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Revenues (Details) - USD ($) $ in Thousands | 12 Months Ended
--- | ---
Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | $ 859,634 | $ 796,392 | $ 763,520
Transferred at Point in Time [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | 825,021 | 762,819 | 732,390
Transferred over Time [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | 34,613 | 33,573 | 31,130
Orthopedic Surgery [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | 446,728 | 428,944 | 422,103
Orthopedic Surgery [Member] | Transferred at Point in Time [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | 413,630 | 396,147 | 391,114
Orthopedic Surgery [Member] | Transferred over Time [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | 33,098 | 32,797 | 30,989
General Surgery [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | 412,906 | 367,448 | 341,417
General Surgery [Member] | Transferred at Point in Time [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | 411,391 | 366,672 | 341,276
General Surgery [Member] | Transferred over Time [Member] |  |  |
Disaggregation of Revenue [Line Items] |  |  |
Net Sales | $ 1,515 | $ 776 | $ 141

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