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Business Segments (Details) - USD ($)
$ in Thousands
3 Months Ended 6 Months Ended
Jun. 30, 2019
Jun. 30, 2018
Jun. 30, 2019
Jun. 30, 2018
Segment Reporting Information [Line Items]        
Net sales $ 238,263 $ 212,820 $ 456,641 $ 414,884
Orthopedic Surgery        
Segment Reporting Information [Line Items]        
Net sales 115,757 110,131 229,194 218,994
General Surgery        
Segment Reporting Information [Line Items]        
Net sales $ 122,506 $ 102,689 $ 227,447 $ 195,890