Accrued Expenses (Details) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017	Jun. 30, 2017
Other Income and Expenses [Abstract]
Capital expenditures	$ 2,476	$ 1,947
Payroll	1,483	1,580
Professional fees	1,284	546
Interest expense	763	240
Clinical studies	603	596
Royalties	578	856	$ 400
Medicaid and Medicare	542	1,487
Inventory and Supplies	460	58
Rebates	332	83
Income Tax	60	58
Other	688	650
Accrued expenses	$ 9,269	$ 8,101	$ 9,166