Business Segment Information - Summary of Net Sales by Geographic Destination for Each Reporting Unit (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	$ 108,709	$ 102,738
BioStim [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	46,163	44,539
Extremity Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	27,504	23,945
Spine Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	20,707	19,267
Biologics [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	14,335	14,987
U.S. [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	84,954	82,116
U.S. [Member] | BioStim [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	46,137	44,539
U.S. [Member] | Extremity Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	6,916	6,579
U.S. [Member] | Spine Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	17,579	16,035
U.S. [Member] | Biologics [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	14,322	14,963
International [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	23,755	20,622
International [Member] | BioStim [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	26
International [Member] | Extremity Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	20,588	17,366
International [Member] | Spine Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	3,128	3,232
International [Member] | Biologics [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	$ 13	$ 24