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Fair value measurements and investments (Tables)

3 Months Ended

Mar. 31, 2022

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Schedule of Financial Assets and Liabilities Recorded at Fair Value on Recurring Basis

The fair value measurements of the Company’s financial assets and liabilities measured on a recurring basis were as follows:

		March 31, 2022																December 31, 2021
(U.S. Dollars, in thousands)		Level 1				Level 2				Level 3				Total				Total
Assets
Neo Medical convertible loan agreements		$	—			$	—			$	5,780			$	5,780			$	7,148
Neo Medical preferred equity securities			—				6,084				—				6,084				5,413
Bone Biologics equity securities			243				—				—				243				309
Other investments			—				—				1,535				1,535				1,505
Total		$	243			$	6,084			$	7,315			$	13,642			$	14,375
Liabilities
Spinal Kinetics contingent consideration		$	—			$	—			$	(11,700	)		$	(11,700	)		$	(17,200	)
Deferred compensation plan			—				(1,285	)			—				(1,285	)			(1,314	)
Total		$	—			$	(1,285	)		$	(11,700	)		$	(12,985	)		$	(18,514	)

Schedule of Reconciliation of Investments in Equity Securities

The table below presents a reconciliation of the beginning and ending balances of the Company’s investment in Neo Medical preferred equity securities:

(U.S. Dollars, in thousands)		2022				2021
Fair value of Neo Medical preferred equity securities at January 1		$	5,413			$	5,000
Conversion of loan into preferred equity securities			671				—
Fair value of Neo Medical preferred equity securities at March 31			6,084				5,000
Cumulative unrealized gain on Neo Medical preferred equity securities			413				—

Schedule of Changes in Valuation of Securities

Changes in the fair value of the investment recorded during the three months ended March 31, 2022 and 2021, are shown in the table below:

(U.S. Dollars, in thousands)		2022				2021
Bone Biologics equity securities at January 1		$	309			$	—
Fair value adjustments recognized in other expense, net			(66	)			—
Bone Biologics equity securities at March 31		$	243			$	—

Schedule of Reconciliation For Contingent Consideration Measured At Fair Value Using Significant Unobservable Inputs

The following table provides a reconciliation of the beginning and ending balances for the Spinal Kinetics contingent consideration measured at estimated fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)		2022				2021
Spinal Kinetics contingent consideration estimated fair value at January 1		$	17,200			$	35,400
Increase (decrease) in fair value recognized in acquisition-related amortization and remeasurement			(5,500	)			1,500
Spinal Kinetics contingent consideration estimated fair value at March 31		$	11,700			$	36,900

Fair Value, Inputs, Level 3 [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Schedule of Reconciliation For Convertible Loans Measured At Fair Value Using Significant Unobservable Inputs

The following table provides a reconciliation of the beginning and ending balances of the Convertible Loans, measured at fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)		2022				2021
Fair value of Neo Medical Convertible Loans at January 1		$	7,148			$	7,160
Interest recognized in interest income, net			112				96
Foreign currency remeasurement recognized in other expense, net			(69	)			(330	)
Unrealized loss recognized in other comprehensive income (loss)			(740	)			(726	)
Conversion of loan into preferred equity securities			(671	)			—
Fair value of Neo Medical Convertible Loans at March 31			5,780				6,200
Amortized cost basis of Neo Medical Convertible Loans at March 31			5,581				5,045

Schedule of Changes in Valuation of Securities

The following table provides quantitative information related to certain key assumptions utilized within the valuation as of March 31, 2022:

(U.S. Dollars, in thousands)		Fair Value as of  March 31, 2022				Unobservable inputs		Estimate
Neo Medical Convertible Loan		$	5,780			Cost of equity discount rate			16.9	%
						Implied volatility			71.3	%

The following table provides a range of key assumptions used within the valuation as of March 31, 2022:

(U.S. Dollars, in thousands)		Fair Value as of March 31, 2022				Valuation Technique		Unobservable inputs		Range
Spinal Kinetics contingent consideration		$	11,700			Discounted cash flow		Revenue discount rate		5.9% - 7.4%
								Payment discount rate		3.2% - 4.7%
								Projected year of achievement		2023

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