CONMED (CNMD) 10-Q 28 Jul 22 2022 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2022	Jul. 25, 2022
Cover [Abstract]
Entity Registrant Name	CONMED CORPORATION
Document Quarterly Report	true
Document Type	10-Q
Document Period End Date	Jun. 30, 2022
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q2
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		30,466,261
Amendment Flag	false

Consolidated Condensed Statemen

Consolidated Condensed Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Statement of Comprehensive Income [Abstract]
Net sales	$ 277,190	$ 255,161	$ 519,516	$ 487,837
Cost of sales	125,413	113,737	231,748	217,964
Gross profit	151,777	141,424	287,768	269,873
Selling and administrative expense	115,826	104,399	218,701	202,739
Research and development expense	11,493	11,318	22,165	21,344
Operating expenses	127,319	115,717	240,866	224,083
Income from operations	24,458	25,707	46,902	45,790
Interest expense	5,928	9,420	10,926	19,772
Other expense (see Note 11)	112,011	0	112,011	0
Income (loss) before income taxes	(93,481)	16,287	(76,035)	26,018
Provision for income taxes	74,810	2,997	77,281	2,868
Net income (loss)	(168,291)	13,290	(153,316)	23,150
Comprehensive income (loss)	$ (172,636)	$ 17,743	$ (156,221)	$ 28,486
Per share data:
Basic (in dollars per share)	$ (5.65)	$ 0.46	$ (5.18)	$ 0.80
Diluted (in dollars per share)	$ (5.65)	$ 0.41	$ (5.18)	$ 0.72
Weighted average common shares:
Basic (shares)	29,775	29,125	29,601	29,052
Diluted (shares)	29,775	32,464	29,601	31,964

Consolidated Condensed Balance

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 53,152	$ 20,847
Accounts receivable, net	202,119	183,882
Inventories	289,714	231,644
Prepaid expenses and other current assets	32,203	23,750
Total current assets	577,188	460,123
Property, plant and equipment, net	111,592	108,863
Goodwill	756,753	617,528
Other intangible assets, net	519,320	471,049
Other assets	107,408	108,454
Total assets	2,072,261	1,766,017
Current liabilities:
Current portion of long-term debt	272	12,249
Accounts payable	73,972	58,197
Accrued compensation and benefits	50,359	60,488
Other current liabilities	76,490	65,712
Total current liabilities	201,093	196,646
Long-term debt	982,427	672,407
Deferred income taxes	105,938	68,537
Other long-term liabilities	109,835	42,992
Total liabilities	1,399,293	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	401,182	396,771
Retained earnings	352,089	496,605
Accumulated other comprehensive loss	(57,108)	(54,203)
Less: 837,621 and 1,925,893 shares of common stock in treasury, at cost in 2022 and 2021, respectively	(23,508)	(54,051)
Total shareholders’ equity	672,968	785,435
Total liabilities and shareholders’ equity	$ 2,072,261	$ 1,766,017

Consolidated Condensed Balanc_2

Consolidated Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Jun. 30, 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)	837,621	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
Pension liability, net of income tax						631
Foreign currency translation adjustments						(3,674)
Net income (loss)					9,860
Comprehensive income (loss)		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, 2020			31,299
Balance at period start at Dec. 31, 2020		709,038	$ 313	382,628	457,417	(63,681)	(67,639)
Comprehensive income (loss):
Cash flow hedging gain, net		5,147
Pension liability, net of income tax		1,262
Foreign currency translation adjustments		(1,073)
Net income (loss)		23,150
Comprehensive income (loss)		28,486
Balance at period end (shares) at Jun. 30, 2021			31,299
Balance at period end at Jun. 30, 2021		744,499	$ 313	393,663	468,924	(58,345)	(60,056)
Balance at period start (shares) at Mar. 31, 2021			31,299
Balance at period start at Mar. 31, 2021		725,570	$ 313	388,959	461,464	(62,798)	(62,368)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		2,726		414			2,312
Stock-based compensation		4,290		4,290
Dividends on common stock ($0.20 per share)		(5,830)			(5,830)
Comprehensive income (loss):
Cash flow hedging gain, net		1,221				1,221
Pension liability, net of income tax		631				631
Foreign currency translation adjustments		2,601				2,601
Net income (loss)		13,290			13,290
Comprehensive income (loss)		17,743
Balance at period end (shares) at Jun. 30, 2021			31,299
Balance at period end at Jun. 30, 2021		744,499	$ 313	393,663	468,924	(58,345)	(60,056)
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
Pension liability, net of income tax						521
Foreign currency translation adjustments						(163)
Net income (loss)					14,975
Comprehensive income (loss)		$ 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
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)
Comprehensive income (loss):
Cash flow hedging gain, net		5,744
Pension liability, net of income tax		1,012
Foreign currency translation adjustments		(9,661)
Net income (loss)		(153,316)
Comprehensive income (loss)		(156,221)
Balance at period end (shares) at Jun. 30, 2022			31,299
Balance at period end at Jun. 30, 2022		672,968	$ 313	401,182	352,089	(57,108)	(23,508)
Balance at period start (shares) at Mar. 31, 2022			31,299
Balance at period start at Mar. 31, 2022		789,546	$ 313	365,555	526,472	(52,763)	(50,031)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		1,244		611			633
Stock-based compensation		5,755		5,755
Dividends on common stock ($0.20 per share)		(6,092)			(6,092)
Stock Issued During Period, Value, Conversion of Convertible Securities		0		(25,890)			25,890
Adjustments to Additional Paid in Capital, Convertible Note Premium on Extinguishment		103,125		103,125
Adjustments to Additional Paid in Capital, Settlement of Convertible Notes Hedge Transactions		118,912		118,912
Adjustments to Additional Paid in Capital, Warrant Settled		(96,758)		(96,758)
Adjustments to Additional Paid in Capital, Convertible Note Hedge, Net of Income Tax		(142,128)		(142,128)
Issuance of warrants		72,000		72,000
Comprehensive income (loss):
Cash flow hedging gain, net		4,662				4,662
Pension liability, net of income tax		490				490
Foreign currency translation adjustments		(9,497)				(9,497)
Net income (loss)		(168,291)			(168,291)
Comprehensive income (loss)		(172,636)
Balance at period end (shares) at Jun. 30, 2022			31,299
Balance at period end at Jun. 30, 2022		$ 672,968	$ 313	$ 401,182	$ 352,089	$ (57,108)	$ (23,508)
[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
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021
Statement of Stockholders' Equity [Abstract]
Dividends per share of common stock (in dollars per share)	$ 0.20	$ 0.20	$ 0.20	$ 0.20

Consolidated Condensed Statem_4

Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021
Cash flows from operating activities:
Net income (loss)	$ (153,316)	$ 23,150
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation	8,090	8,741
Amortization of debt discount	0	5,031
Amortization of deferred debt issuance costs	1,916	2,116
Amortization	26,065	27,316
Stock-based compensation	10,218	7,676
Deferred income taxes	70,402	(1,781)
Loss on early extinguishment of debt	3,426	0
Loss on convertible notes conversion premium	103,125	0
Loss on convertible notes hedge transactions settlement	5,460	0
Increase (decrease) in cash flows from changes in assets and liabilities:
Accounts receivable	(17,779)	7,780
Inventories	(35,549)	(16,693)
Accounts payable	13,724	2,547
Accrued compensation and benefits	(12,260)	(769)
Other assets	(11,388)	(12,289)
Other liabilities	6,936	3,798
Net cash provided by operating activities	19,070	56,623
Cash flows from investing activities:
Purchases of property, plant and equipment	(9,398)	(6,103)
Payments related to business acquisition, net of cash acquired	(142,555)	0
Net cash used in investing activities	(151,953)	(6,103)
Cash flows from financing activities:
Payments on term loan	(92,981)	(8,281)
Payments on revolving line of credit	(312,000)	(161,000)
Proceeds from revolving line of credit	172,000	139,000
Payments to redeem convertible notes	(275,000)	0
Proceeds from issuance of convertible notes	800,000	0
Payments related to debt issuance costs	(21,187)	0
Dividends paid on common stock	(11,773)	(11,588)
Purchases of convertible notes hedge transactions	(187,600)	0
Proceeds from issuance of warrants	72,000	0
Proceeds from settlement of convertible notes hedge transactions	86,228	0
Payment for settlement of warrants	(69,534)	0
Other, net	6,457	10,902
Net cash provided by (used in) financing activities	166,610	(30,967)
Effect of exchange rate changes on cash and cash equivalents	(1,422)	(521)
Net increase in cash and cash equivalents	32,305	19,032
Cash and cash equivalents at beginning of period	20,847	27,356
Cash and cash equivalents at end of period	53,152	46,388
Non-cash investing and financing activities:
Contingent consideration	69,402	0
Dividends payable	$ 6,092	$ 5,830

Operations

Operations	6 Months Ended
	Jun. 30, 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	6 Months Ended
	Jun. 30, 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 June 30, 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 July 28, 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	6 Months Ended
	Jun. 30, 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 then outstanding net of issuance costs (the "2.625% Notes" described more fully in Note 11); • 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 2.625% 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 on the 2.625% Notes by approximately $2.6 million during the three months ended March 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 2.625% Notes using the if-converted method. During the three months ended June 30, 2022, the Company repurchased and extinguished $275.0 million principal value of the 2.625% Notes as further discussed in Note 11. Concurrently, the Company entered into a Supplemental Indenture related to the remaining $70.0 million in 2.625% Notes, pursuant to which the Company irrevocably elected to settle the principal value of those 2.625% Notes in cash. As a result, in periods in which the Company has net income, only the conversion premium will affect the dilutive share count. As the Company was in a net loss position for the three and six months ended June 30, 2022, there were no dilutive potential shares included in the computation of diluted shares outstanding for the three and six months ended June 30, 2022. 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 June 30, 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.

Business Combinations

Business Combinations	6 Months Ended
	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Business Combinations On June 13, 2022, we acquired In2Bones Global, Inc. ("In2Bones") and all of its stock (the "In2Bones Acquisition") for an aggregate upfront payment of $145.0 million in cash. We paid $143.0 million upon closing, with a $2.0 million purchase price adjustment holdback, pursuant to the merger agreement for the In2Bones Acquisition. In addition, there are potential earn-out payments to In2Bones’ equity holders in an amount up to $110.0 million based on the achievement of certain revenue targets for In2Bones products during the sixteen (16) successive quarters commencing on July 1, 2022. In2Bones is a global developer, manufacturer and distributor of medical devices for the treatment of disorders and injuries of the upper (hand, wrist, elbow) and lower (foot and ankle) extremities. The In2Bones Acquisition was funded through a combination of cash on hand and long-term borrowings as further described in Note 11. The following table summarizes the estimated fair values of the assets acquired and liabilities assumed as a result of the In2Bones Acquisition. The assessment of fair value is based on preliminary valuations and estimates that were available to management at the time the consolidated condensed financial statements were prepared. Accordingly, the allocation of purchase price is preliminary and therefore subject to adjustment during the measurement adjustment period. Cash $ 445 Accounts receivable, net 5,036 Inventories 24,247 Prepaid expenses and other current assets 403 Current assets 30,131 Goodwill 140,338 Developed technology 37,300 Distributor relationships 26,600 Other long-term assets 2,875 Total assets acquired $ 237,244 Current liabilities assumed 5,972 Deferred income taxes 16,457 Contingent consideration 69,402 Other long-term liabilities 413 Total liabilities assumed $ 92,244 Net assets acquired $ 145,000 The goodwill recorded as part of the In2Bones Acquisition primarily represents revenue synergies, the related cost to enter into this new product offering and the In2Bones assembled workforce. Goodwill is not deductible for tax purposes. The weighted amortization period for intangibles acquired is 15 years. Distributor relationships and developed technology are each being amortized over a weighted average life of 15 years. The contingent consideration was recorded at fair value at the date of acquisition based on the consideration expected to be transferred, estimated as the probability-weighted future cash flows, discounted back to present value. The fair value of contingent consideration is measured using projected payment dates, discount rates, probabilities of payment, and projected revenues. The recurring Level 3 fair value measurements of contingent consideration for which the liability is recorded include the following significant unobservable inputs: Unobservable Input Assumptions Discount rate 5.67% Revenue volatility 12.75% Projected year of payment 2023-2026 Net sales and earnings were immaterial to both the three and six months ended June 30, 2022. We also believe the proforma information is immaterial for disclosure for the three and six months ended June 30, 2022 and 2021.

Revenues

Revenues	6 Months Ended
	Jun. 30, 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 June 30, 2022 June 30, 2021 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 40,461 $ 108,721 $ 149,182 $ 40,777 $ 102,813 $ 143,590 Europe, Middle East & Africa 32,060 22,468 54,528 27,120 20,143 47,263 Asia Pacific 27,674 16,201 43,875 26,284 16,136 42,420 Americas (excluding the United States) 19,987 9,618 29,605 13,712 8,176 21,888 Total sales from contracts with customers $ 120,182 $ 157,008 $ 277,190 $ 107,893 $ 147,268 $ 255,161 Timing of Revenue Recognition Goods transferred at a point in time $ 110,060 $ 155,451 $ 265,511 $ 97,649 $ 146,105 $ 243,754 Services transferred over time 10,122 1,557 11,679 10,244 1,163 11,407 Total sales from contracts with customers $ 120,182 $ 157,008 $ 277,190 $ 107,893 $ 147,268 $ 255,161 Six Months Ended Six Months Ended June 30, 2022 June 30, 2021 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 78,408 $ 202,001 $ 280,409 $ 77,907 $ 189,625 $ 267,532 Europe, Middle East & Africa 62,041 42,794 104,835 53,172 38,688 91,860 Asia Pacific 51,091 29,155 80,246 52,886 28,798 81,684 Americas (excluding the United States) 36,158 17,868 54,026 31,093 15,668 46,761 Total sales from contracts with customers $ 227,698 $ 291,818 $ 519,516 $ 215,058 $ 272,779 $ 487,837 Timing of Revenue Recognition Goods transferred at a point in time $ 208,264 $ 288,773 $ 497,037 $ 195,339 $ 270,499 $ 465,838 Services transferred over time 19,434 3,045 22,479 19,719 2,280 21,999 Total sales from contracts with customers $ 227,698 $ 291,818 $ 519,516 $ 215,058 $ 272,779 $ 487,837 Contract liability balances related to the sale of extended warranties to customers are as follows: June 30, 2022 December 31, 2021 Contract liability $ 17,748 $ 16,760 Revenue recognized during the six months ended June 30, 2022 and June 30, 2021 from amounts included in contract liabilities at the beginning of the period were $7.0 million and $6.1 million, respectively. There were no material contract assets as of June 30, 2022 and December 31, 2021.

Comprehensive Income (Loss)

Comprehensive Income (Loss)	6 Months Ended
	Jun. 30, 2022
Equity [Abstract]
Comprehensive Income (Loss)	Comprehensive Income (Loss) Comprehensive income (loss) consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Net income (loss) $ (168,291) $ 13,290 $ (153,316) $ 23,150 Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $1,491 and $388 for the three months ended June 30, 2022 and 2021, respectively and $1,838 and $1,639 for the six months ended June 30, 2022 and 2021, respectively) 4,662 1,221 5,744 5,147 Pension liability, net of income tax (income tax expense of $158 and $201 for the three months ended June 30, 2022 and 2021, respectively and $284 and $402 for the six months ended June 30, 2022 and 2021, respectively) 490 631 1,012 1,262 Foreign currency translation adjustment (9,497) 2,601 (9,661) (1,073) Comprehensive income (loss) $ (172,636) $ 17,743 $ (156,221) $ 28,486 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 9,851 — (9,661) 190 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (5,421) 1,296 — (4,125) Income tax 1,314 (284) — 1,030 Net current-period other comprehensive income (loss) 5,744 1,012 (9,661) (2,905) Balance, June 30, 2022 $ 9,400 $ (28,659) $ (37,849) $ (57,108) 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 2,723 — (1,073) 1,650 Amounts reclassified from accumulated other comprehensive income before tax a 3,196 1,664 — 4,860 Income tax (772) (402) — (1,174) Net current-period other comprehensive income (loss) 5,147 1,262 (1,073) 5,336 Balance, June 30, 2021 $ (798) $ (35,358) $ (22,189) $ (58,345) (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 7 and Note 13, respectively, for further details.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 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 June 30, 2022 December 31, 2021 Forward exchange contracts Cash flow hedge $ 191,288 $ 172,894 Forward exchange contracts Non-designated 41,704 38,897 The remaining time to maturity as of June 30, 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 (loss) 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 (loss) on our consolidated condensed statements of comprehensive income (loss) and our consolidated condensed balance sheets: Amount of Gain (Loss) Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain (Loss) Reclassified from AOCI Three Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2022 2021 Location of amount reclassified 2022 2021 2022 2021 Foreign exchange contracts $ 9,756 $ (3) Net Sales $ 277,190 $ 255,161 $ 3,403 $ (2,022) Cost of Sales 125,413 113,737 199 410 Pre-tax gain (loss) $ 9,756 $ (3) $ 3,602 $ (1,612) Tax expense (benefit) 2,365 (1) 873 (389) Net gain (loss) $ 7,391 $ (2) $ 2,729 $ (1,223) Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain (Loss) Reclassified from AOCI Six Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2022 2021 Location of amount reclassified 2022 2021 2022 2021 Foreign exchange contracts $ 13,003 $ 3,590 Net Sales $ 519,516 $ 487,837 $ 5,147 $ (3,871) Cost of Sales 231,748 217,964 274 675 Pre-tax gain (loss) $ 13,003 $ 3,590 $ 5,421 $ (3,196) Tax expense (benefit) 3,152 867 1,314 (772) Net gain (loss) $ 9,851 $ 2,723 $ 4,107 $ (2,424) At June 30, 2022, $7.7 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 June 30, Six Months Ended June 30, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income (Loss) 2022 2021 2022 2021 Net gain (loss) on currency forward contracts Selling and administrative expense $ 1,155 $ (809) $ 196 $ (350) Net gain (loss) on currency transaction exposures Selling and administrative expense $ (2,178) $ 243 $ (1,764) $ (879) 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 June 30, 2022 and December 31, 2021: June 30, 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 $ 10,242 $ (56) $ 10,186 Foreign exchange contracts Other long-term assets 2,272 (50) 2,222 $ 12,514 $ (106) $ 12,408 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 15 (262) (247) Total derivatives $ 12,529 $ (368) $ 12,161 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 June 30, 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. The Company values contingent consideration using Level 3 inputs. These include pricing models, discounted cash flow methodologies, or similar techniques, and at least one significant model assumption or input that is unobservable.

Inventories

Inventories	6 Months Ended
	Jun. 30, 2022
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following: June 30, December 31, Raw materials $ 105,531 $ 83,386 Work-in-process 25,656 17,449 Finished goods 158,527 130,809 Total $ 289,714 $ 231,644

Earnings (Loss) Per Share

Earnings (Loss) Per Share	6 Months Ended
	Jun. 30, 2022
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	Earnings (Loss) Per Share Basic earnings (loss) 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 (loss) per share (“diluted EPS”) gives effect to all dilutive potential shares. As the Company was in a net loss position for the three and six months ended June 30, 2022, there were no dilutive potential shares included in the computation of diluted shares outstanding for the three and six months ended June 30, 2022. The following table sets forth the computation of basic and diluted earnings (loss) per share for the three and six months ended June 30, 2022 and 2021: Three Months Ended June 30, 2022 Three Months Ended June 30, 2021 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income (loss) $ (168,291) — $ (168,291) $ 13,290 — $ 13,290 Weighted average shares outstanding 29,775 — 29,775 29,125 — 29,125 Employee stock compensation — — — — 1,357 1,357 Warrants — — — — 620 620 Convertible notes — — — — 1,362 1,362 29,775 — 29,775 29,125 3,339 32,464 EPS $ (5.65) $ (5.65) $ 0.46 $ 0.41 Six Months Ended June 30, 2022 Six Months Ended June 30, 2021 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income (loss) $ (153,316) — $ (153,316) $ 23,150 — $ 23,150 Weighted average shares outstanding 29,601 — 29,601 29,052 — 29,052 Employee stock compensation — — — — 1,300 1,300 Warrants — — — — 411 411 Convertible notes — — — — 1,201 1,201 29,601 — 29,601 29,052 2,912 31,964 EPS $ (5.18) $ (5.18) $ 0.80 $ 0.72 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. Such shares aggregated approximately 0.7 million and 0.5 million for the three and six months ended June 30, 2021, respectively. As the Company was in a net loss position for the three and six months ended June 30, 2022, there were no anti-dilutive shares. The 2.625% Notes and 2.250% convertible notes due in 2027 (the " 2.250% Notes"), more fully described in Note 11, are convertible under certain circumstances, as defined in the respective indentures for each series of notes, into a combination of cash and CONMED common stock. The following is intended to describe the impact of the 2.625% Notes and 2.250% Notes and related hedge transactions on the calculation of diluted EPS. Additional shares to be issued pursuant to the terms of the 2.625% Notes, the 2.250% Notes and related hedge transactions, if any, would occur at settlement. Effective with our adoption of ASU 2020-06 on January 1, 2022 (see Note 3), 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, when permitted or required. Under the if-converted method, when convertible notes require the principal to be paid in cash, then only the conversion premium affects the calculation of diluted EPS. On June 6, 2022, the Company repurchased and extinguished $275.0 million principal value of 2.625% Notes as further discussed in Note 11. Concurrently, the Company entered into a Supplemental Indenture related to the remaining $70.0 million in 2.625% Notes, pursuant to which the Company irrevocably elected to settle the principal value of the 2.625% Notes in cash. Similarly, the 2.250% Notes, issued on June 6, 2022, require the principal to be paid in cash. As a result, in periods in which the Company has net income, only the conversion premium will affect dilutive share count. Accordingly, for periods prior to adoption of ASU 2020-06 on January 1, 2022 and after June 6, 2022, in periods in which the Company has net income, the calculation of diluted EPS includes potential diluted shares upon conversion of the 2.625% Notes and the 2.250% Notes, only when the average market price per share of our common stock for the period is greater than the conversion price and only for the conversion premium, with the principal portion required to be settled in cash. We have entered into convertible notes hedge transactions to increase the effective conversion price of the 2.625% 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. In periods in which the Company has net income, 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. On June 6, 2022, we entered into convertible notes hedge transactions to increase the effective conversion price of the 2.250% Notes from $145.33 to $251.53. 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 $251.53. In periods in which the Company has net income, 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 $251.53, calculated under the treasury stock method.

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	6 Months Ended
	Jun. 30, 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 six months ended June 30, 2022 are as follows: Balance as of December 31, 2021 $ 617,528 Goodwill resulting from business acquisition 140,338 Foreign currency translation (1,113) Balance as of June 30, 2022 $ 756,753 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. During the three months ended June 30, 2022, the Company acquired In2Bones Global, Inc. as further described in Note 4. Goodwill resulting from the acquisition amounted to $140.3 million and acquired intangible assets including distributor relationships and developed technology amounted to $63.9 million. Other intangible assets consist of the following: June 30, 2022 December 31, 2021 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 24 $ 368,835 $ (161,651) $ 342,452 $ (152,934) Sales representation, marketing and promotional rights 25 149,376 (63,000) 149,376 (60,000) Developed technology 15 143,904 (30,208) 106,604 (26,495) Patents and other intangible assets 14 77,191 (51,671) 76,392 (50,890) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 825,850 $ (306,530) $ 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 $8.2 million for both the three months ended June 30, 2022 and 2021, and $16.2 million and $16.6 million in the six months ended June 30, 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 (loss). 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 $ 14,731 $ 3,000 $ 17,731 2023 28,715 6,000 34,715 2024 28,427 6,000 34,427 2025 28,846 6,000 34,846 2026 28,502 6,000 34,502 2027 29,207 6,000 35,207

Long Term Debt

Long Term Debt	6 Months Ended
	Jun. 30, 2022
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following: June 30, 2022 December 31, 2021 Revolving line of credit $ — $ 140,000 Term loan, net of deferred debt issuance costs of $723 and $1,373 in 2022 and 2021, respectively 133,865 226,196 2.625% convertible notes, net of deferred debt issuance costs of $631 and $3,700 in 2022 and 2021, respectively, and unamortized discount of $23,404 in 2021 69,369 317,896 2.250% convertible notes, net of deferred debt issuance costs of $20,915 in 2022 779,085 — Financing leases 380 564 Total debt 982,699 684,656 Less: Current portion 272 12,249 Total long-term debt $ 982,427 $ 672,407 Seventh Amended and Restated Senior Credit Agreement 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 was payable in quarterly installments increasing over the term of the facility. During the three and six months ended June 30, 2022 we made a $90.0 million prepayment on the term loan facility resulting in the elimination of such quarterly payments with the remaining balance due upon the expiration of the term loan facility. The $90.0 million prepayment was accounted for as an extinguishment and resulted in a write-off to other expense of unamortized debt issuance costs of $0.5 million. 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 (1.688% at June 30, 2022) plus an interest rate margin of 1.25% (2.938% at June 30, 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 $134.6 million in borrowings outstanding on the term loan facility as of June 30, 2022. There were no borrowings outstanding under the revolving credit facility as of June 30, 2022. Our available borrowings on the revolving credit facility at June 30, 2022 were $582.8 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 June 30, 2022. We are also required, under certain circumstances, to make mandatory prepayments from net cash proceeds from any issuance of equity and asset sales. 2.625% Convertible Notes On January 29, 2019, we issued $345.0 million in 2.625% convertible notes due in 2024 (the "2.625% Notes"). Interest is payable semi-annually in arrears on February 1 and August 1 of each year, commencing August 1, 2019. The 2.625% Notes will mature on February 1, 2024, unless earlier repurchased or converted. The 2.625% 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 2.625% Notes may be converted at an initial conversion rate of 11.2608 shares of our common stock per $1,000 principal amount of 2.625% Notes (equivalent to an initial conversion price of approximately $88.80 per share of common stock). Holders of the 2.625% Notes may convert the 2.625% 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 2.625% Notes will also have the right to convert the 2.625% 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 2.625% 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. On June 6, 2022, the Company repurchased and extinguished $275.0 million principal amount of the 2.625% Notes for aggregate consideration consisting of $275.0 million in cash and approximately 0.9 million shares of the Company's common stock. During the three and six months ended June 30, 2022, the Company recorded a loss on extinguishment of $103.1 million to other expense based on the fair value of the shares of the Company’s common stock issued in connection with the extinguishment. This loss was not deductible for tax purposes. We also recorded a write-off to other expense of unamortized debt issuance costs related to the 2.625% Notes of $2.9 million. Concurrently, the Company entered into a Supplemental Indenture related to the remaining $70.0 million in 2.625% Notes, in which the Company irrevocably elected to settle the principal value of those 2.625% Notes in cash. Our effective borrowing rate for nonconvertible debt at the time of issuance of the 2.625% 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 and six months ended June 30, 2021, we recorded interest expense related to the amortization of debt discount on the 2.625% Notes of $2.5 million and $5.0 million, respectively, 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 the three months ended June 30, 2022 and 2021, we have recorded interest expense on the 2.625% Notes of $1.7 million and $2.3 million, respectively, and for the six months ended June 30, 2022 and 2021 we have recorded interest expense on the 2.625% Notes of $3.9 million and $4.5 million, respectively, at the contractual coupon rate of 2.625%. The estimated fair value of the 2.625% Notes was approximately $84.6 million as of June 30, 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 2.625% Notes in an over-the-counter market transaction on the last business day of the period. 2.250% Convertible Notes On June 6, 2022, we issued $800.0 million in 2.250% Notes. Interest is payable semi-annually in arrears on June 15 and December 15 of each year, commencing December 15, 2022. The 2.250% Notes will mature on June 15, 2027, unless earlier repurchased or converted. The 2.250% 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, with the principal required to be paid in cash. The 2.250% Notes may be converted at an initial conversion rate of 6.8810 shares of our common stock per $1,000 principal amount of the 2.250% Notes (equivalent to an initial conversion price of approximately $145.33 per share of common stock). Holders of the 2.250% Notes may convert the 2.250% Notes at their option at any time on or after March 15, 2027 through the second scheduled trading day preceding the maturity date. Holders of the 2.250% Notes will also have the right to convert the 2.250% Notes prior to March 15, 2027, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of these proceeds were used to repurchase and extinguish a portion of the 2.625% Notes, pay off our outstanding balance on our revolving line of credit, pay down of $90.0 million of our term loan and partially pay for the In2Bones Acquisition. In addition, approximately $115.6 million of the proceeds were used to pay the cost of certain convertible notes hedge transactions related to the 2.250% Notes. For both the three and six months ended June 30, 2022, we have recorded interest expense on the 2.250% Notes of $1.3 million at the contractual coupon rate of 2.250%. The estimated fair value of the 2.250% Notes was approximately $749.6 million as of June 30, 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 2.250% Notes in an over-the-counter market transaction on the last business day of the period. Convertible Notes Hedge Transactions In connection with the offering of the 2.625% and 2.250% Notes, we entered into convertible notes hedge transactions with a number of financial institutions (each, an “option counterparty”). The convertible notes hedge transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the respective Notes, the number of shares of our common stock underlying the 2.625% and 2.250% Notes. Concurrent with entering into the convertible notes 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. In connection with the repurchase and extinguishment of $275.0 million principal amount of the 2.625% Notes, the Company entered into agreements with the option counterparties to terminate a corresponding portion of the hedges on the 2.625% Notes. The transactions had a net fair value due the Company on execution date of $22.2 million which was recorded as an adjustment to Paid-in Capital. The Company recorded a $5.5 million charge to other expense as a result of a subsequent decline in fair value between execution date and settlement date with the Company receiving net cash of $16.7 million. The termination of the convertible notes hedge resulted in the release of the related deferred tax asset. In connection with the issuance of 2.250% Notes, the Company purchased hedges for $187.6 million ($142.1 million net of tax) and received proceeds from the issuance of warrants totaling $72.0 million, recorded to paid-in capital. The convertible notes 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 notes 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 for the 2.625% Notes and $251.53 for the 2.250% Notes) 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 June 30, 2022 are as follows: Remaining 2022 $ — 2023 — 2024 70,000 2025 — 2026 134,588 2027 800,000 The above amounts exclude deferred debt issuance costs and financing leases.

Guarantees

Guarantees	6 Months Ended
	Jun. 30, 2022
Guarantees [Abstract]
Guarantees	Guarantees We 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 six months ended June 30, are as follows: 2022 2021 Balance as of January 1, $ 2,344 $ 1,826 Provision for warranties 113 864 Claims made (369) (440) Balance as of June 30, $ 2,088 $ 2,250 Costs associated with extended warranty repairs are recorded as incurred and amounted to $3.2 million and $3.4 million for the six months ended June 30, 2022 and 2021, respectively.

Pension Plan

Pension Plan	6 Months Ended
	Jun. 30, 2022
Retirement Benefits [Abstract]
Pension Plan	Pension Plan Net periodic pension cost consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Service cost $ 269 $ 248 $ 538 $ 496 Interest cost on projected benefit obligation 537 451 1,074 902 Expected return on plan assets (1,324) (1,289) (2,648) (2,578) Net amortization and deferral 648 832 1,296 1,664 Net periodic pension cost $ 130 $ 242 $ 260 $ 484

Acquisition and Other Expense

Acquisition and Other Expense	6 Months Ended
	Jun. 30, 2022
Acquisition and Other Expense [Abstract]
Acquisition and Other Expense	Acquisition and Other Expense Acquisition and other expense consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Acquisition costs included in cost of sales $ 349 $ — $ 349 $ — Acquisition costs $ 2,600 $ — $ 2,600 $ — Legal matters 775 — 775 — Restructuring and related costs — — — 414 Acquisition and other costs included in selling and administrative expense $ 3,375 $ — $ 3,375 $ 414 Convertible notes premium on extinguishment $ 103,125 $ — $ 103,125 $ — Change in fair value of convertible notes hedges upon settlement 5,460 — 5,460 — Loss on early extinguishment of debt 3,426 — 3,426 — Debt related costs included in other expense $ 112,011 $ — $ 112,011 $ — During the three and six months ended June 30, 2022 we recognized $0.3 million in costs for inventory step-up adjustments associated with the In2Bones Acquisition, as further described in Note 4. During the three and six months ended June 30, 2022 we recognized $2.6 million in consulting and legal related fees associated with the acquisition of In2Bones, as further described in Note 4. These costs were included in selling and administrative expense. During the three and six months ended June 30, 2022, we recognized $0.8 million in costs related to the settlement of litigation . These costs were included in selling and administrative expense. During the six months ended June 30, 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. During the three and six months ended June 30, 2022, we recorded expense of $103.1 million related to the conversion premium on the repurchase and extinguishment of $275.0 million of the 2.625% Notes, $5.5 million related to the settlement of the associated convertible notes hedge transactions and $3.4 million related to the write-off of deferred financing fees associated with the repurchase and extinguishment of $275.0 million of the 2.625% Notes and the pay down of $90.0 million on our term loan. These costs were recorded in other expense as further discussed in Note 11.

Business Segment

Business Segment	6 Months Ended
	Jun. 30, 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 June 30, Six Months Ended June 30, 2022 2021 2022 2021 Orthopedic surgery $ 120,182 $ 107,893 $ 227,698 $ 215,058 General surgery 157,008 147,268 291,818 272,779 Consolidated net sales $ 277,190 $ 255,161 $ 519,516 $ 487,837

Legal Proceedings

Legal Proceedings	6 Months Ended
	Jun. 30, 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 represented 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. 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. On June 30, 2022, the Court issued a ruling that CONMED had presented overwhelming evidence that it had not breached its obligations under the acquisition agreement, and that CONMED was entitled to judgement on all claims asserted against it. The Company had not recorded any expense related to potential damages in connection with this matter and expects to defend any appeal the former EndoDynamix shareholder representative may file. While the Company believes any potential appeal by the former EndoDynamix shareholder representative has a remote likelihood of prevailing given the fact-intensive nature of the Court's ruling, there can be no assurance that we will prevail in any appeal should one be filed. 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. The Company's motion to dismiss in the Cobb County action was heard on January 10, 2022, and the Court issued a ruling on June 15, 2022 dismissing 44 of the 53 plaintiffs' claims as precluded by the exclusive workers' compensation remedy, as well as one claim from a non-employee plaintiff. As to the remaining claims that were not the subject of the motion to dismiss, CONMED believes it has strong defenses 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.

Interim Reporting (Policies)

Interim Reporting (Policies)	6 Months Ended
	Jun. 30, 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)	6 Months Ended
	Jun. 30, 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 then outstanding net of issuance costs (the "2.625% Notes" described more fully in Note 11); • 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 2.625% 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 on the 2.625% Notes by approximately $2.6 million during the three months ended March 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 2.625% Notes using the if-converted method. During the three months ended June 30, 2022, the Company repurchased and extinguished $275.0 million principal value of the 2.625% Notes as further discussed in Note 11. Concurrently, the Company entered into a Supplemental Indenture related to the remaining $70.0 million in 2.625% Notes, pursuant to which the Company irrevocably elected to settle the principal value of those 2.625% Notes in cash. As a result, in periods in which the Company has net income, only the conversion premium will affect the dilutive share count. As the Company was in a net loss position for the three and six months ended June 30, 2022, there were no dilutive potential shares included in the computation of diluted shares outstanding for the three and six months ended June 30, 2022. 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 June 30, 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.

Business Combinations (Tables)

Business Combinations (Tables)	6 Months Ended
	Jun. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the estimated fair values of the assets acquired and liabilities assumed as a result of the In2Bones Acquisition. The assessment of fair value is based on preliminary valuations and estimates that were available to management at the time the consolidated condensed financial statements were prepared. Accordingly, the allocation of purchase price is preliminary and therefore subject to adjustment during the measurement adjustment period. Cash $ 445 Accounts receivable, net 5,036 Inventories 24,247 Prepaid expenses and other current assets 403 Current assets 30,131 Goodwill 140,338 Developed technology 37,300 Distributor relationships 26,600 Other long-term assets 2,875 Total assets acquired $ 237,244 Current liabilities assumed 5,972 Deferred income taxes 16,457 Contingent consideration 69,402 Other long-term liabilities 413 Total liabilities assumed $ 92,244 Net assets acquired $ 145,000
Fair Value Measurement Inputs and Valuation Techniques	The recurring Level 3 fair value measurements of contingent consideration for which the liability is recorded include the following significant unobservable inputs: Unobservable Input Assumptions Discount rate 5.67% Revenue volatility 12.75% Projected year of payment 2023-2026

Revenues (Tables)

Revenues (Tables)	6 Months Ended
	Jun. 30, 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 June 30, 2022 June 30, 2021 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 40,461 $ 108,721 $ 149,182 $ 40,777 $ 102,813 $ 143,590 Europe, Middle East & Africa 32,060 22,468 54,528 27,120 20,143 47,263 Asia Pacific 27,674 16,201 43,875 26,284 16,136 42,420 Americas (excluding the United States) 19,987 9,618 29,605 13,712 8,176 21,888 Total sales from contracts with customers $ 120,182 $ 157,008 $ 277,190 $ 107,893 $ 147,268 $ 255,161 Timing of Revenue Recognition Goods transferred at a point in time $ 110,060 $ 155,451 $ 265,511 $ 97,649 $ 146,105 $ 243,754 Services transferred over time 10,122 1,557 11,679 10,244 1,163 11,407 Total sales from contracts with customers $ 120,182 $ 157,008 $ 277,190 $ 107,893 $ 147,268 $ 255,161 Six Months Ended Six Months Ended June 30, 2022 June 30, 2021 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 78,408 $ 202,001 $ 280,409 $ 77,907 $ 189,625 $ 267,532 Europe, Middle East & Africa 62,041 42,794 104,835 53,172 38,688 91,860 Asia Pacific 51,091 29,155 80,246 52,886 28,798 81,684 Americas (excluding the United States) 36,158 17,868 54,026 31,093 15,668 46,761 Total sales from contracts with customers $ 227,698 $ 291,818 $ 519,516 $ 215,058 $ 272,779 $ 487,837 Timing of Revenue Recognition Goods transferred at a point in time $ 208,264 $ 288,773 $ 497,037 $ 195,339 $ 270,499 $ 465,838 Services transferred over time 19,434 3,045 22,479 19,719 2,280 21,999 Total sales from contracts with customers $ 227,698 $ 291,818 $ 519,516 $ 215,058 $ 272,779 $ 487,837
Contract with Customer, Asset and Liability	Contract liability balances related to the sale of extended warranties to customers are as follows: June 30, 2022 December 31, 2021 Contract liability $ 17,748 $ 16,760

Comprehensive Income (Loss) (Ta

Comprehensive Income (Loss) (Tables)	6 Months Ended
	Jun. 30, 2022
Equity [Abstract]
Schedule of Comprehensive Income (Loss)	Comprehensive income (loss) consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Net income (loss) $ (168,291) $ 13,290 $ (153,316) $ 23,150 Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $1,491 and $388 for the three months ended June 30, 2022 and 2021, respectively and $1,838 and $1,639 for the six months ended June 30, 2022 and 2021, respectively) 4,662 1,221 5,744 5,147 Pension liability, net of income tax (income tax expense of $158 and $201 for the three months ended June 30, 2022 and 2021, respectively and $284 and $402 for the six months ended June 30, 2022 and 2021, respectively) 490 631 1,012 1,262 Foreign currency translation adjustment (9,497) 2,601 (9,661) (1,073) Comprehensive income (loss) $ (172,636) $ 17,743 $ (156,221) $ 28,486
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 9,851 — (9,661) 190 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (5,421) 1,296 — (4,125) Income tax 1,314 (284) — 1,030 Net current-period other comprehensive income (loss) 5,744 1,012 (9,661) (2,905) Balance, June 30, 2022 $ 9,400 $ (28,659) $ (37,849) $ (57,108) 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 2,723 — (1,073) 1,650 Amounts reclassified from accumulated other comprehensive income before tax a 3,196 1,664 — 4,860 Income tax (772) (402) — (1,174) Net current-period other comprehensive income (loss) 5,147 1,262 (1,073) 5,336 Balance, June 30, 2021 $ (798) $ (35,358) $ (22,189) $ (58,345) (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 7 and Note 13, respectively, for further details.

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 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 June 30, 2022 December 31, 2021 Forward exchange contracts Cash flow hedge $ 191,288 $ 172,894 Forward exchange contracts Non-designated 41,704 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 (loss) on our consolidated condensed statements of comprehensive income (loss) and our consolidated condensed balance sheets: Amount of Gain (Loss) Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain (Loss) Reclassified from AOCI Three Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2022 2021 Location of amount reclassified 2022 2021 2022 2021 Foreign exchange contracts $ 9,756 $ (3) Net Sales $ 277,190 $ 255,161 $ 3,403 $ (2,022) Cost of Sales 125,413 113,737 199 410 Pre-tax gain (loss) $ 9,756 $ (3) $ 3,602 $ (1,612) Tax expense (benefit) 2,365 (1) 873 (389) Net gain (loss) $ 7,391 $ (2) $ 2,729 $ (1,223) Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain (Loss) Reclassified from AOCI Six Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2022 2021 Location of amount reclassified 2022 2021 2022 2021 Foreign exchange contracts $ 13,003 $ 3,590 Net Sales $ 519,516 $ 487,837 $ 5,147 $ (3,871) Cost of Sales 231,748 217,964 274 675 Pre-tax gain (loss) $ 13,003 $ 3,590 $ 5,421 $ (3,196) Tax expense (benefit) 3,152 867 1,314 (772) Net gain (loss) $ 9,851 $ 2,723 $ 4,107 $ (2,424)
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 June 30, Six Months Ended June 30, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income (Loss) 2022 2021 2022 2021 Net gain (loss) on currency forward contracts Selling and administrative expense $ 1,155 $ (809) $ 196 $ (350) Net gain (loss) on currency transaction exposures Selling and administrative expense $ (2,178) $ 243 $ (1,764) $ (879)
Schedule of Fair Value for Forward Foreign Exchange Contracts	The following tables summarize the fair value for forward foreign exchange contracts outstanding at June 30, 2022 and December 31, 2021: June 30, 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 $ 10,242 $ (56) $ 10,186 Foreign exchange contracts Other long-term assets 2,272 (50) 2,222 $ 12,514 $ (106) $ 12,408 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 15 (262) (247) Total derivatives $ 12,529 $ (368) $ 12,161 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)	6 Months Ended
	Jun. 30, 2022
Inventory Disclosure [Abstract]
Schedule of inventory	Inventories consist of the following: June 30, December 31, Raw materials $ 105,531 $ 83,386 Work-in-process 25,656 17,449 Finished goods 158,527 130,809 Total $ 289,714 $ 231,644

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	6 Months Ended
	Jun. 30, 2022
Earnings Per Share [Abstract]
Schedule of calculation of basic and diluted earnings (loss) per share	The following table sets forth the computation of basic and diluted earnings (loss) per share for the three and six months ended June 30, 2022 and 2021: Three Months Ended June 30, 2022 Three Months Ended June 30, 2021 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income (loss) $ (168,291) — $ (168,291) $ 13,290 — $ 13,290 Weighted average shares outstanding 29,775 — 29,775 29,125 — 29,125 Employee stock compensation — — — — 1,357 1,357 Warrants — — — — 620 620 Convertible notes — — — — 1,362 1,362 29,775 — 29,775 29,125 3,339 32,464 EPS $ (5.65) $ (5.65) $ 0.46 $ 0.41 Six Months Ended June 30, 2022 Six Months Ended June 30, 2021 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income (loss) $ (153,316) — $ (153,316) $ 23,150 — $ 23,150 Weighted average shares outstanding 29,601 — 29,601 29,052 — 29,052 Employee stock compensation — — — — 1,300 1,300 Warrants — — — — 411 411 Convertible notes — — — — 1,201 1,201 29,601 — 29,601 29,052 2,912 31,964 EPS $ (5.18) $ (5.18) $ 0.80 $ 0.72

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in the net carrying amount of goodwill for the six months ended June 30, 2022 are as follows: Balance as of December 31, 2021 $ 617,528 Goodwill resulting from business acquisition 140,338 Foreign currency translation (1,113) Balance as of June 30, 2022 $ 756,753
Schedule of Finite-Lived Intangible Assets	Other intangible assets consist of the following: June 30, 2022 December 31, 2021 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 24 $ 368,835 $ (161,651) $ 342,452 $ (152,934) Sales representation, marketing and promotional rights 25 149,376 (63,000) 149,376 (60,000) Developed technology 15 143,904 (30,208) 106,604 (26,495) Patents and other intangible assets 14 77,191 (51,671) 76,392 (50,890) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 825,850 $ (306,530) $ 761,368 $ (290,319)
Schedule of Indefinite-Lived Intangible Assets	Other intangible assets consist of the following: June 30, 2022 December 31, 2021 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 24 $ 368,835 $ (161,651) $ 342,452 $ (152,934) Sales representation, marketing and promotional rights 25 149,376 (63,000) 149,376 (60,000) Developed technology 15 143,904 (30,208) 106,604 (26,495) Patents and other intangible assets 14 77,191 (51,671) 76,392 (50,890) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 825,850 $ (306,530) $ 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 $ 14,731 $ 3,000 $ 17,731 2023 28,715 6,000 34,715 2024 28,427 6,000 34,427 2025 28,846 6,000 34,846 2026 28,502 6,000 34,502 2027 29,207 6,000 35,207

Long Term Debt (Tables)

Long Term Debt (Tables)	6 Months Ended
	Jun. 30, 2022
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	Long-term debt consists of the following: June 30, 2022 December 31, 2021 Revolving line of credit $ — $ 140,000 Term loan, net of deferred debt issuance costs of $723 and $1,373 in 2022 and 2021, respectively 133,865 226,196 2.625% convertible notes, net of deferred debt issuance costs of $631 and $3,700 in 2022 and 2021, respectively, and unamortized discount of $23,404 in 2021 69,369 317,896 2.250% convertible notes, net of deferred debt issuance costs of $20,915 in 2022 779,085 — Financing leases 380 564 Total debt 982,699 684,656 Less: Current portion 272 12,249 Total long-term debt $ 982,427 $ 672,407
Schedule of Maturities of Long-Term Debt	The scheduled maturities of long-term debt outstanding at June 30, 2022 are as follows: Remaining 2022 $ — 2023 — 2024 70,000 2025 — 2026 134,588 2027 800,000 The above amounts exclude deferred debt issuance costs and financing leases.

Guarantees (Tables)

Guarantees (Tables)	6 Months Ended
	Jun. 30, 2022
Guarantees [Abstract]
Changes in the carrying amount of service and product warranties	Changes in the liability for standard warranties for the six months ended June 30, are as follows: 2022 2021 Balance as of January 1, $ 2,344 $ 1,826 Provision for warranties 113 864 Claims made (369) (440) Balance as of June 30, $ 2,088 $ 2,250

Pension Plan (Tables)

Pension Plan (Tables)	6 Months Ended
	Jun. 30, 2022
Retirement Benefits [Abstract]
Schedule of net benefit cost	Net periodic pension cost consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Service cost $ 269 $ 248 $ 538 $ 496 Interest cost on projected benefit obligation 537 451 1,074 902 Expected return on plan assets (1,324) (1,289) (2,648) (2,578) Net amortization and deferral 648 832 1,296 1,664 Net periodic pension cost $ 130 $ 242 $ 260 $ 484

Acquisition and Other Expense (

Acquisition and Other Expense (Tables)	6 Months Ended
	Jun. 30, 2022
Acquisition and Other Expense [Abstract]
Schedule of Acquisition and Other Operating Expense	Acquisition and other expense consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Acquisition costs included in cost of sales $ 349 $ — $ 349 $ — Acquisition costs $ 2,600 $ — $ 2,600 $ — Legal matters 775 — 775 — Restructuring and related costs — — — 414 Acquisition and other costs included in selling and administrative expense $ 3,375 $ — $ 3,375 $ 414 Convertible notes premium on extinguishment $ 103,125 $ — $ 103,125 $ — Change in fair value of convertible notes hedges upon settlement 5,460 — 5,460 — Loss on early extinguishment of debt 3,426 — 3,426 — Debt related costs included in other expense $ 112,011 $ — $ 112,011 $ —

Business Segment (Tables)

Business Segment (Tables)	6 Months Ended
	Jun. 30, 2022
Segment Reporting [Abstract]
Schedule of net sales information by product line	These product lines' net sales are as follows: Three Months Ended June 30, Six Months Ended June 30, 2022 2021 2022 2021 Orthopedic surgery $ 120,182 $ 107,893 $ 227,698 $ 215,058 General surgery 157,008 147,268 291,818 272,779 Consolidated net sales $ 277,190 $ 255,161 $ 519,516 $ 487,837

New Accounting Pronouncements_2

New Accounting Pronouncements (Details) - USD ($) shares in Thousands, $ in Thousands		3 Months Ended			6 Months Ended
	Jun. 06, 2022	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Jan. 01, 2022	Dec. 31, 2021	Jan. 29, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Long-term debt		$ 982,427			$ 982,427			$ 672,407
Paid-in capital		401,182			401,182			396,771
Deferred income taxes		105,938			105,938			68,537
Retained earnings		352,089			352,089			$ 496,605
Interest expense		$ 5,928		$ 9,420	$ 10,926	$ 19,772
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities (in shares)		0		1,362	0	1,201
Repayments of Convertible Debt					$ 275,000	$ 0
2.625 Percent Convertible Notes Due 2024 | Convertible Notes Payable [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Interest rate, stated percentage									2.625%
Repayments of Convertible Debt	$ 275,000
Debt instrument, face amount		$ 70,000			$ 70,000				$ 345,000
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

Business Combinations (Details)

Business Combinations (Details) $ in Thousands	Jun. 13, 2022 USD ($)	Jun. 30, 2022 USD ($)	Dec. 31, 2021 USD ($)
Business Acquisition [Line Items]
Goodwill		$ 756,753	$ 617,528
In2Bones Global Inc
Business Acquisition [Line Items]
Business Combination, Consideration Transferred	$ 145,000
Payments to acquire businesses, gross	143,000
Purchase Price Adjustment Holdback	2,000
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	110,000
Cash	445
Accounts receivable, net	5,036
Inventories	24,247
Prepaid expenses and other current assets	403
Current assets	30,131
Goodwill	140,338
Other long-term assets	2,875
Total assets acquired	237,244
Current liabilities assumed	5,972
Deferred income taxes	16,457
Contingent consideration	69,402
Other long-term liabilities	413
Total liabilities assumed	92,244
Net assets acquired	$ 145,000
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life	15 years
Measurement Input, Discount Rate | Fair Value, Recurring | Fair Value, Inputs, Level 3 | In2Bones Global Inc
Business Acquisition [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.0567
Measurement Input, Revenue Volatility | Fair Value, Recurring | Fair Value, Inputs, Level 3 | In2Bones Global Inc
Business Acquisition [Line Items]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.1275
Developed technology | In2Bones Global Inc
Business Acquisition [Line Items]
Finite-lived intangible assets	$ 37,300
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life	15 years
Distributor Relationships | In2Bones Global Inc
Business Acquisition [Line Items]
Finite-lived intangible assets	$ 26,600
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life	15 years

Revenues (Disaggregated Revenue

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Disaggregation of Revenue [Line Items]
Net Sales	$ 277,190	$ 255,161	$ 519,516	$ 487,837
Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	265,511	243,754	497,037	465,838
Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	11,679	11,407	22,479	21,999
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	120,182	107,893	227,698	215,058
Orthopedic Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	110,060	97,649	208,264	195,339
Orthopedic Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	10,122	10,244	19,434	19,719
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	157,008	147,268	291,818	272,779
General Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	155,451	146,105	288,773	270,499
General Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	1,557	1,163	3,045	2,280
United States
Disaggregation of Revenue [Line Items]
Net Sales	149,182	143,590	280,409	267,532
United States | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	40,461	40,777	78,408	77,907
United States | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	108,721	102,813	202,001	189,625
Americas (excluding the United States)
Disaggregation of Revenue [Line Items]
Net Sales	29,605	21,888	54,026	46,761
Americas (excluding the United States) | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	19,987	13,712	36,158	31,093
Americas (excluding the United States) | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	9,618	8,176	17,868	15,668
Europe, Middle East & Africa
Disaggregation of Revenue [Line Items]
Net Sales	54,528	47,263	104,835	91,860
Europe, Middle East & Africa | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	32,060	27,120	62,041	53,172
Europe, Middle East & Africa | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	22,468	20,143	42,794	38,688
Asia Pacific
Disaggregation of Revenue [Line Items]
Net Sales	43,875	42,420	80,246	81,684
Asia Pacific | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	27,674	26,284	51,091	52,886
Asia Pacific | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	$ 16,201	$ 16,136	$ 29,155	$ 28,798

Revenues (Customer Liability) (

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Contract liability	$ 17,748		$ 16,760
Revenue recognized	$ 7,000	$ 6,100

Comprehensive Income (Loss) (De

Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2022	Jun. 30, 2021
Equity [Abstract]
Net income (loss)	$ (168,291)		$ 13,290		$ (153,316)	$ 23,150
Cash flow hedging gain, net	4,662		1,221		5,744	5,147
Pension liability, net of income tax	490		631		1,012	1,262
Foreign currency translation adjustments	(9,497)		2,601		(9,661)	(1,073)
Comprehensive income (loss)	(172,636)	$ 16,415	17,743	$ 10,743	(156,221)	28,486
Pension liability, tax	158		201		284	402
Cash flow hedging gain, tax	$ 1,491		$ 388		$ 1,838	$ 1,639

Comprehensive Income (Loss) (Ac

Comprehensive Income (Loss) (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2022	Jun. 30, 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		(57,108)
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		190	1,650
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(4,125)	4,860
Reclassification from AOCI, Current Period, Tax		1,030	(1,174)
Net current-period other comprehensive income (loss)		(2,905)	5,336
Accumulated Other Comprehensive Income (Loss), Net of Tax		(57,108)	(58,345)
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		9,851	2,723
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(5,421)	3,196
Reclassification from AOCI, Current Period, Tax		1,314	(772)
Net current-period other comprehensive income (loss)		5,744	5,147
Accumulated Other Comprehensive Income (Loss), Net of Tax		9,400	(798)
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]	1,296	1,664
Reclassification from AOCI, Current Period, Tax		(284)	(402)
Net current-period other comprehensive income (loss)		1,012	1,262
Accumulated Other Comprehensive Income (Loss), Net of Tax		(28,659)	(35,358)
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		(9,661)	(1,073)
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)		(9,661)	(1,073)
Accumulated Other Comprehensive Income (Loss), Net of Tax		$ (37,849)	$ (22,189)
[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 7 and Note 13, 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		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Derivative Instruments, Gain (Loss) [Line Items]
Net sales	$ 277,190	$ 255,161	$ 519,516	$ 487,837
Cost of sales	125,413	113,737	231,748	217,964
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	9,756	(3)	13,003	3,590
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	2,365	(1)	3,152	867
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	7,391	(2)	9,851	2,723
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	3,602	(1,612)	5,421	(3,196)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	873	(389)	1,314	(772)
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	2,729	(1,223)	4,107	(2,424)
Revenues
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	3,403	(2,022)	5,147	(3,871)
Cost of Sales
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	$ 199	$ 410	$ 274	$ 675

Fair Value of Financial Instr_4

Fair Value of Financial Instruments (Foreign Currency Forward Contracts) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Derivative [Line Items]
Foreign Currency Transaction Gain (Loss), before Tax	$ (2,178)	$ 243	$ (1,764)	$ (879)
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	12,529		12,529		$ 5,451
Liabilities Fair Value	(368)		(368)		(771)
Net Fair Value	12,161		12,161		4,680
Foreign Currency Forward Contracts
Derivative [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	1,155	$ (809)	196	$ (350)
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	12,514		12,514		5,413
Liabilities Fair Value	(106)		(106)		(591)
Net Fair Value	12,408		12,408		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	10,242		10,242		5,331
Liabilities Fair Value	(56)		(56)		(430)
Net Fair Value	10,186		10,186		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	2,272		2,272
Liabilities Fair Value	(50)		(50)
Net Fair Value	2,222		$ 2,222
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	41,704		$ 41,704		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	15		15		38
Liabilities Fair Value	(262)		(262)		(180)
Net Fair Value	(247)		$ (247)		(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	191,288		$ 191,288		$ 172,894
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 7,700		$ 7,700

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Inventory Disclosure [Abstract]
Raw materials	$ 105,531	$ 83,386
Work-in-process	25,656	17,449
Finished goods	158,527	130,809
Total inventory	$ 289,714	$ 231,644

Earnings (Loss) Per Share (Deta

Earnings (Loss) Per Share (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Earnings Per Share [Abstract]
Net income (loss)	$ (168,291)	$ 13,290	$ (153,316)	$ 23,150
Interest on Convertible Debt, Net of Tax	0	0	0	0
Net Income (Loss) Available to Common Stockholders, Diluted	$ (168,291)	$ 13,290	$ (153,316)	$ 23,150
Basic-weighted average shares outstanding (in shares)	29,775,000	29,125,000	29,601,000	29,052,000
Incremental Common Shares Attributable to Dilutive Effect of Share-based Payment Arrangements (in shares)	0	1,357,000	0	1,300,000
Incremental Common Shares Attributable to Dilutive Effect of Call Options and Warrants (in shares)	0	620,000	0	411,000
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities (in shares)	0	1,362,000	0	1,201,000
Effect of dilutive potential securities (in shares)	0	3,339,000	0	2,912,000
Diluted- weighted average shares outstanding (in shares)	29,775,000	32,464,000	29,601,000	31,964,000
Basic (in dollars per share)	$ (5.65)	$ 0.46	$ (5.18)	$ 0.80
Diluted (in dollars per share)	$ (5.65)	$ 0.41	$ (5.18)	$ 0.72
Antidilutive securities excluded from computation of earnings per share (in shares)	0	700,000	0	500,000

Earnings (Loss) Per Share - Con

Earnings (Loss) Per Share - Convertible Notes (Details) - USD ($) $ / shares in Units, $ in Thousands			6 Months Ended
	Jun. 06, 2022	Jan. 29, 2019	Jun. 30, 2022	Jun. 30, 2021
Debt Instrument [Line Items]
Repayments of Convertible Debt			$ 275,000	$ 0
Convertible Notes Payable | 2.625 Percent Convertible Notes Due 2024
Debt Instrument [Line Items]
Interest rate, stated percentage		2.625%
Debt instrument, face amount		$ 345,000	$ 70,000
Conversion price (in dollars per share)		$ 88.80
Repayments of Convertible Debt	$ 275,000
Convertible Notes Payable | 2.625 Percent Convertible Notes Due 2024 | Hedge transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)		114.92
Convertible Notes Payable | 2.625 Percent Convertible Notes Due 2024 | Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)		$ 114.92
Convertible Notes Payable | 2.250 Percent Convertible Notes Due 2027
Debt Instrument [Line Items]
Interest rate, stated percentage	2.25%
Debt instrument, face amount	$ 800,000
Conversion price (in dollars per share)	$ 145.33
Convertible Notes Payable | 2.250 Percent Convertible Notes Due 2027 | Hedge transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)	251.53
Convertible Notes Payable | 2.250 Percent Convertible Notes Due 2027 | Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)	$ 251.53

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Goodwill) (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2022 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 617,528
Goodwill, Acquired During Period	140,338
Foreign currency translation	(1,113)
Ending balance	$ 756,753

Goodwill and Other Intangible_4

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
	Jun. 13, 2022	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Dec. 31, 2021
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Gross carrying amount		$ 825,850		$ 825,850		$ 761,368
Intangible assets, Accumulated amortization		(306,530)		(306,530)		(290,319)
Amortization expense		8,200	$ 8,200	16,200	$ 16,600
Future amortization expense [Abstract]
Remaining, 2022		17,731		17,731
2023		34,715		34,715
2024		34,427		34,427
2025		34,846		34,846
2026		34,502		34,502
2027		35,207		35,207
In2Bones Global Inc
Future amortization expense [Abstract]
Finite-lived Intangible Assets Acquired	$ 63,900
Amortization included in expense
Future amortization expense [Abstract]
Remaining, 2022		14,731		14,731
2023		28,715		28,715
2024		28,427		28,427
2025		28,846		28,846
2026		28,502		28,502
2027		29,207		29,207
Amortization recorded as a reduction of revenue
Future amortization expense [Abstract]
Remaining, 2022		3,000		3,000
2023		6,000		6,000
2024		6,000		6,000
2025		6,000		6,000
2026		6,000		6,000
2027		6,000		6,000
Trademarks & tradenames
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Unamortized intangible assets, Gross carrying amount		86,544		86,544		86,544
Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount		368,835		368,835		342,452
Intangible assets, Accumulated amortization		(161,651)		(161,651)		(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		149,376
Intangible assets, Accumulated amortization		(63,000)		(63,000)		(60,000)
Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount		77,191		77,191		76,392
Intangible assets, Accumulated amortization		(51,671)		(51,671)		(50,890)
Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount		143,904		143,904		106,604
Intangible assets, Accumulated amortization		$ (30,208)		$ (30,208)		$ (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)				24 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)				14 years
Weighted Average | Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)				15 years

Long Term Debt (Details)

Long Term Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Long-term Debt and Lease Obligation, Including Current Maturities	$ 982,699	$ 684,656
Finance Lease, Liability	380	564
Current portion of long-term debt	272	12,249
Long-term debt	982,427	672,407
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt	0	140,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt	133,865	226,196
Unamortized Debt Issuance Expense	723	1,373
2.625 Percent Convertible Notes Due 2024 | Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Debt Instrument, Unamortized Discount		23,404
Unamortized Debt Issuance Expense	631	3,700
Convertible Debt	69,369	317,896
2.250 Percent Convertible Notes Due 2027 | Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Unamortized Debt Issuance Expense	20,915
Convertible Debt	$ 779,085	$ 0

Long Term Debt Additional Infor

Long Term Debt Additional Information (Details) $ / shares in Units, shares in Millions			3 Months Ended		6 Months Ended
	Jun. 06, 2022 USD ($) $ / shares	Jan. 29, 2019 USD ($) $ / shares	Jun. 30, 2022 USD ($) shares	Jun. 30, 2021 USD ($)	Jun. 30, 2022 USD ($) shares	Jun. 30, 2021 USD ($)	Dec. 31, 2021 USD ($)	Jul. 16, 2021 USD ($)
Debt Instrument [Line Items]
Amortization of debt discount					$ 0	$ 5,031,000
Repayments of Senior Debt					92,981,000	8,281,000
Loss on early extinguishment of debt					$ 3,426,000	0
Debt Conversion, Converted Instrument, Shares Issued | shares			0.9		0.9
Loss on convertible notes conversion premium					$ (103,125,000)	0
Fair Value of Convertible Notes Hedges and Warrants Net	$ 22,200,000
Purchases of Convertible Notes Hedges	187,600,000				187,600,000	0
Purchases of Convertible Notes Hedges, Net of Tax	142,100,000
Net Proceeds From the Settlement of Convertible Note Hedge Transactions and Warrants	16,700,000
Repayments of Convertible Debt					275,000,000	0
Loss on convertible notes hedge transactions					(5,460,000)	0
Proceeds from issuance of warrants	72,000,000				72,000,000	0
Other Expense
Debt Instrument [Line Items]
Loss on early extinguishment of debt			$ 3,426,000	$ 0	3,426,000	0
Loss on convertible notes conversion premium			(103,125,000)	0	(103,125,000)	0
Loss on convertible notes hedge transactions			(5,460,000)	0	(5,460,000)	0
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross			134,600,000		134,600,000
Long-term Debt			133,865,000		133,865,000		$ 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
Repayments of Senior Debt			90,000,000		90,000,000
Loss on early extinguishment of debt			500,000		500,000
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt			0		0		$ 140,000,000
Line of Credit Facility, Remaining Borrowing Capacity			582,800,000		582,800,000
Letters of Credit Outstanding, Amount			2,200,000		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
Debt Instrument [Line Items]
Debt instrument, face amount		$ 345,000,000	70,000,000		70,000,000
Debt Instrument, Convertible, Carrying Amount of Equity Component		$ 39,100,000
Amortization of debt discount				2,500,000		5,000,000
Interest rate, stated percentage		2.625%
Debt Instrument, Interest Rate, Effective Percentage		6.14%
Interest Expense, Debt			1,700,000	$ 2,300,000	3,900,000	$ 4,500,000
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			84,600,000		84,600,000
Loss on early extinguishment of debt			2,900,000		2,900,000
Loss on convertible notes conversion premium			(103,100,000)		(103,100,000)
Repayments of Convertible Debt	275,000,000
Convertible Notes Payable [Member] | 2.625 Percent Convertible Notes Due 2024 | Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) | $ / shares		$ 114.92
Convertible Notes Payable [Member] | 2.250 Percent Convertible Notes Due 2027
Debt Instrument [Line Items]
Debt instrument, face amount	$ 800,000,000
Interest rate, stated percentage	2.25%
Interest Expense, Debt			1,300,000		1,300,000
Conversion price (in dollars per share) | $ / shares	$ 145.33
Debt Instrument, Convertible, Conversion Ratio	6.8810
Debt Instrument, Fair Value Disclosure			$ 749,600,000		$ 749,600,000
Convertible Notes Payable [Member] | 2.250 Percent Convertible Notes Due 2027 | Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) | $ / shares	$ 251.53
Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Interest Rate, Effective Percentage			2.938%		2.938%
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					1.688%
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%
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
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid		$ 21,000,000
Call Option [Member] | Convertible Notes Payable [Member] | 2.250 Percent Convertible Notes Due 2027
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid	$ 115,600,000

Long Term Debt Maturities of Lo

Long Term Debt Maturities of Long Term Debt (Details) $ in Thousands	Jun. 30, 2022 USD ($)
Maturities of Long-term Debt [Abstract]
Remaining, 2022	$ 0
2023	0
2024	70,000
2025	0
2026	134,588
2027	$ 800,000

Guarantees (Details)

Guarantees (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2022	Jun. 30, 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	113	864
Claims made	(369)	(440)
Balance as of June 30,	2,088	2,250
Extended Product Warranty Disclosure [Abstract]
Product extended warranty expense	$ 3,200	$ 3,400

Pension Plan (Details)

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Retirement Benefits [Abstract]
Service cost	$ 269	$ 248	$ 538	$ 496
Interest cost on projected benefit obligation	537	451	1,074	902
Expected return on plan assets	(1,324)	(1,289)	(2,648)	(2,578)
Net amortization and deferral	648	832	1,296	1,664
Net periodic pension cost	$ 130	$ 242	$ 260	$ 484

Acquisition and Other Expense_2

Acquisition and Other Expense (Details) - USD ($) $ in Thousands		3 Months Ended		6 Months Ended
	Jun. 06, 2022	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021	Jan. 29, 2019
Other Expense [Line Items]
Loss on convertible notes conversion premium				$ (103,125)	$ 0
Loss on convertible notes hedge transactions				(5,460)	0
Loss on early extinguishment of debt				3,426	0
Other expense		$ 112,011	$ 0	112,011	0
Repayments of Senior Debt				92,981	8,281
Repayments of Convertible Debt				275,000	0
2.625 Percent Convertible Notes Due 2024 | Convertible Notes Payable [Member]
Other Expense [Line Items]
Loss on convertible notes conversion premium		(103,100)		(103,100)
Loss on early extinguishment of debt		2,900		2,900
Interest rate, stated percentage						2.625%
Repayments of Convertible Debt	$ 275,000
Amended and Restated Senior Credit Agreement [Member] | Term Loan Facility [Member]
Other Expense [Line Items]
Loss on early extinguishment of debt		500		500
Repayments of Senior Debt		90,000		90,000
Selling and Administrative Expenses
Other Expense [Line Items]
Acquisition and integration costs		2,600	0	2,600	0
Litigation Settlement, Expense		775	0	775	0
Restructuring and related costs		0	0	0	414
Other expense		3,375	0	3,375	414
Selling and Administrative Expenses | Contract Termination [Member]
Other Expense [Line Items]
Restructuring and related costs					400
Cost of Sales
Other Expense [Line Items]
Acquisition and integration costs		349	0	349	0
Other Expense
Other Expense [Line Items]
Loss on convertible notes conversion premium		(103,125)	0	(103,125)	0
Loss on convertible notes hedge transactions		(5,460)	0	(5,460)	0
Loss on early extinguishment of debt		3,426	0	3,426	0
Other expense		$ 112,011	$ 0	$ 112,011	$ 0

Business Segment (Details)

Business Segment (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2022	Jun. 30, 2021	Jun. 30, 2022	Jun. 30, 2021
Segment Reporting Information [Line Items]
Net sales	$ 277,190	$ 255,161	$ 519,516	$ 487,837
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales	120,182	107,893	227,698	215,058
General Surgery
Segment Reporting Information [Line Items]
Net sales	$ 157,008	$ 147,268	$ 291,818	$ 272,779

Legal Proceedings (Details)

Legal Proceedings (Details) - USD ($) $ in Millions	Jan. 18, 2017	Jun. 30, 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