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GOODWILL AND INTANGIBLE ASSETS
 9 Months Ended
Sep. 30, 2026
Intangible Asset, Goodwill and Other [Abstract]  
GOODWILL AND INTANGIBLE ASSETS GOODWILL AND INTANGIBLE ASSETS
Goodwill

Changes in the carrying amount of goodwill for the nine months ended September 30, 2026 were as follows:
Total
Goodwill at January 1, 2026$109,269 
Clinic and other acquisitions7,749 
Foreign currency translation impact1,568 
Goodwill at September 30, 2026
$118,586 

Intangible Assets

As of September 30, 2026, the balances of amortizable intangible assets were as follows:
Weighted-Average Amortization PeriodGross Intangible AssetsAccumulated AmortizationNet Intangible Assets
Patents8.5 years$51,058 $(21,912)$29,146 
Intellectual Property & Capitalized Software6.5 years16,057 (6,803)9,254 
Customer Relationships & Other9.2 years28,722 (7,604)21,118 
License Agreements2.6 years10,865 (8,715)2,150 
Total amortizable assets$106,702 $(45,034)$61,668 

As of December 31, 2025, the balances of amortizable intangible assets were as follows:
Weighted-Average Amortization PeriodGross Intangible AssetsAccumulated AmortizationNet Intangible Assets
Patents9.3 years$49,939 $(18,854)$31,085 
Intellectual Property & Capitalized Software7.1 years16,056 (5,642)10,414 
Customer Relationships & Other9.7 years26,278 (6,107)20,171 
License Agreements2.5 years10,453 (7,321)3,132 
Total amortizable assets$102,726 $(37,924)$64,802 

Licenses are tied to product launches and do not begin amortizing until the product is launched to the market.

Trademarks are non-amortizing intangible assets which were $12,200 and $12,909 as of September 30, 2026 and December 31, 2025, respectively. Trademarks are recorded in Other intangible assets on the condensed consolidated balance sheets. The change in balance during the nine months ended September 30, 2026 was primarily driven by impairment charges related to our ApiFix Ltd. ("ApiFix") and MedTech trademark assets.
During 2026 and 2025, management completed a quantitative analysis whereby we determined the fair value of certain of our trademark assets were below their respective carrying values. We recorded an impairment charge of $611 and $2,268 for the nine months ended September 30, 2026 and 2025, respectively, to reduce the carrying amount of the intangible assets to their estimated fair value.