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Orthofix Medical Inc
(NASDAQ:OFIX) 

OFIX stock logo

Orthofix Medical Inc. operates as a medical device and biologics company in the United States, Italy, Germany, the United Kingdom, Brazil, and internationally. It operates through two segments, Global Spine and Global Extremities. The Global Spine segment manufactures, distributes, and provides supp...

Founded: 1980
Full Time Employees: 1,055
Sector: Healthcare
Industry: Medical Devices

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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 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2014-06-30 2013-12-31 2013-09-30 2013-03-31 2012-12-31 2012-09-30 2012-06-30 2012-03-31 2011-09-30 2010-09-30 2010-06-30 2010-03-31 2009-12-31 2008-09-30 2008-06-30 2008-03-31 2007-12-31 2007-09-30 2007-06-30 2007-03-31 2006-12-31 2006-09-30 2006-06-30 2006-03-31 
                                                                           
      net sales
    196,708,000 219,911,000 205,634,000 203,121,000 193,646,000 215,657,000 196,606,000 198,620,000 188,608,000 200,415,000 184,006,000 187,016,000 175,204,000 122,229,000 113,996,000 118,070,000 106,418,000 125,064,000 112,428,000 121,394,000 105,593,000 117,619,000 110,985,000 73,135,000 104,823,000 121,494,000 113,499,000 115,850,000 109,112,000 121,078,000 111,708,000 111,547,000 108,709,000 116,896,000 105,247,000 108,942,000 102,738,000 108,537,000 98,497,000 104,075,000 98,679,000 104,622,000 101,151,000 100,954,000 89,762,000 100,344,000 100,994,000 100,985,000 106,143,000 92,738,000 100,254,000 112,034,000 114,752,000 119,492,000 143,141,000 144,747,000 138,906,000 142,845,000 138,823,000 158,263,000 129,301,000 130,039,000 128,032,000 128,835,000 121,120,000 123,336,000 117,032,000 116,140,000 83,368,000 84,735,000 81,116,000 
      yoy
    1.58% 1.97% 4.59% 2.27% 2.67% 7.61% 6.85% 6.20% 7.65% 63.97% 61.41% 58.39% 64.64% -2.27% 1.39% -2.74% 0.78% 6.33% 1.30% 65.99% 0.73% -3.19% -2.21% -36.87% -3.93% 0.34% 1.60% 3.86% 0.37% 3.58% 6.14% 2.39% 5.81% 7.70% 6.85% 4.68% 4.11% 3.74% -2.62% 3.09% 9.93% 4.26% 0.16% -0.03% -15.43% 8.20% 0.74% -9.86% -7.50% -22.39% -29.96% -22.60% -17.39% -16.35% 3.11% -8.54% 7.43% 9.85% 8.43% 22.84% 6.75% 5.43% 9.40% 10.93% 45.28% 45.55% 44.28%     
      qoq
    -10.55% 6.94% 1.24% 4.89% -10.21% 9.69% -1.01% 5.31% -5.89% 8.92% -1.61% 6.74% 43.34% 7.22% -3.45% 10.95% -14.91% 11.24% -7.39% 14.96% -10.22% 5.98% 51.75% -30.23% -13.72% 7.04% -2.03% 6.18% -9.88% 8.39% 0.14% 2.61% -7.00% 11.07% -3.39% 6.04% -5.34% 10.19% -5.36% 5.47% -5.68% 3.43% 0.20% 12.47% -10.55% -0.64% 0.01% -4.86% 14.45% -7.50% -10.51% -2.37% -3.97% -16.52% -1.11% 4.21% -2.76% 2.90% -12.28% 22.40% -0.57% 1.57% -0.62% 6.37% -1.80% 5.39% 0.77% 39.31% -1.61% 4.46%  
      cost of sales
    57,162,000 63,569,000 57,111,000 63,588,000 72,027,000 66,816,000 61,553,000 63,871,000 61,366,000 63,785,000 64,243,000 67,465,000 64,875,000 33,053,000 30,573,000 31,600,000 28,318,000 33,254,000 28,307,000 27,439,000 25,914,000 29,071,000 26,243,000 23,166,000 23,409,000 26,191,000 24,896,000 25,812,000 23,708,000 25,626,000 24,020,000 22,835,000 24,147,000 23,562,000 23,717,000 23,177,000 22,581,000 23,320,000 19,880,000 22,515,000 22,136,000 21,411,000 23,865,000 21,910,000 19,339,000 21,457,000 25,268,000 25,414,000 32,517,000 23,920,000 22,699,000 18,503,000 22,373,000 23,676,000 32,882,000 36,029,000 32,266,000 34,087,000 32,694,000 21,166,000 47,998,000 35,048,000 34,238,000 34,486,000 30,742,000 33,008,000 30,796,000 29,960,000 21,007,000 21,199,000 21,459,000 
      gross profit
    139,546,000 156,342,000 148,523,000 139,533,000 121,619,000 148,841,000 135,053,000 134,749,000 127,242,000 136,630,000 119,763,000 119,551,000 110,329,000 89,176,000 83,423,000 86,470,000 78,100,000 91,810,000 84,121,000 93,955,000 79,679,000 88,548,000 84,742,000 49,969,000 81,414,000 95,303,000 88,603,000 90,038,000 85,404,000 95,452,000 87,688,000 88,712,000 84,562,000 93,334,000 81,530,000 85,765,000 80,157,000 85,217,000 78,617,000 81,560,000 76,543,000 83,211,000 77,286,000 79,044,000 70,423,000 78,827,000 75,726,000 75,571,000 73,626,000 68,818,000 77,555,000 93,531,000 92,379,000 95,816,000 110,259,000 108,718,000 106,640,000 108,758,000 106,129,000 137,097,000 81,303,000 94,991,000 93,794,000 94,349,000 90,378,000 90,328,000 86,236,000 86,180,000 62,361,000 63,536,000 59,657,000 
      yoy
    14.74% 5.04% 9.97% 3.55% -4.42% 8.94% 12.77% 12.71% 15.33% 53.21% 43.56% 38.26% 41.27% -2.87% -0.83% -7.97% -1.98% 3.68% -0.73% 88.03% -2.13% -7.09% -4.36% -44.50% -4.67% -0.16% 1.04% 1.49% 1.00% 2.27% 7.55% 3.44% 5.50% 9.53% 3.71% 5.16% 4.72% 2.41% 1.72% 3.18% 8.69% 5.56% 2.06% 4.60% -4.35% 14.54% -2.36% -19.20% -20.30% -28.18% -29.66% -13.97% -13.37% -11.90% 3.89% -20.70% 31.16% 14.49% 13.15% 45.31% -10.04% 5.16% 8.76% 9.48% 44.93% 42.17% 44.55%     
      qoq
    -10.74% 5.26% 6.44% 14.73% -18.29% 10.21% 0.23% 5.90% -6.87% 14.08% 0.18% 8.36% 23.72% 6.90% -3.52% 10.72% -14.93% 9.14% -10.47% 17.92% -10.02% 4.49% 69.59% -38.62% -14.57% 7.56% -1.59% 5.43% -10.53% 8.85% -1.15% 4.91% -9.40% 14.48% -4.94% 7.00% -5.94% 8.40% -3.61% 6.55% -8.01% 7.67% -2.22% 12.24% -10.66% 4.10% 0.21% 2.64% 6.99% -11.27% -17.08% 1.25% -3.59% -13.10% 1.42% 1.95% -1.95% 2.48% -22.59% 68.62% -14.41% 1.28% -0.59% 4.39% 0.06% 4.75% 0.06% 38.20% -1.85% 6.50%  
      gross margin %
    70.94% 71.09% 72.23% 68.69% 62.80% 69.02% 68.69% 67.84% 67.46% 68.17% 65.09% 63.93% 62.97% 72.96% 73.18% 73.24% 73.39% 73.41% 74.82% 77.40% 75.46% 75.28% 76.35% 68.32% 77.67% 78.44% 78.07% 77.72% 78.27% 78.84% 78.50% 79.53% 77.79% 79.84% 77.47% 78.73% 78.02% 78.51% 79.82% 78.37% 77.57% 79.53% 76.41% 78.30% 78.46% 78.56% 74.98% 74.83% 69.36% 74.21% 77.36% 83.48% 80.50% 80.19% 77.03% 75.11% 76.77% 76.14% 76.45% 86.63% 62.88% 73.05% 73.26% 73.23% 74.62% 73.24% 73.69% 74.20% 74.80% 74.98% 73.55% 
      sales, general, and administrative
    134,911,000 136,753,000 148,102,000 136,493,000 132,981,000                                                                   
      research and development
    15,320,000 15,373,000 14,774,000 15,934,000 19,766,000 18,808,000 17,294,000 18,049,000 19,492,000 18,941,000 18,559,000 19,424,000 23,307,000 13,152,000 11,943,000 12,758,000 11,212,000 13,243,000 12,360,000 13,121,000 10,897,000 10,365,000 9,962,000 8,765,000 9,964,000 8,446,000 7,982,000 8,980,000 9,229,000 8,792,000 9,598,000 7,891,000 6,937,000 8,454,000 6,935,000 6,887,000 7,424,000 7,509,000 6,858,000 6,792,000 7,636,000 7,570,000 6,523,000 6,451,000 5,845,000 6,176,000 6,572,000 6,313,000 6,115,000 6,361,000 5,400,000 5,417,000 6,858,000 9,252,000 7,745,000 6,555,000 7,375,000 8,370,000 7,528,000 12,060,000 6,447,000 6,599,000 6,354,000 4,578,250 5,953,000 6,023,000 6,337,000 12,137,500 42,865,000 2,721,000 2,964,000 
      acquisition-related amortization, impairment, and remeasurement
    3,751,000 3,722,000 2,693,000 3,109,000 17,745,000                                                                   
      operating income
    -14,436,000 494,000 -17,046,000 -16,003,000 -48,873,000 -11,477,000 -18,899,000 -24,906,000 -29,337,000 -18,315,000 -24,449,000 -36,632,000 -59,714,000 -556,000 -5,787,000 6,641,000 -3,078,000 -9,353,000 -313,000 4,267,000 -2,916,000 3,705,000 4,175,000 -21,000,000 6,854,000 4,095,000 -18,882,000 451,000 -4,448,000 12,399,000 3,907,000 7,024,000 7,873,000 17,860,000 9,034,000 7,998,000 5,919,000 7,416,000 9,271,000 -2,638,000 7,128,000 7,380,000 4,139,000 4,928,000 -7,192,000 3,953,000 6,508,000 6,704,000 -6,378,000 -15,600,000 4,024,000 24,481,000 21,533,000 20,565,000 22,044,000 23,015,000 18,994,000 21,210,000 31,945,000 330,264,000 -289,517,000 11,537,000 11,591,000 11,587,750 15,791,000 15,618,000 14,942,000 -931,500 -30,457,000 15,071,000  
      yoy
    -70.46% -104.30% -9.80% -35.75% 66.59% -37.34% -22.70% -32.01% -50.87% 3194.06% 322.48% -651.60% 1840.03% -94.06% 1748.88% 55.64% 5.56% -352.44% -107.50% -120.32% -142.54% -9.52% -122.11% -4756.32% -254.09% -66.97% -583.29% -93.58% -156.50% -30.58% -56.75% -12.18% 33.01% 140.83% -2.56% -403.18% -16.96% 0.49% 123.99% -153.53% -199.11% 86.69% -36.40% -26.49% 12.76% -125.34% 61.73% -72.62% -129.62% -175.86% -81.75% 6.37% 13.37% -3.04% -30.99% -93.03% -106.56% 83.84% 175.60% 2750.11% -1933.43% -26.13% -22.43% -1343.99% -151.85% 3.63%      
      qoq
    -3022.27% -102.90% 6.52% -67.26% 325.83% -39.27% -24.12% -15.10% 60.18% -25.09% -33.26% -38.65% 10639.93% -90.39% -187.14% -315.76% -67.09% 2888.18% -107.34% -246.33% -178.70% -11.26% -119.88% -406.39% 67.37% -121.69% -4286.70% -110.14% -135.87% 217.35% -44.38% -10.78% -55.92% 97.70% 12.95% 35.12% -20.19% -20.01% -451.44% -137.01% -3.41% 78.30% -16.01% -168.52% -281.94% -39.26% -2.92% -205.11% -59.12% -487.67% -83.56% 13.69% 4.71% -6.71% -4.22% 21.17% -10.45% -33.60% -90.33% -214.07% -2609.47% -0.47% 0.03% -26.62% 1.11% 4.52% -1704.08% -96.94% -302.09%   
      operating margin %
    -7.34% 0.22% -8.29% -7.88% -25.24% -5.32% -9.61% -12.54% -15.55% -9.14% -13.29% -19.59% -34.08% -0.45% -5.08% 5.62% -2.89% -7.48% -0.28% 3.52% -2.76% 3.15% 3.76% -28.71% 6.54% 3.37% -16.64% 0.39% -4.08% 10.24% 3.50% 6.30% 7.24% 15.28% 8.58% 7.34% 5.76% 6.83% 9.41% -2.53% 7.22% 7.05% 4.09% 4.88% -8.01% 3.94% 6.44% 6.64% -6.01% -16.82% 4.01% 21.85% 18.76% 17.21% 15.40% 15.90% 13.67% 14.85% 23.01% 208.68% -223.91% 8.87% 9.05% 8.99% 13.04% 12.66% 12.77% -0.80% -36.53% 17.79% 0% 
      interest expense
    -5,664,000 -4,351,000 -4,681,000 -3,950,000 -4,506,000 -14,920,000 -5,210,000 -4,943,000 -4,558,000 -4,500,000 -1,576,000 -1,266,000 -1,289,000 -229,000 -277,000 -407,000 -375,000 -437,000 -433,000 -550,000 -417,000    -423,000    -257,000            -38,000 -166,000 -125,000  -272,000 -430,000 -395,000 -492,000 -340,000 -555,000 -560,000 -627,000 -465,000   -2,267,000 -3,481,000 -5,445,000 -5,846,000 -11,112,000 -4,249,000      -5,664,000    -145,000 
      other income
    -734,000 1,665,000 -535,000 5,730,000 1,246,000   -2,510,000 -1,274,000   -20,000 676,000   -3,192,000  185,000 -1,789,000 951,000  2,293,000 1,817,000 5,069,000     -404,000 -1,446,250 -5,054,000 -4,752,000 2,912,000 -821,000 479,000 585,000 -4,348,000 336,500 -634,000 147,000 1,833,000   853,000 691,000 -1,664,000 -1,322,000 363,000 144,000 -1,481,000 4,764,000   660,000   -674,000 100,000    -3,478,000 -4,896,000 -23,546,000 529,000 314,000  -1,755,000 -508,000 344,000 -52,000 
      income before income taxes
    -20,834,000 -2,192,000 -22,262,000 -14,223,000 -52,133,000 -29,710,000 -26,637,000 -32,359,000 -35,169,000 -22,049,000 -28,385,000 -37,918,000 -60,327,000 -2,679,750 -9,372,000 3,042,000 -4,389,000 -9,605,000 -2,535,000 4,668,000 -6,023,000 5,570,000 5,261,000 -16,832,000 5,633,000 4,230,000 -26,842,000 672,000 -5,109,000 11,590,000 -1,328,000 2,021,000 10,602,000 16,618,000 9,498,000 8,659,000 1,616,000 3,707,000 9,108,000 -2,604,000 8,923,000 7,147,000 2,278,000 5,855,000 -6,773,000 1,859,000 4,791,000 6,575,000 -6,574,000 -17,636,000 8,228,000 23,141,000 20,048,000 19,960,000 19,073,000 20,380,000 14,289,000 16,774,000 26,114,000   8,059,000 6,695,000   10,063,000 8,679,000     
      income tax expense
    -74,000 -30,000 -533,000  -961,000 564,000 -751,000 -1,084,000 -851,000 -125,000 -472,000 -1,508,000 -611,000   -553,000                -1,088,000 -5,373,000   -3,924,000 -3,924,000   -3,685,000 -4,294,000 -5,041,000 -3,066,000 -1,778,000 -964,000 -6,949,000 -4,763,000 -3,309,000   -3,320,000 -8,506,000 -6,930,000   -8,002,000 -5,769,000 -6,542,000 -8,622,000   -2,251,000 -3,089,000 4,135,000 -2,616,000 -2,874,000 -2,412,000 -2,140,000 -3,970,000 -2,942,000 -4,310,000 
      net income
    -20,908,000 -2,222,000 -22,795,000 -14,081,000 -53,094,000 -29,146,000 -27,388,000 -33,443,000 -36,020,000 -22,174,000 -28,857,000 -39,426,000 -60,938,000 -7,062,000 -10,716,000 2,489,000 -4,460,000 -32,812,000 -2,171,000 2,420,000 -5,816,000 -9,378,000 4,654,000 -18,424,000 25,665,000 11,686,000 -40,498,000 -547,000 897,000 8,871,000 -1,211,000 925,000 5,226,000 1,568,000 3,456,000 3,853,000 -2,654,000 -3,236,000 9,896,000 -7,387,000 3,893,000 3,369,000 -1,371,000 3,572,000 -8,379,000 -5,798,000 452,000 -683,000 -7,876,000 -19,822,000 2,116,000 20,514,000 7,560,000 11,205,000 12,016,000 12,378,000 8,520,000 10,232,000 17,492,000 252,309,000 -237,251,000 5,808,000 3,606,000 -10,515,000 8,028,000 7,189,000 6,267,000 7,401,000 -35,417,000 12,728,000 8,246,000 
      yoy
    -60.62% -92.38% -16.77% -57.90% 47.40% 31.44% -5.09% -15.18% -40.89% 213.99% 169.29% -1684.01% 1266.32% -78.48% 393.60% 2.85% -23.31% 249.88% -146.65% -113.14% -122.66% -180.25% -111.49% 3268.19% 2761.20% 31.73% 3244.18% -159.14% -82.84% 465.75% -135.04% -75.99% -296.91% -148.45% -65.08% -152.16% -168.17% -196.05% -821.81% -306.80% -146.46% -158.11% -403.32% -622.99% 6.39% -70.75% -78.64% -103.33% -204.18% -276.90% -82.39% 65.73% -11.27% 9.51% -31.31% -95.09% -103.59% 76.17% 385.08% -2499.51% -3055.29% -19.21% -42.46% -242.08% -122.67% -43.52% -24.00%     
      qoq
    840.95% -90.25% 61.88% -73.48% 82.17% 6.42% -18.11% -7.15% 62.44% -23.16% -26.81% -35.30% 762.90% -34.10% -530.53% -155.81% -86.41% 1411.38% -189.71% -141.61% -37.98% -301.50% -125.26% -171.79% 119.62% -128.86% 7303.66% -160.98% -89.89% -832.54% -230.92% -82.30% 233.29% -54.63% -10.30% -245.18% -17.99% -132.70% -233.97% -289.75% 15.55% -345.73% -138.38% -142.63% 44.52% -1382.74% -166.18% -91.33% -60.27% -1036.77% -89.69% 171.35% -32.53% -6.75% -2.92% 45.28% -16.73% -41.50% -93.07% -206.35% -4184.90% 61.06% -134.29% -230.98% 11.67% 14.71% -15.32% -120.90% -378.26% 54.35%  
      net income margin %
    -10.63% -1.01% -11.09% -6.93% -27.42% -13.51% -13.93% -16.84% -19.10% -11.06% -15.68% -21.08% -34.78% -5.78% -9.40% 2.11% -4.19% -26.24% -1.93% 1.99% -5.51% -7.97% 4.19% -25.19% 24.48% 9.62% -35.68% -0.47% 0.82% 7.33% -1.08% 0.83% 4.81% 1.34% 3.28% 3.54% -2.58% -2.98% 10.05% -7.10% 3.95% 3.22% -1.36% 3.54% -9.33% -5.78% 0.45% -0.68% -7.42% -21.37% 2.11% 18.31% 6.59% 9.38% 8.39% 8.55% 6.13% 7.16% 12.60% 159.42% -183.49% 4.47% 2.82% -8.16% 6.63% 5.83% 5.35% 6.37% -42.48% 15.02% 10.17% 
      net loss per common share:
                                                                           
      basic
    -520 -50 -570 -360 -1,350 -750 -710 -880 -950 -590 -770  -1,710 -157.5 -530  -220                                                       
      diluted
    -520 -50 -570 -360 -1,350 -750 -710 -880 -950 -590 -770  -1,710 -157.5 -530  -220                                                       
      weighted-average number of common shares:
                                                                           
      basic
    40,450,000 39,602,345,000 39,766,000 39,501,000 39,188,000 38,133,684,000 38,488,000 38,020,000 37,741,000 36,729,258,000 37,249,000 36,762,000 35,734,000 20,053,548,000 20,091,000 20,031,000 19,897,695,000 19,690,593,000 19,769,823,000 19,650,610,000 19,526,872,000 19,267,920,000 19,335,718,000 19,215,392,000 19,143,934,000 18,903,289,000 18,957,876,000 18,834,886,000 18,750,184,000 18,494,002,000 18,562,204,000 18,413,756,000 18,404,856,000 18,117,405,000 18,180,845,000 18,050,551,000 17,979,675,000 18,144,019,000 18,091,650,000 18,147,681,000 18,477,881,000  18,855,533,000 18,769,415,000 18,731,985,000 18,459,054,000 18,577,540,000 18,445,348,000 18,697,228,000 18,142,935,000 19,431,093,000 18,977,263,000 19,078,590,000 18,827,452,000 18,675,694,000 18,384,451,000                
      diluted
    40,450,000 39,602,345,000 39,766,000 39,501,000 39,188,000 38,133,684,000 38,488,000 38,020,000 37,741,000 36,729,258,000 37,249,000 36,762,000 35,734,000 20,053,548,000 20,091,000 20,113,000 19,897,695,000 19,690,593,000 19,769,823,000 19,938,392,000 19,526,872,000 19,391,718,000 19,398,567,000 19,215,392,000 19,299,820,000 18,903,289,000 18,957,876,000 18,834,886,000 19,191,146,000 18,911,610,000 18,562,204,000 18,835,560,000 18,874,591,000 18,498,745,000 18,572,791,000 18,343,038,000 17,979,675,000 18,463,161,000 18,382,118,000 18,147,681,000 18,749,401,000  18,855,533,000 18,989,579,000 18,731,985,000 18,459,054,000 18,773,386,000 18,621,192,000 18,697,228,000 18,142,935,000 19,691,141,000 19,390,413,000 19,533,021,000 19,215,984,000 19,116,195,000 18,850,625,000                
      other comprehensive income, before tax
    -476,000 -16,000 -274,000 3,464,000 1,746,000 -3,400,000 1,829,000 -2,071,000 633,000   838,000 430,000     -1,470,000 -206,000 -57,000                                                    
      currency translation adjustment
    -476,000 -16,000 -274,000 3,464,000 1,746,000 -3,400,000 1,829,000 -400,000 -1,038,000 1,909,000 -1,442,000 457,000 493,000 2,642,000 -2,105,000 -1,820,000 -488,000 -643,000 -719,000 -155,000 -1,027,000 2,824,000 2,275,000 1,484,000 -1,711,000 1,542,000 -1,893,000 147,000 -449,000 -501,000 -844,000 -1,175,000 697,000 559,000 1,111,000 2,648,000 234,000                                   
      income tax expense related to other comprehensive income
                                                                           
      other comprehensive income, net of tax
    -476,000 -16,000 -274,000 3,464,000 1,746,000 -3,400,000 1,829,000 -2,071,000 633,000   838,000 430,000     -1,264,000 -334,000 -81,000  4,243,000 2,275,000   1,543,000 -6,043,000 -371,000 -2,401,000 -1,571,000 30,000 353,000 697,000 4,909,000 1,111,000 2,648,000 1,699,000                                   
      comprehensive loss
    -21,384,000 -2,238,000 -23,069,000 -10,617,000 -51,348,000 -32,546,000 -25,559,000 -35,514,000 -35,387,000 -21,607,000 -30,609,000  -60,508,000 -4,462,250 -13,057,000  -5,622,000                         955,000 -2,442,000  -12,574,000   -516,000                        
      unrealized gain on debt securities
         417,750   1,671,000 -1,342,000 -310,000 381,000  1,144,000 -236,000 161,000  -827,000 513,000 98,000          800,000 1,240,000 1,960,000  7,050,000                                      
      reclassification adjustment for historical unrealized gain on debt security
         -417,750  -1,671,000                                                                
      income tax benefit
       142,000          -75,000 -1,344,000  -71,000 -23,207,000 364,000 -2,248,000 207,000 -14,948,000 -607,000 -1,592,000 20,032,000 -2,217,250 -13,656,000 -1,219,000 6,006,000 -1,586,500 115,000 -8,000  14,689,000 -6,150,000 418,000 181,000 6,900,000 1,276,000 474,000 254,000 775,000 221,000 225,000 139,000 86,000 164,000 1,880,000 -431,000 1,303,000 1,640,000 -5,591,000 3,267,000 2,044,000      -76,281,000 66,072,000           
      sales and marketing
         74,210,750 96,576,000 100,224,000 100,043,000 97,749,000 94,947,000 99,249,000 93,791,000 59,324,000 55,461,000 59,888,000 54,137,000 57,098,000 56,097,000 57,338,000 50,785,000 53,716,000 52,926,000 43,479,000 54,313,000 58,313,000 54,805,000 56,864,000 53,694,000 53,832,000 49,898,000 51,529,000 50,268,000 51,874,000 47,493,000 50,471,000 48,532,000 48,705,000 41,717,000 46,037,000 44,816,000 44,720,000 46,129,000 42,946,000 44,285,000 42,365,000 40,998,000 42,013,000 44,235,000 42,382,000 48,839,000 51,714,000 49,298,000 49,810,000 58,280,000 57,615,000 57,281,000 57,185,000 56,290,000 62,291,000 50,210,000 53,246,000 50,196,000 48,035,000 47,055,000 47,310,000 44,583,000 46,722,000 36,277,000 31,920,000 30,788,000 
      general and administrative
         24,800,750 33,561,000 33,994,000 31,648,000 34,535,000 27,136,000 34,177,000 48,811,000 25,470,000 19,322,000 15,846,000 19,328,000 18,262,000 16,312,000 18,335,000 16,444,000 18,495,000 16,541,000 15,047,000 17,865,000 22,110,000 21,090,000 21,935,000 20,472,000 20,049,000 22,705,000 22,268,000 19,484,000 17,629,000 18,068,000 20,409,000 18,282,000 21,063,000 18,581,000 17,954,000 16,718,000 23,734,000 19,348,000 22,506,000 21,164,000 23,147,000 18,814,000 17,553,000 18,411,000 13,202,000 18,788,000 11,112,000 13,849,000 14,295,000 20,943,000 20,214,000 21,568,000 20,372,000 21,470,000 28,614,000 19,293,000 18,779,000 22,180,000 23,283,000 16,908,000 16,806,000 15,906,000 16,972,000 11,747,000 12,115,000 12,475,000 
      acquisition-related amortization and remeasurement
         5,031,000 6,521,000 7,388,000 5,396,000 3,720,000 3,570,000 3,333,000 4,134,000 2,274,000 2,484,000 -8,663,000 -3,499,000 12,560,000 -335,000 894,000 4,469,000 2,267,000 1,138,000 3,678,000 -7,582,000 2,339,000 23,608,000 1,808,000 6,457,000                                           
      other expense
         -3,313,000 -2,528,000   766,000 -2,360,000   -1,859,000 -3,308,000  -936,000    -2,690,000    -798,000 -2,196,500 -8,146,000 -236,000              -48,000 -1,736,000         -713,000 -1,020,000   -368,000   -330,000        -556,000     
      income tax benefit related to other comprehensive income
                     7,000 -128,000                                                     
      other comprehensive loss, before tax
             -121,000 -1,752,000   -1,290,500 -2,341,000 -1,659,000 -1,162,000                                                       
      income tax benefit related to other comprehensive loss
                                                                           
      other comprehensive loss, net of tax
             -121,000 -1,752,000   -1,290,500 -2,341,000 -1,659,000 -1,162,000    -1,573,000    -1,711,000                                               
      net income per common share:
                                                                           
      basic
               -1,070    120  -1,670 -110 120 -300 -490 240 -960 1,330 -532.5 -2,140 -30 50                          640 670                
      diluted
               -1,070    120  -1,670 -110 120 -300 -480 240 -960 1,320 -532.5 -2,140 -30 50                          630 660                
      comprehensive income
               -38,588,000    830,000  -34,076,000 -2,505,000 2,339,000 -7,389,000 -5,135,000 6,929,000 -16,940,000 23,954,000 13,229,000 -46,541,000 -918,000 -1,504,000 7,300,000 -1,181,000 1,278,000 5,923,000 6,477,000 4,567,000 6,501,000 -955,000 -5,668,000 13,722,000 -9,849,000 4,613,000   5,402,000  -7,139,000 -2,738,000  -10,135,000 -16,064,000 -1,016,000 21,423,000 9,067,000 6,822,000 14,726,000                 
      unrealized loss on debt securities
                -63,000    -674,000    -726,000        -2,593,000        -3,220,000                                   
      income tax related to other comprehensive income
                       -24,000      550,000 1,388,000 171,000                                            
      other comprehensive loss before tax
                        -1,753,000    -1,711,000                                               
      income tax related to other comprehensive loss
                        180,000                                                   
      interest income
                         -513,750 -731,000 -901,000  96,500 186,000 457,000  -213,000 -181,000 -251,000 -183,000 -522,000 -15,000 76,000 45,000 443,000 471,000 -113,000    74,000                  -4,069,000 -5,390,000 18,243,000 -5,666,000 -5,869,000  2,072,000 -482,000 255,000  
      unrealized loss on debt security
                                                                           
      reclassification adjustment for amortization of historical unrealized gains on debt security
                              -345,000 -689,000                                            
      reclassification adjustment for other-than-temporary impairment on debt security
                             -1,298,250 -5,193,000                                             
      other comprehensive income before tax
                         512,000 2,275,000   -2,753,750 -7,431,000 -542,000 -3,042,000 -1,931,000 396,000 785,000 697,000 7,609,000 1,111,000 2,648,000 2,599,000                                   
      other comprehensive gain, before tax
                                                                           
      other comprehensive gain before tax
                           1,484,000                                                
      income tax related to other comprehensive gain
                                                                           
      other comprehensive gain, net of tax
                           1,484,000                                                
      unrealized gain on debt security
                                                                           
      income tax related to items of other comprehensive income
                                641,000 -199,500 -366,000 -432,000                                        
      changes in fair value of contingent consideration
                                 380,000 1,580,000                                         
      net income from continuing operations
                                 8,862,000 -1,213,000 933,000 5,229,000 1,516,000 3,348,000 4,735,000 -2,308,000 -5,117,000 10,384,000 -6,289,000 4,629,000 2,106,000 -788,000 4,077,000 -7,737,000 -5,090,000 28,000 3,266,000                        
      discontinued operations
                                                                           
      income from discontinued operations
                                 -750    -440,500 65,000       -578,750 -804,000   -1,590,750 260,000     11,386,000 -9,046,000                   
      net income from discontinued operations
                                 -2,250 2,000   -280,000 108,000       -432,500 -583,000   -1,021,250 424,000                         
      net income per common share—basic
                                 470 -70 50 280 80 190 210 -150 -170 550 -410                                
      net income per common share—diluted
                                 460 -70 50 270 90 190 210 -150 -170 540 -410                                
      reclassification adjustment for loss on debt securities in net income
                                        5,585,000                                   
      loss from discontinued operations
                                    -3,000   -1,300,000 -527,000 2,942,000 -1,018,000 -1,572,000 -990,000   -730,000 -781,000   -5,829,000 -4,157,250 -3,041,000 -4,432,000                     
      net loss from discontinued operations
                                   -8,000 -3,000   -882,000 -346,000 1,881,000 -488,000 -1,098,000 -736,000   -505,000 -642,000   -3,949,000                        
      income tax related to items of other comprehensive loss
                                     -225,000   -900,000                                   
      charges related to u.s. government resolutions
                                          1,499,000 12,870,000            284,000 326,000 1,364,000                  
      unrealized gain on derivative instrument
                                                                           
      product sales
                                         65,372,500 84,997,000 90,868,000 85,625,000 89,623,000 87,761,000 86,868,000 76,832,000 86,350,000 88,296,000 88,579,000 93,766,000 81,061,000 88,358,000                     
      marketing service fees
                                         9,940,250 13,500,000 13,207,000 13,054,000 14,999,000 13,390,000 14,086,000 12,930,000 13,934,000 12,698,000 12,406,000 12,377,000 11,677,000 11,896,000                     
      operating expenses
                                                                           
      restatements and related costs
                                         524,000 691,000 545,000 245,000 -193,000 1,147,000 2,213,000                            
      operating expenses - sum
                                         55,766,750 69,346,000 84,198,000 69,415,000 75,831,000 73,147,000   74,874,000 69,218,000 68,867,000 55,829,250 84,418,000 73,531,000   75,251,000 88,215,000 85,703,000  87,548,000 74,184,000             
      other income and expense
                                                                           
      other income and expense - sum
                                         416,500 -163,000 34,000 1,795,000 -128,750 -1,861,000   -646,500 -1,717,000 -129,000 122,750 -2,036,000 4,204,000                     
      net income per common share—basic:
                                            210 -82.5 -70 190                            
      net income per common share—diluted:
                                            210 -82.5 -70 190                            
      other comprehensive income:
                                                                           
      unrealized gain on derivative instruments, net of tax
                                         18,500 -2,000 50,000 26,000 57,500 -706,000 271,000                            
      unrealized gain on debt securities, net of tax
                                         134,750 3,008,000                                 
      foreign currency translation adjustment
                                         367,750 820,000 -570,000 1,221,000 -916,500 -365,000 1,559,000 -4,860,000 -682,000 -3,302,000 198,000                        
      unrealized loss on debt securities, net of tax
                                           -1,942,000 -527,000                               
      other comprehensive loss:
                                                                           
      amortization of intangible assets
                                                405,000 531,000 508,000 661,000 962,000 616,000 504,000 523,000 515,000 530,000 1,247,000 1,319,000 1,402,000 1,410,000 1,447,000 -8,179,000 5,347,000 4,830,000 5,043,000 4,446,000 4,671,000 4,571,000 4,468,000 3,465,000 1,929,000 1,709,000 1,770,000 
      costs related to the accounting review and restatements
                                                5,916,000                           
      net loss per common share—basic:
                                                                           
      net loss per common share—basic
                                                -450                           
      net loss per common share—diluted:
                                                                           
      net loss per common share—diluted
                                                -450                           
      unrealized gain on cross-currency swap, net of tax
                                                665,000 46,000 112,000 -31,000                        
      costs related to the accounting review and restatement
                                                 2,655,000 2,326,000 2,327,000 10,281,000 2,664,000                      
      impairment of goodwill
                                                     19,193,000                      
      net income per common share-basic:
                                                                           
      net income from continuing operations, net of tax
                                                 17.5   -1,586,000 -18,084,000 4,908,000 14,635,000 13,118,000 13,967,000                  
      net income from discontinued operations, net of tax
                                                 -55 20                         
      net income per common share-basic
                                                 -37.5 20 -40 -235 -1,100                      
      net income per common share-diluted:
                                                    -235 -1,100                      
      net income per common share-diluted
                                                 -37.5 20 -40                        
      income tax
                                                    -2,031,500 -448,000                      
      gain on sale of breg, inc., net of tax
                                                       84,000 221,000 1,040,000                  
      net loss from discontinued operations, net of tax
                                                    -2,823,750 -1,738,000 -2,792,000 -2,130,000 -5,558,000                   
      net (loss) from discontinued operations, net of tax
                                                    -150 -100                      
      net income per common share- basic:
                                                                           
      net income per common share- basic
                                                      110 407.5 400 590                  
      net income per common share- diluted:
                                                       397.5 390 580                  
      net income per common share- diluted
                                                      110                     
      net gain on sale of vascular operations
                                                            20,000               
      charges related to u.s. government inquiries
                                                                           
      loss on refinancing of credit facility
                                                            -550,000               
      gain on interest rate swap
                                                             909,000              
      other income - sum
                                                           -2,635,000                
      net income per common share – basic
                                                            480 580              
      net income per common share – diluted
                                                            480 570              
      weighted-average number of common shares – basic
                                                            17,626,319,000 17,579,221,000              
      weighted-average number of common shares – diluted
                                                            17,836,537,000 17,892,886,000              
      loss on sale of vascular operations
                                                             211,000              
      gain on sale of vascular operations
                                                              -12,551,000             
      unrealized non-cash gain on interest rate swap
                                                              345,000             
      net income per common share - basic
                                                              1,000 14,760 -13,870 340 210 -640 480 430 380 460 -2,190 790 510 
      net income per common share - diluted
                                                              990 14,750 -13,870 340 210 -630 480 430 370 450 -2,170 790 510 
      weighted-average number of common shares - basic
                                                              17,489,315,000             
      weighted-average number of common shares - diluted
                                                              17,757,099,000             
      impairment of goodwill and certain intangible assets
                                                               72,380,750 289,523,000           
      gain on sale of pain care® operations
                                                               -392,500   -1,570,000         
      loss on refinancing of senior secured term loan
                                                               -1,433,750 -5,735,000           
      other
                                                               -684,250 -3,822,000 591,000 494,000         
      income (loss) before income taxes
                                                               328,590,000 -303,323,000   7,346,250 10,644,000       
      weighted average number of common shares -basic
                                                                17,101,718,000           
      weighted average number of common shares - diluted
                                                               17,202,943,000 17,101,718,000 17,116,015,000 17,261,172,000 17,047,587,000 16,889,303,000 16,819,166,000 16,926,257,000 16,165,540,000 16,322,827,000 16,166,241,000 16,184,755,000 
      income before minority interests and income taxes
                                                                 8,059,000 6,695,000   10,063,000 8,722,000     
      minority interests
                                                                   -10,000 -10,000  -43,000     
      weighted average number of common shares - basic
                                                               17,119,474,000  17,090,217,000 17,087,003,000 16,638,873,000 16,639,019,000 16,533,646,000 16,464,571,000 16,165,540,000 16,193,086,000 16,037,927,000 16,020,250,000 
      kci settlement, net of litigation costs
                                                                          1,093,000 
      income (loss) before minority interests and income taxes
                                                                   7,359,500 10,654,000       
      kci settlement, net of related costs
                                                                       273,250    
      income (loss) before income tax
                                                                       -805,500 -31,447,000   
      kci settlement
                                                                           
      income before income tax
                                                                         15,670,000 12,556,000 
      total operating income
                                                                          11,660,000 
    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 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2014-06-30 2013-12-31 2013-09-30 2013-03-31 2012-12-31 2012-09-30 2012-06-30 2012-03-31 2011-09-30 2010-09-30 2010-06-30 2010-03-31 2009-12-31 2008-06-30 2008-03-31 2007-12-31 2007-09-30 2007-06-30 2007-03-31 2006-12-31 2006-09-30 2006-06-30 2006-03-31 
                                                                            
        assets
                                                                            
        current assets
                                                                            
        cash and cash equivalents
      120,278,000 82,025,000 62,860,000 65,606,000 57,953,000 83,238,000 30,054,000 26,366,000 26,964,000 33,107,000 33,663,000 37,607,000 49,968,000 50,700,000 51,660,000 59,536,000 71,917,000 87,847,000 82,710,000 79,968,000 94,569,000 96,291,000 79,810,000 172,888,000 57,739,000 69,719,000 56,849,000 52,143,000 46,668,000 69,623,000 53,783,000 45,686,000 77,056,000 81,157,000 53,925,000 44,330,000 41,652,000 39,572,000 46,824,000 40,482,000 39,846,000 63,663,000 63,694,000 55,946,000 29,784,000 36,815,000 29,825,000 28,919,000 30,486,000 22,219,000 33,675,000 31,055,000 53,572,000 50,089,000 47,053,000 29,020,000 15,248,000 19,694,000 18,759,000 13,328,000 16,845,000 26,731,000 25,064,000 23,562,000 15,684,000 21,805,000 25,881,000 37,114,000 49,961,000 48,605,000 
        restricted cash
      592,000 3,090,000 3,086,000 3,083,000 2,500,000 2,500,000 2,500,000 2,500,000 2,500,000 4,650,000         505,000 554,000 488,000 530,000 490,000 503,000 529,000 684,000 654,000  2,540,000 2,566,000 2,459,000       14,369,000       27,253,000 34,424,000 34,630,000 45,248,000 23,761,000 22,732,000 29,446,000 21,314,000 67,319,000 72,913,000 79,371,000 37,222,000 21,987,000 19,309,000 15,963,000 11,630,000 11,709,000 18,226,000 16,453,000 11,570,000 8,519,000 5,897,000 7,300,000 19,524,000   
        accounts receivable
      137,775,000 135,746,000 130,808,000 129,556,000 131,865,000 134,713,000 124,845,000 125,361,000 125,617,000 128,098,000 114,118,000 112,320,000 113,313,000 82,857,000 75,633,000 77,069,000 72,466,000 78,560,000 68,971,000 73,453,000 69,680,000 72,423,000 73,053,000 67,407,000 77,798,000      74,356,000 74,397,000 77,182,000  61,187,000 61,213,000 59,443,000                                  
        inventories
      177,818,000 172,319,000 174,042,000 172,993,000 174,480,000 189,452,000 205,812,000 210,040,000 219,076,000 222,166,000 221,745,000 222,474,000 221,933,000 100,150,000 100,277,000 97,171,000 88,832,000 82,974,000 84,678,000 81,551,000 84,180,000 84,635,000 82,859,000 82,046,000 82,744,000 82,397,000 80,993,000 79,141,000 79,128,000 76,847,000 79,895,000 81,730,000 77,686,000 81,330,000 80,124,000 75,869,000 66,271,000 63,346,000 65,013,000 61,334,000 59,787,000 57,563,000 57,766,000 59,219,000 56,709,000 59,846,000 64,266,000 70,902,000 90,577,000 100,204,000 92,133,000 88,744,000 80,822,000 78,423,000 90,939,000 94,707,000 85,484,000 83,585,000 88,451,000 94,624,000 113,333,000 104,263,000 93,952,000 89,810,000 85,417,000 78,127,000 70,395,000 63,925,000 39,259,000 35,379,000 
        prepaid expenses and other current assets
      25,057,000 23,667,000 23,374,000 24,592,000 23,512,000 23,382,000 23,003,000 21,798,000 24,821,000 32,422,000 24,170,000 26,947,000 24,827,000 22,283,000 19,325,000 21,416,000 21,888,000 20,141,000 23,348,000 22,926,000 14,434,000 16,500,000 18,457,000 20,726,000 21,185,000 20,948,000 19,617,000 20,954,000 16,387,000 17,856,000 34,517,000 35,613,000 31,219,000 25,877,000 18,172,000 17,192,000 19,478,000 19,238,000 20,519,000 19,734,000 19,067,000 31,187,000 31,884,000 24,723,000 25,840,000 26,552,000 39,272,000 43,886,000 25,906,000 27,313,000 32,211,000 32,056,000 28,122,000 25,386,000 21,889,000 21,718,000     28,858,000 22,674,000  25,109,000 21,811,000 21,307,000  18,880,000 14,101,000  
        total current assets
      461,520,000 416,847,000 394,170,000 395,830,000 390,310,000 433,285,000 386,214,000 386,065,000 398,978,000 420,443,000 393,696,000 399,348,000 410,041,000 255,990,000 246,895,000 255,192,000 255,103,000 269,522,000 260,212,000 258,452,000 263,351,000 270,379,000 254,669,000 343,570,000 239,995,000 260,553,000 237,803,000 232,829,000 224,338,000 244,639,000 245,010,000 237,426,000 263,143,000 251,801,000 213,408,000 198,604,000 186,844,000 194,373,000 185,249,000 177,988,000 173,967,000 212,252,000 245,491,000 235,214,000 235,034,000 256,408,000 270,345,000 292,679,000 280,244,000 281,773,000 337,253,000 340,444,000 404,872,000 396,389,000 414,775,000 359,729,000 313,372,000 307,182,000 311,302,000 299,494,000 301,215,000 298,719,000 280,777,000 277,864,000 258,312,000 244,910,000 233,968,000 247,096,000 198,060,000 184,064,000 
        property, plant, and equipment
      125,327,000  130,017,000 129,200,000 130,693,000  146,685,000 154,111,000 158,132,000  152,689,000 140,584,000 136,818,000  57,820,000 58,676,000 58,513,000  58,784,000 62,268,000 62,467,000  63,689,000 65,113,000                                               
        intangible assets
      69,336,000 72,765,000 75,641,000 78,868,000 81,213,000 98,803,000 104,546,000 108,310,000 112,761,000 117,490,000 121,021,000 126,000,000 122,129,000 47,388,000 47,513,000 50,634,000 50,171,000 52,666,000 54,794,000 55,890,000 57,634,000 60,517,000 62,309,000 57,527,000 58,770,000 54,139,000 53,613,000 55,628,000 56,764,000  51,637,000 51,498,000                                       
        goodwill
      194,934,000 194,934,000 194,934,000 194,934,000 194,934,000 194,934,000 194,934,000 194,934,000 194,934,000 194,934,000 194,767,000 191,727,000 202,711,000 71,317,000 71,317,000 71,317,000 71,317,000 71,317,000 83,357,000 83,646,000 83,513,000 84,018,000 83,503,000 82,997,000 82,646,000 71,177,000 71,177,000 71,177,000 71,177,000 72,401,000 70,747,000 70,747,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 53,565,000 55,405,000 72,607,000 74,388,000 73,952,000 73,111,000 180,435,000 179,796,000 176,889,000 174,444,000 176,022,000 185,175,000 318,769,000 318,665,000 319,938,000 319,243,000 315,592,000 314,389,000 313,070,000 329,577,000 178,461,000 176,342,000 
        other long-term assets
      35,484,000 36,702,000 37,848,000 38,325,000 25,994,000 26,468,000 35,493,000 38,578,000 41,245,000 33,388,000 43,479,000 43,628,000 45,437,000 25,705,000 24,571,000 24,383,000 24,959,000 22,095,000 20,503,000 20,515,000 20,769,000 22,292,000 14,915,000 10,026,000 11,110,000 11,907,000 10,420,000 27,204,000 26,735,000 21,641,000 3,166,000 7,082,000 6,814,000 21,073,000 15,683,000 16,664,000 16,413,000 20,463,000 21,136,000 16,421,000 19,557,000 19,491,000 27,457,000 26,876,000 27,351,000 8,970,000 8,838,000 5,834,000 7,385,000 7,386,000 14,153,000 11,303,000 13,541,000 12,815,000 12,385,000 12,138,000           24,695,000   3,190,000 
        total assets
      886,601,000 850,647,000 832,610,000 837,157,000 823,144,000 893,294,000 867,872,000 881,998,000 906,050,000 925,315,000 905,652,000 901,287,000 917,136,000 458,629,000 449,660,000 461,656,000 461,993,000 476,623,000 500,395,000 502,010,000 513,874,000 525,861,000 517,132,000 595,709,000 493,490,000 495,620,000 475,603,000 488,806,000 479,316,000 466,641,000 450,165,000 441,764,000 409,004,000 405,354,000 386,301,000 367,677,000 354,745,000 372,103,000 376,053,000 364,738,000 362,775,000 400,222,000 402,449,000 389,154,000 386,714,000 393,185,000 411,045,000 433,997,000 423,182,000 430,058,000 503,380,000 504,281,000 565,073,000 553,320,000 707,586,000 656,073,000 597,533,000 589,958,000 589,826,000 590,473,000 899,597,000 899,355,000 885,664,000 919,450,000 892,496,000 873,491,000 862,285,000 881,902,000 472,363,000 450,437,000 
        liabilities and shareholders’ equity
                                                                            
        current liabilities
                                                                            
        accounts payable
      54,686,000 58,392,000 50,459,000 45,098,000 45,176,000 48,803,000 47,060,000 50,362,000 57,147,000 58,357,000 53,261,000 51,349,000 45,875,000 27,598,000 28,003,000 32,322,000 27,448,000 26,459,000 19,437,000 20,095,000 21,056,000 23,118,000 16,943,000 14,911,000 19,641,000  17,892,000 19,523,000 19,643,000  15,426,000 14,453,000 14,012,000  13,352,000 14,245,000 16,555,000                                  
        current portion of finance lease liability
      115,000 837,000 814,000 797,000 767,000 755,000 743,000 734,000 724,000 708,000 693,000 678,000 664,000 652,000 638,000 624,000 610,000 2,590,000 2,570,000 2,551,000 2,514,000 510,000 498,000 449,000 357,000 323,000 293,000 301,000 359,000                                          
        other current liabilities
      106,232,000 111,253,000 108,574,000 102,486,000 98,173,000 119,070,000 107,845,000 100,183,000 89,625,000 104,908,000 98,576,000 89,777,000 91,029,000 55,374,000 49,007,000 48,151,000 60,152,000 76,781,000 57,997,000 59,000,000 75,491,000 80,271,000 75,938,000 74,236,000 45,963,000 64,674,000 70,323,000 48,161,000 43,652,000 67,919,000 61,387,000 49,486,000 51,171,000 61,295,000 60,718,000 50,858,000 46,316,000 69,088,000 68,900,000 63,523,000 45,472,000 65,597,000 61,570,000 47,678,000 53,083,000 53,220,000 68,148,000 67,382,000 46,146,000 51,308,000 51,295,000 46,969,000 57,349,000 50,132,000 50,173,000 57,208,000 54,041,000 51,231,000 59,723,000 59,210,000 31,278,000 36,635,000 36,544,000 49,258,000 33,124,000 37,758,000 31,577,000 40,510,000 29,196,000 31,107,000 
        total current liabilities
      161,033,000 170,482,000 159,847,000 148,381,000 144,116,000 168,628,000 161,898,000 155,967,000 150,621,000 165,223,000 152,530,000 141,804,000 137,568,000 83,624,000 77,648,000 81,097,000 88,210,000 105,830,000 80,004,000 81,646,000 99,061,000 103,899,000 93,379,000 89,596,000 65,961,000 84,883,000 88,508,000 67,985,000 63,654,000 85,908,000 76,813,000 63,939,000 65,183,000 79,406,000 74,070,000 65,103,000 62,871,000 83,441,000 83,275,000 77,199,000 58,996,000 81,988,000 78,579,000 64,908,000 69,405,000 66,443,000 81,381,000 83,094,000 66,820,000 66,018,000 65,525,000 68,797,000 152,463,000 146,046,000 171,497,000 137,308,000 79,456,000 81,820,000 86,474,000 88,053,000 71,460,000 79,936,000 73,306,000 83,280,000 73,703,000 64,900,000 61,040,000 66,619,000 45,146,000 42,367,000 
        long-term debt
      221,335,000 157,391,000 157,219,000 157,047,000 156,885,000 157,015,000 112,215,000 113,315,000 115,071,000 93,107,000              100,000,000                        20,000,000 20,000,000 20,000,000 20,000,000 20,000,000 20,000,000 40,000,000 184,945,000 197,445,000 217,445,000 223,450,000 229,305,000 249,132,000 289,242,000 290,065,000 294,588,000 305,584,000 306,440,000 307,255,000 312,055,000 326,868,000 37,000 28,000 
        long-term portion of finance lease liability
      12,937,000 17,060,000 17,240,000 17,448,000 17,636,000 17,835,000 18,027,000 18,160,000 18,345,000 18,532,000 18,715,000 18,894,000 19,068,000 19,239,000 19,407,000 19,571,000 19,730,000 19,890,000 20,044,000 20,193,000 20,283,000 22,338,000 22,463,000 22,506,000 22,471,000 20,648,000 20,767,000 20,847,000 20,879,000                                          
        other long-term liabilities
      56,110,000 55,677,000 55,818,000 55,934,000 46,213,000 46,692,000 49,808,000 48,552,000 51,698,000 49,723,000 48,924,000 49,604,000 51,341,000 18,906,000 19,066,000 19,042,000 18,478,000 13,969,000 35,514,000 37,887,000 39,712,000 42,760,000 46,394,000 38,562,000 49,689,000 62,458,000 59,894,000 52,180,000 51,101,000 45,336,000 50,002,000 57,979,000 30,647,000 29,340,000 26,920,000 25,627,000 24,740,000 25,185,000 19,598,000 29,308,000 28,308,000 27,923,000 26,664,000 26,569,000 26,769,000 26,886,000 11,762,000 12,367,000 12,736,000 12,149,000 4,227,000 4,930,000 5,221,000 3,277,000 3,215,000 3,091,000 2,403,000 2,354,000 4,026,000 6,904,000 12,039,000 12,195,000 7,922,000 6,017,000 2,552,000 1,637,000 1,536,000 1,370,000 1,356,000 1,330,000 
        total liabilities
      451,415,000 400,610,000 390,124,000 378,810,000 364,850,000 390,170,000 341,948,000 335,994,000 335,735,000 326,585,000 290,169,000 261,302,000 252,977,000 121,769,000 116,121,000 119,710,000 126,418,000 139,689,000 135,562,000 139,726,000 159,056,000 168,997,000 162,236,000 250,664,000 138,121,000 167,989,000 169,169,000 141,012,000 135,634,000 131,244,000 126,815,000 121,918,000 95,830,000 108,746,000 100,990,000 90,730,000 87,611,000 108,626,000 102,873,000 106,507,000 87,304,000 109,911,000 105,243,000 91,477,000 96,174,000 93,558,000 106,029,000 128,786,000 112,688,000 111,001,000 101,212,000 105,183,000 187,463,000 199,104,000 369,178,000 345,130,000 305,751,000 314,216,000 326,153,000 350,204,000 447,550,000 456,594,000 451,724,000 488,439,000 477,562,000 469,263,000 469,650,000 504,465,000 71,237,000 68,851,000 
        contingencies
                                                                            
        shareholders’ equity
                                                                            
        common shares 0.10 par value; 100,000 shares authorized; 40,382 and 39,834 issued and outstanding as of march 31, 2026, and december 31, 2025, respectively
      4,038,000                                                                      
        additional paid-in capital
      820,247,000 813,769,000 804,011,000 796,807,000 786,175,000 779,718,000 770,000,000 764,538,000 753,398,000 746,450,000 741,638,000 735,533,000 721,145,000 334,969,000 328,387,000 323,738,000 318,213,000 313,951,000 307,783,000 302,736,000 297,629,000 292,291,000 285,203,000 282,287,000 275,686,000 271,019,000 263,064,000 257,888,000 252,862,000 243,165,000 238,422,000 233,742,000 228,356,000 220,591,000 215,778,000 211,990,000 208,686,000 204,095,000 208,109,000 205,337,000 212,720,000 232,126,000 239,954,000 237,987,000 236,260,000 232,788,000 231,038,000 228,502,000 216,653,000 215,081,000 250,186,000 246,111,000 246,052,000 231,758,000 222,794,000 220,639,000 193,208,000 190,433,000 186,458,000 177,246,000 163,944,000 161,362,000 157,349,000 144,243,000 137,066,000 132,923,000 128,297,000 122,867,000 111,567,000 109,562,000 
        accumulated deficit
      -389,241,000 -368,333,000 -366,111,000 -343,316,000 -329,235,000 -276,141,000 -246,995,000 -219,607,000 -186,164,000                                                              
        accumulated other comprehensive income
      142,000 618,000 634,000 908,000               1,264,000 1,598,000 1,679,000 3,252,000    -3,039,000 -4,581,000 1,462,000 1,833,000 3,296,000 4,867,000 4,837,000 4,484,000 3,787,000            -382,000 959,000 4,149,000 2,699,000 4,958,000 -628,000 2,504,000 1,595,000 88,000 4,471,000 3,601,000 6,445,000 1,703,000 3,848,000 7,190,000 18,778,000 17,883,000 16,686,000 16,384,000 15,525,000 16,154,000 14,260,000 11,900,000 11,506,000 6,700,000 
        total shareholders’ equity
      435,186,000 450,037,000 442,486,000 458,347,000 458,294,000 503,124,000 525,924,000 546,004,000 570,315,000 598,730,000 615,483,000 639,985,000 664,159,000 336,860,000 333,539,000 341,946,000 335,575,000 336,934,000 364,833,000 362,284,000 354,818,000 356,864,000 354,896,000 345,045,000 355,369,000 327,631,000 306,434,000 347,794,000 343,682,000 335,397,000 323,350,000 319,846,000 313,174,000 296,608,000 285,311,000 276,947,000 267,134,000 263,477,000 273,180,000 258,231,000 275,471,000 290,311,000 297,206,000 297,677,000 290,540,000 299,627,000 305,016,000 305,211,000 310,494,000 319,057,000 402,168,000 399,098,000 377,610,000 354,216,000 338,408,000 310,943,000 291,782,000 275,742,000 263,673,000 240,269,000 452,047,000 442,761,000 433,940,000 431,011,000 414,934,000 404,228,000 392,635,000 377,437,000 401,126,000 381,586,000 
        total liabilities and shareholders’ equity
      886,601,000 850,647,000 832,610,000 837,157,000 823,144,000 893,294,000 867,872,000 881,998,000 906,050,000 925,315,000 905,652,000 901,287,000 917,136,000 458,629,000 449,660,000 461,656,000 461,993,000 476,623,000 500,395,000 502,010,000 513,874,000 525,861,000 517,132,000 595,709,000 493,490,000 495,620,000 475,603,000 488,806,000 479,316,000 466,641,000 450,165,000 441,764,000 409,004,000 405,354,000 386,301,000 367,677,000 354,745,000 372,103,000 376,053,000 364,738,000 362,775,000 400,222,000 402,449,000 389,154,000 386,714,000 393,185,000 411,045,000 433,997,000 423,182,000 430,058,000 503,380,000 504,281,000 565,073,000 553,320,000 707,586,000 656,073,000 597,533,000 589,958,000 589,826,000 590,473,000 899,597,000 899,355,000 885,664,000 919,450,000 892,496,000 873,491,000 862,285,000 881,902,000 472,363,000 450,437,000 
        property, plant and equipment
       129,399,000    139,804,000    159,060,000    58,229,000    59,252,000    63,613,000   64,836,000 62,727,000 62,964,000 64,402,000 63,727,000 42,835,000 43,575,000 44,377,000 43,973,000 45,139,000 46,678,000 46,651,000 47,962,000 48,916,000 51,861,000 52,499,000 53,645,000 52,306,000 51,467,000 49,963,000 46,737,000 48,549,000 49,616,000 51,082,000 54,606,000 55,762,000 52,402,000 51,362,000 46,550,000 45,267,000 53,634,000 49,302,000 42,362,000 39,990,000 37,414,000 38,694,000 35,255,000 35,257,000 33,444,000 31,532,000 28,957,000 26,778,000 25,311,000 22,917,000 19,914,000 18,782,000 
        current portion of long-term debt
            6,250,000 4,688,000 3,125,000 1,250,000                                             20,000,000 15,000,000 5,000,000 3,300,000 3,330,000 3,332,000 3,340,000 3,340,000 3,343,000 3,300,000 3,300,000 3,300,000 3,334,000 3,301,000 11,000 111,000 
        common shares 0.10 par value; 100,000 shares authorized; 39,834 and 38,486 issued and outstanding as of december 31, 2025 and 2024, respectively
       3,983,000                                                                     
        common shares 0.10 par value; 100,000 shares authorized; 39,519 and 38,486 issued and outstanding as of september 30, 2025, and december 31, 2024, respectively
        3,952,000                                                                    
        common shares 0.10 par value; 100,000 shares authorized; 39,483 and 38,486 issued and outstanding as of june 30, 2025, and december 31, 2024, respectively
         3,948,000                                                                   
        common shares 0.10 par value; 100,000 shares authorized; 39,096 and 38,486 issued and outstanding as of march 31, 2025, and december 31, 2024, respectively
          3,910,000                                                                  
        accumulated other comprehensive loss
          -2,556,000 -4,302,000 -902,000 -2,731,000 -660,000 -1,293,000 -1,860,000 -108,000 -946,000 -1,376,000 -5,162,000 -2,821,000 -1,162,000      -991,000 -3,266,000 -4,750,000          -1,122,000 -2,233,000 -4,881,000 -6,580,000 -4,148,000 -7,974,000 -5,512,000 -6,232,000 -3,818,000 -2,747,000 -4,577,000                          
        common shares 0.10 par value; 100,000 shares authorized; 38,486 and 37,165 issued and outstanding as of december 31, 2024 and 2023, respectively
           3,849,000                                                                 
        common shares 0.10 par value; 100,000 shares authorized; 38,209 and 37,165 issued and outstanding as of september 30, 2024, and december 31, 2023, respectively
            3,821,000                                                                
        common shares 0.10 par value; 100,000 shares authorized; 38,039 and 37,165 issued and outstanding as of june 30, 2024, and december 31, 2023, respectively
             3,804,000                                                               
        common shares 0.10 par value; 100,000 shares authorized; 37,410 and 37,165 issued and outstanding as of march 31, 2024 and december 31, 2023, respectively
              3,741,000                                                              
        common shares 0.10 par value; 100,000 shares authorized; 37,165 and 20,162 issued and outstanding as of december 31, 2023 and 2022, respectively
               3,717,000                                                             
        retained earnings
               -150,144,000 -127,970,000 -99,113,000 -59,687,000 1,251,000 8,313,000 19,029,000 16,540,000 21,000,000 53,812,000 55,983,000 53,563,000 59,379,000 68,757,000 64,103,000 82,527,000 57,749,000 46,063,000 86,561,000 87,108,000 87,078,000 78,207,000 79,418,000 78,493,000 70,402,000 68,834,000 65,378,000 61,525,000 64,179,000 67,415,000 59,057,000 66,444,000 62,551,000 59,182,000 60,553,000 56,981,000 65,360,000 71,158,000 70,706,000 89,332,000 97,208,000 150,665,000 148,549,000 128,035,000 120,475,000 109,270,000 84,862,000 90,363,000 81,844,000 71,612,000 54,119,000 267,615,000 261,807,000 258,201,000 268,716,000 260,688,000 253,500,000 248,433,000 241,031,000 276,449,000 263,721,000 
        long-term borrowings under credit facility
                70,000,000 51,000,000 45,000,000                                                          
        common shares 0.10 par value; 100,000 shares authorized; 36,750 and 20,162 issued and outstanding as of september 30, 2023 and december 31, 2022, respectively
                3,675,000                                                            
        common shares 0.10 par value; 100,000 shares authorized; 36,733 and 20,162 issued and outstanding as of june 30, 2023 and december 31, 2022, respectively
                 3,673,000                                                           
        common shares 0.10 par value; 50,000 shares authorized; 36,463 and 20,162 issued and outstanding as of march 31, 2023 and december 31, 2022, respectively
                  3,647,000                                                          
        common shares 0.10 par value; 50,000 shares authorized; 20,162 and 19,837 issued and outstanding as of december 31, 2022 and 2021, respectively
                   2,016,000                                                         
        deferred income taxes
                    1,544,000 1,454,000 1,930,000 1,771,000 22,745,000 21,239,000 26,140,000 25,042,000 38,047,000 36,476,000 36,133,000 35,117,000 39,626,000 37,566,000 36,575,000 33,228,000 36,030,000 30,634,000 28,359,000 23,315,000 47,052,000 42,685,000 41,431,000 47,325,000 56,222,000 56,443,000 56,439,000 57,306,000 35,974,000 36,970,000 36,913,000 37,413,000 39,847,000 40,402,000 33,947,000 34,053,000 17,363,000 16,959,000 19,059,000 20,106,000 19,028,000 19,342,000 23,289,000 21,802,000 21,134,000 20,286,000 11,373,000 11,373,000 11,373,000 9,020,000 9,020,000 9,020,000 95,019,000 5,405,000 4,511,000 5,079,000 
        common shares 0.10 par value; 50,000 shares authorized; 20,007 and 19,837 issued and outstanding as of september 30, 2022 and december 31, 2021, respectively
                    2,001,000                                                        
        common shares 0.10 par value; 50,000 shares authorized; 20,000 and 19,837 issued and outstanding as of june 30, 2022 and december 31, 2021, respectively
                     2,000,000                                                       
        common shares 0.10 par value; 50,000,000 shares authorized; 19,841,822 and 19,836,937 issued and outstanding as of march 31, 2022 and december 31, 2021, respectively
                      1,984,000                                                      
        common shares 0.10 par value; 50,000,000 shares authorized; 19,836,937 and 19,423,874 issued and outstanding as of december 31, 2021 and 2020, respectively
                       1,983,000                                                     
        common shares 0.10 par value; 50,000,000 shares authorized; 19,741,410 and 19,423,874 issued and outstanding as of september 30, 2021 and december 31, 2020, respectively
                        1,974,000                                                    
        common shares 0.10 par value; 50,000,000 shares authorized; 19,669,129 and 19,423,874 issued and outstanding as of june 30, 2021 and december 31, 2020, respectively
                         1,967,000                                                   
        common shares 0.10 par value; 50,000,000 shares authorized; 19,474,384 and 19,423,874 issued and outstanding as of march 31, 2021 and december 31, 2020, respectively
                          1,947,000                                                  
        common shares 0.10 par value; 50,000,000 shares authorized; 19,423,874 and 19,022,619 issued and outstanding as of december 31, 2020 and 2019, respectively
                           1,942,000                                                 
        common shares 0.10 par value; 50,000,000 shares authorized; 19,267,420 and 19,022,619 issued and outstanding as of september 30, 2020 and december 31, 2019, respectively
                            1,927,000                                                
        common shares 0.10 par value; 50,000,000 shares authorized; 19,209,063 and 19,022,619 issued and outstanding as of june 30, 2020 and december 31, 2019, respectively
                             1,921,000                                               
        common shares 0.10 par value; 50,000,000 shares authorized; 19,056,178 and 19,022,619 issued and outstanding as of march 31, 2020 and december 31, 2019, respectively
                              1,906,000                                              
        trade accounts receivable, net of allowances of 3,987 and 7,463, respectively
                               86,805,000                                             
        trade accounts payable
                               19,886,000    17,989,000    18,111,000    14,353,000 14,375,000 13,676,000 13,524,000 16,391,000 17,009,000 17,230,000 16,322,000 13,223,000 13,233,000 15,712,000 20,674,000 14,710,000 14,230,000 21,812,000 18,089,000 11,551,000 17,401,000 17,816,000 17,739,000 24,493,000 21,372,000 21,821,000 28,606,000 29,117,000 22,526,000 22,341,000 28,670,000 21,104,000 23,577,000 19,699,000 12,145,000 11,091,000 
        common shares 0.10 par value; 50,000,000 shares authorized; 19,022,619 and 18,579,688 issued and outstanding as of december 31, 2019 and 2018, respectively
                               1,902,000                                             
        trade accounts receivable, net of allowances of 4,073 and 7,463, respectively
                                79,690,000                                            
        common shares 0.10 par value; 50,000,000 shares authorized; 18,875,184 and 18,579,688 issued and outstanding as of september 30, 2019 and december 31, 2018, respectively
                                1,888,000                                            
        trade accounts receivable, net of allowances of 4,205 and 7,463, respectively
                                 80,591,000                                           
        common shares 0.10 par value; 50,000,000 shares authorized; 18,831,581 and 18,579,688 issued and outstanding as of june 30, 2019 and december 31, 2018, respectively
                                 1,883,000                                           
        trade accounts receivable, net of allowances of 7,448 and 7,463, respectively
                                  79,615,000                                          
        common shares 0.10 par value; 50,000,000 shares authorized; 18,790,769 and 18,579,688 issued and outstanding as of march 31, 2019 and december 31, 2018, respectively
                                  1,879,000                                          
        trade accounts receivable
                                   77,747,000    63,437,000    57,848,000    59,839,000    61,358,000   75,567,000  132,425,000 150,316,000        129,777,000 119,097,000 115,452,000  118,793,000 117,861,000 108,754,000  102,248,000 90,228,000 83,071,000 
        patents and other intangible assets
                                   51,897,000   13,150,000 10,461,000 9,915,000 9,508,000 8,530,000 7,461,000 8,020,000 7,822,000 5,602,000 5,302,000 5,368,000 5,626,000 5,888,000 7,152,000 7,455,000 8,075,000 9,046,000 9,821,000 6,765,000 6,880,000 7,000,000 7,294,000 36,399,000 38,938,000 42,794,000 43,993,000 45,619,000 47,628,000 223,181,000 225,082,000 230,305,000 255,609,000 259,651,000 257,692,000 261,159,000 261,943,000 62,623,000 63,977,000 
        common shares 0.10 par value; 50,000,000 shares authorized; 18,579,688 and 18,278,833 issued and outstanding as of december 31, 2018 and 2017, respectively
                                   1,858,000                                         
        common shares 0.10 par value; 50,000,000 shares authorized; 18,536,716 and 18,278,833 issued and outstanding as of september 30, 2018 and december 31, 2017, respectively
                                    1,854,000                                        
        common shares 0.10 par value; 50,000,000 shares authorized; 18,485,788 and 18,278,833 issued and outstanding as of june 30, 2018 and december 31, 2017, respectively
                                     1,849,000                                       
        common shares 0.10 par value; 50,000,000 shares authorized; 18,405,344 and 18,278,833 issued and outstanding as of march 31, 2018 and december 31, 2017, respectively
                                      1,841,000                                      
        common shares 0.10 par value; 50,000,000 shares authorized; 18,278,833 and 17,828,155 issued and outstanding as of december 31, 2017 and 2016, respectively
                                       1,828,000                                     
        common shares 0.10 par value; 50,000,000 shares authorized; 18,212,916 and 17,828,155 issued and outstanding as of september 30, 2017 and december 31, 2016, respectively
                                        1,821,000                                    
        common shares 0.10 par value; 50,000,000 shares authorized; 18,119,430 and 17,828,155 issued and outstanding as of june 30, 2017 and december 31, 2016, respectively
                                         1,812,000                                   
        common shares 0.10 par value; 50,000,000 shares authorized; 18,042,834 and 17,828,155 issued and outstanding as of march 31, 2017 and december 31, 2016, respectively
                                          1,804,000                                  
        common shares 0.10 par value; 50,000,000 shares authorized; 17,828,155 and 18,659,696 issued and outstanding as of december 31, 2016 and 2015, respectively
                                           1,783,000                                 
        current assets:
                                                                            
        trade accounts receivable, less allowance for doubtful accounts of 8,840 and 8,923 at september 30, 2016 and december 31, 2015, respectively
                                            52,893,000                                
        current liabilities:
                                                                            
        shareholders’ equity:
                                                                            
        common shares 0.10 par value; 50,000,000 shares authorized; 18,036,712 and 18,659,696 issued and outstanding as of september 30, 2016 and december 31, 2015, respectively
                                            1,804,000                                
        trade accounts receivable, less allowance for doubtful accounts of 9,560 and 8,923 at june 30, 2016 and december 31, 2015, respectively
                                             56,438,000                               
        common shares 0.10 par value; 50,000,000 shares authorized; 18,108,540 and 18,659,696 issued and outstanding as of june 30, 2016 and december 31, 2015, respectively
                                             1,811,000                               
        trade accounts receivable, less allowance for doubtful accounts of 9,680 and 8,923 at march 31, 2016 and december 31, 2015, respectively
                                              55,267,000                              
        common shares 0.10 par value; 50,000,000 shares authorized; 18,186,835 and 18,659,696 issued and outstanding as of march 31, 2016 and december 31, 2015, respectively
                                              1,819,000                              
        common shares 0.10 par value; 50,000,000 shares authorized; 18,659,696 and 18,611,495 issued and outstanding as of december 31, 2015 and 2014, respectively
                                               1,866,000                             
        trade accounts receivable, less allowance for doubtful accounts of 9,468 and 7,285 at september 30, 2015 and december 31, 2014, respectively
                                                56,173,000                            
        common shares 0.10 par value; 50,000,000 shares authorized; 18,882,661 and 18,611,495 issued and outstanding as of september 30, 2015 and december 31, 2014, respectively
                                                1,888,000                            
        trade accounts receivable, less allowance for doubtful accounts of 7,153 and 7,285 at june 30, 2015 and december 31, 2014, respectively
                                                 58,356,000                           
        common shares 0.10 par value; 50,000,000 shares authorized; 18,839,335 and 18,611,495 issued and outstanding as of june 30, 2015 and december 31, 2014, respectively
                                                 1,884,000                           
        trade accounts receivable, less allowance for doubtful accounts of 6,831 and 7,285 at march 31, 2015 and december 31, 2014, respectively
                                                  58,535,000                          
        common shares 0.10 par value; 50,000,000 shares authorized; 18,757,361 and 18,611,495 issued and outstanding as of march 31, 2015 and december 31, 2014, respectively
                                                  1,876,000                          
        common shares 0.10 par value; 50,000,000 shares authorized; 18,611,495 and 18,102,335 issued and outstanding as of december 31, 2014 and 2013, respectively
                                                   1,861,000                         
        trade accounts receivable, less allowance for doubtful accounts of 8,118 and 9,111 at september 30, 2014 and december 31, 2013, respectively
                                                    62,505,000                        
        common shares 0.10 par value; 50,000,000 shares authorized; 18,604,197 and 18,102,335 issued and outstanding as of september 30, 2014 and december 31, 2013, respectively
                                                    1,861,000                        
        trade accounts receivable, less allowance for doubtful accounts of 8,971 and 9,111 at june 30, 2014 and december 31, 2013, respectively
                                                     63,322,000                       
        common shares 0.10 par value; 50,000,000 shares authorized; 18,534,625 and 18,102,335 issued and outstanding as of june 30, 2014 and december 31, 2013, respectively
                                                     1,854,000                       
        bank borrowings
                                                         16,000 282,000 499,000 1,423,000 1,284,000 2,676,000 2,796,000 2,049,000 2,209,000 8,236,000 10,844,000 8,704,000 8,381,000 8,609,000 2,738,000 78,000 3,109,000 3,794,000 58,000 
        common shares 0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of december 31, 2013 and 2012, respectively
                                                      1,810,000                      
        trade accounts receivable, less allowance for doubtful accounts of 11,460 and 13,543 at september 30, 2013 and december 31, 2012, respectively
                                                       75,252,000                     
        common shares 0.10 par value; 50,000,000 shares authorized; 18,101,476 and 19,339,329 issued and outstanding as of september 30, 2013 and december 31, 2012, respectively
                                                       1,810,000                     
        common shares 0.10 par value; 50,000,000 shares authorized; 19,453,294 and 19,339,329 issued and outstanding as of march 31, 2013 and december 31, 2012, respectively
                                                        1,945,000                    
        escrow receivable
                                                             15,523,000               
        assets held for sale
                                                                            
        accrued charges related to u.s. government resolutions
                                                          76,743,000 83,864,000 82,500,000                
        liabilities held for sale
                                                                            
        common shares 0.10 par value; 50,000,000 shares authorized; 19,339,329 and 18,465,444 issued and outstanding as of december 31, 2012 and 2011, respectively
                                                         1,934,000                   
        trade accounts receivable, less allowance for doubtful accounts of 13,381 and 9,376 at september 30, 2012 and december 31, 2011, respectively
                                                          155,978,000                  
        common shares 0.10 par value; 50,000,000 shares authorized; 19,279,466 and 18,465,444 issued and outstanding as of september 30, 2012 and december 31, 2011, respectively
                                                          1,928,000                  
        trade accounts receivable, less allowance for doubtful accounts of 11,072 and 9,376 at june 30, 2012 and december 31, 2011, respectively
                                                           149,472,000                 
        common shares 0.10 par value; 50,000,000 shares authorized; 18,946,481 and 18,465,444 issued and outstanding as of june 30, 2012 and december 31, 2011, respectively
                                                           1,895,000                 
        trade accounts receivable, less allowance for doubtful accounts of 11,913 and 10,045 at march 31, 2012 and december 31, 2011, respectively
                                                            156,495,000                
        common shares 0.10 par value; 50,000,000 shares authorized; 18,728,157 and 18,465,444 issued and outstanding as of march 31, 2012 and december 31, 2011, respectively
                                                            1,873,000                
        trade accounts receivable, less allowance for doubtful accounts of 7,621 and 7,250 at september 30, 2011 and december 31, 2010, respectively
                                                             142,197,000               
        accrued charges related to u.s. government inquiries
                                                             46,000,000               
        common shares 0.10 par value; 50,000,000 shares authorized; 18,411,073 and 17,726,645 issued and outstanding as of september 30, 2011 and december 31, 2010, respectively
                                                             1,841,000               
        trade accounts receivable, less allowance for doubtful accounts of 7,025 and 7,205 at september 30, 2010 and december 31, 2009, respectively
                                                              132,750,000              
        prepaid expenses
                                                              5,366,000 5,098,000 6,031,000 4,868,000   8,055,000    5,641,000    
        other current assets
                                                              29,248,000 28,245,000 26,477,000 24,981,000   16,980,000    13,118,000    
        investments, at cost
                                                              345,000 345,000 345,000 345,000           
        deferred taxes and other long-term assets
                                                              21,771,000 24,004,000 19,124,000 19,137,000 16,750,000 17,205,000 16,773,000 31,120,000 25,902,000 25,640,000  16,287,000 9,223,000  
        common shares 0.10 par value; 50,000,000 shares authorized; 17,660,002 and 17,141,710 issued and outstanding as of september 30, 2010 and december 31, 2009, respectively
                                                              1,766,000              
        trade accounts receivable, less allowance for doubtful accounts of 6,608 and 7,205 at june 30, 2010 and december 31, 2009, respectively
                                                               129,449,000             
        common shares 0.10 par value; 50,000,000 shares authorized; 17,620,238 and 17,141,710 issued and outstanding as of june 30, 2010 and december 31, 2009, respectively
                                                               1,762,000             
        trade accounts receivable, less allowance for doubtful accounts of 6,754 and 7,205 at march 31, 2010 and december 31, 2009, respectively
                                                                134,487,000            
        common shares 0.10 par value; 50,000,000 shares authorized; 17,547,037 and 17,141,710 issued and outstanding as of march 31, 2010 and december 31, 2009, respectively
                                                                1,755,000            
        accounts payable to related parties
                                                                 1,481,000   2,189,000    2,474,000    
        common shares 0.10 par value; 50,000,000 shares authorized; 17,141,710 and 17,103,142 issued and outstanding as of december 31, 2009 and 2008, respectively
                                                                 1,714,000           
        investments
                                                                  4,427,000 4,427,000 4,427,000        
        common shares
                                                                  1,710,000 1,709,000  1,668,000 1,655,000 1,651,000  1,639,000 1,604,000 1,603,000 
        trade accounts receivable, less allowance for doubtful accounts of 6,441 and 6,265 at december 31, 2007 and 2006, respectively
                                                                    108,900,000        
        commitments and contingencies
                                                                            
        common shares 0.10 par value
                                                                            
        authorized: 50,000,000
                                                                            
        issued: 17,038,304
                                                                    1,704,000        
        outstanding: 17,038,304
                                                                            
        securities and other investments
                                                                     4,082,000 4,082,000 4,082,000 4,082,000 4,082,000 4,082,000 4,082,000 
        trade accounts receivable, less allowance for doubtful accounts of 6,265and 4,155 at december 31, 2006 and 2005, respectively
                                                                        104,662,000    
        deferred income
                                                                        6,971,000    
        issued: 16,445,859
                                                                        1,645,000    
        outstanding: 16,445,859
                                                                            
        prepaid expenses and other
                                                                           11,930,000 
      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 2017-09-30 2017-06-30 2017-03-31 2016-12-31 2016-09-30 2016-06-30 2016-03-31 2015-12-31 2015-09-30 2015-06-30 2015-03-31 2014-12-31 2014-09-30 2013-12-31 2013-03-31 2012-12-31 2012-09-30 2012-06-30 2012-03-31 2010-06-30 2010-03-31 2008-09-30 2008-06-30 2008-03-31 2007-09-30 2007-06-30 2007-03-31 2006-09-30 2006-06-30 2006-03-31 
                                                                        
          cash flows from operating activities
                                                                        
          net loss
        -20,908,000 -2,222,000 -22,795,000 -14,081,000 -53,094,000 -29,146,000 -27,388,000 -33,443,000 -36,020,000 -22,174,000 -28,857,000 -39,426,000 -60,938,000  -10,716,000 2,489,000 -4,460,000                                                
          adjustments to reconcile net loss to net cash from operating activities
                                                                        
          depreciation, amortization, and impairment
        13,493,000 13,078,000 12,941,000                                                              
          inventory reserve expenses
        2,900,000 3,049,000 2,383,000 10,092,000 15,301,000 6,907,000 5,588,000 7,409,000 6,350,000 3,563,000 6,956,000 9,645,000 7,412,000                                                    
          amortization of operating lease assets, debt costs, and other assets
        1,058,000 1,975,000 1,582,000 1,126,000 1,251,000 11,300,000 1,615,000 1,508,000 1,478,000 2,992,000 1,187,000 1,623,000 1,696,000 735,000 754,000 769,000 798,000 851,000 866,000 890,000 889,000 919,000 903,000 903,000 1,005,000                                        
          provision for expected credit losses
        719,000 -211,000 629,000 779,000 1,058,000 -60,000 486,000 197,000 1,376,000 -85,000 415,000 282,000 208,000 382,000 574,000 539,000 600,000 68,000     -619,000 885,000 679,000                                        
          deferred income taxes
        93,000 -110,000 321,000 -433,000 445,000 378,000 325,000 772,000 408,000 -569,000 333,000 436,000 379,000 293,000 -215,000 272,000 -36,000 22,254,000 -1,708,000 4,907,000 -971,000 13,258,000 -1,287,000 -157,000 -1,027,000 4,702,000 -993,000 -734,000 -1,582,000 2,421,000 -5,806,000 447,000 277,000 21,133,000 -4,131,000 -790,000 5,074,000         -7,128,000 527,000 -1,763,000 -744,000 4,233,000               
          share-based compensation expense
        6,533,000 7,214,000 7,181,000 7,824,000 6,469,000 7,165,000 6,531,000 9,959,000 8,800,000 3,167,000 6,274,000 13,246,000 13,020,000 4,922,000 4,729,000 4,460,000 4,332,000 3,962,000 3,842,000                                              
          loss on disposal of fixed assets
        331,000 279,000 280,000                                                              
          change in valuation of investment securities
        -16,000 -7,000 -10,000    3,129,000 3,678,000 314,000  410,000 -285,000 -207,000                                                    
          change in fair value of contingent consideration
        750,000 660,000 -427,000 -763,000 -610,000 690,000 1,970,000 3,070,000 1,170,000 -600,000 -800,000   -986,000 -10,714,000 -5,500,000 -1,200,000 -2,300,000 -1,575,000 1,500,000 300,000 -700,000 2,100,000 -9,000,000 1,000,000 22,270,000 470,000 5,400,000 380,000                                   
          other
        -178,000 711,000 2,315,000 159,000 -1,347,000 556,000 -1,575,000 3,919,000 944,000 -250,000 1,045,000 11,000 -383,000 903,000 -25,000 621,000 528,000 321,000 848,000 -129,000 24,000 -430,000 135,000 -1,189,000 -744,000 1,126,000 830,000 -109,000 586,000 593,000 193,000 639,000 208,000 575,000 251,000 330,000 242,000         -760,000 2,971,000 4,962,000 -345,000 6,130,000    743,000 489,000 3,062,000 515,000 -2,430,000 -1,328,000 -1,368,000 -767,000 1,398,000 305,000 -264,000 
          changes in operating assets and liabilities
                                                                        
          accounts receivable
        -2,964,000 -4,714,000 -1,958,000 2,710,000 2,379,000 -10,827,000 591,000 -103,000 813,000 -13,323,000 -2,703,000 823,000 4,792,000 -6,786,000 259,000 -5,600,000 5,392,000 -9,778,000 3,715,000 -3,734,000 2,748,000 1,732,000 -4,740,000 9,579,000 6,712,000  237,000 -1,508,000 -2,027,000  138,000 4,562,000 -4,925,000  -515,000 -1,713,000 -2,074,000                 -9,047,000 -8,407,000 -13,805,000 -10,630,000 -5,586,000 -14,829,000 -14,120,000 -4,597,000 -7,397,000 -10,499,000 -3,680,000 
          inventories
        -8,845,000 -1,279,000 -3,579,000 -6,583,000 693,000 4,274,000 -1,249,000 -1,635,000 -6,936,000 -9,887,000 -14,996,000 -16,387,000 -16,781,000 1,886,000 -4,430,000 -9,378,000 -6,211,000 1,485,000 -3,521,000 2,639,000 16,000 -1,119,000 -222,000 1,316,000 -848,000 -717,000 -2,606,000 88,000 -2,477,000 2,818,000 1,629,000 3,587,000 1,664,000 -931,000 -3,595,000 -8,369,000 -2,750,000         2,564,000 3,311,000 4,970,000 -5,126,000 -5,733,000 -3,206,000 1,515,000 732,000 879,000 -66,000 -16,703,000 -16,734,000 -8,447,000 -19,086,000 -15,682,000 -8,224,000 -7,621,000 -5,082,000 -2,103,000 
          prepaid expenses and other current assets
        -1,459,000 -4,723,000 1,191,000 -535,000 141,000 -817,000 -1,307,000 -32,000 2,749,000 835,000 650,000 -1,950,000 2,225,000 -890,000 1,785,000 122,000 -1,891,000 4,153,000 -480,000 -8,500,000 1,993,000 2,073,000 2,410,000 539,000 -496,000 -5,335,000 4,914,000 -4,704,000 1,427,000 -2,625,000 1,427,000 -2,095,000 2,166,000 -7,729,000 -822,000 2,402,000 -203,000         98,000 21,247,000 1,250,000 -179,000 -3,854,000 -2,672,000 -5,982,000 6,317,000 -4,005,000 -2,882,000 -5,250,000 -4,486,000 2,627,000 -5,976,000 -2,890,000     
          accounts payable
        -4,368,000 8,255,000 3,482,000 -6,645,000 -2,493,000 5,803,000 -3,873,000 -6,681,000 -820,000 4,398,000 2,444,000 5,360,000 -3,560,000 -1,673,000 -3,221,000 5,789,000 1,387,000 7,236,000 -321,000 -1,205,000 -1,457,000 5,638,000 1,676,000 -4,810,000 28,000  -1,179,000 -257,000 1,883,000  1,059,000 612,000 -4,459,000  -1,283,000 -1,964,000 1,014,000                 2,898,000 -1,313,000 2,500,000 3,250,000 3,809,000 -2,707,000 2,265,000 -5,069,000 7,551,000 4,000 -667,000 
          other current liabilities
        -5,221,000 6,784,000 12,711,000 -378,000 -21,385,000 12,397,000 7,107,000 4,879,000 -14,856,000 4,089,000 6,405,000 -583,000 -5,842,000 5,198,000 2,924,000 -502,000 -6,993,000 4,964,000 2,954,000 814,000 -7,719,000 233,000 6,764,000 311,000 -1,333,000 -8,063,000 8,485,000 4,301,000 -12,439,000 5,567,000 1,482,000 -3,302,000 -11,310,000 227,000 7,768,000 3,846,000 -23,253,000         2,055,000 -15,580,000 -5,022,000 4,478,000 -10,017,000 939,000     -2,739,000 -5,839,000        
          other long-term assets and liabilities
        472,000 -1,042,000 -2,505,000 971,000 -1,655,000 -3,510,000 -1,352,000 -1,592,000 -2,274,000 -535,000 696,000 213,000 -347,000 -2,419,000 -332,000 907,000 233,000 -4,977,000 145,000 -561,000 348,000 -2,141,000 42,000 1,085,000 -18,582,000 827,000 947,000 -783,000 -3,005,000 -5,787,000 843,000 217,000 597,000  2,944,000 -33,000 -663,000                            
          net cash from operating activities
        -17,610,000 27,697,000 12,402,000 11,639,000 -18,391,000 23,730,000 11,671,000 8,984,000 -18,595,000 -6,694,000 477,000 -5,516,000 -34,020,000 2,348,000 -1,264,000 -4,913,000 -7,709,000 11,779,000 6,432,000 -2,177,000 2,441,000 22,291,000 21,887,000 17,630,000 12,464,000 11,943,000 11,746,000 9,383,000 -1,039,000 21,089,000 15,797,000 16,592,000 -3,560,000 29,847,000 13,767,000 6,257,000 3,470,000 6,311,000 17,128,000 16,844,000 4,424,000 16,988,000 17,282,000 4,013,000 4,941,000 14,992,000 18,092,000 14,929,000 15,454,000 -57,189,000 10,639,000 8,790,000 48,966,000 11,791,000 -412,000 2,421,000 2,254,000 902,000 13,758,000 1,757,000 1,596,000 -9,395,000 1,564,000 1,771,000 
          cash flows from investing activities
                                                                        
          capital expenditures
        -10,661,000 -10,877,000 -9,904,000 -7,109,000 -6,736,000 -5,322,000 -9,344,000 -10,543,000 -21,872,000 -12,351,000 -11,472,000 -5,127,000 -5,703,000 -5,329,000 -6,225,000 -2,525,000 -4,670,000 -4,365,000 -3,065,000 -4,285,000 -5,260,000 -4,142,000 -4,952,000 -4,643,000 -4,006,000 -3,804,000 -2,951,000 -2,831,000 -3,224,000 -4,406,000 -3,314,000 -3,721,000 -3,498,000 -3,334,000 -3,517,000 -6,083,000 -6,217,000 -7,487,000 -8,419,000 -5,074,000 -6,745,000 -5,186,000 -5,360,000 -6,029,000 -9,782,000 -11,881,000 -4,353,000 -15,831,000 -12,150,000 -4,112,000 -23,752,000 -17,123,000 -4,571,000 -6,769,000 -4,539,000 -1,618,000 
          free cash flows
        -28,271,000 16,820,000 2,498,000 4,530,000 -25,127,000 23,730,000 6,349,000 -360,000 -29,138,000 -6,694,000 -21,395,000 -17,867,000 -45,492,000 2,348,000 -6,391,000 -10,616,000 -13,038,000 5,554,000 3,907,000 -6,847,000 -1,924,000 22,291,000 18,822,000 17,630,000 8,179,000 6,683,000 7,604,000 4,431,000 -5,682,000 17,083,000 11,993,000 13,641,000 -6,391,000 26,623,000 9,361,000 2,943,000 -251,000 2,813,000 13,794,000 13,327,000 -1,659,000 10,771,000 9,795,000 -4,406,000 -133,000 8,247,000 12,906,000 9,569,000 9,425,000 -66,971,000 10,639,000 8,790,000 48,966,000 -90,000 -4,765,000 -13,410,000 -9,896,000 -3,210,000 -9,994,000 -15,366,000 -2,975,000 -16,164,000 -2,975,000 153,000 
          other investing activities
        146,000 6,000 10,000   -50,000 -50,000 -500,000  84,000                   474,000                            
          net cash from investing activities
        -10,515,000 -10,871,000 -9,894,000 -7,097,000 -6,736,000 -1,135,000 -5,862,000 -9,716,000 -10,867,000 -15,053,000 -22,343,000 -12,819,000 17,084,000 -5,900,000 -5,473,000 -7,494,000 -5,667,000 -8,982,000 -4,239,000 -5,011,000 -4,781,000 -9,390,000 -14,372,000 -4,388,000 -24,184,000 -1,643,000 -4,543,000 -5,422,000 -11,316,000 -5,077,000 -4,372,000 -46,894,000 -4,655,000 -3,658,000 -4,697,000 -4,688,000 -3,431,000 -4,073,000 -3,905,000 -6,570,000 -7,399,000 -6,700,000 -7,623,000 -8,463,000 -15,563,000 -7,031,000 -6,694,000 -5,726,000 -6,468,000 -10,140,000 -4,945,000   12,334,000 19,840,000 -9,586,000 -6,170,000 1,868,000 -25,869,000 -18,579,000 -5,556,000 -343,577,000 -5,647,000 -2,726,000 
          cash flows from financing activities
                                                                        
          proceeds from issuance of common shares
         2,839,000 36,000 3,005,000 49,000 2,946,000 120,000   2,750,000   1,937,000   2,586,000 1,553,000 2,968,000 1,717,000 3,759,000 2,891,000 948,000 4,730,000 298,000 192,000 6,331,000 1,234,000 450,000 1,038,000 4,378,000 1,506,000 995,000 1,406,000 3,876,000 32,000                           
          payments related to finance lease obligation
        -31,000 -198,000 -189,000 -187,000 -188,000 -181,000 -179,000 -174,000 -172,000 -169,000 -163,000 -160,000 -160,000 -153,000 -150,000 -150,000 -2,141,000 -142,000 -135,000 -133,000 -127,000 -119,000 -80,000 -32,000 -92,000 -89,000 -88,000 -89,000 -99,000                                    
          proceeds from credit facility
        64,025,000                                                                
          payment of debt issuance costs and other financing activities
        -24,000 -19,000 -512,000 -1,013,000 -225,000 -845,000 -1,547,000                     -206,000 -120,000                                  
          net cash from financing activities
        63,970,000 2,377,000 -5,152,000 2,640,000 -651,000 31,487,000 -2,456,000 225,000 21,453,000 25,280,000 18,251,000 5,808,000 15,983,000 1,498,000 -252,000 909,000 -2,233,000 2,052,000 855,000 -7,638,000 1,110,000 2,662,000 -101,335,000 101,603,000 315,000 1,922,000 -1,029,000 -1,185,000 -10,396,000 5,000 -697,000 -12,000 3,697,000 940,000 167,000 634,000 1,797,000 -8,450,000 -6,917,000 -9,245,000 -21,500,000 -9,559,000 -1,451,000 27,186,000 8,938,000 494,000 -8,642,000 -985,000 -5,935,000 44,616,000    -16,845,000 -13,626,000 -7,127,000 -4,538,000 -1,239,000 9,328,000 6,447,000 -170,000 325,521,000 -10,462,000 -14,402,000 
          effect of exchange rate changes on cash
        -90,000  -99,000 1,054,000 493,000  335,000 -91,000 -284,000  -329,000 166,000 221,000  -887,000 -883,000 -321,000  -355,000 291,000 -534,000  729,000 278,000 -730,000  -814,000 159,000 -230,000  -172,000 -1,056,000 417,000 103,000 358,000 475,000 244,000 -1,040,000 36,000 -393,000 658,000 -760,000 -460,000 3,426,000 -5,347,000 -1,465,000 -1,850,000 49,000 -431,000    324,000 -914,000 -371,000 -486,000 235,000 136,000 464,000 178,000 54,000 779,000 720,000 176,000 
          net change in cash and cash equivalents
        35,755,000  -2,743,000 8,236,000 -25,285,000  3,688,000 -598,000 -8,293,000  -3,944,000 -12,361,000 -732,000                     27,232,000 9,595,000 2,678,000 2,080,000                            
          cash, cash equivalents, and restricted cash at the beginning of period
        85,115,000  85,738,000  37,757,000      87,847,000  96,821,000  70,403,000  72,189,000                                    
          cash, cash equivalents, and restricted cash at the end of period
        120,870,000  -2,743,000 8,236,000 60,453,000  3,688,000 -598,000 29,464,000      -7,876,000 -12,381,000 71,917,000  2,693,000 -14,535,000 95,057,000  -93,091,000 115,123,000 58,268,000  5,360,000 2,935,000 49,208,000                                    
          components of cash, cash equivalents, and restricted cash at the end of period
                                                                        
          cash and cash equivalents
        120,278,000 19,165,000 -2,746,000 7,653,000 57,953,000 53,184,000 3,688,000 -598,000 26,964,000     -960,000 -7,876,000 -12,381,000 71,917,000 5,137,000 2,742,000 -14,601,000 94,569,000 16,481,000 -93,078,000 115,149,000 57,739,000 12,870,000 4,706,000 5,475,000 46,668,000 15,840,000                                   
          restricted cash
        592,000 4,000 3,000 583,000 2,500,000 2,500,000          -49,000 66,000 488,000 40,000 -13,000 -26,000 529,000 30,000   2,540,000 107,000    14,369,000                 -7,757,000 -4,353,000 -352,000 4,772,000 -1,773,000 -4,270,000 -1,219,000 1,403,000 -5,762,000 13,762,000 13,762,000 
          noncash investing activities - accrued purchases of capital expenditures
        13,524,000  1,933,000                                                              
          noncash investing activities - purchase of intangible assets
              50,000                                                       
          amortization of inventory fair value step-up
                                                                        
          changes in operating assets and liabilities, net of effects of acquisitions
                                                                        
          contingent consideration milestone payment
                                                                      
          cash acquired in seaspine merger
                                                                        
          sale of investment securities
                                                                        
          proceeds from credit facilities
                                                                        
          repayment of borrowings from credit facilities
                                                                        
          payment of debt acquired from seaspine merger
                 -26,899,000                                                    
          payments related to withholdings for share-based compensation
                    -1,958,000 -262,000 -79,000 -1,319,000 -69,000 -371,000 -341,000 -1,748,000 -95,000 -464,000 -919,000 -974,000 -136,000 -922,000 -962,000 -1,011,000 -2,298,000 -1,023,000 -1,027,000 -859,000 -516,000 -121,000 -828,000 -772,000 -2,079,000                            
          effect of exchange rate changes on cash and restricted cash
                                                                        
          net change in cash, cash equivalents, and restricted cash
                     -960,000 -7,876,000 -12,381,000 -15,930,000 4,632,000 2,693,000 -14,535,000 -1,764,000 16,521,000 -93,091,000 115,123,000 -12,135,000 12,900,000 5,360,000 2,935,000 -22,981,000 15,947,000 10,556,000 -31,370,000 -4,101,000                                
          cash, cash equivalents, and restricted cash at the beginning of the year
                                                                        
          cash, cash equivalents, and restricted cash at the end of the year
                                                                        
          components of cash, cash equivalents, and restricted cash at the end of the year
                                                                        
          payments related to tax withholdings for share-based compensation
          -9,000    -1,172,000 -1,947,000 -1,828,000  -167,000                                                      
          repayment of borrowings from credit facility
              -15,000,000                                                        
          depreciation and amortization
            34,431,000 15,994,000 15,173,000 14,032,000 14,862,000 13,969,000 13,097,000 13,327,000 12,670,000 7,421,000 7,570,000 6,512,000 7,516,000 7,446,000 7,151,000 7,559,000 7,443,000 8,247,000 9,030,000 6,942,000 6,327,000 6,519,000 6,275,000 6,178,000 5,727,000 4,998,000 4,738,000 4,554,000 4,369,000 4,703,000 4,974,000 5,372,000 5,075,000         5,784,000 5,578,000 7,200,000 4,995,000 4,796,000 4,447,000 5,351,000 5,667,000 10,345,000 5,398,000 22,707,000 14,777,000 7,397,000 21,334,000 13,958,000 6,937,000 10,937,000 7,307,000 3,522,000 
          gain on disposal of fixed assets
            25,000                                                            
          amortization of inventory fair value step up
               3,047,000 3,047,000 7,038,000 7,921,000 9,449,000 11,636,000                                                    
          interest and loss on the valuation of investment securities
                                                                        
          contract liability
                     -1,396,000 -3,395,000 -3,109,000 -3,071,000                                            
          contingent consideration payments related to asset acquisitions
                                                                       
          payment of contingent consideration
                                -1,340,000                                    
          gain/loss on disposal of fixed assets and instrumentation
                                                                        
          capital expenditures for property, plant, and equipment
              -5,322,000 -9,344,000 -10,543,000  -21,872,000 -12,351,000 -11,472,000  -5,127,000 -5,703,000 -5,329,000      -3,065,000                                          
          capital expenditures for intangible assets
              -490,000 -372,000 -274,000 -492,000 -471,000 -468,000 -363,000 -695,000 -430,000 -333,000 -338,000 -586,000 -464,000 -341,000 -416,000 -530,000 -307,000 -113,000 -659,000 -383,000 -401,000 -470,000 -273,000 -526,000 -268,000 -263,000 -607,000 -434,000 -291,000 -1,374,000 -184,000 -575,000 -571,000 -440,000 -316,000 -483,000 -136,000 -44,000 -39,000 -286,000 -51,000 -366,000 -439,000 -358,000               
          cash acquired in the seaspine merger
                  29,419,000                                                    
          borrowings under credit facility
              40,000,000  19,000,000 6,000,000 45,000,000                                                    
          components of cash and cash equivalents at the end of period
                                                                        
          cash and cash equivalents at the end of period
                29,464,000  -3,944,000 -12,361,000 49,968,000                                                    
          impairment of goodwill
                                                                       
          capital expenditures for property, plant and equipment
                         -6,225,000 -2,525,000 -4,670,000 -4,365,000    -4,285,000 -5,260,000 -4,142,000 -4,952,000 -4,643,000 -4,006,000 -3,804,000 -2,951,000 -2,831,000 -3,224,000 -4,406,000 -3,314,000 -3,721,000 -3,498,000 -3,334,000 -3,517,000 -6,083,000 -6,217,000 -7,487,000 -8,419,000 -5,074,000 -6,745,000 -5,186,000 -5,360,000 -6,029,000 -9,782,000               
          purchase of investment securities
                             -5,000,000                                           
          other financing activities
                  -419,000    -23,000 -22,000 -23,000  -222,000 -320,000 -385,000  -336,000 -282,000 -405,000  -277,000 -277,000 -670,000                                    
          cash and cash equivalents at the beginning of period
                  50,700,000                                                    
          net income
                         -32,812,000 -2,171,000 2,420,000 -5,816,000 -9,378,000 4,654,000 -18,424,000 25,665,000 11,686,000 -40,498,000 -547,000 897,000 8,871,000 -1,211,000 925,000 5,226,000 1,568,000 3,456,000 3,853,000 -2,654,000           -7,876,000 2,116,000 20,514,000 7,560,000 11,205,000 12,016,000 27,724,000 17,492,000 -227,837,000 9,414,000 3,606,000 21,483,000 13,456,000 6,267,000 -14,443,000 20,974,000 8,246,000 
          adjustments to reconcile net income to net cash from operating activities
                                                                        
          acquisition of a business
                             -18,000,000                                        
          asset acquisitions and other investments
                            -6,000,000 -1,240,000 4,000,000 -6,400,000                                   
          proceeds from revolving credit facility
                                                                      
          repayment of revolving credit facility
                                                                       
          interest and gain on valuation of investment securities
                                   -430,000 -593,000                                    
          interest and loss on valuation of investment securities
                       197,000 -9,000    -96,000  219,000                                        
          benefit from expected credit losses
                           -32,000 -182,000                                            
          interest and (gain) loss on valuation of investment securities
                                                                        
          share-based compensation
                            3,721,000 3,808,000 3,841,000 4,699,000 3,859,000 4,162,000 5,844,000 5,849,000 5,685,000 4,538,000 5,261,000 5,215,000 3,916,000 3,433,000 3,632,000 2,676,000 2,816,000         1,621,000 1,730,000 1,553,000 1,943,000 1,206,000 2,097,000 1,520,000 1,480,000 5,448,000 3,013,000 7,855,000 4,657,000 2,094,000      2,127,000 
          components of cash, cash equivalents and restricted cash at the end of period
                                                                        
          amortization of debt costs and other assets
                                     206,000 226,000 217,000 375,000 640,000 353,000 359,000 360,000                            
          benefit from doubtful accounts
                                           288,000 532,000                            
          trade accounts receivable
                                                     20,000 -642,000 -2,011,000 13,779,000 2,224,000               
          trade accounts payable
                                                     331,000 -1,823,000 5,748,000 -7,242,000 3,454,000               
          acquisition of business, net of cash acquired
                                     -545,000                                  
          supplemental disclosure of cash flow information:
                                                                        
          noncash investing activities:
                                                                        
          intangible assets acquired in asset acquisitions
                                                                        
          contingent consideration recognized at acquisition date
                                                                      
          amortization of operating lease assets, debt costs and other assets
                                  974,000 977,000 773,000                                    
          provision for doubtful accounts
                                  223,000 592,000 46,000 -28,000 -211,000 -325,000 -35,000 84,000            399,000 -319,000  3,227,000 4,203,000 3,775,000 2,170,000 3,154,000 3,843,000 1,716,000 4,585,000 3,019,000 1,156,000 3,532,000 2,004,000 876,000 4,330,000 3,349,000 1,921,000 
          purchase of intangible assets
                                     434,000 400,000 1,181,000                                
          other-than-temporary impairment on debt securities
                                         5,585,000                            
          loss on valuation of equity securities
                                                                       
          repurchase and retirement of common shares
                                             -8,429,000 -11,111,000 -17,421,000 -26,464,000                        
          changes in operating assets and liabilities, net of effects of acquisition
                                                                        
          gain on valuation of equity securities
                                       230,000 -1,629,000                                
          revaluation of contingent consideration
                                                                        
          asset acquisition and other investments
                                                                        
          cash, cash equivalents, and restricted cash at the beginning of the period
                                       81,157,000                                
          cash, cash equivalents, and restricted cash at the end of the period
                                       -31,370,000 77,056,000                                
          purchase of intangible assets and other investments
                                        -1,217,000                                
          payment of debt issuance costs
                                        -165,000         -102,000                    -5,708,000   
          noncash activities:
                                                                        
          gain on sale of assets
                                                                        
          other long-term assets
                                                                        
          other long-term liabilities
                                                                        
          purchase of debt securities
                                                 -15,250,000                    
          proceeds from sale of assets
                                                                        
          changes in restricted cash
                                                 27,253,000 7,171,000 361,000 10,383,000 -1,004,000 -8,141,000 46,018,000               
          cash and cash equivalents at the beginning of the year
                                                             13,328,000 13,328,000 25,064,000 25,064,000 25,064,000 25,881,000 25,881,000 25,881,000 63,786,000 63,786,000 63,786,000 
          cash and cash equivalents at the end of the year
                                                                        
          supplemental disclosure of cash flow information
                                                                        
          cash paid during the year for:
                                                                        
          interest
                                                                        
          income taxes
                                                                        
          cash and cash equivalents at the beginning of the period
                                          39,572,000  63,663,000  36,815,000   31,055,000  33,207,000            
          cash and cash equivalents at the end of the period
                                          9,595,000 2,678,000 41,652,000  6,342,000 636,000 39,846,000  7,748,000 26,162,000 29,784,000  906,000  33,675,000  3,483,000 3,036,000 47,053,000 19,694,000 18,759,000 10,286,000 16,845,000 26,731,000 23,562,000 15,684,000 21,805,000 37,114,000 49,961,000 48,605,000 
          purchase of other investments
                                                -1,000,000                       
          repayments of long-term debt
                                                            -25,656,000 -19,829,000 -6,223,000 -5,351,000 -4,524,000       
          cash flows from operating activities:
                                                                        
          cash flows from investing activities:
                                                                        
          purchases of assets and investments
                                                                       
          net proceeds from sale of assets
                                                  4,800,000                    
          cash flows from financing activities:
                                                                        
          tax payments for shares withheld to satisfy withholding obligations
                                                                        
          net increase in cash and cash equivalents
                                              6,342,000 636,000 -23,817,000 -31,000 7,748,000   6,990,000 906,000 8,267,000 2,620,000 -22,517,000 3,483,000 3,036,000 13,846,000 6,366,000 5,431,000   1,667,000    -26,672,000   
          net proceeds from issuance of common shares
                                               8,293,000 4,742,000 2,035,000 23,000 -64,000 1,710,000 129,000 813,000 19,000 2,143,000 1,180,000 11,065,000 6,700,000 6,641,000   1,734,000         
          excess income tax benefit on employee stock-based awards
                                               -117,000 222,000 -689,000 249,000 -3,000 57,000 -408,000 162,000 -164,000 -78,000                
          adjustments to reconcile net income to net cash from operating activities:
                                                                        
          amortization of debt costs
                                                     236,000 128,000 180,000 180,000 181,000 181,000 1,079,000 296,000 117,000 54,000 868,000 632,000 395,000 523,000 203,000 164,000 316,000  254,000 
          amortization of exclusivity agreements
                                                     231,000 231,000                  
          impairment of goodwill and certain assets
                                                                        
          interest accrual on debt securities
                                                                        
          changes in operating assets and liabilities, net of effect of dispositions:
                                                                        
          net proceeds from sale of other investments
                                                                        
          repayment of long term debt
                                                                        
          net decrease in cash and cash equivalents
                                                    -7,031,000           -14,778,000 -8,219,000  -2,319,000 -10,197,000 -4,076,000  -13,825,000  
          gain on sale of breg, inc., net of tax
                                                                        
          escrow receivable
                                                         41,537,000            
          charges related to u.s. government resolutions
                                                         -84,189,000 325,000              
          proceeds from sale of other investments
                                                                        
          net proceeds from sale of breg, inc.
                                                                        
          repayment of bank borrowings
                                                                        
          purchase of common stock
                                                                        
          adjustments to reconcile net loss to net cash from operating activities:
                                                                        
          excess income tax benefit on employee stock-based compensation
                                                      -162,000                  
          change in operating assets and liabilities:
                                                                        
          long-term assets
                                                      235,000  -2,266,000                
          long-term liabilities
                                                      208,000  -743,000                
          sale of other investments
                                                                       
          repurchase of treasury shares
                                                                        
          income tax benefit (expense) on employee stock-based awards
                                                                        
          payment made in connection with acquisition
                                                                        
          payment of refinancing fees and debt issuance costs
                                                                        
          cash payment for purchase of minority interest in subsidiary
                                                                        
          gain on sale of breg, inc.
                                                         -83,000               
          income tax benefit on employee stock-based awards
                                                        563,000                
          change in operating assets and liabilities, net of effect of disposition:
                                                                        
          net proceeds from the sale of breg, inc.
                                                          681,000              
          provision for inventory obsolescence
                                                        896,000 -1,615,000 1,130,000 187,000 649,000 3,933,000 2,868,000          
          (repayment of) proceeds from bank borrowings
                                                        -15,000                
          loss on refinancing of credit facility
                                                                        
          gain on interest rate swap
                                                                        
          net gain on sale of vascular operations
                                                                        
          income tax benefit on employee-stock-based awards
                                                                        
          net proceeds from sale of breg inc.
                                                                        
          net proceeds from the sale of vascular operations
                                                                        
          proceeds from (repayment of) bank borrowings
                                                            69,000            
          effect of exchange rates changes on cash
                                                                        
          excess tax benefit on non-qualified stock options
                                                          -3,477,000 766,000 390,000            
          payment of refinancing fees
                                                               -283,000         
          change in operating assets and liabilities, net of effect of acquisitions:
                                                                        
          tax benefit on non-qualified stock options
                                                             1,792,000 1,628,000 22,000 22,000 17,000 1,164,000 694,000 396,000 2,048,000 66,000 53,000 
          change in operating assets and liabilities, net of effect of sale of vascular operations and acquisitions:
                                                                        
          charges related to u.s. government inquiries
                                                                        
          net proceeds from sale of vascular operations
                                                                        
          change in restricted cash
                                                                        
          deferred taxes
                                                             -2,279,000 -1,417,000 -76,861,000   -3,919,000 -3,103,000 -2,978,000 -8,808,000 -7,681,000 -951,000 
          benefit from inventory obsolescence
                                                                        
          change in fair value of interest rate swap
                                                             -1,254,000 -345,000          
          current liabilities
                                                             -7,458,000 -108,000   -616,000 8,277,000 1,282,000 6,539,000 -29,882,000 -22,457,000 -20,194,000 
          proceeds from sale of investments held at cost
                                                                        
          net proceeds from sale of assets, principally vascular operations
                                                             24,215,000 24,193,000          
          proceeds from bank borrowings
                                                             1,023,000    1,361,000 7,870,000 8,438,000     
          gain on sale of vascular operations
                                                             -12,339,000 -12,551,000          
          proceeds from issuance of common stock
                                                             5,996,000 4,613,000          
          repayments of bank borrowings
                                                              -38,000          
          loss on refinancing of senior secured term loan
                                                               3,660,000         
          impairment of goodwill and certain intangible assets
                                                               289,523,000         
          impairment of investments held at cost
                                                               1,500,000         
          amortization of step up of fair value in inventory
                                                               365,000 242,000 152,000       
          gain on sale of pain care® operations
                                                               -1,570,000 -1,570,000 -1,570,000       
          minority interest
                                                                235,000 88,000  -10,000 -10,000    
          changes in operating assets and liabilities:
                                                                        
          investment related to collaborative arrangement
                                                                        
          proceeds from sale of pain care® operations
                                                               5,980,000 5,980,000 5,980,000       
          repurchase of equity
                                                                        
          change in inventory obsolescence estimate
                                                               10,913,000         
          payments made in connection with acquisitions and investments in subsidiaries, net of cash acquired
                                                               -501,000         
          proceeds from sale of investment held at cost
                                                               766,000         
          proceeds from (repayments of) bank borrowings
                                                               -2,377,000 -1,131,000        
          payments made in connection with acquisitions and investments, net of cash acquired
                                                                        
          net proceeds from issue of common shares
                                                                1,922,000 1,907,000       
          minority interests
                                                                        
          deferred royalty income
                                                                        
          loss on sale or disposal of fixed assets
                                                                        
          in-process research & development
                                                                        
          impairment of certain intangible assets
                                                                        
          other current assets
                                                                        
          capital expenditures for tangible assets
                                                                        
          repayment of long-term debt
                                                                  -6,524,000 -5,649,000 -4,834,000    
          proceeds from long-term debt
                                                                  19,000      
          in process research & development
                                                                        
          stock-based compensation
                                                                  8,006,000 5,121,000     
          amortization of step up of fair value in inventory acquired from blackstone
                                                                  2,718,000 1,860,000     
          investments in affiliates and subsidiaries
                                                                  -2,117,000 -1,456,000 -985,000 -336,808,000 -1,108,000  
          net proceeds from issuance of common stock
                                                                  6,799,000 2,964,000 1,637,000 11,172,000 923,000 637,000 
          payment of debt issuance cost
                                                                        
          stock based compensation
                                                                    2,599,000    
          step up of fair value in inventory
                                                                    930,000    
          prepaid expenses and other
                                                                    -2,474,000 -4,994,000 -2,321,000 -202,000 
          proceeds (repayments) of bank borrowings
                                                                    2,631,000    
          share based compensation
                                                                     4,980,000 3,903,000  
          loss (gain) on sale or disposal of fixed assets
                                                                        
          capital expenditures for tangible and intangible assets
                                                                        
          proceeds from sale of assets and marketable securities
                                                                        
          proceeds from sale of joint venture
                                                                        
          proceeds from settlement of distributor agreement
                                                                        
          proceeds from loans and borrowings
                                                                     333,048,000 3,709,000  
          repayment of loans and borrowings
                                                                     -15,039,000 -15,160,000  
          net cash provided (used in) by financing activities
                                                                        
          acquired in process research and development
                                                                     40,000,000   
          investment in subsidiaries and affiliates
                                                                       -1,108,000 
          net repayment of loans and borrowings
                                                                       -15,092,000 
          (decrease) increase in cash and cash equivalents
                                                                       -15,181,000