RTI Surgical (RTIX) 10-K 13 Mar 17 2016 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2016	Mar. 03, 2017	Jun. 30, 2016
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2,016
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		58,462,397
Entity Public Float			$ 208.3

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Current Assets:
Cash and cash equivalents	$ 13,849	$ 12,614
Accounts receivable - less allowances of $1,728 at December 31, 2016 and $1,454 at December 31, 2015	41,488	47,243
Inventories - net	119,743	118,673
Prepaid and other current assets	5,213	13,184
Total current assets	180,293	191,714
Property, plant and equipment - net	83,298	84,992
Deferred tax assets - net	24,968	22,385
Goodwill	54,887	54,887
Other intangible assets - net	23,994	26,213
Other assets - net	591	471
Total assets	368,031	380,662
Current Liabilities:
Accounts payable	26,112	20,446
Accrued expenses	22,030	28,609
Current portion of deferred revenue	4,742	4,865
Current portion of short and long-term obligations	6,080	5,853
Total current liabilities	58,964	59,773
Long-term obligations - less current portion	77,267	73,384
Other long-term liabilities	256	472
Deferred revenue	6,612	9,354
Total liabilities	143,099	142,983
Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding	60,016	56,323
Stockholders' equity:
Common stock, $.001 par value: 150,000,000 shares authorized; 58,433,397 and 57,803,111 shares issued and outstanding, respectively	58	58
Additional paid-in capital	417,428	417,725
Accumulated other comprehensive loss	(8,316)	(7,042)
Accumulated deficit	(243,338)	(228,939)
Less treasury stock, 368,949 and 230,352 shares, respectively, at cost	(916)	(446)
Total stockholders' equity	164,916	181,356
Total liabilities and stockholders' equity	$ 368,031	$ 380,662

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 1,728	$ 1,454
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	58,433,397	58,433,397
Common stock, shares outstanding	57,803,111	57,803,111
Treasury stock, shares	368,949	230,352

Consolidated Statements of Comp

Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Statement [Abstract]
Revenues	$ 272,865	$ 282,293	$ 262,810
Costs of processing and distribution	140,516	132,551	129,013
Gross profit	132,349	149,742	133,797
Expenses:
Marketing, general and administrative	116,125	107,439	107,653
Research and development	16,090	15,065	15,536
Strategic review costs	1,150
CEO Retirement and transition costs	4,404
Contested proxy expenses	2,680
Asset impairment and abandonments	5,435	814
Litigation settlement and settlement charges		804	185
Restructuring charges	1,107
Severance costs	1,039	995	4,798
Total operating expenses	148,030	125,117	128,172
Operating (loss) income	(15,681)	24,625	5,625
Other (expense) income:
Interest expense	(1,655)	(1,492)	(1,357)
Interest income	8	3	9
Foreign exchange (loss) gain	(132)	78	(88)
Total other expense - net	(1,779)	(1,411)	(1,436)
(Loss) income before income tax benefit (provision)	(17,460)	23,214	4,189
Income tax benefit (provision)	3,061	(8,299)	(1,493)
Net (loss) income	(14,399)	14,915	2,696
Convertible preferred dividend	(3,508)	(3,305)	(3,113)
Net (loss) income applicable to common shares	(17,907)	11,610	(417)
Other comprehensive loss:
Unrealized foreign currency translation loss	(1,274)	(3,161)	(3,069)
Comprehensive (loss) income	$ (19,181)	$ 8,449	$ (3,486)
Net (loss) income per common share - basic	$ (0.31)	$ 0.20	$ (0.01)
Net (loss) income per common share - diluted	$ (0.31)	$ 0.20	$ (0.01)
Weighted average shares outstanding - basic	58,236,745	57,611,231	56,735,924
Weighted average shares outstanding - diluted	58,236,745	58,590,494	56,735,924

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, 2013	$ 168,053		$ 56	$ 415,426		$ (812)	$ (246,550)	$ (67)
Net (loss) 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 (loss) 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)
Net (loss) income	(14,399)						(14,399)
Foreign currency translation adjustment	(1,274)					(1,274)
Exercise of common stock options	57			57
Stock-based compensation	3,590			3,590
Purchase of treasury stock	(470)							(470)
Amortization of preferred stock Series A issuance costs		(185)			(185)
Preferred stock Series A dividend		$ (3,508)			$ (3,508)
Change in income tax benefit from stock-based compensation	(251)			(251)
Ending Balance at Dec. 31, 2016	$ 164,916		$ 58	$ 417,428		$ (8,316)	$ (243,338)	$ (916)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Cash flows from operating activities:
Net (loss) income	$ (14,399)	$ 14,915	$ 2,696
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization expense	16,510	16,522	15,395
Provision for bad debts and product returns	895	1,568	891
Provision for inventory write-downs	13,880	5,390	3,763
Amortization of deferred revenue	(4,867)	(6,225)	(5,420)
Deferred income tax provision	(3,395)	5,543	502
Stock-based compensation	3,590	2,548	3,032
Asset impairment	5,435
Other	603	2,280	958
Change in assets and liabilities:
Accounts receivable	4,756	(10,435)	(8,058)
Inventories	(15,369)	(11,990)	(11,244)
Accounts payable	4,583	(12,660)	4,087
Accrued expenses	(6,536)	5,532	1,375
Deferred revenue	2,000	2,000
Other operating assets and liabilities	7,637	(5,992)	(1,083)
Net cash provided by operating activities	15,323	8,996	6,894
Cash flows from investing activities:
Purchases of property, plant and equipment	(15,337)	(17,740)	(15,577)
Patent and acquired intangible asset costs	(2,615)	(498)	(737)
Net cash used in investing activities	(17,952)	(18,238)	(16,314)
Cash flows from financing activities:
Proceeds from exercise of common stock options	57	2,505	889
Proceeds from long-term obligations	17,000	8,750	7,000
Net (payments) proceeds from short-term obligations	(1,511)	422	658
Payments on long-term obligations	(11,424)	(5,294)	(682)
Other financing activities	(458)	(109)	5
Net cash provided by financing activities	3,664	6,274	7,870
Effect of exchange rate changes on cash and cash equivalents	200	(121)	(1,468)
Net increase (decrease) in cash and cash equivalents	1,235	(3,089)	(3,018)
Cash and cash equivalents, beginning of period	12,614	15,703	18,721
Cash and cash equivalents, end of period	13,849	12,614	15,703
Supplemental cash flow disclosure:
Cash paid for interest	1,224	1,425	1,624
Cash paid for income taxes, net of refunds	(238)	3,667	578
Non-cash acquisition of property, plant and equipment	952	3,795	1,947
Stock-based compensation related to severance		310
Change in accrual for dividend payable	$ 3,508	$ 3,305	$ 3,113

Business

Business	12 Months Ended
	Dec. 31, 2016
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, 2016
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Principles of Consolidation RTIDS is a taxable not-for-profit Use of Estimates Foreign Currency Translation Fair Value of Financial Instruments Cash and Cash Equivalents Accounts Receivable Allowances Inventories first-in, first-out Non-tissue 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 to 5 years Software Costs Debt Issuance Costs— Long-Lived Assets Goodwill Goodwill and Other Intangible Assets year-end Goodwill is tested for impairment annually by comparing the fair value of the reporting unit to its carrying amount, including goodwill. The Company adopted Accounting Standards Update (“ASU”) No. 2011-08, Intangibles – Goodwill and Other: Testing Goodwill for Impairment, than-not more-likely-than-not 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 non-compete non-compete 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 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 consists of service processing, tissue recovery fees, biomedical laboratory fees, recognition of previously deferred revenues, shipping fees, distribution of reproductions of our allografts to distributors for demonstration purposes and restocking fees which is included in revenues. Stock-Based Compensation Plans Accounting for Stock Compensation Staff Accounting Bulletin No. 107 pre-vesting Research and Development Costs Income Taxes year-end Earnings Per Share Year Ended December 31, 2016 2015 2014 Basic shares 58,236,745 57,611,231 56,735,924 Effect of dilutive securities: Stock options — 979,263 — Diluted shares 58,236,745 58,590,494 56,735,924 Options to purchase 5,764,607 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2016, 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 5,661,514 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. For the years ended December 31, 2016, 2015 and 2014, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted

Recently Issued Accounting Stan

Recently Issued Accounting Standards	12 Months Ended
	Dec. 31, 2016
Accounting Changes and Error Corrections [Abstract]
Recently Issued Accounting Standards	3. Recently Issued Accounting Standards. Simplifying the Test for Goodwill Impairment No. 2017-04, Simplifying the Test for Goodwill Impairment” No. 2017-04”). No. 2017-04 No. 2017-04, No. 2017-04 No. 2017-04 Business Combinations – Clarifying the Definition of a Business No. 2017-01, Business Combinations – Clarifying the Definition of a Business” No. 2017-01”). 2017-01 2017-01 2017-01 2017-01 Compensation – Stock Compensation No. 2016-09, “Compensation – Stock Compensation” 2016-09”). 2016-09 2016-09 Leases No. 2016-02 2016-02”), Leases (Topic 842) “Leases (Topic 840)” 2016-02 Income Taxes No. 2015-17, “ Income Taxes (Topic 740) ” No. 2015-17 2015-17 non-current Simplifying the Measurement of Inventory No. 2015-11, “Inventory (Topic 330): Simplifying the Measurement of Inventory” No. 2015-11 first-in, first-out No. 2015-11 No. 2015-11 Presentation of Financial Statements - Going Concern “Presentation of Financial Statements - Going Concern (Subtopic 205-40).” Simplifying the Presentation of Debt Issuance Costs No. 2015-03, Interest – Imputation of Interest: Simplifying the Presentation of Debt Issuance Costs” No. 2015-03”). No. 2015-03 No. 2015-03 No. 2015-03 assets-net”. Revenue from Contracts with Customers No. 2014-09, “Revenue from Contracts with Customers” 2014-09”), “Revenue Recognition” 2014-09 2014-09 2014-09 In March and April 2016, the FASB issued two updates to the revenue recognition guidance: ASU 2016-08 “Principal Versus Agent Considerations” 2016-10, “Identifying Performance Obligations and Licensing” In May 2016, the FASB issued ASU Update No. 2016-12 “Narrow-Scope Improvements and Practical Expedients” 2016-12”) The Company has not determined the impact ASU 2014-09, 2016-08, 2016-10 2016-12

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	4. Stock-Based Compensation 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 2015 Incentive Compensation Plan – The following weighted-average assumptions were used to determine the fair value of options under FASB ASC 718: Year Ended December 31, 2016 2015 2014 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 1.85 % 1.67 % 2.29 % Volatility factor 45.57 % 46.29 % 46.53 % Dividend yield — — — Stock Options Stock options outstanding, exercisable and available for grant at December 31, 2016, are summarized as follows: Number of Weighted Weighted Aggregate Outstanding at January 1, 2016 5,661,514 $ 4.49 Granted 619,352 3.31 Exercised (21,000 ) 2.72 Forfeited or expired (495,259 ) 5.54 Outstanding at December 31, 2016 5,764,607 $ 4.28 4.49 $ 348 Vested or expected to vest at December 31, 2016 5,590,546 $ 4.28 4.35 $ 348 Exercisable at December 31, 2016 4,082,632 $ 4.33 3.07 $ 348 Available for grant at December 31, 2016 3,314,686 The aggregate intrinsic value in the table above represents the total pre-tax For the years ended December 31, 2016, 2015 and 2014, the Company recognized stock-based compensation as follows: Year Ended December 31, 2016 2015 2014 Stock-based compensation: Costs of processing and distribution $ 140 $ 132 $ 132 Marketing, general and administrative 3,406 2,356 2,840 Research and development 44 60 60 Total $ 3,590 $ 2,548 $ 3,032 For the years ended December 31, 2016, 2015, and 2014, the Company recognized total income tax benefits from stock-based compensation of $1,460, $1,022, and $1,198, respectively. As of December 31, 2016, there was $2,212 of total unrecognized stock-based compensation related to nonvested stock options. That expense is expected to be recognized over a weighted-average period of 2.92 years. Other information concerning stock options are as follows: Year Ended December 31, 2016 2015 2014 Weighted average fair value of stock options granted $ 1.55 $ 2.50 $ 1.87 Aggregate intrinsic value of stock options exercised 12 1,584 295 The aggregate intrinsic value of stock options exercised in a period represents the pre-tax Restricted Stock Awards During the first quarter of 2016, the Company granted 223,563 shares of time-based restricted stock and 223,563 shares of performance-based restricted stock. Both sets of awards vest over a three-year period, with a weighted-average grant date fair value of $3.31 per share. During the third quarter of 2016, the Company granted 162,160 shares of restricted stock with a weighted-average grant date fair value of $3.70 per share which vest over a one-year

Inventories

Inventories	12 Months Ended
	Dec. 31, 2016
Inventory Disclosure [Abstract]
Inventories	5. Inventories Inventories by stage of completion are as follows: December 31, 2016 2015 Unprocessed tissue, raw materials and supplies $ 31,745 $ 33,028 Tissue and work in process 38,552 36,614 Implantable tissue and finished goods 49,446 49,031 $ 119,743 $ 118,673 For the years ended December 31, 2016, 2015, and 2014, the Company had inventory write-downs of $13,880, $5,390 and $3,763, respectively, relating primarily to excess quantities and obsolescence of inventories. The increase in 2016 primarily relates to an inventory charge of $9,556 as a result of writing-off certain excess quantities primarily of hernia and sports medicine inventory.

Property, Plant and Equipment

Property, Plant and Equipment	12 Months Ended
	Dec. 31, 2016
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment	6. Property, Plant and Equipment Property, plant and equipment are as follows: December 31, 2016 2015 Land $ 2,324 $ 2,319 Buildings and improvements 59,187 63,699 Processing equipment 38,387 41,831 Surgical instruments 18,394 15,702 Office equipment, furniture and fixtures 1,701 4,657 Computer equipment and software 11,852 11,804 Construction in process 17,554 10,850 Office equipment under capital leases — 152 149,399 151,014 Less accumulated depreciation (66,101 ) (66,022 ) $ 83,298 $ 84,992 For the years ended December 31, 2016, 2015, and 2014, the Company had depreciation expense in connection with property, plant and equipment of $12,835, $12,240, and $11,010, respectively.

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2016
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	7. Goodwill Goodwill for both years ended December 31, 2016 and 2015 was $54,887. The Company performed its annual goodwill impairment test as of December 31, 2016, and concluded that there was no impairment of goodwill.

Other Intangible Assets

Other Intangible Assets	12 Months Ended
	Dec. 31, 2016
Goodwill and Intangible Assets Disclosure [Abstract]
Other Intangible Assets	8. Other Intangible Assets Other intangible assets are as follows: December 31, 2016 December 31, 2015 Gross Accumulated Gross Accumulated Patents $ 11,559 $ 4,159 $ 11,532 $ 3,448 Acquired licensing rights 12,204 8,302 10,850 7,691 Marketing and procurement intangible assets 20,694 8,002 22,179 7,209 Total $ 44,457 $ 20,463 $ 44,561 $ 18,348 For the years ended December 31, 2016, 2015, and 2014, the Company had amortization expense of other intangible assets of $3,675, $4,282, and $4,385, respectively. At December 31, 2016, management’s estimates of future amortization expense for the next five years are as follows: Amortization Expense 2017 $ 3,400 2018 3,400 2019 3,400 2020 3,400 2021 3,400 $ 17,000

Fair Value Information

Fair Value Information	12 Months Ended
	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Fair Value Information	9. Fair Value Information Long-lived assets, including property and equipment and intangible assets subject to amortization were impaired and written down to their estimated fair values during the fourth quarter of 2016. Fair value is measured as of the impairment date using Level 3 inputs. Level 3 is defined as unobservable inputs in which there is little or no market data available, which require the reporting entity to develop its own assumptions. The long-lived asset level 3 fair value was determined using a market approach, which used inputs that included replacement costs (unobservable), physical deterioration estimates (unobservable), economic obsolescence (unobservable), and market sales data for comparable assets. The following table summarizes impairments of long-lived assets and the related post impairment fair values of the corresponding assets for the year ended December 31, 2016: Year Ended December 31, 2016 Impairment Fair Value Property, plant and equipment - net $ 4,717 $ 4,708 Other intangible assets - net 718 150 $ 5,435 $ 4,858

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2016
Other Liabilities Disclosure [Abstract]
Accrued Expenses	10. Accrued Expenses Accrued expenses are as follows: December 31, 2016 2015 Accrued compensation $ 4,904 $ 4,740 Accrued severance charges 410 865 Accrued restructuring charges 95 — Accrued CEO retirement and transition costs 2,406 — Accrued distributor commissions 4,422 3,835 Accrued donor recovery fees 6,350 7,144 Accrued taxes — 514 Accrued indemnification liability — 6,579 Other 3,443 4,932 $ 22,030 $ 28,609 The Company accrues for the estimated donor recovery fees due to third party recovery agencies as tissue is received. In addition, on July 11, 2016, the Company resolved all final claims on the indemnification escrow fund regarding the 2013 Pioneer acquisition under the terms of the acquisition agreement. The resolution of the final claims resulted in a reduction in prepaid and other current assets and accrued expenses of $6,694 and $6,579 respectively with no impact on the Statement of Comprehensive (Loss) Income.

Short and Long-Term Obligations

Short and Long-Term Obligations	12 Months Ended
	Dec. 31, 2016
Debt Disclosure [Abstract]
Short and Long-Term Obligations	11. Short and Long-Term Obligations Short and long-term obligations are as follows: December 31, 2016 2015 Term loan $ 50,347 $ 53,722 Credit facilities 33,000 25,477 Capital leases — 38 Total 83,347 79,237 Less current portion (6,080 ) (5,853 ) Long-term portion $ 77,267 $ 73,384 The Company obtained from TD Bank and Regions Bank, a 5-year, In addition to the credit facility with TD Bank and Regions Bank, the Company had through its German subsidiary, three credit facilities with three German banks. As of December 31, 2016, the three credit facilities with the three German banks were paid off and terminated. The total available credit on the Company’s one revolving credit facility at December 31, 2016 was $9,500. The Company’s ability to access its revolving credit facility is subject to and can be limited by the Company’s compliance with the Company’s financial and other covenants. The Company was in compliance with the financial covenants related to its revolving credit facility as of December 31, 2016. As of December 31, 2016, the Company paid off all remaining capital leases. Interest expense associated with the amortization of debt issuance costs for the years ended December 31, 2016, 2015 and 2014 was $202, $148 and $142, respectively. As of December 31, 2016, contractual maturities of short and long-term obligations are as follows: Term Loan Credit Total 2017 $ 6,080 $ — $ 6,080 2018 44,267 33,000 77,267 $ 50,347 $ 33,000 $ 83,347

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Income Taxes	12. Income Taxes The Company’s income tax benefit (provision) consists of the following components: Year Ended December 31, 2016 2015 2014 Current: Federal $ (150 ) $ (988 ) $ (1,062 ) State (92 ) (159 ) (150 ) International 456 (544 ) (86 ) Total current 214 (1,691 ) (1,298 ) Deferred: Federal 2,477 (5,695 ) (1,118 ) State 562 68 (76 ) International (192 ) (981 ) 999 Total deferred 2,847 (6,608 ) (195 ) Total income tax benefit (provision) $ 3,061 $ (8,299 ) $ (1,493 ) The components of the deferred tax assets and liabilities consisted of the following at: December 31, 2016 December 31, 2015 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities Allowance for bad debts $ 485 $ — $ 376 $ — Deferred compensation 4,675 — 4,013 — Inventory 12,811 — 10,604 — Fixed assets and intangibles — (5,690 ) — (7,667 ) Investments 2,133 — 2,133 — Net operating losses 4,547 — 2,830 — Tax credits 5,235 — 4,645 — Deferred revenue 3,804 — 4,968 — Accrued liabilities 2,004 — 1,847 — Other — (120 ) — (258 ) Valuation allowance (4,916 ) — (1,106 ) — Total $ 30,778 $ (5,810 ) $ 30,310 $ (7,925 ) The Company expects its deferred tax assets of $24,968, net of the valuation allowance at December 31, 2016 of $4,916, 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 $4,916 and $1,106 have been established at December 31, 2016 and December 31, 2015, respectively, against a portion of the deferred tax assets. The Company recorded a tax benefit from the exercise of stock options in the amount of $546, $1,139, and $539 for the years ended December 31, 2016, 2015 and 2014, respectively. As of December 31, 2016, the Company has U.S. federal net operating loss carryforwards of $1,978 that will expire in the years 2026 and 2027. As of December 31, 2016, the Company has U.S. state net operating loss carryforwards of $22,799 that will expire in the years 2018 through 2036. As of December 31, 2016, the Company has foreign net operating loss carryforwards of $10,194 that will carryfoward indefinitely. As of December 31, 2016, the Company has research tax credit carryforwards of $6,002 that will expire in years 2028 through 2036. As of December 31, 2016, the Company has alternative minimum tax credit carryforwards of $827 that will carryfoward indefinitely. 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, 2016 and 2015, the amount of undistributed earnings related to the Company’s foreign subsidiaries considered to be indefinitely reinvested was $5,031 and $11,227, 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, 2016, 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 French and German operations are in cumulative loss positions. Since inception, the Company’s French operations have generated losses. As a result, the Company has historically recorded a full valuation allowance on its French subsidiary’s deferred tax assets. During the quarter ended September 30, 2016, the Company’s German operations entered into a cumulative loss position. As a result, the Company recorded a full valuation allowance on its German subsidiary’s 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, 2016. 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, 2016, the Company has $1,591 of unrecognized tax benefits, which was 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, 2016 2015 2014 Opening balance $ 1,986 $ 1,787 $ 2,825 Reductions based on tax positions related to the current year — — (136 ) Additions for tax positions of prior years — 199 — Reductions for tax positions of prior years (60 ) — (902 ) Reductions for expiration of statute of limitations (335 ) — — $ 1,591 $ 1,986 $ 1,787 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 2016, 2015 and 2014 and no interest and penalties accrued at December 31, 2016 and 2015. The Company is undergoing an examination by the Internal Revenue Service (“IRS”). The IRS examination covers the 2015 tax year. During the year ended December 31, 2016, the Company’s German subsidiary completed an examination by the German tax authorities. The examination covered the German subsidiary’s 2010 through 2013 tax years. No material adjustments were recorded as a result of the German examination. The effective tax rate differs from the statutory federal income tax rate for the following reasons: Year Ended December 31, 2016 2015 2014 Statutory federal rate 35.00 % 35.00 % 35.00 % State income taxes—net of federal tax benefit 1.73 % 0.25 % 3.51 % Foreign rate differential (3.29 %) (2.18 %) 4.99 % Other permanent items (3.15 %) 0.56 % (1.25 %) Research tax credits 7.02 % (0.28 %) (7.52 %) Domestic production activities deduction 1.38 % — (4.33 %) Valuation allowance (21.71 %) 0.85 % 5.26 % Other reconciling items, net 0.55 % 1.55 % (0.02 %) Effective tax rate 17.53 % 35.75 % 35.64 % For the years ended December 31, 2016, 2015 and 2014, the Company had no individually significant other reconciling items.

Preferred Stock

Preferred Stock	12 Months Ended
	Dec. 31, 2016
Equity [Abstract]
Preferred Stock	13. Preferred Stock Preferred stock is as follows: Preferred Stock Preferred Stock Net Liquidation Value Issuance Costs Total Balance at January 1, 2014 $ 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 Accrued dividend payable 3,508 — 3,508 Amortization of preferred stock issuance costs — 185 185 Balance at December 31, 2016 $ 60,676 $ (660 ) $ 60,016 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 Company’s credit agreement with TD Bank and Regions Bank contains various covenants of financial conditions which, if not met, would restrict the Company from paying dividends. 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, 2016
Equity [Abstract]
Stockholders' Equity	14. Stockholders’ Equity Preferred Stock Common Stock

Strategic Review Costs

Strategic Review Costs	12 Months Ended
	Dec. 31, 2016
Text Block [Abstract]
Strategic Review Costs	15. Strategic Review Costs The Company recorded strategic review costs related to the comprehensive strategic review of the Company’s business lines and operations to leverage the Company’s expertise, technology and products and identify opportunities to increase stockholder value, which resulted in $1,150 of expenses for the year ended December 31, 2016.

CEO Retirement and Transition C

CEO Retirement and Transition Costs	12 Months Ended
	Dec. 31, 2016
Postemployment Benefits [Abstract]
CEO Retirement and Transition Costs	16. CEO Retirement and Transition Costs The Company recorded Chief Executive Officer retirement and transition costs related to the retirement of our former Chief Executive Officer pursuant to the Executive Transition Agreement dated August 29, 2012 (as amended and extended to date), which resulted in $4,404 of expenses for the year ended December 31, 2016. The total Chief Executive Officer retirement and transition costs are expected to be paid in full prior to the first quarter of 2019. The following table includes a rollforward of CEO retirement and transition costs included in accrued expenses, see Note 10. Accrued CEO retirement and transition costs at January 1, 2016 $ — CEO retirement and transition costs accured in 2016 4,404 Stock-based compensation (1,535 ) Cash payments (463 ) Accrued restructuring charges at December 31, 2016 $ 2,406

Contested Proxy Expenses

Contested Proxy Expenses	12 Months Ended
	Dec. 31, 2016
Text Block [Abstract]
Contested Proxy Expenses	17. Contested Proxy Expenses The Company recorded contested proxy expenses of $2,680 for the year ended December 31, 2016.

Restructuring Charges

Restructuring Charges	12 Months Ended
	Dec. 31, 2016
Restructuring Charges	18. Restructuring Charges The Company instituted a restructuring plan which was completed in 2016 primarily related to closure of our French distribution and tissue procurement office, which resulted in $1,107 of expenses for the year ended December 31, 2016. The following table includes a rollforward of restructuring charges included in accrued expenses, see Note 10. Accrued restructuring charges at January 1, 2016 $ — French distribution and tissue procurement office closure costs 1,107 Asset abandonments (640 ) Cash payments (372 ) Accrued restructuring charges at December 31, 2016 $ 95
Employee Severance [Member]
Restructuring Charges	19. Severance Charges The Company recorded 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 were paid in full by December 31, 2016. 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 to reduce headcount and improve operational efficiencies, which resulted in $1,039 of expenses for the year ended December 31, 2016. The total severance charges are expected to be paid in full prior to the first quarter of 2018. Severance payments are made to terminated employees over periods ranging from one month to twelve months and are not expected to 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 10. Accrued severance charges at January 1, 2015 $ 2,771 Employee separation expenses accrued in 2015 995 Severance cash payments (2,591 ) Stock based compensation (310 ) Accrued severance charges at December 31, 2015 865 Employee separation expenses accrued in 2016 1,039 Severance cash payments (1,494 ) Accrued severance charges at December 31, 2016 $ 410 Subsequent to December 31, 2016, we have continued to execute on a restructuring plan, and have incurred additional severance related charges that will be recognized in 2017.

Retirement Benefits

Retirement Benefits	12 Months Ended
	Dec. 31, 2016
Compensation and Retirement Disclosure [Abstract]
Retirement Benefits	20. 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, 2016, 2015 and 2014, the amounts expensed under the plan were $3,094, $3,034 and $2,663, respectively.

Concentrations of Risk

Concentrations of Risk	12 Months Ended
	Dec. 31, 2016
Risks and Uncertainties [Abstract]
Concentrations of Risk	21. Concentrations of Risk Distribution Year Ended December 31, 2016 2015 2014 Percent of revenues derived from: Distributor Zimmer 16 % 24 % 18 % Medtronic 9 % 10 % 12 % Davol 3 % 3 % 5 % International 9 % 8 % 9 % 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, 2016
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	22. Commitments and Contingencies Distribution Agreement with Medtronic non-exclusive 12-month non-renewal Exclusive License Agreement with Athersys non-refundable Distribution Agreement with Zimmer Dental Inc. Distribution Agreement with Davol non-refundable non-refundable 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 non-cancelable Future minimum lease commitments under non-cancelable Operating Leases 2017 $ 1,936 2018 1,347 2019 1,007 2020 587 2021 and beyond 115 $ 4,992

Legal and Regulatory Actions

Legal and Regulatory Actions	12 Months Ended
	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Legal and Regulatory Actions	23. 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, 2016 will have a material adverse impact on its financial position or results of operations. Litigation and Settlement Charges. — Coloplast — co-defendant 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 (“Tissue-Non-Coloplast Tissue-Non-Coloplast 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. On September 30, 2014, the Company received a letter from the FDA regarding our map3® cellular allogeneic bone graft. The letter addresses some technical aspects of the processing of the map3® allograft, as well as language included on the Company’s website. The Company has ongoing dialogue with the FDA where comprehensive packages of data have been provided to address the FDA’s comments and provide clarifying information regarding the technical components of the implant processing. The Company believes that in both developing and processing of map3®, the Company has properly considered the relevant regulatory requirements. Additionally, the Company has removed the relevant information from the Company’s website. The Company is committed to resolving the concerns raised by the FDA. However, it is not possible to predict the specific outcome or timing of a resolution at this time.

Segment Data

Segment Data	12 Months Ended
	Dec. 31, 2016
Segment Reporting [Abstract]
Segment Data	24. 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. Effective January 1, 2016, the reporting of the Company’s lines of business is composed primarily of six categories: spine; sports medicine and orthopedics; surgical specialties; cardiothoracic; international; and global commercial. The Company’s previous lines of business were composed of: spine; ortho fixation; sports medicine; bone graft substitutes and general orthopedic; dental; and surgical specialties. The prior year comparable revenue information has been restated to conform to the current year presentation. The Company believes that the change in the reporting of its lines of business will facilitate a better understanding of the Company’s lines of business and align more closely with the end markets in which the Company competes. 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, 2016, 2015 and 2014: Year Ended December 31, 2016 2015 2014 (In thousands) Revenues: Spine $ 73,907 27.1 % $ 57,983 20.5 % $ 52,270 19.9 % Sports medicine and orthopedics 50,143 18.4 % 50,712 18.0 % 48,975 18.6 % Surgical specialties 4,466 1.6 % 3,029 1.1 % 1,631 0.6 % Cardiothoracic 11,147 4.1 % 8,699 3.1 % 6,997 2.7 % International 21,185 7.8 % 18,338 6.5 % 20,327 7.7 % Subtotal direct 160,848 59.0 % 138,761 49.2 % 130,200 49.5 % Global commercial 99,127 36.3 % 129,930 46.0 % 120,910 46.0 % Other revenues 12,890 4.7 % 13,602 4.8 % 11,700 4.5 % Total revenues $ 272,865 100.0 % $ 282,293 100.0 % $ 262,810 100.0 % Domestic revenues $ 247,756 90.8 % $ 260,387 92.2 % $ 238,936 90.9 % International revenues 25,109 9.2 % 21,906 7.8 % 23,874 9.1 % Total revenues $ 272,865 100.0 % $ 282,293 100.0 % $ 262,810 100.0 % The following table presents property, plant and equipment - net by significant geographic location: December 31, 2016 2015 Property, plant and equipment - net: Domestic $ 77,596 $ 72,901 International 5,702 12,091 Total $ 83,298 $ 84,992

Quarterly Results of Operations

Quarterly Results of Operations (Unaudited)	12 Months Ended
	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Quarterly Results of Operations (Unaudited)	25. 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 $ 67,351 $ 67,620 $ 66,547 $ 71,347 Gross profit 36,025 33,949 34,274 28,101 Net income (loss) applicable to common shares 1,543 (3,162 ) (4,489 ) (11,799 ) Net income (loss) per common share: Basic $ 0.03 $ (0.05 ) $ (0.08 ) $ (0.20 ) Diluted 0.03 (0.05 ) $ (0.08 ) $ (0.20 ) In 2016, the Company’s net income was negatively impacted by an excess inventory charge of $9,556, strategic review costs of $1,150, CEO retirement and transition costs of $4,404, contested proxy expenses of $2,680, asset impairment of $5,435, restructuring charges of $1,107 and severance charges of $1,039. 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 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.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2016
Subsequent Events [Abstract]
Subsequent Events	26. 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, 2016
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, 2016, 2015 and 2014 (Dollars in thousands) Description Balance at Charged to Deductions- Write-offs, Balance at For the year ended December 31, 2016: Allowance for doubtful accounts $ 1,454 $ 645 $ 371 $ 1,728 Allowance for product returns 714 250 335 629 Allowance for excess and obsolescence 7,083 13,880 6,165 14,798 Deferred tax asset valuation allowance 1,106 3,833 23 4,916 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 excess and 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 excess and obsolescence 5,399 3,763 4,050 5,112 Deferred tax asset valuation allowance 469 490 — 959

Summary of Significant Accoun33

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2016
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation RTIDS is a taxable not-for-profit
Use of Estimates	Use of Estimates
Foreign Currency Translation	Foreign Currency Translation
Presentation of Financial Statements - Going Concern	Presentation of Financial Statements - Going Concern “Presentation of Financial Statements - Going Concern (Subtopic 205-40).”
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 first-in, first-out Non-tissue Simplifying the Measurement of Inventory No. 2015-11, “Inventory (Topic 330): Simplifying the Measurement of Inventory” No. 2015-11 first-in, first-out No. 2015-11 No. 2015-11
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 to 5 years
Software Costs	Software Costs
Debt Issuance Costs	Debt Issuance Costs—
Long-Lived Assets	Long-Lived Assets
Goodwill	Goodwill Goodwill and Other Intangible Assets year-end Goodwill is tested for impairment annually by comparing the fair value of the reporting unit to its carrying amount, including goodwill. The Company adopted Accounting Standards Update (“ASU”) No. 2011-08, Intangibles – Goodwill and Other: Testing Goodwill for Impairment, than-not more-likely-than-not 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. Simplifying the Test for Goodwill Impairment No. 2017-04, Simplifying the Test for Goodwill Impairment” No. 2017-04”). No. 2017-04 No. 2017-04, No. 2017-04 No. 2017-04
Other Intangible Assets	Other Intangible Assets non-compete non-compete 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 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 consists of service processing, tissue recovery fees, biomedical laboratory fees, recognition of previously deferred revenues, shipping fees, distribution of reproductions of our allografts to distributors for demonstration purposes and restocking fees which is included in revenues.
Stock-Based Compensation Plans	Stock-Based Compensation Plans Accounting for Stock Compensation Staff Accounting Bulletin No. 107 pre-vesting Compensation – Stock Compensation No. 2016-09, “Compensation – Stock Compensation” 2016-09”). 2016-09 2016-09
Research and Development Costs	Research and Development Costs
Income Taxes	Income Taxes year-end Income Taxes No. 2015-17, “ Income Taxes (Topic 740) ” No. 2015-17 2015-17 non-current
Earnings Per Share	Earnings Per Share Year Ended December 31, 2016 2015 2014 Basic shares 58,236,745 57,611,231 56,735,924 Effect of dilutive securities: Stock options — 979,263 — Diluted shares 58,236,745 58,590,494 56,735,924 Options to purchase 5,764,607 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2016, 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 5,661,514 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. For the years ended December 31, 2016, 2015 and 2014, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted
Business Combinations - Clarifying the Definition of a Business	Business Combinations – Clarifying the Definition of a Business No. 2017-01, Business Combinations – Clarifying the Definition of a Business” No. 2017-01”). 2017-01 2017-01 2017-01 2017-01
Leases	Leases No. 2016-02 2016-02”), Leases (Topic 842) “Leases (Topic 840)” 2016-02
Simplifying the Presentation of Debt Issuance Costs	Simplifying the Presentation of Debt Issuance Costs No. 2015-03, Interest – Imputation of Interest: Simplifying the Presentation of Debt Issuance Costs” No. 2015-03”). No. 2015-03 No. 2015-03 No. 2015-03 assets-net”.
Revenue from Contracts with Customers	Revenue from Contracts with Customers No. 2014-09, “Revenue from Contracts with Customers” 2014-09”), “Revenue Recognition” 2014-09 2014-09 2014-09 In March and April 2016, the FASB issued two updates to the revenue recognition guidance: ASU 2016-08 “Principal Versus Agent Considerations” 2016-10, “Identifying Performance Obligations and Licensing” In May 2016, the FASB issued ASU Update No. 2016-12 “Narrow-Scope Improvements and Practical Expedients” 2016-12”) The Company has not determined the impact ASU 2014-09, 2016-08, 2016-10 2016-12

Summary of Significant Accoun34

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2016
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 to 5 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, 2016 2015 2014 Basic shares 58,236,745 57,611,231 56,735,924 Effect of dilutive securities: Stock options — 979,263 — Diluted shares 58,236,745 58,590,494 56,735,924

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2016
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, 2016 2015 2014 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 1.85 % 1.67 % 2.29 % Volatility factor 45.57 % 46.29 % 46.53 % Dividend yield — — —
Stock Options Outstanding, Exercisable and Available for Grant	Stock options outstanding, exercisable and available for grant at December 31, 2016, are summarized as follows: Number of Weighted Weighted Aggregate Outstanding at January 1, 2016 5,661,514 $ 4.49 Granted 619,352 3.31 Exercised (21,000 ) 2.72 Forfeited or expired (495,259 ) 5.54 Outstanding at December 31, 2016 5,764,607 $ 4.28 4.49 $ 348 Vested or expected to vest at December 31, 2016 5,590,546 $ 4.28 4.35 $ 348 Exercisable at December 31, 2016 4,082,632 $ 4.33 3.07 $ 348 Available for grant at December 31, 2016 3,314,686
Stock-Based Compensation Recognized	For the years ended December 31, 2016, 2015 and 2014, the Company recognized stock-based compensation as follows: Year Ended December 31, 2016 2015 2014 Stock-based compensation: Costs of processing and distribution $ 140 $ 132 $ 132 Marketing, general and administrative 3,406 2,356 2,840 Research and development 44 60 60 Total $ 3,590 $ 2,548 $ 3,032
Other Information Concerning Stock Options	Other information concerning stock options are as follows: Year Ended December 31, 2016 2015 2014 Weighted average fair value of stock options granted $ 1.55 $ 2.50 $ 1.87 Aggregate intrinsic value of stock options exercised 12 1,584 295

Inventories (Tables)

Inventories (Tables)	12 Months Ended
	Dec. 31, 2016
Inventory Disclosure [Abstract]
Components of Inventories	Inventories by stage of completion are as follows: December 31, 2016 2015 Unprocessed tissue, raw materials and supplies $ 31,745 $ 33,028 Tissue and work in process 38,552 36,614 Implantable tissue and finished goods 49,446 49,031 $ 119,743 $ 118,673

Property, Plant and Equipment (

Property, Plant and Equipment (Tables)	12 Months Ended
	Dec. 31, 2016
Property, Plant and Equipment [Abstract]
Components of Property, Plant and Equipment	Property, plant and equipment are as follows: December 31, 2016 2015 Land $ 2,324 $ 2,319 Buildings and improvements 59,187 63,699 Processing equipment 38,387 41,831 Surgical instruments 18,394 15,702 Office equipment, furniture and fixtures 1,701 4,657 Computer equipment and software 11,852 11,804 Construction in process 17,554 10,850 Office equipment under capital leases — 152 149,399 151,014 Less accumulated depreciation (66,101 ) (66,022 ) $ 83,298 $ 84,992

Other Intangible Assets (Tables

Other Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2016
Goodwill and Intangible Assets Disclosure [Abstract]
Components of Other Intangible Assets	Other intangible assets are as follows: December 31, 2016 December 31, 2015 Gross Accumulated Gross Accumulated Patents $ 11,559 $ 4,159 $ 11,532 $ 3,448 Acquired licensing rights 12,204 8,302 10,850 7,691 Marketing and procurement intangible assets 20,694 8,002 22,179 7,209 Total $ 44,457 $ 20,463 $ 44,561 $ 18,348
Estimates of Future Amortization Expense	At December 31, 2016, management’s estimates of future amortization expense for the next five years are as follows: Amortization Expense 2017 $ 3,400 2018 3,400 2019 3,400 2020 3,400 2021 3,400 $ 17,000

Fair Value Information (Tables)

Fair Value Information (Tables)	12 Months Ended
	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Summary of Impairments of Long-Lived Assets and Related Post Impairment Fair Values	The following table summarizes impairments of long-lived assets and the related post impairment fair values of the corresponding assets for the year ended December 31, 2016: Year Ended December 31, 2016 Impairment Fair Value Property, plant and equipment - net $ 4,717 $ 4,708 Other intangible assets - net 718 150 $ 5,435 $ 4,858

Accrued Expenses (Tables)

Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2016
Other Liabilities Disclosure [Abstract]
Accrued Expenses	Accrued expenses are as follows: December 31, 2016 2015 Accrued compensation $ 4,904 $ 4,740 Accrued severance charges 410 865 Accrued restructuring charges 95 — Accrued CEO retirement and transition costs 2,406 — Accrued distributor commissions 4,422 3,835 Accrued donor recovery fees 6,350 7,144 Accrued taxes — 514 Accrued indemnification liability — 6,579 Other 3,443 4,932 $ 22,030 $ 28,609

Short and Long-Term Obligatio41

Short and Long-Term Obligations (Tables)	12 Months Ended
	Dec. 31, 2016
Debt Disclosure [Abstract]
Short and Long-Term Obligations	Short and long-term obligations are as follows: December 31, 2016 2015 Term loan $ 50,347 $ 53,722 Credit facilities 33,000 25,477 Capital leases — 38 Total 83,347 79,237 Less current portion (6,080 ) (5,853 ) Long-term portion $ 77,267 $ 73,384
Contractual Maturities of Long-Term Obligations	As of December 31, 2016, contractual maturities of short and long-term obligations are as follows: Term Loan Credit Total 2017 $ 6,080 $ — $ 6,080 2018 44,267 33,000 77,267 $ 50,347 $ 33,000 $ 83,347

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Income Tax Benefit (Provision)	The Company’s income tax benefit (provision) consists of the following components: Year Ended December 31, 2016 2015 2014 Current: Federal $ (150 ) $ (988 ) $ (1,062 ) State (92 ) (159 ) (150 ) International 456 (544 ) (86 ) Total current 214 (1,691 ) (1,298 ) Deferred: Federal 2,477 (5,695 ) (1,118 ) State 562 68 (76 ) International (192 ) (981 ) 999 Total deferred 2,847 (6,608 ) (195 ) Total income tax benefit (provision) $ 3,061 $ (8,299 ) $ (1,493 )
Deferred Tax Assets and Liabilities	The components of the deferred tax assets and liabilities consisted of the following at: December 31, 2016 December 31, 2015 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities Allowance for bad debts $ 485 $ — $ 376 $ — Deferred compensation 4,675 — 4,013 — Inventory 12,811 — 10,604 — Fixed assets and intangibles — (5,690 ) — (7,667 ) Investments 2,133 — 2,133 — Net operating losses 4,547 — 2,830 — Tax credits 5,235 — 4,645 — Deferred revenue 3,804 — 4,968 — Accrued liabilities 2,004 — 1,847 — Other — (120 ) — (258 ) Valuation allowance (4,916 ) — (1,106 ) — Total $ 30,778 $ (5,810 ) $ 30,310 $ (7,925 )
Unrecognized Tax Benefits	The Company’s unrecognized tax benefits are summarized as follows: Year Ended December 31, 2016 2015 2014 Opening balance $ 1,986 $ 1,787 $ 2,825 Reductions based on tax positions related to the current year — — (136 ) Additions for tax positions of prior years — 199 — Reductions for tax positions of prior years (60 ) — (902 ) Reductions for expiration of statute of limitations (335 ) — — $ 1,591 $ 1,986 $ 1,787
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, 2016 2015 2014 Statutory federal rate 35.00 % 35.00 % 35.00 % State income taxes—net of federal tax benefit 1.73 % 0.25 % 3.51 % Foreign rate differential (3.29 %) (2.18 %) 4.99 % Other permanent items (3.15 %) 0.56 % (1.25 %) Research tax credits 7.02 % (0.28 %) (7.52 %) Domestic production activities deduction 1.38 % — (4.33 %) Valuation allowance (21.71 %) 0.85 % 5.26 % Other reconciling items, net 0.55 % 1.55 % (0.02 %) Effective tax rate 17.53 % 35.75 % 35.64 %

Preferred Stock (Tables)

Preferred Stock (Tables)	12 Months Ended
	Dec. 31, 2016
Equity [Abstract]
Schedule of Preferred Stock	Preferred stock is as follows: Preferred Stock Preferred Stock Net Liquidation Value Issuance Costs Total Balance at January 1, 2014 $ 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 Accrued dividend payable 3,508 — 3,508 Amortization of preferred stock issuance costs — 185 185 Balance at December 31, 2016 $ 60,676 $ (660 ) $ 60,016

CEO Retirement and Transition44

CEO Retirement and Transition Costs (Tables)	12 Months Ended
	Dec. 31, 2016
Schedule of Restructuring Charges	The following table includes a rollforward of restructuring charges included in accrued expenses, see Note 10. Accrued restructuring charges at January 1, 2016 $ — French distribution and tissue procurement office closure costs 1,107 Asset abandonments (640 ) Cash payments (372 ) Accrued restructuring charges at December 31, 2016 $ 95
Employee Severance [Member]
Schedule of Restructuring Charges	The following table includes a rollforward of severance charges included in accrued expenses, see Note 10. Accrued severance charges at January 1, 2015 $ 2,771 Employee separation expenses accrued in 2015 995 Severance cash payments (2,591 ) Stock based compensation (310 ) Accrued severance charges at December 31, 2015 865 Employee separation expenses accrued in 2016 1,039 Severance cash payments (1,494 ) Accrued severance charges at December 31, 2016 $ 410
Former Chief Executive Officer [Member]
Schedule of Restructuring Charges	The following table includes a rollforward of CEO retirement and transition costs included in accrued expenses, see Note 10. Accrued CEO retirement and transition costs at January 1, 2016 $ — CEO retirement and transition costs accured in 2016 4,404 Stock-based compensation (1,535 ) Cash payments (463 ) Accrued restructuring charges at December 31, 2016 $ 2,406

Concentrations of Risk (Tables)

Concentrations of Risk (Tables)	12 Months Ended
	Dec. 31, 2016
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, 2016 2015 2014 Percent of revenues derived from: Distributor Zimmer 16 % 24 % 18 % Medtronic 9 % 10 % 12 % Davol 3 % 3 % 5 % International 9 % 8 % 9 %

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Future Minimum Lease Commitments under Non-Cancelable Operating Leases	Future minimum lease commitments under non-cancelable Operating Leases 2017 $ 1,936 2018 1,347 2019 1,007 2020 587 2021 and beyond 115 $ 4,992

Segment Data (Tables)

Segment Data (Tables)	12 Months Ended
	Dec. 31, 2016
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, 2016, 2015 and 2014: Year Ended December 31, 2016 2015 2014 (In thousands) Revenues: Spine $ 73,907 27.1 % $ 57,983 20.5 % $ 52,270 19.9 % Sports medicine and orthopedics 50,143 18.4 % 50,712 18.0 % 48,975 18.6 % Surgical specialties 4,466 1.6 % 3,029 1.1 % 1,631 0.6 % Cardiothoracic 11,147 4.1 % 8,699 3.1 % 6,997 2.7 % International 21,185 7.8 % 18,338 6.5 % 20,327 7.7 % Subtotal direct 160,848 59.0 % 138,761 49.2 % 130,200 49.5 % Global commercial 99,127 36.3 % 129,930 46.0 % 120,910 46.0 % Other revenues 12,890 4.7 % 13,602 4.8 % 11,700 4.5 % Total revenues $ 272,865 100.0 % $ 282,293 100.0 % $ 262,810 100.0 % Domestic revenues $ 247,756 90.8 % $ 260,387 92.2 % $ 238,936 90.9 % International revenues 25,109 9.2 % 21,906 7.8 % 23,874 9.1 % Total revenues $ 272,865 100.0 % $ 282,293 100.0 % $ 262,810 100.0 %
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, 2016 2015 Property, plant and equipment - net: Domestic $ 77,596 $ 72,901 International 5,702 12,091 Total $ 83,298 $ 84,992

Quarterly Results of Operatio48

Quarterly Results of Operations (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2016
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 $ 67,351 $ 67,620 $ 66,547 $ 71,347 Gross profit 36,025 33,949 34,274 28,101 Net income (loss) applicable to common shares 1,543 (3,162 ) (4,489 ) (11,799 ) Net income (loss) per common share: Basic $ 0.03 $ (0.05 ) $ (0.08 ) $ (0.20 ) Diluted 0.03 (0.05 ) $ (0.08 ) $ (0.20 ) 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

Summary of Significant Accoun49

Summary of Significant Accounting Policies - Additional Information (Detail)	3 Months Ended	12 Months Ended
	Dec. 31, 2015USD ($)$ / shares	Dec. 31, 2016USD ($)Segment$ / sharesshares	Dec. 31, 2015USD ($)$ / sharesshares	Dec. 31, 2014$ / 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)	$ (5,435,000)	(814,000)
Number of reportable segments | Segment		1
Other identifiable intangible assets	$ 0	$ 0	$ 0
Acquired exclusivity rights, remaining amortization period		8 years
Dividend yield		0.00%
Common stock price ranging | $ / shares	$ 4.49	$ 4.28	$ 4.49
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		5,764,607	5,661,514	5,735,784
German Bank Credit Facilities [Member]
Summary Of Significant Accounting Policies [Line Items]
Asset abandonments		$ (5,400,000)	$ (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	$ 2.69
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	$ 9.57
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 Accoun50

Summary of Significant Accounting Policies - Property, Plant, and Equipment are Stated at Cost Less Accumulated Depreciation (Detail)	12 Months Ended
	Dec. 31, 2016
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
Minimum [Member] | Surgical Instruments [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
Maximum [Member] | Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property plant and equipment useful life	5 years

Summary of Significant Accoun51

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, 2016	Dec. 31, 2015	Dec. 31, 2014
Earnings Per Share [Abstract]
Basic shares	58,236,745	57,611,231	56,735,924
Effect of dilutive securities: Stock options		979,263
Diluted shares	58,236,745	58,590,494	56,735,924

Recently Issued Accounting St52

Recently Issued Accounting Standards - Additional Information (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Accounting Changes and Error Corrections [Abstract]
Debt issuance costs	$ 403	$ 403

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		12 Months Ended
	Sep. 30, 2016	Mar. 31, 2016	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Contractual term of stock options granted			10 years
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			$ (3,061)	$ 8,299	$ 1,493
Total unrecognized stock-based compensation			$ 961
Stock-based compensation awards, weighted-average period recognized			1 year 4 months 24 days
Restricted Stock Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period	1 year
Restricted stock granted during period	162,160
Weighted-average grant date fair value of restricted stock granted	$ 3.70
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			$ 1,460	$ 1,022	$ 1,198
Total unrecognized stock-based compensation			$ 2,212
Stock-based compensation awards, weighted-average period recognized			2 years 11 months 1 day
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			4,656,587
Performance Based Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period		3 years
Restricted stock granted during period		223,563
Weighted-average grant date fair value of restricted stock granted		$ 3.31
Time Based Restricted Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period		3 years
Restricted stock granted during period		223,563
Weighted-average grant date fair value of restricted stock granted		$ 3.31

Stock-Based Compensation - Weig

Stock-Based Compensation - Weighted-Average Assumptions Used to Determine Fair Value of Options (Detail)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
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	1.85%	1.67%	2.29%
Volatility factor	45.57%	46.29%	46.53%
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, 2016USD ($)$ / sharesshares
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Outstanding, Number of Options	5,661,514
Granted, Number of Options	619,352
Exercised, Number of Options	(21,000)
Forfeited or expired, Number of Options	(495,259)
Outstanding, Number of Options	5,764,607
Vested or expected to vest, Number of Options	5,590,546
Exercisable, Number of Options	4,082,632
Available for grant, Number of Options	3,314,686
Outstanding, Weighted Average Exercise Price | $ / shares	$ 4.49
Granted, Weighted Average Exercise Price | $ / shares	3.31
Exercised, Weighted Average Exercise Price | $ / shares	2.72
Forfeited or expired, Weighted Average Exercise Price | $ / shares	5.54
Outstanding, Weighted Average Exercise Price | $ / shares	4.28
Vested or expected to vest, Weighted Average Exercise Price | $ / shares	4.28
Exercisable, Weighted Average Exercise Price | $ / shares	$ 4.33
Outstanding, Weighted Average Remaining Contractual Life (Years)	4 years 5 months 27 days
Vested or expected to vest, Weighted Average Remaining Contractual Life (Years)	4 years 4 months 6 days
Exercisable, Weighted Average Remaining Contractual Life (Years)	3 years 26 days
Outstanding, Aggregate Intrinsic Value | $	$ 348
Vested or expected to vest, Aggregate Intrinsic Value | $	348
Exercisable, Aggregate Intrinsic Value | $	$ 348

Stock-Based Compensation - St56

Stock-Based Compensation - Stock-Based Compensation Recognized (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 3,590	$ 2,548	$ 3,032
Costs of Processing and Distribution [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	140	132	132
Marketing, General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	3,406	2,356	2,840
Research and Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 44	$ 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, 2016	Dec. 31, 2015	Dec. 31, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Weighted average fair value of stock options granted	$ 1.55	$ 2.50	$ 1.87
Aggregate intrinsic value of stock options exercised	$ 12	$ 1,584	$ 295

Inventories - Components of Inv

Inventories - Components of Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Inventory Disclosure [Abstract]
Unprocessed tissue, raw materials and supplies	$ 31,745	$ 33,028
Tissue and work in process	38,552	36,614
Implantable tissue and finished goods	49,446	49,031
Inventory - net	$ 119,743	$ 118,673

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Inventory [Line Items]
Provision for inventory write-downs	$ 13,880	$ 5,390	$ 3,763
Excess inventory charge	9,556
Hernia and Sports Medicine Inventory [Member]
Inventory [Line Items]
Excess inventory charge	$ 9,556

Property, Plant and Equipment -

Property, Plant and Equipment - Components of Property, Plant and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 149,399	$ 151,014
Less accumulated depreciation	(66,101)	(66,022)
Property, plant and equipment, net	83,298	84,992
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	2,324	2,319
Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	59,187	63,699
Processing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	38,387	41,831
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	18,394	15,702
Office Equipment, Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	1,701	4,657
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	11,852	11,804
Construction in Process [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 17,554	10,850
Office Equipment Under Capital Leases [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross		$ 152

Property,Plant and Equipment -

Property,Plant and Equipment - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Property, Plant and Equipment [Abstract]
Depreciation expense in connection with property, plant and equipment	$ 12,835	$ 12,240	$ 11,010

Goodwill - Additional Informati

Goodwill - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	$ 54,887	$ 54,887
Goodwill impairment loss	$ 0

Other Intangible Assets - Compo

Other Intangible Assets - Components of Other Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 44,457	$ 44,561
Accumulated Amortization	20,463	18,348
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,559	11,532
Accumulated Amortization	4,159	3,448
Acquired Licensing Rights [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	12,204	10,850
Accumulated Amortization	8,302	7,691
Marketing and Procurement Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	20,694	22,179
Accumulated Amortization	$ 8,002	$ 7,209

Other Intangible Assets - Addit

Other Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense of other intangible assets	$ 3,675	$ 4,282	$ 4,385

Other Intangible Assets - Estim

Other Intangible Assets - Estimates of Future Amortization Expense (Detail) $ in Thousands	Dec. 31, 2016USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2,017	$ 3,400
2,018	3,400
2,019	3,400
2,020	3,400
2,021	3,400
Total future amortization expense	$ 17,000

Fair Value Information - Summar

Fair Value Information - Summary of Impairments of Long-Lived Assets and Related Post Impairment Fair Values (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)
Fair Value Disclosures [Abstract]
Property, plant and equipment - net, impairment	$ 4,717
Other intangible assets - net, impairment	718
Asset impairment	5,435
Property, plant and equipment - net, fair value	4,708
Other intangible assets - net, fair value	150
Post impairment fair values	$ 4,858

Accrued Expenses - Accrued Expe

Accrued Expenses - Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Payables and Accruals [Abstract]
Accrued compensation	$ 4,904	$ 4,740
Accrued severance charges	410	865
Accrued restructuring charges	95
Accrued CEO retirement and transition costs	2,406
Accrued distributor commissions	4,422	3,835
Accrued donor recovery fees	6,350	7,144
Accrued taxes		514
Accrued indemnification liability		6,579
Other	3,443	4,932
Total accrued expenses	$ 22,030	$ 28,609

Accrued Expenses - Additional I

Accrued Expenses - Additional Information (Detail) - USD ($) $ in Thousands	Jul. 11, 2016	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Payables and Accruals [Abstract]
Reduction in prepaid and other current assets	$ 6,694
Reduction in accrued expenses	$ 6,579	$ (6,536)	$ 5,532	$ 1,375

Short and Long-Term Obligatio69

Short and Long-Term Obligations - Short and Long-Term Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Debt Disclosure [Abstract]
Term loan	$ 50,347	$ 53,722
Credit facilities	33,000	25,477
Capital leases		38
Debt and capital lease obligation, total	83,347	79,237
Debt and capital lease obligation, total	83,347	79,237
Less current portion	(6,080)	(5,853)
Long-term portion	$ 77,267	$ 73,384

Short and Long-Term Obligatio70

Short and Long-Term Obligations - Additional Information (Detail)	Mar. 31, 2017	Nov. 07, 2016USD ($)	Feb. 28, 2017	Dec. 31, 2016USD ($)Debt_Instruments	Dec. 31, 2015USD ($)	Dec. 31, 2014USD ($)	Nov. 06, 2016USD ($)	Jun. 29, 2016USD ($)	Jun. 29, 2015USD ($)
Line of Credit Facility [Line Items]
Credit outstanding				$ 33,000,000	$ 25,477,000
Interest expense associated with the amortization of debt issuance costs				202,000	$ 148,000	$ 142,000
Minimum [Member]
Line of Credit Facility [Line Items]
Leverage to EBITDA Ratio		250.00%
Maximum [Member]
Line of Credit Facility [Line Items]
Leverage to EBITDA Ratio		325.00%
Scenario, Forecast [Member]
Line of Credit Facility [Line Items]
Leverage to EBITDA Ratio	300.00%
Credit Facilities [Member]
Line of Credit Facility [Line Items]
Credit outstanding				$ 33,000,000
Long-term obligations outstanding, number | Debt_Instruments				1
Current borrowing capacity				$ 9,500,000
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				3.37%
Aggregate principal payment on term loan				$ 8,250,000
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.
Amount of final balloon principal payment				$ 41,375,000
TD Bank and Regions Bank Senior Secured Facility [Member] | Minimum [Member]
Line of Credit Facility [Line Items]
Variable interest rate				1.00%
TD Bank and Regions Bank Senior Secured Facility [Member] | Maximum [Member]
Line of Credit Facility [Line Items]
Variable interest rate				2.75%
TD Bank and Regions Bank Senior Secured Facility [Member] | Scenario, Forecast [Member]
Line of Credit Facility [Line Items]
Variable interest rate			3.00%
TD Bank and Regions Bank Senior Secured Facility [Member] | Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Credit facility, borrowing capacity		$ 42,500,000		$ 20,000,000			$ 45,000,000	$ 45,000,000	$ 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]
Long-term obligations outstanding, number | Debt_Instruments				3
Number of credit facilities paid off and cancelled | Debt_Instruments				3

Short and Long-Term Obligatio71

Short and Long-Term Obligations - Contractual Maturities of Long-Term Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
2,017	$ 6,080
2,018	77,267
Debt and capital lease obligation, total	83,347	$ 79,237
Term Loan [Member]
Debt Instrument [Line Items]
2,017	6,080
2,018	44,267
Debt and capital lease obligation, total	50,347
Credit Facilities [Member]
Debt Instrument [Line Items]
2,018	33,000
Debt and capital lease obligation, total	$ 33,000

Income Taxes - Income Tax Benef

Income Taxes - Income Tax Benefit (Provision) (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Current:
Federal	$ (150)	$ (988)	$ (1,062)
State	(92)	(159)	(150)
International	456	(544)	(86)
Total current	214	(1,691)	(1,298)
Deferred:
Federal	2,477	(5,695)	(1,118)
State	562	68	(76)
International	(192)	(981)	999
Total deferred	2,847	(6,608)	(195)
Total income tax benefit (provision)	$ 3,061	$ (8,299)	$ (1,493)

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Deferred income tax asset, allowance for bad debts	$ 485	$ 376
Deferred income tax asset, deferred compensation	4,675	4,013
Deferred income tax asset, inventory	12,811	10,604
Deferred income tax asset, fixed assets and intangibles	0	0
Deferred income tax asset, investments	2,133	2,133
Deferred income tax asset, net operating losses	4,547	2,830
Deferred income tax asset, tax credits	5,235	4,645
Deferred income tax asset, deferred revenue	3,804	4,968
Deferred income tax asset, accrued liabilities	2,004	1,847
Deferred income tax asset, other	0	0
Deferred income tax asset, valuation allowance	(4,916)	(1,106)
Deferred income tax asset, total	30,778	30,310
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	(5,690)	(7,667)
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	(120)	(258)
Deferred income tax liability, valuation allowance	0	0
Deferred income tax liability, total	$ (5,810)	$ (7,925)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013
Operating Loss Carryforwards [Line Items]
Deferred tax assets	$ 24,968,000
Deferred tax assets, valuation allowances	4,916,000
Tax benefit from exercise of stock options	546,000	$ 1,139,000	$ 539,000
Research tax credit carryforwards	$ 6,002,000
Research tax credit carryforwards, first year of expiration period	2,028
Research tax credit carryforwards, last year of expiration period	2,036
Alternative minimum tax credit carryforwards	$ 827,000
Undistributed earnings of foreign subsidiaries	$ 5,031,000	11,227,000
Primary measure of cumulative losses, number of rolling years	3 years
Utilized percentage of deferred tax assets before expiration	100.00%
Unrecognized tax benefits	$ 1,591,000	1,986,000	1,787,000	$ 2,825,000
Interest and penalties recorded	0	0	0
Interest and penalties accrued	0	0
Significant other reconciling items	0	0	$ 0
Domestic Tax Authority [Member]
Operating Loss Carryforwards [Line Items]
Deferred tax assets, valuation allowances	4,916,000	$ 1,106,000
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	$ 22,799,000
Net operating loss carryforward expiration period, start year	2,018
Net operating loss carryforward expiration period, end year	2,036
Foreign Tax Authority [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards	$ 10,194,000
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, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Opening balance	$ 1,986	$ 1,787	$ 2,825
Reductions based on tax positions related to the current year			(136)
Additions for tax positions of prior years		199
Reductions for tax positions of prior years	(60)		(902)
Reductions for expiration of statute of limitations	(335)
Closing balance	$ 1,591	$ 1,986	$ 1,787

Income Taxes - Effective Tax Ra

Income Taxes - Effective Tax Rate Differs from the Statutory Federal Income Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Disclosure [Abstract]
Statutory federal rate	35.00%	35.00%	35.00%
State income taxes-net of federal tax benefit	1.73%	0.25%	3.51%
Foreign rate differential	(3.29%)	(2.18%)	4.99%
Other permanent items	(3.15%)	0.56%	(1.25%)
Research tax credits	7.02%	(0.28%)	(7.52%)
Domestic production activities deduction	1.38%		(4.33%)
Valuation allowance	(21.71%)	0.85%	5.26%
Other reconciling items, net	0.55%	1.55%	(0.02%)
Effective tax rate	17.53%	35.75%	35.64%

Preferred Stock - Schedule of P

Preferred Stock - Schedule of Preferred Stock (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Jan. 01, 2014
Temporary Equity [Line Items]
Net Total	$ 60,016	$ 56,323	$ 52,834	$ 49,537
Accrued dividend payable	3,508	3,305	3,113
Amortization of preferred stock issuance costs	185	184	184
Amortization of preferred stock issuance costs	185	184	184
Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Preferred Stock Liquidation Value	60,676	57,168	53,863	50,750
Preferred Stock Issuance Costs	(660)	(845)	(1,029)	$ (1,213)
Accrued dividend payable	$ 3,508	$ 3,305	$ 3,113

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, 2016
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 days

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016Voteshares	Dec. 31, 2015shares
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

Strategic Review Costs - Additi

Strategic Review Costs - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)
Research and Development [Abstract]
Strategic review costs	$ 1,150

CEO Retirement and Transition81

CEO Retirement and Transition Costs - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)
Postemployment Benefits Disclosure [Line Items]
Retirement and transition costs	$ 4,404
Former Chief Executive Officer [Member]
Postemployment Benefits Disclosure [Line Items]
Retirement and transition costs	$ 4,404

CEO Retirement and Transition82

CEO Retirement and Transition Costs - Schedule of Restructuring Charges (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Restructuring Cost and Reserve [Line Items]
CEO retirement and transition costs accrued in 2016	$ 4,404
Stock-based compensation		$ (310)
Cash payments	(372)
Accrued restructuring charges at December 31, 2016	2,406
Former Chief Executive Officer [Member]
Restructuring Cost and Reserve [Line Items]
CEO retirement and transition costs accrued in 2016	4,404
Stock-based compensation	(1,535)
Cash payments	(463)
Accrued restructuring charges at December 31, 2016	$ 2,406

Contested Proxy Expenses - Addi

Contested Proxy Expenses - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)
Other Income and Expenses [Abstract]
Contested proxy expenses	$ 2,680

Restructuring Charges - Additio

Restructuring Charges - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)
Restructuring and Related Activities [Abstract]
French distribution and tissue procurement office closure costs	$ 1,107

Restructuring Charges - Schedul

Restructuring Charges - Schedule of Restructuring Charges (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2016USD ($)
Restructuring and Related Activities [Abstract]
French distribution and tissue procurement office closure costs	$ 1,107
Asset abandonments	(640)
Cash payments	(372)
Accrued restructuring charges, ending balance	$ 95

Severance Charges - Additional

Severance Charges - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Restructuring and Related Activities [Abstract]
Severance charges related to the termination of former employees	$ 1,039	$ 995	$ 4,798

Severance Charges - Schedule of

Severance Charges - Schedule of Restructuring Charges (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Restructuring Cost and Reserve [Line Items]
Employee separation expenses accrued	$ 1,039	$ 995	$ 4,798
Severance cash payments	(372)
Stock based compensation		(310)
Accrued restructuring charges, ending balance	95
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Accrued restructuring charges, beginning balance	865	2,771
Employee separation expenses accrued	1,039	995
Severance cash payments	(1,494)	(2,591)
Stock based compensation		(310)
Accrued restructuring charges, ending balance	$ 410	$ 865	$ 2,771

Retirement Benefits - Additiona

Retirement Benefits - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Defined Benefit Plan Disclosure [Line Items]
Cost recognized under benefit plan	$ 3,094	$ 3,034	$ 2,663
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, 2016Companies
Risks and Uncertainties [Abstract]
Companies with revenues	12
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, 2016	Dec. 31, 2015	Dec. 31, 2014
Zimmer Biomet Holdings, Inc. [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	16.00%	24.00%	18.00%
Medtronic, PLC [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	9.00%	10.00%	12.00%
Davol, Inc. [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	3.00%	3.00%	5.00%
International Customers [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	9.00%	8.00%	9.00%

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, 2016	Dec. 31, 2015	Dec. 31, 2014
Commitment And Contingencies [Line Items]
Exclusivity payments								$ 3,500
Deferred revenue recognition								2,000	$ 2,000
Rent expense								$ 1,378	$ 1,443	$ 1,609
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 Contingencies92

Commitments and Contingencies - Future Minimum Lease Commitments under Non-Cancelable Operating Leases (Detail) $ in Thousands	Dec. 31, 2016USD ($)
Commitments and Contingencies Disclosure [Abstract]
2,017	$ 1,936
2,018	1,347
2,019	1,007
2,020	587
2021 and beyond	115
Total	$ 4,992

Legal and Regulatory Actions -

Legal and Regulatory Actions - Additional Information (Detail) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2015USD ($)Entity	Dec. 31, 2016LitigationClaims
Commitments and Contingencies Disclosure [Abstract]
Outstanding claims | Litigation		0
Litigation and settlement charges | $	$ 804
Number of entities which agreement signed | Entity	3
Claims for which the Company Parties are providing defense and indemnification | Claims		1,445

Segment Data - Additional Infor

Segment Data - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2016Segment
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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Segment Reporting Information [Line Items]
Other revenues									$ 12,890	$ 13,602	$ 11,700
Revenues	$ 71,347	$ 66,547	$ 67,620	$ 67,351	$ 76,121	$ 66,529	$ 71,609	$ 68,034	$ 272,865	$ 282,293	$ 262,810
Percentage of other revenues									4.70%	4.80%	4.50%
Percentage of revenues									100.00%	100.00%	100.00%
Domestic [Member]
Segment Reporting Information [Line Items]
Revenues									$ 247,756	$ 260,387	$ 238,936
Percentage of domestic revenues									90.80%	92.20%	90.90%
International [Member]
Segment Reporting Information [Line Items]
Revenues									$ 25,109	$ 21,906	$ 23,874
Percentage of international revenues									9.20%	7.80%	9.10%
Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 160,848	$ 138,761	$ 130,200
Percentage of sales revenue									59.00%	49.20%	49.50%
Spine [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 73,907	$ 57,983	$ 52,270
Percentage of sales revenue									27.10%	20.50%	19.90%
Sports Medicine and Orthopedics [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 50,143	$ 50,712	$ 48,975
Percentage of sales revenue									18.40%	18.00%	18.60%
Surgical Specialties [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 4,466	$ 3,029	$ 1,631
Percentage of sales revenue									1.60%	1.10%	0.60%
Cardiothoracic [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 11,147	$ 8,699	$ 6,997
Percentage of sales revenue									4.10%	3.10%	2.70%
International [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 21,185	$ 18,338	$ 20,327
Percentage of sales revenue									7.80%	6.50%	7.70%
Global Commercial [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 99,127	$ 129,930	$ 120,910
Percentage of sales revenue									36.30%	46.00%	46.00%

Segment Data - Schedule of Prop

Segment Data - Schedule of Property, Plant and Equipment - Net by Significant Geographic Location (Detail) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 83,298	$ 84,992
Domestic [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	77,596	72,901
International [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 5,702	$ 12,091

Quarterly Results of Operatio97

Quarterly Results of Operations (Unaudited) - Results of Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Quarterly Financial Information Disclosure [Abstract]
Revenues	$ 71,347	$ 66,547	$ 67,620	$ 67,351	$ 76,121	$ 66,529	$ 71,609	$ 68,034	$ 272,865	$ 282,293	$ 262,810
Gross profit	28,101	34,274	33,949	36,025	40,307	35,233	37,203	36,999	132,349	149,742	133,797
Net income (loss) applicable to common shares	$ (11,799)	$ (4,489)	$ (3,162)	$ 1,543	$ 3,321	$ 2,670	$ 2,685	$ 2,934	$ (17,907)	$ 11,610	$ (417)
Net income (loss) per common share:
Basic	$ (0.20)	$ (0.08)	$ (0.05)	$ 0.03	$ 0.06	$ 0.05	$ 0.05	$ 0.05	$ (0.31)	$ 0.20	$ (0.01)
Diluted	$ (0.20)	$ (0.08)	$ (0.05)	$ 0.03	$ 0.06	$ 0.05	$ 0.05	$ 0.05	$ (0.31)	$ 0.20	$ (0.01)

Quarterly Results of Operatio98

Quarterly Results of Operations (Unaudited) - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Dec. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Interim Reporting [Line Items]
Excess inventory charge		$ 9,556
Strategic review costs		1,150
CEO Retirement and transition costs		4,404
Contested proxy expenses		2,680
Asset abandonments	$ 814	5,435	$ 814
Restructuring charges		1,107
Severance charges		$ 1,039	$ 995	$ 4,798
Litigation settlement charge	804
Pioneer [Member]
Interim Reporting [Line Items]
Severance charges	$ 995

Schedule II - Valuation and Q99

Schedule II - Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Allowance for Doubtful Accounts [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	$ 1,454	$ 818	$ 492
Charged to Costs and Expenses	645	1,037	709
Deductions- Write-offs, Payments	371	401	383
Balance at End of Period	1,728	1,454	818
Allowance for Product Returns [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	714	525	343
Charged to Costs and Expenses	250	531	182
Deductions- Write-offs, Payments	335	342
Balance at End of Period	629	714	525
Allowance for Excess and Obsolescence [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	7,083	5,112	5,399
Charged to Costs and Expenses	13,880	5,390	3,763
Deductions- Write-offs, Payments	6,165	3,419	4,050
Balance at End of Period	14,798	7,083	5,112
Deferred Tax Asset Valuation Allowance [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	1,106	959	469
Charged to Costs and Expenses	3,833	197	490
Deductions- Write-offs, Payments	23	50
Balance at End of Period	$ 4,916	$ 1,106	$ 959