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Business Segments (Details) - USD ($)
$ in Thousands
3 Months Ended
Mar. 31, 2020
Mar. 31, 2019
Segment Reporting Information [Line Items]    
Net sales $ 214,010 $ 218,378
Orthopedic Surgery    
Segment Reporting Information [Line Items]    
Net sales 99,283 113,437
General Surgery    
Segment Reporting Information [Line Items]    
Net sales $ 114,727 $ 104,941