RTI Surgical (RTIX) 10-K 2 Mar 18 2017 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2017	Feb. 23, 2018	Jun. 30, 2017
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2017
Document Fiscal Year Focus	2,017
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		62,757,731
Entity Public Float			$ 347.8

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Current Assets:
Cash and cash equivalents	$ 22,381	$ 13,849
Accounts receivable-less allowances of $1,471 at December 31, 2017 and $1,728 at December 31, 2016	35,081	41,488
Inventories-net	111,927	119,743
Prepaid and other current assets	16,285	5,213
Total current assets	185,674	180,293
Property, plant and equipment-net	79,564	83,298
Deferred tax assets-net	9,575	24,968
Goodwill	46,242	54,887
Other intangible assets-net	23,070	23,994
Other assets-net	1,781	591
Total assets	345,906	368,031
Current Liabilities:
Accounts payable	18,252	26,112
Accrued expenses	25,610	22,030
Current portion of deferred revenue	4,868	4,742
Current portion of short and long-term obligations	4,268	6,080
Total current liabilities	52,998	58,964
Long-term obligations-less current portion	42,076	77,267
Other long-term liabilities	1,431	256
Deferred revenue	3,741	6,612
Total liabilities	100,246	143,099
Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding	63,923	60,016
Stockholders' equity:
Common stock, $.001 par value: 150,000,000 shares authorized; 62,694,441 and 58,433,397 shares issued and outstanding, respectively	63	58
Additional paid-in capital	429,459	417,428
Accumulated other comprehensive loss	(6,329)	(8,316)
Accumulated deficit	(237,066)	(243,338)
Less treasury stock, 1,114,071 and 368,949 shares, respectively, at cost	(4,390)	(916)
Total stockholders' equity	181,737	164,916
Total liabilities and stockholders' equity	$ 345,906	$ 368,031

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 1,471	$ 1,728
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	62,694,441	62,694,441
Common stock, shares outstanding	58,433,397	58,433,397
Treasury stock, shares	1,114,071	368,949

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Statement [Abstract]
Revenues	$ 279,563	$ 272,865	$ 282,293
Costs of processing and distribution	137,042	140,516	132,551
Gross profit	142,521	132,349	149,742
Expenses:
Marketing, general and administrative	115,103	116,125	107,439
Research and development	13,375	16,090	15,065
Severance and restructuring costs	12,173	2,146	995
Strategic review costs		1,150
Executive transition costs	2,781	4,404
Contested proxy expenses		2,680
Asset impairment and abandonments	3,739	5,435	814
Litigation settlement and settlement charges			804
Acquisition expenses	630
Gain on cardiothoracic closure business divestiture	(34,090)
Total operating expenses	113,711	148,030	125,117
Operating income (loss)	28,810	(15,681)	24,625
Other (expense) income:
Interest expense	(3,180)	(1,655)	(1,492)
Interest income	8	8	3
Foreign exchange gain (loss)	87	(132)	78
Total other expense-net	(3,085)	(1,779)	(1,411)
Income (loss) before income tax (provision) benefit	25,725	(17,460)	23,214
Income tax (provision) benefit	(19,453)	3,061	(8,299)
Net income (loss)	6,272	(14,399)	14,915
Convertible preferred dividend	(3,723)	(3,508)	(3,305)
Net income (loss) applicable to common shares	2,549	(17,907)	11,610
Other comprehensive income (loss):
Unrealized foreign currency translation gain (loss)	1,987	(1,274)	(3,161)
Comprehensive income (loss)	$ 4,536	$ (19,181)	$ 8,449
Net income (loss) per common share-basic	$ 0.04	$ (0.31)	$ 0.20
Net income (loss) per common share-diluted	$ 0.04	$ (0.31)	$ 0.20
Weighted average shares outstanding-basic	59,684,289	58,236,745	57,611,231
Weighted average shares outstanding-diluted	60,599,952	58,236,745	58,590,494

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, 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)
Change in income tax benefit from stock-based compensation	152			152
Amortization of preferred stock Series A issuance costs		$ (186)			$ (186)
Preferred stock Series A dividend		(3,305)			(3,305)
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)
Change in income tax benefit from stock-based compensation	(251)			(251)
Amortization of preferred stock Series A issuance costs		(185)			(185)
Preferred stock Series A dividend		(3,508)			(3,508)
Ending Balance at Dec. 31, 2016	164,916		58	417,428		(8,316)	(243,338)	(916)
Net (loss) income	6,272						6,272
Foreign currency translation adjustment	1,987					1,987
Exercise of common stock options	9,181		5	9,176
Stock-based compensation	6,762			6,762
Purchase of treasury stock	(3,474)							(3,474)
Amortization of preferred stock Series A issuance costs		(184)			(184)
Preferred stock Series A dividend		$ (3,723)			$ (3,723)
Ending Balance at Dec. 31, 2017	$ 181,737		$ 63	$ 429,459		$ (6,329)	$ (237,066)	$ (4,390)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Cash flows from operating activities:
Net income (loss)	$ 6,272	$ (14,399)	$ 14,915
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization expense	14,226	16,510	16,522
Provision for bad debts and product returns	946	895	1,568
Provision for inventory write-downs	5,066	13,880	5,390
Amortization of deferred revenue	(4,744)	(4,867)	(6,225)
Deferred income tax provision	13,329	(3,395)	5,543
Stock-based compensation	6,660	3,590	2,548
Asset impairment and abandonments	3,739	5,435
Gain on cardiothoracic closure business divestiture	(34,090)
Other	2,392	603	2,280
Change in assets and liabilities:
Accounts receivable	5,784	4,756	(10,435)
Inventories	1,375	(15,369)	(11,990)
Accounts payable	(12,899)	4,583	(12,660)
Accrued expenses	2,599	(6,536)	5,532
Deferred revenue	2,000	2,000	2,000
Other operating assets and liabilities	(10,200)	7,637	(5,992)
Net cash provided by operating activities	2,455	15,323	8,996
Cash flows from investing activities:
Purchases of property, plant and equipment	(12,301)	(15,337)	(17,740)
Patent and acquired intangible asset costs	(2,266)	(2,615)	(498)
Proceeds from sale of building	1,818
Cardiothoracic closure business divestiture	51,000
Net cash provided by (used in) investing activities	38,251	(17,952)	(18,238)
Cash flows from financing activities:
Proceeds from exercise of common stock options	5,060	57	2,505
Proceeds from long-term obligations	6,000	17,000	8,750
Net (payments) proceeds from short-term obligations		(1,511)	422
Payments on long-term obligations	(43,000)	(11,424)	(5,294)
Other financing activities	(458)	(458)	(109)
Net cash (used in) provided by financing activities	(32,398)	3,664	6,274
Effect of exchange rate changes on cash and cash equivalents	224	200	(121)
Net increase (decrease) in cash and cash equivalents	8,532	1,235	(3,089)
Cash and cash equivalents, beginning of period	13,849	12,614	15,703
Cash and cash equivalents, end of period	22,381	13,849	12,614
Supplemental cash flow disclosure:
Cash paid for interest	3,023	1,224	1,425
Cash paid for income taxes, net of refunds	12,142	(238)	3,667
Non-cash acquisition of property, plant and equipment	593	952	3,795
Stock-based compensation related to severance			310
Receivable for executive stock option exercise	1,234
Stock-based compensation related to sale of CT business	102
Change in accrual for dividend payable	$ 3,723	$ 3,508	$ 3,305

Business

Business	12 Months Ended
	Dec. 31, 2017
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), while our manufacturing facilities produce metal and synthetic implants. 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, 2017
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 consolidated financial statements has been determined by using available market information and appropriate valuation methodologies. The carrying value of all current assets and current liabilities approximates fair value because of their short-term nature. The carrying value of the long-term debt obligations approximates fair value. The carrying value of capital lease obligations approximates their fair value, based on current market prices. 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. We evaluate our goodwill for impairment by utilizing an income approach and a market approach. The conclusion from these two approaches are generally weighted equally and then adjusted to incorporate a control premium or acquisition premium that reflects the additional amount a buyer is willing to pay for elements of control and for a premium that reflects the buyer’s perception of its ability to add value through synergies. In general, the income approach employs a discounted cash flow model that considers: 1) assumptions that marketplace participants would use in their estimates of fair value, including the cash flow period, terminal values based on a terminal growth rate and the discount rate; 2) current period actual results; and 3) projected results for future periods that have been prepared and approved by senior management of the Company. The forecasted cash flows do not include synergies that a marketplace participant would be expecting to achieve. The market approach employs market multiples from guideline public companies operating in our industry. Estimates of fair value are derived by applying multiples based on revenue and earnings before interest, taxes, depreciation and amortization (“EBITDA”) adjusted for size and performance metrics relative to peer companies. A control premium was included in determining the fair value under this approach. If the carrying amount of the reporting unit exceeds its calculated fair value, the second step of the goodwill impairment test is performed in accordance with FASB ASC 350 to measure the amount of the impairment loss, if any. Both approaches used in the analysis have a degree of uncertainty. Potential events or changes in circumstances which could impact the key assumptions used in our goodwill impairment evaluation are as follows: • Change in peer group or performance of peer group companies • Change in the Company’s markets and estimates of future operating performance • Change in the Company’s estimated market cost of capital • Change in implied control premiums related to acquisitions in the medical device industry Goodwill represents the excess of purchase price over fair value of tangible net assets of acquired businesses at the acquisition date, after amounts allocated to other identifiable intangible assets. Factors that contribute to the recognition of goodwill include securing synergies that are specific to our business and not available to other market participants and are expected to increase revenues and profits; acquisition of a talented workforce; cost savings opportunities; the strategic benefit of expanding our presence in core and adjacent markets; and diversifying our product portfolio. Other Intangible Assets Other intangible assets are tested for impairment 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 consist 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 pre-vesting Research and Development Costs Income Taxes year-end Treasury Stock Earnings Per Share Year Ended December 31, 2017 2016 2015 Weighted average basic shares 59,684,289 58,236,745 57,611,231 Effect of dilutive securities: Stock options 915,663 — 979,263 Weighted average diluted shares 60,599,952 58,236,745 58,590,494 Options to purchase 4,692,037 shares of common stock at prices ranging from $2.69 to $8.20 per share which were outstanding as of December 31, 2017, 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 5,764,607 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. For the years ended December 31, 2017, 2016 and 2015, 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, 2017
Accounting Changes and Error Corrections [Abstract]
Recently Issued Accounting Standards	3. Recently Issued Accounting Standards. Income Statement—Reporting Comprehensive Income 2017-14, “ Income Statement—Reporting Comprehensive Income ” 2014-09. Earnings Per Share 2017-11, Earnings Per Share” “Distinguishing Liabilities from Equity” “Derivative and Hedging” 470-20, re-characterize 250-10-45-5 45-10. Compensation—Stock Compensation 2017-09, “Compensation—Stock Compensation” 2017-09 Other Income—Gains and Losses from the Derecognition of Nonfinancial Assets 2017-05, “Other Income-Gains and Losses from the Derecognition of Nonfinancial Assets” 610-20): 2017-05 Simplifying the Test for Goodwill Impairment No. 2017-04, 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 ASU 2016-09 pre-adoption share-based based-payments 2016-09 2016-09 2016-09 Leases No. 2016-02 2016-02”), Leases (Topic 842) “Leases (Topic 840)” 2016-02 Simplifying the Measurement of Inventory No. 2015-11, “Inventory Simplifying the Measurement of Inventory” No. 2015-11 first-in, first-out No. 2015-11 No. 2015-11 2015-11 2015-11 Revenue from Contracts with Customers The Company identified two contracts which previously resulted in revenue recognition occurring at the time of shipment; however, under the new revenue recognition standard, the Company is required to recognize revenue over time. The Company currently estimates the impact of adopting the new revenue standard on the two contracts will result in a $1,800 to $2,200 reduction in accumulated deficit, the cumulative effect adjustment under the modified retrospective approach, a $2,500 to $3,000 increase in accounts receivable, and a $700 to $800 decrease in deferred tax assets. The Company also identified a contract that contains significant upfront payments; however, the Company has not yet finalized its assessment of the contract. Except for the three contracts discussed above, the Company does not anticipate the finalization of this assessment will result in a material impact to the Company’s financial position, results of operations, and disclosures.

Cardiothoracic Closure Business

Cardiothoracic Closure Business Divestiture	12 Months Ended
	Dec. 31, 2017
Discontinued Operations and Disposal Groups [Abstract]
Cardiothoracic Closure Business Divestiture	4. Cardiothoracic Closure Business Divestiture The Company completed the sale of substantially all of the assets related to its Cardiothoracic closure business (the “CT Business”) to A&E Advanced Closure Systems, LLC (a subsidiary of A&E Medical Corporation) (“A&E”) pursuant to an Asset Purchase Agreement between the Company and A&E, dated August 3, 2017 (the “Asset Purchase Agreement”). The total consideration received by the Company under the Asset Purchase Agreement was composed of $54,000 in cash consideration, $3,000 of which is being held in escrow for up to twelve months to satisfy possible indemnification obligations, if any (the “Escrow Amount”), plus an additional $5,000 in contingent cash consideration if A&E reaches certain revenue milestones (the “Contingent Consideration”). The Company is also entitled to an additional $1,000 in consideration if the Company successfully obtains a certain FDA regulatory clearance. As a part of the transaction, the Company also entered into a multi-year Contract Manufacturing Agreement with A&E (the “Contract Manufacturing Agreement”). Under the Contract Manufacturing Agreement, the Company agreed to continue to support the CT Business by manufacturing existing products and engineering, developing, and manufacturing potential future products for A&E. The Company elected to account for the Contingent Consideration arrangement including the Escrow Amount, as a gain contingency in accordance with ASC 450 Contingencies. As such, the Contingent Consideration and Escrow Amount were excluded in measuring the fair value of the consideration to be received in connection with the transaction. The calculation of the gain on the CT Business divestiture is as follows: Proceeds from cardiothoracic closure business divestiture $ 51,000 Inventories—net (2,893 ) Property, plant and equipment—net (1,299 ) Goodwill (8,645 ) Other intangible assets—net (280 ) Cardiothoracic closure business divestiture expenses (3,793 ) Gain on cardiothoracic closure business divestiture $ 34,090

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	5. 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 five to 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, 2017 2016 2015 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 2.26 % 1.85 % 1.67 % Volatility factor 47.39 % 45.57 % 46.29 % Dividend yield — — — Stock Options Stock options outstanding, exercisable and available for grant at December 31, 2017, are summarized as follows: Number of Options Weighted Weighted Aggregate Outstanding at January 1, 2017 5,764,607 $ 4.28 Granted 2,875,438 3.64 Exercised (2,572,859 ) 3.57 Forfeited or expired (1,375,149 ) 5.69 Outstanding at December 31, 2017 4,692,037 $ 3.86 5.86 $ 2,554 Vested or expected to vest at December 31, 2017 4,247,224 $ 3.87 5.69 $ 2,301 Exercisable at December 31, 2017 1,422,953 $ 4.28 3.65 $ 530 Available for grant at December 31, 2017 1,949,068 The aggregate intrinsic value in the table above represents the total pre-tax For the years ended December 31, 2017, 2016 and 2015, the Company recognized stock-based compensation as follows: Year Ended December 31, 2017 2016 2015 Stock-based compensation: Costs of processing and distribution $ 132 $ 140 $ 132 Marketing, general and administrative 6,586 3,406 2,356 Research and development 44 44 60 Total $ 6,762 $ 3,590 $ 2,548 As of December 31, 2017, there was $3,344 of total unrecognized stock-based compensation related to nonvested stock options. That expense is expected to be recognized over a weighted-average period of 1.96 years. Other information concerning stock options are as follows: Year Ended December 31, 2017 2016 2015 Weighted average fair value of stock options granted $ 1.66 $ 1.55 $ 2.50 Aggregate intrinsic value of stock options exercised 2,786 12 1,584 The aggregate intrinsic value of stock options exercised in a period represents the pre-tax Restricted Stock Awards The value of restricted stock awards is determined by the market value of the Company’s common stock at the date of grant. In 2017, restricted stock awards in the amount of 1,546,890 shares and 154,687 shares was granted to employees and non-employee Number of Weighted Unvested at January 1, 2017 530,988 $ 3.64 Granted 1,701,577 4.05 Vested (960,652 ) 3.77 Forfeited (138,389 ) 3.56 Unvested at December 31, 2017 1,133,524 $ 4.15 Inducement Grant President and Chief Executive Office On January 26, 2017 (the “Grant Date”), the Company issued an inducement grant to its President and Chief Executive Officer, Mr. Camille Farhat. This grant was in the form of: (1) a restricted stock award agreement (the “Restricted Stock Agreement #1”); (2) another restricted stock award agreement (the “Restricted Stock Agreement #2”); and (3) a stock option agreement (the “Option Agreement”). Under the Restricted Stock Agreement #1, the Company granted Mr. Farhat 850,000 shares of restricted common stock. On the first anniversary of the Grant Date, 170,000 shares will vest. The remaining shares will vest on the last day of each calendar quarter at a rate of 42,500 shares per calendar quarter commencing after the first anniversary of the Grant Date and continuing for four years after. Vesting of these shares may accelerate upon the occurrence of either of two performance conditions. On December 4, 2017, the Company and Mr. Farhat entered into the First Amendment to the Restricted Stock Agreement #1 (the “Amendment”). The Amendment revised the vesting conditions for the Company’s common stock, par value $0.001 per share (the “Common Stock”), granted under the Restricted Stock Agreement #1. Pursuant to the Amendment, certain acceleration conditions contained in the Restricted Stock Agreement #1 were deleted and 425,000 shares of restricted Common Stock vested on December 4, 2017 (the “Vested Grant”). If Mr. Farhat voluntarily leaves the employment of the Company (other than for “Good Reason”) or is terminated for “Cause” (as those terms are defined in the Employment Agreement between the Company and Mr. Farhat, dated January 26, 2017) on or before March 31, 2019, then Mr. Farhat will forfeit all of the shares of the Vested Grant that would not have otherwise vested under vesting schedule contained in the Restricted Stock Agreement #1 at the time of termination. For example, if Mr. Farhat leaves the employment of the Company without Good Reason on June 1, 2018, he will forfeit 425,000 of the 637,500 vested restricted shares of Common Stock granted under the Restricted Stock Agreement #1. Pursuant to the Amendment, Mr. Farhat will also be required to hold the shares of the Vested Grant until March 31, 2019, except to the extent those shares would have vested under the vesting schedule contained in the Restricted Stock Agreement #1 at the time of a proposed transfer by Mr. Farhat. The unaccelerated shares of restricted Common Stock granted under the Restricted Stock Agreement #1 will vest under vesting schedule contained in the Restricted Stock Agreement #1. Pursuant to the Restricted Stock Agreement #1 vesting schedule, 170,000 of the unaccelerated restricted shares will vest on January 26, 2018, and the remaining unaccelerated restricted shares will vest in 42,500 share increments on the last day of each calendar quarter commencing on March 31, 2018, continuing until all unaccelerated restricted shares have vested. Under the terms of the Amendment, the final tranche of shares of restricted Common Stock granted under the Restricted Stock Agreement #1 will vest as of June 30, 2019, instead of on December 31, 2021, which would have been the case if no acceleration occurred. Under the Restricted Stock Agreement #2, the Company granted Mr. Farhat 150,000 shares of restricted common stock. These 150,000 restricted shares will become fully vested on the latest date (the “Purchase Date”) on which the fair market value of the cumulative amount of shares that Mr. Farhat purchases on the open market equals $500, so long as the Purchase Date is on or before March 15, 2018. After vesting, the shares will be non-transferable Under the Option Agreement, the Company granted Mr. Farhat the option to purchase 1,950,000 shares of common stock (the “Stock Options”). The exercise price for the Stock Options is $3.20. The Stock Options will expire on January 26, 2022. The Stock Options will vest based on the Company’s attainment of three average stock price benchmarks. The first 650,000 shares will vest if the Company’s average publicly traded stock price is over $6.00 for a sixty-consecutive calendar day period. The next 650,000 shares will vest if the Company’s average publicly traded stock price is over $7.00 for a sixty-consecutive calendar day period. The final 650,000 shares will vest if the Company’s average publicly traded stock price is over $8.00 for a sixty-consecutive calendar day period. The vesting of the Stock Options is cumulative. Chief Financial and Administrative Officer On September 18, 2017 (the “Grant Date”), the Company issued an inducement grant to its Chief Financial and Administrative Officer, Mr. Jonathon Singer. This grant was in the form of: (1) a restricted stock award agreement (the “Restricted Stock Agreement”); and (2) a stock option agreement (the “Option Agreement”). This inducement grant was made under the RTI Surgical, Inc. 2015 Incentive Compensation Plan, which was filed with the SEC on May 5, 2015. Under the Restricted Stock Agreement, the Company granted Mr. Singer 109,890 shares of restricted Common Stock. The shares will vest over a three-year period. On the first anniversary of the Grant Date, 36,630 shares will vest. On the second anniversary of the Grant Date, an additional 36,630 shares will vest. On the third anniversary of the Grant Date, the final 36,630 shares will vest. Under the Option Agreement, the Company granted Mr. Singer the option to purchase 306,900 shares of Common Stock (the “Stock Options”), as of the Grant Date. The exercise price for the Stock Options is $4.55 per share. The Stock Options will expire on September 18, 2027. The Stock Options will vest based the Company’s attainment of three average stock price benchmarks. The first 102,300 shares will vest if the Company’s average publicly traded stock price is over $7.00 per share for a sixty-consecutive calendar day period. The next 102,300 shares will vest if the Company’s average publicly traded stock price is over $8.00 per share for a sixty-consecutive calendar day period. The final 102,300 shares will vest if the Company’s average publicly traded stock price is over $9.00 per share for a sixty-consecutive calendar day period. The vesting of the Stock Options is cumulative.

Inventories

Inventories	12 Months Ended
	Dec. 31, 2017
Inventory Disclosure [Abstract]
Inventories	6. Inventories Inventories by stage of completion are as follows: December 31, 2017 2016 Unprocessed tissue, raw materials and supplies $ 22,071 $ 31,745 Tissue and work in process 40,481 38,552 Implantable tissue and finished goods 49,375 49,446 $ 111,927 $ 119,743 For the years ended December 31, 2017, 2016, and 2015, the Company had inventory write-downs of $5,066, $13,880 and $5,390, respectively, relating primarily to excess quantities and obsolescence of inventories.

Prepaid and Other Current Asset

Prepaid and Other Current Assets	12 Months Ended
	Dec. 31, 2017
Text Block [Abstract]
Prepaid and Other Current Assets	7. Prepaid and Other Current Assets Prepaid and Other Current Assets are as follows: December 31, 2017 2016 Income tax receivable $ 9,825 $ 1,041 Receivable for executive stock option exercise 1,234 — Other 5,226 4,172 $ 16,285 $ 5,213

Property, Plant and Equipment

Property, Plant and Equipment	12 Months Ended
	Dec. 31, 2017
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment	8. Property, Plant and Equipment Property, plant and equipment are as follows: December 31, 2017 2016 Land $ 2,020 $ 2,324 Buildings and improvements 57,954 59,187 Processing equipment 44,137 38,387 Surgical instruments 21,256 18,394 Office equipment, furniture and fixtures 1,352 1,701 Computer equipment and software 19,332 11,852 Construction in process 5,980 17,554 152,031 149,399 Less accumulated depreciation (72,467 ) (66,101 ) $ 79,564 $ 83,298 For the years ended December 31, 2017, 2016, and 2015, the Company had depreciation expense in connection with property, plant and equipment of $10,513, $12,835, and $12,240, respectively. In addition, on October 20, 2017, the Company sold an owned property previously used for administrative, distribution and marketing functions for $1,818 net of selling costs.

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	9. Goodwill The change in the carrying amount of goodwill for the year ended December 31, 2017 is as follows: Year Ended December 31, 2017 2016 Balance at January 1 $ 54,887 $ 54,887 Goodwill disposed of related to sale of CT business 8,645 — Balance at December 31 $ 46,242 $ 54,887 On August 3, 2017, the Company completed the sale of substantially all of the assets related to its CT Business to A&E, which resulted in the disposal of goodwill. In connection with the sale of the Company’s CT Business, we also performed the goodwill impairment test on an interim basis as of August 3, 2017, and concluded that there was no impairment to goodwill. The Company performed its annual goodwill impairment test as of December 31, 2017, and concluded that there was no impairment of goodwill.

Other Intangible Assets

Other Intangible Assets	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Other Intangible Assets	10. Other Intangible Assets Other intangible assets are as follows: December 31, 2017 December 31, 2016 Gross Accumulated Gross Accumulated Patents $ 11,373 $ 4,890 $ 11,559 $ 4,159 Acquired licensing rights 14,747 9,097 12,204 8,302 Marketing and procurement intangible assets 20,603 9,666 20,694 8,002 Total $ 46,723 $ 23,653 $ 44,457 $ 20,463 For the years ended December 31, 2017, 2016, and 2015, the Company had amortization expense of other intangible assets of $3,713, $3,675, and $4,282, respectively. At December 31, 2017, management’s estimates of future amortization expense for the next five years are as follows: Amortization 2018 $ 3,800 2019 3,800 2020 3,700 2021 3,700 2022 3,500

Fair Value Information

Fair Value Information	12 Months Ended
	Dec. 31, 2017
Fair Value Disclosures [Abstract]
Fair Value Information	11. 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 No impairments on long-lived assets were recorded for the year ended December 31, 2017.

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2017
Other Liabilities Disclosure [Abstract]
Accrued Expenses	12. Accrued Expenses Accrued expenses are as follows: December 31, 2017 2016 Accrued compensation $ 8,257 $ 4,904 Accrued severance and restructuring charges 3,279 505 Accrued executive transition costs 2,300 2,406 Accrued distributor commissions 3,889 4,422 Accrued donor recovery fees 4,144 6,350 Other 3,741 3,443 $ 25,610 $ 22,030 The Company accrues for the estimated donor recovery fees due to third party recovery agencies as tissue is received.

Short and Long-Term Obligations

Short and Long-Term Obligations	12 Months Ended
	Dec. 31, 2017
Debt Disclosure [Abstract]
Short and Long-Term Obligations	13. Short and Long-Term Obligations Short and long-term obligations are as follows: December 31, 2017 2016 Term loan $ 24,250 $ 50,750 Revolving Credit facility 22,500 33,000 Less unamortized debt issuance costs (406 ) (403 ) Total 46,344 83,347 Less current portion (4,268 ) (6,080 ) Long-term portion $ 42,076 $ 77,267 The Company entered into a Third Amended and Restated Loan Agreement, dated as of August 3, 2017 (the “2017 Loan Agreement”), among the Company, TD Bank, N.A. and First Tennessee Bank National Association, as Lenders (together with the various financial institutions as in the future may become parties thereto, the “Lenders”), and TD Bank, N.A., as administrative agent for the Lenders. The 2017 Loan Agreement represents a modification of the Second Amended and Restated Loan Agreement dated July 16, 2013 between the Company, TD Bank, N.A. and Regions Bank (as amended, the “2013 Loan Agreement”). The 2017 Loan Agreement provides for a revolving credit facility (the “Revolving Credit Facility”), in the aggregate principal amount of $42,500 which is unchanged from the final Amendment to the 2013 Loan Agreement. The Company used $22,000 of the proceeds from the sale of the CT Business to partially pay down amounts owed under the 2013 Loan Agreement, and $10,000 to pay down amounts owed under the Revolving Credit Facility. Subsequent to the pay down, the outstanding principal balance on the 2013 Loan Agreement Term Loan amounted to $25,375 which became the principal amount of the 2017 Loan Agreement (the “Term Loan Facility” and, together with the Revolving Credit Facility the “Facility”). The Facility is secured by substantially all the assets of the Company and its domestic subsidiaries and is guaranteed by the Company’s domestic subsidiaries, as well as 65% of the stock of the Company’s foreign subsidiaries. Borrowings made under the 2017 Loan Agreement initially will bear interest at a rate per annum equal to monthly LIBOR plus a margin of up to 3.50%. Interest is payable quarterly in arrears, and principal on the Term Loan Facility is payable in quarterly payments of $1,125, each commencing October 1, 2017. The maturity date of the Facility is September 15, 2019, which represents an extension from the 2013 Loan Agreement maturity date of July 16, 2018. The Company may make optional prepayments on the Facility without penalty at the end of any LIBOR interest period. At December 31, 2017, the interest rate for the Term Loan and Revolving Credit Facility is 4.86%. As of December 31, 2017, there was $22,500 outstanding on the revolving credit facility. The term loan facility requires aggregate principal payments of $6,750 from January 1, 2018 through June 30, 2019, with a final balloon principal payment of $17,500 on September 15, 2019. The credit agreement also contains various restrictive covenants which limit, among other things, indebtedness and liens, as well as payment of dividends, while requiring a minimum cash balance on hand of $10,000 and certain financial covenant ratios. The total available credit on the Company’s revolving credit facility at December 31, 2017 was $20,000. 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, 2017. Interest expense associated with the amortization of debt issuance costs for the years ended December 31, 2017, 2016 and 2015 was $409, $202 and $148, respectively. As of December 31, 2017, contractual maturities of the Term Loan net of debt issuance costs, and the Revolving Credit Facility are as follows: Term Loan Revolving Total 2018 $ 4,268 $ — $ 4,268 2019 19,576 22,500 42,076 $ 23,844 $ 22,500 $ 46,344

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Income Taxes	14. Income Taxes The Company’s income tax (provision) benefit consists of the following components: Year Ended December 31, 2017 2016 2015 Current: Federal $ (3,176 ) $ (150 ) $ (988 ) State (915 ) (92 ) (159 ) International — 456 (544 ) Total current (4,091 ) 214 (1,691 ) Deferred: Federal (14,340 ) 2,477 (5,695 ) State (1,022 ) 562 68 International — (192 ) (981 ) Total deferred (15,362 ) 2,847 (6,608 ) Total income tax (provision) benefit $ (19,453 ) $ 3,061 $ (8,299 ) The components of the deferred tax assets and liabilities consisted of the following at: December 31, 2017 December 31, 2016 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities Allowance for bad debts $ 186 $ — $ 485 $ — Deferred compensation 1,783 — 4,675 — Inventory 5,905 — 12,811 — Fixed assets and intangibles — (7,370 ) — (5,690 ) Investments — — 2,133 — Net operating losses 8,106 — 4,547 — Tax credits 4,387 — 5,235 — Deferred revenue 1,874 — 3,804 — Accrued liabilities 2,072 — 2,004 — Other — (110 ) — (120 ) Valuation allowance (7,258 ) — (4,916 ) — Total $ 17,055 $ (7,480 ) $ 30,778 $ (5,810 ) The Company expects its deferred tax assets of $9,575, net of the valuation allowance at December 31, 2017 of $7,258, to be realized through the generation of future taxable income and the reversal of existing taxable temporary differences. On December 22, 2017, the US government enacted comprehensive tax legislation commonly referred to as the Tax Cuts and Jobs Act (the “Tax Legislation”). The Tax Legislation makes broad and complex changes to the U.S. tax code including, but not limited to the following: • Reduction of the U.S. federal corporate tax rate from 35% to 21% • Requiring a transition tax on certain unrepatriated earnings of foreign subsidiaries • Bonus depreciation that will allow for full expensing of qualified property • Elimination of the corporate alternative minimum tax • The repeal of the domestic production activity deduction • Limitations on the deductibility of certain executive compensation • Limitations on net operating losses generated after December 31, 2017 In addition, beginning in 2018, the Tax Legislation includes a global intangible low-taxed The SEC staff issued SAB 118, which provides guidance on accounting for the tax effects of the Tax Legislation. SAB 118 provides a measurement period that should not extend beyond one year from the Tax Legislation enactment date for companies to complete the accounting under ASC 740. In accordance with SAB 118, the Company must reflect the income tax effects of those aspects of the Tax Legislation for which the accounting under ASC 740 is complete. To the extent that the Company’s accounting for certain income tax effects of the Tax Legislation is incomplete, but the Company is able to determine a reasonable estimate, it must record a provisional estimate in the consolidated financial statements. If the Company cannot determine a provisional estimate, it should continue to apply ASC 740 on the basis of the provisions of the tax laws that were in effect immediately before the enactment of the Tax Legislation In connection with our initial analysis of the impact of the Tax Legislation, the Company has recorded provisional tax expense of $2,187 in the period ending December 31, 2017. This provisional tax expense consists of $1,436 to revalue the Company’s deferred tax assets using the reduced corporate tax rate and $751 related to the transition tax. Given the complexity of the Tax Legislation and anticipated guidance from the U.S. Treasury about implementing the Tax Legislation, the Company’s analysis and accounting for the income tax effects of the Tax Legislation is preliminary. The amounts recorded by the Company to revalue its deferred tax assets and impact of the transition tax are provisional estimates. The Company has not fully completed its analysis of certain aspects of the Tax Legislation that could result in adjustments to the revaluation of the Company’s deferred tax assets, and its analysis and calculation of foreign earnings subject to the transition tax. Upon completion of the Company’s analysis, these estimates may be adjusted through income tax expense in the consolidated financial statement. 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 $7,258 and $4,916 have been established at December 31, 2017 and December 31, 2016, respectively, against a portion of the deferred tax assets. As of December 31, 2017, the Company has U.S. federal net operating loss carryforwards of $1,635 that will expire in the years 2026 and 2027. As of December 31, 2017, the Company has U.S. state net operating loss carryforwards of $42,420 that will expire in the years 2018 through 2037. As of December 31, 2017, the Company has foreign net operating loss carryforwards of $20,551 that will carryfoward indefinitely. As of December 31, 2017, the Company has research tax credit carryforwards of $4,403 that will expire in years 2030 through 2037. As of December 31, 2017, the Company has foreign tax credit carryforwards of $751 that will expire in 2037. 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. 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 consolidated U.S. operations are in a cumulative income position. However, one U.S. entity (“Entity”) is in a three-year cumulative loss position. Future taxable income exclusive of reversing temporary differences and carryforwards is one source of taxable income available that can be used to realize tax benefits. During 2017, the Company has undertaken various cost reduction activities to reduce complexity and increase operational excellence within the organization. The Entity anticipates generating significant cost savings from the various cost reduction activities. After adjusting the Entity’s cumulative losses to include the projected costs savings, the Entity’s operations project future profits sufficient to utilize the Entity’s separate state deferred tax assets before expiration. The Company considers this objectively verifiable evidence that all its U.S. deferred tax assets are more likely than not realizable. The Company’s foreign operations are in three-year cumulative loss position. As a result, the Company has recorded a full valuation allowance on its foreign subsidiary’s deferred tax assets. As such, valuation allowances of $7,258 and $4,916 have been established at December 31, 2017 and December 31, 2016, respectively, against a portion of the deferred tax assets. 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, 2017, 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, 2017 2016 2015 Opening balance $ 1,591 $ 1,986 $ 1,787 Reductions based on tax positions related to the current year — — — Additions for tax positions of prior years — — 199 Reductions for tax positions of prior years — (60 ) — Reductions for expiration of statute of limitations — (335 ) — $ 1,591 $ 1,591 $ 1,986 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 2017, 2016 and 2015 and no interest and penalties accrued at December 31, 2017 and 2016. The Company’s 2015 U.S. federal income tax return is under examination by the Internal Revenue Service (“IRS”). Currently, the Company has not recorded any material adjustments related to the IRS examination. The effective tax rate differs from the statutory federal income tax rate for the following reasons: Year Ended December 31, 2017 2016 2015 Statutory federal rate 35.00 % 35.00 % 35.00 % State income taxes—net of federal tax benefit 2.43 % 1.73 % 0.25 % Foreign rate differential 2.85 % (3.29 %) (2.18 %) Tax legislation—transition tax 2.92 % — — Tax legislation—revaluation of deferred tax assets 5.58 % — — Other permanent items 1.63 % (3.15 %) 0.56 % Tax credits (4.62 %) 7.02 % (0.28 %) Domestic production activities deduction 0.00 % 1.38 % — Goodwill disposal 11.76 % — — Officer compensation 4.26 % Stock-based compensation 6.18 % — — Valuation allowance 5.94 % (21.71 %) 0.85 % Other reconciling items, net 1.69 % 0.55 % 1.55 % Effective tax rate 75.62 % 17.53 % 35.75 % For the years ended December 31, 2017, 2016 and 2015, the Company had no individually significant other reconciling items.

Preferred Stock

Preferred Stock	12 Months Ended
	Dec. 31, 2017
Equity [Abstract]
Preferred Stock	15. Preferred Stock Preferred stock is as follows: Preferred Stock Preferred Stock Net Total Balance at January 1, 2015 $ 53,863 $ (1,029 ) $ 52,834 Accrued dividend 3,305 — 3,305 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2015 57,168 (845 ) 56,323 Accrued dividend 3,508 — 3,508 Amortization of preferred stock issuance costs — 185 185 Balance at December 31, 2016 60,676 (660 ) 60,016 Accrued dividend 3,723 — 3,723 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2017 $ 64,399 $ (476 ) $ 63,923 On June 12, 2013, the Company and WSHP Biologics Holdings, LLC, an affiliate of Water Street Healthcare Partners, a leading healthcare-focused private equity firm (“Water Street”), entered into an investment agreement. Pursuant to the terms of the investment agreement, the Company issued $50,000 of convertible preferred equity to Water Street in a private placement which closed on July 16, 2013, with preferred stock issuance costs of $1,290. 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. Our credit agreement with TD Bank and First Tennessee 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, 2017
Equity [Abstract]
Stockholders' Equity	16. Stockholders’ Equity Preferred Stock Common Stock

Executive Transition Costs

Executive Transition Costs	12 Months Ended
	Dec. 31, 2017
Equity [Abstract]
Executive Transition Costs	17. Executive 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. In addition, the Company recorded executive transition costs of $2,781 as a result of hiring a new Chief Executive Officer and Chief Financial and Administrative Officer for the year ended December 31, 2017, separately disclosed on the Consolidated Statements of Comprehensive Income (Loss). The total executive transition costs of which $1,169 is cash basis is expected to be paid in full in 2018. The following table includes a rollforward of executive transition costs included in accrued expenses, see Note 12. Accrued executive transition costs at January 1, 2016 $ — Executive transition costs accrued in 2016 4,404 Stock-based compensation (1,535 ) Cash payments (463 ) Accrued executive transition costs at December 31, 2016 2,406 Executive transition costs accrued in 2017 2,781 Stock-based compensation (1,612 ) Cash payments (1,275 ) Accrued executive transition costs at December 31, 2017 $ 2,300

Severance and Restructuring Cos

Severance and Restructuring Costs	12 Months Ended
	Dec. 31, 2017
Employee Severance [Member]
Severance and Restructuring Costs	18. Severance and Restructuring Costs The Company recorded severance and restructuring costs related to the reduction of our organizational structure which resulted in $995 of expenses for the year ended December 31, 2015. The total severance and restructuring costs were paid in full by December 31, 2016. Severance and restructuring payments were made 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 severance and restructuring costs related to the reduction of our organizational structure which resulted in $2,146 of expenses for the year ended December 31, 2016. The total severance and restructuring costs are expected to be paid in full prior to the first quarter of 2018. Severance and restructuring payments are made 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 Company recorded severance and restructuring costs related to the reduction of our organizational structure which resulted in $12,173 of expenses for the year ended December 31, 2017, separately disclosed on the Consolidated Statements of Comprehensive Income (Loss). The total severance and restructuring costs are expected to be paid in full prior to the fourth quarter of 2018. Severance and restructuring payments are made 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 and restructuring costs included in accrued expenses, see Note 12. Accrued severance and restructuring charges at January 1, 2015 $ 2,771 Severance and restructuring expenses accrued in 2015 995 Severance and restructuring cash payments (2,591 ) Stock based compensation (310 ) Accrued severance and restructuring charges at December 31, 2015 865 Severance and restructuring expenses accrued in 2016 2,146 Severance and restructuring cash payments (1,866 ) Asset abandonments (640 ) Accrued severance and restructuring charges at December 31, 2016 505 Severance and restructuring expenses accrued in 2017 12,173 Severance and restructuring cash payments (8,246 ) Stock based compensation (1,153 ) Accrued severance and restructuring charges at December 31, 2017 $ 3,279

Retirement Benefits

Retirement Benefits	12 Months Ended
	Dec. 31, 2017
Retirement Benefits [Abstract]
Retirement Benefits	19. Retirement Benefits The Company has a qualified 401(k) plan available to all U.S. employees who meet certain eligibility requirements. The 401(k) plan allows each employee to contribute up to the annual maximum allowed under the Internal Revenue Code. The Company has the discretion to make matching contributions up to 6% of the employee’s earnings. For the years ended December 31, 2017, 2016 and 2015, the amounts expensed under the plan were $3,036, $3,094 and $3,034, respectively.

Concentrations of Risk

Concentrations of Risk	12 Months Ended
	Dec. 31, 2017
Risks and Uncertainties [Abstract]
Concentrations of Risk	20. Concentrations of Risk Distribution Year Ended December 31, 2017 2016 2015 Percent of revenues derived from: Distributor Zimmer 17 % 16 % 24 % Medtronic 9 % 9 % 10 % The Company’s distribution agreements are subject to termination by either party for a variety of causes. No assurance can be given that such distribution agreements will be renewed beyond their expiration dates, continue in their current form or at similar rate structures. Any termination or interruption in the distribution of the Company’s implants through one of its major distributors could have a material adverse effect on the Company’s operations. Tissue Supply

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2017
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	21. Commitments and Contingencies Distribution Agreement with A&E 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 2018 $ 1,574 2019 939 2020 559 2021 117 $ 3,189

Legal and Regulatory Actions

Legal and Regulatory Actions	12 Months Ended
	Dec. 31, 2017
Commitments and Contingencies Disclosure [Abstract]
Legal and Regulatory Actions	22. Legal and Regulatory Actions The Company is, from time to time, involved in litigation relating to claims arising out of its operations in the ordinary course of business. The Company believes that none of these claims that were outstanding as of December 31, 2017 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 its map3 ® ® on-site ® non-compliance. ® ® ®

Segment Data

Segment Data	12 Months Ended
	Dec. 31, 2017
Segment Reporting [Abstract]
Segment Data	23. Segment Data The Company distributes human tissue, bovine and porcine animal tissue, metal and synthetic implants through various distribution channels. The Company operates in one reportable segment composed of six lines of business. The 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. Effective October 1, 2017, we renamed our global commercial line of business category to Original Equipment Manufacturer (“OEM”). 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, 2017, 2016 and 2015: Year Ended December 31, 2017 2016 2015 (In thousands) Revenues: Spine $ 77,514 27.7 % $ 73,907 27.1 % $ 57,983 20.5 % Sports medicine and orthopedics 50,231 18.0 % 50,143 18.4 % 50,712 18.0 % Surgical specialties 6,980 2.5 % 4,466 1.6 % 3,029 1.1 % Cardiothoracic 8,164 2.9 % 11,147 4.1 % 8,699 3.1 % International 23,240 8.3 % 21,185 7.8 % 18,338 6.5 % Subtotal direct 166,129 59.4 % 160,848 59.0 % 138,761 49.2 % OEM 103,011 36.9 % 99,127 36.3 % 129,930 46.0 % Other revenues 10,423 3.7 % 12,890 4.7 % 13,602 4.8 % Total revenues $ 279,563 100.0 % $ 272,865 100.0 % $ 282,293 100.0 % Domestic revenues $ 253,599 90.7 % $ 247,756 90.8 % $ 260,387 92.2 % International revenues 25,964 9.3 % 25,109 9.2 % 21,906 7.8 % Total revenues $ 279,563 100.0 % $ 272,865 100.0 % $ 282,293 100.0 % The following table presents property, plant and equipment—net by significant geographic location: December 31, 2017 2016 Property, plant and equipment—net: Domestic $ 73,363 $ 77,596 International 6,201 5,702 Total $ 79,564 $ 83,298

Quarterly Results of Operations

Quarterly Results of Operations (Unaudited)	12 Months Ended
	Dec. 31, 2017
Quarterly Financial Information Disclosure [Abstract]
Quarterly Results of Operations (Unaudited)	24. Quarterly Results of Operations (Unaudited) The following table sets forth the results of operations for the periods indicated: March 31, June 30, September 30, December 31, Quarter Ended: Revenues $ 69,939 $ 72,120 $ 66,688 $ 70,816 Gross profit 35,779 36,963 33,511 36,268 Net (loss) income applicable to common shares (2,782 ) (2,613 ) 16,548 (8,604 ) Net (loss) income per common share: Basic $ (0.05 ) $ (0.04 ) $ 0.28 $ (0.14 ) Diluted (0.05 ) (0.04 ) $ 0.22 $ (0.14 ) In 2017, the Company’s net income was negatively impacted by severance and restructuring costs of $12,173, executive transition costs of $2,781, asset impairment and abandonments of $3,739, acquisition expenses of $630, tax effect on new tax legislation of $2,187 offset set by a gain on CT Business divestiture of $34,090. 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, severance and restructuring costs of $2,146, strategic review costs of $1,150, executive transition costs of $4,404, contested proxy expenses of $2,680, and an asset impairment of $5,435.

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2017
Subsequent Events [Abstract]
Subsequent Events	25. Subsequent Events The Company evaluated subsequent events as of the issuance date of the consolidated financial statements as defined by FASB ASC 855 Subsequent Events ®

Schedule II - Valuation and Qua

Schedule II - Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2017
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, 2017, 2016 and 2015 (Dollars in thousands) Description Balance at Charged to Deductions- Balance at For the year ended December 31, 2017: Allowance for doubtful accounts $ 1,728 $ 418 $ 675 $ 1,471 Allowance for product returns 629 528 47 1,110 Allowance for excess and obsolescence 14,798 5,066 11,762 8,102 Deferred tax asset valuation allowance 4,916 1,668 (674 ) 7,258 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

Summary of Significant Accoun33

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2017
Accounting Changes and Error Corrections [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
Fair Value of Financial Instruments	Fair Value of Financial Instruments consolidated financial statements has been determined by using available market information and appropriate valuation methodologies. The carrying value of all current assets and current liabilities approximates fair value because of their short-term nature. The carrying value of the long-term debt obligations approximates fair value. The carrying value of capital lease obligations approximates their fair value, based on current market prices.
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 Simplifying the Measurement of Inventory” No. 2015-11 first-in, first-out No. 2015-11 No. 2015-11 2015-11 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. We evaluate our goodwill for impairment by utilizing an income approach and a market approach. The conclusion from these two approaches are generally weighted equally and then adjusted to incorporate a control premium or acquisition premium that reflects the additional amount a buyer is willing to pay for elements of control and for a premium that reflects the buyer’s perception of its ability to add value through synergies. 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, No. 2017-04”). No. 2017-04 No. 2017-04, No. 2017-04 No. 2017-04
Other Intangible Assets	Other Intangible Assets Other intangible assets are tested for impairment 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 consist 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 pre-vesting Compensation—Stock Compensation 2017-09, “Compensation—Stock Compensation” 2017-09 Compensation – Stock Compensation No. 2016-09, “ Compensation – Stock Compensation ” 2016-09”). 2016-09 ASU 2016-09 pre-adoption share-based based-payments 2016-09 2016-09 2016-09
Research and Development Costs	Research and Development Costs
Income Taxes	Income Taxes year-end
Treasury Stock	Treasury Stock
Earnings Per Share	Earnings Per Share Year Ended December 31, 2017 2016 2015 Weighted average basic shares 59,684,289 58,236,745 57,611,231 Effect of dilutive securities: Stock options 915,663 — 979,263 Weighted average diluted shares 60,599,952 58,236,745 58,590,494 Options to purchase 4,692,037 shares of common stock at prices ranging from $2.69 to $8.20 per share which were outstanding as of December 31, 2017, 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 5,764,607 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. For the years ended December 31, 2017, 2016 and 2015, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted In July 2017, the FASB issued ASU 2017-11, Earnings Per Share” “Distinguishing Liabilities from Equity” “Derivative and Hedging” 470-20, re-characterize 250-10-45-5 45-10.
Income Statement-Reporting Comprehensive Income	Income Statement—Reporting Comprehensive Income 2017-14, “ Income Statement—Reporting Comprehensive Income ” 2014-09.
Other Income-Gains and Losses from the Derecognition of Nonfinancial Assets	Other Income—Gains and Losses from the Derecognition of Nonfinancial Assets 2017-05, “Other Income-Gains and Losses from the Derecognition of Nonfinancial Assets” 610-20): 2017-05
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
Revenue from Contracts with Customers	Revenue from Contracts with Customers The Company identified two contracts which previously resulted in revenue recognition occurring at the time of shipment; however, under the new revenue recognition standard, the Company is required to recognize revenue over time. The Company currently estimates the impact of adopting the new revenue standard on the two contracts will result in a $1,800 to $2,200 reduction in accumulated deficit, the cumulative effect adjustment under the modified retrospective approach, a $2,500 to $3,000 increase in accounts receivable, and a $700 to $800 decrease in deferred tax assets. The Company also identified a contract that contains significant upfront payments; however, the Company has not yet finalized its assessment of the contract. Except for the three contracts discussed above, the Company does not anticipate the finalization of this assessment will result in a material impact to the Company’s financial position, results of operations, and disclosures.

Summary of Significant Accoun34

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2017
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, 2017 2016 2015 Weighted average basic shares 59,684,289 58,236,745 57,611,231 Effect of dilutive securities: Stock options 915,663 — 979,263 Weighted average diluted shares 60,599,952 58,236,745 58,590,494

Cardiothoracic Closure Busine35

Cardiothoracic Closure Business Divestiture (Tables)	12 Months Ended
	Dec. 31, 2017
Discontinued Operations and Disposal Groups [Abstract]
Schedule of Calculation of Gain of CT Business Divestiture	The calculation of the gain on the CT Business divestiture is as follows: Proceeds from cardiothoracic closure business divestiture $ 51,000 Inventories—net (2,893 ) Property, plant and equipment—net (1,299 ) Goodwill (8,645 ) Other intangible assets—net (280 ) Cardiothoracic closure business divestiture expenses (3,793 ) Gain on cardiothoracic closure business divestiture $ 34,090

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2017
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, 2017 2016 2015 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 2.26 % 1.85 % 1.67 % Volatility factor 47.39 % 45.57 % 46.29 % Dividend yield — — —
Stock Options Outstanding, Exercisable and Available for Grant	Stock options outstanding, exercisable and available for grant at December 31, 2017, are summarized as follows: Number of Options Weighted Weighted Aggregate Outstanding at January 1, 2017 5,764,607 $ 4.28 Granted 2,875,438 3.64 Exercised (2,572,859 ) 3.57 Forfeited or expired (1,375,149 ) 5.69 Outstanding at December 31, 2017 4,692,037 $ 3.86 5.86 $ 2,554 Vested or expected to vest at December 31, 2017 4,247,224 $ 3.87 5.69 $ 2,301 Exercisable at December 31, 2017 1,422,953 $ 4.28 3.65 $ 530 Available for grant at December 31, 2017 1,949,068
Stock-Based Compensation Recognized	For the years ended December 31, 2017, 2016 and 2015, the Company recognized stock-based compensation as follows: Year Ended December 31, 2017 2016 2015 Stock-based compensation: Costs of processing and distribution $ 132 $ 140 $ 132 Marketing, general and administrative 6,586 3,406 2,356 Research and development 44 44 60 Total $ 6,762 $ 3,590 $ 2,548
Other Information Concerning Stock Options	Other information concerning stock options are as follows: Year Ended December 31, 2017 2016 2015 Weighted average fair value of stock options granted $ 1.66 $ 1.55 $ 2.50 Aggregate intrinsic value of stock options exercised 2,786 12 1,584
Unvested Restricted Stock Awards	The following table summarizes information about unvested restricted stock awards as of December 31, 2017: Number of Weighted Unvested at January 1, 2017 530,988 $ 3.64 Granted 1,701,577 4.05 Vested (960,652 ) 3.77 Forfeited (138,389 ) 3.56 Unvested at December 31, 2017 1,133,524 $ 4.15

Inventories (Tables)

Inventories (Tables)	12 Months Ended
	Dec. 31, 2017
Inventory Disclosure [Abstract]
Components of Inventories	Inventories by stage of completion are as follows: December 31, 2017 2016 Unprocessed tissue, raw materials and supplies $ 22,071 $ 31,745 Tissue and work in process 40,481 38,552 Implantable tissue and finished goods 49,375 49,446 $ 111,927 $ 119,743

Prepaid and Other Current Ass38

Prepaid and Other Current Assets (Tables)	12 Months Ended
	Dec. 31, 2017
Text Block [Abstract]
Schedule of Prepaid and Other Current Assets	Prepaid and Other Current Assets are as follows: December 31, 2017 2016 Income tax receivable $ 9,825 $ 1,041 Receivable for executive stock option exercise 1,234 — Other 5,226 4,172 $ 16,285 $ 5,213

Property, Plant and Equipment (

Property, Plant and Equipment (Tables)	12 Months Ended
	Dec. 31, 2017
Property, Plant and Equipment [Abstract]
Components of Property, Plant and Equipment	Property, plant and equipment are as follows: December 31, 2017 2016 Land $ 2,020 $ 2,324 Buildings and improvements 57,954 59,187 Processing equipment 44,137 38,387 Surgical instruments 21,256 18,394 Office equipment, furniture and fixtures 1,352 1,701 Computer equipment and software 19,332 11,852 Construction in process 5,980 17,554 152,031 149,399 Less accumulated depreciation (72,467 ) (66,101 ) $ 79,564 $ 83,298

Goodwill (Tables)

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The change in the carrying amount of goodwill for the year ended December 31, 2017 is as follows: Year Ended December 31, 2017 2016 Balance at January 1 $ 54,887 $ 54,887 Goodwill disposed of related to sale of CT business 8,645 — Balance at December 31 $ 46,242 $ 54,887

Other Intangible Assets (Tables

Other Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Components of Other Intangible Assets	Other intangible assets are as follows: December 31, 2017 December 31, 2016 Gross Accumulated Gross Accumulated Patents $ 11,373 $ 4,890 $ 11,559 $ 4,159 Acquired licensing rights 14,747 9,097 12,204 8,302 Marketing and procurement intangible assets 20,603 9,666 20,694 8,002 Total $ 46,723 $ 23,653 $ 44,457 $ 20,463
Estimates of Future Amortization Expense	At December 31, 2017, management’s estimates of future amortization expense for the next five years are as follows: Amortization 2018 $ 3,800 2019 3,800 2020 3,700 2021 3,700 2022 3,500

Fair Value Information (Tables)

Fair Value Information (Tables)	12 Months Ended
	Dec. 31, 2017
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, 2017
Other Liabilities Disclosure [Abstract]
Accrued Expenses	Accrued expenses are as follows: December 31, 2017 2016 Accrued compensation $ 8,257 $ 4,904 Accrued severance and restructuring charges 3,279 505 Accrued executive transition costs 2,300 2,406 Accrued distributor commissions 3,889 4,422 Accrued donor recovery fees 4,144 6,350 Other 3,741 3,443 $ 25,610 $ 22,030

Short and Long-Term Obligatio44

Short and Long-Term Obligations (Tables)	12 Months Ended
	Dec. 31, 2017
Debt Disclosure [Abstract]
Short and Long-Term Obligations	Short and long-term obligations are as follows: December 31, 2017 2016 Term loan $ 24,250 $ 50,750 Revolving Credit facility 22,500 33,000 Less unamortized debt issuance costs (406 ) (403 ) Total 46,344 83,347 Less current portion (4,268 ) (6,080 ) Long-term portion $ 42,076 $ 77,267
Contractual Maturities of Term Loan Net of Debt Issuance Costs and Revolving Credit Facility	As of December 31, 2017, contractual maturities of the Term Loan net of debt issuance costs, and the Revolving Credit Facility are as follows: Term Loan Revolving Total 2018 $ 4,268 $ — $ 4,268 2019 19,576 22,500 42,076 $ 23,844 $ 22,500 $ 46,344

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Income Tax (Provision) Benefit	The Company’s income tax (provision) benefit consists of the following components: Year Ended December 31, 2017 2016 2015 Current: Federal $ (3,176 ) $ (150 ) $ (988 ) State (915 ) (92 ) (159 ) International — 456 (544 ) Total current (4,091 ) 214 (1,691 ) Deferred: Federal (14,340 ) 2,477 (5,695 ) State (1,022 ) 562 68 International — (192 ) (981 ) Total deferred (15,362 ) 2,847 (6,608 ) Total income tax (provision) benefit $ (19,453 ) $ 3,061 $ (8,299 )
Deferred Tax Assets and Liabilities	The components of the deferred tax assets and liabilities consisted of the following at: December 31, 2017 December 31, 2016 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities Allowance for bad debts $ 186 $ — $ 485 $ — Deferred compensation 1,783 — 4,675 — Inventory 5,905 — 12,811 — Fixed assets and intangibles — (7,370 ) — (5,690 ) Investments — — 2,133 — Net operating losses 8,106 — 4,547 — Tax credits 4,387 — 5,235 — Deferred revenue 1,874 — 3,804 — Accrued liabilities 2,072 — 2,004 — Other — (110 ) — (120 ) Valuation allowance (7,258 ) — (4,916 ) — Total $ 17,055 $ (7,480 ) $ 30,778 $ (5,810 )
Unrecognized Tax Benefits	The Company’s unrecognized tax benefits are summarized as follows: Year Ended December 31, 2017 2016 2015 Opening balance $ 1,591 $ 1,986 $ 1,787 Reductions based on tax positions related to the current year — — — Additions for tax positions of prior years — — 199 Reductions for tax positions of prior years — (60 ) — Reductions for expiration of statute of limitations — (335 ) — $ 1,591 $ 1,591 $ 1,986
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, 2017 2016 2015 Statutory federal rate 35.00 % 35.00 % 35.00 % State income taxes—net of federal tax benefit 2.43 % 1.73 % 0.25 % Foreign rate differential 2.85 % (3.29 %) (2.18 %) Tax legislation—transition tax 2.92 % — — Tax legislation—revaluation of deferred tax assets 5.58 % — — Other permanent items 1.63 % (3.15 %) 0.56 % Tax credits (4.62 %) 7.02 % (0.28 %) Domestic production activities deduction 0.00 % 1.38 % — Goodwill disposal 11.76 % — — Officer compensation 4.26 % Stock-based compensation 6.18 % — — Valuation allowance 5.94 % (21.71 %) 0.85 % Other reconciling items, net 1.69 % 0.55 % 1.55 % Effective tax rate 75.62 % 17.53 % 35.75 %

Preferred Stock (Tables)

Preferred Stock (Tables)	12 Months Ended
	Dec. 31, 2017
Equity [Abstract]
Schedule of Preferred Stock	Preferred stock is as follows: Preferred Stock Preferred Stock Net Total Balance at January 1, 2015 $ 53,863 $ (1,029 ) $ 52,834 Accrued dividend 3,305 — 3,305 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2015 57,168 (845 ) 56,323 Accrued dividend 3,508 — 3,508 Amortization of preferred stock issuance costs — 185 185 Balance at December 31, 2016 60,676 (660 ) 60,016 Accrued dividend 3,723 — 3,723 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2017 $ 64,399 $ (476 ) $ 63,923

Severance and Restructuring C47

Severance and Restructuring Costs (Tables)	12 Months Ended
	Dec. 31, 2017
Former Chief Executive Officer [Member]
Schedule of Restructuring Charges	The following table includes a rollforward of executive transition costs included in accrued expenses, see Note 12. Accrued executive transition costs at January 1, 2016 $ — Executive transition costs accrued in 2016 4,404 Stock-based compensation (1,535 ) Cash payments (463 ) Accrued executive transition costs at December 31, 2016 2,406 Executive transition costs accrued in 2017 2,781 Stock-based compensation (1,612 ) Cash payments (1,275 ) Accrued executive transition costs at December 31, 2017 $ 2,300
Employee Severance [Member]
Schedule of Restructuring Charges	The following table includes a rollforward of severance and restructuring costs included in accrued expenses, see Note 12. Accrued severance and restructuring charges at January 1, 2015 $ 2,771 Severance and restructuring expenses accrued in 2015 995 Severance and restructuring cash payments (2,591 ) Stock based compensation (310 ) Accrued severance and restructuring charges at December 31, 2015 865 Severance and restructuring expenses accrued in 2016 2,146 Severance and restructuring cash payments (1,866 ) Asset abandonments (640 ) Accrued severance and restructuring charges at December 31, 2016 505 Severance and restructuring expenses accrued in 2017 12,173 Severance and restructuring cash payments (8,246 ) Stock based compensation (1,153 ) Accrued severance and restructuring charges at December 31, 2017 $ 3,279

Concentrations of Risk (Tables)

Concentrations of Risk (Tables)	12 Months Ended
	Dec. 31, 2017
Risks and Uncertainties [Abstract]
Schedule of Percentage of Total Revenues Derived from Company's Largest Distributors	The following table presents percentage of total revenues derived from the Company’s largest distributors: Year Ended December 31, 2017 2016 2015 Percent of revenues derived from: Distributor Zimmer 17 % 16 % 24 % Medtronic 9 % 9 % 10 %

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2017
Commitments and Contingencies Disclosure [Abstract]
Future Minimum Lease Commitments under Non-Cancelable Operating Leases	Future minimum lease commitments under non-cancelable Operating 2018 $ 1,574 2019 939 2020 559 2021 117 $ 3,189

Segment Data (Tables)

Segment Data (Tables)	12 Months Ended
	Dec. 31, 2017
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, 2017, 2016 and 2015: Year Ended December 31, 2017 2016 2015 (In thousands) Revenues: Spine $ 77,514 27.7 % $ 73,907 27.1 % $ 57,983 20.5 % Sports medicine and orthopedics 50,231 18.0 % 50,143 18.4 % 50,712 18.0 % Surgical specialties 6,980 2.5 % 4,466 1.6 % 3,029 1.1 % Cardiothoracic 8,164 2.9 % 11,147 4.1 % 8,699 3.1 % International 23,240 8.3 % 21,185 7.8 % 18,338 6.5 % Subtotal direct 166,129 59.4 % 160,848 59.0 % 138,761 49.2 % OEM 103,011 36.9 % 99,127 36.3 % 129,930 46.0 % Other revenues 10,423 3.7 % 12,890 4.7 % 13,602 4.8 % Total revenues $ 279,563 100.0 % $ 272,865 100.0 % $ 282,293 100.0 % Domestic revenues $ 253,599 90.7 % $ 247,756 90.8 % $ 260,387 92.2 % International revenues 25,964 9.3 % 25,109 9.2 % 21,906 7.8 % Total revenues $ 279,563 100.0 % $ 272,865 100.0 % $ 282,293 100.0 %
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, 2017 2016 Property, plant and equipment—net: Domestic $ 73,363 $ 77,596 International 6,201 5,702 Total $ 79,564 $ 83,298

Quarterly Results of Operatio51

Quarterly Results of Operations (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2017
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 $ 69,939 $ 72,120 $ 66,688 $ 70,816 Gross profit 35,779 36,963 33,511 36,268 Net (loss) income applicable to common shares (2,782 ) (2,613 ) 16,548 (8,604 ) Net (loss) income per common share: Basic $ (0.05 ) $ (0.04 ) $ 0.28 $ (0.14 ) Diluted (0.05 ) (0.04 ) $ 0.22 $ (0.14 ) 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 )

Summary of Significant Accoun52

Summary of Significant Accounting Policies - Additional Information (Detail)	3 Months Ended	12 Months Ended
	Dec. 31, 2017USD ($)$ / shares	Dec. 31, 2017USD ($)Segment$ / sharesshares	Dec. 31, 2016USD ($)$ / sharesshares	Dec. 31, 2015USD ($)$ / 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		$ (3,739,000)	(5,435,000)	$ (814,000)
Number of reportable segments | Segment		1
Other identifiable intangible assets	$ 0	$ 0	$ 0
Dividend yield		0.00%
Common stock repurchased, share repurchased | shares		745,122	138,597	49,454
Common stock repurchased, value		$ 3,500,000	$ 400,000	$ 300,000
Common stock price ranging | $ / shares	$ 3.86	$ 3.86	$ 4.28
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		4,692,037	5,764,607	5,661,514
Acquired Exclusivity Rights [Member]
Summary Of Significant Accounting Policies [Line Items]
Acquired exclusivity rights, remaining amortization period		8 years
German Bank Credit Facilities [Member]
Summary Of Significant Accounting Policies [Line Items]
Asset abandonments			$ (5,435,000)	$ (814,000)
Us Bank Credit Facilities [Member]
Summary Of Significant Accounting Policies [Line Items]
Asset abandonments	$ (3,539,000)
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]
Intangible assets, amortization period		5 years
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] | Acquired Licensing Rights [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]
Intangible assets, amortization period		25 years
Common stock price ranging | $ / shares	$ 8.20	$ 8.20	$ 9.57	$ 9.57
Maximum [Member] | Patents [Member]
Summary Of Significant Accounting Policies [Line Items]
Intangible assets, amortization period		16 years
Maximum [Member] | Acquired Licensing Rights [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 Accoun53

Summary of Significant Accounting Policies - Property, Plant, and Equipment are Stated at Cost Less Accumulated Depreciation (Detail)	12 Months Ended
	Dec. 31, 2017
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 Accoun54

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, 2017	Dec. 31, 2016	Dec. 31, 2015
Earnings Per Share [Abstract]
Weighted average basic shares	59,684,289	58,236,745	57,611,231
Effect of dilutive securities: Stock options	915,663		979,263
Weighted average diluted shares	60,599,952	58,236,745	58,590,494

Recently Issued Accounting St55

Recently Issued Accounting Standards - Additional Information (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2017USD ($)Contract	Dec. 31, 2016USD ($)	Dec. 31, 2015USD ($)	Jan. 01, 2018USD ($)
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Income tax expense	$ 19,453	$ (3,061)	$ 8,299
Accounting Standards Update 2016-09 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Income tax expense	$ 1,591
Accounting Standards Update 2014-09 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of contracts affected | Contract	2
Accounting Standards Update 2014-09 [Member] | Accumulated Deficit [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of change on equity or net assets	$ 1,800
Accounting Standards Update 2014-09 [Member] | Accounts Receivable [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of change on equity or net assets	2,500
Accounting Standards Update 2014-09 [Member] | Deferred Tax Assets [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of change on equity or net assets	$ 700
Accounting Standards Update 2014-09 [Member] | Subsequent Event [Member] | Accumulated Deficit [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of change on equity or net assets				$ 2,200
Accounting Standards Update 2014-09 [Member] | Subsequent Event [Member] | Accounts Receivable [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of change on equity or net assets				3,000
Accounting Standards Update 2014-09 [Member] | Subsequent Event [Member] | Deferred Tax Assets [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cumulative effect of change on equity or net assets				$ 800

Cardiothoracic Closure Busine56

Cardiothoracic Closure Business Divestiture - Additional Information (Detail) - Discontinued Operations, Disposed of by Sale [Member] - Cardiothoracic [Member] $ in Thousands	Aug. 03, 2017USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses	$ 54,000
Escrow deposit	3,000
If the Company Obtains Certain FDA Regulatory Clearance [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contingent cash consideration receivable	1,000
If A&E Reaches Certain Revenue Milestones [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Contingent cash consideration receivable	$ 5,000

Cardiothoracic Closure Busine57

Cardiothoracic Closure Business Divestiture - Schedule of Calculation of Gain of CT Business Divestiture (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2017USD ($)
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from cardiothoracic closure business divestiture	$ 51,000
Gain on cardiothoracic closure business divestiture	34,090
Discontinued Operations, Disposed of by Sale [Member] | Cardiothoracic [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from cardiothoracic closure business divestiture	51,000
Inventories-net	(2,893)
Property, plant and equipment-net	(1,299)
Goodwill	(8,645)
Other intangible assets-net	(280)
Cardiothoracic closure business divestiture expenses	(3,793)
Gain on cardiothoracic closure business divestiture	$ 34,090

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($)	Jun. 01, 2018	Jan. 26, 2018	Dec. 04, 2017	Dec. 31, 2017	Jun. 30, 2017	Dec. 31, 2017	Mar. 31, 2018	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
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%
Total unrecognized stock-based compensation				$ 3,684,000		$ 3,684,000
Stock-based compensation awards, weighted-average period recognized						1 year 9 months 3 days
Common Stock, par value				$ 0.001		$ 0.001		$ 0.001
Number of options granted						2,875,438
Exercise price for stock option issued						$ 3.64
Number of shares expected to vest				4,247,224		4,247,224
Former Chief Executive Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						1,950,000
Exercise price for stock option issued						$ 3.20
Stock option expiration date						Jan. 26, 2022
Vesting term						The Stock Options will vest based on the Company’s attainment of three average stock price benchmarks. The first 650,000 shares will vest if the Company’s average publicly traded stock price is over $6.00 for a sixty-consecutive calendar day period. The next 650,000 shares will vest if the Company’s average publicly traded stock price is over $7.00 for a sixty-consecutive calendar day period. The final 650,000 shares will vest if the Company’s average publicly traded stock price is over $8.00 for a sixty-consecutive calendar day period. The vesting of the Stock Options is cumulative.
Former Chief Executive Officer [Member] | Tranche One [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						650,000
Exercise price for stock option issued						$ 6
Former Chief Executive Officer [Member] | Tranche Two [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						650,000
Exercise price for stock option issued						$ 7
Former Chief Executive Officer [Member] | Tranche Three [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						650,000
Exercise price for stock option issued						$ 8
Former Chief Financial and Administrative Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						306,900
Exercise price for stock option issued						$ 4.55
Stock option expiration date						Sep. 18, 2027
Vesting term						The Stock Options will vest based the Company’s attainment of three average stock price benchmarks. The first 102,300 shares will vest if the Company’s average publicly traded stock price is over $7.00 per share for a sixty-consecutive calendar day period. The next 102,300 shares will vest if the Company’s average publicly traded stock price is over $8.00 per share for a sixty-consecutive calendar day period. The final 102,300 shares will vest if the Company’s average publicly traded stock price is over $9.00 per share for a sixty-consecutive calendar day period. The vesting of the Stock Options is cumulative.
Former Chief Financial and Administrative Officer [Member] | Tranche One [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						102,300
Exercise price for stock option issued						$ 7
Former Chief Financial and Administrative Officer [Member] | Tranche Two [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						102,300
Exercise price for stock option issued						$ 8
Former Chief Financial and Administrative Officer [Member] | Tranche Three [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of options granted						102,300
Exercise price for stock option issued						$ 9
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		4,656,587
Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Contractual term of stock options granted						5 years
Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Contractual term of stock options granted						10 years
Restricted Stock Awards [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted						1,701,577
Number of shares vested						960,652
Number of shares to be forfeited						138,389
Restricted Stock Awards [Member] | Employee Directors [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted						1,546,890
Restricted Stock Awards [Member] | Non-Employee Directors [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted						154,687
Restricted Stock Awards [Member] | Restricted Stock Agreement Two [Member] | Former Chief Executive Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted				150,000
Number of shares expected to vest				150,000		150,000
Number of shares vested					150,000
Fair value of shares granted				$ 500,000		$ 500,000
Fair value of shares issued					$ 572,000
Shares non transferable period					1 year
Restricted stock award vested effective date					May 18, 2017
Restricted Stock Awards [Member] | Restricted Stock Agreement [Member] | Former Chief Financial and Administrative Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period						3 years
Number of shares granted						109,890
Restricted Stock Awards [Member] | Restricted Stock Agreement [Member] | Former Chief Financial and Administrative Officer [Member] | Tranche One [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest				36,630		36,630
Restricted Stock Awards [Member] | Restricted Stock Agreement [Member] | Former Chief Financial and Administrative Officer [Member] | Tranche Two [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest				36,630		36,630
Restricted Stock Awards [Member] | Restricted Stock Agreement [Member] | Former Chief Financial and Administrative Officer [Member] | Tranche Three [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest				36,630		36,630
Restricted Stock Awards [Member] | Restricted Stock Agreement One [Member] | Former Chief Executive Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period						4 years
Number of shares granted						850,000
Common Stock, par value			$ 0.001
Number of shares vested			425,000
Restricted stock award vested effective date						Mar. 31, 2019
Restricted Stock Awards [Member] | Restricted Stock Agreement One [Member] | Former Chief Executive Officer [Member] | Scenario, Forecast [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted	637,500
Number of shares to be forfeited	425,000
Restricted Stock Awards [Member] | Subsequent Event [Member] | Restricted Stock Agreement One [Member] | Former Chief Executive Officer [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest		170,000
Quarterly vesting rate		42,500
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]
Total unrecognized stock-based compensation				$ 3,344,000		$ 3,344,000
Stock-based compensation awards, weighted-average period recognized						1 year 11 months 15 days
Stock Options [Member] | Minimum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period						1 year
Stock Options [Member] | Maximum [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock-based compensation award, vesting period						5 years
Unaccelerated Restricted Shares [Member] | Restricted Stock Agreement One [Member] | Scenario, Forecast [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest							42,500
Unaccelerated Restricted Shares [Member] | Subsequent Event [Member] | Restricted Stock Agreement One [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares expected to vest		170,000

Stock-Based Compensation - Weig

Stock-Based Compensation - Weighted-Average Assumptions Used to Determine Fair Value of Options (Detail)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
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	2.26%	1.85%	1.67%
Volatility factor	47.39%	45.57%	46.29%
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, 2017USD ($)$ / sharesshares
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Outstanding, Number of Options	5,764,607
Granted, Number of Options	2,875,438
Exercised, Number of Options	(2,572,859)
Forfeited or expired, Number of Options	(1,375,149)
Outstanding, Number of Options	4,692,037
Vested or expected to vest, Number of Options	4,247,224
Exercisable, Number of Options	1,422,953
Available for grant, Number of Options	1,949,068
Outstanding, Weighted Average Exercise Price | $ / shares	$ 4.28
Granted, Weighted Average Exercise Price | $ / shares	3.64
Exercised, Weighted Average Exercise Price | $ / shares	3.57
Forfeited or expired, Weighted Average Exercise Price | $ / shares	5.69
Outstanding, Weighted Average Exercise Price | $ / shares	3.86
Vested or expected to vest, Weighted Average Exercise Price | $ / shares	3.87
Exercisable, Weighted Average Exercise Price | $ / shares	$ 4.28
Outstanding, Weighted Average Remaining Contractual Life (Years)	5 years 10 months 10 days
Vested or expected to vest, Weighted Average Remaining Contractual Life (Years)	5 years 8 months 9 days
Exercisable, Weighted Average Remaining Contractual Life (Years)	3 years 7 months 24 days
Outstanding, Aggregate Intrinsic Value | $	$ 2,554
Vested or expected to vest, Aggregate Intrinsic Value | $	2,301
Exercisable, Aggregate Intrinsic Value | $	$ 530

Stock-Based Compensation - St61

Stock-Based Compensation - Stock-Based Compensation Recognized (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 6,762	$ 3,590	$ 2,548
Costs of Processing and Distribution [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	132	140	132
Marketing, General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	6,586	3,406	2,356
Research and Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 44	$ 44	$ 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, 2017	Dec. 31, 2016	Dec. 31, 2015
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Weighted average fair value of stock options granted	$ 1.66	$ 1.55	$ 2.50
Aggregate intrinsic value of stock options exercised	$ 2,786	$ 12	$ 1,584

Stock-Based Compensation - Unve

Stock-Based Compensation - Unvested Restricted Stock Awards (Detail) - Restricted Stock Awards [Member]	12 Months Ended
	Dec. 31, 2017$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Number of shares | shares	530,988
Granted, Number of shares | shares	1,701,577
Vested, Number of shares | shares	(960,652)
Forfeited, Number of shares | shares	(138,389)
Ending Balance, Number of shares | shares	1,133,524
Beginning Balance, Weighted Average Grant Date Fair Value | $ / shares	$ 3.64
Granted, Weighted Average Grant Date Fair Value | $ / shares	4.05
Vested, Weighted Average Grant Date Fair Value | $ / shares	3.77
Forfeited, Weighted Average Grant Date Fair Value | $ / shares	3.56
Ending Balance, Weighted Average Grant Date Fair Value | $ / shares	$ 4.15

Inventories - Components of Inv

Inventories - Components of Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Inventory Disclosure [Abstract]
Unprocessed tissue, raw materials and supplies	$ 22,071	$ 31,745
Tissue and work in process	40,481	38,552
Implantable tissue and finished goods	49,375	49,446
Inventory - net	$ 111,927	$ 119,743

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Inventory Disclosure [Abstract]
Provision for inventory write-downs	$ 5,066	$ 13,880	$ 5,390

Prepaid and Other Assets - Sche

Prepaid and Other Assets - Schedule of Prepaid and Other Current Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Income tax receivable	$ 9,825	$ 1,041
Receivable for executive stock option exercise	1,234
Other	5,226	4,172
Prepaid and other current assets	$ 16,285	$ 5,213

Property, Plant and Equipment -

Property, Plant and Equipment - Components of Property, Plant and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 152,031	$ 149,399
Less accumulated depreciation	(72,467)	(66,101)
Property, plant and equipment, net	79,564	83,298
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	2,020	2,324
Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	57,954	59,187
Processing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	44,137	38,387
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	21,256	18,394
Office Equipment, Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	1,352	1,701
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	19,332	11,852
Construction in Process [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 5,980	$ 17,554

Property, Plant and Equipment68

Property, Plant and Equipment - Additional Information (Detail) - USD ($) $ in Thousands	Oct. 20, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Depreciation expense in connection with property, plant and equipment		$ 10,513	$ 12,835	$ 12,240
Disposal on owned Property	$ 1,818

Goodwill - Schedule of Goodwill

Goodwill - Schedule of Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Goodwill and Intangible Assets Disclosure [Abstract]
Beginning Balance	$ 54,887	$ 54,887
Goodwill disposed of related to sale of CT business	8,645	0
Ending Balance	$ 46,242	$ 54,887

Goodwill - Additional Informati

Goodwill - Additional Information (Detail) - USD ($)	Aug. 03, 2017	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment loss	$ 0	$ 0

Other Intangible Assets - Compo

Other Intangible Assets - Components of Other Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 46,723	$ 44,457
Accumulated Amortization	23,653	20,463
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,373	11,559
Accumulated Amortization	4,890	4,159
Acquired Licensing Rights [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	14,747	12,204
Accumulated Amortization	9,097	8,302
Marketing and Procurement Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	20,603	20,694
Accumulated Amortization	$ 9,666	$ 8,002

Other Intangible Assets - Addit

Other Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense of other intangible assets	$ 3,713	$ 3,675	$ 4,282

Other Intangible Assets - Estim

Other Intangible Assets - Estimates of Future Amortization Expense (Detail) $ in Thousands	Dec. 31, 2017USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2,018	$ 3,800
2,019	3,800
2,020	3,700
2,021	3,700
2,022	$ 3,500

Fair Value Information - Summar

Fair Value Information - Summary of Impairments of Long-Lived Assets and Related Post Impairment Fair Values (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Property, plant and equipment-net, impairment	$ 0	$ 4,717
Other intangible assets-net, impairment		718
Asset impairment	$ 3,739	5,435
Property, plant and equipment-net, fair value		4,708
Other intangible assets-net, fair value		150
Post impairment fair values		$ 4,858

Fair Value Information - Additi

Fair Value Information - Additional information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Impairment on long-lived assets	$ 0	$ 4,717

Accrued Expenses - Accrued Expe

Accrued Expenses - Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Payables and Accruals [Abstract]
Accrued compensation	$ 8,257	$ 4,904
Accrued severance and restructuring charges	3,279	505
Accrued executive transition costs	2,300	2,406
Accrued distributor commissions	3,889	4,422
Accrued donor recovery fees	4,144	6,350
Other	3,741	3,443
Total accrued expenses	$ 25,610	$ 22,030

Short and Long-Term Obligatio77

Short and Long-Term Obligations - Short and Long-Term Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Debt Disclosure [Abstract]
Term loan	$ 24,250	$ 50,750
Revolving Credit facility	22,500	33,000
Less unamortized debt issuance costs	(406)	(403)
Debt and capital lease obligation, total	46,344	83,347
Debt and capital lease obligation, total	46,344	83,347
Less current portion	(4,268)	(6,080)
Long-term portion	$ 42,076	$ 77,267

Short and Long-Term Obligatio78

Short and Long-Term Obligations - Additional Information (Detail) - USD ($)	Aug. 03, 2017	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Sep. 15, 2019
Line of Credit Facility [Line Items]
Interest rate for term loan and revolving credit facility		4.86%
Aggregate principal payment on term loan		$ 6,750,000
Credit facility, outstanding		22,500,000	$ 33,000,000
Minimum cash balance required for covenant compliance		$ 10,000,000
Covenant Terms of Credit Facility		The credit agreement also contains various restrictive covenants which limit, among other things, indebtedness and liens, as well as payment of dividends, while requiring a minimum cash balance on hand of $10,000 and certain financial covenant ratios.
Interest expense associated with the amortization of debt issuance costs		$ 409,000	$ 202,000	$ 148,000
Scenario, Forecast [Member]
Line of Credit Facility [Line Items]
Amount of final balloon principal payment					$ 17,500,000
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Repayments of secured debt	$ 10,000,000
Credit facility, outstanding		22,500,000
Current borrowing capacity		$ 20,000,000
2017 Loan Agreement [Member]
Line of Credit Facility [Line Items]
Aggregate principal payment on term loan	$ 1,125,000
Debt instrument, date of first required payment	Oct. 1, 2017
Debt instrument, maturity date	Sep. 15, 2019
2017 Loan Agreement [Member] | LIBOR [Member]
Line of Credit Facility [Line Items]
Interest rate for term loan and revolving credit facility	3.50%
2017 Loan Agreement [Member] | Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Credit facility, borrowing capacity	$ 42,500,000
2017 Loan Agreement [Member] | Term Loan [Member]
Line of Credit Facility [Line Items]
Aggregate principal amount	25,375,000
2013 Loan Agreement [Member]
Line of Credit Facility [Line Items]
Repayments of secured debt	$ 22,000,000
Percentage of foreign subsidiaries stock held as collateral	65.00%
Debt instrument, maturity date	Jul. 16, 2018

Short and Long-Term Obligatio79

Short and Long-Term Obligations - Contractual Maturities of Term Loan Net of Debt Issuance Costs and Revolving Credit Facility (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Debt Instrument [Line Items]
2,018	$ 4,268
2,019	42,076
Debt and capital lease obligation, total	46,344	$ 83,347
Term Loan [Member]
Debt Instrument [Line Items]
2,018	4,268
2,019	19,576
Debt and capital lease obligation, total	23,844
Revolving Credit Facility [Member]
Debt Instrument [Line Items]
2,019	22,500
Debt and capital lease obligation, total	$ 22,500

Income Taxes - Income Tax (Prov

Income Taxes - Income Tax (Provision) Benefit (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current:
Federal	$ (3,176)	$ (150)	$ (988)
State	(915)	(92)	(159)
International		456	(544)
Total current	(4,091)	214	(1,691)
Deferred:
Federal	(14,340)	2,477	(5,695)
State	(1,022)	562	68
International		(192)	(981)
Total deferred	(15,362)	2,847	(6,608)
Total income tax (provision) benefit	$ (19,453)	$ 3,061	$ (8,299)

Income Taxes - Deferred Tax Ass

Income Taxes - Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Deferred income tax asset, allowance for bad debts	$ 186	$ 485
Deferred income tax asset, deferred compensation	1,783	4,675
Deferred income tax asset, inventory	5,905	12,811
Deferred income tax asset, fixed assets and intangibles	0	0
Deferred income tax asset, investments		2,133
Deferred income tax asset, net operating losses	8,106	4,547
Deferred income tax asset, tax credits	4,387	5,235
Deferred income tax asset, deferred revenue	1,874	3,804
Deferred income tax asset, accrued liabilities	2,072	2,004
Deferred income tax asset, other	0	0
Deferred income tax asset, valuation allowance	(7,258)	(4,916)
Deferred income tax asset, total	17,055	30,778
Deferred income tax liability, allowance for bad debts	0	0
Deferred income tax liability, deferred compensation	0	0
Deferred income tax liability, inventory	0	0
Deferred income tax liability, fixed assets and intangibles	(7,370)	(5,690)
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	(110)	(120)
Deferred income tax liability, valuation allowance	0	0
Deferred income tax liability, total	$ (7,480)	$ (5,810)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Operating Loss Carryforwards [Line Items]
Deferred tax assets		$ 9,575,000
Deferred tax assets, valuation allowances		$ 7,258,000
Statutory federal rate		35.00%	35.00%	35.00%
Income tax expense benfit due to change in tax rate		$ 2,187,000
Change in Tax Rate Revaluation of Deferred Tax Assets		1,436,000
Income tax expense benfit, transition tax expense		$ 751,000
Tax Cuts and Jobs Act of 2017, Accounting Complete		false
Research tax credit carryforwards		$ 4,403,000
Research tax credit carryforwards, first year of expiration period		2,030
Research tax credit carryforwards, last year of expiration period		2,037
Foreign tax credit carryforwards		$ 751,000
Foreign tax credit carryforwards, expiration period		2,037
Primary measure of cumulative losses, number of rolling years		3 years
Unrecognized tax benefits		$ 1,591,000	$ 1,591,000	$ 1,986,000	$ 1,787,000
Interest and penalties recorded		0	0	0
Interest and penalties accrued		0	0
Significant other reconciling items		0	0	$ 0
Scenario, Forecast [Member]
Operating Loss Carryforwards [Line Items]
Statutory federal rate	21.00%
Domestic Tax Authority [Member]
Operating Loss Carryforwards [Line Items]
Deferred tax assets, valuation allowances		7,258,000	$ 4,916,000
U S Federal [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards		$ 1,635,000
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		$ 42,420,000
Net operating loss carryforward expiration period, start year		2,018
Net operating loss carryforward expiration period, end year		2,037
Foreign Tax Authority [Member]
Operating Loss Carryforwards [Line Items]
Net operating loss carryforwards		$ 20,551,000

Income Taxes - Unrecognized Tax

Income Taxes - Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Opening balance	$ 1,591	$ 1,986	$ 1,787
Reductions based on tax positions related to the current year	0	0	0
Additions for tax positions of prior years			199
Reductions for tax positions of prior years		(60)
Reductions for expiration of statute of limitations		(335)
Closing balance	$ 1,591	$ 1,591	$ 1,986

Income Taxes - Effective Tax Ra

Income Taxes - Effective Tax Rate Differs from the Statutory Federal Income Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Statutory federal rate	35.00%	35.00%	35.00%
State income taxes-net of federal tax benefit	2.43%	1.73%	0.25%
Foreign rate differential	2.85%	(3.29%)	(2.18%)
Tax legislation-transition tax	2.92%
Tax legislation-revaluation of deferred tax assets	5.58%
Other permanent items	1.63%	(3.15%)	0.56%
Tax credits	(4.62%)	7.02%	(0.28%)
Domestic production activities deduction	(0.00%)	1.38%
Goodwill disposal	11.76%
Officer compensation	4.26%
Stock-based compensation	6.18%
Valuation allowance	5.94%	(21.71%)	0.85%
Other reconciling items, net	1.69%	0.55%	1.55%
Effective tax rate	75.62%	17.53%	35.75%

Preferred Stock - Schedule of P

Preferred Stock - Schedule of Preferred Stock (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Temporary Equity [Line Items]
Net Total	$ 63,923	$ 60,016	$ 56,323	$ 52,834
Accrued dividend	3,723	3,508	3,305
Amortization of preferred stock issuance costs	184	185	184
Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Net Total	64,399	60,676	57,168	53,863
Preferred Stock Issuance Costs	(476)	(660)	(845)	$ (1,029)
Accrued dividend	3,723	3,508	3,305
Amortization of preferred stock issuance costs	$ 184	$ 185	$ 184

Preferred Stock - Additional In

Preferred Stock - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Jul. 16, 2013	Jun. 12, 2013	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Preferred stock issuance cost			$ 476	$ 660	$ 845	$ 1,029
Private Placement with WSHP [Member] | Convertible Preferred Stock [Member]
Temporary Equity [Line Items]
Convertible preferred stock issued		$ 50,000
Preferred stock issuance cost	$ 1,290
Private Placement with WSHP [Member] | 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
Private Placement with WSHP [Member] | 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, 2017Voteshares	Dec. 31, 2016shares
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

Executive Transition Costs - Ad

Executive Transition Costs - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Postemployment Benefits Disclosure [Line Items]
Executive transition costs		$ 2,781	$ 4,404
Former Chief Executive Officer [Member]
Postemployment Benefits Disclosure [Line Items]
Executive transition costs		$ 2,781	$ 4,404
Scenario, Forecast [Member] | Former Chief Executive Officer [Member]
Postemployment Benefits Disclosure [Line Items]
Executive transition costs	$ 1,169

Executive Transition Costs - Sc

Executive Transition Costs - Schedule of Restructuring Charges (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Restructuring Cost and Reserve [Line Items]
Executive transition costs accrued	$ 2,781	$ 4,404
Stock-based compensation			$ (310)
Chief Executive Officer and Chief Financial and Administrative Officer [Member]
Restructuring Cost and Reserve [Line Items]
Accrued executive transition costs at January 1, 2016	2,406
Executive transition costs accrued	2,781	4,404
Stock-based compensation	(1,612)	(1,535)
Cash payments	(1,275)	(463)
Accrued executive transition costs at December 31, 2016	$ 2,300	$ 2,406

Severance and Restructuring C90

Severance and Restructuring Costs - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Restructuring and Related Activities [Abstract]
Severance and restructuring costs related to the reduction	$ 12,173	$ 2,146	$ 995

Severance and Restructuring C91

Severance and Restructuring Costs - Schedule of Restructuring Charges (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Restructuring Cost and Reserve [Line Items]
Accrued severance and restructuring charges, beginning balance	$ 505
Severance and restructuring expenses accrued	12,173	$ 2,146	$ 995
Stock based compensation			310
Accrued severance and restructuring charges, ending balance	3,279	505
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Accrued severance and restructuring charges, beginning balance	505	865	2,771
Severance and restructuring expenses accrued	12,173	2,146	995
Severance and restructuring cash payments	(8,246)	(1,866)	(2,591)
Stock based compensation	(1,153)		(310)
Asset abandonments		(640)
Accrued severance and restructuring charges, ending balance	$ 3,279	$ 505	$ 865

Retirement Benefits - Additiona

Retirement Benefits - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Defined Benefit Plan Disclosure [Line Items]
Cost recognized under benefit plan	$ 3,036	$ 3,094	$ 3,034
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, 2017Companies
Risks and Uncertainties [Abstract]
Companies with revenues	13
Companies with significant revenues	2

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, 2017	Dec. 31, 2016	Dec. 31, 2015
Zimmer Biomet Holdings, Inc. [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	17.00%	16.00%	24.00%
Medtronic, PLC [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	9.00%	9.00%	10.00%

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Thousands	Aug. 03, 2017	Oct. 12, 2013	Sep. 30, 2010	Sep. 10, 2010	Jul. 13, 2009	Mar. 31, 2015	Mar. 31, 2013	Dec. 31, 2010	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Commitment And Contingencies [Line Items]
Exclusivity payments									$ 3,500
Deferred revenue recognition									2,000	$ 2,000	$ 2,000
Rent expense									$ 1,325	$ 1,378	$ 1,443
Discontinued Operations, Disposed of by Sale [Member] | Cardiothoracic [Member]
Commitment And Contingencies [Line Items]
Proceeds from divestiture of businesses	$ 54,000
Escrow deposit	3,000
Discontinued Operations, Disposed of by Sale [Member] | Cardiothoracic [Member] | If A&E Reaches Certain Revenue Milestones [Member]
Commitment And Contingencies [Line Items]
Contingent cash consideration receivable	5,000
Discontinued Operations, Disposed of by Sale [Member] | Cardiothoracic [Member] | If the Company Obtains Certain FDA Regulatory Clearance [Member]
Commitment And Contingencies [Line Items]
Contingent cash consideration receivable	$ 1,000
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
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

Commitments and Contingencies96

Commitments and Contingencies - Future Minimum Lease Commitments under Non-Cancelable Operating Leases (Detail) $ in Thousands	Dec. 31, 2017USD ($)
Commitments and Contingencies Disclosure [Abstract]
2,018	$ 1,574
2,019	939
2,020	559
2,021	117
Total	$ 3,189

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, 2017LitigationClaims
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		1,214

Segment Data - Additional Infor

Segment Data - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2017Segment
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, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Other revenues									$ 10,423	$ 12,890	$ 13,602
Revenues	$ 70,816	$ 66,688	$ 72,120	$ 69,939	$ 71,347	$ 66,547	$ 67,620	$ 67,351	$ 279,563	$ 272,865	$ 282,293
Percentage of other revenues									3.70%	4.70%	4.80%
Percentage of revenues									100.00%	100.00%	100.00%
Domestic [Member]
Segment Reporting Information [Line Items]
Revenues									$ 253,599	$ 247,756	$ 260,387
Percentage of domestic revenues									90.70%	90.80%	92.20%
International [Member]
Segment Reporting Information [Line Items]
Revenues									$ 25,964	$ 25,109	$ 21,906
Percentage of international revenues									9.30%	9.20%	7.80%
Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 166,129	$ 160,848	$ 138,761
Percentage of sales revenue									59.40%	59.00%	49.20%
Spine [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 77,514	$ 73,907	$ 57,983
Percentage of sales revenue									27.70%	27.10%	20.50%
Sports Medicine and Orthopedics [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 50,231	$ 50,143	$ 50,712
Percentage of sales revenue									18.00%	18.40%	18.00%
Surgical Specialties [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 6,980	$ 4,466	$ 3,029
Percentage of sales revenue									2.50%	1.60%	1.10%
Cardiothoracic [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 8,164	$ 11,147	$ 8,699
Percentage of sales revenue									2.90%	4.10%	3.10%
International [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 23,240	$ 21,185	$ 18,338
Percentage of sales revenue									8.30%	7.80%	6.50%
OEM [Member] | Tissue Distribution [Member]
Segment Reporting Information [Line Items]
Tissue distribution									$ 103,011	$ 99,127	$ 129,930
Percentage of sales revenue									36.90%	36.30%	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, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 79,564	$ 83,298
Domestic [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	73,363	77,596
International [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 6,201	$ 5,702

Quarterly Results of Operati101

Quarterly Results of Operations (Unaudited) - Results of Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Revenues	$ 70,816	$ 66,688	$ 72,120	$ 69,939	$ 71,347	$ 66,547	$ 67,620	$ 67,351	$ 279,563	$ 272,865	$ 282,293
Gross profit	36,268	33,511	36,963	35,779	28,101	34,274	33,949	36,025	142,521	132,349	149,742
Net income (loss) applicable to common shares	$ (8,604)	$ 16,548	$ (2,613)	$ (2,782)	$ (11,799)	$ (4,489)	$ (3,162)	$ 1,543	$ 2,549	$ (17,907)	$ 11,610
Net income (loss) per common share:
Basic	$ (0.14)	$ 0.28	$ (0.04)	$ (0.05)	$ (0.20)	$ (0.08)	$ (0.05)	$ 0.03	$ 0.04	$ (0.31)	$ 0.20
Diluted	$ (0.14)	$ 0.22	$ (0.04)	$ (0.05)	$ (0.20)	$ (0.08)	$ (0.05)	$ 0.03	$ 0.04	$ (0.31)	$ 0.20

Quarterly Results of Operati102

Quarterly Results of Operations (Unaudited) - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Interim Reporting [Line Items]
Severance and restructuring costs	$ 12,173	$ 2,146	$ 995
Executive transition costs	2,781	4,404
Asset impairment and abandonments	3,739	5,435	$ 814
Acquisition expenses	630
Tax effect on new legislation	2,187
Offset set by a gain on CT Business divestiture	34,090
Excess inventory charge		9,556
Strategic review costs		1,150
Contested proxy expenses		$ 2,680
Discontinued Operations, Disposed of by Sale [Member] | Cardiothoracic [Member]
Interim Reporting [Line Items]
Offset set by a gain on CT Business divestiture	$ 34,090

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) - Subsequent Event [Member] - Zyga Technology Inc [Member] $ in Thousands	Jan. 04, 2018USD ($)
Subsequent Event [Line Items]
Date of merger agreement	Jan. 4, 2018
Payments to acquire businesses	$ 21,000
Clinical Milestones [Member]
Subsequent Event [Line Items]
Earnout consideration	1,000
Earn Out Payment [Member]
Subsequent Event [Line Items]
Revenue based earnout consideration	$ 35,000

Schedule II - Valuation and 104

Schedule II - Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Allowance for Doubtful Accounts [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	$ 1,728	$ 1,454	$ 818
Charged to Costs and Expenses	418	645	1,037
Deductions- Write-offs, Payments	675	371	401
Balance at End of Period	1,471	1,728	1,454
Allowance for Product Returns [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	629	714	525
Charged to Costs and Expenses	528	250	531
Deductions- Write-offs, Payments	47	335	342
Balance at End of Period	1,110	629	714
Allowance for Excess and Obsolescence [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	14,798	7,083	5,112
Charged to Costs and Expenses	5,066	13,880	5,390
Deductions- Write-offs, Payments	11,762	6,165	3,419
Balance at End of Period	8,102	14,798	7,083
Deferred Tax Asset Valuation Allowance [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	4,916	1,106	959
Charged to Costs and Expenses	1,668	3,833	197
Deductions- Write-offs, Payments	(674)	23	50
Balance at End of Period	$ 7,258	$ 4,916	$ 1,106