v3.26.1
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)
$ in Thousands
 6 Months Ended
Jun. 30, 2026
Jun. 30, 2025
OPERATING ACTIVITIES    
Net loss $ (17,850) $ (17,772)
Adjustments to reconcile net loss to net cash used in operating activities:    
Depreciation and amortization 11,427 10,218
Stock-based compensation 8,173 9,111
Accretion of acquisition installment payable 220 98
Deferred income taxes (82) 245
Non-cash other 161 (100)
Changes in certain operating assets and liabilities:    
Accounts receivable - trade (6,536) (11,381)
Inventories (2,553) (8,899)
Prepaid expenses and other current assets 201 (501)
Accounts payable - trade 3,140 3,720
Accrued expenses and other liabilities 2,209 2,509
Other (869) (1,866)
Net cash used in operating activities (2,359) (14,618)
INVESTING ACTIVITIES    
Other acquisitions, including clinics, net of cash acquired (5,936) (320)
Sale of short-term marketable securities 13,000 0
Investment in private companies and purchases of licenses (330) (1,540)
Loss on investment in private companies 284 0
Purchases of property and equipment (5,805) (7,672)
Net cash provided by (used in) investing activities 1,213 (9,532)
FINANCING ACTIVITIES    
Proceeds from issuance of debt 0 25,000
Payment on debt issuance costs (289) 0
Payments on mortgage notes (85) (78)
Payments on acquisition notes (977) (248)
Net cash (used in) provided by financing activities (1,351) 24,674
Effect of exchange rate changes on cash, cash equivalents and restricted cash (68) 304
NET (DECREASE) INCREASE IN CASH, CASH EQUIVALENTS AND RESTRICTED CASH (2,565) 828
Cash, cash equivalents and restricted cash, beginning of year 21,620 45,777
Cash, cash equivalents and restricted cash, end of period 19,055 46,605
SUPPLEMENTAL DISCLOSURES    
Cash paid for interest 3,741 2,552
Transfer of instruments between property and equipment and inventory (980) 651
Right-of-use assets obtained in exchange for lease liabilities 1,265 3,311
Capital contribution associated with reclassification of MedTech liability to equity 0 2,062
Medtech    
SUPPLEMENTAL DISCLOSURES    
Issuance of common shares in connection with Boston O&P acquisition 2,398 226
LOC Acquisition    
SUPPLEMENTAL DISCLOSURES    
Issuance of common shares in connection with Boston O&P acquisition 1,656 0
Boston Brace International, Inc    
SUPPLEMENTAL DISCLOSURES    
Issuance of common shares in connection with Boston O&P acquisition 0 233
Vendor    
SUPPLEMENTAL DISCLOSURES    
Issuance of common shares in connection with Boston O&P acquisition $ 0 $ 1,261