It has been about a month since the last earnings report for Integra LifeSciences (IART). Shares have lost about 4.9% in that time frame, underperforming the S&P 500.Will the recent negative trend continue leading up to its next earnings release, or is Integra due for a breakout? Before we dive into how investors and analysts have reacted as of late, let's take a quick look at the most recent earnings report in order to get a better handle on the important catalysts. Integra LifeSciences Posts Earnings Beat, Gross Margin UpIntegra LifeSciences delivered adjusted earnings per share (EPS) of 65 cents in the first quarter of 2019, up 12.1% from the year-ago figure. The same also surpassed the Zacks Consensus Estimate by 6.6%.Revenue DiscussionTotal revenues in the reported quarter inched up 0.7% year over year to $359.7 million but lagged the Zacks Consensus Estimate by 0.6%. Excluding revenues from the current-period acquisitions, product discontinuations and the effect of currency exchange rates, organic revenues rose 3.1% year over year, in line with the earlier-provided guidance for 2019.The company also stated that it remains on track to achieve its full-year financial targets.Coming to product categories, revenues from the company's Codman Specialty Surgical segment dipped 0.7% to $234.6 million. The quarter’s performance was majorly affected by the company’s exit from the transition services agreements covering Western Europe. Integra LifeSciences is currently into integration activities in the ERP (Enterprise Resource Planning) conversion.Orthopedics and Tissue Technologies revenues totaled $125.1 million in the first quarter, up 3.4% year over year. The upside was fueled by an improved sales force effectiveness, product introductions and double-digit growth in both ankle and shoulder product lines.Margin TrendGross margin expanded 455 basis points (bps) to 64.2% in the reported quarter to $230.8 million on an 8.4% rise in gross profit. Selling, general and administrative expenses rose 6.9% to $174.9 million in the quarter under review while research and development expenses slipped a nominal 0.2% to $18.3 million. Overall, adjusted operating margin saw a 178-bp expansion to 10.4% in the quarter.Financial PositionIntegra LifeSciences exited the first quarter with cash and cash equivalents of $157 million, up from $138 million at the end of 2018. Net cash flow from operating activities in the first quarter was $187.6 million, up from $127.2 million a year ago.2019 OutlookIntegra LifeSciences has reaffirmed its earnings and revenue guidance for 2019. The company still expects 2019 revenues in the range of $1.515-$1.525 billion, indicating 3.5% growth at the midpoint. Organic revenue growth is expected at roughly 5%. The Zacks Consensus Estimate for 2019 revenues is pegged at $1.52 billion, near the high end of the guided range.The company has reiterated its adjusted earnings per share in the band of $2.65-$2.72. The Zacks Consensus Estimate for 2019 adjusted earnings stands at $2.68, within but near the lower end of the company’s guided range.How Have Estimates Been Moving Since Then?In the past month, investors have witnessed an upward trend in fresh estimates.VGM ScoresAt this time, Integra has a nice Growth Score of B, though it is lagging a lot on the Momentum Score front with a D. However, the stock was allocated a grade of B on the value side, putting it in the top 40% for this investment strategy.Overall, the stock has an aggregate VGM Score of C. If you aren't focused on one strategy, this score is the one you should be interested in.OutlookEstimates have been broadly trending upward for the stock, and the magnitude of these revisions looks promising. Notably, Integra has a Zacks Rank #3 (Hold). We expect an in-line return from the stock in the next few months.Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free report Integra LifeSciences Holdings Corporation (IART): Free Stock Analysis Report To read this article on Zacks.com click here.