The Company operates an equity-based compensation plan (“2021 Plan”), which allows for the issuance of stock options (incentive and nonqualified), restricted stock, dividend equivalents, restricted stock units (“RSUs”), performance restricted stock units (“PRSUs”), and other stock-based and cash awards (collectively, the “2021 Plan Awards”). As of December 31, 2025, 23,233,862 shares of Class A common stock were authorized to be awarded and 11,346,834 shares were available for 2021 Plan Awards.

The Company also operates the 2023 Retention Equity Award Plan (the “2023 Plan” and, together with the 2021 Plan, the “Plans”), the purpose of which is to retain and motivate critical personnel over the short-term by providing them additional incentives in the form of RSUs (the “Retention Awards” and together with the “2021 Plan Awards,” the “Awards”). As of December 31, 2025, 600,000 shares of Class A common stock were authorized to be awarded under the 2023 Plan and 69,050 shares were available for Retention Awards.

Equity-based compensation expense for Awards granted under the Plans and inducement awards for the years ended December 31, 2025, 2024 and 2023 totaled $12,193, $12,829 and $2,370, respectively. The expense is primarily included in selling, general and administrative expense with a nominal amount in research and development expense on the consolidated statements of operations and comprehensive income (loss) based upon the classification of the employee. There were no income tax benefits related to equity-based compensation expense for the years ended December 31, 2025, 2024 and 2023.

During the years ended December 31, 2025 and 2024, the Company granted time-based RSUs which vest at various dates through November 15, 2029. RSU compensation expense is recognized over the vesting period, which is typically between 1 and 4 years. Unamortized compensation expense related to the RSUs totaled $8,968 at December 31, 2025, and is expected to be recognized over a weighted average period of approximately 2.73 years.


	Number of units	Weighted-average grant- date fair value per unit
Unvested at December 31, 2023	2,066	$	4.51
Granted	2,563	5.66
Vested	(1,839)	4.45
Forfeited or canceled	(378)	5.74
Unvested at December 31, 2024	2,412	5.52
Granted	1,494	8.68
Vested	(928)	6.15
Forfeited or canceled	(201)	6.79
Unvested at December 31, 2025	2,777	$	6.90

During the year ended December 31, 2025, the Company granted PRSUs subject to a 3-year cliff vesting period, contingent upon the achievement of a designated market condition at the end of the vesting term. The market condition is based on the Company’s relative total shareholder return (“TSR”). Compensation expense related to PRSUs is recognized on a straight-line basis over the 3-year vesting period. The fair value of the PRSUs was determined on the grant date using a Monte Carlo simulation model, which estimated TSR for the Company’s Class A common stock relative to a peer group consisting of companies included in the Russell 2000 Medical Equipment Index, along with additional selected companies. The number of shares of Class A common stock issuable upon vesting of the PRSUs is determined based on achievement of the TSR. Actual shares issued may range from 0% to 200% of the target award granted.

Unamortized compensation expense related to PRSUs totaled $1,178 at December 31, 2025, and is expected to be recognized over a weighted-average period of approximately two years. A summary of PRSU award activity for the year ended December 31, 2025 is as follows (number of units in thousands):

During the years ended December 31, 2025 and 2024, the Company granted time-based stock options which vest over 1 to 4 years following the date of grant and expire within 10 years. The fair value of time-based stock options is determined using the Black-Scholes valuation model, with such value recognized as expense over the service period, which is typically 1 to 4 years, net of actual forfeitures. A summary of the Company’s assumptions used in determining the fair value of the stock options granted during the years ended December 31, 2025 and 2024 are shown in the following table:


	2025		2024
Risk-free interest rate	3.8% - 4.5%		3.9% - 4.3%
Expected dividend yield	—	%	—	%
Expected stock price volatility	37.9% - 38.9%		36.1% - 38.2%
Expected life of stock options (years)	6.25		6.25

The weighted-average grant date fair value of options granted during the year ended December 31, 2025 was $4.19 per share. The expected term of the options granted is estimated using the simplified method. Expected volatility is based on the historical volatility of the Company’s peers’ common stock. The risk-free interest rate is determined based upon a constant U.S. Treasury security rate with a contractual life that approximates the expected term of the option. Unamortized compensation expense related to the options totaled $2,516 at December 31, 2025, and is expected to be recognized over a weighted average period of approximately 2.77 years.


	Number of options	Weighted-average exercise price		Weighted average remaining contractual term (in years)	Aggregate intrinsic value(1)
Outstanding at December 31, 2023	4,347	$	8.68	7.31	$	4,383
Granted	1,835	5.42
Exercised	(422)	7.18
Forfeited or canceled	(1,131)	9.26
Outstanding at December 31, 2024	4,629	7.73		7.14	$	17,049
Granted	581	9.29
Exercised	(219)	4.70
Forfeited or canceled	(327)	12.02
Outstanding at December 31, 2025	4,664	7.77		7.06	$	7,780
Exercisable and vested at December 31, 2025	2,268	$	9.25	5.95	$	2,880

(1) The aggregate intrinsic value is based upon the difference between the Company’s closing stock price at the date of the consolidated balance sheets and the exercise price of the stock option for in-the-money stock options. The intrinsic value of outstanding stock options fluctuates based upon the trading value of the Company’s Class A common stock.

The Company operates a non-qualified Employee Stock Purchase Plan (“ESPP”), that allows eligible employees to purchase shares of Class A common stock through payroll deductions at a discounted price. As of December 31, 2025, 1,713,325 shares were reserved for issuance under the ESPP. A total of 208,147, 229,767 and 516,976 shares were issued under the ESPP and $480, $445 and $352 of expense was recognized for the years ended December 31, 2025, 2024 and 2023, respectively.

The Company has various defined contribution plans which are offered in Canada, Germany, the Netherlands, the United Kingdom and Israel. In some cases, these plans are required by local laws or regulations. Contributions are primarily discretionary, except in some countries where contributions are contractually required. These plans cover substantially all eligible employees in the countries where the plans are offered either voluntarily or statutorily.

In the United States, the Company provides a 401(k) defined contribution plan (“U.S. Plan”) that covers substantially all U.S. employees that meet minimum age requirements. The Company matches 100% of the employees’ contribution up to 4% of the employees’ wages and 50% on the next 2%. The U.S. Plan also provides for an additional matching contribution at the Company’s discretion.

Company contributions totaled $5,797, $6,715, and $5,836 for all global plans during the years ended December 31, 2025, 2024 and 2023, respectively. The expense is included in cost of sales, selling, general and administrative expense and research and development expense on the consolidated statement of operations and comprehensive income (loss) based upon the classification of the employee.