Business segment information (Tables)

12 Months Ended

Dec. 31, 2015

Segment Reporting [Abstract]

Schedule of Net Sales by SBU Reporting Segment

The table below presents net sales by SBU reporting segment. Net sales include product sales and marketing service fees.

	Year Ended December 31,
(U.S. Dollars in thousands)	2015					2014					2013
	Net Sales		Percent of Total Net Sales			Net Sales		Percent of Total Net Sales			Net Sales		Percent of Total Net Sales
BioStim	$	164,955		41.6	%	$	154,676		38.5	%	$	145,085		36.5	%
Biologics		59,832		15.1	%		55,881		13.9	%		53,746		13.5	%
Extremity Fixation		96,034		24.2	%		109,678		27.3	%		103,359		26.0	%
Spine Fixation		75,668		19.1	%		82,042		20.4	%		95,421		24.0	%
Total net sales	$	396,489		100.0	%	$	402,277		100.0	%	$	397,611		100.0	%

Summary of Net Margin, Defined as Gross Profit Less Sales and Marketing Expenses from Continuing Operations by SBU Reporting Segment

The table below presents net margin, defined as gross profit less sales and marketing expenses by SBU reporting segment:

Net Margin by SBU	Year Ended December 31,
(U.S. Dollars in thousands)	2015			2014			2013
Net margin
BioStim	$	67,878		$	66,096		$	63,847
Biologics		27,226			26,629			24,794
Extremity Fixation		29,493			31,586			23,704
Spine Fixation		8,547			14,243			4,329
Corporate		(1,260	)		(1,736	)		(1,443	)
Total net margin	$	131,884		$	136,818		$	115,231
General and administrative		87,157			79,074			67,517
Research and development		26,389			24,994			26,768
Restatements and related costs		9,083			15,614			12,945
Impairment of goodwill		—			—			19,193
Operating income (loss)	$	9,255		$	17,136		$	(11,192	)

Schedule of Depreciation and Amortization by GBU Reporting Segment

The following table presents depreciation and amortization by SBU reporting segment:

	Year Ended December 31,
(U.S. Dollars in thousands)	2015		2014			2013
BioStim	$	2,933	$	1,623		$	1,979
Biologics		1,157		1,161			648
Extremity Fixation		6,636		8,442			7,265
Spine Fixation		10,050		11,711			12,834
Corporate		147		(59	)		96
Total	$	20,923	$	22,878		$	22,822

Summary of Net Sales by Geographic Destination

The following data includes net sales by geographic destination:

(U.S. Dollars in thousands)	2015		2014		2013
U.S.	$	305,505	$	294,682	$	293,032
Italy		15,655		19,573		16,755
United Kingdom		11,376		11,402		10,002
Brazil		13,512		19,633		26,786
Others		50,441		56,987		51,036
Total net sales	$	396,489	$	402,277	$	397,611

Summary of Property, Plant and Equipment of Reporting Segments by Geographic Area

The following data includes property, plant and equipment by geographic area:

(U.S. Dollars in thousands)	2015		2014
U.S.	$	42,534	$	37,029
Italy		6,015		6,865
United Kingdom		998		1,368
Brazil		1,036		1,308
Others		1,723		1,979
Total	$	52,306	$	48,549