7Baggers

OrthoPediatrics Corp
(NASDAQ:KIDS) 

KIDS stock logo

OrthoPediatrics Corp., a medical device company, designs, develops, and markets anatomically appropriate implants and devices for the treatment of children with orthopedic conditions in the United States and internationally. The company offers trauma and deformity correction products; scoliosis proc...

Founded: 2006
IPO Price: $36.50 (Oct 12, 2017)
Full Time Employees: 94
CEO: David Bailey  
Sector: Healthcare
Industry: Medical Devices
Medical Devices
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At a glance:
Bull Thesis:
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Income Statements:
Quarterly
Annual
    Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 2017-09-30 
                                       
      net revenue
    		59,362,000 61,605,000 61,250,000 61,082,000 52,411,000 52,667,000 54,573,000 52,802,000 44,685,000 37,613,000 39,972,000 39,559,000 31,588,000 30,994,000 34,950,000 32,928,000 23,417,000 24,813,000 25,079,000 26,695,000 21,462,000 18,924,000 22,205,000 13,593,000 16,356,000 18,952,000 20,744,000 18,200,000 14,656,000 14,568,000 15,820,000 15,077,000 12,094,000 11,681,000 12,375,000 
      cost of revenue
    		15,972,000 16,499,000 15,976,000 17,063,000 14,149,000 17,102,000 14,513,000 12,003,000 12,511,000 10,899,000 9,019,000 9,534,000 8,027,000 9,770,000 9,061,000 7,947,000 4,851,000 6,732,000 6,525,000 6,252,000 5,137,000 3,806,000 4,566,000 3,532,000 4,143,000 4,502,000 4,849,000 4,581,000 4,001,000 4,054,000 3,843,000 3,807,000 3,175,000 2,849,000 2,884,000 
      gross profit
    		43,390,000 45,106,000 45,274,000 44,019,000 38,262,000 35,565,000 40,060,000 40,799,000 32,174,000 26,714,000 30,953,000 30,025,000 23,561,000 21,224,000 25,889,000 24,981,000 18,566,000 18,081,000 18,554,000 20,443,000 16,325,000 15,118,000 17,639,000 10,061,000 12,213,000 14,450,000 15,895,000 13,619,000 10,655,000 10,514,000 11,977,000 11,270,000 8,919,000 8,832,000 9,491,000 
      yoy
    		13.40% 26.83% 13.02% 7.89% 18.92% 33.13% 29.42% 35.88% 36.56% 25.87% 19.56% 20.19% 26.90% 17.38% 39.53% 22.20% 13.73% 19.60% 5.19% 103.19% 33.67% 4.62% 10.97% -26.13% 14.62% 37.44% 32.71% 20.84% 19.46% 19.04% 26.19%     
      qoq
    		-3.80% -0.37% 2.85% 15.05% 7.58% -11.22% -1.81% 26.81% 20.44% -13.69% 3.09% 27.44% 11.01% -18.02% 3.63% 34.55% 2.68% -2.55% -9.24% 25.23% 7.98% -14.29% 75.32% -17.62% -15.48% -9.09% 16.71% 27.82% 1.34% -12.22% 6.27% 26.36% 0.99% -6.94%  
      operating expenses:
    		                                   
      sales and marketing
    		18,470,000 18,399,000 18,652,000 19,103,000 16,572,000 16,784,000 16,750,000 16,593,000 14,169,000 12,439,000 13,582,000 13,165,000 12,216,000 10,945,000 11,919,000 12,431,000 9,758,000 9,986,000 9,862,000 10,876,000 8,949,000 9,433,000 9,237,000 5,620,000 7,564,000 8,360,000 8,771,000 7,606,000 6,547,000 6,558,000 7,150,000 6,776,000 6,079,000 5,405,000 5,633,000 
      general and administrative
    		31,024,000 29,954,000 29,155,000 30,443,000 30,280,000 24,431,000 26,299,000 27,329,000 24,730,000 19,594,000 18,507,000 19,654,000 17,666,000 16,554,000 15,116,000 14,546,000 13,167,000 11,898,000 11,034,000 11,088,000 12,041,000 10,036,000 9,823,000 10,577,000 7,881,000 7,216,000 7,267,000 6,569,000 5,612,000 4,545,000 4,877,000 5,499,000 6,017,000 6,690,000 3,487,000 
      restructuring
    		 296,000 2,294,000 2,971,000 40,000                               
      research and development
    		2,231,000 2,259,000 2,333,000 2,159,000 2,351,000 2,916,000 2,577,000 2,543,000 2,998,000 2,747,000 2,387,000 2,792,000 2,270,000 2,034,000 2,206,000 1,747,000 2,027,000 1,608,000 1,302,000 1,325,000 1,308,000 2,050,000 1,077,000 881,000 1,265,000 1,905,000 1,396,000 1,234,000 1,213,000 1,277,000 1,122,000 1,115,000 1,218,000 941,000 1,127,000 
      total operating expenses
    		51,725,000 53,278,000 54,702,000 54,676,000 49,243,000 49,620,000 45,626,000 46,465,000 41,897,000 34,780,000 35,461,000 35,611,000 32,152,000 29,533,000 32,850,000 28,724,000 24,952,000 23,642,000 22,198,000 23,289,000 22,298,000 27,861,000 20,137,000 17,078,000 16,710,000 17,481,000 17,434,000 15,409,000 13,372,000 12,380,000 13,149,000 13,390,000 13,314,000 13,036,000 10,247,000 
      operating income
    		-8,335,000 -8,172,000 -9,428,000 -10,657,000 -10,981,000 -14,055,000 -5,566,000 -5,666,000 -9,723,000 -8,066,000 -4,508,000 -5,586,000 -8,591,000 -8,309,000 -6,961,000 -3,743,000 -6,386,000 -5,561,000 -3,644,000 -2,846,000 -5,973,000 -12,743,000 -2,498,000 -7,017,000 -4,497,000 -3,031,000 -1,539,000 -1,790,000 -2,717,000 -1,866,000 -1,172,000 -2,120,000 -4,395,000 -4,204,000 -756,000 
      yoy
    		-24.10% -41.86% 69.39% 88.09% 12.94% 74.25% 23.47% 1.43% 13.18% -2.92% -35.24% 49.24% 34.53% 49.42% 91.03% 31.52% 6.91% -56.36% 45.88% -59.44% 32.82% 320.42% 62.31% 292.01% 65.51% 62.43% 31.31% -15.57% -38.18% -55.61% 55.03%     
      qoq
    		1.99% -13.32% -11.53% -2.95% -21.87% 152.52% -1.76% -41.73% 20.54% 78.93% -19.30% -34.98% 3.39% 19.37% 85.97% -41.39% 14.84% 52.61% 28.04% -52.35% -53.13% 410.13% -64.40% 56.04% 48.37% 96.95% -14.02% -34.12% 45.61% 59.22% -44.72% -51.76% 4.54% 456.08%  
      other expense:
    		                                   
      interest expense
    		2,102,000 1,932,000 1,822,000 1,116,000 1,126,000 1,319,000 404,000 261,000 637,000 -303,000 21,000 294,000 -210,000 -61,000 708,000 1,212,000 566,000 396,000 542,000 581,000 728,000 624,000 1,010,000 1,399,000 379,000 1,306,000 1,297,000 632,000 303,000 533,000 608,000 562,000 552,000 633,000 761,000 
      other expense
    		421,000 -341,000 648,000 -4,709,000  1,035,000 -63,000 120,000      128,000 945,000 827,000  -281,000 -267,000 -375,000 -160,000 -332,000 122,000 121,000 69,000 -8,000 41,000 37,000  69,000 85,000 10,000 53,000 8,000 20,000 
      total other expense
    		2,523,000 -410,250 2,470,000 -3,593,000 -518,000 1,141,250 3,571,000 381,000 613,000                           
      net loss before income taxes
    		-10,858,000 -9,763,000 -11,898,000 -7,064,000 -10,463,000                               
      income tax (benefit) charge
    		-171,000 30,000 -125,000                                 
      net income
    		-10,687,000 -10,103,000 -11,773,000 -7,113,000 -10,659,000 -16,069,000 -7,919,000 -6,029,000 -7,805,000 -6,691,000 -4,591,000 -2,886,000 -6,806,000 -7,848,000 18,539,000 -333,000 -9,100,000 72,000 -2,197,000 -3,756,000 -10,379,000 -14,013,000 -4,539,000 -9,447,000 -4,945,000 -5,429,000 -2,664,000 -2,618,000 -3,020,000 -2,468,000 -1,865,000 -2,692,000 -5,000,000 -4,845,000 -1,537,000 
      yoy
    		0.26% -37.13% 48.67% 17.98% 36.57% 140.16% 72.49% 108.91% 14.68% -14.74% -124.76% 766.67% -25.21% -11000.00% -943.83% -91.13% -12.32% -100.51% -51.60% -60.24% 109.89% 158.11% 70.38% 260.85% 63.74% 119.98% 42.84% -2.75% -39.60% -49.06% 21.34%     
      qoq
    		5.78% -14.18% 65.51% -33.27% -33.67% 102.92% 31.35% -22.75% 16.65% 45.74% 59.08% -57.60% -13.28% -142.33% -5667.27% -96.34% -12738.89% -103.28% -41.51% -63.81% -25.93% 208.72% -51.95% 91.04% -8.92% 103.79% 1.76% -13.31% 22.37% 32.33% -30.72% -46.16% 3.20% 215.22%  
      weighted-average shares outstanding
    		                                   
      basic and diluted
    		23,685,055,000  23,565,779,000 23,460,144,000 23,230,871,000  23,171,249,000 23,145,064,000 22,820,779,000                           
      net income per share
    		           -0.13 -0.3   -0.02 -0.47 0.01 -0.11 -0.19 -0.54 -0.75 -0.24 -0.54 -0.3 -0.37 -0.18 -0.18 -0.21 -0.19 -0.15 -0.21 -0.41 -1.04 -1.7 
      basic and diluted
    		-0.45 -0.315 -0.5 -0.3 -0.46 -0.235 -0.34 -0.26 -0.34                           
      intangible asset impairment
    		 2,370,000 2,268,000                                 
      loss on early extinguishment of debt
    		      3,230,000                             
      income tax charge
    		   49,000 196,000                               
      other income
    		    -1,644,000    -24,000    -331,000    -105,000                   
      tradename impairment
    		                                   
      fair value adjustment of contingent consideration
    		         -6,000  -2,304,000 -670,000 -480,000 -23,010,000 -5,010,000 2,570,000 -5,510,000 -1,430,000 990,000 4,150,000 1,701,000 909,000 910,000            
      income before income taxes
    		     -6,380,000 -9,137,000 -6,047,000 -10,336,000 -6,903,000 -3,742,000 -3,287,000 -7,380,000 -7,896,000 14,396,000 -772,000 -9,417,000 -166,000 -2,489,000 -4,042,000 -10,691,000               
      provision for income taxes
    		     -941,750 -1,218,000 -18,000 -2,531,000 -212,000 849,000 -401,000 -574,000 -48,000 -4,143,000 -439,000 -317,000 -238,000 -292,000 -286,000 -312,000               
      trademark impairment
    		          985,000    3,609,000                     
      other expenses:
    		                                   
      other loss
    		         -351,750 -787,000 -289,000                        
      total other income
    		         -1,163,000 -766,000                         
      weighted-average shares outstanding
    		                                   
      basic
    		 23,459,425,000    23,077,704,000    22,675,477,000 22,762,823,000   20,704,556,000 21,150,219,000                     
      diluted
    		 23,459,425,000    23,077,704,000    22,675,477,000 22,762,823,000   20,947,727,000 21,295,323,000                     
      net income per share
    		           -0.13 -0.3   -0.02 -0.47 0.01 -0.11 -0.19 -0.54 -0.75 -0.24 -0.54 -0.3 -0.37 -0.18 -0.18 -0.21 -0.19 -0.15 -0.21 -0.41 -1.04 -1.7 
      basic
    		         -0.29 -0.2   -0.38 0.88                     
      diluted
    		         -0.29 -0.2   -0.37 0.87                     
      total other expenses
    		           -2,299,000 -1,211,000 -413,000 -21,357,000 -2,971,000 3,031,000 -5,395,000 -1,155,000 1,196,000 4,718,000 1,993,000 2,041,000 2,430,000 448,000 1,298,000 1,338,000 669,000 303,000 602,000 693,000 572,000 605,000 641,000 781,000 
      weighted-average common stock - basic and diluted
    		           22,704,723,000 22,506,024,000   19,792,286,000 19,366,911,000  19,291,374,000 19,275,779,000 19,200,231,000  19,112,797,000 17,549,118,000 16,423,853,000  14,639,020,000 14,451,979,000 14,367,056,000  12,624,858,000 12,549,226,000    
      net income per share
    		           -0.13 -0.3   -0.02 -0.47 0.01 -0.11 -0.19 -0.54 -0.75 -0.24 -0.54 -0.3 -0.37 -0.18 -0.18 -0.21 -0.19 -0.15 -0.21 -0.41 -1.04 -1.7 
      other expenses
    		                                   
      net income from continuing operations
    		                     -14,013,000 -4,539,000 -9,447,000  -4,329,000 -2,877,000 -2,459,000        
      net income from discontinued operations
    		                                   
      net loss from discontinued operations
    		                           -159,000        
      net gain from discontinued operations
    		                         13,500 213,000         
      net loss attributable to common stockholders
    		                         -5,429,000 -2,664,000 -2,618,000  -2,468,000 -1,865,000 -2,692,000 -5,000,000 -15,079,000 -3,021,000 
      weighted-average common shares - basic and diluted
    		                 19,268,255,000    18,056,828,000    14,624,194,000    12,567,387,000   12,073,776,000 4,017,330,000 1,773,385,000 
    Balance Sheets:
    Quarterly
    Annual
      Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 2017-09-30 
                                         
        assets
      		                                   
        current assets:
      		                                   
        cash
      		12,193,000 19,556,000 16,826,000 44,553,000 33,439,000 43,820,000        8,991,000 35,423,000        88,372,000 113,054,000 53,580,000 70,777,000 19,669,000 21,858,000 52,774,000 60,691,000 24,463,000 26,506,000 34,591,000 42,582,000 2,238,000 
        restricted cash
      		2,052,000 2,064,000 2,058,000 2,052,000 1,990,000 1,957,000 1,998,000 1,963,000 1,962,000 1,972,000 1,592,000 1,596,000 1,481,000 1,471,000 1,449,000 1,357,000 1,363,000 1,365,000 1,368,000 1,371,000 1,369,000 1,374,000 1,369,000 1,361,000 1,361,000 1,250,000          
        short-term investments
      		36,616,000 41,295,000 40,902,000 25,596,000 25,333,000 25,013,000 25,017,000  26,141,000  71,780,000 83,472,000 73,074,000                       
        accounts receivable - trade, net of allowances of 1,615 and 1,145, respectively
      		54,430,000                                   
        inventories
      		134,021,000 133,790,000 128,807,000 125,265,000 119,752,000 117,005,000 120,934,000 116,366,000 112,689,000 105,851,000 100,533,000 90,983,000 84,922,000 78,192,000 74,041,000 67,484,000 64,077,000 57,569,000 55,458,000 56,376,000 55,266,000 52,989,000 52,032,000 48,875,000 43,966,000 38,000,000 34,533,000 32,855,000 28,081,000 25,541,000 26,646,000 24,816,000 22,004,000 19,498,000 18,434,000 
        prepaid expenses and other current assets
      		6,554,000 5,876,000 5,985,000 6,439,000 7,552,000 7,021,000 6,489,000 4,499,000 5,056,000 3,750,000 3,980,000 3,642,000 4,005,000 3,966,000 2,751,000 2,712,000 3,048,000 3,229,000 2,745,000 2,471,000 1,884,000 2,618,000 2,065,000 1,534,000 1,514,000 1,464,000 1,623,000 1,277,000 1,452,000 1,256,000 1,045,000 1,063,000 1,114,000 831,000 615,000 
        total current assets
      		245,866,000 256,419,000 245,852,000 257,702,000 232,059,000 237,173,000 248,312,000 193,783,000 203,725,000 226,496,000 226,172,000 223,255,000 224,976,000 226,719,000 224,558,000 148,148,000 131,424,000 133,648,000 135,459,000 145,388,000 152,028,000 158,429,000 161,378,000 180,377,000 115,121,000 128,058,000 108,720,000 106,843,000 93,111,000 97,156,000 61,844,000 62,735,000 65,949,000 69,561,000 28,891,000 
        property and equipment
      		48,554,000 49,555,000 51,204,000 52,928,000 52,622,000 50,596,000 54,765,000 53,482,000 48,721,000 41,048,000 40,236,000 40,071,000 36,916,000 34,286,000 36,313,000 36,601,000 31,068,000 28,515,000 28,783,000 28,242,000 28,342,000 27,227,000 24,275,000 24,131,000 24,078,000 21,349,000 21,532,000 20,915,000 16,789,000 12,768,000 12,774,000 12,770,000 12,280,000 10,391,000 9,749,000 
        other assets:
      		                                   
        amortizable intangible assets
      		63,802,000 64,802,000 63,262,000 62,950,000 62,348,000 64,427,000 65,955,000 67,848,000 70,382,000 69,275,000 69,513,000 71,932,000 64,642,000 64,980,000 66,285,000 58,777,000 53,476,000 55,494,000 54,904,000 50,552,000 50,901,000 50,284,000 48,898,000 42,206,000 15,121,000 14,484,000 10,200,000 10,458,000 1,846,000 1,921,000 2,000,000 2,080,000 2,154,000 2,089,000 2,183,000 
        goodwill
      		115,173,000 109,269,000 103,613,000 99,019,000 93,673,000 93,844,000 91,262,000 90,512,000 91,481,000 83,699,000 80,894,000 82,911,000 84,127,000 86,821,000 88,044,000 71,707,000 70,987,000 72,349,000 70,490,000 69,656,000 68,463,000 70,511,000 60,148,000 68,420,000 15,179,000 26,183,000 10,732,000 10,971,000        
        other intangible assets
      		12,914,000 12,909,000 15,941,000 17,082,000 16,736,000 16,752,000 18,744,000 18,669,000 18,792,000 15,287,000 15,008,000 16,087,000 15,629,000 14,921,000 14,854,000 15,708,000 14,040,000 14,268,000 13,957,000 13,817,000 13,618,000 13,961,000 13,305,000 13,357,000 4,700,000 4,490,000 2,240,000 2,170,000 260,000 260,000 260,000 260,000 260,000 260,000 260,000 
        other non-current assets
      		15,881,000 15,676,000 13,614,000 13,925,000 12,812,000 10,417,000 10,256,000 6,467,000 4,084,000 2,940,000 621,000 614,000                        
        total other assets
      		207,770,000 202,656,000 196,430,000 192,976,000 185,569,000 185,440,000 186,217,000 183,496,000 184,739,000 171,201,000 166,036,000 171,544,000 164,398,000 166,722,000 169,183,000 146,192,000 138,503,000 142,111,000 139,351,000 134,025,000 132,982,000 134,756,000 122,351,000 123,983,000 35,000,000 45,157,000 23,172,000 23,674,000 2,106,000 2,181,000 2,260,000 2,340,000 2,414,000 2,349,000 2,443,000 
        total assets
      		502,190,000 508,630,000 493,486,000 503,606,000 470,250,000 473,209,000 489,294,000 430,761,000 437,185,000 438,745,000 432,444,000 434,870,000 426,290,000 427,727,000 430,054,000 330,941,000 300,995,000 304,274,000 303,593,000 307,655,000 313,352,000 320,412,000 308,004,000 328,491,000 174,199,000 194,564,000 153,424,000 151,432,000 112,006,000 112,105,000 76,878,000 77,845,000 80,643,000 82,301,000 41,083,000 
        liabilities and stockholders' equity
      		                                   
        current liabilities:
      		                                   
        accounts payable - trade
      		19,701,000 18,786,000 7,164,000 12,687,000 14,199,000 8,908,000 11,647,000 17,002,000 19,736,000 12,649,000 22,587,000 20,890,000 16,692,000 11,150,000 10,881,000 14,591,000 14,578,000 9,325,000 8,972,000 10,142,000 12,009,000 10,038,000 6,904,000 6,003,000 8,262,000 6,467,000 7,746,000 6,000,000 6,344,000 3,971,000 5,903,000 5,455,000 7,197,000 5,495,000 5,102,000 
        accrued compensation and benefits
      		12,768,000 13,693,000 13,821,000 13,398,000 11,325,000 13,888,000 13,221,000 12,616,000 9,772,000 11,325,000 8,671,000 8,159,000 6,242,000 6,744,000 6,323,000 6,087,000 4,433,000 5,351,000 4,655,000 5,651,000 4,850,000 4,540,000 4,772,000 4,501,000 2,977,000 4,349,000 3,858,000 4,011,000 2,670,000 3,552,000 3,302,000 3,237,000 2,313,000 2,905,000 2,288,000 
        current portion of long-term debt with affiliate
      		172,000 170,000 166,000 164,000 162,000 160,000 158,000 156,000 154,000 152,000 150,000 148,000 146,000 144,000 143,000 141,000 139,000 137,000 136,000 134,000 132,000 131,000 129,000 128,000 126,000 124,000 123,000 121,000 120,000 118,000 117,000 115,000 114,000 113,000 111,000 
        current portion of acquisition installment payable
      		2,758,000 2,194,000 1,181,000 610,000 1,368,000 1,347,000 1,325,000 1,304,000 10,368,000 10,149,000 9,937,000 9,713,000 8,000,000 7,815,000 7,630,000 7,445,000 12,934,000 12,862,000 12,791,000 12,683,000 12,496,000 12,233,000 11,920,000 11,485,000            
        other current liabilities
      		11,784,000 11,354,000 10,900,000 11,807,000 10,451,000 9,659,000 8,274,000 8,491,000 5,790,000 7,391,000 6,582,000 5,401,000 4,138,000 5,018,000 3,769,000 2,949,000 2,249,000 2,040,000 1,464,000 1,719,000 1,886,000 1,744,000 2,022,000 2,654,000 2,467,000 2,723,000 1,372,000 1,537,000 1,689,000 1,576,000 1,594,000 1,683,000 946,000 954,000 2,915,000 
        total current liabilities
      		47,183,000 46,197,000 33,232,000 38,666,000 37,505,000 33,962,000 34,625,000 39,569,000 45,820,000 41,666,000 47,927,000 44,311,000 35,218,000 30,871,000 28,746,000 31,213,000 34,333,000 29,715,000 28,018,000 30,329,000 36,623,000 35,028,000 25,747,000 24,771,000 13,832,000 13,663,000 46,184,000 42,187,000 10,823,000 9,217,000 10,916,000 10,490,000 10,570,000 9,467,000 10,416,000 
        long-term liabilities:
      		                                   
        long-term term loan
      		48,312,000 48,189,000 48,065,000 47,942,000 24,013,000 23,957,000 23,948,000                             
        long-term convertible note
      		48,644,000 48,486,000 48,327,000 48,168,000 48,040,000 47,913,000 47,831,000                             
        long-term debt with affiliate, net of current portion
      		240,000 283,000 326,000 368,000 410,000 451,000 491,000 532,000 572,000 611,000 650,000 688,000 725,000 763,000 799,000 31,836,000 872,000 907,000 942,000 977,000 1,011,000 1,044,000 1,078,000 21,017,000 21,043,000 26,067,000 21,090,000 21,112,000 21,134,000 21,156,000 21,330,000 21,360,000 21,389,000 21,418,000 19,986,000 
        other long-term debt, net of current portion
      		3,191,000 2,862,000 2,456,000 526,000 563,000 635,000 244,000                             
        acquisition installment payable, net of current portion
      		2,961,000 2,898,000 227,000 224,000 2,493,000 2,452,000 2,412,000 2,371,000 3,613,000 3,551,000 3,489,000 3,427,000 8,215,000 8,019,000 7,822,000 7,626,000 14,690,000 14,309,000 13,927,000 13,546,000 13,165,000 12,784,000 12,402,000 12,021,000            
        deferred income taxes
      		3,355,000 3,582,000 3,804,000 3,525,000 3,389,000 3,381,000 4,025,000 4,739,000 5,202,000 5,483,000 5,492,000 5,564,000 6,022,000 5,954,000 5,457,000 6,280,000 4,335,000 4,771,000 4,848,000 5,060,000 5,233,000 5,755,000              
        other long-term liabilities
      		9,592,000 9,537,000 7,740,000 8,673,000 6,691,000 5,892,000 4,799,000 3,007,000 1,815,000 1,112,000 557,000 562,000 645,000 492,000 440,000 300,000 241,000 293,000 320,000 292,000 315,000 323,000 332,000 120,000 57,000  45,000         
        total long-term liabilities
      		116,295,000 115,837,000 110,945,000 109,426,000 85,599,000 84,681,000 83,750,000 19,899,000 20,781,000 20,054,000 10,188,000 10,247,000 17,917,000 18,208,000 17,978,000 72,512,000 51,618,000 49,190,000 54,457,000 55,725,000 54,584,000 50,616,000 42,821,000 61,258,000 21,100,000 38,540,000 21,135,000 21,163,000 21,134,000 21,156,000 25,277,000 25,298,000 25,319,000 25,339,000 27,486,000 
        total liabilities
      		163,478,000 162,034,000 144,177,000 148,092,000 123,104,000 118,643,000 118,375,000 59,468,000 66,601,000 61,720,000 58,115,000 54,558,000 53,135,000 49,079,000 46,724,000 103,725,000 85,951,000 78,905,000 82,475,000 86,054,000 91,207,000 85,644,000 68,568,000 86,029,000 34,932,000 52,203,000 67,319,000 63,350,000 31,957,000 30,373,000 36,193,000 35,788,000 35,889,000 34,806,000 37,902,000 
        stockholders' equity:
      		                                   
        common stock
      		6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 6,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 5,000 4,000 4,000 4,000 4,000 4,000 4,000 2,000 2,000 2,000 2,000 1,000 
        additional paid-in capital
      		626,009,000 622,325,000 618,041,000 613,790,000 604,989,000 600,897,000 597,009,000 593,087,000 583,086,000 580,287,000 577,540,000 574,677,000 562,769,000 560,810,000 559,339,000 418,354,000 396,425,000 394,899,000 392,929,000 391,415,000 390,000,000 388,622,000 387,117,000 385,510,000 274,578,000 271,182,000 210,479,000 209,262,000 198,478,000 197,442,000 153,649,000 153,055,000 152,601,000 150,424,000 9,541,000 
        accumulated deficit
      		-285,899,000 -275,212,000 -265,109,000 -253,336,000 -246,223,000 -235,564,000 -219,495,000 -211,576,000 -205,547,000 -197,742,000 -191,051,000 -186,460,000 -183,574,000 -176,768,000 -168,920,000 -187,459,000 -187,126,000 -178,026,000 -178,098,000 -175,901,000 -172,145,000 -161,766,000 -147,753,000 -143,214,000 -133,767,000 -128,822,000 -123,393,000 -120,729,000 -118,111,000 -115,091,000 -112,623,000 -110,758,000 -108,066,000 -103,066,000 -82,221,000 
        accumulated other comprehensive loss
      		-1,404,000 -523,000 -3,629,000 -4,946,000 -11,626,000 -10,773,000 -6,601,000 -10,224,000 -6,961,000 -5,526,000 -12,166,000 -7,911,000 -6,046,000           161,000 -1,361,000 -3,000 -985,000 -455,000 -322,000       
        total stockholders' equity
      		338,712,000 346,596,000 349,309,000 355,514,000 347,146,000 354,566,000 370,919,000 371,293,000 370,584,000 377,025,000 374,329,000 380,312,000 373,155,000 378,648,000 383,330,000 227,216,000 215,044,000 225,369,000 221,118,000 221,601,000 222,145,000 234,768,000 239,436,000 242,462,000 139,267,000 142,361,000 86,105,000 88,082,000 80,049,000 81,732,000 40,685,000 42,057,000 44,754,000 47,495,000  
        total liabilities and stockholders' equity
      		502,190,000 508,630,000 493,486,000 503,606,000 470,250,000 473,209,000 489,294,000 430,761,000 437,185,000 438,745,000 432,444,000 434,870,000 426,290,000 427,727,000 430,054,000 330,941,000 300,995,000 304,274,000 303,593,000 307,655,000 313,352,000 320,412,000 308,004,000 328,491,000 174,199,000 194,564,000 153,424,000 151,432,000 112,006,000 112,105,000 76,878,000 77,845,000 80,643,000   
        accounts receivable - trade, net of allowances of 1,501 and 1,145, respectively
      		 53,838,000                                  
        commitments and contingencies
      		                                   
        accounts receivable - trade, net of allowances of 1,486 and 1,145, respectively
      		  51,274,000                                 
        accounts receivable - trade, net of allowances of 1,410 and 1,145, respectively
      		   53,797,000                                
        accounts receivable - trade, net of allowances of 1,242 and 1,145, respectively
      		    43,993,000                               
        accounts receivable - trade, net of allowances of 1,145 and 1,373, respectively
      		     42,357,000                              
        cash and cash equivalents
      		      51,047,000 28,927,000 21,602,000 31,055,000 10,640,000 9,713,000 34,656,000   37,198,000 17,957,000 7,641,000 6,334,000 10,565,000 21,426,000 28,758,000              
        accounts receivable - trade, net of allowances of 1,025 and 1,373, respectively
      		      42,827,000                             
        accounts receivable - trade, net of allowances of 1,026 and 1,373, respectively
      		       42,028,000                            
        long-term debt
      		       9,250,000 9,579,000 9,297,000                          
        accounts receivable - trade, net of allowances of 1,195 and 1,373, respectively
      		        36,275,000                           
        short term investments
      		         49,251,000    109,299,000 84,710,000 13,963,000 27,068,000 45,902,000 51,349,000 55,288,000 55,209,000 55,141,000              
        accounts receivable - trade, net of allowances of 1,373 and 1,056, respectively
      		         34,617,000                          
        contingent consideration
      		           6,000 2,310,000 2,980,000 3,460,000 26,470,000 31,480,000 28,910,000 34,420,000 35,850,000 34,860,000 30,710,000 29,009,000 28,100,000            
        accounts receivable - trade, net of allowances of 1,412 and 1,056, respectively
      		          37,647,000                         
        accounts receivable - trade, net of allowances of 1,097 and 1,056, respectively
      		           33,849,000                        
        accounts receivable - trade, net of allowances of 942 and 1,056, respectively
      		            26,838,000                       
        accounts receivable - trade, less allowance for doubtful accounts of 1,056 and 347, respectively
      		             24,800,000                      
        accumulated other comprehensive income
      		             -5,400,000 -7,095,000 -3,684,000 5,740,000 8,491,000 6,282,000 6,082,000 4,285,000 7,907,000 67,000        -343,000 -242,000 217,000 135,000 193,000 
        accounts receivable - trade, less allowance for doubtful accounts of 608 and 347, respectively
      		              26,184,000                     
        accounts receivable - trade, less allowance for doubtful accounts of 412 and 347, respectively
      		               25,434,000                    
        accounts receivable - trade, less allowance for doubtful accounts of 357 and 347, respectively
      		                17,911,000                   
        accounts receivable - trade, less allowance for doubtful accounts of 347 and 433, respectively
      		                 17,942,000                  
        notes receivable
      		                  59,000 95,000 323,000 337,000 476,000 656,000 582,000 564,000 545,000 515,000 508,000 502,000      
        accrued legal settlements
      		                    5,250,000 6,342,000              
        accounts receivable - trade, less allowance for doubtful accounts of 373 and 433, respectively
      		                  18,146,000                 
        accounts receivable - trade, less allowance for doubtful accounts of 372 and 433, respectively
      		                   19,222,000                
        accounts receivable - trade, less allowance for doubtful accounts of 361 and 433, respectively
      		                    16,551,000               
        accounts receivable - trade, less allowance for doubtful accounts of 433 and 506, respectively
      		                     17,212,000              
        accounts receivable - trade, less allowance for doubtful accounts of 208 and 506, respectively
      		                      17,064,000             
        accounts receivable - trade, less allowance for doubtful accounts of 185 and 506, respectively
      		                       14,897,000            
        accounts receivable - trade, less allowance for doubtful accounts of 176 and 506, respectively
      		                        14,118,000           
        treasury stock
      		                        -187,000           
        accounts receivable - trade, less allowance for doubtful accounts of 506 and 134, respectively
      		                         16,003,000          
        operating lease liabilities
      		                         63,000  24,000        
        deferred revenue
      		                         12,410,000          
        accounts receivable - trade, less allowance for doubtful accounts of 365 and 134, respectively
      		                          14,182,000         
        current assets held for sale
      		                          38,168,000 35,364,000        
        short-term debt with affiliate
      		                          30,000,000 30,000,000        
        current liabilities held for sale
      		                          3,085,000 494,000        
        accounts receivable - trade, less allowance for doubtful accounts of 218 and 134, respectively
      		                           14,974,000        
        operating lease right-of-use asset
      		                           75,000        
        operating lease liabilities, net of current portion
      		                           51,000        
        accounts receivable - trade, less allowance for doubtful accounts of 134 and 134, respectively
      		                            10,296,000       
        accounts receivable - trade, less allowance for doubtful accounts of 134 and 143, respectively
      		                             8,999,000      
        inventories held by international distributors
      		                             167,000 234,000 595,000 1,402,000 1,047,000 579,000 
        revolving credit facility with affiliate
      		                              3,947,000 3,938,000 3,930,000 3,921,000 7,500,000 
        accumulated other comprehensive (loss) income
      		                             -623,000      
        accounts receivable - trade, less allowance for doubtful accounts of 131 and 143, respectively
      		                              9,456,000 9,755,000 6,838,000   
        accounts receivable - trade, less allowance for doubtful accounts of 143 and 152, respectively
      		                                 5,603,000  
        liabilities, redeemable convertible preferred stock and stockholders' equity
      		                                   
        redeemable convertible preferred stock
      		                                   
        series a preferred stock, 0.00025 par value; 0 cumulative preferred dividends, december 31, 2017 and 7,439 december 31, 2016; 0 and 1,000,000 shares authorized, issued and outstanding as of december 31, 2017 and 2016, respectively
      		                                   
        series b preferred stock, 0.00025 par value; 0 cumulative preferred dividends, december 31, 2017 and 8,864 december 31, 2016; 0 and 6,000,000 shares authorized as of december 31, 2017 and 2016, respectively; 0 and 4,446,978 shares issued and outstanding as of december 31, 2017 and 2016, respectively
      		                                   
        stockholders' equity
      		                                   
        total liabilities, redeemable convertible preferred stock and stockholders' equity
      		                                 82,301,000  
        accounts receivable - trade, less allowance for doubtful accounts of 148 and 152, respectively
      		                                  5,686,000 
        deferred charges
      		                                  1,339,000 
        liabilities, redeemable convertible preferred stock and stockholders' deficit
      		                                   
        series a preferred stock, 0.00025 par value; 8,874 cumulative preferred dividends, september 30, 2017 and 7,439 december 31, 2016; 1,000,000 shares authorized, issued and outstanding
      		                                  24,874,000 
        series b preferred stock, 0.00025 par value; 11,793 cumulative preferred dividends, september 30, 2017 and 8,864 december 31, 2016; 6,000,000 shares authorized; 4,446,978 shares issued and outstanding
      		                                  50,793,000 
        stockholders' deficit:
      		                                   
        total stockholders' deficit
      		                                  -72,486,000 
        total liabilities, redeemable convertible preferred stock and stockholders' deficit
      		                                  41,083,000 
      Cashflow Statements:
      Quarterly
      Annual
        Unit: USD2026-03-31 2025-12-31 2025-09-30 2025-06-30 2025-03-31 2024-12-31 2024-09-30 2024-06-30 2024-03-31 2023-12-31 2023-09-30 2023-06-30 2023-03-31 2022-12-31 2022-09-30 2022-06-30 2022-03-31 2021-12-31 2021-09-30 2021-06-30 2021-03-31 2020-12-31 2020-09-30 2020-06-30 2020-03-31 2019-12-31 2019-09-30 2019-06-30 2019-03-31 2018-12-31 2018-09-30 2018-06-30 2018-03-31 2017-12-31 
                                          
          operating activities
        		                                  
          net loss
        		-10,687,000 -10,103,000 -11,773,000 -7,113,000 -10,659,000  -7,919,000 -6,029,000 -7,805,000   -2,886,000 -6,806,000   -333,000 -9,100,000 72,000 -2,197,000 -3,756,000 -10,379,000 -14,013,000 -4,539,000 -9,447,000 -4,945,000 -5,429,000 -2,664,000 -2,618,000 -3,020,000 -2,468,000 -1,865,000 -2,692,000 -5,000,000 -4,845,000 
          adjustments to reconcile net loss to net cash from operating activities:
        		                                  
          depreciation and amortization
        		5,721,000 5,602,000 5,299,000 5,170,000 5,048,000 3,993,000 5,280,000 4,779,000 5,028,000 5,187,000 4,270,000 4,080,000 3,848,000 3,520,000 3,287,000 3,331,000 2,961,000 2,810,000 2,723,000 2,608,000 2,539,000 2,314,000 2,411,000 1,910,000 1,375,000 1,413,000 1,346,000 1,084,000 828,000 715,000 777,000 719,000 681,000 657,000 
          stock-based compensation
        		3,982,000 4,416,000 4,251,000 5,252,000 3,859,000 3,888,000 3,922,000 2,939,000 2,799,000 2,747,000 2,364,000 3,302,000 2,113,000 1,701,000 1,682,000 1,770,000 1,526,000 1,672,000 1,439,000 1,415,000 1,316,000 1,484,000 1,259,000 2,495,000 958,000 707,000 733,000 692,000 471,000 286,000 268,000 454,000 2,177,000 2,397,000 
          accretion of acquisition installment payable
        		72,000 -16,000 7,000 36,000 62,000 62,000 62,000 256,000 281,000 280,000 280,000 431,000 381,000                      
          deferred income taxes
        		-314,000 -273,000 -125,000 49,000 196,000 -829,000 -952,000 -510,000 -2,445,000 -264,000 76,000 -401,000 -574,000 -228,000 -4,048,000 -439,000 -317,000 -238,000 -288,000 -290,000 -312,000              
          non-cash other
        		50,000 332,000 12,000 -239,000 139,000                              
          changes in certain operating assets and liabilities:
        		                                  
          accounts receivable - trade
        		-183,000 -1,096,000 3,111,000 -9,884,000 -1,497,000 429,000 -595,000 -5,738,000 1,155,000 3,154,000 -3,914,000 -6,962,000 -2,002,000 1,584,000 1,047,000 -6,616,000 2,000 250,000 1,065,000 -2,434,000 653,000 -62,000 -1,998,000 849,000 760,000 -694,000 373,000 -4,319,000 -1,180,000 276,000 75,000 -2,917,000 -1,235,000 83,000 
          inventories
        		139,000 -576,000 1,006,000 -6,993,000 -1,906,000 957,000 -3,734,000 -3,789,000 -6,631,000 -4,081,000 -10,338,000 -5,881,000 -5,979,000 -2,126,000 -3,907,000 -4,155,000 -6,750,000 -1,806,000 53,000 -789,000 -2,508,000 270,000 -2,741,000 -4,503,000 -5,096,000 -3,276,000 -1,185,000 -3,020,000 -2,286,000 406,000 -1,363,000 -2,522,000 -2,202,000 -1,011,000 
          prepaid expenses and other current assets
        		-483,000 238,000 677,000 18,000 -519,000 573,000 -1,731,000 550,000 -953,000 290,000 -268,000 105,000 -33,000 -1,202,000 139,000 445,000 112,000 -499,000 -244,000 -602,000 708,000 -504,000 -281,000 122,000 -56,000 223,000 -346,000 182,000 -196,000 -211,000 18,000 51,000 -283,000 -216,000 
          accounts payable - trade
        		704,000 10,128,000 -5,681,000 -1,487,000 5,207,000 -2,512,000 -5,918,000 -2,412,000 6,562,000 -10,001,000 1,768,000 4,183,000 5,541,000 180,000 -5,687,000 40,000 5,258,000 389,000 -1,147,000 -1,867,000 2,058,000 2,916,000 901,000 -2,485,000 1,739,000 -1,279,000 1,746,000 -439,000 2,373,000 -1,932,000 448,000 -1,742,000 1,702,000 393,000 
          accrued expenses and other liabilities
        		-3,571,000 458,000 -1,719,000 5,037,000 -2,528,000 229,000 -651,000 6,008,000 -5,049,000 3,564,000 1,963,000 2,896,000 -1,571,000 1,544,000 667,000 1,823,000 -690,000 1,263,000 -1,248,000 634,000 446,000 -516,000 -429,000 1,565,000 -1,694,000 1,935,000 -346,000 1,076,000 -719,000 149,000 -263,000 1,661,000 -600,000 -255,000 
          other
        		1,283,000 -1,111,000 191,000 -308,000 -1,558,000 3,366,000 -1,273,000 -2,146,000 368,000 -1,722,000 -1,264,000 -936,000 -709,000 -367,000 1,243,000 -118,000 -222,000 -91,000 -152,000 -203,000 -138,000 -61,000 26,000 -53,000 3,000 -2,000 -138,000 11,000 128,000 -16,000 362,000 -459,000 82,000 -58,000 
          net cash from operating activities
        		-3,287,000 10,348,000 -581,000 -10,462,000 -4,156,000 -3,987,000 -10,279,000 -6,092,000 -6,690,000 -7,543,000 -8,669,000 -4,373,000 -6,461,000 -3,341,000 -6,058,000 -8,170,000 -4,197,000 -1,235,000 -937,000 -8,976,000 -1,915,000 -157,000 -3,666,000 -7,751,000 -6,956,000 -6,926,000 -429,000 -6,943,000 -3,471,000 -2,728,000 -1,182,000 -6,640,000 -5,033,000 -3,323,000 
          capital expenditures
        		-1,760,000 -599,000 -2,839,000 -3,445,000 -4,227,000 262,000 -1,381,000 -6,684,000 -6,460,000 -3,836,000 -2,479,000 -5,623,000 -4,940,000 523,000 -1,089,000 -5,268,000 -4,197,000 -1,635,000 -1,994,000 -1,725,000 -2,749,000 -4,056,000 -1,288,000 -1,207,000 -3,953,000 -1,280,000 -2,022,000 -3,551,000 -4,963,000 58,000 -1,144,000 -1,396,000 -2,771,000 -1,258,000 
          free cash flows
        		-5,047,000 9,749,000 -3,420,000 -13,907,000 -8,383,000 -3,725,000 -11,660,000 -12,776,000 -13,150,000 -11,379,000 -11,148,000 -9,996,000 -11,401,000 -2,818,000 -7,147,000 -13,438,000 -8,394,000 -2,870,000 -2,931,000 -10,701,000 -4,664,000 -4,213,000 -4,954,000 -8,958,000 -10,909,000 -8,206,000 -2,451,000 -10,494,000 -8,434,000 -2,670,000 -2,326,000 -8,036,000 -7,804,000 -4,581,000 
          investing activities
        		                                  
          other acquisitions, including clinics, net of cash acquired
        		-6,777,000                                  
          sale of short-term marketable securities
        		5,000,000     0 0 26,381,000 23,474,000 23,864,000 16,693,000 35,097,000 37,250,000 1,343,000 13,929,000 13,100,000 18,500,000                  
          investment in private companies and purchases of licenses
        		-250,000                                  
          purchases of property and equipment
        		-1,760,000 -599,000 -2,839,000 -3,445,000 -4,227,000 262,000 -1,381,000 -6,684,000 -6,460,000 -3,836,000 -2,479,000 -5,623,000 -4,940,000 523,000 -1,089,000 -5,268,000 -4,197,000 -1,635,000 -1,994,000 -1,725,000 -2,749,000 -4,056,000 -1,288,000 -1,207,000 -3,953,000 -1,280,000 -2,022,000 -3,551,000 -4,963,000 58,000 -1,144,000 -1,396,000 -2,771,000 -1,258,000 
          net cash from investing activities
        		-3,787,000 -7,259,000 -26,838,000 -3,545,000 -5,987,000 -2,412,000 -26,768,000 19,697,000 -3,679,000 17,922,000 9,668,000 -18,223,000 32,310,000 -23,227,000 -103,919,000 -528,000 14,303,000 2,965,000 -3,044,000 -1,725,000 -5,607,000 -59,056,000 -1,288,000 -3,726,000 -5,623,000 -1,529,000 -1,736,000 -53,675,000 -4,982,000 -459,000 -1,159,000 -1,417,000 -2,930,000 -1,258,000 
          financing activities
        		                                  
          payments on mortgage notes
        		-41,000 -39,000 -41,000 -39,000 -39,000 -39,000 -42,000 -36,000 -35,000 -37,000 -36,000 -35,000 -36,000 -35,000 -35,000 -34,000 -33,000 -34,000 -33,000 -32,000 -32,000 -37,000 -27,000 -30,000 -31,000 -30,000 -29,000 -30,000 -29,000 -29,000 -28,000 -28,000 -28,000 2,000 
          payments on acquisition notes
        		-573,000                                  
          net cash from financing activities
        		-614,000 -417,000 -282,000 24,800,000 -126,000 -541,000 58,518,000 -4,269,000 -573,000 9,387,000 -15,000 -2,035,000 -36,000 -35,000 108,268,000 27,774,000 -33,000 -34,000 42,000 -32,000 30,000 -16,000 -19,679,000 70,957,000 -4,530,000 59,966,000 455,000 30,062,000 536,000 39,415,000 298,000 -28,000 -28,000 44,925,000 
          effect of exchange rate changes on cash, cash equivalents and restricted cash
        		313,000  -20,000 383,000 -79,000  684,000 -2,010,000 1,479,000  -61,000 -197,000 -138,000                      
          net decrease in cash, cash equivalents and restricted cash
        		-7,375,000    -10,348,000                              
          cash, cash equivalents and restricted cash, beginning of year
        		21,620,000  0 0 45,777,000  0 0 33,027,000  0 0 10,462,000                      
          cash, cash equivalents and restricted cash, end of period
        		14,245,000  -27,721,000 11,176,000 35,429,000  22,155,000 7,326,000 23,564,000  923,000 -24,828,000 36,137,000                      
          supplemental disclosures
        		                                  
          cash paid for interest
        		1,869,000    1,269,000   537,000 223,000   0 11,000   47,000 13,000    15,000    379,000 1,997,000 1,297,000 632,000 303,000 533,000 608,000 562,000 552,000 634,000 
          transfer of instruments between property and equipment and inventory
        		-126,000    -461,000   164,000 117,000                          
          right-of-use assets obtained in exchange for lease liabilities
        		793,000    1,682,000                              
          issuance of common shares in connection with loc acquisition
        		257,000                                  
          issuance of common shares in connection with boston o&p acquisition
        		    233,000                              
          debt issuance costs not yet paid
        		289,000                                  
          adjustments to reconcile net income to net cash from operating activities:
        		                                  
          goodwill and other intangible asset impairments
        		 2,349,000                                 
          loss on early extinguishment of debt
        		     0                             
          fair value adjustment of contingent consideration
        		         -6,000 0 -2,304,000 -670,000 -480,000 -23,010,000 -5,010,000 2,570,000 -5,510,000 -1,430,000 990,000 4,150,000 1,701,000 909,000            
          changes in certain operating assets and liabilities, net of acquisitions:
        		                                  
          acquisition of boston o&p, net of cash acquired
        		     0 468,000 0 -20,693,000                          
          acquisition of medtech, net of cash acquired
        		                                  
          acquisition of rhino assets
        		                                  
          purchase of short-term marketable securities
        		 0    0    0 -4,000,000   -25,093,000                     
          proceeds from issuance of debt
        		 0 0   0                             
          payment of debt issuance costs
        		     -322,000 -2,742,000                            
          proceeds from exercise of stock options
        		         0    0 21,000   0 75,000 0 62,000 21,000 348,000 593,000 688,000 0 484,000 92,000 565,000 84,000     
          installment payment for apifix
        		     0 0   0 0   0 0                    
          installment payment for medtech
        		     0 0                            
          payments on clinic acquisition notes
        		 -378,000 -241,000 -161,000 -87,000                              
          payment on debt
        		     0                             
          effect of exchange rate changes on cash
        		             193,000 26,000 159,000 241,000 -392,000 -295,000 -126,000 155,000 -380,000 -41,000 -6,000 23,000          
          net increase in cash and restricted cash
        		             -26,410,000                     
          cash and restricted cash, beginning of period
        		                                  
          cash and restricted cash, end of period
        		             -26,410,000 -1,683,000 19,235,000 19,320,000 1,304,000 -4,234,000 -10,859,000 22,795,000 -59,609,000 -24,674,000 59,474,000 54,941,000          
          acquisitions, net of cash acquired
        		                                  
          investment in private companies
        		  -467,000 0 -1,540,000                              
          net increase in cash, cash equivalents and restricted cash
        		  -27,721,000    22,155,000 7,326,000 -9,463,000  923,000 -24,828,000 25,675,000                      
          clinic acquisition, net of cash acquired
        		   -100,000 -220,000                              
          net income
        		         -6,691,000    -7,848,000                     
          impairment
        		                                  
          clinic acquisitions, net of cash acquired
        		                                  
          acquisition of mdo, net of cash acquired
        		                                  
          acquisition of pega, net of cash acquired
        		             0                     
          payments on debt with affiliate
        		             0                     
          proceeds from issuance of debt with affiliate
        		             0 0           0 0       -2,147,000 
          proceeds from issuance of common stock, net of issuance costs
        		             0        0 0            
          tradename impairment
        		                                  
          payments on acquisition note
        		      0 -390,000 -538,000                          
          acquisition of medtech
        		          0                        
          issuance of common shares for apifix installment
        		                                  
          issuance of common shares for medtech installment
        		                                  
          trademark impairment
        		         0    0                     
          changes in certain current assets and liabilities:
        		                                  
          accrued legal settlements
        		                 0 0 -5,250,000 -1,092,000              
          acquisition of devise ortho assets
        		                                  
          purchases of licenses
        		                 0 -5,050,000 0 -2,858,000     -100,000 0 -151,000 -19,000 -15,000 -15,000 -21,000 -159,000 0 
          acquisition of md ortho, net of cash acquired
        		              0                    
          acquisition of pega medical, net of cash acquired
        		                                  
          acquisition of rhino
        		                                  
          issuance of common shares to acquire md ortho
        		                                  
          issuance of common shares to acquire medtech
        		                                  
          transfer of instruments from property and equipment to inventory
        		            332,000   -76,000 -54,000    57,000    182,000 444,000 326,000 50,000 217,000 -699,000 467,000 290,000 304,000 53,000 
          acquisition installment payable
        		             381,000 381,000 1,092,000 453,000 453,000 489,000 568,000 644,000 695,000 816,000            
          acquisition of telos, net of cash acquired
        		                     0 0 0 -1,670,000          
          acquisition of apifix, net of cash acquired
        		                     0 0            
          acquisition of band-lok intangible assets
        		                     0 0            
          cash and restricted cash, beginning of year
        		              0 0 9,006,000  0 0 30,132,000  0 0 72,027,000          
          net increase in cash
        		               19,235,000 10,314,000  -4,234,000    -24,674,000       36,228,000 -2,043,000 -8,085,000 -7,991,000 40,344,000 
          loss on sale of discontinued operations
        		                                  
          net cash from operating activities - continuing operations
        		                     -157,000 -3,666,000   -6,192,000 -648,000        
          net cash used by operating activities - discontinued operations
        		                                  
          acquisition of vilex and orthex, net of cash acquired
        		                          239,000        
          sale of short term investments
        		                                  
          purchase of short term investments
        		                                  
          payments on note with affiliate
        		                       0 -5,000,000          
          repurchases of common shares
        		                        -187,000          
          net decrease in cash
        		                    -7,337,000    -17,086,000  -1,710,000 -30,556,000 -7,917,000      
          issuance of common shares to acquire telos
        		                        1,750,000          
          purchase of notes receivable
        		                                  
          payment of revolving credit facility with affiliate
        		                                  
          net cash from operating activities - discontinued operations
        		                          219,000        
          less cash of discontinued operations, end of period
        		                          479,000        
          cash of continuing operations, end of period
        		                      -24,674,000    -2,189,000        
          net cash from investing activities - continuing operations
        		                                  
          net cash from investing activities - discontinued operations
        		                                  
          acquisition of vilex, net of cash acquired
        		                                  
          payment of preferred stock dividends
        		                                  
          shares surrendered by employees to pay taxes on restricted shares
        		                                  
          cash, beginning of year
        		                         0 0 0 60,691,000 0 0 0 42,582,000 0 
          accretion of redeemable convertible preferred stock
        		                                 199,000 
          acquisition consideration of common shares
        		                         0 0        
          intellectual property license
        		                                  
          divestiture consideration allocated to assets held for sale
        		                                  
          payment of term note b with revolving credit facility
        		                                  
          cash, end of period
        		                          -1,710,000 -30,556,000 52,774,000 36,228,000 -2,043,000 -8,085,000 34,591,000 40,344,000 
          inventories held by international distributors
        		                           37,000 130,000 67,000 361,000 807,000 -355,000 -468,000 
          research and development fee obligation
        		                                  
          payments of deferred offering costs
        		                                  
          loss on sale of assets held for sale
        		                                  
          proceeds from assets held for sale
        		                                  
          research and development fee obligation termination