Business Segments and Geographic Areas (Details) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017 USD ($)	Sep. 30, 2017 USD ($)	Jun. 30, 2017 USD ($)	Mar. 31, 2017 USD ($)	Dec. 31, 2016 USD ($)	Sep. 30, 2016 USD ($)	Jun. 30, 2016 USD ($)	Mar. 31, 2016 USD ($)	Dec. 31, 2017 USD ($) Customers	Dec. 31, 2016 USD ($) Customers	Dec. 31, 2015 USD ($) Customers
Segment Reporting Information [Line Items]
Net sales	$ 222,555	$ 190,117	$ 197,154	$ 186,567	$ 204,094	$ 184,792	$ 193,433	$ 181,201	$ 796,392	$ 763,520	$ 719,168
Number of customer representing over 10% of consolidated net sales | Customers									0	0	0
United States [Member]
Segment Reporting Information [Line Items]
Net sales									$ 411,041	$ 399,107	$ 361,452
Americas (excluding the United States) [Member]
Segment Reporting Information [Line Items]
Net sales									91,169	87,532	86,867
EMEA [Member]
Segment Reporting Information [Line Items]
Net sales									155,849	147,985	145,565
Asia Pacific [Member]
Segment Reporting Information [Line Items]
Net sales									138,333	128,896	125,284
Orthopedic Surgery [Member]
Segment Reporting Information [Line Items]
Net sales									428,944	422,103	444,978
General Surgery [Member]
Segment Reporting Information [Line Items]
Net sales									$ 367,448	$ 341,417	$ 274,190