Anika Therapeutics (ANIK) 10-Q 5 May 22 2022 Q1 Quarterly report Financial data

Document And Entity Information

Document And Entity Information - shares	3 Months Ended
	Mar. 31, 2022	Apr. 28, 2022
Document Information [Line Items]
Entity Central Index Key	0000898437
Entity Registrant Name	Anika Therapeutics, Inc.
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Document Fiscal Period Focus	Q1
Document Fiscal Year Focus	2022
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2022
Document Transition Report	false
Entity File Number	001-14027
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	04-3145961
Entity Address, Address Line One	32 Wiggins Avenue
Entity Address, City or Town	Bedford
Entity Address, State or Province	MA
Entity Address, Postal Zip Code	01730
City Area Code	781
Local Phone Number	457-9000
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	ANIK
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		14,543,860

Consolidated Balance Sheets (Cu

Consolidated Balance Sheets (Current Period Unaudited) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 90,325	$ 94,386
Accounts receivable, less allowance for credit losses of $1,350 and $1,442 at March 31, 2022 and December 31, 2021, respectively	29,313	29,843
Inventories, net	35,225	36,010
Prepaid expenses and other current assets	10,459	8,289
Total current assets	165,322	168,528
Property and equipment, net	47,954	47,602
Right-of-use assets	20,517	20,957
Other long-term assets	20,385	20,285
Intangible assets, net	80,436	82,382
Goodwill	7,625	7,781
Total assets	342,239	347,535
Current liabilities:
Accounts payable	7,444	7,633
Accrued expenses and other current liabilities	15,233	17,847
Contingent consideration	4,315	4,315
Total current liabilities	26,992	29,795
Other long-term liabilities	684	1,258
Deferred tax liability	9,956	10,157
Lease liabilities	18,820	19,240
Commitments and contingencies (Note 9)
Stockholders’ equity:
Preferred stock, $0.01 par value; 1,250 shares authorized, no shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively		0
Common stock, $0.01 par value; 90,000 shares authorized, 14,518 and 14,441 shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively	145	144
Additional paid-in-capital	68,796	67,081
Accumulated other comprehensive loss	(5,799)	(5,718)
Retained earnings	222,645	225,578
Total stockholders’ equity	285,787	287,085
Total liabilities and stockholders’ equity	$ 342,239	$ 347,535

Consolidated Balance Sheets (_2

Consolidated Balance Sheets (Current Period Unaudited) (Parentheticals) - USD ($) shares in Thousands, $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Accounts receivable, reserves	$ 1,350	$ 1,442
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	1,250	1,250
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	90,000	90,000
Common stock, shares issued (in shares)	14,518	14,441
Common stock, shares outstanding (in shares)	14,518	14,441

Consolidated Statements of Oper

Consolidated Statements of Operations and Comprehensive Income (Loss) (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue	$ 36,693	$ 34,292
Cost of revenue	14,889	13,318
Gross Profit	21,804	20,974
Operating expenses:
Research and development	6,157	6,361
Selling, general and administrative	19,201	18,175
Change in fair value of contingent consideration	0	(4,820)
Total operating expenses	25,358	19,716
(Loss) income from operations	(3,554)	1,258
Interest and other income (expense), net	(154)	(43)
(Loss) income before income taxes	(3,708)	1,215
Benefit from income taxes	(775)	(1,623)
Net (loss) income	$ (2,933)	$ 2,838
Net (loss) income per share:
Basic (in dollars per share)	$ (0.20)	$ 0.20
Diluted (in dollars per share)	$ (0.20)	$ 0.20
Weighted average common shares outstanding:
Basic (in shares)	14,466	14,343
Diluted (in shares)	14,466	14,435
Net (loss) income	$ (2,933)	$ 2,838
Foreign currency translation adjustment	(81)	(509)
Comprehensive (loss) income	$ (3,014)	$ 2,329

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands	Restricted Stock Units (RSUs) [Member]Common Stock [Member]	Restricted Stock Units (RSUs) [Member]Additional Paid-in Capital [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Total
Balance (in shares) at Dec. 31, 2020			14,329
Balance at Dec. 31, 2020			$ 143	$ 55,355	$ 221,444	$ (4,542)	$ 272,400
Issuance of common stock for equity awards (in shares)			0
Issuance of common stock for equity awards			$ 0	1	0	0	1
Vesting of restricted stock units (in shares)	46
Vesting of restricted stock units	$ 1	$ (1)
Stock-based compensation expense			$ 0	2,259	0	0	2,259
Retirement of common stock for minimum tax withholdings (in shares)			(9)
Retirement of common stock for minimum tax withholdings			$ 0	(333)	0	0	(333)
Net (loss) income			0	0	2,838	0	2,838
Other comprehensive loss			$ 0	0	0	(509)	(509)
Balance (in shares) at Mar. 31, 2021			14,366
Balance at Mar. 31, 2021			$ 144	57,281	224,282	(5,051)	276,656
Balance (in shares) at Dec. 31, 2021			14,441
Balance at Dec. 31, 2021			$ 144	67,081	225,578	(5,718)	287,085
Issuance of common stock for equity awards (in shares)			1
Issuance of common stock for equity awards			$ 0	15	0	0	15
Vesting of restricted stock units (in shares)	106
Vesting of restricted stock units	$ 1	$ (1)
Stock-based compensation expense			$ 0	2,545	0	0	2,545
Retirement of common stock for minimum tax withholdings (in shares)			(30)
Retirement of common stock for minimum tax withholdings			$ 0	(844)	0	0	(844)
Net (loss) income			0	0	(2,933)	0	(2,933)
Other comprehensive loss			$ 0	0	0	(81)	(81)
Balance (in shares) at Mar. 31, 2022			14,518
Balance at Mar. 31, 2022			$ 145	$ 68,796	$ 222,645	$ (5,799)	$ 285,787

Consolidated Statements of Cash

Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows from operating activities:
Net (loss) income	$ (2,933)	$ 2,838
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	1,671	1,545
Amortization of acquisition related intangible assets	1,946	1,963
Amortization of acquisition related inventory step-up	0	2,578
Non-cash operating lease cost	403	405
Change in fair value of contingent consideration	0	(4,820)
Loss on disposal of fixed assets	0	831
Stock-based compensation expense	2,545	2,259
Deferred income taxes	(273)	(1,162)
Provision (recovery) for credit losses	5	(21)
Provision for inventory	586	277
Changes in operating assets and liabilities:
Accounts receivable	383	(2,478)
Inventories	(602)	(4,040)
Prepaid expenses, other current and long-term assets	(1,189)	87
Accounts payable	(473)	188
Operating lease liabilities	(387)	(385)
Accrued expenses, other current and long-term liabilities	(2,929)	(1,254)
Income taxes	(622)	(1,242)
Net cash used in operating activities	(1,869)	(2,431)
Cash flows from investing activities:
Acquisition of Parcus Medical and Arthrosurface, net of cash acquired	0	(350)
Proceeds from maturities of investments	0	2,501
Purchases of property and equipment	(1,326)	(417)
Net cash (used in) provided by investing activities	(1,326)	1,734
Cash flows from financing activities:
Cash paid for tax withheld on vested restricted stock awards	(846)	(332)
Proceeds from exercises of equity awards	15	0
Payments made on finance leases	(31)	(119)
Net cash used in financing activities	(862)	(451)
Exchange rate impact on cash	(4)	(70)
Decrease in cash and cash equivalents	(4,061)	(1,218)
Cash and cash equivalents at beginning of period	94,386	95,817
Cash and cash equivalents at end of period	90,325	94,599
Non-cash Investing Activities:
Purchases of property and equipment included in accounts payable and accrued expenses	728	570
Accounting Standards Update 2016-02 [Member]
Non-cash Investing Activities:
Right-of-use assets obtained in exchange for operating lease liabilities	$ 0	$ 220

Note 1 - Nature of Business

Note 1 - Nature of Business	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Nature of Operations [Text Block]	1. Nature of Business Anika Therapeutics, Inc. (the “Company”) is a global joint preservation company that creates and delivers meaningful advancements in early intervention orthopedic care, including in the areas of osteoarthritis (“OA”) pain management, regenerative solutions, soft tissue repair and bone preserving joint technologies. In early 2020, 30 The Company is subject to risks common to companies in the life sciences industry including, but not There continue to be uncertainties regarding the pandemic of the novel coronavirus (“COVID- 19” 19 19 may may 19.

Note 2 - Basis of Presentation

Note 2 - Basis of Presentation	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Business Description and Basis of Presentation [Text Block]	2. Basis of Presentation The accompanying unaudited condensed consolidated financial statements and related notes have been prepared by the Company pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) and in accordance with accounting principles generally accepted in the United States (“US GAAP”). The financial statements include the accounts of Anika Therapeutics, Inc. and its subsidiaries. Inter-company transactions and balances have been eliminated. Certain information and footnote disclosures normally included in annual financial statements prepared in accordance with US GAAP have been or omitted pursuant to SEC rules and regulations relating to interim financial statements. The December 31, 2021 The accompanying unaudited condensed consolidated financial statements and related notes should be read in conjunction with the Company’s annual financial statements filed with its Annual Report on Form 10 December 31, 2021. three March 31, 2022 not December 31, 2022. Segment Information Operating segments are components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company’s chief operating decision maker as of March 31, 2022 280, Segment Reportin one

Note 3 - Business Combinations

Note 3 - Business Combinations	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Business Combination Disclosure [Text Block]	3. Business Combinations Parcus Medical, LLC On January 24, 2020, January 4, 2020 ( Consideration Transferred Pursuant to the Parcus Medical Merger Agreement, the Company acquired all outstanding equity of Parcus Medical for estimated total purchase consideration of $75.1 million, as of January 24, 2020, Cash consideration $ 32,794 Deferred consideration 1,642 Estimated fair value of contingent consideration 40,700 Estimated total purchase consideration $ 75,136 Pursuant to the Parcus Medical Merger Agreement, contingent consideration represents additional payments that the Company may 2020 2022. The fair value of contingent consideration related to net sales as of January 24, 2020, March 31, 2022 March 31, 2022. The deferred consideration related to certain purchase price holdbacks was resolved within one March 31, 2022, March 31, 2022 not Acquisition-related costs were not three March 31, 2020. March 31, 2020 Fair Value of Net Assets Acquired The estimate of fair value as of the acquisition date required the use of significant assumptions and estimates. Critical estimates included, but were not may The allocation of purchase price to the identifiable assets acquired and liabilities assumed was based on estimates of fair value as of January 24, 2020, Recognized identifiable assets acquired and liabilities assumed: Cash and cash equivalents $ 196 Accounts receivable 2,029 Inventories 10,968 Prepaid expenses and other current assets 364 Property and equipment, net 1,099 Right-of-use assets 944 Intangible assets 44,000 Accounts payable, accrued expenses and other current liabilities (2,763 ) Other long-term liabilities (594 ) Lease liabilities (735 ) Net assets acquired 55,508 Goodwill 19,628 Estimated total purchase consideration $ 75,136 Subsequent to the acquisition date, during the three September 30, 2020, January 24, 2020 The acquired intangible assets based on estimates of fair value as of January 24, 2020 Developed technology $ 41,100 Trade name 1,800 Customer relationships 1,100 Total acquired intangible assets $ 44,000 The fair value of developed technology will be amortized over a useful life of 15 years, the fair value of customer relationships over 10 years, and the fair value of the trade name over 5 years. The excess of the purchase price over the fair value of the net assets acquired was recorded as goodwill and assigned to the newly established reporting unit for Parcus Medical and Arthrosurface. The goodwill was impaired in 2020 no December 31, 2020. Arthrosurface, Inc. On February 3, 2020, January 4, 2020 ( Consideration Transferred Pursuant to the Arthrosurface Merger Agreement, the Company acquired all outstanding equity of Arthrosurface for estimated total purchase consideration of $90.3 million, as of February 3, 2020 Cash consideration $ 61,909 Estimated fair value of contingent consideration 28,376 Estimated total purchase consideration $ 90,285 Pursuant to the Arthrosurface Merger Agreement, the Company could be required to make future payments of up to $40.0 million depending on the achievement of regulatory milestones and the level of net sales of Arthrosurface products from 2020 2021. February 3, 2020 February 3, 2020 October 2020 July 2021 two December 31, 2021, no Acquisition-related costs were not three March 31, 2020. March 31, 2020 Fair Value of Net Assets Acquired The estimate of fair value required the use of significant assumptions and estimates. Critical estimates included, but were not may The allocation of purchase price to the identifiable assets acquired and liabilities assumed was based on estimates of fair value as of February 3, 2020, Recognized identifiable assets acquired and liabilities assumed: Cash and cash equivalents $ 1,072 Accounts receivable 5,368 Inventories 15,652 Prepaid expenses and other current assets 535 Property, plant and equipment 3,394 Other long-term assets 7,548 Intangible assets 48,900 Accounts payable, accrued expenses and other liabilities (3,929 ) Deferred tax liabilities (11,147 ) Net assets acquired 67,393 Goodwill 22,892 Estimated total purchase consideration $ 90,285 Intangible assets acquired consist of: Developed technology $ 37,000 Trade name 3,400 Customer relationships 7,900 IPR&D 600 Total acquired intangible assets $ 48,900 The fair value of developed technology will be amortized over an estimated useful life of 15 years, the fair value of customer relationships over 10 years, and the fair value of trade names over 5 years. A total of $0.6 million represents the fair value of IPR&D with an indefinite useful life which was impaired during the quarter ended December 31, 2021. The excess of the purchase price over the fair value of the net assets acquired was recorded as goodwill and assigned to the newly established reporting unit for Parcus Medical and Arthrosurface. The Goodwill was impaired in 2020 no December 31, 2020.

Note 4 - Fair Value Measurement

Note 4 - Fair Value Measurements	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Fair Value Disclosures [Text Block]	4. Fair Value Measurements The Company has certain cash equivalents in money market funds that are classified within Level 1 not 3 no three March 31, 2022 2021. 3, Business Combinations March 31, 2022. The classification of the Company’s cash equivalents and other current liabilities within the fair value hierarchy was as follows: Active Markets for Identical Assets Significant Other Significant (Unadjusted) Observable Inputs Unobservable Inputs March 31, 2022 (Level 1) (Level 2) (Level 3) Amortized Cost Cash equivalents: Money Market Funds $ 67,052 $ 67,052 $ - $ - $ 67,052 Other current liabilities: Contingent Consideration - Short Term $ 4,315 $ - $ - $ 4,315 $ - Active Markets for Identical Assets Significant Other Significant (Unadjusted) Observable Inputs Unobservable Inputs December 31, 2021 (Level 1) (Level 2) (Level 3) Amortized Cost Cash equivalents: Money Market Funds $ 67,046 $ 67,046 $ - $ - $ 67,046 Other current liabilities: Contingent Consideration - Short Term $ 4,315 $ - $ - $ 4,315 $ - The following table provides a rollforward of the contingent consideration related to business acquisitions discussed in Note 3, Business Combinations Three Months Ended March 31, 2022 2021 Balance, beginning $ 4,315 $ 35,410 Change in fair value - (4,820 ) Balance, ending $ 4,315 $ 30,590

Note 5 - Inventories

Note 5 - Inventories	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Inventory Disclosure [Text Block]	5. Inventories Inventories consist of the following: March 31, December 31, 2022 2021 Raw materials $ 16,901 $ 16,881 Work-in-process 13,599 11,442 Finished goods 24,257 26,731 Total $ 54,757 $ 55,054 Inventories $ 35,225 $ 36,010 Other long-term assets 19,532 19,044 Total $ 54,757 $ 55,054 Inventories are stated net of inventory reserves of approximately $6.9 million and $9.1 million, as of March 31, 2022 December 31, 2021,

Note 6 - Intangible Assets

Note 6 - Intangible Assets	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	6. Intangible Assets Intangible assets as of March 31, 2022 December 31, 2021 Three Months Ended March 31, 2022 December 31, 2021 Gross Value Less: Accumulated Currency Translation Adjustment Less: Accumulated Amortization Net Book Value Net Book Value Weighted Average Useful Life Developed technology $ 89,580 $ (1,608 ) $ (19,340 ) $ 68,632 $ 70,081 15 IPR&D 2,656 (1,006 ) - 1,650 1,650 Indefinite Customer relationships 9,000 - (1,952 ) 7,048 7,273 10 Distributor relationships 4,700 (415 ) (4,285 ) - - 5 Patents 1,000 (189 ) (644 ) 167 179 16 Tradenames 5,200 - (2,261 ) 2,939 3,199 5 Total $ 112,136 $ (3,218 ) $ (28,482 ) $ 80,436 $ 82,382 13 The aggregate amortization expense related to intangible assets was $1.9 million for the three March 31, 2022 2021.

Note 7 - Goodwill

Note 7 - Goodwill	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Goodwill Disclosure [Text Block]	7. Goodwill The Company assesses goodwill for impairment annually, or, under certain circumstances, more frequently, such as when events or changes in circumstances indicate there may Changes in the carrying value of goodwill for the three March 31, 2022 Three Month Ended March 31, 2022 Balance, beginning $ 7,781 Effect of foreign currency adjustments (156 ) Balance, ending $ 7,625

Note 8 - Accrued Expenses

Note 8 - Accrued Expenses	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Accounts Payable and Accrued Liabilities Disclosure [Text Block]	8. Accrued Expenses Accrued expenses consist of the following: March 31, 2022 December 31, 2021 Compensation and related expenses $ 7,457 $ 9,523 Professional fees 2,967 3,590 Operating lease liability - current 1,528 1,526 Clinical trial costs 2,014 1,961 Financing lease liability - current 122 188 Other 1,145 1,059 Total $ 15,233 $ 17,847

Note 9 - Commitments and Contin

Note 9 - Commitments and Contingencies	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	9. Commitments and Contingencies In certain of its contracts, the Company warrants to its customers that the products it manufactures conform to the product specifications as in effect at the time of delivery of the specific product. The Company may not third March 31, 2022 December 31, 2021 no The Company is also involved from time-to-time in various legal proceedings arising in the normal course of business. Although the outcomes of these legal proceedings are inherently difficult to predict, the Company does not On October 21, 2021, not 2022.

Note 10 - Revenue and Geographi

Note 10 - Revenue and Geographic Information	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Revenue from Contract with Customer [Text Block]	10. Revenue and Geographic Information Revenue by product family was as follows: Three Months Ended March 31, 2022 2021 OA Pain Management $ 22,733 $ 19,316 Joint Preservation and Restoration 12,139 12,219 Non-Orthopedic 1,821 2,757 Total $ 36,693 $ 34,292 Revenue from the Company’s sole significant customer, DePuy Synthes Mitek Sports Medicine, part of the Johnson & Johnson Medical Companies, as a percentage of the Company’s total revenue was 39% and 41% for the three March 31, 2022 2021, The Company receives payments from its customers based on billing schedules established in each contract. Up-front payments and fees are recorded as deferred revenue upon receipt or when due, and may March 31, 2022 December 31, 2021, Total revenue by geographic location based on the location of the customer in total and as a percentage of total revenue were as follows: Three Months Ended March 31, 2022 2021 Percentage of Percentage of Revenue Revenue Revenue Revenue Geographic Location: United States $ 26,773 73 % $ 25,005 73 % Europe 5,796 16 % 5,480 16 % Other 4,124 11 % 3,807 11 % Total $ 36,693 100 % $ 34,292 100 %

Note 11 - Equity Incentive Plan

Note 11 - Equity Incentive Plan	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Share-Based Payment Arrangement [Text Block]	11. Equity Incentive Plan Equity Incentive Plan The Anika Therapeutics, Inc. 2017 “2017 June 13, 2017 June 18, 2019, June 16, 2020 June 16, 2021. 2017 may 2017 no may 2017 March 31, 2022 2017 The Anika Therapeutics, Inc. 2021 November 4, 2021. may not 2017 March 31, 2022 The Company may three ten The Company presents the expenses related to stock-based compensation awards in the same expense line items as cash compensation paid to each of its employees as follows (in thousands): Three Months Ended March 31, 2022 2021 Cost of revenue $ 176 $ 129 Research and development 367 241 Selling, general and administrative 2,002 1,889 Total stock-based compensation expense $ 2,545 $ 2,259 Stock Options Stock options are granted to purchase common shares at prices that are equal to the fair market value of the shares on the date the options are granted or, in the case of premium options, are granted with an exercise price at 110% of the market price of the Company’s common stock on the date of grant. Options generally vest in equal annual installments over a period of three The following summarizes the activity under the Company’s stock option plans: Number of Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term (in years) Aggregate Intrinsic Value (in thousands) Outstanding as of December 31, 2021 1,175,993 $ 39.56 Granted 416,197 $ 28.37 Exercised (437 ) $ 9.10 $ 10 Forfeited and canceled (47,858 ) $ 38.23 Outstanding as of March 31, 2022 1,543,895 $ 36.59 8.6 $ 9 Vested, March 31, 2022 485,869 $ 41.89 7.5 $ 9 Vested or expected to vest, March 31, 2022 1,543,895 $ 36.59 8.6 $ 9 The aggregate intrinsic value of options exercised for the three March 31, 2021 The Company granted 416,197 stock options during the three March 31, 2022, The Company uses the Black-Scholes pricing model to determine the fair value of options granted. The calculation of the fair value of stock options is affected by the stock price on the grant date, the expected volatility of the Company’s common stock over the expected term of the award, the expected life of the award, the risk-free interest rate and the dividend yield. The Company estimates the fair value of TSRs using Monte-Carlo simulation model where the expected volatility assumption is evaluated over 6.3 years. The actual number of TSR options that may March 31, 2022. The assumptions used in the Black-Scholes pricing model for options granted during the three March 31, 2022 2021, Three Months Ended March 31, 2022 2021 Risk free interest rate 1.3 % - 1.9 % 0.3 % - 0.6 % Expected volatility 53.8 % - 54.6 % 54.8 % - 55.4 % Expected life (years) 4.5 4.0 Expected dividend yield 0.0 % 0.0 % Fair value per option $ 11.37 $ 13.90 As of March 31, 2022, Restricted Stock Units RSUs generally vest in equal annual installments over a three RSU activity for the three March 31, 2022 Number of Shares Weighted Average Fair Value Outstanding as of December 31, 2021 412,658 $ 36.33 Granted 420,452 $ 25.75 Vested (87,953 ) $ 35.19 Forfeited and cancelled (32,376 ) $ 35.27 Outstanding as of March 31, 2022 712,781 $ 30.28 The weighted-average grant-date fair value per share of RSUs granted was $34.07 for the three March 31, 2021. three March 31, 2022 2021, As of March 31, 2022, Performance Stock Units PSU activity for the three March 31, 2022 Number of Shares Weighted Average Fair Value Outstanding as of December 31, 2021 158,297 $ 37.44 Performance factor adjustment 2,125 $ 32.53 Vested (19,125 ) $ 32.53 Forfeited and cancelled (23,400 ) $ 41.86 Outstanding as of March 31, 2022 117,897 $ 34.98 The total fair value of PSUs vested was $0.6 million for the three March 31, 2022. March 31, 2022, none Employee Stock Purchase Plan On March 17, 2021, 2021 may six first 2022 Risk-free interest rate 0.06 % Expected stock price volatility 32.58 % Expected life of options (in years) 0.5 Expected dividend yield 0.0 %

Note 12 - Income Taxes

Note 12 - Income Taxes	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Income Tax Disclosure [Text Block]	12. Income Taxes The Company recorded an income tax benefit of $0.8 million for the three March 31, 2022, three March 31, 2021, three March 31, 2022, 2021, first 2021. first 2022 The Company files income tax returns in the United States on a federal basis, in certain U.S. states, and in certain foreign jurisdictions. The associated tax filings remain subject to examination by applicable tax authorities for a certain length of time following the tax year to which those filings relate, which varies by jurisdiction. In connection with the preparation of the financial statements, the Company assessed whether it is more likely than not not December 31, 2021, not March 31, 2022.

Note 13 - Earnings Per Share ("

Note 13 - Earnings Per Share ("EPS")	3 Months Ended
	Mar. 31, 2022
Notes to Financial Statements
Earnings Per Share [Text Block]	13. Earnings Per Share ( EPS ) Basic EPS is calculated by dividing net income (loss) by the weighted average number of shares outstanding during the period. Unvested restricted shares, although legally issued and outstanding, are not The following table provides share information used in the calculation of the Company's basic and diluted earnings per share (in thousands): Three Months Ended March 31, 2022 2021 Shares used in the calculation of basic EPS 14,466 14,343 Effect of dilutive securities: Share based awards - 92 Diluted shares used in the calculation of EPS 14,466 14,435 The Company had a net loss during the three March 31, 2022, three March 31, 2021 not

Significant Accounting Policies

Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Segment Reporting, Policy [Policy Text Block]	Segment Information Operating segments are components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker, or decision-making group, in deciding how to allocate resources and in assessing performance. The Company’s chief operating decision maker as of March 31, 2022 280, Segment Reportin one

Note 3 - Business Combinations

Note 3 - Business Combinations (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Business Acquisitions, by Acquisition [Table Text Block]	Cash consideration $ 32,794 Deferred consideration 1,642 Estimated fair value of contingent consideration 40,700 Estimated total purchase consideration $ 75,136 Cash consideration $ 61,909 Estimated fair value of contingent consideration 28,376 Estimated total purchase consideration $ 90,285
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]	Recognized identifiable assets acquired and liabilities assumed: Cash and cash equivalents $ 196 Accounts receivable 2,029 Inventories 10,968 Prepaid expenses and other current assets 364 Property and equipment, net 1,099 Right-of-use assets 944 Intangible assets 44,000 Accounts payable, accrued expenses and other current liabilities (2,763 ) Other long-term liabilities (594 ) Lease liabilities (735 ) Net assets acquired 55,508 Goodwill 19,628 Estimated total purchase consideration $ 75,136 Recognized identifiable assets acquired and liabilities assumed: Cash and cash equivalents $ 1,072 Accounts receivable 5,368 Inventories 15,652 Prepaid expenses and other current assets 535 Property, plant and equipment 3,394 Other long-term assets 7,548 Intangible assets 48,900 Accounts payable, accrued expenses and other liabilities (3,929 ) Deferred tax liabilities (11,147 ) Net assets acquired 67,393 Goodwill 22,892 Estimated total purchase consideration $ 90,285 Intangible assets acquired consist of: Developed technology $ 37,000 Trade name 3,400 Customer relationships 7,900 IPR&D 600 Total acquired intangible assets $ 48,900
Schedule of Finite-Lived Intangible Assets Acquired as Part of Business Combination [Table Text Block]	Developed technology $ 41,100 Trade name 1,800 Customer relationships 1,100 Total acquired intangible assets $ 44,000

Note 4 - Fair Value Measureme_2

Note 4 - Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Fair Value, Assets Measured on Recurring Basis [Table Text Block]	Active Markets for Identical Assets Significant Other Significant (Unadjusted) Observable Inputs Unobservable Inputs March 31, 2022 (Level 1) (Level 2) (Level 3) Amortized Cost Cash equivalents: Money Market Funds $ 67,052 $ 67,052 $ - $ - $ 67,052 Other current liabilities: Contingent Consideration - Short Term $ 4,315 $ - $ - $ 4,315 $ - Active Markets for Identical Assets Significant Other Significant (Unadjusted) Observable Inputs Unobservable Inputs December 31, 2021 (Level 1) (Level 2) (Level 3) Amortized Cost Cash equivalents: Money Market Funds $ 67,046 $ 67,046 $ - $ - $ 67,046 Other current liabilities: Contingent Consideration - Short Term $ 4,315 $ - $ - $ 4,315 $ -
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]	Three Months Ended March 31, 2022 2021 Balance, beginning $ 4,315 $ 35,410 Change in fair value - (4,820 ) Balance, ending $ 4,315 $ 30,590

Note 5 - Inventories (Tables)

Note 5 - Inventories (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Inventory, Current [Table Text Block]	March 31, December 31, 2022 2021 Raw materials $ 16,901 $ 16,881 Work-in-process 13,599 11,442 Finished goods 24,257 26,731 Total $ 54,757 $ 55,054 Inventories $ 35,225 $ 36,010 Other long-term assets 19,532 19,044 Total $ 54,757 $ 55,054

Note 6 - Intangible Assets (Tab

Note 6 - Intangible Assets (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Finite-Lived and Indefinite-Lived Intangible Assets by Major Class [Table Text Block]	Three Months Ended March 31, 2022 December 31, 2021 Gross Value Less: Accumulated Currency Translation Adjustment Less: Accumulated Amortization Net Book Value Net Book Value Weighted Average Useful Life Developed technology $ 89,580 $ (1,608 ) $ (19,340 ) $ 68,632 $ 70,081 15 IPR&D 2,656 (1,006 ) - 1,650 1,650 Indefinite Customer relationships 9,000 - (1,952 ) 7,048 7,273 10 Distributor relationships 4,700 (415 ) (4,285 ) - - 5 Patents 1,000 (189 ) (644 ) 167 179 16 Tradenames 5,200 - (2,261 ) 2,939 3,199 5 Total $ 112,136 $ (3,218 ) $ (28,482 ) $ 80,436 $ 82,382 13

Note 7 - Goodwill (Tables)

Note 7 - Goodwill (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Goodwill [Table Text Block]	Three Month Ended March 31, 2022 Balance, beginning $ 7,781 Effect of foreign currency adjustments (156 ) Balance, ending $ 7,625

Note 8 - Accrued Expenses (Tabl

Note 8 - Accrued Expenses (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Accrued Liabilities [Table Text Block]	March 31, 2022 December 31, 2021 Compensation and related expenses $ 7,457 $ 9,523 Professional fees 2,967 3,590 Operating lease liability - current 1,528 1,526 Clinical trial costs 2,014 1,961 Financing lease liability - current 122 188 Other 1,145 1,059 Total $ 15,233 $ 17,847

Note 10 - Revenue and Geograp_2

Note 10 - Revenue and Geographic Information (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Revenue from External Customers by Products and Services [Table Text Block]	Three Months Ended March 31, 2022 2021 OA Pain Management $ 22,733 $ 19,316 Joint Preservation and Restoration 12,139 12,219 Non-Orthopedic 1,821 2,757 Total $ 36,693 $ 34,292
Schedule of Revenue and Operating Income by Geographical Areas [Table Text Block]	Three Months Ended March 31, 2022 2021 Percentage of Percentage of Revenue Revenue Revenue Revenue Geographic Location: United States $ 26,773 73 % $ 25,005 73 % Europe 5,796 16 % 5,480 16 % Other 4,124 11 % 3,807 11 % Total $ 36,693 100 % $ 34,292 100 %

Note 11 - Equity Incentive Pl_2

Note 11 - Equity Incentive Plan (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Share-Based Payment Arrangement, Expensed and Capitalized, Amount [Table Text Block]	Three Months Ended March 31, 2022 2021 Cost of revenue $ 176 $ 129 Research and development 367 241 Selling, general and administrative 2,002 1,889 Total stock-based compensation expense $ 2,545 $ 2,259
Share-Based Payment Arrangement, Option, Activity [Table Text Block]	Number of Options Weighted Average Exercise Price Weighted Average Remaining Contractual Term (in years) Aggregate Intrinsic Value (in thousands) Outstanding as of December 31, 2021 1,175,993 $ 39.56 Granted 416,197 $ 28.37 Exercised (437 ) $ 9.10 $ 10 Forfeited and canceled (47,858 ) $ 38.23 Outstanding as of March 31, 2022 1,543,895 $ 36.59 8.6 $ 9 Vested, March 31, 2022 485,869 $ 41.89 7.5 $ 9 Vested or expected to vest, March 31, 2022 1,543,895 $ 36.59 8.6 $ 9
Schedule of Share-Based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	Three Months Ended March 31, 2022 2021 Risk free interest rate 1.3 % - 1.9 % 0.3 % - 0.6 % Expected volatility 53.8 % - 54.6 % 54.8 % - 55.4 % Expected life (years) 4.5 4.0 Expected dividend yield 0.0 % 0.0 % Fair value per option $ 11.37 $ 13.90 2022 Risk-free interest rate 0.06 % Expected stock price volatility 32.58 % Expected life of options (in years) 0.5 Expected dividend yield 0.0 %
Share-Based Payment Arrangement, Restricted Stock and Restricted Stock Unit, Activity [Table Text Block]	Number of Shares Weighted Average Fair Value Outstanding as of December 31, 2021 412,658 $ 36.33 Granted 420,452 $ 25.75 Vested (87,953 ) $ 35.19 Forfeited and cancelled (32,376 ) $ 35.27 Outstanding as of March 31, 2022 712,781 $ 30.28
Schedule of Nonvested Performance-Based Units Activity [Table Text Block]	Number of Shares Weighted Average Fair Value Outstanding as of December 31, 2021 158,297 $ 37.44 Performance factor adjustment 2,125 $ 32.53 Vested (19,125 ) $ 32.53 Forfeited and cancelled (23,400 ) $ 41.86 Outstanding as of March 31, 2022 117,897 $ 34.98

Note 13 - Earnings Per Share _2

Note 13 - Earnings Per Share ("EPS") (Tables)	3 Months Ended
	Mar. 31, 2022
Notes Tables
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Three Months Ended March 31, 2022 2021 Shares used in the calculation of basic EPS 14,466 14,343 Effect of dilutive securities: Share based awards - 92 Diluted shares used in the calculation of EPS 14,466 14,435

Note 3 - Business Combination_2

Note 3 - Business Combinations (Details Textual) $ in Thousands	Feb. 03, 2020USD ($)	Jan. 24, 2020USD ($)	Jul. 31, 2021USD ($)	Oct. 31, 2020USD ($)	Mar. 31, 2022USD ($)	Mar. 31, 2020USD ($)	Dec. 31, 2021USD ($)
Business Combination, Contingent Consideration, Liability, Current					$ 4,315		$ 4,315
Finite-Lived Intangible Asset, Useful Life (Year)					13 years
Developed Technology Rights [Member]
Finite-Lived Intangible Asset, Useful Life (Year)					15 years
Customer Relationships [Member]
Finite-Lived Intangible Asset, Useful Life (Year)					10 years
Trade Names [Member]
Finite-Lived Intangible Asset, Useful Life (Year)					5 years
Parcus Medical [Member]
Business Combination, Consideration Transferred, Total		$ 75,136
Business Combination, Contingent Consideration Arrangements, Change in Range of Outcomes, Contingent Consideration, Liability, Value, High		60,000
Business Combination, Contingent Consideration, Liability, Current					$ 4,300
Business Combination, Acquisition Related Costs						$ 1,900
Business Combination, Provisional Information, Initial Accounting Incomplete, Adjustment, Inventory		1,900
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles		$ 44,000
Parcus Medical [Member] | Developed Technology Rights [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		15 years
Parcus Medical [Member] | Customer Relationships [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		10 years
Parcus Medical [Member] | Trade Names [Member]
Finite-Lived Intangible Asset, Useful Life (Year)		5 years
Parcus Medical [Member] | Measurement Input, Weighted Average Cost of Capital [Member]
Business Combination, Contingent Consideration, Liability, Measurement Input					11.5
Parcus Medical [Member] | Minimum [Member] | Measurement Input, Discount Rate [Member]
Business Combination, Contingent Consideration, Liability, Measurement Input					3.2
Parcus Medical [Member] | Maximum [Member] | Measurement Input, Discount Rate [Member]
Business Combination, Contingent Consideration, Liability, Measurement Input					4.1
Arthrosurface [Member]
Business Combination, Consideration Transferred, Total	$ 90,285
Business Combination, Contingent Consideration Arrangements, Change in Range of Outcomes, Contingent Consideration, Liability, Value, High	40,000
Business Combination, Acquisition Related Costs						$ 2,200
Payment for Contingent Consideration Liability, Financing Activities			$ 10,000	$ 5,000
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles	$ 48,900
Arthrosurface [Member] | Developed Technology Rights [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	15 years
Arthrosurface [Member] | Customer Relationships [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	10 years
Arthrosurface [Member] | Trade Names [Member]
Finite-Lived Intangible Asset, Useful Life (Year)	5 years
Arthrosurface [Member] | In Process Research and Development [Member]
Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Finite-Lived Intangibles							$ 600

Note 3 - Business Combination_3

Note 3 - Business Combinations - Consideration Transferred (Details) - USD ($) $ in Thousands	Feb. 03, 2020	Jan. 24, 2020
Parcus Medical [Member]
Cash consideration		$ 32,794
Deferred consideration		1,642
Estimated fair value of contingent consideration		40,700
Estimated total purchase consideration		$ 75,136
Arthrosurface [Member]
Cash consideration	$ 61,909
Estimated fair value of contingent consideration	28,376
Estimated total purchase consideration	$ 90,285

Note 3 - Business Combination_4

Note 3 - Business Combinations - Fair Value of Net Assets Acquired (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021	Feb. 03, 2020	Jan. 24, 2020
Goodwill	$ 7,625	$ 7,781
Parcus Medical [Member]
Cash and cash equivalents				$ 196
Accounts receivable				2,029
Inventories				10,968
Prepaid expenses and other current assets				364
Property and equipment, net				1,099
Right-of-use assets				944
Intangible assets				44,000
Accounts payable, accrued expenses and other current liabilities				(2,763)
Other long-term liabilities				(594)
Lease liabilities				(735)
Net assets acquired				55,508
Goodwill				19,628
Estimated total purchase consideration				75,136
Intangible assets				44,000
Parcus Medical [Member] | Developed Technology Rights [Member]
Intangible assets				41,100
Parcus Medical [Member] | Trade Names [Member]
Intangible assets				1,800
Parcus Medical [Member] | Customer Relationships [Member]
Intangible assets				$ 1,100
Arthrosurface [Member]
Cash and cash equivalents			$ 1,072
Accounts receivable			5,368
Inventories			15,652
Prepaid expenses and other current assets			535
Property and equipment, net			3,394
Intangible assets			48,900
Accounts payable, accrued expenses and other current liabilities			(3,929)
Net assets acquired			67,393
Goodwill			22,892
Estimated total purchase consideration			90,285
Other long-term assets			7,548
Deferred tax liabilities			(11,147)
Intangible assets			48,900
Arthrosurface [Member] | Developed Technology Rights [Member]
Intangible assets			37,000
Arthrosurface [Member] | Trade Names [Member]
Intangible assets			3,400
Arthrosurface [Member] | Customer Relationships [Member]
Intangible assets			7,900
Arthrosurface [Member] | In Process Research and Development [Member]
Intangible assets		$ 600
Intangible assets			$ 600

Note 3 - Business Combination_5

Note 3 - Business Combinations - Intangible Assets Acquired (Details) - Parcus Medical [Member] $ in Millions	Jan. 24, 2020USD ($)
Intangible assets	$ 44
Developed Technology Rights [Member]
Intangible assets	41.1
Trade Names [Member]
Intangible assets	1.8
Customer Relationships [Member]
Intangible assets	$ 1.1

Note 4 - Fair Value Measureme_3

Note 4 - Fair Value Measurements - Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Business Combination, Contingent Consideration, Liability, Current	$ 4,315	$ 4,315
Estimate of Fair Value Measurement [Member]
Business Combination, Contingent Consideration, Liability, Current	4,315	4,315
Estimate of Fair Value Measurement [Member] | Fair Value, Inputs, Level 1 [Member]
Business Combination, Contingent Consideration, Liability, Current	0	0
Estimate of Fair Value Measurement [Member] | Fair Value, Inputs, Level 2 [Member]
Business Combination, Contingent Consideration, Liability, Current	0	0
Estimate of Fair Value Measurement [Member] | Fair Value, Inputs, Level 3 [Member]
Business Combination, Contingent Consideration, Liability, Current	4,315	4,315
Reported Value Measurement [Member]
Business Combination, Contingent Consideration, Liability, Current	0	0
Money Market Funds [Member] | Estimate of Fair Value Measurement [Member]
Cash equivalents	67,052	67,046
Money Market Funds [Member] | Estimate of Fair Value Measurement [Member] | Fair Value, Inputs, Level 1 [Member]
Cash equivalents	67,052	67,046
Money Market Funds [Member] | Estimate of Fair Value Measurement [Member] | Fair Value, Inputs, Level 2 [Member]
Cash equivalents	0	0
Money Market Funds [Member] | Estimate of Fair Value Measurement [Member] | Fair Value, Inputs, Level 3 [Member]
Cash equivalents	0	0
Money Market Funds [Member] | Reported Value Measurement [Member]
Cash equivalents	$ 67,052	$ 67,046

Note 4 - Fair Value Measureme_4

Note 4 - Fair Value Measurements - Contingent Consideration (Details) - Contingent Consideration [Member] - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Balance	$ 4,315	$ 35,410
Change in fair value	0	(4,820)
Balance	$ 4,315	$ 30,590

Note 5 - Inventories (Details T

Note 5 - Inventories (Details Textual) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Inventory Valuation Reserves	$ 6.9	$ 9.1

Note 5 - Inventories - Summary

Note 5 - Inventories - Summary of Inventories (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Raw materials	$ 16,901	$ 16,881
Work-in-process	13,599	11,442
Finished goods	24,257	26,731
Total	54,757	55,054
Inventories	35,225	36,010
Other long-term assets	$ 19,532	$ 19,044

Note 6 - Intangible Assets (Det

Note 6 - Intangible Assets (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Amortization of Intangible Assets	$ 1.9	$ 1.9

Note 6 - Intangible Assets - Su

Note 6 - Intangible Assets - Summary of Intangible Assets (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Gross value	$ 112,136
Accumulated Currency Translation Adjustment	(3,218)
Accumulated Amortization	(28,482)
Net book value	$ 80,436	$ 82,382
Useful life (Year)	13 years
Developed Technology Rights [Member]
Gross value	$ 89,580
Accumulated Currency Translation Adjustment	(1,608)
Accumulated Amortization	(19,340)
Net book value	$ 68,632	70,081
Useful life (Year)	15 years
In Process Research and Development [Member]
Gross value	$ 2,656
Accumulated Currency Translation Adjustment	(1,006)
Accumulated Amortization	0
Net book value	1,650	1,650
Customer Relationships [Member]
Gross value	9,000
Accumulated Currency Translation Adjustment	0
Accumulated Amortization	(1,952)
Net book value	$ 7,048	7,273
Useful life (Year)	10 years
Distribution Rights [Member]
Gross value	$ 4,700
Accumulated Currency Translation Adjustment	(415)
Accumulated Amortization	(4,285)
Net book value	$ 0	0
Useful life (Year)	5 years
Patents [Member]
Gross value	$ 1,000
Accumulated Currency Translation Adjustment	(189)
Accumulated Amortization	(644)
Net book value	$ 167	179
Useful life (Year)	16 years
Trade Names [Member]
Gross value	$ 5,200
Accumulated Currency Translation Adjustment	0
Accumulated Amortization	(2,261)
Net book value	$ 2,939	$ 3,199
Useful life (Year)	5 years

Note 7 - Goodwill - Changes in

Note 7 - Goodwill - Changes in the Carrying Value of Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2022USD ($)
Balance	$ 7,781
Effect of foreign currency adjustments	(156)
Balance	$ 7,625

Note 8 - Accrued Expenses - Sum

Note 8 - Accrued Expenses - Summary of Accrued Expenses (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Compensation and related expenses	$ 7,457	$ 9,523
Professional fees	2,967	3,590
Clinical trial costs	2,014	1,961
Other	1,145	1,059
Total	15,233	17,847
Accrued Expenses and Other Current Liabilities [Member]
Operating lease liability - current	1,528	1,526
Financing lease liability - current	$ 122	$ 188

Note 9 - Commitments and Cont_2

Note 9 - Commitments and Contingencies (Details Textual) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Standard and Extended Product Warranty Accrual, Ending Balance	$ 0	$ 0

Note 10 - Revenue and Geograp_3

Note 10 - Revenue and Geographic Information (Details Textual) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Revenues From Agreements as Percent of Total Revenue	39.00%	41.00%
Contract with Customer, Liability, Total	$ 0.3		$ 1

Note 10 - Revenue and Geograp_4

Note 10 - Revenue and Geographic Information - Revenues (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue	$ 36,693	$ 34,292
OA Pain Management [member]
Revenue	22,733
Percentage of revenue		19316.00%
Joint Preservation and Restoration [Member]
Revenue	12,139
Percentage of revenue		12219.00%
Non-Orthopedic [Member]
Revenue	1,821
Percentage of revenue		2757.00%
Product [Member]
Revenue	$ 36,693
Percentage of revenue		34292.00%

Note 10 - Revenue and Geograp_5

Note 10 - Revenue and Geographic Information - Total Revenue by Geographic Location (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue	$ 36,693	$ 34,292
Percentage of Revenue	100.00%	100.00%
UNITED STATES
Revenue	$ 26,773	$ 25,005
Percentage of Revenue	73.00%	73.00%
Europe [Member]
Revenue	$ 5,796	$ 5,480
Percentage of Revenue	16.00%	16.00%
Other Location [Member]
Revenue	$ 4,124	$ 3,807
Percentage of Revenue	11.00%	11.00%

Note 11 - Equity Incentive Pl_3

Note 11 - Equity Incentive Plan (Details Textual) - USD ($)	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021	Nov. 04, 2021	Mar. 17, 2021	Jun. 13, 2017
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Available for Grant (in shares)	900,000
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Grants in Period, Gross (in shares)	416,197
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term (Year)	4 years 6 months	4 years
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Number, Ending Balance (in shares)	1,543,895		1,175,993
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Grants in Period, Weighted Average Grant Date Fair Value (in dollars per share)	$ 28.37	$ 34.07
Premium-Priced Employee Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Premium Priced Options, Exercise Price as Percentage of Market Price	110.00%
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Grants in Period, Gross (in shares)	382,201
Share-Based Payment Arrangement, Option [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Expiration Period (Year)			10 years
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 11,800,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)	2 years 1 month 6 days
Share-Based Payment Arrangement, Option [Member] | Minimum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Award Vesting Period (Year)	3 years
Total Shareholder Return ("TSRs") Options [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Award Vesting Period (Year)	2 years 8 months 12 days
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions, Expected Term (Year)	6 years 3 months 18 days
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Number, Ending Balance (in shares)	104,638
Total Shareholder Return ("TSRs") Options [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Percentage of Target Number	0.00%
Total Shareholder Return ("TSRs") Options [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Percentage of Target Number	150.00%
Restricted Stock Units (RSUs) [Member]
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Amount, Total	$ 18,400,000
Share-Based Payment Arrangement, Nonvested Award, Cost Not yet Recognized, Period for Recognition (Year)	2 years 4 months 24 days
Share-Based Compensation Arrangement by Share-Based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value	$ 3,300,000	$ 2,100,000
Restricted Stock Units (RSUs) [Member] | Minimum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Award Vesting Period (Year)	3 years
Performance Shares [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value	$ 600,000
Performance Shares [Member] | Minimum [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Award Vesting Period (Year)	3 years
The 2017 Plan [Member]
Number of Shares Available for Grant Reduced By Each Share Award Issued Other Than Options or SARs (in shares)						2
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in shares)						4,600,000
The 2021 Inducement Plan [Member]
Share-Based Compensation Arrangement by Share-Based Payment Award, Number of Shares Available for Grant (in shares)	70,591
Common Stock, Capital Shares Reserved for Future Issuance (in shares)				125,000
Share-Based Compensation Arrangement by Share-Based Payment Award, Award Vesting Period (Year)	3 years
Share-Based Compensation Arrangement by Share-Based Payment Award, Expiration Period (Year)	10 years
Employee Stock Purchase Plan (ESPP) [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized (in shares)					200,000
Share Based Compensation Arrangement by Share Based Payment Award Number of Shares Authorized per Offering Period (in shares)					800
Share Based Compensation Arrangement by Share Based Payment Award, Value Authorized					$ 25,000
Represents Share Based Compensation Arrangement by Share Based Payment Award, Payroll Deduction percentage					10.00%
Represents Share Based Compensation Arrangement by Share Based Payment Award, the Purchase Price for Each Share Purchased, Percentage					85.00%

Note 11 - Equity Incentive Pl_4

Note 11 - Equity Incentive Plan - Total Stock-based Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Stock-based compensation expense	$ 2,545	$ 2,259
Cost of Sales [Member]
Stock-based compensation expense	176	129
Research and Development Expense [Member]
Stock-based compensation expense	367	241
Selling, General and Administrative Expenses [Member]
Stock-based compensation expense	$ 2,002	$ 1,889

Note 11 - Equity Incentive Pl_5

Note 11 - Equity Incentive Plan - Stock Options (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Outstanding, shares (in shares)	1,175,993
Outstanding, Weighted Average Exercise (in dollars per share)	$ 39.56
Granted, shares (in shares)	416,197
Granted, Weighted Average Exercise Price (in dollars per share)	$ 28.37	$ 34.07
Exercised, shares (in shares)	(437)
Exercised, Weighted Average Exercise Price (in dollars per share)	$ 9.10
Exercised, Aggregate Intrinsic Value	$ 10
Forfeited and canceled, shares (in shares)	(47,858)
Forfeited and canceled, Weighted Average Exercise Price (in dollars per share)	$ 38.23
Outstanding, shares (in shares)	1,543,895
Outstanding, Weighted Average Exercise Price (in dollars per share)	$ 36.59
Outstanding, Weighted Average Remaining Contractual Term (Year)	8 years 7 months 6 days
Outstanding, Aggregate Intrinsic Value	$ 9
Vested, shares (in shares)	485,869
Vested, Weighted Average Exercise Price (in dollars per share)	$ 41.89
Vested, Weighted Average Remaining Contractual Term (Year)	7 years 6 months
Vested, Aggregate Intrinsic Value	$ 9
Vested and expected to vest, shares (in shares)	1,543,895
Vested and expected to vest, Weighted Average Exercise Price (in dollars per share)	$ 36.59
Vested and expected to vest, Weighted Average Remaining Contractual Term (Year)	8 years 7 months 6 days
Vested and expected to vest, Aggregate Intrinsic Value	$ 9

Note 11 - Equity Incentive Pl_6

Note 11 - Equity Incentive Plan - Assumptions Used to Estimate Fair Value of Stock Options and Stock Appreciation Rights (Details)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Expected life (years) (Year)	4 years 6 months	4 years
Expected dividend yield	0.00%	0.00%
Fair value per option	0.1137	0.1390
Expected life of options (in years) (Year)	4 years 6 months	4 years
Expected dividend yield	0.00%	0.00%
Employee Stock Purchase Plan (ESPP) [Member]
Risk free interest rate	0.06%
Expected volatility	32.58%
Expected life (years) (Year)	6 months
Expected dividend yield	0.00%
Risk-free interest rate	0.06%
Expected stock price volatility	32.58%
Expected life of options (in years) (Year)	6 months
Expected dividend yield	0.00%
Minimum [Member]
Risk free interest rate	1.30%	0.30%
Expected volatility	53.80%	54.80%
Risk-free interest rate	1.30%	0.30%
Expected stock price volatility	53.80%	54.80%
Maximum [Member]
Risk free interest rate	1.90%	0.60%
Expected volatility	54.60%	55.40%
Risk-free interest rate	1.90%	0.60%
Expected stock price volatility	54.60%	55.40%

Note 11 - Equity Incentive Pl_7

Note 11 - Equity Incentive Plan - Restricted Stock Activity (Details) - Restricted Stock Units (RSUs) [Member]	3 Months Ended
	Mar. 31, 2022$ / sharesshares
Outstanding, shares (in shares) | shares	412,658
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 36.33
Granted (in shares) | shares	420,452
Granted, weighted average grant date fair value (in dollars per share) | $ / shares	$ 25.75
Vested, shares (in shares) | shares	(87,953)
Vested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 35.19
Forfeited and cancelled, shares (in shares) | shares	(32,376)
Forfeited and cancelled, weighted average grant date fair value (in dollars per share) | $ / shares	$ 35.27
Outstanding, shares (in shares) | shares	712,781
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 30.28

Note 11 - Equity Incentive Pl_8

Note 11 - Equity Incentive Plan - Performance Stock Units (Details) - Performance Shares [Member]	3 Months Ended
	Mar. 31, 2022$ / sharesshares
Outstanding, shares (in shares) | shares	158,297
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 37.44
Performance factor adjustment (in shares) | shares	2,125
Performance factor adjustment (in dollars per share) | $ / shares	$ 32.53
Vested, shares (in shares) | shares	(19,125)
Vested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 32.53
Forfeited and cancelled, shares (in shares) | shares	(23,400)
Forfeited and cancelled, weighted average grant date fair value (in dollars per share) | $ / shares	$ 41.86
Outstanding, shares (in shares) | shares	117,897
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 34.98

Note 12 - Income Taxes (Details

Note 12 - Income Taxes (Details Textual) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Income Tax Expense (Benefit), Total	$ (775)	$ (1,623)
Effective Income Tax Rate Reconciliation, Percent, Total	20.90%	133.60%
Unrecognized Tax Benefits, Ending Balance	$ 0
Foreign Tax Authority [Member] | Ministry of Economic Affairs and Finance, Italy [Member]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount			$ (900)

Note 13 - Earnings Per Share _3

Note 13 - Earnings Per Share ("EPS") (Details Textual) shares in Millions	3 Months Ended
	Mar. 31, 2021shares
Share-Based Payment Arrangement, Option [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share, Amount (in shares)	1.2

Note 13 - Earnings Per Share _4

Note 13 - Earnings Per Share ("EPS") - Basic and Diluted Earnings Per Share (Details) - shares shares in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Basic (in shares)	14,466	14,343
Share based awards (in shares)	0	92
Diluted shares used in the calculation of EPS (in shares)	14,466	14,435