0001193125-22-061686 | 10-K | XBRL Viewer | Organogenesis Holdings INC

Prepaid Expenses and Other Current Assets

7. Prepaid Expenses and Other Current Assets

Prepaid expenses and other current assets consisted of the following:


	December 31,
	2021		2020
Subscriptions	$	2,745	$	2,013
Conferences and marketing expenses		538		63
Deposits		1,216		1,438
Reimbursement of offering expenses		—		1,009
Insurance		358		240
Other		112		172

	$	4,969	$	4,935

Deposits are funds held by vendors which are expected to be released within twelve months and therefore they are recorded as current assets.

Property and Equipment, Net

12 Months Ended

Dec. 31, 2021

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

8. Property and Equipment, Net

Property and equipment consisted of the following:


	December 31,
	2021			2020
Leasehold improvements	$	30,531		$	39,574
Building		4,943			—
Furniture, computers and equipment		53,959			48,236

	89,433			87,810
Accumulated depreciation and amortization		(57,729	)		(73,797	)
Construction in progress		47,456			41,779

	$	79,160		$	55,792

Depreciation expense was $5,781, $4,438, and $3,783, for the years ended December 31, 2021, 2020, and 2019, respectively. As of December 31, 2020, the Company had $21,689 of buildings under finance leases recorded within leasehold improvements and had $18,716 recorded

within accumulated depreciation related to these buildings. In August 2021, the Company purchased one building previously under a finance lease from a related party and removed the building from leasehold improvements and recorded the asset to buildings. In November 2021, the Company exercised the option to extend the leases of the other buildings previously under finance leases for additional five years. These leases were reclassified from finance leases to operating leases upon the Company’s reassessment of the lease classification according to ASC

842-10-25-1

Lease Classification.

The related finance lease assets and the accumulated depreciation were removed from property and equipment, net and were recorded to operating

lease right-of-use assets

on the consolidated balance sheet as of December 31, 2021. See Note “17. Leases”.

Construction in progress primarily represents unfinished construction work on the aforementioned purchased building and, more recently, improvements at the Company’s leased facilities in Canton and Norwood, Massachusetts.

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2021

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

9. Goodwill and Intangible Assets

Goodwill was $28,772 as of December 31, 2021 and 2020.

Identifiable intangible assets consisted of the following as of December 31, 2021:


	Original Cost		Accumulated Amortization			Net Book Value
Developed technology	$	32,620	$	(17,709	)	$	14,911
Trade names and trademarks		2,080		(1,183	)		897
Customer relationship		10,690		(1,381	)		9,309
Independent sales agency network		4,500		(4,500	)		—
Patent		7,623		(7,623	)		—
Non-compete agreements		1,010		(454	)		556

Total	$	58,523	$	(32,850	)	$	25,673

Identifiable intangible assets consisted of the following as of December 31, 2020:


	Original Cost		Accumulated Amortization			Net Book Value
Developed technology	$	32,620	$	(14,330	)	$	18,290
Trade names and trademarks		2,080		(906	)		1,174
Customer relationship		10,690		(312	)		10,378
Independent sales agency network		4,500		(4,500	)		—
Patent		7,623		(7,623	)		—
Non-compete agreements		1,010		(230	)		780

Total	$	58,523	$	(27,901	)	$	30,622

Amortization of intangible assets, calculated on a straight-line basis or using an accelerated method, which reflects the pattern in which the economic benefits of the intangible assets are consumed, was $4,949, $3,745

, and

$6,043 for the years ended December 31, 2021, 2020, and 2019, respectively. Estimated future annual amortization expense related to these intangible assets is as follows:


2022	$	4,883
2023		4,918
2024		3,403
2025		3,323
2026		3,043
Thereafter		6,103

Total	$	25,673

Accrued Expenses and Other Current Liabilities

12 Months Ended

Dec. 31, 2021

Accrued Expenses and Other Current Liabilities

10. Accrued Expenses and Other Current Liabilities

Accrued expenses and other current liabilities consisted of the following:


	December 31,
	2021		2020
Personnel costs	$	26,865	$	18,943
Royalties		3,458		2,971
Accrued but unpaid lease obligations and interest		3,963		—
Other		2,303		2,059

	$	36,589	$	23,973

The accrued but unpaid lease obligations and the interest accrual on these obligations were previously included in the long-term portion of the finance lease obligations, and other liabilities as of December 31, 2020. The reclassification was due to the purchase of a building previously recorded as a finance lease from a related party (see Note “17. Leases”) and the termination of the 2019 Credit Agreement (see Note “12. Long-Term Debt Obligations”).

Restructuring

12 Months Ended

Dec. 31, 2021

Restructuring and Related Activities [Abstract]

Restructuring

11. Restructuring

On October 21, 2020, the Company committed to a plan to restructure the workforce and consolidate its La Jolla facilities as part of the

Company’s long-term plan to consolidate manufacturing operations into Massachusetts to reduce the Company’s cost structure. The majority of the restructuring costs have been incurred as of December

2021

, with certain facility and storage costs continuing through the middle of

2024

. The restructuring will result in a charge of approximately $

7.5

million, of which approximately $

4.0

million is attributable to the retention benefits associated with approximately

employees and the remaining $

3.5

million is related to the facility closures. As employees are required to provide future services, employee retention and other benefit-related costs related to the Company’s restructuring are expensed over the service period.

As a result of this restructuring activity, the Company incurred a pre-tax charge of $4,704 and $618 in the year ended December 31, 2021 and 2020, respectively. These charges were included in selling, general and administrative expenses in the consolidated statements of operations. The liability related to the restructuring activities was $3,168 and $618 as of December 30, 2021 and 2020, respectively, and was included in accrued expenses and other current liabilities in the consolidated balance sheets. The following table provides a roll-forward of the restructuring liability.


	Employee			Facility

Liability balance as of December 31, 2019	$	—		$	—
Expenses		618			—
Cash distributions		—			—

Liability balance as of December 31, 2020		618			—
Expenses		3,513			1,191
Cash distributions		(1,614	)		(540	)

Liability balance as of December 31, 2021	$	2,517		$	651

Long-Term Debt Obligations

12 Months Ended

Dec. 31, 2021

Long-term Debt, Unclassified [Abstract]

Long-Term Debt Obligations

12. Long-Term Debt Obligations


	December 31,
	2021			2020
Line of credit	$	—		$	10,000

Term loan		74,062			60,000
Less debt discount and debt issuance cost		(637	)		(290	)

Term loan, net of debt discount and debt issuance cost	$	73,425		$	59,710

2021 Credit Agreement

In August 2021, the Company, as borrower, its subsidiaries, as guarantors, a

nd Silicon

Valley Bank (“SVB”), and the several other lenders thereto (collectively, the “Lenders”) entered into a credit agreement (the “2021 Credit Agreement”), providing for a term loan facility not to exceed $75,000 (the “Term Loan Facility”) and a revolving credit facility not to exceed $125,000 (the “Revolving Facility”). The Company’s obligations to the Lenders are secured by substantially all of the Company’s assets, including intellectual property. Capitalized terms used herein and not otherwise defined are defined as set forth in the 2021

Credit Agreement.

Advances made under the 2021 Credit Agreement may be either Eurodollar Loans or ABR Loans, at the Company’s option. For Eurodollar Loans, the interest rate is a per annum interest rate equal to LIBOR plus

an Applicable Margin between 2.00% to 3.25% based on the Total Net Leverage Ratio. For ABR Loans, the interest rate is equal to (1) the highest of (a) the Wall Street Journal Prime Rate, (b) the Federal Funds Rate plus

0.50

% and (c) the LIBOR rate plus 1.0%,

plus

(2) an Applicable Margin between 1.00% to 2.25% based on the Total Net Leverage

Ratio.

The

2021 Credit Agreement requires the Company to make consecutive quarterly installment payments equal to the following percentages of the original principal amount of the Term Loans: (a) from September 30, 2021 through and including June 30, 2022, 0.625 (or $469) ; (b) from September 30, 2022 through and including June 30, 2023, 1.250% (or $938); (c) from September 30, 2023 through and including June 30, 2025, 1.875% (or $1,406) and (d) from September 30, 2025 and the last day of each quarter thereafter until August 6, 2026 (the “Term Loan Maturity Date”), 2.50% (or $1,875). The Company may prepay the Term Loan Facility, provided that any Term Loans prepaid prior to August 6, 2022 must be accompanied by a prepayment premium equal to 1.00% of the aggregate amount of Term Loans prepaid. Once repaid, amounts borrowed under the Term Loan Facility may not

be re-borrowed.

The Company must pay in arrears, on the first day of each quarter prior to August 6, 2026 (the “Revolving Termination Date”) and on the Revolving Termination Date, a fee for the

Company’s non-use of

available funds

in an amount equal to the Commitment Fee Rate per annum, multiplied by the difference between (x) the Total Revolving Commitments and (y) the sum of (i) the average for the period of the daily closing balance of the Revolving Loans, excluding the aggregate principal amount of Swingline Loans, (ii) the aggregate undrawn amount of all Letters of Credit outstanding at such time and (iii) the aggregate amount of all L/C Disbursements that have not yet been reimbursed or converted into Revolving Loans or Swingline Loans. The Commitment Fee Rate is between

0.25%

0.45%

based on the Total Net Leverage Ratio. The maturity date for advances made under the Revolving Facility is the Revolving Termination Date. The Company may elect to reduce or terminate the Revolving Facility in its entirety at any time by repaying all outstanding principal, unpaid accrued interest and, with respect to any such reduction or termination of the Revolving Commitments made prior to August 6, 2022,

1.00%

of the aggregate amount of the Revolving Commitments so reduced or

terminated.

Under the 2021 Credit Agreement, the Company is required to comply with certain financial covenants including the Consolidated Fixed Charge Coverage Ratio and Consolidated Total Net Leverage Ratio, tested quarterly. In addition, the Company is also required to make representations and warranties and comply with certain

non-financial

covenants that are customary in loan agreements of this type, including restrictions on the payment of dividends, repurchase of stock, incurrence of indebtedness, dispositions and acquisitions.

As of December 31, 2021, the Company had outstanding borrowings of $74,062 under the Term Loan Facility and $0 under the Revolving Facility with $125,000 available for future revolving borrowings. The Company recorded additional debt issuance costs and related fees of $604 in connection with the Term Loan Facility, which are recorded as a reduction of the carrying value of the term loan on the Company’s consolidated balance sheets. In connection with the Revolving Facility, the Company recorded debt issuance costs and related fees of $1,223, which are recorded as other assets. Both of these costs are being amortized to interest expense through the maturity date of the facilities.

Future payments of the 2021 Credit Agreement, as of December 31, 2021, are as follows for the calendar years ending December 31:


2022	$	2,812
2023		4,687
2024		5,625
2025		6,563
2026 and beyond		54,375

Total	$	74,062

2019 Credit Agreement

In March 2019, the Company, its subsidiaries and SVB, and the several other lenders thereto entered into a credit agreement, as amended (the “2019 Credit Agreement”), providing for a term loan facility of $40,000 and a revolving credit facility of up to $60,000. Both facilities were set to mature in 2024. The interest rate for the term loan facility was a floating per

annum interest rate equal to the greater of 3.75% above the Wall Street Journal Prime Rate and 9.25%. The interest rate for advances under the revolving facility was a floating per annum interest rate equal to the greater of the Wall Street Journal Prime Rate and 5.50%

. If the Company elected to prepay the loan or terminate the facilities, the Company was required to pay a certain percentage of the outstanding principal as a prepayment fee. A final payment fee (the “Final Payment”) of 6.5% multiplied by the original aggregate principal amount of term loan facility was due upon the earlier to occur of the maturity date of the term loan or prepayment of all outstanding principal.

In August 2021, upon entering into the 2021 Credit Agreement, the Company paid an aggregate amount of $70,559 due under the 2019 Credit Agreement, including unpaid principal, accrued interest, the Final Payment and a prepayment fee, with proceeds from the 2021 Credit Agreement, and the 2019 Credit Agreement was terminated. Upon termination of the 2019 Credit Agreement, the Company recognized $1,883 as loss on the extinguishment of the loan for the year ended December 31, 2021.

Master Lease Agreement

In April 2017, the Company entered into the Master Lease Agreement (the “ML Agreement”) with Eastward Fund Management LLC. In March 2019, upon entering into the 2019 Credit Agreement, the Company paid an aggregate amount of $17,649 due under the ML Agreement with proceeds from the 2019 Credit Agreement, and the ML Agreement was terminated. Upon termination of the ML Agreement, the Company recognized $1,862 as loss on the extinguishment of the loan.

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

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Share-based Payment Arrangement [Abstract]

Stockholders' Equity

12 Months Ended

Dec. 31, 2021

Equity [Abstract]

Stockholders' Equity

13. Stockholders’ Equity

As of December 31, 2021, the

issued shares of Class A common stock include 728,548 treasury shares that were reacquired in connection with the redemption of redeemable shares in March 2019. These redeemable shares were initially issued in connection with the acquisition of Nutech Medical, Inc. (“NuTech Medical”) in 2017 and included a put right. The holders of the shares exercised the right to put the shares back to the Company at an agreed-upon exercise price of $9.28 per share on March 24, 2019.

Each share of Class A common stock entitles the holder to one vote on all matters submitted to the stockholders for a vote. Class A common stockholders are entitled to receive dividends, as may be declared by the Board of Directors. Through December 31, 2021, no cash dividends have been declared

or paid.

At December 31, 2021 and 2020, the Company has reserved the following shares of Class A common stock for future issuance:


	December 31,
	2021		2020
Shares reserved for issuance for outstanding options		6,596,969		6,425,040
Shares reserved for issuance for outstanding restricted stock units		764,871		806,048
Shares reserved for issuance for future grants		5,644,691		6,832,649

Total shares of authorized common stock reserved for future issuance		13,006,531		14,063,737

Warrant Exchange and Warrant Exercise

As of December 31, 2018, the Company had 4.3 million private warrants outstanding, 4.1 million of which were issued to Avista Capital Partners IV, L.P. and Avista Capital Partners IV (Offshore), L.P. in connection with the Avista Merger on December 10, 2018 (the “Private Warrants”), and 31.0 million public warrants outstanding that were issued in connection with the initial public offering of Avista Healthcare Public Acquisition Corp. on October 10, 2016 (the “Public Warrants”, together with the Private Warrants, the “Warrants”).

In the third quarter of 2019, the Company executed a series of transactions related to its then outstanding 30,890,748 Public Warrants and 4,100,000 Private Warrants. The Company issued an aggregate of 2,845,280 shares of Class A common stock for 29,950,150 Public Warrants at an exchange rate of 0.095. The Company issued an aggregate of 80,451 shares of Class A common stock for the remaining Public Warrants at an exchange rate of 0.0855. The Company issued an aggregate of 389,501 shares of Class A common stock for the Private Warrants at an exchange rate of 0.095.

As the fair value of the Warrants exchanged in the warrant exchange transactions immediately prior to the exchanges was less than the fair value of the Class A common stock issued, the Company

recorded a non-cash deemed dividend

of $

568

for the incremental fair value provided to the Warrant holders in the year ended December 31, 2019.

The Company originally classified the Warrants as equity on its financial statements. As a result of the issuance of the SEC Statement in 2021, the Company reevaluated the historical accounting treatment of its Public Warrants and Private Warrants and determined that the Private Warrants should have been recorded at fair value as a liability in the Company’s consolidated balance sheet with changes to the fair value recorded to the consolidated statements of operations. See Note “2. Significant Accounting Policies” for detail.

2020 Underwritten Public Offering

In November 2020, the Company

closed a public offering (the “2020 Underwritten Public Offering”) of 17,500,000 shares of the Company’s Class A common stock, par value $0.0001 per share, at a price per share to the public of $3.25, less underwriting discounts and commissions. In connection with this offering, the Company issued a total of 19,916,708 shares of Class A common stock with gross proceeds of $64,729 and net proceeds of $59,073 after deducting underwriter discounts, payment of the fee to the Avista entities and other offering expenses in the aggregate amount of $5,656. $1,009 of the offering expenses which should have been reimbursed to the Company by the underwriters on November 17, 2020 was not received until January 2021 and was included in prepaid expenses and other current assets on the consolidated balance sheet as of December 31, 2020. $4,647, representing the offering expenses net of the reimbursement was recorded to

additional paid-in capital

against the proceeds

received.

2019 Underwritten Public Offering

In November 2019, the Company closed a public offering (the “2019 Underwritten Public Offering”) of 9,000,000 shares of the Company’s Class A common stock, par value $0.0001 per share, at a price per share to the public of $5.00, less underwriting discounts and commissions. In connection with this offering, the Company issued a total of 10,068,056 shares with gross proceeds of $50,340 and net proceeds of $46,831 after deducting underwriter discounts, payment of the fee to the Avista entities and other offering expenses in the aggregate amount of $3,510 which were recorded to additional

paid-in

capital net against the proceeds received.

Share-Based Compensation

12 Months Ended

Dec. 31, 2021

Equity Incentive Plan Share-Based Compensation

14. Share-Based Compensation

Stock Incentive

Plans-the

2018 Plan

On November 28, 2018, the Board of Directors of the Company adopted, and on December 10, 2018, the Company’s stockholders approved, the Organogenesis 2018 Equity and Incentive Plan (the “2018 Plan”). The purposes of the 2018 Plan are to provide long-term incentives and rewards to the Company’s employees, officers, directors and other key persons (including consultants), to attract and retain persons with the requisite experience and ability, and to more closely align the interests of such employees, officers, directors and other key persons with the interests of the Company’s stockholders.

The 2018 Plan authorizes the Company’s Board of Directors or a committee of not less than two independent directors (in either case, the “Administrator”) to grant the following types of awards:

non-statutory

stock options; incentive stock options; restricted stock awards; restricted stock units; stock appreciation rights; unrestricted stock awards; performance share awards; and dividend equivalent rights. The 2018 Plan is administered by the Company’s Board of Directors.

As of December 31, 2021, a total of 9,198,996 shares of Class A common stock have been authorized to be issued under the 2018 Plan (subject to adjustment in the case of any stock dividend, stock split, reverse stock split, or similar change in capitalization of the Company).

Stock Incentive

Plans-the

2003 Plan

The Organogenesis 2003 Stock Incentive Plan (the “2003 Plan”), provides for the Company to issue restricted stock awards, or to grant incentive stock options or

non-statutory

stock options. Incentive stock options may be granted only to the Company’s employees. Restricted stock awards and

non-statutory

stock options may be granted to employees, members of the Board of Directors, outside advisors and consultants of the Company.

Effective as of the closing of the Avista Merger on December 10, 2018, no additional awards may be made under the 2003 Plan and as a result (i) any shares in respect of stock options that are expired or terminated under the 2003 Plan without having been fully exercised will not be available for future awards; (ii) any shares in respect of restricted stock that are forfeited to, or otherwise repurchased by the Company, will not be available for future awards; and (iii) any shares of Class A common stock that are tendered to the Company by a participant to exercise an award will not be available for future awards.

Stock-Based Compensation Expense

Stock options awarded under the stock incentive plans expire 10 years after the grant date and typically vest over four or five years. Restricted stock units awarded typically vest over four years.

During the years ended December 31, 2021, 2020, and 2019, the Company recorded stock-based compensation expense of $3,864, $1,661, and $936, respectively, within selling, general and administrative expenses on the consolidated statements of operations.

Restricted Stock Units (RSUs)

During the year ended December 31, 2021, the Company granted 310,692 time-based restricted stock units to its employees, executives and the Board of Directors. Each restricted stock unit represents the contingent right to receive one share of the Company’s Class A common stock. The fair value of the restricted stock units was based on the fair market value of the Company’s stock on the date of grant.

The activity of restricted stock units is set forth below:


	Number of Shares			Weighted Average Grant Date Fair Value
Unvested at December 31, 2020		787,923		$	3.81
Granted		310,692			14.29
Vested		(248,305	)		4.20
Canceled/Forfeited		(85,439	)		7.64

Unvested at December 31, 2021		764,871		$	7.52

As of December 31, 2021, the total unrecognized compensation cost related to unvested restricted stock units expected to vest was $3,273 and the weighted average remaining recognition period for unvested awards was 2.72 years.

Stock Options

The stock options granted during the years ended December 31, 2021, and 2020 were 1,069,658 and 1,553,723, respectively. The assumptions that the Company used to determine the grant-date fair value of stock options granted during these periods were as follows, presented on a weighted-average basis:


	Year Ended December 31,
	2021			2020
Risk-free interest rate		0.83	%		0.46	%
Expected term (in years)		6.22			6.22
Expected volatility		39.31	%		37.42	%
Expected dividend yield		0.0	%		0.0	%
Exercise price	$	13.57		$	4.04
Underlying stock price	$	13.57		$	3.37

These assumptions resulted in an estimated weighted-average grant-date fair value per share of stock options granted during the years ended December 31, 2021 and 2020 of $5.32 and $1.05, respectively.

The following table summarizes the Company’s stock option activity since December 31, 2020:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term		Aggregate Intrinsic Value
						(in years)
Outstanding as of December 31, 2020		6,615,223		$	2.32		5.22		34,438
Granted		1,069,658			13.57
Exercised		(955,736	)		2.29				10,121
Canceled / forfeited		(132,176	)		4.67

Outstanding as of December 31, 2021		6,596,969			4.10		5.20		38,524

Options exercisable as of December 31, 2021		4,342,519			1.80		3.47		32,292

Options vested or expected to vest as of December 31, 2021		6,216,308		$	3.79		4.98		37,618

The aggregate intrinsic value of stock options is calculated as the difference between the exercise price of the stock options and the fair value of the Company’s Class A common stock for those stock options that have exercise prices lower than the fair value of the Company’s Class A common stock.

The total fair value of options vested during the years ended December 31, 2021 and 2020 was $813 and $678, respectively.

As of December 31, 2021, the total unrecognized stock compensation expense was $3,998 and was expected to be recognized over a weighted-average period of 2.92 years.

Between 2010 and 2013, a former executive to

k several partial recourse notes totaling $635 to exercise his 675,990 shares of stock options. The notes were secured with these shares held by the former executive. When the loans were outstanding, the options were not considered exercised and were included within the options outstanding for accounting purposes. As of December 31, 2020, $334 of the principal balance of the partial recourse notes was outstanding and 195,278 shares were not considered outstanding for accounting purposes. In the three months ended March 31, 2021, the former executive repaid the remaining principal balance of the notes

(see Note

“19. Related Parties Transactions”). The repayments were treated as the exercise price for the 195,278 shares of the options and were included in the consolidated statement of stockholders’ equity. As of December 31, 2021, the partial recourse notes were paid off and all of the 675,990 shares used to secure the notes were considered outstanding f

accounting purposes.

Income Taxes

12 Months Ended

Dec. 31, 2021

Income Tax Disclosure [Abstract]

Income Taxes

15. Income Taxes

The components of the income tax expense (benefit) consisted of the following for the years ended December 31, 2021, 2020, and 2019:


	Year Ended December 31,
	2021			2020			2019
Income tax expense (benefit):
Current tax expense (benefit)
Federal	$	—		$	(106	)	$	(105	)
State		899			505			116
Foreign		(39	)		19			28

Total current tax expense		860			418			39

Deferred tax expense (benefit)
Federal		(30,506	)		109			105
State		(1,470	)		—			—
Foreign		—			3			6

Total deferred tax expense		(31,976	)		112			111

Total income tax expense (benefit)	$	(31,116	)	$	530		$	150

On a periodic basis, the Company reassess the valuation allowance on its deferred income tax assets, weighing positive and negative evidence to assess the recoverability of the deferred tax assets. In the fourth quarter of fiscal year 2021, the Company assessed the valuation allowance and considered positive evidence, including significant cumulative consolidated income over the three years ended December 31, 2021, revenue growth and expectations of future profitability, and negative evidence, including the impact of a negative change in the economic climate, significant risks and uncertainties in the business and restrictions on tax loss utilization in certain state jurisdictions. After assessing both the positive evidence and the negative evidence, the Company determined it was more likely than not that its deferred tax assets would be realized in the future and released the valuation allowance on its net deferred tax assets as of December 31, 2021, resulting in a benefit from income taxes of $48,252.

As of December 31, 2021, the Company had available for the reduction of future years’ federal taxable income, net operating loss carry-forwards of approximately $103,619. Of these carry-forwards, $45,138 will expire from the year ended December 31, 2021 through

2037

and $58,481 can be carried forward indefinitely. The Company had state net operating loss carry-forwards of approximately $25,431 expiring from the year ended December 31, 2021 through 2039. At December 31, 2021, the Company had available for the reduction of future years’ federal taxable income, research and development credits of approximately $1,003 expiring between December 31, 2022 and

December 31, 2039.

Deferred income taxes reflect the net tax effects of temporary differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for income tax purposes. Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2021 and 2020 are as follows:


	December 31,
	2021			2020
Net operating loss carryforwards

Federal	$	21,760		$	31,783
State		1,612			3,342
Foreign		16			18
Other		7,556			5,829
163j interest		—			4,979
Stock-based compensation		676			357
Finance leases		632			2,991
Operating leases		12,918			—
Fixed assets		2,748			2,589

Net deferred tax assets before valuation allowance		47,918			51,888
Valuation allowance		—			(48,252	)
ROU assets		(12,273	)		—
Intangibles		(3,651	)		(3,618	)

Net deferred tax assets	$	31,994		$	18

The Company’s subsidiary in Switzerland is carrying a deferred tax asset of approximately $16 relating to a net operating loss carryover that is expected to be benefited in the next couple of years.

The Company has not recorded withholding taxes on the undistributed earnings of its Swiss subsidiary because it is the Company’s intent to reinvest such earnings indefinitely.

Ownership changes, as defined in the Internal Revenue Code, may limit the amount of net operating losses and research and development tax credit carryforwards that can be utilized annually to offset future taxable income. Subsequent ownership changes could further affect the limitation in future years. The Company completed an analysis in 2021 and determined that it had not experienced an ownership change during the periods 2001 through 2021.

The differences between income taxes expected at the U.S. federal statutory income tax rate of 21% and the reported consolidated income tax benefit (expense) are summarized as follows:


	December 31,
	2021			2020			2019
U.S. federal statutory income tax rate		21.0	%		21.0	%		21.0	%
Federal valuation allowance		(70.6	)%		(28.9	)%		(17.6	)%
State valuation allowance		(9.1	)%		(4.8	)%		(3.9	)%
State and local income taxes		6.8	%		6.2	%		3.5	%
Nondeductible expenses		0.8	%		6.0	%		(1.4	)%
Uncertain tax position reserves		0.9	%		0.4	%		(0.1	)%
Research and development credits		0.9	%		3.0	%		(1.9	)%

Effective income tax rate		(49.3	)%		2.9	%		(0.4	)%

The Company recognizes the tax benefit from an uncertain tax position only if it

is more-likely-than-not that

the tax position will be sustained on examination by taxing authorities, based on the technical merits of the position.

The tax benefits recognized in the financial statements from such a position are measured based on the

largest

benefit that has a greater than 50% likelihood of being realized upon ultimate settlement.

The amount of unrecognized tax benefits is

$2,307, $2,870, and $3,192 as of December 31, 2021, 2020, and 2019, respectively. The net decrease primarily relates to the expiration of the carryforward period for certain Federal and Massachusetts R&D credits previously included as an unrecognized tax benefit.

A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below:


	Year Ended December 31,
	2021			2020			2019
Gross balance at beginning of year	$	2,123		$	2,618		$	3,286
Additions based on tax positions related to the current period		153			111			133
Reductions for tax positions of prior years		(664	)		(606	)		(801	)

Gross balance at end of year	$	1,612		$	2,123		$	2,618

The Company files income tax returns in the U.S. federal and state jurisdictions and Switzerland. With limited exceptions, the Company is no longer subject to federal, state, local or foreign examinations for years prior to December 31, 2017. However, carryforward attributes that were generated prior to December 31, 2017 may still be adjusted upon examination by state or local tax authorities if they either have been or will be used in a future period.

The Company recognizes interest and penalty-related expenses in tax expenses. There was $330 and $317 of interest recorded for uncertain tax positions for the years ended December 31, 2021 and 2020, respectively, which was classified in accrued expenses in the consolidated balance sheets. These amounts are not reflected in the reconciliation above.

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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Reference 2: http://www.xbrl.org/2003/role/disclosureRef
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Revision to Previously Issued Financial Statements

Net Income (Loss) Per Share (EPS)

12 Months Ended

Dec. 31, 2021

Earnings Per Share [Abstract]

Net Loss Per Share

16. Net Income (Loss) Per Share (EPS)

Basic EPS is calculated by dividing net income (loss) by the weighted-average number of shares outstanding during the period. Diluted EPS is calculated by dividing net income (loss) by the weighted-average number of shares outstanding plus the dilutive effect, if any, of outstanding equity awards using the treasury stock method which includes consideration of unrecognized compensation expenses as additional proceeds.

A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income (loss) attributable to the Class A common stockholders is as follows:


	Year Ended December 31,
	2021		2020		2019
Numerator:
Net Income (loss)	$	94,902	$	17,234	$	(38,709	)
Less: Non-cash dividend to warrant holders		—		—		568

Net Income (loss) attributable to common shareholders	$	94,902	$	17,234	$	(39,277	)

Denominator:
Weighted average common shares outstanding—basic		128,331,022		107,737,936		92,840,401
Dilutive effect of restricted stock units		469,123		135,932		—
Dilutive effect of options		4,862,514		3,486,963		—

Weighted-average common shares outstanding—diluted		133,662,659		111,360,831		92,840,401
Earnings (loss) per share—basic	$	0.74	$	0.16	$	(0.42	)

Earnings (loss) per share—diluted	$	0.71	$	0.15	$	(0.42	)

For the year

ended December 31, 2021 and 2020, outstanding stock-based awards of 994,168 and 1,792,085 were excluded from the diluted EPS calculation as they are anti-dilutive. For the year ended December 31, 2019, the Company had a net loss. As such, 7,179,636 shares of potentially dilutive securities have been excluded from the computation of diluted net loss per share as these securities have anti-dilutive effects and including them would reduce the net loss per share. Therefore, the weighted-average number of common shares outstanding used to calculate both basic and diluted net loss per share attributable to Class A common stockholders was the same for this period.

Leases

12 Months Ended

Dec. 31, 2021

Leases [Abstract]

Leases

17. Leases

As of December 31, 2021 and 2020, the Company’s contracts that contained a lease consisted primarily of real estate, equipment and vehicle leases.

The Company leases real estate for office, lab, warehouse and production space under noncancelable operating and finance leases that expire at various dates through 2035, subject to the Company’s options to terminate or renew certain leases for an additional five to ten years.

The Company leases vehicles under operating leases for certain employees and has fleet services agreements for service on these vehicles. The minimum lease term for each newly leased vehicle is 367 days with renewal options. The Company may terminate the vehicle lease after the minimum lease term upon thirty days’ prior notice.

The Company also leases other equipment under noncancelable operating and finance leases that expire at various dates through 2025.

The Company determines if an arrangement is a lease at lease inception. The options to extend or terminate a lease are included in the lease terms when it is reasonably certain that the Company will exercise the options. Operating leases are included in operating

lease right-of-use assets

and operating lease obligations on the consolidated balance sheets. Finance

lease right-of-use assets

are included in property and equipment, net, and the related liabilities are included in finance lease obligations on the consolidated balance sheets.

Right-of-use assets

represent the Company’s right to use an underlying asset for the lease term and lease liabilities represent the Company’s obligation to make lease payments arising from the

leases. Right-of-use assets

and lease liabilities are recognized based on the present value of the fixed lease payments over the lease term at the commencement date.

The right-of-use assets

also include any initial direct costs incurred and lease payments made at or before the commencement date and are reduced by lease incentives. The Company uses its incremental borrowing rate as the discount rate to determine the present value of the lease payments for leases that do not have a readily determinable implicit discount rate. The Company’s incremental borrowing rate is the rate of interest that it would have to borrow on a collateralized basis over a similar term and amount in a similar economic environment. The Company determines the incremental borrowing rates for its leases by adjusting the risk-free interest rate with a credit risk premium corresponding to the Company’s credit rating.

The Company records rent expense for its operating leases on a straight-line basis from the lease commencement date until the end of the lease term. The Company records finance lease cost as a combination of the depreciation expense for

the right-of-use assets

and interest expense for the outstanding lease liabilities using the discount rate discussed above. Variable lease payments are primarily related to the office and fleet leases which include but are not limited to taxes, insurance, common area maintenance and maintenance programs for leased vehicles. Variable lease payments are based on the occurrence or usage; therefore, they are not included as part of the

initial right-of-use assets

and liabilities calculation.

In March

2019, the Company entered into an agreement to lease approximately 43,850 square feet of office and laboratory space in Norwood, Massachusetts. The rent commencement date was February 1, 2020. The

initial lease

term was ten years from the rent commencement date and included an option for an early extension term of five years which was exercisable during the first two years after the rent commencement date. The Company exercised the option to extend the lease for additional five years in December 2021. In addition to the early extension term, the lease provides the Company with an option to extend the lease term for a period of ten years, if exercised, at rental rates equal to the then fair market value. Annual lease payments during the first year were $1,052 with increases of $44 each year during the

initial ten-year lease

term, an increase of $44 during the first year of the early extension term and $33 during year two through five of the early extension term. Upon execution of the agreement, the Company delivered a security deposit in the form of a letter of credit of $526 to the landlord. Following 36 months from the rent commencement date, the security deposit may be reduced by $263.

In August 2020, the Company entered into a lease for approximately 23,000 square feet in San Diego, California for office and laboratory use. The lease commenced on April 1, 2021. The initial lease term is ten years from the lease commencement date, with an option to extend the term for a period of five years. Annual lease payments during the first year were $1,562 with a 3% increase each year during the lease term. A security deposit of $237 is required throughout the term of the lease.

On January 1, 2013, the Company entered into finance lease arrangements with 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC for office and laboratory space in Canton, Massachusetts. 65 Dan Road SPE, LLC, 85 Dan Road Associates, LLC, Dan Road Equity I, LLC and 275 Dan Road SPE, LLC are related parties as the owners of these entities are also stockholders of the Company. Other than the lease with 275 Dan Road SPE, LLC which was terminated in August 2021 as discussed below, the remaining three leases were set to terminate on December 31, 2022 and each contained a renewal option for a five-year period with the rental rate at the greater of (i) rent for the last year of the prior term, or (ii) the then fair market value. The Company exercised the option to extend the leases for additional five years in November 2021. These leases were reclassified from finance leases to operating leases upon the Company’s reassessment of the lease classification according to ASC

842-10-25-1

Lease Classification.

The related finance lease assets and liabilities were reclassified to operating

lease right-of-use assets

and operating lease obligations on the consolidated balance sheet as of December 31, 2021.

As of December 31, 2020, the Company owed an aggregate of $10,336 of accrued but unpaid lease obligations under the aforementioned leases. Effective April 1, 2019, the Company agreed to accrue interest on the accrued but unpaid lease obligations at an interest rate equal to the rate charged in the 2019 Credit Agreement.

These accrued but unpaid lease obligations as well as the accrued interest on these obligations were

subordinated to the 2019 Credit Agreement. With the termination of the 2019 Credit Agreement and the execution of the 2021 Credit Agreement (see Note “12. Long-Term Debt Obligations”) in August 2021, these obligations are no longer subordinated to the Company’s existing loans.

In August 2021, the Company purchased the building (the “275 Dan Road Building”) under the lease with 275 Dan Road SPE, LLC for $6,013 and the lease was terminated. The Company recorded an asset of $4,943 to buildings within fixed asset, net in accordance with ASC

842-20-40-2

Purchase of the Underlying Asset

to account for the purchase of the leased asset. The asset value includes $408 net book value of the right of use asset removed from leasehold improvement and the difference of $4,535 between the cash paid and the lease liability extinguished. In connection with the purchase of the 275 Dan Road Building, the Company paid 50% of the accrued but unpaid lease obligations associated with this building and the accrued interest thereof. The remaining balance is to be paid in five installments on January 4, 2022, April 1, 2022, July 1, 2022, October 3, 2022 and January 3, 2023. The interest on the balance of the accrued but unpaid lease obligations associated with the 275 Dan Road Building was reduced to an annual simple rate of 4.5%.

The accrued but unpaid lease obligations as well as the related interest accruals are shown below. The decrease of the interest portion of rent in arrears was due to the payment made by the Company in connection with the purchase of the 275 Dan Road Building as mentioned in the previous paragraph.


	December 31,
		2021		2020

Principal portion of rent in arrears	$	7,246	$	6,946
Interest portion of rent in arrears		—		2,865
Unpaid operating and common area maintenance costs		558		525

Total accrued but unpaid lease obligations	$	7,804	$	10,336
Accrued interest on accrued but unpaid lease obligations	$	1,938	$	1,673

The components of lease cost were as follows:


	Classification	Year Ended December 31, 2021
Finance lease
Amortization of right-of-use assets	COGS and SG&A	$	1,707
Interest on lease liabilities	Interest Expense		980

Total Finance lease cost			2,687
Operating lease cost	COGS, R&D, SG&A		7,066
Short-term lease cost	COGS, R&D, SG&A		2,869
Variable lease cost	COGS, R&D, SG&A		4,808

Total lease cost		$	17,430

Supplemental balance sheet information related to finance leases was as follows:


	December 31, 2021			January 1 2021
Property and equipment, gross	$	1,174		$	22,989
Accumulated depreciation		(961	)		(19,250	)

Property and equipment, net	$	213		$	3,739

Current portion of finance lease obligations	$	200		$	3,619
Finance lease long-term obligations		—			11,442

Total finance lease liabilities	$	200		$	15,061

Supplemental cash flow information related to leases was as follows:


	Year Ended December 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	7,276
Operating cash flows for finance leases	$	1,427
Financing cash flows for finance leases	$	2,630
Right-of-use assets obtained in exchange for lease obligations—upon adoption:
Operating leases	$	13,525
Finance leases		—
Right-of-use assets obtained in exchange for lease obligations—post adoption:
Operating leases	$	40,268
Finance leases		—


	December 31, 2021
Weighted-average remaining lease term
Finance leases		0.45
Operating leases		8.22


	December 31, 2021
Weighted-average discount rate
Finance leases		11.30	%
Operating leases		4.51	%

As of December 31, 2021, the maturities of lease liabilities were as follows:


	Operating leases			Finance leases

2022	$	14,032		$	207
2023		8,100			—
2024		7,315			—
2025		7,526			—
2026		7,435			—
Thereafter		25,936			—

Total lease payments		70,344			207
Less: interest		(11,666	)		(7	)

Total lease liabilities	$	58,678		$	200

Under ASC 840, for the years ended December 31, 2020 and

2019, t

he Company recorded lease expenses of $6,509 and $6,231, respectively, for operating leases.

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies Disclosure	18. Commitments and Contingencies Royalties The Company entered into a license agreement with a university for cer t ain patent rights related to the development, use and production of one of its advanced wound care products. Under this agreement, the Company incurred a royalty based on a percentage of net product sales, for the use of these patents until the patents expired, which was in November 2006. Accrued royalties totaled $1,187 as of December 31, 2021 and 2020, respectively, and are classified as part of accrued expenses and other current liabilities on the Company’s consolidated balance sheets. There was no royalty expense incurred during the years ended December 31, 2021, 2020, and 2019 related to this agreement. In October 2017, the Company entered into a license agreement with a third party. Under the license agreement, the Company is required to pay royalties based on a percentage of net sales of the licensed product that occur, after December 31, 2017, through the expiration of the underlying patent in October 2026, subject to minimum royalty payment provisions. The Company recorded royalty expense of $5,929, $4,370, and $3,778 during the years ended December 31, 2021, 2020, and 2019, respectively, within selling, general and administrative expenses on the consolidated statements of operations. As part of the NuTech Medical acquisition, the Company inherited certain product development and consulting agreements for ongoing consulting services and royalty payments based on a percentage of net sales on certain products over a period of 15 years from the execution of the agreements. These product development and consulting agreements were canceled in January 2020 for total consideration of $1,950 which was paid on February 14 , 2020. The $1,950 cancellation fee was recorded within selling, general and administrative expenses on the consolidated statement of operations for the year ended December 31, 2020. Legal Matters In conducting its activities, the Company, from time to time, is subject to various claims and also has claims against others. In management’s opinion, the ultimate resolution of such claims would not have a material effect on the financial position, operating results or cash flows of the Company. The Company accrues for these claims when amounts due are probable and estimable. The Company accrued $150 as of December 31, 2021 and 2020 in relation to certain pending lawsuits. The purchase price for NuTech Medical acquired in 2017 included $7,500 deferred acquisition consideration of which the Company paid $2,500 in 2017. The remaining $5,000 of deferred acquisition consideration plus accrued interest owed to the sellers of NuTech Medical was previously in dispute. In February 2020, the Company entered into a settlement agreement with the sellers of NuTech Medical and settled the dispute for $4,000 of which, $2,000 was paid immediately on February 24, 2020 and the remaining $2,000 was paid in four quarterly installments of $500 each. As of March 31, 2021, the entire settlement was paid off. In addition, the Company assumed from the sellers of NuTech Medical the payment responsibilities related to a legacy lawsuit existing at the acquisition date of NuTech Medical. The assumed legacy lawsuit was settled in October 2020. In connection with the settlement of the deferred acquisition consideration dispute and the legacy lawsuit, the Company recorded a gain of $2,246 for the year ended December 31, 2020. The gain was included as a component of other expense, net, on the consolidated statement of operations.

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2021
Related Party Transactions [Abstract]
Related Party Transactions	19. Related Parties Transactions Lease obligations to affiliates, including accrued but unpaid lease obligations, and purchase of an asset under a finance lease with an affiliate are further described in Note “17. Leases”. During 2010, the Company’s Board of Directors approved a loan program that permitted the Company to make loans to three executives of the Company (the “Employer Loans”) to (i) provide them with liquidity (“Liquidity Loans”) and (ii) fund the exercise of vested stock options (“Option Loans”). Two of the executives left the Company in 2014. The Employer Loans matured with all principal and accrued interest due on the tenth anniversary of the issuance date of each subject loan. Interest on the Employer Loans was at various rates ranging from 2.30%—3.86% per annum, compounded annually. The Employer Loans were secured by shares of the Company’s Class A common stock held by the former executives. With respect to the Liquidity Loans, the Company had no personal recourse against the borrowers beyond the pledged shares. As of December 31, 2020, Liquidity Loans and Option Loans to one former executive were outstanding with an aggregate principal balance of $100 and $334, respectively. During the three months ended March 31, 2021, this former executive paid off the outstanding principal balance of his Employer Loans and the related interest receivable. As a result, the Company recorded $179 as a recovery of the previously reserved related party receivables within selling, general and administrative expenses on the consolidated statement of operations for the year ended December 31, 2021. The $334 of the repaid principal balance of the Option Loans was recorded to equity. See Note “14. Share-Based Compensation”.

Employee Benefit Plan	12 Months Ended
Employee Benefit Plan	Dec. 31, 2021
Retirement Benefits [Abstract]
Employee Benefit Plan	20. Employee Benefit Plan The Company maintains a 401(k) Savings Plan (the “Plan”) for the U.S. employees. Under the Plan, eligible employees may contribute, subject to statutory limitations, a percentage of their salary to the Plan. Contributions made by the Company are made at the discretion of the Board of Directors and vest immediately. During the years ended December 31, 2021, 2020, and 2019, the Company made employer contributions of $3,092, $2,731, and $2,290, respectively.

Subsequent Events	12 Months Ended
Subsequent Events	Dec. 31, 2021
Subsequent Events [Abstract]
Subsequent Events	21. Subsequent Events The Company has performed an evaluation of subsequent events through the time of filing this Annual Report on Form 10-K with the SEC. In the first quarter of 202 2 , 1,126,157 shares of options and 495,389 shares of restricted stock units were granted to our Board of Directors and executives. The majority of these options and restricted stock units will vest over four years.

Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2021

Accounting Policies [Abstract]

Private Warrant Reclassification

10-Q

and the Company’s annual reports on Form

10-K

previously filed with the SEC. The Company assessed the materiality of this error on prior period financial statements in accordance with the SEC Staff Accounting Bulletin Number 99, Materiality, and

ASC 250-10,

Accounting Changes and Error Corrections. The Company determined that this error was not material to the financial statements of any prior annual or interim period.

To correct the misstatements above, the Company revised its previously issued financial statements as follows:


	As of December 31, 2020
CONSOLIDATED BALANCE SHEETS	As Previously Reported			Adjustments			As Revised
Property and equipment, net	$	60,068		$	(4,276	)	$	55,792
Total assets	$	294,494		$	(4,276	)	$	290,218
Additional paid-in capital	$	299,129		$	(2,299	)	$	296,830
Accumulated deficit	$	(153,058	)	$	(1,977	)	$	(155,035	)
Total stockholders’ equity	$	146,084		$	(4,276	)	$	141,808
Total liabilities and stockholders’ equity	$	294,494		$	(4,276	)	$	290,218


	For the Year Ended December 31, 2020							For the Year Ended December 31, 2019
CONSOLIDATED STATEMENTS OF OPERATIONS	As Previously Reported		Adjustments			As Revised		As Previously Reported			Adjustments			As Revised
Selling, general and administrative	$	203,478	$	715		$	204,193	$	199,693		$	395		$	200,088
Total operating expenses	$	223,564	$	715		$	224,279	$	214,492		$	395		$	214,887
Income from operations	$	27,415	$	(715	)	$	26,700	$	(29,459	)	$	(395	)	$	(29,854	)
Change in fair value of warrant liability								$	—		$	2,140		$	2,140
Total other expense, net								$	(10,845	)	$	2,140		$	(8,705	)
Net income (loss) before income taxes	$	18,479	$	(715	)	$	17,764	$	(40,304	)	$	1,745		$	(38,559	)
Net income (loss)								$	(40,454	)	$	1,745		$	(38,709	)
Non-cash deemed dividend to warrant holders								$	(645	)	$	77		$	(568	)
Net income (loss) attributed to common shareholders	$	17,949	$	(715	)	$	17,234	$	(41,099	)	$	1,822		$	(39,277	)
Net income (loss), per share:
Basic	$	0.17				$	0.16	$	(0.44	)				$	(0.42	)
Diluted	$	0.16				$	0.15	$	(0.44	)				$	(0.42	)


	For the Year Ended December 31, 2020
CONSOLIDATED STATEMENTS OF CASH FLOWS	As Previously Reported			Adjustments			As Revised

Net loss	$	17,949		$	(715	)	$	17,234
Depreciation	$	3,723		$	715		$	4,438
Recovery of certain notes receivable from related parties	$	(1,516	)	$	1,516		$	—
Prepaid expenses and other current assets	$	(971	)	$	616		$	(355	)
Accounts payable	$	(635	)	$	(3,467	)	$	(4,102	)
Net cash provided by (used in) operating activities	$	6,801		$	(1,335	)	$	5,466
Purchases of property and equipment	$	(21,145	)	$	3,467		$	(17,678	)
Proceeds from the repayment of notes receivable from related parties	$	2,132		$	(2,132	)	$	—
Net cash used in investing activities	$	(24,833	)	$	1,335		$	(23,498	)


	For the Year Ended December 31, 2019
CONSOLIDATED STATEMENTS OF CASH FLOWS	As Previously Reported			Adjustments			As Revised
Net loss	$	(40,454	)	$	1,745		$	(38,709	)
Depreciation	$	3,388		$	395		$	3,783
Change in fair value of warrant liability	$	—		$	(2,140	)	$	(2,140	)

Use of Estimates

Principles of Consolidation

Segment Reporting

Cash and Cash Equivalents

Restricted Cash

The Company had restricted cash of $599 and $412 as of December 31, 2021 and 2020, respectively. Restricted cash represents employee deposits in connection with the Company’s health benefit plan.

Accounts Receivable, Net

Inventories

Inventories are stated at the lower of cost (determined under the

first-in

first-out

Property and Equipment, Net

consisted of leasehold improvements, building, furniture and computers, and equipment.

Property and equipment’s estimated useful lives are as follows:


Leasehold improvements		Lesser of the life of the lease or the economic life of the asset
Building		30 years
Furniture and computers		3-5 years
Equipment		5-10 years

Upon retirement or sale, the cost of assets disposed of, and the related accumulated deprecia

tion

Goodwill

In accordance with ASC Topic 350,

Intangibles—Goodwill and Other,

There was no impairment of goodwill recorded during the years ended December 31, 2021, 2020, or 2019.

Intangible Assets Subject to Amortization

non-compete


Trade names and trademarks		1-12 years
Developed technology		6-12 years
Customer relationships		10 years
Non-compete agreements		5 years

Impairment of Long-Lived Assets

Deferred Offering Costs

The Company capitalizes certain legal, professional accounting and other third-party fees that are directly associated with

in-process

paid-in

capital against proceeds received from the 2020 and 2019 Underwritten Public Offering, respectively (see Note “13. Stockholders’ Equity”).

Revenue Recognition

Product Revenue

Reserves for Variable Consideration

Product Returns

Rebates and Allowances

GPO Fees

Other Revenue Policies

Sales, value add, and other taxes collected on behalf of third parties are excluded from revenue.

Applying the practical expedient in paragraph ASC

606-10-32-18,

Applying the practical expedient in ASC

340-40-25-4,

Applying the practical expedient in ASC

606-10-25-18B,

Disaggregation of Revenue

The following table sets forth revenue by product category:


	Year Ended December 31,
	2021		2020		2019
Advanced Wound Care revenue	$	430,839	$	294,624	$	220,744
Surgical and Sports Medicine revenue		37,220		43,674		40,237

Total revenue	$	468,059	$	338,298	$	260,981

For all periods presented, net revenue generated outside the United States represented less than 1% of total net revenue.

Stock-Based Compensation

Advertising

Research and Development Costs

Foreign Currency

The Company’s functional currency, including the Company’s Swiss subsidiary, Organogenesis GmbH, is the U.S. dollar. Foreign currency gains and losses resulting

from re-measurement of

assets and liabilities held in foreign currencies and transactions settled in a currency other than the functional currency are included separately

as non-operating income

or expense in the consolidated statements of operations as a component of other expense, net. The foreign currency amounts recorded for all periods presented were insignificant.

Valuation of Contingent Purchase Earnout

In connection with the acquisition of CPN Biosciences, LLC (“CPN”), the Company recognized a

non-current liability

Income Taxes

of $48.3 million

in income taxes. See Note “15. Income Taxes.”

The Company accounts for uncertain income tax positions recognized in the consolidated financial statements by applying a

two-step

more-likely-than-not

Fair Value of Financial Instruments

•

Level 1—Quoted prices in active markets for identical assets or liabilities.

•

Net Income (Loss) per Share

The Company determines net income (loss) per share in accordance with the authoritative guidance in ASC Topic 260,

Earnings Per Share

Emerging Growth Company

as ASU 2016-02,

Leases

Recently Adopted Accounting Pronouncements

In February 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update

No. 2016-02

(“ASU

2016-02”),

Leases

(

Topic 842),

as further amended (“ASC 842”), to increase

transparency and comparability among organizations by requiring the recognition of, at the lease commencement date, a lease liability for the obligation to make lease payments, and a

right-of-use

Leases

months or

less. The Company also elected to account for lease components and the associated

non-lease

components in the contracts as a single lease component

right-of-use

asset in the amount of $13,525. The

right-of-use

asset reflects adjustments for

de-recognition

In December 2019, the FASB issued ASU

No. 2019-12,

Income Taxes—Simplifying the Accounting for Income Taxes

2019-12

Recently Issued Accounting Pronouncements Not Yet Adopted

In June 2016, the FASB issued

ASU 2016-13,

Financial Instruments—Credit Losses (Topic 326):

Measurement of Credit Losses on Financial Instruments

(“ASU 2016-13”). Subsequent

to the issuance of

ASU 2016-13, the

FASB has issued the following updates:

ASU 2018-19,

Codification Improvements to Topic 326, Financial Instruments—Credit Losses

ASU 2019-04,

Codification Improvements to Topic 326, Financial Instruments—Credit Losses, Topic 815,

Derivatives and Hedging

and Topic 825

Financial Instruments

ASU 2019-05,

Financial Instruments—Credit Losses (Topic 326)—Targeted Transition Relief

and

ASU 2019-11,

Codification Improvements to Topic 326

Financial Instruments—Credit Losses

. The objective of

ASU 2016-13 and

ASU 2016-13

and the related impact on the Company’s consolidated financial statements.

In March 2020, the FASB issued ASU

No. 2020-04,

Reference Rate Reform

(Topic 848): Facilitation of the Effects of

Reference Rate Reform

on Financial Reporting

(“ASU

2020-04”).

ASU

2020-04

No. 2021-01,

Reference Rate Reform

(Topic 848): Scope

(“ASU

2021-01”),

to clarify certain optional expedients and exceptions in Topic 848 for contract modifications and hedge accounting to apply to derivatives that are affected by the discounting transition. Both ASU

2020-04

and ASU

2021-01

are effective upon issuance

2020-04

and ASU

2021-01

and does not expect a material impact on the Company’s consolidated financial statements.

Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2021

Accounting Policies [Abstract]

Schedule Of Revision Of Previously Issued Financial Statements To Correct The Misstatements

To correct the misstatements above, the Company revised its previously issued financial statements as follows:


	As of December 31, 2020
CONSOLIDATED BALANCE SHEETS	As Previously Reported			Adjustments			As Revised
Property and equipment, net	$	60,068		$	(4,276	)	$	55,792
Total assets	$	294,494		$	(4,276	)	$	290,218
Additional paid-in capital	$	299,129		$	(2,299	)	$	296,830
Accumulated deficit	$	(153,058	)	$	(1,977	)	$	(155,035	)
Total stockholders’ equity	$	146,084		$	(4,276	)	$	141,808
Total liabilities and stockholders’ equity	$	294,494		$	(4,276	)	$	290,218


	For the Year Ended December 31, 2020							For the Year Ended December 31, 2019
CONSOLIDATED STATEMENTS OF OPERATIONS	As Previously Reported		Adjustments			As Revised		As Previously Reported			Adjustments			As Revised
Selling, general and administrative	$	203,478	$	715		$	204,193	$	199,693		$	395		$	200,088
Total operating expenses	$	223,564	$	715		$	224,279	$	214,492		$	395		$	214,887
Income from operations	$	27,415	$	(715	)	$	26,700	$	(29,459	)	$	(395	)	$	(29,854	)
Change in fair value of warrant liability								$	—		$	2,140		$	2,140
Total other expense, net								$	(10,845	)	$	2,140		$	(8,705	)
Net income (loss) before income taxes	$	18,479	$	(715	)	$	17,764	$	(40,304	)	$	1,745		$	(38,559	)
Net income (loss)								$	(40,454	)	$	1,745		$	(38,709	)
Non-cash deemed dividend to warrant holders								$	(645	)	$	77		$	(568	)
Net income (loss) attributed to common shareholders	$	17,949	$	(715	)	$	17,234	$	(41,099	)	$	1,822		$	(39,277	)
Net income (loss), per share:
Basic	$	0.17				$	0.16	$	(0.44	)				$	(0.42	)
Diluted	$	0.16				$	0.15	$	(0.44	)				$	(0.42	)


	For the Year Ended December 31, 2020
CONSOLIDATED STATEMENTS OF CASH FLOWS	As Previously Reported			Adjustments			As Revised

Net loss	$	17,949		$	(715	)	$	17,234
Depreciation	$	3,723		$	715		$	4,438
Recovery of certain notes receivable from related parties	$	(1,516	)	$	1,516		$	—
Prepaid expenses and other current assets	$	(971	)	$	616		$	(355	)
Accounts payable	$	(635	)	$	(3,467	)	$	(4,102	)
Net cash provided by (used in) operating activities	$	6,801		$	(1,335	)	$	5,466
Purchases of property and equipment	$	(21,145	)	$	3,467		$	(17,678	)
Proceeds from the repayment of notes receivable from related parties	$	2,132		$	(2,132	)	$	—
Net cash used in investing activities	$	(24,833	)	$	1,335		$	(23,498	)


	For the Year Ended December 31, 2019
CONSOLIDATED STATEMENTS OF CASH FLOWS	As Previously Reported			Adjustments			As Revised
Net loss	$	(40,454	)	$	1,745		$	(38,709	)
Depreciation	$	3,388		$	395		$	3,783
Change in fair value of warrant liability	$	—		$	(2,140	)	$	(2,140	)

Summary of Estimated Useful Lives of Property Plant and Equipment


Leasehold improvements		Lesser of the life of the lease or the economic life of the asset
Building		30 years
Furniture and computers		3-5 years
Equipment		5-10 years

Schedule of Finite-Lived Intangible Assets

Amortization of intangible assets with finite lives is calculated on the straight-line or accelerated method based on the following estimated useful lives:


Trade names and trademarks		1-12 years
Developed technology		6-12 years
Customer relationships		10 years
Non-compete agreements		5 years

Schedule of Revenue by Product Category

The following table sets forth revenue by product category:


	Year Ended December 31,
	2021		2020		2019
Advanced Wound Care revenue	$	430,839	$	294,624	$	220,744
Surgical and Sports Medicine revenue		37,220		43,674		40,237

Total revenue	$	468,059	$	338,298	$	260,981

Fair Value Measurement of Financial Instruments (Tables)

12 Months Ended

Dec. 31, 2021

Fair Value Disclosures [Abstract]

Fair Value, by Balance Sheet Grouping

Fair Value Measurements

as of December 31, 2021 Using:

Level 1

Level 2

Level 3

Total

Liabilities:

Earnout liability

—


	Fair Value Measurements
	as of December 31, 2020 Using:
	Level 1		Level 2		Level 3		Total
Liabilities:
Earnout liability	$	—	$	—	$	3,985	$	3,985

	$	—	$	—	$	3,985	$	3,985

Summary of Fair Value of Earnout liability

The following table provides a roll-forward of the fair value of the Company’s Earnout liability, for which fair value is determined using Level 3 inputs:


	Earnout liability

Balance as of December 31, 2019	$	—
Acquisition Date fair value		3,782
Change in fair value		203

Balance as of December 31, 2020		3,985
Change in fair value		(3,985	)

Balance as of December 31, 2021	$	—

Fair Value Recognized As a Component of Other Expense


	Warrant liability

Balance as of December 31, 2019	$	3,936
Change in fair value		(2,140	)
Settled in warrant exchange transaction		(1,796	)

Balance as of December 31, 2020	$	—

Accounts receivable, net (Tables)

12 Months Ended

Dec. 31, 2021

Receivables [Abstract]

Schedule of accounts receivable

Accounts receivable consisted of the following:


	December 31,
	2021			2020
Accounts receivable	$	87,613		$	59,473
Less—allowance for doubtful accounts		(5,153	)		(2,669	)

	$	82,460		$	56,804

Schedule of allowance for doubtful accounts

The Company’s allowance for doubtful accounts was comprised of the following:


Balance as of December 31, 2019	$	1,988
Additions		1,183
Write-offs		(502	)

Balance as of December 31, 2020	$	2,669
Additions		2,999
Write-offs		(515	)

Balance as of December 31, 2021	$	5,153

Inventories (Tables)

12 Months Ended

Dec. 31, 2021

Inventory Disclosure [Abstract]

Schedule of Inventory, Current

Inventories, net of related reserves, consisted of the following:


	December 31,
	2021		2020
Raw materials	$	9,023	$	10,075
Work in process		991		1,305
Finished goods		15,008		16,419

	$	25,022	$	27,799

Prepaid Expenses and Other Current Assets (Tables)

12 Months Ended

Dec. 31, 2021

Schedule of prepaid expenses and other current assets

Prepaid expenses and other current assets consisted of the following:


	December 31,
	2021		2020
Subscriptions	$	2,745	$	2,013
Conferences and marketing expenses		538		63
Deposits		1,216		1,438
Reimbursement of offering expenses		—		1,009
Insurance		358		240
Other		112		172

	$	4,969	$	4,935

Property and Equipment, Net (Tables)

12 Months Ended

Dec. 31, 2021

Property, Plant and Equipment [Abstract]

Property and Equipment, Net

Property and equipment consisted of the following:


	December 31,
	2021			2020
Leasehold improvements	$	30,531		$	39,574
Building		4,943			—
Furniture, computers and equipment		53,959			48,236

	89,433			87,810
Accumulated depreciation and amortization		(57,729	)		(73,797	)
Construction in progress		47,456			41,779

	$	79,160		$	55,792

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2021

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Finite-Lived Intangible Assets

Identifiable intangible assets consisted of the following as of December 31, 2021:


	Original Cost		Accumulated Amortization			Net Book Value
Developed technology	$	32,620	$	(17,709	)	$	14,911
Trade names and trademarks		2,080		(1,183	)		897
Customer relationship		10,690		(1,381	)		9,309
Independent sales agency network		4,500		(4,500	)		—
Patent		7,623		(7,623	)		—
Non-compete agreements		1,010		(454	)		556

Total	$	58,523	$	(32,850	)	$	25,673

Identifiable intangible assets consisted of the following as of December 31, 2020:


	Original Cost		Accumulated Amortization			Net Book Value
Developed technology	$	32,620	$	(14,330	)	$	18,290
Trade names and trademarks		2,080		(906	)		1,174
Customer relationship		10,690		(312	)		10,378
Independent sales agency network		4,500		(4,500	)		—
Patent		7,623		(7,623	)		—
Non-compete agreements		1,010		(230	)		780

Total	$	58,523	$	(27,901	)	$	30,622

Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]

Estimated future annual amortization expense related to these intangible assets is as follows:


2022	$	4,883
2023		4,918
2024		3,403
2025		3,323
2026		3,043
Thereafter		6,103

Total	$	25,673

Accrued Expenses and Other Current Liabilities (Tables)

12 Months Ended

Dec. 31, 2021

Schedule of Accounts Payable and Accrued Liabilities

Accrued expenses and other current liabilities consisted of the following:


	December 31,
	2021		2020
Personnel costs	$	26,865	$	18,943
Royalties		3,458		2,971
Accrued but unpaid lease obligations and interest		3,963		—
Other		2,303		2,059

	$	36,589	$	23,973

Restructuring (Tables)

12 Months Ended

Dec. 31, 2021

Restructuring and Related Activities [Abstract]

Summary of liability related to the restructuring activities

The following table provides a roll-forward of the restructuring liability.


	Employee			Facility

Liability balance as of December 31, 2019	$	—		$	—
Expenses		618			—
Cash distributions		—			—

Liability balance as of December 31, 2020		618			—
Expenses		3,513			1,191
Cash distributions		(1,614	)		(540	)

Liability balance as of December 31, 2021	$	2,517		$	651

Long-Term Debt Obligations (Tables)

12 Months Ended

Dec. 31, 2021

Long-term Debt, Unclassified [Abstract]

Schedule of long-term debt obligations


	December 31,
	2021			2020
Line of credit	$	—		$	10,000

Term loan		74,062			60,000
Less debt discount and debt issuance cost		(637	)		(290	)

Term loan, net of debt discount and debt issuance cost	$	73,425		$	59,710

Schudle of future payments of term loan facility

Future payments of the 2021 Credit Agreement, as of December 31, 2021, are as follows for the calendar years ending December 31:


2022	$	2,812
2023		4,687
2024		5,625
2025		6,563
2026 and beyond		54,375

Total	$	74,062

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

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Schedule Of Common Stock Shares Reserved For Future Issuance

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2021

Equity [Abstract]

At December 31, 2021 and 2020, the Company has reserved the following shares of Class A common stock for future issuance:


	December 31,
	2021		2020
Shares reserved for issuance for outstanding options		6,596,969		6,425,040
Shares reserved for issuance for outstanding restricted stock units		764,871		806,048
Shares reserved for issuance for future grants		5,644,691		6,832,649

Total shares of authorized common stock reserved for future issuance		13,006,531		14,063,737

Share-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2021

Share-based Payment Arrangement [Abstract]

Summary of Unvested Restricted Stock Units

The activity of restricted stock units is set forth below:


	Number of Shares			Weighted Average Grant Date Fair Value
Unvested at December 31, 2020		787,923		$	3.81
Granted		310,692			14.29
Vested		(248,305	)		4.20
Canceled/Forfeited		(85,439	)		7.64

Unvested at December 31, 2021		764,871		$	7.52

Schedule of Fair Value of Stock Options Granted to Employees and Directors


	Year Ended December 31,
	2021			2020
Risk-free interest rate		0.83	%		0.46	%
Expected term (in years)		6.22			6.22
Expected volatility		39.31	%		37.42	%
Expected dividend yield		0.0	%		0.0	%
Exercise price	$	13.57		$	4.04
Underlying stock price	$	13.57		$	3.37

Summary of Stock Option Activity

The following table summarizes the Company’s stock option activity since December 31, 2020:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term		Aggregate Intrinsic Value
						(in years)
Outstanding as of December 31, 2020		6,615,223		$	2.32		5.22		34,438
Granted		1,069,658			13.57
Exercised		(955,736	)		2.29				10,121
Canceled / forfeited		(132,176	)		4.67

Outstanding as of December 31, 2021		6,596,969			4.10		5.20		38,524

Options exercisable as of December 31, 2021		4,342,519			1.80		3.47		32,292

Options vested or expected to vest as of December 31, 2021		6,216,308		$	3.79		4.98		37,618

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2021

Income Tax Disclosure [Abstract]

Schedule of Components of Income Tax Expense (Benefit)

The components of the income tax expense (benefit) consisted of the following for the years ended December 31, 2021, 2020, and 2019:


	Year Ended December 31,
	2021			2020			2019
Income tax expense (benefit):
Current tax expense (benefit)
Federal	$	—		$	(106	)	$	(105	)
State		899			505			116
Foreign		(39	)		19			28

Total current tax expense		860			418			39

Deferred tax expense (benefit)
Federal		(30,506	)		109			105
State		(1,470	)		—			—
Foreign		—			3			6

Total deferred tax expense		(31,976	)		112			111

Total income tax expense (benefit)	$	(31,116	)	$	530		$	150

Component of Company's Deferred Tax Assets and Liabilities

Significant components of the Company’s deferred tax assets and liabilities as of December 31, 2021 and 2020 are as follows:


	December 31,
	2021			2020
Net operating loss carryforwards

Federal	$	21,760		$	31,783
State		1,612			3,342
Foreign		16			18
Other		7,556			5,829
163j interest		—			4,979
Stock-based compensation		676			357
Finance leases		632			2,991
Operating leases		12,918			—
Fixed assets		2,748			2,589

Net deferred tax assets before valuation allowance		47,918			51,888
Valuation allowance		—			(48,252	)
ROU assets		(12,273	)		—
Intangibles		(3,651	)		(3,618	)

Net deferred tax assets	$	31,994		$	18

Schedule of Effective Income Tax Rate Reconciliation

The differences between income taxes expected at the U.S. federal statutory income tax rate of 21% and the reported consolidated income tax benefit (expense) are summarized as follows:


	December 31,
	2021			2020			2019
U.S. federal statutory income tax rate		21.0	%		21.0	%		21.0	%
Federal valuation allowance		(70.6	)%		(28.9	)%		(17.6	)%
State valuation allowance		(9.1	)%		(4.8	)%		(3.9	)%
State and local income taxes		6.8	%		6.2	%		3.5	%
Nondeductible expenses		0.8	%		6.0	%		(1.4	)%
Uncertain tax position reserves		0.9	%		0.4	%		(0.1	)%
Research and development credits		0.9	%		3.0	%		(1.9	)%

Effective income tax rate		(49.3	)%		2.9	%		(0.4	)%

Schedule of Unrecognized Tax Benefits Roll Forward

A tabular roll forward of the Company’s uncertainties in its income tax provision liability is presented below:


	Year Ended December 31,
	2021			2020			2019
Gross balance at beginning of year	$	2,123		$	2,618		$	3,286
Additions based on tax positions related to the current period		153			111			133
Reductions for tax positions of prior years		(664	)		(606	)		(801	)

Gross balance at end of year	$	1,612		$	2,123		$	2,618

Net Income (Loss) Per Share (EPS) (Tables)

12 Months Ended

Dec. 31, 2021

Earnings Per Share [Abstract]

Schedule of Earnings Per Share, Basic and Diluted

A reconciliation of the numerator and denominator used in the calculation of the basic and diluted net income (loss) attributable to the Class A common stockholders is as follows:


	Year Ended December 31,
	2021		2020		2019
Numerator:
Net Income (loss)	$	94,902	$	17,234	$	(38,709	)
Less: Non-cash dividend to warrant holders		—		—		568

Net Income (loss) attributable to common shareholders	$	94,902	$	17,234	$	(39,277	)

Denominator:
Weighted average common shares outstanding—basic		128,331,022		107,737,936		92,840,401
Dilutive effect of restricted stock units		469,123		135,932		—
Dilutive effect of options		4,862,514		3,486,963		—

Weighted-average common shares outstanding—diluted		133,662,659		111,360,831		92,840,401
Earnings (loss) per share—basic	$	0.74	$	0.16	$	(0.42	)

Earnings (loss) per share—diluted	$	0.71	$	0.15	$	(0.42	)

Leases (Tables)

12 Months Ended

Dec. 31, 2021

Leases [Abstract]

Schedule of Lease Cost

The components of lease cost were as follows:


	Classification	Year Ended December 31, 2021
Finance lease
Amortization of right-of-use assets	COGS and SG&A	$	1,707
Interest on lease liabilities	Interest Expense		980

Total Finance lease cost			2,687
Operating lease cost	COGS, R&D, SG&A		7,066
Short-term lease cost	COGS, R&D, SG&A		2,869
Variable lease cost	COGS, R&D, SG&A		4,808

Total lease cost		$	17,430

Summary of Balance Sheet Information Related To Finance Leases

Supplemental balance sheet information related to finance leases was as follows:


	December 31, 2021			January 1 2021
Property and equipment, gross	$	1,174		$	22,989
Accumulated depreciation		(961	)		(19,250	)

Property and equipment, net	$	213		$	3,739

Current portion of finance lease obligations	$	200		$	3,619
Finance lease long-term obligations		—			11,442

Total finance lease liabilities	$	200		$	15,061

Schedule of Accrued but Unpaid Lease Obligations

Summary of Cash Flow Information Related To Leases

Supplemental cash flow information related to leases was as follows:


	Year Ended December 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	7,276
Operating cash flows for finance leases	$	1,427
Financing cash flows for finance leases	$	2,630
Right-of-use assets obtained in exchange for lease obligations—upon adoption:
Operating leases	$	13,525
Finance leases		—
Right-of-use assets obtained in exchange for lease obligations—post adoption:
Operating leases	$	40,268
Finance leases		—


	December 31, 2021
Weighted-average remaining lease term
Finance leases		0.45
Operating leases		8.22


	December 31, 2021
Weighted-average discount rate
Finance leases		11.30	%
Operating leases		4.51	%

Summary of Maturities of Lease Liabilities

As of December 31, 2021, the maturities of lease liabilities were as follows:


	Operating leases			Finance leases

2022	$	14,032		$	207
2023		8,100			—
2024		7,315			—
2025		7,526			—
2026		7,435			—
Thereafter		25,936			—

Total lease payments		70,344			207
Less: interest		(11,666	)		(7	)

Total lease liabilities	$	58,678		$	200

Nature of the Business and Basis of Presentation - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2021 Segments
Business Acquisition [Line Items]
Number of Operating Segments	1
Number of Reportable Segments	1

Significant Accounting Policies - Property, Plant and Equipment (Detail)	12 Months Ended
	Dec. 31, 2021
Leasehold improvements
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Estimated Useful Lives	Lesser of the life of the lease or the economic life of the asset
Building
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	30 years
Furniture and computers \| Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	3 years
Furniture and computers \| Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment \| Minimum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	5 years
Equipment \| Maximum
Significant Accounting Policies [Line Items]
Property, Plant and Equipment, Useful Life	10 years

Significant Accounting Policies -Schedule of Finite-Lived Intangible Assets (Detail)	12 Months Ended
	Dec. 31, 2021
Trade names and trademarks \| Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	1 year
Trade names and trademarks \| Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Developed technology \| Minimum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	6 years
Developed technology \| Maximum
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	12 years
Customer relationships
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	10 years
Non-compete agreements
Significant Accounting Policies [Line Items]
Finite-Lived Intangible Asset, Useful Life	5 years

Significant Accounting Policies - Schedule of Revenue by Product Category (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Total net revenue	$ 468,059	$ 338,298	$ 260,981
Advanced Wound Care
Total net revenue	430,839	294,624	220,744
Surgical & Sports Medicine
Total net revenue	$ 37,220	$ 43,674	$ 40,237

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

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Significant Accounting Policies - Schedule of Consolidated Balance Sheets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018
Property and equipment, net	$ 79,160	$ 55,792
Total assets	443,259	290,218
Additional paid-in capital		296,830
Accumulated deficit	(60,133)	(155,035)
Total stockholders' equity	242,035	141,808	$ 52,022	$ 39,939
Total liabilities and stockholders' equity	$ 443,259	290,218
As Previously Reported
Property and equipment, net		60,068
Total assets		294,494
Additional paid-in capital		299,129
Accumulated deficit		(153,058)
Total stockholders' equity		146,084		$ 47,041
Total liabilities and stockholders' equity		294,494
Adjustments
Property and equipment, net		(4,276)
Total assets		(4,276)
Additional paid-in capital		(2,299)
Accumulated deficit		(1,977)
Total stockholders' equity		(4,276)
Total liabilities and stockholders' equity		$ (4,276)

Sum of the carrying amounts as of the balance sheet date of all assets that are recognized. Assets are probable future economic benefits obtained or controlled by an entity as a result of past transactions or events.

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-Name Accounting Standards Codification
-Topic 280
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Reference 21: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2003/role/disclosureRef
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Amount of liabilities and equity items, including the portion of equity attributable to noncontrolling interests, if any.

The cumulative amount of the reporting entity's undistributed earnings or deficit.

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

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Significant Accounting Policies - Schedule of Consolidated Statements of Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Selling, general and administrative	$ 250,200	$ 204,193	$ 200,088
Total operating expenses	280,942	224,279	214,887
Income from operations	72,918	26,700	(29,854)
Change in fair value of warrant liability			2,140
Total other expense, net	(9,132)	(8,936)	(8,705)
Net income (loss) before income taxes	63,786	17,764	(38,559)
Net income (loss)	94,902	17,234	(38,709)
Non-cash deemed dividend to warrant holders			(568)
Net income (loss) attributed to common shareholders	$ 94,902	$ 17,234	$ (39,277)
Net income (loss), per share:
Basic	$ 0.74	$ 0.16	$ (0.42)
Diluted	$ 0.71	$ 0.15	$ (0.42)
As Previously Reported
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Selling, general and administrative		$ 203,478	$ 199,693
Total operating expenses		223,564	214,492
Income from operations		27,415	(29,459)
Total other expense, net			(10,845)
Net income (loss) before income taxes		18,479	(40,304)
Net income (loss)		17,949	(40,454)
Non-cash deemed dividend to warrant holders			(645)
Net income (loss) attributed to common shareholders		$ 17,949	$ (41,099)
Net income (loss), per share:
Basic		$ 0.17	$ (0.44)
Diluted		$ 0.16	$ (0.44)
Adjustments
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Selling, general and administrative		$ 715	$ 395
Total operating expenses		715	395
Income from operations		(715)	(395)
Change in fair value of warrant liability			2,140
Total other expense, net			2,140
Net income (loss) before income taxes		(715)	1,745
Net income (loss)		(715)	1,745
Non-cash deemed dividend to warrant holders			77
Net income (loss) attributed to common shareholders		$ (715)	$ 1,822

Significant Accounting Policies - Schedule of Consolidated Statements of Cash Flows (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net income (loss)	$ 94,902	$ 17,234	$ (38,709)
Depreciation	5,781	4,438	3,783
Change in fair value of warrant liability			(2,140)
Recovery of certain notes receivable from related parties		0
Prepaid expenses and other current assets	(34)	(355)	(625)
Accounts payable	3,847	(4,102)	4,700
Net cash provided by (used in) operating activities	61,978	5,466	(33,528)
Purchases of property and equipment	(31,220)	(17,678)	(5,984)
Proceeds from the repayment of notes receivable from related parties		0
Net cash used in investing activities	$ (31,220)	(23,498)	(6,234)
As Previously Reported
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net income (loss)		17,949	(40,454)
Depreciation		3,723	3,388
Recovery of certain notes receivable from related parties		(1,516)
Prepaid expenses and other current assets		(971)
Accounts payable		(635)
Net cash provided by (used in) operating activities		6,801
Purchases of property and equipment		(21,145)
Proceeds from the repayment of notes receivable from related parties		2,132
Net cash used in investing activities		(24,833)
Adjustments
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Net income (loss)		(715)	1,745
Depreciation		715	395
Change in fair value of warrant liability			$ (2,140)
Recovery of certain notes receivable from related parties		1,516
Prepaid expenses and other current assets		616
Accounts payable		(3,467)
Net cash provided by (used in) operating activities		(1,335)
Purchases of property and equipment		3,467
Proceeds from the repayment of notes receivable from related parties		(2,132)
Net cash used in investing activities		$ 1,335

Significant Accounting Policies - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Jan. 01, 2021	Jul. 22, 2019	Dec. 31, 2018
Significant Accounting Policies [Line Items]
GPO Fees	$ 2,963	$ 3,572	$ 3,096
Restricted Cash, Current	$ 599	412
Equity issuance costs recorded to additional paid-in capital		4,647	3,510
Lease liabilities, Term	12 months
Operating lease liability	$ 58,678			$ 15,935
Right-of-use asset	49,144	0		$ 13,525
Impairment of goodwill	0	0	$ 0
Deferred Income tax benefit	48,252
Common Stock [Member]
Significant Accounting Policies [Line Items]
Common stock issued in warrant exchange (shares)			3,315,232
Private Warrants [Member]
Significant Accounting Policies [Line Items]
Number of Warrants						4,100,000
Public Warrants [Member]
Significant Accounting Policies [Line Items]
Number of Warrants			0		30,890,748	31,000,000.0
Selling, General and Administrative Expenses
Significant Accounting Policies [Line Items]
Advertising Expense	$ 5,522	$ 2,722	$ 1,059

Acquisition - Additional Information (Detail) - USD ($) $ in Thousands		12 Months Ended
	Sep. 17, 2020	Dec. 31, 2020	Dec. 31, 2021
Payments to acquire businesses gross		$ 5,820
Business Acquisitions, Contingent Consideration Liability Noncurrent	$ 3,782	$ 3,985	$ 0
CPN Biosciences, LLC
Business Acquisitions, Aggregate Consideration	19,024
Payments to acquire businesses gross	$ 5,820
Issuance of common stock associated with business acquisition	1,947,953
Business Acquisitions, Liabilities Incurred	$ 1,436
Business Acquisitions, Contingent Consideration Liability Noncurrent	$ 3,782
Earnout Calculation	70.00%
CPN Biosciences, LLC \| Total Consideration Including Holdback [Member]
Payments to acquire businesses gross	$ 6,427
Common Stock [Member]
Issuance of common stock associated with business acquisition		1,947,953
Common Stock [Member] \| CPN Biosciences, LLC \| Total Consideration Including Holdback [Member]
Business Acquisitions, Number Of Shares Issued	2,151,438
Business Acquisitions, Equity Interests Issued And Issuable	$ 8,815

Fair Value Measurement of Financial Instruments - Financial Assets And Liabilities Measured At Fair Value (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020	Sep. 17, 2020
Liabilities:
Liabilities	$ 0	$ 3,985	$ 3,782
Fair Value, Measurements, Recurring
Liabilities:
Liabilities		3,985
Fair Value, Measurements, Recurring \| Earnout Liability [Member]
Liabilities:
Liabilities		3,985
Fair Value, Measurements, Recurring \| Fair Value, Inputs, Level 3
Liabilities:
Liabilities		3,985
Fair Value, Measurements, Recurring \| Fair Value, Inputs, Level 3 \| Earnout Liability [Member]
Liabilities:
Liabilities		$ 3,985

Fair Value Measurement of Financial Instruments - Fair value of the Company's Earnout liability (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Business Acquisition, Contingent Consideration [Line Items]
Change in fair value	$ (3,985)	$ 203
Fair Value, Inputs, Level 3 \| Earnout Liability [Member]
Business Acquisition, Contingent Consideration [Line Items]
Beginning balance	3,985
Acquisition Date fair value		3,782
Change in fair value	(3,985)	203
Ending balance		$ 3,985

Fair Value Measurement of Financial Instruments - Fair Value Recognized As a Component of Other Expense (Detail) - Warrant [Member] $ in Thousands	12 Months Ended
	Dec. 31, 2020 USD ($)
Balance as of December 31, 2019	$ 3,936
Change in fair value	(2,140)
Settled in warrant exchange transaction	(1,796)
Balance as of December 31, 2020

Fair Value Measurement of Financial Instruments - Additional Information (Detail) - USD ($) $ in Thousands, shares in Millions	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2021	Dec. 31, 2020	Sep. 17, 2020	Dec. 31, 2018
Earnout liability		$ 0	$ 3,985	$ 3,782
Change in fair value of warrant liability	$ (2,140)
Private Warrants [Member]
Number of Warrants					4.1
Change in fair value of warrant liability	$ 2,140

Accounts receivable, net (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Receivables [Abstract]
Accounts receivable	$ 87,613	$ 59,473
Less—allowance for doubtful accounts	(5,153)	(2,669)
Accounts receivable	$ 82,460	$ 56,804

Accounts receivable, net - Doubtful Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Balance	$ 2,669	$ 1,988
Additions	2,999	1,183	$ 239
Write-offs	(515)	(502)
Balance	$ 5,153	$ 2,669	$ 1,988

Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Raw materials	$ 9,023	$ 10,075
Work in process	991	1,305
Finished goods	15,008	16,419
Inventory	$ 25,022	$ 27,799

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Inventory reserve and obsolescence charged to cost of goods	$ 12,079	$ 3,050	$ 1,297

Prepaid Expenses and Other Current Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Subscriptions	$ 2,745	$ 2,013
Conferences and marketing expenses	538	63
Deposits	1,216	1,438
Reimbursement of offering expenses	0	1,009
Insurance	358	240
Other	112	172
Prepaid Expense	$ 4,969	$ 4,935

Property and Equipment, Net (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Property, Plant and Equipment, Gross	$ 89,433	$ 87,810
Accumulated depreciation and amortization	(57,729)	(73,797)
Property, Plant and Equipment, Net	79,160	55,792
Leasehold improvements
Property, Plant and Equipment, Gross	30,531	39,574
Building
Property, Plant and Equipment, Gross	4,943
Furniture, computers and equipment
Property, Plant and Equipment, Gross	53,959	48,236
Construction in progress
Property, Plant and Equipment, Net	$ 47,456	$ 41,779

Property and Equipment, Net - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Jan. 01, 2021
Depreciation expense	$ 5,781	$ 4,438	$ 3,783
Finance leases recorded within leasehold improvements	1,174			$ 22,989
Accumulated depreciation to finance lease asset recorded within leasehold improvement	$ 961			$ 19,250
Leasehold improvements
Finance leases recorded within leasehold improvements		21,689
Accumulated depreciation to finance lease asset recorded within leasehold improvement		$ 18,716

Goodwill and Intangible Assets - Identifiable intangible assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Original Cost	$ 58,523	$ 58,523
Accumulated Amortization	(32,850)	(27,901)
Net Book Value	25,673	30,622
Developed technology
Original Cost	32,620	32,620
Accumulated Amortization	(17,709)	(14,330)
Net Book Value	14,911	18,290
Trade names and trademarks
Original Cost	2,080	2,080
Accumulated Amortization	(1,183)	(906)
Net Book Value	897	1,174
Customer relationship
Original Cost	10,690	10,690
Accumulated Amortization	(1,381)	(312)
Net Book Value	9,309	10,378
Independent sales agency network
Original Cost	4,500	4,500
Accumulated Amortization	(4,500)	(4,500)
Patent
Original Cost	7,623	7,623
Accumulated Amortization	(7,623)	(7,623)
Non-compete agreements
Original Cost	1,010	1,010
Accumulated Amortization	(454)	(230)
Net Book Value	$ 556	$ 780

Goodwill and Intangible Assets - Estimated future annual amortization expense (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
2022	$ 4,883
2023	4,918
2024	3,403
2025	3,323
2026	3,043
Thereafter	6,103
Total	$ 25,673	$ 30,622

Goodwill and Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Goodwill	$ 28,772	$ 28,772
Amortization of Intangible Assets	$ 4,949	$ 3,745	$ 6,043

Accrued Expenses and Other Current Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Payables and Accruals [Abstract]
Personnel costs	$ 26,865	$ 18,943
Royalties	3,458	2,971
Accrued but unpaid lease obligations and interest	3,963
Other	2,303	2,059
Total Accrued Expenses and Other Current Liabilities	$ 36,589	$ 23,973

Restructuring - Summary of liability related to the restructuring activities (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020
Employee Cost [Member]
Beginning balance	$ 618	$ 0
Expenses	3,513	618
Cash distributions	(1,614)	0
Ending balance	2,517	618
Facility and Other [Member]
Beginning balance	0	0
Expenses	1,191	0
Cash distributions	(540)	0
Ending balance	$ 651	$ 0

Restructuring - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2021 USD ($)	Dec. 31, 2020 USD ($)	Oct. 21, 2020 USD ($) Employees
Restructuring Cost and Reserve [Line Items]
Restructuring and Related Cost			$ 7,500
Number of employees to retention Benefits \| Employees			65
Restructuring Reserve Current	$ 3,168	$ 618
Selling, General and Administrative Expenses
Restructuring Cost and Reserve [Line Items]
Restructuring Charges	4,704	618
Employee Cost
Restructuring Cost and Reserve [Line Items]
Restructuring and Related Cost			$ 4,000
Restructuring Charges	3,513	618
Facility and Other
Restructuring Cost and Reserve [Line Items]
Restructuring and Related Cost			$ 3,500
Restructuring Charges	$ 1,191	$ 0

Long-Term Debt Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2021	Dec. 31, 2020
Line of credit	$ 0	$ 10,000
Term loan	74,062	60,000
Less debt discount and debt issuance cost	(637)	(290)
Term loan, net of debt discount and debt issuance cost	$ 73,425	$ 59,710

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

Long-Term Debt Obligations - Future payments of term loan (Detail) $ in Thousands	Dec. 31, 2021 USD ($)
2022	$ 2,812
2023	4,687
2024	5,625
2025	6,563
2026 and beyond	54,375
Total	$ 74,062

Amount, after unamortized (discount) premium and debt issuance costs, of long-term debt. Includes, but not limited to, notes payable, bonds payable, debentures, mortgage loans and commercial paper. Excludes capital lease obligations.