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Business Segments and Geographic Areas (Details) $ in Thousands | 3 Months Ended | 12 Months Ended
--- | --- | ---
Dec. 31, 2017 USD ($) | Sep. 30, 2017 USD ($) | Jun. 30, 2017 USD ($) | Mar. 31, 2017 USD ($) | Dec. 31, 2016 USD ($) | Sep. 30, 2016 USD ($) | Jun. 30, 2016 USD ($) | Mar. 31, 2016 USD ($) | Dec. 31, 2017 USD ($) Customers | Dec. 31, 2016 USD ($) Customers | Dec. 31, 2015 USD ($) Customers
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net sales | $ 222,555 | $ 190,117 | $ 197,154 | $ 186,567 | $ 204,094 | $ 184,792 | $ 193,433 | $ 181,201 | $ 796,392 | $ 763,520 | $ 719,168
Number of customer representing over 10% of consolidated net sales | Customers |  |  |  |  |  |  |  |  | 0 | 0 | 0
United States [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net sales |  |  |  |  |  |  |  |  | $ 411,041 | $ 399,107 | $ 361,452
Americas (excluding the United States) [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net sales |  |  |  |  |  |  |  |  | 91,169 | 87,532 | 86,867
EMEA [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net sales |  |  |  |  |  |  |  |  | 155,849 | 147,985 | 145,565
Asia Pacific [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net sales |  |  |  |  |  |  |  |  | 138,333 | 128,896 | 125,284
Orthopedic Surgery [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net sales |  |  |  |  |  |  |  |  | 428,944 | 422,103 | 444,978
General Surgery [Member] |  |  |  |  |  |  |  |  |  |  |
Segment Reporting Information [Line Items] |  |  |  |  |  |  |  |  |  |  |
Net sales |  |  |  |  |  |  |  |  | $ 367,448 | $ 341,417 | $ 274,190

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- Definition Total revenue from sale of goods and services rendered during the reporting period, in the normal course of business, reduced by sales returns and allowances, and sales discounts. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 225 -SubTopic 10 -Section S99 -Paragraph 2 -Subparagraph (SX 210.5-03.1) -URI http://asc.fasb.org/extlink&oid=63488584&loc=d3e20235-122688 + Details
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