Segment and Geographic Information - Significant expense categories and other specified amounts (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2024 USD ($) segment	Dec. 31, 2023 USD ($)	Dec. 31, 2022 USD ($)
Significant expense categories and other specified amounts
Number of operating segments | segment	1
Net revenue	$ 256,182	$ 216,389	$ 181,383
Cost of goods sold:
Gross profit	191,489	164,435	149,266
Operating expenses:
Research and development	27,066	30,078	24,650
Selling, general and administrative:
Depreciation and amortization	18,546	15,542	13,728
Operating loss	(40,778)	(45,665)	(61,707)
Other income (expense):
Other income (expense), net	(1,171)	(1,183)	123
Loss on early extinguishment of debt		(5,308)
Income tax expense (benefit)	1,159	213	(64)
Net loss	(54,639)	(57,534)	(65,649)
Single reportable segment
Significant expense categories and other specified amounts
Net revenue	256,182	216,389	181,383
Cost of goods sold:
Standard cost of goods sold	39,009	30,870	20,571
Shipping costs	10,234	10,861	9,637
Excess and obsolete inventory	10,094	4,037	485
Other cost of goods sold	5,356	6,186	1,424
Gross profit	191,489	164,435	149,266
Operating expenses:
Research and development	27,066	30,078	24,650
Selling, general and administrative:
Commissions	70,259	58,733	50,731
Marketing and medical education	23,536	24,907	22,455
General and administrative	75,686	65,046	59,580
Depreciation and amortization	18,546	15,542	13,728
Other segment expenses	$ 17,174	$ 15,794	$ 12,829
Segment Reporting, Other Segment Item, Composition, Description	Other segment expenses include bonus, salaries and management support related to selling functions	Other segment expenses include bonus, salaries and management support related to selling functions	Other segment expenses include bonus, salaries and management support related to selling functions
Legal settlement			$ 27,000
Operating loss	$ (40,778)	$ (45,665)	(61,707)
Other income (expense):
Other income (expense), net	(1,171)	(1,183)	123
Loss on early extinguishment of debt		(5,308)
Interest income	1,798	1,891
Interest expenses	(13,329)	(7,056)	(4,129)
Income tax expense (benefit)	1,159	213	(64)
Net loss	$ (54,639)	$ (57,534)	$ (65,649)