Fair value measurements and investments (Tables)

12 Months Ended

Dec. 31, 2022

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

The Company’s available for sale debt securities, equity securities, contingent consideration, and deferred compensation plan liabilities are the only financial instruments recorded at fair value on a recurring basis as follows:

(U.S. Dollars, in thousands)	Balance December 31, 2022			Level 1		Level 2			Level 3
Assets
Neo Medical convertible loan agreement	$	7,140		$	—	$	—		$	7,140
Neo Medical preferred equity securities		6,084			—		6,084			—
Bone Biologics equity securities		—			—		—			—
Other investments		1,726			—		—			1,726
Total	$	14,950		$	—	$	6,084		$	8,866
Liabilities
Spinal Kinetics contingent consideration		—		$	—	$	—		$	—
Deferred compensation plan		(1,515	)		—		(1,515	)		—
Total	$	(1,515	)	$	—	$	(1,515	)	$	—

(U.S. Dollars, in thousands)	Balance December 31, 2021			Level 1		Level 2			Level 3
Assets
Neo Medical convertible loan agreements	$	7,148		$	—	$	—		$	7,148
Neo Medical preferred equity securities		5,413			—		5,413			—
Bone Biologics equity securities		309			309		—			—
Other Investments		1,505			—		—			1,505
Total	$	14,375		$	309	$	5,413		$	7,148
Liabilities
Spinal Kinetics contingent consideration	$	(17,200	)	$	—	$	—		$	(17,200	)
Deferred compensation plan		(1,314	)		—		(1,314	)		—
Total	$	(18,514	)	$	—	$	(1,314	)	$	(17,200	)

Schedule of Reconciliation of Carrying Value of Investments in Equity Securities

The table below presents a reconciliation of the carrying value of the Company’s investment in Neo Medical preferred equity securities for the years ended December 31, 2022, and 2021:

(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		—
Foreign currency remeasurement recognized in other income, net		—		77
Unrealized gain recognized in other income (expense), net		—		336
Fair value of Neo Medical preferred equity securities at December 31		6,084		5,413
Cumulative unrealized gain on Neo Medical preferred equity securities		413		413

The remaining

Schedule of Changes in Valuation of Securities

The following table presents the changes in fair value recognized for each of the years ended December 31, 2022, 2021, and 2020:

(U.S. Dollars, in thousands)	2022			2021		2020
Bone Biologics equity securities at January 1	$	309		$	—	$	219
Fair value adjustments and impairments recognized in other income (expense), net		(183	)		309		(219	)
Proceeds from the disposition of equity securities		(126	)		—		—
Bone Biologics equity securities at December 31	$	—		$	309		—

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 contingent consideration measured at fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)	2022			2021
Spinal Kinetics contingent consideration at January 1	$	17,200		$	35,400
Decrease in fair value recognized in acquisition-related amortization and remeasurement		(17,200	)		(3,200	)
Payment made		—			(15,000	)
Spinal Kinetics contingent consideration at December 31		—		$	17,200

Fair Value, Inputs, Level 3 [Member]

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

The following table provides a reconciliation of the beginning and ending balances of the Convertible Loan(s), 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
Additions		—			671
Interest recognized in interest income, net		436			421
Foreign currency remeasurement recognized in other income (expense), net		(67	)		(162	)
Unrealized gain (loss) recognized in other comprehensive income (loss)		294			(942	)
Conversion of Additional Convertible Loan into preferred equity securities		(671	)		—
Fair value of Neo Medical Convertible Loan(s) at December 31		7,140			7,148
Amortized cost basis of Neo Medical Convertible Loan(s) at December 31		5,907			6,209

Schedule of Changes in Valuation of Securities

The following table provides quantitative information related to certain key assumptions utilized within the valuation of the Convertible Loan as of December 31, 2022:

(U.S. Dollars, in thousands)	Fair Value as of December 31, 2022		Unobservable inputs	Estimate
Neo Medical Convertible Loan	$	7,140	Cost of equity discount rate		18.0	%
			Implied volatility		73.9	%