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Business Segments (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2017
Sep. 30, 2016
Sep. 30, 2017
Sep. 30, 2016
Segment Reporting Information [Line Items]        
Net sales $ 190,117 $ 184,792 $ 573,837 $ 559,426
Orthopedic Surgery        
Segment Reporting Information [Line Items]        
Net sales 98,581 99,353 307,931 310,518
General Surgery        
Segment Reporting Information [Line Items]        
Net sales $ 91,536 $ 85,439 $ 265,906 $ 248,908