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Goodwill and Intangible Assets
12 Months Ended
Dec. 31, 2023
Goodwill and Intangible Assets Disclosure [Abstract]  
Goodwill and Intangible Assets Disclosure Goodwill and Intangible Assets
 
The following table summarizes the activity in Goodwill, by segment during the years ended December 31, 2023 and 2022: 
 Prevention & RecoveryReconstructiveTotal
 (In thousands)
Balance, January 1, 2022$1,088,533 $845,725 $1,934,258 
Goodwill attributable to acquisitions(1)
— 61,241 61,241 
Impact of foreign currency translation(10,897)(1,014)(11,911)
Balance, December 31, 20221,077,636 905,952 1,983,588 
Goodwill attributable to acquisitions(1)
— 43,683 43,683 
Impact of foreign currency translation23,859 9,763 33,622 
Balance, December 31, 2023$1,101,495 $959,398 $2,060,893 
(1) Includes purchase accounting adjustments associated with acquisitions discussed in Note 5, “Acquisitions”.

The following table summarizes the Company’s Intangible assets, excluding Goodwill: 
Year Ended December 31,
20232022
Gross
Carrying
Amount
Accumulated
Amortization
Gross
Carrying
Amount
Accumulated
Amortization
(In thousands)
Definite-Lived Intangible Assets
Acquired customer relationships$548,234 $(279,757)$528,489 $(215,962)
Acquired technology632,801 (184,216)553,284 (134,967)
Acquired trade names458,917 (100,061)414,801 (74,644)
Software83,849 (42,910)72,371 (39,202)
Other intangible assets16,335 (5,829)9,917 (3,360)
 $1,740,136 $(612,773)$1,578,862 $(468,135)
 
Amortization expense related to acquired intangible assets, including acquired customer relationships, acquired technology, and acquired trade names, are presented on the face of the Consolidated Statements of Operations. Other intangible assets amortization expense consists primarily of amortization of software intangibles and is recorded as a component of Selling, general, and administrative expense in the Consolidated Statements of Operations. Total amortization expense is $140.2 million, $133.7 million, and $125.0 million for the years ended December 31, 2023, 2022 and 2021, respectively.

See Note 2, “Summary of Significant Accounting Policies” for discussion regarding impairment of Intangible assets.
Expected Amortization Expense
 
The Company’s expected annual amortization expense for intangible assets for the next five years is as follows: 
 December 31, 2023
 (In thousands)
2024$145,822 
2025144,572 
2026139,483 
2027131,403 
202896,556