Surgalign (SRGAQ) 10-K/A 8 Jun 20 2018 FY Annual report (amended) Financial data

Document and Entity Information

Document and Entity Information - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2018	May 19, 2020	Jun. 29, 2018
Document and Entity Information [Abstract]
Document Type	10-K/A
Amendment Flag	false
Document Period End Date	Dec. 31, 2018
Document Fiscal Year Focus	2018
Document Fiscal Period Focus	FY
Trading Symbol	RTIX
Entity Registrant Name	RTI Surgical Holdings, Inc.
Entity Central Index Key	0001760173
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	No
Entity Voluntary Filers	No
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity File Number	0-31271
Entity Tax Identification Number	59-3466543
Entity Address, Address Line One	520 Lake Cook Road
Entity Address, Address Line Two	Suite 315
Entity Address, City or Town	Deerfield
Entity Address, State or Province	IL
Entity Address, Postal Zip Code	60015
City Area Code	877
Local Phone Number	343-6832
Document Annual Report	true
Document Transition Report	false
Entity Filer Category	Accelerated Filer
Entity Interactive Data Current	Yes
Title of 12(b) Security	Common Stock, $0.001 par value
Security Exchange Name	NASDAQ
Entity Common Stock, Shares Outstanding		74,564,450
Entity Public Float			$ 286

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Current Assets:
Cash and cash equivalents	$ 10,949	$ 22,381
Accounts receivable-less allowances of $2,380 at December 31, 2018 and $1,471 at December 31, 2017	48,096	35,198
Inventories-net	107,655	111,944
Prepaid and other current assets	8,413	16,626
Total current assets	175,113	186,149
Property, plant and equipment-net	77,954	79,564
Deferred tax assets-net	17,760	9,455
Goodwill	59,798	46,242
Other intangible assets-net	25,557	22,574
Other assets-net	4,003	1,781
Total assets	360,185	345,765
Current Liabilities:
Accounts payable	26,219	18,182
Accrued expenses	25,865	25,759
Current portion of deferred revenue	4,908	4,868
Current portion of short and long-term obligations		4,268
Total current liabilities	56,992	53,077
Long-term obligations-less current portion	49,073	42,076
Acquisition contingencies	4,986
Other long-term liabilities	633	1,431
Deferred revenue	744	3,741
Total liabilities	112,428	100,325
Commitments and contingencies (Note 22)
Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding	66,226	63,923
Stockholders' equity:
Common stock, $.001 par value: 150,000,000 shares authorized; 63,469,185 and 62,694,441 shares issued and outstanding, respectively	64	63
Additional paid-incapital	433,143	429,459
Accumulated other comprehensive loss	(7,270)	(6,329)
Accumulated deficit	(239,537)	(237,286)
Less treasury stock, 1,221,180 and 1,114,071 shares, respectively, at cost	(4,869)	(4,390)
Total stockholders' equity	181,531	181,517
Total liabilities and stockholders' equity	$ 360,185	$ 345,765

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 2,660	$ 1,731
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	5,000,000	5,000,000
Preferred stock, shares issued	50,000	50,000
Preferred stock, shares outstanding	50,000	50,000
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares issued	63,469,185	62,694,441
Common stock, shares outstanding	63,469,185	62,694,441
Treasury stock, shares	1,221,180	1,114,071

Consolidated Statements of Comp

Consolidated Statements of Comprehensive (Loss) Income - USD ($) $ in Thousands	Oct. 20, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Statement [Abstract]
Revenues		$ 70,386	$ 70,450	$ 70,385	$ 69,141	$ 71,111	$ 67,246	$ 71,578	$ 70,414	$ 66,482	$ 69,924	$ 67,517	$ 139,526	$ 141,992	$ 137,441	$ 209,976	$ 209,238	$ 203,923	$ 280,362	$ 280,349	$ 275,984
Costs of processing and distribution			32,222	40,486	35,638		33,434	34,917	34,225	32,406	34,975	31,814	76,124	69,142	66,789	108,346	102,576	99,195	140,719	137,277	142,657
Gross profit		38,013	38,228	29,899	33,503	36,410	33,812	36,661	36,189	34,076	34,949	35,703	63,402	72,850	70,652	101,630	106,662	104,728	139,643	143,072	133,327
Expenses:
Marketing, general and administrative	$ 1,818		29,671	29,327	28,578		27,678	29,576	29,709	28,774	28,402	27,856	57,905	59,285	56,258	87,576	86,963	85,032	119,724	115,009	116,666
Research and development			3,606	3,270	3,421		2,741	3,740	3,688	3,789	4,084	4,161	6,691	7,428	8,245	10,297	10,169	12,034	14,410	13,315	16,297
Severance and restructuring costs			994	251	742		2,891	2,959	4,526	328	1,818		993	7,485	1,818	1,987	10,376	2,146	2,808	12,016	2,146
Strategic review costs										650								650			1,150
Executive transition costs										4,107								4,107		2,818	4,404
Contested proxy expenses											2,372				2,372			2,372			2,680
Asset impairment and abandonments			104	4,515	129				236				4,644	236		4,748	236		5,070	4,034	5,241
Acquisition and integration expenses			1,941		800								800			2,741			4,943	630
Cardiothoracic closure business divestiture contingency consideration			(3,000)													(3,000)			(3,000)
Gain on cardiothoracic closure business divestiture							(34,090)										(34,090)			(34,090)
Total operating expenses			33,316	37,363	33,670		(780)	36,275	38,159	37,648	36,676	32,017	71,033	74,434	68,693	104,349	73,654	106,341	143,955	113,732	148,584
Operating (loss) income			4,912	(7,464)	(167)		34,592	386	(1,970)	(3,572)	(1,727)	3,686	(7,631)	(1,584)	1,959	(2,719)	33,008	(1,613)	(4,312)	29,340	(15,257)
Other (expense) income:
Interest expense			(611)	(777)	(835)		(741)	(915)	(819)	(308)	(392)	(361)	(1,612)	(1,734)	(753)	(2,223)	(2,475)	(1,061)	(2,771)	(3,180)	(1,655)
Interest income			14	6	11					1	6	1	17		7	31		8	35	8	8
Loss on extinguishment of debt				(309)									(309)			(309)			(309)
Foreign exchange (loss) gain			(1)	(71)	49		60	(75)	20	(67)	(38)	46	(22)	(55)	8	(23)	5	(59)	(34)	87	(129)
Total other expense-net			(598)	(1,151)	(775)		(681)	(990)	(799)	(374)	(424)	(314)	(1,926)	(1,789)	(738)	(2,524)	(2,470)	(1,112)	(3,079)	(3,085)	(1,776)
(Loss) income before income tax benefit (provision)			4,314	(8,615)	(942)		33,911	(604)	(2,769)	(3,946)	(2,151)	3,372	(9,557)	(3,373)	1,221	(5,243)	30,538	(2,725)	(7,391)	26,255	(17,033)
Income tax benefit (provision)			(1,317)	2,813	(175)		(16,235)	(1,061)	892	450	474	(1,232)	2,638	(169)	(758)	1,321	(16,404)	(308)	4,268	(19,349)	3,228
Net (loss) income		$ 799	2,997	(5,802)	(1,117)	$ (7,228)	17,676	(1,665)	(1,877)	(3,496)	(1,677)	2,140	(6,919)	(3,542)	463	(3,922)	14,134	(3,033)	(3,123)	6,906	(13,805)
Convertible preferred dividend			(173)	(981)	(966)		(938)	(924)	(910)	(883)	(870)	(858)	(1,947)	(1,834)	(1,728)	(2,120)	(2,772)	(2,611)	(2,120)	(3,723)	(3,508)
Net (loss) income applicable to common shares			2,824	(6,783)	(2,083)		16,738	(2,589)	(2,787)	(4,379)	(2,547)	1,282	(8,866)	(5,376)	(1,265)	(6,042)	11,362	(5,644)	(5,243)	3,183	(17,313)
Other comprehensive (loss) income:
Unrealized foreign currency translation loss			(130)	(914)	393		434	1,093	320	241	(556)	462	(521)	1,413	(94)	(651)	1,847	147	(941)	1,987	(1,274)
Comprehensive (loss) income			$ 2,694	$ (7,697)	$ (1,690)		$ 17,172	$ (1,496)	$ (2,467)	$ (4,138)	$ (3,103)	$ 1,744	$ (9,387)	$ (3,963)	$ (1,359)	$ (6,693)	$ 13,209	$ (5,497)	$ (6,184)	$ 5,170	$ (18,587)
Net (loss) income per common share-basic		$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.28	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Net (loss) income per common share-diluted		$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.23	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Weighted average shares outstanding-basic																			63,521,703	59,684,289	58,236,745
Weighted average shares outstanding-diluted																			63,521,703	60,599,952	58,236,745

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Series A Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Additional Paid-in Capital [Member]Series A Preferred Stock [Member]	Accumulated Other Comprehensive Loss [Member]	Accumulated Deficit [Member]	Treasury Stock [Member]
Beginning Balance at Jan. 01, 2016	$ 179,908		$ 58	$ 417,725		$ (7,042)	$ (230,387)	$ (446)
Net (loss) income	2,140
Foreign currency translation adjustment	462
Ending Balance at Mar. 31, 2016	181,985
Beginning Balance at Jan. 01, 2016	179,908		58	417,725		(7,042)	(230,387)	(446)
Net (loss) income	463
Foreign currency translation adjustment	(94)
Ending Balance at Jun. 30, 2016	179,443
Beginning Balance at Jan. 01, 2016	179,908		58	417,725		(7,042)	(230,387)	(446)
Net (loss) income	(3,033)
Foreign currency translation adjustment	147
Ending Balance at Sep. 30, 2016	177,356
Beginning Balance at Jan. 01, 2016	179,908		58	417,725		(7,042)	(230,387)	(446)
Net (loss) income	(13,805)						(13,805)
Foreign currency translation adjustment	(1,274)					(1,274)
Exercise of common stock options	57			57
Stock-based compensation	3,590			3,590
Purchase of treasury stock	(470)							(470)
Change in income tax benefit from stock-based compensation	(251)			(251)
Amortization of preferred stock Series A issuance costs		$ (185)			$ (185)
Preferred stock Series A dividend		(3,508)			(3,508)
Ending Balance at Dec. 31, 2016	164,062		58	417,428		(8,316)	(244,192)	(916)
Beginning Balance at Mar. 31, 2016	181,985
Net (loss) income	(1,677)
Foreign currency translation adjustment	(556)
Ending Balance at Jun. 30, 2016	179,443
Net (loss) income	(3,496)
Foreign currency translation adjustment	241
Ending Balance at Sep. 30, 2016	177,356
Beginning Balance at Dec. 31, 2016	164,062		58	417,428		(8,316)	(244,192)	(916)
Net (loss) income	(1,877)
Foreign currency translation adjustment	320
Ending Balance at Mar. 31, 2017	162,348
Beginning Balance at Dec. 31, 2016	164,062		58	417,428		(8,316)	(244,192)	(916)
Net (loss) income	(3,542)
Foreign currency translation adjustment	1,413
Ending Balance at Jun. 30, 2017	163,688
Beginning Balance at Dec. 31, 2016	164,062		58	417,428		(8,316)	(244,192)	(916)
Net (loss) income	14,134
Foreign currency translation adjustment	1,847
Ending Balance at Sep. 30, 2017	182,977
Beginning Balance at Dec. 31, 2016	164,062		58	417,428		(8,316)	(244,192)	(916)
Net (loss) income	6,906						6,906
Foreign currency translation adjustment	1,987					1,987
Exercise of common stock options	9,181		5	9,176
Stock-based compensation	6,762			6,762
Purchase of treasury stock	(3,474)							(3,474)
Amortization of preferred stock Series A issuance costs		(184)			(184)
Preferred stock Series A dividend		(3,723)			(3,723)
Ending Balance at Dec. 31, 2017	181,517		63	429,459		(6,329)	(237,286)	(4,390)
Beginning Balance at Mar. 31, 2017	162,348
Net (loss) income	(1,665)
Foreign currency translation adjustment	1,093
Ending Balance at Jun. 30, 2017	163,688
Net (loss) income	17,676
Foreign currency translation adjustment	434
Ending Balance at Sep. 30, 2017	182,977
Net (loss) income	(7,228)
Ending Balance at Dec. 31, 2017	181,517		63	429,459		(6,329)	(237,286)	(4,390)
Net (loss) income	(1,117)
Foreign currency translation adjustment	393
Ending Balance at Mar. 31, 2018	181,856
Beginning Balance at Dec. 31, 2017	181,517		63	429,459		(6,329)	(237,286)	(4,390)
Net (loss) income	(6,919)
Foreign currency translation adjustment	(521)
Ending Balance at Jun. 30, 2018	175,360
Beginning Balance at Dec. 31, 2017	181,517		63	429,459		(6,329)	(237,286)	(4,390)
Net (loss) income	(3,922)
Foreign currency translation adjustment	(651)
Ending Balance at Sep. 30, 2018	179,955
Beginning Balance at Dec. 31, 2017	181,517		63	429,459		(6,329)	(237,286)	(4,390)
Accumulated effect of adoption of the revenue recognition standard	872						872
Net (loss) income	(3,123)						(3,123)
Foreign currency translation adjustment	(941)					(941)
Exercise of common stock options	1,243		1	1,242
Stock-based compensation	4,745			4,745
Purchase of treasury stock	(479)							(479)
Amortization of preferred stock Series A issuance costs		(183)			(183)
Preferred stock Series A dividend		$ (2,120)			$ (2,120)
Ending Balance at Dec. 31, 2018	181,531		64	433,143		(7,270)	(239,537)	(4,869)
Beginning Balance at Mar. 31, 2018	181,856
Net (loss) income	(5,802)
Foreign currency translation adjustment	(914)
Ending Balance at Jun. 30, 2018	175,360
Net (loss) income	2,997
Foreign currency translation adjustment	(130)
Ending Balance at Sep. 30, 2018	179,955
Net (loss) income	799
Ending Balance at Dec. 31, 2018	$ 181,531		$ 64	$ 433,143		$ (7,270)	$ (239,537)	$ (4,869)

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net (loss) income	$ (3,123)	$ 6,906	$ (13,805)
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization expense	14,579	14,233	16,528
Provision for bad debts and product returns	1,721	946	895
Provision for inventory write-downs	15,122	5,066	13,880
Amortization of deferred revenue	(4,958)	(4,744)	(4,867)
Deferred income tax provision	(4,692)	13,573	(3,492)
Stock-based compensation	4,745	6,660	3,590
Asset impairment and abandonments	5,070	4,034	5,241
Cardiothoracic closure business divestiture contingency consideration	(3,000)	(34,090)	0
Other	1,330	2,392	603
Change in assets and liabilities:
Accounts receivable	(10,829)	5,116	1,710
Inventories	(11,957)	1,610	(13,228)
Accounts payable	8,035	(12,936)	4,549
Accrued expenses	(827)	5,667	(5,722)
Deferred revenue	2,000	2,000	2,000
Other operating assets and liabilities	4,036	(10,645)	7,441
Net cash (used in) provided by operating activities	17,252	5,788	15,323
Cash flows from investing activities:
Purchases of property, plant and equipment	(11,042)	(12,301)	(15,337)
Patent and acquired intangible asset costs	(3,695)	(2,266)	(2,615)
Proceeds from sale of building		1,818
Cardiothoracic closure business divestiture	3,000	51,000
Net cash (used in) provided by investing activities	(32,737)	38,251	(17,952)
Cash flows from financing activities:
Proceeds from exercise of common stock options	2,356	5,060	57
Proceeds from long-term obligations	74,425	6,000	17,000
Net (payments) proceeds from short-term obligations			(1,511)
Payments on long-term obligations	(71,171)	(43,000)	(11,424)
Payments for treasury stock	(478)	(3,474)
Other financing activities	(1,039)	(317)	(458)
Net cash provided by (used in) financing activities	4,093	(35,731)	3,664
Effect of exchange rate changes on cash and cash equivalents	(40)	224	200
Net (decrease) increase in cash and cash equivalents	(11,432)	8,532	1,235
Cash and cash equivalents, beginning of period	22,381	13,849	12,614
Cash and cash equivalents, end of period	10,949	22,381	13,849
Supplemental cash flow disclosure:
Cash paid for interest	3,047	3,023	1,224
Cash paid for income taxes, net of refunds	(6,403)	12,142	(238)
Non-cash acquisition of property, plant and equipment	1,217	593	952
Receivable for executive stock option exercise		1,234
Stock-based compensation related to sale of CT business		102
Increase in accrual for dividend payable	2,120	$ 3,723	$ 3,508
Zyga Technology Inc [Member]
Cash flows from investing activities:
Payments to acquire businesses	$ (21,000)

Business

Business	12 Months Ended
	Dec. 31, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Business	1. Business RTI Surgical Holdings, Inc. (f/k/a RTI Surgical, Inc.) (the “Company”), and its subsidiaries recover and process human and animal tissue and manufacture metal and synthetic implants and instruments. The processing transforms the tissue into either conventional or precision machined allograft implants (human) or xenograft implants (animal), while our manufacturing facilities produce metal and synthetic implants. The implants are used for orthopedic and other surgical applications to promote the natural healing of human bone and other human tissue. These implants are distributed domestically and internationally, for use in reconstruction and fracture repair.

Summary of Significant Accounti

Summary of Significant Accounting Policies	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	2. Summary of Significant Accounting Policies Restatement of Financial Statements As previously announced, the Audit Committee of the Board of Directors (the “Board”) of the Company, with the assistance of independent legal and forensic accounting advisors has conducted an internal investigation of matters relating to the Company’s revenue recognition practices for certain contractual arrangements, primarily with OEM customers, including the accounting treatment, financial reporting and internal controls related to such arrangements (the “Investigation”). The Investigation was precipitated by an ongoing investigation by the SEC initially related to the periods 2014 through 2016. The SEC Investigation is ongoing, and the Company is cooperating with the SEC in its investigation. Based on the results of the internal investigation, the Company has restated its financial statements to correct errors. See Notes 27 and 28 for additional information. The corrections contained in the financial statements, which we refer to herein collectively as the “Restatement,” were prepared following the internal investigation by the Audit Committee of the Company’s Board of Directors. Principles of Consolidation RTIDS is a taxable not-for-profit Use of Estimates Foreign Currency Translation Fair Value of Financial Instruments Cash and Cash Equivalents Accounts Receivable Allowances Inventories first-in, first-out Non-tissue Surgical Instruments Property, Plant and Equipment Buildings 25 to 40 years Building improvements and leasehold improvements 8 to 40 years Processing equipment 7 to 10 years Office equipment, furniture and fixtures 5 to 7 years Computer hardware and software 3 to 7 years Surgical instruments 3 to 5 years Software Costs Debt Issuance Costs— Long-Lived Assets As further discussed in Note 23, during the second quarter of 2018, we recorded an impairment of $4,515 related to our map3 ® During the fourth quarter of 2016, the Company concluded a strategic review of its business lines and operations, and updated its financial projections. As a result, the Company’s financial projections related to its hernia business line were adjusted downward. This business line is a significant driver of revenue for the Tutogen Germany asset group. As a result, during the fourth quarter of 2016, the Company completed an asset group impairment test and determined the carrying value was not recoverable as of December 31, 2016. The Company used a market approach to determine the fair value of the Tutogen Germany asset group’s long-lived assets and recognized impairment charges related to identified intangibles and property and equipment of $5,435. Goodwill Goodwill and Other Intangible Assets year-end Goodwill is tested for impairment annually by comparing the fair value of the reporting unit to its carrying amount, including goodwill. We evaluate our goodwill for impairment by utilizing an income approach and a market approach. The conclusion from these two approaches are generally weighted equally and then adjusted to incorporate a control premium or acquisition premium that reflects the additional amount a buyer is willing to pay for elements of control and for a premium that reflects the buyer’s perception of its ability to add value through synergies. In general, the income approach employs a discounted cash flow model that considers: 1) assumptions that marketplace participants would use in their estimates of fair value, including the cash flow period, terminal values based on a terminal growth rate and the discount rate; 2) current period actual results; and 3) projected results for future periods that have been prepared and approved by senior management of the Company. The forecasted cash flows do not include synergies that a marketplace participant would be expecting to achieve. The market approach employs market multiples from guideline public companies operating in our industry. Estimates of fair value are derived by applying multiples based on revenue and earnings before interest, taxes, depreciation and amortization (“EBITDA”) adjusted for size and performance metrics relative to peer companies. A control premium was included in determining the fair value under this approach. Both approaches used in the analysis have a degree of uncertainty. Potential events or changes in circumstances which could impact the key assumptions used in our goodwill impairment evaluation are as follows: • Change in peer group or performance of peer group companies • Change in the Company’s markets and estimates of future operating performance • Change in the Company’s estimated market cost of capital • Change in implied control premiums related to acquisitions in the medical device industry Goodwill represents the excess of purchase price over fair value of tangible net assets of acquired businesses at the acquisition date, after amounts allocated to other identifiable intangible assets. Factors that contribute to the recognition of goodwill include securing synergies that are specific to our business, not available to other market participants, and are expected to increase revenues and profits; acquisition of a talented workforce; cost savings opportunities; the strategic benefit of expanding our presence in core and adjacent markets; and diversifying our product portfolio. Other Intangible Assets Other intangible assets are tested for impairment whenever events or circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. The recoverability test is described in the Company’s accounting policy for long-lived assets set forth above. Revenue Recognition The Company permits returns of implants in accordance with the terms of contractual agreements with customers if the implant is returned in a timely manner, in unopened packaging, and from the normal channels of distribution. Allowances for returns are provided based upon analysis of the Company’s historical patterns of returns matched against the revenues from which they originated. The Company records estimated implant returns, discounts, rebates and other distribution incentives as a reduction of revenue in the same period revenue is recognized. Estimates of implant returns are recorded for anticipated implant returns based on historical distributions and returns information. Estimates of discounts, rebates and other distribution incentives are recorded based on contractual terms, historical experience and trend analysis. Other revenues consist of service processing, tissue recovery fees, biomedical laboratory fees, recognition of previously deferred revenues, shipping fees, distribution of reproductions of our allografts to distributors for demonstration purposes and restocking fees which is included in revenues. Stock-Based Compensation Plans Accounting for Stock Compensation pre-vesting Research and Development Costs Income Taxes year-end Treasury Stock Earnings Per Share Year Ended December 31, 2018 2017 2016 Weighted average basic shares 63,521,703 59,684,289 58,236,745 Effect of dilutive securities: Stock options — 915,663 — Weighted average diluted shares 63,521,703 60,599,952 58,236,745 Options to purchase 4,275,744 shares of common stock at prices ranging from $2.69 to $5.23 per share which were outstanding as of December 31, 2018, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. Options to purchase 4,662,037 shares of common stock at prices ranging from $2.69 to $8.20 per share which were outstanding as of December 31, 2017, were included in the computation of diluted EPS because dilutive shares are factored into the calculation of EPS when income applicable to common shares is reported. Options to purchase 5,764,607 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2016, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. For the years ended December 31, 2018, 2017 and 2016, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted

Recently Issued Accounting Stan

Recently Issued Accounting Standards.	12 Months Ended
	Dec. 31, 2018
Accounting Changes and Error Corrections [Abstract]
Recently Issued Accounting Standards.	3. Recently Issued Accounting Standards. Fair Value Measurement 2018-13, “ Fair Value Measurement (Topic 820): Disclosure Framework — Changes to the Disclosure Requirements for Fair Value Measurement. ” 2018-13 2018-13 Earnings Per Share 2017-11, Earnings Per Share” “Distinguishing Liabilities from Equity” “Derivative and Hedging” 2017-11 470-20, 2017-11 re-characterize 2017-11 2017-11 250-10-45-5 45-10. 2017-11 2017-11 Compensation—Stock Compensation 2017-09, “Compensation—Stock Compensation” 2017-09 2017-09 Other Income—Gains and Losses from the Derecognition of Nonfinancial Assets 2017-05, “Other Income-Gains and Losses from the Derecognition of Nonfinancial Assets” 610-20): 2017-05 2017-05 2017-05 2017-05 Business Combinations – Clarifying the Definition of a Business No. 2017-01, Business Combinations – Clarifying the Definition of a Business” 2017-01 2017-01 2017-01 2017-01 Leases 2016-02, Leases (Topic 842) “ Leases (Topic 840). ” 2016-02 right-of-use We continue to finalize our calculations, including our discount rate assumptions, related to ASU 2016-02. 2016-02. 2016-02. Revenue from Contracts with Customers Adoption Impact The Company identified three contracts which previously resulted in revenue recognition occurring at the time of shipment; however, under the new revenue recognition standard, the Company is required to recognize revenue over time. The assessment of our January 1, 2018, consolidated balance sheet under ASC Topic 606 resulted in a cumulative-effect adjustment to opening retained earnings, unbilled accounts receivable and costs incurred for inventory. The effects of the adoption under ASC Topic 606 are outlined in the following table: Year Ended December 31, 2017 Impact January 1, 2018 (as restated) (as reported) (as restated) Accounts receivable $ 35,198 $ 3,243 $ 38,441 Inventories—net 111,944 (995 ) 110,949 Accrued expenses — 1,110 1,110 Deferred tax assets 9,455 (266 ) 9,189 Accumulated deficit (237,287 ) 872 (236,415 ) The impact of adoption of Topic 606 to the Company’s consolidated balance sheets and statements of comprehensive (loss) income for the year ended December 31, 2018, was as follows: Year Ended December 31, 2018 Excluding Impact As Restated of Topic 606 (as restated) Accounts receivable $ 48,096 $ 41,243 Inventories—net 107,655 111,353 Accrued expenses 25,865 25,348 Deferred tax assets 17,760 17,185 Accumulated deficit (239,537 ) (242,751 ) Year Ended December 31, 2018 Excluding Impact As of Topic 606 (as restated) Total revenues $ 280,362 $ 276,943 Cost of processing and distribution 140,719 138,815 Income tax benefit 4,268 4,744 Net income (loss) applicable to common shares (5,243 ) (6,282 ) Disaggregation of revenue The Company operates in one reportable segment composed of four lines of business. Effective January 1, 2018, the reporting of the Company’s lines of business are composed of four franchises or lines of business: spine; sports; OEM and international. The following table presents revenues from these four franchises for the year ended December 31, 2018: Year Ended December 31, 2018 (as restated) Revenues: Spine $ 79,812 Sports 54,560 OEM 120,024 International 25,966 Total revenues from contracts with customers $ 280,362 The following table presents revenues recognized at a point in time and over time for the year ended December 31, 2018: Year Ended December 31, 2018 (as restated) Revenue recognized at a point in time $ 239,619 Revenue recognized over time 40,743 Total revenues from contracts with customers $ 280,362 Performance Obligations The Company’s performance obligations consist mainly of transferring control of implants identified in the contracts. Some of the Company’s contracts offer assurance-type warranties in connection with the sale of a product to a customer. Assurance-type warranties provide a customer with assurance that the related product will function as the parties intended because it complies with agreed-upon specifications. Such warranties do not represent a separate performance obligation and are not material to the consolidated financial statements. When Performance Obligations Are Satisfied The Company typically transfers control at a point in time upon shipment or delivery of the implants for direct sales, or upon implantation for sales of consigned inventory. The customer is able to direct the use of, and obtain substantially all of the benefits from, the implant at the time the implant is shipped, delivered, or implanted, respectively based on the terms of the contract. For performance obligations related to the aforementioned three contracts with exclusively built inventory clauses, the Company typically satisfies its performance obligations evenly over the contract term as inventory is built. Such exclusively manufactured inventory has no alternative use and the Company has an enforceable right to payment for performance to date. The Company uses the input method to measure the manufacturing activities completed to date, which depicts the progress of the Company’s performance obligation of transferring control of exclusively built inventory. For the contracts with upfront and annual exclusivity fees, revenue related to those fees is recognized over the contract term following a consistent method of measuring progress towards satisfaction of the performance obligation. The Company uses the method and measure of progress that best depicts the transfer of control to the customer of the goods or services to date relative to the remaining goods or services promised under the contract. Significant Payment Terms The contract with the customer states the final terms of the sale, including the description, quantity, and price of each implant distributed. Payment for OEM contracts is typically due in full within 30 days of delivery or the start of the contract term. For the remaining lines of business, payment terms are typically due in full within 30 to 60 days of delivery. The Company performs a review of each specific customer’s credit worthiness and ability to pay prior to acceptance as a customer. Further, the Company performs periodic reviews of its customers’ creditworthiness prospectively. Since the customer agrees to a stated price in the contract that does not vary over the contract, the majority of contracts do not contain variable consideration. Nature of Goods and Services The Company distributes biologic, metal and synthetic implants. In some instances, the Company also enters into contracts with customers for exclusively manufactured inventory based on customer specifications. Returns In the normal course of business, the Company accepts product returns. The amount of consideration the Company ultimately receives varies depending upon the return terms that the Company may offer, which are accounted for as variable consideration when estimating the amount of revenue to recognize. The Company establishes provisions for estimated returns based on historical experience. The restated amount recorded on the Company’s balance sheets for product return allowance was $708 and $795 at December 31, 2018 and 2017, respectively. Liabilities for return allowances are included in “Accrued expenses”. Critical Accounting Estimates Estimates are used to determine the amount of variable consideration in contracts, and the measure of progress for contracts where revenue is recognized over time. The Company reviews and updates these estimates regularly. Our contracts generally do not include multiple performance obligations, and accordingly do not generally require estimates of the standalone selling price for each performance obligation. Contract Asset and Liability The opening and closing balances of the Company’s accounts receivable, contract asset and current and long-term contract liability are as follows: Contract Contract Accounts Liability Liability Receivable (Current) (Long-Term) (as restated) (as reported) (as reported) Opening 1/1/2018 $ 38,441 $ 5,978 $ 3,741 Closing 12/31/2018 48,096 5,425 744 Increase/(decrease) 9,655 (553 ) (2,997 ) Contract liabilities consist primarily of the return allowance described above, and of deferred revenue arising from upfront and annual exclusivity fees. The difference between the opening and closing balances of the Company’s contract liabilities primarily results from the Company’s performance of the Company’s contractual obligations over time. The Company recognizes sales commissions as incurred because the amortization period is less than one year. The Company does not incur other incremental costs relating to obtaining a contract with a customer, and therefore, does not have material contract assets, or impairment losses associated therewith. Revenue recognized for the year ended December 31, 2018, from amounts included in contract liabilities at the beginning of the period was $4,958. As of January 1, 2018 and December 31, 2018, $2,133 and $6,577 respectively, of unbilled receivables in connection with our exclusively built inventory contracts are included in accounts receivable.

Acquisition of Zyga Technology,

Acquisition of Zyga Technology, Inc.	12 Months Ended
	Dec. 31, 2018
Zyga Technology Inc [Member]
Acquisition of Zyga Technology, Inc.	4. Acquisition of Zyga Technology, Inc. On January 4, 2018, the Company acquired Zyga Technology, Inc. (“Zyga”), a leading spine-focused medical device company that develops and produces innovative minimally invasive devices to treat underserved conditions of the lumbar spine. Zyga’s primary product is the SImmetry ® The Company has accounted for the acquisition of Zyga under ASC 805, Business Combinations The purchase price was financed as follows: Cash proceeds from revolving credit facility $ 18,000 Cash from RTI Surgical 3,000 Total purchase price $ 21,000 In the fourth quarter of 2018, the Company completed its valuation of the tax accounts associated with the purchase price allocation. The table below represents an allocation of the total consideration to Zyga’s tangible and intangible assets and liabilities fair values as of January 4, 2018. During the three months ended December 31, 2018, the Company made the following changes to the fair values of acquired assets and liabilities as a result of completing the valuation of acquired deferred tax assets: increased deferred tax assets by $3,066 and decreased goodwill by $3,066. Including acquisition contingencies, the total consideration for the Zyga acquisition was $25,986. Inventories $ 1,099 Accounts receivable 573 Other current assets 53 Property, plant and equipment 151 Other assets 26 Deferred tax assets 4,715 Current liabilities (947 ) Acquisition contingencies (4,986 ) Net tangible assets acquired 684 Other intangible assets 6,760 Goodwill 13,556 Total net assets acquired $ 21,000 Total net assets acquired as of January 4, 2018, are all part of the Company’s only operating segment. Fair values are based on management’s estimates and assumptions including variations of the income approach, the cost approach and the market approach. Other intangible assets include patents of $6,500 with a useful life of 13 years, trademarks of $80 with a useful life of 1 year and selling and marketing relationships of $180 with a useful life of 7 years. The Company believes that the acquisition of Zyga has offered and continues to offer the potential for substantial strategic and financial benefits. The transaction further advances our strategic transformation focused on reducing complexity, driving operational excellence and accelerating growth. The Company believes the acquisition will enhance stockholder value through, among other things, enabling the Company to capitalize on the following strategic advantages and opportunities: • Zyga’s innovative minimally invasive treatment should accentuate our spine portfolio and opens significant opportunities to accelerate our Spine-focused expansion strategy. • Zyga should leverage the core competencies of our Spine franchise by pursuing niche differentiated products, to gain scale and customer retention and support portfolio pull-through. These potential benefits resulted in the Company paying a premium for Zyga resulting in the recognition of $13,556 of goodwill assigned to the Company’s only operating segment and reporting unit. For tax purposes, none of the goodwill is deductible. The amount of Zyga’s revenues and net loss since the January 4, 2018, acquisition date, included in the Company’s Consolidated Statement of Comprehensive (Loss) Income for the year ended December 31, 2018, excluding acquisition related costs of approximately $800, are $4,757 and $2,573, respectively. The following unaudited pro forma information shows the results of the Company’s operations as though the acquisition had occurred as of January 1, 2017 (in thousands, except per share data): Year End December 31, 2018 2017 Revenues $ 4,809 $ 4,649 Net loss applicable to common shares (2,640 ) (4,239 ) Basic net loss per share (0.04 ) (0.07 ) Diluted net loss per share (0.04 ) (0.07 ) The unaudited pro forma results have been prepared for comparative purposes only and are not necessarily indicative of the actual results of operations had the acquisition taken place as of the beginning of the periods presented, or the results that may occur in the future. These amounts exclude costs incurred which are directly attributable to the acquisition, and which do not have a continuing impact on the combined companies’ operating results.

Cardiothoracic Closure Business

Cardiothoracic Closure Business Divestiture	12 Months Ended
	Dec. 31, 2018
Discontinued Operations and Disposal Groups [Abstract]
Cardiothoracic Closure Business Divestiture	5. Cardiothoracic Closure Business Divestiture The Company completed the sale of substantially all of the assets related to its Cardiothoracic closure business (the “CT Business”) to A&E Advanced Closure Systems, LLC (a subsidiary of A&E Medical Corporation) (“A&E”) pursuant to an Asset Purchase Agreement between the Company and A&E, dated August 3, 2017 (the “Asset Purchase Agreement”). The total cash consideration received by the Company under the Asset Purchase Agreement was composed of $54,000, $3,000 of which was held in escrow (the “Escrow Amount”) to satisfy possible indemnification obligations, of which there were none. As such, the Company earned and received the $3,000 cash consideration in the third quarter of 2018. An additional $5,000 in contingent cash consideration is earned if A&E reaches certain revenue milestones (the “Contingent Consideration”). The Company also earned and received an additional $1,000 in consideration for successfully obtaining certain U.S. Food and Drug Administration (“FDA”) regulatory clearance. As a part of the transaction, the Company also entered into a multi-year Contract Manufacturing Agreement with A&E (the “Contract Manufacturing Agreement”). Under the Contract Manufacturing Agreement, the Company agreed to continue to support the CT Business by manufacturing existing products and engineering, developing, and manufacturing potential future products for A&E. The Company elected to account for the Contingent Consideration arrangement including the Escrow Amount, as a gain contingency in accordance with ASC 450 Contingencies. As such, the Contingent Consideration and Escrow Amount were excluded in measuring the fair value of the consideration to be received in connection with the transaction. The calculation of the gain on the CT Business divestiture is as follows: Proceeds from cardiothoracic closure business divestiture $ 51,000 Inventories—net (2,893 ) Property, plant and equipment—net (1,299 ) Goodwill (8,645 ) Other intangible assets—net (280 ) Cardiothoracic closure business divestiture expenses (3,793 ) Gain on cardiothoracic closure business divestiture $ 34,090

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	6. Stock-Based Compensation The Company’s policy is to grant stock options at an exercise price equal to 100% of the market value of a share of common stock at closing on the date of the grant. The Company’s stock options generally have five to ten-year 2018 Incentive Compensation Plan – 2015 Incentive Compensation Plan – The following weighted-average assumptions were used to determine the fair value of options under FASB ASC 718: Year Ended December 31, 2018 2017 2016 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 2.75 % 2.26 % 1.85 % Volatility factor 43.74 % 47.39 % 45.57 % Dividend yield — — — Stock Options Stock options outstanding, exercisable and available for grant at December 31, 2018, are summarized as follows: Weighted Weighted Average Average Remaining Aggregate Number of Exercise Contractual Intrinsic Options Price Life (Years) Value (as restated) (as restated) (as restated) (as restated) Outstanding at January 1, 2018 4,662,037 $ 3.86 — — Granted 722,122 4.32 — — Exercised (352,015 ) 3.53 — — Forfeited or expired (756,400 ) 4.99 — — Outstanding at December 31, 2018 4,275,744 $ 3.76 4.15 $ 1,161 Vested or expected to vest at December 31, 2018 3,472,364 $ 3.77 3.93 $ 924 Exercisable at December 31, 2018 1,019,844 $ 3.94 2.43 $ 169 Available for grant at December 31, 2018 5,454,302 The aggregate intrinsic value in the table above represents the total pre-tax For the years ended December 31, 2018, 2017 and 2016, the Company recognized stock-based compensation as follows: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) Stock-based compensation: Costs of processing and distribution $ 132 $ 132 $ 140 Marketing, general and administrative 4,553 6,586 3,406 Research and development 60 44 44 Total $ 4,745 $ 6,762 $ 3,590 As of December 31, 2018, there was $2,059 of total unrecognized stock-based compensation related to nonvested stock options. That expense is expected to be recognized over a weighted-average period of 1.72 years. Other information concerning stock options are as follows: Year Ended December 31, 2018 2017 2016 Weighted average fair value of stock options granted $ 2.05 $ 1.66 $ 1.55 Aggregate intrinsic value of stock options exercised 349 2,786 12 The aggregate intrinsic value of stock options exercised in a period represents the pre-tax Restricted Stock Awards The value of restricted stock awards is determined by the market value of the Company’s common stock at the date of grant. In 2018, restricted stock awards in the amount of 686,038 shares and 141,176 shares was granted to employees and non-employee Weighted Average Number of Grant Date Shares Fair Value (as restated) (as restated) Unvested at January 1, 2018 1,120,190 $ 4.15 Granted 827,214 4.29 Vested (635,205 ) 4.07 Forfeited (279,484 ) 4.13 Unvested at December 31, 2018 1,032,715 $ 4.32 Inducement Grant President and Chief Executive Office On January 26, 2017, the Company issued an inducement grant to its President and Chief Executive Officer, Mr. Camille Farhat. This grant was in the form of: (1) a restricted stock award agreement (the “Restricted Stock Agreement #1”); (2) another restricted stock award agreement (the “Restricted Stock Agreement #2”); and (3) a stock option agreement. Under the Restricted Stock Agreement #1, the Company granted Mr. Farhat 850,000 shares of restricted common stock. On the first anniversary of the grant date, 170,000 shares will vest. The remaining shares will vest on the last day of each calendar quarter at a rate of 42,500 shares per calendar quarter commencing after the first anniversary of the grant date and continuing for four years after. Vesting of these shares may accelerate upon the occurrence of either of two performance conditions. On December 4, 2017, the Company and Mr. Farhat entered into the First Amendment to the Restricted Stock Agreement #1 (the “Amendment”). The Amendment revised the vesting conditions for the Company’s common stock, par value $0.001 per share (the “Common Stock”), granted under the Restricted Stock Agreement #1. Pursuant to the Amendment, certain acceleration conditions contained in the Restricted Stock Agreement #1 were deleted and 425,000 shares of restricted Common Stock vested on December 4, 2017 (the “Vested Grant”). If Mr. Farhat voluntarily leaves the employment of the Company (other than for “Good Reason”) or is terminated for “Cause” (as those terms are defined in the Employment Agreement between the Company and Mr. Farhat, dated January 26, 2017) on or before March 31, 2019, then Mr. Farhat will forfeit all of the shares of the Vested Grant that would not have otherwise vested under vesting schedule contained in the Restricted Stock Agreement #1 at the time of termination. Pursuant to the Amendment, Mr. Farhat will also be required to hold the shares of the Vested Grant until March 31, 2019, except to the extent those shares would have vested under the vesting schedule contained in the Restricted Stock Agreement #1 at the time of a proposed transfer by Mr. Farhat. The unaccelerated shares of restricted Common Stock granted under the Restricted Stock Agreement #1 will vest under vesting schedule contained in the Restricted Stock Agreement #1. Pursuant to the Restricted Stock Agreement #1 vesting schedule, 170,000 of the unaccelerated restricted shares vested on January 26, 2018, and the remaining unaccelerated restricted shares will vest in 42,500 share increments on the last day of each calendar quarter commencing on March 31, 2018, continuing until all unaccelerated restricted shares have vested. Under the terms of the Amendment, the final tranche of shares of restricted Common Stock granted under the Restricted Stock Agreement #1 will vest as of June 30, 2019, instead of on December 31, 2021, which would have been the case if no acceleration occurred. Under the Restricted Stock Agreement #2, the Company granted Mr. Farhat 150,000 shares of restricted common stock. These 150,000 restricted shares became fully vested, effective May 18, 2017. Under the Option Agreement, the Company granted Mr. Farhat the option to purchase 1,950,000 shares of common stock. The exercise price for the Stock Options is $3.20. The stock options will expire on January 26, 2022. The stock options will vest based on the Company’s attainment of three average stock price benchmarks. The first 650,000 shares will vest if the Company’s average publicly traded stock price is over $6.00 for a sixty-consecutive calendar day period. The next 650,000 shares will vest if the Company’s average publicly traded stock price is over $7.00 for a sixty-consecutive calendar day period. The final 650,000 shares will vest if the Company’s average publicly traded stock price is over $8.00 for a sixty-consecutive calendar day period. The vesting of the stock options is cumulative. Chief Financial and Administrative Officer On September 18, 2017, the Company issued an inducement grant to its Chief Financial and Administrative Officer, Mr. Jonathon Singer. This grant was in the form of: (1) a restricted stock award agreement (the “Restricted Stock Agreement”); and (2) a stock option agreement. This inducement grant was made under the RTI Surgical, Inc. 2015 Incentive Compensation Plan, which was filed with the SEC on May 5, 2015. Under the Restricted Stock Agreement, the Company granted Mr. Singer 109,890 shares of restricted Common Stock. The shares will vest over a three-year period. On the first anniversary of the grant date, 36,630 shares vested. On the second anniversary of the grant date, an additional 36,630 shares will vest. On the third anniversary of the grant date, the final 36,630 shares will vest. Under the Option Agreement, the Company granted Mr. Singer the option to purchase 306,900 shares of Common Stock, as of the grant date. The exercise price for the Stock Options is $4.55 per share. The stock options will expire on September 18, 2027. The stock options will vest based the Company’s attainment of three average stock price benchmarks. The first 102,300 shares will vest if the Company’s average publicly traded stock price is over $7.00 per share for a sixty-consecutive calendar day period. The next 102,300 shares will vest if the Company’s average publicly traded stock price is over $8.00 per share for a sixty-consecutive calendar day period. The final 102,300 shares will vest if the Company’s average publicly traded stock price is over $9.00 per share for a sixty-consecutive calendar day period. The vesting of the stock options is cumulative.

Inventories

Inventories	12 Months Ended
	Dec. 31, 2018
Inventory Disclosure [Abstract]
Inventories	7. Inventories Inventories by stage of completion are as follows: December 31, 2018 2017 (as restated) (as restated) Unprocessed tissue, raw materials and supplies $ 24,211 $ 22,071 Tissue and work in process 31,796 40,481 Implantable tissue and finished goods 51,648 49,392 $ 107,655 $ 111,944 For the years ended December 31, 2018, 2017, and 2016, the Company had inventory write-downs of $15,122, $5,066 and $13,880, respectively, relating primarily to excess quantities and obsolescence of inventories. Included in the year ended December 31, 2018, are $1,023 of product obsolescence related to the rationalization of our international distribution infrastructure and $6,559 of inventory write-off ® write-off

Prepaid and Other Current Asset

Prepaid and Other Current Assets	12 Months Ended
	Dec. 31, 2018
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Prepaid and Other Current Assets	8. Prepaid and Other Current Assets Prepaid and Other Current Assets are as follows: December 31, 2018 2017 (as restated) (as restated) Income tax receivable $ 3,920 $ 10,241 Receivable for executive stock option exercise — 1,234 Prepaid expenses 2,013 1,592 Other 2,480 3,559 $ 8,413 $ 16,626

Property, Plant and Equipment

Property, Plant and Equipment	12 Months Ended
	Dec. 31, 2018
Property, Plant and Equipment [Abstract]
Property, Plant and Equipment	9. Property, Plant and Equipment Property, plant and equipment are as follows: December 31, 2018 2017 Land $ 2,020 $ 2,020 Buildings and improvements 58,093 57,954 Processing equipment 42,599 44,137 Surgical instruments 24,070 21,256 Office equipment, furniture and fixtures 1,877 1,352 Computer equipment and software 18,873 19,332 Construction in process 8,934 5,980 156,466 152,031 Less accumulated depreciation (78,512 ) (72,467 ) $ 77,954 $ 79,564 For the years ended December 31, 2018, 2017, and 2016, the Company had depreciation expense in connection with property, plant and equipment of $10,619, $10,513, and $12,835, respectively. For the year ended December 31, 2018, the Company recorded asset impairment and abandonment charges of $1,797, relating to lower distributions of our map3 ®

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	10. Goodwill The change in the carrying amount of goodwill for the year ended December 31, 2018, is as follows: Year Ended December 31, 2018 2017 Balance at January 1 $ 46,242 $ 54,887 Goodwill acquired related to Zyga acquisition 13,556 — Goodwill disposed of related to sale of Cardiothoracic closure business — 8,645 Balance at December 31 $ 59,798 $ 46,242 Goodwill acquired during the year ended December 31, 2018, includes the excess of the Zyga purchase price over the sum of the amounts assigned to assets acquired less liabilities assumed. The Company considered the decreased forecasted distributions of our map3 ®

Other Intangible Assets

Other Intangible Assets	12 Months Ended
	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Other Intangible Assets	11. Other Intangible Assets Other intangible assets are as follows: December 31, 2018 December 31, 2017 Gross Gross Carrying Accumulated Carrying Accumulated Amount Amortization Amount Amortization (as restated) (as restated) (as restated) (as restated) Patents $ 15,469 $ 4,191 $ 11,061 $ 4,892 Acquired licensing rights 11,671 6,468 14,566 9,097 Marketing and procurement intangible assets 20,355 11,279 20,603 9,667 Total $ 47,495 $ 21,938 $ 46,230 $ 23,656 For the years ended December 31, 2018, 2017, and 2016, the Company had amortization expense of other intangible assets of $3,960, $3,720, and $3,693, respectively. For the year ended December 31, 2018, the Company recorded asset impairment and abandonment charges of $3,029, including $2,718 relating to lower distributions of our map3 ® At December 31, 2018, management’s estimates of future amortization expense for the next five years are as follows: Amortization Expense 2019 $ 4,200 2020 4,100 2021 4,100 2022 4,100 2023 1,800

Fair Value Information

Fair Value Information	12 Months Ended
	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Fair Value Information	12. Fair Value Information Fair value is defined as the price that would be received upon the sale of an asset or paid to transfer a liability in an orderly transaction between market participants on the measurement date. Valuation techniques used to measure fair value maximize the use of observable inputs and minimize the use of unobservable inputs. The fair value hierarchy defines a three-level valuation hierarchy for classification and disclosure of fair value measurements as follows: Level 1 – Quoted prices in active markets for identical assets or liabilities. Level 2 – Inputs other than Level 1 that are observable, either directly or indirectly, such as quoted prices for similar assets or liabilities; quoted prices in markets that are not active; or other inputs that are observable or can be corroborated by observable market data for substantially the full term of the assets or liabilities. Level 3 – Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. On January 4, 2018, the Company acquired Zyga as further explained in Note 4 above. The Company estimates a contingent liability related to the clinical milestone and revenue based earnout of $4,986. The fair value of the contingent liability was measured using Level 3 inputs. Long-lived assets, including property and equipment and intangible assets subject to amortization were impaired and written down to their estimated fair values during the second quarter of 2018 and the fourth quarter of 2016. Fair value is measured as of the impairment date using Level 3 inputs. The long-lived asset level 3 fair value was determined using a market approach, which used inputs that included replacement costs (unobservable), physical deterioration estimates (unobservable), economic obsolescence (unobservable), and market sales data for comparable assets. The following table summarizes impairments of long-lived assets and the related post impairment fair values of the corresponding assets for the year ended December 31, 2016 and 2018: Year Ended December 31, 2016 Impairment Fair Value Property, plant and equipment - net $ 4,717 $ 4,708 Other intangible assets - net 718 150 $ 5,435 $ 4,858 Year Ended December 31, 2018 Impairment Fair Value Property, plant and equipment - net $ 1,797 $ — Other intangible assets - net 2,718 — $ 4,515 $ — No impairments on long-lived assets were recorded for the year ended December 31, 2017.

Accrued Expenses

Accrued Expenses	12 Months Ended
	Dec. 31, 2018
Other Liabilities Disclosure [Abstract]
Accrued Expenses	13. Accrued Expenses Accrued expenses are as follows: December 31, 2018 2017 (as restated) (as restated) Accrued compensation $ 8,308 $ 8,257 Accrued severance and restructuring costs 1,302 3,122 Accrued executive transition costs 43 2,300 Accrued distributor commissions 3,907 3,889 Accrued donor recovery fees 3,018 4,144 Other 9,287 4,047 $ 25,865 $ 25,759

Short and Long-Term Obligations

Short and Long-Term Obligations	12 Months Ended
	Dec. 31, 2018
Debt Disclosure [Abstract]
Short and Long-Term Obligations	14. Short and Long-Term Obligations Short and long-term obligations are as follows: December 31, December 31, 2018 2017 Term loan $ — $ 24,250 Revolving credit facility 50,000 22,500 Less unamortized debt issuance costs (927 ) (406 ) Total 49,073 46,344 Less current portion — (4,268 ) Long-term portion $ 49,073 $ 42,076 On June 5, 2018, the Company terminated its 2017 loan agreement with TD Bank, N.A. and First Tennessee Bank National Association. The 2017 loan agreement provided for a revolving credit facility in the aggregate principal amount of $42,500. Borrowings under the 2017 loan agreement had an interest rate per annum equal to monthly LIBOR plus a margin of up to 3.50%. The maturity date of the revolving credit facility was September 15, 2019. On June 5, 2018, the Company entered into a Credit Agreement (the “2018 Credit Agreement”), as borrowers, with JP Morgan Chase Bank, N.A., as lender (together with the various financial institutions as in the future may become parties thereto, the “Lenders”) and as administrative agent for the Lenders. The 2018 Credit Agreement provides for a revolving credit facility in the aggregate principal amount of up to $100,000 (the “Facility”). The Company and Pioneer will be able to, at their option, and subject to customary conditions and Lender approval, request an increase to the Facility by up to $50,000. The Facility is guaranteed by the Company’s domestic subsidiaries and is secured by: (i) substantially all of the assets of the Company and Pioneer; (ii) substantially all of the assets of each of the Company’s domestic subsidiaries; and (iii) 65% of the stock of the Company’s foreign subsidiaries. The initial borrowings made under the 2018 Credit Agreement will bear interest at a rate per annum equal to the monthly REVLIBOR30 Rate (“CBFR Loans”) plus an adjustable margin of up to 2.00% (the “CBFR Rate”). The Company may elect to convert the interest rate for the initial borrowings to a rate per annum equal to the adjusted LIBO Rate (“Eurodollar Loans”) plus an adjustable margin of up to 2.00% (the “Eurodollar Rate”). For all subsequent borrowings, the Company may elect to apply either the CBFR Rate or Eurodollar Rate. The applicable margin is subject to adjustment after the end of each fiscal quarter, based upon the Company’s average quarterly availability. The maturity date of the Facility is June 5, 2023. The Company may make optional prepayments on the Facility without penalty. The Company paid certain customary closing costs and bank fees upon entering into the 2018 Credit Agreement in the amount of $1,049. The Company is subject to certain affirmative and negative covenants, including (but not limited to), covenants limiting the Company’s ability to: incur certain additional indebtedness; create certain liens; enter into sale and leaseback transactions; and consolidate or merge with, or convey, transfer or lease all or substantially all of its assets to another person. The Company is required to maintain a minimum fixed charge coverage ratio of at least 1.00:1.00 (the “Required Minimum Fixed Charge Coverage Ratio”) during either of the following periods (each, a “Covenant Testing Period”): (i) a period beginning on a date that a default has occurred and is continuing under the loan documents entered into by the Company in conjunction with the 2018 Credit Agreement through the first date on which no default has occurred and is continuing; or (ii) a period beginning on a date that availability under the Facility is less than the specified covenant testing threshold and continuing until availability under the Facility is greater than or equal to the specified covenant testing threshold for thirty (30) consecutive days. The Required Minimum Fixed Charge Coverage Ratio is measured on the last day of each calendar month during the Covenant Testing Period (each a “Calculation Date”), and is calculated using the minimum fixed charge coverage ratio for the twelve (12) consecutive months ended on each Calculation Date. The amounts owed under the 2018 Credit Agreement may be accelerated upon the occurrence of certain events of default customary for facilities for similarly rated borrowers. At December 31, 2018, the interest rate for the Facility was 4.10%. As of December 31, 2018, there was $50,000 outstanding on the Facility and total remaining available credit on the Facility was $43,713. The Company’s ability to access the Facility is subject to and can be limited by the Company’s compliance with the Company’s financial and other covenants. The Company was in compliance with the financial covenants related to the Facility as of December 31, 2018. Interest expense associated with the amortization of debt issuance costs for the years ended December 31, 2018, 2017 and 2016 was $528, $409 and $202, respectively. For the year ended December 31, 2018, loss on extinguishment of debt associated with refinancing the Company’s debt was $309.

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Income Taxes	15. Income Taxes The Company’s pre-tax income consists of the following components: Year Ended December 31, 2018 2017 2016 Pre-tax income: Domestic (U.S., state and local) $ (9,052 ) $ 30,121 $ (7,722 ) Foreign 1,661 (3,866 ) (9,314 ) Total (7,391 ) 26,255 (17,036 ) The Company’s income tax benefit (provision) consists of the following components: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) Current: Federal $ 967 $ (2,910 ) $ (88 ) State (205 ) (833 ) (84 ) International (376 ) — 456 Total current 386 (3,743 ) 284 Deferred: Federal 2,356 (14,554 ) 2,547 State (2,446 ) (1,052 ) 589 International 3,972 — (192 ) Total deferred 3,882 (15,606 ) 2,944 Total income tax benefit (provision) $ 4,268 $ (19,349 ) $ 3,228 The Company’s deferred tax assets and liabilities consists of the following components: December 31, 2018 December 31, 2017 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities (as restated) (as restated) (as restated) (as restated) Accounts receivable $ 513 $ — $ 190 $ — Accrued liabilities 2,358 — 2,072 — Deferred compensation 1,372 — 1,783 — Fixed assets and intangibles — (5,862 ) 66 (7,370 ) Inventory 7,631 — 5,905 — Net operating losses 8,198 — 8,106 — Revenue 650 — 1,874 — Tax credits 5,993 — 4,263 — Other — — — (110 ) Valuation allowance (3,093 ) — (7,258 ) — Total $ 23,622 $ (5,862 ) $ 16,935 $ (7,480 ) The Company expects its deferred tax assets of $17,760 net of the valuation allowance at December 31, 2018 of $3,093, to be realized through the generation of future taxable income and the reversal of existing taxable temporary differences. On December 22, 2017, the U.S. government enacted the Tax Cuts and Jobs Act of 2017 (the “Tax Legislation”). The Tax Legislation makes broad and complex changes to the U.S. tax code including, but not limited to the following: • Reduction of the U.S. federal corporate tax rate from 35% to 21%; • Requiring a transition tax on certain unrepatriated earnings of foreign subsidiaries; • Bonus depreciation that will allow for full expensing of qualified property; • Elimination of the corporate alternative minimum tax; • The repeal of the domestic production activity deduction; • Limitations on the deductibility of certain executive compensation; and • Limitations on net operating losses generated after December 31, 2017. In addition, beginning in 2018, the Tax Legislation includes a global intangible low-taxed On December 22, 2017, the SEC staff issued SAB 118, which provides guidance on accounting for the tax effects of the Tax Legislation. SAB 118 provides a measurement period that should not extend beyond one year from the Tax Legislation enactment date for companies to complete the accounting under ASC 740. The Company has completed its accounting for the tax effects of the Tax Legislation. In 2018, the Company recorded a tax benefit of $650, and in 2017, the Company recorded a tax provision of $2,187, relating to the revaluation of deferred tax assets and transition tax. Valuation allowances are established when necessary to reduce deferred tax assets to amounts which are more likely than not to be realized. As such, valuation allowances of $3,093, and $7,258 have been established at December 31, 2018 and December 31, 2017, respectively, against a portion of the deferred tax assets. As of December 31, 2018, the Company has U.S. federal net operating loss carryforwards of $9,973 that will expire in years 2026 through 2037. In addition, the Company has U.S. federal net operating loss carryforwards of $1,337 that will carryforward indefinitely. As of December 31, 2018, the Company has U.S. state net operating loss carryforwards of $41,844 that will expire in the years 2022 through 2038. As of December 31, 2018, the Company has foreign net operating loss carryforwards of $13,754 that will carryforward indefinitely. As of December 31, 2018, the Company has research tax credit carryforwards of $6,270 that will expire in years 2029 through 2038. U.S. income taxes have not been provided on the undistributed earnings of the Company’s foreign subsidiaries. It is not practicable to estimate the amount of tax that might be payable. The Company’s intention is to indefinitely reinvest earnings of its foreign subsidiaries outside of the U.S. The Company evaluates the need for deferred tax asset valuation allowances based on a more likely than not standard. The ability to realize deferred tax assets depends on the ability to generate sufficient taxable income within the carryback or carryforward periods provided for in the tax law for each applicable tax jurisdiction. The assessment regarding whether a valuation allowance is required or should be adjusted also considers all available positive and negative evidence. It is difficult to conclude a valuation allowance is not required when there is significant objective and verifiable negative evidence, such as cumulative losses in recent years. The Company utilizes a rolling three-years of actual results as the primary measure of cumulative losses in recent years. On a rolling three-years, the Company’s consolidated U.S. operations are in a cumulative income position. However, one U.S. entity (“Entity”) is in a three-year cumulative loss position. The Company has established a valuation allowance on the Entity’s separate state deferred tax assets. The Company’s foreign operations are in three-year cumulative loss position. Future taxable income exclusive of reversing temporary differences and carryforwards is one source of taxable income that may be available under the tax law to realize a tax benefit for deductible temporary differences and carryforwards. Beginning in 2017 the company began a restructuring plan, which was finalized in 2018. The efforts under this plan have led the Company to achieve operational excellence and a reduction in complexities which resulted in current year positive earnings within its foreign subsidiary. The changes within the operations are projected to generate future taxable earnings. The Company considers the current year and future earnings to be objectively verifiable evidence which will allow the Company to fully utilize its foreign deferred tax assets. The Company believes this positive evidence outweighs the negative evidence of its foreign subsidiaries’ cumulative three-year loss position, resulting in a release of allowance related to foreign deferred tax assets. The Company will continue to regularly assess the realizability of our deferred tax assets. Changes in historical earnings performance and future earnings projections, among other factors, may cause the Company to adjust its valuation allowance, which would impact the Company’s income tax expense in the period the Company determines that these factors have changed. As of December 31, 2018, the Company has $1,088 of unrecognized tax benefits, which was recorded net against deferred tax assets in the accompanying consolidated balance sheet. The Company’s unrecognized tax benefits are summarized as follows: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) Opening balance $ 1,591 $ 1,591 $ 1,986 Reductions based on tax positions related to the current year — — — Additions for tax positions of prior years — — — Reductions for tax positions of prior years (415 ) — (60 ) Reductions for expiration of statute of limitations (88 ) — (335 ) $ 1,088 $ 1,591 $ 1,591 The unrecognized tax benefits if recognized, would favorably impact the Company’s effective tax rate. The Company’s policy is to recognize interest accrued related to unrecognized tax benefits in interest expense and penalties in the provision for income taxes. Interest and penalties recorded in 2018, 2017 and 2016 and interest and penalties accrued at December 31, 2018 and 2017 were inconsequential. During the year ended December 31, 2018, the Internal Revenue Service (“IRS”) completed its examination of the Company’s 2015 U.S. federal income tax return. No material adjustments were recorded to the Company’s consolidated financial statements as a result of the examination. The effective tax rate differs from the statutory federal income tax rate for the following reasons: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) Statutory federal rate 21.00% 35.00% 35.00% State income taxes—net of federal tax benefit (4.58% ) 2.37% 1.73% Foreign rate differential 14.36% 2.54% (2.47% ) Acquisition expenses (7.26% ) — — Goodwill disposal — 11.52% — Life insurance (0.98% ) (1.38% ) — Officer compensation (7.88% ) 4.18% — Stock-based compensation (3.90% ) 6.06% — Tax credits 8.65% (4.53% ) 7.28% Tax legislation 9.23% 8.33% — Valuation allowances 21.93% 6.08% (22.11% ) Uncertain tax positions 6.86% — — Other reconciling items, net 0.32% 3.52% (0.48% ) Effective tax rate 57.75% 73.69% 18.95%

Preferred Stock

Preferred Stock	12 Months Ended
	Dec. 31, 2018
Equity [Abstract]
Preferred Stock	16. Preferred Stock Preferred stock is as follows: Preferred Stock Preferred Stock Net Liquidation Value Issuance Costs Total Balance at January 1, 2016 $ 57,168 $ (845 ) $ 56,323 Accrued dividend 3,508 — 3,508 Amortization of preferred stock issuance costs — 185 185 Balance at December 31, 2016 60,676 (660 ) 60,016 Accrued dividend 3,723 — 3,723 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2017 64,399 (476 ) 63,923 Accrued dividend 2,120 — 2,120 Amortization of preferred stock issuance costs — 183 183 Balance at December 31, 2018 $ 66,519 $ (293 ) $ 66,226 On June 12, 2013, the Company and WSHP Biologics Holdings, LLC, an affiliate of Water Street Healthcare Partners, a leading healthcare-focused private equity firm (“Water Street”), entered into an investment agreement. Pursuant to the terms of the investment agreement, the Company issued $50,000 of convertible preferred equity to Water Street in a private placement which closed on July 16, 2013, with preferred stock issuance costs of $1,290. The preferred stock accrues dividends at a rate of 6% per annum. To the extent dividends are not paid in cash in any quarter, the dividends which have accrued on each outstanding share of preferred stock during such three-month period will accumulate until paid in cash or converted to common stock. The Preferred Stock will be convertible at the election of the holders into shares of the Company’s common stock at an initial conversion price of $4.39 per share which would result in a conversion ratio of approximately 228 shares of common stock for each share of Preferred Stock. The Preferred Stock is convertible at the election of the Company five years after its issuance or at any time if the Company’s common stock closes at or above $7.98 per share for at least 20 consecutive trading days. The Company may, upon 30 days’ notice, redeem the Preferred Stock, in whole or in part, five years after its issuance at the initial liquidation preference of $1,000 per share of the Preferred Stock plus an amount per share equal to accrued but unpaid dividends (collectively, the “Liquidation Value”). The holders of the Preferred Stock may require the Company to redeem their Preferred Stock, in whole or in part, at the Liquidation Value seven years after its issuance or upon the occurrence of a change of control. On August 1, 2018, the Company and WSHP Biologics Holdings, LLC, a related party, entered into an Amended and Restated Certificate of Designation of Series A Convertible Preferred Stock of RTI Surgical, Inc. (the “Amended and Restated Certificate of Designation”). Pursuant to the Amended and Restated Certificate of Designation: (1) dividends on the Series A Preferred Stock will not accrue after July 16, 2018 (in the event of a default by the Company, dividends will begin accruing and will continue to accrue until the default is cured); (2) the Company may not force a redemption of the Series A Preferred Stock prior to July 16, 2020; and (3) the holders of the Series A Preferred Stock may not convert the Series A Preferred Stock into common stock prior to July 16, 2021 (with certain exceptions). The Company evaluated and concluded on a qualitative basis the amendment qualifies as modification accounting to the preferred shares, which did not result in a change in the valuation of the shares.

Stockholders' Equity

Stockholders' Equity	12 Months Ended
	Dec. 31, 2018
Equity [Abstract]
Stockholders' Equity	17. Stockholders’ Equity Preferred Stock Common Stock

Executive Transition Costs

Executive Transition Costs	12 Months Ended
	Dec. 31, 2018
Restructuring and Related Activities [Abstract]
Executive Transition Costs	18. Executive Transition Costs The Company recorded Chief Executive Officer retirement and transition costs related to the retirement of our former Chief Executive Officer pursuant to the Executive Transition Agreement dated August 29, 2012 (as amended and extended to date), which resulted in $4,404 of expenses for the year ended December 31, 2016. The total Chief Executive Officer retirement and transition costs are expected to be paid in full in the first quarter of 2019. In addition, the Company recorded executive transition costs of $2,818 as a result of hiring a new Chief Executive Officer and Chief Financial and Administrative Officer for the year ended December 31, 2017, separately disclosed on the Consolidated Statements of Comprehensive (Loss) Income. The total executive transition costs of which $1,169 is cash basis was paid in full in 2018. The following table includes a rollforward of executive transition costs included in accrued expenses, see Note 13. As Accrued executive transition costs at January 1, 2016 $ — Executive transition costs accrued in 2016 4,404 Stock-based compensation (1,535 ) Cash payments (463 ) Accrued executive transition costs at December 31, 2016 2,406 Executive transition costs accrued in 2017 2,818 Stock-based compensation (1,612 ) Cash payments (1,275 ) Accrued executive transition costs at December 31, 2017 2,337 Executive transition costs accrued in 2018 — Cash payments (2,294 ) Accrued executive transition costs at December 31, 2018 $ 43

Severance and Restructuring Cos

Severance and Restructuring Costs	12 Months Ended
	Dec. 31, 2018
Restructuring and Related Activities [Abstract]
Severance and Restructuring Costs	19. Severance and Restructuring Costs The Company recorded severance and restructuring costs related to the reduction of our organizational structure which resulted in $2,146 of expenses for the year ended December 31, 2016. The total severance and restructuring costs were paid in full in the first quarter of 2018. Severance and restructuring payments were made over periods ranging from one month to twelve months and did not have a material impact on cash flows of the Company in any quarterly period. The Company recorded severance and restructuring costs related to the reduction of our organizational structure which resulted in $12,016 of expenses for the year ended December 31, 2017. The total severance and restructuring costs were paid in full in the fourth quarter of 2018. Severance and restructuring payments were made over periods ranging from one month to twelve months and did not have a material impact on cash flows of the Company in any quarterly period. The Company recorded severance and restructuring costs related to the reduction of our organizational structure which resulted in $2,808 of expenses for the year ended December 31, 2018. The total severance and restructuring costs are expected to be paid in full by the fourth quarter of 2019. Severance and restructuring payments are made over periods ranging from one month to twelve months and are not expected to have a material impact on cash flows of the Company in any quarterly period. The following table includes a rollforward of severance and restructuring costs included in accrued expenses, see Note 13. As Restated Accrued severance and restructuring charges at January 1, 2016 $ 865 Severance and restructuring expenses accrued in 2016 2,146 Severance and restructuring cash payments (1,866 ) Asset abandonments (640 ) Accrued severance and restructuring charges at December 31, 2016 505 Severance and restructuring expenses accrued in 2017 12,016 Severance and restructuring cash payments (8,246 ) Stock based compensation (1,153 ) Accrued severance and restructuring charges at December 31, 2017 3,122 Severance and restructuring expenses accrued in 2018 2,808 Severance and restructuring cash payments (4,628 ) Accrued severance and restructuring charges at December 31, 2018 $ 1,302

Retirement Benefits

Retirement Benefits	12 Months Ended
	Dec. 31, 2018
Retirement Benefits [Abstract]
Retirement Benefits	20. Retirement Benefits The Company has a qualified 401(k) plan available to all U.S. employees who meet certain eligibility requirements. The 401(k) plan allows each employee to contribute up to the annual maximum allowed under the Internal Revenue Code. The Company has the discretion to make matching contributions up to 6% of the employee’s earnings. For the years ended December 31, 2018, 2017 and 2016, the amounts expensed under the plan were $2,757, $3,036 and $3,094, respectively.

Concentrations of Risk

Concentrations of Risk	12 Months Ended
	Dec. 31, 2018
Risks and Uncertainties [Abstract]
Concentrations of Risk	21. Concentrations of Risk Distribution Year Ended December 31, 2018 2017 2016 (as reported) (as reported) (as reported) Percent of revenues derived from: Distributor Zimmer 21 % 17 % 16 % Medtronic 8 % 9 % 9 % Synthes 5 % 4 % 4 % The Company’s distribution agreements are subject to termination by either party for a variety of causes. No assurance can be given that such distribution agreements will be renewed beyond their expiration dates, continue in their current form or at similar rate structures. Any termination or interruption in the distribution of the Company’s implants through one of its major distributors could have a material adverse effect on the Company’s operations. Tissue Supply

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	22. Commitments and Contingencies Agreement to acquire Paradigm ® ® Under the terms of the agreement, the Company will pay $100,000 in cash and issue 10,729,614 shares of RTI common stock at closing, and revenue based earnout consideration of up to $150,000 in a combination of cash and RTI common stock. The shares of RTI stock to be issued at closing were valued based on the volume weighted average closing trading price for the five trading days prior to the date of execution of the definitive agreement, representing $50,000 of value. RTI intends to fund the cash portion of the consideration with approximately $100,000 in new, fully-committed debt financing. The Company has not completed its preliminary purchase price allocation. Acquisition of Zyga ® Distribution Agreement with A&E Distribution Agreement with Medtronic non-exclusive 12-month non-renewal Distribution Agreement with Zimmer Dental Inc. Distribution Agreement with Davol non-refundable non-refundable The Company’s aforementioned revenue recognition methods related to the Zimmer and Davol distribution agreements do not result in the deferral of revenue less than amounts that would be refundable in the event the agreements were to be terminated in future periods. Additionally, the Company evaluates the appropriateness of the aforementioned revenue recognition methods on an ongoing basis. Leases non-cancelable Future minimum lease commitments under non-cancelable Operating 2019 $ 1,374 2020 806 2021 276 2022 162 2023 166 2024 and beyond 882 $ 3,666

Legal and Regulatory Actions

Legal and Regulatory Actions	12 Months Ended
	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Legal and Regulatory Actions	23. Legal and Regulatory Actions The Company is, from time to time, involved in litigation relating to claims arising out of its operations in the ordinary course of business. The Company believes that none of these claims that were outstanding as of December 31, 2018 will have a material adverse impact on its financial position or results of operations. The Company’s accounting policy is to accrue for legal costs as they are incurred. Coloplast — co-defendant In addition to claims made directly against the Company, Coloplast, a distributor of TSM’s and certain allografts processed and private labeled for them under a contract with the Company, has also been named as a defendant in individual TSM cases in various federal and state courts. Coloplast requested that the Company indemnify or defend Coloplast in those claims which allege injuries caused by the Company’s allograft implants, and on April 24, 2014, Coloplast sued RTI Surgical, Inc. in the Fourth Judicial District of Minnesota for declaratory relief and breach of contract. On December 11, 2014, Coloplast entered into a settlement agreement with RTI Surgical, Inc. and Tutogen Medical, Inc. (the “Company Parties”) resulting in dismissal of the case. Under the terms of the settlement agreement, the Company Parties are responsible for the defense and indemnification of two categories of present and future claims: (1) tissue only (where Coloplast is solely the distributor of Company processed allograft tissue and no Coloplast-manufactured or distributed synthetic mesh is identified) (“Tissue Only Claims”), and (2) tissue plus non-Coloplast (“Tissue-Non-Coloplast Tissue-Non-Coloplast Based on the current information available to the Company, the impact that current or any future TSM litigation may have on the Company cannot be reasonably estimated. LifeNet — map3 ® — ® ® on-site ® non-compliance. ® ® During the second quarter of 2018 the Company, based on its ongoing dialogue with the FDA and the continued negative impact of the warning letter on map3 ® ® ® write-off During the third quarter of 2018, the Company decided to stop procurement, manufacturing and distributing its map3 ® ®

Segment Data

Segment Data	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Segment Data	24. Segment Data The Company distributes human tissue, bovine and porcine animal tissue, metal and synthetic implants through various distribution channels. The Company operates in one reportable segment composed of four lines of business. Effective January 1, 2018, the reporting of the Company’s lines of business is composed of four franchises or lines of business: spine; sports; OEM and international. The Company’s previous lines of business were composed of: spine; sports medicine and orthopedics; surgical specialties; cardiothoracic; international; and OEM. Effective January 1, 2018, the other revenues category is included in the OEM line of business. The prior year comparable revenue information has been restated to conform to the current year presentation. The Company believes that the change in the reporting of its lines of business is aligned with the Company’s focused strategy of reducing complexity and better understanding of its lines of business. Discrete financial information is not available for these four lines of business. The following table presents revenues from these four franchises and their respective percentages of the Company’s total revenues for the years ended December 31, 2018, 2017 and 2016: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) (In thousands) Revenues: Spine $ 79,812 28.4 % $ 77,646 27.6 % $ 74,086 26.9 % Sports 54,560 19.5 % 57,070 20.4 % 54,629 19.8 % OEM 120,024 42.8 % 111,506 39.8 % 111,013 40.2 % International 25,966 9.3 % 25,964 9.3 % 25,109 9.1 % Cardiothoracic — 0.0 % 8,163 2.9 % 11,147 4.0 % Total revenues $ 280,362 100.0 % $ 280,349 100.0 % $ 275,984 100.0 % The following table presents property, plant and equipment—net by significant geographic location: December 31, 2018 2017 Property, plant and equipment - net: Domestic $ 72,501 $ 73,363 International 5,453 6,201 Total $ 77,954 $ 79,564

Quarterly Results of Operations

Quarterly Results of Operations (Unaudited)	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Quarterly Results of Operations (Unaudited)	25. Quarterly Results of Operations (Unaudited) The following tables sets forth the results of operations for the periods indicated (the quarterly results of operations for the year ended December 31, 2018 reflects our adoption of Financial Accounting Standards Board issued Accounting Standards Update (“ASU”) 2014-09, Year Ended December 31, 2018 First Second Third Fourth Quarter Quarter Quarter Quarter (as restated) (as restated) (as restated) (as restated) Revenues $ 69,141 $ 70,385 $ 70,450 $ 70,386 Gross profit 33,503 29,899 38,228 38,013 Net (loss) income (1,117 ) (5,802 ) 2,997 799 Net (loss) income per common share - basic $ (0.03 ) $ (0.11 ) $ 0.04 $ 0.01 Net (loss) income per common share - diluted $ (0.03 ) $ (0.11 ) $ 0.04 $ 0.01 Year Ended December 31, 2017 First Second Third Fourth Quarter Quarter Quarter Quarter (as restated) (as restated) (as restated) (as restated) Revenues $ 70,414 $ 71,578 $ 67,246 $ 71,111 Gross profit 36,189 36,661 33,812 36,410 Net (loss) income (1,877 ) (1,665 ) 17,676 (7,228 ) Net (loss) income per common share - basic $ (0.05 ) $ (0.04 ) $ 0.28 $ (0.13 ) Net (loss) income per common share - diluted $ (0.05 ) $ (0.04 ) $ 0.23 $ (0.13 )

Subsequent Events

Subsequent Events	12 Months Ended
	Dec. 31, 2018
Subsequent Events [Abstract]
Subsequent Events	26. Subsequent Events The Company evaluated subsequent events as of the issuance date of the consolidated financial statements as defined by FASB ASC 855 Subsequent Events

Restatement of Prior Period Fin

Restatement of Prior Period Financial Statements	12 Months Ended
	Dec. 31, 2018
Accounting Changes and Error Corrections [Abstract]
Restatement of Prior Period Financial Statements	27. Restatement of Prior Period Financial Statements Subsequent to the original issuance of its consolidated financial statements, the Company identified certain errors in its historical annual consolidated financial statements, primarily related to the timing of the recognition of revenue for goods shipped early to customers without obtaining authorized approval. Based on the results of the Investigation, the Company has concluded that revenue for certain invoices should have been recognized at a later date than when originally recognized. In response to binding purchase orders from certain OEM customers, goods were shipped and received by the customers before requested delivery dates and agreed-upon delivery windows. In many instances the OEM customers requested or approved the early shipments, but the Company has determined that on other occasions the goods were delivered early without request by the customer or obtaining the customers’ affirmative approval. In addition, the Company has concluded that in July 2017 an adjustment was improperly made to a product return provision in the Direct Division. The revenue for shipments with unapproved early delivery is being restated, as well as for other orders that shipped earlier than the purchase order due date in the system for which the Company could not locate evidence that the OEM customers had requested or approved the shipments. The Company has concluded that in the periods from 2015 through the fourth quarter of 2018, certain adjustments were improperly or erroneously made via manual journal entries to accrual/reserve accounts, including a July 2017 adjustment to a product return provision in the Direct Division, among others. Accordingly, the Company has restated its financial statements to correct these errors. As such the restated audited financial statements for the years ended December 31, 2018, 2017 and 2016, and the unaudited financial statements for the quarterly periods within these years commencing with the first quarter of 2016, are defined as the “Restated Periods”. In addition to the correction of the errors discussed above, the Company has also made other immaterial corrections in all periods presented. Such immaterial corrections reflected in the Restated Periods and, together with the other corrections described above, are referred to herein as “Current and Prior Period Adjustments.” The corrections are included in these financial statements contained herein, which we refer to herein collectively as the “Restatement”. This Note 27 to the Company’s consolidated financial statements discloses the impact on the restated financial statements for the years ended December 31, 2018, 2017, and 2016 and the nature of the associated adjustments. The impact of the Restatement on interim periods in 2018, 2017, and 2016 is described in Note 28. The corrections included in the financial statements contained herein are further described below. The corrections included in these financial statements contained herein, which we refer to herein collectively as the “Restatement,” were prepared following an independent review by the Audit Committee of the Company’s Board of Directors. Impact of Restatement The following errors in the Company’s annual financial statements were identified and corrected as a result of the Investigation and the Current and Prior Period Adjustments: a. Revenue b. Costs of processing and distribution c. Operating expenses d. Accounts receivable e. Inventories - net f. Prepaid and other current assets g. Property, plant and equipment – net h. Deferred tax assets i. Other intangible assets – net j. Accounts payable k. Accrued expenses l. Other long-term liabilities m. Payments for treasury stock Restated Condensed Consolidated Balance Sheet Amounts (in thousands) As of December 31, 2018 As Previously Adjustments As Restated Accounts receivable $ 48,351 $ (255) $ 48,096 Inventories - net 107,471 184 107,655 Prepaid and other current assets 8,791 (378 ) 8,413 Total current assets 175,562 (449 ) 175,113 Deferred tax assets - net 17,510 250 17,760 Other intangible assets - net 26,359 (802 ) 25,557 Total assets $ 361,186 $ (1,001 ) $ 360,185 Accounts payable $ 26,309 $ (90) $ 26,219 Accrued expenses 24,683 1,182 25,865 Total current liabilities 55,900 1,092 56,992 Total liabilities 111,336 1,092 112,428 Accumulated deficit (237,444 ) (2,093 ) (239,537 ) Total stockholders’ equity 183,624 (2,093 ) 181,531 Total liabilities and stockholders’ equity $ 361,186 $ (1,001 ) $ 360,185 As of December 31, 2017 As Previously Adjustments As Restated Accounts receivable $ 35,081 $ 117 $ 35,198 Inventories - net 111,927 17 111,944 Prepaid and other current assets 16,285 341 16,626 Total current assets 185,674 475 186,149 Deferred tax assets - net 9,575 (120 ) 9,455 Other intangible assets - net 23,070 (496 ) 22,574 Total assets $ 345,906 $ (141 ) $ 345,765 Accounts payable $ 18,252 $ (70) $ 18,182 Accrued expenses 25,610 149 25,759 Total current liabilities 52,998 79 53,077 Total liabilities 100,246 79 100,325 Accumulated deficit (237,066 ) (220 ) (237,286 ) Total stockholders’ equity 181,737 (220 ) 181,517 Total liabilities and stockholders’ equity $ 345,906 $ (141 ) $ 345,765 Restated Condensed Consolidated Balance Sheet Amounts (in thousands) As of December 31, 2016 As Previously Adjustments As Restated Accounts receivable $ 41,488 $ (551) $ 40,937 Inventories - net 119,743 251 119,994 Prepaid and other current assets 5,213 (34 ) 5,179 Total current assets 180,293 (334 ) 179,959 Property, plant and equipment - net 83,298 104 83,402 Deferred tax assets - net 24,968 124 25,092 Other intangible assets - net 23,994 30 24,024 Total assets $ 368,031 $ (76 ) $ 367,955 Accounts payable $ 26,112 $ (34) $ 26,078 Accrued expenses 22,030 414 22,444 Total current liabilities 58,964 380 59,344 Other long-term liabilities 256 400 656 Total liabilities 143,099 780 143,879 Accumulated deficit (243,338 ) (856 ) (244,194 ) Total stockholders’ equity 164,916 (856 ) 164,060 Total liabilities and stockholders’ equity $ 368,031 $ (76 ) $ 367,955 Restated Condensed Consolidated Statements of Income Amounts (in thousands), except per share data Year Ended December 31, 2018 As Previously Adjustments As Restated Revenues $ 280,855 $ (493) $ 280,362 Costs of processing and distribution 140,732 (13 ) 140,719 Gross profit 140,123 (480 ) 139,643 Marketing, general and administrative 119,217 507 119,724 Severance and restructuring costs 2,280 528 2,808 Asset impairment and abandonments 4,774 296 5,070 Total operating expenses 142,624 1,331 143,955 Operating (loss) (2,501 ) (1,811 ) (4,312 ) (Loss) before income tax benefit (5,580 ) (1,811 ) (7,391 ) Income tax benefit 4,331 (63 ) 4,268 Net (loss) (1,249 ) (1,874 ) (3,123 ) Net (loss) applicable to common shares $ (3,369 ) $ (1,874 ) $ (5,243 ) Comprehensive (loss) income $ (4,310 ) $ (1,874 ) $ (6,184 ) Net (loss) per common share - basic $ (0.05 ) $ (0.03 ) $ (0.08 ) Net (loss) per common share - diluted $ (0.05 ) $ (0.03 ) $ (0.08 ) Restated Condensed Consolidated Statements of Income Amounts (in thousands), except per share data Year Ended December 31, 2017 As Previously Adjustments As Restated Revenues $ 279,563 $ 786 $ 280,349 Costs of processing and distribution 137,042 235 137,277 Gross profit 142,521 551 143,072 Marketing, general and administrative 115,103 (94 ) 115,009 Research and development 13,375 (60 ) 13,315 Severance and restructuring costs 12,173 (157 ) 12,016 Executive transition costs 2,781 37 2,818 Asset impairment and abandonments 3,739 295 4,034 Total operating expenses 113,711 21 113,732 Operating income 28,810 530 29,340 Income before income tax (provision) 25,725 530 26,255 Income tax (provision) (19,453 ) 104 (19,349 ) Net income 6,272 634 6,906 Net income applicable to common shares $ 2,549 $ 634 $ 3,183 Comprehensive income $ 4,536 $ 634 $ 5,170 Net income per common share - basic $ 0.04 $ 0.01 $ 0.05 Net income per common share - diluted $ 0.04 $ 0.01 $ 0.05 Year Ended December 31, 2016 As Previously Adjustments As Restated Revenues $ 272,865 $ 3,119 $ 275,984 Costs of processing and distribution 140,516 2,141 142,657 Gross profit 132,349 978 133,327 Marketing, general and administrative 116,125 541 116,666 Research and development 16,090 207 16,297 Asset impairment and abandonments 5,435 (194 ) 5,241 Total operating expenses 148,030 554 148,584 Operating (loss) (15,681 ) 424 (15,257 ) Foreign exchange (loss) gain (132 ) 3 (129 ) Total other expense - net (1,779 ) 3 (1,776 ) (Loss) before income tax benefit (17,460 ) 427 (17,033 ) Income tax benefit 3,061 167 3,228 Net (loss) (14,399 ) 594 (13,805 ) Net (loss) applicable to common shares $ (17,907 ) $ 594 $ (17,313 ) Comprehensive (loss) $ (19,181 ) $ 594 $ (18,587 ) Net (loss) per common share - basic $ (0.31 ) $ 0.01 $ (0.30 ) Net (loss) per common share - diluted $ (0.31 ) $ 0.01 $ (0.30 ) Restated Condensed Consolidated Statements of Cash Flow Amounts (in thousands) Year Ended December 31, 2018 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (1,250 ) $ (1,873 ) $ (3,123 ) Depreciation and amortization expense 14,569 10 14,579 Provision for bad debts and product returns 1,195 526 1,721 Deferred income tax (benefit) (4,322 ) (370 ) (4,692 ) Asset impairment and abandonments 4,774 296 5,070 Accounts receivable (11,201 ) 372 (10,829 ) Inventories (11,790 ) (167 ) (11,957 ) Accounts payable 8,054 (19 ) 8,035 Accrued expenses (1,812 ) 985 (827 ) Other operating assets and liabilities 3,318 718 4,036 Net cash provided by operating activities 16,774 478 17,252 Cash flows from financing activities Payments for treasury stock — (478 ) (478 ) Net cash used in financing — (478 ) 4,093 Year Ended December 31, 2017 As Previously Adjustments As Restated Cash flows from operating activities: Net income $ 6,272 $ 636 $ 6,906 Depreciation and amortization expense 14,226 7 14,233 Deferred income tax provision 13,329 244 13,573 Asset impairment and abandonments 3,739 295 4,034 Accounts receivable 5,784 (668 ) 5,116 Inventories 1,375 235 1,610 Accounts payable (12,899 ) (37 ) (12,936 ) Accrued expenses 2,599 3,066 5,665 Other operating assets and liabilities (10,200 ) (445 ) (10,645 ) Net cash provided by operating activities 2,455 3,333 5,788 Cash flows from financing activities Payments for treasury stock — (3,474 ) (3,474 ) Other financing activities (458 ) 141 (317 ) Net cash used in financing (32,398 ) (3,333 ) (35,731 ) Year Ended December 31, 2016 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (14,399 ) $ 594 $ (13,805 ) Depreciation and amortization expense 16,510 18 16,528 Deferred income tax (benefit) (3,395 ) (97 ) (3,492 ) Asset impairment and abandonments 5,435 (194 ) 5,241 Accounts receivable 4,756 (3,046 ) 1,710 Inventories (15,369 ) 2,141 (13,228 ) Accounts payable 4,583 (34 ) 4,549 Accrued expenses (6,536 ) 814 (5,722 ) Other operating assets and liabilities 7,637 (196 ) 7,441 Net cash provided by operating activities 15,323 — 15,323

Restatement of Prior Period Qua

Restatement of Prior Period Quarterly Financial Statements (Unaudited)	12 Months Ended
	Dec. 31, 2018
Text Block [Abstract]
Restatement of Prior Period Quarterly Financial Statements (Unaudited)	28. Restatement of Prior Period Quarterly Financial Statements (Unaudited) As discussed in greater detail in Note 27—Restatement of Prior Period Financial Statements, the Company determined to restate its previously issued unaudited condensed consolidated financial statements for the quarterly periods within the years ended December 31, 2018, 2017 and 2016. The following tables summarize the impacts of the results on our previously reported condensed statements of operations and balances sheets included in our Quarterly Reports on Form 10-Q Condensed Consolidated Balance Sheets (Unaudited) March 31, June 30, September 30, (as restated) (as restated) (as restated) Assets Current Assets: Cash and cash equivalents $ 13,812 $ 14,246 $ 10,022 Accounts receivable 41,781 44,238 44,189 Inventories - net 107,280 101,767 103,823 Prepaid and other current assets 16,314 8,149 8,313 Total current assets 179,187 168,400 166,347 Property, plant and equipment - net 79,150 76,838 77,344 Deferred tax assets - net 11,884 14,514 11,842 Goodwill 65,254 64,863 62,864 Other intangible assets - net 23,667 20,128 25,701 Other assets - net 1,806 1,838 5,150 Total assets $ 360,948 $ 346,581 $ 349,248 Liabilities and Stockholders’ Equity Current Liabilities: Accounts payable $ 14,670 $ 14,727 $ 19,212 Accrued expenses 23,687 23,787 22,163 Current portion of deferred revenue 4,944 5,020 4,990 Current portion of short and long-term obligations 4,268 — — Total current liabilities 47,569 43,534 46,365 Long-term obligations - less current portion 57,009 53,416 49,021 Other long-term liabilities 5,131 5,155 5,759 Deferred revenue 4,448 3,155 1,968 Total liabilities 114,157 105,260 103,113 Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding 64,935 65,961 66,180 Stockholders’ equity: Common stock, $.001 par value: 150,000,000 shares authorized; 63,401,208, 63,377,839, and 63,461,700 shares issued and outstanding, respectively 63 63 63 Additional paid-in capital 430,014 430,311 432,077 Accumulated other comprehensive loss (5,936 ) (6,850 ) (6,980 ) Accumulated deficit (237,532 ) (243,334 ) (240,336 ) Less treasury stock, 1,195,901, 1,213,009, and 1,221,180 shares, respectively, at cost (4,753 ) (4,830 ) (4,869 ) Total stockholders’ equity 181,856 175,360 179,955 Total liabilities and stockholders’ equity $ 360,948 $ 346,581 $ 349,248 Condensed Consolidated Balance Sheets (Unaudited) March 31, June 30, September 30, (as restated) (as restated) (as restated) Assets Current Assets: Cash and cash equivalents $ 17,598 $ 13,675 $ 17,744 Accounts receivable 36,179 38,363 36,009 Inventories - net 117,578 117,199 114,737 Prepaid and other current assets 5,932 6,221 9,704 Assets held for sale — 1,750 1,750 Total current assets 177,287 177,208 179,944 Property, plant and equipment - net 85,118 84,379 82,794 Deferred tax assets - net 25,918 24,862 18,437 Goodwill 54,887 54,887 46,242 Other intangible assets - net 24,458 23,893 23,704 Other assets - net 1,023 991 1,841 Total assets $ 368,691 $ 366,220 $ 352,962 Liabilities and Stockholders’ Equity Current Liabilities: Accounts payable $ 28,326 $ 27,711 $ 24,411 Accrued expenses 23,196 20,606 20,442 Current portion of deferred revenue 4,686 4,718 4,793 Current portion of short and long-term obligations 5,301 5,779 4,268 Total current liabilities 61,509 58,814 53,914 Long-term obligations - less current portion 75,813 74,360 45,643 Other long-term liabilities 655 1,241 2,544 Deferred revenue 7,394 6,176 4,959 Total liabilities 145,371 140,591 107,060 Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding 60,972 61,941 62,925 Stockholders’ equity: Common stock, $.001 par value: 150,000,000 shares authorized; 58,537,016 and 59,445,223, 60,544,896 shares issued and outstanding, respectively 58 59 59 Additional paid-in capital 417,414 419,324 420,503 Accumulated other comprehensive loss (7,996 ) (6,903 ) (6,469 ) Accumulated deficit (246,071 ) (247,735 ) (230,059 ) Less treasury stock, 410,396 shares, for each respective period, at cost (1,057 ) (1,057 ) (1,057 ) Total stockholders’ equity 162,348 163,688 182,977 Total liabilities and stockholders’ equity $ 368,691 $ 366,220 $ 352,962 Condensed Consolidated Balance Sheets (Unaudited) March 31, June 30, September 30, (as restated) (as restated) (as restated) Assets Current Assets: Cash and cash equivalents $ 11,728 $ 12,754 $ 11,624 Accounts receivable 38,572 36,139 37,324 Inventories - net 124,363 121,635 125,418 Prepaid and other current assets 13,157 13,777 7,473 Total current assets 187,820 184,305 181,839 Property, plant and equipment - net 87,538 88,201 89,070 Deferred tax assets - net 21,931 21,939 21,348 Goodwill 54,887 54,887 54,887 Other intangible assets - net 26,235 25,672 25,640 Other assets - net 432 405 393 Total assets $ 378,843 $ 375,409 $ 373,177 Liabilities and Stockholders’ Equity Current Liabilities: Accounts payable $ 24,301 $ 25,760 $ 23,287 Accrued expenses 21,869 20,581 17,087 Current portion of deferred revenue 4,922 4,891 4,816 Current portion of short and long-term obligations 5,658 4,995 4,689 Total current liabilities 56,750 56,227 49,879 Long-term obligations - less current portion 72,290 72,173 78,720 Other long-term liabilities 510 527 395 Deferred revenue 10,081 8,896 7,754 Total liabilities 139,631 137,823 136,748 Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding 57,227 58,143 59,073 Stockholders’ equity: Common stock, $.001 par value: 150,000,000 shares authorized; 58,026,674, and 58,031,674, 57,417,397 shares issued and outstanding, respectively 58 58 58 Additional paid-in capital 417,308 416,999 418,166 Accumulated other comprehensive loss (6,580 ) (7,136 ) (6,895 ) Accumulated deficit (228,247 ) (229,924 ) (233,419 ) Less treasury stock, 259,443 shares, for each respective period, at cost (554 ) (554 ) (554 ) Total stockholders’ equity 181,985 179,443 177,356 Total liabilities and stockholders’ equity $ 378,843 $ 375,409 $ 373,177 Condensed Consolidated Statements of Income (Unaudited) Three Months Ended March 31, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 69,141 $ 70,414 $ 67,517 Costs of processing and distribution 35,638 34,225 31,814 Gross profit 33,503 36,189 35,703 Expenses: Marketing, general and administrative 28,578 29,709 27,856 Research and development 3,421 3,688 4,161 Severance and restructuring costs 742 4,526 — Asset impairment and abandonments 129 236 — Acquisition and integration expenses 800 — — Total operating expenses 33,670 38,159 32,017 Operating (loss) income (167 ) (1,970 ) 3,686 Other (expense) income: Interest expense (835 ) (819 ) (361 ) Interest income 11 — 1 Foreign exchange gain 49 20 46 Total other expense - net (775 ) (799 ) (314 ) (Loss) income before income tax (provision) benefit (942 ) (2,769 ) 3,372 Income tax (provision) benefit (175 ) 892 (1,232 ) Net (loss) income (1,117 ) (1,877 ) 2,140 Convertible preferred dividend (966 ) (910 ) (858 ) Net (loss) income applicable to common shares $ (2,083 ) $ (2,787 ) $ 1,282 Other comprehensive (loss) income: Unrealized foreign currency translation gain 393 320 462 Comprehensive (loss) income $ (1,690 ) $ (2,467 ) $ 1,744 Net (loss) income per common share - basic $ (0.03 ) $ (0.05 ) $ 0.02 Net (loss) income per common share - diluted $ (0.03 ) $ (0.05 ) $ 0.02 Condensed Consolidated Statements of Income (Unaudited) Six Months Ended June 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 139,526 $ 141,992 $ 137,441 Costs of processing and distribution 76,124 69,142 66,789 Gross profit 63,402 72,850 70,652 Expenses: Marketing, general and administrative 57,905 59,285 56,258 Research and development 6,691 7,428 8,245 Severance and restructuring costs 993 7,485 1,818 Contested proxy expenses — — 2,372 Asset impairment and abandonments 4,644 236 — Acquisition and integration expenses 800 — — Total operating expenses 71,033 74,434 68,693 Operating (loss) income (7,631 ) (1,584 ) 1,959 Other (expense) income: Interest expense (1,612 ) (1,734 ) (753 ) Interest income 17 — 7 Loss on extinguishment of debt (309 ) — — Foreign exchange (loss) gain (22 ) (55 ) 8 Total other expense—net (1,926 ) (1,789 ) (738 ) (Loss) income before income tax benefit (provision) (9,557 ) (3,373 ) 1,221 Income tax benefit (provision) 2,638 (169 ) (758 ) Net (loss) income (6,919 ) (3,542 ) 463 Convertible preferred dividend (1,947 ) (1,834 ) (1,728 ) Net (loss) applicable to common shares $ (8,866 ) $ (5,376 ) $ (1,265 ) Other comprehensive (loss) income: Unrealized foreign currency translation (loss) gain (521 ) 1,413 (94 ) Comprehensive (loss) income $ (9,387 ) $ (3,963 ) $ (1,359 ) Net (loss) income per common share—basic $ (0.14 ) $ (0.09 ) $ (0.02 ) Net (loss) income per common share—diluted $ (0.14 ) $ (0.09 ) $ (0.02 ) Condensed Consolidated Statements of Income (Unaudited) Nine Months Ended September 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 209,976 $ 209,238 $ 203,923 Costs of processing and distribution 108,346 102,576 99,195 Gross profit 101,630 106,662 104,728 Expenses: Marketing, general and administrative 87,576 86,963 85,032 Research and development 10,297 10,169 12,034 Severance and restructuring costs 1,987 10,376 2,146 Strategic review costs — — 650 Executive transition costs — — 4,107 Contested proxy expenses — — 2,372 Asset impairment and abandonments 4,748 236 — Acquisition and integration expenses 2,741 — — Cardiothoracic closure business divestiture contingency consideration (3,000 ) — — Gain on cardiothoracic closure business divestiture — (34,090 ) — Total operating expenses 104,349 73,564 106,341 Operating (loss) income (2,719 ) 33,008 (1,613 ) Other (expense) income: Interest expense (2,223 ) (2,475 ) (1,061 ) Interest income 31 — 8 Loss on extinguishment of debt (309 ) — — Foreign exchange (loss) gain (23 ) 5 (59 ) Total other expense—net (2,524 ) (2,470 ) (1,112 ) (Loss) income before income tax (provision) benefit (5,243 ) 30,538 (2,725 ) Income tax benefit (provision) 1,321 (16,404 ) (308 ) Net (loss) income (3,922 ) 14,134 (3,033 ) Convertible preferred dividend (2,120 ) (2,772 ) (2,611 ) Net (loss) income applicable to common shares $ (6,042 ) $ 11,362 $ (5,644 ) Other comprehensive (loss) income: Unrealized foreign currency translation (loss) gain (651 ) 1,847 147 Comprehensive (loss) income $ (6,693 ) $ 13,209 $ (5,497 ) Net (loss) income per common share—basic $ (0.10 ) $ 0.19 $ (0.10 ) Net (loss) income per common share—diluted $ (0.10 ) $ 0.19 $ (0.10 ) Condensed Consolidated Statements of Income (Unaudited) Three Months Ended June 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 70,385 $ 71,578 $ 69,924 Costs of processing and distribution 40,486 34,917 34,975 Gross profit 29,899 36,661 34,949 Expenses: Marketing, general and administrative 29,327 29,576 28,402 Research and development 3,270 3,740 4,084 Severance and restructuring costs 251 2,959 1,818 Contested proxy expenses — — 2,372 Asset impairment and abandonments 4,515 — — Total operating expenses 37,363 36,275 36,676 Operating (loss) income (7,464 ) 386 (1,727 ) Other (expense) income: Interest expense (777 ) (915 ) (392 ) Interest income 6 — 6 Loss on extinguishment of debt (309 ) — — Foreign exchange (loss) (71 ) (75 ) (38 ) Total other expense—net (1,151 ) (990 ) (424 ) (Loss) before income tax benefit (provision) (8,615 ) (604 ) (2,151 ) Income tax benefit (provision) 2,813 (1,061 ) 474 Net (loss) income applicable to common shares (5,802 ) (1,665 ) (1,677 ) Convertible preferred dividend (981 ) (924 ) (870 ) Net (loss) applicable to common shares $ (6,783 ) $ (2,589 ) $ (2,547 ) Other comprehensive (loss): Unrealized foreign currency translation (loss) gain (914 ) 1,093 (556 ) Comprehensive (loss) $ (7,697 ) $ (1,496 ) $ (3,103 ) Net (loss) per common share—basic $ (0.11 ) $ (0.04 ) $ (0.04 ) Net (loss) per common share—diluted $ (0.11 ) $ (0.04 ) $ (0.04 ) Condensed Consolidated Statements of Income (Unaudited) Three Months Ended September 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 70,450 $ 67,246 $ 66,482 Costs of processing and distribution 32,222 33,434 32,406 Gross profit 38,228 33,812 34,076 Expenses: Marketing, general and administrative 29,671 27,678 28,774 Research and development 3,606 2,741 3,789 Severance and restructuring costs 994 2,891 328 Strategic review costs — — 650 Executive transition costs — — 4,107 Asset impairment and abandonments 104 — — Acquisition and integration expenses 1,941 — — Cardiothoracic closure business divestiture contingency consideration (3,000 ) — — Gain on cardiothoracic closure business divestiture — (34,090 ) — Total operating expenses 33,316 (780 ) 37,648 Operating income 4,912 34,592 (3,572 ) Other (expense) income: Interest expense (611 ) (741 ) (308 ) Interest income 14 — 1 Foreign exchange (loss) gain (1 ) 60 (67 ) Total other expense—net (598 ) (681 ) (374 ) Income (loss) before income tax (provision) benefit 4,314 33,911 (3,946 ) Income tax (provision) benefit (1,317 ) (16,235 ) 450 Net income (loss) 2,997 17,676 (3,496 ) Convertible preferred dividend (173 ) (938 ) (883 ) Net income (loss) applicable to common shares $ 2,824 $ 16,738 $ (4,379 ) Other comprehensive income (loss): Unrealized foreign currency translation (loss) gain (130 ) 434 241 Comprehensive income (loss) $ 2,694 $ 17,172 $ (4,138 ) Net income (loss) per common share—basic $ 0.04 $ 0.28 $ (0.08 ) Net income (loss) per common share—diluted $ 0.04 $ 0.23 $ (0.08 ) Condensed Consolidated Statements of Cash Flows Amounts (Unaudited) For the Three Months Ended March 31, 2018 2017 2016 (as restated) (as restated) (as restated) Cash flows from operating activities: Net (loss) income $ (1,117 ) $ (1,877 ) $ 2,139 Adjustments to reconcile net loss to net cash (used in) provided by operating activities: Depreciation and amortization expense 3,584 3,568 4,310 Provision for bad debts and product returns 149 344 304 Provision for inventory write-downs 2,641 1,789 945 Amortization of deferred revenue (1,217 ) (1,274 ) (1,217 ) Deferred income tax (benefit) provision (112 ) (989 ) 357 Stock-based compensation 1,280 834 500 Asset impairment and abandonments — 236 — Other 409 114 168 Change in assets and liabilities: Accounts receivable (3,182 ) 4,468 4,903 Inventories 1,557 799 (3,843 ) Accounts payable (3,513 ) 108 2,764 Accrued expenses (2,866 ) 702 (7,076 ) Deferred revenue 2,000 2,000 2,000 Other operating assets and liabilities (699 ) (1,245 ) 169 Net cash (used in) provided by operating activities (1,086 ) 9,577 6,423 Cash flows from investing activities: Purchases of property, plant and equipment (2,118 ) (3,283 ) (4,637 ) Patent and acquired intangible asset costs (330 ) (319 ) (1,196 ) Acquisition of Zyga Technology (21,000 ) — — Net cash used in investing activities (23,448 ) (3,602 ) (5,833 ) Cash flows from financing activities: Proceeds from exercise of common stock options 1,394 108 — Proceeds from long-term obligations 20,000 2,000 3,000 Net (payments) on short-term obligations — — (249 ) Payments on long-term obligations (5,125 ) (4,250 ) (4,133 ) Payments for treasury stock (363 ) — — Other financing activities — (142 ) (108 ) Net cash provided by (used in) financing activities 15,906 (2,284 ) (1,490 ) Effect of exchange rate changes on cash and cash equivalents 59 58 14 Net (decrease) increase in cash and cash equivalents (8,569 ) 3,749 (886 ) Cash and cash equivalents, beginning of period 22,381 13,849 12,614 Cash and cash equivalents, end of period $ 13,812 $ 17,598 $ 11,728 Supplemental cash flow disclosure: Cash paid for interest $ 600 $ 1,458 $ 393 Cash paid for income taxes, net of refunds — — 38 Non-cash acquisition of property, plant and equipment 157 2,234 1,586 Increase in accrual for dividend payable 966 910 858 Condensed Consolidated Statements of Cash Flows Amounts (Unaudited) For the Six Months Ended June 30, 2018 2017 2016 (as restated) (as restated) (as restated) Cash flows from operating activities: Net (loss) income $ (6,919 ) $ (3,541 ) $ 462 Adjustments to reconcile net loss to net cash provided by operating activities: Depreciation and amortization expense 7,068 7,129 8,694 Provision for bad debts and product returns 494 560 495 Provision for inventory write-downs 10,865 3,753 2,370 Amortization of deferred revenue (2,435 ) (2,460 ) (2,434 ) Deferred income tax (benefit) provision (2,856 ) (431 ) 210 Stock-based compensation 2,570 2,248 1,100 Asset impairment and abandonments 4,644 236 — Other 610 873 264 Change in assets and liabilities: Accounts receivable (6,185 ) 2,313 7,066 Inventories (1,139 ) (8 ) (2,780 ) Accounts payable (3,803 ) 998 4,495 Accrued expenses (2,429 ) (2,142 ) (8,318 ) Deferred revenue 2,000 2,000 2,000 Other operating assets and liabilities 7,333 (915 ) (415 ) Net cash provided by operating activities 9,818 10,613 13,209 Cash flows from investing activities: Purchases of property, plant and equipment (3,856 ) (7,160 ) (9,403 ) Patent and acquired intangible asset costs (728 ) (1,845 ) (1,391 ) Acquisition of Zyga Technology (21,000 ) — — Net cash (used in) investing activities (25,584 ) (9,005 ) (10,794 ) Cash flows from financing activities: Proceeds from exercise of common stock options 1,429 1,575 14 Proceeds from long-term obligations 74,425 4,000 7,000 Net (payments) on short-term obligations — — (849 ) Payments on long-term obligations (66,750 ) (7,375 ) (8,299 ) Payments for treasury stock (440 ) — — Other financing activities (1,026 ) (142 ) (108 ) Net cash provided by (used in) financing activities 7,638 (1,942 ) (2,242 ) Effect of exchange rate changes on cash and cash equivalents (7 ) 160 (33 ) Net (decrease) increase in cash and cash equivalents (8,135 ) (174 ) 140 Cash and cash equivalents, beginning of period 22,381 13,849 12,614 Cash and cash equivalents, end of period $ 14,246 $ 13,675 $ 12,754 Supplemental cash flow disclosure: Cash paid for interest $ 1,974 $ 2,303 $ 789 Cash paid for income taxes, net of refunds 6,698 32 176 Non-cash acquisition of property, plant and equipment 676 879 1,257 Increase in accrual for dividend payable 1,947 1,834 1,728 Condensed Consolidated Statements of Cash Flows Amounts (Unaudited) For the Nine Months Ended September 30, 2018 2017 2016 (as restated) (as restated) (as restated) Cash flows from operating activities: Net (loss) income $ (3,922 ) $ 14,135 $ (3,033 ) Adjustments to reconcile net loss to net cash provided by (used in) operating activities: Depreciation and amortization expense 10,794 10,704 13,087 Provision for bad debts and product returns 845 816 946 Provision for inventory write-downs 12,906 4,488 4,422 Amortization of deferred revenue (3,652 ) (3,601 ) (3,650 ) Deferred income tax (benefit) provision (1,300 ) 5,542 599 Stock-based compensation 3,650 4,011 3,075 Asset impairment and abandonments 4,748 236 — Cardiothoracic closure business divestiture contingency consideration (3,000 ) — — Gain on cardiothoracic closure business divestiture — (34,090 ) — Other 728 1,475 580 Change in assets and liabilities: Accounts receivable (6,518 ) 4,397 5,463 Inventories (5,758 ) (749 ) (8,511 ) Accounts payable 826 (5,727 ) 1,095 Accrued expenses (4,046 ) (2,566 ) (11,610 ) Deferred revenue 2,000 2,000 2,000 Other operating assets and liabilities 3,184 (3,929 ) 5,571 Net cash provided by (used in) operating activities 11,485 (2,858 ) 10,034 Cash flows from investing activities: Purchases of property, plant and equipment (7,106 ) (10,358 ) (12,774 ) Patent and acquired intangible asset costs (2,798 ) (2,124 ) (2,195 ) Acquisition of Zyga Technology (21,000 ) — — Cardiothoracic closure business divestiture 3,000 51,000 — Net cash (used in) provided by investing activities (27,904 ) 38,518 (14,969 ) Cash flows from financing activities: Proceeds from exercise of common stock options 2,334 1,872 14 Proceeds from long-term obligations 74,425 6,000 15,000 Net (payments) on short-term obligations — — (1,511 ) Payments on long-term obligations (71,171 ) (39,375 ) (9,424 ) Payments for treasury stock (478 ) — — Other financing activities (1,035 ) (457 ) (108 ) Net cash provided by (used in) financing activities 4,075 (31,960 ) 3,971 Effect of exchange rate changes on cash and cash equivalents (15 ) 195 (26 ) Net (decrease) increase in cash and cash equivalents (12,359 ) 3,895 (990 ) Cash and cash equivalents, beginning of period 22,381 13,849 12,614 Cash and cash equivalents, end of period $ 10,022 $ 17,744 $ 11,624 Supplemental cash flow disclosure: Cash paid for interest $ 2,517 $ 2,632 $ 1,224 Cash paid for income taxes, net of refunds (6,659 ) 12,032 282 Non-cash acquisition of property, plant and equipment 471 498 1,445 Stock-based compensation related to sale of CT business — 102 — Increase in accrual for dividend payable 2,120 2,772 2,611 Restated Consolidated Balance Sheet Amounts (Unaudited) As of March 31, 2018 As Previously Adjustments As Restated Accounts receivable $ 41,594 $ 187 $ 41,781 Inventories—net 106,694 586 107,280 Prepaid and other current assets 16,192 122 16,314 Total current assets 178,292 895 179,187 Deferred tax assets—net 11,929 (45 ) 11,884 Other intangible assets—net 24,163 (496 ) 23,667 Total assets $ 360,594 $ 354 $ 360,948 Accounts payable $ 14,740 $ (70 ) $ 14,670 Accrued expenses 22,890 797 23,687 Total current liabilities 46,842 727 47,569 Total liabilities 113,430 727 114,157 Accumulated deficit (237,159 ) (373 ) (237,532 ) Total stockholders’ equity 182,229 (373 ) 181,856 Total liabilities and stockholders’ equity $ 360,594 $ 354 $ 360,948 As of June 30, 2018 As Previously Adjustments As Restated Accounts receivable $ 45,576 $ (1,338 ) $ 44,238 Inventories—net 101,022 745 101,767 Prepaid and other current assets 8,038 111 8,149 Total current assets 168,882 (482 ) 168,400 Deferred tax assets—net 14,448 66 14,514 Other intangible assets—net 20,624 (496 ) 20,128 Total assets $ 347,493 $ (912 ) $ 346,581 Accounts payable $ 14,797 $ (70 ) $ 14,727 Accrued expenses 23,914 (127 ) 23,787 Total current liabilities 43,731 (197 ) 43,534 Total liabilities 105,457 (197 ) 105,260 Accumulated deficit (242,619 ) (715 ) (243,334 ) Total stockholders’ equity 176,075 (715 ) 175,360 Total liabilities and stockholders’ equity $ 347,493 $ (912 ) $ 346,581 Restated Consolidated Balance Sheet Amounts (Unaudited) As of September 30, 2018 As Previously Adjustments As Restated Accounts receivable $ 44,141 $ 48 $ 44,189 Inventories—net 103,891 (68 ) 103,823 Prepaid and other current assets 8,613 (300 ) 8,313 Total current assets 166,667 (320 ) 166,347 Deferred tax assets—net 11,875 (33 ) 11,842 Other intangible assets—net 26,197 (496 ) 25,701 Total assets $ 350,097 $ (849 ) $ 349,248 Accounts payable $ 19,282 $ (70 ) $ 19,212 Accrued expenses 22,121 42 22,163 Total current liabilities 46,393 (28 ) 46,365 Total liabilities 103,141 (28 ) 103,113 Accumulated deficit (239,515 ) (821 ) (240,336 ) Total stockholders’ equity 180,776 (821 ) 179,955 Total liabilities and stockholders’ equity $ 350,097 $ (849 ) $ 349,248 As of March 31, 2017 As Previously Adjustments As Restated Accounts receivable $ 36,294 $ (115 ) $ 36,179 Inventories—net 117,392 186 117,578 Prepaid and other current assets 5,888 44 5,932 Total current assets 177,172 115 177,287 Deferred tax assets—net 25,889 29 25,918 Other intangible assets—net 24,560 (102 ) 24,458 Total assets $ 368,649 $ 42 $ 368,691 Accounts payable $ 28,360 $ (34 ) $ 28,326 Accrued expenses 22,659 537 23,196 Total current liabilities 61,006 503 61,509 Other long-term liabilities 255 400 655 Total liabilities 144,468 903 145,371 Accumulated deficit (245,210 ) (861 ) (246,071 ) Total stockholders’ equity 163,209 (861 ) 162,348 Total liabilities and stockholders’ equity $ 368,649 $ 42 $ 368,691 Restated Consolidated Balance Sheet Amounts (Unaudited) As of June 30, 2017 As Previously Adjustments As Restated Accounts receivable $ 39,099 $ (736 ) $ 38,363 Inventories—net 116,773 426 117,199 Prepaid and other current assets 6,177 44 6,221 Total current assets 177,474 (266 ) 177,208 Deferred tax assets—net 24,868 (6 ) 24,862 Other intangible assets—net 23,995 (102 ) 23,893 Total assets $ 366,594 $ (374 ) $ 366,220 Accounts payable $ 27,745 $ (34 ) $ 27,711 Accrued expenses 20,950 (344 ) 20,606 Total current liabilities 59,192 (378 ) 58,814 Other long-term liabilities 841 400 1,241 Total liabilities 140,569 22 140,591 Accumulated deficit (246,899 ) (836 ) (247,735 ) Common stock and additional paid-in capital, less treasury stock 417,886 440 418,326 Total stockholders’ equity 164,084 (396 ) 163,688 Total liabilities and stockholders’ equity $ 366,594 $ (374 ) $ 366,220 As of September 30, 2017 As Previously Adjustments As Restated Accounts receivable $ 36,188 $ (179 ) $ 36,009 Inventories—net 114,568 169 114,737 Prepaid and other current assets 9,806 (102 ) 9,704 Total current assets 180,056 (112 ) 179,944 Deferred tax assets—net 18,543 (106 ) 18,437 Other intangible assets—net 23,806 (102 ) 23,704 Total assets $ 353,282 $ (320 ) $ 352,962 Accounts payable $ 24,445 $ (34 ) $ 24,411 Accrued expenses 20,482 (40 ) 20,442 Total current liabilities 53,988 (74 ) 53,914 Other long-term liabilities 2,144 400 2,544 Total liabilities 106,734 326 107,060 Accumulated deficit (229,413 ) (646 ) (230,059 ) Total stockholders’ equity 183,623 (646 ) 182,977 Total liabilities and stockholders’ equity $ 353,282 $ (320 ) $ 352,962 Restated Consolidated Balance Sheet Amounts (Unaudited) As of March 31, 2016 As Previously Adjustments As Restated Accounts receivable $ 42,000 $ (3,428 ) $ 38,572 Inventories - net 122,459 1,904 124,363 Total current assets 189,344 (1,524 ) 187,820 Deferred tax assets - net 21,847 84 21,931 Other intangible assets - net 26,277 (42 ) 26,235 Total assets $ 380,325 $ (1,482 ) $ 378,843 Accrued expenses $ 21,642 $ 227 $ 21,869 Total current liabilities 56,523 227 56,750 Total liabilities 139,404 227 139,631 Accumulated deficit (226,538 ) (1,709 ) (228,247 ) Total stockholders’ equity 183,694 (1,709 ) 181,985 Total liabilities and stockholders’ equity $ 380,325 $ (1,482 ) $ 378,843 As of June 30, 2016 As Previously Adjustments As Restated Accounts receivable $ 37,263 $ (1,124 ) $ 36,139 Inventories - net 121,035 600 121,635 Total current assets 184,829 (524 ) 184,305 Deferred tax assets - net 22,240 (301 ) 21,939 Other intangible assets - net 25,714 (42 ) 25,672 Total assets $ 376,276 $ (867 ) $ 375,409 Accrued expenses $ 20,354 $ 227 $ 20,581 Total current liabilities 56,000 227 56,227 Total liabilities 137,596 227 137,823 Accumulated deficit (228,830 ) (1,094 ) (229,924 ) Total stockholders’ equity 180,537 (1,094 ) 179,443 Total liabilities and stockholders’ equity $ 376,276 $ (867 ) $ 375,409 Restated Consolidated Balance Sheet Amounts (Unaudited) As of September 30, 2016 As Previously Adjustments As Restated Accounts receivable $ 38,512 $ (1,188 ) $ 37,324 Inventories - net 125,250 168 125,418 Prepaid and other current assets 7,437 36 7,473 Total current assets 182,823 (984 ) 181,839 Deferred tax assets - net 21,555 (207 ) 21,348 Other intangible assets - net 25,682 (42 ) 25,640 Total assets $ 374,410 $ (1,233 ) $ 373,177 Accrued expenses $ 17,337 $ (250 ) $ 17,087 Total current liabilities 50,129 (250 ) 49,879 Total liabilities 136,998 (250 ) 136,748 Accumulated deficit (232,436 ) (983 ) (233,419 ) Total stockholders’ equity 178,339 (983 ) 177,356 Total liabilities and stockholders’ equity $ 374,410 $ (1,233 ) $ 373,177 Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Three Months Ended March 31, 2018 (as reported) (adjustments) (as restated) Revenues $ 69,890 $ (749 ) $ 69,141 Costs of processing and distribution 36,208 (570 ) 35,638 Gross profit 33,682 (179 ) 33,503 Marketing, general and administrative 28,389 189 28,578 Severance and restructuring costs 884 (142 ) 742 Total operating expenses 33,623 47 33,670 Operating income (loss) 59 (226 ) (167 ) (Loss) before income tax (provision) (716 ) (226 ) (942 ) Income tax (provision) (249 ) 74 (175 ) Net (loss) income applicable to common shares (965 ) (152 ) (1,117 ) Comprehensive (loss) $ (1,538 ) $ (152 ) $ (1,690 ) Net (loss) per common share - basic $ (0.03 ) $ (0.00 ) $ (0.03 ) Net (loss) per common share - diluted $ (0.03 ) $ (0.00 ) $ (0.03 ) Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Three Months Ended March 31, 2017 (as reported) (adjustments) (as restated) Revenues $ 69,939 $ 475 $ 70,414 Costs of processing and distribution 34,160 65 34,225 Gross profit 35,779 410 36,189 Marketing, general and administrative 29,671 38 29,709 Severance and restructuring costs 4,403 123 4,526 Asset impairment and abandonments — 236 236 Total operating expenses 37,762 397 38,159 Operating (loss) (1,983 ) 13 (1,970 ) (Loss) before income tax benefit (2,782 ) 13 (2,769 ) Income tax benefit 910 (18 ) 892 Net (loss) (1,872 ) (5 ) (1,877 ) Comprehensive (loss) $ (2,462 ) $ (5 ) $ (2,467 ) Net (loss) per common share - basic $ (0.05 ) $ (0.00 ) $ (0.05 ) Net (loss) per common share - diluted $ (0.05 ) $ (0.00 ) $ (0.05 ) Three Months Ended March 31, 2016 (as reported) (adjustments) (as restated) Revenues $ 67,351 $ 166 $ 67,517 Costs of processing and distribution 31,326 488 31,814 Gross profit 36,025 (322 ) 35,703 Marketing, general and administrative 27,860 (4 ) 27,856 Total operating expenses 32,021 (4 ) 32,017 Operating income 4,004 (318 ) 3,686 Income (loss) before income tax (provision) 3,690 (318 ) 3,372 Income tax (provision) (1,289 ) 57 (1,232 ) Net income 2,401 (261 ) 2,140 Comprehensive income $ 2,005 $ (261 ) $ 1,744 Net income per common share - basic $ 0.03 $ (0.01 ) $ 0.02 Net income per common share - diluted $ 0.03 $ (0.01 ) $ 0.02 Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Six Months Ended June 30, 2018 (as reported) (adjustments) (as restated) Revenues $ 140,575 $ (1,049 ) $ 139,526 Costs of processing and distribution 76,853 (729 ) 76,124 Gross profit 63,722 (320 ) 63,402 Marketing, general and administrative 57,655 250 57,905 Severance and restructuring costs 884 109 993 Total operating expenses 70,674 359 71,033 Operating (loss) (6,952 ) (679 ) (7,631 ) (Loss) before income tax benefit (8,878 ) (679 ) (9,557 ) Income tax benefit 2,453 185 2,638 Net (loss) (6,425 ) (494 ) (6,919 ) Comprehensive (loss) $ (8,893 ) $ (494 ) $ (9,387 ) Net (loss) per common share - basic $ (0.13 ) $ (0.01 ) $ (0.14 ) Net (loss) per common share - diluted $ (0.13 ) $ (0.01 ) $ (0.14 ) Six Months Ended June 30, 2017 (as reported) (adjustments) (as restated) Revenues $ 142,059 $ (67 ) $ 141,992 Costs of processing and distribution 69,317 (175 ) 69,142 Gross profit 72,742 108 72,850 Marketing, general and administrative 59,167 118 59,285 Severance and restructuring costs 7,803 (318 ) 7,485 Asset impairment and abandonments — 236 236 Total operating expenses 74,398 36 74,434 Operating (loss) (1,656 ) 72 (1,584 ) (Loss) before income tax (provision) (3,445 ) 72 (3,373 ) Income tax (provision) (116 ) (53 ) (169 ) Net (loss) (3,561 ) 19 (3,542 ) Comprehensive (loss) $ (3,982 ) $ 19 $ (3,963 ) Net (loss) per common share - basic $ (0.09 ) $ 0.00 $ (0.09 ) Net (loss) per common share - diluted $ (0.09 ) $ 0.00 $ (0.09 ) Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Six Months Ended June 30, 2016 (as reported) (adjustments) (as restated) Revenues $ 134,971 $ 2,470 $ 137,441 Costs of processing and distribution 64,997 1,792 66,789 Gross profit 69,974 678 70,652 Marketing, general and administrative 55,954 (4 ) 55,950 Total operating expenses 68,697 (4 ) 68,693 Operating income 1,277 682 1,959 Income (loss) before income tax (provision) 539 682 1,221 Income tax (provision) (430 ) (328 ) (758 ) Net income 109 354 463 Comprehensive (loss) $ (1,713 ) $ 354 $ (1,359 ) Net (loss) per common share - basic $ (0.03 ) $ 0.01 $ (0.02 ) Net (loss) per common share - diluted $ (0.03 ) $ 0.01 $ (0.02 ) Nine Months Ended September 30, 2018 (as reported) (adjustments) (as restated) Revenues $ 209,639 $ 337 $ 209,976 Costs of processing and distribution 108,262 84 108,346 Gross profit 101,377 253 101,630 Marketing, general and administrative 87,326 250 87,576 Severance and restructuring costs 1,708 279 1,987 Total operating expenses 103,820 529 104,349 Operating (loss) (2,443 ) (276 ) (2,719 ) (Loss) before income tax benefit (4,967 ) (276 ) (5,243 ) Income tax benefit (provision) 1,646 (325 ) 1,321 Net (loss) (3,321 ) (601 ) (3,922 ) Comprehensive (loss) $ (6,092 ) $ (601 ) $ (6,693 ) Net (loss) per common share - basic $ (0.09 ) $ (

Schedule II Valuation and Quali

Schedule II Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2018
SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]
Schedule II Valuation and Qualifying Accounts	RTI SURGICAL HOLDINGS, INC. (F/K/A RTI SURGICAL, INC.) AND SUBSIDIARIES Valuation and Qualifying Accounts Years Ended December 31, 2018, 2017 and 2016 (Dollars in thousands) Description Balance at Charged to Deductions- Balance at (as restated) (as restated) (as restated) (as restated) For the year ended December 31, 2018: Allowance for doubtful accounts $ 1,731 $ 1,105 $ 176 $ 2,660 Allowance for product returns 795 616 703 708 Allowance for excess and obsolescence 8,102 15,122 7,871 15,353 Deferred tax asset valuation allowance 7,258 2,368 6,533 3,093 For the year ended December 31, 2017: Allowance for doubtful accounts 1,870 536 675 1,731 Allowance for product returns 582 410 197 795 Allowance for excess and obsolescence 14,798 5,066 11,762 8,102 Deferred tax asset valuation allowance 4,916 1,668 (674 ) 7,258 For the year ended December 31, 2016: Allowance for doubtful accounts 1,454 787 371 1,870 Allowance for product returns 714 108 240 582 Allowance for excess and obsolescence 7,083 13,880 6,165 14,798 Deferred tax asset valuation allowance 1,106 3,833 23 4916

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Restatement of Financial Statements	Restatement of Financial Statements As previously announced, the Audit Committee of the Board of Directors (the “Board”) of the Company, with the assistance of independent legal and forensic accounting advisors has conducted an internal investigation of matters relating to the Company’s revenue recognition practices for certain contractual arrangements, primarily with OEM customers, including the accounting treatment, financial reporting and internal controls related to such arrangements (the “Investigation”). The Investigation was precipitated by an ongoing investigation by the SEC initially related to the periods 2014 through 2016. The SEC Investigation is ongoing, and the Company is cooperating with the SEC in its investigation. Based on the results of the internal investigation, the Company has restated its financial statements to correct errors. See Notes 27 and 28 for additional information. The corrections contained in the financial statements, which we refer to herein collectively as the “Restatement,” were prepared following the internal investigation by the Audit Committee of the Company’s Board of Directors.
Principles of Consolidation	Principles of Consolidation RTIDS is a taxable not-for-profit
Use of Estimates	Use of Estimates
Foreign Currency Translation	Foreign Currency Translation
Fair Value of Financial Instruments	Fair Value of Financial Instruments
Cash and Cash Equivalents	Cash and Cash Equivalents
Accounts Receivable Allowances	Accounts Receivable Allowances
Inventories	Inventories first-in, first-out Non-tissue
Surgical Instruments	Surgical Instruments
Property, Plant and Equipment	Property, Plant and Equipment Buildings 25 to 40 years Building improvements and leasehold improvements 8 to 40 years Processing equipment 7 to 10 years Office equipment, furniture and fixtures 5 to 7 years Computer hardware and software 3 to 7 years Surgical instruments 3 to 5 years
Software Costs	Software Costs
Debt Issuance Costs	Debt Issuance Costs—
Long-Lived Assets	Long-Lived Assets As further discussed in Note 23, during the second quarter of 2018, we recorded an impairment of $4,515 related to our map3 ® During the fourth quarter of 2016, the Company concluded a strategic review of its business lines and operations, and updated its financial projections. As a result, the Company’s financial projections related to its hernia business line were adjusted downward. This business line is a significant driver of revenue for the Tutogen Germany asset group. As a result, during the fourth quarter of 2016, the Company completed an asset group impairment test and determined the carrying value was not recoverable as of December 31, 2016. The Company used a market approach to determine the fair value of the Tutogen Germany asset group’s long-lived assets and recognized impairment charges related to identified intangibles and property and equipment of $5,435.
Goodwill	Goodwill Goodwill and Other Intangible Assets year-end Goodwill is tested for impairment annually by comparing the fair value of the reporting unit to its carrying amount, including goodwill. We evaluate our goodwill for impairment by utilizing an income approach and a market approach. The conclusion from these two approaches are generally weighted equally and then adjusted to incorporate a control premium or acquisition premium that reflects the additional amount a buyer is willing to pay for elements of control and for a premium that reflects the buyer’s perception of its ability to add value through synergies. In general, the income approach employs a discounted cash flow model that considers: 1) assumptions that marketplace participants would use in their estimates of fair value, including the cash flow period, terminal values based on a terminal growth rate and the discount rate; 2) current period actual results; and 3) projected results for future periods that have been prepared and approved by senior management of the Company. The forecasted cash flows do not include synergies that a marketplace participant would be expecting to achieve. The market approach employs market multiples from guideline public companies operating in our industry. Estimates of fair value are derived by applying multiples based on revenue and earnings before interest, taxes, depreciation and amortization (“EBITDA”) adjusted for size and performance metrics relative to peer companies. A control premium was included in determining the fair value under this approach. Both approaches used in the analysis have a degree of uncertainty. Potential events or changes in circumstances which could impact the key assumptions used in our goodwill impairment evaluation are as follows: • Change in peer group or performance of peer group companies • Change in the Company’s markets and estimates of future operating performance • Change in the Company’s estimated market cost of capital • Change in implied control premiums related to acquisitions in the medical device industry Goodwill represents the excess of purchase price over fair value of tangible net assets of acquired businesses at the acquisition date, after amounts allocated to other identifiable intangible assets. Factors that contribute to the recognition of goodwill include securing synergies that are specific to our business, not available to other market participants, and are expected to increase revenues and profits; acquisition of a talented workforce; cost savings opportunities; the strategic benefit of expanding our presence in core and adjacent markets; and diversifying our product portfolio.
Other Intangible Assets	Other Intangible Assets Other intangible assets are tested for impairment whenever events or circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. The recoverability test is described in the Company’s accounting policy for long-lived assets set forth above.
Revenue Recognition	Revenue Recognition The Company permits returns of implants in accordance with the terms of contractual agreements with customers if the implant is returned in a timely manner, in unopened packaging, and from the normal channels of distribution. Allowances for returns are provided based upon analysis of the Company’s historical patterns of returns matched against the revenues from which they originated. The Company records estimated implant returns, discounts, rebates and other distribution incentives as a reduction of revenue in the same period revenue is recognized. Estimates of implant returns are recorded for anticipated implant returns based on historical distributions and returns information. Estimates of discounts, rebates and other distribution incentives are recorded based on contractual terms, historical experience and trend analysis. Other revenues consist of service processing, tissue recovery fees, biomedical laboratory fees, recognition of previously deferred revenues, shipping fees, distribution of reproductions of our allografts to distributors for demonstration purposes and restocking fees which is included in revenues.
Stock-Based Compensation Plans	Stock-Based Compensation Plans Accounting for Stock Compensation pre-vesting
Research and Development Costs	Research and Development Costs
Income Taxes	Income Taxes year-end
Treasury Stock	Treasury Stock
Earnings Per Share	Earnings Per Share Year Ended December 31, 2018 2017 2016 Weighted average basic shares 63,521,703 59,684,289 58,236,745 Effect of dilutive securities: Stock options — 915,663 — Weighted average diluted shares 63,521,703 60,599,952 58,236,745 Options to purchase 4,275,744 shares of common stock at prices ranging from $2.69 to $5.23 per share which were outstanding as of December 31, 2018, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. Options to purchase 4,662,037 shares of common stock at prices ranging from $2.69 to $8.20 per share which were outstanding as of December 31, 2017, were included in the computation of diluted EPS because dilutive shares are factored into the calculation of EPS when income applicable to common shares is reported. Options to purchase 5,764,607 shares of common stock at prices ranging from $2.69 to $9.57 per share which were outstanding as of December 31, 2016, were not included in the computation of diluted EPS because dilutive shares are not factored into the calculation of EPS when a loss applicable to common shares is reported as they would be anti-dilutive. For the years ended December 31, 2018, 2017 and 2016, 50,000 shares of convertible preferred stock and accrued but unpaid dividends were anti-dilutive on an as if-converted

Summary of Significant Accoun_3

Summary of Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2018
Accounting Policies [Abstract]
Schedule Of Estimated Useful Lives Of Property Plant And Equipment	Depreciation is computed on the straight-line method over the following estimated useful lives of the assets: Buildings 25 to 40 years Building improvements and leasehold improvements 8 to 40 years Processing equipment 7 to 10 years Office equipment, furniture and fixtures 5 to 7 years Computer hardware and software 3 to 7 years Surgical instruments 3 to 5 years
Schedule of Weighted Average Number of Shares	A reconciliation of the number of common shares used in the calculation of basic and diluted EPS is presented below: Year Ended December 31, 2018 2017 2016 Weighted average basic shares 63,521,703 59,684,289 58,236,745 Effect of dilutive securities: Stock options — 915,663 — Weighted average diluted shares 63,521,703 60,599,952 58,236,745

Recently Issued Accounting St_2

Recently Issued Accounting Standards. (Tables)	12 Months Ended
	Dec. 31, 2018
Accounting Changes and Error Corrections [Abstract]
Schedule of Effect of Adoption under ASC Topic 606	The effects of the adoption under ASC Topic 606 are outlined in the following table: Year Ended December 31, 2017 Impact January 1, 2018 (as restated) (as reported) (as restated) Accounts receivable $ 35,198 $ 3,243 $ 38,441 Inventories—net 111,944 (995 ) 110,949 Accrued expenses — 1,110 1,110 Deferred tax assets 9,455 (266 ) 9,189 Accumulated deficit (237,287 ) 872 (236,415 )
Schedule of Impact of Adoption of Topic 606 to the Balance Sheets and Income Statement	The impact of adoption of Topic 606 to the Company’s consolidated balance sheets and statements of comprehensive (loss) income for the year ended December 31, 2018, was as follows: Year Ended December 31, 2018 Excluding Impact As Restated of Topic 606 (as restated) Accounts receivable $ 48,096 $ 41,243 Inventories—net 107,655 111,353 Accrued expenses 25,865 25,348 Deferred tax assets 17,760 17,185 Accumulated deficit (239,537 ) (242,751 ) Year Ended December 31, 2018 Excluding Impact As of Topic 606 (as restated) Total revenues $ 280,362 $ 276,943 Cost of processing and distribution 140,719 138,815 Income tax benefit 4,268 4,744 Net income (loss) applicable to common shares (5,243 ) (6,282 )
Revenue Recognition from Four Categories	The following table presents revenues from these four franchises for the year ended December 31, 2018: Year Ended December 31, 2018 (as restated) Revenues: Spine $ 79,812 Sports 54,560 OEM 120,024 International 25,966 Total revenues from contracts with customers $ 280,362
Revenue Recognized at a Point in Time and Over Time	The following table presents revenues recognized at a point in time and over time for the year ended December 31, 2018: Year Ended December 31, 2018 (as restated) Revenue recognized at a point in time $ 239,619 Revenue recognized over time 40,743 Total revenues from contracts with customers $ 280,362
Contract with Customer, Asset and Liability	The opening and closing balances of the Company’s accounts receivable, contract asset and current and long-term contract liability are as follows: Contract Contract Accounts Liability Liability Receivable (Current) (Long-Term) (as restated) (as reported) (as reported) Opening 1/1/2018 $ 38,441 $ 5,978 $ 3,741 Closing 12/31/2018 48,096 5,425 744 Increase/(decrease) 9,655 (553 ) (2,997 )

Acquisition of Zyga Technolog_2

Acquisition of Zyga Technology, Inc. (Tables)	12 Months Ended
	Dec. 31, 2018
Business Combinations [Abstract]
Acquisition Purchase Price	The purchase price was financed as follows: Cash proceeds from revolving credit facility $ 18,000 Cash from RTI Surgical 3,000 Total purchase price $ 21,000
Summary of Final Allocation of Total Consideration to Tangible and Intangible Assets and Liabilities	The table below represents an allocation of the total consideration to Zyga’s tangible and intangible assets and liabilities fair values as of January 4, 2018. Inventories $ 1,099 Accounts receivable 573 Other current assets 53 Property, plant and equipment 151 Other assets 26 Deferred tax assets 4,715 Current liabilities (947 ) Acquisition contingencies (4,986 ) Net tangible assets acquired 684 Other intangible assets 6,760 Goodwill 13,556 Total net assets acquired $ 21,000
Pro Forma Information of Operations	The following unaudited pro forma information shows the results of the Company’s operations as though the acquisition had occurred as of January 1, 2017 (in thousands, except per share data): Year End December 31, 2018 2017 Revenues $ 4,809 $ 4,649 Net loss applicable to common shares (2,640 ) (4,239 ) Basic net loss per share (0.04 ) (0.07 ) Diluted net loss per share (0.04 ) (0.07 )

Cardiothoracic Closure Busine_2

Cardiothoracic Closure Business Divestiture (Tables)	12 Months Ended
	Dec. 31, 2018
Discontinued Operations and Disposal Groups [Abstract]
Schedule of Calculation of Gain of CT Business Divestiture	The calculation of the gain on the CT Business divestiture is as follows: Proceeds from cardiothoracic closure business divestiture $ 51,000 Inventories—net (2,893 ) Property, plant and equipment—net (1,299 ) Goodwill (8,645 ) Other intangible assets—net (280 ) Cardiothoracic closure business divestiture expenses (3,793 ) Gain on cardiothoracic closure business divestiture $ 34,090

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of Weighted-Average Assumptions Used to Determine Fair Value of Options	The following weighted-average assumptions were used to determine the fair value of options under FASB ASC 718: Year Ended December 31, 2018 2017 2016 Expected term (years) 6.50 6.50 6.50 Risk free interest rate 2.75 % 2.26 % 1.85 % Volatility factor 43.74 % 47.39 % 45.57 % Dividend yield — — —
Stock Options Outstanding, Exercisable and Available for Grant	Stock options outstanding, exercisable and available for grant at December 31, 2018, are summarized as follows: Weighted Weighted Average Average Remaining Aggregate Number of Exercise Contractual Intrinsic Options Price Life (Years) Value (as restated) (as restated) (as restated) (as restated) Outstanding at January 1, 2018 4,662,037 $ 3.86 — — Granted 722,122 4.32 — — Exercised (352,015 ) 3.53 — — Forfeited or expired (756,400 ) 4.99 — — Outstanding at December 31, 2018 4,275,744 $ 3.76 4.15 $ 1,161 Vested or expected to vest at December 31, 2018 3,472,364 $ 3.77 3.93 $ 924 Exercisable at December 31, 2018 1,019,844 $ 3.94 2.43 $ 169 Available for grant at December 31, 2018 5,454,302
Stock-Based Compensation Recognized	For the years ended December 31, 2018, 2017 and 2016, the Company recognized stock-based compensation as follows: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) Stock-based compensation: Costs of processing and distribution $ 132 $ 132 $ 140 Marketing, general and administrative 4,553 6,586 3,406 Research and development 60 44 44 Total $ 4,745 $ 6,762 $ 3,590
Other Information Concerning Stock Options	Other information concerning stock options are as follows: Year Ended December 31, 2018 2017 2016 Weighted average fair value of stock options granted $ 2.05 $ 1.66 $ 1.55 Aggregate intrinsic value of stock options exercised 349 2,786 12
Unvested Restricted Stock Awards	The following table summarizes information about unvested restricted stock awards as of December 31, 2018: Weighted Average Number of Grant Date Shares Fair Value (as restated) (as restated) Unvested at January 1, 2018 1,120,190 $ 4.15 Granted 827,214 4.29 Vested (635,205 ) 4.07 Forfeited (279,484 ) 4.13 Unvested at December 31, 2018 1,032,715 $ 4.32

Inventories (Tables)

Inventories (Tables)	12 Months Ended
	Dec. 31, 2018
Inventory Disclosure [Abstract]
Components of Inventories	Inventories by stage of completion are as follows: December 31, 2018 2017 (as restated) (as restated) Unprocessed tissue, raw materials and supplies $ 24,211 $ 22,071 Tissue and work in process 31,796 40,481 Implantable tissue and finished goods 51,648 49,392 $ 107,655 $ 111,944

Prepaid and Other Current Ass_2

Prepaid and Other Current Assets (Tables)	12 Months Ended
	Dec. 31, 2018
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Schedule of Prepaid and Other Current Assets	Prepaid and Other Current Assets are as follows: December 31, 2018 2017 (as restated) (as restated) Income tax receivable $ 3,920 $ 10,241 Receivable for executive stock option exercise — 1,234 Prepaid expenses 2,013 1,592 Other 2,480 3,559 $ 8,413 $ 16,626

Property, Plant and Equipment (

Property, Plant and Equipment (Tables)	12 Months Ended
	Dec. 31, 2018
Property, Plant and Equipment [Abstract]
Components of Property, Plant and Equipment	Property, plant and equipment are as follows: December 31, 2018 2017 Land $ 2,020 $ 2,020 Buildings and improvements 58,093 57,954 Processing equipment 42,599 44,137 Surgical instruments 24,070 21,256 Office equipment, furniture and fixtures 1,877 1,352 Computer equipment and software 18,873 19,332 Construction in process 8,934 5,980 156,466 152,031 Less accumulated depreciation (78,512 ) (72,467 ) $ 77,954 $ 79,564

Goodwill (Tables)

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The change in the carrying amount of goodwill for the year ended December 31, 2018, is as follows: Year Ended December 31, 2018 2017 Balance at January 1 $ 46,242 $ 54,887 Goodwill acquired related to Zyga acquisition 13,556 — Goodwill disposed of related to sale of Cardiothoracic closure business — 8,645 Balance at December 31 $ 59,798 $ 46,242

Other Intangible Assets (Tables

Other Intangible Assets (Tables)	12 Months Ended
	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Components of Other Intangible Assets	Other intangible assets are as follows: December 31, 2018 December 31, 2017 Gross Gross Carrying Accumulated Carrying Accumulated Amount Amortization Amount Amortization (as restated) (as restated) (as restated) (as restated) Patents $ 15,469 $ 4,191 $ 11,061 $ 4,892 Acquired licensing rights 11,671 6,468 14,566 9,097 Marketing and procurement intangible assets 20,355 11,279 20,603 9,667 Total $ 47,495 $ 21,938 $ 46,230 $ 23,656
Estimates of Future Amortization Expense	At December 31, 2018, management’s estimates of future amortization expense for the next five years are as follows: Amortization Expense 2019 $ 4,200 2020 4,100 2021 4,100 2022 4,100 2023 1,800

Fair Value Information (Tables)

Fair Value Information (Tables)	12 Months Ended
	Dec. 31, 2018
Fair Value Disclosures [Abstract]
Summary of Impairments of Long-Lived Assets and Related Post Impairment Fair Values	The following table summarizes impairments of long-lived assets and the related post impairment fair values of the corresponding assets for the year ended December 31, 2016 and 2018: Year Ended December 31, 2016 Impairment Fair Value Property, plant and equipment - net $ 4,717 $ 4,708 Other intangible assets - net 718 150 $ 5,435 $ 4,858 Year Ended December 31, 2018 Impairment Fair Value Property, plant and equipment - net $ 1,797 $ — Other intangible assets - net 2,718 — $ 4,515 $ —

Accrued Expenses (Tables)

Accrued Expenses (Tables)	12 Months Ended
	Dec. 31, 2018
Other Liabilities Disclosure [Abstract]
Accrued expenses	Accrued expenses are as follows: December 31, 2018 2017 (as restated) (as restated) Accrued compensation $ 8,308 $ 8,257 Accrued severance and restructuring costs 1,302 3,122 Accrued executive transition costs 43 2,300 Accrued distributor commissions 3,907 3,889 Accrued donor recovery fees 3,018 4,144 Other 9,287 4,047 $ 25,865 $ 25,759

Short and Long-Term Obligatio_2

Short and Long-Term Obligations (Tables)	12 Months Ended
	Dec. 31, 2018
Debt Disclosure [Abstract]
'Short and Long-Term Obligations	Short and long-term obligations are as follows: December 31, December 31, 2018 2017 Term loan $ — $ 24,250 Revolving credit facility 50,000 22,500 Less unamortized debt issuance costs (927 ) (406 ) Total 49,073 46,344 Less current portion — (4,268 ) Long-term portion $ 49,073 $ 42,076

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Summary of Pre-Tax Income	The Company’s pre-tax income consists of the following components: Year Ended December 31, 2018 2017 2016 Pre-tax income: Domestic (U.S., state and local) $ (9,052 ) $ 30,121 $ (7,722 ) Foreign 1,661 (3,866 ) (9,314 ) Total (7,391 ) 26,255 (17,036 )
Schedule of Income Tax Benefit(Provision)	The Company’s income tax benefit (provision) consists of the following components: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) Current: Federal $ 967 $ (2,910 ) $ (88 ) State (205 ) (833 ) (84 ) International (376 ) — 456 Total current 386 (3,743 ) 284 Deferred: Federal 2,356 (14,554 ) 2,547 State (2,446 ) (1,052 ) 589 International 3,972 — (192 ) Total deferred 3,882 (15,606 ) 2,944 Total income tax benefit (provision) $ 4,268 $ (19,349 ) $ 3,228
Schedule of Company Deferred Tax Assets and Liabilities	The Company’s deferred tax assets and liabilities consists of the following components: December 31, 2018 December 31, 2017 Deferred Income Tax Deferred Income Tax Assets Liabilities Assets Liabilities (as restated) (as restated) (as restated) (as restated) Accounts receivable $ 513 $ — $ 190 $ — Accrued liabilities 2,358 — 2,072 — Deferred compensation 1,372 — 1,783 — Fixed assets and intangibles — (5,862 ) 66 (7,370 ) Inventory 7,631 — 5,905 — Net operating losses 8,198 — 8,106 — Revenue 650 — 1,874 — Tax credits 5,993 — 4,263 — Other — — — (110 ) Valuation allowance (3,093 ) — (7,258 ) — Total $ 23,622 $ (5,862 ) $ 16,935 $ (7,480 )
Schedule of Company Unrecognized Tax Benefits are Summarized	The Company’s unrecognized tax benefits are summarized as follows: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) Opening balance $ 1,591 $ 1,591 $ 1,986 Reductions based on tax positions related to the current year — — — Additions for tax positions of prior years — — — Reductions for tax positions of prior years (415 ) — (60 ) Reductions for expiration of statute of limitations (88 ) — (335 ) $ 1,088 $ 1,591 $ 1,591
Schedule of Effective Tax Rate Differs from the Statutory Federal Income Tax Rate	The effective tax rate differs from the statutory federal income tax rate for the following reasons: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) Statutory federal rate 21.00% 35.00% 35.00% State income taxes—net of federal tax benefit (4.58% ) 2.37% 1.73% Foreign rate differential 14.36% 2.54% (2.47% ) Acquisition expenses (7.26% ) — — Goodwill disposal — 11.52% — Life insurance (0.98% ) (1.38% ) — Officer compensation (7.88% ) 4.18% — Stock-based compensation (3.90% ) 6.06% — Tax credits 8.65% (4.53% ) 7.28% Tax legislation 9.23% 8.33% — Valuation allowances 21.93% 6.08% (22.11% ) Uncertain tax positions 6.86% — — Other reconciling items, net 0.32% 3.52% (0.48% ) Effective tax rate 57.75% 73.69% 18.95%

Preferred Stock (Tables)

Preferred Stock (Tables)	12 Months Ended
	Dec. 31, 2018
Equity [Abstract]
Schedule of Preferred Stock	Preferred stock is as follows: Preferred Stock Preferred Stock Net Liquidation Value Issuance Costs Total Balance at January 1, 2016 $ 57,168 $ (845 ) $ 56,323 Accrued dividend 3,508 — 3,508 Amortization of preferred stock issuance costs — 185 185 Balance at December 31, 2016 60,676 (660 ) 60,016 Accrued dividend 3,723 — 3,723 Amortization of preferred stock issuance costs — 184 184 Balance at December 31, 2017 64,399 (476 ) 63,923 Accrued dividend 2,120 — 2,120 Amortization of preferred stock issuance costs — 183 183 Balance at December 31, 2018 $ 66,519 $ (293 ) $ 66,226

Severance and Restructuring C_2

Severance and Restructuring Costs (Tables)	12 Months Ended
	Dec. 31, 2018
Chief Executive Officer And Chief Financial And Administrative Officer [Member]
Schedule of Restructuring Charges	The following table includes a rollforward of executive transition costs included in accrued expenses, see Note 13. As Accrued executive transition costs at January 1, 2016 $ — Executive transition costs accrued in 2016 4,404 Stock-based compensation (1,535 ) Cash payments (463 ) Accrued executive transition costs at December 31, 2016 2,406 Executive transition costs accrued in 2017 2,818 Stock-based compensation (1,612 ) Cash payments (1,275 ) Accrued executive transition costs at December 31, 2017 2,337 Executive transition costs accrued in 2018 — Cash payments (2,294 ) Accrued executive transition costs at December 31, 2018 $ 43
Employee Severance [Member]
Schedule of Restructuring Charges	The following table includes a rollforward of severance and restructuring costs included in accrued expenses, see Note 13. As Restated Accrued severance and restructuring charges at January 1, 2016 $ 865 Severance and restructuring expenses accrued in 2016 2,146 Severance and restructuring cash payments (1,866 ) Asset abandonments (640 ) Accrued severance and restructuring charges at December 31, 2016 505 Severance and restructuring expenses accrued in 2017 12,016 Severance and restructuring cash payments (8,246 ) Stock based compensation (1,153 ) Accrued severance and restructuring charges at December 31, 2017 3,122 Severance and restructuring expenses accrued in 2018 2,808 Severance and restructuring cash payments (4,628 ) Accrued severance and restructuring charges at December 31, 2018 $ 1,302

Concentrations of Risk (Tables)

Concentrations of Risk (Tables)	12 Months Ended
	Dec. 31, 2018
Risks and Uncertainties [Abstract]
Schedule of Percentage of Total Revenues Derived from Company's Largest Distributors	The following table presents percentage of total revenues derived from the Company’s largest distributors: Year Ended December 31, 2018 2017 2016 (as reported) (as reported) (as reported) Percent of revenues derived from: Distributor Zimmer 21 % 17 % 16 % Medtronic 8 % 9 % 9 % Synthes 5 % 4 % 4 %

Commitments and Contingencies (

Commitments and Contingencies (Tables)	12 Months Ended
	Dec. 31, 2018
Commitments and Contingencies Disclosure [Abstract]
Future Minimum Lease Commitments Under Non-Cancelable Operating Leases	Future minimum lease commitments under non-cancelable Operating 2019 $ 1,374 2020 806 2021 276 2022 162 2023 166 2024 and beyond 882 $ 3,666

Segment Data (Tables)

Segment Data (Tables)	12 Months Ended
	Dec. 31, 2018
Segment Reporting [Abstract]
Summary of Segment Data	The following table presents revenues from these four franchises and their respective percentages of the Company’s total revenues for the years ended December 31, 2018, 2017 and 2016: Year Ended December 31, 2018 2017 2016 (as restated) (as restated) (as restated) (In thousands) Revenues: Spine $ 79,812 28.4 % $ 77,646 27.6 % $ 74,086 26.9 % Sports 54,560 19.5 % 57,070 20.4 % 54,629 19.8 % OEM 120,024 42.8 % 111,506 39.8 % 111,013 40.2 % International 25,966 9.3 % 25,964 9.3 % 25,109 9.1 % Cardiothoracic — 0.0 % 8,163 2.9 % 11,147 4.0 % Total revenues $ 280,362 100.0 % $ 280,349 100.0 % $ 275,984 100.0 %
Summary of Revenues by Geographic Location	The following table presents property, plant and equipment—net by significant geographic location: December 31, 2018 2017 Property, plant and equipment - net: Domestic $ 72,501 $ 73,363 International 5,453 6,201 Total $ 77,954 $ 79,564

Quarterly Results of Operatio_2

Quarterly Results of Operations (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2018
Quarterly Financial Information Disclosure [Abstract]
Schedule of Quarterly Results of Operations	We have not adjusted the quarterly results of operations for any other period or as of any other date presented. See Note 3, Revenue from Contracts with Customers.): Year Ended December 31, 2018 First Second Third Fourth Quarter Quarter Quarter Quarter (as restated) (as restated) (as restated) (as restated) Revenues $ 69,141 $ 70,385 $ 70,450 $ 70,386 Gross profit 33,503 29,899 38,228 38,013 Net (loss) income (1,117 ) (5,802 ) 2,997 799 Net (loss) income per common share - basic $ (0.03 ) $ (0.11 ) $ 0.04 $ 0.01 Net (loss) income per common share - diluted $ (0.03 ) $ (0.11 ) $ 0.04 $ 0.01 Year Ended December 31, 2017 First Second Third Fourth Quarter Quarter Quarter Quarter (as restated) (as restated) (as restated) (as restated) Revenues $ 70,414 $ 71,578 $ 67,246 $ 71,111 Gross profit 36,189 36,661 33,812 36,410 Net (loss) income (1,877 ) (1,665 ) 17,676 (7,228 ) Net (loss) income per common share - basic $ (0.05 ) $ (0.04 ) $ 0.28 $ (0.13 ) Net (loss) income per common share - diluted $ (0.05 ) $ (0.04 ) $ 0.23 $ (0.13 )

Restatement of Prior Period F_2

Restatement of Prior Period Financial Statements (Tables)	12 Months Ended
	Dec. 31, 2018
Accounting Changes and Error Corrections [Abstract]
Schedule of Restated Consolidated Balance Sheets	Restated Condensed Consolidated Balance Sheet Amounts (in thousands) As of December 31, 2018 As Previously Adjustments As Restated Accounts receivable $ 48,351 $ (255) $ 48,096 Inventories - net 107,471 184 107,655 Prepaid and other current assets 8,791 (378 ) 8,413 Total current assets 175,562 (449 ) 175,113 Deferred tax assets - net 17,510 250 17,760 Other intangible assets - net 26,359 (802 ) 25,557 Total assets $ 361,186 $ (1,001 ) $ 360,185 Accounts payable $ 26,309 $ (90) $ 26,219 Accrued expenses 24,683 1,182 25,865 Total current liabilities 55,900 1,092 56,992 Total liabilities 111,336 1,092 112,428 Accumulated deficit (237,444 ) (2,093 ) (239,537 ) Total stockholders’ equity 183,624 (2,093 ) 181,531 Total liabilities and stockholders’ equity $ 361,186 $ (1,001 ) $ 360,185 As of December 31, 2017 As Previously Adjustments As Restated Accounts receivable $ 35,081 $ 117 $ 35,198 Inventories - net 111,927 17 111,944 Prepaid and other current assets 16,285 341 16,626 Total current assets 185,674 475 186,149 Deferred tax assets - net 9,575 (120 ) 9,455 Other intangible assets - net 23,070 (496 ) 22,574 Total assets $ 345,906 $ (141 ) $ 345,765 Accounts payable $ 18,252 $ (70) $ 18,182 Accrued expenses 25,610 149 25,759 Total current liabilities 52,998 79 53,077 Total liabilities 100,246 79 100,325 Accumulated deficit (237,066 ) (220 ) (237,286 ) Total stockholders’ equity 181,737 (220 ) 181,517 Total liabilities and stockholders’ equity $ 345,906 $ (141 ) $ 345,765 Restated Condensed Consolidated Balance Sheet Amounts (in thousands) As of December 31, 2016 As Previously Adjustments As Restated Accounts receivable $ 41,488 $ (551) $ 40,937 Inventories - net 119,743 251 119,994 Prepaid and other current assets 5,213 (34 ) 5,179 Total current assets 180,293 (334 ) 179,959 Property, plant and equipment - net 83,298 104 83,402 Deferred tax assets - net 24,968 124 25,092 Other intangible assets - net 23,994 30 24,024 Total assets $ 368,031 $ (76 ) $ 367,955 Accounts payable $ 26,112 $ (34) $ 26,078 Accrued expenses 22,030 414 22,444 Total current liabilities 58,964 380 59,344 Other long-term liabilities 256 400 656 Total liabilities 143,099 780 143,879 Accumulated deficit (243,338 ) (856 ) (244,194 ) Total stockholders’ equity 164,916 (856 ) 164,060 Total liabilities and stockholders’ equity $ 368,031 $ (76 ) $ 367,955
Schedule of Restated Condensed Consolidated Statements of Income	Restated Condensed Consolidated Statements of Income Amounts (in thousands), except per share data Year Ended December 31, 2018 As Previously Adjustments As Restated Revenues $ 280,855 $ (493) $ 280,362 Costs of processing and distribution 140,732 (13 ) 140,719 Gross profit 140,123 (480 ) 139,643 Marketing, general and administrative 119,217 507 119,724 Severance and restructuring costs 2,280 528 2,808 Asset impairment and abandonments 4,774 296 5,070 Total operating expenses 142,624 1,331 143,955 Operating (loss) (2,501 ) (1,811 ) (4,312 ) (Loss) before income tax benefit (5,580 ) (1,811 ) (7,391 ) Income tax benefit 4,331 (63 ) 4,268 Net (loss) (1,249 ) (1,874 ) (3,123 ) Net (loss) applicable to common shares $ (3,369 ) $ (1,874 ) $ (5,243 ) Comprehensive (loss) income $ (4,310 ) $ (1,874 ) $ (6,184 ) Net (loss) per common share - basic $ (0.05 ) $ (0.03 ) $ (0.08 ) Net (loss) per common share - diluted $ (0.05 ) $ (0.03 ) $ (0.08 ) Restated Condensed Consolidated Statements of Income Amounts (in thousands), except per share data Year Ended December 31, 2017 As Previously Adjustments As Restated Revenues $ 279,563 $ 786 $ 280,349 Costs of processing and distribution 137,042 235 137,277 Gross profit 142,521 551 143,072 Marketing, general and administrative 115,103 (94 ) 115,009 Research and development 13,375 (60 ) 13,315 Severance and restructuring costs 12,173 (157 ) 12,016 Executive transition costs 2,781 37 2,818 Asset impairment and abandonments 3,739 295 4,034 Total operating expenses 113,711 21 113,732 Operating income 28,810 530 29,340 Income before income tax (provision) 25,725 530 26,255 Income tax (provision) (19,453 ) 104 (19,349 ) Net income 6,272 634 6,906 Net income applicable to common shares $ 2,549 $ 634 $ 3,183 Comprehensive income $ 4,536 $ 634 $ 5,170 Net income per common share - basic $ 0.04 $ 0.01 $ 0.05 Net income per common share - diluted $ 0.04 $ 0.01 $ 0.05 Year Ended December 31, 2016 As Previously Adjustments As Restated Revenues $ 272,865 $ 3,119 $ 275,984 Costs of processing and distribution 140,516 2,141 142,657 Gross profit 132,349 978 133,327 Marketing, general and administrative 116,125 541 116,666 Research and development 16,090 207 16,297 Asset impairment and abandonments 5,435 (194 ) 5,241 Total operating expenses 148,030 554 148,584 Operating (loss) (15,681 ) 424 (15,257 ) Foreign exchange (loss) gain (132 ) 3 (129 ) Total other expense - net (1,779 ) 3 (1,776 ) (Loss) before income tax benefit (17,460 ) 427 (17,033 ) Income tax benefit 3,061 167 3,228 Net (loss) (14,399 ) 594 (13,805 ) Net (loss) applicable to common shares $ (17,907 ) $ 594 $ (17,313 ) Comprehensive (loss) $ (19,181 ) $ 594 $ (18,587 ) Net (loss) per common share - basic $ (0.31 ) $ 0.01 $ (0.30 ) Net (loss) per common share - diluted $ (0.31 ) $ 0.01 $ (0.30 )
Schedule of Restated Condensed Consolidated Statement of Cash Flows	Restated Condensed Consolidated Statements of Cash Flow Amounts (in thousands) Year Ended December 31, 2018 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (1,250 ) $ (1,873 ) $ (3,123 ) Depreciation and amortization expense 14,569 10 14,579 Provision for bad debts and product returns 1,195 526 1,721 Deferred income tax (benefit) (4,322 ) (370 ) (4,692 ) Asset impairment and abandonments 4,774 296 5,070 Accounts receivable (11,201 ) 372 (10,829 ) Inventories (11,790 ) (167 ) (11,957 ) Accounts payable 8,054 (19 ) 8,035 Accrued expenses (1,812 ) 985 (827 ) Other operating assets and liabilities 3,318 718 4,036 Net cash provided by operating activities 16,774 478 17,252 Cash flows from financing activities Payments for treasury stock — (478 ) (478 ) Net cash used in financing — (478 ) 4,093 Year Ended December 31, 2017 As Previously Adjustments As Restated Cash flows from operating activities: Net income $ 6,272 $ 636 $ 6,906 Depreciation and amortization expense 14,226 7 14,233 Deferred income tax provision 13,329 244 13,573 Asset impairment and abandonments 3,739 295 4,034 Accounts receivable 5,784 (668 ) 5,116 Inventories 1,375 235 1,610 Accounts payable (12,899 ) (37 ) (12,936 ) Accrued expenses 2,599 3,066 5,665 Other operating assets and liabilities (10,200 ) (445 ) (10,645 ) Net cash provided by operating activities 2,455 3,333 5,788 Cash flows from financing activities Payments for treasury stock — (3,474 ) (3,474 ) Other financing activities (458 ) 141 (317 ) Net cash used in financing (32,398 ) (3,333 ) (35,731 ) Year Ended December 31, 2016 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (14,399 ) $ 594 $ (13,805 ) Depreciation and amortization expense 16,510 18 16,528 Deferred income tax (benefit) (3,395 ) (97 ) (3,492 ) Asset impairment and abandonments 5,435 (194 ) 5,241 Accounts receivable 4,756 (3,046 ) 1,710 Inventories (15,369 ) 2,141 (13,228 ) Accounts payable 4,583 (34 ) 4,549 Accrued expenses (6,536 ) 814 (5,722 ) Other operating assets and liabilities 7,637 (196 ) 7,441 Net cash provided by operating activities 15,323 — 15,323

Restatement of Prior Period Q_2

Restatement of Prior Period Quarterly Financial Statements (Unaudited) (Tables)	12 Months Ended
	Dec. 31, 2018
Accounting Changes and Error Corrections [Abstract]
Schedule of Restated Consolidated Balance Sheets (Unaudited)	Condensed Consolidated Balance Sheets (Unaudited) March 31, June 30, September 30, (as restated) (as restated) (as restated) Assets Current Assets: Cash and cash equivalents $ 13,812 $ 14,246 $ 10,022 Accounts receivable 41,781 44,238 44,189 Inventories - net 107,280 101,767 103,823 Prepaid and other current assets 16,314 8,149 8,313 Total current assets 179,187 168,400 166,347 Property, plant and equipment - net 79,150 76,838 77,344 Deferred tax assets - net 11,884 14,514 11,842 Goodwill 65,254 64,863 62,864 Other intangible assets - net 23,667 20,128 25,701 Other assets - net 1,806 1,838 5,150 Total assets $ 360,948 $ 346,581 $ 349,248 Liabilities and Stockholders’ Equity Current Liabilities: Accounts payable $ 14,670 $ 14,727 $ 19,212 Accrued expenses 23,687 23,787 22,163 Current portion of deferred revenue 4,944 5,020 4,990 Current portion of short and long-term obligations 4,268 — — Total current liabilities 47,569 43,534 46,365 Long-term obligations - less current portion 57,009 53,416 49,021 Other long-term liabilities 5,131 5,155 5,759 Deferred revenue 4,448 3,155 1,968 Total liabilities 114,157 105,260 103,113 Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding 64,935 65,961 66,180 Stockholders’ equity: Common stock, $.001 par value: 150,000,000 shares authorized; 63,401,208, 63,377,839, and 63,461,700 shares issued and outstanding, respectively 63 63 63 Additional paid-in capital 430,014 430,311 432,077 Accumulated other comprehensive loss (5,936 ) (6,850 ) (6,980 ) Accumulated deficit (237,532 ) (243,334 ) (240,336 ) Less treasury stock, 1,195,901, 1,213,009, and 1,221,180 shares, respectively, at cost (4,753 ) (4,830 ) (4,869 ) Total stockholders’ equity 181,856 175,360 179,955 Total liabilities and stockholders’ equity $ 360,948 $ 346,581 $ 349,248 Condensed Consolidated Balance Sheets (Unaudited) March 31, June 30, September 30, (as restated) (as restated) (as restated) Assets Current Assets: Cash and cash equivalents $ 17,598 $ 13,675 $ 17,744 Accounts receivable 36,179 38,363 36,009 Inventories - net 117,578 117,199 114,737 Prepaid and other current assets 5,932 6,221 9,704 Assets held for sale — 1,750 1,750 Total current assets 177,287 177,208 179,944 Property, plant and equipment - net 85,118 84,379 82,794 Deferred tax assets - net 25,918 24,862 18,437 Goodwill 54,887 54,887 46,242 Other intangible assets - net 24,458 23,893 23,704 Other assets - net 1,023 991 1,841 Total assets $ 368,691 $ 366,220 $ 352,962 Liabilities and Stockholders’ Equity Current Liabilities: Accounts payable $ 28,326 $ 27,711 $ 24,411 Accrued expenses 23,196 20,606 20,442 Current portion of deferred revenue 4,686 4,718 4,793 Current portion of short and long-term obligations 5,301 5,779 4,268 Total current liabilities 61,509 58,814 53,914 Long-term obligations - less current portion 75,813 74,360 45,643 Other long-term liabilities 655 1,241 2,544 Deferred revenue 7,394 6,176 4,959 Total liabilities 145,371 140,591 107,060 Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding 60,972 61,941 62,925 Stockholders’ equity: Common stock, $.001 par value: 150,000,000 shares authorized; 58,537,016 and 59,445,223, 60,544,896 shares issued and outstanding, respectively 58 59 59 Additional paid-in capital 417,414 419,324 420,503 Accumulated other comprehensive loss (7,996 ) (6,903 ) (6,469 ) Accumulated deficit (246,071 ) (247,735 ) (230,059 ) Less treasury stock, 410,396 shares, for each respective period, at cost (1,057 ) (1,057 ) (1,057 ) Total stockholders’ equity 162,348 163,688 182,977 Total liabilities and stockholders’ equity $ 368,691 $ 366,220 $ 352,962 Condensed Consolidated Balance Sheets (Unaudited) March 31, June 30, September 30, (as restated) (as restated) (as restated) Assets Current Assets: Cash and cash equivalents $ 11,728 $ 12,754 $ 11,624 Accounts receivable 38,572 36,139 37,324 Inventories - net 124,363 121,635 125,418 Prepaid and other current assets 13,157 13,777 7,473 Total current assets 187,820 184,305 181,839 Property, plant and equipment - net 87,538 88,201 89,070 Deferred tax assets - net 21,931 21,939 21,348 Goodwill 54,887 54,887 54,887 Other intangible assets - net 26,235 25,672 25,640 Other assets - net 432 405 393 Total assets $ 378,843 $ 375,409 $ 373,177 Liabilities and Stockholders’ Equity Current Liabilities: Accounts payable $ 24,301 $ 25,760 $ 23,287 Accrued expenses 21,869 20,581 17,087 Current portion of deferred revenue 4,922 4,891 4,816 Current portion of short and long-term obligations 5,658 4,995 4,689 Total current liabilities 56,750 56,227 49,879 Long-term obligations - less current portion 72,290 72,173 78,720 Other long-term liabilities 510 527 395 Deferred revenue 10,081 8,896 7,754 Total liabilities 139,631 137,823 136,748 Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding 57,227 58,143 59,073 Stockholders’ equity: Common stock, $.001 par value: 150,000,000 shares authorized; 58,026,674, and 58,031,674, 57,417,397 shares issued and outstanding, respectively 58 58 58 Additional paid-in capital 417,308 416,999 418,166 Accumulated other comprehensive loss (6,580 ) (7,136 ) (6,895 ) Accumulated deficit (228,247 ) (229,924 ) (233,419 ) Less treasury stock, 259,443 shares, for each respective period, at cost (554 ) (554 ) (554 ) Total stockholders’ equity 181,985 179,443 177,356 Total liabilities and stockholders’ equity $ 378,843 $ 375,409 $ 373,177 Condensed Consolidated Statements of Income (Unaudited) As of March 31, 2018 As Previously Adjustments As Restated Accounts receivable $ 41,594 $ 187 $ 41,781 Inventories—net 106,694 586 107,280 Prepaid and other current assets 16,192 122 16,314 Total current assets 178,292 895 179,187 Deferred tax assets—net 11,929 (45 ) 11,884 Other intangible assets—net 24,163 (496 ) 23,667 Total assets $ 360,594 $ 354 $ 360,948 Accounts payable $ 14,740 $ (70 ) $ 14,670 Accrued expenses 22,890 797 23,687 Total current liabilities 46,842 727 47,569 Total liabilities 113,430 727 114,157 Accumulated deficit (237,159 ) (373 ) (237,532 ) Total stockholders’ equity 182,229 (373 ) 181,856 Total liabilities and stockholders’ equity $ 360,594 $ 354 $ 360,948 As of June 30, 2018 As Previously Adjustments As Restated Accounts receivable $ 45,576 $ (1,338 ) $ 44,238 Inventories—net 101,022 745 101,767 Prepaid and other current assets 8,038 111 8,149 Total current assets 168,882 (482 ) 168,400 Deferred tax assets—net 14,448 66 14,514 Other intangible assets—net 20,624 (496 ) 20,128 Total assets $ 347,493 $ (912 ) $ 346,581 Accounts payable $ 14,797 $ (70 ) $ 14,727 Accrued expenses 23,914 (127 ) 23,787 Total current liabilities 43,731 (197 ) 43,534 Total liabilities 105,457 (197 ) 105,260 Accumulated deficit (242,619 ) (715 ) (243,334 ) Total stockholders’ equity 176,075 (715 ) 175,360 Total liabilities and stockholders’ equity $ 347,493 $ (912 ) $ 346,581 Restated Consolidated Balance Sheet Amounts (Unaudited) As of September 30, 2018 As Previously Adjustments As Restated Accounts receivable $ 44,141 $ 48 $ 44,189 Inventories—net 103,891 (68 ) 103,823 Prepaid and other current assets 8,613 (300 ) 8,313 Total current assets 166,667 (320 ) 166,347 Deferred tax assets—net 11,875 (33 ) 11,842 Other intangible assets—net 26,197 (496 ) 25,701 Total assets $ 350,097 $ (849 ) $ 349,248 Accounts payable $ 19,282 $ (70 ) $ 19,212 Accrued expenses 22,121 42 22,163 Total current liabilities 46,393 (28 ) 46,365 Total liabilities 103,141 (28 ) 103,113 Accumulated deficit (239,515 ) (821 ) (240,336 ) Total stockholders’ equity 180,776 (821 ) 179,955 Total liabilities and stockholders’ equity $ 350,097 $ (849 ) $ 349,248 As of March 31, 2017 As Previously Adjustments As Restated Accounts receivable $ 36,294 $ (115 ) $ 36,179 Inventories—net 117,392 186 117,578 Prepaid and other current assets 5,888 44 5,932 Total current assets 177,172 115 177,287 Deferred tax assets—net 25,889 29 25,918 Other intangible assets—net 24,560 (102 ) 24,458 Total assets $ 368,649 $ 42 $ 368,691 Accounts payable $ 28,360 $ (34 ) $ 28,326 Accrued expenses 22,659 537 23,196 Total current liabilities 61,006 503 61,509 Other long-term liabilities 255 400 655 Total liabilities 144,468 903 145,371 Accumulated deficit (245,210 ) (861 ) (246,071 ) Total stockholders’ equity 163,209 (861 ) 162,348 Total liabilities and stockholders’ equity $ 368,649 $ 42 $ 368,691 Restated Consolidated Balance Sheet Amounts (Unaudited) As of June 30, 2017 As Previously Adjustments As Restated Accounts receivable $ 39,099 $ (736 ) $ 38,363 Inventories—net 116,773 426 117,199 Prepaid and other current assets 6,177 44 6,221 Total current assets 177,474 (266 ) 177,208 Deferred tax assets—net 24,868 (6 ) 24,862 Other intangible assets—net 23,995 (102 ) 23,893 Total assets $ 366,594 $ (374 ) $ 366,220 Accounts payable $ 27,745 $ (34 ) $ 27,711 Accrued expenses 20,950 (344 ) 20,606 Total current liabilities 59,192 (378 ) 58,814 Other long-term liabilities 841 400 1,241 Total liabilities 140,569 22 140,591 Accumulated deficit (246,899 ) (836 ) (247,735 ) Common stock and additional paid-in capital, less treasury stock 417,886 440 418,326 Total stockholders’ equity 164,084 (396 ) 163,688 Total liabilities and stockholders’ equity $ 366,594 $ (374 ) $ 366,220 As of September 30, 2017 As Previously Adjustments As Restated Accounts receivable $ 36,188 $ (179 ) $ 36,009 Inventories—net 114,568 169 114,737 Prepaid and other current assets 9,806 (102 ) 9,704 Total current assets 180,056 (112 ) 179,944 Deferred tax assets—net 18,543 (106 ) 18,437 Other intangible assets—net 23,806 (102 ) 23,704 Total assets $ 353,282 $ (320 ) $ 352,962 Accounts payable $ 24,445 $ (34 ) $ 24,411 Accrued expenses 20,482 (40 ) 20,442 Total current liabilities 53,988 (74 ) 53,914 Other long-term liabilities 2,144 400 2,544 Total liabilities 106,734 326 107,060 Accumulated deficit (229,413 ) (646 ) (230,059 ) Total stockholders’ equity 183,623 (646 ) 182,977 Total liabilities and stockholders’ equity $ 353,282 $ (320 ) $ 352,962 Restated Consolidated Balance Sheet Amounts (Unaudited) As of March 31, 2016 As Previously Adjustments As Restated Accounts receivable $ 42,000 $ (3,428 ) $ 38,572 Inventories - net 122,459 1,904 124,363 Total current assets 189,344 (1,524 ) 187,820 Deferred tax assets - net 21,847 84 21,931 Other intangible assets - net 26,277 (42 ) 26,235 Total assets $ 380,325 $ (1,482 ) $ 378,843 Accrued expenses $ 21,642 $ 227 $ 21,869 Total current liabilities 56,523 227 56,750 Total liabilities 139,404 227 139,631 Accumulated deficit (226,538 ) (1,709 ) (228,247 ) Total stockholders’ equity 183,694 (1,709 ) 181,985 Total liabilities and stockholders’ equity $ 380,325 $ (1,482 ) $ 378,843 As of June 30, 2016 As Previously Adjustments As Restated Accounts receivable $ 37,263 $ (1,124 ) $ 36,139 Inventories - net 121,035 600 121,635 Total current assets 184,829 (524 ) 184,305 Deferred tax assets - net 22,240 (301 ) 21,939 Other intangible assets - net 25,714 (42 ) 25,672 Total assets $ 376,276 $ (867 ) $ 375,409 Accrued expenses $ 20,354 $ 227 $ 20,581 Total current liabilities 56,000 227 56,227 Total liabilities 137,596 227 137,823 Accumulated deficit (228,830 ) (1,094 ) (229,924 ) Total stockholders’ equity 180,537 (1,094 ) 179,443 Total liabilities and stockholders’ equity $ 376,276 $ (867 ) $ 375,409 Restated Consolidated Balance Sheet Amounts (Unaudited) As of September 30, 2016 As Previously Adjustments As Restated Accounts receivable $ 38,512 $ (1,188 ) $ 37,324 Inventories - net 125,250 168 125,418 Prepaid and other current assets 7,437 36 7,473 Total current assets 182,823 (984 ) 181,839 Deferred tax assets - net 21,555 (207 ) 21,348 Other intangible assets - net 25,682 (42 ) 25,640 Total assets $ 374,410 $ (1,233 ) $ 373,177 Accrued expenses $ 17,337 $ (250 ) $ 17,087 Total current liabilities 50,129 (250 ) 49,879 Total liabilities 136,998 (250 ) 136,748 Accumulated deficit (232,436 ) (983 ) (233,419 ) Total stockholders’ equity 178,339 (983 ) 177,356 Total liabilities and stockholders’ equity $ 374,410 $ (1,233 ) $ 373,177
Schedule of Restated Condensed Consolidated Statements of Income (Unaudited)	Condensed Consolidated Statements of Income (Unaudited) Three Months Ended March 31, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 69,141 $ 70,414 $ 67,517 Costs of processing and distribution 35,638 34,225 31,814 Gross profit 33,503 36,189 35,703 Expenses: Marketing, general and administrative 28,578 29,709 27,856 Research and development 3,421 3,688 4,161 Severance and restructuring costs 742 4,526 — Asset impairment and abandonments 129 236 — Acquisition and integration expenses 800 — — Total operating expenses 33,670 38,159 32,017 Operating (loss) income (167 ) (1,970 ) 3,686 Other (expense) income: Interest expense (835 ) (819 ) (361 ) Interest income 11 — 1 Foreign exchange gain 49 20 46 Total other expense - net (775 ) (799 ) (314 ) (Loss) income before income tax (provision) benefit (942 ) (2,769 ) 3,372 Income tax (provision) benefit (175 ) 892 (1,232 ) Net (loss) income (1,117 ) (1,877 ) 2,140 Convertible preferred dividend (966 ) (910 ) (858 ) Net (loss) income applicable to common shares $ (2,083 ) $ (2,787 ) $ 1,282 Other comprehensive (loss) income: Unrealized foreign currency translation gain 393 320 462 Comprehensive (loss) income $ (1,690 ) $ (2,467 ) $ 1,744 Net (loss) income per common share - basic $ (0.03 ) $ (0.05 ) $ 0.02 Net (loss) income per common share - diluted $ (0.03 ) $ (0.05 ) $ 0.02 Condensed Consolidated Statements of Income (Unaudited) Six Months Ended June 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 139,526 $ 141,992 $ 137,441 Costs of processing and distribution 76,124 69,142 66,789 Gross profit 63,402 72,850 70,652 Expenses: Marketing, general and administrative 57,905 59,285 56,258 Research and development 6,691 7,428 8,245 Severance and restructuring costs 993 7,485 1,818 Contested proxy expenses — — 2,372 Asset impairment and abandonments 4,644 236 — Acquisition and integration expenses 800 — — Total operating expenses 71,033 74,434 68,693 Operating (loss) income (7,631 ) (1,584 ) 1,959 Other (expense) income: Interest expense (1,612 ) (1,734 ) (753 ) Interest income 17 — 7 Loss on extinguishment of debt (309 ) — — Foreign exchange (loss) gain (22 ) (55 ) 8 Total other expense—net (1,926 ) (1,789 ) (738 ) (Loss) income before income tax benefit (provision) (9,557 ) (3,373 ) 1,221 Income tax benefit (provision) 2,638 (169 ) (758 ) Net (loss) income (6,919 ) (3,542 ) 463 Convertible preferred dividend (1,947 ) (1,834 ) (1,728 ) Net (loss) applicable to common shares $ (8,866 ) $ (5,376 ) $ (1,265 ) Other comprehensive (loss) income: Unrealized foreign currency translation (loss) gain (521 ) 1,413 (94 ) Comprehensive (loss) income $ (9,387 ) $ (3,963 ) $ (1,359 ) Net (loss) income per common share—basic $ (0.14 ) $ (0.09 ) $ (0.02 ) Net (loss) income per common share—diluted $ (0.14 ) $ (0.09 ) $ (0.02 ) Condensed Consolidated Statements of Income (Unaudited) Nine Months Ended September 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 209,976 $ 209,238 $ 203,923 Costs of processing and distribution 108,346 102,576 99,195 Gross profit 101,630 106,662 104,728 Expenses: Marketing, general and administrative 87,576 86,963 85,032 Research and development 10,297 10,169 12,034 Severance and restructuring costs 1,987 10,376 2,146 Strategic review costs — — 650 Executive transition costs — — 4,107 Contested proxy expenses — — 2,372 Asset impairment and abandonments 4,748 236 — Acquisition and integration expenses 2,741 — — Cardiothoracic closure business divestiture contingency consideration (3,000 ) — — Gain on cardiothoracic closure business divestiture — (34,090 ) — Total operating expenses 104,349 73,564 106,341 Operating (loss) income (2,719 ) 33,008 (1,613 ) Other (expense) income: Interest expense (2,223 ) (2,475 ) (1,061 ) Interest income 31 — 8 Loss on extinguishment of debt (309 ) — — Foreign exchange (loss) gain (23 ) 5 (59 ) Total other expense—net (2,524 ) (2,470 ) (1,112 ) (Loss) income before income tax (provision) benefit (5,243 ) 30,538 (2,725 ) Income tax benefit (provision) 1,321 (16,404 ) (308 ) Net (loss) income (3,922 ) 14,134 (3,033 ) Convertible preferred dividend (2,120 ) (2,772 ) (2,611 ) Net (loss) income applicable to common shares $ (6,042 ) $ 11,362 $ (5,644 ) Other comprehensive (loss) income: Unrealized foreign currency translation (loss) gain (651 ) 1,847 147 Comprehensive (loss) income $ (6,693 ) $ 13,209 $ (5,497 ) Net (loss) income per common share—basic $ (0.10 ) $ 0.19 $ (0.10 ) Net (loss) income per common share—diluted $ (0.10 ) $ 0.19 $ (0.10 ) Condensed Consolidated Statements of Income (Unaudited) Three Months Ended June 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 70,385 $ 71,578 $ 69,924 Costs of processing and distribution 40,486 34,917 34,975 Gross profit 29,899 36,661 34,949 Expenses: Marketing, general and administrative 29,327 29,576 28,402 Research and development 3,270 3,740 4,084 Severance and restructuring costs 251 2,959 1,818 Contested proxy expenses — — 2,372 Asset impairment and abandonments 4,515 — — Total operating expenses 37,363 36,275 36,676 Operating (loss) income (7,464 ) 386 (1,727 ) Other (expense) income: Interest expense (777 ) (915 ) (392 ) Interest income 6 — 6 Loss on extinguishment of debt (309 ) — — Foreign exchange (loss) (71 ) (75 ) (38 ) Total other expense—net (1,151 ) (990 ) (424 ) (Loss) before income tax benefit (provision) (8,615 ) (604 ) (2,151 ) Income tax benefit (provision) 2,813 (1,061 ) 474 Net (loss) income applicable to common shares (5,802 ) (1,665 ) (1,677 ) Convertible preferred dividend (981 ) (924 ) (870 ) Net (loss) applicable to common shares $ (6,783 ) $ (2,589 ) $ (2,547 ) Other comprehensive (loss): Unrealized foreign currency translation (loss) gain (914 ) 1,093 (556 ) Comprehensive (loss) $ (7,697 ) $ (1,496 ) $ (3,103 ) Net (loss) per common share—basic $ (0.11 ) $ (0.04 ) $ (0.04 ) Net (loss) per common share—diluted $ (0.11 ) $ (0.04 ) $ (0.04 ) Condensed Consolidated Statements of Income (Unaudited) Three Months Ended September 30, 2018 2017 2016 (as restated) (as restated) (as restated) Revenues $ 70,450 $ 67,246 $ 66,482 Costs of processing and distribution 32,222 33,434 32,406 Gross profit 38,228 33,812 34,076 Expenses: Marketing, general and administrative 29,671 27,678 28,774 Research and development 3,606 2,741 3,789 Severance and restructuring costs 994 2,891 328 Strategic review costs — — 650 Executive transition costs — — 4,107 Asset impairment and abandonments 104 — — Acquisition and integration expenses 1,941 — — Cardiothoracic closure business divestiture contingency consideration (3,000 ) — — Gain on cardiothoracic closure business divestiture — (34,090 ) — Total operating expenses 33,316 (780 ) 37,648 Operating income 4,912 34,592 (3,572 ) Other (expense) income: Interest expense (611 ) (741 ) (308 ) Interest income 14 — 1 Foreign exchange (loss) gain (1 ) 60 (67 ) Total other expense—net (598 ) (681 ) (374 ) Income (loss) before income tax (provision) benefit 4,314 33,911 (3,946 ) Income tax (provision) benefit (1,317 ) (16,235 ) 450 Net income (loss) 2,997 17,676 (3,496 ) Convertible preferred dividend (173 ) (938 ) (883 ) Net income (loss) applicable to common shares $ 2,824 $ 16,738 $ (4,379 ) Other comprehensive income (loss): Unrealized foreign currency translation (loss) gain (130 ) 434 241 Comprehensive income (loss) $ 2,694 $ 17,172 $ (4,138 ) Net income (loss) per common share—basic $ 0.04 $ 0.28 $ (0.08 ) Net income (loss) per common share—diluted $ 0.04 $ 0.23 $ (0.08 ) Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Three Months Ended March 31, 2017 (as reported) (adjustments) (as restated) Revenues $ 69,939 $ 475 $ 70,414 Costs of processing and distribution 34,160 65 34,225 Gross profit 35,779 410 36,189 Marketing, general and administrative 29,671 38 29,709 Severance and restructuring costs 4,403 123 4,526 Asset impairment and abandonments — 236 236 Total operating expenses 37,762 397 38,159 Operating (loss) (1,983 ) 13 (1,970 ) (Loss) before income tax benefit (2,782 ) 13 (2,769 ) Income tax benefit 910 (18 ) 892 Net (loss) (1,872 ) (5 ) (1,877 ) Comprehensive (loss) $ (2,462 ) $ (5 ) $ (2,467 ) Net (loss) per common share - basic $ (0.05 ) $ (0.00 ) $ (0.05 ) Net (loss) per common share - diluted $ (0.05 ) $ (0.00 ) $ (0.05 ) Three Months Ended March 31, 2016 (as reported) (adjustments) (as restated) Revenues $ 67,351 $ 166 $ 67,517 Costs of processing and distribution 31,326 488 31,814 Gross profit 36,025 (322 ) 35,703 Marketing, general and administrative 27,860 (4 ) 27,856 Total operating expenses 32,021 (4 ) 32,017 Operating income 4,004 (318 ) 3,686 Income (loss) before income tax (provision) 3,690 (318 ) 3,372 Income tax (provision) (1,289 ) 57 (1,232 ) Net income 2,401 (261 ) 2,140 Comprehensive income $ 2,005 $ (261 ) $ 1,744 Net income per common share - basic $ 0.03 $ (0.01 ) $ 0.02 Net income per common share - diluted $ 0.03 $ (0.01 ) $ 0.02 Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Six Months Ended June 30, 2018 (as reported) (adjustments) (as restated) Revenues $ 140,575 $ (1,049 ) $ 139,526 Costs of processing and distribution 76,853 (729 ) 76,124 Gross profit 63,722 (320 ) 63,402 Marketing, general and administrative 57,655 250 57,905 Severance and restructuring costs 884 109 993 Total operating expenses 70,674 359 71,033 Operating (loss) (6,952 ) (679 ) (7,631 ) (Loss) before income tax benefit (8,878 ) (679 ) (9,557 ) Income tax benefit 2,453 185 2,638 Net (loss) (6,425 ) (494 ) (6,919 ) Comprehensive (loss) $ (8,893 ) $ (494 ) $ (9,387 ) Net (loss) per common share - basic $ (0.13 ) $ (0.01 ) $ (0.14 ) Net (loss) per common share - diluted $ (0.13 ) $ (0.01 ) $ (0.14 ) Six Months Ended June 30, 2017 (as reported) (adjustments) (as restated) Revenues $ 142,059 $ (67 ) $ 141,992 Costs of processing and distribution 69,317 (175 ) 69,142 Gross profit 72,742 108 72,850 Marketing, general and administrative 59,167 118 59,285 Severance and restructuring costs 7,803 (318 ) 7,485 Asset impairment and abandonments — 236 236 Total operating expenses 74,398 36 74,434 Operating (loss) (1,656 ) 72 (1,584 ) (Loss) before income tax (provision) (3,445 ) 72 (3,373 ) Income tax (provision) (116 ) (53 ) (169 ) Net (loss) (3,561 ) 19 (3,542 ) Comprehensive (loss) $ (3,982 ) $ 19 $ (3,963 ) Net (loss) per common share - basic $ (0.09 ) $ 0.00 $ (0.09 ) Net (loss) per common share - diluted $ (0.09 ) $ 0.00 $ (0.09 ) Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Six Months Ended June 30, 2016 (as reported) (adjustments) (as restated) Revenues $ 134,971 $ 2,470 $ 137,441 Costs of processing and distribution 64,997 1,792 66,789 Gross profit 69,974 678 70,652 Marketing, general and administrative 55,954 (4 ) 55,950 Total operating expenses 68,697 (4 ) 68,693 Operating income 1,277 682 1,959 Income (loss) before income tax (provision) 539 682 1,221 Income tax (provision) (430 ) (328 ) (758 ) Net income 109 354 463 Comprehensive (loss) $ (1,713 ) $ 354 $ (1,359 ) Net (loss) per common share - basic $ (0.03 ) $ 0.01 $ (0.02 ) Net (loss) per common share - diluted $ (0.03 ) $ 0.01 $ (0.02 ) Nine Months Ended September 30, 2018 (as reported) (adjustments) (as restated) Revenues $ 209,639 $ 337 $ 209,976 Costs of processing and distribution 108,262 84 108,346 Gross profit 101,377 253 101,630 Marketing, general and administrative 87,326 250 87,576 Severance and restructuring costs 1,708 279 1,987 Total operating expenses 103,820 529 104,349 Operating (loss) (2,443 ) (276 ) (2,719 ) (Loss) before income tax benefit (4,967 ) (276 ) (5,243 ) Income tax benefit (provision) 1,646 (325 ) 1,321 Net (loss) (3,321 ) (601 ) (3,922 ) Comprehensive (loss) $ (6,092 ) $ (601 ) $ (6,693 ) Net (loss) per common share - basic $ (0.09 ) $ (0.01 ) $ (0.10 ) Net (loss) per common share - diluted $ (0.09 ) $ (0.01 ) $ (0.10 ) Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Nine Months Ended September 30, 2017 (as reported) (adjustments) (as restated) Revenues $ 208,747 $ 491 $ 209,238 Costs of processing and distribution 102,494 82 102,576 Gross profit 106,253 409 106,662 Marketing, general and administrative 86,845 118 86,963 Research and development 10,229 (60 ) 10,169 Severance and restructuring costs 10,623 (247 ) 10,376 Asset impairment and abandonments — 236 236 Total operating expenses 73,607 47 73,654 Operating income 32,646 362 33,008 Income before income tax (provision) 30,176 362 30,538 Income tax (provision) (16,251 ) (153 ) (16,404 ) Net income 13,925 209 14,134 Comprehensive income $ 13,000 $ 209 $ 13,209 Net income per common share - basic $ 0.19 $ 0.00 $ 0.19 Net income per common share - diluted $ 0.19 $ 0.00 $ 0.19 Nine Months Ended September 30, 2016 (as reported) (adjustments) (as restated) Revenues $ 201,518 $ 2,405 $ 203,923 Costs of processing and distribution 97,270 1,925 99,195 Gross profit 104,248 480 104,728 Marketing, general and administrative 84,678 46 84,724 Total operating expenses 106,295 46 106,341 Operating (loss) (2,047 ) 434 (1,613 ) (Loss) before income tax (provision) (3,159 ) 434 (2,725 ) Income tax (provision) (338 ) 30 (308 ) Net (loss) (3,497 ) 464 (3,033 ) Comprehensive (loss) $ (5,961 ) $ 464 $ (5,497 ) Net (loss) per common share - basic $ (0.10 ) $ (0.00 ) $ (0.10 ) Net (loss) per common share - diluted $ (0.10 ) $ (0.00 ) $ (0.10 ) Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Three Months Ended June 30, 2018 (as reported) (adjustments) (as restated) Revenues $ 70,685 $ (300 ) $ 70,385 Costs of processing and distribution 40,645 (159 ) 40,486 Gross profit 30,040 (141 ) 29,899 Marketing, general and administrative 29,266 61 29,327 Severance and restructuring costs — 251 251 Total operating expenses 37,051 312 37,363 Operating (loss) (7,011 ) (453 ) (7,464 ) (Loss) before income tax benefit (8,162 ) (453 ) (8,615 ) Income tax benefit 2,702 111 2,813 Net (loss) (5,460 ) (342 ) (5,802 ) Comprehensive (loss) $ (7,355 ) $ (342 ) $ (7,697 ) Net (loss) per common share - basic $ (0.10 ) $ (0.01 ) $ (0.11 ) Net (loss) per common share - diluted $ (0.10 ) $ (0.01 ) $ (0.11 ) Three Months Ended June 30, 2017 (as reported) (adjustments) (as restated) Revenues $ 72,120 $ (542 ) $ 71,578 Costs of processing and distribution 35,157 (240 ) 34,917 Gross profit 36,963 (302 ) 36,661 Marketing, general and administrative 29,496 80 29,576 Severance and restructuring costs 3,400 (441 ) 2,959 Total operating expenses 36,636 (361 ) 36,275 Operating (loss) 327 59 386 (Loss) before income tax (provision) (663 ) 59 (604 ) Income tax (provision) (1,026 ) (35 ) (1,061 ) Net (loss) (1,689 ) 24 (1,665 ) Comprehensive (loss) $ (1,520 ) $ 24 $ (1,496 ) Net (loss) per common share - basic $ (0.04 ) $ 0.00 $ (0.04 ) Net (loss) per common share - diluted $ (0.04 ) $ 0.00 $ (0.04 ) Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Three Months Ended June 30, 2016 (as reported) (adjustments) (as restated) Revenues $ 67,620 $ 2,304 $ 69,924 Costs of processing and distribution 33,671 1,304 34,975 Gross profit 33,949 1,000 34,949 Operating (loss) (2,727 ) 1,000 (1,727 ) (Loss) income before income tax benefit (3,151 ) 1,000 (2,151 ) Income tax benefit 859 (385 ) 474 Net (loss) (2,292 ) 615 (1,677 ) Comprehensive (loss) $ (3,718 ) $ 615 $ (3,103 ) Net (loss) per common share - basic $ (0.05 ) $ 0.01 $ (0.04 ) Net (loss) per common share - diluted $ (0.05 ) $ 0.01 $ (0.04 ) Three Months Ended September 30, 2018 (as reported) (adjustments) (as restated) Revenues $ 69,064 $ 1,386 $ 70,450 Costs of processing and distribution 31,409 813 32,222 Gross profit 37,655 573 38,228 Severance and restructuring costs 824 170 994 Total operating expenses 33,146 170 33,316 Operating income 4,509 403 4,912 Income (loss) before income tax (provision) 3,911 403 4,314 Income tax (provision) (807 ) (510 ) (1,317 ) Net income 3,104 (107 ) 2,997 Comprehensive income $ 2,801 $ (107 ) $ 2,694 Net income per common share - basic $ 0.05 $ (0.01 ) $ 0.04 Net income per common share - diluted $ 0.04 $ (0.00 ) $ 0.04 Restated and Revised Consolidated Statements of Income Amounts (Unaudited) Three Months Ended September 30, 2017 (as reported) (adjustments) (as restated) Revenues $ 66,688 $ 558 $ 67,246 Costs of processing and distribution 33,177 257 33,434 Gross profit 33,511 301 33,812 Research and development 2,801 (60 ) 2,741 Severance and restructuring costs 2,820 71 2,891 Total operating expenses (791 ) 11 (780 ) Operating income 34,302 290 34,592 Income before income tax (provision) 33,621 290 33,911 Income tax benefit (provision) (16,135 ) (100 ) (16,235 ) Net income 17,486 190 17,676 Comprehensive income $ 16,982 $ 190 $ 17,172 Net income per common share - basic $ 0.28 $ 0.00 $ 0.28 Net income per common share - diluted $ 0.23 $ 0.00 $ 0.23 Three Months Ended September 30, 2016 (as reported) (adjustments) (as restated) Revenues $ 66,547 $ (65 ) $ 66,482 Costs of processing and distribution 32,273 133 32,406 Gross profit 34,274 (198 ) 34,076 Marketing, general and administrative 28,724 50 28,774 Total operating expenses 37,598 50 37,648 Operating (loss) (3,324 ) (248 ) (3,572 ) (Loss) before income tax benefit (3,698 ) (248 ) (3,946 ) Income tax benefit 92 358 450 Net (loss) (3,606 ) 110 (3,496 ) Comprehensive (loss) $ (4,248 ) $ 110 $ (4,138 ) Net (loss) per common share - basic $ (0.08 ) $ 0.00 $ (0.08 ) Net (loss) per common share - diluted $ (0.08 ) $ 0.00 $ (0.08 )
Schedule of Restated Condensed Consolidated Statement of Cash Flows (Unaudited)	Condensed Consolidated Statements of Cash Flows Amounts (Unaudited) For the Three Months Ended March 31, 2018 2017 2016 (as restated) (as restated) (as restated) Cash flows from operating activities: Net (loss) income $ (1,117 ) $ (1,877 ) $ 2,139 Adjustments to reconcile net loss to net cash (used in) provided by operating activities: Depreciation and amortization expense 3,584 3,568 4,310 Provision for bad debts and product returns 149 344 304 Provision for inventory write-downs 2,641 1,789 945 Amortization of deferred revenue (1,217 ) (1,274 ) (1,217 ) Deferred income tax (benefit) provision (112 ) (989 ) 357 Stock-based compensation 1,280 834 500 Asset impairment and abandonments — 236 — Other 409 114 168 Change in assets and liabilities: Accounts receivable (3,182 ) 4,468 4,903 Inventories 1,557 799 (3,843 ) Accounts payable (3,513 ) 108 2,764 Accrued expenses (2,866 ) 702 (7,076 ) Deferred revenue 2,000 2,000 2,000 Other operating assets and liabilities (699 ) (1,245 ) 169 Net cash (used in) provided by operating activities (1,086 ) 9,577 6,423 Cash flows from investing activities: Purchases of property, plant and equipment (2,118 ) (3,283 ) (4,637 ) Patent and acquired intangible asset costs (330 ) (319 ) (1,196 ) Acquisition of Zyga Technology (21,000 ) — — Net cash used in investing activities (23,448 ) (3,602 ) (5,833 ) Cash flows from financing activities: Proceeds from exercise of common stock options 1,394 108 — Proceeds from long-term obligations 20,000 2,000 3,000 Net (payments) on short-term obligations — — (249 ) Payments on long-term obligations (5,125 ) (4,250 ) (4,133 ) Payments for treasury stock (363 ) — — Other financing activities — (142 ) (108 ) Net cash provided by (used in) financing activities 15,906 (2,284 ) (1,490 ) Effect of exchange rate changes on cash and cash equivalents 59 58 14 Net (decrease) increase in cash and cash equivalents (8,569 ) 3,749 (886 ) Cash and cash equivalents, beginning of period 22,381 13,849 12,614 Cash and cash equivalents, end of period $ 13,812 $ 17,598 $ 11,728 Supplemental cash flow disclosure: Cash paid for interest $ 600 $ 1,458 $ 393 Cash paid for income taxes, net of refunds — — 38 Non-cash acquisition of property, plant and equipment 157 2,234 1,586 Increase in accrual for dividend payable 966 910 858 Condensed Consolidated Statements of Cash Flows Amounts (Unaudited) For the Six Months Ended June 30, 2018 2017 2016 (as restated) (as restated) (as restated) Cash flows from operating activities: Net (loss) income $ (6,919 ) $ (3,541 ) $ 462 Adjustments to reconcile net loss to net cash provided by operating activities: Depreciation and amortization expense 7,068 7,129 8,694 Provision for bad debts and product returns 494 560 495 Provision for inventory write-downs 10,865 3,753 2,370 Amortization of deferred revenue (2,435 ) (2,460 ) (2,434 ) Deferred income tax (benefit) provision (2,856 ) (431 ) 210 Stock-based compensation 2,570 2,248 1,100 Asset impairment and abandonments 4,644 236 — Other 610 873 264 Change in assets and liabilities: Accounts receivable (6,185 ) 2,313 7,066 Inventories (1,139 ) (8 ) (2,780 ) Accounts payable (3,803 ) 998 4,495 Accrued expenses (2,429 ) (2,142 ) (8,318 ) Deferred revenue 2,000 2,000 2,000 Other operating assets and liabilities 7,333 (915 ) (415 ) Net cash provided by operating activities 9,818 10,613 13,209 Cash flows from investing activities: Purchases of property, plant and equipment (3,856 ) (7,160 ) (9,403 ) Patent and acquired intangible asset costs (728 ) (1,845 ) (1,391 ) Acquisition of Zyga Technology (21,000 ) — — Net cash (used in) investing activities (25,584 ) (9,005 ) (10,794 ) Cash flows from financing activities: Proceeds from exercise of common stock options 1,429 1,575 14 Proceeds from long-term obligations 74,425 4,000 7,000 Net (payments) on short-term obligations — — (849 ) Payments on long-term obligations (66,750 ) (7,375 ) (8,299 ) Payments for treasury stock (440 ) — — Other financing activities (1,026 ) (142 ) (108 ) Net cash provided by (used in) financing activities 7,638 (1,942 ) (2,242 ) Effect of exchange rate changes on cash and cash equivalents (7 ) 160 (33 ) Net (decrease) increase in cash and cash equivalents (8,135 ) (174 ) 140 Cash and cash equivalents, beginning of period 22,381 13,849 12,614 Cash and cash equivalents, end of period $ 14,246 $ 13,675 $ 12,754 Supplemental cash flow disclosure: Cash paid for interest $ 1,974 $ 2,303 $ 789 Cash paid for income taxes, net of refunds 6,698 32 176 Non-cash acquisition of property, plant and equipment 676 879 1,257 Increase in accrual for dividend payable 1,947 1,834 1,728 Condensed Consolidated Statements of Cash Flows Amounts (Unaudited) For the Nine Months Ended September 30, 2018 2017 2016 (as restated) (as restated) (as restated) Cash flows from operating activities: Net (loss) income $ (3,922 ) $ 14,135 $ (3,033 ) Adjustments to reconcile net loss to net cash provided by (used in) operating activities: Depreciation and amortization expense 10,794 10,704 13,087 Provision for bad debts and product returns 845 816 946 Provision for inventory write-downs 12,906 4,488 4,422 Amortization of deferred revenue (3,652 ) (3,601 ) (3,650 ) Deferred income tax (benefit) provision (1,300 ) 5,542 599 Stock-based compensation 3,650 4,011 3,075 Asset impairment and abandonments 4,748 236 — Cardiothoracic closure business divestiture contingency consideration (3,000 ) — — Gain on cardiothoracic closure business divestiture — (34,090 ) — Other 728 1,475 580 Change in assets and liabilities: Accounts receivable (6,518 ) 4,397 5,463 Inventories (5,758 ) (749 ) (8,511 ) Accounts payable 826 (5,727 ) 1,095 Accrued expenses (4,046 ) (2,566 ) (11,610 ) Deferred revenue 2,000 2,000 2,000 Other operating assets and liabilities 3,184 (3,929 ) 5,571 Net cash provided by (used in) operating activities 11,485 (2,858 ) 10,034 Cash flows from investing activities: Purchases of property, plant and equipment (7,106 ) (10,358 ) (12,774 ) Patent and acquired intangible asset costs (2,798 ) (2,124 ) (2,195 ) Acquisition of Zyga Technology (21,000 ) — — Cardiothoracic closure business divestiture 3,000 51,000 — Net cash (used in) provided by investing activities (27,904 ) 38,518 (14,969 ) Cash flows from financing activities: Proceeds from exercise of common stock options 2,334 1,872 14 Proceeds from long-term obligations 74,425 6,000 15,000 Net (payments) on short-term obligations — — (1,511 ) Payments on long-term obligations (71,171 ) (39,375 ) (9,424 ) Payments for treasury stock (478 ) — — Other financing activities (1,035 ) (457 ) (108 ) Net cash provided by (used in) financing activities 4,075 (31,960 ) 3,971 Effect of exchange rate changes on cash and cash equivalents (15 ) 195 (26 ) Net (decrease) increase in cash and cash equivalents (12,359 ) 3,895 (990 ) Cash and cash equivalents, beginning of period 22,381 13,849 12,614 Cash and cash equivalents, end of period $ 10,022 $ 17,744 $ 11,624 Supplemental cash flow disclosure: Cash paid for interest $ 2,517 $ 2,632 $ 1,224 Cash paid for income taxes, net of refunds (6,659 ) 12,032 282 Non-cash acquisition of property, plant and equipment 471 498 1,445 Stock-based compensation related to sale of CT business — 102 — Increase in accrual for dividend payable 2,120 2,772 2,611 Restated and Revised Consolidated Statement of Cash Flows Amounts (Unaudited) For the Three Months Ended March 31, 2018 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (965 ) (152 ) $ (1,117 ) Deferred income tax (benefit) (38 ) (74 ) (112 ) Accounts receivable (3,112 ) (70 ) (3,182 ) Inventories 2,127 (570 ) 1,557 Accrued expenses (3,877 ) 1,011 (2,866 ) Other operating assets and liabilities (917 ) 218 (699 ) Net cash (used in) operating activities (1,449 ) 363 (1,086 ) Cash flows from financing activities Payments for treasury stock — (363 ) (363 ) Net cash used by financing activities 16,269 (363 ) 15,906 Restated and Revised Consolidated Statement of Cash Flows Amounts (Unaudited) For the Three Months Ended March 31, 2017 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (1,872 ) $ (5 ) $ (1,877 ) Deferred income tax (benefit) (1,085 ) 96 (989 ) Asset impairment and abandonments — 236 236 Accounts receivable 4,905 (437 ) 4,468 Inventories 734 65 799 Accrued expenses 579 123 702 Other operating assets and liabilities (1,167 ) (78 ) (1,245 ) Net cash provided by operating activities 9,577 — 9,577 For the Three Months Ended March 31, 2016 As Previously Adjustments As Restated Cash flows from operating activities: Net income $ 2,401 $ (262 ) $ 2,139 Deferred income tax (benefit) 413 (56 ) 357 Accounts receivable 5,073 (170 ) 4,903 Inventories (4,331 ) 488 (3,843 ) Net cash provided by operating activities 6,423 — 6,423 For the Six Months Ended June 30, 2018 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (6,425 ) $ (494 ) $ (6,919 ) Deferred income tax (benefit) (2,671 ) (185 ) (2,856 ) Accounts receivable (7,640 ) 1,455 (6,185 ) Inventories (411 ) (728 ) (1,139 ) Accrued expenses (2,592 ) 163 (2,429 ) Other operating assets and liabilities 7,104 229 7,333 Net cash provided by operating activities 9,378 440 9,818 Cash flows from financing activities Payments for treasury stock — (440 ) (440 ) Net cash used by financing activities 8,078 (440 ) 7,638 Restated and Revised Consolidated Statement of Cash Flows Amounts (Unaudited) For the Six Months Ended June 30, 2017 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (3,561 ) $ 20 $ (3,541 ) Deferred income tax (benefit) (561 ) 130 (431 ) Stock-based compensation 1,808 440 2,248 Asset impairment and abandonments — 236 236 Accounts receivable 2,128 185 2,313 Inventories 167 (175 ) (8 ) Accrued expenses (1,384 ) (758 ) (2,142 ) Other operating assets and liabilities (837 ) (78 ) (915 ) Net cash provided by operating activities 10,613 — 10,613 For the Six Months Ended June 30, 2016 As Previously Adjustments As Restated Cash flows from operating activities: Net income $ 109 $ 353 $ 462 Deferred income tax (benefit) (119 ) 329 210 Accounts receivable 9,540 (2,474 ) 7,066 Inventories (4,572 ) 1,792 (2,780 ) Net cash provided by operating activities 13,209 — 13,209 For the Nine Months Ended September 30, 2018 As Previously Adjustments As Restated Cash flows from operating activities: Net income $ (3,321 ) $ (601 ) $ (3,922 ) Deferred income tax (benefit) (1,214 ) (86 ) (1,300 ) Accounts receivable (6,587 ) 69 (6,518 ) Inventories (5,843 ) 85 (5,758 ) Accrued expenses (4,417 ) 371 (4,046 ) Other operating assets and liabilities 2,544 640 3,184 Net cash provided by operating activities 11,007 478 11,485 Cash flows from financing activities: Payments for treasury stock — (478 ) (478 ) Net cash used in financing 4,553 (478 ) 4,075 Restated and Revised Consolidated Statement of Cash Flows Amounts (Unaudited) For the Nine Months Ended September 30, 2017 As Previously Adjustments As Restated Cash flows from operating activities: Net income $ 13,925 $ 210 $ 14,135 Deferred income tax (benefit) 5,312 230 5,542 Asset impairment and abandonments — 236 236 Accounts receivable 4,770 (373 ) 4,397 Inventories (831 ) 82 (749 ) Accrued expenses (2,112 ) (454 ) (2,566 ) Other operating assets and liabilities (3,998 ) 69 (3,929 ) Net cash (used in) operating activities (2,858 ) — (2,858 ) For the Nine Months Ended September 30, 2016 As Previously Adjustments As Restated Cash flows from operating activities: Net (loss) $ (3,497 ) $ 464 $ (3,033 ) Deferred income tax (provision) 366 233 599 Accounts receivable 7,872 (2,409 ) 5,463 Inventories (10,736 ) 2,225 (8,511 ) Accrued expenses (11,360 ) (250 ) (11,610 ) Other operating assets and liabilities 5,834 (263 ) 5,571 Net cash provided by operating activities 10,034 — 10,034

Summary of Significant Accoun_4

Summary of Significant Accounting Policies - Estimated Useful Lives of Assets (Detail)	12 Months Ended
	Dec. 31, 2018
Minimum [Member] | Building [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	25 years
Minimum [Member] | Building Improvements and Leasehold Improvements [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	8 years
Minimum [Member] | Processing Equipment [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	7 years
Minimum [Member] | Office Equipment, Furniture and Fixtures [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	5 years
Minimum [Member] | Computer Hardware And Software [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	3 years
Minimum [Member] | Surgical Instruments [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	3 years
Maximum [Member] | Building [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	40 years
Maximum [Member] | Building Improvements and Leasehold Improvements [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	40 years
Maximum [Member] | Processing Equipment [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	10 years
Maximum [Member] | Office Equipment, Furniture and Fixtures [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	7 years
Maximum [Member] | Computer Hardware And Software [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	7 years
Maximum [Member] | Surgical Instruments [Member]
Property Plant And Equipment Estimated Useful Lifes [Line Items]
Estimated Useful Life of Assets	5 years

Summary of Significant Accoun_5

Summary of Significant Accounting Policies - Additional Information (Detail) $ / shares in Units, $ in Thousands	3 Months Ended		12 Months Ended
	Jun. 30, 2018USD ($)	Dec. 31, 2017USD ($)$ / sharesshares	Dec. 31, 2018USD ($)Reporting_unit$ / sharesshares	Dec. 31, 2017USD ($)$ / sharesshares	Dec. 31, 2016USD ($)$ / sharesshares
Other identifiable intangible assets					$ 5,435
Number of reporting unit | Reporting_unit			1
Repurchase of common stock, shares | shares		745,122	107,109	745,122	138,597
Repurchase of common stock, value			$ 479	$ 3,474	$ 470
Convertible Preferred Stock [Member]
Antidilutive securities excluded from computation of earnings per share | shares			50,000	50,000	50,000
Stock Option [Member]
Antidilutive securities excluded from computation of earnings per share | shares			4,275,744	4,662,037	5,764,607
Map3 product [Member]
Asset impairment	$ 4,515
UNITED STATES
Asset abandonments		$ 3,539
Minimum [Member] | Stock Option [Member]
Common stock price per share, shares | $ / shares		$ 2.69	$ 2.69	$ 2.69	$ 2.69
Minimum [Member] | Patents [Member]
Estimated useful lives of intangible assets			8 years
Minimum [Member] | Procurement Contracts [Member]
Estimated useful lives of intangible assets			5 years
Maximum [Member] | Stock Option [Member]
Common stock price per share, shares | $ / shares		$ 8.20	$ 5.23	$ 8.20	$ 9.57
Maximum [Member] | Patents [Member]
Estimated useful lives of intangible assets			16 years
Maximum [Member] | Procurement Contracts [Member]
Estimated useful lives of intangible assets			25 years

Summary of Significant Accoun_6

Summary of Significant Accounting Policies - Reconciliation of Common Shares used in Calculation of Basic and Diluted EPS (Detail) - shares (Detail) - shares	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Accounting Policies [Abstract]
Weighted average basic shares	63,521,703	59,684,289	58,236,745
Effect of dilutive securities:
Stock options		915,663
Weighted average diluted shares	63,521,703	60,599,952	58,236,745

Recently Issued Accounting St_3

Recently Issued Accounting Standards - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2018USD ($)SegmentBusiness	Jan. 01, 2018USD ($)	Dec. 31, 2017USD ($)
Number of contracts identified	3
Number of business lines | Business	4
Number of reportable segment | Segment	1
Remaining payment terms	$ 0
Product return allowance	708,000		$ 795,000
Revenue recognized from customer liability	4,958,000
Unbilled receivables	$ 6,577	$ 2,133
OEM [Member]
Contract payment due	30 days
Maximum [Member]
Lease term	12 months
Remaining payment terms	$ 0
Minimum [Member]
Remaining payment terms	$ 0

Recently Issued Accounting St_4

Recently Issued Accounting Standards - Schedule of Effect of Adoption under ASC Topic 606 (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Jan. 01, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Accounts receivable	$ 48,096	$ 44,189	$ 44,238	$ 41,781		$ 35,198	$ 36,009	$ 38,363	$ 36,179	$ 40,937	$ 37,324	$ 36,139	$ 38,572
Inventories-net	107,655	103,823	101,767	107,280		111,944	114,737	117,199	117,578	119,994	125,418	121,635	124,363
Accrued expenses	25,865
Deferred tax assets	17,760					9,455				25,092
Accumulated deficit	(239,537)	$ (240,336)	$ (243,334)	$ (237,532)		(237,286)	$ (230,059)	$ (247,735)	$ (246,071)	$ (244,194)	$ (233,419)	$ (229,924)	$ (228,247)
Difference between Revenue Guidance in Effect before and after Topic 606 [Member]
Accounts receivable						3,243
Inventories-net						(995)
Accrued expenses						1,110
Deferred tax assets						(266)
Accumulated deficit						$ 872
Calculated under Revenue Guidance in Effect before Topic 606 [Member]
Accounts receivable	41,243				$ 38,441
Inventories-net	111,353				110,949
Accrued expenses	25,348				1,110
Deferred tax assets	17,185				9,189
Accumulated deficit	$ (242,751)				$ (236,415)

Recently Issued Accounting St_5

Recently Issued Accounting Standards - Schedule of Impact of Adoption of Topic 606 to the Balance Sheets and Income Statement (Detail) - USD ($) $ in Thousands	3 Months Ended											6 Months Ended			9 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	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Jan. 01, 2018
Accounts receivable	$ 48,096	$ 44,189	$ 44,238	$ 41,781	$ 35,198	$ 36,009	$ 38,363	$ 36,179	$ 37,324	$ 36,139	$ 38,572	$ 44,238	$ 38,363	$ 36,139	$ 44,189	$ 36,009	$ 37,324	$ 48,096	$ 35,198	$ 40,937
Inventories-net	107,655	103,823	101,767	107,280	111,944	114,737	117,199	117,578	125,418	121,635	124,363	101,767	117,199	121,635	103,823	114,737	125,418	107,655	111,944	119,994
Accrued expenses	25,865																	25,865
Deferred tax assets	17,760				9,455													17,760	9,455	25,092
Accumulated deficit	(239,537)	(240,336)	(243,334)	(237,532)	(237,286)	(230,059)	(247,735)	(246,071)	(233,419)	(229,924)	(228,247)	(243,334)	(247,735)	(229,924)	(240,336)	(230,059)	(233,419)	(239,537)	(237,286)	(244,194)
Total revenues	70,386	70,450	70,385	69,141	$ 71,111	67,246	71,578	70,414	66,482	69,924	67,517	139,526	141,992	137,441	209,976	209,238	203,923	280,362	280,349	275,984
Cost of processing and distribution		32,222	40,486	35,638		33,434	34,917	34,225	32,406	34,975	31,814	76,124	69,142	66,789	108,346	102,576	99,195	140,719	137,277	142,657
Income tax benefit (provision)		(1,317)	2,813	(175)		(16,235)	(1,061)	892	450	474	(1,232)	2,638	(169)	(758)	1,321	(16,404)	(308)	4,268	(19,349)	3,228
Net income (loss) applicable to common shares		$ 2,824	$ (6,783)	$ (2,083)		$ 16,738	$ (2,589)	$ (2,787)	$ (4,379)	$ (2,547)	$ 1,282	$ (8,866)	$ (5,376)	$ (1,265)	$ (6,042)	$ 11,362	$ (5,644)	(5,243)	$ 3,183	$ (17,313)
Calculated under Revenue Guidance in Effect before Topic 606 [Member]
Accounts receivable	41,243																	41,243			$ 38,441
Inventories-net	111,353																	111,353			110,949
Accrued expenses	25,348																	25,348			1,110
Deferred tax assets	17,185																	17,185			9,189
Accumulated deficit	$ (242,751)																	(242,751)			$ (236,415)
Total revenues																		276,943
Cost of processing and distribution																		138,815
Income tax benefit (provision)																		4,744
Net income (loss) applicable to common shares																		$ (6,282)

Recently Issued Accounting St_6

Recently Issued Accounting Standards - Revenue Recognition from Two Business Lines (Detail) - USD ($) $ in Thousands	3 Months Ended											6 Months Ended			9 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	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation of Revenue [Line Items]
Revenues	$ 70,386	$ 70,450	$ 70,385	$ 69,141	$ 71,111	$ 67,246	$ 71,578	$ 70,414	$ 66,482	$ 69,924	$ 67,517	$ 139,526	$ 141,992	$ 137,441	$ 209,976	$ 209,238	$ 203,923	$ 280,362	$ 280,349	$ 275,984
Spine [Member]
Disaggregation of Revenue [Line Items]
Revenues																		79,812	77,646	74,086
Sports [Member]
Disaggregation of Revenue [Line Items]
Revenues																		54,560	57,070	54,629
OEM [Member]
Disaggregation of Revenue [Line Items]
Revenues																		120,024	111,506	111,013
International [Member]
Disaggregation of Revenue [Line Items]
Revenues																		$ 25,966	$ 25,964	$ 25,109

Recently Issued Accounting St_7

Recently Issued Accounting Standards - Revenues Recognized at a Point in Time and Over Time (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Disaggregation of Revenue [Line Items]
Revenue recognized at a point in time	$ 280,362
Transferred at Point in Time [Member]
Disaggregation of Revenue [Line Items]
Revenue recognized at a point in time	239,619
Transferred over Time [Member]
Disaggregation of Revenue [Line Items]
Revenue recognized at a point in time	$ 40,743

Recently Issued Accounting St_8

Recently Issued Accounting Standards - Contract with Customer, Asset and Liability (Detail) $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)
Accounting Changes and Error Corrections [Abstract]
Accounts Receivable	$ 9,655
Contract Liability (Current)	(553)
Contract Liability (Long-term)	$ (2,997)

Acquisition of Zyga Technology

Acquisition of Zyga Technology Inc. - Additional Information (Detail) - USD ($) $ in Thousands	Jan. 04, 2018	Dec. 31, 2018	Sep. 30, 2018	Mar. 31, 2018	Jun. 30, 2018	Sep. 30, 2018	Dec. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Business Acquisition [Line Items]
Cash from RTI Surgical				$ 21,000	$ 21,000	$ 21,000
Acquisition and integration expenses			$ 1,941	800	800	2,741	$ 4,943	$ 630
Goodwill		$ 59,798	$ 62,864	65,254	$ 64,863	$ 62,864	59,798	46,242	$ 46,242	$ 54,887	$ 54,887	$ 54,887	$ 54,887	$ 54,887	$ 54,887
Zyga Technology Inc [Member]
Business Acquisition [Line Items]
Date of merger agreement	Jan. 4, 2018
Payments to acquire businesses	$ 21,000
Cash from RTI Surgical	3,000						21,000
Earnout consideration	4,986
Acquisition related costs	1,430	800					$ 800	$ 4,757				$ 2,573
Acquisition and integration expenses				$ 800
Increased in deferred tax assets		3,066
Decreased in goodwill		3,066
Total purchase price including acquisition contingencies		$ 25,986
Goodwill	13,556
Zyga Technology Inc [Member] | Clinical Milestones [Member]
Business Acquisition [Line Items]
Earnout consideration	1,000
Zyga Technology Inc [Member] | Earn Out Payment [Member]
Business Acquisition [Line Items]
Revenue based earnout consideration	35,000
Zyga Technology Inc [Member] | Patents [Member]
Business Acquisition [Line Items]
Other intangible assets	$ 6,500
Other intangible assets, useful life	13 years
Zyga Technology Inc [Member] | Trademarks [Member]
Business Acquisition [Line Items]
Other intangible assets	$ 80
Other intangible assets, useful life	1 year
Zyga Technology Inc [Member] | Marketing-Related Intangible Assets [Member]
Business Acquisition [Line Items]
Other intangible assets	$ 180
Other intangible assets, useful life	7 years
Zyga Technology Inc [Member] | Revolving Credit Facility [Member]
Business Acquisition [Line Items]
Cash proceeds from revolving credit facility	$ 18,000

Acquisition of Zyga Technolog_3

Acquisition of Zyga Technology Inc. - Acquisition Purchase Price (Detail) - USD ($) $ in Thousands	Jan. 04, 2018	Mar. 31, 2018	Jun. 30, 2018	Sep. 30, 2018	Dec. 31, 2018
Business Combination, Transactions [Line Items]
Cash from RTI Surgical		$ 21,000	$ 21,000	$ 21,000
Zyga Technology Inc [Member]
Business Combination, Transactions [Line Items]
Cash from RTI Surgical	$ 3,000				$ 21,000
Total purchase price	21,000
Zyga Technology Inc [Member] | Revolving Credit Facility [Member]
Business Combination, Transactions [Line Items]
Cash proceeds from revolving credit facility	$ 18,000

Acquisition of Zyga Technolog_4

Acquisition of Zyga Technology Inc. - Summary of Final Allocation of Total Consideration to Tangible and Intangible Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Jan. 04, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Business Combination, Transactions [Line Items]
Acquisition contingencies	$ (4,986)
Goodwill	$ 59,798	$ 62,864	$ 64,863	$ 65,254		$ 46,242	$ 46,242	$ 54,887	$ 54,887	$ 54,887	$ 54,887	$ 54,887	$ 54,887
Zyga Technology Inc [Member]
Business Combination, Transactions [Line Items]
Inventories					$ 1,099
Accounts receivable					573
Other current assets					53
Property, plant and equipment					151
Other assets					26
Deferred tax assets					4,715
Current liabilities					(947)
Acquisition contingencies					(4,986)
Net tangible assets acquired					684
Other intangible assets					6,760
Goodwill					13,556
Total net assets acquired					$ 21,000

Acquisition of Zyga Technolog_5

Acquisition of Zyga Technology, Inc. - Pro Forma Information of Operations (Detail) - Zyga Technology Inc [Member] - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Business Acquisition, Pro Forma Information [Line Items]
Revenues	$ 4,809	$ 4,649
Net loss applicable to common shares	$ (2,640)	$ (4,239)
Basic net loss per share	$ (0.04)	$ (0.07)
Diluted net loss per share	$ (0.04)	$ (0.07)

Cardiothoracic Closure Busine_3

Cardiothoracic Closure Business Divestiture - Additional Information (Detail) - USD ($) $ in Thousands	Aug. 30, 2017	Aug. 03, 2017	Sep. 30, 2018	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2018	Dec. 31, 2017
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses				$ 3,000	$ 51,000	$ 3,000	$ 51,000
Discontinued Operations, Disposed of by Sale [Member] | Cardiothoracic [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from divestiture of businesses	$ 54,000
Escrow deposit	3,000
Cash consideration		$ 51,000	$ 3,000
Contingent consideration earned upon certain revenue milestones	5,000
Contingent cash consideration receivable	$ 1,000

Cardiothoracic Closure Busine_4

Cardiothoracic Closure Business Divestiture - Schedule of Calculation of Gain of CT Business Divestiture (Detail) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended		9 Months Ended	12 Months Ended
	Aug. 03, 2017	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2017	Dec. 31, 2017	Dec. 31, 2018
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Goodwill					$ (8,645)	$ 0
Gain on cardiothoracic closure business divestiture			$ 34,090	$ 34,090	$ 34,090
Cardiothoracic [Member] | Discontinued Operations, Disposed of by Sale [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from cardiothoracic closure business divestiture	$ 51,000	$ 3,000
Inventories-net	(2,893)
Property, plant and equipment-net	(1,299)
Goodwill	(8,645)
Other intangible assets-net	(280)
Cardiothoracic closure business divestiture expenses	(3,793)
Gain on cardiothoracic closure business divestiture	$ 34,090

Stock-Based Compensation - Addi

Stock-Based Compensation - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands

Dec. 04, 2018

Mar. 31, 2018

Sep. 18, 2017

Jan. 26, 2017

Jan. 26, 2017

Dec. 31, 2018

Sep. 30, 2018

Jun. 30, 2018

Dec. 31, 2017

Sep. 30, 2017

Jun. 30, 2017

Mar. 31, 2017

Sep. 30, 2016

Jun. 30, 2016

Mar. 31, 2016

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Percentage of market value of common stock, stock options exercise price

100.00%

Percentage of market value of common stock, restricted stock award granted

100.00%

Shares granted

827,214

Common stock, par value

$ 0.001

$ 0.001

$ 0.001

$ 0.001

$ 0.001

$ 0.001

$ 0.001

$ 0.001

$ 0.001

$ 0.001

$ 0.001

Shares vested

635,205

Option to purchase number of shares, granted

722,122

Mr. Jonathon Singer | First Anniversary [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares vested

36,630

Mr. Jonathon Singer | Second Anniversary [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

36,630

Mr. Jonathon Singer | Third Anniversary [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

36,630

Minimum [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Contractual term of stock options granted

5 years

Maximum [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Contractual term of stock options granted

10 years

Stock Option [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Total unrecognized stock-based compensation

$ 2,059

Stock-based compensation awards, weighted-average period recognized

1 year 8 months 19 days

Stock Option [Member] | Minimum [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Stock-based compensation award, vesting period

1 year

Stock Option [Member] | Maximum [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Stock-based compensation award, vesting period

5 years

Restricted Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Total unrecognized stock-based compensation

$ 3,079

Stock-based compensation awards, weighted-average period recognized

1 year 7 months 6 days

Restricted Stock [Member] | Employee [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares granted

686,038

Restricted Stock [Member] | Non-Employee [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares granted

141,176

Restricted Stock [Member] | Minimum [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Stock-based compensation award, vesting period

1 year

Restricted Stock [Member] | Maximum [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Stock-based compensation award, vesting period

3 years

Restricted Stock Agreement #1 [Member] | Mr. Camille Farhat | Common Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares granted

850,000

Share based compensation arrangement by share based payment award number of options expected to vest

170,000

170,000

42,500

Stock-based compensation award, vesting rights description

On the first anniversary of the grant date, 170,000 shares will vest. The remaining shares will vest on the last day of each calendar quarter at a rate of 42,500 shares per calendar quarter commencing after the first anniversary of the grant date and continuing for four years after. Vesting of these shares may accelerate upon the occurrence of either of two performance conditions.

Common stock, par value

$ 0.001

$ 0.001

Shares vested

425,000

unaccelerated Restricted Stock [Member] | Mr. Camille Farhat | Common Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares vested

42,500

170,000

Restricted Stock Agreement #2 [Member] | Mr. Camille Farhat | Common Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares granted

150,000

Shares expected to vest

150,000

Stock Option Agreements [Member] | Mr. Camille Farhat

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share-based compensation arrangement exercise price

$ 3.20

$ 3.20

Share-based compensation arrangement expiration date

Jan. 26, 2022

Stock Option Agreements [Member] | Mr. Camille Farhat | Average Stock Price Benchmark One [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

650,000

650,000

Stock-based compensation award, vesting rights description

Company's average publicly traded stock price is over $6.00 for a sixty-consecutive calendar day period.

Stock Option Agreements [Member] | Mr. Camille Farhat | Average Stock Price Benchmark Two [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

650,000

650,000

Stock-based compensation award, vesting rights description

Company's average publicly traded stock price is over $7.00 for a sixty-consecutive calendar day period.

Stock Option Agreements [Member] | Mr. Camille Farhat | Average Stock Price Benchmark Three [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

650,000

650,000

Stock-based compensation award, vesting rights description

Company's average publicly traded stock price is over $8.00 for a sixty-consecutive calendar day period.

Stock Option Agreements [Member] | Mr. Camille Farhat | Common Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Option to purchase number of shares, granted

1,950,000

Stock Option Agreements [Member] | Mr. Jonathon Singer

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share-based compensation arrangement exercise price

$ 4.55

Share-based compensation arrangement expiration date

Sep. 18, 2027

Stock Option Agreements [Member] | Mr. Jonathon Singer | Average Stock Price Benchmark One [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

102,300

Stock-based compensation award, vesting rights description

Company's average publicly traded stock price is over $7.00 per share for a sixty-consecutive calendar day period.

Stock Option Agreements [Member] | Mr. Jonathon Singer | Average Stock Price Benchmark Two [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

102,300

Stock-based compensation award, vesting rights description

Company's average publicly traded stock price is over $8.00 per share for a sixty-consecutive calendar day period.

Stock Option Agreements [Member] | Mr. Jonathon Singer | Average Stock Price Benchmark Three [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Share based compensation arrangement by share based payment award number of options expected to vest

102,300

Stock-based compensation award, vesting rights description

Company's average publicly traded stock price is over $9.00 per share for a sixty-consecutive calendar day period.

Stock Option Agreements [Member] | Mr. Jonathon Singer | Common Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Option to purchase number of shares, granted

306,900

Restricted Stock Agreement [Member] | Mr. Jonathon Singer | Common Stock [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares granted

109,890

2018 Equity Incentive Plan [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares of common stock allowed to be issued

5,726,035

2015 Equity Incentive Plan [Member]

Share-based Compensation Arrangement by Share-based Payment Award [Line Items]

Shares of common stock allowed to be issued

4,656,587

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Weighted-Average Assumptions Used to Determine Fair Value of Options (Detail)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Expected term (years)	6 years 6 months	6 years 6 months	6 years 6 months
Risk free interest rate	2.75%	2.26%	1.85%
Volatility factor	43.74%	47.39%	45.57%
Dividend yield	0.00%	0.00%	0.00%

Stock-Based Compensation - Stoc

Stock-Based Compensation - Stock Options Outstanding, Exercisable and Available for Grant (Detail) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018USD ($)$ / sharesshares
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Number of Options outstanding, beginning balance	4,662,037
Granted, Number of Options	722,122
Exercised, Number of Options	(352,015)
Forfeited or expired, Number of Options	(756,400)
Number of Options Outstanding, ending balance	4,275,744
Vested or expected, Number of Options	3,472,364
Exercisable, Number of Options	1,019,844
Available for grant, Number of Options	5,454,302
Beginning balance, Weighted Average Exercise Price | $ / shares	$ 3.86
Granted, Weighted Average Exercise Price | $ / shares	4.32
Exercised, Weighted Average Exercise Price | $ / shares	3.53
Forfeited or expired, Weighted Average Exercise Price | $ / shares	4.99
Ending balance, Weighted Average Exercise Price | $ / shares	3.76
Vested or expected to vest Weighted Average Exercise Prices | $ / shares	3.77
Exercisable Weighted Average Exercise Price | $ / shares	$ 3.94
Outstanding at December 31, 2018	4 years 1 month 24 days
Vested or expected to vest at December 31, 2018	3 years 11 months 4 days
Exercisable at December 31, 2018	2 years 5 months 4 days
Outstanding at December 31, 2018 | $	$ 1,161
Vested or expected to vest at December 31, 2018 | $	924
Exercisable at December 31, 2018 | $	$ 169

Stock-Based Compensation - St_2

Stock-Based Compensation - Stock-Based Compensation Recognized (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 4,745	$ 6,762	$ 3,590
Costs Of Processing And Distribution[Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	132	132	140
Marketing General And Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	4,553	6,586	3,406
Research and Development Expense [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation	$ 60	$ 44	$ 44

Stock-Based Compensation - Othe

Stock-Based Compensation - Other Information Concerning Stock Options (Detail) - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Weighted average fair value of stock options granted	$ 2.05	$ 1.66	$ 1.55
Aggregate intrinsic value of stock options exercised	$ 349	$ 2,786	$ 12

Stock-Based Compensation - Unve

Stock-Based Compensation - Unvested Restricted Stock Awards (Detail)	12 Months Ended
	Dec. 31, 2018$ / sharesshares
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Beginning Balance, Number of shares | shares	1,120,190
Granted, Number of shares | shares	827,214
Vested, Number of shares | shares	(635,205)
Forfeited, Number of shares | shares	(279,484)
Ending Balance, Number of shares | shares	1,032,715
Beginning balance, Weighted Average Grant Date Fair Value | $ / shares	$ 4.15
Granted, Weighted Average Grant Date Fair Value | $ / shares	4.29
Vested, Weighted Average Grant Date Fair Value | $ / shares	4.07
Forfeited, Weighted Average Grant Date Fair Value | $ / shares	4.13
Ending balance, Weighted Average Grant Date Fair Value | $ / shares	$ 4.32

Inventories - Components of Inv

Inventories - Components of Inventories (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Inventory Disclosure [Abstract]
Unprocessed tissue, raw materials and supplies	$ 24,211	$ 22,071
Tissue and work in process	31,796	40,481
Implantable tissue and finished goods	51,648	49,392
Total	$ 107,655	$ 111,944

Inventories - Additional inform

Inventories - Additional information (Detail) - USD ($) $ in Thousands

3 Months Ended

6 Months Ended

9 Months Ended

12 Months Ended

Mar. 31, 2018

Mar. 31, 2017

Mar. 31, 2016

Jun. 30, 2018

Jun. 30, 2017

Jun. 30, 2016

Sep. 30, 2018

Sep. 30, 2017

Sep. 30, 2016

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Inventory [Line Items]

Provision for inventory write downs

$ 2,641

$ 1,789

$ 945

$ 6,559

$ 3,753

$ 2,370

$ 12,906

$ 4,488

$ 4,422

$ 15,122

$ 5,066

$ 13,880

Product obsolescence

1,023

Map3 Implant [Member]

Inventory [Line Items]

Provision for inventory write downs

$ 6,559

Sports Inventory [Member]

Inventory [Line Items]

Provision for inventory write downs

$ 9,556

Prepaid and Other Current Ass_3

Prepaid and Other Current Assets - Schedule of Prepaid and Other Current Assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Deferred Costs, Capitalized, Prepaid, and Other Assets Disclosure [Abstract]
Income tax receivable	$ 10,241	$ 3,920
Receivable for executive stock option exercise	1,234
Prepaid expenses	1,592	2,013
Other	3,559	2,480
Prepaid and other current assets	$ 16,626	$ 8,413	$ 8,313	$ 8,149	$ 16,314	$ 9,704	$ 6,221	$ 5,932	$ 5,179	$ 7,473	$ 13,777	$ 13,157

Property, Plant and Equipment -

Property, Plant and Equipment - Components of Property, Plant and Equipment (Detail) - USD ($) $ in Thousands	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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 156,466				$ 152,031
Less accumulated depreciation	(78,512)				(72,467)
Property, plant and equipment, net	77,954	$ 77,344	$ 76,838	$ 79,150	79,564	$ 82,794	$ 84,379	$ 85,118	$ 83,402	$ 89,070	$ 88,201	$ 87,538
Land [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	2,020				2,020
Building and Improvements [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	58,093				57,954
Processing Equipment [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	42,599				44,137
Surgical Instruments [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	24,070				21,256
Office Equipment, Furniture and Fixtures [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	1,877				1,352
Computer Equipment and Software [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	18,873				19,332
Construction in Progress [Member]
Property, Plant and Equipment [Line Items]
Property, plant and equipment, gross	$ 8,934				$ 5,980

Property, Plant and Equipment_2

Property, Plant and Equipment - Additional Information (Detail) - USD ($) $ in Thousands	Oct. 20, 2017	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Depreciation expense in connection with property, plant and equipment																	$ 10,619	$ 10,513	$ 12,835
Asset impairment and abandonments		$ 104	$ 4,515	$ 129			$ 236				$ 4,644	$ 236		$ 4,748	$ 236		5,070	4,034	5,241
Net of selling costs	$ 1,818	$ 29,671	$ 29,327	$ 28,578	$ 27,678	$ 29,576	$ 29,709	$ 28,774	$ 28,402	$ 27,856	$ 57,905	$ 59,285	$ 56,258	$ 87,576	$ 86,963	$ 85,032	119,724	$ 115,009	$ 116,666
Map3 Implant [Member]
Property, Plant and Equipment [Line Items]
Asset impairment and abandonments																	$ 1,797

Goodwill - Schedule of Goodwill

Goodwill - Schedule of Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017
Goodwill [Line Items]
Beginning Balance	$ 46,242	$ 54,887
Goodwill disposed of related to sale of Cardiothoracic closure business	0	8,645
Ending Balance	59,798	46,242
Zyga Technology Inc [Member]
Goodwill [Line Items]
Goodwill acquired	$ 13,556	$ 0

Goodwill - Additional Informati

Goodwill - Additional Information (Detail)	3 Months Ended
	Jun. 30, 2018USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill impairment	$ 0

Other Intangible Assets - Compo

Other Intangible Assets - Components of Other Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 47,495	$ 46,230
Accumulated Amortization	21,938	23,656
Patents [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	15,469	11,061
Accumulated Amortization	4,191	4,892
Licensing Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	11,671	14,566
Accumulated Amortization	6,468	9,097
Marketing and Procurement and Other Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	20,355	20,603
Accumulated Amortization	$ 11,279	$ 9,667

Other Intangible Assets - Addit

Other Intangible Assets - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Finite-Lived Intangible Assets [Line Items]
Amortization expense of other intangible assets	$ 3,960	$ 3,720	$ 3,693
Impairment and abandonment charges	3,029
Map3 Implant [Member]
Finite-Lived Intangible Assets [Line Items]
Impairment and abandonment charges	$ 2,718

Other Intangible Assets - Estim

Other Intangible Assets - Estimates of Future Amortization Expense (Detail) $ in Thousands	Dec. 31, 2018USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2019	$ 4,200
2020	4,100
2021	4,100
2022	4,100
2023	$ 1,800

Fair Value Information - Additi

Fair Value Information - Additional Information (Detail) $ in Thousands	Jan. 04, 2018USD ($)
Zyga Technology Inc [Member]
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent liability	$ 4,986

Fair Value Information - Summar

Fair Value Information - Summary of long lived assets (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Property, plant and equipment - net, impairment	$ 1,797	$ 4,717
Other intangible assets - net, impairment	2,718	718
Impairment	$ 4,515	5,435
Property, plant and equipment fair value		4,708
Other intangible assets fair value		150
Fair value		$ 4,858

Accrued expenses - Accrued expe

Accrued expenses - Accrued expenses (Detail) - USD ($) $ in Thousands	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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Payables and Accruals [Abstract]
Accrued compensation	$ 8,308				$ 8,257
Accrued severance and restructuring costs	1,302				3,122
Accrued executive transition costs	43				2,300
Accrued distributor commissions	3,907				3,889
Accrued donor recovery fees	3,018				4,144
Other	9,287				4,047
Total accrued expenses	$ 25,865	$ 22,163	$ 23,787	$ 23,687	$ 25,759	$ 20,442	$ 20,606	$ 23,196	$ 22,444	$ 17,087	$ 20,581	$ 21,869

Short and Long-Term Obligatio_3

Short and Long-Term Obligations - Short and Long-Term Obligations (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Debt Disclosure [Abstract]
Term loan	$ 0				$ 24,250
Revolving credit facility	50,000				22,500
Less unamortized debt issuance costs	(927)				(406)
Debt and capital lease obligation, total	49,073				46,344
Less current portion	0				(4,268)
Long-term portion	$ 49,073	$ 49,021	$ 53,416	$ 57,009	$ 42,076	$ 45,643	$ 74,360	$ 75,813	$ 78,720	$ 72,173	$ 72,290

Short and Long-Term Obligatio_4

Short and Long-Term Obligations - Additional Information (Detail) - USD ($)

Jun. 05, 2018

Jun. 30, 2018

Jun. 30, 2018

Sep. 30, 2018

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Mar. 31, 2018

Sep. 30, 2017

Jun. 30, 2017

Mar. 31, 2017

Sep. 30, 2016

Jun. 30, 2016

Mar. 31, 2016

Line of Credit Facility [Line Items]

Cash and cash equivalents

$ 14,246,000

$ 14,246,000

$ 10,022,000

$ 10,949,000

$ 22,381,000

$ 13,812,000

$ 17,744,000

$ 13,675,000

$ 17,598,000

$ 11,624,000

$ 12,754,000

$ 11,728,000

Amortization of debt issuance cost

528,000

$ 409,000

$ 202,000

Loss on extinguishment of debt

$ 309,000

$ 309,000

$ 309,000

$ 309,000

Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Credit facility, variable interest rate

4.10%

Line of credit outstanding amount

$ 50,000,000

Line of credit remaining borrowing capacity

$ 43,713,000

2017 Loan Agreement [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Credit facility, original borrowing capacity

$ 42,500

Debt instrument, maturity date

Sep. 15, 2019

2017 Loan Agreement [Member] | Revolving Credit Facility [Member] | London Interbank Offered Rate (LIBOR) [Member]

Line of Credit Facility [Line Items]

Debt Instrument, Basis Spread on Variable Rate

3.50%

2018 Loan Agreement [Member]

Line of Credit Facility [Line Items]

Debt instrument, maturity date

Jun. 5, 2023

Percentage of foreign subsidiaries stock held as collateral

65.00%

Credit facility guaranteed description

The Facility is guaranteed by the Company's domestic subsidiaries and is secured by (i) substantially all of the assets of the Company and Pioneer; (ii) substantially all of the assets of each of the Company's domestic subsidiaries; and (iii) 65% of the stock of the Company's foreign subsidiaries.

Cash and cash equivalents

$ 1,049,000

Minimum fixed charge coverage ratio

100.00%

Covenant Terms of Credit Facility

(the "Required Minimum Fixed Charge Coverage Ratio") during either of the following periods (each, a "Covenant Testing Period") (i) a period beginning on a date that a default has occurred and is continuing under the loan documents entered into by the Company in conjunction with the 2018 Credit Agreement through the first date on which no default has occurred and is continuing; or (ii) a period beginning on a date that availability under the Facility is less than the specified covenant testing threshold and continuing until availability under the Facility is greater than or equal to the specified covenant testing threshold for thirty (30) consecutive days. The Required Minimum Fixed Charge Coverage Ratio is measured on the last day of each calendar month during the Covenant Testing Period (each a "Calculation Date"), and is calculated using the minimum fixed charge coverage ratio for the twelve (12) consecutive months ending on each Calculation Date. The amounts owed under the 2018 Credit Agreement may be accelerated upon the occurrence of certain events of default customary for facilities for similarly rated borrowers.

2018 Loan Agreement [Member] | Revolving Credit Facility [Member]

Line of Credit Facility [Line Items]

Credit facility, original borrowing capacity

$ 100,000,000

2018 Loan Agreement [Member] | Revolving Credit Facility [Member] | Maximum [Member]

Line of Credit Facility [Line Items]

Credit facility, additional borrowing capacity

$ 50,000,000

2018 Loan Agreement [Member] | Revolving Credit Facility [Member] | Debt Instrument Variable Rate Base CBFR Using Monthly REVLIBOR30 Rate [Member]

Line of Credit Facility [Line Items]

Credit facility, variable interest rate

2.00%

2018 Loan Agreement [Member] | Revolving Credit Facility [Member] | Debt Instrument Variable Rate Base Eurodollars Adjusted LIBO Rate [Member]

Line of Credit Facility [Line Items]

Credit facility, variable interest rate

2.00%

Income Taxes - Schedule of Pre-

Income Taxes - Schedule of Pre-Tax Income (Detail) - USD ($) $ in Thousands	3 Months Ended									6 Months Ended			9 Months Ended			12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Taxes Provision (Benefit) [Line Items]
Domestic (U.S., state and local)																$ (9,052)	$ 30,121	$ (7,722)
Foreign																1,661	(3,866)	(9,314)
Total pre-tax income	$ 4,314	$ (8,615)	$ (942)	$ 33,911	$ (604)	$ (2,769)	$ (3,946)	$ (2,151)	$ 3,372	$ (9,557)	$ (3,373)	$ 1,221	$ (5,243)	$ 30,538	$ (2,725)	$ (7,391)	$ 26,255	(17,033)
Adjustments [Member]
Income Taxes Provision (Benefit) [Line Items]
Total pre-tax income																		$ (17,036)

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Tax Benefit(Provision) (Detail) - USD ($) $ in Thousands	3 Months Ended									6 Months Ended			9 Months Ended			12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Current:
Federal																$ 967	$ (2,910)	$ (88)
State																(205)	(833)	(84)
International																(376)		456
Total current																386	(3,743)	284
Deferred:
Federal																2,356	(14,554)	2,547
State																(2,446)	(1,052)	589
International																3,972		(192)
Total deferred																3,882	(15,606)	2,944
Income tax benefit (provision)	$ (1,317)	$ 2,813	$ (175)	$ (16,235)	$ (1,061)	$ 892	$ 450	$ 474	$ (1,232)	$ 2,638	$ (169)	$ (758)	$ 1,321	$ (16,404)	$ (308)	$ 4,268	$ (19,349)	$ 3,228

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Assets and Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Income Tax Disclosure [Abstract]
Accounts receivable	$ 513				$ 190
Accrued liabilities	2,358				2,072
Deferred compensation	1,372				1,783
Fixed assets and intangibles					66
Inventory	7,631				5,905
Net operating losses	8,198				8,106
Revenue	650				1,874
Tax credits	5,993				4,263
Other	0				0
Valuation allowance	(3,093)				(7,258)
Total Deferred Income Tax Assets	23,622	$ 11,842	$ 14,514	$ 11,884	16,935	$ 18,437	$ 24,862	$ 25,918	$ 21,348	$ 21,939	$ 21,931
Fixed assets and intangibles	(5,862)				(7,370)
Other					(110)
Total Deferred Income Tax Liabilities	$ (5,862)				$ (7,480)

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Jan. 01, 2016
Income Taxes [Line Items]
Deferred tax assets	$ 17,760
Domestic deferred tax assets, valuation allowances	$ 3,093	$ 7,258
U.S. federal corporate tax rate	21.00%	35.00%	35.00%
Income tax expense (benefit) due to change in tax rate	$ (650)	$ 2,187
Research tax credit carryforwards	$ 6,270
Research tax credit carryforwards, expiration start	2029
Research tax credit carryforwards, expiration end	2038
Cumulative loss position period	3 years
Unrecognized tax benefits	$ 1,088	1,591	$ 1,591	$ 1,986
Interest and penalties accrued	0	$ 0
U.S. Federal [Member]
Income Taxes [Line Items]
Net operating loss carryforwards, subject to expiration	9,973
Net operating loss carryforwards, not subject to expiration	$ 1,337
Net operating loss carryforwards, expiration year start	2026
Net operating loss carryforwards, expiration year end	2037
U.S. State [Member]
Income Taxes [Line Items]
Net operating loss carryforwards, expiration year start	2022
Net operating loss carryforwards, expiration year end	2038
Net operating loss carryforwards, subject to expiration	$ 41,844
Foreign [Member]
Income Taxes [Line Items]
Net operating loss carryforwards, not subject to expiration	$ 13,754

Income Taxes - Summary of Unrec

Income Taxes - Summary of Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Opening balance	$ 1,591	$ 1,591	$ 1,986
Reductions based on tax positions related to the current year	0	0	0
Additions for tax positions of prior years	0	0	0
Reductions for tax positions of prior years	(415)		(60)
Reductions for expiration of statute of limitations	(88)		(335)
Closing balance	$ 1,088	$ 1,591	$ 1,591

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Tax Rate Differs from the Statutory Federal Income Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Income Tax Disclosure [Abstract]
Statutory federal rate	21.00%	35.00%	35.00%
State income taxes-net of federal tax benefit	(4.58%)	2.37%	1.73%
Foreign rate differential	14.36%	2.54%	(2.47%)
Acquisition expenses	(7.26%)
Goodwill disposal	0.00%	11.52%	0.00%
Life insurance	(0.98%)	(1.38%)
Officer compensation	(7.88%)	4.18%
Stock-based compensation	(3.90%)	6.06%
Tax credits	8.65%	(4.53%)	7.28%
Tax legislation	9.23%	8.33%
Valuation allowances	21.93%	6.08%	(22.11%)
Uncertain tax positions	6.86%
Other reconciling items, net	(0.32%)	3.52%	(0.48%)
Effective tax rate	57.75%	73.69%	18.95%

Preferred Stock - Schedule of P

Preferred Stock - Schedule of Preferred Stock (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Balance	$ 63,923	$ 60,016	$ 56,323
Accrued dividend	2,120	3,723	3,508
Balance	66,226	63,923	60,016
Amortization of preferred stock issuance costs	183	184	185
Series A Preferred Stock [Member]
Balance	64,399	60,676	57,168
Accrued dividend	2,120	3,723	3,508
Balance	66,519	64,399	60,676
Balance	(476)	(660)	(845)
Amortization of preferred stock issuance costs	(183)	(184)	(185)
Balance	$ (293)	$ (476)	$ (660)

Preferred Stock - Additional In

Preferred Stock - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Jul. 16, 2013	Jun. 12, 2013	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Jan. 01, 2016
Series A Preferred Stock [Member]
Preferred stock issuance cost			$ (293)	$ (476)	$ (660)	$ (845)
Private Placement [Member] | Series A Preferred Stock [Member]
Preferred stock dividend rate	6.00%
Convertible preferred stock, liquidation preference per share			$ 1,000
Convertible referred stock, stockholders stagnation period for conversion			7 years
Private Placement [Member] | Convertible Preferred Stock [Member]
Convertible preferred stock issued		$ 50,000
Preferred stock issuance cost	$ 1,290
Preferred stock conversion price per share			$ 4.39
Convertible preferred stock, shares issued upon conversion			228
Convertible preferred stock, stock price trigger			$ 7.98
Convertible preferred stock, Description of Conversion			The Preferred Stock will be convertible at the election of the holders into shares of the Company's common stock at an initial conversion price of $4.39 per share which would result in a conversion ratio of approximately 228 shares of common stock for each share of Preferred Stock. The Preferred Stock is convertible at the election of the Company five years after its issuance or at any time if the Company's common stock closes at or above $7.98 per share for at least 20 consecutive trading days.
Convertible preferred stock, stagnation period for conversion			5 years
Convertible preferred stock, consecutive trading days			20 days

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - shares	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	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Equity [Abstract]
Preferred stock, shares authorized	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000
Preferred stock, shares issued	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000
Preferred stock, shares outstanding	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000
Common stock, shares authorized	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000
Common stock, voting rights description	Holders of common stock are entitled to one vote for each share held at all stockholder meetings.

Executive Transition Costs - Ad

Executive Transition Costs - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended	12 Months Ended
	Sep. 30, 2016	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Restructuring Cost and Reserve [Line Items]
Executive transition costs	$ 4,107	$ 4,107		$ 2,818	$ 4,404
Cash Basis [Member]
Restructuring Cost and Reserve [Line Items]
Executive transition costs			$ 1,169
Former Chief Executive Officer [Member]
Restructuring Cost and Reserve [Line Items]
Executive transition costs					4,404
Chief Executive Officer And Chief Financial And Administrative Officer [Member]
Restructuring Cost and Reserve [Line Items]
Executive transition costs				$ 2,818	$ 4,404

Executive Transition Costs - Sc

Executive Transition Costs - Schedule of Restructuring Charges (Detail) - USD ($) $ in Thousands	3 Months Ended	9 Months Ended	12 Months Ended
	Sep. 30, 2016	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Restructuring Cost and Reserve [Line Items]
Executive transition costs accrued in 2016	$ 4,107	$ 4,107		$ 2,818	$ 4,404
Stock-based compensation			$ (4,745)	(6,762)	(3,590)
Chief Executive Officer And Chief Financial And Administrative Officer [Member]
Restructuring Cost and Reserve [Line Items]
Accrued executive transition costs, beginning balance		$ 0	2,337	2,406	0
Executive transition costs accrued in 2016				2,818	4,404
Stock-based compensation				(1,612)	(1,535)
Cash payments			(2,294)	(1,275)	(463)
Accrued executive transition costs, ending balance			$ 43	$ 2,337	$ 2,406

Severance and Restructuring C_3

Severance and Restructuring Costs - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Severance and restructuring costs	$ 2,808	$ 12,016	$ 2,146

Severance and Restructuring C_4

Severance and Restructuring Costs - Schedule of Restructuring Charge (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Restructuring Cost and Reserve [Line Items]
Accrued severance and restructuring charges, beginning balance	$ 3,122
Accrued severance and restructuring charges, ending balance	1,302	$ 3,122
Employee Severance [Member]
Restructuring Cost and Reserve [Line Items]
Accrued severance and restructuring charges, beginning balance	3,122	505	$ 865
Severance and restructuring expenses accrued	2,808	12,016	2,146
Severance and restructuring cash payments	(4,628)	(8,246)	(1,866)
Asset abandonments			(640)
Stock based compensation		(1,153)
Accrued severance and restructuring charges, ending balance	$ 1,302	$ 3,122	$ 505

Retirement Benefits - Additiona

Retirement Benefits - Additional Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Amounts expensed	$ 2,757	$ 3,036	$ 3,094
Plan name	401(k) plan
Maximum [Member]
Employer matching contribution, percent of match	6.00%

Concentrations of Risk - Additi

Concentrations of Risk - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2018Company
Risks and Uncertainties [Abstract]
Number of independent companies	14
Number of distribution companies	3

Concentrations of Risk - Schedu

Concentrations of Risk - Schedule of Percentage of Total Revenues Derived from Company's Largest Distributors (Detail) - Distributor Concentration Risk [Member] - Sales Revenue, Net [Member]	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Zimmer [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	21.00%	17.00%	16.00%
Medtronic [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	8.00%	9.00%	9.00%
Synthes [Member]
Concentration Risk [Line Items]
Percentage of sales revenue	5.00%	4.00%	4.00%

Commitments and Contingencies -

Commitments and Contingencies - Additional Information (Detail) - USD ($) $ in Thousands

Nov. 01, 2018

Jan. 04, 2018

Aug. 03, 2017

Oct. 12, 2013

Sep. 30, 2010

Sep. 30, 2018

Mar. 31, 2018

Mar. 31, 2015

Mar. 31, 2013

Dec. 31, 2010

Jun. 30, 2018

Sep. 30, 2018

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Jun. 13, 2009

Commitment And Contingencies [Line Items]

Cash from RTI Surgical

$ 21,000

$ 21,000

$ 21,000

Upfront payment

$ 13,000

Upfront payment period

10 years

Operating leases, rent expense

$ 1,300

$ 1,325

$ 1,378

Zimmer [Member]

Commitment And Contingencies [Line Items]

Initial agreement term

10 years

Davol [Member]

Commitment And Contingencies [Line Items]

Initial agreement term

10 years

Non-refundable license fee

$ 8,000

Revenue milestone payment

$ 3,500

Deferred revenue recognition

$ 1,500

$ 1,715

AE medical corporation [Member]

Commitment And Contingencies [Line Items]

Payments to acquire businesses

$ 54,000

$ 3,000

Escrow deposit

3,000

Escrow amount to satisfy possible indemnification obligations

0

AE medical corporation [Member] | AE Medical Corporation Reaches Certain Milestones [Member]

Commitment And Contingencies [Line Items]

Payments to acquire businesses

5,000

AE medical corporation [Member] | US food and drug administration regulatory clearance [Member]

Commitment And Contingencies [Line Items]

Payments to acquire businesses

$ 1,000

Medtronic [Member]

Commitment And Contingencies [Line Items]

Decline in cumulative fees received, trailing period

12 months

Distribution agreement automatic renewal term

5 years

Period prior to expiration of initial term for notice

1 year

Paradigm spine [Member]

Commitment And Contingencies [Line Items]

Agreement to acquire business

$ 300,000

Cash to be paid at closing

$ 150,000

Number of common stock to be issued at closing, shares

10,729,614

Number of common stock to be issued at closing, value

$ 50,000

Potential debt to finance business combination

100,000

Paradigm spine [Member] | Maximum [Member]

Commitment And Contingencies [Line Items]

Revenue based earnout considerations

$ 150,000

Zyga Technology Inc [Member]

Commitment And Contingencies [Line Items]

Payments to acquire businesses

$ 21,000

Cash from RTI Surgical

3,000

$ 21,000

Earnout consideration

$ 4,986

Date of merger agreement

Jan. 4, 2018

Zyga Technology Inc [Member] | Clinical Milestones [Member]

Commitment And Contingencies [Line Items]

Earnout consideration

$ 1,000

Zyga Technology Inc [Member] | Earn Out Payment [Member]

Commitment And Contingencies [Line Items]

Revenue based earnout consideration

35,000

Zyga Technology Inc [Member] | Revolving Credit Facility [Member]

Commitment And Contingencies [Line Items]

Cash proceeds from credit facility

$ 18,000

Commitments and Contingencies_2

Commitments and Contingencies - Future Minimum Lease Commitments Under Non-Cancelable Operating Leases (Detail) $ in Thousands	Dec. 31, 2018USD ($)
Commitments and Contingencies Disclosure [Abstract]
2019	$ 1,374
2020	806
2021	276
2022	162
2023	166
2024 and beyond	882
Total	$ 3,666

Legal and Regulatory Actions -

Legal and Regulatory Actions - Additional Information (Detail) - USD ($) $ in Thousands

3 Months Ended

6 Months Ended

9 Months Ended

12 Months Ended

Mar. 31, 2018

Mar. 31, 2017

Mar. 31, 2016

Jun. 30, 2018

Jun. 30, 2017

Jun. 30, 2016

Sep. 30, 2018

Sep. 30, 2017

Sep. 30, 2016

Dec. 31, 2018

Dec. 31, 2017

Dec. 31, 2016

Loss Contingencies [Line Items]

Provision for inventory write-downs

$ 2,641

$ 1,789

$ 945

$ 6,559

$ 3,753

$ 2,370

$ 12,906

$ 4,488

$ 4,422

$ 15,122

$ 5,066

$ 13,880

Product Licensing Rights [Member]

Loss Contingencies [Line Items]

Impairment of intangible assets

2,718

Property, Plant and Equipment [Member]

Loss Contingencies [Line Items]

Asset impairment

$ 1,797

Segment Data - Additional Infor

Segment Data - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2018SegmentBusiness
Segment Reporting [Abstract]
Number of reportable segments | Segment	1
Lines of business | Business	4

Segment Data - Summary of Segme

Segment Data - Summary of Segment Data (Detail) - USD ($) $ in Thousands	3 Months Ended											6 Months Ended			9 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	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Disaggregation of Revenue [Line Items]
Total revenues	$ 70,386	$ 70,450	$ 70,385	$ 69,141	$ 71,111	$ 67,246	$ 71,578	$ 70,414	$ 66,482	$ 69,924	$ 67,517	$ 139,526	$ 141,992	$ 137,441	$ 209,976	$ 209,238	$ 203,923	$ 280,362	$ 280,349	$ 275,984
Total revenues, percentage																		100.00%	100.00%	100.00%
Spine [Member]
Disaggregation of Revenue [Line Items]
Total revenues																		$ 79,812	$ 77,646	$ 74,086
Total revenues, percentage																		28.40%	27.60%	26.90%
Sports [Member]
Disaggregation of Revenue [Line Items]
Total revenues																		$ 54,560	$ 57,070	$ 54,629
Total revenues, percentage																		19.50%	20.40%	19.80%
OEM [Member]
Disaggregation of Revenue [Line Items]
Total revenues																		$ 120,024	$ 111,506	$ 111,013
Total revenues, percentage																		42.80%	39.80%	40.20%
International [Member]
Disaggregation of Revenue [Line Items]
Total revenues																		$ 25,966	$ 25,964	$ 25,109
Total revenues, percentage																		9.30%	9.30%	9.10%
Cardiothoracic [Member]
Disaggregation of Revenue [Line Items]
Total revenues																			$ 8,163	$ 11,147
Total revenues, percentage																		0.00%	2.90%	4.00%

Segment Data - Summary of Reven

Segment Data - Summary of Revenues by Geographic Location (Detail) - USD ($) $ in Thousands	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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Disaggregation of Revenue [Line Items]
Property, plant and equipment - net	$ 77,954	$ 77,344	$ 76,838	$ 79,150	$ 79,564	$ 82,794	$ 84,379	$ 85,118	$ 83,402	$ 89,070	$ 88,201	$ 87,538
U.S. Federal [Member]
Disaggregation of Revenue [Line Items]
Property, plant and equipment - net	72,501				73,363
Foreign [Member]
Disaggregation of Revenue [Line Items]
Property, plant and equipment - net	$ 5,453				$ 6,201

Quarterly Results of Operatio_3

Quarterly Results of Operations (Unaudited) - Schedule of Quarterly Results of Operations (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended											6 Months Ended			9 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	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Quarterly Financial Information Disclosure [Abstract]
Revenues	$ 70,386	$ 70,450	$ 70,385	$ 69,141	$ 71,111	$ 67,246	$ 71,578	$ 70,414	$ 66,482	$ 69,924	$ 67,517	$ 139,526	$ 141,992	$ 137,441	$ 209,976	$ 209,238	$ 203,923	$ 280,362	$ 280,349	$ 275,984
Gross profit	38,013	38,228	29,899	33,503	36,410	33,812	36,661	36,189	34,076	34,949	35,703	63,402	72,850	70,652	101,630	106,662	104,728	139,643	143,072	133,327
Net (loss) income	$ 799	$ 2,997	$ (5,802)	$ (1,117)	$ (7,228)	$ 17,676	$ (1,665)	$ (1,877)	$ (3,496)	$ (1,677)	$ 2,140	$ (6,919)	$ (3,542)	$ 463	$ (3,922)	$ 14,134	$ (3,033)	$ (3,123)	$ 6,906	$ (13,805)
Net (loss) income per common share - basic	$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.28	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Net (loss) income per common share - diluted	$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.23	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)

Restatement of Prior Period F_3

Restatement of Prior Period Financial Statements - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended									6 Months Ended			9 Months Ended			12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Operating expenses	$ 33,316	$ 37,363	$ 33,670	$ (780)	$ 36,275	$ 38,159	$ 37,648	$ 36,676	$ 32,017	$ 71,033	$ 74,434	$ 68,693	$ 104,349	$ 73,654	$ 106,341	$ 143,955	$ 113,732	$ 148,584
Accounts receivable	44,189	44,238	41,781	36,009	38,363	36,179	37,324	36,139	38,572	44,238	38,363	36,139	44,189	36,009	37,324	48,096	35,198	40,937
Inventories	103,823	101,767	107,280	114,737	117,199	117,578	125,418	121,635	124,363	101,767	117,199	121,635	103,823	114,737	125,418	107,655	111,944	119,994
Prepaid and other current assets	8,313	8,149	16,314	9,704	6,221	5,932	7,473	13,777	13,157	8,149	6,221	13,777	8,313	9,704	7,473	8,413	16,626	5,179
Property plant and equipment	77,344	76,838	79,150	82,794	84,379	85,118	89,070	88,201	87,538	76,838	84,379	88,201	77,344	82,794	89,070	77,954	79,564	83,402
Other intangible assets - net	25,701	20,128	23,667	23,704	23,893	24,458	25,640	25,672	26,235	20,128	23,893	25,672	25,701	23,704	25,640	25,557	22,574	24,024
Accounts payable	19,212	14,727	14,670	24,411	27,711	28,326	23,287	25,760	24,301	14,727	27,711	25,760	19,212	24,411	23,287	26,219	18,182	26,078
Accrued expenses	22,163	23,787	23,687	20,442	20,606	23,196	17,087	20,581	21,869	23,787	20,606	20,581	22,163	20,442	17,087	25,865	25,759	22,444
Other long term liabilities				2,544	1,241	655					1,241			2,544				656
Payments for treasury stock			363							440			478			478	3,474
Restatement Adjustment [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Operating expenses	170	312	47	11	(361)	397	50		(4)	359	36	(4)	529	47	46	1,331	21	554
Accounts receivable	48	(1,338)	187	(179)	(736)	(115)	(1,188)	(1,124)	(3,428)	(1,338)	(736)	(1,124)	48	(179)	(1,188)	(255)	117	(551)
Inventories	(68)	745	586	169	426	186	168	600	1,904	745	426	600	(68)	169	168	184	17	251
Prepaid and other current assets	(300)	111	122	(102)	44	44	36			111	44		(300)	(102)	36	(378)	341	(34)
Property plant and equipment																		104
Other intangible assets - net	(496)	(496)	(496)	(102)	(102)	(102)	(42)	(42)	(42)	(496)	(102)	(42)	(496)	(102)	(42)	(802)	(496)	30
Accounts payable	(70)	(70)	(70)	(34)	(34)	(34)				(70)	(34)		(70)	(34)		(90)	(70)	(34)
Accrued expenses	$ 42	$ (127)	797	(40)	(344)	537	$ (250)	$ 227	$ 227	(127)	(344)	$ 227	42	(40)	$ (250)	1,182	149	414
Other long term liabilities				$ 400	$ 400	$ 400					$ 400			$ 400				400
Payments for treasury stock			$ 363							$ 440			$ 478			478	3,474
Revenue Recognition [Member] | Restatement Adjustment [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Increase decrease in revenue																(500)	800	3,100
Costs of processing and distribution																	200	2,100
Operating expenses																1,300
Accounts receivable																(300)	100	(600)
Inventories																200
Prepaid and other current assets																(400)	300	(100)
Property plant and equipment																		100
Deferred tax assets																300	(100)	100
Other intangible assets - net																(800)	(500)
Accounts payable																(100)	(100)
Accrued expenses																1,200	100	400
Other long term liabilities																		400
Payments for treasury stock																500	3,300
Revenue Recognition [Member] | Restatement Adjustment [Member] | Maximum [Member]
Error Corrections and Prior Period Adjustments Restatement [Line Items]
Costs of processing and distribution																$ (100)
Operating expenses																	100	600
Inventories																	$ 100	300
Other intangible assets - net																		100
Accounts payable																		$ 100

Restatement of Prior Period F_4

Restatement of Prior Period Financial Statements - Restated Condensed Consolidated Balance Sheet (Detail) - USD ($) $ in Thousands	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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jan. 01, 2016
Current Assets:
Accounts receivable	$ 48,096	$ 44,189	$ 44,238	$ 41,781	$ 35,198	$ 36,009	$ 38,363	$ 36,179	$ 40,937	$ 37,324	$ 36,139	$ 38,572
Inventories - net	107,655	103,823	101,767	107,280	111,944	114,737	117,199	117,578	119,994	125,418	121,635	124,363
Prepaid and other current assets	8,413	8,313	8,149	16,314	16,626	9,704	6,221	5,932	5,179	7,473	13,777	13,157
Total current assets	175,113	166,347	168,400	179,187	186,149	179,944	177,208	177,287	179,959	181,839	184,305	187,820
Property, plant and equipment - net	77,954	77,344	76,838	79,150	79,564	82,794	84,379	85,118	83,402	89,070	88,201	87,538
Deferred tax assets - net	17,760				9,455				25,092
Other intangible assets - net	25,557	25,701	20,128	23,667	22,574	23,704	23,893	24,458	24,024	25,640	25,672	26,235
Total assets	360,185	349,248	346,581	360,948	345,765	352,962	366,220	368,691	367,955	373,177	375,409	378,843
Current Liabilities:
Accounts payable	26,219	19,212	14,727	14,670	18,182	24,411	27,711	28,326	26,078	23,287	25,760	24,301
Accrued expenses	25,865	22,163	23,787	23,687	25,759	20,442	20,606	23,196	22,444	17,087	20,581	21,869
Total current liabilities	56,992	46,365	43,534	47,569	53,077	53,914	58,814	61,509	59,344	49,879	56,227	56,750
Other long-term liabilities						2,544	1,241	655	656
Total liabilities	112,428	103,113	105,260	114,157	100,325	107,060	140,591	145,371	143,879	136,748	137,823	139,631
Stockholders' equity:
Accumulated deficit	(239,537)	(240,336)	(243,334)	(237,532)	(237,286)	(230,059)	(247,735)	(246,071)	(244,194)	(233,419)	(229,924)	(228,247)
Total stockholders' equity	181,531	179,955	175,360	181,856	181,517	182,977	163,688	162,348	164,062	177,356	179,443	181,985	$ 179,908
Total liabilities and stockholders' equity	360,185	349,248	346,581	360,948	345,765	352,962	366,220	368,691	367,955	373,177	375,409	378,843
Adjustments [Member]
Stockholders' equity:
Total stockholders' equity									164,060
Previously Reported [Member]
Current Assets:
Accounts receivable	48,351	44,141	45,576	41,594	35,081	36,188	39,099	36,294	41,488	38,512	37,263	42,000
Inventories - net	107,471	103,891	101,022	106,694	111,927	114,568	116,773	117,392	119,743	125,250	121,035	122,459
Prepaid and other current assets	8,791	8,613	8,038	16,192	16,285	9,806	6,177	5,888	5,213	7,437
Total current assets	175,562	166,667	168,882	178,292	185,674	180,056	177,474	177,172	180,293	182,823	184,829	189,344
Property, plant and equipment - net									83,298
Deferred tax assets - net	17,510				9,575				24,968
Other intangible assets - net	26,359	26,197	20,624	24,163	23,070	23,806	23,995	24,560	23,994	25,682	25,714	26,277
Total assets	361,186	350,097	347,493	360,594	345,906	353,282	366,594	368,649	368,031	374,410	376,276	380,325
Current Liabilities:
Accounts payable	26,309	19,282	14,797	14,740	18,252	24,445	27,745	28,360	26,112
Accrued expenses	24,683	22,121	23,914	22,890	25,610	20,482	20,950	22,659	22,030	17,337	20,354	21,642
Total current liabilities	55,900	46,393	43,731	46,842	52,998	53,988	59,192	61,006	58,964	50,129	56,000	56,523
Other long-term liabilities						2,144	841	255	256
Total liabilities	111,336	103,141	105,457	113,430	100,246	106,734	140,569	144,468	143,099	136,998	137,596	139,404
Stockholders' equity:
Accumulated deficit	(237,444)	(239,515)	(242,619)	(237,159)	(237,066)	(229,413)	(246,899)	(245,210)	(243,338)	(232,436)	(228,830)	(226,538)
Total stockholders' equity	183,624				181,737				164,916
Total liabilities and stockholders' equity	361,186	350,097	347,493	360,594	345,906	353,282	366,594	368,649	368,031	374,410	376,276	380,325
Restatement Adjustment [Member]
Current Assets:
Accounts receivable	(255)	48	(1,338)	187	117	(179)	(736)	(115)	(551)	(1,188)	(1,124)	(3,428)
Inventories - net	184	(68)	745	586	17	169	426	186	251	168	600	1,904
Prepaid and other current assets	(378)	(300)	111	122	341	(102)	44	44	(34)	36
Total current assets	(449)	(320)	(482)	895	475	(112)	(266)	115	(334)	(984)	(524)	(1,524)
Property, plant and equipment - net									104
Deferred tax assets - net	250				(120)				124
Other intangible assets - net	(802)	(496)	(496)	(496)	(496)	(102)	(102)	(102)	30	(42)	(42)	(42)
Total assets	(1,001)	(849)	(912)	354	(141)	(320)	(374)	42	(76)	(1,233)	(867)	(1,482)
Current Liabilities:
Accounts payable	(90)	(70)	(70)	(70)	(70)	(34)	(34)	(34)	(34)
Accrued expenses	1,182	42	(127)	797	149	(40)	(344)	537	414	(250)	227	227
Total current liabilities	1,092	(28)	(197)	727	79	(74)	(378)	503	380	(250)	227	227
Other long-term liabilities						400	400	400	400
Total liabilities	1,092	(28)	(197)	727	79	326	(22)	903	780	(250)	227	227
Stockholders' equity:
Accumulated deficit	(2,093)	(821)	(715)	(373)	(220)	(646)	(836)	(861)	(856)	(983)	(1,094)	(1,709)
Total stockholders' equity	(2,093)				(220)				(856)
Total liabilities and stockholders' equity	$ (1,001)	$ (849)	$ (912)	$ 354	$ (141)	$ (320)	$ (374)	$ 42	$ (76)	$ (1,233)	$ (867)	$ (1,482)

Restatement of Prior Period F_5

Restatement of Prior Period Financial Statements - Restated Condensed Consolidated Income Statement (Detail) - USD ($) $ / shares in Units, $ in Thousands	Oct. 20, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Error Corrections and Prior Period Adjustments Revision [Line Items]
Revenues		$ 70,386	$ 70,450	$ 70,385	$ 69,141	$ 71,111	$ 67,246	$ 71,578	$ 70,414	$ 66,482	$ 69,924	$ 67,517	$ 139,526	$ 141,992	$ 137,441	$ 209,976	$ 209,238	$ 203,923	$ 280,362	$ 280,349	$ 275,984
Costs of processing and distribution			32,222	40,486	35,638		33,434	34,917	34,225	32,406	34,975	31,814	76,124	69,142	66,789	108,346	102,576	99,195	140,719	137,277	142,657
Gross profit		38,013	38,228	29,899	33,503	36,410	33,812	36,661	36,189	34,076	34,949	35,703	63,402	72,850	70,652	101,630	106,662	104,728	139,643	143,072	133,327
Marketing, general and administrative	$ 1,818		29,671	29,327	28,578		27,678	29,576	29,709	28,774	28,402	27,856	57,905	59,285	56,258	87,576	86,963	85,032	119,724	115,009	116,666
Research and development			3,606	3,270	3,421		2,741	3,740	3,688	3,789	4,084	4,161	6,691	7,428	8,245	10,297	10,169	12,034	14,410	13,315	16,297
Severance and restructuring costs																			2,808	(12,016)
Executive transition costs										4,107								4,107		2,818	4,404
Asset impairment and abandonments			104	4,515	129				236				4,644	236		4,748	236		5,070	4,034	5,241
Total operating expenses			33,316	37,363	33,670		(780)	36,275	38,159	37,648	36,676	32,017	71,033	74,434	68,693	104,349	73,654	106,341	143,955	113,732	148,584
Operating (loss) income			4,912	(7,464)	(167)		34,592	386	(1,970)	(3,572)	(1,727)	3,686	(7,631)	(1,584)	1,959	(2,719)	33,008	(1,613)	(4,312)	29,340	(15,257)
Foreign exchange (loss) gain			(1)	(71)	49		60	(75)	20	(67)	(38)	46	(22)	(55)	8	(23)	5	(59)	(34)	87	(129)
Total other expense - net			(598)	(1,151)	(775)		(681)	(990)	(799)	(374)	(424)	(314)	(1,926)	(1,789)	(738)	(2,524)	(2,470)	(1,112)	(3,079)	(3,085)	(1,776)
(Loss) income before income tax (provision) benefit			4,314	(8,615)	(942)		33,911	(604)	(2,769)	(3,946)	(2,151)	3,372	(9,557)	(3,373)	1,221	(5,243)	30,538	(2,725)	(7,391)	26,255	(17,033)
Income tax benefit (provision)			(1,317)	2,813	(175)		(16,235)	(1,061)	892	450	474	(1,232)	2,638	(169)	(758)	1,321	(16,404)	(308)	4,268	(19,349)	3,228
Net (loss) income		$ 799	2,997	(5,802)	(1,117)	$ (7,228)	17,676	(1,665)	(1,877)	(3,496)	(1,677)	2,140	(6,919)	(3,542)	463	(3,922)	14,134	(3,033)	(3,123)	6,906	(13,805)
Net (loss) applicable to common shares			2,824	(6,783)	(2,083)		16,738	(2,589)	(2,787)	(4,379)	(2,547)	1,282	(8,866)	(5,376)	(1,265)	(6,042)	11,362	(5,644)	(5,243)	3,183	(17,313)
Comprehensive (loss) income			$ 2,694	$ (7,697)	$ (1,690)		$ 17,172	$ (1,496)	$ (2,467)	$ (4,138)	$ (3,103)	$ 1,744	$ (9,387)	$ (3,963)	$ (1,359)	$ (6,693)	$ 13,209	$ (5,497)	$ (6,184)	$ 5,170	$ (18,587)
Net (loss) income per common share - basic		$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.28	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Net (loss) income per common share - diluted		$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.23	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Previously Reported [Member]
Error Corrections and Prior Period Adjustments Revision [Line Items]
Revenues			$ 69,064	$ 70,685	$ 69,890		$ 66,688	$ 72,120	$ 69,939	$ 66,547	$ 67,620	$ 67,351	$ 140,575	$ 142,059	$ 134,971	$ 209,639	$ 208,747	$ 201,518	$ 280,855	$ 279,563	$ 272,865
Costs of processing and distribution			31,409	40,645	36,208		33,177	35,157	34,160	32,273	33,671	31,326	76,853	69,317	64,997	108,262	102,494	97,270	140,732	137,042	140,516
Gross profit			37,655	30,040	33,682		33,511	36,963	35,779	34,274	33,949	36,025	63,722	72,742	69,974	101,377	106,253	104,248	140,123	142,521	132,349
Marketing, general and administrative																			119,217	115,103	116,125
Research and development							2,801										10,229			13,375	16,090
Severance and restructuring costs																			2,280	(12,173)
Executive transition costs																				2,781
Asset impairment and abandonments																			4,774	3,739	5,435
Total operating expenses			33,146	37,051	33,623		(791)	36,636	37,762	37,598		32,021	70,674	74,398	68,697	103,820	73,607	106,295	142,624	113,711	148,030
Operating (loss) income			4,509	(7,011)	59		34,302	327	(1,983)	(3,324)	(2,727)	4,004	(6,952)	(1,656)	1,277	(2,443)	32,646	(2,047)	(2,501)	28,810	(15,681)
Foreign exchange (loss) gain																					(132)
Total other expense - net																					(1,779)
(Loss) income before income tax (provision) benefit			3,911	(8,162)	(716)		33,621	(663)	(2,782)	(3,698)	(3,151)	3,690	(8,878)	(3,445)	539	(4,967)	30,176	(3,159)	(5,580)	25,725	(17,460)
Income tax benefit (provision)			(807)	2,702	(249)		(16,135)	(1,026)	910	92	859	(1,289)	2,453	(116)	(430)	1,646	(16,251)	(338)	4,331	(19,453)	3,061
Net (loss) income			3,104	(5,460)	(965)		17,486	(1,689)	(1,872)	(3,606)	(2,292)	2,401	(6,425)	(3,561)	109	(3,321)	13,925	(3,497)	(1,249)	6,272	(14,399)
Net (loss) applicable to common shares																			(3,369)	2,549	(17,907)
Comprehensive (loss) income			$ 2,801	$ (7,355)	$ (1,538)		$ 16,982	$ (1,520)	$ (2,462)	$ (4,248)	$ (3,718)	$ 2,005	$ (8,893)	$ (3,982)	$ (1,713)	$ (6,092)	$ 13,000	$ (5,961)	$ (4,310)	$ 4,536	$ (19,181)
Net (loss) income per common share - basic			$ 0.05	$ (0.10)	$ (0.03)		$ 0.28	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.05)	$ 0.03	$ (0.13)	$ (0.09)	$ (0.03)	$ (0.09)	$ 0.19	$ (0.10)	$ (0.05)	$ 0.04	$ (0.31)
Net (loss) income per common share - diluted			$ 0.04	$ (0.10)	$ (0.03)		$ 0.23	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.05)	$ 0.03	$ (0.13)	$ (0.09)	$ (0.03)	$ (0.09)	$ 0.19	$ (0.10)	$ (0.05)	$ 0.04	$ (0.31)
Restatement Adjustment [Member]
Error Corrections and Prior Period Adjustments Revision [Line Items]
Revenues			$ 1,386	$ (300)	$ (749)		$ 558	$ (542)	$ 475	$ (65)	$ 2,304	$ 166	$ (1,049)	$ (67)	$ 2,470	$ 337	$ 491	$ 2,405	$ (493)	$ 786	$ 3,119
Costs of processing and distribution			813	(159)	(570)		257	(240)	65	133	1,304	488	(729)	(175)	1,792	84	82	1,925	(13)	235	2,141
Gross profit			573	(141)	(179)		301	(302)	410	(198)	1,000	(322)	(320)	108	678	253	409	480	(480)	551	978
Marketing, general and administrative																			507	(94)	541
Research and development							(60)										(60)			(60)	207
Severance and restructuring costs																			528	157
Executive transition costs																				37
Asset impairment and abandonments									236					236			236		296	295	(194)
Total operating expenses			170	312	47		11	(361)	397	50		(4)	359	36	(4)	529	47	46	1,331	21	554
Operating (loss) income			403	(453)	(226)		290	59	13	(248)	1,000	(318)	(679)	72	682	(276)	362	434	(1,811)	530	424
Foreign exchange (loss) gain																					3
Total other expense - net																					3
(Loss) income before income tax (provision) benefit			403	(453)	(226)		290	59	13	(248)	1,000	(318)	(679)	72	682	(276)	362	434	(1,811)	530	427
Income tax benefit (provision)			(510)	111	74		(100)	(35)	(18)	358	(385)	57	185	(53)	(328)	(325)	(153)	30	(63)	104	167
Net (loss) income			(107)	(342)	(152)		190	24	(5)	110	615	(261)	(494)	19	354	(601)	209	464	(1,874)	634	594
Net (loss) applicable to common shares																			(1,874)	634	594
Comprehensive (loss) income			$ (107)	$ (342)	$ (152)		$ 190	$ 24	$ (5)	$ 110	$ 615	$ (261)	$ (494)	$ 19	$ 354	$ (601)	$ 209	$ 464	$ (1,874)	$ 634	$ 594
Net (loss) income per common share - basic			$ (0.01)	$ (0.01)	$ 0		$ 0	$ 0	$ 0	$ 0	$ 0.01	$ (0.01)	$ (0.01)	$ 0	$ 0.01	$ (0.01)	$ 0	$ 0	$ (0.03)	$ 0.01	$ 0.01
Net (loss) income per common share - diluted			$ 0	$ (0.01)	$ 0		$ 0	$ 0	$ 0	$ 0	$ 0.01	$ (0.01)	$ (0.01)	$ 0	$ 0.01	$ (0.01)	$ 0	$ 0	$ (0.03)	$ 0.01	$ 0.01

Restatement of Prior Period F_6

Restatement of Prior Period Financial Statements - Restated Condensed Consolidated Cash Flow (Detail) - USD ($) $ in Thousands	3 Months Ended					6 Months Ended			9 Months Ended			12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Mar. 31, 2017	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net (loss) income			$ (1,117)	$ (1,877)	$ 2,139	$ (6,919)	$ (3,541)	$ 462	$ (3,922)	$ 14,135	$ (3,033)	$ (3,123)	$ 6,906	$ (13,805)
Depreciation and amortization expense			3,584	3,568	4,310	7,068	7,129	8,694	10,794	10,704	13,087	14,579	14,233	16,528
Provision for bad debts and product returns			149	344	304	494	560	495	845	816	946	1,721	946	895
Deferred income tax (benefit)			(112)	(989)	357	(2,856)	(431)	210	(1,300)	5,542	599	(4,692)	13,573	(3,492)
Asset impairment and abandonments	$ 104	$ 4,515	129	236		4,644	236		4,748	236		5,070	4,034	5,241
Accounts receivable			(3,182)	4,468	4,903	(6,185)	(2,313)	7,066	(6,518)	4,397	5,463	(10,829)	5,116	1,710
Inventories			1,557	799	(3,843)	(1,139)	(8)	(2,780)	(5,758)	(749)	(8,511)	(11,957)	1,610	(13,228)
Accounts payable			(3,513)	108	2,764	(3,803)	998	4,495	826	(5,727)	1,095	8,035	(12,936)	4,549
Accrued expenses			(2,866)	702	(7,076)	(2,429)	(2,142)	(8,318)	(4,046)	(2,566)	(11,610)	(827)	5,667	(5,722)
Other operating assets and liabilities			(699)	(1,245)	169	7,333	(915)	(415)	3,184	(3,929)	5,571	4,036	(10,645)	7,441
Net cash provided by operating activities			(1,086)	9,577	6,423	9,818	10,613	13,209	11,485	(2,858)	10,034	17,252	5,788	15,323
Cash flows from financing activities
Payments for treasury stock			(363)			(440)			(478)			(478)	(3,474)
Other financing activities				(142)	(108)	(1,026)	(142)	(108)	(1,035)	(457)	(108)	(1,039)	(317)	(458)
Net cash used in financing			15,906	(2,284)	(1,490)	7,638	(1,942)	(2,242)	4,075	(31,960)	3,971	4,093	(35,731)	3,664
Adjustments [Member]
Cash flows from operating activities:
Accrued expenses													5,665
Previously Reported [Member]
Cash flows from operating activities:
Net (loss) income			(965)	(1,872)	2,401	(6,425)	(3,561)	109	(3,321)	13,925	(3,497)	(1,250)	6,272	(14,399)
Depreciation and amortization expense												14,569	14,226	16,510
Provision for bad debts and product returns												1,195
Deferred income tax (benefit)			(38)	(1,085)	413	(2,671)	(561)	(119)	(1,214)	5,312	366	(4,322)	13,329	(3,395)
Asset impairment and abandonments												4,774	3,739	5,435
Accounts receivable			(3,112)	4,905	5,073	(7,640)	2,128	9,540	(6,587)	4,770	7,872	(11,201)	5,784	4,756
Inventories			2,127	734	(4,331)	(411)	167	(4,572)	(5,843)	(831)	(10,736)	(11,790)	1,375	(15,369)
Accounts payable												8,054	(12,899)	4,583
Accrued expenses			(3,877)	579		(2,592)	(1,384)		(4,417)	(2,112)	(11,360)	(1,812)	2,599	(6,536)
Other operating assets and liabilities			(917)	(1,167)		7,104	(837)		2,544	(3,998)	5,834	3,318	(10,200)	7,637
Net cash provided by operating activities			(1,449)	9,577	6,423	9,378	10,613	13,209	11,007	(2,858)	10,034	16,774	2,455	15,323
Cash flows from financing activities
Other financing activities													(458)
Net cash used in financing			16,269			8,078			4,553				(32,398)
Restatement Adjustment [Member]
Cash flows from operating activities:
Net (loss) income			(152)	(5)	(262)	(494)	20	353	(601)	210	464	(1,873)	636	594
Depreciation and amortization expense												10	7	18
Provision for bad debts and product returns												526
Deferred income tax (benefit)			(74)	96	(56)	(185)	130	329	(86)	230	233	(370)	244	97
Asset impairment and abandonments				236			236			236		296	295	(194)
Accounts receivable			(70)	(437)	(170)	1,455	185	(2,474)	69	(373)	(2,409)	372	(668)	(3,046)
Inventories			(570)	65	$ 488	(728)	(175)	$ 1,792	85	82	2,225	(167)	235	2,141
Accounts payable												(19)	(37)	(34)
Accrued expenses			1,011	123		163	(758)		371	(454)	(250)	985	3,066	814
Other operating assets and liabilities			218	$ (78)		229	$ (78)		640	$ 69	$ (263)	718	(445)	$ (196)
Net cash provided by operating activities			363			440			478			478	3,333
Cash flows from financing activities
Payments for treasury stock			(363)			(440)			(478)			(478)	(3,474)
Other financing activities													141
Net cash used in financing			$ (363)			$ (440)			$ (478)			$ (478)	$ (3,333)

Restatement of Prior Period Q_3

Restatement of Prior Period Quarterly Financial Statements (Unaudited) - Condensed Consolidated Balance Sheets (Unaudited) (Detail) - USD ($) $ in Thousands	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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jan. 01, 2016
Current Assets:
Cash and cash equivalents	$ 10,949	$ 10,022	$ 14,246	$ 13,812	$ 22,381	$ 17,744	$ 13,675	$ 17,598		$ 11,624	$ 12,754	$ 11,728
Accounts receivable	48,096	44,189	44,238	41,781	35,198	36,009	38,363	36,179	$ 40,937	37,324	36,139	38,572
Inventories - net	107,655	103,823	101,767	107,280	111,944	114,737	117,199	117,578	119,994	125,418	121,635	124,363
Prepaid and other current assets	8,413	8,313	8,149	16,314	16,626	9,704	6,221	5,932	5,179	7,473	13,777	13,157
Assets held for sale						1,750	1,750
Total current assets	175,113	166,347	168,400	179,187	186,149	179,944	177,208	177,287	179,959	181,839	184,305	187,820
Property, plant and equipment - net	77,954	77,344	76,838	79,150	79,564	82,794	84,379	85,118	83,402	89,070	88,201	87,538
Deferred tax assets - net		11,842	14,514	11,884		18,437	24,862	25,918		21,348	21,939	21,931
Goodwill	59,798	62,864	64,863	65,254	46,242	46,242	54,887	54,887	54,887	54,887	54,887	54,887
Other intangible assets - net	25,557	25,701	20,128	23,667	22,574	23,704	23,893	24,458	24,024	25,640	25,672	26,235
Other assets - net	4,003	5,150	1,838	1,806	1,781	1,841	991	1,023		393	405	432
Total assets	360,185	349,248	346,581	360,948	345,765	352,962	366,220	368,691	367,955	373,177	375,409	378,843
Current Liabilities:
Accounts payable	26,219	19,212	14,727	14,670	18,182	24,411	27,711	28,326	26,078	23,287	25,760	24,301
Accrued expenses	25,865	22,163	23,787	23,687	25,759	20,442	20,606	23,196	22,444	17,087	20,581	21,869
Current portion of deferred revenue	4,908	4,990	5,020	4,944	4,868	4,793	4,718	4,686		4,816	4,891	4,922
Current portion of short and long-term obligations				4,268	4,268	4,268	5,779	5,301		4,689	4,995	5,658
Total current liabilities	56,992	46,365	43,534	47,569	53,077	53,914	58,814	61,509	59,344	49,879	56,227	56,750
Long-term obligations - less current portion	49,073	49,021	53,416	57,009	42,076	45,643	74,360	75,813		78,720	72,173	72,290
Other long-term liabilities	633	5,759	5,155	5,131	1,431	2,544	1,241	655		395	527	510
Deferred revenue	744	1,968	3,155	4,448	3,741	4,959	6,176	7,394		7,754	8,896	10,081
Total liabilities	112,428	103,113	105,260	114,157	100,325	107,060	140,591	145,371	143,879	136,748	137,823	139,631
Preferred stock Series A, $.001 par value: 5,000,000 shares authorized; 50,000 shares issued and outstanding	66,226	66,180	65,961	64,935	63,923	62,925	61,941	60,972	60,016	59,073	58,143	57,227	$ 56,323
Stockholders' equity:
Common stock, $.001 par value: 150,000,000 shares authorized; 58,026,674, and 58,031,674, 57,417,397 shares issued and outstanding, respectively	64	63	63	63	63	59	59	58		58	58	58
Additional paid-incapital		432,077	430,311	430,014		420,503	419,324	417,414		418,166	416,999	417,308
Accumulated other comprehensive loss	(7,270)	(6,980)	(6,850)	(5,936)	(6,329)	(6,469)	(6,903)	(7,996)		(6,895)	(7,136)	(6,580)
Accumulated deficit	(239,537)	(240,336)	(243,334)	(237,532)	(237,286)	(230,059)	(247,735)	(246,071)	(244,194)	(233,419)	(229,924)	(228,247)
Less treasury stock, 1,195,901, 1,213,009, and 1,221,180 shares, respectively, at cost	(4,869)	(4,869)	(4,830)	(4,753)	(4,390)	(1,057)	(1,057)	(1,057)		(554)	(554)	(554)
Total stockholders' equity	181,531	179,955	175,360	181,856	181,517	182,977	163,688	162,348	164,062	177,356	179,443	181,985	$ 179,908
Total liabilities and stockholders' equity	$ 360,185	$ 349,248	$ 346,581	$ 360,948	$ 345,765	$ 352,962	$ 366,220	$ 368,691	$ 367,955	$ 373,177	$ 375,409	$ 378,843

Restatement of Prior Period Q_4

Restatement of Prior Period Quarterly Financial Statements (Unaudited) - Condensed Consolidated Balance Sheets (Unaudited) (Parenthetical) (Detail) - $ / shares	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Accounting Changes and Error Corrections [Abstract]
Preferred stock, par value	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001
Preferred stock, shares authorized	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000	5,000,000
Preferred stock, shares issued	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000
Preferred stock, shares outstanding	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000	50,000
Common stock, par value	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001
Common stock, shares authorized	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000	150,000,000
Common stock, shares issued	63,469,185	63,461,700	63,377,839	63,401,208	62,694,441	60,544,896	59,445,223	58,537,016	57,417,397	58,031,674	58,026,674
Common stock, shares outstanding	63,469,185	63,461,700	63,377,839	63,401,208	62,694,441	60,544,896	59,445,223	58,537,016	57,417,397	58,031,674	58,026,674
Treasury stock, shares	1,221,180	1,221,180	1,213,009	1,195,901	1,114,071	410,396	410,396	410,396	259,443	259,443	259,443

Restatement of Prior Period Q_5

Restatement of Prior Period Quarterly Financial Statements (Unaudited) - Condensed Consolidated Statements of Income (Unaudited) (Detail) - USD ($) $ / shares in Units, $ in Thousands	Oct. 20, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Error Corrections and Prior Period Adjustments Revision [Line Items]
Revenues		$ 70,386	$ 70,450	$ 70,385	$ 69,141	$ 71,111	$ 67,246	$ 71,578	$ 70,414	$ 66,482	$ 69,924	$ 67,517	$ 139,526	$ 141,992	$ 137,441	$ 209,976	$ 209,238	$ 203,923	$ 280,362	$ 280,349	$ 275,984
Costs of processing and distribution			32,222	40,486	35,638		33,434	34,917	34,225	32,406	34,975	31,814	76,124	69,142	66,789	108,346	102,576	99,195	140,719	137,277	142,657
Gross profit		38,013	38,228	29,899	33,503	36,410	33,812	36,661	36,189	34,076	34,949	35,703	63,402	72,850	70,652	101,630	106,662	104,728	139,643	143,072	133,327
Expenses:
Marketing, general and administrative	$ 1,818		29,671	29,327	28,578		27,678	29,576	29,709	28,774	28,402	27,856	57,905	59,285	56,258	87,576	86,963	85,032	119,724	115,009	116,666
Research and development			3,606	3,270	3,421		2,741	3,740	3,688	3,789	4,084	4,161	6,691	7,428	8,245	10,297	10,169	12,034	14,410	13,315	16,297
Severance and restructuring costs			994	251	742		2,891	2,959	4,526	328	1,818		993	7,485	1,818	1,987	10,376	2,146	2,808	12,016	2,146
Strategic review costs										650								650			1,150
Executive transition costs										4,107								4,107		2,818	4,404
Contested proxy expenses											2,372				2,372			2,372			2,680
Asset impairment and abandonments			104	4,515	129				236				4,644	236		4,748	236		5,070	4,034	5,241
Acquisition and integration expenses			1,941		800								800			2,741			4,943	630
Cardiothoracic closure business divestiture contingency consideration			(3,000)													(3,000)			(3,000)
Gain on cardiothoracic closure business divestiture							(34,090)										(34,090)			(34,090)
Total operating expenses			33,316	37,363	33,670		(780)	36,275	38,159	37,648	36,676	32,017	71,033	74,434	68,693	104,349	73,654	106,341	143,955	113,732	148,584
Operating (loss) income			4,912	(7,464)	(167)		34,592	386	(1,970)	(3,572)	(1,727)	3,686	(7,631)	(1,584)	1,959	(2,719)	33,008	(1,613)	(4,312)	29,340	(15,257)
Other (expense) income:
Interest expense			(611)	(777)	(835)		(741)	(915)	(819)	(308)	(392)	(361)	(1,612)	(1,734)	(753)	(2,223)	(2,475)	(1,061)	(2,771)	(3,180)	(1,655)
Interest income			14	6	11					1	6	1	17		7	31		8	35	8	8
Loss on extinguishment of debt				(309)									(309)			(309)			(309)
Foreign exchange (loss) gain			(1)	(71)	49		60	(75)	20	(67)	(38)	46	(22)	(55)	8	(23)	5	(59)	(34)	87	(129)
Total other expense - net			(598)	(1,151)	(775)		(681)	(990)	(799)	(374)	(424)	(314)	(1,926)	(1,789)	(738)	(2,524)	(2,470)	(1,112)	(3,079)	(3,085)	(1,776)
(Loss) income before income tax (provision) benefit			4,314	(8,615)	(942)		33,911	(604)	(2,769)	(3,946)	(2,151)	3,372	(9,557)	(3,373)	1,221	(5,243)	30,538	(2,725)	(7,391)	26,255	(17,033)
Income tax benefit (provision)			(1,317)	2,813	(175)		(16,235)	(1,061)	892	450	474	(1,232)	2,638	(169)	(758)	1,321	(16,404)	(308)	4,268	(19,349)	3,228
Net (loss) income		$ 799	2,997	(5,802)	(1,117)	$ (7,228)	17,676	(1,665)	(1,877)	(3,496)	(1,677)	2,140	(6,919)	(3,542)	463	(3,922)	14,134	(3,033)	(3,123)	6,906	(13,805)
Convertible preferred dividend			(173)	(981)	(966)		(938)	(924)	(910)	(883)	(870)	(858)	(1,947)	(1,834)	(1,728)	(2,120)	(2,772)	(2,611)	(2,120)	(3,723)	(3,508)
Net (loss) income applicable to common shares			2,824	(6,783)	(2,083)		16,738	(2,589)	(2,787)	(4,379)	(2,547)	1,282	(8,866)	(5,376)	(1,265)	(6,042)	11,362	(5,644)	(5,243)	3,183	(17,313)
Other comprehensive (loss) income:
Unrealized foreign currency translation loss			(130)	(914)	393		434	1,093	320	241	(556)	462	(521)	1,413	(94)	(651)	1,847	147	(941)	1,987	(1,274)
Comprehensive (loss) income			$ 2,694	$ (7,697)	$ (1,690)		$ 17,172	$ (1,496)	$ (2,467)	$ (4,138)	$ (3,103)	$ 1,744	$ (9,387)	$ (3,963)	$ (1,359)	$ (6,693)	$ 13,209	$ (5,497)	$ (6,184)	$ 5,170	$ (18,587)
Net (loss) income per common share - basic		$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.28	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Net (loss) income per common share - diluted		$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.23	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Adjustments [Member]
Expenses:
Total operating expenses																	$ 73,564
Other (expense) income:
(Loss) income before income tax (provision) benefit																					$ (17,036)

Restatement of Prior Period Q_6

Restatement of Prior Period Quarterly Financial Statements (Unaudited) - Condensed Consolidated Statement of Cash Flows (Unaudited) (Detail) - USD ($) $ in Thousands	3 Months Ended						6 Months Ended			9 Months Ended			12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2017	Mar. 31, 2017	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net loss			$ (1,117)		$ (1,877)	$ 2,139	$ (6,919)	$ (3,541)	$ 462	$ (3,922)	$ 14,135	$ (3,033)	$ (3,123)	$ 6,906	$ (13,805)
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Depreciation and amortization expense			3,584		3,568	4,310	7,068	7,129	8,694	10,794	10,704	13,087	14,579	14,233	16,528
Provision for bad debts and product returns			149		344	304	494	560	495	845	816	946	1,721	946	895
Provision for inventory write-downs			2,641		1,789	945	6,559	3,753	2,370	12,906	4,488	4,422	15,122	5,066	13,880
Amortization of deferred revenue			(1,217)		(1,274)	(1,217)	(2,435)	(2,460)	(2,434)	(3,652)	(3,601)	(3,650)	(4,958)	(4,744)	(4,867)
Deferred income tax provision			(112)		(989)	357	(2,856)	(431)	210	(1,300)	5,542	599	(4,692)	13,573	(3,492)
Stock-based compensation			1,280		834	500	2,570	2,248	1,100	3,650	4,011	3,075	4,745	6,660	3,590
Asset impairment and abandonments	$ 104	$ 4,515	129		236		4,644	236		4,748	236		5,070	4,034	5,241
Cardiothoracic closure business divestiture contingency consideration	(3,000)									(3,000)			(3,000)
Gain on cardiothoracic closure business divestiture				$ (34,090)							(34,090)			(34,090)
Other			409		114	168	610	873	264	728	1,475	580	1,330	2,392	603
Change in assets and liabilities:
Accounts receivable			(3,182)		4,468	4,903	(6,185)	(2,313)	7,066	(6,518)	4,397	5,463	(10,829)	5,116	1,710
Inventories			1,557		799	(3,843)	(1,139)	(8)	(2,780)	(5,758)	(749)	(8,511)	(11,957)	1,610	(13,228)
Accounts payable			(3,513)		108	2,764	(3,803)	998	4,495	826	(5,727)	1,095	8,035	(12,936)	4,549
Accrued expenses			(2,866)		702	(7,076)	(2,429)	(2,142)	(8,318)	(4,046)	(2,566)	(11,610)	(827)	5,667	(5,722)
Deferred revenue			2,000		2,000	2,000	2,000	2,000	2,000	2,000	2,000	2,000	2,000	2,000	2,000
Other operating assets and liabilities			(699)		(1,245)	169	7,333	(915)	(415)	3,184	(3,929)	5,571	4,036	(10,645)	7,441
Net cash (used in) provided by operating activities			(1,086)		9,577	6,423	9,818	10,613	13,209	11,485	(2,858)	10,034	17,252	5,788	15,323
Cash flows from investing activities:
Purchases of property, plant and equipment			(2,118)		(3,283)	(4,637)	(3,856)	(7,160)	(9,403)	(7,106)	(10,358)	(12,774)	(11,042)	(12,301)	(15,337)
Patent and acquired intangible asset costs			(330)		(319)	(1,196)	(728)	(1,845)	(1,391)	(2,798)	(2,124)	(2,195)	(3,695)	(2,266)	(2,615)
Acquisition of Zyga Technology			(21,000)				(21,000)			(21,000)
Cardiothoracic closure business divestiture										3,000	51,000		3,000	51,000
Net cash (used in) provided by investing activities			(23,448)		(3,602)	(5,833)	(25,584)	(9,005)	(10,794)	(27,904)	38,518	(14,969)	(32,737)	38,251	(17,952)
Cash flows from financing activities:
Proceeds from exercise of common stock options			1,394		108		1,429	1,575	14	2,334	1,872	14	2,356	5,060	57
Proceeds from long-term obligations			20,000		2,000	3,000	74,425	4,000	7,000	74,425	6,000	15,000	74,425	6,000	17,000
Net (payments) proceeds from short-term obligations						(249)			(849)			(1,511)			(1,511)
Payments on long-term obligations			(5,125)		(4,250)	(4,133)	(66,750)	(7,375)	(8,299)	(71,171)	(39,375)	(9,424)	(71,171)	(43,000)	(11,424)
Payments for treasury stock			(363)				(440)			(478)			(478)	(3,474)
Other financing activities					(142)	(108)	(1,026)	(142)	(108)	(1,035)	(457)	(108)	(1,039)	(317)	(458)
Net cash provided by financing activities			15,906		(2,284)	(1,490)	7,638	(1,942)	(2,242)	4,075	(31,960)	3,971	4,093	(35,731)	3,664
Effect of exchange rate changes on cash and cash equivalents			59		58	14	(7)	160	(33)	(15)	195	(26)	(40)	224	200
Net decrease in cash and cash equivalents			(8,569)		3,749	(886)	(8,135)	(174)	140	(12,359)	3,895	(990)	(11,432)	8,532	1,235
Cash and cash equivalents, beginning of period	14,246	13,812	22,381	13,675	13,849	12,614	22,381	13,849	12,614	22,381	13,849	12,614	22,381	13,849	12,614
Cash and cash equivalents, end of period	$ 10,022	$ 14,246	13,812	$ 17,744	17,598	11,728	14,246	13,675	12,754	10,022	17,744	11,624	10,949	22,381	13,849
Supplemental cash flow disclosure:
Cash paid for interest			600		1,458	393	1,974	2,303	789	2,517	2,632	1,224	3,047	3,023	1,224
Cash paid for income taxes, net of refunds						38	6,698	32	176	(6,659)	12,032	282	(6,403)	12,142	(238)
Non-cash acquisition of property, plant and equipment			157		2,234	1,586	676	879	1,257	471	498	1,445	1,217	593	952
Stock-based compensation related to sale of CT business											102			102
Increase in accrual for dividend payable			$ 966		$ 910	$ 858	1,947	$ 1,834	$ 1,728	$ 2,120	$ 2,772	$ 2,611	$ 2,120	3,723	$ 3,508
Adjustments [Member]
Adjustments to reconcile net loss to net cash (used in) provided by operating activities:
Provision for inventory write-downs							$ 10,865
Change in assets and liabilities:
Accrued expenses														$ 5,665

Restatement of Prior Period Q_7

Restatement of Prior Period Quarterly Financial Statements (Unaudited) - Schedule of Restated Consolidated Balance Sheets (Unaudited) (Detail) - USD ($) $ in Thousands	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, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016
Current Assets:
Accounts receivable	$ 48,096	$ 44,189	$ 44,238	$ 41,781	$ 35,198	$ 36,009	$ 38,363	$ 36,179	$ 40,937	$ 37,324	$ 36,139	$ 38,572
Inventories - net	107,655	103,823	101,767	107,280	111,944	114,737	117,199	117,578	119,994	125,418	121,635	124,363
Prepaid and other current assets	8,413	8,313	8,149	16,314	16,626	9,704	6,221	5,932	5,179	7,473	13,777	13,157
Total current assets	175,113	166,347	168,400	179,187	186,149	179,944	177,208	177,287	179,959	181,839	184,305	187,820
Deferred tax assets - net	23,622	11,842	14,514	11,884	16,935	18,437	24,862	25,918		21,348	21,939	21,931
Other intangible assets - net	25,557	25,701	20,128	23,667	22,574	23,704	23,893	24,458	24,024	25,640	25,672	26,235
Total assets	360,185	349,248	346,581	360,948	345,765	352,962	366,220	368,691	367,955	373,177	375,409	378,843
Current Liabilities:
Accounts payable	26,219	19,212	14,727	14,670	18,182	24,411	27,711	28,326	26,078	23,287	25,760	24,301
Accrued expenses	25,865	22,163	23,787	23,687	25,759	20,442	20,606	23,196	22,444	17,087	20,581	21,869
Total current liabilities	56,992	46,365	43,534	47,569	53,077	53,914	58,814	61,509	59,344	49,879	56,227	56,750
Other long-term liabilities						2,544	1,241	655	656
Total liabilities	112,428	103,113	105,260	114,157	100,325	107,060	140,591	145,371	143,879	136,748	137,823	139,631
Stockholders' equity:
Accumulated deficit	(239,537)	(240,336)	(243,334)	(237,532)	(237,286)	(230,059)	(247,735)	(246,071)	(244,194)	(233,419)	(229,924)	(228,247)
Common stock and additional paid-in capital, less treasury stock	433,143				429,459		418,326
Total stockholders' equity		179,955	175,360	181,856		182,977	163,688	162,348		177,356	179,443	181,985
Total liabilities and stockholders' equity	360,185	349,248	346,581	360,948	345,765	352,962	366,220	368,691	367,955	373,177	375,409	378,843
Previously Reported [Member]
Current Assets:
Accounts receivable	48,351	44,141	45,576	41,594	35,081	36,188	39,099	36,294	41,488	38,512	37,263	42,000
Inventories - net	107,471	103,891	101,022	106,694	111,927	114,568	116,773	117,392	119,743	125,250	121,035	122,459
Prepaid and other current assets	8,791	8,613	8,038	16,192	16,285	9,806	6,177	5,888	5,213	7,437
Total current assets	175,562	166,667	168,882	178,292	185,674	180,056	177,474	177,172	180,293	182,823	184,829	189,344
Deferred tax assets - net		11,875	14,448	11,929		18,543	24,868	25,889		21,555	22,240	21,847
Other intangible assets - net	26,359	26,197	20,624	24,163	23,070	23,806	23,995	24,560	23,994	25,682	25,714	26,277
Total assets	361,186	350,097	347,493	360,594	345,906	353,282	366,594	368,649	368,031	374,410	376,276	380,325
Current Liabilities:
Accounts payable	26,309	19,282	14,797	14,740	18,252	24,445	27,745	28,360	26,112
Accrued expenses	24,683	22,121	23,914	22,890	25,610	20,482	20,950	22,659	22,030	17,337	20,354	21,642
Total current liabilities	55,900	46,393	43,731	46,842	52,998	53,988	59,192	61,006	58,964	50,129	56,000	56,523
Other long-term liabilities						2,144	841	255	256
Total liabilities	111,336	103,141	105,457	113,430	100,246	106,734	140,569	144,468	143,099	136,998	137,596	139,404
Stockholders' equity:
Accumulated deficit	(237,444)	(239,515)	(242,619)	(237,159)	(237,066)	(229,413)	(246,899)	(245,210)	(243,338)	(232,436)	(228,830)	(226,538)
Common stock and additional paid-in capital, less treasury stock							417,886
Total stockholders' equity		180,776	176,075	182,229		183,623	164,084	163,209		178,339	180,537	183,694
Total liabilities and stockholders' equity	361,186	350,097	347,493	360,594	345,906	353,282	366,594	368,649	368,031	374,410	376,276	380,325
Restatement Adjustment [Member]
Current Assets:
Accounts receivable	(255)	48	(1,338)	187	117	(179)	(736)	(115)	(551)	(1,188)	(1,124)	(3,428)
Inventories - net	184	(68)	745	586	17	169	426	186	251	168	600	1,904
Prepaid and other current assets	(378)	(300)	111	122	341	(102)	44	44	(34)	36
Total current assets	(449)	(320)	(482)	895	475	(112)	(266)	115	(334)	(984)	(524)	(1,524)
Deferred tax assets - net		(33)	66	45		(106)	(6)	29		(207)	(301)	84
Other intangible assets - net	(802)	(496)	(496)	(496)	(496)	(102)	(102)	(102)	30	(42)	(42)	(42)
Total assets	(1,001)	(849)	(912)	354	(141)	(320)	(374)	42	(76)	(1,233)	(867)	(1,482)
Current Liabilities:
Accounts payable	(90)	(70)	(70)	(70)	(70)	(34)	(34)	(34)	(34)
Accrued expenses	1,182	42	(127)	797	149	(40)	(344)	537	414	(250)	227	227
Total current liabilities	1,092	(28)	(197)	727	79	(74)	(378)	503	380	(250)	227	227
Other long-term liabilities						400	400	400	400
Total liabilities	1,092	(28)	(197)	727	79	326	(22)	903	780	(250)	227	227
Stockholders' equity:
Accumulated deficit	(2,093)	(821)	(715)	(373)	(220)	(646)	(836)	(861)	(856)	(983)	(1,094)	(1,709)
Common stock and additional paid-in capital, less treasury stock							440
Total stockholders' equity		(821)	(715)	(373)		(646)	(396)	(861)		(983)	(1,094)	(1,709)
Total liabilities and stockholders' equity	$ (1,001)	$ (849)	$ (912)	$ 354	$ (141)	$ (320)	$ (374)	$ 42	$ (76)	$ (1,233)	$ (867)	$ (1,482)

Restatement of Prior Period Q_8

Restatement of Prior Period Quarterly Financial Statements (Unaudited) - Schedule of Restated and Revised Consolidated Statements of Income (Unaudited) (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended											6 Months Ended			9 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	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Error Corrections and Prior Period Adjustments Revision [Line Items]
Revenues	$ 70,386	$ 70,450	$ 70,385	$ 69,141	$ 71,111	$ 67,246	$ 71,578	$ 70,414	$ 66,482	$ 69,924	$ 67,517	$ 139,526	$ 141,992	$ 137,441	$ 209,976	$ 209,238	$ 203,923	$ 280,362	$ 280,349	$ 275,984
Costs of processing and distribution		32,222	40,486	35,638		33,434	34,917	34,225	32,406	34,975	31,814	76,124	69,142	66,789	108,346	102,576	99,195	140,719	137,277	142,657
Gross profit	38,013	38,228	29,899	33,503	36,410	33,812	36,661	36,189	34,076	34,949	35,703	63,402	72,850	70,652	101,630	106,662	104,728	139,643	143,072	133,327
Marketing, general and administrative			29,327	28,578			29,576	29,709	28,774		27,856	57,905	59,285	55,950	87,576	86,963	84,724
Research and development		3,606	3,270	3,421		2,741	3,740	3,688	3,789	4,084	4,161	6,691	7,428	8,245	10,297	10,169	12,034	14,410	13,315	16,297
Severance and restructuring costs		994	251	742		2,891	2,959	4,526	328	1,818		993	7,485	1,818	1,987	10,376	2,146	2,808	12,016	2,146
Asset impairment and abandonments		104	4,515	129				236				4,644	236		4,748	236		5,070	4,034	5,241
Total operating expenses		33,316	37,363	33,670		(780)	36,275	38,159	37,648	36,676	32,017	71,033	74,434	68,693	104,349	73,654	106,341	143,955	113,732	148,584
Operating (loss) income		4,912	(7,464)	(167)		34,592	386	(1,970)	(3,572)	(1,727)	3,686	(7,631)	(1,584)	1,959	(2,719)	33,008	(1,613)	(4,312)	29,340	(15,257)
(Loss) income before income tax (provision) benefit		4,314	(8,615)	(942)		33,911	(604)	(2,769)	(3,946)	(2,151)	3,372	(9,557)	(3,373)	1,221	(5,243)	30,538	(2,725)	(7,391)	26,255	(17,033)
Income tax benefit (provision)		(1,317)	2,813	(175)		(16,235)	(1,061)	892	450	474	(1,232)	2,638	(169)	(758)	1,321	(16,404)	(308)	4,268	(19,349)	3,228
Net (loss) income	$ 799	2,997	(5,802)	(1,117)	$ (7,228)	17,676	(1,665)	(1,877)	(3,496)	(1,677)	2,140	(6,919)	(3,542)	463	(3,922)	14,134	(3,033)	(3,123)	6,906	(13,805)
Comprehensive (loss) income		$ 2,694	$ (7,697)	$ (1,690)		$ 17,172	$ (1,496)	$ (2,467)	$ (4,138)	$ (3,103)	$ 1,744	$ (9,387)	$ (3,963)	$ (1,359)	$ (6,693)	$ 13,209	$ (5,497)	$ (6,184)	$ 5,170	$ (18,587)
Net (loss) income per common share - basic	$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.28	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Net (loss) income per common share - diluted	$ 0.01	$ 0.04	$ (0.11)	$ (0.03)	$ (0.13)	$ 0.23	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.04)	$ 0.02	$ (0.14)	$ (0.09)	$ (0.02)	$ (0.10)	$ 0.19	$ (0.10)	$ (0.08)	$ 0.05	$ (0.30)
Previously Reported [Member]
Error Corrections and Prior Period Adjustments Revision [Line Items]
Revenues		$ 69,064	$ 70,685	$ 69,890		$ 66,688	$ 72,120	$ 69,939	$ 66,547	$ 67,620	$ 67,351	$ 140,575	$ 142,059	$ 134,971	$ 209,639	$ 208,747	$ 201,518	$ 280,855	$ 279,563	$ 272,865
Costs of processing and distribution		31,409	40,645	36,208		33,177	35,157	34,160	32,273	33,671	31,326	76,853	69,317	64,997	108,262	102,494	97,270	140,732	137,042	140,516
Gross profit		37,655	30,040	33,682		33,511	36,963	35,779	34,274	33,949	36,025	63,722	72,742	69,974	101,377	106,253	104,248	140,123	142,521	132,349
Marketing, general and administrative			29,266	28,389			29,496	29,671	28,724		27,860	57,655	59,167	55,954	87,326	86,845	84,678
Research and development						2,801										10,229			13,375	16,090
Severance and restructuring costs		824		884		2,820	3,400	4,403				884	7,803		1,708	10,623
Asset impairment and abandonments																		4,774	3,739	5,435
Total operating expenses		33,146	37,051	33,623		(791)	36,636	37,762	37,598		32,021	70,674	74,398	68,697	103,820	73,607	106,295	142,624	113,711	148,030
Operating (loss) income		4,509	(7,011)	59		34,302	327	(1,983)	(3,324)	(2,727)	4,004	(6,952)	(1,656)	1,277	(2,443)	32,646	(2,047)	(2,501)	28,810	(15,681)
(Loss) income before income tax (provision) benefit		3,911	(8,162)	(716)		33,621	(663)	(2,782)	(3,698)	(3,151)	3,690	(8,878)	(3,445)	539	(4,967)	30,176	(3,159)	(5,580)	25,725	(17,460)
Income tax benefit (provision)		(807)	2,702	(249)		(16,135)	(1,026)	910	92	859	(1,289)	2,453	(116)	(430)	1,646	(16,251)	(338)	4,331	(19,453)	3,061
Net (loss) income		3,104	(5,460)	(965)		17,486	(1,689)	(1,872)	(3,606)	(2,292)	2,401	(6,425)	(3,561)	109	(3,321)	13,925	(3,497)	(1,249)	6,272	(14,399)
Comprehensive (loss) income		$ 2,801	$ (7,355)	$ (1,538)		$ 16,982	$ (1,520)	$ (2,462)	$ (4,248)	$ (3,718)	$ 2,005	$ (8,893)	$ (3,982)	$ (1,713)	$ (6,092)	$ 13,000	$ (5,961)	$ (4,310)	$ 4,536	$ (19,181)
Net (loss) income per common share - basic		$ 0.05	$ (0.10)	$ (0.03)		$ 0.28	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.05)	$ 0.03	$ (0.13)	$ (0.09)	$ (0.03)	$ (0.09)	$ 0.19	$ (0.10)	$ (0.05)	$ 0.04	$ (0.31)
Net (loss) income per common share - diluted		$ 0.04	$ (0.10)	$ (0.03)		$ 0.23	$ (0.04)	$ (0.05)	$ (0.08)	$ (0.05)	$ 0.03	$ (0.13)	$ (0.09)	$ (0.03)	$ (0.09)	$ 0.19	$ (0.10)	$ (0.05)	$ 0.04	$ (0.31)
Restatement Adjustment [Member]
Error Corrections and Prior Period Adjustments Revision [Line Items]
Revenues		$ 1,386	$ (300)	$ (749)		$ 558	$ (542)	$ 475	$ (65)	$ 2,304	$ 166	$ (1,049)	$ (67)	$ 2,470	$ 337	$ 491	$ 2,405	$ (493)	$ 786	$ 3,119
Costs of processing and distribution		813	(159)	(570)		257	(240)	65	133	1,304	488	(729)	(175)	1,792	84	82	1,925	(13)	235	2,141
Gross profit		573	(141)	(179)		301	(302)	410	(198)	1,000	(322)	(320)	108	678	253	409	480	(480)	551	978
Marketing, general and administrative			61	189			80	38	50		(4)	250	118	(4)	250	118	46
Research and development						(60)										(60)			(60)	207
Severance and restructuring costs		170	251	(142)		71	(441)	123				109	(318)		279	(247)
Asset impairment and abandonments								236					236			236		296	295	(194)
Total operating expenses		170	312	47		11	(361)	397	50		(4)	359	36	(4)	529	47	46	1,331	21	554
Operating (loss) income		403	(453)	(226)		290	59	13	(248)	1,000	(318)	(679)	72	682	(276)	362	434	(1,811)	530	424
(Loss) income before income tax (provision) benefit		403	(453)	(226)		290	59	13	(248)	1,000	(318)	(679)	72	682	(276)	362	434	(1,811)	530	427
Income tax benefit (provision)		(510)	111	74		(100)	(35)	(18)	358	(385)	57	185	(53)	(328)	(325)	(153)	30	(63)	104	167
Net (loss) income		(107)	(342)	(152)		190	24	(5)	110	615	(261)	(494)	19	354	(601)	209	464	(1,874)	634	594
Comprehensive (loss) income		$ (107)	$ (342)	$ (152)		$ 190	$ 24	$ (5)	$ 110	$ 615	$ (261)	$ (494)	$ 19	$ 354	$ (601)	$ 209	$ 464	$ (1,874)	$ 634	$ 594
Net (loss) income per common share - basic		$ (0.01)	$ (0.01)	$ 0		$ 0	$ 0	$ 0	$ 0	$ 0.01	$ (0.01)	$ (0.01)	$ 0	$ 0.01	$ (0.01)	$ 0	$ 0	$ (0.03)	$ 0.01	$ 0.01
Net (loss) income per common share - diluted		$ 0	$ (0.01)	$ 0		$ 0	$ 0	$ 0	$ 0	$ 0.01	$ (0.01)	$ (0.01)	$ 0	$ 0.01	$ (0.01)	$ 0	$ 0	$ (0.03)	$ 0.01	$ 0.01

Restatement of Prior Period Q_9

Restatement of Prior Period Quarterly Financial Statements (Unaudited) - Schedule of Restated and Revised Consolidated Statements of Cash Flows (Unaudited) (Detail) - USD ($) $ in Thousands	3 Months Ended					6 Months Ended			9 Months Ended			12 Months Ended
	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Mar. 31, 2017	Mar. 31, 2016	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2016	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2016	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Cash flows from operating activities:
Net income (loss)			$ (1,117)	$ (1,877)	$ 2,139	$ (6,919)	$ (3,541)	$ 462	$ (3,922)	$ 14,135	$ (3,033)	$ (3,123)	$ 6,906	$ (13,805)
Deferred income tax (provision) benefit			(112)	(989)	357	(2,856)	(431)	210	(1,300)	5,542	599	(4,692)	13,573	(3,492)
Stock-based compensation			1,280	834	500	2,570	2,248	1,100	3,650	4,011	3,075	4,745	6,660	3,590
Asset impairment and abandonments	$ 104	$ 4,515	129	236		4,644	236		4,748	236		5,070	4,034	5,241
Accounts receivable			(3,182)	4,468	4,903	(6,185)	(2,313)	7,066	(6,518)	4,397	5,463	(10,829)	5,116	1,710
Inventories			1,557	799	(3,843)	(1,139)	(8)	(2,780)	(5,758)	(749)	(8,511)	(11,957)	1,610	(13,228)
Accrued expenses			(2,866)	702	(7,076)	(2,429)	(2,142)	(8,318)	(4,046)	(2,566)	(11,610)	(827)	5,667	(5,722)
Other operating assets and liabilities			(699)	(1,245)	169	7,333	(915)	(415)	3,184	(3,929)	5,571	4,036	(10,645)	7,441
Net cash (used in) provided by operating activities			(1,086)	9,577	6,423	9,818	10,613	13,209	11,485	(2,858)	10,034	17,252	5,788	15,323
Cash flows from financing activities
Payments for treasury stock			(363)			(440)			(478)			(478)	(3,474)
Net cash used by financing activities			15,906	(2,284)	(1,490)	7,638	(1,942)	(2,242)	4,075	(31,960)	3,971	4,093	(35,731)	3,664
Previously Reported [Member]
Cash flows from operating activities:
Net income (loss)			(965)	(1,872)	2,401	(6,425)	(3,561)	109	(3,321)	13,925	(3,497)	(1,250)	6,272	(14,399)
Deferred income tax (provision) benefit			(38)	(1,085)	413	(2,671)	(561)	(119)	(1,214)	5,312	366	(4,322)	13,329	(3,395)
Stock-based compensation							1,808
Asset impairment and abandonments												4,774	3,739	5,435
Accounts receivable			(3,112)	4,905	5,073	(7,640)	2,128	9,540	(6,587)	4,770	7,872	(11,201)	5,784	4,756
Inventories			2,127	734	(4,331)	(411)	167	(4,572)	(5,843)	(831)	(10,736)	(11,790)	1,375	(15,369)
Accrued expenses			(3,877)	579		(2,592)	(1,384)		(4,417)	(2,112)	(11,360)	(1,812)	2,599	(6,536)
Other operating assets and liabilities			(917)	(1,167)		7,104	(837)		2,544	(3,998)	5,834	3,318	(10,200)	7,637
Net cash (used in) provided by operating activities			(1,449)	9,577	6,423	9,378	10,613	13,209	11,007	(2,858)	10,034	16,774	2,455	15,323
Cash flows from financing activities
Net cash used by financing activities			16,269			8,078			4,553				(32,398)
Restatement Adjustment [Member]
Cash flows from operating activities:
Net income (loss)			(152)	(5)	(262)	(494)	20	353	(601)	210	464	(1,873)	636	594
Deferred income tax (provision) benefit			(74)	96	(56)	(185)	130	329	(86)	230	233	(370)	244	97
Stock-based compensation							440
Asset impairment and abandonments				236			236			236		296	295	(194)
Accounts receivable			(70)	(437)	(170)	1,455	185	(2,474)	69	(373)	(2,409)	372	(668)	(3,046)
Inventories			(570)	65	$ 488	(728)	(175)	$ 1,792	85	82	2,225	(167)	235	2,141
Accrued expenses			1,011	123		163	(758)		371	(454)	(250)	985	3,066	814
Other operating assets and liabilities			218	$ (78)		229	$ (78)		640	$ 69	$ (263)	718	(445)	$ (196)
Net cash (used in) provided by operating activities			363			440			478			478	3,333
Cash flows from financing activities
Payments for treasury stock			(363)			(440)			(478)			(478)	(3,474)
Net cash used by financing activities			$ (363)			$ (440)			$ (478)			$ (478)	$ (3,333)

Schedule II - Valuation and Qua

Schedule II - Valuation and Qualifying Accounts (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016
Allowance for Doubtful Accounts [Member]
Valuation And Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	$ 1,731	$ 1,870	$ 1,454
Charged to Costs and Expenses	1,105	536	787
Deductions- Write-offs, Payments	176	675	371
Balance at End of Period	2,660	1,731	1,870
Allowance For Product Returns [Member]
Valuation And Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	795	582	714
Charged to Costs and Expenses	616	410	108
Deductions- Write-offs, Payments	703	197	240
Balance at End of Period	708	795	582
Allowance For Excess And Obsolescence [Member]
Valuation And Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	8,102	14,798	7,083
Charged to Costs and Expenses	15,122	5,066	13,880
Deductions- Write-offs, Payments	7,871	11,762	23
Balance at End of Period	15,353	8,102	14,798
Deferred Tax Asset Valuation Allowance [Member]
Valuation And Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	7,258	4,916	1,106
Charged to Costs and Expenses	2,368	1,668	3,833
Deductions- Write-offs, Payments	6,533	(674)	89
Balance at End of Period	$ 3,093	$ 7,258	$ 4,916