CONMED (CNMD) 10-Q 2 Nov 18 2018 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2018	Oct. 30, 2018
Document and Entity Information [Abstract]
Entity Registrant Name	CONMED CORP
Entity Central Index Key	816,956
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Emerging Growth Company	false
Entity Small Business	false
Document Type	10-Q
Document Period End Date	Sep. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q3
Amendment Flag	false
Entity Common Stock, Shares Outstanding		28,128,672

Consolidated Condensed Statemen

Consolidated Condensed Statements of Comprehensive Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Statement of Comprehensive Income [Abstract]
Net sales	$ 202,307	$ 190,117	$ 617,191	$ 573,837
Cost of sales	91,680	87,570	280,736	266,753
Gross profit	110,627	102,547	336,455	307,084
Selling and administrative expense	84,983	80,807	259,156	259,396
Research and development expense	14,122	8,270	31,817	23,929
Operating expenses	99,105	89,077	290,973	283,325
Income from operations	11,522	13,470	45,482	23,759
Interest expense	5,214	4,806	15,123	13,323
Income before income taxes	6,308	8,664	30,359	10,436
Provision for income taxes	483	1,467	5,158	1,645
Net income	5,825	7,197	25,201	8,791
Comprehensive income	$ 7,136	$ 10,446	$ 27,845	$ 19,666
Per share data:
Basic (in dollars per share)	$ 0.21	$ 0.26	$ 0.90	$ 0.31
Diluted (in dollars per share)	0.20	0.26	0.87	0.31
Dividends per share of common stock (in dollars per share)	$ 0.20	$ 0.20	$ 0.60	$ 0.60
Weighted average common shares:
Basic (shares)	28,124	27,924	28,096	27,915
Diluted (shares)	29,088	28,183	28,872	28,124

Consolidated Condensed Balance

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Current assets:
Cash and cash equivalents	$ 29,691	$ 32,622
Accounts receivable, net	161,000	167,037
Inventories	153,618	141,436
Prepaid expenses and other current assets	19,153	15,688
Total current assets	363,462	356,783
Property, plant and equipment, net	113,701	116,229
Goodwill	400,977	401,954
Other intangible assets, net	415,191	414,940
Other assets	69,649	68,055
Total assets	1,362,980	1,357,961
Current liabilities:
Current portion of long-term debt	18,045	14,699
Accounts payable	48,227	42,044
Accrued compensation and benefits	34,422	34,258
Other current liabilities	64,199	59,002
Total current liabilities	164,893	150,003
Long-term debt	442,900	471,744
Deferred income taxes	79,250	77,668
Other long-term liabilities	23,281	27,114
Total liabilities	710,324	726,529
Commitments and contingencies
Shareholders' equity:
Preferred stock, par value $.01 per share; authorized 500,000 shares; none outstanding	0	0
Common stock, par value $.01 per share; 100,000,000 shares authorized; 31,299,194 shares issued in 2018 and 2017, respectively	313	313
Paid-in capital	339,033	333,795
Retained earnings	448,875	440,085
Accumulated other comprehensive loss	(46,434)	(49,078)
Less: 3,175,822 and 3,338,015 shares of common stock in treasury, at cost in 2018 and 2017, respectively	(89,131)	(93,683)
Total shareholders’ equity	652,656	631,432
Total liabilities and shareholders’ equity	$ 1,362,980	$ 1,357,961

Consolidated Condensed Balanc_2

Consolidated Condensed Balance Sheets (Parenthetical) - $ / shares	Sep. 30, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Preferred stock, par value (dollars per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (in shares)	500,000	500,000
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	100,000,000	100,000,000
Common stock, shares issued (in shares)	31,299,194	31,299,194
Treasury stock, shares (in shares)	3,175,822	3,338,015

Consolidated Condensed Statem_2

Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Cash flows from operating activities:
Net income	$ 25,201	$ 8,791
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	13,881	14,993
Amortization	32,329	28,069
Stock-based compensation	7,465	6,340
Impairment charges	4,212	0
Deferred income taxes	(1,268)	(5,129)
Increase in cash flows from changes in assets and liabilities:
Accounts receivable	4,361	6,210
Inventories	(13,677)	(12,062)
Accounts payable	6,212	7,801
Accrued compensation and benefits	465	(5,151)
Other assets	(20,323)	(17,917)
Other liabilities	(8,860)	12,809
Total operating	24,797	35,963
Net cash provided by operating activities	49,998	44,754
Cash flows from investing activities:
Purchases of property, plant and equipment	(11,751)	(9,232)
Payments to Acquire Businesses Net of Cash Acquired and Asset Acquisitions	0	(15,194)
Net cash used in investing activities	(11,751)	(24,426)
Cash flows from financing activities:
Payments on term loan	(9,844)	(6,563)
Payments on revolving line of credit	(119,000)	(98,000)
Proceeds from revolving line of credit	104,000	115,000
Dividends paid on common stock	(16,819)	(16,722)
Other, net	1,043	(887)
Net cash used in financing activities	(40,620)	(7,172)
Effect of exchange rate changes on cash and cash equivalents	(558)	3,450
Net increase (decrease) in cash and cash equivalents	(2,931)	16,606
Cash and cash equivalents at beginning of period	32,622	27,428
Cash and cash equivalents at end of period	29,691	44,034
Non-cash investing and financing activities:
Contractual obligations from asset acquisition	25,849	0
Dividends payable	$ 5,625	$ 5,585

Operations

Operations	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Operations	Operations CONMED Corporation (“CONMED”, the “Company”, “we” or “us”) is a medical technology company that provides surgical devices and equipment for minimally invasive procedures. The Company’s products are used by surgeons and physicians in a variety of specialties including orthopedics, general surgery, gynecology, neurosurgery, thoracic surgery and gastroenterology.

Interim Financial Information

Interim Financial Information	9 Months Ended
	Sep. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Interim financial information	Interim Financial Information The accompanying unaudited consolidated condensed financial statements have been prepared in accordance with generally accepted accounting principles for interim financial information and with the instructions to Form 10-Q and Article 10 of Regulation S-X. Accordingly, they do not include all of the information and footnotes required by generally accepted accounting principles for annual financial statements. The information herein reflects all normal recurring material adjustments, which are, in the opinion of management, necessary for the fair statements of the results for the periods presented. The consolidated condensed financial statements herein consist of all wholly-owned domestic and foreign subsidiaries with all significant intercompany transactions eliminated. Results for the period ended September 30, 2018 are not necessarily indicative of the results that may be expected for the year ending December 31, 2018 . The consolidated condensed financial statements and notes thereto should be read in conjunction with the consolidated financial statements and notes for the year ended December 31, 2017 included in our Annual Report on Form 10-K.

Revenues

Revenues	9 Months Ended
	Sep. 30, 2018
Revenue from Contract with Customer [Abstract]
Revenue from Contract with Customer	Revenues The Company adopted Accounting Standards Update ("ASU") No. 2014-09, Revenue from Contracts with Customers, which is codified in Accounting Standards Codification ("ASC") 606, effective January 1, 2018. ASC 606 is a comprehensive new revenue recognition model that requires a company to recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration the company expects to receive in exchange for those goods or services. The Company has applied the modified retrospective approach to adoption whereby the standard is applied only to the current period. Adoption of ASC 606 did not have a material impact on our consolidated condensed financial statements. Certain costs previously included in selling and administrative expense and principally related to administrative fees paid to group purchasing organizations are required to be recorded as a reduction of revenue under the new standard. These costs amounted to $2.4 million and $2.0 million during the three months ended September 30, 2018 and 2017 , respectively, and $6.3 million and $5.8 million during the nine months ended September 30, 2018 and 2017 , respectively. These costs are included as a reduction in net sales in the three and nine months ended September 30, 2018 and as selling and administrative expense in the three and nine months ended September 30, 2017 , respectively. There is no impact on net income or earnings per share as a result of this change. The Company recognizes revenue when we have satisfied a performance obligation by transferring a promised good or service (that is an asset) to a customer. An asset is transferred when the customer obtains control of that asset. The following policies apply to our major categories of revenue transactions: • Revenue is recognized when product is shipped and the customer obtains control of the product. • We place certain of our capital equipment with customers on a loaned basis and at no charge in exchange for commitments to purchase related single-use products over time periods generally ranging from one to three years. In these circumstances, no revenue is recognized upon capital equipment shipment as the equipment is loaned and subject to return if certain minimum single-use purchases are not met. Revenue is recognized upon the sale and shipment of the related single-use products. The cost of the equipment is amortized over its estimated useful life which is generally five years. • Product returns are only accepted at the discretion of the Company and in accordance with our “Returned Goods Policy”. Historically, the level of product returns has not been significant. We accrue for sales returns, rebates and allowances based upon an analysis of historical customer returns and credits, rebates, discounts and current market conditions. • Our terms of sale to customers generally do not include any obligations to perform future services. Limited warranties are provided for capital equipment sales and provisions for warranty are provided at the time of product sale based upon an analysis of historical data. • Amounts billed to customers related to shipping and handling have been included in net sales. Shipping and handling costs included in selling and administrative expense were $10.0 million and $9.6 million for the nine months ended September 30, 2018 and 2017 , respectively. • We sell to a diversified base of customers around the world and, therefore, believe there is no material concentration of credit risk. • We assess the risk of loss on accounts receivable and adjust the allowance for doubtful accounts based on this risk assessment. Historically, losses on accounts receivable have not been material. Management believes that the allowance for doubtful accounts of $2.7 million at September 30, 2018 is adequate to provide for probable losses resulting from accounts receivable. We recognize revenue in accordance with the terms of our agreement with Musculoskeletal Transplant Foundation (“MTF”) on a net basis as our role is that of an agent earning a commission or fee. MTF is responsible for the sourcing, processing and distribution of allograft tissue for sports medicine procedures while the Company represents, markets and promotes MTF’s sports medicine allograft tissues to customers. The Company is paid a “Service Fee” by MTF which is calculated as a percentage of the amounts invoiced by MTF to customers for sports medicine allograft tissues. The Company accounts for the services as a series of distinct performance obligations and each service is recognized over time as MTF simultaneously receives and consumes the benefit. We sell extended warranties to customers that are typically for a period of one to three years. The related revenue is recorded as a contract liability and recognized over the life of the contract on a straight-line basis, which is reflective of our obligation to stand ready to provide repair services. The Company previously expensed as incurred commissions paid for the sale of extended warranty contracts to customers. Under the new guidance, the Company capitalizes these contract acquisition costs and realizes the expense in line with the related extended warranty contract revenue recognition. Upon adoption of the new standard, we recorded a cumulative adjustment of $0.4 million net of income taxes to beginning shareholders’ equity in order to capitalize costs incurred to obtain contracts with customers. The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended September 30, 2018 September 30, 2017 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 39,574 $ 67,955 $ 107,529 $ 38,044 $ 60,260 $ 98,304 Americas (excluding the United States) 14,949 7,347 22,296 15,147 7,945 23,092 Europe, Middle East & Africa 23,206 11,492 34,698 22,623 11,027 33,650 Asia Pacific 25,200 12,584 37,784 22,767 12,304 35,071 Total sales from contracts with customers $ 102,929 $ 99,378 $ 202,307 $ 98,581 $ 91,536 $ 190,117 Timing of Revenue Recognition Goods transferred at a point in time $ 94,640 $ 98,992 $ 193,632 $ 91,047 $ 91,307 $ 182,354 Services transferred over time 8,289 386 8,675 7,534 229 7,763 Total sales from contracts with customers $ 102,929 $ 99,378 $ 202,307 $ 98,581 $ 91,536 $ 190,117 Nine Months Ended Nine Months Ended September 30, 2018 September 30, 2017 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 123,782 $ 199,653 $ 323,435 $ 121,320 $ 176,421 $ 297,741 Americas (excluding the United States) 48,307 23,374 71,681 43,256 22,902 66,158 Europe, Middle East & Africa 80,951 38,420 119,371 76,774 35,655 112,429 Asia Pacific 68,883 33,821 102,704 66,581 30,928 97,509 Total sales from contracts with customers $ 321,923 $ 295,268 $ 617,191 $ 307,931 $ 265,906 $ 573,837 Timing of Revenue Recognition Goods transferred at a point in time $ 297,096 $ 294,196 $ 591,292 $ 283,728 $ 265,391 $ 549,119 Services transferred over time 24,827 1,072 25,899 24,203 515 24,718 Total sales from contracts with customers $ 321,923 $ 295,268 $ 617,191 $ 307,931 $ 265,906 $ 573,837 Contract liability balances related to the sale of extended warranties to customers are as follows: September 30, 2018 December 31, 2017 Contract liability $ 10,375 $ 7,786 Revenue recognized during nine months ended September 30, 2018 and September 30, 2017 from amounts included in contract liabilities at the beginning of the period were $6.6 million and $4.7 million , respectively. There were no material contract assets as of September 30, 2018 and December 31, 2017 .

Comprehensive Income

Comprehensive Income	9 Months Ended
	Sep. 30, 2018
Equity [Abstract]
Comprehensive Income	Comprehensive Income Comprehensive income consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Net income $ 5,825 $ 7,197 $ 25,201 $ 8,791 Other comprehensive income (loss): Pension liability, net of income tax (income tax expense of $162 and $294 for the three months ended September 30, 2018 and 2017, respectively, and $488 and $880 for the nine months ended September 30, 2018 and 2017, respectively) 510 500 1,529 1,501 Cash flow hedging gain (loss) net of income tax (income tax expense (benefit) of $378 and ($790) for the three months ended September 30, 2018 and 2017, respectively, and $2,102 and ($2,312) for the nine months ended September 30, 2018 and 2017, respectively) 1,185 (1,348 ) 6,598 (3,946 ) Foreign currency translation adjustment (384 ) 4,097 (5,483 ) 13,320 Comprehensive income $ 7,136 $ 10,446 $ 27,845 $ 19,666 Accumulated other comprehensive loss consists of the following: Cash Flow Hedging Gain (Loss) Pension Liability Cumulative Translation Adjustments Accumulated Other Comprehensive Income (Loss) Balance, December 31, 2017 $ (3,530 ) $ (25,813 ) $ (19,735 ) $ (49,078 ) Other comprehensive income (loss) before reclassifications, net of tax 5,462 — (5,483 ) (21 ) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,498 2,017 — 3,515 Income tax (362 ) (488 ) — (850 ) Net current-period other comprehensive income (loss) 6,598 1,529 (5,483 ) 2,644 Balance, September 30, 2018 $ 3,068 $ (24,284 ) $ (25,218 ) $ (46,434 ) Cash Flow Hedging Gain (Loss) Pension Liability Cumulative Translation Adjustments Accumulated Other Comprehensive Income (Loss) Balance, December 31, 2016 $ 1,546 $ (26,458 ) $ (33,614 ) $ (58,526 ) Other comprehensive income (loss) before reclassifications, net of tax (3,939 ) — 13,320 9,381 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (11 ) 2,381 — 2,370 Income tax 4 (880 ) — (876 ) Net current-period other comprehensive income (loss) (3,946 ) 1,501 13,320 10,875 Balance, September 30, 2017 $ (2,400 ) $ (24,957 ) $ (20,294 ) $ (47,651 ) (a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 5 and Note 10, respectively, for further details.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	Fair Value of Financial Instruments We enter into derivative instruments for risk management purposes only. We operate internationally and in the normal course of business are exposed to fluctuations in interest rates, foreign exchange rates and commodity prices. These fluctuations can increase the costs of financing, investing and operating the business. We use forward contracts, a type of derivative instrument, to manage certain foreign currency exposures. By nature, all financial instruments involve market and credit risks. We enter into forward contracts with major investment grade financial institutions and have policies to monitor the credit risk of those counterparties. While there can be no assurance, we do not anticipate any material non-performance by any of these counterparties. Foreign Currency Forward Contracts. We hedge forecasted intercompany sales denominated in foreign currencies through the use of forward contracts. We account for these forward contracts as cash flow hedges. To the extent these forward contracts meet hedge accounting criteria, changes in their fair value are not included in current earnings but are included in accumulated other comprehensive loss. These changes in fair value will be recognized into earnings as a component of sales or cost of sales when the forecasted transaction occurs. The notional contract amounts for forward contracts outstanding at September 30, 2018 which have been accounted for as cash flow hedges totaled $147.8 million . Net realized gains (losses) recognized for forward contracts accounted for as cash flow hedges approximated $0.1 million and $(0.5) million for the three months ended September 30, 2018 and 2017 , respectively, and $(1.5) million and $0.0 million for the nine months ended September 30, 2018 and 2017 , respectively. At September 30, 2018 , $1.7 million of net unrealized gains on forward contracts accounted for as cash flow hedges, and included in accumulated other comprehensive loss, are expected to be recognized in earnings in the next twelve months. We also enter into forward contracts to exchange foreign currencies for United States dollars in order to hedge our currency transaction exposures. These forward contracts settle each month at month-end, at which time we enter into new forward contracts. We have not designated these forward contracts as hedges and have not applied hedge accounting to them. The notional contract amounts for forward contracts outstanding at September 30, 2018 which have not been designated as hedges totaled $30.8 million . Net realized gains (losses) recognized in connection with those forward contracts not accounted for as hedges approximated $0.2 million and $(0.5) million for the three months ended September 30, 2018 and 2017 , respectively, offsetting gains (losses) on our intercompany receivables of $(0.5) million and $0.4 million for the three months ended September 30, 2018 and 2017 , respectively. Net realized gains (losses) approximated $0.6 million and $(1.2) million for the nine months ended September 30, 2018 and 2017 , respectively, offsetting gains (losses) on our intercompany receivables of $(1.2) million and $0.7 million for the nine months ended September 30, 2018 and 2017 , respectively. These gains and losses have been recorded in selling and administrative expense in the consolidated condensed statements of comprehensive income. We record these forward foreign exchange contracts at fair value. The following tables summarize the fair value for forward foreign exchange contracts outstanding at September 30, 2018 and December 31, 2017 : September 30, 2018 Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts $ 3,787 $ (685 ) $ 3,102 Derivatives not designated as hedging instruments: Foreign exchange contracts 28 (135 ) (107 ) Total derivatives $ 3,815 $ (820 ) $ 2,995 December 31, 2017 Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts $ 346 $ (5,945 ) $ (5,599 ) Derivatives not designated as hedging instruments: Foreign exchange contracts 4 (78 ) (74 ) Total derivatives $ 350 $ (6,023 ) $ (5,673 ) Our forward foreign exchange contracts are subject to a master netting agreement and qualify for netting in the consolidated condensed balance sheets. Accordingly, at September 30, 2018 , we have recorded the net fair value of $2.4 million and $0.7 million in prepaid expenses and other current assets and non-current other assets, respectively. At December 31, 2017 , we have recorded the net fair value of $5.7 million in other current liabilities. Fair Value Disclosure. FASB guidance defines fair value and establishes a framework for measuring fair value and related disclosure requirements. This guidance applies when fair value measurements are required or permitted. The guidance indicates, among other things, that a fair value measurement assumes that the transaction to sell an asset or transfer a liability occurs in the principal market for the asset or liability or, in the absence of a principal market, the most advantageous market for the asset or liability. Fair value is defined based upon an exit price model. Valuation Hierarchy. A valuation hierarchy was established for disclosure of the inputs to the valuations used to measure fair value. This hierarchy prioritizes the inputs into three broad levels as follows. Level 1 inputs are quoted prices (unadjusted) in active markets for identical assets or liabilities. Level 2 inputs are quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar assets in markets that are not active; inputs other than quoted prices that are observable for the asset or liability, including interest rates, yield curves and credit risks or inputs that are derived principally from, or corroborated by, observable market data through correlation. Level 3 inputs are unobservable inputs based on our own assumptions used to measure assets and liabilities at fair value. A financial asset or liability’s classification within the hierarchy is determined based on the lowest level input that is significant to the fair value measurement. There have been no significant changes in the assumptions. Valuation Techniques. Assets and liabilities carried at fair value and measured on a recurring basis as of September 30, 2018 consist of forward foreign exchange contracts. The Company values its forward foreign exchange contracts using quoted prices for similar assets. The most significant assumption is quoted currency rates. The value of the forward foreign exchange contract assets and liabilities were valued using Level 2 inputs and are listed in the table above. The carrying amounts reported in our consolidated condensed balance sheets for cash and cash equivalents, accounts receivable, accounts payable and long-term debt approximate fair value.

Inventories

Inventories	9 Months Ended
	Sep. 30, 2018
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following: September 30, December 31, Raw materials $ 43,474 $ 41,844 Work-in-process 15,837 14,666 Finished goods 94,307 84,926 Total $ 153,618 $ 141,436

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share Basic earnings per share (“basic EPS”) is computed by dividing net income by the weighted average number of common shares outstanding for the reporting period. Diluted earnings per share (“diluted EPS”) gives effect to all dilutive potential shares outstanding resulting from employee stock options, restricted stock units, performance share units and stock appreciation rights ("SARs") during the period. The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2018 and 2017 : Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Net income $ 5,825 $ 7,197 $ 25,201 $ 8,791 Basic – weighted average shares outstanding 28,124 27,924 28,096 27,915 Effect of dilutive potential securities 964 259 776 209 Diluted – weighted average shares outstanding 29,088 28,183 28,872 28,124 Net income (per share) Basic $ 0.21 $ 0.26 $ 0.90 $ 0.31 Diluted 0.20 0.26 0.87 0.31 The shares used in the calculation of diluted EPS exclude options and SARs to purchase shares where the exercise price was greater than the average market price of common shares for the period and the effect of the inclusion would be anti-dilutive. Such shares aggregated approximately 0.0 million and 0.6 million for the three and nine months ended September 30, 2018 , respectively, and approximately 1.3 million and 1.2 million for the three and nine months ended September 30, 2017 .

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	9 Months Ended
	Sep. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Other Intangible Assets	Goodwill and Other Intangible Assets The changes in the net carrying amount of goodwill for the nine months ended September 30, 2018 are as follows: Balance as of December 31, 2017 $ 401,954 Foreign currency translation (977 ) Balance as of September 30, 2018 $ 400,977 Assets and liabilities of acquired businesses are recorded at their estimated fair values as of the date of acquisition. Goodwill represents costs in excess of fair values assigned to the underlying net assets of acquired businesses. Other intangible assets consist of the following: September 30, 2018 December 31, 2017 Weighted Average Amortization Period (Years) Gross Carrying Amount Accumulated Amortization Gross Carrying Amount Accumulated Amortization Amortized intangible assets: Customer and distributor relationships 29 $ 214,598 $ (94,371 ) $ 214,685 $ (86,137 ) Sales representation, marketing and promotional rights 25 149,376 (40,500 ) 149,376 (36,000 ) Patents and other intangible assets 15 61,292 (43,700 ) 69,668 (42,127 ) Developed technology 16 88,132 (6,180 ) 62,283 (3,352 ) Unamortized intangible assets: Trademarks and tradenames 86,544 — 86,544 — 24 $ 599,942 $ (184,751 ) $ 582,556 $ (167,616 ) Customer and distributor relationships, trademarks and tradenames, developed technology and patents and other intangible assets primarily represent allocations of purchase price to identifiable intangible assets of acquired businesses. Sales representation, marketing and promotional rights represent intangible assets created under our agreement with Musculoskeletal Transplant Foundation (“MTF”). Amortization expense related to intangible assets which are subject to amortization totaled $6.0 million and $5.3 million in the three months ended September 30, 2018 and 2017 , respectively, and $17.2 million and $15.6 million in the nine months ended September 30, 2018 and 2017 , respectively, and is included as a reduction of revenue (for amortization related to our sales representation, marketing and promotional rights) and in selling and administrative expense (for all other intangible assets) in the consolidated condensed statements of comprehensive income. Included in developed technology is $25.8 million of earn-out consideration that is considered probable as of September 30, 2018 associated with a prior asset acquisition. This is recorded in other current liabilities at September 30, 2018 . This acquired developed technology has a weighted average useful life of 14 years. During the three months ended September 30, 2018 , the Company wrote off $9.5 million related to an in-process research and development asset and recorded the net charge to research and development expense. Refer to Notes 11 and 13 for further details. The estimated intangible asset amortization expense remaining for the year ending December 31, 2018 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2018 $ 4,493 $ 1,500 $ 5,993 2019 17,622 6,000 23,622 2020 17,639 6,000 23,639 2021 16,686 6,000 22,686 2022 15,227 6,000 21,227 2023 14,615 6,000 20,615

Guarantees

Guarantees	9 Months Ended
	Sep. 30, 2018
Guarantees [Abstract]
Guarantees	Guarantees We provide warranties on certain of our products at the time of sale and sell extended warranties. The standard warranty period for our capital equipment is generally one year and our extended warranties typically vary from one to three years. Liability under service and warranty policies is based upon a review of historical warranty and service claim experience. Adjustments are made to accruals as claim data and historical experience warrant. Changes in the carrying amount of service and product standard warranties for the nine months ended September 30 , are as follows: 2018 2017 Balance as of January 1, $ 1,750 $ 1,954 Provision for warranties 1,036 787 Claims made (937 ) (907 ) Balance as of September 30, $ 1,849 $ 1,834 Costs associated with extended warranty repairs are recorded as incurred and amounted to $4.0 million and $2.8 million for the nine months ended September 30, 2018 and 2017 , respectively.

Pension Plan

Pension Plan	9 Months Ended
	Sep. 30, 2018
Retirement Benefits [Abstract]
Pension Plan	Pension Plan Net periodic pension cost consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Service cost $ 169 $ 151 $ 506 $ 452 Interest cost on projected benefit obligation 701 693 2,104 2,080 Expected return on plan assets (1,354 ) (1,325 ) (4,063 ) (3,975 ) Net amortization and deferral 672 794 2,017 2,381 Net periodic pension cost $ 188 $ 313 $ 564 $ 938 We do not expect to make any pension contributions during 2018 .

Acquisition, Restructuring and

Acquisition, Restructuring and Other Expense	9 Months Ended
	Sep. 30, 2018
Acquisition, Restructuring and Other Expense [Abstract]
Acquisition, Restructuring and Other Expense	Acquisition, Restructuring and Other Expense Acquisition, restructuring and other expense consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Restructuring costs included in cost of sales $ — $ 1,306 $ — $ 2,778 Business acquisition costs $ 1,073 $ 128 $ 1,073 $ 1,020 Restructuring costs — — — 1,347 Legal matters — 327 — 17,041 Acquisition, restructuring and other expense included in selling and administrative expense $ 1,073 $ 455 $ 1,073 $ 19,408 Impairment charges included in research and development expense $ 4,212 $ — $ 4,212 $ — During the three and nine months ended September 30, 2018 , we recorded a $1.1 million charge to selling and administrative expense associated with a vacant lease related to a prior acquisition. During the three and nine months ended September 30, 2017 , we incurred $0.1 million and $1.0 million , respectively, in costs associated with the January 4, 2016 acquisition of SurgiQuest, Inc. The costs were associated with expensing of unvested options acquired and integration related costs. During the three and nine months ended September 30, 2018 , we recorded a net charge of $4.2 million to research and development expense mainly associated with the impairment of an in-process research and development asset, net of the release of previously accrued contingent consideration in other current and long-term liabilities, as further described in Note 13. During 2017 , we continued our operational restructuring plan. As part of this plan, we engaged a consulting firm to assist us in streamlining our product offering and improving our operational efficiency. As a result, we identified certain catalog numbers to be discontinued and consolidated into existing product offerings and recorded a $1.3 million charge during the three months ended September 30, 2017 to write-off inventory which no longer is offered for sale. For the nine months ended September 30, 2017 we incurred $2.8 million in costs associated with the operational restructuring. These costs were charged to cost of sales and included severance, inventory and other charges. During the nine months ended September 30, 2017 , we restructured certain selling and administrative functions and incurred $1.3 million in costs consisting principally of severance charges. During the nine months ended September 30, 2017 , we incurred $12.2 million in costs associated with the SurgiQuest, Inc. vs. Lexion Medical litigation verdict whereby SurgiQuest was found liable for $2.2 million in compensatory damages with an additional $10.0 million in punitive damages as further described in Note 13. These costs were paid on July 10, 2018. In addition, during the three and nine months ended September 30, 2017 , we incurred $0.3 million and $4.8 million , respectively, in costs associated with this litigation and other legal matters.

Business Segments

Business Segments	9 Months Ended
	Sep. 30, 2018
Segment Reporting [Abstract]
Business Segments	Business Segments We are accounting and reporting for our business as a single operating segment entity engaged in the development, manufacturing and sale on a global basis of surgical devices and related equipment. Our product lines consist of orthopedic surgery and general surgery. Orthopedic surgery consists of sports medicine instrumentation and small bone, large bone and specialty powered surgical instruments as well as imaging systems for use in minimally invasive surgery procedures including 2DHD and 3DHD vision technologies and service fees related to the promotion and marketing of sports medicine allograft tissue. General surgery consists of a complete line of endo-mechanical instrumentation for minimally invasive laparoscopic and gastrointestinal procedures, a line of cardiac monitoring products as well as electrosurgical generators and related instruments. These product lines' net sales are as follows: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Orthopedic surgery $ 102,929 $ 98,581 $ 321,923 $ 307,931 General surgery 99,378 91,536 295,268 265,906 Consolidated net sales $ 202,307 $ 190,117 $ 617,191 $ 573,837

Legal Proceedings

Legal Proceedings	9 Months Ended
	Sep. 30, 2018
Commitments and Contingencies Disclosure [Abstract]
Legal Proceedings	Legal Proceedings From time to time, we are subject to claims alleging product liability, patent infringement or other claims incurred in the ordinary course of business. These may involve our United States or foreign operations, or sales by foreign distributors. Likewise, from time to time, the Company may receive an information request or subpoena from a government agency such as the Securities and Exchange Commission, Department of Justice, Equal Employment Opportunity Commission, the Occupational Safety and Health Administration, the Department of Labor, the Treasury Department or other federal and state agencies or foreign governments or government agencies. These information requests or subpoenas may or may not be routine inquiries, or may begin as routine inquiries and over time develop into enforcement actions of various types. Likewise, we receive reports of alleged misconduct from employees and third parties, which we investigate as appropriate. Manufacturers of medical devices have been the subject of various enforcement actions relating to interactions with health care providers domestically or internationally whereby companies are claimed to have provided health care providers with inappropriate incentives to purchase their products. Similarly, the Foreign Corrupt Practices Act ("FCPA") imposes obligations on manufacturers with respect to interactions with health care providers who may be considered government officials based on their affiliation with public hospitals. The FCPA also requires publicly listed manufacturers to maintain accurate books and records, and maintain internal accounting controls sufficient to provide assurance that transactions are accurately recorded, lawful and in accordance with management's authorization. The FCPA poses unique challenges both because manufacturers operate in foreign cultures in which conduct illegal under the FCPA may not be illegal in local jurisdictions, and because, in some cases, a United States manufacturer may face risks under the FCPA based on the conduct of third parties over whom the manufacturer may not have complete control. While CONMED has not experienced any material enforcement action to date, there can be no assurance that the Company will not be subject to a material enforcement action in the future, or that the Company will not incur costs including, in the form of fees for lawyers and other consultants, that are material to the Company’s results of operations in the course of responding to a future inquiry or investigation. Manufacturers of medical products may face exposure to significant product liability claims. To date, we have not experienced any product liability claims that have been material to our financial statements or financial condition, but any such claims arising in the future could have a material adverse effect on our business, results of operations or cash flows. We currently maintain commercial product liability insurance of $30 million per incident and $30 million in the aggregate annually, which we believe is adequate. This coverage is on a claims-made basis. There can be no assurance that claims will not exceed insurance coverage, that the carriers will be solvent or that such insurance will be available to us in the future at a reasonable cost. We establish reserves sufficient to cover probable losses associated with any such pending claims. We do not expect that the resolution of any pending claims, investigations or reports of alleged misconduct will have a material adverse effect on our financial condition, results of operations or cash flows. There can be no assurance, however, that future claims or investigations, or the costs associated with responding to such claims, investigations or reports of misconduct, especially claims and investigations not covered by insurance, will not have a material adverse effect on our financial condition, results of operations or cash flows. Our operations are subject, and in the past have been subject, to a number of environmental laws and regulations governing, among other things, air emissions; wastewater discharges; the use, handling and disposal of hazardous substances and wastes; soil and groundwater remediation and employee health and safety. In some jurisdictions, environmental requirements may be expected to become more stringent in the future. In the United States, certain environmental laws can impose liability for the entire cost of site restoration upon each of the parties that may have contributed to conditions at the site regardless of fault or the lawfulness of the party’s activities. While we do not believe that the present costs of environmental compliance and remediation are material, there can be no assurance that future compliance or remedial obligations would not have a material adverse effect on our financial condition, results of operations or cash flows. In April 2017, the previously disclosed lawsuit involving a false advertising claim by Lexion Medical ("Lexion") against SurgiQuest arising prior to the acquisition of SurgiQuest by CONMED went to trial in federal court in the District of Delaware. The claims arose under the Lanham Act, as well as Delaware state laws. Lexion sought damages of $22.0 million for alleged lost profits and $18.7 million for costs related to alleged “corrective advertising,” as well as damages claimed for disgorgement of SurgiQuest’s alleged profits and attorneys' fees. On January 4, 2016, SurgiQuest became a subsidiary of CONMED, and we assumed the costs and liabilities related to the Lexion lawsuit subject to the terms of the merger agreement. On April 11, 2017, a jury returned a verdict finding SurgiQuest liable for $2.2 million in compensatory damages with an additional $10.0 million in punitive damages. These costs were recorded in selling and administrative expense during the nine months ended September 30, 2017 . The District Court entered judgment on April 13, 2017. SurgiQuest and Lexion each filed post-verdict motions. Lexion sought an equitable award for disgorgement of SurgiQuest’s alleged profits, for so-called corrective advertising and for attorney’s fees. CONMED sought to vacate the award of punitive damages. By memorandum decision dated May 16, 2018, the District Court denied both Lexion’s and SurgiQuest’s post-verdict motions. The period within which either Lexion or SurgiQuest was able to pursue an appeal expired in June without either party seeking to appeal the judgment. CONMED paid the judgment, together with post-judgment interest, in a total amount of $12.3 million on July 10, 2018. In 2014, the Company acquired EndoDynamix, Inc. The agreement governing the terms of the acquisition provides that, if various conditions are met, certain contingent payments relating to the first commercial sale of the products (the milestone payment), as well as royalties based on sales (the revenue based payments), are due to the seller. We had notified the seller that there was a need to redesign the product, and that, as a consequence, the first commercial sale had been delayed. Consequently, the payment of contingent milestone and revenue-based payments were delayed. On January 18, 2017, the seller provided notice ("the Notice") seeking $12.7 million , which essentially represents the seller's view as to the sum of the projected contingent milestone and revenue-based payments on an accelerated basis. CONMED responded to the Notice denying that there was any basis for acceleration of the payments due under the acquisition agreement. On February 22, 2017, the representative of the former shareholders of EndoDynamix filed a complaint in Delaware Chancery Court claiming breach of contract with respect to the duty to commercialize the product and seeking the contingent payments on an accelerated basis. We believe that there was a substantive contractual basis to support the Company's decision to redesign the product, such that there was no legitimate basis for seeking the acceleration of the contingent payments at that time. The Company recently decided to halt the development of the EndoDynamix clip applier for a number of reasons. While we recorded a charge to write off assets and released previously accrued contingent consideration as described in Note 11, we expect to defend the claims asserted by the sellers of EndoDynamix in the Delaware Court, although there can be no assurance that we will prevail in the litigation.

New Accounting Pronouncements

New Accounting Pronouncements	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards In May 2014, the FASB issued Accounting Standards Update ("ASU") No. 2014-09, Revenue from Contracts with Customers, along with amendments issued in 2015 and 2016, which is codified in Accounting Standards Codification ("ASC") 606. This ASU is a comprehensive new revenue recognition model that requires a company to recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration the company expects to receive in exchange for those goods or services. We adopted this new guidance as of January 1, 2018, applying the modified retrospective method, and it did not have a material impact on our consolidated financial statements as further described in Note 3. In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash. The amendments in this ASU require that a statement of cash flows explain the change during the period in total cash, cash equivalents and amounts generally described as restricted cash or restricted cash equivalents. The Company adopted this new guidance effective January 1, 2018 and it did not have a material impact on the consolidated financial statements. In March 2017, the FASB issued ASU No. 2017-07, Compensation Retirement Benefits (ASC 715) - Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost. This ASU requires companies to record the service component of net periodic pension cost in the same income statement line as other compensation costs arising from services rendered by the pertinent employees during the period. The other components of net periodic pension cost would be presented in the income statement separately from the service cost component and outside the subtotal of income from operations, if one is presented. The Company adopted this new guidance effective January 1, 2018 and it did not have a material impact on the consolidated financial statements. In May 2017, the FASB issued ASU No. 2017-09, Compensation - Stock Based Compensation (ASC 718) - Scope of Modification Accounting. This ASU does not change the accounting for modifications but clarifies that modification accounting guidance should be applied if there is a change to the value, vesting conditions, or award classification and would not be required if the changes are considered non-substantive. The Company adopted this new guidance effective January 1, 2018 and it did not have a material impact on the consolidated financial statements. In August 2018, the FASB issued ASU 2018-15, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract. This guidance requires companies to determine if costs associated with hosted cloud computing services are capitalized or expensed depending on the nature of the cost and the project stage during which they are incurred. Generally, companies will only capitalize costs related to the development and implementation of the cloud computing arrangement. This guidance is effective for fiscal years beginning after December 15, 2019 and early adoption is permitted in any interim period. We early adopted this new guidance, on a prospective basis, effective July 1, 2018 and it did not have a material impact on the consolidated financial statements. Recently Issued Accounting Standards, Not Yet Adopted In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”), along with amendments issued in 2017 and 2018. This ASU requires lessees to record leases on their balance sheets but recognize the expenses on their income statements in a manner similar to current practice. ASU 2016-02 states that a lessee would recognize a lease liability for the obligation to make lease payments and a right-to-use asset for the right to use the underlying asset for the lease term. The new standard is effective for interim and annual periods beginning after December 15, 2018 and early adoption is permitted. The Company will adopt the new standard on January 1, 2019, and anticipates applying the modified retrospective approach along with certain practical expedients. We have completed a preliminary assessment of the impact of this ASU, which we expect to finalize during the fourth quarter. We expect the new standard to materially impact our balance sheet by requiring us to record right-of-use assets and lease liabilities related to operating leases that have not been recorded on the balance sheet under current GAAP, but we do not expect this update to have a material impact on our net income, earnings per share or cash flows. In January 2017, the FASB issued ASU No. 2017-04, Intangibles - Goodwill and Other (Topic 350): Simplifying the Accounting for Goodwill Impairment. This ASU removes Step 2 of the goodwill impairment test, which requires hypothetical purchase price allocation. A goodwill impairment will now be the amount by which the reporting unit's carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. This new guidance is effective for periods beginning after December 15, 2019, however early adoption is permitted. The Company will be adopting this guidance in conjunction with our annual impairment testing during the fourth quarter of 2018. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities. This ASU makes more financial and non-financial hedging strategies eligible for hedge accounting. It also amends the presentation and disclosure requirements and changes how companies assess effectiveness. It is intended to more closely align hedge accounting with companies’ risk management strategies, simplify the application of hedge accounting and increase transparency as to the scope and results of hedging programs. This guidance is effective for fiscal years beginning after December 15, 2018, including interim periods within that reporting period. Early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In February 2018, the FASB issued ASU 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220). This ASU provides entities with the option to eliminate the stranded tax effects associated with the change in tax rates under the 2017 Tax Cuts and Jobs Act through a reclassification of the stranded tax effects from accumulated other comprehensive income (“AOCI”) to retained earnings. This guidance is effective for fiscal years beginning after December 15, 2018 with early adoption permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In June 2018, the FASB issued ASU 2018-07 Compensation – Stock Compensation (Topic 718), Improvements to Nonemployee Share-Based Payment Accounting. This ASU is intended to simplify aspects of share-based compensation issued to non-employees by making the guidance consistent with accounting for employee share-based compensation. This guidance is effective for fiscal years beginning after December 15, 2018, including interim periods within that fiscal year. Early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement, which modifies the disclosure requirements on fair value measurements. This update is effective for fiscal years beginning after December 15, 2019 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In August 2018, the FASB issued ASU 2018-14, Compensation-Retirement Benefits-Defined Benefit Plans-General (Topic 715-20): Disclosure Framework-Changes to the Disclosure Requirements for Defined Benefit Plans, which modifies the disclosure requirements for defined benefit pension plans and other postretirement plans. This ASU is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2018
Income Tax Disclosure [Abstract]
Income Tax Disclosure [Text Block]	Income Taxes On December 22, 2017 the 2017 Tax Cuts and Jobs Act (“Tax Reform”) was enacted. At December 31, 2017 , the Company recorded estimated provisional amounts for the deemed repatriation toll charge implemented by Tax Reform, related to foreign tax credits, deferred tax revaluation amounts and deferred tax liabilities on unremitted foreign earnings. Staff Accounting Bulletin No. (SAB) 118 provides an extended measurement period to finalize the effects of Tax Reform for the period of enactment. During the three and nine months ended September 30, 2018 the Company recorded a provisional tax benefit of $0.2 million , primarily resulting from further analysis of the deemed repatriation toll charge and related foreign tax credits offset in part by the revaluation of certain deferred tax amounts. As the analysis of Tax Reform remains ongoing, further adjustments to the provisional amounts may impact the provision for income taxes in future periods. FASB Staff Q&A, Topic 740, No. 5, Accounting for Global Intangible Low-Taxed Income, ("GILTI") allows for an election to account for GILTI under the deferred method which requires recognizing deferred taxes for basis differences which will impact the GILTI inclusion upon reversal or as a period cost. The Company is still evaluating this election and will complete its accounting for Tax Reform, including this election, within the measurement period prescribed by SAB 118. Income tax expense has been recorded at an effective tax rate of 7.7% and 16.9% for the three months ended September 30, 2018 and 2017 , respectively, and at an effective tax rate of 17.0% and 15.8% for the nine months ended September 30, 2018 and 2017 , respectively. The lower effective rate for the three months ended September 30, 2018 , as compared to the same period in the prior year, was primarily the result of recording discrete income tax benefits associated with the provisional adjustment for Tax Reform, stock options, and other federal income tax items which reduced the effective rate by 18.5% for the three months ended September 30, 2018 as compared to a reduction of 9.2% for discrete items during the three months ended September 30, 2017. The higher effective rate for the nine months ended September 30, 2018 , as compared to the same period in the prior year, was due to increased federal tax expense resulting from adjustments to the December 31, 2017 tax balances related to Tax Reform. In addition, the lower federal statutory tax rate of 21% enacted with Tax Reform was offset by other provisions of Tax Reform including GILTI as well as income earned in foreign jurisdictions with effective tax rates in excess of the federal statutory rate.

Revenues (Policies)

Revenues (Policies)	9 Months Ended
	Sep. 30, 2018
Revenue from Contract with Customer [Abstract]
Revenue Recognition, Policy	The Company recognizes revenue when we have satisfied a performance obligation by transferring a promised good or service (that is an asset) to a customer. An asset is transferred when the customer obtains control of that asset. The following policies apply to our major categories of revenue transactions: • Revenue is recognized when product is shipped and the customer obtains control of the product. • We place certain of our capital equipment with customers on a loaned basis and at no charge in exchange for commitments to purchase related single-use products over time periods generally ranging from one to three years. In these circumstances, no revenue is recognized upon capital equipment shipment as the equipment is loaned and subject to return if certain minimum single-use purchases are not met. Revenue is recognized upon the sale and shipment of the related single-use products. The cost of the equipment is amortized over its estimated useful life which is generally five years. • Product returns are only accepted at the discretion of the Company and in accordance with our “Returned Goods Policy”. Historically, the level of product returns has not been significant. We accrue for sales returns, rebates and allowances based upon an analysis of historical customer returns and credits, rebates, discounts and current market conditions. • Our terms of sale to customers generally do not include any obligations to perform future services. Limited warranties are provided for capital equipment sales and provisions for warranty are provided at the time of product sale based upon an analysis of historical data. • Amounts billed to customers related to shipping and handling have been included in net sales. Shipping and handling costs included in selling and administrative expense were $10.0 million and $9.6 million for the nine months ended September 30, 2018 and 2017 , respectively. • We sell to a diversified base of customers around the world and, therefore, believe there is no material concentration of credit risk. • We assess the risk of loss on accounts receivable and adjust the allowance for doubtful accounts based on this risk assessment. Historically, losses on accounts receivable have not been material. Management believes that the allowance for doubtful accounts of $2.7 million at September 30, 2018 is adequate to provide for probable losses resulting from accounts receivable. We recognize revenue in accordance with the terms of our agreement with Musculoskeletal Transplant Foundation (“MTF”) on a net basis as our role is that of an agent earning a commission or fee. MTF is responsible for the sourcing, processing and distribution of allograft tissue for sports medicine procedures while the Company represents, markets and promotes MTF’s sports medicine allograft tissues to customers. The Company is paid a “Service Fee” by MTF which is calculated as a percentage of the amounts invoiced by MTF to customers for sports medicine allograft tissues. The Company accounts for the services as a series of distinct performance obligations and each service is recognized over time as MTF simultaneously receives and consumes the benefit. We sell extended warranties to customers that are typically for a period of one to three years. The related revenue is recorded as a contract liability and recognized over the life of the contract on a straight-line basis, which is reflective of our obligation to stand ready to provide repair services.

New Accounting Pronouncements (

New Accounting Pronouncements (Policies)	9 Months Ended
	Sep. 30, 2018
Accounting Policies [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards In May 2014, the FASB issued Accounting Standards Update ("ASU") No. 2014-09, Revenue from Contracts with Customers, along with amendments issued in 2015 and 2016, which is codified in Accounting Standards Codification ("ASC") 606. This ASU is a comprehensive new revenue recognition model that requires a company to recognize revenue when it transfers promised goods or services to customers in an amount that reflects the consideration the company expects to receive in exchange for those goods or services. We adopted this new guidance as of January 1, 2018, applying the modified retrospective method, and it did not have a material impact on our consolidated financial statements as further described in Note 3. In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash. The amendments in this ASU require that a statement of cash flows explain the change during the period in total cash, cash equivalents and amounts generally described as restricted cash or restricted cash equivalents. The Company adopted this new guidance effective January 1, 2018 and it did not have a material impact on the consolidated financial statements. In March 2017, the FASB issued ASU No. 2017-07, Compensation Retirement Benefits (ASC 715) - Improving the Presentation of Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost. This ASU requires companies to record the service component of net periodic pension cost in the same income statement line as other compensation costs arising from services rendered by the pertinent employees during the period. The other components of net periodic pension cost would be presented in the income statement separately from the service cost component and outside the subtotal of income from operations, if one is presented. The Company adopted this new guidance effective January 1, 2018 and it did not have a material impact on the consolidated financial statements. In May 2017, the FASB issued ASU No. 2017-09, Compensation - Stock Based Compensation (ASC 718) - Scope of Modification Accounting. This ASU does not change the accounting for modifications but clarifies that modification accounting guidance should be applied if there is a change to the value, vesting conditions, or award classification and would not be required if the changes are considered non-substantive. The Company adopted this new guidance effective January 1, 2018 and it did not have a material impact on the consolidated financial statements. In August 2018, the FASB issued ASU 2018-15, Intangibles-Goodwill and Other-Internal-Use Software (Subtopic 350-40): Customer's Accounting for Implementation Costs Incurred in a Cloud Computing Arrangement That Is a Service Contract. This guidance requires companies to determine if costs associated with hosted cloud computing services are capitalized or expensed depending on the nature of the cost and the project stage during which they are incurred. Generally, companies will only capitalize costs related to the development and implementation of the cloud computing arrangement. This guidance is effective for fiscal years beginning after December 15, 2019 and early adoption is permitted in any interim period. We early adopted this new guidance, on a prospective basis, effective July 1, 2018 and it did not have a material impact on the consolidated financial statements. Recently Issued Accounting Standards, Not Yet Adopted In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842) (“ASU 2016-02”), along with amendments issued in 2017 and 2018. This ASU requires lessees to record leases on their balance sheets but recognize the expenses on their income statements in a manner similar to current practice. ASU 2016-02 states that a lessee would recognize a lease liability for the obligation to make lease payments and a right-to-use asset for the right to use the underlying asset for the lease term. The new standard is effective for interim and annual periods beginning after December 15, 2018 and early adoption is permitted. The Company will adopt the new standard on January 1, 2019, and anticipates applying the modified retrospective approach along with certain practical expedients. We have completed a preliminary assessment of the impact of this ASU, which we expect to finalize during the fourth quarter. We expect the new standard to materially impact our balance sheet by requiring us to record right-of-use assets and lease liabilities related to operating leases that have not been recorded on the balance sheet under current GAAP, but we do not expect this update to have a material impact on our net income, earnings per share or cash flows. In January 2017, the FASB issued ASU No. 2017-04, Intangibles - Goodwill and Other (Topic 350): Simplifying the Accounting for Goodwill Impairment. This ASU removes Step 2 of the goodwill impairment test, which requires hypothetical purchase price allocation. A goodwill impairment will now be the amount by which the reporting unit's carrying value exceeds its fair value, not to exceed the carrying amount of goodwill. This new guidance is effective for periods beginning after December 15, 2019, however early adoption is permitted. The Company will be adopting this guidance in conjunction with our annual impairment testing during the fourth quarter of 2018. In August 2017, the FASB issued ASU No. 2017-12, Derivatives and Hedging (Topic 815): Targeted Improvements to Accounting for Hedging Activities. This ASU makes more financial and non-financial hedging strategies eligible for hedge accounting. It also amends the presentation and disclosure requirements and changes how companies assess effectiveness. It is intended to more closely align hedge accounting with companies’ risk management strategies, simplify the application of hedge accounting and increase transparency as to the scope and results of hedging programs. This guidance is effective for fiscal years beginning after December 15, 2018, including interim periods within that reporting period. Early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In February 2018, the FASB issued ASU 2018-02, Income Statement - Reporting Comprehensive Income (Topic 220). This ASU provides entities with the option to eliminate the stranded tax effects associated with the change in tax rates under the 2017 Tax Cuts and Jobs Act through a reclassification of the stranded tax effects from accumulated other comprehensive income (“AOCI”) to retained earnings. This guidance is effective for fiscal years beginning after December 15, 2018 with early adoption permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In June 2018, the FASB issued ASU 2018-07 Compensation – Stock Compensation (Topic 718), Improvements to Nonemployee Share-Based Payment Accounting. This ASU is intended to simplify aspects of share-based compensation issued to non-employees by making the guidance consistent with accounting for employee share-based compensation. This guidance is effective for fiscal years beginning after December 15, 2018, including interim periods within that fiscal year. Early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In August 2018, the FASB issued ASU 2018-13, Fair Value Measurement (Topic 820): Disclosure Framework-Changes to the Disclosure Requirements for Fair Value Measurement, which modifies the disclosure requirements on fair value measurements. This update is effective for fiscal years beginning after December 15, 2019 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements. In August 2018, the FASB issued ASU 2018-14, Compensation-Retirement Benefits-Defined Benefit Plans-General (Topic 715-20): Disclosure Framework-Changes to the Disclosure Requirements for Defined Benefit Plans, which modifies the disclosure requirements for defined benefit pension plans and other postretirement plans. This ASU is effective for fiscal years beginning after December 15, 2020 and early adoption is permitted. The Company is currently assessing the impact of this guidance on our consolidated financial statements.

Revenues (Tables)

Revenues (Tables)	9 Months Ended
	Sep. 30, 2018
Revenue from Contract with Customer [Abstract]
Disaggregation of Revenue	The following tables present revenue disaggregated by primary geographic market where the products are sold, by product line and timing of revenue recognition: Three Months Ended Three Months Ended September 30, 2018 September 30, 2017 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 39,574 $ 67,955 $ 107,529 $ 38,044 $ 60,260 $ 98,304 Americas (excluding the United States) 14,949 7,347 22,296 15,147 7,945 23,092 Europe, Middle East & Africa 23,206 11,492 34,698 22,623 11,027 33,650 Asia Pacific 25,200 12,584 37,784 22,767 12,304 35,071 Total sales from contracts with customers $ 102,929 $ 99,378 $ 202,307 $ 98,581 $ 91,536 $ 190,117 Timing of Revenue Recognition Goods transferred at a point in time $ 94,640 $ 98,992 $ 193,632 $ 91,047 $ 91,307 $ 182,354 Services transferred over time 8,289 386 8,675 7,534 229 7,763 Total sales from contracts with customers $ 102,929 $ 99,378 $ 202,307 $ 98,581 $ 91,536 $ 190,117 Nine Months Ended Nine Months Ended September 30, 2018 September 30, 2017 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 123,782 $ 199,653 $ 323,435 $ 121,320 $ 176,421 $ 297,741 Americas (excluding the United States) 48,307 23,374 71,681 43,256 22,902 66,158 Europe, Middle East & Africa 80,951 38,420 119,371 76,774 35,655 112,429 Asia Pacific 68,883 33,821 102,704 66,581 30,928 97,509 Total sales from contracts with customers $ 321,923 $ 295,268 $ 617,191 $ 307,931 $ 265,906 $ 573,837 Timing of Revenue Recognition Goods transferred at a point in time $ 297,096 $ 294,196 $ 591,292 $ 283,728 $ 265,391 $ 549,119 Services transferred over time 24,827 1,072 25,899 24,203 515 24,718 Total sales from contracts with customers $ 321,923 $ 295,268 $ 617,191 $ 307,931 $ 265,906 $ 573,837
Contract with Customer, Asset and Liability	Contract liability balances related to the sale of extended warranties to customers are as follows: September 30, 2018 December 31, 2017 Contract liability $ 10,375 $ 7,786

Comprehensive Income (Tables)

Comprehensive Income (Tables)	9 Months Ended
	Sep. 30, 2018
Equity [Abstract]
Schedule of Comprehensive Income	Comprehensive income consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Net income $ 5,825 $ 7,197 $ 25,201 $ 8,791 Other comprehensive income (loss): Pension liability, net of income tax (income tax expense of $162 and $294 for the three months ended September 30, 2018 and 2017, respectively, and $488 and $880 for the nine months ended September 30, 2018 and 2017, respectively) 510 500 1,529 1,501 Cash flow hedging gain (loss) net of income tax (income tax expense (benefit) of $378 and ($790) for the three months ended September 30, 2018 and 2017, respectively, and $2,102 and ($2,312) for the nine months ended September 30, 2018 and 2017, respectively) 1,185 (1,348 ) 6,598 (3,946 ) Foreign currency translation adjustment (384 ) 4,097 (5,483 ) 13,320 Comprehensive income $ 7,136 $ 10,446 $ 27,845 $ 19,666
Schedule of Accumulated Other Comprehensive Loss	Accumulated other comprehensive loss consists of the following: Cash Flow Hedging Gain (Loss) Pension Liability Cumulative Translation Adjustments Accumulated Other Comprehensive Income (Loss) Balance, December 31, 2017 $ (3,530 ) $ (25,813 ) $ (19,735 ) $ (49,078 ) Other comprehensive income (loss) before reclassifications, net of tax 5,462 — (5,483 ) (21 ) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,498 2,017 — 3,515 Income tax (362 ) (488 ) — (850 ) Net current-period other comprehensive income (loss) 6,598 1,529 (5,483 ) 2,644 Balance, September 30, 2018 $ 3,068 $ (24,284 ) $ (25,218 ) $ (46,434 ) Cash Flow Hedging Gain (Loss) Pension Liability Cumulative Translation Adjustments Accumulated Other Comprehensive Income (Loss) Balance, December 31, 2016 $ 1,546 $ (26,458 ) $ (33,614 ) $ (58,526 ) Other comprehensive income (loss) before reclassifications, net of tax (3,939 ) — 13,320 9,381 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (11 ) 2,381 — 2,370 Income tax 4 (880 ) — (876 ) Net current-period other comprehensive income (loss) (3,946 ) 1,501 13,320 10,875 Balance, September 30, 2017 $ (2,400 ) $ (24,957 ) $ (20,294 ) $ (47,651 ) (a) The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 5 and Note 10, respectively, for further details.

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	9 Months Ended
	Sep. 30, 2018
Fair Value Disclosures [Abstract]
Schedule of Fair Value for Forward Foreign Exchange Contracts	The following tables summarize the fair value for forward foreign exchange contracts outstanding at September 30, 2018 and December 31, 2017 : September 30, 2018 Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts $ 3,787 $ (685 ) $ 3,102 Derivatives not designated as hedging instruments: Foreign exchange contracts 28 (135 ) (107 ) Total derivatives $ 3,815 $ (820 ) $ 2,995 December 31, 2017 Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts $ 346 $ (5,945 ) $ (5,599 ) Derivatives not designated as hedging instruments: Foreign exchange contracts 4 (78 ) (74 ) Total derivatives $ 350 $ (6,023 ) $ (5,673 )

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2018
Inventory Disclosure [Abstract]
Schedule of inventory	Inventories consist of the following: September 30, December 31, Raw materials $ 43,474 $ 41,844 Work-in-process 15,837 14,666 Finished goods 94,307 84,926 Total $ 153,618 $ 141,436

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2018
Earnings Per Share [Abstract]
Schedule of calculation of basic and diluted earnings per share	The following table sets forth the computation of basic and diluted earnings per share for the three and nine months ended September 30, 2018 and 2017 : Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Net income $ 5,825 $ 7,197 $ 25,201 $ 8,791 Basic – weighted average shares outstanding 28,124 27,924 28,096 27,915 Effect of dilutive potential securities 964 259 776 209 Diluted – weighted average shares outstanding 29,088 28,183 28,872 28,124 Net income (per share) Basic $ 0.21 $ 0.26 $ 0.90 $ 0.31 Diluted 0.20 0.26 0.87 0.31

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets (Tables)	9 Months Ended
	Sep. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in the net carrying amount of goodwill for the nine months ended September 30, 2018 are as follows: Balance as of December 31, 2017 $ 401,954 Foreign currency translation (977 ) Balance as of September 30, 2018 $ 400,977
Schedule of Finite-Lived and Indefinite-Lived Intangible Assets	Other intangible assets consist of the following: September 30, 2018 December 31, 2017 Weighted Average Amortization Period (Years) Gross Carrying Amount Accumulated Amortization Gross Carrying Amount Accumulated Amortization Amortized intangible assets: Customer and distributor relationships 29 $ 214,598 $ (94,371 ) $ 214,685 $ (86,137 ) Sales representation, marketing and promotional rights 25 149,376 (40,500 ) 149,376 (36,000 ) Patents and other intangible assets 15 61,292 (43,700 ) 69,668 (42,127 ) Developed technology 16 88,132 (6,180 ) 62,283 (3,352 ) Unamortized intangible assets: Trademarks and tradenames 86,544 — 86,544 — 24 $ 599,942 $ (184,751 ) $ 582,556 $ (167,616 )
Schedule of Estimated Amortization Expense	The estimated intangible asset amortization expense remaining for the year ending December 31, 2018 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2018 $ 4,493 $ 1,500 $ 5,993 2019 17,622 6,000 23,622 2020 17,639 6,000 23,639 2021 16,686 6,000 22,686 2022 15,227 6,000 21,227 2023 14,615 6,000 20,615

Guarantees (Tables)

Guarantees (Tables)	9 Months Ended
	Sep. 30, 2018
Guarantees [Abstract]
Changes in the carrying amount of service and product warranties	Changes in the carrying amount of service and product standard warranties for the nine months ended September 30 , are as follows: 2018 2017 Balance as of January 1, $ 1,750 $ 1,954 Provision for warranties 1,036 787 Claims made (937 ) (907 ) Balance as of September 30, $ 1,849 $ 1,834

Pension Plan (Tables)

Pension Plan (Tables)	9 Months Ended
	Sep. 30, 2018
Retirement Benefits [Abstract]
Schedule of net benefit cost	Net periodic pension cost consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Service cost $ 169 $ 151 $ 506 $ 452 Interest cost on projected benefit obligation 701 693 2,104 2,080 Expected return on plan assets (1,354 ) (1,325 ) (4,063 ) (3,975 ) Net amortization and deferral 672 794 2,017 2,381 Net periodic pension cost $ 188 $ 313 $ 564 $ 938

Acquisition, Restructuring an_2

Acquisition, Restructuring and Other Expense (Tables)	9 Months Ended
	Sep. 30, 2018
Acquisition, Restructuring and Other Expense [Abstract]
Schedule of Acquisition, Restructuring and Other Expense	Acquisition, restructuring and other expense consists of the following: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Restructuring costs included in cost of sales $ — $ 1,306 $ — $ 2,778 Business acquisition costs $ 1,073 $ 128 $ 1,073 $ 1,020 Restructuring costs — — — 1,347 Legal matters — 327 — 17,041 Acquisition, restructuring and other expense included in selling and administrative expense $ 1,073 $ 455 $ 1,073 $ 19,408 Impairment charges included in research and development expense $ 4,212 $ — $ 4,212 $ —

Business Segments (Tables)

Business Segments (Tables)	9 Months Ended
	Sep. 30, 2018
Segment Reporting [Abstract]
Schedule of net sales information by product line	These product lines' net sales are as follows: Three Months Ended September 30, Nine Months Ended September 30, 2018 2017 2018 2017 Orthopedic surgery $ 102,929 $ 98,581 $ 321,923 $ 307,931 General surgery 99,378 91,536 295,268 265,906 Consolidated net sales $ 202,307 $ 190,117 $ 617,191 $ 573,837

Revenues (Details)

Revenues (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Jan. 01, 2018
Revenue from Contract with Customer [Abstract]
Allowance for Doubtful Accounts Receivable, Current	$ 2,700		$ 2,700
New Accounting Pronouncement or Change in Accounting Principle, Cumulative Effect of Change on Equity or Net Assets					$ 400
Disaggregation of Revenue [Line Items]
Selling and administrative expense	84,983	$ 80,807	259,156	$ 259,396
Sales Revenue, Net [Member]
Disaggregation of Revenue [Line Items]
Sales Commissions and Fees	$ 2,400		6,300
Selling and Administrative Expenses [Member]
Disaggregation of Revenue [Line Items]
Sales Commissions and Fees		$ 2,000		5,800
Shipping and Handling [Member]
Disaggregation of Revenue [Line Items]
Selling and administrative expense			$ 10,000	$ 9,600

Revenues (Disaggregated Revenue

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Disaggregation of Revenue [Line Items]
Net Sales	$ 202,307	$ 190,117	$ 617,191	$ 573,837
Transferred at Point in Time [Member]
Disaggregation of Revenue [Line Items]
Net Sales	193,632	182,354	591,292	549,119
Transferred over Time [Member]
Disaggregation of Revenue [Line Items]
Net Sales	8,675	7,763	25,899	24,718
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	102,929	98,581	321,923	307,931
Orthopedic Surgery | Transferred at Point in Time [Member]
Disaggregation of Revenue [Line Items]
Net Sales	94,640	91,047	297,096	283,728
Orthopedic Surgery | Transferred over Time [Member]
Disaggregation of Revenue [Line Items]
Net Sales	8,289	7,534	24,827	24,203
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	99,378	91,536	295,268	265,906
General Surgery | Transferred at Point in Time [Member]
Disaggregation of Revenue [Line Items]
Net Sales	98,992	91,307	294,196	265,391
General Surgery | Transferred over Time [Member]
Disaggregation of Revenue [Line Items]
Net Sales	386	229	1,072	515
UNITED STATES
Disaggregation of Revenue [Line Items]
Net Sales	107,529	98,304	323,435	297,741
UNITED STATES | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	39,574	38,044	123,782	121,320
UNITED STATES | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	67,955	60,260	199,653	176,421
Americas (excluding the United States) [Member]
Disaggregation of Revenue [Line Items]
Net Sales	22,296	23,092	71,681	66,158
Americas (excluding the United States) [Member] | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	14,949	15,147	48,307	43,256
Americas (excluding the United States) [Member] | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	7,347	7,945	23,374	22,902
EMEA [Member]
Disaggregation of Revenue [Line Items]
Net Sales	34,698	33,650	119,371	112,429
EMEA [Member] | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	23,206	22,623	80,951	76,774
EMEA [Member] | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	11,492	11,027	38,420	35,655
Asia Pacific [Member]
Disaggregation of Revenue [Line Items]
Net Sales	37,784	35,071	102,704	97,509
Asia Pacific [Member] | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	25,200	22,767	68,883	66,581
Asia Pacific [Member] | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	$ 12,584	$ 12,304	$ 33,821	$ 30,928

Revenues (Customer Liability) (

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Revenue from Contract with Customer [Abstract]
Contract liability	$ 10,375		$ 7,786
Contract with Customer, Liability, Revenue Recognized	$ 6,600	$ 4,700

Comprehensive Income (Details)

Comprehensive Income (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Equity [Abstract]
Net income	$ 5,825	$ 7,197	$ 25,201	$ 8,791
Pension liability, net of income tax	510	500	1,529	1,501
Cash flow hedging gain (loss), net of income tax	1,185	(1,348)	6,598	(3,946)
Foreign currency translation adjustment	(384)	4,097	(5,483)	13,320
Comprehensive income	7,136	10,446	27,845	19,666
Pension liability, tax	162	294	488	880
Cash flow hedging gain (loss), tax	$ 378	$ (790)	$ 2,102	$ (2,312)

Comprehensive Income (Accumulat

Comprehensive Income (Accumulated Other Comprehensive income (loss)) (Details) - USD ($) $ in Thousands		9 Months Ended
		Sep. 30, 2018	Sep. 30, 2017
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		$ (49,078)
Accumulated other comprehensive income (loss)		(46,434)
Accumulated Other Comprehensive Income (Loss) [Member]
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		(49,078)	$ (58,526)
Other comprehensive income (loss) before reclassifications		(21)	9,381
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	3,515	2,370
Reclassification from AOCI, Current Period, Tax		(850)	(876)
Net current-period other comprehensive income (loss)		2,644	10,875
Accumulated other comprehensive income (loss)		(46,434)	(47,651)
Cash Flow Hedging Gain (Loss) [Member]
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		(3,530)	1,546
Other comprehensive income (loss) before reclassifications		5,462	(3,939)
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	1,498	(11)
Reclassification from AOCI, Current Period, Tax		(362)	4
Net current-period other comprehensive income (loss)		6,598	(3,946)
Accumulated other comprehensive income (loss)		3,068	(2,400)
Pension Liability [Member]
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		(25,813)	(26,458)
Other comprehensive income (loss) before reclassifications		0	0
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	2,017	2,381
Reclassification from AOCI, Current Period, Tax		(488)	(880)
Net current-period other comprehensive income (loss)		1,529	1,501
Accumulated other comprehensive income (loss)		(24,284)	(24,957)
Cumulative Translation Adjustment [Member]
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		(19,735)	(33,614)
Other comprehensive income (loss) before reclassifications		(5,483)	13,320
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	0	0
Reclassification from AOCI, Current Period, Tax		0	0
Net current-period other comprehensive income (loss)		(5,483)	13,320
Accumulated other comprehensive income (loss)		$ (25,218)	$ (20,294)
[1]	The cash flow hedging gain (loss) and pension liability accumulated other comprehensive income (loss) components are included in sales or cost of sales and as a component of net periodic pension cost, respectively. Refer to Note 5 and Note 10, respectively, for further details.

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Foreign Currency Forward Contracts) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Derivative [Line Items]
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 1,700		$ 1,700
Foreign Currency Transaction Gain (Loss), before Tax	(500)	$ 400	(1,200)	$ 700
Prepaid Expenses And Other Current Assets and Non-current Other Assets [Domain]
Derivative Assets and Liabilities at Fair Value [Abstract]
Fair value, assets	3,815		3,815
Derivative Liability, Fair Value, Gross Liability	(820)		(820)
Derivative Assets (Liabilities), at Fair Value, Net	2,995		2,995
Prepaid Expenses and Other Current Assets [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Derivative Assets (Liabilities), at Fair Value, Net	2,400		2,400
Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Fair value, assets					$ 350
Derivative Liability, Fair Value, Gross Liability					(6,023)
Derivative Assets (Liabilities), at Fair Value, Net					(5,673)
Other Noncurrent Assets [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Derivative Assets (Liabilities), at Fair Value, Net	700		700
Foreign Currency Forward Contracts [Member]
Derivative [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	200	(500)	600	(1,200)
Designated as Hedging Instrument [Member] | Foreign Currency Forward Contracts [Member] | Prepaid Expenses And Other Current Assets and Non-current Other Assets [Domain]
Derivative Assets and Liabilities at Fair Value [Abstract]
Fair value, assets	3,787		3,787
Derivative Liability, Fair Value, Gross Liability	(685)		(685)
Derivative Assets (Liabilities), at Fair Value, Net	3,102		3,102
Designated as Hedging Instrument [Member] | Foreign Currency Forward Contracts [Member] | Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Fair value, assets					346
Derivative Liability, Fair Value, Gross Liability					(5,945)
Derivative Assets (Liabilities), at Fair Value, Net					(5,599)
Not Designated as Hedging Instrument [Member] | Foreign Currency Forward Contracts [Member]
Derivative [Line Items]
Notional amount of cash flow hedges	30,800		30,800
Not Designated as Hedging Instrument [Member] | Foreign Currency Forward Contracts [Member] | Prepaid Expenses And Other Current Assets and Non-current Other Assets [Domain]
Derivative Assets and Liabilities at Fair Value [Abstract]
Fair value, assets	28		28
Derivative Liability, Fair Value, Gross Liability	(135)		(135)
Derivative Assets (Liabilities), at Fair Value, Net	(107)		(107)
Not Designated as Hedging Instrument [Member] | Foreign Currency Forward Contracts [Member] | Other Current Liabilities [Member]
Derivative Assets and Liabilities at Fair Value [Abstract]
Fair value, assets					4
Derivative Liability, Fair Value, Gross Liability					(78)
Derivative Assets (Liabilities), at Fair Value, Net					$ (74)
Cash Flow Hedging [Member] | Foreign Currency Forward Contracts [Member]
Derivative [Line Items]
Notional amount of cash flow hedges	147,800		147,800
Cash flow hedges realized gains (losses)	$ 100	$ (500)	$ (1,500)	$ 0

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Sep. 30, 2018	Dec. 31, 2017
Inventory Disclosure [Abstract]
Raw materials	$ 43,474	$ 41,844
Work-in-process	15,837	14,666
Finished goods	94,307	84,926
Total inventory	$ 153,618	$ 141,436

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Earnings Per Share [Abstract]
Net income	$ 5,825	$ 7,197	$ 25,201	$ 8,791
Basic-weighted average shares outstanding (in shares)	28,124	27,924	28,096	27,915
Effect of dilutive potential securities (in shares)	964	259	776	209
Diluted- weighted average shares outstanding (in shares)	29,088	28,183	28,872	28,124
Basic (in dollars per share)	$ 0.21	$ 0.26	$ 0.90	$ 0.31
Diluted (in dollars per share)	$ 0.20	$ 0.26	$ 0.87	$ 0.31
Antidilutive securities excluded from computation of earnings per share (in shares)	0	1,300	600	1,200

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Goodwill) (Details) $ in Thousands	9 Months Ended
	Sep. 30, 2018USD ($)
Goodwill [Roll Forward]
Beginning balance	$ 401,954
Foreign currency translation	(977)
Ending balance	$ 400,977

Goodwill and Other Intangible_4

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Accumulated amortization	$ (184,751)		$ (184,751)		$ (167,616)
Intangible assets, Gross carrying amount	599,942		599,942		582,556
Amortization expense	6,000	$ 5,300	17,200	$ 15,600
Future amortization expense [Abstract]
Remaining, 2018	5,993		5,993
2,019	23,622		23,622
2,020	23,639		23,639
2,021	22,686		22,686
2,022	21,227		21,227
2,023	20,615		20,615
Expense
Future amortization expense [Abstract]
Remaining, 2018	4,493		4,493
2,019	17,622		17,622
2,020	17,639		17,639
2,021	16,686		16,686
2,022	15,227		15,227
2,023	14,615		14,615
Reduction of Revenue
Future amortization expense [Abstract]
Remaining, 2018	1,500		1,500
2,019	6,000		6,000
2,020	6,000		6,000
2,021	6,000		6,000
2,022	6,000		6,000
2,023	6,000		6,000
Trademarks and Tradenames
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Unamortized intangible assets, Gross carrying amount	86,544		86,544		86,544
Customer and Distributor Relationships [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	214,598		214,598		214,685
Intangible assets, Accumulated amortization	(94,371)		(94,371)		(86,137)
Sales representation, marketing and promotional rights [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	149,376		149,376		149,376
Intangible assets, Accumulated amortization	(40,500)		(40,500)		(36,000)
Patents and Other Intangible Assets [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	61,292		61,292		69,668
Intangible assets, Accumulated amortization	(43,700)		(43,700)		(42,127)
In Process Research and Development [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Impairment of Intangible Assets, Finite-lived	9,500
Technology-Based Intangible Assets [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount	88,132		88,132		62,283
Intangible assets, Accumulated amortization	$ (6,180)		(6,180)		$ (3,352)
Finite-lived intangible assets acquired			$ 25,800
Weighted average amortization period (in years)			14 years
Weighted Average
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)			24 years
Weighted Average | Customer and Distributor Relationships [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)			29 years
Weighted Average | Sales representation, marketing and promotional rights [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)			25 years
Weighted Average | Patents and Other Intangible Assets [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)			15 years
Weighted Average | Technology-Based Intangible Assets [Member]
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)			16 years

Guarantees (Details)

Guarantees (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017
Guarantor Obligations [Line Items]
Standard warranty period (in years)	1 year
Movement in Standard Product Warranty Accrual [Roll Forward]
Balance as of January 1,	$ 1,750	$ 1,954
Provision for warranties	1,036	787
Claims made	(937)	(907)
Balance as of September 30,	1,849	1,834
Extended Product Warranty Disclosure [Abstract]
Product Extended Warranty Expense	$ 4,000	$ 2,800

Pension Plan (Details)

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Retirement Benefits [Abstract]
Service cost	$ 169	$ 151	$ 506	$ 452
Interest cost on projected benefit obligation	701	693	2,104	2,080
Expected return on plan assets	(1,354)	(1,325)	(4,063)	(3,975)
Net amortization and deferral	672	794	2,017	2,381
Net periodic pension cost	$ 188	$ 313	$ 564	$ 938

Acquisition, Restructuring an_3

Acquisition, Restructuring and Other Expense (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Acquisition, Restructuring and Other Expense [Line Items]
Legal Matters		$ 300		$ 4,800
Cost of Sales [Member]
Acquisition, Restructuring and Other Expense [Line Items]
Restructuring costs	$ 0	1,306	$ 0	2,778
Selling and Administrative Expenses [Member]
Acquisition, Restructuring and Other Expense [Line Items]
Business acquisition costs	1,073	128	1,073	1,020
Legal Matters	0	327	0	17,041
Acquisition, restructuring and other expense included in selling and administrative expense	1,073	455	1,073	19,408
Selling and Administrative Expenses [Member] | Administrative Restructuring [Member]
Acquisition, Restructuring and Other Expense [Line Items]
Restructuring costs	0	0	0	1,347
Research and Development Expense [Member]
Acquisition, Restructuring and Other Expense [Line Items]
Impairment Charges	$ 4,212	$ 0	$ 4,212	0
SurgiQuestInc | Selling and Administrative Expenses [Member]
Acquisition, Restructuring and Other Expense [Line Items]
Loss Contingency, Damages Awarded, Value				12,200
Compensatory damages [Member] | SurgiQuestInc | Selling and Administrative Expenses [Member]
Acquisition, Restructuring and Other Expense [Line Items]
Loss Contingency, Damages Awarded, Value				2,200
Punitive damages [Member] | SurgiQuestInc | Selling and Administrative Expenses [Member]
Acquisition, Restructuring and Other Expense [Line Items]
Loss Contingency, Damages Awarded, Value				$ 10,000

Business Segments (Details)

Business Segments (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Segment Reporting Information [Line Items]
Net sales	$ 202,307	$ 190,117	$ 617,191	$ 573,837
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales	102,929	98,581	321,923	307,931
General Surgery
Segment Reporting Information [Line Items]
Net sales	$ 99,378	$ 91,536	$ 295,268	$ 265,906

Legal Proceedings (Details)

Legal Proceedings (Details) - USD ($) $ in Millions	Jul. 10, 2018	Jan. 18, 2017	Sep. 30, 2017	Sep. 30, 2018
Loss Contingencies [Line Items]
Product liability insurance, amount per incident				$ 30
Product liability insurance, aggregate annual amount				$ 30
Loss Contingency, Damages Paid, Value	$ 12.3
Lexion Alleged Lost Profits [Member]
Loss Contingencies [Line Items]
Damages sought			$ 22
Lexion Costs Related to Alleged Corrective Advertising [Member]
Loss Contingencies [Line Items]
Damages sought			18.7
Pending Litigation [Member] | EndoDynamix, Inc. [Member]
Loss Contingencies [Line Items]
Damages sought		$ 12.7
SurgiQuestInc | Selling and Administrative Expenses [Member]
Loss Contingencies [Line Items]
Loss Contingency, Damages Awarded, Value			12.2
Compensatory damages [Member] | SurgiQuestInc | Selling and Administrative Expenses [Member]
Loss Contingencies [Line Items]
Loss Contingency, Damages Awarded, Value			2.2
Punitive damages [Member] | SurgiQuestInc | Selling and Administrative Expenses [Member]
Loss Contingencies [Line Items]
Loss Contingency, Damages Awarded, Value			$ 10

Income Taxes (Details)

Income Taxes (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017
Income Tax Disclosure [Abstract]
Tax Cuts And Jobs Act Of 2017, Incomplete Accounting Transition, Net Benefit For Repatriation Accumulated Foreign Earnings And Other Credits Provisional, Income Tax Benefit	$ 0.2		$ 0.2
Effective Income Tax Rate Reconciliation, Percent	7.70%	16.90%	17.00%	15.80%
Effective Income Tax Rate Reconciliation,Other Reconciling Items, Percent	18.50%	9.20%
Effective Income Tax Rate Reconciliation, at Federal Statutory Income Tax Rate, Percent			21.00%