Document and Entity Information - USD ($) $ in Millions	12 Months Ended
Document and Entity Information - USD ($) $ in Millions	Dec. 31, 2017	Feb. 27, 2018	Jun. 30, 2017
Document and Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2017
Document Fiscal Year Focus	2017
Document Fiscal Period Focus	FY
Trading Symbol	iart
Entity Registrant Name	INTEGRA LIFESCIENCES HOLDINGS CORP
Entity Central Index Key	0000917520
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Public Float			$ 3,415.7
Entity Common Stock, Shares Outstanding (in shares)		78,494,242

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Statement [Abstract]
Total revenue, net	$ 1,188,236	$ 992,075	$ 882,734
Costs and Expenses:
Cost of goods sold	435,511	349,089	326,542
Research and development	63,455	58,155	50,895
Selling, general and administrative	624,096	455,629	415,757
Intangible asset amortization	20,370	13,862	9,953
Total costs and expenses	1,143,432	876,735	803,147
Operating income	44,804	115,340	79,587
Interest income	255	24	30
Interest expense	(35,019)	(25,803)	(23,534)
Other income, net	1,345	845	4,588
Income from continuing operations before income taxes	11,385	90,406	60,671
(Benefit from) provision for income taxes	(53,358)	15,842	53,820
Net income from continuing operations	64,743	74,564	6,851
Loss from discontinued operations (net of tax benefit)	0	0	(10,370)
Net income (loss)	$ 64,743	$ 74,564	$ (3,519)
Net income (loss) per share - basic:
Income from continuing operations (in dollars per share)	$ 0.84	$ 1.00	$ 0.10
Loss from discontinued operations (in dollars per share)	0.00	0.00	(0.15)
Net income (loss) per share - basic (in dollars per share)	0.84	1.00	(0.05)
Net income (loss) per share - diluted:
Income from continuing operations (in dollars per share)	0.82	0.94	0.10
Loss from discontinued operations (in dollars per share)	0.00	0.00	(0.15)
Net income (loss) per share - diluted (in dollars per share)	$ 0.82	$ 0.94	$ (0.05)
Weighted average common shares outstanding (See Note 12):
Basic (in shares)	76,897	74,386	68,990
Diluted (in shares)	79,121	79,194	71,354

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 64,743	$ 74,564	$ (3,519)
Other comprehensive income (loss), before tax:
Change in foreign currency translation adjustments	37,454	(10,278)	(25,841)
Unrealized gain (loss) on derivatives
Unrealized derivative (loss) gain arising during period	(3,425)	1,871	(25)
Less: Reclassification adjustments for losses included in net loss	2,958	0	(923)
Unrealized (loss) gain on derivatives	(6,383)	1,871	898
Defined benefit pension plan - net (loss) gain arising during period	(57)	(45)	904
Total other comprehensive income (loss), before tax	31,014	(8,452)	(24,039)
Income tax expense (benefit) related to items in other comprehensive loss	2,333	(800)	(375)
Total other comprehensive income (loss), net of tax	33,347	(9,252)	(24,414)
Comprehensive income (loss), net of tax	$ 98,090	$ 65,312	$ (27,933)

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Current Assets:
Cash and cash equivalents	$ 174,935	$ 102,055
Trade accounts receivable, net of allowances of $8,882 and $6,319	251,799	148,186
Inventories, net	296,332	217,263
Prepaid expenses and other current assets	99,080	27,666
Total current assets	822,146	495,170
Property, plant and equipment, net	269,251	222,369
Intangible assets, net	1,159,627	561,175
Goodwill	937,905	510,571
Deferred tax assets	6,250	6,935
Other assets	16,078	11,734
Total assets	3,211,257	1,807,954
Current Liabilities:
Borrowings under senior credit facility	60,000	0
Accounts payable, trade	93,967	29,057
Deferred revenue	11,051	6,812
Accrued compensation	73,392	52,762
Short-term portion of contingent consideration	22,793	0
Accrued expenses and other current liabilities	87,708	34,970
Total current liabilities	348,911	123,601
Long-term borrowings under senior credit facility	1,781,142	665,000
Deferred tax liabilities	65,130	148,941
Other liabilities	53,768	30,745
Total liabilities	2,248,951	968,287
Commitments and contingencies
Stockholders’ Equity:
Preferred Stock; no par value; 15,000 authorized shares; none outstanding	0	0
Common stock; $0.01 par value; 240,000 authorized shares; 81,306 and 77,666 issued at December 31, 2017 and 2016, respectively	813	777
Additional paid-in capital	821,758	798,652
Treasury stock, at cost; 2,912 and 2,946 shares at December 31, 2017 and 2016, respectively	(121,644)	(123,051)
Accumulated other comprehensive loss	(23,807)	(57,154)
Retained earnings	285,186	220,443
Total stockholders’ equity	962,306	839,667
Total liabilities and stockholders’ equity	$ 3,211,257	$ 1,807,954

CONSOLIDATED BALANCE SHEETS (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Trade accounts receivable, allowances	$ 8,882	$ 6,319
Preferred Stock, par value (in dollars per share)
Preferred Stock, authorized shares (in shares)	15,000,000	15,000,000
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)	240,000,000	240,000,000
Common stock, shares issued (in shares)	81,306,000	77,666,000
Treasury stock, shares (in shares)	2,912,000	2,946,000

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
OPERATING ACTIVITIES:
Net income (loss)	$ 64,743	$ 74,564	$ (3,519)
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Loss from discontinued operations, net of tax	0	0	10,370
Depreciation and amortization	88,945	72,665	58,863
Non-cash impairment charges	3,290	0	380
Deferred income tax benefit	(67,304)	(6,474)	(351)
Non-cash valuation allowance	0	0	37,210
Share-based compensation	21,550	17,310	15,450
Amortization of debt issuance costs	2,722	2,529	2,264
Non-cash interest expense	0	8,074	7,911
Realized loss on sale of sale of short-term investment	2,287	0	0
Loss on disposal of property and equipment	6,989	1,765	481
Gain on divestiture of business	(2,645)	0	0
Change in fair value of contingent consideration and others	(4,710)	(13)	(177)
Gain on bargain purchase	0	0	(1,111)
Payment of accreted interest	0	(42,786)	(384)
Changes in assets and liabilities, net of business acquisitions:
Accounts receivable	(89,698)	(17,518)	(16,231)
Inventories	99	(9,576)	(3,759)
Prepaid expenses and other current assets	(33,808)	14,912	(233)
Other non-current assets	(914)	(475)	610
Accounts payable, accrued expenses and other current liabilities	95,321	(414)	8,208
Deferred revenue	3,874	1,251	136
Other non-current liabilities	23,803	591	945
Net cash provided by operating activities of continuing operations	114,544	116,405	117,063
Net cash used in operating activities of discontinued operations	0	0	(12,209)
Net cash provided by operating activities	114,544	116,405	104,854
INVESTING ACTIVITIES:
Change in restricted cash	0	4,165	(4,087)
Proceeds from sale of short-term investments	16,951	0	0
Proceeds from note receivable	483	0	0
Cash used in business acquisitions, net of cash acquired	(1,241,946)	225	(328,888)
Purchases of property and equipment	(43,503)	(47,328)	(33,413)
Proceeds from sales of property and equipment	293	316	1,438
Proceeds from divestiture of business	46,387	0	0
Net cash used in investing activities of continuing operations	(1,221,335)	(42,622)	(364,950)
Net cash used in investing activities of discontinued operations	0	0	(7,060)
Net cash used in investing activities	(1,221,335)	(42,622)	(372,010)
FINANCING ACTIVITIES:
Borrowings under senior credit facility	1,307,000	680,000	545,000
Repayments under senior credit facility	(117,000)	(511,250)	(465,625)
Net cash paid for contingent consideration	(4,661)	0	0
Proceeds from the issuance of common stock, net of issuance costs	0	0	219,669
Distribution to SeaSpine	0	0	(47,013)
Payment of liability component of convertible notes	0	(184,313)	(2,519)
Payment of capital lease obligation	0	(653)	(709)
Debt issuance costs	(19,043)	(4,530)	(1,426)
Proceeds from exercised stock options	9,774	10,481	7,345
Cash taxes paid in net equity settlement	(7,123)	(4,851)	(6,580)
Net cash provided by (used in) financing activities	1,168,947	(15,116)	248,142
Effect of exchange rate changes on cash and cash equivalents	10,724	(4,744)	(4,848)
Net increase (decrease) in cash and cash equivalents	72,880	53,923	(23,862)
Cash and cash equivalents at beginning of period	102,055	48,132	71,994
Cash and cash equivalents at end of period	$ 174,935	$ 102,055	$ 48,132

CONSOLIDATED STATEMENTS OF CHANGES IN STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Income (Loss)	Retained Earnings
Beginning Balance at Dec. 31, 2014	$ 704,322	$ 833	$ (367,121)	$ 779,138	$ (23,488)	$ 314,960
Beginning Balance, shares (in shares) at Dec. 31, 2014		83,288
Beginning Balance, Treasury Stock, shares (in shares) at Dec. 31, 2014			(17,814)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	(3,519)					(3,519)
Other comprehensive income (loss), net of tax	(24,414)
Separation of SeaSpine	(167,229)				(1,667)	(165,562)
Other comprehensive income (loss), net of tax and SeaSpine	(22,747)				(22,747)
Treasury Share purchases (in shares)			(16)
Issuance of common stock	219,680	$ 80		219,600
Issuance of common stock, shares (in shares)		8,006
Issuance of common stock through employee stock purchase plan	231			231
Issuance of common stock through employee stock purchase plan (in shares)		8
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes	5,255	$ 4		5,251
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes (in shares)		412
Share-based compensation	15,450			15,450
Ending Balance at Dec. 31, 2015	751,443	$ 917	$ (367,121)	1,019,670	(47,902)	145,879
Ending Balance, shares (in shares) at Dec. 31, 2015		91,714
Ending Balance, Treasury Stock, shares (in shares) at Dec. 31, 2015			(17,830)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	74,564					74,564
Other comprehensive income (loss), net of tax	(9,252)				(9,252)
Treasury shares retirement	0	$ (178)	$ 367,121	(366,943)
Treasury shares retirement (in shares)		(17,830)	(17,830)
Issuance of common stock through employee stock purchase plan	391	$ 1		390
Issuance of common stock through employee stock purchase plan (in shares)		12
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes	5,211	$ 8		5,203
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes (in shares)		824
Settlement of convertible notes		$ 29		(29)
Settlement of convertible notes (in shares)		2,946
Exercise of convertible note hedge			$ (123,051)	123,051
Exercise of convertible note hedge (in shares)			(2,946)
Share-based compensation	17,310			17,310
Ending Balance at Dec. 31, 2016	$ 839,667	$ 777	$ (123,051)	798,652	(57,154)	220,443
Ending Balance, shares (in shares) at Dec. 31, 2016		77,666
Ending Balance, Treasury Stock, shares (in shares) at Dec. 31, 2016	(2,946)		(2,946)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income (loss)	$ 64,743					64,743
Other comprehensive income (loss), net of tax	33,347				33,347
Issuance of common stock	1	$ 1
Issuance of common stock, shares (in shares)		135
Issuance of common stock through employee stock purchase plan	509	$ 0		509
Issuance of common stock through employee stock purchase plan (in shares)		12
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes	2,137	$ 7	$ 1,407	723
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes (in shares)		653	19
Exercise of warrants (in shares)		2,840
Exercise of warrants		$ 28		(28)
Share-based compensation	21,902			21,902
Ending Balance at Dec. 31, 2017	$ 962,306	$ 813	$ (121,644)	$ 821,758	$ (23,807)	$ 285,186
Ending Balance, shares (in shares) at Dec. 31, 2017		81,306
Ending Balance, Treasury Stock, shares (in shares) at Dec. 31, 2017	(2,912)		(2,927)

BUSINESS	12 Months Ended
BUSINESS	Dec. 31, 2017
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BUSINESS	BUSINESS Integra LifeSciences Holdings Corporation (the “Company”) was incorporated in Delaware in 1989. The Company, a world leader in medical devices, is dedicated to limiting uncertainty for surgeons through the development, manufacturing, and marketing of cost-effective surgical implants and medical instruments. Its products are used primarily in neurosurgery, extremity reconstruction, orthopedics and general surgery. The Company sells its products directly through various sales forces and through a variety of other distribution channels.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES

BASIS OF PRESENTATION

These financial statements and the accompanying notes are prepared in accordance with accounting principles generally accepted in the United States of America and conform to Regulation S-X under the Securities Exchange Act of 1934, as amended.

PRINCIPLES OF CONSOLIDATION

The consolidated financial statements include the accounts of the Company and its subsidiaries, all of which are wholly owned. All intercompany accounts and transactions are eliminated in consolidation. See Note 4, Acquisitions and Pro Forma Results, for details of new subsidiaries included in the consolidation.

On July 1, 2015, the Company completed the distribution of 100% of the outstanding common shares of SeaSpine Holdings Corporation ("SeaSpine") to Integra shareholders who received one share of SeaSpine common stock for every three shares, on a pre-split basis, of Integra common stock held as of the close of business on the record date, June 19, 2015. The Company has classified the results of operations, cash flows, and related assets and liabilities of SeaSpine as discontinued operations for all periods presented in the Company's consolidated financial statements. Unless indicated otherwise, the information in the Notes to the consolidated financial statements relates to the Company's continuing operations. Refer to Note 3, Discontinued Operations, for additional information regarding the distribution.

USE OF ESTIMATES

The preparation of consolidated financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the reported amounts 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 and in-process research and development ("IPR&D"), 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, 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, and valuation 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.

RECLASSIFICATIONS

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

CASH AND CASH EQUIVALENTS

The Company considers all short-term, highly liquid investments purchased with original maturities of three months or less to be cash equivalents. These investments are carried at cost, which approximates fair value.

TRADE ACCOUNTS RECEIVABLE AND ALLOWANCES FOR DOUBTFUL ACCOUNTS RECEIVABLE

Trade accounts receivable are recorded at the invoiced amount and do not bear interest. The Company grants credit to customers in the normal course of business, but generally does not require collateral or any other security to support its receivables.

The Company evaluates the collectability of accounts receivable based on a combination of factors. In circumstances where a specific customer is unable to meet its financial obligations to the Company, a provision to the allowances for doubtful accounts is recorded against amounts due to reduce the net recognized receivable to the amount that is reasonably expected to be collected. For all other customers, a provision to the allowances for doubtful accounts is recorded based on factors including the length of time the receivables are past due, the current business environment and the Company's historical experience. Provisions to the allowances for doubtful accounts are recorded to selling, general and administrative expenses. Account balances are charged off against the allowance when it is probable that the receivable will not be recovered. Provision for doubtful accounts, associated with accounts receivable, included in selling, general and administrative expense, were $2.0 million, $0.4 million, and $1.0 million for the years ended December 31, 2017, 2016 and 2015, respectively.

INVENTORIES

Inventories, consisting of purchased materials, direct labor and manufacturing overhead, are stated at the lower of cost, the value determined by the first-in, first-out method, or net realizable value. Inventories consisted of the following:



	December 31,
	2017		2016
	(In thousands)
Finished goods	$	190,100	$	127,973
Work in process	58,637		50,043
Raw materials	47,595		39,247
Total inventories, net	$	296,332	$	217,263

At each balance sheet date, the Company evaluates inventories for excess quantities, obsolescence or shelf life expiration. This evaluation includes analysis of historical sales levels by product, projections of future demand, the risk of technological or competitive obsolescence for products, general market conditions, a review of the shelf life expiration dates for products, as well as the feasibility of reworking or using excess or obsolete products or components in the production or assembly of other products that are not obsolete or for which there are not excess quantities in inventory. To the extent that management determines there are excess or obsolete inventory or quantities with a shelf life that is too near its expiration for the Company to reasonably expect that it can sell those products prior to their expiration, the Company adjusts the carrying value to estimated net realizable value.

The Company capitalizes inventory costs associated with certain products prior to regulatory approval, based on management's judgment of probable economic benefit. The Company could be required to expense previously capitalized costs related to pre-approval inventory upon a change in such judgment, due to, among other potential factors, a denial or delay of approval by necessary regulatory bodies or a decision by management to discontinue the related development program. No such amounts were capitalized at December 31, 2017 or 2016.

PROPERTY, PLANT AND EQUIPMENT

Property, plant and equipment are stated at historical cost less accumulated depreciation and any impairment charges. The Company provides for depreciation using the straight-line method over the estimated useful lives of the assets. Leasehold improvements are amortized over the lesser of the lease term or the useful life. The cost of major additions and improvements is capitalized, while maintenance and repair costs that do not improve or extend the lives of the respective assets are charged to operations as incurred. The cost of computer software developed or obtained for internal use is accounted for in accordance with the Accounting Standards Codification 350-40, Internal-Use Software.

Property, plant and equipment balances and corresponding lives were as follows:



	December 31,
	2017			2016			Useful Lives
	(In thousands)
Land	$	1,881		$	2,147
Buildings and building improvements	20,243			17,677			5-40 years
Leasehold improvements	90,329			82,432			1-20 years
Machinery and production equipment	137,914			103,818			3-20 years
Surgical instrument kits	30,511			19,871			4-5 years
Information systems and hardware	127,946			111,145			1-7 years
Furniture, fixtures, and office equipment	17,394			16,896			1-15 years
Construction-in-progress	62,967			59,222
Total	489,185			413,208
Less: Accumulated depreciation	(219,934		)	(190,839		)
Property, plant and equipment, net	$	269,251		$	222,369

Depreciation expense associated with property, plant and equipment was $36.1 million, $31.2 million, and $27.0 million for the years ended December 31, 2017, 2016 and 2015, respectively.

The Company leased certain computer equipment under capital lease agreements. The gross carrying value of such leases amounted to $2.0 million at December 31, 2016. The accumulated depreciation of such leases amounted to $2.0 million at December 31, 2016, and the cost is included as a component of furniture, fixtures, office equipment and information systems and hardware. There are no outstanding capital lease agreements as of December 31, 2017.

CAPITALIZED INTEREST

The interest cost on capital projects, including facilities build-out and internal use software, is capitalized and included in the cost of the project. Capitalization commences with the first expenditure for the project and continues until the project is substantially complete and ready for its intended use. When no debt is incurred specifically for a project, interest is capitalized on project expenditures using the weighted average cost of the Company's outstanding borrowings. For the years ended December 31, 2017 and 2016, respectively, the Company capitalized $1.1 million and $1.0 million of interest expense into property, plant and equipment.

ACQUISITIONS

Results of operations of acquired companies are included in the Company’s results of operations as of the respective acquisition dates. The purchase price of each acquisition is allocated to the net assets acquired based on estimates of their fair values at the date of the acquisition. Any purchase price in excess of these net assets is recorded as goodwill. The allocation of purchase price in certain cases may be subject to revision based on the final determination of fair values during the measurement period, which may be up to one year from the acquisition date.

Contingent consideration is recognized at the estimated fair value on the acquisition date. Subsequent changes to the fair value of contingent payments are recognized in selling, general and administrative expense in consolidated statements of operations. Contingent payments related to acquisitions consist of development, regulatory, and commercial milestone payments, in addition to sales-based payments, and are valued using discounted cash flow techniques. The fair value of development, regulatory, and commercial milestone payments reflects management’s expectations of probability of payment, and increases or decreases as the probability of payment or expectation of timing of payments changes. The fair value of sales-based payments is based upon probability-weighted future revenue estimates and increases or decreases as revenue estimates or expectation of timing of payments changes.

GOODWILL AND OTHER INTANGIBLE ASSETS

The excess of the cost over the fair value of net assets of acquired businesses is recorded as goodwill. Goodwill is not subject to amortization, but is reviewed for impairment at the reporting unit level annually, or more frequently if impairment indicators arise. The Company's assessment of the recoverability of goodwill is based upon a comparison of the carrying value of goodwill with its estimated fair value. 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 October 2017, as part of the Company's branding strategy, the Company adopted the Codman name by rebranding the Specialty Surgical Solutions segment to Codman Specialty Surgical. The change in name does not have an effect on our reportable segments or reporting units.

The Company has two reportable segments with three underlying reporting units: Instruments and Neurosurgery, under Codman Specialty Surgical and Orthopedics and Tissue Technologies. Refer to Note 13 - Segment and Geographic Information for more information on reportable segments.

The Company estimated the fair value of the three reporting units using a discounted cash flow model, 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 following:


•	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.

Given the excess of the Instruments, Neurosurgery and Orthopedics and Tissue Technologies estimated fair values over their carrying values after the reallocation of goodwill, no impairment was recognized.

The Company elected to early adopt ASU 2017-4, Simplifying the Test for Goodwill Impairment, effective January 1, 2017. The Company performed its annual goodwill impairment test as of July 31, 2017. In reviewing goodwill for impairment, the 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 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 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 quantitative impairment test.

The Company elected to perform a qualitative analysis for its three reporting units as of July 31, 2017. The Company determined, after performing qualitative analysis, that there was no evidence that it is more likely than not that the fair value of any identified reporting unit was less that the carrying amounts, therefore, it was not necessary to perform a quantitative impairment test.

Changes in the carrying amount of goodwill in 2017 and 2016 were as follows:



	Codman Specialty Surgical			Orthopedics and Tissue Technologies			Total
	(In thousands)
Goodwill at January 1, 2016	$	284,976		$	227,413		$	512,389
TEI acquisition working capital adjustment	—			(174		)	(174		)
Foreign currency translation and other	(618		)	(1,026		)	(1,644		)
Goodwill at December 31, 2016	$	284,358		$	226,213		$	510,571
Derma Sciences acquisition	—			73,765			73,765
TGX Medical acquisition	641			—			641
Codman acquisition	346,220			—			346,220
Divestment to Natus	(2,861		)	—			(2,861		)
Foreign currency translation and other	6,409			3,160			9,569
Goodwill at December 31, 2017	$	634,767		$	303,138		$	937,905

When the Company acquires a business, the assets acquired, including IPR&D, and liabilities assumed are recorded at their respective fair values as of the acquisition date. The Company's policy defines IPR&D as the fair value of those projects for which the related products have not received regulatory approval and have no alternative future use. Determining the fair value of intangible assets, including IPR&D, acquired as part of a business combination requires the Company to make significant estimates. These estimates include the amount and timing of projected future cash flows, the discount rate used to discount those cash flows to present value, the assessment of the asset’s life cycle, and the consideration of legal, technical, regulatory, economic, and competitive risks. The fair value assigned to other intangible assets, including IPR&D, is determined by estimating the future cash flows of each project or technology and discounting the net cash flows back to their present values. The discount rate used is determined at the time of measurement in accordance with accepted valuation methodologies.

IPR&D acquired in a business combination is capitalized as an indefinite-lived intangible asset. Development costs incurred after the acquisition are expensed as incurred. Upon receipt of regulatory approval, the indefinite-lived intangible asset is then accounted for as a finite-lived intangible asset and amortized on a straight-line basis or accelerated basis, as appropriate, over its estimated useful life. If the research and debt project is subsequently abandoned, the indefinite-lived intangible asset is charged to expense. IPR&D acquired outside of a business combination is expensed immediately.

Due to the uncertainty associated with research and development projects, there is risk that actual results will differ materially from the original cash flow projections and that the research and development project will result in a successful commercial product. The risks associated with achieving commercialization include, but are not limited to, delay or failure to obtain regulatory approvals to conduct clinical trials, delay or failure to obtain required market clearances, delays or issues with patent issuance, or validity and litigation.

Other intangible assets include patents, trademarks, purchased technology, and supplier and customer relationships. Identifiable intangible assets are initially recorded at fair market value at the time of acquisition generally using an income or cost approach. The Company capitalizes costs incurred to renew or extend the term of recognized intangible assets and amortizes those costs over their expected useful lives.

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



	Weighted Average Life	December 31, 2017
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	19 years	$	869,174	$	(124,096	)	$	745,078
Customer relationships	13 years	233,430		(91,961		)	141,469
Trademarks/brand names	28 years	104,879		(22,293		)	82,586
Codman trade name	Indefinite	162,900		—			162,900
Supplier relationships	27 years	34,721		(15,092		)	19,629
All other⁽¹⁾	4 years	11,511		(3,546		)	7,965
		$	1,416,615	$	(256,988	)	$	1,159,627



	Weighted Average Life	December 31, 2016
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	17 years	$	479,964	$	(94,991	)	$	384,973
Customer relationships	12 years	152,335		(77,005		)	75,330
Trademarks/brand names	30 years	90,507		(19,158		)	71,349
Supplier relationships	27 years	34,721		(13,664		)	21,057
All other⁽¹⁾	5 years	10,806		(2,340		)	8,466
		$	768,333	$	(207,158	)	$	561,175


(1)	At December 31, 2017 and 2016, all other included IPR&D of $1.0 million, which was indefinite-lived.

The Company performs its assessment of the recoverability of indefinite-lived intangible assets annually during the third quarter, or more frequently as impairment indicators arise, and it is based upon a comparison of the carrying value of such assets to their estimated fair values. The Company performed its most recent annual assessment during the third quarter of 2017, which resulted in no impairments.

There were no impairment charges for research and development expenses related to IPR&D projects during 2017 and 2016.

During the third quarter of 2017, the Company recorded an impairment charge of $3.3 million in cost of goods sold related to completed technology assets acquired from Tarsus Medical, Inc. ("Tarsus Technology"), since the underlying product will no longer be sold. Tarsus Technology was included in the Orthopedic and Tissue Technology segment.

During 2015, the Company recorded impairment charges of $0.4 million in research and development expense related to IPR&D projects that have been discontinued in its Orthopedics and Tissue Technologies segment.

Amortization expense (including amounts reported in cost of product revenues, but excluding any possible future amortization associated with acquired IPR&D) for the years ended December 31, 2017, 2016 and 2015 was $52.8 million, $41.5 million and $32.2 million, respectively. Annual amortization expense is expected to approximate $66.9 million in 2018, $66.8 million in 2019, $66.7 million in 2020, $65.7 million in 2021, $62.2 million in 2022 and $658.9 million thereafter. Amortization of product technology based intangible assets totaled $35.7 million, $27.6 million and $22.3 million for the years ended December 31, 2017, 2016 and 2015, respectively, and is presented by the Company within cost of goods sold.

LONG-LIVED ASSETS

Long-lived assets held and used by the Company, including property, plant and equipment and intangible assets, are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset may not be recoverable. For purposes of evaluating the recoverability of long-lived assets to be held and used, a recoverability test is performed using projected undiscounted net cash flows applicable to the long-lived assets. If an impairment exists, the amount of such impairment is calculated based on the estimated fair value of the asset. Impairments to long-lived assets to be disposed of are recorded based upon the difference between the carrying value and the fair value of the applicable assets.

INTEGRA FOUNDATION

The Company may periodically make contributions to the Integra Foundation, Inc. The Integra Foundation was incorporated in 2002 exclusively for charitable, educational, and scientific purposes and qualifies under IRC 501(c)(3) as an exempt private foundation. Under its charter, the Integra Foundation engages in activities that promote health, the diagnosis and treatment of disease, and the development of medical science through grants, contributions and other appropriate means. The Integra Foundation is a separate legal entity and is not a subsidiary of the Company; therefore, its results are not included in these consolidated financial statements. The Company contributed $0.5 million and $0.9 million to the Integra Foundation during the years ended December 31, 2017 and 2015, respectively. There were no contributions to the Integra Foundation during 2016. These contributions were recorded in selling, general, and administrative expense.

DERIVATIVES

The Company develops, manufactures, and sells medical devices globally, and its earnings and cash flows are exposed to market risk from changes in interest rates and currency exchange rates. The Company addresses these risks through a risk management program that includes the use of derivative financial instruments, and operates the program pursuant to documented corporate risk management policies. All derivative financial instruments are recognized in the financial statements at fair value in accordance with the authoritative guidance. Under the guidance, for those instruments that are designated and qualify as hedging instruments, the hedging instrument must be designated as a fair value hedge, cash flow hedge, or a hedge of a net investment in a foreign operation, based on the exposure being hedged. The accounting for changes in the fair value of a derivative instrument depends on whether it has been designated and qualifies as part of a hedging relationship and, further, on the type of hedging relationship. The Company's derivative instruments do not subject its earnings or cash flows to material risk, and gains and losses on these derivatives generally offset losses and gains on the item being hedged. The Company has not entered into derivative transactions for speculative purposes and from time to time, the Company may enter into derivatives that are not designated as hedging instruments in order to protect itself from currency volatility due to intercompany balances.

All derivative instruments are recognized at their fair values as either assets or liabilities on the balance sheet. The Company determines the fair value of its derivative instruments, using the framework prescribed by the authoritative guidance, by considering the estimated amount the Company would receive to sell or transfer these instruments at the reporting date and by taking into account: expected forward interest rates, currency exchange rates, the creditworthiness of the counterparty for assets, and its creditworthiness for liabilities. In certain instances, the Company utilizes a discounted cash flow model to measure fair value. Generally, the Company uses inputs that include quoted prices for similar assets or liabilities in active markets, other observable inputs for the asset or liability and inputs derived principally from, or corroborated by, observable market data by correlation or other means. The Company has classified all of its derivative assets and liabilities within Level 2 of the fair value hierarchy because observable inputs are available for substantially the full term of its derivative instruments. The Company classifies derivatives designated as hedges in the same category as the item being hedged for cash flow presentation purposes.

The Company also has entered into an foreign currency forward contract that is not designated as a hedging instrument for accounting purposes. This contract is recorded at fair value, with the changes in fair value recognized into other income, net on the consolidated financial statements.

FOREIGN CURRENCY

All assets and liabilities of foreign subsidiaries which have a functional currency other than the U.S. dollar are translated at the rate of exchange at year-end, while elements of the income statement are translated at the average exchange rates in effect during the year. The net effect of these translation adjustments is shown as a component of accumulated other comprehensive income (loss). These currency translation adjustments are not currently adjusted for income taxes as they relate to permanent investments in non-U.S. subsidiaries. Foreign currency transaction (loss) gain of $(2.9) million, $0.3 million and $(0.5) million are reported in other income, net in the statements of operations, for the year ended December 31, 2017, 2016 and 2015, respectively.

INCOME TAXES

Income taxes are accounted for by using the asset and liability method. Deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax basis. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax assets will not be realized. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period when the change is enacted.

The Company recognizes a tax benefit from an uncertain tax position only if it is more likely than not to be sustained upon examination based on the technical merits of the position. Reserves are established for positions that don't meet this recognition threshold. The reserve is measured as the largest amount of benefit determined on a cumulative probability basis that the Company believes is more likely than not to be realized upon ultimate settlement of the position. These reserves are classified as long-term liabilities in the consolidated balance sheets of the Company, unless the reserves are expected to be paid in cash during the next twelve months, in which case they are classified as current liabilities. The Company also records interest and penalties accrued in relation to uncertain tax benefits as a component of income tax expense.

While the Company believes it has identified all reasonably identifiable exposures and the reserve it has established for identifiable exposures is appropriate under the circumstances, it is possible that additional exposures exist and that exposures may be settled at amounts different than the amounts reserved. It is also possible that changes in facts and circumstances could cause the Company to either materially increase or reduce the carrying amount of its tax reserve.

The Company continues to indefinitely reinvest substantially all of its foreign earnings. The current provisional analysis indicates that the Company has sufficient U.S. liquidity, including borrowing capacity, to fund foreseeable U.S. cash needs without requiring the repatriation of foreign cash. The Tax Cuts and Jobs Act (the “2017 Tax Act”), enacted in December 2017, imposes a toll tax on a deemed repatriation of undistributed earnings of foreign subsidiaries. One time or unusual items that may impact the ability or intent to keep the foreign earnings and cash indefinitely reinvested include significant U.S. acquisitions, loans from a foreign subsidiary, changes in tax laws.

On December 22, 2017, the SEC staff issued Staff Accounting Bulletin No. 118 to address the application of U.S. GAAP in situations when a registrant does not have the necessary information available, prepared, or analyzed (including computations) in reasonable detail to complete the accounting for certain income tax effects of the 2017 Tax Act. The Company has recognized the provisional tax impacts related to deemed repatriated earnings and the revaluation of deferred tax assets and liabilities and included these amounts in its consolidated financial statements for the year ended December 31, 2017. The ultimate impact may differ from these provisional amounts, possibly materially, due to, among other things, additional analysis, changes in interpretations and assumptions the Company has made, additional regulatory guidance that may be issued, and actions the Company may take as a result of the 2017 Tax Act.

REVENUE RECOGNITION

Total revenues, net, include product sales, product royalties and other revenues, such as fees received under research, licensing, distribution arrangements, research grants, and technology-related royalties.

Revenue is recognized when persuasive evidence of an arrangement exists, delivery has occurred; title and risk of loss have passed to the customer, there is a fixed or determinable sales price, and collectability of that sales price is reasonably assured. For product sales, the Company's stated terms are primarily FOB shipping point and with most customers, title and risk of loss pass to the customer at that time. With certain United States customers, the Company retains risk of loss until the customers receive the product, and in those situations, the Company recognizes revenue upon receipt by the customer. A portion of the Company's product revenue is generated from consigned inventory maintained at hospitals and distributors, and also from inventory physically held by field sales representatives. For these types of products sales, the Company retains title until receiving appropriate notification that the product has been used or implanted, at which time revenue is recognized.

Each revenue transaction is evidenced by either a contract with the customer or a valid purchase order and an invoice which includes all relevant terms of sale. There are generally no significant customer acceptance or other conditions that prevent the Company from recognizing revenue in accordance with its delivery terms. In certain cases, where the Company has performance obligations that are significant to the functionality of the product, the Company recognizes revenue upon fulfillment of its obligation.

Sales invoices issued to customers contain the Company's price for each product or service. The Company performs a review of each specific customer's credit worthiness and ability to pay prior to accepting them as a customer. Further, the Company performs periodic reviews of its customers' status prospectively.

The Company records a provision for estimated returns and allowances on revenues in the same period as the related revenues are recorded. These estimates are based on historical sales returns and discounts and other known factors. The provisions are recorded as a reduction to revenues.

The Company's return policy, as set forth in its product catalogs and sales invoices, requires the Company to review and authorize the return of product in advance. Upon authorization, a credit will be issued for goods returned within a set amount of days from shipment, which is generally ninety days.

Product royalties are estimated and recognized in the same period that the royalty-based products are sold by the Company's strategic partners. The Company estimates and recognizes royalty revenue based upon communication with licensees, historical information and expected sales trends. Differences between actual revenues and estimated royalty revenues are adjusted in the period in which they become known, which is typically the following quarter. Historically, such adjustments have not been significant.

Other operating revenues may include fees received under research, licensing, and distribution arrangements, technology-related royalties and research grants. Non-refundable fees received under research, licensing and distribution arrangements or for the licensing of technology are recognized as revenue when received if the Company has no continuing obligations to the other party. For those arrangements where the Company has continuing performance obligations, revenue is recognized using the lesser of the amount of non-refundable cash received or the result achieved using the proportional performance method of accounting based upon the estimated cost to complete these obligations. Research grant revenue is recognized when the related expenses are incurred.

SHIPPING AND HANDLING FEES AND COSTS

Amounts billed to customers for shipping and handling are included in revenues. The related shipping and freight charges incurred by the Company are included in cost of goods sold. Distribution and handling costs of $13.5 million, $13.6 million and $13.7 million were recorded in selling, general and administrative expense during the years ended December 31, 2017, 2016 and 2015, respectively.

PRODUCT WARRANTIES

Certain of the Company's medical devices, including monitoring systems and neurosurgical systems, are reusable and are designed to operate over long periods of time. These products are sold with warranties which may extend for up to two years from date of purchase. The Company accrues estimated product warranty costs at the time of sale based on historical experience. Any additional amounts are recorded when such costs are probable and can be reasonably estimated. Accrued warranty expense of $0.7 million and $0.8 million is recorded in the consolidated balance sheet at December 31, 2017 and 2016, respectively.

RESEARCH AND DEVELOPMENT

Research and development costs, including salaries, depreciation, consultant and other external fees, and facility costs directly attributable to research and development activities, are expensed in the period in which they are incurred.

EMPLOYEE TERMINATION BENEFITS AND OTHER EXIT-RELATED COSTS

The Company does not have a written severance plan, and it does not offer similar termination benefits to affected employees in all restructuring initiatives. Accordingly, in situations where minimum statutory termination benefits must be paid to the affected employees, the Company records employee severance costs associated with these restructuring activities in accordance with the authoritative guidance for non-retirement post-employment benefits. Charges associated with these activities are recorded when the payment of benefits is probable and can be reasonably estimated. In all other situations where the Company pays out termination benefits, including supplemental benefits paid in excess of statutory minimum amounts and benefits offered to affected employees based on management's discretion, the Company records these termination costs in accordance with the authoritative guidance for ASC Topic 712 Compensation-Nonretirement Benefits and ASC Topic 420 One-time Employee Termination Benefits.

The timing of the recognition of charges for employee severance costs other than minimum statutory benefits depends on whether the affected employees are required to render service beyond their legal notification period in order to receive the benefits. If affected employees are required to render service beyond their legal notification period, charges are recognized over the future service period. Otherwise, charges are recognized when management has approved a specific plan and employee communication requirements have been met.

For leased facilities and equipment that have been abandoned, the Company records estimated lease losses based on the fair value of the lease liability, as measured by the present value of future lease payments subsequent to abandonment, less the present value of any estimated sublease income on the cease-use date. For owned facilities and equipment that will be disposed of, the Company records impairment losses based on fair value less costs to sell. The Company also reviews the remaining useful life of long-lived assets following a decision to exit a facility and may accelerate depreciation or amortization of these assets, as appropriate.

AMENDMENT TO THE CERTIFICATE OF INCORPORATION AND STOCK SPLIT

On October 25, 2016, the Board of Directors recommended, subject to stockholder approval, an Amendment to the Company’s Certificate of Incorporation (the “Amendment”) to increase the number of authorized shares of common stock from 60.0 million shares to 240.0 million shares with $0.01 per share par value, for the purpose of, among other things, affecting a two-for-one stock split. The Stockholders approved the amendment on its special Stockholders Meeting on December 21, 2016 and the Company filed a certificate of amendment to the amended and restated certificate of incorporation to effect the increase in authorized share of common stock and the two-for-one-stock split. Stockholders of record, as of the close of markets on December 21, 2016, became entitled to receive one additional share of common stock for each share held. The shares were distributed on January 3, 2017. No fractional shares of common stock were issued as a result of the two-for-one stock split. The adjusted stock price was reflected on the NASDAQ stock market on January 4, 2017.

The shares of common stock retained a par value of $0.01 per share. Accordingly, the stockholders' equity reflects the stock split by reclassifying from "Additional paid-in capital" to "Common stock" in an amount equal to the par value of the increased shares resulting from the stock split. All share and per share amounts of common stock contained in the Company's financial statements have been restated for all periods to give retroactive effect to the stock split.

STOCK-BASED COMPENSATION

The Company applies the authoritative guidance for stock-based compensation. This guidance requires companies to recognize the expense related to the fair value of their stock-based compensation awards. Stock-based compensation expense for stock option awards granted after January 1, 2006 was based on the fair value on the grant date using the binomial distribution model. The Company recognizes compensation expense for stock option awards, restricted stock awards, performance stock awards and contract stock awards over the requisite service period of the award. All excess tax benefits and taxes and tax deficiencies from stock-based compensation are included in provision for income taxes in the consolidated statement of operations.

PENSION BENEFITS

A defined benefit pension plan covers former employees in Germany. Various factors are considered in determining the pension liability, including the number of employees expected to be paid their salary levels and years of service, the expected return on plan assets, the discount rate used to determine the benefit obligations, the timing of benefit payments and other actuarial assumptions. If the actual results and events for the pension plans differ from current assumptions, the benefit obligation may be over or under valued.

The Company acquired several funded and unfunded non-U.S. defined benefit pension plans as part of Codman Neurosurgery acquisition. The Company recognizes the underfunded status of the defined benefit pension plans as an asset or a liability in the balance sheet, with changes in the funded status recorded through other comprehensive income in the year in which those changes occur.

Retirement benefit plan assumptions are reassessed on an annual basis or more frequently if changes in circumstances indicate a re-evaluation of assumptions are required. The key benefit plan assumptions are the discount rate and expected rate of return on plan assets. The discount rate is based on average rates on bonds that matched the expected cash outflows of the benefit plans. The expected rate of return is based on historical and expected returns on the various categories of plan assets.

In September 2015, the Company completed the buy-out of its defined benefit pension plan in the United Kingdom (the "U.K.") which covered certain employees and retirees. All plan assets of the defined benefit pension plan were transferred to an independent financial services firm and the Company made cash contributions of approximately $1.8 million for the year-ended December 31, 2015. The Company recorded expenses totaling approximately $5.6 million in selling, general and administrative costs in conjunction with the buy-out of the plan. The buy-out of the U.K. pension plan eliminated future obligations of the Company under this plan.

Total contributions to the defined benefit plans were $0.5 million and $2.2 million during the years ended December 31, 2017 and 2015. There were no contributions to the defined benefit plans for the year ended December 31, 2016.

The Company use the corridor approach in measuring the amount of net periodic benefit pension cost to recognize each period. The corridor approach defers all actuarial gains and losses resulting from variances between actual results and actuarial assumptions. Those unrecognized gains and losses are amortized when the net gains and losses exceed 10% of the greater of the market-related value of plan assets or the projected benefit obligation at the beginning of the year. The amount in excess of the corridor is amortized over the average remaining service period to retirement date of active plan participants.

CONCENTRATION OF CREDIT RISK

Financial instruments, which potentially subject the Company to concentrations of credit risk, consist principally of cash and cash equivalents, which are held at major financial institutions, investment-grade marketable debt securities and trade receivables.

The Company's products are sold on an uncollateralized basis and on credit terms based upon a credit risk assessment of each customer. A portion of the Company's trade receivables to customers outside the United States includes sales to foreign distributors, who then sell to government owned or supported healthcare systems.

None of the Company's customers accounted for 10% or more of the consolidated net sales during the years ended December 31, 2017, 2016 and 2015.

RECENTLY ISSUED AND ADOPTED ACCOUNTING STANDARDS

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 will become effective for all annual periods and interim reporting period beginning after December 15, 2017. Early adoption as of January 1, 2017 is permitted. The Company will adopt this standard on January 1, 2018. The Company expects to apply the modified retrospective method. Based on preliminary results of the Company's assessment of the impact, the Company does not expect the adoption of ASU 2014-09 to have a material impact on the consolidated financial statements. The impact will primarily relate to: (i) the timing of recognition for goods in transit, in which control has been transferred to customers at the time of shipment and; (ii) the timing of recognition of revenue in the Company's private label business from point in time to over time during the manufacturing process.

In July 2015, the FASB issued Update No. 2015-11, Simplifying the Measurement of Inventory. The amendment requires an entity to measure inventory that is within the scope of this amendment at the lower of cost and net realizable value. Existing impairment models will continue to be used for inventories that are accounted for using the last-in first-out (“LIFO”) method. The ASU requires prospective adoption for inventory measurements for fiscal years beginning after December 15, 2016 and interim periods within those fiscal years for public business entities. Early adoption is permitted. The Company adopted ASU 2015-11 as of January 1, 2017 on a prospective basis, and there was no significant impact of this guidance on its consolidated financial statements.

In February 2016, the FASB issued Update No. 2016-02, Leases (Topic 842). Under current accounting guidance an entity is not required to report operating leases on the balance sheet. The amendment requires that lessees recognize virtually all of their leases on the balance sheet by recording a right-of-use asset and lease liability (other than leases that meet the definition of a "short-term lease"). This update will become effective for all annual periods and interim reporting periods beginning after December 15, 2018. The new standard must be adopted using a modified retrospective transition. Early adoption is permitted. The Company is in the process of evaluating the impact of this standard on its financial statements.

In August 2016, the FASB issued Update No. 2016-15, Classification of Certain Cash Receipts and Cash Payments. The guidance addresses the classification of cash flows related to debt repayment or extinguishment costs, settlement of zero-coupon debt instruments or debt instruments with coupon rate that are insignificant in relation to the effective interest rate of the borrowing, contingent consideration payments made after business combination, proceeds from the settlement of insurance claims and corporate-owned life insurance, distribution received from equity method investees and beneficial interest in securitization transactions. This update will become effective for all annual periods and interim reporting periods beginning after December 15, 2017. Early adoption is permitted. The Company does not expect the adoption of ASU 2016-15 to have a material impact on its

consolidated financial statements.

In October 2016, the FASB issued Update No. 2016-16, Intra-Entity Transfers of Assets Other Than Inventory. The guidance requires the income tax consequences of intra-entity transfers of assets other than inventory to be recognized as current period income tax expense or benefit and removes the requirement to defer and amortize the consolidated tax consequences of intra-entity transfers. The new standard will be effective for all annual periods beginning after December 15, 2017. Early adoption is permitted. The Company does not expect the adoption of ASU 2016-16 to have a material impact on its consolidated financial statements.

In January 2017, the FASB issued Update 2017-04, Simplifying the Test for Goodwill Impairment. The standard eliminates the second step in the goodwill impairment test which requires an entity to determine the implied fair value of the reporting unit’s goodwill. Instead, an entity should recognize an impairment loss if the carrying value of the net assets assigned to the reporting unit exceeds the fair value of the reporting unit, with the impairment loss not to exceed the amount of goodwill allocated to the reporting unit. The standard is effective for annual and interim goodwill impairment tests conducted in fiscal years beginning after December 15, 2019. Early adoption is permitted. The Company elected to early adopt ASU 2017-04 effective January 1, 2017 and applied the new guidance in its annual assessment in the third quarter of 2017. The Company performed its annual goodwill impairment assessment as of July 31, 2017. The Company elected to perform a qualitative analysis for its reporting units. The Company determined, after performing the qualitative analysis, that there was no evidence that it is more likely than not that the fair value of any identified reporting unit was less than the carrying amount, and therefore, it was not necessary to perform quantitative analysis for any reporting units.

In January 2017, the FASB issued Update No. 2017-01, Business Combinations. The standard provides guidance for evaluating whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. The guidance provides a screen to determine when an integrated set of assets and activities (a “set”) does not qualify to be a business. The screen requires that when substantially all of the fair value of the gross assets acquired (or disposed of) is concentrated in an identifiable asset or a group of similar identifiable assets, the set of assets and activities is not a business. If the screen is not met, the guidance requires a set of assets and activities to be considered a business and to include, at a minimum, an input and a substantive process that together significantly contribute to the ability to create outputs and removes the evaluation as to whether a market participant could replace the missing elements. The new standard will be effective for all annual periods beginning after December 15, 2017. Early adoption is permitted. The Company elected to early adopt ASU 2017-01 effective January 1, 2017. The implementation of the amended guidance did not have any material impact on the Company's consolidated financial statements.

In March 2017, the FASB issued Update No. 2017-07, Compensation - Retirement Benefits (Topic 715): Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost. The guidance requires that an employer report the service cost component in the same line item or items as other compensation costs arising from services rendered by the pertinent employees during the period. The other components of net benefit cost are required to be presented in the income statement separately from the service cost component and outside a subtotal of income from operations, if one is presented. If a separate line item or items are used to present the other components of net benefit cost, that line item or items must be appropriately described. If a separate line item or items are not used, the line item or items used in the income statement to present the other components of net benefit cost must be disclosed. In addition, the amendments also allow only the service cost component to be eligible for capitalization when applicable. The new standard will be effective for annual periods beginning after December 15, 2017. The Company does not expect the adoption of ASU 2017-07 to have a material impact on its consolidated financial statements.

In May 2017, the FASB issued ASU 2017-09, Stock Compensation (Topic 718): Scope of Modification Accounting. The update to provide clarity and reduce both (1) diversity in practice and (2) cost and complexity when applying the guidance in Topic 718, Compensation-Stock Compensation, to a change to the terms or conditions of a share-based payment award. The new standard will be effective for all annual periods beginning after December 15, 2017. Early adoption is permitted. The Company does not expect the adoption of ASU 2017-09 to have a material impact on its consolidated financial statements.

In August 2017, the FASB issued ASU 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities. This update amends the hedge accounting rules to simplify the application of hedge accounting guidance and better portray the economic results of risk management activities in the financial statements. The guidance expands the ability to hedge nonfinancial and financial risk components, reduces complexity in fair value hedges of interest rate risk, eliminates the requirement to separately measure and report hedge ineffectiveness, as well as eases certain hedge effectiveness assessment requirements. This update will become effective for all annual periods and interim reporting periods beginning after December 15, 2018. Early adoption is permitted. The Company elected to early adopt ASU 2017-01 effective January 1, 2017 using modified retrospective method. The implementation of the amended guidance did not have any material impact on the Company's consolidated financial statements.

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

SUPPLEMENTAL CASH FLOW INFORMATION

In addition to the $42.8 million and $0.4 million payment of accreted interest associated with the settlement of the 1.625% Convertible Senior Notes due in 2016 ("2016 Convertible Notes") during the years ended December 31, 2016 and 2015, respectively, cash paid for interest during the years ended December 31, 2017, 2016 and 2015 was $32.3 million (net of $1.1 million that was capitalized into construction in progress), $14.4 million (net of $1.0 million that was capitalized into construction in progress) and $12.7 million (net of $1.7 million that was capitalized into construction in progress), respectively.

As part of settlement of 1.625% 2016 Convertible Notes in December 2016, the Company issued 2.9 million shares of common stock with fair value of $122.0 million. The Company also received 2.9 million shares of common stock from the exercise of call options with hedge participants with fair value of $123.1 million at the date of the exercise which was held as treasury stock as of December 31, 2016.

For the year ended December 31, 2017, the affiliates of the initial purchasers of 2016 Convertible Notes (the “hedge participants”) exercised 8,707,202 warrants. As a result, the Company issued 2,839,743 shares of common stock for year ended December 31, 2017.

Cash paid for income taxes, net of refunds, for the years ended December 31, 2017, 2016 and 2015 was $14.6 million, $4.3 million and $21.3 million, respectively.

Property and equipment purchases included in liabilities at December 31, 2017, 2016 and 2015 were $7.8 million, $4.7 million and $4.7 million, respectively.

DISCONTINUED OPERATIONS

12 Months Ended

Dec. 31, 2017

Discontinued Operations and Disposal Groups [Abstract]

DISCONTINUED OPERATIONS

On October 29, 2014, Integra's Board of Directors approved the announcement of a plan to separate SeaSpine from Integra as a new, publicly traded medical technology company focused on the design, development and commercialization of surgical solutions for the treatment of patients suffering from spinal disorders. Integra's board of directors based this determination, in part, on its belief that the tax-free distribution of SeaSpine shares to Integra stockholders is the most efficient manner to separate the business from Integra's other medical technology businesses. On November 3, 2014, the Company announced its intention to separate its spine business, which was previously a separate reportable segment. On July 1, 2015, the Company completed the distribution of 100% of the outstanding common stock of SeaSpine to Integra stockholders, who received one share of SeaSpine common stock for every three shares, on a pre-split basis, of Integra common stock held as of the close of business on the record date, June 19, 2015. The Company and SeaSpine share three board members, including the chair of Integra’s board of directors who is lead director for SeaSpine. The separation agreement ensures that SeaSpine had approximately $47.0 million of total cash immediately following the distribution. No gain or loss was recognized on the part of the Company or shareholders as a result of the distribution resulting from the separation of the spine business.

The historical results of operations, cash flows, and statement of financial position of SeaSpine have been presented as discontinued operations in the consolidated financial statements and prior periods have been revised. Discontinued operations include results of SeaSpine's business except for certain allocated corporate overhead costs and certain costs associated with transition services provided by Integra to SeaSpine. These allocated costs will remain part of continuing operations. Discontinued operations also include other costs incurred by Integra to separate SeaSpine from the fourth quarter of 2014 through the second quarter of 2015. These costs include transaction charges, advisory and consulting fees, and information system expenses. For the third quarter 2015 and going forward, SeaSpine as a stand-alone public company have separately reported its financial results. Due to differences between the basis of presentation for discontinued operations and the basis of presentation as a stand-alone company, the financial results of SeaSpine included within discontinued operations for the Company may not be indicative of actual financial results of SeaSpine as a stand-alone company.

The following table summarizes results from discontinued operations of SeaSpine included in the consolidated statement of operations for the year ended December 31, 2015 (in thousands):



Total revenue	$	65,775
Costs and expenses	80,618
Operating loss	(14,843		)
Other expense, net	(766		)
Loss from discontinued operations before tax	(15,609		)
Benefit for income taxes	(5,239		)
Loss from discontinued operations	$	(10,370	)

No income or expense has been recorded for the SeaSpine business after the separation from Integra on July 1, 2015.

The following table presents Integra's spine business assets and liabilities removed from the consolidated balance sheet as of July 1, 2015:



Assets:
Cash	$	47,178
Accounts receivable	20,856
Inventory	49,425
Other current assets	13,411
Current assets of discontinued operations	130,870
Property, plant, and equipment, net	21,093
Intangible assets, net	43,122
Other assets	4,465
Non-current assets of discontinued operations	68,680
Total assets of discontinued operations	$	199,550
Liabilities:
Accounts payable	$	7,072
Accrued compensation	5,964
Accrued expenses and other current liabilities	3,361
Current liabilities of discontinued operations	16,397
Deferred tax liabilities	13,331
Other liabilities	2,593
Long-term liabilities of discontinued operations	15,924
Total liabilities of discontinued operations	$	32,321

The removal of SeaSpine's net assets and unrealized accelerated currency translation adjustment is presented as a reduction in Integra's retained earnings and accumulated other comprehensive loss.

In order to effect the separation and govern Integra's relationship with SeaSpine after the separation, the Company entered into a Separation and Distribution Agreement and other agreements including a Tax Matters Agreement, an Employee Matters Agreement, several supply agreements, and a Transition Services Agreement. The Separation and Distribution Agreement governs the separation of the spine business, the transfer of assets and other matters related to the Company's relationship with SeaSpine.

The Tax Matters Agreement governs the respective rights, responsibilities and obligations of SeaSpine and Integra with respect to taxes, tax attributes, tax returns, tax proceedings and certain other tax matters.

The Employee Matters Agreement governs the compensation and employee benefit obligations with respect to the current and former employees and non-employee directors of SeaSpine and Integra, and generally allocates liabilities and responsibilities relating to employee compensation, benefit plans and programs. The Employee Matters Agreement provides that employees of SeaSpine will no longer participate in benefit plans sponsored or maintained by Integra. In addition, the Employee Matters Agreement provides that each of the parties will be responsible for their respective former and current employees and compensation plans for such current employees.

The Company entered into several Supply Agreements in which SeaSpine engaged Integra to be the product supplier of Integra's former Integra Mozaik^TMproduct line ("Mozaik") for a three-year period following the separation after which there will be no defined terms and this will be considered a normal purchase/sale arrangement. This product line has been licensed to SeaSpine in conjunction with the spin-off. Prior to the spin-off, the sale of Mozaik products from an Integra facility to a SeaSpine facility eliminated in Integra's historical consolidated financial results of operations. The revenue and cost of goods sold related to prior sales of Mozaik to SeaSpine have been restated and are presented in Integra's continuing operations results of operations. The Company has recorded $0.7 million, $0.8 million, and $6.2 million in revenue related to the sale of Mozaik products for the year-ended December 31, 2017, 2016 and 2015, respectively and $0.3 million, $0.7 million and $3.8 million in cost of goods sold for the years ended December 31, 2017, 2016 and 2015, respectively, in its continuing operations.

Under the terms of the Transition Services Agreement, the Company agreed to provide administrative, site services, information technology systems and various other corporate and support services to SeaSpine over various periods after the separation on a cost or cost-plus basis. The most significant components of the service income were the provision of information systems and legal services which was completed by the end of the first quarter of 2016. In the year-ended December 31, 2016 and 2015, other income (expense), net includes $0.3 million and $2.7 million of income in respect of the provision of services to SeaSpine, respectively.

ACQUISITIONS, DIVESTITURE AND PRO FORMA RESULTS

12 Months Ended

Dec. 31, 2017

Business Combinations [Abstract]

ACQUISITIONS, DIVESTITURE AND PRO FORMA RESULTS

Johnson & Johnson's Codman Neurosurgery Business

On February 14, 2017, the Company entered into a binding offer letter (the “Offer Letter”) with DePuy Synthes, Inc., a Delaware corporation (“DePuy Synthes”), a wholly-owned subsidiary of Johnson & Johnson, pursuant to which Integra made a binding offer to acquire certain assets, and assume certain liabilities, of Johnson & Johnson’s Codman neurosurgery business (the “Codman Acquisition”). The assets and liabilities subject to the proposed Codman Acquisition relate to the research, development, manufacturing, marketing, distribution and sale of certain products used in connection with neurosurgery procedures. The purchase price for the Codman Acquisition is $1.014 billion, subject to adjustments set forth in the Purchase Agreement (as defined below) relating to the book value of inventory transferred to the Company at the closing of the Codman Acquisition, the book value of certain inventory retained by DePuy Synthes and the amount of certain prepaid taxes.

Pursuant to the terms of the Offer Letter, following the conclusion of certain statutory information or consultation processes in connection with the Codman Acquisition by the employees of DePuy Synthes and its affiliates in France, Switzerland, and Germany, on May 11, 2017, DePuy Synthes accepted the Company’s offer and countersigned the Asset Purchase Agreement (the “Purchase Agreement”) with respect to the Codman Acquisition, previously executed by the Company.

On October 2, 2017, upon the terms and subject to the conditions set forth in the Purchase Agreement, the Codman Acquisition was completed. Under the terms of the Purchase Agreement, the Company paid an aggregate purchase price of $1.014 billion, subject to adjustments set forth in the Purchase Agreement relating to the book value of inventory transferred to the Company at the closing of the Codman Acquisition, the book value of certain inventory retained by DePuy Synthes will be transferred to the Company in the future along with certain prepaid taxes.

To facilitate the completion of the Codman Acquisition, the Company drew $700.0 million from the Term Loan A-1 component of the Senior Credit Facility and used cash available as of October 2, 2017.

The Codman Acquisition was accounted for using the acquisition method of business combination under ASC 805, Business Combinations.

The Company recorded revenue for Codman Neurosurgery of approximately $76.9 million, in the consolidated statements of operations and comprehensive income for the year ended December 31, 2017. The net income or loss attributable to this acquisition cannot be identified on a stand-alone basis because it is in the process of being integrated into the Company's operations.

The following summarizes the preliminary allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Preliminary Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Inventory	77,921
Assets held for sale	30,813
Other current assets	2,036
Property, plant and equipment	35,949
Intangible assets:
Codman corporate trade name	162,900		Indefinite
Completed technology	379,900		22 years
Goodwill	346,219
Total assets acquired	1,035,738
Accrued expenses	1,730
Pension liabilities	19,917
Net assets acquired	$	1,014,091

As of December 31, 2017, certain amounts relating to the valuation of property, plant and equipment and pension liabilities have not been finalized. The finalization of these matters may result in changes to goodwill.

Goodwill was allocated to the Codman Special Surgical segment. Goodwill is the excess of the consideration transferred over the net assets recognized and represents the expected revenue and cost synergies of the combined company and assembled workforce. Goodwill recognized as a result of the acquisition is generally deductible for income tax purposes.

The Company wrote-off construction in progress of $6.3 million related to a project acquired from Codman Neurosurgery that the Company decided to discontinue after the Codman Acquisition.

Divestiture to Natus

On September 8, 2017, to facilitate the acquisition of the Codman Neurosurgery Business, the Company and certain of its subsidiaries entered into an asset purchase agreement (the “Divestiture Agreement”) with Natus Medical Incorporated (“Natus”), pursuant to which the Company agreed to divest its Camino® Intracranial Pressure monitoring and the U.S. rights to its fixed pressure shunts businesses within its Codman Specialty Surgical segment together with certain neurosurgery assets acquired as part of the Codman Acquisition, which includes Codman U.S. dural graft implant, external ventricular drainage catheter and cerebrospinal fluid collection systems businesses (the “Divestiture”). The Divestiture Agreement was entered into in connection with the review of the Codman Acquisition by the Federal Trade Commission and the antitrust authority of Spain.

On October 6, 2017, upon the terms and subject to the conditions of the Divestiture Agreement, the Divestiture was completed and Natus paid an aggregate purchase price of $46.4 million.

Assets and liabilities divested consisted of the following as of October 6, 2017 (amounts in thousands):



Inventories	$	8,348
Prepaid expenses and other current assets	36
Assets held for sale	30,813
Property, plant and equipment, net	1,122
Goodwill	2,861
Total assets divested	$	43,180

Deferred revenue	$	1,082
Accrued compensation	209
Total liabilities divested	$	1,291

Assets held for sale includes assets and liabilities related to U.S. dural graft implant, external ventricular drainage catheters and cerebrospinal fluid collection systems businesses acquired as part of acquisition of Codman Neurosurgery.

The transitional supply agreement with Natus requires the Company to provide to Natus certain assets defined in the transitional supply agreement upon termination. The Company recognized a liability of $1.3 million, included in other liabilities in consolidated balance sheet, related to estimated cost of assets to be provided to Natus upon termination of transitional supply agreement.

The Divestiture does not represent a strategic shift that will have a major effect on the Company's operations and financial statements. Goodwill was allocated to the assets and liabilities divested using the relative fair value method. The Company recognized a gain on sale of business of $2.6 million included in other income, net in its consolidated statement of operations for the year ended December 31, 2017.

TGX Medical

On April 4, 2017, the Company entered into a Membership Interest Purchase Agreement (the "Purchase Agreement"), by and among the Company, MCF I LP THX Medical System LLC Holdings, Inc., Terragraphix, Inc. and TGX Medical Systems, LLC (collectively, "TGX Medical"). Pursuant to the Purchase Agreement, the Company purchased all issued and outstanding membership interests in TGX Medical for $5.4 million.

TGX Medical designs, develops and markets software solutions that track surgical instruments from the operating room, through sterilization to storage, which helps ensure that the instruments have been properly cleaned, assembled and maintained. TGX Medical’s customers are located in the U.S. and Canada.

The Company recorded revenue for TGX Medical of approximately $0.6 million in the consolidated statements of operations and comprehensive income for year ended December 31, 2017. The net income or loss attributable to this acquisition cannot be identified on a stand-alone basis because it is in the process of being integrated into the Company's operations.

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Cash and cash equivalents	$	49
Accounts receivables	279
Property, plant and equipment	3
Intangible assets:
Completed technology	4,707		13 Years
Goodwill	641
Total assets acquired	5,679
Accounts payable	13
Accrued expenses and other current liabilities	65
Other liabilities	234
Net assets acquired	$	5,367

Goodwill was allocated to the Codman Surgical Solutions segment. Goodwill is the excess of the consideration transferred over the net assets recognized and represents the expected revenue and cost synergies of the combined company and assembled workforce. Goodwill recognized as a result of the acquisition is not deductible for income tax purposes.

Derma Sciences

On February 24, 2017, the Company executed the Agreement and Plan of Merger (the "Merger Agreement") under which the Company acquired all of the outstanding shares of Derma Sciences, Inc., a Delaware corporation ("Derma Sciences") for an aggregate purchase price of approximately $210.8 million, including payment of certain of Derma Sciences' closing expenses and settlement of stock-based compensation plans of $4.8 million and $4.3 million, respectively. The purchase price consisted of a cash payment to the former shareholders of Derma Sciences of approximately $201.7 million upon the closing of the transaction.

Derma Sciences is a tissue regeneration company focused on advanced wound and burn care that offers products to help manage chronic and hard-to-heal wounds, especially those resulting from diabetes and poor vascular functioning.

The Company recorded revenue for Derma Sciences of approximately $84.6 million in the consolidated statements of operations and comprehensive income for the year ended December 31, 2017. The net income or loss attributable to this acquisition cannot be identified on a stand-alone basis because it has been integrated into the Company's operations.

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Cash and cash equivalents	$	16,512
Short-term investments	19,238
Accounts receivable	8,949
Inventory	17,977
Prepaid expenses and other current assets	4,369
Property, plant and equipment	4,311
Intangible assets:
Customer relationship	78,300		14 years
Trademarks/brand names	13,500		15 years
Completed technology	11,600		14 years
Non-compete agreement	280		1 year
Goodwill	73,765
Deferred tax assets	14,524
Other assets	101
Total assets acquired	263,426
Accounts payable	4,560
Accrued expenses and other current liabilities	7,409
Contingent liability	37,174
Other liabilities	3,805
Net assets acquired	$	210,478

Goodwill was allocated to the Orthopedics and Tissue Technologies segment. Goodwill is the excess of the consideration transferred over the net assets recognized and represents the expected revenue and cost synergies of the combined company and assembled workforce. Goodwill recognized as a result of the acquisition is not deductible for income tax purposes.

In the second quarter of 2017, the Company adjusted its preliminary purchase price allocation of other liabilities by $1.7 million because of additional liabilities for sales and use tax, employment tax and unclaimed property. In the third quarter of 2017, the Company adjusted the purchase price and goodwill by $0.3 million, as a result of cash received from escrow related to the acquisition of BioD LLC ("BioD") by Derma Sciences. BioD is a wholly owned subsidiary of Derma Sciences.

Short-term Investments

Short-term investments recognized at the acquisition date of Derma Sciences are investments in equity and debt securities including certificates of deposit purchased with an original maturity greater than three months which are deposited in various U.S. financial institutions and are fully insured by the Federal Deposit Insurance Corporation. The Company considers securities with original maturities of greater than 90 days to be available for sale securities. Securities under this classification are recorded at fair value and unrealized gains and losses are recorded within accumulated other comprehensive income. The estimated fair value of the available for sale securities is determined based on quoted market prices. The Company evaluates securities with unrealized losses to determine whether such losses, if any, are other than temporary. Short-term investments are classified as Level 1 in fair value hierarchy. Fair values of short-term investments are determined using the unadjusted quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the balance sheet date.

In the second quarter of 2017, the Company sold the acquired short-term investments and recognized a realized loss of $2.3 million included in other income, net in the consolidated statement of operations.

Deferred Taxes

The acquired deferred taxes of $14.5 million include a deferred tax asset of $39.7 million related to a federal net operating loss which the Company expects to utilize against income in future periods and a deferred tax asset of $16.4 million related to intangibles acquired by Derma Sciences in previous periods, offset by a deferred tax liability of $41.1 million for new intangibles for which the Company will not receive a tax benefit and deferred tax liability $0.5 million related to various deferred items. In the second quarter of 2017, the Company decreased the preliminary estimated value of the net deferred tax assets by $1.5 million to reflect adjustments to preliminary estimated fair values of assets and liabilities acquired. In fourth quarter of 2017, the Company decreased the preliminary value of the deferred tax asset by $3.3 million to reflect returns filed for periods prior to the acquisition date and adjustments for expected effective state tax rates.

United States Food and Drug Administration ("FDA") Untitled Letter

On June 22, 2015, the FDA issued an Untitled Letter (the "Untitled Letter") alleging that BioD morselized amniotic membrane based products do not meet the criteria for regulation as human cellular tissue-based products (“HCT/Ps”) solely under Section 361 of the Public Health Service Act and that, as a result, BioD would need a biologics license to lawfully market those morselized products. Since the issuance of the Untitled Letter, BioD and more recently, the Company have been in discussion with the FDA to communicate its disagreement with the FDA’s assertion that certain products are more than minimally manipulated. The FDA has not changed its position that certain of the BioD acquired products are not eligible for marketing solely under Section 361.

In November 2017, the FDA issued the final guidance document related to human tissue titled, “Regulatory Considerations for Human Cells, Tissues, and Cellular and Tissue-Based Products: Minimal Manipulation and Homologous Use” (the “HCT/P Final Guidance”). The HCT/P Final Guidance maintains the FDA’s position that products such as the Company’s morselized amniotic membrane tissue based products do not meet the criteria for regulation solely as HCT/Ps. In addition, the FDA articulated a risk-based approach to enforcement and, while some uses for amniotic membrane tissue based products would enjoy as much as thirty-six months of enforcement discretion, other high risk uses could be subject to immediate enforcement action. The Company does not believe the uses for its amniotic membrane tissue based products fall into the high risk category. Nonetheless, we can make no assurances that the FDA will continue to exercise its enforcement discretion with respect to the Company’s amniotic membrane tissue based products, and any potential action of the FDA could have a financial impact regarding the sales of such products. Although the Company continues to disagree with the FDA’s position, the Company has been considering and continues to consider regulatory approval pathways for its amniotic membrane tissue based products. Revenues from BioD morselized amniotic material based products for the year ended December 31, 2017 were less than 1.0% of consolidated revenues.

Contingent Consideration

The Company assumed contingent consideration incurred by Derma Sciences related to its acquisitions of BioD and the intellectual property related to the Medihoney product. The Company accounted for the contingent liabilities by recording their fair value on the date of the acquisition based on a discounted cash-flow model. The contingent liabilities recognized as part of the Derma Sciences acquisition relate to the following:


i.	contractual incentive payments that could be made to former equity owners of BioD if net sales of BioD products exceed a certain amount for the twelve-month periods ending June 30, 2017 and 2018 ("BioD Earnout Payments");


ii.	a contractual incentive payment that could be made to the former equity owners if there has been no specific enforcement action or notice by the FDA against the specific BioD products as a result of the Untitled Letter for a certain period after closing as defined by the agreement ("Product Payment"); and


iii.	contractual incentive payments that could be made to the former owner of the intellectual property relating to the Medihoney product line, if net sales of Medihoney products exceed certain amounts defined in the agreement between Derma Sciences and the former owner of the intellectual property of Medihoney for any twelve-month period ("Medihoney Earnout Payments").

At the date of the acquisition, net sales used in estimating the BioD Earnout Payments is based on the weighted average of different possible scenarios using revenue volatility of 13.5%. The BioD Earnout Payments were valued using a discount rate of 3.0%. The maximum payout related to the BioD Earnout Payments is $26.5 million. The estimated fair value as of February 24, 2017 was $9.1 million. In August 2017, the Company paid $4.8 million for the twelve-month period ending June 30, 2017 component of the BioD Earnout Payments. The Company recognized $4.0 million gain from change in estimated fair value, included in selling, general and administrative expenses, in the consolidated statement of operations for the year ended December 31, 2017. As of December 31, 2017, the estimated fair value of the remaining portion of the BioD Earnout Payments is $0.3 million.

At the date of acquisition, the Company estimated that the probability of the Product Payment was 98.0% and valued it at a discount rate of 2.5%. The maximum payout related to the Product Payment is $29.7 million. The estimated fair value as of February 24, 2017 was $26.8 million. In the second quarter of 2017, the Company adjusted the preliminary estimated fair value to increase the Product Payment by $0.9 million related to additional products that should have been included in the preliminary estimate based on the Merger Agreement. On May 25, 2017, the Company made full payment for the Product Payment of $26.6 million. The payment was included in cash used in business acquisition, net of cash acquired within investing activities in the condensed consolidated statements of cash flows since the payment was made shortly after the acquisition.

At the date of the acquisition, net sales used in estimating the Medihoney Earnout Payments is based on the weighted average of different possible scenarios using revenue volatility of 27.5%. The Medihoney Earnout Payments were valued using a discount rate of 4.5%. The maximum payout related to the Medihoney Earnout Payments is $5.0 million. The estimated fair value as of February 24, 2017 and December 31, 2017 was $1.4 million.

These fair value measurements were based on significant inputs not observed in the market and thus represented a Level 3 measurement. The contingent considerations are re-measured to fair value at each reporting date until the contingency is resolved, and those changes in fair value are recognized in earnings. Depending on the expected timing of the estimated payments, the acquisition date fair values and subsequent remeasurement could be different.

Tekmed

On December 15, 2015, the Company acquired the assets of Tekmed Instruments S.p.A ("Tekmed") for an aggregate purchase price of $14.1 million including a minimal amount of working capital and purchase adjustment which was recorded as an adjustment to assumed liabilities. Tekmed was a distributor of the Company's and third parties' products in Italy and focused on neurosurgery and neurotrauma, along with representation in plastic and reconstructive surgery, cardiovascular surgery, image diagnostics, general surgery, anesthesia and intensive care, interventional radiology, and proton therapy. This acquisition enables the Company to sell directly into the market support the Codman Specialty Surgical division's growth in Italy along with other key Integra franchises.

The revenue and net income or loss attributable to this acquisition cannot be identified on a stand-alone basis because it has been integrated into the Company's operations.

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Inventory	$	1,143
Property, plant and equipment	669
Other current assets	11
Intangible assets:
Supplier Contracts	4,981		2 - 13 Years
Goodwill	9,665
Total assets acquired	16,469
Accrued expenses and other liabilities acquired	802
Deferred tax liability	1,564
Net assets acquired	$	14,103

Tornier's United States Toe & Ankle Business

On October 2, 2015, the Company acquired the United States rights to Tornier's Salto Talaris® and Salto Talaris® XT ankle replacement products and Tornier's Futura^TM silastic toe replacement products (the "Salto and Futura") for $6.0 million in cash. Under the agreement, Integra acquired the U.S. rights to the Salto Talaris® Total Ankle Prosthesis, Salto Talaris® XT Revision Total Ankle Prosthesis, Futura™ Primus Flexible Great Toe system, Futura™ Classic Flexible Great Toe system, and Futura™ Lesser Metatarsal Phalangeal system. The agreement also includes an option to purchase, in the future, the rights to the Salto Talaris®, Salto Talaris® XT, Salto Mobile, and Futura™ silastic toe replacement products outside the United States. The estimated fair value of the net assets acquired exceeded the purchase price for the Salto and Futura product lines and resulted in the Company recording a gain of $1.1 million for the year-ended December 31, 2015 in other income. The acquired toe and ankle products enhances the Company's lower extremities product offering and accelerates its entry into the U.S. total ankle replacement market.

The revenue and net income or loss attributable to this acquisition cannot be identified on a stand-alone basis because it has been integrated into the Company's operations.

The following summarizes the allocation of the purchase price as based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Inventory	$	2,688
Property, plant, and equipment	1,453
Intangible assets:
Ankle product family	3,210		11 years
Toe product family	460		10 years
Total assets acquired	7,811
Deferred tax liability	700
Net assets acquired	$	7,111

TEI

On July 17, 2015, the Company executed the two merger agreements (collectively, the "Agreements") under which the Company acquired TEI Biosciences, Inc., a Delaware corporation ("TEI Bio"), and TEI Medical Inc., a Delaware corporation ("TEI Med", collectively "TEI") for an aggregate purchase price of approximately $312.2 million ($210.9 million for TEI Bio and $101.3 million for TEI Med) including a working capital adjustment of $0.2 million ($0.5 million for TEI Bio offset by $0.7 million cash received for TEI Med) which was recorded as a reduction from goodwill. The purchase price consisted of a cash payment to the former shareholders of TEI Bio and TEI Med of approximately $312.4 million upon the closing of the transaction, net of $1.2 million of acquired cash. The acquired assets included a contingent receivable with a fair value of $0.4 million at acquisition and will be paid to the Company if the sale of products used in breast surgery in the United States drops below $6.0 million in either 2016 or 2017. The fair value of this asset is based on future sales projections of the products under various potential scenarios and weighting the probability of these outcomes. At the date of the acquisition, the cash flow projection was discounted using an internal rate of return of 11.0%. These fair value measurements were based on significant inputs not observed in the market and thus represented a Level 3 measurement. In April 2017, the Company received from escrow $1.2 million related to the contingent consideration for 2016 calendar year. For the year ended December 31, 2017 and 2016, the Company recognized $1.6 million and $1.3 million gain, respectively, related to change in fair value of contingent receivable, included in selling, general and administrative expenses in the consolidated statements of operations. As of December 31, 2017, the fair value of this contingent receivable of $2.0 million is included in prepaid expenses and other current assets in the consolidated balance sheet. As of December 31, 2016, the $1.7 million balance of this contingent receivable is included in Prepaid expenses and other current assets and Other current assets of $1.2 million and $0.5 million, respectively.

TEI Bio is in the business of developing and commercializing biologic devices for soft tissue repair and regenerative applications, including dura and hernia repair and plastic and reconstructive surgery. TEI Med holds a license to TEI Bio’s regenerative technology in the fields of wound healing and orthopedics.

The revenue and net income or loss attributable to this acquisition cannot be identified on a stand-alone basis because it has been integrated into the Company's operations.

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Cash	$	1,241
Accounts receivable, net	9,011
Inventory	23,223
Property, plant, and equipment	2,027
Income tax receivable	5,135
Other current assets	2,670
Intangible assets:
Developed technology	167,400		14 - 16 Years
Contractual relationships	51,345		11 - 14 Years
Leasehold interest	69
Goodwill	147,704
Total assets acquired	409,825
Accrued expenses and other liabilities	9,732
Deferred tax liabilities	87,908
Net assets acquired	$	312,185

Pro Forma Results (unaudited)

The following unaudited pro forma financial information summarizes the results of operations for the years ended December 31, 2017 and 2016 as if the acquisitions of Codman Neurosurgery, Derma Sciences and TGX Medical and Divestiture to Natus, which were completed by the Company during 2017 had been completed as of the beginning 2016. The pro forma results are based upon certain assumptions and estimates, and they give effect to actual operating results prior to the acquisitions and adjustments to reflect (i) the change in interest expense, depreciation expense, intangible asset amortization and fair value inventory step-up, (ii) timing of recognition for certain expenses that will not be recurring in the post-acquisition period, which includes $2.9 million incurred by Derma Sciences prior to acquisition and $24.9 million incurred by Integra, (iii) gain from the sale of business of $2.6 million related to the Divestiture to Natus, and (iv) income taxes at a rate consistent with the Company’s statutory rate at the date of the acquisitions. 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 acquisitions had taken place on the basis assumed above, nor are they indicative of the results of future combined operations.



	Year Ended December 31,
	2017		2016		2015
	(Pro forma)
	(In thousands except per share amounts)
Total revenue from continuing operations	$	1,428,491	$	1,446,903	$	940,005
Net income from continuing operations	$	81,730	$	27,520	$	10,694

Basic earnings per share from continuing operations	$	1.06	$	0.37	$	0.31

DEBT

12 Months Ended

Dec. 31, 2017

Debt Disclosure [Abstract]

DEBT

Amended and Restated Senior Credit Agreement

On March 31, 2017, the Company entered into an amendment (the "March 2017 Amendment") to its fourth amended and restated Senior Credit Facility with a syndicate of lending banks with Bank of America, N.A., as Administrative Agent. The March 2017 Amendment increased the aggregate principal amount from $1.5 billion to $2.2 billion available to the Company through the following facilities:


i.	a $500.0 million Term Loan A facility;


ii.	a $700.0 million Term Loan A-1, which was available in a single drawing on a delayed basis at the time of closing of the Codman Acquisition (see Note 4 - Acquisitions, Divestitures and Pro forma Results); and


iii.	a $1.0 billion revolving credit facility, which includes a $60.0 million sublimit for the issuance of standby letters of credit and a $60.0 million sublimit for swingline loans.

In connection with the March 2017 Amendment, the Company’s maximum consolidated total leverage ratio in the financial covenants was increased to the following:



Fiscal Quarter		Maximum Consolidated Total Leverage Ratio

December 31, 2016 through before the first fiscal quarter after the delayed draw date of Term Loan A-1		4.50 : 1.00
First fiscal quarter ended after the delayed draw date of Term Loan A-1 through September 30, 2018		5.50 : 1.00
October 1, 2018 through September 30, 2019		5.00 : 1.00
October 1, 2019 through September 30, 2020		4.50 : 1.00
October 1, 2020 and thereafter		4.00 : 1.00

There was no change in the maturity date, which remains at December 7, 2021.

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


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 2.00%), 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 0.35%), based on the Company’s consolidated total leverage ratio, on the amount available for borrowing under the revolving 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 December 31, 2017 the Company was in compliance with all such covenants. The Company capitalized $19.1 million and $4.5 million of incremental financing costs in 2017 and 2016, respectively, in connection with the modifications of the Senior Credit Facility. The Company wrote-off previously capitalized financing cost of $0.5 million as interest expense in 2016 related to the modifications. No previously capitalized financing cost was written-off in 2017.

In October 2017, to facilitate the completion of the Codman Acquisition, the Company drew $700.0 million from the Term Loan A-1 component of the Senior Credit Facility. The Company capitalized $19.1 million of incremental financing costs related to the drawing of Term A-1 component.

At December 31, 2017 and 2016, there was $655.0 million and $165.0 million outstanding, respectively, under the revolving portion of the Senior Credit Facility at a weighted average interest rate of 3.7% and 2.2%, respectively. At December 31, 2017 and 2016 there was $500.0 million outstanding under the Term Loan A component of the Senior Credit Facility at a weighted average interest rate of 3.6% and 2.2%, respectively. At December 31, 2017, there was $700.0 million outstanding under the Term Loan A-1 component of the Senior Credit Facility at a weighted average interest rate of 3.6%.

The fair value of outstanding borrowings of the Senior Credit Facility's revolving credit facility, Term Loan A and Term Loan A-1 components at December 31, 2017 was approximately $661.0 million, $502.7 million and $703.7 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.

Letters of credit outstanding as of December 31, 2017 and 2016 totaled $0.6 million and $0.5 million, respectively. There were no amounts drawn as of December 31, 2017.

Contractual repayments of the Term A and Term A-1 components of Senior Credit Facility are due as follows:



Year Ended December 31,	Principal Repayment
	(In thousands)
2018	$	60,000
2019	60,000
2020	90,000
2021	990,000

The outstanding balance of revolving credit component of the Senior Credit Facility is due on December 7, 2021.

2016 Convertible Senior Notes

On December 15, 2016, the Company extinguished its 2016 Convertible Notes by paying the remaining principal amount of $227.1 million and issued 2.9 million shares of common stock with fair a value of $122.0 million related to excess conversion value. No gain or loss on extinguishment was recognized as a result of the conversion. The Company also received 2.9 million shares of common stock from the exercise of call option with hedge participants with a fair value of $123.1 million at the date of the exercise. The shares of common stock received from exercise of the call option are held as treasury stock as of December 31, 2016 at a weighted average price of $41.78 for a total of $123.1 million.

The 2016 Convertible Notes were issued on June 15, 2011 with the aggregate principal of $230.0 million and maturity date of December 15, 2016. The 2016 Convertible Notes bore interest at a rate of 1.625% per annum payable semi-annually in arrears on December 15 and June 15 of each year. The 2016 Convertible Notes were senior, unsecured obligations and were convertible into cash and, if applicable, shares of its common stock based on a conversion rate defined within the note agreement.

In connection with the issuance of the 2016 Convertible Notes, the Company entered into call transactions and warrant transactions, primarily with the hedge participants. The initial strike price of the call transaction was approximately $28.72 per share, subject to customary anti-dilution adjustments. The initial strike price of the warrant transaction was approximately $35.03 per share, subject to customary anti-dilution adjustments. The strike price of the call transactions and warrant transactions has been adjusted similarly to the 2016 Convertible Notes as a result of the spin-off of the Company's spine business in July 2015 to $26.42 per share and $32.22 per share, respectively. The warrants expired on a series of expiration dates from March 2017 to August 2017. For the year ended December 31, 2017, the hedge participants exercised 8,707,202 warrants. As a result, the Company issued 2,839,743 shares of common stock for year ended December 31, 2017. The Company has no warrants outstanding as of December 31, 2017.

Convertible Note Interest

The interest expense components of the Company’s convertible notes are as follows:



	Years Ended December 31,
	2016		2015
	(In thousands)
2016 Convertible Notes:
Amortization of the discount on the liability component (1)	$	8,073	$	7,917
Cash interest related to the contractual interest coupon (2)	3,407		3,430
Total	$	11,480	$	11,347


(1)	The amortization of the discount on the liability component of the 2016 Convertible Notes is presented net of capitalized interest of $0.3 million and $0.6 million for the years ended December 31, 2016 and 2015, respectively.


(2)	The cash interest related to the contractual interest coupon on the 2016 Convertible Notes is presented net of capitalized interest of $0.1 million and $0.3 million for the years ended December 31, 2016 and 2015.

DERIVATIVE INSTRUMENTS

12 Months Ended

Dec. 31, 2017

Derivative Instruments and Hedging Activities Disclosure [Abstract]

DERIVATIVE INSTRUMENTS

Interest Rate Hedging

The Company’s interest rate risk relates to U.S. dollar denominated variable interest rate borrowings. The Company uses interest rate swap derivative instruments to manage earnings and cash flow exposure resulting from changes in interest rates. These interest rate swaps apply a fixed interest rate on a portion of our expected LIBOR-indexed floating-rate borrowings. The Company held the following interest rate swaps as of December 31, 2017 (dollar amounts in thousands):



Hedged Item	Current Notional Amount		Designation Date	Effective Date	Termination Date	Fixed Interest Rate		Floating Rate	Estimated Fair Value
									Assets (Liabilities)
3-month USD LIBOR Loan	$	50,000	June 22, 2016	December 31, 2016	June 30, 2019	1.062	%	3-month USD LIBOR	$	675
3-month USD LIBOR Loan	50,000		June 22, 2016	December 31, 2016	June 30, 2019	1.062	%	3-month USD LIBOR	672
1-month USD LIBOR Loan	50,000		July 12, 2016	December 31, 2016	June 30, 2019	0.825	%	1-month USD LIBOR	779
3-month USD LIBOR Loan	50,000		February 6, 2017	June 30, 2017	June 30, 2020	1.834	%	3-month USD LIBOR	318
1-month USD LIBOR Loan	100,000		February 6, 2017	June 30, 2017	June 30, 2020	1.652	%	1-month USD LIBOR	858
1-month USD LIBOR Loan	100,000		March 27, 2017	December 31, 2017	June 30, 2021	1.971	%	1-month USD LIBOR	337
1-month USD LIBOR Loan	150,000		December 13, 2017	January 1, 2018	December 31, 2022	2.201	%	1-month USD LIBOR	(455		)
1-month USD LIBOR Loan	150,000		December 13, 2017	January 1, 2018	December 31, 2022	2.201	%	1-month USD LIBOR	(434		)
1-month USD LIBOR Loan	100,000		December 13, 2017	July 1, 2019	June 30, 2024	2.423	%	1-month USD LIBOR	(684		)
1-month USD LIBOR Loan	50,000		December 13, 2017	July 1, 2019	June 30, 2024	2.423	%	1-month USD LIBOR	(255		)
1-month USD LIBOR Loan	200,000		December 13, 2017	January 1, 2018	December 31, 2024	2.313	%	1-month USD LIBOR	(1,219		)
Total interested rate derivatives designated as cash flow hedge	$	1,050,000							$	592

The Company designated these derivative instruments as cash flow hedges. The Company assess the effectiveness of these derivative instruments and recorded the 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 affected earnings, at which point the effective portion of any gain or loss was 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.

In 2017, the Company reclassified $0.1 million of pre-tax losses recorded as net in AOCI related to the interest rate hedges to earnings prior to the date of expiration. No gain or loss was reclassified to interest expense from AOCI in 2016.

The Company expects that approximately $0.3 million of pre-tax income recorded in AOCI related to interest rate hedges could be reclassified to earnings in 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. For contracts that are designated as a hedging instruments, the Company assess the effectiveness of the contracts. The change in fair value of foreign currency cash flow hedges are recorded in AOCI, net of tax, until the hedged item affects earnings. Once the related hedged item affects earnings, the Company reclassifies amounts recorded in AOCI 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. For contracts not designated as hedging instruments, the change in fair value of the contracts are recognized in other income (expense), net in the consolidated statements of operation, along with the offsetting foreign currency gain or loss on the underlying assets or liabilities.

The success of the Company’s hedging program depends, in part, on forecasts of certain activity denominated in foreign currencies. 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.

On November 28, 2017, the Company entered into a foreign currency forward contract, with a notional amount of $8.9 million to mitigate the foreign currency exchange risk related to a certain intercompany loan denominated in Swiss Francs ("CHF"). The contract is not designated as a hedging instrument. The Company recognized $0.1 million gain from the change in fair value of the contract, which was included in other income (expense), net in the consolidated statement of operations. The fair value of the foreign currency forward contact was $0.1 million as of December 31, 2017.

Cross-Currency Rate Swap

On October 2, 2017, the Company entered into cross currency swap agreements to convert a notional amount of $300.0 million equivalent to 291.2 million of CHF denominated intercompany loans into U.S. dollars. The CHF denominated intercompany loans were the result of the purchase of intellectual property by a subsidiary in Switzerland as part of the Codman Acquisition. The objective of these cross-currency swaps is to reduce volatility of earnings and cash flows associated with changes in the foreign currency exchange rate. Under the terms of these contracts, which have been designated as cash flow hedges, the Company will make interest payments in Swiss Francs and receive interest in U.S. dollars. Upon the maturity of these contracts, the Company will pay the principal amount of the loans in Swiss Francs and receive U.S. dollars from the counterparties.

The Company held the following cross-currency rate swaps as of December 31, 2017 (dollar amounts in thousands):



	Effective Date	Termination Date	Fixed Rate	Aggregate Notional Amount		Fair Value Asset (Liability)

Pay CHF	October 2, 2017	October 2, 2020	1.75%	CHF	97,065	$	(742	)
Receive U.S.$	October 2, 2017	October 2, 2020	4.38%	$	100,000	$	(742	)

Pay CHF	October 2, 2017	October 2, 2021	1.85%	CHF	48,533	(610		)
Receive U.S.$	October 2, 2017	October 2, 2021	4.46%	$	50,000	(610		)

Pay CHF	October 2, 2017	October 2, 2022	1.95%	CHF	145,598	(2,605		)
Receive U.S.$	October 2, 2017	October 2, 2022	4.52%	$	150,000	(2,605		)

Total						$	(3,957	)

The cross-currency swaps were carried on the consolidated balance sheet at fair value, and changes in the fair values were recorded as unrealized gains or losses in AOCI. The Company recorded a gain of $1.1 million in other income, net related to change in fair value related to the foreign currency rate translation to offset the gains or losses recognized on the intercompany loan. For the year ended December 31, 2017, the Company recorded a loss of $2.1 million in AOCI related to change in fair value of the cross-currency swap and a gain of $1.9 million in other income, net included in the consolidated statements of operations related to the interest rate differential of the cross-currency swap. The estimated gain that is expected to be reclassified to other income, net from AOCI as of December 31, 2017 within the next twelve months is $7.8 million. As of December 31, 2017, the Company does not expect any gains or losses will be reclassified into earnings as a result of the discontinuance of these cash flow hedges because the original forecasted transaction will not occur.

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 values of the interest rate swaps and cross-currency swaps were developed using a market approach based on publicly available market yield curves and the terms of the swap. The Company performs ongoing assessments of counterparty credit risk.

The following table summarizes the fair value and presentation in the consolidated balance sheet for derivatives designated as hedging instruments:



	Fair Value as of December 31,
	2017		2016
Location on Balance Sheet ⁽¹⁾:	(In thousands)
Derivatives designated as hedges — Assets:
Prepaid expenses and other current assets
Interest rate swap⁽²⁾	$	1,521	$	242
Cross-currency swap	7,757		—
Other assets
Interest rate swap⁽²⁾	2,491		1,629
Total Derivatives designated as hedges — Assets	$	11,769	$	1,871

Derivatives designated as hedge — Liabilities
Accrued expenses and other current liabilities
Interest rate swap⁽²⁾	$	1,845	$	—
Other liabilities
Interest rate swap⁽²⁾	1,575		—
Cross-currency swap	11,714		—
Total Derivative designated as hedges — Liabilities	$	15,134	$	—


⁽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 December 31, 2017 and 2016, the total notional amounts related to the Company’s interest rate swaps were $1.1 billion and $150.0 million, respectively.

The following presents the effect of derivative instruments designated as cash flow hedges on the accompanying consolidated statements of operations during the years ended December 31, 2017 and 2016:



	Balance in AOCI Beginning of Year		Amount of Gain (Loss) Recognized in AOCI			Amount of Gain (Loss) Reclassified from AOCI into Earnings			Balance in AOCI End of Year			Location in Statements of Operations
	(In thousands)
Year Ended December 31, 2017
Interest rate swap	$	1,871	$	(1,355	)	$	(76	)	$	592		Interest (expense)
Cross-currency swap	—		(2,070		)	3,034			(5,104		)	Other income (expense)
	$	1,871	$	(3,425	)	$	2,958		$	(4,512	)
Year Ended December 31, 2016
Interest rate swap	$	—	$	1,871		$	—		$	1,871		Interest (expense)
	$	—	$	1,871		$	—		$	1,871

TREASURY STOCK	12 Months Ended
TREASURY STOCK	Dec. 31, 2017
Treasury Stock Transactions, Excluding Value of Shares Reissued [Abstract]
TREASURY STOCK	TREASURY STOCK On October 25, 2016, the Board of Directors approved a resolution to retire approximately 17.8 million treasury stocks with an aggregate cost of $367.1 million and return such shares to authorized and unissued shares of common stock. These shares became available for issue on October 28, 2016. The effect of retiring these treasury stocks was recognized in Common stock and Additional paid-in capital. There was no effect on total stockholders’ equity as a result of retiring the treasury shares. On October 25, 2016, the Board of Directors terminated its October 2014 authorization for the repurchase of its outstanding common stock and authorized management to repurchase up to $150.0 million of its outstanding common stock through December 2018. Shares may be repurchased either in the open market or in privately negotiated transactions. As of December 31, 2017, there remained $150.0 million available for repurchases under this authorization. As part of the conversion of the 2016 Convertible Notes, the Company received 2.9 million shares of common stock from the exercise of call options with hedge participants. The shares of common stock received from exercise of the call options are held as treasury stock, and there were 2.9 million share of treasury stock outstanding as of December 31, 2017 and 2016, with cost of $121.6 million and $123.1 million, respectively, at a weighted average of $41.77 and $41.78 per share, respectively. There were no treasury stock repurchases under this authorization during the years ended December 31, 2017 and 2016.

STOCK-BASED COMPENSATION

12 Months Ended

Dec. 31, 2017

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

STOCK-BASED COMPENSATION

Stock-based compensation expense - all related to employees and members of the Board of Directors - recognized under the authoritative guidance was as follows:



	Years Ended December 31,
	2017		2016		2015
	(In thousands)
Selling, general and administrative	$	19,785	$	15,829	$	14,461
Research and development	1,273		1,048		714
Cost of goods sold	492		433		275
Total stock-based compensation expense	21,550		17,310		15,450
Total estimated tax benefit related to stock-based compensation expense	15,448		10,569		5,792
Net effect on net income	$	6,102	$	6,741	$	9,658

Estimated tax benefit related to stock-based compensation expense for the year ended December 31, 2017 does not include adjustments related to the effect of 2017 Tax Act.

EMPLOYEE STOCK PURCHASE PLAN

The purpose of the Employee Stock Purchase Plan (the “ESPP”) is to provide eligible employees of the Company 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. Under the ESPP, a total of 3.0 million shares of common stock are reserved for issuance. These shares will be made available either from the Company’s authorized but unissued shares of common stock or from shares of common stock reacquired by the Company as treasury stock. At December 31, 2017, 2.1 million shares remain available for purchase under the ESPP. During the years ended December 31, 2017, 2016 and 2015, the Company issued 12,168 shares, 12,494 shares and 12,040 shares under the ESPP for $0.6 million, $0.5 million and $0.4 million, respectively.

EQUITY AWARD PLANS

As of December 31, 2017, the Company had stock options, restricted stock awards, performance stock awards, 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”)).

In May 2010 and May 2017, the stockholders of the Company approved amendments to the 2003 Plan to increase by 3.5 million and 1.7 million, respectively, the number of shares of common stock that may be issued under the 2003 Plan. The Company has reserved 4.0 million shares under each of the 2000 Plan and the 2001 Plan, and 14.7 million shares under the 2003 Plan. The Plans permit the Company to grant incentive and non-qualified stock options, stock appreciation rights, restricted stock, contract stock, performance stock, or dividend equivalent rights to designated directors, officers, employees and associates of the Company.

Stock options issued under the Plans become exercisable over specified periods, generally within four years from the date of grant for officers and employees, and within one year from the date of the grant for members of the Board of Directors. The awards 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 ratably over specified periods, generally three years after the date of grant.

In connection with the separation of SeaSpine on July 1, 2015 and in accordance with the Employee Matters Agreement, the Company made certain adjustments to the exercise price and number of share-based compensation awards with the intention of preserving the intrinsic value of the awards prior to the separation. Stock options issued in 2015 prior to the separation converted to those of the entity where the employee is working post-separation. Stock options issued prior to 2015 converted to both Integra and SeaSpine options such that the holders received stock options in both companies. The exercise price of these outstanding awards was adjusted to preserve the value of the awards immediately prior to the separation. Performance stock, restricted stock, and contract stock were adjusted for all employees holding outstanding awards to provide holders performance stock, restricted stock, and contract stock in the company that employs such employee following the separation. The adjustments to the Company's stock-based compensation awards resulted in an increase in incremental fair value of $4.4 million, of which $0.3 million, $0.7 million and $3.3 million was recorded during the year ended December 31, 2017, 2016 and 2015, respectively. The remaining $0.1 million will be recognized prospectively over the remaining term of outstanding awards, adjusted, as applicable, for forfeitures.

Stock Options

The Company values stock option grants using the binomial distribution model. Management believes that the binomial distribution model is preferable to the Black-Scholes model because it is a more flexible model that gives consideration to the impact of non-transferability and vesting provisions in valuing employee stock options.

In determining the value of stock options granted, the Company considered that it has never paid cash dividends and does not currently intend to pay cash dividends, and thus has assumed a 0% dividend yield. Expected volatilities are based on the historical volatility of the Company’s stock price. The expected life of stock options is estimated based on historical data on exercise of stock options, post-vesting forfeitures and other factors to estimate the expected term of the stock options granted. The risk-free interest rates are derived from the U.S. Treasury yield curve in effect on the date of grant for instruments with a remaining term similar to the expected life of the options. The Company adopted ASU 2016-09 and elected to account for forfeitures as they occur.

The following weighted-average assumptions were used in the calculation of fair value:



	Years Ended December 31,
	2017	2016	2015
Dividend yield	0%	0%	0%
Expected volatility	30%	29%	29%
Risk free interest rate	2.18%	1.94%	1.96%
Expected life of option from grant date	8 years	8 years	8 years

The following table summarizes the Company’s stock option activity.



			Weighted Average Exercise Price		Weighted Average Contractual Term in Years	Aggregate Intrinsic Value

	Shares
Stock Options	(In thousands)					(In thousands)
Outstanding at January 1, 2017	2,083		$	20.65
Granted	187		41.72
Exercised	(531	)	17.60
Forfeited or Expired	—		—
Outstanding at December 31, 2017	1,739		$	23.84	3.54	$	41,753
Vested or expected to vest at December 31, 2017	1,739		$	23.84	3.54	$	41,753
Exercisable at December 31, 2017	1,333		$	19.95	2.63	$	37,208

The intrinsic value of options exercised for the years ended December 31, 2017, 2016 and 2015 were $16.2 million, $9.7 million and $5.8 million, respectively. The weighted average grant date fair value of options granted during the years ended December 31, 2017, 2016 and 2015 was $16.95, $12.48 and $8.59, respectively. Cash received from option exercises was $9.8 million, $10.5 million and $7.3 million, for the years ended December 31, 2017, 2016 and 2015, respectively. The realized tax benefit from options exercised were $6.2 million, $3.7 million and $2.2 million for the years ended December 31, 2017, 2016 and 2015, respectively.

As of December 31, 2017, there was approximately $4.0 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.

Awards of Restricted Stock, Performance Stock and Contract Stock

The following table summarizes the Company’s awards of restricted stock, performance stock and contract stock for the year ended December 31, 2017.



					Performance Stock and Contract Stock Awards
	Restricted Stock Awards				Performance Stock and Contract Stock Awards
	Shares		Weighted Average Grant Date Fair Value Per Share		Shares		Weighted Average Grant Date Fair Value Per Share


	(In thousands)				(In thousands)
Unvested, January 1, 2017	512		$	28.49	345		$	21.62
Granted	286		44.15		213		43.75
Adjustments for performance achievement related to award target	—		—		25		36.90
Cancellations	(61	)	36.00		(12	)	30.52
Released	(286	)	27.89		(225	)	43.11
Vested but not released	—		—		(174	)	32.40
Unvested, December 31, 2017	451		$	37.79	172		$	33.61

The Company recognized $18.5 million, $15.6 million and $10.2 million in expense related to such awards during the years ended December 31, 2017, 2016 and 2015, respectively. The total fair market value of shares vested and released in 2017, 2016 and 2015 was $22.2 million, $16.2 million and $19.9 million, respectively. Vested awards include shares that have been fully earned, but had not been delivered as of December 31, 2017.

Performance stock awards have performance features associated with them. Performance stock, restricted stock and contract stock awards generally have requisite service periods of three years. The fair value of these awards is being expensed on a straight-line basis over the vesting period.

As of December 31, 2017, there was approximately $16.9 million of total unrecognized compensation costs related to unvested restricted stock, performance stock and contract stock awards. These costs are expected to be recognized over a weighted-average period of approximately two years.

At December 31, 2017, there are approximately 0.5 million vested Restricted Units and 0.2 million vested performance share units held by various employees for which the related shares have not yet been issued. The final determination of the number of shares to be issued in respect of an award based on achievement of pre-defined performance metrics is made by the Company's Compensation Committee of the Board of Directors.

At December 31, 2017, there were approximately 3.4 million shares available for grant under the Plans.

The Company capitalized into inventory, share based compensation costs of $0.5 million, $0.5 million and $0.3 million for the years ended December 31, 2017, 2016 and 2015, respectively. Such share based compensation was recognized as cost of goods sold when related inventory was sold.

RETIREMENT BENEFIT PLANS

12 Months Ended

Dec. 31, 2017

Retirement Benefits [Abstract]

RETIREMENT BENEFIT PLANS

DEFINED BENEFIT PLANS

The Company maintains a defined benefit pension plan that covers former employees in its manufacturing plant located in Tuttlingen, Germany (the “Germany Plan”). The Company closed the Tuttlingen, Germany plant in December 2005. The Company did not terminate the Germany Plan, and the Company remains obligated for the accrued pension benefits related to this plan.

As part of the acquisition of Codman Neurosurgery, the Company assumed various defined benefit which covers certain employees acquired with Codman Neurosurgery in Austria, France, Japan, Germany and Switzerland.

Net periodic benefit costs for the Company’s defined benefit pension plans for the year ended December 31, 2017 included the following amounts (amounts in thousand):



Service cost	$	565
Interest cost	95
Expected return on plan assets	(224		)
Recognized net actuarial loss	8
Net period benefit cost	$	444

The following weighted average assumptions were used to develop net periodic pension benefit cost and the actuarial present value of projected pension benefit obligations for the year ended December 31, 2017:



Discount rate	0.74	%
Expected return on plan assets	3.08	%
Rate of compensation increase	1.70	%

The Company’s discount rates are determined by considering current yield curves representing high quality, long-term fixed income instruments. The resulting discount rates are consistent with the duration of plan liabilities. In 2017, the discount rate was prescribed as the current yield on corporate bonds with an average rating of AA or AAA of equivalent currency and term to the liabilities. The expected return on plan assets represents the average rate of return expected to be earned on plan assets over the period the benefits included in the benefit obligation are to be paid. In developing the expected rate of return, the Company considers returns of historical market data as well as actual returns on the plan assets. Using this reference information, the long-term return expectations for each asset category are developed according to the allocation among those investment categories.

The assessment is determined using projections from external financial sources, long-term historical averages, actual returns by asset class and the various asset class allocations by market.

The following sets forth the change in projected benefit obligations and the change in plan assets for the years ended December 31, 2017 and a reconciliation of the funded status at December 31, 2017 (amounts in thousands):



Change In Projected Benefit Obligations
Projected benefit obligation, beginning of year	$	668
Interest cost	95
Service cost	565
Actuarial loss	(12		)
Employee contribution	180
Premiums paid	(89		)
Benefit payment	(19		)
Transfer from Codman Neurosurgery acquisition	46,448
Effect of foreign currency exchange rates	(175		)
Projected benefit obligation, end of year	$	47,661

Change In Plan Assets
Plan assets at fair value, beginning of year	$	—
Actual return on plan assets	82
Employer contributions	450
Employee contributions	180
Premiums paid	(89		)
Transfer from Codman Neurosurgery acquisition	26,477
Effect of foreign currency exchange rates	(157		)
Plan assets at fair value, end of year	$	26,943



Reconciliation Of Funded Status
Fair value of plan assets	$	26,943
Benefit obligations	47,661
Unfunded benefit obligation	$	20,718

The unfunded benefit obligation is included in other liabilities in the consolidated balance sheet at December 31, 2017.

As of December 31, 2017, the Company has $0.4 million gain recognized within accumulated other comprehensive income (loss) that has not been recognized as component of net periodic cost. The combined accumulated benefit obligation for the defined benefit plans was $42.9 million as of December 31, 2017.

Unrecognized gains and losses are amortized over the average remaining future service for each plan. For plans with no active employees, they are amortized over the average life expectancy. The amortization of gains and losses is determined by using a 10% corridor of the greater of the market value of assets or the accumulated benefit obligation. Total unamortized gains and losses in excess of the corridor are amortized over the average remaining future service.

Prior service costs/benefits for the pension plans are amortized over the average remaining future service of plan participants at the time of the plan amendment. Prior service cost/benefit is amortized over the average remaining service to full eligibility age of plan participants at the time of the plan amendment.

The net plan assets of the pension plans are invested in common trusts as of December 31, 2017. Common trusts are classified as Level 2 in fair value hierarchy. The fair value of common trusts is valued at net asset value based on the fair values of the underlying investments of the trusts as determined by the sponsor of the trusts. The investment strategy of the Company's defined benefit plans is both to meet the liabilities of the plans as they fall due and to maximize the return on invested assets within appropriate risk profile.

The investment strategy for the Company’s defined benefit plans is both to meet the liabilities of the plans as they fall due and to maximize the return on invested assets within appropriate risk tolerances. The benefit plans in Austria, France and Germany had no assets at December 31, 2017.

As of December 31, 2017, no plan assets are expected to be returned to the Company in the next twelve months.

The following table is the summary of expected future benefit payments (in thousands):



2018	$	158
2019	225
2020	296
2021	454
2022	466
Next five years	5,380

As of December 31, 2017, contributions expected to be paid to the plan in 2018 is $1.8 million.

In September 2015, the Company completed the buy-out of its defined benefit pension plan in the U.K. which covered certain employees and retirees. All plan assets of the defined benefit pension plan were transferred to an independent financial services firm and the Company made cash contributions of approximately $1.8 million for the year-ended December 31, 2015. The Company recorded expenses totaling approximately $5.6 million in selling, general and administrative costs in conjunction with the buy-out of the plan. The buy-out of the U.K. pension plan eliminated future obligations of the Company under this plan.

DEFINED CONTRIBUTION PLANS

The Company also has various defined contribution savings plans that cover substantially all employees in the United States, Belgium, Canada, France, Japan, Netherlands, the U.K. and Puerto Rico. The Company matches a certain percentage of each employee’s contributions as per the provisions of the plans. Total contributions by the Company to the plans were $7.2 million, $5.6 million and $3.7 million for the years ended December 31, 2017, 2016 and 2015, respectively.

LEASES AND RELATED PARTY LEASES

12 Months Ended

Dec. 31, 2017

Leases [Abstract]

LEASES AND RELATED PARTY LEASES

The Company leases administrative, manufacturing, research and distribution facilities and various manufacturing, office and transportation equipment through operating lease agreements. Future minimum lease payments under operating leases at December 31, 2017 were as follows:



	Related Parties		Third Parties		Total
	(In thousands)
2018	$	296	$	13,449	$	13,745
2019	296		12,245		12,541
2020	296		9,534		9,830
2021	296		7,058		7,354
2022	296		5,849		6,145
Thereafter	2,019		45,714		47,733
Total minimum lease payments	$	3,499	$	93,849	$	97,348

Total rental expense for the years ended December 31, 2017, 2016 and 2015 and was $12.9 million, $10.3 million and $10.1 million, respectively, and included $0.3 million, in related party rental expense in each of the three years.

There were no future minimum lease payments under capital leases at December 31, 2017.

Related Party Leases

Until December 27, 2016, the Company leased certain production equipment from a corporation whose sole stockholder is a general partnership, of which the Company’s principal owner and former Chairman and director is a partner and the President. Under the terms of the lease agreement, the Company pays $0.1 million per year to the related party lessor. Effective December 27, 2016, the Company purchased the production equipment for $0.4 million.

The Company also leases its manufacturing facility in Plainsboro, New Jersey, from a general partnership that is 50% owned by a corporation whose shareholders are trusts, whose beneficiaries include family members of the Company’s principal owner and former Chairman and director. The term of the current lease agreement is through October 31, 2032 at an annual rate of approximately $0.3 million per year. The current lease agreement also provides (i) a 5-year renewal option for the Company to extend the lease from November 1, 2032 through October 31, 2037 at the fair market rental rate of the premises, and (ii) another 5-year renewal option to extend the lease from November 1, 2037 through October 31, 2042 at the fair market rental rate of the premises.

INCOME TAXES

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

INCOME TAXES

Income (Loss) before income taxes consisted of the following:



	Years Ended December 31,
	2017			2016		2015
	(In thousands)
United States operations	$	(32,640	)	$	51,351	$	37,450
Foreign operations	44,025			39,055		23,221
Total	$	11,385		$	90,406	$	60,671

The 2017 Tax Act is making significant changes to the previous tax law. Included among the numerous changes are a reduction of the federal statutory rate from 35% to 21%, limitations on the deductibility of interest expense and executive compensation, and the elimination of certain domestic tax deductions such as the domestic production activities deduction. Additionally, the 2017 Tax Act imposes a one-time repatriation tax on accumulated foreign subsidiaries’ untaxed foreign earnings (the “Toll Tax”).

The 2017 Tax Act implements a territorial tax system and includes base erosion provisions on non-U.S. earnings, which subjects certain foreign earnings to additional taxation as global intangible low-taxed income (“GILTI”). These provisions are effective on January 1, 2018. The Company has not completed its full analysis related to the GILTI provision within the 2017 Tax Act. The Company has not yet elected a policy as to whether it will recognize deferred taxes for basis difference expected to reverse as GILTI or whether the Company will account for GILTI as a period costs if and when incurred.

Deferred tax assets and liabilities are measured at the enacted tax rate expected to apply when they are realized or settled. We recognized an estimated benefit of $43.4 million from the re-measurement of the Company’s net deferred tax liabilities at the reduced rate of 21%.

The 2017 Tax Act eliminates the deferral of U.S. income tax on unrepatriated earnings from foreign subsidiaries through the imposition of the Toll Tax, a one-time tax in 2017 on deemed repatriated foreign earnings, which is paid over an eight-year period. The tax is assessed on the foreign subsidiary accumulated foreign earnings that were not previously taxed. Foreign earnings in cash and cash equivalents are taxed at 15.5% and all other earnings are taxed at 8.0%. The calculation of the Toll Tax allows for the ability to offset positive foreign earnings with existing foreign deficits and use of foreign tax credits. The Company prepared a reasonable estimate of this tax and expects to continue to refine the estimate as it finalizes its 2017 tax returns. As of December 31, 2017, we recorded an estimated income tax expense of $5.5 million related to the Toll Tax, of which, $0.4 million is expected to be paid within one year.

On December 22, 2017, the SEC staff issued Staff Accounting Bulletin No. 118 to address the application of U.S. GAAP in situations when a registrant does not have the necessary information available, prepared, or analyzed (including computations) in reasonable detail to complete the accounting for certain income tax effects of the 2017 Tax Act. The Company has made reasonable estimates of the impact of the 2017 Tax Act on its consolidated financial statements and has recognized the provisional tax impacts related to deemed repatriated earnings and the revaluation of deferred tax assets and liabilities, as well as its indefinite reinvestment assertion. and included these amounts in its consolidated financial statements for the year ended December 31, 2017. The ultimate impact may differ from these provisional amounts, possibly materially, due to, among other things, additional analysis, changes in interpretations and assumptions the Company has made, additional regulatory guidance that may be issued, and actions the Company may take as a result of the 2017 Tax Act. The accounting is expected to be completed before filing the 2017 U.S. corporate income tax return in 2018.

A reconciliation of the U.S. Federal statutory rate to the Company’s effective tax rate is as follows:



	Years Ended December 31,
	2017		2016		2015
Federal statutory rate	35.0	%	35.0	%	35.0	%
Increase (decrease) in income taxes resulting from:
State income taxes, net of federal tax benefit	(17.0	)%	(0.2	)%	1.3	%
Foreign operations	(112.7	)%	(10.0	)%	(12.5	)%
Spine valuation allowance	—	%	—	%	61.1	%
Excess tax benefits from stock compensation	(57.9	)%	(3.9	)%	—	%
Charitable contributions	(10.6	)%	(0.4	)%	(1.0	)%
Nondeductible meals and entertainment	8.8	%	0.8	%	0.9	%
Domestic production activities deduction	—	%	(2.6	)%	(2.4	)%
Intercompany profit in inventory	11.6	%	1.0	%	3.1	%
Nondeductible facilitative costs	22.5	%	0.2	%	3.1	%
Changes in valuation allowances	8.0	%	0.4	%	0.3	%
Uncertain tax positions	(4.6	)%	(0.3	)%	0.2	%
Research and development credit	(13.2	)%	(1.2	)%	(1.9	)%
Return to provision	(4.3	)%	(1.5	)%	1.7	%
Reduction of book gain on sale of assets	(4.6	)%	—	%	—	%
Tax reform — Toll Tax	48.1	%	—	%	—	%
Tax reform — remeasurement of deferred tax assets and liabilities	(378.6	)%	—	%	—	%
Other	0.8	%	0.2	%	(0.2	)%
Effective tax rate	(468.7	)%	17.5	%	88.7	%

The effective tax rate decreased by 486.2% in 2017 compared with 2016 primarily from recording an income tax benefit of $43.4 million resulted from the reduction of the U.S. tax rate from 35% to 21%, offset by an expense of $5.5 million for the Toll Tax imposed on deemed repatriation of foreign untaxed earnings. In addition, the jurisdictional mix of income before tax in U.S.-based operations relative to foreign operations was a driver of a lower effective tax rate in 2017. The change in jurisdictional mix of income results primarily from significant acquisition and integrations costs incurred in the U.S. for the 2017 acquisitions of Derma Sciences and Codman Neurosurgery.

During 2017, the Company's foreign operations generated a $1.2 million increase in income tax expense when compared with 2016, as a result of, among other factors, the geographic and business mix of taxable earnings and losses. The 2017 foreign effective tax rate is 15.7%, an increase of approximately 2.9% over the rate in 2016. The Company's foreign tax rate is primarily based upon statutory rates.

The Company is negotiating a reduced corporate tax rate of 8% for the manufacturing operations in Switzerland. Once finalized, the negotiated rate will be available through 2024.

During 2016, the Company's foreign operations generated a $0.8 million increase in income tax expense when compared with 2015, as a result of, among other factors, the geographic and business mix of taxable earnings and losses and the re-establishment of an income tax benefit in France for half of the year related to intercompany interest. The 2016 foreign effective tax rate is 12.7%, a decrease of approximately 2.1% over the rate in 2015. The Company's foreign tax rate is primarily based upon statutory tax rates and is not related to a tax holiday or negotiated tax rate.

The provision for income taxes consisted of the following:



	Years Ended December 31,
	2017			2016			2015
	(In thousands)
Current:
Federal	$	6,644		$	13,700		$	46,665
State	1,233			2,503			2,301
Foreign	6,069			6,113			5,205
Total current	$	13,946		$	22,316		$	54,171
Deferred:
Federal	(66,466		)	(3,400		)	1,282
State	(758		)	(1,751		)	(394		)
Foreign	(80		)	(1,323		)	(1,239		)
Total deferred	$	(67,304	)	$	(6,474	)	$	(351	)
Provision for income taxes	$	(53,358	)	$	15,842		$	53,820

The income tax effects of significant temporary differences that give rise to deferred tax assets and liabilities, shown before jurisdictional netting, are presented below:



	December 31,
	2017			2016
	(In thousands)
Assets:
Doubtful accounts	$	1,811		$	2,344
Inventory related items	29,266			30,074
Tax credits	6,015			1,040
Accrued vacation	2,556			3,264
Accrued bonus	997			7,842
Stock compensation	10,426			16,031
Deferred revenue	2,395			2,345
Net operating loss carryforwards	37,492			15,058
Unrealized foreign exchange loss	1,177			96
Charitable contributions carryforward	1,287			5
Others	3,077			128
Total deferred tax assets	96,499			78,227
Less valuation allowance	(7,961		)	(3,604		)
Deferred tax assets after valuation allowance	$	88,538		$	74,623
Liabilities:
Intangible and fixed assets	(146,327		)	(215,438		)
Others	(1,091		)	(1,191		)
Total deferred tax liabilities	$	(147,418	)	$	(216,629	)
Total net deferred tax liabilities	$	(58,880	)	$	(142,006	)

The deferred tax assets and liabilities are measured based on the enacted tax rates that apply in years in which the temporary differences are expected to be realized or incurred. The Company re-measured its deferred tax assets and liabilities as a result of the 2017 Tax Act. The primary impact of this re-measurement was a decrease in the net deferred tax liability for the reduction of the U.S. statutory income tax rate from 35% to 21%.

At December 31, 2017, the Company had net operating loss carryforwards of $148.2 million for federal income tax purposes, $26.4 million for foreign income tax purposes and $28.2 million for state income tax purposes to offset future taxable income. The federal net operating loss carryforwards expire through 2033, $1.0 million of the foreign net operating loss carryforwards expire through 2026 with the remaining $25.4 million having an indefinite carry forward period. The state net operating loss carryforwards expire through 2037.

A valuation allowance of $8.0 million, $3.6 million and $4.9 million is recorded against the Company’s gross deferred tax assets of $96.5 million, $78.2 million, and $82.5 million recorded at December 31, 2017, 2016 and 2015, respectively.

The valuation allowance relates to deferred tax assets for certain items that will be deductible for income tax purposes under very limited circumstances and for which the Company believes it is not more likely than not that it will realize the associated tax benefit. In the event that the Company determines that it would be able to realize more or less than the recorded amount of net deferred tax assets, an adjustment to the deferred tax asset valuation allowance would be recorded in the period such a determination is made.

The Company’s valuation allowance increased by $4.4 million, and $1.3 million in 2017 and 2016, respectively. The 2017 overall increase in the valuation allowance was primarily due to establishing a valuation allowance against research credits as part of the acquisition of Derma Sciences.

A reconciliation of the beginning and ending amount of uncertain tax benefits is as follows:



	Years Ended December 31,
	2017			2016			2015
	(In thousands)
Balance, beginning of year	$	754		$	1,085		$	959
Gross increases:
Current year tax positions	402			—			—
Prior years' tax positions	—			380			541
Gross decreases:
Prior years' tax positions	(777		)	(546		)	—
Settlements	—			—			—
Statute of limitations lapses	(17		)	(131		)	(404		)
Other	62			(34		)	(11		)
Balance, end of year	$	424		$	754		$	1,085

Approximately $0.4 million of the balance at December 31, 2017 relates to uncertain tax positions that, if recognized, would affect the annual effective tax rate. Included in the balance of uncertain tax positions at December 31, 2017 is less than $0.1 million related to tax positions for which it is reasonably possible that the total amounts could be reduced during the twelve months following December 31, 2017.

The Company recognizes interest and penalties relating to uncertain tax positions in income tax expense. The Company recognized a minimal benefit for the years ended December 31, 2017, 2016 and 2015. The Company had minimal interest and penalties accrued for the years ended December 31, 2017 and 2016 and 2015.

The Company files Federal income tax returns, as well as multiple state, local and foreign jurisdiction tax returns. The Company is no longer subject to examinations of its Federal income tax returns by the IRS through fiscal year 2013. All significant state and local matters have been concluded through fiscal 2012. All significant foreign matters have been settled through fiscal 2012.

NET INCOME (LOSS) PER SHARE

12 Months Ended

Dec. 31, 2017

Earnings Per Share [Abstract]

NET INCOME (LOSS) PER SHARE

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



	Years Ended December 31,
	2017		2016		2015
	(In thousands, except per share amounts)
Basic net income (loss) per share:
Net income from continuing operations	$	64,743	$	74,564	$	6,851
Net loss from discontinued operations	—		—		(10,370		)
Net income (loss)	$	64,743	$	74,564	$	(3,519	)

Weighted average common shares outstanding	76,897		74,386		68,990

Basic net income per common share from continuing operations	$	0.84	$	1.00	$	0.10
Basic net loss per common share from discontinued operations	—		—		(0.15		)
Basic net income (loss) per common share	$	0.84	$	1.00	$	(0.05	)

Diluted net income (loss) per share:
Net income from continuing operations	$	64,743	$	74,564	$	6,851
Net loss from discontinued operations	—		—		(10,370		)
Net income (loss)	$	64,743	$	74,564	$	(3,519	)

Weighted average common shares outstanding — Basic	76,897		74,386		68,990
Effect of dilutive securities:
2016 Convertible notes	—		2,296		922
Warrants	971		1,166		—
Stock options and restricted stock	1,253		1,346		1,442
Weighted average common shares for diluted earnings per share	79,121		79,194		71,354


Diluted net income per common share from continuing operations	$	0.82	$	0.94	$	0.10
Diluted net loss per common share from discontinued operations	—		—		(0.15		)
Diluted net income (loss) per common share	$	0.82	$	0.94	$	(0.05	)

In connection with the separation of SeaSpine on July 1, 2015 and in accordance with the Employee Matters Agreement, the Company made certain adjustments to the exercise price and number of share-based compensation awards with the intention of preserving the intrinsic value of the awards prior to the separation. Stock options issued in 2015 prior to the separation converted to those of the entity where the employee is working post-separation. Stock options issued prior to 2015 converted to both Integra and SeaSpine options such that the holders received stock options in both companies. The exercise price of these outstanding awards was adjusted to preserve the value of the awards immediately prior to the separation. Performance stock, restricted stock, and contract stock were adjusted to provide holders performance stock, restricted stock, and contract stock in the company that employs such employee following the separation. The adjustments to the Company's stock-based compensation awards resulted in an increase in incremental fair value of $4.4 million, of which $0.3 million, $0.7 million and $3.3 million were recorded during the year-ended December 31, 2017, 2016 and 2015, respectively. The remaining $0.1 million will be recognized prospectively over the remaining term of outstanding awards, adjusted, as applicable, for forfeitures.

Common stock of approximately 0.2 million shares at December 31, 2017, 2016 and 2015, that are issuable through exercise of dilutive securities were not included in the computation of diluted net income per share because their effect would have been anti-dilutive.

For the year-ended December 31, 2015 and for the period from January 1, 2016 to December 15, 2016, the date of 2016 Convertible Notes settlement, the potential excess conversion value on the 2016 Convertible Notes was included in the Company's dilutive share calculation because the average stock price for period outstanding exceeded the conversion price. On December 15, 2016, the Company settled the 2016 Convertible Notes and issued 2.9 million shares of common stock related to the conversion premium of 2016 Convertible Notes. The Company also exercised the call option with hedge participants and received 2.9 million shares of common stock. See Note 5 for additional information related to our 2016 Convertible Notes.

The Company also had warrants outstanding related to its 2016 Convertible Notes for the year ended 2016 and 2015 and the Company's 2016 Convertible Notes are convertible to common shares in certain circumstances (see Note 5). These warrants and the excess conversion value of the 2016 Convertible 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 years ended December 31, 2017 and 2016, the potential excess conversion value on the 2016 Notes were included in the Company's dilutive share calculation because the average stock price for the years ended December 31, 2017 and 2016 exceeded the conversion price.

Performance Shares and Restricted Units that entitle the holders to approximately 0.5 million shares of common stock are included in the basic and diluted weighted average shares outstanding calculation from their date of issuance because no further consideration is due related to the issuance of the underlying common shares.

ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS)

12 Months Ended

Dec. 31, 2017

Stockholders' Equity Note [Abstract]

ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS)

Changes in accumulated other comprehensive income (loss) by component between December 31, 2017 and 2016 are presented in the table below, net of tax:



	Gains and Losses on Cash Flow Hedges			Defined Benefit Pension Items			Foreign Currency Items			Short-term Investment			Total
	(In thousands)
Balance at January 1, 2017	$	1,071		$	(36	)	$	(58,189	)	$	—		$	(57,154	)
Other comprehensive (loss) income before reclassifications	(2,122		)	(57		)	37,454			(3,019		)	32,256
Less: Income (loss) reclassified from accumulated other comprehensive income (loss)	1,928			—			—			(3,019		)	(1,091		)
Current period other comprehensive (loss) income	(4,050		)	(57		)	37,454			—			33,347
Balance at December 31, 2017	$	(2,979	)	$	(93	)	$	(20,735	)	$	—		$	(23,807	)

For the year ended December 31, 2017, income tax expense related to comprehensive losses from cash flow hedges was $2.3 million and a minimal amount related to benefit pension items.

COMMITMENTS AND CONTINGENCIES

12 Months Ended

Dec. 31, 2017

Commitments and Contingencies Disclosure [Abstract]

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 it sells. 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 the Company's 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.

TEI, acquired by Integra on July 17, 2015, manufactures a bovine-derived surgical mesh product for Boston Scientific Corporation ("BSC”) and has been named as a defendant in lawsuits under a broad range of products liability theories, many of which have not been served on TEI. As of December 31, 2017, only ten active cases remained against TEI. Pursuant to an indemnification agreement with BSC (i) BSC is managing the litigation; (ii) TEI has in place a products liability insurance policy, of which it must exhaust $3.0 million before BSC’s indemnity begins to cover relevant claims (and of which only a small portion has been utilized to date and against which the insurer has reserved the entire $3.0 million). Because the thrust of products liability litigation focuses on synthetic surgical mesh products, counsel is filing motions to dismiss on behalf of TEI in many cases. In addition, Integra has certain protections in the merger agreements with TEI which would indemnify it for approximately $30.0 million for the first fifteen months after closing and between $20.0 and $30.0 million for the remainder of the three-year period after closing for losses relating to a variety of matters, including half of certain products liability claims (including those related to the product it manufactures for BSC) not covered by insurance. As of March 1, 2018, no indemnification payments were received nor owed in relation to the lawsuits.

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.

Contingent Consideration

The Company determined the fair value of contingent consideration during the twelve-month period ended December 31, 2017 and 2016 to reflect the change in estimate, additions, payments, transfers and the time value of money during the period.

A reconciliation of the opening balances to the closing balances of these Level 3 measurements for the year ended December 31, 2017 and 2016 is as follows (in thousands):



	Contingent Consideration Liabilities Related to Acquisition of Derma Sciences (See Note 4)						Contingent Consideration Liability Related to Acquisition of Confluent Surgical, Inc.					Location in Financial Statements
	Short-term			Long-term			Short-term		Long-term
Balance as of January 1, 2016	$	—		$	—		$	—	$	21,831
Change in fair value	—			—			—		205			Selling, general and administrative
Balance as of December 31, 2016	—			—			—		22,036
Additions from acquisition of Derma Sciences	33,707			3,467			—		—
Transfers from long-term to current portion	2,193			(2,193		)	22,184		(22,184		)
Payments	(31,346		)	—			—		—
Change in fair value	(4,239		)	113			294		148			Selling, general and administrative
Balance as of December 31, 2017	$	315		$	1,387		$	22,478	$	—

On January 15, 2014, the Company acquired all outstanding shares of Confluent Surgical, Inc., ("Confluent Surgical"). The purchase price includes contingent consideration. 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 fair values of contingent consideration related to the acquisition of Confluent Surgical were estimated using a discounted cash flow model using discount rate of 2.2%. The Company expects to receive the U.S. and European governmental approvals and pay the related contingent consideration in 2018.

The Company assesses these assumptions on an ongoing basis as additional information affecting the assumptions is obtained. The contingent consideration balance was included in accrued expenses and other current liabilities and other liabilities at December 31, 2017 and in other liabilities at December 31, 2016.

Supply Agreement Liability and Above Market Supply Agreement Liability

On January 15, 2014, the Company entered into a transitional supply agreement with Covidien Group S.a.r.l ("Covidien"). This agreement contains financial incentives to 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 in each of the following three years.

The Company determined the fair value of its supply agreement liability and above market supply agreement liability with Covidien for the year ended December 31, 2017 and 2016 to reflect the payments, change in estimate and the time value of money during the period.

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



	Supply Agreement Liability						Above Market Supply Agreement Liability						Location in Statement of Operations
	Short-term			Long-term			Short-term			Long-term
Balance as of January 1, 2016	$	1,991		$	161		$	—		$	931
Payments	(2,000		)	—			—			(47		)
Transfer from long-term to current potion	161			(161		)	—			—
Loss from increase in fair value	14			—			—			1,083			Selling, general and administrative
Other	—			—			—			681			Goodwill
Balance as of December 31, 2016	166			—			—			2,648
Payments	(166		)	—			(113		)	(415		)
Transfer	—			—			3,273			(3,273		)
Loss from increase in fair value	—			—			(519		)	1,040			Selling, general and administrative
Balance as of December 31, 2017	$	—		$	—		$	2,641		$	—

The fair values of supply agreement liability and above market supply agreement liability were estimated using a discounted cash flow model using discount rate of 12.0%. The Company assesses the assumptions on an ongoing basis as additional information impacting assumptions is obtained. The supply agreement liability - short-term and above market supply agreement liability - short-term were included in accrued expenses and other current liabilities and the supply agreement - long term and above market supply agreement liability - long-term were included in other liabilities in the consolidated balance sheets.

There were no transfers between Level 1, 2 or 3 during 2017 or 2016. If the Company's estimates regarding the fair value of its contingent consideration, supply agreement liability and above market supply agreement liability are inaccurate, a future adjustment to these estimated fair values may be required which could change significantly.

BioD

On April 7, 2017, the Company's indirect wholly-owned subsidiary, BioD filed an action in the Superior Court of New Jersey, Chancery Division, Middlesex County seeking a declaration that the resignation of Russell Olsen, the former CEO of BioD, was “for Good Reason” (as defined in Olsen’s employment agreement); a finding that Olsen breached the implied covenant of good faith and fair dealing, committed legal fraud, equitable fraud and negligent misrepresentation; and an award of damages for such actions, including a return of severance fees paid to Olsen. BioD was acquired in August 2016 by Derma Sciences, which Integra subsequently acquired in February 2017. After receiving a job offer from Integra that Olsen believed materially diminished his title and authority, on February 24, 2017 Olsen indicated his intention to terminate his position with BioD for Good Reason, as otherwise permitted by his employment agreement with BioD. Shortly thereafter, Cynthia Weatherly (as representative of the former equity owners of BioD) claimed in a letter to Derma Sciences that Olsen’s resignation was a “termination Without Cause” (as also defined in Olsen’s employment agreement), which would arguably trigger an acceleration of the earn out under a merger agreement between Derma Sciences, BioD and other parties (the "BioD Merger Agreement"), which was entered into in July 2016, and require as a result of the acceleration the payment of $26.5 million by BioD. As previously disclosed and described in Note 4 - Business Acquisition, to the Company's consolidated financial statements for the year ended December 31, 2017, Integra assumed this contingent liability in connection with its acquisition of Derma Sciences. The action for a declaratory judgment was filed to clarify that Olsen’s termination was for Good Reason and not Without Cause. If the employment agreement was terminated for Good Reason, then the Company believes that the earn out provision under the BioD Merger Agreement should not be accelerated and the likelihood of loss is remote.

SEGMENT AND GEOGRAPHIC INFORMATION

12 Months Ended

Dec. 31, 2017

Segment Reporting [Abstract]

SEGMENT AND GEOGRAPHIC INFORMATION

In the first quarter of 2015, the Company began to disclose three global reportable segments as a result of changes in how the Company internally manages and reports the results of its businesses to its chief operating decision maker. On July 1, 2015, the Company completed the separation of its spine business, which was a reportable segment. See Note 3 - Discontinued Operations for additional information. Following the separation, the Company is disclosing two reportable segments.

In October 2017, as part of our branding strategy, the Company leveraged the globally recognized Codman name by rebranding the Specialty Surgical Solutions segment to Codman Specialty Surgical.

The two reportable segments and their activities are described below:

•

The Codman Specialty Surgical segment includes (i) the Neurosurgery business, which sells a full line of products for neurosurgery and neuro critical care such as tissue ablation equipment, dural repair products, cerebral spinal fluid management devices, intracranial monitoring equipment, and cranial stabilization equipment and (ii) the precision tools and instruments business, which sells more than 60,000 instrument patterns and surgical and lighting products to hospitals, surgery centers, and dental, podiatry, and veterinary offices.


•	The Orthopedics and Tissue Technologies segment 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 Corporate and other category includes (i) various legal, finance, information systems, executive, and human resource functions, (ii) brand management, and (iii) share-based compensation costs. Prior to the realignment, costs related to procurement, manufacturing operations and logistics for the Company's entire organization were not allocated to operating segments. In connection with the realignment, a portion of these costs have now been incorporated into the disclosed operating segments.

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 years ended December 31, 2017, 2016 and 2015 are as follows:



	Years Ended December 31,
	2017			2016			2015
	(In thousands)
Segment Net Sales
Codman Specialty Surgical	$	720,301		$	632,524		$	586,918
Orthopedics and Tissue Technologies	467,935			359,551			295,816
Total revenues	$	1,188,236		$	992,075		$	882,734
Segment Profit
Codman Specialty Surgical	$	292,971		$	256,629		$	242,479
Orthopedics and Tissue Technologies	129,697			103,852			87,844
Segment profit	422,668			360,481			330,323
Amortization	(20,370)			(13,862)			(9,953)
Corporate and other	(357,494		)	(231,279		)	(240,783		)
Operating income	$	44,804		$	115,340		$	79,587

The Company does not allocate any assets to the reportable segments, and, therefore, no asset information is reported to the chief operating decision maker and disclosed in the financial information for each segment.

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

Total revenue, net and long-lived assets (tangible) by major geographic area are summarized below:



	United States*		Europe		Rest of the World		Consolidated
	(In thousands)
Total revenue, net:
2017	$	894,260	$	150,147	$	143,829	$	1,188,236
2016	765,608		120,588		105,879		992,075
2015	680,824		103,057		98,853		882,734
Total long-lived assets:
2017	$	247,154	$	30,942	$	7,233	$	285,329
2016	213,898		18,970		1,235		234,103

* Includes long-lived assets in Puerto Rico.

SELECTED QUARTERLY INFORMATION - UNAUDITED

12 Months Ended

Dec. 31, 2017

Selected Quarterly Financial Information [Abstract]

SELECTED QUARTERLY INFORMATION - UNAUDITED



(In thousands, except per share data)
Quarter	Total revenue, net		Gross margin		Net income		Per Share - Basic (1)		Per Share - Diluted (1)
2017
First	$	258,636	$	172,051	$	6,394	$	0.09	$	0.08
Second	282,164		183,166		10,835		0.14		0.14
Third	278,834		177,077		3,159		0.04		0.04
Fourth (3) (4)	368,602		220,431		44,355		0.57		0.56
	$	1,188,236	$	752,725	$	64,743

2016
First (2)	$	236,770	$	151,997	$	13,419	$	0.18	$	0.18
Second	249,309		159,744		12,755		0.17		0.16
Third	250,332		161,003		20,144		0.27		0.25
Fourth	255,664		170,242		28,246		0.38		0.35
	$	992,075	$	642,986	$	74,564

(1) Per common share amounts for the quarters and full years have been calculated separately. Accordingly, quarterly amounts do not necessarily add to the annual amount because of differences in the weighted average common shares outstanding during each period principally due to the effect of the Company’s issuing shares of its common stock during the year.

(2) The net income for first quarter of 2016 was adjusted to reflect the effect of the adoption of ASU 2016-09 in second quarter of 2016 of $1.8 million. The earning per share were also restated to reflect the adoption of ASU 2016-09.

(3) The net income for the fourth quarter of 2017 includes gain on sale of business of $2.6 million related to Divestiture to Natus.

(4) The net income for the fourth quarter of 2017 includes benefit from income taxes of $43.4 million related to the re-measurement of our deferred taxes resulting from a reduction of the federal statutory rate from 35% to 21% from the 2017 Tax Act (see Note 11, Income Taxes).

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS

12 Months Ended

Dec. 31, 2017

Valuation and Qualifying Accounts [Abstract]

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS

SCHEDULE II — VALUATION AND QUALIFYING ACCOUNTS



	Balance at Beginning of Period		Charged to Costs and Expenses			Charged to Other Accounts			Deductions					Balance at End of Period
Description	Balance at Beginning of Period		Charged to Costs and Expenses			Charged to Other Accounts			Deductions					Balance at End of Period
	(In thousands)
Year ended December 31, 2017
Allowance for doubtful accounts and sales returns and allowances	$	6,319	$	4,920		1,518		⁽¹⁾	$	(3,875	)	⁽²⁾		$	8,882
Deferred tax assets valuation allowance	3,604		740			3,617		⁽¹⁾	—			⁽²⁾		7,961
Year ended December 31, 2016:
Allowance for doubtful accounts and sales returns and allowances	$	5,572	$	2,009		$	—		$	(1,262	)	⁽²	⁾	$	6,319
Deferred tax assets valuation allowance	4,887		(1,228		)	—			(55		)	⁽²	⁾	3,604
Year ended December 31, 2015:
Allowance for doubtful accounts and sales returns and allowances	$	5,659	$	1,262		$	—		$	(1,349	)	⁽²	⁾	$	5,572
Deferred tax asset valuation allowance	6,772		80			—			(1,965		)	⁽²	⁾	4,887


⁽¹⁾	Charges to other accounts primarily relates to amounts acquired through acquisition of Derma Sciences and effect of foreign currency translations.


⁽²⁾	Deductions primarily relates to allowance for doubtful accounts written off during the year, net of recoveries and other adjustments.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Policies)

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Basis Of Presentation

BASIS OF PRESENTATION

Principles Of Consolidation

PRINCIPLES OF CONSOLIDATION

Use Of Estimates

USE OF ESTIMATES

Reclassifications

RECLASSIFICATIONS

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

Cash And Cash Equivalents

CASH AND CASH EQUIVALENTS

Trade Accounts Receivable And Allowances For Doubtful Accounts Receivable

TRADE ACCOUNTS RECEIVABLE AND ALLOWANCES FOR DOUBTFUL ACCOUNTS RECEIVABLE

Inventories

INVENTORIES



	December 31,
	2017		2016
	(In thousands)
Finished goods	$	190,100	$	127,973
Work in process	58,637		50,043
Raw materials	47,595		39,247
Total inventories, net	$	296,332	$	217,263

Property, Plant And Equipment

PROPERTY, PLANT AND EQUIPMENT

Capitalized Interest

CAPITALIZED INTEREST

Acquisitions

ACQUISITIONS

Goodwill And Other Intangible Assets

GOODWILL AND OTHER INTANGIBLE ASSETS


•	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.

•

Changes in the carrying amount of goodwill in 2017 and 2016 were as follows:



	Codman Specialty Surgical			Orthopedics and Tissue Technologies			Total
	(In thousands)
Goodwill at January 1, 2016	$	284,976		$	227,413		$	512,389
TEI acquisition working capital adjustment	—			(174		)	(174		)
Foreign currency translation and other	(618		)	(1,026		)	(1,644		)
Goodwill at December 31, 2016	$	284,358		$	226,213		$	510,571
Derma Sciences acquisition	—			73,765			73,765
TGX Medical acquisition	641			—			641
Codman acquisition	346,220			—			346,220
Divestment to Natus	(2,861		)	—			(2,861		)
Foreign currency translation and other	6,409			3,160			9,569
Goodwill at December 31, 2017	$	634,767		$	303,138		$	937,905

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



	Weighted Average Life	December 31, 2017
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	19 years	$	869,174	$	(124,096	)	$	745,078
Customer relationships	13 years	233,430		(91,961		)	141,469
Trademarks/brand names	28 years	104,879		(22,293		)	82,586
Codman trade name	Indefinite	162,900		—			162,900
Supplier relationships	27 years	34,721		(15,092		)	19,629
All other⁽¹⁾	4 years	11,511		(3,546		)	7,965
		$	1,416,615	$	(256,988	)	$	1,159,627



	Weighted Average Life	December 31, 2016
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	17 years	$	479,964	$	(94,991	)	$	384,973
Customer relationships	12 years	152,335		(77,005		)	75,330
Trademarks/brand names	30 years	90,507		(19,158		)	71,349
Supplier relationships	27 years	34,721		(13,664		)	21,057
All other⁽¹⁾	5 years	10,806		(2,340		)	8,466
		$	768,333	$	(207,158	)	$	561,175


(1)	At December 31, 2017 and 2016, all other included IPR&D of $1.0 million, which was indefinite-lived.

LONG-LIVED ASSETS

INTEGRA FOUNDATION

DERIVATIVES

FOREIGN CURRENCY

INCOME TAXES

REVENUE RECOGNITION

Shipping And Handling Fees And Costs

SHIPPING AND HANDLING FEES AND COSTS

Amounts billed to customers for shipping and handling are included in revenues. The related shipping and freight charges incurred by the Company are included in cost of goods sold.

Product Warranties

PRODUCT WARRANTIES

Research And Development

RESEARCH AND DEVELOPMENT

Employee Termination Benefits And Other Exit-Related Costs

EMPLOYEE TERMINATION BENEFITS AND OTHER EXIT-RELATED COSTS

Amendment to the Certificate of Incorporation and Stock Split

AMENDMENT TO THE CERTIFICATE OF INCORPORATION AND STOCK SPLIT

Stock-Based Compensation

STOCK-BASED COMPENSATION

Pension Benefits

PENSION BENEFITS

Concentration Of Credit Risk

CONCENTRATION OF CREDIT RISK

Recently Issued and Adopted Accounting Standards

RECENTLY ISSUED AND ADOPTED ACCOUNTING STANDARDS

consolidated financial statements.

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

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Tables)

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Schedule Of Inventories, Net



	December 31,
	2017		2016
	(In thousands)
Finished goods	$	190,100	$	127,973
Work in process	58,637		50,043
Raw materials	47,595		39,247
Total inventories, net	$	296,332	$	217,263

Schedule Of Property, Plant And Equipment Balances And Corresponding Lives

Property, plant and equipment balances and corresponding lives were as follows:



	December 31,
	2017			2016			Useful Lives
	(In thousands)
Land	$	1,881		$	2,147
Buildings and building improvements	20,243			17,677			5-40 years
Leasehold improvements	90,329			82,432			1-20 years
Machinery and production equipment	137,914			103,818			3-20 years
Surgical instrument kits	30,511			19,871			4-5 years
Information systems and hardware	127,946			111,145			1-7 years
Furniture, fixtures, and office equipment	17,394			16,896			1-15 years
Construction-in-progress	62,967			59,222
Total	489,185			413,208
Less: Accumulated depreciation	(219,934		)	(190,839		)
Property, plant and equipment, net	$	269,251		$	222,369

Schedule Of Changes In Carrying Amount Of Goodwill

Changes in the carrying amount of goodwill in 2017 and 2016 were as follows:



	Codman Specialty Surgical			Orthopedics and Tissue Technologies			Total
	(In thousands)
Goodwill at January 1, 2016	$	284,976		$	227,413		$	512,389
TEI acquisition working capital adjustment	—			(174		)	(174		)
Foreign currency translation and other	(618		)	(1,026		)	(1,644		)
Goodwill at December 31, 2016	$	284,358		$	226,213		$	510,571
Derma Sciences acquisition	—			73,765			73,765
TGX Medical acquisition	641			—			641
Codman acquisition	346,220			—			346,220
Divestment to Natus	(2,861		)	—			(2,861		)
Foreign currency translation and other	6,409			3,160			9,569
Goodwill at December 31, 2017	$	634,767		$	303,138		$	937,905

Schedule of Finite-Lived Intangible Assets

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



	Weighted Average Life	December 31, 2017
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	19 years	$	869,174	$	(124,096	)	$	745,078
Customer relationships	13 years	233,430		(91,961		)	141,469
Trademarks/brand names	28 years	104,879		(22,293		)	82,586
Codman trade name	Indefinite	162,900		—			162,900
Supplier relationships	27 years	34,721		(15,092		)	19,629
All other⁽¹⁾	4 years	11,511		(3,546		)	7,965
		$	1,416,615	$	(256,988	)	$	1,159,627



	Weighted Average Life	December 31, 2016
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	17 years	$	479,964	$	(94,991	)	$	384,973
Customer relationships	12 years	152,335		(77,005		)	75,330
Trademarks/brand names	30 years	90,507		(19,158		)	71,349
Supplier relationships	27 years	34,721		(13,664		)	21,057
All other⁽¹⁾	5 years	10,806		(2,340		)	8,466
		$	768,333	$	(207,158	)	$	561,175


(1)	At December 31, 2017 and 2016, all other included IPR&D of $1.0 million, which was indefinite-lived.

Schedule of Indefinite-Lived Intangible Assets

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



	Weighted Average Life	December 31, 2017
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	19 years	$	869,174	$	(124,096	)	$	745,078
Customer relationships	13 years	233,430		(91,961		)	141,469
Trademarks/brand names	28 years	104,879		(22,293		)	82,586
Codman trade name	Indefinite	162,900		—			162,900
Supplier relationships	27 years	34,721		(15,092		)	19,629
All other⁽¹⁾	4 years	11,511		(3,546		)	7,965
		$	1,416,615	$	(256,988	)	$	1,159,627



	Weighted Average Life	December 31, 2016
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in Thousands)
Completed technology	17 years	$	479,964	$	(94,991	)	$	384,973
Customer relationships	12 years	152,335		(77,005		)	75,330
Trademarks/brand names	30 years	90,507		(19,158		)	71,349
Supplier relationships	27 years	34,721		(13,664		)	21,057
All other⁽¹⁾	5 years	10,806		(2,340		)	8,466
		$	768,333	$	(207,158	)	$	561,175


(1)	At December 31, 2017 and 2016, all other included IPR&D of $1.0 million, which was indefinite-lived.

DISCONTINUED OPERATIONS (Tables)

12 Months Ended

Dec. 31, 2017

Discontinued Operations and Disposal Groups [Abstract]

Balance Sheet and Income Statement of Disposal Group

The following table summarizes results from discontinued operations of SeaSpine included in the consolidated statement of operations for the year ended December 31, 2015 (in thousands):



Total revenue	$	65,775
Costs and expenses	80,618
Operating loss	(14,843		)
Other expense, net	(766		)
Loss from discontinued operations before tax	(15,609		)
Benefit for income taxes	(5,239		)
Loss from discontinued operations	$	(10,370	)

The following table presents Integra's spine business assets and liabilities removed from the consolidated balance sheet as of July 1, 2015:



Assets:
Cash	$	47,178
Accounts receivable	20,856
Inventory	49,425
Other current assets	13,411
Current assets of discontinued operations	130,870
Property, plant, and equipment, net	21,093
Intangible assets, net	43,122
Other assets	4,465
Non-current assets of discontinued operations	68,680
Total assets of discontinued operations	$	199,550
Liabilities:
Accounts payable	$	7,072
Accrued compensation	5,964
Accrued expenses and other current liabilities	3,361
Current liabilities of discontinued operations	16,397
Deferred tax liabilities	13,331
Other liabilities	2,593
Long-term liabilities of discontinued operations	15,924
Total liabilities of discontinued operations	$	32,321

Assets and liabilities divested consisted of the following as of October 6, 2017 (amounts in thousands):



Inventories	$	8,348
Prepaid expenses and other current assets	36
Assets held for sale	30,813
Property, plant and equipment, net	1,122
Goodwill	2,861
Total assets divested	$	43,180

Deferred revenue	$	1,082
Accrued compensation	209
Total liabilities divested	$	1,291

- Definition

Tabular disclosure of information related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

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Reference 2: http://www.xbrl.org/2003/role/presentationRef
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Reference 3: http://www.xbrl.org/2003/role/presentationRef
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Reference 4: http://www.xbrl.org/2003/role/presentationRef
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Reference 7: http://www.xbrl.org/2003/role/presentationRef
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Reference 10: http://www.xbrl.org/2003/role/presentationRef
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-Name Accounting Standards Codification
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Reference 11: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
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Reference 12: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 205
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+ Details

ACQUISITIONS, DIVESTITURE AND PRO FORMA RESULTS (Tables)

12 Months Ended

Dec. 31, 2017

Business Combinations [Abstract]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

The following summarizes the preliminary allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Preliminary Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Inventory	77,921
Assets held for sale	30,813
Other current assets	2,036
Property, plant and equipment	35,949
Intangible assets:
Codman corporate trade name	162,900		Indefinite
Completed technology	379,900		22 years
Goodwill	346,219
Total assets acquired	1,035,738
Accrued expenses	1,730
Pension liabilities	19,917
Net assets acquired	$	1,014,091

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Inventory	$	1,143
Property, plant and equipment	669
Other current assets	11
Intangible assets:
Supplier Contracts	4,981		2 - 13 Years
Goodwill	9,665
Total assets acquired	16,469
Accrued expenses and other liabilities acquired	802
Deferred tax liability	1,564
Net assets acquired	$	14,103

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Cash	$	1,241
Accounts receivable, net	9,011
Inventory	23,223
Property, plant, and equipment	2,027
Income tax receivable	5,135
Other current assets	2,670
Intangible assets:
Developed technology	167,400		14 - 16 Years
Contractual relationships	51,345		11 - 14 Years
Leasehold interest	69
Goodwill	147,704
Total assets acquired	409,825
Accrued expenses and other liabilities	9,732
Deferred tax liabilities	87,908
Net assets acquired	$	312,185

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Cash and cash equivalents	$	16,512
Short-term investments	19,238
Accounts receivable	8,949
Inventory	17,977
Prepaid expenses and other current assets	4,369
Property, plant and equipment	4,311
Intangible assets:
Customer relationship	78,300		14 years
Trademarks/brand names	13,500		15 years
Completed technology	11,600		14 years
Non-compete agreement	280		1 year
Goodwill	73,765
Deferred tax assets	14,524
Other assets	101
Total assets acquired	263,426
Accounts payable	4,560
Accrued expenses and other current liabilities	7,409
Contingent liability	37,174
Other liabilities	3,805
Net assets acquired	$	210,478

The following summarizes the allocation of the purchase price as based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Inventory	$	2,688
Property, plant, and equipment	1,453
Intangible assets:
Ankle product family	3,210		11 years
Toe product family	460		10 years
Total assets acquired	7,811
Deferred tax liability	700
Net assets acquired	$	7,111

The following summarizes the allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed:



	Purchase Price Allocation		Weighted Average Life
	(Dollars in thousands)
Cash and cash equivalents	$	49
Accounts receivables	279
Property, plant and equipment	3
Intangible assets:
Completed technology	4,707		13 Years
Goodwill	641
Total assets acquired	5,679
Accounts payable	13
Accrued expenses and other current liabilities	65
Other liabilities	234
Net assets acquired	$	5,367

Pro Forma Financial Information, Summary of Results of Operations



	Year Ended December 31,
	2017		2016		2015
	(Pro forma)
	(In thousands except per share amounts)
Total revenue from continuing operations	$	1,428,491	$	1,446,903	$	940,005
Net income from continuing operations	$	81,730	$	27,520	$	10,694

Basic earnings per share from continuing operations	$	1.06	$	0.37	$	0.31

Schedule of Assets and Liabilities Divested

The following table summarizes results from discontinued operations of SeaSpine included in the consolidated statement of operations for the year ended December 31, 2015 (in thousands):



Total revenue	$	65,775
Costs and expenses	80,618
Operating loss	(14,843		)
Other expense, net	(766		)
Loss from discontinued operations before tax	(15,609		)
Benefit for income taxes	(5,239		)
Loss from discontinued operations	$	(10,370	)

The following table presents Integra's spine business assets and liabilities removed from the consolidated balance sheet as of July 1, 2015:



Assets:
Cash	$	47,178
Accounts receivable	20,856
Inventory	49,425
Other current assets	13,411
Current assets of discontinued operations	130,870
Property, plant, and equipment, net	21,093
Intangible assets, net	43,122
Other assets	4,465
Non-current assets of discontinued operations	68,680
Total assets of discontinued operations	$	199,550
Liabilities:
Accounts payable	$	7,072
Accrued compensation	5,964
Accrued expenses and other current liabilities	3,361
Current liabilities of discontinued operations	16,397
Deferred tax liabilities	13,331
Other liabilities	2,593
Long-term liabilities of discontinued operations	15,924
Total liabilities of discontinued operations	$	32,321

Assets and liabilities divested consisted of the following as of October 6, 2017 (amounts in thousands):



Inventories	$	8,348
Prepaid expenses and other current assets	36
Assets held for sale	30,813
Property, plant and equipment, net	1,122
Goodwill	2,861
Total assets divested	$	43,180

Deferred revenue	$	1,082
Accrued compensation	209
Total liabilities divested	$	1,291

- Definition

+ References

+ Details

DEBT (Tables)

12 Months Ended

Dec. 31, 2017

Debt Disclosure [Abstract]

Schedule of Long-term Debt Maximum Leverage Ratios

In connection with the March 2017 Amendment, the Company’s maximum consolidated total leverage ratio in the financial covenants was increased to the following:



Fiscal Quarter		Maximum Consolidated Total Leverage Ratio

December 31, 2016 through before the first fiscal quarter after the delayed draw date of Term Loan A-1		4.50 : 1.00
First fiscal quarter ended after the delayed draw date of Term Loan A-1 through September 30, 2018		5.50 : 1.00
October 1, 2018 through September 30, 2019		5.00 : 1.00
October 1, 2019 through September 30, 2020		4.50 : 1.00
October 1, 2020 and thereafter		4.00 : 1.00

Schedule of Maturities of Long-term Debt

Contractual repayments of the Term A and Term A-1 components of Senior Credit Facility are due as follows:



Year Ended December 31,	Principal Repayment
	(In thousands)
2018	$	60,000
2019	60,000
2020	90,000
2021	990,000

Components of Interest Expense

The interest expense components of the Company’s convertible notes are as follows:



	Years Ended December 31,
	2016		2015
	(In thousands)
2016 Convertible Notes:
Amortization of the discount on the liability component (1)	$	8,073	$	7,917
Cash interest related to the contractual interest coupon (2)	3,407		3,430
Total	$	11,480	$	11,347


(1)	The amortization of the discount on the liability component of the 2016 Convertible Notes is presented net of capitalized interest of $0.3 million and $0.6 million for the years ended December 31, 2016 and 2015, respectively.


(2)	The cash interest related to the contractual interest coupon on the 2016 Convertible Notes is presented net of capitalized interest of $0.1 million and $0.3 million for the years ended December 31, 2016 and 2015.

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

DERIVATIVE INSTRUMENTS (Tables)

12 Months Ended

Dec. 31, 2017

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Derivative Instruments

The Company held the following interest rate swaps as of December 31, 2017 (dollar amounts in thousands):



Hedged Item	Current Notional Amount		Designation Date	Effective Date	Termination Date	Fixed Interest Rate		Floating Rate	Estimated Fair Value
									Assets (Liabilities)
3-month USD LIBOR Loan	$	50,000	June 22, 2016	December 31, 2016	June 30, 2019	1.062	%	3-month USD LIBOR	$	675
3-month USD LIBOR Loan	50,000		June 22, 2016	December 31, 2016	June 30, 2019	1.062	%	3-month USD LIBOR	672
1-month USD LIBOR Loan	50,000		July 12, 2016	December 31, 2016	June 30, 2019	0.825	%	1-month USD LIBOR	779
3-month USD LIBOR Loan	50,000		February 6, 2017	June 30, 2017	June 30, 2020	1.834	%	3-month USD LIBOR	318
1-month USD LIBOR Loan	100,000		February 6, 2017	June 30, 2017	June 30, 2020	1.652	%	1-month USD LIBOR	858
1-month USD LIBOR Loan	100,000		March 27, 2017	December 31, 2017	June 30, 2021	1.971	%	1-month USD LIBOR	337
1-month USD LIBOR Loan	150,000		December 13, 2017	January 1, 2018	December 31, 2022	2.201	%	1-month USD LIBOR	(455		)
1-month USD LIBOR Loan	150,000		December 13, 2017	January 1, 2018	December 31, 2022	2.201	%	1-month USD LIBOR	(434		)
1-month USD LIBOR Loan	100,000		December 13, 2017	July 1, 2019	June 30, 2024	2.423	%	1-month USD LIBOR	(684		)
1-month USD LIBOR Loan	50,000		December 13, 2017	July 1, 2019	June 30, 2024	2.423	%	1-month USD LIBOR	(255		)
1-month USD LIBOR Loan	200,000		December 13, 2017	January 1, 2018	December 31, 2024	2.313	%	1-month USD LIBOR	(1,219		)
Total interested rate derivatives designated as cash flow hedge	$	1,050,000							$	592

The Company held the following cross-currency rate swaps as of December 31, 2017 (dollar amounts in thousands):



	Effective Date	Termination Date	Fixed Rate	Aggregate Notional Amount		Fair Value Asset (Liability)

Pay CHF	October 2, 2017	October 2, 2020	1.75%	CHF	97,065	$	(742	)
Receive U.S.$	October 2, 2017	October 2, 2020	4.38%	$	100,000	$	(742	)

Pay CHF	October 2, 2017	October 2, 2021	1.85%	CHF	48,533	(610		)
Receive U.S.$	October 2, 2017	October 2, 2021	4.46%	$	50,000	(610		)

Pay CHF	October 2, 2017	October 2, 2022	1.95%	CHF	145,598	(2,605		)
Receive U.S.$	October 2, 2017	October 2, 2022	4.52%	$	150,000	(2,605		)

Total						$	(3,957	)

Summary of Fair Value in Balance Sheet for Derivatives Designated as Hedging Instruments

The following table summarizes the fair value and presentation in the consolidated balance sheet for derivatives designated as hedging instruments:



	Fair Value as of December 31,
	2017		2016
Location on Balance Sheet ⁽¹⁾:	(In thousands)
Derivatives designated as hedges — Assets:
Prepaid expenses and other current assets
Interest rate swap⁽²⁾	$	1,521	$	242
Cross-currency swap	7,757		—
Other assets
Interest rate swap⁽²⁾	2,491		1,629
Total Derivatives designated as hedges — Assets	$	11,769	$	1,871

Derivatives designated as hedge — Liabilities
Accrued expenses and other current liabilities
Interest rate swap⁽²⁾	$	1,845	$	—
Other liabilities
Interest rate swap⁽²⁾	1,575		—
Cross-currency swap	11,714		—
Total Derivative designated as hedges — Liabilities	$	15,134	$	—


⁽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 December 31, 2017 and 2016, the total notional amounts related to the Company’s interest rate swaps were $1.1 billion and $150.0 million, respectively.

Effect of Derivative Instruments Designated as Cash Flow Hedges on Statements of Operations

The following presents the effect of derivative instruments designated as cash flow hedges on the accompanying consolidated statements of operations during the years ended December 31, 2017 and 2016:



	Balance in AOCI Beginning of Year		Amount of Gain (Loss) Recognized in AOCI			Amount of Gain (Loss) Reclassified from AOCI into Earnings			Balance in AOCI End of Year			Location in Statements of Operations
	(In thousands)
Year Ended December 31, 2017
Interest rate swap	$	1,871	$	(1,355	)	$	(76	)	$	592		Interest (expense)
Cross-currency swap	—		(2,070		)	3,034			(5,104		)	Other income (expense)
	$	1,871	$	(3,425	)	$	2,958		$	(4,512	)
Year Ended December 31, 2016
Interest rate swap	$	—	$	1,871		$	—		$	1,871		Interest (expense)
	$	—	$	1,871		$	—		$	1,871

- Definition

Tabular disclosure of pertinent information about a derivative or group of derivatives on a disaggregated basis, such as for individual instruments, or small groups of similar instruments. May include a combination of the type of instrument, risks being hedged, notional amount, hedge designation, related hedged item, inception date, maturity date, or other relevant item.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 815
-SubTopic 10
-Section 50
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-Name Accounting Standards Codification
-Topic 235
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-Subparagraph (SX 210.4-08.(n)(2))
-URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690

+ Details

STOCK-BASED COMPENSATION (Tables)

12 Months Ended

Dec. 31, 2017

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Summary Of Employee Stock-Based Compensation Expense

Stock-based compensation expense - all related to employees and members of the Board of Directors - recognized under the authoritative guidance was as follows:



	Years Ended December 31,
	2017		2016		2015
	(In thousands)
Selling, general and administrative	$	19,785	$	15,829	$	14,461
Research and development	1,273		1,048		714
Cost of goods sold	492		433		275
Total stock-based compensation expense	21,550		17,310		15,450
Total estimated tax benefit related to stock-based compensation expense	15,448		10,569		5,792
Net effect on net income	$	6,102	$	6,741	$	9,658

Summary Of Weighted-Average Assumptions

The following weighted-average assumptions were used in the calculation of fair value:



	Years Ended December 31,
	2017	2016	2015
Dividend yield	0%	0%	0%
Expected volatility	30%	29%	29%
Risk free interest rate	2.18%	1.94%	1.96%
Expected life of option from grant date	8 years	8 years	8 years

Summary Of Stock Option Activity

The following table summarizes the Company’s stock option activity.



			Weighted Average Exercise Price		Weighted Average Contractual Term in Years	Aggregate Intrinsic Value

	Shares
Stock Options	(In thousands)					(In thousands)
Outstanding at January 1, 2017	2,083		$	20.65
Granted	187		41.72
Exercised	(531	)	17.60
Forfeited or Expired	—		—
Outstanding at December 31, 2017	1,739		$	23.84	3.54	$	41,753
Vested or expected to vest at December 31, 2017	1,739		$	23.84	3.54	$	41,753
Exercisable at December 31, 2017	1,333		$	19.95	2.63	$	37,208

Summary Of Restricted Stock, Performance Stock, and Contract Stock

The following table summarizes the Company’s awards of restricted stock, performance stock and contract stock for the year ended December 31, 2017.



					Performance Stock and Contract Stock Awards
	Restricted Stock Awards				Performance Stock and Contract Stock Awards
	Shares		Weighted Average Grant Date Fair Value Per Share		Shares		Weighted Average Grant Date Fair Value Per Share


	(In thousands)				(In thousands)
Unvested, January 1, 2017	512		$	28.49	345		$	21.62
Granted	286		44.15		213		43.75
Adjustments for performance achievement related to award target	—		—		25		36.90
Cancellations	(61	)	36.00		(12	)	30.52
Released	(286	)	27.89		(225	)	43.11
Vested but not released	—		—		(174	)	32.40
Unvested, December 31, 2017	451		$	37.79	172		$	33.61

RETIREMENT BENEFIT PLANS (Tables)

12 Months Ended

Dec. 31, 2017

Retirement Benefits [Abstract]

Schedule of Net Periodic Benefit Costs

Net periodic benefit costs for the Company’s defined benefit pension plans for the year ended December 31, 2017 included the following amounts (amounts in thousand):



Service cost	$	565
Interest cost	95
Expected return on plan assets	(224		)
Recognized net actuarial loss	8
Net period benefit cost	$	444

Schedule of Weighted Average Assumptions Used



Discount rate	0.74	%
Expected return on plan assets	3.08	%
Rate of compensation increase	1.70	%

Schedule of Benefit Obligations and Plan Assets



Change In Projected Benefit Obligations
Projected benefit obligation, beginning of year	$	668
Interest cost	95
Service cost	565
Actuarial loss	(12		)
Employee contribution	180
Premiums paid	(89		)
Benefit payment	(19		)
Transfer from Codman Neurosurgery acquisition	46,448
Effect of foreign currency exchange rates	(175		)
Projected benefit obligation, end of year	$	47,661

Change In Plan Assets
Plan assets at fair value, beginning of year	$	—
Actual return on plan assets	82
Employer contributions	450
Employee contributions	180
Premiums paid	(89		)
Transfer from Codman Neurosurgery acquisition	26,477
Effect of foreign currency exchange rates	(157		)
Plan assets at fair value, end of year	$	26,943

Schedule of Funded Status



Reconciliation Of Funded Status
Fair value of plan assets	$	26,943
Benefit obligations	47,661
Unfunded benefit obligation	$	20,718

Schedule of Expected Benefit Payments and Minimum Contribution on Unfunded Plans

The following table is the summary of expected future benefit payments (in thousands):



2018	$	158
2019	225
2020	296
2021	454
2022	466
Next five years	5,380

LEASES AND RELATED PARTY LEASES (Tables)

12 Months Ended

Dec. 31, 2017

Leases [Abstract]

Schedule Of Minimum Lease Payments for Operating Leases

Future minimum lease payments under operating leases at December 31, 2017 were as follows:



	Related Parties		Third Parties		Total
	(In thousands)
2018	$	296	$	13,449	$	13,745
2019	296		12,245		12,541
2020	296		9,534		9,830
2021	296		7,058		7,354
2022	296		5,849		6,145
Thereafter	2,019		45,714		47,733
Total minimum lease payments	$	3,499	$	93,849	$	97,348

INCOME TAXES (Tables)

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Schedule Of Income (Loss) Before Income Taxes

Income (Loss) before income taxes consisted of the following:



	Years Ended December 31,
	2017			2016		2015
	(In thousands)
United States operations	$	(32,640	)	$	51,351	$	37,450
Foreign operations	44,025			39,055		23,221
Total	$	11,385		$	90,406	$	60,671

Schedule Of Effective Income Tax Rate Reconciliation

A reconciliation of the U.S. Federal statutory rate to the Company’s effective tax rate is as follows:



	Years Ended December 31,
	2017		2016		2015
Federal statutory rate	35.0	%	35.0	%	35.0	%
Increase (decrease) in income taxes resulting from:
State income taxes, net of federal tax benefit	(17.0	)%	(0.2	)%	1.3	%
Foreign operations	(112.7	)%	(10.0	)%	(12.5	)%
Spine valuation allowance	—	%	—	%	61.1	%
Excess tax benefits from stock compensation	(57.9	)%	(3.9	)%	—	%
Charitable contributions	(10.6	)%	(0.4	)%	(1.0	)%
Nondeductible meals and entertainment	8.8	%	0.8	%	0.9	%
Domestic production activities deduction	—	%	(2.6	)%	(2.4	)%
Intercompany profit in inventory	11.6	%	1.0	%	3.1	%
Nondeductible facilitative costs	22.5	%	0.2	%	3.1	%
Changes in valuation allowances	8.0	%	0.4	%	0.3	%
Uncertain tax positions	(4.6	)%	(0.3	)%	0.2	%
Research and development credit	(13.2	)%	(1.2	)%	(1.9	)%
Return to provision	(4.3	)%	(1.5	)%	1.7	%
Reduction of book gain on sale of assets	(4.6	)%	—	%	—	%
Tax reform — Toll Tax	48.1	%	—	%	—	%
Tax reform — remeasurement of deferred tax assets and liabilities	(378.6	)%	—	%	—	%
Other	0.8	%	0.2	%	(0.2	)%
Effective tax rate	(468.7	)%	17.5	%	88.7	%

Schedule Of Provision For Income Taxes

The provision for income taxes consisted of the following:



	Years Ended December 31,
	2017			2016			2015
	(In thousands)
Current:
Federal	$	6,644		$	13,700		$	46,665
State	1,233			2,503			2,301
Foreign	6,069			6,113			5,205
Total current	$	13,946		$	22,316		$	54,171
Deferred:
Federal	(66,466		)	(3,400		)	1,282
State	(758		)	(1,751		)	(394		)
Foreign	(80		)	(1,323		)	(1,239		)
Total deferred	$	(67,304	)	$	(6,474	)	$	(351	)
Provision for income taxes	$	(53,358	)	$	15,842		$	53,820

Schedule Of Deferred Tax Assets And Liabilities

The income tax effects of significant temporary differences that give rise to deferred tax assets and liabilities, shown before jurisdictional netting, are presented below:



	December 31,
	2017			2016
	(In thousands)
Assets:
Doubtful accounts	$	1,811		$	2,344
Inventory related items	29,266			30,074
Tax credits	6,015			1,040
Accrued vacation	2,556			3,264
Accrued bonus	997			7,842
Stock compensation	10,426			16,031
Deferred revenue	2,395			2,345
Net operating loss carryforwards	37,492			15,058
Unrealized foreign exchange loss	1,177			96
Charitable contributions carryforward	1,287			5
Others	3,077			128
Total deferred tax assets	96,499			78,227
Less valuation allowance	(7,961		)	(3,604		)
Deferred tax assets after valuation allowance	$	88,538		$	74,623
Liabilities:
Intangible and fixed assets	(146,327		)	(215,438		)
Others	(1,091		)	(1,191		)
Total deferred tax liabilities	$	(147,418	)	$	(216,629	)
Total net deferred tax liabilities	$	(58,880	)	$	(142,006	)

Schedule Of Uncertain Tax Benefits Reconciliation

A reconciliation of the beginning and ending amount of uncertain tax benefits is as follows:



	Years Ended December 31,
	2017			2016			2015
	(In thousands)
Balance, beginning of year	$	754		$	1,085		$	959
Gross increases:
Current year tax positions	402			—			—
Prior years' tax positions	—			380			541
Gross decreases:
Prior years' tax positions	(777		)	(546		)	—
Settlements	—			—			—
Statute of limitations lapses	(17		)	(131		)	(404		)
Other	62			(34		)	(11		)
Balance, end of year	$	424		$	754		$	1,085

NET INCOME (LOSS) PER SHARE (Tables)

12 Months Ended

Dec. 31, 2017

Earnings Per Share [Abstract]

Basic And Diluted Net Income (Loss) Per Share

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



	Years Ended December 31,
	2017		2016		2015
	(In thousands, except per share amounts)
Basic net income (loss) per share:
Net income from continuing operations	$	64,743	$	74,564	$	6,851
Net loss from discontinued operations	—		—		(10,370		)
Net income (loss)	$	64,743	$	74,564	$	(3,519	)

Weighted average common shares outstanding	76,897		74,386		68,990

Basic net income per common share from continuing operations	$	0.84	$	1.00	$	0.10
Basic net loss per common share from discontinued operations	—		—		(0.15		)
Basic net income (loss) per common share	$	0.84	$	1.00	$	(0.05	)

Diluted net income (loss) per share:
Net income from continuing operations	$	64,743	$	74,564	$	6,851
Net loss from discontinued operations	—		—		(10,370		)
Net income (loss)	$	64,743	$	74,564	$	(3,519	)

Weighted average common shares outstanding — Basic	76,897		74,386		68,990
Effect of dilutive securities:
2016 Convertible notes	—		2,296		922
Warrants	971		1,166		—
Stock options and restricted stock	1,253		1,346		1,442
Weighted average common shares for diluted earnings per share	79,121		79,194		71,354


Diluted net income per common share from continuing operations	$	0.82	$	0.94	$	0.10
Diluted net loss per common share from discontinued operations	—		—		(0.15		)
Diluted net income (loss) per common share	$	0.82	$	0.94	$	(0.05	)

COMMITMENTS AND CONTINGENCIES (Tables)

12 Months Ended

Dec. 31, 2017

Commitments and Contingencies Disclosure [Abstract]

Schedule of Contingent Consideration

A reconciliation of the opening balances to the closing balances of these Level 3 measurements for the year ended December 31, 2017 and 2016 is as follows (in thousands):



	Contingent Consideration Liabilities Related to Acquisition of Derma Sciences (See Note 4)						Contingent Consideration Liability Related to Acquisition of Confluent Surgical, Inc.					Location in Financial Statements
	Short-term			Long-term			Short-term		Long-term
Balance as of January 1, 2016	$	—		$	—		$	—	$	21,831
Change in fair value	—			—			—		205			Selling, general and administrative
Balance as of December 31, 2016	—			—			—		22,036
Additions from acquisition of Derma Sciences	33,707			3,467			—		—
Transfers from long-term to current portion	2,193			(2,193		)	22,184		(22,184		)
Payments	(31,346		)	—			—		—
Change in fair value	(4,239		)	113			294		148			Selling, general and administrative
Balance as of December 31, 2017	$	315		$	1,387		$	22,478	$	—

Fair Value, Net Derivative Asset (Liability) Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]

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



	Supply Agreement Liability						Above Market Supply Agreement Liability						Location in Statement of Operations
	Short-term			Long-term			Short-term			Long-term
Balance as of January 1, 2016	$	1,991		$	161		$	—		$	931
Payments	(2,000		)	—			—			(47		)
Transfer from long-term to current potion	161			(161		)	—			—
Loss from increase in fair value	14			—			—			1,083			Selling, general and administrative
Other	—			—			—			681			Goodwill
Balance as of December 31, 2016	166			—			—			2,648
Payments	(166		)	—			(113		)	(415		)
Transfer	—			—			3,273			(3,273		)
Loss from increase in fair value	—			—			(519		)	1,040			Selling, general and administrative
Balance as of December 31, 2017	$	—		$	—		$	2,641		$	—

SEGMENT AND GEOGRAPHIC INFORMATION (Tables)

12 Months Ended

Dec. 31, 2017

Segment Reporting [Abstract]

Schedule of Segment Reporting Information, by Segment

Net sales and profit by reportable segment for the years ended December 31, 2017, 2016 and 2015 are as follows:



	Years Ended December 31,
	2017			2016			2015
	(In thousands)
Segment Net Sales
Codman Specialty Surgical	$	720,301		$	632,524		$	586,918
Orthopedics and Tissue Technologies	467,935			359,551			295,816
Total revenues	$	1,188,236		$	992,075		$	882,734
Segment Profit
Codman Specialty Surgical	$	292,971		$	256,629		$	242,479
Orthopedics and Tissue Technologies	129,697			103,852			87,844
Segment profit	422,668			360,481			330,323
Amortization	(20,370)			(13,862)			(9,953)
Corporate and other	(357,494		)	(231,279		)	(240,783		)
Operating income	$	44,804		$	115,340		$	79,587

Total revenue, net and long-lived assets (tangible) by major geographic area are summarized below:



	United States*		Europe		Rest of the World		Consolidated
	(In thousands)
Total revenue, net:
2017	$	894,260	$	150,147	$	143,829	$	1,188,236
2016	765,608		120,588		105,879		992,075
2015	680,824		103,057		98,853		882,734
Total long-lived assets:
2017	$	247,154	$	30,942	$	7,233	$	285,329
2016	213,898		18,970		1,235		234,103

* Includes long-lived assets in Puerto Rico.

SELECTED QUARTERLY INFORMATION - UNAUDITED (Tables)

12 Months Ended

Dec. 31, 2017

Selected Quarterly Financial Information [Abstract]

Selected Quarterly Information



(In thousands, except per share data)
Quarter	Total revenue, net		Gross margin		Net income		Per Share - Basic (1)		Per Share - Diluted (1)
2017
First	$	258,636	$	172,051	$	6,394	$	0.09	$	0.08
Second	282,164		183,166		10,835		0.14		0.14
Third	278,834		177,077		3,159		0.04		0.04
Fourth (3) (4)	368,602		220,431		44,355		0.57		0.56
	$	1,188,236	$	752,725	$	64,743

2016
First (2)	$	236,770	$	151,997	$	13,419	$	0.18	$	0.18
Second	249,309		159,744		12,755		0.17		0.16
Third	250,332		161,003		20,144		0.27		0.25
Fourth	255,664		170,242		28,246		0.38		0.35
	$	992,075	$	642,986	$	74,564

(3) The net income for the fourth quarter of 2017 includes gain on sale of business of $2.6 million related to Divestiture to Natus.

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Narrative) (Details)						1 Months Ended	3 Months Ended		12 Months Ended			30 Months Ended
	Jul. 31, 2017 Segment	Dec. 21, 2016 shares	Dec. 15, 2016 shares	Oct. 25, 2016 $ / shares shares	Jul. 02, 2015	Dec. 31, 2016 USD ($) $ / shares shares	Sep. 30, 2017 USD ($)	Mar. 31, 2015 Segment	Dec. 31, 2017 USD ($) Customer Segment $ / shares shares	Dec. 31, 2016 USD ($) Customer $ / shares shares	Dec. 31, 2015 USD ($) Customer	Dec. 31, 2017 USD ($) Segment $ / shares shares	Oct. 24, 2016 shares
Summary Of Significant Accounting Policies [Line Items]
Stock split ratio, Common stock		2		2
Provision for doubtful accounts									$ 2,000,000	$ 400,000	$ 1,000,000
Inventory, capitalized expenses									0	0
Depreciation expense									36,100,000	31,200,000	27,000,000
Interest expense capitalized to property, plant, and equipment									$ 1,100,000	1,000,000
Number of reportable segments \| Segment								3	2			2
Number of underlying reporting units \| Segment	3								3
Goodwill, impairment loss									$ 0
Impairment of indefinite-lived Assets							$ 0
Amortization expense									52,800,000	41,500,000	32,200,000
Annual amortization expense expected to approximate in 2018									66,900,000			$ 66,900,000
Annual amortization expense expected to approximate in 2019									66,800,000			66,800,000
Annual amortization expense expected to approximate in 2020									66,700,000			66,700,000
Annual amortization expense expected to approximate in 2021									65,700,000			65,700,000
Annual amortization expense expected to approximate in 2022									62,200,000			62,200,000
Annual amortization expense expected to approximate thereafter									658,900,000			658,900,000
Charitable contributions									500,000	0	900,000
Foreign currency transaction (loss) gain									$ (2,900,000)	300,000	(500,000)
Number of days from shipment to issue a credit									90 days
Distribution and handling costs									$ 13,500,000	13,600,000	13,700,000
Extended warranties, in years (up to)									2 years
Accrued warranty expense						$ 800,000			$ 700,000	$ 800,000		$ 700,000
Common stock, shares authorized (in shares) \| shares				240,000,000.0		240,000,000			240,000,000	240,000,000		240,000,000	60,000,000.0
Common stock, par value (in dollars per share) \| $ / shares				$ 0.01		$ 0.01			$ 0.01	$ 0.01		$ 0.01
Stock split, number of additional shares of common stock for each share held (in shares) \| shares		1
Fractional shares issued (in shares) \| shares		0
Defined benefit plan, contributions by employer									$ 450,000		1,800,000
Defined benefit plan, recognized net gain (loss) due to settlements and curtailments											(5,600,000)
Pension contributions									500,000	$ 0	2,200,000
Payment of accreted interest									0	(42,786,000)	(384,000)
Interest paid									32,300,000	14,400,000	12,700,000
Interest paid, capitalized into construction in progress									1,100,000	1,000,000	1,700,000
Stock issued during period, shares, conversion of convertible securities (in shares) \| shares			2,900,000
Treasury stock, cost						$ 123,100,000			121,600,000	123,100,000		$ 121,600,000
Income taxes paid									14,600,000	4,300,000	21,300,000
Property and equipment purchases included in liabilities									$ 7,800,000	$ 4,700,000	$ 4,700,000
Sales Revenue, Net
Summary Of Significant Accounting Policies [Line Items]
Concentration risk, number of customers over benchmark \| Customer									0	0	0
Concentration risk, percentage									10.00%	10.00%	10.00%
Common Stock
Summary Of Significant Accounting Policies [Line Items]
Settlement of convertible notes						$ 122,000,000				$ 29,000
Stock issued during period, shares, conversion of convertible securities (in shares) \| shares						2,900,000				2,946,000
Exercise of warrants (in shares) \| shares									2,840,000
2016 Convertible Senior Notes
Summary Of Significant Accounting Policies [Line Items]
Interest rate on debt						1.625%				1.625%	1.625%
Tarsus Medical, Inc. \| Orthopedics and Tissue Technologies
Summary Of Significant Accounting Policies [Line Items]
Impairment of finite-lived assets							$ 3,300,000
In-process research and development
Summary Of Significant Accounting Policies [Line Items]
Impairment charges									$ 0	$ 0	$ 400,000
Technology
Summary Of Significant Accounting Policies [Line Items]
Amortization expense, included in cost of product revenues									$ 35,700,000	27,600,000	$ 22,300,000
Computer Equipment
Summary Of Significant Accounting Policies [Line Items]
Capital leased assets, gross						$ 2,000,000				2,000,000
Capital leases, accumulated depreciation						$ 2,000,000				$ 2,000,000
SeaSpine Inc. \| Discontinued Operations, Disposed of by Means Other than Sale, Spinoff
Summary Of Significant Accounting Policies [Line Items]
Distribution of spinoff shares					100.00%
Shares of Integra for share of SeaSpine					0.3333
Convertible Debt
Summary Of Significant Accounting Policies [Line Items]
Warrants exercised (in shares) \| shares									8,707,202
Exercise of warrants (in shares) \| shares									2,839,743
Convertible Debt \| 2016 Convertible Senior Notes
Summary Of Significant Accounting Policies [Line Items]
Interest rate on debt			1.625%

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Schedule Of Inventories, Net) (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Finished goods	$ 190,100	$ 127,973
Work in process	58,637	50,043
Raw materials	47,595	39,247
Total inventories, net	$ 296,332	$ 217,263

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Schedule Of Property, Plant And Equipment Balances And Corresponding Lives) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 489,185	$ 413,208
Less: Accumulated depreciation	(219,934)	(190,839)
Property, plant and equipment, net	269,251	222,369
Land
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	1,881	2,147
Buildings and building improvements
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 20,243	17,677
Buildings and building improvements \| Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	5 years
Buildings and building improvements \| Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	40 years
Leasehold improvements
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 90,329	82,432
Leasehold improvements \| Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	1 year
Leasehold improvements \| Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	20 years
Machinery and production equipment
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 137,914	103,818
Machinery and production equipment \| Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	3 years
Machinery and production equipment \| Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	20 years
Surgical instrument kits
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 30,511	19,871
Surgical instrument kits \| Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	4 years
Surgical instrument kits \| Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	5 years
Information systems and hardware
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 127,946	111,145
Information systems and hardware \| Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	1 year
Information systems and hardware \| Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	7 years
Furniture, fixtures, and office equipment
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 17,394	16,896
Furniture, fixtures, and office equipment \| Minimum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	1 year
Furniture, fixtures, and office equipment \| Maximum
Property, Plant and Equipment [Line Items]
Property, plant and equipment, useful life	15 years
Construction-in-progress
Property, Plant and Equipment [Line Items]
Property, plant, and equipment, gross	$ 62,967	$ 59,222

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Schedule Of Changes In Carrying Amount Of Goodwill) (Details) - USD ($) $ in Thousands		3 Months Ended	12 Months Ended
	Jul. 17, 2015	Sep. 30, 2017	Dec. 31, 2017	Dec. 31, 2016
Goodwill [Roll Forward]
Beginning of period			$ 510,571	$ 512,389
Foreign currency translation and other			9,569	(1,644)
Divestment to Natus			(2,861)
End of period			937,905	510,571
TEI
Goodwill [Roll Forward]
TEI acquisition working capital adjustment	$ 200			(174)
Derma Sciences
Goodwill [Roll Forward]
TEI acquisition working capital adjustment		$ 300
Acquisition			73,765
End of period			73,765
TGX Medical
Goodwill [Roll Forward]
Acquisition			641
End of period			641
Codman
Goodwill [Roll Forward]
Acquisition			346,220
End of period			346,219
Codman Specialty Surgical
Goodwill [Roll Forward]
Beginning of period			284,358	284,976
Foreign currency translation and other			6,409	(618)
Divestment to Natus			(2,861)
End of period			634,767	284,358
Codman Specialty Surgical \| TEI
Goodwill [Roll Forward]
TEI acquisition working capital adjustment				0
Codman Specialty Surgical \| Derma Sciences
Goodwill [Roll Forward]
Acquisition			0
Codman Specialty Surgical \| TGX Medical
Goodwill [Roll Forward]
Acquisition			641
Codman Specialty Surgical \| Codman
Goodwill [Roll Forward]
Acquisition			346,220
Orthopedics and Tissue Technologies
Goodwill [Roll Forward]
Beginning of period			226,213	227,413
Foreign currency translation and other			3,160	(1,026)
Divestment to Natus			0
End of period			303,138	226,213
Orthopedics and Tissue Technologies \| TEI
Goodwill [Roll Forward]
TEI acquisition working capital adjustment				$ (174)
Orthopedics and Tissue Technologies \| Derma Sciences
Goodwill [Roll Forward]
Acquisition			73,765
Orthopedics and Tissue Technologies \| TGX Medical
Goodwill [Roll Forward]
Acquisition			0
Orthopedics and Tissue Technologies \| Codman
Goodwill [Roll Forward]
Acquisition			$ 0

SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES (Components Of Company's Identifiable Intangible Assets) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Goodwill And Other Intangible Assets [Line Items]
Accumulated Amortization	$ (256,988)	$ (207,158)
Finite and indefinite-lived intangible assets, cost	1,416,615	768,333
Finite and indefinite-lived assets, net	1,159,627	$ 561,175
Codman trade name
Goodwill And Other Intangible Assets [Line Items]
Indefinite-lived intangible assets, cost	$ 162,900
Completed technology
Goodwill And Other Intangible Assets [Line Items]
Weighted Average Life	19 years	17 years
Finite-lived intangible assets, cost	$ 869,174	$ 479,964
Accumulated Amortization	(124,096)	(94,991)
Finite-lived intangible assets, net	$ 745,078	$ 384,973
Customer relationships
Goodwill And Other Intangible Assets [Line Items]
Weighted Average Life	13 years	12 years
Finite-lived intangible assets, cost	$ 233,430	$ 152,335
Accumulated Amortization	(91,961)	(77,005)
Finite-lived intangible assets, net	$ 141,469	$ 75,330
Trademarks/brand names
Goodwill And Other Intangible Assets [Line Items]
Weighted Average Life	28 years	30 years
Finite-lived intangible assets, cost	$ 104,879	$ 90,507
Accumulated Amortization	(22,293)	(19,158)
Finite-lived intangible assets, net	$ 82,586	$ 71,349
Supplier relationships
Goodwill And Other Intangible Assets [Line Items]
Weighted Average Life	27 years	27 years
Finite-lived intangible assets, cost	$ 34,721	$ 34,721
Accumulated Amortization	(15,092)	(13,664)
Finite-lived intangible assets, net	$ 19,629	$ 21,057
All other
Goodwill And Other Intangible Assets [Line Items]
Weighted Average Life	4 years	5 years
Finite-lived intangible assets, cost	$ 11,511	$ 10,806
Accumulated Amortization	(3,546)	(2,340)
Finite-lived intangible assets, net	7,965	8,466
In-process research and development
Goodwill And Other Intangible Assets [Line Items]
Other Indefinite-lived Intangible Assets	$ 1,000	$ 1,000

DISCONTINUED OPERATIONS (Narrative) (Details)		12 Months Ended			30 Months Ended
DISCONTINUED OPERATIONS (Narrative) (Details)	Jul. 02, 2015 director	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Dec. 31, 2017 USD ($)	Jul. 01, 2015 USD ($)	Oct. 29, 2014 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Income or expense after separation		$ 0	$ 0	$ (10,370,000)
SeaSpine Inc. \| Supply Agreement Liability - Current
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue, SeaSpine		700,000	800,000	6,200,000
Cost of goods sold, SeaSpine		300,000	700,000	3,800,000
SeaSpine Inc. \| Information Technology and Administrative Support
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Revenue, SeaSpine			$ 300,000	2,700,000
SeaSpine Inc. \| Discontinued Operations, Disposed of by Means Other than Sale, Spinoff
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Distribution of spinoff shares	100.00%
Shares of Integra for share of SeaSpine	0.3333
Cash following distribution						$ 47,178,000	$ 47,000,000
Gain (loss) recognized as result of distribution		$ 0
Income or expense after separation				$ (10,370,000)	$ 0
SeaSpine Inc. \| Discontinued Operations, Disposed of by Means Other than Sale, Spinoff \| Director
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of shared board members \| director	3

DISCONTINUED OPERATIONS (Summary of Statements of Operations, Discontinued Operations) (Details) - USD ($)	12 Months Ended			30 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Loss from discontinued operations	$ 0	$ 0	$ (10,370,000)
SeaSpine Inc. \| Discontinued Operations, Disposed of by Means Other than Sale, Spinoff
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Total revenue			65,775,000
Costs and expenses			80,618,000
Operating loss			(14,843,000)
Other expense, net			(766,000)
Loss from discontinued operations before tax			(15,609,000)
Benefit for income taxes			(5,239,000)
Loss from discontinued operations			$ (10,370,000)	$ 0

DISCONTINUED OPERATIONS (Summary of Assets and Liabilities, Discontinued Operations) (Details) - SeaSpine Inc. - Discontinued Operations, Disposed of by Means Other than Sale, Spinoff - USD ($) $ in Thousands	Jul. 01, 2015	Oct. 29, 2014
Disposal Group, Including Discontinued Operation, Assets, Current [Abstract]
Cash	$ 47,178	$ 47,000
Accounts receivable	20,856
Inventory	49,425
Other current assets	13,411
Current assets of discontinued operations	130,870
Disposal Group, Including Discontinued Operation, Assets, Noncurrent [Abstract]
Property, plant, and equipment, net	21,093
Intangible assets, net	43,122
Other assets	4,465
Non-current assets of discontinued operations	68,680
Total assets of discontinued operations	199,550
Disposal Group, Including Discontinued Operation, Liabilities, Current [Abstract]
Accounts payable	7,072
Accrued compensation	5,964
Accrued expenses and other current liabilities	3,361
Current liabilities of discontinued operations	16,397
Disposal Group, Including Discontinued Operation, Liabilities, Noncurrent [Abstract]
Deferred tax liabilities	13,331
Other liabilities	2,593
Long-term liabilities of discontinued operations	15,924
Total liabilities of discontinued operations	$ 32,321

ACQUISITIONS, DIVESTITURE AND PRO FORMA RESULTS (Narrative) (Details) $ in Thousands								1 Months Ended			3 Months Ended								6 Months Ended	9 Months Ended	10 Months Ended	12 Months Ended
	Oct. 02, 2017 USD ($)	May 25, 2017 USD ($)	Apr. 04, 2017 USD ($)	Feb. 24, 2017 USD ($)	Dec. 15, 2015 USD ($)	Oct. 02, 2015 USD ($)	Jul. 17, 2015 USD ($) acquisition	Oct. 31, 2017 USD ($)	Aug. 31, 2017 USD ($)	Apr. 30, 2017 USD ($)	Dec. 31, 2017 USD ($)	Sep. 30, 2017 USD ($)	Jun. 30, 2017 USD ($)	Mar. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)	Sep. 30, 2016 USD ($)	Jun. 30, 2016 USD ($)	Mar. 31, 2016 USD ($)	Jun. 30, 2017 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Oct. 06, 2017 USD ($)
Business Acquisition [Line Items]
Amount drawn from loan																						$ 1,307,000	$ 680,000	$ 545,000
Realized loss, included in other income, net																			$ 2,300
Deferred tax assets, other											$ 3,077				$ 128					$ 3,077	$ 3,077	3,077	128
Payment for contingent consideration																						4,661	0	0
Gain recognized, amount																						0	0	1,111
Number of businesses acquired \| acquisition							2
Cash used in business acquisition, net of cash acquired																						1,241,946	(225)	328,888
Contingent consideration, received from escrow										$ 1,200
Increase in fair value of contingent receivable																						1,600	1,300
Net income (loss)											44,355	$ 3,159	$ 10,835	$ 6,394	28,246	$ 20,144	$ 12,755	$ 13,419				64,743	74,564	(3,519)
Interest Expense, Intangible Asset Amortization, and External Expenses Related to Acquisition
Business Acquisition [Line Items]
Net income (loss)																						$ 24,900
Product Concentration Risk \| BioD Morselized Amniotic Membrane Based Products
Business Acquisition [Line Items]
Revenue from product, Percentage																						1.00%
Derma Sciences \| Interest Expense, Intangible Asset Amortization, and External Expenses Related to Acquisition
Business Acquisition [Line Items]
Net income (loss)																						$ 2,900
Codman Specialty Surgical
Business Acquisition [Line Items]
Aggregate purchase price received																									$ 46,400
Assets provided upon termination of transitional supply agreement liability											1,300									1,300	1,300	1,300
Codman Specialty Surgical \| Disposal Group, Held-for-sale, Not Discontinued Operations
Business Acquisition [Line Items]
Gain on sale of business, included in other income, net																						2,600
Term loan A-1 \| Secured Debt
Business Acquisition [Line Items]
Amount drawn from loan								$ 700,000
Codman
Business Acquisition [Line Items]
Consideration transferred	$ 1,014,000
Write off of construction in progress																						6,300
Revenue since acquisition date																						76,900
Net assets acquired											1,014,091									1,014,091	1,014,091	1,014,091
Codman \| Term loan A-1 \| Secured Debt
Business Acquisition [Line Items]
Amount drawn from loan	$ 700,000
TGX Medical
Business Acquisition [Line Items]
Consideration transferred			$ 5,400
Revenue since acquisition date																				600
Business combination, cash acquired											49									49	49	49
Net assets acquired											5,367									5,367	5,367	5,367
Derma Sciences
Business Acquisition [Line Items]
Consideration transferred				$ 210,800
Revenue since acquisition date																					84,600
Payment of closing expenses				4,800
Payment of stock plan settlement				4,300
Payments to acquire business				$ 201,700
Preliminary purchase price allocation adjustment													1,700
Adjustment to purchase price and goodwill												$ 300
Deferred taxes											14,524									14,524	14,524	14,524
Deferred tax assets, operating loss carryforwards											39,700									39,700	39,700	39,700
Deferred tax assets, goodwill and intangible assets											16,400									16,400	16,400	16,400
Deferred tax liabilities, intangible assets											41,100									41,100	41,100	41,100
Deferred tax assets, other											500									500	500	500
Adjustment, deferred tax assets											3,300		1,500						$ 1,500	3,300	3,300	3,300
Business combination, cash acquired											16,512									16,512	16,512	16,512
Net assets acquired											210,478									210,478	210,478	210,478
Derma Sciences \| BioD Earnout Payments
Business Acquisition [Line Items]
Revenue volatility				13.50%
Discount rate				3.00%
Contingent consideration arrangements, maximum payout				$ 26,500
Contingent consideration, liability				$ 9,100							300									300	300	300
Payment for contingent consideration									$ 4,800
Fair Value, Measurement with Unobservable Inputs Reconciliation, Recurring Basis, Liability, Gain (Loss) Included in Earnings																						4,000
Derma Sciences \| Product Payment Contingent Consideration
Business Acquisition [Line Items]
Discount rate				2.50%
Contingent consideration arrangements, maximum payout				$ 29,700
Contingent consideration, liability				$ 26,800
Product payment probability rate				98.00%
Change in fair value of contingent consideration													$ 900
Payment for contingent consideration liability		$ 26,600
Derma Sciences \| Medihoney Earnout Payments
Business Acquisition [Line Items]
Revenue volatility				27.50%
Discount rate				4.50%
Contingent consideration arrangements, maximum payout				$ 5,000
Contingent consideration, liability				$ 1,400							1,400									1,400	1,400	1,400
Tekmed
Business Acquisition [Line Items]
Consideration transferred					$ 14,100
Net assets acquired											14,103									14,103	14,103	14,103
Salto and Futura
Business Acquisition [Line Items]
Payments to acquire business						$ 6,000
Net assets acquired											7,111									7,111	7,111	7,111
Salto and Futura \| Other Income
Business Acquisition [Line Items]
Gain recognized, amount																								$ 1,100
TEI
Business Acquisition [Line Items]
Consideration transferred							$ 312,200
Adjustment to purchase price and goodwill							$ 200																(174)
Discount rate							11.00%
Cash used in business acquisition, net of cash acquired							$ 312,400
Business combination, cash acquired							1,200
Contingent receivable							400				$ 2,000				1,700					$ 2,000	$ 2,000	$ 2,000	1,700
Contingent consideration, asset, revenue threshold to realize asset							6,000
TEI \| Prepaid Expenses and Other Current Assets
Business Acquisition [Line Items]
Contingent receivable															1,200								1,200
TEI \| Other assets
Business Acquisition [Line Items]
Contingent receivable															$ 500								$ 500
TEI Biosciences Inc.
Business Acquisition [Line Items]
Consideration transferred							210,900
Adjustment to purchase price and goodwill							500
TEI Medical Inc.
Business Acquisition [Line Items]
Consideration transferred							101,300
Adjustment to purchase price and goodwill							$ 700

ACQUISITIONS, DIVESTITURE AND PRO FORMA RESULTS (Schedule of Assets Acquired and Liabilities Assumed) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Other current assets	$ 2,036
Intangible assets:
Goodwill	937,905	$ 510,571	$ 512,389
Codman
Business Acquisition [Line Items]
Inventory	77,921
Assets held for sale	30,813
Property, plant and equipment	35,949
Intangible assets:
Goodwill	346,219
Total assets acquired	1,035,738
Accrued expenses	1,730
Pension liabilities	19,917
Net assets acquired	1,014,091
Codman \| Completed technology
Intangible assets:
Intangible assets	$ 379,900
Wtd. Avg. Life	22 years
Codman \| Trade name
Intangible assets:
Codman corporate trade name	$ 162,900
TGX Medical
Business Acquisition [Line Items]
Cash and cash equivalents	49
Accounts receivables	279
Property, plant and equipment	3
Intangible assets:
Goodwill	641
Total assets acquired	5,679
Accounts payable	13
Accrued expenses and other current liabilities	65
Other liabilities	234
Net assets acquired	5,367
TGX Medical \| Completed technology
Intangible assets:
Intangible assets	$ 4,707
Wtd. Avg. Life	13 years
Derma Sciences
Business Acquisition [Line Items]
Cash and cash equivalents	$ 16,512
Short-term investments	19,238
Accounts receivables	8,949
Inventory	17,977
Prepaid expenses and other current assets	4,369
Property, plant and equipment	4,311
Intangible assets:
Goodwill	73,765
Deferred tax assets	14,524
Other assets	101
Total assets acquired	263,426
Accounts payable	4,560
Accrued expenses and other current liabilities	7,409
Contingent liability	37,174
Other liabilities	3,805
Net assets acquired	210,478
Derma Sciences \| Completed technology
Intangible assets:
Intangible assets	$ 11,600
Wtd. Avg. Life	14 years
Derma Sciences \| Customer relationship
Intangible assets:
Intangible assets	$ 78,300
Wtd. Avg. Life	14 years
Derma Sciences \| Trademarks/brand names
Intangible assets:
Intangible assets	$ 13,500
Wtd. Avg. Life	15 years
Derma Sciences \| Non-compete agreement
Intangible assets:
Intangible assets	$ 280
Wtd. Avg. Life	1 year
Tekmed
Business Acquisition [Line Items]
Inventory	$ 1,143
Other current assets	11
Property, plant and equipment	669
Intangible assets:
Goodwill	9,665
Total assets acquired	16,469
Accrued expenses and other liabilities	802
Deferred tax liability	1,564
Net assets acquired	14,103
Tekmed \| Supplier Contracts
Intangible assets:
Intangible assets	$ 4,981
Tekmed \| Minimum \| Supplier Contracts
Intangible assets:
Wtd. Avg. Life	2 years
Tekmed \| Maximum \| Supplier Contracts
Intangible assets:
Wtd. Avg. Life	13 years
Salto and Futura
Business Acquisition [Line Items]
Inventory	$ 2,688
Property, plant and equipment	1,453
Intangible assets:
Total assets acquired	7,811
Deferred tax liability	700
Net assets acquired	7,111
Salto and Futura \| Ankle product family
Intangible assets:
Intangible assets	$ 3,210
Wtd. Avg. Life	11 years
Salto and Futura \| Toe product family
Intangible assets:
Intangible assets	$ 460
Wtd. Avg. Life	10 years
TEI Biosciences Inc and TEI Medical Inc.
Business Acquisition [Line Items]
Cash and cash equivalents	$ 1,241
Accounts receivables	9,011
Inventory	23,223
Other current assets	2,670
Property, plant and equipment	2,027
Income tax receivable	5,135
Intangible assets:
Goodwill	147,704
Total assets acquired	409,825
Accrued expenses and other liabilities	9,732
Deferred tax liability	87,908
Net assets acquired	312,185
TEI Biosciences Inc and TEI Medical Inc. \| Developed Technology
Intangible assets:
Intangible assets	167,400
TEI Biosciences Inc and TEI Medical Inc. \| Contractual Relationships
Intangible assets:
Intangible assets	51,345
TEI Biosciences Inc and TEI Medical Inc. \| Leasehold interest
Intangible assets:
Intangible assets	$ 69
TEI Biosciences Inc and TEI Medical Inc. \| Minimum \| Developed Technology
Intangible assets:
Wtd. Avg. Life	14 years
TEI Biosciences Inc and TEI Medical Inc. \| Minimum \| Contractual Relationships
Intangible assets:
Wtd. Avg. Life	11 years
TEI Biosciences Inc and TEI Medical Inc. \| Maximum \| Developed Technology
Intangible assets:
Wtd. Avg. Life	16 years
TEI Biosciences Inc and TEI Medical Inc. \| Maximum \| Contractual Relationships
Intangible assets:
Wtd. Avg. Life	14 years

ACQUISITIONS, DIVESTITURE AND PRO FORMA RESULTS (Schedule of Assets and Liabilities Divested) (Details) - Disposal Group, Held-for-sale, Not Discontinued Operations - Codman Specialty Surgical $ in Thousands	Oct. 06, 2017 USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Inventories	$ 8,348
Prepaid expenses and other current assets	36
Assets held for sale	30,813
Property, plant and equipment, net	1,122
Goodwill	2,861
Total assets of discontinued operations	43,180
Deferred revenue	1,082
Accrued compensation	209
Current liabilities of discontinued operations	$ 1,291

ACQUISITIONS, DIVESTITURE AND PRO FORMA RESULTS (Pro Forma Financial Information Summarization Results of Operations) (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Combinations [Abstract]
Total revenue from continuing operations	$ 1,428,491	$ 1,446,903	$ 940,005
Net income from continuing operations	$ 81,730	$ 27,520	$ 10,694
Net income from continuing operations per share:
Basic earnings per share from continuing operations, Pro forma (in dollars per share)	$ 1.06	$ 0.37	$ 0.31

DEBT (Narrative) (Details) - USD ($)		1 Months Ended	12 Months Ended
DEBT (Narrative) (Details) - USD ($)	Dec. 15, 2016	Oct. 31, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Mar. 31, 2017	Mar. 30, 2017	Jul. 31, 2015	Jun. 15, 2011
Debt Instrument [Line Items]
Maximum borrowing capacity						$ 2,200,000,000.0	$ 1,500,000,000.0
Amortization of debt issuance costs			$ 2,722,000	$ 2,529,000	$ 2,264,000
Amount drawn from loan			1,307,000,000	680,000,000	545,000,000
Principal amount paid			0	184,313,000	$ 2,519,000
Common stock from the exercise of call option with hedge participants (in shares)	2,900,000
Common stock from the exercise of call option with hedge participants, value			$ 121,600,000	$ 123,100,000
Price per share (in dollars per share)			$ 41.77	$ 41.78
Convertible Debt
Debt Instrument [Line Items]
Strike price of the call transaction (in dollars per share)								$ 26.42	$ 28.72
Strike price of warrant transactions (in dollars per share)								$ 32.22	$ 35.03
Warrants exercised (in shares)			8,707,202
Common stock from the exercise of warrants (in shares)			2,839,743
Warrants outstanding (in shares)			0
Revolving Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity						1,000,000,000
Line of credit facility outstanding			$ 655,000,000	$ 165,000,000
Weighted average interest rate on debt			3.70%	2.20%
Revolving Credit Facility \| Level 2
Debt Instrument [Line Items]
Outstanding borrowings			$ 661,000,000
Standby Letters of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity						60,000,000
Swingline Loan
Debt Instrument [Line Items]
Maximum borrowing capacity						60,000,000
Term Loan A Facility \| Secured Debt
Debt Instrument [Line Items]
Maximum borrowing capacity						500,000,000.0
Line of credit facility outstanding			$ 500,000,000	$ 500,000,000
Weighted average interest rate on debt			3.60%	2.20%
Term Loan A Facility \| Secured Debt \| Level 2
Debt Instrument [Line Items]
Outstanding borrowings			$ 502,700,000
Term loan A-1 \| Secured Debt
Debt Instrument [Line Items]
Maximum borrowing capacity						$ 700,000,000
Capitalized incremental financing costs		$ 19,100,000
Amount drawn from loan		$ 700,000,000
Line of credit facility outstanding			700,000,000
Term loan A-1 \| Secured Debt \| Level 2
Debt Instrument [Line Items]
Outstanding borrowings			703,700,000
Senior Credit Facility
Debt Instrument [Line Items]
Cash balance threshold above which excess amount is not subject to any restriction of use or investment			40,000,000
Capitalized incremental financing costs			$ 19,100,000	$ 4,500,000
Senior Credit Facility \| Minimum
Debt Instrument [Line Items]
Line of credit, commitment fee percentage			0.15%
Senior Credit Facility \| Maximum
Debt Instrument [Line Items]
Line of credit, commitment fee percentage			0.35%
Senior Credit Facility \| Eurodollar \| Minimum
Debt Instrument [Line Items]
Interest rates available to the company at its option			1.00%
Senior Credit Facility \| Eurodollar \| Maximum
Debt Instrument [Line Items]
Interest rates available to the company at its option			2.00%
Senior Credit Facility \| Federal Funds
Debt Instrument [Line Items]
Interest rates available to the company at its option			0.50%
Senior Credit Facility \| One Month Eurodollar Rate
Debt Instrument [Line Items]
Interest rates available to the company at its option			1.00%
Senior Credit Facility \| Standby Letters of Credit
Debt Instrument [Line Items]
Line of credit facility outstanding			$ 0
Letters of credit outstanding			600,000	500,000
July 2014 Amendment
Debt Instrument [Line Items]
Amortization of debt issuance costs			$ 0	$ 500,000
2016 Convertible Senior Notes
Debt Instrument [Line Items]
Principal amount outstanding									$ 230,000,000
Interest rate on debt				1.625%	1.625%
2016 Convertible Senior Notes \| Convertible Debt
Debt Instrument [Line Items]
Principal amount paid	$ 227,100,000
Stock issued during period, shares, conversion of convertible securities (in shares)	2,900,000
Settlement of convertible notes	$ 122,000,000
Gain or loss on extinguishment	$ 0
Interest rate on debt	1.625%

DEBT (Maximum Total Leverage Ratio Table) (Details) - Senior Credit Facility	Dec. 31, 2017
December 31, 2016 through before the first fiscal quarter after the delayed draw date of Term Loan A-1
Debt Instrument [Line Items]
Maximum Consolidated Total Leverage Ratio	4.50
First fiscal quarter ended after the delayed draw date of Term Loan A-1 through September 30, 2018
Debt Instrument [Line Items]
Maximum Consolidated Total Leverage Ratio	5.50
October 1, 2018 through September 30, 2019
Debt Instrument [Line Items]
Maximum Consolidated Total Leverage Ratio	5.00
October 1, 2019 through September 30, 2020
Debt Instrument [Line Items]
Maximum Consolidated Total Leverage Ratio	4.50
October 1, 2020 and thereafter
Debt Instrument [Line Items]
Maximum Consolidated Total Leverage Ratio	4.00

DEBT (Schedule of Debt Maturity) (Details) $ in Thousands	Dec. 31, 2017 USD ($)
Debt Disclosure [Abstract]
2018	$ 60,000
2019	60,000
2020	90,000
2021	$ 990,000

DEBT (Components of Interest Expense) (Details) - 2016 Convertible Senior Notes - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Amortization of the discount on the liability component	$ 8,073	$ 7,917
Cash interest related to the contractual interest coupon	3,407	3,430
Total	11,480	11,347
Amortization of debt discount, capitalized interest	300	600
Cash interest related to contractual interest coupon, capitalized interest	$ 100	$ 300

DERIVATIVE INSTRUMENTS (Schedule of Interest Rate Swap Derivatives) (Details) - Designated as Hedging Instrument	Dec. 31, 2017 USD ($)
Interest Rate Swap
Derivative [Line Items]
Current Notional Amount	$ 1,050,000,000
Cash Flow Hedging
Derivative [Line Items]
Estimated Fair Value	592,000
Cash Flow Hedging \| 3-Month USD LIBOR \| Interest Rate Swap Designated June 22, 2016 Tranche 1
Derivative [Line Items]
Current Notional Amount	$ 50,000,000
Fixed Interest Rate	1.062%
Estimated Fair Value	$ 675,000
Cash Flow Hedging \| 3-Month USD LIBOR \| Interest Rate Swap Designated June 22, 2016 Tranche 2
Derivative [Line Items]
Current Notional Amount	$ 50,000,000
Fixed Interest Rate	1.062%
Estimated Fair Value	$ 672,000
Cash Flow Hedging \| 3-Month USD LIBOR \| Interest Rate Swap Designated February 6, 2017 Tranche 1
Derivative [Line Items]
Current Notional Amount	$ 50,000,000
Fixed Interest Rate	1.834%
Estimated Fair Value	$ 318,000
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated July 12, 2016
Derivative [Line Items]
Current Notional Amount	$ 50,000,000
Fixed Interest Rate	0.825%
Estimated Fair Value	$ 779,000
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated February 6, 2017 Tranche 2
Derivative [Line Items]
Current Notional Amount	$ 100,000,000
Fixed Interest Rate	1.652%
Estimated Fair Value	$ 858,000
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated March 27, 2017
Derivative [Line Items]
Current Notional Amount	$ 100,000,000
Fixed Interest Rate	1.971%
Estimated Fair Value	$ 337,000
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated December 13, 2017 Tranche 1
Derivative [Line Items]
Current Notional Amount	$ 150,000,000
Fixed Interest Rate	2.201%
Estimated Fair Value	$ (455,000)
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated December 13, 2017 Tranche 2
Derivative [Line Items]
Current Notional Amount	$ 150,000,000
Fixed Interest Rate	2.201%
Estimated Fair Value	$ (434,000)
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated December 13, 2017 Tranche 3
Derivative [Line Items]
Current Notional Amount	$ 100,000,000
Fixed Interest Rate	2.423%
Estimated Fair Value	$ (684,000)
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated December 13, 2017 Tranche 4
Derivative [Line Items]
Current Notional Amount	$ 50,000,000
Fixed Interest Rate	2.423%
Estimated Fair Value	$ (255,000)
Cash Flow Hedging \| 1-Month USD LIBOR \| Interest Rate Swap Designated December 13, 2017 Tranche 5
Derivative [Line Items]
Current Notional Amount	$ 200,000,000
Fixed Interest Rate	2.313%
Estimated Fair Value	$ (1,219,000)

DERIVATIVE INSTRUMENTS (Narrative) (Details) SFr in Millions		12 Months Ended
	Nov. 28, 2017 USD ($)	Dec. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Oct. 02, 2017 USD ($)	Oct. 02, 2017 CHF (SFr)
Derivative [Line Items]
Loss reclassified into income			$ 0
Gain reclassified into income			0
Amount estimated to be reclassified to earnings during next twelve months		$ 300,000
Reclassification from AOCI, foreign currency rate translation, intercompany loan		2,958,000	0	$ (923,000)
Loss recorded to AOCI		3,425,000	$ (1,871,000)
Interest Rate Swap
Derivative [Line Items]
Loss reclassified into income		100,000
Foreign Currency Forward Contract \| Not Designated as Hedging Instrument
Derivative [Line Items]
Notional amount	$ 8,900,000.0
Gain from change in fair value of the contract	$ 100,000
Derivative fair value		100,000
Cross Currency Interest Rate Swap \| Codman
Derivative [Line Items]
Amount estimated to be reclassified to earnings during next twelve months		7,800,000
Reclassification from AOCI, foreign currency rate translation, intercompany loan		1,100,000
Gain reclassified into income		1,900,000
Cross Currency Interest Rate Swap \| Codman \| Short
Derivative [Line Items]
Notional amount					$ 300,000,000.0
Cross Currency Interest Rate Swap \| Codman \| Long
Derivative [Line Items]
Notional amount \| SFr						SFr 291.2
Other income (expense) \| Cross Currency Interest Rate Swap
Derivative [Line Items]
Loss recorded to AOCI		2,070,000
Other income (expense) \| Cross Currency Interest Rate Swap \| Codman
Derivative [Line Items]
Loss recorded to AOCI		$ 2,100,000

DERIVATIVE INSTRUMENTS (Schedule of Cross Currency Swap Derivatives) (Details)	Dec. 31, 2017 USD ($)	Dec. 31, 2017 CHF (SFr)	Oct. 02, 2017 USD ($)	Oct. 02, 2017 CHF (SFr)
Codman \| Cross Currency Interest Rate Swap \| Long
Derivative [Line Items]
Aggregate Notional Amount \| SFr				SFr 291,200,000
Codman \| Cross Currency Interest Rate Swap \| Short
Derivative [Line Items]
Aggregate Notional Amount			$ 300,000,000.0
Cash Flow Hedging \| Designated as Hedging Instrument
Derivative [Line Items]
Fair Value Asset (Liability)	$ 592,000
Cash Flow Hedging \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap
Derivative [Line Items]
Fair Value Asset (Liability)	(3,957,000)
Cash Flow Hedging \| Swap One \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap
Derivative [Line Items]
Fair Value Asset (Liability)	$ (742,000)
Cash Flow Hedging \| Swap One \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap \| Long
Derivative [Line Items]
Fixed Rate	1.75%	1.75%
Aggregate Notional Amount \| SFr		SFr 97,065,000
Cash Flow Hedging \| Swap One \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap \| Short
Derivative [Line Items]
Fixed Rate	4.38%	4.38%
Aggregate Notional Amount	$ 100,000,000
Cash Flow Hedging \| Swap Two \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap
Derivative [Line Items]
Fair Value Asset (Liability)	$ (610,000)
Cash Flow Hedging \| Swap Two \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap \| Long
Derivative [Line Items]
Fixed Rate	1.85%	1.85%
Aggregate Notional Amount \| SFr		SFr 48,533,000
Cash Flow Hedging \| Swap Two \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap \| Short
Derivative [Line Items]
Fixed Rate	4.46%	4.46%
Aggregate Notional Amount	$ 50,000,000
Cash Flow Hedging \| Swap Three \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap
Derivative [Line Items]
Fair Value Asset (Liability)	$ (2,605,000)
Cash Flow Hedging \| Swap Three \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap \| Long
Derivative [Line Items]
Fixed Rate	1.95%	1.95%
Aggregate Notional Amount \| SFr		SFr 145,598,000
Cash Flow Hedging \| Swap Three \| Designated as Hedging Instrument \| Codman \| Cross Currency Interest Rate Swap \| Short
Derivative [Line Items]
Fixed Rate	4.52%	4.52%
Aggregate Notional Amount	$ 150,000,000

DERIVATIVE INSTRUMENTS (Fair Value of Derivative Instruments By Balance Sheet Location) (Details) - Designated as Hedging Instrument - USD ($)	Dec. 31, 2017	Dec. 31, 2016
Derivatives, Fair Value [Line Items]
Total Derivatives designated as hedges — Assets	$ 11,769,000	$ 1,871,000
Total Derivative designated as hedges — Liabilities	15,134,000	0
Interest rate swap
Derivatives, Fair Value [Line Items]
Notional amount	1,050,000,000
Interest rate swap \| Prepaid expenses and other current assets
Derivatives, Fair Value [Line Items]
Total Derivatives designated as hedges — Assets	1,521,000	242,000
Interest rate swap \| Other assets
Derivatives, Fair Value [Line Items]
Total Derivatives designated as hedges — Assets	2,491,000	1,629,000
Notional amount		150,000,000
Interest rate swap \| Accrued expenses and other current liabilities
Derivatives, Fair Value [Line Items]
Total Derivative designated as hedges — Liabilities	1,845,000	0
Interest rate swap \| Other liabilities
Derivatives, Fair Value [Line Items]
Total Derivative designated as hedges — Liabilities	1,575,000	0
Cross-currency swap \| Prepaid expenses and other current assets
Derivatives, Fair Value [Line Items]
Total Derivatives designated as hedges — Assets	7,757,000	0
Cross-currency swap \| Other liabilities
Derivatives, Fair Value [Line Items]
Total Derivative designated as hedges — Liabilities	$ 11,714,000	$ 0

DERIVATIVE INSTRUMENTS (Effect of Derivative Instruments Designated Cash Flow Hedges on Statements of Operations) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance in AOCI Beginning of Year	$ 1,871	$ 0
Amount of Gain (Loss) Recognized in AOCI	(3,425)	1,871
Amount of Gain (Loss) Reclassified from AOCI into Earnings	2,958	0
Balance in AOCI End of Year	(4,512)	1,871
Interest rate swap \| Interest (expense)
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance in AOCI Beginning of Year	1,871	0
Amount of Gain (Loss) Recognized in AOCI	(1,355)	1,871
Amount of Gain (Loss) Reclassified from AOCI into Earnings	(76)	0
Balance in AOCI End of Year	592	1,871
Cross-currency swap \| Other income (expense)
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance in AOCI Beginning of Year	0
Amount of Gain (Loss) Recognized in AOCI	(2,070)
Amount of Gain (Loss) Reclassified from AOCI into Earnings	3,034
Balance in AOCI End of Year	$ (5,104)	$ 0

TREASURY STOCK (Narrative) (Details) - USD ($)		12 Months Ended
TREASURY STOCK (Narrative) (Details) - USD ($)	Oct. 25, 2016	Dec. 31, 2017	Dec. 31, 2016
Treasury Stock Transactions, Excluding Value of Shares Reissued [Abstract]
Treasury stock, shares, retired (in shares)	17,800,000
Treasury stock, aggregate cost	$ 367,100,000	$ 121,644,000	$ 123,051,000
Stock repurchase program, authorized amount (up to)	$ 150,000,000.0
Amount available for share repurchase under this latest authorization		$ 150,000,000.0
Treasury stock outstanding (in shares)	2,900,000	2,900,000	2,900,000
Treasury stock, cost		$ 121,600,000	$ 123,100,000
Treasury stock, price per share (in dollars per share)		$ 41.77	$ 41.78
Stock repurchased during period (in shares)		0	0

STOCK-BASED COMPENSATION (Summary Of Employee Stock-Based Compensation Expense) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 21,550	$ 17,310	$ 15,450
Total estimated tax benefit related to stock-based compensation expense	15,448	10,569	5,792
Net effect on net income	6,102	6,741	9,658
Selling, general and administrative
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	19,785	15,829	14,461
Research and development
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	1,273	1,048	714
Cost of goods sold
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Total stock-based compensation expense	$ 492	$ 433	$ 275

STOCK-BASED COMPENSATION (Narrative) (Details) $ / shares in Units, $ in Thousands		1 Months Ended		12 Months Ended
	Jul. 02, 2015 USD ($)	May 31, 2017 shares	May 31, 2010 shares	Dec. 31, 2017 USD ($) stock_based_compensation_plan $ / shares shares	Dec. 31, 2016 USD ($) $ / shares shares	Dec. 31, 2015 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares available for purchase (in shares) \| shares				3,400,000
Number of stock-based compensation plans \| stock_based_compensation_plan				3
Share-based compensation expense recognized				$ 21,550	$ 17,310	$ 15,450
Dividend yield				0.00%	0.00%	0.00%
Intrinsic value, options exercised				$ 16,200	$ 9,700	$ 5,800
Weighted average grant date fair value of options granted (in dollars per share) \| $ / shares				$ 16.95	$ 12.48	$ 8.59
Proceeds from exercised stock options				$ 9,774	$ 10,481	$ 7,345
Tax benefit realized from stock options exercised				6,200	3,700	2,200
Capitalized share-based compensation cost				500	500	300
Discontinued Operations, Disposed of by Means Other than Sale, Spinoff \| SeaSpine Inc.
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Incremental increase in stock based award expense after spinoff	$ 4,400
Share-based compensation expense recognized				300	$ 700	$ 3,300
Total unrecognized compensation costs related to unvested awards				$ 100
2003 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock reserved for issuance (in shares) \| shares				14,700,000
Increase in authorized shares (in shares) \| shares		1,700,000	3,500,000
2000 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock reserved for issuance (in shares) \| shares				4,000,000
2001 Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock reserved for issuance (in shares) \| shares				4,000,000.0
Employee Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock reserved for issuance (in shares) \| shares				3,000,000
Shares available for purchase (in shares) \| shares				2,100,000
Shares issued (in shares) \| shares				12,168	12,494	12,040
ESPP proceeds received				$ 600	$ 500	$ 400
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period				4 years
Total unrecognized compensation costs related to unvested awards				$ 4,000
Weighted-average period for cost recognition, in years				2 years
Employee Stock Option \| Director
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period				1 year
Employee Stock Option \| Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period, in years				6 years
Employee Stock Option \| Directors and Certain Executive Officers \| Minimum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period, in years				6 years
Employee Stock Option \| Directors and Certain Executive Officers \| Maximum
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period, in years				10 years
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period				3 years
Vested but not issued (in shares) \| shares				500,000
Restricted Stock, Performance Stock and Contract Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based compensation expense recognized				$ 18,500	15,600	10,200
Total unrecognized compensation costs related to unvested awards				$ 16,900
Weighted-average period for cost recognition, in years				2 years
Fair value of shares vested				$ 22,200	$ 16,200	$ 19,900
Requisite service periods of performance stock, restricted stock and contract stock awards, in years				3 years
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Vested but not issued (in shares) \| shares				200,000

STOCK-BASED COMPENSATION (Summary Of Weighted-Average Assumptions) (Details)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Dividend yield	0.00%	0.00%	0.00%
Expected volatility	30.00%	29.00%	29.00%
Risk free interest rate	2.18%	1.94%	1.96%
Expected life of option from grant date	8 years	8 years	8 years

STOCK-BASED COMPENSATION (Summary Of Stock Option Activity) (Details) $ / shares in Units, shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2017 USD ($) $ / shares shares
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding [Roll Forward]
Outstanding at beginning of year (in shares) \| shares	2,083
Granted (in shares) \| shares	187
Exercised (in shares) \| shares	(531)
Forfeited or Expired (in shares) \| shares	0
Outstanding at end of year (in shares) \| shares	1,739
Vested or expected to vest at end of year (in shares) \| shares	1,739
Exercisable at end of year (in shares) \| shares	1,333
Share-based Compensation Arrangement by Share-based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Roll Forward]
Weighted Average Exercise Price, Outstanding at beginning of year (in dollars per share) \| $ / shares	$ 20.65
Weighted Average Exercise Price, Granted (in dollars per share) \| $ / shares	41.72
Weighted Average Exercise Price, Exercised (in dollars per share) \| $ / shares	17.60
Weighted Average Exercise Price, Forfeited or Expired (in dollars per share) \| $ / shares	0.00
Weighted Average Exercise Price, Outstanding at end of year (in dollars per share) \| $ / shares	23.84
Weighted Average Exercise Price, Vested or expected to vest at end of year (in dollars per share) \| $ / shares	23.84
Weighted Average Exercise Price, Exercisable at end of year (in dollars per share) \| $ / shares	$ 19.95
Weighted Average Contractual Term in Years, Outstanding at end of year	3 years 6 months 14 days
Weighted Average Contractual Term in Years, Vested or expected to vest at end of year	3 years 6 months 14 days
Weighted Average Contractual Term in Years, Exercisable at end of year	2 years 7 months 16 days
Aggregate Intrinsic Value, Outstanding at end of year \| $	$ 41,753
Aggregate Intrinsic Value, Vested or expected to vest at end of year \| $	41,753
Aggregate Intrinsic Value, Exercisable at end of year \| $	$ 37,208

STOCK-BASED COMPENSATION (Summary Of Vested And Unvested Restricted Stock, Performance Stock, and Contract Stock) (Details) shares in Thousands	12 Months Ended
	Dec. 31, 2017 $ / shares shares
Restricted Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Unvested beginning balance (in shares) \| shares	512
Granted (in shares) \| shares	286
Cancellations (in shares) \| shares	(61)
Released (in shares) \| shares	(286)
Vested but not released (in shares) \| shares	0
Unvested ending balance (in shares) \| shares	451
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Roll Forward]
Weighted Average Grant Date Fair Value Per Share, Unvested beginning balance (in dollars per share) \| $ / shares	$ 28.49
Weighted Average Grant Date Fair Value Per Share, Granted (in dollars per share) \| $ / shares	44.15
Weighted Average Grant Date Fair Value Per Share, Cancellations (in dollars per share) \| $ / shares	36.00
Weighted Average Grant Date Fair Value Per Share, Released (in dollars per share) \| $ / shares	27.89
Weighted Average Grant Date Fair Value Per Share, Vested but not released (in dollars per share) \| $ / shares	0.00
Weighted Average Grant Date Fair Value Per Share, Unvested ending balance (in dollars per share) \| $ / shares	$ 37.79
Performance Stock and Contract Stock Awards
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Number of Shares [Roll Forward]
Unvested beginning balance (in shares) \| shares	345
Granted (in shares) \| shares	213
Adjustments for performance achievement related to award target (in shares) \| shares	25
Cancellations (in shares) \| shares	(12)
Released (in shares) \| shares	(225)
Vested but not released (in shares) \| shares	(174)
Unvested ending balance (in shares) \| shares	172
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Roll Forward]
Weighted Average Grant Date Fair Value Per Share, Unvested beginning balance (in dollars per share) \| $ / shares	$ 21.62
Weighted Average Grant Date Fair Value Per Share, Granted (in dollars per share) \| $ / shares	43.75
Adjustments for performance achievement related to award target (in dollars per share) \| $ / shares	36.90
Weighted Average Grant Date Fair Value Per Share, Cancellations (in dollars per share) \| $ / shares	30.52
Weighted Average Grant Date Fair Value Per Share, Released (in dollars per share) \| $ / shares	43.11
Weighted Average Grant Date Fair Value Per Share, Vested but not released (in dollars per share) \| $ / shares	32.40
Weighted Average Grant Date Fair Value Per Share, Unvested ending balance (in dollars per share) \| $ / shares	$ 33.61

RETIREMENT BENEFITS PLANS (Narrative) (Details) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Defined Benefit Plan Disclosure [Line Items]
Unrecognized net actuarial gain included in accumulated other comprehensive income	$ 400,000
Accumulated benefit obligation	42,900,000
Fair value of plan assets	26,943,000	$ 0
Plan assets expected to be returned next twelve months	0
Contributions expected to be paid to plan in 2018	1,800,000
Employer contributions	450,000		$ 1,800,000
Selling, general and administrative expenses recorded in conjunction with the buy-out of the plan			5,600,000
Total contributions made	7,200,000	$ 5,600,000	$ 3,700,000
AUSTRIA \| Foreign Plan
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0
FRANCE \| Foreign Plan
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	0
GERMANY \| Foreign Plan
Defined Benefit Plan Disclosure [Line Items]
Fair value of plan assets	$ 0

RETIREMENT BENEFIT PLANS (Schedule of Net Periodic Benefit Costs) (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2017 USD ($)
Retirement Benefits [Abstract]
Service cost	$ 565
Interest cost	95
Expected return on plan assets	(224)
Recognized net actuarial loss	8
Net period benefit cost	$ 444

RETIREMENT BENEFIT PLANS (Schedule of Assumptions Used Periodic Benefit Cost and Actuarial Present Value) (Details)	12 Months Ended
	Dec. 31, 2017
Retirement Benefits [Abstract]
Discount rate	0.74%
Expected return on plan assets	3.08%
Rate of compensation increase	1.70%

RETIREMENT BENEFIT PLANS (Schedule of Change in Benefit Obligations and Plan Assets) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2015
Change In Projected Benefit Obligations
Projected benefit obligation, beginning of year	$ 668
Interest cost	95
Service cost	565
Actuarial loss	(12)
Employee contribution	180
Premiums paid	(89)
Benefit payment	(19)
Effect of foreign currency exchange rates	(175)
Projected benefit obligation, end of year	47,661
Change In Plan Assets
Plan assets at fair value, beginning of year	0
Actual return on plan assets	82
Employer contributions	450	$ 1,800
Employee contributions	180
Premiums paid	(89)
Effect of foreign currency exchange rates	(157)
Plan assets at fair value, end of year	26,943
Codman
Change In Projected Benefit Obligations
Transfer from Codman Neurosurgery acquisition	46,448
Change In Plan Assets
Transfer from Codman Neurosurgery acquisition	$ 26,477

RETIREMENT BENEFIT PLANS (Scheduled of Funded Status) (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Retirement Benefits [Abstract]
Fair value of plan assets	$ 26,943	$ 0
Benefit obligations	47,661	$ 668
Unfunded benefit obligation	$ 20,718

RETIREMENT BENEFIT PLANS (Schedule of Expected Benefit Payments and Minimum Contribution on Unfunded Plans) (Details) $ in Thousands	Dec. 31, 2017 USD ($)
Retirement Benefits [Abstract]
2018	$ 158
2019	225
2020	296
2021	454
2022	466
Next five years	$ 5,380

LEASES AND RELATED PARTY LEASES (Schedule Of Minimum Lease Payments) (Details) $ in Thousands	Dec. 31, 2017 USD ($)
Operating Leased Assets [Line Items]
2018	$ 13,745
2019	12,541
2020	9,830
2021	7,354
2022	6,145
Thereafter	47,733
Total minimum lease payments	97,348
Related Parties
Operating Leased Assets [Line Items]
2018	296
2019	296
2020	296
2021	296
2022	296
Thereafter	2,019
Total minimum lease payments	3,499
Third Parties
Operating Leased Assets [Line Items]
2018	13,449
2019	12,245
2020	9,534
2021	7,058
2022	5,849
Thereafter	45,714
Total minimum lease payments	$ 93,849

LEASES AND RELATED PARTY LEASES (Narrative) (Details) - USD ($)		12 Months Ended
	Dec. 27, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 27, 2016	Dec. 31, 2015
Operating Leased Assets [Line Items]
Rental expense		$ 12,900,000	$ 10,300,000		$ 10,100,000
Future minimum lease payments, capital leases		0
Production equipment purchased		43,503,000	$ 47,328,000		33,413,000
Related Party
Operating Leased Assets [Line Items]
Rental expense		$ 300,000			$ 100,000
Payment per year to related party lessor				$ 100,000
Production equipment purchased	$ 400,000
Percent of manufacturing facility owned by corporation whose shareholders are trusts whose beneficiaries include family members of company's former chairman		50.00%
Annual rate of lease agreement		$ 300,000
Related Party \| Five-Year Option Lease From November 1, 2032 Through October 31, 2037
Operating Leased Assets [Line Items]
Option to extend lease, years		5 years
Period for extended lease		November 1, 2032 through October 31, 2037
Related Party \| Five-Year Option Lease From November 1, 2037 Through October 31, 2042
Operating Leased Assets [Line Items]
Option to extend lease, years		5 years
Period for extended lease		November 1, 2037 through October 31, 2042

INCOME TAXES (Schedule Of Income Before Income Taxes) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
United States operations	$ (32,640)	$ 51,351	$ 37,450
Foreign operations	44,025	39,055	23,221
Income from continuing operations before income taxes	$ 11,385	$ 90,406	$ 60,671

INCOME TAXES (Narrative) (Details) - USD ($) $ in Thousands	12 Months Ended
INCOME TAXES (Narrative) (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax [Line Items]
Tax benefit, re-measurement of net deferred tax liabilities, Tax Cuts and Jobs Act of 2017	$ 43,400
Income tax expense, Tax Cuts and Jobs Act of 2017	5,500
Income tax expense, to be paid within one year, Tax Cuts and Jobs Act of 2017	$ 400
Decrease in effective income tax rate during the period	486.20%
Effective income tax rate reconciliation, foreign income tax rate differential, increase (decrease), amount	$ 1,200	$ (800)
Effective foreign income tax rate	15.70%	12.70%
Increase (decrease) in effective foreign income tax rate during period	2.90%	(2.10%)
Operating loss carryforwards, not subject to expiration	$ 25,400
Deferred tax assets, valuation allowance	7,961	$ 3,604	$ 4,900
Deferred tax assets, gross	96,499	78,227	82,500
Valuation allowance, period increase	4,400	1,300
Unrecognized tax benefits that would impact effective tax rate	400
Amount of unrecorded benefit reasonably possible to be recognized	100
Penalties and interest expense	0	0	0
Penalties and interest accrued	0	$ 0	$ 0
Federal
Income Tax [Line Items]
Operating loss carryforwards	148,200
Foreign Tax Authority
Income Tax [Line Items]
Operating loss carryforwards	26,400
Operating loss carryforwards, subject to expiration	$ 1,000
Foreign Tax Authority \| Switzerland
Income Tax [Line Items]
Reduced corporate tax rate	8.00%
State and Local Jurisdiction
Income Tax [Line Items]
Operating loss carryforwards	$ 28,200

INCOME TAXES (Schedule of Effective Tax Rate Reconciliation) (Details)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Federal statutory rate	35.00%	35.00%	35.00%
Increase (decrease) in income taxes resulting from:
State income taxes, net of federal tax benefit	(17.00%)	(0.20%)	1.30%
Foreign operations	(112.70%)	(10.00%)	(12.50%)
Spine valuation allowance	0.00%	0.00%	61.10%
Excess tax benefits from stock compensation	(57.90%)	(3.90%)	0.00%
Charitable contributions	(10.60%)	(0.40%)	(1.00%)
Nondeductible meals and entertainment	8.80%	0.80%	0.90%
Domestic production activities deduction	(0.00%)	(2.60%)	(2.40%)
Intercompany profit in inventory	11.60%	1.00%	3.10%
Nondeductible facilitative costs	22.50%	0.20%	3.10%
Changes in valuation allowances	8.00%	0.40%	0.30%
Uncertain tax positions	(4.60%)	(0.30%)	0.20%
Research and development credit	(13.20%)	(1.20%)	(1.90%)
Return to provision	(4.30%)	(1.50%)	1.70%
Reduction of book gain on sale of assets	(4.60%)	0.00%	0.00%
Tax reform — Toll Tax	48.10%	0.00%	0.00%
Tax reform — remeasurement of deferred tax assets and liabilities	(378.60%)	0.00%	0.00%
Other	0.80%	0.20%	(0.20%)
Effective tax rate	(468.70%)	17.50%	88.70%

INCOME TAXES (Schedule Of Provision For Income Taxes) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current:
Federal	$ 6,644	$ 13,700	$ 46,665
State	1,233	2,503	2,301
Foreign	6,069	6,113	5,205
Total current	13,946	22,316	54,171
Deferred:
Federal	(66,466)	(3,400)	1,282
State	(758)	(1,751)	(394)
Foreign	(80)	(1,323)	(1,239)
Total deferred	(67,304)	(6,474)	(351)
Provision for income taxes	$ (53,358)	$ 15,842	$ 53,820

INCOME TAXES (Schedule Of Deferred Tax Assets And Liabilities) (Details) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Assets:
Doubtful accounts	$ 1,811	$ 2,344
Inventory related items	29,266	30,074
Tax credits	6,015	1,040
Accrued vacation	2,556	3,264
Accrued bonus	997	7,842
Stock compensation	10,426	16,031
Deferred revenue	2,395	2,345
Net operating loss carryforwards	37,492	15,058
Unrealized foreign exchange loss	1,177	96
Charitable contributions carryforward	1,287	5
Others	3,077	128
Total deferred tax assets	96,499	78,227	$ 82,500
Less valuation allowance	(7,961)	(3,604)	$ (4,900)
Deferred tax assets after valuation allowance	88,538	74,623
Liabilities:
Intangible and fixed assets	(146,327)	(215,438)
Others	(1,091)	(1,191)
Total deferred tax liabilities	(147,418)	(216,629)
Total net deferred tax liabilities	$ (58,880)	$ (142,006)

INCOME TAXES (Schedule of Uncertain Tax Benefits Reconciliation) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Reconciliation of Uncertain Tax Benefits [Roll Forward]
Balance, beginning of year	$ 754	$ 1,085	$ 959
Gross increases:
Current year tax positions	402	0	0
Prior years' tax positions	0	380	541
Gross decreases:
Prior years' tax positions	(777)	(546)	0
Settlements	0	0	0
Statute of limitations lapses	(17)	(131)	(404)
Other	62	(34)	(11)
Balance, end of year	$ 424	$ 754	$ 1,085

NET INCOME (LOSS) PER SHARE (Basic and Diluted Net Income Per Share) (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Basic net income (loss) per share:
Net income from continuing operations									$ 64,743	$ 74,564	$ 6,851
Net loss from discontinued operations									0	0	(10,370)
Net income (loss)	$ 44,355	$ 3,159	$ 10,835	$ 6,394	$ 28,246	$ 20,144	$ 12,755	$ 13,419	$ 64,743	$ 74,564	$ (3,519)
Weighted average common shares outstanding, basic (in shares)									76,897	74,386	68,990
Basic net income per common share from continuing operations (in dollars per share)									$ 0.84	$ 1.00	$ 0.10
Loss from discontinued operations (in dollars per share)									0.00	0.00	(0.15)
Net income (loss) per share - basic (in dollars per share)	$ 0.57	$ 0.04	$ 0.14	$ 0.09	$ 0.38	$ 0.27	$ 0.17	$ 0.18	$ 0.84	$ 1.00	$ (0.05)
Diluted net income (loss) per share:
Net income from continuing operations									$ 64,743	$ 74,564	$ 6,851
Net loss from discontinued operations									0	0	(10,370)
Net income (loss)	$ 44,355	$ 3,159	$ 10,835	$ 6,394	$ 28,246	$ 20,144	$ 12,755	$ 13,419	$ 64,743	$ 74,564	$ (3,519)
Weighted average common shares outstanding, basic (in shares)									76,897	74,386	68,990
Effect of dilutive securities:
2016 Convertible notes (in shares)									0	2,296	922
Warrants (in shares)									971	1,166	0
Stock options and restricted stock (in shares)									1,253	1,346	1,442
Weighted average common shares for diluted earnings per share (in shares)									79,121	79,194	71,354
Diluted net income per common share from continuing operations (in dollars per share)									$ 0.82	$ 0.94	$ 0.10
Diluted net loss per common share from discontinued operations (in dollars per share)									0.00	0.00	(0.15)
Net income (loss) per share - diluted (in dollars per share)	$ 0.56	$ 0.04	$ 0.14	$ 0.08	$ 0.35	$ 0.25	$ 0.16	$ 0.18	$ 0.82	$ 0.94	$ (0.05)

NET INCOME (LOSS) PER SHARE (Narrative) (Details) - USD ($) $ in Thousands, shares in Millions			12 Months Ended
	Dec. 15, 2016	Jul. 02, 2015	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Allocated share-based compensation expense			$ 21,550	$ 17,310	$ 15,450
Shares excluded from computation as their effect would be antidilutive (in shares)			0.2	0.2	0.2
Stock issued during period, shares, conversion of convertible securities (in shares)	2.9
Common stock from the exercise of call option with hedge participants (in shares)	2.9
Performance Shares and Restricted Units
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Additional EPS shares			0.5
Discontinued Operations, Disposed of by Means Other than Sale, Spinoff \| SeaSpine Inc.
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Increase in incremental fair value, stock-based compensation awards		$ 4,400
Allocated share-based compensation expense			$ 300	$ 700	$ 3,300
Compensation cost not yet recognized			$ 100

ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS) (Schedule of Accumulated Other Comprehensive Income (Loss)) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	$ 839,667	$ 751,443	$ 704,322
Other comprehensive (loss) income before reclassifications	32,256
Less: Income (loss) reclassified from accumulated other comprehensive income (loss)	(1,091)
Total other comprehensive income (loss), net of tax	33,347	(9,252)	(24,414)
Ending Balance	962,306	839,667	751,443
Gains and Losses on Cash Flow Hedges
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	1,071
Other comprehensive (loss) income before reclassifications	(2,122)
Less: Income (loss) reclassified from accumulated other comprehensive income (loss)	1,928
Total other comprehensive income (loss), net of tax	(4,050)
Ending Balance	(2,979)	1,071
Defined Benefit Pension Items
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	(36)
Other comprehensive (loss) income before reclassifications	(57)
Less: Income (loss) reclassified from accumulated other comprehensive income (loss)	0
Total other comprehensive income (loss), net of tax	(57)
Ending Balance	(93)	(36)
Foreign Currency Items
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	(58,189)
Other comprehensive (loss) income before reclassifications	37,454
Less: Income (loss) reclassified from accumulated other comprehensive income (loss)	0
Total other comprehensive income (loss), net of tax	37,454
Ending Balance	(20,735)	(58,189)
Short-term Investment
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	0
Other comprehensive (loss) income before reclassifications	(3,019)
Less: Income (loss) reclassified from accumulated other comprehensive income (loss)	(3,019)
Total other comprehensive income (loss), net of tax	0
Ending Balance	0	0
AOCI Attributable to Parent
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning Balance	(57,154)	(47,902)	(23,488)
Total other comprehensive income (loss), net of tax	33,347	(9,252)
Ending Balance	$ (23,807)	$ (57,154)	$ (47,902)

ACCUMULATED OTHER COMPREHENSIVE INCOME (LOSS) (Narrative) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Accumulated Other Comprehensive Income (Loss) [Line Items]
Income tax expense (benefit) related to items in other comprehensive loss	$ 2,333	$ (800)	$ (375)
Pension Plan
Accumulated Other Comprehensive Income (Loss) [Line Items]
Income tax expense (benefit) related to items in other comprehensive loss	0
Cash Flow Hedging
Accumulated Other Comprehensive Income (Loss) [Line Items]
Income tax expense (benefit) related to items in other comprehensive loss	$ 2,300

COMMITMENTS AND CONTINGENCIES (Narrative) (Details)				12 Months Ended
COMMITMENTS AND CONTINGENCIES (Narrative) (Details)	Mar. 01, 2018 USD ($)	Feb. 24, 2017 USD ($)	Jul. 17, 2015 USD ($)	Dec. 31, 2017 case	Jan. 15, 2014 USD ($)
Supply Agreement And Above Market Supply Agreement
Loss Contingencies [Line Items]
Discount rate				12.00%
TEI
Loss Contingencies [Line Items]
Number of active cases \| case				10
Indemnification policy in place			$ 3,000,000.0
Discount rate			11.00%
TEI \| Subsequent Event
Loss Contingencies [Line Items]
Indemnification payments received	$ 0
Indemnification payments owed	$ 0
TEI \| Indemnification period one - up to fifteen months after close
Loss Contingencies [Line Items]
Maximum indemnification from acquisition			$ 30,000,000
Period of indemnification			15 months
TEI \| Indemnification period two - up to three years after close
Loss Contingencies [Line Items]
Maximum indemnification from acquisition			$ 30,000,000
Period of indemnification			3 years
Minimum indemnification from acquisition			$ 20,000,000
TEI \| Third party insurer
Loss Contingencies [Line Items]
Indemnification policy in place			$ 3,000,000.0
Confluent Surgical, Inc.
Loss Contingencies [Line Items]
Contingent consideration arrangements, maximum payout					$ 30,000,000
Contingent Consideration Liability \| Confluent Surgical, Inc.
Loss Contingencies [Line Items]
Discount rate				2.20%
Cash Consideration One \| Confluent Surgical, Inc.
Loss Contingencies [Line Items]
Contingent consideration arrangements, maximum payout					25,000,000
Cash Consideration Two \| Confluent Surgical, Inc.
Loss Contingencies [Line Items]
Contingent consideration arrangements, maximum payout					$ 5,000,000
BioD Earnout Payments \| Derma Sciences
Loss Contingencies [Line Items]
Contingent consideration arrangements, maximum payout		$ 26,500,000
Discount rate		3.00%

COMMITMENTS AND CONTINGENCIES (Fair Value Contingent Consideration) (Details) - Contingent Consideration Liability - Level 3 - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Accrued expenses and other current liabilities \| Derma Sciences
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	$ 0	$ 0
Additions from acquisition of Derma Sciences	33,707
Transfers from long-term to current portion	2,193
Payments	(31,346)
Balance, End of Period	315	0
Accrued expenses and other current liabilities \| Derma Sciences \| Selling, general and administrative
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value	(4,239)
Accrued expenses and other current liabilities \| Confluent Surgical, Inc.
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	0	0
Additions from acquisition of Derma Sciences	0
Transfers from long-term to current portion	22,184
Payments	0
Balance, End of Period	22,478	0
Accrued expenses and other current liabilities \| Confluent Surgical, Inc. \| Selling, general and administrative
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value	294
Other Noncurrent Liabilities \| Derma Sciences
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	0	0
Additions from acquisition of Derma Sciences	3,467
Transfers from long-term to current portion	(2,193)
Payments	0
Balance, End of Period	1,387	0
Other Noncurrent Liabilities \| Derma Sciences \| Selling, general and administrative
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value	113
Other Noncurrent Liabilities \| Confluent Surgical, Inc.
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	22,036	21,831
Additions from acquisition of Derma Sciences	0
Transfers from long-term to current portion	(22,184)
Payments	0
Balance, End of Period	0	22,036
Other Noncurrent Liabilities \| Confluent Surgical, Inc. \| Selling, general and administrative
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Change in fair value	$ 148	$ 205

COMMITMENTS AND CONTINGENCIES (Fair Value Supply Agreement) (Details) - Level 3 - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Accrued Expenses And Other Current Liabilities \| Supply Agreement Liability, Short-term
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Transfer from long-term to current potion	$ 0
Accrued Expenses And Other Current Liabilities \| Supply Agreement Liability, Short-term \| Selling, general and administrative
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Loss from increase in fair value	0
Other Noncurrent Liabilities \| Supply Agreement Liability, Long-term
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Payments	0
Transfer from long-term to current potion	0
Commitments \| Accrued Expenses And Other Current Liabilities \| Supply Agreement Liability, Short-term
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	166	$ 1,991
Payments	(166)	(2,000)
Transfer from long-term to current potion		161
Balance, End of Period	0	166
Commitments \| Accrued Expenses And Other Current Liabilities \| Supply Agreement Liability, Short-term \| Selling, general and administrative
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Loss from increase in fair value		14
Commitments \| Accrued Expenses And Other Current Liabilities \| Supply Agreement Liability, Short-term \| Goodwill
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Other		0
Commitments \| Accrued Expenses And Other Current Liabilities \| Above Market Supply Agreement Liability, Short-term
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	0	0
Payments	(113)
Transfer from long-term to current potion	3,273
Loss from increase in fair value	(519)
Balance, End of Period	2,641	0
Commitments \| Other Noncurrent Liabilities \| Supply Agreement Liability, Long-term
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	0	161
Transfer from long-term to current potion		(161)
Balance, End of Period	0	0
Commitments \| Other Noncurrent Liabilities \| Above Market Supply Agreement Liability, Long-term
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, Beginning of Period	2,648	931
Payments	(415)	(47)
Transfer from long-term to current potion	(3,273)
Balance, End of Period	0	2,648
Commitments \| Other Noncurrent Liabilities \| Above Market Supply Agreement Liability, Long-term \| Selling, general and administrative
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Loss from increase in fair value	$ 1,040	1,083
Commitments \| Other Noncurrent Liabilities \| Above Market Supply Agreement Liability, Long-term \| Goodwill
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Other		$ 681

SEGMENT AND GEOGRAPHIC INFORMATION (Narrative) (Details)	3 Months Ended	12 Months Ended	30 Months Ended
	Mar. 31, 2015 Segment	Dec. 31, 2017 Segment product	Dec. 31, 2017 Segment
Segment Reporting Information [Line Items]
Number of reportable segments \| Segment	3	2	2
Codman Specialty Surgical
Segment Reporting Information [Line Items]
Number of products offered (more than) \| product		60,000

SEGMENT AND GEOGRAPHIC INFORMATION (Net Sales and Profit by Reportable Segment) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Net Sales
Revenues	$ 368,602	$ 278,834	$ 282,164	$ 258,636	$ 255,664	$ 250,332	$ 249,309	$ 236,770	$ 1,188,236	$ 992,075	$ 882,734
Segment Profit
Operating income									44,804	115,340	79,587
Amortization									(20,370)	(13,862)	(9,953)
Codman Specialty Surgical
Segment Net Sales
Revenues									720,301	632,524	586,918
Orthopedics and Tissue Technologies
Segment Net Sales
Revenues									467,935	359,551	295,816
Operating Segments
Segment Profit
Operating income									422,668	360,481	330,323
Operating Segments \| Codman Specialty Surgical
Segment Profit
Operating income									292,971	256,629	242,479
Operating Segments \| Orthopedics and Tissue Technologies
Segment Profit
Operating income									129,697	103,852	87,844
Segment Reconciling Items
Segment Profit
Amortization									(20,370)	(13,862)	(9,953)
Corporate, Non-Segment
Segment Profit
Operating income									$ (357,494)	$ (231,279)	$ (240,783)

SEGMENT AND GEOGRAPHIC INFORMATION (Total Revenue by Major Geographic Area) (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Total revenue, net	$ 368,602	$ 278,834	$ 282,164	$ 258,636	$ 255,664	$ 250,332	$ 249,309	$ 236,770	$ 1,188,236	$ 992,075	$ 882,734
Total long-lived assets	285,329				234,103				285,329	234,103
United States (Includes long-lived assets in Puerto Rico)
Segment Reporting Information [Line Items]
Total revenue, net									894,260	765,608	680,824
Total long-lived assets	247,154				213,898				247,154	213,898
Europe
Segment Reporting Information [Line Items]
Total revenue, net									150,147	120,588	103,057
Total long-lived assets	30,942				18,970				30,942	18,970
Rest of the World
Segment Reporting Information [Line Items]
Total revenue, net									143,829	105,879	$ 98,853
Total long-lived assets	$ 7,233				$ 1,235				$ 7,233	$ 1,235

SELECTED QUARTERLY INFORMATION - UNAUDITED (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Total revenue, net	$ 368,602	$ 278,834	$ 282,164	$ 258,636	$ 255,664	$ 250,332	$ 249,309	$ 236,770	$ 1,188,236	$ 992,075	$ 882,734
Gross margin	220,431	177,077	183,166	172,051	170,242	161,003	159,744	151,997	752,725	642,986
Net income	$ 44,355	$ 3,159	$ 10,835	$ 6,394	$ 28,246	$ 20,144	$ 12,755	$ 13,419	$ 64,743	$ 74,564	$ (3,519)
Per Share-Basic (in dollars per share)	$ 0.57	$ 0.04	$ 0.14	$ 0.09	$ 0.38	$ 0.27	$ 0.17	$ 0.18	$ 0.84	$ 1.00	$ (0.05)
Per Share-Diluted (in dollars per share)	$ 0.56	$ 0.04	$ 0.14	$ 0.08	$ 0.35	$ 0.25	$ 0.16	$ 0.18	$ 0.82	$ 0.94	$ (0.05)
Tax benefit, re-measurement of net deferred tax liabilities, Tax Cuts and Jobs Act of 2017									$ 43,400
Codman Specialty Surgical \| Disposal Group, Held-for-sale, Not Discontinued Operations
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Gain on sale of business, included in other income, net									$ 2,600
Accounting Standards Update 2016-09
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net income, restated to reflect the effect of adoption							$ 1,800

SCHEDULE II - VALUATION AND QUALIFYING ACCOUNTS (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Allowance for doubtful accounts and sales returns and allowances
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	$ 6,319	$ 5,572	$ 5,659
Charged to Costs and Expenses	4,920	2,009	1,262
Charged to Other Accounts	1,518	0	0
Deductions	(3,875)	(1,262)	(1,349)
Balance at End of Period	8,882	6,319	5,572
Deferred tax assets valuation allowance
Movement in Valuation Allowances and Reserves [Roll Forward]
Balance at Beginning of Period	3,604	4,887	6,772
Charged to Costs and Expenses	740	(1,228)	80
Charged to Other Accounts	3,617	0	0
Deductions	0	(55)	(1,965)
Balance at End of Period	$ 7,961	$ 3,604	$ 4,887