Fair value measurements and investments (Tables)

12 Months Ended

Dec. 31, 2020

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)	Balance December 31, 2020			Level 1		Level 2			Level 3
Assets
Neo Medical convertible loan agreement	$	7,160		$	—	$	—		$	7,160
Neo Medical preferred equity securities		5,000			—		5,000			—
Bone Biologics equity securities		—			—		—			—
Total	$	12,160		$	—	$	5,000		$	7,160
Liabilities
Spinal Kinetics contingent consideration	$	(35,400	)	$	—	$	—		$	(35,400	)
Other contingent consideration		(375	)		—		—			(375	)
Deferred compensation plan		(1,441	)		—		(1,441	)		—
Total	$	(37,216	)	$	—	$	(1,441	)	$	(35,775	)

(U.S. Dollars, in thousands)	Balance December 31, 2019			Level 1		Level 2			Level 3
Assets
Bone Biologics equity securities	$	219		$	—	$	219		$	—
Total	$	219		$	-	$	219		$	-
Liabilities
Spinal Kinetics contingent consideration	$	(42,700	)	$	—	$	—		$	(42,700	)
Deferred compensation plan		(1,255	)		—		(1,255	)		—
Total	$	(43,955	)	$	—	$	(1,255	)	$	(42,700	)

Schedule of Valuation Methodology and Unobservable Inputs for Level 3 Assets and Liabilities Measured at Fair Value

The changes in valuation of these securities for the years ended December 31, 2020, 2019, and 2018 are shown below:

(U.S. Dollars, in thousands)	2020			2019		2018
Bone Biologics equity securities at January 1	$	219		$	219	$	2,768
Impact of adoption of ASU 2016-01 recognized in other income		—			—		1,629
Purchase of additional common stock		—			—		500
Fair value adjustments and impairments recognized in other expense		(219	)		—		(4,678	)
Bone Biologics equity securities at December 31	$	—		$	219	$	219

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)	2020			2019
Spinal Kinetics contingent consideration at January 1	$	42,700		$	28,560
Increase (decrease) in fair value recognized in acquisition-related amortization and remeasurement		(7,300	)		29,140
Payment made		—			(15,000	)
Spinal Kinetics contingent consideration at December 31	$	35,400		$	42,700

Fair Value, Inputs, Level 3 [Member]

Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]

Schedule of Reconciliation For Convertible 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, measured at fair value using significant unobservable inputs (Level 3):

(U.S. Dollars, in thousands)	2020		2019
Fair value of Neo Medical Convertible Loan at January 1	$	—	$	—
Issuance date		5,000		—
Interest recognized in interest income, net		103		—
Foreign currency remeasurement recognized in other income (expense), net		176		—
Unrealized gain (loss) recognized in other comprehensive income (loss)		1,881		—
Fair value of Neo Medical Convertible Loan at December 31		7,160		—
Amortized cost basis of Neo Medical Convertible Loan at December 31		5,279		—

Schedule of Valuation Methodology and Unobservable Inputs for Level 3 Assets and Liabilities Measured at Fair Value

The following table provides quantitative information related to certain key assumptions utilized within the valuation as of December 31, 2020:

(U.S. Dollars, in thousands)	Fair Value as of December 31, 2020		Unobservable inputs	Estimate
Neo Medical Convertible Loan	$	7,160	Cost of equity discount rate		21.1	%
			Implied volatility		108.1	%

The following table provides a range of key assumptions used within the valuation as of December 31, 2020:

(U.S. Dollars, in thousands)	Fair Value as of December 31, 2020		Valuation Technique	Unobservable inputs	Range
Spinal Kinetics contingent consideration	$	35,400	Discounted cash flow	Revenue discount rate	8.09% - 8.12%
				Payment discount rate	3.83% - 3.90%
				Projected year of payment	2021 - 2022

Schedule of Reconciliation of Debt Securities

The following table provides a reconciliation of the beginning and ending balances for the eNeura debt security, when it was measured at fair value as an available for sale debt security (prior to its change in classification):

(U.S. Dollars, in thousands)	2020		2019			2018
Balance at January 1	$	—	$	17,820		$	16,050
Gains (losses) recorded for the period
Recognized in other expense, net		—		—			—
Recognized in other comprehensive income (loss)		—		(2,593	)		1,770
Change in classification of debt security to held to maturity		—		(15,227	)		—
Issuance of Warrant as consideration for extension		—		491			—
Impairment of Warrant		—		(491	)		—
Balance at December 31	$	—	$	—		$	17,820