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Business Segments and Geographic Areas (Details) $ in Thousands	12 Months Ended
	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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Number of Customer Representing over Ten Percent of Consolidated Net Sales

+ References

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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
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-Paragraph 1
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-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

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Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

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