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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($)
$ in Thousands
 3 Months Ended 12 Months Ended
Mar. 31, 2021
Mar. 31, 2020
Dec. 31, 2020
OPERATING ACTIVITIES:      
Net income $ 45,394 $ 9,180  
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 29,214 29,151  
Non-cash impairment charges 2,754 0  
Deferred income tax (benefit) provision (1,234) 5,068  
Share-based compensation 6,334 3,750  
Amortization of debt issuance costs and expenses associated with debt refinancing 1,721 4,246  
Non-cash lease expense 1,522 178  
Accretion of bond issuance discount 0 2,529  
Loss on disposal of property and equipment (2) 374  
Gain from the sale of business (42,876) 0  
Change in fair value of contingent consideration and others 281 (1,051)  
Changes in assets and liabilities:      
Accounts receivable 16,756 28,301  
Inventories (2,332) (26,236)  
Prepaid expenses and other current assets (3,574) 4,683  
Other non-current assets 10,419 3,000  
Accounts payable, accrued expenses and other current liabilities 14,449 (40,413)  
Contract liabilities (83) 338  
Other non-current liabilities (9,662) (2,284)  
Net cash provided by operating activities 69,081 20,814  
INVESTING ACTIVITIES:      
Purchases of property and equipment (6,675) (16,519)  
Proceeds from sale of Extremity Orthopedics business 191,736 0  
Proceeds from sale of property and equipment 0 34  
Cash (paid) provided for business acquisitions, net of cash acquired (302,627) 0  
Acquired in-process research and development 0 (5,000)  
Net cash used in investing activities (117,566) (21,485)  
FINANCING ACTIVITIES:      
Proceeds from borrowings of long-term indebtedness 600 113,200  
Payments on debt (2,200) (344,200)  
Purchase of option hedge on convertible notes 0 (104,248)  
Proceeds from convertible notes issuance 0 575,000  
Proceeds from sale of stock purchase warrants 0 44,562  
Payment of debt issuance costs 0 (20,264)  
Purchases of treasury stock 0 (100,000)  
Proceeds from exercised stock options 2,222 2,303  
Cash taxes paid in net equity settlement (3,637) (4,348)  
Net cash (used) provided by financing activities (3,015) 162,005  
Effect of exchange rate changes on cash and cash equivalents (9,690) (2,533)  
Net increase in cash and cash equivalents (61,190) 158,801  
Cash and cash equivalents at beginning of period 470,166 198,911 $ 198,911
Cash and cash equivalents at end of period $ 408,976 $ 357,712 $ 470,166