Business segment information

12 Months Ended

Dec. 31, 2021

Segment Reporting [Abstract]

Business segment information

16. Business segment information

The Company has two reporting segments: Global Spine and Global Orthopedics. These reporting segments represent the operating segments for which the Chief Executive Officer, who is also Chief Operating Decision Maker (the “CODM”), reviews financial information and makes resource allocation decisions among businesses. The primary metric used by the CODM in managing the Company is earnings before interest, tax, depreciation, and amortization (“EBITDA”). The Company neither discretely allocates assets, other than goodwill, to its operating segments nor evaluates the operating segments using discrete asset information. Accordingly, the reporting segment information has been prepared based on these two reporting segments.

Global Spine

The Global Spine reporting segment offers three primary product categories: Bone Growth Therapies, Spinal Implants, and Biologics.

The Bone Growth Therapies product category manufactures, distributes, and provides support services of market leading bone growth stimulator devices that enhance bone fusion. These Class III medical devices are indicated as an adjunctive, noninvasive treatment to improve fusion success rates in the cervical and lumbar spine as well as a therapeutic treatment for non-spine fractures that have not healed (non-unions). This product category uses distributors and sales representatives to sell its devices to hospitals, healthcare providers, and patients, primarily in the U.S.

The Spinal Implants product category designs, develops, and markets a broad portfolio of motion preservation and fixation implant products used in surgical procedures of the spine. Spinal Implants distributes its products through a global network of distributors and sales representatives to sell spine products to hospitals and healthcare providers.

The Biologics product category provides a portfolio of regenerative products and tissue forms that allow physicians to successfully treat a variety of spinal and orthopedic conditions. This product category specializes in the marketing of the Company’s  regeneration tissue forms and distributes its tissues to hospitals and healthcare providers, primarily in the U.S., through a network of independent distributors and sales representatives. The partnership with MTF allows the Company to exclusively market the Trinity Evolution and Trinity ELITE tissue forms for musculoskeletal defects to enhance bony fusion and also allows the Company to exclusively distribute the Alloquent and fiberFUSE allografts.

Global Orthopedics

The Global Orthopedics reporting segment offers products and solutions that allow physicians to successfully treat a variety of orthopedic conditions unrelated to the spine. This reporting segment specializes in the design, development, and marketing of the Company’s orthopedic products used in fracture repair, deformity correction, and bone reconstruction procedures. Global Orthopedics distributes its products through a global network of distributors and sales representatives to sell orthopedic products to hospitals, and healthcare providers.

Corporate

Corporate activities are comprised of the operating expenses and activities of the Company not necessarily identifiable within the two reporting segments.

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

	Year Ended December 31,
	2021					2020					2019
(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	$	187,448		40.4	%	$	171,396		42.2	%	$	197,181		42.9	%
Spinal Implants		115,094		24.8	%		94,857		23.3	%		94,544		20.6	%
Biologics		56,421		12.1	%		55,482		13.6	%		65,496		14.2	%
Global Spine		358,963		77.3	%		321,735		79.1	%		357,221		77.7	%
Global Orthopedics		105,516		22.7	%		84,827		20.9	%		102,734		22.3	%
Net sales	$	464,479		100.0	%	$	406,562		100.0	%	$	459,955		100.0	%

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)	2021			2020			2019
Global Spine	$	58,014		$	63,036		$	39,528
Global Orthopedics		3,374			(4,993	)		7,496
Corporate		(31,691	)		(25,382	)		(49,252	)
Total EBITDA		29,697			32,661			(2,228	)
Depreciation and amortization		(29,599	)		(30,546	)		(24,699	)
Goodwill impairment		(11,756	)		—			—
Interest expense, net		(1,837	)		(2,483	)		(122	)
Loss before income taxes	$	(13,495	)	$	(368	)	$	(27,049	)

The following table presents depreciation and amortization by reporting segment:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2021		2020		2019
Global Spine	$	17,548	$	18,362	$	14,329
Global Orthopedics		8,233		7,896		5,575
Corporate		3,818		4,288		4,795
Total	$	29,599	$	30,546	$	24,699

Geographical information

The following data includes net sales by geographic destination:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2021		2020		2019
U.S.	$	361,945	$	327,280	$	361,939
Italy		20,187		18,733		19,560
Germany		13,716		11,940		12,688
United Kingdom		10,552		7,147		10,090
France		10,475		8,354		8,747
Brazil		5,108		2,347		7,685
Others		42,496		30,761		39,246
Net sales	$	464,479	$	406,562	$	459,955

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)	2021		2020		2019
Global Spine
U.S.	$	337,455	$	304,595	$	335,410
International		21,508		17,140		21,811
Total Global Spine		358,963		321,735		357,221
Global Orthopedics
U.S.	$	24,490		22,685		26,529
International		81,026		62,142		76,205
Total Global Orthopedics		105,516		84,827		102,734
Consolidated
U.S.		361,945		327,280		361,939
International		102,534		79,282		98,016
Net sales	$	464,479	$	406,562	$	459,955

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

(U.S. Dollars, in thousands)	2021		2020
U.S.	$	45,090	$	47,646
Italy		9,412		10,503
Germany		2,544		2,516
United Kingdom		1,193		1,540
Brazil		91		163
Others		922		1,245
Total	$	59,252	$	63,613