RTI Surgical (RTIX) 10-K 7 Mar 16 2015 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2015	Feb. 26, 2016	Jun. 30, 2015
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2015
Document Fiscal Year Focus	2,015
Document Fiscal Period Focus	FY
Trading Symbol	RTIX
Entity Registrant Name	RTI SURGICAL, INC.
Entity Central Index Key	1,100,441
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		57,803,111
Entity Public Float			$ 372.2

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Current Assets:
Cash and cash equivalents	$ 12,614	$ 15,703
Accounts receivable - less allowances of $1,454 at December 31, 2015 and $818 at December 31, 2014	47,243	38,833
Inventories - net	118,673	113,464
Prepaid and other current assets	13,184	6,668
Deferred tax assets - net		22,828
Total current assets	191,714	197,496
Property, plant and equipment - net	84,992	77,028
Deferred tax assets - net	22,385	6,193
Goodwill	54,887	54,887
Other intangible assets - net	26,213	30,261
Other assets - net	874	12,270
Total assets	381,065	378,135
Current Liabilities:
Accounts payable	20,446	26,834
Accrued expenses	28,609	24,689
Current portion of deferred revenue	4,865	5,984
Current portion of short and long-term obligations	6,009	6,479
Total current liabilities	59,929	63,986
Long-term obligations - less current portion	73,631	69,413
Other long-term liabilities	472	11,607
Deferred revenue	9,354	12,460
Total liabilities	143,386	157,466
Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding	56,323	52,834
Stockholders' equity:
Common stock, $.001 par value: 150,000,000 shares authorized; 57,803,111 and 56,917,414 shares issued and outstanding, respectively	58	57
Additional paid-in capital	417,725	415,702
Accumulated other comprehensive loss	(7,042)	(3,881)
Accumulated deficit	(228,939)	(243,854)
Less treasury stock, 230,352 and 180,898 shares, respectively, at cost	(446)	(189)
Total stockholders' equity	181,356	167,835
Total liabilities and stockholders' equity	$ 381,065	$ 378,135

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 1,454	$ 818
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	50,000	50,000
Preferred stock, shares outstanding	50,000	50,000
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares issued	57,803,111	56,917,414
Common stock, shares outstanding	57,803,111	56,917,414
Treasury stock, shares	230,352	180,898

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Statement [Abstract]
Revenues	$ 282,293	$ 262,810	$ 197,979
Costs of processing and distribution	132,551	129,013	117,874
Gross profit	149,742	133,797	80,105
Expenses:
Marketing, general and administrative	107,439	107,653	81,635
Research and development	15,065	15,536	15,241
Asset abandonments	814
Litigation and settlement charges	804	185	3,000
Restructuring charges			2,881
Acquisition expenses			6,004
Severance charges	995	4,798
Total operating expenses	125,117	128,172	108,761
Operating income (loss)	24,625	5,625	(28,656)
Other (expense) income:
Interest expense	(1,492)	(1,357)	(542)
Interest income	3	9	23
Foreign exchange gain (loss)	78	(88)	251
Total other expense - net	(1,411)	(1,436)	(268)
Income (loss) before income tax (provision) benefit	23,214	4,189	(28,924)
Income tax (provision) benefit	(8,299)	(1,493)	11,110
Net income (loss)	14,915	2,696	(17,814)
Convertible preferred dividend	(3,305)	(3,113)	(1,375)
Net income (loss) applicable to common shares	11,610	(417)	(19,189)
Other comprehensive (loss) gain:
Unrealized foreign currency translation (loss) gain	(3,161)	(3,069)	964
Comprehensive income (loss)	$ 8,449	$ (3,486)	$ (18,225)
Net income (loss) per common share - basic	$ 0.20	$ (0.01)	$ (0.34)
Net income (loss) per common share - diluted	$ 0.20	$ (0.01)	$ (0.34)
Weighted average shares outstanding - basic	57,611,231	56,735,924	56,258,624
Weighted average shares outstanding - diluted	58,590,494	56,735,924	56,258,624

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Series A Preferred Stock [Member]	Common Stock [Member]	Additional Paid-In Capital [Member]	Additional Paid-In Capital [Member]Series A Preferred Stock [Member]	Accumulated Other Comprehensive Loss [Member]	Accumulated Deficit [Member]	Treasury Stock [Member]
Beginning Balance at Dec. 31, 2012	$ 183,992		$ 56	$ 414,482		$ (1,776)	$ (228,736)	$ (34)
Net income	(17,814)						(17,814)
Foreign currency translation adjustment	964					964
Exercise of common stock options	332			332
Stock-based compensation	2,220			2,220
Purchase of treasury stock	(33)							(33)
Amortization of preferred stock Series A issuance costs		$ (77)			$ (77)
Preferred stock Series A dividend		(1,375)			(1,375)
Change in income tax benefit from stock-based compensation	(156)			(156)
Ending Balance at Dec. 31, 2013	168,053		56	415,426		(812)	(246,550)	(67)
Net income	2,696						2,696
Foreign currency translation adjustment	(3,069)					(3,069)
Exercise of common stock options	889		1	888
Stock-based compensation	3,032			3,032
Purchase of treasury stock	(122)							(122)
Amortization of preferred stock Series A issuance costs		(184)			(184)
Preferred stock Series A dividend		(3,113)			(3,113)
Change in income tax benefit from stock-based compensation	(347)			(347)
Ending Balance at Dec. 31, 2014	167,835		57	415,702		(3,881)	(243,854)	(189)
Net income	14,915						14,915
Foreign currency translation adjustment	(3,161)					(3,161)
Exercise of common stock options	2,505		1	2,504
Stock-based compensation	2,858			2,858
Purchase of treasury stock	(257)							(257)
Amortization of preferred stock Series A issuance costs		(186)			(186)
Preferred stock Series A dividend		$ (3,305)			$ (3,305)
Change in income tax benefit from stock-based compensation	152			152
Ending Balance at Dec. 31, 2015	$ 181,356		$ 58	$ 417,725		$ (7,042)	$ (228,939)	$ (446)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Cash flows from operating activities:
Net income (loss)	$ 14,915	$ 2,696	$ (17,814)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization expense	16,522	15,395	12,202
Provision for bad debts and product returns	1,568	891	435
Provision for inventory write-downs	5,390	3,763	1,785
Amortization of deferred revenue	(6,225)	(5,420)	(6,451)
Deferred income tax provision (benefit)	5,543	502	(11,544)
Stock-based compensation	2,548	3,032	2,220
Other	2,280	958	227
Change in assets and liabilities:
Accounts receivable	(10,435)	(8,058)	(50)
Inventories	(11,990)	(11,244)	5,231
Accounts payable	(12,660)	4,087	5,276
Accrued expenses	5,532	1,375	(3,247)
Deferred revenue	2,000		6,000
Other operating assets and liabilities	(5,992)	(1,083)	1,276
Net cash provided by (used in) operating activities	8,996	6,894	(4,454)
Cash flows from investing activities:
Purchases of property, plant and equipment	(17,740)	(15,577)	(15,011)
Patent and acquired intangible asset costs	(498)	(737)	(915)
Acquisition of Pioneer Surgical Technology			(126,307)
Net cash used in investing activities	(18,238)	(16,314)	(142,233)
Cash flows from financing activities:
Proceeds from exercise of common stock options	2,505	889	332
Proceeds from long-term obligations	8,750	7,000	68,250
Net proceeds from short-term obligations	422	658	638
Payment of debt issuance costs			(699)
Proceeds from preferred stock issuance			50,000
Payment of preferred stock issuance costs			(1,290)
Payment of preferred stock dividend			(625)
Payments on long-term obligations	(5,294)	(682)	(142)
Other financing activities	(109)	5	(841)
Net cash provided by financing activities	6,274	7,870	115,623
Effect of exchange rate changes on cash and cash equivalents	(121)	(1,468)	89
Net decrease in cash	(3,089)	(3,018)	(30,975)
Cash and cash equivalents, beginning of period	15,703	18,721	49,696
Cash and cash equivalents, end of period	12,614	15,703	18,721
Supplemental cash flow disclosure:
Cash paid for interest	1,425	1,624	570
Cash paid for income taxes, net of refunds	3,667	578	2,819
Non-cash acquisition of property, plant and equipment	3,795	1,947	1,557
Stock-based compensation related to severance	310
Change in accrual for dividend payable	$ 3,305	$ 3,113	$ 750

Business

Business	12 Months Ended
	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business	1. Business RTI Surgical, Inc. (the “Company”), and its subsidiaries recover and process human and animal tissue and manufacture metal and synthetic implants and instruments. The processing transforms the tissue into either conventional or precision machined allograft implants (human) or xenograft implants (animal). The implants are used for orthopedic and other surgical applications to promote the natural healing of human bone and other human tissue. These implants are distributed domestically and internationally, for use in reconstruction and fracture repair.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2015
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Principles of Consolidation RTIDS is a taxable not-for-profit entity organized and controlled by the Company. RTIDS is the corporate entity that is responsible for procuring tissue for the Company. Expenses incurred by RTIDS to procure tissue are passed through to the Company. RTIDS has no significant assets or liabilities except for its intercompany accounts receivable and accounts payable to tissue recovery agencies. The Company pays all expenses of RTIDS. Use of Estimates Foreign Currency Translation Fair Value of Financial Instruments Cash and Cash Equivalents Accounts Receivable Allowances Inventories Implant and Product Recalls Surgical Instruments Property, Plant and Equipment Buildings 25 to 40 years Building improvements and leasehold improvements 8 to 40 years Processing equipment 7 to 10 years Office equipment, furniture and fixtures 5 to 7 years Computer hardware and software 3 to 7 years Surgical instruments 3 years Software Costs Debt Issuance Costs— Long-Lived Assets Goodwill Goodwill and Other Intangible Assets Goodwill is tested for impairment annually by comparing the fair value of the reporting unit to its carrying amount, including goodwill. The Company adopted ASU No. 2011-08, Intangibles – Goodwill and Other: Testing Goodwill for Impairment, In general, the income approach employs a discounted cash flow model that considers: 1) assumptions that marketplace participants would use in their estimates of fair value, including the cash flow period, terminal values based on a terminal growth rate and the discount rate; 2) current period actual results, and 3) projected results for future periods that have been prepared and approved by senior management of the Company. The forecasted cash flows do not include synergies that a marketplace participant would be expecting to achieve. The market approach employs market multiples from guideline public companies operating in our industry. Estimates of fair value are derived by applying multiples based on revenue and earnings before interest, taxes, depreciation and amortization (“EBITDA”) adjusted for size and performance metrics relative to peer companies. A control premium was included in determining the fair value under this approach. If the carrying amount of the reporting unit exceeds its calculated fair value, the second step of the goodwill impairment test is performed in accordance with FASB ASC 350 to measure the amount of the impairment loss, if any. Both approaches used in the analysis have a degree of uncertainty. Potential events or changes in circumstances which could impact the key assumptions used in our goodwill impairment evaluation are as follows: • Change in peer group or performance of peer group companies • Change in the Company’s markets and estimates of future operating performance • Change in the Company’s estimated market cost of capital • Change in implied control premiums related to acquisitions in the medical device industry. Goodwill represents the excess of purchase price over fair value of tangible net assets of acquired businesses at the acquisition date, after amounts allocated to other identifiable intangible assets. Factors that contribute to the recognition of goodwill include securing synergies that are specific to our business and not available to other market participants and are expected to increase revenues and profits; acquisition of a talented workforce; cost savings opportunities; the strategic benefit of expanding our presence in core and adjacent markets; and diversifying our product portfolio. Other Intangible Assets Other intangible assets are tested for impairment annually (if indefinite lived) or whenever events or circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. The Company had one asset group for the year ended December 31, 2014 and 2015. The recoverability test is described in the Company’s accounting policy for long-lived assets set forth above. Revenue Recognition The Company permits returns of implants in accordance with the terms of contractual agreements with customers if the implant is returned in a timely manner, in unopened packaging, and from the normal channels of distribution. Allowances for returns are provided based upon analysis of the Company’s historical patterns of returns matched against the revenues from which they originated. The Company records estimated implant returns, discounts, rebates and other distribution incentives as a reduction of revenue in the same period revenue is recognized. Estimates of implant returns are recorded for anticipated implant returns based on historical distributions and returns information. Estimates of discounts, rebates and other distribution incentives are recorded based on contractual terms, historical experience and trend analysis. Other Revenues Stock-Based Compensation Plans Accounting for Stock Compensation Staff Accounting Bulletin No. 107 Research and Development Costs Income Taxes Earnings Per Share Year Ended December 31, 2015 2014 2013 Basic shares 57,611,231 56,735,924 56,258,624 Effect of dilutive securities: Stock options 979,263 — — Diluted shares 58,590,494 56,735,924 56,258,624 Options to purchase 5,661,514 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2015, were included in the computation of diluted EPS because dilutive shares are factored into the calculation of EPS when income applicable to common shares is reported. Options to purchase 5,735,784 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2014, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. Options to purchase 5,518,604 shares of common stock at prices ranging from $2.54 to $13.52 per share which were outstanding as of December 31, 2013, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. For the years ended December 31, 2015, 2014 and 2013, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted basis and were not included in the computation of diluted net income (loss) per common share.

Recently Issued Accounting Stan

Recently Issued Accounting Standards	12 Months Ended
	Dec. 31, 2015
Accounting Changes and Error Corrections [Abstract]
Recently Issued Accounting Standards	3. Recently Issued Accounting Standards. Income Taxes “Income Taxes (Topic 740)” Simplifying the Measurement of Inventory “Inventory (Topic 330): Simplifying the Measurement of Inventory” Presentation of Financial Statements - Going Concern “Presentation of Financial Statements - Going Concern (Subtopic 205-40).” Revenue from Contracts with Customers “Revenue from Contracts with Customers (Topic 606)” “Revenue Recognition”

Merger with Pioneer Surgical Te

Merger with Pioneer Surgical Technology, Inc.	12 Months Ended
	Dec. 31, 2015
Business Combinations [Abstract]
Merger with Pioneer Surgical Technology, Inc.	4. Merger with Pioneer Surgical Technology, Inc. On July 16, 2013, the Company completed its acquisition of Pioneer. Under the terms of the merger agreement dated June 12, 2013, the Company acquired Pioneer for $126,307 in cash. The transaction was funded through a combination of cash on hand, a new credit facility and a concurrent private placement of convertible preferred equity. The Company obtained from Toronto-Dominion Bank, N.A., TD Securities “USA” LLC (“TD Bank”) and Regions Bank, a 5-year, $80,000 senior secured facility, which includes a $60,000 term loan and a $20,000 revolving credit facility, that matures on July 16, 2018 with a variable interest rate between 100 and 300 basis points in excess of the one month LIBOR rate. On June 29, 2015, the Company entered into a third amendment to the second amended and restated loan agreement with TD Bank and Regions Bank, which increased the maximum revolving credit amount from $20,000 to $30,000. Additionally, the Company received $50,000 in gross proceeds from a private placement of convertible preferred equity to WSHP Biologics Holdings, LLC, (“WSHP”), a leading healthcare-focused private equity firm. The convertible preferred stock is convertible into shares of the Company’s common stock. The convertible preferred stock will also accrue dividends at a rate of 6% per year. In 2013, the Company capitalized $1,989 in financing costs associated with the preferred stock issuance and the debt issuance and expensed $6,004 of acquisition costs. The acquisition costs are reflected separately in the accompanying Consolidated Statements of Comprehensive Income (Loss). The Company has accounted for the acquisition of Pioneer under ASC 805, Business Combinations The purchase price was financed as follows: (In thousands) Cash proceeds from term loan $ 60,000 Net cash proceeds from preferred share issuance 48,710 Cash from RTI Surgical 17,597 Total purchase price $ 126,307 The table below represents an allocation of the total consideration to Pioneer’s tangible and intangible assets and liabilities based on management’s estimate of their respective fair values as of July 16, 2013. (In thousands) Inventories $ 35,972 Accounts receivable 10,567 Other current assets 6,059 Property, plant and equipment 15,258 Other assets 13,260 Current liabilities (10,893 ) Other long-term liabilities (19,841 ) Net tangible assets acquired 50,382 Other intangible assets 23,100 Goodwill 52,825 Total net assets acquired $ 126,307 Total net assets acquired as of July 16, 2013, are all part of the Company’s only operating segment. Fair values are based on management’s estimates and assumptions including variations of the income approach, the cost approach and the market approach. The Company believes that the acquisition of Pioneer has offered and continues to offer the potential for substantial strategic and financial benefits. The transaction will enhance the Company’s existing core competency in biologics processing with the addition of Pioneer’s core competency in metals and synthetics. The Company believes the acquisition will enhance stockholder value through, among other things, enabling the Company to capitalize on the following strategic advantages and opportunities: • Diversification of its implant portfolio. • Expansion of its direct distribution and marketing organizations. • Enhancement of its current international business. • Improvement of its margin profile and additional revenue opportunities. These potential benefits resulted in the Company paying a premium for Pioneer resulting in the recognition of goodwill. The $52,825 of goodwill was assigned to the Company’s only operating segment and reporting unit. The fair value of receivables acquired is $10,567, with the gross contractual amount being $11,712, of which $1,145 was not expected to be collected. The amount of Pioneer’s revenues and net income since the July 16, 2013 acquisition date, included in the Company’s Consolidated Statement of Comprehensive (Loss) Income for the year ended December 31, 2013, are $35,994 and $894, respectively. The following unaudited pro forma information shows the results of the Company’s operations as though the acquisition had occurred as of the beginning of that period (in thousands, except per share data): December 31, Revenues $ 243,001 Net loss applicable to common shares (5,597 ) Basic net loss per share (0.10 ) Diluted net loss per share (0.10 ) The unaudited pro forma results have been prepared for comparative purposes only and are not necessarily indicative of the actual results of operations had the merger taken place as of the beginning of the periods presented, or the results that may occur in the future. These amounts have been calculated to reflect the additional depreciation, amortization, preferred dividend, and interest expense that would have been incurred assuming the fair value of adjustments and borrowings occurred on January 1, 2013, together with the consequential tax effects. In addition, these amounts exclude costs incurred which are directly attributable to the acquisition, and which do not have a continuing impact on the combined companies’ operating results. The Company completed its analysis of the purchase price allocation in the third quarter of 2014.

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	5. Stock-Based Compensation The Company has six stock-based compensation plans (although it may currently issue awards only under one of such plans). The Company’s policy is to grant stock options at an exercise price equal to 100% of the market value of a share of common stock at closing on the date of the grant. The Company’s stock options generally have ten-year contractual terms and vest over a one to five year period from the date of grant. The Company’s policy is to grant restricted stock awards at a fair value equal to 100% of the market value of a share of common stock at closing on the date of the grant. The Company’s restricted stock awards generally vest over one to three year periods. 2015 Incentive Compensation Plan – 1998 Stock Option Plan, 2004 Equity Incentive Plan, 2010 Equity Incentive Plan, TMI 1996 Stock Option Plan and TMI 2006 Incentive and Non-Statutory Stock Option Plan – The following weighted-average assumptions were used to determine the fair value of options under FASB ASC 718: Year Ended December 31, 2015 2014 2013 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 1.67 % 2.29 % 1.30 % Volatility factor 46.29 % 46.53 % 47.50 % Dividend yield — — — Stock Options Stock options outstanding, exercisable and available for grant at December 31, 2015, are summarized as follows: Number of Weighted Exercise Weighted Contractual Aggregate Intrinsic Value Outstanding at January 1, 2015 5,735,784 $ 4.34 Granted 950,000 5.27 Exercised (858,130 ) 4.30 Forfeited or expired (166,140 ) 4.82 Outstanding at December 31, 2015 5,661,514 $ 4.49 5.75 $ 1,544 Vested or expected to vest at December 31, 2015 5,394,566 $ 4.48 5.61 $ 1,517 Exercisable at December 31, 2015 3,435,614 $ 4.56 4.21 $ 1,188 Available for grant at December 31, 2015 4,530,421 The aggregate intrinsic value in the tables above represents the total pre-tax intrinsic value of stock options for which the fair market value of the underlying common stock exceeded the respective stock option exercise price. For the years ended December 31, 2015, 2014 and 2013, the Company recognized stock-based compensation as follows: Year Ended December 31, 2015 2014 2013 Stock-based compensation: Costs of processing and distribution $ 132 $ 132 $ 132 Marketing, general and administrative 2,356 2,840 2,028 Research and development 60 60 60 Total $ 2,548 $ 3,032 $ 2,220 For the years ended December 31, 2015, 2014, and 2013, the Company recognized total income tax benefits from stock-based compensation of $1,022, $1,198, and $883, respectively. As of December 31, 2015, there was $3,241 of total unrecognized stock-based compensation related to nonvested stock options. That expense is expected to be recognized over a weighted-average period of 3.12 years. Other information concerning stock options are as follows: Year Ended December 31, 2015 2014 2013 Weighted average fair value of stock options granted $ 2.50 $ 1.87 $ 1.66 Aggregate intrinsic value of stock options exercised 1,584 295 117 The aggregate intrinsic value of stock options exercised in a period represents the pre-tax cumulative difference between the fair market value of the underlying common stock and the stock option exercise prices, of the stock options exercised during the period. Restricted Stock Awards During 2015, the Company granted 201,166 shares of restricted stock with a weighted-average grant date fair value of $5.43 per share. As of December 31, 2015, there was $705 of total unrecognized stock-based compensation related to time-based, nonvested restricted stock. That expense is expected to be recognized on a straight-line basis over a weighted-average period of 1.12 years.

Inventories

Inventories	12 Months Ended
	Dec. 31, 2015
Inventory Disclosure [Abstract]
Inventories	6. Inventories Inventories by stage of completion are as follows: December 31, 2015 2014 Unprocessed tissue, raw materials and supplies $ 33,028 $ 31,626 Tissue and work in process 36,614 44,688 Implantable tissue and finished goods 49,031 37,150 $ 118,673 $ 113,464 For the years ended December 31, 2015, 2014, and 2013, the Company had inventory write-downs of $5,390, $3,763 and $1,785, respectively, relating primarily to product obsolescence.

Property, Plant and Equipment

Property, Plant and Equipment	12 Months Ended
	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment	7. Property, Plant and Equipment Property, plant and equipment are as follows: December 31, 2015 2014 Land $ 2,319 $ 2,474 Buildings and improvements 63,699 49,483 Processing equipment 41,831 45,878 Surgical instruments 15,702 9,428 Office equipment, furniture and fixtures 4,657 3,863 Computer equipment and software 11,804 7,674 Construction in process 10,850 20,957 Office equipment under capital leases 152 152 151,014 139,909 Less accumulated depreciation (66,022 ) (62,881 ) $ 84,992 $ 77,028 For the years ended December 31, 2015, 2014, and 2013, the Company had depreciation expense in connection with property, plant and equipment of $12,240, $11,010, and $8,267, respectively.

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	8. Goodwill Goodwill for both years ended December 31, 2015 and 2014 was $54,887. The Company performed its annual goodwill impairment test as of December 31, 2015, and concluded that there was no impairment of goodwill.

Other Intangible Assets

Other Intangible Assets	12 Months Ended
	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Other Intangible Assets	9. Other Intangible Assets Other intangible assets are as follows: December 31, 2015 December 31, 2014 Gross Accumulated Gross Accumulated Patents $ 11,532 $ 3,448 $ 11,420 $ 2,727 Acquired licensing rights 10,850 7,691 10,850 6,538 Marketing and procurement intangible assets 22,179 7,209 22,342 5,086 Total $ 44,561 $ 18,348 $ 44,612 $ 14,351 For the years ended December 31, 2015, 2014, and 2013, the Company had amortization expense of other intangible assets of $4,282, $4,385, and $3,935, respectively. At December 31, 2015, management’s estimates of future amortization expense for the next five years are as follows: Amortization 2016 $ 3,400 2017 3,300 2018 3,300 2019 3,300 2020 3,300 $ 16,600

Other Assets

Other Assets	12 Months Ended
	Dec. 31, 2015
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Other Assets	10. Other Assets Other assets are as follows: December 31, 2015 2014 Indemnification asset $ — $ 11,394 Other 874 876 $ 874 $ 12,270 Under the Pioneer acquisition agreement as described in Note 4, Pioneer deposited $13,000 in an escrow account and indemnified the Company for up to $13,000 for various outstanding and potential legal issues. At acquisition, the Company recorded a $13,000 indemnification asset and a corresponding $13,000 indemnification liability. Under the acquisition agreement, the Company submitted claims against the escrow account during the initial escrow period which ended on October 16, 2014. Under certain provisions of the agreement, the claims period for certain claims may be extended to 30 months after the closing date. Claims made against the escrow that remain unresolved at the end of the claims period will be retained in escrow until resolved. During the fourth quarter of 2015, the Company successfully resolved certain claims. The Company expects to resolve the remaining claims within the next 12 months, and as such has reclassified the remaining indemnification asset and liability to prepaid and other current assets and accrued expenses, respectively. Interest expense associated with the amortization of debt issuance costs for the years ended December 31, 2015, 2014 and 2013 was $148, $142 and $57, respectively. The remaining unamortized debt issuance costs are included in Other in the table above.

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2015
Other Liabilities Disclosure [Abstract]
Accrued Expenses	11. Accrued Expenses Accrued expenses are as follows: December 31, 2015 2014 Accrued compensation $ 4,740 $ 6,220 Accrued severance charges 717 2,771 Accrued distributor commissions 3,835 3,159 Accrued donor recovery fees 7,144 3,249 Accrued taxes 514 1,249 Accrued restructuring charges — 13 Accrued indemnification liability 6,579 — Other 5,080 8,028 $ 28,609 $ 24,689 The Company accrues for the estimated donor recovery fees due to third party recovery agencies as tissue is received.

Short and Long-Term Obligations

Short and Long-Term Obligations	12 Months Ended
	Dec. 31, 2015
Debt Disclosure [Abstract]
Short and Long-Term Obligations	12. Short and Long-Term Obligations Short and long-term obligations are as follows: December 31, 2015 2014 Term loan $ 54,125 $ 59,375 Credit facilities 25,477 16,435 Capital leases 38 82 Total 79,640 75,892 Less current portion (6,009 ) (6,479 ) Long-term portion $ 73,631 $ 69,413 The Company obtained from TD Bank and Regions Bank, a 5-year, $80,000 senior secured facility, which includes a $60,000 term loan and a $20,000 revolving credit facility that matures on July 16, 2018, with a variable interest rate between 100 and 175 basis points in excess of the one month LIBOR rate. On October 15, 2014, the Company entered into a second amendment to the second amended and restated loan agreement with TD Bank, N.A. and Regions Bank, which amended the loan agreement to remove certain financial covenants. On June 29, 2015, the Company entered into a third amendment to the second amended and restated loan agreement with TD Bank, N.A. and Regions Bank, which increased the maximum revolving credit amount from $20,000 to $30,000. At December 31, 2015, the interest rate for the term loan and revolving credit facility is 1.86%. The facility is secured by substantially all the assets of the Company and its subsidiaries and guaranteed by the Company’s domestic subsidiaries, other than RTIDS. As of December 31, 2015, there was $24,000 outstanding on the revolving credit facility. The term loan facility requires aggregate principal payments of $18,000 from January 1, 2015 through June 30, 2018, with a final balloon principal payment at the end of the loan agreement. The credit agreement also contains various restrictive covenants which limit, among other things, indebtedness and liens, as well as payment of dividends, while requiring a minimum cash balance on hand of $10,000 and certain financial covenant ratios. The Company was in compliance with all financial covenants related to its senior secured credit facility as of December 31, 2015. In addition to the credit facility with TD Bank and Regions Bank, the Company has through its German subsidiary, three credit facilities with three German banks as of December 31, 2015. Under the terms of the revolving credit facilities, the Company may borrow up to 1,700 Euro, or approximately $1,854, for working capital needs. The 1,000 Euro revolving credit facility is secured by a mortgage on the Company’s German facility. The 500 Euro revolving credit facility is secured by accounts receivable of the Company’s German subsidiary. The 200 Euro revolving credit facility is unsecured. The current interest rates for these lines of credit vary from 2.55% to 8.50%. As of December 31, 2015, there was $1,477 outstanding on revolving credit facilities with German banks. The total available credit on the Company’s four revolving credit facilities at December 31, 2015 was $6,377. The Company was in compliance with all financial covenants related to its revolving credit facilities as of December 31, 2015. The Company has capital leases with interest rates ranging from 1.49% to 2.85% and maturity dates through 2017. The $38 representing future maturities of capital leases includes immaterial interest at December 31, 2015. The present value of minimum lease payments as of December 31, 2015 was $38. As of December 31, 2015, contractual maturities of short and long-term obligations are as follows: Term Loan Credit Capital Total 2016 $ 4,500 $ 1,477 $ 32 $ 6,009 2017 5,250 — 6 5,256 2018 44,375 24,000 — 68,375 $ 54,125 $ 25,477 $ 38 $ 79,640

Other Long-Term Liabilities

Other Long-Term Liabilities	12 Months Ended
	Dec. 31, 2015
Text Block [Abstract]
Other Long-Term Liabilities	13. Other Long-Term Liabilities Other long-term liabilities are as follows: December 31, 2015 2014 Indemnification liability $ — $ 11,394 Other 472 213 $ 472 $ 11,607 As described in Note 10, the Company has reclassified the remaining indemnification liability to accrued expenses.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income Taxes	14. Income Taxes The Company’s income tax (provision) benefit consists of the following components: Year Ended December 31, 2015 2014 2013 Current: Federal $ (988 ) $ (1,062 ) $ 127 State (159 ) (150 ) 167 International (544 ) (86 ) 219 Total current (1,691 ) (1,298 ) 513 Deferred: Federal (5,695 ) (1,118 ) 8,017 State 68 (76 ) 1,675 International (981 ) 999 905 Total deferred (6,608 ) (195 ) 10,597 Total income tax (provision) benefit $ (8,299 ) $ (1,493 ) $ 11,110 The components of the deferred tax assets and liabilities consisted of the following at: December 31, 2015 December 31, 2014 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities Current: Allowance for bad debts $ — $ — $ 415 $ — Inventory — — 11,513 — Net operating losses — — 340 — Tax credits — — 2,370 — Deferred compensation — — 3,912 — Deferred revenue — — 1,969 — Accrued liabilities — — 2,517 Other — — — (208 ) Total current — — 23,036 (208 ) Noncurrent: Allowance for bad debts 376 — — — Deferred compensation 4,013 — — — Inventory 10,604 — — — Fixed assets and intangibles — (7,667 ) — (6,485 ) Investments 2,133 — 2,073 — Net operating losses 2,830 — 3,293 — Tax credits 4,645 — 2,596 — Deferred revenue 4,968 — 5,318 — Accrued liabilities 1,847 — 357 — Other — (258 ) — — Valuation allowance (1,106 ) — (959 ) — Total noncurrent 30,310 (7,925 ) 12,678 (6,485 ) Total $ 30,310 $ (7,925 ) $ 35,714 $ (6,693 ) The Company expects its deferred tax assets of $22,385, net of the valuation allowance at December 31, 2015 of $1,106, to be realized through the generation of future taxable income and the reversal of existing taxable temporary differences, see Note 3. Valuation allowances are established when necessary to reduce deferred tax assets to amounts which are more likely than not to be realized. As such, valuation allowances of $1,106 and $959 have been established at December 31, 2015 and December 31, 2014, respectively, against a portion of the deferred tax assets relating to certain net operating loss carryforwards. The Company recorded a tax benefit from the exercise of stock options in the amount of $1,139, $539, and $315 for the years ended December 31, 2015, 2014 and 2013, respectively. As of December 31, 2015, the Company has U.S. federal net operating loss carryforwards of $1,978 that will expire in 2027. As of December 31, 2015, the Company has U.S. state net operating loss carryforwards of $20,766 that will expire in the years 2018 through 2035. As of December 31, 2015, the Company has foreign net operating loss carryforwards of $4,447 that will carryfoward indefinitely. As of December 31, 2015, the Company has research tax credit carryforwards of $5,693 that will expire in years 2027 through 2035. As of December 31, 2015, the Company has alternative minimum tax credit carryforwards of $827 that will carryfoward indefinitely. On December 18, 2015, the Protecting Americans from Tax Hikes (“PATH”) Act was signed into law. The PATH retroactively extended the research tax credit to the beginning of 2015. In addition, under PATH the research tax credit is made permanent. Under ASC 740, Accounting for Income Taxes U.S. income taxes have not been provided on the undistributed earnings of the Company’s foreign subsidiaries. It is not practicable to estimate the amount of tax that might be payable. The Company’s intention is to indefinitely reinvest earnings of its foreign subsidiaries outside of the U.S. As of December 31, 2015 and 2014, the amount of undistributed earnings related to the Company’s foreign subsidiaries considered to be indefinitely reinvested was $11,227 and $7,238, respectively. The Company evaluates the need for deferred tax asset valuation allowances based on a more likely than not standard. The ability to realize deferred tax assets depends on the ability to generate sufficient taxable income within the carryback or carryforward periods provided for in the tax law for each applicable tax jurisdiction. The assessment regarding whether a valuation allowance is required or should be adjusted also considers all available positive and negative evidence. It is difficult to conclude a valuation allowance is not required when there is significant objective and verifiable negative evidence, such as cumulative losses in recent years. The Company utilizes a rolling three years of actual results as the primary measure of cumulative losses in recent years. On a rolling three years, the Company’s U.S. operations are in a cumulative income position. The Company considers this objectively verifiable evidence that its current U.S. operations existing on December 31, 2015, have consistently demonstrated the ability to operate at a profit. The Company has a history of utilizing 100 percent of its U.S. deferred taxes assets before they expire and the forecasts of taxable earnings project a complete realization of all U.S. deferred tax assets before they expire, including under stressed scenarios. The Company’s German and French operations are in a cumulative loss position. However, after adjusting projections of profitability for items not indicative of its ability to generate taxable income in future years its German operations are in a cumulative income position. The Company considers this objectively verifiable evidence that its current German operations existing on December 31, 2015, have consistently demonstrated the ability to operate at a profit. As of December 31, 2015, the Company’s German deferred tax assets primarily relate to net operating loss carryforwards. In general, the Company’s foreign net operating loss carryforwards can be carried forward indefinitely. As a result, the Company has not recorded an additional valuation allowance charge on its German deferred tax assets. The Company has recorded additional valuation allowances on its French deferred tax assets. The Company has evaluated all available positive and negative evidence, including the extent to which that evidence was objectively verifiable. The Company has concluded, for those jurisdictions where valuation allowances have not been established, the positive evidence outweighed the negative evidence and the deferred tax assets are more likely than not realizable as of December 31, 2015. The Company will continue to regularly assess the realizability of our deferred tax assets. Changes in historical earnings performance and future earnings projections, among other factors, may cause the Company to adjust its valuation allowance, which would impact the Company’s income tax expense in the period the Company determines that these factors have changed. As of December 31, 2015, the Company has $1,986 of unrecognized tax benefits, of which $110 were recorded in other liabilities and $1,876 of unrecognized tax benefits were recorded net against deferred tax assets in the accompanying consolidated balance sheet. The Company’s unrecognized tax benefits are summarized as follows: Year Ended December 31, 2015 2014 2013 Opening balance $ 1,787 $ 2,825 $ 1,797 Reductions based on tax positions related to the current year — (136 ) (174 ) Additions for tax positions of prior years 199 — 1,337 Reductions for tax positions of prior years — (902 ) (135 ) $ 1,986 $ 1,787 $ 2,825 The unrecognized tax benefits if recognized, would favorably impact the Company’s effective tax rate. The Company’s policy is to recognize interest accrued related to unrecognized tax benefits in interest expense and penalties in the provision for income taxes. There were no interest and penalties recorded in 2015, 2014 and 2013 and no interest and penalties accrued at December 31, 2015 and 2014. One of the Company’s foreign subsidiaries is undergoing an examination by the German tax authorities. The German examination covers the foreign subsidiary’s 2010 through 2013 tax years. The effective tax rate differs from the statutory federal income tax rate for the following reasons: Year Ended December 31, 2015 2014 2013 Statutory federal rate 35.00 % 35.00 % 35.00 % State income taxes—net of federal tax benefit 0.25 % 3.51 % 4.14 % Foreign rate differential (2.18 %) 4.99 % (0.46 %) Other permanent expenses 0.56 % (1.25 %) (4.27 %) Research tax credits (0.28 %) (7.52 %) 3.56 % Domestic production activities deduction — (4.33 %) — Unrecognized tax benefits — 0.86 % Valuation allowance 0.85 % 5.26 % — Other reconciling items, net 1.55 % (0.02 %) (0.42 %) Effective tax rate 35.75 % 35.64 % 38.41 % For the years ended December 31, 2015, 2014 and 2013, the Company had no individually significant other reconciling items.

Preferred Stock

Preferred Stock	12 Months Ended
	Dec. 31, 2015
Equity [Abstract]
Preferred Stock	15. Preferred Stock Preferred stock is as follows: Preferred Stock Preferred Stock Net Total Balance at July 16, 2013 $ 50,000 $ (1,290 ) $ 48,710 Accrued dividend payable 1,375 — 1,375 Dividend paid (625 ) — (625 ) Amortization of preferred stock issuance costs — 77 77 Balance at December 31, 2013 50,750 (1,213 ) 49,537 Accrued dividend payable 3,113 — 3,113 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2014 53,863 (1,029 ) 52,834 Accrued dividend payable 3,305 — 3,305 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2015 $ 57,168 $ (845 ) $ 56,323 On June 12, 2013, the Company and WSHP entered into an investment agreement. Pursuant to the terms of the investment agreement, the Company agreed to a $50,000 private placement of convertible preferred equity with WSHP. In connection with the closing of the transactions contemplated by the investment agreement, the Company and WSHP amended the investment agreement on July 15, 2013, and the Company filed a Certificate of Designation of Series A Convertible Preferred Stock creating the Series A Convertible Preferred Stock, par value $0.001 per share (the “Preferred Stock”), and establishing the designations, preferences, and other rights of the Preferred Stock. The Preferred Stock accrues dividends at a rate of 6% per annum. To the extent dividends are not paid in cash in any quarter, the dividends which have accrued on each outstanding share of Preferred Stock during such three-month period will accumulate until paid in cash or converted to common stock. The payments of dividends may be restricted by various covenants under our credit agreement with TD Bank and Regions Bank. The Preferred Stock will be convertible at the election of the holders into shares of the Company’s common stock at an initial conversion price of $4.39 per share which would result in a conversion ratio of approximately 228 shares of common stock for each share of Preferred Stock. The Preferred Stock is convertible at the election of the Company five years after its issuance or at any time if the Company’s common stock closes at or above $7.98 per share for at least 20 consecutive trading days. The Company may, upon 30 days notice, redeem the Preferred Stock, in whole or in part, five years after its issuance at the initial liquidation preference of $1,000 per share of the Preferred Stock plus an amount per share equal to accrued but unpaid dividends (collectively, the “Liquidation Value”). The holders of the Preferred Stock may require the Company to redeem their Preferred Stock, in whole or in part, at the Liquidation Value seven years after its issuance or upon the occurrence of a change of control.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2015
Equity [Abstract]
Stockholders' Equity	16. Stockholders’ Equity Preferred Stock Common Stock

Restructuring Charges

Restructuring Charges	12 Months Ended
	Dec. 31, 2015
Restructuring Charges	17. Restructuring Charges The Company instituted a restructuring plan primarily related to termination of employees and a location closure as a result of the integration activities following the acquisition of Pioneer, which resulted in $2,881 of expenses for the year ended December 31, 2013. The total restructuring charges were paid in full by February 28, 2015. Severance payments were made to terminated employees over periods ranging from one month to twelve months and did not have a material impact on cash flows of the Company in any quarterly period. The following table includes a rollforward of restructuring charges included in accrued expenses, see Note 11. Accrued restructuring charges at January 1, 2015 $ 13 Cash payments (13 ) Accrued restructuring charges at December 31, 2015 $ —
Employee Severance [Member]
Restructuring Charges	18. Severance Charges The Company recorded severance charges related to the termination of former employees as a result of the Company flattening its organizational structure, which resulted in $4,798 of expenses for the year ended December 31, 2014. The total severance charges were paid in full by December 31, 2015. Severance payments were made to terminated employees over periods ranging from one month to twelve months and did not have a material impact on cash flows of the Company in any quarterly period. The Company recorded additional severance charges related to the termination of former employees as a result of the Company reorganizing its distribution force, which resulted in $995 of expenses for the year ended December 31, 2015. The total severance charges are expected to be paid in full prior to December 31, 2016. Severance payments are made to terminated employees over periods ranging from one month to twelve months and will not have a material impact on cash flows of the Company in any quarterly period. The following table includes a rollforward of severance charges included in accrued expenses, see Note 11. Accrued severance charges at January 1, 2015 $ 2,771 Severance cash payments (2,591 ) Stock based compensation (310 ) Employee separation expenses accrued in 2015 995 Accrued severance charges at December 31, 2015 $ 865

Retirement Benefits

Retirement Benefits	12 Months Ended
	Dec. 31, 2015
Compensation and Retirement Disclosure [Abstract]
Retirement Benefits	19. Retirement Benefits The Company has a qualified 401(k) plan available to all U.S. employees who meet certain eligibility requirements. The 401(k) plan allows each employee to contribute up to the annual maximum allowed under the Internal Revenue Code. The Company has the discretion to make matching contributions up to 6% of the employee’s earnings. For the years ended December 31, 2015, 2014 and 2013, the amounts expensed under the plan were $3,034, $2,663 and $1,964, respectively.

Concentrations of Risk

Concentrations of Risk	12 Months Ended
	Dec. 31, 2015
Risks and Uncertainties [Abstract]
Concentrations of Risk	20. Concentrations of Risk Distribution Year Ended December 31, 2015 2014 2013 Percent of revenues derived from: Distributor Zimmer Biomet Holdings, Inc. 24 % 18 % 17 % Medtronic, PLC 10 % 12 % 16 % Davol, Inc. 3 % 5 % 9 % International 8 % 9 % 10 % The Company’s distribution agreements are subject to termination by either party for a variety of causes. No assurance can be given that such distribution agreements will be renewed beyond their expiration dates, continue in their current form or at similar rate structures. Any termination or interruption in the distribution of the Company’s implants through one of its major distributors could have a material adverse effect on the Company’s operations. Tissue Supply

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	21. Commitments and Contingencies Distribution Agreement with Medtronic Exclusive License Agreement with Athersys Distribution Agreement with Zimmer Dental Inc. Distribution Agreement with Davol The Company’s aforementioned revenue recognition methods related to the Zimmer and Davol distribution agreements do not result in the deferral of revenue less than amounts that would be refundable in the event the agreements were to be terminated in future periods. Additionally, the Company evaluates the appropriateness of the aforementioned revenue recognition methods on an ongoing basis. Leases Future minimum lease commitments under non-cancelable operating leases as of December 31, 2015 are as follows: Operating 2016 $ 1,874 2017 1,121 2018 560 2019 319 2020 and beyond 144 $ 4,018

Legal and Regulatory Actions

Legal and Regulatory Actions	12 Months Ended
	Dec. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Legal and Regulatory Actions	22. Legal and Regulatory Actions The Company is, from time to time, involved in litigation relating to claims arising out of its operations in the ordinary course of business. The Company believes that none of these claims that were outstanding as of December 31, 2015 will have a material adverse impact on its financial position or results of operations. Litigation and Settlement Charges. — Lanx, Inc. — Coloplast — In addition to claims made directly against the Company, Coloplast, a distributor of TSM’s and certain allografts processed and private labeled for them under a contract with the Company, has also been named as a defendant in individual TSM cases in various federal and state courts. Coloplast requested that the Company indemnify or defend Coloplast in those claims which allege injuries caused by the Company’s allograft implants, and on April 24, 2014, Coloplast sued RTI Surgical, Inc. in the Fourth Judicial District of Minnesota for declaratory relief and breach of contract. On December 11, 2014, Coloplast entered into a settlement agreement with RTI Surgical, Inc. and Tutogen Medical, Inc. (the “Company Parties”) resulting in dismissal of the case. Under the terms of the settlement agreement, the Company Parties are responsible for the defense and indemnification of two categories of present and future claims: (1) tissue only (where Coloplast is solely the distributor of Company processed allograft tissue and no Coloplast-manufactured or distributed synthetic mesh is identified) (“Tissue Only Claims”), and (2) tissue plus non-Coloplast synthetic mesh (“Tissue-Non-Coloplast Claims”). There are presently 435 Tissue Only Claims and 443 Tissue-Non-Coloplast Claims for which the Company Parties are providing defense and indemnification. The defense and indemnification of these cases are covered under the Company’s insurance policy subject to a reservation of rights by the insurer. Based on the current information available to the Company, it is not possible to evaluate and estimate with reasonable certainty the impact that current or any future TSM litigation may have on the Company. The Company’s accounting policy is to accrue for legal costs as they are incurred. In the quarter ended September 30, 2014, the Company received a letter from the FDA regarding the Company’s map3 ® ® ® In October 2012, the Company received a warning letter from the FDA related to environmental monitoring activities in certain areas of its processing facility in Alachua, Florida. The FDA re-inspected the processing facility in Alachua, Florida in September 2013, and determined that the Company had addressed the FDA’s concerns from the previous inspection. In October 2013, the Company received a final close out letter from the FDA to formally resolve their concerns. The warning letter did not restrict the Company’s ability to process or distribute implants, nor did it require the withdrawal of any implants from the marketplace.

Segment Data

Segment Data	12 Months Ended
	Dec. 31, 2015
Segment Reporting [Abstract]
Segment Data	23. Segment Data The Company distributes human tissue, bovine and porcine animal tissue, metal and synthetic implants through various distribution channels. The Company operates in one reportable segment composed of six lines of business. The Company’s lines of business are composed primarily of six categories: spine, ortho fixation, sports medicine, BGS and general orthopedic, dental and surgical specialties. Discrete financial information is not available for these six lines of business. The following table presents revenues from these six categories and other revenues and their respective percentages of the Company’s total revenues for the years ended December 31, 2015, 2014 and 2013: Year Ended December 31, 2015 2014 2013 (In thousands) Revenues: Spine $ 76,968 27.3 % $ 82,663 31.5 % $ 57,334 28.9 % Ortho fixation 55,585 19.7 % 37,133 14.1 % 14,525 7.3 % Sports medicine 46,735 16.5 % 46,758 17.8 % 42,594 21.5 % BGS and general orthopedic 42,283 15.0 % 36,747 14.0 % 27,864 14.1 % Dental 23,621 8.4 % 20,810 7.9 % 19,779 10.0 % Surgical specialties 23,499 8.3 % 26,999 10.3 % 27,666 14.0 % Other revenues 13,602 4.8 % 11,700 4.5 % 8,217 4.2 % Total revenues $ 282,293 100.0 % $ 262,810 100.0 % $ 197,979 100.0 % Domestic revenues $ 260,387 92.2 % $ 238,936 90.9 % $ 177,207 89.5 % International revenues 21,906 7.8 % 23,874 9.1 % 20,772 10.5 % Total revenues $ 282,293 100.0 % $ 262,810 100.0 % $ 197,979 100.0 % The following table presents property, plant and equipment - net by significant geographic location: December 31, 2015 2014 Property, plant and equipment - net: Domestic $ 72,901 $ 63,009 International 12,091 14,019 Total $ 84,992 $ 77,028

Quarterly Results of Operations

Quarterly Results of Operations (Unaudited)	12 Months Ended
	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Quarterly Results of Operations (Unaudited)	24. Quarterly Results of Operations (Unaudited) The following table sets forth the results of operations for the periods indicated: March 31, June 30, September 30, December 31, Quarter Ended: Revenues $ 68,034 $ 71,609 $ 66,529 $ 76,121 Gross profit 36,999 37,203 35,233 40,307 Net income applicable to common shares 2,934 2,685 2,670 3,321 Net income per common share: Basic $ 0.05 $ 0.05 $ 0.05 $ 0.06 Diluted 0.05 0.05 0.05 0.06 The Company’s acquisition of Pioneer added diversification of our implant portfolio, expanded our direct distribution and marketing organizations and enhanced our international business. The Company continues to maintain its commitment to research and development and the introduction of new strategically targeted allograft, xenograft, metal and synthetic implants as well as focused clinical efforts to support their acceptance in the marketplace. In the fourth quarter of 2015, the Company’s net income was negatively impacted by asset abandonments of $814, litigation and settlement charges of $804 and severance charges of $995. The following table sets forth the results of operations for the periods indicated: March 31, June 30, September 30, December 31, Quarter Ended: Revenues $ 60,745 $ 66,029 $ 65,163 $ 70,873 Gross profit 26,198 35,054 34,693 37,852 Net (loss) income applicable to common shares (3,060 ) 1,577 1,202 (136 ) Net (loss) income per common share: Basic $ (0.05 ) $ 0.03 $ 0.02 $ (0.00 ) Diluted (0.05 ) 0.03 0.02 (0.00 ) The Company’s acquisition of Pioneer added diversification to our implant portfolio, expanded our direct distribution and marketing organizations and enhanced our international business. The Company continues to maintain its commitment to research and development and the introduction of new strategically targeted allograft, xenograft, metal and synthetic implants as well as focused clinical efforts to support their acceptance in the marketplace. In 2014, the Company’s net income was negatively impacted by an inventory purchase accounting adjustment of $5,708, a severance charge of $4,798 and a litigation settlement charge of $185.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2015
Subsequent Events [Abstract]
Subsequent Events	25. Subsequent Events The Company evaluated subsequent events as of the issuance date of the consolidated financial statements as defined by FASB ASC 855 Subsequent Events

Schedule II - Valuation and Qua

Schedule II - Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2015
Valuation and Qualifying Accounts [Abstract]
Schedule II - Valuation and Qualifying Accounts	RTI SURGICAL, INC. AND SUBSIDIARIES Schedule II Valuation and Qualifying Accounts Years Ended December 31, 2015, 2014 and 2013 (Dollars in thousands) Description Balance at Charged to Deductions- Balance at For the year ended December 31, 2015: Allowance for doubtful accounts $ 818 $ 1,037 $ 401 $ 1,454 Allowance for product returns 525 531 342 714 Allowance for obsolescence 5,112 5,390 3,419 7,083 Deferred tax asset valuation allowance 959 197 50 1,106 For the year ended December 31, 2014: Allowance for doubtful accounts 492 709 383 818 Allowance for product returns 343 182 — 525 Allowance for obsolescence 5,399 3,763 4,050 5,112 Deferred tax asset valuation allowance 469 490 — 959 For the year ended December 31, 2013: Allowance for doubtful accounts 346 180 34 492 Allowance for product returns 283 255 195 343 Allowance for obsolescence 7,735 1,785 4,121 5,399 Deferred tax asset valuation allowance 469 — — 469

Summary of Significant Accoun32

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2015
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation RTIDS is a taxable not-for-profit entity organized and controlled by the Company. RTIDS is the corporate entity that is responsible for procuring tissue for the Company. Expenses incurred by RTIDS to procure tissue are passed through to the Company. RTIDS has no significant assets or liabilities except for its intercompany accounts receivable and accounts payable to tissue recovery agencies. The Company pays all expenses of RTIDS.
Use of Estimates	Use of Estimates
Foreign Currency Translation	Foreign Currency Translation
Fair Value of Financial Instruments	Fair Value of Financial Instruments
Cash and Cash Equivalents	Cash and Cash Equivalents
Accounts Receivable Allowances	Accounts Receivable Allowances
Inventories	Inventories Simplifying the Measurement of Inventory “Inventory (Topic 330): Simplifying the Measurement of Inventory”
Presentation of Financial Statements - Going Concern	Presentation of Financial Statements - Going Concern “Presentation of Financial Statements - Going Concern (Subtopic 205-40).”
Implant and Product Recalls	Implant and Product Recalls
Surgical Instruments	Surgical Instruments
Property, Plant and Equipment	Property, Plant and Equipment Buildings 25 to 40 years Building improvements and leasehold improvements 8 to 40 years Processing equipment 7 to 10 years Office equipment, furniture and fixtures 5 to 7 years Computer hardware and software 3 to 7 years Surgical instruments 3 years
Software Costs	Software Costs
Debt Issuance Costs	Debt Issuance Costs—
Long-Lived Assets	Long-Lived Assets
Goodwill	Goodwill Goodwill and Other Intangible Assets Goodwill is tested for impairment annually by comparing the fair value of the reporting unit to its carrying amount, including goodwill. The Company adopted ASU No. 2011-08, Intangibles – Goodwill and Other: Testing Goodwill for Impairment, In general, the income approach employs a discounted cash flow model that considers: 1) assumptions that marketplace participants would use in their estimates of fair value, including the cash flow period, terminal values based on a terminal growth rate and the discount rate; 2) current period actual results, and 3) projected results for future periods that have been prepared and approved by senior management of the Company. The forecasted cash flows do not include synergies that a marketplace participant would be expecting to achieve. The market approach employs market multiples from guideline public companies operating in our industry. Estimates of fair value are derived by applying multiples based on revenue and earnings before interest, taxes, depreciation and amortization (“EBITDA”) adjusted for size and performance metrics relative to peer companies. A control premium was included in determining the fair value under this approach. If the carrying amount of the reporting unit exceeds its calculated fair value, the second step of the goodwill impairment test is performed in accordance with FASB ASC 350 to measure the amount of the impairment loss, if any. Both approaches used in the analysis have a degree of uncertainty. Potential events or changes in circumstances which could impact the key assumptions used in our goodwill impairment evaluation are as follows: • Change in peer group or performance of peer group companies • Change in the Company’s markets and estimates of future operating performance • Change in the Company’s estimated market cost of capital • Change in implied control premiums related to acquisitions in the medical device industry. Goodwill represents the excess of purchase price over fair value of tangible net assets of acquired businesses at the acquisition date, after amounts allocated to other identifiable intangible assets. Factors that contribute to the recognition of goodwill include securing synergies that are specific to our business and not available to other market participants and are expected to increase revenues and profits; acquisition of a talented workforce; cost savings opportunities; the strategic benefit of expanding our presence in core and adjacent markets; and diversifying our product portfolio.
Revenue from Contracts with Customers	Revenue from Contracts with Customers “Revenue from Contracts with Customers (Topic 606)” “Revenue Recognition”
Other Intangible Assets	Other Intangible Assets Other intangible assets are tested for impairment annually (if indefinite lived) or whenever events or circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. The Company had one asset group for the year ended December 31, 2014 and 2015. The recoverability test is described in the Company’s accounting policy for long-lived assets set forth above.
Revenue Recognition	Revenue Recognition The Company permits returns of implants in accordance with the terms of contractual agreements with customers if the implant is returned in a timely manner, in unopened packaging, and from the normal channels of distribution. Allowances for returns are provided based upon analysis of the Company’s historical patterns of returns matched against the revenues from which they originated. The Company records estimated implant returns, discounts, rebates and other distribution incentives as a reduction of revenue in the same period revenue is recognized. Estimates of implant returns are recorded for anticipated implant returns based on historical distributions and returns information. Estimates of discounts, rebates and other distribution incentives are recorded based on contractual terms, historical experience and trend analysis.
Other Revenues	Other Revenues
Stock-Based Compensation Plans	Stock-Based Compensation Plans Accounting for Stock Compensation Staff Accounting Bulletin No. 107
Research and Development Costs	Research and Development Costs
Income Taxes	Income Taxes Income Taxes “Income Taxes (Topic 740)”
Earnings Per Share	Earnings Per Share Year Ended December 31, 2015 2014 2013 Basic shares 57,611,231 56,735,924 56,258,624 Effect of dilutive securities: Stock options 979,263 — — Diluted shares 58,590,494 56,735,924 56,258,624 Options to purchase 5,661,514 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2015, were included in the computation of diluted EPS because dilutive shares are factored into the calculation of EPS when income applicable to common shares is reported. Options to purchase 5,735,784 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2014, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. Options to purchase 5,518,604 shares of common stock at prices ranging from $2.54 to $13.52 per share which were outstanding as of December 31, 2013, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. For the years ended December 31, 2015, 2014 and 2013, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted basis and were not included in the computation of diluted net income (loss) per common share.

Summary of Significant Accoun33

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2015
Accounting Policies [Abstract]
Property, Plant, and Equipment are Stated at Cost Less Accumulated Depreciation	Depreciation is computed on the straight-line method over the following estimated useful lives of the assets: Buildings 25 to 40 years Building improvements and leasehold improvements 8 to 40 years Processing equipment 7 to 10 years Office equipment, furniture and fixtures 5 to 7 years Computer hardware and software 3 to 7 years Surgical instruments 3 years
Reconciliation of Common Stock used in Calculation of Basic and Diluted Earnings Per Share	A reconciliation of the number of common shares used in the calculation of basic and diluted EPS is presented below: Year Ended December 31, 2015 2014 2013 Basic shares 57,611,231 56,735,924 56,258,624 Effect of dilutive securities: Stock options 979,263 — — Diluted shares 58,590,494 56,735,924 56,258,624

Merger with Pioneer Surgical 34

Merger with Pioneer Surgical Technology, Inc. (Tables)	12 Months Ended
	Dec. 31, 2015
Business Combinations [Abstract]
Summary of Purchase Price	The purchase price was financed as follows: (In thousands) Cash proceeds from term loan $ 60,000 Net cash proceeds from preferred share issuance 48,710 Cash from RTI Surgical 17,597 Total purchase price $ 126,307
Allocation of Total Consideration of Tangible and Intangible Assets Acquired and Liabilities Assumed	The table below represents an allocation of the total consideration to Pioneer’s tangible and intangible assets and liabilities based on management’s estimate of their respective fair values as of July 16, 2013. (In thousands) Inventories $ 35,972 Accounts receivable 10,567 Other current assets 6,059 Property, plant and equipment 15,258 Other assets 13,260 Current liabilities (10,893 ) Other long-term liabilities (19,841 ) Net tangible assets acquired 50,382 Other intangible assets 23,100 Goodwill 52,825 Total net assets acquired $ 126,307
Unaudited Pro Forma Information of Company's Operations	The following unaudited pro forma information shows the results of the Company’s operations as though the acquisition had occurred as of the beginning of that period (in thousands, except per share data): December 31, Revenues $ 243,001 Net loss applicable to common shares (5,597 ) Basic net loss per share (0.10 ) Diluted net loss per share (0.10 )

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Weighted-Average Assumptions Used to Determine Fair Value of Options	The following weighted-average assumptions were used to determine the fair value of options under FASB ASC 718: Year Ended December 31, 2015 2014 2013 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 1.67 % 2.29 % 1.30 % Volatility factor 46.29 % 46.53 % 47.50 % Dividend yield — — —
Stock Options Outstanding, Exercisable and Available for Grant	Stock options outstanding, exercisable and available for grant at December 31, 2015, are summarized as follows: Number of Weighted Exercise Weighted Contractual Aggregate Intrinsic Value Outstanding at January 1, 2015 5,735,784 $ 4.34 Granted 950,000 5.27 Exercised (858,130 ) 4.30 Forfeited or expired (166,140 ) 4.82 Outstanding at December 31, 2015 5,661,514 $ 4.49 5.75 $ 1,544 Vested or expected to vest at December 31, 2015 5,394,566 $ 4.48 5.61 $ 1,517 Exercisable at December 31, 2015 3,435,614 $ 4.56 4.21 $ 1,188 Available for grant at December 31, 2015 4,530,421
Stock-Based Compensation Recognized	For the years ended December 31, 2015, 2014 and 2013, the Company recognized stock-based compensation as follows: Year Ended December 31, 2015 2014 2013 Stock-based compensation: Costs of processing and distribution $ 132 $ 132 $ 132 Marketing, general and administrative 2,356 2,840 2,028 Research and development 60 60 60 Total $ 2,548 $ 3,032 $ 2,220
Other Information Concerning Stock Options	Other information concerning stock options are as follows: Year Ended December 31, 2015 2014 2013 Weighted average fair value of stock options granted $ 2.50 $ 1.87 $ 1.66 Aggregate intrinsic value of stock options exercised 1,584 295 117

Inventories (Tables)

Inventories (Tables)	12 Months Ended
	Dec. 31, 2015
Inventory Disclosure [Abstract]
Components of Inventories	Inventories by stage of completion are as follows: December 31, 2015 2014 Unprocessed tissue, raw materials and supplies $ 33,028 $ 31,626 Tissue and work in process 36,614 44,688 Implantable tissue and finished goods 49,031 37,150 $ 118,673 $ 113,464

Property, Plant and Equipment (

Property, Plant and Equipment (Tables)	12 Months Ended
	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Components of Property, Plant and Equipment	Property, plant and equipment are as follows: December 31, 2015 2014 Land $ 2,319 $ 2,474 Buildings and improvements 63,699 49,483 Processing equipment 41,831 45,878 Surgical instruments 15,702 9,428 Office equipment, furniture and fixtures 4,657 3,863 Computer equipment and software 11,804 7,674 Construction in process 10,850 20,957 Office equipment under capital leases 152 152 151,014 139,909 Less accumulated depreciation (66,022 ) (62,881 ) $ 84,992 $ 77,028

Other Intangible Assets (Tables

Other Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Components of Other Intangible Assets	Other intangible assets are as follows: December 31, 2015 December 31, 2014 Gross Accumulated Gross Accumulated Patents $ 11,532 $ 3,448 $ 11,420 $ 2,727 Acquired licensing rights 10,850 7,691 10,850 6,538 Marketing and procurement intangible assets 22,179 7,209 22,342 5,086 Total $ 44,561 $ 18,348 $ 44,612 $ 14,351
Estimates of Future Amortization Expense	At December 31, 2015, management’s estimates of future amortization expense for the next five years are as follows: Amortization 2016 $ 3,400 2017 3,300 2018 3,300 2019 3,300 2020 3,300 $ 16,600

Other Assets (Tables)

Other Assets (Tables)	12 Months Ended
	Dec. 31, 2015
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Schedule of Other Assets	Other assets are as follows: December 31, 2015 2014 Indemnification asset $ — $ 11,394 Other 874 876 $ 874 $ 12,270

Accrued Expenses (Tables)

Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2015
Other Liabilities Disclosure [Abstract]
Accrued Expenses	Accrued expenses are as follows: December 31, 2015 2014 Accrued compensation $ 4,740 $ 6,220 Accrued severance charges 717 2,771 Accrued distributor commissions 3,835 3,159 Accrued donor recovery fees 7,144 3,249 Accrued taxes 514 1,249 Accrued restructuring charges — 13 Accrued indemnification liability 6,579 — Other 5,080 8,028 $ 28,609 $ 24,689

Short and Long-Term Obligatio41

Short and Long-Term Obligations (Tables)	12 Months Ended
	Dec. 31, 2015
Debt Disclosure [Abstract]
Short and Long-Term Obligations	Short and long-term obligations are as follows: December 31, 2015 2014 Term loan $ 54,125 $ 59,375 Credit facilities 25,477 16,435 Capital leases 38 82 Total 79,640 75,892 Less current portion (6,009 ) (6,479 ) Long-term portion $ 73,631 $ 69,413
Contractual Maturities of Short and Long-Term Obligations	As of December 31, 2015, contractual maturities of short and long-term obligations are as follows: Term Loan Credit Capital Total 2016 $ 4,500 $ 1,477 $ 32 $ 6,009 2017 5,250 — 6 5,256 2018 44,375 24,000 — 68,375 $ 54,125 $ 25,477 $ 38 $ 79,640

Other Long-Term Liabilities (Ta

Other Long-Term Liabilities (Tables)	12 Months Ended
	Dec. 31, 2015
Text Block [Abstract]
Schedule of Other Long-Term Liabilities	Other long-term liabilities are as follows: December 31, 2015 2014 Indemnification liability $ — $ 11,394 Other 472 213 $ 472 $ 11,607

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Income Tax Benefit (Provision)	The Company’s income tax (provision) benefit consists of the following components: Year Ended December 31, 2015 2014 2013 Current: Federal $ (988 ) $ (1,062 ) $ 127 State (159 ) (150 ) 167 International (544 ) (86 ) 219 Total current (1,691 ) (1,298 ) 513 Deferred: Federal (5,695 ) (1,118 ) 8,017 State 68 (76 ) 1,675 International (981 ) 999 905 Total deferred (6,608 ) (195 ) 10,597 Total income tax (provision) benefit $ (8,299 ) $ (1,493 ) $ 11,110
Deferred Tax Assets and Liabilities	The components of the deferred tax assets and liabilities consisted of the following at: December 31, 2015 December 31, 2014 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities Current: Allowance for bad debts $ — $ — $ 415 $ — Inventory — — 11,513 — Net operating losses — — 340 — Tax credits — — 2,370 — Deferred compensation — — 3,912 — Deferred revenue — — 1,969 — Accrued liabilities — — 2,517 Other — — — (208 ) Total current — — 23,036 (208 ) Noncurrent: Allowance for bad debts 376 — — — Deferred compensation 4,013 — — — Inventory 10,604 — — — Fixed assets and intangibles — (7,667 ) — (6,485 ) Investments 2,133 — 2,073 — Net operating losses 2,830 — 3,293 — Tax credits 4,645 — 2,596 — Deferred revenue 4,968 — 5,318 — Accrued liabilities 1,847 — 357 — Other — (258 ) — — Valuation allowance (1,106 ) — (959 ) — Total noncurrent 30,310 (7,925 ) 12,678 (6,485 ) Total $ 30,310 $ (7,925 ) $ 35,714 $ (6,693 )
Unrecognized Tax Benefits	The Company’s unrecognized tax benefits are summarized as follows: Year Ended December 31, 2015 2014 2013 Opening balance $ 1,787 $ 2,825 $ 1,797 Reductions based on tax positions related to the current year — (136 ) (174 ) Additions for tax positions of prior years 199 — 1,337 Reductions for tax positions of prior years — (902 ) (135 ) $ 1,986 $ 1,787 $ 2,825
Effective Tax Rate Differs from the Statutory Federal Income Tax Rate	The effective tax rate differs from the statutory federal income tax rate for the following reasons: Year Ended December 31, 2015 2014 2013 Statutory federal rate 35.00 % 35.00 % 35.00 % State income taxes—net of federal tax benefit 0.25 % 3.51 % 4.14 % Foreign rate differential (2.18 %) 4.99 % (0.46 %) Other permanent expenses 0.56 % (1.25 %) (4.27 %) Research tax credits (0.28 %) (7.52 %) 3.56 % Domestic production activities deduction — (4.33 %) — Unrecognized tax benefits — 0.86 % Valuation allowance 0.85 % 5.26 % — Other reconciling items, net 1.55 % (0.02 %) (0.42 %) Effective tax rate 35.75 % 35.64 % 38.41 %

Preferred Stock (Tables)

Preferred Stock (Tables)	12 Months Ended
	Dec. 31, 2015
Equity [Abstract]
Schedule of Preferred Stock	Preferred stock is as follows: Preferred Stock Preferred Stock Net Total Balance at July 16, 2013 $ 50,000 $ (1,290 ) $ 48,710 Accrued dividend payable 1,375 — 1,375 Dividend paid (625 ) — (625 ) Amortization of preferred stock issuance costs — 77 77 Balance at December 31, 2013 50,750 (1,213 ) 49,537 Accrued dividend payable 3,113 — 3,113 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2014 53,863 (1,029 ) 52,834 Accrued dividend payable 3,305 — 3,305 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2015 $ 57,168 $ (845 ) $ 56,323

Restructuring Charges (Tables)

Restructuring Charges (Tables)	12 Months Ended
	Dec. 31, 2015
Schedule of Restructuring Charges	The following table includes a rollforward of restructuring charges included in accrued expenses, see Note 11. Accrued restructuring charges at January 1, 2015 $ 13 Cash payments (13 ) Accrued restructuring charges at December 31, 2015 $ —
Employee Severance [Member]
Schedule of Restructuring Charges	The following table includes a rollforward of severance charges included in accrued expenses, see Note 11. Accrued severance charges at January 1, 2015 $ 2,771 Severance cash payments (2,591 ) Stock based compensation (310 ) Employee separation expenses accrued in 2015 995 Accrued severance charges at December 31, 2015 $ 865

Concentrations of Risk (Tables)

Concentrations of Risk (Tables)	12 Months Ended
	Dec. 31, 2015
Risks and Uncertainties [Abstract]
Schedule of Percentage of Total Revenues Derived from Company's Largest Distributors and International Distribution	The following table presents percentage of total revenues derived from the Company’s largest distributors and international distribution: Year Ended December 31, 2015 2014 2013 Percent of revenues derived from: Distributor Zimmer Biomet Holdings, Inc. 24 % 18 % 17 % Medtronic, PLC 10 % 12 % 16 % Davol, Inc. 3 % 5 % 9 % International 8 % 9 % 10 %

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Future Minimum Lease Commitments under Non-Cancelable Operating Leases	Future minimum lease commitments under non-cancelable operating leases as of December 31, 2015 are as follows: Operating 2016 $ 1,874 2017 1,121 2018 560 2019 319 2020 and beyond 144 $ 4,018

Segment Data (Tables)

Segment Data (Tables)	12 Months Ended
	Dec. 31, 2015
Segment Reporting [Abstract]
Revenues from Tissue Distribution and Other Revenues	The following table presents revenues from these six categories and other revenues and their respective percentages of the Company’s total revenues for the years ended December 31, 2015, 2014 and 2013: Year Ended December 31, 2015 2014 2013 (In thousands) Revenues: Spine $ 76,968 27.3 % $ 82,663 31.5 % $ 57,334 28.9 % Ortho fixation 55,585 19.7 % 37,133 14.1 % 14,525 7.3 % Sports medicine 46,735 16.5 % 46,758 17.8 % 42,594 21.5 % BGS and general orthopedic 42,283 15.0 % 36,747 14.0 % 27,864 14.1 % Dental 23,621 8.4 % 20,810 7.9 % 19,779 10.0 % Surgical specialties 23,499 8.3 % 26,999 10.3 % 27,666 14.0 % Other revenues 13,602 4.8 % 11,700 4.5 % 8,217 4.2 % Total revenues $ 282,293 100.0 % $ 262,810 100.0 % $ 197,979 100.0 % Domestic revenues $ 260,387 92.2 % $ 238,936 90.9 % $ 177,207 89.5 % International revenues 21,906 7.8 % 23,874 9.1 % 20,772 10.5 % Total revenues $ 282,293 100.0 % $ 262,810 100.0 % $ 197,979 100.0 %
Schedule of Property, Plant and Equipment - Net by Significant Geographic Location	The following table presents property, plant and equipment - net by significant geographic location: December 31, 2015 2014 Property, plant and equipment - net: Domestic $ 72,901 $ 63,009 International 12,091 14,019 Total $ 84,992 $ 77,028

Quarterly Results of Operatio49

Quarterly Results of Operations (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Results of Operations	The following table sets forth the results of operations for the periods indicated: March 31, June 30, September 30, December 31, Quarter Ended: Revenues $ 68,034 $ 71,609 $ 66,529 $ 76,121 Gross profit 36,999 37,203 35,233 40,307 Net income applicable to common shares 2,934 2,685 2,670 3,321 Net income per common share: Basic $ 0.05 $ 0.05 $ 0.05 $ 0.06 Diluted 0.05 0.05 0.05 0.06 March 31, June 30, September 30, December 31, Quarter Ended: Revenues $ 60,745 $ 66,029 $ 65,163 $ 70,873 Gross profit 26,198 35,054 34,693 37,852 Net (loss) income applicable to common shares (3,060 ) 1,577 1,202 (136 ) Net (loss) income per common share: Basic $ (0.05 ) $ 0.03 $ 0.02 $ (0.00 ) Diluted (0.05 ) 0.03 0.02 (0.00 )

Summary of Significant Accoun50

Summary of Significant Accounting Policies - Additional Information (Detail)	3 Months Ended	12 Months Ended
	Dec. 31, 2015USD ($)$ / shares	Dec. 31, 2015USD ($)AssetsSegment$ / sharesshares	Dec. 31, 2014USD ($)Assets$ / sharesshares	Dec. 31, 2013$ / sharesshares
Summary Of Significant Accounting Policies [Line Items]
Cash equivalents	$ 0	$ 0	$ 0
Banks and short-term investments with an original maturity		Three months or less
Banks and short-term investments with an original maturity		3 months
Cash and cash equivalents including overnight repurchase agreements backed by US Government securities		101.00%
Asset abandonments	(814,000)	$ (814,000)
Number of reportable segments | Segment		1
Other identifiable intangible assets	$ 0	$ 0	$ 0
Acquired exclusivity rights, remaining amortization period		8 years
Number of asset groups with intangible assets | Assets		1	1
Dividend yield		0.00%
Common stock price ranging | $ / shares	$ 4.49	$ 4.49	$ 4.34
Stock Options [Member]
Summary Of Significant Accounting Policies [Line Items]
Dividend yield		0.00%	0.00%	0.00%
Antidilutive securities excluded from computation of earnings per share | shares		5,661,514	5,735,784	5,518,604
German Bank Credit Facilities [Member]
Summary Of Significant Accounting Policies [Line Items]
Asset abandonments		$ 814,000
Convertible Preferred Stock [Member]
Summary Of Significant Accounting Policies [Line Items]
Antidilutive securities excluded from computation of earnings per share | shares		50,000	50,000	50,000
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Common stock price ranging | $ / shares	2.69	$ 2.69	$ 2.69	$ 2.54
Minimum [Member] | Patents [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		8 years
Minimum [Member] | Trademarks [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		5 years
Minimum [Member] | Acquired Licensing Rights [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		5 years
Minimum [Member] | Customer Lists [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		5 years
Minimum [Member] | Non-compete Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		5 years
Minimum [Member] | Distribution Agreement [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		5 years
Minimum [Member] | Procurement Contracts [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		5 years
Maximum [Member]
Summary Of Significant Accounting Policies [Line Items]
Common stock price ranging | $ / shares	$ 9.57	$ 9.57	$ 9.57	$ 13.52
Maximum [Member] | Patents [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		16 years
Maximum [Member] | Trademarks [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		25 years
Maximum [Member] | Acquired Licensing Rights [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		25 years
Maximum [Member] | Customer Lists [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		25 years
Maximum [Member] | Non-compete Agreements [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		25 years
Maximum [Member] | Distribution Agreement [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		25 years
Maximum [Member] | Procurement Contracts [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		25 years

Summary of Significant Accoun51

Summary of Significant Accounting Policies - Property, Plant, and Equipment are Stated at Cost Less Accumulated Depreciation (Detail)	12 Months Ended
	Dec. 31, 2015
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	3 years
Minimum [Member] | Building [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	25 years
Minimum [Member] | Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	8 years
Minimum [Member] | Processing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	7 years
Minimum [Member] | Office Equipment, Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	5 years
Minimum [Member] | Computer Hardware and Software [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	3 years
Maximum [Member] | Building [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	40 years
Maximum [Member] | Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	40 years
Maximum [Member] | Processing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	10 years
Maximum [Member] | Office Equipment, Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	7 years
Maximum [Member] | Computer Hardware and Software [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	7 years

Summary of Significant Accoun52

Summary of Significant Accounting Policies - Reconciliation of Common Stock Used in Calculation of Basic and Diluted Earnings Per Share (Detail) - shares	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Earnings Per Share [Abstract]
Basic shares	57,611,231	56,735,924	56,258,624
Effect of dilutive securities: Stock options	979,263
Diluted shares	58,590,494	56,735,924	56,258,624

Merger with Pioneer Surgical 53

Merger with Pioneer Surgical Technology, Inc. - Additional Information (Detail) - USD ($)	Jul. 16, 2013	Dec. 31, 2015	Dec. 31, 2013	Jun. 29, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Business acquisition, cash consideration			$ 126,307,000
Acquisition costs			6,004,000
Goodwill		$ 54,887,000			$ 54,887,000
Pioneer [Member]
Business Acquisition [Line Items]
Business acquisition, agreement date		Jun. 12, 2013
Business acquisition, cash consideration	$ 126,307,000
Business acquisition date		Jul. 16, 2013
Amount of senior secured facility obtained	80,000,000
Proceeds from issuance of convertible preferred stock		$ 50,000,000
Financing cost and expense			1,989,000
Acquisition costs			6,004,000
Goodwill	52,825,000
Fair value of receivables	10,567,000
Contractual amount, gross	11,712,000
Uncollected amount	1,145,000
Revenue			35,994,000
Net income			$ 894,000
Pioneer [Member] | Convertible Preferred Stock [Member]
Business Acquisition [Line Items]
Convertible preferred stock dividend rate		6.00%
Pioneer [Member] | Revolving Credit Facility [Member]
Business Acquisition [Line Items]
Credit facility, borrowing capacity	20,000,000			$ 30,000,000
Pioneer [Member] | Bank Term Loan [Member]
Business Acquisition [Line Items]
Amount of senior secured facility obtained	$ 60,000,000
Pioneer [Member] | Senior Secured Facility [Member]
Business Acquisition [Line Items]
Term of senior secured credit facility		5 years
Maturity date of senior secured credit facility		Jul. 16, 2018
Pioneer [Member] | Senior Secured Facility [Member] | Minimum [Member]
Business Acquisition [Line Items]
Variable interest rate range		1.00%
Pioneer [Member] | Senior Secured Facility [Member] | Maximum [Member]
Business Acquisition [Line Items]
Variable interest rate range		3.00%

Merger with Pioneer Surgical 54

Merger with Pioneer Surgical Technology, Inc. - Summary of Purchase Price (Detail) - Pioneer [Member] $ in Thousands	Jul. 16, 2013USD ($)
Business Acquisition [Line Items]
Cash proceeds from term loan	$ 60,000
Net cash proceeds from preferred share issuance	48,710
Cash from RTI Surgical	17,597
Total purchase price	$ 126,307

Merger with Pioneer Surgical 55

Merger with Pioneer Surgical Technology, Inc. - Allocation of Total Consideration of Tangible and Intangible Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014	Jul. 16, 2013
Business Acquisition [Line Items]
Goodwill	$ 54,887	$ 54,887
Pioneer [Member]
Business Acquisition [Line Items]
Inventories			$ 35,972
Accounts receivable			10,567
Other current assets			6,059
Property, plant and equipment			15,258
Other assets			13,260
Current liabilities			(10,893)
Other long-term liabilities			(19,841)
Net tangible assets acquired			50,382
Other intangible assets			23,100
Goodwill			52,825
Total net assets acquired			$ 126,307

Merger with Pioneer Surgical 56

Merger with Pioneer Surgical Technology, Inc. - Unaudited Pro Forma Information of Company's Operations (Detail) - Pioneer [Member] $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2013USD ($)$ / shares
Business Acquisition [Line Items]
Revenues | $	$ 243,001
Net loss applicable to common shares | $	$ (5,597)
Basic net loss per share | $ / shares	$ (0.10)
Diluted net loss per share | $ / shares	$ (0.10)

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2015USD ($)Plans$ / sharesshares	Dec. 31, 2014USD ($)	Dec. 31, 2013USD ($)
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Contractual term of stock options granted	10 years
Stock-based compensation plans | Plans	6
Percentage of market value of common stock, stock options exercise price	100.00%
Percentage of market value of common stock, restricted stock award granted	100.00%
Income tax benefits	$ 8,299	$ 1,493	$ (11,110)
Total unrecognized stock-based compensation	$ 705
Stock-based compensation awards, weighted-average period recognized	1 year 1 month 13 days
Restricted stock granted during period | shares	201,166
Weighted-average grant date fair value of restricted stock granted | $ / shares	$ 5.43
Restricted Stock Awards [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period	1 year
Restricted Stock Awards [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period	3 years
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Income tax benefits	$ 1,022	$ 1,198	$ 883
Total unrecognized stock-based compensation	$ 3,241
Stock-based compensation awards, weighted-average period recognized	3 years 1 month 13 days
Stock Options [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period	1 year
Stock Options [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period	5 years
2015 Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock allowed to be issued | shares	4,656,587

Stock-Based Compensation - Weig

Stock-Based Compensation - Weighted-Average Assumptions Used to Determine Fair Value of Options (Detail)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Dividend yield	0.00%
Stock Options [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expected term (years)	6 years 6 months	6 years 6 months	6 years 6 months
Risk free interest rate	1.67%	2.29%	1.30%
Volatility factor	46.29%	46.53%	47.50%
Dividend yield	0.00%	0.00%	0.00%

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Options Outstanding, Exercisable and Available for Grant (Detail) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2015USD ($)$ / sharesshares
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Outstanding, Number of Shares	5,735,784
Granted, Number of Shares	950,000
Exercised, Number of Shares	(858,130)
Forfeited or expired, Number of Shares	(166,140)
Outstanding, Number of Shares	5,661,514
Vested or expected to vest, Number of Shares	5,394,566
Exercisable, Number of Shares	3,435,614
Available for grant, Number of Shares	4,530,421
Outstanding, Weighted Average Exercise Price | $ / shares	$ 4.34
Granted, Weighted Average Exercise Price | $ / shares	5.27
Exercised, Weighted Average Exercise Price | $ / shares	4.30
Forfeited or expired, Weighted Average Exercise Price | $ / shares	4.82
Outstanding, Weighted Average Exercise Price | $ / shares	4.49
Vested or expected to vest, Weighted Average Exercise Price | $ / shares	4.48
Exercisable, Weighted Average Exercise Price | $ / shares	$ 4.56
Outstanding, Weighted Average Remaining Contractual Life (Years)	5 years 9 months
Vested or expected to vest, Weighted Average Remaining Contractual Life (Years)	5 years 7 months 10 days
Exercisable, Weighted Average Remaining Contractual Life (Years)	4 years 2 months 16 days
Outstanding, Aggregate Intrinsic Value | $	$ 1,544
Vested or expected to vest, Aggregate Intrinsic Value | $	1,517
Exercisable, Aggregate Intrinsic Value | $	$ 1,188

Stock-Based Compensation - St60

Stock-Based Compensation - Stock-Based Compensation Recognized (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Stock-based compensation	$ 2,548	$ 3,032	$ 2,220
Costs of Processing and Distribution [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Stock-based compensation	132	132	132
Marketing, General and Administrative [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Stock-based compensation	2,356	2,840	2,028
Research and Development [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Stock-based compensation	$ 60	$ 60	$ 60

Stock-Based Compensation - Othe

Stock-Based Compensation - Other Information Concerning Stock Options (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Weighted average fair value of stock options granted	$ 2.50	$ 1.87	$ 1.66
Aggregate intrinsic value of stock options exercised	$ 1,584	$ 295	$ 117

Inventories - Components of Inv

Inventories - Components of Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Inventory Disclosure [Abstract]
Unprocessed tissue, raw materials and supplies	$ 33,028	$ 31,626
Tissue and work in process	36,614	44,688
Implantable tissue and finished goods	49,031	37,150
Inventory - net	$ 118,673	$ 113,464

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Inventory Disclosure [Abstract]
Provision for inventory write-downs	$ 5,390	$ 3,763	$ 1,785

Property, Plant and Equipment -

Property, Plant and Equipment - Components of Property, Plant and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 151,014	$ 139,909
Less accumulated depreciation	(66,022)	(62,881)
Property, plant and equipment, net	84,992	77,028
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	2,319	2,474
Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	63,699	49,483
Processing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	41,831	45,878
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	15,702	9,428
Office Equipment, Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	4,657	3,863
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	11,804	7,674
Construction in Process [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	10,850	20,957
Office Equipment Under Capital Leases [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 152	$ 152

Property,Plant and Equipment -

Property,Plant and Equipment - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Property, Plant and Equipment [Abstract]
Depreciation expense in connection with property, plant and equipment	$ 12,240	$ 11,010	$ 8,267

Goodwill - Additional Informati

Goodwill - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	$ 54,887,000	$ 54,887,000
Goodwill impairment loss	$ 0

Other Intangible Assets - Compo

Other Intangible Assets - Components of Other Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 44,561	$ 44,612
Accumulated Amortization	18,348	14,351
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,532	11,420
Accumulated Amortization	3,448	2,727
Acquired Licensing Rights [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	10,850	10,850
Accumulated Amortization	7,691	6,538
Marketing and Procurement Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	22,179	22,342
Accumulated Amortization	$ 7,209	$ 5,086

Other Intangible Assets - Addit

Other Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense of other intangible assets	$ 4,282	$ 4,385	$ 3,935

Other Intangible Assets - Estim

Other Intangible Assets - Estimates of Future Amortization Expense (Detail) $ in Thousands	Dec. 31, 2015USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2,016	$ 3,400
2,017	3,300
2,018	3,300
2,019	3,300
2,020	3,300
Total future amortization expense	$ 16,600

Other Assets - Schedule of Othe

Other Assets - Schedule of Other Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Indemnification assets	$ 13,000	$ 11,394
Other	874	876
Total other assets	$ 874	$ 12,270

Other Assets - Additional Infor

Other Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Deposit in escrow account	$ 13,000
Indemnification assets	13,000	$ 11,394
Indemnification liability	$ 13,000	11,394
Claim period end date against escrow account	Oct. 16, 2014
Extended claim period against escrow account	30 months
Interest expense associated with the amortization of debt issuance costs	$ 148	$ 142	$ 57

Accrued Expenses - Accrued Expe

Accrued Expenses - Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Payables and Accruals [Abstract]
Accrued compensation	$ 4,740	$ 6,220
Accrued severance charges	717	2,771
Accrued distributor commissions	3,835	3,159
Accrued donor recovery fees	7,144	3,249
Accrued taxes	514	1,249
Accrued restructuring charges		13
Accrued indemnification liability	6,579
Other	5,080	8,028
Total accrued expenses	$ 28,609	$ 24,689

Short and Long-Term Obligatio73

Short and Long-Term Obligations - Short and Long-Term Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Debt Disclosure [Abstract]
Term loan	$ 54,125	$ 59,375
Credit facilities	25,477	16,435
Capital leases	38	82
Debt and capital lease obligation, total	79,640	75,892
Debt and capital lease obligation, total	79,640	75,892
Less current portion	(6,009)	(6,479)
Long-term portion	$ 73,631	$ 69,413

Short and Long-Term Obligatio74

Short and Long-Term Obligations - Additional Information (Detail)	Jul. 16, 2013USD ($)	Dec. 31, 2015USD ($)Debt_Instruments	Dec. 31, 2015EUR (€)	Jun. 29, 2015USD ($)	Dec. 31, 2014USD ($)
Line of Credit Facility [Line Items]
Credit outstanding		$ 25,477,000			$ 16,435,000
Maturity date of capital leases		2,017
Future maturities of capital leases		$ 38,000			$ 82,000
Present value of minimum lease payments		38,000
Credit Facilities [Member]
Line of Credit Facility [Line Items]
Credit outstanding		$ 24,000,000
Long-term obligations outstanding, number | Debt_Instruments		4
Current borrowing capacity		$ 6,377,000
Capital Lease Obligations [Member]
Line of Credit Facility [Line Items]
Minimum interest rate		1.49%
Maximum interest rate		2.85%
TD Bank and Regions Bank Senior Secured Facility [Member]
Line of Credit Facility [Line Items]
Term of senior secured credit facility	5 years
Amount of senior secured facility obtained	$ 80,000,000
Maturity date of senior secured credit facility	Jul. 16, 2018
Description of variable interest rate basis		One month LIBOR rate
Revolving credit facility, variable interest rate		1.86%	1.86%
Aggregate principal payment on term loan		$ 18,000,000
Minimum cash balance required for covenant compliance		$ 10,000,000
Covenant Terms of Credit Facility		The credit agreement also contains various restrictive covenants which limit, among other things, indebtedness and liens, as well as payment of dividends, while requiring a minimum cash balance on hand of $10,000 and certain financial covenant ratios.
TD Bank and Regions Bank Senior Secured Facility [Member] | Minimum [Member]
Line of Credit Facility [Line Items]
Variable interest rate range	1.00%
TD Bank and Regions Bank Senior Secured Facility [Member] | Maximum [Member]
Line of Credit Facility [Line Items]
Variable interest rate range	1.75%
TD Bank and Regions Bank Senior Secured Facility [Member] | Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Credit facility, borrowing capacity	$ 20,000,000			$ 30,000,000
TD Bank and Regions Bank Senior Secured Facility [Member] | Term Loan [Member]
Line of Credit Facility [Line Items]
Amount of senior secured facility obtained	$ 60,000,000
German Bank Credit Facilities [Member]
Line of Credit Facility [Line Items]
Credit facility, borrowing capacity		$ 1,854,000	€ 1,700,000
Long-term obligations outstanding, number | Debt_Instruments		3
Unsecured revolving credit facility | €			200,000
Minimum interest rate		2.55%
Maximum interest rate		8.50%
German Bank Credit Facilities [Member] | Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Credit outstanding		$ 1,477,000
German Bank Credit Facilities [Member] | Secured by Mortgage [Member]
Line of Credit Facility [Line Items]
Revolving credit facility | €			1,000,000
German Bank Credit Facilities [Member] | Secured by Accounts Receivable [Member]
Line of Credit Facility [Line Items]
Revolving credit facility | €			€ 500,000

Short and Long-Term Obligatio75

Short and Long-Term Obligations - Contractual Maturities of Short and Long-Term Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
2,016	$ 6,009
2,017	5,256
2,018	68,375
Debt and capital lease obligation, total	79,640	$ 75,892
Term Loan [Member]
Debt Instrument [Line Items]
2,016	4,500
2,017	5,250
2,018	44,375
Debt and capital lease obligation, total	54,125
Credit Facilities [Member]
Debt Instrument [Line Items]
2,016	1,477
2,018	24,000
Debt and capital lease obligation, total	25,477
Capital Leases [Member]
Debt Instrument [Line Items]
2,016	32
2,017	6
Debt and capital lease obligation, total	$ 38

Other Long-Term Liabilities - S

Other Long-Term Liabilities - Schedule of Other Long-Term Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Other Liabilities Disclosure [Abstract]
Indemnification liability	$ 13,000	$ 11,394
Other	472	213
Total other long-term liabilities	$ 472	$ 11,607

Income Taxes - Income Tax Benef

Income Taxes - Income Tax Benefit (Provision) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Current:
Federal	$ (988)	$ (1,062)	$ 127
State	(159)	(150)	167
International	(544)	(86)	219
Total current	(1,691)	(1,298)	513
Deferred:
Federal	(5,695)	(1,118)	8,017
State	68	(76)	1,675
International	(981)	999	905
Total deferred	(6,608)	(195)	10,597
Total income tax (provision) benefit	$ (8,299)	$ (1,493)	$ 11,110

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Current:
Deferred income tax asset, allowance for bad debts		$ 415
Deferred income tax asset, inventory		11,513
Deferred income tax asset, net operating losses		340
Deferred income tax asset, tax credits		2,370
Deferred income tax asset, deferred compensation		3,912
Deferred income tax asset, deferred revenue		1,969
Deferred income tax asset, accrued liabilities		2,517
Deferred income tax asset, other	$ 0	0
Deferred income tax asset, total current		23,036
Noncurrent:
Deferred income tax asset, allowance for bad debts	376
Deferred income tax asset, deferred compensation	4,013
Deferred income tax asset, inventory	10,604
Deferred income tax asset, fixed assets and intangibles	0	0
Deferred income tax asset, investments	2,133	2,073
Deferred income tax asset, net operating losses	2,830	3,293
Deferred income tax asset, tax credits	4,645	2,596
Deferred income tax asset, deferred revenue	4,968	5,318
Deferred income tax asset, accrued liabilities	1,847	357
Deferred income tax asset, other	0	0
Deferred income tax asset, valuation allowance	(1,106)	(959)
Deferred income tax asset, total noncurrent	30,310	12,678
Deferred income tax asset, total	30,310	35,714
Current:
Deferred income tax liability, allowance for bad debts	0	0
Deferred income tax liability, inventory	0	0
Deferred income tax liability, net operating losses	0	0
Deferred income tax liability, tax credits	0	0
Deferred income tax liability, deferred compensation	0	0
Deferred income tax liability, deferred revenue	0	0
Deferred income tax liability, accrued liabilities	0	0
Deferred income tax liability, other		(208)
Deferred income tax liability, total current		(208)
Noncurrent:
Deferred income tax liability, allowance for bad debts	0	0
Deferred income tax liability, deferred compensation	0	0
Deferred income tax liability, inventory	0	0
Deferred income tax liability, fixed assets and intangibles	(7,667)	(6,485)
Deferred income tax liability, investments	0	0
Deferred income tax liability, net operating losses	0	0
Deferred income tax liability, tax credits	0	0
Deferred income tax liability, deferred revenue	0	0
Deferred income tax liability, accrued liabilities	0	0
Deferred income tax liability, other	(258)
Deferred income tax liability, valuation allowance	0	0
Deferred income tax liability, total noncurrent	(7,925)	(6,485)
Deferred income tax liability, total	$ (7,925)	$ (6,693)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Dec. 31, 2012
Operating Loss Carryforwards [Line Items]
Deferred tax assets	$ 30,310,000	$ 35,714,000
Deferred tax assets, valuation allowances	1,106,000
Tax benefit from exercise of stock options	1,139,000	539,000	$ 315,000
Research tax credit carryforwards	$ 5,693,000
Research tax credit carryforwards, first year of expiration period	2,027
Research tax credit carryforwards, last year of expiration period	2,035
Alternative minimum tax credit carryforwards	$ 827,000
Undistributed earnings of foreign subsidiaries	$ 11,227,000	7,238,000
Primary measure of cumulative losses, number of rolling years	3 years
Utilized percentage of deferred tax assets before expiration	100.00%
Unrecognized tax benefits	$ 1,986,000	1,787,000	2,825,000	$ 1,797,000
Interest and penalties recorded	0	0	0
Interest and penalties accrued	0	0
Significant other reconciling items	0	0	$ 0
Other Liabilities [Member]
Operating Loss Carryforwards [Line Items]
Unrecognized tax benefits	110,000
Deferred Tax Asset Net [Member]
Operating Loss Carryforwards [Line Items]
Unrecognized tax benefits	1,876,000
Domestic Tax Authority [Member]
Operating Loss Carryforwards [Line Items]
Deferred tax assets, valuation allowances	1,106,000	$ 959,000
U S Federal [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 1,978,000
Net operating loss carryforwards, expiration start year	2,026
Net operating loss carryforwards, expiration end year	2,027
U S State [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 20,766,000
Net operating loss carryforward expiration period, start year	2,018
Net operating loss carryforward expiration period, end year	2,035
Foreign Tax Authority [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 4,447,000
Foreign Tax Authority [Member] | Earliest Tax Year [Member]
Operating Loss Carryforwards [Line Items]
Income tax examination year	2,010
Foreign Tax Authority [Member] | Latest Tax Year [Member]
Operating Loss Carryforwards [Line Items]
Income tax examination year	2,013

Income Taxes - Unrecognized Tax

Income Taxes - Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Opening balance	$ 1,787	$ 2,825	$ 1,797
Reductions based on tax positions related to the current year		(136)	(174)
Additions for tax positions of prior years	199		1,337
Reductions for tax positions of prior years		(902)	(135)
Closing balance	$ 1,986	$ 1,787	$ 2,825

Income Taxes - Effective Tax Ra

Income Taxes - Effective Tax Rate Differs from the Statutory Federal Income Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Statutory federal rate	35.00%	35.00%	35.00%
State income taxes-net of federal tax benefit	0.25%	3.51%	4.14%
Foreign rate differential	(2.18%)	4.99%	(0.46%)
Other permanent expenses	0.56%	(1.25%)	(4.27%)
Research tax credits	(0.28%)	(7.52%)	3.56%
Domestic production activities deduction		(4.33%)
Unrecognized tax benefits			0.86%
Valuation allowance	0.85%	5.26%
Other reconciling items, net	1.55%	(0.02%)	(0.42%)
Effective tax rate	35.75%	35.64%	38.41%

Preferred Stock - Schedule of P

Preferred Stock - Schedule of Preferred Stock (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Jul. 16, 2013
Temporary Equity [Line Items]
Net Total	$ 56,323	$ 52,834	$ 49,537	$ 48,710
Accrued dividend payable	3,305	3,113	1,375
Dividend paid			(625)
Amortization of preferred stock issuance costs	184	184	77
Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Preferred Stock Liquidation Value	57,168	53,863	50,750	50,000
Preferred Stock Issuance Costs	(845)	(1,029)	(1,213)	$ (1,290)
Accrued dividend payable	3,305	3,113	1,375
Dividend paid			(625)
Amortization of preferred stock issuance costs	$ 184	$ 184	$ 77

Preferred Stock - Additional In

Preferred Stock - Additional Information (Detail) - Private Placement with WSHP [Member] - USD ($) $ / shares in Units, $ in Thousands	Jul. 15, 2013	Jun. 12, 2013	Dec. 31, 2015
Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Convertible preferred stock issued		$ 50,000
Convertible preferred stock, par value	$ 0.001
Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Preferred stock dividend rate	6.00%
Preferred stock conversion price per share	$ 4.39
Convertible preferred stock, shares to be issued upon approval for each share of preferred stock	228
Closing price of share	$ 7.98
Convertible preferred stock, Description of Conversion			The Preferred Stock will be convertible at the election of the holders into shares of the Company's common stock at an initial conversion price of $4.39 per share which would result in a conversion ratio of approximately 228 shares of common stock for each share of Preferred Stock. The Preferred Stock is convertible at the election of the Company five years after its issuance or at any time if the Company's common stock closes at or above $7.98 per share for at least 20 consecutive trading days.
Preferred stock conversion period after issuance	5 years
Liquidation value	$ 1,000
Convertible preferred stock, Description of Conversion Two			The Company may, upon 30 days notice, redeem the Preferred Stock, in whole or in part, five years after its issuance at the initial liquidation preference of $1,000 per share of the Preferred Stock plus an amount per share equal to accrued but unpaid dividends (collectively, the “Liquidation Value”). The holders of the Preferred Stock may require the Company to redeem their Preferred Stock, in whole or in part, at the Liquidation Value seven years after its issuance or upon the occurrence of a change of control.
Preferred stock conversion after issuance, Conversion Two	7 years
Series A Preferred Stock [Member] | Minimum [Member]
Temporary Equity [Line Items]
Consecutive trading days	20 months

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2015Voteshares	Dec. 31, 2014shares
Equity [Abstract]
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	50,000	50,000
Preferred stock, shares outstanding	50,000	50,000
Common stock, shares authorized	150,000,000	150,000,000
Votes per common share | Vote	1

Restructuring Charges - Additio

Restructuring Charges - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2013
Restructuring Cost and Reserve [Line Items]
Expenses for integration activities		$ 2,881
Minimum [Member] | Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Severance payment period	1 month
Maximum [Member] | Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Severance payment period	12 months

Restructuring Charges - Schedul

Restructuring Charges - Schedule of Restructuring Charges (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2015USD ($)
Restructuring and Related Activities [Abstract]
Accrued restructuring charges, beginning balance	$ 13
Cash payments	$ (13)

Severance Charges - Additional

Severance Charges - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Restructuring Cost and Reserve [Line Items]
Severance charges related to the termination of former employees	$ 995	$ 4,798
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Severance charges related to the termination of former employees	$ 995
Minimum [Member] | Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Severance payment period	1 month
Maximum [Member] | Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Severance payment period	12 months

Severance Charges - Schedule of

Severance Charges - Schedule of Severance Charges (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014
Restructuring Cost and Reserve [Line Items]
Accrued restructuring charges, beginning balance	$ 13
Severance cash payments	(13)
Stock based compensation	(310)
Employee separation expenses accrued in 2015	995	$ 4,798
Accrued restructuring charges, ending balance		13
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Accrued restructuring charges, beginning balance	2,771
Severance cash payments	(2,591)
Stock based compensation	(310)
Employee separation expenses accrued in 2015	995
Accrued restructuring charges, ending balance	$ 865	$ 2,771

Retirement Benefits - Additiona

Retirement Benefits - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Defined Benefit Plan Disclosure [Line Items]
Cost recognized under benefit plan	$ 3,034	$ 2,663	$ 1,964
Maximum [Member]
Defined Benefit Plan Disclosure [Line Items]
Retirement benefits, employer contribution percent	6.00%

Concentrations of Risk - Additi

Concentrations of Risk - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2015Companies
Risks and Uncertainties [Abstract]
Companies with revenues	13
Companies with significant revenues	3

Concentrations of Risk - Schedu

Concentrations of Risk - Schedule of Percentage of Total Revenues Derived from Company's Largest Distributors and International Distribution (Detail) - Distributors Concentration Risk [Member] - Sales Revenue, Net [Member]	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Zimmer Biomet Holdings, Inc. [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	24.00%	18.00%	17.00%
Medtronic, PLC [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	10.00%	12.00%	16.00%
Davol, Inc. [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	3.00%	5.00%	9.00%
International Customers [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	8.00%	9.00%	10.00%

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Thousands	Oct. 12, 2013	Sep. 30, 2010	Sep. 10, 2010	Jul. 13, 2009	Mar. 31, 2015	Mar. 31, 2013	Dec. 31, 2010	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Commitment And Contingencies [Line Items]
Exclusivity payments								$ 3,500
Deferred revenue recognition								2,000		$ 6,000
Rent expense								$ 1,443	$ 1,609	$ 1,529
Davol, Inc. [Member]
Commitment And Contingencies [Line Items]
Non-refundable license fee				$ 8,000
Initial agreement term								10 years
Revenue milestone payment							$ 3,500
Exclusivity payments								$ 8,000
Exclusive worldwide distribution agreement, extended expiration date								Jul. 13, 2019
Deferred revenue recognition					$ 1,500	$ 1,715
Medtronic, PLC [Member]
Commitment And Contingencies [Line Items]
Decline in cumulative fees received, trailing period	12 months
Distribution agreement automatic renewal term	5 years
Period prior to expiration of initial term for notice	1 year
Agreement expiration date	Jun. 30, 2014
Athersys, Inc. [Member]
Commitment And Contingencies [Line Items]
Non-refundable license fee			$ 3,000
License fee payable in three time-based installments			1,000
Payment contingent upon successful achievement of certain development milestones			2,000
Payment contingent upon achievement of certain cumulative revenue milestones			$ 32,500
Exclusive license agreement, period maximum			5 years
Zimmer Biomet Holdings, Inc. [Member]
Commitment And Contingencies [Line Items]
Initial agreement term		10 years
Upfront payment		$ 13,000
Upfront payment period		10 days

Commitments and Contingencies93

Commitments and Contingencies - Future Minimum Lease Commitments under Non-Cancelable Operating Leases (Detail) $ in Thousands	Dec. 31, 2015USD ($)
Commitments and Contingencies Disclosure [Abstract]
2,016	$ 1,874
2,017	1,121
2,018	560
2,019	319
2020 and beyond	144
Total	$ 4,018

Legal and Regulatory Actions -

Legal and Regulatory Actions - Additional Information (Detail) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2015USD ($)LitigationEntity	Dec. 31, 2015USD ($)LitigationClaims	Dec. 31, 2014USD ($)
Loss Contingencies [Line Items]
Outstanding claims | Litigation	0	0
Litigation and settlement charges | $	$ 804		$ 185
Number of entities which agreement signed | Entity	3
Settlement payment made to Lanx | $		$ 325
Tissue Only Claims [Member]
Loss Contingencies [Line Items]
Claims for which the Company Parties are providing defense and indemnification | Claims		435
Tissue Non Coloplast Claims[Member]
Loss Contingencies [Line Items]
Claims for which the Company Parties are providing defense and indemnification | Claims		443

Segment Data - Additional Infor

Segment Data - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2015Segment
Segment Reporting [Abstract]
Number of reportable segments	1
Lines of business	6

Segment Data - Revenues from Ti

Segment Data - Revenues from Tissue Distribution and Other Revenues (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Segment Reporting Information [Line Items]
Other revenues									$ 13,602	$ 11,700	$ 8,217
Revenues	$ 76,121	$ 66,529	$ 71,609	$ 68,034	$ 70,873	$ 65,163	$ 66,029	$ 60,745	$ 282,293	$ 262,810	$ 197,979
Percentage of other revenues									4.80%	4.50%	4.20%
Percentage of revenues									100.00%	100.00%	100.00%
Domestic [Member]
Segment Reporting Information [Line Items]
Revenues									$ 260,387	$ 238,936	$ 177,207
Percentage of domestic revenues									92.20%	90.90%	89.50%
International [Member]
Segment Reporting Information [Line Items]
Revenues									$ 21,906	$ 23,874	$ 20,772
Percentage of international revenues									7.80%	9.10%	10.50%
Spine [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 76,968	$ 82,663	$ 57,334
Percentage of sales revenue									27.30%	31.50%	28.90%
Ortho Fixation [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 55,585	$ 37,133	$ 14,525
Percentage of sales revenue									19.70%	14.10%	7.30%
Sports Medicine [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 46,735	$ 46,758	$ 42,594
Percentage of sales revenue									16.50%	17.80%	21.50%
BGS and General Orthopedic [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 42,283	$ 36,747	$ 27,864
Percentage of sales revenue									15.00%	14.00%	14.10%
Dental [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 23,621	$ 20,810	$ 19,779
Percentage of sales revenue									8.40%	7.90%	10.00%
Surgical Specialties [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 23,499	$ 26,999	$ 27,666
Percentage of sales revenue									8.30%	10.30%	14.00%

Segment Data - Schedule of Prop

Segment Data - Schedule of Property, Plant and Equipment - Net by Significant Geographic Location (Detail) - USD ($) $ in Thousands	Dec. 31, 2015	Dec. 31, 2014
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 84,992	$ 77,028
Domestic [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	72,901	63,009
International [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 12,091	$ 14,019

Quarterly Results of Operatio98

Quarterly Results of Operations (Unaudited) - Results of Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2014	Sep. 30, 2014	Jun. 30, 2014	Mar. 31, 2014	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]
Revenues	$ 76,121	$ 66,529	$ 71,609	$ 68,034	$ 70,873	$ 65,163	$ 66,029	$ 60,745	$ 282,293	$ 262,810	$ 197,979
Gross profit	40,307	35,233	37,203	36,999	37,852	34,693	35,054	26,198	149,742	133,797	80,105
Net (loss) income applicable to common shares	$ 3,321	$ 2,670	$ 2,685	$ 2,934	$ (136)	$ 1,202	$ 1,577	$ (3,060)	$ 11,610	$ (417)	$ (19,189)
Net (loss) income per common share:
Basic	$ 0.06	$ 0.05	$ 0.05	$ 0.05	$ 0	$ 0.02	$ 0.03	$ (0.05)	$ 0.20	$ (0.01)	$ (0.34)
Diluted	$ 0.06	$ 0.05	$ 0.05	$ 0.05	$ 0	$ 0.02	$ 0.03	$ (0.05)	$ 0.20	$ (0.01)	$ (0.34)

Quarterly Results of Operatio99

Quarterly Results of Operations (Unaudited) - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2015	Dec. 31, 2014
Interim Reporting [Line Items]
Litigation settlement charge	$ 804		$ 185
Severance charges		$ 995	4,798
Asset abandonments	814	$ 814
Inventory purchase accounting adjustment value			5,708
Pioneer [Member]
Interim Reporting [Line Items]
Severance charges	$ 995		$ 4,798

Schedule II - Valuation and 100

Schedule II - Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Allowance for Doubtful Accounts [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	$ 818	$ 492	$ 346
Charged to Costs and Expenses	1,037	709	180
Deductions- Write-offs, Payments	401	383	34
Balance at End of Period	1,454	818	492
Allowance for Product Returns [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	525	343	283
Charged to Costs and Expenses	531	182	255
Deductions- Write-offs, Payments	342		195
Balance at End of Period	714	525	343
Allowance for Obsolescence [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	5,112	5,399	7,735
Charged to Costs and Expenses	5,390	3,763	1,785
Deductions- Write-offs, Payments	3,419	4,050	4,121
Balance at End of Period	7,083	5,112	5,399
Deferred Tax Asset Valuation Allowance [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	959	469	469
Charged to Costs and Expenses	197	490
Deductions- Write-offs, Payments	50
Balance at End of Period	$ 1,106	$ 959	$ 469