Business Segment Information - Schedule of Depreciation and Amortization by Reporting Segment (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 20,124	$ 20,841	$ 20,923
Operating Segments [Member] | BioStim [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization	2,133	2,754	2,933
Operating Segments [Member] | Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization	6,040	5,742	6,636
Operating Segments [Member] | Spine Fixation [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization	6,949	8,118	10,050
Operating Segments [Member] | Biologics [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization	752	1,011	1,157
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Depreciation and amortization	$ 4,250	$ 3,216	$ 147