivalents at end of period	24,864	36,769
Non-cash investing and financing activities:
Dividends payable	$ 5,899	$ 5,813

Operations

Operations	3 Months Ended
	Mar. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Operations	OperationsCONMED Corporation (“CONMED”, the “Company”, “we” or “us”) is a medical technology company that provides surgical devices and equipment for minimally invasive procedures.  The Company’s products are used by surgeons and other healthcare professionals in a variety of specialties including orthopedics, general surgery, gynecology, thoracic surgery and gastroenterology.

Interim Financial Information

Interim Financial Information	3 Months Ended
	Mar. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Interim Financial Information	Interim Financial Information The accompanying unaudited consolidated condensed financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for annual financial statements. The information herein reflects all normal recurring material adjustments, which are, in the opinion of management, necessary to fairly present the results for the periods presented. The consolidated condensed financial statements herein consist of all wholly-owned domestic and foreign subsidiaries with all significant intercompany transactions eliminated. Results for the period ended March 31, 2022 are not necessarily indicative of the results that may be expected for the year ending December 31, 2022. The consolidated condensed financial statements and notes thereto should be read in conjunction with the consolidated financial statements and notes for the year ended December 31, 2021 included in our Annual Report on Form 10-K. Use of Estimates Preparation of the consolidated condensed financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated condensed financial statements and the reported amounts of revenue and expenses during the reporting period. Due to the COVID-19 pandemic, there has been uncertainty and disruption in the global economy and financial markets. We are not aware of any specific event or circumstance that would require an update to our estimates or judgments or a revision of the carrying value of our assets or liabilities as of May 5, 2022, the date of issuance of this Quarterly Report on Form 10-Q. These estimates may change, as new events occur and additional information is obtained. Actual results could differ materially from these estimates under different assumptions or conditions.

New Accounting Pronouncements

New Accounting Pronouncements	3 Months Ended
	Mar. 31, 2022
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity ("ASU 2020-06"), which simplifies the accounting for convertible instruments by removing certain separation models requiring separate accounting for embedded conversion features which will result in more convertible debt instruments accounted for as a single liability. The ASU eliminates certain settlement conditions that are required for equity classification to qualify for the derivative scope exception. The ASU addresses how convertible instruments are accounted for in the calculation of diluted earnings per share by using the if-converted method. The ASU is effective for fiscal years beginning after December 15, 2021, with early adoption permitted no earlier than fiscal years beginning after December 15, 2020. The Company adopted this standard on January 1, 2022 using the modified retrospective method. The adoption of this new guidance resulted in an increase of approximately $22.6 million to long-term debt in the consolidated condensed balance sheets, to reflect the full principal amount of the convertible notes outstanding net of issuance costs, a reduction of approximately $37.9 million to additional paid-in capital, net of income tax effects, to remove the equity component separately recorded for the conversion features associated with the convertible notes, a decrease to deferred income tax liabilities of approximately $5.5 million, and a cumulative-effect adjustment of approximately $20.8 million, net of income tax effects, to the beginning balance of retained earnings as of January 1, 2022. The adoption of this new guidance reduced interest expense related to amortization of debt discount by approximately $2.6 million during the three months ended March 31, 2022 and is expected to reduce interest expense by approximately $10.4 million for the year ended December 31, 2022. Additionally, the dilutive share count increased by approximately 2.5 million shares as a result of calculating the impact of dilution from the Company's convertible notes using the if-converted method. Diluted EPS increased by approximately $0.07 in the quarter ended March 31, 2022 as a result of adoption of this new standard. Recently Issued Accounting Standards, Not Yet Adopted In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022. The Company has not adopted this ASU as of March 31, 2022. Our seventh amended and restated senior credit agreement includes language to address the change from LIBOR to an alternative base rate, therefore we do not believe reference rate reform will have a significant impact on our consolidated financial statements, however will continue to monitor our transition away from LIBOR and the potential to elect to apply this guidance in our consolidated financial statements in the event that we are impacted by reference rate reform.

Revenues

Revenues	3 Months Ended
	Mar. 31, 2022
Revenue from Contract with Customer [Abstract]
Revenues	Revenues The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended March 31, 2022 March 31, 2021 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 37,947 $ 93,280 $ 131,227 $ 37,131 $ 86,812 $ 123,943 Europe, Middle East & Africa 29,980 20,326 50,306 26,052 18,544 44,596 Asia Pacific 23,418 12,954 36,372 26,602 12,662 39,264 Americas (excluding the United States) 16,172 8,250 24,422 17,381 7,493 24,874 Total sales from contracts with customers $ 107,517 $ 134,810 $ 242,327 $ 107,166 $ 125,511 $ 232,677 Timing of Revenue Recognition Goods transferred at a point in time $ 98,204 $ 133,322 $ 231,526 $ 97,690 $ 124,394 $ 222,084 Services transferred over time 9,313 1,488 10,801 9,476 1,117 10,593 Total sales from contracts with customers $ 107,517 $ 134,810 $ 242,327 $ 107,166 $ 125,511 $ 232,677 Contract liability balances related to the sale of extended warranties to customers are as follows: March 31, 2022 December 31, 2021 Contract liability $ 17,534 $ 16,760 Revenue recognized during the three months ended March 31, 2022 and March 31, 2021 from amounts included in contract liabilities at the beginning of the period were $3.9 million and $3.4 million, respectively. There were no material contract assets as of March 31, 2022 and December 31, 2021.

Comprehensive Income

Comprehensive Income	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Comprehensive Income	Comprehensive Income Comprehensive income consists of the following: Three Months Ended March 31, 2022 2021 Net income $ 14,975 $ 9,860 Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $346 and $1,250 for the three months ended March 31, 2022 and 2021, respectively) 1,082 3,926 Pension liability, net of income tax (income tax expense of $127 and $201 for the three months ended March 31, 2022 and 2021, respectively) 521 631 Foreign currency translation adjustment (163) (3,674) Comprehensive income $ 16,415 $ 10,743 Accumulated other comprehensive loss consists of the following: Cash Flow Pension Cumulative Accumulated Balance, December 31, 2021 $ 3,656 $ (29,671) $ (28,188) $ (54,203) Other comprehensive income (loss) before reclassifications, net of tax 2,460 — (163) 2,297 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (1,819) 648 — (1,171) Income tax 441 (127) — 314 Net current-period other comprehensive income (loss) 1,082 521 (163) 1,440 Balance, March 31, 2022 $ 4,738 $ (29,150) $ (28,351) $ (52,763) Cash Flow Pension Cumulative Accumulated Balance, December 31, 2020 $ (5,945) $ (36,620) $ (21,116) $ (63,681) Other comprehensive income (loss) before reclassifications, net of tax 2,725 — (3,674) (949) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,584 832 — 2,416 Income tax (383) (201) — (584) Net current-period other comprehensive income (loss) 3,926 631 (3,674) 883 Balance, March 31, 2021 $ (2,019) $ (35,989) $ (24,790) $ (62,798) (a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	3 Months Ended
	Mar. 31, 2022
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments We enter into derivative instruments for risk management purposes only. We operate internationally and, in the normal course of business, are exposed to fluctuations in interest rates, foreign exchange rates and commodity prices. These fluctuations can increase the costs of financing, investing and operating the business. We use forward contracts, a type of derivative instrument, to manage certain foreign currency exposures. By nature, all financial instruments involve market and credit risks. We enter into forward contracts with major investment grade financial institutions and have policies to monitor the credit risk of those counterparties. While there can be no assurance, we do not anticipate any material non-performance by any of these counterparties. Foreign Currency Forward Contracts. We hedge forecasted intercompany sales denominated in foreign currencies through the use of forward contracts. We account for these forward contracts as cash flow hedges. To the extent these forward contracts meet hedge accounting criteria, changes in their fair value are not included in current earnings but are included in accumulated other comprehensive loss. These changes in fair value will be recognized into earnings as a component of sales or cost of sales when the forecasted transaction occurs. We also enter into forward contracts to exchange foreign currencies for United States dollars in order to hedge our currency transaction exposures on intercompany receivables designated in foreign currencies. These forward contracts settle each month at month-end, at which time we enter into new forward contracts. We have not designated these forward contracts as hedges and have not applied hedge accounting to them. The following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation March 31, 2022 December 31, 2021 Forward exchange contracts Cash flow hedge $ 189,696 $ 172,894 Forward exchange contracts Non-designated 57,255 38,897 The remaining time to maturity as of March 31, 2022 is within two years for hedge designated foreign exchange contracts and approximately one month for non-hedge designated forward exchange contracts. Statement of comprehensive income presentation Derivatives designated as cash flow hedges Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) ("AOCI") and net earnings on our consolidated condensed statements of comprehensive income and our consolidated condensed balance sheets: Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income Amount of Gain (Loss) Reclassified from AOCI Three Months Ended March 31, Total Amount of Line Item Presented Derivative Instrument 2022 2021 Location of amount reclassified 2022 2021 2022 2021 Foreign exchange contracts $ 3,247 $ 3,593 Net Sales $ 242,327 $ 232,677 $ 1,744 $ (1,849) Cost of Sales 106,336 104,228 75 265 Pre-tax gain (loss) $ 3,247 $ 3,593 $ 1,819 $ (1,584) Tax expense (benefit) 787 868 441 (383) Net gain (loss) $ 2,460 $ 2,725 $ 1,378 $ (1,201) At March 31, 2022, $4.5 million of net unrealized gains on forward contracts accounted for as cash flow hedges, and included in accumulated other comprehensive loss, are expected to be recognized in earnings in the next twelve months. Derivatives not designated as cash flow hedges Net gains and losses from derivative instruments not accounted for as hedges and gains and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income were: Three Months Ended March 31, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income 2022 2021 Net gain (loss) on currency forward contracts Selling and administrative expense $ (958) $ 458 Net gain (loss) on currency transaction exposures Selling and administrative expense $ 415 $ (1,123) Balance sheet presentation We record these forward foreign exchange contracts at fair value. The following tables summarize the fair value for forward foreign exchange contracts outstanding at March 31, 2022 and December 31, 2021: March 31, 2022 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 6,518 $ (570) $ 5,948 Foreign exchange contracts Other long-term assets 651 (344) 307 $ 7,169 $ (914) $ 6,255 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 46 (213) (167) Total derivatives $ 7,215 $ (1,127) $ 6,088 December 31, 2021 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 5,331 $ (430) $ 4,901 Foreign exchange contracts Other long-term liabilities 82 (161) (79) $ 5,413 $ (591) $ 4,822 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 38 (180) (142) Total derivatives $ 5,451 $ (771) $ 4,680 Our forward foreign exchange contracts are subject to a master netting agreement and qualify for netting in the consolidated condensed balance sheets. Fair Value Disclosure. FASB guidance defines fair value and establishes a framework for measuring fair value and related disclosure requirements. This guidance applies when fair value measurements are required or permitted. The guidance indicates, among other things, that a fair value measurement assumes that the transaction to sell an asset or transfer a liability occurs in the principal market for the asset or liability or, in the absence of a principal market, the most advantageous market for the asset or liability. Fair value is defined based upon an exit price model. Valuation Hierarchy. A valuation hierarchy was established for disclosure of the inputs to the valuations used to measure fair value. This hierarchy prioritizes the inputs into three broad levels as follows. Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets in markets that are not active, inputs other than quoted prices that are observable for the asset or liability, including interest rates, yield curves and credit risks, or inputs that are derived principally from or corroborated by observable market data through correlation. Level 3 inputs are unobservable inputs based on our own assumptions used to measure assets and liabilities at fair value. A financial asset or liability’s classification within the hierarchy is determined based on the lowest level input that is significant to the fair value measurement. There have been no significant changes in the assumptions. Valuation Techniques. Assets and liabilities carried at fair value and measured on a recurring basis as of March 31, 2022 consist of forward foreign exchange contracts. The Company values its forward foreign exchange contracts using quoted prices for similar assets. The most significant assumption is quoted currency rates. The value of the forward foreign exchange contract assets and liabilities were valued using Level 2 inputs and are listed in the table above.

Inventories

Inventories	3 Months Ended
	Mar. 31, 2022
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following: March 31, December 31, Raw materials $ 89,986 $ 83,386 Work-in-process 22,210 17,449 Finished goods 141,533 130,809 Total $ 253,729 $ 231,644

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share Basic earnings per share (“basic EPS”) is computed by dividing net income by the weighted average number of common shares outstanding for the reporting period. Diluted earnings per share (“diluted EPS”) gives effect to all dilutive potential shares outstanding resulting from employee stock compensation as well as the 2.625% convertible notes due in 2024 (the “Notes”) and related hedge transactions during the period. The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2022 and 2021: Three Months Ended March 31, 2022 Basic EPS Adjustments Diluted EPS Net income $ 14,975 $ 1,715 $ 16,690 Weighted average shares outstanding 29,428 — 29,428 Employee stock compensation — 1,158 1,158 Warrants — 684 684 Convertible notes — 3,885 3,885 29,428 5,727 35,155 EPS $ 0.51 $ 0.47 Three Months Ended March 31, 2021 Basic EPS Adjustments Diluted EPS Net income $ 9,860 $ — $ 9,860 Weighted average shares outstanding 28,972 — 28,972 Employee stock compensation — 1,221 1,221 Warrants — 170 170 Convertible notes — 1,015 1,015 28,972 2,406 31,378 EPS $ 0.34 $ 0.31 The shares used in the calculation of diluted EPS exclude employee stock options and stock appreciation rights to purchase shares where the exercise price was greater than the average market price of common shares for the period and the effect of the inclusion would be anti-dilutive. The Notes are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The following is intended to describe the impact of the Notes and related hedge transactions on the calculation of diluted EPS. Additional shares to be issued pursuant to the terms of the Notes and related hedge transactions, if any, would occur at maturity. Effective with our adoption of ASU 2020-06 on January 1, 2022 (refer to Note 3 for further detail), the Company began using the if-converted method to compute diluted EPS. Under the if-converted method, in the calculation of diluted EPS, the numerator is adjusted for interest expense applicable to the convertible notes (net of tax) and the denominator is adjusted to include additional common shares assuming the principal portion of the Notes and the conversion premium are settled in common shares. For periods prior to adoption of ASU 2020-06, the calculation of diluted EPS includes potential diluted shares upon conversion of the Notes only when the average market price per share of our common stock for the period is greater than the conversion price of the Notes of $88.80 and only for the conversion premium with the principal portion of the Notes assumed to be settled in cash. We previously entered into convertible notes hedge transactions to increase the effective conversion price of the Notes from $88.80 to $114.92. However, our convertible notes hedges are not included when calculating potential dilutive shares since their effect is always anti-dilutive. Concurrent with entering into the hedge transactions, we entered into warrant transactions under which we agreed to sell shares of our common stock at $114.92. The calculation of diluted EPS includes potential diluted shares to be issued under the warrants when the average market price per share of our common stock for the period is greater than $114.92, calculated under the treasury stock method.

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Other Intangible Assets	Goodwill and Other Intangible Assets The changes in the net carrying amount of goodwill for the three months ended March 31, 2022 are as follows: Balance as of December 31, 2021 $ 617,528 Foreign currency translation 6 Balance as of March 31, 2022 $ 617,534 Assets and liabilities of acquired businesses are recorded at their estimated fair values as of the date of acquisition. Goodwill represents costs in excess of fair values assigned to the underlying net assets of acquired businesses. Other intangible assets consist of the following: March 31, 2022 December 31, 2021 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 25 $ 342,391 $ (157,285) $ 342,452 $ (152,934) Sales representation, marketing and promotional rights 25 149,376 (61,500) 149,376 (60,000) Developed technology 16 106,604 (28,266) 106,604 (26,495) Patents and other intangible assets 15 76,849 (51,292) 76,392 (50,890) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 761,764 $ (298,343) $ 761,368 $ (290,319) Customer and distributor relationships, trademarks and tradenames, developed technology and patents and other intangible assets primarily represent allocations of purchase price to identifiable intangible assets of acquired businesses. Sales representation, marketing and promotional rights represent intangible assets created under our agreement with Musculoskeletal Transplant Foundation (“MTF”). Amortization expense related to intangible assets which are subject to amortization totaled $8.0 million and $8.3 million in the three months ended March 31, 2022 and 2021, respectively, and is included as a reduction of revenue (for amortization related to our sales representation, marketing and promotional rights) and in selling and administrative expense (for all other intangible assets) in the consolidated condensed statements of comprehensive income. The estimated intangible asset amortization expense remaining for the year ending December 31, 2022 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2022 $ 18,321 $ 4,500 $ 22,821 2023 25,729 6,000 31,729 2024 25,205 6,000 31,205 2025 25,400 6,000 31,400 2026 24,889 6,000 30,889 2027 24,499 6,000 30,499

Long Term Debt

Long Term Debt	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following: March 31, 2022 December 31, 2021 Revolving line of credit $ 151,000 $ 140,000 Term loan, net of deferred debt issuance costs of $1,297 and $1,373 in 2022 and 2021, respectively 223,290 226,196 2.625% convertible notes, net of deferred debt issuance costs of $3,986 and $3,700 in 2022 and 2021, respectively, and unamortized discount of $23,404 in 2021 341,014 317,896 Financing leases 469 564 Total debt 715,773 684,656 Less: Current portion 12,231 12,249 Total long-term debt $ 703,542 $ 672,407 On July 16, 2021, we entered into a seventh amended and restated senior credit agreement consisting of: (a) a $233.5 million term loan facility and (b) a $585.0 million revolving credit facility. The revolving credit facility will terminate and the loans outstanding under the term loan facility will expire on July 16, 2026. The term loan is payable in quarterly installments increasing over the term of the facility. Proceeds from the term loan facility and borrowings under the revolving credit facility were used to repay the then existing senior credit agreement. Interest rates are at LIBOR (0.50% at March 31, 2022) plus an interest rate margin of 1.25% (1.750% at March 31, 2022). For borrowings where we elect to use the alternate base rate, the initial base rate is the greatest of (i) the Prime Rate, (ii) the Federal Funds Rate plus 0.50% or (iii) the one-month Adjusted LIBOR plus 1.00%, plus, in each case, an interest rate margin. There were $224.6 million in borrowings outstanding on the term loan facility as of March 31, 2022. There were $151.0 million in borrowings outstanding under the revolving credit facility as of March 31, 2022. Our available borrowings on the revolving credit facility at March 31, 2022 were $431.8 million with approximately $2.2 million of the facility set aside for outstanding letters of credit. The seventh amended and restated senior credit agreement is collateralized by substantially all of our personal property and assets. The seventh amended and restated senior credit agreement contains covenants and restrictions which, among other things, require the maintenance of certain financial ratios and restrict dividend payments and the incurrence of certain indebtedness and other activities, including acquisitions and dispositions. We were in full compliance with these covenants and restrictions as of March 31, 2022. We are also required, under certain circumstances, to make mandatory prepayments from net cash proceeds from any issuance of equity and asset sales. On January 29, 2019, we issued $345.0 million in 2.625% convertible notes due in 2024 (the "Notes"). Interest is payable semi-annually in arrears on February 1 and August 1 of each year, commencing August 1, 2019. The Notes will mature on February 1, 2024, unless earlier repurchased or converted. The Notes represent subordinated unsecured obligations and are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The Notes may be converted at an initial conversion rate of 11.2608 shares of our common stock per $1,000 principal amount of Notes (equivalent to an initial conversion price of approximately $88.80 per share of common stock). Holders of the Notes may convert the Notes at their option at any time on or after November 1, 2023 through the second scheduled trading day preceding the maturity date. Holders of the Notes will also have the right to convert the Notes prior to November 1, 2023, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of the net proceeds from the offering of the Notes were used as part of the financing for the Buffalo Filter acquisition and $21.0 million were used to pay the cost of certain convertible notes hedge transactions as further described below. Our effective borrowing rate for nonconvertible debt at the time of issuance of the Notes was estimated to be 6.14%, which resulted in $51.6 million of the $345.0 million aggregate principal amount of Notes issued, or $39.1 million after taxes, being attributable to equity. For the three months ended March 31, 2021, we recorded interest expense related to the amortization of debt discount on the Notes of $2.5 million at the effective interest rate of 6.14%. On January 1, 2022, we adopted ASU 2020-06 using the modified retrospective approach as further described in Note 3. This ASU eliminated the equity component separately recorded for the conversion features associated with the convertible notes and related debt discount. For both the three months ended March 31, 2022 and 2021, we have recorded interest expense on the Notes of $2.3 million at the contractual coupon rate of 2.625%. The estimated fair value of the Notes was approximately $596.9 million as of March 31, 2022 based on a market approach which represents a Level 2 valuation in the fair value hierarchy. The estimated fair value was determined based on the estimated or actual bids and offers of the Notes in an over-the-counter market transaction on the last business day of the period. In connection with the offering of the Notes, we entered into convertible note hedge transactions with a number of financial institutions (each, an “option counterparty”). The convertible note hedge transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the Notes, the number of shares of our common stock underlying the Notes. Concurrently with entering into the convertible note hedge transactions, we also entered into separate warrant transactions with each option counterparty whereby we sold to such option counterparty warrants to purchase, subject to customary anti-dilution adjustments, the same number of shares of our common stock. The convertible note hedge transactions are expected generally to reduce the potential dilution upon conversion of the Notes and/or offset any cash payments we are required to make in excess of the principal amount of converted Notes, as the case may be, in the event that the market price per share of our common stock, as measured under the terms of the convertible note hedge transactions, is greater than the strike price of the convertible note hedge transactions, which initially corresponds to the conversion price of the Notes and is subject to anti-dilution adjustments substantially similar to those applicable to the conversion rate of the Notes. If, however, the market price per share of our common stock, as measured under the terms of the warrant transactions, exceeds the strike price ($114.92) of the warrants, there would nevertheless be dilution to the extent that such market price exceeds the strike price of the warrants as noted in Note 8, unless we elect to settle the warrants in cash. The scheduled maturities of long-term debt outstanding at March 31, 2022 are as follows: Remaining 2022 $ 8,944 2023 14,906 2024 365,869 2025 23,850 2026 307,018 2027 — The above amounts exclude deferred debt issuance costs and financing leases.

Guarantees

Guarantees	3 Months Ended
	Mar. 31, 2022
Guarantees [Abstract]
Guarantees	GuaranteesWe provide warranties on certain of our products at the time of sale and sell extended warranties. The standard warranty period for our capital equipment is generally one year and our extended warranties typically vary from one to three years. Liability under service and warranty policies is based upon a review of historical warranty and service claim experience. Adjustments are made to accruals as claim data and historical experience warrant. Changes in the liability for standard warranties for the three months ended March 31, are as follows: 2022 2021 Balance as of January 1, $ 2,344 $ 1,826 Provision for warranties 197 291 Claims made (187) (206) Balance as of March 31, $ 2,354 $ 1,911 Costs associated with extended warranty repairs are recorded as incurred and amounted to $1.6 million for both the three months ended March 31, 2022 and 2021.

Pension Plan

Pension Plan	3 Months Ended
	Mar. 31, 2022
Retirement Benefits [Abstract]
Pension Plan	Pension Plan Net periodic pension cost consists of the following: Three Months Ended March 31, 2022 2021 Service cost $ 269 $ 248 Interest cost on projected benefit obligation 537 451 Expected return on plan assets (1,324) (1,289) Net amortization and deferral 648 832 Net periodic pension cost $ 130 $ 242

Other Expense

Other Expense	3 Months Ended
	Mar. 31, 2022
Other Expense [Abstract]
Other Expense	Other Expense Other expense consists of the following, which is included in selling and administrative expense: Three Months Ended March 31, 2022 2021 Restructuring and related costs $ — $ 414 Other expense included in selling and administrative expense $ — $ 414 During the three months ended March 31, 2021 we recorded a charge of $0.4 million related to the restructuring of our sales force which consisted primarily of termination payments to Orthopedic distributors made in exchange for ongoing assistance to transition to employee-based sales representatives and severance. These costs were charged to selling and administrative expense.

Business Segment

Business Segment	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Business Segment	Business Segment We are accounting and reporting for our business as a single operating segment entity engaged in the development, manufacturing and sale on a global basis of surgical devices and related equipment. Our chief operating decision maker (the CEO) evaluates the various global product portfolios on a net sales basis and evaluates profitability, investment, cash flow metrics and allocates resources on a consolidated worldwide basis due to shared infrastructure and resources. Our product lines consist of orthopedic surgery and general surgery. Orthopedic surgery consists of sports medicine instrumentation and small bone, large bone and specialty powered surgical instruments as well as imaging systems for use in minimally invasive surgery procedures and fees related to the sales representation, promotion and marketing of sports medicine allograft tissue. General surgery consists of a complete line of endo-mechanical instrumentation for minimally invasive laparoscopic and gastrointestinal procedures, smoke evacuation devices, a line of cardiac monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales are as follows: Three Months Ended March 31, 2022 2021 Orthopedic surgery $ 107,517 $ 107,166 General surgery 134,810 125,511 Consolidated net sales $ 242,327 $ 232,677

Legal Proceedings

Legal Proceedings	3 Months Ended
	Mar. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Legal Proceedings	Legal Proceedings From time to time, the Company may receive an information request, subpoena or warrant from a government agency such as the Securities and Exchange Commission, Department of Justice, Equal Employment Opportunity Commission, the Occupational Safety and Health Administration, the United States Food and Drug Administration, the Department of Labor, the Treasury Department or other federal and state agencies or foreign governments or government agencies. These information requests, subpoenas or warrants may or may not be routine inquiries, or may begin as routine inquiries and over time develop into enforcement actions of various types. Likewise, if we receive reports of alleged misconduct from employees and third parties, we investigate as appropriate. Manufacturers of medical devices have been the subject of various enforcement actions relating to interactions with health care providers domestically or internationally whereby companies are claimed to have provided health care providers with inappropriate incentives to purchase their products. Similarly, the Foreign Corrupt Practices Act ("FCPA") imposes obligations on manufacturers with respect to interactions with health care providers who may be considered government officials based on their affiliation with public hospitals. The FCPA also requires publicly listed manufacturers to maintain accurate books and records, and maintain internal accounting controls sufficient to provide assurance that transactions are accurately recorded, lawful and in accordance with management's authorization. The FCPA poses unique challenges both because manufacturers operate in foreign cultures in which conduct illegal under the FCPA may not be illegal in local jurisdictions, and because, in some cases, a United States manufacturer may face risks under the FCPA based on the conduct of third parties over whom the manufacturer may not have complete control. While CONMED has not experienced any material enforcement action to date, there can be no assurance that the Company will not be subject to a material enforcement action in the future, or that the Company will not incur costs including, in the form of fees for lawyers and other consultants, that are material to the Company’s results of operations in the course of responding to a future inquiry or investigation. Manufacturers of medical products may face exposure to significant product liability claims, as well as patent infringement and other claims incurred in the ordinary course of business. To date, we have not experienced any claims that have been material to our financial statements or financial condition, but any such claims arising in the future could have a material adverse effect on our business, results of operations or cash flows. We currently maintain commercial product liability insurance of $35 million per incident and $35 million in the aggregate annually, which we believe is adequate. This coverage is on a claims-made basis. There can be no assurance that claims will not exceed insurance coverage, that the carriers will be solvent or that such insurance will be available to us in the future at a reasonable cost. Our operations are subject, and in the past have been subject, to a number of environmental laws and regulations governing, among other things, air emissions; wastewater discharges; the use, handling and disposal of hazardous substances and wastes; soil and groundwater remediation and employee health and safety. Likewise, the operations of our suppliers and sterilizers are subject to similar environmental laws and regulations. In some jurisdictions, environmental requirements may be expected to become more stringent in the future. In the United States, certain environmental laws can impose liability for the entire cost of site restoration upon each of the parties that may have contributed to conditions at the site regardless of fault or the lawfulness of the party’s activities. While we do not believe that the present costs of environmental compliance and remediation are material, there can be no assurance that future compliance or remedial obligations would not have a material adverse effect on our financial condition, results of operations or cash flows. In 2014, the Company acquired EndoDynamix, Inc. The agreement governing the terms of the acquisition provides that, if various conditions are met, certain contingent payments relating to the first commercial sale of the products (the milestone payment), as well as royalties based on sales (the revenue based payments), are due to the seller. In 2016, we notified the seller that there was a need to redesign the product, and that, as a consequence, the first commercial sale had been delayed. Consequently, the payment of contingent milestone and revenue-based payments were delayed. On January 18, 2017, the seller provided notice (the "Notice") seeking $12.7 million under a liquidated damages clause, which essentially represents the seller's view as to the sum of the projected contingent milestone and revenue-based payments on an accelerated basis. CONMED responded to the Notice denying that there was any basis for acceleration of the payments due under the acquisition agreement. On February 22, 2017, the representative of the former shareholders of EndoDynamix filed a complaint in Delaware Chancery Court claiming breach of contract with respect to the duty to commercialize the product and seeking the contingent payments on an accelerated basis. We believe that there was a substantive contractual basis to support the Company's decision to redesign the product, such that there was no legitimate basis for seeking the liquidated damages. In the third quarter of 2018, the Company decided to halt the development of the EndoDynamix clip applier and recorded a charge to write off assets and released a previously accrued contingent consideration liability. In court filings the Plaintiffs claim to seek liquidated damages, as well as additional damages up to $24.8 million. A non-jury trial in the Delaware Chancery Court commenced on March 18, 2021, and testimony concluded on April 7, 2021. The parties have submitted post-trial briefs and the Court heard oral arguments at a hearing on September 16, 2021 and requested additional briefs which were filed in March 2022. The Court has not issued a ruling. The Company has not recorded any expense related to potential damages in connection with this matter because the Company does not believe any potential loss is probable. We expect to defend the claims asserted by the sellers of EndoDynamix, although there can be no assurance that we will prevail in the trial and/or any resulting appeals. CONMED is defending two Georgia State Court actions. The first action was filed in Cobb County by various employees, former employees, contract workers and others against CONMED and against a contract sterilizer (the "Cobb County Action"). The second action was filed in Douglas County against CONMED’s landlord and other allegedly related entities (the "Douglas County Action"). Plaintiffs in the lawsuits allege personal injury and related claims purportedly arising from or relating to exposure to Ethylene Oxide, a chemical used to sterilize certain products. CONMED is defending the claims asserted directly against it and is providing indemnification for certain other defendants for these claims based on contractual provisions. Both actions are in their early stages and discovery has not yet started. The Company's motion to dismiss in the Cobb County action was heard on January 10, 2022. CONMED believes it has strong defenses to the claims and will vigorously defend itself and all parties it is indemnifying. As with any litigation, there are risks, including the risk that CONMED may not prevail with respect to the defense of the underlying claims, or with respect to securing adequate insurance coverage for the indemnification claims. The Company is unable to estimate any range of possible loss at this time, and has not recorded any expense related to potential damages in connection with this matter because the Company does not believe any potential loss is probable. CONMED has submitted the foregoing claims for insurance coverage. One insurer is providing coverage for certain of the claims asserted directly against the Company. CONMED is currently litigating two lawsuits in the United States District Court for the Northern District of New York with Federal Insurance Company (“Chubb”): one involving CONMED’s claim for coverage for the indemnification claims arising from the Cobb County Action, and the other concerning CONMED’s claim for coverage for the indemnification claims arising from the Douglas County Action. On March 10, 2022, the Court ruled in favor of CONMED with respect to coverage for the indemnification claims arising from the Cobb County Action . Chubb has filed a motion for reconsideration, and may also appeal. CONMED believes its position is well-grounded in the facts and the law, and expects a similar ruling in the coverage case concerning the Douglas County Action, but there can be no assurance that CONMED will prevail in either of the two coverage cases. In addition, one of CONMED’s contract sterilizers, which is defending toxic tort claims asserted by various residents in the areas around its processing facility, has placed CONMED on notice of a claim for indemnification relating to some of those claims. CONMED is reviewing the notice, and has not at this time taken any position on the notice. From time to time, we are also subject to negligence and other claims arising out of the ordinary conduct of our business, including, for example, accidents our employees may experience within the course of their employment or otherwise. We are currently defending one such claim, which we expect to be fully covered by insurance, involving potentially significant personal injuries. The Company is unable to estimate any range of possible loss at this time, and therefore has not recorded any liability related to potential damages in connection with this matter. We record reserves sufficient to cover probable and estimable losses associated with any such pending claims. We do not expect that the resolution of any pending claims, investigations or reports of alleged misconduct will have a material adverse effect on our financial condition, results of operations or cash flows. There can be no assurance, however, that future claims or investigations, or the costs associated with responding to such claims, investigations or reports of misconduct, especially claims and investigations not covered by insurance, will not have a material adverse effect on our financial condition, results of operations or cash flows.

Subsequent Events

Subsequent Events	3 Months Ended
	Mar. 31, 2022
Subsequent Events [Abstract]
Subsequent Events	Subsequent Events On May 4, 2022, we entered into an Agreement and Plan of Merger (the “Merger Agreement”), by and among CONMED, Odyssey Merger Sub, Inc., a Delaware corporation and newly formed wholly-owned subsidiary of CONMED (“Merger Sub”), In2Bones Global, Inc., a Delaware corporation (“In2Bones”), and Sheryl Moroschak, solely in her capacity as representative of In2Bones’ equity holders (the “Holder Representative”). Pursuant to the Merger Agreement, CONMED will acquire In2Bones by way of a merger of Merger Sub with and into In2Bones (the “Merger”), with In2Bones surviving the Merger as a wholly-owned subsidiary of CONMED. Pursuant to the Merger Agreement, upon consummation of the Merger (the “Closing”), CONMED will pay In2Bones’ equity holders an aggregate upfront payment of $145 million in cash, as adjusted and payable pursuant to the Merger Agreement (the “Closing Purchase Price”). The adjustments to the Closing Purchase Price include, among others, (i) an upward adjustment for any cash held by In2Bones at the Closing, (ii) a downward adjustment for In2Bones’ outstanding indebtedness, transaction expenses and other related fees and expenses and (iii) an upward or downward adjustment, as applicable, networking adjustment based on a target range. The Merger Agreement also provides for earn-out payments to In2Bones’ equity holders in an amount up to $110 million based on the achievement of certain revenue targets for In2Bones products during the sixteen (16) successive quarters commencing on the first day of the first full quarter following the Closing date.

Interim Reporting (Policies)

Interim Reporting (Policies)	3 Months Ended
	Mar. 31, 2022
Quarterly Financial Information Disclosure [Abstract]
Use of Estimates	Use of Estimates Preparation of the consolidated condensed financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated condensed financial statements and the reported amounts of revenue and expenses during the reporting period.

New Accounting Pronouncements (

New Accounting Pronouncements (Policies)	3 Months Ended
	Mar. 31, 2022
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity ("ASU 2020-06"), which simplifies the accounting for convertible instruments by removing certain separation models requiring separate accounting for embedded conversion features which will result in more convertible debt instruments accounted for as a single liability. The ASU eliminates certain settlement conditions that are required for equity classification to qualify for the derivative scope exception. The ASU addresses how convertible instruments are accounted for in the calculation of diluted earnings per share by using the if-converted method. The ASU is effective for fiscal years beginning after December 15, 2021, with early adoption permitted no earlier than fiscal years beginning after December 15, 2020. The Company adopted this standard on January 1, 2022 using the modified retrospective method. The adoption of this new guidance resulted in an increase of approximately $22.6 million to long-term debt in the consolidated condensed balance sheets, to reflect the full principal amount of the convertible notes outstanding net of issuance costs, a reduction of approximately $37.9 million to additional paid-in capital, net of income tax effects, to remove the equity component separately recorded for the conversion features associated with the convertible notes, a decrease to deferred income tax liabilities of approximately $5.5 million, and a cumulative-effect adjustment of approximately $20.8 million, net of income tax effects, to the beginning balance of retained earnings as of January 1, 2022. The adoption of this new guidance reduced interest expense related to amortization of debt discount by approximately $2.6 million during the three months ended March 31, 2022 and is expected to reduce interest expense by approximately $10.4 million for the year ended December 31, 2022. Additionally, the dilutive share count increased by approximately 2.5 million shares as a result of calculating the impact of dilution from the Company's convertible notes using the if-converted method. Diluted EPS increased by approximately $0.07 in the quarter ended March 31, 2022 as a result of adoption of this new standard. Recently Issued Accounting Standards, Not Yet Adopted In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022. The Company has not adopted this ASU as of March 31, 2022. Our seventh amended and restated senior credit agreement includes language to address the change from LIBOR to an alternative base rate, therefore we do not believe reference rate reform will have a significant impact on our consolidated financial statements, however will continue to monitor our transition away from LIBOR and the potential to elect to apply this guidance in our consolidated financial statements in the event that we are impacted by reference rate reform.

Revenues (Tables)

Revenues (Tables)	3 Months Ended
	Mar. 31, 2022
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended March 31, 2022 March 31, 2021 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 37,947 $ 93,280 $ 131,227 $ 37,131 $ 86,812 $ 123,943 Europe, Middle East & Africa 29,980 20,326 50,306 26,052 18,544 44,596 Asia Pacific 23,418 12,954 36,372 26,602 12,662 39,264 Americas (excluding the United States) 16,172 8,250 24,422 17,381 7,493 24,874 Total sales from contracts with customers $ 107,517 $ 134,810 $ 242,327 $ 107,166 $ 125,511 $ 232,677 Timing of Revenue Recognition Goods transferred at a point in time $ 98,204 $ 133,322 $ 231,526 $ 97,690 $ 124,394 $ 222,084 Services transferred over time 9,313 1,488 10,801 9,476 1,117 10,593 Total sales from contracts with customers $ 107,517 $ 134,810 $ 242,327 $ 107,166 $ 125,511 $ 232,677
Contract with Customer, Asset and Liability	Contract liability balances related to the sale of extended warranties to customers are as follows: March 31, 2022 December 31, 2021 Contract liability $ 17,534 $ 16,760

Comprehensive Income (Tables)

Comprehensive Income (Tables)	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Schedule of Comprehensive Income	Comprehensive income consists of the following: Three Months Ended March 31, 2022 2021 Net income $ 14,975 $ 9,860 Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $346 and $1,250 for the three months ended March 31, 2022 and 2021, respectively) 1,082 3,926 Pension liability, net of income tax (income tax expense of $127 and $201 for the three months ended March 31, 2022 and 2021, respectively) 521 631 Foreign currency translation adjustment (163) (3,674) Comprehensive income $ 16,415 $ 10,743
Schedule of Accumulated Other Comprehensive Loss	Accumulated other comprehensive loss consists of the following: Cash Flow Pension Cumulative Accumulated Balance, December 31, 2021 $ 3,656 $ (29,671) $ (28,188) $ (54,203) Other comprehensive income (loss) before reclassifications, net of tax 2,460 — (163) 2,297 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (1,819) 648 — (1,171) Income tax 441 (127) — 314 Net current-period other comprehensive income (loss) 1,082 521 (163) 1,440 Balance, March 31, 2022 $ 4,738 $ (29,150) $ (28,351) $ (52,763) Cash Flow Pension Cumulative Accumulated Balance, December 31, 2020 $ (5,945) $ (36,620) $ (21,116) $ (63,681) Other comprehensive income (loss) before reclassifications, net of tax 2,725 — (3,674) (949) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,584 832 — 2,416 Income tax (383) (201) — (584) Net current-period other comprehensive income (loss) 3,926 631 (3,674) 883 Balance, March 31, 2021 $ (2,019) $ (35,989) $ (24,790) $ (62,798) (a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	3 Months Ended
	Mar. 31, 2022
Fair Value Disclosures [Abstract]
Schedule of Notional Amounts of Outstanding Derivative Positions	The following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation March 31, 2022 December 31, 2021 Forward exchange contracts Cash flow hedge $ 189,696 $ 172,894 Forward exchange contracts Non-designated 57,255 38,897
Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)	Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) ("AOCI") and net earnings on our consolidated condensed statements of comprehensive income and our consolidated condensed balance sheets: Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income Amount of Gain (Loss) Reclassified from AOCI Three Months Ended March 31, Total Amount of Line Item Presented Derivative Instrument 2022 2021 Location of amount reclassified 2022 2021 2022 2021 Foreign exchange contracts $ 3,247 $ 3,593 Net Sales $ 242,327 $ 232,677 $ 1,744 $ (1,849) Cost of Sales 106,336 104,228 75 265 Pre-tax gain (loss) $ 3,247 $ 3,593 $ 1,819 $ (1,584) Tax expense (benefit) 787 868 441 (383) Net gain (loss) $ 2,460 $ 2,725 $ 1,378 $ (1,201)
Derivatives Not Designated as Hedging Instruments	Net gains and losses from derivative instruments not accounted for as hedges and gains and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income were: Three Months Ended March 31, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income 2022 2021 Net gain (loss) on currency forward contracts Selling and administrative expense $ (958) $ 458 Net gain (loss) on currency transaction exposures Selling and administrative expense $ 415 $ (1,123)
Schedule of Fair Value for Forward Foreign Exchange Contracts	The following tables summarize the fair value for forward foreign exchange contracts outstanding at March 31, 2022 and December 31, 2021: March 31, 2022 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 6,518 $ (570) $ 5,948 Foreign exchange contracts Other long-term assets 651 (344) 307 $ 7,169 $ (914) $ 6,255 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 46 (213) (167) Total derivatives $ 7,215 $ (1,127) $ 6,088 December 31, 2021 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 5,331 $ (430) $ 4,901 Foreign exchange contracts Other long-term liabilities 82 (161) (79) $ 5,413 $ (591) $ 4,822 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 38 (180) (142) Total derivatives $ 5,451 $ (771) $ 4,680

Inventories (Tables)

Inventories (Tables)	3 Months Ended
	Mar. 31, 2022
Inventory Disclosure [Abstract]
Schedule of inventory	Inventories consist of the following: March 31, December 31, Raw materials $ 89,986 $ 83,386 Work-in-process 22,210 17,449 Finished goods 141,533 130,809 Total $ 253,729 $ 231,644

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Schedule of calculation of basic and diluted earnings per share	The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2022 and 2021: Three Months Ended March 31, 2022 Basic EPS Adjustments Diluted EPS Net income $ 14,975 $ 1,715 $ 16,690 Weighted average shares outstanding 29,428 — 29,428 Employee stock compensation — 1,158 1,158 Warrants — 684 684 Convertible notes — 3,885 3,885 29,428 5,727 35,155 EPS $ 0.51 $ 0.47 Three Months Ended March 31, 2021 Basic EPS Adjustments Diluted EPS Net income $ 9,860 $ — $ 9,860 Weighted average shares outstanding 28,972 — 28,972 Employee stock compensation — 1,221 1,221 Warrants — 170 170 Convertible notes — 1,015 1,015 28,972 2,406 31,378 EPS $ 0.34 $ 0.31

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in the net carrying amount of goodwill for the three months ended March 31, 2022 are as follows: Balance as of December 31, 2021 $ 617,528 Foreign currency translation 6 Balance as of March 31, 2022 $ 617,534
Schedule of Finite-Lived Intangible Assets	Other intangible assets consist of the following: March 31, 2022 December 31, 2021 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 25 $ 342,391 $ (157,285) $ 342,452 $ (152,934) Sales representation, marketing and promotional rights 25 149,376 (61,500) 149,376 (60,000) Developed technology 16 106,604 (28,266) 106,604 (26,495) Patents and other intangible assets 15 76,849 (51,292) 76,392 (50,890) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 761,764 $ (298,343) $ 761,368 $ (290,319)
Schedule of Indefinite-Lived Intangible Assets	Other intangible assets consist of the following: March 31, 2022 December 31, 2021 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 25 $ 342,391 $ (157,285) $ 342,452 $ (152,934) Sales representation, marketing and promotional rights 25 149,376 (61,500) 149,376 (60,000) Developed technology 16 106,604 (28,266) 106,604 (26,495) Patents and other intangible assets 15 76,849 (51,292) 76,392 (50,890) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 761,764 $ (298,343) $ 761,368 $ (290,319)
Schedule of Estimated Amortization Expense	The estimated intangible asset amortization expense remaining for the year ending December 31, 2022 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2022 $ 18,321 $ 4,500 $ 22,821 2023 25,729 6,000 31,729 2024 25,205 6,000 31,205 2025 25,400 6,000 31,400 2026 24,889 6,000 30,889 2027 24,499 6,000 30,499

Long Term Debt (Tables)

Long Term Debt (Tables)	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	Long-term debt consists of the following: March 31, 2022 December 31, 2021 Revolving line of credit $ 151,000 $ 140,000 Term loan, net of deferred debt issuance costs of $1,297 and $1,373 in 2022 and 2021, respectively 223,290 226,196 2.625% convertible notes, net of deferred debt issuance costs of $3,986 and $3,700 in 2022 and 2021, respectively, and unamortized discount of $23,404 in 2021 341,014 317,896 Financing leases 469 564 Total debt 715,773 684,656 Less: Current portion 12,231 12,249 Total long-term debt $ 703,542 $ 672,407
Schedule of Maturities of Long-Term Debt	The scheduled maturities of long-term debt outstanding at March 31, 2022 are as follows: Remaining 2022 $ 8,944 2023 14,906 2024 365,869 2025 23,850 2026 307,018 2027 — The above amounts exclude deferred debt issuance costs and financing leases.

Guarantees (Tables)

Guarantees (Tables)	3 Months Ended
	Mar. 31, 2022
Guarantees [Abstract]
Changes in the carrying amount of service and product warranties	Changes in the liability for standard warranties for the three months ended March 31, are as follows: 2022 2021 Balance as of January 1, $ 2,344 $ 1,826 Provision for warranties 197 291 Claims made (187) (206) Balance as of March 31, $ 2,354 $ 1,911

Pension Plan (Tables)

Pension Plan (Tables)	3 Months Ended
	Mar. 31, 2022
Retirement Benefits [Abstract]
Schedule of net benefit cost	Net periodic pension cost consists of the following: Three Months Ended March 31, 2022 2021 Service cost $ 269 $ 248 Interest cost on projected benefit obligation 537 451 Expected return on plan assets (1,324) (1,289) Net amortization and deferral 648 832 Net periodic pension cost $ 130 $ 242

Other Expense (Tables)

Other Expense (Tables)	3 Months Ended
	Mar. 31, 2022
Other Expense [Abstract]
Schedule of Other Operating Expense	Other expense consists of the following, which is included in selling and administrative expense: Three Months Ended March 31, 2022 2021 Restructuring and related costs $ — $ 414 Other expense included in selling and administrative expense $ — $ 414

Business Segment (Tables)

Business Segment (Tables)	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Schedule of net sales information by product line	These product lines' net sales are as follows: Three Months Ended March 31, 2022 2021 Orthopedic surgery $ 107,517 $ 107,166 General surgery 134,810 125,511 Consolidated net sales $ 242,327 $ 232,677

New Accounting Pronouncements_2

New Accounting Pronouncements (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2022	Jan. 01, 2022	Dec. 31, 2021
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Long-term debt	$ 703,542				$ 672,407
Paid-in capital	365,555				396,771
Deferred income taxes	63,226				68,537
Retained earnings	526,472				$ 496,605
Interest expense	$ 4,998	$ 10,351
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities (in shares)	3,885	1,015
Accounting Standards Update 2020-06
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Long-term debt				$ 22,600
Paid-in capital				(37,900)
Deferred income taxes				(5,500)
Retained earnings				$ 20,800
Interest expense	$ (2,600)
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities (in shares)	2,500
Increase to Earnings Per Share, Diluted (in dollars per share)	$ 0.07
Accounting Standards Update 2020-06 | Forecast [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Interest expense			$ (10,400)

Revenues (Disaggregated Revenue

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Disaggregation of Revenue [Line Items]
Net Sales	$ 242,327	$ 232,677
Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	231,526	222,084
Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	10,801	10,593
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	107,517	107,166
Orthopedic Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	98,204	97,690
Orthopedic Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	9,313	9,476
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	134,810	125,511
General Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	133,322	124,394
General Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	1,488	1,117
United States
Disaggregation of Revenue [Line Items]
Net Sales	131,227	123,943
United States | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	37,947	37,131
United States | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	93,280	86,812
Americas (excluding the United States)
Disaggregation of Revenue [Line Items]
Net Sales	24,422	24,874
Americas (excluding the United States) | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	16,172	17,381
Americas (excluding the United States) | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	8,250	7,493
Europe, Middle East & Africa
Disaggregation of Revenue [Line Items]
Net Sales	50,306	44,596
Europe, Middle East & Africa | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	29,980	26,052
Europe, Middle East & Africa | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	20,326	18,544
Asia Pacific
Disaggregation of Revenue [Line Items]
Net Sales	36,372	39,264
Asia Pacific | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	23,418	26,602
Asia Pacific | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	$ 12,954	$ 12,662

Revenues (Customer Liability) (

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Contract liability	$ 17,534		$ 16,760
Revenue recognized	$ 3,900	$ 3,400

Comprehensive Income (Details)

Comprehensive Income (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Equity [Abstract]
Net income	$ 14,975	$ 9,860
Cash flow hedging gain, net	1,082	3,926
Pension liability, net of income tax	521	631
Foreign currency translation adjustments	(163)	(3,674)
Comprehensive income	16,415	10,743
Pension liability, tax	127	201
Cash flow hedging gain, tax	$ 346	$ 1,250

Comprehensive Income (Accumulat

Comprehensive Income (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Thousands		3 Months Ended
		Mar. 31, 2022	Mar. 31, 2021
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		$ (54,203)
Accumulated Other Comprehensive Income (Loss), Net of Tax		(52,763)
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		(54,203)	$ (63,681)
Other comprehensive income (loss) before reclassifications, net of tax		2,297	(949)
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(1,171)	2,416
Reclassification from AOCI, Current Period, Tax		314	(584)
Net current-period other comprehensive income (loss)		1,440	883
Accumulated Other Comprehensive Income (Loss), Net of Tax		(52,763)	(62,798)
Cash Flow Hedging Gain (Loss)
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		3,656	(5,945)
Other comprehensive income (loss) before reclassifications, net of tax		2,460	2,725
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(1,819)	1,584
Reclassification from AOCI, Current Period, Tax		441	(383)
Net current-period other comprehensive income (loss)		1,082	3,926
Accumulated Other Comprehensive Income (Loss), Net of Tax		4,738	(2,019)
Pension Liability
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		(29,671)	(36,620)
Other comprehensive income (loss) before reclassifications, net of tax		0	0
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	648	832
Reclassification from AOCI, Current Period, Tax		(127)	(201)
Net current-period other comprehensive income (loss)		521	631
Accumulated Other Comprehensive Income (Loss), Net of Tax		(29,150)	(35,989)
Cumulative Translation Adjustments
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		(28,188)	(21,116)
Other comprehensive income (loss) before reclassifications, net of tax		(163)	(3,674)
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	0	0
Reclassification from AOCI, Current Period, Tax		0	0
Net current-period other comprehensive income (loss)		(163)	(3,674)
Accumulated Other Comprehensive Income (Loss), Net of Tax		$ (28,351)	$ (24,790)
[1]	The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 6 and Note 12, respectively, for further details.

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Amounts Recorded In and Reclassified From AOCI) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Derivative Instruments, Gain (Loss) [Line Items]
Net sales	$ 242,327	$ 232,677
Cost of sales	106,336	104,228
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	3,247	3,593
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	787	868
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	2,460	2,725
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	1,819	(1,584)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	441	(383)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	1,378	(1,201)
Revenues
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	1,744	(1,849)
Cost of Sales
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	$ 75	$ 265

Fair Value of Financial Instr_4

Fair Value of Financial Instruments (Foreign Currency Forward Contracts) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Derivative [Line Items]
Foreign Currency Transaction Gain (Loss), before Tax	$ 415	$ (1,123)
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	7,215		$ 5,451
Liabilities Fair Value	(1,127)		(771)
Net Fair Value	6,088		4,680
Foreign Currency Forward Contracts
Derivative [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	(958)	$ 458
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	7,169		5,413
Liabilities Fair Value	(914)		(591)
Net Fair Value	6,255		4,822
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Prepaid Expenses and Other Current Assets [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	6,518		5,331
Liabilities Fair Value	(570)		(430)
Net Fair Value	5,948		4,901
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Other Noncurrent Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value			82
Liabilities Fair Value			(161)
Net Fair Value			(79)
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Other Noncurrent Assets [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	651
Liabilities Fair Value	(344)
Net Fair Value	$ 307
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge	1 month
Notional amount of cash flow hedges	$ 57,255		38,897
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts | Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	46		38
Liabilities Fair Value	(213)		(180)
Net Fair Value	$ (167)		(142)
Cash flow hedge | Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge	2 years
Notional amount of cash flow hedges	$ 189,696		$ 172,894
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 4,500

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Inventory Disclosure [Abstract]
Raw materials	$ 89,986	$ 83,386
Work-in-process	22,210	17,449
Finished goods	141,533	130,809
Total inventory	$ 253,729	$ 231,644

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Earnings Per Share [Abstract]
Net income	$ 14,975	$ 9,860
Interest on Convertible Debt, Net of Tax	1,715	0
Net Income (Loss) Available to Common Stockholders, Diluted	$ 16,690	$ 9,860
Basic-weighted average shares outstanding (in shares)	29,428	28,972
Incremental Common Shares Attributable to Dilutive Effect of Share-based Payment Arrangements (in shares)	1,158	1,221
Incremental Common Shares Attributable to Dilutive Effect of Call Options and Warrants (in shares)	684	170
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities (in shares)	3,885	1,015
Effect of dilutive potential securities (in shares)	5,727	2,406
Diluted- weighted average shares outstanding (in shares)	35,155	31,378
Basic (in dollars per share)	$ 0.51	$ 0.34
Diluted (in dollars per share)	$ 0.47	$ 0.31

Earnings Per Share - Convertibl

Earnings Per Share - Convertible Notes (Details) - Convertible Notes Payable - 2.625 Percent Convertible Notes Due 2024 [Member]	Jan. 29, 2019$ / shares
Debt Instrument [Line Items]
Interest rate, stated percentage	2.625%
Conversion price (in dollars per share)	$ 88.80
Hedge transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)	114.92
Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)	$ 114.92

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Goodwill) (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 617,528
Foreign currency translation	6
Ending balance	$ 617,534

Goodwill and Other Intangible_4

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Gross carrying amount	$ 761,764		$ 761,368
Intangible assets, Accumulated amortization	(298,343)		(290,319)
Amortization expense	8,000	$ 8,300
Future amortization expense [Abstract]
Remaining, 2022	22,821
2023	31,729
2024	31,205
2025	31,400
2026	30,889
2027	30,499
Amortization included in expense
Future amortization expense [Abstract]
Remaining, 2022	18,321
2023	25,729
2024	25,205
2025	25,400
2026	24,889
2027	24,499
Amortization recorded as a reduction of revenue
Future amortization expense [Abstract]
Remaining, 2022	4,500
2023	6,000
2024	6,000
2025	6,000
2026	6,000
2027	6,000
Trademarks & tradenames
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Unamortized intangible assets, Gross carrying amount	86,544		86,544
Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	342,391		342,452
Intangible assets, Accumulated amortization	(157,285)		(152,934)
Sales representation, marketing and promotional rights
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	149,376		149,376
Intangible assets, Accumulated amortization	(61,500)		(60,000)
Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	76,849		76,392
Intangible assets, Accumulated amortization	(51,292)		(50,890)
Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	106,604		106,604
Intangible assets, Accumulated amortization	$ (28,266)		$ (26,495)
Weighted Average
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	22 years
Weighted Average | Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	25 years
Weighted Average | Sales representation, marketing and promotional rights
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	25 years
Weighted Average | Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	15 years
Weighted Average | Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	16 years

Long Term Debt (Details)

Long Term Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Long-term Debt and Lease Obligation, Including Current Maturities	$ 715,773	$ 684,656
Finance Lease, Liability	469	564
Current portion of long-term debt	12,231	12,249
Long-term debt	703,542	672,407
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt	151,000	140,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt	223,290	226,196
Unamortized Debt Issuance Expense	1,297	1,373
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount		23,404
Unamortized Debt Issuance Expense	3,986	3,700
Convertible Debt	$ 341,014	$ 317,896

Long Term Debt Additional Infor

Long Term Debt Additional Information (Details)	Jan. 29, 2019USD ($)$ / shares	Mar. 31, 2022USD ($)	Mar. 31, 2021USD ($)	Dec. 31, 2021USD ($)	Jul. 16, 2021USD ($)
Debt Instrument [Line Items]
Amortization of debt discount		$ 0	$ 2,503,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross		224,600,000
Long-term Debt		223,290,000		$ 226,196,000
Term Loan Facility [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount					$ 233,500,000
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt		151,000,000		$ 140,000,000
Line of Credit Facility, Remaining Borrowing Capacity		431,800,000
Letters of Credit Outstanding, Amount		2,200,000
Line of Credit [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity					$ 585,000,000
Convertible Notes Payable [Member] | 2.625 Percent Convertible Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount	$ 345,000,000
Debt Instrument, Convertible, Carrying Amount of Equity Component	$ 39,100,000
Amortization of debt discount			2,500,000
Interest rate, stated percentage	2.625%
Debt Instrument, Interest Rate, Effective Percentage	6.14%
Interest Expense, Debt		2,300,000	$ 2,300,000
Debt Instrument, Convertible, Gross Amount of Equity Component	$ 51,600,000
Conversion price (in dollars per share) | $ / shares	$ 88.80
Debt Instrument, Convertible, Conversion Ratio	11.2608
Debt Instrument, Fair Value Disclosure		$ 596,900,000
Convertible Notes Payable [Member] | 2.625 Percent Convertible Notes Due 2024 [Member] | Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) | $ / shares	$ 114.92
Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage		1.75%
Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member] | London Interbank Offered Rate (LIBOR) [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		1.25%
Debt Instrument, Variable Rate Basis		0.50%
Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member] | Adjusted LIBOR
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		1.00%
Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member] | Fed Funds Effective Rate Overnight Index Swap Rate [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate		0.50%
Call Option [Member] | Convertible Notes Payable [Member] | 2.625 Percent Convertible Notes Due 2024 [Member]
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid	$ 21,000,000

Long Term Debt Maturities of Lo

Long Term Debt Maturities of Long Term Debt (Details) $ in Thousands	Mar. 31, 2022USD ($)
Maturities of Long-term Debt [Abstract]
Remaining, 2022	$ 8,944
2023	14,906
2024	365,869
2025	23,850
2026	307,018
2027	$ 0

Guarantees (Details)

Guarantees (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Guarantees [Abstract]
Standard warranty period (in years)	1 year
Movement in Standard Product Warranty Accrual [Roll Forward]
Balance as of January 1,	$ 2,344	$ 1,826
Provision for warranties	197	291
Claims made	(187)	(206)
Balance as of March 31,	2,354	$ 1,911
Extended Product Warranty Disclosure [Abstract]
Product extended warranty expense	$ 1,600

Pension Plan (Details)

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Retirement Benefits [Abstract]
Service cost	$ 269	$ 248
Interest cost on projected benefit obligation	537	451
Expected return on plan assets	(1,324)	(1,289)
Net amortization and deferral	648	832
Net periodic pension cost	$ 130	$ 242

Other Expense (Details)

Other Expense (Details) - Selling and Administrative Expenses - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Other Expense [Line Items]
Restructuring and related costs	$ 0	$ 414
Other expense	$ 0	414
Contract Termination [Member]
Other Expense [Line Items]
Restructuring and related costs		$ 400

Business Segment (Details)

Business Segment (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Net sales	$ 242,327	$ 232,677
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales	107,517	107,166
General Surgery
Segment Reporting Information [Line Items]
Net sales	$ 134,810	$ 125,511

Legal Proceedings (Details)

Legal Proceedings (Details) - USD ($) $ in Millions	Jan. 18, 2017	Mar. 31, 2022
Loss Contingencies [Line Items]
Product liability insurance, amount per incident		$ 35
Product liability insurance, aggregate annual amount		$ 35
Pending Litigation | EndoDynamix, Inc. | Liquidated Damages
Loss Contingencies [Line Items]
Loss Contingency, Damages Sought, Value	$ 12.7
Pending Litigation | EndoDynamix, Inc. | Additional Damages
Loss Contingencies [Line Items]
Loss Contingency, Damages Sought, Value	$ 24.8

Subsequent Events (Details)

Subsequent Events (Details) - In2Bones Global Inc - Subsequent Event [Member]	May 04, 2022USD ($)
Subsequent Event [Line Items]
Business Combination, Aggregate Upfront Payment To Be Made	$ 145,000,000
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	$ 110,000,000