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Consolidated Statements of Cash Flows - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2021 | Dec. 31, 2020 | Dec. 31, 2019
Cash flows from operating activities: |  |  |
Net income (loss) | $ 4,134 | $ (23,982) | $ 27,193
Adjustments to reconcile net income (loss) to net cash provided by operating activities: |  |  |
Depreciation | 6,480 | 6,083 | 4,957
Amortization of acquisition related intangible assets | 7,837 | 7,381 | 1,034
Amortization of acquisition related inventory step-up | 6,465 | 11,082 | 0
Non-cash operating lease cost | 1,708 | 1,531 | 1,179
Goodwill impairment charge | 0 | 42,520 | 0
Change in fair value of contingent consideration | (21,095) | (28,666) | 0
Loss on disposal of fixed assets | 993 | 265 | 927
Loss on impairment of intangible asset | 600 | 2,439 | 389
Stock-based compensation expense | 11,085 | 5,386 | 6,087
Deferred income taxes | (1,766) | (3,543) | 794
Provision (recovery) for doubtful accounts | 64 | 549 | (499)
Provision for inventory | 6,628 | 5,490 | 1,612
Other | (18) | (12) | (25)
Changes in operating assets and liabilities: |  |  |
Accounts receivable | (6,216) | 5,855 | (1,839)
Inventories | (6,619) | (14,177) | (5,585)
Prepaid expenses, other current and long-term assets | 1,424 | (1,783) | (1,641)
Accounts payable | (1,100) | 822 | 767
Operating lease liabilities | (1,626) | (1,439) | (1,065)
Accrued expenses, other current and long-term liabilities | 3,510 | (142) | 3,805
Income taxes | (1,311) | (2,072) | (1,085)
Payments of contingent consideration | (2,780) | (522) | 0
Net cash provided by operating activities | 8,397 | 13,065 | 37,005
Cash flows from investing activities: |  |  |
Acquisition of Parcus Medical and Arthrosurface, net of cash acquired | (476) | (94,601) | 0
Proceeds from maturities of investments | 2,501 | 45,000 | 146,366
Purchases of investments | 0 | (20,035) | (103,848)
Purchases of property and equipment | (5,143) | (1,628) | (2,827)
Net cash (used in) provided by investing activities | (3,118) | (71,264) | 39,691
Cash flows from financing activities: |  |  |
Payments made on finance leases | (201) | (208) | 0
Proceeds from long term debt | 0 | 50,000 | 0
Repayments of long term debt | 0 | (50,350) | 0
Repurchases of common stock | 0 | 0 | (30,000)
Cash paid for tax withheld on vested restricted stock awards | (486) | (262) | (293)
Proceeds from exercises of equity awards | 1,128 | 1,524 | 22,151
Payments of contingent consideration | (7,220) | (4,478) | 0
Net cash used by financing activities | (6,779) | (3,774) | (8,142)
Exchange rate impact on cash | 69 | 327 | (133)
(Decrease) increase in cash and cash equivalents | (1,431) | (61,646) | 68,421
Cash and cash equivalents at beginning of period | 95,817 | 157,463 | 89,042
Cash and cash equivalents at end of period | 94,386 | 95,817 | 157,463
Supplemental disclosure of cash flow information: |  |  |
Cash paid for income taxes, net of refunds | 1,233 | 993 | 9,257
Right-of-use assets obtained in exchange for operating lease liabilities | 2,392 | 2,340 |
Non-cash investing activities: |  |  |
Purchases of property and equipment included in accounts payable and accrued expenses | 15 | 17 | 137
Consideration for acquisitions included in accounts payable and accrued expenses | 0 | 476 | 0
Contingent consideration fair value on acquisition date | 0 | 69,076 | 0
Accounting Standards Update 2016-02 [Member] |  |  |
Supplemental disclosure of cash flow information: |  |  |
Right-of-use assets obtained in exchange for operating lease liabilities | $ 220 | $ 0 | $ 24,110

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