Business segment information (Tables)

12 Months Ended

Dec. 31, 2021

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,
	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	%

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)	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	)

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)	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

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)	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

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)	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