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Integra LifeSciences Holdings Corporation

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Ticker iart
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Sector Healthcare
Industry Medical - Devices
Employees 4396
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FY2012 Annual Report · Integra LifeSciences Holdings Corporation
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Integra 2012 Annual Report

LIMITING UNCERTAINTY   
IS HOW WE MAKE A DIFFERENCE.

Company at a Glance
•   World leader in medical technology, with a focus on regenerative medicine

•   Founded in 1989 and headquartered in Plainsboro, NJ

•   Offers innovative solutions in orthopedic extremity surgery, neurosurgery, spine surgery, and reconstructive and general surgery

•   Employs approximately 3,500 people worldwide

•   Sells through direct reps in the U.S., Canada, major European markets and Australia, and through distributors in these and over 100 countries

Selected Financial Data:
2012 Revenues by Segment

Segment 

% of Total Revenues 

Key Product Areas 

2012  Revenues

U.S. Neurosurgery

21%

Dural repair, ultrasonic aspiration, cranial stabilization, 
stereotaxy, neuro critical care

$171 Million

U.S. Instruments

19%

U.S. Extremities

15%

U.S. Spine & Other

23%

International

22%

General and specialty hand-held surgical instruments 
in the hospital and office-based settings; surgical 
headlights and retractors

$162 Million

Soft tissue repair for nerve, tendon, skin and wound; 
fixation and joint replacement in foot, ankle, hand, 
wrist, elbow and shoulder

$123 Million

MIS spine system, traditional spine fusion,  
orthobiologics, private label 

$191 Million

Select product lines from each of Neurosurgery, 
Instruments, Extremities and Spine

$184 Million

2012 Revenues by Geographic Area

Total Revenues

Region

2012 Revenues

United States

$643 Million

Europe

$691 Million

Rest of World

$697 Million

Operating Cash Flow

Diluted Earnings Per Share

*

*

In 2012, we generated $58.7 million in cash flows from operations, which was reduced by a $29.8 million tax 
withholding payment in connection with the release of certain deferred stock units and $30.6 million of  
accreted interest paid at the maturity of our 2012 Senior Convertible Note.

To our  Stockholders:

In 2012, we made significant progress against achieving our vision to become a multi-billion dollar global medical technology
company.  Despite  rising  costs,  shifting  demographics,  increasing  regulations,  compliance  costs  and  taxes,  and  an  uncertain  global
economy, we generated significant value for our stockholders.

2012 Financial Performance

Last year, we delivered on our financial commitments, reporting revenues and adjusted earnings per share1 at the high end of
our  original  guidance  for  the  year.  We  increased  reported  revenues  7%  and  increased  adjusted  EBITDA2  by  7%.  Our  business
generated substantial cash flows, which we used to pay off a maturing series of convertible notes, and for capital investment in our
new regenerative medicine manufacturing facility in New Jersey and our global enterprise resource management system project.

2012 Accomplishments

We  made  great  strides  over  the  course  of  the  year  and  achieved  several  important  operational  milestones.  These  include  the

following:

(cid:127) Integrated our SeaSpine and Ascension acquisitions;
(cid:127) Expanded internationally, refined and fortified selling efforts in Europe and China, and defined strategies and priorities in

other  key markets;

(cid:127) Significantly  enhanced  our  Quality  Systems  and  Operations  functions,  hiring  two  key  leaders,  completing  substantial
remediation  work  in  our  Plainsboro,  New  Jersey,  manufacturing  plant,  and  forming  a  detailed  plan  to  establish  the
fundamental systems and infrastructure we need  to  drive growth;

(cid:127) Established a centralized sourcing group to optimize our purchases globally and by division, and realized significant savings;

and

(cid:127) Made  substantial  progress  toward  implementing  our  global  enterprise  resource  management  system,  which  we  began

operating in a pilot site in February.

Our philanthropic efforts continued to be strong. We donated products worth over $3.5 million to organizations that support

medical missions, and the Integra Foundation made almost 100 grants toward research and education.

Our Strategy in 2013 and Beyond

Integra aspires to become a multi-billion dollar global medical technology company whose products enhance millions of lives.
To  advance  that  vision,  we  developed  a  three-pronged  strategy  to  execute  more  effectively  through  improved  planning  and
communication in our business, optimize the company so that our infrastructure and operations are cost-effective and able to support
a  larger  business,  and  accelerate  growth  in  both  revenues  and  profit  margins  through  new  product  launches,  expansion  of  sales
channels  and strategic acquisitions.

We continue to invest in product development, with a focus on regenerative medicine and orthopedics, and expect to launch as
many as 25 new products in 2013. Among them is a modular shoulder system with a reverse option that will enable us to build a more
comprehensive distributor network for our shoulder and elbow product lines. We expect our shoulder offering to be differentiated,
and by pairing it with our regenerative medicine portfolio, we believe we can become a significant player in the $650 million shoulder
market.

We  are  also  funding  clinical  evidence  to  enhance  product  launches  and  obtain  favorable  coverage  decisions  by  insurance
carriers.  We  expect  to  complete  the  clinical  trial  to  support  the  effectiveness  of  our  dermal  regenerative  products  in  diabetic
foot ulcers by the end of 2013. If the trial and regulatory submissions are successful, we plan to launch the product for this indication
in the United States, with reimbursement, in 2015. We believe that clinical, regulatory and reimbursement success would dramatically
increase the opportunity for our dermal regenerative medicine products.

We are very excited about the opportunities to accelerate growth by increasing our international presence. Our International
team is building on its success in China, registering and launching several products in new markets this year. We are also optimistic
about  the  growth of our regenerative products in both Brazil and  Europe.

1  For  a  reconciliation  of  GAAP  Net  Income  to  adjusted  earnings  per  share,  please  see  our  Current  Report  on  Form  8-K  filed
February 21, 2013.
2 For a reconciliation of GAAP Net Income to Adjusted EBITDA, please see our Current Report on Form 8-K filed February 21,
2013.

Integra  has  made  great  strides  towards  maximizing  our  infrastructure  through  streamlining  manufacturing  and  distribution,
centralizing  strategic  sourcing  and  procurement,  and  optimizing  inventory  planning.  We  are  well  underway  toward  implementing  a
common  ERP  system,  and  in  2012,  announced  our  commitment  to  implementing  a  common  quality  system.  We  expect  these
investments to  make us a more efficient company, with improvements  in both earnings and cash flow.

Investing in our People

Ultimately, our colleagues are our most important partners. While it is important to focus on our infrastructure and products, it
is also vital to invest in our colleagues, and we have implemented new programs that will enhance execution skills and help ensure
that we effectively tackle the critical issues that we face. We are building a strong bench of leaders and a return-focused culture at
every  level of  the company.

Commitment to  Quality

Over the past year, we have made substantial commitments to our Quality and Global Operations organizations. We hired new
leaders with solid industry experience, spent significant sums on enhanced quality for our plants and remediation of processes and
procedures, and initiated plans to implement a global quality system. We take our commitment to quality seriously, and we plan to
continue to build and enhance our quality team and quality systems in the coming years. We have some significant work to do to clear
outstanding FDA warning letters, but we are confident that we will  emerge as a better company as a result.

Your Board of Directors

Integra’s Leadership Team is enriched by the breadth and depth of experience on our Board of Directors. We are pleased to
welcome  Mr.  Lloyd  Howell  as  a  new  director.  Mr.  Howell,  an  Executive  Vice  President  at  Booz  Allen  Hamilton,  brings  unique,
valuable  insights and experiences to Integra’s Board that  will complement the capabilities of our current Board members.

We  are  also  grateful  to  Ms.  Anne  VanLent  for  her  eight  years  of  service  on  our  Board.  Her  guidance  and  advice  has  been

well-regarded, and we are very thankful for her time and energy over the years.

Looking  Ahead

This  is  an  exciting,  though  challenging,  time  to  be  a  part  of  the  healthcare  industry.  Integra  has  the  people,  products  and
opportunity to become the industry leader it aspires to be, and we have a clear strategy with underlying plans to realize our vision and
remain a high-quality investment for our stockholders.

I’d like to thank the entire Integra team, as well as our stockholders. I’m very proud to be part of an organization that helps
millions of patients worldwide. With our strong foundation and committed leadership, there are huge opportunities ahead, and I look
forward to the great things we will accomplish together on this journey.

Sincerely,

28MAR201300050006

Peter  Arduini
President and  Chief Executive Officer

STOCK PERFORMANCE GRAPH

The  following  line  graph  and  table  compare,  for  the  period  from  December  31,  2007  through  December  31,  2012,  the  yearly
change in the cumulative total stockholder return on the Company’s common stock with the cumulative total return of the Nasdaq
Stock Market — U.S. Index and the Nasdaq Medical Devices, Instruments and Supplies, Manufacturers and Distributors Index. The
graph assumes that the value of the investment in the Company’s common stock and the relevant index was $100 at December 31,
2007 and that all dividends were reinvested. The closing market price of the Company’s common stock on December 31, 2012 was
$38.97 per share.

Comparison of Five Year Cumulative Total Return
Value of Investment of $100 on December 31, 2007

$200

$150

$100

$50

$0

Integra LifeSciences Holdings Corporation

Nasdaq Medical Devices, Instruments and Supplies, Manufacturers and Distributors Index

Nasdaq Stock Market - U.S. Index

2007

2008

2009

2010

2011

2012

28MAR201300165201

Comparison of Cumulative Total Return  among  Integra LifeSciences Holdings  Corporation,
the Nasdaq Medical Devices, Instruments and Supplies, Manufacturers and
Distributors Index, and the Nasdaq Stock Market — U.S. Index

Integra  LifeSciences Holdings Corporation
Nasdaq Medical Devices, Instruments and Supplies, Manufacturers  and

Distributors  Index

Nasdaq Stock Market — U.S. Index

12/07

12/08

12/09

12/10

12/11

12/12

$100

$66

$88

$113

$ 74

$ 93

$100
$100

$54
$61

$79
$88

$ 84
$104

$ 96
$105

$107
$124

The  graph  and  table  above  depict  the  past  performance  of  the  Company’s  stock  price.  The  Company  neither  makes  nor

endorses any predictions as to future stock performance.

(This page has been left blank intentionally.)

UNITED STATES SECURITIES  AND  EXCHANGE  COMMISSION
Washington, DC 20549
Form 10-K

(Mark One)

(cid:1) ANNUAL REPORT PURSUANT TO SECTION 13  OR  15(d)

OF THE  SECURITIES EXCHANGE  ACT  OF 1934
For the fiscal year ended December 31,  2012

(cid:1)

TRANSITION REPORT PURSUANT  TO  SECTION 13  OR  15(d)
OF  THE SECURITIES EXCHANGE ACT OF  1934
For the transition period from 

 to 

COMMISSION  FILE  NO. 0-26224
INTEGRA LIFESCIENCES HOLDINGS CORPORATION
(EXACT NAME OF REGISTRANT  AS SPECIFIED  IN  ITS CHARTER)

DELAWARE
(STATE OR OTHER JURISDICTION OF
INCORPORATION OR ORGANIZATION)

311 ENTERPRISE DRIVE
PLAINSBORO, NEW JERSEY
(ADDRESS OF PRINCIPAL EXECUTIVE OFFICES)

51-0317849
(I.R.S. EMPLOYER
IDENTIFICATION NO.)

08536
(ZIP CODE)

REGISTRANT’S TELEPHONE NUMBER, INCLUDING AREA CODE:  (609)  275-0500

SECURITIES REGISTERED PURSUANT TO  SECTION  12(b)  OF  THE  ACT:

Title of Each Class

Common Stock, Par Value $.01 Per Share

Name of Exchange on Which Registered

The  Nasdaq Stock Market  LLC

SECURITIES REGISTERED  PURSUANT  TO SECTION 12(g)  OF  THE ACT:
NONE

Indicate  by  check  mark  if  the  registrant  is  a  well-known  seasoned  issuer,  as  defined  in  Rule  405  of  the  Securities

Act. Yes (cid:1) No (cid:1)

Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or 15(d) of the Securities

Exchange Act. Yes (cid:1) No (cid:1)

Indicate by check mark whether the registrant: (1) has filed all reports required to be filed by Section 13 or 15(d) of the
Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required
to file such reports), and (2) has been subject to such filing  requirements  for the  past  90 days.  Yes (cid:1) No (cid:1)

Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any,
every  Interactive  Data  File  required  to  be  submitted  and  posted  pursuant  to  Rule  405  of  Regulation  S-T  (§232.405  of  this
chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such
files). Yes (cid:1) No (cid:1)

Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K is not contained herein,
and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by
reference in Part III of this Form 10-K  or any  amendment  to  this Form 10-K. (cid:1)

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer or
a  smaller  reporting  company.  See  the  definitions  of  ‘‘large  accelerated  filer’’,  ‘‘accelerated  filer’’  and  ‘‘smaller  reporting
company’’ in Rule 12b-2 of the Exchange  Act. (Check  one):
Large accelerated filer (cid:1)

Smaller reporting company (cid:1)

Accelerated filer (cid:1)

Non-accelerated filer (cid:1)
(Do  not check if  a smaller reporting  company)

Indicate  by  check  mark  whether  the  registrant  is  a  shell  company  (as  defined  in  Rule  12b-2  of  the  Exchange

Act). Yes (cid:1) No (cid:1)

As  of  June  30,  2012,  the  aggregate  market  value  of  the  registrant’s  common  stock  held  by  non-affiliates  was
approximately  $726.4  million  based  upon  the  closing  sales  price  of  the  registrant’s  common  stock  on  The  Nasdaq  Global
Market  on  such  date.  The  number  of  shares  of  the  registrant’s  Common  Stock,  $0.01  par  value,  outstanding  as  of
February 22, 2013 was 27,989,027.

DOCUMENTS INCORPORATED BY REFERENCE:

Certain portions of the registrant’s definitive proxy statement relating to its scheduled May 22, 2013 Annual Meeting of

Stockholders are incorporated by reference in Part III of  this report.

INTEGRA LIFESCIENCES HOLDINGS CORPORATION
TABLE OF CONTENTS

PART I

Item 1.

Business . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 1A. Risk Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 1B. Unresolved Staff Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 2.

Item 3.

Item 4.

PART II

Item 5.

Item 6.

Item 7.

Properties . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Legal Proceedings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mine Safety Disclosures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer
Purchases of Equity Securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Selected Financial Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Management’s Discussion  and  Analysis of Financial Condition and Results of
Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 7A. Quantitative and Qualitative  Disclosures About Market  Risk . . . . . . . . . . . . . . . . . .

Item 8.

Item 9.

Financial Statements and  Supplementary Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Changes in and Disagreements with Accountants on  Accounting and Financial
Disclosures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 9A. Controls and Procedures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 9B. Other Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART III

Item 10.

Directors, Executive Officers  and Corporate Governance . . . . . . . . . . . . . . . . . . . . .

Item 11.

Executive Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 12.

Security Ownership of Certain  Beneficial  Owners  and Management  and Related
Stockholder Matters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Item 13.

Certain Relationships, Related Transactions, and Director Independence . . . . . . . . . .

Item 14.

Principal Accountant Fees and Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PART IV

Item 15.

Exhibits and Financial Statements Schedules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SIGNATURES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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PART I

ITEM 1. BUSINESS

OVERVIEW

The  terms  ‘‘we,’’  ‘‘our,’’  ‘‘us,’’  ‘‘Company’’  and  ‘‘Integra’’  refer  to  Integra  LifeSciences  Holdings

Corporation, a Delaware corporation, and  its  subsidiaries  unless the context  suggests otherwise.

Integra,  headquartered  in  Plainsboro,  New  Jersey,  is  a  world  leader  in  medical  technology.  The
Company employs approximately 3,500 people around the world who are dedicated to limiting uncertainty
for  surgeons,  so  that  they  can  concentrate  on  providing  the  best  patient  care.  Integra  offers  innovative
solutions  in  orthopedic  extremity  surgery,  neurosurgery,  spine  surgery,  and  reconstructive  and  general
surgery. Revenues grew to $830.9 million  in 2012, an  increase of 6.5% from $780.1 million in  2011.

Integra  was  founded  on  a  technology  platform  to  repair  and  regenerate  tissue  with  engineered
collagen devices. The Company has developed numerous product lines for applications ranging from burn
and deep tissue wounds to regeneration of dura mater in the brain and repair of nerve and tendon. Over
the  past  20  years,  Integra  has  grown  by  building  upon  this  core  regenerative  medicine  technology,
acquiring businesses in markets with overlapping customer bases and developing products to further meet
the needs of its target customers.

VISION

We  aspire  to  be  a  multi-billion  dollar  diversified  global  medical  technology  company  that  helps
patients by limiting uncertainty for medical professionals, and is a high quality investment for shareholders.
We  will  achieve  these  goals  by  delivering  on  our  Brand  Promises  to  our  customers  worldwide  and  by
becoming a top player in all markets  in  which we compete.

STRATEGY

Our  strategy  is  built  around  three  pillars  —  optimize,  execute  and  accelerate  growth.  These  three
pillars form our strategic objectives to optimize our infrastructure, to deliver on our commitments through
improved  planning  and  communication,  and  to  grow  by  introducing  new  products  through  internal
development, expanding geographically, and strategic acquisitions.

This is an essential strategic approach for two reasons. First, the costs inherent in operating a medical
technology company have increased at an accelerating rate in recent years and are expected to rise. Scale is
therefore correlated with rates of profitability in our industry. Second, over the course of the past twelve
years,  our  focus  on  growing  the  company  through  over  40  acquisitions  took  precedence  over  optimizing
our systems and processes, with the result that our operating footprint is more complex and less efficient
than it can be. While we have demonstrated that we can quickly and profitably integrate new products and
businesses,  and  have  an  active  program  to  evaluate  similar  opportunities,  we  must  simplify  our  structure
and processes into singular, common systems in order to continue to add scale efficiently and profitably.

To  that  end,  our  executive  leadership  team  has  set  forth  several  near-term  objectives  aligned  to  this

strategy:

Portfolio  Optimization. Our  investments  in  innovative  product  development  should  result  in  a  multi-
generational pipeline for our key products. Consistent with Integra’s competitive advantage, our product
development efforts will focus on regenerative medicine. We are also funding clinical evidence to support

1

successful  launches  and  improved  reimbursement  for  existing  products.  These  activities  should  result  in
more targeted and effective product development.

Geographic Expansion. We generate less than one quarter of our revenues from markets outside the
United  States,  and  see  an  opportunity  to  accelerate  revenue  growth  by  increasing  our  international
presence. We are securing ownership or other control of our product registrations and distribution system,
and  expanding  our  infrastructure  in  key  markets.  We  also  have  a  prioritized  plan  for  registering  and
launching our existing products in countries where we already have some selling presence, but are missing
key leading brands. We expect these efforts to increase our international business to a larger proportion of
our overall revenues.

Strategic  Corporate  Development. Over  the  years,  we  have  successfully  acquired  and  in-licensed
businesses, products and technologies to grow our business. Our corporate development program is a core
competency,  and  an  important  part  of  our  strategy  is  to  continue  to  pursue  strategic  transactions  and
licensing  agreements  to  increase  scale.  Acquisitions  in  particular  may  add  a  technology,  expand
international  distribution,  leverage  one  of  our  existing  sales  channels,  or  provide  a  new  channel  for  an
existing  technology.  These  capabilities  are  increasingly  important  to  remain  competitive  in  today’s
environment.

Structural Cost Reduction. We have a large and complex manufacturing and distribution footprint. We
have  initiated  plans  to  generate  higher  marginal  profit  and  increase  cash  flow  by  optimizing  these
operations around five centers of excellence. In addition, we have a significant number of suppliers for a
company  of  our  size,  and  have  centralized  strategic  sourcing  and  procurement  efforts.  As  a  result,  we
expect to reduce our supply base by 30%, which will help us better leverage our spending power to lower
our overall costs. In conjunction with these activities, we are optimizing our inventory planning to increase
cycles  and  decrease  working  capital  requirements.  Overall,  these  structural  efficiencies  should  drive
significant savings in our P&L and increase  our cash flows.

Common  Systems  Implementations. Our  initiatives  rely  upon  complexity  reduction  and  common
processes  across  our  global  operations.  We  have  two  important  efforts  underway  to  enable  that
simplification. First, we are well along in an implementation of a common ERP system, which will reduce
our current 27 systems to a single instance. Second, we recently embarked on a move toward a common
corporate  quality  system,  which  will  enable  a  consistent  approach  across  locations,  reduce  redundancies,
and  increase  overall  efficiency  in  this  important  function.  These  efforts  will  help  remove  costs  and
complexity from our operations, enable us to leverage our existing capabilities as we grow, and integrate
future acquisitions more quickly.

Finally,  to  ensure  that  our  colleagues  work  together  to  achieve  these  strategic  objectives,  we  are
investing  in  training  programs,  and  developing  a  strong  leadership  and  return-focused  culture.  These
objectives and investments are building  a  foundation necessary to support a growing, multi-billion dollar
global  medical  technology  company.  Taken  together,  our  strategy  to  execute,  optimize  and  accelerate
growth  will  enable  us  to  become  a  company  that  helps  limit  uncertainty  for  our  customers  and  touches
millions of patients each year, while driving returns  for our shareholders.

BUSINESS SEGMENTS

Prior to 2012, we operated in one segment. In 2012, due to changes in how the Company internally
manages and reports the results of its businesses to its Chief Operating Decision Maker (‘‘CODM’’), we
began reporting the following five reportable business segments: U.S. Neurosurgery, U.S. Extremities, U.S.
Instruments,  U.S.  Spine  and  Other,  and  International.  We  included  financial  information  regarding  our
reportable  business  segments  and  certain  geographic  information  under  ‘‘Item  7.  Management’s

2

Discussion and Analysis of Financial Condition and Results of Operations’’ and in Note 13, ‘‘Segment and
Geographic Information’’ to our Consolidated  Financial Statements.

U.S. Neurosurgery

Our U.S. Neurosurgery sales organization sells a full line of products specifically for neurosurgery and
neuro critical care. We have products for each step of a cranial procedure and the care of the patient after
surgery.  Our  key  products  include  dural  repair  products,  cerebral  spinal  fluid  (‘‘CSF’’)  management
devices, tissue ablation equipment, intracranial monitoring equipment and cranial stabilization equipment.
We  sell  equipment  used  in  the  neurosurgery  operating  room  and  neurosurgery  intensive  care  unit
(‘‘NICU’’). We sell our products through directly employed sales representatives.

U.S. Extremities

Extremity  reconstruction  is  a  growing  area  of  the  orthopedic  market.  We  define  extremity
reconstruction  to  mean  the  repair  of  soft  tissue  and  the  orthopedic  reconstruction  of  bone  in  the  foot,
ankle  and  leg  below  the  knee  (Lower  Extremity),  and  the  hand,  wrist,  elbow  and  shoulder  (Upper
Extremity).  Our  key  products  include  bone  and  joint  fixation  devices,  implants  and  instruments  for
osteoarthritis,  rheumatoid  arthritis,  wrist  arthroplasty,  carpel  tunnel  syndrome,  and  cubital  tunnel
syndrome.  Other  key  products  include  our  regenerative  medicine  devices  for  the  treatment  of  acute  and
chronic wounds, peripheral nerve repair and protection and tendon repair, and bone graft substitutes. We
sell  our  products  through  a  large  direct  sales  organization  and  through  specialty  distributors  focused  on
their respective surgical disciplines.

U.S. Instruments

Our U.S. Instruments business is among the largest surgical instrument suppliers in the United States.
Our portfolio includes over 60,000 instrument patterns and surgical products sold into a broad universe of
users,  including  hospitals,  surgery  centers,  and  physician,  dental  and  veterinary  offices.  In  addition  to
selling  hand-held  instruments,  we  sell  surgical  headlight  systems  and  table-mounted  retractors.  Our
brands  —  Jarit(cid:2),  Miltex(cid:2),  Padgett(cid:2),  Ruggles(cid:2),  Luxtec(cid:2)  and  Omni-Tract(cid:2)  —  are  well-known.  While  we
reach the Acute/Hospital segment primarily with a direct sales force, we reach the diverse Alternate Site
market with distributors.

U.S. Spine and Other

Our U.S. Spine and Other segment offers comprehensive spinal fusion technologies that surgeons use
along the full length of the spine, as well as a broad and deferential offering of related orthobiologics. In
2012,  our  Spine  business  launched  multiple  new  implants  into  targeted  growth  markets,  including  the
integrated interbody fusion device market, the minimally invasive market, and the deformity market. Our
key spinal hardware products include integrated interbody fusion devices, minimally invasive solutions, and
deformity correction. We market and sell a complete line of orthobiologics, including demineralized bone
products,  collagen  ceramic  matrices  and  pure  synthetic  bone  grafting  solutions,  to  neurosurgeons,  and
spine, orthopedic, trauma, and foot and ankle surgeons. We sell our products through specialty distributors
focused  on  our  spine  and  orthopedic  surgeon  customers,  as  well  as  through  some  direct  sales
representatives.

This  segment  also  includes  private-label  sales  of  a  broad  set  of  our  regenerative  medicine
technologies.  Our  customers  are  other  large  medical  technology  companies  that  sell  to  end  markets
primarily in orthopedics and wound care.

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International

The  International  segment  sells  similar  products  to  those  discussed  above,  but  they  are  managed
through  the  following  geographies:  (i)  Europe,  Middle  East  and  Africa,  and  (ii)  Central/South  America,
Asia-Pacific and Canada.

PRODUCTS — OVERVIEW

We  are  a  fully  integrated  medical  technology  company  that  offers  thousands  of  products  for  the
medical  specialties  we  target.  We  distinguish  ourselves  by  emphasizing  the  importance  of  regenerative
medicine,  which  we  define  as  surgical  implants  derived  from  our  proprietary  collagen  matrix  technology
and other biologic platforms. Our objective is to develop, acquire or otherwise provide products that will
limit uncertainty for hospitals and surgeons. These products include our regenerative medicine implants,
metal implants, instruments and equipment for orthopedic surgery, neurosurgery and  general surgery.

In  2012,  approximately  24%  of  our  revenues  came  from  collagen-based  regenerative  medicine
products.  While  these  products  vary  in  composition  and  structure,  they  operate  under  similar  principles.
We build our matrix products from collagen, which is the basic structural protein that binds cells together
in the body. Our matrices (whether for the dura mater, dermis, peripheral nerves, tendon or bone) provide
a scaffold to support the infiltration of the patient’s own cells and the growth of blood vessels. Eventually,
those  infiltrating  cells  consume  the  collagen  of  the  implanted  matrix  and  promote  the  development  of  a
new native extracellular matrix. In their interaction with the patient’s body, our collagen matrices provide
an environment to inhibit the formation of scar tissue, so the implant is absorbed over time, leaving healthy
native tissue in its place. This basic technology can be applied to many different procedures. We sell these
regenerative medicine products through most of our sales channels and reach additional markets through
our  private-label sales.

RESEARCH AND DEVELOPMENT  STRATEGY

Our research and development activities focus on identifying unmet surgical needs and meeting those
needs with innovative solutions and products. We apply our core competency in regenerative medicine to
products for neurosurgical, orthopedic and spinal applications, and we have extensive programs in neuro-
monitoring,  cranial  stabilization,  tissue  ablation,  spine,  and  extremity  fixation,  and  joint  arthroplasty.  In
addition  to  our  activities  aimed  at  acquiring  or  in-licensing  new  products,  we  are  optimizing  our  current
portfolio  through  product  franchise  review  and  rationalization.  We  are  focusing  our  development  efforts
on innovative products with an emphasis on clinical research and  product efficacy.

Regenerative Medicine. Because implants derived from our regenerative medicine platform represent a
fast-growing, high-margin opportunity for us, we allocate a large portion of our research and development
budget  to  these  products.  Our  regenerative  medicine  development  program  applies  our  expertise  in
biomaterials and collagen matrices to neurosurgical, orthopedic and spinal surgery applications, as well as
dermal regeneration, tendon and nerve  repair,  and  chronic  and acute  wounds.

Extremity  Reconstruction. We  develop  fixation  devices  and  other  implants  and  instruments  for  upper

and lower extremities.

Spine. Our  expertise  in  implant  engineering,  biomaterials  development  and  biomechanical  testing
provides a strong foundation for developing new products for the spine. Additionally, we hold a number of
spine patents that serve as a platform for future products, with particular emphasis in minimally invasive
technologies. While we plan to continue filling the gaps in our portfolio so that our current customers can
use our products for more procedures, we  are also  developing  novel technologies and  new indications.

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We  have  based  our  strong  orthobiologic  product  development  capability  on  our  bone  matrix
technology  and  our  collagen  technology,  which  is  the  basis  of  our  osteoconductive  collagen  ceramic
scaffold.  We  continue  to  develop  line  extensions  based  on  these  foundation  technologies  that  further
complete our offerings. In 2011, we created a complete portfolio of orthobiologic products specifically for
our spine distribution network. We will continue to invest in the development of new novel technologies
for bone grafting.

Neurosurgery. We  focus  on  expanding  the  market  for  our  dural  repair  products,  developing  the  next

generation tissue ablation system, and a new critical care neuro monitoring system.

Instruments. We work with a number of principally German instrument partners to bring new patterns
to the market, enabling us to add new instruments with minimal R&D expense. Our lighting franchise is
among the more dynamic, leading to ongoing development  in LED technology.

COMPETITION

Our  competition  in  extremity  reconstruction  includes  Johnson  &  Johnson,  Synthes,  Inc.,  Stryker
Corporation, Tornier, Inc., Wright Medical Group, Inc., Zimmer, Inc., and Small Bone Innovations, Inc., as
well  as  other  major  orthopedic  companies  that  carry  a  full  line  of  small  bone  and  joint  fixation  and  soft
tissue products.

Competitors  in  the  spine  and  orthobiologics  markets  include  Medtronic,  Inc.,  Johnson  &  Johnson,
Globus  Medical  Inc.,  NuVasive,  Inc.,  Orthofix,  Stryker  Corporation,  Synthes,  Inc.,  Zimmer,  Inc.,  and
Alphatec Spine, Inc., and also include several smaller, biologic-focused companies.

Our  competitors  in  the  neurosurgery  markets  are  Johnson  &  Johnson,  Medtronic,  Inc.  and  Stryker
Corporation.  In  addition,  many  of  our  neurosurgery  product  lines  compete  with  smaller  specialized
companies and larger companies that do not otherwise focus on neurosurgery.

Within the instruments market, we compete with the Aesculap division of B. Braun Medical Inc., as
well as V. Mueller, a division of CareFusion in the United States. In addition, we compete with Symmetry
Medical  and  many  smaller  instrument  companies  in  the  reusable  and  disposable  specialty  instruments
markets. We rely on the depth and breadth of our sales and marketing organization and our procurement
operation to maintain our competitive position  in surgical instruments and allied surgical products.

Finally,  in  certain  cases  our  products  compete  primarily  against  medical  practices  that  treat  a
condition  without  using  a  medical  device  or  any  particular  product,  such  as  medical  practices  that  use
autograft  tissue  instead  of  our  dermal  regeneration  products,  duraplasty  products  and  nerve  repair
products. Depending on the product line, we compete on the basis of our products’ features, strength of
our sales force or distributor, sophistication of our technology and cost effectiveness of our solution to the
customer’s medical requirements.

GOVERNMENT REGULATION

As  a  manufacturer  and  marketer  of  medical  devices,  we  are  subject  to  extensive  regulation  by  the
Food and Drug Administrations (‘‘FDA’’) and the Center for Medicare Services of the U.S. Department of
Health and Human Services and other federal governmental agencies and, in some jurisdictions, by state
and foreign governmental authorities. These regulations govern the introduction of new medical devices,
the observance of certain standards with respect to the design, manufacture, testing, labeling, promotion
and sales of the devices, the maintenance of certain records, the ability to track devices, the reporting of
potential product defects, the import  and  export of devices, and other matters.

5

Our Plainsboro, New Jersey manufacturing facility was inspected by the FDA during the third quarter
of  2011  which  resulted  in  the  issuance  of  FDA  Form  483  observations,  and  we  subsequently  received  a
warning  letter  from  the  FDA  on  December  21,  2011  related  to  that  inspection.  The  FDA  inspected  our
manufacturing facility in Andover, England in June 2012. Subsequently, on November 5, 2012, we received
a  warning  letter  from  the  FDA  related  to  quality  systems  issues  at  the  Andover  manufacturing  facility.
Finally, the FDA inspected our Anasco, Puerto Rico facility in October and November 2012, and issued us
a warning letter for that facility in February 2013. We have undertaken significant efforts to remediate the
observations  that  the  FDA  has  made  since  the  conclusion  of  the  inspections,  and  relieving  the  warning
letters  is a top priority.

The regulatory process of obtaining product approvals and clearances can be onerous and costly. The
FDA  requires,  as  a  condition  to  marketing  a  medical  device  in  the  United  States,  that  we  secure  a
Premarket Notification clearance pursuant to Section 510(k) of the Federal Food, Drug and Cosmetic Act
(the  ‘‘FD&C  Act’’),  an  approved  Premarket  Approval  application  (or  supplemental  PMA  application).
Obtaining these approvals and clearances can take up to several years and involves preclinical studies and
clinical testing. On December 27, 2011 the FDA issued a Draft Guidance, ‘‘The 510(k) Program: Evaluating
Substantial  Equivalence  in  Premarket  Notifications  510(k).’’  These  changes  to  the  510(k)  Premarket
Notification  process  may  result  in  more  extensive  testing,  clinical  trial  requirements  and  other
requirements. To perform clinical trials for significant risk devices in the United States on an unapproved
product, we are required to obtain an Investigational Device Exemption (‘‘IDE’’) from the FDA. The FDA
may also require a filing for FDA approval prior to marketing products that are modifications of existing
products  or  new  indications  for  existing  products.  Moreover,  after  clearance/approval  is  given,  if  the
product is shown to be hazardous or defective, the FDA and foreign regulatory agencies have the power to
withdraw  the  clearance  or  require  us  to  change  the  device,  its  manufacturing  process  or  its  labeling,  to
supply additional proof of its safety and effectiveness or to recall, repair, replace or refund the cost of the
medical device. Because we currently export medical devices manufactured in the United States that have
not been approved by the FDA for distribution in the United States, we are required to obtain approval/
registration in the country we are exporting to and maintain certain records relating to exports and make
these available to the FDA for inspection, if required.

The FDA Medical Device User Fee and Modernization Act of 2002 and the FDA Amendments Act of
2007 established regulations governing user fees for certain regulatory submissions to the FDA. Currently
user  fees  are  required  for  510(k)  PMA’s,  certain  PMA  supplements,  PMA  annual  reports,  FDA
establishment registrations and other regulatory submissions.

Human Cells, Tissues and Cellular and Tissue-Based Products

Integra manufactures medical devices derived  from human tissue (demineralized bone  tissue).

The  FDA  has  specific  regulations  governing  human  cells,  tissues  and  cellular  and  tissue-based
products, or HCT/Ps. An HCT/P is a product containing, or consisting of, human cells or tissue intended
for transplantation into a human patient.  Examples include bone, ligament, skin and cornea.

Some HCT/Ps also meet the definition of a biological product, medical device or drug regulated under
the FD&C Act. These biologic, device or drug HCT/Ps must comply both with the requirements exclusively
applicable  to  HCT/Ps  and,  in  addition,  with  requirements  applicable  to  biologics,  devices  or  drugs,
including premarket clearance or approval from  the FDA.

Section  361  of  the  Public  Health  Service  Act  (‘‘PHSA’’),  authorizes  the  FDA  to  issue  regulations  to
prevent  the  introduction,  transmission  or  spread  of  communicable  disease.  HCT/Ps  regulated  as  ‘‘361’’
HCT/Ps  are  subject  to  requirements  relating  to  registering  facilities  and  listing  products  with  the  FDA,
screening and testing for tissue donor eligibility, Good Tissue Practice when processing, storing, labeling,

6

and  distributing  HCT/Ps,  including  required  labeling  information,  stringent  record  keeping,  and  adverse
event reporting.

The  American  Association  of  Tissue  Banks  (‘‘AATB’’)  has  issued  operating  standards  for  tissue
banking. Compliance with these standards is a requirement in order to become an AATB-accredited tissue
establishment. In addition, some states have their own tissue banking regulations. We are licensed or have
permits for tissue banking in California, Florida,  New  York and Maryland.

National Organ Transplant Act. Procurement of certain human organs and tissue for transplantation is
subject to the restrictions of the National Organ Transplant Act (‘‘NOTA’’), which prohibits the transfer of
certain  human  organs,  including  skin  and  related  tissue  for  valuable  consideration,  but  permits  the
reasonable  payment  associated  with  the  removal,  transportation,  implantation,  processing,  preservation,
quality  control  and  storage  of  human  tissue  and  skin.  We  reimburse  tissue  banks  for  their  expenses
associated with the recovery, storage and transportation of donated human tissue that they provide to us
for  processing.  We  include  in  our  pricing  structure  amounts  paid  to  tissue  banks  to  reimburse  them  for
their  expenses  associated  with  the  recovery  and  transportation  of  the  tissue,  in  addition  to  certain  costs
associated with processing, preservation, quality control and storage of the tissue, marketing and medical
education  expenses,  and  costs  associated  with  development  of  tissue  processing  technologies.  NOTA
payment allowances may be interpreted to limit the amount of costs and expenses that we may recover in
our  pricing for our products, thereby  reducing our future  revenue  and  profitability.

Postmarket Requirements. After a device is cleared or approved for commercial distribution, numerous
regulatory  requirements  apply.  These  include  the  FDA  Quality  System  Regulations  which  cover  the
procedures  and  documentation  of  the  design,  testing,  production,  control,  quality  assurance,  labeling,
packaging,  sterilization,  storage  and  shipping  of  medical  devices;  the  FDA’s  general  prohibition  against
promoting  products  for  unapproved  or  ‘off-label’  uses;  the  Medical  Device  Reporting  regulation,  which
requires that manufacturers report to the FDA if their device may have caused or contributed to a death or
serious injury or malfunctioned in a way that would likely cause or contribute to a death or serious injury if
it were to recur; and the Reports of Corrections and Removals regulation, which require manufacturers to
report recalls and field corrective actions to the FDA if initiated to reduce a risk to health posed by the
device or to remedy a violation of the  FD&C Act.

We  are  also  required  to  register  with  the  FDA  as  a  medical  device  manufacturer.  As  such,  our
manufacturing sites are subject to periodic inspection by the FDA for compliance with the FDA’s Quality
System  Regulations.  These  regulations  require  that  we  manufacture  our  products  and  maintain  our
documents  in  a  prescribed  manner  with  respect  to  design,  manufacturing,  testing  and  control  activities.
Further,  we  are  required  to  comply  with  various  FDA  requirements  and  other  legal  requirements  for
labeling  and  promotion.  If  the  FDA  believes  that  a  company  is  not  in  compliance  with  applicable
regulations,  it  may  issue  a  warning  letter,  institute  proceedings  to  detain  or  seize  products,  issue  a  recall
order,  impose  operating  restrictions,  enjoin  future  violations  and  assess  civil  penalties  against  that
company, its officers or its employees and may recommend criminal prosecution to the U.S. Department of
Justice.

Medical  device  regulations  also  are  in  effect  in  many  of  the  countries  outside  the  United  States  in
which we do business. These laws range from comprehensive medical device approval and Quality System
requirements  for  some  or  all  of  our  medical  device  products  to  simpler  requests  for  product  data  or
certifications.  The  number  and  scope  of  these  requirements  are  increasing.  Under  the  European  Union
Medical Device Directive, medical devices must meet the Medical Device Directive standards and receive
CE  Mark  Certification  prior  to  marketing  in  the  European  Union  (the  ‘‘EU’’).  CE  Mark  Certification
requires a comprehensive Quality System program, comprehensive technical documentation and data on
the product, which are then reviewed by a Notified Body. A Notified Body is an organization designated by
the  national  governments  of  the  European  Union  member  states  to  make  independent  judgments  about

7

whether a product complies with the requirements established by each CE marking directive. The Medical
Device Directive, ISO 9000 series and ISO 13485 are recognized international quality standards that are
designed  to  ensure  that  we  develop  and  manufacture  quality  medical  devices.  Other  countries  are  also
instituting  regulations  regarding  medical  devices.  Compliance  with  these  regulations  requires  extensive
documentation  and  clinical  reports  for  all  of  our  products,  revisions  to  labeling,  and  other  requirements
such  as  facility  inspections  to  comply  with  the  registration  requirements.  A  recognized  Notified  Body
audits our facilities annually to verify our  compliance with these standards.

In  the  EU,  our  products  that  contain  human  derived  tissue,  including  demineralized  bone  material,
are  not  medical  devices  as  defined  in  the  Medical  Device  Directive  (93/42/EC).  They  are  also  not
medicinal products as defined in Directive 2001/83/EC. Today, regulations, if applicable, are different from
one EU member state to the next. Because of the absence of a harmonized regulatory framework and the
proposed regulation for advanced therapy medicinal products in the EU, the approval process for human-
derived cell or tissue-based medical products  may be extensive, lengthy, expensive,  and unpredictable.

Certain  countries,  as  well  as  the  EU,  have  issued  regulations  that  govern  products  that  contain
materials  derived  from  animal  sources.  Regulatory  authorities  are  particularly  concerned  with  materials
infected with the agent that causes bovine spongiform encephalopathy (‘‘BSE’’), otherwise known as mad
cow disease. These regulations affect our dermal regeneration products, duraplasty products, biomaterial
products for the spine, nerve and tendon repair products and certain other products, all of which contain
material derived from bovine tissue. Although we take great care to provide that our products are safe and
free of agents that can cause disease, products that contain materials derived from animals, including our
products, may become subject to additional regulation, or even be banned in certain countries, because of
concern over the potential for prion transmission. Significant new regulations, a ban of our products, or a
movement  away  from  bovine-derived  products  because  of  an  outbreak  of  BSE  could  have  a  material
adverse effect on our current business or our ability to expand our business. See ‘‘Item 1A. Risk Factors —
Certain  of  our  products  contain  materials  derived  from  animal  sources  and  may  become  subject  to
additional regulation.’’

We  are  subject  to  laws  and  regulations  pertaining  to  healthcare  fraud  and  abuse,  including  anti-
kickback  laws  and  physician  self-referral  laws  that  regulate  the  means  by  which  companies  in  the  health
care  industry  may  market  their  products  to  hospitals  and  health  care  professionals  and  may  compete  by
discounting  the  prices  of  their  products.  The  delivery  of  our  products  is  subject  to  regulation  regarding
reimbursement, and federal healthcare laws apply when a customer submits a claim for a product that is
reimbursed  under  a  federally  funded  healthcare  program.  These  rules  require  that  we  exercise  care  in
structuring  our  sales  and  marketing  practices  and  customer  discount  arrangements.  See  ‘‘Item  1A.  Risk
Factors — Oversight of the medical device industry might affect the manner in which we may sell medical
devices and compete in the marketplace.’’

Our international operations subject us to laws regarding sanctioned countries, entities and persons,
customs,  import-export,  laws  regarding  transactions  in  foreign  countries,  the  U.S.  Foreign  Corrupt
Practices  Act  and  local  anti-bribery  and  other  laws  regarding  interactions  with  healthcare  professionals.
Among other things, these laws restrict, and in some cases prohibit, United States companies from directly
or  indirectly  selling  goods,  technology  or  services  to  people  or  entities  in  certain  countries.  In  addition,
these  laws  require  that  we  exercise  care  in  structuring  our  sales  and  marketing  practices  in  foreign
countries.

Our  research,  development  and  manufacturing  processes  involve  the  controlled  use  of  certain
hazardous  materials.  We  are  subject  to  country-specific,  federal,  state  and  local  laws  and  regulations
governing  the  use,  manufacture,  storage,  handling  and  disposal  of  these  materials  and  certain  waste
products. We believe that our environmental, health and safety procedures for handling and disposing of
these materials comply with the standards prescribed by the controlling laws and regulations. However, risk

8

of accidental releases or injury from these materials is possible. These risks are managed to minimize or
eliminate  associated  business  impacts.  In  the  event  of  this  type  of  accident,  we  could  be  held  liable  for
damages that may result, and any liability could exceed our resources. We could be subject to a regulatory
shutdown  of  a  facility  that  could  prevent  the  distribution  and  sale  of  products  manufactured  there  for  a
significant period of time and we could suffer a casualty loss that could require a shutdown of the facility in
order  to  repair  it,  any  of  which  could  have  a  material,  adverse  effect  on  our  business.  Although  we
continuously strive to maintain full compliance with respect to all applicable global environmental, health
and  safety  laws  and  regulations,  we  could  incur  substantial  costs  to  fully  comply  with  future  laws  and
regulations, and our operations, business or assets may be impacted. Furthermore, global environmental,
health and safety compliance is an ongoing process. Integra has compliance procedures in place for EHS
programs, driven by a centrally led organizational structure that ensures proper implementation, which is
essential to our overall business objectives.

In addition to the above regulations, we are and may be subject to regulation under country-specific
federal  and  state  laws,  including,  but  not  limited  to,  requirements  regarding  record  keeping,  and  the
maintenance of personal information, including personal health information. As a public company, we are
subject  to  the  securities  laws  and  regulations,  including  the  Sarbanes-Oxley  Act  of  2002.  We  also  are
subject  to  other  present,  and  could  be  subject  to  possible  future,  local,  state,  federal  and  foreign
regulations.

Third-Party  Reimbursement. Healthcare  providers  that  purchase  medical  devices  generally  rely  on
third-party payors, including the Medicare and Medicaid programs and private payors, such as indemnity
insurers, employer group health insurance programs and managed care plans, to reimburse all or part of
the cost of the products. As a result, demand for our products is and will continue to be dependent in part
on  the  coverage  and  reimbursement  policies  of  these  payors.  The  manner  in  which  reimbursement  is
sought and obtained varies based upon the type of payor involved and the setting in which the product is
furnished  and  utilized.  Reimbursement  from  Medicare,  Medicaid  and  other  third-party  payors  may  be
subject to periodic adjustments as a result of legislative, regulatory and policy changes as well as budgetary
pressures. Possible reductions in, or eliminations of, coverage or reimbursement by third-party payors as a
result  of  these  changes  may  affect  our  customers’  revenue  and  ability  to  purchase  our  products.  Any
changes  in  the  healthcare  regulatory,  payment  or  enforcement  landscape  relative  to  our  customers’
healthcare services has the potential  to  significantly affect our operations  and revenue.

INTELLECTUAL PROPERTY

We  seek  patent  and  trademark  protection  for  our  key  technology,  products  and  product
improvements, both in the United States and in selected foreign countries. When determined appropriate,
we have enforced and plan to continue to enforce and defend our patent and trademark rights. In general,
however,  we  do  not  rely  solely  on  our  patent  and  trademark  estate  to  provide  us  with  any  significant
competitive  advantages  as  it  relates  to  our  existing  product  lines.  We  also  rely  upon  trade  secrets  and
continuing  technological  innovations  to  develop  and  maintain  our  competitive  position.  In  an  effort  to
protect our trade secrets, we have a policy of requiring our employees, consultants and advisors to execute
proprietary  information  and  invention  assignment  agreements  upon  commencement  of  employment  or
consulting relationships with us. These agreements also provide that all confidential information developed
or made known to the individual during the course of their relationship with us must be kept confidential,
except in specified circumstances.

AccuDrain(cid:2),  Accell(cid:2),  Accell  Evo3(cid:2),  Advansys(cid:2),  Atoll(cid:4),  Ascension(cid:2),  Auragen(cid:4),  Bold(cid:2),  Budde(cid:2),
Buzz(cid:4),  Camino(cid:2),  CRW(cid:2),  Coral(cid:2),  CUSA(cid:2),  Daytona(cid:4),  DenLite(cid:2),  DuraGen(cid:2),  DynaGraft(cid:2)  II,  First
Choice(cid:2),  Hallu(cid:2),  HeliCote(cid:2),  HeliPlug(cid:2),  HeliTape(cid:2),  HeliMend(cid:2),  Helistat(cid:2),  Helitene(cid:2),  HINTEGRA(cid:2),
ICOS  (cid:4),  Inforce(cid:2),  Integra(cid:2),  Integra  Mozaik(cid:4),  Jarit(cid:2),  Licox(cid:2),  LimiTorr(cid:4),  Luxtec(cid:2),  Malibu(cid:4),  Manta
Ray(cid:4),  Miltex(cid:2),  Movement(cid:2),  NeuraGen(cid:2),  NeuraWrap(cid:4),  NewPort(cid:4),  NuGrip(cid:4),  Omni-Tract(cid:2),

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OrthoBlast(cid:2)  II,  OSV  II(cid:2),  Qwix(cid:2),  Padgett(cid:2),  Panta(cid:2),  Redmond(cid:4),  Ruggles(cid:2),  SafeGuard(cid:2),  SeaSpine(cid:2),
Sonoma(cid:4), Subtalar MBA(cid:2), TenoGlide(cid:2), Titan(cid:4), Trel-X(cid:4), Trel-XC(cid:2), Trel-XPress(cid:4), Tibiaxys(cid:2), Uni-CP(cid:4),
Uni-Clip(cid:2),  Universal2(cid:4),  Ventrix(cid:2),  XKnife(cid:2),  Zuma(cid:4),  and  the  Integra  logo  are  some  of  the  material
trademarks  of  Integra  LifeSciences  Corporation  and  its  subsidiaries.  MAYFIELD(cid:2)  is  a  registered
trademark of SM USA, Inc., and is used by Integra  under license.

EMPLOYEES

At December 31, 2012, we had approximately 3,500 employees engaged in production and production
support  (including  warehouse,  engineering  and  facilities  personnel),  quality  assurance/quality  control,
research  and  development,  regulatory  and  clinical  affairs,  sales,  marketing,  administration  and  finance.
Except for certain employees at our facilities in France and Mexico, none of our employees is subject to a
collective bargaining agreement.

FINANCIAL INFORMATION ABOUT  GEOGRAPHIC AREAS

Financial  information  about  our  geographical  areas  is  set  forth  under  ‘‘Item  7.  Management’s
Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations  —  Geographic  Product
Revenues  and  Operations’’  and  in  our  financial  statements  Note  13,  ‘‘Segment  and  Geographic
Information,’’ to our Consolidated Financial Statements.

SOURCES OF RAW MATERIALS

In general, raw materials essential to our businesses are readily available from multiple sources. For
reasons of quality assurance, availability, or cost effectiveness, certain components and raw materials are
available only from a sole supplier. Our policy is to maintain sufficient inventory of components so that our
production will not be significantly disrupted even if a particular component or material is not available for
a period of time.

Certain of our products, including our dermal regeneration products, duraplasty products, biomaterial
products  for  the  spine,  nerve  and  tendon  repair  products  and  certain  other  products,  contain  material
derived from bovine tissue. We take great care to provide that our products are safe and free of agents that
can cause disease. In particular, the collagen used in the products that Integra manufactures is derived only
from the deep flexor tendon of cattle less than 24 months old from New Zealand, a country that has never
had a reported case of bovine spongiform encephalopathy, or from the United States. The World Health
Organization  classifies  different  types  of  cattle  tissue  for  relative  risk  of  BSE  transmission.  Deep  flexor
tendon is in the lowest-risk category for BSE transmission (the same category as milk, for example), and is
therefore considered to have a negligible  risk  of  containing the agent  that causes BSE.

Certain  of  our  demineralized  bone  matrix  products  contain  human  tissue  in  the  form  of  ground
cortical and cancellous bone. We source the bone tissue only from FDA and the American Association of
Tissue Banks (‘‘AATB’’) registered and inspected tissue banks. The donors are rigorously screened, tested,
and processed in accordance with the FDA and AATB requirements. Only donated tissue from FDA and
AATB  registered,  inspected,  non-profit  tissue  banks  is  qualified  to  source  for  our  raw  materials.
Additionally,  each  donor  must  pass  all  of  the  FDA-specified  bacterial  and  viral  testing  before  the  raw
material is distributed to Integra for further processing. We receive with each donor lot a certification of
the safety of the raw material from the  tissue bank’s medical  director.

As an added assurance of safety, each lot of bone is released into the manufacturing process only after
our staff of quality assurance microbiologists screen the incoming bone and serology test records. During
our  manufacturing  process,  the  bone  particles  are  subjected  to  our  proprietary  process  and  terminally

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sterilized. We have demonstrated through our testing that this type of rigorous processing further enhances
the safety and effectiveness of our demineralized bone  material products.

SEASONALITY

Revenues during our fourth quarter tend to be stronger than other quarters because many hospitals
increase their purchases of our products during the fourth quarter to coincide with the end of their budget
cycles.

AVAILABLE INFORMATION

We are subject to the informational requirements of the Securities Exchange Act of 1934, as amended,
(the ‘‘Exchange Act’’). In accordance with the Exchange Act, we file annual, quarterly and special reports,
proxy statements and other information with the Securities and Exchange Commission. You may view our
financial information, including the information contained in this report, and other reports we file with the
Securities  and  Exchange  Commission,  on  the  Internet,  without  charge  as  soon  as  reasonably  practicable
after we file them with the Securities and Exchange Commission, in the ‘‘SEC Filings’’ page of the Investor
Relations  section  of  our  website  at  www.integralife.com.  You  may  also  obtain  a  copy  of  any  of  these
reports,  without  charge,  from  our  investor  relations  department,  311  Enterprise  Drive,  Plainsboro,  NJ
08536. Alternatively, you may view or obtain reports filed with the Securities and Exchange Commission at
the SEC Public Reference Room at 100 F Street, N.E. in Washington, D.C. 20549, or at the Securities and
Exchange Commission’s Internet site at www.sec.gov. Please call the Securities and Exchange Commission
at 1-800-SEC-0330 for further information on the operation of  the  public  reference facilities.

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SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS

We have made statements in this report, including statements under ‘‘Business’’ and ‘‘Management’s
Discussion and Analysis of Financial Condition and Results of Operations’’ that constitute forward-looking
statements within the meaning of Section 27A of the Securities Act of 1933, as amended (the ‘‘Securities
Act’’), and Section 21E of the Exchange Act. These forward-looking statements are subject to a number of
risks, uncertainties and assumptions about us  including, among other things:

(cid:127) general economic and business conditions, both nationally and in  our international  markets;

(cid:127) our  expectations  and  estimates  concerning  future  financial  performance,  financing  plans  and  the

impact of competition;

(cid:127) anticipated trends in our business;

(cid:127) anticipated demand for our products, particularly  capital equipment;

(cid:127) our ability to produce collagen-based products in sufficient quantities to meet sales demands;

(cid:127) our expectations concerning our ongoing restructuring, integration and manufacturing transfer and

expansion activities;

(cid:127) existing and future regulations affecting our business,  and enforcement of those regulations;

(cid:127) our ability to obtain additional debt and equity financing to fund capital expenditures and working

capital requirements and acquisitions;

(cid:127) physicians’  willingness  to  adopt  our  recently  launched  and  planned  products,  third-party  payors’
willingness  to  provide  or  continue  reimbursement  for  these  products  and  our  ability  to  secure
regulatory approval for products in development;

(cid:127) initiatives launched by our competitors;

(cid:127) our ability to protect our intellectual  property, including  trade secrets;

(cid:127) our  ability  to  complete  acquisitions, 

integrate  operations  post-acquisition  and  maintain

relationships with customers of acquired entities;

(cid:127) our  ability  to  remediate  all  matters  identified  in  FDA  warning  letters  that  we  received  or  may

receive; and

(cid:127) other risk factors described in the  section entitled ‘‘Risk Factors’’ in this report.

You  can  identify  these  forward-looking  statements  by  forward-looking  words  such  as  ‘‘believe,’’
‘‘may,’’ ‘‘could,’’ ‘‘might,’’ ‘‘will,’’ ‘‘estimate,’’ ‘‘continue,’’ ‘‘anticipate,’’ ‘‘intend,’’ ‘‘seek,’’ ‘‘plan,’’ ‘‘expect,’’
‘‘should,’’ ‘‘would’’ and similar expressions in this report. We undertake no obligation to publicly update or
revise any forward-looking statements, whether as a result of new information, future events or otherwise.
In  light  of  these  risks  and  uncertainties,  the  forward-looking  events  and  circumstances  discussed  in  this
report  may  not  occur  and  actual  results  could  differ  materially  from  those  anticipated  or  implied  in  the
forward-looking statements.

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ITEM 1A. RISK FACTORS

Risks Related to Our Business

Our operating results may fluctuate.

Our  operating  results,  including  components  of  operating  results  such  as  gross  margin  and  cost  of
product  sales,  may  fluctuate  from  time  to  time,  and  such  fluctuations  could  affect  our  stock  price.  Our
operating  results  have  fluctuated  in  the  past  and  can  be  expected  to  fluctuate  from  time  to  time  in  the
future. Some  of the factors that may cause  these  fluctuations include:

(cid:127) economic  conditions  in  the  United  States  or  abroad,  especially  in  Europe,  which  could  affect  the
ability of hospitals and other customers to purchase our products and could result in a reduction in
elective and non-reimbursed operative  procedures;

(cid:127) the impact of acquisitions;

(cid:127) the impact of our restructuring activities;

(cid:127) the timing of significant customer orders, which tend to increase in the fourth quarter to coincide

with the end of budget cycles for many hospitals;

(cid:127) market acceptance of our existing products, as  well as products in development;

(cid:127) the timing of regulatory approvals;

(cid:127) changes in the rates of exchange between the U.S. dollar and other currencies of foreign countries

in which we do business, such as the euro and  the British pound;

(cid:127) expenses  incurred  and  business  lost  in  connection  with  product  field  correction  actions  or  recalls;

(cid:127) changes in the cost or decreases in the  supply of raw materials, including energy and steel;

(cid:127) our ability to manufacture and ship our products efficiently or in sufficient quantities to meet sales

demands;

(cid:127) the timing of our research and development expenditures;

(cid:127) reimbursement  for  our  products  by  third-party  payors  such  as  Medicare,  Medicaid  and  private

health insurers;

(cid:127) inspections of our manufacturing facilities for compliance with Quality System Regulations (Good
Manufacturing Practices) which could result in Form 483 observations, warning letters, injunctions
or other adverse findings from the FDA or  from equivalent regulatory  bodies;

(cid:127) the FDA’s reform to the 510(k) Premarket Notification process which could make it more difficult
to obtain clearance of our medical devices and could result in the requirement of clinical trial data
in order to obtain FDA clearance; and

(cid:127) the  increased  regulatory  scrutiny  of  certain  of  our  products,  including  products  which  we

manufacture for others, could result  in their being removed  from the market.

The industry and market segments in which we operate are highly competitive, and we may be unable to compete
effectively with other companies.

In  general,  there  is  intense  competition  among  medical  device  companies.  We  compete  with
established  medical  technology  companies  in  many  of  our  product  areas.  Competition  also  comes  from
early-stage companies that have alternative technological solutions for our primary clinical targets, as well
as universities, research institutions and other non-profit entities. Many of our competitors have access to

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greater  financial,  technical,  research  and  development,  marketing,  manufacturing,  sales,  distribution,
administrative,  consulting  and  other  resources  than  we  do.  Our  competitors  may  be  more  effective  at
developing commercial products. Our competitors may be able to gain market share by offering lower-cost
products or by offering products that enjoy better reimbursement methodologies from third-party payors,
such as Medicare, Medicaid and private  healthcare  insurance.

Our  competitive  position  will  depend  on  our  ability  to  achieve  market  acceptance  for  our  products,
develop new products, implement production and marketing plans, secure regulatory approval for products
under development, obtain and maintain reimbursement coverage under Medicare, Medicaid and private
healthcare insurance, obtain patent protection and to produce products consistently in sufficient quantities
to  meet  demand.  We  may  need  to  develop  new  applications  for  our  products  to  remain  competitive.
Technological  advances  by  one  or  more  of  our  current  or  future  competitors  or  their  achievement  of
superior  reimbursement  from  Medicare,  Medicaid  and  private  healthcare  insurance  could  render  our
present or future products obsolete or uneconomical. Our future success will depend upon our ability to
compete effectively against current technology as well as to respond effectively to technological advances.
Competitive  pressures  could  adversely  affect  our  profitability.  Additionally,  purchasing  decisions  of  our
customers may be based on clinical evidence or comparative effectiveness studies and, because of our vast
array of products, we might not be able to fund the studies necessary or provide the required information
to  compete  effectively.  Other  companies  may  have  more  resources  available  to  fund  such  studies.  For
example, competitors have launched and have been developing products to compete with our duraplasty
products,  extremity  reconstruction  implants,  neuro  critical  care  monitors  and  ultrasonic  tissue  ablation
devices, among others.

Our  largest  competitors  in  the  neurosurgery  markets  are  Medtronic,  Inc.,  Johnson  &  Johnson  and
Stryker Corporation. In addition, many of our neurosurgery product lines compete with smaller specialized
companies or larger companies that do not otherwise focus on neurosurgery. Our competitors in extremity
reconstruction include Johnson & Johnson, Synthes, Inc. and Stryker Corporation, as well as other major
orthopedic  companies  that  carry  a  full  line  of  reconstructive  products.  We  also  compete  with  Wright
Medical  Group,  Inc.,  Small  Bone  Innovations,  Inc.,  Tornier,  Inc.  and  other  companies  in  the  extremity
reconstruction market category. Our competitors in the spinal implant and orthobiologics markets include
Medtronic,  Inc.,  Johnson  &  Johnson,  Synthes,  Inc.,  Stryker  Corporation,  Zimmer,  Inc.,  NuVasive,  Inc.,
Globus Medical, Inc., Alphatec Spine, Inc., Orthofix and several smaller, biologically focused companies.
In surgical instruments, we compete with V. Mueller, as well as the Aesculap division of B. Braun Medical,
Inc. In addition, we compete with Symmetry Medical Inc. and many smaller instrument companies in the
reusable and disposable specialty instruments markets. Our private-label products face diverse and broad
competition,  depending  on  the  market  addressed  by  the  product.  Finally,  in  certain  cases  our  products
compete primarily against medical practices that treat a condition without using a device or any particular
product,  such  as  the  medical  practices  that  use  autograft  tissue  instead  of  our  dermal  regeneration
products, duraplasty products and nerve repair products.

Our  current  strategy  involves  growth  through  acquisitions,  which  requires  us  to  incur  substantial  costs  and
potential liabilities for which we may never realize  the anticipated benefits.

In addition to internally generated growth, our current strategy involves growth through acquisitions.
Since the beginning of 2010, we have acquired 4 businesses or product lines at a total cost of approximately
$158.9 million.

We may be unable to continue to implement our growth strategy, and our strategy ultimately may be
unsuccessful.  A  significant  portion  of  our  growth  in  revenues  has  resulted  from,  and  is  expected  to
continue to result from, the acquisition of businesses complementary to our own. We engage in evaluations
of potential acquisitions and are in various stages of discussion regarding possible acquisitions, certain of
which, if consummated, could be significant to us. Any new acquisition could result in material transaction

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expenses,  increased  interest  and  amortization  expense,  increased  depreciation  expense,  increased
operating expense, and possible in-process research and development charges for acquisitions that do not
meet  the  definition  of  a  ‘‘business,’’  any  of  which  could  have  a  material  adverse  effect  on  our  operating
results. Certain businesses that we acquire may not have adequate financial, disclosure, regulatory, quality
or other compliance controls at the time we acquire them. As we grow by acquisition, we must manage and
integrate  the  new  businesses  to  bring  them  into  our  systems  for  financial,  disclosure,  compliance,
regulatory  and  quality  control,  realize  economies  of  scale,  and  control  costs.  In  addition,  acquisitions
involve  other  risks,  including  diversion  of  management  resources  otherwise  available  for  ongoing
development of our business and risks associated with entering markets in which our marketing teams and
sales force has limited experience or where experienced distribution alliances are not available. Our future
profitability  will  depend  in  part  upon  our  ability  to  develop  further  our  resources  to  adapt  to  these  new
products or business areas and to identify and enter into or maintain satisfactory distribution networks. We
may  not  be  able  to  identify  suitable  acquisition  candidates  in  the  future,  obtain  acceptable  financing  or
consummate  any  future  acquisitions.  If  we  cannot  integrate  acquired  operations,  manage  the  cost  of
providing our products or price our products appropriately, our profitability could suffer. In addition, as a
result  of  our  acquisitions  of  other  healthcare  businesses,  we  may  be  subject  to  the  risk  of  unanticipated
business  uncertainties,  regulatory  and  other  compliance  matters  or  legal  liabilities  relating  to  those
acquired  businesses  for  which  the  sellers  of  the  acquired  businesses  may  not  indemnify  us,  for  which  we
may not be able to obtain insurance (or adequate insurance), or for which the indemnification may not be
sufficient to cover the ultimate liabilities.

Our future financial results could be adversely affected by  impairments or other  charges.

Since  we  have  grown  through  acquisitions,  we  have  $294.0  million  of  goodwill  and  $48.5  million  of
indefinite-lived  intangible  assets  as  of  December  31,  2012.  Under  the  authoritative  guidance  for
determining the useful life of intangible assets, we are required to test both goodwill and indefinite-lived
intangible  assets  for  impairment  on  an  annual  basis  based  upon  a  fair  value  approach,  rather  than
amortizing them over time. We are also required to test goodwill and indefinite-lived intangible assets for
impairment between annual tests if an event occurs such as a significant decline in revenues or cash flows
for  certain  products,  or  the  discount  rates  used  in  the  calculations  of  discounted  cash  flow  change
significantly,  or  circumstances  change  that  would  more  likely  than  not  reduce  our  enterprise  fair  value
below its book value. If such a decline, rate change or circumstance were to materialize, we may record an
impairment  of  these  intangible  assets  that  could  be  material  to  the  financial  statements.  See
‘‘Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations  —  Critical
Accounting Estimates’’ of this report.

The  guidance  on  long-lived  assets  requires  that  we  assess  the  impairment  of  our  long-lived  assets,
including  finite-lived  intangible  assets,  whenever  events  or  changes  in  circumstances  indicate  that  the
carrying value may not be recoverable as measured by the sum of the expected future undiscounted cash
flows. As of December 31, 2012, we had  $163.8  million of finite-lived  intangible  assets.

Decisions  relating  to  our  trade  names  may  occur  over  time  as  our  re-branding  strategy  is
implemented. Additionally, we may discontinue certain products in the future as we continue to assess the
profitability  of  our  product  lines.  As  a  result,  we  may  need  to  record  impairment  charges  or  accelerate
amortization on certain trade names  or technology-related intangible  assets in the  future.

The value of a medical device business is often volatile, and the assumptions underlying our estimates
made in connection with our assessments under the guidance may change as a result of that volatility or
other  factors  outside  our  control  and  may  result  in  impairment  charges.  The  amount  of  any  such
impairment charges could be significant and could have a material adverse effect on our reported financial
results for the period in which the charge is taken and could have an adverse effect on the market price of
our  securities, including the notes and the common stock into which they  may be converted.

15

Current  economic  conditions  may  adversely  affect  the  ability  of  hospitals,  other  customers,  suppliers  and
distributors to access funds or otherwise have available liquidity, which could reduce orders for our products or
interrupt  our  production  or  distribution  or  result  in  a  reduction  in  elective  and  non-reimbursed  operative
procedures.

Current  economic  conditions,  especially  in  Europe,  may  adversely  affect  the  ability  of  hospitals  and
other  customers  to  access  funds  to  enable  them  to  fund  their  operating  and  capital  budgets.  As  a  result,
hospitals and other customers may reduce budgets or put all or part of their budgets on hold or close their
operations, which could have a negative effect on our sales, particularly the sales of capital equipment such
as our ultrasonic surgical aspirators, neuromonitors and stereotactic products, or  result in  a reduction in
elective  and  non-reimbursed  procedures.  Governmental  austerity  policies  in  Europe  and  other  markets
have reduced and could continue to reduce the amount of money available to purchase medical products,
including our products.

To market our products under development we will first need to obtain regulatory approval. Further, if we fail to
comply with the extensive governmental regulations that affect our business, we could be subject to penalties and
could be precluded from marketing our  products.

As  a  manufacturer  and  marketer  of  medical  devices,  we  are  subject  to  extensive  regulation  by  the
FDA  and  the  Center  for  Medicare  Services  of  the  U.S.  Department  of  Health  and  Human  Services  and
other  federal  governmental  agencies  and,  in  some  jurisdictions,  by  state  and  foreign  governmental
authorities.  These  regulations  govern  the  introduction  of  new  medical  devices,  the  observance  of  certain
standards with respect to the design, manufacture, testing, labeling, promotion and sales of the devices, the
maintenance of certain records, the ability to track devices, the reporting of potential product defects, the
import  and  export  of  devices  and  other  matters.  We  are  facing  an  increasing  amount  of  scrutiny  and
compliance costs as more states are implementing regulations governing medical devices, pharmaceuticals
and/or  biologics  which  affect  many  of  our  products.  As  a  result,  we  have  been  implementing  additional
procedures, controls and tracking and reporting processes, as well as paying additional permit and license
fees, where required.

Our  products  under  development  are  subject  to  FDA  approval  or  clearance  prior  to  marketing  for
commercial  use.  The  process  of  obtaining  necessary  FDA  approvals  or  clearances  can  take  years  and  is
expensive and uncertain. The FDA has issued new Guidance Documents regarding the Refuse to Accept
Policy for 510(k)s, Acceptance and Filing Reviews for Premarket Approval Process (PMA) and the e-Copy
Program for medical device submissions. We must be in substantial compliance with these FDA Guidance
Documents for the FDA to review our submissions.

Our inability to obtain required regulatory approval on a timely or acceptable basis could harm our
business. Further, approval or clearance may place substantial restrictions on the indications for which the
product may be marketed or to whom it may be marketed, warnings that may be required to accompany
the  product  or  additional  restrictions  placed  on  the  sale  and/or  use  of  the  product.  Further  studies,
including clinical trials and FDA approvals, may be required to gain approval for the use of a product for
clinical  indications  other  than  those  for  which  the  product  was  initially  approved  or  cleared  or  for
significant changes to the product. These studies could take years to complete and could be expensive, and
there is no guarantee that the results will convince the FDA to approve or clear the additional indication.
Any negative outcome in our clinical trials, including as a result of any interim analysis which we may do
with  respect  to  our  clinical  trials  from  time  to  time,  could  adversely  affect  our  ability  to  launch  new
products,  which  could  affect  our  sales  and  our  ability  to  achieve  reimbursement  for  new  or  existing
products.  In  addition,  for  products  with  an  approved  PMA,  the  FDA  requires  annual  reports  and  may
require  post-approval  surveillance  programs  and/or  studies  to  monitor  the  products’  safety  and
effectiveness. Results of post-approval programs may limit or expand the further marketing of the product.
We  are  also  seeing  third-party  payors  require  clinical  trial  data  for  products  cleared  through  the  510(k)

16

process in order to continue reimbursement coverage. There is also no guarantee that the payors will agree
to continue reimbursement or provide additional coverage based upon these clinical trials. These clinical
trials could take years to complete and be expensive, and there is no guarantee that the FDA will approve
the  additional  indications  for  use.  If  the  FDA  does  not  approve  the  additional  indications  for  use,  our
ability to obtain reimbursement for these products and our ability to compete against alternative products
or technologies could suffer and, consequently, affect our  sales.

Another  risk  of  application  to  the  FDA  relates  to  the  regulatory  classification  of  new  products  or
proposed new uses for existing products. In the filing of each application, we make a judgment about the
appropriate form and content of the application. If the FDA disagrees with our judgment in any particular
case and, for example, requires us to file a Premarket Approval (PMA) application rather than allowing us
to market for approved uses while we seek broader approvals or requires extensive additional clinical data,
the time and expense required to obtain the required approval might be significantly increased or approval
might not be granted. Furthermore, the timing of approvals in the U.S. and Europe is now dependent on
the class of product. Any of our Class III devices (those categorized as supporting or sustaining human life,
are  of  substantial  importance  in  preventing  impairment  of  human  health,  or  which  present  a  potential,
unreasonable risk of illness or injury) and products of animal origin take an extensive amount of time to
obtain approval in the European Union, and all require clinical reports or clinical trial data which can be
costly.

The  FDA  Safety  and  Innovation  Act  (FDASIA),  which  includes  the  Medical  Device  User  Fee
Amendments of 2012 (MDUFA III), as well as other medical device provisions, went into effect October 1,
2012. This includes performance goals and user fees paid to FDA by medical device companies when they
register  and  list  with  FDA  and  when  they  submit  an  application  to  market  a  device  in  the  US.  This  will
affect the fees paid to the FDA over the 5 year period that FDASIA is in effect. As part of FDASIA, there
are also new requirements regarding FDA Establishment Registration and Listing of Medical Devices. All
foreign manufacturers must register and list medical devices for sale in the U.S. All of our facilities comply
with  these  requirements.  However,  we  also  source  products  from  foreign  contract  manufacturers.  From
this business practice, it is possible that some of our foreign contract manufacturers will not comply with
the  new  requirements  and  choose  not  to  register  with  the  FDA.  In  such  an  event,  we  will  need  to
determine if there are alternative foreign contract manufacturers who comply with these requirements. If
such a foreign contract manufacturer is a sole supplier of one of our products, there is risk that we may not
be able to source another supplier.

Our  manufacturing  facilities  must  be  in  compliance  with  FDA  Quality  System  Regulations  (current
Good  Manufacturing  Practices).  In  addition,  approved  products  are  subject  to  continuing  FDA
requirements  relating  to  quality  control  and  quality  assurance,  maintenance  of  records,  reporting  of
adverse  events  and  product  recalls,  documentation,  and  labeling  and  promotion  of  medical  devices.  For
example, some of our orthobiologics products are subject to FDA and certain state regulations regarding
human cells, tissues, and cellular or tissue-based products, which include requirements for Establishment
Registration and listing, donor eligibility, current good tissue practices, labeling, adverse-event reporting,
and inspection and enforcement. Some states have their own tissue banking regulation. We are licensed or
have permits as a tissue bank in California, Florida, New York and Maryland. In addition, tissue banks may
undergo  voluntary  accreditation  by  the  AATB.  The  AATB  has  issued  operating  standards  for  tissue
banking. Compliance with these standards is a requirement  in order  to  become a  licensed tissue bank.

The FDA and foreign regulatory authorities require that our products be manufactured according to
rigorous standards. These and future regulatory requirements could significantly increase our production
or purchasing costs and could even prevent us from making or obtaining our products in amounts sufficient
to meet market demand. If we or a third-party manufacturer change our approved manufacturing process,
the  FDA  may  require  a  new  approval  before  that  process  may  be  used.  Failure  to  develop  our

17

manufacturing capability could mean that, even if we were to develop promising new products, we might
not be able to produce them profitably, as a result of delays and additional capital  investment costs.

All of our manufacturing facilities, both international and domestic, are also subject to inspections by
or  under  the  authority  of  the  FDA  and  other  regulatory  agencies.  Failure  to  comply  with  applicable
regulatory requirements could subject us to issuance of FDA Form 483 Inspectional Observations, warning
letters or enforcement action by the FDA or other agencies, including product seizures, recalls, withdrawal
of clearances or approvals, restrictions on or injunctions against marketing our product or products based
on  our  technology,  denials  of  requests  for  exportation  certificates  to  foreign  governments,  cessation  of
operations and civil and criminal penalties, any of which  could materially affect  our business.

We  have  received  warning  letters  at  our  Plainsboro,  New  Jersey,  Andover,  England,  and  Anasco,
Puerto  Rico  facilities.  We  have  incurred,  and  will  incur,  expenses  to  remediate  issues  identified  in  those
warning letters and other observations issued in connection with other inspections at other facilities, and to
prepare our manufacturing facilities for anticipated FDA inspections. The FDA has notified us that it will
not grant requests for exportation certificates to foreign governments until the violations identified in the
warning letters have been corrected. If such remediation cannot be completed in a timely manner, we may
not be able to produce certain products for a period of time or may not be able to sell such products in
certain markets. There can be no assurance that such remediation and preparation activities will address
all  such  observations  to  the  FDA’s  satisfaction,  or  that  the  FDA  will  not  impose  additional  regulatory
sanctions with respect to such observations.

We manufacture medical devices that are subject to various electrical safety standards. Many countries
have  adopted  the  recommendations  of  the  International  Electrotechnical  Commission  (‘‘IEC’’)  for  the
safety  and  effectiveness  of  medical  electrical  equipment.  The  IEC  is  a  non-profit,  non-governmental
international standards organization that prepares and publishes International Standards for all electrical,
electronic  and  related  technologies.  Their  updated  standards  are  being  implemented  in  some  markets
starting  in  July  2012  and  will  continue  to  be  adopted  over  the  following  years  worldwide.  If  we  cannot
comply with these standards, we may not be able to sell some of our products in the affected markets. Most
of  our  affected  products  have  already  been  modified  to  meet  the  new  standards  and  are  substantially  in
compliance  with  these  standards.  Except  in  limited  circumstances,  we  do  not  anticipate  any  delays  in
selling our products in the markets that have adopted the IEC updated  standards.

We are also subject to other regulatory requirements of countries outside the United States where we
do  business.  For  example,  under  the  European  Union  Medical  Device  Directive  (MDD),  all  medical
devices must meet the Medical Device Directive standards in order to obtain CE Mark Certification prior
to  marketing  in  the  EU.  CE  Mark  Certification  requires  a  comprehensive  Quality  System  program,
comprehensive technical and clinical documentation and data on the product, which a Notified Body in the
EU  reviews.  In  addition,  we  must  be  certified  to  the  ISO  13485:2003  Quality  System  standards  and
maintain  this  certification  in  order  to  market  our  products  in  the  EU,  Canada,  Japan,  Latin  America,
countries  in  the  Asia-Pacific  region  and  most  other  countries  outside  the  United  States.  The  EU  has
revised the Medical Device Directive  (93/42/EC as  amended by 2007/47/EC).

Compliance with these regulations requires extensive documentation, clinical reports for all products
sold  in  the  EU  and  other  requirements.  Requirements  to  meet  these  regulations  can  be  costly  and  are
mandatory  to  market  our  products  in  the  EU.  Many  other  countries  have  instituted  new  medical  device
regulations  and/or  revised  current  medical  device  regulations.  These  regulations  often  require  extensive
documentation, including clinical data and could require audits of our manufacturing facilities in order to
gain  approval  to  sell  our  products  in  that  country.  There  are  also  associated  fees  with  these  new
regulations. These regulations are required for all new products and re-registration of our medical devices,
and could involve lengthy and expensive reviews.

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Our  products  that  contain  human  derived  tissue,  including  those  containing  demineralized  bone
matrices, are not medical devices in the EU as defined in the Medical Device Directive (93/42/EC). They
are also not medicinal products as defined in Directive 2001/83/EC. Today, regulations, if applicable, differ
from one EU member state to the next. Because of the absence of a harmonized regulatory framework, the
approval  process  for  human-derived  cell  or  tissue  based  medical  products  may  be  extensive,  lengthy,
expensive,  and  unpredictable.  Among  others,  some  of  our  orthobiologics  products  are  subject  to  EU
member states’ regulations that govern the donation, procurement, testing, coding, traceability, processing,
preservation,  storage,  and  distribution  of  human  tissues  and  cells  and  cellular  or  tissue-based  products.
These EU member states’ regulations include requirements for registration, listing, labeling, adverse-event
reporting,  and  inspection  and  enforcement.  Some  EU  member  states  have  their  own  tissue  banking
regulations. In addition, some EU member states have instituted new requirements for additional testing
of donors that may prevent our obtaining approval of  certain products in those member  states.

Certain of our products contain materials derived from animal sources and may become subject to additional
regulation.

Certain of our products, including our dermal regeneration products, duraplasty products, biomaterial
products  for  the  spine,  nerve  and  tendon  repair  products  and  certain  other  products,  contain  material
derived from bovine tissue. In 2012 approximately 24% of our products contained material derived from
bovine  tissue.  Products  that  contain  materials  derived  from  animal  sources, 
including  food,
pharmaceuticals  and  medical  devices,  are  subject  to  scrutiny  in  the  media  and  by  regulatory  authorities.
Regulatory authorities are concerned about the potential for the transmission of disease from animals to
humans via those materials. This public scrutiny has been particularly acute in Japan and Western Europe
with respect to products derived from animal sources, because of concern that materials infected with the
agent that causes bovine spongiform encephalopathy, otherwise known as BSE or mad cow disease, may, if
ingested or implanted, cause a variant of the human Creutzfeldt-Jakob Disease, an ultimately fatal disease
with  no  known  cure.  Cases  of  BSE  in  cattle  discovered  in  Canada  and  the  United  States  have  increased
awareness of  the issue in North America.

We  take  care  to  provide  that  our  products  are  safe  and  free  of  agents  that  can  cause  disease.  In
particular,  we  have  qualified  a  source  of  collagen  from  a  country  outside  the  United  States  that  is
considered BSE-free. The World Health Organization classifies different types of cattle tissue for relative
risk  of  BSE  transmission.  Deep  flexor  tendon  is  in  the  lowest-risk  categories  for  BSE  transmission  (the
same category as milk, for example), and is therefore considered to have a negligible risk of containing the
agent  that  causes  BSE  (an  improperly  folded  protein  known  as  a  prion).  Nevertheless,  products  that
contain  materials  derived  from  animals,  including  our  products,  could  become  subject  to  additional
regulation,  or  even  be  banned  in  certain  countries,  because  of  concern  over  the  potential  for  the
transmission of prions. Significant new regulation, or a ban of our products, could have a material adverse
effect on our current business or our  ability to expand our business.

Certain countries, such as Japan, China, Taiwan and Argentina, have issued regulations that require
our  collagen  products  be  processed  from  bovine  tendon  sourced  from  countries  where  no  cases  of  BSE
have occurred, and the EU has requested that our dural replacement products and other products that are
used in neurological tissue be sourced from bovine tendon sourced from a country where no cases of BSE
have occurred. Currently, we purchase our tendon from the United States and New Zealand. We received
approval in the EU, Japan, Taiwan, China and Argentina for the use of New Zealand-sourced tendon in
the manufacturing of our products. If we cannot continue to use or qualify a source of tendon from New
Zealand or another country that has never had a case of BSE, we will not be permitted to sell our collagen
products in certain countries.

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Certain  of  our  products  are  derived  from  human  tissue  and  are  subject  to  additional  regulations  and
requirements.

We  manufacture  medical  devices  derived  from  human  tissue  (demineralized  bone  tissue).  The  FDA
has specific regulations governing human cells, tissues and cellular and tissue-based products, or HCT/Ps.
An HCT/P is a product containing or consisting of human cells or tissue intended for transplantation into a
human patient. Examples include bone, ligament, skin and  cornea.

Some HCT/Ps also meet the definition of a biological product, medical device or drug regulated under
the  FD&C  ACT.  Section  361  of  the  PHSA  authorizes  the  FDA  to  issue  regulations  to  prevent  the
introduction,  transmission  or  spread  of  communicable  disease.  HCT/Ps  regulated  as  ‘‘361’’  HCT/Ps  are
subject  to  requirements  relating  to  registering  facilities  and  listing  products  with  FDA,  screening  and
testing  for  tissue  donor  eligibility,  Good  Tissue  Practice,  or  GTP,  when  processing,  storing,  labeling,  and
distribution HCT/Ps, including required labeling information, stringent record keeping; and adverse event
reporting.  These  biologic,  device  or  drug  HCT/Ps  must  comply  both  with  the  requirements  exclusively
applicable  to  361  HCT/Ps  and,  in  addition,  with  requirements  applicable  to  biologics,  devices  or  drugs,
including premarket clearance or approval.

The  American  Association  of  Tissue  Banks  (‘‘AATB’’)  has  issued  operating  standards  for  tissue
banking. Compliance with these standards is a requirement in order to become a licensed tissue bank. In
addition, some states have their own tissue banking regulations. We are licensed or have permits as a tissue
bank in California, Florida, New York and Maryland.

In  addition,  procurement  of  certain  human  organs  and  tissue  for  transplantation  is  subject  to  the
restrictions of the National Organ Transplant Act (‘‘NOTA’’), which prohibits the transfer of certain human
organs,  including  skin  and  related  tissue  for  valuable  consideration,  but  permits  the  reasonable  payment
associated  with  the  removal,  transportation,  implantation,  processing,  preservation,  quality  control  and
storage  of  human  tissue  and  skin.  We  reimburse  tissue  banks  for  their  expenses  associated  with  the
recovery, storage and transportation of donated human tissue that they provide to us for processing. We
include  in  our  pricing  structure  amounts  paid  to  tissue  banks  to  reimburse  them  for  their  expenses
associated  with  the  recovery  and  transportation  of  the  tissue,  in  addition  to  certain  costs  associated  with
processing,  preservation,  quality  control  and  storage  of  the  tissue,  marketing  and  medical  education
expenses,  and  costs  associated  with  development  of  tissue  processing  technologies.  NOTA  payment
allowances may be interpreted to limit the amount of costs and expenses that we can recover in our pricing
for  our  products,  thereby  reducing  our  future  revenue  and  profitability.  If  we  were  to  be  found  to  have
violated NOTA’s prohibition on the sale or transfer of human tissue for valuable consideration, we would
potentially be subject to criminal enforcement sanctions, which could materially and adversely affect our
results of operations.

In  the  EU,  regulations,  if  applicable,  differ  from  one  EU  member  state  to  the  next.  Because  of  the
absence  of  a  harmonized  regulatory  framework  and  the  proposed  regulation  for  advanced  therapy
medicinal products in the EU, as well as for other countries, the approval process for human derived cell
or tissue based medical products could be extensive, lengthy, expensive, and unpredictable. Among others,
some  of  our  orthobiologics  products  are  subject  to  EU  member  states’  regulations  that  govern  the
donation, procurement, testing, coding, traceability, processing, preservation, storage, and distribution of
human  tissues  and  cells  and  cellular  or  tissue-based  products.  These  EU  member  states’  regulations
include  requirements  for  registration,  listing,  labeling,  adverse-event  reporting,  and  inspection  and
enforcement. Some EU member states have their  own tissue banking regulations.

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Lack of market acceptance for our products or market preference for technologies that compete with our products
could reduce our revenues and profitability.

We cannot be certain that our current products or any other products that we develop or market will
achieve or maintain market acceptance. Certain of the medical indications that our devices can treat can
also be treated by other medical devices or by medical practices that do not include a device. The medical
community widely accepts many alternative treatments, and certain of these other treatments have a long
history of use. For example, the use of autograft tissue is a well-established means for repairing the dermis,
and it competes for acceptance in the market with our collagen-based  wound care products.

We  cannot  be  certain  that  our  devices  and  procedures  will  be  able  to  replace  those  established
treatments or that physicians, the medical community or third-party payors, including Medicare, Medicaid
and private health insurers, will accept and utilize our devices or any other medical products that we may
develop.  For  example,  market  acceptance  of  our  bone  graft  substitutes  will  depend  on  our  ability  to
demonstrate  that  our  bone  graft  substitutes  and  technologies  are  an  attractive  alternative  to  existing
treatment  options.  Additionally,  if  there  are  negative  events  in  the  industry,  whether  real  or  perceived,
there  could  be  a  negative  impact  on  the  industry  as  a  whole.  For  example,  we  believe  that  some  in  the
medical  community  have  lingering  concerns  over  the  risk  of  disease  transmission  through  the  use  of
natural bone graft substitutes.

In addition, our future success depends, in part, on our ability to develop additional products. Even if
we  determine  that  a  product  candidate  has  medical  benefits,  the  cost  of  commercializing  that  product
candidate  could  be  too  high  to  justify  development.  Competitors  could  develop  products  that  are  more
effective,  achieve  or  maintain  more  favorable  reimbursement  status  from  third-party  payors,  including
Medicare,  Medicaid  and  third-party  health  insurance,  cost  less  or  are  ready  for  commercial  introduction
before  our  products.  If  we  are  unable  to  develop  additional  commercially  viable  products,  our  future
prospects could be adversely affected.

Market  acceptance  of  our  products  depends  on  many  factors,  including  our  ability  to  convince
prospective  collaborators  and  customers  that  our  technology  is  an  attractive  alternative  to  other
technologies,  to  manufacture  products  in  sufficient  quantities  and  at  acceptable  costs,  and  to  supply  and
service  sufficient  quantities  of  our  products  directly  or  through  our  distribution  alliances.  In  addition,
unfavorable  reimbursement  methodologies,  or  adverse  determinations  of  third-party  payors,  including
Medicare,  Medicaid  and  private  health  insurers,  against  our  products  or  third-party  determinations  that
favor  a  competitor’s  product  over  ours,  could  harm  acceptance  or  continued  use  of  our  products.  The
industry  is  subject  to  rapid  and  continuous  change  arising  from,  among  other  things,  consolidation,
technological improvements, the pressure on third-party payors and providers to reduce healthcare costs,
and  healthcare  reform  legislation.  One  or  more  of  these  factors  may  vary  unpredictably,  and  such
variations could have a material adverse effect on our competitive position. We may not be able to adjust
our  contemplated plan of development  to  meet  changing  market  demands.

Our intellectual property rights may not provide meaningful commercial protection for our products, potentially
enabling third parties to use our technology or very similar technology and could reduce our ability to compete in
the market.

To  compete  effectively,  we  depend,  in  part,  on  our  ability  to  maintain  the  proprietary  nature  of  our
technologies and manufacturing processes, which includes the ability to obtain, protect and enforce patents
on our technology and to protect our trade secrets. We own or have licensed patents that cover aspects of
some  of  our  product  lines.  Our  patents,  however,  may  not  provide  us  with  any  significant  competitive
advantage. Others may challenge our patents and, as a result, our patents could be narrowed, invalidated
or  rendered  unenforceable.  Competitors  may  develop  products  similar  to  ours  that  our  patents  do  not
cover. In addition, our current and future patent applications may not result in the issuance of patents in

21

the United States or foreign countries. Further, there is a substantial backlog of patent applications at the
U.S. Patent and Trademark Office, and the approval or rejection of patent applications may take several
years.

Our competitive position depends, in part, upon unpatented trade secrets which we may be unable to protect.

Our competitive position also depends upon unpatented trade secrets, which are difficult to protect.
We  cannot  assure  you  that  others  will  not  independently  develop  substantially  equivalent  proprietary
information and techniques or otherwise gain access to our trade secrets, that our trade secrets will not be
disclosed or that we can effectively protect our rights to unpatented trade secrets.

In  an  effort  to  protect  our  trade  secrets,  we  require  our  employees,  consultants  and  advisors  to
execute  confidentiality  and  invention  assignment  agreements  upon  commencement  of  employment  or
consulting  relationships  with  us.  These  agreements  provide  that,  except  in  specified  circumstances,  all
confidential information developed or made known to the individual during the course of their relationship
with  us  must  be  kept  confidential.  We  cannot  assure  you,  however,  that  these  agreements  will  provide
meaningful  protection  for  our  trade  secrets  or  other  proprietary  information  in  the  event  of  the
unauthorized use or disclosure of confidential information.

Our success will depend partly on our ability to operate without infringing or misappropriating the proprietary
rights of others.

We  may  be  sued  for  infringing  the  intellectual  property  rights  of  others.  In  addition,  we  may  find  it
necessary, if threatened, to initiate a lawsuit seeking a declaration from a court that we do not infringe the
proprietary  rights  of  others  or  that  their  rights  are  invalid  or  unenforceable.  If  we  do  not  prevail  in  any
litigation, in addition to any damages we might have to pay, we would be required to stop the infringing
activity  (which  could  include  a  cessation  of  selling  the  products  in  question)  or  obtain  a  license  for  the
proprietary rights involved. Any required license may be unavailable to us on acceptable terms, if at all. In
addition, some licenses may be nonexclusive and allow our competitors to access the same technology we
license.

If we fail to obtain a required license or are unable to design our products so as not to infringe on the
proprietary  rights  of  others,  we  may  be  unable  to  sell  some  of  our  products,  and  this  potential  inability
could have a material adverse effect  on  our revenues and  profitability.

We may be involved in lawsuits relating to our intellectual property rights and promotional practices, which may
be expensive.

To  protect  or  enforce  our  intellectual  property  rights,  we  may  have  to  initiate  or  defend  legal
proceedings, such as infringement suits or opposition proceedings, against or by third parties. In addition,
we  may  have  to  institute  proceedings  regarding  our  competitors’  promotional  practices  or  defend
proceedings regarding our promotional practices. Legal proceedings are costly, and, even if we prevail, the
cost  of  the  legal  proceedings  could  affect  our  profitability.  In  addition,  litigation  is  time-consuming  and
could divert management attention and resources away from our business. Moreover, in response to our
claims against other parties, those parties  could assert counterclaims against  us.

It  may be difficult to replace some of our  suppliers.

Outside vendors, some of whom are sole-source suppliers, provide key components and raw materials
used in the manufacture of our products. Although we believe that alternative sources for many of these
components  and  raw  materials  are  available,  any  interruption  in  supply  of  a  limited  or  sole-source
component or raw material could harm our ability to manufacture our products until a new or alternative

22

source of supply is identified and qualified. In addition, an uncorrected defect or supplier’s variation in a
component or raw material, either unknown to us or incompatible with our manufacturing process, could
harm our ability to manufacture products. We may not be able to find a sufficient alternative supplier in a
reasonable  time  period,  or  on  commercially  reasonable  terms,  if  at  all,  and  our  ability  to  produce  and
supply our products could be impaired. We believe that these factors are most likely to affect the following
products that we manufacture:

(cid:127) our collagen-based products, such as the INTEGRA(cid:2) Dermal Regeneration Template and wound
dressing products, the DuraGen(cid:2) family of products, and our Absorbable Collagen Sponges;

(cid:127) our  products  made  from  silicone,  such  as  our  neurosurgical  shunts  and  drainage  systems  and

hemodynamic shunts;

(cid:127) products  which  use  many  different  electronic  parts  from  numerous  suppliers,  such  as  our

intracranial monitors and catheters; and

(cid:127) products  that  use  pyrolytic  carbon  (i.e.,  PyroCarbon)  technology,  such  as  certain  of  our

reconstructive extremity orthopedic implants.

In addition, some of our orthobiologics products rely on a small number of tissue banks accredited by
the American Association of Tissue Banks, or AATB, for the supply of human tissue, a crucial component
of  our  bone  graft  substitutes.  We  cannot  be  certain  that  these  tissue  banks  will  be  able  to  fulfill  our
requirements  or  that  we  will  be  able  to  successfully  negotiate  with  other  accredited  tissue  facilities  on
satisfactory terms.

If  we  were  suddenly  unable  to  purchase  products  from  one  or  more  of  these  companies,  we  would
need  a  significant  period  of  time  to  qualify  a  replacement,  and  the  production  of  any  affected  products
could be disrupted.

While it is our policy to maintain sufficient inventory of components so that our production will not be
significantly disrupted even if a particular component or material is not available for a period of time, we
remain at risk that we will not be able to qualify new components or materials quickly enough to prevent a
disruption if one or more of our suppliers  ceases production  of  important components or materials.

If any of our manufacturing facilities were damaged and/or our manufacturing or business processes interrupted,
we could experience lost revenues and our business could be  seriously harmed.

Damage  to  our  manufacturing,  development  or  research  facilities  because  of  fire,  extreme  weather
conditions, natural disaster, power loss, communications failure, unauthorized entry or other events, such
as a flu or other health epidemic, could cause us to cease development and manufacturing of some or all of
our  products.  In  particular,  our  San  Diego  and  Irvine,  California  facilities  are  susceptible  to  earthquake
damage,  wildfire  damage  and  power  losses  from  electrical  shortages  as  are  other  businesses  in  the
Southern  California  area.  Our  Anasco,  Puerto  Rico  plant,  where  we  manufacture  collagen,  silicone  and
our private-label products, is vulnerable to hurricane, storm, earthquake and wind damage. Although we
maintain property damage and business interruption insurance coverage on these facilities, our insurance
might  not  cover  all  losses  under  such  circumstances,  and  we  may  not  be  able  to  renew  or  obtain  such
insurance in the future on acceptable  terms with adequate  coverage  or at reasonable costs.

In  addition,  certain  of  our  surgical  instruments  have  some  manufacturing  processes  performed  by
third parties in Pakistan, which is subject to political instability and unrest, and we purchase a much smaller
amount  of  instruments  directly  from  vendors  there.  Such  instability  could  interrupt  our  ability  to  sell
surgical  instruments  to  our  customers  and  could  have  a  material  adverse  effect  on  our  revenues  and
earnings. While we have developed a relationship with an alternative provider of these services in another
country, and continue to work to develop other providers in other countries, we cannot guarantee that we

23

will be completely successful in achieving all of these relationships. Even if we are successful in establishing
all of these alternative relationships, we cannot guarantee that we will be able to do so at the same level of
costs or that we will be able to pass along additional costs to our customers.

Further,  we  manufacture  certain  products  in  Europe  and  our  European  headquarters  is  located  in
France,  which  has  experienced  labor  strikes.  Thus  far,  strikes  have  not  had  a  material  impact  on  our
business;  however,  if  such  strikes  were  to  occur,  there  is  no  assurance  that  they  would  not  disrupt  our
business, and any such disruption could have a  material adverse  effect on  our business.

We  implemented  an  enterprise  business  system  to  support  certain  of  our  transaction  processing  for
accounting and financial reporting, supply chain and manufacturing. A third party hosts and maintains this
system. Currently, we do not have a comprehensive disaster recovery plan for the Company’s infrastructure
but  we  have  adopted  alternative  solutions  to  mitigate  business  risk,  including  backup  equipment,  power
and  communications.  We  also  implemented  a  comprehensive  backup  and  recovery  process  for  our  key
software  applications.  Our  global  production  and  distribution  operations  are  dependent  on  the  effective
management  of  information  flow  between  facilities.  An  interruption  of  the  support  provided  by  our
enterprise business systems could have a  material adverse effect on the business.

We are exposed to a variety of risks relating to our international sales and operations, including fluctuations in
exchange rates, local economic conditions  and  delays in  collection of accounts  receivable.

We  generate  significant  revenues  outside  the  United  States  in  multiple  foreign  currencies  including
euros,  British  pounds,  Swiss  francs,  Canadian  dollars,  Japanese  yen  and  Australian  dollars,  and  in  U.S.
dollar-denominated transactions conducted with customers who generate revenue in currencies other than
the  U.S.  dollar.  For  those  foreign  customers  who  purchase  our  products  in  U.S.  dollars,  currency
fluctuations between the U.S. dollar and the currencies in which those customers do business may have a
negative impact on the demand for our products in foreign countries where the U.S. dollar has increased in
value compared to the local currency.

Since  we  have  operations  based  outside  the  United  States  and  we  generate  revenues  and  incur
operating expenses in multiple foreign currencies including euros, British pounds, Swiss francs, Canadian
dollars, Japanese yen and Australian dollars, we experience currency exchange risk with respect to those
foreign currency-denominated revenues  and expenses.

Although  we  address  currency  risk  management  through  regular  operating  and  financing  activities,
and, on a limited basis, through the use of derivative financial instruments, those actions may not prove to
be fully effective. For a description of our use of derivative financial instruments, see Note 5, ‘‘Derivative
Instruments.’’

We  cannot  predict  the  consolidated  effects  of  exchange  rate  fluctuations  upon  our  future  operating
results because of the number of currencies involved, the variability of currency exposure and the potential
volatility of currency exchange rates. Our international operations subject us to laws regarding sanctioned
countries,  entities  and  persons,  customs,  import-export,  laws  regarding  transactions  in  foreign  countries,
the  U.S.  Foreign  Corrupt  Practices  Act  and  local  anti-bribery  and  other  laws  regarding  interactions  with
healthcare  professionals,  and  product  registration  requirements.  Among  other  things,  these  laws  restrict,
and in some cases prohibit, U.S. companies from directly or indirectly selling goods, technology or services
to people or entities in certain countries. In addition, these laws require that we exercise care in structuring
our  sales and marketing practices and  effecting product registrations in  foreign countries.

Local economic conditions, legal, regulatory or political considerations, disruptions from strikes, the
effectiveness  of  our  sales  representatives  and  distributors,  local  competition,  in-country  reimbursement
methodologies  and  changes  in  local  medical  practice  could  also  affect  our  sales  to  foreign  markets.

24

Relationships with customers and effective terms of sale frequently vary by country, often with longer-term
receivables than are typical in the United States.

The adoption of healthcare reform in the United States may adversely affect our business, results of operations
and/or financial condition.

In  March  2010,  significant  reforms  to  the  U.S.  healthcare  system  were  adopted  in  the  form  of  the
Patient Protection and Affordable Care Act (the ‘‘PPACA’’). The PPACA includes provisions that, among
other things, reduce and/or limit Medicare reimbursement, require all individuals to have health insurance
(with limited exceptions) and impose new and/or increased taxes. Specifically, the law requires the medical
device  industry  to  subsidize  healthcare  reform  by  implementing  a  2.3%  excise  tax  on  the  sale  of  certain
medical devices by a manufacturer, producer or importer of such devices in the United States starting after
December 31, 2012. The 2013 excise tax is estimated to be between $9 and $12 million. Other elements of
this  legislation,  such  as  comparative  effectiveness  research,  an  independent  payment  advisory  board,
payment system reforms (including shared savings pilots) and other provisions, could materially change the
way health care is developed and delivered, and result in additional costs for us. The PPACA could reduce
medical  procedure  volumes,  impact  the  demand  for  our  products  or  the  prices  at  which  we  sell  our
products, and could have a material  adverse  effect on  our business and/or results  of operations.

Further,  the  PPACA  encourages  hospitals  and  physicians  to  work  collaboratively  through  shared
savings  programs,  such  as  accountable  care  organizations,  as  well  as  other  bundled  payment  initiatives,
which may ultimately result in the reduction of medical device purchases and the consolidation of medical
device  suppliers  used  by  hospitals.  While  passage  of  the  PPACA  may  ultimately  expand  the  pool  of
potential  end-users  of  our  products,  the  above-discussed  changes  could  adversely  affect  our  financial
results and business.

Various  healthcare  reform  proposals  have  also  emerged  at  the  state  level.  We  cannot  predict  what
healthcare  initiatives,  if  any,  will  be  implemented  at  the  federal  or  state  level,  or  the  effect  any  future
legislation or regulation will have on  us.

Changes in the healthcare industry may require us to decrease the selling price for our products, may reduce the
size of the market for our products, or may eliminate a market, any of which could have a negative impact on our
financial performance.

Trends  toward  managed  care,  healthcare  cost  containment  and  other  changes  in  government  and
private  sector  initiatives  in  the  United  States  and  other  countries  in  which  we  do  business  are  placing
increased emphasis on the delivery of more cost-effective medical therapies that could adversely affect the
sale and/or the prices of our products.  For  example:

(cid:127) as  mentioned  above,  new  legislation,  which  is  intended  to  expand  access  to  health  insurance
coverage over time, will result in major changes in the United States healthcare system that could
have an adverse effect on our business, including a 2.3% excise tax on U.S. sales of most medical
devices, implemented in 2013, which will  adversely effect on our earnings;

(cid:127) third-party  payors  of  hospital  services  and  hospital  outpatient  services,  including  Medicare,
Medicaid and private healthcare insurers, annually revise their payment methodologies, which can
result in stricter standards for reimbursement of hospital charges for certain medical procedures or
the elimination of reimbursement;

(cid:127) Medicare, Medicaid and private healthcare insurer cutbacks could create downward price pressure

on our products;

(cid:127) local  Medicare  coverage  determinations  will  eliminate  reimbursement  for  certain  of  our  matrix
wound  dressing  products  in  most  regions,  negatively  affecting  our  market  for  these  products,  and

25

future determinations could eliminate reimbursement for these products in other regions and could
eliminate reimbursement for other products;

(cid:127) there has been a consolidation among healthcare facilities and purchasers of medical devices in the
United  States  some  of  whom  prefer  to  limit  the  number  of  suppliers  from  whom  they  purchase
medical  products,  and  these  entities  may  decide  to  stop  purchasing  our  products  or  demand
discounts on our prices;

(cid:127) we  are  party  to  contracts  with  group  purchasing  organizations,  which  negotiate  pricing  for  many
member hospitals, that require us to discount our prices for certain of our products and limit our
ability to raise prices for certain of our products, particularly surgical  instruments;

(cid:127) there is economic pressure to contain healthcare costs in domestic and international markets, and,
regardless of the consolidation discussed above, providers generally are exploring ways to cut costs
by eliminating purchases or driving reductions in the prices that they  pay  for medical devices;

(cid:127) there are proposed and existing laws, regulations and industry policies in domestic and international
markets regulating the sales and marketing practices and the pricing and profitability of companies
in the healthcare industry;

(cid:127) proposed  laws  or  regulations  will  permit  hospitals  to  provide  financial  incentives  to  doctors  for
reducing hospital costs (known as gainsharing), will award physician efficiency (known as physician
profiling),  and  will  encourage  partnership  with  healthcare  service  and  goods  providers  to  reduce
prices;

(cid:127) the  growing  prevalence  of  physician-owned  distributorships  catering  to  the  spinal  surgery  market
has  reduced  and  may  continue  to  reduce  our  ability  to  compete  effectively  for  business  from
surgeons who own such distributorships;  and

(cid:127) there  have  been  initiatives  by  third-party  payors  to  challenge  the  prices  charged  for  medical

products that could affect our ability to sell  products on a competitive basis.

Any and all of the above factors could materially and adversely affect our levels of revenue and our

profitability.

Oversight  of  the  medical  device  industry  might  affect  the  manner  in  which  we  may  sell  medical  devices  and
compete in the marketplace.

There are laws and regulations that govern the means by which companies in the healthcare industry
may market their products to healthcare professionals and may compete by discounting the prices of their
products,  including  for  example,  the  federal  Anti-Kickback  Statute,  the  federal  False  Claims  Act,  the
federal Health Insurance Portability and Accountability Act of 1996, state law equivalents to these federal
laws that are meant to protect against fraud and abuse and analogous laws in foreign countries. Violations
of these laws are punishable by criminal and civil sanctions, including, but not limited to, in some instances
civil  and  criminal  penalties,  damages,  fines,  exclusion  from  participation  in  federal  and  state  healthcare
programs,  including  Medicare  and  Medicaid.  Although  we  exercise  care  in  structuring  our  sales  and
marketing  practices  and  customer  discount  arrangements  to  comply  with  those  laws  and  regulations,  we
cannot assure that:

(cid:127) government  officials  charged  with  responsibility  for  enforcing  those  laws  will  not  assert  that  our
sales and marketing practices or customer discount arrangements are in violation of those laws or
regulations; or

(cid:127) government regulators or courts will interpret those laws or regulations in a manner consistent with

our  interpretation.

26

Correspondingly, federal and state laws are also sometimes open to interpretation, and from time to
time  we  may  find  ourselves  at  a  competitive  disadvantage  if  our  interpretation  differs  from  that  of  our
competitors.  AdvaMed,  the  principal  United  States  trade  association  for  the  medical  device  industry,
promulgates a model code of conduct that sets forth standards by which its members should abide in the
promotion of their products. We have in place policies and procedures for compliance that we believe are
at least as stringent as those set forth in the revised AdvaMed Code, and we provide routine training to our
sales  and  marketing  personnel  on  our  policies  regarding  sales  and  marketing  practices.  Pursuant  to  the
revised AdvaMed Code, we have certified our adoption of the revised AdvaMed Code. Nevertheless, the
sales and marketing practices of our industry have been the subject of increased scrutiny from federal and
state  government  agencies,  and  we  believe  that  this  trend  will  continue.  For  example,  recent  federal
legislation,  state  legislation  and  foreign  legislation  requires  detailed  disclosure  of  gifts  and  other
remuneration  made  to  healthcare  professionals.  In  addition,  prosecutorial  scrutiny  and  governmental
oversight,  on  the  state  and  federal  levels,  over  some  major  device  companies  regarding  the  retention  of
healthcare  professionals  as  consultants  has  limited  the  manner  in  which  medical  device  companies  may
retain healthcare professionals as consultants. Various hospital organizations, medical societies and trade
associations  are  establishing  their  own  practices  that  may  require  detailed  disclosures  of  relationships
between healthcare professionals and medical device companies or ban or restrict certain marketing and
sales practices such as gifts and business meals.

Our private-label product lines depend significantly on key relationships with third parties, which we could be
unable to establish and maintain.

Our  private-label  business  depends  in  part  on  our  entering  into  and  maintaining  collaborative  or
alliance agreements with third parties concerning product marketing, as well as research and development
programs.  The  third  parties  with  whom  we  have  entered  into  agreements  might  terminate  these
agreements  for  a  variety  of  reasons,  including  developing  other  sources  for  the  products  that  we  supply.
Termination of our most important relationships could adversely affect our expectations for the growth of
private-label products.

We may  have significant product liability  exposure and our insurance may not  cover all potential  claims.

We are exposed to product liability and other claims in the event that our technologies or products are
alleged  to  have  caused  harm.  We  may  not  be  able  to  obtain  insurance  for  the  potential  liability  on
acceptable  terms  with  adequate  coverage  or  at  reasonable  costs.  Any  potential  product  liability  claims
could exceed the amount of our insurance coverage or may be excluded from coverage under the terms of
the policy. Our insurance may not be renewed at a cost and level of coverage comparable to that then in
effect.

We are subject to requirements relating to hazardous materials which may impose significant compliance or other
costs on us.

Our  research,  development  and  manufacturing  processes  involve  the  controlled  use  of  certain
hazardous materials. In addition, we own and/or lease a number of facilities at which hazardous materials
have been used in the past. Finally, we have acquired various companies that historically have used certain
hazardous materials and that have owned and/or leased facilities at which hazardous materials have been
used.  For  all  of  these  reasons,  we  are  subject  to  federal,  state,  foreign,  and  local  laws  and  regulations
governing  the  use,  manufacture,  storage,  handling,  treatment,  remediation,  and  disposal  of  hazardous
materials  and  certain  waste  products  (‘‘Environmental  Laws’’).  For  example,  our  allograft  bone  tissue
processing may generate waste materials, which in the United States, are classified as medical waste under
Environmental  Laws.  Although  we  believe  that  our  procedures  for  handling  and  disposing  of  hazardous
materials  comply  with  the  Environmental  Laws,  the  Environmental  Laws  may  be  amended  in  ways  that
increase our cost of compliance, perhaps  materially.

27

Furthermore,  the  risk  of  accidental  contamination  or  injury  from  these  materials  cannot  be
eliminated, and there is also a risk that such contamination previously has occurred in connection with one
of  our  facilities  or  in  connection  with  one  of  the  companies  we  have  purchased.  In  the  event  of  such  an
accident,  or  contamination  we  could  be  held  liable  for  any  damages  that  result  and  any  related  liability
could exceed the limits or fall outside the coverage of our insurance and could exceed our resources. We
may not be able to maintain insurance on  acceptable terms or at all.

We may  experience difficulties implementing our new global enterprise resource planning system

We are engaged in a multi-year implementation of a new global enterprise resource planning system
(‘‘ERP’’) to improve our operational efficiency. The ERP is designed to accurately maintain our financial
reporting  data  and  provide  information  to  our  management  team  important  to  the  operation  of  the
business.  Our  ERP  has  required,  and  will  require,  the  investment  of  significant  human  and  financial
resources.  The  implementation  of  this  new  ERP  system  involves  numerous  risks,  including  disruption  to
our  normal  accounting  procedures  and  internal  control  over  financial  reporting,  inaccuracies  in  the
conversion  of  electronic  data,  difficulties  integrating  the  systems  and  processes,  additional  costs  to
continue to refine the system’s functionality, and disruption of our financial reporting process. We may not
be  able  to  successfully  implement  the  ERP  without  experiencing  significant  delays,  increased  costs,  or
other  difficulties.  Any  significant  disruption  or  deficiency  in  the  design  or  implementation  of  the  ERP
could  adversely  affect  our  ability  to  estimate  supply  chain  needs,  plan  production  requirements,  process
orders, ship product, send invoices and track payments, fulfill contractual obligations, accurately forecast
sales, or otherwise operate our business,  all of which could negatively impact  sales and profits.

New regulations related to ‘‘conflict minerals’’ may force us to incur additional expenses, may make our supply
chain more complex and may result in  damage to our  reputation with  customers.

On August 22, 2012, the Securities and Exchange Commission adopted new disclosure regulations for
public companies that manufacture products that contain certain minerals (i.e., tin, tantalum, tungsten or
gold) known as conflict minerals, if these conflict minerals are necessary to the functionality or production
of our products. These regulations require such companies to report annually whether or not such conflict
minerals originate from the Democratic Republic of Congo (‘‘DRC’’) and adjoining countries and in some
cases  to  perform  extensive  due  diligence  on  their  supply  chains  for  such  conflict  minerals.  The
implementation of these new requirements could adversely affect the sourcing, availability and pricing of
conflict minerals used in the manufacture of medical devices, including our products. In addition, we may
incur  additional  costs  to  comply  with  the  disclosure  requirements,  including  costs  related  to  determining
the source of any of the relevant conflict minerals used in our products. Since our supply chain is complex,
the  due  diligence  procedures  that  we  implement  may  not  enable  us  to  determine  the  origins  for  these
conflict  minerals  or  determine  that  these  conflict  minerals  are  DRC  conflict-free,  which  may  harm  our
reputation. We may also face difficulties in satisfying any customers who may require that our products be
certified as DRC conflict-free, which could harm our relationships with these customers and result in a loss
of revenue. These new requirements also could have the effect of limiting the pool of suppliers from which
we  source  these  conflict  minerals,  and  we  may  be  unable  to  obtain  conflict-free  minerals  at  competitive
prices,  which  could  increase  our  costs  and  adversely  affect  our  manufacturing  operations  and  our
profitability.

28

ITEM 1B. UNRESOLVED STAFF COMMENTS

As of the filing of this Annual Report on Form 10-K, we had no unresolved comments from the staff
of the Securities and Exchange Commission that were received not less than 180 days before the end of our
2012 fiscal year.

ITEM 2. PROPERTIES

Our  principal  executive  offices  are  located  in  Plainsboro,  New  Jersey.  Our  principal  manufacturing
and  research  facilities  are  located  in  California,  Massachusetts,  New  Jersey,  Ohio,  Pennsylvania,  France,
Germany, Ireland, Mexico, Puerto Rico and the United Kingdom. Our instrument procurement operations
are  located  in  Germany.  Our  primary  distribution  centers  are  located  in  Nevada,  Ohio,  Pennsylvania,
Australia,  Belgium,  Canada  and  France.  In  addition,  we  lease  several  smaller  facilities  to  support
additional  administrative,  assembly,  and  distribution  operations.  Third  parties  own  and  operate  the
facilities in Nevada and Belgium. We own our facilities in Biot, France and Andover, United Kingdom, and
certain  facilities  in  Ohio  and  Pennsylvania  and  we  lease  all  of  our  other  facilities.  We  also  have  repair
centers in California, Massachusetts,  Ohio,  Australia and Germany.

Our manufacturing facilities are registered with the FDA. Our facilities are subject to FDA inspection
to ensure compliance with Quality System regulations. Our Plainsboro, New Jersey manufacturing facility
was  inspected  by  the  FDA  during  the  third  quarter  of  2011  which  resulted  in  the  issuance  of  FDA
Form  483  observations,  and  we  subsequently  received  a  warning  letter  from  the  FDA  on  December  21,
2011  related  to  that  inspection.  The  FDA  inspected  our  manufacturing  facility  in  Andover,  England  in
June  2012.  Subsequently,  on  November  5,  2012,  we  received  a  warning  letter  from  the  FDA  related  to
quality systems issues at the Andover manufacturing facility. Finally, the FDA inspected our manufacturing
facility  in  Anasco,  Puerto  Rico  in  October  and  November  2012,  and  we  received  a  warning  letter  in
February  2013.  We  have  undertaken  significant  efforts  to  remediate  the  observations  that  the  FDA  has
made since the conclusion of the inspections.

ITEM 3. LEGAL PROCEEDINGS

Various lawsuits, claims and proceedings are pending or have been settled by us; the most significant

of which are described below.

On June 6, 2012, the Company was contacted by the United States Attorney’s Office for the District of
New  Jersey  regarding  the  activities  of  two  sales  representatives  in  a  single  region  within  our  Extremities
Reconstruction  division  pertaining  to  the  alleged  creation  of  invoices  for  products  that  were  not  sold  or
surgeries that did not take place for extremities indications. The Company is cooperating with the United
States Attorney’s office on a voluntary basis and is not a subject or target of an investigation at this time.

We  are  subject  to  various  claims,  lawsuits  and  proceedings  in  the  ordinary  course  of  business,
including  claims  by  current  or  former  employees,  distributors  and  competitors  and  with  respect  to  our
products  and  products  liability  claims.  In  the  opinion  of  management,  such  claims  are  either  adequately
covered  by  insurance  or  otherwise  indemnified,  or  are  not  expected,  individually  or  in  the  aggregate,  to
result  in  a  material  adverse  effect  on  our  financial  condition.  However,  it  is  possible  that  our  results  of
operations,  financial  position  and  cash  flows  in  a  particular  period  could  be  materially  affected  by  these
contingencies.

ITEM 4. MINE SAFETY DISCLOSURES

Not applicable.

29

PART II

ITEM 5. MARKET FOR REGISTRANT’S COMMON  EQUITY, RELATED STOCKHOLDER  MATTERS

AND ISSUER PURCHASES OF EQUITY SECURITIES

Market Information, Holders and Dividends

Our common stock trades on The NASDAQ Global Market under the symbol ‘‘IART.’’ The following

table lists the high and low sales prices  for our common  stock  for  each quarter  for the  last two years:

Fourth Quarter
Third Quarter
Second Quarter
First  Quarter

2012

2011

High

Low

High

Low

$41.72
$42.76
$38.18
$35.74

$35.99
$35.71
$31.61
$23.22

$38.80
$48.26
$52.90
$51.79

$28.07
$34.92
$45.50
$44.64

We  have  not  paid  any  cash  dividends  on  our  common  stock  since  our  formation.  Our  credit  facility
limits the amount of dividends that we  may pay. See ‘‘Item  7. Management’s Discussion and Analysis of
Financial  Condition  and  Results  of  Operations  —  Liquidity  and  Capital  Resources  —  Amended  and
Restated  Senior  Credit  Agreement.’’  Any  future  determinations  to  pay  cash  dividends  on  the  common
stock will be at the discretion of our Board of Directors and will depend upon our results of operations,
cash flows, and financial condition and other factors deemed relevant by the Board of Directors.

The number of stockholders of record as of February 22, 2013 was approximately 549, which includes

stockholders whose shares were held in nominee name.

Sales of Unregistered Securities

There  were  no  sales  of  unregistered  securities  during  the  years  ended  December  31,  2012,  2011  or

2010.

Issuer  Purchases of Equity Securities

On  October  29,  2010,  the  Company’s  Board  of  Directors  authorized  the  Company  to  repurchase
shares  of  the  Company’s  common  stock  for  an  aggregate  purchase  price  not  to  exceed  $75.0  million
through December 31, 2012. Shares may be purchased either in the open market or in privately negotiated
transactions.

In addition to the authorization above, on June 3, 2011, the Company’s Board of Directors separately
authorized the Company to repurchase shares of common stock from the proceeds of the 2016  Notes in
connection with that offering.

On October 23, 2012, the Company’s Board of Directors terminated the October 2010 authorization
and authorized the repurchase of up to $75.0 million of its outstanding common stock through December
2014.

There  have  been  no  shares  of  common  stock  repurchased  by  the  Company  under  any  of  these

authorizations in the year ended December 31, 2012.

See Note 6, ‘‘Treasury Stock,’’ in our Consolidated  Financial  Statements for  further details.

30

ITEM 6. SELECTED FINANCIAL DATA

The  information  set  forth  below  should  be  read  in  conjunction  with  ‘‘Item  7.  Management’s
Discussion and Analysis of Financial Condition and Results of Operations’’ and our consolidated financial
statements and related notes included elsewhere in this report. We have acquired numerous businesses and
product  lines  during  the  previous  five  years.  As  a  result  of  these  acquisitions,  the  consolidated  financial
results and balance sheet data for certain of the periods presented below may not be directly comparable.

Operating Results:
Total revenues, net
Costs and expenses(1)

Operating income
Interest income (expense), net(2)(3)
Other income (expense), net

Income before income taxes
Provision for (benefit from) income taxes

Net income

Diluted net income per share
Weighted average common shares

outstanding for diluted net income per
share

Financial Position:
Cash, cash equivalents
Total assets
Long-term borrowings under the

revolving portion of the senior credit
facility(2)

Long-term debt(3)
Retained earnings
Stockholders’ equity

Years Ended December 31,

2012

2011

2010

2009

2008

(In thousands, except per share data)

$ 830,871
757,089

$ 780,078
725,166

$ 732,068
633,374

$682,487
584,663

$ 654,604
607,193

73,782
(21,032)
(721)

52,029
10,825

41,204

1.44

$

$

54,912
(27,175)
757

28,494
505

27,989

0.95

$

$

98,694
(18,131)
1,551

82,114
16,445

97,824
(22,596)
(2,076)

73,152
22,197

$

$

65,669

$ 50,955

2.17

$

1.74

$

$

47,411
(27,971)
(905)

18,535
(9,192)

27,727

0.96

28,516

29,495

30,149

29,292

28,378

Years Ended December 31,

2012

2011

2010

2009

2008

(In thousands)

$
96,938
1,163,599

$ 100,808
1,144,109

$ 128,763
1,017,308

$ 71,891
940,102

$ 183,546
1,026,014

321,875
197,672
302,023
517,775

179,688
352,576
260,819
492,638

— 160,000
148,754
167,161
444,885

294,842
232,830
499,963

160,000
299,480
116,206
372,309

(1) In 2008, we recorded an in-process research and development charge of $25.2 million in connection
with  the  Integra  Spine  (as  hereinafter  defined)  acquisition  and  we  also  recorded  an  $18.0  million
stock-based  compensation  charge  related  to  restricted  stock  units  that  were  vested  on  the  date  of
grant.

In  2011,  we  recorded  a  total  of  $13.3  million  in  stock-based  compensation  charges  related  to  our
former  chief  executive  officer’s  employment  agreement  extension,  accelerated  vesting  of  his
outstanding shares upon the appointment of the new chief executive officer, and his minimum annual
stock-based compensation award which was fully vested on the date  of  grant.

(2) For each of the periods presented we report the borrowings outstanding under the revolving portion
of  our  senior  credit  facility  as  long-term  debt  based  on  our  current  intent  and  ability  to  repay  the
borrowings outside of the following twelve-month periods. At December 31, 2012, we have a total of

31

$321.9  million  outstanding  on  our  senior  credit  facility  and  $278.1  million  available  for  future
borrowings.

(3) In 2007, we issued $165.0 million of 2.75% senior convertible notes due 2010 (the ‘‘2010 Notes’’) and
$165.0 million of 2.375% senior convertible notes due 2012 (the ‘‘2012 Notes’’). The 2010 Notes were
paid  off  in  June  2010  in  accordance  with  their  terms.  The  2012  Notes  were  repaid  in  June  2012  in
accordance with their terms.

In 2011, we issued $230.0 million of 1.625% convertible senior notes due in 2016 (the ‘‘2016 Notes’’).
We expect to satisfy any conversion of the 2016 Notes with cash up to their principal amount pursuant
to  the  net  share  settlement  mechanism  set  forth  in  the  indenture  and,  with  respect  to  any  excess
conversion value, with shares of common stock.

32

ITEM 7. MANAGEMENT’S DISCUSSION AND  ANALYSIS OF FINANCIAL CONDITION AND

RESULTS OF OPERATIONS

The  following  discussion  and  analysis  of  our  financial  condition  and  results  of  operations  should  be
read  together  with  the  selected  consolidated  financial  data  and  our  financial  statements  and  the  related
notes appearing elsewhere in this report. This discussion and analysis contains forward-looking statements
that  involve  risks,  uncertainties  and  assumptions.  Our  actual  results  may  differ  materially  from  those
anticipated  in  these  forward-looking  statements  as  a  result  of  many  factors,  including  but  not  limited  to
those under the heading ‘‘Risk Factors.’’

GENERAL

Integra is a world leader in medical devices focused on limiting uncertainty for surgeons so they can
concentrate  on  providing  the  best  patient  care.  Integra  provides  customers  with  clinically  relevant,
innovative and cost-effective products that improve the quality of life for patients. We focus on cranial and
spinal  procedures,  small  bone  and  joint  injuries,  the  repair  and  reconstruction  of  soft  tissue,  and
instruments for surgery.

We manage our business through a combination of product groups and geography, and accordingly,
we  report  our  financial  results  under  five  reportable  segments  —  U.S.  Instruments,  U.S.  Neurosurgery,
U.S. Extremities, U.S. Spine and Other (which consists of our U.S. Spine, U.S. Orthobiologics and Private
Label businesses) and International.

We  present  revenues  in  the  following  three  product  categories:  Orthopedics,  Neurosurgery  and
Instruments.  Our  orthopedics  products  group  includes  specialty  metal  implants  for  surgery  of  the
extremities,  shoulder  and  spine,  orthobiologics  products  for  repair  and  grafting  of  bone,  dermal
regeneration products and tissue-engineered wound dressings and nerve and tendon repair products. Our
neurosurgery products group includes, among other things, dural grafts that are indicated for the repair of
the  dura  mater,  ultrasonic  surgery  systems  for  tissue  ablation,  cranial  stabilization  and  brain  retraction
systems,  systems  for  measurement  of  various  brain  parameters  and  devices  used  to  gain  access  to  the
cranial  cavity  and  to  drain  excess  cerebrospinal  fluid  from  the  ventricles  of  the  brain.  Our  instruments
products group includes a wide range of specialty and general surgical and dental instruments and surgical
lighting for sale to hospitals, outpatient surgery centers, and physician, veterinarian and dental practices.

We  manufacture  many  of  our  products  in  plants  located  in  the  United  States,  Puerto  Rico,  France,
Germany,  Ireland,  the  United  Kingdom  and  Mexico.  We  also  source  most  of  our  handheld  surgical
instruments and specialty metal and pyrocarbon implants  through specialized third-party vendors.

In  the  United  States,  we  have  several  sales  channels.  We  sell  orthopedics  products  through  a  large
direct sales organization and through specialty distributors focused on their respective surgical specialties.
Neurosurgery products are sold through directly employed sales representatives. Instruments products are
sold through two sales channels, both directly and through distributors and wholesalers, depending on the
customer  call  point.  We  sell  in  the  international  markets  through  a  combination  of  a  direct  sales
organization and distributors.

We also market certain products through strategic partners  in the United States.

Our objective is to become a multi-billion dollar diversified global medical technology company that
helps  patients  by  limiting  uncertainty  for  medical  professionals,  and  is  a  high-quality  investment  for
shareholders. We will achieve these goals by delivering on our Brand Promises to our customers worldwide
and by becoming a top player in all markets in which we compete. Our strategy includes the following key

33

elements: geographic expansion, disciplined focus and execution, global quality assurance and acquiring or
in-licensing products that fit existing sales channels, margin expansion and leveraging platform synergies.

We  aim  to  achieve  growth  in  our  revenues  while  maintaining  strong  financial  results.  While  we  pay
attention to any meaningful trend in our financial results, we pay particular attention to measurements that
are indicative of long-term profitable growth. These measurements include (1) revenue growth (including
internal growth and by acquisitions), (2) gross margins on total revenues, (3) operating margins (which we
aim  to  continually  expand  as  we  leverage  our  existing  infrastructure),  (4)  earnings  before  interest,  taxes,
depreciation, and amortization, and (5) earnings  per  diluted  share of common stock.

We  believe that we are particularly effective in the following aspects of  our business:

(cid:127) Regenerative  Medicine  Platform. We  have  developed  numerous  product  lines  through  our
proprietary collagen matrix and demineralized bone matrix technologies that are sold through every
one of our sales channels.

(cid:127) Diversification  and  Platform  Synergies. Each  of  our  three  selling  platforms  contributes  a  different
strength  to  our  core  business.  Orthopedics  enables  us  to  grow  our  top  line  and  increase  gross
margins.  Neurosurgery  provides  stable  growth  as  a  market  with  few  elective  procedures.  The
Instruments business has a strong capacity to generate cash flows. We have unique synergies among
these  platforms,  such  as  our  regenerative  medicine  technology,  instrument  sourcing  capabilities,
and Group Purchasing Organization (‘‘GPO’’) contract management.

(cid:127) Unique Sales Footprint. Our sales footprint provides us with a unique set of customer call-points and
synergies. Each of our sales channels can benefit from the GPO and Integrated Delivery Network
(‘‘IDN’’) relationships that our Instruments group manages. We have market-leading products for
neurosurgeons, many of whom also perform spine surgeries, and we have yet to fully leverage those
relationships to sell our spine products. We also have clinical expertise across all of our channels in
the  United  States,  and  have  an  opportunity  to  expand  and  leverage  this  expertise  in  markets
worldwide.

(cid:127) Ability to Change and Adapt. Our corporate culture is truly what enables us to adapt and reinvent
ourselves.  We  have  demonstrated  that  we  can  quickly  and  profitably  integrate  new  products  and
businesses. This core strength has made it possible for us to grow over the years, and is key to our
ability  to grow into a multi-billion dollar company.

ACQUISITIONS

Our  strategy  for  growing  our  business  includes  the  acquisition  of  complementary  product  lines  and
companies. Our recent acquisitions of businesses, assets and product lines may make our financial results
for  the  year  ended  December  31,  2012  not  directly  comparable  to  those  of  the  corresponding  prior-year
period. See Note 3, ‘‘Acquisitions and Pro Forma Results’’ to our consolidated financial statements for a
further discussion.

From January 2010 through December 2012, we acquired the following businesses, assets and product

lines:

In September 2011, we acquired Ascension Orthopedics, Inc. (‘‘Ascension’’) for $66.0 million, which
includes  amounts  paid  for  working  capital  adjustments  of  $0.2  million  less  amounts  received  from  our
escrow of $0.7 million. Ascension, based in Austin, Texas, develops and distributes a range of implants for
the shoulder, elbow, wrist, hand, foot and ankle. In particular, Ascension adds a significant number of new
and  differentiated products to our extremities portfolio and access to the shoulder market.

34

In May 2011, we acquired SeaSpine, Inc. (‘‘SeaSpine’’) for approximately $88.7 million, which includes
amounts  paid  for  working  capital  adjustments  of  $0.3  million  and  indemnification  holdbacks  totaling
$7.4 million, all of which was released to the seller prior to December 31, 2012. SeaSpine, based in Vista,
California, offers spinal fusion products to customers across the U.S. and in select markets in Europe. The
addition of the SeaSpine business effectively doubled our distribution footprint and customer base in the
U.S. spine hardware market.

In  September  2010,  we  acquired  certain  assets  as  well  as  the  distribution  rights  for  our  extremity
reconstruction product lines in Australia from Culley Investments Pty. Ltd. (‘‘Culley’’) for approximately
$1.6  million  (1.7  million  Australian  dollars)  in  cash.  For  eight  years,  Culley  had  been  our  distributor  of
these products in Australia. The acquisition provides us with the ability to sell orthopedic products directly
to our Australian customers.

In  May  2010,  we  acquired  certain  assets  and  liabilities  of  the  surgical  headlight  business  of  Welch
Allyn,  Inc.  (‘‘Welch’’)  for  approximately  $2.4  million  in  cash  and  $0.2  million  of  working  capital
adjustments.  The  acquired  assets  have  furthered  our  goal  of  expanding  our  reach  into  the  surgical
headlight market.

FACILITY OPTIMIZATION ACTIVITIES

As  a  result  of  our  ongoing  acquisition  strategy  and  significant  growth  in  recent  years,  we  have
undertaken  cost-saving  initiatives  to  consolidate  manufacturing  and  distribution  facilities  and  transfer
activities, implement a global enterprise resource planning system, eliminate duplicative positions, realign
various sales and marketing activities, and to expand and upgrade production capacity for our regenerative
medicine products.

While we expect a positive impact from ongoing restructuring, integration and manufacturing transfer

and expansion activities, such results remain uncertain.

MANAGEMENT CHANGES

On December 20, 2011, the Company’s Board of Directors approved the following changes that went
into  effect  on  January  3,  2012:  (i)  Peter  Arduini  was  promoted  from  the  role  of  President  and  Chief
Operating Officer to the role of President and Chief Executive Officer (‘‘CEO’’), and was appointed to the
Board  of  Directors,  (ii)  Stuart  Essig  was  appointed  Executive  Chairman  of  the  Board  of  Directors,  and
(iii)  Richard  Caruso,  the  former  Chairman  of  the  Board  of  Directors,  remained  as  a  director  of  the
Company.

On June 7, 2012, Stuart Essig terminated his employment with the Company and ceased to serve as
Executive  Chairman  of  the  Board  of  Directors  and  as  an  officer  or  employee  of  the  Company  and  its
subsidiaries  and  affiliates.  Mr.  Essig  continues  to  serve  as  Chairman  of  the  Board  of  Directors  and  as  a
non-employee member of the Board.

RESULTS OF OPERATIONS

Executive Summary

Net  income  in  2012  was  $41.2  million,  or  $1.44  per  diluted  share,  as  compared  to  $28.0  million,  or

$0.95 per diluted share in 2011 and $65.7  million, or $2.17  per diluted  share in 2010.

Revenues over the past three years increased approximately $50.0 million each year, which generated
approximately $20.0 to $35.0 million of additional gross margin. Costs and expenses increased sequentially

35

as  new  headcount,  especially  in  selling  general  and  administrative,  joined  the  Company  either  through
acquisitions or new hires. Costs and expenses in 2011 included an incremental stock-based compensation
expense of $13.3 million related to our former CEO’s employment agreement and the accelerated vesting
of awards upon appointment of our new CEO. These items result in our operating income declining from
2010 to 2011 and increasing from 2011 to 2012.

Changes  in  income  before  taxes  result  from  the  operating  items  described  above  and  changes  in
interest expense, which increased in 2011 and decreased in 2012 as our 2012 convertible notes matured and
a  portion  of  our  interest  cost  was  capitalized  in  our  construction  in  progress  balance.  See  Note  2
‘‘Summary of Significant Accounting Policies — Out-of-Period Adjustment’’ to our consolidated financial
statements for a further discussion.

Income  tax  expense  declined  sharply  in  2011  and  increase  again  in  2012  in  response  to  significant
changes in U.S. income. These items result in our net income declining from 2010 to 2011 and increasing
from 2011 to 2012.

Special Charges

Income before taxes includes the following special charges:

SPECIAL CHARGES
Plainsboro, New Jersey manufacturing  facility  remediation costs
Global ERP implementation charges
Facility optimization charges
Certain employee termination charges
Discontinued product lines charges
Acquisition-related charges
Impairment charges
European entity restructuring charges
Convertible debt non-cash interest(1)
Certain executive compensation charges
Financing charges

Total

Years Ended December 31,

2012

2011

2010

(In thousands)

$ 7,939
16,384
10,098
1,356
1,368
2,808
141
—
8,520

$ 5,830
17,068
2,956
2,705
3,926
5,253
2,648
378
10,521
— 13,391
790
—

$ —
3,462
1,676
1,498
506
2,509
856
1,329
7,125
2,188
—

$48,614

$65,466

$21,149

(1) The  2012  amount  has  been  reduced  by  $1.6  million,  representing  the  non-cash  interest  that  was
capitalized as a component of the historical cost of assets constructed for the Company’s own use. See
Note 2 ‘‘Summary of Significant Accounting  Policies’’ for more information.

36

The items reported above are reflected in  the consolidated  statements of operations as follows:

Cost of goods sold
Research and development
Selling, general and administrative
Intangible asset amortization
Interest expense

Total

Years Ended December 31,

2012

2011

2010

$16,425
—
23,669
—
8,520

(In thousands)
$13,418
669
37,420
2,648
11,311

$ 3,642
102
9,424
856
7,125

$48,614

$65,466

$21,149

We typically define special charges as items for which the amounts and/or timing of such expenses may
vary  significantly  from  period  to  period,  depending  upon  our  acquisition,  integration  and  restructuring
activities, and for which the amounts are non-cash in nature, or for which the amounts are not expected to
recur  at  the  same  magnitude  as  we  implement  certain  tax  planning  strategies.  We  believe  that  given  our
ongoing strategy of seeking acquisitions, our continuing focus on rationalizing our existing manufacturing
and distribution infrastructure and our continuing review of various product lines in relation to our current
business strategy, some of the special charges discussed above could recur with similar materiality in the
future. In 2010 we began investing significant resources in the global implementation of a single enterprise
resource  planning  system.  We  began  capitalizing  certain  costs  for  the  project  starting  in  2011  and
continued to do so in 2012.

We believe that the separate identification of these special charges provides important supplemental
information  to  investors  regarding  financial  and  business  trends  relating  to  our  financial  condition  and
results of operations. Investors may find this information useful in assessing comparability of our operating
performance  from  period  to  period,  against  the  business  model  objectives  that  management  has
established, and against other companies in our industry. We provide this information to investors so that
they can analyze our operating results in the same way that management does and to use this information
in their assessment of our core business and valuation  of  Integra.

Update on Remediation Activities

Remediation  activities  in  our  regenerative  medicine  facility  in  Plainsboro,  New  Jersey  affected
revenues  and  gross  margin  in  the  year  2012.  We  received  a  warning  letter  from  the  FDA  in  December
2011, related to quality systems and compliance issues at that plant. The letter resulted from an inspection
held at that facility in August 2011, and did not identify any new observations that were not provided in the
Form  483  that  followed  the  inspection.  The  warning  letter  did  not  restrict  our  ability  to  manufacture  or
ship products, nor did it require the recall of any product. In June and July 2012, the FDA again inspected
the regenerative medicine facility. The second inspection closed out on July 30, 2012 and a FDA Form 483
Inspectional Observations was issued. We have been addressing the Form 483 observations, warning letter
citations and communicating with the FDA on a monthly basis. Our efforts with respect to closing out the
warning letter are well along, and we do not expect the FDA to return for another inspection at this facility
until some time in 2013.

Since August 2011, we have undertaken significant efforts to remediate the observations that the FDA
has  made  and  continue  to  do  so,  including  both  capital  investment  for  new  equipment,  leasehold
improvements and incremental spending to improve or revise quality systems. We expensed approximately
$7.9  million  and  $5.8  million  in  the  year  ended  December  31,  2012  and  2011,  respectively.  In  2012,  the
$7.9  million  in  expenses  consisted  of  $3.2  million  of  expenses  associated  with  remediation  of  the
Plainsboro,  New  Jersey  collagen  device  facility  and  $4.7  million  for  unplanned  idle  time  and

37

underutilization.  In  2011,  the  $5.8  million  in  expenses,  consisted  of  $2.1  million  of  expenses  related  to
remediation  and  $3.7  million  for  unplanned  idle  time  and  underutilization.  The  capital  expenditures
directed to the remediation of our regenerative medicine facility were $5.2 million and $2.3 million for the
years ended December 31, 2012 and 2011, respectively. In 2013, we expect to spend between $1.5 million
and  $2.0  million  in  the  Plainsboro  facility  and  have  remediation  activities  completed  by  the  end  of  the
second  quarter.

The  FDA  inspected  our  neurosurgery  manufacturing  facility  in  Andover,  England  in  June  2012.
Subsequently, on November 5, 2012, we received a warning letter from the FDA dated November 1, 2012
related  to  quality  systems  issues  at  the  Andover  manufacturing  facility.  The  warning  letter  identified
violations  related  to  corrective  and  preventative  actions,  process  validations,  internal  quality  audits,  and
internal review of the suitability and effectiveness of the quality system at defined intervals. We filed the
FDA  warning  letter  as  an  exhibit  to  a  Current  Report  on  Form  8-K  on  November  13,  2012.  Since  the
conclusion  of  the  FDA  inspection  in  June  2012,  we  have  undertaken  significant  efforts  to  remediate  the
observations that the FDA has made and continue to do so. We are providing the FDA with monthly status
reports and working cooperatively with  the FDA to resolve any outstanding issues.

On February 14, 2013, we received a warning letter from the FDA relating to quality systems issues at
our  manufacturing  facility  located  in  Anasco,  Puerto  Rico.  The  letter  resulted  from  an  inspection
conducted  at  that  facility  during  October  and  November  2012.  On  February  15,  2013  we  stopped
distribution of our collagen products manufactured in the Anasco facility in order to confirm that we had
successfully  validated  all  such  products  and  engaged  a  third-party  consultant  having  appropriate  quality
system regulations expertise to confirm such validations. On February 22, 2013 the third-party consultant
certified the completeness of such validations and we resumed distribution of collagen products from the
Anasco facility. We continue to assess and address warning letter citations and will provide our response to
the FDA by March 8, 2013 after which we will provide periodic status reports and work cooperatively with
the FDA to resolve any outstanding issues.

Revenues and Gross Margin

Our revenues and gross margin on product revenues were as follows:

Orthopedics
Neurosurgery
Instruments

Total revenues
Cost of goods sold

Gross margin on total revenues

Years Ended December 31,

2012

2011

2010

$369,312
277,527
184,032

830,871
314,427

(In thousands)
$328,933
272,538
178,607

780,078
299,150

$290,274
263,147
178,647

732,068
268,188

$516,444

$480,928

$463,880

Gross margin as a percentage of total revenues

62.2%

61.7%

63.4%

38

Revenues by Reportable Segment

Net sales by reportable segment for the three years ended December 31, 2012, 2011 and 2010 are as

follows:

U.S. Neurosurgery
U.S. Instruments
U.S. Extremities
U.S. Spine and Other
International*

Total revenues

Years Ended December 31,

2012

2011

2010

$171,278
162,323
122,847
190,546
183,877

(In thousands)
$165,652
155,833
98,109
174,479
186,005

$165,606
157,853
89,529
152,274
166,806

$830,871

$780,078

$732,068

*

The Company attributes revenue to geographic areas based on the location of the customer. There are
certain  revenues  managed  by  the  various  U.S.  segments  above  that  are  generated  from  non-U.S.
customers and therefore included in  Europe and the  Rest of World revenues.

Revenues

Year Ended December 31, 2012 Compared with  Year Ended December 31, 2011.

For  the  year  ended  December  31,  2012,  total  revenues  increased  by  $50.8  million  or  7%,  to
$830.9  million  from  $780.1  million  during  the  prior  year.  Domestic  revenues  increased  by  9%  to
$642.8  million  and  were  77%  of  total  revenues  for  the  year  ended  December  31,  2012.  International
revenues were essentially flat at $188.1 million as compared to 2011. Foreign exchange fluctuations, arising
primarily  from  a  weaker  euro  throughout  the  year  compared  to  the  U.S.  dollar,  accounted  for  a
$6.8 million decrease in revenues for the year ended December 31, 2012. On a constant currency basis, our
overall revenues increased 7% compared  to 2011.

U.S. Neurosurgery revenues were $171.3 million, an increase of 3% from the prior year. The increase
resulted from stronger sales of our market-leading duraplasty products and cranial stabilization products
and strength in our critical care.

U.S. Instruments revenues were $162.3 million, an increase of 4% from the prior year. We continued
to  experience  strong  sales  within  instruments,  largely  driven  by  strength  in  our  acute  care  sales  channel,
and continued growth of our LED surgical headlamp product, which was launched in late 2011, and sales
to our alternate site customers.

U.S. Extremities revenues were $122.8 million, an increase of 25% from the prior year. This growth
resulted primarily from significant increases in sales of our dermal and wound care products. Sales of our
metal  implants  also  increased  more  than  30%,  especially  products  for  the  foot  and  ankle  and  hand  and
wrist, in  part because of the acquisition  of Ascension Orthopedics in September  2011.

U.S.  Spine  and  Other  revenues,  which  include  our  Spine  hardware,  orthobiologics  and  private  label
products, were $190.5 million, an increase of 9% from the prior year. We continued double digit growth in
our orthobiologics business, led by a strong demand for our EVO3 and Integra Mozaik products. Our sales
team has been focusing on signing up new distributors, essential to our incremental growth, and as a result
we have seen some increases in sales. Our Spine hardware products also experienced double-digit growth

39

over  last  year  despite  continuing  price  erosion  because  of  increasing  competition,  in  part  because  of  the
acquisition of SeaSpine in May 2011.

International segment revenues were $183.9 million, down 1% from the prior year. Foreign currency
fluctuations,  arising  primarily  from  a  weaker  euro  throughout  the  year,  compared  to  the  U.S.  dollar  in
2011,  accounted  for  a  $6.8  million  decrease  in  the  revenue  for  the  year  ended  December  31,  2012.  Our
sales in Europe declined 6%, but on a constant currency basis sales would have been in line with prior year.
We saw decreases in capital spending as European hospitals continued to control costs and manage their
budgets.  Our  Rest  of  World  markets  posted  a  5%  increase.  The  Neurosurgery  and  Extremities  product
categories  posted  the  strongest  performances  from  a  product  standpoint.  We  continue  to  expand  our
growth in China as we transition to a new distribution network.

With  our  global  reach,  we  generate  revenues  in  multiple  foreign  currencies,  including  euros,  British
pounds,  Swiss  francs,  Canadian  dollars,  Japanese  yen  and  Australian  dollars.  Accordingly,  we  will
experience currency exchange risk with respect to those foreign currency denominated revenues.

Year Ended December 31, 2011 Compared with  Year Ended December 31, 2010.

For  the  year  ended  December  31,  2011,  total  revenues  increased  by  $48.0  million  or  7%,  to
$780.1  million  from  $732.1  million  during  the  prior  year.  Domestic  revenues  increased  by  5%  to
$590.0  million  and  were  76%  of  total  revenues  for  the  year  ended  December  31,  2011.  International
revenues  increased  $19.4  million  to  $190.1  million,  an  increase  of  11%  compared  to  2010.  Foreign
exchange fluctuations, arising primarily from a stronger euro during the second and third quarters of 2011
and a stronger Australian dollar throughout the year compared to the U.S. dollar than in 2010, accounted
for a net $7.9 million increase in revenues for the year ended December 31, 2011. On a constant currency
basis, our overall revenues increased 6% compared  to  2010.

U.S.  Neurosurgery  revenues  were  $165.7  million,  in  line  with  the  prior  year.  We  experienced  strong
sales of neuromonitoring devices used in the critical care setting and duraplasty products. During 2010, we
had  higher  than  normal  sales  levels  in  neurosurgery,  especially  with  our  tissue  ablation  products  as  the
rebound  from  the  early  stages  of  the  global  economic  slowdown  in  2009  was  realized.  The  strong
comparable from 2010 muted some of the 2011  increases in revenues.

U.S. Instruments revenues were $155.8 million, a slight decrease from the prior year. Our sales growth
in surgical lighting was offset by weakness in sales of both hospital and alternate site instruments. In the
alternate site channel, our largest distributors purchased fewer instruments in the fourth quarter in order
to reduce their inventories at the end of the year. That said, our distributors were selling our instruments
to  their  final  customers  at  consistent  levels,  and  as  a  result,  we  believed  that  we  were  not  losing  market
share.  Normal  buying  patterns  returned  in  the  second  half  of  2012  once  our  distributors  attained  their
desired inventory levels. On the acute care side, new ambulatory surgery centers and hospital starts during
2011 had a smaller impact when compared to 2010.

U.S. Extremities revenues were $98.1 million, an increase of 10% from the prior year. The impact of
our  acquisition  of  Ascension  drove  most  of  this  increase  in  revenue.  Sales  of  engineered  regenerative
medicine products for skin and wound repair also increased over the full year 2010. Remediation work in
our Plainsboro, New Jersey facility resulted in shortages of our regenerative medicine products because the
part of the plant that manufactures these products was out of production in December of 2011.

U.S.  Spine  and  Other  revenues,  which  include  our  Spine  hardware,  orthobiologics  and  private  label
products,  were  $174.5  million,  an  increase  of  15%  from  the  prior  year.  Most  of  the  increase  came  from
sales of spinal implants from our SeaSpine acquisition. We also experienced a significant increase in our
orthobiologics  business.  The  overall  spine  market  began  experiencing  reductions  in  both  the  average

40

selling price of products, and procedure volumes. Finally, we saw a decrease in our private-label product
revenue as the sales volume of the underlying products by our strategic partners declined. This decline also
resulted in decreased royalty revenues.

International segment revenues were $186.0 million, up 12% from the prior year. European sales grew
approximately 9% in 2011 compared to the prior year resulting primarily from changes in foreign exchange
rates,  which  had  an  impact  on  our  neurosurgery  and  orthopedics  products,  and  to  a  lesser  extent,
instruments. Sales to customers in the Rest of the World region increased approximately 14% for the year
ended  December  31,  2011  and  we  experienced  this  increase  in  all  product  lines  across  all  other  foreign
geographies.

Gross  Margin

Gross margin as a percentage of revenues was 62.2% in 2012, 61.7% in 2011, and 63.4% in 2010. Cost
of  product  revenues  in  2012,  2011,  and  2010  included  $2.8  million,  $3.3  million,  and  $1.8  million,
respectively,  in  fair  value  inventory  purchase  accounting  adjustments  recorded  in  connection  with
acquisitions, and $6.6 million, $8.2 million, and $5.9 million, respectively, of amortization for technology-
based intangible assets inclusive of impairments.

The increase in gross margin percentage from 2011 to 2012 resulted primarily from favorable product
mix  and  lower  amortization  expense  offset  by  increased  spending  on  quality  processes  and  remediation
costs.

The decrease in gross margin percentage from 2010 to 2011 resulted primarily from higher write-offs
and  reserves  for  excess  and  obsolete  inventory  in  our  orthopedics  products,  fair-value  inventory
adjustments  on  our  SeaSpine  and  Ascension  acquisitions,  and  higher  costs  of  manufacturing  than  in  the
prior-year period.

We  expect  our  consolidated  gross  margin  percentage  for  the  full  year  2013  to  stay  around  63%.  We
expect  to  complete  the  remediation  work  at  our  Plainsboro,  New  Jersey  regenerative  medicine
manufacturing  facility  at  the  end  of  the  second  quarter  of  2013.  Additionally,  our  gross  margin  will  be
impacted  by  the  amount  of  Medical  Device  tax  capitalized  into  inventory  and  recorded  in  cost  of  goods
sold as these products are sold to third  party customers.

The Health Care and Education Reconciliation Act of 2010 imposed a tax equal to 2.3% on the sales
price of any taxable medical device by a medical device manufacturer, producer or importer of such device.
Beginning in 2013, the Company expects to pay a tax deductible manufacturer’s excise tax imposed on the
first sale of certain medical devices in the United States. The Company expects to capitalize the excise tax
in its inventory and subsequently record it in cost of goods sold as these products are sold to third party
customers.

Other Operating Expenses

The following is a summary of other operating  expenses as  a percent of total  revenues:

Research and development
Selling, general and administrative
Intangible asset amortization

41

Years Ended December 31,

2012

2011

2010

6.1% 6.6% 6.6%
44.9% 45.9% 41.7%
2.2% 2.1% 1.6%

Total  operating  expenses,  which  consist  of  research  and  development  expenses,  selling,  general  and
administrative  expenses  and  intangible  asset  amortization  expense,  increased  $16.6  million  or  4%  to
$442.7 million in 2012, compared to $426.0  million in  the same period last  year.

RESEARCH  AND  DEVELOPMENT. Research  and  development  expenses  decreased  slightly  to
$51.0  million  in  2012,  compared  to  $51.5  million  in  2011  and  increased  from  $48.1  million  in  2010.  The
decrease  in  research  and  development  cost  from  2012  to  2011  was  mostly  driven  by  a  reduction  in
headcount.  The  increase  in  research  and  development  from  2010  to  2011  resulted  primarily  from  our
SeaSpine  and  Ascension  acquisitions,  and  to  a  lesser  extent,  headcount  increases  to  focus  on  projects  in
our  neurosurgery and extremity reconstruction  product lines.

We target full-year 2013 spending on research and development to be between 6.5% and 7% of total

revenues.

SELLING, GENERAL AND ADMINISTRATIVE. Selling, general and administrative expenses in the
year  ended  December  31,  2012  increased  by  $15.0  million  or  4.2%  to  $373.1  million  compared  to
$358.1  million  in  the  same  period  last  year.  Selling  and  marketing  expenses  increased  by  $24.3  million,
primarily  resulting  from  a  higher  proportion  of  sales  through  distributors,  which  generally  have  a  higher
cost than the direct selling model. Additionally, bonuses and commission costs were higher as a result of
increases  in  revenue  and  headcount.  We  also  added  significantly  to  our  planning  and  customer  services
departments.  Furthermore,  we  incurred  $1.1  million  of  expenses  in  the  second  quarter  to  terminate  an
exclusive product distribution agreement with a former distributor in China, which included the transfer of
certain  product  registration  rights  back  to  us.  General  and  administrative  costs  were  down  $9.3  million,
primarily because of prior year incremental charges of $13.3 million of stock based-compensation related
to the executive changes as noted below and $1.7 million of acquisition related costs that did not repeat in
the  current  period.  These  decreases  were  offset  by  increases  in  our  spending  on  the  global  enterprise
resource  planning  system,  accrued  non-selling  bonuses,  consulting  and  other  costs  related  to  various
strategic projects and the addition of our SeaSpine  and Ascension  operations.

Selling,  general  and  administrative  expenses  in  the  year  ended  December  31,  2011  increased  by
$53.0 million or 17.4% to $358.1 million compared to $305.1 million in the same period last year. Selling
expenses  increased  by  $20.5  million  primarily  because  of  an  increase  in  revenues  and  the  corresponding
commission  costs,  as  well  as  the  impact  of  our  SeaSpine  and  Ascension  acquisitions.  General  and
administrative costs increased $32.6 million because of charges related to the implementation of our global
enterprise  resource  planning  system  of  $17.1  million,  incremental  stock-based  compensation  charges  of
$13.3  million  related  to  the  renewal  of  our  former  Chief  Executive  Officer’s  employment  agreement  in
May  2011,  the  accelerated  vesting  of  awards  upon  the  appointment  of  a  new  chief  executive  officer  in
December 2011 and the minimum annual equity award for 2011 for our former Chief Executive Officer,
acquisition-related costs of $1.7 million, severance costs, and to a lesser extent, increases in compensation
costs brought on by increased headcount.

For  2013,  we  expect  general  and  administrative  expenses  to  be  flat  compared  to  2012;  however,  we
expect to grow the sales team, resulting in similar overall costs as a percentage of revenue. We also expect
to  incur  significant  costs  related  to  upgrading  our  enterprise  resource  planning  system,  which  will  be
characterized as special charges. We expect our reported selling, general, and administrative expenses to be
between 44 and 46 percent of revenue  in 2013.

INTANGIBLE ASSET AMORTIZATION. Amortization expense (excluding amounts reported in cost
of  product  revenues  for  technology-based  intangible  assets)  in  the  year  ended  December  31,  2012  was
$18.5 million compared to $16.4 million last year. The increase primarily resulted from amortization of the
significant  intangible  assets  added  as  part  of  our  Ascension  acquisition  that  occurred  during  the  third
quarter of 2011.

42

In  2011,  amortization  expense  (excluding  amounts  reported  in  cost  of  product  revenues  for
technology-based intangible assets) increased by $4.4 million to $16.4 million compared to $12.0 million in
2010. The increase primarily resulted from accelerated amortization of $1.5 million for several trade names
that were phased out through the end of 2012 as part of our rebranding strategy, the impairment of trade
names totaling $1.1 million, and incremental amortization on intangible assets acquired through business
combinations that occurred in 2011.

We  may  discontinue  certain  products  in  the  future  as  we  continue  to  assess  the  profitability  of  our
product  lines.  As  our  profitability  assessment  evolves,  we  may  make  further  decisions  about  our  trade
names  and  incur  additional  impairment  charges  or  accelerated  amortization.  We  expect  total  annual
amortization  expense  (including  amounts  reported  in  cost  of  product  revenues)  to  be  approximately
$19.0 million in 2013, $18.1 million in 2014, $16.3 million in 2015, $14.0 million in 2016 and $12.1 million in
2017.

Non-Operating Income and Expenses

The following is a summary of non-operating  income  and expenses:

Interest income
Interest expense
Other income (expense)

Total non-operating income and expense

Interest Income and Interest Expense

Years Ended December 31,

2012

2011

2010

(In thousands)

$ 1,205
(22,237)
(721)

465
$
(27,640)
757

225
$
(18,356)
1,551

$(21,753) $(26,418) $(16,580)

We  recorded  interest  income  on  our  invested  cash  of  $1.2  million,  $0.5  million  and  $0.2  million  in
2012,  2011  and  2010,  respectively.  The  increase  in  interest  income  is  primarily  a  result  of  short-term
investments in time deposit accounts  held  outside the United States during the year.

Interest  expense  was  $22.2  million,  $27.6  million  and  $18.4  million  in  2012,  2011  and  2010,
respectively.  In  the  fourth  quarter  of  2012  interest  expense  has  been  reduced  by  $3.9  million;  of  that
$3.3  million  represents  the  cumulative  correction  of  immaterial  errors  in  capitalized  interest  on  our
construction  in  progress  balance.  See  Note  2 
‘‘Summary  of  Significant  Accounting  Policies  —
Out-of-Period  Adjustment’’  to  our  consolidated  financial  statements  for  a  further  discussion.  The
$3.3 million correction reflects $1.5 million, $1.4 million and $0.4 million of interest expense that should
have been capitalized in the first three quarters of 2012 and the year ended December 31, 2011 and 2010,
respectively.  Based  upon  our  evaluation  of  relevant  factors  related  to  this  matter,  we  concluded  that  the
uncorrected adjustments in our previously issued consolidated financial statements for any of the periods
affected are immaterial and that the impact of recording the cumulative correction in the fourth quarter of
2012 is not material to our earnings  for the full  year  ending December  31, 2012.

Our reported interest expense for the years ended December 31, 2012, 2011 and 2010 includes non-
cash  interest  related  to  the  accounting  for  convertible  securities  of  $8.5  million,  $10.6  million  and
$7.6  million,  respectively.  The  expense  was  primarily  associated  with  the  principal  amount  of  the
outstanding  2016  Notes,  2012  Notes  and  2010  Notes  and  interest  and  fees  related  to  our  $600.0  million
senior secured credit facility. In the fourth quarter of 2012, we capitalized a total of $1.6 million of non-
cash interest, and included it in the historical cost of assets constructed for the Company’s own use. The

43

total  interest  capitalized  consisted  of  $0.9  million,  $0.6  million  and  $0.1  million  of  the  non-cash  interest
expenses from the years ended December 31, 2012, 2011 and 2010, respectively.

Interest expense in the year ended December 31, 2012 decreased by $5.4 million primarily as a result
of the June repayment of our 2012 Notes and capitalizing a portion of our interest cost relating to certain
assets constructed for our internal use.

Interest expense increased for the year ended December 31, 2011 compared to the same period last
year primarily because of increased average borrowings under our Senior Credit Facility during the period
and  interest  related  to  our  2016  Notes  issued  in  June  2011.  Although  overall  borrowings  increased,  we
refinanced our Senior Credit Facility in June 2011 and as a result, the applicable rates used for borrowings
decreased by 75 basis points, which was accompanied by a decrease in the annual commitment fee by an
average 13.8 basis points. Furthermore, the coupon interest rate on the 2016 Notes is 75 basis points lower
than the 2012 Notes. Finally, the impact of our interest rate swap resulted in additional interest expense of
$2.3 million during the period.

Our  reported  interest  expense  for  the  years  ended  December  31,  2012,  2011  and  2010  included
$2.7  million,  $3.4  million  and  $1.6  million,  respectively,  of  non-cash  amortization  of  debt  issuance  costs.
The 2011 amount includes approximately $0.8 million of fees expensed in connection with our refinancing
in June  2011.

Other  Income (Expense)

In 2012, net other expense of $0.7 million  consisted predominantly  of foreign exchange losses.

In  2011,  net  other  income  of  $0.8  million  consisted  of  research  and  development  reimbursements
from third-party partners and foreign governments, partially offset by foreign exchange losses. In 2010, net
other  income  was  $1.6  million  consisting  primarily  of  foreign  exchange  gains  of  $1.1  million,  and  other
gains of $0.5 million.

Income Taxes

Our  effective  income  tax  rate  was  20.8%,  1.8%  and  20.0%  of  income  before  income  taxes  in  2012,
2011 and 2010, respectively. See Note 10, ‘‘Income Taxes,’’ in our consolidated financial statements for a
reconciliation of the United States Federal statutory rate  to our  effective tax rate.

In  2012,  our  full-year  worldwide  income  increased  significantly,  primarily  due  to  the  increase  of
earnings generated in the United States. The shift in the mix of earnings caused a significant increase in
our worldwide effective tax rate. This increase was partially offset by a reversal of $2.6 million of accruals,
which  includes interest for uncertain  tax  positions.

In 2011, we recorded a reversal of $2.5 million of accruals, which included interest, for uncertain tax
positions due to matters that were considered effectively settled. We recorded additional tax expenses of
$1.7  million  for  a  correction  to  a  state  deferred  tax  asset  relating  to  2009  and  recorded  a  tax  benefit  of
$2.2 million relating to the correction of various deferred tax items for periods prior to 2011 that largely
impacted  foreign  operations.  These  amounts  were  not  material  to  the  current  or  prior  periods  and  were
therefore recorded in 2011.

In  2010,  we  recorded  a  tax  benefit  of  $4.5  million  related  to  the  settlement  of  several  uncertain  tax
positions and a benefit related to the passing of the Tax Relief, Unemployment Insurance Reauthorization
and Job Creation Act of 2010 (the ‘‘TRUJ Act’’). Since the TRUJ Act was passed during the fourth quarter
of 2010, we recorded the tax impact for  the entire  year  at  that time.

44

Our effective tax rate could vary from year to year depending on, among other factors, the geographic
and  business  mix  and  taxable  earnings  and  losses.  We  consider  these  factors  and  other,  including  our
history of generating taxable earnings, in assessing our ability to realize deferred tax assets. We expect our
effective income tax rate for 2013 to be 17%, inclusive of the reinstated research and development credit.

The American Taxpayer Relief Act of 2012 was signed into law by the President of the United States
on January 2, 2013. In part, the bill approved a retroactive extension of certain business tax provisions that
expired  at  the  end  of  2011  and  2012.  These  extensions,  which  included  the  research  and  development
credit,  are  taken  into  account  for  financial  reporting  purposes  in  the  quarter  in  which  the  legislation  is
enacted  by  Congress  and  signed  into  law  by  the  President.  Accordingly,  the  Company  will  recognize
approximately  $0.9  million  of  income  tax  benefit  associated  with  the  2012  research  and  development  tax
credit in its 2013 financial statements.

We have recorded a valuation allowance of $14.2 million against the remaining $110.5 million of gross
deferred tax assets recorded at December 31, 2012. This valuation allowance relates to deferred tax assets
for which the Company does not believe it has satisfied the more likely than not threshold for realization.
We do not anticipate additional income tax benefits through future reductions in the valuation allowance.
However, if we determine that we would be able to realize more or less than the recorded amount of net
deferred tax assets, we will record an adjustment to the deferred tax asset valuation allowance in the period
such a determination is made. Our deferred tax asset valuation allowance decreased $18.1 million in 2012
and $4.3 million in 2011, and increased  $0.5 million in  2010.

At December 31, 2012 we had net operating loss carryforwards of $58.4 million for federal income tax
purposes, $57.1 million for foreign income tax purposes and $56.9 million for state income tax purposes to
offset  future  taxable  income.  The  federal  net  operating  loss  carryforwards  expire  through  2029,
$42.8  million  of  the  foreign  net  operating  loss  carryforwards  expire  through  2021  with  the  remaining
$14.3 million having an indefinite carry forward period. The state net operating loss carryforwards expire
through 2031.

Income taxes are not provided on certain undistributed earnings of non-U.S. subsidiaries because such
earnings  are  expected  to  be  permanently  reinvested.  Undistributed  earnings  of  such  foreign  subsidiaries
totaled  $165.3  million,  $168.8  million  and  $142.2  million  at  December  31,  2012,  2011  and  2010,
respectively.

GEOGRAPHIC PRODUCT REVENUES  AND  OPERATIONS

We attribute revenues to geographic areas based on the location of the customer. There are certain
revenues  that  the  various  U.S.  segments  manage  that  are  generated  from  non-U.S.  customers  and
therefore included in Europe and the Rest of World revenues below — these revenues are not significant.
Total revenue by major geographic area consisted of the following:

United States
Europe
Rest of World

Total Revenues

Years Ended December 31,

2012

2011

2010

$642,830
90,920
97,121

(In thousands)
$589,946
97,184
92,948

$561,307
89,044
81,717

$830,871

$780,078

$732,068

In  2012  sales  to  our  U.S.  customers  increased  approximately  9.0%  compared  to  the  prior  year,
resulting from a full-year impact of the SeaSpine and Ascension acquisitions, with steady increases in all of

45

our U.S. segments sales. Over the past few years, the austerity measures of certain European governments,
which  have  reduced  expenditures  on  healthcare,  have  negatively  affected  revenues  from  our  European
customers.  We  saw  decreases  in  capital  spending  as  European  hospitals  have  been  reducing  spending.
While  the  economic  downturn  has  not  significantly  affected  our  ability  to  collect  receivables,  the  macro-
economic  conditions  and  liquidity  issues  in  certain  countries  continue  to  hamper  our  sales  volumes.
European  sales  declined  approximately  6%  in  2012  compared  to  the  prior  year  resulting  primarily  from
changes  in  foreign  exchange  rates,  which  had  an  impact  on  our  neurosurgery  and  orthopedics  products,
and  to  a  lesser  extent,  instruments.  Sales  to  customers  in  the  Rest  of  the  World  region  increased
approximately 5% for the year ended December 31, 2012. We experienced this increase in all product lines
across all Rest of the World geographies.

In  2011,  sales  to  U.S.  customers  increased  approximately  5%  compared  to  the  prior  year,  primarily
resulting from the incremental impact of the SeaSpine and Ascension acquisitions, with neurosurgery sales
increasing  and  instrument  sales  decreasing.  The  effects  of  European  austerity  measures  had  a  negative
impact  on  our  sales  during  that  period.  That  said,  European  sales  grew  approximately  9%  in  2011
compared to the prior year resulting primarily from changes in foreign exchange rates. Sales to customers
in the Rest of the World region increased approximately 14% for the year ended December 31, 2011 and
we experienced this increase in all product lines across all  other  foreign geographies.

With  our  global  reach,  we  generate  revenues  and  incur  operating  expenses  in  multiple  foreign
currencies,  including  euros,  British  pounds,  Swiss  francs,  Canadian  dollars,  Japanese  yen  and  Australian
dollars.  Accordingly,  we  will  experience  currency  exchange  risk  with  respect  to  those  foreign  currency
denominated revenues and operating expenses. The Company generated revenues denominated in foreign
currencies of $133.3 million, $142.4 million and $125.8 million during the years ended December 31, 2012,
2011 and 2010, respectively.

We will continue to assess the potential effects that changes in foreign currency exchange rates could
have  on  our  business.  However,  either  a  strengthening  or  a  weakening  of  the  dollar  against  individual
foreign  currencies  could  reduce  future  revenues  and  gross  margins.  If  we  believe  this  potential  impact
presents  a  significant  risk  to  our  business,  we  may  enter  into  derivative  financial  instruments  to  mitigate
this  risk.

Additionally, we generate significant revenues outside the United States, a portion of which are U.S.
dollar-denominated transactions conducted with customers who generate revenue in currencies other than
the U.S. dollar. As a result, currency fluctuations between the U.S. dollar and the currencies in which those
customers do business may have an impact on the demand for  our products in foreign  countries.

Local economic conditions, regulatory, legal or political considerations, the effectiveness of our sales
representatives and distributors, local competition and changes in local medical practice all could combine
to affect our sales  into markets outside the United  States.

Relationships with customers and effective terms of sale frequently vary by country, often with longer-

term receivables than are typical in the  United  States.

Economic  conditions  in  certain  European  countries,  especially  Greece,  Ireland,  Italy,  Portugal  and
Spain,  remained  challenging  through  2012.  Accounts  receivable  from  customers  in  these  countries
represented approximately $4.3 million of our total accounts receivable balance of which $0.4 million was
reserved  at  December  31,  2012.  At  December  31,  2011,  the  accounts  receivable  from  customers  in  these
countries  was  $5.8  million  of  which  $0.8  million  was  reserved.  We  continually  evaluate  receivables  for
potential  collection  risks  associated  with  our  customers.  If  the  financial  condition  of  customers  or  their
respective  countries’  healthcare  systems  continue  to  deteriorate  it  may  negatively  impact  our  results  in
future periods.

46

LIQUIDITY AND CAPITAL RESOURCES

Cash and Marketable Securities

We  had  cash  and  cash  equivalents  totaling  approximately  $96.9  million  and  $100.8  million  at

December 31, 2012 and December 31, 2011, respectively.

We determined that our existing cash, future cash to be generated from operations, and our remaining
$278.1  million  of  borrowing  capacity  under  our  senior  secured  revolving  credit  facility,  if  needed,  will
satisfy our foreseeable working capital, debt repayment and capital expenditure requirements for at least
the next twelve months.

In 2013, we anticipate that our principal uses of cash will include payments of the new Medical Device
Tax in a range of $9 - $12 million. We also plan to spend between $55.0 million and $65.0 million on capital
expenditures  primarily  for  our  continued  expansion  of  regenerative  medicine  manufacturing  capacity,
support maintenance in our existing plants, our enterprise resource planning system implementation, and
additions to our instrument kits used  in  sales of orthopedic products.

During  the  quarter  ended  December  31  2012,  we  repatriated  approximately  $31.7  million  from  our
foreign  subsidiaries.  The  decision  to  repatriate  the  $31.7  million  was  made  in  the  fourth  quarter  upon
finalization  of  a  plan  which  indicated  that  the  earnings  could  be  brought  back  to  the  United  States  with
minimal  tax  impact.  The  repatriation  does  not  impact  the  Company’s  assertion  that  our  earnings  from
foreign  operations  have  been  and  will  continue  to  be  indefinitely  reinvested  in  those  operations.  The
Company  considers  these  amounts  to  be  indefinitely  reinvested  to  finance  international  growth  and
expansion.

At December 31, 2012, our non-U.S. subsidiaries held approximately $84.3 million of cash and cash
equivalents that are available for use by all of our operations around the world. However, if these funds
were  repatriated  to  the  United  States  or  used  for  United  States  operations,  certain  amounts  could  be
subject to United States tax for the incremental amount in excess of the foreign tax paid.

Cash Flows

Net cash provided by operating activities
Net cash used in investing activities
Net cash provided by (used in) financing  activities
Effect of exchange rate fluctuations on cash

Net increase (decrease) in cash and cash equivalents

Year Ended December 31,

2012

2011

(In thousands)

$ 58,715
(79,276)
12,135
4,556

$ 104,328
(190,376)
60,137
(2,044)

$ (3,870) $ (27,955)

In  the  second  quarter  of  2012,  we  borrowed  $155  million  from  our  senior  credit  facility  to  fund  the
June repayment of our 2012 Notes of $165 million, of which we classified $134 million as a financing use of
cash  for  the  repayment  of  the  debt  component,  and  $31  million  as  an  operating  use  of  cash  for  the
repayment of accreted interest.

In  the  fourth  quarter,  we  used  $29.8  million  of  cash  to  pay  withheld  federal  and  state  taxes  in
connection with the release to Stuart Essig, our former Chief Executive Officer and current Chairman of
the Board, of approximately 1.67 million deferred stock units (‘‘SUs’’) as a result of his ceasing to be an
employee  of  the  Company.  This  payment  was  classified  as  an  operating  use  of  cash.  We  retained

47

approximately 745,000 shares equal in value to the required withholding taxes, which were approximately
44% of the then aggregate fair market value of the SUs. We will be able to deduct the total amount of such
deferred compensation from our Federal and state corporation taxes, but will not receive the cash benefits
of such deductions in the same period. The payment of the SUs in the current year generated net operating
losses  which  will  be  utilized  as  deductions  against  federal  and  state  corporate  income  taxes  on  our  2012
U.S. Corporation income tax return.

Cash Flows Provided by Operating Activities

We generated operating cash flows of $58.7 million, $104.3 million and $105.6 million for years ended

December 31, 2012, 2011 and 2010, respectively.

Operating cash flows were lower than the same period in 2011 largely because of the repayment of our
convertible 2012 Notes of $165.0 million, of which $31.0 million were classified as an operating use of cash
for the repayment of accreted interest. Cash from operations was also negatively impacted by a one-time
tax withholding payment of $29.8 million related to our former CEO’s deferred equity compensation. Net
income for the year ended December 31, 2012, plus items included in those earnings that did not result in a
change  to  our  cash  balance,  amounted  to  approximately  $82.7  million.  Changes  in  working  capital
decreased  cash  flows  by  approximately  $22.1  million.  Among  the  changes  in  working  capital,  accounts
receivable provided $3.8 million of cash, inventory used $0.7 million of cash, prepaid expenses and other
current  assets  used  $3.1  million  of  cash,  and  accounts  payable,  accrued  expenses  and  other  current
liabilities  used  $21.1  million  of  cash,  where  the  $29.8  million  cash  paid  for  federal  and  state  taxes  was
presented.

Net income for the year ended December 31, 2011, plus items included in those earnings that did not
result  in  a  change  to  our  cash  balance,  amounted  to  $119.4  million.  In  2011,  the  impact  of  net  working
capital items on operating cash flows excluding the impact of acquisitions was a decrease of $12.3 million.
Increases in accounts receivable used $1.9 million of cash, increases in prepaid expenses and other current
assets  used  $0.4  million  of  cash,  which  includes  a  tax  refund  of  $10.0  million,  and  decreases  in  accounts
payable, accrued expenses, and other current liabilities used $11.8 million of cash. Decreases in inventory
provided $1.7 million of cash.

Net income for the year ended December 31, 2010, plus items included in those earnings that did not
result  in  a  change  to  our  cash  balance,  amounted  to  approximately  $131.2  million.  Additionally,  we  paid
$6.6 million in accreted interest related to the repurchase of our 2010 Notes at their maturity. In 2010, the
net impact of working capital items on operating cash flows was a decrease of $11.3 million. Increases in
both accounts receivable and inventory  resulted in a  use of cash; however, those increases  resulted from
higher  overall  sales,  and  accounts  receivable  was  lower  as  a  percentage  of  sales  compared  to  2009.
Additionally,  increases  in  our  prepaid  expenses  and  other  current  assets  used  $6.5  million  of  cash.
Increases  in  accounts  payable  and  accrued  expenses  primarily  offset  these  uses  of  cash.  The  change  in
other liabilities resulted in part from $4.5 million in reversals of income tax reserves for audits that were
concluded during the year.

Cash Flows Used in Investing Activities

During  the  year  ended  December  31,  2012,  we  paid  $69.0  million  in  cash  for  capital  expenditures,
most  of  which  was  directed  to  the  expansion  and  remediation  of  our  regenerative  medicine  production
capacity and implementation of a global enterprise resource planning system. We released $7.4 million of
our indemnification holdback to the sellers of SeaSpine, Inc. We also experienced net unfavorable impact
in short-term time deposit accounts representing the  impact of changes in  foreign exchange  rates.

48

During  the  year  ended  December  31,  2011,  we  paid  $152.0  million  (net  of  $0.8  million  of  cash
acquired)  related  to  our  acquisitions  of  Ascension  Orthopedics,  Inc.  and  SeaSpine,  Inc.  and  invested
$38.4  million  in  capital  expenditures  related  primarily  to  expanding  our  regenerative  medicine
manufacturing capacity and to the implementation of our  global enterprise resource planning system.

During  the  year  ended  December  31,  2010,  we  paid  $5.2  million  for  acquisition  of  businesses  and

invested $37.1 million in capital expenditures.

Cash Flows Provided by Financing Activities

Our  principal  uses  of  cash  for  financing  activities  in  the  year  ended  December  31,  2012  were  the
payment of the liability component of our 2012 Notes of $134.4 million and $12.8 million of repayments
under  our  Senior  Credit  Facility  offset  by  $155.0  million  of  borrowings  under  our  Senior  Credit  Facility.

Our  principal  sources  of  cash  from  financing  activities  in  the  year  ended  December  31,  2011  were
from $230.0 million in borrowings under the 2016 Notes issued in June 2011 and proceeds from the related
warrant  sale  of  $28.5  million.  These  amounts  were  offset  by  $68.4  million  in  payments  under  our  Senior
Credit  Facility,  $42.9  million  for  the  call  option  on  our  2016  Notes,  debt  issuance  costs  of  $8.1  million,
treasury stock purchases of $83.5 million and proceeds from stock option exercises and the tax impact of
stock based compensation of $4.5 million.

Our  principal  sources  of  cash  from  financing  activities  in  the  year  ended  December  31,  2010  were
from  $105.0  million  of  borrowings  under  our  Senior  Credit  Facility  and  $19.7  million  in  proceeds  from
stock option exercises and the tax impact of stock-based compensation offset by $31.3 million in treasury
stock purchases, debt issuance cost of $6.8 million, repayment of the liability component of our 2010 Notes
of $71.4 million and repayments under our Senior  Credit Facility $16.9 million.

Working Capital

At December 31, 2012 and December 31, 2011, working capital was $346.1 million and $350.4 million,

respectively.

Amended and Restated Senior Credit Agreement

On August 10, 2010, the Company entered into an amended and restated credit agreement (the ‘‘First
Amendment’’) with a syndicate of lending banks and further amended the agreement on June 8, 2011 (the
‘‘Second  Amendment’’,  and  collectively  referred  to  herein  as  the  ‘‘Senior  Credit  Facility’’).  The  Second
Amendment  increased  the  revolving  credit  component  from  $450.0  million  to  $600.0  million  and
eliminated  the  $150.0  million  term  loan  component  that  existed  under  the  First  Amendment,  allows  the
Company to further increase the size of the revolving credit component by an aggregate of $200.0 million
with  additional  commitments,  provides  the  Company  with  decreased  borrowing  rates  and  annual
commitment fees, and provides more favorable financial covenants. The Second Amendment extended the
Senior  Credit  Facility’s  maturity  date  from  August  10,  2015  to  June  8,  2016.  Both  the  First  Amendment
and  the  Second  Amendment  are  collateralized  by  substantially  all  of  the  assets  of  the  Company’s  U.S.
subsidiaries, excluding intangible assets. At December 31, 2012, the Company was in compliance with all
such covenants.

On May 11, 2012, the Company entered into another amendment to the Senior Credit Facility. The
2012  amendment  modified  certain  financial  and  negative  covenants  as  disclosed  in  Note  4,  the  effect  of
which  was to increase the Company’s  capacity to borrow.

49

Borrowings under the Senior Credit Facility currently bear interest, at the Company’s option, at a rate
equal to (i) the Eurodollar Rate (as defined in the Senior Credit Facility, which definition has not changed)
in effect from time to time plus the applicable rate (ranging from 1.00% to 1.75%) or (ii) the highest of
(x) the weighted average overnight Federal funds rate, as published by the Federal Reserve Bank of New
York,  plus  0.5%,  (y)  the  prime  lending  rate  of  Bank  of  America,  N.A.  or  (z)  the  one-month  Eurodollar
Rate  plus  1.0%.  The  applicable  rates  are  based  on  the  Company’s  consolidated  total  leverage  ratio
(defined as the ratio of (a) consolidated funded indebtedness less cash in excess of $40 million that is not
subject to any restriction of the use or investment thereof to (b) consolidated EBITDA) at the time of the
applicable borrowing. The Company will also pay an annual commitment fee (ranging from 0.15% to 0.3%,
based  on  the  Company’s  consolidated  total  leverage  ratio)  on  the  daily  amount  by  which  the  revolving
credit facility exceeds the outstanding  loans  and letters of credit under  the credit  facility.

We  plan  to  utilize  the  Senior  Credit  Facility  for  working  capital,  capital  expenditures,  share
repurchases, acquisitions, debt repayments and other general corporate purposes. At December 31, 2012
and December 31, 2011, there were $321.9 million and $179.7 million outstanding, respectively, under the
Senior  Credit  Facility  at  a  weighted  average  interest  rate  of  1.8%  and  2.0%,  respectively.  The  Company
considers  the  balance  to  be  long-term  in  nature  based  on  its  current  intent  and  ability  to  repay  the
borrowing  outside  of  the  next  twelve-month  period.  At  December  31,  2012,  there  was  approximately
$278.1 million available for borrowing under the  Senior Credit  Facility.

Convertible Debt and Related Hedging Activities

We  pay  interest  each  June  15  and  December  15  on  our  $230.0  million  senior  convertible  notes  due
December 2016 (‘‘2016 Notes’’) at an annual interest rate of 1.625%. We paid interest each June 15 and
December 15 on our $165.0 million senior convertible note due June 2012 (‘‘2012 Notes’’) at annual rate of
2.375% and repaid the 2012 Notes in full  during June 2012  in accordance with their  term.

The  2016  Notes  are  senior,  unsecured  obligations  of  Integra,  and  are  convertible  into  cash  and,  if
applicable,  shares  of  our  common  stock  based  on  an  initial  conversion  rate,  subject  to  adjustment,  of
17.4092 shares per $1,000 principal amount of 2016 Notes (which represents an initial conversion price of
approximately $57.44 per share). We expect to satisfy any conversion of the 2016 Notes with cash up to the
principal  amount  pursuant  to  the  net  share  settlement  mechanism  set  forth  in  the  respective  indenture
and,  with  respect  to  any  excess  conversion  value,  with  shares  of  our  common  stock.  The  2016  Notes  are
convertible only in the following circumstances: (1) if the closing sale price of our common stock exceeds
150%  of  the  conversion  price  during  a  period  as  defined  in  the  applicable  indenture;  (2)  if  the  average
trading  price  per  $1,000  principal  amount  of  the  2016  Notes  is  less  than  or  equal  to  98%  of  the  average
conversion value of the 2016 Notes during a period as defined in the applicable indenture; (3) at any time
on or after June 15, 2016; or (4) if specified corporate transactions occur. The issue price of the 2016 Notes
was equal to their face amounts, which is also the amount holders are entitled to receive at maturity if the
2016 Notes are not converted. None of these conditions existed with respect to the 2016 Notes; therefore
the 2016 Notes are classified as long-term.

In  connection  with  the  issuance  of  the  2016  Notes,  we  entered  into  call  transactions  and  warrant
transactions, primarily with affiliates of the initial purchasers of the 2016 Notes (the ‘‘hedge participants’’).
The  cost  of  the  call  transactions  to  us  was  approximately  $42.9  million  for  the  2016  Notes.  We  received
approximately  $28.5  million  of  proceeds  from  the  warrant  transactions  for  2016  Notes.  The  call
transactions involved our purchasing call options from the hedge participants, and the warrant transactions
involved us selling call options to the hedge participants with a higher strike price than the purchased call
options.  The  initial  strike  price  of  the  call  transactions  is  approximately  $57.44,  subject  to  anti-dilution
adjustments  substantially  similar  to  those  in  the  2016  Notes.  The  initial  strike  price  of  the  warrant
transactions is approximately $70.05 for  the 2016 Notes, subject  to  customary anti-dilution adjustments.

50

We may from time to time seek to retire or purchase a portion of our outstanding 2016 Notes through
cash  purchases  and/or  exchanges  for  equity  securities,  in  open  market  purchases,  privately  negotiated
transactions  or  otherwise.  Such  repurchases  or  exchanges,  if  any,  will  depend  on  prevailing  market
conditions,  our  liquidity  requirements,  contractual  restrictions  and  other  factors.  Under  certain
circumstances, the call options associated with any repurchased 2016 Notes may terminate early, but only
with  respect  to  the  number  of  2016  Notes  that  cease  to  be  outstanding.  The  amounts  involved  may  be
material.

Share Repurchase Plan

On October 29, 2010, our Board of Directors authorized us to repurchase shares of our common stock

for an aggregate purchase price not to  exceed $75.0  million  through December  31, 2012.

On  October  23,  2012,  our  Board  of  Directors  terminated  the  October  2010  authorization  and
authorized the repurchase of up to $75.0 million of outstanding common stock through December 2014.
Shares  may  be  purchased  either  in  the  open  market  or  in  privately  negotiated  transactions.  We
repurchased no shares under this program though December 31, 2012 and $75.0 million remains available
under the authorization.

Dividend Policy

We  have  not  paid  any  cash  dividends  on  our  common  stock  since  our  formation.  Our  Senior  Credit
Facility limits the amount of dividends that we may pay. Any future determinations to pay cash dividends
on  our  common  stock  will  be  at  the  discretion  of  our  Board  of  Directors  and  will  depend  upon  our
financial  condition,  results  of  operations,  cash  flows  and  other  factors  deemed  relevant  by  the  Board  of
Directors.

Contractual Obligations and Commitments

As of December 31, 2012, we were obligated to pay the following amounts under various agreements:

Convertible Securities(1)
Revolving Credit Facility(2)
Interest(3)
Employment Agreements(4)
Operating Leases
Purchase Obligations
Other

Total

Total

Less than
1 Year

$230.0
321.9
14.9
3.6
40.7
22.1
4.9

$638.1

$ —
—
3.7
1.9
10.9
8.6
2.4

$27.5

1-3 Years

3-5 Years

(In millions)

$ — $230.0
321.9
3.7
—
6.6
5.6
0.3

—
7.5
1.7
15.1
4.7
1.7

$30.7

$568.1

More  than
5  Years

$ —
—
—
—
8.1
3.2
0.5

$11.8

(1) The  estimated  debt  service  obligation  of  the  senior  convertible  securities  includes  interest  expense
representing  the  amortization  of  the  discount  on  the  liability  component  of  the  senior  convertible
notes in accordance with the authoritative guidance. See Note 4, ‘‘Debt,’’ of our consolidated financial
statements for additional information.

(2) The  Company  may  borrow  and  make  payments  against  the  credit  facility  from  time  to  time  and
considers  all  of  the  outstanding  amounts  to  be  long  term  based  on  its  current  intent  and  ability  to
repay the borrowing outside of the next twelve-month period.

51

(3) Interest  is  calculated  on  the  convertible  securities  based  on  current  interest  rates  paid  by  the
Company. As the revolving credit facility can be repaid at any time, no interest has been included in
the calculation.

(4) Amounts  shown  under  Employment  Agreements  do  not  include  compensation  resulting  from  a

change in control.

Excluded  from  the  contractual  obligations  table  is  the  liability  for  uncertain  tax  benefits,  including
interest  and  penalties,  totaling  $7.6  million.  This  liability  for  uncertain  tax  benefits  has  been  excluded
because  we  cannot  make  a  reliable  estimate  of  the  period  in  which  the  uncertain  tax  benefits  may  be
realized.

Off-Balance Sheet Arrangements

There were no off-balance sheet arrangements during the year ended December 31, 2012 that have or
are  reasonably  likely  to  have,  a  current  or  future  effect  on  our  financial  condition,  changes  in  financial
condition, revenues or expenses, results of operations, liquidity, capital expenditures or capital resources
that is material to our interests.

CRITICAL ACCOUNTING POLICIES AND THE USE OF ESTIMATES

Our  discussion  and  analysis  of  financial  condition  and  results  of  operations  is  based  upon  our
consolidated  financial  statements,  which  have  been  prepared  in  accordance  with  accounting  principles
generally accepted in the United States of America. The preparation of these financial statements requires
us  to  make  estimates  and  assumptions  that  affect  the  reported  amounts  of  assets  and  liabilities,  the
disclosure  of  contingent  liabilities,  and  the  reported  amounts  of  revenues  and  expenses.  Significant
estimates  affecting  amounts  reported  or  disclosed  in  the  consolidated  financial  statements  include
allowances  for  doubtful  accounts  receivable  and  sales  returns  and  allowances,  net  realizable  value  of
inventories,  valuation  of  intangible  assets  including  in-process  research  and  development,  amortization
periods for acquired intangible assets, estimates of projected cash flows and discount rates used to value
intangible assets and test goodwill and intangible assets for impairment, estimates of projected cash flows
and  depreciation  and  amortization  periods  for  long-lived  assets,  computation  of  taxes,  computation  of
valuation  allowances  recorded  against  deferred  tax  assets,  valuation  of  stock-based  compensation,
valuation  of  pension  assets  and  liabilities,  valuation  of  derivative  instruments,  valuation  of  the  equity
component  of  convertible  debt  instruments,  valuation  of  debt  instruments  and  loss  contingencies.  These
estimates  are  based  on  historical  experience  and  on  various  other  assumptions  that  are  believed  to  be
reasonable under the current circumstances. Actual  results could differ  from  these  estimates.

We believe that the following accounting policies, which form the basis for developing these estimates,
are those that are most critical to the presentation of our consolidated financial statements and require the
more difficult subjective and complex judgments:

Allowances For Doubtful Accounts Receivable and  Sales Returns  and Allowances

We  evaluate  the  collectability  of  accounts  receivable  based  on  a  combination  of  factors.  In
circumstances  where  a  specific  customer  is  unable  to  meet  its  financial  obligations  to  us,  we  record  an
allowance against amounts due to reduce the net recognized receivable to the amount that we reasonably
expect to collect. For all other customers, we record allowances for doubtful accounts based on the length
of time the receivables are past due, the current business environment and our historical experience. If the
financial condition of customers or the length of time that receivables are past due were to change, we may
change  the  recorded  amount  of  allowances  for  doubtful  accounts  in  the  future  through  charges  or
reductions to selling, general and administrative expense.

52

We record a provision for estimated sales returns and allowances on revenues in the same period as
the related revenues are recorded. We base these estimates on historical sales returns and allowances and
other known factors. If actual returns or allowances differ from our estimates and the related provisions
for sales returns and allowances, we may change the sales returns and allowances provision in the future
through an increase or decrease in revenues.

Inventories

Inventories, consisting of purchased materials, direct labor and manufacturing overhead, are stated at
the lower of cost (determined by the first-in, first-out method) or market. At each balance sheet date, we
evaluate  ending  inventories  for  excess  quantities,  obsolescence  or  shelf-life  expiration.  Our  evaluation
includes an analysis of historical sales levels by product, projections of future demand by product, the risk
of technological or competitive obsolescence for our products, general market conditions, a review of the
shelf-life  expiration  dates  for  our  products,  and  the  feasibility  of  reworking  or  using  excess  or  obsolete
products or components in the production or assembly of other products that are not obsolete or for which
we do not have excess quantities in inventory. To the extent that we determine there are excess or obsolete
quantities or quantities with a shelf life that is too near its expiration for us to reasonably expect that we
can sell those products prior to their expiration, we adjust their carrying value to estimated net realizable
value. If future demand or market conditions are lower than our projections, or if we are unable to rework
excess or obsolete quantities into other products, we may record further adjustments to the carrying value
of inventory through a charge to cost  of product revenues  in the period the revision is made.

Valuation of Goodwill, Identifiable Intangible Assets, In-Process Research and Development  Charges

We  allocate  the  purchase  price  of  acquired  businesses  and  product  lines  to  appropriate  reporting
units.  We  review  goodwill,  identifiable  intangible  assets  with  indefinite  lives  and  capitalized  in-process
research  and  development  for  impairment  annually.  We  continually  assess  whether  events  or  changes  in
circumstances represent a ‘triggering’ event that would require us to complete an impairment assessment.
Factors  that  we  consider  in  determining  whether  a  triggering  event  has  occurred  include  a  significant
change  in  the  business  climate,  legal  factors,  operating  performance  indicators,  competition,  sale  or
disposition of significant assets or products, or the termination of development programs. Application of
these impairment tests requires significant judgments, including estimation of future cash flows, which is
dependent on internal forecasts, estimation of the long-term rate of growth for our businesses, the useful
life over which cash flows will occur  and  determination of our weighted-average cost of capital.

Changes  in  the  projected  cash  flows  and  discount  rate  estimates  and  assumptions  underlying  the
valuations  of  identifiable  intangible  assets,  in-process  research  and  development  and  goodwill  could
materially affect the determination of fair value at acquisition or during subsequent periods when tested
for impairment.

Our  finite-lived  assets  are  reviewed  for  impairment  and  to  ensure  their  useful  lives  are  appropriate

whenever events or changes indicate  their  carrying value of the assets may not be recoverable.

Derivatives

We develop, manufacture, and sell medical devices globally. Our earnings and cash flows are exposed
to market risk from changes in interest rates and currency exchange rates. We address these risks through a
risk  management  program  that  includes  the  use  of  derivative  financial  instruments,  and  operate  the
program pursuant to documented corporate risk management policies. All derivative financial instruments
are  recognized  in  the  financial  statements  at  fair  value  in  accordance  with  the  authoritative  guidance.
Under  the  guidance,  for  those  instruments  that  are  designated  and  qualify  as  hedging  instruments,  the
hedging  instrument  must  be  designated  as  a  fair  value  hedge,  cash  flow  hedge,  or  a  hedge  of  a  net

53

investment in a foreign operation, based on the exposure being hedged. The accounting for changes in the
fair value of a derivative instrument depends on whether it has been designated and qualifies as part of a
hedging relationship and, further, on the type of hedging relationship. Our derivative instruments do not
subject our earnings or cash flows to material risk, and gains and losses on these derivatives generally offset
losses and gains on the item being hedged. We have not entered into derivative transactions for speculative
purposes  and all of our derivatives are designated as hedges.

All  derivative  instruments  are  recognized  at  their  fair  values  as  either  assets  or  liabilities  on  the
balance sheet. We determine the fair value of our derivative instruments, using the framework prescribed
by  the  authoritative  guidance,  by  considering  the  estimated  amount  we  would  receive  to  sell  or  transfer
these  instruments  at  the  reporting  date  and  by  taking  into  account  expected  forward  interest  rates,
currency exchange rates, the creditworthiness of the counterparty for assets, and our creditworthiness for
liabilities.  In  certain  instances,  we  may  utilize  a  discounted  cash  flow  model  to  measure  fair  value.
Generally, we use inputs that include quoted prices for similar assets or liabilities in active markets; other
observable inputs for the asset or liability; and inputs that are derived principally from, or corroborated by,
observable  market  data  by  correlation  or  other  means.  As  of  December  31,  2012,  observable  inputs  are
available for substantially the full term of our  derivative  instruments.

Income Taxes

Since  we  conduct  operations  on  a  global  basis,  our  effective  tax  rate  has  and  will  depend  upon  the
geographic distribution of our pre-tax earnings among locations with varying tax rates. Changes in the tax
rates of the various jurisdictions in which we operate affect our profits. In addition, we maintain a reserve
for uncertain tax benefits, changes to which could impact our effective tax rate in the period such changes
are made. The effective tax rate can also be impacted by changes in valuation allowances of deferred tax
assets, and tax law changes.

Our  provision  for  income  taxes  may  change  period-to-period  based  on  specific  events,  such  as  the
settlement of income tax audits and changes in tax laws, as well as general factors, including the geographic
mix  of  income  before  taxes,  state  and  local  taxes  and  the  effects  of  the  Company’s  global  income  tax
strategies.  We  maintain  strategic  management  and  operational  activities  in  overseas  subsidiaries  and  our
foreign  earnings  are  taxed  at  rates  that  are  generally  lower  than  in  the  United  States.  See  Note  10,
‘‘Income  Taxes,’’  in  our  consolidated  financial  statements  for  disclosures  related  to  foreign  and  domestic
pretax income, foreign and domestic income tax (benefit) expense and the effect foreign taxes have on our
overall effective tax rate.

We  recognize  a  tax  benefit  from  an  uncertain  tax  position  only  if  it  is  more  likely  than  not  to  be
sustained upon examination based on the technical merits of the position. The amount of the accrual for
which  an  exposure  exists  is  measured  by  determining  the  amount  that  has  a  greater  than  50  percent
likelihood  of  being  realized  upon  ultimate  settlement  of  the  position.  Components  of  the  reserve  are
classified  as  a  long-term  liability  in  the  consolidated  balance  sheets.  We  record  interest  and  penalties
accrued in relation to uncertain tax benefits  as a component of income tax expense.

We  believe  we  have  identified  all  reasonably  identifiable  exposures  and  the  reserve  we  have
established for identifiable exposures is appropriate under the circumstances; however, it is possible that
additional  exposures  exist  and  that  exposures  will  be  settled  at  amounts  different  than  the  amounts
reserved.  It  is  also  possible  that  changes  in  facts  and  circumstances  could  cause  us  to  either  materially
increase or reduce the carrying amount  of  our tax reserves.

Our  deferred  income  taxes  reflect  the  net  tax  effects  of  temporary  differences  between  the  carrying
amounts of assets and liabilities for financial reporting purposes and their basis for income tax purposes,
and  also  the  temporary  differences  created  by  the  tax  effects  of  capital  loss,  net  operating  loss  and  tax

54

credit carryforwards. We record valuation allowances to reduce deferred tax assets to the amounts that are
more likely than not to be realized. We could recognize no benefit from our deferred tax assets or we could
recognize  some  or  all  of  the  future  benefit  depending  on  the  amount  and  timing  of  taxable  income  we
generate in the future.

Our  policy  is  to  provide  income  taxes  on  earnings  of  certain  foreign  subsidiaries  only  to  the  extent

those earnings are taxable or are expected to be remitted.

Loss Contingencies

We  are  subject  to  claims  and  lawsuits  in  the  ordinary  course  of  our  business,  including  claims  by
employees  or  former  employees,  with  respect  to  our  products  and  involving  commercial  disputes.  We
accrue  for  loss  contingencies  when  it  is  deemed  probable  that  a  loss  has  been  incurred  and  that  loss  is
estimable.  The  amounts  accrued  are  based  on  the  full  amount  of  the  estimated  loss  before  considering
insurance proceeds, if applicable, and do not include an estimate for legal fees expected to be incurred in
connection  with  the  loss  contingency.  We  consistently  accrue  legal  fees  expected  to  be  incurred  in
connection  with  loss  contingencies  as  those  fees  are  incurred  by  outside  counsel  as  a  period  cost.  Our
financial  statements  do  not  reflect  any  material  amounts  related  to  possible  unfavorable  outcomes  of
claims  and  lawsuits  to  which  we  are  currently  a  party  because  we  currently  believe  that  such  claims  and
lawsuits  are  not  expected,  individually  or  in  the  aggregate,  to  result  in  a  material  adverse  effect  on  our
financial  condition.  However,  it  is  possible  that  these  contingencies  could  materially  affect  our  results  of
operations, financial position and cash flows in a particular period if we change our assessment of the likely
outcome of these matters.

Recently Issued and Adopted Accounting  Standards

On  July  27,  2012,  the  Financial  Accounting  Standards  Board  issued  Accounting  Standards  Update
No. 2012-02, Testing Indefinite-Lived Intangible Assets for Impairment. The revised standard is intended to
reduce  the  cost  and  complexity  of  testing  indefinite-lived  intangible  assets  other  than  goodwill  for
impairment  by  providing  entities  with  an  option  to  perform  a  ‘‘qualitative’’  assessment  to  determine
whether  further  impairment  testing  is  necessary.  The  revised  standard  allows  an  entity  first  to  assess
qualitative factors to determine whether events and circumstances indicate that it is more likely than not
(that is, a likelihood of more than 50 percent) that an indefinite-lived intangible asset is impaired. If it is
more likely than not that the asset is impaired, the entity must calculate the fair value of the asset, compare
the fair value to its carrying amount, and record an impairment charge, if the carrying amount exceeds fair
value.  However,  if  an  entity  concludes  that  it  is  not  more  likely  than  not  that  the  asset  is  impaired,  no
further  action  is  required.  The  qualitative  assessment  is  not  an  accounting  policy  election.  An  entity  can
choose to perform the qualitative assessment on none, some, or all of its indefinite-lived intangible assets.
Moreover,  an  entity  can  bypass  the  qualitative  assessment  for  any  indefinite-lived  intangible  asset  in  any
period and proceed directly to the quantitative impairment test, and then choose to perform the qualitative
assessment in any subsequent period. The revised standard is effective for annual and interim impairment
tests performed for fiscal years beginning after September 15, 2012. However, an entity can choose to early
adopt the revised standard even if its annual or interim impairment test date is before July 27, 2012 (the
date on which the revised standard was issued), provided that its financial statements for the most recent
annual or interim period have not yet been issued. The Company elected to adopt this standard early and
such adoption did  not have a material impact on the Company’s  financial statements.

55

ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK

We  are  exposed  to  various  market  risks,  including  changes  in  foreign  currency  exchange  rates  and
interest rates that could adversely affect our results of operations and financial condition. To manage the
volatility  relating  to  these  typical  business  exposures,  we  may  enter  into  various  derivative  transactions
when  appropriate.  We  do  not  hold  or  issue  derivative  instruments  for  trading  or  other  speculative
purposes.

Foreign Currency Exchange and Other  Rate Risks

We operate on a global basis and are exposed to the risk that changes in foreign currency exchange
rates could adversely affect our financial condition, results of operations and cash flows. We are primarily
exposed to foreign currency exchange rate risk with respect to transactions and net assets denominated in
euros,  Swiss  francs,  British  pounds,  Canadian  dollars,  and  Australian  dollars.  We  manage  the  foreign
currency exposure centrally, on a combined basis, which allows us to net exposures and to take advantage
of  any  natural  offsets.  To  mitigate  the  impact  of  currency  fluctuations  on  transactions  denominated  in
nonfunctional currencies, we periodically enter into derivative financial instruments in the form of foreign
currency exchange forward contracts with major financial institutions. We temporarily record realized and
unrealized  gains  and  losses  on  these  contracts  that  qualify  as  cash  flow  hedges  in  other  comprehensive
income, and then recognize them in other income or expense when the hedged item affects net earnings.

From  time  to  time,  we  enter  into  foreign  currency  forward  exchange  contracts  with  terms  of  up  to
12 months to manage currency exposures for transactions denominated in a currency other than an entity’s
functional  currency.  As  a  result,  the  impact  of  foreign  currency  gains/losses  recognized  in  earnings  are
partially  offset  by  gains/losses  on  the  related  foreign  currency  forward  exchange  contracts  in  the  same
reporting  period.  At  December  31,  2012,  the  notional  amount  of  foreign  currency  contracts  outstanding
not designated as hedges was equivalent to $3.9 million. There were no foreign currency forward contracts
outstanding  at  December  31,  2012  that  were  designated  as  hedges.  At  December  31,  2011,  the  notional
amount of foreign currency forward contracts outstanding that were designated as hedges was equivalent
to $1.6 million, and the amount not designated as hedges was equivalent to $3.3 million.

We maintain written policies and procedures governing our risk management activities. With respect
to cash flow hedges, changes in cash flows attributable to hedged transactions are generally expected to be
completely  offset  by  changes  in  the  fair  value  of  hedge  instruments.  Consequently,  foreign  currency
exchange contracts would not subject us to material risk due to exchange rate movements, because gains
and losses on these contracts offset gains and losses on the assets, liabilities or transactions being hedged.

The results of operations discussed herein  have not been  materially affected  by  inflation.

Interest Rate Risk

Cash and Cash Equivalents — We are exposed to the risk of interest rate fluctuations on the interest
income earned on our cash and cash equivalents. A hypothetical 100 basis point movement in interest rates
applicable  to  our  cash  and  cash  equivalents  outstanding  at  December  31,  2012  would  increase  interest
income by approximately $1.0 million on an annual basis. No significant decrease in interest income would
be  expected  as  our  cash  balances  are  earning  interest  at  rates  of  approximately  32  basis  points.  We  are
subject to foreign currency exchange risk with respect to cash balances maintained in foreign currencies.

Senior  Credit  Facility  — Our  interest  rate  risk  relates  primarily  to  U.S.  dollar  LIBOR-indexed
borrowings.  We  have  used  an  interest  rate  derivative  instrument  to  manage  our  earnings  and  cash  flow
exposure to changes in interest rates by utilizing a forward-starting interest rate swap that began to offset a
portion of our interest payments in the first quarter of 2011. This interest rate derivative instrument fixed

56

the  interest  rate  on  a  portion  of  our  expected  LIBOR-indexed  floating-rate  borrowings  beginning  on
December  31,  2010.  The  interest  rate  swap  had  a  notional  amount  of  $127.5  million  outstanding  as  of
December  31,  2012.  We  recognized  $1.9  million  of  additional  interest  expense  related  to  this  derivative
during 2012. The fair value of our interest rate derivative instrument was a net liability of $4.1 million at
December 31, 2012.

Based  on  our  outstanding  borrowings  at  December  31,  2012,  a  one-percentage  point  change  in
interest rates would have impacted interest expense on the unhedged portion of the debt by $1.9 million on
an annualized basis.

ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA

Financial  statements  and  the  financial  statement  schedules  specified  by  this  Item,  together  with  the

report thereon of PricewaterhouseCoopers LLP, are presented following  Item 15 of this report.

Information on quarterly results of operations is set forth in our financial statements under Note 14,

‘‘Selected Quarterly Information — Unaudited,’’ to the Consolidated Financial  Statements.

ITEM 9. CHANGES IN AND DISAGREEMENTS WITH  ACCOUNTANTS  ON ACCOUNTING  AND

FINANCIAL DISCLOSURES

Not applicable.

ITEM 9A. CONTROLS AND PROCEDURES

Evaluation of Disclosure Controls and  Procedures

We  maintain  disclosure  controls  and  procedures  that  are  designed  to  provide  reasonable  assurance
that information required to be disclosed in our Exchange Act reports is recorded, processed, summarized
and  reported  within  the  time  periods  specified  in  the  Securities  and  Exchange  Commission’s  rules  and
forms  and  that  such  information  is  accumulated  and  communicated  to  our  management,  including  our
principal  executive  officer  and  principal  financial  officer,  as  appropriate,  to  allow  for  timely  decisions
regarding  required  disclosure.  Disclosure  controls  and  procedures,  no  matter  how  well  designed  and
operated,  can  provide  only  reasonable  assurance  of  achieving  the  desired  control  objectives,  and
management  is  required  to  apply  its  judgment  in  evaluating  the  cost-benefit  relationship  of  possible
controls  and  procedures.  Management  has  designed  our  disclosure  controls  and  procedures  to  provide
reasonable assurance of achieving the desired control objectives.

As  required  by  Exchange  Act  Rule  13a-15(b),  we  have  carried  out  an  evaluation,  under  the
supervision  and  with  the  participation  of  our  management,  including  our  principal  executive  officer  and
principal financial officer, of the effectiveness of the design and operation of our disclosure controls and
procedures  as  of  December  31,  2012.  Based  upon  this  evaluation,  our  principal  executive  officer  and
principal  financial  officer  concluded  that  our  disclosure  controls  and  procedures  were  effective  as  of
December 31, 2012 to provide such reasonable assurance.

As  previously  disclosed,  the  Company  is  in  the  process  of  a  multi-year  implementation  of  a  global
enterprise resource planning (‘‘ERP’’) system. In 2013, the Company expects the ERP will be deployed in
certain  U.S.  operations.  In  addition,  in  response  to  business  integration  activities,  the  Company  has  and
will continue to further align and streamline the design and operation of the financial control environment
to be responsive to the changing business  model.

57

Management’s Report on Internal Control  Over  Financial Reporting

Management is responsible for establishing and maintaining adequate internal control over financial
reporting as defined in Rules 13a-15(f) under the Securities Exchange Act of 1934, as amended. Internal
control  over  financial  reporting  is  designed  to  provide  reasonable  assurance  regarding  the  reliability  of
financial  reporting  and  the  preparation  of  financial  statements  for  external  purposes  in  accordance  with
generally  accepted  accounting  principles  in  the  United  States  of  America  (‘‘GAAP’’).  We  recognize  that
because  of  its  inherent  limitations,  internal  control  over  financial  reporting  may  not  prevent  or  detect
misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk
that controls may become inadequate because of changes in conditions or that the degree of compliance
with the policies and procedures may deteriorate.

To  evaluate  the  effectiveness  of  our  internal  control  over  financial  reporting,  management  used  the
criteria  described  in  Internal  Control  —  Integrated  Framework  issued  by  the  Committee  of  Sponsoring
Organizations  of  the  Treadway  Commission  (‘‘COSO’’).  Based  upon  this  evaluation,  management
concluded that our internal control over financial  reporting was effective as  of December  31, 2012.

The effectiveness of the Company’s internal control over financial reporting as of December 31, 2012
has  been  audited  by  PricewaterhouseCoopers  LLP,  an  independent  registered  public  accounting  firm,  as
stated in their report which appears herein.

Changes in Internal Control Over Financial Reporting

There were no changes in our internal control over financial reporting (as defined in Rule 13a-15(f)
under the Exchange Act) that occurred during the quarter ended December 31, 2012 that have materially
affected, or are reasonably likely to materially affect, our internal  control over financial reporting.

ITEM 9B. OTHER INFORMATION

Not applicable.

58

INCORPORATION BY REFERENCE

PART III

The information called for by Item 5. Market for Registrant’s Common Equity, Related Stockholder
Matters  and  Issuer  Purchases  of  Equity  Securities  relating  to  equity  compensation  plans,  Item  10.
Directors,  Executive  Officers  and  Corporate  Governance,  Item  11.  Executive  Compensation,  Item  12.
Security  Ownership  of  Certain  Beneficial  Owners  and  Management  and  Related  Stockholder  Matters,
Item  13.  Certain  Relationships  and  Related  Transactions,  and  Director  Independence  and  Item  14.
Principal  Accountant  Fees  and  Services  is  incorporated  herein  by  reference  to  the  Company’s  definitive
proxy  statement  for  its  Annual  Meeting  of  Stockholders  scheduled  to  be  held  on  May  22,  2013,  which
definitive proxy statement is expected to be filed with the Commission not later than 120 days after the end
of the fiscal year to which this report  relates.

59

ITEM 15. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES

PART IV

(a) Documents filed as a part of this report.

1.

Financial Statements.

The following financial statements and financial statement schedules are filed as a part of this report:

Report of Independent Registered Public Accounting  Firm
Consolidated Statements of Operations  for the years ended December 31,  2012, 2011 and 2010
Consolidated Statements of Comprehensive Income for  the years ended December 31, 2012,  2011

and 2010

Consolidated Balance Sheets as of December 31,  2012 and 2011
Consolidated Statements of Cash Flows  for  the years ended December  31, 2012,  2011 and 2010
Consolidated Statements of Changes  in  Stockholders’ Equity for the years ended  December 31,

2012, 2011 and 2010

Notes to Consolidated Financial Statements

2.

Financial Statement Schedules.

Schedule II — Valuation and Qualifying  Accounts

F-1
F-2

F-3
F-4
F-5

F-6
F-7

F-45

All  other  schedules  not  listed  above  have  been  omitted,  because  they  are  not  applicable  or  are  not
required, or because the required information is included in the consolidated financial statements or notes
thereto.

3. Exhibits required to be filed by Item 601 of Regulation  S-K.

3.1(a)

3.1(b)

3.1(c)

3.2

4.1

Amended and Restated Certificate of Incorporation of the Company dated February 16, 1993
(Incorporated by reference to Exhibit 3.1(a) to the Company’s Annual Report on Form 10-K
for  the year ended December 31, 2005)

Certificate  of  Amendment  to  Amended  and  Restated  Certificate  of  Incorporation  of  the
Company dated May 22, 1998 (Incorporated by reference to Exhibit 3.1(b) to the Company’s
Annual Report on Form 10-K for the year  ended  December  31, 1998)

Certificate  of  Amendment  to  Amended  and  Restated  Certificate  of  Incorporation  of  the
Company dated May 17, 1999 (Incorporated by reference to Exhibit 3.1(c) to the Company’s
Annual Report on Form 10-K for the year  ended  December  31, 2004)

Amended and Restated Bylaws of the Company, effective as of May 17, 2012 (Incorporated
by reference to Exhibit 3.2 to the Company’s Current Report on Form 8-K filed on April 13,
2012)

Purchase  Agreement,  dated  June  9,  2011,  by  and  between  Integra  LifeSciences  Holdings
Corporation  and  J.P.  Morgan  Securities  LLC,  Merrill  Lynch,  Pierce,  Fenner  &  Smith
Incorporated,  Morgan  Stanley  &  Co.  LLC,  Deutsche  Bank  Securities  Inc.,  RBC  Capital
Markets, LLC and Wells Fargo Securities, LLC (Incorporated by reference to Exhibit 4.1 to
the Company’s Current Report on Form 8-K filed  on June 15, 2011)

60

4.2

4.3(a)

4.3(b)

4.3(c)

4.3(d)

4.3(e)

4.3(f)

4.3(g)

Indenture, dated June 15, 2011, by and between Integra LifeSciences Holdings Corporation
and  Wells  Fargo  Bank,  National  Association,  as  trustee  (Incorporated  by  reference  to
Exhibit 4.2 to the Company’s Current Report on Form 8-K  filed on June 15, 2011)

Credit  Agreement,  dated  as  of  December  22,  2005,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing  Line  Lender  and  L/C  Issuer,  Citibank  FSB  and  SunTrust  Bank,  as  Co-Syndication
Agents,  and  Royal  Bank  of  Canada  and  Wachovia  Bank,  National  Association,  as
Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s
Current Report on Form 8-K filed on December 29,  2005)

First  Amendment,  dated  as  of  February  15,  2006,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing  Line  Lender  and  L/C  Issuer,  Citibank  FSB  and  SunTrust  Bank,  as  Co-Syndication
Agents,  and  Royal  Bank  of  Canada  and  Wachovia  Bank,  National  Association,  as
Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  4.3(b)  to  the  Company’s
Annual Report on Form 10-K for the year  ended  December  31, 2005)

Second  Amendment,  dated  as  of  February  23,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing  Line  Lender  and  L/C  Issuer,  Citibank  FSB  and  SunTrust  Bank,  as  Co-Syndication
Agents,  and  Royal  Bank  of  Canada  and  Wachovia  Bank,  National  Association,  as
Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  4.1  to  the  Company’s
Current Report on Form 8-K filed on February 27,  2007)

Third  Amendment,  dated  as  of  June  4,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing Line Lender and L/C Issuer, Citibank, N.A., successor by merger to Citibank, FSB, as
Syndication  Agent  and  JPMorgan  Chase  Bank,  N.A.,  Deutsche  Bank  Trust  Company
Americas  and  Royal  Bank  of  Canada,  as  Co-Documentation  Agents  (Incorporated  by
reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on June 6, 2007)

Fourth  Amendment,  dated  as  of  September  5,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing Line Lender and L/C Issuer, Citibank, N.A., successor by merger to Citibank FSB, as
Syndication  Agent  and  JPMorgan  Chase  Bank,  N.A.,  Deutsche  Bank  Trust  Company
Americas  and  Royal  Bank  of  Canada,  as  Co-Documentation  Agents  (Incorporated  by
reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on September 6,
2007)

Amended  and  Restated  Credit  Agreement,  dated  as  of  August  10,  2010,  among  Integra
LifeSciences  Holdings  Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as
Administrative  Agent,  Swing  Line  Lender  and  L/C  Issuer,  JP  Morgan  Chase  Bank,  as
Syndication  Agent,  and  HSBC  Bank  USA,  NA,  RBC  Capital  Markets,  Wells  Fargo  Bank,
N.A.,  Fifth  Third  Bank,  DNB  NOR  Bank  ASA  and  TD  Bank,  N.A.,  as  Co-Documentation
Agents  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on
Form 8-K filed on August 10, 2010)

Second Amended and Restated Credit Agreement, dated as of June 8, 2011, among Integra
LifeSciences  Holdings  Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.  as
Administrative  Agent,  Swing  Line  Lender  and  L/C  Issuer,  JPMorgan  Chase  Bank  N.A.  as
Syndication  Agent,  and,  HSBC  Bank  USA,  NA,  Royal  Bank  of  Canada,  Wells  Fargo  Bank,
N.A.,  Fifth  Third  Bank,  DNB  NOR  Bank  ASA,  and  TD  Bank,  N.A.,  as  Co-Documentation
Agents  (Incorporated  by  reference  to  Exhibit  4.3  to  the  Company’s  Quarterly  Report  on
Form 10-Q filed on July 29, 2011)

61

4.3(h)

4.4

4.5

4.6

4.7

4.8

4.9

4.10

4.11

4.12

First  Amendment,  dated  as  of  May  11,  2012,  to  Second  Amended  and  Restated  Credit
Agreement dated as of June 8, 2011, among Integra LifeSciences Holdings Corporation, the
lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,  Swing  Line  Lender
and  L/C  Issuer,  JPMorgan  Chase  Bank,  N.A.,  as  Syndication  Agent,  and  HSBC  Bank,  NA,
Royal Bank of Canada, Wells Fargo Bank, NA, Fifth Third Bank, DNB Nor Bank ASA and
TD  Bank,  N.A.,  as  Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  4.1  to
the Company’s Current Report on Form 8-K filed  on May  14, 2012)

Security  Agreement,  dated  as  of  December  22,  2005,  among  Integra  LifeSciences  Holdings
Corporation and the additional grantors party thereto in favor of Bank of America, N.A., as
administrative  and  collateral  agent  (Incorporated  by  reference  to  Exhibit  4.4  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)

Pledge  Agreement,  dated  as  of  December  22,  2005,  among  Integra  LifeSciences  Holdings
Corporation and the additional grantors party thereto in favor of Bank of America, N.A., as
administrative  and  collateral  agent  (Incorporated  by  reference  to  Exhibit  4.5  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)

Subsidiary Guaranty Agreement, dated as of December 22, 2005, among the guarantors party
thereto  and  individually  as  a  ‘‘Guarantor’’),  in  favor  of  Bank  of  America,  N.A.,  as
administrative  and  collateral  agent  (Incorporated  by  reference  to  Exhibit  4.6  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)

Indenture,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings  Corporation,  Integra
LifeSciences Corporation and Wells Fargo Bank, N.A., as trustee (Incorporated by reference
to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on  June 12, 2007)

Form of 2.75% Senior Convertible Note due 2010 (included in Exhibit 4.8) (Incorporated by
reference to Exhibit B to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on
June 12, 2007)

Indenture,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings  Corporation,  Integra
LifeSciences Corporation and Wells Fargo Bank, N.A., as trustee (Incorporated by reference
to Exhibit 4.3 to the Company’s Current Report on Form 8-K filed on  June 12, 2007)

Form of 2.375% Senior Convertible Note due 2012 (included in Exhibit 4.10) (Incorporated
by reference to Exhibit B to Exhibit 4.3 to the Company’s Current Report on Form 8-K filed
on June 12, 2007)

Registration  Rights  Agreement,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  Banc  of  America  Securities  LLC,  J.P.  Morgan  Securities  Inc.  and  Morgan
Stanley & Co., Incorporated, as representatives of the several initial purchasers (Incorporated
by reference to Exhibit 4.5 to the Company’s Current Report on Form 8-K filed on June 12,
2007)

Registration  Rights  Agreement,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  Banc  of  America  Securities  LLC,  J.P.  Morgan  Securities  Inc.  and  Morgan
Stanley & Co., Incorporated, as representatives of the several initial purchasers (Incorporated
by reference to Exhibit 4.6 to the Company’s Current Report on Form 8-K filed on June 12,
2007)

10.1(a)

Lease  between  Plainsboro  Associates  and  American  Biomaterials  Corporation  dated  as  of
April  16,  1985,  as  assigned  to  Colla-Tec,  Inc.  on  September  30,  1988  and  as  amended  on
November 1, 1992 as Lease Modification #1 (Incorporated by reference to Exhibit 10.30 to
the  Company’s  Registration  Statement  on  Form  10/A  (File  No.  0-26224)  which  became
effective on August 8, 1995)

62

10.1(b)

10.1(c)

10.2(a)

10.2(b)

10.3

10.4

10.5

10.6

10.7(a)

10.7(b)

10.8(a)

10.8(b)

Lease  Modification  #2  entered  into  as  of  October  28,  2005,  by  and  between  Plainsboro
Associates and Integra LifeSciences Corporation (Incorporated by reference to Exhibit 10.1
to the Company’s Current Report on  Form 8-K filed on November  2, 2005)

Lease  Modification  #3  entered  into  as  of  March  2,  2011,  by  and  between  Plainsboro
Associates and Integra LifeSciences Corporation (Incorporated by reference to Exhibit 10.1
to the Company’s Current Report on  Form 8-K filed on March 3,  2011)

Equipment  Lease  Agreement  between  Medicus  Corporation  and  the  Company,  dated  as  of
June 1, 2000 (Incorporated by reference to Exhibit 10.1 to the Company’s Quarterly Report
on Form 10-Q for the quarter ended June 30, 2000)

First  Amendment  to  Equipment  Lease  Agreement  between  Medicus  Corporation  and  the
Company,  dated  as  of  June  29,  2010  (Incorporated  by  reference  to  Exhibit  10.2  to  the
Company’s Quarterly Report on Form 10-Q for  the quarter ended  June  30, 2010)

Form  of  Indemnification  Agreement  between  the  Company  and  [
]  dated  August  16,
1995, including a schedule identifying the individuals that are a party to such Indemnification
Agreements  (Incorporated  by  reference  to  Exhibit  10.37  to  the  Company’s  Registration
Statement on Form S-1 (File No. 33-98698) which  became effective on January  24, 1996)*

1996  Incentive  Stock  Option  and  Non-Qualified  Stock  Option  Plan  (as  amended  through
December  27,  1997)  (Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s  Current
Report on Form 8-K filed on February  3, 1998)*

1998  Stock  Option  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.3 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

1999  Stock  Option  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.4 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

Employee Stock Purchase Plan (as amended on May 17, 2004) (Incorporated by reference to
Exhibit  4.1  to  the  Company’s  Registration  Statement  on  Form  S-8  (Registration
No. 333-127488) filed on August 12,  2005)*

First  Amendment  to  Employee  Stock  Purchase  Plan,  dated  October  26,  2005  (Incorporated
by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
November 1, 2005)*

2000  Equity  Incentive  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.5 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

Amendment  to  2000  Equity  Incentive  Plan  (effective  as  of  May  17,  2012)  (Incorporated  by
reference to Exhibit 10.7 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2012)*

10.8(c)

Amendment to 2000 Equity Incentive Plan (effective as of  January  1, 2013)*+

10.9(a)

10.9(b)

2001  Equity  Incentive  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.6 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

Amendment  to  2001  Equity  Incentive  Plan  (effective  as  of  May  17,  2012)  (Incorporated  by
reference to Exhibit 10.8 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2012)*

63

10.9(c)

Amendment to 2001 Equity Incentive Plan (effective as of  January  1, 2013)*+

10.10(a)

Second  Amended  and  Restated  2003  Equity  Incentive  Plan  effective  May  19,  2010
(Incorporated by reference to Exhibit 10 to the Company’s Current Report on Form 8-K filed
May 21, 2010)*

10.10(b) Amendment  to  the  Second  Amended  and  Restated  2003  Equity  Incentive  Plan  effective
May 17, 2012 (Incorporated by reference to Exhibit 10.9 to the Company’s Quarterly Report
on Form 10-Q for the quarter ended June 30, 2012)*

10.10(c)

10.11(a)

Amendment  to  the  Second  Amended  and  Restated  2003  Equity  Incentive  Plan  effective
January 1, 2013*+

Second  Amended  and  Restated  Employment  Agreement  dated  July  27,  2004  between  the
Company  and  Stuart  M.  Essig  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s
Quarterly Report on Form 10-Q for the quarter ended September  30, 2004)*

10.11(b) Amendment 2006-1, dated as of December 19, 2006, to the Second Amended and Restated
Employment  Agreement,  between  the  Company  and  Stuart  M.  Essig  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 22, 2006)*

10.11(c)

Amendment  2008-1,  dated  as  of  March  6,  2008,  to  the  Second  Amended  and  Restated
Employment  Agreement,  between  the  Company  and  Stuart  M.  Essig  (Incorporated  by
reference  to  Exhibit  10.12(c)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2007)*

10.11(d) Amendment  2008-2,  dated  as  of  August  6,  2008,  to  the  Second  Amended  and  Restated
Employment  Agreement  between  Stuart  M.  Essig  and  the  Company  (Incorporated  by
reference to Exhibit 10.7 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2008)*

10.11(e) Amendment  2009-1,  dated  as  of  April  13,  2009,  to  the  Second  Amended  and  Restated
Employment  Agreement  between  Stuart  M.  Essig  and  the  Company  (Incorporated  by
reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  April  13,
2009)*

10.11(f)

10.11(g)

10.11(h)

10.12

Letter  Agreement  dated  May  17,  2011  between  the  Company  and  Stuart  M.  Essig
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed May 23, 2011)*

Letter  dated  December  20,  2011  from  Stuart  M.  Essig  to  the  Company  (Incorporated  by
reference to Exhibit 10.3 to the Company’s Current Report on Form 8-K filed December 23,
2011)*

Letter  Agreement  dated  June  7,  2012  between  Stuart  M.  Essig  and  the  Company
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed on June 7, 2012)*

Indemnity letter agreement dated December 27, 1997 from the Company to Stuart M. Essig
(Incorporated  by  reference  to  Exhibit  10.5  to  the  Company’s  Current  Report  on  Form  8-K
filed on February 3, 1998)*

10.13(a) Registration Rights Provisions for Stuart M. Essig (Incorporated by reference to Exhibit B of

Exhibit 10.1 to the Company’s Current Report on Form 8-K  filed on February 3,  1998)*

10.13(b) Registration Rights Provisions for Stuart M. Essig (Incorporated by reference to Exhibit 10.2

to the Company’s Current Report on  Form 8-K filed on January 8, 2001)*

64

10.13(c)

Registration Rights Provisions for Stuart M. Essig (Incorporated by reference to Exhibit B of
Exhibit  10.1  to  the  Company’s  Quarterly  Report  on  Form  10-Q  for  the  quarter  ended
September 30, 2004)*

10.14(a) Amended and Restated 2005 Employment Agreement between John B. Henneman, III and
the  Company  dated  December  19,  2005  (Incorporated  by  reference  to  Exhibit  10.16  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)*

10.14(b) Amendment  2008-1,  dated  as  of  January  2,  2008,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.15(b)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2007)*

10.14(c)

Amendment  2008-2,  dated  as  of  December  18,  2008,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 24, 2008)*

10.14(d) Amendment  2009-1,  dated  as  of  April  13,  2009,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.5  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  April  13,
2009)*

10.14(e) Amendment  2010-1,  dated  as  of  October  12,  2010,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.3  to  the  Company’s  Current  Report  on  Form  8-K  filed  October  12,
2010)*

10.14(f)

10.15

10.16(a)

10.16(b)

10.16(c)

10.17(a)

Letter  dated  as  of  February  22,  2012  from  John  B.  Henneman,  III  to  the  Company
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed February 22, 2012)*

Consulting  Agreement,  dated  October  12,  2010,  between  the  Company  and  Inception
Surgical  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on
Form 8-K filed on October 12, 2010)*

Severance Agreement between Judith O’Grady and the Company dated as of January 4, 2010
(Incorporated by reference to Exhibit 10.17 to the Company’s Annual Report on Form 10-K
for  the year ended December 31, 2009)*

Severance Agreement between Judith O’Grady and the Company dated as of January 3, 2011
(Incorporated  by  reference  to  Exhibit  10.17(a)  to  the  Company’s  Annual  Report  on
Form 10-K for the year ended December 31, 2010)*

Severance Agreement between Judith O’Grady and the Company dated as of January 3, 2012
(Incorporated  by  reference  to  Exhibit  10.16(c)  to  the  Company’s  Annual  Report  on
Form 10-K for the year ended December 31, 2011)*

Employment  Agreement,  dated  as  of  October  12,  2010,  between  Peter  J.  Arduini  and  the
Company  (Incorporated  by  reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on
Form 8-K filed October 12, 2010)*

10.17(b) Amended and Restated Employment Agreement dated December 20, 2011 between Peter J.
Arduini  and  the  Company  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s
Current Report on Form 8-K filed December 23, 2011)*

65

10.18

10.19(a)

Form  of  Notice  of  Stock  Option  Grant  with  Eight-Year  Term  for  Peter  J.  Arduini
(Incorporated  by  reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on  Form  8-K
filed December 23, 2011)*

Lease  Contract,  dated  April  1,  2005,  between  the  Puerto  Rico  Industrial  Development
Company and Integra CI, Inc. (executed on September 15, 2006) (Incorporated by reference
to  Exhibit  10.3  to  the  Company’s  Quarterly  Report  on  Form  10-Q  for  the  quarter  ended
September 30, 2006)

10.19(b) Amendment to Lease Contract dated as of November 2, 2011, between Integra CI, Inc. and
Puerto Rico Industrial Development Company (Incorporated by reference to Exhibit 10.1 to
the Company’s Current Report on Form 8-K filed  on November 7,  2011)

10.19(c)

Termination of Amendment to Lease Contract, dated as of April 2, 2012, between Integra CI,
Inc.  and  Puerto  Rico  Industrial  Development  Company  (Incorporated  by  reference  to
Exhibit  10.2  to  the  Company’s  Quarterly  Report  on  Form  10-Q  for  the  quarter  ended
March 31, 2012)

10.20

10.21

10.22

Restricted Units Agreement dated December 27, 1997 between the Company and Stuart M.
Essig  (Incorporated  by  reference  to  Exhibit  10.3  to  the  Company’s  Current  Report  on
Form 8-K filed on February 3, 1998)*

Stock Option Grant and Agreement pursuant to 1999 Stock Option Plan dated December 22,
2000 between the Company and Stuart M. Essig (Incorporated by reference to Exhibit 4.1 to
the Company’s Current Report on Form 8-K filed  on January  8, 2001)*

Stock  Option  Grant  and  Agreement  pursuant  to  2000  Equity  Incentive  Plan  dated
December 22, 2000 between the Company and Stuart M. Essig (Incorporated by reference to
Exhibit 4.2 to the Company’s Current Report on Form 8-K  filed on January 8, 2001)*

10.23(a) Restricted Units Agreement dated December 22, 2000 between the Company and Stuart M.
Essig  (Incorporated  by  reference  to  Exhibit  4.3  to  the  Company’s  Current  Report  on
Form 8-K filed on January 8, 2001)*

10.23(b) Amendment  2006-1,  dated  as  of  October  30,  2006,  to  the  Stuart  M.  Essig  Restricted  Units
Agreement dated as of December 22, 2000 (Incorporated by reference to Exhibit 10.1 to the
Company’s Current Report on Form 8-K filed on  November 3, 2006)*

10.24

10.25(a)

Stock  Option  Grant  and  Agreement  pursuant  to  2003  Equity  Incentive  Plan  dated  July  27,
2004 between the Company and Stuart M. Essig (Incorporated by reference to Exhibit 10.30
to the Company’s Annual Report on Form 10-K for  the year ended December 31, 2004)*

Contract  Stock/Restricted  Units  Agreement  pursuant  to  2003  Equity  Incentive  Plan  dated
July  27,  2004  between  the  Company  and  Stuart  M.  Essig  (Incorporated  by  reference  to
Exhibit  10.31  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2004)*

10.25(b) Amendment  2006-1,  dated  as  of  October  30,  2006,  to  the  Stuart  M.  Essig  Contract  Stock/
Restricted  Units  Agreement  dated  as  of  July  27,  2004  (Incorporated  by  reference  to
Exhibit 10.2 to the Company’s Current Report on Form 8-K  filed on November  3, 2006)*

10.25(c)

Amendment  2008-1,  dated  as  of  March  6,  2008,  to  the  Stuart  M.  Essig  Contract  Stock/
Restricted  Units  Agreement  dated  as  of  July  27,  2004  (Incorporated  by  reference  to
Exhibit  10.25(c)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2007)*

66

10.25(d) Amendment  2011-1,  dated  as  of  May  17,  2011,  to  the  Stuart  M.  Essig  Contract  Stock/
Restricted  Units  Agreement  dated  as  of  July  24,  2004  (Incorporated  by  reference  to
Exhibit 10.6 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30,
2011)*

10.26

10.27

10.28

Contract  Stock/Units  Agreement  dated  as  of  May  17,  2011  between  the  Company  and
Stuart M. Essig (Incorporated by reference to Exhibit 10.2 to the Company’s Current Report
on Form 8-K filed on May 23, 2011)*

Form  of  Amendment  2011-1  to  Contract  Stock/Restricted  Units  Agreements  between  the
Company  and  Mr.  Essig  (Incorporated  by  reference  to  Exhibit  10.5  to  the  Company’s
Quarterly Report on Form 10-Q for the quarter ended June 30, 2011)*

Form  of  Stock  Option  Grant  and  Agreement  between  the  Company  and  Stuart  M.  Essig
(Incorporated by reference to Exhibit 10.32 to the Company’s Annual Report on Form 10-K
for  the year ended December 31, 2004)*

10.29(a)

Form  of  Contract  Stock/Restricted  Units  Agreement  for  Stuart  M.  Essig  (Incorporated  by
reference to Exhibit 10.8 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2008)*

10.29(b) New  Form  of  Contract  Stock/Restricted  Units  Agreement  (for  Annual  Equity  Awards)  for
Stuart  M.  Essig  (Incorporated  by  reference  to  Exhibit  10.28(b)  to  the  Company’s  Annual
Report on Form 10-K for the year ended December  31, 2010)*

10.29(c)

Form  of  Amendment  2011-1  to  Contract  Stock/Restricted  Units  Agreement  betweeen  the
Company  and  Mr.  Essig  (Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s
Quarterly Report on Form 10-Q for the quarter ended June 30, 2011)*

10.30

10.31

10.32

10.33

10.34

10.35

10.36

Form  of  Performance  Stock  Agreement  for  Stuart  M.  Essig  (Incorporated  by  reference  to
Exhibit 10.9 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30,
2008)*

Form of Restricted Stock Agreement for Stuart M. Essig for 2009 (Incorporated by reference
to Exhibit 10.3 to the Company’s Current Report on Form  8-K filed April 13, 2009)*

New Form of Contract Stock/Restricted Units Agreement pursuant to 2003 Equity Incentive
Plan  (for  2011)  Annual  Equity  Award  for  Stuart  M.  Essig)  (Incorporated  by  reference  to
Exhibit 10.3 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30,
2011)*

Form  of  Notice  of  Grant  of  Stock  Option  and  Stock  Option  Agreement  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  July  29,
2005)*

Form of Non-Qualified Stock Option Agreement (Non-Directors) (Incorporated by reference
to  Exhibit  10.35  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2004)*

Form  of  Incentive  Stock  Option  Agreement  (Incorporated  by  reference  to  Exhibit  10.36  to
the Company’s Annual Report on Form 10-K for  the year  ended December 31, 2004)*

Form  of  Non-Qualified  Stock  Option  Agreement  (Directors)  (Incorporated  by  reference  to
Exhibit  10.37  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2004)*

10.37(a)

Compensation  of  Directors  of  the  Company  effective  May  17,  2011  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 16, 2010)*

67

10.37(b)

10.37(c)

10.38(a)

Compensation  of  Non-Employee  Directors  of  the  Company  effective  May  17,  2012
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed on April 13, 2012)*

Compensation  of  Non-Employee  Directors  of  the  Company  effective  May  22,  2013
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed on December 14, 2012)*

Form  of  Restricted  Stock  Agreement  for  Non-Employee  Directors  under  the  2003  Equity
Incentive Plan (Incorporated by reference to Exhibit 10.4 to the Company’s Quarterly Report
on Form 10-Q for the quarter ended June 30, 2012)*

10.38(b) New  Form  of  Restricted  Stock  Agreement  for  Non-Employee  Directors  under  the  2003

Equity Incentive Plan*+

10.38(c)

10.38(d)

Form of Restricted Stock Agreement for Executive Officers — Annual Vesting (Incorporated
by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
February 25, 2009)*

Form of Restricted Stock Agreement for Executive Officers — Annual Vesting (Incorporated
by reference to Exhibit 10.5 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2012)*

10.38(e) New Form of Restricted Stock Agreement for  Executive Officers — Annual  Vesting*+

10.38(f)

10.38(g)

Form of Restricted Stock Agreement for Executive Officers — Cliff Vesting (Incorporated by
reference  to  Exhibit  10.8  to  the  Company’s  Quarter  Report  on  Form  10-Q  for  the  quarter
ended March 31, 2009)*

Form of Restricted Stock Agreement for Executive Officers — Cliff Vesting (Incorporated by
reference  to  Exhibit  10.6  to  the  Company’s  quarterly  report  on  Form  10-Q  for  the  quarter
ended June 30, 2012)*

10.38(h) New Form of Restricted Stock Agreement for  Executive Officers — Cliff  Vesting*+

10.38(i)

10.38(j)

10.38(k)

10.38(l)

Form of Restricted Stock Agreement for Mr. Henneman for 2008 and 2009 (Incorporated by
reference  to  Exhibit  10.6  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  April  13,
2009)*

Form of Contract Stock/Restricted Units Agreement pursuant to 2003 Equity Incentive Plan
for  Mr.  Henneman  (Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s  Current
Report on Form 8-K filed on December  24, 2008)*

Form  of  Option  Agreement  for  John  B.  Henneman,  III  (Incorporated  by  reference  to
Exhibit 10.1 to the Company’s Current Report on Form 8-K  filed on June 6, 2008)*

Form  of  Performance  Stock  Agreement  for  John  B.  Henneman,  III  (Incorporated  by
reference  to  Exhibit  10.37(b)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2007)*

10.38(m) Form  of  Contract  Stock/Restricted  Units  Agreement  (for  Signing  Grant)  for  Mr.  Arduini
(Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s  Current  Report  on  Form  8-K
filed on October 12, 2010)*

10.38(n)

Form  of  Contract  Stock/Restricted  Units  Agreement  (for  Annual  Equity  Awards)  for
Mr. Arduini (Incorporated by reference to Exhibit 10.5 to the Company’s Current Report on
Form 8-K filed on October 12, 2010)*

10.38(o)

Form of Non-Qualified Stock Option Agreement for Mr. Arduini (Incorporated by reference
to  Exhibit  10.6  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  October  12,  2010)*

68

10.38(p)

10.38(q)

Form  of  Restricted  Stock  Agreement  for  Mr.  Henneman  (Incorporated  by  reference  to
Exhibit 10.7 to the Company’s Current Report on Form 8-K  filed on October 12, 2010)*

Form of Restricted Stock Agreement (Annual Vesting) for Mr. Henneman (Incorporated by
reference  to  Exhibit  10.39(n)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2011) *

10.39

10.40

10.41

10.42

10.43

10.44

10.45

10.46

10.47

10.48

10.49

Asset Purchase Agreement, dated as of September 7, 2005, by and between Tyco Healthcare
Group  LP  and  Sherwood  Services,  AG  and  Integra  LifeSciences  Corporation  and  Integra
LifeSciences (Ireland) Limited (Incorporated by reference to Exhibit 10.1 to the Company’s
Current Report on Form 8-K filed on September  13, 2005)

Stock Purchase Agreement, dated as of April 19, 2006, by and between ASP/Miltex LLC and
Integra  LifeSciences  Corporation  (Incorporated  by  reference  to  Exhibit  10.1  to  the
Company’s Current Report on Form 8-K filed on  April  25, 2006)

Stock  Agreement  and  Plan  of  Merger,  dated  as  of  June  30,  2006,  by  and  between  Integra
LifeSciences  Corporation,  Integra  California,  Inc.,  Kinetikos  Medical,  Inc.,  Telegraph  Hill
Partners  Management  LLC,  as  Shareholders  Representative,  and  the  Shareholders  party
thereto  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on
Form 8-K filed on July 7, 2006)

Amended  and  Restated  Management  Incentive  Compensation  Plan,  as  of  January  1,  2008
(Incorporated  by  reference  to  Exhibit  10.43(c)  to  the  Company’s  Annual  Report  on
Form 10-K for the year ended December 31, 2007)*

Form  of  2010  Convertible  Bond  Hedge  Transaction  Confirmation,  dated  June  6,  2007,
between Integra LifeSciences Holdings Corporation and dealer (Incorporated by reference to
Exhibit 10.1 to the Company’s Current Report on Form 8-K  filed on June 12, 2007)

Form  of  2012  Convertible  Bond  Hedge  Transaction  Confirmation,  dated  June  6,  2007,
between Integra LifeSciences Holdings Corporation and dealer (Incorporated by reference to
Exhibit 10.2 to the Company’s Current Report on Form 8-K  filed on June 12, 2007)

Form of 2010 Amended and Restated Issuer Warrant Transaction Confirmation, dated June 6,
2007,  between  Integra  LifeSciences  Holdings  Corporation  and  dealer  (Incorporated  by
reference  to  Exhibit  10.3  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  June  12,
2007)

Form of 2012 Amended and Restated Issuer Warrant Transaction Confirmation, dated June 6,
2007,  between  Integra  LifeSciences  Holdings  Corporation  and  dealer  (Incorporated  by
reference  to  Exhibit  10.4  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  June  12,
2007)

Letter  Agreement,  dated  June  9,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Call  Option  Transaction
(Incorporated by reference to Exhibit 10.4 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  9,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences  Holdings  Corporation,  regarding 
the  Base  Call  Option  Transaction
(Incorporated by reference to Exhibit 10.8 to the Company’s Form 8-K filed on June 15, 2011)

Letter Agreement, dated June 9, 2011, between The Royal Bank of Scotland plc and Integra
LifeSciences  Holdings  Corporation,  regarding 
the  Base  Call  Option  Transaction
(Incorporated by reference to Exhibit 10.6 to the Company’s Form 8-K filed on June 15, 2011)

69

10.50

10.51

10.52

10.53

10.54

10.55

10.56

10.57

10.58

10.59

10.60

10.61

10.62

Letter Agreement, dated June 9, 2011, between Wells Fargo Bank, National Association and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Call  Option  Transaction
(Incorporated by reference to Exhibit 10.2 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  9,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Warrant  Transaction
(Incorporated by reference to Exhibit 10.3 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  9,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences Holdings Corporation, regarding the Base Warrant Transaction (Incorporated by
reference to Exhibit 10.7 to the Company’s  Form 8-K filed  on June 15,  2011)

Letter Agreement, dated June 9, 2011, between The Royal Bank of Scotland plc and Integra
LifeSciences Holdings Corporation, regarding the Base Warrant Transaction (Incorporated by
reference to Exhibit 10.5 to the Company’s  Form 8-K filed  on June 15,  2011)

Letter Agreement, dated June 9, 2011, between Wells Fargo Bank, National Association and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Warrant  Transaction
(Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  14,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra LifeSciences Holdings Corporation, regarding the Additional Call Option Transaction
(Incorporated by reference to Exhibit 10.9 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  14,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences  Holdings  Corporation,  regarding  the  Additional  Call  Option  Transaction
(Incorporated  by  reference  to  Exhibit  10.10  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter Agreement, dated June 14, 2011, between The Royal Bank of Scotland plc and Integra
LifeSciences  Holdings  Corporation,  regarding  the  Additional  Call  Option  Transaction
(Incorporated  by  reference  to  Exhibit  10.11  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter Agreement, dated June 14, 2011, between Wells Fargo Bank, National Association and
Integra LifeSciences Holdings Corporation, regarding the Additional Call Option Transaction
(Incorporated  by  reference  to  Exhibit  10.12  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter  Agreement,  dated  June  14,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.13  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter  Agreement,  dated  June  14,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences  Holdings  Corporation,  regarding 
the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.14  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter Agreement, dated June 14, 2011, between The Royal Bank of Scotland plc and Integra
LifeSciences  Holdings  Corporation,  regarding 
the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.15  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter Agreement, dated June 14, 2011, between Wells Fargo Bank, National Association and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.16  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

70

10.63

10.64

10.65

Unit  Purchase  Agreement,  dated  as  of  July  23,  2008,  by  and  among  Integra  LifeSciences
Holdings  Corporation,  Theken  Spine  LLC,  Randall  R.  Theken  and  the  other  members  of
Theken  Spine,  LLC  party  thereto  (Incorporated  by  reference  to  Exhibit  10.1  to  the
Company’s Current Report on Form 8-K filed on  July  24, 2008)

Form of Indemnification Agreement for Non-Employee Directors and Officers (Incorporated
by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 24, 2008)*

Piggyback  Registration  Rights  Agreement  dated  December  22,  2008  between  Integra
LifeSciences Holdings Corporation and George Heenan, Thomas Gilliam and Michael Evers,
as  trustees  of  The  Bruce  A.  LeVahn  2008  Trust  and  Steven  M.  LeVahn  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 29, 2008)

10.66(a)

10.66(b)

Lease  Agreement  between  109  Morgan  Lane,  LLC  and  Integra  LifeSciences  Corporation,
dated May 15, 2008 (Incorporated by reference to Exhibit 10.10 to the Company’s Quarterly
Report on Form 10-Q for the quarter ended June 30, 2008)

First  Amendment  to  Lease  Agreement  between  109  Morgan  Lane,  LLC  and  Integra
LifeSciences Corporation, dated March 9, 2009 (Incorporated by reference to Exhibit 10.9 to
the Company’s Quarterly Report on Form 10-Q  for the quarter ended  March 31, 2009)

18

21

23

31.1

31.2

32.1

32.2

99.1

99.2

99.3

Preferability  Letter  of  Independent  Public  Accounting  Firm  dated  July  31,  2012
(Incorporated by reference to Exhibit 18.1 to the Company’s Quarterly Report on Form 10-Q
for  the quarter ended June 30, 2012)

Subsidiaries of the Company+

Consent of Pricewaterhouse Coopers LLP+

Certification  of  Principal  Executive  Officer  Pursuant  to  Section  302  of  the  Sarbanes-Oxley
Act of 2002+

Certification of Principal Financial Officer Pursuant to Section 302 of the Sarbanes-Oxley Act
of 2002+

Certification  of  Principal  Executive  Officer  Pursuant  to  Section  906  of  the  Sarbanes-Oxley
Act of 2002+

Certification of Principal Financial Officer Pursuant to Section 906 of the Sarbanes-Oxley Act
of 2002+

Letter, dated December 21, 2011, from the United States Food and Drug Administration to
Integra  LifeSciences  Corporation  (Incorporated  by  reference  to  Exhibit  99.1  to  the
Company’s Current Report on Form 8-K filed on  January 5,  2012)

Food and Drug Administration Form FDA-483, dated July 30, 2012, relating to inspection of
Plainsboro,  NJ  manufacturing  facility  (Incorporated  by  reference  to  Exhibit  99.1  to  the
Company’s Quarterly Report on Form 10-Q for  the quarter ended  June  30, 2012)

Letter,  dated  November  1,  2012,  from  the  United  States  Food  and  Drug  Administration  to
Integra  NeuroSciences  Ltd.  (Incorporated  by  reference  to  Exhibit  99.1  to  the  Company’s
Current Report on Form 8-K filed on November 13, 2012)

101.INS

XBRL Instance Document+#

101.SCH

XBRL Taxonomy Extension  Schema Document+#

101.CAL

XBRL Taxonomy Extension  Calculation Linkbase  Document+#

71

101.DEF

XBRL Definition Linkbase  Document

101.LAB

XBRL Taxonomy Extension  Labels Linkbase Document+#

101.PRE

XBRL Taxonomy Extension  Presentation Linkbase Document+#

*

Indicates a management contract or compensatory plan or arrangement.

+ Indicates this document is filed as an  exhibit  herewith.

# The  financial  information  of  Integra  LifeSciences  Holdings  Corporation  Annual  Report  on
Form  10-K  for  the  year  ended  December  31,  2012  filed  on  February  26,  2013  formatted  in  XBRL
(Extensible  Business  Reporting  Language):  (i)  the  Consolidated  Statements  of  Operations,  (ii)  the
Consolidated  Balance  Sheets,  (iii)  Parenthetical  Data  to  the  Consolidated  Balance  Sheets,  (iv)  the
Consolidated Statements of Cash Flows, (v) the Consolidated Statements of Changes in Stockholders’
Equity,  and (vi) Notes to Consolidated Financial Statements, is  furnished electronically herewith.

The  Company’s  Commission  File  Number  for  Reports  on  Form  10-K,  Form  10-Q  and  Form  8-K  is

0-26224.

72

Pursuant to the requirements of Section 13 of the Securities Exchange Act of 1934, the registrant has

duly caused this report to be signed on  its behalf by  the undersigned, thereunto duly authorized.

SIGNATURES

INTEGRA LIFESCIENCES HOLDINGS
CORPORATION

By: /s/ Peter J. Arduini

Peter J. Arduini
President and Chief Executive Officer

Date: February 26, 2013

Pursuant  to  the  requirements  of  the  Securities  Exchange  Act  of  1934,  this  report  has  been  signed

below by the following persons, on behalf of  the registrant in the capacities indicated.

Signature

Title

Date

/s/ Peter J.Arduini

Peter J. Arduini

President and Chief Executive Officer,
and Director (Principal Executive
Officer)

February 26,  2013

/s/ John B. Henneman, III

John B. Henneman, III

Corporate Vice President, Finance and
Administration, and Chief Financial
Officer
(Principal Financial Officer)

February 26, 2013

/s/ Jerry E. Corbin

Jerry  E. Corbin

/s/ Stuart M. Essig

Stuart M. Essig

/s/ Richard E. Caruso, Ph.D.

Richard E. Caruso, Ph.D.

/s/ Keith Bradley, Ph.D.

Keith Bradley, Ph.D.

Corporate Vice President and
Corporate Controller
(Principal Accounting Officer)

February  26, 2013

Chairman of the Board

February 26, 2013

Director

February 26, 2013

Director

February 26, 2013

73

Signature

Title

Date

/s/ Neal Moszkowski

Neal Moszkowski

/s/ Raymond G. Murphy

Raymond G. Murphy

/s/ Christian Schade

Christian Schade

/s/ James M. Sullivan

James M. Sullivan

/s/ Anne M. VanLent

Anne M. VanLent

Director

February 26, 2013

Director

February 26, 2013

Director

February 26, 2013

Director

February 26, 2013

Director

February 26, 2013

74

REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Board of Directors and Stockholders  of
Integra LifeSciences Holdings Corporation:

In our opinion, the consolidated balance sheets and the related consolidated statements of operations,
comprehensive  income,  changes  in  stockholders’  equity  and  cash  flows  present  fairly,  in  all  material
respects,  the  financial  position  of  Integra  LifeSciences  Holdings  Corporation  and  its  subsidiaries  at
December 31, 2012 and 2011, and the results of their operations and their cash flows for each of the three
years in the period ended December 31, 2012 in conformity with accounting principles generally accepted
in  the  United  States  of  America.  In  addition,  in  our  opinion,  the  financial  statement  Schedule  II  —
Valuation  and  Qualifying  Accounts  presents  fairly,  in  all  material  respects,  the  information  set  forth
therein when read in conjunction with the related consolidated financial statements. Also in our opinion,
the Company maintained, in all material respects, effective internal control over financial reporting as of
December 31, 2012, based on criteria established in Internal Control — Integrated Framework issued by
the  Committee  of  Sponsoring  Organizations  of  the  Treadway  Commission  (COSO).  The  Company’s
management is responsible for these financial statements and financial statement schedule, for maintaining
effective  internal  control  over  financial  reporting  and  for  its  assessment  of  the  effectiveness  of  internal
control  over  financial  reporting,  included  in  Management’s  Report  on  Internal  Control  Over  Financial
Reporting  appearing  under  Item  9A.  Our  responsibility  is  to  express  opinions  on  these  financial
statements,  on  the  financial  statement  schedule,  and  on  the  Company’s  internal  control  over  financial
reporting based on our integrated audits. We conducted our audits in accordance with the standards of the
Public Company Accounting Oversight Board (United States). Those standards require that we plan and
perform  the  audits  to  obtain  reasonable  assurance  about  whether  the  financial  statements  are  free  of
material misstatement and whether effective internal control over financial reporting was maintained in all
material  respects.  Our  audits  of  the  financial  statements  included  examining,  on  a  test  basis,  evidence
supporting  the  amounts  and  disclosures  in  the  financial  statements,  assessing  the  accounting  principles
used  and  significant  estimates  made  by  management,  and  evaluating  the  overall  financial  statement
presentation. Our audit of internal control over financial reporting included obtaining an understanding of
internal control over financial reporting, assessing the risk that a material weakness exists, and testing and
evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits
also  included  performing  such  other  procedures  as  we  considered  necessary  in  the  circumstances.  We
believe that our audits provide a reasonable  basis for our opinions.

A  company’s  internal  control  over  financial  reporting  is  a  process  designed  to  provide  reasonable
assurance  regarding  the  reliability  of  financial  reporting  and  the  preparation  of  financial  statements  for
external  purposes  in  accordance  with  generally  accepted  accounting  principles.  A  company’s  internal
control over financial reporting includes those policies and procedures that (i) pertain to the maintenance
of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the  transactions  and  dispositions  of  the
assets  of  the  company;  (ii)  provide  reasonable  assurance  that  transactions  are  recorded  as  necessary  to
permit  preparation  of  financial  statements  in  accordance  with  generally  accepted  accounting  principles,
and that receipts and expenditures of the company are being made only in accordance with authorizations
of management and directors of the company; and (iii) provide reasonable assurance regarding prevention
or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have
a material effect on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect
misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk
that controls may become inadequate because of changes in conditions, or that the degree of compliance
with the policies or procedures may deteriorate.

/s/ PricewaterhouseCoopers LLP

Florham Park, New Jersey
February 25, 2013

F-1

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

CONSOLIDATED STATEMENTS OF OPERATIONS

Years Ended December 31,

2012

2011

2010

Total revenue, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $830,871

(In thousands, except per share amounts)
$732,068
$780,078

Costs and Expenses:

Cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

314,427

299,150

268,188

Research and development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

51,012

51,451

48,114

Selling, general and administrative . . . . . . . . . . . . . . . . . . . . . . . . .

373,114

358,132

305,055

Intangible asset amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18,536

16,433

12,017

Total costs  and expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

757,089

725,166

633,374

Operating income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

73,782

54,912

98,694

Interest income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,205

465

225

Interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(22,237)

(27,640)

(18,356)

Other income (expense), net

. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(721)

757

1,551

Income before income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

52,029

28,494

Provision for income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10,825

505

82,114

16,445

Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,204

$ 27,989

$ 65,669

Basic net income per common share . . . . . . . . . . . . . . . . . . . . . . $

Diluted net income per common share . . . . . . . . . . . . . . . . . . . . $

1.46

1.44

$

$

0.97

0.95

$

$

2.21

2.17

Weighted average common shares outstanding  (See Note 11):

Basic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

28,232

Diluted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

28,516

28,952

29,495

29,548

30,149

The accompanying notes are an integral part of these  condensed  consolidated financial statements.

F-2

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME

Years Ended December 31,

2012

2011

2010

Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $41,204

(In thousands)
$27,989

$ 65,669

Other comprehensive income, before tax

Foreign currency translation adjustments . . . . . . . . . . . . . . . . . . . . . . .

5,224

(5,624)

(10,616)

Unrealized gain/(loss) on derivatives

Unrealized derivative gains/(losses) arising during period . . . . . . . . .

(2,062)

(6,306)

2,486

Less: Reclassification adjustments for  gains/(losses) included in net

income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(2,210)

(2,269)

2,782

Unrealized gain/(loss) on derivatives . . . . . . . . . . . . . . . . . . . . . . . . . .

148

(4,037)

(296)

Defined benefit pension plan

Net gain/(loss) arising during period . . . . . . . . . . . . . . . . . . . . . . . .

(1,313)

Defined benefit pension plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1,313)

861

861

329

329

Total other comprehensive income (loss),  before tax . . . . . . . . . . . . . . . .

4,059

(8,800)

(10,583)

Income tax (expense) benefit related to items in other

comprehensive income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

237

1,502

(117)

Total other comprehensive income (loss),  net of tax . . . . . . . . . . . . . . . .

4,296

(7,298)

(10,700)

Comprehensive income, net of tax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $45,500

$20,691

$ 54,969

The accompanying notes are an integral part of these  condensed  consolidated financial statements.

F-3

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

CONSOLIDATED BALANCE SHEETS

December 31,
2012

December 31,
2011

(In thousands)

Current Assets:

ASSETS

Cash and cash equivalents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Trade accounts receivable, net of allowances of $7,221  and $6,978 . . . . . . . .
Inventories, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prepaid expenses and other current assets . . . . . . . . . . . . . . . . . . . . . . . . .

Total current assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property, plant and equipment, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Intangible assets, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Goodwill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

96,938
114,916
171,806
39,100
30,291

453,051
177,898
212,267
294,067
15,957
10,359

$ 100,808
118,129
171,261
36,155
25,904

452,257
131,383
237,122
292,980
17,239
13,128

Total assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,163,599

$1,144,109

Current Liabilities:

LIABILITIES AND STOCKHOLDERS’ EQUITY

Accounts payable, trade . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Deferred revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accrued compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accrued expenses and other current  liabilities . . . . . . . . . . . . . . . . . . . . . .

Total current liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Long-term borrowings under senior credit facility . . . . . . . . . . . . . . . . . . .
Long-term convertible securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

36,742
3,505
34,914
31,768

106,929
321,875
197,672
5,393
13,955

$

27,656
4,543
28,010
41,659

101,868
179,688
352,576
5,726
11,613

Total liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 645,824

$ 651,471

Commitments and contingencies
Stockholders’ Equity:

Preferred Stock; no par value; 15,000  authorized shares; none outstanding
Common stock; $0.01 par value; 60,000  authorized shares; 36,852 and

35,734 issued at December 31, 2012 and 2011,  respectively . . . . . . . . . . .
Additional paid-in capital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Treasury stock, at cost; 8,903 shares at December 31, 2012  and 2011,

369
587,301

357
607,676

respectively . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(367,121)

(367,121)

Accumulated other comprehensive income (loss):

Foreign currency translation adjustment . . . . . . . . . . . . . . . . . . . . . . . . .
Pension liability adjustment, net of tax . . . . . . . . . . . . . . . . . . . . . . . . . .
Unrealized (loss) gain on derivatives, net  of tax . . . . . . . . . . . . . . . . . . .
Retained earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(1,270)
(1,154)
(2,373)
302,023

Total stockholders’ equity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

517,775

(6,494)
(131)
(2,468)
260,819

492,638

Total liabilities and stockholders’ equity . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1,163,599

$1,144,109

The accompanying notes are an integral part of these  condensed  consolidated financial statements.

F-4

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

CONSOLIDATED STATEMENTS OF CASH FLOWS

Years Ended December 31,

2012

2011

2010

(In thousands)

OPERATING ACTIVITIES:

Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 41,204
Adjustments to reconcile  net income  to  net cash  provided  by operating

$ 27,989

$ 65,669

activities:
Depreciation and amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred income tax provision (benefit) . . . . . . . . . . . . . . . . . . . . . . . . .
Share-based compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amortization of debt issuance costs . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Non-cash interest expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Payment of accreted interest
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Loss on disposal of property and equipment . . . . . . . . . . . . . . . . . . . . . .
Excess tax benefits from stock-based compensation arrangements
. . . . . . .
Other, net . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Changes in assets and liabilities,  net  of  business acquisitions:

Accounts receivable . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inventories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prepaid expenses and other current assets . . . . . . . . . . . . . . . . . . . . . .
Other non-current assets
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accounts payable, accrued expenses and  other current  liabilities . . . . . . .
Deferred revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other non-current liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

52,611
1,537
9,051
2,725
8,520
(30,617)
1,312
(3,634)

3,783
(711)
(3,067)
(938)
(21,071)
(1,051)
(939)

50,172
1,156
26,805
3,387
10,591
—
—
(848)
164

(1,878)
1,702
(395)
375
(11,842)
104
(3,154)

39,172
4,128
17,209
1,490
7,125
(6,599)
—
(3,580)
(3)

(3,783)
(7,374)
(6,452)
(179)
6,736
(457)
(7,531)

Net cash provided by operating activities . . . . . . . . . . . . . . . . . . . . . . . . . . $ 58,715

$ 104,328

$105,571

INVESTING ACTIVITIES:

Cash used in business acquisitions, net of cash acquired . . . . . . . . . . . . . . .
Purchases of property and equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Purchases of short-term investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Maturities of short-term investments . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(7,278)
(69,031)
(67,907)
64,940

(151,951)
(38,425)
—
—

(5,178)
(37,138)
—
—

Net cash used in  investing activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ (79,276) $(190,376) $ (42,316)

FINANCING ACTIVITIES:

Borrowings under senior credit facility . . . . . . . . . . . . . . . . . . . . . . . . . . .
Repayments under  senior  credit facility . . . . . . . . . . . . . . . . . . . . . . . . . . .
Proceeds from liability component of convertible notes . . . . . . . . . . . . . . . .
Proceeds from equity component of convertible  notes . . . . . . . . . . . . . . . . .
Proceeds from sale of stock purchase warrants . . . . . . . . . . . . . . . . . . . . . .
Purchase of option hedge on convertible  notes . . . . . . . . . . . . . . . . . . . . . .
Payment of liability component of convertible notes . . . . . . . . . . . . . . . . . .
Debt  issuance costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Purchases of treasury stock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Proceeds from exercised stock options
. . . . . . . . . . . . . . . . . . . . . . . . . . .
Excess tax benefits from stock-based compensation  arrangements . . . . . . . . .

155,000
(12,812)
—
—
—
—
(134,383)
—
—
696
3,634

145,000
(213,437)
186,830
43,170
28,451
(42,895)

105,000
(16,875)
—
—
—
—
— (71,351)
(6,796)
(31,278)
16,146
3,580

(8,064)
(83,463)
3,697
848

Net cash provided by (used in) financing  activities . . . . . . . . . . . . . . . . . . $ 12,135

$ 60,137

$ (1,574)

Effect of exchange rate changes on cash and cash  equivalents . . . . . . . . . . . . .

4,556

(2,044)

(4,809)

Net increase (decrease) in cash and cash equivalents . . . . . . . . . . . . . . . . . . .
Cash and cash equivalents at beginning of  period . . . . . . . . . . . . . . . . . . . . .

(3,870)
100,808

(27,955)
128,763

56,872
71,891

Cash and cash equivalents at end of period . . . . . . . . . . . . . . . . . . . . . . . . . $ 96,938

$ 100,808

$128,763

The accompanying notes are an integral part of these  condensed  consolidated financial statements.

F-5

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

CONSOLIDATED STATEMENTS OF  CHANGES IN STOCKHOLDERS’ EQUITY

Common  Stock

Treasury  Stock

Shares

Amount

Shares

Amount

Additional
Paid-In
Capital

Accumulated
Other
Comprehensive
Income (Loss)

Retained
Earnings

Total
Equity

(In thousands)
Balance, December 31, 2009 . . . . . . . . 34,740 $347 (6,136) $(252,380) $520,852

$ 8,905

$167,161 $444,885

Net income . . . . . . . . . . . . . . . . . . .

Total comprehensive income (loss) . . . .

65,669

65,669

(10,700)

(10,700)

Issuance of common stock through

employee benefit plans . . . . . . . . . .

787

8

Share-based compensation . . . . . . . . .

— —

—

—

— 10,610

— 20,769

—

—

Repurchase of common  stock . . . . . . .

(858)

(31,278)

— 10,618

— 20,769

(31,278)

Balance, December 31, 2010 . . . . . . . . 35,527 $355 (6,994) $(283,658) $552,231

$ (1,795) $232,830 $499,963

Net Income . . . . . . . . . . . . . . . . . . .

— —

—

—

—

27,989

27,989

Total comprehensive income (loss) . . . .

(7,298)

(7,298)

Proceeds from equity component on

convertible notes . . . . . . . . . . . . . .

— —

Proceeds from sale of stock purchase

warrants . . . . . . . . . . . . . . . . . . . .

— —

Purchase of option hedge on

convertible notes . . . . . . . . . . . . . .

— —

Equity portion of convertible notes

issuance costs

. . . . . . . . . . . . . . . .

— —

Issuance of common stock through

employee benefit plans . . . . . . . . . .

207

2

Share-based compensation . . . . . . . . .

— —

—

—

—

—

—

—

— 43,170

— 28,451

— (42,895)

— (1,334)

—

374

— 27,679

Repurchase of common  stock . . . . . . .

— — (1,909)

(83,463)

—

—

—

—

—

—

—

—

— 43,170

— 28,451

— (42,895)

— (1,334)

—

376

— 27,679

— (83,463)

Balance, December 31, 2011 . . . . . . . . 35,734 $357 (8,903) $(367,121) $607,676

$ (9,093) $260,819 $492,638

Net Income . . . . . . . . . . . . . . . . . . .

— —

—

—

—

—

41,204

41,204

Total comprehensive income (loss) . . . .

4,296

4,296

Issuance of common stock through

employee benefit plans . . . . . . . . . .

9

Share-based compensation . . . . . . . . . 1,109

1

11

250

(20,625)

251

(20,614)

Repurchase of common  stock . . . . . . .

— —

—

—

—

—

—

—

Balance, December 31, 2012 . . . . . . . . 36,852 $369 (8,903) $(367,121) $587,301

$ (4,797) $302,023 $517,775

The accompanying notes are an integral part of these  condensed  consolidated financial statements.

F-6

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS

1. BUSINESS

Integra LifeSciences Holdings Corporation (the ‘‘Company’’) was incorporated in Delaware in 1989.
The Company, a world leader in medical devices, is dedicated to limiting uncertainty for surgeons through
the  development,  manufacturing,  and  marketing  of  cost-effective  surgical  implants  and  medical
instruments.  Its  products  are  used  primarily  in  neurosurgery,  extremity  reconstruction,  orthopedics  and
general surgery.

The  Company  sells  its  products  directly  through  various  sales  forces  and  through  a  variety  of  other

distribution channels.

2.

SUMMARY OF SIGNIFICANT  ACCOUNTING  POLICIES

BASIS OF PRESENTATION

These financial statements and the accompanying notes are prepared in accordance with accounting
principles generally accepted in the United States of America and conform to Regulation S-X under the
Securities Exchange Act of 1934, as amended.

PRINCIPLES OF CONSOLIDATION

The consolidated financial statements include the accounts of the Company and its subsidiaries, all of
which  are  wholly  owned.  All  significant  intercompany  accounts  and  transactions  are  eliminated  in
consolidation. See Note 3, ‘‘Acquisitions and Pro Forma Results’’, for details of new subsidiaries included
in the consolidation.

USE OF ESTIMATES

The  preparation  of  consolidated  financial  statements  in  conformity  with  generally  accepted
accounting  principles  requires  management  to  make  estimates  and  assumptions  that  affect  the  reported
amount  of  assets  and  liabilities,  the  disclosure  of  contingent  liabilities,  and  the  reported  amounts  of
revenues and expenses. Significant estimates affecting amounts reported or disclosed in the consolidated
financial statements include allowances for doubtful accounts receivable and sales returns and allowances,
net realizable value of inventories, valuation of intangible assets and in-process research and development,
amortization periods for acquired intangible assets, discount rates and estimated projected cash flows used
to  value  and  test  impairments  of  long-lived  assets  and  goodwill,  estimates  of  projected  cash  flows,
depreciation  and  amortization  periods  for  long-lived  assets,  computation  of  taxes,  valuation  allowances
recorded  against  deferred  tax  assets,  the  valuation  of  stock-based  compensation,  valuation  of  pension
assets and liabilities, valuation of derivative instruments, valuation of the equity component of convertible
debt instruments, and valuation of debt instruments and loss contingencies. These estimates are based on
historical  experience  and  on  various  other  assumptions  that  are  believed  to  be  reasonable  under  the
current circumstances. Actual results  could differ from  these  estimates.

OUT-OF-PERIOD ADJUSTMENT

In  the  fourth  quarter  of  2012,  interest  expense  has  been  reduced  by  $3.3  million  for  the  cumulative
correction of immaterial errors in capitalized interest on our construction in progress balances related to
prior periods. The $3.3 million decrease in interest expense reflects (a) $1.5 million of interest expense that
should have been capitalized in previous quarters in 2012, and (b) $1.4 million and $0.4 million of interest
expense  that  should  have  been  capitalized  in  the  year  ended  December  31,  2011  and  2010,  respectively.
Based  upon  our  evaluation  of  relevant  factors  related  to  this  matter,  we  concluded  that  the  uncorrected
adjustments in our previously issued consolidated financial statements for any of the periods affected are

F-7

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

immaterial and that the impact of recording the cumulative correction in the fourth quarter of 2012 is not
material to our earnings for the full year  ending December  31, 2012.

RECLASSIFICATIONS

Certain amounts from the prior years’ financial statements have been reclassified in order to conform

to the current year’s presentation.

CASH AND CASH EQUIVALENTS

The Company considers all short-term, highly liquid investments purchased with original maturities of

three months or less to be cash equivalents.

TRADE ACCOUNTS RECEIVABLE AND ALLOWANCES FOR DOUBTFUL  ACCOUNTS RECEIVABLE

Trade  accounts  receivable  are  recorded  at  the  invoiced  amount  and  do  not  bear  interest.  The
Company  grants  credit  to  customers  in  the  normal  course  of  business,  but  generally  does  not  require
collateral or any other security to support  its  receivables.

The Company evaluates the collectability of accounts receivable based on a combination of factors. In
circumstances  where  a  specific  customer  is  unable  to  meet  its  financial  obligations  to  the  Company,  a
provision  to  the  allowances  for  doubtful  accounts  is  recorded  against  amounts  due  to  reduce  the  net
recognized receivable to the amount that is reasonably expected to be collected. For all other customers, a
provision to the allowances for doubtful accounts is recorded based on factors including the length of time
the  receivables  are  past  due,  the  current  business  environment  and  the  Company’s  historical  experience.
Provisions  to  the  allowances  for  doubtful  accounts  are  recorded  to  selling,  general  and  administrative
expenses. Account balances are charged off against the allowance when it is probable that the receivable
will not be recovered.

INVENTORIES

Inventories, consisting of purchased materials, direct labor and manufacturing overhead, are stated at
the lower of cost, the value determined by the first-in, first-out method, or market. Inventories consisted of
the following:

December 31,

2012

2011

(In thousands)

Finished goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $102,401
39,944
Work in process . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
29,461
Raw materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$106,972
36,070
28,219

Total inventories, net

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $171,806

$171,261

At each balance sheet date, the Company evaluates inventories for excess quantities, obsolescence or
shelf  life  expiration.  This  evaluation  includes  analysis  of  historical  sales  levels  by  product,  projections  of
future  demand,  the  risk  of  technological  or  competitive  obsolescence  for  products,  general  market
conditions, a review of the shelf life expiration dates for products, as well as the feasibility of reworking or
using excess or obsolete products or components in the production or assembly of other products that are
not  obsolete  or  for  which  there  are  not  excess  quantities  in  inventory.  To  the  extent  that  management
determines  there  are  excess  or  obsolete  inventory  or  quantities  with  a  shelf  life  that  is  too  near  its

F-8

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

expiration for the Company to reasonably expect that it can sell those products prior to their expiration,
the Company adjusts the carrying value to estimated net realizable value.

The Company capitalizes inventory costs associated with certain products prior to regulatory approval,
based on management’s judgment of probable future commercialization. The Company could be required
to expense previously capitalized costs related to pre-approval inventory upon a change in such judgment,
due  to,  among  other  potential  factors,  a  denial  or  delay  of  approval  by  necessary  regulatory  bodies  or  a
decision  by  management  to  discontinue  the  related  development  program.  No  such  amounts  were
capitalized at December 31, 2012 or  2011.

PROPERTY, PLANT AND EQUIPMENT

Property,  plant  and  equipment  are  stated  at  cost.  The  Company  provides  for  depreciation  using  the
straight-line method over the estimated useful lives of the assets. Leasehold improvements are amortized
over  the  lesser  of  the  lease  term  or  the  useful  life.  The  cost  of  major  additions  and  improvements  is
capitalized, while maintenance and repair costs that do not improve or extend the lives of the respective
assets  are  charged  to  operations  as  incurred.  The  cost  of  computer  software  developed  or  obtained  for
internal  use  is  accounted  for  in  accordance  with  the  Accounting  Standards  Codification  350-40,
Internal-Use Software.

Property, plant and equipment balances  and corresponding lives were  as follows:

December 31,

2012

2011

Useful Lives

Land . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Buildings and building improvements . . . . . . . . . . . . . . .
Leasehold improvements . . . . . . . . . . . . . . . . . . . . . . . .
Machinery and production equipment . . . . . . . . . . . . . . .
Furniture, fixtures, office equipment and information

$

(In thousands)
2,768
7,908
46,240
122,556

2,709
7,376
38,030
98,731

systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Construction-in-progress . . . . . . . . . . . . . . . . . . . . . . . .

57,837
79,639

52,363
52,965

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less: Accumulated depreciation . . . . . . . . . . . . . . . . . . .

316,948
(139,050)

252,174
(120,791)

Property, plant and equipment, net . . . . . . . . . . . . . . . . . $ 177,898

$ 131,383

5-40 years
1-20 years
3-20 years

1-15 years

Depreciation expense associated with property, plant and equipment was $27.5 million, $25.5 million

and $21.3 million for the years ended December 31, 2012,  2011 and  2010, respectively.

CAPITALIZED INTEREST

The  interest  cost  on  capital  projects,  including  facilities  build-out  and  internal  use  software,  is
capitalized and included in the cost of the project. Capitalization commences with the first expenditure for
the project and continues until the project is substantially complete and ready for its intended use. When
no  debt  is  incurred  specifically  for  a  project,  interest  is  capitalized  on  project  expenditures  using  the
weighted average cost of the Company’s outstanding borrowings. The Company capitalized $3.9 million of
interest expense into property, plant and equipment, of which $2.1 million , $1.4 million and $0.4 million
related to the first three quarters of 2012 and to the year ended December 31, 2011 and 2010, respectively.
See  Note  2  ‘‘Summary  of  Significant  Accounting  Policies  —  Out-of-Period  Adjustment’’  to  our
consolidated financial statements for  a further discussion.

F-9

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

GOODWILL AND  OTHER INTANGIBLE  ASSETS

The excess of the cost over the fair value of net assets of acquired businesses is recorded as goodwill.
Goodwill is not subject to amortization, but is reviewed for impairment at the reporting unit level annually,
or  more  frequently  if  impairment  indicators  arise.  The  Company’s  assessment  of  the  recoverability  of
goodwill  is  based  upon  a  comparison  of  the  carrying  value  of  goodwill  with  its  estimated  fair  value.  The
Company  revised  its  operating  segments  and  reporting  segments  in  connection  with  the  change  in  the
Company’s  Chief  Executive  Officer  (who  serves  as  the  Company’s  chief  operating  decision  maker)
effective  January  3,  2012.  As  a  result,  the  Company  reassigned  the  goodwill  to  these  new  reportable
segments based on the relative fair value of the Company’s eight underlying reporting units as of January 1,
2012.

Historically, goodwill was tested annually for impairment as of June 30 of each fiscal year. Effective in
the  quarter  ended  June  30,  2012,  the  Company  adopted  a  new  accounting  principle  whereby  the  annual
impairment  review  of  goodwill  will  be  performed  as  of  July  31  of  each  year.  The  change  in  the  annual
goodwill  impairment  testing  date  was  made  to  better  align  the  annual  goodwill  impairment  test  with  the
timing  of  the  Company’s  annual  strategic  planning  process.  In  line  with  this  change,  the  Company
performed an assessment of the goodwill in each of its reporting units during the first quarter of 2012. This
change in accounting principle does not delay, accelerate or avoid an impairment charge. Accordingly, the
Company believes that the change described  above is  preferable under  the circumstances.

On July 31, 2012, the Company performed the annual goodwill impairment test. The Company first
assessed  the  qualitative  factors  to  determine  whether  it  is  more  likely  than  not  that  the  fair  value  of  the
reporting units is less than their carrying amounts. The Company performed this qualitative assessment for
seven  reporting  units  that  each  had  an  estimated  fair  value  that  was  in  excess  of  its  carrying  value  by  a
significant amount. For each reporting unit, the Company weighed the relative impact of factors that are
specific  to  the  reporting  unit  as  well  as  industry  and  macroeconomic  factors.  The  reporting  unit  specific
factors that were considered included the results of the most recent impairment tests, as well as financial
performance and changes to the reporting units’ carrying amounts since the most recent impairment tests.
The Company concluded that each of the reporting unit specific and industry factors had either a positive
or neutral impact on their fair values. The Company also determined that macroeconomic factors during
2012 did not have a significant impact on the discount and growth rates used for the January 1 tests. Based
on the qualitative assessment, the Company concluded that for all reporting units, except U.S. Spine, it is
more likely than not that their carrying  values are  less than their fair  values  at July 31, 2012.

The  Company  performed  the  first  step  of  the  goodwill  impairment  test  for  its  U.S.  Spine  business.
This component has $31.7 million of allocated goodwill. As a result of the annual impairment assessment,
the Company determined that the fair value exceeded its carrying value by approximately 13% at July 31,
2012. However, if future results do not meet or exceed the Company’s forecasts, or if unfavorable changes
occur  in  the  weighted-average  cost  of  capital,  growth  assumptions  for  future  revenue,  terminal  value
growth rate and/or forecasted cash flows utilized in the discounted cash flow analysis, the Company may
record  an  impairment  of  this  goodwill  at  a  future  date.  No  impairment  of  goodwill  has  been  identified
during any of the periods presented.

F-10

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Changes in the carrying amount of goodwill in 2012 and 2011  were as follows:

Goodwill, gross . . . . . . . . . . . .
Accumulated impairment losses

Goodwill at December 31, 2011
SeaSpine, Inc. working capital

adjustment . . . . . . . . . . . . . .

Ascension Orthopedics, Inc.
working capital adjustment
and other . . . . . . . . . . . . . . .
Foreign currency translation . . .

U.S.
Neurosurgery

U.S.
Instruments

U.S.
Extremities

U.S.
Spine and
Other

International

Total

$93,913
—

$93,913

$57,270
—

$57,270

(In thousands)

$60,544
—

$55,693
—

$25,560
—

$292,980
—

$60,544

$55,693

$25,560

$292,980

289

399

244

(448)
257

237

109

289

(448)
1,246

Balance, December 31, 2012 . . .

$94,312

$57,514

$60,353

$56,219

$25,669

$294,067

Identifiable  intangible  assets  are  initially  recorded  at  fair  market  value  at  the  time  of  acquisition
generally  using  an  income  or  cost  approach.  The  Company  capitalizes  costs  incurred  to  renew  or  extend
the term of recognized intangible assets and amortizes those costs over  their expected useful  lives.

The components of the Company’s identifiable intangible assets were as  follows:

December 31, 2012

December  31, 2011

Weighted
Average
Life

Cost

Accumulated
Amortization

Net

Weighted
Average
Life

Cost

Accumulated
Amortization

Net

(Dollars in Thousands)

12 years $ 75,692
Completed technology . . . .
147,690
12 years
Customer relationships . . .
33,807
Trademarks/brand  names . .
30 years
48,484
Trademarks/brand  names . . Indefinite
34,721
27 years
Supplier relationships . . . .
4,519
4 years
All other(1) . . . . . . . . . . .

11  years $ 75,990
$ (38,402) $ 37,290
147,230
11  years
77,685
33,669
18,773
32  years
48,484
48,484 Indefinite
33,810
26 years
26,904
11,434
6 years
3,131

(70,005)
(15,034)
—
(7,817)
(1,388)

$ (32,157) $ 43,833
89,882
22,772
48,484
28,421
3,730

(57,348)
(10,897)
—
(5,389)
(7,704)

$344,913

$(132,646) $212,267

$350,617

$(113,495) $237,122

(1) At December 31, 2012 and 2011, all other included in-process research and development of $1.7 million, which
was indefinite lived. Additionally, the change in the cost and amortization of ‘‘All Other’’ reflects the write off of
fully amortized assets.

During the first quarter of 2012, the Company recorded impairment charges of $0.1 million in cost of
goods sold of its U.S. Neurosurgery segment related to technology assets whose related products are being
discontinued.  The  Company  performs  its  assessment  of  the  recoverability  of  indefinite-lived  intangible
assets  annually  during  the  second  quarter,  or  more  frequently  as  impairment  indicators  arise,  and  it  is
based upon a comparison of the carrying value of such assets to their estimated fair values. The Company
performed  its  most  recent  annual  assessment  during  the  second  quarter  of  2012,  which  resulted  in  no
additional impairments.

During the second quarter of 2011, the Company identified one indefinite-lived trade name asset that
it will no longer use as a result of its rebranding strategy, which resulted in an impairment of $0.9 million.
This charge has been recorded as a component of amortization  expense.

F-11

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

During the year ended December 31, 2011, the Company recorded impairment charges to finite-lived
intangible assets of $2.1 million related to technology assets whose related products are being discontinued
and $0.2 million related to a trade name that will no longer be used because of its rebranding strategy. The
Company  has  recorded  the  charges  as  a  component  of  cost  of  goods  sold  and  amortization  expense,
respectively.

During the year ended December 31, 2010, the Company recorded a $0.8 million impairment charge
to  finite-lived  intangible  assets  related  to  several  trade  names.  The  impairment  charge  relates  to
management’s decision with respect to the Company’s re-branding strategy for several legacy trade names.
The Company recorded the charge as a  component of  amortization expense.

Amortization  expense  for  the  years  ended  December  31,  2012,  2011  and  2010  was  $25.1  million,
$24.6  million  and  $17.9  million,  respectively.  Annual  amortization  expense  is  expected  to  approximate
$19.0 million in 2013, $18.1 million in 2014, $16.3 million in 2015, $14.0 million in 2016 and $12.1 million in
2017. Amortization of product technology based intangible assets, which totaled $6.6 million, $8.2 million
and $5.9 million for the years ended December 31, 2012, 2011 and 2010, respectively, is presented by the
Company within cost of goods sold.

LONG-LIVED ASSETS

Long-lived  assets  held  and  used  by  the  Company,  including  property,  plant  and  equipment  and
intangible assets, are reviewed for impairment whenever events or changes in circumstances indicate that
the carrying amount of an asset may not be recoverable. For purposes of evaluating the recoverability of
long-lived assets to be held and used, a recoverability test is performed using projected undiscounted net
cash  flows  applicable  to  the  long-lived  assets.  If  an  impairment  exists,  the  amount  of  such  impairment  is
calculated based on the estimated fair value of the asset. Impairments to long-lived assets to be disposed of
are  recorded  based  upon  the  difference  between  the  carrying  value  and  the  fair  value  of  the  applicable
assets.

INTEGRA FOUNDATION

The  Company  may  periodically  make  contributions  to  the  Integra  Foundation,  Inc.  The  Integra
Foundation  was  incorporated  in  2002  exclusively  for  charitable,  educational,  and  scientific  purposes  and
qualifies under IRC 501(c)(3) as an exempt private foundation. Under its charter, the Integra Foundation
engages in activities that promote health, the diagnosis and treatment of disease, and the development of
medical science through grants, contributions and other appropriate means. The Integra Foundation is a
separate legal entity and is not a subsidiary of the Company. Therefore, its results are not included in these
consolidated financial statements. The Company contributed $1.0 million, $0.3 million and $0.7 million to
the  Integra  Foundation  during  the  years  ended  December  31,  2012,  2011  and  2010,  respectively.  These
contributions were recorded in selling, general, and administrative expense.

DERIVATIVES

The  Company  develops,  manufactures,  and  sells  medical  devices  globally  and  its  earnings  and  cash
flows are exposed to market risk from changes in interest rates and currency exchange rates. The Company
addresses  these  risks  through  a  risk  management  program  that  includes  the  use  of  derivative  financial
instruments, and operates the program pursuant to documented corporate risk management policies. All
derivative financial instruments are recognized in the financial statements at fair value in accordance with
the authoritative guidance. Under the guidance, for those instruments that are designated and qualify as
hedging instruments, the hedging instrument must be designated as a fair value hedge, cash flow hedge, or
a hedge of a net investment in a foreign operation, based on the exposure being hedged. The accounting

F-12

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

for  changes  in  the  fair  value  of  a  derivative  instrument  depends  on  whether  it  has  been  designated  and
qualifies as part of a hedging relationship and, further, on the type of hedging relationship. The Company’s
derivative  instruments  do  not  subject  its  earnings  or  cash  flows  to  material  risk,  and  gains  and  losses  on
these derivatives generally offset losses and gains on the item being hedged. The Company has not entered
into derivative transactions for speculative purposes and from time to time, the Company may enter into
derivatives that are not designated as hedging instruments in order to protect itself from currency volatility
due to intercompany balances.

All  derivative  instruments  are  recognized  at  their  fair  values  as  either  assets  or  liabilities  on  the
balance sheet. The Company determines the fair value of its derivative instruments, using the framework
prescribed by the authoritative guidance, by considering the estimated amount the Company would receive
to  sell  or  transfer  these  instruments  at  the  reporting  date  and  by  taking  into  account:  expected  forward
interest  rates,  currency  exchange  rates,  the  creditworthiness  of  the  counterparty  for  assets,  and  its
creditworthiness for liabilities. In certain instances, the Company utilizes a discounted cash flow model to
measure  fair  value.  Generally,  the  Company  uses  inputs  that  include  quoted  prices  for  similar  assets  or
liabilities in active markets, other observable inputs for the asset or liability and inputs derived principally
from,  or  corroborated  by,  observable  market  data  by  correlation  or  other  means.  The  Company  has
classified  all  of  its  derivative  assets  and  liabilities  within  Level  2  of  the  fair  value  hierarchy  because
observable inputs are available for substantially the full term of its derivative instruments. The Company
classifies derivatives that meet the definition of hedges in the same category as the item being hedged for
cash flow presentation purposes.

FOREIGN CURRENCY

All assets and liabilities of foreign subsidiaries which have a functional currency other than the U.S.
dollar  are  translated  at  the  rate  of  exchange  at  year-end,  while  elements  of  the  income  statement  are
translated  at  the  average  exchange  rates  in  effect  during  the  year.  The  net  effect  of  these  translation
adjustments is shown as a component of accumulated other comprehensive income (loss). These currency
translation  adjustments  are  not  currently  adjusted  for  income  taxes  as  they  relate  to  permanent
investments in non-U.S. subsidiaries. Foreign currency transaction gains and losses are reported in Other
income (expense), net.

INCOME TAXES

Income taxes are accounted for by using the asset and liability method in accounting for income taxes.
Deferred tax assets and liabilities are recognized for the estimated future tax consequences attributable to
differences  between  the  financial  statement  carrying  amounts  of  existing  assets  and  liabilities  and  their
respective tax basis. A valuation allowance is provided when it is more likely than not that some portion or
all  of  the  deferred  tax  assets  will  not  be  realized.  The  effect  on  deferred  tax  assets  and  liabilities  of  a
change in tax rates is recognized in income  in the period when the change is enacted.

The Company recognizes a tax benefit from an uncertain tax position only if it is more likely than not
to be sustained upon examination based on the technical merits of the position. Reserves are established
for positions that don’t meet this recognition threshold. The reserve is measured as the largest amount of
benefit determined on a cumulative probability basis that the Company believes is more likely than not to
be realized upon ultimate settlement of the position. These reserves are classified as long-term liabilities in
the consolidated balance sheets of the Company. The Company also records interest and penalties accrued
in relation to uncertain tax benefits as  a  component of income tax expense.

While the Company believes it has identified all reasonably identifiable exposures and the reserve it
has  established  for  identifiable  exposures  is  appropriate  under  the  circumstances,  it  is  possible  that

F-13

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

additional  exposures  exist  and  that  exposures  may  be  settled  at  amounts  different  than  the  amounts
reserved.  It  is  also  possible  that  changes  in  facts  and  circumstances  could  cause  the  Company  to  either
materially increase or reduce the carrying  amount of its tax  reserve.

The Company’s policy has been to leave its unremitted foreign earnings invested indefinitely outside
the United States, and it intends to continue this policy. As such, taxes have not been provided on any of
the remaining accumulated foreign unremitted earnings. Where it has become apparent that some or all of
the undistributed earnings will be remitted  in the foreseeable future, tax consequences  are considered.

REVENUE RECOGNITION

Total revenues, net, include product sales, product royalties and other revenues, such as fees received

under research, licensing, distribution arrangements,  research  grants, and  technology-related royalties.

Revenue is recognized when persuasive evidence of an arrangement exists, delivery has occurred; title
and risk of loss have passed to the customer, there is a fixed or determinable sales price, and collectability
of that sales price is reasonably assured. For product sales, the Company’s stated terms are primarily FOB
shipping  point  and  with  most  customers,  title  and  risk  of  loss  pass  to  the  customer  at  that  time.  With
certain United States customers, the Company retains risk of loss until the customers receive the product,
and in those situations, the Company recognizes revenue upon receipt by the customer. A portion of the
Company’s  revenue  is  generated  from  consigned  inventory  maintained  at  hospitals,  distributors  or  with
field  sales  representatives.  For  these  consigned  products,  the  Company  retains  title  until  receiving
appropriate notification that the product has been used or implanted, at which time revenue is recognized.

Each revenue transaction is evidenced by either a contract with the customer or a valid purchase order
and  an  invoice  which  includes  all  relevant  terms  of  sale.  There  are  generally  no  significant  customer
acceptance or other conditions that prevent the Company from recognizing revenue in accordance with its
delivery terms. In certain cases, where the Company has performance obligations that are significant to the
functionality of the product, the Company recognizes revenue upon  fulfillment  of its  obligation.

Sales  invoices  issued  to  customers  contain  the  Company’s  price  for  each  product  or  service.  The
Company  performs  a  review  of  each  specific  customer’s  credit  worthiness  and  ability  to  pay  prior  to
accepting  them  as  a  customer.  Further,  the  Company  performs  periodic  reviews  of  its  customers’  status
prospectively.

The  Company  records  a  provision  for  estimated  returns  and  allowances  on  revenues  in  the  same
period  as  the  related  revenues  are  recorded.  These  estimates  are  based  on  historical  sales  returns  and
discounts and other known factors. The provisions are  recorded as a reduction to revenues.

The  Company’s  return  policy,  as  set  forth  in  its  product  catalogs  and  sales  invoices,  requires  the
Company to review and authorize the return of product in advance. Upon authorization, a credit will be
issued for goods returned within a set  amount  of  days from shipment,  which is  generally ninety  days.

Product royalties are estimated and recognized in the same period that the royalty-based products are
sold  by  the  Company’s  strategic  partners.  The  Company  estimates  and  recognizes  royalty  revenue  based
upon communication with licensees, historical information and expected sales trends. Differences between
actual  revenues  and  estimated  royalty  revenues  are  adjusted  in  the  period  in  which  they  become  known,
which  is typically the following quarter.  Historically,  such adjustments  have not been significant.

Other  operating  revenues  may  include  fees  received  under  research,  licensing,  and  distribution
arrangements,  technology-related  royalties  and  research  grants.  Non-refundable  fees  received  under
research,  licensing  and  distribution  arrangements  or  for  the  licensing  of  technology  are  recognized  as
revenue  when  received  if  the  Company  has  no  continuing  obligations  to  the  other  party.  For  those

F-14

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

arrangements  where  the  Company  has  continuing  performance  obligations,  revenue  is  recognized  using
the  lesser  of  the  amount  of  non-refundable  cash  received  or  the  result  achieved  using  the  proportional
performance method of accounting based upon the estimated cost to complete these obligations. Research
grant revenue is recognized when the  related  expenses are incurred.

SHIPPING AND HANDLING FEES AND COSTS

Amounts billed to customers for shipping and handling are included in revenues. The related shipping
and freight charges incurred by the Company are included in cost of goods sold. Distribution and handling
costs of $13.6 million, $11.5 million and $9.6 million were recorded in selling, general and administrative
expense during the years ended December 31, 2012, 2011  and 2010,  respectively.

PRODUCT WARRANTIES

Certain  of  the  Company’s  medical  devices,  including  monitoring  systems  and  neurosurgical  systems,
are  reusable  and  are  designed  to  operate  over  long  periods  of  time.  These  products  are  sold  with
warranties which may extend for up to two years from date of purchase. The Company accrues estimated
product  warranty  costs  at  the  time  of  sale  based  on  historical  experience.  Any  additional  amounts  are
recorded  when  such  costs  are  probable  and  can  be  reasonably  estimated.  The  balance  of  the  accrued
warranty expense was $0.4 million at year ended  December 31,  2012 and 2011.

RESEARCH AND DEVELOPMENT

Research and development costs, including salaries, depreciation, consultant and other external fees,
and facility costs directly attributable to research and development activities, are expensed in the period in
which  they are incurred.

In-process  research  and  development  recorded  in  connection  with  acquisitions  represent  the  value
assigned  to  acquired  assets  to  be  used  in  research  and  development  activities  and  for  which  there  is  no
alternative use. Value is generally assigned to these assets based on the net present value of the projected
cash flows expected to be generated  by those  assets.

During  2011  and  2010  the  Company  capitalized  $1.7  million  and  $0.3  million  of  in-process  research

and development costs related to acquisitions. There were none capitalized in  2012.

EMPLOYEE TERMINATION BENEFITS  AND OTHER EXIT-RELATED COSTS

The  Company  does  not  have  a  written  severance  plan,  and  it  does  not  offer  similar  termination
benefits  to  affected  employees  in  all  restructuring  initiatives.  Accordingly,  in  situations  where  minimum
statutory  termination  benefits  must  be  paid  to  the  affected  employees,  the  Company  records  employee
severance costs associated with these restructuring activities in accordance with the authoritative guidance
for non-retirement post-employment benefits. Charges associated with these activities are recorded when
the  payment  of  benefits  is  probable  and  can  be  reasonably  estimated.  In  all  other  situations  where  the
Company  pays  out  termination  benefits,  including  supplemental  benefits  paid  in  excess  of  statutory
minimum  amounts  and  benefits  offered  to  affected  employees  based  on  management’s  discretion,  the
Company records these termination costs in accordance with the authoritative guidance for exit or disposal
costs.

The timing of the recognition of charges for employee severance costs other than minimum statutory
benefits  depends  on  whether  the  affected  employees  are  required  to  render  service  beyond  their  legal
notification  period  in  order  to  receive  the  benefits.  If  affected  employees  are  required  to  render  service
beyond  their  legal  notification  period,  charges  are  recognized  ratably  over  the  future  service  period.

F-15

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Otherwise,  charges  are  recognized  when  management  has  approved  a  specific  plan  and  employee
communication requirements have been met.

For leased facilities and equipment that have been abandoned, the Company records estimated lease
losses  based  on  the  fair  value  of  the  lease  liability,  as  measured  by  the  present  value  of  future  lease
payments  subsequent  to  abandonment,  less  the  present  value  of  any  estimated  sublease  income  on  the
cease-use  date.  For  owned  facilities  and  equipment  that  will  be  disposed  of,  the  Company  records
impairment losses based on fair value less costs to sell. The Company also reviews the remaining useful life
of long-lived assets following a decision to exit a facility and may accelerate depreciation or amortization of
these assets, as appropriate.

STOCK-BASED COMPENSATION

The  Company  applies  the  authoritative  guidance  for  stock-based  compensation.  This  guidance
requires  companies  to  recognize  the  expense  related  to  the  fair  value  of  their  stock-based  compensation
awards.  Stock-based  compensation  expense  for  stock  option  awards  granted  after  January  1,  2006  was
based on the fair value on the grant  date using the  binomial  distribution model.

The  Company  recognized  compensation  expense  for  stock  option  awards,  restricted  stock  awards,
performance stock awards and contract stock awards on a ratable basis over the requisite service period of
the award. The long form method was used in the determination of the windfall tax benefit in accordance
with the guidance.

PENSION BENEFITS

Defined benefit pension plans cover certain employees and retirees in the U.K. and former employees
in Germany. Various factors are considered in determining the pension liability, including the number of
employees expected to be paid their salary levels and years of service, the expected return on plan assets,
the  discount  rate  used  to  determine  the  benefit  obligations,  the  timing  of  benefit  payments  and  other
actuarial  assumptions.  If  the  actual  results  and  events  for  the  pension  plans  differ  from  current
assumptions, the benefit obligation may  be  over or under valued.

Retirement benefit plan assumptions are reassessed on an annual basis or more frequently if changes
in  circumstances  indicate  a  re-evaluation  of  assumptions  are  required.  The  key  benefit  plan  assumptions
are  the  discount  rate  and  expected  rate  of  return  on  plan  assets.  The  discount  rate  is  based  on  average
rates on bonds that matched the expected cash outflows of the benefit plans. The expected rate of return is
based on historical and expected returns on the various categories  of plan  assets.

Pension  contributions  are  expected  to  be  consistent  over  the  next  few  years  since  the  Germany  and
U.K.  plans  are  frozen.  Contributions  to  the  plans  during  the  years  ended  December  31,  2012,  2011  and
2010 were $0.8 million, $1.1 million and $1.1  million, respectively.

CONCENTRATION OF CREDIT RISK

Financial instruments, which potentially subject the Company to concentrations of credit risk, consist
principally  of  cash  and  cash  equivalents,  which  are  held  at  major  financial  institutions,  investment-grade
marketable debt securities and trade  receivables.

The Company’s products are sold on an uncollateralized basis and on credit terms based upon a credit
risk assessment of each customer. A portion of the Company’s trade receivables to customers outside the
United  States  includes  sales  to  foreign  distributors,  who  then  sell  to  government  owned  or  supported
healthcare  systems.  The  current  economic  conditions  in  many  southern  European  countries,  especially
Greece, Ireland, Italy, Portugal and Spain remain uncertain. Accounts receivable from customers in these

F-16

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

countries  was  approximately  $4.3  million  at  December  31,  2012,  of  which  $0.4  million  was  reserved.  At
December 31, 2011, the accounts receivable from customers in these countries was $5.8 million, of which
$0.8 million was reserved.

RECENTLY ISSUED AND ADOPTED ACCOUNTING STANDARDS

On  July  27,  2012,  the  Financial  Accounting  Standards  Board  issued  Accounting  Standards  Update
No. 2012-02, Testing Indefinite-Lived Intangible Assets for Impairment. The revised standard is intended to
reduce  the  cost  and  complexity  of  testing  indefinite-lived  intangible  assets  other  than  goodwill  for
impairment  by  providing  entities  with  an  option  to  perform  a  ‘‘qualitative’’  assessment  to  determine
whether  further  impairment  testing  is  necessary.  The  revised  standard  allows  an  entity  first  to  assess
qualitative factors to determine whether events and circumstances indicate that it is more likely than not
(that is, a likelihood of more than 50 percent) that an indefinite-lived intangible asset is impaired. If it is
more likely than not that the asset is impaired, the entity must calculate the fair value of the asset, compare
the fair value to its carrying amount, and record an impairment charge, if the carrying amount exceeds fair
value.  However,  if  an  entity  concludes  that  it  is  not  more  likely  than  not  that  the  asset  is  impaired,  no
further  action  is  required.  The  qualitative  assessment  is  not  an  accounting  policy  election.  An  entity  can
choose to perform the qualitative assessment on none, some, or all of its indefinite-lived intangible assets.
Moreover,  an  entity  can  bypass  the  qualitative  assessment  for  any  indefinite-lived  intangible  asset  in  any
period and proceed directly to the quantitative impairment test, and then choose to perform the qualitative
assessment in any subsequent period. The revised standard is effective for annual and interim impairment
tests performed for fiscal years beginning after September 15, 2012. However, an entity can choose to early
adopt the revised standard even if its annual or interim impairment test date is before July 27, 2012 (the
date on which the revised standard was issued), provided that its financial statements for the most recent
annual or interim period have not yet been issued. The Company elected to adopt this standard early and
such adoption did  not have a material impact on the Company’s  financial statements.

SUPPLEMENTAL CASH FLOW INFORMATION

In addition to the payment of accreted interest associated with the settlement of the 2012 Convertible
Notes, cash paid for interest for the years ended December 31, 2012, 2011 and 2010 was $12.0 million (net
of  $2.1  million  that  was  capitalized  into  construction  in  progress),  $13.2  million  and  $8.8  million,
respectively.  Cash  paid  for  income  taxes  for  the  years  ended  December  31,  2012,  2011  and  2010  was
$12.7 million, $14.5 million and $23.4 million, respectively. Property and equipment purchases included in
liabilities  at  December  31,  2012,  2011  and  2010  were  $9.5  million,  $6.4  million  and  $1.1  million,
respectively.

During the year ended December 31, 2010, 282,086 stock options were exercised, whereby in lieu of a
cash payment for the exercise price, an option holder tendered 73,546 shares of Company stock that had a
fair market value of approximately $3.1 million. These tendered shares  were then immediately retired.

In  connection  with  the  amendment  and  restatement  of  the  Company’s  Senior  Credit  Facility  during
the year ended December 31, 2010, $150.0 million of the Company’s revolving credit facility was converted
into a term loan, which was subsequently eliminated  under the June 2011  amendment.

F-17

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

3. ACQUISITIONS AND PRO FORMA RESULTS

Ascension Orthopedics, Inc.

On  September  23,  2011,  the  Company  acquired  Ascension  Orthopedics,  Inc.  (‘‘Ascension’’)  for
$66.0  million,  which  includes  amounts  paid  for  working  capital  adjustments  of  $0.2  million  less  amounts
received from escrow of $0.7 million. Ascension, based in Austin, Texas, develops and distributes a range of
implants for the shoulder, elbow, wrist, hand, foot and  ankle.

The following summarizes the final allocation of the purchase price based on fair value of the assets

acquired and liabilities assumed:

Final
Purchase Price
Allocation

(Dollars in thousands)

Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accounts receivable . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other current assets . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property, plant and equipment . . . . . . . . . . . . . . . . . . .
Other long-term assets . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax asset — long term . . . . . . . . . . . . . . . . . .
Intangible assets:

Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Customer relationships . . . . . . . . . . . . . . . . . . . . . . .
In-process research and development . . . . . . . . . . . . .
Supplier relationship . . . . . . . . . . . . . . . . . . . . . . . . .
Trade name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Goodwill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total assets acquired . . . . . . . . . . . . . . . . . . . . . . . . .
Accounts payable and other liabilities . . . . . . . . . . . . . .

$

627
12,760
2,917
2,398
4,649
70
12,543

7,885
5,750
1,739
4,510
560
15,460

71,868
5,827

Net assets acquired . . . . . . . . . . . . . . . . . . . . . . . . . . .

$66,041

Wtd. Avg.  Life:
10 years
12 years
Indefinite
10 years
1 year

Management determined the preliminary fair value of net assets acquired during the third quarter of
2011  and  finalized  the  working  capital  adjustment  in  the  second  quarter  of  2012.  Measurement  period
adjustments  included  above  reflected  a  decrease  in  the  total  fair  value  of  inventory  acquired  and  a
decrease in the value of long-term deferred tax assets acquired which was recorded in the fourth quarter of
2011. The measurement period adjustments were made to reflect facts and circumstances existing as of the
acquisition  date,  and  did  not  result  from  intervening  events  subsequent  to  the  acquisition  date.  These
adjustments did not have a significant impact on the Company’s previously reported consolidated financial
statements and, therefore, the Company has  not  retrospectively adjusted those financial statements.

The  goodwill  recorded  in  connection  with  this  acquisition  is  based  on  (i)  expected  cost  savings,
operating synergies and other benefits expected to result from the combined operations, (ii) the value of
the  going-concern  element  of  Ascension’s  existing  business  (that  is,  the  higher  rate  of  return  on  the
assembled  net  assets  versus  if  the  Company  had  acquired  all  of  the  net  assets  separately),  and
(iii) intangible assets that do not qualify for separate recognition such as Ascension’s assembled workforce.
The goodwill acquired will not be deductible  for tax purposes.

F-18

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

SeaSpine, Inc.

On  May  23,  2011,  the  Company  acquired  all  of  the  outstanding  common  stock  of  SeaSpine,  Inc.
(‘‘SeaSpine’’)  for  $88.7  million,  which  includes  amounts  paid  for  working  capital  adjustments  of
$0.3 million and indemnification holdbacks totaling $7.4 million all of which was released to the seller prior
to  December  31,  2012.  SeaSpine  is  based  in  Vista,  California  and  designs,  develops  and  manufactures
spinal fixation products and synthetic  bone substitute products.

The following summarizes the final allocation of the purchase price based on fair value of the assets

acquired and liabilities assumed:

Final Purchase Price
Allocation

(Dollars in thousands)

Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accounts receivable . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other current assets . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property, plant and equipment . . . . . . . . . . . . . . . . . . .
Deferred tax asset — long term . . . . . . . . . . . . . . . . . .
Intangible assets:

Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Customer relationships . . . . . . . . . . . . . . . . . . . . . . .
Non-compete agreements . . . . . . . . . . . . . . . . . . . . .
Trade name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Goodwill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total assets acquired . . . . . . . . . . . . . . . . . . . . . . . . .
Accounts payable and other liabilities . . . . . . . . . . . . . .

$

201
14,900
7,608
623
9,177
302

3,000
41,200
1,900
300
14,572

93,783
5,108

Net assets acquired . . . . . . . . . . . . . . . . . . . . . . . . . . .

$88,675

Wtd. Avg.  Life:
8 years
13 years
4 years
1 year

Management determined the preliminary fair value of net assets acquired during the second quarter
of  2011  and  finalized  the  working  capital  adjustment  in  the  first  quarter  of  2012.  Measurement  period
adjustments  included  above  reflect  a  decrease  in  the  total  fair  value  of  consideration  to  be  transferred
pursuant  to  the  final  working  capital  adjustment.  These  measurement  period  adjustments  were  made  to
reflect  facts  and  circumstances  existing  as  of  the  acquisition  date,  and  did  not  result  from  intervening
events  subsequent  to  the  acquisition  date.  This  adjustment  did  not  have  a  significant  impact  on  the
Company’s  previously  reported  consolidated  financial  statements  and,  therefore,  the  Company  has  not
retrospectively adjusted those financial  statements.

The  goodwill  recorded  in  connection  with  this  acquisition  is  based  on  the  benefits  the  Company
expects  to  generate  from  SeaSpine’s  future  cash  flows.  For  tax  purposes,  the  Company  is  treating  the
acquisition as an asset acquisition; therefore, the goodwill will be deductible for tax purposes.

Culley Investments Pty. Ltd.

In  September  2010,  the  Company  acquired  certain  assets  as  well  as  the  distribution  rights  for  its
extremity  reconstruction  product  lines  in  Australia  from  Culley  Investments  Pty.  Ltd.  (‘‘Culley’’)  for
approximately $1.6 million (1.7 million Australian dollars) in cash. The Company had determined that this
acquisition met the definition of a business under the authoritative guidance. For eight years, Culley had

F-19

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

been the Company’s distributor of these products in Australia. The acquisition provides the Company with
the ability to  sell orthopedic products directly to its Australian customers.

Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property, plant and equipment . . . . . . . . . . . . . . . . . . .
Intangible assets — Customer relationships . . . . . . . . . .

Final Purchase Price
Allocation

(Dollars in thousands)
$ 878
319
373

Wtd. Avg. Life:
12 years

Total net assets acquired . . . . . . . . . . . . . . . . . . . . . . . .

$1,570

Welch Allyn, Inc.

In May 2010, the Company acquired certain assets and liabilities of the surgical headlight business of
Welch  Allyn,  Inc.  (‘‘Welch’’)  for  approximately  $2.4  million  in  cash  and  $0.2  million  of  working  capital
adjustments.  The  Company  determined  that  this  acquisition  met  the  definition  of  a  business  under  the
authoritative guidance. The Company believes that the assets acquired will further its goal of expanding its
reach  into  the  surgical  headlight  market.  The  goodwill  recorded  in  connection  with  this  acquisition  was
based  on  the  benefits  the  Company  expects  to  generate  from  Welch’s  future  cash  flows  and  is  not
deductible for tax purposes.

Accounts receivable . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inventory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Property, plant and equipment . . . . . . . . . . . . . . . . . . .
Intangible assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Customer relationships . . . . . . . . . . . . . . . . . . . . . . .
Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
In-Process research and development . . . . . . . . . . . . .
Goodwill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Final Purchase Price
Allocation

(Dollars in thousands)
$ 518
138
280

Wtd. Avg. Life:
15 years
6 years
Indefinite

490
263
312
601

Total net assets acquired . . . . . . . . . . . . . . . . . . . . . . . .

$2,602

Pro Forma Results (unaudited)

The following unaudited pro forma financial information summarizes the results of operations for the
year  ended  December  31,  2011  as  if  the  acquisitions  completed  by  the  Company  during  2011  had  been
completed as of January 1, 2010. The pro forma results are based upon certain assumptions and estimates,
and  they  give  effect  to  actual  operating  results  prior  to  the  acquisitions  and  adjustments  to  reflect
(i) increased interest expense, depreciation expense, intangible asset amortization and fair value inventory
step-up,  (ii)  decreases  in  certain  expenses  that  will  not  be  recurring  in  the  post-acquisition  entity,  and
(iii) income taxes at a rate consistent with the Company’s statutory rate. No effect has been given to other
cost  reductions  or  operating  synergies.  As  a  result,  these  pro  forma  results  do  not  necessarily  represent

F-20

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

results that would have occurred if the acquisitions had taken place on the basis assumed above, nor are
they indicative of the results of future  combined  operations.

Total Revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net income per share:
Basic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Diluted . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. DEBT

Amended and Restated Senior Credit Agreement

Year Ended
December 31, 2011

(In thousands
except per share amounts)
$811,933
$ 23,236

$
$

0.80
0.79

On  August  10,  2010,  the  Company  entered  into  an  amended  and  restated  credit  agreement  with  a
syndicate of lending banks (the ‘‘Senior Credit Facility’’), it amended the Senior Credit Facility on June 8,
2011, and further amended it on May  11, 2012.

The June 8, 2011 amendment:

i. increased  the  revolving  credit  component  from  $450  million  to  $600  million  and  eliminated  the
$150  million  term  loan  component  that  existed  under  the  original  amended  and  restated  credit
agreement;

ii. allows the Company to further increase the size of the revolving credit component by an aggregate of

$200 million with additional commitments;

iii. provides  the  Company  with  decreased  borrowing  rates  and  annual  commitment  fees,  and  provides

more favorable financial covenants; and

iv. extended the maturity date from August  10, 2015 to June 8, 2016.

On  May  11,  2012,  the  Company  entered  into  another  amendment  to  the  Senior  Credit  Facility  (the
‘‘2012 Amendment’’). The 2012 Amendment modified certain financial and negative covenants. The 2012
Amendment provides that the Company’s Maximum Consolidated Total Leverage Ratio (a measure of net
debt to consolidated EBITDA, in each case as defined in the Senior Credit Facility, as amended) during
any consecutive four quarter period should not be greater than 3.75 to 1.00 during any such period ending
on December 31, 2013 (instead of March 31, 2012). In addition, when calculating consolidated EBITDA
for any period, the 2012 Amendment permits the addition of certain costs and expenses in the calculation
of consolidated net income for such period, to the extent deducted in the calculation of consolidated net
income. The Company capitalized $0.4 million of incremental financing costs in connection with the 2012
Amendment.

The  Senior  Credit  Facility  is  collateralized  by  substantially  all  of  the  assets  of  the  Company’s  U.S.
subsidiaries,  excluding  intangible  assets.  The  Senior  Credit  Facility  is  subject  to  various  financial  and
negative covenants and at December  31, 2012,  the Company was in  compliance with  all  such covenants.

Borrowings under the Senior Credit Facility currently bear interest, at the Company’s option, at a rate
equal to (i) the Eurodollar Rate (as defined in the Senior Credit Facility, which definition has not changed)
in effect from time to time plus the applicable rate (ranging from 1.00% to 1.75%) or (ii) the highest of
(x) the weighted average overnight Federal funds rate, as published by the Federal Reserve Bank of New
York,  plus  0.5%,  (y)  the  prime  lending  rate  of  Bank  of  America,  N.A.  or  (z)  the  one-month  Eurodollar

F-21

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Rate  plus  1.0%.  The  applicable  rates  are  based  on  the  Company’s  consolidated  total  leverage  ratio
(defined as the ratio of (a) consolidated funded indebtedness less cash in excess of $40 million that is not
subject to any restriction of the use or investment thereof to (b) consolidated EBITDA) at the time of the
applicable borrowing.

The Company will also pay an annual commitment fee (ranging from 0.15% to 0.30%, based on the
Company’s  consolidated  total  leverage  ratio)  on  the  daily  amount  by  which  the  revolving  credit  facility
exceeds the outstanding loans and letters of  credit under the credit facility.

At  December  31,  2012  and  December  31,  2011,  there  was  $321.9  million  and  $179.7  million
outstanding, respectively, under the Senior Credit Facility at a weighted average interest rate of 1.8% and
2.0%, respectively. At December 31, 2012, there was approximately $278.1 million available for borrowing
under the Senior Credit Facility. The fair value of outstanding borrowings under the Senior Credit Facility
at December 31, 2012 was approximately $310.3 million. The fair value of the Senior Credit Facility was
determined by using a discounted cash flow model based on current market interest rates available to the
Company.  These  inputs  are  corroborated  by  observable  market  data  for  similar  liabilities  and  therefore
classified within Level 2 of the fair value hierarchy. Level 2 inputs represent inputs that are observable for
the asset or liability, either directly or indirectly  and are  other than active market observable  inputs  that
reflect unadjusted quoted prices for identical assets or liabilities. The Company considers the balance to be
long  term  in  nature  based  on  its  current  intent  and  ability  to  repay  the  borrowing  outside  of  the  next
twelve-month period.

2016 Convertible Senior Notes

On  June  15,  2011,  the  Company  issued  $230.0  million  aggregate  principal  amount  of  its  1.625%
Convertible  Senior  Notes  due  2016  (the  ‘‘2016  Notes’’).  The  2016  Notes  mature  on  December  15,  2016,
and  bear  interest  at  a  rate  of  1.625%  per  annum  payable  semi-annually  in  arrears  on  December  15  and
June  15  of  each  year.  The  portion  of  the  debt  proceeds  that  was  classified  as  equity  at  the  time  of  the
offering was $43.2 million, an equivalent of that amount is being amortized to interest expense using the
effective  interest  method  through  December  2016.  The  effective  interest  rate  implicit  in  the  liability
component  is  5.6%.  The  fair  value  of  the  liability  of  the  2016  Notes  was  determined  using  a  discounted
cash  flow  model  based  on  current  market  interest  rates  available  to  the  Company.  These  inputs  are
corroborated by observable market data  for similar  liabilities  and therefore classified within Level 2.

At  December  31,  2012,  the  carrying  amount  of  the  liability  component  was  $197.7  million,  the
remaining  unamortized  discount  was  $32.3  million,  and  the  principal  amount  outstanding  was
$230.0 million. The fair value of the 2016 Notes at December 31, 2012 was approximately $232.9 million.
At December 31, 2011, the carrying amount of the liability component was $190.6 million, the remaining
unamortized discount was $39.4 million and the principal amount outstanding  was  $230.0 million.

The 2016 Notes are senior, unsecured obligations of the Company, and are convertible into cash and,
if  applicable,  shares  of  its  common  stock  based  on  an  initial  conversion  rate,  subject  to  adjustment  of
17.4092 shares per $1,000 principal amount of 2016 Notes (which represents an initial conversion price of
approximately $57.44 per share). The Company will satisfy any conversion of the 2016 Notes with cash up
to the principal amount of the 2016 Notes pursuant to the net share settlement mechanism set forth in the
indenture and, with respect to any excess conversion value, with shares of the Company’s common stock.
The  2016  Notes  are  convertible  only  in  the  following  circumstances:  (1)  if  the  closing  sale  price  of  the
Company’s  common  stock  exceeds  150%  of  the  conversion  price  during  a  period  as  defined  in  the
indenture;  (2)  if  the  average  trading  price  per  $1,000  principal  amount  of  the  2016  Notes  is  less  than  or
equal  to  98%  of  the  average  conversion  value  of  the  2016  Notes  during  a  period  as  defined  in  the
indenture; (3) at any time on or after June 15, 2016; or (4) if specified corporate transactions occur. The

F-22

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

issue price of the 2016 Notes was equal to their face amount, which is also the amount holders are entitled
to  receive  at  maturity  if  the  2016  Notes  are  not  converted.  As  of  December  31,  2012,  none  of  these
conditions existed with respect to the 2016 Notes and as a result, the 2016 Notes are classified as long term.

In  connection  with  the  issuance  of  the  2016  Notes,  the  Company  entered  into  call  transactions  and
warrant  transactions,  primarily  with  affiliates  of  the  initial  purchasers  of  such  notes  (the  ‘‘hedge
participants’’). The initial strike price of the call transaction is approximately $57.44 per share, subject to
customary  anti-dilution  adjustments.  The  initial  strike  price  of  the  warrant  transaction  is  approximately
$70.05 per share, subject to customary  anti-dilution  adjustments.

2012 Senior Convertible Notes

On  June  11,  2007,  the  Company  issued  $165.0  million  aggregate  principal  amount  of  its  2012  Notes
(the ‘‘2012 Notes’’). The 2012 Notes bear interest at a rate of 2.375% per annum payable semi-annually in
arrears on December 1 and June 1 of each year. In accordance with the accounting guidance for debt with
conversion and other options, the Company accounted for the liability and equity components of the 2012
Notes separately. The portion of the debt proceeds that the Company had classified as equity at the time of
the  offering,  and  recognized  as  a  debt  discount,  was  determined  based  on  the  fair  value  of  similar  debt
instruments  that  did  not  include  a  conversion  feature  and  amounted  to  $30.6  million.  The  Company
amortized the debt discount to interest expense using the effective interest method through June 2012. The
effective  interest  rate  implicit  in  the  liability  component  was  based  on  the  Company’s  estimated  non-
convertible borrowing rate at the date the  2012  Notes were issued and was 6.8%.

In  connection  with  the  issuance  of  the  2012  Notes,  the  Company  entered  into  call  transactions  and
warrant  transactions,  primarily  with  affiliates  of  the  initial  purchasers  of  such  notes  (the  ‘‘hedge
participants’’). The total cost of the call transactions to the Company was approximately $30.4 million and
the  Company  received  approximately  $12.2  million  of  proceeds  from  the  warrant  transactions.  The  call
transactions involve the Company’s purchasing call options from the hedge participants, and the warrant
transactions involve the Company’s selling call options to the hedge participants with a higher strike price
than the purchased call options.

In  June  2012,  the  Company  repaid  the  2012  Notes  at  maturity  with  long-term  borrowings  from  its
Senior Credit Facility and cash on hand. The related bond hedge contracts terminated in components over
the 100 trading day period commencing 90 days  after the maturity  of the 2012 Notes.

F-23

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Convertible Note Interest

The interest expense components of  the Company’s  convertible notes are as  follows:

Years Ended December 31,

2012

2011

2010

(In thousands)

2016 Notes:
Amortization of the discount on the  liability component(1) . . . . . . $5,993
3,154
Cash interest related to the contractual  interest coupon(2) . . . . . .

$ 3,740
2,024

$ —
—

Total

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $9,147

$ 5,764

$ —

2012 Notes:
Amortization of the discount on the  liability component(1) . . . . . . $2,527
1,378
Cash interest related to the contractual  interest coupon(2) . . . . . .

$ 6,850
3,919

$ 6,401
3,919

Total

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $3,905

$10,769

$10,320

2010 Notes:
Amortization of the discount on the  liability component . . . . . . . . $ — $ — $ 1,190
830
Cash interest related to the contractual  interest coupon . . . . . . . .

—

—

Total

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ — $ — $ 2,020

(1) In 2012, the amortization of the discount on the liability component of the 2016 and 2012 Notes are

presented net of capitalized interest of $1.1 million and $0.5  million, respectively.

(2) In 2012, the cash interest related to the contractual interest coupon on the 2016 and 2012 Notes are

presented net of capitalized interest of $0.6 million and $0.3  million.

5. DERIVATIVE INSTRUMENTS

Interest Rate Hedging

The  Company’s  interest  rate  risk  relates  to  U.S.  dollar  denominated  variable  LIBOR  interest  rate
borrowings.  The  Company  uses  an  interest  rate  swap  derivative  instrument  entered  into  on  August  10,
2010  with  an  effective  date  of  December  31,  2010  to  manage  its  earnings  and  cash  flow  exposure  to
changes in interest rates by converting a portion of its floating-rate debt into fixed-rate debt beginning on
December 31, 2010. This interest rate  swap expires on  August 10, 2015.

The Company designates this derivative instrument as a cash flow hedge. The Company records the
effective portion of any change in the fair value of a derivative instrument designated as a cash flow hedge
as unrealized gains or losses in accumulated other comprehensive income (‘‘AOCI’’), net of tax, until the
hedged item affects earnings, at which point the effective portion of any gain or loss will be reclassified to
earnings.  If  the  hedged  cash  flow  does  not  occur,  or  if  it  becomes  probable  that  it  will  not  occur,  the
Company will reclassify the amount of any gain or loss on the related cash flow hedge to interest expense
at that time.

The  Company  expects  that  approximately  $1.9  million  of  pre-tax  losses  recorded  as  net  in  AOCI

related to the interest rate hedge could be reclassified  to  earnings within  the next twelve months.

F-24

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Foreign Currency Hedging

From time to time the Company enters into foreign currency hedge contracts intended to protect the
U.S. dollar value of certain forecasted foreign currency denominated transactions. The Company records
the effective portion of any change in the fair value of foreign currency cash flow hedges in AOCI, net of
tax, until the hedged item affects earnings. Once the related hedged item affects earnings, the Company
reclassifies  the  effective  portion  of  any  related  unrealized  gain  or  loss  on  the  foreign  currency  cash  flow
hedge to earnings. If the hedged forecasted transaction does not occur, or if it becomes probable that it will
not  occur,  the  Company  will  reclassify  the  amount  of  any  gain  or  loss  on  the  related  cash  flow  hedge  to
earnings at that time.

The  success  of  the  Company’s  hedging  program  depends,  in  part,  on  forecasts  of  certain  activity
denominated in euros. The Company may experience unanticipated currency exchange gains or losses to
the  extent  that  there  are  differences  between  forecasted  and  actual  activity  during  periods  of  currency
volatility. In addition, changes in currency exchange rates related to any unhedged transactions may affect
its  earnings and cash flows.

Counterparty Credit Risk

The Company manages its concentration of counterparty credit risk on its derivative instruments by
limiting  acceptable  counterparties  to  a  group  of  major  financial  institutions  with  investment  grade  credit
ratings,  and  by  actively  monitoring  their  credit  ratings  and  outstanding  positions  on  an  ongoing  basis.
Therefore,  the  Company  considers  the  credit  risk  of  the  counterparties  to  be  low.  Furthermore,  none  of
the  Company’s  derivative  transactions  are  subject  to  collateral  or  other  security  arrangements,  and  none
contain provisions that depend upon  the  Company’s credit ratings from  any credit rating agency.

Fair Value of Derivative Instruments

The Company has classified all of its derivative instruments within Level 2 of the fair value hierarchy
because  observable  inputs  are  available  for  substantially  the  full  term  of  the  derivative  instruments.  The
fair value of the foreign currency forward exchange contracts related to inventory purchases is determined
by comparing the forward rate as of the period end and the settlement rate specified in each contract. The
fair  value  of  the  interest  rate  swap  was  developed  using  a  market  approach  based  on  publicly  available
market  yield  curves  and  the  terms  of  the  swap.  The  Company  performs  ongoing  assessments  of
counterparty credit risk.

F-25

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The  following  table  summarizes  the  fair  value,  notional  amounts  presented  in  U.S.  dollars,  and
presentation  in  the  consolidated  balance  sheet  for  derivatives  designated  as  hedging  instruments  as  of
December 31, 2012 and December 31, 2011:

Location on  Balance Sheet(1):

Fair Value as of

Notional Amount as  of

December 31,
2012

December 31,
2011

December 31,
2012

December 31,
2011

(In thousands)

Derivatives designated as hedges — Liabilities:
Interest rate swap — Accrued expenses  and  other

current liabilities(2) . . . . . . . . . . . . . . . . . . . . .

$1,888

$1,634

Foreign currency forward contracts —  Accrued

expenses and other current liabilities . . . . . . . . .
Interest rate swap — Other liabilities(2) . . . . . . . .

—
2,238

108
2,458

$—

$1,597

Total  Derivatives designated as hedges —

Liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$4,126

$4,200

(1) The Company classifies derivative assets and liabilities as current based on the cash flows expected to

be incurred within the following 12 months.

(2) At  December  31,  2012  and  December  31,  2011,  the  notional  amount  related  to  the  Company’s  sole
interest rate swap was $127.5 million and $139.7 million, respectively. In the next twelve months, the
Company expects to reduce the notional amount by $15.0 million.

The  following  presents  the  effect  of  derivative  instruments  designated  as  cash  flow  hedges  on  the
accompanying consolidated statements of operations during the years ended December 31, 2012 and 2011:

Balance in
AOCI
Beginning of
Year

Year Ended December 31, 2012
Foreign currency forward

contracts . . . . . . . . . . . . . . $ (216)
(4,091)

Interest rate swap . . . . . . . . .

$(4,307)

Year Ended December 31, 2011
Foreign currency forward

contracts . . . . . . . . . . . . . . $ —
(270)

Interest rate swap . . . . . . . . .

$ (270)

Amount of
Gain (Loss)
Recognized in
AOCI

Amount of
Gain (Loss)

Reclassified from Balance in

AOCI into
Earnings

AOCI
End of
Year

Location in
Statements of
Operations

(Effective Portion) (Effective  Portion)

(In thousands)

$ (127)
(1,935)

$(2,062)

$ (216)
(6,090)

$(6,306)

$ (309)
(1,901)

$(2,210)

$ —
(2,269)

$(2,269)

$

(34) Costs  of goods  sold

(4,125) Interest (expense)

$(4,159)

$ (216) Costs of goods  sold
(4,091) Interest (expense)

$(4,307)

The Company recognized no gains or losses resulting from ineffectiveness of cash flow hedges during
the  years  ended  December  31,  2012  and  2011.  At  December  31,  2012,  there  were  foreign  currency
contracts outstanding not designated as  hedges with  the notional  amount equivalent  to  $3.9 million.

F-26

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

6. TREASURY STOCK

On  October  29,  2010,  the  Company’s  Board  of  Directors  authorized  the  Company  to  repurchase
shares  of  the  Company’s  common  stock  for  an  aggregate  purchase  price  not  to  exceed  $75.0  million
through December 31, 2012. Shares may be purchased either in the open market or in privately negotiated
transactions.

On October 23, 2012, the Company’s Board of Directors terminated the October 2010 authorization
and authorized the repurchase of up to $75.0 million of its outstanding common stock through December
2014  (the  ‘‘2012  Authorization’’).  As  of  December  31,  2012,  there  remained  $75.0  million  available  for
repurchases under this authorization.

In addition to the authorizations above, on June 3, 2011, the Company’s Board of Directors separately
authorized the Company to repurchase shares of common stock from the proceeds of the 2016  Notes in
connection with that offering.

The following table sets forth the Company’s treasury stock activity:

Years Ended December 31,

2012

2011

$

# of Shares

$

# of Shares

(In thousands)

Shares repurchased in the open market  in connection

with the 2010 Authorization . . . . . . . . . . . . . . . . . . $—

Shares repurchased in connection with the issuance of

the 2016 Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . —

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —

—

—

—

$45,893

1,104

37,570

$83,463

805

1,909

There were no treasury stock repurchases during the year ended December 31, 2012.

7.

STOCK-BASED COMPENSATION

Employees stock-purchase compensation expense recognized under the authoritative guidance was as

follows:

Years Ended December 31,

2012

2011

2010

Selling, general and administrative . . . . . . . . . . . . . . . . . . . . . . . . $8,646
335
Research and development . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
70
Cost of goods sold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(In thousands)
$26,310
404
91

$16,694
426
89

Total employee stock-based compensation expense . . . . . . . . . . . .
Total tax benefit related to employees stock-based compensation

9,051

26,805

17,209

expense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,532

10,468

7,006

Net effect on net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $5,519

$16,337

$10,203

EMPLOYEE STOCK PURCHASE PLAN

The purpose of the Employee Stock Purchase Plan (the ‘‘ESPP’’) is to provide eligible employees of
the  Company  with  the  opportunity  to  acquire  shares  of  common  stock  at  periodic  intervals  by  means  of
accumulated  payroll  deductions.  Under  the  ESPP,  a  total  of  1.5  million  shares  of  common  stock  are

F-27

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

reserved  for  issuance.  These  shares  will  be  made  available  either  from  the  Company’s  authorized  but
unissued shares of common stock or from shares of common stock reacquired by the Company as treasury
shares.  At  December  31,  2012,  1.1  million  shares  remain  available  for  purchase  under  the  ESPP.  During
the  years  ended  December  31,  2012,  2011  and  2010,  the  Company  issued  6,315  shares,  8,523  shares  and
5,515 shares under the ESPP for $0.2  million, $0.2 million and $0.2 million, respectively.

The ESPP was amended in 2005 to reduce the discount available to participants to five percent and to
fix the price against which such discount would be applied. Accordingly, the ESPP is a non-compensatory
plan.

EQUITY  AWARD PLANS

As of December 31, 2012, the Company had stock options, restricted stock awards, performance stock
awards,  contract  stock  awards  and  restricted  stock  unit  awards  outstanding  under  three  plans,  the  2000
Equity Incentive Plan (the ‘‘2000 Plan’’), the 2001 Equity Incentive Plan (the ‘‘2001 Plan’’), and the 2003
Equity Incentive Plan (the ‘‘2003 Plan,’’ and collectively, (the ‘‘Plans’’).

In July 2008 and May 2010, the stockholders of the Company approved amendments to the 2003 Plan
to  increase  by  750,000  and  1,750,000,  respectively,  the  number  of  shares  of  common  stock  that  may  be
issued under the 2003 Plan. The Company has reserved 2,000,000 shares under each of the 2000 Plan and
the 2001 Plan, and 6,500,000 shares under the 2003 Plan. The Plans permit the Company to grant incentive
and  non-qualified  stock  options,  stock  appreciation  rights,  restricted  stock,  contract  stock,  performance
stock,  or  dividend  equivalent  rights  to  designated  directors,  officers,  employees  and  associates  of  the
Company.

Stock options issued under the Plans become exercisable over specified periods, generally within four
years from the date of grant for officers, directors and employees, and generally expire six years from the
grant date for employees and from six to ten years for directors and certain executive officers. Restricted
stock issued under the Plans vests over  specified  periods, generally three years after the  date of grant.

Stock Options

The Company values stock option grants using the binomial distribution model. Management believes
that  the  binomial  distribution  model  is  preferable  to  the  Black-Scholes  model  because  the  binomial
distribution  model  is  a  more  flexible  model  that  considers  the  impact  of  non-transferability,  and  vesting
provisions in the valuation of employee stock  options.

In determining the value of stock options granted, the Company considered that it has never paid cash
dividends and does not currently intend to pay cash dividends, and thus has assumed a 0% dividend yield.
Expected  volatilities  are  based  on  the  historical  volatility  of  the  Company’s  stock  price  with  forward-
looking assumptions. The expected life of stock options is estimated based on historical data on exercise of
stock options, post-vesting forfeitures and other factors to estimate the expected term of the stock options
granted. The risk-free interest rates are derived from the U.S. Treasury yield curve in effect on the date of
grant  for  instruments  with  a  remaining  term  similar  to  the  expected  life  of  the  options.  In  addition,  the
Company  applies  an  expected  forfeiture  rate  when  amortizing  stock-based  compensation  expenses.  The
estimate  of  the  forfeiture  rates  is  based  primarily  upon  historical  experience  of  employee  turnover.  As
individual  grant  awards  become  fully  vested,  stock-based  compensation  expense  is  adjusted  to  recognize
actual forfeitures.

F-28

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The following weighted-average assumptions were used in  the calculation of fair value:

Years Ended December 31,

2012

2011

2010

Dividend yield . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0%
30%
Expected volatility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Risk free interest rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1.33% 2.47% 2.82%
8 years
Expected life of option from grant date . . . . . . . . . . . . . . . . . . . . 8  years

0%
30%

0%
28%

8 years

The following table summarizes the Company’s stock  option activity:

Stock Options

Outstanding at December 31,

2011 . . . . . . . . . . . . . . . . . . .
Granted . . . . . . . . . . . . . . . . . .
Exercised . . . . . . . . . . . . . . . . .
Forfeited or Expired . . . . . . . . .

Outstanding at December 31,

Shares

(In thousands)

Weighted Average
Exercise Price

Weighted Average
Contractual
Term in Years

Aggregate
Intrinsic  Value

(In thousands)

1,483
254
(13)
(15)

$38.68
32.26
35.76
37.49

2012 . . . . . . . . . . . . . . . . . . .

1,709

$37.76

4.0 years

$5,874

Vested or expected to vest at

December 31, 2012 . . . . . . . .

1,709

$37.76

4.0 years

$5,874

Exercisable at December 31,

2012 . . . . . . . . . . . . . . . . . . .

1,465

$38.68

3.5 years

$4,222

The  intrinsic  value  of  options  exercised  for  the  years  ended  December  31,  2012,  2011  and  2010  was
negligible,  $1.4  million  and  $14.4  million,  respectively.  The  weighted  average  grant  date  fair  value  of
options granted during the years ended December 31, 2012, 2011 and 2010 was $12.18, $19.18 and $17.03,
respectively. Cash received from option exercises was $0.7 million, $3.7 million and $16.1 million, for the
years ended December 31, 2012, 2011 and 2010,  respectively.

As of December 31, 2012, there was approximately $2.0 million of total unrecognized compensation
costs related to unvested stock options. These costs are expected to be recognized over a weighted-average
period of approximately two years.

F-29

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Awards of Restricted Stock, Performance  Stock and Contract  Stock

The  following  table  summarizes  the  Company’s  awards  of  restricted  stock,  performance  stock  and

contract stock for the year ended December  31, 2012:

Restricted Stock Awards

Performance Stock and
Contract Stock Awards

Unvested, December 31, 2011 . . . . . . . . . .
Granted . . . . . . . . . . . . . . . . . . . . . . . . .
Cancellations . . . . . . . . . . . . . . . . . . . . . .
Released . . . . . . . . . . . . . . . . . . . . . . . . .

Shares

(In thousands)
305
243
(31)
(171)

Unvested, December 31, 2012 . . . . . . . . . .

346

Wtd. Avg
Grant Date
Fair Value
Per Share

$38.37
35.44
36.40
35.72

$37.80

Wtd.  Avg
Grant  Date
Fair Value
Per Share

$29.15
34.64
—
38.33

$30.49

Shares

(In thousands)
144
60
—
(5)

199

The  Company  recognized  $7.7  million,  $24.5  million  and  $13.5  million  in  expense  related  to  such
awards during the years ended December 31, 2012, 2011 and 2010, respectively. The total fair market value
of shares vested in 2012, 2011 and 2010  was $6.7  million,  $29.7 million and $11.5  million, respectively.

Performance  stock  awards  have  performance  features  associated  with  them.  Performance  stock,
restricted stock and contract stock awards generally have requisite service periods of three years. The fair
value of these awards is being expensed on a straight-line basis over the vesting period. As of December 31,
2012, there was approximately $13.0 million of total unrecognized compensation costs related to unvested
awards. These costs are expected to be recognized over a weighted-average period of approximately two
years.

On June 7, 2012, Stuart Essig terminated his employment with the Company and ceased to serve as
Executive  Chairman  of  the  Board  of  Directors  and  as  an  officer  or  employee  of  the  Company  and  its
subsidiaries  and  affiliates.  Mr.  Essig  continues  to  serve  as  Chairman  of  the  Board  of  Directors  and  as  a
non-employee member of the Board. In the fourth quarter, the Company distributed to him in the form of
shares of its common stock 1.67 million deferred stock units (‘‘SUs’’), less shares withheld for taxes, as a
result of the termination of his employment.

At December 31, 2012, there are approximately 0.12 million additional vested Restricted Units held by
various  employees  for  which  the  related  shares  have  not  yet  been  issued.  Included  in  this  amount  are
34,868  units  granted  in  October  2010  in  connection  with  the  Company’s  hiring  of  its  Chief  Executive
Officer for which the Company immediately expensed $1.5 million as these shares were fully vested at the
date  of  grant.

At  December  31,  2012,  there  were  approximately  2.1  million  shares  available  for  grant  under  the

Plans.

F-30

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

8. RETIREMENT BENEFIT PLANS

DEFINED BENEFIT PLANS

The  Company  maintains  defined  benefit  pension  plans  that  cover  employees  in  its  manufacturing
plants  located  in  Andover,  United  Kingdom  (the  ‘‘UK  Plan’’)  and  Tuttlingen,  Germany  (the  ‘‘Germany
Plan’’).  The  Company  closed  the  Tuttlingen,  Germany  plant  in  December  2005.  The  Company  did  not
terminate the Germany Plan, and the Company remains obligated for the accrued pension benefits related
to this plan. The plans cover certain current  and  former employees.

Effective March 31, 2011, the Company froze the benefits due to the participants of the UK Plan in
their  entirety;  this  curtailment  resulted  in  a  $0.3  million  reduction  in  the  projected  benefit  obligations
which the Company recorded on that date. The Company recorded the entire curtailment gain as an offset
to  the  unrecognized  net  actuarial  loss  in  accumulated  other  comprehensive  income;  therefore,  this  gain
had no impact on the condensed consolidated statements of operations.

Net  periodic  benefit  costs  for  the  Company’s  defined  benefit  pension  plans  included  the  following

amounts:

Years Ended December 31,

2012

2011

2010

(In thousands)

Service cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ — $ 26
650
Interest cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
582
(589)
(392)
Expected return on plan assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
—
Recognized net actuarial loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . —

$ 93
645
(515)
86

Net period benefit cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 190

$ 87

$ 309

The following weighted average assumptions were used to develop net periodic pension benefit cost

and the actuarial present value of projected pension benefit obligations:

Years Ended December 31,

2012

2011

2010

Discount rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2% 4.7% 5.4%
Expected return on plan assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3.0% 2.9% 5.2%
Rate of compensation increase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.0% 0.0% 3.4%

The  discount  rate  is  set  using  the  Bank  of  America  Merrill  Lynch  AA  Corporate  Bond  yield  curve
weighted by the UK benefit plan cash flows for the year ending December 31, 2012. The expected return
on plan assets represents the average rate of return expected to be earned on plan assets over the period
the benefits included in the benefit obligation are to be paid. In developing the expected rate of return, the
Company  considers  long-term  compound  annualized  returns  of  historical  market  data  as  well  as  actual
returns  on  the  plan  assets  and  applies  adjustments  that  reflect  more  recent  capital  market  experience.
Using this reference information, the long-term return expectations for each asset category are developed
according to the allocation among those investment categories. In 2012, 2011 and 2010, the discount rate
was prescribed as the current yield on corporate bonds with an average rating of AA of equivalent currency
and term to the liabilities.

F-31

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The following sets forth the change in projected benefit obligations and the change in plan assets for
the years ended December 31, 2012 and 2011 and a reconciliation of the funded status at December 31,
2012 and 2011:

Years Ended December 31,

2012

2011

(In thousands)

CHANGE IN PROJECTED BENEFIT OBLIGATION

Projected benefit obligation, beginning of year . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Service cost
Interest cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Participant contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Benefits paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Actuarial loss (gain) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Curtailment gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Effect of foreign currency exchange rates . . . . . . . . . . . . . . . . . . . . .

$12,556
—
582
—
(604)
807
—
577

$12,042
26
650
5
(688)
610
(116)
27

Projected benefit obligation, end of year . . . . . . . . . . . . . . . . . . . . .

$13,918

$12,556

CHANGE IN PLAN ASSETS

Plan assets at fair value, beginning of year . . . . . . . . . . . . . . . . . . . .
Actual return on plan assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Employer contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Participant contributions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Benefits paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Effect of foreign currency exchange rates . . . . . . . . . . . . . . . . . . . . .

$13,226
41
797
—
(591)
607

$10,834
1,970
1,115
11
(678)
(26)

Plan assets at fair value, end of year . . . . . . . . . . . . . . . . . . . . . . . .

$14,080

$13,226

RECONCILIATION OF FUNDED  STATUS
Funded status, projected benefit obligation in excess of (less than) plan
assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Unrecognized net  actuarial loss . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accumulated other comprehensive loss . . . . . . . . . . . . . . . . . . . . . . . .

Years Ended December 31,

2012

2011

(In thousands)

$

162
1,512
(1,512)

$

670
199
(199)

Amounts recognized . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$

162

$

670

The net asset position at December 31,  2012 and 2011 is  included in other assets.

The  combined  accumulated  benefit  obligation  for  the  defined  benefit  plans  was  $13.9  million  and

$12.6 million as of December 31, 2012 and 2011, respectively.

The investment strategy for the Company’s defined benefit plans is both to meet the liabilities of the
plans as they fall due and to maximize the return on invested assets within appropriate risk tolerances. The
U.K.  Plan  invests  in  pooled  funds  which  provide  a  diversification  that  supports  the  overall  investment
objectives. The Germany Plan had no  assets at December 31, 2012 or December 31, 2011.

F-32

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Based on the assets which comprise each of the funds, the weighted-average allocation of plan assets

by asset category is as follows:

Equity securities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Corporate bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Government bonds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Cash . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

December 31,

2012

2011

0%
0%
0%
0%
99% 97%
3%

1%

100% 100%

The fair value of the Company’s pension plan assets at December 31,  2012 and 2011 is  as follows:

Fair Value Measurements at December 31, 2012:

Manager/Fund

Asset  Category

Total

Quoted
Prices in
Active

Markets for Significant

Significant

Identical Observable Unobservable

Assets
(Level 1)

Inputs
(Level 2)

Inputs
(Level 3)

(In thousands)

Bank account
Legal & General Index-Linked

. . . . . . . . . . . . . . . . Cash

$

195

$195

$ —

$—

Gilts Index (various tenors)(a)

. . Index-linked

11,909

—

11,909

—

Legal & General Over 15 Years

government bonds

Gilts Index (b) . . . . . . . . . . . . . . Government bonds

1,976

—

1,976

Total . . . . . . . . . . . . . . . . . . . . . . .

$14,080

$195

$13,885

—

$—

Fair Value Measurements at December 31, 2011:

Manager/Fund

Asset  Category

Total

Quoted
Prices in
Active

Markets for Significant

Significant

Identical Observable Unobservable

Assets
(Level 1)

Inputs
(Level 2)

Inputs
(Level 3)

(In thousands)

Bank account
Legal & General Index-Linked

. . . . . . . . . . . . . . . . Cash

$

344

$344

$ —

$—

Gilts Index (various tenors)(a)

. . Index-linked

11,117

—

11,117

—

Legal & General Over 15 Years

government bonds

Gilts Index(b) . . . . . . . . . . . . . . Government bonds

1,765

—

1,765

Total . . . . . . . . . . . . . . . . . . . . . . .

$13,226

$344

$12,882

—

$—

(a) This category represents funds consisting of index-linked gilts and is designated to follow a benchmark

index.

(b) This category represents funds consisting of gilts and is  designated to follow a benchmark index.

F-33

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The Level 2 investments are single priced. The fund prices are calculated by the trustee by taking the
closing  market  price  of  each  underlying  investment  using  a  variety  of  independent  pricing  sources  (i.e.,
quoted market prices). The prices also include income receivable and expenses payable, where applicable.

Based on year-end exchange rates, the Company anticipates contributing approximately $0.9 million

to its defined benefit plans in 2013.

Also  based  on  year-end  exchange  rates,  the  Company  expects  to  pay  the  following  estimated  future

benefit payments in the years indicated:

2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2018–2022 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Expected Future
Benefit Payments

(In thousands)
$ 543
575
592
607
624
3,497

Included in Accumulated Other Comprehensive Income is $1.5 million of unrecognized net actuarial
loss, a portion of which is expected to be recognized as a component of net periodic benefit cost in 2013.

DEFINED CONTRIBUTION PLANS

The  Company  also  has  various  defined  contribution  savings  plans  that  cover  substantially  all
employees in the United States, the United Kingdom and Puerto Rico. The Company matches a certain
percentage of each employee’s contributions as per the provisions of the plans. Total contributions by the
Company to the plans were $2.7 million, $2.4 million and $2.0 million for the years ended December 31,
2012, 2011 and 2010, respectively.

9. LEASES AND RELATED PARTY  LEASES

The  Company  leases  administrative,  manufacturing,  research  and  distribution  facilities  and  various
manufacturing, office and transportation equipment through operating lease agreements. Future minimum
lease payments under operating leases at December 31, 2012 were as follows:

Related Parties

Third Parties

Total

2013 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2016 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2017 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Thereafter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total minimum lease payments . . . . . . . . . . . . . . . . . . . .

$ 272
272
272
272
272
4,433

$5,793

(In thousands)
$10,598
8,978
5,528
3,762
2,329
3,658

$10,870
9,250
5,800
4,034
2,601
8,091

$34,853

$40,646

Total  rental  expense  for  the  years  ended  December  31,  2012,  2011  and  2010  and  was  $10.9  million,
$9.3  million  and  $8.2  million,  respectively,  and  included  $0.3  million,  in  related  party  rental  expense  in
each  of the three years.

F-34

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Related  Party Leases

The  Company  leases  certain  production  equipment  from  a  corporation  whose  sole  stockholder  is  a
general partnership, of which the Company’s former Chairman (and current director) is a partner and the
President.  The  term  of  the  lease  is  through  March  31,  2022,  and  the  Company  has  an  option  to  renew
through March 31, 2032. Under the terms of the lease agreement, the Company pays $0.1 million per year
to the related party lessor. The Company also leases its manufacturing facility in Plainsboro, New Jersey,
from  a  general  partnership  that  is  50%  owned  by  a  corporation  whose  shareholders  are  trusts,  whose
beneficiaries include family members of the Company’s former Chairman (and current director). The term
of the current lease agreement is through October 31, 2032 at an annual rate of approximately $0.3 million
per year. The current lease agreement also provides (i) a 5-year renewal option for the Company to extend
the lease from November 1, 2032 through October 31, 2037 at the fair market rental rate of the premises,
and  (ii)  another  5-year  renewal  option  to  extend  the  lease  from  November  1,  2037  through  October  31,
2042 at the fair market rental rate of  the premises.

10. INCOME TAXES

Income before income taxes consisted of the following:

United States operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $25,293
26,736
Foreign operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(In thousand)
$ 1,507
26,987

$37,026
45,088

Total

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $52,029

$28,494

$82,114

A  reconciliation  of  the  U.S.  Federal  statutory  rate  to  the  Company’s  effective  tax  rate  is  as  follows:

Years Ended December 31,

2012

2011

2010

Years Ended December 31,

2012

2011

2010

Federal statutory rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35.0%
Increase (decrease) in income taxes resulting  from:
State income taxes, net of federal tax benefit
2.6%
Foreign operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (14.9)% (18.1)% (10.3)%
—%
(0.3)%
Incentive stock option expense . . . . . . . . . . . . . . . . . . . . . . . —%
1.7%
(0.4)% (14.0)%
Changes in valuation allowances . . . . . . . . . . . . . . . . . . . . . .
(2.5)% (5.8)% (4.6)%
Uncertain tax positions . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(1.3)% (4.1)%
0.8%
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . .

35.0%

35.0%

6.0%

2.8%

Effective tax rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.8%

1.8%

20.0%

The effective tax rate increased by 19 percentage points in 2012 compared with 2011 primarily due to
a change in the mix of earnings related to higher U.S. income offset by tax benefits for foreign tax credits,
foreign earnings taxed at lower statutory rates and increased benefit from the favorable settlement of tax
audits.

During  2012,  the  Company  recorded  an  income  tax  benefit  of  $2.1  million  for  the  release  of  a  tax
contingency reserve, an income tax benefit of $0.2 million for a change in state tax law, and an income tax
expense of $0.2 million for the settlement  of an  IRS audit of years 2008, 2009, and  2010.

F-35

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

During  2012,  the  Company’s  foreign  operations  resulted  in  a  $7.8  million  income  tax  benefit  as  a
result  of,  among  other  factors,  the  geographic  and  business  mix  of  taxable  earnings  and  losses.  The
Company’s operations in Ireland contribute to the majority of this income tax benefit, as income earned in
Ireland is taxed at a corporate income tax rate that is significantly lower than the US corporate rate. The
2012 foreign effective tax rate is 7.8%, an increase of approximately 9.5 percentage points over the rate in
2011, which included a tax benefit of $1.6 million relating to the correction of various deferred tax items
for  periods  prior  to  2011.  The  Company’s  foreign  tax  rate  is  based  upon  statutory  tax  rates  and  is  not
related to a tax holiday or negotiated tax  rate.

During  the  second  and  fourth  quarters  of  2011,  the  Company  recorded  additional  tax  expense  of
$1.7  million  for  a  correction  to  a  state  deferred  tax  asset  relating  to  2009  and  an  income  tax  benefit  of
$2.2  million  for  the  correction  of  various  other  deferred  tax  items  relating  to  periods  prior  to  2011  that
largely  impacted  foreign  operations,  respectively.  Since  neither  one  of  these  changes  are  material  to  the
December 31, 2011 or previous years’ financial results, they have been recorded in the second and fourth
quarters of 2011 as discrete events, respectively.

In the fourth quarter of 2010, the Company recorded the full year income tax benefit related to the

passing of the Tax Relief, Unemployment Insurance  Reauthorization and  Job  Creation Act of 2010.

Income  taxes  are  not  provided  on  certain  undistributed  earnings  of  non-U.S.  subsidiaries,  because
such earnings are expected to be indefinitely reinvested and it would not be practicable to determine the
amount of the related unrecognized deferred income tax liability. Undistributed earnings of such foreign
subsidiaries totaled $165.3 million $168.8 million and $142.2 million at December 31, 2012, 2011 and 2010,
respectively.

The American Taxpayer Relief Act of 2012 was signed into law by the President of the United States
on January 2, 2013. In part, the bill approved a retroactive extension of certain business tax provisions that
expired  at  the  end  of  2011  and  2012.  These  extensions,  which  included  the  research  and  development
credit,  are  taken  into  account  for  financial  reporting  purposes  in  the  quarter  in  which  the  legislation  is
enacted  by  Congress  and  signed  into  law  by  the  President.  Accordingly,  there  was  no  income  tax  benefit
associated with the 2012 research and development tax credit in the  2012 financial statements.

The provision for income taxes consisted of  the following:

Years Ended December 31,

2012

2011

2010

(In thousands)

Current:

Federal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,614
1,373
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4,301
Foreign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ (934) $ 2,686
1,136
(1,530)
8,495
1,813

Total current . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 9,288
Deferred:

$ (651) $12,317

Federal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
State . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Foreign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,053
497
(3,013)

1,078
2,236
(2,158)

2,522
835
771

Total deferred . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,537

$ 1,156

$ 4,128

Provision for income taxes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $10,825

$

505

$16,445

F-36

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

The  income  tax  effects  of  significant  temporary  differences  that  give  rise  to  deferred  tax  assets  and

liabilities, shown before jurisdictional  netting, are presented below:

December 31,

2012

2011

(In thousands)

Current assets:

Doubtful accounts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 1,829
26,549
Inventory write-downs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,275
Tax  credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2,335
Accrued vacation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4,111
Accrued bonus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4,095
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$ 1,822
24,695
2,865
2,163
2,330
3,132

Total current deferred tax assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Less valuation allowance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

42,194
(2,922)

37,007
(702)

Current deferred tax assets after valuation allowance . . . . . . . . . . . . . . $ 39,272

$ 36,305

Current liabilities:

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(314)

(179)

Total current deferred tax liabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . $

(314) $

(179)

Net current deferred tax assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 38,958

$ 36,126

Non-current assets:

Benefit and compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
Stock compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred revenue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net operating loss carryforwards . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financing costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Federal & state tax credits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(500) $ 8,991
28,659
148
48,251
1,472
1,333
—

12,730
162
36,037
—
19,851
—

Total non-current deferred tax assets . . . . . . . . . . . . . . . . . . . . . . . . . .
Less valuation allowance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

68,280
(11,321)

88,854
(31,602)

Non-current deferred tax assets after  valuation  allowance . . . . . . . . . . . $ 56,959

$ 57,252

Non-current liabilities:

Intangible & fixed  assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Non-cash interest amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(46,650)
—
—
359

(43,152)
(548)
(1,847)
(191)

Total non-current deferred tax liabilities . . . . . . . . . . . . . . . . . . . . . . . $(46,291) $(45,738)

Net non-current deferred tax assets . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 10,668

$ 11,514

Total  net deferred tax assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 49,626

$ 47,640

At December 31, 2012, the Company had net operating loss carryforwards of $58.4 million for federal
income tax purposes, $57.1 million for foreign income tax purposes and $56.9 million for state income tax
purposes to offset future taxable income. The federal net operating loss carryforwards expire through 2030,

F-37

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

$42.8  million  of  the  foreign  net  operating  loss  carryforwards  expire  through  2021  with  the  remaining
$14.3 million having an indefinite carry forward period. The state net operating loss carryforwards expire
through 2031.

Deferred  tax  assets  relating  to  tax  benefits  of  employee  stock  option  grants  have  been  reduced  to
reflect exercises in 2012. Some exercises have resulted in tax deductions in excess of previously recorded
benefits based on the option value at the time of grant (‘‘windfalls’’). Although these additional tax benefits
are reflected in net operating tax loss carryforwards the additional tax benefit associated with the windfall
is  not  recognized  until  the  deduction  reduces  taxes  payable.  Accordingly,  since  the  tax  benefit  does  not
reduce  our  current  taxes  payable  in  2012  due  to  net  operating  loss  carryforwards,  these  ‘‘windfall’’  tax
benefits are not reflected in our net operating losses in deferred tax assets for 2012. Windfalls included in
net operating loss carryforwards but not  reflected  in deferred  tax  assets for 2012 are  $0.1 million.

A  valuation  allowance  of  $14.2  million,  $32.3  million  and  $36.6  million  is  recorded  against  the
Company’s  gross  deferred  tax  assets  of  $110.5  million,  $125.9  million  and  $112.9  million  recorded  at
December 31, 2012, 2011 and 2010, respectively.

The  valuation  allowance  relates  to  deferred  tax  assets  for  certain  items  that  will  be  deductible  for
income tax purposes under very limited circumstances and for which the Company believes it is not more
likely than not that it will realize the associated tax benefit. The Company does not anticipate additional
income tax benefits through future reductions in the valuation allowance. However, in the event that the
Company  determines  that  it  would  be  able  to  realize  more  or  less  than  the  recorded  amount  of  net
deferred tax assets, an adjustment to the deferred tax asset valuation allowance would be recorded in the
period such a determination is made.

The  Company’s  valuation  allowance  decreased  by  $18.1  million  and  $4.3  million  in  2012  and  2011,
respectively.  The  2012  overall  decrease  in  the  valuation  allowance  was  primarily  due  to  expiring  net
operating losses in Switzerland which is offset by a reduction in the related deferred tax asset. Further, the
Company recorded $0.3 million decrease to the valuation allowance in Switzerland related to an increase
in the expected future realizability of  remaining net  operating losses.

A reconciliation of the beginning and  ending amount of uncertain tax  benefits is as follows:

Years Ended December 31,

2012

2011

2010

Balance, beginning of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 3,927
7,796
(3,523)
(2,064)

Additions for tax positions of prior years . . . . . . . . . . . . . . . . .
Settlements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lapse of statute . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(In thousands)
$ 5,530
1,001
(962)
(1,642)

$10,909
1,685
(5,264)
(1,800)

Balance, end of year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 6,136

$ 3,927

$ 5,530

Approximately  $5.1  million  of  the  balance  at  December  31,  2012  relates  to  uncertain  tax  positions
that,  if  recognized,  would  affect  the  annual  effective  tax  rate.  Included  in  the  balance  of  uncertain  tax
positions at December 31, 2012 is $3.3 million related to tax positions for which it is reasonably possible
that the total amounts could be reduced during the twelve months following December 31, 2012, as a result
of expiring statutes of limitations.

The  Company  recognizes  interest  and  penalties  relating  to  uncertain  tax  positions  in  income  tax
expense. The Company recognized a $0.1 million expense, a $0.5 million benefit, and a $0.9 million benefit
for  interest  and  penalties  in  the  income  statement  during  the  years  ended  December  31,  2012,  2011  and

F-38

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

2010, respectively. The Company had approximately $1.4 million, $1.3 million, and $2.1 million of interest
and penalties accrued at December 31,  2012, 2011 and 2010, respectively.

During 2012, the Company settled the review of years 2008 through 2010 with the IRS, which resulted
in  $2.1  million  being  recorded  in  the  consolidated  statement  of  operations  as  an  income  tax  benefit,
partially offset by an additional Federal income tax expense of $0.2 million in 2012, as a result of receiving
the  agreed  upon  settlement.  In  addition,  the  Company  reclassified  $4.2  million  from  deferred  taxes  to
long-term liabilities, which had no effect on the current year tax provision. These amounts include interest
and penalties related to the settlement.

During  2010,  the  Company  settled  the  review  for  the  years  2005  through  2007  with  the  IRS  which
resulted  in  $4.0  million  in  taxes  being  reclassified  from  long-term  liabilities  to  current  taxes  payable  and
deferred taxes, and $4.5 million being recorded in the consolidated statement of operations as an income
tax  benefit.  This  settlement  was  approved  by  the  IRS  Joint  Committee  on  Taxation  in  December  2011,
formally  closing  the  2005  through  2007  audit.  The  Company  recorded  an  additional  federal  income  tax
benefit of $0.1 million in 2011 as a result of receiving the agreed upon settlement. These amounts include
interest and penalties related to the settlement and tax benefit.

The Company files Federal income tax returns, as well as multiple state, local and foreign jurisdiction
tax returns. The Company is no longer subject to examinations of its Federal income tax returns by the IRS
through fiscal year 2007. All significant state and local matters have been concluded through fiscal 2004.
All significant foreign matters have been  settled through fiscal 2005.

11. NET INCOME PER SHARE

Certain  of  the  Company’s  restricted  unvested  share  units  contain  rights  to  receive  nonforfeitable
dividends, and thus, are participating securities requiring the two-class method of computing earnings per
share.  The  participating  securities  had  an  insignificant  impact  on  the  calculation  of  earnings  per  share
(impacts  the  rounding  by  less  than  $0.01  per  share)  on  2011  and  2010  years  presented;  therefore,  the
Company does not present the full calculation below.

Basic and diluted net income per share  was  as follows (in thousands, except per share  amounts):

Years Ended December 31,

2012

2011

2010

(In thousands,
except per share amounts)

Basic net income per share:
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $41,204
28,232
Weighted average common shares outstanding . . . . . . . . . . . . . .
Basic net income per common share . . . . . . . . . . . . . . . . . . . . . $
1.46
Diluted net income per share:
Net income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $41,204
Weighted average common shares outstanding —  Basic . . . . . . . .
28,232
Effect of dilutive securities:
Stock options and restricted stock . . . . . . . . . . . . . . . . . . . . . . .

284

$27,989
28,952
0.97

$

$65,669
29,548
2.21

$

$27,989
28,952

$65,669
29,548

543

601

Weighted average common shares for  diluted earnings  per  share .
Diluted net income per common share . . . . . . . . . . . . . . . . . . . . $

28,516
1.44

29,495
0.95

$

30,149
2.17

$

F-39

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Common stock of approximately 1.0 million, 0.3 million and 0.7 million shares at December 31, 2012,
2011 and 2010, respectively, that are issuable through exercise or conversion of dilutive securities were not
included  in  the  computation  of  diluted  net  income  per  share  because  their  effect  would  have  been
antidilutive.

Performance Shares and Restricted Units that entitle the holders to approximately 0.1 million shares
of  common  stock  are  included  in  the  basic  and  diluted  weighted  average  shares  outstanding  calculation
from  their  date  of  issuance  because  no  further  consideration  is  due  related  to  the  issuance  of  the
underlying common shares.

12. COMMITMENTS AND CONTINGENCIES

In  consideration  for  certain  technology,  manufacturing,  distribution  and  selling  rights  and  licenses
granted  to  the  Company,  the  Company  has  agreed  to  pay  royalties  on  the  sales  of  products  that  are
commercialized  relative  to  the  granted  rights  and  licenses.  Royalty  payments  under  these  agreements  by
the Company were not significant for any of the periods presented.

The  Company  is  subject  to  various  claims,  lawsuits  and  proceedings  in  the  ordinary  course  of  the
Company’s  business,  including  claims  by  current  or  former  employees,  distributors  and  competitors  and
with respect to its products and product liability claims, lawsuits and proceedings, some of which have been
settled  by  the  Company.  In  the  opinion  of  management,  such  claims  are  either  adequately  covered  by
insurance  or  otherwise  indemnified,  or  are  not  expected,  individually  or  in  the  aggregate,  to  result  in  a
material  adverse  effect  on  our  financial  condition.  However,  it  is  possible  that  the  Company’s  results  of
operations,  financial  position  and  cash  flows  in  a  particular  period  could  be  materially  affected  by  these
contingencies.

On June 6, 2012, the Company was contacted by the United States Attorney’s Office for the District of
New  Jersey  regarding  the  activities  of  two  sales  representatives  in  a  single  region  within  our  Extremities
Reconstruction  division  pertaining  to  the  alleged  creation  of  invoices  for  products  that  were  not  sold  or
surgeries that did not take place for extremities indications. The Company is cooperating with the United
States Attorney’s office on a voluntary basis and is not a subject or target of an investigation at this time.

The Company accrues for loss contingencies when it is deemed probable that a loss has been incurred
and that loss is estimable. The amounts accrued are based on the full amount of the estimated loss before
considering insurance proceeds, and do not include an estimate for legal fees expected to be incurred in
connection with the loss contingency. The Company consistently accrues legal fees expected to be incurred
in connection with loss contingencies as  those fees are incurred by outside  counsel as a period cost.

13. SEGMENT AND GEOGRAPHIC  INFORMATION

Starting in the first quarter of 2012, because of changes in how the Company internally manages and
reports the results of its businesses to its chief operating decision maker, the Company began reporting five
reportable  segments.  The  five  reportable  segments  are  U.S.  Neurosurgery,  U.S.  Instruments,  U.S.
Extremities, U.S. Spine and Other, and International. The U.S. Neurosurgery segment sells a full line of
products  specifically  for  neurosurgery  and  critical  care  such  as  tissue  ablation  equipment,  dural  repair
products,  cerebral  spinal  fluid  management  devices,  intracranial  monitoring  equipment,  and  cranial
stabilization  equipment.  The  U.S.  Instruments  business  sells  more  than  60,000  instrument  patterns  and
surgical products and lighting to hospitals, surgery centers, and dental, podiatry, and veterinary offices. The
U.S.  Extremities  segment  includes  the  U.S.  extremity  reconstruction  business,  which  includes  such
offerings as skin and wound repair, bone and joint fixation, implants in the upper and lower extremities,
bone grafts and nerve and tendon repair. The U.S. Spine and Other segment includes (i) the U.S. Spine
business,  which  focuses  on  spinal  fusion,  spinal  implants,  and  deformity  correction,  (ii)  the  U.S.

F-40

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Orthobiologics business, which focuses on bone graft substitutes and other related medical devices that are
used  to  enhance  the  repair  and  regeneration  of  bone  in  various  types  of  orthopedic  surgical  procedures,
and (iii) the Private Label business, which sells the Company’s regenerative medicine and other products
to  strategic  partners.  The  International  segment  sells  similar  products  to  those  discussed  above,  but  are
managed  through  the  following  geographies:  (i)  Europe,  Middle  East  and  Africa,  and  (ii)  Central/South
America,  Asia-Pacific  and  Canada.  The  Corporate  and  other  category  includes  (i)  various  legal,  finance,
executive,  and  human  resource  functions,  (ii)  brand  management,  (iii)  share-based  compensation  costs,
and  (iv)  costs  related  to  procurement,  manufacturing  operations  and  logistics  for  the  Company’s  entire
organization.  Accordingly,  the  segment  information  for  the  prior  years  has  been  restated  in  accordance
with authoritative guidance on segment reporting. The accounting policies of the reportable segments are
the same as those described in Note 2.

None  of  the  Company’s  customers  accounted  for  10%  or  more  of  the  consolidated  net  sales  during

our  year ended December 31, 2012, 2011  and  2010.

The  operating  results  of  the  various  reportable  segments  as  presented  are  not  comparable  to  one
another because (i) certain operating segments are more dependent than others on corporate functions for
unallocated general and administrative and/or operational manufacturing functions, and (ii) the Company
does  not  allocate  certain  manufacturing  costs  and  general  and  administrative  costs  to  the  operating
segment results.

Net sales and profit by reportable segment for the year ended December 31, 2012, 2011 and 2010 are

as follows:

Segment Net Sales

Years Ended December 31,

2012

2011

2010

(In thousands)

U.S. Neurosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 171,278
162,323
U.S. Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
122,847
U.S. Extremities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
190,546
U.S. Spine and Other . . . . . . . . . . . . . . . . . . . . . . . . . .
183,877
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
International

$ 165,652
155,833
98,109
174,479
186,005

$ 165,606
157,853
89,529
152,274
166,806

Total revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 830,871

$ 780,078

$ 732,068

Segment Profit

U.S. Neurosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 91,070
36,550
U.S. Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
49,432
U.S. Extremities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
55,891
U.S. Spine and Other . . . . . . . . . . . . . . . . . . . . . . . . . .
61,336
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
International

$ 86,206
29,753
38,540
51,011
64,164

$ 83,804
27,350
39,347
57,643
59,636

Segment profit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Amortization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Corporate and other . . . . . . . . . . . . . . . . . . . . . . . . . . . .

294,279
(18,536)
(201,961)

269,674
(16,433)
(198,329)

267,780
(12,017)
(157,069)

Operating income . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 73,782

$ 54,912

$ 98,694

The  Company  does  not  allocate  any  assets  to  the  reportable  segments,  and,  therefore,  no  asset
information is reported to the chief operating decision maker and disclosed in the financial information for
each  segment.

F-41

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

Revenue by major product category consisted of the following:

Orthopedics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $369,312
277,527
Neurosurgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
184,032
Instruments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(In thousands)
$328,933
272,538
178,607

$290,274
263,147
178,647

Total Revenues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $830,871

$780,078

$732,068

Years Ended December 31,

2012

2011

2010

The Company attributes revenue to geographic areas based on the location of the customer. There are
certain revenues managed by the various U.S. segments above that are generated from non-U.S. customers
and therefore included in Europe and  the Rest  of  World revenues below.

Total revenue, net and long-lived assets (tangible)  by major geographic  area are summarized  below:

United States*

Europe

Rest of  the World

Consolidated

(In thousands)

Total revenue, net:

2012 . . . . . . . . . . . . . . . . . . . . . . . . .
2011 . . . . . . . . . . . . . . . . . . . . . . . . .
2010 . . . . . . . . . . . . . . . . . . . . . . . . .

$642,830
589,946
561,307

$90,920
97,184
89,044

Total long-lived assets:

2012 . . . . . . . . . . . . . . . . . . . . . . . . .
2011 . . . . . . . . . . . . . . . . . . . . . . . . .

$166,508
125,880

$20,242
17,274

$97,121
92,948
81,717

$ 1,507
1,357

$830,871
780,078
732,068

$188,257
144,511

*

Includes long-lived assets in Puerto Rico.

F-42

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

14. SELECTED QUARTERLY INFORMATION  — UNAUDITED

First
Quarter

Second
Quarter

Third
Quarter

Fourth
Quarter

(In thousands, except per share data)

Total revenue, net:

2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $196,185
181,041
2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$210,170
193,329

$210,084
202,185

$214,432
203,523

Gross margin:

2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $121,510
116,120
2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$131,896
120,491

$130,536
123,534

$132,502
120,783

Net income (loss):

2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6,693
11,487

Basic net income (loss) per common share(1)(2):

2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0.24
0.39

Diluted net income (loss) per common

share(1)(2):
2012 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $
2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

0.23
0.38

$

$

$

8,514
699

$ 13,211
11,243

$ 12,786
4,560

$

$

0.30
0.02

0.30
0.02

$

$

0.46
0.39

0.46
0.39

0.46
0.16

0.46
0.16

(1) Per  common  share  amounts  for  the  quarters  and  full  years  have  been  calculated  separately.
Accordingly, quarterly amounts do not necessarily add to the annual amount because of differences in
the weighted average common shares outstanding during each period principally due to the effect of
the Company’s issuing shares of its common  stock  during the year.

(2) Certain  of  the  Company’s  unvested  restricted  share  units  contain  rights  to  receive  nonforfeitable
dividends, and thus, are participating securities requiring the two-class method of computing earnings
per share. The participating securities had an insignificant impact on the calculation of earnings per
share (impacts the rounding by less than $0.01 per share) on all of the periods presented; therefore,
the Company does not present the full calculation.

Interest  expense  for  the  fourth  quarter  of  2012  includes  an  out-of-period  adjustment  to  record  a
decrease to interest expense of $3.3 million related to not capitalizing interest cost on certain construction
in progress balances, of which $1.5 million related to the first three quarters of 2012, $1.4 million for the
full  year  2011  and  $0.4  million  for  the  last  quarter  of  2010.  The  Company  believes  that  both  the  actual
interest expense errors and the correction of those errors out of period in the fourth quarter of 2012 are
not material.

The  Company  incurred  incremental  costs  related  to  the  implementation  of  its  global  enterprise
resource  planning  system  in  the  first,  second,  third,  and  fourth  quarters  of  2012  of  $3.7  million,
$3.6 million, $4.8 million and $4.3 million, respectively.

The  Company  incurred  costs  related  to  the  remediation  of  an  FDA  warning  letter  and  the  related
underutilization  at  its  Plainsboro,  New  Jersey  manufacturing  facility  of  $1.6  million,  $1.8  million,
$3.8 million and $0.7 million in the first,  second,  third  and fourth quarters  of 2012, respectively.

F-43

INTEGRA LIFESCIENCES HOLDINGS CORPORATION

NOTES TO CONSOLIDATED FINANCIAL STATEMENTS — (Continued)

15. SUBSEQUENT EVENTS

On  January  24,  2013,  the  Company  acquired  all  outstanding  preferred  and  common  stock  of  Tarsus
Medical, Inc. for $3.0 million which includes amounts paid into escrow, subject to certain working capital
adjustments.  The  acquisition  agreement  includes  a  provision  whereby  Integra  must  pay  additional  cash
considerations,  the  first  of  $1.5  million  and  the  second  up  to  $14.5  million  to  the  selling  shareholders  of
Tarsus Medical, Inc. upon reaching certain selling milestones. The Company believes that Tarsus Medical’s
technology will allow it to enter the syndesmosis repair market. Since the acquisition occurred subsequent
to  December  31,  2012,  the  acquisition  is  not  included  in  the  results  of  operations  for  any  of  the  periods
presented.

F-44

SCHEDULE II — VALUATION AND  QUALIFYING ACCOUNTS

Balance at
Beginning of
Period

Charged to
Costs and
Expenses

Charged to
Other
Accounts(1)

Deductions

Balance at
End  of
Period

(In thousands)

Description

Year ended December 31, 2012:

Allowance for doubtful accounts and sales

returns and allowances . . . . . . . . . . . . .

$ 6,978

$ 1,315

$ —

$(1,072)

$ 7,221

Deferred tax asset valuation allowance . . . .

32,304

(16,979)

477

(1,559)

14,243

Year ended December 31, 2011:

Allowance for doubtful accounts and sales

returns and allowances . . . . . . . . . . . . .

$ 7,322

$ 1,118

$ —

$(1,462)

$ 6,978

Deferred tax asset valuation allowance . . . .

36,634

127

(4,238)

(219)

32,304

Year ended December 31, 2010:

Allowance for doubtful accounts and sales

returns and allowances . . . . . . . . . . . . .

$11,216

$ (2,167)

$ —

$(1,727)

$ 7,322

Deferred tax asset valuation allowance . . . .

36,131

431

1,160

(1,088)

36,634

(1) In 2012, $0.5 million of deferred tax liability was reclassified to the valuation allowance with no impact
to  the  consolidated  statement  of  operations.  In  2011,  $4.2  million  of  the  valuation  allowance  was
reclassified to long-term taxes payable with no impact to the consolidated statements of operations. In
2010, $1.2 million of deferred tax liability was reclassified to the valuation allowance with no impact to
the consolidated statement of operations.

F-45

3.1(a)

3.1(b)

3.1(c)

3.2

4.1

4.2

4.3(a)

4.3(b)

4.3(c)

4.3(d)

EXIBIT INDEX

Amended and Restated Certificate of Incorporation of the Company dated February 16, 1993
(Incorporated by reference to Exhibit 3.1(a) to the Company’s Annual Report on Form 10-K
for  the year ended December 31, 2005)

Certificate  of  Amendment  to  Amended  and  Restated  Certificate  of  Incorporation  of  the
Company dated May 22, 1998 (Incorporated by reference to Exhibit 3.1(b) to the Company’s
Annual Report on Form 10-K for the year  ended  December  31, 1998)

Certificate  of  Amendment  to  Amended  and  Restated  Certificate  of  Incorporation  of  the
Company dated May 17, 1999 (Incorporated by reference to Exhibit 3.1(c) to the Company’s
Annual Report on Form 10-K for the year  ended  December  31, 2004)

Amended and Restated Bylaws of the Company, effective as of May 17, 2012 (Incorporated
by reference to Exhibit 3.2 to the Company’s Current Report on Form 8-K filed on April 13,
2012)

Purchase  Agreement,  dated  June  9,  2011,  by  and  between  Integra  LifeSciences  Holdings
Corporation  and  J.P.  Morgan  Securities  LLC,  Merrill  Lynch,  Pierce,  Fenner  &  Smith
Incorporated,  Morgan  Stanley  &  Co.  LLC,  Deutsche  Bank  Securities  Inc.,  RBC  Capital
Markets, LLC and Wells Fargo Securities, LLC (Incorporated by reference to Exhibit 4.1 to
the Company’s Current Report on Form 8-K filed  on June 15, 2011)

Indenture, dated June 15, 2011, by and between Integra LifeSciences Holdings Corporation
and  Wells  Fargo  Bank,  National  Association,  as  trustee  (Incorporated  by  reference  to
Exhibit 4.2 to the Company’s Current Report on Form 8-K  filed on June 15, 2011)

Credit  Agreement,  dated  as  of  December  22,  2005,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing  Line  Lender  and  L/C  Issuer,  Citibank  FSB  and  SunTrust  Bank,  as  Co-Syndication
Agents,  and  Royal  Bank  of  Canada  and  Wachovia  Bank,  National  Association,  as
Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s
Current Report on Form 8-K filed on December 29,  2005)

First  Amendment,  dated  as  of  February  15,  2006,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing  Line  Lender  and  L/C  Issuer,  Citibank  FSB  and  SunTrust  Bank,  as  Co-Syndication
Agents,  and  Royal  Bank  of  Canada  and  Wachovia  Bank,  National  Association,  as
Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  4.3(b)  to  the  Company’s
Annual Report on Form 10-K for the year  ended  December  31, 2005)

Second  Amendment,  dated  as  of  February  23,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing  Line  Lender  and  L/C  Issuer,  Citibank  FSB  and  SunTrust  Bank,  as  Co-Syndication
Agents,  and  Royal  Bank  of  Canada  and  Wachovia  Bank,  National  Association,  as
Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  4.1  to  the  Company’s
Current Report on Form 8-K filed on February 27,  2007)

Third  Amendment,  dated  as  of  June  4,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing Line Lender and L/C Issuer, Citibank, N.A., successor by merger to Citibank, FSB, as
Syndication  Agent  and  JPMorgan  Chase  Bank,  N.A.,  Deutsche  Bank  Trust  Company
Americas  and  Royal  Bank  of  Canada,  as  Co-Documentation  Agents  (Incorporated  by
reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on June 6, 2007)

4.3(e)

4.3(f)

4.3(g)

4.3(h)

4.4

4.5

4.6

4.7

4.8

4.9

Fourth  Amendment,  dated  as  of  September  5,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,
Swing Line Lender and L/C Issuer, Citibank, N.A., successor by merger to Citibank FSB, as
Syndication  Agent  and  JPMorgan  Chase  Bank,  N.A.,  Deutsche  Bank  Trust  Company
Americas  and  Royal  Bank  of  Canada,  as  Co-Documentation  Agents  (Incorporated  by
reference to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on September 6,
2007)

Amended  and  Restated  Credit  Agreement,  dated  as  of  August  10,  2010,  among  Integra
LifeSciences  Holdings  Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.,  as
Administrative  Agent,  Swing  Line  Lender  and  L/C  Issuer,  JP  Morgan  Chase  Bank,  as
Syndication  Agent,  and  HSBC  Bank  USA,  NA,  RBC  Capital  Markets,  Wells  Fargo  Bank,
N.A.,  Fifth  Third  Bank,  DNB  NOR  Bank  ASA  and  TD  Bank,  N.A.,  as  Co-Documentation
Agents  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on
Form 8-K filed on August 10, 2010)

Second Amended and Restated Credit Agreement, dated as of June 8, 2011, among Integra
LifeSciences  Holdings  Corporation,  the  lenders  party  thereto,  Bank  of  America,  N.A.  as
Administrative  Agent,  Swing  Line  Lender  and  L/C  Issuer,  JPMorgan  Chase  Bank  N.A.  as
Syndication  Agent,  and,  HSBC  Bank  USA,  NA,  Royal  Bank  of  Canada,  Wells  Fargo  Bank,
N.A.,  Fifth  Third  Bank,  DNB  NOR  Bank  ASA,  and  TD  Bank,  N.A.,  as  Co-Documentation
Agents  (Incorporated  by  reference  to  Exhibit  4.3  to  the  Company’s  Quarterly  Report  on
Form 10-Q filed on July 29, 2011)

First  Amendment,  dated  as  of  May  11,  2012,  to  Second  Amended  and  Restated  Credit
Agreement dated as of June 8, 2011, among Integra LifeSciences Holdings Corporation, the
lenders  party  thereto,  Bank  of  America,  N.A.,  as  Administrative  Agent,  Swing  Line  Lender
and  L/C  Issuer,  JPMorgan  Chase  Bank,  N.A.,  as  Syndication  Agent,  and  HSBC  Bank,  NA,
Royal Bank of Canada, Wells Fargo Bank, NA, Fifth Third Bank, DNB Nor Bank ASA and
TD  Bank,  N.A.,  as  Co-Documentation  Agents  (Incorporated  by  reference  to  Exhibit  4.1  to
the Company’s Current Report on Form 8-K filed  on May  14, 2012)

Security  Agreement,  dated  as  of  December  22,  2005,  among  Integra  LifeSciences  Holdings
Corporation and the additional grantors party thereto in favor of Bank of America, N.A., as
administrative  and  collateral  agent  (Incorporated  by  reference  to  Exhibit  4.4  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)

Pledge  Agreement,  dated  as  of  December  22,  2005,  among  Integra  LifeSciences  Holdings
Corporation and the additional grantors party thereto in favor of Bank of America, N.A., as
administrative  and  collateral  agent  (Incorporated  by  reference  to  Exhibit  4.5  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)

Subsidiary Guaranty Agreement, dated as of December 22, 2005, among the guarantors party
thereto  and  individually  as  a  ‘‘Guarantor’’),  in  favor  of  Bank  of  America,  N.A.,  as
administrative  and  collateral  agent  (Incorporated  by  reference  to  Exhibit  4.6  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)

Indenture,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings  Corporation,  Integra
LifeSciences Corporation and Wells Fargo Bank, N.A., as trustee (Incorporated by reference
to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on  June 12, 2007)

Form of 2.75% Senior Convertible Note due 2010 (included in Exhibit 4.8) (Incorporated by
reference to Exhibit B to Exhibit 4.1 to the Company’s Current Report on Form 8-K filed on
June 12, 2007)

Indenture,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings  Corporation,  Integra
LifeSciences Corporation and Wells Fargo Bank, N.A., as trustee (Incorporated by reference
to Exhibit 4.3 to the Company’s Current Report on Form 8-K filed on  June 12, 2007)

4.10

4.11

4.12

10.1(a)

10.1(b)

10.1(c)

10.2(a)

10.2(b)

10.3

10.4

10.5

10.6

Form of 2.375% Senior Convertible Note due 2012 (included in Exhibit 4.10) (Incorporated
by reference to Exhibit B to Exhibit 4.3 to the Company’s Current Report on Form 8-K filed
on June 12, 2007)

Registration  Rights  Agreement,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  Banc  of  America  Securities  LLC,  J.P.  Morgan  Securities  Inc.  and  Morgan
Stanley & Co., Incorporated, as representatives of the several initial purchasers (Incorporated
by reference to Exhibit 4.5 to the Company’s Current Report on Form 8-K filed on June 12,
2007)

Registration  Rights  Agreement,  dated  June  11,  2007,  among  Integra  LifeSciences  Holdings
Corporation,  Banc  of  America  Securities  LLC,  J.P.  Morgan  Securities  Inc.  and  Morgan
Stanley & Co., Incorporated, as representatives of the several initial purchasers (Incorporated
by reference to Exhibit 4.6 to the Company’s Current Report on Form 8-K filed on June 12,
2007)

Lease  between  Plainsboro  Associates  and  American  Biomaterials  Corporation  dated  as  of
April  16,  1985,  as  assigned  to  Colla-Tec,  Inc.  on  September  30,  1988  and  as  amended  on
November 1, 1992 as Lease Modification #1 (Incorporated by reference to Exhibit 10.30 to
the  Company’s  Registration  Statement  on  Form  10/A  (File  No.  0-26224)  which  became
effective on August 8, 1995)

Lease  Modification  #2  entered  into  as  of  October  28,  2005,  by  and  between  Plainsboro
Associates and Integra LifeSciences Corporation (Incorporated by reference to Exhibit 10.1
to the Company’s Current Report on  Form 8-K filed on November  2, 2005)

Lease  Modification  #3  entered  into  as  of  March  2,  2011,  by  and  between  Plainsboro
Associates and Integra LifeSciences Corporation (Incorporated by reference to Exhibit 10.1
to the Company’s Current Report on  Form 8-K filed on March 3,  2011)

Equipment  Lease  Agreement  between  Medicus  Corporation  and  the  Company,  dated  as  of
June 1, 2000 (Incorporated by reference to Exhibit 10.1 to the Company’s Quarterly Report
on Form 10-Q for the quarter ended June 30, 2000)

First  Amendment  to  Equipment  Lease  Agreement  between  Medicus  Corporation  and  the
Company,  dated  as  of  June  29,  2010  (Incorporated  by  reference  to  Exhibit  10.2  to  the
Company’s Quarterly Report on Form 10-Q for  the quarter ended  June  30, 2010)

Form  of  Indemnification  Agreement  between  the  Company  and  [
]  dated  August  16,
1995, including a schedule identifying the individuals that are a party to such Indemnification
Agreements  (Incorporated  by  reference  to  Exhibit  10.37  to  the  Company’s  Registration
Statement on Form S-1 (File No. 33-98698) which  became effective on January  24, 1996)*

1996  Incentive  Stock  Option  and  Non-Qualified  Stock  Option  Plan  (as  amended  through
December  27,  1997)  (Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s  Current
Report on Form 8-K filed on February  3, 1998)*

1998  Stock  Option  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.3 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

1999  Stock  Option  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.4 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

10.7(a)

Employee Stock Purchase Plan (as amended on May 17, 2004) (Incorporated by reference to
Exhibit  4.1  to  the  Company’s  Registration  Statement  on  Form  S-8  (Registration
No. 333-127488) filed on August 12,  2005)*

10.7(b)

10.8(a)

10.8(b)

First  Amendment  to  Employee  Stock  Purchase  Plan,  dated  October  26,  2005  (Incorporated
by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
November 1, 2005)*

2000  Equity  Incentive  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.5 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

Amendment  to  2000  Equity  Incentive  Plan  (effective  as  of  May  17,  2012)  (Incorporated  by
reference to Exhibit 10.7 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2012)*

10.8(c)

Amendment to 2000 Equity Incentive Plan (effective as of  January  1, 2013)*+

10.9(a)

10.9(b)

2001  Equity  Incentive  Plan  (amended  and  restated  as  of  July  26,  2005)  (Incorporated  by
reference to Exhibit 10.6 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended September 30, 2005)*

Amendment  to  2001  Equity  Incentive  Plan  (effective  as  of  May  17,  2012)  (Incorporated  by
reference to Exhibit 10.8 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2012)*

10.9(c)

Amendment to 2001 Equity Incentive Plan (effective as of  January  1, 2013)*+

10.10(a)

Second  Amended  and  Restated  2003  Equity  Incentive  Plan  effective  May  19,  2010
(Incorporated by reference to Exhibit 10 to the Company’s Current Report on Form 8-K filed
May 21, 2010)*

10.10(b) Amendment  to  the  Second  Amended  and  Restated  2003  Equity  Incentive  Plan  effective
May 17, 2012 (Incorporated by reference to Exhibit 10.9 to the Company’s Quarterly Report
on Form 10-Q for the quarter ended June 30, 2012)*

10.10(c)

10.11(a)

Amendment  to  the  Second  Amended  and  Restated  2003  Equity  Incentive  Plan  effective
January 1, 2013*+

Second  Amended  and  Restated  Employment  Agreement  dated  July  27,  2004  between  the
Company  and  Stuart  M.  Essig  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s
Quarterly Report on Form 10-Q for the quarter ended September  30, 2004)*

10.11(b) Amendment 2006-1, dated as of December 19, 2006, to the Second Amended and Restated
Employment  Agreement,  between  the  Company  and  Stuart  M.  Essig  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 22, 2006)*

10.11(c)

Amendment  2008-1,  dated  as  of  March  6,  2008,  to  the  Second  Amended  and  Restated
Employment  Agreement,  between  the  Company  and  Stuart  M.  Essig  (Incorporated  by
reference  to  Exhibit  10.12(c)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2007)*

10.11(d) Amendment  2008-2,  dated  as  of  August  6,  2008,  to  the  Second  Amended  and  Restated
Employment  Agreement  between  Stuart  M.  Essig  and  the  Company  (Incorporated  by
reference to Exhibit 10.7 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2008)*

10.11(e) Amendment  2009-1,  dated  as  of  April  13,  2009,  to  the  Second  Amended  and  Restated
Employment  Agreement  between  Stuart  M.  Essig  and  the  Company  (Incorporated  by
reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  April  13,
2009)*

10.11(f)

10.11(g)

10.11(h)

10.12

Letter  Agreement  dated  May  17,  2011  between  the  Company  and  Stuart  M.  Essig
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed May 23, 2011)*

Letter  dated  December  20,  2011  from  Stuart  M.  Essig  to  the  Company  (Incorporated  by
reference to Exhibit 10.3 to the Company’s Current Report on Form 8-K filed December 23,
2011)*

Letter  Agreement  dated  June  7,  2012  between  Stuart  M.  Essig  and  the  Company
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed on June 7, 2012)*

Indemnity letter agreement dated December 27, 1997 from the Company to Stuart M. Essig
(Incorporated  by  reference  to  Exhibit  10.5  to  the  Company’s  Current  Report  on  Form  8-K
filed on February 3, 1998)*

10.13(a) Registration Rights Provisions for Stuart M. Essig (Incorporated by reference to Exhibit B of

Exhibit 10.1 to the Company’s Current Report on Form 8-K  filed on February 3,  1998)*

10.13(b) Registration Rights Provisions for Stuart M. Essig (Incorporated by reference to Exhibit 10.2

to the Company’s Current Report on  Form 8-K filed on January 8, 2001)*

10.13(c)

Registration Rights Provisions for Stuart M. Essig (Incorporated by reference to Exhibit B of
Exhibit  10.1  to  the  Company’s  Quarterly  Report  on  Form  10-Q  for  the  quarter  ended
September 30, 2004)*

10.14(a) Amended and Restated 2005 Employment Agreement between John B. Henneman, III and
the  Company  dated  December  19,  2005  (Incorporated  by  reference  to  Exhibit  10.16  to  the
Company’s Annual Report on Form 10-K for  the  year ended December 31,  2005)*

10.14(b) Amendment  2008-1,  dated  as  of  January  2,  2008,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.15(b)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2007)*

10.14(c)

Amendment  2008-2,  dated  as  of  December  18,  2008,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 24, 2008)*

10.14(d) Amendment  2009-1,  dated  as  of  April  13,  2009,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.5  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  April  13,
2009)*

10.14(e) Amendment  2010-1,  dated  as  of  October  12,  2010,  to  the  Amended  and  Restated  2005
Employment Agreement between John B. Henneman, III and the Company (Incorporated by
reference  to  Exhibit  10.3  to  the  Company’s  Current  Report  on  Form  8-K  filed  October  12,
2010)*

10.14(f)

10.15

10.16(a)

Letter  dated  as  of  February  22,  2012  from  John  B.  Henneman,  III  to  the  Company
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed February 22, 2012)*

Consulting  Agreement,  dated  October  12,  2010,  between  the  Company  and  Inception
Surgical  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on
Form 8-K filed on October 12, 2010)*

Severance Agreement between Judith O’Grady and the Company dated as of January 4, 2010
(Incorporated by reference to Exhibit 10.17 to the Company’s Annual Report on Form 10-K
for  the year ended December 31, 2009)*

10.16(b)

10.16(c)

10.17(a)

Severance Agreement between Judith O’Grady and the Company dated as of January 3, 2011
(Incorporated  by  reference  to  Exhibit  10.17(a)  to  the  Company’s  Annual  Report  on
Form 10-K for the year ended December 31, 2010)*

Severance Agreement between Judith O’Grady and the Company dated as of January 3, 2012
(Incorporated  by  reference  to  Exhibit  10.16(c)  to  the  Company’s  Annual  Report  on
Form 10-K for the year ended December 31, 2011)*

Employment  Agreement,  dated  as  of  October  12,  2010,  between  Peter  J.  Arduini  and  the
Company  (Incorporated  by  reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on
Form 8-K filed October 12, 2010)*

10.17(b) Amended and Restated Employment Agreement dated December 20, 2011 between Peter J.
Arduini  and  the  Company  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s
Current Report on Form 8-K filed December 23, 2011)*

10.18

10.19(a)

Form  of  Notice  of  Stock  Option  Grant  with  Eight-Year  Term  for  Peter  J.  Arduini
(Incorporated  by  reference  to  Exhibit  10.2  to  the  Company’s  Current  Report  on  Form  8-K
filed December 23, 2011)*

Lease  Contract,  dated  April  1,  2005,  between  the  Puerto  Rico  Industrial  Development
Company and Integra CI, Inc. (executed on September 15, 2006) (Incorporated by reference
to  Exhibit  10.3  to  the  Company’s  Quarterly  Report  on  Form  10-Q  for  the  quarter  ended
September 30, 2006)

10.19(b) Amendment to Lease Contract dated as of November 2, 2011, between Integra CI, Inc. and
Puerto Rico Industrial Development Company (Incorporated by reference to Exhibit 10.1 to
the Company’s Current Report on Form 8-K filed  on November 7,  2011)

10.19(c)

Termination of Amendment to Lease Contract, dated as of April 2, 2012, between Integra CI,
Inc.  and  Puerto  Rico  Industrial  Development  Company  (Incorporated  by  reference  to
Exhibit  10.2  to  the  Company’s  Quarterly  Report  on  Form  10-Q  for  the  quarter  ended
March 31, 2012)

10.20

10.21

10.22

Restricted Units Agreement dated December 27, 1997 between the Company and Stuart M.
Essig  (Incorporated  by  reference  to  Exhibit  10.3  to  the  Company’s  Current  Report  on
Form 8-K filed on February 3, 1998)*

Stock Option Grant and Agreement pursuant to 1999 Stock Option Plan dated December 22,
2000 between the Company and Stuart M. Essig (Incorporated by reference to Exhibit 4.1 to
the Company’s Current Report on Form 8-K filed  on January  8, 2001)*

Stock  Option  Grant  and  Agreement  pursuant  to  2000  Equity  Incentive  Plan  dated
December 22, 2000 between the Company and Stuart M. Essig (Incorporated by reference to
Exhibit 4.2 to the Company’s Current Report on Form 8-K  filed on January 8, 2001)*

10.23(a) Restricted Units Agreement dated December 22, 2000 between the Company and Stuart M.
Essig  (Incorporated  by  reference  to  Exhibit  4.3  to  the  Company’s  Current  Report  on
Form 8-K filed on January 8, 2001)*

10.23(b) Amendment  2006-1,  dated  as  of  October  30,  2006,  to  the  Stuart  M.  Essig  Restricted  Units
Agreement dated as of December 22, 2000 (Incorporated by reference to Exhibit 10.1 to the
Company’s Current Report on Form 8-K filed on  November 3, 2006)*

10.24

Stock  Option  Grant  and  Agreement  pursuant  to  2003  Equity  Incentive  Plan  dated  July  27,
2004 between the Company and Stuart M. Essig (Incorporated by reference to Exhibit 10.30
to the Company’s Annual Report on Form 10-K for  the year ended December 31, 2004)*

10.25(a)

Contract  Stock/Restricted  Units  Agreement  pursuant  to  2003  Equity  Incentive  Plan  dated
July  27,  2004  between  the  Company  and  Stuart  M.  Essig  (Incorporated  by  reference  to
Exhibit  10.31  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2004)*

10.25(b) Amendment  2006-1,  dated  as  of  October  30,  2006,  to  the  Stuart  M.  Essig  Contract  Stock/
Restricted  Units  Agreement  dated  as  of  July  27,  2004  (Incorporated  by  reference  to
Exhibit 10.2 to the Company’s Current Report on Form 8-K  filed on November  3, 2006)*

10.25(c)

Amendment  2008-1,  dated  as  of  March  6,  2008,  to  the  Stuart  M.  Essig  Contract  Stock/
Restricted  Units  Agreement  dated  as  of  July  27,  2004  (Incorporated  by  reference  to
Exhibit  10.25(c)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2007)*

10.25(d) Amendment  2011-1,  dated  as  of  May  17,  2011,  to  the  Stuart  M.  Essig  Contract  Stock/
Restricted  Units  Agreement  dated  as  of  July  24,  2004  (Incorporated  by  reference  to
Exhibit 10.6 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30,
2011)*

10.26

10.27

10.28

Contract  Stock/Units  Agreement  dated  as  of  May  17,  2011  between  the  Company  and
Stuart M. Essig (Incorporated by reference to Exhibit 10.2 to the Company’s Current Report
on Form 8-K filed on May 23, 2011)*

Form  of  Amendment  2011-1  to  Contract  Stock/Restricted  Units  Agreements  between  the
Company  and  Mr.  Essig  (Incorporated  by  reference  to  Exhibit  10.5  to  the  Company’s
Quarterly Report on Form 10-Q for the quarter ended June 30, 2011)*

Form  of  Stock  Option  Grant  and  Agreement  between  the  Company  and  Stuart  M.  Essig
(Incorporated by reference to Exhibit 10.32 to the Company’s Annual Report on Form 10-K
for  the year ended December 31, 2004)*

10.29(a)

Form  of  Contract  Stock/Restricted  Units  Agreement  for  Stuart  M.  Essig  (Incorporated  by
reference to Exhibit 10.8 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2008)*

10.29(b) New  Form  of  Contract  Stock/Restricted  Units  Agreement  (for  Annual  Equity  Awards)  for
Stuart  M.  Essig  (Incorporated  by  reference  to  Exhibit  10.28(b)  to  the  Company’s  Annual
Report on Form 10-K for the year ended December  31, 2010)*

10.29(c)

Form  of  Amendment  2011-1  to  Contract  Stock/Restricted  Units  Agreement  betweeen  the
Company  and  Mr.  Essig  (Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s
Quarterly Report on Form 10-Q for the quarter ended June 30, 2011)*

10.30

10.31

10.32

10.33

Form  of  Performance  Stock  Agreement  for  Stuart  M.  Essig  (Incorporated  by  reference  to
Exhibit 10.9 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30,
2008)*

Form of Restricted Stock Agreement for Stuart M. Essig for 2009 (Incorporated by reference
to Exhibit 10.3 to the Company’s Current Report on Form  8-K filed April 13, 2009)*

New Form of Contract Stock/Restricted Units Agreement pursuant to 2003 Equity Incentive
Plan  (for  2011)  Annual  Equity  Award  for  Stuart  M.  Essig)  (Incorporated  by  reference  to
Exhibit 10.3 to the Company’s Quarterly Report on Form 10-Q for the quarter ended June 30,
2011)*

Form  of  Notice  of  Grant  of  Stock  Option  and  Stock  Option  Agreement  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  July  29,
2005)*

10.34

10.35

10.36

10.37(a)

10.37(b)

10.37(c)

10.38(a)

Form of Non-Qualified Stock Option Agreement (Non-Directors) (Incorporated by reference
to  Exhibit  10.35  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2004)*

Form  of  Incentive  Stock  Option  Agreement  (Incorporated  by  reference  to  Exhibit  10.36  to
the Company’s Annual Report on Form 10-K for  the year  ended December 31, 2004)*

Form  of  Non-Qualified  Stock  Option  Agreement  (Directors)  (Incorporated  by  reference  to
Exhibit  10.37  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year  ended
December 31, 2004)*

Compensation  of  Directors  of  the  Company  effective  May  17,  2011  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 16, 2010)*

Compensation  of  Non-Employee  Directors  of  the  Company  effective  May  17,  2012
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed on April 13, 2012)*

Compensation  of  Non-Employee  Directors  of  the  Company  effective  May  22,  2013
(Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K
filed on December 14, 2012)*

Form  of  Restricted  Stock  Agreement  for  Non-Employee  Directors  under  the  2003  Equity
Incentive Plan (Incorporated by reference to Exhibit 10.4 to the Company’s Quarterly Report
on Form 10-Q for the quarter ended June 30, 2012)*

10.38(b) New  Form  of  Restricted  Stock  Agreement  for  Non-Employee  Directors  under  the  2003

Equity Incentive Plan*+

10.38(c)

10.38(d)

Form of Restricted Stock Agreement for Executive Officers — Annual Vesting (Incorporated
by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
February 25, 2009)*

Form of Restricted Stock Agreement for Executive Officers — Annual Vesting (Incorporated
by reference to Exhibit 10.5 to the Company’s Quarterly Report on Form 10-Q for the quarter
ended June 30, 2012)*

10.38(e) New Form of Restricted Stock Agreement for  Executive Officers — Annual  Vesting*+

10.38(f)

10.38(g)

Form of Restricted Stock Agreement for Executive Officers — Cliff Vesting (Incorporated by
reference  to  Exhibit  10.8  to  the  Company’s  Quarter  Report  on  Form  10-Q  for  the  quarter
ended March 31, 2009)*

Form of Restricted Stock Agreement for Executive Officers — Cliff Vesting (Incorporated by
reference  to  Exhibit  10.6  to  the  Company’s  quarterly  report  on  Form  10-Q  for  the  quarter
ended June 30, 2012)*

10.38(h) New Form of Restricted Stock Agreement for  Executive Officers — Cliff  Vesting*+

10.38(i)

10.38(j)

Form of Restricted Stock Agreement for Mr. Henneman for 2008 and 2009 (Incorporated by
reference  to  Exhibit  10.6  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  April  13,
2009)*

Form of Contract Stock/Restricted Units Agreement pursuant to 2003 Equity Incentive Plan
for  Mr.  Henneman  (Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s  Current
Report on Form 8-K filed on December  24, 2008)*

10.38(k)

Form  of  Option  Agreement  for  John  B.  Henneman,  III  (Incorporated  by  reference  to
Exhibit 10.1 to the Company’s Current Report on Form 8-K  filed on June 6, 2008)*

10.38(l)

Form  of  Performance  Stock  Agreement  for  John  B.  Henneman,  III  (Incorporated  by
reference  to  Exhibit  10.37(b)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2007)*

10.38(m) Form  of  Contract  Stock/Restricted  Units  Agreement  (for  Signing  Grant)  for  Mr.  Arduini
(Incorporated  by  reference  to  Exhibit  10.4  to  the  Company’s  Current  Report  on  Form  8-K
filed on October 12, 2010)*

10.38(n)

10.38(o)

10.38(p)

10.38(q)

10.39

10.40

10.41

10.42

10.43

10.44

10.45

10.46

Form  of  Contract  Stock/Restricted  Units  Agreement  (for  Annual  Equity  Awards)  for
Mr. Arduini (Incorporated by reference to Exhibit 10.5 to the Company’s Current Report on
Form 8-K filed on October 12, 2010)*

Form of Non-Qualified Stock Option Agreement for Mr. Arduini (Incorporated by reference
to  Exhibit  10.6  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  October  12,  2010)*

Form  of  Restricted  Stock  Agreement  for  Mr.  Henneman  (Incorporated  by  reference  to
Exhibit 10.7 to the Company’s Current Report on Form 8-K  filed on October 12, 2010)*

Form of Restricted Stock Agreement (Annual Vesting) for Mr. Henneman (Incorporated by
reference  to  Exhibit  10.39(n)  to  the  Company’s  Annual  Report  on  Form  10-K  for  the  year
ended December 31, 2011) *

Asset Purchase Agreement, dated as of September 7, 2005, by and between Tyco Healthcare
Group  LP  and  Sherwood  Services,  AG  and  Integra  LifeSciences  Corporation  and  Integra
LifeSciences (Ireland) Limited (Incorporated by reference to Exhibit 10.1 to the Company’s
Current Report on Form 8-K filed on September  13, 2005)

Stock Purchase Agreement, dated as of April 19, 2006, by and between ASP/Miltex LLC and
Integra  LifeSciences  Corporation  (Incorporated  by  reference  to  Exhibit  10.1  to  the
Company’s Current Report on Form 8-K filed on  April  25, 2006)

Stock  Agreement  and  Plan  of  Merger,  dated  as  of  June  30,  2006,  by  and  between  Integra
LifeSciences  Corporation,  Integra  California,  Inc.,  Kinetikos  Medical,  Inc.,  Telegraph  Hill
Partners  Management  LLC,  as  Shareholders  Representative,  and  the  Shareholders  party
thereto  (Incorporated  by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on
Form 8-K filed on July 7, 2006)

Amended  and  Restated  Management  Incentive  Compensation  Plan,  as  of  January  1,  2008
(Incorporated  by  reference  to  Exhibit  10.43(c)  to  the  Company’s  Annual  Report  on
Form 10-K for the year ended December 31, 2007)*

Form  of  2010  Convertible  Bond  Hedge  Transaction  Confirmation,  dated  June  6,  2007,
between Integra LifeSciences Holdings Corporation and dealer (Incorporated by reference to
Exhibit 10.1 to the Company’s Current Report on Form 8-K  filed on June 12, 2007)

Form  of  2012  Convertible  Bond  Hedge  Transaction  Confirmation,  dated  June  6,  2007,
between Integra LifeSciences Holdings Corporation and dealer (Incorporated by reference to
Exhibit 10.2 to the Company’s Current Report on Form 8-K  filed on June 12, 2007)

Form of 2010 Amended and Restated Issuer Warrant Transaction Confirmation, dated June 6,
2007,  between  Integra  LifeSciences  Holdings  Corporation  and  dealer  (Incorporated  by
reference  to  Exhibit  10.3  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  June  12,
2007)

Form of 2012 Amended and Restated Issuer Warrant Transaction Confirmation, dated June 6,
2007,  between  Integra  LifeSciences  Holdings  Corporation  and  dealer  (Incorporated  by
reference  to  Exhibit  10.4  to  the  Company’s  Current  Report  on  Form  8-K  filed  on  June  12,
2007)

10.47

10.48

10.49

10.50

10.51

10.52

10.53

10.54

10.55

10.56

10.57

10.58

10.59

10.60

Letter  Agreement,  dated  June  9,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Call  Option  Transaction
(Incorporated by reference to Exhibit 10.4 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  9,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences  Holdings  Corporation,  regarding 
the  Base  Call  Option  Transaction
(Incorporated by reference to Exhibit 10.8 to the Company’s Form 8-K filed on June 15, 2011)

Letter Agreement, dated June 9, 2011, between The Royal Bank of Scotland plc and Integra
the  Base  Call  Option  Transaction
LifeSciences  Holdings  Corporation,  regarding 
(Incorporated by reference to Exhibit 10.6 to the Company’s Form 8-K filed on June 15, 2011)

Letter Agreement, dated June 9, 2011, between Wells Fargo Bank, National Association and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Call  Option  Transaction
(Incorporated by reference to Exhibit 10.2 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  9,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Warrant  Transaction
(Incorporated by reference to Exhibit 10.3 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  9,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences Holdings Corporation, regarding the Base Warrant Transaction (Incorporated by
reference to Exhibit 10.7 to the Company’s  Form 8-K filed  on June 15,  2011)

Letter Agreement, dated June 9, 2011, between The Royal Bank of Scotland plc and Integra
LifeSciences Holdings Corporation, regarding the Base Warrant Transaction (Incorporated by
reference to Exhibit 10.5 to the Company’s  Form 8-K filed  on June 15,  2011)

Letter Agreement, dated June 9, 2011, between Wells Fargo Bank, National Association and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Base  Warrant  Transaction
(Incorporated by reference to Exhibit 10.1 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  14,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra LifeSciences Holdings Corporation, regarding the Additional Call Option Transaction
(Incorporated by reference to Exhibit 10.9 to the Company’s Form 8-K filed on June 15, 2011)

Letter  Agreement,  dated  June  14,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences  Holdings  Corporation,  regarding  the  Additional  Call  Option  Transaction
(Incorporated  by  reference  to  Exhibit  10.10  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter Agreement, dated June 14, 2011, between The Royal Bank of Scotland plc and Integra
LifeSciences  Holdings  Corporation,  regarding  the  Additional  Call  Option  Transaction
(Incorporated  by  reference  to  Exhibit  10.11  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter Agreement, dated June 14, 2011, between Wells Fargo Bank, National Association and
Integra LifeSciences Holdings Corporation, regarding the Additional Call Option Transaction
(Incorporated  by  reference  to  Exhibit  10.12  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter  Agreement,  dated  June  14,  2011,  between  Deutsche  Bank  AG,  London  Branch  and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.13  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter  Agreement,  dated  June  14,  2011,  between  Royal  Bank  of  Canada  and  Integra
LifeSciences  Holdings  Corporation,  regarding 
the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.14  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

10.61

10.62

10.63

10.64

10.65

Letter Agreement, dated June 14, 2011, between The Royal Bank of Scotland plc and Integra
LifeSciences  Holdings  Corporation,  regarding 
the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.15  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Letter Agreement, dated June 14, 2011, between Wells Fargo Bank, National Association and
Integra  LifeSciences  Holdings  Corporation,  regarding  the  Additional  Warrant  Transaction
(Incorporated  by  reference  to  Exhibit  10.16  to  the  Company’s  Form  8-K  filed  on  June  15,
2011)

Unit  Purchase  Agreement,  dated  as  of  July  23,  2008,  by  and  among  Integra  LifeSciences
Holdings  Corporation,  Theken  Spine  LLC,  Randall  R.  Theken  and  the  other  members  of
Theken  Spine,  LLC  party  thereto  (Incorporated  by  reference  to  Exhibit  10.1  to  the
Company’s Current Report on Form 8-K filed on  July  24, 2008)

Form of Indemnification Agreement for Non-Employee Directors and Officers (Incorporated
by  reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 24, 2008)*

Piggyback  Registration  Rights  Agreement  dated  December  22,  2008  between  Integra
LifeSciences Holdings Corporation and George Heenan, Thomas Gilliam and Michael Evers,
as  trustees  of  The  Bruce  A.  LeVahn  2008  Trust  and  Steven  M.  LeVahn  (Incorporated  by
reference  to  Exhibit  10.1  to  the  Company’s  Current  Report  on  Form  8-K  filed  on
December 29, 2008)

10.66(a)

10.66(b)

Lease  Agreement  between  109  Morgan  Lane,  LLC  and  Integra  LifeSciences  Corporation,
dated May 15, 2008 (Incorporated by reference to Exhibit 10.10 to the Company’s Quarterly
Report on Form 10-Q for the quarter ended June 30, 2008)

First  Amendment  to  Lease  Agreement  between  109  Morgan  Lane,  LLC  and  Integra
LifeSciences Corporation, dated March 9, 2009 (Incorporated by reference to Exhibit 10.9 to
the Company’s Quarterly Report on Form 10-Q  for the quarter ended  March 31, 2009)

18

21

23

31.1

31.2

32.1

32.2

99.1

99.2

Preferability  Letter  of  Independent  Public  Accounting  Firm  dated  July  31,  2012
(Incorporated by reference to Exhibit 18.1 to the Company’s Quarterly Report on Form 10-Q
for  the quarter ended June 30, 2012)

Subsidiaries of the Company+

Consent of Pricewaterhouse Coopers LLP+

Certification  of  Principal  Executive  Officer  Pursuant  to  Section  302  of  the  Sarbanes-Oxley
Act of 2002+

Certification of Principal Financial Officer Pursuant to Section 302 of the Sarbanes-Oxley Act
of 2002+

Certification  of  Principal  Executive  Officer  Pursuant  to  Section  906  of  the  Sarbanes-Oxley
Act of 2002+

Certification of Principal Financial Officer Pursuant to Section 906 of the Sarbanes-Oxley Act
of 2002+

Letter, dated December 21, 2011, from the United States Food and Drug Administration to
Integra  LifeSciences  Corporation  (Incorporated  by  reference  to  Exhibit  99.1  to  the
Company’s Current Report on Form 8-K filed on  January 5,  2012)

Food and Drug Administration Form FDA-483, dated July 30, 2012, relating to inspection of
Plainsboro,  NJ  manufacturing  facility  (Incorporated  by  reference  to  Exhibit  99.1  to  the
Company’s Quarterly Report on Form 10-Q for  the quarter ended  June  30, 2012)

99.3

Letter,  dated  November  1,  2012,  from  the  United  States  Food  and  Drug  Administration  to
Integra  NeuroSciences  Ltd.  (Incorporated  by  reference  to  Exhibit  99.1  to  the  Company’s
Current Report on Form 8-K filed on November 13, 2012)

101.INS

XBRL Instance Document+#

101.SCH

XBRL Taxonomy Extension  Schema Document+#

101.CAL

XBRL Taxonomy Extension  Calculation Linkbase  Document+#

101.DEF

XBRL Definition Linkbase  Document

101.LAB

XBRL Taxonomy Extension  Labels Linkbase Document+#

101.PRE

XBRL Taxonomy Extension  Presentation Linkbase Document+#

*

Indicates a management contract or compensatory plan or arrangement.

+ Indicates this document is filed as an  exhibit  herewith.

# The  financial  information  of  Integra  LifeSciences  Holdings  Corporation  Annual  Report  on
Form  10-K  for  the  year  ended  December  31,  2012  filed  on  February  26,  2013  formatted  in  XBRL
(Extensible  Business  Reporting  Language):  (i)  the  Consolidated  Statements  of  Operations,  (ii)  the
Consolidated  Balance  Sheets,  (iii)  Parenthetical  Data  to  the  Consolidated  Balance  Sheets,  (iv)  the
Consolidated Statements of Cash Flows, (v) the Consolidated Statements of Changes in Stockholders’
Equity,  and (vi) Notes to Consolidated Financial Statements, is  furnished electronically herewith.

The  Company’s  Commission  File  Number  for  Reports  on  Form  10-K,  Form  10-Q  and  Form  8-K  is

0-26224.

(This page has been left blank intentionally.)

Corporate Officers

Peter J. Arduini
President, Chief Executive Officer and Director

Debbie Leonetti
Corporate Vice President, President - International

Jerry E. Corbin
Corporate Vice President, Corporate Controller

John Mooradian
Corporate Vice President, Global Operations and Supply Chain

Robert T. Davis, Jr.
Corporate Vice President, President - Neurosurgery

Judith E. O’Grady, R.N., M.S.N., R.A.C.
Corporate Vice President, Global Regulatory  Affairs, and Corporate  Compliance Officer

Richard D. Gorelick
Corporate Vice President, General Counsel,  
Administration and Secretary

John B. Henneman, III
Corporate Vice President, Finance  
and Administration, and Chief Financial Officer

Brian Larkin 
Corporate Vice President, President -  
Global Spine and Orthobiologics,   
and Head of Strategic Development

Outside Directors

Stuart M. Essig, Ph. D.
Chairman of the Board

Keith Bradley, Ph.D. (1) (3)
Chair, Compensation Committee 
Former Professor of International Management  
and Management Strategy at the Open University 
and Cass Business School, London

Richard E. Caruso, Ph.D. 
President of The Provco Group, LTD. 

Lloyd W. Howell, Jr. 
Executive Vice President, Booz Allen Hamilton

Corporate Information

Annual Meeting
The 2013 Annual Meeting of Stockholders  
will be held at 9:00 a.m., Wednesday, May 22, 2013 at 

Integra LifeSciences Holdings Corporation 
315 Enterprise Drive 
Plainsboro, New Jersey 08536

Stock Trading Information
Integra stock trades on the Nasdaq National Market  
under the symbol ‘‘IART’’ 

Investor Relations
Contact the Integra Investor Relations department at  
IR@integralife.com for business-related inquiries 

Stockholders may obtain, without charge, a copy  
of the following documents:

• 

• 
• 

Proxy statement for the 2013 Annual Meeting  
of Stockholders
Quarterly reports on Form 10-Q
Additional copies of the 2012 Annual Report

Requests for these documents should be addressed to:

Investor Relations Department 
Integra LifeSciences Holdings Corporation 
311 Enterprise Drive 
Plainsboro, New Jersey 08536 
Email: IR@integralife.com

Robert D. Paltridge
Corporate Vice President, President - Extremity Reconstruction

Dan Reuvers
Corporate Vice President, President - Surgical Instruments

Padma Thiruvengadam
Corporate Vice President, Chief Human Resources Officer

Joseph Vinhais
Corporate Vice President, Global Quality Assurance

Neal Moszkowski (1) (3)
Co-Chief Executive Officer of TowerBrook  
Capital Partners, LP

Raymond G. Murphy (2)
Chair, Audit Committee  
Former Senior Vice President and Treasurer,  
Time Warner Inc.

Christian S. Schade (1) (2)
Executive Vice President and Chief Financial  
Officer, Omthera Pharmaceuticals, Inc.

James M. Sullivan (2) (3) (4)
Chair, Nominating and Corporate Governance Committee 

Former Executive Vice President of Lodging  
Development, Marriott International, Inc.

Anne M. VanLent  (2)
President, AMV Advisors

(1) 

(2) 

Compensation Committee member

Audit Committee member

(3)  Nominating and Corporate Governance  

Committee member

(4) 

Presiding Director

Internet Address
Additional information about the Company, including a copy of this Annual Report and quarterly 
reports on Form 10-Q, a description of our business and products, recent financial data and press 
releases, investor relations calendar and stock price information is available on our home page on 
the Internet at www.integralife.com. 

Headquarters
Integra LifeSciences Holdings Corporation 
311 Enterprise Drive 
Plainsboro, New Jersey 08536 
(609) 275-0500 phone 
(609) 799-3297 fax

Stock Account Maintenance
Our transfer agent, American Stock Transfer and Trust Company,  
can help you with a variety of stockholder related services, including:

• 
• 
• 
• 

change of address 
lost stock certificates 
transfer of stock to another person 
verification of your holdings

You can call our transfer agent toll-free at (800) 937-5449 or reach them on the Internet at  
www.amstock.com.

Independent Registered Public Accounting Firm
PricewaterhouseCoopers LLP 
Florham Park, New Jersey

For more information please contact:
Integra  n  311 Enterprise Drive, Plainsboro, NJ 08536
609-275-0500 USA  n  +1-609-936-5400 outside USA 
integralife.com

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vegetable oils

Integra and the Integra logo are registered trademarks of Integra LifeSciences Corporation. ©2013 Integra. All rights reserved. Printed in the USA.