Fair value measurements and investments (Tables)

12 Months Ended

Dec. 31, 2023

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 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)	Level 1		Level 2			Level 3			Balance December 31, 2023
Assets
Neo Medical convertible loan agreement	$	—	$	—		$	6,760		$	6,760
Neo Medical preferred equity securities		—		4,951			—			4,951
Bone Biologics equity securities		—		—			—			—
Other investments		—		—			1,309			1,309
Total	$	—	$	4,951		$	8,069		$	13,020
Liabilities
Lattus contingent consideration	$	—	$	—		$	(8,500	)	$	(8,500	)
Spinal Kinetics contingent consideration		—		—			—			—
Deferred compensation plan		—		(1,674	)		—			(1,674	)
Total	$	—	$	(1,674	)	$	—		$	(10,174	)

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

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, 2023, and 2022:

(U.S. Dollars, in thousands)	2023			2022
Fair value of Neo Medical preferred equity securities at January 1	$	6,084		$	5,413
Conversion of loan into preferred equity securities		—			671
Foreign currency remeasurement recognized in other income, net		388			—
Unrealized loss recognized in other income (expense), net		(1,521	)		—
Fair value of Neo Medical preferred equity securities at December 31	$	4,951		$	6,084
Cumulative unrealized gain (loss) on Neo Medical preferred equity securities		(720	)		413

The

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)	2023		2022
Spinal Kinetics contingent consideration at January 1	$	—	$	17,200
Decrease in fair value recognized in acquisition-related amortization and remeasurement		—		(17,200	)
Payment made		—		—
Spinal Kinetics contingent consideration at December 31	$	—	$	—

(U.S. Dollars, in thousands)	2023			2022
Lattus contingent consideration estimated fair value at January 5	$	11,200		$	—
Decrease in fair value recognized in acquisition-related amortization and remeasurement		(2,700	)		—
Lattus contingent consideration estimated fair value at December 31	$	8,500		$	—

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, 2023, 2022, and 2021:

(U.S. Dollars, in thousands)	2023		2022			2021
Bone Biologics equity securities at January 1	$	—	$	309		$	—
Fair value adjustments and impairments recognized in other income (expense), net		—		(183	)		309
Proceeds from the disposition of equity securities		—		(126	)		—
Bone Biologics equity securities at December 31	$	—	$	—		$	309

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 Loan(s), measured at fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)	2023			2022
Fair value of Neo Medical Convertible Loans at January 1	$	7,140		$	7,148
Additions		—			—
Interest recognized in interest income, net		496			436
Foreign currency remeasurement recognized in other income (expense), net		617			(67	)
Unrealized gain (loss) recognized in other comprehensive income (loss)		(1,233	)		294
Expected credit loss recognized in other income (expense), net		(260	)		—
Conversion of Additional Convertible Loan into preferred equity securities		—			(671	)
Fair value of Neo Medical Convertible Loans at December 31	$	6,760		$	7,140
Contractual value of Neo Medical Convertible Loans at December 31	$	7,020		$	5,907
Allowance for credit loss recognized in other income (expense), net		(260	)		—
Amortized cost basis of Neo Medical Convertible Loans at December 31	$	6,760		$	5,907

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, 2023:

(U.S. Dollars, in thousands)	Fair Value as of December 31, 2023		Unobservable inputs	Estimate
Neo Medical Convertible Loan	$	6,760	Cost of equity discount rate		19.3	%
			Present value factor		15.3	%
			Implied volatility		81.1	%

The following table provides quantitative information related to certain key assumptions utilized within the valuation as of December 31, 2023:

(U.S. Dollars, in thousands)	Fair Value as of  December 31, 2023		Unobservable inputs	Estimate
Lattus Contingent Consideration	$	8,500	Counterparty discount rate		14.0	%
			Revenue risk-adjusted discount rate		6.5	%