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Business Segments (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Segment Reporting Information [Line Items]        
Net sales $ 233,590 $ 202,307 $ 690,232 $ 617,191
Orthopedic Surgery        
Segment Reporting Information [Line Items]        
Net sales 110,328 102,929 339,522 321,923
General Surgery        
Segment Reporting Information [Line Items]        
Net sales $ 123,262 $ 99,378 $ 350,710 $ 295,268