LeMaitre Vascular (LMAT) 10-K 11 Mar 19 2018 FY Annual report Financial data

Document And Entity Information

Document And Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2018	Mar. 06, 2019	Jun. 30, 2018
Document Information [Line Items]
Entity Registrant Name	LEMAITRE VASCULAR INC
Entity Central Index Key	0001158895
Trading Symbol	lmat
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Well-known Seasoned Issuer	No
Entity Emerging Growth Company	false
Entity Small Business	false
Entity Common Stock, Shares Outstanding (in shares)		18,670,632
Entity Public Float			$ 372,895,620
Document Type	10-K
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Amendment Flag	false
Entity Shell Company	false

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Assets
Cash and cash equivalents	$ 26,318	$ 19,096
Short-term marketable securities	21,668	22,564
Accounts receivable, net of allowances of $399 at December 31, 2018, and $349 at December 31, 2017	15,721	15,000
Inventory and other deferred costs	27,388	21,046
Prepaid expenses and other current assets	2,922	2,605
Total current assets	94,017	80,311
Property and equipment, net	14,102	12,378
Goodwill	29,868	23,844
Other intangibles, net	13,692	8,234
Deferred tax assets	1,215	1,378
Other assets	194	178
Total assets	153,088	126,323
Liabilities and stockholders’ equity
Accounts payable	1,732	1,543
Accrued expenses	15,847	9,770
Acquisition-related obligations	2,179	1,876
Total current liabilities	19,758	13,189
Deferred tax liabilities	484	2,176
Other long-term liabilities	2,611	1,188
Total liabilities	22,853	16,553
Stockholders’ equity:
Preferred stock, $0.01 par value; authorized 3,000,000 shares; none outstanding
Common stock, $0.01 par value; authorized 37,000,000 shares; issued 21,110,224 shares at December 31, 2018, and 20,745,051 shares at December 31, 2017	211	207
Additional paid-in capital	98,442	93,127
Retained earnings	45,831	28,333
Accumulated other comprehensive loss	(3,900)	(2,289)
Treasury stock, at cost; 1,501,511 shares at December 31, 2018 and 1,480,101 shares at December 31, 2017	(10,349)	(9,608)
Total stockholders’ equity	130,235	109,770
Total liabilities and stockholders’ equity	$ 153,088	$ 126,323

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parentheticals) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Accounts receivable, allowances	$ 399	$ 349
Preferred stock, par value (in dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	3,000,000	3,000,000
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	37,000,000	37,000,000
Common stock, shares issued (in shares)	21,110,224	20,745,041
Treasury stock, at cost (in shares)	1,501,511	1,480,101

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Revenue from Contract with Customer, Including Assessed Tax	$ 105,568	$ 100,867	$ 89,151
Cost of sales	31,629	30,170	26,215
Gross profit	73,939	70,697	62,936
Sales and marketing	27,318	25,948	26,105
General and administrative	17,689	17,010	14,354
Research and development	8,197	6,636	6,141
Gain on divestitures and acquisitions	(7,474)
Total operating expenses	45,730	49,594	46,600
Income from operations	28,209	21,103	16,336
Other income (expense):
Interest income	631	179	81
Interest expense	(2)	(21)	(14)
Foreign currency loss	(394)	(155)	(161)
Income before income taxes	28,444	21,106	16,242
Provision for income taxes	5,501	3,929	5,652
Net income	$ 22,943	$ 17,177	$ 10,590
Earnings per share of common stock:
Basic (in dollars per share)	$ 1.18	$ 0.91	$ 0.57
Diluted (in dollars per share)	$ 1.13	$ 0.86	$ 0.55
Weighted-average shares outstanding:
Basic (in shares)	19,426	18,961	18,485
Diluted (in shares)	20,242	20,033	19,241
Cash dividends declared per common share (in dollars per share)	$ 0.28	$ 0.22	$ 0.18

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Net income	$ 22,943	$ 17,177	$ 10,590
Other comprehensive income (loss):
Foreign currency translation adjustment, net	(1,626)	2,294	(534)
Unrealized gain (loss) on short-term marketable securities	15
Total other comprehensive income (loss)	(1,611)	2,294	(534)
Comprehensive income	$ 21,332	$ 19,471	$ 10,056

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Treasury Stock [Member]	Total
Balance (in shares) at Dec. 31, 2015	19,748,321				1,431,139
Balance at Dec. 31, 2015	$ 197	$ 82,094	$ 8,161	$ (4,049)	$ (8,519)	$ 77,884
Net income			10,590			10,590
Other comprehensive income				(534)		(534)
Cummaltive effect adjustment to retained earnings		165	(93)			72
Issuance of common stock for stock options exercised (in shares)	233,798
Issuance of common stock for stock options exercised	$ 3	1,439				1,442
Vested restricted stock units (in shares)	58,229
Vested restricted stock units
Stock-based compensation expense		1,680				1,680
Repurchase of common stock at cost (in shares)					21,671
Repurchase of common stock at cost					$ (311)	(311)
Common stock cash dividend paid			(3,323)			(3,323)
Balance (in shares) at Dec. 31, 2016	20,040,348				1,452,810
Balance at Dec. 31, 2016	$ 200	85,378	15,335	(4,583)	$ (8,830)	87,500
Net income			17,177			17,177
Other comprehensive income				2,294		2,294
Issuance of common stock for stock options exercised (in shares)	635,503
Issuance of common stock for stock options exercised	$ 7	5,493				5,500
Vested restricted stock units (in shares)	69,190
Vested restricted stock units
Stock-based compensation expense		2,256				2,256
Repurchase of common stock at cost (in shares)					27,291
Repurchase of common stock at cost					$ (778)	(778)
Common stock cash dividend paid			(4,179)			(4,179)
Balance (in shares) at Dec. 31, 2017	20,745,041				1,480,101
Balance at Dec. 31, 2017	$ 207	93,127	28,333	(2,289)	$ (9,608)	109,770
Net income			22,943			22,943
Other comprehensive income				(1,611)		$ (1,611)
Issuance of common stock for stock options exercised (in shares)	303,379					303,379	[1]
Issuance of common stock for stock options exercised	$ 3	2,966				$ 2,969
Vested restricted stock units (in shares)	61,804
Vested restricted stock units
Stock-based compensation expense		2,349				2,349
Repurchase of common stock at cost (in shares)					21,410
Repurchase of common stock at cost					$ (741)	(741)
Common stock cash dividend paid			(5,445)			(5,445)
Balance (in shares) at Dec. 31, 2018	21,110,224				1,501,511
Balance at Dec. 31, 2018	$ 211	$ 98,442	$ 45,831	$ (3,900)	$ (10,349)	$ 130,235
[1]	The aggregate intrinsic value of shares exercised represents the difference between the exercise price and the closing price of our stock on the date of exercise.

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Operating activities
Net income	$ 22,943	$ 17,177	$ 10,590
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	4,324	4,055	3,591
Stock-based compensation	2,349	2,256	1,680
Fair value adjustments to contingent consideration obligations	(29)	106
Provision for doubtful accounts and allowances	264	230	105
Provision for inventory write-downs	671	396	362
Provision (benefit) for deferred income taxes	(2,152)	300	140
Gain on acquisitions and divestitures	(7,474)
Foreign currency transaction gain	259	(29)	59
Changes in operating assets and liabilities:
Accounts receivable	(1,283)	(1,507)	(922)
Inventory and other deferred costs	(4,262)	(1,352)	(134)
Prepaid expenses and other assets	(418)	(288)	1,528
Accounts payable and other liabilities	4,314	1,524	(103)
Net cash provided by operating activities	19,506	22,868	16,896
Investing activities
Purchases of property and equipment	(3,054)	(6,417)	(2,841)
Payments related to acquisitions	(12,282)		(14,368)
Purchases of short-term marketable securities	(19,619)	(22,541)
Proceeds from sales of marketable securities	20,500
Proceeds from divestitures	7,400
Purchase of intellectual property			(2)
Net cash used in investing activities	(7,055)	(28,958)	(17,211)
Financing activities
Payment of deferred acquisition consideration	(1,199)	(463)	(385)
Proceeds from issuance of common stock	2,969	5,500	1,442
Purchase of treasury stock	(741)	(778)	(311)
Common stock cash dividend paid	(5,445)	(4,179)	(3,323)
Net cash provided by (used in) financing activities	(4,416)	80	(2,577)
Effect of exchange rate changes on cash and cash equivalents	(813)	818	(271)
Net increase (decrease) in cash and cash equivalents	7,222	(5,192)	(3,163)
Cash and cash equivalents at beginning of year	19,096	24,288	27,451
Cash and cash equivalents at end of year	$ 26,318	$ 19,096	$ 24,288

Note 1 - Significant Accounting

Note 1 - Significant Accounting Policies and Related Matters	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Significant Accounting Policies [Text Block]	1. Description of Business Unless the context requires otherwise, references to LeMaitre Vascular, we, our, and us refer to LeMaitre Vascular, Inc. and our subsidiaries. We develop, manufacture, and market medical devices and implants used primarily in the field of vascular surgery. We also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. We operate in a Consolidation and Basis of Presentation Our consolidated financial statements include the accounts of LeMaitre Vascular and the accounts of our wholly-owned subsidiaries, LeMaitre Vascular GmbH, LeMaitre Vascular GK, Vascutech Acquisition LLC, LeMaitre Acquisition LLC, LeMaitre Vascular SAS, LeMaitre Vascular S.r.l., LeMaitre Vascular Spain SL, LeMaitre Vascular Switzerland GmbH, LeMaitre Vascular ULC, LeMaitre Vascular AS, LeMaitre Vascular Pty Ltd, Bio Nova International Pty Ltd, LeMaitre Vascular, Ltd., LeMaitre Medical Technology (Shanghai) Co. Ltd, LeMaitre Cardial SAS and LeMaitre Vascular Singapore Pte Ltd. All significant intercompany accounts and transactions have been eliminated in consolidation. Foreign Currency Translation Balance sheet accounts of foreign subsidiaries are translated into U.S. dollars at year-end exchange rates. Operating accounts are translated at average exchange rates for each year. Net translation gains or losses are adjusted directly to a separate component of other comprehensive income (loss) within stockholders’ equity. Foreign exchange transaction gains (losses), substantially all of which relate to intercompany activity between us and our foreign subsidiaries, are included in other income (expense) in the accompanying consolidated statements of operations. Estimates The preparation of financial statements in conformity with U.S. generally accepted accounting principles (GAAP) requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Our estimates and assumptions, including those related to bad debts, inventory and other deferred costs, intangible assets, sales returns and discounts, and income taxes are reviewed on an ongoing basis and updated as appropriate. Actual results could differ from those estimates. Revenue Recognition Our revenue is derived primarily from the sale of disposable or implantable devices used during vascular surgery. We sell primarily directly to hospitals and to a lesser extent to distributors, as described below, and, during the periods presented in our consolidated financial statements, entered into consigned inventory arrangements with either hospitals or distributors on a limited basis. With the acquisition of the RestoreFlow allograft business, we also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. These revenues are recognized when services have been provided and the tissue has been shipped to the customer, provided all other revenue recognition criteria discussed in the succeeding paragraph have been met. On January 1, 2018 2014 09, Revenue from Contracts with Customers (Topic 606 not not no 606 Step 1: Step 2: Step 3: Step 4: Step 5: Revenue is recognized when or as a company satisfies a performance obligation by transferring a promised good or service to a customer (which is when the customer obtains control of that good or service). In instances in which shipping and handling activities are performed after a customer takes control of the goods (such as when title passes upon shipment from our dock), we have made the policy election allowed under Topic 606 not We generally reference customer purchase orders to determine the existence of a contract. Orders that are not one not We recognize revenue, net of allowances for returns and discounts, fees paid to group purchasing organizations, and any sales and value added taxes required to be invoiced, which we have elected to exclude from the measurement of the transaction price as allowed by the standard, at the time of shipment (taking into consideration contractual shipping terms), or in the case of consigned inventory, when it is consumed. Shipment is the point at which control of the product and title passes to our customers, and at which LeMaitre Vascular has a present right to receive payment for the goods. Below is a disaggregation of our revenue by major geographic area, which is among the primary categorizations used by management in evaluating financial performance, for the periods indicated (in thousands): Year ended December 31, 2018 2017 Americas $ 63,649 $ 62,696 Europe, Middle East and Africa 35,319 32,517 Asia/Pacific Rim 6,600 5,654 Total $ 105,568 $ 100,867 Except as discussed in Note 6, not no not 30 60 no Customers returning products may 18 twelve 30 not not Research and Development Expense Research and development costs, principally salaries, laboratory testing, and supplies, are expensed as incurred and also include royalty payments associated with licensed and acquired intellectual property. Shipping and Handling Costs Shipping and handling fees paid by customers are recorded within net sales, with the related expense recorded in cost of sales. Advertising Costs Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows: Year ended December 31, 2018 2017 2016 (in thousands) Advertising expense $ 299 $ 305 $ 378 Cash and Cash Equivalents We consider all highly liquid instruments purchased with maturity dates of 90 Short-term Marketable Securitie Our short-term marketable securities are available-for-sale securities carried at fair value, with unrealized gains and losses recorded in other comprehensive income. Concentrations of Credit Risk Our financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. Cash equivalents represent highly liquid investments with maturities of 90 $250,000. $18.8 December 31, 2018. Our accounts receivable are with customers based in the United States and internationally. Accounts receivable generally are due within 30 90 may 90 240 We closely monitor outstanding receivables for potential collection risks, including those that may may December 31, 2018 $1.0 $0.7 December 31, 2018, may not may We write off accounts receivable when they become uncollectible. Such credit losses have historically been within our expectations and allowances. The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable. We review our allowance for doubtful accounts on a monthly basis and all past due balances are reviewed individually for collectability. The provision for the allowance for doubtful accounts is recorded in general and administrative expenses. The following is a summary of our allowance for doubtful accounts and sales returns: Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2018 $ 349 $ 264 $ 214 $ 399 Year ended December 31, 2017 258 230 139 349 Year ended December 31, 2016 243 105 90 258 Fair Value of Financial Instruments Our financial instruments include cash and cash equivalents, short-term marketable securities, accounts receivable and trade payables. The fair value of these instruments approximates their carrying value based upon their short-term nature or variable rates of interest. Unrealized gains and losses on our short-term marketable securities are recorded in other comprehensive income and were not December 31, 2018. Inventory and Other Deferred Costs Inventory and Other Deferred Costs consists of finished products, work-in-process, raw materials and costs deferred in connection with human tissue cryopreservation services of our RestoreFlow allograft business. We value inventory and other deferred costs at the lower of cost or market value. Cost includes materials, labor and manufacturing overhead and is determined using the first first may not may Property and Equipment Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows: Description Useful Life (in years) Computers and equipment 3 – 5 Machinery and equipment 3 – 10 Leasehold improvements The shorter of its useful life or lease term Expenditures for maintenance and repairs are charged to operations when incurred, while additions and betterments are capitalized. When assets are retired or disposed, the asset’s original cost and related accumulated depreciation are eliminated from the accounts and any gain or loss is reflected in the statement of operations. Valuation of Business Combinations We assign the value of the consideration transferred to acquire a business to the tangible assets and identifiable intangible assets acquired and liabilities assumed on the basis of their fair values at the date of acquisition. We assess the fair value of assets, including intangible assets, using a variety of methods and are usually performed by an independent appraiser who measures fair value from the perspective of a market participant. Acquisitions have been accounted for using the acquisition method, and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. Acquisition transaction costs have been recorded in general and administrative expenses, and are expensed as incurred. Allocation of the purchase price for acquisitions is based on estimates of the fair value of the net assets acquired and, for acquisitions completed within the past year, is subject to adjustment upon finalization of the purchase price allocation. Our acquisitions have historically been made at prices above the fair value of the acquired assets, resulting in goodwill, due to expectations of synergies of combining the businesses. These synergies include use of our existing commercial infrastructure to expand sales of the acquired businesses’ products, use of the commercial infrastructure of the acquired businesses to cost-effectively expand sales of our products, and the elimination of redundant facilities, functions and staffing. Contingent Consideration Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income. Impairment of Long-lived Assets We review our long-lived assets (primarily property and equipment and intangible assets) subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may not Goodwill Goodwill represents the amount of consideration paid in connection with business acquisitions in excess of the fair value of assets acquired and liabilities assumed. Goodwill is evaluated for impairment annually or more frequently if indicators of impairment are present or changes in circumstances suggest that an impairment may December 31 not” two not” 50 no December 31, 2018, 2017 2016. Other Intangible Assets Other intangible assets consist primarily of patents, trademarks, technology licenses, and customer relationships acquired in connection with business acquisitions and asset acquisitions and are amortized over their estimated useful lives, ranging from 2 16 Stock-based Compensation We recognize, as expense, the estimated fair value of stock options to employees which is determined using the Black-Scholes option pricing model. Share-based compensation charges are recorded across the consolidated statement of operations based upon the grantee’s primary function. We have elected to recognize the compensation cost of all share-based awards on a straight-line basis over the vesting period of the award. In periods that we grant stock options, fair value assumptions are based on volatility, interest, dividend yield, and expected term over which the stock options will be outstanding. The computation of expected volatility is based on the historical volatility of the company’s stock. The interest rate for periods within the contractual life of the award is based on the U.S. Treasury risk-free interest rate in effect at the time of grant. Historical data on exercise patterns is the basis for estimating the expected life of an option. The expected annual dividend rate was calculated by dividing our annual dividend, based on the most recent quarterly dividend rate, by the closing stock price on the grant date. We also issue restricted stock units (RSUs) as an additional form of equity compensation to our employees, officers, and directors, pursuant to our stockholder-approved 2006 no Commitments and Contingencies In the normal course of business, we are subject to proceedings, lawsuits, and other claims and assessments for matters related to, among other things, patent infringement, business acquisitions, employment, commercial matters and product recalls. We assess the likelihood of any adverse judgments or outcomes to these matters as well as potential ranges of probable losses. A determination of the amount of reserves required, if any, for these contingencies is made after careful analysis of each individual issue. The required reserves may December 31, 2018, 2017 2016, not Income Taxes We account for income taxes under the asset and liability method of accounting for income taxes. Under the asset and liability method, deferred taxes are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. The provision for income taxes includes taxes currently payable and deferred taxes resulting from the tax effects of temporary differences between the financial statement and tax bases of assets and liabilities. We maintain valuation allowances where it is more likely than not not We recognize, measure, present and disclose in our financial statements, uncertain tax positions that we have taken or expect to take on a tax return. We recognize in our financial statements the impact of tax positions that meet a “more likely than not” fifty Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense. Comprehensive Income Comprehensive income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than reported net income, comprehensive income includes foreign currency translation adjustments, which are disclosed in the accompanying consolidated statements of comprehensive income. There were no December 31, 2018, 2017 2016. Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $3.9 $2.3 December 31, 2018 2017, Restructuring We record restructuring charges incurred in connection with consolidation or relocation of operations, exited business lines, reductions in force, or distributor terminations. These restructuring charges, which reflect our commitment to a termination or exit plan that will begin within twelve Earnings per Share We compute basic earnings per share by dividing net income available for common stockholders by the weighted average number of shares outstanding during the year. Except where the result would be anti-dilutive to net income per share, diluted earnings per share has been computed using the treasury stock method and reflects the potential vesting of restricted common stock and the potential exercise of stock options, as well as their related income tax effects. The computation of basic and diluted net income per share is as follows: Year ended December 31, 2018 2017 2016 (in thousands, except per share data) Basic: Net income available for common stockholders $ 22,943 $ 17,177 $ 10,590 Weighted average shares outstanding 19,426 18,961 18,485 Basic earnings per share $ 1.18 $ 0.91 $ 0.57 Diluted: Net income available for common stockholders $ 22,943 $ 17,177 $ 10,590 Weighted-average shares outstanding 19,426 18,961 18,485 Common stock equivalents, if dilutive 816 1,072 756 Shares used in computing diluted earnings per common share 20,242 20,033 19,241 Diluted earnings per share $ 1.13 $ 0.86 $ 0.55 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 230 6 45 Recent Accounting Pronouncements In August 2018, 2018 15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350 40 January 1, 2020, not In August 2018, 2018 13 820 January 1, 2020, not In February 2018, 2018 02, Income Statement – Reporting Other Comprehensive Income (Topic 220 not January 1, 2019, not In January 2017, 2017 04, 2” not January 1, 2020, not In February 2016, No. 2016 02, Leases (Topic 842 2018 11, Leases (Topic 842 no December 15, 2018, January 1, 2019, not not may not not $6.1 $6.7 $6.6 $7.2

Note 2 - Acquisitions and Dives

Note 2 - Acquisitions and Divestitures	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Business Combination Disclosure [Text Block]	2. Acquisitions are accounted for using the acquisition method and the acquired businesses’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. In each case for the acquisitions disclosed below, pro forma information assuming the acquisition had occurred at the beginning of the earliest period presented is not Our acquisitions have historically been made at prices above the fair value of the acquired identifiable assets, resulting in goodwill, due to expectations of synergies that will be realized by combining businesses. These synergies include the use of our existing sales channel to expand sales of the acquired businesses’ products, consolidation of manufacturing facilities, and the leveraging of our existing administrative infrastructure. The fair market valuations associated with these transactions fall within Level 3 13 Cardial On October 22, 2018, December 31, 2018 $1.1 The purchase price for the acquired assets, including the land and building, inventory, machinery and equipment, intellectual property, permits and approvals, data and records, and customer and supplier information, was €2.0 $2.3 €1.1 $1.3 €0.5 $0.5 €0.4 $0.4 two twelve eighteen no may The following table summarizes the preliminary purchase price allocation: Allocated Fair Value (in thousands) Inventory € 2,419 Land and building 750 Equipment and supplies 94 Intangible assets 623 Bargain purchase gain (1,946 ) Purchase price € 1,940 The bargain purchase gain was recorded to reflect the excess of the net assets acquired over the purchase price. We recorded deferred taxes on this gain of €0.5 $0.6 €1.4 $1.6 The following table reflects the preliminary allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Allocated Fair Value Weighted Average Useful Life (in thousands) (in years) Customer relationships € 250 16.0 Intellectual property 237 5.0 Non-compete agreement 46 5.0 Tradenames 90 5.0 Total intangible assets € 623 The weighted-average amortization period of the acquired intangible assets was 9.4 Applied Medical On September 20, 2018, 60% 40% twelve December 31, 2018 $0.8 The purchase price for the acquired assets, which included inventory, machinery and equipment, intellectual property, permits and approvals, data and records, and customer and supplier information, was $14.2 $11 $2 12 $1.2 24 $3.2 $3.043 3.75% The following table summarizes the preliminary purchase price allocation: Allocated Fair Value (in thousands) Inventory $ 739 Equipment and supplies 416 Intangible assets 6,527 Goodwill 6,361 Purchase price $ 14,043 The goodwill results from expected synergies of combining the acquired products and customer information to our existing operations, and is deductible for tax purposes over 15 The following table reflects the preliminary allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Allocated Fair Value Weighted Average Useful Life (in thousands) (in years) Customer relationships $ 4,475 16.0 Intellectual property 1,316 7.0 Non-compete agreement 530 5.0 Tradenames 206 7.0 Total intangible assets $ 6,527 The weighted-average amortization period of the acquired intangible assets was 13.0 Reddick Divestiture On April 5, 2018, $7.4 two six $5.9 Allocated Fair Value (in thousands) Inventory $ 308 Deferred revenue - transition services agreement 1,081 Goodwill 135 Gain on divestiture 5,876 Consideration received $ 7,400 Under the terms of the transition services agreement, we have agreed to manufacture the Reddick products for the buyer at prices at or in some cases below our cost. We allocated a portion of the consideration received to this agreement to reflect it at fair value and recorded it as deferred revenue. As the products are sold to the buyer, we amortize a portion of the deferred revenue to adjust the gross margin on the sale to fair value on a specific identification basis. Additionally, as the Reddick product lines that were divested constituted a business, we allocated a portion of our goodwill to this divestiture based on the fair value of the business sold in relation to the fair value of the business that will be retained. RestoreFlow Allografts On November 10, 2016, $12 three $2 $6 $2 not 15 18 not $0.9 $1.1 $0.9 May 2018 $2 There were also two first 50% first 12 $6 not $2 second 50% second 12 $9 not $2 $0.1 two 14.1% not no The RestoreFlow business derives revenue from human tissue preservation services, in particular the processing and cryopreservation of veins and arteries. By federal law, human tissues cannot be bought or sold. Therefore, the tissues we obtain and preserve are not The acquired assets included intellectual property, permits and approvals, data and records, equipment and furnishings, accounts receivable, inventory, literature, and customer and supplier information. We also assumed certain accounts payable. We accounted for the acquisition as a business combination. The following table summarizes the final purchase price allocation: Allocated (in thousands) Accounts receivable $ 394 Deferred cryopreservation costs 2,583 Equipment and supplies 125 Accounts payable (286 ) Intangible assets 4,544 Goodwill 5,599 Purchase price $ 12,959 The goodwill is deductible for tax purposes over 15 The following table reflects the allocation of purchase consideration to the acquired intangible assets and related estimated useful lives: Allocated Weighted (in thousands) (in years) Non-compete agreements $ 180 5.0 Tradename 271 9.0 Procurement contracts 617 9.0 Technology 2,793 10.5 Customer relationships 683 12.5 Total intangible assets $ 4,544 The weighted-average amortization period of the acquired intangible assets was 10.3 ProCol Biologic Graft On March 18, 2016, $2.7 $2.0 $0.7 50% three 10% $0.3 December 31, 2018, 2017 2016, not Assets acquired included inventory, intellectual property and a related license, the ProCol trade name, customer lists, non-compete agreements and certain equipment and supplies. We did not The following table summarizes the purchase price allocation: Allocated Fair Value (in thousands) Inventory $ 2,080 Manufacturing equipment and supplies 25 Intangible assets 620 Goodwill 318 Purchase price $ 3,043 The goodwill is deductible for tax purposes over 15 The following table reflects the allocation of the acquired intangible assets and related estimated useful lives: Allocated Fair Value Weighted Average Useful Life (in thousands) (in years) Non-compete agreement $ 84 5.0 Tradename 109 9.5 Technology 277 9.0 Customer relationships 150 9.0 Total intangible assets $ 620 The weighted-average amortization period of the acquired intangible assets was 8.6

Note 3 - Inventory and Other De

Note 3 - Inventory and Other Deferred Costs	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Inventory and Other Deferred Costs Disclosure [Text Block]	3. Inventory and other deferred costs consists of the following: December 31, 2018 December 31, 2017 (in thousands) Raw materials $ 4,085 $ 3,200 Work-in-process 5,095 3,745 Finished products 16,391 12,278 Other deferred costs 1,817 1,823 Total inventory and other deferred costs $ 27,388 $ 21,046 We held inventory on consignment of $1.7 $1.4 December 31, 2018 2017, In connection with our acquisition of the RestoreFlow allograft business, other deferred costs include costs incurred for the preservation of human vascular tissues available for shipment, tissues currently in active processing, and tissues held in quarantine pending release to implantable status. By federal law, human tissues cannot be bought or sold. Therefore, the tissues we preserve are not

Note 4 - Property and Equipment

Note 4 - Property and Equipment	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Property, Plant and Equipment Disclosure [Text Block]	4. Property and equipment consists of the following: As of December 31, 2018 2017 (in thousands) Computers and equipment $ 4,077 $ 3,204 Machinery and equipment 13,718 12,223 Building and leasehold improvements 11,651 10,843 Gross property and equipment 29,446 26,270 Less accumulated depreciation (15,344 ) (13,892 ) Property and equipment, net $ 14,102 $ 12,378 During the years ended December 31, 2018, 2017 2016 $1.0 $0.2 $0.1 Depreciation expense is as follows: Year ended December 31, 2018 2017 2016 (in thousands) Depreciation expense $ 2,564 $ 2,266 $ 1,986

Note 5 - Goodwill and Other Int

Note 5 - Goodwill and Other Intangibles	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Goodwill and Intangible Assets Disclosure [Text Block]	5. Goodwill consists of the following: As of December 31, 2018 2017 Balance at beginning of year $ 23,844 $ 23,426 Additions for acquisitions 6,361 - Purchase accounting adjustments - 257 Divestiture adjustment (135 ) Effects of currency exchange (202 ) 161 Balance at end of year $ 29,868 $ 23,844 Other intangibles consist of the following: December 31, 2018 December 31, 2017 Gross Net Gross Net Carrying Accumulated Carrying Carrying Accumulated Carrying Value Amortization Value Value Amortization Value (in thousands) Product technology and intellectual property $ 11,728 $ 5,726 $ 6,002 $ 10,267 $ 4,908 $ 5,359 Trademarks, tradenames and licenses 2,246 1,561 685 1,948 1,468 480 Customer relationships 10,065 3,806 6,259 5,383 3,299 2,084 Other intangible assets 2,145 1,399 746 1,575 1,264 311 Total identifiable intangible assets $ 26,184 $ 12,492 $ 13,692 $ 19,173 $ 10,939 $ 8,234 These assets are being amortized over useful lives ranging from 2 16 December 31, 2018, 9.5 Year ended December 31, 2018 2017 2016 (in thousands) Amortization expense $ 1,760 $ 1,790 $ 1,605 Estimated amortization expense for each of the next five December 31, 2018, Year ended December 31, 2019 2020 2021 2022 2023 (in thousands) Amortization expense $ 2,088 $ 1,839 $ 1,624 $ 1,420 $ 1,347

Note 6 - Accrued Expenses and O

Note 6 - Accrued Expenses and Other Long-term Liabilities	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Accounts Payable, Accrued Liabilities, and Other Liabilities Disclosure, Noncurrent [Text Block]	6. Accrued expenses consist of the following: December 31, 2018 December 31, 2017 (in thousands) Compensation and related taxes $ 7,973 $ 6,494 Income and other taxes 2,927 703 Professional fees 43 35 Deferred revenue 552 - Other 4,352 2,538 Total $ 15,847 $ 9,770 As discussed in Note 2 nine twelve December 31, 2018: December 31, 2018 (in thousands) Beginning contract liability balance $ - Deferred revenue recorded 1,081 Revenue recognized upon satisfaction of performance obligations in the period (529 ) Ending balance $ 552 Other long-term liabilities consist of the following: December 31, 2018 December 31, 2017 (in thousands) Acquisition-related liabilities $ 1,326 $ 127 Deferred rent 530 561 Income taxes 559 321 Other 196 179 Total $ 2,611 $ 1,188

Note 7 - Commitments and Contin

Note 7 - Commitments and Contingencies	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Commitments and Contingencies Disclosure [Text Block]	7. Leases We conduct the majority of our operations in leased facilities, which are accounted for as operating leases. Certain leases include renewal options. We also lease automobiles under operating leases. There were no December 31, 2018 2017. Rent expense under all operating leases was as follows: Year ended December 31, 2018 2017 2016 (in thousands) Rent expense $ 2,090 $ 2,190 $ 1,580 At December 31, 2018, one Less than 1-3 3-5 More than Contractual obligations Total 1 year years years 5 years (in thousands) Operating leases $ 7,435 $ 1,826 $ 3,053 $ 2,556 $ - Inventory purchase commitments $ 2,195 $ 2,072 $ 123 $ - $ - As part of our normal course of business, we have commitments to purchase $2.2 2019. not

Note 8 - Income Taxes

Note 8 - Income Taxes	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Income Tax Disclosure [Text Block]	8. Income (loss) before income taxes is as follows: Year ended December 31, 2018 2017 2016 (in thousands) United States $ 22,256 $ 17,778 $ 12,600 Foreign 6,188 3,328 3,642 Total $ 28,444 $ 21,106 $ 16,242 Certain of our foreign subsidiaries are included in the U.S. tax return as branches but are included as foreign for purposes of the table above. The provision (benefit) for income taxes is as follows: Year ended December 31, 2018 2017 2016 (in thousands) Current: Federal $ 4,262 $ 2,451 $ 4,409 State 673 292 393 Foreign 2,718 886 710 7,653 3,629 5,512 Deferred: Federal (1,512 ) (268 ) 197 State (145 ) 390 166 Foreign (495 ) 178 (223 ) (2,152 ) 300 140 Provision for income taxes $ 5,501 $ 3,929 $ 5,652 We have reviewed the tax positions taken, or to be taken, in our tax returns for all tax years currently open to examination by a taxing authority. As of December 31, 2018, $0.7 may twelve December 31, 2019. 2026. 2018 2017 2016 (in thousands) Unrecognized tax benefits at the beginning of year $ 525 $ 390 $ 82 Additions for tax positions of current year 73 83 95 Additions for tax positions of prior years 113 57 213 Reductions for settlements with taxing authorities. - - - Reductions for lapses of the applicable statutes of limitations - (5 ) - Unrecognized tax benefits at the end of the year $ 711 $ 525 $ 390 Deferred taxes are attributable to the following temporary differences: As of December 31, 2018 2017 (in thousands) Deferred tax assets: Inventory $ 976 $ 569 Net operating loss carryforwards 1,421 1,898 Tax credit carryforwards 828 760 Capital loss carryforwards 279 1,168 Reserves and accruals 802 629 Intangible assets 2,737 1,138 Stock options 373 322 Other 91 65 Total deferred tax assets 7,507 6,549 Deferred tax liabilities: Property and equipment (1,416 ) (1,203 ) Goodwill (3,023 ) (2,932 ) Foreign branch deferred offset (1,032 ) (1,177 ) Other (50 ) (44 ) Total deferred tax liabilities (5,521 ) (5,356 ) Net deferred tax assets before valuation allowance 1,986 1,193 Valuation allowance (1,255 ) (1,991 ) Net deferred tax liabiltity $ 731 $ (798 ) Deferred tax classification Long-term deferred tax asset $ 1,215 $ 1,378 Long-term deferred tax liability (484 ) (2,176 ) Net long-term deferred tax liability $ 731 $ (798 ) We elected to adopt ASU 2016 09 third 2016. $0.3 $3.7 $1.1 2016, 2017, 2018 In 2016, $0.3 2016 not 2017, $0.2 2018, $0.7 As of December 31, 2018, $1.3 not may Realization of our deferred tax assets is dependent on our generating sufficient taxable income in future periods. Although we believe it is more likely than not not may As of December 31, 2018, $1.3 not $2.7 not $0.9 not $0.1 not $33,000 not $4,000 not $0.9 not $1.4 2020, In December 2018, no no not A reconciliation of the federal statutory rate to our effective tax rate is as follows: 2018 2017 2016 Federal statutory rate 21.0 % 35.0 % 35.0 % State tax, net of federal benefit 1.4 % 1.7 % 1.3 % Effect of foreign taxes 3.8 % (0.6% ) (1.9% ) Federal tax on foreign income 1.4 % 1.7 % 1.6 % Valuation allowance (3.2% ) 0.1 % (2.6% ) Foreign deferred tax liability offset (0.3% ) (0.2% ) 1.5 % Manufacturing deduction 0.0 % (1.5% ) (2.5% ) Research & development tax credits (0.7% ) (0.6% ) (0.7% ) Stock options (3.3% ) (15.8% ) (0.7% ) Uncertain tax positions 0.8 % 0.6 % 2.0 % Other permanent differences (0.7% ) 1.0 % 1.2 % Change in tax laws 0.0 % 2.9 % 0.0 % Deferred tax remeasurement 0.0 % (5.0% ) 0.0 % Other (0.9% ) (0.7% ) 0.5 % Effective tax rate 19.3 % 18.6 % 34.8 % In 2016 2013 2014 $0.2 $0.2 August 2018, 2013 2016. no not As of December 31, 2018, United States 2015 and forward Foreign 2011 and forward

Note 9 - Stockholders' Equity

Note 9 - Stockholders' Equity	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Stockholders' Equity Note Disclosure [Text Block]	9. Authorized Shares Our certificate of incorporation, as amended and restated from time to time, authorizes the issuance of up to 37,000,000 3,000,000 Under the terms of our certificate of incorporation, our board of directors is authorized to issue shares of the preferred stock in one no Stock Award Plans In May 2006 2006 2006 2006 5,500,000 not four five no ten 2006 no 2006 may 2006 7,118,003 1,212,644 December 31, 2018. We have computed the fair value of employee stock options granted each year using the following weighted average assumptions: 2018 2017 2016 Dividend yield 1.2 % 0.7 % 1.3 % Volatility 41.3 % 39.1 % 34.5 % Risk-free interest rate 2.7 % 2.2 % 1.2 % Weighted average expected option term (in years) 4.8 4.6 5.5 Weighted average fair value per share of options granted $ 8.28 $ 10.37 $ 4.04 A summary of option activity as of December 31, 2018 Weighted Weighted Average Aggregate Number Average Remaining Intrinsic of Shares Exercise Price Contractual Term Value (in years) Balance outstanding at December 31, 2017 (1) 1,536,282 $ 13.86 4.15 $ 27,771,635 Granted 280,423 $ 23.56 Exercised (2) (303,379 ) $ 9.79 $ 7,196,175 Canceled / Expired (50,751 ) $ 13.79 Balance outstanding at December 31, 2018 (3) 1,462,575 $ 16.41 4.54 $ 12,214,422 Vested and exercisable at December 31, 2018 (4) 504,988 $ 11.51 2.65 $ 6,482,151 Expected to vest at December 31, 2018 957,587 $ 18.99 5.54 Total 1,462,575 ( 1 The aggregate intrinsic value represents the difference between the exercise price and $31.84, December 31, 2017, ( 2 The aggregate intrinsic value of shares exercised represents the difference between the exercise price and the closing price of our stock on the date of exercise. ( 3 The aggregate intrinsic value represents the difference between the exercise price and $23.64, December 31, 2018, ( 4 The aggregate intrinsic value represents the difference between the exercise price and $23.64, December 31, 2018, Restricted Stock Units A summary of our RSU activity is as follows: Weighted Average Grant Date Shares Fair Value Balance outstanding at December 31, 2017 216,750 $ 18.10 Granted 87,088 $ 23.65 Vested (1) (63,478 ) $ 15.11 Canceled (22,465 ) $ 17.75 Balance outstanding at December 31, 2018 217,895 $ 21.21 ( 1 The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements. The fair values of the RSUs that vested during 2018, 2017, 2016 $1.9 $1.9 $0.8 We repurchase shares of our common stock in order to cover any minimum tax withholding liability associated with RSU vestings. A summary of our repurchases is as follows: 2018 2017 Shares of common stock repurchased 21,410 27,291 Average per share repurchase price $ 34.62 $ 28.51 Aggregage purchase price (in thousands) $ 741 $ 778 Stock-based Compensation The components of stock-based compensation expense included in the consolidated statements of operations are as follows: 2018 2017 2016 (in thousands) Stock option awards $ 1,457 $ 1,612 $ 1,116 Restricted stock units 892 644 564 Total stock-based compensation $ 2,349 $ 2,256 $ 1,680 Stock-based compensation is included in our statements of operations as follows: 2018 2017 2016 (in thousands) Cost of sales $ 272 $ 188 $ 175 Sales and marketing 529 403 373 General and administrative 1,293 1,484 983 Research and development 255 181 149 Total stock-based compensation $ 2,349 $ 2,256 $ 1,680 General and administrative stock-based compensation expense for 2017 $0.5 We expect to record the unamortized portion of share-based compensation expense of $9.7 December 31, 2018, 3.8 Stock Repurchase Plan s On July 25, 2017, $7.5 July 25, 2018. not On February 14, 2019, $10.0mm may February 14, 2020, Dividends In February 2011, Record Date Payment Date Per Share Amount Dividend Payment (in thousands) Fiscal Year 2018 March 22, 2018 April 5, 2018 $ 0.070 $ 1,351 May 22, 2018 June 7, 2018 $ 0.070 $ 1,353 August 22, 2018 September 6, 2018 $ 0.070 $ 1,369 November 20, 2018 December 6, 2018 $ 0.070 $ 1,372 Fiscal Year 2017 March 22, 2017 April 6, 2017 $ 0.055 $ 1,029 May 24, 2017 June 8, 2017 $ 0.055 $ 1,036 August 23, 2017 September 6, 2017 $ 0.055 $ 1,055 November 22, 2017 December 7, 2017 $ 0.055 $ 1,060 On February 14, 2019, $0.085 April 5, 2019, March 22, 2019, $1.7

Note 10 - Profit-sharing Plan

Note 10 - Profit-sharing Plan	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Compensation and Employee Benefit Plans [Text Block]	10. We offer a 401 may six $0.3 $0.2 $0.1 2018, 2017 2016,

Note 11 - Segment and Enterpris

Note 11 - Segment and Enterprise-wide Disclosures	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Segment Reporting Disclosure [Text Block]	1 1 . Segment and Enterprise-wide Disclosures The FASB establishes standards for reporting information regarding operating segments in financial statements. Operating segments are identified as components of an enterprise that engage in business activities for which separate, discrete financial information is available and is regularly reviewed by the chief operating decision-maker in making decisions on how to allocate resources and assess performance. We view our operations and manage our business as one No Most of our revenues are generated in the United States, Germany, and other European countries, Canada, the United Kingdom and Japan, and substantially all of our assets are located in the United States, Australia and France. Net sales to unaffiliated customers by country were as follows: Year ended December 31, 2018 2017 2016 (in thousands) United States $ 59,078 $ 58,470 $ 50,439 Germany 12,445 11,576 10,350 Other countries 34,045 30,821 28,362 Net sales $ 105,568 $ 100,867 $ 89,151 Total property and equipment held by geography were as follows: As of December 31, 2018 2017 (in thousands) United States $ 11,006 $ 10,275 Australia 1,460 1,639 France 1,071 - Germany 430 369 Other countries 135 95 Total property and equipment $ 14,102 $ 12,378

Note 12 - Supplemental Cash Flo

Note 12 - Supplemental Cash Flow Information	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Cash Flow, Supplemental Disclosures [Text Block]	1 2 . Supplemental Cash Flow Information Supplemental disclosures of cash flow information are as follows: Year ended December 31, 2018 2017 2016 (in thousands) Cash paid for income taxes, net $ 5,521 $ 3,146 $ 4,231

Note 13 - Fair Value Measuremen

Note 13 - Fair Value Measurements	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Fair Value Disclosures [Text Block]	1 3 . Fair Value Measurements The fair value accounting guidance requires that assets and liabilities carried at fair value be classified and disclosed in one three • Level 1 • Level 2 1, not • Level 3 no Level 1 December 31, 2018 We had no 2 December 31, 2018. As discussed in Notes 1 2, 3 2016, $5.1 $1.1 $4.0 first 12 24 $1.0 first 2018. not not three 10% $0.3 2. 3 Year ended December 31, 2018 2017 2016 (in thousands) Beginning balance $ 1,300 $ 1,320 $ - Additions - - 1,301 Payments (1,199 ) (126 ) (68 ) Change in fair value included in earnings (29 ) 106 87 Ending balance $ 72 $ 1,300 $ 1,320

Note 14 - Quarterly Financial D

Note 14 - Quarterly Financial Data (Unaudited)	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Quarterly Financial Information [Text Block]	1 4 . Quarterly Financial Data (unaudited) Three months ended 2018 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 25,994 $ 27,020 $ 24,165 $ 28,389 Gross profit 18,474 18,992 17,255 19,218 Income (loss) from operations 4,862 11,541 4,613 7,193 Net income 3,853 8,751 4,314 6,025 Earnings per share Basic $ 0.20 $ 0.45 $ 0.22 $ 0.31 Diluted $ 0.19 $ 0.43 $ 0.21 $ 0.30 Three months ended 2017 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 24,139 $ 25,753 $ 24,822 $ 26,153 Gross profit 17,353 17,516 17,577 18,251 Income (loss) from operations 4,193 5,536 5,053 6,321 Net income (loss) 3,219 4,632 5,042 4,284 Earnings per share Basic $ 0.17 $ 0.25 $ 0.26 $ 0.22 Diluted $ 0.16 $ 0.23 $ 0.25 $ 0.21

Note 15 - Accumulated Other Com

Note 15 - Accumulated Other Comprehensive Income (Loss)	12 Months Ended
	Dec. 31, 2018
Notes to Financial Statements
Comprehensive Income (Loss) Note [Text Block]	15. Year ended December 31, 2018 2017 2016 (in thousands) Beginning balance $ (2,289 ) $ (4,583 ) $ (4,049 ) $ - Other comprehensive income (loss) before reclassifications (1,611 ) 2,294 (534 ) Amounts reclassified from accumulated other comprehensive loss - - - Ending Balance $ (3,900 ) $ (2,289 ) $ (4,583 ) Changes to our accumulated other comprehensive loss consisted primarily of foreign currency translation for the years ended December 31, 2018, 2017 2016.

Significant Accounting Policies

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Basis of Accounting, Policy [Policy Text Block]	Description of Business Unless the context requires otherwise, references to LeMaitre Vascular, we, our, and us refer to LeMaitre Vascular, Inc. and our subsidiaries. We develop, manufacture, and market medical devices and implants used primarily in the field of vascular surgery. We also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. We operate in a single segment in which our principal product lines include the following: anastomotic clips, angioscopes, balloon catheters, biologic vascular grafts, biologic vascular patches, carotid shunts, polyester vascular grafts, powered phlebectomy devices, radiopaque marking tape, remote endarterectomy devices, surgical glue and valvulotomes. Our offices are located in Burlington, Massachusetts; Fox River Grove, Illinois; Vaughan, Canada; Sulzbach, Germany; Milan, Italy; Madrid, Spain; Saint-Etienne, France; North Melbourne, Australia; Tokyo, Japan; and Shanghai, China and Singapore.
Consolidation, Policy [Policy Text Block]	Consolidation and Basis of Presentation Our consolidated financial statements include the accounts of LeMaitre Vascular and the accounts of our wholly-owned subsidiaries, LeMaitre Vascular GmbH, LeMaitre Vascular GK, Vascutech Acquisition LLC, LeMaitre Acquisition LLC, LeMaitre Vascular SAS, LeMaitre Vascular S.r.l., LeMaitre Vascular Spain SL, LeMaitre Vascular Switzerland GmbH, LeMaitre Vascular ULC, LeMaitre Vascular AS, LeMaitre Vascular Pty Ltd, Bio Nova International Pty Ltd, LeMaitre Vascular, Ltd., LeMaitre Medical Technology (Shanghai) Co. Ltd, LeMaitre Cardial SAS and LeMaitre Vascular Singapore Pte Ltd. All significant intercompany accounts and transactions have been eliminated in consolidation.
Foreign Currency Transactions and Translations Policy [Policy Text Block]	Foreign Currency Translation Balance sheet accounts of foreign subsidiaries are translated into U.S. dollars at year-end exchange rates. Operating accounts are translated at average exchange rates for each year. Net translation gains or losses are adjusted directly to a separate component of other comprehensive income (loss) within stockholders’ equity. Foreign exchange transaction gains (losses), substantially all of which relate to intercompany activity between us and our foreign subsidiaries, are included in other income (expense) in the accompanying consolidated statements of operations.
Use of Estimates, Policy [Policy Text Block]	Estimates The preparation of financial statements in conformity with U.S. generally accepted accounting principles (GAAP) requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Our estimates and assumptions, including those related to bad debts, inventory and other deferred costs, intangible assets, sales returns and discounts, and income taxes are reviewed on an ongoing basis and updated as appropriate. Actual results could differ from those estimates.
Revenue Recognition, Policy [Policy Text Block]	Revenue Recognition Our revenue is derived primarily from the sale of disposable or implantable devices used during vascular surgery. We sell primarily directly to hospitals and to a lesser extent to distributors, as described below, and, during the periods presented in our consolidated financial statements, entered into consigned inventory arrangements with either hospitals or distributors on a limited basis. With the acquisition of the RestoreFlow allograft business, we also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. These revenues are recognized when services have been provided and the tissue has been shipped to the customer, provided all other revenue recognition criteria discussed in the succeeding paragraph have been met. On January 1, 2018 2014 09, Revenue from Contracts with Customers (Topic 606 not not no 606 Step 1: Step 2: Step 3: Step 4: Step 5: Revenue is recognized when or as a company satisfies a performance obligation by transferring a promised good or service to a customer (which is when the customer obtains control of that good or service). In instances in which shipping and handling activities are performed after a customer takes control of the goods (such as when title passes upon shipment from our dock), we have made the policy election allowed under Topic 606 not We generally reference customer purchase orders to determine the existence of a contract. Orders that are not one not We recognize revenue, net of allowances for returns and discounts, fees paid to group purchasing organizations, and any sales and value added taxes required to be invoiced, which we have elected to exclude from the measurement of the transaction price as allowed by the standard, at the time of shipment (taking into consideration contractual shipping terms), or in the case of consigned inventory, when it is consumed. Shipment is the point at which control of the product and title passes to our customers, and at which LeMaitre Vascular has a present right to receive payment for the goods. Below is a disaggregation of our revenue by major geographic area, which is among the primary categorizations used by management in evaluating financial performance, for the periods indicated (in thousands): Year ended December 31, 2018 2017 Americas $ 63,649 $ 62,696 Europe, Middle East and Africa 35,319 32,517 Asia/Pacific Rim 6,600 5,654 Total $ 105,568 $ 100,867 Except as discussed in Note 6, not no not 30 60 no Customers returning products may 18 twelve 30 not not
Research and Development Expense, Policy [Policy Text Block]	Research and Development Expense Research and development costs, principally salaries, laboratory testing, and supplies, are expensed as incurred and also include royalty payments associated with licensed and acquired intellectual property.
Shipping and Handling [Policy Text Block]	Shipping and Handling Costs Shipping and handling fees paid by customers are recorded within net sales, with the related expense recorded in cost of sales.
Advertising Costs, Policy [Policy Text Block]	Advertising Costs Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows: Year ended December 31, 2018 2017 2016 (in thousands) Advertising expense $ 299 $ 305 $ 378
Cash and Cash Equivalents, Policy [Policy Text Block]	Cash and Cash Equivalents We consider all highly liquid instruments purchased with maturity dates of 90
Marketable Securities, Policy [Policy Text Block]	Short-term Marketable Securitie Our short-term marketable securities are available-for-sale securities carried at fair value, with unrealized gains and losses recorded in other comprehensive income.
Concentration Risk, Credit Risk, Policy [Policy Text Block]	Concentrations of Credit Risk Our financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. Cash equivalents represent highly liquid investments with maturities of 90 $250,000. $18.8 December 31, 2018. Our accounts receivable are with customers based in the United States and internationally. Accounts receivable generally are due within 30 90 may 90 240 We closely monitor outstanding receivables for potential collection risks, including those that may may December 31, 2018 $1.0 $0.7 December 31, 2018, may not may We write off accounts receivable when they become uncollectible. Such credit losses have historically been within our expectations and allowances. The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable. We review our allowance for doubtful accounts on a monthly basis and all past due balances are reviewed individually for collectability. The provision for the allowance for doubtful accounts is recorded in general and administrative expenses. The following is a summary of our allowance for doubtful accounts and sales returns: Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2018 $ 349 $ 264 $ 214 $ 399 Year ended December 31, 2017 258 230 139 349 Year ended December 31, 2016 243 105 90 258
Fair Value of Financial Instruments, Policy [Policy Text Block]	Fair Value of Financial Instruments Our financial instruments include cash and cash equivalents, short-term marketable securities, accounts receivable and trade payables. The fair value of these instruments approximates their carrying value based upon their short-term nature or variable rates of interest. Unrealized gains and losses on our short-term marketable securities are recorded in other comprehensive income and were not December 31, 2018.
Inventory and Other Deferred Costs [Policy Text Block]	Inventory and Other Deferred Costs Inventory and Other Deferred Costs consists of finished products, work-in-process, raw materials and costs deferred in connection with human tissue cryopreservation services of our RestoreFlow allograft business. We value inventory and other deferred costs at the lower of cost or market value. Cost includes materials, labor and manufacturing overhead and is determined using the first first may not may
Property, Plant and Equipment, Policy [Policy Text Block]	Property and Equipment Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows: Description Useful Life (in years) Computers and equipment 3 – 5 Machinery and equipment 3 – 10 Leasehold improvements The shorter of its useful life or lease term Expenditures for maintenance and repairs are charged to operations when incurred, while additions and betterments are capitalized. When assets are retired or disposed, the asset’s original cost and related accumulated depreciation are eliminated from the accounts and any gain or loss is reflected in the statement of operations.
Business Combinations Policy [Policy Text Block]	Valuation of Business Combinations We assign the value of the consideration transferred to acquire a business to the tangible assets and identifiable intangible assets acquired and liabilities assumed on the basis of their fair values at the date of acquisition. We assess the fair value of assets, including intangible assets, using a variety of methods and are usually performed by an independent appraiser who measures fair value from the perspective of a market participant. Acquisitions have been accounted for using the acquisition method, and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. Acquisition transaction costs have been recorded in general and administrative expenses, and are expensed as incurred. Allocation of the purchase price for acquisitions is based on estimates of the fair value of the net assets acquired and, for acquisitions completed within the past year, is subject to adjustment upon finalization of the purchase price allocation. Our acquisitions have historically been made at prices above the fair value of the acquired assets, resulting in goodwill, due to expectations of synergies of combining the businesses. These synergies include use of our existing commercial infrastructure to expand sales of the acquired businesses’ products, use of the commercial infrastructure of the acquired businesses to cost-effectively expand sales of our products, and the elimination of redundant facilities, functions and staffing.
Contingent Consideration [Policy Text Block]	Contingent Consideration Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income.
Impairment or Disposal of Long-Lived Assets, Policy [Policy Text Block]	Impairment of Long-lived Assets We review our long-lived assets (primarily property and equipment and intangible assets) subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may not
Goodwill and Intangible Assets, Goodwill, Policy [Policy Text Block]	Goodwill Goodwill represents the amount of consideration paid in connection with business acquisitions in excess of the fair value of assets acquired and liabilities assumed. Goodwill is evaluated for impairment annually or more frequently if indicators of impairment are present or changes in circumstances suggest that an impairment may December 31 not” two not” 50 no December 31, 2018, 2017 2016.
Goodwill and Intangible Assets, Intangible Assets, Policy [Policy Text Block]	Other Intangible Assets Other intangible assets consist primarily of patents, trademarks, technology licenses, and customer relationships acquired in connection with business acquisitions and asset acquisitions and are amortized over their estimated useful lives, ranging from 2 16
Share-based Compensation, Option and Incentive Plans Policy [Policy Text Block]	Stock-based Compensation We recognize, as expense, the estimated fair value of stock options to employees which is determined using the Black-Scholes option pricing model. Share-based compensation charges are recorded across the consolidated statement of operations based upon the grantee’s primary function. We have elected to recognize the compensation cost of all share-based awards on a straight-line basis over the vesting period of the award. In periods that we grant stock options, fair value assumptions are based on volatility, interest, dividend yield, and expected term over which the stock options will be outstanding. The computation of expected volatility is based on the historical volatility of the company’s stock. The interest rate for periods within the contractual life of the award is based on the U.S. Treasury risk-free interest rate in effect at the time of grant. Historical data on exercise patterns is the basis for estimating the expected life of an option. The expected annual dividend rate was calculated by dividing our annual dividend, based on the most recent quarterly dividend rate, by the closing stock price on the grant date. We also issue restricted stock units (RSUs) as an additional form of equity compensation to our employees, officers, and directors, pursuant to our stockholder-approved 2006 no
Commitments and Contingencies, Policy [Policy Text Block]	Commitments and Contingencies In the normal course of business, we are subject to proceedings, lawsuits, and other claims and assessments for matters related to, among other things, patent infringement, business acquisitions, employment, commercial matters and product recalls. We assess the likelihood of any adverse judgments or outcomes to these matters as well as potential ranges of probable losses. A determination of the amount of reserves required, if any, for these contingencies is made after careful analysis of each individual issue. The required reserves may December 31, 2018, 2017 2016, not
Income Tax, Policy [Policy Text Block]	Income Taxes We account for income taxes under the asset and liability method of accounting for income taxes. Under the asset and liability method, deferred taxes are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. The provision for income taxes includes taxes currently payable and deferred taxes resulting from the tax effects of temporary differences between the financial statement and tax bases of assets and liabilities. We maintain valuation allowances where it is more likely than not not We recognize, measure, present and disclose in our financial statements, uncertain tax positions that we have taken or expect to take on a tax return. We recognize in our financial statements the impact of tax positions that meet a “more likely than not” fifty Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense.
Comprehensive Income, Policy [Policy Text Block]	Comprehensive Income Comprehensive income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than reported net income, comprehensive income includes foreign currency translation adjustments, which are disclosed in the accompanying consolidated statements of comprehensive income. There were no December 31, 2018, 2017 2016. Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $3.9 $2.3 December 31, 2018 2017,
Costs Associated with Exit or Disposal Activities or Restructurings, Policy [Policy Text Block]	Restructuring We record restructuring charges incurred in connection with consolidation or relocation of operations, exited business lines, reductions in force, or distributor terminations. These restructuring charges, which reflect our commitment to a termination or exit plan that will begin within twelve
Earnings Per Share, Policy [Policy Text Block]	Earnings per Share We compute basic earnings per share by dividing net income available for common stockholders by the weighted average number of shares outstanding during the year. Except where the result would be anti-dilutive to net income per share, diluted earnings per share has been computed using the treasury stock method and reflects the potential vesting of restricted common stock and the potential exercise of stock options, as well as their related income tax effects. The computation of basic and diluted net income per share is as follows: Year ended December 31, 2018 2017 2016 (in thousands, except per share data) Basic: Net income available for common stockholders $ 22,943 $ 17,177 $ 10,590 Weighted average shares outstanding 19,426 18,961 18,485 Basic earnings per share $ 1.18 $ 0.91 $ 0.57 Diluted: Net income available for common stockholders $ 22,943 $ 17,177 $ 10,590 Weighted-average shares outstanding 19,426 18,961 18,485 Common stock equivalents, if dilutive 816 1,072 756 Shares used in computing diluted earnings per common share 20,242 20,033 19,241 Diluted earnings per share $ 1.13 $ 0.86 $ 0.55 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 230 6 45
New Accounting Pronouncements, Policy [Policy Text Block]	Recent Accounting Pronouncements In August 2018, 2018 15, Intangibles—Goodwill and Other—Internal-Use Software (Subtopic 350 40 January 1, 2020, not In August 2018, 2018 13 820 January 1, 2020, not In February 2018, 2018 02, Income Statement – Reporting Other Comprehensive Income (Topic 220 not January 1, 2019, not In January 2017, 2017 04, 2” not January 1, 2020, not In February 2016, No. 2016 02, Leases (Topic 842 2018 11, Leases (Topic 842 no December 15, 2018, January 1, 2019, not not may not not $6.1 $6.7 $6.6 $7.2

Note 1 - Significant Accounti_2

Note 1 - Significant Accounting Policies and Related Matters (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Disaggregation of Revenue [Table Text Block]	Year ended December 31, 2018 2017 Americas $ 63,649 $ 62,696 Europe, Middle East and Africa 35,319 32,517 Asia/Pacific Rim 6,600 5,654 Total $ 105,568 $ 100,867
Schedule of Advertising Expenses [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Advertising expense $ 299 $ 305 $ 378
Allowance for Credit Losses on Financing Receivables [Table Text Block]	Balance at Additions Deductions Balance at Beginning (recoveries) charged from End of of Period to Income Reserves Period (in thousands) Allowance for doubtful accounts and sales returns: Year ended December 31, 2018 $ 349 $ 264 $ 214 $ 399 Year ended December 31, 2017 258 230 139 349 Year ended December 31, 2016 243 105 90 258
Schedule of Property, Plant and Equipment Estimated Useful Lives [Table Text Block]	Description Useful Life (in years) Computers and equipment 3 – 5 Machinery and equipment 3 – 10 Leasehold improvements The shorter of its useful life or lease term
Schedule of Earnings Per Share, Basic and Diluted [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands, except per share data) Basic: Net income available for common stockholders $ 22,943 $ 17,177 $ 10,590 Weighted average shares outstanding 19,426 18,961 18,485 Basic earnings per share $ 1.18 $ 0.91 $ 0.57 Diluted: Net income available for common stockholders $ 22,943 $ 17,177 $ 10,590 Weighted-average shares outstanding 19,426 18,961 18,485 Common stock equivalents, if dilutive 816 1,072 756 Shares used in computing diluted earnings per common share 20,242 20,033 19,241 Diluted earnings per share $ 1.13 $ 0.86 $ 0.55 Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive 230 6 45

Note 2 - Acquisitions and Div_2

Note 2 - Acquisitions and Divestitures (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed [Table Text Block]	Allocated Fair Value (in thousands) Inventory € 2,419 Land and building 750 Equipment and supplies 94 Intangible assets 623 Bargain purchase gain (1,946 ) Purchase price € 1,940 Allocated Fair Value (in thousands) Inventory $ 739 Equipment and supplies 416 Intangible assets 6,527 Goodwill 6,361 Purchase price $ 14,043 Allocated (in thousands) Accounts receivable $ 394 Deferred cryopreservation costs 2,583 Equipment and supplies 125 Accounts payable (286 ) Intangible assets 4,544 Goodwill 5,599 Purchase price $ 12,959 Allocated Fair Value (in thousands) Inventory $ 2,080 Manufacturing equipment and supplies 25 Intangible assets 620 Goodwill 318 Purchase price $ 3,043
Schedule of Finite-Lived Intangible Assets Acquired as Part of Business Combination [Table Text Block]	Allocated Fair Value Weighted Average Useful Life (in thousands) (in years) Customer relationships € 250 16.0 Intellectual property 237 5.0 Non-compete agreement 46 5.0 Tradenames 90 5.0 Total intangible assets € 623 Allocated Fair Value Weighted Average Useful Life (in thousands) (in years) Customer relationships $ 4,475 16.0 Intellectual property 1,316 7.0 Non-compete agreement 530 5.0 Tradenames 206 7.0 Total intangible assets $ 6,527 Allocated Weighted (in thousands) (in years) Non-compete agreements $ 180 5.0 Tradename 271 9.0 Procurement contracts 617 9.0 Technology 2,793 10.5 Customer relationships 683 12.5 Total intangible assets $ 4,544 Allocated Fair Value Weighted Average Useful Life (in thousands) (in years) Non-compete agreement $ 84 5.0 Tradename 109 9.5 Technology 277 9.0 Customer relationships 150 9.0 Total intangible assets $ 620
Disposal Groups, Including Discontinued Operations [Table Text Block]	Allocated Fair Value (in thousands) Inventory $ 308 Deferred revenue - transition services agreement 1,081 Goodwill 135 Gain on divestiture 5,876 Consideration received $ 7,400

Note 3 - Inventory and Other _2

Note 3 - Inventory and Other Deferred Costs (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Inventory, Current [Table Text Block]	December 31, 2018 December 31, 2017 (in thousands) Raw materials $ 4,085 $ 3,200 Work-in-process 5,095 3,745 Finished products 16,391 12,278 Other deferred costs 1,817 1,823 Total inventory and other deferred costs $ 27,388 $ 21,046

Note 4 - Property and Equipme_2

Note 4 - Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Property, Plant and Equipment [Table Text Block]	As of December 31, 2018 2017 (in thousands) Computers and equipment $ 4,077 $ 3,204 Machinery and equipment 13,718 12,223 Building and leasehold improvements 11,651 10,843 Gross property and equipment 29,446 26,270 Less accumulated depreciation (15,344 ) (13,892 ) Property and equipment, net $ 14,102 $ 12,378
Depreciation Expense [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Depreciation expense $ 2,564 $ 2,266 $ 1,986

Note 5 - Goodwill and Other I_2

Note 5 - Goodwill and Other Intangibles (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Goodwill [Table Text Block]	As of December 31, 2018 2017 Balance at beginning of year $ 23,844 $ 23,426 Additions for acquisitions 6,361 - Purchase accounting adjustments - 257 Divestiture adjustment (135 ) Effects of currency exchange (202 ) 161 Balance at end of year $ 29,868 $ 23,844
Schedule of Finite-Lived Intangible Assets [Table Text Block]	December 31, 2018 December 31, 2017 Gross Net Gross Net Carrying Accumulated Carrying Carrying Accumulated Carrying Value Amortization Value Value Amortization Value (in thousands) Product technology and intellectual property $ 11,728 $ 5,726 $ 6,002 $ 10,267 $ 4,908 $ 5,359 Trademarks, tradenames and licenses 2,246 1,561 685 1,948 1,468 480 Customer relationships 10,065 3,806 6,259 5,383 3,299 2,084 Other intangible assets 2,145 1,399 746 1,575 1,264 311 Total identifiable intangible assets $ 26,184 $ 12,492 $ 13,692 $ 19,173 $ 10,939 $ 8,234
Finite-lived Intangible Assets Amortization Expense [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Amortization expense $ 1,760 $ 1,790 $ 1,605
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense [Table Text Block]	Year ended December 31, 2019 2020 2021 2022 2023 (in thousands) Amortization expense $ 2,088 $ 1,839 $ 1,624 $ 1,420 $ 1,347

Note 6 - Accrued Expenses and_2

Note 6 - Accrued Expenses and Other Long-term Liabilities (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Accrued Liabilities [Table Text Block]	December 31, 2018 December 31, 2017 (in thousands) Compensation and related taxes $ 7,973 $ 6,494 Income and other taxes 2,927 703 Professional fees 43 35 Deferred revenue 552 - Other 4,352 2,538 Total $ 15,847 $ 9,770
Contract with Customer, Asset and Liability [Table Text Block]	December 31, 2018 (in thousands) Beginning contract liability balance $ - Deferred revenue recorded 1,081 Revenue recognized upon satisfaction of performance obligations in the period (529 ) Ending balance $ 552
Other Noncurrent Liabilities [Table Text Block]	December 31, 2018 December 31, 2017 (in thousands) Acquisition-related liabilities $ 1,326 $ 127 Deferred rent 530 561 Income taxes 559 321 Other 196 179 Total $ 2,611 $ 1,188

Note 7 - Commitments and Cont_2

Note 7 - Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Rent Expense [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Rent expense $ 2,090 $ 2,190 $ 1,580
Contractual Obligation, Fiscal Year Maturity Schedule [Table Text Block]	Less than 1-3 3-5 More than Contractual obligations Total 1 year years years 5 years (in thousands) Operating leases $ 7,435 $ 1,826 $ 3,053 $ 2,556 $ - Inventory purchase commitments $ 2,195 $ 2,072 $ 123 $ - $ -

Note 8 - Income Taxes (Tables)

Note 8 - Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Income before Income Tax, Domestic and Foreign [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) United States $ 22,256 $ 17,778 $ 12,600 Foreign 6,188 3,328 3,642 Total $ 28,444 $ 21,106 $ 16,242
Schedule of Components of Income Tax Expense (Benefit) [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Current: Federal $ 4,262 $ 2,451 $ 4,409 State 673 292 393 Foreign 2,718 886 710 7,653 3,629 5,512 Deferred: Federal (1,512 ) (268 ) 197 State (145 ) 390 166 Foreign (495 ) 178 (223 ) (2,152 ) 300 140 Provision for income taxes $ 5,501 $ 3,929 $ 5,652
Schedule of Unrecognized Tax Benefits Roll Forward [Table Text Block]	2018 2017 2016 (in thousands) Unrecognized tax benefits at the beginning of year $ 525 $ 390 $ 82 Additions for tax positions of current year 73 83 95 Additions for tax positions of prior years 113 57 213 Reductions for settlements with taxing authorities. - - - Reductions for lapses of the applicable statutes of limitations - (5 ) - Unrecognized tax benefits at the end of the year $ 711 $ 525 $ 390
Schedule of Deferred Tax Assets and Liabilities [Table Text Block]	As of December 31, 2018 2017 (in thousands) Deferred tax assets: Inventory $ 976 $ 569 Net operating loss carryforwards 1,421 1,898 Tax credit carryforwards 828 760 Capital loss carryforwards 279 1,168 Reserves and accruals 802 629 Intangible assets 2,737 1,138 Stock options 373 322 Other 91 65 Total deferred tax assets 7,507 6,549 Deferred tax liabilities: Property and equipment (1,416 ) (1,203 ) Goodwill (3,023 ) (2,932 ) Foreign branch deferred offset (1,032 ) (1,177 ) Other (50 ) (44 ) Total deferred tax liabilities (5,521 ) (5,356 ) Net deferred tax assets before valuation allowance 1,986 1,193 Valuation allowance (1,255 ) (1,991 ) Net deferred tax liabiltity $ 731 $ (798 ) Deferred tax classification Long-term deferred tax asset $ 1,215 $ 1,378 Long-term deferred tax liability (484 ) (2,176 ) Net long-term deferred tax liability $ 731 $ (798 )
Schedule of Effective Income Tax Rate Reconciliation [Table Text Block]	2018 2017 2016 Federal statutory rate 21.0 % 35.0 % 35.0 % State tax, net of federal benefit 1.4 % 1.7 % 1.3 % Effect of foreign taxes 3.8 % (0.6% ) (1.9% ) Federal tax on foreign income 1.4 % 1.7 % 1.6 % Valuation allowance (3.2% ) 0.1 % (2.6% ) Foreign deferred tax liability offset (0.3% ) (0.2% ) 1.5 % Manufacturing deduction 0.0 % (1.5% ) (2.5% ) Research & development tax credits (0.7% ) (0.6% ) (0.7% ) Stock options (3.3% ) (15.8% ) (0.7% ) Uncertain tax positions 0.8 % 0.6 % 2.0 % Other permanent differences (0.7% ) 1.0 % 1.2 % Change in tax laws 0.0 % 2.9 % 0.0 % Deferred tax remeasurement 0.0 % (5.0% ) 0.0 % Other (0.9% ) (0.7% ) 0.5 % Effective tax rate 19.3 % 18.6 % 34.8 %
Summary of Income Tax Examinations [Table Text Block]	United States 2015 and forward Foreign 2011 and forward

Note 9 - Stockholders' Equity (

Note 9 - Stockholders' Equity (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Share-based Payment Award, Stock Options, Valuation Assumptions [Table Text Block]	2018 2017 2016 Dividend yield 1.2 % 0.7 % 1.3 % Volatility 41.3 % 39.1 % 34.5 % Risk-free interest rate 2.7 % 2.2 % 1.2 % Weighted average expected option term (in years) 4.8 4.6 5.5 Weighted average fair value per share of options granted $ 8.28 $ 10.37 $ 4.04
Share-based Compensation, Stock Options, Activity [Table Text Block]	Weighted Weighted Average Aggregate Number Average Remaining Intrinsic of Shares Exercise Price Contractual Term Value (in years) Balance outstanding at December 31, 2017 (1) 1,536,282 $ 13.86 4.15 $ 27,771,635 Granted 280,423 $ 23.56 Exercised (2) (303,379 ) $ 9.79 $ 7,196,175 Canceled / Expired (50,751 ) $ 13.79 Balance outstanding at December 31, 2018 (3) 1,462,575 $ 16.41 4.54 $ 12,214,422 Vested and exercisable at December 31, 2018 (4) 504,988 $ 11.51 2.65 $ 6,482,151 Expected to vest at December 31, 2018 957,587 $ 18.99 5.54 Total 1,462,575
Schedule of Share-based Compensation, Restricted Stock Units Award Activity [Table Text Block]	Weighted Average Grant Date Shares Fair Value Balance outstanding at December 31, 2017 216,750 $ 18.10 Granted 87,088 $ 23.65 Vested (1) (63,478 ) $ 15.11 Canceled (22,465 ) $ 17.75 Balance outstanding at December 31, 2018 217,895 $ 21.21
Accelerated Share Repurchases [Table Text Block]	2018 2017 Shares of common stock repurchased 21,410 27,291 Average per share repurchase price $ 34.62 $ 28.51 Aggregage purchase price (in thousands) $ 741 $ 778
Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Table Text Block]	2018 2017 2016 (in thousands) Stock option awards $ 1,457 $ 1,612 $ 1,116 Restricted stock units 892 644 564 Total stock-based compensation $ 2,349 $ 2,256 $ 1,680 2018 2017 2016 (in thousands) Cost of sales $ 272 $ 188 $ 175 Sales and marketing 529 403 373 General and administrative 1,293 1,484 983 Research and development 255 181 149 Total stock-based compensation $ 2,349 $ 2,256 $ 1,680
Schedule of Dividends Payable [Table Text Block]	Record Date Payment Date Per Share Amount Dividend Payment (in thousands) Fiscal Year 2018 March 22, 2018 April 5, 2018 $ 0.070 $ 1,351 May 22, 2018 June 7, 2018 $ 0.070 $ 1,353 August 22, 2018 September 6, 2018 $ 0.070 $ 1,369 November 20, 2018 December 6, 2018 $ 0.070 $ 1,372 Fiscal Year 2017 March 22, 2017 April 6, 2017 $ 0.055 $ 1,029 May 24, 2017 June 8, 2017 $ 0.055 $ 1,036 August 23, 2017 September 6, 2017 $ 0.055 $ 1,055 November 22, 2017 December 7, 2017 $ 0.055 $ 1,060

Note 11 - Segment and Enterpr_2

Note 11 - Segment and Enterprise-wide Disclosures (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Revenue from External Customers Attributed to Foreign Countries by Geographic Area [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) United States $ 59,078 $ 58,470 $ 50,439 Germany 12,445 11,576 10,350 Other countries 34,045 30,821 28,362 Net sales $ 105,568 $ 100,867 $ 89,151
Schedule of Revenue from External Customers and Long-Lived Assets, by Geographical Areas [Table Text Block]	As of December 31, 2018 2017 (in thousands) United States $ 11,006 $ 10,275 Australia 1,460 1,639 France 1,071 - Germany 430 369 Other countries 135 95 Total property and equipment $ 14,102 $ 12,378

Note 12 - Supplemental Cash F_2

Note 12 - Supplemental Cash Flow Information (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Cash Flow, Supplemental Disclosures [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Cash paid for income taxes, net $ 5,521 $ 3,146 $ 4,231

Note 13 - Fair Value Measurem_2

Note 13 - Fair Value Measurements (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Beginning balance $ 1,300 $ 1,320 $ - Additions - - 1,301 Payments (1,199 ) (126 ) (68 ) Change in fair value included in earnings (29 ) 106 87 Ending balance $ 72 $ 1,300 $ 1,320

Note 14 - Quarterly Financial_2

Note 14 - Quarterly Financial Data (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Quarterly Financial Information [Table Text Block]	Three months ended 2018 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 25,994 $ 27,020 $ 24,165 $ 28,389 Gross profit 18,474 18,992 17,255 19,218 Income (loss) from operations 4,862 11,541 4,613 7,193 Net income 3,853 8,751 4,314 6,025 Earnings per share Basic $ 0.20 $ 0.45 $ 0.22 $ 0.31 Diluted $ 0.19 $ 0.43 $ 0.21 $ 0.30 Three months ended 2017 March 31 June 30 September 30 December 31 (in thousands, except per share data) Total net sales $ 24,139 $ 25,753 $ 24,822 $ 26,153 Gross profit 17,353 17,516 17,577 18,251 Income (loss) from operations 4,193 5,536 5,053 6,321 Net income (loss) 3,219 4,632 5,042 4,284 Earnings per share Basic $ 0.17 $ 0.25 $ 0.26 $ 0.22 Diluted $ 0.16 $ 0.23 $ 0.25 $ 0.21

Note 15 - Accumulated Other C_2

Note 15 - Accumulated Other Comprehensive Income (Loss) (Tables)	12 Months Ended
	Dec. 31, 2018
Notes Tables
Schedule of Accumulated Other Comprehensive Income (Loss) [Table Text Block]	Year ended December 31, 2018 2017 2016 (in thousands) Beginning balance $ (2,289 ) $ (4,583 ) $ (4,049 ) $ - Other comprehensive income (loss) before reclassifications (1,611 ) 2,294 (534 ) Amounts reclassified from accumulated other comprehensive loss - - - Ending Balance $ (3,900 ) $ (2,289 ) $ (4,583 )

Note 1 - Significant Accounti_3

Note 1 - Significant Accounting Policies and Related Matters (Details Textual) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)	Dec. 31, 2017USD ($)	Dec. 31, 2016USD ($)	Jan. 01, 2019USD ($)
Accounts Receivable, Net, Current, Total	$ 15,721	$ 15,000
Goodwill, Impairment Loss	0	0	$ 0
Reclassification from Accumulated Other Comprehensive Income, Current Period, Net of Tax	0	0	$ 0
Accumulated Other Comprehensive Income (Loss), Foreign Currency Translation Adjustment, Net of Tax, Ending Balance	$ 3,900	$ 2,300
Number of Operating Segments	1
ITALY
Accounts Receivable, Net, Current, Total	$ 1,000
SPAIN
Accounts Receivable, Net, Current, Total	700
Geographic Distribution, Foreign [Member]
Cash, Ending Balance	$ 18,800
Minimum [Member]
Period of Payments Received from Customers	30 days
Finite-Lived Intangible Asset, Useful Life	2 years
Minimum [Member] | Accounting Standards Update 2016-02 [Member] | Scenario, Forecast [Member]
Operating Lease, Right-of-Use Asset				$ 6,100
Operating Lease, Liability, Total				6,600
Maximum [Member]
Period of Payments Received from Customers	60 days
Finite-Lived Intangible Asset, Useful Life	16 years
Maximum [Member] | Accounting Standards Update 2016-02 [Member] | Scenario, Forecast [Member]
Operating Lease, Right-of-Use Asset				6,700
Operating Lease, Liability, Total				$ 7,200

Note 1 - Significant Accounti_4

Note 1 - Significant Accounting Policies and Related Matters - Disaggregation of Revenue by Major Geographic Area (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Revenue	$ 105,568	$ 100,867
Americas [Member]
Revenue	63,649	62,696
EMEA [Member]
Revenue	35,319	32,517
Asia Pacific [Member]
Revenue	$ 6,600	$ 5,654

Note 1 - Significant Accounti_5

Note 1 - Significant Accounting Policies and Related Matters - Summary of Advertising Costs (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Advertising expense	$ 299	$ 305	$ 378

Note 1 - Significant Accounti_6

Note 1 - Significant Accounting Policies and Related Matters - Allowance for Doubtful Accounts and Sales Returns (Details) - Allowance for Doubtful Accounts and Sales Returns [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Balance	$ 349	$ 258	$ 243
Additions (recoveries) charged to income	264	230	105
Deductions from reserves	214	139	90
Balance	$ 399	$ 349	$ 258

Note 1 - Significant Accounti_7

Note 1 - Significant Accounting Policies and Related Matters - Summary of Property and Equipment (Details)	12 Months Ended
	Dec. 31, 2018
Computers and Equipment [Member] | Minimum [Member]
Useful life (Year)	3 years
Computers and Equipment [Member] | Maximum [Member]
Useful life (Year)	5 years
Machinery and Equipment [Member] | Minimum [Member]
Useful life (Year)	3 years
Machinery and Equipment [Member] | Maximum [Member]
Useful life (Year)	10 years
Leasehold Improvements [Member]
Estimated useful life	The shorter of its useful life or lease term

Note 1 - Significant Accounti_8

Note 1 - Significant Accounting Policies and Related Matters - Computation of Basic and Diluted Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Basic:
Net income available for common stockholders	$ 6,025	$ 4,314	$ 8,751	$ 3,853	$ 4,284	$ 5,042	$ 4,632	$ 3,219	$ 22,943	$ 17,177	$ 10,590
Weighted average shares outstanding (in shares)									19,426	18,961	18,485
Basic earnings per share (in dollars per share)	$ 0.31	$ 0.22	$ 0.45	$ 0.20	$ 0.22	$ 0.26	$ 0.25	$ 0.17	$ 1.18	$ 0.91	$ 0.57
Diluted:
Net income available for common stockholders	$ 6,025	$ 4,314	$ 8,751	$ 3,853	$ 4,284	$ 5,042	$ 4,632	$ 3,219	$ 22,943	$ 17,177	$ 10,590
Weighted average shares outstanding (in shares)									19,426	18,961	18,485
Common stock equivalents, if dilutive (in shares)									816	1,072	756
Shares used in computing diluted earnings per common share (in shares)									20,242	20,033	19,241
Diluted earnings per share (in dollars per share)	$ 0.30	$ 0.21	$ 0.43	$ 0.19	$ 0.21	$ 0.25	$ 0.23	$ 0.16	$ 1.13	$ 0.86	$ 0.55
Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive (in shares)									230	6	45

Note 2 - Acquisitions and Div_3

Note 2 - Acquisitions and Divestitures (Details Textual) $ in Thousands, € in Millions

Oct. 22, 2018USD ($)

Oct. 22, 2018EUR (€)

Sep. 20, 2018USD ($)

Apr. 05, 2018USD ($)

Nov. 10, 2016USD ($)

Mar. 18, 2016USD ($)

Dec. 31, 2018USD ($)

Dec. 31, 2018USD ($)

Dec. 31, 2018USD ($)

Sep. 30, 2018USD ($)

Jun. 30, 2018USD ($)

Mar. 31, 2018USD ($)

Dec. 31, 2017USD ($)

Sep. 30, 2017USD ($)

Jun. 30, 2017USD ($)

Mar. 31, 2017USD ($)

Dec. 31, 2018USD ($)

Dec. 31, 2017USD ($)

Dec. 31, 2016USD ($)

Oct. 22, 2018EUR (€)

May 31, 2018USD ($)

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life

9 years 182 days

Revenue from Contract with Customer, Including Assessed Tax

$ 28,389

$ 24,165

$ 27,020

$ 25,994

$ 26,153

$ 24,822

$ 25,753

$ 24,139

$ 105,568

$ 100,867

$ 89,151

Reddick Divestiture [Member]

Proceeds from Sale of Productive Assets, Total

$ 7,400

Long-term Purchase Commitment, Period

2 years

Gain (Loss) on Disposition of Assets for Financial Service Operations, Total

$ 5,900

UNITED STATES

Revenue from Contract with Customer, Including Assessed Tax

$ 59,078

$ 58,470

$ 50,439

Cardial [Member]

Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual

$ 1,100

Business Combination, Consideration Transferred, Total

$ 2,300

€ 2

Payments to Acquire Businesses, Gross

1,300

1.1

Business Combination, Consideration Transferred, Liabilities Incurred

500

0.5

Business Combination, Deferred Purchase Consideration

400

€ 0.4

Deferred Tax Assets, Business Combinations

600

€ 0.5

Business Combination, Bargain Purchase, Gain Recognized, Amount

$ 1,600

€ 1.4

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life

9 years 146 days

9 years 146 days

Applied Medical [Member]

Business Combination, Pro Forma Information, Revenue of Acquiree since Acquisition Date, Actual

$ 800

Business Combination, Consideration Transferred, Total

$ 14,200

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life

13 years

Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed Current Assets Deferred Costs

$ 3,200

Acquisition Date Fair Value

$ 3,043

Business Combination ,Fair Value Inputs, Discount Rate

3.75%

Business Acquisition, Purchase Price Allocation, Goodwill Expected Tax Deductible, Period

15 years

Applied Medical [Member] | Closing Date [Member]

Business Combination, Consideration Transferred, Total

$ 11,000

Applied Medical [Member] | 12 Months Following the Closing Date [Member]

Business Combination, Consideration Transferred, Total

2,000

Applied Medical [Member] | 24 Months Following the Closing Date [Member]

Business Combination, Consideration Transferred, Total

$ 1,200

Applied Medical [Member] | UNITED STATES

Percentage of Sales by Major Product Lines

60.00%

Applied Medical [Member] | Foreign [Member]

Percentage of Sales by Major Product Lines

40.00%

Balloon Supply Agreement [Member] | Reddick Divestiture [Member]

Long-term Purchase Commitment, Period

6 years

Restore Flow Allografts [Member]

Business Combination, Consideration Transferred, Total

$ 12,000

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life

10 years 109 days

Business Combination Recognized Identifiable Assets Acquired and Liabilities Assumed Current Assets Deferred Costs

$ 2,583

Business Acquisition, Purchase Price Allocation, Goodwill Expected Tax Deductible, Period

15 years

Business Combination, Contingent Consideration, Liability, Total

$ 900

$ 2,000

Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, High

$ 6,000

Estimated Weighted Average Cost of Capital

14.10%

Restore Flow Allografts [Member] | Non-employee Investors [Member]

Acquisition Date Fair Value

$ 900

Business Combination, Contingent Consideration, Liability, Total

1,100

Restore Flow Allografts [Member] | Contingency One [Member]

Business Combination, Contingent Consideration, Liability, Total

2,000

Restore Flow Allografts [Member] | Earn-outs Payment One [Member] | Minimum [Member]

Revenue from Contract with Customer, Including Assessed Tax

6,000

Restore Flow Allografts [Member] | Earn-outs Payment Two [Member] | Minimum [Member]

Revenue from Contract with Customer, Including Assessed Tax

9,000

Restore Flow Allografts [Member] | Earn-outs Payment Two [Member] | Maximum [Member]

Business Combination, Contingent Consideration, Liability, Total

2,000

Restore Flow Allografts [Member] | Combined Earn-out Payment [Member]

Acquisition Date Fair Value

$ 100

ProCol Biologic Graft [Member]

Business Combination, Consideration Transferred, Total

$ 2,700

Acquired Finite-lived Intangible Assets, Weighted Average Useful Life

8 years 219 days

Business Acquisition, Purchase Price Allocation, Goodwill Expected Tax Deductible, Period

15 years

Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Current Assets, Other

$ 2,000

Business Combination, Recognized Identifiable Assets Acquired and Liabilities Assumed, Other Noncurrent Assets

$ 700

Percentage of Payment Made for Assets Acquired

50.00%

Business Combination Contingent Consideration Measurement as Percentage of Revenue

10.00%

Business Combination, Provisional Information, Initial Accounting Incomplete, Adjustment, Consideration Transferred

$ 300

Note 2 - Acquisitions and Div_4

Note 2 - Acquisitions and Divestitures - Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Oct. 22, 2018	Sep. 20, 2018	Dec. 31, 2017	Dec. 31, 2016	Nov. 10, 2016	Mar. 18, 2016
Intangible assets						$ 4,544
Goodwill	$ 29,868			$ 23,844	$ 23,426
Restore Flow Allografts [Member]
Equipment and supplies						125
Intangible assets						4,544
Purchase price						12,959
Goodwill						5,599
Accounts receivable						394
Deferred cryopreservation costs						2,583
Accounts payable						$ (286)
Cardial [Member]
Inventory		$ 2,419
Land and building		750
Equipment and supplies		94
Intangible assets		623
Bargain purchase gain		(1,946)
Purchase price		$ 1,940
Applied Medical [Member]
Inventory			$ 739
Equipment and supplies			416
Intangible assets			6,527
Purchase price			14,043
Goodwill			6,361
Deferred cryopreservation costs			$ 3,200
ProCol Biologic Graft [Member]
Inventory							$ 2,080
Equipment and supplies							25
Intangible assets							620
Purchase price							3,043
Goodwill							$ 318

Note 2 - Acquisitions and Div_5

Note 2 - Acquisitions and Divestitures - Acquired Intangible Assets and Related Estimated Useful Lives (Details) - USD ($) $ in Thousands	Oct. 22, 2018	Sep. 20, 2018	Nov. 10, 2016	Mar. 18, 2016	Dec. 31, 2018
Allocated fair value			$ 4,544
Weighted average useful life (Year)					9 years 182 days
Cardial [Member]
Allocated fair value	$ 623
Weighted average useful life (Year)	9 years 146 days
Applied Medical [Member]
Allocated fair value		$ 6,527
Weighted average useful life (Year)		13 years
ProCol Biologic Graft [Member]
Allocated fair value				$ 620
Weighted average useful life (Year)				8 years 219 days
Noncompete Agreements [Member]
Allocated fair value			$ 180
Weighted average useful life (Year)			5 years
Noncompete Agreements [Member] | Cardial [Member]
Allocated fair value	$ 46
Weighted average useful life (Year)	5 years
Noncompete Agreements [Member] | Applied Medical [Member]
Allocated fair value		$ 530
Weighted average useful life (Year)		5 years
Noncompete Agreements [Member] | ProCol Biologic Graft [Member]
Allocated fair value				$ 84
Weighted average useful life (Year)				109 years
Trade Names [Member]
Allocated fair value			$ 271
Weighted average useful life (Year)			9 years
Trade Names [Member] | Cardial [Member]
Allocated fair value	$ 90
Weighted average useful life (Year)	5 years
Trade Names [Member] | Applied Medical [Member]
Allocated fair value		$ 206
Weighted average useful life (Year)		7 years
Customer Relationships [Member]
Allocated fair value			$ 683
Weighted average useful life (Year)			12 years 182 days
Customer Relationships [Member] | Cardial [Member]
Allocated fair value	$ 250
Weighted average useful life (Year)	16 years
Customer Relationships [Member] | Applied Medical [Member]
Allocated fair value		$ 4,475
Weighted average useful life (Year)		1316 years
Customer Relationships [Member] | ProCol Biologic Graft [Member]
Allocated fair value				$ 150
Weighted average useful life (Year)				9 years
Procurement Contracts [Member]
Allocated fair value			$ 617
Weighted average useful life (Year)			9 years
Technology [Member]
Allocated fair value			$ 2,793
Weighted average useful life (Year)			10 years 182 days
Technology [Member] | ProCol Biologic Graft [Member]
Allocated fair value				$ 277
Weighted average useful life (Year)				9 years
Intellectual Property [Member] | Cardial [Member]
Allocated fair value	$ 237
Weighted average useful life (Year)	5 years

Note 2 - Acquisitions and Div_6

Note 2 - Acquisitions and Divestitures - Asset Purchase Agreement (Details) - Reddick Divestiture [Member] $ in Thousands	Apr. 05, 2018USD ($)
Inventory	$ 308
Deferred revenue - transition services agreement	1,081
Goodwill	135
Gain on divestiture	5,876
Consideration received	$ 7,400

Note 3 - Inventory and Other _3

Note 3 - Inventory and Other Deferred Costs (Details Textual) - USD ($) $ in Millions	Dec. 31, 2018	Dec. 31, 2017
Other Inventory, Materials, Supplies and Merchandise under Consignment, Gross	$ 1.7	$ 1.4

Note 3 - Inventory and Other _4

Note 3 - Inventory and Other Deferred Costs - Summary of Inventories and Other Deferred Costs (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Raw materials	$ 4,085	$ 3,200
Work-in-process	5,095	3,745
Finished products	16,391	12,278
Other deferred costs	1,817	1,823
Total inventory and other deferred costs	$ 27,388	$ 21,046

Note 4 - Property and Equipme_3

Note 4 - Property and Equipment (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Impairment of Long-Lived Assets Held-for-use	$ 1	$ 0.2	$ 0.1

Note 4 - Property and Equipme_4

Note 4 - Property and Equipment - Summary of Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Gross property and equipment	$ 29,446	$ 26,270
Less accumulated depreciation	(15,344)	(13,892)
Property and equipment, net	14,102	12,378
Computers and Equipment [Member]
Gross property and equipment	4,077	3,204
Machinery and Equipment [Member]
Gross property and equipment	13,718	12,223
Building and Leasehold Improvements [Member]
Gross property and equipment	$ 11,651	$ 10,843

Note 4 - Property and Equipme_5

Note 4 - Property and Equipment - Depreciation Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Depreciation expense	$ 2,564	$ 2,266	$ 1,986

Note 5 - Goodwill and Other I_3

Note 5 - Goodwill and Other Intangibles (Details Textual)	12 Months Ended
	Dec. 31, 2018
Acquired Finite-lived Intangible Assets, Weighted Average Useful Life	9 years 182 days
Minimum [Member]
Finite-Lived Intangible Asset, Useful Life	2 years
Maximum [Member]
Finite-Lived Intangible Asset, Useful Life	16 years

Note 5 - Goodwill and Other I_4

Note 5 - Goodwill and Other Intangibles - Schedule of Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Balance at beginning of year	$ 23,844	$ 23,426
Additions for acquisitions	6,361
Purchase accounting adjustments		257
Divestiture adjustment	(135)
Effects of currency exchange	(202)	161
Balance at end of year	$ 29,868	$ 23,844

Note 5 - Goodwill and Other I_5

Note 5 - Goodwill and Other Intangibles - Components of Identifiable Intangible Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Gross carrying value	$ 26,184	$ 19,173
Accumulated amortization	12,492	10,939
Net carrying value	13,692	8,234
Product Technology and Intellectual Property [Member]
Gross carrying value	11,728	10,267
Accumulated amortization	5,726	4,908
Net carrying value	6,002	5,359
Trademarks, Tradenames and Licenses [Member]
Gross carrying value	2,246	1,948
Accumulated amortization	1,561	1,468
Net carrying value	685	480
Customer Relationships [Member]
Gross carrying value	10,065	5,383
Accumulated amortization	3,806	3,299
Net carrying value	6,259	2,084
Other Intangible Assets [Member]
Gross carrying value	2,145	1,575
Accumulated amortization	1,399	1,264
Net carrying value	$ 746	$ 311

Note 5 - Goodwill and Other I_6

Note 5 - Goodwill and Other Intangibles - Amortization Expense Included in General and Administrative Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Amortization expense	$ 1,760	$ 1,790	$ 1,605

Note 5 - Goodwill and Other I_7

Note 5 - Goodwill and Other Intangibles - Estimated Amortization Expense for Each of Five Succeeding Fiscal Years (Details) $ in Thousands	Dec. 31, 2018USD ($)
2019	$ 2,088
2020	1,839
2021	1,624
2022	1,420
2023	$ 1,347

Note 6 - Accrued Expenses and_3

Note 6 - Accrued Expenses and Other Long-term Liabilities - Accrued Expenses (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Compensation and related taxes	$ 7,973	$ 6,494
Income and other taxes	2,927	703
Professional fees	43	35
Deferred revenue	552
Other	4,352	2,538
Total	$ 15,847	$ 9,770

Note 6 - Accrued Expenses and_4

Note 6 - Accrued Expenses and Other Long-term Liabilities - Deferred Revenue (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Beginning contract liability balance
Deferred revenue recorded	1,081
Revenue recognized upon satisfaction of performance obligations in the period	(529)
Ending balance	$ 552

Note 6 - Accrued Expenses and_5

Note 6 - Accrued Expenses and Other Long-term Liabilities - Other Long-term Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Acquisition-related liabilities	$ 1,326	$ 127
Deferred rent	530	561
Income taxes	559	321
Other	196	179
Total	$ 2,611	$ 1,188

Note 7 - Commitments and Cont_3

Note 7 - Commitments and Contingencies (Details Textual) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Capital Leased Assets, Gross, Total	$ 0	$ 0
Recorded Unconditional Purchase Obligation, Total	$ 2,200

Note 7 - Commitments and Cont_4

Note 7 - Commitments and Contingencies - Rent Expenses (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Rent expense	$ 2,090	$ 2,190	$ 1,580

Note 7 - Commitments and Cont_5

Note 7 - Commitments and Contingencies - Minimum Rental Commitments (Details)	Dec. 31, 2018USD ($)
Operating leases, total	$ 7,435,000
Operating leases, less than 1 year	1,826,000
Operating leases, 1-3 years	3,053,000
Operating leases, 3-5 years	2,556,000
Operating leases, more than 5 years
Inventory purchase commitments, total	2,195
Inventory purchase commitments, less than 1 year	2,072
Inventory purchase commitments, 1-3 years	123
Inventory purchase commitments, 3-5 years
Inventory purchase commitments, more than 5 years

Note 8 - Income Taxes (Details

Note 8 - Income Taxes (Details Textual) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Unrecognized Tax Benefits, Ending Balance	$ 711,000	$ 525,000	$ 390,000	$ 82,000
Income Tax Expense (Benefit), Total	5,501,000	3,929,000	5,652,000
Deferred Tax Assets, Valuation Allowance, Total	1,255,000	1,991,000
Deferred Tax Assets, Operating Loss Carryforwards, Total	1,421,000	1,898,000
Deferred Tax Assets, Capital Loss Carryforwards	279,000	1,168,000
State and Local Jurisdiction [Member]
Tax Credit Carryforward, Amount	1,400,000
State and Local Jurisdiction [Member] | Internal Revenue Service (IRS) [Member]
Tax Adjustments, Settlements, and Unusual Provisions		200,000
State and Local Jurisdiction [Member] | Spain and Switzerland [Member] | Deferred Tax Assets [Member]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount			(300,000)
State and Local Jurisdiction [Member] | Massachusetts [Member] | Tax Credit Carryforwards [Member]
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount			200,000
Foreign Tax Authority [Member] | AUSTRALIA
Valuation Allowance, Deferred Tax Asset, Increase (Decrease), Amount	(700,000)
Deferred Tax Assets, Operating Loss Carryforwards, Total	1,300,000
Deferred Tax Assets, Capital Loss Carryforwards	900,000
Foreign Tax Authority [Member] | FRANCE
Deferred Tax Assets, Operating Loss Carryforwards, Total	2,700,000
Foreign Tax Authority [Member] | SPAIN
Deferred Tax Assets, Operating Loss Carryforwards, Total	900,000
Foreign Tax Authority [Member] | NORWAY
Deferred Tax Assets, Operating Loss Carryforwards, Total	100,000
Foreign Tax Authority [Member] | ITALY
Deferred Tax Assets, Operating Loss Carryforwards, Total	33,000
Foreign Tax Authority [Member] | SWEDEN
Deferred Tax Assets, Operating Loss Carryforwards, Total	4,000
Domestic Tax Authority [Member] | Internal Revenue Service (IRS) [Member]
Tax Adjustments, Settlements, and Unusual Provisions			200,000
Accounting Standards Update 2016-09 [Member]
Income Tax Expense (Benefit), Total	$ (1,100,000)	$ (3,700,000)	$ (300,000)

Note 8 - Income Taxes - Income

Note 8 - Income Taxes - Income (Loss) Before Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
United States	$ 22,256	$ 17,778	$ 12,600
Foreign	6,188	3,328	3,642
Total	$ 28,444	$ 21,106	$ 16,242

Note 8 - Income Taxes - The Pro

Note 8 - Income Taxes - The Provision (Benefit) for Income Taxes (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Current:
Federal	$ 4,262	$ 2,451	$ 4,409
State	673	292	393
Foreign	2,718	886	710
	7,653	3,629	5,512
Deferred:
Federal	(1,512)	(268)	197
State	(145)	390	166
Foreign	(495)	178	(223)
	(2,152)	300	140
Provision for income taxes	$ 5,501	$ 3,929	$ 5,652

Note 8 - Income Taxes - Reconci

Note 8 - Income Taxes - Reconciliation of Beginning and Ending Amount of Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Unrecognized tax benefits at the beginning of year	$ 525	$ 390	$ 82
Additions for tax positions of current year	73	83	95
Additions for tax positions of prior years	113	57	213
Reductions for settlements with taxing authorities.
Reductions for lapses of the applicable statutes of limitations		(5)
Unrecognized tax benefits at the end of the year	$ 711	$ 525	$ 390

Note 8 - Income Taxes - Deferre

Note 8 - Income Taxes - Deferred Taxes (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Deferred tax assets:
Inventory	$ 976	$ 569
Net operating loss carryforwards	1,421	1,898
Tax credit carryforwards	828	760
Capital loss carryforwards	279	1,168
Reserves and accruals	802	629
Intangible assets	2,737	1,138
Stock options	373	322
Other	91	65
Total deferred tax assets	7,507	6,549
Deferred tax liabilities:
Property and equipment	(1,416)	(1,203)
Goodwill	(3,023)	(2,932)
Foreign branch deferred offset	(1,032)	(1,177)
Other	(50)	(44)
Total deferred tax liabilities	(5,521)	(5,356)
Net deferred tax assets before valuation allowance	1,986	1,193
Valuation allowance	(1,255)	(1,991)
Net deferred tax asset	731
Net deferred tax liabiltity		(798)
Deferred tax classification
Long-term deferred tax asset	1,215	1,378
Long-term deferred tax liability	(484)	(2,176)
Net long-term deferred tax asset	$ 731
Net long-term deferred tax liability		$ (798)

Note 8 - Income Taxes - Recon_2

Note 8 - Income Taxes - Reconciliation of the Federal Statutory Rate to Effective Tax Rate (Details)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Federal statutory rate	21.00%	35.00%	35.00%
State tax, net of federal benefit	1.40%	1.70%	1.30%
Effect of foreign taxes	3.80%	(0.60%)	(1.90%)
Federal tax on foreign income	1.40%	1.70%	1.60%
Valuation allowance	(3.20%)	0.10%	(2.60%)
Foreign deferred tax liability offset	(0.30%)	(0.20%)	1.50%
Manufacturing deduction	0.00%	(1.50%)	(2.50%)
Research & development tax credits	(0.70%)	(0.60%)	(0.70%)
Stock options	(3.30%)	(15.80%)	(0.70%)
Uncertain tax positions	0.80%	0.60%	2.00%
Other permanent differences	(0.70%)	1.00%	1.20%
Change in tax laws	0.00%	2.90%	0.00%
Deferred tax remeasurement	0.00%	(5.00%)	0.00%
Other	(0.90%)	(0.70%)	0.50%
Effective tax rate	19.30%	18.60%	34.80%

Note 8 - Income Taxes - Summary

Note 8 - Income Taxes - Summary of Tax Years Subject to Examination in Most Significant Tax Jurisdictions (Details)	12 Months Ended
	Dec. 31, 2018
Domestic Tax Authority [Member]
Income tax year under examination	2015 2016 2017 2018
Foreign Tax Authority [Member]
Income tax year under examination	2011 2012 2013 2014 2015 2016 2017 2018

Note 9 - Stockholders' Equity_2

Note 9 - Stockholders' Equity (Details Textual) - USD ($) $ / shares in Units, $ in Thousands	Feb. 14, 2019	Dec. 31, 2018	Jul. 25, 2018	Dec. 31, 2017	Dec. 31, 2016	Jul. 25, 2017
Common Stock, Shares Authorized		37,000,000		37,000,000
Preferred Stock, Shares Authorized		3,000,000		3,000,000
Preferred Stock, Shares Outstanding, Ending Balance		0		0
Share-based Compensation Arrangement by Share-based Payment Award, Number of Additional Shares Authorized		5,500,000
Share-based Compensation Arrangement by Share-based Payment Award, Expiration Period		10 years
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Authorized		7,118,003
Share-based Compensation Arrangement by Share-based Payment Award, Number of Shares Available for Grant		1,212,644
Share Price		$ 23.64		$ 31.84
Allocated Share-based Compensation Expense, Total		$ 2,349		$ 2,256	$ 1,680
Common Stock, Dividends, Per Share, Declared		$ 0.28		$ 0.22	$ 0.18
Subsequent Event [Member]
Common Stock, Dividends, Per Share, Declared	$ 0.085
Dividends Payable, Date to be Paid	Apr. 5, 2019
Dividends Payable, Date of Record	Mar. 22, 2019
Dividends Payable	$ 1,700
Stock Repurchase Program [Member]
Stock Repurchased During Period, Shares			0
Stock Repurchase Program [Member] | Common Stock [Member]
Stock Repurchase Program, Authorized Amount						$ 7,500
Stock Repurchase Program [Member] | Common Stock [Member] | Subsequent Event [Member]
Stock Repurchase Program, Authorized Amount	$ 10,000
General and Administrative Expense [Member]
Allocated Share-based Compensation Expense, Total		$ 1,293		$ 1,484	$ 983
General and Administrative Expense [Member] | President [Member]
Allocated Share-based Compensation Expense, Total				500
Employee Stock Option [Member]
Allocated Share-based Compensation Expense, Total		$ 1,457		1,612	1,116
Employee Stock Option [Member] | Share-based Compensation Award, Tranche One [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period		4 years
Employee Stock Option [Member] | Share-based Compensation Award, Tranche Two [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Award Vesting Period		5 years
Restricted Stock Units (RSUs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Vested in Period, Fair Value		$ 1,900		1,900	800
Allocated Share-based Compensation Expense, Total		892		$ 644	$ 564
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Total		$ 9,700
Employee Service Share-based Compensation, Nonvested Awards, Compensation Cost Not yet Recognized, Period for Recognition		3 years 292 days
Stock Repurchased During Period, Shares		21,410		27,291

Note 9 - Stockholders' Equity -

Note 9 - Stockholders' Equity - Weighted Average Assumptions (Details) - Employee Stock Option [Member] - $ / shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Dividend yield	1.20%	0.70%	1.30%
Volatility	41.30%	39.10%	34.50%
Risk-free interest rate	2.70%	2.20%	1.20%
Weighted average expected option term (Year)	4 years 292 days	4 years 219 days	5 years 182 days
Weighted average fair value per share of options granted (in dollars per share)	$ 8.28	$ 10.37	$ 4.04

Note 9 - Stockholders' Equity_3

Note 9 - Stockholders' Equity - Summary of Option Activity (Details) - USD ($)		12 Months Ended
		Dec. 31, 2018		Dec. 31, 2017	[1]
Outstanding (in shares)	[1]	1,536,282
Outstanding, weighted average exercise price (in dollars per share)	[1]	$ 13.86
Outstanding, weighted average contractual term (Year)		4 years 197 days	[2]	4 years 54 days
Outstanding, aggregate intrinsic value		$ 12,214,422	[2]	$ 27,771,635
Granted (in shares)		280,423
Granted, weighted average exercise price (in dollars per share)		$ 23.56
Exercised (in shares)	[3]	(303,379)
Exercised, weighted average exercise price (in dollars per share)	[3]	$ 9.79
Exercised, aggregate intrinsic value	[3]	$ 7,196,175
Canceled / Expired (in shares)		(50,751)
Canceled / Expired, weighted average exercise price (in dollars per share)		$ 13.79
Outstanding (in shares)		1,462,575	[2]	1,536,282
Outstanding, weighted average exercise price (in dollars per share)		$ 16.41	[2]	$ 13.86
Vested and exercisable (in shares)	[4]	504,988
Vested and exercisable, weighted average exercise price (in dollars per share)	[4]	$ 11.51
Vested and exercisable, weighted average contractual term (Year)	[4]	2 years 237 days
Vested and exercisable, aggregate intrinsic value	[4]	$ 6,482,151
Expected to vest (in shares)		957,587
Expected to vest, weighted average exercise price (in dollars per share)		$ 18.99
Expected to vest, weighted average contractual term (Year)		5 years 197 days
Total (in shares)		1,462,575
[1]	The aggregate intrinsic value represents the difference between the exercise price and $31.84, the closing price of our stock on December 31, 2017, for all in-the-money options outstanding.
[2]	The aggregate intrinsic value represents the difference between the exercise price and $23.64, the closing price of our stock on December 31, 2018, for all in-the-money options outstanding.
[3]	The aggregate intrinsic value of shares exercised represents the difference between the exercise price and the closing price of our stock on the date of exercise.
[4]	The aggregate intrinsic value represents the difference between the exercise price and $23.64, the closing price of our stock on December 31, 2018, for all in-the-money options vested and exercisable as of that date.

Note 9 - Stockholders' Equity_4

Note 9 - Stockholders' Equity - Summary of RSU Activity (Details) - Restricted Stock Units (RSUs) [Member]	12 Months Ended
	Dec. 31, 2018$ / sharesshares
Outstanding (in shares) | shares	216,750
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 18.10
Granted (in shares) | shares	87,088
Granted, weighted average grant date fair value (in dollars per share) | $ / shares	$ 23.65
Vested (in shares) | shares	(63,478)	[1]
Vested, weighted average grant date fair value (in dollars per share) | $ / shares	$ 15.11	[1]
Canceled (in shares) | shares	(22,465)
Canceled, weighted average grant date fair value (in dollars per share) | $ / shares	$ 17.75
Outstanding (in shares) | shares	217,895
Outstanding, weighted average grant date fair value (in dollars per share) | $ / shares	$ 21.21
[1]	The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements.

Note 9 - Stockholders' Equity_5

Note 9 - Stockholders' Equity - Summary of Repurchases (Details) - Restricted Stock Units (RSUs) [Member] - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Shares of common stock repurchased (in shares)	21,410	27,291
Average per share repurchase price (in dollars per share)	$ 34.62	$ 28.51
Aggregage purchase price (in thousands)	$ 741	$ 778

Note 9 - Stockholders' Equity_6

Note 9 - Stockholders' Equity - Stock-based Compensation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Allocated Share-based Compensation Expense, Total	$ 2,349	$ 2,256	$ 1,680
Cost of Sales [Member]
Allocated Share-based Compensation Expense, Total	272	188	175
Sales [Member]
Allocated Share-based Compensation Expense, Total	529	403	373
General and Administrative Expense [Member]
Allocated Share-based Compensation Expense, Total	1,293	1,484	983
Research and Development Expense [Member]
Allocated Share-based Compensation Expense, Total	255	181	149
Employee Stock Option [Member]
Allocated Share-based Compensation Expense, Total	1,457	1,612	1,116
Restricted Stock Units (RSUs) [Member]
Allocated Share-based Compensation Expense, Total	$ 892	$ 644	$ 564

Note 9 - Stockholders' Equity_7

Note 9 - Stockholders' Equity - Dividend Activity (Details) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Per share amount (in dollars per share)	$ 0.28	$ 0.22	$ 0.18
Quarterly Dividends 1 [Member]
Record date	Mar. 22, 2018	Mar. 22, 2017
Payment date	Apr. 5, 2018	Apr. 6, 2017
Per share amount (in dollars per share)	$ 0.07	$ 0.055
Dividend payment	$ 1,351	$ 1,029
Quarterly Dividends 2 [Member]
Record date	May 22, 2018	May 24, 2017
Payment date	Jun. 7, 2018	Jun. 8, 2017
Per share amount (in dollars per share)	$ 0.07	$ 0.055
Dividend payment	$ 1,353	$ 1,036
Quarterly Dividends 3 [Member]
Record date	Aug. 22, 2018	Aug. 23, 2017
Payment date	Sep. 6, 2018	Sep. 6, 2017
Per share amount (in dollars per share)	$ 0.07	$ 0.055
Dividend payment	$ 1,369	$ 1,055
Quarterly Dividends 4 [Member]
Record date	Nov. 20, 2018	Nov. 22, 2017
Payment date	Dec. 6, 2018	Dec. 7, 2017
Per share amount (in dollars per share)	$ 0.07	$ 0.055
Dividend payment	$ 1,372	$ 1,060

Note 10 - Profit-sharing Plan (

Note 10 - Profit-sharing Plan (Details Textual) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Defined Contribution, Plan Employers Matching Contribution, Annual Vesting Period	6 years
Deferred Profit Sharing [Member]
Defined Contribution Plan, Employer Discretionary Contribution Amount	$ 0.3	$ 0.2	$ 0.1

Note 11 - Segment and Enterpr_3

Note 11 - Segment and Enterprise-wide Disclosures (Details Textual)	12 Months Ended
	Dec. 31, 2018
Number of Operating Segments	1

Note 11 - Segment and Enterpr_4

Note 11 - Segment and Enterprise-wide Disclosures - Net Sales to Unaffiliated Customers by Geography (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Total net sales	$ 28,389	$ 24,165	$ 27,020	$ 25,994	$ 26,153	$ 24,822	$ 25,753	$ 24,139	$ 105,568	$ 100,867	$ 89,151
UNITED STATES
Total net sales									59,078	58,470	50,439
GERMANY
Total net sales									12,445	11,576	10,350
Other Countries [Member]
Total net sales									$ 34,045	$ 30,821	$ 28,362

Note 11 - Segment and Enterpr_5

Note 11 - Segment and Enterprise-wide Disclosures - Property and Equipment Held by Geography (Details) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Total property and equipment	$ 14,102	$ 12,378
UNITED STATES
Total property and equipment	11,006	10,275
AUSTRALIA
Total property and equipment	1,460	1,639
FRANCE
Total property and equipment	1,071
GERMANY
Total property and equipment	430	369
Other Countries [Member]
Total property and equipment	$ 135	$ 95

Note 12 - Supplemental Cash F_3

Note 12 - Supplemental Cash Flow Information - Schedule of Supplemental Cash Flow Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash paid for income taxes, net	$ 5,521	$ 3,146	$ 4,231

Note 13 - Fair Value Measurem_3

Note 13 - Fair Value Measurements (Details Textual) - USD ($) $ in Thousands	Mar. 18, 2016	Dec. 31, 2018	May 31, 2018	Nov. 10, 2016
Restore Flow Allografts [Member]
Business Combination, Contingent Consideration, Liability, Total			$ 2,000	$ 900
Restore Flow Allografts [Member] | Non-employee Investors [Member]
Business Combination, Contingent Consideration, Liability, Total				1,100
Acquisition Date Fair Value				900
ProCol Biologic Graft [Member]
Business Combination Contingent Consideration Measurement as Percentage of Revenue	10.00%
Business Combination, Provisional Information, Initial Accounting Incomplete, Adjustment, Consideration Transferred	$ 300
Fair Value, Inputs, Level 2 [Member] | Fair Value, Measurements, Recurring [Member]
Assets, Fair Value Disclosure		$ 0
Fair Value, Inputs, Level 3 [Member] | Restore Flow Allografts [Member]
Acquisition Date Fair Value				1,000
Fair Value, Inputs, Level 3 [Member] | Restore Flow Allografts [Member] | Earn Out Payment [Member]
Business Combination, Contingent Consideration, Liability, Total				4,000
Fair Value, Inputs, Level 3 [Member] | Restore Flow Allografts [Member] | Non-employee Investors [Member]
Business Combination, Contingent Consideration, Liability, Total				1,100
Fair Value, Inputs, Level 3 [Member] | Restore Flow Allografts [Member] | Maximum [Member]
Business Combination, Contingent Consideration, Liability, Total				$ 5,100
Fair Value, Inputs, Level 3 [Member] | ProCol Biologic Graft [Member]
Business Combination Contingent Consideration Measurement as Percentage of Revenue	10.00%
Business Combination, Provisional Information, Initial Accounting Incomplete, Adjustment, Consideration Transferred	$ 300

Note 13 - Fair Value Measurem_4

Note 13 - Fair Value Measurements - Rollforward of the Fair Value as Determined by Level 3 (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Beginning balance	$ 1,300	$ 1,320
Additions			1,301
Payments	(1,199)	(126)	(68)
Change in fair value included in earnings	(29)	106	87
Ending balance	$ 72	$ 1,300	$ 1,320

Note 14 - Quarterly Financial_3

Note 14 - Quarterly Financial Data (Unaudited) - Quarterly Financial Data (Unaudited) (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Total net sales	$ 28,389	$ 24,165	$ 27,020	$ 25,994	$ 26,153	$ 24,822	$ 25,753	$ 24,139	$ 105,568	$ 100,867	$ 89,151
Gross profit	19,218	17,255	18,992	18,474	18,251	17,577	17,516	17,353	73,939	70,697	62,936
Income (loss) from operations	7,193	4,613	11,541	4,862	6,321	5,053	5,536	4,193	28,209	21,103	16,336
Net income	$ 6,025	$ 4,314	$ 8,751	$ 3,853	$ 4,284	$ 5,042	$ 4,632	$ 3,219	$ 22,943	$ 17,177	$ 10,590
Basic:
Basic (in dollars per share)	$ 0.31	$ 0.22	$ 0.45	$ 0.20	$ 0.22	$ 0.26	$ 0.25	$ 0.17	$ 1.18	$ 0.91	$ 0.57
Diluted (in dollars per share)	$ 0.30	$ 0.21	$ 0.43	$ 0.19	$ 0.21	$ 0.25	$ 0.23	$ 0.16	$ 1.13	$ 0.86	$ 0.55
Total net sales	$ 28,389	$ 24,165	$ 27,020	$ 25,994	$ 26,153	$ 24,822	$ 25,753	$ 24,139	$ 105,568	$ 100,867	$ 89,151
Gross profit	19,218	17,255	18,992	18,474	18,251	17,577	17,516	17,353	73,939	70,697	62,936
Income (loss) from operations	7,193	4,613	11,541	4,862	6,321	5,053	5,536	4,193	28,209	21,103	16,336
Net income	$ 6,025	$ 4,314	$ 8,751	$ 3,853	$ 4,284	$ 5,042	$ 4,632	$ 3,219	$ 22,943	$ 17,177	$ 10,590

Note 15 - Accumulated Other C_3

Note 15 - Accumulated Other Comprehensive Income (Loss) - Schedule of Accumulated Other Comprehensive Income (Loss) (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Balance	$ 109,770	$ 87,500	$ 77,884
Balance	130,235	109,770	87,500
AOCI Attributable to Parent [Member]
Balance	(2,289)	(4,583)	(4,049)
Other comprehensive income (loss) before reclassifications	(1,611)	2,294	(534)
Amounts reclassified from accumulated other comprehensive loss
Balance	$ (3,900)	$ (2,289)	$ (4,583)