Accrued Expenses (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017	Sep. 30, 2017
Other Income and Expenses [Abstract]
Interest expense	$ 2,335	$ 240
Payroll	1,595	1,580
Professional fees	1,221	546
Inventory and Supplies	1,191	58
Capital expenditures	1,042	1,947
Rebates	343	83
Royalties	613	856	$ 600
Clinical studies	593	596
Medicaid and Medicare	365	1,487
Income Tax	30	58
Other	1,109	650
Accrued expenses	$ 10,437	$ 8,101	$ 12,572