Document:

Amendment No. 1 to Matrix Commercialization Collaboration Agreement

 Exhibit 10.3 
 AMENDMENT NO. 1 TO 
 MATRIX COMMERCIALIZATION COLLABORATION

 AGREEMENT 
 THIS AMENDMENT NO. 1 TO MATRIX COMMERCIALIZATION COLLABORATION AGREEMENT (this “Amendment”) is dated as of December 15, 2010 by and between Musculoskeletal Transplant
Foundation, Inc., a non-profit corporation formed under the laws of the District of Columbia, and having a principal place of business at 125 May Street, Suite 300, Edison, New Jersey 08837 (“MTF”), and Orthofix
Holdings, Inc., a corporation organized under the laws of the State of Delaware, and having a principal place of business at 10115 Kincey Avenue, Suite 250, Huntersville, North Carolina 28078 (“Orthofix”) (each individually a
“Party” and collectively the “Parties”). 
 W I T
N E S S E T H: 
 WHEREAS, the parties have entered into that
certain Matrix Commercialization Collaboration Agreement dated as of July 28, 2008 (the “Original Agreement”); and 
 WHEREAS, contemporaneously with the settlement of certain litigation commenced by NuVasive, Inc. and Osiris Therapeutics, Inc. against the parties in the United States District Court for the
District of New Jersey (2:2010 cv 01995), the Parties desire to amend the Original Agreement upon the terms and subject to the conditions set forth herein; 
 NOW, THEREFORE, in consideration of the foregoing premises and mutual covenants and promises set forth herein, the Parties agree as follows: 

ARTICLE I 

AMENDMENTS 
 A. Section 7.1(a) of the Original Agreement is hereby amended by deleting the phrase “(x) pursuant to Section 13.4 or (y)” contained in the second sentence thereof. 

B. Section 7.1(b) of the Original Agreement is hereby amended by deleting the phrase “(x) pursuant to Section 13.4
or (y)” contained in the second sentence thereof. 
 C. Section 13.1 of the Original Agreement is hereby amended by
deleting the first sentence thereof in its entirety and inserting the following in lieu thereof: 

“Unless sooner terminated pursuant to the terms herein, this Agreement will commence on the Effective Date and
will continue until the later of (x) the expiration or earlier termination of the NuVasive License or (y) the tenth (10th) anniversary of the Effective Date (such longer period referred to as the “Initial Term”).”

 D. Section 13.2 of the Original Agreement is hereby deleted in its entirety and the
following inserted in lieu thereof: 
 “13.2 Termination of Default. Either Party may terminate this
Agreement in the event of the material breach or material default by the other Party of the material terms and conditions hereof which is not cured, as set forth in this Section 13.2. In the event of such a material breach or material
default, the terminating Party will first give to the other Party written notice of the proposed termination of this Agreement, specifying the grounds therefor. Upon receipt of such notice, the other Party will have one hundred eighty
(180) days to cure such material breach or material default. In the event of determination in a final, non-appealable decision by a court of competent jurisdiction that such other Party has committed, and failed to cure, such breach or default
within such period, then this Agreement will terminate automatically upon such determination. Termination of this Agreement pursuant to this Section 13.2 will not affect any other rights or remedies which may be available to the
non-defaulting Party.” 
 E. Section 13.4 of the Original Agreement is hereby deleted in its entirety and the
following inserted in lieu thereof: 
 “13.4 [Deleted].” 

F. Section 17.3 of the Original Agreement is hereby amended by deleting the last sentence in its entirety. 

G. Addendum 1 of the Original Agreement is hereby amended by adding the following definition in appropriate alphabetical sequence:

 “NuVasive License” has the meaning assigned to such term under the Sublicense Agreement dated
December __, 2010 between the parties (as may from time to time be amended). 
 ARTICLE II 

MISCELLANEOUS 
 A. Except as amended hereby, the Original Agreement shall remain in full force and effect. 
 B. This Amendment may be executed in counterparts, each of which shall be deemed to be an original, and all of which taken together will constitute one and the same instrument. 

 IN WITNESS WHEREOF, the parties have caused this Amendment to be executed and
delivered as of the date first written above. 
  

									
	MUSCULOSKELETAL TRANSPLANT FOUNDATION, INC.	 		 	ORTHOFIX HOLDINGS, INC.
					
	By	 	/s/ Bruce W. Stroever	 		 	By	 	/s/ Alan W. Milinazzo
	President and CEO	 		 	CEO and PresidentForm of Restricted Stock Grant Agreement

 Exhibit 10.13 
 Restricted Stock Grant Agreement under 
 the Orthofix International N.V.

 Amended and Restated 2004 Long-Term Incentive Plan 
 This Restricted Stock Grant Agreement (the “Agreement”) is made this              day of
             (the “Grant Date”) between Orthofix International N.V., a Curacao company (the “Company”), and the person signing this
Agreement adjacent to the caption “Award Recipient” on the signature page hereof (the “Award Recipient”). Capitalized terms used and not otherwise defined herein shall have the meanings attributed thereto in the
Orthofix International N.V. Amended and Restated 2004 Long-Term Incentive Plan, as amended (the “Plan”). 
 WHEREAS, pursuant to the Plan, the Company desires to afford the Award Recipient the opportunity to acquire Common Shares on the terms and conditions set forth herein; 

NOW, THEREFORE, in connection with the mutual covenants hereinafter set forth and for other good and valuable consideration, the parties
hereto agree as follows: 
 1. Grant of Restricted Stock. 

(a) Number of Shares/Vesting. The Company hereby grants to the Award Recipient, on the Grant Date, an
Award of              Common Shares under the Plan subject to the vesting schedule and terms and conditions set forth below (the “Restricted
Stock”). Subject to earlier termination in accordance with the Plan or this Agreement and the terms and conditions herein, Restricted Stock granted under this Agreement shall vest with respect to 33 1/3% of the shares covered hereby on
each of the first, second and third anniversaries of the Grant Date (each, a “Vesting Date”); provided, however, for the avoidance of doubt, that there shall be no proportionate or partial vesting in the periods prior to or
between each Vesting Date. 
 (b) Additional Documents. The Award Recipient agrees to execute
such additional documents and complete and execute such forms as the Company may require for purposes of this Agreement. 
 (c) Issuance of Restricted Stock; Dividend and Distribution Rights. Upon the vesting of any Restricted Stock pursuant to the terms hereof, the restrictions of Sections 1 and 3 shall lapse
with respect to such vested Restricted Stock. As soon as practicable following the vesting of any Restricted Stock, the Company shall, in its sole discretion, either: (i) deliver or cause to be delivered to the Award Recipient (or a
Permitted Transferee, a transferee under a domestic relations order, or following the Award Recipient’s death, the Award Recipient’s estate, personal representative or beneficiary, as applicable) one or more share certificates for the
appropriate number of Common Shares that have vested (less any Common Shares withheld under Section 7 below), or (ii) cause its third-party recordkeeper to credit an account established and maintained in the name of the Award Recipient (or
a Permitted Transferee, a transferee under a domestic relations order, or following the Award Recipient’s death, the Award Recipient’s estate, personal representative or beneficiary, as applicable) with the number of Common Shares that
have vested (less any Common Shares withheld under Section 7 below). Such Common Shares shall be fully paid and nonassessable and shall be issued in the name of the Award Recipient (or a Permitted Transferee, a transferee under a domestic
relations order, or following the Award Recipient’s death, the Award Recipient’s estate, personal representative or beneficiary, as applicable). 
 2. Incorporation of Plan. The Award Recipient acknowledges receipt of the Plan, a copy of which is annexed hereto, and represents that he or she is familiar with its terms and provisions and
hereby accepts this grant of Restricted Stock subject to all of the terms and provisions of the Plan and all interpretations, amendments, rules and regulations which may, from time to time, be promulgated and adopted pursuant to the Plan. The Plan
is incorporated herein by reference. In the event of any conflict or inconsistency between the Plan and this Agreement, the Plan shall govern and this Agreement shall be interpreted to minimize or eliminate any such conflict or inconsistency.

 3. Restrictions on Transfer. Unless the Committee determines otherwise after the Grant Date,
the Restricted Stock shall not be transferable other than by will or by the laws of descent and distribution or pursuant to a domestic relations order; provided, however, the Restricted Stock may be transferred to the Award Recipient’s family
members or to one or more trusts or partnerships established in whole or in part for the benefit of 

 
one or more of such family members (collectively, the “Permitted Transferees”). Any Restricted Stock transferred to a Permitted Transferee shall be further transferable
only by will or the laws of descent and distribution or, for no consideration, to another Permitted Transferee of the Award Recipient. The Committee may in its discretion permit transfers of Restricted Stock other than those contemplated by this
Section. Any Restricted Stock transferred pursuant to this Section 3 will remain subject to the provisions contained in Section 1(a), this Section 3 and Section 5. 

4. Notification of Election Under Section 83(b) of the Code. If the Award Recipient shall, in
connection with the grant of Restricted Stock under this Agreement, make the election permitted under Section 83(b) of the Internal Revenue Code of 1986, as amended (the “Code”), (i.e., an election to include in
gross income in the year of transfer the amounts specified in Section 83(b) of the Code), then the Award Recipient must make such election using a form provided by the Company and shall promptly request such form from the Company. The
election must be received by the Internal Revenue Service within 30 calendar days following the Grant Date. The Award Recipient shall also provide the Company with a copy of such election within 10 calendar days of filing a notice of election
with the Internal Revenue Service and shall, at the same time as such notice of election is provided to the Company, remit to the Company in cash an amount sufficient to satisfy any tax withholding obligations. 

5. Termination of Employment. 

(a) General. A termination of employment shall be deemed to have occurred if the Award Recipient is no longer
employed by, or otherwise providing services to, the Company or any of its Subsidiaries for any reason. The Committee shall have discretion to determine whether an authorized leave of absence (as a result of disability or otherwise) shall constitute
a termination of employment for purposes of the Plan and this Agreement. 
 (b) Termination of Employment
Other than for Cause, Death, Permanent Disability or Voluntary Termination. If, prior to vesting, the Award Recipient’s employment is terminated, the Restricted Stock shall be considered vested as of the date of such termination of
employment with respect to the aggregate number of Common Shares as to which the Restricted Stock would have been vested as of December 31 of the year in which such termination of employment occurs. The unvested portion of the Restricted Stock
shall be forfeited by the Award Recipient, a Permitted Transferee, or a transferee under a domestic relations order, as applicable, and cancelled by the Company as of the date of the Award Recipient’s termination of employment, and the Award
Recipient shall have no further right or interest therein. In no event shall this Section 5(b) apply if termination is (i) for Cause, (ii) by reason of death or Permanent Disability or (iii) as a result of a Voluntary
Termination. 
 (c) [Intentionally Omitted]. 

(d) Termination of Employment for Cause; Voluntary Termination. If, prior to vesting, (i) the Award
Recipient’s employment with the Company and its Subsidiaries is terminated by the Company or any of its Subsidiaries for Cause, or (ii) the Award Recipient terminates employment under circumstances constituting a Voluntary Termination, the
unvested portion of the Restricted Stock shall be forfeited by the Award Recipient, a Permitted Transferee, or a transferee under a domestic relations order, as applicable, and cancelled by the Company as of the date of the Award Recipient’s
termination of employment, and the Award Recipient, Permitted Transferee, or transferee under a domestic relations order, as applicable, shall have no further right or interest therein unless the Committee in its sole discretion shall determine
otherwise. 
 (e) Termination of Employment for Death or Permanent Disability. If the Award
Recipient’s employment with the Company and its Subsidiaries terminates by reason of death or Permanent Disability, the Restricted Stock shall automatically vest in full as of the date of the Award Recipient’s termination of employment.

 6 Change in Control. Upon the occurrence of a Change in Control, the Restricted Stock shall
automatically vest in full. 
 7. Withholding. The Award Recipient (or a Permitted Transferee, a
transferee under a domestic relations order, or following the Award Recipient’s death, the Award Recipient’s estate, personal representative, or beneficiary, as applicable) shall be liable for any and all U.S. federal, state or local taxes
of any kind required by law to be withheld with respect to the vesting of Restricted Stock, as well as for any and all 

 
applicable withholding tax requirements of any other country or jurisdiction. When the Restricted Stock vests, the Company shall cause the Award Recipient (or a Permitted Transferee, a
transferee under a domestic relations order, or following the Award Recipient’s death, the Award Recipient’s estate, personal representative, or beneficiary, as applicable) to satisfy all of his or her tax withholding obligations by having
the Company withhold a number of Common Shares that would otherwise become vested having a Fair Market Value (as of the close of business on the Vesting Date) not in excess of the minimum amount of tax withholding obligations required by law to be
withheld with respect to such vesting. 
 8. No Employment or Other Rights. This grant of
Restricted Stock does not confer upon the Award Recipient any right to be continued in the employment of, or otherwise provide services to, the Company or any Subsidiary or other affiliate thereof, or interfere with or limit in any way the
right of the Company or any Subsidiary or other affiliate thereof to terminate such Award Recipient’s employment or other service relationship at any time. For purposes of this Agreement only, the term “employment” shall include
circumstances under which Award Recipient provides consulting or other services to the Company or any of its Subsidiaries as an independent contractor, but such Award Recipient is not, nor shall be considered, an employee; provided, however, nothing
in this Section 8 or this Agreement shall create an employment relationship between such person and the Company or its applicable Subsidiary, as the usages described in this Section are for convenience only. 

9. Adjustment of and Changes in Common Shares. In the event of any merger, consolidation, recapitalization,
reclassification, stock dividend, extraordinary dividend, or other event or change in corporate structure affecting the Common Shares, the Committee shall make such adjustments, if any, as it deems appropriate in the number and class of shares
subject to the Restricted Stock. The foregoing adjustments shall be determined by the Committee in its sole discretion. 
 10. Rights as a Shareholder. Except as otherwise provided in this Agreement, the Award Recipient shall have all rights of a stockholder with respect to the Restricted Stock granted under
this Agreement, including voting rights. Notwithstanding the foregoing, dividends with respect to any Restricted Stock granted under this Agreement shall accrue, but shall not be paid, until the Award Recipient shall become the holder of record
thereof, and no adjustment shall be made for dividends or distributions or other rights in respect of any Restricted Stock for which the record date is prior to the date upon which the Award Recipient shall become the holder of record thereof.

 11. Discretionary Nature of Plan. The Plan is discretionary in nature, and the Company may
suspend, modify, amend or terminate the Plan in its sole discretion at any time, subject to the terms of the Plan and any applicable limitations imposed by law. This Restricted Stock grant under the Plan is a one-time benefit and does not
create any contractual or other right to receive additional Restricted Stock or other benefits in lieu of Restricted Stock in the future. Future grants, if any, will be at the sole discretion of the Committee, including, but not limited to, the
timing of any grant, the number of shares of Restricted Stock granted, and the vesting provisions. 

12. Miscellaneous Provisions. 

(a) Applicable Law. The validity, construction, interpretation and effect of this instrument will be
governed by and construed in accordance with the laws of the State of New York, without giving effect to the conflicts of laws provisions thereof. 
 (b) Notice. Any notice required by the terms of this Agreement shall be delivered or made electronically, over the Internet or otherwise (with request for assurance of recipient in a
manner typical with respect to communications of that type), or given in writing. Any notice given in writing shall be deemed effective upon personal delivery or upon deposit with the United States Postal Service, by registered or certified
mail, with postage and fees prepaid, and shall be addressed to the Company at its principal executive office and to the Award Recipient at the address that he or she has most recently provided to the Company. Any notice given electronically
shall be deemed effective on the date of transmission. 
 (c) Headings. The headings of sections
and subsections are included solely for convenience of reference and shall not affect the meaning of the provisions of this Agreement. 

 (d) Counterparts. This Agreement may be executed in two or more
counterparts, each of which shall be deemed to be an original but all of which together will constitute one and the same instrument. 
 (e) Amendments. The Board and the Committee shall have the power to alter or amend the terms of the grant of Restricted Stock as set forth herein from time to time, in any manner consistent
with the provisions of Sections 16 and 19 of the Plan, and any alteration or amendment of the terms of this grant of Restricted Stock by the Board or the Committee shall, upon adoption, become and be binding on all persons affected thereby without
requirement for consent or other action with respect thereto by any such person. The Committee shall give notice to the Award Recipient of any such alteration or amendment as promptly as practicable after the adoption thereof. The foregoing shall
not restrict the ability of the Award Recipient and the Board or the Committee by mutual written consent to alter or amend the terms of this grant of Restricted Stock in any manner which is consistent with the Plan. 

(f) Binding Effect. This Agreement shall be binding upon the heirs, executors, administrators and successors
of the Award Recipient and the Company. 
 (g) Entire Agreement. This Agreement and the Plan
constitute the entire agreement between the Award Recipient and the Company regarding the grant of Restricted Stock and supersede all prior arrangements or understandings (whether oral or written and whether express or implied) with respect
thereto.
 13. Definitions. For purposes of this Agreement, the following capitalized words shall
have the meanings set forth below. 
 “Cause” shall mean termination of the Award Recipient’s
employment because of the Award Recipient’s (i) involvement in fraud, misappropriation or embezzlement related to the business or property of the Company, (ii) conviction for, or guilty plea to, a felony or crime of similar gravity in
the jurisdiction in which such conviction or guilty plea occurs, (iii) unauthorized disclosure of any trade secrets or other confidential information relating to the Company’s business and affairs (except to the extent such disclosure is
required under applicable law), or (iv) such other circumstances constituting a termination for cause under any Employment Agreement. 
 “Change in Control” shall mean: 

(i) the acquisition by any individual, entity or group (within the meaning of Section 13(d)(3) or 14(d)(2) of
the Securities Exchange Act of 1934 (the “Exchange Act”)) (a “Person”) of beneficial ownership (within the meaning of Rule 13d-3 promulgated under the Exchange Act) of 50% or more of either
(A) the then outstanding shares of the Company’s common stock (the “Outstanding Common Stock”) or (B) the combined voting power of the then outstanding voting securities of the Company entitled to vote
generally in the election of directors (the “Outstanding Voting Securities”); excluding, however, the following: (1) any acquisition directly from the Company, other than an acquisition by virtue of the exercise of a
conversion privilege unless the security being so converted was itself acquired directly from the Company; (2) any acquisition by the Company; (3) any acquisition by any employee benefit plan (or related trust) sponsored or maintained by
the Company or any entity controlled by the Company; or (4) any acquisition pursuant to a transaction which complies with clauses (A), (B) and (C) of subsection (iii) of this definition of Change of Control; or 

(ii) a change in the composition of the Board such that the individuals who, as of the date hereof, constitute the
Board (such Board shall be hereinafter referred to as the “Incumbent Board”) cease for any reason to constitute at least a majority of the Board; provided, however, for purposes of this paragraph, that any individual who
becomes a member of the Board subsequent to the date hereof, whose election, or nomination for election by the Company’s shareholders, was approved by a vote of at least a majority of those individuals who are members of the Board and who were
also members of the Incumbent Board (or deemed to be such pursuant to this proviso) shall be considered as though such individual were a member of the Incumbent Board; but provided further that any such individual whose initial assumption of
office occurs as a result of either an actual or threatened election contest (as such terms are used in Rule 14a-11 of Regulation 14A promulgated under the Exchange Act) or other actual or threatened solicitation of proxies or consents by or on
behalf of a Person other than the Board shall not be so considered as a member of the Incumbent Board; or 

 (iii) consummation of a reorganization, merger or consolidation or sale
or other disposition of all or substantially all of the assets of the Company (“Corporate Transaction”); excluding, however, such a Corporate Transaction pursuant to which all of the following conditions are met:
(A) all or substantially all of the individuals and entities who are the beneficial owners, respectively, of the Outstanding Common Stock and Outstanding Voting Securities immediately prior to such Corporate Transaction will beneficially own,
directly or indirectly, more than 50% of, respectively, the outstanding shares of common stock, and the combined voting power of the then outstanding voting securities entitled to vote generally in the election of directors, as the case may be, of
the corporation resulting from such Corporate Transaction (including, without limitation, a corporation which as a result of such transaction owns the Company or all or substantially all of the Company’s assets either directly or through one or
more subsidiaries) in substantially the same proportions as their ownership, immediately prior to such Corporate Transaction, of the Outstanding Common Stock and Outstanding Voting Securities, as the case may be, (B) no Person (other than the
Company, any employee benefit plan (or related trust) of the Company or such corporation resulting from such Corporate Transaction) will beneficially own, directly or indirectly, 50% or more of, respectively, the outstanding shares of common stock
of the corporation resulting from such Corporate Transaction or the combined voting power of the outstanding voting securities of such corporation entitled to vote generally in the election of directors except to the extent that such ownership
existed prior to the Corporate Transaction, and (C) individuals who were members of the Incumbent Board will constitute at least a majority of the members of the board of directors of the corporation resulting from such Corporate Transaction;

 (iv) the approval by the shareholders of the Company of a complete liquidation or dissolution of the
Company; or 
 (v) any similar or other definition contained in any Employment Agreement (even if broader
than as defined above). 
 “Committee” shall mean the Compensation Committee of the Board or such other
committee appointed by the Board to administer the Plan. 
 “Employment Agreement” shall mean a written
employment, change in control or change of control agreement between the Award Recipient and the Company and/or a Subsidiary. Employment Agreement expressly does not include any offer letter, at-will employment arrangements or an employment or
similar agreement entered into outside the United States solely for purposes of complying with local law requirements with respect to employment. For purposes of this Agreement only and subject to Section 8, the term “Employment
Agreement” shall include a written agreement under which the Award Recipient provides consulting or other services as an independent contractor to the Company. 
 “Permanent Disability” shall mean termination of the Award Recipient’s employment as a result of a physical or mental incapacity which substantially prevents the Award
Recipient from performing his or her duties as an employee and that has continued for at least 180 days and can reasonably be expected to continue indefinitely. Any dispute as to whether or not the Award Recipient is disabled within the meaning of
the preceding sentence shall be resolved by a physician selected by the Committee. 
 “Voluntary
Termination” shall occur when the Award Recipient voluntarily ceases employment with, or the provision of services to, the Company and its Subsidiaries for any reason or no reason (e.g., the Award Recipient elects to cease being an
employee or provide consulting services or the Award Recipient resigns or quits). For the avoidance of doubt, a Voluntary Termination shall not occur as a result of termination of employment as a result of death, Permanent Disability (as
provided hereunder), or termination for “good reason” or similar words (as permitted hereunder and pursuant to an Employment Agreement) or as the result of the Optionee’s retirement in accordance with the Company’s retirement
policies. 
 (Remainder of page intentionally left blank) 

 EXECUTED on the date first written above. 

 

							
	COMPANY:	 		 	ORTHOFIX INTERNATIONAL N.V.
				
		 		 	By:	 	 
		 		 	Name:	 	Alan W. Milinazzo
		 		 	Title:	 	Chief Executive Officer
			
	AWARD RECIPIENT:	 		 	
				
		 		 	By:	 	 
		 		 	Name:	 	[            ]
		 		 	Title:	 	[            ]

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