Fair value measurements and investments (Tables)

6 Months Ended

Jun. 30, 2022

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Schedule of Financial Assets and Liabilities Recorded at Fair Value on Recurring Basis

The fair value measurements of the Company’s financial assets and liabilities measured on a recurring basis were as follows:

	June 30, 2022											December 31, 2021
(U.S. Dollars, in thousands)	Level 1		Level 2			Level 3			Total			Total
Assets
Neo Medical convertible loan agreements	$	—	$	—		$	5,820		$	5,820		$	7,148
Neo Medical preferred equity securities		—		6,084			—			6,084			5,413
Bone Biologics equity securities		80		—			—			80			309
Other investments		—		—			1,666			1,666			1,505
Total	$	80	$	6,084		$	7,486		$	13,650		$	14,375
Liabilities
Spinal Kinetics contingent consideration	$	—	$	—		$	(986	)	$	(986	)	$	(17,200	)
Deferred compensation plan		—		(1,245	)		—			(1,245	)		(1,314	)
Total	$	—	$	(1,245	)	$	(986	)	$	(2,231	)	$	(18,514	)

Schedule of Reconciliation of Investments in Equity Securities

The table below presents a reconciliation of the beginning and ending balances of the Company’s investment in Neo Medical preferred equity securities:

(U.S. Dollars, in thousands)	2022		2021
Fair value of Neo Medical preferred equity securities at January 1	$	5,413	$	5,000
Conversion of loan into preferred equity securities		671		—
Fair value of Neo Medical preferred equity securities at June 30		6,084		5,000
Cumulative unrealized gain on Neo Medical preferred equity securities		413		—

Schedule of Changes in Valuation of Securities

Changes in the fair value of the investment recorded during the six months ended June 30, 2022 and 2021, are shown in the table below:

(U.S. Dollars, in thousands)	2022			2021
Bone Biologics equity securities at January 1	$	309		$	—
Fair value adjustments recognized in other expense, net		(186	)		—
Proceeds from the disposition of equity securities		(42	)		—
Bone Biologics equity securities at June 30	$	80		$	—

Schedule of Reconciliation For Contingent Consideration Measured At Fair Value Using Significant Unobservable Inputs

The following table provides a reconciliation of the beginning and ending balances for the Spinal Kinetics contingent consideration measured at estimated fair value using significant unobservable inputs (Level 3).

(U.S. Dollars, in thousands)	2022			2021
Spinal Kinetics contingent consideration estimated fair value at January 1	$	17,200		$	35,400
Increase (decrease) in fair value recognized in acquisition-related amortization and remeasurement		(16,214	)		300
Payment made		—			(15,000	)
Spinal Kinetics contingent consideration estimated fair value at June 30	$	986		$	20,700

Fair Value, Inputs, Level 3 [Member]

Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]

Schedule of Reconciliation For Convertible Loans Measured At Fair Value Using Significant Unobservable Inputs

The following table provides a reconciliation of the beginning and ending balances of the Convertible Loans, measured at fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)	2022			2021
Fair value of Neo Medical Convertible Loans at January 1	$	7,148		$	7,160
Interest recognized in interest income, net		217			198
Foreign currency remeasurement recognized in other expense, net		(257	)		(230	)
Unrealized loss recognized in other comprehensive loss		(615	)		(628	)
Conversion of loan into preferred equity securities		(671	)		—
Fair value of Neo Medical Convertible Loans at June 30		5,820			6,500
Amortized cost basis of Neo Medical Convertible Loans at June 30		5,496			5,247

Schedule of Changes in Valuation of Securities

The following table provides quantitative information related to certain key assumptions utilized within the valuation as of June 30, 2022:

(U.S. Dollars, in thousands)	Fair Value as of  June 30, 2022		Unobservable inputs	Estimate
Neo Medical Convertible Loan	$	5,820	Cost of equity discount rate		17.0	%
			Implied volatility		73.4	%

The following table provides a range of key assumptions used within the valuation as of June 30, 2022:

(U.S. Dollars, in thousands)	Fair Value as of June 30, 2022		Valuation Technique	Unobservable inputs	Range
Spinal Kinetics contingent consideration	$	986	Discounted cash flow	Revenue discount rate	5.9% - 7.3%
				Payment discount rate	7.6% - 8.9%