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Business Segments and Geographic Areas (Details) $ in Thousands | 12 Months Ended
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Dec. 31, 2018 USD ($) Customers | Dec. 31, 2017 USD ($) Customers | Dec. 31, 2016 USD ($) Customers
Segment Reporting Information [Line Items] |  |  |
Net Sales | $ 859,634 | $ 796,392 | $ 763,520
Number of customer representing over 10% of consolidated net sales | Customers | 0 | 0 | 0
United States [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | $ 448,648 | $ 411,041 | $ 399,107
Americas (excluding the United States) [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 97,528 | 91,169 | 87,532
EMEA [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 166,563 | 155,849 | 147,985
Asia Pacific [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 146,895 | 138,333 | 128,896
Orthopedic Surgery [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 446,728 | 428,944 | 422,103
Orthopedic Surgery [Member] | United States [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 172,462 | 167,602 | 171,158
Orthopedic Surgery [Member] | Americas (excluding the United States) [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 66,519 | 60,439 | 56,773
Orthopedic Surgery [Member] | EMEA [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 112,998 | 106,921 | 103,709
Orthopedic Surgery [Member] | Asia Pacific [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 94,749 | 93,982 | 90,463
General Surgery [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 412,906 | 367,448 | 341,417
General Surgery [Member] | United States [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 276,186 | 243,439 | 227,949
General Surgery [Member] | Americas (excluding the United States) [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 31,009 | 30,730 | 30,759
General Surgery [Member] | EMEA [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | 53,565 | 48,928 | 44,276
General Surgery [Member] | Asia Pacific [Member] |  |  |
Segment Reporting Information [Line Items] |  |  |
Net Sales | $ 52,146 | $ 44,351 | $ 38,433

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- Definition Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 4 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130543-203045 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 1 -Subparagraph (a) -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130539-203045 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -SubTopic 10 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130545-203045 + Details
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