RTI Surgical (RTIX) 10-Q 3 Aug 18 2018 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2018	Jul. 27, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q2
Trading Symbol	RTIX
Entity Registrant Name	RTI SURGICAL, INC.
Entity Central Index Key	1,100,441
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		63,377,839

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Current Assets:
Cash and cash equivalents	$ 14,246	$ 22,381
Accounts receivable - less allowances of $1,661 at June 30, 2018 and $1,471 at December 31, 2017	45,576	35,081
Inventories - net	101,022	111,927
Prepaid and other current assets	8,038	16,285
Total current assets	168,882	185,674
Property, plant and equipment - net	76,838	79,564
Deferred tax assets - net	14,448	9,575
Goodwill	64,863	46,242
Other intangible assets - net	20,624	23,070
Other assets - net	1,838	1,781
Total assets	347,493	345,906
Current Liabilities:
Accounts payable	14,797	18,252
Accrued expenses	23,914	25,610
Current portion of deferred revenue	5,020	4,868
Current portion of short and long-term obligations		4,268
Total current liabilities	43,731	52,998
Long-term obligations - less current portion	53,416	42,076
Other long-term liabilities	5,155	1,431
Deferred revenue	3,155	3,741
Total liabilities	105,457	100,246
Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding	65,961	63,923
Stockholders' equity:
Common stock, $.001 par value: 150,000,000 shares authorized; 63,377,839 and 62,694,441 shares issued and outstanding, respectively	63	63
Additional paid-in capital	430,311	429,459
Accumulated other comprehensive loss	(6,850)	(6,329)
Accumulated deficit	(242,619)	(237,066)
Less treasury stock, 1,213,009 and 1,114,071 shares, respectively, at cost	(4,830)	(4,390)
Total stockholders' equity	176,075	181,737
Total liabilities and stockholders' equity	$ 347,493	$ 345,906

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 1,661	$ 1,471
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	63,377,839	62,694,441
Common stock, shares outstanding	63,377,839	62,694,441
Treasury stock, shares	1,213,009	1,114,071

Condensed Consolidated Statemen

Condensed Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Income Statement [Abstract]
Revenues	$ 70,685	$ 72,120	$ 140,575	$ 142,059
Costs of processing and distribution	40,645	35,157	76,853	69,317
Gross profit	30,040	36,963	63,722	72,742
Expenses:
Marketing, general and administrative	29,266	29,496	57,655	59,167
Research and development	3,270	3,740	6,691	7,428
Severance and restructuring costs		3,400	884	7,803
Asset impairment and abandonments	4,515		4,644
Acquisition and integration expenses			800
Total operating expenses	37,051	36,636	70,674	74,398
Operating (loss) income	(7,011)	327	(6,952)	(1,656)
Other (expense) income:
Interest expense	(777)	(915)	(1,612)	(1,734)
Interest income	6		17
Loss on extinguishment of debt	(309)		(309)
Foreign exchange gain	(71)	(75)	(22)	(55)
Total other expense - net	(1,151)	(990)	(1,926)	(1,789)
Loss before income tax provision	(8,162)	(663)	(8,878)	(3,445)
Income tax benefit (provision)	2,702	(1,026)	2,453	(116)
Net loss	(5,460)	(1,689)	(6,425)	(3,561)
Convertible preferred dividend	(981)	(924)	(1,947)	(1,834)
Net loss applicable to common shares	(6,441)	(2,613)	(8,372)	(5,395)
Other comprehensive (loss) gain:
Unrealized foreign currency translation (loss) gain	(914)	1,093	(521)	1,413
Comprehensive loss	$ (7,355)	$ (1,520)	$ (8,893)	$ (3,982)
Net loss per common share - basic	$ (0.10)	$ (0.04)	$ (0.13)	$ (0.09)
Net loss per common share - diluted	$ (0.10)	$ (0.04)	$ (0.13)	$ (0.09)
Weighted average shares outstanding - basic	63,405,708	58,935,786	63,400,737	58,715,791
Weighted average shares outstanding - diluted	63,405,708	58,935,786	63,400,737	58,715,791

Condensed Consolidated Stateme5

Condensed Consolidated Statement of Stockholders' Equity - 6 months ended Jun. 30, 2018 - 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, 2017	$ 181,737		$ 63	$ 429,459		$ (6,329)	$ (237,066)	$ (4,390)
Accumulated effect of adoption of the revenue recognition standard	872						872
Net loss	(6,425)						(6,425)
Foreign currency translation adjustment	(521)					(521)
Exercise of common stock options	320			320
Stock-based compensation	2,570			2,570
Purchase of treasury stock	(440)							(440)
Amortization of preferred stock Series A issuance costs		$ (91)			$ (91)
Preferred stock Series A dividend		$ (1,947)			$ (1,947)
Ending Balance at Jun. 30, 2018	$ 176,075		$ 63	$ 430,311		$ (6,850)	$ (242,619)	$ (4,830)

Condensed Consolidated Stateme6

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Cash flows from operating activities:
Net loss	$ (5,460)	$ (1,689)	$ (6,425)	$ (3,561)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization expense	3,484	3,561	7,068	7,129
Provision for bad debts and product returns	345	216	494	560
Provision for inventory write-downs	8,224	1,964	10,865	3,753
Amortization of deferred revenue	(1,218)	(1,186)	(2,435)	(2,460)
Deferred income tax (benefit) provision	(2,633)	524	(2,671)	(561)
Stock-based compensation	1,290	974	2,570	1,808
Asset impairment and abandonments	4,515		4,644
Other	330	759	610	873
Change in assets and liabilities:
Accounts receivable	(4,528)	(2,777)	(7,640)	2,128
Inventories	(2,538)	(567)	(411)	167
Accounts payable	(290)	890	(3,803)	998
Accrued expenses	1,285	(1,963)	(2,592)	(1,384)
Deferred revenue			2,000	2,000
Other operating assets and liabilities	8,021	330	7,104	(837)
Net cash provided by operating activities	10,827	1,036	9,378	10,613
Cash flows from investing activities:
Purchases of property, plant and equipment	(1,738)	(3,877)	(3,856)	(7,160)
Patent and acquired intangible asset costs	(398)	(1,526)	(728)	(1,845)
Acquisition of Zyga Technology			(21,000)
Net cash used in investing activities	(2,136)	(5,403)	(25,584)	(9,005)
Cash flows from financing activities:
Proceeds from exercise of common stock options	35	1,467	1,429	1,575
Proceeds from long-term obligations	54,425	2,000	74,425	4,000
Payments on long-term obligations	(61,625)	(3,125)	(66,750)	(7,375)
Other financing activities	(1,026)		(1,026)	(142)
Net cash (used in) provided by financing activities	(8,191)	342	8,078	(1,942)
Effect of exchange rate changes on cash and cash equivalents	(66)	102	(7)	160
Net increase (decrease) in cash and cash equivalents	434	(3,923)	(8,135)	(174)
Cash and cash equivalents, beginning of period	13,812	17,598	22,381	13,849
Cash and cash equivalents, end of period	14,246	13,675	14,246	13,675
Supplemental cash flow disclosure:
Cash paid for interest	1,374	845	1,974	2,303
Income tax refunds, net of payments	6,698	32	6,698	32
Non-cash acquisition of property, plant and equipment	663	566	676	879
Increase in accrual for dividend payable	$ 981	$ 924	$ 1,947	$ 1,834

Operations and Organization

Operations and Organization	6 Months Ended
	Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Operations and Organization	1. Operations and Organization RTI Surgical is a global surgical implant company that designs, develops, manufactures and distributes biologic, metal and synthetic implants. The Company’s implants are used in orthopedic, spine, sports medicine, general surgery, trauma and other surgical procedures to repair and promote the natural healing of human bone and other human tissues and improve surgical outcomes. The Company manufactures metal and synthetic implants and processes donated human musculoskeletal and other tissue and bovine and porcine animal tissue in producing allograft and xenograft implants using its proprietary BIOCLEANSE ® ® ®

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	2. Basis of Presentation The accompanying unaudited condensed consolidated financial statements include all adjustments, consisting of normal recurring accruals, which the Company considers necessary for a fair presentation of the results of operations for the periods shown. The condensed consolidated financial statements have been prepared in accordance with the instructions to Form 10-Q 10-01 S-X, 10-K The condensed consolidated financial statements include the accounts of RTI Surgical, Inc. and its wholly owned subsidiaries, Pioneer Surgical Technology, Inc. (“Pioneer”), Tutogen Medical, Inc. (“TMI”), Zyga Technology, Inc. (“Zyga”), RTI Surgical, Inc. – Cardiovascular (inactive), Biological Recovery Group, Inc. (inactive) and RTI Services, Inc. (inactive). The condensed consolidated financial statements also include the accounts of RTI Donor Services, Inc. (“RTIDS”), which is a controlled entity.

Recently Issued Accounting Stan

Recently Issued Accounting Standards	6 Months Ended
	Jun. 30, 2018
Accounting Changes and Error Corrections [Abstract]
Recently Issued Accounting Standards	3. Recently Issued Accounting Standards 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 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 Revenue from Contracts with Customers Adoption Impact The Company identified three 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 assessment of our January 1, 2018, condensed consolidated balance sheet under ASC Topic 606 resulted in a cumulative-effect adjustment to opening retained earnings, unbilled accounts receivable and costs incurred for inventory. The effects of the adoption under ASC Topic 606 are outlined in the following table: Year Ended Impact January 1, 2018 Accounts receivable $ 35,081 $ 4,014 $ 39,095 Inventories - net 111,927 (1,766 ) 110,161 Accrued expenses — 1,110 1,110 Deferred tax assets 9,575 (266 ) 9,309 Accumulated deficit (237,066 ) 872 (236,194 ) The impact of adoption of Topic 606 to the Company’s condensed consolidated statements of comprehensive loss for the three and six months ended June 30, 2018 was as follows: For the Three Months Ended June 30, 2018 For the Six Months Ended June 30, 2018 Excluding Impact Excluding Impact As Reported of Topic 606 As Reported of Topic 606 Total revenues $ 70,685 $ 69,777 $ 140,575 $ 138,348 Cost of processing and distribution 40,645 40,331 76,853 75,896 Income tax benefit 2,702 2,889 2,453 2,852 Net loss (6,441 ) (6,848 ) (8,372 ) (9,243 ) Disaggregation of revenue The Company operates in one reportable segment composed of four lines of business. Effective January 1, 2018, the reporting of the Company’s lines of business are composed primarily of four categories: spine; sports; original equipment manufacturer (“OEM”) and international. The following table presents revenues from these four categories for the three and six months ended June 30, 2018: For the Three Months Ended For the Six Months Ended Revenues: Spine $ 18,934 $ 38,197 Sports 14,190 27,625 OEM 31,170 61,290 International 6,391 13,463 Total revenues from contracts with customers $ 70,685 $ 140,575 The following table presents revenues recognized at a point in time and over time for the three and six months ended June 30, 2018: For the Three Months Ended For the Six Months Ended Revenue recognized at a point in time $ 61,534 $ 121,697 Revenue recognized over time 9,151 18,878 Total revenues from contracts with customers $ 70,685 $ 140,575 Performance Obligations The Company’s performance obligations consist mainly of transferring control of implants identified in the contracts. Some of the Company’s contracts offer assurance-type warranties in connection with the sale of a product to a customer. Assurance-type warranties provide a customer with assurance that the related product will function as the parties intended because it complies with agreed-upon specifications. Such warranties do not represent a separate performance obligation and are not material to the condensed consolidated financial statements. When Performance Obligations Are Satisfied The Company typically transfers control at a point in time upon shipment or delivery of the implants for direct sales, or upon implantation for sales of consigned inventory. The customer is able to direct the use of, and obtain substantially all of the benefits from, the implant at the time the implant is shipped, delivered, or implanted, respectively based on the terms of the contract. For performance obligations related to the aforementioned three contracts with exclusively built inventory clauses, the Company typically satisfies its performance obligations evenly over the contract term as inventory is built. Such exclusively manufactured inventory has no alternative use and the Company has an enforceable right to payment for performance to date. The Company uses the input method to measure the manufacturing activities completed to date, which depicts the progress of the Company’s performance obligation of transferring control of exclusively built inventory. For the contracts with upfront and annual exclusivity fees, revenue related to those fees is recognized over the contract term following a consistent method of measuring progress towards satisfaction of the performance obligation. The Company uses the method and measure of progress that best depicts the transfer of control to the customer of the goods or services to date relative to the remaining goods or services promised under the contract. Significant Payment Terms The contract with the customer states the final terms of the sale, including the description, quantity, and price of each implant distributed. Payment for OEM contracts is typically due in full within 30 days of delivery or the start of the contract term. For the remaining lines of business, payment terms are typically due in full within 30 to 60 days of delivery. The Company performs a review of each specific customer’s credit worthiness and ability to pay prior to acceptance as a customer. Further, the Company performs periodic reviews of its customers’ creditworthiness prospectively. Since the customer agrees to a stated price in the contract that does not vary over the contract, the majority of contracts do not contain variable consideration. Nature of Goods and Services The Company distributes biologic, metal and synthetic implants. In some instances, the Company also enters into contracts with customers for exclusively manufactured inventory based on customer specifications. Returns In the normal course of business, the Company does accept product returns. The amount of consideration the Company ultimately receives varies depending upon the return terms that the Company may offer, which are accounted for as variable consideration when estimating the amount of revenue to recognize. The Company establishes provisions for estimated returns based on historical experience. The amount recorded on the Company’s balance sheets for product return allowance was $1,190 million and $1,110 million at June 30, 2018 and December 31, 2017, respectively. Liabilities for return allowances are included in “Accrued expenses”. Actual product returns have not differed materially from estimated amounts reserved in the accompanying condensed financial statements. Critical Accounting Estimates Estimates are used to determine the amount of variable consideration in contracts, and the measure of progress for contracts where revenue is recognized over time. The Company reviews and updates these estimates regularly. Our contracts generally do not include multiple performance obligations, and accordingly do not generally require estimates of the standalone selling price for each performance obligation. Some contracts with customers include variable consideration primarily related to volume rebates. The Company estimates variable consideration at the most likely amount to determine the total consideration which the Company expects to be entitled. Estimated amounts are included in the transaction price to the extent it is probable that a significant reversal of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved. The Company’s estimates of variable consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of our anticipated performance and all information (historical, current and forecasted) that is reasonably available. Contract Asset and Liability The opening and closing balances of the Company’s accounts receivable, contract asset and current and long-term contract liability are as follows: Accounts Contract Contract Opening 1/1/2018 $ 39,095 $ 5,978 $ 3,741 Closing 6/30/2018 45,576 6,210 3,155 Increase/(decrease) 6,481 232 (586 ) Contract liabilities consist primarily of the return allowance described above, and of deferred revenue arising from upfront and annual exclusivity fees. The difference between the opening and closing balances of the Company’s contract liabilities primarily results from the Company’s performance of the Company’s contractual obligations over time. The Company recognizes sales commissions as incurred because the amortization period is less than one year. The Company does not incur other incremental costs relating to obtaining a contract with a customer, and therefore, does not have material contract assets, or impairment losses associated therewith. Revenue recognized for the six months ended June 30, 2018 from amounts included in contract liabilities at the beginning of the period was $2,434.

Acquisition of Zyga Technology,

Acquisition of Zyga Technology, Inc.	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Acquisition of Zyga Technology, Inc.	4. Acquisition of Zyga Technology, Inc. On January 4, 2018, the Company acquired Zyga Technology, Inc. (“Zyga”), a leading spine-focused medical device company that develops and produces innovative minimally invasive devices to treat underserved conditions of the lumbar spine. Zyga’s primary product is the SImmetry ® The Company has accounted for the acquisition of Zyga under ASC 805, Business Combinations The purchase price was financed as follows: (In thousands) Cash proceeds from revolving credit facility $ 18,000 Cash from RTI Surgical 3,000 Total purchase price $ 21,000 The valuation of the acquired assets and liabilities is not yet complete, and as such, the Company has not yet finalized its allocation of the purchase price for the acquisition. The table below represents an allocation of the total consideration to Zyga’s tangible and intangible assets and liabilities based on management’s preliminary estimate of their respective fair values as of January 4, 2018. During the three months ended June 30, 2018, the Company made the following changes to the preliminary fair values of acquired assets and liabilities: increased inventory by $500, decreased deferred tax assets by $150, decreased current liabilities by $41 and decreased goodwill by $391. (In thousands) Inventories $ 1,549 Accounts receivable 573 Other current assets 53 Property, plant and equipment 151 Other assets 26 Deferred tax assets 2,674 Current liabilities (947 ) Acquisition contingencies (3,700 ) Net tangible assets acquired 379 Other intangible assets 2,000 Goodwill 18,621 Total net assets acquired $ 21,000 Total net assets acquired as of January 4, 2018, are all part of the Company’s only operating segment. Fair values are based on management’s preliminary estimates and assumptions including variations of the income approach, the cost approach and the market approach. Other intangible assets include patents, trademarks, and selling and marketing relationships. The Company believes that the acquisition of Zyga has offered and continues to offer the potential for substantial strategic and financial benefits. The transaction further advances our strategic transformation focused on reducing complexity, driving operational excellence and accelerating growth. The Company believes the acquisition will enhance stockholder value through, among other things, enabling the Company to capitalize on the following strategic advantages and opportunities: • Zyga’s innovative minimally invasive treatment should accentuate our spine portfolio and opens significant opportunities to accelerate our Spine-focused expansion strategy. • Zyga should leverage the core competencies of our Spine franchise by pursuing niche differentiated products, to gain scale and customer retention and support portfolio pull-through. These potential benefits resulted in the Company paying a premium for Zyga resulting in the recognition of $18,621 of goodwill assigned to the Company’s only operating segment and reporting unit. The amount of Zyga’s revenues and net loss since the January 4, 2018 acquisition date, included in the Company’s Condensed Consolidated Statement of Comprehensive Loss for the quarter ended March 31, 2018, excluding acquisition related costs of approximately $800, are $1,160 and $760, respectively. The following unaudited pro forma information shows the results of the Company’s operations as though the acquisition had occurred as of the beginning of that period (in thousands, except per share data): For the Three Months Ended March 31, 2018 2017 Revenues $ 1,212 $ 1,086 Net loss applicable to common shares (827 ) (1,211 ) Basic net loss per share (0.01 ) (0.02 ) Diluted net loss per share (0.01 ) (0.02 ) The pro forma results have been prepared for comparative purposes only and are not necessarily indicative of the actual results of operations had the acquisition taken place as of the beginning of the periods presented, or the results that may occur in the future. These amounts exclude costs incurred which are directly attributable to the acquisition, and which do not have a continuing impact on the combined companies’ operating results. The Company is currently completing its analysis of the purchase price allocation which it expects to complete by December 31, 2018.

Stock-Based Compensation

Stock-Based Compensation	6 Months Ended
	Jun. 30, 2018
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 2018 Incentive Compensation Plan – 2015 Incentive Compensation Plan – Stock Options As of June 30, 2018, there was $3,143 of total unrecognized stock-based compensation related to nonvested stock options. The expense related to these stock options is expected to be recognized over a weighted-average period of 1.89 years. Stock options outstanding, exercisable and available for grant at June 30, 2018, are summarized as follows: Number of Weighted Price Weighted Aggregate Value Outstanding at January 1, 2018 4,692,037 $ 3.86 Granted 623,100 4.26 Exercised (91,453 ) 3.50 Forfeited or expired (422,516 ) 5.50 Outstanding at June 30, 2018 4,801,168 $ 3.78 6.18 $ 4,261 Vested or expected to vest at June 30, 2018 4,396,733 $ 3.76 6.00 $ 3,975 Exercisable at June 30, 2018 1,336,471 $ 3.97 4.39 $ 1,031 Available for grant at June 30, 2018 5,676,935 The aggregate intrinsic value in the tables above represents the total pre-tax Other information concerning stock options are as follows: For the Six Months Ended 2018 2017 Weighted average fair value of stock options granted $ 2.02 $ 2.24 Aggregate intrinsic value of stock options exercised 98 533 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. For the six months ended June 30, 2018, restricted stock awards in the amount of 562,427 shares and 141,176 shares were granted to employees and non-employee Number of Weighted Grant Date Fair Value Unvested at January 1, 2018 1,120,190 $ 4.15 Granted 703,603 4.22 Vested (281,052 ) 3.77 Forfeited (111,657 ) 4.46 Unvested at June 30, 2018 1,431,084 $ 4.24 For the three and six months ended June 30, 2018 and 2017, the Company recognized stock-based compensation as follows: For the Three Months Ended For the Six Months Ended 2018 2017 2018 2017 Stock-based compensation: Costs of processing and distribution $ 33 $ 22 $ 66 $ 45 Marketing, general and administrative 1,242 942 2,474 1,744 Research and development 15 10 30 19 Total $ 1,290 $ 974 $ 2,570 $ 1,808

Net Income Per Common Share

Net Income Per Common Share	6 Months Ended
	Jun. 30, 2018
Earnings Per Share [Abstract]
Net Income Per Common Share	6. Net Income Per Common Share A reconciliation of the number of shares of common stock used in the calculation of basic and diluted net income per common share is presented below: For the Three Months Ended For the Six Months Ended June 30, 2018 2017 2018 2017 Basic shares 63,405,708 58,935,786 63,400,737 58,715,791 Effect of dilutive securities: Stock options — — — — Diluted shares 63,405,708 58,935,786 63,400,737 58,715,791 For the three months ended June 30, 2018 and 2017, approximately 1,590,662 and 1,350,051, respectively, and for the six months ended June 30, 2018 and 2017, approximately 1,447,911 and 2,422,661, respectively, of issued stock options were not included in the computation of diluted net income per common share because they were anti-dilutive because their exercise price exceeded the market price. For the three months ended June 30, 2018 and 2017, options to purchase 659,785 and 1,005,138, respectively, and for the six months ended June 30, 2018 and 2017, options to purchase 618,776 and 687,268, respectively, of common stock were not included in the computation of diluted loss per share because dilutive shares are not factored into this calculation when a net loss is reported. For the three and six months ended June 30, 2018 and 2017, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted

Inventories

Inventories	6 Months Ended
	Jun. 30, 2018
Inventory Disclosure [Abstract]
Inventories	7. Inventories Inventories by stage of completion are as follows: June 30, 2018 December 31, 2017 Unprocessed tissue, raw materials and supplies $ 21,638 $ 22,071 Tissue and work in process 31,707 40,481 Implantable tissue and finished goods 47,677 49,375 $ 101,022 $ 111,927 For the three months ended June 30, 2018 and 2017, the Company had inventory write-downs of $8,224 and $1,964, respectively, and for the six months ended June 30, 2018 and 2017, the Company had inventory write-downs of $10,865 and $3,753, respectively, relating primarily to product obsolescence. For the three months ended March 31, 2018, $1,023 of product obsolescence was due to the rationalization of our international distribution infrastructure. For the three months ended June 30, 2018, $6,559 of inventory write-off ®

Prepaid and Other Current Asset

Prepaid and Other Current Assets	6 Months Ended
	Jun. 30, 2018
Text Block [Abstract]
Prepaid and Other Current Assets	8. Prepaid and Other Current Assets Prepaid and Other Current Assets are as follows: June 30, 2018 December 31, 2017 Income tax receivable $ 3,133 $ 9,825 Receivable for executive stock option exercise — 1,234 Prepaid expenses 4,487 3,521 Other 418 1,705 $ 8,038 $ 16,285

Property, Plant and Equipment

Property, Plant and Equipment	6 Months Ended
	Jun. 30, 2018
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment	9. Property, Plant and Equipment Property, plant and equipment are as follows: June 30, 2018 December 31, 2017 Land $ 2,041 $ 2,020 Buildings and improvements 58,106 57,954 Processing equipment 41,254 44,137 Surgical instruments 22,308 21,256 Office equipment, furniture and fixtures 1,482 1,352 Computer equipment and software 19,237 19,332 Construction in process 7,533 5,980 151,961 152,031 Less accumulated depreciation (75,123 ) (72,467 ) $ 76,838 $ 79,564 For the three months ended June 30, 2018 and 2017, the Company had depreciation expense in connection with property, plant and equipment of $2,524 and $2,652, respectively, and for the six months ended June 30, 2018 and 2017, the Company had depreciation expense in connection with property, plant and equipment of $5,147 and $5,324, respectively. For the three months ended June 30, 2018, the Company had $1,797 of asset impairment and abandonment charges relating to decreased forecasted distributions of our map3 ®

Goodwill

Goodwill	6 Months Ended
	Jun. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	10. Goodwill Goodwill acquired during the six months ended June 30, 2018 includes the excess of the Zyga purchase price over the sum of the amounts assigned to assets acquired less liabilities assumed. June 30, 2018 December 31, 2017 Balance at January 1 $ 46,242 $ 54,887 Goodwill acquired related to Zyga acquisition 18,621 — Goodwill disposed of related to sale of Cardiothoracic closure business — 8,645 Balance at June 30 $ 64,863 $ 46,242 The Company considered the decreased forecasted distributions of our map3 ®

Other Intangible Assets

Other Intangible Assets	6 Months Ended
	Jun. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Other Intangible Assets	11. Other Intangible Assets Other intangible assets are as follows: June 30, 2018 December 31, 2017 Gross Carrying Accumulated Gross Carrying Accumulated Patents $ 11,122 $ 4,973 $ 11,373 $ 4,890 Acquired licensing rights 8,668 6,067 14,747 9,097 Marketing and procurement and other intangible assets 22,587 10,713 20,603 9,666 Total $ 42,377 $ 21,753 $ 46,723 $ 23,653 For the three months ended June 30, 2018 and 2017, the Company had amortization expense of other intangible assets of $960 and $909, respectively, and for the six months ended June 30, 2018 and 2017, the Company had amortization expense of other intangible assets of $1,921 and $1,805, respectively. For the three months ended June 30, 2018, the Company had $2,718 of asset impairment and abandonment charges relating to decreased forecasted distributions of our map3 ® At June 30, 2018, management’s estimates of future amortization expense for the next five years are as follows: Amortization 2018 $ 1,750 2019 3,500 2020 3,400 2021 3,400 2022 3,400 2023 1,100

Accrued Expenses

Accrued Expenses	6 Months Ended
	Jun. 30, 2018
Other Liabilities Disclosure [Abstract]
Accrued Expenses	12. Accrued Expenses Accrued expenses are as follows: June 30, 2018 December 31, Accrued compensation $ 6,145 $ 8,257 Accrued severance and restructuring costs 1,447 3,279 Accrued executive transition costs 1,601 2,300 Accrued distributor commissions 3,771 3,889 Accrued donor recovery fees 6,242 4,144 Other 4,708 3,741 $ 23,914 $ 25,610 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	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Short and Long-Term Obligations	13. Short and Long-Term Obligations Short and long-term obligations are as follows: June 30, 2018 December 31, 2017 Term loan $ — $ 24,250 Revolving credit facility 54,425 22,500 Less unamortized debt issuance costs (1,009 ) (406 ) Total 53,416 46,344 Less current portion — (4,268 ) Long-term portion $ 53,416 $ 42,076 On June 5, 2018, the Company entered into a Credit Agreement (the “2018 Credit Agreement”), as a borrower with JP Morgan Chase Bank, N.A., as lender (together with the various financial institutions as in the future may become parties thereto, the “Lenders”) and as administrative agent for the Lenders. The 2018 Credit Agreement provides for a revolving credit facility in the aggregate principal amount of up to $100,000 (the “Facility”). The Company will be able to, at its option, and subject to customary conditions and Lender approval, request an increase to the Facility by up to $50,000. The Facility is guaranteed by the Company’s domestic subsidiaries and is secured by: (i) substantially all of the assets of the Company and Pioneer Surgical; (ii) substantially all of the assets of each of the Company’s domestic subsidiaries; and (iii) 65% of the stock of the Company’s foreign subsidiaries. The initial borrowings made under the 2018 Credit Agreement will bear interest at a rate per annum equal to the monthly REVLIBOR30 Rate (“CBFR Loans”) plus an adjustable margin of up to 2.00% (the “CBFR Rate”). The Company may elect to convert the interest rate for the initial borrowings to a rate per annum equal to the adjusted LIBO Rate (“Eurodollar Loans”) plus an adjustable margin of up to 2.00% (the “Eurodollar Rate”). For all subsequent borrowings, the Company may elect to apply either the CBFR Rate or Eurodollar Rate. The applicable margin is subject to adjustment after the end of each fiscal quarter, based upon the Company’s average quarterly availability. The maturity date of the Facility is June 5, 2023. The Company may make optional prepayments on the Facility without penalty. The Company paid certain customary closing costs and bank fees upon entering into the 2018 Credit Agreement. The Company is subject to certain affirmative and negative covenants, including (but not limited to), covenants limiting the Company’s ability to: incur certain additional indebtedness; create certain liens; enter into sale and leaseback transactions; and consolidate or merge with, or convey, transfer or lease all or substantially all of its assets to another person. During any period beginning on a date that either (i) a default has occurred and is continuing under the loan documents entered into by the Company in conjunction with the Credit Agreement (the “Loan Documents”) or (ii) availability under the Facility is less than the specified covenant testing threshold, and continuing until either (a) no default has occurred and is continuing under the Loan Documents or (b) availability under the Facility is greater than or equal to the specified covenant testing threshold for thirty (30) consecutive days, respectively, (the “Covenant Testing Period”) the Company is required to maintain a minimum fixed charge coverage ratio of at least 1.00:1.00 (the “Required Minimum Fixed Charge Coverage Ratio”). The Required Minimum Fixed Charge Coverage Ratio is measured on the last day of each calendar month during the Covenant Testing Period (each a “Calculation Date”), and is calculated using the minimum fixed charge coverage ratio for the twelve (12) consecutive months ending on each Calculation Date. The amounts owed under the 2018 Credit Agreement may be accelerated upon the occurrence of certain events of default customary for facilities for similarly rated borrowers. At June 30, 2018, the interest rate for the Facility was 3.73%. As of June 30, 2018, there was $54,425 outstanding on the Facility and total remaining available credit on the Facility was $35,129. The Company’s ability to access the 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 the Facility as of June 30, 2018. For the three months ended June 30, 2018 and 2017, interest expense associated with the amortization of debt issuance costs was $365 and $150, respectively, and for the six months ended June 30, 2018 and 2017, interest expense associated with the amortization of debt issuance costs was $423 and $262, respectively. For the three and six months ended June 30, 2018, loss on extinguishment of debt associated with refinancing the Company’s debt was $309.

Other long-term liabilities

Other long-term liabilities	6 Months Ended
	Jun. 30, 2018
Text Block [Abstract]
Other long-term liabilities	14. Other long-term liabilities Other long-term liabilities are as follows: June 30, 2018 December 31, 2017 Acquisition contingencies $ 3,700 $ Other 1,455 1,431 $ 5,155 $ 1,431 Acquisition contingencies represent the Company’s preliminary fair value estimate of the Zyga acquisition clinical milestone and revenue earnout contingencies.

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Income Taxes	15. Income Taxes The Company expects its deferred tax assets of $14,448, net of the valuation allowance at June 30, 2018 of $7,381, to be realized through the generation of future taxable income and the reversal of existing taxable temporary differences. On December 22, 2017, the U.S. 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 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. 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-year basis, 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 undertook 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 operation is in a 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 $7,381 and $7,258 have been established at June 30, 2018 and December 31, 2017, 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. During the three months ended June 30, 2018, the Internal Revenue Service (“IRS”) completed its examination of the Company’s 2015 U.S. federal income tax return. No material adjustments were recorded to the Company’s condensed consolidated financial statements as a result of the examination.

Preferred Stock

Preferred Stock	6 Months Ended
	Jun. 30, 2018
Equity [Abstract]
Preferred Stock	16. Preferred Stock 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. Preferred stock is as follows: Preferred Stock Preferred Stock Net Total Balance at January 1, 2018 $ 64,399 $ (476 ) $ 63,923 Accrued dividend payable 1,947 — 1,947 Amortization of preferred stock issuance costs — 91 91 Balance at June 30, 2018 $ 66,346 $ (385 ) $ 65,961

Severance and Restructuring Cos

Severance and Restructuring Costs	6 Months Ended
	Jun. 30, 2018
Employee Severance [Member]
Severance and Restructuring Costs	17. Severance and Restructuring Costs The Company recorded severance and restructuring costs related to the reduction of our organizational structure which resulted in $884 of expenses for the six months ended June 30, 2018. Severance and restructuring payments are made to terminated employees over periods ranging from one month to twelve months and are not expected to have a material impact on cash flows of the Company in any quarterly period. The following table includes a roll-forward of severance and restructuring costs included in accrued expenses, see Note 12. Accrued severance and restructuring costs at January 1, 2018 $ 3,279 Severance and restructuring costs accrued in 2018 884 Subtotal severance and restructuring costs 4,163 Severance and restructuring cash payments (2,716 ) Accrued severance and restructuring costs at June 30, 2018 $ 1,447

Executive Transition Costs

Executive Transition Costs	6 Months Ended
	Jun. 30, 2018
Equity [Abstract]
Executive Transition Costs	18. 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. The total executive transition costs, of which $1,169 is cash basis, are expected to be paid in full in 2018. The following table includes a roll-forward of executive transition costs included in accrued expenses, see Note 12. Accrued executive transition costs at January 1, 2018 2,300 Cash payments (699 ) Accrued executive transition costs at June 30, 2018 $ 1,601

Legal Actions

Legal Actions	6 Months Ended
	Jun. 30, 2018
Commitments and Contingencies Disclosure [Abstract]
Legal Actions	19. Legal 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 June 30, 2018, will have a material adverse impact on its financial position or results of operations. 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, the impact that current or any future TSM litigation may have on the Company cannot be reasonably estimated. The Company’s accounting policy is to accrue for legal costs as they are incurred.

Regulatory Actions

Regulatory Actions	6 Months Ended
	Jun. 30, 2018
Text Block [Abstract]
Regulatory Actions	20. Regulatory Actions On September 30, 2014, the Company received a letter from the FDA regarding its map3 ® ® on-site ® non-compliance. ® ® ® ® During the second quarter 2018 the Company, based on its ongoing dialogue with the FDA and the continued negative impact of the warning letter on map3 ® ® ® write-off

Segment Data

Segment Data	6 Months Ended
	Jun. 30, 2018
Segment Reporting [Abstract]
Segment Data	21. 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 four lines of business. Effective January 1, 2018, the reporting of the Company’s lines of business are composed primarily of four categories: spine; sports; original equipment manufacturer (“OEM”) and international. The Company’s previous lines of business were composed of: spine; sports medicine and orthopedics; surgical specialties; cardiothoracic; international; and OEM. Effective January 1, 2018, the other revenues category is included in the OEM line of business. The prior year comparable revenue information has been restated to conform to the current year presentation. The Company believes that the change in the reporting of the Company’s lines of business is aligned with our focused strategy of reducing complexity and better understanding of our lines of business. Additionally, on August 3, 2017, we completed the sale of substantially all of the assets related to our CT Business to A&E Advanced Closure Systems, LLC (a subsidiary of A&E Medical Corporation) (“A&E”). In connection with the CT Business sale, we entered into a multi-year Contract Manufacturing Agreement with A&E whereby we continue to support the CT Business under A&E’s ownership through the manufacturing of existing products, which generates revenue for our OEM business. Discrete financial information is not available for these four lines of business. The following table presents revenues from these four categories for the three and six months ended June 30, 2018 and 2017, respectively: For the Three Months Ended June 30, For the Six Months Ended June 30, 2018 2017 2018 2017 Revenues: Spine $ 18,934 $ 19,419 $ 38,197 $ 39,757 Sports 14,190 14,453 27,625 29,129 OEM 31,170 27,983 61,290 53,125 International 6,391 6,592 13,463 13,224 Cardiothoracic — 3,673 — 6,824 Total revenues $ 70,685 $ 72,120 $ 140,575 $ 142,059 The following table presents percentage of total revenues derived from the Company’s largest distributors: For the Three Months Ended June 30, For the Six Months Ended June 30, 2018 2017 2018 2017 Percent of revenues derived from: Distributor Zimmer Biomet Holdings, Inc. 20 % 14 % 21 % 15 % Medtronic, PLC 8 % 8 % 8 % 9 % DePuy Synthes 6 % 4 % 5 % 4 % The following table presents property, plant and equipment - net by significant geographic location: June 30, 2018 December 31, 2017 Property, plant and equipment - net: Domestic $ 70,948 $ 73,363 International 5,890 6,201 Total $ 76,838 $ 79,564

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2018
Subsequent Events [Abstract]
Subsequent Events	22. Subsequent Events The Company evaluated subsequent events as of the issuance date of the condensed consolidated financial statements as defined by FASB ASC 855 Subsequent Events, 1. On July 27, 2018, RTI Donor Services, Inc. (“RTIDS”), which is a controlled entity of the Company, entered into an agreement with BloodCenter of Wisconsin, Inc. (“BCW”) for the sale of substantially all of the assets related to RTIDS’s Wisconsin tissue recovery operations to BCW. The sale will be made pursuant to an Asset Purchase Agreement between RTIDS and BCW, dated July 27, 2018 (the “Asset Purchase Agreement”), which sets forth a closing date for the sale of September 1, 2018. In connection with the Asset Purchase Agreement, RTIDS agreed to assign to BCW, and BCW agreed to assume, certain tissue recovery agreements (the “Assigned Agreements”). BCW further agreed to offer employment to RTIDS employees whose duties involved performing under the Assigned Agreements. As a part of the transaction, RTIDS also entered into a multi-year tissue allocation agreement with BCW (the “Tissue Allocation Agreement”). Under the Tissue Allocation Agreement, BCW has agreed to provide RTIDS with services relating to the sourcing and delivery of donated human cadaveric tissue, principally through tissue sourced from facilities formerly serviced by RTIDS. 2. On July 31, 2018, RTI Donor Services, Inc. (“RTIDS”), which is a controlled entity of the Company, entered into an agreement with Lions Eye Institute for Transplant and Research, Inc. (“LEITR”) for the sale of substantially all of the assets related to RTIDS’s Florida tissue recovery operations to LEITR. The sale will be made pursuant to an Asset Purchase Agreement between RTIDS and LEITR, dated July 31, 2018 (the “Asset Purchase Agreement”), which sets forth a closing date for the sale of November 1, 2018. In connection with the Asset Purchase Agreement, RTIDS agreed to assign to LEITR, and BCW agreed to assume, certain tissue recovery agreements (the “Assigned Agreements”). LEITR further intends to offer employment to RTIDS employees whose duties involved performing under the Assigned Agreements. As a part of the transaction, RTIDS also entered into a multi-year tissue allocation agreement with LEITR (the “Tissue Allocation Agreement”). Under the Tissue Allocation Agreement, LEITR has agreed to provide RTIDS with services relating to the sourcing and delivery of donated human cadaveric tissue, principally through tissue sourced from facilities formerly serviced by RTIDS. 3. On August 1, 2018, the Company signed an exclusive distribution agreement with Aziyo Biologics, Inc., a fully integrated regenerative medicine company. Under the agreement, Aziyo Biologics, Inc. will provide ViBone ® ® ® 4. On August 1, 2018, the Company, agreed to an Amended and Restated Certificate of Designation of Series A Convertible Preferred Stock of RTI Surgical, Inc. amending certain provisions of the current preferred stock agreement. The primary provisions of the amendment include: (1) dividends on the Series A Preferred Stock will not accrue after July 16, 2018; (2) the Company may not force a redemption of the Series A Preferred Stock prior to July 16, 2020; and (3) the holders of the Series A Preferred Stock may not convert the Series A Preferred Stock into common stock prior to July 16, 2021.

Recently Issued Accounting St29

Recently Issued Accounting Standards (Policies)	6 Months Ended
	Jun. 30, 2018
Accounting Changes and Error Corrections [Abstract]
Compensation - Stock Compensation	Compensation—Stock Compensation 2017-09, “ Compensation—Stock Compensation ” 2017-09
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
Revenue from Contracts with Customers	Revenue from Contracts with Customers Adoption Impact The Company identified three 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 assessment of our January 1, 2018, condensed consolidated balance sheet under ASC Topic 606 resulted in a cumulative-effect adjustment to opening retained earnings, unbilled accounts receivable and costs incurred for inventory. The effects of the adoption under ASC Topic 606 are outlined in the following table: Year Ended Impact January 1, 2018 Accounts receivable $ 35,081 $ 4,014 $ 39,095 Inventories - net 111,927 (1,766 ) 110,161 Accrued expenses — 1,110 1,110 Deferred tax assets 9,575 (266 ) 9,309 Accumulated deficit (237,066 ) 872 (236,194 ) The impact of adoption of Topic 606 to the Company’s condensed consolidated statements of comprehensive loss for the three and six months ended June 30, 2018 was as follows: For the Three Months Ended June 30, 2018 For the Six Months Ended June 30, 2018 Excluding Impact Excluding Impact As Reported of Topic 606 As Reported of Topic 606 Total revenues $ 70,685 $ 69,777 $ 140,575 $ 138,348 Cost of processing and distribution 40,645 40,331 76,853 75,896 Income tax benefit 2,702 2,889 2,453 2,852 Net loss (6,441 ) (6,848 ) (8,372 ) (9,243 ) Disaggregation of revenue The Company operates in one reportable segment composed of four lines of business. Effective January 1, 2018, the reporting of the Company’s lines of business are composed primarily of four categories: spine; sports; original equipment manufacturer (“OEM”) and international. The following table presents revenues from these four categories for the three and six months ended June 30, 2018: For the Three Months Ended For the Six Months Ended Revenues: Spine $ 18,934 $ 38,197 Sports 14,190 27,625 OEM 31,170 61,290 International 6,391 13,463 Total revenues from contracts with customers $ 70,685 $ 140,575 The following table presents revenues recognized at a point in time and over time for the three and six months ended June 30, 2018: For the Three Months Ended For the Six Months Ended Revenue recognized at a point in time $ 61,534 $ 121,697 Revenue recognized over time 9,151 18,878 Total revenues from contracts with customers $ 70,685 $ 140,575 Performance Obligations The Company’s performance obligations consist mainly of transferring control of implants identified in the contracts. Some of the Company’s contracts offer assurance-type warranties in connection with the sale of a product to a customer. Assurance-type warranties provide a customer with assurance that the related product will function as the parties intended because it complies with agreed-upon specifications. Such warranties do not represent a separate performance obligation and are not material to the condensed consolidated financial statements. When Performance Obligations Are Satisfied The Company typically transfers control at a point in time upon shipment or delivery of the implants for direct sales, or upon implantation for sales of consigned inventory. The customer is able to direct the use of, and obtain substantially all of the benefits from, the implant at the time the implant is shipped, delivered, or implanted, respectively based on the terms of the contract. For performance obligations related to the aforementioned three contracts with exclusively built inventory clauses, the Company typically satisfies its performance obligations evenly over the contract term as inventory is built. Such exclusively manufactured inventory has no alternative use and the Company has an enforceable right to payment for performance to date. The Company uses the input method to measure the manufacturing activities completed to date, which depicts the progress of the Company’s performance obligation of transferring control of exclusively built inventory. For the contracts with upfront and annual exclusivity fees, revenue related to those fees is recognized over the contract term following a consistent method of measuring progress towards satisfaction of the performance obligation. The Company uses the method and measure of progress that best depicts the transfer of control to the customer of the goods or services to date relative to the remaining goods or services promised under the contract. Significant Payment Terms The contract with the customer states the final terms of the sale, including the description, quantity, and price of each implant distributed. Payment for OEM contracts is typically due in full within 30 days of delivery or the start of the contract term. For the remaining lines of business, payment terms are typically due in full within 30 to 60 days of delivery. The Company performs a review of each specific customer’s credit worthiness and ability to pay prior to acceptance as a customer. Further, the Company performs periodic reviews of its customers’ creditworthiness prospectively. Since the customer agrees to a stated price in the contract that does not vary over the contract, the majority of contracts do not contain variable consideration. Nature of Goods and Services The Company distributes biologic, metal and synthetic implants. In some instances, the Company also enters into contracts with customers for exclusively manufactured inventory based on customer specifications. Returns In the normal course of business, the Company does accept product returns. The amount of consideration the Company ultimately receives varies depending upon the return terms that the Company may offer, which are accounted for as variable consideration when estimating the amount of revenue to recognize. The Company establishes provisions for estimated returns based on historical experience. The amount recorded on the Company’s balance sheets for product return allowance was $1,190 million and $1,110 million at June 30, 2018 and December 31, 2017, respectively. Liabilities for return allowances are included in “Accrued expenses”. Actual product returns have not differed materially from estimated amounts reserved in the accompanying condensed financial statements. Critical Accounting Estimates Estimates are used to determine the amount of variable consideration in contracts, and the measure of progress for contracts where revenue is recognized over time. The Company reviews and updates these estimates regularly. Our contracts generally do not include multiple performance obligations, and accordingly do not generally require estimates of the standalone selling price for each performance obligation. Some contracts with customers include variable consideration primarily related to volume rebates. The Company estimates variable consideration at the most likely amount to determine the total consideration which the Company expects to be entitled. Estimated amounts are included in the transaction price to the extent it is probable that a significant reversal of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved. The Company’s estimates of variable consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of our anticipated performance and all information (historical, current and forecasted) that is reasonably available. Contract Asset and Liability The opening and closing balances of the Company’s accounts receivable, contract asset and current and long-term contract liability are as follows: Accounts Contract Contract Opening 1/1/2018 $ 39,095 $ 5,978 $ 3,741 Closing 6/30/2018 45,576 6,210 3,155 Increase/(decrease) 6,481 232 (586 ) Contract liabilities consist primarily of the return allowance described above, and of deferred revenue arising from upfront and annual exclusivity fees. The difference between the opening and closing balances of the Company’s contract liabilities primarily results from the Company’s performance of the Company’s contractual obligations over time. The Company recognizes sales commissions as incurred because the amortization period is less than one year. The Company does not incur other incremental costs relating to obtaining a contract with a customer, and therefore, does not have material contract assets, or impairment losses associated therewith. Revenue recognized for the six months ended June 30, 2018 from amounts included in contract liabilities at the beginning of the period was $2,434.

Recently Issued Accounting St30

Recently Issued Accounting Standards (Tables)	6 Months Ended
	Jun. 30, 2018
Revenue Recognition from Four Categories	The following table presents revenues from these four categories for the three and six months ended June 30, 2018: For the Three Months Ended For the Six Months Ended Revenues: Spine $ 18,934 $ 38,197 Sports 14,190 27,625 OEM 31,170 61,290 International 6,391 13,463 Total revenues from contracts with customers $ 70,685 $ 140,575
Revenues Recognized at a Point in Time and Over Time	The following table presents revenues recognized at a point in time and over time for the three and six months ended June 30, 2018: For the Three Months Ended For the Six Months Ended Revenue recognized at a point in time $ 61,534 $ 121,697 Revenue recognized over time 9,151 18,878 Total revenues from contracts with customers $ 70,685 $ 140,575
Contract with Customer, Asset and Liability	The opening and closing balances of the Company’s accounts receivable, contract asset and current and long-term contract liability are as follows: Accounts Contract Contract Opening 1/1/2018 $ 39,095 $ 5,978 $ 3,741 Closing 6/30/2018 45,576 6,210 3,155 Increase/(decrease) 6,481 232 (586 )
Accounting Standards Update 2014-09 [Member]
Schedule of Prior Period Adjustments	The effects of the adoption under ASC Topic 606 are outlined in the following table: Year Ended Impact January 1, 2018 Accounts receivable $ 35,081 $ 4,014 $ 39,095 Inventories - net 111,927 (1,766 ) 110,161 Accrued expenses — 1,110 1,110 Deferred tax assets 9,575 (266 ) 9,309 Accumulated deficit (237,066 ) 872 (236,194 )
Impact of Adoption of Topic 606 to Condensed Consolidated Statements of Comprehensive Loss	The impact of adoption of Topic 606 to the Company’s condensed consolidated statements of comprehensive loss for the three and six months ended June 30, 2018 was as follows: For the Three Months Ended June 30, 2018 For the Six Months Ended June 30, 2018 Excluding Impact Excluding Impact As Reported of Topic 606 As Reported of Topic 606 Total revenues $ 70,685 $ 69,777 $ 140,575 $ 138,348 Cost of processing and distribution 40,645 40,331 76,853 75,896 Income tax benefit 2,702 2,889 2,453 2,852 Net loss (6,441 ) (6,848 ) (8,372 ) (9,243 )

Acquisition of Zyga Technolog31

Acquisition of Zyga Technology, Inc. (Tables)	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Acquisition Purchase Price	The purchase price was financed as follows: (In thousands) Cash proceeds from revolving credit facility $ 18,000 Cash from RTI Surgical 3,000 Total purchase price $ 21,000
Summary of Allocation of Total Consideration to Tangible and Intangible Assets and Liabilities	The table below represents an allocation of the total consideration to Zyga’s tangible and intangible assets and liabilities based on management’s preliminary estimate of their respective fair values as of January 4, 2018. During the three months ended June 30, 2018, the Company made the following changes to the preliminary fair values of acquired assets and liabilities: increased inventory by $500, decreased deferred tax assets by $150 and decreased goodwill by $350. (In thousands) Inventories $ 1,549 Accounts receivable 573 Other current assets 53 Property, plant and equipment 151 Other assets 26 Deferred tax assets 2,674 Current liabilities (947 ) Acquisition contingencies (3,700 ) Net tangible assets acquired 379 Other intangible assets 2,000 Goodwill 18,621 Total net assets acquired $ 21,000
Pro Forma Information of Company's Operations	The following unaudited pro forma information shows the results of the Company’s operations as though the acquisition had occurred as of the beginning of that period (in thousands, except per share data): For the Three Months Ended March 31, 2018 2017 Revenues $ 1,212 $ 1,086 Net loss applicable to common shares (827 ) (1,211 ) Basic net loss per share (0.01 ) (0.02 ) Diluted net loss per share (0.01 ) (0.02 )

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock Options Outstanding, Exercisable and Available for Grant	Stock options outstanding, exercisable and available for grant at June 30, 2018, are summarized as follows: Number of Weighted Price Weighted Aggregate Value Outstanding at January 1, 2018 4,692,037 $ 3.86 Granted 623,100 4.26 Exercised (91,453 ) 3.50 Forfeited or expired (422,516 ) 5.50 Outstanding at June 30, 2018 4,801,168 $ 3.78 6.18 $ 4,261 Vested or expected to vest at June 30, 2018 4,396,733 $ 3.76 6.00 $ 3,975 Exercisable at June 30, 2018 1,336,471 $ 3.97 4.39 $ 1,031 Available for grant at June 30, 2018 5,676,935
Other Information Concerning Stock Options	Other information concerning stock options are as follows: For the Six Months Ended 2018 2017 Weighted average fair value of stock options granted $ 2.02 $ 2.24 Aggregate intrinsic value of stock options exercised 98 533
Unvested Restricted Stock Awards	The following table summarizes information about unvested restricted stock awards as of June 30, 2018: Number of Weighted Grant Date Fair Value Unvested at January 1, 2018 1,120,190 $ 4.15 Granted 703,603 4.22 Vested (281,052 ) 3.77 Forfeited (111,657 ) 4.46 Unvested at June 30, 2018 1,431,084 $ 4.24
Stock-Based Compensation Recognized	For the three and six months ended June 30, 2018 and 2017, the Company recognized stock-based compensation as follows: For the Three Months Ended For the Six Months Ended 2018 2017 2018 2017 Stock-based compensation: Costs of processing and distribution $ 33 $ 22 $ 66 $ 45 Marketing, general and administrative 1,242 942 2,474 1,744 Research and development 15 10 30 19 Total $ 1,290 $ 974 $ 2,570 $ 1,808

Net Income Per Common Share (Ta

Net Income Per Common Share (Tables)	6 Months Ended
	Jun. 30, 2018
Earnings Per Share [Abstract]
Reconciliation of Common Stock used in Calculation of Basic and Diluted Earnings Per Share	A reconciliation of the number of shares of common stock used in the calculation of basic and diluted net income per common share is presented below: For the Three Months Ended For the Six Months Ended June 30, 2018 2017 2018 2017 Basic shares 63,405,708 58,935,786 63,400,737 58,715,791 Effect of dilutive securities: Stock options — — — — Diluted shares 63,405,708 58,935,786 63,400,737 58,715,791

Inventories (Tables)

Inventories (Tables)	6 Months Ended
	Jun. 30, 2018
Inventory Disclosure [Abstract]
Components of Inventories	Inventories by stage of completion are as follows: June 30, 2018 December 31, 2017 Unprocessed tissue, raw materials and supplies $ 21,638 $ 22,071 Tissue and work in process 31,707 40,481 Implantable tissue and finished goods 47,677 49,375 $ 101,022 $ 111,927

Prepaid and Other Current Ass35

Prepaid and Other Current Assets (Tables)	6 Months Ended
	Jun. 30, 2018
Text Block [Abstract]
Schedule of Prepaid and Other Current Assets	Prepaid and Other Current Assets are as follows: June 30, 2018 December 31, 2017 Income tax receivable $ 3,133 $ 9,825 Receivable for executive stock option exercise — 1,234 Prepaid expenses 4,487 3,521 Other 418 1,705 $ 8,038 $ 16,285

Property, Plant and Equipment (

Property, Plant and Equipment (Tables)	6 Months Ended
	Jun. 30, 2018
Property, Plant and Equipment [Abstract]
Components of Property, Plant and Equipment	Property, plant and equipment are as follows: June 30, 2018 December 31, 2017 Land $ 2,041 $ 2,020 Buildings and improvements 58,106 57,954 Processing equipment 41,254 44,137 Surgical instruments 22,308 21,256 Office equipment, furniture and fixtures 1,482 1,352 Computer equipment and software 19,237 19,332 Construction in process 7,533 5,980 151,961 152,031 Less accumulated depreciation (75,123 ) (72,467 ) $ 76,838 $ 79,564

Goodwill (Tables)

Goodwill (Tables)	6 Months Ended
	Jun. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	Goodwill acquired during the six months ended June 30, 2018 includes the excess of the Zyga purchase price over the sum of the amounts assigned to assets acquired less liabilities assumed. June 30, 2018 December 31, 2017 Balance at January 1 $ 46,242 $ 54,887 Goodwill acquired related to Zyga acquisition 18,621 — Goodwill disposed of related to sale of Cardiothoracic closure business — 8,645 Balance at June 30 $ 64,863 $ 46,242

Other Intangible Assets (Tables

Other Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Components of Other Intangible Assets	Other intangible assets are as follows: June 30, 2018 December 31, 2017 Gross Carrying Accumulated Gross Carrying Accumulated Patents $ 11,122 $ 4,973 $ 11,373 $ 4,890 Acquired licensing rights 8,668 6,067 14,747 9,097 Marketing and procurement and other intangible assets 22,587 10,713 20,603 9,666 Total $ 42,377 $ 21,753 $ 46,723 $ 23,653
Estimates of Future Amortization Expense	At June 30, 2018, management’s estimates of future amortization expense for the next five years are as follows: Amortization 2018 $ 1,750 2019 3,500 2020 3,400 2021 3,400 2022 3,400 2023 1,100

Accrued Expenses (Tables)

Accrued Expenses (Tables)	6 Months Ended
	Jun. 30, 2018
Other Liabilities Disclosure [Abstract]
Accrued Expenses	Accrued expenses are as follows: June 30, 2018 December 31, Accrued compensation $ 6,145 $ 8,257 Accrued severance and restructuring costs 1,447 3,279 Accrued executive transition costs 1,601 2,300 Accrued distributor commissions 3,771 3,889 Accrued donor recovery fees 6,242 4,144 Other 4,708 3,741 $ 23,914 $ 25,610

Short and Long-Term Obligatio40

Short and Long-Term Obligations (Tables)	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Short and Long-Term Obligations	Short and long-term obligations are as follows: June 30, 2018 December 31, 2017 Term loan $ — $ 24,250 Revolving credit facility 54,425 22,500 Less unamortized debt issuance costs (1,009 ) (406 ) Total 53,416 46,344 Less current portion — (4,268 ) Long-term portion $ 53,416 $ 42,076

Other long-term liabilities (Ta

Other long-term liabilities (Tables)	6 Months Ended
	Jun. 30, 2018
Text Block [Abstract]
Summary of Other long-term liabilities	Other long-term liabilities are as follows: June 30, 2018 December 31, 2017 Acquisition contingencies $ 3,700 $ Other 1,455 1,431 $ 5,155 $ 1,431

Preferred Stock (Tables)

Preferred Stock (Tables)	6 Months Ended
	Jun. 30, 2018
Equity [Abstract]
Schedule of Preferred Stock	Preferred stock is as follows: Preferred Stock Preferred Stock Net Total Balance at January 1, 2018 $ 64,399 $ (476 ) $ 63,923 Accrued dividend payable 1,947 — 1,947 Amortization of preferred stock issuance costs — 91 91 Balance at June 30, 2018 $ 66,346 $ (385 ) $ 65,961

Severance and Restructuring C43

Severance and Restructuring Costs (Tables)	6 Months Ended
	Jun. 30, 2018
Former Chief Executive Officer [Member]
Schedule of Restructuring Charges	The following table includes a roll-forward of executive transition costs included in accrued expenses, see Note 12. Accrued executive transition costs at January 1, 2018 2,300 Cash payments (699 ) Accrued executive transition costs at June 30, 2018 $ 1,601
Employee Severance [Member]
Schedule of Restructuring Charges	The following table includes a roll-forward of severance and restructuring costs included in accrued expenses, see Note 12. Accrued severance and restructuring costs at January 1, 2018 $ 3,279 Severance and restructuring costs accrued in 2018 884 Subtotal severance and restructuring costs 4,163 Severance and restructuring cash payments (2,716 ) Accrued severance and restructuring costs at June 30, 2018 $ 1,447

Segment Data (Tables)

Segment Data (Tables)	6 Months Ended
	Jun. 30, 2018
Segment Reporting [Abstract]
Revenues from Tissue Distribution and Other Revenues	The following table presents revenues from these four categories for the three and six months ended June 30, 2018 and 2017, respectively: For the Three Months Ended June 30, For the Six Months Ended June 30, 2018 2017 2018 2017 Revenues: Spine $ 18,934 $ 19,419 $ 38,197 $ 39,757 Sports 14,190 14,453 27,625 29,129 OEM 31,170 27,983 61,290 53,125 International 6,391 6,592 13,463 13,224 Cardiothoracic — 3,673 — 6,824 Total revenues $ 70,685 $ 72,120 $ 140,575 $ 142,059
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: For the Three Months Ended June 30, For the Six Months Ended June 30, 2018 2017 2018 2017 Percent of revenues derived from: Distributor Zimmer Biomet Holdings, Inc. 20 % 14 % 21 % 15 % Medtronic, PLC 8 % 8 % 8 % 9 % DePuy Synthes 6 % 4 % 5 % 4 %
Schedule of Property, Plant and Equipment - Net by Significant Geographic Location	The following table presents property, plant and equipment - net by significant geographic location: June 30, 2018 December 31, 2017 Property, plant and equipment - net: Domestic $ 70,948 $ 73,363 International 5,890 6,201 Total $ 76,838 $ 79,564

Operations and Organization - A

Operations and Organization - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2018Country
Accounting Policies [Abstract]
Number of countries that receive distribution	40

Recently Issued Accounting St46

Recently Issued Accounting Standards - Additional Information (Detail) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2018USD ($)SegmentContract	Dec. 31, 2017USD ($)
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of reportable segment | Segment	1
Lines of business | Segment	4
Product return allowance recorded | $	$ 1,190,000	$ 1,110,000
Revenue recognized from amounts included in contract liabilities | $	$ 2,434
Accounting Standards Update 2014-09 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Number of contracts affected | Contract	3

Recently Issued Accounting St47

Recently Issued Accounting Standards - Schedule of Prior Period Adjustments (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Jan. 01, 2018	Dec. 31, 2017
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accounts receivable	$ 45,576	$ 39,095	$ 35,081
Inventories - net	101,022		111,927
Accrued expemses	23,914		25,610
Deferred tax assets	14,448		9,575
Accumulated deficit	$ (242,619)		(237,066)
Calculated under Revenue Guidance in Effect before Topic 606 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accounts receivable			35,081
Inventories - net			111,927
Deferred tax assets			9,575
Accumulated deficit			$ (237,066)
Accounting Standards Update 2014-09 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accounts receivable		39,095
Inventories - net		110,161
Accrued expemses		1,110
Deferred tax assets		9,309
Accumulated deficit		(236,194)
Difference between Revenue Guidance in Effect before and after Topic 606 [Member] | Accounting Standards Update 2014-09 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Accounts receivable		4,014
Inventories - net		(1,766)
Accrued expemses		1,110
Deferred tax assets		(266)
Accumulated deficit		$ 872

Recently Issued Accounting St48

Recently Issued Accounting Standards - Impact of Adoption of Topic 606 to Condensed Consolidated Statements of Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Total revenues	$ 70,685	$ 72,120	$ 140,575	$ 142,059
Cost of processing and distribution	40,645	35,157	76,853	69,317
Income tax benefit	2,702	(1,026)	2,453	(116)
Net loss	(6,441)	$ (2,613)	(8,372)	$ (5,395)
Accounting Standards Update 2014-09 [Member] | Calculated under Revenue Guidance in Effect before Topic 606 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Total revenues	69,777		138,348
Cost of processing and distribution	40,331		75,896
Income tax benefit	2,889		2,852
Net loss	$ (6,848)		$ (9,243)

Recently Issued Accounting St49

Recently Issued Accounting Standards - Revenue Recognition from Four Categories (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	$ 70,685	$ 72,120	$ 140,575	$ 142,059
Spine [Member] | Tissue Distribution [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	18,934		38,197
Sports [Member] | Tissue Distribution [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	14,190		27,625
OEM [Member] | Tissue Distribution [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	31,170		61,290
International [Member] | Tissue Distribution [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	$ 6,391		$ 13,463

Recently Issued Accounting St50

Recently Issued Accounting Standards - Revenues Recognized at a Point in Time and Over Time (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	$ 70,685	$ 72,120	$ 140,575	$ 142,059
Transferred at Point in Time [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	61,534		121,697
Transferred over Time [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Revenues	$ 9,151		$ 18,878

Recently Issued Accounting St51

Recently Issued Accounting Standards - Contract with Customer, Asset and Liability (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jan. 01, 2018	Dec. 31, 2017
Accounting Changes and Error Corrections [Abstract]
Accounts receivable	$ 45,576	$ 39,095	$ 35,081
Contract Liability (Current)	6,210	5,978
Contract Liability (Long-Term)	3,155	$ 3,741
Accounts Receivable, Increase/(decrease)	6,481
Contract Liability (Current), Increase/(decrease)	232
Contract Liability (Long-Term), Increase/(decrease)	$ (586)

Acquisition of Zyga Technology

Acquisition of Zyga Technology Inc. - Additional Information (Detail) - USD ($) $ in Thousands	Jan. 04, 2018	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Combinations [Line Items]
Cash from RTI Surgical				$ 21,000
Acquisition and integration expenses				800
Goodwill		$ 64,863		64,863	$ 46,242	$ 54,887
Revolving Credit Facility [Member]
Business Combinations [Line Items]
Cash proceeds from revolving credit facility	$ 18,000
Zyga Technology Inc. [Member]
Business Combinations [Line Items]
Date of merger agreement	Jan. 4, 2018
Payments to acquire businesses	$ 21,000
Cash from RTI Surgical	3,000
Acquisition related costs	1,430
Acquisition and integration expenses			$ 800	800
Changes to the preliminary fair values of acquired assets and liabilities, Inventory		500
Changes to the preliminary fair values of acquired assets and liabilities, Deferred tax assets		(150)
Changes to the preliminary fair values of acquired assets and liabilities, Current liabilities		(41)
Changes to the preliminary fair values of acquired assets and liabilities, Gooswill		(391)
Goodwill	18,621	$ 18,621		$ 18,621
Revenue			1,160
Net loss			$ (760)
Zyga Technology Inc. [Member] | Clinical Milestones [Member]
Business Combinations [Line Items]
Earnout consideration	1,000
Zyga Technology Inc. [Member] | Earn Out Payment [Member]
Business Combinations [Line Items]
Earnout consideration	3,700
Revenue based earnout consideration	$ 35,000

Acquisition of Zyga Technolog53

Acquisition of Zyga Technology Inc. - Acquisition Purchase Price (Detail) - USD ($) $ in Thousands	Jan. 04, 2018	Jun. 30, 2018
Business Combinations [Line Items]
Cash from RTI Surgical		$ 21,000
Zyga Technology Inc. [Member]
Business Combinations [Line Items]
Cash from RTI Surgical	$ 3,000
Total purchase price	21,000
Revolving Credit Facility [Member]
Business Combinations [Line Items]
Cash proceeds from revolving credit facility	$ 18,000

Acquisition of Zyga Technolog54

Acquisition of Zyga Technology Inc. - Summary of Allocation of Total Consideration to Tangible and Intangible Assets and Liabilities (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Jan. 04, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Combinations [Line Items]
Goodwill	$ 64,863		$ 46,242	$ 54,887
Zyga Technology Inc. [Member]
Business Combinations [Line Items]
Inventories		$ 1,549
Accounts receivable		573
Other current assets		53
Property, plant and equipment		151
Other assets		26
Deferred tax assets		2,674
Current liabilities		(947)
Acquisition contingencies	(3,700)	(3,700)
Net tangible assets acquired		379
Other intangible assets		2,000
Goodwill	$ 18,621	18,621
Total net assets acquired		$ 21,000

Acquisition of Zyga Technolog55

Acquisition of Zyga Technology Inc. - Pro Forma Information of Company's Operations (Detail) - Zyga Technology Inc. [Member] - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended
	Mar. 31, 2018	Mar. 31, 2017
Business Acquisition Pro Forma Information [Line Items]
Revenues	$ 1,212	$ 1,086
Net loss applicable to common shares	$ (827)	$ (1,211)
Basic net loss per share	$ (0.01)	$ (0.02)
Diluted net loss per share	$ (0.01)	$ (0.02)

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)shares
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 | $	$ 4,448
Stock-based compensation awards, weighted-average period recognized	1 year 10 months 28 days
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
2018 Equity Incentive Plan [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock allowed to be issued	5,726,035
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	703,603
Restricted Stock Awards [Member] | Employee Directors [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted	562,427
Restricted Stock Awards [Member] | Non-Employee Directors [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares granted	141,176
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 | $	$ 3,143
Stock-based compensation awards, weighted-average period recognized	1 year 10 months 20 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

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Options Outstanding, Exercisable and Available for Grant (Detail) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)$ / sharesshares
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Outstanding, Number of Shares	4,692,037
Granted, Number of Shares	623,100
Exercised, Number of Shares	(91,453)
Forfeited or expired, Number of Shares	(422,516)
Outstanding, Number of Shares	4,801,168
Vested or expected to vest, Number of Shares	4,396,733
Exercisable, Number of Shares	1,336,471
Available for grant, Number of Shares	5,676,935
Outstanding, Weighted Average Exercise Price | $ / shares	$ 3.86
Granted, Weighted Average Exercise Price | $ / shares	4.26
Exercised, Weighted Average Exercise Price | $ / shares	3.50
Forfeited or expired, Weighted Average Exercise Price | $ / shares	5.50
Outstanding, Weighted Average Exercise Price | $ / shares	3.78
Vested or expected to vest, Weighted Average Exercise Price | $ / shares	3.76
Exercisable, Weighted Average Exercise Price | $ / shares	$ 3.97
Outstanding, Weighted Average Remaining Contractual Life (Years)	6 years 2 months 4 days
Vested or expected to vest, Weighted Average Remaining Contractual Life (Years)	6 years
Exercisable, Weighted Average Remaining Contractual Life (Years)	4 years 4 months 20 days
Outstanding, Aggregate Intrinsic Value | $	$ 4,261
Vested or expected to vest, Aggregate Intrinsic Value | $	3,975
Exercisable, Aggregate Intrinsic Value | $	$ 1,031

Stock-Based Compensation - Othe

Stock-Based Compensation - Other Information Concerning Stock Options (Detail) - USD ($) $ / shares in Units, $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Weighted average fair value of stock options granted	$ 2.02	$ 2.24
Aggregate intrinsic value of stock options exercised	$ 98	$ 533

Stock-Based Compensation - Unve

Stock-Based Compensation - Unvested Restricted Stock Awards (Detail) - Restricted Stock Awards [Member]	6 Months Ended
	Jun. 30, 2018$ / sharesshares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Beginning Balance, Number of shares | shares	1,120,190
Granted, Number of shares | shares	703,603
Vested, Number of shares | shares	(281,052)
Forfeited, Number of shares | shares	(111,657)
Ending Balance, Number of shares | shares	1,431,084
Beginning Balance, Weighted Average Grant Date Fair Value | $ / shares	$ 4.15
Granted, Weighted Average Grant Date Fair Value | $ / shares	4.22
Vested, Weighted Average Grant Date Fair Value | $ / shares	3.77
Forfeited, Weighted Average Grant Date Fair Value | $ / shares	4.46
Ending Balance, Weighted Average Grant Date Fair Value | $ / shares	$ 4.24

Stock-Based Compensation - St60

Stock-Based Compensation - Stock-Based Compensation Recognized (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 1,290	$ 974	$ 2,570	$ 1,808
Costs of Processing and Distribution [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	33	22	66	45
Marketing, General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	1,242	942	2,474	1,744
Research and Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 15	$ 10	$ 30	$ 19

Net Income Per Common Share - R

Net Income Per Common Share - Reconciliation of Common Stock Used in Calculation of Basic and Diluted Earnings Per Share (Detail) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Earnings Per Share [Abstract]
Basic shares	63,405,708	58,935,786	63,400,737	58,715,791
Effect of dilutive securities: Stock options	0	0	0	0
Diluted shares	63,405,708	58,935,786	63,400,737	58,715,791

Net Income Per Common Share - A

Net Income Per Common Share - Additional Information (Detail) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Common Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive stock excluded from the computation of diluted EPS	659,785	1,005,138	618,776	687,268
Convertible Preferred Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Potential Dilutive Securities included in computation of diluted EPS	50,000	50,000	50,000	50,000
Stock Options [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Anti-dilutive stock excluded from the computation of diluted EPS	1,590,662	1,350,051	1,447,911	2,422,661

Inventories - Components of Inv

Inventories - Components of Inventories (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Inventory Disclosure [Abstract]
Unprocessed tissue, raw materials and supplies	$ 21,638	$ 22,071
Tissue and work in process	31,707	40,481
Implantable tissue and finished goods	47,677	49,375
Inventory - net	$ 101,022	$ 111,927

Inventories - Additional Inform

Inventories - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended			6 Months Ended
	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Inventory [Line Items]
Provision for inventory write-downs	$ 8,224		$ 1,964	$ 10,865	$ 3,753
Product obsolescence		$ 1,023
Map3 Inventory [Member]
Inventory [Line Items]
Provision for inventory write-downs	$ 6,559

Prepaid and Other Current Ass65

Prepaid and Other Current Assets - Schedule of Prepaid and Other Current Assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Income tax receivable	$ 3,133	$ 9,825
Receivable for executive stock option exercise		1,234
Prepaid expenses	4,487	3,521
Other	418	1,705
Prepaid and other current assets	$ 8,038	$ 16,285

Property, Plant and Equipment -

Property, Plant and Equipment - Components of Property, Plant and Equipment (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 151,961	$ 152,031
Less accumulated depreciation	(75,123)	(72,467)
Property, plant and equipment, net	76,838	79,564
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	2,041	2,020
Buildings and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	58,106	57,954
Processing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	41,254	44,137
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	22,308	21,256
Office Equipment, Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	1,482	1,352
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	19,237	19,332
Construction in Process [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 7,533	$ 5,980

Property, Plant and Equipment67

Property, Plant and Equipment - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Property, Plant and Equipment [Line Items]
Depreciation expense in connection with property, plant and equipment	$ 2,524	$ 2,652	$ 5,147	$ 5,324
Asset impairment and abandonments	4,515		$ 4,644
Map3 Inventory [Member]
Property, Plant and Equipment [Line Items]
Asset impairment and abandonments	$ 1,797

Goodwill - Schedule of Goodwill

Goodwill - Schedule of Goodwill (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Beginning Balance	$ 46,242	$ 54,887
Goodwill acquired related to Zyga acquisition	18,621
Goodwill disposed of related to sale of Cardiothoracic closure business		8,645
Ending Balance	$ 64,863	$ 46,242

Goodwill - Additional Informati

Goodwill - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2018USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment loss	$ 0

Other Intangible Assets - Compo

Other Intangible Assets - Components of Other Intangible Assets (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 42,377	$ 46,723
Accumulated Amortization	21,753	23,653
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,122	11,373
Accumulated Amortization	4,973	4,890
Acquired Licensing Rights [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	8,668	14,747
Accumulated Amortization	6,067	9,097
Marketing and Procurement and Other Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	22,587	20,603
Accumulated Amortization	$ 10,713	$ 9,666

Other Intangible Assets - Addit

Other Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Finite-Lived Intangible Assets [Line Items]
Amortization expense of other intangible assets	$ 960	$ 909	$ 1,921	$ 1,805
Map3 Inventory [Member]
Finite-Lived Intangible Assets [Line Items]
Impairment charges of acquiring licensing rights	$ 2,718

Other Intangible Assets - Estim

Other Intangible Assets - Estimates of Future Amortization Expense (Detail) $ in Thousands	Jun. 30, 2018USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2,018	$ 1,750
2,019	3,500
2,020	3,400
2,021	3,400
2,022	3,400
2,023	$ 1,100

Accrued Expenses - Accrued Expe

Accrued Expenses - Accrued Expenses (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Payables and Accruals [Abstract]
Accrued compensation	$ 6,145	$ 8,257
Accrued severance and restructuring cost	1,447	3,279
Accrued executive transition costs	1,601	2,300
Accrued distributor commissions	3,771	3,889
Accrued donor recovery fees	6,242	4,144
Other	4,708	3,741
Total accrued expenses	$ 23,914	$ 25,610

Short and Long-Term Obligatio74

Short and Long-Term Obligations - Short and Long-Term Obligations (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Debt Disclosure [Abstract]
Term loan		$ 24,250
Revolving credit facility	$ 54,425	22,500
Less unamortized debt issuance costs	(1,009)	(406)
Debt and capital lease obligation, total	53,416	46,344
Debt and capital lease obligation, total	53,416	46,344
Less current portion		(4,268)
Long-term portion	$ 53,416	$ 42,076

Short and Long-Term Obligatio75

Short and Long-Term Obligations - Additional Information (Detail) - USD ($) $ in Thousands	Jun. 05, 2018	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Line of Credit Facility [Line Items]
Debt instrument, maturity date	Jun. 5, 2023
Credit facility, outstanding		$ 54,425		$ 54,425		$ 22,500
Interest expense associated with the amortization of debt issuance costs		365	$ 150	423	$ 262
Loss on extinguishment of debt		$ (309)		$ (309)
Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Interest rate revolving credit facility		3.73%		3.73%
Credit facility, outstanding		$ 54,425		$ 54,425
Current borrowing capacity		$ 35,129		$ 35,129
2018 Loan Agreement [Member]
Line of Credit Facility [Line Items]
Percentage of foreign subsidiaries stock held as collateral	65.00%
Credit facility guaranteed description				The Facility is guaranteed by the Company's domestic subsidiaries and is secured by (i) substantially all of the assets of the Company and Pioneer Surgical; (ii) substantially all of the assets of each of the Company's domestic subsidiaries; and (iii) 65% of the stock of the Company's foreign subsidiaries.
Minimum fixed charge coverage ratio	0.01
Covenant Terms of Credit Facility				During any period beginning on a date that either (i) a default has occurred and is continuing under the loan documents entered into by the Company in conjunction with the Credit Agreement (the "Loan Documents") or (ii) availability under the Facility is less than the specified covenant testing threshold, and continuing until either (a) no default has occurred and is continuing under the Loan Documents or (b) availability under the Facility is greater than or equal to the specified covenant testing threshold for thirty (30) consecutive days, respectively, (the "Covenant Testing Period") the Company is required to maintain a minimum fixed charge coverage ratio of at least 1.001.00 (the "Required Minimum Fixed Charge Coverage Ratio").
2018 Loan Agreement [Member] | Revolving Credit Facility [Member]
Line of Credit Facility [Line Items]
Credit facility, original borrowing capacity	$ 100,000
Credit facility, additional borrowing capacity	$ 50,000
2018 Loan Agreement [Member] | Revolving Credit Facility [Member] | Debt Instrument Variable Rate Base CBFR Using Monthly REVLIBOR30 Rate [Member]
Line of Credit Facility [Line Items]
Interest rate revolving credit facility	2.00%

Summary of Other Long-term Liab

Summary of Other Long-term Liabilities (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Jan. 04, 2018	Dec. 31, 2017
Other	$ 1,455		$ 1,431
Total other long-term liabilities	5,155		$ 1,431
Zyga Technology Inc. [Member]
Acquisition contingencies	$ 3,700	$ 3,700

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Operating Loss Carryforwards [Line Items]
Deferred tax assets	$ 14,448
Deferred tax assets, valuation allowances	$ 7,381
Statutory federal rate	21.00%	35.00%
Income tax expense benfit due to change in tax rate		$ 2,187
Change in Tax Rate Revaluation of Deferred Tax Assets		1,436
Income tax expense benfit, transition tax expense		$ 751
Tax Cuts and Jobs Act of 2017, Accounting Complete		false
Primary measure of cumulative losses, number of rolling years		3 years
Domestic Tax Authority [Member]
Operating Loss Carryforwards [Line Items]
Deferred tax assets, valuation allowances	$ 7,381	$ 7,258

Preferred Stock - Additional In

Preferred Stock - Additional Information (Detail) - USD ($) $ in Thousands	Jul. 16, 2013	Jun. 12, 2013	Jun. 30, 2018	Dec. 31, 2017
Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Preferred stock issuance cost			$ 385	$ 476
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 - Schedule of P

Preferred Stock - Schedule of Preferred Stock (Detail) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Temporary Equity [Line Items]
Net Total	$ 65,961	$ 63,923
Accrued dividend payable	1,947
Amortization of preferred stock issuance costs	91
Series A Preferred Stock [Member]
Temporary Equity [Line Items]
Net Total	66,346	64,399
Preferred Stock Issuance Costs	(385)	$ (476)
Accrued dividend payable	1,947
Amortization of preferred stock issuance costs	$ 91

Severance and Restructuring C80

Severance and Restructuring Costs - Additional Information (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)
Restructuring and Related Activities [Abstract]
Severance and restructuring costs related to the reduction	$ 884

Severance and Restructuring C81

Severance and Restructuring Costs - Schedule of Restructuring Charges (Detail) $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)
Restructuring Cost and Reserve [Line Items]
Accrued severance and restructuring costs, beginning balance	$ 3,279
Severance and restructuring costs accrued in 2018	884
Accrued severance and restructuring costs, ending balance	1,447
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Accrued severance and restructuring costs, beginning balance	3,279
Severance and restructuring costs accrued in 2018	884
Subtotal severance and restructuring costs	4,163
Severance and restructuring cash payments	(2,716)
Accrued severance and restructuring costs, ending balance	$ 1,447

Executive Transition Costs - Ad

Executive Transition Costs - Additional Information (Detail) - Former Chief Executive Officer [Member] - 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
Scenario, Forecast [Member]
Postemployment Benefits Disclosure [Line Items]
Executive transition costs	$ 1,169

Executive Transition Costs - Sc

Executive Transition Costs - Schedule of Restructuring Charges (Detail) - Chief Executive Officer and Chief Financial and Administrative Officer [Member] $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)
Restructuring Cost and Reserve [Line Items]
Accrued executive transition costs at January 1, 2018	$ 2,300
Cash payments	(699)
Accrued executive transition costs at June 30, 2018	$ 1,601

Legal Actions - Additional Info

Legal Actions - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2018LitigationClaims
Commitments and Contingencies Disclosure [Abstract]
Outstanding claims | Litigation	0
Claims for which the Company Parties are providing defense and indemnification | Claims	1,157

Regulatory Actions - Additional

Regulatory Actions - Additional Information (Detail) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Regulatory Order Considerations And Management Plans [Line Items]
Provision for inventory write-downs	$ 8,224,000	$ 1,964,000	$ 10,865,000	$ 3,753,000
Goodwill impairment loss			$ 0
Map3 Inventory [Member]
Regulatory Order Considerations And Management Plans [Line Items]
Impairment charge of property, plant and equipment	1,797,000
Impairment charges of acquiring licensing rights	2,718,000
Provision for inventory write-downs	$ 6,559,000

Segment Data - Additional Infor

Segment Data - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2018Segment
Segment Reporting [Abstract]
Number of reportable segments	1
Lines of business	4

Segment Data - Revenues from Ti

Segment Data - Revenues from Tissue Distribution and Other Revenues (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Segment Reporting Information [Line Items]
Total revenues	$ 70,685	$ 72,120	$ 140,575	$ 142,059
Spine [Member] | Tissue Distribution [Member] | Service [Member]
Segment Reporting Information [Line Items]
Total revenues	18,934	19,419	38,197	39,757
Sports [Member] | Tissue Distribution [Member] | Service [Member]
Segment Reporting Information [Line Items]
Total revenues	14,190	14,453	27,625	29,129
OEM [Member] | Tissue Distribution [Member] | Service [Member]
Segment Reporting Information [Line Items]
Total revenues	31,170	27,983	61,290	53,125
International [Member] | Tissue Distribution [Member] | Service [Member]
Segment Reporting Information [Line Items]
Total revenues	$ 6,391	6,592	$ 13,463	13,224
Cardiothoracic [Member] | Tissue Distribution [Member] | Service [Member]
Segment Reporting Information [Line Items]
Total revenues		$ 3,673		$ 6,824

Segment Data - Schedule of Perc

Segment Data - Schedule of Percentage of Total Revenues Derived from Company's Largest Distributors (Detail) - Distributors Concentration Risk [Member] - Sales Revenue, Net [Member]	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Zimmer Biomet Holdings, Inc. [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	20.00%	14.00%	21.00%	15.00%
Medtronic, PLC [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	8.00%	8.00%	8.00%	9.00%
DePuy Synthes [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	6.00%	4.00%	5.00%	4.00%

Segment Data - Schedule of Prop

Segment Data - Schedule of Property, Plant and Equipment - Net by Significant Geographic Location (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 76,838	$ 79,564
Domestic [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	70,948	73,363
International [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment - net	$ 5,890	$ 6,201