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Goodwill and Other Intangible Assets | 12 Months Ended
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Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract] |
Goodwill and Other Intangible Assets | Goodwill and Other Intangible Assets The changes in the net carrying amount of goodwill for the years ended December 31, are as follows:
| 2018 |  | 2017
Balance as of January 1, | $ | 401,954 |  |  | $ | 397,664 |
Goodwill resulting from business combinations | — |  |  | 2,209 |
Foreign currency translation | (1,514 | ) |  | 2,081 |
Balance as of December 31, | $ | 400,440 |  |  | $ | 401,954 |
During 2017, we entered into a business combination for which we recorded $2.2 million to goodwill. Total accumulated goodwill impairment losses aggregated $107.0 million at December 31, 2018 and 2017, respectively. Other intangible assets consist of the following:
| December 31, 2018 |  | December 31, 2017
| Weighted Average Amortization Period (Years) | Gross Carrying Amount |  | Accumulated Amortization |  | Gross Carrying Amount |  | Accumulated Amortization
Intangible assets with definite lives: |  |  |  |  |  |  |  |
Customer and distributor relationships | 29 | $ | 214,577 |  |  | $ | (97,131 | ) |  | $ | 214,685 |  |  | $ | (86,137 | )
Sales representation, marketing and promotional rights | 25 | 149,376 |  |  | (42,000 | ) |  | 149,376 |  |  | (36,000 | )
Patents and other intangible assets | 14 | 61,473 |  |  | (44,242 | ) |  | 69,668 |  |  | (42,127 | )
Developed technology | 16 | 91,965 |  |  | (7,369 | ) |  | 62,283 |  |  | (3,352 | )
Intangible assets with indefinite lives: |  |  |  |  |  |  |  |  |  |  |  |
Trademarks and tradenames |  | 86,544 |  |  | — |  |  | 86,544 |  |  | — |
| 24 | $ | 603,935 |  |  | $ | (190,742 | ) |  | $ | 582,556 |  |  | $ | (167,616 | )
On January 3, 2012, the Company entered into an agreement with MTF to obtain the right to represent, market, and promote MTF's allograft tissues within the field of sports medicine. The initial consideration from the Company included a $63.0 million up-front payment for the rights and certain assets, with an additional $84.0 million contingently payable over a four year period depending on MTF meeting supply targets for tissue. On January 6, 2016, we paid the final $16.7 million additional consideration installment. Amortization expense related to intangible assets which are subject to amortization totaled $23.2 million, $21.3 million and $20.0 million for the years ending December 31, 2018, 2017 and 2016, 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 statements of comprehensive income. Included in developed technology is $21.3 million of earn-out consideration that was paid during 2018 and an additional accrual of $8.4 million that is considered probable as of December 31, 2018 associated with a prior asset acquisition. The accrual is recorded in other current liabilities at December 31, 2018. This developed technology has a weighted average useful life of 15 years. During the year ended December 31, 2018, the Company wrote off $9.5 million related to an in-process research and development asset and recorded the net charge to research and development expense. Refer to Notes 12 and 13 for further details. The estimated amortization expense related to intangible assets at December 31, 2018 and for each of the five succeeding years is as follows:
| Amortization included in expense |  | Amortization recorded as a reduction of revenue |  | Total
2019 | 17,978 |  |  | 6,000 |  |  | $ | 23,978 |
2020 | 17,995 |  |  | 6,000 |  |  | $ | 23,995 |
2021 | 17,042 |  |  | 6,000 |  |  | $ | 23,042 |
2022 | 15,583 |  |  | 6,000 |  |  | $ | 21,583 |
2023 | 14,879 |  |  | 6,000 |  |  | $ | 20,879 |

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- Definition The entire disclosure for goodwill and intangible assets. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -URI http://asc.fasb.org/topic&trid=2144416 + Details
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