Business segment information (Tables)

12 Months Ended

Dec. 31, 2022

Segment Reporting [Abstract]

Schedule of Net Sales by Major Product Category by Reporting Segment

The table below presents net sales by major product category by reporting segment:

	Year Ended December 31,
	2022					2021					2020
(U.S. Dollars, in thousands)	Net Sales		Percent of Total Net Sales			Net Sales		Percent of Total Net Sales			Net Sales		Percent of Total Net Sales
Bone Growth Therapies	$	187,247		40.7	%	$	187,448		40.4	%	$	171,396		42.2	%
Spinal Implants		109,546		23.8	%		115,094		24.8	%		94,857		23.3	%
Biologics		56,381		12.2	%		56,421		12.1	%		55,482		13.6	%
Global Spine		353,174		76.7	%		358,963		77.3	%		321,735		79.1	%
Global Orthopedics		107,539		23.3	%		105,516		22.7	%		84,827		20.9	%
Net sales	$	460,713		100.0	%	$	464,479		100.0	%	$	406,562		100.0	%

Summary of EBITDA by Reporting Segment

The following table presents EBITDA, the primary metric used in managing the Company, by reporting segment:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2022			2021			2020
Global Spine	$	60,649		$	58,014		$	63,036
Global Orthopedics		(4,037	)		3,374			(4,993	)
Corporate		(44,011	)		(31,691	)		(25,382	)
Total EBITDA		12,601			29,697			32,661
Depreciation and amortization		(29,019	)		(29,599	)		(30,546	)
Goodwill impairment		—			(11,756	)		—
Interest expense, net		(1,288	)		(1,837	)		(2,483	)
Loss before income taxes	$	(17,706	)	$	(13,495	)	$	(368	)

Schedule of Depreciation and Amortization by Reporting Segment

The following table presents depreciation and amortization by reporting segment:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2022		2021		2020
Global Spine	$	18,213	$	17,548	$	18,362
Global Orthopedics		6,696		8,233		7,896
Corporate		4,110		3,818		4,288
Total	$	29,019	$	29,599	$	30,546

Summary of Net Sales by Geographic Destination

The following data includes net sales by geographic destination:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2022		2021		2020
U.S.	$	358,843	$	361,945	$	327,280
Italy		19,098		20,187		18,733
Germany		11,569		13,716		11,940
United Kingdom		10,171		10,552		7,147
France		10,377		10,475		8,354
Brazil		5,668		5,108		2,347
Others		44,987		42,496		30,761
Net sales	$	460,713	$	464,479	$	406,562

The table below presents net sales by geographic destination for each reporting segment and for the consolidated Company:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2022		2021		2020
Global Spine
U.S.	$	332,846	$	337,455	$	304,595
International		20,328		21,508		17,140
Total Global Spine		353,174		358,963		321,735
Global Orthopedics
U.S.	$	25,997		24,490		22,685
International		81,542		81,026		62,142
Total Global Orthopedics		107,539		105,516		84,827
Consolidated
U.S.		358,843		361,945		327,280
International		101,870		102,534		79,282
Net sales	$	460,713	$	464,479	$	406,562

Summary of Property, Plant and Equipment of Reporting Segments by Geographic Area

The following data includes property, plant, and equipment by geographic area:

(U.S. Dollars, in thousands)	2022		2021
U.S.	$	44,802	$	45,090
Italy		8,535		9,412
Germany		3,115		2,544
United Kingdom		1,149		1,193
Brazil		85		91
Others		543		922
Total	$	58,229	$	59,252