CONMED (CNMD) 10-Q26 Oct 232023 Q3 Quarterly reportFinancial data

Company Profile

Cover Page

Cover Page - shares	9 Months Ended
Cover Page - shares	Sep. 30, 2023	Oct. 23, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Fiscal Period Focus	Q3
Document Period End Date	Sep. 30, 2023
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Entity File Number	001-39218
Entity Registrant Name	CONMED CORPORATION
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	16-0977505
Entity Address, Address Line One	11311 Concept Blvd
Entity Address, City or Town	Largo,
Entity Address, State or Province	FL
Entity Address, Postal Zip Code	33773
City Area Code	727
Local Phone Number	392-6464
Title of 12(b) Security	Common Stock, $0.01 par value
Trading Symbol	CNMD
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		30,752,199
Entity Central Index Key	0000816956
Amendment Flag	false

Consolidated Condensed Statemen

Consolidated Condensed Statements of Comprehensive Income (Loss) (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Net sales	$ 304,578	$ 275,088	$ 917,699	$ 794,605
Cost of sales	136,519	123,473	423,629	355,222
Gross profit	168,059	151,615	494,070	439,383
Selling and administrative expense	125,295	114,600	385,080	333,302
Research and development expense	12,464	12,767	38,574	34,932
Operating expenses	137,759	127,367	423,654	368,234
Income from operations	30,300	24,248	70,416	71,149
Interest expense	10,019	8,536	30,271	19,462
Other expense (See Note 11)	0	0	0	112,011
Income (loss) before income taxes	20,281	15,712	40,145	(60,324)
Provision (benefit) for income taxes	4,444	(30,438)	8,757	46,842
Net income (loss)	15,837	46,150	31,388	(107,166)
Comprehensive income (loss)	$ 14,825	$ 43,125	$ 35,287	$ (113,096)
Per share data:
Basic (in dollars per share)	$ 0.52	$ 1.51	$ 1.02	$ (3.59)
Diluted (in dollars per share)	$ 0.50	$ 1.48	$ 0.99	$ (3.59)
Weighted average common shares:
Basic (in shares)	30,741	30,473	30,638	29,892
Diluted (in shares)	31,689	31,103	31,563	29,892

Consolidated Condensed Balance

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 30,502	$ 28,942
Accounts receivable, net	230,196	191,345
Inventories	325,824	332,320
Prepaid expenses and other current assets	39,127	28,619
Total current assets	625,649	581,226
Property, plant and equipment, net	120,436	115,611
Goodwill	815,143	815,429
Other intangible assets, net	657,353	681,799
Other assets	107,094	103,527
Total assets	2,325,675	2,297,592
Current liabilities:
Current portion of long-term debt	70,625	69,746
Accounts payable	81,871	73,393
Accrued compensation and benefits	60,334	54,733
Other current liabilities	163,489	98,680
Total current liabilities	376,319	296,552
Long-term debt	942,166	985,076
Deferred income taxes	66,913	66,725
Other long-term liabilities	144,072	203,694
Total liabilities	1,529,470	1,552,047
Commitments and contingencies
Shareholders' equity:
Preferred stock, par value $.01 per share; authorized 500,000 shares; none outstanding	0	0
Common stock, par value $0.01 per share; 100,000,000 shares authorized; 31,299,194 shares issued in 2023 and 2022, respectively	313	313
Paid-in capital	439,731	413,235
Retained earnings	425,612	412,631
Accumulated other comprehensive loss	(53,959)	(57,858)
Less: 552,016 and 811,532 shares of common stock in treasury, at cost, in 2023 and 2022, respectively	(15,492)	(22,776)
Total shareholders’ equity	796,205	745,545
Total liabilities and shareholders’ equity	$ 2,325,675	$ 2,297,592

Consolidated Condensed Balanc_2

Consolidated Condensed Balance Sheets (Unaudited) (Parenthetical) - $ / shares	Sep. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Preferred stock, par value (dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	500,000	500,000
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	31,299,194	31,299,194
Treasury stock, shares (in shares)	552,016	811,532

Consolidated Condensed Statem_2

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands		Total	Common Stock	Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Loss	Treasury Stock
Balance at period start (in shares) at Dec. 31, 2021			31,299
Balance at period start at Dec. 31, 2021		$ 785,435	$ 313	$ 396,771	$ 496,605	$ (54,203)	$ (54,051)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		6,252		2,232			4,020
Stock-based compensation		4,463		4,463
Dividends on common stock ($0.20 per share)		(5,899)			(5,899)
Comprehensive income:
Cash flow hedging gain, net						1,082
Pension liability, net of income tax						521
Foreign currency translation adjustments						(163)
Net income (loss)					14,975
Comprehensive income (loss)		$ 16,415
Accounting Standards Update [Extensible Enumeration]		Accounting Standards Update 2020-06
Balance at period end (in shares) at Mar. 31, 2022			31,299
Balance at period end at Mar. 31, 2022		$ 789,546	$ 313	365,555	526,472	(52,763)	(50,031)
Balance at period end (Accounting Standards Update 2020-06) at Mar. 31, 2022	[1]	(17,120)		(37,911)	20,791
Balance at period start (in shares) at Dec. 31, 2021			31,299
Balance at period start at Dec. 31, 2021		785,435	$ 313	396,771	496,605	(54,203)	(54,051)
Comprehensive income:
Cash flow hedging gain, net		10,577
Pension liability, net of income tax		1,502
Foreign currency translation adjustments		(18,009)
Net income (loss)		(107,166)
Comprehensive income (loss)		(113,096)
Balance at period end (in shares) at Sep. 30, 2022			31,299
Balance at period end at Sep. 30, 2022		716,337	$ 313	407,095	392,144	(60,133)	(23,082)
Balance at period start (in shares) at Mar. 31, 2022			31,299
Balance at period start at Mar. 31, 2022		789,546	$ 313	365,555	526,472	(52,763)	(50,031)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		1,244		611			633
Stock-based compensation		5,755		5,755
Dividends on common stock ($0.20 per share)		(6,092)			(6,092)
Shares issued for the settlement of convertible notes		0		(25,890)			25,890
Convertible note premium on extinguishment		103,125		103,125
Settlement of convertible notes hedge transactions		118,912		118,912
Settlement of warrants		(96,758)		(96,758)
Issuance of convertible notes hedge transactions, net of tax		(142,128)		(142,128)
Issuance of warrants		72,000		72,000
Comprehensive income:
Cash flow hedging gain, net						4,662
Pension liability, net of income tax						490
Foreign currency translation adjustments						(9,497)
Net income (loss)					(168,291)
Comprehensive income (loss)		(172,636)
Balance at period end (in shares) at Jun. 30, 2022			31,299
Balance at period end at Jun. 30, 2022		672,968	$ 313	401,182	352,089	(57,108)	(23,508)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		585		159			426
Stock-based compensation		5,754		5,754
Dividends on common stock ($0.20 per share)		(6,095)			(6,095)
Comprehensive income:
Cash flow hedging gain, net		4,833				4,833
Pension liability, net of income tax		490				490
Foreign currency translation adjustments		(8,348)				(8,348)
Net income (loss)		46,150			46,150
Comprehensive income (loss)		43,125
Balance at period end (in shares) at Sep. 30, 2022			31,299
Balance at period end at Sep. 30, 2022		716,337	$ 313	407,095	392,144	(60,133)	(23,082)
Balance at period start (in shares) at Dec. 31, 2022			31,299
Balance at period start at Dec. 31, 2022		745,545	$ 313	413,235	412,631	(57,858)	(22,776)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		2,600		556			2,044
Stock-based compensation		5,726		5,726
Dividends on common stock ($0.20 per share)		(6,113)			(6,113)
Comprehensive income:
Cash flow hedging gain, net						877
Pension liability, net of income tax						403
Foreign currency translation adjustments						1,596
Net income (loss)					1,819
Comprehensive income (loss)		4,695
Balance at period end (in shares) at Mar. 31, 2023			31,299
Balance at period end at Mar. 31, 2023		752,453	$ 313	419,517	408,337	(54,982)	(20,732)
Balance at period start (in shares) at Dec. 31, 2022			31,299
Balance at period start at Dec. 31, 2022		745,545	$ 313	413,235	412,631	(57,858)	(22,776)
Comprehensive income:
Cash flow hedging gain, net		4,110
Pension liability, net of income tax		1,210
Foreign currency translation adjustments		(1,421)
Net income (loss)		31,388
Comprehensive income (loss)		35,287
Balance at period end (in shares) at Sep. 30, 2023			31,299
Balance at period end at Sep. 30, 2023		796,205	$ 313	439,731	425,612	(53,959)	(15,492)
Balance at period start (in shares) at Mar. 31, 2023			31,299
Balance at period start at Mar. 31, 2023		752,453	$ 313	419,517	408,337	(54,982)	(20,732)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		11,697		6,841			4,856
Stock-based compensation		6,422		6,422
Dividends on common stock ($0.20 per share)		(6,145)			(6,145)
Comprehensive income:
Cash flow hedging gain, net						503
Pension liability, net of income tax						403
Foreign currency translation adjustments						1,129
Net income (loss)					13,732
Comprehensive income (loss)		15,767
Balance at period end (in shares) at Jun. 30, 2023			31,299
Balance at period end at Jun. 30, 2023		780,194	$ 313	432,780	415,924	(52,947)	(15,876)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		1,149		765			384
Stock-based compensation		6,186		6,186
Dividends on common stock ($0.20 per share)		(6,149)			(6,149)
Comprehensive income:
Cash flow hedging gain, net		2,730				2,730
Pension liability, net of income tax		403				403
Foreign currency translation adjustments		(4,145)				(4,145)
Net income (loss)		15,837			15,837
Comprehensive income (loss)		14,825
Balance at period end (in shares) at Sep. 30, 2023			31,299
Balance at period end at Sep. 30, 2023		$ 796,205	$ 313	$ 439,731	$ 425,612	$ (53,959)	$ (15,492)

[1] (1) We recorded the cumulative impact of adopting Accounting Standards Update (ASU) 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40): Accounting for Convertible Instruments and Contracts in an Entity’s Own Equity in 2022.

Consolidated Condensed Statem_3

Consolidated Condensed Statements of Shareholders' Equity (Unaudited) (Parenthetical) - $ / shares	3 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022
Statement of Stockholders' Equity [Abstract]
Dividends per share of common stock (in dollars per share)	$ 0.20	$ 0.20	$ 0.20	$ 0.20	$ 0.20	$ 0.20

Consolidated Condensed Statem_4

Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Cash flows from operating activities:
Net income (loss)	$ 31,388	$ (107,166)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation	12,148	12,028
Amortization of deferred debt issuance costs	4,558	3,404
Amortization	41,724	39,754
Stock-based compensation	18,334	15,972
Deferred income taxes	(891)	38,442
Non-cash adjustment to fair value of contingent consideration liability	6,949	0
Loss on early extinguishment of debt	0	3,426
Loss on convertible notes conversion premium	0	103,125
Loss on convertible notes hedge transactions settlement	0	5,460
Increase (decrease) in cash flows from changes in assets and liabilities:
Accounts receivable	(38,015)	(16,092)
Inventories	5,286	(52,126)
Accounts payable	8,133	14,475
Accrued compensation and benefits	5,461	(8,261)
Other assets	(21,978)	(11,710)
Other liabilities	(4,144)	4,232
Net cash provided by operating activities	68,953	44,963
Cash flows from investing activities:
Purchases of property, plant and equipment	(14,177)	(16,109)
Payments related to business acquisitions, net of cash acquired	0	(227,102)
Other	(1,000)	0
Net cash used in investing activities	(15,177)	(243,211)
Cash flows from financing activities:
Payments on term loan	0	(92,981)
Payments on revolving line of credit	(560,000)	(404,000)
Proceeds from revolving line of credit	512,000	317,000
Payments to redeem convertible notes	0	(275,000)
Proceeds from issuance of convertible notes	0	800,000
Payments related to debt issuance costs	0	(21,830)
Dividends paid on common stock	(18,353)	(17,865)
Purchases of convertible notes hedge transactions	0	(187,600)
Proceeds from issuance of warrants	0	72,000
Proceeds from settlement of convertible notes hedge transactions	0	86,228
Payment for settlement of warrants	0	(69,534)
Other, net	14,687	7,067
Net cash provided by (used in) financing activities	(51,666)	213,485
Effect of exchange rate changes on cash and cash equivalents	(550)	(2,730)
Net increase in cash and cash equivalents	1,560	12,507
Cash and cash equivalents at beginning of period	28,942	20,847
Cash and cash equivalents at end of period	30,502	33,354
Non-cash investing and financing activities:
Contingent consideration	0	183,914
Dividends payable	$ 6,149	$ 6,095

Operations

Operations	9 Months Ended
Operations	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Operations	OperationsCONMED Corporation (“CONMED”, the “Company”, “we” or “us”) is a medical technology company that provides devices and equipment for surgical procedures. The Company’s products are used by surgeons and other healthcare professionals in a variety of specialties including orthopedics, general surgery, gynecology, thoracic surgery and gastroenterology.

Interim Financial Information

Interim Financial Information	9 Months Ended
Interim Financial Information	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Interim Financial Information	Interim Financial Information The accompanying unaudited consolidated condensed financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for annual financial statements. The information herein reflects all normal recurring material adjustments, which are, in the opinion of management, necessary to fairly present the results for the periods presented. The consolidated condensed financial statements herein consist of all wholly-owned domestic and foreign subsidiaries with all significant intercompany transactions eliminated. Results for the period ended September 30, 2023 are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. The consolidated condensed financial statements and notes thereto should be read in conjunction with the consolidated financial statements and notes for the year ended December 31, 2022 included in our Annual Report on Form 10-K. Use of Estimates Preparation of the consolidated condensed financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated condensed financial statements and the reported amounts of revenue and expenses during the reporting period. While there has been uncertainty and disruption in the global economy and financial markets, we are not aware of any specific event or circumstance that would require an update to our estimates or judgments or a revision of the carrying value of our assets or liabilities as of October 26, 2023, the date of issuance of this Quarterly Report on Form 10-Q. These estimates may change, as new events occur and additional information is obtained. Actual results could differ materially from these estimates under different assumptions or conditions.

New Accounting Pronouncements

New Accounting Pronouncements	9 Months Ended
New Accounting Pronouncements	Sep. 30, 2023
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Issued Accounting Standards, Not Yet Adopted In March 2020, the Financial Accounting Standards Board ("FASB") issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022 and was extended through December 31, 2024 by ASU 2022-06, Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848. The Company has not adopted these ASUs as of September 30, 2023. Our seventh amended and restated senior credit agreement includes language to address the change from LIBOR to SOFR, an alternative base rate, therefore we do not believe reference rate reform will have a significant impact on our consolidated financial statements.

Business Combinations

Business Combinations	9 Months Ended
Business Combinations	Sep. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Business CombinationsOn June 13, 2022, we acquired In2Bones Global, Inc. ("In2Bones") and all of its stock (the "In2Bones Acquisition") for an aggregate upfront payment of $145.2 million in cash. In addition, there are potential earn-out payments to In2Bones’ equity holders in an amount up to $110.0 million based on the achievement of certain revenue targets for In2Bones products during the sixteen (16) successive quarters commencing on July 1, 2022. In2Bones is a global developer, manufacturer and distributor of medical devices for the treatment of disorders and injuries of the lower extremities (foot and ankle). The In2Bones Acquisition was funded through a combination of cash on hand and long-term borrowings as further described in Note 11. Proforma information for In2Bones is immaterial for disclosure for the three and nine months ended September 30, 2023 and 2022. Purchase accounting has been completed for the In2Bones Acquisition. On August 9, 2022, we acquired Biorez, Inc. ("Biorez") and all of its stock (the "Biorez Acquisition") for an aggregate upfront payment of $85.5 million in cash. We paid $84.1 million as of September 30, 2023, with a $1.4 million holdback, pursuant to the merger agreement for the Biorez Acquisition. In addition, there are potential earn-out payments to Biorez’ equity holders in an amount up to $165.0 million based on the achievement of certain revenue targets for Biorez products during the sixteen (16) successive quarters commencing on October 1, 2022. Biorez is a medical device start-up focused on advancing the healing of soft tissue using its proprietary BioBrace ® implant technology. The Biorez Acquisition was funded through a combination of cash on hand and long-term borrowings. Proforma information for Biorez is immaterial for disclosure for the three and nine months ended September 30, 2023 and 2022. Purchase accounting has been completed for the Biorez Acquisition. We incurred costs for the amortization of inventory step-up to fair value of $2.2 million and $6.5 million during the three and nine months ended September 30, 2023, respectively, and $2.1 million and $2.4 million during the three and nine months ended September 30, 2022, respectively, related to the In2Bones acquisition, which were recorded in cost of sales. During the nine months ended September 30, 2023, we recognized $0.8 million in integration costs and professional fees related to the In2Bones and Biorez acquisitions that were included in selling and administrative expense. During the three and nine months ended September 30, 2022, we recognized $3.7 million and $6.3 million, respectively, in consulting fees, legal fees and other integration costs related to the acquisitions of In2Bones and Biorez, which were included in selling and administrative expense.

Revenues

Revenues	9 Months Ended
Revenues	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Revenues	Revenues The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended September 30, 2023 September 30, 2022 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 46,273 $ 124,250 $ 170,523 $ 45,688 $ 110,033 $ 155,721 Europe, Middle East & Africa 28,001 23,436 51,437 26,914 20,300 47,214 Asia Pacific 29,995 23,289 53,284 28,242 17,223 45,465 Americas (excluding the United States) 20,398 8,936 29,334 17,774 8,914 26,688 Total sales from contracts with customers $ 124,667 $ 179,911 $ 304,578 $ 118,618 $ 156,470 $ 275,088 Timing of Revenue Recognition Goods transferred at a point in time $ 115,722 $ 177,915 $ 293,637 $ 108,875 $ 154,856 $ 263,731 Services transferred over time 8,945 1,996 10,941 9,743 1,614 11,357 Total sales from contracts with customers $ 124,667 $ 179,911 $ 304,578 $ 118,618 $ 156,470 $ 275,088 Nine Months Ended Nine Months Ended September 30, 2023 September 30, 2022 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 147,557 $ 362,223 $ 509,780 $ 124,097 $ 312,034 $ 436,131 Europe, Middle East & Africa 93,703 72,032 165,735 88,955 63,093 152,048 Asia Pacific 93,365 58,632 151,997 79,333 46,379 125,712 Americas (excluding the United States) 62,008 28,179 90,187 53,932 26,782 80,714 Total sales from contracts with customers $ 396,633 $ 521,066 $ 917,699 $ 346,317 $ 448,288 $ 794,605 Timing of Revenue Recognition Goods transferred at a point in time $ 367,118 $ 515,529 $ 882,647 $ 317,140 $ 443,629 $ 760,769 Services transferred over time 29,515 5,537 35,052 29,177 4,659 33,836 Total sales from contracts with customers $ 396,633 $ 521,066 $ 917,699 $ 346,317 $ 448,288 $ 794,605 Contract liability balances related to the sale of extended warranties to customers are as follows: September 30, 2023 December 31, 2022 Contract liability $ 18,645 $ 19,114 Revenue recognized during the nine months ended September 30, 2023 and September 30, 2022 from amounts included in contract liabilities at the beginning of the period were $10.4 million and $9.5 million, respectively. There were no material contract assets as of September 30, 2023 and December 31, 2022.

Comprehensive Income (Loss)

Comprehensive Income (Loss)	9 Months Ended
Comprehensive Income (Loss)	Sep. 30, 2023
Equity [Abstract]
Comprehensive Income	Comprehensive Income (Loss) Comprehensive income (loss) consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net income (loss) $ 15,837 $ 46,150 $ 31,388 $ (107,166) Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $873 and $1,546 for the three months ended September 30, 2023 and 2022, respectively, and $1,315 and $3,384 for the nine months ended September 30, 2023 and 2022, respectively) 2,730 4,833 4,110 10,577 Pension liability, net of income tax (income tax expense of $129 and $157 for the three months ended September 30, 2023 and 2022, respectively, and $387 and $439 for the nine months ended September 30, 2023 and 2022, respectively.) 403 490 1,210 1,502 Foreign currency translation adjustment (4,145) (8,348) (1,421) (18,009) Comprehensive income (loss) $ 14,825 $ 43,125 $ 35,287 $ (113,096) Accumulated other comprehensive loss consists of the following: Cash Flow Pension Cumulative Accumulated Balance, December 31, 2022 $ 2,497 $ (23,749) $ (36,606) $ (57,858) Other comprehensive income (loss) before reclassifications, net of tax 8,692 — (1,421) 7,271 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (6,048) 1,597 — (4,451) Income tax 1,466 (387) — 1,079 Net current-period other comprehensive income (loss) 4,110 1,210 (1,421) 3,899 Balance, September 30, 2023 $ 6,607 $ (22,539) $ (38,027) $ (53,959) Cash Flow Pension Cumulative Accumulated Balance, December 31, 2021 $ 3,656 $ (29,671) $ (28,188) $ (54,203) Other comprehensive income (loss) before reclassifications, net of tax 18,711 — (18,009) 702 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (10,736) 1,941 — (8,795) Income tax 2,602 (439) — 2,163 Net current-period other comprehensive income (loss) 10,577 1,502 (18,009) (5,930) Balance, September 30, 2022 $ 14,233 $ (28,169) $ (46,197) $ (60,133) (a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive loss components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 7 and Note 13, respectively, for further details.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
Fair Value of Financial Instruments	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments We enter into derivative instruments for risk management purposes only. We operate internationally and, in the normal course of business, are exposed to fluctuations in interest rates, foreign exchange rates and commodity prices. These fluctuations can increase the costs of financing, investing and operating the business. We use forward contracts, a type of derivative instrument, to manage certain foreign currency exposures. By nature, all financial instruments involve market and credit risks. We enter into forward contracts with major investment grade financial institutions and have policies to monitor the credit risk of those counterparties. While there can be no assurance, we do not anticipate any material non-performance by any of these counterparties. Foreign Currency Forward Contracts. We hedge forecasted intercompany sales denominated in foreign currencies through the use of forward contracts. We account for these forward contracts as cash flow hedges. To the extent these forward contracts meet hedge accounting criteria, changes in their fair value are not included in current earnings (loss) but are included in accumulated other comprehensive loss. These changes in fair value will be recognized into earnings (loss) as a component of sales or cost of sales when the forecasted transaction occurs. We also enter into forward contracts to exchange foreign currencies for United States dollars in order to hedge our currency transaction exposures on intercompany receivables designated in foreign currencies. These forward contracts settle each month at month-end, at which time we enter into new forward contracts. We have not designated these forward contracts as hedges and have not applied hedge accounting to them. The following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation September 30, 2023 December 31, 2022 Forward exchange contracts Cash flow hedge $ 218,929 $ 198,473 Forward exchange contracts Non-designated 49,918 81,929 The remaining time to maturity as of September 30, 2023 is within two years for hedge designated foreign exchange contracts and approximately one month for non-hedge designated forward exchange contracts. Statement of comprehensive income (loss) presentation Derivatives designated as cash flow hedges Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) ("AOCI") and net earnings on our consolidated condensed statements of comprehensive income (loss) and our consolidated condensed balance sheets: Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain Reclassified from AOCI Three Months Ended September 30, Total Amount of Line Item Presented Derivative Instrument 2023 2022 Location of amount reclassified 2023 2022 2023 2022 Foreign exchange contracts $ 6,180 $ 11,695 Net Sales $ 304,578 $ 275,088 $ 1,095 $ 5,090 Cost of Sales 136,519 123,473 1,482 225 Pre-tax gain $ 6,180 $ 11,695 $ 2,577 $ 5,315 Tax expense 1,498 2,835 625 1,288 Net gain $ 4,682 $ 8,860 $ 1,952 $ 4,027 Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain Reclassified from AOCI Nine Months Ended September 30, Total Amount of Line Item Presented Derivative Instrument 2023 2022 Location of amount reclassified 2023 2022 2023 2022 Foreign exchange contracts $ 11,471 $ 24,698 Net Sales $ 917,699 $ 794,605 $ 2,585 $ 10,237 Cost of Sales 423,629 355,222 3,463 499 Pre-tax gain $ 11,471 $ 24,698 $ 6,048 $ 10,736 Tax expense 2,779 5,987 1,466 2,602 Net gain $ 8,692 $ 18,711 $ 4,582 $ 8,134 At September 30, 2023, $5.7 million of net unrealized gains on forward contracts accounted for as cash flow hedges, and included in accumulated other comprehensive loss, are expected to be recognized in earnings in the next twelve months. Derivatives not designated as cash flow hedges Net gains from derivative instruments not accounted for as hedges and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income (loss) were: Three Months Ended September 30, Nine Months Ended September 30, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income (Loss) 2023 2022 2023 2022 Net gain on currency forward contracts Selling and administrative expense $ 227 $ 892 $ 630 $ 1,088 Net loss on currency transaction exposures Selling and administrative expense $ (552) $ (1,110) $ (1,831) $ (2,874) Balance sheet presentation We record these forward foreign exchange contracts at fair value. The following tables summarize the fair value for forward foreign exchange contracts outstanding at September 30, 2023 and December 31, 2022: September 30, 2023 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 8,124 $ (658) $ 7,466 Foreign exchange contracts Other assets 1,344 (89) 1,255 $ 9,468 $ (747) $ 8,721 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 39 (150) (111) Total derivatives $ 9,507 $ (897) $ 8,610 December 31, 2022 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 6,757 $ (3,121) $ 3,636 Foreign exchange contracts Other long-term liabilities 60 (400) (340) $ 6,817 $ (3,521) $ 3,296 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 48 (395) (347) Total derivatives $ 6,865 $ (3,916) $ 2,949 Our forward foreign exchange contracts are subject to a master netting agreement and qualify for netting in the consolidated condensed balance sheets. Fair Value Disclosure. FASB guidance defines fair value and establishes a framework for measuring fair value and related disclosure requirements. This guidance applies when fair value measurements are required or permitted. The guidance indicates, among other things, that a fair value measurement assumes that the transaction to sell an asset or transfer a liability occurs in the principal market for the asset or liability or, in the absence of a principal market, the most advantageous market for the asset or liability. Fair value is defined based upon an exit price model. Valuation Hierarchy. A valuation hierarchy was established for disclosure of the inputs to the valuations used to measure fair value. This hierarchy prioritizes the inputs into three broad levels as follows. Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets in markets that are not active, inputs other than quoted prices that are observable for the asset or liability, including interest rates, yield curves and credit risks, or inputs that are derived principally from or corroborated by observable market data through correlation. Level 3 inputs are unobservable inputs based on our own assumptions used to measure assets and liabilities at fair value. A financial asset or liability’s classification within the hierarchy is determined based on the lowest level input that is significant to the fair value measurement. There have been no significant changes in the assumptions. Valuation Techniques. Assets and liabilities carried at fair value and measured on a recurring basis as of September 30, 2023 consist of forward foreign exchange contracts and contingent consideration. The Company values its forward foreign exchange contracts using quoted prices for similar assets. The most significant assumption is quoted currency rates. The value of the forward foreign exchange contract assets and liabilities were valued using Level 2 inputs and are listed in the table above. The Company values contingent consideration from the In2Bones and Biorez acquisitions using Level 3 inputs. The contingent consideration was recorded at fair value at the date of acquisition based on the consideration expected to be transferred, estimated as the probability-weighted future cash flows, discounted back to present value. The fair value of contingent consideration is measured using projected payment dates, discount rates, revenue volatilities and projected revenues. The recurring Level 3 fair value measurements of contingent consideration for which the liabilities are recorded include the following significant unobservable inputs as of September 30, 2023: Assumptions Unobservable Input In2Bones Biorez Discount rate 8.02% 12.71% Revenue volatility 14.50% 21.38% Projected year of payment 2023-2026 2023-2026 Adjustments to the fair value of contingent consideration relate to the passage of time and changes in market assumptions. Changes in the fair value of contingent consideration liabilities for the nine months ended September 30, 2023 are as follows: In2Bones Biorez Location in Financial Statements Balance as of January 1, 2023 $ 70,198 $ 116,234 Changes in fair value of contingent consideration 860 6,089 Selling and administrative expense Balance as of September 30, 2023 $ 71,058 $ 122,323 Contingent consideration of $82.5 million and $110.9 million is included in other current liabilities and other long-term liabilities, respectively, in the consolidated condensed balance sheet at September 30, 2023. Contingent consideration of $18.6 million and $167.8 million is included in other current liabilities and other long-term liabilities, respectively, in the consolidated condensed balance sheet at December 31, 2022.

Inventories

Inventories	9 Months Ended
Inventories	Sep. 30, 2023
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following: September 30, December 31, Raw materials $ 115,547 $ 110,677 Work-in-process 30,382 26,166 Finished goods 179,895 195,477 Total $ 325,824 $ 332,320

Earnings (Loss) Per Share

Earnings (Loss) Per Share	9 Months Ended
Earnings (Loss) Per Share	Sep. 30, 2023
Earnings Per Share [Abstract]
Earnings (Loss) Per Share	Earnings (Loss) Per Share Basic earnings (loss) per share (“basic EPS”) is computed by dividing net income (loss) by the weighted average number of common shares outstanding for the reporting period. Diluted earnings per share for the three and nine months ended September 30, 2023 and the three months ended September 30, 2022 (“diluted EPS”) gives effect to all dilutive potential shares. As the Company was in a net loss position for the nine months ended September 30, 2022, there were no dilutive potential shares included in the computation of diluted shares outstanding. The following tables set forth the computation of basic and diluted earnings (loss) per share, as applicable, for the three and nine months ended September 30, 2023 and 2022: Three Months Ended September 30, 2023 Three Months Ended September 30, 2022 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income $ 15,837 $ — $ 15,837 $ 46,150 $ — $ 46,150 Weighted average shares outstanding 30,741 — 30,741 30,473 — 30,473 Stock compensation — 770 770 — 585 585 Convertible notes — 178 178 — 45 45 30,741 948 31,689 30,473 630 31,103 EPS $ 0.52 $ 0.50 $ 1.51 $ 1.48 Nine Months Ended September 30, 2023 Nine Months Ended September 30, 2022 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income (loss) $ 31,388 — $ 31,388 $ (107,166) — $ (107,166) Weighted average shares outstanding 30,638 — 30,638 29,892 — 29,892 Stock compensation — 758 758 — — — Warrants — 15 15 — — — Convertible notes — 152 152 — — — 30,638 925 31,563 29,892 — 29,892 EPS $ 1.02 $ 0.99 $ (3.59) $ (3.59) The shares used in the calculation of diluted EPS exclude stock options and stock appreciation rights to purchase shares where the exercise price was greater than the average market price of common shares for the period and the effect of the inclusion would be anti-dilutive. Such shares aggregated approximately 1.7 million and 1.8 million for the three and nine months ended September 30, 2023, respectively, and 2.0 million for the three months ended September 30, 2022. As the Company was in a net loss position for the nine months ended September 30, 2022, there were no anti-dilutive shares.

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	9 Months Ended
Goodwill and Other Intangible Assets	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Other Intangible Assets	Goodwill and Other Intangible Assets The changes in the net carrying amount of goodwill for the nine months ended September 30, 2023 are as follows: Balance as of December 31, 2022 $ 815,429 Foreign currency translation (286) Balance as of September 30, 2023 $ 815,143 Assets and liabilities of acquired businesses are recorded at their estimated fair values as of the date of acquisition. Goodwill represents costs in excess of fair values assigned to the underlying net assets of acquired businesses. Other intangible assets consist of the following: September 30, 2023 December 31, 2022 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 24 $ 369,812 $ (184,040) $ 369,854 $ (170,870) Sales representation, marketing and promotional rights 25 149,376 (70,500) 149,376 (66,000) Developed technology 18 320,204 (42,087) 320,204 (34,675) Patents and other intangible assets 16 81,677 (53,633) 79,838 (52,472) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 1,007,613 $ (350,260) $ 1,005,816 $ (324,017) Customer and distributor relationships, trademarks and tradenames, developed technology and patents and other intangible assets primarily represent allocations of purchase price to identifiable intangible assets of acquired businesses. Sales representation, marketing and promotional rights represent intangible assets created under our agreement with Musculoskeletal Transplant Foundation (“MTF”). Amortization expense related to intangible assets which are subject to amortization totaled $8.7 million for both the three months ended September 30, 2023 and 2022 and $26.3 million and $24.9 million for the nine months ended September 30, 2023 and 2022, respectively, and is included as a reduction of revenue (for amortization related to our sales representation, marketing and promotional rights) and in selling and administrative expense (for all other intangible assets) in the consolidated condensed statements of comprehensive income (loss). The estimated intangible asset amortization expense remaining for the year ending December 31, 2023 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2023 $ 7,338 $ 1,500 $ 8,838 2024 28,730 6,000 34,730 2025 29,607 6,000 35,607 2026 29,371 6,000 35,371 2027 30,411 6,000 36,411 2028 33,543 6,000 39,543

Long Term Debt

Long Term Debt	9 Months Ended
Long Term Debt	Sep. 30, 2023
Debt Disclosure [Abstract]
Long-Term Debt	Long-Term Debt Long-term debt consists of the following: September 30, 2023 December 31, 2022 Revolving line of credit $ 22,000 $ 70,000 Term loan, net of deferred debt issuance costs of $575 and $729 in 2023 and 2022, respectively 134,013 133,858 2.625% convertible notes, net of deferred debt issuance costs of $93 and $432 in 2023 and 2022, respectively 69,907 69,568 2.250% convertible notes, net of deferred debt issuance costs of $15,644 and $18,834 in 2023 and 2022, respectively 784,356 781,166 Financing leases 2,515 230 Total debt 1,012,791 1,054,822 Less: Current portion 70,625 69,746 Total long-term debt $ 942,166 $ 985,076 Seventh Amended and Restated Senior Credit Agreement On July 16, 2021, we entered into a seventh amended and restated senior credit agreement consisting of: (a) a $233.5 million term loan facility and (b) a $585.0 million revolving credit facility. The revolving credit facility will terminate and the loans outstanding under the term loan facility will expire on July 16, 2026. The term loan was payable in quarterly installments increasing over the term of the facility. During 2022, we made a $90.0 million prepayment on the term loan facility resulting in the elimination of such quarterly payments with the remaining balance due upon the expiration of the term loan facility. The $90.0 million prepayment was accounted for as an extinguishment and resulted in a write-off to other expense of unamortized debt issuance costs of $0.5 million for the nine months ended September 30, 2022. Proceeds from the term loan facility and borrowings under the revolving credit facility were used to repay the then existing senior credit agreement. Interest rates are at the term Secured Overnight Financing Rate plus 0.114% ("Adjusted Term SOFR") (5.489% at September 30, 2023) plus an interest rate margin of 1.125% (6.614% at September 30, 2023). For borrowings where we elect to use the alternate base rate, the initial base rate is the greatest of (i) the Prime Rate, (ii) the Federal Funds Rate plus 0.50% or (iii) the one-month Adjusted Term SOFR plus 1.00%, plus, in each case, an interest rate margin. There were $134.6 million in borrowings outstanding on the term loan facility as of September 30, 2023. There were $22.0 million in borrowings outstanding under the revolving credit facility as of September 30, 2023. Our available borrowings on the revolving credit facility at September 30, 2023 were $561.4 million with approximately $1.6 million of the facility set aside for outstanding letters of credit. The carrying amounts of the term loan and revolving credit facility approximate fair value. The seventh amended and restated senior credit agreement is collateralized by substantially all of our personal property and assets. The seventh amended and restated senior credit agreement contains covenants and restrictions which, among other things, require the maintenance of certain financial ratios and restrict dividend payments and the incurrence of certain indebtedness and other activities, including acquisitions and dispositions. We were in full compliance with these covenants and restrictions as of September 30, 2023. We are also required, under certain circumstances, to make mandatory prepayments from net cash proceeds from any issuance of equity and asset sales. 2.625% Convertible Notes On January 29, 2019, we issued $345.0 million aggregate principal amount of 2.625% convertible notes due in 2024 (the "2.625% Notes"). Interest is payable semi-annually in arrears on February 1 and August 1 of each year, commencing August 1, 2019. The 2.625% Notes will mature on February 1, 2024, unless earlier repurchased or converted. The 2.625% Notes represent subordinated unsecured obligations and are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The 2.625% Notes may be converted at an initial conversion rate of 11.2608 shares of our common stock per $1,000 principal amount of 2.625% Notes (equivalent to an initial conversion price of approximately $88.80 per share of common stock). Holders of the 2.625% Notes may convert the 2.625% Notes at their option at any time on or after November 1, 2023 through the second scheduled trading day preceding the maturity date. Holders of the 2.625% Notes will also have the right to convert the 2.625% Notes prior to November 1, 2023, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of the net proceeds from the offering of the 2.625% Notes were used as part of the financing for the Buffalo Filter acquisition and $21.0 million were used to pay the cost of certain convertible notes hedge transactions as further described below. On June 6, 2022, the Company repurchased and extinguished $275.0 million principal amount of the 2.625% Notes for aggregate consideration consisting of $275.0 million in cash and approximately 0.9 million shares of the Company's common stock. During the nine months ended September 30, 2022, the Company recorded a loss on extinguishment of $103.1 million to other expense based on the fair value of the shares of the Company’s common stock issued in connection with the extinguishment. This loss was not deductible for tax purposes. We also recorded a write-off to other expense of unamortized debt issuance costs related to the 2.625% Notes of $2.9 million. Concurrently, the Company entered into a Supplemental Indenture related to the remaining $70.0 million in 2.625% Notes, in which the Company irrevocably elected to settle the principal value of those 2.625% Notes in cash. The $70.0 million in 2.625% Notes are reflected in the current portion of long-term debt at September 30, 2023. For both the three months ended September 30, 2023 and 2022, we have recorded interest expense on the 2.625% Notes of $0.5 million, and for the nine months ended September 30, 2023 and 2022, we have recorded interest expense on the 2.625% Notes of $1.4 million and $4.4 million, respectively, at the contractual coupon rate of 2.625%. The estimated fair value of the 2.625% Notes was approximately $81.2 million as of September 30, 2023 based on a market approach which represents a Level 2 valuation in the fair value hierarchy. The estimated fair value was determined based on the estimated or actual bids and offers of the 2.625% Notes in an over-the-counter market transaction on the last business day of the period. 2.250% Convertible Notes On June 6, 2022, we issued $800.0 million aggregate principal amount of 2.250% Notes. Interest is payable semi-annually in arrears on June 15 and December 15 of each year, commencing December 15, 2022. The 2.250% Notes will mature on June 15, 2027, unless earlier repurchased or converted. The 2.250% Notes represent subordinated unsecured obligations and are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock, with the principal required to be paid in cash. The 2.250% Notes may be converted at an initial conversion rate of 6.8810 shares of our common stock per $1,000 principal amount of the 2.250% Notes (equivalent to an initial conversion price of approximately $145.33 per share of common stock). Holders of the 2.250% Notes may convert the 2.250% Notes at their option at any time on or after March 15, 2027 through the second scheduled trading day preceding the maturity date. Holders of the 2.250% Notes will also have the right to convert the 2.250% Notes prior to March 15, 2027, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of these proceeds were used to repurchase and extinguish a portion of the 2.625% Notes, pay off our then outstanding balance on our revolving line of credit, pay down of $90.0 million of our term loan and partially pay for the In2Bones Acquisition. In addition, approximately $115.6 million of the proceeds were used to pay the cost of certain convertible notes hedge transactions related to the 2.250% Notes. For both the three months ended September 30, 2023 and 2022, we have recorded interest expense on the 2.250% Notes of $4.5 million, and for the nine months ended September 30, 2023 and 2022, we have recorded interest expense on the 2.250% Notes of $13.5 million and $5.8 million, respectively, at the contractual coupon rate of 2.250%. The estimated fair value of the 2.250% Notes was approximately $754.0 million as of September 30, 2023 based on a market approach which represents a Level 2 valuation in the fair value hierarchy. The estimated fair value was determined based on the estimated or actual bids and offers of the 2.250% Notes in an over-the-counter market transaction on the last business day of the period. Convertible Notes Hedge Transactions In connection with the offerings of the 2.625% and 2.250% Notes, we entered into convertible notes hedge transactions with a number of financial institutions (each, an “option counterparty”). The convertible notes hedge transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the respective Notes, the number of shares of our common stock underlying the 2.625% and 2.250% Notes. Concurrent with entering into the convertible notes hedge transactions, we also entered into separate warrant transactions with each option counterparty whereby we sold to such option counterparty warrants to purchase, subject to customary anti-dilution adjustments, the same number of shares of our common stock. In connection with the repurchase and extinguishment of $275.0 million principal amount of the 2.625% Notes, the Company entered into agreements with the option counterparties to terminate a corresponding portion of the hedges on the 2.625% Notes. The Company recorded a $5.5 million charge to other expense as a result of a subsequent decline in fair value between execution date and settlement date during the nine months ended September 30, 2022. The convertible notes hedge transactions are expected generally to reduce the potential dilution upon conversion of the Notes and/or offset any cash payments we are required to make in excess of the principal amount of converted Notes, as the case may be, in the event that the market price per share of our common stock, as measured under the terms of the convertible notes hedge transactions, is greater than the strike price of the convertible notes hedge transactions, which initially corresponds to the conversion price of the Notes and is subject to anti-dilution adjustments substantially similar to those applicable to the conversion rate of the Notes. If, however, the market price per share of our common stock, as measured under the terms of the warrant transactions, exceeds the strike price ($114.92 for the 2.625% Notes and $251.53 for the 2.250% Notes) of the warrants, there would nevertheless be dilution to the extent that such market price exceeds the strike price of the warrants, unless we elect to settle the warrants in cash. The scheduled maturities of long-term debt outstanding at September 30, 2023 are as follows: Remaining, 2023 $ — 2024 70,000 2025 — 2026 156,588 2027 800,000 2028 — The above amounts exclude deferred debt issuance costs and financing leases.

Guarantees

Guarantees	9 Months Ended
Guarantees	Sep. 30, 2023
Guarantees [Abstract]
Guarantees	Guarantees We provide warranties on certain of our products at the time of sale and sell extended warranties. The standard warranty period for our capital equipment is generally one year and our extended warranties typically vary from one to three years. Liability under service and warranty policies is based upon a review of historical warranty and service claim experience. Adjustments are made to accruals as claim data and historical experience warrant. Changes in the liability for standard warranties for the nine months ended September 30, are as follows: 2023 2022 Balance as of January 1, $ 1,944 $ 2,344 Provision for warranties 388 297 Claims made (569) (624) Balance as of September 30, $ 1,763 $ 2,017 Costs associated with extended warranty repairs are recorded as incurred and amounted to $3.9 million and $4.6 million for the nine months ended September 30, 2023 and 2022, respectively.

Pension Plan

Pension Plan	9 Months Ended
Pension Plan	Sep. 30, 2023
Retirement Benefits [Abstract]
Pension Plan	Pension Plan Net periodic pension cost consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Service cost $ 194 $ 269 $ 582 $ 807 Interest cost on projected benefit obligation 911 537 2,733 1,611 Expected return on plan assets (1,032) (1,324) (3,096) (3,972) Net amortization and deferral 532 647 1,597 1,941 Net periodic pension cost $ 605 $ 129 $ 1,816 $ 387

Business Segment

Business Segment	9 Months Ended
Business Segment	Sep. 30, 2023
Segment Reporting [Abstract]
Business Segment	Business Segment We are accounting and reporting for our business as a single operating segment entity engaged in the development, manufacturing and sale on a global basis of surgical devices and related equipment. Our chief operating decision maker (the CEO) evaluates the various global product portfolios on a net sales basis and evaluates profitability, investment, cash flow metrics and allocates resources on a consolidated worldwide basis due to shared infrastructure and resources. Our product lines consist of orthopedic surgery and general surgery. Orthopedic surgery consists of sports medicine and lower extremities instrumentation and implants, small bone, large bone and specialty powered surgical instruments as well as imaging systems for use in minimally invasive surgery procedures and fees related to the sales representation, promotion and marketing of sports medicine allograft tissue. General surgery consists of a complete line of endo-mechanical instrumentation for minimally invasive laparoscopic and gastrointestinal procedures, smoke evacuation devices, a line of cardiac monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales are as follows: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Orthopedic surgery $ 124,667 $ 118,618 $ 396,633 $ 346,317 General surgery 179,911 156,470 521,066 448,288 Consolidated net sales $ 304,578 $ 275,088 $ 917,699 $ 794,605

Legal Proceedings

Legal Proceedings	9 Months Ended
Legal Proceedings	Sep. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Legal Proceedings	Legal Proceedings From time to time, the Company may receive an information request, subpoena or warrant from a government agency such as the Securities and Exchange Commission, Department of Justice, Equal Employment Opportunity Commission, the Occupational Safety and Health Administration, the United States Food and Drug Administration, the Department of Labor, the Treasury Department or other federal and state agencies or foreign governments or government agencies. These information requests, subpoenas or warrants may or may not be routine inquiries, or may begin as routine inquiries and over time develop into enforcement actions of various types. Likewise, if we receive reports of alleged misconduct from employees and third parties, we investigate as appropriate. Manufacturers of medical devices have been the subject of various enforcement actions relating to interactions with health care providers domestically or internationally whereby companies are claimed to have provided health care providers with inappropriate incentives to purchase their products. Similarly, the Foreign Corrupt Practices Act ("FCPA") imposes obligations on manufacturers with respect to interactions with health care providers who may be considered government officials based on their affiliation with public hospitals. The FCPA also requires publicly listed manufacturers to maintain accurate books and records, and maintain internal accounting controls sufficient to provide assurance that transactions are accurately recorded, lawful and in accordance with management's authorization. The FCPA poses unique challenges both because manufacturers operate in foreign cultures in which conduct illegal under the FCPA may not be illegal in local jurisdictions, and because, in some cases, a United States manufacturer may face risks under the FCPA based on the conduct of third parties over whom the manufacturer may not have complete control. While CONMED has not experienced any material enforcement action to date, there can be no assurance that the Company will not be subject to a material enforcement action in the future, or that the Company will not incur costs including, in the form of fees for lawyers and other consultants, that are material to the Company’s results of operations in the course of responding to a future inquiry or investigation. Manufacturers of medical products may face exposure to significant product liability claims, as well as patent infringement and other claims incurred in the ordinary course of business. To date, we have not experienced any claims that have been material to our financial statements or financial condition, but any such claims arising in the future could have a material adverse effect on our business, results of operations or cash flows. We currently maintain commercial product liability insurance of $35 million per incident and $35 million in the aggregate annually, which we believe is adequate. This coverage is on a claims-made basis. There can be no assurance that claims will not exceed insurance coverage, that the carriers will be solvent or that such insurance will be available to us in the future at a reasonable cost. Our operations are subject, and in the past have been subject, to a number of environmental laws and regulations governing, among other things, air emissions; wastewater discharges; the use, handling and disposal of hazardous substances and wastes; soil and groundwater remediation and employee health and safety. Likewise, the operations of our suppliers and sterilizers are subject to similar environmental laws and regulations. In some jurisdictions, environmental requirements may be expected to become more stringent in the future. In the United States, certain environmental laws can impose liability for the entire cost of site restoration upon each of the parties that may have contributed to conditions at the site regardless of fault or the lawfulness of the party’s activities. While we do not believe that the present costs of environmental compliance and remediation are material, there can be no assurance that future compliance or remedial obligations would not have a material adverse effect on our financial condition, results of operations or cash flows. CONMED is defending two Georgia State Court actions. The first action was filed in Cobb County by various employees, former employees, contract workers and others against CONMED and against a contract sterilizer (the "Cobb County Action"). The second action was filed in Douglas County against CONMED’s landlord and other allegedly related entities (the "Douglas County Action"). Plaintiffs in the lawsuits allege personal injury and related claims purportedly arising from or relating to exposure to Ethylene Oxide, a chemical used to sterilize certain products. CONMED is defending the claims asserted directly against it and is providing indemnification for certain other defendants based on contractual provisions. Both actions are in their early stages. The Company's motion to dismiss in the Cobb County action was heard on January 10, 2022, and the Court issued a ruling on June 15, 2022 dismissing 44 of the 51 plaintiffs' claims as precluded by the exclusive workers' compensation remedy, as well as one claim from a non-employee plaintiff. As to the remaining claims that were not the subject of the motion to dismiss, CONMED believes it has strong defenses and will vigorously defend itself and all parties it is indemnifying. As with any litigation, there are risks, including the risk that CONMED may not prevail with respect to the defense of the underlying claims, or with respect to securing adequate insurance coverage for the indemnification claims. The Company is unable to estimate a range of possible loss at this time, and has not recorded any expense related to potential damages in connection with this matter because the Company does not believe any potential loss is probable. CONMED submitted the foregoing claims for insurance coverage. One insurer is providing coverage for certain of the claims asserted directly against the Company. CONMED litigated two lawsuits in the United States District Court for the Northern District of New York ("the Northern District") with Federal Insurance Company (“Chubb”): one involving CONMED’s claim for coverage for the indemnification claims arising from the Cobb County Action, and the other concerning CONMED’s claim for coverage for the indemnification claims arising from the Douglas County Action. On March 10, 2022, the Court ruled in favor of CONMED with respect to coverage for the indemnification claims arising from the Cobb County Action. Chubb's motion for reconsideration was denied, and Chubb filed a notice of appeal. On August 9, 2022, CONMED won a similar ruling finding in its favor and against Chubb as to the coverage case concerning the Douglas County Action. Chubb appealed that decision as well. Chubb subsequently withdrew its appeal in connection with a settlement between the parties. Chubb disputes the amount it owes in fees incurred by the Company's attorneys defending the Douglas County action going forward. Accordingly, CONMED has commenced a third action against Chubb in the Northern District to enforce the terms of the settlement agreement, although there can be no assurance that CONMED will prevail. In addition, one of CONMED’s contract sterilizers, which is defending toxic tort claims asserted by various residents in the areas around its processing facility, has placed CONMED on notice of a claim for indemnification relating to some of those claims. CONMED is reviewing the notice, and has not at this time taken any position on the notice. The government of Italy passed a law in late 2015 to tax medical device companies on revenue derived from sales to public hospitals. The tax is calculated and based on provincial spending over and above certain thresholds. Since the law was enacted, the Italian government essentially made no effort to administer or collect the tax. A lack of interpretative guidance and complexity of the law resulted in uncertainty as to the actual amount of liability. In September 2022, the Italian government passed a further decree which, amongst other provisions, delegated administration and collection to the provincial level for the years 2015 – 2018. The Italy medical device tax represents variable consideration in the form of a retroactive discount potentially owed to the customer, which is ultimately the Italian government. The Company is challenging the imposition of the medical device tax in Italy, as have many other medical device companies, on the ground that the law was never implemented properly with regulations. While the Company is informed that its position is well-grounded in the law, there can be no assurance that the Company will prevail. No amounts have been remitted to date. From time to time, we are also subject to negligence and other claims arising out of the ordinary conduct of our business, including, for example, automobile or other accidents our employees may experience within the course of their employment or otherwise and which may, on occasion, involve potentially significant personal injuries or other exposures. We record reserves sufficient to cover probable and estimable losses associated with any such pending claims. We do not expect that the resolution of any pending claims, investigations or reports of alleged misconduct will have a material adverse effect on our financial condition, results of operations or cash flows. There can be no assurance, however, that future claims or investigations, or the costs associated with responding to such claims, investigations or reports of misconduct, especially claims and investigations not covered by insurance, will not have a material adverse effect on our financial condition, results of operations or cash flows.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net income (loss)	$ 15,837	$ 46,150	$ 31,388	$ (107,166)

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Interim Reporting (Policies)

Interim Reporting (Policies)	9 Months Ended
Interim Reporting (Policies)	Sep. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Use of Estimates	Use of Estimates Preparation of the consolidated condensed financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the consolidated condensed financial statements and the reported amounts of revenue and expenses during the reporting period.

New Accounting Pronouncements (

New Accounting Pronouncements (Policies)	9 Months Ended
New Accounting Pronouncements (Policies)	Sep. 30, 2023
Accounting Standards Update and Change in Accounting Principle [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Issued Accounting Standards, Not Yet Adopted In March 2020, the Financial Accounting Standards Board ("FASB") issued ASU 2020-04, Reference Rate Reform (Topic 848): Facilitation of the Effects of Reference Rate Reform on Financial Reporting, which provides optional guidance if certain criteria are met for entities that have contracts, hedging relationships, and other transactions that reference LIBOR or other reference rates expected to be discontinued as a result of reference rate reform. This ASU is effective as of March 12, 2020 through December 31, 2022 and was extended through December 31, 2024 by ASU 2022-06, Reference Rate Reform (Topic 848): Deferral of the Sunset Date of Topic 848. The Company has not adopted these ASUs as of September 30, 2023. Our seventh amended and restated senior credit agreement includes language to address the change from LIBOR to SOFR, an alternative base rate, therefore we do not believe reference rate reform will have a significant impact on our consolidated financial statements.

Revenues (Tables)

Revenues (Tables)	9 Months Ended
Revenues (Tables)	Sep. 30, 2023
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended September 30, 2023 September 30, 2022 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 46,273 $ 124,250 $ 170,523 $ 45,688 $ 110,033 $ 155,721 Europe, Middle East & Africa 28,001 23,436 51,437 26,914 20,300 47,214 Asia Pacific 29,995 23,289 53,284 28,242 17,223 45,465 Americas (excluding the United States) 20,398 8,936 29,334 17,774 8,914 26,688 Total sales from contracts with customers $ 124,667 $ 179,911 $ 304,578 $ 118,618 $ 156,470 $ 275,088 Timing of Revenue Recognition Goods transferred at a point in time $ 115,722 $ 177,915 $ 293,637 $ 108,875 $ 154,856 $ 263,731 Services transferred over time 8,945 1,996 10,941 9,743 1,614 11,357 Total sales from contracts with customers $ 124,667 $ 179,911 $ 304,578 $ 118,618 $ 156,470 $ 275,088 Nine Months Ended Nine Months Ended September 30, 2023 September 30, 2022 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 147,557 $ 362,223 $ 509,780 $ 124,097 $ 312,034 $ 436,131 Europe, Middle East & Africa 93,703 72,032 165,735 88,955 63,093 152,048 Asia Pacific 93,365 58,632 151,997 79,333 46,379 125,712 Americas (excluding the United States) 62,008 28,179 90,187 53,932 26,782 80,714 Total sales from contracts with customers $ 396,633 $ 521,066 $ 917,699 $ 346,317 $ 448,288 $ 794,605 Timing of Revenue Recognition Goods transferred at a point in time $ 367,118 $ 515,529 $ 882,647 $ 317,140 $ 443,629 $ 760,769 Services transferred over time 29,515 5,537 35,052 29,177 4,659 33,836 Total sales from contracts with customers $ 396,633 $ 521,066 $ 917,699 $ 346,317 $ 448,288 $ 794,605
Contract with Customer, Asset and Liability	Contract liability balances related to the sale of extended warranties to customers are as follows: September 30, 2023 December 31, 2022 Contract liability $ 18,645 $ 19,114

Comprehensive Income (Loss) (Ta

Comprehensive Income (Loss) (Tables)	9 Months Ended
Comprehensive Income (Loss) (Tables)	Sep. 30, 2023
Equity [Abstract]
Schedule of Comprehensive Income (Loss)	Comprehensive income (loss) consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Net income (loss) $ 15,837 $ 46,150 $ 31,388 $ (107,166) Other comprehensive income (loss): Cash flow hedging gain, net of income tax (income tax expense of $873 and $1,546 for the three months ended September 30, 2023 and 2022, respectively, and $1,315 and $3,384 for the nine months ended September 30, 2023 and 2022, respectively) 2,730 4,833 4,110 10,577 Pension liability, net of income tax (income tax expense of $129 and $157 for the three months ended September 30, 2023 and 2022, respectively, and $387 and $439 for the nine months ended September 30, 2023 and 2022, respectively.) 403 490 1,210 1,502 Foreign currency translation adjustment (4,145) (8,348) (1,421) (18,009) Comprehensive income (loss) $ 14,825 $ 43,125 $ 35,287 $ (113,096)
Schedule of Accumulated Other Comprehensive Loss	Accumulated other comprehensive loss consists of the following: Cash Flow Pension Cumulative Accumulated Balance, December 31, 2022 $ 2,497 $ (23,749) $ (36,606) $ (57,858) Other comprehensive income (loss) before reclassifications, net of tax 8,692 — (1,421) 7,271 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (6,048) 1,597 — (4,451) Income tax 1,466 (387) — 1,079 Net current-period other comprehensive income (loss) 4,110 1,210 (1,421) 3,899 Balance, September 30, 2023 $ 6,607 $ (22,539) $ (38,027) $ (53,959) Cash Flow Pension Cumulative Accumulated Balance, December 31, 2021 $ 3,656 $ (29,671) $ (28,188) $ (54,203) Other comprehensive income (loss) before reclassifications, net of tax 18,711 — (18,009) 702 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (10,736) 1,941 — (8,795) Income tax 2,602 (439) — 2,163 Net current-period other comprehensive income (loss) 10,577 1,502 (18,009) (5,930) Balance, September 30, 2022 $ 14,233 $ (28,169) $ (46,197) $ (60,133) (a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive loss components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 7 and Note 13, respectively, for further details.

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	9 Months Ended
Fair Value of Financial Instruments (Tables)	Sep. 30, 2023
Fair Value Disclosures [Abstract]
Schedule of Notional Amounts of Outstanding Derivative Positions	The following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation September 30, 2023 December 31, 2022 Forward exchange contracts Cash flow hedge $ 218,929 $ 198,473 Forward exchange contracts Non-designated 49,918 81,929
Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)	Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) ("AOCI") and net earnings on our consolidated condensed statements of comprehensive income (loss) and our consolidated condensed balance sheets: Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain Reclassified from AOCI Three Months Ended September 30, Total Amount of Line Item Presented Derivative Instrument 2023 2022 Location of amount reclassified 2023 2022 2023 2022 Foreign exchange contracts $ 6,180 $ 11,695 Net Sales $ 304,578 $ 275,088 $ 1,095 $ 5,090 Cost of Sales 136,519 123,473 1,482 225 Pre-tax gain $ 6,180 $ 11,695 $ 2,577 $ 5,315 Tax expense 1,498 2,835 625 1,288 Net gain $ 4,682 $ 8,860 $ 1,952 $ 4,027 Amount of Gain Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income (Loss) Amount of Gain Reclassified from AOCI Nine Months Ended September 30, Total Amount of Line Item Presented Derivative Instrument 2023 2022 Location of amount reclassified 2023 2022 2023 2022 Foreign exchange contracts $ 11,471 $ 24,698 Net Sales $ 917,699 $ 794,605 $ 2,585 $ 10,237 Cost of Sales 423,629 355,222 3,463 499 Pre-tax gain $ 11,471 $ 24,698 $ 6,048 $ 10,736 Tax expense 2,779 5,987 1,466 2,602 Net gain $ 8,692 $ 18,711 $ 4,582 $ 8,134
Derivatives Not Designated as Hedging Instruments	Net gains from derivative instruments not accounted for as hedges and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income (loss) were: Three Months Ended September 30, Nine Months Ended September 30, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income (Loss) 2023 2022 2023 2022 Net gain on currency forward contracts Selling and administrative expense $ 227 $ 892 $ 630 $ 1,088 Net loss on currency transaction exposures Selling and administrative expense $ (552) $ (1,110) $ (1,831) $ (2,874)
Schedule of Fair Value for Forward Foreign Exchange Contracts	The following tables summarize the fair value for forward foreign exchange contracts outstanding at September 30, 2023 and December 31, 2022: September 30, 2023 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 8,124 $ (658) $ 7,466 Foreign exchange contracts Other assets 1,344 (89) 1,255 $ 9,468 $ (747) $ 8,721 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 39 (150) (111) Total derivatives $ 9,507 $ (897) $ 8,610 December 31, 2022 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Derivatives designated as hedged instruments: Foreign exchange contracts Prepaid expenses and other current assets $ 6,757 $ (3,121) $ 3,636 Foreign exchange contracts Other long-term liabilities 60 (400) (340) $ 6,817 $ (3,521) $ 3,296 Derivatives not designated as hedging instruments: Foreign exchange contracts Other current liabilities 48 (395) (347) Total derivatives $ 6,865 $ (3,916) $ 2,949
Fair Value Measurement Inputs and Valuation Techniques	The recurring Level 3 fair value measurements of contingent consideration for which the liabilities are recorded include the following significant unobservable inputs as of September 30, 2023: Assumptions Unobservable Input In2Bones Biorez Discount rate 8.02% 12.71% Revenue volatility 14.50% 21.38% Projected year of payment 2023-2026 2023-2026
Schedule of Business Acquisitions by Acquisition, Contingent Consideration	Changes in the fair value of contingent consideration liabilities for the nine months ended September 30, 2023 are as follows: In2Bones Biorez Location in Financial Statements Balance as of January 1, 2023 $ 70,198 $ 116,234 Changes in fair value of contingent consideration 860 6,089 Selling and administrative expense Balance as of September 30, 2023 $ 71,058 $ 122,323

Inventories (Tables)

Inventories (Tables)	9 Months Ended
Inventories (Tables)	Sep. 30, 2023
Inventory Disclosure [Abstract]
Schedule of Inventory	Inventories consist of the following: September 30, December 31, Raw materials $ 115,547 $ 110,677 Work-in-process 30,382 26,166 Finished goods 179,895 195,477 Total $ 325,824 $ 332,320

Earnings (Loss) Per Share (Tabl

Earnings (Loss) Per Share (Tables)	9 Months Ended
Earnings (Loss) Per Share (Tables)	Sep. 30, 2023
Earnings Per Share [Abstract]
Schedule of Calculation of Basic and Diluted Earnings (Loss) Per Share	The following tables set forth the computation of basic and diluted earnings (loss) per share, as applicable, for the three and nine months ended September 30, 2023 and 2022: Three Months Ended September 30, 2023 Three Months Ended September 30, 2022 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income $ 15,837 $ — $ 15,837 $ 46,150 $ — $ 46,150 Weighted average shares outstanding 30,741 — 30,741 30,473 — 30,473 Stock compensation — 770 770 — 585 585 Convertible notes — 178 178 — 45 45 30,741 948 31,689 30,473 630 31,103 EPS $ 0.52 $ 0.50 $ 1.51 $ 1.48 Nine Months Ended September 30, 2023 Nine Months Ended September 30, 2022 Basic EPS Adjustments Diluted EPS Basic EPS Adjustments Diluted EPS Net income (loss) $ 31,388 — $ 31,388 $ (107,166) — $ (107,166) Weighted average shares outstanding 30,638 — 30,638 29,892 — 29,892 Stock compensation — 758 758 — — — Warrants — 15 15 — — — Convertible notes — 152 152 — — — 30,638 925 31,563 29,892 — 29,892 EPS $ 1.02 $ 0.99 $ (3.59) $ (3.59)

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets (Tables)	9 Months Ended
Goodwill and Other Intangible Assets (Tables)	Sep. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in the net carrying amount of goodwill for the nine months ended September 30, 2023 are as follows: Balance as of December 31, 2022 $ 815,429 Foreign currency translation (286) Balance as of September 30, 2023 $ 815,143
Schedule of Finite-Lived Intangible Assets	Other intangible assets consist of the following: September 30, 2023 December 31, 2022 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 24 $ 369,812 $ (184,040) $ 369,854 $ (170,870) Sales representation, marketing and promotional rights 25 149,376 (70,500) 149,376 (66,000) Developed technology 18 320,204 (42,087) 320,204 (34,675) Patents and other intangible assets 16 81,677 (53,633) 79,838 (52,472) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 1,007,613 $ (350,260) $ 1,005,816 $ (324,017)
Schedule of Indefinite-Lived Intangible Assets	Other intangible assets consist of the following: September 30, 2023 December 31, 2022 Weighted Average Amortization Period (Years) Gross Accumulated Gross Accumulated Intangible assets with definite lives: 22 Customer and distributor relationships 24 $ 369,812 $ (184,040) $ 369,854 $ (170,870) Sales representation, marketing and promotional rights 25 149,376 (70,500) 149,376 (66,000) Developed technology 18 320,204 (42,087) 320,204 (34,675) Patents and other intangible assets 16 81,677 (53,633) 79,838 (52,472) Intangible assets with indefinite lives: Trademarks and tradenames 86,544 — 86,544 — $ 1,007,613 $ (350,260) $ 1,005,816 $ (324,017)
Schedule of Estimated Amortization Expense	The estimated intangible asset amortization expense remaining for the year ending December 31, 2023 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2023 $ 7,338 $ 1,500 $ 8,838 2024 28,730 6,000 34,730 2025 29,607 6,000 35,607 2026 29,371 6,000 35,371 2027 30,411 6,000 36,411 2028 33,543 6,000 39,543

Long Term Debt (Tables)

Long Term Debt (Tables)	9 Months Ended
Long Term Debt (Tables)	Sep. 30, 2023
Debt Disclosure [Abstract]
Schedule of Long-Term Debt	Long-term debt consists of the following: September 30, 2023 December 31, 2022 Revolving line of credit $ 22,000 $ 70,000 Term loan, net of deferred debt issuance costs of $575 and $729 in 2023 and 2022, respectively 134,013 133,858 2.625% convertible notes, net of deferred debt issuance costs of $93 and $432 in 2023 and 2022, respectively 69,907 69,568 2.250% convertible notes, net of deferred debt issuance costs of $15,644 and $18,834 in 2023 and 2022, respectively 784,356 781,166 Financing leases 2,515 230 Total debt 1,012,791 1,054,822 Less: Current portion 70,625 69,746 Total long-term debt $ 942,166 $ 985,076
Schedule of Maturities of Long-Term Debt	The scheduled maturities of long-term debt outstanding at September 30, 2023 are as follows: Remaining, 2023 $ — 2024 70,000 2025 — 2026 156,588 2027 800,000 2028 — The above amounts exclude deferred debt issuance costs and financing leases.

Guarantees (Tables)

Guarantees (Tables)	9 Months Ended
Guarantees (Tables)	Sep. 30, 2023
Guarantees [Abstract]
Changes in the Carrying Amount of Service and Product Warranties	Changes in the liability for standard warranties for the nine months ended September 30, are as follows: 2023 2022 Balance as of January 1, $ 1,944 $ 2,344 Provision for warranties 388 297 Claims made (569) (624) Balance as of September 30, $ 1,763 $ 2,017

Pension Plan (Tables)

Pension Plan (Tables)	9 Months Ended
Pension Plan (Tables)	Sep. 30, 2023
Retirement Benefits [Abstract]
Schedule of Net Benefit Cost	Net periodic pension cost consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Service cost $ 194 $ 269 $ 582 $ 807 Interest cost on projected benefit obligation 911 537 2,733 1,611 Expected return on plan assets (1,032) (1,324) (3,096) (3,972) Net amortization and deferral 532 647 1,597 1,941 Net periodic pension cost $ 605 $ 129 $ 1,816 $ 387

Business Segment (Tables)

Business Segment (Tables)	9 Months Ended
Business Segment (Tables)	Sep. 30, 2023
Segment Reporting [Abstract]
Schedule of Net Sales Information by Product Line	These product lines' net sales are as follows: Three Months Ended September 30, Nine Months Ended September 30, 2023 2022 2023 2022 Orthopedic surgery $ 124,667 $ 118,618 $ 396,633 $ 346,317 General surgery 179,911 156,470 521,066 448,288 Consolidated net sales $ 304,578 $ 275,088 $ 917,699 $ 794,605

Business Combinations (Details)

Business Combinations (Details) - USD ($) $ in Millions			3 Months Ended		9 Months Ended
Business Combinations (Details) - USD ($) $ in Millions	Aug. 09, 2022	Jun. 13, 2022	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
In2Bones Global Inc
Business Acquisition [Line Items]
Business Combination, Consideration Transferred		$ 145.2
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High		$ 110
In2Bones Global Inc \| Cost of Sales
Business Acquisition [Line Items]
Amortization of inventory step-up adjustments			$ 2.2	$ 2.1	$ 6.5	$ 2.4
Biorez Inc
Business Acquisition [Line Items]
Business Combination, Consideration Transferred	$ 85.5
Payments to acquire businesses, gross	84.1
Purchase Price Adjustment Holdback	1.4
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High	$ 165
In2Bones Global Inc and Biorez Inc \| Selling and Administrative Expenses
Business Acquisition [Line Items]
Acquisition and integration costs				$ 3.7	$ 0.8	$ 6.3

Revenues (Disaggregated Revenue

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation of Revenue [Line Items]
Net Sales	$ 304,578	$ 275,088	$ 917,699	$ 794,605
Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	293,637	263,731	882,647	760,769
Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	10,941	11,357	35,052	33,836
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	124,667	118,618	396,633	346,317
Orthopedic Surgery \| Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	115,722	108,875	367,118	317,140
Orthopedic Surgery \| Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	8,945	9,743	29,515	29,177
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	179,911	156,470	521,066	448,288
General Surgery \| Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	177,915	154,856	515,529	443,629
General Surgery \| Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	1,996	1,614	5,537	4,659
United States
Disaggregation of Revenue [Line Items]
Net Sales	170,523	155,721	509,780	436,131
United States \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	46,273	45,688	147,557	124,097
United States \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	124,250	110,033	362,223	312,034
Americas (excluding the United States)
Disaggregation of Revenue [Line Items]
Net Sales	29,334	26,688	90,187	80,714
Americas (excluding the United States) \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	20,398	17,774	62,008	53,932
Americas (excluding the United States) \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	8,936	8,914	28,179	26,782
Europe, Middle East & Africa
Disaggregation of Revenue [Line Items]
Net Sales	51,437	47,214	165,735	152,048
Europe, Middle East & Africa \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	28,001	26,914	93,703	88,955
Europe, Middle East & Africa \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	23,436	20,300	72,032	63,093
Asia Pacific
Disaggregation of Revenue [Line Items]
Net Sales	53,284	45,465	151,997	125,712
Asia Pacific \| Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	29,995	28,242	93,365	79,333
Asia Pacific \| General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	$ 23,289	$ 17,223	$ 58,632	$ 46,379

Revenues (Customer Liability) (

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Revenue from Contract with Customer [Abstract]
Contract liability	$ 18,645		$ 19,114
Revenue recognized	$ 10,400	$ 9,500

Comprehensive Income (Loss) (De

Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	3 Months Ended						9 Months Ended
	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Sep. 30, 2022
Equity [Abstract]
Net income (loss)	$ 15,837			$ 46,150			$ 31,388	$ (107,166)
Cash flow hedging gain, net	2,730			4,833			4,110	10,577
Pension liability, net of income tax	403			490			1,210	1,502
Foreign currency translation adjustments	(4,145)			(8,348)			(1,421)	(18,009)
Comprehensive income (loss)	14,825	$ 15,767	$ 4,695	43,125	$ (172,636)	$ 16,415	35,287	(113,096)
Cash flow hedging gain, tax	873			1,546			1,315	3,384
Pension liability, tax	$ 129			$ 157			$ 387	$ 439

Comprehensive Income (Loss) (Ac

Comprehensive Income (Loss) (Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2023	Sep. 30, 2022
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		$ (57,858)
Accumulated Other Comprehensive Income (Loss), Net of Tax		(53,959)
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		(57,858)	$ (54,203)
Other comprehensive income (loss) before reclassifications, net of tax		7,271	702
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(4,451)	(8,795)
Reclassification from AOCI, Current Period, Tax		1,079	2,163
Net current-period other comprehensive income (loss)		3,899	(5,930)
Accumulated Other Comprehensive Income (Loss), Net of Tax		(53,959)	(60,133)
Cash Flow Hedging Gain (Loss)
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		2,497	3,656
Other comprehensive income (loss) before reclassifications, net of tax		8,692	18,711
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(6,048)	(10,736)
Reclassification from AOCI, Current Period, Tax		1,466	2,602
Net current-period other comprehensive income (loss)		4,110	10,577
Accumulated Other Comprehensive Income (Loss), Net of Tax		6,607	14,233
Pension Liability
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		(23,749)	(29,671)
Other comprehensive income (loss) before reclassifications, net of tax		0	0
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	1,597	1,941
Reclassification from AOCI, Current Period, Tax		(387)	(439)
Net current-period other comprehensive income (loss)		1,210	1,502
Accumulated Other Comprehensive Income (Loss), Net of Tax		(22,539)	(28,169)
Cumulative Translation Adjustments
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated Other Comprehensive Income (Loss), Net of Tax		(36,606)	(28,188)
Other comprehensive income (loss) before reclassifications, net of tax		(1,421)	(18,009)
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	0	0
Reclassification from AOCI, Current Period, Tax		0	0
Net current-period other comprehensive income (loss)		(1,421)	(18,009)
Accumulated Other Comprehensive Income (Loss), Net of Tax		$ (38,027)	$ (46,197)

[1]The cash flow hedging gain (loss) and pension liability accumulated other comprehensive loss components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 7 and Note 13, respectively, for further details.

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Amounts Recorded In and Reclassified From AOCI) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Derivative Instruments, Gain (Loss) [Line Items]
Net sales	$ 304,578	$ 275,088	$ 917,699	$ 794,605
Cost of sales	136,519	123,473	423,629	355,222
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification and Tax	6,180	11,695	11,471	24,698
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, Tax	1,498	2,835	2,779	5,987
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), before Reclassification, after Tax	4,682	8,860	8,692	18,711
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	2,577	5,315	6,048	10,736
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	625	1,288	1,466	2,602
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	1,952	4,027	4,582	8,134
Revenues
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	1,095	5,090	2,585	10,237
Cost of Sales
Derivative Instruments, Gain (Loss) [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, before Tax	$ 1,482	$ 225	$ 3,463	$ 499

Fair Value of Financial Instr_4

Fair Value of Financial Instruments (Foreign Currency Forward Contracts) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Derivative [Line Items]
Net loss on currency transaction exposures	$ (552)	$ (1,110)	$ (1,831)	$ (2,874)
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	9,507		9,507		$ 6,865
Liabilities Fair Value	(897)		(897)		(3,916)
Net Fair Value	8,610		8,610		2,949
Foreign Currency Forward Contracts
Derivative [Line Items]
Net gain on currency forward contracts	227	$ 892	630	$ 1,088
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	9,468		9,468		6,817
Liabilities Fair Value	(747)		(747)		(3,521)
Net Fair Value	8,721		8,721		3,296
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Prepaid Expenses and Other Current Assets
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	8,124		8,124		6,757
Liabilities Fair Value	(658)		(658)		(3,121)
Net Fair Value	7,466		7,466		3,636
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Other Noncurrent Assets
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	1,344		1,344
Liabilities Fair Value	(89)		(89)
Net Fair Value	1,255		$ 1,255
Derivatives designated as hedged instruments: \| Foreign Currency Forward Contracts \| Other Noncurrent Liabilities
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value					60
Liabilities Fair Value					(400)
Net Fair Value					(340)
Derivatives not designated as hedging instruments: \| Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge			1 month
Notional amount of cash flow hedges	49,918		$ 49,918		81,929
Derivatives not designated as hedging instruments: \| Foreign Currency Forward Contracts \| Other Current Liabilities
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	39		39		48
Liabilities Fair Value	(150)		(150)		(395)
Net Fair Value	(111)		$ (111)		(347)
Cash flow hedge \| Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge			2 years
Notional amount of cash flow hedges	218,929		$ 218,929		$ 198,473
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 5,700		$ 5,700

Fair Value of Financial Instr_5

Fair Value of Financial Instruments (Contingent Consideration) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Non-cash adjustment to fair value of contingent consideration liability	$ 6,949	$ 0
Business Combination, Contingent Consideration, Liability, Current	82,500		$ 18,600
Business Combination, Contingent Consideration, Liability, Noncurrent	110,900		$ 167,800
In2Bones Global Inc
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Balance as of January 1, 2023	70,198
Non-cash adjustment to fair value of contingent consideration liability	860
Balance as of September 30, 2023	$ 71,058
In2Bones Global Inc \| Fair Value, Inputs, Level 3 \| Fair Value, Recurring \| Measurement Input, Discount Rate
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.0802
In2Bones Global Inc \| Fair Value, Inputs, Level 3 \| Fair Value, Recurring \| Measurement Input, Revenue Volatility
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.1450
Biorez Inc
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Balance as of January 1, 2023	$ 116,234
Non-cash adjustment to fair value of contingent consideration liability	6,089
Balance as of September 30, 2023	$ 122,323
Biorez Inc \| Fair Value, Inputs, Level 3 \| Fair Value, Recurring \| Measurement Input, Discount Rate
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.1271
Biorez Inc \| Fair Value, Inputs, Level 3 \| Fair Value, Recurring \| Measurement Input, Revenue Volatility
Business Combination, Contingent Consideration Arrangements, Change in Amount of Contingent Consideration [Abstract]
Business Combination, Contingent Consideration, Liability, Measurement Input	0.2138

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Inventory Disclosure [Abstract]
Raw materials	$ 115,547	$ 110,677
Work-in-process	30,382	26,166
Finished goods	179,895	195,477
Total inventory	$ 325,824	$ 332,320

Earnings (Loss) Per Share (Deta

Earnings (Loss) Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Net income (loss)	$ 15,837	$ 46,150	$ 31,388	$ (107,166)
Interest on Convertible Debt, Net of Tax	0	0	0	0
Net Income (Loss) Available to Common Stockholders, Diluted	$ 15,837	$ 46,150	$ 31,388	$ (107,166)
Basic-weighted average shares outstanding (in shares)	30,741	30,473	30,638	29,892
Incremental Common Shares Attributable to Dilutive Effect of Share-based Payment Arrangements (in shares)	770	585	758	0
Incremental Common Shares Attributable to Dilutive Effect of Call Options and Warrants (in shares)			15	0
Incremental Common Shares Attributable to Dilutive Effect of Conversion of Debt Securities (in shares)	178	45	152	0
Effect of dilutive potential securities (in shares)	948	630	925	0
Diluted- weighted average shares outstanding (in shares)	31,689	31,103	31,563	29,892
Basic (in dollars per share)	$ 0.52	$ 1.51	$ 1.02	$ (3.59)
Diluted (in dollars per share)	$ 0.50	$ 1.48	$ 0.99	$ (3.59)
Antidilutive securities excluded from computation of earnings per share (in shares)	1,700	2,000	1,800	0

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Goodwill) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2023 USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 815,429
Foreign currency translation	(286)
Ending balance	815,143
Goodwill [Line Items]
Goodwill	$ 815,143

Goodwill and Other Intangible_4

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022	Dec. 31, 2022
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Gross carrying amount	$ 1,007,613		$ 1,007,613		$ 1,005,816
Intangible assets, Accumulated amortization	(350,260)		(350,260)		(324,017)
Amortization expense	8,700	$ 8,700	26,300	$ 24,900
Future amortization expense [Abstract]
Remaining, 2023	8,838		8,838
2024	34,730		34,730
2025	35,607		35,607
2026	35,371		35,371
2027	36,411		36,411
2028	39,543		39,543
Amortization included in expense
Future amortization expense [Abstract]
Remaining, 2023	7,338		7,338
2024	28,730		28,730
2025	29,607		29,607
2026	29,371		29,371
2027	30,411		30,411
2028	33,543		33,543
Amortization recorded as a reduction of revenue
Future amortization expense [Abstract]
Remaining, 2023	1,500		1,500
2024	6,000		6,000
2025	6,000		6,000
2026	6,000		6,000
2027	6,000		6,000
2028	6,000		6,000
Trademarks & tradenames
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Unamortized intangible assets, Gross carrying amount	86,544		86,544		86,544
Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	369,812		369,812		369,854
Intangible assets, Accumulated amortization	(184,040)		(184,040)		(170,870)
Sales representation, marketing and promotional rights
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	149,376		149,376		149,376
Intangible assets, Accumulated amortization	(70,500)		(70,500)		(66,000)
Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	320,204		320,204		320,204
Intangible assets, Accumulated amortization	(42,087)		(42,087)		(34,675)
Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	81,677		81,677		79,838
Intangible assets, Accumulated amortization	$ (53,633)		$ (53,633)		$ (52,472)
Weighted Average
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	22 years		22 years
Weighted Average \| Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	24 years		24 years
Weighted Average \| Sales representation, marketing and promotional rights
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	25 years		25 years
Weighted Average \| Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	18 years		18 years
Weighted Average \| Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)	16 years		16 years

Long Term Debt (Details)

Long Term Debt (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Finance Lease, Liability	$ 2,515	$ 230
Long-term Debt and Lease Obligation, Including Current Maturities	1,012,791	1,054,822
Current portion of long-term debt	70,625	69,746
Long-term debt	942,166	985,076
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt	22,000	70,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt	134,013	133,858
Unamortized Debt Issuance Expense	575	729
2.625 Percent Convertible Notes Due 2024 \| Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Convertible Debt	69,907	69,568
Unamortized Debt Issuance Expense	93	432
2.250 Percent Convertible Notes Due 2027 \| Convertible Notes Payable [Member]
Debt Instrument [Line Items]
Convertible Debt	784,356	781,166
Unamortized Debt Issuance Expense	$ 15,644	$ 18,834

Long Term Debt Additional Infor

Long Term Debt Additional Information (Details) $ / shares in Units, shares in Millions			3 Months Ended		9 Months Ended
	Jun. 06, 2022 USD ($) $ / shares shares	Jan. 29, 2019 USD ($) $ / shares	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Dec. 31, 2022 USD ($)	Jul. 16, 2021 USD ($)
Debt Instrument [Line Items]
Repayments of Senior Debt					$ 0	$ 92,981,000
Loss on early extinguishment of debt					0	3,426,000
Payments to redeem convertible notes					0	275,000,000
Loss on convertible notes conversion premium					0	103,125,000
Loss on convertible notes hedge transactions settlement					0	5,460,000
Other Expense
Debt Instrument [Line Items]
Loss on convertible notes hedge transactions settlement						5,500,000
Term Loan Facility [Member]
Debt Instrument [Line Items]
Long-term Debt			$ 134,013,000		134,013,000		$ 133,858,000
Term Loan Facility [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Debt instrument, face amount								$ 233,500,000
Repayments of Senior Debt	$ 90,000,000
Loss on early extinguishment of debt						500,000
Long-term Debt, Gross			134,600,000		134,600,000
Line of Credit [Member]
Debt Instrument [Line Items]
Long-term Debt			22,000,000		22,000,000		$ 70,000,000
Line of Credit [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Line of Credit Facility, Maximum Borrowing Capacity								$ 585,000,000
Line of Credit Facility, Remaining Borrowing Capacity			561,400,000		561,400,000
Letters of Credit Outstanding, Amount			1,600,000		1,600,000
Convertible Notes Payable [Member] \| 2.625 Percent Convertible Notes Due 2024
Debt Instrument [Line Items]
Debt instrument, face amount		$ 345,000,000	70,000,000		70,000,000
Loss on early extinguishment of debt						2,900,000
Interest rate, stated percentage		2.625%
Debt Instrument, Convertible, Conversion Ratio		11.2608
Conversion price (in dollars per share) \| $ / shares		$ 88.80
Payments to redeem convertible notes	$ 275,000,000
Debt Conversion, Converted Instrument, Shares Issued \| shares	0.9
Loss on convertible notes conversion premium						103,100,000
Interest Expense, Debt			500,000	$ 500,000	1,400,000	4,400,000
Debt Instrument, Fair Value Disclosure			81,200,000		81,200,000
Convertible Notes Payable [Member] \| 2.625 Percent Convertible Notes Due 2024 \| Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) \| $ / shares		$ 114.92
Convertible Notes Payable [Member] \| 2.250 Percent Convertible Notes Due 2027
Debt Instrument [Line Items]
Debt instrument, face amount	$ 800,000,000
Interest rate, stated percentage	2.25%
Debt Instrument, Convertible, Conversion Ratio	6.8810
Conversion price (in dollars per share) \| $ / shares	$ 145.33
Interest Expense, Debt			4,500,000	$ 4,500,000	13,500,000	$ 5,800,000
Debt Instrument, Fair Value Disclosure			$ 754,000,000		$ 754,000,000
Convertible Notes Payable [Member] \| 2.250 Percent Convertible Notes Due 2027 \| Warrant
Debt Instrument [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share) \| $ / shares	$ 251.53
Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member]
Debt Instrument [Line Items]
Term SOFR Interest Rate Spread Adjustment			0.114%		0.114%
Adjusted Term SOFR Interest Rate			5.489%		5.489%
Debt Instrument, Interest Rate, Effective Percentage			6.614%		6.614%
Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member] \| Adjusted Term SOFR Interest Rate
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate					1.125%
Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member] \| Fed Funds Effective Rate Overnight Index Swap Rate [Member]
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate					0.50%
Long-term Debt [Member] \| Amended and Restated Senior Credit Agreement [Member] \| Adjusted Term SOFR
Debt Instrument [Line Items]
Debt Instrument, Basis Spread on Variable Rate					1%
Call Option [Member] \| Convertible Notes Payable [Member] \| 2.625 Percent Convertible Notes Due 2024
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid		$ 21,000,000
Call Option [Member] \| Convertible Notes Payable [Member] \| 2.250 Percent Convertible Notes Due 2027
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid	$ 115,600,000

Long Term Debt Maturities of Lo

Long Term Debt Maturities of Long Term Debt (Details) $ in Thousands	Sep. 30, 2023 USD ($)
Maturities of Long-term Debt [Abstract]
Remaining, 2023	$ 0
2024	70,000
2025	0
2026	156,588
2027	800,000
2028	$ 0

Guarantees (Details)

Guarantees (Details) - USD ($) $ in Thousands	9 Months Ended
Guarantees (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022
Guarantees [Abstract]
Standard warranty period (in years)	1 year
Movement in Standard Product Warranty Accrual [Roll Forward]
Balance as of January 1,	$ 1,944	$ 2,344
Provision for warranties	388	297
Claims made	(569)	(624)
Balance as of September 30,	1,763	2,017
Extended Product Warranty Disclosure [Abstract]
Product extended warranty expense	$ 3,900	$ 4,600

Pension Plan (Details)

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Pension Plan (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Retirement Benefits [Abstract]
Service cost	$ 194	$ 269	$ 582	$ 807
Interest cost on projected benefit obligation	911	537	2,733	1,611
Expected return on plan assets	(1,032)	(1,324)	(3,096)	(3,972)
Net amortization and deferral	532	647	1,597	1,941
Net periodic pension cost	$ 605	$ 129	$ 1,816	$ 387

Business Segment (Details)

Business Segment (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
Business Segment (Details) - USD ($) $ in Thousands	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting Information [Line Items]
Net sales	$ 304,578	$ 275,088	$ 917,699	$ 794,605
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales	124,667	118,618	396,633	346,317
General Surgery
Segment Reporting Information [Line Items]
Net sales	$ 179,911	$ 156,470	$ 521,066	$ 448,288

Legal Proceedings (Details)

Legal Proceedings (Details) $ in Millions	Sep. 30, 2023 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Product liability insurance, aggregate annual amount	$ 35
Product liability insurance, amount per incident	$ 35