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Business Segment
 9 Months Ended
Sep. 30, 2025
Segment Reporting [Abstract]  
Business Segment Business Segment
We account and report for our business as a single operating segment entity engaged in the development, manufacturing and sale on a global basis of surgical devices and related equipment. The Company derives revenue globally and manages the business on a consolidated basis due to shared infrastructure and resources. Our chief operating decision maker ("CODM"), the President and Chief Executive Officer, evaluates the various global product portfolios on a net sales basis and evaluates profitability, investment, cash flow metrics and allocates resources on a consolidated worldwide basis.
Our product lines consist of orthopedic surgery and general surgery. Orthopedic surgery consists of sports medicine and lower extremities instrumentation and implants, small bone, large bone and specialty powered surgical instruments as well as imaging systems for use in minimally invasive surgical procedures and fees related to sales representation, promotion and marketing of sports medicine allograft tissue. General surgery consists of a complete line of endo-mechanical instrumentation for minimally invasive laparoscopic and gastrointestinal procedures, clinical insufflation, smoke evacuation devices, a line of cardiac monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales are as follows:
Three Months Ended September 30,Nine Months Ended September 30,
 2025202420252024
Orthopedic surgery$138,193 $130,537 $417,216 $404,986 
General surgery199,733 186,164 584,310 556,085 
Consolidated net sales$337,926 $316,701 $1,001,526 $961,071 
The following table includes significant segment expenses:
Three Months Ended September 30,Nine Months Ended September 30,
2025202420252024
Net sales
$337,926 $316,701 $1,001,526 $961,071 
Cost of sales
171,807 137,706 469,336 426,383 
Salesforce and commission expense
59,404 55,124 175,760 167,720 
Marketing expense
16,915 16,053 49,782 48,002 
Distribution expense
13,085 12,039 38,270 36,831 
General and administrative expense
31,941 28,396 97,609 89,388 
Stock-based compensation expense
4,585 6,123 23,352 19,336 
Amortization expense
7,233 7,158 21,597 21,466 
Non-cash adjustments to fair value of contingent consideration liability1,341 (27,049)3,504 (42,267)
Research and development expense
13,901 13,558 40,985 41,250 
Interest expense
7,606 9,252 23,716 28,440 
Other expense
— — 418 — 
Provision for income taxes
1,414 7,471 11,548 20,719 
Other segment items(a)
5,835 1,886 15,333 5,135 
Net income
$2,859 $48,984 $30,316 $98,668 
(a)Other segment items consist of (i) third party services pertaining to review of potential issues with certain royalty payments to surgeons involved in design teams during the three and nine months ended September 30, 2025 and 2024; (ii) cash compensation costs related to advisory services provided by our former Chief Executive Officer during the nine months ended September 30, 2025; (iii) consulting fees related to operational optimization during the three and nine months ended September 30, 2025; (iv) gain on the sale of a product line during the nine months ended September 30, 2025; and (v) restructuring related costs and income related to the termination of a distributor agreement during the nine months ended September 30, 2024.
Total assets for the Company's single operating segment are the same as presented on the Company's consolidated balance sheet, which is used to measure segment performance.