Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 130,708	$ 128,702
Accumulated Amortization	(56,289)	(49,136)
Net Carrying Amount	74,419	79,566
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	20,985	19,378
Accumulated Amortization	(5,850)	(5,012)
Net Carrying Amount	15,135	14,366
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	8,012	8,012
Accumulated Amortization	(6,280)	(5,766)
Net Carrying Amount	1,732	2,246
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	27,008	26,930
Accumulated Amortization	(9,016)	(7,411)
Net Carrying Amount	17,992	19,519
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	30,246	29,998
Accumulated Amortization	(8,035)	(6,586)
Net Carrying Amount	22,211	23,412
Covenants not to compete
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,028	1,028
Accumulated Amortization	(1,016)	(1,000)
Net Carrying Amount	12	28
Customer lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	40,009	39,936
Accumulated Amortization	(26,092)	(23,361)
Net Carrying Amount	13,917	16,575
In-process technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	3,420	3,420
Accumulated Amortization	0	0
Net Carrying Amount	$ 3,420	$ 3,420