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Revenues | 3 Months Ended
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Mar. 31, 2019
Revenue from Contract with Customer [Abstract] |
Revenues | Revenues The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition:
| Three Months Ended |  | Three Months Ended
| March 31, 2019 |  | March 31, 2018
| Orthopedic Surgery |  | General Surgery |  | Total |  | Orthopedic Surgery |  | General Surgery |  | Total
Primary Geographic Markets |  |  |  |  |  |  |  |  |  |  |
United States | $ | 45,256 |  |  | $ | 71,770 |  |  | $ | 117,026 |  |  | $ | 43,152 |  |  | $ | 63,099 |  |  | $ | 106,251 |
Americas (excluding the United States) | 15,042 |  |  | 7,462 |  |  | 22,504 |  |  | 16,771 |  |  | 7,679 |  |  | 24,450 |
Europe, Middle East & Africa | 30,402 |  |  | 15,930 |  |  | 46,332 |  |  | 28,302 |  |  | 12,984 |  |  | 41,286 |
Asia Pacific | 22,737 |  |  | 9,779 |  |  | 32,516 |  |  | 20,637 |  |  | 9,440 |  |  | 30,077 |
Total sales from contracts with customers | $ | 113,437 |  |  | $ | 104,941 |  |  | $ | 218,378 |  |  | $ | 108,862 |  |  | $ | 93,202 |  |  | $ | 202,064 |
Timing of Revenue Recognition |  |  |  |  |  |  |  |  |  |  |
Goods transferred at a point in time | $ | 104,739 |  |  | $ | 104,425 |  |  | $ | 209,164 |  |  | $ | 100,791 |  |  | $ | 92,881 |  |  | $ | 193,672 |
Services transferred over time | 8,698 |  |  | 516 |  |  | 9,214 |  |  | 8,071 |  |  | 321 |  |  | 8,392 |
Total sales from contracts with customers | $ | 113,437 |  |  | $ | 104,941 |  |  | $ | 218,378 |  |  | $ | 108,862 |  |  | $ | 93,202 |  |  | $ | 202,064 |
Contract liability balances related to the sale of extended warranties to customers are as follows:
| March 31, 2019 |  | December 31, 2018
Contract liability | $ | 12,027 |  |  | $ | 11,043 |
Revenue recognized during the three months ended March 31, 2019 and March 31, 2018 from amounts included in contract liabilities at the beginning of the period were $2.3 million and $1.8 million, respectively. There were no material contract assets as of March 31, 2019 and December 31, 2018.

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- Definition The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 606 -URI http://asc.fasb.org/topic&trid=49130388 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -URI http://asc.fasb.org/topic&trid=2122369 + Details
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