v3.24.0.1
Segment Information
 12 Months Ended
Dec. 31, 2023
Segment Reporting [Abstract]  
Segment Information Segment Information
The Company conducts its continuing operations through the Prevention & Recovery and Reconstructive operating segments, which also represent the Company’s reportable segments.

• Prevention & Recovery - a leader in orthopedic solutions and recovery sciences, providing devices, software and services across the patient care continuum from injury prevention to rehabilitation after surgery, injury, or from degenerative disease.

•Reconstructive - innovation market-leader positioned in the fast-growing surgical implant business, offering a comprehensive suite of reconstructive joint products for the hip, knee, shoulder, elbow, foot, ankle, and finger.

The Company’s management, including the chief operating decision maker, evaluates the operating results of each of its reportable segments based upon Net sales and Adjusted EBITDA, which excludes from Net loss from continuing operations the effect of restructuring and certain other charges, MDR and related costs, acquisition-related intangible asset amortization and other non-cash charges, strategic transaction costs, stock-based compensation, insurance settlement gain, and inventory step-up charges from the operating income of the Company’s operating segments.

The Company’s segment results were as follows:
Year Ended December 31,
202320222021
(In thousands)
Net sales:
Prevention & Recovery $1,076,776 $1,027,628 $1,026,029 
Reconstructive 630,421 535,473 400,159 
Total Net sales$1,707,197 $1,563,101 $1,426,188 
Segment Adjusted EBITDA(1):
Prevention & Recovery$152,501 $141,344 $133,500 
     Reconstructive116,726 94,726 72,496 
Total Adjusted EBITDA(1)
$269,227 $236,070 $205,996 
Depreciation, amortization and impairment
     Prevention & Recovery$115,752 $104,458 $97,898 
     Reconstructive101,357 98,507 89,091 
Total depreciation, amortization and impairment $217,109 $202,965 $186,989 
Capital expenditures:
     Prevention & Recovery$26,356 $25,140 $19,514 
     Reconstructive95,867 74,407 49,077 
     Total capital expenditures$122,223 $99,547 $68,591 
(1) The following is a reconciliation of Income from continuing operations before income taxes to Adjusted EBITDA:
Year Ended December 31,
202320222021
(In thousands)
Loss from continuing operations before income taxes$(67,128)$(2,069)$(121,781)
Restructuring and other charges(1)
19,950 18,960 13,914 
MDR and other costs(2)
27,400 16,709 7,949 
Strategic transaction costs38,250 61,024 23,448 
Stock-based compensation32,079 31,493 25,737 
Depreciation and other amortization83,592 76,664 70,069 
Amortization of acquired intangibles133,517 126,301 116,920 
Insurance settlement gain(3)
— (36,705)— 
Inventory step-up148 12,802 10,758 
Interest expense, net19,749 24,052 29,112 
Debt extinguishment charges7,333 20,396 29,870 
Gain on investment in ESAB Corporation— (102,669)— 
Gain on cost basis investment— (8,800)— 
Other income, net(25,663)(2,088)— 
Adjusted EBITDA (non-GAAP)269,227 236,070 205,996 
(1) Restructuring and other charges includes $2.6 million, $1.7 million and $5.2 million of expense classified as Cost of sales on the Company’s Consolidated Statements of Operations for the years ended December 31, 2023, 2022 and 2021, respectively.
(2) Primarily related to costs specific to compliance with medical device reporting regulations and other requirements of the European Union MDR. These costs are classified as Selling, general and administrative expense on our Consolidated Statements of Operations.
(3) Insurance settlement gain is related to the 2019 acquisition of DJO.

December 31,
20232022
(In thousands)
Total assets(1):
    Prevention & Recovery$2,414,014 $2,470,917 
    Reconstructive2,095,320 1,802,331 
Total$4,509,334 $4,273,248 
(1) Includes allocation of certain centrally managed assets, including cash and cash equivalents.

The detail of the Company’s operations by geography is as follows:
Year Ended December 31,
202320222021
(In thousands)
Net sales by origin(1):
United States$1,152,360 $1,062,765 $1,030,440 
Foreign locations554,837 500,336 395,748 
Total$1,707,197 $1,563,101 $1,426,188 
(1) The Company attributes revenues from external customers to individual countries based upon the country in which the sale was originated.
December 31,
20232022
(In thousands)
Property, plant and equipment, net(1):
United States$179,146 $157,897 
Switzerland45,995 41,113 
Germany20,147 16,450 
 Mexico8,006 6,605 
France5,529 3,058 
Other foreign locations11,975 11,618 
Total$270,798 $236,741 
(1) As the Company does not allocate all long-lived assets (specifically intangible assets) to each individual country, evaluation of long-lived assets in total is impracticable.