v3.22.4
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
OPERATING ACTIVITIES      
Net income (loss) $ 1,258,000 $ (16,260,000) $ (32,944,000)
Adjustments to reconcile net income (loss) to net cash used in operating activities:      
Impairment 3,609,000 0 0
Depreciation and amortization 13,099,000 10,680,000 8,010,000
Stock-based compensation 6,679,000 5,842,000 6,196,000
Fair value adjustment of contingent consideration (25,930,000) (1,800,000) 3,520,000
Acquisition installment payable 2,307,000 2,154,000 2,397,000
Deferred income taxes (5,032,000) (1,128,000) (723,000)
Changes in certain current assets and liabilities:      
Accounts receivable - trade (3,983,000) (466,000) (451,000)
Inventories (16,938,000) (5,050,000) (12,070,000)
Prepaid expenses and other current assets (506,000) (637,000) (719,000)
Accounts payable - trade (209,000) (567,000) 3,071,000
Accrued legal settlements 0 (6,342,000) 6,342,000
Accrued expenses and other liabilities 3,344,000 1,095,000 (1,074,000)
Other 536,000 (584,000) (85,000)
Net cash used in operating activities (21,766,000) (13,063,000) (18,530,000)
INVESTING ACTIVITIES      
Acquisition of MDO, net of cash acquired (8,360,000) 0 0
Acquisition of Pega, net of cash acquired (31,730,000) 0 0
Acquisition of Devise Ortho assets 0 (650,000) 0
Acquisition of Telos, net of cash acquired 0 0 (1,670,000)
Acquisition of ApiFix, net of cash acquired 0 0 (1,723,000)
Sale of short-term marketable securities 46,872,000 9,250,000 0
Purchase of short-term marketable securities (110,122,000) 0 (55,000,000)
Purchases of property and equipment (10,031,000) (8,103,000) (10,504,000)
Net cash used in investing activities (113,371,000) (7,411,000) (69,693,000)
FINANCING ACTIVITIES      
Payments on debt with affiliate (31,000,000) 0 (25,000,000)
Proceeds from issuance of debt with affiliate 31,000,000 0 0
Proceeds from issuance of common stock, net of issuance costs 139,282,000 0 70,207,000
Proceeds from exercise of stock options 63,000 137,000 1,650,000
Installment payment for ApiFix (3,234,000) 0 0
Payments on mortgage notes (137,000) (131,000) (125,000)
Net cash provided by financing activities 135,974,000 6,000 46,732,000
Effect of exchange rate changes on cash 619,000 (658,000) (404,000)
NET INCREASE (DECREASE) IN CASH AND RESTRICTED CASH 1,456,000 (21,126,000) (41,895,000)
Cash and restricted cash, beginning of period 9,006,000 30,132,000 72,027,000
Cash and restricted cash, end of period 10,462,000 9,006,000 30,132,000
SUPPLEMENTAL DISCLOSURES      
Cash paid for interest 700,000 56,000 1,233,000
Transfer of instruments from property and equipment to inventory (234,000) 453,000 415,000
Telos      
SUPPLEMENTAL DISCLOSURES      
Issuance of common shares in acquisition 0 0 1,568,000
ApiFix      
Adjustments to reconcile net income (loss) to net cash used in operating activities:      
Impairment 3,609,000    
SUPPLEMENTAL DISCLOSURES      
Issuance of common shares in acquisition 0 0 35,176,000
ApiFix acquisition installment      
SUPPLEMENTAL DISCLOSURES      
Issuance of common shares in acquisition 10,410,000 0 0
Band-Lok      
SUPPLEMENTAL DISCLOSURES      
Issuance of common shares in acquisition 0 0 2,644,000
Devise Ortho      
SUPPLEMENTAL DISCLOSURES      
Issuance of common shares in acquisition 0 298,000 0
MDO      
SUPPLEMENTAL DISCLOSURES      
Issuance of common shares in acquisition 9,707,000 0 0
Band-Lok intangible assets      
INVESTING ACTIVITIES      
Payments to acquire intangible assets 0 0 (796,000)
Licenses      
INVESTING ACTIVITIES      
Payments to acquire intangible assets $ 0 $ (7,908,000) $ 0