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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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+ 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
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-Name Accounting Standards Codification
-Topic 606
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-URI http://asc.fasb.org/extlink&oid=109196051&loc=SL49130545-203045

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