0000917520-26-000041 | 10-Q | XBRL Viewer | Integra Lifesciences Holdings Corp

NET LOSS PER SHARE

3 Months Ended

Mar. 31, 2026

Basic and diluted net loss per share was as follows:


	Three Months Ended March 31,
Dollars in thousands, except per share amounts	2026		2025
Basic net loss per share:
Net loss	$	(4,617)	$	(25,293)
Weighted average common shares outstanding	76,951		76,463

Basic net loss per common share	$	(0.06)	$	(0.33)

Diluted net loss per share:
Net loss	$	(4,617)	$	(25,293)

Weighted average common shares outstanding — Basic	76,951		76,463
Effect of dilutive securities:
Stock options and restricted stock	—		—
Weighted average common shares for diluted earnings per share	76,951		76,463

Diluted net loss per common share	$	(0.06)	$	(0.33)

Basic earnings per share is computed by dividing net income by the weighted-average common shares outstanding during the period. Diluted earnings per share is computed based on the weighted-average common shares outstanding plus the effect of dilutive potential common shares outstanding during the period calculated using the treasury stock method. Dilutive potential common shares include employee equity share options, non-vested shares, and similar equity instruments granted by the Company. Potential common share equivalents have been excluded where their inclusion would be anti-dilutive. For periods in which the Company generated a net loss, the Company does not include the potential impact of dilutive securities in diluted net loss per share, as the impact of these items is anti-dilutive.

Common stock of approximately 1.6 million and 1.6 million shares at March 31, 2026 and 2025, respectively, were not included in the computation of diluted net income and diluted net loss per share, respectively, because their effect would have been anti-dilutive.

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Current assets:
Cash and cash equivalents	$ 236,809	$ 235,048
Short-term investments	28,693	28,693
Trade accounts receivable, net of allowances of $7,410 and $7,230	264,413	278,849
Inventories, net	495,035	492,735
Prepaid expenses	97,713	96,089
Other current assets	49,354	28,130
Total current assets	1,172,017	1,159,544
Property, plant and equipment, net	446,882	444,335
Right of use asset - operating leases	137,197	140,568
Intangible assets, net	1,105,345	1,134,663
Goodwill	613,247	615,157
Deferred tax assets, net	68,078	69,854
Other assets	34,960	37,880
Total assets	3,577,726	3,602,001
Current liabilities:
Current portion of borrowings under senior credit facility	38,750	38,750
Current portion of borrowings under securitization facility	0	87,800
Current portion of lease liability - operating leases	13,932	14,019
Accounts payable, trade	87,948	95,726
Contract liabilities	11,623	11,463
Income tax payable	3,236	3,651
Accrued compensation	58,040	74,079
Accrued expenses and other current liabilities	133,317	130,493
Total current liabilities	346,846	455,981
Long-term borrowings under senior credit facility	1,750,255	1,729,556
Long-term borrowings under securitization facility	76,400	0
Lease liability - operating leases	160,116	163,059
Deferred tax liabilities	6,143	5,664
Other liabilities	195,560	204,278
Total liabilities	2,535,320	2,558,538
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; 92,174 and 92,286 issued at March 31, 2026 and December 31, 2025, respectively	922	923
Additional paid-in capital	1,340,722	1,338,386
Treasury stock, at cost; 14,356 shares and 14,399 shares at March 31, 2026 and December 31, 2025, respectively	(687,122)	(689,210)
Accumulated other comprehensive loss	(30,940)	(30,077)
Retained earnings	418,824	423,441
Total stockholders’ equity	1,042,406	1,043,463
Total liabilities and stockholders’ equity	$ 3,577,726	$ 3,602,001

LEASES AND RELATED PARTY LEASES

3 Months Ended

Mar. 31, 2026

Leases [Abstract]

LEASES AND RELATED PARTY LEASES

The Company leases administrative, manufacturing, research and distribution facilities, equipment and vehicles through operating lease agreements. The Company has no finance leases as of March 31, 2026. Many of the Company’s facility leases include both lease (e.g., fixed payments including rent) and non-lease components (e.g., common-area or other maintenance costs). For vehicles, the Company has elected the practical expedient to group lease and non-lease components.

Most facility leases include one or more options to renew. The exercise of lease renewal options is typically at the Company’s sole discretion, therefore, the majority of renewals to extend the lease terms are not included in the Right of Use (“ROU”) assets and lease liabilities as they are not reasonably certain of exercise. The Company regularly evaluates renewal options and when they are reasonably certain of exercise, the renewal period is included in the lease term.

As most of the Company’s leases do not provide an implicit rate, the Company uses a collateralized incremental borrowing rate based on the information available at the lease commencement date in determining the present value of the lease payments.

Total operating lease expense for the three months ended March 31, 2026 and March 31, 2025 was $6.4 million and $5.9 million, respectively, which includes $0.1 million in related party operating lease expense.

Supplemental balance sheet information related to operating leases were as follows:


Dollars in thousands, except lease term and discount rate	March 31, 2026			December 31, 2025
ROU assets	$	137,197		$	140,568

Current lease liabilities	13,932			14,019
Non-current lease liabilities	160,116			163,059
Total lease liabilities	$	174,048		$	177,078

Weighted average remaining lease term (in years):
Leased facilities	15.6 years			15.7 years
Leased vehicles	2.8 years			2.7 years
Leased equipment	2.8 years			2.9 years

Weighted average discount rate:
Leased facilities	5.4		%	5.4		%
Leased vehicles	3.1		%	3.2		%
Leased equipment	6.6		%	6.9		%

Supplemental cash flow information related to leases for the three months ended March 31, 2026 and 2025 were as follows:


Dollars in thousands	March 31, 2026		March 31, 2025
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	5,660	$	5,890

ROU assets obtained in exchange for lease liabilities, net of modifications:
Operating leases	$	232	$	958

Future minimum lease payments under operating leases at March 31, 2026 were as follows:


Dollars in thousands	Related Parties		Third Parties		Total
Remainder of 2026	$	222	$	13,223	$	13,445
2027	296		21,784		22,080
2028	296		19,053		19,349
2029	246		18,766		19,012
2030	—		18,261		18,261
2031	—		17,826		17,826
Thereafter	—		148,993		148,993
Total minimum lease payments	$	1,060	$	257,906	$	258,966
Less: Imputed interest					84,918
Total lease liabilities					174,048
Less: Current lease liabilities					13,932
Long-term lease liabilities					160,116

There were no future minimum lease payments under finance leases at March 31, 2026.

Related Party Leases

The Company leases one of its manufacturing facilities in Plainsboro, New Jersey, from a general partnership that is 50% owned by a principal stockholder of the Company. The term of the current lease agreement is through October 31, 2029 at an annual rate of approximately $0.3 million. The current lease agreement also provides (i) a 5-year renewal option for the Company to extend the lease from November 1, 2029 through October 31, 2034 at the fair market rental rate of the premises, and (ii) another 5-year renewal option to extend the lease from November 1, 2034 through October 31, 2039 at the fair market rental rate of the premises.

CONDENSED CONSOLIDATED STATEMENTS OF CHANGES IN SHAREHOLDERS' EQUITY (UNAUDITED) - USD ($) shares in Thousands, $ in Thousands	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	Accumulated Other Comprehensive Loss	Retained Earnings
Balance, beginning of period, (in shares) at Dec. 31, 2024		91,609
Balance, beginning of period at Dec. 31, 2024	$ 1,545,280	$ 916	$ (691,411)	$ 1,323,431	$ (27,571)	$ 939,915
Balance, beginning of period, treasury stock (in shares) at Dec. 31, 2024			(14,445)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	(25,293)					(25,293)
Other comprehensive income (loss), net of tax	3,465				3,465
Issuance of common stock through employee stock purchase plan (in shares)		44
Issuance of common stock through employee stock purchase plan	957			957
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes and forfeitures (in shares)		483	21
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes and forfeitures	(2,130)	$ 5	$ 1,032	(3,167)
Share-based compensation	1,860			1,860
Balance, end of period (in shares) at Mar. 31, 2025		92,136
Balance, end of period at Mar. 31, 2025	1,524,139	$ 921	$ (690,379)	1,323,081	(24,106)	914,622
Balance, beginning of period, treasury stock (in shares) at Mar. 31, 2025			(14,424)
Balance, beginning of period, (in shares) at Dec. 31, 2025		92,286
Balance, beginning of period at Dec. 31, 2025	$ 1,043,463	$ 923	$ (689,210)	1,338,386	(30,077)	423,441
Balance, beginning of period, treasury stock (in shares) at Dec. 31, 2025	(14,399)		(14,399)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net loss	$ (4,617)					(4,617)
Other comprehensive income (loss), net of tax	(863)				(863)
Issuance of common stock through employee stock purchase plan (in shares)		64
Issuance of common stock through employee stock purchase plan	761	$ 1		760
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes and forfeitures	(1,375)	$ (2)	$ 2,088	(3,461)
Issuance of common stock for vesting of share based awards, net of shares withheld for taxes and forfeitures (in shares)		(176)	43
Share-based compensation	5,037			5,037
Balance, end of period (in shares) at Mar. 31, 2026		92,174
Balance, end of period at Mar. 31, 2026	$ 1,042,406	$ 922	$ (687,122)	$ 1,340,722	$ (30,940)	$ 418,824
Balance, beginning of period, treasury stock (in shares) at Mar. 31, 2026	(14,356)		(14,356)

SEGMENT AND GEOGRAPHIC INFORMATION - Schedule of Revenue by Major Geographic Area (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Segment Reporting Information [Line Items]
Total Revenues	$ 391,918	$ 382,653
United States
Segment Reporting Information [Line Items]
Total Revenues	289,380	282,217
Europe
Segment Reporting Information [Line Items]
Total Revenues	39,962	35,326
Asia Pacific
Segment Reporting Information [Line Items]
Total Revenues	45,212	45,105
Rest of World
Segment Reporting Information [Line Items]
Total Revenues	$ 17,364	$ 20,005

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

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+ Details

INCOME TAXES

3 Months Ended

Mar. 31, 2026

Income Tax Disclosure [Abstract]

INCOME TAXES

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


	Three Months Ended March 31,
	2026		2025
Reported tax rate	(91.7)	%	15.8	%

The Company’s effective income tax rates for the three months ended March 31, 2026 and 2025 were (91.7)% and 15.8%, respectively. For the three months ended March 31, 2026, the Company’s effective tax rate was primarily driven by a $2.9 million tax expense related to a shortfall from stock-based compensation, due to market conditions. For the three months ended March 31, 2025, the Company’s effective tax rate was driven by federal, state, and international tax benefits generated from operating losses in certain jurisdictions, offset by a $2.1 million tax expense related to a shortfall from stock-based compensation.

Changes to income tax laws and regulations, in any of the tax jurisdictions in which the Company operates, could impact the effective tax rate. Various governments, both U.S. and non-U.S., are increasingly focused on tax reform and revenue-raising legislation. On July 4, 2025, the One Big Beautiful Bill Act (“OBBBA”) was enacted in the U.S., with certain provisions effective in 2025 and others implemented through 2027. The OBBBA included the permanent extension of certain expiring provisions of the 2017 Tax Cuts and Jobs Act, the immediate expensing of previously capitalized research and development costs, and reduced limitations on interest expense deductions, among other provisions.

Further, the Company continues to monitor legislation in foreign jurisdictions, enacted in response to ongoing efforts led by the Organization of Economic Cooperation and Development (“OECD”). The OECD released Pillar Two model rules, defining a new 15% global minimum tax for each jurisdiction in which a multinational corporation operates, effective beginning in 2024.

- Definition

The entire disclosure for income tax.

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+ Details

DEBT - Narrative (Details) - USD ($)	Apr. 10, 2026	Aug. 15, 2025	Jun. 06, 2025	Feb. 07, 2020	Mar. 31, 2026	Dec. 31, 2025	Mar. 24, 2023
Debt Instrument [Line Items]
Current portion of borrowings under senior credit facility					$ 38,750,000	$ 38,750,000
Interest payments, remainder of fiscal year					31,300,000
Interest payments, year one					39,500,000
Interest payments, year two					8,600,000
Securitization program outstanding borrowings, maximum limit					$ 150,000,000.0
Security facility, weighted average interest rate					4.70%	4.80%
Carrying Value
Debt Instrument [Line Items]
Debt issuance costs, net					$ 2,870,000	$ 3,257,000
Debt instrument, gross, fair value disclosure					1,868,275,000	1,859,363,000
Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure					1,855,995,000	1,855,498,000
Revolving Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity							$ 1,300,000,000
Standby Letters of Credit
Debt Instrument [Line Items]
Maximum borrowing capacity							60,000,000.0
Swingline Loans
Debt Instrument [Line Items]
Maximum borrowing capacity							60,000,000.0
Senior Credit Facility
Debt Instrument [Line Items]
Debt issuance costs, net			$ 3,900,000
Maximum borrowing capacity							2,100,000,000
Senior Credit Facility \| Revolving Credit Facility \| Level 2 \| Carrying Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure					1,075,000,000	1,045,000,000
Senior Credit Facility \| Revolving Credit Facility \| Level 2 \| Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure					1,069,462,000	1,043,340,000
Senior Credit Facility \| Standby Letters of Credit
Debt Instrument [Line Items]
Letters of credit outstanding					3,000,000.0	$ 3,000,000.0
Line of credit facility outstanding					$ 0
Senior Credit Facility \| Covenant Relief Period \| Minimum
Debt Instrument [Line Items]
Line of credit, commitment fee percentage			0.15%
Senior Credit Facility \| Covenant Relief Period \| Maximum
Debt Instrument [Line Items]
Line of credit, commitment fee percentage			0.33%
Senior Credit Facility \| Thereafter Covenant Relief Period \| Minimum
Debt Instrument [Line Items]
Line of credit, commitment fee percentage			0.15%
Senior Credit Facility \| Thereafter Covenant Relief Period \| Maximum
Debt Instrument [Line Items]
Line of credit, commitment fee percentage			0.30%
Senior Credit Facility \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Debt instrument, basis spread adjustment on variable rate			0.10%
Interest rates available to the company at its option			1.00%
Senior Credit Facility \| Secured Overnight Financing Rate (SOFR) \| Covenant Relief Period \| Minimum
Debt Instrument [Line Items]
Interest rates available to the company at its option			1.00%
Senior Credit Facility \| Secured Overnight Financing Rate (SOFR) \| Covenant Relief Period \| Maximum
Debt Instrument [Line Items]
Interest rates available to the company at its option			2.13%
Senior Credit Facility \| Secured Overnight Financing Rate (SOFR) \| Thereafter Covenant Relief Period \| Minimum
Debt Instrument [Line Items]
Interest rates available to the company at its option			1.00%
Senior Credit Facility \| Secured Overnight Financing Rate (SOFR) \| Thereafter Covenant Relief Period \| Maximum
Debt Instrument [Line Items]
Interest rates available to the company at its option			1.75%
Senior Credit Facility \| Overnight Federal Funds Rate
Debt Instrument [Line Items]
Interest rates available to the company at its option			0.50%
Term Loan Facility \| Secured Debt
Debt Instrument [Line Items]
Maximum borrowing capacity							$ 775,000,000.0
Weighted average interest rate on debt					5.90%	5.70%
Current portion of borrowings under senior credit facility					$ 38,800,000	$ 38,800,000
Term Loan Facility \| Secured Debt \| Level 2 \| Carrying Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure					716,875,000	726,563,000
Term Loan Facility \| Secured Debt \| Level 2 \| Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure					713,448,000	725,480,000
2025 Notes \| Convertible Debt
Debt Instrument [Line Items]
Debt, interest rate				0.50%
Repayments of convertible debt		$ 575,000,000.0
Shares issued to settle convertible senior notes (in shares)		0
Debt instrument, convertible, conversion price (in dollars per share)				$ 73.67
Class of warrant or right, exercise price of warrants or rights (in dollars per share)				$ 113.34
2025 Notes \| Convertible Debt \| Call Option
Debt Instrument [Line Items]
Payments for option index to issuers equity				$ 104,200,000
Proceeds from issuance of warrants				$ 44,500,000
Securitization \| Subsequent Event
Debt Instrument [Line Items]
Debt issuance costs, gross	$ 300,000
Securitization \| Subsequent Event \| Debt Covenant, Consolidated Total Leverage Ratio, Range One
Debt Instrument [Line Items]
Line of credit, commitment fee percentage	1.25%
Securitization \| Subsequent Event \| Debt Covenant, Consolidated Total Leverage Ratio, Range Five
Debt Instrument [Line Items]
Line of credit, commitment fee percentage	0.95%
Securitization \| Level 2 \| Carrying Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure					76,400,000	87,800,000
Securitization \| Level 2 \| Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure					$ 73,085,000	$ 86,678,000

TREASURY STOCK	3 Months Ended
TREASURY STOCK	Mar. 31, 2026
Equity [Abstract]
TREASURY STOCK	TREASURY STOCK As of March 31, 2026 and December 31, 2025, there were 14.4 million and 14.4 million shares of treasury stock outstanding with a cost of $687.1 million and $689.2 million, respectively, at a weighted average cost per share of $47.86 for both periods. On December 31, 2025, the Company’s share repurchase program expired. At the time of expiration, approximately $50.0 million remained available for repurchase. The Company did not adopt a new share repurchase program upon the expiration.

DEBT - Schedule of Maximum Total Leverage Ratio Table (Details) - Senior Credit Facility	Jun. 06, 2025
June 30, 2025 through June 30, 2026
Debt Instrument [Line Items]
Debt instrument, covenant, maximum leverage ratio	5.00
September 30, 2026
Debt Instrument [Line Items]
Debt instrument, covenant, maximum leverage ratio	4.75
December 31, 2026
Debt Instrument [Line Items]
Debt instrument, covenant, maximum leverage ratio	4.50
March 31, 2027 and the last day of each fiscal quarter thereafter
Debt Instrument [Line Items]
Debt instrument, covenant, maximum leverage ratio	4.00

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Mar. 31, 2026
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

COMMITMENTS AND CONTINGENCIES

3 Months Ended

Mar. 31, 2026

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.

In the ordinary course of its business, the Company is involved in, from time to time, various legal actions, including any matters described below, involving product liability, employment, intellectual property and commercial disputes, shareholder related matters, environmental proceedings, tax disputes, and governmental proceedings and investigations, some of which have been settled by the Company. In the opinion of management, such matters 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.

The Company accrues for loss contingencies when it is deemed probable that a loss has been incurred and that loss is estimable. If the reasonable estimate of a probable loss is a range, and no amount within the range is a better estimate than any other, the minimum amount of the range is recorded. In most cases, significant judgment is required to estimate the amount and timing of a loss to be recorded and actual results may differ from these estimates. 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.

On December 21, 2023, Fortis Advisors, LLC (representative of the security holders of ACell, Inc. (“ACell”)) filed for arbitration against Integra LifeSciences before the Court of International Arbitration of the International Chamber of Commerce claiming breach of contract related to the earnout consideration from the 2021 acquisition of ACell. Refer to the “Contingent Consideration” subheading of this Note for additional information on the ACell contingent consideration. The arbitration was held in September 2025. On April 15, 2026, the arbitration tribunal issued its decision finding in Integra’s favor on all claims and awarding the company its attorneys’ fees and costs to be paid by Fortis.

On September 12, 2023, a securities class action complaint, captioned Pembroke Pines Firefighters & Police Officers Pension Fund v. Integra LifeSciences Holdings Corporation, No. 23-cv-20321 (D.N.J.), was filed by a purported stockholder of the Company in the United States District Court for the District of New Jersey (the “Pembroke Litigation”) against the Company and certain of the Company’s current and former executive officers. The Pembroke Litigation, filed on behalf of a putative class of stockholders who purchased or acquired the Company’s common stock between March 11, 2019 and May 22, 2023, inclusive, alleges violations of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934, as amended, and Rule 10b-5 promulgated thereunder, on the basis of purportedly materially false and misleading statements and omissions relating to certain quality systems issues identified by the FDA at the Company’s Boston facility, the Company’s efforts to remediate those issues, and the Company’s forecasts for certain products in its Tissue Reconstruction segment. The complaint seeks, among other things, compensatory damages, attorneys’ fees, expert fees, and other costs. The Company believes that it has strong defenses to the allegations in the Pembroke Litigation, and intends to continue to defend the matter vigorously. On July 1, 2025, the class action complaint was dismissed without prejudice. The plaintiffs filed a Second Amended Complaint on August 14, 2025. The Company has filed a motion to dismiss the Second Amended Complaint on October 14, 2025. On March 16, 2026, the plaintiffs filed their Supplemental Amended Complaint, in response to which the Company filed its Supplemental Motion to Dismiss on April 3, 2026.

On May 13, 2025 and May 16, 2025, derivative lawsuits captioned Leverett v. Integra LifeSciences Holding Corp. et al, No. 3:2025-cv-04214 (D.N.J.) and Simpkins v. Integra LifeSciences Holding Corp. et al, No. 3:2025-cv-04446 (D.N.J.) were filed in the United States District Court for the District of New Jersey. The actions purport to assert derivative claims on behalf of the Company against its current Board of Directors and certain of its current or former officers and directors. The actions assert claims that the individual defendants breached their fiduciary duties and harmed the Company by making false and misleading statements and omissions relating to certain quality systems issues identified by the U.S. Food and Drug Administration (“FDA”) at the Company’s Boston, Massachusetts manufacturing facility, the Company’s efforts to remediate those issues, and the Company’s forecasts for certain products in its Tissue Reconstruction segment. The complaint seeks, among other things, compensatory damages, attorneys' fees, expert fees, and other costs. The Company believes that it has strong defenses to the allegations in the lawsuits and intends to defend the matters vigorously. These derivative actions have stayed pending resolution of the motion to dismiss in the Pembroke litigation.

Contingent Consideration

The Company determined the fair value of contingent consideration during the three month period ended March 31, 2026 and March 31, 2025 to reflect the change in estimate, additions, payments, transfers and the time value of money during each period.

A reconciliation of the opening balances to the closing balances of these Level 3 measurements for the three months ended March 31, 2026 and March 31, 2025 is as follows (in thousands):


Three Months Ended March 31, 2026	Contingent Consideration Liability Related to the Acquisition of:
	Arkis (1)		Derma Sciences (2)		Surgical Innovations Associates (SIA), Inc. (2)		Total
Balance as of January 1, 2026	$	6,299	$	350	19,400		26,049
Payment	—		—		—		—
Change in fair value of contingent consideration liabilities	9		(2)		(1,300)		(1,293)
Balance as of March 31, 2026	6,308		348		18,100		24,756

Short-Term - Accrued expenses and other liabilities	$	—	$	—	$	18,100	$	18,100
Long-Term - Other liabilities	6,308		348		—		6,656
Total	6,308		348		18,100		24,756


Three Months Ended March 31, 2025	Contingent Consideration Liability Related to the Acquisition of:
	Arkis (1)		Derma Sciences (2)		ACell (2)		Surgical Innovations Associates (SIA), Inc. (2)		Total
Balance as of January 1, 2025	$	12,968	$	2,686	$	3	$	54,000	69,657
Payment	(5,000)		—		—		—		(5,000)
Change in fair value of contingent consideration liabilities	(812)		50		—		600		(162)
Balance as of March 31, 2025	$	7,156	$	2,736	$	3	$	54,600	64,495

Short-Term - Accrued expenses and other liabilities	$	3,598	$	—	$	—	$	35,000	$	38,598
Long-Term - Other liabilities	3,558		2,736		3		19,600		25,897
Total	7,156		2,736		3		54,600		64,495

(1) Location in financial statements: Research and development

(2) Location in financial statements: Selling, general and administrative

Arkis BioSciences Inc.

As part of the acquisition of Arkis BioSciences Inc. (“Arkis”), the Company is required to pay the former shareholders of Arkis up to $25.5 million based on the timing of certain development milestones of $10.0 million and commercial sales milestones of $15.5 million, respectively. The Company used a probability weighted income approach to calculate the fair value of the contingent consideration that considered the possible outcomes of scenarios related to each specified milestone. The Company estimated the fair value of the contingent consideration to be $13.1 million at the acquisition date. In the first quarter of 2025, the Company paid out a development milestone related to design verification procedures for $5.0 million.

Derma Sciences, Inc.

The Company assumed contingent consideration incurred by Derma Sciences, Inc. (“Derma Sciences”) related to its acquisitions of BioD, LLC and the intellectual property related to Medihoney® products. The Company accounted for the contingent liabilities by recording the fair value on the date of the acquisition based on a probability weighted income approach. The Company has already paid $33.3 million related to the aforementioned contingent liabilities. One contingent milestone remains, which relates to net sales of Medihoney products exceeding certain amounts defined in the agreement between the Company and Derma Sciences. The potential maximum undiscounted payment amounts to $3.0 million.

Surgical Innovations Associates, Inc.

As part of the acquisition of Surgical Innovations Associates, Inc. (“SIA”), the Company is required to pay to the former shareholders of SIA up to $90.0 million for two separate payments, which are dependent on (1) achieving certain revenue-based performance milestones in 2023, 2024, and 2025 (up to $50.0 million in additional payments), as well as (2) the approval by the FDA of the pre-market approval ("PMA") application for DuraSorb for certain uses by certain timing targets (up to $40.0 million in additional payments). The Company estimated the fair value of the contingent consideration for the revenue based milestone to be $32.6 million at the acquisition date and $25.0 million for the PMA approval milestone at the acquisition date. In the second quarter of 2025, the Company paid out $18.1 million related to the 2024 performance year. Similarly, in the second quarter of 2024, the Company paid out $12.4 million related to the 2023 performance year. The Company calculated the remaining milestone payment for the 2025 performance year based on actual sales for the year ended December 31, 2025 and expects to make the 2025 performance year payment, totaling $18.1 million, in the second quarter of 2026. The Company used probabilities of achieving the conditions to calculate the fair value of the contingent consideration for the PMA approval milestone.

DERIVATIVE INSTRUMENTS - Schedule of Cross Currency Swap Derivatives (Details) SFr in Thousands, $ in Thousands	Mar. 31, 2026 USD ($)	Mar. 31, 2026 CHF (SFr)	Dec. 31, 2025 USD ($)	Dec. 31, 2025 CHF (SFr)	Nov. 30, 2025 USD ($)	Nov. 30, 2025 CHF (SFr)	Feb. 28, 2025 USD ($)	Feb. 28, 2025 CHF (SFr)	Dec. 31, 2020 USD ($)	Dec. 31, 2020 CHF (SFr)
Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Aggregate Notional Amount	$ 900,000		$ 900,000
Fair Value Asset (Liability)	29,126		27,246
Cross Currency Interest Rate Swap One \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Fair Value Asset (Liability)	$ (50,500)		(54,149)
Cross Currency Interest Rate Swap One \| Cash Flow Hedges \| Designated as Hedging Instrument \| Long
Derivative [Line Items]
Fixed Rate	3.25%	3.25%
Aggregate Notional Amount \| SFr		SFr 299,387		SFr 305,137
Cross Currency Interest Rate Swap One \| Cash Flow Hedges \| Designated as Hedging Instrument \| Short
Derivative [Line Items]
Fixed Rate	6.14%	6.14%
Aggregate Notional Amount	$ 336,088		342,543
Cross Currency Interest Rate Swap Two \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Fair Value Asset (Liability)	$ (2,581)		(2,684)
Cross Currency Interest Rate Swap Two \| Cash Flow Hedges \| Designated as Hedging Instrument \| Long
Derivative [Line Items]
Fixed Rate	4.00%	4.00%
Aggregate Notional Amount \| SFr		SFr 56,644		56,644
Cross Currency Interest Rate Swap Two \| Cash Flow Hedges \| Designated as Hedging Instrument \| Short
Derivative [Line Items]
Fixed Rate	7.11%	7.11%
Aggregate Notional Amount	$ 70,000		70,000
Cross Currency Interest Rate Swap Three \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Fair Value Asset (Liability)	$ (1,969)		(2,834)
Cross Currency Interest Rate Swap Three \| Cash Flow Hedges \| Designated as Hedging Instrument \| Long
Derivative [Line Items]
Fixed Rate	3.00%	3.00%
Aggregate Notional Amount \| SFr		SFr 80,920		SFr 80,920
Cross Currency Interest Rate Swap Three \| Cash Flow Hedges \| Designated as Hedging Instrument \| Short
Derivative [Line Items]
Fixed Rate	6.23%	6.23%
Aggregate Notional Amount	$ 100,000		100,000
Cross-currency swap
Derivative [Line Items]
Aggregate Notional Amount					$ 170,000	SFr 137,600	$ 368,400	SFr 328,100	$ 471,600	SFr 420,100
Cross-currency swap \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Fair Value Asset (Liability)	$ (55,050)		$ (59,667)

BASIS OF PRESENTATION - Schedule of Restructuring Charges (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Restructuring Reserve [Roll Forward]
Balance, beginning of the year	$ 10,774	$ 5,151
Payments and other adjustments	(5,870)	(1,330)
Balance, end of the period	8,749	9,420
Cost of Goods Sold
Restructuring Reserve [Roll Forward]
Charges:	$ 537	$ 6
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Cost of goods sold	Cost of goods sold
Research and development
Restructuring Reserve [Roll Forward]
Charges:	$ 662	$ 342
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Research and development	Research and development
Selling, general and administrative
Restructuring Reserve [Roll Forward]
Charges:	$ 2,646	$ 5,251
Restructuring Charges, Statement of Income or Comprehensive Income [Extensible Enumeration]	Selling, general and administrative	Selling, general and administrative

- Definition

Amount of expenses associated with exit or disposal activities pursuant to an authorized plan. Excludes expenses related to a discontinued operation or an asset retirement obligation.

+ References + Details

ACCUMULATED OTHER COMPREHENSIVE LOSS (Tables)

3 Months Ended

Mar. 31, 2026

Equity [Abstract]

Schedule of Comprehensive Loss

Comprehensive loss for the three months ended March 31, 2026 and 2025:


	Three Months Ended March 31,
Dollars in thousands	2026		2025
Net loss	$	(4,617)	$	(25,293)
Foreign currency translation adjustment	(476)		11,631
Change in unrealized (gain) loss on derivatives, net of tax	(220)		(8,016)
Pension liability adjustment, net of tax	(167)		(150)
Comprehensive loss, net	$	(5,480)	$	(21,828)

Schedule of Changes in Accumulated Other Comprehensive Loss by Component

Changes in accumulated other comprehensive loss by component between December 31, 2025 and March 31, 2026 are presented in the table below, net of tax:


Dollars in thousands	Gains and Losses on Derivatives		Defined Benefit Pension Items		Foreign Currency Items		Total
Balance at January 1, 2026	$	15,948	$	4,984	$	(51,009)	$	(30,077)
Other comprehensive gain	10,593		—		1,890		12,483
Less: Amounts reclassified from accumulated other comprehensive income, net	10,813		167		2,366		13,346
Net current-period other comprehensive (loss)	(220)		(167)		(476)		(863)
Balance at March 31, 2026	$	15,728	$	4,817	$	(51,485)	$	(30,940)

TREASURY STOCK (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2026	Dec. 31, 2025
Class of Stock [Line Items]
Treasury stock outstanding (in shares)	14,356	14,399
Treasury stock	$ 687,122	$ 689,210
Treasury stock, average cost per share (in dollars per share)	$ 47.86	$ 47.86
2023 Share Repurchase Program
Class of Stock [Line Items]
Remaining amount under share repurchase	$ 50,000

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

+ Details

SEGMENT AND GEOGRAPHIC INFORMATION (Tables)

3 Months Ended

Mar. 31, 2026

Segment Reporting [Abstract]

Schedule of Segment Reporting Information

Net sales and profit by each reportable segment for the three months ended March 31, 2026 and 2025 are as follows:


	Three Months Ended March 31, 2026
Dollars in thousands	Specialty Surgery		Tissue Reconstruction		Corporate and Other		Total
Total revenue, net	$	283,135	$	108,783	$	—	$	391,918

Cost of goods sold	110,475		37,459		27,002		174,936
Research and development	11,853		7,532		4,116		23,501
Selling, general & administrative	77,681		43,526		57,028		178,235
Intangible asset amortization	—		—		3,776		3,776

Total cost and expenses	200,009		88,517		91,922		380,448

Operating income (loss)	$	83,126	$	20,266	$	(91,922)	11,470
Interest income							4,106
Interest expense							(22,465)
Other income, net							4,480
Loss before income taxes							$	(2,409)


	Three Months Ended March 31, 2025
Dollars in thousands	Specialty Surgery		Tissue Reconstruction		Corporate and Other		Total
Total revenue, net	$	280,664	$	101,989	$	—	$	382,653

Cost of goods sold (1)	109,861		49,270		29,090		188,221
Research and development (1)	14,795		5,972		3,961		24,728
Selling, general & administrative (1)	83,787		42,304		55,406		181,497
Intangible asset amortization	—		—		3,704		3,704

Total cost and expenses	208,443		97,546		92,161		398,150

Operating income (loss)	$	72,221	$	4,443	$	(92,161)	(15,497)
Interest income							4,420
Interest expense							(18,815)
Other income, net							(144)
Loss before income taxes							$	(30,036)

(1) The amounts reported for the three months ended March 31, 2025 have been retrospectively recast to reflect the realignment of certain cost and expense information as discussed in Note 1. Basis of Presentation.

Schedule of Geographic Revenue, by Area

Total revenue by major geographic area consisted of the following:


	Three Months Ended March 31,
Dollars in thousands	2026		2025
United States	$	289,380	$	282,217
Europe	39,962		35,326
Asia Pacific	45,212		45,105
Rest of World	17,364		20,005
Total Revenues	$	391,918	$	382,653

SEGMENT AND GEOGRAPHIC INFORMATION - Schedule of Segment Reporting Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Segment Reporting Information [Line Items]
Total revenue, net	$ 391,918	$ 382,653
Cost of goods sold	174,936	188,221
Research and development	23,501	24,728
Selling, general & administrative	178,235	181,497
Intangible asset amortization	3,776	3,704
Total costs and expenses	380,448	398,150
Operating income (loss)	11,470	(15,497)
Interest income	4,106	4,420
Interest expense	(22,465)	(18,815)
Other income, net	4,480	(144)
Loss before income taxes	(2,409)	(30,036)
Specialty Surgery
Segment Reporting Information [Line Items]
Total revenue, net	283,135	280,664
Tissue Reconstruction
Segment Reporting Information [Line Items]
Total revenue, net	108,783	101,989
Operating Segments \| Specialty Surgery
Segment Reporting Information [Line Items]
Total revenue, net	283,135	280,664
Cost of goods sold	110,475	109,861
Research and development	11,853	14,795
Selling, general & administrative	77,681	83,787
Intangible asset amortization	0	0
Total costs and expenses	200,009	208,443
Operating income (loss)	83,126	72,221
Operating Segments \| Tissue Reconstruction
Segment Reporting Information [Line Items]
Total revenue, net	108,783	101,989
Cost of goods sold	37,459	49,270
Research and development	7,532	5,972
Selling, general & administrative	43,526	42,304
Intangible asset amortization	0	0
Total costs and expenses	88,517	97,546
Operating income (loss)	20,266	4,443
Corporate and Other
Segment Reporting Information [Line Items]
Total revenue, net	0	0
Cost of goods sold	27,002	29,090
Research and development	4,116	3,961
Selling, general & administrative	57,028	55,406
Intangible asset amortization	3,776	3,704
Total costs and expenses	91,922	92,161
Operating income (loss)	$ (91,922)	$ (92,161)

GOODWILL AND OTHER INTANGIBLE ASSETS - Schedule of Components of Company's Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Intangible Asset, Acquired, Finite-Lived [Line Items]
Cost	$ 1,988,653	$ 1,992,731
Accumulated Amortization	(883,308)	(858,068)
Net	1,105,345	1,134,663
Codman tradename
Intangible Asset, Acquired, Finite-Lived [Line Items]
Cost	179,170	179,959
Net	$ 179,170	$ 179,959
Completed technology
Intangible Asset, Acquired, Finite-Lived [Line Items]
Weighted Average Life	17 years	17 years
Cost	$ 1,483,774	$ 1,486,304
Accumulated Amortization	(654,169)	(632,204)
Net	$ 829,605	$ 854,100
Customer relationships
Intangible Asset, Acquired, Finite-Lived [Line Items]
Weighted Average Life	12 years	12 years
Cost	$ 169,070	$ 169,369
Accumulated Amortization	(146,201)	(145,187)
Net	$ 22,869	$ 24,182
Trademarks/brand names
Intangible Asset, Acquired, Finite-Lived [Line Items]
Weighted Average Life	27 years	27 years
Cost	$ 103,082	$ 103,454
Accumulated Amortization	(48,736)	(47,799)
Net	$ 54,346	$ 55,655
Supplier relationships
Intangible Asset, Acquired, Finite-Lived [Line Items]
Weighted Average Life	30 years	30 years
Cost	$ 30,211	$ 30,211
Accumulated Amortization	(20,349)	(20,104)
Net	$ 9,862	$ 10,107
All other
Intangible Asset, Acquired, Finite-Lived [Line Items]
Weighted Average Life	6 years	6 years
Cost	$ 23,346	$ 23,434
Accumulated Amortization	(13,853)	(12,774)
Net	$ 9,493	$ 10,660

LEASES AND RELATED PARTY LEASES - Schedule of Future Minimum Lease Payment Under Operating Leases (Details) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Operating Leased Assets [Line Items]
Remainder of 2026	$ 13,445
2027	22,080
2028	19,349
2029	19,012
2030	18,261
2031	17,826
Thereafter	148,993
Total minimum lease payments	258,966
Less: Imputed interest	84,918
Total lease liabilities	174,048	$ 177,078
Less: Current lease liabilities	13,932	14,019
Long-term lease liabilities	160,116	$ 163,059
Related Parties
Operating Leased Assets [Line Items]
Remainder of 2026	222
2027	296
2028	296
2029	246
2030	0
2031	0
Thereafter	0
Total minimum lease payments	1,060
Third Parties
Operating Leased Assets [Line Items]
Remainder of 2026	13,223
2027	21,784
2028	19,053
2029	18,766
2030	18,261
2031	17,826
Thereafter	148,993
Total minimum lease payments	$ 257,906

DEBT (Tables)

3 Months Ended

Mar. 31, 2026

Debt Disclosure [Abstract]

Schedule of Long-term Debt Maximum Leverage Ratios

Under the terms of the June 2025 Amendment, the Company’s Consolidated Total Leverage Ratio (defined, as of any date of determination, as the ratio of (a) Consolidated Funded Indebtedness as of such date (as defined in the Senior Credit Facility) less cash that is not subject to any restriction on the use or investment thereof to (b) Consolidated EBITDA (as defined in the Senior Credit Facility)) for the period of four consecutive fiscal quarters ending on such date was modified to the following:


Fiscal Quarter Ending						Maximum Consolidated Total Leverage Ratio
June 30, 2025 through June 30, 2026						5.00 to 1.00
September 30, 2026						4.75 to 1.00
December 31, 2026						4.50 to 1.00
March 31, 2027 and the last day of each fiscal quarter thereafter						4.00 to 1.00

Schedule of Contractual Repayments of Debt

Contractual repayments of the term loan component of the Senior Credit Facility are due as follows:


As of March 31, 2026	Principal Repayment
Dollars in thousands
Remainder of 2026	$	29,063
2027	53,281
2028	634,531
	$	716,875

Schedule of Carrying Amounts and Estimated Fair Values of Debt Instruments

The carrying amounts and the estimated fair values of debt as of March 31, 2026 and December 31, 2025 are as follows:


		March 31, 2026				December 31, 2025
	Fair Value Measurement	Carrying Value		Estimated Fair Value		Carrying Value		Estimated Fair Value
Dollars in thousands
Senior credit facility - term loan	Level 2	$	716,875	$	713,448	$	726,563	$	725,480
Senior credit facility - revolving component	Level 2	1,075,000		1,069,462		1,045,000		1,043,340
Securitization	Level 2	76,400		73,085		87,800		86,678
Subtotal		$	1,868,275	$	1,855,995	$	1,859,363	$	1,855,498
Debt issuance costs		(2,870)				(3,257)
Total debt		$	1,865,405	$	1,855,995	$	1,856,106	$	1,855,498

- 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://fasb.org/us-gaap/role/ref/legacyRef
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(22))
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-URI https://asc.fasb.org/1943274/2147480566/210-10-S99-1

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 942
-SubTopic 235
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147477314/942-235-S99-2

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
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-Name Accounting Standards Codification
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-Paragraph 4
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-URI https://asc.fasb.org/1943274/2147480738/235-10-S50-4

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
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-Paragraph 3
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-URI https://asc.fasb.org/1943274/2147480678/235-10-S99-3

Reference 5: http://www.xbrl.org/2003/role/exampleRef
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-Name Accounting Standards Codification
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-Paragraph 69B
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481568/470-20-55-69B

Reference 6: http://www.xbrl.org/2003/role/exampleRef
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Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
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Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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-Section 50
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147481112/505-10-50-7

+ Details

DEBT

3 Months Ended

Mar. 31, 2026

Debt Disclosure [Abstract]

DEBT

Amendment to the Seventh Amended and Restated Credit Agreement

On March 24, 2023, the Company entered into the March 2023 Amendment of the Senior Credit Facility with a syndicate of lending banks with Bank of America, N.A., as Administrative Agent. The March 2023 Amendment of the Senior Credit Facility extended the maturity date to March 24, 2028, amended the contractual repayments of the term loan component, and amended the interest rate from LIBOR to SOFR-indexed interest. 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 March 31, 2026, the Company was in compliance with all such covenants.

On June 6, 2025, in response to the risks and uncertainties surrounding the Company’s future results of operations due to tariffs, the Company entered into the June 2025 Amendment of the Senior Credit Facility (the “June 2025 Amendment”) with a syndicate of lending banks with Bank of America, N.A., as Administrative Agent. The June 2025 Amendment did not increase the Company’s total indebtedness or extend the maturity date of the Senior Credit Facility.


Fiscal Quarter Ending						Maximum Consolidated Total Leverage Ratio
June 30, 2025 through June 30, 2026						5.00 to 1.00
September 30, 2026						4.75 to 1.00
December 31, 2026						4.50 to 1.00
March 31, 2027 and the last day of each fiscal quarter thereafter						4.00 to 1.00

In addition to the foregoing, from the date of the June 2025 Amendment through the fiscal quarter ending December 31, 2026 (the “Covenant Relief Period”), the Amendment, among other things, also: (i) temporarily establishes, during the Covenant Relief Period, a revised applicable rate schedule; (ii) temporarily limits, during the Covenant Relief Period, the Company’s ability to make certain investments; (iii) temporarily restricts, during the Covenant Relief Period, the Company’s ability to incur incremental indebtedness under the Senior Credit Facility, create certain liens, make certain restricted payments and incur or guarantee indebtedness of excluded subsidiaries; and (iv) temporarily prohibits, during the Covenant Relief Period, the Company from selling, transferring or exclusively licensing material intellectual property to a subsidiary of the Company that is not a loan party under the Senior Credit Facility or designating any subsidiary that owns or exclusively licenses any material intellectual property as an excluded subsidiary under the Senior Credit Facility.

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

i.Term SOFR in effect from time to time plus 0.10% plus the applicable rate (ranging from 1.00% to 2.13% during the Covenant Relief Period and from 1.00% to 1.75% thereafter) 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%;

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

3.the one-month Term SOFR plus 1.00%.

The applicable rates are based on the Company’s Consolidated Total Leverage Ratio for the period of four consecutive fiscal quarters ending on such date.

The Company will pay an annual commitment fee (ranging from 0.15% to 0.33% during the Covenant Relief Period and from 0.15% to 0.30% thereafter), based on the Company’s Consolidated Total Leverage Ratio, on the amount available for borrowing under the revolving credit facility component of the Senior Credit Facility.

In connection with the June 2025 Amendment, the Company incurred $3.9 million in fees to creditors and third parties.

The Company continues to have the aggregate principal amount of up to approximately $2.1 billion available to it through the following facilities: (i) a $775.0 million term loan facility, and (ii) a $1.3 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. The terms of the Senior Credit Facility limit the amount of dividends the Company may pay.

At March 31, 2026 and December 31, 2025, there was $1,075.0 million and $1,045.0 million, respectively, outstanding under the revolving credit facility component of the Senior Credit Facility. At March 31, 2026 and December 31, 2025, there was $716.9 million and $726.6 million outstanding under the term loan component of the Senior Credit Facility at a weighted average interest rate of 5.9% and 5.7%, respectively. As of March 31, 2026 and December 31, 2025 there was $38.8 million of the term loan component of the Senior Credit Facility classified as current on the condensed consolidated balance sheet.

The fair value of the term loan component and revolving credit facility component of the Senior Credit Facility at March 31, 2026 was $713.4 million, and $1,069.5 million, respectively. The fair value was 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.

As of March 31, 2026 and December 31, 2025, letters of credit outstanding totaled $3.0 million. There were no amounts drawn under the letters of credit outstanding as of March 31, 2026.

Contractual repayments of the term loan component of the Senior Credit Facility are due as follows:


As of March 31, 2026	Principal Repayment
Dollars in thousands
Remainder of 2026	$	29,063
2027	53,281
2028	634,531
	$	716,875

Future interest payments on the term loan component of the Senior Credit Facility based on current interest rates are expected to approximate $31.3 million for the remainder of 2026, $39.5 million in 2027 and $8.6 million in 2028. Interest is calculated on the term loan component of the Senior Credit Facility based on SOFR plus the certain amounts set forth in the Senior Credit Facility. As the revolving credit facility component of the Senior Credit Facility and Securitization Facility (defined below) can be repaid at any time, no interest has been included in the calculation.

Any outstanding borrowings on the revolving credit facility component of the Senior Credit Facility are due on March 24, 2028.

Convertible Senior Notes

The Company’s 0.5% Convertible Senior Notes due 2025 (the “2025 Notes”) issued in February 2020 pursuant to an indenture, dated as of February 7, 2020 (the “Original Indenture”), between the Company and Citibank, N.A., as trustee, matured on August 15, 2025. The 2025 Notes were settled upon maturity for $575.0 million in cash, excluding accrued interest, funded by borrowings on the revolving credit facility component of the Senior Credit Facility. No shares were issued to settle the 2025 Notes.

In connection with the issuance of the 2025 Notes, the Company entered into call transactions and warrant transactions, primarily with affiliates of the initial purchasers of the 2025 Notes (the “hedge participants”). The cost of the call transactions was $104.2 million for the 2025 Notes. The Company received $44.5 million of proceeds from the warrant transactions for the 2025 Notes. The call transactions involved purchasing call options from the hedge participants, and the warrant transactions involved selling call options to the hedge participants with a higher strike price than the purchased call options. The initial strike price of the call transactions was $73.67, subject to anti-dilution adjustments substantially similar to those in the 2025 Notes. The initial strike price of the warrant transactions was $113.34 for the 2025 Notes, subject to customary anti-dilution adjustments. The call transactions entered into with the hedge participants expired in August 2025 and the warrant transactions entered into with the hedge participants expired ratably over the period from November 2025 through February 2026.

Securitization Facility

The Company maintains an accounts receivable securitization facility (the “Securitization Facility”) under which accounts receivable of certain domestic subsidiaries are sold on a non-recourse basis to a special purpose entity (“SPE”), which is a bankruptcy-remote, consolidated subsidiary of the Company. Accordingly, the assets of the SPE are not available to satisfy the obligations of the Company or any of its subsidiaries. From time to time, the SPE may finance such accounts receivable with a revolving loan facility secured by a pledge of such accounts receivable. The amount of outstanding borrowings on the Securitization Facility at any one time is limited to $150.0 million. The Securitization Facility Agreement (“Securitization Agreement”) governing the Securitization Facility contains certain covenants and termination events. An occurrence of an event of default or a termination event under this Securitization Agreement may give rise to the right of its counterparty to terminate this facility. As of March 31, 2026, the Company was in compliance with the covenants and none of the termination events had occurred.

At March 31, 2026 and December 31, 2025, the Company had $76.4 million and $87.8 million, respectively, of outstanding borrowings under its Securitization Facility with an interest rate of 4.7% and 4.8%, respectively. The fair value of the outstanding borrowing of the Securitization Facility at March 31, 2026 was $73.1 million. 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.

On April 10, 2026, the Company entered into an amendment to the Securitization Facility Agreement with a syndicate of lending banks with PNC Bank, N.A., as Administrative Agent (the “2026 Securitization Facility Amendment”). The 2026 Securitization Facility Amendment extended the maturity date from December 15, 2026 to April 10, 2029 and modified the terms of certain financial covenants and termination events but did not increase the borrowing capacity available to the Company under the Securitization Facility. Under the terms of the 2026 Securitization Facility Amendment, fees on the Company’s borrowings drawn under the Securitization Facility were modified and will range between 95 basis points and 125 basis points based upon the Company’s Consolidated Total Leverage Ratio. The Company incurred approximately $0.3 million of new issuance costs associated with the 2026 Securitization Facility Amendment which will be amortized over the remaining term of the Securitization Agreement as amended.

Debt Issuance Costs

Debt issuance costs associated with the Senior Credit Facility (other than the revolving credit facility component) are presented as a reduction to the carrying value of the related debt. Debt issuance costs associated with the revolving credit facility component of the Senior Credit Facility are capitalized within other long-term assets on the consolidated balance sheet.

Estimated Fair Value of Debt Measurements

The carrying amounts and the estimated fair values of debt as of March 31, 2026 and December 31, 2025 are as follows:


		March 31, 2026				December 31, 2025
	Fair Value Measurement	Carrying Value		Estimated Fair Value		Carrying Value		Estimated Fair Value
Dollars in thousands
Senior credit facility - term loan	Level 2	$	716,875	$	713,448	$	726,563	$	725,480
Senior credit facility - revolving component	Level 2	1,075,000		1,069,462		1,045,000		1,043,340
Securitization	Level 2	76,400		73,085		87,800		86,678
Subtotal		$	1,868,275	$	1,855,995	$	1,859,363	$	1,855,498
Debt issuance costs		(2,870)				(3,257)
Total debt		$	1,865,405	$	1,855,995	$	1,856,106	$	1,855,498

- Definition

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

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 8A
-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480434/815-10-50-8A

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

SEGMENT AND GEOGRAPHIC INFORMATION

3 Months Ended

Mar. 31, 2026

Segment Reporting [Abstract]

SEGMENT AND GEOGRAPHIC INFORMATION

The Company is organized primarily on the basis of products and operates two global reportable segments. Resources are allocated and performance is assessed by the Company’s President and Chief Executive Officer, which the Company has determined to be the Chief Operating Decision Maker (“CODM”).

During the three months ended March 31, 2026, the Company renamed its two reportable segments to better align with the reportable segments’ business activities, structures, and strategies. The reportable segment name change did not result in any change to the composition of the reportable segments and has no impact on previously reported financial information. The two reportable segments and their activities are described below.

•The Specialty Surgery reportable segment operations consist of (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; (ii) the Instruments business, which sells more than 40,000 instrument patterns and surgical and lighting products to hospitals, surgery centers, dental, podiatry, and veterinary offices; and (iii) the ENT business, which includes instrumentation, balloon technologies for sinus dilation and eustachian tube dilation, as well as surgical navigation systems.

•The Tissue Reconstruction reportable segment operations consists of the Wound Reconstruction business, which sells offerings such as skin and wound repair, plastics and surgical reconstruction products and nerve and tendon repair products. The Tissue Reconstruction segment also includes the Company’s private label business which performs contract manufacturing for third parties.

The Corporate and Other category includes a portion of various executive, finance, human resource, information systems and legal functions which are not allocated to the reportable segments. During the three months ended March 31, 2026, the Company updated the allocation of certain cost and expense information that the CODM regularly reviews to evaluate performance for decision-making purposes from the Corporate and Other category to the Company’s reportable segments to align with how the CODM reviews and manages the business. As a result of this update, the Company retrospectively recast prior period results, by reportable segment, to conform to the current period presentation. This update had no impact on the Company’s consolidated results of operations.

For both reportable segments, the CODM uses segment revenue and segment operating income to assess the performance for each segment and in the annual budgeting and forecasting process. The CODM considers budget-to-actual variances on a quarterly basis for segment revenue and segment operating income when making decisions about allocating capital and personnel to the reportable segments.

The operating results of the 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 reportable segments.

Net sales and profit by each reportable segment for the three months ended March 31, 2026 and 2025 are as follows:


	Three Months Ended March 31, 2026
Dollars in thousands	Specialty Surgery		Tissue Reconstruction		Corporate and Other		Total
Total revenue, net	$	283,135	$	108,783	$	—	$	391,918

Cost of goods sold	110,475		37,459		27,002		174,936
Research and development	11,853		7,532		4,116		23,501
Selling, general & administrative	77,681		43,526		57,028		178,235
Intangible asset amortization	—		—		3,776		3,776

Total cost and expenses	200,009		88,517		91,922		380,448

Operating income (loss)	$	83,126	$	20,266	$	(91,922)	11,470
Interest income							4,106
Interest expense							(22,465)
Other income, net							4,480
Loss before income taxes							$	(2,409)


	Three Months Ended March 31, 2025
Dollars in thousands	Specialty Surgery		Tissue Reconstruction		Corporate and Other		Total
Total revenue, net	$	280,664	$	101,989	$	—	$	382,653

Cost of goods sold (1)	109,861		49,270		29,090		188,221
Research and development (1)	14,795		5,972		3,961		24,728
Selling, general & administrative (1)	83,787		42,304		55,406		181,497
Intangible asset amortization	—		—		3,704		3,704

Total cost and expenses	208,443		97,546		92,161		398,150

Operating income (loss)	$	72,221	$	4,443	$	(92,161)	(15,497)
Interest income							4,420
Interest expense							(18,815)
Other income, net							(144)
Loss before income taxes							$	(30,036)

The Company does not allocate any assets to the reportable segments. No asset information is reported to the CODM and disclosed in the financial information for each segment. The Company attributes revenues to geographic areas based on the location of the customer. Total revenue by major geographic area consisted of the following:


	Three Months Ended March 31,
Dollars in thousands	2026		2025
United States	$	289,380	$	282,217
Europe	39,962		35,326
Asia Pacific	45,212		45,105
Rest of World	17,364		20,005
Total Revenues	$	391,918	$	382,653

- Definition

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

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+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS - Narrative (Details)	3 Months Ended
	Mar. 31, 2026 USD ($)	Jun. 30, 2025 USD ($)	Mar. 31, 2025 USD ($)
Goodwill [Line Items]
Goodwill impairment charge		$ 511,400,000
Amortization	$ 27,000,000.0		$ 26,500,000
Expected annual amortization expense, remainder of 2026	80,800,000
Expected annual amortization expense, in 2027	106,800,000
Expected annual amortization expense, in 2028	103,200,000
Expected annual amortization expense, in 2029	97,900,000
Expected annual amortization expense, in 2030	91,800,000
Expected annual amortization expense, in 2031	88,800,000
Expected annual amortization expense, thereafter	359,900,000
Completed technology
Goodwill [Line Items]
Amortization of product technology	$ 23,200,000		$ 22,800,000
Codman tradename
Goodwill [Line Items]
Impairment of indefinite-lived intangible assets		0
Tissue Reconstruction
Goodwill [Line Items]
Goodwill impairment charge		123,300,000
Neurosurgery
Goodwill [Line Items]
Goodwill impairment charge		249,000,000.0
Instruments
Goodwill [Line Items]
Goodwill impairment charge		$ 139,100,000
Measurement Input, Long-Term Revenue Growth Rate \| Tissue Reconstruction \| Valuation Technique, Discounted Cash Flow
Goodwill [Line Items]
Measurement input		0.025
Measurement Input, Long-Term Revenue Growth Rate \| Neurosurgery \| Valuation Technique, Discounted Cash Flow
Goodwill [Line Items]
Measurement input		0.025
Measurement Input, Long-Term Revenue Growth Rate \| Instruments \| Valuation Technique, Discounted Cash Flow
Goodwill [Line Items]
Measurement input		0.025
Measurement Input, Discount Rate \| Valuation Technique, Discounted Cash Flow \| Codman tradename
Goodwill [Line Items]
Indefinite-lived intangible assets, measurement input		0.145
Measurement Input, Discount Rate \| Tissue Reconstruction \| Valuation Technique, Discounted Cash Flow
Goodwill [Line Items]
Measurement input		0.135
Measurement Input, Discount Rate \| Neurosurgery \| Valuation Technique, Discounted Cash Flow
Goodwill [Line Items]
Measurement input		0.135
Measurement Input, Discount Rate \| Instruments \| Valuation Technique, Discounted Cash Flow
Goodwill [Line Items]
Measurement input		0.120

DEBT - Schedule of Carrying Amounts and Estimated Fair Values of Debt Instruments (Details) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025	Jun. 06, 2025
Carrying Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	$ 1,868,275	$ 1,859,363
Debt issuance costs	(2,870)	(3,257)
Total debt	1,865,405	1,856,106
Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	1,855,995	1,855,498
Total debt	1,855,995	1,855,498
Senior Credit Facility
Debt Instrument [Line Items]
Debt issuance costs			$ (3,900)
Securitization Facility \| Level 2 \| Carrying Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	76,400	87,800
Securitization Facility \| Level 2 \| Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	73,085	86,678
Secured Debt \| Term Loan Facility \| Level 2 \| Carrying Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	716,875	726,563
Secured Debt \| Term Loan Facility \| Level 2 \| Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	713,448	725,480
Revolving Credit Facility \| Senior Credit Facility \| Level 2 \| Carrying Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	1,075,000	1,045,000
Revolving Credit Facility \| Senior Credit Facility \| Level 2 \| Estimated Fair Value
Debt Instrument [Line Items]
Debt instrument, gross, fair value disclosure	$ 1,069,462	$ 1,043,340

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Statement of Financial Position [Abstract]
Trade accounts receivable, allowances	$ 7,410	$ 7,230
Preferred stock, par value (in dollars per share)	$ 0	$ 0
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, authorized shares (in shares)	240,000,000	240,000,000
Common stock, issued (in shares)	92,174,000	92,286,000
Treasury stock outstanding (in shares)	14,356,000	14,399,000

STOCK-BASED COMPENSATION (Details) $ / shares in Units, $ in Millions	3 Months Ended
	Mar. 31, 2026 USD ($) $ / shares shares
Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Total unrecognized compensation costs related to unvested awards \| $	$ 4.0
Weighted-average period for cost recognition, in years	3 years
Employee Stock Option \| Directors
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	1 year
Employee Stock Option \| Employees
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period, in years	8 years
Restricted Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Total unrecognized compensation costs related to unvested awards \| $	$ 54.2
Weighted-average period for cost recognition, in years	2 years
Performance Stock
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Awards granted during the period (in shares) \| shares	1,149,357
Other than options, weighted average grant date fair value (in dollars per share) \| $ / shares	$ 9.61
Restricted Stock Units (RSUs)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	3 years
Awards granted during the period (in shares) \| shares	2,397,075
Other than options, weighted average grant date fair value (in dollars per share) \| $ / shares	$ 9.79
Maximum \| Employee Stock Option
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Award vesting period	4 years
Maximum \| Employee Stock Option \| Directors and Certain Executive Officers
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period, in years	10 years
Minimum \| Employee Stock Option \| Directors and Certain Executive Officers
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration period, in years	6 years

INCOME TAXES - Summary of Effective Tax Rate (Details)	3 Months Ended
INCOME TAXES - Summary of Effective Tax Rate (Details)	Mar. 31, 2026	Mar. 31, 2025
Income Tax Disclosure [Abstract]
Reported tax rate	(91.70%)	15.80%

REVENUES FROM CONTRACTS WITH CUSTOMERS

3 Months Ended

Mar. 31, 2026

Revenue from Contract with Customer [Abstract]

REVENUES FROM CONTRACTS WITH CUSTOMERS

Summary of Accounting Policies on Revenue Recognition

Revenue is recognized upon the transfer of control of promised products or services to the customers in an amount that reflects the consideration the Company expects to receive in exchange for those products and services.

Performance Obligations

The Company’s performance obligations consist mainly of transferring control of goods and services identified in the contracts, purchase orders, or invoices. The Company has no significant multi-element contracts with customers.

Significant Estimates

Usage-based royalties and licenses are estimated based on the provisions of contracts with customers 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 reported licensee sales and those that were estimated are adjusted in the period in which they become known, which is typically the following quarter. Historically, such adjustments have not been significant.

The Company estimates returns, price concessions, and discount allowances using the expected value method based on historical trends and other known factors. Rebate allowances are estimated using the most likely method based on each customer contract.

The Company’s return policy, as set forth in its product catalogs and sales invoices, requires review and authorization in advance prior to the return of product. Upon the authorization, a credit will be issued for the goods returned within a set amount of days from the shipment, which is generally 90 days.

The Company disregards the effects of a financing component if the Company expects, at contract inception, that the period between the transfer and customer payment for the goods or services will be one year or less. The Company has no significant revenues recognized on payments expected to be received more than one year after the transfer of control of products or services to customers.

Contract Assets and Liabilities

Revenues recognized from the Company’s private label business that are not invoiced to the customers as a result of recognizing revenue over time are recorded as a contract asset included in the prepaid expenses and other current assets account in the consolidated balance sheet. Upon invoicing to the customer, the balance is recorded in trade receivable, net in the consolidated balance sheet.

Other operating revenues may include fees received under service agreements. Non-refundable fees received under multiple-period service agreements are recognized as revenue as the Company satisfies the performance obligations to the other party. A portion of the transaction price allocated to the performance obligations to be satisfied in the future periods is recognized as contract liability.

The following table summarizes the changes in the contract asset and liability balances for the three months ended March 31, 2026:




Dollars in thousands	Total
Contract Asset
Contract asset, January 1, 2026	$	6,844
Transferred to trade receivables from contract asset included in beginning of the year contract asset	$	(4,551)

Contract asset, net of transferred to trade receivables on contracts during the period	$	4,363
Contract asset, March 31, 2026	$	6,656

Contract Liability
Contract liability, January 1, 2026	$	23,010
Recognition of revenue included in beginning of year contract liability	$	(4,074)

Contract liability, net of revenue recognized on contracts during the period	$	3,481
Foreign currency translation	$	8
Contract liability, March 31, 2026	$	22,425

As of March 31, 2026, the short-term portion of the contract liability of $11.6 million, representing 52% of unsatisfied or partially unsatisfied performance obligations, is expected to be recognized as revenue within 12 months and is included in current liabilities in the consolidated balance sheet. The long-term portion of $10.8 million, representing the remaining balance to be recognized thereafter, is included in other liabilities in the consolidated balance sheet.

Shipping and Handling Fees

The Company elected to account for shipping and handling activities as a fulfillment cost rather than a separate performance obligation. Amounts billed to customers for shipping and handling are included as part of the transaction price and recognized as revenue when control of underlying products is transferred to the customer. The related shipping and freight charges incurred by the Company are included in the cost of goods sold.

Product Warranties

Certain of the Company’s medical devices, including monitoring systems and neurosurgical systems, are designed to operate over long periods of time. These products are sold with warranties which may extend for up to two years from the date of purchase. The warranties are not considered a separate performance obligation. The Company estimates its product warranties using the expected value method based on historical trends and other known factors. The Company includes them in accrued expenses and other current liabilities in the consolidated balance sheet.

Taxes Collected from Customers

The Company elected to exclude from the measurement of the transaction price all taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction and collected by the entity from a customer.

Disaggregated Revenue

The following table presents revenues disaggregated by the major sources of revenues for the three months ended March 31, 2026 and 2025 (dollar amounts in thousands):


	Three Months Ended March 31, 2026		Three Months Ended March 31, 2025
Neurosurgery	$	198,195	$	190,912
Instruments	47,233		50,950
ENT	37,707		38,802
Total Specialty Surgery	283,135		280,664

Wound Reconstruction	79,648		74,779
Private Label	29,135		27,210
Total Tissue Reconstruction	108,783		101,989
Total Revenue	$	391,918	$	382,653

See Note 15. Segment and Geographic Information, for details of revenues based on the location of the customer.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

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-Name Accounting Standards Codification
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+ Details

REVENUES FROM CONTRACTS WITH CUSTOMERS - Schedule of Changes in Contract Assets and Liabilities (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2026 USD ($)
Contract Asset
Contract asset, Beginning of period	$ 6,844
Transferred to trade receivables from contract asset included in beginning of the year contract asset	(4,551)
Contract asset, net of transferred to trade receivables on contracts during the period	4,363
Contract asset, End of period	6,656
Contract Liability
Contract liability, Beginning of period	23,010
Recognition of revenue included in beginning of year contract liability	(4,074)
Contract liability, net of revenue recognized on contracts during the period	3,481
Foreign currency translation	8
Contract liability, End of period	$ 22,425

GOODWILL AND OTHER INTANGIBLE ASSETS - Schedule of Changes in Carrying Amount of Goodwill (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2026 USD ($)
Goodwill [Roll Forward]
Goodwill at beginning of period	$ 615,157
Foreign currency translation	(1,910)
Goodwill at end of period	613,247
Specialty Surgery
Goodwill [Roll Forward]
Goodwill at beginning of period	344,167
Foreign currency translation	(1,069)
Goodwill at end of period	343,098
Tissue Reconstruction
Goodwill [Roll Forward]
Goodwill at beginning of period	270,990
Foreign currency translation	(841)
Goodwill at end of period	$ 270,149

- Definition

Amount, after accumulated impairment loss, of asset representing future economic benefit arising from other asset acquired in business combination or from joint venture formation or both, that is not individually identified and separately recognized.

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+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)

3 Months Ended

Mar. 31, 2026

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Changes in Carrying Amount of Goodwill

Changes in the carrying amount of goodwill for the three-month period ended March 31, 2026 were as follows:


Dollars in thousands	Specialty Surgery		Tissue Reconstruction		Total
Goodwill at December 31, 2025	$	344,167	$	270,990	$	615,157

Foreign currency translation	(1,069)		(841)		(1,910)
Goodwill at March 31, 2026	$	343,098	$	270,149	$	613,247

Schedule of Finite-Lived Intangible Assets

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


	March 31, 2026
Dollars in thousands	Weighted Average Life	Cost		Accumulated Amortization		Net
Completed technology	17 years	$	1,483,774	$	(654,169)	$	829,605
Customer relationships	12 years	169,070		(146,201)		22,869
Trademarks/brand names	27 years	103,082		(48,736)		54,346
Codman tradename	Indefinite	179,170		—		179,170
Supplier relationships	30 years	30,211		(20,349)		9,862
All other	6 years	23,346		(13,853)		9,493
		$	1,988,653	$	(883,308)	$	1,105,345


	December 31, 2025
Dollars in thousands	Weighted Average Life	Cost		Accumulated Amortization		Net
Completed technology	17 years	$	1,486,304	$	(632,204)	$	854,100
Customer relationships	12 years	169,369		(145,187)		24,182
Trademarks/brand names	27 years	103,454		(47,799)		55,655
Codman tradename	Indefinite	179,959		—		179,959
Supplier relationships	30 years	30,211		(20,104)		10,107
All other	6 years	23,434		(12,774)		10,660
		$	1,992,731	$	(858,068)	$	1,134,663

Schedule of Indefinite-Lived Intangible Assets

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


	March 31, 2026
Dollars in thousands	Weighted Average Life	Cost		Accumulated Amortization		Net
Completed technology	17 years	$	1,483,774	$	(654,169)	$	829,605
Customer relationships	12 years	169,070		(146,201)		22,869
Trademarks/brand names	27 years	103,082		(48,736)		54,346
Codman tradename	Indefinite	179,170		—		179,170
Supplier relationships	30 years	30,211		(20,349)		9,862
All other	6 years	23,346		(13,853)		9,493
		$	1,988,653	$	(883,308)	$	1,105,345


	December 31, 2025
Dollars in thousands	Weighted Average Life	Cost		Accumulated Amortization		Net
Completed technology	17 years	$	1,486,304	$	(632,204)	$	854,100
Customer relationships	12 years	169,369		(145,187)		24,182
Trademarks/brand names	27 years	103,454		(47,799)		55,655
Codman tradename	Indefinite	179,959		—		179,959
Supplier relationships	30 years	30,211		(20,104)		10,107
All other	6 years	23,434		(12,774)		10,660
		$	1,992,731	$	(858,068)	$	1,134,663

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

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+ Details

DERIVATIVE INSTRUMENTS - Schedule of Net Investment Hedges Derivatives (Details) SFr in Thousands, $ in Thousands	Mar. 31, 2026 USD ($)	Mar. 31, 2026 CHF (SFr)	Dec. 31, 2025 USD ($)	Dec. 31, 2025 CHF (SFr)	Nov. 30, 2025 USD ($)	Nov. 30, 2025 CHF (SFr)	Feb. 28, 2025 USD ($)	Feb. 28, 2025 CHF (SFr)	Dec. 31, 2020 USD ($)	Dec. 31, 2020 CHF (SFr)
Cross-currency swap
Derivative [Line Items]
Aggregate Notional Amount					$ 170,000	SFr 137,600	$ 368,400	SFr 328,100	$ 471,600	SFr 420,100
Net Investment Hedges \| Designated as Hedging Instrument \| Cross-currency swap
Derivative [Line Items]
Fair Value Asset (Liability)	$ (78,067)		$ (82,199)
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap One
Derivative [Line Items]
Fair Value Asset (Liability)	$ (44,759)		(47,619)
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap One \| Long
Derivative [Line Items]
Fixed Rate	0.00%	0.00%
Aggregate Notional Amount \| SFr		SFr 192,140		SFr 192,140
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap One \| Short
Derivative [Line Items]
Fixed Rate	1.94%	1.94%
Aggregate Notional Amount	$ 200,000		200,000
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Two
Derivative [Line Items]
Fair Value Asset (Liability)	$ (9,762)		(10,568)
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Two \| Long
Derivative [Line Items]
Fixed Rate	0.00%	0.00%
Aggregate Notional Amount \| SFr		SFr 66,525		66,525
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Two \| Short
Derivative [Line Items]
Fixed Rate	2.54%	2.54%
Aggregate Notional Amount	$ 75,000		75,000
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Three
Derivative [Line Items]
Fair Value Asset (Liability)	$ (12,051)		(12,407)
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Three \| Long
Derivative [Line Items]
Fixed Rate	0.00%	0.00%
Aggregate Notional Amount \| SFr		SFr 68,483		68,483
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Three \| Short
Derivative [Line Items]
Fixed Rate	2.74%	2.74%
Aggregate Notional Amount	$ 75,000		75,000
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Four
Derivative [Line Items]
Fair Value Asset (Liability)	$ (9,308)		(9,394)
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Four \| Long
Derivative [Line Items]
Fixed Rate	0.00%	0.00%
Aggregate Notional Amount \| SFr		SFr 67,800		67,800
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Four \| Short
Derivative [Line Items]
Fixed Rate	3.24%	3.24%
Aggregate Notional Amount	$ 75,000		75,000
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Five
Derivative [Line Items]
Fair Value Asset (Liability)	$ (2,187)		(2,211)
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Five \| Long
Derivative [Line Items]
Fixed Rate	0.00%	0.00%
Aggregate Notional Amount \| SFr		SFr 59,693		SFr 59,693
Net Investment Hedges \| Designated as Hedging Instrument \| Cross Currency Interest Rate Swap Five \| Short
Derivative [Line Items]
Fixed Rate	2.66%	2.66%
Aggregate Notional Amount	$ 75,000		$ 75,000

ACCUMULATED OTHER COMPREHENSIVE LOSS - Schedule of Comprehensive Loss (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Equity [Abstract]
Net loss	$ (4,617)	$ (25,293)
Foreign currency translation adjustment	(476)	11,631
Change in unrealized (gain) loss on derivatives, net of tax	(220)	(8,016)
Pension liability adjustment, net of tax	(167)	(150)
Comprehensive loss, net	$ (5,480)	$ (21,828)

- Definition

Amount after tax of increase (decrease) in equity from transactions and other events and circumstances from net income and other comprehensive income, attributable to parent entity. Excludes changes in equity resulting from investments by owners and distributions to owners.

+ References + Details

- Definition

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

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+ Details

DEBT - Schedule of Contractual Maturity Table (Details) $ in Thousands	Mar. 31, 2026 USD ($)
Debt Disclosure [Abstract]
Remainder of 2026	$ 29,063
2027	53,281
2028	634,531
Total long-term debt	$ 716,875

- Definition

Amount, after deduction of unamortized premium (discount) and debt issuance cost, of long-term debt. Excludes lease obligation.

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+ Details

DERIVATIVE INSTRUMENTS - Narrative (Details) $ in Thousands, € in Millions, ¥ in Millions, ¥ in Millions, SFr in Millions	3 Months Ended
	Mar. 31, 2026 USD ($)	Mar. 31, 2026 CHF (SFr)	Mar. 31, 2025 USD ($)	Apr. 28, 2026 CHF (SFr)	Mar. 31, 2026 CHF (SFr)	Mar. 31, 2026 CNY (¥)	Mar. 31, 2026 EUR (€)	Mar. 31, 2026 JPY (¥)	Dec. 31, 2025 USD ($)	Nov. 30, 2025 USD ($) intercompany_loan	Nov. 30, 2025 CHF (SFr) intercompany_loan	Jul. 25, 2025 USD ($)	Jul. 25, 2025 CHF (SFr)	Feb. 28, 2025 USD ($)	Feb. 28, 2025 CHF (SFr)	Dec. 31, 2021 USD ($)	Dec. 31, 2021 JPY (¥)	Dec. 31, 2020 USD ($)	Dec. 31, 2020 CHF (SFr)
Derivative [Line Items]
Gain (loss) estimated to be reclassified to earnings during next twelve months	$ 11,100
Designated as Hedging Instrument
Derivative [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Earnings	16,538		$ (4,148)
Not Designated as Hedging Instrument
Derivative [Line Items]
Derivative assets (liabilities), at fair value, net	1,300								$ 1,000
Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Current notional amount	900,000								$ 900,000
Interest rate swaps
Derivative [Line Items]
Gain (loss) estimated to be reclassified to earnings during next twelve months	17,400
Interest rate swaps \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Earnings	4,380		1,426
Cross-currency swap
Derivative [Line Items]
Gain (loss) estimated to be reclassified to earnings during next twelve months	10,000
Current notional amount										$ 170,000	SFr 137.6			$ 368,400	SFr 328.1			$ 471,600	SFr 420.1
Intercompany loan quarterly payments \| SFr		SFr 5.8
Number of intercompany loans \| intercompany_loan										2	2
Gain (loss) reclassified into other income	3,500		1,200
Cross-currency swap \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Gain (loss) reclassified into other income	5,900		(9,400)
Amount of Gain (Loss) Reclassified from AOCI into Earnings	8,668		(8,230)
Cross-currency swap \| Net Investment Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Earnings	3,080		2,633
Cross Currency Interest Rate Swap One
Derivative [Line Items]
Intercompany loan, face amount \| SFr											SFr 80.9
Intercompany loan, annual payments \| SFr		8.1
Cross Currency Interest Rate Swap Two
Derivative [Line Items]
Intercompany loan, face amount \| SFr											SFr 56.6
Intercompany loan, annual payments \| SFr		SFr 8.1
Foreign currency swaps \| Not Designated as Hedging Instrument
Derivative [Line Items]
Current notional amount	3,600							¥ 400.0								$ 7,300	¥ 800.0
Foreign currency swaps \| Net Investment Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Current notional amount												$ 75,000	SFr 59.7	$ 75,000	SFr 67.8
Foreign currency forward contracts \| Cost of sales
Derivative [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Earnings	500		200
Foreign currency forward contracts \| Other income, net
Derivative [Line Items]
Amount of Gain (Loss) Reclassified from AOCI into Earnings	(100)		(200)
Foreign currency forward contracts \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative [Line Items]
Current notional amount \| SFr					SFr 14.1
Amount of Gain (Loss) Reclassified from AOCI into Earnings	410		$ 23
Foreign currency forward contracts \| Cash Flow Hedges \| Designated as Hedging Instrument \| Subsequent Event
Derivative [Line Items]
Current notional amount \| SFr				SFr 3.1
CNH Exchange Forward \| Not Designated as Hedging Instrument
Derivative [Line Items]
Current notional amount	4,400					¥ 30.0
CHF Exchange Forward \| Not Designated as Hedging Instrument
Derivative [Line Items]
Current notional amount	5,100				SFr 4.0
EUR Exchange Forward \| Not Designated as Hedging Instrument
Derivative [Line Items]
Current notional amount	$ 8,200						€ 7.0

ACQUISITIONS AND DIVESTITURES (Details) - Durepair Regeneration Matrix - USD ($) $ in Millions		1 Months Ended
	Oct. 02, 2024	Oct. 31, 2026	Oct. 30, 2025
Business Combination [Line Items]
Upfront payment	$ 45.0
Payments for asset acquisitions	$ 10.0		$ 15.0
Forecast
Business Combination [Line Items]
Payments for asset acquisitions		$ 20.0

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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+ Details

COMMITMENTS AND CONTINGENCIES (Tables)

3 Months Ended

Mar. 31, 2026

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 three months ended March 31, 2026 and March 31, 2025 is as follows (in thousands):


Three Months Ended March 31, 2026	Contingent Consideration Liability Related to the Acquisition of:
	Arkis (1)		Derma Sciences (2)		Surgical Innovations Associates (SIA), Inc. (2)		Total
Balance as of January 1, 2026	$	6,299	$	350	19,400		26,049
Payment	—		—		—		—
Change in fair value of contingent consideration liabilities	9		(2)		(1,300)		(1,293)
Balance as of March 31, 2026	6,308		348		18,100		24,756

Short-Term - Accrued expenses and other liabilities	$	—	$	—	$	18,100	$	18,100
Long-Term - Other liabilities	6,308		348		—		6,656
Total	6,308		348		18,100		24,756


Three Months Ended March 31, 2025	Contingent Consideration Liability Related to the Acquisition of:
	Arkis (1)		Derma Sciences (2)		ACell (2)		Surgical Innovations Associates (SIA), Inc. (2)		Total
Balance as of January 1, 2025	$	12,968	$	2,686	$	3	$	54,000	69,657
Payment	(5,000)		—		—		—		(5,000)
Change in fair value of contingent consideration liabilities	(812)		50		—		600		(162)
Balance as of March 31, 2025	$	7,156	$	2,736	$	3	$	54,600	64,495

Short-Term - Accrued expenses and other liabilities	$	3,598	$	—	$	—	$	35,000	$	38,598
Long-Term - Other liabilities	3,558		2,736		3		19,600		25,897
Total	7,156		2,736		3		54,600		64,495

(1) Location in financial statements: Research and development

(2) Location in financial statements: Selling, general and administrative

STOCK-BASED COMPENSATION	3 Months Ended
STOCK-BASED COMPENSATION	Mar. 31, 2026
Share-Based Payment Arrangement [Abstract]
STOCK-BASED COMPENSATION	STOCK-BASED COMPENSATION As of March 31, 2026, the Company had stock options, restricted stock awards, performance stock units and restricted stock units outstanding under the Integra LifeSciences Holdings Corporation Fifth Amended and Restated 2003 Equity Incentive Plan, as amended (the “2003 Plan”). Stock options issued under the 2003 Plan become exercisable over specified periods, generally within four years from the date of grant for officers and employees, within one year from date of grant for directors which generally expire eight years from the grant date for employees, and from six to ten years for directors and certain executive officers, except in certain instances that result in accelerated vesting due to death, disability, retirement age or change-in-control provisions within their grant agreements. The Company values stock option grants using the binomial distribution model. Restricted stock issued under the 2003 Plan vests over specified periods, generally three years after the date of grant. The vesting of performance stock issued under the 2003 Plan is subject to service and performance conditions. Stock Options As of March 31, 2026, there were 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 three years. There were no stock options granted during the three months ended March 31, 2026. Restricted Stock and Performance Stock Performance stock units, restricted stock units and restricted stock awards generally have requisite service periods of three years, except in certain instances that result in accelerated vesting due to death, disability, retirement age provision or change-in-control provisions in their grant agreements. Performance stock units are subject to graded vesting conditions based on specific revenue and profitability targets. The Company expenses the fair value of restricted stock awards and restricted stock units on a straight-line basis over the requisite service period. As of March 31, 2026, there was approximately $54.2 million of total unrecognized compensation costs related to these unvested awards. The Company expects to recognize these costs over a weighted-average period of approximately two years. The Company granted 2,397,075 restricted stock units and 1,149,357 performance stock units during the three months ended March 31, 2026. For the three months ended March 31, 2026, the weighted average grant date fair value for restricted stock units and performance stock units granted was $9.79 and $9.61 per award, respectively. The Company also maintains an Employee Stock Purchase Plan (the “ESPP”), which provides eligible employees with the opportunity to acquire shares of common stock at periodic intervals by means of accumulated payroll deductions. The ESPP is a non-compensatory plan based on its terms.

REVENUES FROM CONTRACTS WITH CUSTOMERS - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Dec. 31, 2025
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Number of days from shipment to issue a credit on returned goods	90 days
Short-term portion of contract liability	$ 11,623	$ 11,463
Long-term portion of contract liability	$ 10,800
Product warranty period (up to)	2 years
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2026-04-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Expected performance obligation, percentage	52.00%
Performance obligations expected to be satisfied, expected timing	12 months

DERIVATIVE INSTRUMENTS - Schedule of Fair Value of Derivative Instruments By Balance Sheet Location (Details) - Designated as Hedging Instrument - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Assets	$ 46,389	$ 44,703
Total derivatives designated as hedges — Liabilities	150,994	159,294
Interest rate swap \| Cash Flow Hedges \| Prepaid expenses and other current assets
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Assets	18,401	16,126
Interest rate swap \| Cash Flow Hedges \| Other assets
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Assets	12,151	12,749
Interest rate swap \| Cash Flow Hedges \| Accrued expenses and other current liabilities
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Liabilities	1,040	1,103
Interest rate swap \| Cash Flow Hedges \| Other liabilities
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Liabilities	386	526
Cross-currency swap \| Cash Flow Hedges \| Prepaid expenses and other current assets
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Assets	8,343	8,325
Cross-currency swap \| Cash Flow Hedges \| Other liabilities
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Liabilities	63,393	67,992
Cross-currency swap \| Net Investment Hedges \| Prepaid expenses and other current assets
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Assets	7,494	7,474
Cross-currency swap \| Net Investment Hedges \| Accrued expenses and other current liabilities
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Liabilities	8,072	8,798
Cross-currency swap \| Net Investment Hedges \| Other liabilities
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Liabilities	77,489	80,875
Foreign currency forward contracts \| Cash Flow Hedges \| Prepaid expenses and other current assets
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Assets	0	29
Foreign currency forward contracts \| Cash Flow Hedges \| Accrued expenses and other current liabilities
Derivatives, Fair Value [Line Items]
Total derivatives designated as hedges — Liabilities	$ 614	$ 0

RETIREMENT PLANS (Details) - USD ($) $ in Millions	3 Months Ended
RETIREMENT PLANS (Details) - USD ($) $ in Millions	Mar. 31, 2026	Mar. 31, 2025	Dec. 31, 2025
Retirement Benefits [Abstract]
Net periodic benefit costs	$ 0.4	$ 0.4
Service cost component	1.0	$ 0.8
Estimated fair value of plan assets	$ 71.1		$ 71.7
Defer payment and taxation, base salary, percentage (up to)	75.00%
Defer payment and taxation, bonus and other eligible cash compensation, percentage (up to)	100.00%
Deferred compensation plan, fair value of assets	$ 7.3		$ 7.9

- Definition

Amount of asset segregated and restricted to provide benefit under defined benefit plan. Asset includes, but is not limited to, stock, bond, other investment, earning from investment, and contribution by employer and employee.

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+ Details

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS (UNAUDITED) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Income Statement [Abstract]
Total revenue, net	$ 391,918	$ 382,653
Costs and expenses:
Cost of goods sold	174,936	188,221
Research and development	23,501	24,728
Selling, general and administrative	178,235	181,497
Intangible asset amortization	3,776	3,704
Total costs and expenses	380,448	398,150
Operating income (loss)	11,470	(15,497)
Interest income	4,106	4,420
Interest expense	(22,465)	(18,815)
Other income (expense), net	4,480	(144)
Loss before income taxes	(2,409)	(30,036)
Provision for income taxes	2,208	(4,743)
Net loss	$ (4,617)	$ (25,293)
Net loss per share
Basic (in dollars per share)	$ (0.06)	$ (0.33)
Diluted (in dollars per share)	$ (0.06)	$ (0.33)
Weighted average common shares outstanding (See Note 13):
Basic (in shares)	76,951	76,463
Diluted (in shares)	76,951	76,463
Comprehensive loss (See Note 14)	$ (5,480)	$ (21,828)

SEGMENT AND GEOGRAPHIC INFORMATION - Narrative (Details)	3 Months Ended
	Mar. 31, 2026 Segment product
Segment Reporting Information [Line Items]
Number of reportable segments \| Segment	2
Specialty Surgery
Segment Reporting Information [Line Items]
Number of products offered (more than) \| product	40,000

COMMITMENTS AND CONTINGENCIES - Schedule of Contingent Consideration (Details) - Contingent Consideration Liability - Level 3 - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, beginning of period	$ 26,049	$ 69,657
Payment	0	(5,000)
Change in fair value of contingent consideration liabilities	(1,293)	(162)
Balance, end of period	24,756	64,495
Short-Term - Accrued expenses and other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	18,100	38,598
Long-Term - Other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	6,656	25,897
Arkis
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, beginning of period	6,299	12,968
Payment	0	(5,000)
Change in fair value of contingent consideration liabilities	9	(812)
Balance, end of period	6,308	7,156
Arkis \| Short-Term - Accrued expenses and other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	0	3,598
Arkis \| Long-Term - Other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	6,308	3,558
Derma Sciences
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, beginning of period	350	2,686
Payment	0	0
Change in fair value of contingent consideration liabilities	(2)	50
Balance, end of period	348	2,736
Derma Sciences \| Short-Term - Accrued expenses and other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	0	0
Derma Sciences \| Long-Term - Other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	348	2,736
ACell
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, beginning of period		3
Payment		0
Change in fair value of contingent consideration liabilities		0
Balance, end of period		3
ACell \| Short-Term - Accrued expenses and other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period		0
ACell \| Long-Term - Other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period		3
Surgical Innovation Associates, Inc.
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, beginning of period	19,400	54,000
Payment	0	0
Change in fair value of contingent consideration liabilities	(1,300)	600
Balance, end of period	18,100	54,600
Surgical Innovation Associates, Inc. \| Short-Term - Accrued expenses and other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	18,100	35,000
Surgical Innovation Associates, Inc. \| Long-Term - Other liabilities
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance, end of period	$ 0	$ 19,600

Cover - shares	3 Months Ended
Cover - shares	Mar. 31, 2026	May 04, 2026
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2026
Document Transition Report	false
Entity File Number	000-26224
Entity Registrant Name	INTEGRA LIFESCIENCES HOLDINGS CORP
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	51-0317849
Entity Address	1100 Campus Road
Entity City	Princeton
Entity State	NJ
Entity Postal Zip Code	08540
City Area Code	609
Local Phone Number	275-0500
Title of 12(b) Security	Common Stock, Par Value $0.01 Per Share
Trading Symbol	IART
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Smaller Reporting Company	false
Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding (in shares)		77,796,903
Amendment Flag	false
Document Fiscal Year Focus	2026
Document Fiscal Period Focus	Q1
Entity Central Index Key	0000917520
Current Fiscal Year End Date	--12-31

NET LOSS PER SHARE - Schedule of Basic and Diluted Net Loss Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Basic net loss per share:
Net loss	$ (4,617)	$ (25,293)
Weighted average common shares outstanding - Basic (in shares)	76,951	76,463
Basic net loss per common share (in dollars per share)	$ (0.06)	$ (0.33)
Diluted net loss per share:
Net loss	$ (4,617)	$ (25,293)
Weighted average common shares outstanding - Basic (in shares)	76,951	76,463
Effect of dilutive securities:
Stock options and restricted stock (in shares)	0	0
Weighted average common shares for diluted earnings per share (in shares)	76,951	76,463
Diluted net loss per common share (in dollars per share)	$ (0.06)	$ (0.33)

- Definition

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

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

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+ Details

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

+ References

+ Details

REVENUES FROM CONTRACTS WITH CUSTOMERS - Schedule of Revenues Disaggregated by Major Source (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Disaggregation of Revenue [Line Items]
Total Revenue	$ 391,918	$ 382,653
Specialty Surgery
Disaggregation of Revenue [Line Items]
Total Revenue	283,135	280,664
Specialty Surgery \| Neurosurgery
Disaggregation of Revenue [Line Items]
Total Revenue	198,195	190,912
Specialty Surgery \| Instruments
Disaggregation of Revenue [Line Items]
Total Revenue	47,233	50,950
Specialty Surgery \| ENT
Disaggregation of Revenue [Line Items]
Total Revenue	37,707	38,802
Tissue Reconstruction
Disaggregation of Revenue [Line Items]
Total Revenue	108,783	101,989
Tissue Reconstruction \| Wound Reconstruction
Disaggregation of Revenue [Line Items]
Total Revenue	79,648	74,779
Tissue Reconstruction \| Private Label
Disaggregation of Revenue [Line Items]
Total Revenue	$ 29,135	$ 27,210

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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LEASES AND RELATED PARTY LEASES (Tables)

3 Months Ended

Mar. 31, 2026

Leases [Abstract]

Schedule of Supplemental Balance Sheet Information

Supplemental balance sheet information related to operating leases were as follows:


Dollars in thousands, except lease term and discount rate	March 31, 2026			December 31, 2025
ROU assets	$	137,197		$	140,568

Current lease liabilities	13,932			14,019
Non-current lease liabilities	160,116			163,059
Total lease liabilities	$	174,048		$	177,078

Weighted average remaining lease term (in years):
Leased facilities	15.6 years			15.7 years
Leased vehicles	2.8 years			2.7 years
Leased equipment	2.8 years			2.9 years

Weighted average discount rate:
Leased facilities	5.4		%	5.4		%
Leased vehicles	3.1		%	3.2		%
Leased equipment	6.6		%	6.9		%

Schedule of Supplemental Cash Flow Information

Supplemental cash flow information related to leases for the three months ended March 31, 2026 and 2025 were as follows:


Dollars in thousands	March 31, 2026		March 31, 2025
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$	5,660	$	5,890

ROU assets obtained in exchange for lease liabilities, net of modifications:
Operating leases	$	232	$	958

Schedule of Operating Lease Maturities

Future minimum lease payments under operating leases at March 31, 2026 were as follows:


Dollars in thousands	Related Parties		Third Parties		Total
Remainder of 2026	$	222	$	13,223	$	13,445
2027	296		21,784		22,080
2028	296		19,053		19,349
2029	246		18,766		19,012
2030	—		18,261		18,261
2031	—		17,826		17,826
Thereafter	—		148,993		148,993
Total minimum lease payments	$	1,060	$	257,906	$	258,966
Less: Imputed interest					84,918
Total lease liabilities					174,048
Less: Current lease liabilities					13,932
Long-term lease liabilities					160,116

BASIS OF PRESENTATION (Tables)

3 Months Ended

Mar. 31, 2026

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Restructuring and Related Costs

The following table summarizes the activity in the restructuring related accrual balances included within accrued expenses and other current liabilities in the consolidated balance sheet for the three months ended March 31, 2026 and 2025.


	Three Months Ended March 31,
(Dollars in thousands)	2026		2025
Balance, beginning of the year	$	10,774	$	5,151
Charges:
Cost of Goods Sold	537		6
Research and development	662		342
Selling, general and administrative	2,646		5,251
Payments and other adjustments	(5,870)		(1,330)
Balance, end of the period	$	8,749	$	9,420

BASIS OF PRESENTATION

3 Months Ended

Mar. 31, 2026

Organization, Consolidation and Presentation of Financial Statements [Abstract]

BASIS OF PRESENTATION

General

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

In the opinion of management, the March 31, 2026 unaudited condensed consolidated financial statements contain all adjustments (consisting only of normal recurring adjustments) necessary for a fair statement of the financial position, statement of changes in shareholders’ equity, results of operations and cash flows of the Company for the periods presented. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles in the United States (“GAAP”) have been condensed or omitted in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. These unaudited condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements for the year ended December 31, 2025 included in the Company’s Annual Report on Form 10-K. The consolidated balance sheet as of December 31, 2025 was derived from audited financial statements, but does not include all disclosures required by GAAP. Operating results for the three-month period ended March 31, 2026 are not necessarily indicative of the results to be expected for the entire year.

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

Recent Accounting Pronouncements

In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses (“ASU 2024-03”), and in January 2025, the FASB issued ASU 2025-01, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Clarifying the Effective Date (“ASU 2025-01”). ASU 2024-03 requires additional disclosure of the nature of expenses included in the income statement. The standard requires disclosures about specific types of expenses included in the expense captions presented in the income statement. This ASU is effective for fiscal years beginning after December 15, 2026, and interim periods beginning after December 15, 2027, with early adoption permitted. The requirements should be applied on a prospective basis while retrospective application is permitted. The Company is currently evaluating the impact that the adoption of this guidance will have on its disclosures.

In September 2025, the FASB issued ASU 2025-06, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software (“ASU 2025-06”), which removes all references to software development project stages and requires entities to start capitalizing software costs when both of the following occur: (i) management has authorized and committed to funding the software project and (ii) it is probable that the project will be completed and the software will be used to perform the function intended. This ASU is effective for fiscal years beginning after December 15, 2027, and interim periods within those fiscal years, with early adoption permitted as of the beginning of a fiscal year. The amendment may be applied prospectively, retrospectively, or via a modified prospective transition method. The Company is currently evaluating the impact that the adoption of this guidance will have on its consolidated financial statements.

In November 2025, the FASB issued ASU 2025-09, Derivatives and Hedging (Topic 815): Hedge Accounting Improvements (“ASU 2025-09”), which amends existing guidance to clarify and enhance the hedge accounting guidance in FASB Topic 815 and better align hedge accounting with the economics of an entity’s risk management strategies to enable entities to achieve and maintain hedge accounting for highly effective economic hedges. This ASU is effective for fiscal years beginning after December 15, 2026, and interim periods within those fiscal years, with early adoption permitted. The amendment may be applied prospectively for all hedging relationships. The Company is currently evaluating the impact that the adoption of this guidance will have on its consolidated financial statements.

In December 2025, the FASB issued ASU 2025-10, Government Grants (Topic 832): Accounting for Government Grants by Business Entities (“ASU 2025-10”), which establishes authoritative guidance on the recognition, measurement, presentation, and disclosure for government grants received by business entities. This amendment defines a government grant, establishes when and how a grant related to an asset or income is recognized and measured, and includes presentation and disclosure requirements. This ASU is effective for fiscal years beginning after December 15, 2028, and interim periods within those fiscal years, with early adoption permitted. The amendment may be applied using a modified prospective, modified retrospective, or fully retrospective transition method. The Company is currently evaluating the impact that the adoption of this guidance will have on its consolidated financial statements.

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

Cash and cash equivalents

The Company had cash and cash equivalents, primarily consisting of cash on-hand, as well as time deposits with original maturities of three months or less and money market funds, which are highly liquid and readily convertible to cash, totaling approximately $236.8 million and $235.0 million at March 31, 2026 and December 31, 2025, respectively.

Short-term investments

The Company had short-term investments, primarily consisting of time deposits with original maturities between three months and one year, totaling approximately $28.7 million and $28.7 million at March 31, 2026 and December 31, 2025, respectively. The short-term investments are valued based on Level 1 measurements in the fair value hierarchy.

IEEPA tariff refund receivable

In February 2026, the U.S. Supreme Court ruled to invalidate the U.S. administration’s tariff program implemented during 2025 under the International Emergency Economic Powers Act (“IEEPA”), concluding that IEEPA did not authorize the broad import duties previously imposed. Subsequent to the U.S. Supreme Court ruling, the U.S. Court of International Trade issued an order directing U.S. Customs and Border Protection (“CBP”) to establish an administrative process to issue refunds of any IEEPA tariffs imposed without appropriate authority. On April 20, 2026, the CBP launched an online portal referred to as the Consolidated Administration and Processing of Entries (“CAPE”) that can be used to submit IEEPA tariff refund requests. All requests will be reviewed by the CBP to determine validity prior to the issuance of refunds

Any tariffs paid have been capitalized in inventory and have been recognized in cost of goods sold as those products subject to tariffs have been sold. During the three months ended March 31, 2026, the Company applied the guidance within FASB Topic 405-20, Liabilities - Extinguishments of Liabilities (“ASC 405-20”). As a result, the Company recognized a receivable of $18.7 million, recorded in other current assets, for tariffs previously paid on imported goods that are subject to refund. Of this amount, $3.4 million had been previously expensed in 2025 to cost of goods sold and $15.3 million would have been expensed in the current year. These adjustments relate to the legal right to receive a refund of IEEPA tariffs previously imposed on the Company without appropriate authority.

Employee termination benefits

During the three months ended March 31, 2026, the Company adopted a written severance plan that covers most U.S. employees. In situations outside the U.S., the Company has severance policies that meet or exceed the minimum statutory termination benefits requirements by country that must be paid to the affected employees. The Company records employee severance costs associated with restructuring activities in accordance with the authoritative guidance for non-retirement post-employment benefits. Charges associated with these restructuring activities are recorded when the payment of benefits is probable and can be reasonably estimated. In situations where the Company pays out termination benefits in excess of the Company’s severance policies based on management’s discretion, the Company records these termination costs once communication is made to the affected employees.

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.

The Company incurred employee termination costs on restructuring activities in the consolidated statement of operations for the three months ended March 31, 2026 and 2025. The following table summarizes the activity in the restructuring related accrual balances included within accrued expenses and other current liabilities in the consolidated balance sheet for the three months ended March 31, 2026 and 2025.


	Three Months Ended March 31,
(Dollars in thousands)	2026		2025
Balance, beginning of the year	$	10,774	$	5,151
Charges:
Cost of Goods Sold	537		6
Research and development	662		342
Selling, general and administrative	2,646		5,251
Payments and other adjustments	(5,870)		(1,330)
Balance, end of the period	$	8,749	$	9,420

Segment information

During the three months ended March 31, 2026, the Company updated the allocation of certain cost and expense information from the Corporate and Other category to the Company’s two reportable segments to align with how the Company’s Chief Operating Decision Maker (“CODM”) reviews and manages the business. As a result of this update, the Company retrospectively recast prior period results, by segment, to conform to the current period presentation. This update had no impact on the Company’s consolidated results of operations. See Note 15. Segment and Geographic Information, for details of the reallocation of certain cost of goods sold and operating expense information to the Company’s reportable segments.

In addition, during the three months ended March 31, 2026, the Company renamed its Codman Specialty Surgical reportable segment to Specialty Surgery and its Tissue Technologies reportable segment to Tissue Reconstruction to better align with the reportable segments’ business activities, structures, and strategies. The reportable segment name change did not result in any change to the composition of the reportable segments and has no impact on previously reported financial information.

GOODWILL AND OTHER INTANGIBLE ASSETS

3 Months Ended

Mar. 31, 2026

Goodwill and Intangible Assets Disclosure [Abstract]

GOODWILL AND OTHER INTANGIBLE ASSETS

Goodwill

Changes in the carrying amount of goodwill for the three-month period ended March 31, 2026 were as follows:


Dollars in thousands	Specialty Surgery		Tissue Reconstruction		Total
Goodwill at December 31, 2025	$	344,167	$	270,990	$	615,157

Foreign currency translation	(1,069)		(841)		(1,910)
Goodwill at March 31, 2026	$	343,098	$	270,149	$	613,247

In accordance with FASB Topic 350, Intangibles—Goodwill and Other (“ASC 350”), goodwill is not subject to amortization but is tested for impairment at the reporting unit level annually in the third quarter. Additionally, the Company may perform interim tests of goodwill for impairment if an event occurs or circumstances change that could potentially reduce the fair value

of a reporting unit below its carrying amount. The carrying value of each reporting unit is determined by assigning the assets and liabilities, including the existing goodwill and intangible assets, to those reporting units. An impairment loss is recognized when the reporting unit’s carrying amount exceeds its estimated fair value.

The Company tests for impairment by either performing a qualitative evaluation or a quantitative test. The qualitative evaluation is an assessment of factors, including reporting unit specific operating results as well as industry, market and general economic conditions, to determine whether it is more likely than not that the fair values of a reporting unit is less than its carrying amount, including goodwill. The Company may elect to bypass this qualitative evaluation for some or all of its reporting units and perform a quantitative test. The quantitative test uses a combination of both an income approach and a market approach to determine the fair value of the reporting unit. The income approach utilizes the estimated discounted cash flows for the reporting unit, while the market approach utilizes comparable publicly-traded companies’ revenue and earnings before interest, taxes, depreciation, and amortization (“EBITDA”) multiples. Estimates and assumptions used in the income approach to calculate projected future discounted cash flows included revenue growth rates, cost of sales, terminal growth rates, and a discount rate for each reporting unit. Discount rates are determined using a weighted average cost of capital for risk factors specific to each reporting unit and other market and industry data. The assumptions used are inherently subject to uncertainty and slight changes in these assumptions could have a significant impact on the concluded value. The estimates and assumptions applied represent a Level 3 measurement in the fair value hierarchy. Level 3 inputs are supported by limited or no market activity and reflect the Company’s assumptions in measuring fair value.

During the second quarter of 2025, the Company performed a quantitative assessment of its Tissue Reconstruction, Neurosurgery, and Instruments and ENT reporting units in accordance with ASC 350 due to the decrease in the price per share of the Company’s common stock related to a number of factors including recent tariff changes that have created broad economic uncertainty and the impact of quality, operational, and supply issues. The Company recognized an aggregate charge of $511.4 million in goodwill impairment expense in the consolidated statement of operations in the second quarter of 2025. The quantitative test for the Tissue Reconstruction reporting unit utilized a terminal growth rate of 2.5% and a discount rate of 13.5% in the income approach. The Company determined, after performing the quantitative analysis, that the fair value of the Tissue Reconstruction reporting unit was less than its carrying amount and recognized an impairment of $123.3 million. The quantitative test for the Neurosurgery reporting unit utilized a terminal growth rate of 2.5% and a discount rate of 13.5% in the income approach. The Company determined, after performing the quantitative analysis, that the fair value of the Neurosurgery reporting unit was less than its carrying amount and recognized an impairment of $249.0 million. The quantitative test for the Instruments and ENT reporting unit utilized a terminal growth rate of 2.5% and a discount rate of 12.0% in the income approach. The Company determined, after performing the quantitative analysis, that the fair value of the Instruments and ENT reporting unit was less than its carrying amount and recognized an impairment of $139.1 million.

In the third quarter of 2025, the Company performed its annual test of its reporting units for impairment and completed a qualitative evaluation of its Tissue Reconstruction and Neurosurgery reporting units. The Instruments and ENT reporting unit had been deemed fully-impaired during the second quarter of 2025 and was excluded from this evaluation. After performing the qualitative analysis, the Company concluded that it was more likely than not that the fair values of the Tissue Reconstruction and Neurosurgery reporting units were greater than their carrying amounts. Therefore, it was not necessary to perform a quantitative impairment test.

During the three months ended March 31, 2026, the Company observed a decline in the market valuation of the Company’s common stock along with a volatile macroeconomic environment due to continuing tensions in global trade relationships and the ongoing military conflict between the U.S., Israel, and Iran. As a result, the Company has evaluated whether an event has occurred or circumstances changed that could potentially reduce the fair value of a reporting unit below its carrying amount as of March 31, 2026, and determined it was not more likely than not that the fair values of the Tissue Reconstruction and Neurosurgery reporting units was less than their respective carrying values. The Company will continue to evaluate changes in events and circumstances which could impact this conclusion in the future, including quantitative and qualitative factors such as the Company’s market capitalization or macroeconomic conditions affecting the Company’s forecast results. If an event occurs or circumstances change that could potentially reduce the fair value of a reporting unit below its carrying amount, the Company will perform an interim assessment of goodwill for impairment. The Company will also continue to monitor conditions that may require the Company to perform an interim assessment of its intangible assets for impairment.

Other Intangible Assets

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


	March 31, 2026
Dollars in thousands	Weighted Average Life	Cost		Accumulated Amortization		Net
Completed technology	17 years	$	1,483,774	$	(654,169)	$	829,605
Customer relationships	12 years	169,070		(146,201)		22,869
Trademarks/brand names	27 years	103,082		(48,736)		54,346
Codman tradename	Indefinite	179,170		—		179,170
Supplier relationships	30 years	30,211		(20,349)		9,862
All other	6 years	23,346		(13,853)		9,493
		$	1,988,653	$	(883,308)	$	1,105,345


	December 31, 2025
Dollars in thousands	Weighted Average Life	Cost		Accumulated Amortization		Net
Completed technology	17 years	$	1,486,304	$	(632,204)	$	854,100
Customer relationships	12 years	169,369		(145,187)		24,182
Trademarks/brand names	27 years	103,454		(47,799)		55,655
Codman tradename	Indefinite	179,959		—		179,959
Supplier relationships	30 years	30,211		(20,104)		10,107
All other	6 years	23,434		(12,774)		10,660
		$	1,992,731	$	(858,068)	$	1,134,663

Intangible Assets with Indefinite Lives

The Company does not amortize intangible assets with indefinite lives but tests its intangible assets with indefinite lives for impairment annually in the third quarter in accordance with ASC 350. Additionally, the Company performs interim tests of its intangible assets with indefinite lives for impairment if an event occurs or circumstances change that could potentially reduce the fair value of an indefinite lived intangible asset below its carrying amount. The Company tests for impairment by either performing a qualitative evaluation or a quantitative test. The qualitative evaluation is an assessment of factors, including specific operating results as well as industry, market and general economic conditions, to determine whether it is more likely than not that the fair values of the intangible asset is less than its carrying amount. The Company may elect to bypass this qualitative evaluation and perform a quantitative test.

During the second quarter of 2025 the Company performed a quantitative assessment of its Codman tradename intangible asset in accordance with ASC 350 due to the decrease in the price per share of the Company’s common stock related to a number of factors including recent tariff changes that have created broad economic uncertainty and the impact of quality, operational, and supply issues. In performing this test, the Company utilized a discount rate of 14.5%. The assumptions used in evaluating the Codman tradename for impairment are subject to change and are tracked against historical results by management. Based on the results of the quantitative test, the Company recorded no impairment to the Codman tradename intangible asset.

In the third quarter of 2025, the Company performed its annual test of its intangible assets with indefinite lives for impairment and completed a qualitative evaluation of its Codman tradename intangible asset. After performing the qualitative analysis, the Company concluded that it was more likely than not that the fair value of the Codman tradename intangible asset was greater than its carrying amount. Therefore, it was not necessary to perform a quantitative impairment test.

Intangible Assets with Definite Lives

Developed technologies and other definite-lived intangible assets are amortized over their estimated useful lives either using the straight-line method or, if reliably determinable, based on the pattern of which the economic benefit of the asset is expected to be utilized. Definite-lived intangible assets are periodically evaluated for impairment in accordance with FASB Topic 360, Property, Plant and Equipment (“ASC 360”) whenever events or changes in circumstances indicate that a definite-lived intangible asset’s carrying value may not be recoverable.

Total amortization of intangible assets for the three months ended March 31, 2026 was $27.0 million. Of this amount, $23.2 million was related to amortization of technology based intangibles and included in cost of goods sold.

Total amortization of intangible assets for the three months ended March 31, 2025 was $26.5 million. Of this amount, $22.8 million was related to amortization of technology based intangibles and included in cost of goods sold.

Based on quarter-end exchange rates, amortization expense (including amounts reported in cost of goods sold) is expected to be approximately $80.8 million for the remainder of 2026, $106.8 million in 2027, $103.2 million in 2028, $97.9 million in 2029, $91.8 million in 2030, $88.8 million in 2031 and $359.9 million thereafter.

DERIVATIVE INSTRUMENTS

3 Months Ended

Mar. 31, 2026

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 the Company’s expected SOFR-indexed borrowings. Additionally, the Company entered into a basis swap where the Company receives Term SOFR and pays daily compounded SOFR to convert the portfolio of swaps from daily compounded SOFR to Term SOFR.

The Company held the following interest rate swaps as of March 31, 2026 and December 31, 2025 (dollar amounts in thousands):


	March 31, 2026		December 31, 2025						March 31, 2026		December 31, 2025
Hedged Item	Notional Amount				Effective Date	Termination Date	Fixed Interest Rate		Estimated Fair Value
									Asset (Liability)
1-month Term SOFR Loan	100,000		100,000		December 30, 2022	December 31, 2027	2.885	%	1,380		950
1-month Term SOFR Loan	100,000		100,000		December 30, 2022	December 31, 2027	2.867	%	1,444		1,006
1-month Term SOFR Loan	575,000		575,000		July 31, 2025	December 31, 2027	1.415	%	22,757		22,094
1-month Term SOFR Loan	125,000		125,000		July 1, 2025	December 31, 2027	1.404	%	4,970		4,825
Basis Swap (1)	—		—		March 24, 2023	December 31, 2027	N/A		(1,425)		(1,629)
	$	900,000	$	900,000					$	29,126	$	27,246
(1) The notional of the basis swap amortizes to match the total notional of the interest rate swap portfolio over time

The interest rate swaps are carried on the consolidated balance sheet at fair value and changes in the fair values were recorded as unrealized gains or losses in accumulated other comprehensive income (“AOCI”). Related gain/loss amounts recognized in AOCI and earnings are presented in the Effects of Derivative Instruments table below. The estimated gain that is expected to be reclassified to interest income from AOCI as of March 31, 2026 within the next twelve months is $17.4 million.

The Company has designated these derivative instruments as cash flow hedges. The Company assesses the effectiveness of these derivative instruments and has recorded the changes in the fair value of the derivative instrument designated as a cash flow hedge as unrealized gains or losses in AOCI, net of tax, until the hedged item affected earnings, at which point 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 remaining amount of any gain or loss on the related cash flow hedge recorded in AOCI to interest expense at that time.

Foreign Currency Hedging

From time to time, the Company enters into foreign currency hedge contracts intended to protect the U.S. dollar value of certain forecasted foreign currency denominated transactions. The Company assesses the effectiveness of the contracts that are designated as hedging instruments. The changes in fair value of foreign currency cash flow hedges are recorded in AOCI, net of tax. Those amounts are subsequently reclassified to earnings from AOCI as impacted by the hedged item when the hedged item affects 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 changes in fair value of the contracts are recognized in other income, 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 anticipated currency exchange gains or losses to the extent that there are differences between forecasted and actual activities during periods of currency volatility. In addition, changes in currency exchange rates related to any unhedged transactions may affect earnings and cash flows.

Cross-Currency Rate Swaps

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 (“CHFs”) and receive interest in U.S. dollars. Upon the maturity of these contracts, the Company will pay the principal amount of the loans in CHFs and receive U.S. dollars from the counterparties.

In December 2020, the Company entered into cross-currency swap agreements to convert a notional amount of $471.6 million equivalent to 420.1 million of a CHF-denominated intercompany loan into U.S. dollars. The CHF-denominated intercompany loan was the result of an intra-entity transfer of certain intellectual property rights to a subsidiary in Switzerland completed during the fourth quarter of 2020. The intercompany loan requires quarterly principal payments of CHF 5.8 million plus accrued interest. As a result, the aggregate notional amount of the related cross-currency swaps will decrease by a corresponding amount. In February 2025, the Company amended the CHF-denominated intercompany loan to extend the maturity to December 2030. Concurrently, the Company amended the cross-currency swap agreement, with a notional amount of $368.4 million, equivalent to CHF 328.1 million, to extend the maturity to December 2030.

In November 2025, the Company entered into cross-currency swap agreements to convert an aggregate notional amount of $170.0 million equivalent to 137.6 million of two CHF-denominated intercompany loans into U.S. dollars. The CHF-denominated intercompany loans were the result of an intra-entity transfer of certain intellectual property rights to a subsidiary in Switzerland completed during the fourth quarter of 2025. The intercompany loan of CHF 80.9 million which matures in September 2028 requires quarterly interest payments and annual principal payments of CHF 8.1 million in September 2026 and September 2027; the intercompany loan of CHF 56.6 million which matures in September 2030 requires quarterly interest payments and a principal payment of CHF 8.1 million in September 2029. As the principal outstanding decreases on the intercompany loans, the aggregate notional amount of the related cross-currency swaps will decrease by a corresponding amount.

The Company held the following cross-currency rate swaps as of March 31, 2026 and December 31, 2025 (dollar amounts in thousands):


				March 31, 2026	December 31, 2025	March 31, 2026		December 31, 2025
	Effective Date	Termination Date	Fixed Rate	Aggregate Notional Amount		Fair Value Asset (Liability)

Pay CHF	February 20, 2025	December 20, 2030	3.25%	299,387	305,137	(50,500)		(54,149)
Receive U.S.$			6.14%	336,088	342,543

Pay CHF	November 10, 2025	September 30, 2030	4.00%	56,644	56,644	(2,581)		(2,684)
Receive U.S.$			7.11%	70,000	70,000

Pay CHF	November 10, 2025	September 29, 2028	3.00%	80,920	80,920	$	(1,969)	$	(2,834)
Receive U.S.$			6.23%	100,000	100,000

Total						$	(55,050)	$	(59,667)

The cross-currency swaps designated as cash flow hedges are carried on the consolidated balance sheet at fair value, and changes in the fair values were recorded as unrealized gains or losses in AOCI. Related gain/loss amounts recognized in AOCI and earnings are presented in the Effects of Derivative Instruments table below. The estimated gain that is expected to be reclassified to other income (expense), net from AOCI as of March 31, 2026 within the next twelve months is $10.0 million.

For the three months ended March 31, 2026 and 2025, the Company recorded a gain of $5.9 million and a loss of $(9.4) million, respectively, in other income, net related to change in fair value related to the foreign currency rate translation to offset the gains and losses, respectively, recognized on the intercompany loans.

For the three months ended March 31, 2026 and 2025, the Company recorded gains of $3.5 million and $1.2 million, respectively, in other income, net included in the consolidated statements of operations related to the interest rate differential of the cross-currency swaps.

Net Investment Hedges

The Company manages certain foreign exchange risks through a variety of strategies, including hedging. The Company is exposed to foreign exchange risk from its international operations through foreign currency purchases, net investments in foreign subsidiaries, and foreign currency assets and liabilities created in the normal course of business.

In February 2025, the Company entered into a cross-currency swap agreement with a notional amount of CHF 67.8 million equivalent to $75.0 million, where the Company agreed with third-parties to sell CHF in exchange for U.S. dollars at a specified rate at the maturity of the contract. The new cross-currency swap agreement was designated as a net investment hedge to partially offset the effects of foreign currency on foreign subsidiaries.

On July 25, 2025, the Company entered into a cross-currency swap agreement with a notional amount of CHF 59.7 million, equivalent to $75.0 million, where the Company agreed with third-parties to sell CHF in exchange for U.S. dollars at a specified rate at the maturity of the contract. The new cross-currency swap agreement was designated as a net investment hedge to partially offset the effects of foreign currency on foreign subsidiaries.

The Company held the following cross-currency rate swaps designated as net investment hedges as of March 31, 2026 and December 31, 2025, respectively (dollar amounts in thousands):


					March 31, 2026	December 31, 2025	March 31, 2026		December 31, 2025
	Effective Date	Termination Date	Fixed Rate	Aggregate Notional Amount			Fair Value Asset (Liability)

Pay CHF	May 26, 2022	December 16, 2028	—%	CHF	192,140	192,140	(44,759)		(47,619)
Receive U.S.$			1.94%	$	200,000	200,000

Pay CHF	November 17, 2023	December 17, 2029	—%	CHF	66,525	66,525	(9,762)		(10,568)
Receive U.S.$			2.54%	$	75,000	75,000

Pay CHF	May 6, 2024	December 18, 2030	—%	CHF	68,483	68,483	(12,051)		(12,407)
Receive U.S.$			2.74%	$	75,000	75,000

Pay CHF	February 21, 2025	December 15, 2031	—%	CHF	67,800	67,800	(9,308)		(9,394)
Receive U.S.$			3.24%	$	75,000	75,000

Pay CHF	July 25, 2025	December 15, 2032	—%	CHF	59,693	59,693	(2,187)		(2,211)
Receive U.S.$			2.66%	$	75,000	75,000

Total							$	(78,067)	$	(82,199)

The net investment hedges are carried on the consolidated balance sheet at fair value and changes in the fair values were recorded as unrealized gains or losses in AOCI. Related gain/loss amounts recognized in AOCI and earnings are presented in the Effects of Derivative Instruments table below. The estimated gain that is expected to be reclassified to interest income from AOCI as of March 31, 2026 within the next twelve months is $11.1 million.

Foreign Currency Forward Contracts

The Company has entered into forward contracts designated as cash flow hedges for forecasted purchases in foreign currencies, primarily CHF-denominated intercompany purchases. These contracts typically settle at various dates within twelve months of execution. As of March 31, 2026, the notional amount of foreign currency forward contracts was CHF 14.1 million. The foreign currency forward contracts are 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 changes in fair value will be recognized into earnings as a component of cost of sales when the forecasted-transaction occurs.

For the three months ended March 31, 2026 and 2025, amounts reclassified to earnings included (i) the effective hedge component amounts of $0.5 million and $0.2 million, respectively, within cost of goods sold, and (ii) forward‑points amortization of $(0.1) million and $(0.2) million, respectively, within other income (expense), net. Related gain/loss amounts recognized in AOCI and earnings are presented in the Effects of Derivative Instruments table below.

On April 28, 2026, the Company entered into foreign currency forwards with a notional amount of CHF 3.1 million to be designated as a cash flow hedge to mitigate the exchange rate risk of CHF-denominated intercompany purchases. These contracts settle at various dates within twelve months of execution.

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 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 for derivatives designated as hedging instruments in the condensed consolidated balance sheets as of March 31, 2026 and December 31, 2025:


	Fair Value as of
Location on Balance Sheet (1):	March 31, 2026		December 31, 2025
Dollars in thousands
Derivatives designated as hedges — Assets:
Prepaid expenses and other current assets
Cash Flow Hedges
Interest rate swap	$	18,401	$	16,126
Cross-currency swap	8,343		8,325
Foreign currency forward contracts	—		29
Net Investment Hedges
Cross-currency swap	7,494		7,474
Other assets
Cash Flow Hedges
Interest rate swap	12,151		12,749




Total derivatives designated as hedges — Assets	$	46,389	$	44,703

Derivatives designated as hedges — Liabilities:
Accrued expenses and other current liabilities
Cash Flow Hedges
Interest rate swap	$	1,040	$	1,103

Foreign currency forward contracts	614		—
Net Investment Hedges
Cross-currency swap	8,072		8,798
Other liabilities
Cash Flow Hedges
Interest rate swap	386		526
Cross-currency swap	63,393		67,992

Net Investment Hedges
Cross-currency swap	77,489		80,875
Total derivatives designated as hedges — Liabilities	$	150,994	$	159,294

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

Effects of Derivative Instruments

The following presents the effect of derivative instruments designated as cash flow hedges and net investment hedges on the accompanying condensed consolidated statement of operations during the three months ended March 31, 2026 and 2025:


Dollars in thousands	Balance in AOCI Beginning of Quarter		Amount of Gain (Loss) Recognized in AOCI		Amount of Gain (Loss) Reclassified from AOCI into Earnings		Balance in AOCI End of Quarter		Location in Statements of Operations
Three Months Ended March 31, 2026
Cash Flow Hedges
Interest rate swap	$	27,247	$	6,261	$	4,380	$	29,128	Interest expense
Cross-currency swap	(6,583)		7,364		8,668		(7,887)		Other income, net
Foreign Currency Forward Contract	727		(439)		410		(122)		Cost of sales
Net Investment Hedges
Cross-currency swap	(93,141)		7,213		3,080		(89,008)		Interest income
	$	(71,750)	$	20,399	$	16,538	$	(67,889)
Three Months Ended March 31, 2025
Cash Flow Hedges
Interest rate swap	$	48,794	$	(7,463)	$	1,426	$	39,905	Interest expense
Cross-currency swap	(11,621)		(10,032)		(8,230)		(13,423)		Other income, net
Foreign Currency Forward Contract	$	(624)	$	436	$	23	$	(211)
Net Investment Hedges
Cross-currency swap	(31,130)		(3,435)		2,633		(37,198)		Interest income
	$	5,419	$	(20,494)	$	(4,148)	$	(10,927)

Derivative Instruments not Designated Hedges

From time to time, the Company enters into foreign currency forward contracts to mitigate risk from the fluctuations in foreign currency exchange rates associated with intercompany balances in Chinese yuan (“CNH”) CHF, and EUR. These contracts typically settle at various dates within twelve months of execution. As of March 31, 2026, the notional amounts totaled CNH 30.0 million, CHF 4.0 million, and EUR 7.0 million equivalent to $4.4 million, $5.1 million, and $8.2 million, respectively.

In 2021, the Company entered into a foreign currency swap, with a notional amount of JPY 800.0 million, equivalent to $7.3 million, to mitigate the risk from fluctuations in foreign currency exchange rates associated with an intercompany loan denominated in Japanese yen. In a foreign currency swap transaction, the Company agrees with another party to exchange, at specified intervals, the difference between one currency and another currency at a fixed exchange rate, generally set at inception, calculated by reference to an agreed upon notional amount. The notional amount of each currency is exchanged at the inception and termination of the currency swap by each party. The Company subsequently paid down a portion of this swap, bringing the notional amount down to JPY 400.0 million, equivalent to $3.6 million as of March 31, 2026.

The fair value of the foreign currency swaps not designated as hedges was $1.3 million and $1.0 million as of March 31, 2026 and December 31, 2025, respectively.

The following table summarizes the gains and losses on derivative instruments not designated as hedges on the condensed consolidated statements of income, which was included in other income:


Dollars in thousands	Three Months Ended March 31,
	2026		2025
Foreign currency forward contracts	(222)		174
Foreign currency swaps	(54)		$	169
Total	$	(276)	$	343

- Definition

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

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+ Details

INVENTORIES

3 Months Ended

Mar. 31, 2026

Inventory Disclosure [Abstract]

INVENTORIES

Inventories, net consisted of the following:


Dollars in thousands	March 31, 2026		December 31, 2025
Finished goods	$	253,149	$	262,614
Work in process	109,675		99,348
Raw materials	132,211		130,773
Total inventories, net	$	495,035	$	492,735

ACCUMULATED OTHER COMPREHENSIVE LOSS - Narrative (Details) $ in Thousands	3 Months Ended
	Mar. 31, 2026 USD ($)
Accumulated Other Comprehensive Income (Loss) [Line Items]
(Loss) gain reclassified from AOCI	$ 13,346
Gains and Losses on Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
(Loss) gain reclassified from AOCI	10,813
Other income \| Gains and Losses on Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
(Loss) gain reclassified from AOCI	7,300
Cost of sales \| Gains and Losses on Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
(Loss) gain reclassified from AOCI	300
Interest income \| Gains and Losses on Derivatives
Accumulated Other Comprehensive Income (Loss) [Line Items]
(Loss) gain reclassified from AOCI	$ 5,700

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

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+ Details

FAIR VALUE MEASUREMENTS

3 Months Ended

Mar. 31, 2026

Fair Value Disclosures [Abstract]

FAIR VALUE MEASUREMENTS

FASB Topic 820, Fair Value Measurement (“ASC 820”) defines fair value as the price that would be received to sell an asset or paid to transfer a liability in an orderly transaction between market participants at the measurement date. When determining fair value, the Company considers the principal or most advantageous market in which it would transact and considers assumptions that market participants would use when pricing the asset or liability.

Valuation techniques used to measure fair value should maximize the use of observable inputs and minimize the use of unobservable inputs. ASC 820 establishes a three-level hierarchy of the inputs (i.e., assumptions that market participants would use in pricing an asset or liability) used to measure fair value, giving the highest priority to quoted prices in active markets and the lowest priority to unobservable inputs in measuring fair value. The categorization within the valuation hierarchy is based on the lowest level of input that is significant to the entire fair value measurement. The three levels of the valuation hierarchy are defined as follows:

Level 1: Inputs to the valuation methodology are quoted prices in active markets for identical assets or liabilities.

Level 2: Inputs to the valuation methodology are other observable inputs, including quoted market prices for similar assets or liabilities in active markets; quoted prices for identical or similar assets or liabilities in markets that are not active; inputs other than quoted prices that are observable for the asset or liability; and inputs that are derived principally from or corroborated by observable market data by correlation or other means.

Level 3: Inputs to the valuation methodology are unobservable inputs that are supported by little or no market activity and are based on management’s best estimate of inputs market participants would use in pricing the asset or liability at the measurement date, including assumptions about risk.

Assets and Liabilities Measured at Fair Value on a Recurring Basis

The Company has investments in time deposits that are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices, as well as certain debt obligations that are classified within Level 1 of the fair value hierarchy because they are valued using quoted market prices. The investments in time deposits are classified as cash and cash equivalents and short-term investments on the consolidated balance sheets which is determined based on maturities at the time of purchase and re-evaluated at each balance sheet date.

The Company also has investments in derivative instruments, which are comprised of interest rate swaps, cross currency swaps, net investment hedges, and forward foreign currency contracts that are classified within Level 2 of the fair value hierarchy because they are valued using analyses obtained from independent third-party valuation specialists based on market observable inputs. The fair values of these derivative contracts represent the estimated amounts the Company would receive or pay to terminate the contracts. Refer to Note 7. Derivative Instruments for further discussion and information on these derivative contracts.

In addition, the Company has contingent consideration liabilities that are classified within Level 3 of the fair value hierarchy because they are measured at fair value using significant unobservable inputs, including management’s forecast of future revenues for the acquired businesses as well as management’s estimates of the likelihood of achieving the other specified criteria. Refer to Note 16. Commitments and Contingencies for additional information on these contingent consideration liabilities.

Assets and liabilities measured and recorded at fair value on a recurring basis as of March 31, 2026 and December 31, 2025 consisted of the following:


Dollars in thousands	Fair Value Measurement	March 31, 2026		December 31, 2025
Assets:
Cash and cash equivalents	Level 1	$	236,809	$	235,048
Short-term investments	Level 1	28,693		28,693
Interest rate swaps	Level 2	29,126		27,246

Foreign currency forward contracts	Level 2	—		29
Foreign currency forward contracts (not designated as hedges)	Level 2	1,291		1,015
Total Assets:		$	295,919	$	292,031

Liabilities:
Cross currency rate swaps	Level 2	$	55,050	$	59,667
Net investment hedges	Level 2	78,067		82,199
Foreign currency forward contracts	Level 2	614		—
Contingent consideration	Level 3	24,756		26,049

Total Liabilities:		$	158,487	$	167,915

There were no transfers into or out of Level 3 during the three months ended March 31, 2026 and 2025.

Assets and Liabilities Measured at Fair Value on a Non-Recurring Basis

The Company remeasures the fair value of certain assets and liabilities, including property, plant and equipment, operating lease - right of use assets, and goodwill and other intangible assets, upon the occurrence of certain events. The amounts recognized were recorded to remeasure the carrying amount of assets to the assets’ fair values, which were generally estimated, based upon a market participant’s perspective, using Level 3 measurements, including values estimated using the income approach.

Other than the fair value estimates disclosed in Note 2. Acquisitions and Divestitures, Note 5. Goodwill and Other Intangible Assets, and Note 10. Leases and Related Party Leases, there were no non-recurring fair value measurements during the three months ended March 31, 2026 and 2025.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

NET LOSS PER SHARE (Tables)

3 Months Ended

Mar. 31, 2026

Earnings Per Share [Abstract]

Schedule of Basic and Diluted Net Loss Per Share

Basic and diluted net loss per share was as follows:


	Three Months Ended March 31,
Dollars in thousands, except per share amounts	2026		2025
Basic net loss per share:
Net loss	$	(4,617)	$	(25,293)
Weighted average common shares outstanding	76,951		76,463

Basic net loss per common share	$	(0.06)	$	(0.33)

Diluted net loss per share:
Net loss	$	(4,617)	$	(25,293)

Weighted average common shares outstanding — Basic	76,951		76,463
Effect of dilutive securities:
Stock options and restricted stock	—		—
Weighted average common shares for diluted earnings per share	76,951		76,463

Diluted net loss per common share	$	(0.06)	$	(0.33)

BASIS OF PRESENTATION (Policies)	3 Months Ended
BASIS OF PRESENTATION (Policies)	Mar. 31, 2026
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	BASIS OF PRESENTATION General The terms “we,” “our,” “us,” “Company” and “Integra” refer to Integra LifeSciences Holdings Corporation, a Delaware corporation, and its subsidiaries unless the context suggests otherwise. In the opinion of management, the March 31, 2026 unaudited condensed consolidated financial statements contain all adjustments (consisting only of normal recurring adjustments) necessary for a fair statement of the financial position, statement of changes in shareholders’ equity, results of operations and cash flows of the Company for the periods presented. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles in the United States (“GAAP”) have been condensed or omitted in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. These unaudited condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements for the year ended December 31, 2025 included in the Company’s Annual Report on Form 10-K. The consolidated balance sheet as of December 31, 2025 was derived from audited financial statements, but does not include all disclosures required by GAAP. Operating results for the three-month period ended March 31, 2026 are not necessarily indicative of the results to be expected for the entire year. The preparation of consolidated financial statements is in conformity with GAAP, which requires management to make estimates and assumptions that affect the reported amount of assets and liabilities, the disclosure of contingent liabilities, and the reported amounts of revenues and expenses. Significant estimates affecting amounts reported or disclosed in the unaudited condensed consolidated financial statements include allowances for doubtful accounts receivable and sales returns and allowances, net realizable value of inventories, valuation of intangible assets including amortization periods for acquired intangible assets, discount rates and estimated projected cash flows used to value and test impairments of long-lived assets and goodwill, estimates of projected cash flows and depreciation and amortization periods for long-lived assets, computation of taxes, valuation allowances recorded against deferred tax assets, the valuation of stock-based compensation, valuation of derivative instruments, valuation of contingent liabilities, the fair value of debt instruments and loss contingencies. These estimates are based on historical experience and on various other assumptions that are believed to be reasonable under the current circumstances. Actual results could differ from these estimates.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In November 2024, the FASB issued ASU 2024-03, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Disaggregation of Income Statement Expenses (“ASU 2024-03”), and in January 2025, the FASB issued ASU 2025-01, Income Statement - Reporting Comprehensive Income - Expense Disaggregation Disclosures (Subtopic 220-40): Clarifying the Effective Date (“ASU 2025-01”). ASU 2024-03 requires additional disclosure of the nature of expenses included in the income statement. The standard requires disclosures about specific types of expenses included in the expense captions presented in the income statement. This ASU is effective for fiscal years beginning after December 15, 2026, and interim periods beginning after December 15, 2027, with early adoption permitted. The requirements should be applied on a prospective basis while retrospective application is permitted. The Company is currently evaluating the impact that the adoption of this guidance will have on its disclosures. In September 2025, the FASB issued ASU 2025-06, Intangibles - Goodwill and Other - Internal-Use Software (Subtopic 350-40): Targeted Improvements to the Accounting for Internal-Use Software (“ASU 2025-06”), which removes all references to software development project stages and requires entities to start capitalizing software costs when both of the following occur: (i) management has authorized and committed to funding the software project and (ii) it is probable that the project will be completed and the software will be used to perform the function intended. This ASU is effective for fiscal years beginning after December 15, 2027, and interim periods within those fiscal years, with early adoption permitted as of the beginning of a fiscal year. The amendment may be applied prospectively, retrospectively, or via a modified prospective transition method. The Company is currently evaluating the impact that the adoption of this guidance will have on its consolidated financial statements. In November 2025, the FASB issued ASU 2025-09, Derivatives and Hedging (Topic 815): Hedge Accounting Improvements (“ASU 2025-09”), which amends existing guidance to clarify and enhance the hedge accounting guidance in FASB Topic 815 and better align hedge accounting with the economics of an entity’s risk management strategies to enable entities to achieve and maintain hedge accounting for highly effective economic hedges. This ASU is effective for fiscal years beginning after December 15, 2026, and interim periods within those fiscal years, with early adoption permitted. The amendment may be applied prospectively for all hedging relationships. The Company is currently evaluating the impact that the adoption of this guidance will have on its consolidated financial statements. In December 2025, the FASB issued ASU 2025-10, Government Grants (Topic 832): Accounting for Government Grants by Business Entities (“ASU 2025-10”), which establishes authoritative guidance on the recognition, measurement, presentation, and disclosure for government grants received by business entities. This amendment defines a government grant, establishes when and how a grant related to an asset or income is recognized and measured, and includes presentation and disclosure requirements. This ASU is effective for fiscal years beginning after December 15, 2028, and interim periods within those fiscal years, with early adoption permitted. The amendment may be applied using a modified prospective, modified retrospective, or fully retrospective transition method. The Company is currently evaluating the impact that the adoption of this guidance will have on its consolidated financial statements. There are no other recently issued accounting pronouncements that are expected to have any significant effect on the Company’s financial position, results of operations, or cash flows.
Cash and cash equivalents	Cash and cash equivalents The Company had cash and cash equivalents, primarily consisting of cash on-hand, as well as time deposits with original maturities of three months or less and money market funds, which are highly liquid and readily convertible to cash, totaling approximately $236.8 million and $235.0 million at March 31, 2026 and December 31, 2025, respectively.
Short-term investments	Short-term investments The Company had short-term investments, primarily consisting of time deposits with original maturities between three months and one year, totaling approximately $28.7 million and $28.7 million at March 31, 2026 and December 31, 2025, respectively. The short-term investments are valued based on Level 1 measurements in the fair value hierarchy.
Employee termination benefits	Employee termination benefits During the three months ended March 31, 2026, the Company adopted a written severance plan that covers most U.S. employees. In situations outside the U.S., the Company has severance policies that meet or exceed the minimum statutory termination benefits requirements by country that must be paid to the affected employees. The Company records employee severance costs associated with restructuring activities in accordance with the authoritative guidance for non-retirement post-employment benefits. Charges associated with these restructuring activities are recorded when the payment of benefits is probable and can be reasonably estimated. In situations where the Company pays out termination benefits in excess of the Company’s severance policies based on management’s discretion, the Company records these termination costs once communication is made to the affected employees. 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.
Segment information	Segment information During the three months ended March 31, 2026, the Company updated the allocation of certain cost and expense information from the Corporate and Other category to the Company’s two reportable segments to align with how the Company’s Chief Operating Decision Maker (“CODM”) reviews and manages the business. As a result of this update, the Company retrospectively recast prior period results, by segment, to conform to the current period presentation. This update had no impact on the Company’s consolidated results of operations. See Note 15. Segment and Geographic Information, for details of the reallocation of certain cost of goods sold and operating expense information to the Company’s reportable segments. In addition, during the three months ended March 31, 2026, the Company renamed its Codman Specialty Surgical reportable segment to Specialty Surgery and its Tissue Technologies reportable segment to Tissue Reconstruction to better align with the reportable segments’ business activities, structures, and strategies. The reportable segment name change did not result in any change to the composition of the reportable segments and has no impact on previously reported financial information.
Summary of Accounting Policies on Revenue Recognition and Shipping and Handling Fees	Summary of Accounting Policies on Revenue Recognition Revenue is recognized upon the transfer of control of promised products or services to the customers in an amount that reflects the consideration the Company expects to receive in exchange for those products and services. Performance Obligations The Company’s performance obligations consist mainly of transferring control of goods and services identified in the contracts, purchase orders, or invoices. The Company has no significant multi-element contracts with customers. Significant Estimates Usage-based royalties and licenses are estimated based on the provisions of contracts with customers 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 reported licensee sales and those that were estimated are adjusted in the period in which they become known, which is typically the following quarter. Historically, such adjustments have not been significant. The Company estimates returns, price concessions, and discount allowances using the expected value method based on historical trends and other known factors. Rebate allowances are estimated using the most likely method based on each customer contract. The Company’s return policy, as set forth in its product catalogs and sales invoices, requires review and authorization in advance prior to the return of product. Upon the authorization, a credit will be issued for the goods returned within a set amount of days from the shipment, which is generally 90 days. The Company disregards the effects of a financing component if the Company expects, at contract inception, that the period between the transfer and customer payment for the goods or services will be one year or less. The Company has no significant revenues recognized on payments expected to be received more than one year after the transfer of control of products or services to customers. Contract Assets and Liabilities Revenues recognized from the Company’s private label business that are not invoiced to the customers as a result of recognizing revenue over time are recorded as a contract asset included in the prepaid expenses and other current assets account in the consolidated balance sheet. Upon invoicing to the customer, the balance is recorded in trade receivable, net in the consolidated balance sheet. Other operating revenues may include fees received under service agreements. Non-refundable fees received under multiple-period service agreements are recognized as revenue as the Company satisfies the performance obligations to the other party. A portion of the transaction price allocated to the performance obligations to be satisfied in the future periods is recognized as contract liability. Shipping and Handling Fees The Company elected to account for shipping and handling activities as a fulfillment cost rather than a separate performance obligation. Amounts billed to customers for shipping and handling are included as part of the transaction price and recognized as revenue when control of underlying products is transferred to the customer. The related shipping and freight charges incurred by the Company are included in the cost of goods sold.
Product Warranties	Product Warranties Certain of the Company’s medical devices, including monitoring systems and neurosurgical systems, are designed to operate over long periods of time. These products are sold with warranties which may extend for up to two years from the date of purchase. The warranties are not considered a separate performance obligation. The Company estimates its product warranties using the expected value method based on historical trends and other known factors. The Company includes them in accrued expenses and other current liabilities in the consolidated balance sheet.
Taxes Collected from Customers	Taxes Collected from Customers The Company elected to exclude from the measurement of the transaction price all taxes assessed by a governmental authority that are both imposed on and concurrent with a specific revenue-producing transaction and collected by the entity from a customer.

BASIS OF PRESENTATION - Narrative (Details) $ in Thousands	3 Months Ended
BASIS OF PRESENTATION - Narrative (Details) $ in Thousands	Mar. 31, 2026 USD ($) Segment	Dec. 31, 2025 USD ($)
Product Information [Line Items]
Receivable for recovery of import duties, net	$ 18,700
Cash and cash equivalents	236,809	$ 235,048
Short-term investments	28,693	$ 28,693
Import duties expensed and capitalized	3,400
Import duties that would have been expensed in current year	$ 15,300
Number of reportable segments \| Segment	2
Number of operating segments \| Segment	2

INVENTORIES (Details) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Inventory Disclosure [Abstract]
Finished goods	$ 253,149	$ 262,614
Work in process	109,675	99,348
Raw materials	132,211	130,773
Total inventories, net	$ 495,035	$ 492,735

DERIVATIVE INSTRUMENTS - Schedule of Derivative Instruments (Details) - Cash Flow Hedges - Designated as Hedging Instrument - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Derivative [Line Items]
Notional Amount	$ 900,000	$ 900,000
Estimated Fair Value	29,126	27,246
Interest Rate Swap Designated December 18, 2018 Tranche 1
Derivative [Line Items]
Notional Amount	$ 100,000	100,000
Fixed Rate	2.885%
Estimated Fair Value	$ 1,380	950
Interest Rate Swap Designated December 18, 2018 Tranche 2
Derivative [Line Items]
Notional Amount	$ 100,000	100,000
Fixed Rate	2.867%
Estimated Fair Value	$ 1,444	1,006
Interest Rate Swap Designated December 15, 2020 Tranche 1
Derivative [Line Items]
Notional Amount	$ 575,000	575,000
Fixed Rate	1.415%
Estimated Fair Value	$ 22,757	22,094
Interest Rate Swap Designated December 15, 2020 Tranche 2
Derivative [Line Items]
Notional Amount	$ 125,000	125,000
Fixed Rate	1.404%
Estimated Fair Value	$ 4,970	4,825
Interest Rate Swap Designated March 31, 2023
Derivative [Line Items]
Notional Amount	0	0
Estimated Fair Value	$ (1,425)	$ (1,629)

FAIR VALUE MEASUREMENTS (Tables)

3 Months Ended

Mar. 31, 2026

Fair Value Disclosures [Abstract]

Schedule of Fair Value Measurements, Recurring and Nonrecurring

Assets and liabilities measured and recorded at fair value on a recurring basis as of March 31, 2026 and December 31, 2025 consisted of the following:


Dollars in thousands	Fair Value Measurement	March 31, 2026		December 31, 2025
Assets:
Cash and cash equivalents	Level 1	$	236,809	$	235,048
Short-term investments	Level 1	28,693		28,693
Interest rate swaps	Level 2	29,126		27,246

Foreign currency forward contracts	Level 2	—		29
Foreign currency forward contracts (not designated as hedges)	Level 2	1,291		1,015
Total Assets:		$	295,919	$	292,031

Liabilities:
Cross currency rate swaps	Level 2	$	55,050	$	59,667
Net investment hedges	Level 2	78,067		82,199
Foreign currency forward contracts	Level 2	614		—
Contingent consideration	Level 3	24,756		26,049

Total Liabilities:		$	158,487	$	167,915

INCOME TAXES (Tables)

3 Months Ended

Mar. 31, 2026

Income Tax Disclosure [Abstract]

Schedule of Effective Income Tax Rate

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


	Three Months Ended March 31,
	2026		2025
Reported tax rate	(91.7)	%	15.8	%

DERIVATIVE INSTRUMENTS (Tables)

3 Months Ended

Mar. 31, 2026

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Schedule of Derivative Instruments

The Company held the following interest rate swaps as of March 31, 2026 and December 31, 2025 (dollar amounts in thousands):


	March 31, 2026		December 31, 2025						March 31, 2026		December 31, 2025
Hedged Item	Notional Amount				Effective Date	Termination Date	Fixed Interest Rate		Estimated Fair Value
									Asset (Liability)
1-month Term SOFR Loan	100,000		100,000		December 30, 2022	December 31, 2027	2.885	%	1,380		950
1-month Term SOFR Loan	100,000		100,000		December 30, 2022	December 31, 2027	2.867	%	1,444		1,006
1-month Term SOFR Loan	575,000		575,000		July 31, 2025	December 31, 2027	1.415	%	22,757		22,094
1-month Term SOFR Loan	125,000		125,000		July 1, 2025	December 31, 2027	1.404	%	4,970		4,825
Basis Swap (1)	—		—		March 24, 2023	December 31, 2027	N/A		(1,425)		(1,629)
	$	900,000	$	900,000					$	29,126	$	27,246
(1) The notional of the basis swap amortizes to match the total notional of the interest rate swap portfolio over time

The Company held the following cross-currency rate swaps as of March 31, 2026 and December 31, 2025 (dollar amounts in thousands):


				March 31, 2026	December 31, 2025	March 31, 2026		December 31, 2025
	Effective Date	Termination Date	Fixed Rate	Aggregate Notional Amount		Fair Value Asset (Liability)

Pay CHF	February 20, 2025	December 20, 2030	3.25%	299,387	305,137	(50,500)		(54,149)
Receive U.S.$			6.14%	336,088	342,543

Pay CHF	November 10, 2025	September 30, 2030	4.00%	56,644	56,644	(2,581)		(2,684)
Receive U.S.$			7.11%	70,000	70,000

Pay CHF	November 10, 2025	September 29, 2028	3.00%	80,920	80,920	$	(1,969)	$	(2,834)
Receive U.S.$			6.23%	100,000	100,000

Total						$	(55,050)	$	(59,667)

The Company held the following cross-currency rate swaps designated as net investment hedges as of March 31, 2026 and December 31, 2025, respectively (dollar amounts in thousands):


					March 31, 2026	December 31, 2025	March 31, 2026		December 31, 2025
	Effective Date	Termination Date	Fixed Rate	Aggregate Notional Amount			Fair Value Asset (Liability)

Pay CHF	May 26, 2022	December 16, 2028	—%	CHF	192,140	192,140	(44,759)		(47,619)
Receive U.S.$			1.94%	$	200,000	200,000

Pay CHF	November 17, 2023	December 17, 2029	—%	CHF	66,525	66,525	(9,762)		(10,568)
Receive U.S.$			2.54%	$	75,000	75,000

Pay CHF	May 6, 2024	December 18, 2030	—%	CHF	68,483	68,483	(12,051)		(12,407)
Receive U.S.$			2.74%	$	75,000	75,000

Pay CHF	February 21, 2025	December 15, 2031	—%	CHF	67,800	67,800	(9,308)		(9,394)
Receive U.S.$			3.24%	$	75,000	75,000

Pay CHF	July 25, 2025	December 15, 2032	—%	CHF	59,693	59,693	(2,187)		(2,211)
Receive U.S.$			2.66%	$	75,000	75,000

Total							$	(78,067)	$	(82,199)

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

The following table summarizes the fair value for derivatives designated as hedging instruments in the condensed consolidated balance sheets as of March 31, 2026 and December 31, 2025:


	Fair Value as of
Location on Balance Sheet (1):	March 31, 2026		December 31, 2025
Dollars in thousands
Derivatives designated as hedges — Assets:
Prepaid expenses and other current assets
Cash Flow Hedges
Interest rate swap	$	18,401	$	16,126
Cross-currency swap	8,343		8,325
Foreign currency forward contracts	—		29
Net Investment Hedges
Cross-currency swap	7,494		7,474
Other assets
Cash Flow Hedges
Interest rate swap	12,151		12,749




Total derivatives designated as hedges — Assets	$	46,389	$	44,703

Derivatives designated as hedges — Liabilities:
Accrued expenses and other current liabilities
Cash Flow Hedges
Interest rate swap	$	1,040	$	1,103

Foreign currency forward contracts	614		—
Net Investment Hedges
Cross-currency swap	8,072		8,798
Other liabilities
Cash Flow Hedges
Interest rate swap	386		526
Cross-currency swap	63,393		67,992

Net Investment Hedges
Cross-currency swap	77,489		80,875
Total derivatives designated as hedges — Liabilities	$	150,994	$	159,294

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

Schedule of Effect of Derivative Instruments Designated as Cash Flow Hedges and Net Investment Hedges on Statements of Operations


Dollars in thousands	Balance in AOCI Beginning of Quarter		Amount of Gain (Loss) Recognized in AOCI		Amount of Gain (Loss) Reclassified from AOCI into Earnings		Balance in AOCI End of Quarter		Location in Statements of Operations
Three Months Ended March 31, 2026
Cash Flow Hedges
Interest rate swap	$	27,247	$	6,261	$	4,380	$	29,128	Interest expense
Cross-currency swap	(6,583)		7,364		8,668		(7,887)		Other income, net
Foreign Currency Forward Contract	727		(439)		410		(122)		Cost of sales
Net Investment Hedges
Cross-currency swap	(93,141)		7,213		3,080		(89,008)		Interest income
	$	(71,750)	$	20,399	$	16,538	$	(67,889)
Three Months Ended March 31, 2025
Cash Flow Hedges
Interest rate swap	$	48,794	$	(7,463)	$	1,426	$	39,905	Interest expense
Cross-currency swap	(11,621)		(10,032)		(8,230)		(13,423)		Other income, net
Foreign Currency Forward Contract	$	(624)	$	436	$	23	$	(211)
Net Investment Hedges
Cross-currency swap	(31,130)		(3,435)		2,633		(37,198)		Interest income
	$	5,419	$	(20,494)	$	(4,148)	$	(10,927)

Schedule of Derivatives Not Designated as Hedging Instruments

The following table summarizes the gains and losses on derivative instruments not designated as hedges on the condensed consolidated statements of income, which was included in other income:


Dollars in thousands	Three Months Ended March 31,
	2026		2025
Foreign currency forward contracts	(222)		174
Foreign currency swaps	(54)		$	169
Total	$	(276)	$	343

FAIR VALUE MEASUREMENTS - Schedule Assets and Liabilities on a Recurring Basis (Details) - Fair Value, Recurring - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Assets:
Total assets	$ 295,919	$ 292,031
Liabilities:
Total liabilities	158,487	167,915
Level 1
Assets:
Cash and cash equivalents	236,809	235,048
Short-term investments	28,693	28,693
Level 2 \| Interest rate swaps
Assets:
Derivative asset	29,126	27,246
Level 2 \| Foreign currency forward contracts
Liabilities:
Derivative liabilities	614	0
Level 2 \| Foreign currency forward contracts \| Designated as Hedging Instrument
Assets:
Derivative asset	0	29
Level 2 \| Foreign currency forward contracts \| Not Designated as Hedging Instrument
Assets:
Derivative asset	1,291	1,015
Level 2 \| Cross-currency swap \| Cash Flow Hedges
Liabilities:
Derivative liabilities	55,050	59,667
Level 2 \| Net Investment Hedges \| Net Investment Hedges
Liabilities:
Derivative liabilities	78,067	82,199
Level 3
Liabilities:
Contingent consideration	$ 24,756	$ 26,049

LEASES AND RELATED PARTY LEASES - Schedule of Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 5,660	$ 5,890
ROU assets obtained in exchange for lease liabilities, net of modifications:
Operating leases	$ 232	$ 958

INCOME TAXES - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
INCOME TAXES - Narrative (Details) - USD ($) $ in Millions	Mar. 31, 2026	Mar. 31, 2025
Income Tax Disclosure [Abstract]
Effective income tax rate	(91.70%)	15.80%
Effective income tax reconciliation, tax benefit, excess stock-based compensation deductions	$ 2.9	$ 2.1

INVENTORIES (Tables)

3 Months Ended

Mar. 31, 2026

Inventory Disclosure [Abstract]

Schedule of Inventories, Net

Inventories, net consisted of the following:


Dollars in thousands	March 31, 2026		December 31, 2025
Finished goods	$	253,149	$	262,614
Work in process	109,675		99,348
Raw materials	132,211		130,773
Total inventories, net	$	495,035	$	492,735

LEASES AND RELATED PARTY LEASES - Narrative (Details)	3 Months Ended
LEASES AND RELATED PARTY LEASES - Narrative (Details)	Mar. 31, 2026 USD ($) renewalOption	Mar. 31, 2025 USD ($)
Operating Leased Assets [Line Items]
Number of renewal options (or more) \| renewalOption	1
Operating lease expense	$ 6,400,000	$ 5,900,000
Future minimum lease payments, finance leases	0
Related Party
Operating Leased Assets [Line Items]
Operating lease expense	$ 100,000	$ 100,000
Percent of manufacturing facility owned by corporation whose shareholders are trusts whose beneficiaries include family members of company's former director	50.00%
Annual rate of lease agreement	$ 300,000
Related Party \| Five Year Option Lease Period One
Operating Leased Assets [Line Items]
Period for extended lease	November 1, 2029 through October 31, 2034
Related Party \| Five Year Option Lease Period Two
Operating Leased Assets [Line Items]
Option to extend lease, years	5 years
Period for extended lease	November 1, 2034 through October 31, 2039
Affiliated Entity \| Five Year Option Lease Period One
Operating Leased Assets [Line Items]
Option to extend lease, years	5 years

ACCUMULATED OTHER COMPREHENSIVE LOSS

3 Months Ended

Mar. 31, 2026

Equity [Abstract]

ACCUMULATED OTHER COMPREHENSIVE LOSS

Comprehensive loss for the three months ended March 31, 2026 and 2025:


	Three Months Ended March 31,
Dollars in thousands	2026		2025
Net loss	$	(4,617)	$	(25,293)
Foreign currency translation adjustment	(476)		11,631
Change in unrealized (gain) loss on derivatives, net of tax	(220)		(8,016)
Pension liability adjustment, net of tax	(167)		(150)
Comprehensive loss, net	$	(5,480)	$	(21,828)

Changes in accumulated other comprehensive loss by component between December 31, 2025 and March 31, 2026 are presented in the table below, net of tax:


Dollars in thousands	Gains and Losses on Derivatives		Defined Benefit Pension Items		Foreign Currency Items		Total
Balance at January 1, 2026	$	15,948	$	4,984	$	(51,009)	$	(30,077)
Other comprehensive gain	10,593		—		1,890		12,483
Less: Amounts reclassified from accumulated other comprehensive income, net	10,813		167		2,366		13,346
Net current-period other comprehensive (loss)	(220)		(167)		(476)		(863)
Balance at March 31, 2026	$	15,728	$	4,817	$	(51,485)	$	(30,940)

For the three months ended March 31, 2026, the Company reclassified gains of $7.3 million and $5.7 million from AOCI to other income and interest income, respectively. Additionally, the Company reclassified a loss of $0.3 million from AOCI to cost of goods sold.

DERIVATIVE INSTRUMENTS - Schedule of Effect of Derivative Instruments Designated Cash Flow Hedges on Statements of Operations (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance, beginning of period	$ 1,043,463	$ 1,545,280
Balance, end of period	1,042,406	1,524,139
Accumulated Other Comprehensive Loss
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance, beginning of period	(30,077)	(27,571)
Balance, end of period	(30,940)	(24,106)
Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Roll Forward]
Amount of Gain (Loss) Recognized in AOCI	20,399	(20,494)
Amount of Gain (Loss) Reclassified from AOCI into Earnings	16,538	(4,148)
Designated as Hedging Instrument \| Accumulated Other Comprehensive Loss
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance, beginning of period	(71,750)	5,419
Balance, end of period	(67,889)	(10,927)
Interest rate swap \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance, beginning of period	27,247	48,794
Amount of Gain (Loss) Recognized in AOCI	6,261	(7,463)
Amount of Gain (Loss) Reclassified from AOCI into Earnings	4,380	1,426
Balance, end of period	29,128	39,905
Cross-currency swap \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance, beginning of period	(6,583)	(11,621)
Amount of Gain (Loss) Recognized in AOCI	7,364	(10,032)
Amount of Gain (Loss) Reclassified from AOCI into Earnings	8,668	(8,230)
Balance, end of period	(7,887)	(13,423)
Cross-currency swap \| Net Investment Hedges \| Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance, beginning of period	(93,141)	(31,130)
Amount of Gain (Loss) Recognized in AOCI	7,213	(3,435)
Amount of Gain (Loss) Reclassified from AOCI into Earnings	3,080	2,633
Balance, end of period	(89,008)	(37,198)
Foreign Currency Forward Contract \| Cost of sales
Derivative Instruments, Gain (Loss) [Roll Forward]
Amount of Gain (Loss) Reclassified from AOCI into Earnings	500	200
Foreign Currency Forward Contract \| Other income, net
Derivative Instruments, Gain (Loss) [Roll Forward]
Amount of Gain (Loss) Reclassified from AOCI into Earnings	(100)	(200)
Foreign Currency Forward Contract \| Cash Flow Hedges \| Designated as Hedging Instrument
Derivative Instruments, Gain (Loss) [Roll Forward]
Balance, beginning of period	727	(624)
Amount of Gain (Loss) Recognized in AOCI	(439)	436
Amount of Gain (Loss) Reclassified from AOCI into Earnings	410	23
Balance, end of period	$ (122)	$ (211)

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
OPERATING ACTIVITIES:
Net loss	$ (4,617)	$ (25,293)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation and amortization	38,430	37,188
Deferred income tax provision (benefit)	1,326	(1,832)
Share-based compensation	5,165	1,870
Amortization of debt issuance costs and expenses associated with debt refinancing	995	1,385
Non-cash lease adjustment	330	(254)
Loss on disposal of property and equipment	90	495
Change in fair value of contingent consideration and others	(1,293)	(162)
Changes in assets and liabilities:
Accounts receivable	13,645	21,451
Inventories	(4,329)	(13,696)
Prepaid expenses and other current assets	(21,877)	(17,551)
Other non-current assets	1,385	1,510
Accounts payable, accrued expenses and other current liabilities	(19,186)	(18,000)
Contract liabilities	(630)	244
Other non-current liabilities	369	1,388
Net cash provided by (used in) operating activities	9,803	(11,257)
INVESTING ACTIVITIES:
Purchases of property and equipment	(14,848)	(28,920)
Purchases of short-term investments	0	(7,000)
Net cash used in investing activities	(14,848)	(35,920)
FINANCING ACTIVITIES:
Proceeds from borrowings of long-term indebtedness	44,500	54,400
Payments on debt	(35,588)	(15,244)
Payments for contingent considerations	0	(2,600)
Proceeds from exercised stock options and employee stock purchase plan	760	957
Cash taxes paid in net equity settlement	(1,375)	(2,136)
Net cash provided by financing activities	8,297	35,377
Effect of exchange rate changes on cash and cash equivalents	(1,491)	4,529
Net increase (decrease) in cash and cash equivalents	1,761	(7,271)
Cash and cash equivalents at beginning of period	235,048	246,375
Cash and cash equivalents at end of period	$ 236,809	$ 239,104

COMMITMENTS AND CONTINGENCIES - Narrative (Details) $ in Thousands	3 Months Ended					12 Months Ended
	Jun. 30, 2026 USD ($)	Mar. 31, 2026 USD ($) liability	Jun. 30, 2025 USD ($)	Mar. 31, 2025 USD ($)	Jun. 30, 2024 USD ($)	Dec. 31, 2022 USD ($) payment	Dec. 31, 2019 USD ($)
Loss Contingencies [Line Items]
Payment for contingent consideration		$ 0		$ 2,600
Arkis
Loss Contingencies [Line Items]
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)							$ 25,500
Contingent consideration							13,100
Arkis \| Development Milestones
Loss Contingencies [Line Items]
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)							10,000
Payment for contingent consideration				$ 5,000
Arkis \| Commercial Sales Milestones
Loss Contingencies [Line Items]
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)							$ 15,500
Derma Sciences
Loss Contingencies [Line Items]
Number of liabilities \| liability		1
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)		$ 3,000
Derma Sciences \| BioD Earnout Payments and Medihoney Earnout Payments
Loss Contingencies [Line Items]
Payment for contingent consideration		$ 33,300
Surgical Innovation Associates, Inc.
Loss Contingencies [Line Items]
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)						$ 90,000
Business acquisition, number of payments \| payment						2
Surgical Innovation Associates, Inc. \| Revenue Based Performance Milestones
Loss Contingencies [Line Items]
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)						$ 32,600
Payment for contingent consideration			$ 18,100		$ 12,400
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)						50,000
Surgical Innovation Associates, Inc. \| Revenue Based Performance Milestones \| Forecast
Loss Contingencies [Line Items]
Payment for contingent consideration	$ 18,100
Surgical Innovation Associates, Inc. \| FDA Approval Of Premarket Approval
Loss Contingencies [Line Items]
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)						25,000
Contingent consideration, cash payments due upon achievement of certain revenue-based performance milestones (up to)						$ 40,000

RETIREMENT PLANS	3 Months Ended
RETIREMENT PLANS	Mar. 31, 2026
Retirement Benefits [Abstract]
RETIREMENT PLANS	RETIREMENT PLANS The Company has various defined benefit plans which cover certain employees in France, Japan, Germany and Switzerland. Net periodic benefit costs for the Company’s defined benefit pension plans for the three months ended March 31, 2026 were $0.4 million. The components of the net periodic benefit costs other than the service cost component of $1.0 million for the three months ended March 31, 2026 are included in other income, net in the consolidated statements of operations. Net periodic benefit costs for the Company’s defined benefit pension plans for the three months ended March 31, 2025 were $0.4 million. The components of the net periodic benefit costs other than the service cost component of $0.8 million for the three months ended March 31, 2025 are included in other income, net in the consolidated statements of operations. The estimated fair values of plan assets were $71.1 million and $71.7 million as of March 31, 2026 and December 31, 2025, respectively. The net plan assets of the pension plans are invested in common trusts as of March 31, 2026 and December 31, 2025. Common trusts are classified as Level 2 in the fair value hierarchy. The fair value of common trusts is valued at the 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 an appropriate risk profile. Deferred Compensation Plan The Company maintains a deferred compensation plan in which certain employees of the Company may defer the payment and taxation of up to 75% of their base salary and up to 100% of bonus amounts and other eligible cash compensation. This deferred compensation is invested in funds offered under this plan and is valued based on Level 1 measurements in the fair value hierarchy. Assets of the Company’s deferred compensation plan are included in other current assets and recorded at fair value based on their quoted market prices. The fair value of these assets were $7.3 million and $7.9 million as of March 31, 2026 and December 31, 2025, respectively. Offsetting liabilities relating to the deferred compensation plan are included in other liabilities.

- Definition

The entire disclosure for retirement benefits.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 715
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (o)
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-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/exampleRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
-URI https://asc.fasb.org/1943274/2147480506/715-20-50-1

+ Details

NET LOSS PER SHARE - Narrative (Details) - shares shares in Millions	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Earnings Per Share [Abstract]
Shares excluded from computation as their effect would be antidilutive (in shares)	1.6	1.6

LEASES AND RELATED PARTY LEASES - Schedule of Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Mar. 31, 2026	Dec. 31, 2025
Lessee, Lease, Description [Line Items]
ROU assets	$ 137,197	$ 140,568
Current lease liabilities	13,932	14,019
Non-current lease liabilities	160,116	163,059
Total lease liabilities	$ 174,048	$ 177,078
Leased facilities
Lessee, Lease, Description [Line Items]
Weighted average remaining lease term (in years)	15 years 7 months 6 days	15 years 8 months 12 days
Weighted average discount rate	5.40%	5.40%
Leased vehicles
Lessee, Lease, Description [Line Items]
Weighted average remaining lease term (in years)	2 years 9 months 18 days	2 years 8 months 12 days
Weighted average discount rate	3.10%	3.20%
Leased equipment
Lessee, Lease, Description [Line Items]
Weighted average remaining lease term (in years)	2 years 9 months 18 days	2 years 10 months 24 days
Weighted average discount rate	6.60%	6.90%

REVENUES FROM CONTRACTS WITH CUSTOMERS (Tables)

3 Months Ended

Mar. 31, 2026

Revenue from Contract with Customer [Abstract]

Schedule of Changes in Contract Assets and Contract Liabilities

The following table summarizes the changes in the contract asset and liability balances for the three months ended March 31, 2026:




Dollars in thousands	Total
Contract Asset
Contract asset, January 1, 2026	$	6,844
Transferred to trade receivables from contract asset included in beginning of the year contract asset	$	(4,551)

Contract asset, net of transferred to trade receivables on contracts during the period	$	4,363
Contract asset, March 31, 2026	$	6,656

Contract Liability
Contract liability, January 1, 2026	$	23,010
Recognition of revenue included in beginning of year contract liability	$	(4,074)

Contract liability, net of revenue recognized on contracts during the period	$	3,481
Foreign currency translation	$	8
Contract liability, March 31, 2026	$	22,425

Schedule of Disaggregation of Revenue

The following table presents revenues disaggregated by the major sources of revenues for the three months ended March 31, 2026 and 2025 (dollar amounts in thousands):


	Three Months Ended March 31, 2026		Three Months Ended March 31, 2025
Neurosurgery	$	198,195	$	190,912
Instruments	47,233		50,950
ENT	37,707		38,802
Total Specialty Surgery	283,135		280,664

Wound Reconstruction	79,648		74,779
Private Label	29,135		27,210
Total Tissue Reconstruction	108,783		101,989
Total Revenue	$	391,918	$	382,653

ACQUISITIONS AND DIVESTITURES	3 Months Ended
ACQUISITIONS AND DIVESTITURES	Mar. 31, 2026
Business Combination, Asset Acquisition, Transaction between Entities under Common Control, and Joint Venture Formation [Abstract]
ACQUISITIONS AND DIVESTITURES	ACQUISITIONS AND DIVESTITURES Acquisition of Durepair® On October 2, 2024, the Company completed the acquisition of the product rights for Durepair Regeneration Matrix (“Durepair”), a non-synthetic dura substitute for repair of the dura mater during neurosurgical procedures, from Medtronic plc for total consideration of $45.0 million. The Company made cash payments of $10.0 million upon the closing of the acquisition in October 2024, $15.0 million on the first anniversary of the acquisition in October 2025, and will make an additional cash payment of $20.0 million upon the second anniversary of the acquisition in October 2026. The additional cash payment to be made in October 2026 is included at its present value in accrued expenses and other current liabilities as of March 31, 2026. The acquisition of the product rights for Durepair, which consist of certain patents and trademarks, regulatory approvals, and other records, has been accounted for as an asset acquisition in accordance with FASB Topic 805, Business Combinations (“ASC 805”) as the acquisition does not include an assembled workforce and substantially all of the fair value of the assets acquired is concentrated in a single identifiable intangible asset.

ACCUMULATED OTHER COMPREHENSIVE LOSS - Schedule of Changes in Accumulated Other Comprehensive Income (Loss) by Component (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Balance, beginning of period	$ 1,043,463	$ 1,545,280
Other comprehensive gain	12,483
Less: Amounts reclassified from accumulated other comprehensive income, net	13,346
Net current-period other comprehensive (loss)	(863)	3,465
Balance, end of period	1,042,406	1,524,139
Total
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Balance, beginning of period	(30,077)	(27,571)
Net current-period other comprehensive (loss)	(863)	3,465
Balance, end of period	(30,940)	$ (24,106)
Gains and Losses on Derivatives
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Balance, beginning of period	15,948
Other comprehensive gain	10,593
Less: Amounts reclassified from accumulated other comprehensive income, net	10,813
Net current-period other comprehensive (loss)	(220)
Balance, end of period	15,728
Defined Benefit Pension Items
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Balance, beginning of period	4,984
Other comprehensive gain	0
Less: Amounts reclassified from accumulated other comprehensive income, net	167
Net current-period other comprehensive (loss)	(167)
Balance, end of period	4,817
Foreign Currency Items
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Balance, beginning of period	(51,009)
Other comprehensive gain	1,890
Less: Amounts reclassified from accumulated other comprehensive income, net	2,366
Net current-period other comprehensive (loss)	(476)
Balance, end of period	$ (51,485)

- Definition

Amount of equity (deficit) attributable to parent. Excludes temporary equity and equity attributable to noncontrolling interest.

+ References

Reference 1: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
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-Name Accounting Standards Codification
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

DERIVATIVE INSTRUMENTS - Schedule of Derivatives Not Designated as Hedging Instruments (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2026	Mar. 31, 2025
Derivative Instruments, Gain (Loss) [Line Items]
Derivative instruments not designated as hedging instruments, gain (loss), net	$ (276)	$ 343
Foreign currency forward contracts
Derivative Instruments, Gain (Loss) [Line Items]
Derivative instruments not designated as hedging instruments, gain (loss), net	(222)	174
Foreign currency swaps
Derivative Instruments, Gain (Loss) [Line Items]
Derivative instruments not designated as hedging instruments, gain (loss), net	$ (54)	$ 169

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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