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Fair value measurements and investments (Tables) | 12 Months Ended
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Dec. 31, 2023
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 Company’s available for sale debt securities, equity securities, contingent consideration, and deferred compensation plan liabilities are the only financial instruments recorded at fair value on a recurring basis as follows:
(U.S. Dollars, in thousands) |  | Level 1 |  |  | Level 2 |  |  | Level 3 |  |  | Balance December 31, 2023 |
Assets |  |  |  |  |  |  |  |  |  |  |  |
Neo Medical convertible loan agreement |  | $ | — |  |  | $ | — |  |  | $ | 6,760 |  |  | $ | 6,760 |
Neo Medical preferred equity securities |  |  | — |  |  |  | 4,951 |  |  |  | — |  |  |  | 4,951 |
Bone Biologics equity securities |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |
Other investments |  |  | — |  |  |  | — |  |  |  | 1,309 |  |  |  | 1,309 |
Total |  | $ | — |  |  | $ | 4,951 |  |  | $ | 8,069 |  |  | $ | 13,020 |
Liabilities |  |  |  |  |  |  |  |  |  |  |  |
Lattus contingent consideration |  | $ | — |  |  | $ | — |  |  | $ | (8,500 | ) |  | $ | (8,500 | )
Spinal Kinetics contingent consideration |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |
Deferred compensation plan |  |  | — |  |  |  | (1,674 | ) |  |  | — |  |  |  | (1,674 | )
Total |  | $ | — |  |  | $ | (1,674 | ) |  | $ | — |  |  | $ | (10,174 | )
(U.S. Dollars, in thousands) |  | Level 1 |  |  | Level 2 |  |  | Level 3 |  |  | Balance December 31, 2022 |
Assets |  |  |  |  |  |  |  |  |  |  |  |
Neo Medical convertible loan agreements |  | $ | — |  |  | $ | — |  |  | $ | 7,140 |  |  | $ | 7,140 |
Neo Medical preferred equity securities |  |  | — |  |  |  | 6,084 |  |  |  | — |  |  |  | 6,084 |
Bone Biologics equity securities |  |  | — |  |  |  | — |  |  |  | — |  |  |  | — |
Other Investments |  |  | — |  |  |  | — |  |  |  | 1,726 |  |  |  | 1,726 |
Total |  | $ | — |  |  | $ | 6,084 |  |  | $ | 7,140 |  |  | $ | 14,950 |
Liabilities |  |  |  |  |  |  |  |  |  |  |  |
Spinal Kinetics contingent consideration |  | $ | — |  |  | $ | — |  |  | $ | — |  |  | $ | — |
Deferred compensation plan |  |  | — |  |  |  | (1,515 | ) |  |  | — |  |  |  | (1,515 | )
Total |  | $ | — |  |  | $ | (1,515 | ) |  | $ | — |  |  | $ | (1,515 | )
Schedule of Reconciliation of Carrying Value of Investments in Equity Securities | The table below presents a reconciliation of the carrying value of the Company’s investment in Neo Medical preferred equity securities for the years ended December 31, 2023, and 2022:
(U.S. Dollars, in thousands) |  | 2023 |  |  | 2022 |
Fair value of Neo Medical preferred equity securities at January 1 |  | $ | 6,084 |  |  | $ | 5,413 |
Conversion of loan into preferred equity securities |  |  | — |  |  |  | 671 |
Foreign currency remeasurement recognized in other income, net |  |  | 388 |  |  |  | — |
Unrealized loss recognized in other income (expense), net |  |  | (1,521 | ) |  |  | — |
Fair value of Neo Medical preferred equity securities at December 31 |  | $ | 4,951 |  |  | $ | 6,084 |
Cumulative unrealized gain (loss) on Neo Medical preferred equity securities |  |  | (720 | ) |  |  | 413 |
The
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 contingent consideration measured at fair value using significant unobservable inputs (Level 3):
(U.S. Dollars, in thousands) |  | 2023 |  |  | 2022 |
Spinal Kinetics contingent consideration at January 1 |  | $ | — |  |  | $ | 17,200 |
Decrease in fair value recognized in acquisition-related amortization and remeasurement |  |  | — |  |  |  | (17,200 | )
Payment made |  |  | — |  |  |  | — |
Spinal Kinetics contingent consideration at December 31 |  | $ | — |  |  | $ | — |
(U.S. Dollars, in thousands) |  | 2023 |  |  | 2022 |
Lattus contingent consideration estimated fair value at January 5 |  | $ | 11,200 |  |  | $ | — |
Decrease in fair value recognized in acquisition-related amortization and remeasurement |  |  | (2,700 | ) |  |  | — |
Lattus contingent consideration estimated fair value at December 31 |  | $ | 8,500 |  |  | $ | — |
Schedule of Changes in Valuation of Securities | The following table presents the changes in fair value recognized for each of the years ended December 31, 2023, 2022, and 2021:
(U.S. Dollars, in thousands) |  | 2023 |  |  | 2022 |  |  | 2021 |
Bone Biologics equity securities at January 1 |  | $ | — |  |  | $ | 309 |  |  | $ | — |
Fair value adjustments and impairments recognized in other income (expense), net |  |  | — |  |  |  | (183 | ) |  |  | 309 |
Proceeds from the disposition of equity securities |  |  | — |  |  |  | (126 | ) |  |  | — |
Bone Biologics equity securities at December 31 |  | $ | — |  |  | $ | — |  |  | $ | 309 |
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 Loan(s), measured at fair value using significant unobservable inputs (Level 3):
(U.S. Dollars, in thousands) |  | 2023 |  |  | 2022 |
Fair value of Neo Medical Convertible Loans at January 1 |  | $ | 7,140 |  |  | $ | 7,148 |
Additions |  |  | — |  |  |  | — |
Interest recognized in interest income, net |  |  | 496 |  |  |  | 436 |
Foreign currency remeasurement recognized in other income (expense), net |  |  | 617 |  |  |  | (67 | )
Unrealized gain (loss) recognized in other comprehensive income (loss) |  |  | (1,233 | ) |  |  | 294 |
Expected credit loss recognized in other income (expense), net |  |  | (260 | ) |  |  | — |
Conversion of Additional Convertible Loan into preferred equity securities |  |  | — |  |  |  | (671 | )
Fair value of Neo Medical Convertible Loans at December 31 |  | $ | 6,760 |  |  | $ | 7,140 |
Contractual value of Neo Medical Convertible Loans at December 31 |  | $ | 7,020 |  |  | $ | 5,907 |
Allowance for credit loss recognized in other income (expense), net |  |  | (260 | ) |  |  | — |
Amortized cost basis of Neo Medical Convertible Loans at December 31 |  | $ | 6,760 |  |  | $ | 5,907 |
Schedule of Changes in Valuation of Securities | The following table provides quantitative information related to certain key assumptions utilized within the valuation of the Convertible Loan as of December 31, 2023:
(U.S. Dollars, in thousands) |  | Fair Value as of December 31, 2023 |  |  | Unobservable inputs |  | Estimate |
Neo Medical Convertible Loan |  | $ | 6,760 |  |  | Cost of equity discount rate |  |  | 19.3 | %
|  |  |  |  | Present value factor |  |  | 15.3 | %
|  |  |  |  | Implied volatility |  |  | 81.1 | %
The following table provides quantitative information related to certain key assumptions utilized within the valuation as of December 31, 2023:
(U.S. Dollars, in thousands) |  | Fair Value as of December 31, 2023 |  |  | Unobservable inputs |  | Estimate |
Lattus Contingent Consideration |  | $ | 8,500 |  |  | Counterparty discount rate |  |  | 14.0 | %
|  |  |  |  | Revenue risk-adjusted discount rate |  |  | 6.5 | %

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- Definition Tabular disclosure of the fair value measurement of assets using significant unobservable inputs (Level 3), a reconciliation of the beginning and ending balances, separately presenting changes during the period attributable to the following: (1) total gains or losses for the period (realized and unrealized), segregating those gains or losses included in earnings (or changes in net assets) and gains or losses recognized in other comprehensive income (loss), and a description of where those gains or losses included in earnings (or changes in net assets) are reported in the statement of income (or activities); (2) purchases, sales, issues, and settlements (each type disclosed separately); and (3) transfers in and transfers out of Level 3 (for example, transfers due to changes in the observability of significant inputs), by class of asset. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Section 50 -Paragraph 2 -Subparagraph (c) -SubTopic 10 -Topic 820 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482106/820-10-50-2 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 820 -SubTopic 10 -Section 50 -Paragraph 3 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482106/820-10-50-3 + Details
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- Definition Tabular disclosure of the fair value measurement of liabilities using significant unobservable inputs (Level 3), a reconciliation of the beginning and ending balances, separately presenting changes attributable to the following: (1) total gains or losses for the period (realized and unrealized), segregating those gains or losses included in earnings (or changes in net assets), and gains or losses recognized in other comprehensive income (loss) and a description of where those gains or losses included in earnings (or changes in net assets) are reported in the statement of income (or activities); (2) purchases, sales, issues, and settlements (each type disclosed separately); and (3) transfers in and transfers out of Level 3 (for example, transfers due to changes in the observability of significant inputs) by class of liability. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Section 50 -Paragraph 2 -Subparagraph (c) -SubTopic 10 -Topic 820 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482106/820-10-50-2 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Name Accounting Standards Codification -Topic 820 -SubTopic 10 -Section 50 -Paragraph 3 -Publisher FASB -URI https://asc.fasb.org//1943274/2147482106/820-10-50-3 + Details
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- Definition Tabular disclosure of assets and liabilities, including [financial] instruments measured at fair value that are classified in stockholders' equity, if any, that are measured at fair value on a recurring basis. The disclosures contemplated herein include the fair value measurements at the reporting date by the level within the fair value hierarchy in which the fair value measurements in their entirety fall, segregating fair value measurements using quoted prices in active markets for identical assets (Level 1), significant other observable inputs (Level 2), and significant unobservable inputs (Level 3). + References Reference 1: http://www.xbrl.org/2003/role/disclosureRef -Topic 820 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 2 -Subparagraph (a) -Publisher FASB -URI https://asc.fasb.org//1943274/2147482106/820-10-50-2 Reference 2: http://www.xbrl.org/2003/role/disclosureRef -Topic 820 -SubTopic 10 -Name Accounting Standards Codification -Section 50 -Paragraph 2 -Subparagraph (b) -Publisher FASB -URI https://asc.fasb.org//1943274/2147482106/820-10-50-2 + Details
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