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CNMD Conmed

Document and Entity Information

Document and Entity Information - shares3 Months Ended
Mar. 31, 2021Apr. 26, 2021
Cover [Abstract]
Entity Registrant NameCONMED CORPORATION
Document Quarterly Reporttrue
Document Type10-Q
Document Period End DateMar. 31,
2021
Current Fiscal Year End Date--12-31
Document Fiscal Period FocusQ1
Document Fiscal Year Focus2021
Entity File Number001-39218
Entity Incorporation, State or Country CodeDE
Entity Tax Identification Number16-0977505
Entity Address, Address Line One11311 Concept Blvd
Entity Address, City or TownLargo,
Entity Address, State or ProvinceFL
Entity Address, Postal Zip Code33773
City Area Code727
Local Phone Number392-6464
Entity Central Index Key0000816956
Title of 12(b) SecurityCommon Stock, $0.01 par value
Trading SymbolCNMD
Security Exchange NameNYSE
Entity Current Reporting StatusYes
Entity Interactive Data CurrentYes
Entity Filer CategoryLarge Accelerated Filer
Entity Small Businessfalse
Entity Emerging Growth Companyfalse
Document Transition Reportfalse
Entity Shell Companyfalse
Entity Common Stock, Shares Outstanding29,092,141
Amendment Flagfalse

Consolidated Condensed Statemen

Consolidated Condensed Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) shares in Thousands, $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Statement of Comprehensive Income [Abstract]
Net sales $ 232,677 $ 214,010
Cost of sales104,228 94,851
Gross profit128,449 119,159
Selling and administrative expense98,340 95,867
Research and development expense10,027 10,120
  Operating expenses108,367 105,987
Income from operations20,082 13,172
Interest expense10,351 9,592
Other expense0 89
Income before income taxes9,731 3,491
Benefit from income taxes(129)(2,436)
Net income9,860 5,927
Comprehensive income (loss) $ 10,743 $ (1,121)
Per share data:
Basic (in dollars per share) $ 0.34 $ 0.21
Diluted (in dollars per share) $ 0.31 $ 0.20
Weighted average common shares:
Basic (shares)28,972 28,478
Diluted (shares)31,378 29,707

Consolidated Condensed Balance

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Current assets:
Cash and cash equivalents $ 36,769 $ 27,356
Accounts receivable, net163,954 177,152
Inventories205,797 194,868
Prepaid expenses and other current assets17,849 17,278
Total current assets424,369 416,654
Property, plant and equipment, net109,379 111,407
Goodwill618,104 618,440
Other intangible assets, net493,905 501,537
Other assets100,855 103,635
Total assets1,746,612 1,751,673
Current liabilities:
Current portion of long-term debt20,076 18,415
Accounts payable55,780 53,310
Accrued compensation and benefits40,908 50,171
Other current liabilities65,391 68,305
Total current liabilities182,155 190,201
Long-term debt725,320 735,221
Deferred income taxes56,593 57,875
Other long-term liabilities56,974 59,338
Total liabilities1,021,042 1,042,635
Commitments and contingencies
Shareholders' equity:
Preferred stock, par value $.01 per share; authorized 500,000 shares; none outstanding0 0
Common stock, par value $0.01 per share; 100,000,000 shares authorized; 31,299,194 shares issued in 2021 and 2020, respectively313 313
Paid-in capital388,959 382,628
Retained earnings461,464 457,417
Accumulated other comprehensive loss(62,798)(63,681)
Less: 2,222,233 and 2,410,045 shares of common stock in treasury, at cost in 2021 and 2020, respectively(62,368)(67,639)
Total shareholders’ equity725,570 709,038
Total liabilities and shareholders’ equity $ 1,746,612 $ 1,751,673

Consolidated Condensed Balanc_2

Consolidated Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / sharesMar. 31, 2021Dec. 31, 2020
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)2,222,233 2,410,045

Consolidated Condensed Statem_2

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in ThousandsTotalCommon StockPaid-in CapitalRetained EarningsAccumulated Other Comprehensive LossTreasury Stock
Balance at period start (shares) at Dec. 31, 201931,299
Balance at period start at Dec. 31, 2019 $ 710,467 $ 313 $ 379,324 $ 470,844 $ (59,277) $ (80,737)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans(5,040)(7,736)2,696
Stock-based compensation3,032 3,032
Dividends on common stock ($0.20 per share)(5,703)(5,703)
Comprehensive income (loss):
Cash flow hedging gain, net of income tax2,405 2,405
Pension liability, net of income tax535 535
Foreign currency translation adjustments(9,988)(9,988)
Net income5,927 5,927
Comprehensive income (loss)(1,121)
Balance at period end (shares) at Mar. 31, 202031,299
Balance at period end at Mar. 31, 2020701,635 $ 313 374,620 471,068 (66,325)(78,041)
Balance at period start (shares) at Dec. 31, 202031,299
Balance at period start at Dec. 31, 2020709,038 $ 313 382,628 457,417 (63,681)(67,639)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans8,215 2,944 5,271
Stock-based compensation3,387 3,387
Dividends on common stock ($0.20 per share)(5,813)(5,813)
Comprehensive income (loss):
Cash flow hedging gain, net of income tax3,926 3,926
Pension liability, net of income tax631 631
Foreign currency translation adjustments(3,674)(3,674)
Net income9,860 9,860
Comprehensive income (loss)10,743
Balance at period end (shares) at Mar. 31, 202131,299
Balance at period end at Mar. 31, 2021 $ 725,570 $ 313 $ 388,959 $ 461,464 $ (62,798) $ (62,368)

Consolidated Condensed Statem_3

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) (Parenthetical) - $ / shares3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Dividends per share of common stock (in dollars per share) $ 0.20 $ 0.20

Consolidated Condensed Statem_4

Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Cash flows from operating activities:
Net income $ 9,860 $ 5,927
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation4,757 4,646
Amortization of debt discount2,503 2,264
Amortization of deferred debt issuance costs1,058 819
Amortization13,519 13,776
Stock-based compensation3,387 3,032
Deferred income taxes(2,688)(2,742)
Increase (decrease) in cash flows from changes in assets and liabilities:
Accounts receivable11,957 19,057
Inventories(11,638)(12,313)
Accounts payable2,804 1,705
Accrued compensation and benefits(8,955)(18,397)
Other assets(6,002)(7,260)
Other liabilities1,782 (6,793)
Net cash provided by operating activities22,344 3,721
Cash flows from investing activities:
Purchases of property, plant and equipment(3,109)(2,825)
Payments related to business and asset acquisitions, net of cash acquired0 (3,852)
Net cash used in investing activities(3,109)(6,677)
Cash flows from financing activities:
Payments on term loan(3,313)(3,313)
Payments on revolving line of credit(72,000)(41,000)
Proceeds from revolving line of credit64,000 59,000
Payments related to contingent consideration0 (1,133)
Dividends paid on common stock(5,775)(5,683)
Other, net8,216 (5,132)
Net cash provided by (used in) financing activities(8,872)2,739
Effect of exchange rate changes on cash and cash equivalents(950)(1,330)
Net increase (decrease) in cash and cash equivalents9,413 (1,547)
Cash and cash equivalents at beginning of period27,356 25,856
Cash and cash equivalents at end of period36,769 24,309
Non-cash investing and financing activities:
Dividends payable $ 5,813 $ 5,703

Operations

Operations3 Months Ended
Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
OperationsOperationsCONMED 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 Information3 Months Ended
Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Interim Financial InformationInterim Financial Information The accompanying unaudited consolidated condensed financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for annual financial statements. The information herein reflects all normal recurring material adjustments, which are, in the opinion of management, necessary to fairly present the results for the periods presented. The consolidated condensed financial statements herein consist of all wholly-owned domestic and foreign subsidiaries with all significant intercompany transactions eliminated. Results for the period ended March 31, 2021 are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. 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, 2020 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 April 29, 2021, 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.

Revenues

Revenues3 Months Ended
Mar. 31, 2021
Revenue from Contract with Customer [Abstract]
RevenuesRevenues The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended March 31, 2021 March 31, 2020 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 37,131 $ 86,812 $ 123,943 $ 37,039 $ 81,808 $ 118,847 Europe, Middle East & Africa 26,052 18,544 44,596 25,907 16,615 42,522 Asia Pacific 26,602 12,662 39,264 20,535 8,325 28,860 Americas (excluding the United States) 17,381 7,493 24,874 15,802 7,979 23,781 Total sales from contracts with customers $ 107,166 $ 125,511 $ 232,677 $ 99,283 $ 114,727 $ 214,010 Timing of Revenue Recognition Goods transferred at a point in time $ 97,690 $ 124,394 $ 222,084 $ 90,553 $ 113,901 $ 204,454 Services transferred over time 9,476 1,117 10,593 8,730 826 9,556 Total sales from contracts with customers $ 107,166 $ 125,511 $ 232,677 $ 99,283 $ 114,727 $ 214,010 Contract liability balances related to the sale of extended warranties to customers are as follows: March 31, 2021 December 31, 2020 Contract liability $ 15,231 $ 13,666 Revenue recognized during the three months ended March 31, 2021 and March 31, 2020 from amounts included in contract liabilities at the beginning of the period were $3.4 million and $3.0 million, respectively. There were no material contract assets as of March 31, 2021 and December 31, 2020.

Comprehensive Income (Loss)

Comprehensive Income (Loss)3 Months Ended
Mar. 31, 2021
Equity [Abstract]
Comprehensive Income (Loss)Comprehensive Income (Loss) Comprehensive income (loss) consists of the following: Three Months Ended March 31, 2021 2020 Net income $ 9,860 $ 5,927 Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $1,250 and $766 for the three months ended March 31, 2021 and 2020, respectively) 3,926 2,405 Pension liability, net of income tax (income tax expense of $201 and $170 for the three months ended March 31, 2021 and 2020, respectively) 631 535 Foreign currency translation adjustment (3,674) (9,988) Comprehensive income (loss) $ 10,743 $ (1,121) Accumulated other comprehensive loss consists of the following: Cash Flow Pension Cumulative Accumulated Balance, December 31, 2020 $ (5,945) $ (36,620) $ (21,116) $ (63,681) Other comprehensive income (loss) before reclassifications, net of tax 2,725 — (3,674) (949) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,584 832 — 2,416 Income tax (383) (201) — (584) Net current-period other comprehensive income (loss) 3,926 631 (3,674) 883 Balance, March 31, 2021 $ (2,019) $ (35,989) $ (24,790) $ (62,798) Cash Flow Pension Cumulative Accumulated Balance, December 31, 2019 $ 493 $ (31,691) $ (28,079) $ (59,277) Other comprehensive income (loss) before reclassifications, net of tax 3,257 — (9,988) (6,731) Amounts reclassified from accumulated other comprehensive income (loss) before tax a (1,124) 705 — (419) Income tax 272 (170) — 102 Net current-period other comprehensive income (loss) 2,405 535 (9,988) (7,048) Balance, March 31, 2020 $ 2,898 $ (31,156) $ (38,067) $ (66,325) (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 5 and Note 11, respectively, for further details.

Fair Value of Financial Instrum

Fair Value of Financial Instruments3 Months Ended
Mar. 31, 2021
Fair Value Disclosures [Abstract]
Fair Value of Financial InstrumentsFair Value of Financial Instruments We enter into derivative instruments for risk management purposes only. We operate internationally and, in the normal course of business, are exposed to fluctuations in interest rates, foreign exchange rates and commodity prices. These fluctuations can increase the costs of financing, investing and operating the business. We use forward contracts, a type of derivative instrument, to manage certain foreign currency exposures. By nature, all financial instruments involve market and credit risks. We enter into forward contracts with major investment grade financial institutions and have policies to monitor the credit risk of those counterparties. While there can be no assurance, we do not anticipate any material non-performance by any of these counterparties. Foreign Currency Forward Contracts. We hedge forecasted intercompany sales denominated in foreign currencies through the use of forward contracts. We account for these forward contracts as cash flow hedges. To the extent these forward contracts meet hedge accounting criteria, changes in their fair value are not included in current earnings but are included in accumulated other comprehensive loss. These changes in fair value will be recognized into earnings as a component of sales or cost of sales when the forecasted transaction occurs. We also enter into forward contracts to exchange foreign currencies for United States dollars in order to hedge our currency transaction exposures on intercompany receivables designated in foreign currencies. These forward contracts settle each month at month-end, at which time we enter into new forward contracts. We have not designated these forward contracts as hedges and have not applied hedge accounting to them. The following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation March 31, 2021 December 31, 2020 Forward exchange contracts Cash flow hedge $ 164,562 $ 154,504 Forward exchange contracts Non-designated 45,545 42,380 The remaining time to maturity as of March 31, 2021 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) and net earnings 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 March 31, Total Amount of Line Item Presented Derivative Instrument 2021 2020 Location of amount reclassified 2021 2020 2021 2020 Foreign exchange contracts $ 3,593 $ 4,295 Net Sales $ 232,677 $ 214,010 $ (1,849) $ 1,201 Cost of Sales 104,228 94,851 265 (77) Pre-tax gain (loss) $ 3,593 $ 4,295 $ (1,584) $ 1,124 Tax expense (benefit) 868 1,038 (383) 272 Net gain (loss) $ 2,725 $ 3,257 $ (1,201) $ 852 At March 31, 2021, $2.3 million of net unrealized losses 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 (loss) were: Three Months Ended March 31, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income (Loss) 2021 2020 Net gain (loss) on currency forward contracts Selling and administrative expense $ 458 $ (245) Net loss on currency transaction exposures Selling and administrative expense $ (1,123) $ (191) Balance sheet presentation We record these forward foreign exchange contracts at fair value. The following tables summarize the fair value for forward foreign exchange contracts outstanding at March 31, 2021 and December 31, 2020: March 31, 2021 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Other current liabilities $ 1,557 $ (4,592) $ (3,035) Foreign exchange contracts Other long-term assets 709 (337) 372 $ 2,266 $ (4,929) $ (2,663) Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 8 (179) (171) Total derivatives $ 2,274 $ (5,108) $ (2,834) December 31, 2020 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Other current liabilities $ 1,500 $ (8,826) $ (7,326) Foreign exchange contracts Other long-term liabilities 23 (535) (512) $ 1,523 $ (9,361) $ (7,838) Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 25 (150) (125) Total derivatives $ 1,548 $ (9,511) $ (7,963) Our forward foreign exchange contracts are subject to a master netting agreement and qualify for netting in the consolidated condensed balance sheets. Fair Value Disclosure. FASB guidance defines fair value and establishes a framework for measuring fair value and related disclosure requirements. This guidance applies when fair value measurements are required or permitted. The guidance indicates, among other things, that a fair value measurement assumes that the transaction to sell an asset or transfer a liability occurs in the principal market for the asset or liability or, in the absence of a principal market, the most advantageous market for the asset or liability. Fair value is defined based upon an exit price model. Valuation Hierarchy. A valuation hierarchy was established for disclosure of the inputs to the valuations used to measure fair value. This hierarchy prioritizes the inputs into three broad levels as follows. Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets in markets that are not active, inputs other than quoted prices that are observable for the asset or liability, including interest rates, yield curves and credit risks, or inputs that are derived principally from or corroborated by observable market data through correlation. Level 3 inputs are unobservable inputs based on our own assumptions used to measure assets and liabilities at fair value. A financial asset or liability’s classification within the hierarchy is determined based on the lowest level input that is significant to the fair value measurement. There have been no significant changes in the assumptions. Valuation Techniques. Assets and liabilities carried at fair value and measured on a recurring basis as of March 31, 2021 consist of forward foreign exchange contracts. The Company values its forward foreign exchange contracts using quoted prices for similar assets. The most significant assumption is quoted currency rates. The value of the forward foreign exchange contract assets and liabilities were valued using Level 2 inputs and are listed in the table above.

Inventories

Inventories3 Months Ended
Mar. 31, 2021
Inventory Disclosure [Abstract]
InventoriesInventories Inventories consist of the following: March 31, December 31, Raw materials $ 73,654 $ 71,807 Work-in-process 18,429 15,864 Finished goods 113,714 107,197 Total $ 205,797 $ 194,868

Earnings Per Share

Earnings Per Share3 Months Ended
Mar. 31, 2021
Earnings Per Share [Abstract]
Earnings Per ShareEarnings Per Share Basic earnings per share (“basic EPS”) is computed by dividing net income by the weighted average number of common shares outstanding for the reporting period. Diluted earnings per share (“diluted EPS”) gives effect to all dilutive potential shares outstanding resulting from employee stock options, restricted stock units, performance share units and stock appreciation rights ("SARs") as well as the Notes and related hedge transactions during the period. The following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2021 and 2020: Three Months Ended March 31, 2021 2020 Net income $ 9,860 $ 5,927 Basic – weighted average shares outstanding 28,972 28,478 Effect of dilutive potential securities 2,406 1,229 Diluted – weighted average shares outstanding 31,378 29,707 Net income (per share) Basic $ 0.34 $ 0.21 Diluted 0.31 0.20 The shares used in the calculation of diluted EPS exclude options and SARs 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 0.3 million and 1.1 million for the three months ended March 31, 2021 and 2020, respectively. Our 2.625% convertible notes due in 2024 (the “Notes”) are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The following is intended to describe the impact of the Notes and related hedge transactions on the calculation of diluted EPS. Additional shares to be issued pursuant to the terms of the Notes and related hedge transactions, if any, would occur at maturity. The calculation of diluted EPS includes potential diluted shares upon conversion of the Notes when the average market price per share of our common stock for the period is greater than the conversion price of the Notes of $88.80. We intend to settle in cash the principal outstanding and use the treasury stock method when calculating their potential dilutive effect, if any. During the three months ended March 31, 2021 and 2020, our average share price exceeded the conversion price of the Notes and we included in our diluted share count 1.0 million and 0.1 million shares, respectively, assumed to be issued if the Notes were converted. We previously entered into convertible notes hedge transactions to increase the effective conversion price of the Notes to $114.92. However, our convertible notes hedges are not included when calculating potential dilutive shares since their effect is always anti-dilutive. Concurrently with entering into the hedge transactions, we also previously entered into warrant transactions under which we agreed to sell shares of our common stock at $114.92. The calculation of diluted EPS also includes

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets3 Months Ended
Mar. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Other Intangible AssetsGoodwill and Other Intangible Assets The changes in the net carrying amount of goodwill for the three months ended March 31, 2021 are as follows: Balance as of December 31, 2020 $ 618,440 Foreign currency translation (336) Balance as of March 31, 2021 $ 618,104 Assets and liabilities of acquired businesses are recorded at their estimated fair values as of the date of acquisition. Goodwill represents costs in excess of fair values assigned to the underlying net assets of acquired businesses. Other intangible assets consist of the following: March 31, 2021 December 31, 2020 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: Customer and distributor relationships 24 $ 342,531 $ (139,243) $ 342,639 $ (134,555) Sales representation, marketing and promotional rights 25 149,376 (55,500) 149,376 (54,000) Developed technology 16 106,604 (21,358) 106,604 (19,705) Patents and other intangible assets 16 74,307 (49,356) 73,516 (48,882) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — 22 $ 759,362 $ (265,457) $ 758,679 $ (257,142) 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 $8.3 million and $8.5 million in the three months ended March 31, 2021 and 2020, 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). Included in developed technology is $6.0 million of earn-out consideration that is considered probable as of March 31, 2021 associated with a prior asset acquisition. This is recorded in other current and other long-term liabilities at March 31, 2021. The estimated intangible asset amortization expense remaining for the year ending December 31, 2021 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2021 $ 20,620 $ 4,500 $ 25,120 2022 26,426 6,000 32,426 2023 25,646 6,000 31,646 2024 24,836 6,000 30,836 2025 25,058 6,000 31,058 2026 24,529 6,000 30,529

Long Term Debt

Long Term Debt3 Months Ended
Mar. 31, 2021
Debt Disclosure [Abstract]
Long-term DebtLong-Term Debt Long-term debt consists of the following: March 31, 2021 December 31, 2020 Revolving line of credit $ 199,000 $ 207,000 Term loan, net of deferred debt issuance costs of $1,520 and $1,668 in 2021 and 2020, respectively 236,980 240,145 2.625% convertible notes, net of deferred debt issuance costs of $5,031 and $5,475 in 2021 and 2020, respectively, and unamortized discount of $31,117 and $33,620 in 2021 and 2020, respectively 308,850 305,904 Financing leases 566 587 Total debt 745,396 753,636 Less: Current portion 20,076 18,415 Total long-term debt $ 725,320 $ 735,221 On February 7, 2019 we entered into a sixth amended and restated senior credit agreement consisting of: (a) a $265.0 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 mature on the earlier of (i) February 7, 2024 or (ii) 91 days prior to the earliest scheduled maturity date of the 2.625% convertible notes due in 2024 described below, (if, as of such date, more than $150.0 million in aggregate principal amount of such convertible notes (or any refinancing thereof) remains outstanding). The term loan facility is payable in quarterly installments increasing over the term of the facility. Proceeds from the term loan facility and borrowings under the revolving credit facility were used to repay the then existing senior credit agreement and in part to finance the acquisition of Buffalo Filter. On April 17, 2020, we amended our sixth amended and restated senior credit agreement to suspend our required leverage ratios for up to four quarters as a result of the potential impact from the COVID-19 pandemic. On November 20, 2020, we entered into a third amendment under our senior credit agreement to lower the applicable margin on the loans and lower the interest floor on Eurocurrency loans agreed upon in April 2020. On April 15, 2021, we terminated the suspension period, thus reinstating our required leverage ratios. Interest rates are adjusted so that the applicable margin for base rate loans is 2.00% per annum and for Eurocurrency rate loans is 3.00% per annum, and the applicable commitment fee rate for the revolving credit facility is 0.50%. Following the suspension period, the applicable margin will depend upon CONMED’s consolidated senior secured leverage ratio, using the pricing grid set forth in the amendment. Interest rates were at LIBOR (subject to 0.50% floor) plus an interest rate margin of 3.00% (3.50% at March 31, 2021). There were $238.5 million in borrowings outstanding on the term loan facility as of March 31, 2021. There were $199.0 million in borrowings outstanding under the revolving credit facility as of March 31, 2021. Our available borrowings on the revolving credit facility at March 31, 2021 were $383.4 million with approximately $2.6 million of the facility set aside for outstanding letters of credit. The sixth amended and restated senior credit agreement is collateralized by substantially all of our personal property and assets. The sixth amended and restated senior credit agreement contains covenants and restrictions which, among other things, require the maintenance of certain financial ratios and restrict dividend payments and the incurrence of certain indebtedness and other activities, including acquisitions and dispositions. We were in full compliance with these covenants and restrictions as of March 31, 2021. We are also required, under certain circumstances, to make mandatory prepayments from net cash proceeds from any issuance of equity and asset sales. On January 29, 2019, we issued $345.0 million in 2.625% convertible notes due in 2024 (the "Notes"). Interest is payable semi-annually in arrears on February 1 and August 1 of each year, commencing August 1, 2019. The Notes will mature on February 1, 2024, unless earlier repurchased or converted. The Notes represent subordinated unsecured obligations and are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The Notes may be converted at an initial conversion rate of 11.2608 shares of our common stock per $1,000 principal amount of Notes (equivalent to an initial conversion price of approximately $88.80 per share of common stock). Holders of the Notes may convert the Notes at their option at any time on or after November 1, 2023 through the second scheduled trading day preceding the maturity date. Holders of the Notes will also have the right to convert the Notes prior to November 1, 2023, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of the net proceeds from the offering of the Notes were used as part of the financing for the Buffalo Filter acquisition and $21.0 million were used to pay the cost of certain convertible notes hedge transactions as further described below. Our effective borrowing rate for nonconvertible debt at the time of issuance of the Notes was estimated to be 6.14%, which resulted in $51.6 million of the $345.0 million aggregate principal amount of Notes issued, or $39.1 million after taxes, being attributable to equity. For the three months ended March 31, 2021 and 2020, we have recorded interest expense related to the amortization of debt discount on the Notes of $2.5 million and $2.3 million, respectively, at the effective interest rate of 6.14%. The debt discount on the Notes is being amortized through February 2024. For both the three months ended March 31, 2021 and 2020, we have recorded interest expense on the Notes of $2.3 million at the contractual coupon rate of 2.625%. In connection with the offering of the Notes, we entered into convertible note hedge transactions with a number of financial institutions (each, an “option counterparty”). The convertible note hedge transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the Notes, the number of shares of our common stock underlying the Notes. Concurrently with entering into the convertible note hedge transactions, we also entered into separate warrant transactions with each option counterparty whereby we sold to such option counterparty warrants to purchase, subject to customary anti-dilution adjustments, the same number of shares of our common stock. The convertible note hedge transactions are expected generally to reduce the potential dilution upon conversion of the Notes and/or offset any cash payments we are required to make in excess of the principal amount of converted Notes, as the case may be, in the event that the market price per share of our common stock, as measured under the terms of the convertible note hedge transactions, is greater than the strike price ($114.92) of the convertible note hedge transactions, which initially corresponds to the conversion price of the Notes and is subject to anti-dilution adjustments substantially similar to those applicable to the conversion rate of the Notes. If, however, the market price per share of our common stock, as measured under the terms of the warrant transactions, exceeds the strike price 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 7, unless we elect to settle the warrants in cash. The scheduled maturities of long-term debt outstanding at March 31, 2021 are as follows: Remaining 2021 $ 14,906 2022 24,844 2023 397,750 2024 345,000 2025 — The above amounts exclude debt discount, deferred debt issuance costs and financing leases.

Guarantees

Guarantees3 Months Ended
Mar. 31, 2021
Guarantees [Abstract]
GuaranteesGuarantees 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 warranty policies is based upon a review of historical claim experience. Adjustments are made to accruals as claim data and historical experience warrant. Changes in the liability for standard warranties for the three months ended March 31, are as follows: 2021 2020 Balance as of January 1, $ 1,826 $ 2,186 Provision for warranties 291 355 Claims made (206) (363) Balance as of March 31, $ 1,911 $ 2,178 Costs associated with extended warranty repairs are recorded as incurred and amounted to $1.6 million and $1.5 million for the three months ended March 31, 2021 and 2020, respectively.

Pension Plan

Pension Plan3 Months Ended
Mar. 31, 2021
Retirement Benefits [Abstract]
Pension PlanPension Plan Net periodic pension cost consists of the following: Three Months Ended March 31, 2021 2020 Service cost $ 248 $ 179 Interest cost on projected benefit obligation 451 639 Expected return on plan assets (1,289) (1,255) Net amortization and deferral 832 705 Net periodic pension cost $ 242 $ 268

Acquisition and Other Expense

Acquisition and Other Expense3 Months Ended
Mar. 31, 2021
Acquisition and Other Expense [Abstract]
Acquisition and Other ExpenseAcquisition and Other Expense Acquisition and other expense consist of the following, which are included in cost of sales or selling and administrative expense depending on the nature of the charge: Three Months Ended March 31, 2021 2020 Manufacturing consolidation costs $ — $ 1,785 Acquisition and integration costs — 805 Acquisition and other expense included in cost of sales $ — $ 2,590 Restructuring and related costs $ 414 $ — Acquisition and integration costs — 754 Acquisition and other expense included in selling and administrative expense $ 414 $ 754 During the three months ended March 31, 2020, we incurred $1.8 million in costs related to the consolidation of certain manufacturing operations which were charged to cost of sales. These costs related to winding down operations at certain locations and moving production lines to other facilities. During the three months ended March 31, 2020, we incurred costs for inventory step-up adjustments and other costs of $0.8 million related to a previous acquisition, which were charged to cost of sales. During the three months ended March 31, 2020, we incurred $0.8 million in severance and integration costs mainly related to the Buffalo Filter acquisition, which were included in selling and administrative expense. During the three months ended March 31, 2021, we recorded a charge of $0.4 million related to the restructuring of our sales force which was charged to selling and administrative expense. The charges for sales force restructuring consisted

Business Segment

Business Segment3 Months Ended
Mar. 31, 2021
Segment Reporting [Abstract]
Business SegmentBusiness 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 including 2DHD vision technologies and fees related to the sales representation, promotion and marketing of sports medicine allograft tissue. General surgery consists of a complete line of endo-mechanical instrumentation for minimally invasive laparoscopic and gastrointestinal procedures, smoke evacuation devices, a line of cardiac monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales are as follows: Three Months Ended March 31, 2021 2020 Orthopedic surgery $ 107,166 $ 99,283 General surgery 125,511 114,727 Consolidated net sales $ 232,677 $ 214,010

Legal Proceedings

Legal Proceedings3 Months Ended
Mar. 31, 2021
Commitments and Contingencies Disclosure [Abstract]
Legal ProceedingsLegal 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 $30 million per incident and $30 million in the aggregate annually, which we believe is adequate. This coverage is on a claims-made basis. There can be no assurance that claims will not exceed insurance coverage, that the carriers will be solvent or that such insurance will be available to us in the future at a reasonable cost. Our operations are subject, and in the past have been subject, to a number of environmental laws and regulations governing, among other things, air emissions; wastewater discharges; the use, handling and disposal of hazardous substances and wastes; soil and groundwater remediation and employee health and safety. Likewise, the operations of our suppliers and sterilizers are subject to similar environmental laws and regulations. In some jurisdictions, environmental requirements may be expected to become more stringent in the future. In the United States, certain environmental laws can impose liability for the entire cost of site restoration upon each of the parties that may have contributed to conditions at the site regardless of fault or the lawfulness of the party’s activities. While we do not believe that the present costs of environmental compliance and remediation are material, there can be no assurance that future compliance or remedial obligations would not have a material adverse effect on our financial condition, results of operations or cash flows. In 2014, the Company acquired EndoDynamix, Inc. The agreement governing the terms of the acquisition provides that, if various conditions are met, certain contingent payments relating to the first commercial sale of the products (the milestone payment), as well as royalties based on sales (the revenue based payments), are due to the seller. In 2016, we notified the seller that there was a need to redesign the product, and that, as a consequence, the first commercial sale had been delayed. Consequently, the payment of contingent milestone and revenue-based payments were delayed. On January 18, 2017, the seller provided notice ("the Notice") seeking $12.7 million under a liquidated damages clause, which essentially represents the seller's view as to the sum of the projected contingent milestone and revenue-based payments on an accelerated basis. CONMED responded to the Notice denying that there was any basis for acceleration of the payments due under the acquisition agreement. On February 22, 2017, the representative of the former shareholders of EndoDynamix filed a complaint in Delaware Chancery Court claiming breach of contract with respect to the duty to commercialize the product and seeking the contingent payments on an accelerated basis. We believe that there was a substantive contractual basis to support the Company's decision to redesign the product, such that there was no legitimate basis for seeking the liquidated damages. In the third quarter of 2018, the Company decided to halt the development of the EndoDynamix clip applier. We previously recorded a charge to write off assets and released a previously accrued contingent consideration liability. In a pre-trial filing 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. We expect the parties to submit post-trial briefs in the second quarter of 2021, with the Court to hear oral arguments at a hearing scheduled for July 22, 2021, and the Court to issue a ruling at some point thereafter. The Company has not recorded any expense related to potential damages in connection with this matter because the Company does not believe any potential loss is probable. We expect to defend the claims asserted by the sellers of EndoDynamix, although there can be no assurance that we will prevail in the trial and/or any resulting appeals. 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.

New Accounting Pronouncements

New Accounting Pronouncements3 Months Ended
Mar. 31, 2021
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting PronouncementsNew Accounting Pronouncements Recently Issued Accounting Standards, Not Yet Adopted In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022. The Company has not adopted this ASU as of March 31, 2021, however will continue to monitor the impact of reference rates and will elect to apply this guidance in our consolidated financial statements in the event that we are impacted by reference rate reform. 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, 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 is currently assessing the impact of this guidance on our consolidated financial statements.

Interim Reporting (Policies)

Interim Reporting (Policies)3 Months Ended
Mar. 31, 2021
Quarterly Financial Information Disclosure [Abstract]
Use of Estimates, PolicyUse of Estimates Preparation of the consolidated condensed financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated condensed financial statements and the reported amounts of revenue and expenses during the reporting period.

New Accounting Pronouncements (

New Accounting Pronouncements (Policies)3 Months Ended
Mar. 31, 2021
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting PronouncementsNew Accounting Pronouncements Recently Issued Accounting Standards, Not Yet Adopted In March 2020, the FASB issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022. The Company has not adopted this ASU as of March 31, 2021, however will continue to monitor the impact of reference rates and will elect to apply this guidance in our consolidated financial statements in the event that we are impacted by reference rate reform. 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, 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 is currently assessing the impact of this guidance on our consolidated financial statements.

Revenues (Tables)

Revenues (Tables)3 Months Ended
Mar. 31, 2021
Revenue from Contract with Customer [Abstract]
Disaggregation of RevenueThe following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended March 31, 2021 March 31, 2020 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 37,131 $ 86,812 $ 123,943 $ 37,039 $ 81,808 $ 118,847 Europe, Middle East & Africa 26,052 18,544 44,596 25,907 16,615 42,522 Asia Pacific 26,602 12,662 39,264 20,535 8,325 28,860 Americas (excluding the United States) 17,381 7,493 24,874 15,802 7,979 23,781 Total sales from contracts with customers $ 107,166 $ 125,511 $ 232,677 $ 99,283 $ 114,727 $ 214,010 Timing of Revenue Recognition Goods transferred at a point in time $ 97,690 $ 124,394 $ 222,084 $ 90,553 $ 113,901 $ 204,454 Services transferred over time 9,476 1,117 10,593 8,730 826 9,556 Total sales from contracts with customers $ 107,166 $ 125,511 $ 232,677 $ 99,283 $ 114,727 $ 214,010
Contract with Customer, Asset and LiabilityContract liability balances related to the sale of extended warranties to customers are as follows: March 31, 2021 December 31, 2020 Contract liability $ 15,231 $ 13,666

Comprehensive Income (Loss) (Ta

Comprehensive Income (Loss) (Tables)3 Months Ended
Mar. 31, 2021
Equity [Abstract]
Schedule of Comprehensive Income (Loss)Comprehensive income (loss) consists of the following: Three Months Ended March 31, 2021 2020 Net income $ 9,860 $ 5,927 Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $1,250 and $766 for the three months ended March 31, 2021 and 2020, respectively) 3,926 2,405 Pension liability, net of income tax (income tax expense of $201 and $170 for the three months ended March 31, 2021 and 2020, respectively) 631 535 Foreign currency translation adjustment (3,674) (9,988) Comprehensive income (loss) $ 10,743 $ (1,121)
Schedule of Accumulated Other Comprehensive LossAccumulated other comprehensive loss consists of the following: Cash Flow Pension Cumulative Accumulated Balance, December 31, 2020 $ (5,945) $ (36,620) $ (21,116) $ (63,681) Other comprehensive income (loss) before reclassifications, net of tax 2,725 — (3,674) (949) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,584 832 — 2,416 Income tax (383) (201) — (584) Net current-period other comprehensive income (loss) 3,926 631 (3,674) 883 Balance, March 31, 2021 $ (2,019) $ (35,989) $ (24,790) $ (62,798) Cash Flow Pension Cumulative Accumulated Balance, December 31, 2019 $ 493 $ (31,691) $ (28,079) $ (59,277) Other comprehensive income (loss) before reclassifications, net of tax 3,257 — (9,988) (6,731) Amounts reclassified from accumulated other comprehensive income (loss) before tax a (1,124) 705 — (419) Income tax 272 (170) — 102 Net current-period other comprehensive income (loss) 2,405 535 (9,988) (7,048) Balance, March 31, 2020 $ 2,898 $ (31,156) $ (38,067) $ (66,325) (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 5 and Note 11, respectively, for further details.

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)3 Months Ended
Mar. 31, 2021
Fair Value Disclosures [Abstract]
Schedule of Notional Amounts of Outstanding Derivative PositionsThe following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation March 31, 2021 December 31, 2020 Forward exchange contracts Cash flow hedge $ 164,562 $ 154,504 Forward exchange contracts Non-designated 45,545 42,380
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) and net earnings 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 March 31, Total Amount of Line Item Presented Derivative Instrument 2021 2020 Location of amount reclassified 2021 2020 2021 2020 Foreign exchange contracts $ 3,593 $ 4,295 Net Sales $ 232,677 $ 214,010 $ (1,849) $ 1,201 Cost of Sales 104,228 94,851 265 (77) Pre-tax gain (loss) $ 3,593 $ 4,295 $ (1,584) $ 1,124 Tax expense (benefit) 868 1,038 (383) 272 Net gain (loss) $ 2,725 $ 3,257 $ (1,201) $ 852
Derivatives Not Designated as Hedging InstrumentsNet 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 (loss) were: Three Months Ended March 31, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income (Loss) 2021 2020 Net gain (loss) on currency forward contracts Selling and administrative expense $ 458 $ (245) Net loss on currency transaction exposures Selling and administrative expense $ (1,123) $ (191)
Schedule of Fair Value for Forward Foreign Exchange ContractsThe following tables summarize the fair value for forward foreign exchange contracts outstanding at March 31, 2021 and December 31, 2020: March 31, 2021 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Other current liabilities $ 1,557 $ (4,592) $ (3,035) Foreign exchange contracts Other long-term assets 709 (337) 372 $ 2,266 $ (4,929) $ (2,663) Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 8 (179) (171) Total derivatives $ 2,274 $ (5,108) $ (2,834) December 31, 2020 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Other current liabilities $ 1,500 $ (8,826) $ (7,326) Foreign exchange contracts Other long-term liabilities 23 (535) (512) $ 1,523 $ (9,361) $ (7,838) Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 25 (150) (125) Total derivatives $ 1,548 $ (9,511) $ (7,963)

Inventories (Tables)

Inventories (Tables)3 Months Ended
Mar. 31, 2021
Inventory Disclosure [Abstract]
Schedule of inventoryInventories consist of the following: March 31, December 31, Raw materials $ 73,654 $ 71,807 Work-in-process 18,429 15,864 Finished goods 113,714 107,197 Total $ 205,797 $ 194,868

Earnings Per Share (Tables)

Earnings Per Share (Tables)3 Months Ended
Mar. 31, 2021
Earnings Per Share [Abstract]
Schedule of calculation of basic and diluted earnings per shareThe following table sets forth the computation of basic and diluted earnings per share for the three months ended March 31, 2021 and 2020: Three Months Ended March 31, 2021 2020 Net income $ 9,860 $ 5,927 Basic – weighted average shares outstanding 28,972 28,478 Effect of dilutive potential securities 2,406 1,229 Diluted – weighted average shares outstanding 31,378 29,707 Net income (per share) Basic $ 0.34 $ 0.21 Diluted 0.31 0.20

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets (Tables)3 Months Ended
Mar. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of GoodwillThe changes in the net carrying amount of goodwill for the three months ended March 31, 2021 are as follows: Balance as of December 31, 2020 $ 618,440 Foreign currency translation (336) Balance as of March 31, 2021 $ 618,104
Schedule of Finite-Lived Intangible AssetsOther intangible assets consist of the following: March 31, 2021 December 31, 2020 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: Customer and distributor relationships 24 $ 342,531 $ (139,243) $ 342,639 $ (134,555) Sales representation, marketing and promotional rights 25 149,376 (55,500) 149,376 (54,000) Developed technology 16 106,604 (21,358) 106,604 (19,705) Patents and other intangible assets 16 74,307 (49,356) 73,516 (48,882) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — 22 $ 759,362 $ (265,457) $ 758,679 $ (257,142)
Schedule of Indefinite-Lived Intangible AssetsOther intangible assets consist of the following: March 31, 2021 December 31, 2020 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: Customer and distributor relationships 24 $ 342,531 $ (139,243) $ 342,639 $ (134,555) Sales representation, marketing and promotional rights 25 149,376 (55,500) 149,376 (54,000) Developed technology 16 106,604 (21,358) 106,604 (19,705) Patents and other intangible assets 16 74,307 (49,356) 73,516 (48,882) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — 22 $ 759,362 $ (265,457) $ 758,679 $ (257,142)
Schedule of Estimated Amortization ExpenseThe estimated intangible asset amortization expense remaining for the year ending December 31, 2021 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2021 $ 20,620 $ 4,500 $ 25,120 2022 26,426 6,000 32,426 2023 25,646 6,000 31,646 2024 24,836 6,000 30,836 2025 25,058 6,000 31,058 2026 24,529 6,000 30,529

Long Term Debt (Tables)

Long Term Debt (Tables)3 Months Ended
Mar. 31, 2021
Debt Disclosure [Abstract]
Schedule of Long-term DebtLong-term debt consists of the following: March 31, 2021 December 31, 2020 Revolving line of credit $ 199,000 $ 207,000 Term loan, net of deferred debt issuance costs of $1,520 and $1,668 in 2021 and 2020, respectively 236,980 240,145 2.625% convertible notes, net of deferred debt issuance costs of $5,031 and $5,475 in 2021 and 2020, respectively, and unamortized discount of $31,117 and $33,620 in 2021 and 2020, respectively 308,850 305,904 Financing leases 566 587 Total debt 745,396 753,636 Less: Current portion 20,076 18,415 Total long-term debt $ 725,320 $ 735,221
Schedule of Maturities of Long-term DebtThe scheduled maturities of long-term debt outstanding at March 31, 2021 are as follows: Remaining 2021 $ 14,906 2022 24,844 2023 397,750 2024 345,000 2025 — The above amounts exclude debt discount, deferred debt issuance costs and financing leases.

Guarantees (Tables)

Guarantees (Tables)3 Months Ended
Mar. 31, 2021
Guarantees [Abstract]
Changes in the carrying amount of service and product warrantiesChanges in the liability for standard warranties for the three months ended March 31, are as follows: 2021 2020 Balance as of January 1, $ 1,826 $ 2,186 Provision for warranties 291 355 Claims made (206) (363) Balance as of March 31, $ 1,911 $ 2,178

Pension Plan (Tables)

Pension Plan (Tables)3 Months Ended
Mar. 31, 2021
Retirement Benefits [Abstract]
Schedule of net benefit costNet periodic pension cost consists of the following: Three Months Ended March 31, 2021 2020 Service cost $ 248 $ 179 Interest cost on projected benefit obligation 451 639 Expected return on plan assets (1,289) (1,255) Net amortization and deferral 832 705 Net periodic pension cost $ 242 $ 268

Acquisition and Other Expense (

Acquisition and Other Expense (Tables)3 Months Ended
Mar. 31, 2021
Acquisition and Other Expense [Abstract]
Schedule of Acquisition and Other Operating ExpenseAcquisition and other expense consist of the following, which are included in cost of sales or selling and administrative expense depending on the nature of the charge: Three Months Ended March 31, 2021 2020 Manufacturing consolidation costs $ — $ 1,785 Acquisition and integration costs — 805 Acquisition and other expense included in cost of sales $ — $ 2,590 Restructuring and related costs $ 414 $ — Acquisition and integration costs — 754 Acquisition and other expense included in selling and administrative expense $ 414 $ 754

Business Segment (Tables)

Business Segment (Tables)3 Months Ended
Mar. 31, 2021
Segment Reporting [Abstract]
Schedule of net sales information by product lineThese product lines' net sales are as follows: Three Months Ended March 31, 2021 2020 Orthopedic surgery $ 107,166 $ 99,283 General surgery 125,511 114,727 Consolidated net sales $ 232,677 $ 214,010

Revenues (Disaggregated Revenue

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Disaggregation of Revenue [Line Items]
Net Sales $ 232,677 $ 214,010
Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales222,084 204,454
Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales10,593 9,556
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales107,166 99,283
Orthopedic Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales97,690 90,553
Orthopedic Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales9,476 8,730
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales125,511 114,727
General Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales124,394 113,901
General Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales1,117 826
United States
Disaggregation of Revenue [Line Items]
Net Sales123,943 118,847
United States | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales37,131 37,039
United States | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales86,812 81,808
Americas (excluding the United States)
Disaggregation of Revenue [Line Items]
Net Sales24,874 23,781
Americas (excluding the United States) | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales17,381 15,802
Americas (excluding the United States) | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales7,493 7,979
Europe, Middle East & Africa
Disaggregation of Revenue [Line Items]
Net Sales44,596 42,522
Europe, Middle East & Africa | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales26,052 25,907
Europe, Middle East & Africa | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales18,544 16,615
Asia Pacific
Disaggregation of Revenue [Line Items]
Net Sales39,264 28,860
Asia Pacific | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales26,602 20,535
Asia Pacific | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales $ 12,662 $ 8,325

Revenues (Customer Liability) (

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020
Revenue from Contract with Customer [Abstract]
Contract liability $ 15,231 $ 13,666
Revenue recognized $ 3,400 $ 3,000

Comprehensive Income (Loss) (De

Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Equity [Abstract]
Net income $ 9,860 $ 5,927
Cash flow hedging gain, net of income tax3,926 2,405
Pension liability, net of income tax631 535
Foreign currency translation adjustments(3,674)(9,988)
Comprehensive income (loss)10,743 (1,121)
Pension liability, tax201 170
Cash flow hedging gain, tax $ 1,250 $ 766

Comprehensive Income (Loss) (Ac

Comprehensive Income (Loss) (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax $ (63,681)
Accumulated Other Comprehensive Income (Loss), Net of Tax(62,798)
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax(63,681) $ (59,277)
Other comprehensive income (loss) before reclassifications, net of tax(949)(6,731)
Amounts reclassified from other accumulated comprehensive income (loss) before tax[1]2,416 (419)
Reclassification from AOCI, Current Period, Tax(584)102
Net current-period other comprehensive income (loss)883 (7,048)
Accumulated Other Comprehensive Income (Loss), Net of Tax(62,798)(66,325)
Cash Flow Hedging Gain (Loss)
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax(5,945)493
Other comprehensive income (loss) before reclassifications, net of tax2,725 3,257
Amounts reclassified from other accumulated comprehensive income (loss) before tax[1]1,584 (1,124)
Reclassification from AOCI, Current Period, Tax(383)272
Net current-period other comprehensive income (loss)3,926 2,405
Accumulated Other Comprehensive Income (Loss), Net of Tax(2,019)2,898
Pension Liability
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax(36,620)(31,691)
Other comprehensive income (loss) before reclassifications, net of tax0 0
Amounts reclassified from other accumulated comprehensive income (loss) before tax[1]832 705
Reclassification from AOCI, Current Period, Tax(201)(170)
Net current-period other comprehensive income (loss)631 535
Accumulated Other Comprehensive Income (Loss), Net of Tax(35,989)(31,156)
Cumulative Translation Adjustments
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax(21,116)(28,079)
Other comprehensive income (loss) before reclassifications, net of tax(3,674)(9,988)
Amounts reclassified from other accumulated comprehensive income (loss) before tax[1]0 0
Reclassification from AOCI, Current Period, Tax0 0
Net current-period other comprehensive income (loss)(3,674)(9,988)
Accumulated Other Comprehensive Income (Loss), Net of Tax $ (24,790) $ (38,067)
[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 5 and Note 11, 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 Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Derivative Instruments, Gain (Loss) [Line Items]
Net sales $ 232,677 $ 214,010
Cost of sales104,228 94,851
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax3,593 4,295
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax868 1,038
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax2,725 3,257
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax(1,584)1,124
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax(383)272
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax(1,201)852
Revenues
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax(1,849)1,201
Cost of Sales
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax $ 265 $ (77)

Fair Value of Financial Instr_4

Fair Value of Financial Instruments (Foreign Currency Forward Contracts) (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020
Derivative [Line Items]
Foreign Currency Transaction Gain (Loss), before Tax $ (1,123) $ (191)
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value2,274 $ 1,548
Liabilities Fair Value(5,108)(9,511)
Net Fair Value(2,834)(7,963)
Foreign Currency Forward Contracts
Derivative [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments458 $ (245)
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value2,266 1,523
Liabilities Fair Value(4,929)(9,361)
Net Fair Value(2,663)(7,838)
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Other Noncurrent Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value23
Liabilities Fair Value(535)
Net Fair Value(512)
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value1,557 1,500
Liabilities Fair Value(4,592)(8,826)
Net Fair Value(3,035)(7,326)
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Other Noncurrent Assets [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value709
Liabilities Fair Value(337)
Net Fair Value $ 372
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge1 month
Notional amount of cash flow hedges $ 45,545 42,380
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts | Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value8 25
Liabilities Fair Value(179)(150)
Net Fair Value $ (171)(125)
Cash flow hedge | Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge2 years
Notional amount of cash flow hedges $ 164,562 $ 154,504
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months $ (2,300)

Inventories (Details)

Inventories (Details) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Inventory Disclosure [Abstract]
Raw materials $ 73,654 $ 71,807
Work-in-process18,429 15,864
Finished goods113,714 107,197
Total inventory $ 205,797 $ 194,868

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Earnings Per Share [Abstract]
Net income $ 9,860 $ 5,927
Basic-weighted average shares outstanding (in shares)28,972 28,478
Effect of dilutive potential securities (in shares)2,406 1,229
Diluted- weighted average shares outstanding (in shares)31,378 29,707
Basic (in dollars per share) $ 0.34 $ 0.21
Diluted (in dollars per share) $ 0.31 $ 0.20
Antidilutive securities excluded from computation of earnings per share (in shares)300 1,100
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities1,000 100
Incremental Common Shares Attributable to Dilutive Effect of Call Options and Warrants200

Earnings Per Share - Convertibl

Earnings Per Share - Convertible Notes (Details) - Convertible Notes Payable - 2.625 Percent Convertible Notes Due 2024 [Member]Jan. 29, 2019$ / shares
Debt Instrument [Line Items]
Interest rate, stated percentage2.625%
Conversion price (in dollars per share) $ 88.80
Hedge transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)114.92
Warrant transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) $ 114.92

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Goodwill) (Details) $ in Thousands3 Months Ended
Mar. 31, 2021USD ($)
Goodwill [Roll Forward]
Beginning balance $ 618,440
Foreign currency translation(336)
Ending balance $ 618,104

Goodwill and Other Intangible_4

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020Dec. 31, 2020
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Gross carrying amount $ 759,362 $ 758,679
Intangible assets, Accumulated amortization(265,457)(257,142)
Amortization expense8,300 $ 8,500
Future amortization expense [Abstract]
Remaining, 202125,120
202232,426
202331,646
202430,836
202531,058
202630,529
Amortization included in expense
Future amortization expense [Abstract]
Remaining, 202120,620
202226,426
202325,646
202424,836
202525,058
202624,529
Amortization recorded as a reduction of revenue
Future amortization expense [Abstract]
Remaining, 20214,500
20226,000
20236,000
20246,000
20256,000
20266,000
Trademarks & tradenames
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Unamortized intangible assets, Gross carrying amount86,544 86,544
Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount342,531 342,639
Intangible assets, Accumulated amortization(139,243)(134,555)
Sales representation, marketing and promotional rights
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount149,376 149,376
Intangible assets, Accumulated amortization(55,500)(54,000)
Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount74,307 73,516
Intangible assets, Accumulated amortization(49,356)(48,882)
Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount106,604 106,604
Intangible assets, Accumulated amortization(21,358) $ (19,705)
Asset acquisition, contingent consideration liability $ 6,000
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)16 years
Weighted Average | Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)16 years

Long Term Debt (Details)

Long Term Debt (Details) - USD ($) $ in ThousandsMar. 31, 2021Dec. 31, 2020
Debt Instrument [Line Items]
Long-term Debt and Lease Obligation, Including Current Maturities $ 745,396 $ 753,636
Finance Lease, Liability566 587
Current portion of long-term debt20,076 18,415
Long-term debt725,320 735,221
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt199,000 207,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt236,980 240,145
Unamortized Debt Issuance Expense1,520 1,668
Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Convertible Debt308,850 305,904
Debt Instrument, Unamortized Discount31,117 33,620
Unamortized Debt Issuance Expense $ 5,031 $ 5,475

Long Term Debt Additional Infor

Long Term Debt Additional Information (Details)Jan. 29, 2019USD ($)$ / sharesMar. 31, 2021USD ($)Mar. 31, 2020USD ($)Dec. 31, 2020USD ($)Feb. 07, 2019USD ($)
Debt Instrument [Line Items]
Amortization of debt discount $ 2,503,000 $ 2,264,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt, Gross238,500,000
Long-term Debt236,980,000 $ 240,145,000
Term Loan Facility [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount $ 265,000,000
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt199,000,000 $ 207,000,000
Line of Credit Facility, Remaining Borrowing Capacity383,400,000
Letters of Credit Outstanding, Amount2,600,000
Line of Credit [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity585,000,000
Convertible Notes Payable [Member] | 2.625 Percent Convertible Notes Due 2024 [Member]
Debt Instrument [Line Items]
Debt Instrument, Face Amount $ 345,000,000
Debt Instrument, Convertible, Carrying Amount of Equity Component $ 39,100,000
Amortization of debt discount2,500,000 2,300,000
Interest rate, stated percentage2.625%
Credit Agreement Expiration Trigger Requirement, Convertible Note Outstanding Balance $ 150,000,000
Debt Instrument, Interest Rate, Effective Percentage6.14%
Interest Expense, Debt $ 2,300,000 $ 2,300,000
Debt Instrument, Convertible, Gross Amount of Equity Component $ 51,600,000
Conversion price (in dollars per share) | $ / shares $ 88.80
Debt Instrument, Convertible, Conversion Ratio11.2608
Convertible Notes Payable [Member] | 2.625 Percent Convertible Notes Due 2024 [Member] | Hedge transactions
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) | $ / shares $ 114.92
Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Commitment Fee Percentage0.50%
Debt Instrument, Interest Rate, Effective Percentage3.50%
LIBOR Interest Rate Floor0.50%
London Interbank Offered Rate (LIBOR) [Member] | Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate3.00%
Eurodollar [Member] | Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate3.00%
Base Rate [Member] | Long-term Debt [Member] | Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate2.00%
Call Option [Member] | Convertible Notes Payable [Member] | 2.625 Percent Convertible Notes Due 2024 [Member]
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid $ 21,000,000

Long Term Debt Maturities of Lo

Long Term Debt Maturities of Long Term Debt (Details) $ in ThousandsMar. 31, 2021USD ($)
Maturities of Long-term Debt [Abstract]
Remaining, 2021 $ 14,906
202224,844
2023397,750
2024345,000
2025 $ 0

Guarantees (Details)

Guarantees (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Guarantees [Abstract]
Standard warranty period (in years)1 year
Movement in Standard Product Warranty Accrual [Roll Forward]
Balance as of January 1, $ 1,826 $ 2,186
Provision for warranties291 355
Claims made(206)(363)
Balance as of March 31,1,911 2,178
Extended Product Warranty Disclosure [Abstract]
Product extended warranty expense $ 1,600 $ 1,500

Pension Plan (Details)

Pension Plan (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Retirement Benefits [Abstract]
Service cost $ 248 $ 179
Interest cost on projected benefit obligation451 639
Expected return on plan assets(1,289)(1,255)
Net amortization and deferral832 705
Net periodic pension cost $ 242 268
Defined Benefit Plan, Non-service cost $ 100

Acquisition and Other Expense_2

Acquisition and Other Expense (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Cost of Sales
Acquisition and Other Expense [Line Items]
Manufacturing consolidation costs $ 0 $ 1,785
Acquisition and integration costs0 805
Acquisition and other expense0 2,590
Selling and Administrative Expenses
Acquisition and Other Expense [Line Items]
Restucturing and related costs414 0
Acquisition and integration costs0 754
Acquisition and other expense $ 414 $ 754

Business Segment (Details)

Business Segment (Details) - USD ($) $ in Thousands3 Months Ended
Mar. 31, 2021Mar. 31, 2020
Segment Reporting Information [Line Items]
Net sales $ 232,677 $ 214,010
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales107,166 99,283
General Surgery
Segment Reporting Information [Line Items]
Net sales $ 125,511 $ 114,727

Legal Proceedings (Details)

Legal Proceedings (Details) - USD ($) $ in MillionsJan. 18, 2017Mar. 31, 2021
Loss Contingencies [Line Items]
Product liability insurance, amount per incident $ 30
Product liability insurance, aggregate annual amount $ 30
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