85,974

81,767

^[1]

255,333

243,208

^[1]

Research and development

13,127

13,052

^[1]

39,439

37,577

^[1]

Intangible asset amortization

109,896

99,794

^[1]

333,487

306,037

^[1]

2,995

3,036

^[1]

9,013

9,660

^[1]

Goodwill, Impairment Loss

46,738

Total costs and expenses

211,992

244,387

^[1]

637,272

643,220

^[1]

Operating income (loss)

17,727

(31,141)

^[1]

38,857

(27,775)

^[1]

Interest income

^[1]

145

390

^[1]

Interest expense

(5,916)

(5,316)

^[1]

(16,440)

(15,081)

^[1]

Other income (expense), net

(293)

(263)

^[1]

142

(1,544)

^[1]

Income (loss) before income taxes

11,543

(36,682)

^[1]

22,704

(44,010)

^[1]

1,736

(6,352)

^[1]

5,866

(9,172)

^[1]

Basic net income per common share (in dollars per share)

9,807

(30,330)

^[1]

16,838

(34,838)

^[1]

$ 0.30

$ (1.09)

^[1]

$ 0.52

$ (1.25)

^[1]

Diluted net income per common share (in dollars per share)

$ 0.30

$ (1.09)

^[1]

$ 0.51

$ (1.25)

^[1]

Weighted average common shares outstanding (See Note 10):

Basic (in shares)

32,450

27,896

^[1]

32,374

27,855

^[1]

Diluted (in shares)

32,906

27,896

^[1]

32,844

27,855

^[1]

Cash and cash equivalents

$ (6,364)

$ (21,640)

^[1]

$ 1,593

$ (30,754)

^[1]

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (USD $)
In Thousands, unless otherwise specified

Sep. 30, 2014

Dec. 31, 2013

Current assets:

$ 140,231

$ 120,614

^[1]

Trade accounts receivable, net of allowances of $5,161 and $6,194

120,741

118,145

^[1]

230,455

206,919

^[1]

44,276

48,616

^[1]

Property, plant and equipment, net

26,886

26,858

^[1]

Total current assets

562,589

521,152

^[1]

203,882

200,310

^[1]

Intangible assets, net

413,906

197,163

^[1]

Goodwill

349,574

249,764

^[1]

Accrued expenses and other current liabilities

6,259

15,412

^[1]

Other assets

9,524

8,338

^[1]

Total assets

1,545,734

1,192,139

^[1]

Current liabilities:

Accounts payable, trade

45,935

50,752

^[1]

Deferred revenue

5,183

4,197

^[1]

Accrued compensation

36,957

28,079

^[1]

40,173

36,354

^[1]

Debt, Current

1,875

^[1]

Total current liabilities

130,123

119,382

^[1]

Long-term borrowings under senior credit facility

410,000

186,875

^[1]

Long-term convertible securities

211,095

205,182

^[1]

Deferred tax liabilities

76,782

2,083

^[1]

Other liabilities

31,756

12,527

^[1]

Total liabilities

859,756

526,049

^[1]

Commitments and contingencies

^[1]

Stockholders’ equity:

Preferred stock; no par value; 15,000 authorized shares; none outstanding

^[1]

Common stock; $0.01 par value; 60,000 authorized shares; 41,453 and 41,042 issued at September 30, 2014 and December 31, 2013, respectively

415

410

^[1]

Additional paid-in capital

769,208

750,918

^[1]

Treasury stock, at cost; 8,903 shares at September 30, 2014 and December 31, 2013

(367,121)

^[1]

Accumulated other comprehensive income (loss)

(14,318)

927

^[1]

Total stockholders’ equity

297,794

280,956

^[1]

685,978

666,090

^[1]

Total liabilities and stockholders’ equity

$ 1,545,734

$ 1,192,139

^[1]

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (Parenthetical) (USD $) In Thousands, except Per Share data, unless otherwise specified	Sep. 30, 2014	Dec. 31, 2013
Statement of Financial Position [Abstract]
Trade accounts receivable, allowances	$ 5,161	$ 6,194
Preferred Stock, par value (in dollars per share)	$ 0	$ 0
Preferred Stock, authorized shares (in shares)	15,000	15,000
Preferred Stock, outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	60,000	60,000
Common stock, shares issued (in shares)	41,453	41,042
Treasury stock, shares (in shares)	8,903	8,903

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) (USD $)
In Thousands, unless otherwise specified

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

OPERATING ACTIVITIES:

Adjustments to reconcile net income (loss) to net cash provided by operating activities:

$ 16,838

$ (34,838)

^[1]

Depreciation and amortization

45,105

35,695

^[1]

Non-cash impairment charges

600

46,738

^[1]

Deferred income tax (benefit)

(1,510)

(7,238)

^[1]

Amortization of debt issuance costs

2,060

1,707

^[1]

Non-cash interest expense

5,256

4,865

^[1]

Loss on disposal of property and equipment

505

1,816

^[1]

Loss/(gain) from increase/(decrease) in fair value of contingent consideration liabilities

(878)

^[1]

Share-based compensation

11,688

7,594

^[1]

Excess tax benefits from stock-based compensation arrangements

(1,207)

(140)

^[1]

Changes in assets and liabilities, net of business acquisitions:

Accounts receivable

(3,847)

1,440

^[1]

Inventories

(26,648)

(28,765)

^[1]

Accounts payable, accrued expenses and other current liabilities

6,628

(694)

^[1]

Other non-current assets

(437)

(515)

^[1]

8,794

14,185

^[1]

Deferred revenue

1,069

986

^[1]

Other non-current liabilities

(5,310)

(1,264)

^[1]

Net cash provided by operating activities

58,706

41,572

^[1]

INVESTING ACTIVITIES:

Purchases of property and equipment

(29,466)

(37,722)

^[1]

Sales of property and equipment

533

^[1]

Cash used for business acquisition, net of cash acquired

(235,000)

(2,980)

^[1]

Net cash used in investing activities

(264,466)

(40,169)

^[1]

FINANCING ACTIVITIES:

Borrowings under senior credit facility

385,000

30,000

^[1]

Repayments of Secured Debt

160,000

10,000

Payments of Debt Issuance Costs

(3,110)

(1,053)

^[1]

Principal payments under capital lease obligations

(370)

^[1]

Proceeds from exercised stock options

8,317

420

^[1]

Excess tax benefits from stock-based compensation arrangements

1,207

140

^[1]

Net cash provided by financing activities

231,044

19,507

^[1]

Effect of exchange rate changes on cash and cash equivalents

(5,667)

1,020

^[1]

Net change in cash and cash equivalents

19,617

21,930

^[1]

Cash and cash equivalents at beginning of period

120,614

^[1]

96,938

^[1]

Cash and cash equivalents at end of period

$ 140,231

$ 118,868

^[1]

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

BASIS OF PRESENTATION

9 Months Ended

Sep. 30, 2014

Organization, Consolidation and Presentation of Financial Statements [Abstract]

BASIS OF PRESENTATION

General

The terms “we,” “our,” “us,” “Company” and “Integra” refer to Integra LifeSciences Holdings Corporation, a Delaware corporation, and its subsidiaries unless the context suggests otherwise.

In the opinion of management, the September 30, 2014 unaudited condensed consolidated financial statements contain all adjustments (consisting only of normal recurring adjustments) necessary for a fair statement of the financial position, results of operations and cash flows of the Company. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles have been condensed or omitted in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. These unaudited condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements for the year ended December 31, 2013 included in the Company’s Current Report on Form 8-K dated June 16, 2014, which was filed with the Securities and Exchange Commission on June 20, 2014. The December 31, 2013 consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by accounting principles generally accepted in the United States. Operating results for the three- and nine-month periods ended September 30, 2014 are not necessarily indicative of the results to be expected for the entire year.

The preparation of consolidated financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the reported amount of assets and liabilities, the disclosure of contingent liabilities, and the reported amounts of revenues and expenses. Significant estimates affecting amounts reported or disclosed in the consolidated financial statements include allowances for doubtful accounts receivable and sales returns and allowances, net realizable value of inventories, valuation of intangible assets including in-process research and development, amortization periods for acquired intangible assets, discount rates and estimated projected cash flows used to value and test impairments of long-lived assets and goodwill, estimates of projected cash flows and depreciation and amortization periods for long-lived assets, computation of taxes, valuation allowances recorded against deferred tax assets, the valuation of stock-based compensation, valuation of pension assets and liabilities, valuation of derivative instruments, valuation of the equity component of convertible debt instruments, valuation of contingent liabilities, the fair value of debt instruments and loss contingencies. These estimates are based on historical experience and on various other assumptions that are believed to be reasonable under the current circumstances. Actual results could differ from these estimates.

Certain amounts from the prior year’s financial statements have been reclassified in order to conform to the current year’s presentation.

Change in Accounting Principle

In the first quarter of 2014, the Company changed its method of accounting for the medical device excise tax (“MDET”). Prior to the change the Company recorded the MDET in inventory at the time of the first sale in the United States and then recognized the MDET in cost of goods sold when the medical device was sold to the ultimate customer. Under the new method, the MDET will be recorded in selling, general and administrative expenses in the period the first sale occurs in the United States, which could be an intercompany sale.

The Company believes that this change in accounting principle is preferable as the new method provides a better comparison with the Company's peers, the majority of which expense the MDET at the time of the first sale in the United States.

The medical device excise tax applies to sales beginning January 1, 2013; therefore, this change affected only 2013 financial results. The cumulative effect of the change in the prior year is included in retained earnings as of December 31, 2013. We have revised the comparative results for the three- and nine-month periods ended September 30, 2013 to reflect the retrospective application of the change in accounting principle had the new method been in effect for all periods, as follows:

Condensed Consolidated Statements of Operations and Comprehensive Income:



	Three Months Ended September 30, 2013									Nine Months Ended September 30, 2013
	Originally						As			Originally						As
	Reported			Adjustments			Adjusted			Reported			Adjustments			Adjusted
	(In thousands, except per share amounts)
Cost of goods sold	$	84,101		$	(2,334	)	$	81,767		$	247,437		$	(4,229	)	$	243,208
Selling, general and administrative	95,933			3,861			99,794			295,713			10,324			306,037
Income tax expense (benefit)	(6,605		)	253			(6,352		)	(8,755		)	(417		)	(9,172		)
Net income (loss)	(28,550		)	(1,780		)	(30,330		)	(29,160		)	(5,678		)	(34,838		)
Basic net income (loss) per common share	$	(1.02	)				$	(1.09	)	$	(1.05	)				$	(1.25	)
Diluted net income (loss) per common share	(1.02		)				(1.09		)	(1.05		)				(1.25		)
Comprehensive income (loss)	$	(19,860	)	$	(1,780	)	$	(21,640	)	$	(25,076	)	$	(5,678	)	$	(30,754	)

Condensed Consolidated Balance Sheets:



	December 31, 2013
	Originally					As
	Reported		Adjustments			Adjusted
	(In thousands)
Inventories	$	213,431	$	(6,512	)	$	206,919
Deferred tax assets - current	46,300		2,316			48,616
Prepaid expenses and other current assets	26,752		106			26,858
Retained earnings	285,046		(4,090		)	280,956

Condensed Consolidated Statements of Cash Flows:



	Nine Months Ended September 30, 2013
	Originally						As
	Reported			Adjustments			Adjusted
	(In thousands)
Net income (loss)	$	(29,160	)	$	(5,678	)	$	(34,838	)
Inventories	(34,855		)	6,090			(28,765		)
Prepaid and other current assets	(282		)	(412		)	(694		)

Realignment of Segment Revenues

In the first quarter of 2014 the Company realigned certain products between operating segments. The Company did not change its management structure and has determined that the Company still has the same five reportable segments. The impact of this immaterial change on all periods presented is that (i) the revenues and segment profit of the U.S. Extremities segment is lower, and U.S. Instruments and U.S. Spine and Other segments are higher, and (ii) the global revenues of the Orthopedics product category is lower and the Instruments product category is higher. These changes have been reflected in all periods presented. There has been no change in the Company's net revenues reported.

Recently Issued Accounting Standards

In July 2013, the FASB issued ASU No. 2013-11, Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward, a Similar Tax Loss, or a Tax Credit Carryforward Exists. This updated guidance requires an unrecognized tax benefit to be presented in the financial statements as a reduction to a deferred tax asset for a net operating loss carryforward, similar tax loss, or a tax credit carryforward. To the extent the tax benefit is not available at the reporting date under the governing tax law or if the entity does not intend to use the deferred tax asset for such purpose, the unrecognized tax benefit should be presented as a liability and not combined with deferred tax assets. This ASU is effective for fiscal years and interim periods within those years beginning after December 15, 2013 for public entities and early adoption is permitted. The amendments are to be applied to all unrecognized tax benefits that exist as of the effective date and may be applied retrospectively to each prior reporting period presented. The standard adoption did not have a material impact on the Company's financial statements.

In April 2014, the FASB issued amendments to guidance for reporting discontinued operations and disposals of components of an entity. The amended guidance requires that a disposal representing a strategic shift that has (or will have) a major effect on an entity’s financial results or a business activity classified as held for sale should be reported as discontinued operations. The amendments also expand the disclosure requirements for discontinued operations and add new disclosures for individually significant dispositions that do not qualify as discontinued operations. The amendments are effective prospectively for fiscal years, and interim reporting periods within those years, beginning after December 15, 2014 (early adoption is permitted only for disposals that have not been previously reported). The implementation of the amended guidance is not expected to have a material impact on our consolidated financial position or results of operations.

In May 2014, the FASB issued Update No. 2014-09, Revenue from Contracts with Customers (Topic 606). The core principle of the guidance is that an entity should recognize revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. To achieve that core principle, an entity should: 1) identify the contract(s) with a customer, 2) identify the performance obligations in the contract, 3) determine the transaction price, 4) allocate the transaction price to the performance obligations in the contract, and 5) recognize revenue when (or as) the entity satisfies a performance obligation. This update is effective for annual reporting periods beginning after December 15, 2016, including interim periods within that reporting period, and early adoption is not permitted. The Company is in the process of evaluating the impact of this standard on its financial statements.

In June 2014, the FASB issued Update No. 2014-12, Accounting for Share-Based Payments When the Terms of an Award Provide That a Performance Target Could Be Achieved after the Requisite Service Period (Topic 718). The amendments require that a performance target that affects vesting and that could be achieved after the requisite service period be treated as a performance condition. A reporting entity should apply existing guidance in Topic 718 as it relates to awards with performance conditions that affect vesting to account for such awards. As such, the performance target should not be reflected in estimating the grant-date fair value of the award. Compensation cost should be recognized in the period in which it becomes probable that the performance target will be achieved and should represent the compensation cost attributable to the period(s) for which the requisite service has already been rendered. If the performance target becomes probable of being achieved before the end of the requisite service period, the remaining unrecognized compensation cost should be recognized prospectively over the remaining requisite service period. The requisite service period ends when the employee can cease rendering service and still be eligible to vest in the award if the performance target is achieved. This update is effective for annual reporting periods beginning after December 15, 2015, including interim periods within that reporting period, and early adoption is permitted. The implementation of the amended guidance is not expected to have a material impact on our consolidated financial position or results of operations.

There are no other recently issued accounting pronouncements that are expected to have a material effect on our financial position, results of operations or cash flows.

The entire disclosure for organization, consolidation and basis of presentation of financial statements disclosure.

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+ Details

BUSINESS ACQUISITIONS

9 Months Ended

Sep. 30, 2014

Business Combinations [Abstract]

BUSINESS ACQUISITIONS

Confluent Surgical, Inc.

On January 15, 2014, the Company acquired all outstanding shares of Confluent Surgical, Inc., ("Confluent Surgical") - including its surgical sealant and adhesion barrier product lines - from Covidien Group S.a.r.l, ("Covidien") for an aggregate purchase price of $255.9 million. The purchase price is comprised of an initial cash payment to Covidien of $231.0 million upon the closing of the transaction, a separate prepayment of $4.0 million made under a transitional supply agreement with an affiliate of Covidien, and contingent consideration with an acquisition date fair value of $20.9 million. The potential maximum undiscounted contingent consideration of $30.0 million consists of $25.0 million upon obtaining certain U.S. governmental approvals and $5.0 million upon obtaining certain European governmental approvals, both related to the completion of the transition of the Confluent Surgical business.

The transitional supply agreement secures the supply of the acquired products from an affiliate of Covidien until the earlier of (i) the time that the transition of the Confluent Surgical business as discussed above is complete, or (ii) the fifth anniversary of the effective date of the agreement (the agreement also contains an option to extend for another two years by providing written notice at least 180 days prior to the end of the initial five-year period). This agreement contains financial incentives to the affiliate of Covidien for the timely supply of products each fiscal quarter through the third anniversary of the agreement. The prices paid under the supply agreement are essentially flat through the third anniversary of the agreement, and then increase significantly each of the following three years. The Company also entered into a transition services agreement with an affiliate of Covidien at the closing for services such as customer service, accounting and information technology management, clinical and regulatory affairs, manufacturing transition services, and other functions.

This acquisition complements the Company's global neurosurgery growth strategy aimed at providing a broader set of solutions for surgical procedures in the head.

The Company adjusted the preliminary purchase price allocation during the quarter ended June 30, 2014 to reduce deferred tax liabilities by $12.4 million. This adjustment offset goodwill and was the result of the Company analyzing and revising its tax positions in certain jurisdictions. The purchase price allocation is preliminary because the Company has not yet completed the final analysis of the tax accounts. The following summarizes the preliminary allocation of the purchase price as of September 30, 2014 based on the fair value of the assets acquired and liabilities assumed:



	Preliminary Purchase Price Allocation
	(Dollars in thousands)
Inventory deposit	$	4,000
Fixed assets	438
Intangible assets:			Wtd. Avg. Life
Technology product rights	239,800		20 years
Other	400		Less than 1 year
Deferred tax assets - long term	12
Goodwill	105,331
Total assets acquired	349,981
Contingent supply liability	5,891
Other	731
Deferred tax liabilities - long term	87,464
Net assets acquired	$	255,895

Subsequent to the acquisition date, a regulatory event occurred that resulted in the full-impairment of one of the acquired technology product rights of $0.6 million. This event was not known, or knowable, at the time of the acquisition and therefore the impairment has been included in the Company's cost of sales.

The Company accounted for the contingent supply liability by recording its fair value as a liability on the date of the acquisition based on a discounted cash-flow model. This contingent supply liability relates to contractual quarterly incentive payments that will be made to an affiliate of Covidien if certain supply minimums under the transitional supply agreement are met.

The Company accounted for the contingent consideration by recording its fair value as a liability on the date of the acquisition. The contingent consideration relates to the Company's obtaining certain U.S. and European regulatory approvals. At the date of the acquisition, both of these milestones were valued using a discount rate of 2.2%, which is equivalent to the cost of debt for the estimated time horizon, and an overall probability of occurring of 95%. Accordingly, on January 15, 2014 the Company recorded a $20.9 million liability representing the initial fair value estimate of the probability weighted contingent consideration that management believes will be paid between early 2017 and late 2018. Depending on the expected timing of the estimated payments, the acquisition date fair value of the probability adjusted payments could have been $0.3 million higher or $0.4 million lower. These fair value measurements were based on significant inputs not observed in the market and thus represented a Level 3 measurement. The contingent consideration is re-measured to fair value at each reporting date until the contingency is resolved, and those changes in fair value are recognized in earnings.

The goodwill recorded in connection with this acquisition is based on (i) expected cost savings, operating synergies and other benefits expected to result from the combined operations, (ii) the value of the going-concern element of Confluent Surgical's existing business (that is, the higher rate of return on the assembled net assets versus if the Company had acquired all of the net assets separately), and (iii) intangible assets that do not qualify for separate recognition such as Confluent Surgical's assembled workforce. The goodwill acquired will not be deductible for tax purposes.

Contingent consideration

The fair value of contingent consideration during the nine-months ended September 30, 2014 was (i) increased to reflect current period acquisitions, and the change in the time value of money during the period, and (ii) decreased because the Company believes that it is no longer probable that it will reach certain sales-based milestone targets. A reconciliation of the opening balances to the closing balances of these Level 3 measurements is as follows (in thousands):



				Location in Statement of Operations
Balance as of January 1, 2014	$	1,227
Contingent consideration from Confluent Surgical acquisition	20,895
Loss/(gain) from increase/(decrease) in fair value of contingent consideration liabilities	(878		)	Selling, general and administrative
Fair value at September 30, 2014	$	21,244

The entire contingent consideration balance was included in Other liabilities at September 30, 2014 and December 31, 2013.

Pro Forma Results

The following unaudited pro forma financial information summarizes the results of operations for the three and nine months ended September 30, 2013 as if the Confluent Surgical acquisition completed by the Company during 2014 had been completed as of January 1, 2013. The pro forma results are based upon certain assumptions and estimates, and they give effect to actual operating results prior to the acquisition and adjustments to reflect (i) the change in interest expense, depreciation expense, and intangible asset amortization, (ii) certain external expenses related to the acquisition as if they were incurred on January 1, 2013 that will not be recurring in the post-acquisition periods, and (iii) income taxes on the aforementioned adjustments at the Company’s statutory rate. No effect has been given to other cost reductions or operating synergies. As a result, these pro forma results do not necessarily represent results that would have occurred if the acquisition had taken place on the basis assumed above, nor are they indicative of the results of future combined operations.

The pro forma impact of the Confluent Surgical pre-acquisition results were not material to the 2014 consolidated operating results of the Company; therefore the pro forma impact on the 2014 results of the Company has not been presented below. The pro forma results below also incorporate the impact of the change in accounting for the MDET on the 2013 results which is discussed in Note 1.



	Three Months Ended September 30, 2013			Nine Months Ended September 30, 2013
	(In thousands)
Total revenue	$	229,645		$	664,642
Net income (loss)	$	(28,324	)	$	(30,356	)

The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).

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+ Details

INVENTORIES

9 Months Ended

Sep. 30, 2014

Inventory, Net [Abstract]

INVENTORIES

Inventories, net consisted of the following:



	September 30, 2014		December 31, 2013
	(In thousands)
			(As adjusted)*
Finished goods	$	142,342	$	123,786
Work in process	50,864		47,403
Raw materials	37,249		35,730
	$	230,455	$	206,919

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

Goodwill and Intangible Assets Disclosure [Abstract]

The entire disclosure for inventory. This may include, but is not limited to, the basis of stating inventory, the method of determining inventory cost, the major classes of inventory, and the nature of the cost elements included in inventory. If inventory is stated above cost, accrued net losses on firm purchase commitments for inventory and losses resulting from valuing inventory at the lower-of-cost-or-market may also be included. For LIFO inventory, may disclose the amount and basis for determining the excess of replacement or current cost over stated LIFO value and the effects of a LIFO quantities liquidation that impacts net income.

+ References+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS

9 Months Ended

Sep. 30, 2014

GOODWILL AND OTHER INTANGIBLE ASSETS

The Company reviews goodwill for impairment annually as of July 31 and whenever events or changes in circumstances indicate the carrying value of goodwill may not be recoverable. In reviewing goodwill for impairment, an Company has the option - for any or all of its reporting units that carry goodwill - to first assess qualitative factors to determine whether the existence of events or circumstances leads to a determination that it is more likely than not (i.e. greater than 50%) that the estimated fair value of a reporting unit is less than its carrying amount. If the Company elects to perform a qualitative assessment and determines that an impairment is more likely than not, the Company is then required to perform the two-step quantitative impairment test, otherwise no further analysis is required. The Company also may elect not to perform the qualitative assessment and, instead, proceed directly to step one of the two-step quantitative impairment test. The ultimate outcome of the goodwill impairment review for a reporting unit should be the same whether the Company chooses to perform the qualitative assessment or proceeds directly to the two-step quantitative impairment test. The most recent two-step quantitative impairment test completed for each reporting unit was as of July 31, 2013 (the "Base Valuation"), which resulted in the full impairment of goodwill held by the U.S. Spine reporting unit. At July 31, 2014 the following reporting units carried goodwill: U.S. Neurosurgery, U.S. Instruments, U.S. Extremities, Private Label, EMEA and LAPAC.

At July 31, 2014, management performed a comprehensive analysis of various events and circumstances (i.e. factors) that would likely affect the estimated fair value of all of its reporting units that carried goodwill at that date, and whether those factors would have a positive or negative impact on the fair value of the reporting unit when compared to the Base Valuation. Management considered Company-wide factors such as, but not limited to (i) macroeconomic conditions, (ii) industry conditions, (iii) the Company's overall financial prospects and market capitalization, (iv) the competitive environment, (v) regulatory and political developments, and (vi) any changes in the Company's weighted average cost of capital ("WACC"). Management also considered reporting unit specific factors such as, but not limited to (i) changes in the market for products and services, (ii) strategic business changes, (iii) reporting unit financial performance, (iv) management's most recent prospective revenue estimates, (v) the prospective cost burden of the reporting units, (vi) changes in a reporting unit's management, (vii) how any change in the Company's WACC above might impact the reporting unit specific WACC, and (viii) the suitability of the risk premiums on the reporting unit specific WACC. These factors are then classified by the type of impact they would have on the estimated fair value using positive, neutral, and adverse categories based on current business conditions. The Company then performs an assessment of the level of impact that a particular factor would have on the estimated fair value using high, medium, and low weighting. Finally, management considered all of the factors above in the context of the results of the Base Valuation, and whether it is more likely than not that the carrying value of any of the reporting units that have goodwill exceeds their individual fair value.

Management concluded that at July 31, 2014, based on the totality of information available for each reporting unit that carried goodwill, it was more likely than not that the estimated fair values of the U.S. Neurosurgery, U.S. Extremities, Private Label, EMEA and LAPAC reporting units were greater than their carrying values, and as such, no further analysis was required for those reporting units. The Company proceeded to step one of the quantitative goodwill impairment test for the U.S. Instruments reporting unit, primarily as a result of recent declines in that reporting unit's revenues.

To derive the fair value of the U.S. Instruments reporting unit, as required in step one of the impairment test, the Company used the income approach, specifically the discounted cash flow ("DCF") method, which incorporates significant estimates and assumptions made by management which, by their nature, are characterized by uncertainty. Inputs used to fair value the Company's reporting units are considered inputs of the fair value hierarchy. For Level 3 measurements, significant increases or decreases in long-term growth rates or discount rates in isolation or in combination could result in a significantly lower or higher fair value measurement. The key assumptions impacting the valuation included:


•	The reporting unit's financial projections, which are based on management's assessment of regional and macroeconomic variables, industry trends and market opportunities, and the Company's strategic objectives and future growth plans.

•

The projected terminal value for the reporting unit, which represents the present value of projected cash flows beyond the last period in the discounted cash flow analysis. The terminal value reflects the Company's assumptions related to long-term growth rates and profitability, which are based on several factors, including local and macroeconomic variables, market opportunities, and future growth plans.

•

The discount rate used to measure the present value of the projected future cash flows is set using a weighted-average cost of capital method that considers market and industry data as well as the Company's specific risk factors that are likely to be considered by a market participant. The weighted-average cost of capital is the Company's estimate of the overall after-tax rate of return required by equity and debt holders of a business enterprise.

The Company determined, after performing the Step-1 fair value analysis above, that the U.S. Instruments reporting unit's fair value was in excess of its carrying value; therefore, it was not necessary to proceed to Step-2 of the goodwill impairment test for the U.S. Instruments reporting unit.

Changes in the carrying amount of goodwill for the nine months ended September 30, 2014 were as follows:



	U.S. Neurosurgery			U.S. Instruments			U.S. Extremities			U.S. Spine and Other			International			Total
	(In thousands)
Goodwill, gross	$	95,165		$	58,033		$	61,079		$	56,325		$	25,900		$	296,502
Accumulated impairment losses	—			—			—			(46,738		)	—			(46,738		)
Goodwill at December 31, 2013	95,165			58,033			61,079			9,587			25,900			249,764
Confluent Surgical acquisition	95,373			—			—			—			9,958			105,331
Foreign currency translation	(2,966		)	(901		)	(948		)	(149		)	(557		)	(5,521		)
Goodwill at September 30, 2014	$	187,572		$	57,132		$	60,131		$	9,438		$	35,301		$	349,574

The components of the Company’s identifiable intangible assets were as follows:



	September 30, 2014
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	18 years	$	320,270	$	(58,458	)	$	261,812
Customer relationships	12 years	145,658		(85,762		)	59,896
Trademarks/brand names	31 years	33,316		(15,766		)	17,550
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(10,452		)	24,269
All other⁽¹⁾	4 years	4,620		(2,725		)	1,895
		$	587,069	$	(173,163	)	$	413,906



	December 31, 2013
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	12 years	$	81,238	$	(45,343	)	$	35,895
Customer relationships	12 years	146,627		(79,624		)	67,003
Trademarks/brand names	31 years	33,703		(15,648		)	18,055
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(9,305		)	25,416
All other⁽¹⁾	5 years	4,251		(1,941		)	2,310
		$	349,024	$	(151,861	)	$	197,163


⁽¹⁾	At September 30, 2014 and December 31, 2013, all other included in-process research and development ("IPR&D") of $1.4 million in both periods, which was indefinite-lived.

During the nine months ended September 30, 2014, the Company recorded an impairment charge of $0.6 million in cost of goods sold related to technology assets acquired from Confluent Surgical that will no longer be sold resulting from a regulatory event that occurred after the acquisition date.

Based on quarter-end exchange rates, annual amortization expense (including amounts reported in cost of product revenues, but excluding any possible future amortization associated with acquired in-process research and development) is expected to approximate $31.2 million in 2014, $28.7 million in 2015, $26.6 million in 2016, $24.5 million in 2017 and $24.1 million in 2018. Identifiable intangible assets are initially recorded at fair market value at the time of acquisition using an income or cost approach.

The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final. May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.

+ References+ Details

DEBT

9 Months Ended

Sep. 30, 2014

Debt Disclosure [Abstract]

DEBT

Amended and Restated Senior Credit Agreement

On July 2, 2014, the Company entered into an amended and restated credit agreement (the "Senior Credit Facility") with a syndicate of lending banks, Bank of America, N.A., as Administrative Agent, Swing Line Lender and L/C Issuer, Wells Fargo Bank, National Association, as Syndication Agent and HSBC Bank USA, National Association, Royal Bank of Canada, Citizens Bank, National Association, DNB Capital LLC, Credit Agricole-Corporate and Investment Bank and TD Bank, N.A., as Co-Documentation Agents. The Company's Senior Credit Facility was originally amended and restated on August 10, 2010, and that agreement was then amended on June 8, 2011, May 11, 2012, and June 21, 2013, as previously disclosed.

The 2014 amended and restated Senior Credit Facility created an aggregate principal amount of up to $900.0 million available to the Company through the following facilities:


i.	a $750.0 million revolving credit facility (increased from $600.0 million), which includes a $60.0 million sublimit for the issuance of standby letters of credit and a $60.0 million sublimit for swingline loans, and


ii.	a $150.0 million term loan facility.

The Senior Credit Facility allows the Company to further increase the size of either the revolving credit facility or the term loan facility, or a combination thereof, by an aggregate of $200.0 million with additional commitments. The July 2014 amended and restated Senior Credit Facility extended the maturity date of the prior facility from June 8, 2016 to July 2, 2019.

Borrowings under the Senior Credit Facility bear interest, at the Company’s option, at a rate equal to:


i.	the Eurodollar Rate (as defined in the amendment and restatement) in effect from time to time plus the applicable rate (ranging from 1.00% to 1.75%), or


ii.	the highest of:


1.	the weighted average overnight Federal funds rate, as published by the Federal Reserve Bank of New York, plus 0.50%, or


2.	the prime lending rate of Bank of America, N.A., or


3.	the one-month Eurodollar Rate plus 1.00%.

The applicable rates are based on the Company’s consolidated total leverage ratio (defined as the ratio of (a) consolidated funded indebtedness less cash in excess of $40.0 million that is not subject to any restriction of the use or investment thereof to (b) consolidated EBITDA) at the time of the applicable borrowing.

The Company will also pay an annual commitment fee (ranging from 0.15% to 0.30%, based on the Company’s consolidated total leverage ratio) on the daily amount by which the revolving credit facility exceeds the outstanding loans and letters of credit under the credit facility.

The Senior Credit Facility is collateralized by substantially all of the assets of the Company’s U.S. subsidiaries, excluding intangible assets. The Senior Credit Facility is subject to various financial and negative covenants and at September 30, 2014 the Company was in compliance with all such covenants. In connection with the modification of the 2014 amendment and restatement of the Senior Credit Facility the Company capitalized $3.1 million of incremental financing costs, and expensed $0.3 million of previously capitalized financing costs.

On July 2, 2014, the Company borrowed $422.0 million under the Senior Credit Facility consisting of a $150.0 million term loan and $272.0 million under its revolving credit facility. The Company used the funds to repay the balance of its previous Senior Credit Facility. The outstanding borrowings have one, two, three, six months, or, if available, twelve months interest periods.

At September 30, 2014 and December 31, 2013, there was $261.9 million and $186.9 million outstanding under the revolving credit component of the Senior Credit Facility at a weighted average interest rate of 1.7% and 2.0%, respectively. At September 30, 2014, there was approximately $488.1 million available for borrowing under the Senior Credit Facility. The Company considers the balance to be long-term in nature based on its current intent and ability to repay the borrowing outside of the next twelve-month period.

At September 30, 2014 there was $150.0 million outstanding under the term loan component of the Senior Credit Facility at a weighted average interest rate of 1.7%. Contractual repayments of the term loan do not begin until September 30, 2015 and are due as follows:



Year Ended December 31,	Principal Repayment
	(In thousands)
2015	$	3,750
2016	9,375
2017	13,125
2018	15,000
2019	108,750
	$	150,000

The fair value of outstanding borrowings of the Senior Credit Facility's revolving credit facility and term loan components at September 30, 2014 was approximately $241.4 million and $139.1 million, respectively. These fair values were determined by using a discounted cash flow model based on current market interest rates available to the Company. These inputs are corroborated by observable market data for similar liabilities and therefore classified within Level 2 of the fair value hierarchy. Level 2 inputs represent inputs that are observable for the asset or liability, either directly or indirectly and are other than active market observable inputs that reflect unadjusted quoted prices for identical assets or liabilities.

2016 Convertible Senior Notes

On June 15, 2011, the Company issued $230.0 million aggregate principal amount of its 1.625% Convertible Senior Notes due in 2016 (the “2016 Notes”). The 2016 Notes mature on December 15, 2016, and bear interest at a rate of 1.625% per annum payable semi-annually in arrears on December 15 and June 15 of each year. The portion of the debt proceeds that was classified as equity at the time of the offering was $43.2 million, an equivalent of that amount is being amortized to interest expense using the effective interest method through December 2016. The effective interest rate implicit in the liability component is 5.6%.

At September 30, 2014, the carrying amount of the liability component was $211.1 million, the remaining unamortized discount was $18.9 million, and the principal amount outstanding was $230.0 million. The fair value of the 2016 Notes at September 30, 2014 was approximately $247.7 million. At December 31, 2013, the carrying amount of the liability component was $205.2 million, the remaining unamortized discount was $24.8 million and the principal amount outstanding was $230.0 million. The fair value of the liability of the 2016 Notes was determined using a discounted cash flow model based on current market interest rates available to the Company. These inputs are corroborated by observable market data for similar liabilities and therefore classified within Level 2.

The 2016 Notes are senior, unsecured obligations of the Company, and are convertible into cash and, if applicable, shares of its common stock based on an initial conversion rate, subject to adjustment of 17.4092 shares per $1,000 principal amount of 2016 Notes (which represents an initial conversion price of approximately $57.44 per share). The Company will satisfy any conversion of the 2016 Notes with cash up to the principal amount of the 2016 Notes pursuant to the net share settlement mechanism set forth in the indenture and, with respect to any excess conversion value, with shares of the Company’s common stock. The 2016 Notes are convertible only in the following circumstances: (1) if the closing sale price of the Company’s common stock exceeds 150% of the conversion price during a period as defined in the indenture; (2) if the average trading price per $1,000 principal amount of the 2016 Notes is less than or equal to 98% of the average conversion value of the 2016 Notes during a period as defined in the indenture; (3) at any time on or after June 15, 2016; or (4) if specified corporate transactions occur. The issue price of the 2016 Notes was equal to their face amount, which is also the amount holders are entitled to receive at maturity if the 2016 Notes are not converted. As of September 30, 2014, none of these conditions existed with respect to the 2016 Notes and as a result, the 2016 Notes are classified as long term.

In connection with the issuance of the 2016 Notes, the Company entered into call transactions and warrant transactions, primarily with affiliates of the initial purchasers of such notes (the “hedge participants”). The initial strike price of the call transaction is approximately $57.44 per share, subject to customary anti-dilution adjustments. The initial strike price of the warrant transaction is approximately $70.05 per share, subject to customary anti-dilution adjustments.

Convertible Note Interest

The interest expense components of the Company’s convertible notes are as follows (net of capitalized interest amounts):



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
	(In thousands)
2016 Notes:
Amortization of the discount on the liability component	$	1,822	$	1,633	$	5,256	$	4,865
Cash interest related to the contractual interest coupon	853		807		2,491		2,438
Total	$	2,675	$	2,440	$	7,747	$	7,303

Derivative Instruments and Hedging Activities Disclosure [Abstract]

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References+ Details

DERIVATIVE INSTRUMENTS

9 Months Ended

Sep. 30, 2014

DERIVATIVE INSTRUMENTS

Interest Rate Hedging

The Company’s interest rate risk relates to U.S. dollar denominated variable LIBOR interest rate borrowings. The Company uses an interest rate swap derivative instrument entered into on August 10, 2010 with an effective date of December 31, 2010 to manage its earnings and cash flow exposure to changes in interest rates by converting a portion of its floating-rate debt into fixed-rate debt beginning on December 31, 2010. This interest rate swap expires on August 10, 2015.

The Company designates this derivative instrument as a cash flow hedge. The Company records the effective portion of any change in the fair value of a derivative instrument designated as a cash flow hedge as unrealized gains or losses in accumulated other comprehensive income (“AOCI”), net of tax, until the hedged item affects earnings, at which point the effective portion of any gain or loss will be reclassified to earnings. If the hedged cash flow does not occur, or if it becomes probable that it will not occur, the Company will reclassify the amount of any gain or loss on the related cash flow hedge to interest expense at that time.

The Company expects that approximately $1.3 million of pre-tax losses recorded as net in AOCI related to the interest rate hedge could be reclassified to earnings within the next twelve months.

Foreign Currency Hedging

From time to time the Company enters into foreign currency hedge contracts intended to protect the U.S. dollar value of certain forecasted foreign currency denominated transactions. The Company records the effective portion of any change in the fair value of foreign currency cash flow hedges in AOCI, net of tax, until the hedged item affects earnings. Once the related hedged item affects earnings, the Company reclassifies the effective portion of any related unrealized gain or loss on the foreign currency cash flow hedge to earnings. If the hedged forecasted transaction does not occur, or if it becomes probable that it will not occur, the Company will reclassify the amount of any gain or loss on the related cash flow hedge to earnings at that time.

The success of the Company’s hedging program depends, in part, on forecasts of certain activity denominated in euros. The Company may experience unanticipated currency exchange gains or losses to the extent that there are differences between forecasted and actual activity during periods of currency volatility. In addition, changes in currency exchange rates related to any unhedged transactions may affect its earnings and cash flows.

Counterparty Credit Risk

The Company manages its concentration of counterparty credit risk on its derivative instruments by limiting acceptable counterparties to a group of major financial institutions with investment grade credit ratings, and by actively monitoring their credit ratings and outstanding positions on an ongoing basis. Therefore, the Company considers the credit risk of the counterparties to be low. Furthermore, none of the Company’s derivative transactions are subject to collateral or other security arrangements, and none contain provisions that depend upon the Company’s credit ratings from any credit rating agency.

Fair Value of Derivative Instruments

The Company has classified all of its derivative instruments within Level 2 of the fair value hierarchy because observable inputs are available for substantially the full term of the derivative instruments. The fair value of the foreign currency forward exchange contracts related to inventory purchases is determined by comparing the forward rate as of the period end and the settlement rate specified in each contract. The fair value of the interest rate swaps was developed using a market approach based on publicly available market yield curves and the terms of the related swap. The Company performs ongoing assessments of counterparty credit risk.

The following table summarizes the fair value and presentation for derivatives designated as hedging instruments in the condensed consolidated balance sheets as of September 30, 2014 and December 31, 2013:



	Fair Value as of
Location on Balance Sheet ⁽¹⁾:	September 30, 2014		December 31, 2013
	(In thousands)
Derivatives designated as hedges — Liabilities:
Interest rate swap — Accrued expenses and other current liabilities ⁽²⁾	$	1,289	$	1,676
Interest rate swap — Other liabilities⁽²⁾	—		763
Total Derivatives designated as hedges — Liabilities	$	1,289	$	2,439


⁽¹⁾	The Company classifies derivative assets and liabilities as current based on the cash flows expected to be incurred within the following 12 months.


⁽²⁾	At September 30, 2014 and December 31, 2013, the notional amount related to the Company’s sole interest rate swap was $101.3 million and $112.5 million, respectively. In the next twelve months, the Company expects to reduce the notional amount by the entire $101.3 million.

The following presents the effect of derivative instruments designated as cash flow hedges on the accompanying condensed consolidated statements of operations during the three and nine months ended September 30, 2014 and 2013:



	Balance in AOCI Beginning of Quarter			Amount of Gain (Loss) Recognized in AOCI- Effective Portion			Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion			Balance in AOCI End of Quarter			Location in Statements of Operations
	(In thousands)
Three Months Ended September 30, 2014
Interest rate swap	$	(1,713	)	$	(9	)	$	(433	)	$	(1,289	)	Interest (expense)
Three Months Ended September 30, 2013
Forward currency forward contracts	$	162		$	(19	)	$	110		$	33		Cost of goods sold
Interest rate swap	(3,030		)	(258		)	(483		)	(2,805		)	Interest (expense)
	$	(2,868	)	$	(277	)	$	(373	)	$	(2,772	)



	Balance in AOCI Beginning of Year			Amount of Gain (Loss) Recognized in AOCI- Effective Portion			Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion			Balance in AOCI End of Quarter			Location in Statements of Operations
	(In thousands)
Nine Months Ended September 30, 2014
Interest rate swap	(2,439		)	(179		)	(1,329		)	(1,289		)	Interest (expense)
Nine Months Ended September 30, 2013
Forward currency forward contracts	(34		)	142			75			$	33		Cost of goods sold
Interest rate swap	(4,125		)	(159		)	(1,479		)	(2,805		)	Interest (expense)
	$	(4,159	)	$	(17	)	$	(1,404	)	$	(2,772	)

The Company recognized no gains or losses resulting from ineffectiveness of cash flow hedges during the nine months ended September 30, 2014 and 2013.

The entire disclosure for derivative instruments and hedging activities including, but not limited to, risk management strategies, non-hedging derivative instruments, assets, liabilities, revenue and expenses, and methodologies and assumptions used in determining the amounts.

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STOCK-BASED COMPENSATION	9 Months Ended
STOCK-BASED COMPENSATION	Sep. 30, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
STOCK-BASED COMPENSATION	STOCK-BASED COMPENSATION As of September 30, 2014, the Company had stock options, restricted stock awards, performance stock units, contract stock awards and restricted stock unit awards outstanding under three plans, the 2000 Equity Incentive Plan (the “2000 Plan”), the 2001 Equity Incentive Plan (the “2001 Plan”), and the 2003 Equity Incentive Plan (the “2003 Plan,” and collectively, the “Plans”). Stock options issued under the Plans become exercisable over specified periods, generally within four years from the date of grant for officers, directors, and employees, and generally expire six years from the grant date for employees, and from six to ten years for directors and certain executive officers. Restricted stock issued under the Plans vests over specified periods, generally three years after the date of grant. The vesting of performance stock, issued under the Plans, is subject to service and performance conditions. Stock Options As of September 30, 2014, there were approximately $1.7 million of total unrecognized compensation costs related to unvested stock options. These costs are expected to be recognized over a weighted-average period of approximately two years. There were approximately 80,991 stock options granted during the nine months ended September 30, 2014. Awards of Restricted Stock, Performance Stock and Contract Stock Performance stock, restricted stock and contract stock awards generally have requisite service periods of three years. Performance stock units are subject to graded vesting conditions and the Company expenses their fair value over the requisite service period. The Company expenses the fair value of restricted stock and contract stock awards on a straight-line basis over the vesting period or requisite service period, whichever is shorter. As of September 30, 2014, there were approximately $14.7 million of total unrecognized compensation costs related to these unvested awards. The Company expects to recognize these costs over a weighted-average period of approximately two years. The Company granted 255,407 restricted stock awards/stock units and 90,025 performance shares during the nine months ended September 30, 2014. During the three months ended June 30, 2014, the Company recorded an incremental stock compensation expense of $3.0 million in connection with the accelerated vesting of grants due to the amendment of an executive employment contract. The expense, which was comprised of both restricted shares and performance shares, was measured based on the difference between (i) the fair value of the awards on the date of modification and (ii) previously recognized compensation expense for such awards. The expense related to the acceleration of performance stock, included in the compensation expense amount above, was recorded in its entirety on the date of modification as the Company believes the performance obligation will be satisfied. The Company has no formal policy related to the repurchase of shares for the purpose of satisfying stock-based compensation obligations. The Company also maintains an Employee Stock Purchase Plan (the “ESPP”), which provides eligible employees with the opportunity to acquire shares of common stock at periodic intervals by means of accumulated payroll deductions. The ESPP is a non-compensatory plan based on its terms.

The entire disclosure for compensation-related costs for equity-based compensation, which may include disclosure of policies, compensation plan details, allocation of equity compensation, incentive distributions, equity-based arrangements to obtain goods and services, deferred compensation arrangements, employee stock ownership plan details and employee stock purchase plan details.

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TREASURY STOCK	9 Months Ended
TREASURY STOCK	Sep. 30, 2014
Treasury Stock Transactions, Excluding Value of Shares Reissued [Abstract]
TREASURY STOCK	TREASURY STOCK On October 23, 2012, the Company's Board of Directors authorized a repurchase plan of up to $75.0 million of its outstanding common stock through December 2014. The Company has not repurchased any of its outstanding shares of common stock during the nine month periods ended September 30, 2014 and 2013. As of September 30, 2014, there remained $75.0 million available for repurchases under this authorization. See Note 14 - Subsequent Events regarding changes to this share repurchase plan made after September 30, 2014.

INCOME TAXES

9 Months Ended

Sep. 30, 2014

Income Tax Disclosure [Abstract]

INCOME TAXES

The following table provides a summary of the Company’s effective tax rate:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
			(As adjusted)*				(As adjusted)*

Reported tax rate	15.0	%	17.3	%	25.8	%	20.8	%

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

The Company’s effective income tax rates for the three months ended September 30, 2014 and 2013 were 15.0% and 17.3%, respectively. The primary drivers of the overall tax rate for the three months ended September 30, 2014 were a tax benefit of $1.6 million that was recognized for the release of uncertain tax positions due to the expiration of statute of limitations, partially offset by an expense of $0.5 million relating to a state income tax audit settlement and an expense of $0.3 million relating to foreign returns filed during the quarter. The primary drivers of the overall tax rate for the three months ended September 30, 2013 were the goodwill impairment charge that was partially deductible for tax purposes, partially offset by a benefit of $2.3 million for the release of uncertain tax positions and related interest due to the expiration of the statute of limitations.

The Company's effective income tax rates for the nine months ended September 30, 2014 and 2013 were 25.8% and 20.8%, respectively. The primary drivers of the income tax rate for the nine months ended September 30, 2014 were an expense of $1.2 million relating to state income tax audit settlements, an expense of $0.4 million for a foreign income tax audit settlement, and an expense of $0.3 million from a change in state filing positions; offset by a benefit of $2.0 million for the release of uncertain tax positions and related interest due to the expiration of statute of limitations. The primary drivers of the income tax rate for the nine months ended September 30, 2013 were a benefit of $3.5 million for the release of uncertain tax positions, a benefit of $0.5 million relating to the granting of Irish research credits for 2011 and 2012, and a benefit of $0.9 million due to the extension of the Federal research credit, enacted through the American Taxpayer Relief Act. These benefits in 2013 were recorded against a book loss, relating primarily to goodwill impairment; accordingly, they had the effect of increasing the effective tax rate in that period.

The Company expects its effective income tax rate for the full year to be approximately 23% to 24%, resulting largely from the release of uncertain tax positions, domestic and foreign audit settlements, as well as the jurisdictional mix of pretax income in U.S.-based operations relative to foreign operations. This estimate could be revised in the future as additional information is presented to the Company.

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

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NET INCOME PER SHARE

9 Months Ended

Sep. 30, 2014

Earnings Per Share [Abstract]

NET INCOME PER SHARE

NET INCOME (LOSS) PER SHARE

Basic and diluted net income (loss) per share was as follows:



	Three Months Ended September 30,					Nine Months Ended September 30,
	2014		2013			2014		2013
	(In thousands, except per share amounts)
			(As adjusted)*					(As adjusted)*
Basic net income (loss) per share:
Net income (loss)	$	9,807	$	(30,330	)	$	16,838	$	(34,838	)
Weighted average common shares outstanding	32,450		27,896			32,374		27,855
Basic net income (loss) per common share	$	0.30	$	(1.09	)	$	0.52	$	(1.25	)

Diluted net income (loss) per share:
Net income (loss)	$	9,807	$	(30,330	)	$	16,838	$	(34,838	)

Weighted average common shares outstanding — Basic	32,450		27,896			32,374		27,855
Effect of dilutive securities:
Stock options and restricted stock	456		—			470		—
Weighted average common shares for diluted earnings per share	32,906		27,896			32,844		27,855
Diluted net income (loss) per common share	$	0.30	$	(1.09	)	$	0.51	$	(1.25	)

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

At September 30, 2014 and 2013, the Company had 1.4 million and 1.7 million of outstanding stock options, respectively. The Company also has warrants outstanding relating to its 2016 Notes at September 30, 2014 and 2013 and the Company's 2016 Notes are convertible to common shares in certain circumstances (see Note 5). Stock options, restricted stock, warrants and the excess conversion value of the 2016 Notes are included in the diluted earnings per share calculation using the treasury stock method, unless the effect of including such items would be anti-dilutive.

For the three months ended September 30, 2014 and 2013, 0.2 million of anti-dilutive stock options were excluded from the diluted earnings per share calculation. For the nine months ended September 30, 2014, 0.2 million of anti-dilutive stock options were excluded. For the three and nine months ended September 30, 2013, all stock options, and all restricted stock were excluded from the diluted earnings per share calculation using the treasury stock method because of their anti-dilutive effect. The effect of outstanding warrants were anti-dilutive because the strike price of the warrants exceeded the Company’s average stock price for the periods, and the potential excess conversion value of the 2016 Notes were anti-dilutive because the conversion price exceeded the Company's stock price; therefore, these amounts have been excluded from the diluted earnings per share calculation in all periods presented.

COMPREHENSIVE (LOSS) INCOME

The entire disclosure for earnings per share.

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COMPREHENSIVE (LOSS) INCOME

9 Months Ended

Sep. 30, 2014

Equity [Abstract]

COMPREHENSIVE INCOME (LOSS)

Comprehensive income (loss) was as follows:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2014			2013			2014			2013
	(In thousands)
				(As adjusted)*						(As adjusted)*
Net income (loss)	$	9,807		$	(30,330	)	$	16,838		$	(34,838	)
Foreign currency translation adjustment	(16,537		)	8,711			(15,952		)	3,288
Change in unrealized gain on derivatives, net of tax	241			47			655			794
Pension liability adjustment, net of tax	125			(68		)	52			2
Comprehensive income (loss)	$	(6,364	)	$	(21,640	)	$	1,593		$	(30,754	)

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

Changes in Accumulated Other Comprehensive Income (Loss) by component between December 31, 2013 and September 30, 2014 are presented in the table below, net of tax:



	Gains and (Losses) on Cash Flow Hedges			Defined Benefit Pension Items			Foreign Currency Items			Total
	(In thousands)
Beginning balance	$	(1,390	)	$	(2,287	)	$	4,604		$	927
Other comprehensive income (loss) before reclassifications	(102		)	52			(15,952		)	(16,002		)
Amounts reclassified from accumulated other comprehensive income	757			—			—			757
Net current-period other comprehensive income (loss)	655			52			(15,952		)	(15,245		)
Ending balance	$	(735	)	$	(2,235	)	$	(11,348	)	$	(14,318	)

The reclassification adjustments out of Accumulated Other Comprehensive Income (Loss) during the three and nine months ended September 30, 2014 were as follows:



Three Months Ended September 30, 2014
Details about Accumulated Other Comprehensive Income (Loss) Components	Amount Reclassified from Accumulated Other Comprehensive Income (Loss)			Affected Line Item in the Statement where Net Income (Loss) is Presented
	(In thousands)
Gains and losses on cash flow hedges
Interest rate swap	$	(433	)	Interest (expense)
	192			Tax (expense) or benefit
	$	(241	)	Net of tax


Nine Months Ended September 30, 2014
Details about Accumulated Other Comprehensive Income (Loss) Components	Amount Reclassified from Accumulated Other Comprehensive Income (Loss)			Affected Line Item in the Statement where Net Income (Loss) is Presented
	(In thousands)
Gains and losses on cash flow hedges
Interest rate swap	$	(1,328	)	Interest (expense)
	571			Tax (expense) or benefit
	$	(757	)	Net of tax

The entire disclosure for comprehensive income, which includes, but is not limited to, 1) the amount of income tax expense or benefit allocated to each component of other comprehensive income, including reclassification adjustments, 2) the reclassification adjustments for each classification of other comprehensive income and 3) the ending accumulated balances for each component of comprehensive income.

SEGMENT AND GEOGRAPHIC INFORMATION

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+ Details

SEGMENT AND GEOGRAPHIC INFORMATION

9 Months Ended

Sep. 30, 2014

Segment Reporting [Abstract]

The Company internally manages and reports the results of its businesses to its chief operating decision maker through five reportable segments. The five reportable segments and a description of their activities are described below:


•	The U.S. Neurosurgery segment sells a full line of products specifically for neurosurgery and critical care such as tissue ablation equipment, dural repair products, cerebral spinal fluid management devices, intracranial monitoring equipment, and cranial stabilization equipment.


•	The U.S. Instruments business sells more than 60,000 instrument patterns and surgical and lighting products to hospitals, surgery centers, and dental, podiatry, and veterinary offices.


•	The U.S. Extremities segment includes the U.S. Extremity reconstruction business, which includes such offerings as skin and wound repair, bone and joint fixation, implants in the upper and lower extremities, bone grafts and nerve and tendon repair.

•

The U.S. Spine and Other segment includes (i) the U.S. Spine business, which focuses on spinal fusion, spinal implants, and deformity correction, together with bone graft substitutes and other related medical devices that are used to enhance the repair and regeneration of bone in various types of orthopedic surgical procedures, and (ii) the Private Label business, which sells the Company’s regenerative medicine and other products to strategic partners.


•	The International segment sells similar products to those discussed above, but are managed through the following geographies: (i) Europe, Middle East and Africa, and (ii) Central/South America, Asia-Pacific and Canada.

The Corporate and other category includes: (i) various legal, finance, information systems, executive, and human resource functions, (ii) brand management, (iii) share-based compensation costs, and (iv) costs related to procurement, manufacturing operations and logistics for the Company’s entire organization.

The operating results of the various reportable segments as presented are not comparable to one another because: (i) certain operating segments are more dependent than others on corporate functions for unallocated general and administrative and/or operational manufacturing functions, and (ii) the Company does not allocate certain manufacturing costs and general and administrative costs to the operating segment results. Net sales and profit by reportable segment for the three and nine months ended September 30, 2014 and 2013 are as follows:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2014			2013			2014			2013
	(In thousands)
				(As adjusted)*						(As adjusted)*
Segment Net Sales
U.S. Neurosurgery	$	62,323		$	45,114		$	177,265		$	125,877
U.S. Instruments	39,853			43,004			116,078			121,900
U.S. Extremities	36,746			31,831			103,083			93,802
U.S. Spine and Other	42,015			47,408			128,168			134,889
International	48,782			45,889			151,535			138,977
Total revenues	$	229,719		$	213,246		$	676,129		$	615,445
Segment Profit
U.S. Neurosurgery	$	35,889		$	23,080		$	94,247		$	59,770
U.S. Instruments	12,416			13,713			34,728			35,963
U.S. Extremities	14,983			13,117			40,907			34,613
U.S. Spine and Other	13,108			(31,043		)	39,801			(4,844		)
International	15,170			14,693			49,549			41,697
Segment profit	91,566			33,560			259,232			167,199
Amortization	(2,995		)	(3,036)			(9,013)			(9,660)
Corporate and other	(70,844		)	(61,665		)	(211,362		)	(185,314		)
Operating income (loss)	$	17,727		$	(31,141	)	$	38,857		$	(27,775	)

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

Certain 2013 segment revenues and the related impact on segment profit above have been reclassified in order to conform with the current year's presentation.

Revenue by major product category consisted of the following:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
	(In thousands)
Orthopedics	$	91,650	$	92,125	$	271,958	$	271,862
Neurosurgery	92,089		72,639		269,717		204,283
Instruments	45,980		48,482		134,454		139,300
Total Revenues	$	229,719	$	213,246	$	676,129	$	615,445

The Company attributes revenues to geographic areas based on the location of the customer. There are certain revenues managed by the various U.S. segments that are generated from non-U.S. customers and therefore are included in Europe and the Rest of World revenues below. Total revenue by major geographic area consisted of the following:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
	(In thousands)
United States	$	180,101	$	166,555	$	522,288	$	473,740
Europe	23,850		21,543		75,026		68,936
Rest of World	25,768		25,148		78,815		72,769
Total Revenues	$	229,719	$	213,246	$	676,129	$	615,445

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

COMMITMENTS AND CONTINGENCIES	9 Months Ended
COMMITMENTS AND CONTINGENCIES	Sep. 30, 2014
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES In consideration for certain technology, manufacturing, distribution, and selling rights and licenses granted to the Company, the Company has agreed to pay royalties on sales of certain products that we sell. The royalty payments that the Company made under these agreements were not significant for any of the periods presented. The Company is subject to various claims, lawsuits and proceedings in the ordinary course of the Company's business, including claims by current or former employees, distributors and competitors and with respect to its products and product liability claims, lawsuits and proceedings, some of which have been settled by the Company. In the opinion of management, such claims are either adequately covered by insurance or otherwise indemnified, or are not expected, individually or in the aggregate, to result in a material adverse effect on our financial condition. However, it is possible that the Company's results of operations, financial position and cash flows in a particular period could be materially affected by these contingencies. On June 6, 2012, the Company was contacted by the United States Attorney's Office for the District of New Jersey regarding the activities of sales representatives in a single region within our Extremities Reconstruction division. The U.S. Attorney's Office was investigating the activities of three sales representatives, one of whom was a supervisor until terminated by the Company for failure to cooperate with this investigation. The activities at issue pertained to alleged improper billing of products for extremities indications. On August 12, 2014, the United States Attorney for the District of New Jersey announced that two former Integra sales representatives, one of whom was a supervisor, entered guilty pleas as a result of the investigation. According to the United States Attorney for the District of New Jersey, these individuals acted without the awareness of the Company. The Company cooperated with the U.S. Attorney’s Office on a voluntary basis throughout the investigation and has reimbursed affected customers. The reimbursements were made in historical periods and were not material. The Company was not a subject or target of the investigation, and believes the investigation to now be concluded. The Company accrues for loss contingencies when it is deemed probable that a loss has been incurred and that loss is estimable. The amounts accrued are based on the full amount of the estimated loss before considering insurance proceeds, and do not include an estimate for legal fees expected to be incurred in connection with the loss contingency. The Company consistently accrues legal fees expected to be incurred in connection with loss contingencies as those fees are incurred by outside counsel as a period cost.

Organization, Consolidation and Presentation of Financial Statements [Abstract]

The entire disclosure for commitments and contingencies.

+ References+ Details

SUBSEQUENT EVENT (Notes)	9 Months Ended
SUBSEQUENT EVENT (Notes)	Sep. 30, 2014
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENTS Acquisition of MicroFrance On October 27, 2014, the Company completed a stock and asset purchase agreement (the “Purchase Agreement”) with Medtronic, Inc. (“Medtronic”), a Minnesota corporation and Medtronic Xomed Instrumentation, SAS (“MicroFrance”), a French corporation and an indirect wholly-owned subsidiary of Medtronic, for the acquisition by the Company of all of the capital stock of MicroFrance and certain assets of Medtronic and its affiliates related to MicroFrance’s business. MicroFrance is engaged in the business of developing, manufacturing, marketing and distributing reusable handheld surgical instrument products, which are specialized for ear, nose and throat and laparoscopic procedures and providing related services. Under the terms of the Purchase Agreement, the Company paid Medtronic a net purchase price of approximately $60.0 million for the stock and assets acquired subject to a purchase price adjustment for certain working capital changes. The Company also entered into a distribution agreement, an independent sales representative agreement, and a supply agreement with an affiliate of Medtronic at the closing. In addition, the Company entered into a transition services agreement with Medtronic at the closing. The Company has not yet performed the purchase price allocation, and will do so during the fourth quarter. Share Repurchase Authorization On October 28, 2014, our Board of Directors terminated the previous share repurchase plan dated October 23, 2012, and authorized a new repurchase of up to $75.0 million of outstanding common stock through December 2016. Shares may be repurchased either in the open market or in privately negotiated transactions. Spine Business Spinoff and Organizational Changes On November 3, 2014, the Company announced its plan for 2015 to spinoff its spine business, and realign the remaining business into two global reporting segments. The spinoff will create a separate, independent medical technology company focused on developing, marketing and selling spine hardware and orthobiologics. The realignment of the remaining business will result in two globally managed divisions, with one providing Specialty Surgical Solutions and the other Orthopedics and Tissue Technologies. These moves to align the portfolio are part of a broader strategy to transform the business that includes optimization and accelerating growth. Spinoff of the Spine Business Under the proposed plan, the spine business will spinoff from Integra and operate as an independent, publicly held company. The new spine company will have a comprehensive portfolio of spinal hardware solutions, including unique interbody devices, minimally invasive surgery, and deformity, and a top-three orthobiologics offering, including a full range of osteoconductive and osteoinductive solutions utilizing unique demineralized bone, collagen and synthetic matrices. The spinoff transaction is expected to take the form of a tax-free distribution to Integra shareholders of publicly traded stock in the new spine company. The transaction is expected to be completed within twelve months, subject to certain customary and other conditions, including final approval by the Integra Board of Directors, confirmation of the tax-free nature of the transaction, and the effectiveness of a registration statement that will be filed with the Securities and Exchange Commission, including information about the separation, distribution and related matters. While the Company expects any spinoff transaction to close within twelve months, there can be no assurances regarding the ultimate timing of the transaction or that the transaction will be completed. The Company expects to incur one-time charges related to the transaction during the reporting periods preceding the separation and does not otherwise expect this to impact the Company's financial results in 2014. Alignment of Integra Portfolio: Creating the Specialty Surgical Solutions Division In addition to the above announced separation of the Spine business in a separate publicly traded company, in 2015 the Company plans to realign the remaining business into 2 global reporting segments, Specialty Surgical Solutions and Orthopedics and Tissue Technologies. The new Specialty Surgical Solutions organization will integrate globally what today are the Neurosurgery and Instruments businesses within Integra. Robert T. Davis, Jr., CVP, President, Specialty Surgical Solutions, will lead this newly-created division. The new global Specialty Surgical Solutions division will leverage Integra’s market-leading positions in both neurosurgery and instruments and will open up a larger potential market in which this business can achieve its communicated growth trajectory. In addition, Mark Augusti, CVP, President, Orthopedics and Tissue Technologies, will also take on global responsibility for that division. Dan Reuvers, CVP, President, International, will continue to run an International region management structure to prioritize and focus Integra’s investments in International markets. These plans to realign the business have not taken place yet and therefore these proposed changes have not impacted the Company's current segment disclosures. The Company is in the process of determining how this realignment will impact its segment information in 2015.

BASIS OF PRESENTATION (Tables)

9 Months Ended

Sep. 30, 2014

Schedule of New Accounting Pronouncements and Changes in Accounting Principles

Condensed Consolidated Statements of Operations and Comprehensive Income:



	Three Months Ended September 30, 2013									Nine Months Ended September 30, 2013
	Originally						As			Originally						As
	Reported			Adjustments			Adjusted			Reported			Adjustments			Adjusted
	(In thousands, except per share amounts)
Cost of goods sold	$	84,101		$	(2,334	)	$	81,767		$	247,437		$	(4,229	)	$	243,208
Selling, general and administrative	95,933			3,861			99,794			295,713			10,324			306,037
Income tax expense (benefit)	(6,605		)	253			(6,352		)	(8,755		)	(417		)	(9,172		)
Net income (loss)	(28,550		)	(1,780		)	(30,330		)	(29,160		)	(5,678		)	(34,838		)
Basic net income (loss) per common share	$	(1.02	)				$	(1.09	)	$	(1.05	)				$	(1.25	)
Diluted net income (loss) per common share	(1.02		)				(1.09		)	(1.05		)				(1.25		)
Comprehensive income (loss)	$	(19,860	)	$	(1,780	)	$	(21,640	)	$	(25,076	)	$	(5,678	)	$	(30,754	)

Condensed Consolidated Balance Sheets:



	December 31, 2013
	Originally					As
	Reported		Adjustments			Adjusted
	(In thousands)
Inventories	$	213,431	$	(6,512	)	$	206,919
Deferred tax assets - current	46,300		2,316			48,616
Prepaid expenses and other current assets	26,752		106			26,858
Retained earnings	285,046		(4,090		)	280,956

Condensed Consolidated Statements of Cash Flows:



	Nine Months Ended September 30, 2013
	Originally						As
	Reported			Adjustments			Adjusted
	(In thousands)
Net income (loss)	$	(29,160	)	$	(5,678	)	$	(34,838	)
Inventories	(34,855		)	6,090			(28,765		)
Prepaid and other current assets	(282		)	(412		)	(694		)

Tabular disclosure of changes in accounting principles, including adoption of new accounting pronouncements, that describes the new methods, amount and effects on financial statement line items.

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+ Details

BUSINESS ACQUISITIONS (Tables)

9 Months Ended

Sep. 30, 2014

Schedule of Contingent Consideration

A reconciliation of the opening balances to the closing balances of these Level 3 measurements is as follows (in thousands):



				Location in Statement of Operations
Balance as of January 1, 2014	$	1,227
Contingent consideration from Confluent Surgical acquisition	20,895
Loss/(gain) from increase/(decrease) in fair value of contingent consideration liabilities	(878		)	Selling, general and administrative
Fair value at September 30, 2014	$	21,244

Confluent Surgical, Inc.

Schedule of Purchase Price Allocation



	Preliminary Purchase Price Allocation
	(Dollars in thousands)
Inventory deposit	$	4,000
Fixed assets	438
Intangible assets:			Wtd. Avg. Life
Technology product rights	239,800		20 years
Other	400		Less than 1 year
Deferred tax assets - long term	12
Goodwill	105,331
Total assets acquired	349,981
Contingent supply liability	5,891
Other	731
Deferred tax liabilities - long term	87,464
Net assets acquired	$	255,895

Pro Forma Information



	Three Months Ended September 30, 2013			Nine Months Ended September 30, 2013
	(In thousands)
Total revenue	$	229,645		$	664,642
Net income (loss)	$	(28,324	)	$	(30,356	)

Schedule Of Inventory, Net

Tabular disclosure of the fair value measurement of liabilities using significant unobservable inputs (Level 3), a reconciliation of the beginning and ending balances, separately presenting changes attributable to the following: (1) total gains or losses for the period (realized and unrealized), segregating those gains or losses included in earnings (or changes in net assets), and gains or losses recognized in other comprehensive income (loss) and a description of where those gains or losses included in earnings (or changes in net assets) are reported in the statement of income (or activities); (2) purchases, sales, issues, and settlements (each type disclosed separately); and (3) transfers in and transfers out of Level 3 (for example, transfers due to changes in the observability of significant inputs) by class of liability.

+ References+ Details

INVENTORIES (Tables)

9 Months Ended

Sep. 30, 2014

Inventory, Net [Abstract]

Inventories, net consisted of the following:



	September 30, 2014		December 31, 2013
	(In thousands)
			(As adjusted)*
Finished goods	$	142,342	$	123,786
Work in process	50,864		47,403
Raw materials	37,249		35,730
	$	230,455	$	206,919

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)

9 Months Ended

Sep. 30, 2014

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule Of Changes In Carrying Amount Of Goodwill

Changes in the carrying amount of goodwill for the nine months ended September 30, 2014 were as follows:



	U.S. Neurosurgery			U.S. Instruments			U.S. Extremities			U.S. Spine and Other			International			Total
	(In thousands)
Goodwill, gross	$	95,165		$	58,033		$	61,079		$	56,325		$	25,900		$	296,502
Accumulated impairment losses	—			—			—			(46,738		)	—			(46,738		)
Goodwill at December 31, 2013	95,165			58,033			61,079			9,587			25,900			249,764
Confluent Surgical acquisition	95,373			—			—			—			9,958			105,331
Foreign currency translation	(2,966		)	(901		)	(948		)	(149		)	(557		)	(5,521		)
Goodwill at September 30, 2014	$	187,572		$	57,132		$	60,131		$	9,438		$	35,301		$	349,574

Components Of Company's Identifiable Intangible Assets

The components of the Company’s identifiable intangible assets were as follows:



	September 30, 2014
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	18 years	$	320,270	$	(58,458	)	$	261,812
Customer relationships	12 years	145,658		(85,762		)	59,896
Trademarks/brand names	31 years	33,316		(15,766		)	17,550
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(10,452		)	24,269
All other⁽¹⁾	4 years	4,620		(2,725		)	1,895
		$	587,069	$	(173,163	)	$	413,906



	December 31, 2013
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	12 years	$	81,238	$	(45,343	)	$	35,895
Customer relationships	12 years	146,627		(79,624		)	67,003
Trademarks/brand names	31 years	33,703		(15,648		)	18,055
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(9,305		)	25,416
All other⁽¹⁾	5 years	4,251		(1,941		)	2,310
		$	349,024	$	(151,861	)	$	197,163


⁽¹⁾	At September 30, 2014 and December 31, 2013, all other included in-process research and development ("IPR&D") of $1.4 million in both periods, which was indefinite-lived.

DEBT (Tables)

9 Months Ended

Sep. 30, 2014

Term loan maturities [Line Items]

Components Of Interest Expense

The interest expense components of the Company’s convertible notes are as follows (net of capitalized interest amounts):



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
	(In thousands)
2016 Notes:
Amortization of the discount on the liability component	$	1,822	$	1,633	$	5,256	$	4,865
Cash interest related to the contractual interest coupon	853		807		2,491		2,438
Total	$	2,675	$	2,440	$	7,747	$	7,303

Term Loan [Member]

Term loan maturities [Line Items]

Schedule of Maturities of Long-term Debt [Table Text Block]



Year Ended December 31,	Principal Repayment
	(In thousands)
2015	$	3,750
2016	9,375
2017	13,125
2018	15,000
2019	108,750
	$	150,000

DERIVATIVE INSTRUMENTS (Tables)

9 Months Ended

Sep. 30, 2014

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Summary Of Fair Value In Balance Sheet For Derivatives Designated As Hedging Instruments



	Fair Value as of
Location on Balance Sheet ⁽¹⁾:	September 30, 2014		December 31, 2013
	(In thousands)
Derivatives designated as hedges — Liabilities:
Interest rate swap — Accrued expenses and other current liabilities ⁽²⁾	$	1,289	$	1,676
Interest rate swap — Other liabilities⁽²⁾	—		763
Total Derivatives designated as hedges — Liabilities	$	1,289	$	2,439


⁽¹⁾	The Company classifies derivative assets and liabilities as current based on the cash flows expected to be incurred within the following 12 months.


⁽²⁾	At September 30, 2014 and December 31, 2013, the notional amount related to the Company’s sole interest rate swap was $101.3 million and $112.5 million, respectively. In the next twelve months, the Company expects to reduce the notional amount by the entire $101.3 million.

Effect Of Derivative Instruments Designated As Cash Flow Hedges On Statements Of Operations



	Balance in AOCI Beginning of Quarter			Amount of Gain (Loss) Recognized in AOCI- Effective Portion			Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion			Balance in AOCI End of Quarter			Location in Statements of Operations
	(In thousands)
Three Months Ended September 30, 2014
Interest rate swap	$	(1,713	)	$	(9	)	$	(433	)	$	(1,289	)	Interest (expense)
Three Months Ended September 30, 2013
Forward currency forward contracts	$	162		$	(19	)	$	110		$	33		Cost of goods sold
Interest rate swap	(3,030		)	(258		)	(483		)	(2,805		)	Interest (expense)
	$	(2,868	)	$	(277	)	$	(373	)	$	(2,772	)



	Balance in AOCI Beginning of Year			Amount of Gain (Loss) Recognized in AOCI- Effective Portion			Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion			Balance in AOCI End of Quarter			Location in Statements of Operations
	(In thousands)
Nine Months Ended September 30, 2014
Interest rate swap	(2,439		)	(179		)	(1,329		)	(1,289		)	Interest (expense)
Nine Months Ended September 30, 2013
Forward currency forward contracts	(34		)	142			75			$	33		Cost of goods sold
Interest rate swap	(4,125		)	(159		)	(1,479		)	(2,805		)	Interest (expense)
	$	(4,159	)	$	(17	)	$	(1,404	)	$	(2,772	)

INCOME TAXES (Tables)

9 Months Ended

Sep. 30, 2014

Income Tax Disclosure [Abstract]

Schedule of Effective Income Tax Rate Reconciliation

The following table provides a summary of the Company’s effective tax rate:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
			(As adjusted)*				(As adjusted)*

Reported tax rate	15.0	%	17.3	%	25.8	%	20.8	%

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

NET INCOME PER SHARE (Tables)

9 Months Ended

Sep. 30, 2014

Earnings Per Share [Abstract]

Basic And Diluted Net Income Per Share

Basic and diluted net income (loss) per share was as follows:



	Three Months Ended September 30,					Nine Months Ended September 30,
	2014		2013			2014		2013
	(In thousands, except per share amounts)
			(As adjusted)*					(As adjusted)*
Basic net income (loss) per share:
Net income (loss)	$	9,807	$	(30,330	)	$	16,838	$	(34,838	)
Weighted average common shares outstanding	32,450		27,896			32,374		27,855
Basic net income (loss) per common share	$	0.30	$	(1.09	)	$	0.52	$	(1.25	)

Diluted net income (loss) per share:
Net income (loss)	$	9,807	$	(30,330	)	$	16,838	$	(34,838	)

Weighted average common shares outstanding — Basic	32,450		27,896			32,374		27,855
Effect of dilutive securities:
Stock options and restricted stock	456		—			470		—
Weighted average common shares for diluted earnings per share	32,906		27,896			32,844		27,855
Diluted net income (loss) per common share	$	0.30	$	(1.09	)	$	0.51	$	(1.25	)

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

COMPREHENSIVE (LOSS) INCOME (Tables)

9 Months Ended

Sep. 30, 2014

Equity [Abstract]

Schedule of Comprehensive (Loss) Income

Comprehensive income (loss) was as follows:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2014			2013			2014			2013
	(In thousands)
				(As adjusted)*						(As adjusted)*
Net income (loss)	$	9,807		$	(30,330	)	$	16,838		$	(34,838	)
Foreign currency translation adjustment	(16,537		)	8,711			(15,952		)	3,288
Change in unrealized gain on derivatives, net of tax	241			47			655			794
Pension liability adjustment, net of tax	125			(68		)	52			2
Comprehensive income (loss)	$	(6,364	)	$	(21,640	)	$	1,593		$	(30,754	)

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

Schedule of Changes in Accumulated Other Comprehensive Income by Component

Changes in Accumulated Other Comprehensive Income (Loss) by component between December 31, 2013 and September 30, 2014 are presented in the table below, net of tax:



	Gains and (Losses) on Cash Flow Hedges			Defined Benefit Pension Items			Foreign Currency Items			Total
	(In thousands)
Beginning balance	$	(1,390	)	$	(2,287	)	$	4,604		$	927
Other comprehensive income (loss) before reclassifications	(102		)	52			(15,952		)	(16,002		)
Amounts reclassified from accumulated other comprehensive income	757			—			—			757
Net current-period other comprehensive income (loss)	655			52			(15,952		)	(15,245		)
Ending balance	$	(735	)	$	(2,235	)	$	(11,348	)	$	(14,318	)

Reclassification out of Accumulated Other Comprehensive Income (Loss)

The reclassification adjustments out of Accumulated Other Comprehensive Income (Loss) during the three and nine months ended September 30, 2014 were as follows:



Three Months Ended September 30, 2014
Details about Accumulated Other Comprehensive Income (Loss) Components	Amount Reclassified from Accumulated Other Comprehensive Income (Loss)			Affected Line Item in the Statement where Net Income (Loss) is Presented
	(In thousands)
Gains and losses on cash flow hedges
Interest rate swap	$	(433	)	Interest (expense)
	192			Tax (expense) or benefit
	$	(241	)	Net of tax


Nine Months Ended September 30, 2014
Details about Accumulated Other Comprehensive Income (Loss) Components	Amount Reclassified from Accumulated Other Comprehensive Income (Loss)			Affected Line Item in the Statement where Net Income (Loss) is Presented
	(In thousands)
Gains and losses on cash flow hedges
Interest rate swap	$	(1,328	)	Interest (expense)
	571			Tax (expense) or benefit
	$	(757	)	Net of tax

SEGMENT AND GEOGRAPHIC INFORMATION (Tables)

9 Months Ended

Sep. 30, 2014

Segment Reporting [Abstract]

Total Revenue By Major Geographic Area

Net sales and profit by reportable segment for the three and nine months ended September 30, 2014 and 2013 are as follows:



	Three Months Ended September 30,						Nine Months Ended September 30,
	2014			2013			2014			2013
	(In thousands)
				(As adjusted)*						(As adjusted)*
Segment Net Sales
U.S. Neurosurgery	$	62,323		$	45,114		$	177,265		$	125,877
U.S. Instruments	39,853			43,004			116,078			121,900
U.S. Extremities	36,746			31,831			103,083			93,802
U.S. Spine and Other	42,015			47,408			128,168			134,889
International	48,782			45,889			151,535			138,977
Total revenues	$	229,719		$	213,246		$	676,129		$	615,445
Segment Profit
U.S. Neurosurgery	$	35,889		$	23,080		$	94,247		$	59,770
U.S. Instruments	12,416			13,713			34,728			35,963
U.S. Extremities	14,983			13,117			40,907			34,613
U.S. Spine and Other	13,108			(31,043		)	39,801			(4,844		)
International	15,170			14,693			49,549			41,697
Segment profit	91,566			33,560			259,232			167,199
Amortization	(2,995		)	(3,036)			(9,013)			(9,660)
Corporate and other	(70,844		)	(61,665		)	(211,362		)	(185,314		)
Operating income (loss)	$	17,727		$	(31,141	)	$	38,857		$	(27,775	)

* See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

Certain 2013 segment revenues and the related impact on segment profit above have been reclassified in order to conform with the current year's presentation.

Revenue by major product category consisted of the following:



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
	(In thousands)
Orthopedics	$	91,650	$	92,125	$	271,958	$	271,862
Neurosurgery	92,089		72,639		269,717		204,283
Instruments	45,980		48,482		134,454		139,300
Total Revenues	$	229,719	$	213,246	$	676,129	$	615,445



	Three Months Ended September 30,				Nine Months Ended September 30,
	2014		2013		2014		2013
	(In thousands)
United States	$	180,101	$	166,555	$	522,288	$	473,740
Europe	23,850		21,543		75,026		68,936
Rest of World	25,768		25,148		78,815		72,769
Total Revenues	$	229,719	$	213,246	$	676,129	$	615,445

New Accounting Pronouncements or Change in Accounting Principle [Line Items]

Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss.

+ References+ Details

BASIS OF PRESENTATION - Schedule of New Accounting Pronouncements and Changes in Accounting Principles (Details) (USD $)
In Thousands, except Per Share data, unless otherwise specified

3 Months Ended

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Dec. 31, 2013

$ 85,974

$ 81,767

^[1]

$ 255,333

$ 243,208

^[1]

109,896

99,794

^[1]

333,487

306,037

^[1]

1,736

(6,352)

^[1]

5,866

(9,172)

^[1]

Earnings Per Share, Basic

9,807

(30,330)

^[1]

16,838

(34,838)

^[1]

$ 0.30

$ (1.09)

^[1]

$ 0.52

$ (1.25)

^[1]

Earnings Per Share, Diluted

$ 0.30

$ (1.09)

^[1]

$ 0.51

$ (1.25)

^[1]

(6,364)

(21,640)

^[1]

1,593

(30,754)

^[1]

230,455

206,919

^[1]

44,276

48,616

^[1]

26,886

26,858

^[1]

Increase (Decrease) in Inventories

297,794

280,956

^[1]

(26,648)

(28,765)

^[1]

Increase (Decrease) in Prepaid Expense and Other Assets

6,628

(694)

^[1]

Scenario, Previously Reported [Member]

New Accounting Pronouncements or Change in Accounting Principle [Line Items]

84,101

247,437

95,933

295,713

(6,605)

(8,755)

Earnings Per Share, Basic

(28,550)

(29,160)

$ (1.02)

$ (1.05)

Earnings Per Share, Diluted

$ (1.02)

$ (1.05)

(19,860)

(25,076)

213,431

46,300

26,752

Increase (Decrease) in Inventories

285,046

(34,855)

Increase (Decrease) in Prepaid Expense and Other Assets

(282)

Restatement Adjustment [Member]

New Accounting Pronouncements or Change in Accounting Principle [Line Items]

(2,334)

(4,229)

3,861

10,324

253

(417)

(1,780)

(5,678)

(1,780)

(5,678)

(6,512)

2,316

106

Increase (Decrease) in Inventories

(4,090)

6,090

Increase (Decrease) in Prepaid Expense and Other Assets

$ (412)

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

BUSINESS ACQUISITIONS - Narrative (Details) (USD $)

9 Months Ended

0 Months Ended

3 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Jan. 15, 2014

Confluent Surgical, Inc.

Sep. 30, 2014

Confluent Surgical, Inc.

Jan. 15, 2014

Confluent Surgical, Inc.

Potential Cash Consideration Fair Value

Jan. 15, 2014

Confluent Surgical, Inc.

Cash Consideration Two

Jun. 30, 2014

Deferred Tax Liability [Member]

Confluent Surgical, Inc.

Business combination, consideration transferred

$ 255,895,000

Payments to Acquire Businesses, Payment for Business Interest

231,000,000

Payments to Acquire Businesses, Payments for Transitional Supply Agreement

4,000,000

Contingent consideration from Confluent Surgical acquisition

20,900,000

Business acquisition, additional cash consideration payable upon completion of milestones

30,000,000

25,000,000

5,000,000

Goodwill, Purchase Accounting Adjustments

12,386,000

Impairment of intangible assets

600,000

46,738,000

^[1]

600,000

Fair value inputs, discount rate

2.20%

Fair Value Input, Probability of Event

95.00%

Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, Incremental Increase in Liability

300,000

Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, Incremental Decrease in Liability

$ 400,000

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

BUSINESS ACQUISITIONS - Schedule of Purchase Price Allocation (Details) (USD $)
In Thousands, unless otherwise specified

9 Months Ended

Sep. 30, 2014

Dec. 31, 2013

Jan. 15, 2014

Confluent Surgical, Inc.

Sep. 30, 2014

Confluent Surgical, Inc.

Developed Technology Rights

Jan. 15, 2014

Confluent Surgical, Inc.

Developed Technology Rights

Jan. 15, 2014

Confluent Surgical, Inc.

Other Intangible Assets

Sep. 30, 2014

Confluent Surgical, Inc.

Other Intangible Assets

Maximum

Deferred tax assets - long term

Inventory deposit

$ 4,000

Fixed assets

438

Finite Intangible Assets

239,800

400

Goodwill

349,574

249,764

^[1]

105,331

Total assets acquired

349,981

Contingent supply liability

5,891

Other

731

Deferred tax liabilities - long term

87,464

Net assets acquired

$ 255,895

Weighted average useful life

20 years

1 year

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

BUSINESS ACQUISITIONS - Schedule of Contingent Consideration (Details) (USD $)
In Thousands, unless otherwise specified

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Level 3

Potential Cash Consideration Fair Value

Jan. 15, 2014

Level 3

Potential Cash Consideration Fair Value

Dec. 31, 2013

Level 3

Potential Cash Consideration Fair Value

Sep. 30, 2014

Level 3

Selling, General and Administrative Expenses

Potential Cash Consideration Fair Value

Business Acquisition, Contingent Consideration [Roll Forward]

Balance as of January 1, 2014

$ 21,244

$ 1,227

Contingent consideration from Confluent Surgical acquisition

20,895

Loss/(gain) from increase/(decrease) in fair value of contingent consideration liabilities

(878)

^[1]

(878)

Fair value at September 30, 2014

$ 21,244

$ 1,227

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

BUSINESS ACQUISITIONS - Pro Forma Information (Details) (USD $)
In Thousands, unless otherwise specified

3 Months Ended

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Total revenue, net

$ 229,719

$ 213,246

^[1]

$ 676,129

$ 615,445

^[1]

9,807

(30,330)

^[1]

16,838

(34,838)

^[1]

Confluent Surgical, Inc.

Total revenue, net

229,645

664,642

$ (28,324)

$ (30,356)

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 04

-Paragraph 20

-Article 9

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 230

-SubTopic 10

-Section 45

-Paragraph 28

-URI http://asc.fasb.org/extlink&oid=31042434&loc=d3e3602-108585

Reference 3: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Other Comprehensive Income

-URI http://asc.fasb.org/extlink&oid=6519514

Reference 4: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Net Income

-URI http://asc.fasb.org/extlink&oid=6518256

Reference 5: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 260

-SubTopic 10

-Section 50

-Paragraph 1

-URI http://asc.fasb.org/extlink&oid=6371337&loc=d3e3550-109257

Reference 6: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 944

-SubTopic 225

-Section S99

-Paragraph 1

-Subparagraph (SX 210.7-04.19)

-URI http://asc.fasb.org/extlink&oid=6879464&loc=d3e573970-122913

Reference 7: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 225

-SubTopic 10

-Section S99

-Paragraph 2

-Subparagraph (SX 210.5-03.18)

-URI http://asc.fasb.org/extlink&oid=26872669&loc=d3e20235-122688

Reference 8: http://www.xbrl.org/2003/role/presentationRef

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-Name Accounting Standards Codification

-Topic 944

-SubTopic 225

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-Paragraph 1

-Subparagraph (SX 210.7-04.22)

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Reference 9: http://www.xbrl.org/2003/role/presentationRef

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-Name Accounting Standards Codification

-Topic 220

-SubTopic 10

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-Paragraph 6

-URI http://asc.fasb.org/extlink&oid=28358780&loc=d3e565-108580

Reference 10: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 03

-Paragraph 19

-Article 5

+ Details

INVENTORIES (Inventory, Net) (Details) (USD $)
In Thousands, unless otherwise specified

Sep. 30, 2014

Dec. 31, 2013

Inventory, Net [Abstract]

Finished goods

$ 142,342

$ 123,786

^[1]

Work-in process

50,864

47,403

^[1]

Raw materials

37,249

35,730

^[1]

$ 230,455

$ 206,919

^[1]

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

Carrying amount, net of reserves and adjustments, as of the balance sheet date of merchandise or goods which are partially completed. This inventory is generally comprised of raw materials, labor and factory overhead costs, which require further materials, labor and overhead to be converted into finished goods, and which generally require the use of estimates to determine percentage complete and pricing.

+ References+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS - Narrative (Details) (USD $)

9 Months Ended

3 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Confluent Surgical, Inc.

Impairment of intangible assets

$ 600,000

$ 46,738,000

^[1]

$ 600,000

Annual amortization expense expected to approximate in 2014

31,200,000

Annual amortization expense expected to approximate in 2015

28,700,000

Annual amortization expense expected to approximate in 2016

26,600,000

Annual amortization expense expected to approximate in 2017

24,500,000

Annual amortization expense expected to approximate in 2018

$ 24,100,000

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

GOODWILL AND OTHER INTANGIBLE ASSETS - Schedule of Changes in Carrying Amount of Goodwill (Details) (USD $)
In Thousands, unless otherwise specified

9 Months Ended

Sep. 30, 2014

Dec. 31, 2013

$ 296,502

(46,738)

249,764

^[1]

105,331

(5,521)

349,574

U.S. Neurosurgery

95,165

95,165

95,373

(2,966)

187,572

U.S. Instruments

58,033

58,033

(901)

57,132

U.S. Extremities

61,079

61,079

(948)

60,131

U.S. Spine And Other [Member]

56,325

(46,738)

9,587

(149)

9,438

International

25,900

25,900

9,958

(557)

Acquired Finite-Lived Intangible Assets [Line Items]

$ 35,301

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

GOODWILL AND OTHER INTANGIBLE ASSETS - Components of Company's Identifiable Intangible Assets (Details) (USD $)
In Thousands, unless otherwise specified

9 Months Ended

12 Months Ended

Sep. 30, 2014

Dec. 31, 2013

$ 587,069

$ 349,024

(173,163)

(151,861)

Acquired Finite-Lived Intangible Assets [Line Items]

413,906

197,163

Completed technology

18 years

12 years

320,270

81,238

(58,458)

(45,343)

Acquired Finite-Lived Intangible Assets [Line Items]

261,812

35,895

Customer relationships

12 years

145,658

146,627

(85,762)

(79,624)

Acquired Finite-Lived Intangible Assets [Line Items]

59,896

67,003

Trademarks/brand names

31 years

33,316

33,703

(15,766)

(15,648)

Acquired Finite-Lived Intangible Assets [Line Items]

17,550

18,055

Trademarks/brand names indefinite

48,484

Acquired Finite-Lived Intangible Assets [Line Items]

48,484

Supplier relationships

27 years

34,721

(10,452)

(9,305)

Acquired Finite-Lived Intangible Assets [Line Items]

24,269

25,416

All other

4 years

^[1]

5 years

^[1]

4,620

^[1]

4,251

^[1]

(2,725)

^[1]

(1,941)

^[1]

Acquired Finite-Lived Intangible Assets [Line Items]

1,895

^[1]

2,310

^[1]

In Process Research and Development [Member]

Other Indefinite-lived Intangible Assets

$ 1,389

$ 1,419

[1]	At September 30, 2014 and December 31, 2013, all other included in-process research and development ("IPR&D") of $1.4 million in both periods, which was indefinite-lived.

DEBT -Narrative (Details) (USD $)

0 Months Ended

Sep. 30, 2014

Dec. 31, 2013

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Minimum

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Maximum

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Maximum

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Standby Letters of Credit [Member]

Maximum

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Revolving Credit Facility

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Revolving Credit Facility

Maximum

Jul. 02, 2014

July Two Thousand Fourteen Amendment [Member]

Swingline Loan [Member]

Maximum

Sep. 30, 2014

Term Loan [Member]

Jul. 02, 2014

June Two Thousand Eleven Amendment [Member]

Revolving Credit Facility

Maximum

Sep. 30, 2014

Revolving Credit Facility

Dec. 31, 2013

Revolving Credit Facility

Jun. 15, 2011

2016 Convertible Senior Notes

Sep. 30, 2014

2016 Convertible Senior Notes

Dec. 31, 2013

2016 Convertible Senior Notes

Jul. 02, 2014

Term Loan [Member]

July Two Thousand Fourteen Amendment [Member]

Jul. 02, 2014

Term Loan [Member]

July Two Thousand Fourteen Amendment [Member]

Maximum

Jul. 02, 2014

Federal Funds [Member]

July Two Thousand Fourteen Amendment [Member]

Jul. 02, 2014

London Interbank Offered Rate (LIBOR) [Member]

July Two Thousand Fourteen Amendment [Member]

Jul. 02, 2014

Eurodollar [Member]

July Two Thousand Fourteen Amendment [Member]

Minimum

Jul. 02, 2014

Eurodollar [Member]

July Two Thousand Fourteen Amendment [Member]

Maximum

Debt Instrument [Line Items]

Senior credit facility, maximum borrowing capacity

$ 900,000,000

$ 60,000,000

$ 750,000,000

$ 60,000,000

$ 600,000,000

$ 150,000,000

Additional commitments

200,000,000

Interest rates available to the Company at its option

0.50%

1.00%

1.75%

Cash balance threshold above which excess amount is not subject to any restriction of use or investment

40,000,000

Line of credit, commitment fee percentage

0.15%

0.30%

Proceeds from Lines of Credit

422,000,000

272,000,000

150,000,000

Line of credit facility outstanding

261,900,000

186,900,000

Weighted average interest rate on debt

1.70%

2.00%

Available borrowings under senior secured revolving credit facility

488,100,000

term loan, amount outstanding

150,000,000

Line of Credit Facility, Fair Value of Amount Outstanding

241,400,000

Long-term Debt, Fair Value

139,058,000

Fair value of outstanding borrowings

247,700,000

Principal amount outstanding

230,000,000

Interest rate on debt

1.625%

Portion of the debt proceeds that was classified as equity at the time of the offering

43,200,000

Effective interest rate implicit in the liability component

5.60%

Carrying amount of liability

211,095,000

205,182,000

^[1]

211,100,000

205,200,000

Unamortized discount

18,900,000

24,800,000

Common stock based on initial conversion rate ratio (in shares)

17.4092

Principal amount to be considered for conversion purpose

1,000

Initial conversion price, per share

$ 57.44

Maximum selling price of company's common stock

150.00%

Principal amount of notes per average trading price

$ 1,000

Maximum average conversion value of the Notes

98.00%

Earliest conversion date

June 15, 2016

Strike price of the call transaction (in dollars per share)

$ 57.44

Strike price of warrant transactions (in dollars per share)

$ 70.05

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

DEBT -5 year payout table (Details) (Term Loan [Member], USD $) In Thousands, unless otherwise specified	Sep. 30, 2014
Term Loan [Member]
Term loan maturities [Line Items]
Long-term Debt, Maturities, Repayments of Principal in 2015	$ 3,750
Long-term Debt, Maturities, Repayments of Principal in 2016	9,375
Long-term Debt, Maturities, Repayments of Principal in 2017	13,125
Long-term Debt, Maturities, Repayments of Principal in 2018	15,000
Long-term Debt, Maturities, Repayments of Principal in 2019	108,750
Secured Debt	$ 150,000

DEBT - Components of Interest Expense (Detail) (2016 Convertible Senior Notes, USD $) In Thousands, unless otherwise specified	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
2016 Convertible Senior Notes
Debt Instrument [Line Items]
Amortization of the discount on the liability component	$ 1,822	$ 1,633	$ 5,256	$ 4,865
Cash interest related to the contractual interest coupon	853	807	2,491	2,438
Total	$ 2,675	$ 2,440	$ 7,747	$ 7,303

DERIVATIVE INSTRUMENTS - Narrative (Detail) (USD $) In Millions, unless otherwise specified	9 Months Ended
	Sep. 30, 2014
Derivative [Line Items]
Interest rate swap expiration date	August 10, 2015
Interest Rate Swap [member]
Derivative [Line Items]
Pretax losses expected to be reclassified from AOCI in next 12 months	$ 1.3

DERIVATIVE INSTRUMENTS - Summary of Fair Value in Balance Sheet for Derivatives Designated Hedging Instruments (Detail) (USD $)

9 Months Ended

Sep. 30, 2014

Dec. 31, 2013

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Fair value of derivative liabilities

$ 1,289,000

^[1]

$ 2,439,000

^[1]

Interest Rate Swap [member]

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Notional amount derivative instruments

101,300,000

112,500,000

Reduction In Notional Amount Of Interest Rate Derivatives In Next Twelve Months

101,300,000

Interest Rate Swap [member] | Accrued expenses and other current liabilities

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Fair value of derivative liabilities

1,289,000

^[1],[2]

1,676,000

^[1],[2]

Interest Rate Swap [member] | Other liabilities

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Fair value of derivative liabilities

$ 0

^[1],[2]

$ 763,000

^[1],[2]

[1]	The Company classifies derivative assets and liabilities as current based on the cash flows expected to be incurred within the following 12 months.
[2]	At September 30, 2014 and December 31, 2013, the notional amount related to the Company’s sole interest rate swap was $101.3 million and $112.5 million, respectively. In the next twelve months, the Company expects to reduce the notional amount by the entire $101.3 million.

DERIVATIVE INSTRUMENTS - Effect of Derivative Instruments Designated Cash Flow Hedges on Statements of Operations (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended		9 Months Ended
	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Derivative Instruments, Gain (Loss) [Line Items]
Balance in AOCI Beginning of Period		$ (2,868)		$ (4,159)
Amount of Gain (Loss) Recognized in AOCI- Effective Portion		(277)		(17)
Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion		(373)		(1,404)
Balance in AOCI End of Period		(2,772)		(2,772)
Cost of goods sold [Member] \| Foreign Currency Forward Contracts
Derivative Instruments, Gain (Loss) [Line Items]
Balance in AOCI Beginning of Period		162		(34)
Amount of Gain (Loss) Recognized in AOCI- Effective Portion		(19)		142
Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion		110		75
Balance in AOCI End of Period		33		33
Interest Expense [Member] \| Interest Rate Swap [member]
Derivative Instruments, Gain (Loss) [Line Items]
Balance in AOCI Beginning of Period	(1,713)	(3,030)	(2,439)	(4,125)
Amount of Gain (Loss) Recognized in AOCI- Effective Portion	(9)	(258)	(179)	(159)
Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion	(433)	(483)	(1,329)	(1,479)
Balance in AOCI End of Period	$ (1,289)	$ (2,805)	$ (1,289)	$ (2,805)

STOCK-BASED COMPENSATION - Narrative (Detail) (USD $) In Millions, except Share data, unless otherwise specified	3 Months Ended	9 Months Ended
	Jun. 30, 2014	Sep. 30, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Net of Forfeitures		80,991
Requisite service periods of awards, in years		3 years
Share-based Compensation Arrangement by Share-based Payment Award Accelerated Compensation Cost	$ 3.0
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options exercisable, vesting period, in years		4 years
Total unrecognized compensation costs		1.7
Weighted-average period for cost recognition, in years		2 years
Restricted stock awards/stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options exercisable, vesting period, in years		3 years
Total unrecognized compensation costs		$ 14.7
Weighted-average period for cost recognition, in years		2 years
Awards granted during period		255,407
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period		90,025
Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration Period, in years		6 years
Directors and Certain Executive Officers \| Minimum \| Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration Period, in years		6 years
Directors and Certain Executive Officers \| Maximum \| Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration Period, in years		10 years

TREASURY STOCK (Additional Information) (Detail) (USD $)	9 Months Ended	0 Months Ended
	Sep. 30, 2014	Oct. 23, 2012 October 2012 Authorization
Accelerated Share Repurchases [Line Items]
Stock repurchase program, authorized amount		$ 75,000,000
Amount available for share repurchase under this latest authorization	$ 75,000,000

INCOME TAXES - Narrative (Details) (USD $)	3 Months Ended		9 Months Ended
INCOME TAXES - Narrative (Details) (USD $)	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Income Tax [Line Items]
Effective Income Tax Rate Reconciliation, Tax Credit, Amount			$ 900,000
Reported tax rate	15.00%	17.30%	25.80%	20.80%
Unrecognized Tax Benefits, Reduction Resulting from Lapse of Applicable Statute of Limitations	1,600,000	2,300,000	2,000,000	3,500,000
Income tax reconciliation, settlements with tax authority	500,000		1,200,000
Effective Income Tax Rate Reconciliation, Tax Settlement, Foreign, Amount			400,000
Minimum
Income Tax [Line Items]
Effective tax rate estimate			23.00%
Maximum
Income Tax [Line Items]
Effective tax rate estimate			24.00%
Foreign Tax Authority [Member]
Income Tax [Line Items]
Effective Income Tax Rate Reconciliation, Tax Credit, Research, Amount				500,000
Current State and Local Tax Expense (Benefit)	300,000
State and Local Jurisdiction [Member]
Income Tax [Line Items]
Current State and Local Tax Expense (Benefit)			$ 300,000

Amount of current state and local tax expense (benefit) pertaining to income (loss) from continuing operations.

+ References+ Details

INCOME TAXES - Summary of Effective Tax Rate (Detail)	3 Months Ended		9 Months Ended
INCOME TAXES - Summary of Effective Tax Rate (Detail)	Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Income Tax Disclosure [Abstract]
Reported tax rate	15.00%	17.30%	25.80%	20.80%

NET INCOME PER SHARE - Narrative (Detail) In Millions, unless otherwise specified			3 Months Ended	9 Months Ended
	Sep. 30, 2014	Jun. 30, 2013	Sep. 30, 2014 Stock Compensation Plan	Sep. 30, 2014 Stock Compensation Plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Stock options, shares outstanding (in shares)	1.4	1.7
Shares excluded from computation as their effect would be anti-dilutive			0.2	0.2

Securities (including those issuable pursuant to contingent stock agreements) that could potentially dilute basic earnings per share (EPS) or earnings per unit (EPU) in the future that were not included in the computation of diluted EPS or EPU because to do so would increase EPS or EPU amounts or decrease loss per share or unit amounts for the period presented.

+ References+ Details

NET INCOME PER SHARE - Basic and Diluted Net Income Per Share (Detail) (USD $)
In Thousands, except Per Share data, unless otherwise specified

3 Months Ended

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Basic net income per share:

Weighted average common shares outstanding (in shares)

$ 9,807

$ (30,330)

^[1]

$ 16,838

$ (34,838)

^[1]

32,450

27,896

^[1]

32,374

27,855

^[1]

Basic net income per common share (in dollars per share)

$ 0.30

$ (1.09)

^[1]

$ 0.52

$ (1.25)

^[1]

Diluted net income per share:

Weighted average common shares outstanding (in shares)

$ 9,807

$ (30,330)

^[1]

$ 16,838

$ (34,838)

^[1]

32,450

27,896

^[1]

32,374

27,855

^[1]

Effect of dilutive securities:

Stock options and restricted stock (in shares)

456

470

Weighted average common shares for diluted earnings per share (in shares)

32,906

27,896

^[1]

32,844

27,855

^[1]

Diluted net income per common share (in dollars per share)

$ 0.30

$ (1.09)

^[1]

$ 0.51

$ (1.25)

^[1]

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References+ Details

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References+ Details

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ Details

COMPREHENSIVE (LOSS) INCOME - Schedule of Comprehensive Loss Income (Detail) (USD $)
In Thousands, unless otherwise specified

3 Months Ended

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Equity [Abstract]

Foreign currency translation adjustment

$ 9,807

$ (30,330)

^[1]

$ 16,838

$ (34,838)

^[1]

(16,537)

8,711

(15,952)

3,288

Change in unrealized gain on derivatives, net of tax

241

655

794

Pension liability adjustment, net of tax

125

(68)

Comprehensive income (loss)

$ (6,364)

$ (21,640)

^[1]

$ 1,593

$ (30,754)

^[1]

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ Details

Amount after tax, before reclassification adjustments of gain (loss) on foreign currency translation adjustments, foreign currency transactions designated and effective as economic hedges of a net investment in a foreign entity and intra-entity foreign currency transactions that are of a long-term-investment nature.

+ References+ Details

Accumulated Other Comprehensive Income (Loss) [Line Items]

Amount after tax of increase (decrease) in accumulated gain (loss) from derivative instruments designated and qualifying as the effective portion of cash flow hedges and an entity's share of an equity investee's increase (decrease) in deferred hedging gain (loss).

+ References+ Details

COMPREHENSIVE (LOSS) INCOME (Schedule of Changes in Accumulated Other Comprehensive Income by Component (Details) (USD $)
In Thousands, unless otherwise specified

3 Months Ended

9 Months Ended

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Jun. 30, 2013

Dec. 31, 2012

Accumulated Other Comprehensive Income Loss Cumulative Changes In Net Gain Loss From Cash Flow Hedge Effect Before Tax

$ (2,772)

$ (2,868)

$ (4,159)

Accumulated Other Comprehensive Income (Loss) [Roll Forward]

Other comprehensive income (loss) before reclassifications

927

^[1]

(16,002)

Amounts reclassified from accumulated other comprehensive income

757

Net current-period other comprehensive income (loss)

(15,245)

Derivative Instruments, Gain (Loss) Recognized in Other Comprehensive Income (Loss), Effective Portion, Net

(14,318)

(277)

(17)

Derivative Instruments, Gain (Loss) Reclassified from Accumulated OCI into Income, Effective Portion, Net

(373)

(1,404)

Gains and Losses on Cash Flow Hedges

Accumulated Other Comprehensive Income (Loss) [Roll Forward]

Other comprehensive income (loss) before reclassifications

(1,390)

(102)

Amounts reclassified from accumulated other comprehensive income

757

Net current-period other comprehensive income (loss)

655

Accumulated Other Comprehensive Income (Loss) [Roll Forward]

(735)

Defined Benefit Pension Items

Other comprehensive income (loss) before reclassifications

(2,287)

Amounts reclassified from accumulated other comprehensive income

Net current-period other comprehensive income (loss)

Accumulated Other Comprehensive Income (Loss) [Roll Forward]

(2,235)

Foreign Currency Items

Other comprehensive income (loss) before reclassifications

4,604

(15,952)

Amounts reclassified from accumulated other comprehensive income

Net current-period other comprehensive income (loss)

(15,952)

$ (11,348)

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]

Accumulated change in equity from transactions and other events and circumstances from non-owner sources, net of tax effect, at period end. Excludes Net Income (Loss), and accumulated changes in equity from transactions resulting from investments by owners and distributions to owners. Includes foreign currency translation items, certain pension adjustments, unrealized gains and losses on certain investments in debt and equity securities, other than temporary impairment (OTTI) losses related to factors other than credit losses on available-for-sale and held-to-maturity debt securities that an entity does not intend to sell and it is not more likely than not that the entity will be required to sell before recovery of the amortized cost basis, as well as changes in the fair value of derivatives related to the effective portion of a designated cash flow hedge.

+ References+ Details

COMPREHENSIVE (LOSS) INCOME (Reclassification Adjustment from AOCI) (Details) (USD $)
In Thousands, unless otherwise specified

3 Months Ended

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

Interest (expense)

$ (5,916)

$ (5,316)

^[1]

$ (16,440)

$ (15,081)

^[1]

Tax (expense) or benefit

(1,736)

6,352

^[1]

(5,866)

9,172

^[1]

Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]

9,807

(30,330)

^[1]

16,838

(34,838)

^[1]

Reclassification out of Accumulated Other Comprehensive Income | Gains and Losses on Cash Flow Hedges

Tax (expense) or benefit

192

571

Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]

(241)

(757)

Reclassification out of Accumulated Other Comprehensive Income | Gains and Losses on Cash Flow Hedges | Interest Rate Swap [member]

Interest (expense)

$ (433)

$ (1,328)

[1]	See Note 1 of these condensed consolidated financial statements for discussion of the impact of the change in accounting for the medical device excise tax.

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ Details

SEGMENT AND GEOGRAPHIC INFORMATION - Net Sales and Profit by Reportable Segment (Detail) (USD $)
In Thousands, unless otherwise specified

3 Months Ended

9 Months Ended

Sep. 30, 2014

Sep. 30, 2013

Sep. 30, 2014

Sep. 30, 2013

$ 229,719

$ 213,246

$ 676,129

$ 615,445

Intangible asset amortization

17,727

(31,141)

^[1]

38,857

(27,775)

^[1]

(2,995)

(3,036)

^[1]

(9,013)

(9,660)

^[1]

Operating Segments

91,566

33,560

259,232

167,199

Operating Segments | U.S. Neurosurgery

62,323

45,114

177,265

125,877

35,889

23,080

94,247

59,770

Operating Segments | U.S. Instruments

39,853

43,004

116,078

121,900

12,416

13,713

34,728

35,963

Operating Segments | U.S. Extremities

36,746

31,831

103,083

93,802

14,983

13,117

40,907

34,613

Operating Segments | U.S. Spine And Other [Member]

42,015

47,408

128,168

134,889

13,108

(31,043)

39,801

(4,844)

Operating Segments | International

48,782

45,889

151,535

138,977

15,170

14,693

49,549

41,697

Corporate, Non-Segment