Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Other
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 128,702	$ 97,680
Accumulated Amortization	(49,136)	(38,127)
Net Carrying Amount	79,566	59,553
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	19,378	16,528
Accumulated Amortization	(5,012)	(3,737)
Net Carrying Amount	14,366	12,791
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	8,012	7,262
Accumulated Amortization	(5,766)	(4,686)
Net Carrying Amount	2,246	2,576
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	26,930	23,783
Accumulated Amortization	(7,411)	(5,568)
Net Carrying Amount	19,519	18,215
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	29,998	16,224
Accumulated Amortization	(6,586)	(4,686)
Net Carrying Amount	23,412	11,538
Covenants not to compete
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,028	1,028
Accumulated Amortization	(1,000)	(968)
Net Carrying Amount	28	60
Customer lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	39,936	31,935
Accumulated Amortization	(23,361)	(18,482)
Net Carrying Amount	16,575	13,453
In-process technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	3,420	920
Accumulated Amortization	0	0
Net Carrying Amount	$ 3,420	$ 920