Orthofix Medical Inc.
For the period ended Jun 30, 2026. Filed Aug 5, 2026.
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Jun 30, 2026 · Filed Aug 5, 2026
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Notes to the Unaudited Condensed Consolidated Financial Statements
- Business and basis of presentation
Description of the Business
Orthofix Medical Inc. (the "Company" or "Orthofix") is a global medical technology company dedicated to advancing healing and restoring mobility for patients with complex musculoskeletal conditions. Headquartered in Lewisville, Texas, the Company offers a differentiated portfolio of spinal implants, therapeutic solutions, limb reconstruction systems, biologics, and enabling technologies, including the 7D FLASH Navigation System. The Company’s technology-enabled solutions are designed to support surgeons across the continuum of care and improve outcomes for patients.
Basis of Presentation
The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States ("U.S. GAAP") for interim financial information and with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. Pursuant to these rules and regulations, certain information and note disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted. In the opinion of management, all adjustments (consisting of normal recurring items) considered necessary for a fair statement have been included. These condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and related notes contained in the Company's Annual Report on Form 10-K for the year ending December 31, 2025. Operating results for the three and six months ended June 30, 2026, are not necessarily indicative of the results that may be expected for other interim periods or the year ending December 31, 2026.
The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. On an ongoing basis, the Company evaluates its estimates, including those related to revenue recognition; contractual allowances; allowances for expected credit losses; inventories; valuation of intangible assets; goodwill; fair value measurements, including contingent consideration; litigation and contingent liabilities; tax matters; and share-based compensation. Actual results could differ from these estimates.
- Recently adopted accounting standards and recently issued accounting pronouncements
Recently Issued Accounting Pronouncements
| Topic | Description of Guidance | Effective Date | Status of Company's Evaluation |
|---|---|---|---|
| Disclosure Improvements - Codification Amendments in Response to the SEC's Disclosure Update and Simplification Initiative (Accounting Standard Update "ASU" 2023-06) | Adds interim and annual disclosure requirements to a variety of subtopics in the Accounting Standards Codification, including those focusing on accounting changes, earnings per share, debt, and repurchase agreements. The guidance will be applied prospectively. The effective date will be the date when the SEC's removal of the related disclosure requirement becomes effective, with early adoption prohibited. | Various | The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. |
| Disaggregation of Income Statement Expenses (ASU 2024-03) | Improves financial reporting by requiring that public business entities disclose additional information about specific expense categories in the notes to the financial statements at interim and annual reporting periods. The amendments are to be applied prospectively to financial statements issued for reporting periods after the effective date or retrospectively to all prior periods presented in the financial statements. | January 1, 2027 | The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. |
| Targeted Improvements to the Accounting for Internal-Use Software (ASU 2025-06) | Aligns the accounting for internal-use software with how software is developed to increase the operability of the recognition and capitalization of internal-use software costs in accordance with Subtopic 350-40. Early adoption is permitted as of the beginning of an annual reporting period. The guidance is to be applied prospectively to new software costs incurred as of the beginning of the adoption period for all projects, including in-process projects. | January 1, 2028 | The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. |
| Narrow-Scope Requirements for Interim Reporting (ASU 2025-11) | Clarifies interim disclosure requirements and applicability of Topic 270, Interim Reporting for events since the end of the last annual reporting period that have a material impact on the entity. Early adoption is permitted and the amendments are to be applied prospectively or retrospectively to any or all periods presented in the financial statements. | January 1, 2028 | The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. |
Other recently issued ASUs, excluding those ASUs which have already been disclosed as adopted or described above, were assessed and determined not applicable, or are expected to have minimal impact on the Company's condensed consolidated financial statements.
- Inventories
Inventories were as follows:
| (U.S. Dollars, in thousands) | June 30,2026 | December 31,2025 |
|---|---|---|
| (Unaudited) | ||
| Raw materials | $31,807 | $22,865 |
| Work-in-process | 63,472 | 63,255 |
| Finished products | 89,196 | 86,199 |
| Inventories | $184,475 | $172,319 |
- Leases
A summary of the Company's lease portfolio as of June 30, 2026, and December 31, 2025, is presented in the table below:
| (U.S. Dollars, in thousands) | Classification | June 30,2026 | December 31,2025 |
|---|---|---|---|
| (Unaudited) | |||
| Assets | |||
| Operating leases | Other long-term assets | $20,918 | $22,279 |
| Finance leases | Property, plant, and equipment, net | 9,292 | 14,442 |
| Total lease assets | $30,210 | $36,721 | |
| Liabilities | |||
| Current | |||
| Operating leases | Other current liabilities | $3,061 | $3,147 |
| Finance leases | Current portion of finance lease liability | 125 | 837 |
| Long-term | |||
| Operating leases | Other long-term liabilities | 24,220 | 25,413 |
| Finance leases | Long-term portion of finance lease liability | 12,903 | 17,060 |
| Total lease liabilities | $40,309 | $46,457 | |
The Company entered into an amendment for its corporate headquarters location in Lewisville, Texas in January 2026, extending the contractual term of its lease to 2040, while also maintaining its existing lease term extension options within the agreement. Accordingly, the Company reassessed the lease classification and remeasured the lease liability based on the terms of the amendment. This resulted in a decrease in the recognized finance lease liability and finance lease right-of-use asset of approximately $4.8 million, respectively, with this decrease largely driven by an increase in the Company incremental borrowing rate.
Supplemental cash flow information related to leases was as follows:
| Six Months Ended June 30, | ||
|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 |
| Cash paid for amounts included in the measurement of lease liabilities | ||
| Operating cash flows from operating leases | $4,309 | $4,407 |
| Operating cash flows from finance leases | 735 | 401 |
| Financing cash flows from finance leases | 56 | 375 |
| ROU assets obtained in exchange for lease obligations | ||
| Operating leases | 256 | 11,690 |
| Finance leases | — | 28 |
- Long-term debt
The carrying values of the Company's outstanding debt obligations as of June 30, 2026, and December 31, 2025, were as follows:
| (U.S. Dollars, in thousands) | June 30,2026 | December 31,2025 |
|---|---|---|
| (Unaudited) | ||
| Outstanding Term Loans | ||
| Principal amount | $225,000 | $160,000 |
| Unamortized original debt discount | (2,447) | (1,839) |
| Unamortized debt issuance costs and lenders fees | (962) | (770) |
| Total indebtedness from outstanding term loans | $221,591 | $157,391 |
| Current portion of long-term debt | $— | $— |
| Long-term debt | 221,591 | 157,391 |
| Total indebtedness outstanding | $221,591 | $157,391 |
On November 7, 2024, the Company, as borrower, and its U.S. subsidiaries entered into a $275.0 million secured credit agreement (the "Credit Agreement") with Oxford Finance LLC, as administrative agent and as collateral agent ("Oxford") and certain lenders party thereto, including Oxford, K2 HealthVentures LLC, and HSBC Ventures USA Inc. The Credit Agreement provides for a $160.0 million senior secured term loan (the "Initial Term Loan") and a $65.0 million senior secured delayed draw term loan facility (the "Term B Loan"). In addition, at Oxford's discretion, an additional $50.0 million of draw capacity is available through January 1, 2029 (the "Term C Loan" and, collectively with the Term B Loan and the Initial Term Loan, the "Credit Facilities").
On January 15, 2026, the Company borrowed $65.0 million via the Term B Loan to provide capital flexibility ahead of the expiration of the tranche. The Credit Facilities, to the extent ultimately drawn, will each mature in November 2029, following an interest-only payment period ending December 2028, and monthly amortization of principal and accrued interest between January 2029 and November 2029. The Credit Agreement contains financial covenants requiring the Company to maintain (i) a minimum level of liquidity at all times and (ii) a maximum total debt-to-EBITDA leverage ratio (measured on a quarterly basis) during the term of the facility. As of June 30, 2026, the Company was in compliance with all required financial covenants.
As of June 30, 2026, the Company hadno borrowings on its available lines of credit in Italy, which provide up to an aggregate amount of €5.5 million ($6.3 million).
- Fair value measurements
The fair value measurements of the Company's financial assets and liabilities measured on a recurring basis were as follows:
| June 30,2026 · December 31,2025 | |||||
|---|---|---|---|---|---|
| (U.S. Dollars, in thousands) | Level 1 | Level 2 | Level 3 | Total | Total |
| (Unaudited) | |||||
| Liabilities | |||||
| Lattus Contingent Consideration | $— | $— | $9,548 | $9,548 | $7,930 |
| Deferred compensation plan | — | 1,543 | — | 1,543 | 1,720 |
| Total | $— | $1,543 | $9,548 | $11,091 | $9,650 |
Lattus Contingent Consideration
In connection with the merger with SeaSpine Holdings Corporation ("SeaSpine") in 2023 (the "Merger"), the Company assumed a contingent consideration obligation under a purchase agreement between SeaSpine and Lattus Spine LLC ("Lattus") executed in December 2022. Under the terms of this agreement, the Company may be required to make installment payments to Lattus (the "Lattus Contingent Consideration") at certain dates based on future net sales of certain products (the "Lateral Products").
Theestimated fair value of the Lattus Contingent Consideration is determined using a Monte Carlo simulation and a discounted cash flow model requiring significant inputs which are not observable in the market. The significant inputs include assumptions related to the estimated future sales of Lateral Products, revenue risk-adjusted discount rates, revenue volatility, and discount rates matched tothe timing of payments. The following table provides a reconciliation of the beginning and ending balances for the Lattus Contingent Consideration measured at estimated fair value using significant unobservable inputs (Level 3):
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 |
|---|---|---|
| Lattus Contingent Consideration estimated fair value at January 1 | $7,930 | $15,400 |
| Change in fair value recognized in acquisition-related amortization, impairment, and remeasurement | 1,618 | (1,373) |
| Lattus Contingent Consideration estimated fair value at June 30 | $9,548 | $14,027 |
The estimated fair value of the Lattus Contingent Consideration as of June 30, 2026, was$9.5 million; however, the actual amount ultimately paid could be higher or lower. As of June 30, 2026, the Company classified the remaining Lattus Contingent Consideration of $9.5 million within other current liabilities.
The following table provides quantitative information related to certain key assumptions utilized within the valuation as of June 30, 2026:
| (Unaudited, U.S. Dollars, in thousands) | Fair Value as of June 30, 2026 | Unobservable inputs | Estimate |
|---|---|---|---|
| Lattus Contingent Consideration | $9,548 | Counterparty discount rates | 11.5% |
| Revenue risk-adjusted discount rates | 6.0% | ||
On July 1, 2026, the Company made an installment payment related to the Lattus Contingent Consideration of $5.1 million.
- Commitments and Contingencies
Arbitration claims with former executives
In September 2023, the Company's Board of Directors (the "Board") terminated the employment of Keith Valentine, John Bostjancic, and Patrick Keran, who had served respectively as the Company’s President and Chief Executive Officer, Chief Financial Officer, and Chief Legal Officer (collectively, the "Former Executives"). The Board’s decision followed an investigation conducted by independent outside legal counsel and directed and overseen by a committee of certain of the Company’s independent directors. At the time of termination, the Company notified each of the Former Executives that their respective terminations of employment were being made for "Cause," as such term is defined in applicable employment-related agreements (including each executive’s respective Change in Control and Severance Agreement, dated June 19, 2023 (the "CIC and Severance Agreements"). The Former Executives subsequently made claims against the Company in arbitration in the State of California, asserting breach of contract because each of them was entitled to the severance payments and other equity-based rights that would be owed to them if their respective termination had been made "without Cause" under the CIC and Severance Agreements, and further asserting damages for purported defamation, false light invasion of privacy, and deceit, as well as indemnification and advancement for attorneys’ fees.
On January 26, 2026, the arbitrator in Mr. Valentine’s matter issued a decision denying Mr. Valentine’s defamation, false light invasion of privacy, and deceit claims, and his indemnification of fees claim. Based on the evidence presented during the arbitration process, the arbitrator found that Mr. Valentine’s conduct met the legal definition of "acts of moral turpitude" and that the public statements that the Company made about Mr. Valentine in a press release and filings with the SEC subsequent to the termination of his employment were true. Although Mr. Valentine’s conduct was found to meet the legal definition of "acts of moral turpitude" for purposes of his defamation and other tort claims, and although engaging in "material acts of moral turpitude" would constitute "Cause" under the CIC and Severance Agreement, the arbitrator maintained his preliminary decision issued on October 2, 2025, finding that (i) Mr. Valentine’s conduct prior to his entry into the CIC and Severance Agreement on June 19, 2023 could not be considered for purposes of determining whether "Cause" existed under such agreement, and (ii) his conduct between that date and his termination of employment on September 11, 2023, did not amount to "Cause". As a result, the arbitrator issued an interim award to Mr. Valentine for breach of contract damages in the amount of $11.8 million, finding such amount to be equivalent to the severance and equity-based rights that Mr. Valentine would have received in a "without Cause" termination. The arbitrator also awarded accrued interest, at the pre-judgment interest rate of 10% under California law. On April 22, 2026, the Company made a payment in satisfaction of the arbitrator’s interim award plus accrued interest, in the amount of $14.8 million. On June 24, 2026, the arbitrator issued his final award. The final award (i) confirmed the amounts in the interim award (which were paid by the Company on April 22, 2026), and (ii) awarded an additional $1.1 million to Mr. Valentine for attorneys' fees, costs, and expenses, which the Company has accrued as of June 30, 2026.
On April 15, 2026, Mr. Keran’s arbitration claims were settled for $4.25 million. On April 22, 2026, the Company and Mr. Bostjancic entered into a settlement agreement covering all of Mr. Bostjancic’s claims, in the amount of $4.25 million. Payments were made to each of Mr. Keran and Mr. Bostjancic in the amount of $4.25 million, respectively, in the second quarter of 2026.
In addition to the Former Executives’ arbitration claims, in September 2024, Messrs. Valentine, Bostjancic and Keran filed an action in California State Court against former director and interim CEO Catherine Burzik and current director Wayne Burris, seeking relief for, among other things, alleged defamation, false light invasion of privacy, intentional misrepresentation, false promise, and tortious interference with contract. Mr. Bostjancic dismissed his claims in this action in connection with his settlement agreement. The Company disagrees with the allegations contained in the action against Ms. Burzik and Mr. Burris and will continue vigorously defending the asserted claims. The Company currently cannot reasonably estimate a possible loss, or range of loss, that may arise from the action.
Securities class action complaints
On August 21, 2024, a securities class action complaint captioned Bernal v. Orthofix Medical Inc., et al., Case No. 24-cv-00690, was filed in the United States District Court for the Eastern District of Texas (the "Bernal Complaint"). The plaintiff, a purported Company shareholder, alleges through the complaint violations of Sections 10(b) and 20(a) of the Exchange Act, and SEC Rule 10b-5 promulgated thereunder, and names as defendants the Company and the following former Company directors and officers: Jon Serbousek (former director and former President and Chief Executive Officer), Keith Valentine (former director and former President and Chief Executive Officer), John Bostjancic (former Chief Financial Officer), and Patrick Keran (former Chief Legal Officer). The complaint alleges that the Company made, and the named former directors and officers caused the Company to make, materially false and misleading statements between October 11, 2022, and September 12, 2023, that, according to the complaint, falsely assured the market of Messrs. Valentine, Bostjancic, and Keran's respective commitments to, among other things, ethical and legal standards and corporate responsibility.
On September 6, 2024, a securities class action complaint captioned O'Hara v. Orthofix Medical Inc., et al., Case No. 24-cv-01593, was filed in the United States District Court for the Southern District of California (the "O'Hara Complaint"). The plaintiff, a purported former shareholder of SeaSpine at the time of the Merger, alleges through the complaint violations of Sections 11, 12 and 15 of the Securities Act, and names most of the same defendants as the Bernal Complaint, as well as certain additional current and/or former Company directors and officers. The complaint makes similar assertions to the Bernal complaint, and alleges that the Company's registration statement on Form S-4 filed in 2022 in connection with the Merger, as well as related written and oral offering materials, contained untrue statements of material fact and material omissions, including, among other things, with respect to the effectiveness of the Company's internal controls. On November 26, 2024, the O'Hara Complaint was transferred to the Eastern District of Texas, and on December 11, 2024, the O'Hara Complaint was consolidated with the Bernal Complaint. On April 17, 2025, the plaintiffs filed an amended complaint in the consolidated action, captioned In re Orthofix Medical Inc. Securities Litigation, with substantially the same allegations contained in the Bernal Complaint and the O'Hara Complaint. The consolidated case is captioned In re Orthofix Medical Inc. Securities Litigation, Case No. 24-cv-00690 and is pending in the Eastern District of Texas. The Company and the individual defendants moved to dismiss the amended complaint on May 15, 2025. On March 9, 2026, the Court granted defendants’ motion to dismiss the plaintiffs’ claims under the Exchange Act (but not those under the Securities Act), finding that (i) all but one of the Company’s statements at issue were immaterial as a matter of law, and (ii) no statements caused loss. The Court provided the plaintiffs with leave to amend their complaint to address pleading deficiencies, and plaintiffs filed an amended complaint on April 8, 2026, which the Company and the individual defendants moved to dismiss on May 8, 2026.
On October 28, 2024, a derivative shareholder complaint was filed against certain of the Company's current and former officers and directors alleging derivative liability for the allegations made in the two complaints noted above. On December 18, 2024, a second derivative shareholder complaint was filed with the same allegations made in the first derivative shareholder complaint. On March 21, 2025, the two derivative shareholder complaints were consolidated into one case.
The Company disagrees with the legal claims asserted in these complaints and is vigorously defending them. Due in part to the preliminary nature of these three matters, the Company currently cannot reasonably estimate a possible loss, or range of loss, that may arise from the respective complaints.
Commitments
As a result of the Merger, the Company became party to agreements with certain distributor partners that provide the Company with an option to purchase, and an option for those partners to require the Company to purchase, the distribution business of those partners at specified future dates. At such time, the Company or distributor may (in certain cases, subject to satisfying certain conditions) submit written notice to the other of its intention to exercise its rights and initiate or require the purchase. Upon receipt of the written notice, the Company and the distributor will work in good faith to consummate the purchase, provided that the distributor meets the required conditions of such purchase option. Under certain of these agreements, the purchase price would be paid in shares of the Company's common stock, whereas for others, the purchase price can be paid in cash or shares, at the Company's option. Based on the closing price of the Company's common stock as of June 30, 2026, assuming the options under all the relevant agreements were exercised, the estimated total number of shares the Company would issue under these agreements was approximately 0.5 million shares for agreements that must be settled in shares of the Company's stock. The Company has received notification from one such distributor, who has notified the Company of its decision to exercise its buyout option. The Company is currently in negotiations with this distributor with respect to the conditions of a potential acquisition, the consummation of which may be deferred to a future date.
Italian Medical Device Payback (IMDP)
In 2015, the Italian Parliament introduced rules for entities that supply goods and services to the Italian National Healthcare System. A key provision of the law is a 'payback' measure, requiring medical device companies in Italy to make payments to the Italian government if medical device expenditures exceed regional maximum ceilings. Companies are required to make payments equal to a percentage of expenditures exceeding maximum regional caps.
In the third quarter of 2022, the Italian Ministry of Health provided guidelines to the Italian regions and provinces on seeking payback of expenditure overruns relating to the 2015 through 2018 calendar years. Since receiving the guidelines, several regions and provinces have requested payment from affected medical device companies, including the Company. The Company has taken legal action to dispute the legality of such measures. In July 2024, the Italian Constitutional Court issued two judgments following public hearings on the matter held in May 2024. These judgments (i) declared the payback system itself as constitutionally legitimate and (ii) extended previously communicated reductions in the payback liability for certain fiscal years to all medical device companies, regardless of whether or not they had waived their legal claims on the matter.
The Company accounts for the estimated cost of the IMDP as sales, general, and administrative expense and periodically reassesses the liability based upon current facts and circumstances. As a result, the Company recorded expenses of $0.4 million and $0.7 million for thethree and six months ended June 30, 2026, respectively, and expenses of $0.3 million and $0.6 million for thethree and six months ended June 30, 2025. As of June 30, 2026, the Company has accrued $11.0 million related to the IMDP, which it has classified within other long-term liabilities; however, the actual liability could be higher or lower than the amount accrued once all legal proceedings are resolved and upon further clarification of the IMDP by the Italian authorities.
- Accumulated other comprehensive income (loss)
The components of and changes in accumulated other comprehensive income (loss) were as follows:
| (Unaudited, U.S. Dollars, in thousands) | CurrencyTranslationAdjustments | Neo Medical Convertible Loan | Accumulated OtherComprehensive Income (Loss) |
|---|---|---|---|
| Balance at December 31, 2025 | $846 | $(228) | $618 |
| Other comprehensive loss | (895) | — | (895) |
| Income taxes | — | — | — |
| Balance at June 30, 2026 | $(49) | $(228) | $(277) |
- Revenue recognition and accounts receivable
Revenue recognition
The Company has two reporting segments: Global Spine and Global Limb Reconstruction. Within the Global Spine reporting segment, there are two product categories: (i) Therapeutic Solutions (formerly Bone Growth Therapies), and (ii) Spinal Implants, Biologics, and Enabling Technologies.
The tables below present net sales by product category and reporting segment:
| Three Months Ended June 30, | |||
|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | Change |
| Therapeutic Solutions | $64,152 | $62,573 | 2.5% |
| Spinal Implants, Biologics, and Enabling Technologies | 109,091 | 107,251 | 1.7% |
| Global Spine | 173,243 | 169,824 | 2.0% |
| Global Limb Reconstruction | 37,690 | 33,297 | 13.2% |
| Net sales | $210,933 | $203,121 | 3.8% |
| Six Months Ended June 30, | |||
|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | Change |
| Therapeutic Solutions | $121,926 | $117,623 | 3.7% |
| Spinal Implants, Biologics, and Enabling Technologies | 215,169 | 216,037 | -0.4% |
| Global Spine | 337,095 | 333,660 | 1.0% |
| Global Limb Reconstruction | 70,546 | 63,107 | 11.8% |
| Net sales | $407,641 | $396,767 | 2.7% |
Product sales and marketing service fees
The table below presents product sales and marketing service fees, which are both components of net sales:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| Product sales | $199,979 | $191,395 | $386,095 | $373,028 |
| Marketing service fees | 10,954 | 11,726 | 21,546 | 23,739 |
| Net sales | $210,933 | $203,121 | $407,641 | $396,767 |
Marketing service fees are received from MTF Biologics ("MTF") based on total sales of biologic tissues and relate solely to the Biologics product category within the Global Spine reporting segment, whereas product sales primarily consist of the sale of Therapeutic Solutions, Spinal Implants, non-MTF sourced Biologics, Enabling Technologies, and Global Limb Reconstruction products. As MTF is the single supplier for certain allografts in the Company's Biologics portfolio, which are derived from deceased donors for their bone grafts and living donors for their amnion grafts, any event or circumstance that would impact MTF's continued access to donors or the Company's ability to market these tissues may adversely impact the Company's financial results.
Accounts receivable and related allowances
The following table provides the detail of changes in the Company's allowance for expected credit losses for thethree and six months ended June 30, 2026, and 2025:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| Allowance for expected credit losses beginning balance | $8,990 | $8,602 | $8,308 | $7,418 |
| Current period provision for expected credit losses | 2,872 | 779 | 3,591 | 1,837 |
| Write-offs charged against the allowance and other | (1,254) | (747) | (1,259) | (758) |
| Effect of changes in foreign exchange rates | (45) | 275 | (77) | 412 |
| Allowance for expected credit losses ending balance | $10,563 | $8,909 | $10,563 | $8,909 |
- Business segment information
The Company's operations are managed throughtwo reporting segments: Global Spine and Global Limb Reconstruction. These reporting segments represent the operating segments for which the President and Chief Executive Officer, who is also the Chief Operating Decision Maker (CODM), reviews financial information and makes resource allocation decisions among businesses. Theprimary metric used by the CODM in managing the Company is adjusted earnings before interest, tax, depreciation, and amortization ("adjusted EBITDA", a non-GAAP financial measure). Adjusted EBITDA represents earnings before interest income (expense), income taxes, depreciation and amortization, and excludes the impact of share-based compensation and long-term incentive plan expense; gains and losses related to changes in foreign exchange rates; charges related to the Merger and other strategic investments; restructuring costs and impairments related to the discontinuation of the M6 product lines (as defined in Note 15); acquisition-related fair value adjustments; gains and/or losses on investments; litigation and investigation charges; refunds associated with the Employee Retention Credit established by the Coronavirus Aid, Relief, and Economic Security Act; and certain costs associated with employee transitions.
Corporate activities are comprised of operating expenses not directly identifiable within the two reporting segments, such as human resources, finance, legal, and information technology functions. The Company neither discretely allocates assets, other than goodwill, to its operating segments nor evaluates the operating segments using discrete asset information.
Global Spine
The Global Spine reporting segment offers two primary product categories: (i) Therapeutic Solutions and (ii) Spinal Implants, Biologics, and Enabling Technologies.
The Therapeutic Solutions product category manufactures, distributes, and provides support services for market-leading bone growth stimulation devices that enhance bone fusion. These Class II medical devices with special controls are indicated as an adjunctive, noninvasive treatment to improve fusion success rates in the cervical and lumbar spine as well as a therapeutic treatment for non-spinal, appendicular fractures, treating both fresh or nonunion fractures. These products are sold almost exclusively in the U.S., using distributors and direct sales representatives to provide these devices to healthcare providers and their patients.
Spinal Implants, Biologics, and Enabling Technologies is comprised of (i) a broad portfolio of spine fixation implant products used in surgical procedures of the spine, (ii) one of the most comprehensive biologics portfolios in both the demineralized bone matrix and cellular allograft market segments, and (iii) image-guided surgical solutions to facilitate degenerative, minimally invasive, and complex surgical procedures. Spinal Implants, Biologics, and Enabling Technologies products are sold through a network of distributors and sales representatives to hospitals and healthcare providers on a global basis for Spinal Implants and Enabling Technologies, and primarily within the U.S. for Biologics.
Global Limb Reconstruction
The Global Limb Reconstruction reporting segment offers products and solutions for the underserved limb reconstruction market that encompasses four pillars: deformity correction, limb lengthening, complex fracture management, and limb preservation. This reporting segment specializes in the design, development, and marketing of external and internal fixation limb reconstruction products that are coupled with enabling digital technologies to serve the complete patient treatment pathway. The Company sells these products worldwide through a global network of distributors and sales representatives to hospitals, healthcare organizations, and healthcare providers.
The following table presents adjusted EBITDA, the primary metric used in managing the Company, by reporting segment:
| Three Months Ended June 30, 2026 · Six Months Ended June 30, 2026 | |||||||
|---|---|---|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) · Global Spine · Global Limb Reconstruction · Total · Global Spine · Global Limb Reconstruction · Total | |||||||
| Segment revenues | $173,243 | $37,690 | $210,933 | $337,095 | $70,546 | $407,641 | |
| Less: | |||||||
| Non-GAAP Cost of sales | 44,561 | 14,664 | 59,225 | 87,403 | 29,279 | 116,682 | |
| Non-GAAP Sales, general, and administrative | 100,992 | 22,088 | 123,080 | 199,013 | 42,289 | 241,302 | |
| Non-GAAP Research and development | 11,528 | 3,083 | 14,611 | 22,925 | 6,082 | 29,007 | |
| Other segment expenses | 63 | 20 | 83 | 322 | 958 | 1,280 | |
| Add: | |||||||
| Non-GAAP Depreciation, amortization, and share-based compensation expense | 9,490 | 3,311 | 12,801 | 18,558 | 6,539 | 25,097 | |
| Segment Adjusted EBITDA | $25,589 | $1,146 | $26,735 | $45,990 | $(1,523) | $44,467 | |
| Reconciling items: | |||||||
| Corporate operating expenses | $6,597 | $14,635 | |||||
| Interest expense, net | 6,085 | 11,749 | |||||
| Depreciation and amortization | 13,273 | 26,766 | |||||
| Share-based compensation and long-term incentive plan expense | 7,945 | 14,583 | |||||
| Foreign exchange impact | 746 | 1,646 | |||||
| SeaSpine merger-related costs | 572 | 503 | |||||
| Restructuring costs and impairments related to M6 product lines | 1,085 | 1,338 | |||||
| Strategic investments | 634 | 1,584 | |||||
| Acquisition-related fair value adjustments | 868 | 1,618 | |||||
| Interest and loss on investments | — | (16) | |||||
| Litigation and investigation costs | 2,185 | 5,101 | |||||
| Employee Retention Credit | — | (951) | |||||
| Employee transition costs | 1,742 | 1,742 | |||||
| Loss before income taxes | $(14,997) | $(35,831) | |||||
| Three Months Ended June 30, 2025 · Six Months Ended June 30, 2025 | |||||||
|---|---|---|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) · Global Spine · Global Limb Reconstruction · Total · Global Spine · Global Limb Reconstruction · Total | |||||||
| Segment Revenues | $169,824 | $33,297 | $203,121 | $333,660 | $63,107 | $396,767 | |
| Less: | |||||||
| Non-GAAP Cost of sales | 42,811 | 12,266 | 55,077 | 87,398 | 24,137 | 111,535 | |
| Non-GAAP Sales, general, and administrative | 97,169 | 17,990 | 115,159 | 189,708 | 35,911 | 225,619 | |
| Non-GAAP Research and development | 11,761 | 2,674 | 14,435 | 23,384 | 5,526 | 28,910 | |
| Other segment expenses (benefits) | 2,464 | 6 | 2,470 | 6,907 | (169) | 6,738 | |
| Add: | |||||||
| Non-GAAP Depreciation, amortization, and share-based compensation expense | 10,814 | 2,124 | 12,938 | 19,686 | 4,756 | 24,442 | |
| Segment Adjusted EBITDA | $26,433 | $2,485 | $28,918 | $45,949 | $2,458 | $48,407 | |
| Reconciling items: | |||||||
| Corporate operating expenses | $8,273 | $16,331 | |||||
| Interest expense, net | 3,950 | 8,456 | |||||
| Depreciation and amortization | 16,871 | 51,302 | |||||
| Share-based compensation and long-term incentive plan expense | 7,824 | 14,293 | |||||
| Foreign exchange impact | (2,751) | (3,795) | |||||
| SeaSpine merger-related costs | 4,886 | 6,016 | |||||
| Restructuring costs and impairments related to M6 product lines | 3,354 | 15,480 | |||||
| Strategic investments | 353 | 3,867 | |||||
| Acquisition-related fair value adjustments | (763) | (1,373) | |||||
| Interest and loss on investments | (31) | (31) | |||||
| Litigation and investigation costs | 4,029 | 7,071 | |||||
| Employee Retention Credit | (2,854) | (2,854) | |||||
| Loss before income taxes | $(14,223) | $(66,356) | |||||
The following table presents depreciation, amortization, and impairment by reporting segment:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| Global Spine | $9,986 | $14,851 | $20,204 | $46,753 |
| Global Limb Reconstruction | 2,807 | 1,419 | 5,585 | 3,355 |
| Corporate | 480 | 601 | 977 | 1,194 |
| Total | $13,273 | $16,871 | $26,766 | $51,302 |
Geographical information
The table below presents net sales by geographic destination for each reporting segment and for the consolidated Company:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| Global Spine | ||||
| U.S. | $159,990 | $161,850 | $312,407 | $314,553 |
| International | 13,253 | 7,974 | 24,688 | 19,107 |
| Total Global Spine | 173,243 | 169,824 | 337,095 | 333,660 |
| Global Limb Reconstruction | ||||
| U.S. | 10,043 | 9,888 | 18,954 | 18,866 |
| International | 27,647 | 23,409 | 51,592 | 44,241 |
| Total Global Limb Reconstruction | 37,690 | 33,297 | 70,546 | 63,107 |
| Consolidated | ||||
| U.S. | 170,033 | 171,738 | 331,361 | 333,419 |
| International | 40,900 | 31,383 | 76,280 | 63,348 |
| Net sales | $210,933 | $203,121 | $407,641 | $396,767 |
The following data includes net sales by geographic area:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| U.S. | $170,033 | $171,738 | $331,361 | $333,419 |
| Italy | 6,003 | 5,646 | 11,906 | 10,699 |
| France | 3,266 | 3,184 | 5,898 | 5,809 |
| United Kingdom | 3,694 | 3,118 | 7,567 | 6,155 |
| Germany | 2,315 | 2,265 | 4,485 | 4,473 |
| Brazil | 1,918 | 988 | 2,952 | 2,123 |
| Others | 23,704 | 16,182 | 43,472 | 34,089 |
| Net sales | $210,933 | $203,121 | $407,641 | $396,767 |
The following data includes property, plant, and equipment by geographic area:
| (U.S. Dollars, in thousands) | June 30,2026 | December 31,2025 |
|---|---|---|
| (Unaudited) | ||
| U.S. | $116,655 | $114,483 |
| Italy | 9,434 | 9,893 |
| Germany | 1,008 | 1,360 |
| Others | 3,660 | 3,663 |
| Total | $130,757 | $129,399 |
- Acquisition-related amortization, impairment, and remeasurement
Acquisition-related amortization, impairment, and remeasurement consists of (i) amortization and impairment related to intangible assets acquired through business combinations or asset acquisitions and (ii) remeasurement of any related contingent consideration arrangements. Components of acquisition-related amortization, impairment, and remeasurement are as follows:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| Amortization and impairment of acquired intangibles | $2,999 | $3,872 | $6,000 | $22,227 |
| Changes in fair value of contingent consideration | 868 | (763) | 1,618 | (1,373) |
| Total | $3,867 | $3,109 | $7,618 | $20,854 |
- Share-based compensation
Components of share-based compensation expense are as follows:
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| Cost of sales | $462 | $468 | $793 | $929 |
| Sales, general, and administrative | 6,864 | 6,915 | 12,722 | 12,564 |
| Research and development | 409 | 441 | 753 | 800 |
| Total | $7,735 | $7,824 | $14,268 | $14,293 |
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, U.S. Dollars, in thousands) | 2026 | 2025 | 2026 | 2025 |
| Stock options | $1,857 | $1,594 | $3,088 | $2,463 |
| Market-based stock options | 90 | 592 | 277 | 1,238 |
| Time-based restricted stock units | 3,581 | 3,528 | 6,466 | 6,522 |
| Market-based / performance-based restricted stock units | 1,829 | 1,650 | 3,623 | 3,070 |
| Stock purchase plan | 378 | 460 | 814 | 1,000 |
| Total | $7,735 | $7,824 | $14,268 | $14,293 |
During the three months ended June 30, 2026, and 2025, the Company issued 0.3 million and 0.4 million shares, respectively, of common stock related to stock purchase plan issuances, stock option exercises, and the vesting of restricted stock units. During thesix months ended June 30, 2026, and 2025, the Company issued 0.9 million and 1.0 million shares, respectively, of common stock related to stock purchase plan issuances, stock option exercises, and the vesting of restricted stock units.
- Income taxes
Generally, income tax provisions for interim periods are based on an estimated annual income tax rate, adjusted for discrete tax items, with any changes affecting the estimated annual effective tax rate recorded in the interim period in which the change occurs. Due to losses in the Company's U.S., Canadian and Italian operations for whichno tax benefit is recognized, the Company determined the estimated annual effective tax rate method would not provide a reliable estimate of the Company's overall annual effective tax rate. As such, the Company has calculated the tax provision using the actual effective rate for thesix months ended June 30, 2026. Due to the impact of temporary differences on the Company's current U.S. tax liability for whichno deferred tax benefit is recognized, the Company's effective tax rate may vary in future quarters.
For the three months ended June 30, 2026, and 2025, the effective tax rate was(5.3%) and 1.0%, respectively. For the six months ended June 30, 2026, and 2025, the effective tax rate was(2.4%) and(1.2%), respectively. The primary factors affecting the Company's effective tax rate for the three and six months ended June 30, 2026, were certain losses for whichno tax benefit is recognized and tax amortization on certain acquired intangibles.
- Earnings per share (EPS)
For the three and six months ended June 30, 2026, no adjustments were made to net income for purposes of calculating basic and diluted EPS under the treasury stock method. The following is a reconciliation of the weighted average shares used in diluted EPS computations.
| Three Months Ended June 30, | Six Months Ended June 30, | |||
|---|---|---|---|---|
| (Unaudited, In thousands) | 2026 | 2025 | 2026 | 2025 |
| Weighted average common shares-basic | 40,906 | 39,501 | 40,677 | 39,317 |
| Effect of dilutive securities | ||||
| Unexercised stock options and stock purchase plan | — | — | — | — |
| Unvested restricted stock units | — | — | — | — |
| Weighted average common shares-diluted | 40,906 | 39,501 | 40,677 | 39,317 |
There were 9.0 million and 8.7 million weighted average outstanding options, time-based restricted stock units, performance-based stock units, and market-based stock units not included in the diluted EPS computation for thethree months ended June 30, 2026, and 2025, respectively, and 8.6 million and 8.4 million weighted average outstanding options, time-based restricted stock units, performance-based stock units, and market-based stock units not included in the diluted EPS computation for thesix months ended June 30, 2026, and 2025, respectively, because either (i) inclusion of these awards was anti-dilutive, or (ii) for performance-based stock units and market-based stock units, all necessary conditions had not been satisfied by the end of the respective period.
- Discontinuation of M6 product lines
In February 2025, the Company announced the discontinuation of its M6-C artificial cervical disc and M6-L artificial lumbar disc product lines (together, the "M6 artificial discs" or "M6 product lines") in order to allocate associated resources and investment to more profitable growth opportunities. Financial results for the Company's M6 product lines continue to be presented within the Company's consolidated statements of operations and comprehensive loss. A summary of impairment charges recognized during thethree and six months ended June 30, 2025, and the associated financial statement lines in which such costs were recognized is shown in the table below. All such changes are included within the Company's Global Spine reporting segment. All related inventory; property, plant, and equipment; and intangible asset balances were fully impaired in the prior year; therefore, there wereno further impairments recorded on these assets in the current year.
| (Unaudited, U.S. Dollars, in thousands) · Financial Statement Line Item · Three Months Ended June 30, 2025 · Six Months Ended June 30, 2025 | |||||
|---|---|---|---|---|---|
| Inventory reserve charges | Cost of sales | $2,548 | $11,251 | ||
| Impairment of property, plant, and equipment | Operating expenses | 608 | 6,834 | ||
| Impairment of developed technology intangible asset | Acquisition-related amortization, impairment, and remeasurement | — | 14,097 | ||
| Loss on M6 inventories and long-lived assets held for sale | $3,156 | $32,182 | |||
- Subsequent Events
Centers for Medicare & Medicaid Services fee schedule updates
On April 16, 2026, the U.S. Food and Drug Administration (“FDA”) issued a final order reclassifying non-invasive bone growth stimulators from Class III to Class II devices. Following that order, the Centers for Medicare & Medicaid Services (“CMS”) modified certain billing requirements and Medicare fee schedule treatment applicable to non-invasive bone growth stimulators billed under HCPCS codes E0747, E0748 and E0760 (the “Devices”) for dates of service on or after May 18, 2026.
On July 1, 2026, CMS issued revised guidance that withdrew those changes and directed that Devices furnished on or after May 18, 2026, be processed and paid consistent with the treatment in effect prior to the FDA reclassification. Based on these developments, the Company currently expects average Medicare reimbursement for these codes will return to the rates in effect prior to May 18, 2026.
Lattus Contingent Consideration Payment
On July 1, 2026, the Company made an installment payment related to the Lattus Contingent Consideration of $5.1 million. See Note 6 for further discussion of the Company’s obligations in relation to the Lattus Contingent Consideration.
The text of this filing, as the company filed it with the SEC, without its images or exhibits. This is not investment advice.