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Goodwill and Other Intangible Assets | 9 Months Ended
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Sep. 30, 2023
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 nine months ended September 30, 2023 are as follows:
Balance as of December 31, 2022 | $ | 815,429 |
Foreign currency translation | (286) |
Balance as of September 30, 2023 | $ | 815,143 |
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:
| September 30, 2023 |  | December 31, 2022
| Weighted Average Amortization Period (Years) | Gross Carrying Amount |  | Accumulated Amortization |  | Gross Carrying Amount |  | Accumulated Amortization
Intangible assets with definite lives: | 22 |  |  |  |  |  |  |
Customer and distributor relationships | 24 | $ | 369,812 |  |  | $ | (184,040) |  |  | $ | 369,854 |  |  | $ | (170,870) |
Sales representation, marketing and promotional rights | 25 | 149,376 |  |  | (70,500) |  |  | 149,376 |  |  | (66,000) |
Developed technology | 18 | 320,204 |  |  | (42,087) |  |  | 320,204 |  |  | (34,675) |
Patents and other intangible assets | 16 | 81,677 |  |  | (53,633) |  |  | 79,838 |  |  | (52,472) |
Intangible assets with indefinite lives: |  |  |  |  |  |  |  |
Trademarks and tradenames |  | 86,544 |  |  | — |  |  | 86,544 |  |  | — |
|  | $ | 1,007,613 |  |  | $ | (350,260) |  |  | $ | 1,005,816 |  |  | $ | (324,017) |
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 for both the three months ended September 30, 2023 and 2022 and $26.3 million and $24.9 million for the nine months ended September 30, 2023 and 2022, 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). The estimated intangible asset amortization expense remaining for the year ending December 31, 2023 and for each of the five succeeding years is as follows:
| Amortization included in expense |  | Amortization recorded as a reduction of revenue |  | Total
Remaining, 2023 | $ | 7,338 |  |  | $ | 1,500 |  |  | $ | 8,838 |
2024 | 28,730 |  |  | 6,000 |  |  | 34,730 |
2025 | 29,607 |  |  | 6,000 |  |  | 35,607 |
2026 | 29,371 |  |  | 6,000 |  |  | 35,371 |
2027 | 30,411 |  |  | 6,000 |  |  | 36,411 |
2028 | 33,543 |  |  | 6,000 |  |  | 39,543 |

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