Business segment information (Tables)

12 Months Ended

Dec. 31, 2020

Segment Reporting [Abstract]

Schedule of Net Sales by Major Product Category by Reporting Segment

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

	Year Ended December 31,
	2020					2019					2018
(U.S. Dollars, in thousands)	Net Sales		Percent of Total Net Sales			Net Sales		Percent of Total Net Sales			Net Sales		Percent of Total Net Sales
Bone Growth Therapies	$	171,396		42.2	%	$	197,181		42.9	%	$	195,252		43.1	%
Spinal Implants		94,857		23.3	%		94,544		20.6	%		91,658		20.2	%
Biologics		55,482		13.6	%		65,496		14.2	%		59,684		13.2	%
Global Spine		321,735		79.1	%		357,221		77.7	%		346,594		76.5	%
Global Extremities		84,827		20.9	%		102,734		22.3	%		106,448		23.5	%
Net sales	$	406,562		100.0	%	$	459,955		100.0	%	$	453,042		100.0	%

Summary of EBITDA by Reporting Segment

The following table presents EBITDA, the primary metric used in managing the Company, by reporting segment:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2020			2019			2018
Global Spine	$	63,036		$	39,528		$	76,545
Global Extremities		(4,993	)		7,496			9,453
Corporate		(25,382	)		(49,252	)		(43,626	)
Total EBITDA		32,661			(2,228	)		42,372
Depreciation and amortization		(30,546	)		(24,699	)		(18,659	)
Interest expense, net		(2,483	)		(122	)		(828	)
Income (loss) before income taxes	$	(368	)	$	(27,049	)	$	22,885

Schedule of Depreciation and Amortization by Reporting Segment

The following table presents depreciation and amortization by reporting segment:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2020		2019		2018
Global Spine	$	18,362	$	14,329	$	9,512
Global Extremities		7,896		5,575		5,342
Corporate		4,288		4,795		3,805
Total	$	30,546	$	24,699	$	18,659

Summary of Net Sales by Geographic Destination

The following data includes net sales by geographic destination:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2020		2019		2018
U.S.	$	327,280	$	361,939	$	355,353
Italy		18,733		19,560		19,331
Germany		11,940		12,688		11,606
United Kingdom		7,147		10,090		8,731
Brazil		2,347		7,685		7,120
Others		39,115		47,993		50,901
Net sales	$	406,562	$	459,955	$	453,042

The table below presents net sales by geographic destination for each reporting segment and for the consolidated Company:

	Year Ended December 31,
(U.S. Dollars, in thousands)	2020		2019		2018
Global Spine
U.S.	$	304,595	$	335,410	$	326,994
International		17,140		21,811		19,600
Total Global Spine		321,735		357,221		346,594
Global Extremities
U.S.	$	22,685		26,529		28,359
International		62,142		76,205		78,089
Total Global Extremities		84,827		102,734		106,448
Consolidated
U.S.		327,280		361,939		355,353
International		79,282		98,016		97,689
Net sales	$	406,562	$	459,955	$	453,042

Summary of Property, Plant and Equipment of Reporting Segments by Geographic Area

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

(U.S. Dollars, in thousands)	2020		2019
U.S.	$	47,646	$	51,278
Italy		10,503		7,937
Germany		2,516		849
United Kingdom		1,540		1,082
Brazil		163		141
Others		1,245		1,440
Total	$	63,613	$	62,727