CONMED (CNMD) 10-Q 1 Aug 19 2019 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2019	Jul. 29, 2019
Cover page.
Entity Incorporation, State or Country Code	NY
Entity Registrant Name	CONMED CORPORATION
City Area Code	315
Local Phone Number	797-8375
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Central Index Key	0000816956
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity Filer Category	Large Accelerated Filer
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Small Business	false
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q2
Amendment Flag	false
Title of 12(b) Security	Common Stock, $0.01 par value
Entity Common Stock, Shares Outstanding		28,292,720
Entity File Number	0-16093
Entity Tax Identification Number	16-0977505
Entity Address, Address Line One	525 French Road
Entity Address, City or Town	Utica,
Entity Address, State or Province	NY
Entity Address, Postal Zip Code	13502
Trading Symbol	CNMD
Security Exchange Name	NASDAQ

Consolidated Condensed Statemen

Consolidated Condensed Statements of Comprehensive Income (Unaudited) - USD ($) shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Statement of Comprehensive Income [Abstract]
Net sales	$ 238,263	$ 212,820	$ 456,641	$ 414,884
Cost of sales	107,073	96,549	204,013	189,056
Gross profit	131,190	116,271	252,628	225,828
Selling and administrative expense	100,726	89,604	199,952	174,172
Research and development expense	11,806	9,985	22,381	17,696
Operating expenses	112,532	99,589	222,333	191,868
Income from operations	18,658	16,682	30,295	33,960
Other expense	321	0	4,546	0
Interest expense	11,839	5,091	21,208	9,909
Income before income taxes	6,498	11,591	4,541	24,051
Provision (benefit) for income taxes	803	2,872	(2,175)	4,675
Net income	5,695	8,719	6,716	19,376
Comprehensive income	$ 5,751	$ 7,307	$ 6,847	$ 20,709
Per share data:
Basic (in dollars per share)	$ 0.20	$ 0.31	$ 0.24	$ 0.69
Diluted (in dollars per share)	$ 0.19	$ 0.30	$ 0.23	$ 0.67
Weighted average common shares:
Basic (shares)	28,276	28,075	28,228	28,059
Diluted (shares)	29,337	28,846	29,197	28,739

Consolidated Condensed Balance

Consolidated Condensed Balance Sheets (Unaudited) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 22,549	$ 17,511
Accounts receivable, net	179,039	181,550
Inventories	172,802	154,599
Prepaid expenses and other current assets	22,887	20,691
Total current assets	397,277	374,351
Property, plant and equipment, net	117,329	113,245
Goodwill	616,427	400,440
Other intangible assets, net	538,210	413,193
Other assets	90,160	67,909
Total assets	1,759,403	1,369,138
Current liabilities:
Current portion of long-term debt	13,515	18,336
Accounts payable	51,139	53,498
Accrued compensation and benefits	36,755	42,924
Other current liabilities	54,392	46,186
Total current liabilities	155,801	160,944
Long-term debt	796,148	438,564
Deferred income taxes	74,800	81,061
Other long-term liabilities	35,645	26,299
Total liabilities	1,062,394	706,868
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 2019 and 2018, respectively	313	313
Paid-in capital	376,519	341,738
Retained earnings	460,267	464,851
Accumulated other comprehensive loss	(55,606)	(55,737)
Less: 3,010,251 and 3,167,422 shares of common stock in treasury, at cost in 2019 and 2018, respectively	(84,484)	(88,895)
Total shareholders’ equity	697,009	662,270
Total liabilities and shareholders’ equity	$ 1,759,403	$ 1,369,138

Consolidated Condensed Balanc_2

Consolidated Condensed Balance Sheets (Parenthetical) - $ / shares	Jun. 30, 2019	Dec. 31, 2018
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)	3,010,251	3,167,422

Consolidated Statements of Shar

Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($) shares in Thousands, $ in Thousands		Total	Common Stock	Paid-in Capital	Retained Earnings	Accumulated Other Comprehensive Loss	Treasury Stock
Balance at period start (shares) at Dec. 31, 2017			31,299
Balance at period start at Dec. 31, 2017		$ 631,432	$ 313	$ 333,795	$ 440,085	$ (49,078)	$ (93,683)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		657		(1,344)			2,001
Stock-based compensation		2,303		2,303
Dividends on common stock ($0.20 per share)		(5,606)			(5,606)
Comprehensive income (loss):
Foreign currency translation adjustments						649
Pension liability, net of income tax						510
Cash flow hedging gain (loss), net of income tax						1,586
Net income					10,657
Total comprehensive income		13,402
Balance at period end (shares) at Mar. 31, 2018			31,299
Balance at period end at Mar. 31, 2018		642,628	$ 313	334,754	445,576	(46,333)	(91,682)
Balance at period start (shares) at Dec. 31, 2017			31,299
Balance at period start at Dec. 31, 2017		631,432	$ 313	333,795	440,085	(49,078)	(93,683)
Comprehensive income (loss):
Foreign currency translation adjustments		(5,100)
Pension liability, net of income tax		1,020
Cash flow hedging gain (loss), net of income tax		5,413
Net income		19,376
Balance at period end (shares) at Jun. 30, 2018			31,299
Balance at period end at Jun. 30, 2018		648,192	$ 313	336,560	448,675	(47,745)	(89,611)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Cumulative effect of change in accounting principle | Accounting Standards Update 2014-09	[1]	440			440
Balance at period start (shares) at Mar. 31, 2018			31,299
Balance at period start at Mar. 31, 2018		642,628	$ 313	334,754	445,576	(46,333)	(91,682)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		1,227		(844)			2,071
Stock-based compensation		2,650		2,650
Dividends on common stock ($0.20 per share)		(5,620)			(5,620)
Comprehensive income (loss):
Foreign currency translation adjustments		(5,749)				(5,749)
Pension liability, net of income tax		510				510
Cash flow hedging gain (loss), net of income tax		3,827				3,827
Net income		8,719			8,719
Total comprehensive income		7,307
Balance at period end (shares) at Jun. 30, 2018			31,299
Balance at period end at Jun. 30, 2018		648,192	$ 313	336,560	448,675	(47,745)	(89,611)
Balance at period start (shares) at Dec. 31, 2018			31,299
Balance at period start at Dec. 31, 2018		662,270	$ 313	341,738	464,851	(55,737)	(88,895)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		1,748		(769)			2,517
Stock-based compensation		2,703		2,703
Dividends on common stock ($0.20 per share)		(5,643)			(5,643)
Convertible note discount (net of income tax expense)		39,145		39,145
Convertible note hedge, (net of income tax benefit)		(38,829)		(38,829)
Issuance of warrants		30,567		30,567
Comprehensive income (loss):
Foreign currency translation adjustments						(578)
Pension liability, net of income tax						547
Cash flow hedging gain (loss), net of income tax						106
Net income					1,021
Total comprehensive income		1,096
Balance at period end (shares) at Mar. 31, 2019			31,299
Balance at period end at Mar. 31, 2019		693,057	$ 313	374,555	460,229	(55,662)	(86,378)
Balance at period start (shares) at Dec. 31, 2018			31,299
Balance at period start at Dec. 31, 2018		662,270	$ 313	341,738	464,851	(55,737)	(88,895)
Comprehensive income (loss):
Foreign currency translation adjustments		530
Pension liability, net of income tax		1,093
Cash flow hedging gain (loss), net of income tax		(1,492)
Net income		6,716
Balance at period end (shares) at Jun. 30, 2019			31,299
Balance at period end at Jun. 30, 2019		697,009	$ 313	376,519	460,267	(55,606)	(84,484)
Balance at period start (shares) at Mar. 31, 2019			31,299
Balance at period start at Mar. 31, 2019		693,057	$ 313	374,555	460,229	(55,662)	(86,378)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Common stock issued under employee plans		750		(1,144)			1,894
Stock-based compensation		3,108		3,108
Dividends on common stock ($0.20 per share)		(5,657)			(5,657)
Comprehensive income (loss):
Foreign currency translation adjustments		1,108				1,108
Pension liability, net of income tax		546				546
Cash flow hedging gain (loss), net of income tax		(1,598)				(1,598)
Net income		5,695			5,695
Total comprehensive income		5,751
Balance at period end (shares) at Jun. 30, 2019			31,299
Balance at period end at Jun. 30, 2019		$ 697,009	$ 313	$ 376,519	$ 460,267	$ (55,606)	$ (84,484)
[1]	We recorded the cumulative impact of adopting ASU 2014-09, Revenue from Contracts with Customers, in 2018. See Note 16 for further discussion regarding the adoption of these accounting standards.

Consolidated Statements of Sh_2

Consolidated Statements of Shareholders' Equity (Unaudited) Consolidated Statements of Shareholders' Equity (Parenthetical) - USD ($) $ in Thousands	3 Months Ended
	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2018	Mar. 31, 2018
Dividends per share of common stock (in dollars per share)	$ 0.20	$ 0.20	$ 0.20	$ 0.20
Pension liability, tax	$ 174	$ 173	$ 162	$ 162
Cash flow hedging gain (loss), tax	(509)	34	1,219	505
Paid-in Capital
Convertible Note Discount Income Tax Expense (Benefit)	0	12,470	0	0
Convertible Note Hedge Income Tax Expense (Benefit)	$ 0	$ (12,369)	$ 0	$ 0

Consolidated Condensed Statem_2

Consolidated Condensed Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Cash flows from operating activities:
Net income	$ 6,716	$ 19,376
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation	8,967	9,006
Amortization of debt discount	3,774	0
Amortization	27,076	21,492
Stock-based compensation	5,811	4,953
Deferred income taxes	(6,254)	118
Loss on early extinguishment of debt	300	0
Increase (decrease) in cash flows from changes in assets and liabilities:
Accounts receivable	6,935	3,506
Inventories	(13,809)	(3,014)
Accounts payable	(5,078)	9,981
Accrued compensation and benefits	(6,979)	(2,371)
Other assets	(13,939)	(16,306)
Other liabilities	4,137	(1,094)
Total operating	10,941	26,271
Net cash provided by operating activities	17,657	45,647
Cash flows from investing activities:
Purchases of property, plant and equipment	(9,006)	(7,291)
Payments related to business acquisition, net of cash acquired	(364,928)	0
Net cash used in investing activities	(373,934)	(7,291)
Cash flows from financing activities:
Payments on term loan	(147,688)	(6,563)
Proceeds from term loan	265,000	0
Payments on revolving line of credit	(393,000)	(87,000)
Proceeds from revolving line of credit	343,000	57,000
Proceeds from convertible notes	345,000	0
Payments related to contingent consideration	(4,405)	0
Payments related to debt issuance costs	(16,210)	0
Dividends paid on common stock	(11,269)	(11,198)
Purchases of convertible hedges	(51,198)	0
Proceeds from issuance of warrants	30,567	0
Other, net	1,482	684
Net cash provided by (used in) financing activities	361,279	(47,077)
Effect of exchange rate changes on cash and cash equivalents	36	(500)
Net increase (decrease) in cash and cash equivalents	5,038	(9,221)
Cash and cash equivalents at beginning of period	17,511	32,622
Cash and cash equivalents at end of period	22,549	23,401
Non-cash investing and financing activities:
Contractual obligations from asset acquisition	0	25,849
Dividends payable	$ 5,657	$ 5,620

Operations

Operations	6 Months Ended
	Jun. 30, 2019
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	6 Months Ended
	Jun. 30, 2019
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 June 30, 2019 are not necessarily indicative of the results that may be expected for the year ending December 31, 2019 . 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, 2018 included in our Annual Report on Form 10-K.

Business Acquisition

Business Acquisition	6 Months Ended
	Jun. 30, 2019
Business Combinations [Abstract]
Business Acquisition	Business Acquisition On February 11, 2019 we acquired Buffalo Filter, LLC and all of the issued and outstanding common stock of Palmerton Holdings, Inc. from Filtration Group FGC LLC (the "Buffalo Filter Acquisition") for approximately $365 million in cash. Buffalo Filter develops, manufactures and markets smoke evacuation technologies that are complementary to our general surgery offering. The acquisition was funded through a combination of cash on hand and long-term borrowings as further described below. The following table summarizes the estimated fair values of the assets acquired and liabilities assumed as a result of the Buffalo Filter Acquisition. The assessment of fair value is based on preliminary valuations and estimates that were available to management at the time the consolidated condensed financial statements were prepared. Accordingly, the allocation of purchase price is preliminary and therefore subject to adjustment during the measurement adjustment period. Cash $ 119 Other current assets 9,315 Current assets 9,434 Property, plant & equipment 4,036 Deferred income taxes 80 Goodwill 215,793 Customer relationships 124,000 Developed technology 9,000 Trademarks & tradenames 7,000 Other non-current assets 166 Total assets acquired $ 369,509 Current liabilities assumed 4,462 Total liabilities assumed 4,462 Net assets acquired $ 365,047 The goodwill recorded as part of the acquisition primarily represents revenue synergies, as well as operating efficiencies and cost savings. Goodwill deductible for tax purposes is $215.8 million . The weighted amortization period for intangibles acquired is 16 years. Customer relationships, developed technology and trademarks and tradenames are being amortized over a weighted average life of 16 , 10 and 20 years , respectively. The unaudited pro forma information for the three and six months ended June 30, 2019 and 2018 , assuming Buffalo Filter Acquisition occurred as of January 1, 2018 are presented below. This information has been prepared for comparative purposes only and does not purport to be indicative of the results of operations which actually would have resulted had the Buffalo Filter acquisition occurred on the dates indicated, or which may result in the future. Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net sales $ 238,263 $ 222,407 $ 461,660 $ 433,680 Net income (loss) 8,625 1,890 17,370 (1,319 ) These pro forma results include certain adjustments, primarily due to increases in amortization expense due to fair value adjustments of intangible assets, increases in interest expense due to additional borrowings incurred to finance the acquisition and amortization of debt issuance costs incurred to finance the transaction, and acquisition related costs including transaction costs such as legal, accounting, valuation and other professional services as well as integration costs such as severance and retention. Acquisition related costs included in the determination of pro forma net income for the three months ended June 30, 2018 included $0.5 million in cost of goods sold and $2.5 million in selling and administrative expense and the six months ended June 30, 2018 included $1.2 million in cost of goods sold and $9.7 million in selling and administrative expense on the consolidated condensed statement of comprehensive income. Such amounts are excluded from the determination of pro forma net income for the three and six months ended June 30, 2019 . Net sales associated with Buffalo Filter of $13.5 million and $19.5 million have been recorded in the consolidated condensed statement of comprehensive income for the three and six months ended June 30, 2019 , respectively. It is impracticable to determine the earnings recorded in the consolidated condensed statement of comprehensive income for the three and six months ended June 30, 2019 as these amounts are not separately measured.

Revenues

Revenues	6 Months Ended
	Jun. 30, 2019
Revenue from Contract with Customer [Abstract]
Revenues	Revenues 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 June 30, 2019 June 30, 2018 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 43,335 $ 85,601 $ 128,936 $ 41,057 $ 68,599 $ 109,656 Americas (excluding the United States) 15,781 7,823 23,604 16,586 8,348 24,934 Europe, Middle East & Africa 31,099 15,763 46,862 29,443 13,944 43,387 Asia Pacific 25,542 13,319 38,861 23,045 11,798 34,843 Total sales from contracts with customers $ 115,757 $ 122,506 $ 238,263 $ 110,131 $ 102,689 $ 212,820 Timing of Revenue Recognition Goods transferred at a point in time $ 106,772 $ 121,927 $ 228,699 $ 101,663 $ 102,323 $ 203,986 Services transferred over time 8,985 579 9,564 8,468 366 8,834 Total sales from contracts with customers $ 115,757 $ 122,506 $ 238,263 $ 110,131 $ 102,689 $ 212,820 Six Months Ended Six Months Ended June 30, 2019 June 30, 2018 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 88,590 $ 157,371 $ 245,961 $ 84,209 $ 131,698 $ 215,907 Americas (excluding the United States) 30,823 15,286 46,109 33,357 16,027 49,384 Europe, Middle East & Africa 61,505 31,688 93,193 57,745 26,928 84,673 Asia Pacific 48,276 23,102 71,378 43,683 21,237 64,920 Total sales from contracts with customers $ 229,194 $ 227,447 $ 456,641 $ 218,994 $ 195,890 $ 414,884 Timing of Revenue Recognition Goods transferred at a point in time $ 211,511 $ 226,351 $ 437,862 $ 202,455 $ 195,204 $ 397,659 Services transferred over time 17,683 1,096 18,779 16,539 686 17,225 Total sales from contracts with customers $ 229,194 $ 227,447 $ 456,641 $ 218,994 $ 195,890 $ 414,884 Contract liability balances related to the sale of extended warranties to customers are as follows: June 30, 2019 December 31, 2018 Contract liability $ 12,574 $ 11,043 Revenue recognized during the six months ended June 30, 2019 and June 30, 2018 from amounts included in contract liabilities at the beginning of the period were $4.0 million and $3.7 million , respectively. There were no material contract assets as of June 30, 2019 and December 31, 2018

Comprehensive Income

Comprehensive Income	6 Months Ended
	Jun. 30, 2019
Equity [Abstract]
Comprehensive Income	Comprehensive Income Comprehensive income consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net income $ 5,695 $ 8,719 $ 6,716 $ 19,376 Other comprehensive income (loss): Pension liability, net of income tax (income tax expense of $174 and $162 for the three months ended June 30, 2019 and 2018, respectively, and $347 and $324 for the six months ended June 30, 2019 and 2018, respectively) 546 510 1,093 1,020 Cash flow hedging gain (loss), net of income tax (income tax expense (benefit) of ($509) and $1,219 for the three months ended June 30, 2019 and 2018, respectively, and ($475) and $1,724 for the six months ended June 30, 2019 and 2018, respectively) (1,598 ) 3,827 (1,492 ) 5,413 Foreign currency translation adjustment 1,108 (5,749 ) 530 (5,100 ) Comprehensive income $ 5,751 $ 7,307 $ 6,847 $ 20,709 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, 2018 $ 4,085 $ (31,718 ) $ (28,104 ) $ (55,737 ) Other comprehensive income (loss) before reclassifications, net of tax 1,414 — 530 1,944 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (3,832 ) 1,440 — (2,392 ) Income tax 926 (347 ) — 579 Net current-period other comprehensive income (loss) (1,492 ) 1,093 530 131 Balance, June 30, 2019 $ 2,593 $ (30,625 ) $ (27,574 ) $ (55,606 ) 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 4,165 — (5,100 ) (935 ) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,645 1,344 — 2,989 Income tax (397 ) (324 ) — (721 ) Net current-period other comprehensive income (loss) 5,413 1,020 (5,100 ) 1,333 Balance, June 30, 2018 $ 1,883 $ (24,793 ) $ (24,835 ) $ (47,745 ) (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 6 and Note 12 , respectively, for further details.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2019
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. 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 following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation June 30, 2019 December 31, 2018 Forward exchange contracts Cash flow hedge $ 153,454 $ 155,313 Forward exchange contracts Non-designated 39,762 39,631 The remaining time to maturity as of June 30, 2019 is within 2 years for hedge designated foreign exchange contracts and approximately 1 month for non-hedge designated forward exchange contracts. Statement of comprehensive income presentation Derivatives designated as cash flow hedges Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) and net earnings on our consolidated condensed statement of comprehensive income and our consolidated condensed balance sheet: Amount of Gain (Loss) Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income Amount of Gain (Loss) Reclassified from AOCI Three Months Ended June 30, Three Months Ended June 30, Three Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2019 2018 Location of amount reclassified 2019 2018 2019 2018 Foreign exchange contracts $ 126 $ 4,662 Net Sales $ 238,263 $ 212,820 $ 2,096 $ (415 ) Cost of Sales 107,073 96,549 138 32 Pre-tax gain (loss) $ 126 $ 4,662 $ 2,234 $ (383 ) Tax expense (benefit) 30 1,126 540 (92 ) Net gain (loss) $ 96 $ 3,536 $ 1,694 $ (291 ) Amount of Gain (Loss) Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income Amount of Gain (Loss) Reclassified from AOCI Six Months Ended June 30, Six Months Ended June 30, Six Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2019 2018 Location of amount reclassified 2019 2018 2019 2018 Foreign exchange contracts $ 1,864 $ 5,492 Net Sales $ 456,641 $ 414,884 $ 3,593 $ (1,828 ) Cost of Sales 204,013 189,056 239 183 Pre-tax gain (loss) $ 1,864 $ 5,492 $ 3,832 $ (1,645 ) Tax expense (benefit) 450 1,327 926 (397 ) Net gain (loss) $ 1,414 $ 4,165 $ 2,906 $ (1,248 ) At June 30, 2019 , $2.5 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. Derivatives not designated as cash flow hedges Net gains and losses from derivative instruments not accounted for as hedges offset by gains and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income were: Three Months Ended June 30, Six Months Ended June 30, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income 2019 2018 2019 2018 Net gain (loss) on currency forward contracts Selling and administrative expense $ (312 ) $ 438 $ (493 ) $ 350 Net gain (loss) on currency transaction exposures Selling and administrative expense $ 67 $ (585 ) $ (161 ) $ (712 ) Balance sheet presentation We record these forward foreign exchange contracts at fair value. The following tables summarize the fair value for forward foreign exchange contracts outstanding at June 30, 2019 and December 31, 2018 : June 30, 2019 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts Prepaids and other current assets $ 3,766 $ (441 ) $ 3,325 Foreign exchange contracts Other long-term assets 409 (315 ) 94 $ 4,175 $ (756 ) $ 3,419 Derivatives not designated as hedging instruments: Foreign exchange contracts Prepaids and other current assets 12 (120 ) (108 ) Total derivatives $ 4,187 $ (876 ) $ 3,311 December 31, 2018 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts Prepaids and other current assets $ 5,817 $ (431 ) $ 5,386 Derivatives not designated as hedging instruments: Foreign exchange contracts Prepaids and other current assets 19 (217 ) (198 ) Total derivatives $ 5,836 $ (648 ) $ 5,188 Our forward foreign exchange contracts are subject to a master netting agreement and qualify for netting in the consolidated condensed balance sheets. 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 June 30, 2019 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.

Inventories

Inventories	6 Months Ended
	Jun. 30, 2019
Inventory Disclosure [Abstract]
Inventories	Inventories Inventories consist of the following: June 30, December 31, Raw materials $ 50,559 $ 45,898 Work-in-process 16,475 15,000 Finished goods 105,768 93,701 Total $ 172,802 $ 154,599

Earnings Per Share

Earnings Per Share	6 Months Ended
	Jun. 30, 2019
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 six months ended June 30, 2019 and 2018 : Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net income $ 5,695 $ 8,719 $ 6,716 $ 19,376 Basic – weighted average shares outstanding 28,276 28,075 28,228 28,059 Effect of dilutive potential securities 1,061 771 969 680 Diluted – weighted average shares outstanding 29,337 28,846 29,197 28,739 Net income (per share) Basic $ 0.20 $ 0.31 $ 0.24 $ 0.69 Diluted 0.19 0.30 0.23 0.67 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 0.8 million and 0.6 million for the three and six months ended June 30, 2019 , respectively, and 0.8 million and 0.5 million for the three and six months ended June 30, 2018 , respectively. As more fully described in Note 17 , our 2.625% convertible notes due in 2024 (the “Notes”) are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. Potential dilution upon conversion of the Notes occurs when the market price per share of our common stock, is greater than the conversion price of the Notes of $88.80 . We intend to settle in cash the principal outstanding and use the treasury stock method when calculating their potential dilutive effect, if any. We have entered into convertible note hedge transactions to increase the effective conversion price of the Notes to $114.92 . However, our convertible note hedges are not included when calculating potential dilutive shares since their effect is always anti-dilutive. As of June 30, 2019

Leases

Leases	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Leases	Leases The Company adopted ASU No. 2016-02, Leases (Topic 842) on January 1, 2019 and applied the modified retrospective approach to adoption whereby the standard is applied only to the current period. The Company leases various manufacturing facilities, office facilities and equipment under operating and finance leases. We determine if an arrangement is a lease at inception. Right-of-use ("ROU") assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. We use the implicit rate when readily determinable. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term. Certain of our leases include variable lease payments, mainly when a lease is tied to an index rate. These variable lease payments are recorded as expense in the period incurred and are not material. The Company has lease agreements with lease and non-lease components, which we account for separately. For certain equipment leases, we apply a portfolio approach to efficiently account for the operating lease ROU assets and lease liabilities. We also elected the short-term lease exemption and do not recognize leases with terms less than one year on the balance sheet. The related short-term lease expense is not material. Our leases have remaining lease terms of one year to twelve years , some of which include options to extend the leases for up to five years , and some of which include options to terminate the leases within one year. We only account for such extensions or early terminations when it is reasonably certain we will exercise such options. Lease costs consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2019 Operating lease cost $ 1,986 $ 3,971 Finance lease cost: Depreciation 54 107 Interest on lease liabilities 6 13 Total finance lease cost 60 120 Total lease cost $ 2,046 $ 4,091 Supplemental balance sheet information related to leases is as follows: June 30, 2019 Operating leases Other assets (net of lease impairment of $1,131) $ 14,936 Other current liabilities $ 6,215 Other long-term liabilities 10,217 Total operating lease liabilities $ 16,432 Finance leases Property, plant and equipment, gross $ 1,182 Accumulated depreciation (363 ) Property, plant and equipment, net $ 819 Current portion of long-term debt $ 265 Long-term debt 243 Total finance lease liabilities $ 508 Weighted average remaining lease term (in years) Operating leases 3.75 years Finance leases 3.87 years Weighted average discount rate Operating leases 4.41 % Finance leases 4.91 % Supplemental cash flow information related to leases was as follows: Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 4,268 Financing cash flows from finance leases 162 Right-of-use assets obtained in exchange for lease obligations: Operating leases 849 Finance leases 52 Maturities of lease liabilities as of June 30, 2019 are as follows: Finance Lease Operating Lease Remaining, 2019 $ 180 $ 3,972 2020 234 5,075 2021 35 3,214 2022 88 2,499 2023 5 1,578 2024 — 723 Thereafter — 771 Total lease payments 542 17,832 Less imputed interest (34 ) (1,400 ) Total lease liabilities $ 508 $ 16,432 As of June 30, 2019 , we have no additional operating or finance leases that have not yet commenced. Maturities of lease liabilities under ASC 840 are consistent with the above disclosure. The Company places 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. Placed equipment is loaned and subject to return if minimum single-use purchases are not met. The Company accounts for these placements as operating leases but applies a practical expedient and does not separate the nonlease and lease components from the combined component. Accordingly, the Company accounts for the combined component as a single performance obligation with revenue recognized upon shipment of the related single use-products. The cost of the equipment is amortized over its estimated useful life which is generally five years.
Leases	Leases The Company adopted ASU No. 2016-02, Leases (Topic 842) on January 1, 2019 and applied the modified retrospective approach to adoption whereby the standard is applied only to the current period. The Company leases various manufacturing facilities, office facilities and equipment under operating and finance leases. We determine if an arrangement is a lease at inception. Right-of-use ("ROU") assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. We use the implicit rate when readily determinable. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term. Certain of our leases include variable lease payments, mainly when a lease is tied to an index rate. These variable lease payments are recorded as expense in the period incurred and are not material. The Company has lease agreements with lease and non-lease components, which we account for separately. For certain equipment leases, we apply a portfolio approach to efficiently account for the operating lease ROU assets and lease liabilities. We also elected the short-term lease exemption and do not recognize leases with terms less than one year on the balance sheet. The related short-term lease expense is not material. Our leases have remaining lease terms of one year to twelve years , some of which include options to extend the leases for up to five years , and some of which include options to terminate the leases within one year. We only account for such extensions or early terminations when it is reasonably certain we will exercise such options. Lease costs consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2019 Operating lease cost $ 1,986 $ 3,971 Finance lease cost: Depreciation 54 107 Interest on lease liabilities 6 13 Total finance lease cost 60 120 Total lease cost $ 2,046 $ 4,091 Supplemental balance sheet information related to leases is as follows: June 30, 2019 Operating leases Other assets (net of lease impairment of $1,131) $ 14,936 Other current liabilities $ 6,215 Other long-term liabilities 10,217 Total operating lease liabilities $ 16,432 Finance leases Property, plant and equipment, gross $ 1,182 Accumulated depreciation (363 ) Property, plant and equipment, net $ 819 Current portion of long-term debt $ 265 Long-term debt 243 Total finance lease liabilities $ 508 Weighted average remaining lease term (in years) Operating leases 3.75 years Finance leases 3.87 years Weighted average discount rate Operating leases 4.41 % Finance leases 4.91 % Supplemental cash flow information related to leases was as follows: Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 4,268 Financing cash flows from finance leases 162 Right-of-use assets obtained in exchange for lease obligations: Operating leases 849 Finance leases 52 Maturities of lease liabilities as of June 30, 2019 are as follows: Finance Lease Operating Lease Remaining, 2019 $ 180 $ 3,972 2020 234 5,075 2021 35 3,214 2022 88 2,499 2023 5 1,578 2024 — 723 Thereafter — 771 Total lease payments 542 17,832 Less imputed interest (34 ) (1,400 ) Total lease liabilities $ 508 $ 16,432 As of June 30, 2019 , we have no additional operating or finance leases that have not yet commenced. Maturities of lease liabilities under ASC 840 are consistent with the above disclosure. The Company places 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. Placed equipment is loaned and subject to return if minimum single-use purchases are not met. The Company accounts for these placements as operating leases but applies a practical expedient and does not separate the nonlease and lease components from the combined component. Accordingly, the Company accounts for the combined component as a single performance obligation with revenue recognized upon shipment of the related single use-products. The cost of the equipment is amortized over its estimated useful life which is generally five years.
Leases	Leases The Company adopted ASU No. 2016-02, Leases (Topic 842) on January 1, 2019 and applied the modified retrospective approach to adoption whereby the standard is applied only to the current period. The Company leases various manufacturing facilities, office facilities and equipment under operating and finance leases. We determine if an arrangement is a lease at inception. Right-of-use ("ROU") assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. Operating lease ROU assets and liabilities are recognized at the lease commencement date based on the present value of lease payments over the lease term. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate based on the information available at commencement date in determining the present value of lease payments. We use the implicit rate when readily determinable. Our lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for lease payments is recognized on a straight-line basis over the lease term. Certain of our leases include variable lease payments, mainly when a lease is tied to an index rate. These variable lease payments are recorded as expense in the period incurred and are not material. The Company has lease agreements with lease and non-lease components, which we account for separately. For certain equipment leases, we apply a portfolio approach to efficiently account for the operating lease ROU assets and lease liabilities. We also elected the short-term lease exemption and do not recognize leases with terms less than one year on the balance sheet. The related short-term lease expense is not material. Our leases have remaining lease terms of one year to twelve years , some of which include options to extend the leases for up to five years , and some of which include options to terminate the leases within one year. We only account for such extensions or early terminations when it is reasonably certain we will exercise such options. Lease costs consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2019 Operating lease cost $ 1,986 $ 3,971 Finance lease cost: Depreciation 54 107 Interest on lease liabilities 6 13 Total finance lease cost 60 120 Total lease cost $ 2,046 $ 4,091 Supplemental balance sheet information related to leases is as follows: June 30, 2019 Operating leases Other assets (net of lease impairment of $1,131) $ 14,936 Other current liabilities $ 6,215 Other long-term liabilities 10,217 Total operating lease liabilities $ 16,432 Finance leases Property, plant and equipment, gross $ 1,182 Accumulated depreciation (363 ) Property, plant and equipment, net $ 819 Current portion of long-term debt $ 265 Long-term debt 243 Total finance lease liabilities $ 508 Weighted average remaining lease term (in years) Operating leases 3.75 years Finance leases 3.87 years Weighted average discount rate Operating leases 4.41 % Finance leases 4.91 % Supplemental cash flow information related to leases was as follows: Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 4,268 Financing cash flows from finance leases 162 Right-of-use assets obtained in exchange for lease obligations: Operating leases 849 Finance leases 52 Maturities of lease liabilities as of June 30, 2019 are as follows: Finance Lease Operating Lease Remaining, 2019 $ 180 $ 3,972 2020 234 5,075 2021 35 3,214 2022 88 2,499 2023 5 1,578 2024 — 723 Thereafter — 771 Total lease payments 542 17,832 Less imputed interest (34 ) (1,400 ) Total lease liabilities $ 508 $ 16,432 As of June 30, 2019 , we have no additional operating or finance leases that have not yet commenced. Maturities of lease liabilities under ASC 840 are consistent with the above disclosure. The Company places 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. Placed equipment is loaned and subject to return if minimum single-use purchases are not met. The Company accounts for these placements as operating leases but applies a practical expedient and does not separate the nonlease and lease components from the combined component. Accordingly, the Company accounts for the combined component as a single performance obligation with revenue recognized upon shipment of the related single use-products. The cost of the equipment is amortized over its estimated useful life which is generally five years.

Goodwill and Other Intangible A

Goodwill and Other Intangible Assets	6 Months Ended
	Jun. 30, 2019
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 six months ended June 30, 2019 are as follows: Balance as of December 31, 2018 $ 400,440 Goodwill resulting from business acquisition 215,793 Foreign currency translation 194 Balance as of June 30, 2019 $ 616,427 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. During the six months ended June 30, 2019 , the Company acquired Buffalo Filter as further described in Note 3 . Goodwill resulting from the acquisition amounted to $215.8 million and acquired intangible assets including customer and distributor relationships, developed technology and trademarks and tradenames amounted to $140.0 million . Other intangible assets consist of the following: June 30, 2019 December 31, 2018 Weighted Average Amortization Period (Years) Gross Carrying Amount Accumulated Amortization Gross Carrying Amount Accumulated Amortization Amortized intangible assets: Customer and distributor relationships 24 $ 338,557 $ (105,878 ) $ 214,577 $ (97,131 ) Sales representation, marketing and promotional rights 25 149,376 (45,000 ) 149,376 (42,000 ) Patents and other intangible assets 15 69,174 (45,339 ) 61,473 (44,242 ) Developed technology 15 100,965 (10,189 ) 91,965 (7,369 ) Unamortized intangible assets: Trademarks and tradenames 86,544 — 86,544 — 22 $ 744,616 $ (206,406 ) $ 603,935 $ (190,742 ) 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 $8.3 million and $5.7 million in the three months ended June 30, 2019 and 2018 , respectively, and $15.7 million and $11.2 million in the six months ended June 30, 2019 and 2018 , 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 $4.0 million of earn-out consideration that is considered probable as of June 30, 2019 associated with a prior asset acquisition. This is recorded in other current liabilities at June 30, 2019 . The estimated intangible asset amortization expense remaining for the year ending December 31, 2019 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2019 $ 13,417 $ 3,000 $ 16,417 2020 27,301 6,000 33,301 2021 26,510 6,000 32,510 2022 25,361 6,000 31,361 2023 24,507 6,000 30,507 2024 23,730 6,000 29,730

Guarantees

Guarantees	6 Months Ended
	Jun. 30, 2019
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 1 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 six months ended June 30 , are as follows: 2019 2018 Balance as of January 1, $ 1,798 $ 1,750 Provision for warranties 1,020 678 Claims made (696 ) (611 ) Balance as of June 30, $ 2,122 $ 1,817 Costs associated with extended warranty repairs are recorded as incurred and amounted to $2.8 million and $2.4 million for the six months ended June 30, 2019 and 2018 , respectively.

Pension Plan

Pension Plan	6 Months Ended
	Jun. 30, 2019
Retirement Benefits [Abstract]
Pension Plan	Pension Plan Net periodic pension cost consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Service cost $ 253 $ 169 $ 506 $ 338 Interest cost on projected benefit obligation 782 701 1,564 1,403 Expected return on plan assets (1,181 ) (1,354 ) (2,362 ) (2,709 ) Net amortization and deferral 720 672 1,440 1,344 Net periodic pension cost $ 574 $ 188 $ 1,148 $ 376 We do not expect to make any pension contributions during 2019 . Non-service cost of $0.3 million and $0.6 million are included in other expense in the consolidated condensed statement of comprehensive income for the three and six months ended June 30, 2019

Acquisition, Restructuring and

Acquisition, Restructuring and Other Expense	6 Months Ended
	Jun. 30, 2019
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 June 30, Six Months Ended June 30, 2019 2018 2019 2018 Business acquisition costs included in cost of sales $ 503 $ — $ 1,163 $ — Business acquisition costs included in selling and administrative expense $ 2,461 $ — $ 9,706 $ — Debt refinancing costs included in other expense $ — $ — $ 3,904 $ — During the three and six months ended June 30, 2019 , we incurred $0.5 million and $1.2 million , respectively, in costs for inventory adjustments associated with the acquisition of Buffalo Filter as further described in Note 3. These costs were charged to cost of sales. During the three and six months ended June 30, 2019 , we incurred $2.5 million and $9.7 million in costs associated with the February 11, 2019 acquisition of Buffalo Filter as further described in Note 3 that were included in selling and administrative expense. These costs include investment banking fees in the first quarter of 2019, and, consulting fees, legal fees, severance and integration related costs in the three and six months ended June 30, 2019 . During the six months ended June 30, 2019 , we incurred a $3.6 million charge related to commitment fees paid to certain of our lenders, which provided a financing commitment for the Buffalo Filter acquisition and recorded a loss on the early extinguishment of debt of $0.3 million in conjunction with the sixth amended and restated senior credit agreement as further described in Note 17.

Business Segments

Business Segments	6 Months Ended
	Jun. 30, 2019
Segment Reporting [Abstract]
Business Segments	Business Segment 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 June 30, Six Months Ended June 30, 2019 2018 2019 2018 Orthopedic surgery $ 115,757 $ 110,131 $ 229,194 $ 218,994 General surgery 122,506 102,689 227,447 195,890 Consolidated net sales $ 238,263 $ 212,820 $ 456,641 $ 414,884

Legal Proceedings

Legal Proceedings	6 Months Ended
	Jun. 30, 2019
Commitments and Contingencies Disclosure [Abstract]
Legal Proceedings	Legal Proceedings 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, if we receive reports of alleged misconduct from employees and third parties, 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, as well as patent infringement and other claims incurred in the ordinary course of business. To date, we have not experienced any 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. 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. Likewise, the operations of our suppliers and sterilizers are subject to similar environmental laws and regulations. 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 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. In 2016, we 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. In the third quarter of 2018, the Company decided to halt the development of the EndoDynamix clip applier. While we previously recorded a charge to write off assets and released a previously accrued contingent consideration liability, 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. We record reserves sufficient to cover probable and estimable 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.

New Accounting Pronouncements

New Accounting Pronouncements	6 Months Ended
	Jun. 30, 2019
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards 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 expense 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-of-use ("ROU") asset for the right to use the underlying asset for the lease term. The Company adopted the new standard on January 1, 2019, and applied the modified retrospective approach along with the package of transition practical expedients. The Company has lease agreements with lease and non-lease components, which we account for separately. For certain equipment leases, we apply a portfolio approach to efficiently account for the operating lease ROU assets and lease liabilities. We also elected the short-term lease exemption and do not recognize leases with terms less than one year on the balance sheet. The related short-term lease expense is not material. On January 1, 2019, we recorded initial right-of-use assets and lease liabilities, that were previously unrecorded under prior GAAP, of $17.9 million . Operating lease ROU assets are included in other assets and lease liabilities are included in other current liabilities and other long-term liabilities. Our accounting for finance leases, which were capital leases under prior GAAP, remained substantially unchanged. Finance leases are included in property and equipment, current portion of long-term debt and long-term debt in our consolidated balance sheets. This update did not have a material impact on our net income, earnings per share or cash flows. Refer to Note 9 for further detail on leases. 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. We adopted this update on January 1, 2019 and it did not have a material impact on our consolidated financial statements. In August 2018, the SEC adopted a final rule under SEC Release No. 33-10532, Disclosure Update and Simplification, that amends certain disclosure requirements that were redundant, duplicative, overlapping, outdated or superseded. The amendments also expanded the disclosure requirements on the analysis of shareholders' equity for interim financial statements, in which registrants must now analyze changes in shareholders’ equity, in the form of reconciliation, for the current and comparative year-to-date periods, with subtotals for each interim period. This final rule was effective on November 5, 2018. The Company adopted all relevant disclosure requirements during the fourth quarter of 2018, with the exception of the shareholders’ equity interim disclosures, which was adopted as of January 1, 2019. Recently Issued Accounting Standards, Not Yet Adopted In June 2016, the FASB issued ASU No. 2016-13 Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, along with subsequent amendments issued in 2019. This ASU requires instruments measured at amortized cost, including accounts receivable, to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments. The update is effective for fiscal years beginning after December 31, 2019 and early adoption is permissible during any interim period after December 31, 2018. 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.

Long-Term Debt

Long-Term Debt	6 Months Ended
	Jun. 30, 2019
Debt Disclosure [Abstract]
Debt Disclosure [Text Block]	Long-Term Debt Long-term debt consists of the following: June 30, 2019 December 31, 2018 Revolving line of credit $ 262,000 $ 312,000 Term loan, net of deferred debt issuance costs of $1,727 and $311 in 2019 and 2018, respectively 259,960 144,064 2.625% convertible notes, net of deferred debt issuance costs of $9,964 and unamortized discount of $47,841 in 2019 287,195 — Financing leases 508 — Mortgage notes — 836 Total debt 809,663 456,900 Less: Current portion 13,515 18,336 Total long-term debt $ 796,148 $ 438,564 On February 7, 2019 we entered into a sixth amended and restated senior credit agreement consisting of: (a) a $265.0 million term loan facility and (b) a $585.0 million revolving credit facility. The revolving credit facility will terminate and the loans outstanding under the term loan facility will expire on the earlier of (i) February 7, 2024 or (ii) 91 days prior to the earliest scheduled maturity date of the 2.625% convertible notes due in 2024 described below, (if, as of such date, more than $150.0 million in aggregate principal amount of such convertible notes (or any refinancing thereof) remains outstanding). The term loan facility is payable in quarterly installments increasing over the term of the facility. Proceeds from the term loan facility and borrowings under the revolving credit facility were used to repay the then existing senior credit agreement and in part to finance the acquisition of Buffalo Filter. Initial interest rates are at LIBOR plus an interest rate margin of 1.875% ( 4.250% at June 30, 2019 ). For those borrowings where we elect to use the alternate base rate, the initial base rate will be the greatest of (i) the Prime Rate, (ii) the Federal Funds Rate plus 0.50% or (iii) the one-month Eurocurrency Rate plus 1.00% , plus, in each case, an interest rate margin. There were $261.7 million in borrowings outstanding on the term loan facility as of June 30, 2019 . There were $262.0 million in borrowings outstanding under the revolving credit facility as of June 30, 2019 . Our available borrowings on the revolving credit facility at June 30, 2019 were $320.5 million with approximately $2.5 million of the facility set aside for outstanding letters of credit. The sixth amended and restated senior credit agreement is collateralized by substantially all of our personal property and assets. The sixth amended and restated senior credit agreement contains covenants and restrictions which, among other things, require the maintenance of certain financial ratios and restrict dividend payments and the incurrence of certain indebtedness and other activities, including acquisitions and dispositions. We were in full compliance with these covenants and restrictions as of June 30, 2019 . We are also required, under certain circumstances, to make mandatory prepayments from net cash proceeds from any issuance of equity and asset sales. On January 29, 2019, we issued $345.0 million in 2.625% convertible notes due in 2024 (the "Notes"). Interest is payable semi-annually in arrears on February 1 and August 1 of each year, commencing August 1, 2019. The Notes will mature on February 1, 2024, unless earlier repurchased or converted. The Notes represent subordinated unsecured obligations and are convertible under certain circumstances, as defined in the indenture, into a combination of cash and CONMED common stock. The Notes may be converted at an initial conversion rate of 11.2608 shares of our common stock per $1,000 principal amount of Notes (equivalent to an initial conversion price of approximately $88.80 per share of common stock). Holders of the Notes may convert their Notes at their option at any time on or after November 1, 2023 through the second scheduled trading day preceding the maturity date. Holders of their Notes will also have the right to convert the Notes prior to November 1, 2023, but only upon the occurrence of specified events. The conversion rate is subject to anti-dilution adjustments if certain events occur. A portion of the net proceeds from the offering of the notes were used as part of the financing for the Buffalo Filter acquisition and $21.0 million were used to pay the cost of certain convertible notes hedge transactions as further described below. Our effective borrowing rate for nonconvertible debt at the time of issuance of the Notes was estimated to be 6.14% , which resulted in $51.6 million of the $345.0 million aggregate principal amount of Notes issued, or $39.1 million after taxes, being attributable to equity. For the three and six months ended June 30, 2019 , we have recorded interest expense related to the amortization of debt discount on the Notes of $2.3 million and $3.8 million , respectively, at the effective interest rate of 6.14% . The debt discount on the Notes is being amortized through February 2024. For the three and six months ended June 30, 2019 , we have recorded interest expense on the Notes of $2.3 million and $3.8 million , respectively, at the contractual coupon rate of 2.625% . In connection with the offering of the Notes, we entered into convertible note hedge transactions with a number of financial institutions (each, an “option counterparty”). The convertible note hedge transactions cover, subject to anti-dilution adjustments substantially similar to those applicable to the Notes, the number of shares of our common stock underlying the Notes. Concurrently with entering into the convertible note hedge transactions, we also entered into separate warrant transactions with each option counterparty whereby we sold to such option counterparty warrants to purchase, subject to customary anti-dilution adjustments, the same number of shares of our common stock. The convertible note hedge transactions are expected generally to reduce the potential dilution upon conversion of the Notes and/or offset any cash payments we are required to make in excess of the principal amount of converted Notes, as the case may be, in the event that the market price per share of our common stock, as measured under the terms of the convertible note hedge transactions, is greater than the strike price ( $114.92 ) of the convertible note hedge transactions, which initially corresponds to the conversion price of the Notes and is subject to anti-dilution adjustments substantially similar to those applicable to the conversion rate of the Notes. If, however, the market price per share of our common stock, as measured under the terms of the warrant transactions, exceeds the strike price of the warrants, there would nevertheless be dilution to the extent that such market price exceeds the strike price of the warrants. As of June 30, 2019 , we paid in full our mortgage note in connection with the Largo, Florida property and facilities. The scheduled maturities of long-term debt outstanding at June 30, 2019 are as follows: Remaining, 2019 $ 6,625 2020 13,250 2021 18,219 2022 24,844 2023 460,750 2024 345,000

New Accounting Pronouncements (

New Accounting Pronouncements (Policies)	6 Months Ended
	Jun. 30, 2019
New Accounting Pronouncements and Changes in Accounting Principles [Abstract]
New Accounting Pronouncements	New Accounting Pronouncements Recently Adopted Accounting Standards 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 expense 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-of-use ("ROU") asset for the right to use the underlying asset for the lease term. The Company adopted the new standard on January 1, 2019, and applied the modified retrospective approach along with the package of transition practical expedients. The Company has lease agreements with lease and non-lease components, which we account for separately. For certain equipment leases, we apply a portfolio approach to efficiently account for the operating lease ROU assets and lease liabilities. We also elected the short-term lease exemption and do not recognize leases with terms less than one year on the balance sheet. The related short-term lease expense is not material. On January 1, 2019, we recorded initial right-of-use assets and lease liabilities, that were previously unrecorded under prior GAAP, of $17.9 million . Operating lease ROU assets are included in other assets and lease liabilities are included in other current liabilities and other long-term liabilities. Our accounting for finance leases, which were capital leases under prior GAAP, remained substantially unchanged. Finance leases are included in property and equipment, current portion of long-term debt and long-term debt in our consolidated balance sheets. This update did not have a material impact on our net income, earnings per share or cash flows. Refer to Note 9 for further detail on leases. 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. We adopted this update on January 1, 2019 and it did not have a material impact on our consolidated financial statements. In August 2018, the SEC adopted a final rule under SEC Release No. 33-10532, Disclosure Update and Simplification, that amends certain disclosure requirements that were redundant, duplicative, overlapping, outdated or superseded. The amendments also expanded the disclosure requirements on the analysis of shareholders' equity for interim financial statements, in which registrants must now analyze changes in shareholders’ equity, in the form of reconciliation, for the current and comparative year-to-date periods, with subtotals for each interim period. This final rule was effective on November 5, 2018. The Company adopted all relevant disclosure requirements during the fourth quarter of 2018, with the exception of the shareholders’ equity interim disclosures, which was adopted as of January 1, 2019. Recently Issued Accounting Standards, Not Yet Adopted In June 2016, the FASB issued ASU No. 2016-13 Financial Instruments-Credit Losses (Topic 326): Measurement of Credit Losses on Financial Instruments, along with subsequent amendments issued in 2019. This ASU requires instruments measured at amortized cost, including accounts receivable, to be presented at the net amount expected to be collected. The new model requires an entity to estimate credit losses based on historical information, current information, and reasonable and supportable forecasts, including estimates of prepayments. The update is effective for fiscal years beginning after December 31, 2019 and early adoption is permissible during any interim period after December 31, 2018. 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.

Business Acquisition (Tables)

Business Acquisition (Tables)	6 Months Ended
	Jun. 30, 2019
Business Combinations [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table summarizes the estimated fair values of the assets acquired and liabilities assumed as a result of the Buffalo Filter Acquisition. The assessment of fair value is based on preliminary valuations and estimates that were available to management at the time the consolidated condensed financial statements were prepared. Accordingly, the allocation of purchase price is preliminary and therefore subject to adjustment during the measurement adjustment period. Cash $ 119 Other current assets 9,315 Current assets 9,434 Property, plant & equipment 4,036 Deferred income taxes 80 Goodwill 215,793 Customer relationships 124,000 Developed technology 9,000 Trademarks & tradenames 7,000 Other non-current assets 166 Total assets acquired $ 369,509 Current liabilities assumed 4,462 Total liabilities assumed 4,462 Net assets acquired $ 365,047
Business Acquisition, Pro Forma Information	The unaudited pro forma information for the three and six months ended June 30, 2019 and 2018 , assuming Buffalo Filter Acquisition occurred as of January 1, 2018 are presented below. This information has been prepared for comparative purposes only and does not purport to be indicative of the results of operations which actually would have resulted had the Buffalo Filter acquisition occurred on the dates indicated, or which may result in the future. Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net sales $ 238,263 $ 222,407 $ 461,660 $ 433,680 Net income (loss) 8,625 1,890 17,370 (1,319 )

Revenues (Tables)

Revenues (Tables)	6 Months Ended
	Jun. 30, 2019
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 June 30, 2019 June 30, 2018 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 43,335 $ 85,601 $ 128,936 $ 41,057 $ 68,599 $ 109,656 Americas (excluding the United States) 15,781 7,823 23,604 16,586 8,348 24,934 Europe, Middle East & Africa 31,099 15,763 46,862 29,443 13,944 43,387 Asia Pacific 25,542 13,319 38,861 23,045 11,798 34,843 Total sales from contracts with customers $ 115,757 $ 122,506 $ 238,263 $ 110,131 $ 102,689 $ 212,820 Timing of Revenue Recognition Goods transferred at a point in time $ 106,772 $ 121,927 $ 228,699 $ 101,663 $ 102,323 $ 203,986 Services transferred over time 8,985 579 9,564 8,468 366 8,834 Total sales from contracts with customers $ 115,757 $ 122,506 $ 238,263 $ 110,131 $ 102,689 $ 212,820 Six Months Ended Six Months Ended June 30, 2019 June 30, 2018 Orthopedic Surgery General Surgery Total Orthopedic Surgery General Surgery Total Primary Geographic Markets United States $ 88,590 $ 157,371 $ 245,961 $ 84,209 $ 131,698 $ 215,907 Americas (excluding the United States) 30,823 15,286 46,109 33,357 16,027 49,384 Europe, Middle East & Africa 61,505 31,688 93,193 57,745 26,928 84,673 Asia Pacific 48,276 23,102 71,378 43,683 21,237 64,920 Total sales from contracts with customers $ 229,194 $ 227,447 $ 456,641 $ 218,994 $ 195,890 $ 414,884 Timing of Revenue Recognition Goods transferred at a point in time $ 211,511 $ 226,351 $ 437,862 $ 202,455 $ 195,204 $ 397,659 Services transferred over time 17,683 1,096 18,779 16,539 686 17,225 Total sales from contracts with customers $ 229,194 $ 227,447 $ 456,641 $ 218,994 $ 195,890 $ 414,884
Contract with Customer, Asset and Liability	Contract liability balances related to the sale of extended warranties to customers are as follows: June 30, 2019 December 31, 2018 Contract liability $ 12,574 $ 11,043

Comprehensive Income (Tables)

Comprehensive Income (Tables)	6 Months Ended
	Jun. 30, 2019
Equity [Abstract]
Schedule of Comprehensive Income	Comprehensive income consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net income $ 5,695 $ 8,719 $ 6,716 $ 19,376 Other comprehensive income (loss): Pension liability, net of income tax (income tax expense of $174 and $162 for the three months ended June 30, 2019 and 2018, respectively, and $347 and $324 for the six months ended June 30, 2019 and 2018, respectively) 546 510 1,093 1,020 Cash flow hedging gain (loss), net of income tax (income tax expense (benefit) of ($509) and $1,219 for the three months ended June 30, 2019 and 2018, respectively, and ($475) and $1,724 for the six months ended June 30, 2019 and 2018, respectively) (1,598 ) 3,827 (1,492 ) 5,413 Foreign currency translation adjustment 1,108 (5,749 ) 530 (5,100 ) Comprehensive income $ 5,751 $ 7,307 $ 6,847 $ 20,709
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, 2018 $ 4,085 $ (31,718 ) $ (28,104 ) $ (55,737 ) Other comprehensive income (loss) before reclassifications, net of tax 1,414 — 530 1,944 Amounts reclassified from accumulated other comprehensive income (loss) before tax a (3,832 ) 1,440 — (2,392 ) Income tax 926 (347 ) — 579 Net current-period other comprehensive income (loss) (1,492 ) 1,093 530 131 Balance, June 30, 2019 $ 2,593 $ (30,625 ) $ (27,574 ) $ (55,606 ) 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 4,165 — (5,100 ) (935 ) Amounts reclassified from accumulated other comprehensive income (loss) before tax a 1,645 1,344 — 2,989 Income tax (397 ) (324 ) — (721 ) Net current-period other comprehensive income (loss) 5,413 1,020 (5,100 ) 1,333 Balance, June 30, 2018 $ 1,883 $ (24,793 ) $ (24,835 ) $ (47,745 ) (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 6 and Note 12 , respectively, for further details.

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2019
Fair Value Disclosures [Abstract]
Schedule of Notional Amounts of Outstanding Derivative Positions	The following table presents the notional contract amounts for forward contracts outstanding: As of FASB ASC Topic 815 Designation June 30, 2019 December 31, 2018 Forward exchange contracts Cash flow hedge $ 153,454 $ 155,313 Forward exchange contracts Non-designated 39,762 39,631
Schedule of Cash Flow Hedges Included in Accumulated Other Comprehensive Income (Loss)	Foreign exchange contracts designated as cash flow hedges had the following effects on accumulated other comprehensive income (loss) and net earnings on our consolidated condensed statement of comprehensive income and our consolidated condensed balance sheet: Amount of Gain (Loss) Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income Amount of Gain (Loss) Reclassified from AOCI Three Months Ended June 30, Three Months Ended June 30, Three Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2019 2018 Location of amount reclassified 2019 2018 2019 2018 Foreign exchange contracts $ 126 $ 4,662 Net Sales $ 238,263 $ 212,820 $ 2,096 $ (415 ) Cost of Sales 107,073 96,549 138 32 Pre-tax gain (loss) $ 126 $ 4,662 $ 2,234 $ (383 ) Tax expense (benefit) 30 1,126 540 (92 ) Net gain (loss) $ 96 $ 3,536 $ 1,694 $ (291 ) Amount of Gain (Loss) Recognized in AOCI Consolidated Condensed Statements of Comprehensive Income Amount of Gain (Loss) Reclassified from AOCI Six Months Ended June 30, Six Months Ended June 30, Six Months Ended June 30, Total Amount of Line Item Presented Derivative Instrument 2019 2018 Location of amount reclassified 2019 2018 2019 2018 Foreign exchange contracts $ 1,864 $ 5,492 Net Sales $ 456,641 $ 414,884 $ 3,593 $ (1,828 ) Cost of Sales 204,013 189,056 239 183 Pre-tax gain (loss) $ 1,864 $ 5,492 $ 3,832 $ (1,645 ) Tax expense (benefit) 450 1,327 926 (397 ) Net gain (loss) $ 1,414 $ 4,165 $ 2,906 $ (1,248 )
Derivatives Not Designated as Hedging Instruments	Net gains and losses from derivative instruments not accounted for as hedges offset by gains and losses on our intercompany receivables on our consolidated condensed statements of comprehensive income were: Three Months Ended June 30, Six Months Ended June 30, Derivative Instrument Location on Consolidated Condensed Statements of Comprehensive Income 2019 2018 2019 2018 Net gain (loss) on currency forward contracts Selling and administrative expense $ (312 ) $ 438 $ (493 ) $ 350 Net gain (loss) on currency transaction exposures Selling and administrative expense $ 67 $ (585 ) $ (161 ) $ (712 )
Schedule of Fair Value for Forward Foreign Exchange Contracts	The following tables summarize the fair value for forward foreign exchange contracts outstanding at June 30, 2019 and December 31, 2018 : June 30, 2019 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts Prepaids and other current assets $ 3,766 $ (441 ) $ 3,325 Foreign exchange contracts Other long-term assets 409 (315 ) 94 $ 4,175 $ (756 ) $ 3,419 Derivatives not designated as hedging instruments: Foreign exchange contracts Prepaids and other current assets 12 (120 ) (108 ) Total derivatives $ 4,187 $ (876 ) $ 3,311 December 31, 2018 Location on Consolidated Condensed Balance Sheet Asset Fair Value Liabilities Fair Value Net Fair Value Derivatives designated as hedged instruments: Foreign exchange contracts Prepaids and other current assets $ 5,817 $ (431 ) $ 5,386 Derivatives not designated as hedging instruments: Foreign exchange contracts Prepaids and other current assets 19 (217 ) (198 ) Total derivatives $ 5,836 $ (648 ) $ 5,188

Inventories (Tables)

Inventories (Tables)	6 Months Ended
	Jun. 30, 2019
Inventory Disclosure [Abstract]
Schedule of inventory	Inventories consist of the following: June 30, December 31, Raw materials $ 50,559 $ 45,898 Work-in-process 16,475 15,000 Finished goods 105,768 93,701 Total $ 172,802 $ 154,599

Earnings Per Share (Tables)

Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2019
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 six months ended June 30, 2019 and 2018 : Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Net income $ 5,695 $ 8,719 $ 6,716 $ 19,376 Basic – weighted average shares outstanding 28,276 28,075 28,228 28,059 Effect of dilutive potential securities 1,061 771 969 680 Diluted – weighted average shares outstanding 29,337 28,846 29,197 28,739 Net income (per share) Basic $ 0.20 $ 0.31 $ 0.24 $ 0.69 Diluted 0.19 0.30 0.23 0.67

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2019
Leases [Abstract]
Lease Cost	Lease costs consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2019 Operating lease cost $ 1,986 $ 3,971 Finance lease cost: Depreciation 54 107 Interest on lease liabilities 6 13 Total finance lease cost 60 120 Total lease cost $ 2,046 $ 4,091
Supplemental Balance Sheet Information Related to Leases	Supplemental balance sheet information related to leases is as follows: June 30, 2019 Operating leases Other assets (net of lease impairment of $1,131) $ 14,936 Other current liabilities $ 6,215 Other long-term liabilities 10,217 Total operating lease liabilities $ 16,432 Finance leases Property, plant and equipment, gross $ 1,182 Accumulated depreciation (363 ) Property, plant and equipment, net $ 819 Current portion of long-term debt $ 265 Long-term debt 243 Total finance lease liabilities $ 508 Weighted average remaining lease term (in years) Operating leases 3.75 years Finance leases 3.87 years Weighted average discount rate Operating leases 4.41 % Finance leases 4.91 %
Supplemental Cash Flow Information Related to Leases	Supplemental cash flow information related to leases was as follows: Six Months Ended June 30, 2019 Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 4,268 Financing cash flows from finance leases 162 Right-of-use assets obtained in exchange for lease obligations: Operating leases 849 Finance leases 52
Operating Lease, Liability, Maturity	Maturities of lease liabilities as of June 30, 2019 are as follows: Finance Lease Operating Lease Remaining, 2019 $ 180 $ 3,972 2020 234 5,075 2021 35 3,214 2022 88 2,499 2023 5 1,578 2024 — 723 Thereafter — 771 Total lease payments 542 17,832 Less imputed interest (34 ) (1,400 ) Total lease liabilities $ 508 $ 16,432
Finance Lease, Liability, Maturity	Maturities of lease liabilities as of June 30, 2019 are as follows: Finance Lease Operating Lease Remaining, 2019 $ 180 $ 3,972 2020 234 5,075 2021 35 3,214 2022 88 2,499 2023 5 1,578 2024 — 723 Thereafter — 771 Total lease payments 542 17,832 Less imputed interest (34 ) (1,400 ) Total lease liabilities $ 508 $ 16,432

Goodwill and Other Intangible_2

Goodwill and Other Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The changes in the net carrying amount of goodwill for the six months ended June 30, 2019 are as follows: Balance as of December 31, 2018 $ 400,440 Goodwill resulting from business acquisition 215,793 Foreign currency translation 194 Balance as of June 30, 2019 $ 616,427
Schedule of Finite-Lived and Indefinite-Lived Intangible Assets	Other intangible assets consist of the following: June 30, 2019 December 31, 2018 Weighted Average Amortization Period (Years) Gross Carrying Amount Accumulated Amortization Gross Carrying Amount Accumulated Amortization Amortized intangible assets: Customer and distributor relationships 24 $ 338,557 $ (105,878 ) $ 214,577 $ (97,131 ) Sales representation, marketing and promotional rights 25 149,376 (45,000 ) 149,376 (42,000 ) Patents and other intangible assets 15 69,174 (45,339 ) 61,473 (44,242 ) Developed technology 15 100,965 (10,189 ) 91,965 (7,369 ) Unamortized intangible assets: Trademarks and tradenames 86,544 — 86,544 — 22 $ 744,616 $ (206,406 ) $ 603,935 $ (190,742 )
Schedule of Estimated Amortization Expense	The estimated intangible asset amortization expense remaining for the year ending December 31, 2019 and for each of the five succeeding years is as follows: Amortization included in expense Amortization recorded as a reduction of revenue Total Remaining, 2019 $ 13,417 $ 3,000 $ 16,417 2020 27,301 6,000 33,301 2021 26,510 6,000 32,510 2022 25,361 6,000 31,361 2023 24,507 6,000 30,507 2024 23,730 6,000 29,730

Guarantees (Tables)

Guarantees (Tables)	6 Months Ended
	Jun. 30, 2019
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 six months ended June 30 , are as follows: 2019 2018 Balance as of January 1, $ 1,798 $ 1,750 Provision for warranties 1,020 678 Claims made (696 ) (611 ) Balance as of June 30, $ 2,122 $ 1,817

Pension Plan (Tables)

Pension Plan (Tables)	6 Months Ended
	Jun. 30, 2019
Retirement Benefits [Abstract]
Schedule of net benefit cost	Net periodic pension cost consists of the following: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Service cost $ 253 $ 169 $ 506 $ 338 Interest cost on projected benefit obligation 782 701 1,564 1,403 Expected return on plan assets (1,181 ) (1,354 ) (2,362 ) (2,709 ) Net amortization and deferral 720 672 1,440 1,344 Net periodic pension cost $ 574 $ 188 $ 1,148 $ 376

Acquisition, Restructuring an_2

Acquisition, Restructuring and Other Expense (Tables)	6 Months Ended
	Jun. 30, 2019
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 June 30, Six Months Ended June 30, 2019 2018 2019 2018 Business acquisition costs included in cost of sales $ 503 $ — $ 1,163 $ — Business acquisition costs included in selling and administrative expense $ 2,461 $ — $ 9,706 $ — Debt refinancing costs included in other expense $ — $ — $ 3,904 $ —

Business Segments (Tables)

Business Segments (Tables)	6 Months Ended
	Jun. 30, 2019
Segment Reporting [Abstract]
Schedule of net sales information by product line	These product lines' net sales are as follows: Three Months Ended June 30, Six Months Ended June 30, 2019 2018 2019 2018 Orthopedic surgery $ 115,757 $ 110,131 $ 229,194 $ 218,994 General surgery 122,506 102,689 227,447 195,890 Consolidated net sales $ 238,263 $ 212,820 $ 456,641 $ 414,884

Long-Term Debt (Tables)

Long-Term Debt (Tables)	6 Months Ended
	Jun. 30, 2019
Debt Disclosure [Abstract]
Schedule of Long-term Debt Instruments [Table Text Block]	Long-term debt consists of the following: June 30, 2019 December 31, 2018 Revolving line of credit $ 262,000 $ 312,000 Term loan, net of deferred debt issuance costs of $1,727 and $311 in 2019 and 2018, respectively 259,960 144,064 2.625% convertible notes, net of deferred debt issuance costs of $9,964 and unamortized discount of $47,841 in 2019 287,195 — Financing leases 508 — Mortgage notes — 836 Total debt 809,663 456,900 Less: Current portion 13,515 18,336 Total long-term debt $ 796,148 $ 438,564
Schedule of Maturities of Long-term Debt [Table Text Block]	The scheduled maturities of long-term debt outstanding at June 30, 2019 are as follows: Remaining, 2019 $ 6,625 2020 13,250 2021 18,219 2022 24,844 2023 460,750 2024 345,000

Business Acquisition (Details)

Business Acquisition (Details) - USD ($) $ in Thousands	Feb. 11, 2019	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Business Acquisition [Line Items]
Payments to acquire businesses, gross	$ 365,000
Cash	119
Other current assets	9,315
Current assets	9,434
Property, plant & equipment	4,036
Deferred income taxes	80
Goodwill		$ 616,427		$ 616,427		$ 400,440
Other non-current assets	166
Total assets acquired	369,509
Current liabilities assumed	4,462
Total liabilities assumed	4,462
Net assets acquired	365,047
Goodwill, expected tax deductible amount	215,800
Net sales		238,263	$ 222,407	461,660	$ 433,680
Net income (loss)		8,625	1,890	17,370	(1,319)
Net sales		238,263	212,820	456,641	414,884
Cost of Sales
Business Acquisition [Line Items]
Business acquisition costs		503	0	1,163	0
Selling and Administrative Expenses
Business Acquisition [Line Items]
Business acquisition costs		2,461	0	9,706	0
Buffalo Filter LLC
Business Acquisition [Line Items]
Goodwill	$ 215,793
Weighted average amortization period (in years)	16 years
Net sales		$ 13,500		$ 19,500
Customer relationships
Business Acquisition [Line Items]
Intangible assets	$ 124,000
Customer relationships | Buffalo Filter LLC
Business Acquisition [Line Items]
Weighted average amortization period (in years)	16 years
Developed technology
Business Acquisition [Line Items]
Intangible assets	$ 9,000
Developed technology | Buffalo Filter LLC
Business Acquisition [Line Items]
Weighted average amortization period (in years)	10 years
Trademarks & tradenames
Business Acquisition [Line Items]
Intangible assets	$ 7,000
Trademarks & tradenames | Buffalo Filter LLC
Business Acquisition [Line Items]
Weighted average amortization period (in years)	20 years
Pro Forma | Cost of Sales
Business Acquisition [Line Items]
Business acquisition costs			500		1,200
Pro Forma | Acquisition-related Costs | Selling and Administrative Expenses
Business Acquisition [Line Items]
Business acquisition costs			$ 2,500		$ 9,700

Revenues (Disaggregated Revenue

Revenues (Disaggregated Revenues) (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Disaggregation of Revenue [Line Items]
Net Sales	$ 238,263	$ 212,820	$ 456,641	$ 414,884
Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	228,699	203,986	437,862	397,659
Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	9,564	8,834	18,779	17,225
Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	115,757	110,131	229,194	218,994
Orthopedic Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	106,772	101,663	211,511	202,455
Orthopedic Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	8,985	8,468	17,683	16,539
General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	122,506	102,689	227,447	195,890
General Surgery | Goods transferred at a point in time
Disaggregation of Revenue [Line Items]
Net Sales	121,927	102,323	226,351	195,204
General Surgery | Services transferred over time
Disaggregation of Revenue [Line Items]
Net Sales	579	366	1,096	686
United States
Disaggregation of Revenue [Line Items]
Net Sales	128,936	109,656	245,961	215,907
United States | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	43,335	41,057	88,590	84,209
United States | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	85,601	68,599	157,371	131,698
Americas (excluding the United States)
Disaggregation of Revenue [Line Items]
Net Sales	23,604	24,934	46,109	49,384
Americas (excluding the United States) | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	15,781	16,586	30,823	33,357
Americas (excluding the United States) | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	7,823	8,348	15,286	16,027
Europe, Middle East & Africa
Disaggregation of Revenue [Line Items]
Net Sales	46,862	43,387	93,193	84,673
Europe, Middle East & Africa | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	31,099	29,443	61,505	57,745
Europe, Middle East & Africa | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	15,763	13,944	31,688	26,928
Asia Pacific
Disaggregation of Revenue [Line Items]
Net Sales	38,861	34,843	71,378	64,920
Asia Pacific | Orthopedic Surgery
Disaggregation of Revenue [Line Items]
Net Sales	25,542	23,045	48,276	43,683
Asia Pacific | General Surgery
Disaggregation of Revenue [Line Items]
Net Sales	$ 13,319	$ 11,798	$ 23,102	$ 21,237

Revenues (Customer Liability) (

Revenues (Customer Liability) (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Revenue from Contract with Customer [Abstract]
Contract liability	$ 12,574		$ 11,043
Revenue recognized	$ 4,000	$ 3,700

Comprehensive Income (Details)

Comprehensive Income (Details) - USD ($) $ in Thousands	3 Months Ended				6 Months Ended
	Jun. 30, 2019	Mar. 31, 2019	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2019	Jun. 30, 2018
Equity [Abstract]
Net income	$ 5,695		$ 8,719		$ 6,716	$ 19,376
Pension liability, net of income tax	546		510		1,093	1,020
Cash flow hedging gain (loss), net of income tax	(1,598)		3,827		(1,492)	5,413
Foreign currency translation adjustments	1,108		(5,749)		530	(5,100)
Comprehensive income	5,751		7,307		6,847	20,709
Pension liability, tax	174	$ 173	162	$ 162	347	324
Cash flow hedging gain (loss), tax	$ (509)	$ 34	$ 1,219	$ 505	$ (475)	$ 1,724

Comprehensive Income (Accumulat

Comprehensive Income (Accumulated Other Comprehensive income (loss)) (Details) - USD ($) $ in Thousands		6 Months Ended
		Jun. 30, 2019	Jun. 30, 2018
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		$ (55,737)
Accumulated other comprehensive income (loss)		(55,606)
Accumulated Other Comprehensive Loss
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		(55,737)	$ (49,078)
Other comprehensive income (loss) before reclassifications		1,944	(935)
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(2,392)	2,989
Reclassification from AOCI, Current Period, Tax		579	(721)
Net current-period other comprehensive income (loss)		131	1,333
Accumulated other comprehensive income (loss)		(55,606)	(47,745)
Cash Flow Hedging Gain (Loss)
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		4,085	(3,530)
Other comprehensive income (loss) before reclassifications		1,414	4,165
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	(3,832)	1,645
Reclassification from AOCI, Current Period, Tax		926	(397)
Net current-period other comprehensive income (loss)		(1,492)	5,413
Accumulated other comprehensive income (loss)		2,593	1,883
Pension Liability
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		(31,718)	(25,813)
Other comprehensive income (loss) before reclassifications		0	0
Amounts reclassified from other accumulated comprehensive income (loss) before tax	[1]	1,440	1,344
Reclassification from AOCI, Current Period, Tax		(347)	(324)
Net current-period other comprehensive income (loss)		1,093	1,020
Accumulated other comprehensive income (loss)		(30,625)	(24,793)
Cumulative Translation Adjustments
Accumulated other comprehensive income (loss) [Roll Forward]
Accumulated other comprehensive income (loss)		(28,104)	(19,735)
Other comprehensive income (loss) before reclassifications		530	(5,100)
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)		530	(5,100)
Accumulated other comprehensive income (loss)		$ (27,574)	$ (24,835)
[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 6 and Note 12 , 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		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Derivative [Line Items]
Net sales	$ 238,263	$ 212,820	$ 456,641	$ 414,884
Cost of sales	107,073	96,549	204,013	189,056
Other Comprehensive Income (Loss), before Reclassifications, before Tax	126	4,662	1,864	5,492
Other Comprehensive Income (Loss), Tax	30	1,126	450	1,327
Other comprehensive income (loss) before reclassifications	96	3,536	1,414	4,165
Foreign Currency Transaction Gain (Loss), before Tax	67	(585)	(161)	(712)
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	4,187		4,187		$ 5,836
Liabilities Fair Value	(876)		(876)		(648)
Net Fair Value	3,311		3,311		5,188
Foreign Currency Forward Contracts
Derivative [Line Items]
Gain (Loss) on Foreign Currency Derivative Instruments Not Designated as Hedging Instruments	(312)	438	(493)	350
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	4,175		4,175
Liabilities Fair Value	(756)		(756)
Net Fair Value	3,419		3,419
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Prepaids and other current assets
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	3,766		3,766		5,817
Liabilities Fair Value	(441)		(441)		(431)
Net Fair Value	3,325		3,325		5,386
Derivatives designated as hedged instruments: | Foreign Currency Forward Contracts | Other long-term assets
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	409		409
Liabilities Fair Value	(315)		(315)
Net Fair Value	94		94
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts
Derivative [Line Items]
Notional amount of cash flow hedges	39,762		39,762		39,631
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts | Prepaids and other current assets
Derivative Assets and Liabilities at Fair Value [Abstract]
Asset Fair Value	12		12		19
Liabilities Fair Value	(120)		(120)		(217)
Net Fair Value	(108)		$ (108)		(198)
Cash flow hedge | Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge			2 years
Notional amount of cash flow hedges	153,454		$ 153,454		$ 155,313
Cash flow hedges realized gains (losses)	2,234	(383)	3,832	(1,645)
Foreign Currency Cash Flow Hedge Gain (Loss) Reclassified to Earnings, Net	1,694	(291)	2,906	(1,248)
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	2,500		$ 2,500
Derivatives not designated as hedging instruments: | Foreign Currency Forward Contracts
Derivative [Line Items]
Maximum Length of Time Hedged in Cash Flow Hedge			1 month
Cash Flow Hedging Gain (Loss)
Derivative [Line Items]
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, Tax	540	(92)	$ 926	(397)
Revenues | Cash flow hedge | Foreign Currency Forward Contracts
Derivative [Line Items]
Cash flow hedges realized gains (losses)	2,096	(415)	3,593	(1,828)
Cost of Sales | Cash flow hedge | Foreign Currency Forward Contracts
Derivative [Line Items]
Cash flow hedges realized gains (losses)	$ 138	$ 32	$ 239	$ 183

Inventories (Details)

Inventories (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Inventory Disclosure [Abstract]
Raw materials	$ 50,559	$ 45,898
Work-in-process	16,475	15,000
Finished goods	105,768	93,701
Total inventory	$ 172,802	$ 154,599

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Earnings Per Share [Abstract]
Net income	$ 5,695	$ 8,719	$ 6,716	$ 19,376
Basic-weighted average shares outstanding (in shares)	28,276	28,075	28,228	28,059
Effect of dilutive potential securities (in shares)	1,061	771	969	680
Diluted- weighted average shares outstanding (in shares)	29,337	28,846	29,197	28,739
Basic (in dollars per share)	$ 0.20	$ 0.31	$ 0.24	$ 0.69
Diluted (in dollars per share)	$ 0.19	$ 0.30	$ 0.23	$ 0.67
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Antidilutive securities excluded from computation of earnings per share (in shares)	800	800	600	500
Convertible Notes Payable | 2.625% Convertible Notes Due 2024
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Option indexed to issuer's equity, strike price (in dollars per share)			$ 114.92
Interest rate, stated percentage	2.625%		2.625%
Conversion price (in dollars per share)	$ 88.80		$ 88.80

Leases - Lease Cost (Details)

Leases - Lease Cost (Details) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2019USD ($)	Jun. 30, 2019USD ($)
Lessee, Lease, Description [Line Items]
Operating lease cost	$ 1,986	$ 3,971
Depreciation	54	107
Interest on lease liabilities	6	13
Total finance lease cost	60	120
Total lease cost	$ 2,046	$ 4,091
Minimum [Member]
Lessee, Lease, Description [Line Items]
Remaining Lease Term		1 year
Maximum [Member]
Lessee, Lease, Description [Line Items]
Remaining Lease Term		12 years
Lessee, Operating Lease, Renewal Term	5 years	5 years

Leases - Supplemental Balance S

Leases - Supplemental Balance Sheet Information (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Leases [Abstract]
Other assets (net of lease impairment of $1,131)	$ 14,936
Operating Lease, Right-Of-Use Asset, Impairment	1,131
Other current liabilities	6,215
Other long-term liabilities	10,217
Total operating lease liabilities	16,432
Property, plant and equipment, gross	1,182
Accumulated depreciation	(363)
Property, plant and equipment, net	819
Current portion of long-term debt	265
Long-term debt	243
Total finance lease liabilities	$ 508	$ 0
Weighted average remaining lease term (in years)
Operating leases	3 years 9 months
Finance leases	3 years 10 months 13 days
Weighted average discount rate
Operating leases	4.41%
Finance leases	4.91%

Leases - Supplemental Cash Flow

Leases - Supplemental Cash Flows Information (Details) $ in Thousands	6 Months Ended
	Jun. 30, 2019USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 4,268
Financing cash flows from finance leases	162
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	849
Finance leases	$ 52

Leases - Maturities of Operatin

Leases - Maturities of Operating and Financing Lease Liabilities (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Finance Lease
Remaining, 2019	$ 180
2020	234
2021	35
2022	88
2023	5
2024	0
Thereafter	0
Total lease payments	542
Less imputed interest	(34)
Total lease liabilities	508	$ 0
Operating Lease
Remaining, 2019	3,972
2020	5,075
2021	3,214
2022	2,499
2023	1,578
2024	723
Thereafter	771
Total lease payments	17,832
Less imputed interest	(1,400)
Total lease liabilities	$ 16,432

Goodwill and Other Intangible_3

Goodwill and Other Intangible Assets (Goodwill) (Details) - USD ($) $ in Thousands	Feb. 11, 2019	Jun. 30, 2019
Goodwill [Roll Forward]
Beginning balance		$ 400,440
Goodwill resulting from business acquisition	$ 215,800	215,793
Foreign currency translation		194
Ending balance		$ 616,427

Goodwill and Other Intangible_4

Goodwill and Other Intangible Assets (Intangible Assets) (Details) - USD ($) $ in Thousands	Feb. 11, 2019	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Intangible assets, Accumulated amortization		$ (206,406)		$ (206,406)		$ (190,742)
Intangible assets, Gross carrying amount		744,616		744,616		603,935
Amortization expense		8,300	$ 5,700	15,700	$ 11,200
Future amortization expense [Abstract]
Remaining, 2019		16,417		16,417
2020		33,301		33,301
2021		32,510		32,510
2022		31,361		31,361
2023		30,507		30,507
2024		29,730		29,730
Amortization included in expense
Future amortization expense [Abstract]
Remaining, 2019		13,417		13,417
2020		27,301		27,301
2021		26,510		26,510
2022		25,361		25,361
2023		24,507		24,507
2024		23,730		23,730
Amortization recorded as a reduction of revenue
Future amortization expense [Abstract]
Remaining, 2019		3,000		3,000
2020		6,000		6,000
2021		6,000		6,000
2022		6,000		6,000
2023		6,000		6,000
2024		6,000		6,000
Trademarks & 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
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount		338,557		338,557		214,577
Intangible assets, Accumulated amortization		(105,878)		(105,878)		(97,131)
Sales representation, marketing and promotional rights
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		(45,000)		(45,000)		(42,000)
Patents and other intangible assets
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount		69,174		69,174		61,473
Intangible assets, Accumulated amortization		(45,339)		(45,339)		(44,242)
Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Amortized intangible assets, Gross carrying amount		100,965		100,965		91,965
Intangible assets, Accumulated amortization		(10,189)		(10,189)		$ (7,369)
Asset Acquisition, Contingent Consideration Liability		$ 4,000		$ 4,000
Weighted Average
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)				22 years
Weighted Average | Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)				24 years
Weighted Average | Sales representation, marketing and promotional rights
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
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)				15 years
Weighted Average | Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible asset useful life (in years)				15 years
Buffalo Filter LLC
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Weighted average amortization period (in years)	16 years
Buffalo Filter LLC | Customer and distributor relationships
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Weighted average amortization period (in years)	16 years
Buffalo Filter LLC | Developed technology
Schedule of Finite-Lived and Indefinite-Lived Assets [Line Items]
Finite-lived intangible assets acquired	$ 140,000
Weighted average amortization period (in years)	10 years

Guarantees (Details)

Guarantees (Details) - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018
Guarantees [Abstract]
Standard warranty period (in years)	1 year
Movement in Standard Product Warranty Accrual [Roll Forward]
Balance as of January 1,	$ 1,798	$ 1,750
Provision for warranties	1,020	678
Claims made	(696)	(611)
Balance as of June 30,	2,122	1,817
Extended Product Warranty Disclosure [Abstract]
Product extended warranty expense	$ 2,800	$ 2,400

Pension Plan (Details)

Pension Plan (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Retirement Benefits [Abstract]
Service cost	$ 253	$ 169	$ 506	$ 338
Interest cost on projected benefit obligation	782	701	1,564	1,403
Expected return on plan assets	(1,181)	(1,354)	(2,362)	(2,709)
Net amortization and deferral	720	672	1,440	1,344
Net periodic pension cost	574	$ 188	1,148	$ 376
Defined Benefit Plan, Non-service cost	$ 300		$ 600

Acquisition, Restructuring an_3

Acquisition, Restructuring and Other Expense (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Acquisition, Restructuring and Other Expense [Line Items]
Debt related commitment fees and debt issuance costs			$ 3,600
Other expense	$ 321	$ 0	4,546	$ 0
Loss on early extinguishment of debt			300	0
Cost of Sales
Acquisition, Restructuring and Other Expense [Line Items]
Business acquisition costs	503	0	1,163	0
Selling and Administrative Expenses
Acquisition, Restructuring and Other Expense [Line Items]
Business acquisition costs	2,461	0	9,706	0
Debt
Acquisition, Restructuring and Other Expense [Line Items]
Other expense	0	$ 0	3,904	$ 0
Fair Value Adjustment to Inventory | Cost of Sales
Acquisition, Restructuring and Other Expense [Line Items]
Business acquisition costs	$ 500		$ 1,200

Business Segments (Details)

Business Segments (Details) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2019	Jun. 30, 2018	Jun. 30, 2019	Jun. 30, 2018
Segment Reporting Information [Line Items]
Net sales	$ 238,263	$ 212,820	$ 456,641	$ 414,884
Orthopedic Surgery
Segment Reporting Information [Line Items]
Net sales	115,757	110,131	229,194	218,994
General Surgery
Segment Reporting Information [Line Items]
Net sales	$ 122,506	$ 102,689	$ 227,447	$ 195,890

Legal Proceedings (Details)

Legal Proceedings (Details) - USD ($) $ in Millions	Jan. 18, 2017	Jun. 30, 2019
Loss Contingencies [Line Items]
Product liability insurance, amount per incident		$ 30
Product liability insurance, aggregate annual amount		$ 30
Pending Litigation | EndoDynamix, Inc.
Loss Contingencies [Line Items]
Damages sought	$ 12.7

New Accounting Pronouncements N

New Accounting Pronouncements New Accounting Pronouncements (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Jan. 01, 2019
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating Lease, Right-of-Use Asset	$ 14,936
Operating Lease, Liability	$ 16,432
Accounting Standards Update 2016-02 [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Operating Lease, Right-of-Use Asset		$ 17,900
Operating Lease, Liability		$ 17,900

Long-Term Debt - Schedule of De

Long-Term Debt - Schedule of Debt (Details) - USD ($) $ in Thousands	Jun. 30, 2019	Dec. 31, 2018
Debt Instrument [Line Items]
Total debt	$ 809,663	$ 456,900
Financing leases	508	0
Less: Current portion	13,515	18,336
Total long-term debt	796,148	438,564
Revolving line of credit
Debt Instrument [Line Items]
Total debt	262,000	312,000
Term loan, net of deferred debt issuance costs of $1,727 and $311 in 2019 and 2018, respectively
Debt Instrument [Line Items]
Total debt	259,960	144,064
Unamortized debt issuance cost	1,727	311
2.625% convertible notes, net of deferred debt issuance costs of $9,964 and unamortized discount of $47,841 in 2019
Debt Instrument [Line Items]
Convertible Debt	287,195	0
Unamortized debt issuance cost	9,964	0
Unamortized discount	47,841	0
Mortgage notes
Debt Instrument [Line Items]
Total debt	$ 0	$ 836

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Details) - USD ($)	3 Months Ended	6 Months Ended
	Jun. 30, 2019	Jun. 30, 2019	Jun. 30, 2018	Dec. 31, 2018
Debt Instrument [Line Items]
Long-term debt	$ 809,663,000	$ 809,663,000		$ 456,900,000
Amortization of debt discount		3,774,000	$ 0
Loans Payable
Debt Instrument [Line Items]
Long-term debt, gross	261,700,000	261,700,000
Long-term debt	259,960,000	259,960,000		144,064,000
Loans Payable | Amended and Restated Senior Credit Agreement
Debt Instrument [Line Items]
Face amount	265,000,000	265,000,000
Revolving line of credit
Debt Instrument [Line Items]
Long-term debt	262,000,000	262,000,000		312,000,000
Remaining borrowing capacity	320,500,000	320,500,000
Revolving line of credit | Amended and Restated Senior Credit Agreement
Debt Instrument [Line Items]
Maximum borrowing capacity	585,000,000	585,000,000
Letter of Credit
Debt Instrument [Line Items]
Letters of credit outstanding, amount	2,500,000	2,500,000
Convertible Notes Payable | 2.625% Convertible Notes Due 2024
Debt Instrument [Line Items]
Face amount	$ 345,000,000	$ 345,000,000
Interest rate, stated percentage	2.625%	2.625%
Interest rate, effective percentage	6.14%	6.14%
Debt Instrument, Convertible, Gross Amount of Equity Component	$ (51,600,000)	$ (51,600,000)
Amortization of debt discount	2,300,000	3,800,000
Interest expense, debt	$ 2,300,000	$ 3,800,000
Initial conversion rate		11.2608
Conversion price (in dollars per share)	$ 88.80	$ 88.80
Option indexed to issuer's equity, strike price (in dollars per share)		$ 114.92
Equity component of convertible debt	$ 39,100,000	$ 39,100,000
Long-term Debt | Amended and Restated Senior Credit Agreement
Debt Instrument [Line Items]
Interest rate, effective percentage	4.25%	4.25%
Mortgage notes
Debt Instrument [Line Items]
Long-term debt	$ 0	$ 0		$ 836,000
London Interbank Offered Rate (LIBOR) | Long-term Debt | Amended and Restated Senior Credit Agreement
Debt Instrument [Line Items]
Basis spread on variable rate		1.875%
Federal Funds Effective Swap Rate | Long-term Debt | Amended and Restated Senior Credit Agreement
Debt Instrument [Line Items]
Basis spread on variable rate		0.50%
Eurodollar | Long-term Debt | Amended and Restated Senior Credit Agreement
Debt Instrument [Line Items]
Basis spread on variable rate		1.00%
Call Option
Debt Instrument [Line Items]
Hedge and warrant transactions, net cash paid		$ 21,000,000

Long-Term Debt - Maturities of

Long-Term Debt - Maturities of Long Term Debt (Details) $ in Thousands	Jun. 30, 2019USD ($)
Debt Disclosure [Abstract]
Remaining, 2019	$ 6,625
2020	13,250
2021	18,219
2022	24,844
2023	460,750
2024	$ 345,000