Goodwill and Other Intangible Assets

9 Months Ended

Sep. 30, 2022

Goodwill and Intangible Assets Disclosure [Abstract]

The changes in the net carrying amount of goodwill for the nine months ended September 30, 2022 are as follows:


Balance as of December 31, 2021	$	617,528

Goodwill resulting from business acquisitions	198,992

Foreign currency translation	(2,260)

Balance as of September 30, 2022	$	814,260

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. During the nine months ended September 30, 2022, the Company acquired In2Bones Global, Inc. and Biorez, Inc. as further described in Note 4. Goodwill resulting from the In2Bones Acquisition amounted to $139.8 million and acquired intangible assets including distributor relationships and developed technology amounted to $64.9 million. Goodwill resulting from the Biorez Acquisition amounted to $59.2 million and acquired intangible assets including developed technology and trademarks and tradenames amounted to $177.9 million.

Other intangible assets consist of the following:


	September 30, 2022					December 31, 2021
	Weighted Average Amortization Period (Years)	Gross Carrying Amount		Accumulated Amortization		Gross Carrying Amount		Accumulated Amortization
Intangible assets with definite lives:	21

Customer and distributor relationships	24	$	369,643	$	(166,190)	$	342,452	$	(152,934)

Sales representation, marketing and promotional rights	25	149,376		(64,500)		149,376		(60,000)

Developed technology	18	320,204		(32,368)		106,604		(26,495)

Patents and other intangible assets	15	78,808		(52,064)		76,392		(50,890)

Intangible assets with indefinite lives:

Trademarks and tradenames		86,544		—		86,544		—

		$	1,004,575	$	(315,122)	$	761,368	$	(290,319)

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 $8.7 million and $8.3 million for the three months ended September 30, 2022 and 2021, respectively, and $24.9 million in both the nine months ended September 30, 2022 and 2021 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).

The estimated intangible asset amortization expense remaining for the year ending December 31, 2022 and for each of the five succeeding years is as follows:


	Amortization included in expense		Amortization recorded as a reduction of revenue		Total
Remaining, 2022	$	7,487	$	1,500	$	8,987
2023	29,263		6,000		35,263
2024	28,947		6,000		34,947
2025	29,423		6,000		35,423
2026	29,196		6,000		35,196
2027	30,235		6,000		36,235