Orthofix Medical (OFIX) 10-K/A 31 Mar 15 2013 FY Annual report (amended) Financial data

Document_and_Entity_Informatio

Document and Entity Information (USD $)	12 Months Ended
In Millions, except Share data, unless otherwise specified	Dec. 31, 2013	Mar. 27, 2015	Jun. 28, 2013
Document And Entity Information [Abstract]
Document Type	10-K/A
Amendment Flag	TRUE
Amendment Description	"Orthofix International N.V. (together with its respective consolidated subsidiaries and affiliates, the “Company,” sometimes referred to as “we,” “us,” or “our”) is filing this amendment (this “Amendment” or “Form 10-K/A”) to its Annual Report on Form 10-K for the fiscal year ended December 31, 2013, which was originally filed on March 31, 2014 (the “Original Form 10-K”). The Original Form 10-K reflected and described the effects of the restatement of the Company’s previously issued consolidated financial statements for the fiscal years ended December 31, 2012 and 2011. In addition, the Original Form 10-K included restated consolidated financial information for the fiscal years ended December 31, 2010 and 2009 in Part II, Item 6, “Selected Financial Data.” The error corrections contained in these restated financial statements, which we refer to herein as the “Original Restatement,” were prepared following an independent review by the Audit Committee (the “Audit Committee”) of the Company’s Board of Directors into certain accounting matters (the “Independent Review”), which is further described herein. In connection with the Company’s preparation of its consolidated interim quarterly financial statements for the fiscal quarter ended June 30, 2014, the Company determined that certain entries with respect to the previously filed financial statements contained in the Original Form 10-K were not properly accounted for under U.S. generally accepted accounting principles (“US GAAP”). As further described below, these additional errors affect the fiscal years ended December 31, 2013, 2012 and 2011, as well as the fiscal quarter ended March 31, 2014. Due to these errors, the Company determined in August 2014 to restate its consolidated financial statements for the fiscal years ended December 31, 2013, 2012 and 2011 (including the interim quarterly periods therein) and the fiscal quarter ended March 31, 2014, and that the previously filed consolidated financial statements for these periods should no longer be relied upon. Contemporaneously with the filing of this Form 10-K/A, the Company is filing (i) an amendment to its Quarterly Report on Form 10-Q for the fiscal quarter ended March 31, 2014 (the “Amended 2014 First Quarter Form 10-Q”), which amendment contains restated consolidated interim financial statements for the fiscal quarters ended March 31, 2014 and 2013, and (ii) its delayed Quarterly Report on Form 10-Q for the fiscal quarter ended June 30, 2014 (the “2014 Second Quarter Form 10-Q”), which report contains restated consolidated interim financial statements for the fiscal quarter ended June 30, 2013. Restated consolidated interim financial statements for the fiscal quarter ended September 30, 2013 will also be contained in the Company’s Quarterly Report on Form 10-Q for the fiscal quarter ended September 30, 2014, which the Company expects to file on or prior to November 10, 2014. The corrections of the additional errors in this Form 10-K/A and the Amended 2014 First Quarter Form 10-Q are referred to herein as the “Further Restatement.” "
Document Period End Date	31-Dec-13
Document Fiscal Year Focus	2013
Document Fiscal Period Focus	FY
Trading Symbol	OFIX
Entity Registrant Name	ORTHOFIX INTERNATIONAL N V
Entity Central Index Key	884624
Current Fiscal Year End Date	-19
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	No
Entity Voluntary Filers	No
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		18,754,831
Entity Public Float			$497.50

Consolidated_Balance_Sheets

Consolidated Balance Sheets (USD $)	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$28,924				$30,767				$32,743	$13,561
Restricted cash	23,761				21,314
Trade accounts receivable, less allowances of $9,111 and $6,673 at December 31, 2013 and 2012, respectively	70,811				103,802
Inventories	72,678				69,813
Deferred income taxes	39,999				38,487
Prepaid expenses and other current assets	28,933				36,449
Total current assets	265,106				300,632
Property, plant and equipment, net	54,372				52,793
Patents and other intangible assets, net	9,046				7,290
Goodwill	53,565		72,758		74,388				73,094
Deferred income taxes	22,394				21,523
Other long-term assets	7,492				7,920
Total assets	411,975	415,524	446,321	464,153	464,546	528,174	520,848	680,596
Current liabilities:
Bank borrowings					16
Trade accounts payable	20,674				22,575
Other current liabilities	49,676				42,742
Total current liabilities	70,350				65,333
Long-term debt	20,000				20,000
Deferred income taxes	13,026				11,350
Other long-term liabilities	12,736				11,424
Total liabilities	116,112	108,531	114,175	103,178	108,107	195,755	207,927	382,051
Contingencies (Note 17)
Shareholders' equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of December 31, 2013 and 2012, respectively	1,810				1,934
Additional paid-in capital	216,653				246,306
Retained earnings	73,897				102,709
Accumulated other comprehensive income	3,503				5,490
Total shareholders' equity	295,863	306,993	332,146	360,975	356,439	332,419	312,921	298,545	280,304
Total liabilities and shareholders' equity	$411,975	$415,524	$446,321	$464,153	$464,546	$528,174	$520,848	$680,596

Consolidated_Balance_Sheets_Pa

Consolidated Balance Sheets (Parenthetical) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified
Statement of Financial Position [Abstract]
Trade accounts receivable, allowances	$9,111	$6,673
Common shares, par value	$0.10	$0.10
Common shares, authorized	50,000,000	50,000,000
Common shares, issued	18,102,335	19,339,329
Common shares, outstanding	18,102,335	19,339,329

Consolidated_Statements_of_Ope

Consolidated Statements of Operations and Comprehensive Income (Loss) (USD $)	3 Months Ended								6 Months Ended	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Income Statement [Abstract]
Product sales										$349,552	$393,647	$398,695
Marketing service fees										48,059	46,542	36,824
Net sales	105,886	91,806	97,640	102,279	115,607	105,818	111,601	107,163		397,611	440,189	435,519
Cost of sales	34,123	25,064	21,884	25,841	26,751	24,887	24,943	24,145		106,912	100,726	96,415
Gross profit	71,763	66,742	75,756	76,438	88,856	80,931	86,658	83,018		290,699	339,463	339,104
Operating expenses
Sales and marketing										175,468	178,771	185,156
General and administrative										64,830	53,650	64,785
Research and development										26,768	28,577	22,861
Amortization of intangible assets										2,687	2,298	2,550
Costs related to the accounting review and restatement										12,945
Impairment of goodwill									19,193	19,193
Charges related to U.S. Government resolutions (Note 17)											1,295	57,141
Total operating expenses	81,842	80,843	68,836	70,370	62,338	63,988	70,036	68,229		301,891	264,591	332,493
Operating (loss) income	-10,079	-14,101	6,920	6,068	26,518	16,943	16,622	14,789		-11,192	74,872	6,611
Other income and (expense)
Interest expense, net										-1,827	-4,161	-5,441
Other income (expense)										2,416	-1,646	-2,533
Total other income (expense)										589	-5,807	-7,974
(Loss) income before income taxes										-10,603	69,065	-1,363
Income tax expense										-7,602	-23,944	-14,443	6,028
Net (loss) income from continuing operations	-9,639	-16,504	2,012	5,926	17,518	9,312	11,421	6,870		-18,205	45,121	-15,806
Discontinued operations (Note 16)
Gain on sale of Breg, Inc., net of tax											1,345
Loss from discontinued operations										-15,510	-3,494	-2,705
Income tax benefit										4,903	-120	813
Net loss from discontinued operations										-10,607	-2,269	-1,892
Net (loss) income	-10,412	-18,836	-3,011	3,447	22,954	3,747	8,802	7,349		-28,812	42,852	-17,698
Net (loss) income per common share-basic:
Net (loss) income from continuing operations	($0.53)	($0.91)	$0.11	$0.31	$0.91	$0.49	$0.61	$0.37		($0.97)	$2.38	($0.87)
Net loss from discontinued operations										($0.57)	($0.12)	($0.10)
Net (loss) income per common share-basic	($0.58)	($1.04)	($0.16)	$0.18	$1.19	$0.20	$0.47	$0.39		($1.54)	$2.26	($0.97)
Net (loss) income per common share-diluted:
Net (loss) income from continuing operations	($0.53)	($0.91)	$0.10	$0.30	$0.89	$0.48	$0.59	$0.36		($0.97)	$2.33	($0.87)
Net loss from discontinued operations										($0.57)	($0.12)	($0.10)
Net (loss) income per common share-diluted	($0.58)	($1.04)	($0.16)	$0.18	$1.17	$0.19	$0.46	$0.38		($1.54)	$2.21	($0.97)
Weighted average number of common shares:
Basic										18,697,228	18,977,263	18,219,343
Diluted										18,697,228	19,390,413	18,219,343
Other comprehensive (loss) income , before tax:
Translation adjustment										-1,708	1,131	-1,897
Unrealized gain (loss) on derivative instrument										-443	416	-693
Other comprehensive income (loss), before tax										-2,151	1,547	-2,590
Income tax related to components of other comprehensive income	164				-153				164	164	-153	256
Other comprehensive income (loss), net of tax										-1,987	1,394	-2,334
Comprehensive (loss) income										($30,799)	$44,246	($20,032)

Consolidated_Statements_of_Cha

Consolidated Statements of Changes in Shareholders' Equity (USD $)	Total	Common Shares [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income [Member]
In Thousands, except Share data
Balance, Amount at Dec. 31, 2010	$293,918	$1,772	$195,597	$90,119	$6,430
Balance, Shares at Dec. 31, 2010		17,726,645
Cumulative effect of adjustments on opening balance	-12,564			-12,564
Balance, Amount (Restated)	281,354	1,772	195,597	77,555	6,430
Balance, Shares (Restated)		17,726,645
Net income (loss)	-17,698			-17,698
Unrealized gain (loss) on derivative instrument	-437				-437
Translation adjustment	-1,897				-1,897
Purchase of minority interest	-517		-517
Tax benefit on exercise of stock options	1,737		1,737
Reclassification for tax benefit on exercise of stock options	-8,999		-8,999
Share-based compensation expense	6,648		6,648
Common shares issued	20,113	74	20,039
Common shares issued, Shares		738,799
Balance, Amount at Dec. 31, 2011	280,304	1,846	214,505	59,857	4,096
Balance, Shares at Dec. 31, 2011		18,465,444
Net income (loss)	42,852			42,852
Unrealized gain (loss) on derivative instrument	263				263
Translation adjustment	1,131				1,131
Share-based compensation expense	6,303		6,303
Common shares issued	25,586	88	25,498
Common shares issued, Shares		873,885
Balance, Amount at Dec. 31, 2012	356,439	1,934	246,306	102,709	5,490
Balance, Shares at Dec. 31, 2012	19,339,329	19,339,329
Net income (loss)	-28,812			-28,812
Unrealized gain (loss) on derivative instrument	-279				-279
Translation adjustment	-1,708				-1,708
Share-based compensation expense	6,267		6,267
Common shares issued	3,450	20	3,430
Common shares issued, Shares		200,584
Retirement of repurchased common stock	-39,494	-144	-39,350
Retirement of repurchased common stock, Shares		-1,437,578
Balance, Amount at Dec. 31, 2013	$295,863	$1,810	$216,653	$73,897	$3,503
Balance, Shares at Dec. 31, 2013	18,102,335	18,102,335

Consolidated_Statements_of_Cha1

Consolidated Statements of Changes in Shareholders' Equity (Parenthetical) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Statement of Stockholders' Equity [Abstract]
Unrealized gain (loss) on derivative instrument, tax (benefit)	($164)	$153	($256)

Consolidated_Statements_of_Cas

Consolidated Statements of Cash Flows (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Cash flows from operating activities:
Net (loss) income	($28,812)	$42,852	($17,698)
Adjustments to reconcile net (loss) income to net cash provided by operating activities:
Depreciation and amortization	22,822	20,732	23,182
Amortization of debt costs	720	1,737	1,239
Amortization of exclusivity agreements	1,546	1,289	374
Provision for doubtful accounts	4,590	2,212	4,580
Deferred income taxes	2,829	3,771	-13,941
Share-based compensation	6,267	6,303	6,648
Impairment of goodwill	19,193
Gain on sale of Breg, Inc., net of tax		-1,345
Excess income tax benefit on employee stock-based awards	-82	-1,020	-1,737
Other	4,536	4,798	2,298
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable	28,562	-11,128	6,645
Inventories	-3,213	-384	-12,705
Escrow receivable		41,537	-32,562
Prepaid expenses and other current assets	8,764	-14,575	2,382
Trade accounts payable	-2,280	4,575	2,322
Charges related to U.S. Government resolutions		-83,178	89,101
Other current liabilities	6,969	-5,239	3,516
Other long-term assets	-5,329	-3,391	-2,317
Other long-term liabilities	-40	616	3,403
Net cash provided by operating activities	67,042	10,162	64,730
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	-24,787	-27,994	-24,965
Capital expenditures for intangible assets	-4,891	-780	-793
Payment made in connection with acquisition			-5,250
Purchase of other investments	-1,374	-714	-468
Proceeds from sale of other investments		878
Net proceeds from sale of Breg, Inc.		153,773
Net cash (used in) provided by investing activities	-31,052	125,163	-31,476
Cash flows from financing activities:
Net proceeds from issuance of common shares	3,450	25,586	20,113
Payment of refinancing fees and debt issuance costs			-758
Repayments of long-term debt	-16	-188,695	-7,500
Repayment of bank borrowings, net		-1,297	-2,561
Changes in restricted cash	-2,375	25,799	-24,178
Purchase of common stock	-39,494
Cash payment for purchase of minority interest in subsidiary			-517
Excess income tax benefit on employee stock-based awards	82	1,020	1,737
Net cash used in financing activities	-38,353	-137,587	-13,664
Effect of exchange rate changes on cash	520	286	-408
Net (decrease) increase in cash and cash equivalents	-1,843	-1,976	19,182
Cash and cash equivalents at the beginning of the year	30,767	32,743	13,561
Cash and cash equivalents at the end of the year	28,924	30,767	32,743
Cash paid during the year for:
Interest	2,046	4,569	17,088
Income taxes	$8,773	$18,268	$26,227

Summary_of_significant_account

Summary of significant accounting policies	12 Months Ended
	Dec. 31, 2013
Accounting Policies [Abstract]
Summary of significant accounting policies	1	Summary of significant accounting policies
		(a)	Basis of consolidation
	The consolidated financial statements include the financial statements of the Company and its wholly owned and majority-owned subsidiaries and entities over which the Company has control. All intercompany accounts and transactions are eliminated in consolidation.
		(b)	Reclassifications
	The Company has reclassified certain line items to conform to the current year presentation. The reclassifications have no effect on previously reported net earnings or shareholders’ equity.
		(c)	Use of estimates in preparation of financial statements
	The preparation of financial statements in conformity with United States generally accepted accounting principles (“U.S. GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, we evaluate these estimates, including those related to contractual allowances, doubtful accounts, inventories, potential intangible assets and goodwill impairment, income taxes, and share-based compensation. We base our estimates on historical experience, future expectations and on other relevant assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results could differ from those estimates.
		(d)	Foreign currency translation
	The financial statements for operations outside the United States are generally maintained in their local currency. All foreign currency denominated balance sheet accounts, except shareholders’ equity, are translated to U.S. dollars at year end exchange rates and revenue and expense items are translated at weighted average rates of exchange prevailing during the year. Gains and (losses) resulting from the translation of foreign currency are recorded in the accumulated other comprehensive income component of shareholders’ equity. Transactional foreign currency gains and (losses), including those generated from intercompany operations, are included in other expense, net and were $0.5 million loss, $0.4 million loss and $1.7 million loss for the years ended December 31, 2013, 2012 and 2011, respectively.
		(e)	Cash and cash equivalents
	The Company considers all highly liquid investments with an original maturity of three months or less at the date of purchase to be cash equivalents.
		(f)	Restricted cash
	Restricted cash consists of cash held at certain subsidiaries, the distribution or transfer of which to Orthofix International N.V. (the “Parent”) or other subsidiaries that are not parties to the credit facility described in Note 9 is restricted. The senior secured credit facility restricts the Parent and subsidiaries that are not parties to the facility from access to cash held by Orthofix Holdings, Inc. and its subsidiaries. All credit party subsidiaries have access to this cash for operational and debt repayment purposes.
		(g)	Market risk
	In the ordinary course of business, the Company is exposed to the impact of changes in interest rates and foreign currency fluctuations. The Company’s objective is to limit the impact of such movements on earnings and cash flows. In order to achieve this objective, the Company seeks to balance its non-U.S. dollar denominated income and expenditures. During 2013, 2012 and 2011, the Company made use of a foreign currency swap agreement to manage cash flow exposure generated from foreign currency fluctuations.
	The Company generally does not require collateral on trade receivables.
		(h)	Inventories
	Inventories are valued at the lower of cost or estimated net realizable value, after provision for excess, obsolete or impaired items which is reviewed and updated on a periodic basis by management. For inventory procured or produced, whether internally or through contract manufacturing arrangements, at our manufacturing facility in Italy, cost is determined on a weighted-average basis, which approximates the first-in, first-out (“FIFO”) method, due to the high turn-over rate of inventory at this location. For inventory procured or produced, whether internally or through contract manufacturing arrangements, at our manufacturing facility in Texas, standard costs, which approximates actual cost on the FIFO method, is used to value inventory. Standard costs are reviewed annually by management, or more often in the event circumstances indicate a change in cost has occurred. The valuation of work-in-process, finished products, field inventory and consignment inventory includes the cost of materials, labor and other production costs. Field inventory represents immediately saleable finished products inventory that is in the possession of the Company’s direct sales representatives. Consignment inventory represents immediately saleable finished products located at third party customers, such as distributors and hospitals.
		(i)	Long-lived assets, including intangibles
	Property, plant and equipment is stated at cost less accumulated depreciation. Costs include all expenditures necessary to place the asset in service, including freight and sales and use taxes. Plant equipment also includes instrumentation held by customers and is generally used to facilitate the implantation of the Company’s products, the associated cost and accumulated depreciation as of December 31, 2013 was $56.7 million and ($35.4 million), respectively. Depreciation is computed on a straight-line basis over the useful lives of the assets. Depreciation of leasehold improvements is computed over the shorter of the lease term or the useful life of the asset. The useful lives are as follows:
			Years
	Buildings			25 to 33
	Plant equipment and instrumentation			2 to 10
	Furniture and fixtures			4 to 8
	Expenditures for maintenance and repairs and minor renewals and improvements, which do not extend the lives of the respective assets, are expensed as incurred. All other expenditures for renewals and improvements are capitalized. The assets and related accumulated depreciation are adjusted for property retirements and disposals, with the resulting gain or loss included in operations. Fully depreciated assets remain in the accounts until retired from service.
	Patents and other intangible assets are recorded at cost, or when acquired as a part of a business combination at estimated fair value. These assets primarily include patents and other technology agreements (“developed technologies”) and trademarks. Identifiable intangible assets which are considered definite lived are amortized over their useful lives using a method of amortization that reflects the pattern in which the economic benefit of the intangible assets is consumed. The Company’s weighted average amortization period for developed technologies is 11 years.
	Intangible and long-lived assets with definite lives, such as developed technologies, are tested for impairment if any adverse conditions exist or change in circumstances have occurred that would indicate impairment or a change in the remaining useful life. If an impairment indicator exists, the Company tests the intangible asset for recoverability. For purposes of the recoverability test, the Company groups its intangible assets with other assets and liabilities at the lowest level of identifiable cash flows if the intangible asset does not generate cash flows independent of other assets and liabilities. If the carrying value of the intangible asset (asset group) exceeds the undiscounted cash flows expected to result from the use and eventual disposition of the intangible asset (asset group), the Company will write the carrying value down to the fair value in the period identified.
	The Company generally calculates fair value of indefinite-lived intangible assets as the present value of estimated future cash flows. In determining the estimated future cash flows associated with intangible assets, the Company uses estimates and assumptions about future revenue contributions, cost structures and remaining useful lives of the asset (asset group). The use of alternative assumptions, including estimated cash flows, discount rates, and alternative estimated remaining useful lives could result in different calculations of impairment.
		(j)	Goodwill
	The Company tests goodwill at least annually for impairment. The Company tests more frequently if indicators are present or changes in circumstances suggest that impairment may exist. These indicators include, among others, declines in sales, earnings or cash flows, or the development of a material adverse change in the business climate. The Company assesses goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment, referred to as a reporting unit. The Company has identified four reporting units, which are consistent with the Company’s reporting segments: BioStim, Biologics, Extremity Fixation, and Spine Fixation.
	In order to calculate the respective carrying values, the Company initially recorded goodwill based on the purchase price allocation performed at the time of acquisition. Corporate assets and liabilities that directly relate to a reporting unit’s operations are ascribed directly to that reporting unit. Corporate assets and liabilities that are not directly related to a specific reporting unit, but from which the reporting unit benefits, are allocated based on the respective contribution measure of each reporting unit. Effective July 1, 2013, the Company re-aligned its reporting units and consequently reallocated the carrying value of goodwill from its previous reporting units to its new reporting units based on the relative fair value of each new reporting unit to total enterprise value at July 1, 2013.
	As a result of the Company’s change in reporting structure, the Company allocated goodwill to each reporting unit, and subsequently evaluated each reporting unit for possible impairment of goodwill, as there were indicators of impairment when completing a qualitative analysis. The result of this analysis was a full impairment of the goodwill allocated to the Extremity Fixation and Spine Fixation reportable units, totaling $19.2 million.
	The Company’s annual goodwill impairment analysis, which was performed qualitatively during the fourth quarter of 2013, did not result in any additional impairment charge.
		(k)	Derivative instruments
	The Company manages its exposure to fluctuating cash flows resulting from changes in interest rates and foreign exchange within the consolidated financial statements according to its hedging policy. Under the policy, the Company may engage in non-leveraged transactions involving various financial derivative instruments to manage exposed positions. The policy requires the Company to formally document the relationship between the hedging instrument and hedged item, as well as its risk-management objective and strategy for undertaking the hedge transaction. For instruments designated as a cash flow hedge, the Company formally assesses (both at the hedge’s inception and on an ongoing basis) whether the derivative that is used in the hedging transaction has been effective in offsetting changes in the cash flows of the hedged item and whether such derivative may be expected to remain effective in future periods. If it is determined that a derivative is not (or has ceased to be) effective as a hedge, the Company will discontinue the related hedge accounting prospectively. Such a determination would be made when (1) the derivative is no longer effective in offsetting changes in the cash flows of the hedged item; (2) the derivative expires or is sold, terminated or exercised; or (3) management determines that designating the derivative as a hedging instrument is no longer appropriate. Ineffective portions of changes in the fair value of cash flow hedges are recognized in earnings.
	The Company records all derivatives as either assets or liabilities on the balance sheet at their respective fair values. For a cash flow hedge, the effective portion of the derivative’s change in fair value (i.e. gains or losses) is initially reported as a component of other comprehensive income, net of related taxes, and subsequently reclassified into net earnings when the hedged exposure is no longer effective.
	The Company utilizes a cross currency swap to manage its foreign currency exposure related to a portion of the Company’s intercompany receivable of a U.S. dollar functional currency subsidiary that is denominated in Euro. The cross currency swap has been accounted for as a cash flow hedge in accordance with ASC Topic 815, Derivatives and Hedging.
		(l)	Accumulated other comprehensive income
	Accumulated other comprehensive income is comprised of foreign currency translation adjustments and the effective portion of the gain (loss) on the Company’s cross-currency swap, which is designated and accounted for as a cash flow hedge (see Note 10) and the unrealized gain (loss) on warrants. The components of and changes in accumulated other comprehensive income are as follows:
	(U.S. Dollars in thousands)		Foreign Currency			Change in			Accumulated Other
			Translation			Fair Value			Comprehensive
			Adjustments						Income
	Balance at December 31, 2011 (Restated)		$	4,228		$	(132	)	$	4,096
	Unrealized gain on cross-currency swaps, net of taxes of $153			—			263			263
	Foreign currency translation adjustment (1)			1,131			—			1,131
	Balance at December 31, 2012 (Restated)			5,359			131			5,490
	Unrealized loss on cross-currency swaps, net of tax benefit of $164			—			(278	)		(278	)
	Unrealized gain (loss) on warrants			—			(1	)		(1	)
	Foreign currency translation adjustment (1)			(1,708	)		—			(1,708	)
	Balance at December 31, 2013 (Restated)		$	3,651		$	(148	)	$	3,503
	-1	As the cash generally remains permanently invested in the non U.S. dollar denominated foreign subsidiaries, no deferred taxes are recognized on the related foreign currency translation adjustment.
		(m)	Revenue recognition and accounts receivable
	Commercial revenue is related to the sale of the Company’s implant products, generally representing hospital customers. Revenues are recognized when these products have been utilized and a confirming purchase order has been received from the hospital.
	Revenue is derived from third-party payors, including commercial insurance carriers, health maintenance organizations, preferred provider organizations and governmental payors such as Medicare, in connection with the sale of our stimulation products. Revenue is recognized when the stimulation product is placed on or implanted in and accepted by the patient. Amounts paid by these third-party payors are generally based on fixed or allowable reimbursement rates. These revenues are recorded at the expected or pre-authorized reimbursement rates, net of any contractual allowances or adjustments. Certain billings are subject to review by the third-party payors and may be subject to adjustment.
	For distributor revenue, which is related primarily to implant products, the Company recognizes revenue either on a sell-in or sell-through basis depending on the specific circumstances of the distributor. In some cases the Company recognizes distributor revenue as title and risk of loss passes at either shipment from the Company’s facilities or receipt at the distributor’s facility, assuming all other revenue recognition criteria has been achieved (the “sell-in method”). Based on the results of the Independent Review, the Company determined in some cases the revenue recognition criteria for distributor sales were not satisfied at the time of shipment or receipt; specifically, the existence of extra-contractual terms or arrangements caused the Company not to meet the fixed or determinable criteria for revenue recognition in some cases, and in others collectability had not been established. In situations where we are unable to satisfy the requirements to recognize revenue on the sell-in method, we recognize revenue relating to distributor arrangements once the product is delivered to the end customer (the “sell-through method”). Because the Company does not have reliable information about when its distributors sell the product through to end customers, the Company uses cash collection from distributors as a basis for revenue recognition under the sell-through method. Although in many cases the Company is legally entitled to the accounts receivable at the time of shipment, the Company has not recognized accounts receivables or any corresponding deferred revenues associated with distributor transactions for which revenue is recognized on the sell-through method. Effective April 1, 2013, all distributor revenue is recognized on the sell-through basis.
	For distributors on the sell-in method prior to April 1, 2013, cost of sales is recognized upon shipment. For sell-through distributors, whose revenue is recognized upon cash receipt, the Company considers whether to match the related cost of sales expense with revenue or to recognize expense upon shipment. In making this assessment, the Company considers the financial viability of its distributors based on their creditworthiness to determine if collectability of amounts sufficient to realize the costs of the products shipped is reasonably assured at the time of shipment to these distributors. In instances where the distributor is determined to be financially viable, the Company defers the costs of sales until the revenue is recognized.
	Biologics revenue is primarily related to a collaborative arrangement with MTF. In 2008, the Company entered into a collaborative arrangement with MTF to develop and commercialize Trinity Evolution®, a stem cell-based bone growth biologic matrix. With the development process completed in 2009, the Company and MTF operated under the terms of a separate commercialization agreement. Under the terms of the 10-year agreement, MTF sourced the tissue, processed it to create the bone growth matrix, packaged and delivered it to the customer in accordance with orders received from the Company. The Company has exclusive global marketing rights for Trinity Evolution® as well as non-exclusive marketing rights for other products, and receives marketing fees from MTF based on total sales. These marketing fees are recorded on a net basis within net sales and were $48.1 million, $46.5 million and $36.8 million in 2013, 2012 and 2011, respectively. On January 10, 2012, the Company announced that it had reached an agreement with MTF to both co-develop and commercialize a new technology for use in bone grafting applications and to expand MTF’s Trinity Evolution® processing capacity. The amendment amends the term of the existing agreement until the later of (i) 15 years after the date that certain development milestones were achieved under the existing agreement (which occurred during 2010) or (ii) the date that certain licensing arrangements between the Company and NuVasive, Inc. expire. MTF is considered the primary obligor in these arrangements and therefore the Company recognizes these marketing service fees on a net basis upon shipment of the product to the customer.
	Revenues exclude any value added or other local taxes, intercompany sales and trade discounts. Shipping and handling costs are included in cost of sales.
	The process for estimating the ultimate collection of accounts receivable involves significant assumptions and judgments. Historical collection and payor reimbursement experience is an integral part of the estimation process related to reserves for doubtful accounts and the establishment of contractual allowances. Accounts receivable are analyzed on a quarterly basis to assess the adequacy of both reserves for doubtful accounts and contractual allowances. Revisions in allowances for doubtful accounts estimates are recorded as an adjustment to bad debt expense within sales and marketing expenses, and contractual allowances are recorded as an adjustment to revenue. These estimates are periodically tested against actual collection experience.
		(n)	Sale of accounts receivable
	The Company will generally sell receivables from certain Italian hospitals each year. The estimated related fee for 2013 and 2012 was $0.8 million and $0.6 million, respectively, which is recorded as interest expense. Trade accounts receivables sold without recourse are removed from the balance sheet at the time of sale.
		(o)	Share-based compensation
	The fair value of service-based stock options are determined using the Black-Scholes valuation model. Such value is recognized as expense over the service period net of estimated forfeitures.
	The fair value of market-based stock options are determined at the date of the grant using the Monte Carlo valuation methodology. Such value is recognized as expense over the requisite service period adjusted for estimated forfeitures for each separately vesting tranche of the award. The Monte Carlo methodology that we use to estimate the fair value of market-based options incorporates into the valuation the possibility that the market condition may not be satisfied.
The expected term of options granted is estimated based on a number of factors, including the vesting and expiration terms of the award, historical employee exercise behavior for both options that are currently outstanding and options that have been exercised or are expired, the historical volatility of the Company’s common stock and an employee’s average length of service. The risk-free interest rate is determined based upon a constant U.S. Treasury security rate with a contractual life that approximates the expected term of the option award. Management estimates expected volatility based on the historical volatility of the Company’s stock. The compensation expense recognized for all equity-based awards is net of estimated forfeitures. Forfeitures are estimated based on an analysis of actual option forfeitures.
	(p)	Advertising costs
The Company expenses all advertising costs as incurred. Advertising expense included in sales and marketing expense for the years ended December 31, 2013, 2012 and 2011 was $0.2 million, $0.3 million and $0.5 million, respectively.
	(q)	Research and development costs
Expenditures related to the collaborative arrangement with MTF are expensed based on the terms of the related agreement. Milestone payments made to MTF in 2013 and 2012 totaled $2.5 million and $3.0 million, respectively. There were no milestone payments made to MTF in 2011. Expenditures for other research and development are expensed as incurred.
	(r)	Income taxes
The Company is subject to income taxes in both the U.S. and foreign jurisdictions, and uses estimates in determining the provision for income taxes. The Company accounts for income taxes using the asset and liability method for accounting and reporting for income taxes. Under this method, deferred tax assets and liabilities are recognized based on temporary differences between the financial reporting and income tax basis of assets and liabilities using statutory rates. This process requires that the Company project the current tax liability and estimate the deferred tax assets and liabilities, including net operating loss and tax credit carry forwards. In assessing the need for a valuation allowance, the Company has considered the recent operating results, future taxable income projections and all prudent and feasible tax planning strategies.
The Company accounts for uncertain tax positions in accordance with ASC 740, Income Taxes, which contains a two-step approach to recognizing and measuring uncertain tax positions. The first step is to evaluate the tax position taken or expected to be taken in a tax return by determining if the weight of available evidence indicates that it is more likely than not that, on an evaluation of the technical merits, the tax position will be sustained on audit, including resolution of any related appeals or litigation processes. The second step is to measure the tax benefit as the largest amount that is more than 50% likely to be realized upon ultimate settlement. The Company reevaluates income tax positions periodically to consider factors such as changes in facts or circumstances, changes in or interpretations of tax law, effectively settled issues under audit, and new audit activity. Such a change in recognition or measurement would result in recognition of a tax benefit or an additional charge to the tax provision.
The Company includes imputed interest and any applicable penalties related to tax issues as part of income tax expense in our consolidated financial statements.
	(s)	Net income (loss) per common share
Net income (loss) per common share—basic is computed using the weighted average number of common shares outstanding during each of the respective years. Net income (loss) per common share—diluted is computed using the weighted average number of common and common equivalent shares outstanding during each of the respective years using the “treasury stock” method, if dilutive. Common equivalent shares represent the dilutive effect of the assumed exercise of outstanding share options (see Note 20). The only differences between basic and diluted shares result from the assumed exercise of certain outstanding share options.
	(t)	Financial instruments and concentration of credit risk
Financial instruments that could subject the Company to a concentration of credit risk consist primarily of cash and cash equivalents and accounts receivable. Generally, the cash is held at large financial institutions and our cash equivalents consist of highly liquid money market funds. The Company performs ongoing credit evaluations of the customers, generally does not require collateral and maintain a reserve for potential credit losses. The Company believes that a concentration of credit risk related to the accounts receivable is limited because the customers are geographically dispersed and the end users are diversified across several industries.
Net sales to our customers and distributors based in Europe were approximately $52 million in 2013 which results in a substantial portion of our trade accounts receivable balance as of December 31, 2013. It is at least reasonably possible that changes in global economic conditions and/or local operating and economic conditions in the regions these distributors operate, or other factors, could affect the future realization of these accounts receivable balances.
	(u)	Recently issued accounting standards
In July 2013, the Financial Accounting Standards Board (“FASB”), issued Accounting Standards Update (“ASU”) No. 2013-11, Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward, A Similar Tax Loss, or a Tax Credit Carryforward Exists. The authoritative guidance concludes that, under certain circumstances, unrecognized tax benefits should be presented in the financial statements as a reduction to a deferred tax asset for a net operating loss carryforward, a similar tax loss, or a tax credit carryforward. We adopted this guidance early, as permitted, for the fiscal year ended December 31, 2013. The adoption of this guidance did not have a material effect on our consolidated financial statements.
In February 2013, the FASB issued ASU No. 2013-02, Comprehensive Income (Topic 220): Reporting of Amounts Reclassified Out of Accumulated Other Comprehensive Income. The standard requires presentation (either in a single note or parenthetically on the face of the financial statements) of the effect of significant amounts reclassified from each component of accumulated other comprehensive income based on its source and the income statement line items affected by the reclassification. If a component is not required to be reclassified to net income in its entirety, a cross reference to the related footnote for additional information is required. The amendments are effective prospectively for reporting periods beginning after December 15, 2013. The adoption of this guidance did not have a material effect on our consolidated financial statements.
On June 16, 2011, the FASB issued ASU No. 2011-05, Presentation of Comprehensive Income. This ASU eliminates the current option to present other comprehensive income and its components in the statement of changes in shareholders’ equity and increases the prominence of other comprehensive income in the statements by providing an alternative to present the components of net income and comprehensive income as either one continuous or two separate but consecutive financial statements. Companies are also required to present reclassification adjustments for items that are reclassified from other comprehensive income to net income within these statements. This standard is to be applied retrospectively and is effective for fiscal years beginning after December 15, 2011 with early adoption permitted. The Company adopted this ASU as of March 31, 2012 and it did not have a material impact on the Company’s consolidated financial statements.

Original_and_Further_Restateme

Original and Further Restatement of the Consolidated Financial Statements	12 Months Ended
	Dec. 31, 2013
Text Block [Abstract]
Original and Further Restatement of the Consolidated Financial Statements	2	Original and Further Restatement of the Consolidated Financial Statements
These consolidated financial statements reflect two restatements, which we refer to herein respectively as the “Original Restatement” and the “Further Restatement.” The Original Restatement, which was contained in the financial statements filed with the Company’s Annual Report on Form 10-K for the year ended December 31, 2013 filed on March 31, 2014 (the “Original Form 10-K”), reflected the restatement of the Company’s previously filed consolidated financial statements for the fiscal years ended December 31, 2012 and 2011, as well as the fiscal quarter ended March 31, 2013. The Original Restatement is further described below under the subheading “– Original Restatement.”
In connection with the Company’s preparation of its consolidated interim quarterly financial statements for the fiscal quarter ended June 30, 2014, the Company determined that certain entries with respect to the previously filed financial statements contained in the Original Form 10-K were not properly accounted for under U.S. GAAP. As further described below, these additional errors affect the fiscal years ended December 31, 2013, 2012 and 2011 and quarterly reporting periods contained within the fiscal years ended December 31, 2013 and 2012, as well as the fiscal quarter ended March 31, 2014. Due to these errors, the Company determined in August 2014 to restate its consolidated financial statements for the fiscal years ended December 31, 2013, 2012 and 2011 (including the interim quarterly periods contained within the fiscal years ended December 31, 2013 and 2012) and the fiscal quarter ended March 31, 2014, and that the previously filed financial statements for these periods should no longer be relied upon. The Amendment No. 1 to Annual Report on Form 10-K for the fiscal year ended December 31, 2013 (this “Amended Form 10-K”), to which these consolidated financial statements form a part, corrects these additional errors. We refer to these additional corrections as the “Further Restatement.” The Further Restatement is further described below under the subheading “Further Restatement,” which follows the description of the Original Restatement contained directly below.
Original Restatement
Background of Original Restatement
In July 2013, the Audit Committee (the “Audit Committee”) of the Company’s Board of Directors (the “Board”) commenced an independent review with the assistance of outside professionals into whether the Company had properly recognized revenue under U.S. GAAP in connection with certain revenue that had been recorded in 2012 and 2011 (the “Independent Review”). In conjunction with the Independent Review, the Company concluded that errors existed in the Company’s previously issued financial statements for the fiscal years ended December 31, 2012 and 2011, the interim quarterly period ended March 31, 2013, and certain other prior periods.
In reaching these conclusions, the Company considered information obtained in the Independent Review, including emails, data and interviews with current and former employees that indicated (i) the existence of extra-contractual terms or arrangements at the onset of the sale and concessions agreed to subsequent to the initial sale, such as extended payment terms and return and exchange rights for sales to distributors with respect to certain transactions, (ii) that at the time of some sales collection was not reasonably assured, and (iii) that certain amounts previously characterized as commissions were paid to related parties of the applicable customer.
The Company assessed the information derived from the Independent Review in making determinations with respect to accounting adjustments reflected in the restated consolidated financial statements contained in the Amendments and in its Annual Report on Form 10-K for the fiscal year ended December 31, 2013, and such determinations are consistent with the findings of the Independent Review. In addition to the matters that were the subject of the Independent Review, certain other adjustments identified by management, including revisions to inventory reserves and royalties, were made to the consolidated financial statements in connection with the restatement.
The correction of these errors had the following impact: decreased net sales by $14.7 million and $28.2 million for the years ended December 31, 2012 and 2011, respectively; and decreased net income from continuing operations by $8.9 million and $14.5 million for the years ended December 31, 2012 and 2011, respectively. The following include descriptions of the significant adjustments to the Company’s financial position and results of operations from the previously reported consolidated financial statements.
Distributor Revenue Recognition
The Company has determined that it previously recognized revenue with respect to certain distributor relationships before all revenue recognition criteria were met. Specifically, the Company has determined that a fixed or determinable sales price did not exist, and/or collection was not reasonably assured, with respect to certain transactions where revenue had previously been recognized at the time of shipment. Specifically, the Company’s review revealed arrangements, or extra-contractual terms, with certain of the Company’s distributors regarding extended payment terms, return or exchange rights, and contingent payment obligations for sales to such distributors with respect to certain transactions. There were also concessions being made subsequent to the shipment of inventory to the distributors and the related revenue recognition. Based on the results of this review, it was determined that these arrangements were not appropriately evaluated under the appropriate revenue recognition criteria applicable under U.S. GAAP. Distributor sales represented approximately 11–13% of the Company’s net sales (prior to the restatement) of approximately $462 million and $470 million for the years ended December 31, 2012 and 2011, respectively.
The Company previously recognized distributor revenue as title and risk of loss passed at either shipment from the Company’s facilities or receipt at the distributor’s facility, assuming all other revenue recognition criteria had been achieved (the “sell-in method”). Based on review of all facts and circumstances related to the arrangements described above, the Company determined that in many instances the revenue recognition criteria under the sell-in method were not satisfied at the time of shipment or receipt; specifically, the existence of extra-contractual terms or arrangements caused the Company not to meet the fixed or determinable criteria for revenue recognition in some cases, and in others collectability had not been established. In situations where the Company is unable to reasonably estimate the effects of these extra-contractual terms, it is precluded from recognizing revenue relating to distributor arrangements until the product is delivered to the end customer. This method is commonly referred to as the “sell-through” revenue recognition method because the vendor does not recognize revenue until the transaction consideration is fixed or determinable, which coincides with the selling of the product through the distribution channel to the end customer. Because the Company does not have reliable information about when its distributors sell the product through to end customers, the Company will use cash collection from distributors as a basis for revenue recognition under the sell-through method. Although in many cases the Company is legally entitled to the accounts receivable at the time of shipment, since the revenue recognition criteria has not been met, the Company has not recognized accounts receivables or any corresponding deferred revenues associated with these transactions.
As part of the review, the Company also considered the accounting treatment for the related cost of sales when distributor revenue is recognized on a sell-through basis. Previously, cost of sales were recognized upon shipment; however, the Company believes the matching of the recognition of costs of sales with revenue is preferred and therefore considered if such costs should be deferred until revenue is recognized on a sell-through basis. In making this assessment, the Company considered the financial viability of its distributors based on their creditworthiness to determine if collectability of amounts sufficient to realize the costs of the products shipped was reasonably assured at the time of shipment to these distributors. In instances where the distributor was determined to be financially viable, the Company determined that costs of sales should be deferred until the revenue is recognized. For those distributors where the Company has concluded that collectability was not reasonably assured, the Company has expensed the related cost of sales upon shipment.
Based on the results of the Independent Review, the Company determined that all distributor transactions should be transitioned to the sell-through method of accounting as of the dates described below:
	•		For distributor transactions within the Company’s Orthopedics division, the Company has determined that sell-through accounting should be applied within the Brazil subsidiary for all prior periods given the frequency with which the Company conducted business under extra-contractual and undocumented terms, as well as the Company’s inability to fully access underlying transactional and other information that would be necessary to evaluate transactions under a sell-in basis. For distributor transactions within the division outside the Brazil subsidiary, there were also sales to four distributors that did not meet the fixed or determinable or collectability revenue recognition criteria and therefore, such sales were adjusted to sell-through accounting in the restatement.
	•		For distributor transactions within the Company’s U.S. Spine division, the Company has determined that sell-through accounting should be applied beginning January 1, 2011. Following its consideration of the information provided from the Independent Review, the Company believes that January 1, 2011 is the date extra-contractual terms became pervasive in the Company’s U.S. business, and it is unaware of circumstances existing prior to that date that would require it to broadly apply sell-through accounting to all distributor transactions within the U.S. Spine division. Additionally, there were sales in 2012 and 2011 for which revenue was previously recognized that did not meet the fixed or determinable criteria and the product associated with such sales was subsequently returned in 2013 (i) under the terms of negotiated agreements whereby the Company terminated its relationships with two distributors and (ii) by an additional distributor who returned certain product sold pursuant to a contingent sales arrangement. Such sales represented approximately $3.3 million and $4.1 million for the years ended December 31, 2012 and 2011, respectively. Due to the return of the product, no revenue will be recognized for these transactions.
	•		The Company has determined that stimulation products sold to distributors within the Company’s U.S. Spine division during 2012 did not meet the fixed or determinable (and in some cases, collectability) revenue recognition criterion at the time of shipment. Therefore, the Company has determined that sell-through accounting should be applied for these sales. Management also determined that many of these distributors (or affiliates thereof) received commission payments as part of the sales transactions, which the Company previously recorded as sales and marketing expense. The Company has recorded adjustments in the restatement to net these commission expenses against revenue, as they represented product discounts.
	•		The Company has determined that it will prospectively apply sell-through accounting for all remaining distributor arrangements (which entails arrangements within the Company’s Orthopedics division outside the Brazil subsidiary) beginning April 1, 2013, the earliest date for which financial statements had not previously been issued by the Company at the time of the determination. Although the Independent Review did not provide information to indicate extra-contractual terms or that historical revenue recognition was inappropriate in these remaining instances, the Company believes the information from the Independent Review indicating that the Company has a history of extra-contractual arrangements for distributor transactions, as described above, provides additional information which should be considered in reassessing the application of sell-through accounting on a prospective basis, particularly given that the Company believes that there is a higher risk associated with distributor arrangements generally.
The effect of adjustments made to the Company’s previously filed consolidated statements of operations as a result of these matters are shown in the tables below. These adjustments also had the following effects on the Company’s previously filed consolidated balance sheets:
	•		Accounts receivable decreased as of December 31, 2012 by $41.3 million related to the de-recognition of receivables for which revenue has been deferred and will now be recognized on a sell-through basis, based on cash collections.
	•		Inventory increased as of December 31, 2012 by $11.0 million to recognize the costs of inventory shipments to distributors determined to be financially viable as discussed previously.
Inventory Reserves
The Company also identified material errors in inventory reserves. One error related to the Company recording an increase of $1.2 million to the Company’s excess and obsolete reserve in the second quarter of 2012 related to a product within the Spine business that was subsequently reversed by the Company in the fourth quarter of 2012. During the Company’s review, it was determined that removing the reserve in the fourth quarter of 2012 was not correct; therefore the reserve has been reinstated.
The Company has also determined that certain inconsistencies existed with respect to how the Company previously computed and recorded inventory reserves. As a result, the Company has reviewed the methodologies used to compute and record inventory reserves and determined that errors in the application of U.S. GAAP existed in prior periods, which required adjustment in these financial statements. Based on this review, the Company has determined that it previously made reductions to previously recorded reserves based on changes in forecasted demand, which it believes was contrary to guidance set forth in ASC Topic 330, Inventory (specifically ASC 330-10-35-14), which states that a write-down of inventory to the lower-of-cost-or-market value at the close of a fiscal year creates a new cost basis that subsequently should not be marked up based on changes in underlying circumstances. The restated consolidated financial statements contain several adjustments to reflect recomputed inventory reserves in each of the relevant periods.
These adjustments resulted in a decrease to inventory (due to an increase in reserves) as of December 31, 2012, by $14.8 million.
Royalties
The Company also reviewed the accounting for royalties and determined there were royalties classified as sales and marketing expense; however, such royalties were based on sales of products and were paid to doctors who consulted on development of those products. Given these amounts are attributable to the cost of producing the Company’s products, the Company determined they are correctly classified as cost of goods sold.
Other Adjustments
In addition to the adjustments recorded to address the Company’s errors in accounting for distributor revenue recognition, inventory reserves, and royalties, the Company has identified other errors that are generally not material, individually or in the aggregate, but have been recorded in connection with the restatement.
Included in Other Adjustments are adjustments to reclassify interest expense from continuing operations to discontinued operations of $3.9 million for the year ended December 31, 2011. The reclassification was necessary as the Company used a portion of the proceeds from the sale of Breg, Inc. to repay in full the remaining $87.5 million balance on the Term Loan Facility and pay down $57.5 million of amounts outstanding under the Revolving Credit Facility.
Further Restatement
Background of Further Restatement
During the second quarter of 2014, the Company’s management noted that the Company’s bad debt expense for its BioStim strategic business unit (“SBU”) during the first quarter of 2014 was higher than internally budgeted. As a result, the Company’s internal finance department reviewed bad debt expense entries in prior periods. In connection with this review, the Company also further considered its accounting methodology with respect to certain prior revenue adjustments related to uncollectible patient co-pay and self-pay amounts. As further described below, after performing this review, the Company determined that errors existed relating to the accounting for uncollectible patient co-pay and self-pay amounts, and that certain bad debt reserves originally recorded in fiscal years 2011 and 2012 were reversed in incorrect periods in the Original Restatement in connection with the change to sell-through accounting for certain distributors. After analyzing these errors, the Company determined to further restate its financial statements as described herein. In addition to these matters, certain other adjustments identified by management, including revisions to inventory reserves, intercompany profit adjustments and accounts receivable reserves, were made to the consolidated financial statements in connection with the Further Restatement, as discussed below.
Co-Pay and Self-Pay Revenue Adjustments
A majority of revenue from the Company’s BioStim SBU is derived from third parties, which is subject to change due to contractual adjustments related to commercial insurance carriers, and may include certain patient co-pay amounts. In addition, certain patient purchasers are without insurance, with revenue derived from “self-pay” arrangements. In previously issued financial statements, the Company recorded these co-pay and self-pay amounts as revenue with estimated uncollectible portions being recognized as bad debt expense. Upon further analysis, it was determined that because collectability of co-pay and self-pay amounts was not reasonably assured, the conditions for revenue recognition had not been met and revenue for those amounts should not have been recognized until collected.
Adjustments to correct the foregoing reduce equally both the Company’s historical net sales and its sales and marketing expense by approximately $2.2 million, $9.0 million and $6.0 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively. These adjustments have no effect on net income from continuing operations, net income or total assets in any period.
Bad Debt Timing Adjustments
In connection with the foregoing, the Company determined to review bad debt expense trends more broadly across all of its business units. As a result of this process, the Company determined that certain bad debt reserves originally recorded in fiscal years 2011 and 2012 were reversed in incorrect periods in the Original Restatement in connection with the change to sell-through accounting for certain distributors. Because the Original Restatement transferred these transactions to sell-through accounting (as opposed to sell-in accounting, which had been used when the original bad debt reserves were recorded), the bad debt reserve was reversed as part of the Original Restatement, as the receivable that was being reserved for was no longer recognized.
Adjustments to correct this error result in an increase of sales and marketing expense of $1.5 million and $1.1 million for the fiscal years ended December 31, 2013 and 2012 and a decrease of sales and marketing expense of $2.1 million for the fiscal year ended December 31, 2011. These adjustments resulted in no impact to the accounts receivable balance as of December 31, 2013 and an increase in accounts receivable by $1.5 million as of December 31, 2012.
Accounts Receivable Reserve Adjustments
As part of analyzing collections experience on accounts receivable, the Company identified that it had incorrectly considered certain deferred revenue amounts included in gross accounts receivable when calculating estimated reserves. Specifically, the computation of the contractual allowances and bad debt allowances, which serves to adjust accounts receivable to the estimated collectible amount, incorrectly assumed that some percentage of the deferred amounts would be collected, rather than fully deferring these amounts.
Adjustments to correct this error resulted in a net decrease in operating income of $0.7 million and $0.2 million for the fiscal years ended December 31, 2013 and 2011, respectively, and a net increase in operating income of $2.1 million for the fiscal year ended December 31, 2012.
This adjustment resulted in a decrease in accounts receivable, net (due to an increase in reserves) as of December 31, 2013 and 2012, by $4.2 million and $3.5 million, respectively.
Intercompany Profit Adjustments
The Company has two manufacturing facilities which support the inventory needs of other subsidiaries through intercompany sales transactions. These intercompany sales include a profit margin for the selling subsidiary (“intercompany profit”) that is eliminated by the Company as part of its consolidated financial reporting process. The elimination of intercompany profit requires determining the affected net inventory amounts and their related intercompany profit margin to eliminate all intercompany profit, resulting in all inventories being carried at historical cost in the Company’s consolidated financial statements.
As described further above under “Original Restatement – Inventory Reserves,” as part of the Original Restatement the Company made certain corrections to prior period excess and obsolete inventory reserves. The effect of these corrections was not properly considered when determining the adjustments needed to eliminate intercompany profits from inventories in the Original Restatement.
Adjustments to correct this error resulted in an increase to cost of sales of $1.1 million, $0.2 million and $0.3 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively.
This adjustment resulted in a decrease in inventory as of December 31, 2013 and 2012, by $2.6 million and $1.5 million, respectively.
Inventory
Inventory Existence
As part of the remediation activities that followed the Original Restatement, the Company expanded its procedures in the second quarter of 2014 to validate the existence of field inventory held by independent sales representatives and noted that, in many cases, this inventory had higher rates of missing inventory (“shrinkage”) than previously estimated. To determine whether these higher error rates were pervasive across its field inventory, the Company counted approximately 90% of its field inventory during the third and fourth fiscal quarters of 2014. These counts resulted in the identification of errors relating to previous estimates of shrinkage.
Adjustments in the Further Restatement to correct these errors, net of the related effect on previously recorded excess and obsolete inventory reserves, resulted in an increase to cost of sales of $0.4 million, $0.3 million and $0.2 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively.
These adjustments resulted in a decrease in inventory as of December 31, 2013 and 2012, by $1.0 million and $0.6 million, respectively.
Inventory Reserves
In connection with its remediation efforts associated with the material weakness noted in the Original Restatement related to inventory reserves the Company concluded that it was not appropriately calculating inventory reserves, including its consideration of demand assumptions for “kits”, which contain a variety of “piece part” components to be used during surgery that have various demand considerations, as well as inventory held by third parties under inventory purchase obligations.
Adjustments to correct these errors resulted in an increase to cost of sales of $3.2 million, 1.5 million and $0.1 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively. These adjustments resulted in a decrease to inventory (due to an increase in reserves) as of December 31, 2013 and 2012, by $14.4 million and $11.8 million, respectively.
Other Adjustments
In addition to the adjustments described above, the Company is correcting certain other items. Principally, these items consist of a decrease to income tax expense of $0.5 million and $1.1 million for the fiscal years ended December 31, 2013 and 2012, respectively, these adjustments are separate from the tax effect of the errors described above.
The effect of the Further Restatement adjustments made to the Company’s previously filed consolidated statements of operations as a result of these matters are shown in the tables below. These adjustments also resulted in a decrease of total assets of $11.2 million as of December 31, 2013, resulting primarily from a decrease of $17.9 million to inventory and $4.8 million to trade accounts receivable, partially offset by an increase of $6.0 million in deferred income taxes. For further discussion of the effect of these entries on retained earnings, see the “Cumulative Adjustments to Shareholders’ Equity at January 1, 2011” table below.
The tables below show the effects of the Original Restatement for each of the fiscal years ended December 31, 2012 and 2011, as well as the effects of the Further Restatement for each of the fiscal years ended December 31, 2013, 2012 and 2011. In each case, the tax effect of the adjustments is estimated based on the Company’s estimated tax rate.
		Year Ended December 31, 2013
					Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)		Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Reported			Self-Pay			Timing			Receivable			Profit									Restatement
					Revenue						Reserve												Adjustments
Net sales		$	400,534		$	(2,242	)	$	—		$	(582	)	$	—		$	—		$	(99	)	$	(2,923	)	$	397,611
Cost of sales			102,300			—			—			—			1,090			3,688			(166	)		4,612			106,912
Gross profit			298,234			(2,242	)		—			(582	)		(1,090	)		(3,688	)		67			(7,535	)		290,699
Operating expenses
Sales and marketing			176,581			(2,242	)		1,455			122			—			—			(448	)		(1,113	)		175,468
General and administrative			65,147			—			—			—			—			—			(317	)		(317	)		64,830
Research and development			26,768			—			—			—			—			—			—			—			26,768
Amortization of intangible assets			2,687			—			—			—			—			—			—			—			2,687
Costs related to the accounting review and restatement			12,945			—			—			—			—			—			—			—			12,945
Impairment of Goodwill			19,193			—			—			—			—			—			—			—			19,193
			303,321			(2,242	)		1,455			122			—			—			(765	)		(1,430	)		301,891
Operating (loss) income			(5,087	)		—			(1,455	)		(704	)		(1,090	)		(3,688	)		832			(6,105	)		(11,192	)
Other income and (expense)			295			—			—			—			—			—			294			294			589
Loss before income taxes			(4,792	)		—			(1,455	)		(704	)		(1,090	)		(3,688	)		1,126			(5,811	)		(10,603	)
Income tax expense			(10,116	)		—			509			246			381			1,290			88			2,514			(7,602	)
Net loss from continuing operations		$	(14,908	)	$	—		$	(946	)	$	(458	)	$	(709	)	$	(2,398	)	$	1,214		$	(3,297	)	$	(18,205	)
		Year Ended December 31, 2012
					Original Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
		in the 2012			Revenue			Reserves									Restatement			Restated in
		Form 10-K															Adjustments			2012
		Prior to																		Form 10-K/A
		Original
		Restatement
Net sales		$	462,320		$	(14,777	)	$	—		$	—		$	38		$	(14,739	)	$	447,581
Cost of sales			86,492			(2,032	)		5,647			8,190			(44	)		11,761			98,253
Gross profit			375,828			(12,745	)		(5,647	)		(8,190	)		82			(26,500	)		349,328
Operating expenses
Sales and marketing			200,343			(6,629	)		—			(8,190	)		1,607			(13,212	)		187,131
General and administrative			53,827			(2	)		—			—			(434	)		(436	)		53,391
Research and development			28,577			—			—			—			—			—			28,577
Amortization of intangible assets			2,098			—			—			—			200			200			2,298
Charges related to U.S. Government resolutions			1,973			—			—			—			(678	)		(678	)		1,295
			286,818			(6,631	)		—			(8,190	)		695			(14,126	)		272,692
Operating income			89,010			(6,114	)		(5,647	)		—			(613	)		(12,374	)		76,636
Other income and (expense)			(6,282	)		—			—			—			(166	)		(166	)		(6,448	)
Income before income taxes			82,728			(6,114	)		(5,647	)		—			(779	)		(12,540	)		70,188
Income tax expense			(28,792	)		1,782			1,645			—			227			3,654			(25,138	)
Net income from continuing operations		$	53,936		$	(4,332	)	$	(4,002	)	$	—		$	(552	)	$	(8,886	)	$	45,050
		Year Ended December 31, 2012
					Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Restated in			Self-Pay			Timing			Receivable			Profit									Restatement
		2012			Revenue						Reserve												Adjustments
		Form 10-K/A
Net sales		$	447,581		$	(9,049	)	$	—		$	1,653		$	—		$	—		$	4		$	(7,392	)	$	440,189
Cost of sales			98,253			—			—			—			207			1,774			492			2,473			100,726
Gross profit			349,328			(9,049	)		—			1,653			(207	)		(1,774	)		(488	)	$	(9,865	)		339,463
Operating expenses
Sales and marketing			187,131			(9,049	)		1,097			(408	)		—			—			—		$	(8,360	)		178,771
General and administrative			53,391			—			—			—			—			—			259			259			53,650
Research and development			28,577			—			—			—			—			—			—			—			28,577
Amortization of intangible assets			2,298			—			—			—			—			—			—			—			2,298
Charges related to U.S. Government resolutions			1,295			—			—			—			—			—			—			—			1,295
			272,692			(9,049	)		1,097			(408	)		—			—			259			(8,101	)		264,591
Operating income			76,636			—			(1,097	)		2,061			(207	)		(1,774	)		(747	)		(1,764	)		74,872
Other income and (expense)			(6,448	)		—			—			—			—			—			641			641		$	(5,807	)
Income before income taxes			70,188			—			(1,097	)		2,061			(207	)		(1,774	)		(106	)		(1,123	)		69,065
Income tax expense			(25,138	)		—			384			(721	)		72			621			838			1,194		$	(23,944	)
Net income from continuing operations		$	45,050		$	—		$	(713	)	$	1,340		$	(135	)	$	(1,153	)	$	732		$	71		$	45,121
		Year Ended December 31, 2011
					Original Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
		in the 2012			Revenue			Reserves									Restatement			Restated in
		Form 10-K															Adjustments			2012
		Prior to																		Form 10-K/A
		Original
		Restatement
Net sales		$	470,121		$	(29,135	)	$	—		$	—		$	985		$	(28,150	)	$	441,971
Cost of sales			92,619			(8,289	)		3,377			7,713			107			2,908			95,527
Gross profit			377,502			(20,846	)		(3,377	)		(7,713	)		878			(31,058	)		346,444
Operating expenses
Sales and marketing			200,145			(1,216	)		—			(7,713	)		2,295			(6,634	)		193,511
General and administrative			64,374			—			—			—			107			107			64,481
Research and development			22,861			—			—			—			—			—			22,861
Amortization of intangible assets			2,350			—			—			—			200			200			2,550
Charges related to U.S. Government resolutions			56,463			—			—			—			678			678			57,141
			346,193			(1,216	)		—			(7,713	)		3,280			(5,649	)		340,544
Operating income			31,309			(19,630	)		(3,377	)		—			(2,402	)		(25,409	)		5,900
Other income and (expense)			(11,868	)		—			—			—			3,915			3,915			(7,953	)
Income (loss) before income taxes			19,441			(19,630	)		(3,377	)		—			1,513			(21,494	)		(2,053	)
Income tax expense			(21,181	)		6,408			1,102			—			(494	)		7,016			(14,165	)
Net loss from continuing operations		$	(1,740	)	$	(13,222	)	$	(2,275	)	$	—		$	1,019		$	(14,478	)	$	(16,218	)
		Year Ended December 31, 2011
					Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Restated in			Self-Pay			Timing			Receivable			Profit									Restatement
		2012			Revenue						Reserve												Adjustments
		Form 10-K/A
Net sales		$	441,971		$	(5,960	)	$	—		$	(439	)	$	—		$	—		$	(53	)	$	(6,452	)	$	435,519
Cost of sales			95,527			—			—			—			253			321			314			888			96,415
Gross profit			346,444			(5,960	)		—			(439	)		(253	)		(321	)		(367	)		(7,340	)		339,104
Operating expenses
Sales and marketing			193,511			(5,960	)		(2,143	)		(252	)		—			—			—			(8,355	)		185,156
General and administrative			64,481			—			—			—			—			—			304			304			64,785
Research and development			22,861			—			—			—			—			—			—			—			22,861
Amortization of intangible assets			2,550			—			—			—			—			—			—			—			2,550
Charges related to U.S. Government resolutions			57,141			—			—			—			—			—			—			—			57,141
			340,544			(5,960	)		(2,143	)		(252	)		—			—			304			(8,051	)		332,493
Operating income			5,900			—			2,143			(187	)		(253	)		(321	)		(671	)		711			6,611
Other income and (expense)			(7,953	)		—			—			—			—			—			(21	)		(21	)		(7,974	)
Loss before income taxes			(2,053	)		—			2,143			(187	)		(253	)		(321	)		(692	)		690			(1,363	)
Income tax expense			(14,165	)		—			(752	)		66			89			113			206			(278	)		(14,443	)
Net loss from continuing operations		$	(16,218	)	$	—		$	1,391		$	(121	)	$	(164	)	$	(208	)	$	(486	)	$	412		$	(15,806	)
The effects of the Further Restatement on the Company’s consolidated balance sheet as of December 31, 2013 are as follows:
		As of December 31, 2013
(U.S. Dollars, in thousands except share and per share data)		Originally			Further			Restated
		Reported in			Restatement
		2013			Adjustments
		Form 10-K
Assets
Current assets:
Cash and cash equivalents		$	30,486		$	(1,562	)	$	28,924
Restricted cash			23,761			—			23,761
Trade accounts receivable, less allowances of $9,111			75,567			(4,756	)		70,811
Inventories			90,577			(17,899	)		72,678
Deferred income taxes			33,947			6,052			39,999
Prepaid expenses and other current assets			25,906			3,027			28,933
Total current assets			280,244			(15,138	)		265,106
Property, plant and equipment, net			54,606			(234	)		54,372
Patents and other intangible assets, net			9,046			—			9,046
Goodwill			53,565			—			53,565
Deferred income taxes			18,336			4,058			22,394
Other long-term assets			7,385			107			7,492
Total assets		$	423,182		$	(11,207	)	$	411,975
Liabilities and shareholders’ equity
Current liabilities:
Trade accounts payable		$	20,674		$	—		$	20,674
Other current liabilities			46,146			3,530			49,676
Total current liabilities			66,820			3,530			70,350
Long-term debt			20,000			—			20,000
Deferred income taxes			13,132			(106	)		13,026
Other long-term liabilities			12,736			—			12,736
Total liabilities			112,688			3,424			116,112
Contingencies (Note 17)
Shareholders’ equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 issued and outstanding			1,810			—			1,810
Additional paid-in capital			216,653			—			216,653
Retained earnings			89,332			(15,435	)		73,897
Accumulated other comprehensive income			2,699			804			3,503
Total shareholders’ equity			310,494			(14,631	)		295,863
Total liabilities and shareholders’ equity		$	423,182		$	(11,207	)	$	411,975
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated balance sheet as of December 31, 2012 are as follows:
		As of December 31, 2012
(U.S. Dollars, in thousands except share and per share data)		As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in the			Restatement
		10-K Prior to			Adjustments			2012			Adjustments
		Original						Form 10-K/A
		Restatement
Assets
Current assets:
Cash and cash equivalents		$	31,055		$	—		$	31,055		$	(288	)	$	30,767
Restricted cash			21,314			—			21,314			—			21,314
Trade accounts receivable, less allowances of $6,673			150,316			(43,004	)		107,312			(3,510	)		103,802
Inventories			88,744			(5,371	)		83,373			(13,560	)		69,813
Deferred income taxes			16,959			16,491			33,450			5,037			38,487
Prepaid expenses and other current assets			32,056			2,023			34,079			2,370			36,449
Total current assets			340,444			(29,861	)		310,583			(9,951	)		300,632
Property, plant and equipment, net			51,362			2,473			53,835			(1,042	)		52,793
Patents and other intangible assets, net			6,880			410			7,290			—			7,290
Goodwill			74,388			—			74,388			—			74,388
Deferred income taxes			19,904			(1,023	)		18,881			2,642			21,523
Other long-term assets			11,303			(3,383	)		7,920			—			7,920
Total assets		$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
Liabilities and shareholders’ equity
Current liabilities:
Bank borrowings		$	16		$	—		$	16		$	—		$	16
Trade accounts payable			21,812			763			22,575			—			22,575
Other current liabilities			46,969			(7,375	)		39,594			3,148			42,742
Total current liabilities			68,797			(6,612	)		62,185			3,148			65,333
Long-term debt			20,000			—			20,000			—			20,000
Deferred income taxes			11,456			—			11,456			(106	)		11,350
Other long-term liabilities			4,930			6,494			11,424			—			11,424
Total liabilities			105,183			(118	)		105,065			3,042			108,107
Contingencies (Note 17)
Shareholders’ equity
Common shares $0.10 par value; 50,000,000 shares authorized; 19,339,329 issued and outstanding			1,934			—			1,934			—			1,934
Additional paid-in capital			246,111			195			246,306			—			246,306
Retained earnings			148,549			(33,702	)		114,847			(12,138	)		102,709
Accumulated other comprehensive income			2,504			2,241			4,745			745			5,490
Total shareholders’ equity			399,098			(31,266	)		367,832			(11,393	)		356,439
Total liabilities and shareholders’ equity		$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
The effects of the Further Restatement on the Company’s consolidated statement of operations and comprehensive income for the year ended December 31, 2013 are as follows:
		Year Ended December 31, 2013
(U.S. Dollars, in thousands, except share and per share data)		Originally			Further			Restated
		Reported in 2013			Restatement
		Form 10-K			Adjustments
Product sales		$	352,796		$	(3,244	)	$	349,552
Marketing service fees			47,738			321			48,059
Net sales			400,534			(2,923	)		397,611
Cost of sales			102,300			4,612			106,912
Gross profit			298,234			(7,535	)		290,699
Operating expenses
Sales and marketing			176,581			(1,113	)		175,468
General and administrative			65,147			(317	)		64,830
Research and development			26,768			—			26,768
Amortization of intangible assets			2,687			—			2,687
Costs related to the accounting review and restatement			12,945			—			12,945
Impairment of Goodwill			19,193			—			19,193
			303,321			(1,430	)		301,891
Operating loss			(5,087	)		(6,105	)		(11,192	)
Other income and (expense)
Interest expense, net			(1,925	)		98			(1,827	)
Other expense			2,220			196			2,416
			295			294			589
Loss before income taxes			(4,792	)		(5,811	)		(10,603	)
Income tax expense			(10,116	)		2,514			(7,602	)
Net loss from continuing operations			(14,908	)		(3,297	)		(18,205	)
Discontinued operations (Note 16)
Loss from discontinued operations			(15,510	)		—			(15,510	)
Income tax benefit (expense)			4,903			—			4,903
Net loss from discontinued operations			(10,607	)		—			(10,607	)
Net loss		$	(25,515	)	$	(3,297	)	$	(28,812	)
Net loss per common share—basic:
Net loss from continuing operations		$	(0.80	)	$	(0.17	)	$	(0.97	)
Net loss from discontinued operations			(0.57	)		—			(0.57	)
Net loss per common share—basic		$	(1.37	)	$	(0.17	)	$	(1.54	)
Net loss per common share—diluted:
Net loss from continuing operations		$	(0.80	)	$	(0.17	)	$	(0.97	)
Net loss from discontinued operations			(0.57	)		—			(0.57	)
Net loss per common share—diluted		$	(1.37	)	$	(0.17	)	$	(1.54	)
Weighted average number of common shares:
Basic			18,697,228			—			18,697,228
Diluted			18,697,228			—			18,697,228
Other comprehensive loss, before tax:
Translation adjustment		$	(1,768	)	$	60		$	(1,708	)
Unrealized gain on derivative instrument			(442	)		(1	)		(443	)
Other comprehensive loss, before tax			(2,210	)		59			(2,151	)
Income tax expense related to components of other comprehensive income			164			—			164
Other comprehensive loss, net of tax			(2,046	)		59			(1,987	)
Comprehensive loss		$	(27,561	)	$	(3,238	)	$	(30,799	)
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of operations and comprehensive income for the year ended December 31, 2012 are as follows:
		Year Ended December 31, 2012
(U.S. Dollars, in thousands, except share and per share data)		As Reported in the			Original			As Originally			Further			Restated
		2012 Form 10-K			Restatement			Restated in the			Restatement
		Prior to Original			Adjustments			2012			Adjustments
		Restatement						Form 10-K/A
Product sales		$	415,850		$	(14,811	)	$	401,039		$	(7,392	)	$	393,647
Marketing service fees			46,470			72			46,542			—			46,542
Net sales			462,320			(14,739	)		447,581			(7,392	)		440,189
Cost of sales			86,492			11,761			98,253			2,473			100,726
Gross profit			375,828			(26,500	)		349,328			(9,865	)		339,463
Operating expenses
Sales and marketing			200,343			(13,212	)		187,131			(8,360	)		178,771
General and administrative			53,827			(436	)		53,391			259			53,650
Research and development			28,577			—			28,577			—			28,577
Amortization of intangible assets			2,098			200			2,298			—			2,298
Charges related to U.S. Government resolutions (Note 17)			1,973			(678	)		1,295			—			1,295
			286,818			(14,126	)		272,692			(8,101	)		264,591
Operating income			89,010			(12,374	)		76,636			(1,764	)		74,872
Other income and (expense)
Interest expense, net			(4,577	)		(166	)		(4,743	)		582			(4,161	)
Other expense			(1,705	)		—			(1,705	)		59			(1,646	)
			(6,282	)		(166	)		(6,448	)		641			(5,807	)
Income before income taxes			82,728			(12,540	)		70,188			(1,123	)		69,065
Income tax expense			(28,792	)		3,654			(25,138	)		1,194			(23,944	)
Net income from continuing operations			53,936			(8,886	)		45,050			71			45,121
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.,			1,345			—			1,345			—			1,345
Loss from discontinued operations			(4,012	)		1,018			(2,994	)		(500	)		(3,494	)
Income tax benefit (expense)			26			(589	)		(563	)		443			(120	)
Net loss from discontinued operations			(2,641	)		429			(2,212	)		(57	)		(2,269	)
Net income		$	51,295		$	(8,457	)	$	42,838		$	14		$	42,852
Net income (loss) per common share—basic:
Net income from continuing operations		$	2.84		$	(0.47	)	$	2.37		$	0.01		$	2.38
Net loss from discontinued operations			(0.14	)		0.02			(0.12	)		—			(0.12	)
Net income per common share—basic		$	2.7		$	(0.45	)	$	2.25		$	0.01		$	2.26
Net income (loss) per common share—diluted:
Net income from continuing operations		$	2.78		$	(0.46	)	$	2.32		$	0.01		$	2.33
Net loss from discontinued operations			(0.14	)		0.03			(0.11	)		(0.01	)		(0.12	)
Net income per common share—diluted:		$	2.64		$	(0.43	)	$	2.21		$	0		$	2.21
Weighted average number of common shares:
Basic			18,977,263			—			18,977,263			—			18,977,263
Diluted			19,390,413			—			19,390,413			—			19,390,413
Other comprehensive income, before tax:
Translation adjustment		$	480		$	288		$	768		$	363		$	1,131
Unrealized gain on derivative instrument			416			—			416			—			416
Other comprehensive income, before tax			896			288			1,184			363			1,547
Income tax expense related to components of other comprehensive income			(153	)		—			(153	)		—			(153	)
Other comprehensive income, net of tax			743			288			1,031			363			1,394
Comprehensive income		$	52,038		$	(8,169	)	$	43,869		$	377		$	44,246
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of operations and comprehensive loss for the year ended December 31, 2011 are as follows:
		Year Ended December 31, 2011
(U.S. Dollars, in thousands, except share and per share data)		As Reported in the			Original			As Originally			Further			Restated
		2012 Form 10-K			Restatement			Restated in the			Restatement
		Prior to Original			Adjustments			2012			Adjustments
		Restatement						Form 10-K/A
Product sales		$	432,975		$	(27,828	)	$	405,147			(6,452	)	$	398,695
Marketing service fees			37,146			(322	)		36,824			—			36,824
Net sales			470,121			(28,150	)		441,971			(6,452	)		435,519
Cost of sales			92,619			2,908			95,527			888			96,415
Gross profit			377,502			(31,058	)		346,444			(7,340	)		339,104
Operating expenses
Sales and marketing			200,145			(6,634	)		193,511			(8,355	)		185,156
General and administrative			64,374			107			64,481			304			64,785
Research and development			22,861			—			22,861			—			22,861
Amortization of intangible assets			2,350			200			2,550			—			2,550
Charges related to U.S. Government resolutions (Note 17)			56,463			678			57,141			—			57,141
			346,193			(5,649	)		340,544			(8,051	)		332,493
Operating income			31,309			(25,409	)		5,900			711			6,611
Other income and (expense)
Interest expense, net			(9,456	)		3,915			(5,541	)		100			(5,441	)
Other expense			(2,412	)		—			(2,412	)		(121	)		(2,533	)
			(11,868	)		3,915			(7,953	)		(21	)		(7,974	)
Income (loss) before income taxes			19,441			(21,494	)		(2,053	)		690			(1,363	)
Income tax expense			(21,181	)		7,016			(14,165	)		(278	)		(14,443	)
Net loss from continuing operations			(1,740	)		(14,478	)		(16,218	)		412			(15,806	)
Discontinued operations (Note 16)
Income (loss) from discontinued operations			1,263			(3,968	)		(2,705	)		—			(2,705	)
Income tax (expense) benefit			(596	)		1,409			813			—			813
Net income (loss) from discontinued operations			667			(2,559	)		(1,892	)		—			(1,892	)
Net loss		$	(1,073	)	$	(17,037	)	$	(18,110	)		412		$	(17,698	)
Net (loss) income per common share—basic:
Net loss from continuing operations		$	(0.10	)	$	(0.79	)	$	(0.89	)	$	0.02		$	(0.87	)
Net income (loss) from discontinued operations			0.04			(0.14	)		(0.10	)		—			(0.10	)
Net loss per common share—basic		$	(0.06	)	$	(0.93	)	$	(0.99	)	$	0.02		$	(0.97	)
Net (loss) income per common share—diluted:
Net loss from continuing operations		$	(0.10	)	$	(0.79	)	$	(0.89	)	$	0.02		$	(0.87	)
Net income (loss) from discontinued operations			0.04			(0.14	)		(0.10	)		—			(0.10	)
Net loss per common share—diluted:		$	(0.06	)	$	(0.93	)	$	(0.99	)	$	0.02		$	(0.97	)
Weighted average number of common shares:
Basic			18,219,343			—			18,219,343			—			18,219,343
Diluted			18,219,343			—			18,219,343			—			18,219,343
Other comprehensive loss, before tax:
Translation adjustment		$	(3,192	)	$	913		$	(2,279	)	$	382		$	(1,897	)
Unrealized loss on derivative instrument			(693	)		—			(693	)		—			(693	)
Other comprehensive loss, before tax			(3,885	)		913			(2,972	)		382			(2,590	)
Income tax benefit related to components of other comprehensive income			256			—			256			—			256
Other comprehensive loss, net of tax			(3,629	)		913			(2,716	)		382			(2,334	)
Comprehensive loss		$	(4,702	)	$	(16,124	)	$	(20,826	)		794		$	(20,032	)
The effects of Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2013 are as follows:
(U.S. Dollars, in thousands)		Year Ended December 31, 2013
		Originally			Further			Restated
		Reported in			Restatement
		2013			Adjustments
		Form 10-K
Cash flows from operating activities:
Net loss		$	(25,515	)	$	(3,297	)	$	(28,812	)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization			22,659			163			22,822
Amortization of debt costs			720			—			720
Amortization of exclusivity agreements			1,546			—			1,546
Provision for doubtful accounts			6,003			(1,413	)		4,590
Deferred income taxes			(1,986	)		4,815			2,829
Share-based compensation			6,267			—			6,267
Impairment of goodwill			19,193			—			19,193
Gain on sale of Breg, Inc., net of tax			—			—			—
Excess income tax benefit on employee stock-based awards			(82	)		—			(82	)
Income tax benefit (expense) on employee stock-based awards			795			(795	)		—
Other			4,442			94			4,536
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable			25,747			2,815			28,562
Inventories			(6,626	)		3,413			(3,213	)
Escrow receivable			—			—			—
Prepaid expenses and other current assets			6,791			1,973			8,764
Trade accounts payable			(2,280	)		—			(2,280	)
Charges related to U.S. Government resolutions			—			—			—
Other current liabilities			8,018			(1,049	)		6,969
Other long-term assets			2,750			(8,079	)		(5,329	)
Other long-term liabilities			(1,561	)		1,521			(40	)
Net cash provided by operating activities			66,881			161			67,042
Cash flows from investing activities:
Capital expenditures for property, plant and equipment			(24,787	)		—			(24,787	)
Capital expenditures for intangible assets			(4,891	)		—			(4,891	)
Purchase of other investments			—			(1,374	)		(1,374	)
Net proceeds from sale of Breg, Inc.			—			—			—
Net cash (used in) provided by investing activities			(29,678	)		(1,374	)		(31,052	)
Cash flows from financing activities:
Net proceeds from issuance of common shares			3,450			—			3,450
Payment of refinancing fees and debt issuance costs			—			—			—
Repayments of long-term debt			(16	)		—			(16	)
Repayment of bank borrowings, net			—			—			—
Changes in restricted cash			(2,375	)		—			(2,375	)
Purchase of common stock			(39,494	)		—			(39,494	)
Cash payment for purchase of minority interest in subsidiary			—			—			—
Excess income tax benefit on employee stock-based awards			82			—			82
Net cash used in financing activities			(38,353	)		—			(38,353	)
Effect of exchange rate changes on cash			581			(61	)		520
Net (decrease) increase in cash and cash equivalents			(569	)		(1,274	)		(1,843	)
Cash and cash equivalents at the beginning of the year			31,055			(288	)		30,767
Cash and cash equivalents at the end of the year		$	30,486		$	(1,562	)	$	28,924
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest		$	2,046		$	—		$	2,046
Income taxes		$	8,773		$	—		$	8,773
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2012 are as follows:
(U.S. Dollars, in thousands)		Year Ended December 31, 2012
		As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in			Restatement
		10-K Prior to			Adjustments			the 2012			Adjustments
		Original						Form 10-K/A
		Restatement
Cash flows from operating activities:
Net income		$	51,295		$	(8,457	)	$	42,838		$	14		$	42,852
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization			20,261			319			20,580			152			20,732
Amortization of debt costs			1,737			—			1,737			—			1,737
Amortization of exclusivity agreements			1,289			—			1,289			—			1,289
Provision for doubtful accounts			13,302			(2,730	)		10,572			(8,360	)		2,212
Deferred income taxes			871			(2,123	)		(1,252	)		5,023			3,771
Share-based compensation			6,303			—			6,303			—			6,303
Impairment of goodwill			—			—			—			—			—
Gain on sale of Breg, Inc, net of tax			(1,345	)		—			(1,345	)		—			(1,345	)
Excess income tax benefit on employee stock-based awards			—			(1,020	)		(1,020	)		—			(1,020	)
Income tax benefit on employee-stock-based awards			—			2,910			2,910			(2,910	)		—
Other			2,125			2,011			4,136			662			4,798
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable			(31,600	)		13,162			(18,438	)		7,310			(11,128	)
Inventories			(6,341	)		3,846			(2,495	)		2,111			(384	)
Escrow receivable			41,537			—			41,537			—			41,537
Prepaid expenses and other current assets			(6,191	)		(9,386	)		(15,577	)		1,002			(14,575	)
Trade accounts payable			5,554			(979	)		4,575			—			4,575
Charges related to U.S. Government resolutions			(82,500	)		(678	)		(83,178	)		—			(83,178	)
Other current liabilities			(2,842	)		(2,887	)		(5,729	)		490			(5,239	)
Other long-term assets			(2,114	)		4,241			2,127			(5,518	)		(3,391	)
Other long-term liabilities			(135	)		751			616			—			616
Net cash provided by operating activities			11,206			(1,020	)		10,186			(24	)		10,162
Cash flows from investing activities:
Capital expenditures for property, plant and equipment			(27,994	)		—			(27,994	)		—			(27,994	)
Capital expenditures for intangible assets			(780	)		—			(780	)		—			(780	)
Purchase of other investments			—			—			—			(714	)		(714	)
Proceeds from sale of other investments			—			—			—			878			878
Net proceeds from sale of Breg Inc.			153,773			—			153,773			—			153,773
Net cash provided by (used in) investing activities			124,999			—			124,999			164			125,163
Cash flows from financing activities:
Net proceeds from issuance of common shares			25,586			—			25,586			—			25,586
Payment of refinancing fees and debt issuance costs			—			—			—			—			—
Repayments of long-term debt			(188,695	)		—			(188,695	)		—			(188,695	)
Proceeds of bank borrowings, net			(1,297	)		—			(1,297	)		—			(1,297	)
Changes in restricted cash			25,799			—			25,799			—			25,799
Cash payment for purchase of minority interest in subsidiary			—			—			—			—			—
Excess income tax benefit on employee stock-based awards			—			1,020			1,020			—			1,020
Net cash used in financing activities			(138,607	)		1,020			(137,587	)		—			(137,587	)
Effect of exchange rates changes on cash			250			—			250			36			286
Net increase (decrease) in cash and cash equivalents			(2,152	)		—			(2,152	)		176			(1,976	)
Cash and cash equivalents at the beginning of the year			33,207			—			33,207			(464	)		32,743
Cash and cash equivalents at the end of the year		$	31,055		$	—		$	31,055		$	(288	)	$	30,767
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest		$	4,569		$	—		$	4,569		$	—		$	4,569
Income taxes		$	18,268		$	—		$	18,268		$	—		$	18,268
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2011 are as follows:
(U.S. Dollars, in thousands)		Year Ended December 31, 2011
		As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in			Restatement
		10-K Prior to			Adjustments			the 2012			Adjustments
		Original						Form 10-K/A
		Restatement
Cash flows from operating activities:
Net loss		$	(1,073	)	$	(17,037	)	$	(18,110	)	$	412		$	(17,698	)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization			22,776			241			23,017			165			23,182
Amortization of debt costs			1,239			—			1,239			—			1,239
Amortization of exclusivity agreements			374			—			374			—			374
Provision for doubtful accounts			11,532			1,404			12,936			(8,356	)		4,580
Deferred income taxes			936			(988	)		(52	)		(13,889	)		(13,941	)
Share-based compensation			6,648			—			6,648			—			6,648
Impairment of goodwill			—			—			—			—			—
Gain on sale of Breg, Inc, net of tax			—			—			—			—			—
Excess income tax benefit on employee stock-based awards			(1,737	)		—			(1,737	)		—			(1,737	)
Income tax benefit on employee-stock-based awards			—			—			—			—			—
Other			4,906			(415	)		4,491			(2,193	)		2,298	)
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable			(25,818	)		26,111			293			6,352			6,645
Inventories			(8,349	)		(4,275	)		(12,624	)		(81	)		(12,705	)
Escrow receivable			(32,562	)		—			(32,562	)		—			(32,562	)
Prepaid expenses and other current assets			(4,057	)		6,886			2,829			(447	)		2,382
Trade accounts payable			576			1,746			2,322			—			2,322
Charges related to U.S. Government resolutions			88,463			638			89,101			—			89,101
Other current liabilities			3,384			(1,965	)		1,419			2,097			3,516
Other long-term assets			(1,588	)		(16,093	)		(17,681	)		15,364			(2,317	)
Other long-term liabilities			(869	)		3,747			2,878			525			3,403
Net cash provided by operating activities			64,781			—			64,781			(51	)		64,730
Cash flows from investing activities:
Capital expenditures for property, plant and equipment			(24,965	)		—			(24,965	)		—			(24,965	)
Capital expenditures for intangible assets			(793	)		—			(793	)		—			(793	)
Payment made in connection with acquisition			(5,250	)		—			(5,250	)		—			(5,250	)
Purchase of other investments			—			—			—			(468	)		(468	)
Net cash provided by (used in) investing activities			(31,008	)		—			(31,008	)		(468	)		(31,476	)
Cash flows from financing activities:
Net proceeds from issuance of common shares			20,113			—			20,113			—			20,113
Payment of refinancing fees and debt issuance costs			(758	)		—			(758	)		—			(758	)
Repayments of long-term debt			(7,500	)		—			(7,500	)		—			(7,500	)
Proceeds of bank borrowings, net			(2,561	)		—			(2,561	)		—			(2,561	)
Changes in restricted cash			(24,178	)		—			(24,178	)		—			(24,178	)
Cash payment for purchase of minority interest in subsidiary			(517	)		—			(517	)		—			(517	)
Excess income tax benefit on employee stock-based awards			1,737			—			1,737			—			1,737
Net cash used in financing activities			(13,664	)		—			(13,664	)		—			(13,664	)
Effect of exchange rates changes on cash			(463	)		—			(463	)		55			(408	)
Net increase (decrease) in cash and cash equivalents			19,646			—			19,646			(464	)		19,182
Cash and cash equivalents at the beginning of the year			13,561			—			13,561			—			13,561
Cash and cash equivalents at the end of the year		$	33,207		$	—		$	33,207		$	(464	)	$	32,743
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest		$	17,088		$	—		$	17,088		$	—		$	17,088
Income taxes		$	26,227		$	—		$	26,227		$	—		$	26,227
2	Original and Further Restatement of the Consolidated Financial Statements
These consolidated financial statements reflect two restatements, which we refer to herein respectively as the “Original Restatement” and the “Further Restatement.” The Original Restatement, which was contained in the financial statements filed with the Company’s Annual Report on Form 10-K for the year ended December 31, 2013 filed on March 31, 2014 (the “Original Form 10-K”), reflected the restatement of the Company’s previously filed consolidated financial statements for the fiscal years ended December 31, 2012 and 2011, as well as the fiscal quarter ended March 31, 2013. The Original Restatement is further described below under the subheading “– Original Restatement.”
In connection with the Company’s preparation of its consolidated interim quarterly financial statements for the fiscal quarter ended June 30, 2014, the Company determined that certain entries with respect to the previously filed financial statements contained in the Original Form 10-K were not properly accounted for under U.S. GAAP. As further described below, these additional errors affect the fiscal years ended December 31, 2013, 2012 and 2011 and quarterly reporting periods contained within the fiscal years ended December 31, 2013 and 2012, as well as the fiscal quarter ended March 31, 2014. Due to these errors, the Company determined in August 2014 to restate its consolidated financial statements for the fiscal years ended December 31, 2013, 2012 and 2011 (including the interim quarterly periods contained within the fiscal years ended December 31, 2013 and 2012) and the fiscal quarter ended March 31, 2014, and that the previously filed financial statements for these periods should no longer be relied upon. The Amendment No. 1 to Annual Report on Form 10-K for the fiscal year ended December 31, 2013 (this “Amended Form 10-K”), to which these consolidated financial statements form a part, corrects these additional errors. We refer to these additional corrections as the “Further Restatement.” The Further Restatement is further described below under the subheading “Further Restatement,” which follows the description of the Original Restatement contained directly below.
Original Restatement
Background of Original Restatement
In July 2013, the Audit Committee (the “Audit Committee”) of the Company’s Board of Directors (the “Board”) commenced an independent review with the assistance of outside professionals into whether the Company had properly recognized revenue under U.S. GAAP in connection with certain revenue that had been recorded in 2012 and 2011 (the “Independent Review”). In conjunction with the Independent Review, the Company concluded that errors existed in the Company’s previously issued financial statements for the fiscal years ended December 31, 2012 and 2011, the interim quarterly period ended March 31, 2013, and certain other prior periods.
In reaching these conclusions, the Company considered information obtained in the Independent Review, including emails, data and interviews with current and former employees that indicated (i) the existence of extra-contractual terms or arrangements at the onset of the sale and concessions agreed to subsequent to the initial sale, such as extended payment terms and return and exchange rights for sales to distributors with respect to certain transactions, (ii) that at the time of some sales collection was not reasonably assured, and (iii) that certain amounts previously characterized as commissions were paid to related parties of the applicable customer.
The Company assessed the information derived from the Independent Review in making determinations with respect to accounting adjustments reflected in the restated consolidated financial statements contained in the Amendments and in its Annual Report on Form 10-K for the fiscal year ended December 31, 2013, and such determinations are consistent with the findings of the Independent Review. In addition to the matters that were the subject of the Independent Review, certain other adjustments identified by management, including revisions to inventory reserves and royalties, were made to the consolidated financial statements in connection with the restatement.
The correction of these errors had the following impact: decreased net sales by $14.7 million and $28.2 million for the years ended December 31, 2012 and 2011, respectively; and decreased net income from continuing operations by $8.9 million and $14.5 million for the years ended December 31, 2012 and 2011, respectively. The following include descriptions of the significant adjustments to the Company’s financial position and results of operations from the previously reported consolidated financial statements.
Distributor Revenue Recognition
The Company has determined that it previously recognized revenue with respect to certain distributor relationships before all revenue recognition criteria were met. Specifically, the Company has determined that a fixed or determinable sales price did not exist, and/or collection was not reasonably assured, with respect to certain transactions where revenue had previously been recognized at the time of shipment. Specifically, the Company’s review revealed arrangements, or extra-contractual terms, with certain of the Company’s distributors regarding extended payment terms, return or exchange rights, and contingent payment obligations for sales to such distributors with respect to certain transactions. There were also concessions being made subsequent to the shipment of inventory to the distributors and the related revenue recognition. Based on the results of this review, it was determined that these arrangements were not appropriately evaluated under the appropriate revenue recognition criteria applicable under U.S. GAAP. Distributor sales represented approximately 11–13% of the Company’s net sales (prior to the restatement) of approximately $462 million and $470 million for the years ended December 31, 2012 and 2011, respectively.
The Company previously recognized distributor revenue as title and risk of loss passed at either shipment from the Company’s facilities or receipt at the distributor’s facility, assuming all other revenue recognition criteria had been achieved (the “sell-in method”). Based on review of all facts and circumstances related to the arrangements described above, the Company determined that in many instances the revenue recognition criteria under the sell-in method were not satisfied at the time of shipment or receipt; specifically, the existence of extra-contractual terms or arrangements caused the Company not to meet the fixed or determinable criteria for revenue recognition in some cases, and in others collectability had not been established. In situations where the Company is unable to reasonably estimate the effects of these extra-contractual terms, it is precluded from recognizing revenue relating to distributor arrangements until the product is delivered to the end customer. This method is commonly referred to as the “sell-through” revenue recognition method because the vendor does not recognize revenue until the transaction consideration is fixed or determinable, which coincides with the selling of the product through the distribution channel to the end customer. Because the Company does not have reliable information about when its distributors sell the product through to end customers, the Company will use cash collection from distributors as a basis for revenue recognition under the sell-through method. Although in many cases the Company is legally entitled to the accounts receivable at the time of shipment, since the revenue recognition criteria has not been met, the Company has not recognized accounts receivables or any corresponding deferred revenues associated with these transactions.
As part of the review, the Company also considered the accounting treatment for the related cost of sales when distributor revenue is recognized on a sell-through basis. Previously, cost of sales were recognized upon shipment; however, the Company believes the matching of the recognition of costs of sales with revenue is preferred and therefore considered if such costs should be deferred until revenue is recognized on a sell-through basis. In making this assessment, the Company considered the financial viability of its distributors based on their creditworthiness to determine if collectability of amounts sufficient to realize the costs of the products shipped was reasonably assured at the time of shipment to these distributors. In instances where the distributor was determined to be financially viable, the Company determined that costs of sales should be deferred until the revenue is recognized. For those distributors where the Company has concluded that collectability was not reasonably assured, the Company has expensed the related cost of sales upon shipment.
Based on the results of the Independent Review, the Company determined that all distributor transactions should be transitioned to the sell-through method of accounting as of the dates described below:
	•		For distributor transactions within the Company’s Orthopedics division, the Company has determined that sell-through accounting should be applied within the Brazil subsidiary for all prior periods given the frequency with which the Company conducted business under extra-contractual and undocumented terms, as well as the Company’s inability to fully access underlying transactional and other information that would be necessary to evaluate transactions under a sell-in basis. For distributor transactions within the division outside the Brazil subsidiary, there were also sales to four distributors that did not meet the fixed or determinable or collectability revenue recognition criteria and therefore, such sales were adjusted to sell-through accounting in the restatement.
	•		For distributor transactions within the Company’s U.S. Spine division, the Company has determined that sell-through accounting should be applied beginning January 1, 2011. Following its consideration of the information provided from the Independent Review, the Company believes that January 1, 2011 is the date extra-contractual terms became pervasive in the Company’s U.S. business, and it is unaware of circumstances existing prior to that date that would require it to broadly apply sell-through accounting to all distributor transactions within the U.S. Spine division. Additionally, there were sales in 2012 and 2011 for which revenue was previously recognized that did not meet the fixed or determinable criteria and the product associated with such sales was subsequently returned in 2013 (i) under the terms of negotiated agreements whereby the Company terminated its relationships with two distributors and (ii) by an additional distributor who returned certain product sold pursuant to a contingent sales arrangement. Such sales represented approximately $3.3 million and $4.1 million for the years ended December 31, 2012 and 2011, respectively. Due to the return of the product, no revenue will be recognized for these transactions.
	•		The Company has determined that stimulation products sold to distributors within the Company’s U.S. Spine division during 2012 did not meet the fixed or determinable (and in some cases, collectability) revenue recognition criterion at the time of shipment. Therefore, the Company has determined that sell-through accounting should be applied for these sales. Management also determined that many of these distributors (or affiliates thereof) received commission payments as part of the sales transactions, which the Company previously recorded as sales and marketing expense. The Company has recorded adjustments in the restatement to net these commission expenses against revenue, as they represented product discounts.
	•		The Company has determined that it will prospectively apply sell-through accounting for all remaining distributor arrangements (which entails arrangements within the Company’s Orthopedics division outside the Brazil subsidiary) beginning April 1, 2013, the earliest date for which financial statements had not previously been issued by the Company at the time of the determination. Although the Independent Review did not provide information to indicate extra-contractual terms or that historical revenue recognition was inappropriate in these remaining instances, the Company believes the information from the Independent Review indicating that the Company has a history of extra-contractual arrangements for distributor transactions, as described above, provides additional information which should be considered in reassessing the application of sell-through accounting on a prospective basis, particularly given that the Company believes that there is a higher risk associated with distributor arrangements generally.
The effect of adjustments made to the Company’s previously filed consolidated statements of operations as a result of these matters are shown in the tables below. These adjustments also had the following effects on the Company’s previously filed consolidated balance sheets:
	•		Accounts receivable decreased as of December 31, 2012 by $41.3 million related to the de-recognition of receivables for which revenue has been deferred and will now be recognized on a sell-through basis, based on cash collections.
	•		Inventory increased as of December 31, 2012 by $11.0 million to recognize the costs of inventory shipments to distributors determined to be financially viable as discussed previously.
Inventory Reserves
The Company also identified material errors in inventory reserves. One error related to the Company recording an increase of $1.2 million to the Company’s excess and obsolete reserve in the second quarter of 2012 related to a product within the Spine business that was subsequently reversed by the Company in the fourth quarter of 2012. During the Company’s review, it was determined that removing the reserve in the fourth quarter of 2012 was not correct; therefore the reserve has been reinstated.
The Company has also determined that certain inconsistencies existed with respect to how the Company previously computed and recorded inventory reserves. As a result, the Company has reviewed the methodologies used to compute and record inventory reserves and determined that errors in the application of U.S. GAAP existed in prior periods, which required adjustment in these financial statements. Based on this review, the Company has determined that it previously made reductions to previously recorded reserves based on changes in forecasted demand, which it believes was contrary to guidance set forth in ASC Topic 330, Inventory (specifically ASC 330-10-35-14), which states that a write-down of inventory to the lower-of-cost-or-market value at the close of a fiscal year creates a new cost basis that subsequently should not be marked up based on changes in underlying circumstances. The restated consolidated financial statements contain several adjustments to reflect recomputed inventory reserves in each of the relevant periods.
These adjustments resulted in a decrease to inventory (due to an increase in reserves) as of December 31, 2012, by $14.8 million.
Royalties
The Company also reviewed the accounting for royalties and determined there were royalties classified as sales and marketing expense; however, such royalties were based on sales of products and were paid to doctors who consulted on development of those products. Given these amounts are attributable to the cost of producing the Company’s products, the Company determined they are correctly classified as cost of goods sold.
Other Adjustments
In addition to the adjustments recorded to address the Company’s errors in accounting for distributor revenue recognition, inventory reserves, and royalties, the Company has identified other errors that are generally not material, individually or in the aggregate, but have been recorded in connection with the restatement.
Included in Other Adjustments are adjustments to reclassify interest expense from continuing operations to discontinued operations of $3.9 million for the year ended December 31, 2011. The reclassification was necessary as the Company used a portion of the proceeds from the sale of Breg, Inc. to repay in full the remaining $87.5 million balance on the Term Loan Facility and pay down $57.5 million of amounts outstanding under the Revolving Credit Facility.
Further Restatement
Background of Further Restatement
During the second quarter of 2014, the Company’s management noted that the Company’s bad debt expense for its BioStim strategic business unit (“SBU”) during the first quarter of 2014 was higher than internally budgeted. As a result, the Company’s internal finance department reviewed bad debt expense entries in prior periods. In connection with this review, the Company also further considered its accounting methodology with respect to certain prior revenue adjustments related to uncollectible patient co-pay and self-pay amounts. As further described below, after performing this review, the Company determined that errors existed relating to the accounting for uncollectible patient co-pay and self-pay amounts, and that certain bad debt reserves originally recorded in fiscal years 2011 and 2012 were reversed in incorrect periods in the Original Restatement in connection with the change to sell-through accounting for certain distributors. After analyzing these errors, the Company determined to further restate its financial statements as described herein. In addition to these matters, certain other adjustments identified by management, including revisions to inventory reserves, intercompany profit adjustments and accounts receivable reserves, were made to the consolidated financial statements in connection with the Further Restatement, as discussed below.
Co-Pay and Self-Pay Revenue Adjustments
A majority of revenue from the Company’s BioStim SBU is derived from third parties, which is subject to change due to contractual adjustments related to commercial insurance carriers, and may include certain patient co-pay amounts. In addition, certain patient purchasers are without insurance, with revenue derived from “self-pay” arrangements. In previously issued financial statements, the Company recorded these co-pay and self-pay amounts as revenue with estimated uncollectible portions being recognized as bad debt expense. Upon further analysis, it was determined that because collectability of co-pay and self-pay amounts was not reasonably assured, the conditions for revenue recognition had not been met and revenue for those amounts should not have been recognized until collected.
Adjustments to correct the foregoing reduce equally both the Company’s historical net sales and its sales and marketing expense by approximately $2.2 million, $9.0 million and $6.0 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively. These adjustments have no effect on net income from continuing operations, net income or total assets in any period.
Bad Debt Timing Adjustments
In connection with the foregoing, the Company determined to review bad debt expense trends more broadly across all of its business units. As a result of this process, the Company determined that certain bad debt reserves originally recorded in fiscal years 2011 and 2012 were reversed in incorrect periods in the Original Restatement in connection with the change to sell-through accounting for certain distributors. Because the Original Restatement transferred these transactions to sell-through accounting (as opposed to sell-in accounting, which had been used when the original bad debt reserves were recorded), the bad debt reserve was reversed as part of the Original Restatement, as the receivable that was being reserved for was no longer recognized.
Adjustments to correct this error result in an increase of sales and marketing expense of $1.5 million and $1.1 million for the fiscal years ended December 31, 2013 and 2012 and a decrease of sales and marketing expense of $2.1 million for the fiscal year ended December 31, 2011. These adjustments resulted in no impact to the accounts receivable balance as of December 31, 2013 and an increase in accounts receivable by $1.5 million as of December 31, 2012.
Accounts Receivable Reserve Adjustments
As part of analyzing collections experience on accounts receivable, the Company identified that it had incorrectly considered certain deferred revenue amounts included in gross accounts receivable when calculating estimated reserves. Specifically, the computation of the contractual allowances and bad debt allowances, which serves to adjust accounts receivable to the estimated collectible amount, incorrectly assumed that some percentage of the deferred amounts would be collected, rather than fully deferring these amounts.
Adjustments to correct this error resulted in a net decrease in operating income of $0.7 million and $0.2 million for the fiscal years ended December 31, 2013 and 2011, respectively, and a net increase in operating income of $2.1 million for the fiscal year ended December 31, 2012.
This adjustment resulted in a decrease in accounts receivable, net (due to an increase in reserves) as of December 31, 2013 and 2012, by $4.2 million and $3.5 million, respectively.
Intercompany Profit Adjustments
The Company has two manufacturing facilities which support the inventory needs of other subsidiaries through intercompany sales transactions. These intercompany sales include a profit margin for the selling subsidiary (“intercompany profit”) that is eliminated by the Company as part of its consolidated financial reporting process. The elimination of intercompany profit requires determining the affected net inventory amounts and their related intercompany profit margin to eliminate all intercompany profit, resulting in all inventories being carried at historical cost in the Company’s consolidated financial statements.
As described further above under “Original Restatement – Inventory Reserves,” as part of the Original Restatement the Company made certain corrections to prior period excess and obsolete inventory reserves. The effect of these corrections was not properly considered when determining the adjustments needed to eliminate intercompany profits from inventories in the Original Restatement.
Adjustments to correct this error resulted in an increase to cost of sales of $1.1 million, $0.2 million and $0.3 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively.
This adjustment resulted in a decrease in inventory as of December 31, 2013 and 2012, by $2.6 million and $1.5 million, respectively.
Inventory
Inventory Existence
As part of the remediation activities that followed the Original Restatement, the Company expanded its procedures in the second quarter of 2014 to validate the existence of field inventory held by independent sales representatives and noted that, in many cases, this inventory had higher rates of missing inventory (“shrinkage”) than previously estimated. To determine whether these higher error rates were pervasive across its field inventory, the Company counted approximately 90% of its field inventory during the third and fourth fiscal quarters of 2014. These counts resulted in the identification of errors relating to previous estimates of shrinkage.
Adjustments in the Further Restatement to correct these errors, net of the related effect on previously recorded excess and obsolete inventory reserves, resulted in an increase to cost of sales of $0.4 million, $0.3 million and $0.2 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively.
These adjustments resulted in a decrease in inventory as of December 31, 2013 and 2012, by $1.0 million and $0.6 million, respectively.
Inventory Reserves
In connection with its remediation efforts associated with the material weakness noted in the Original Restatement related to inventory reserves the Company concluded that it was not appropriately calculating inventory reserves, including its consideration of demand assumptions for “kits”, which contain a variety of “piece part” components to be used during surgery that have various demand considerations, as well as inventory held by third parties under inventory purchase obligations.
Adjustments to correct these errors resulted in an increase to cost of sales of $3.2 million, 1.5 million and $0.1 million for the fiscal years ended December 31, 2013, 2012 and 2011, respectively. These adjustments resulted in a decrease to inventory (due to an increase in reserves) as of December 31, 2013 and 2012, by $14.4 million and $11.8 million, respectively.
Other Adjustments
In addition to the adjustments described above, the Company is correcting certain other items. Principally, these items consist of a decrease to income tax expense of $0.5 million and $1.1 million for the fiscal years ended December 31, 2013 and 2012, respectively, these adjustments are separate from the tax effect of the errors described above.
The effect of the Further Restatement adjustments made to the Company’s previously filed consolidated statements of operations as a result of these matters are shown in the tables below. These adjustments also resulted in a decrease of total assets of $11.2 million as of December 31, 2013, resulting primarily from a decrease of $17.9 million to inventory and $4.8 million to trade accounts receivable, partially offset by an increase of $6.0 million in deferred income taxes. For further discussion of the effect of these entries on retained earnings, see the “Cumulative Adjustments to Shareholders’ Equity at January 1, 2011” table below.
The tables below show the effects of the Original Restatement for each of the fiscal years ended December 31, 2012 and 2011, as well as the effects of the Further Restatement for each of the fiscal years ended December 31, 2013, 2012 and 2011. In each case, the tax effect of the adjustments is estimated based on the Company’s estimated tax rate.
		Year Ended December 31, 2013
					Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)		Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Reported			Self-Pay			Timing			Receivable			Profit									Restatement
					Revenue						Reserve												Adjustments
Net sales		$	400,534		$	(2,242	)	$	—		$	(582	)	$	—		$	—		$	(99	)	$	(2,923	)	$	397,611
Cost of sales			102,300			—			—			—			1,090			3,688			(166	)		4,612			106,912
Gross profit			298,234			(2,242	)		—			(582	)		(1,090	)		(3,688	)		67			(7,535	)		290,699
Operating expenses
Sales and marketing			176,581			(2,242	)		1,455			122			—			—			(448	)		(1,113	)		175,468
General and administrative			65,147			—			—			—			—			—			(317	)		(317	)		64,830
Research and development			26,768			—			—			—			—			—			—			—			26,768
Amortization of intangible assets			2,687			—			—			—			—			—			—			—			2,687
Costs related to the accounting review and restatement			12,945			—			—			—			—			—			—			—			12,945
Impairment of Goodwill			19,193			—			—			—			—			—			—			—			19,193
			303,321			(2,242	)		1,455			122			—			—			(765	)		(1,430	)		301,891
Operating (loss) income			(5,087	)		—			(1,455	)		(704	)		(1,090	)		(3,688	)		832			(6,105	)		(11,192	)
Other income and (expense)			295			—			—			—			—			—			294			294			589
Loss before income taxes			(4,792	)		—			(1,455	)		(704	)		(1,090	)		(3,688	)		1,126			(5,811	)		(10,603	)
Income tax expense			(10,116	)		—			509			246			381			1,290			88			2,514			(7,602	)
Net loss from continuing operations		$	(14,908	)	$	—		$	(946	)	$	(458	)	$	(709	)	$	(2,398	)	$	1,214		$	(3,297	)	$	(18,205	)
		Year Ended December 31, 2012
					Original Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
		in the 2012			Revenue			Reserves									Restatement			Restated in
		Form 10-K															Adjustments			2012
		Prior to																		Form 10-K/A
		Original
		Restatement
Net sales		$	462,320		$	(14,777	)	$	—		$	—		$	38		$	(14,739	)	$	447,581
Cost of sales			86,492			(2,032	)		5,647			8,190			(44	)		11,761			98,253
Gross profit			375,828			(12,745	)		(5,647	)		(8,190	)		82			(26,500	)		349,328
Operating expenses
Sales and marketing			200,343			(6,629	)		—			(8,190	)		1,607			(13,212	)		187,131
General and administrative			53,827			(2	)		—			—			(434	)		(436	)		53,391
Research and development			28,577			—			—			—			—			—			28,577
Amortization of intangible assets			2,098			—			—			—			200			200			2,298
Charges related to U.S. Government resolutions			1,973			—			—			—			(678	)		(678	)		1,295
			286,818			(6,631	)		—			(8,190	)		695			(14,126	)		272,692
Operating income			89,010			(6,114	)		(5,647	)		—			(613	)		(12,374	)		76,636
Other income and (expense)			(6,282	)		—			—			—			(166	)		(166	)		(6,448	)
Income before income taxes			82,728			(6,114	)		(5,647	)		—			(779	)		(12,540	)		70,188
Income tax expense			(28,792	)		1,782			1,645			—			227			3,654			(25,138	)
Net income from continuing operations		$	53,936		$	(4,332	)	$	(4,002	)	$	—		$	(552	)	$	(8,886	)	$	45,050
		Year Ended December 31, 2012
					Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Restated in			Self-Pay			Timing			Receivable			Profit									Restatement
		2012			Revenue						Reserve												Adjustments
		Form 10-K/A
Net sales		$	447,581		$	(9,049	)	$	—		$	1,653		$	—		$	—		$	4		$	(7,392	)	$	440,189
Cost of sales			98,253			—			—			—			207			1,774			492			2,473			100,726
Gross profit			349,328			(9,049	)		—			1,653			(207	)		(1,774	)		(488	)	$	(9,865	)		339,463
Operating expenses
Sales and marketing			187,131			(9,049	)		1,097			(408	)		—			—			—		$	(8,360	)		178,771
General and administrative			53,391			—			—			—			—			—			259			259			53,650
Research and development			28,577			—			—			—			—			—			—			—			28,577
Amortization of intangible assets			2,298			—			—			—			—			—			—			—			2,298
Charges related to U.S. Government resolutions			1,295			—			—			—			—			—			—			—			1,295
			272,692			(9,049	)		1,097			(408	)		—			—			259			(8,101	)		264,591
Operating income			76,636			—			(1,097	)		2,061			(207	)		(1,774	)		(747	)		(1,764	)		74,872
Other income and (expense)			(6,448	)		—			—			—			—			—			641			641		$	(5,807	)
Income before income taxes			70,188			—			(1,097	)		2,061			(207	)		(1,774	)		(106	)		(1,123	)		69,065
Income tax expense			(25,138	)		—			384			(721	)		72			621			838			1,194		$	(23,944	)
Net income from continuing operations		$	45,050		$	—		$	(713	)	$	1,340		$	(135	)	$	(1,153	)	$	732		$	71		$	45,121
		Year Ended December 31, 2011
					Original Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
		in the 2012			Revenue			Reserves									Restatement			Restated in
		Form 10-K															Adjustments			2012
		Prior to																		Form 10-K/A
		Original
		Restatement
Net sales		$	470,121		$	(29,135	)	$	—		$	—		$	985		$	(28,150	)	$	441,971
Cost of sales			92,619			(8,289	)		3,377			7,713			107			2,908			95,527
Gross profit			377,502			(20,846	)		(3,377	)		(7,713	)		878			(31,058	)		346,444
Operating expenses
Sales and marketing			200,145			(1,216	)		—			(7,713	)		2,295			(6,634	)		193,511
General and administrative			64,374			—			—			—			107			107			64,481
Research and development			22,861			—			—			—			—			—			22,861
Amortization of intangible assets			2,350			—			—			—			200			200			2,550
Charges related to U.S. Government resolutions			56,463			—			—			—			678			678			57,141
			346,193			(1,216	)		—			(7,713	)		3,280			(5,649	)		340,544
Operating income			31,309			(19,630	)		(3,377	)		—			(2,402	)		(25,409	)		5,900
Other income and (expense)			(11,868	)		—			—			—			3,915			3,915			(7,953	)
Income (loss) before income taxes			19,441			(19,630	)		(3,377	)		—			1,513			(21,494	)		(2,053	)
Income tax expense			(21,181	)		6,408			1,102			—			(494	)		7,016			(14,165	)
Net loss from continuing operations		$	(1,740	)	$	(13,222	)	$	(2,275	)	$	—		$	1,019		$	(14,478	)	$	(16,218	)
		Year Ended December 31, 2011
					Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)		As Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Restated in			Self-Pay			Timing			Receivable			Profit									Restatement
		2012			Revenue						Reserve												Adjustments
		Form 10-K/A
Net sales		$	441,971		$	(5,960	)	$	—		$	(439	)	$	—		$	—		$	(53	)	$	(6,452	)	$	435,519
Cost of sales			95,527			—			—			—			253			321			314			888			96,415
Gross profit			346,444			(5,960	)		—			(439	)		(253	)		(321	)		(367	)		(7,340	)		339,104
Operating expenses
Sales and marketing			193,511			(5,960	)		(2,143	)		(252	)		—			—			—			(8,355	)		185,156
General and administrative			64,481			—			—			—			—			—			304			304			64,785
Research and development			22,861			—			—			—			—			—			—			—			22,861
Amortization of intangible assets			2,550			—			—			—			—			—			—			—			2,550
Charges related to U.S. Government resolutions			57,141			—			—			—			—			—			—			—			57,141
			340,544			(5,960	)		(2,143	)		(252	)		—			—			304			(8,051	)		332,493
Operating income			5,900			—			2,143			(187	)		(253	)		(321	)		(671	)		711			6,611
Other income and (expense)			(7,953	)		—			—			—			—			—			(21	)		(21	)		(7,974	)
Loss before income taxes			(2,053	)		—			2,143			(187	)		(253	)		(321	)		(692	)		690			(1,363	)
Income tax expense			(14,165	)		—			(752	)		66			89			113			206			(278	)		(14,443	)
Net loss from continuing operations		$	(16,218	)	$	—		$	1,391		$	(121	)	$	(164	)	$	(208	)	$	(486	)	$	412		$	(15,806	)
The effects of the Further Restatement on the Company’s consolidated balance sheet as of December 31, 2013 are as follows:
		As of December 31, 2013
(U.S. Dollars, in thousands except share and per share data)		Originally			Further			Restated
		Reported in			Restatement
		2013			Adjustments
		Form 10-K
Assets
Current assets:
Cash and cash equivalents		$	30,486		$	(1,562	)	$	28,924
Restricted cash			23,761			—			23,761
Trade accounts receivable, less allowances of $9,111			75,567			(4,756	)		70,811
Inventories			90,577			(17,899	)		72,678
Deferred income taxes			33,947			6,052			39,999
Prepaid expenses and other current assets			25,906			3,027			28,933
Total current assets			280,244			(15,138	)		265,106
Property, plant and equipment, net			54,606			(234	)		54,372
Patents and other intangible assets, net			9,046			—			9,046
Goodwill			53,565			—			53,565
Deferred income taxes			18,336			4,058			22,394
Other long-term assets			7,385			107			7,492
Total assets		$	423,182		$	(11,207	)	$	411,975
Liabilities and shareholders’ equity
Current liabilities:
Trade accounts payable		$	20,674		$	—		$	20,674
Other current liabilities			46,146			3,530			49,676
Total current liabilities			66,820			3,530			70,350
Long-term debt			20,000			—			20,000
Deferred income taxes			13,132			(106	)		13,026
Other long-term liabilities			12,736			—			12,736
Total liabilities			112,688			3,424			116,112
Contingencies (Note 17)
Shareholders’ equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 issued and outstanding			1,810			—			1,810
Additional paid-in capital			216,653			—			216,653
Retained earnings			89,332			(15,435	)		73,897
Accumulated other comprehensive income			2,699			804			3,503
Total shareholders’ equity			310,494			(14,631	)		295,863
Total liabilities and shareholders’ equity		$	423,182		$	(11,207	)	$	411,975
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated balance sheet as of December 31, 2012 are as follows:
		As of December 31, 2012
(U.S. Dollars, in thousands except share and per share data)		As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in the			Restatement
		10-K Prior to			Adjustments			2012			Adjustments
		Original						Form 10-K/A
		Restatement
Assets
Current assets:
Cash and cash equivalents		$	31,055		$	—		$	31,055		$	(288	)	$	30,767
Restricted cash			21,314			—			21,314			—			21,314
Trade accounts receivable, less allowances of $6,673			150,316			(43,004	)		107,312			(3,510	)		103,802
Inventories			88,744			(5,371	)		83,373			(13,560	)		69,813
Deferred income taxes			16,959			16,491			33,450			5,037			38,487
Prepaid expenses and other current assets			32,056			2,023			34,079			2,370			36,449
Total current assets			340,444			(29,861	)		310,583			(9,951	)		300,632
Property, plant and equipment, net			51,362			2,473			53,835			(1,042	)		52,793
Patents and other intangible assets, net			6,880			410			7,290			—			7,290
Goodwill			74,388			—			74,388			—			74,388
Deferred income taxes			19,904			(1,023	)		18,881			2,642			21,523
Other long-term assets			11,303			(3,383	)		7,920			—			7,920
Total assets		$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
Liabilities and shareholders’ equity
Current liabilities:
Bank borrowings		$	16		$	—		$	16		$	—		$	16
Trade accounts payable			21,812			763			22,575			—			22,575
Other current liabilities			46,969			(7,375	)		39,594			3,148			42,742
Total current liabilities			68,797			(6,612	)		62,185			3,148			65,333
Long-term debt			20,000			—			20,000			—			20,000
Deferred income taxes			11,456			—			11,456			(106	)		11,350
Other long-term liabilities			4,930			6,494			11,424			—			11,424
Total liabilities			105,183			(118	)		105,065			3,042			108,107
Contingencies (Note 17)
Shareholders’ equity
Common shares $0.10 par value; 50,000,000 shares authorized; 19,339,329 issued and outstanding			1,934			—			1,934			—			1,934
Additional paid-in capital			246,111			195			246,306			—			246,306
Retained earnings			148,549			(33,702	)		114,847			(12,138	)		102,709
Accumulated other comprehensive income			2,504			2,241			4,745			745			5,490
Total shareholders’ equity			399,098			(31,266	)		367,832			(11,393	)		356,439
Total liabilities and shareholders’ equity		$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
The effects of the Further Restatement on the Company’s consolidated statement of operations and comprehensive income for the year ended December 31, 2013 are as follows:
		Year Ended December 31, 2013
(U.S. Dollars, in thousands, except share and per share data)		Originally			Further			Restated
		Reported in 2013			Restatement
		Form 10-K			Adjustments
Product sales		$	352,796		$	(3,244	)	$	349,552
Marketing service fees			47,738			321			48,059
Net sales			400,534			(2,923	)		397,611
Cost of sales			102,300			4,612			106,912
Gross profit			298,234			(7,535	)		290,699
Operating expenses
Sales and marketing			176,581			(1,113	)		175,468
General and administrative			65,147			(317	)		64,830
Research and development			26,768			—			26,768
Amortization of intangible assets			2,687			—			2,687
Costs related to the accounting review and restatement			12,945			—			12,945
Impairment of Goodwill			19,193			—			19,193
			303,321			(1,430	)		301,891
Operating loss			(5,087	)		(6,105	)		(11,192	)
Other income and (expense)
Interest expense, net			(1,925	)		98			(1,827	)
Other expense			2,220			196			2,416
			295			294			589
Loss before income taxes			(4,792	)		(5,811	)		(10,603	)
Income tax expense			(10,116	)		2,514			(7,602	)
Net loss from continuing operations			(14,908	)		(3,297	)		(18,205	)
Discontinued operations (Note 16)
Loss from discontinued operations			(15,510	)		—			(15,510	)
Income tax benefit (expense)			4,903			—			4,903
Net loss from discontinued operations			(10,607	)		—			(10,607	)
Net loss		$	(25,515	)	$	(3,297	)	$	(28,812	)
Net loss per common share—basic:
Net loss from continuing operations		$	(0.80	)	$	(0.17	)	$	(0.97	)
Net loss from discontinued operations			(0.57	)		—			(0.57	)
Net loss per common share—basic		$	(1.37	)	$	(0.17	)	$	(1.54	)
Net loss per common share—diluted:
Net loss from continuing operations		$	(0.80	)	$	(0.17	)	$	(0.97	)
Net loss from discontinued operations			(0.57	)		—			(0.57	)
Net loss per common share—diluted		$	(1.37	)	$	(0.17	)	$	(1.54	)
Weighted average number of common shares:
Basic			18,697,228			—			18,697,228
Diluted			18,697,228			—			18,697,228
Other comprehensive loss, before tax:
Translation adjustment		$	(1,768	)	$	60		$	(1,708	)
Unrealized gain on derivative instrument			(442	)		(1	)		(443	)
Other comprehensive loss, before tax			(2,210	)		59			(2,151	)
Income tax expense related to components of other comprehensive income			164			—			164
Other comprehensive loss, net of tax			(2,046	)		59			(1,987	)
Comprehensive loss		$	(27,561	)	$	(3,238	)	$	(30,799	)
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of operations and comprehensive income for the year ended December 31, 2012 are as follows:
		Year Ended December 31, 2012
(U.S. Dollars, in thousands, except share and per share data)		As Reported in the			Original			As Originally			Further			Restated
		2012 Form 10-K			Restatement			Restated in the			Restatement
		Prior to Original			Adjustments			2012			Adjustments
		Restatement						Form 10-K/A
Product sales		$	415,850		$	(14,811	)	$	401,039		$	(7,392	)	$	393,647
Marketing service fees			46,470			72			46,542			—			46,542
Net sales			462,320			(14,739	)		447,581			(7,392	)		440,189
Cost of sales			86,492			11,761			98,253			2,473			100,726
Gross profit			375,828			(26,500	)		349,328			(9,865	)		339,463
Operating expenses
Sales and marketing			200,343			(13,212	)		187,131			(8,360	)		178,771
General and administrative			53,827			(436	)		53,391			259			53,650
Research and development			28,577			—			28,577			—			28,577
Amortization of intangible assets			2,098			200			2,298			—			2,298
Charges related to U.S. Government resolutions (Note 17)			1,973			(678	)		1,295			—			1,295
			286,818			(14,126	)		272,692			(8,101	)		264,591
Operating income			89,010			(12,374	)		76,636			(1,764	)		74,872
Other income and (expense)
Interest expense, net			(4,577	)		(166	)		(4,743	)		582			(4,161	)
Other expense			(1,705	)		—			(1,705	)		59			(1,646	)
			(6,282	)		(166	)		(6,448	)		641			(5,807	)
Income before income taxes			82,728			(12,540	)		70,188			(1,123	)		69,065
Income tax expense			(28,792	)		3,654			(25,138	)		1,194			(23,944	)
Net income from continuing operations			53,936			(8,886	)		45,050			71			45,121
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.,			1,345			—			1,345			—			1,345
Loss from discontinued operations			(4,012	)		1,018			(2,994	)		(500	)		(3,494	)
Income tax benefit (expense)			26			(589	)		(563	)		443			(120	)
Net loss from discontinued operations			(2,641	)		429			(2,212	)		(57	)		(2,269	)
Net income		$	51,295		$	(8,457	)	$	42,838		$	14		$	42,852
Net income (loss) per common share—basic:
Net income from continuing operations		$	2.84		$	(0.47	)	$	2.37		$	0.01		$	2.38
Net loss from discontinued operations			(0.14	)		0.02			(0.12	)		—			(0.12	)
Net income per common share—basic		$	2.7		$	(0.45	)	$	2.25		$	0.02		$	2.26
Net income (loss) per common share—diluted:
Net income from continuing operations		$	2.78		$	(0.46	)	$	2.32		$	0.01		$	2.33
Net loss from discontinued operations			(0.14	)		0.03			(0.11	)		(0.01	)		(0.12	)
Net income per common share—diluted:		$	2.64		$	(0.43	)	$	2.21		$	0		$	2.21
Weighted average number of common shares:
Basic			18,977,263			—			18,977,263			—			18,977,263
Diluted			19,390,413			—			19,390,413			—			19,390,413
Other comprehensive income, before tax:
Translation adjustment		$	480		$	288		$	768		$	363		$	1,131
Unrealized gain on derivative instrument			416			—			416			—			416
Other comprehensive income, before tax			896			288			1,184			363			1,547
Income tax expense related to components of other comprehensive income			(153	)		—			(153	)		—			(153	)
Other comprehensive income, net of tax			743			288			1,031			363			1,394
Comprehensive income		$	52,038		$	(8,169	)	$	43,869		$	377		$	44,246
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of operations and comprehensive loss for the year ended December 31, 2011 are as follows:
		Year Ended December 31, 2011
(U.S. Dollars, in thousands, except share and per share data)		As Reported in the			Original			As Originally			Further			Restated
		2012 Form 10-K			Restatement			Restated in the			Restatement
		Prior to Original			Adjustments			2012			Adjustments
		Restatement						Form 10-K/A
Product sales		$	432,975		$	(27,828	)	$	405,147			(6,452	)	$	398,695
Marketing service fees			37,146			(322	)		36,824			—			36,824
Net sales			470,121			(28,150	)		441,971			(6,452	)		435,519
Cost of sales			92,619			2,908			95,527			888			96,415
Gross profit			377,502			(31,058	)		346,444			(7,340	)		339,104
Operating expenses
Sales and marketing			200,145			(6,634	)		193,511			(8,355	)		185,156
General and administrative			64,374			107			64,481			304			64,785
Research and development			22,861			—			22,861			—			22,861
Amortization of intangible assets			2,350			200			2,550			—			2,550
Charges related to U.S. Government resolutions (Note 17)			56,463			678			57,141			—			57,141
			346,193			(5,649	)		340,544			(8,051	)		332,493
Operating income			31,309			(25,409	)		5,900			711			6,611
Other income and (expense)
Interest expense, net			(9,456	)		3,915			(5,541	)		100			(5,441	)
Other expense			(2,412	)		—			(2,412	)		(121	)		(2,533	)
			(11,868	)		3,915			(7,953	)		(21	)		(7,974	)
Income (loss) before income taxes			19,441			(21,494	)		(2,053	)		690			(1,363	)
Income tax expense			(21,181	)		7,016			(14,165	)		(278	)		(14,443	)
Net loss from continuing operations			(1,740	)		(14,478	)		(16,218	)		412			(15,806	)
Discontinued operations (Note 16)
Income (loss) from discontinued operations			1,263			(3,968	)		(2,705	)		—			(2,705	)
Income tax (expense) benefit			(596	)		1,409			813			—			813
Net income (loss) from discontinued operations			667			(2,559	)		(1,892	)		—			(1,892	)
Net loss		$	(1,073	)	$	(17,037	)	$	(18,110	)		412		$	(17,698	)
Net (loss) income per common share—basic:
Net loss from continuing operations		$	(0.10	)	$	(0.79	)	$	(0.89	)	$	0.02		$	(0.87	)
Net income (loss) from discontinued operations			0.04			(0.14	)		(0.10	)		—			(0.10	)
Net loss per common share—basic		$	(0.06	)	$	(0.93	)	$	(0.99	)	$	0.02		$	(0.97	)
Net (loss) income per common share—diluted:
Net loss from continuing operations		$	(0.10	)	$	(0.79	)	$	(0.89	)	$	0.02		$	(0.87	)
Net income (loss) from discontinued operations			0.04			(0.14	)		(0.10	)		—			(0.10	)
Net loss per common share—diluted:		$	(0.06	)	$	(0.93	)	$	(0.99	)	$	0.02		$	(0.97	)
Weighted average number of common shares:
Basic			18,219,343			—			18,219,343			—			18,219,343
Diluted			18,219,343			—			18,219,343			—			18,219,343
Other comprehensive loss, before tax:
Translation adjustment		$	(3,192	)	$	913		$	(2,279	)	$	382		$	(1,897	)
Unrealized loss on derivative instrument			(693	)		—			(693	)		—			(693	)
Other comprehensive loss, before tax			(3,885	)		913			(2,972	)		382			(2,590	)
Income tax benefit related to components of other comprehensive income			256			—			256			—			256
Other comprehensive loss, net of tax			(3,629	)		913			(2,716	)		382			(2,334	)
Comprehensive loss		$	(4,702	)	$	(16,124	)	$	(20,826	)		794		$	(20,032	)
The effects of Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2013 are as follows:
(U.S. Dollars, in thousands)		Year Ended December 31, 2013
		Originally			Further			Restated
		Reported in			Restatement
		2013			Adjustments
		Form 10-K
Cash flows from operating activities:
Net loss		$	(25,515	)	$	(3,297	)	$	(28,812	)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization			22,659			163			22,822
Amortization of debt costs			720			—			720
Amortization of exclusivity agreements			1,546			—			1,546
Provision for doubtful accounts			6,003			(1,413	)		4,590
Deferred income taxes			(1,986	)		4,815			2,829
Share-based compensation			6,267			—			6,267
Impairment of goodwill			19,193			—			19,193
Gain on sale of Breg, Inc., net of tax			—			—			—
Excess income tax benefit on employee stock-based awards			(82	)		—			(82	)
Income tax benefit (expense) on employee stock-based awards			795			(795	)		—
Other			4,442			94			4,536
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable			25,747			2,815			28,562
Inventories			(6,626	)		3,413			(3,213	)
Escrow receivable			—			—			—
Prepaid expenses and other current assets			6,791			1,973			8,764
Trade accounts payable			(2,280	)		—			(2,280	)
Charges related to U.S. Government resolutions			—			—			—
Other current liabilities			8,018			(1,049	)		6,969
Other long-term assets			2,750			(8,079	)		(5,329	)
Other long-term liabilities			(1,561	)		1,521			(40	)
Net cash provided by operating activities			66,881			161			67,042
Cash flows from investing activities:
Capital expenditures for property, plant and equipment			(24,787	)		—			(24,787	)
Capital expenditures for intangible assets			(4,891	)		—			(4,891	)
Purchase of other investments			—			(1,374	)		(1,374	)
Net proceeds from sale of Breg, Inc.			—			—			—
Net cash (used in) provided by investing activities			(29,678	)		(1,374	)		(31,052	)
Cash flows from financing activities:
Net proceeds from issuance of common shares			3,450			—			3,450
Payment of refinancing fees and debt issuance costs			—			—			—
Repayments of long-term debt			(16	)		—			(16	)
Repayment of bank borrowings, net			—			—			—
Changes in restricted cash			(2,375	)		—			(2,375	)
Purchase of common stock			(39,494	)		—			(39,494	)
Cash payment for purchase of minority interest in subsidiary			—			—			—
Excess income tax benefit on employee stock-based awards			82			—			82
Net cash used in financing activities			(38,353	)		—			(38,353	)
Effect of exchange rate changes on cash			581			(61	)		520
Net (decrease) increase in cash and cash equivalents			(569	)		(1,274	)		(1,843	)
Cash and cash equivalents at the beginning of the year			31,055			(288	)		30,767
Cash and cash equivalents at the end of the year		$	30,486		$	(1,562	)	$	28,924
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest		$	2,046		$	—		$	2,046
Income taxes		$	8,773		$	—		$	8,773
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2012 are as follows:
(U.S. Dollars, in thousands)		Year Ended December 31, 2012
		As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in			Restatement
		10-K Prior to			Adjustments			the 2012			Adjustments
		Original						Form 10-K/A
		Restatement
Cash flows from operating activities:
Net income		$	51,295		$	(8,457	)	$	42,838		$	14		$	42,852
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization			20,261			319			20,580			152			20,732
Amortization of debt costs			1,737			—			1,737			—			1,737
Amortization of exclusivity agreements			1,289			—			1,289			—			1,289
Provision for doubtful accounts			13,302			(2,730	)		10,572			(8,360	)		2,212
Deferred income taxes			871			(2,123	)		(1,252	)		5,023			3,771
Share-based compensation			6,303			—			6,303			—			6,303
Impairment of goodwill			—			—			—			—			—
Gain on sale of Breg, Inc, net of tax			(1,345	)		—			(1,345	)		—			(1,345	)
Excess income tax benefit on employee stock-based awards			—			(1,020	)		(1,020	)		—			(1,020	)
Income tax benefit on employee-stock-based awards			—			2,910			2,910			(2,910	)		—
Other			2,125			2,011			4,136			662			4,798
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable			(31,600	)		13,162			(18,438	)		7,310			(11,128	)
Inventories			(6,341	)		3,846			(2,495	)		2,111			(384	)
Escrow receivable			41,537			—			41,537			—			41,537
Prepaid expenses and other current assets			(6,191	)		(9,386	)		(15,577	)		1,002			(14,575	)
Trade accounts payable			5,554			(979	)		4,575			—			4,575
Charges related to U.S. Government resolutions			(82,500	)		(678	)		(83,178	)		—			(83,178	)
Other current liabilities			(2,842	)		(2,887	)		(5,729	)		490			(5,239	)
Other long-term assets			(2,114	)		4,241			2,127			(5,518	)		(3,391	)
Other long-term liabilities			(135	)		751			616			—			616
Net cash provided by operating activities			11,206			(1,020	)		10,186			(24	)		10,162
Cash flows from investing activities:
Capital expenditures for property, plant and equipment			(27,994	)		—			(27,994	)		—			(27,994	)
Capital expenditures for intangible assets			(780	)		—			(780	)		—			(780	)
Purchase of other investments			—			—			—			(714	)		(714	)
Proceeds from sale of other investments			—			—			—			878			878
Net proceeds from sale of Breg Inc.			153,773			—			153,773			—			153,773
Net cash provided by (used in) investing activities			124,999			—			124,999			164			125,163
Cash flows from financing activities:
Net proceeds from issuance of common shares			25,586			—			25,586			—			25,586
Payment of refinancing fees and debt issuance costs			—			—			—			—			—
Repayments of long-term debt			(188,695	)		—			(188,695	)		—			(188,695	)
Proceeds of bank borrowings, net			(1,297	)		—			(1,297	)		—			(1,297	)
Changes in restricted cash			25,799			—			25,799			—			25,799
Cash payment for purchase of minority interest in subsidiary			—			—			—			—			—
Excess income tax benefit on employee stock-based awards			—			1,020			1,020			—			1,020
Net cash used in financing activities			(138,607	)		1,020			(137,587	)		—			(137,587	)
Effect of exchange rates changes on cash			250			—			250			36			286
Net increase (decrease) in cash and cash equivalents			(2,152	)		—			(2,152	)		176			(1,976	)
Cash and cash equivalents at the beginning of the year			33,207			—			33,207			(464	)		32,743
Cash and cash equivalents at the end of the year		$	31,055		$	—		$	31,055		$	(288	)	$	30,767
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest		$	4,569		$	—		$	4,569		$	—		$	4,569
Income taxes		$	18,268		$	—		$	18,268		$	—		$	18,268
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2011 are as follows:
(U.S. Dollars, in thousands)		Year Ended December 31, 2011
		As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in			Restatement
		10-K Prior to			Adjustments			the 2012			Adjustments
		Original						Form 10-K/A
		Restatement
Cash flows from operating activities:
Net loss		$	(1,073	)	$	(17,037	)	$	(18,110	)	$	412		$	(17,698	)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization			22,776			241			23,017			165			23,182
Amortization of debt costs			1,239			—			1,239			—			1,239
Amortization of exclusivity agreements			374			—			374			—			374
Provision for doubtful accounts			11,532			1,404			12,936			(8,356	)		4,580
Deferred income taxes			936			(988	)		(52	)		(13,889	)		(13,941	)
Share-based compensation			6,648			—			6,648			—			6,648
Impairment of goodwill			—			—			—			—			—
Gain on sale of Breg, Inc, net of tax			—			—			—			—			—
Excess income tax benefit on employee stock-based awards			(1,737	)		—			(1,737	)		—			(1,737	)
Income tax benefit on employee-stock-based awards			—			—			—			—			—
Other			4,906			(415	)		4,491			(4,833	)		(342	)
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable			(25,818	)		26,111			293			6,352			6,645
Inventories			(8,349	)		(4,275	)		(12,624	)		(81	)		(12,705	)
Escrow receivable			(32,562	)		—			(32,562	)		—			(32,562	)
Prepaid expenses and other current assets			(4,057	)		6,886			2,829			(447	)		2,382
Trade accounts payable			576			1,746			2,322			—			2,322
Charges related to U.S. Government resolutions			88,463			638			89,101			—			89,101
Other current liabilities			3,384			(1,965	)		1,419			2,097			3,516
Other long-term assets			(1,588	)		(16,093	)		(17,681	)		15,364			(2,317	)
Other long-term liabilities			(869	)		3,747			2,878			525			3,403
Net cash provided by operating activities			64,781			—			64,781			(51	)		64,730
Cash flows from investing activities:
Capital expenditures for property, plant and equipment			(24,965	)		—			(24,965	)		—			(24,965	)
Capital expenditures for intangible assets			(793	)		—			(793	)		—			(793	)
Payment made in connection with acquisition			(5,250	)		—			(5,250	)		—			(5,250	)
Purchase of other investments			—			—			—			(468	)		(468	)
Net cash provided by (used in) investing activities			(31,008	)		—			(31,008	)		(468	)		(31,476	)
Cash flows from financing activities:
Net proceeds from issuance of common shares			20,113			—			20,113			—			20,113
Payment of refinancing fees and debt issuance costs			(758	)		—			(758	)		—			(758	)
Repayments of long-term debt			(7,500	)		—			(7,500	)		—			(7,500	)
Proceeds of bank borrowings, net			(2,561	)		—			(2,561	)		—			(2,561	)
Changes in restricted cash			(24,178	)		—			(24,178	)		—			(24,178	)
Cash payment for purchase of minority interest in subsidiary			(517	)		—			(517	)		—			(517	)
Excess income tax benefit on employee stock-based awards			1,737			—			1,737			—			1,737
Net cash used in financing activities			(13,664	)		—			(13,664	)		—			(13,664	)
Effect of exchange rates changes on cash			(463	)		—			(463	)		55			(408	)
Net increase (decrease) in cash and cash equivalents			19,646			—			19,646			(464	)		19,182
Cash and cash equivalents at the beginning of the year			13,561			—			13,561			—			13,561
Cash and cash equivalents at the end of the year		$	33,207		$	—		$	33,207		$	(464	)	$	32,743
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest		$	17,088		$	—		$	17,088		$	—		$	17,088
Income taxes		$	26,227		$	—		$	26,227		$	—		$	26,227
The results of the Further Restatement adjustments to the Company’s previously filed consolidated shareholders’ equity as of January 1, 2011, by category as discussed above under the subheadings “Bad Debt Timing Adjustments”, “Accounts Receivable Reserves”, “Intercompany Profit Adjustments”, “Piece Parts Inventory”, “Inventory Reserves” and “Other Adjustments” are summarized in the table below.
		Cumulative Adjustments to Shareholders’ Equity at
		January 1, 2011
		(U.S. Dollars, in thousands)
Further Restatement Adjustments by Category		Further Restatement			Further			Total Cumulative
Increase (decrease) to Retained earnings		Adjustments for			Restatement			Adjustments
		Years ended			Adjustments to			through
		December 31, 2009			Year ended			December 31, 2010
		and Prior			December 31, 2010
Bad debt timing adjustments		$	—		$	409		$	409
Accounts receivable reserves			(4,383	)		(1,037	)		(5,420	)
Intercompany profit adjustments			(812	)		(203	)		(1,015	)
Inventory existence			(68	)		(16	)		(84	)
Inventory reserves			(13,352	)		2,581			(10,771	)
Other adjustments			(1,426	)		(285	)		(1,711	)
Income tax benefit (expense)			7,416			(1,388	)		6,028
Retained earnings decrease		$	(12,625	)	$	61		$	(12,564	)
The results of the Further Restatement adjustments to the Company’s previously filed consolidated shareholders’ equity as of January 1, 2011, by category as discussed above under the subheadings “Bad Debt Timing Adjustments”, “Accounts Receivable Reserves”, “Intercompany Profit Adjustments”, “Piece Parts Inventory”, “Inventory Reserves” and “Other Adjustments” are summarized in the table below.
		Cumulative Adjustments to Shareholders’ Equity at
		January 1, 2011
		(U.S. Dollars, in thousands)
Further Restatement Adjustments by Category		Further Restatement			Further			Total Cumulative
Increase (decrease) to Retained earnings		Adjustments for			Restatement			Adjustments
		Years ended			Adjustments to			through
		December 31, 2009			Year ended			December 31, 2010
		and Prior			December 31, 2010
Bad debt timing adjustments		$	—		$	409		$	409
Accounts receivable reserves			(4,383	)		(1,037	)		(5,420	)
Intercompany profit adjustments			(812	)		(203	)		(1,015	)
Inventory existence			(68	)		(16	)		(84	)
Inventory reserves			(13,352	)		2,581			(10,771	)
Other adjustments			(1,426	)		(285	)		(1,711	)
Income tax benefit (expense)			7,416			(1,388	)		6,028
Retained earnings decrease		$	(12,625	)	$	61		$	(12,564	)

Inventories

Inventories	12 Months Ended
	Dec. 31, 2013
Inventory Disclosure [Abstract]
Inventories	3	Inventories
			December 31,
	(U.S. Dollars in thousands)		2013		2012
			(Restated)		(Restated)
	Raw materials		$	6,515	$	7,623
	Work-in-process			6,606		7,886
	Finished products			28,291		22,236
	Field inventory			21,312		17,061
	Consignment inventory			2,388		4,235
	Deferred cost of sales			7,566		10,772
			$	72,678	$	69,813
	The Company’s inventories are primarily stated at standard cost, which approximates actual cost determined on a first-in, first-out basis. The Company adjusts the value of its inventory to the extent management determines that the cost cannot be recovered due to obsolescence or other factors. In order to make these determinations, management uses estimates of future demand and sales prices for each product to determine the appropriate inventory reserves and to make corresponding adjustments to the carrying value of these inventories to reflect the lower of cost or market value. In the event of a sudden significant decrease in demand for the Company’s products, or a higher incidence of inventory obsolescence, the Company could be required to increase its inventory reserves, which would increase cost of sales and decrease gross profit.
	Field inventory represents immediately saleable finished products that are in the possession of the Company’s direct sales representatives. Consignment inventory represents immediately saleable finished products located at third party customers, such as distributors and hospitals. Work-in-process, finished products, field inventory and consignment inventory include material, labor and production overhead costs. Deferred cost of sales result from transactions where the Company has shipped product or performed services for which all revenue recognition criteria have not yet been met. Once all revenue recognition criteria have been met, revenue previously recorded as deferred and associated cost of sales are recognized.

Property_plant_and_equipment

Property, plant and equipment	12 Months Ended
	Dec. 31, 2013
Property, Plant and Equipment [Abstract]
Property, plant and equipment	4	Property, plant and equipment
			December 31,
	(U.S. Dollars in thousands)		2013			2012
			(Restated)			(Restated)
	Cost
	Buildings		$	4,075		$	3,911
	Plant, equipment and instrumentation			133,427			121,370
	Furniture and fixtures			5,872			5,567
				143,374			130,848
	Accumulated depreciation			(89,002	)		(78,055	)
			$	54,372		$	52,793
	Depreciation expense for the years ended December 31, 2013, 2012 and 2011 was $20.0 million, $15.8 million and $14.3 million, respectively.

Patents_and_other_intangible_a

Patents and other intangible assets	12 Months Ended
	Dec. 31, 2013
Goodwill and Intangible Assets Disclosure [Abstract]
Patents and other intangible assets	5	Patents and other intangible assets
			December 31,
	(U.S. Dollars in thousands)		2013			2012
						(Restated)
	Cost
	Patents and licenses		$	42,568		$	38,905
	Trademarks—definite lived			620			657
				43,188			39,562
	Accumulated amortization
	Patents and licenses			(33,688	)		(31,845	)
	Trademarks—definite lived			(454	)		(427	)
				(34,142	)		(32,272	)
	Patents and other intangible assets, net		$	9,046		$	7,290
	Amortization expense for intangible assets is estimated to be approximately $2.1 million, $1.8 million, $1.7 million, $1.4 million, $0.5 million and $1.5 million for the periods ending December 31, 2014, 2015, 2016, 2017, 2018 and 2019 and thereafter, respectively.

Goodwill

Goodwill	12 Months Ended
	Dec. 31, 2013
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	6	Goodwill
	The following table presents the changes in the net carrying value of goodwill by reportable segment as well as the reallocation as of July 1, 2013 in conjunction with our change in reportable segments. (See Note 1 “Summary of significant accounting policies”):
	(U.S. Dollars in thousands)		Spine			Orthopedics			BioStim		Biologics		Extremity			Spine Fixation			Total
													Fixation
	At December 31, 2011		$	41,419		$	31,675		$	—	$	—	$	—		$	—		$	73,094
	Foreign currency			145			1,149			—		—		—			—			1,294
	At December 31, 2012			41,564			32,824			—		—		—			—			74,388
	Foreign currency			(163	)		(1,467	)		—		—		—			—			(1,630	)
	At June 30, 2013			41,401			31,357			—		—		—			—			72,758
	Reallocation at July 1, 2013			(41,401	)		(31,357	)		42,678		10,887		9,825			9,368			—
	Impairment			—			—			—		—		(9,825	)		(9,368	)		(19,193	)
	At December 31, 2013		$	—		$	—		$	42,678	$	10,887	$	—		$	—		$	53,565
	Goodwill Impairment
	The Company tests goodwill at least annually for impairment. The Company tests more frequently if indicators are present or changes in circumstances suggest that impairment may exist. These indicators include, among others, declines in sales, earnings or cash flows, or the development of a material adverse change in the business climate. The Company assesses goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment, referred to as a reporting unit.
	In order to calculate the respective carrying values, the Company initially recorded goodwill based on the purchase price allocation performed at the time of acquisition. Corporate assets and liabilities that directly relate to a reporting unit’s operations are ascribed directly to that reporting unit. Corporate assets and liabilities that are not directly related to a specific reporting unit, but from which the reporting unit benefits, are allocated based on the respective contribution measure of each reporting unit. Effective July 1, 2013, the Company re-aligned its segments, and consequently reallocated the carrying value of goodwill to its new reporting units, determined to be the Company’s segments (i.e., BioStim, Biologics, Spine Fixation, and Extremity Fixation), based on the relative fair value of each new reporting unit to total enterprise value at July 1, 2013.
	In the first quarter of 2012, ASU 2011-08, “Testing of Goodwill for Impairment” became effective. ASU 2011-08 allows entities testing goodwill for impairment the option of performing a qualitative assessment before calculating the fair value of a reporting unit (i.e. the first step of the goodwill impairment test). If entities determine, on the basis of qualitative factors, that the fair value of the reporting unit is more likely than not greater than the carrying amount, a quantitative calculation would not be needed.
	As a result of the Company’s change in reporting structure, the Company re-allocated goodwill to each reporting unit. We estimated the fair value of each reporting unit using a weighting of fair values derived from an income approach, a cost approach, and a market approach (all Level 3 fair value measurements). Under the income approach, we calculated the fair value of each reporting unit based on the present value of its estimated future cash flows. Cash flow projections are based on our estimates of revenue growth rates and operating margins, taking into consideration industry and market conditions. The discount rate used was based on the weighted average cost of capital adjusted for the risks associated with the reporting unit and the projected cash flows. The cost approach involves methods of determining a Company’s value by analyzing the market value of a Company’s assets. The market approach estimates fair value based on market multiples of revenue and earnings of comparable publicly traded companies that have similar operating and investment characteristics as our reporting units.
	Upon estimating the fair value of the reporting units, we determined it was less than its carrying value for two of our reporting units, Extremity Fixation and Spine Fixation. As a result, we performed step two of the impairment analysis and allocated the fair value of these reporting units to the estimated fair values of each of the assets and liabilities of the reporting units (including identifiable intangible assets) with the excess fair value being the implied goodwill. Estimating the fair value of certain assets and liabilities requires significant judgment about future cash flows. The implied fair value of the reporting unit’s goodwill was less than its carrying value, which we recorded as a full impairment loss of goodwill for our Spine Fixation and Extremity Fixation reporting units, totaling $19.2 million, during the third quarter of 2013. The Company’s annual goodwill impairment analysis, which was performed qualitatively during the fourth quarter of 2013, did not result in any additional impairment charge.

Bank_borrowings

Bank borrowings	12 Months Ended
	Dec. 31, 2013
Debt Disclosure [Abstract]
Bank borrowings	7	Bank borrowings
	Borrowings under the line of credit consist of borrowings in Euros used to fund international operations. The borrowings under such facility were zero and $0.1 million at December 31, 2013 and 2012, respectively. The weighted average interest rate on borrowings under lines of credit as of December 31, 2013 and 2012 was 3.70%.
	The Company had an unused available line of credit of €5.8 million ($8.0 million) and €5.8 million ($7.6 million) at December 31, 2013 and 2012, respectively, in its Italian line of credit. This line of credit provides the Company the option to borrow amounts in Italy at rates which are determined at the time of borrowing. This line of credit is unsecured.

Other_current_liabilities

Other current liabilities	12 Months Ended
	Dec. 31, 2013
Payables and Accruals [Abstract]
Other current liabilities	8	Other current liabilities
			December 31,
	(U.S. Dollars in thousands)		2013		2012
			(Restated)		(Restated)
	Accrued expenses		$	18,903	$	11,710
	Salaries, bonuses, commissions and related taxes payable			16,598		17,915
	Accrued legal expenses			10,292		8,496
	Other payables			3,883		4,621
			$	49,676	$	42,742

Longterm_debt

Long-term debt	12 Months Ended
	Dec. 31, 2013
Debt Disclosure [Abstract]
Long-term debt	9	Long-term debt
	On August 30, 2010, the Company’s wholly owned U.S. holding company, Orthofix Holdings, Inc. (“Orthofix Holdings”) entered into a Credit Agreement (the “Credit Agreement”) with certain domestic direct and indirect subsidiaries of the Company (the “Guarantors”), JPMorgan Chase Bank, N.A., as Administrative Agent, RBS Citizens, N.A., as Syndication Agent, and certain lender parties thereto.
	The Credit Agreement provides for a five year, $200 million secured revolving credit facility (the “Revolving Credit Facility”), and a five year, $100 million secured term loan facility (the “Term Loan Facility”, and together with the Revolving Credit Facility, the “Credit Facilities”). On January 15, 2015, at the Company’s request, the lenders agreed to reduce the available capacity under the Revolving Credit Facility to $100 million.
	In May 2012, the Company used a portion of the proceeds from the sale of Breg, Inc. (“Breg”) (see Note 16) to repay in full the remaining $87.5 million balance on the Term Loan Facility and pay down $57.5 million of amounts outstanding under the Revolving Credit Facility. This use of proceeds was required by the lenders’ consent dated April 23, 2012 to the Credit Agreement. As a result of the sale of Breg, Breg ceased to be a subsidiary of the Company and, therefore, Breg was released as a credit party under the Credit Agreement. Additionally, the Company paid $20 million in June and $20 million in September 2012 to reduce amounts outstanding under the Revolving Credit Facility. As a result, at December 31, 2012, the Term Loan Facility had been repaid in full and there was $20 million outstanding under the Revolving Credit Facility both at December 31, 2013 and 2012. Borrowings under the Credit Facilities bear interest at a floating rate, which is, at Orthofix Holdings’ option, either the London Inter-Bank Offered Rate (“LIBOR”) plus an applicable margin or a base rate (as defined in the Credit Agreement) plus an applicable margin (in each case subject to adjustment based on financial ratios). Such applicable margin will be up to 3.25% for LIBOR borrowings and up to 2.25% for base rate borrowings depending upon a measurement of the consolidated leverage ratio with respect to the immediately preceding four fiscal quarters. As of December 31, 2013 and 2012, the entire Revolving Credit Facility was at the LIBOR rate plus a margin of 2.50%. The effective interest rate on the Credit Facilities as of December 31, 2013 and 2012 was 2.7%.
	Outstanding principal on the Revolving Credit Facility is due on August 30, 2015.
	Borrowings under the Revolving Credit Facility, which may be made in the future, may be used for working capital, capital expenditures and other general corporate purposes of Orthofix Holdings and its subsidiaries. The Guarantors have guaranteed repayment of Orthofix Holdings’ obligations under the Credit Agreement. The obligations of Orthofix Holdings and each of the Guarantors with respect to the Credit Facilities are secured by a pledge of substantially all of the assets of Orthofix Holdings and each of the Guarantors.
	The Credit Agreement, as amended, requires Orthofix Holdings and the Company to comply with coverage ratios on a consolidated basis and contains affirmative and negative covenants, including limitations on additional debt, liens, investments and acquisitions. The Credit Agreement, as amended, also includes events of default customary for facilities of this type. Upon the occurrence of an event of default, all outstanding loans may be accelerated and/or the lenders’ commitments terminated. The Company was in compliance with the affirmative and negative covenants at December 31, 2012 and there were no events of default.
	On August 14, 2013, the Company and certain required lender parties to the Credit Agreement entered into a Limited Waiver (the “Original Limited Waiver”). Under the Original Limited Waiver, the lenders under the Credit Agreement (the “Lenders”) collectively waived requirements under the Credit Agreement that the Company deliver quarterly financial statements with respect to the fiscal quarters ending on June 30, 2013 and September 30, 2013, and related financial covenant certificates, until the earlier of (i) March 31, 2014 or (ii) the date that is one day after such financial statements are publicly filed or released. In addition, the Original Limited Waiver provided that the restatement of the Company’s financial statements for any period ending on or before March 31, 2013 would not constitute a default or event of default provided that within one business day after the public release or filing of such restated financial statements, the Company delivered corrected financial statements and compliance certificates with respect to such restated periods and immediately paid any additional interest and other fees that would have been owed had applicable interest and fees originally been calculated based on the restated financial statements. The Company was in compliance with the affirmative and negative covenants at December 31, 2013 and there were no events of default.
	On August 14, 2014 the Lenders and the Company entered into a subsequent Limited Waiver which was extended on September 30, 2014, January 15, 2015 and February 26, 2015 (the “Subsequent Limited Waivers”). Under the Subsequent Limited Waivers, the Lenders collectively waived requirements under the Credit Agreement that the Company deliver quarterly financial statements with respect to the fiscal quarters ended June 30, 2014 and September 30, 2014, and related financial covenant certificates, until the earlier of (i) March 31, 2015 or (ii) the date that is one day after such financial statements are publicly filed or released. The Subsequent Limited Waivers also extend the date by which the Company is required to provide certain 2014 fiscal year financial statements until the earlier of (i) one business day following the date that the Company files its Annual Report on Form 10-K for the fiscal year ended December 31, 2014 or (ii) April 30, 2015. In addition, the Subsequent Limited Waivers provided that the Further Restatement would not constitute a default or event of default provided that within one business day after the public release or filing of such restated financial statements, the Company delivered corrected financial statements and compliance certificates with respect to such restated periods and immediately paid any additional interest and other fees that would have been owed had applicable interest and fees originally been calculated based on the restated financial statements.
	Certain subsidiaries of the Company have restrictions on their ability to pay dividends or make intercompany loan advances pursuant to the Company’s Credit Facilities. The net assets of Orthofix Holdings and its subsidiaries are restricted for distributions to the parent company. Domestic subsidiaries of the Company, as parties to the credit agreement, have access to these net assets for operational purposes.
	The amount of restricted net assets of Orthofix Holdings and its subsidiaries as of December 31, 2013 and 2012 is $168.5 million and $194.5 million, respectively. In addition, the Credit Agreement restricts the Company and subsidiaries that are not parties to the Credit Facilities from access to cash held by Orthofix Holdings, Inc. and its subsidiaries. All of the Company’s subsidiaries that are parties to the Credit Agreement have access to this cash for operational and debt repayment purposes. The amount of restricted cash of the Company as of December 31, 2013 and 2012 was $23.8 million and $21.3 million, respectively.
	In conjunction with obtaining the Credit Facilities and the Credit Agreement, as amended, the Company incurred debt issuance costs of $5 million which includes $0.8 million of costs related to the May 2011 amendment. These costs are being amortized using the effective interest method over the life of the Credit Facilities. In conjunction with the Term Loan Facility repayment in May 2012, the Company wrote off $0.8 million of the related debt issuance costs. As of December 31, 2013 and 2012, debt issuance costs, net of accumulated amortization, related to the Credit Agreement were $1.1 million and $1.8 million, respectively.

Derivative_instruments

Derivative instruments	12 Months Ended
	Dec. 31, 2013
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative instruments	10	Derivative instruments
	The tables below disclose the types of derivative instruments the Company owns, the classifications and fair values of these instruments within the balance sheet, and the amount of gain (loss) recognized in other comprehensive income (loss) (“OCI”) or net income (loss).
	(U.S. Dollars, in thousands)		Fair value: favorable			Balance sheet location
			(unfavorable)
	As of December 31, 2013
	Cross-currency swap		$	(1,036	)	Other long-term liabilities
	Warrants		$	107		Other long-term assets
	As of December 31, 2012
	Cross-currency swap		$	305		Other long-term assets
	Warrants		$	—		Other long-term assets
			For the year ended
			December 31,
	(U.S. Dollars in thousands)		2013			2012		2011
	Cross-currency swap and warrants gain (loss) recorded in other comprehensive income (loss), net of taxes		$	(279	)	$	263	$	(437	)
	Cross-currency swap
	On September 30, 2010, the Company entered into a cross-currency swap agreement (the “replacement swap agreement”) with JPMorgan Chase Bank and Royal Bank of Scotland PLC (the “counterparties”) to manage its cash flows related to foreign currency exposure for a portion of the Company’s intercompany receivable of a U.S. dollar functional currency subsidiary that is denominated in Euro.
	Under the terms of the swap agreement, the Company pays Euros based on a €28.7 million notional value and a fixed rate of 5.00% and receives U.S. dollars based on a notional value of $39 million and a fixed rate of 4.635%. The expiration date is December 30, 2016, the date upon which the underlying intercompany debt, to which the swap agreement applies, matures. The swap agreement is designated as a cash flow hedge and therefore the Company recognized an unrealized gain (loss) on the change in fair value, net of tax, within other comprehensive income (loss).
	Warrants
	In 2013, the Company purchased notes receivable from Bone Biologics, Inc. (“Bone Biologics”) totaling $250 thousand, all of which were issued with detachable warrants to purchase common stock of Bone Biologics. As of December 31, 2013 the Company held warrants for 125 thousand shares of Bone Biologics, at an exercise price of $1.00 per share.
	Under the terms of the note and warrant purchase agreements, the warrants to purchase common stock in Bone Biologics are both detachable from the note, exercisable over a seven year period, and transferable by the holder to other parties.

Fair_value_measurements

Fair value measurements	12 Months Ended
	Dec. 31, 2013
Fair Value Disclosures [Abstract]
Fair value measurements	11	Fair value measurements
	Fair value is defined as the price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants on the measurement date. Non-financial assets and liabilities of the Company measured at fair value include any long-lived assets or equity method investments that are impaired in a currently reported period. The authoritative guidance also describes three levels of inputs that may be used to measure fair value:
			Level 1 —		quoted prices in active markets for identical assets and liabilities
			Level 2 —		observable inputs other than quoted prices in active markets for identical assets and liabilities
			Level 3 —		unobservable inputs in which there is little or no market data available, which require the reporting entity to develop its own assumptions
	The Company’s financial instruments include cash equivalents, restricted cash, certificates of deposit, treasury securities, collective trust funds, trade accounts receivable, accounts payable, long-term secured debt, deferred compensation plan liabilities and derivative securities. The carrying value of restricted cash, accounts receivable and accounts payable approximate fair value due to the short-term maturities of these instruments. The Company’s credit facilities carry a floating rate of interest, and therefore, the carrying value is considered to approximate the fair value.
	The Company’s collective trust funds, treasury securities, certificates of deposit, deferred compensation plan liabilities and derivative securities are the only financial instruments recorded at fair value on a recurring basis. The fair value of treasury securities and certificates of deposit are determined based on quoted prices in active markets for identical assets, therefore, the Company has categorized these instruments as Level 1 financial instruments. The cross-currency derivative instrument consists of an over-the-counter contract, which is not traded on a public exchange. The fair value of this derivative swap contract, the common stock warrants, the Company’s collective trust funds and the Company’s deferred compensation plan liabilities are determined based on inputs that are readily available in public markets or can be derived from information available in publicly quoted markets, therefore, the Company has categorized these instruments as Level 2 financial instruments. Changes in the fair value of collective trust funds and deferred compensation plan liabilities are recorded in Other income (expense). The Company also considers counterparty credit risk and its own credit risk in its determination of estimated fair values. The Company has consistently applied these valuation techniques in all periods presented.
	The fair value of the Company’s financial assets and liabilities on a recurring basis were as follows:
	(U.S. Dollars in thousands)		Balance			Level 1		Level 2			Level 3
			December 31,
			2013
			(Restated1)
	Assets
	Collective trust funds		$	1,667		$		$	1,667		$	—
	Treasury securities			660			660					—
	Certificates of deposit			1,562			1,562		—			—
	Derivative securities			107			—		107			—
	Total		$	3,996		$	2,222	$	1,774		$	—
	Liabilities
	Deferred compensation plan		$	(2,506	)	$	—	$	(2,506	)	$	—
	Derivative securities			(1,036	)		—		(1,036	)		—
	Total		$	(3,542	)	$	—	$	(3,542	)	$	—
	(U.S. Dollars in thousands)		Balance			Level 1		Level 2			Level 3
			December 31,
			2012
			(Restated1)
	Assets
	Collective trust funds		$	1,513		$		$	1,513		$	—
	Treasury securities			624			624					—
	Certificates of deposit			288			288		—			—
	Derivative securities			305			—		305			—
	Total		$	2,730		$	912	$	1,818		$	—
	Liabilities
	Deferred compensation plan		$	(2,320	)	$	—	$	(2,320	)	$	—
	Total		$	(2,320	)	$	—	$	(2,320	)	$	—
	1)	The Company has changed the presentation to breakout and provide more description of assets and to include financial instruments not previously included in the table above.

Commitments

Commitments	12 Months Ended
	Dec. 31, 2013
Commitments and Contingencies Disclosure [Abstract]
Commitments	12	Commitments
	Leases
	The Company has entered into operating leases for facilities and equipment. These leases are non-cancellable and typically do not contain renewal options. Certain leases contain rent escalation clauses for which the Company recognizes the expense on a straight-line basis. Rent expense under the Company’s operating leases for the years ended December 31, 2013, 2012 and 2011 was approximately $3.4 million, $4.1 million and $4.8 million, respectively. Future minimum lease payments under operating leases, net of amounts to be received under sub-leases, as of December 31, 2013 are as follows:
	(U.S. Dollars in thousands)
	2014		$	4,342
	2015			4,107
	2016			3,713
	2017			2,974
	2018			2,846
	Thereafter			3,049
	Total		$	21,031
	Inventory purchase commitments
	The Company has inventory purchase commitments with third-party manufacturers for $3.0 million, $1.4 million and $1.8 million as of December 31, 2013, 2012 and 2011, respectively.

Business_segment_information

Business segment information	12 Months Ended
	Dec. 31, 2013
Segment Reporting [Abstract]
Business segment information	13	Business segment information
	On July 1, 2013, we began certain organizational and executive leadership changes to align with how our Chief Executive Officer, who is also our Chief Operating Decision Maker (the “CODM”) reviews performance and makes decisions in managing the Company. We manage our business by our four strategic business units (“SBUs”), which are comprised of BioStim, Biologics, Extremity Fixation, and Spine Fixation supported by Corporate activities. These SBUs represent the segments for which our CODM reviews financial information and makes resource allocation decisions among business units. The primary metric used by the CODM in managing the Company is net margin, which is defined as gross profit less sales and marketing expense. The Company neither discretely allocates assets, other than goodwill, to its operating segments nor evaluates the operating segments using discrete asset information. Accordingly, our segment information has been prepared based on our four SBUs reporting segments. These four segments are discussed below.
	BioStim
	The BioStim SBU manufactures, distributes, and provides support services for market leading devices that enhance bone fusion. These Class III medical devices are indicated as an adjunctive, noninvasive treatment to improve fusion success rates in the cervical and lumbar spine as well as a therapeutic treatment for non-spine fractures that have not healed (non-unions). The devices utilize Orthofix’s patented pulsed electromagnetic field (“PEMF”) technology which is supported by strong basic mechanism of action data in the scientific literature as well as strong level one randomized controlled clinical trials in the medical literature. Current research and clinical studies are also underway to identify potential new clinical indications.
	Biologics
	The Biologics SBU provides a portfolio of regenerative products that allow physicians to successfully treat a variety of spinal and orthopedic conditions. This SBU specializes in the marketing of the Company’s regeneration tissue forms. Biologics markets its tissues through a network of distributors, sales, representatives and affiliates to supply to hospitals, doctors, and other healthcare providers, primarily in the U.S. Our partnership with MTF allows us to exclusively market our Trinity Evolution® and Trinity ELITE® tissue forms for musculoskeletal defects to enhance bony fusion.
	Extremity Fixation
	The Extremity Fixation SBU offers products that allow physicians to successfully treat a variety of orthopedic conditions unrelated to the spine. This SBU specializes in the design, development, and marketing of the Company’s orthopedic products used in fracture repair, deformity correction and bone reconstruction. Extremity Fixation distributes its products through a network of distributors, sales representatives, and affiliates. This SBU uses both distributors and direct sales representatives to sell orthopedics products to hospitals, doctors, and other health providers, globally.
	Spine Fixation
	The Spine Fixation SBU specializes in the design, development and marketing of a broad portfolio of implant products used in surgical procedures of the spine. Spine Fixation distributes its products through a network of distributors and affiliates. This SBU uses distributors and direct sales representatives to sell spine products to hospitals, doctors and other healthcare providers, globally.
	Corporate
	Corporate activities are comprised of the operating expenses, including share-based compensation of Orthofix International N.V. and its holding company subsidiaries, along with activities not necessarily identifiable within the four SBUs.
	External Net Sales by SBU:
	The table below presents external net sales for continuing operations by SBU reporting segment. Net sales include product sales and marketing service fees.
			External Net Sales by SBU
			Year ended December 31,
	(U.S. Dollars in thousands)		2013						2012						2011
			Net Sales			Percent of			Net Sales			Percent of			Net Sales		Percent of
						Total Net						Total Net					Total Net
						Sales						Sales					Sales
			(Restated)						(Restated)						(Restated)
	BioStim		$	145,085			36	%	$	174,562			40	%	$	181,736		42	%
	Biologics			53,746			14	%		53,731			12	%		42,911		10	%
	Extremity Fixation			103,359			26	%		112,011			25	%		119,504		27	%
	Spine Fixation			95,421			24	%		99,885			23	%		91,368		21	%
	Total Net Sales		$	397,611			100	%	$	440,189			100	%	$	435,519		100	%
	The table below presents net margin, defined as gross profit less sales and marketing expenses from continuing operations by SBU reporting segment:
	Net Margin by SBU		Year Ended December 31,
	(U.S. Dollars in thousands)		2013			2012			2011
			(Restated)			(Restated)			(Restated)
	Net Margin
	BioStim		$	63,847		$	88,788		$	92,860
	Biologics			24,794			23,589			18,978
	Extremity Fixation			23,704			34,554			30,773
	Spine Fixation			4,329			15,256			13,037
	Corporate			(1,443	)		(1,495	)		(1,700	)
	Total net margin		$	115,231		$	160,692		$	153,948
	General & administrative			64,830			53,650			64,785
	Research and development			26,768			28,577			22,861
	Amortization of intangible assets			2,687			2,298			2,550
	Costs related to the accounting review and restatement			12,945			—			—
	Impairment of goodwill			19,193			—			—
	Charges related to U.S. Government resolutions			—			1,295			57,141
	Operating (loss) income		$	(11,192	)	$	74,872		$	6,611
	The following table presents depreciation and amortization for continuing operations by SBU reporting segment:
			Depreciation and amortization by SBU
			Year Ended December 31,
	(U.S. Dollars in thousands)		2013			2012			2011
			(Restated)			(Restated)			(Restated)
	BioStim		$	1,979		$	1,659		$	2,122
	Biologics			648			567			436
	Extremity Fixation			7,265			5,201			5,156
	Spine Fixation			12,834			10,800			9,258
	Corporate			96			70			53
	Total		$	22,822		$	18,297		$	17,025
	Geographical information
	The following geographic data includes net sales by geographic destination:
	(U.S. Dollars in thousands)		2013			2012			2011
			(Restated)			(Restated)			(Restated)
	U.S.		$	293,032		$	327,228		$	322,186
	Italy			16,755			18,742			17,447
	U.K.			10,002			8,431			8,206
	Brazil			26,786			31,166			34,424
	Others			51,036			54,622			53,256
Total net sales		$	397,611		$	440,189		$	435,519
Analysis of property, plant and equipment by geographic area:
(U.S. Dollars in thousands)		2013			2012
		(Restated)			(Restated)
U.S.		$	39,287		$	38,504
Italy			8,150			7,625
U.K.			1,871			1,402
Brazil			3,210			3,421
Others			1,854			1,841
Total		$	54,372		$	52,793

Income_taxes

Income taxes	12 Months Ended
	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Income taxes	14	Income taxes
	Income from continuing operations before provision for income taxes consisted of:
			Year Ended
			December 31,
	(US$ in thousands)		2013			2012			2011
			(Restated)			(Restated)			(Restated)
	U.S.		$	(3,546	)	$	56,210		$	4,730
	Non-U.S.			(7,057	)		12,855			(6,093	)
	Total income before taxes		$	(10,603	)	$	69,065		$	(1,363	)
	The provision for (benefit from) income taxes on continuing operations in the accompanying consolidated statements of operations consists of the following:
			Year Ended
			December 31,
	(US$ in thousands)		2013			2012			2011
			(Restated)			(Restated)			(Restated)
	U.S.
	Current		$	2,465		$	16,982		$	26,273
	Deferred			4,013			2,675			(13,241	)
	Total U.S			6,478			19,657			13,032
	Non-U.S.
	Current			2,308			3,191			2,111
	Deferred			(1,184	)		1,096			(700	)
				1,124			4,287			1,411
	Total tax expense		$	7,602		$	23,944		$	14,443
	The tax effects of the significant temporary differences, which comprise the deferred tax assets and liabilities, are as follows:
	(US$ in thousands)		2013			2012
			(Restated)			(Restated)
	Intangible assets and goodwill		$	4,798		$	5,338
	Inventories and related reserves			20,769			19,626
	Deferred revenue and cost of goods sold			11,577			12,336
	Other accruals and reserves			4,778			6,149
	Accrued compensation			3,942			3,791
	Allowance for doubtful accounts			2,040			1,542
	Accrued interest			18,063			17,995
	Net operating loss carryforwards			34,979			27,231
	Other, net			893			590
				101,839			94,598
	Valuation allowance			(31,772	)		(26,361	)
	Deferred tax asset		$	70,067		$	68,237
	Withholding taxes			(13,026	)		(11,351	)
	Property, plant and equipment			(7,674	)		(8,226	)
	Deferred tax liability			(20,700	)		(19,577	)
	Net deferred tax assets		$	49,367		$	48,660
	Reported as:
	Current deferred tax assets			39,999			38,487
	Non-current deferred tax assets			22,394			21,523
	Current deferred tax liability			—			—
	Non-current deferred tax liability			(13,026	)		(11,350	)
	Net deferred tax assets		$	49,367		$	48,660
	The valuation allowance as of December 31, 2013 and 2012 was $31.8 million and $26.4 million, respectively. The net increase in the valuation allowance of $5.4 million during the year principally relates to certain current period foreign losses not benefitted. The valuation allowance is attributable to net operating loss carryforwards and certain temporary differences in certain foreign jurisdictions, the benefit for which is dependent upon the generation of future taxable income in those foreign jurisdictions. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion, or all, of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers the scheduled reversal of deferred tax liabilities, projected future taxable income, and tax planning strategies in making this assessment. Based upon the level of historical taxable income and projections for future taxable income over the periods in which the deferred tax assets are deductible, management believes it is more likely than not the Company will realize the benefits of these temporary differences, net of the existing valuation allowances at December 31, 2013.
	The Company has state net operating loss carryforwards of approximately $24.5 million that will begin to expire in 2014. The Company has net operating losses of foreign taxing jurisdictions of approximately $120.4 million with the majority of the losses related to the Company’s Netherlands operations expiring in various amounts in tax years beginning in 2014. The Company has provided a valuation allowance against a significant portion of these net operating loss carryforwards since it does not believe that this deferred tax asset can be realized prior to expiration.
	The rate reconciliation for continuing operations presented below is based on the U.S. federal income tax rate, rather than the parent company’s country of domicile tax rate. Management believes, given the large proportion of taxable income earned in the United States, such disclosure is more meaningful.
	(US$ in thousands, except percentages)		2013						2012						2011
			Amount			Percent			Amount			Percent			Amount			Percent
			(Restated)			(Restated)			(Restated)			(Restated)			(Restated)			(Restated)
	Statutory U.S. federal income tax rate		$	(3,711	)		35	%	$	24,179			35	%	$	(477	)		35	%
	State taxes, net			2,039			(19.2	)%		2,536			3.7	%		1,809			(132.7	)%
	Foreign rate differential			(510	)		4.8	%		(2,894	)		(4.2	)%		1,549			(113.6	)%
	Valuation allowance—foreign losses			3,913			(36.9	)%		6,189			9	%		4,924			361.3	%
	Italian subsidiary intangible			(2,288	)		21.6	%		(2,214	)		(3.2	)%		(2,421	)		177.6	%
	Goodwill impairment			6,452			(60.9	)%		—			—			—			—
	Domestic manufacturing deduction			(233	)		2.2	%		(1,567	)		(2.3	)%		(1,703	)		125	%
	Withholding taxes			1,676			(15.8	)%		1,679			2.4	%		1,676			(123.0	)%
	Settlement of U.S. Government resolutions			—			—			(1,260	)		(1.8	)%		9,520			(698.5	)%
	Other items, net			264			(2.5	)%		(2,704	)		(3.9	)%		(434	)		31.9	%
Income tax expense/effective rate		$	7,602			(71.7	)%	$	23,944			34.7	%	$	14,443			(1,059.6	)%
The income tax expense and effective tax rate for the year ended 2013 reflect a disproportionate ratio to the $23.9 million of income tax expense and effective tax rate of 34.7% for the tax year ended 2012. The principal factors affecting the Company’s effective tax rate were the company’s mix of earnings amongst various tax jurisdictions, state taxes, and the impairment of $18.4 million in non-deductible goodwill. For the years ended 2012 and 2011, the Company did not record a tax benefit on certain expenses associated with the Company’s estimate of the charges related to U.S. Government resolutions.
On January 2, 2013 the American Taxpayer Relief Act of 2012 (“ACT”) was enacted. The ACT provides tax relief for business by reinstating certain tax benefits and credits retroactively to January 1, 2012. There are several provisions of the Act that impact the Company, most notably the extension of the Research and Development credit. Income tax accounting rules require tax law changes to be recognized in the period of the enactment; as such the Company recognized a tax benefit of $0.3 million in its provision for income taxes in the first quarter of 2013.
The Company’s unrecognized tax benefit was $0.7 million and $1.2 million for the years ended December 31, 2013 and 2012, respectively. The Company recognizes potential accrued interest and penalties related to unrecognized tax benefits within its global operations in income tax expense. The Company had approximately $0.5 million and $0.8 million accrued for payment of interest and penalties as of December 31, 2013 and 2012, respectively.
The entire amount of unrecognized tax benefits, including interest, would favorably impact the Company’s effective tax rate if recognized. As of December 31, 2013, the Company does not expect the amount of unrecognized tax benefits to change significantly over the next twelve months.
A reconciliation of the gross unrecognized tax benefits (excluding interest and penalties) for the years ended December 31, 2013 and December 31, 2012 follows:
(US$ in thousands)		2013			2012
		(Restated)			(Restated)
Balance as of January 1,		$	1,189		$	610
Additions for current year tax positions			183			793
Decreases for prior year tax positions			(12	)		(106	)
Settlements of prior year tax positions			(560	)		—
Expiration of statutes			(77	)		(108	)
Balance as of December 31,		$	723		$	1,189
The Company files a consolidated income tax return in the U.S. federal jurisdiction, the U.K., Italy and numerous consolidated and separate income tax returns in many state and other foreign jurisdictions. The statute of limitations with respect to federal tax authorities is closed for years prior to December 31, 2011. The statute of limitations for the various state tax filings is closed in most instances for the years prior to December 31, 2010. The statute of limitations with respect to the major foreign tax filing jurisdictions is closed for years prior to December 31, 2009.
The Company’s intention is to reinvest the total amount of its unremitted foreign earnings (residing outside Curaçao) in the local jurisdiction, to the extent they are generated and available, or to repatriate the earnings only when tax-effective. As an entity incorporated in Curaçao, “foreign subsidiaries” refer to both U.S. and non-U.S. subsidiaries. Furthermore, only income sourced in the U.S. is subject to U.S. income tax. Unremitted foreign earnings increased from $272.6 million at December 31, 2012 to $329.7 million at December 31, 2013. The $329.7 million includes $341.3 million in U.S subsidiaries. It is not practicable to determine the amounts of net additional income tax that may be payable if such earnings were repatriated. The Company does not anticipate any impact on income tax liabilities since earnings are indefinitely reinvested for both U.S and non-U.S. subsidiaries.
Total cash and cash equivalents at December 31, 2013 were $52.7 million; of which $23.8 million is restricted under the senior secured credit agreement for use in the U.S. and is therefore classified as restricted cash on the balance sheet. The Company’s U.S. business generates sufficient cash flow and has borrowing capacity in the United States to fund its U.S. operations. Cash and cash equivalents of $30.2 million at December 31, 2013 held by non-U.S. subsidiaries is indefinitely reinvested for use in non-U.S. operations.

Related_parties

Related parties	12 Months Ended
	Dec. 31, 2013
Related Party Transactions [Abstract]
Related parties	15	Related parties
	In 2011, we sold $0.5 million in products to OrthoPro, Inc. and Superior Medical Equipment, who were independent distributors for Breg, Inc., and were owned by the son of a former board member.

Sale_of_Breg_and_Disposition_o

Sale of Breg and Disposition of Sports Medicine SBU	12 Months Ended
	Dec. 31, 2013
Discontinued Operations and Disposal Groups [Abstract]
Sale of Breg and Disposition of Sports Medicine SBU	16	Sale of Breg and Disposition of Sports Medicine SBU
	On April 23, 2012, the Company’s subsidiary Orthofix Holdings and Breg entered into a stock purchase agreement (the “SPA”) with Breg Acquisition Corp. (“Buyer”), a newly formed affiliate of Water Street Healthcare Partners II, L.P., pursuant to which Buyer agreed to acquire from Orthofix Holdings all the outstanding shares of Breg, subject to the terms and conditions contained therein (the “Transaction”). Under the terms of the SPA, upon closing of the sale, Orthofix Holdings and the Company agreed to indemnify Buyer with respect to certain specified matters, including the government investigation and product liability matters regarding a previously owned infusion pump product line, and pre-closing sales of cold therapy units and certain post-closing sales of cold therapy units. (See “Matters Related to the Company’s former Breg Subsidiary and Possible Indemnification Obligations under Note 17.) On May 24, 2012 (the “Closing Date”), Orthofix Holdings completed the sale of all of the outstanding shares of Breg for $157.5 million in cash. After adjustments for working capital and indebtedness in accordance with the terms of the SPA, Orthofix Holdings used $145 million of the net proceeds to prepay outstanding Company indebtedness, as required by a lender consent received in connection with the Company’s existing Credit Agreement. As a result of the closing of this Transaction, Breg ceased to be a subsidiary of the Company and, therefore, Breg was released as a credit party under the Credit Agreement. The Company also agreed to enter into certain transition arrangements at the closing, including a transition services agreement pursuant to which the Company agreed to continue to provide administrative operational support for a period of up to twelve months. As a result of the sale of Breg, the Company completed its exit from the Sports Medicine SBU, of which Breg was a significant component.
	The portion of indemnification related to post closing claims related to post-closing sales of cold therapy has created a guarantee under ASC 460—Guarantees and the fair value of the liability has been recorded under the initial recognition criteria in the amount of $2 million at the Closing Date of the transaction. The Company amortizes the fair value of the noncontingent liability ratably over the period of indemnification which is three years. The Company’s obligations under this guarantee were approximately $0.9 million and $1.6 million as of December 31, 2013 and December 31, 2012, respectively.
	Gain on Sale of Discontinued Operations
	The following table presents the value of the asset disposition, proceeds received, net of various working capital adjustments and indebtedness and net gain on sale of Breg as shown in the condensed consolidated statement of operations for the year ended December 31, 2012.
	(U.S. Dollars in thousands)		Total
	Cash proceeds		$	157,500
	Less:
	Working Capital			(7,093	)
	Transaction related expenses			(4,276	)
	Fair value of indemnification			(2,000	)
	Tangible assets			(8,309	)
	Intangible assets			(28,164	)
	Goodwill			(106,200	)
	Gain on sale of Breg			1,458
	Income tax expense			(113	)
	Gain on sale of Breg, net of taxes		$	1,345
	The Sports Medicine SBU contributed $44 million and $108.9 million of net sales in the years ended December 31, 2012 and 2011, respectively. The Sports Medicine SBU had $2.9 million of operating losses and $1.2 million of operating income in the years ended December 31, 2012 and 2011, respectively. The financial information above includes the financial results of Breg operations up to the date of sale.
	The Company’s consolidated financial statements and related footnote disclosures reflect the Sports Medicine SBU as discontinued operations. Income (loss) associated with the Sports Medicine SBU, net of applicable income taxes is shown as income (loss) from discontinued operations for all periods presented.

Contingencies

Contingencies	12 Months Ended
	Dec. 31, 2013
Commitments and Contingencies Disclosure [Abstract]
Contingencies	17	Contingencies
	The Company is party to outstanding legal proceedings, investigations and claims as described below. The Company believes that it is unlikely that the outcome of each of these matters, including the matters discussed below, will have a material adverse effect on it and its subsidiaries as a whole, notwithstanding that the unfavorable resolution of any matter may have a material effect on the Company’s net earnings (if any) in any particular quarter. However, the Company cannot predict with any certainty the final outcome of any legal proceedings, investigations (including any settlement discussions with the government seeking to resolve such investigations) or claims made against it as described in the paragraphs below, and there can be no assurance that the ultimate resolution of any such matter will not have a material adverse impact on the Company’s consolidated financial position, results of operations, or cash flows.
	The Company records accruals for certain outstanding legal proceedings, investigations or claims when it is probable that a liability will be incurred and the amount of the loss can be reasonably estimated. The Company evaluates, on a quarterly basis, developments in legal proceedings, investigations and claims that could affect the amount of any accrual, as well as any developments that would make a loss contingency both probable and reasonably estimable. When a loss contingency is not both probable and reasonably estimable, the Company does not accrue the loss. However, if the loss (or an additional loss in excess of the accrual) is at least a reasonable possibility and material, then the Company discloses a reasonable estimate of the possible loss or range of loss, if such reasonable estimate can be made. If the Company cannot make a reasonable estimate of the possible loss, or range of loss, then that is disclosed.
	The assessments of whether a loss is probable or a reasonable possibility, and whether the loss or range of loss is reasonably estimable, often involve a series of complex judgments about future events. Among the factors that the Company considers in this assessment are the nature of existing legal proceedings, investigations and claims, the asserted or possible damages or loss contingency (if reasonably estimable), the progress of the matter, existing law and precedent, the opinions or views of legal counsel and other advisers, the involvement of the U.S. Government and its agencies in such proceedings, the Company’s experience in similar matters and the experience of other companies, the facts available to the Company at the time of assessment, and how the Company intends to respond, or has responded, to the proceeding, investigation or claim. The Company’s assessment of these factors may change over time as individual proceedings, investigations or claims progress. For matters where the Company is not currently able to reasonably estimate the range of reasonably possible loss, the factors that have contributed to this determination include the following: (i) the damages sought are indeterminate, or an investigation has not manifested itself in a filed civil or criminal complaint, (ii) the matters are in the early stages, (iii) the matters involve novel or unsettled legal theories or a large or uncertain number of actual or potential cases or parties, and/or (iv) discussions with the government or other parties in matters that may be expected ultimately to be resolved through negotiation and settlement have not reached the point where the Company believes a reasonable estimate of loss, or range of loss, can be made. In such instances, the Company believes that there is considerable uncertainty regarding the timing or ultimate resolution of such matters, including a possible eventual loss, fine, penalty or business impact, if any.
	In addition, the Company does not accrue for estimated legal fees and other directly related costs as they are expensed as incurred.
	In addition to the matters described in the paragraphs below, in the normal course of its business, the Company is involved in various lawsuits from time to time and may be subject to certain other contingencies. To the extent losses related to these contingencies are both probable and reasonably estimable, the Company accrues appropriate amounts in the accompanying financial statements and provides disclosures as to the possible range of loss in excess of the amount accrued, if such range is reasonably estimable. The Company believes losses are individually and collectively immaterial as to a possible loss and range of loss.
	Matters Related to the Audit Committee’s Review and the Restatement of Certain of our Consolidated Financial Statements.
	Audit Committee Review
	In July 2013, our Audit Committee began conducting an independent review, with the assistance of outside professionals, of certain accounting matters. This review resulted in the decision to restate certain of our previously filed consolidated financial statements, as reflected in the Original Restatement. As a result of this review and the Original Restatement, the filing of our Quarterly Reports on Form 10-Q for the quarterly periods ended June 30, 2013 and September 30, 2013, and the Original Form 10-K, was not timely. We filed our Quarterly Report on Form 10-Q for the quarterly period ended June 30, 2013 on March 24, 2014, and filed our Quarterly Report on Form 10-Q for the quarterly period ended September 30, 2013 on March 25, 2014. We filed the Original Form 10-K on March 31, 2014. As further described in the explanatory note to this Form 10-K/A, this report also reflects a further restatement of our consolidated financial statements, which we refer to herein as the “Further Restatement.”
	SEC Investigation
	In connection with the initiation of the Audit Committee’s independent review, we initiated contact with the staff of the Division of Enforcement of the SEC (the “SEC Enforcement Staff”) in July 2013 to advise them of these matters. The Audit Committee and the Company, through respective counsel, have been in direct communication with the SEC Enforcement Staff regarding these matters. The SEC is conducting a formal investigation of these matters, and both the Company and the Audit Committee are cooperating fully with the SEC.
	In connection with the above-referenced communications, the Company has received requests from the SEC for documents and other information concerning various accounting practices, internal controls and business practices, and other related matters. Such requests cover the years ended December 31, 2011 and 2012, and in some instances, prior periods. It is anticipated that we may receive additional requests from the SEC in the future, including with respect to the Further Restatement.
	We have previously provided notice concerning our communications with the SEC to the Office of Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”) pursuant to our corporate integrity agreement with HHS-OIG (which agreement is described below in this Item 3).
	We cannot predict if, when or how this matter will be resolved or what, if any, actions we may be required to take as part of any resolution of these matters. Any action by the SEC, HHS-OIG or other governmental agency could result in civil or criminal sanctions against us and/or certain of our current and former officers, directors and employees. At this stage in the matter, we cannot reasonably estimate the possible loss, or range of loss, in connection with it.
	Securities Class Action Complaint
	On August 14, 2013, a securities class action complaint against the Company, currently styled Tejinder Singh v. Orthofix International N.V., et al. (No.:1:13-cv-05696-JGK), was filed in the United States District Court for the Southern District of New York arising out of the then anticipated restatement of our prior financial statements and the matters described above. Since the date or original filing, the complaint has been amended.
	The lead plaintiff’s complaint, as amended, purports to bring claims on behalf of persons who purchased the Company’s common stock between March 2, 2010 and July 29, 2013. The complaint asserts that the Company and four of its former executive officers, Alan W. Milinazzo, Robert S. Vaters, Brian McCollum, and Emily V. Buxton (collectively, the “Individual Defendants”), violated Section 10(b) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), and Securities and Exchange Commission Rule 10b-5 (“Rule 10b-5”) by making false or misleading statements in or relating to the Company’s financial statements. The complaint further asserts that the Individual Defendants were liable as control persons under Section 20(a) of the Exchange Act for any violation by the Company of Section 10(b) of the Exchange Act or Rule 10b-5. As relief, the complaint requests compensatory damages on behalf of the proposed class and lead plaintiff’s attorneys’ fees and costs. On March 6, 2015, the court granted the defendants’ motion to dismiss as to Mr. Milinazzo and denied it with respect to the Company and the other Individual Defendants. This matter remains at an early stage and, as of the date of this Form 10-K/A, we cannot reasonably estimate the possible loss, or range of loss, in connection with it.
	Matters Related to Promeca
	On July 10, 2012, the Company entered into definitive agreements with the DOJ and the SEC agreeing to settle its self-initiated and self-reported internal investigation of our Mexican subsidiary, Promeca S.A. de C.V. (“Promeca”), regarding non-compliance by Promeca with the Foreign Corrupt Practices Act (the “FCPA”). Under the terms of these agreements, the Company voluntarily disgorged profits to the United States government in an amount of $5.2 million, inclusive of pre-judgment interest, and agreed to pay a fine of $2.2 million. The Company paid $2.2 million in July 2012 and $5.2 million in September 2012. As part of the settlement, the Company entered into a three-year deferred prosecution agreement (“DPA”) with the DOJ and a consent to final judgment (the “Consent”) with the SEC.
	The DOJ has agreed not to pursue any criminal charges against the Company in connection with this matter if the Company complied with the terms of the DPA. The DPA takes note of the Company’s self-reporting of this matter to DOJ and the SEC, and of remedial measures, including the implementation of an enhanced compliance program, previously undertaken by the Company. The DPA and the Consent collectively require, among other things, that with respect to anti-bribery compliance matters the Company shall continue to cooperate fully with the government in any future matters related to corrupt payments, false books and records or inadequate internal controls. In that regard, the Company has represented that it has implemented and will continue to implement a compliance and ethics program designed to prevent and detect violations of the FCPA and other applicable anti-corruption laws. The Company will periodically report to the government during the term of the DPA regarding such remediation and implementation of compliance measures. As part of the settlement, the Company also agreed pursuant to the Consent to certain reporting obligations to the SEC regarding the status of the Company’s remediation and implementation of compliance measures. In the event that the Company fails to comply with these obligations, it could be subject to criminal prosecution by the DOJ for the FCPA-related matters we self-reported.
	Review of Potential Improper Payments Involving Brazil Subsidiary
	In August 2013, the Company’s internal legal department was notified of certain allegations involving potential improper payments with respect to its Brazilian subsidiary, Orthofix do Brasil. The Company engaged outside counsel to assist in the review of these matters, focusing on compliance with applicable anti-bribery laws, including the FCPA. This review remains ongoing. The FCPA and related provisions of law provide for potential criminal and civil sanctions in connection with anti-bribery violations, including criminal fines, civil penalties, disgorgement of past profits and other kinds of remedies. The Company currently cannot reasonably estimate a possible loss, or range of loss, in connection with this review.
	Consistent with the provisions of the DPA and the Consent described above, the Company contacted the DOJ and the SEC in August 2013 to voluntarily self-report the Brazil-related allegations, and the Company and its counsel remain in contact with both agencies regarding the status of the review. In the event that the DOJ and the SEC find that the matters related to the Company’s Brazilian subsidiary could give rise to a review of the Company’s obligations under the terms of the DPA and/or the Consent, the Company currently cannot reasonably estimate a possible loss, or range of loss, in connection with that review, including any effects it may have with respect to the DPA and the Consent.
	Corporate Integrity Agreement with HHS-OIG
	As previously disclosed, on June 6, 2012, the Company entered into a definitive settlement agreement with the United States of America, acting through the DOJ and on behalf of HHS-OIG; the TRICARE Management Activity, through its General Counsel; the Office of Personnel Management, in its capacity as administrator of the Federal Employees Health Benefits Program; the United States Department of Veteran Affairs; and the qui tam relator, pursuant to which the Company agreed to pay $34.2 million (plus interest at a rate of 3% from May 5, 2011 through the day before payment was made) to settle criminal and civil matters related to the promotion and marketing of the Company’s regenerative stimulator devices (which the Company has also described in the past as its “bone growth stimulator devices”). In connection with such settlement agreement, Orthofix Inc., the Company’s wholly owned subsidiary, also pled guilty to one felony count of obstruction of a June 2008 federal audit (§18 U.S.C. 1516) and paid a criminal fine of $7.8 million and a mandatory special assessment of $400. Also as previously disclosed, on October 29, 2012, the Company, through Blackstone, entered into a definitive settlement agreement with the U.S. government and the qui tam relator, pursuant to which the Company paid $32 million to settle claims (covering a period prior to Blackstone’s acquisition by the Company) concerning the compensation of physician consultants and related matters. All of the $32 million we paid pursuant to such settlement was funded by proceeds the Company received from an escrow fund established in connection with its acquisition of Blackstone in 2006.
	On June 6, 2012, in connection with these settlements, the Company also entered into a five-year corporate integrity agreement with HHS-OIG (the “CIA”). The CIA acknowledges the existence of the Company’s current compliance program and requires that the Company continues to maintain during the term of the CIA a compliance program designed to promote compliance with federal healthcare and FDA requirements. The Company also is required to maintain several elements of its previously existing program during the term of the CIA, including maintaining a Chief Compliance Officer, a Compliance Committee, and a Code of Conduct. The CIA requires that we conduct certain additional compliance-related activities during the term of the CIA, including various training and monitoring procedures, and maintaining a disciplinary process for compliance obligations.
	Pursuant to the CIA, the Company is required to notify the HHS-OIG in writing, among other things, of: (i) any ongoing government investigation or legal proceeding involving an allegation that the Company has committed a crime or has engaged in fraudulent activities; (ii) any other matter that a reasonable person would consider a probable violation of applicable criminal, civil, or administrative laws related to compliance with federal healthcare programs or FDA requirements; and (iii) any change in location, sale, closing, purchase, or establishment of a new business unit or location related to items or services that may be reimbursed by federal healthcare programs. The Company is also subject to periodic reporting and certification requirements attesting that the provisions of the CIA are being implemented and followed, as well as certain document and record retention mandates. The CIA provides that in the event of an uncured material breach of the CIA, the Company could be excluded from participation in federal healthcare programs and/or subject to monetary penalties.
	Matters Related to the Company’s Former Breg Subsidiary and Possible Indemnification Obligations
	On May 24, 2012, the Company sold Breg to an affiliate of Water Street Healthcare Partners II, L.P. (“Water Street”) pursuant to a stock purchase agreement (the “Breg SPA”). Under the terms of the Breg SPA, upon closing of the sale, the Company and its subsidiary, Orthofix Holdings, Inc., agreed to indemnify Water Street and Breg with respect to certain specified matters, including (i) the government investigation and product liability matters regarding the previously owned infusion pump product line described below, and (ii) pre-closing sales of cold therapy units and certain post-closing sales of cold therapy units. The Company has established an accrual of $4.2 million for its indemnification obligations in connection with the July 2012 verdict described in the third paragraph below; however, actual liability in this case could be higher or lower than the amount accrued. The Company has not established any accrual in connection with its other indemnification obligations under the Breg SPA, and currently cannot reasonably estimate the possible loss, or range of loss, in connection with certain of such obligations (including with respect to the matters described in the three paragraphs below).
	Breg was engaged in the manufacturing and sale of local infusion pumps for pain management from 1999 to 2008. Since 2008, numerous product liability cases have been filed in the United States alleging that the local anesthetic, when dispensed by such infusion pumps inside a joint, causes a rare arthritic condition called “chondrolysis.” The Company incurred losses for settlements and judgments in connection with these matters during 2011, 2012 and 2013 for $1.8 million, $6.8 million and $6.7 million, respectively. The Company has also accrued $2.1 million for judgements and settlements in connection with these matters that were not covered by insurance. Since December 31, 2013, the Company has accrued an additional $3.8 million and paid $4.6 million in connection with these matters that were not covered by insurance. In addition, several cases remain outstanding for which the Company currently cannot reasonably estimate the possible loss, or range of loss.
	On or about August 2, 2010, Breg received a HIPAA subpoena issued by the DOJ. The subpoena seeks documents from the Company and its subsidiaries for the period of January 1, 2000 through the date of the subpoena. The Company believes that document production in response to the subpoena was completed as of July 2012. It believes that this subpoena relates to an investigation by the DOJ into whether Breg’s sale, marketing and labeling of local infusion pumps for pain management, prior to Breg’s divestiture of this product line in 2008, complied with FDA regulations and federal law. The Company is currently cooperating with the U.S. government in connection with this matter.
	At the time of its divestiture by the Company, Breg was currently and had been engaged in the manufacturing and sales of motorized cold therapy units used to reduce pain and swelling. Several domestic product liability cases have been filed in recent years, mostly in California state court, alleging that the use of cold therapy causes skin and/or nerve injury and seeking damages on behalf of individual plaintiffs who were allegedly injured by such units. The majority of these cases are at an early stage and no conclusion can be drawn at the present time regarding their potential outcome. However, the Company believes that meritorious defenses exist to these claims. In July 2012, a jury in one case related to a motorized cold therapy unit previously sold by Breg returned a verdict providing for approximately $2.1 million in compensatory damages to the plaintiff against Breg and $7 million in exemplary damages. The case remains subject to appeal. The Company believes that the damages are without merit; however, the ultimate outcome is uncertain. The Company previously established an accrual and related charge to discontinued operations of $4.2 million for both compensatory damages and exemplary damages for its indemnification obligations in connection with this July 2012 verdict; however, actual liability in this case could be higher or lower than the amount accrued.

Pensions_and_deferred_compensa

Pensions and deferred compensation	12 Months Ended
	Dec. 31, 2013
Compensation and Retirement Disclosure [Abstract]
Pensions and deferred compensation	18	Pensions and deferred compensation
	Orthofix Inc. sponsors a defined contribution plan (the “Orthofix Inc. 401(k) Plan”) covering substantially all full time US employees. The Orthofix Inc. 401(k) Plan allows for participants to contribute up to 15% of their pre-tax compensation, subject to certain limitations, with the Company matching 100% of the first 2% of the employee’s base compensation and 50% of the next 4% of the employee’s base compensation if contributed to the Orthofix Inc. 401(k) Plan. During the years ended December 31, 2013, 2012 and 2011, expenses incurred relating to 401(k) Plans, including matching contributions, were approximately $2.4 million, $2.5 million and $2.5 million, respectively.
	The Company operates defined contribution pension plans for its other International employees not described above meeting minimum service requirements. The Company’s expenses for such pension contributions during 2013, 2012 and 2011 were $0.7 million, $0.7 million and $0.8 million, respectively.
	Under Italian Law, Orthofix S.r.l. accrues, on behalf of its employees, deferred compensation, which is paid on termination of employment. Each year’s provision for deferred compensation is based on a percentage of the employee’s current annual remuneration plus an annual charge. Deferred compensation is also accrued for the leaving indemnity payable to agents in case of dismissal which is regulated by a national contract and is equal to approximately 3.5% of total commissions earned from the Company.
	The Orthofix Deferred Compensation Plan (the “Plan”), administered by the Board of Directors of the Company, effective January 1, 2007, and as amended and restated effective January 1, 2009, is a plan intended to allow a select group of key management and highly compensated employees of the Company to defer the receipt of compensation that would otherwise be payable to them. The terms of this plan are intended to comply in all respects with the provisions of Code Section 409A and Code Section 457A. As of January 1, 2011 the Company disallowed further contributions into the plan and any new plan participants. Distributions are made in accordance with the requirements of Code Section 409A.
	The Company’s expense for deferred compensation during 2013, 2012 and 2011 was approximately $0.3 million, $0.4 million and $0.1 million, respectively. Deferred compensation payments of $0.1 million and $0.8 million were made in 2013 and 2012, respectively, and no deferred compensation payments were made in 2011. The balance as of December 31, 2013 and 2012 was $2.5 and $2.3 million that represents the amount which would be payable if all the employees and agents had terminated employment at that date and is included in other long-term liabilities.

Sharebased_compensation_plans

Share-based compensation plans	12 Months Ended
	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-based compensation plans	19	Share-based compensation plans
	At December 31, 2013, the Company had stock option and award plans, and an employee stock purchase plan which are described below.
	2012 Long Term Incentive Plan
	The Board of Directors adopted the Orthofix International N.V. 2012 Long-Term Incentive Plan (the “2012 LTIP”) on April 13, 2012, subject to shareholder approval which was subsequently provided by shareholder ratification. The 2012 LTIP provides for the grant of options to purchase shares of the Company’s common stock, stock awards (including restricted stock, unrestricted stock, and stock units), stock appreciation rights, performance-based awards and other equity-based awards. All of the Company’s employees and the employees of the Company’s subsidiaries and affiliates are eligible, and may receive awards under the 2012 LTIP. In addition, the Company’s non-employee directors and consultants and advisors who perform services for the Company and the Company’s subsidiaries and affiliates may receive awards under the 2012 LTIP. Incentive share options, however, are only available to the Company’s employees. The Company reserves a total of 1,600,000 shares of common stock for issuance pursuant to the 2012 LTIP, subject to certain adjustments set forth in the 2012 LTIP. At December 31, 2013, there were 515,917 options outstanding under the 2012 LTIP Plan, of which 22,668 were exercisable; in addition, there were 279,039 shares of restricted stock outstanding, none of which were vested.
	2004 Long Term Incentive Plan
	The 2004 Long Term Incentive Plan (the “2004 LTIP Plan”) reserves 3.1 million shares for issuance (in addition to shares (i) available for future awards as of June 29, 2004 under prior plans or (ii) that become available for future issuance upon the expiration or forfeiture after June 29, 2004 of awards upon prior plans). Awards generally vest on years of service with all awards fully vesting within three years from the date of grant for employees and either three or five years from the date of grant for non-employee directors. Awards can be in the form of a stock option, restricted stock, restricted share unit, performance share unit, or other award form determined by the Board of Directors. Awards granted under the 2004 LTIP Plan expire no later than ten years after the date of the grant. The 2004 LTIP Plan provides an annual grant to non-employee directors of 5,000 shares and limits the future the number of shares that may be awarded under the plan as full value awards to 100,000 shares. At December 31, 2013, there were 1,243,262 options outstanding under the 2004 LTIP Plan, of which 1,179,601 were exercisable; in addition, there were 7,665 shares of restricted stock outstanding, none of which were vested.
	Staff Share Option Plan
	The Staff Share Stock Option Plan (the “Staff Share Plan”) is a fixed stock option plan which was adopted in April 1992. Under the Staff Share Plan, the Company granted options to its employees at the estimated fair market value of such options at the date of grant. Options generally vest based on years of service with all options to be fully vested within five years from date of grant. Options granted under the Staff Share Plan expire ten years after the date of grant. There are no options left to be granted under the Staff Plan. At December 31, 2013, there were 15,000 options outstanding and exercisable under the Staff Share Plan.
	Stock Purchase Plan
	The Orthofix International N.V. Amended and Restated Stock Purchase Plan (the “Stock Purchase Plan”) provides for the issuance of shares of the Company’s common stock to eligible employees and directors of the Company and its subsidiaries that elect to participate in the plan and acquire shares of common stock through payroll deductions (including executive officers).
	During each purchase period, eligible employees may designate between 1% and 25% of their compensation to be deducted for the purchase of common stock under the plan (up to 25% for employees working in North America, South America and Asia, and up to 15% for employees working in Europe). For eligible directors, the designated percentage will be an amount equal to his or her annual or other director compensation paid in cash for the current plan year. The purchase price of the shares under the plan is equal to 85% of the fair market value on the first day of the plan year (which is a calendar year, running from January 1 to December 31) or, if lower, on the last day of the plan year.
	Due to the compensatory nature of such plan, the Company has recorded the related share based compensation in the consolidated statement of operations. The aggregate number of shares reserved for issuance under the Employee Stock Purchase Plan is 1,850,000 shares. As of December 31, 2013, 1,437,519 shares had been issued under the Stock Purchase Plan.
	Share-Based Compensation:
	As of December 31, 2013, the unamortized compensation expense relating to options granted and expected to be recognized was $2.8 million. This amount is expected to be recognized through January 2018. The following table shows the detail of share-based compensation by line item in the consolidated statements of operations for the years ended December 31, 2013, 2012 and 2011 and the assumptions for each of these years in which grants were awarded:
	(U.S. Dollars in thousands, except assumptions)		Year Ended			Year Ended			Year Ended
			December 31,			December 31,			December 31,
			2013			2012			2011
	Cost of sales		$	104		$	592		$	153
	Sales and marketing			1,444			1,550			2,031
	General and administrative			4,483			4,023			4,322
	Research and development			236			138			142
	Total		$	6,267		$	6,303		$	6,648
	Assumptions:
	Expected term			5.00 years			4.50 years			4.58 years
	Expected volatility			32.1% – 50.8	%		50.9% – 51.8	%		49.6% – 49.9	%
	Risk free interest rate			0.58% – 1.52	%		0.76% – 0.84	%		.90% – 2.26	%
	Dividend rate			—			—			—
	Weighted average fair value of options granted during the year		$	10.83		$	16.99		$	14.21
	Stock Option Activity:
	Summaries of the status of the Company’s stock option plans as of December 31, 2013 and 2012 and changes during the year ended December 31, 2013 are presented below:
			Options			Weighted Average			Weighted
						Exercise Price			Average
									Remaining
									Contractual
									Term
	Outstanding at December 31, 2012			1,945,955		$	34.5
	Granted			466,250		$	28.51
	Exercised			(79,949	)	$	23.25
	Forfeited			(408,077	)	$	36.33
	Outstanding at December 31, 2013			1,924,179		$	33.12			4.41
	Vested and expected to vest at December 31, 2013			1,839,383		$	33.5			4.17
	Options exercisable at December 31, 2013			1,367,269		$	34.35			2.89
	Outstanding and exercisable by price range as of December 31, 2013
			Options Outstanding									Options Exercisable
	Range of Exercise Prices		Number			Weighted			Weighted			Number		Weighted
			Outstanding			Average			Average			Exercisable		Average
						Remaining			Exercise					Exercise
						Contractual			Price					Price
						Life
	$10.42 – $21.78			232,250			9.31		$	20.79			16,000	$	13.31
	$22.75 – $25.05			326,166			4.1		$	24.73			306,166	$	24.84
	$26.79 – $28.95			230,000			4.79		$	28.45			170,000	$	28.65
	$29.23 – $37.36			225,168			5.1		$	33.14			169,839	$	32.41
	$37.76 – $38.11			230,975			1.69		$	37.99			230,975	$	37.99
	$38.40 – $40.27			351,354			3.17		$	39.76			174,355	$	39.77
	$41.33 – $43.04			178,633			2.84		$	41.66			150,301	$	41.72
	$44.87 – $45.84			140,133			3.05		$	45.02			140,133	$	45.02
	$50.50 – $50.50			2,000			3.01		$	50.5			2,000	$	50.5
	$50.99 – $50.99			7,500			3.04		$	50.99			7,500	$	50.99
	$10.42 – $50.99			1,924,179			4.41		$	33.12			1,367,269	$	34.35
	The weighted average remaining contractual life of exercisable options was 2.89 years at December 31, 2013. The total intrinsic value of options exercised was $0.4 million, $7.2 million and $4.2 million for the years ended December 31, 2013, 2012 and 2011, respectively. The aggregate intrinsic value of options outstanding and options exercisable as of December 31, 2013 is calculated as the difference between the exercise price of the underlying options and the market price of the Company’s common stock for the shares that had exercise prices that were lower than the $22.82 closing price of the Company’s stock on December 31, 2013. The aggregate intrinsic value of options outstanding was $0.5 million, $11.2 million and $10.8 million for the years ended December 31, 2013, 2012, and 2011, respectively. The aggregate intrinsic value of options exercisable was $0.2 million, $9.8 million and $8.4 million for the years ended December 31, 2013, 2012 and 2011, respectively.
	Restricted Stock:
	During the year ended December 31, 2013, the Company granted to employees and non-employee directors 269,791 shares of restricted stock, which vest at various dates through October 2017. During the year ended December 31, 2012, the Company granted to employees and non-employee directors 149,500 shares of restricted stock, which vest at various dates through November 2015. The compensation expense, which represents the fair value of the stock measured at the market price at the date of grant, less estimated forfeitures, is recognized on a straight-line basis over the vesting period. Unamortized compensation expense related to restricted stock amounted to $6.7 million at December 31, 2013.
	A summary of the status of our restricted stock as of December 31, 2013 and 2012 and changes during the year ended December 31, 2013 are presented below:
		Shares			Weighted
					Average Grant
					Date Fair Value
Non-vested as of December 31, 2012			160,831		$	38.34
Granted			269,791		$	27.09
Vested			(62,948	)	$	36.58
Cancelled			(80,970	)	$	38.8
Non-vested as of December 31, 2013			286,704		$	28.01

Earnings_per_share

Earnings per share	12 Months Ended
	Dec. 31, 2013
Earnings Per Share [Abstract]
Earnings per share	20	Earnings per share
	For each of the three years ended December 31, 2013, there were no adjustments to net income (loss) for purposes of calculating basic and diluted net income (loss) available to common shareholders. The following is a reconciliation of the weighted average shares used in the basic and diluted net income (loss) per common share computations.
			Year Ended December 31,
			2013		2012		2011
	Weighted average common shares-basic			18,697,228		18,977,263		18,219,343
	Effect of diluted securities:
	Unexercised stock options net of treasury share repurchase			—		413,150		—
	Weighted average common shares-diluted			18,697,228		19,390,413		18,219,343
	No adjustment has been made in 2013 or 2011 for any common stock equivalents because their effects would be anti-dilutive. For 2013 and 2011, potentially dilutive shares totaled 101,672 and 344,168, respectively.
	Options to purchase shares of common stock with exercise prices in excess of the average market price of common shares are not included in the computation of diluted earnings per share. There were 1,186,259 and 789,650 outstanding options not included in the diluted earnings per share computation for the fiscal year ended December 31, 2013 and 2012, respectively, because the inclusion of these options was anti-dilutive.

Stock_Repurchase_Program

Stock Repurchase Program	12 Months Ended
	Dec. 31, 2013
Text Block [Abstract]
Stock Repurchase Program	21	Stock Repurchase Program
	On May 8, 2013, the Company announced that the Board of Directors had authorized a share repurchase program in an amount up to $50 million. Repurchases began on May 10, 2013 consisting primarily of open market transactions at prevailing market prices in accordance with the guidelines specified under Rule 10b-18 of the Securities Exchange Act of 1934, as amended. Repurchases are being made from cash on hand, cash generated from operations and additional borrowings. The timing of the transactions and the aggregate number of shares of common stock that will be ultimately repurchased under the repurchase program will depend on a variety of factors, including market conditions and the prices at which the securities are repurchased. The Company may discontinue repurchases without prior notice at any time if the Company determines additional repurchases are not warranted. The Company made total repurchases in 2013 of $39.5 million.

Quarterly_financial_data_unaud

Quarterly financial data (unaudited)	12 Months Ended
	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]
Quarterly financial data (unaudited)	22	Quarterly financial data (unaudited)
	We have restated all quarterly periods of 2012 and 2013, to reflect the effects of the Original Restatement and the Further Restatement described herein (see Note 2). The following tables summarize the impacts of the restatement on our previously reported condensed consolidated statements of operations and balance sheets included in our Quarterly Reports on Form 10-Q for each respective period.
	Condensed Consolidated Statement of Operations
	(U.S. Dollars, in thousands, except per share data)
			Originally			Original			Originally			Further			Restated
			Reported in			Restatement			Reported in			Restatement
			2013			Adjustments			2013			Adjustments
			Form 10-Q						Form 10-Q/A
			1st Quarter
	2013
	Net sales		$	100,254		$	3,119		$	103,373		$	(1,094	)	$	102,279
	Cost of sales			22,699			2,918			25,617			224			25,841
	Gross profit			77,555			201			77,756			(1,318	)		76,438
	Operating expense			73,531			(3,862	)		69,669			701			70,370
	Operating income			4,024			4,063			8,087			(2,019	)		6,068
	Net income from continuing operations			4,908			2,702			7,610			(1,684	)		5,926
	Net income		$	2,116		$	2,384		$	4,500		$	(1,053	)	$	3,447
	Net income (loss) per common share:
	Basic:
	Net income from continuing operations		$	0.25		$	0.14		$	0.39		$	(0.08	)	$	0.31
	Net income		$	0.11		$	0.12		$	0.23		$	(0.05	)	$	0.18
	Diluted:
	Net income from continuing operations		$	0.25		$	0.14		$	0.39		$	(0.09	)	$	0.3
	Net income		$	0.11		$	0.12		$	0.23		$	(0.05	)	$	0.18
			Originally			Original			Originally			Further			Restated
			Reported in			Restatement			Reported in			Restatement
			2013			Adjustments			2013			Adjustments
			Form 10-K						Form 10-K
			2nd Quarter
	2013
	Net sales		$	98,280		$	—		$	98,280		$	(640	)	$	97,640
	Cost of sales			20,246			—			20,246			1,638			21,884
	Gross profit			78,034			—			78,034			(2,278	)		75,756
	Operating expense			69,230			—			69,230			(394	)		68,836
	Operating income			8,804			—			8,804			(1,884	)		6,920
	Net income from continuing operations			4,130			—			4,130			(2,118	)		2,012
	Net loss		$	(2,317	)	$	—		$	(2,317	)	$	(694	)	$	(3,011	)
	Net income (loss) per common share:
	Basic:
	Net income from continuing operations		$	0.22		$	—		$	0.22		$	(0.11	)	$	0.11
	Net loss		$	(0.12	)	$	—		$	(0.12	)	$	(0.04	)	$	(0.16	)
	Diluted:
	Net income from continuing operations		$	0.21		$	—		$	0.21		$	(0.11	)	$	0.1
	Net loss		$	(0.12	)	$	—		$	(0.12	)	$	(0.04	)	$	(0.16	)
	Condensed Consolidated Statement of Operations
	(U.S. Dollars, in thousands, except per share data)
			Originally			Original			Originally			Further			Restated
			Reported in			Restatement			Reported in			Restatement
			2013			Adjustments			2013			Adjustments
			Form 10-K						Form 10-K
			3rd Quarter
	2013
	Net sales		$	92,738		$	—		$	92,738		$	(932	)	$	91,806
	Cost of sales			23,920			—			23,920			1,144			25,064
	Gross profit			68,818			—			68,818			(2,076	)		66,742
	Operating expense			84,418			—			84,418			(3,575	)		80,843
	Operating loss			(15,600	)		—			(15,600	)		1,499			(14,101	)
	Net loss from continuing operations			(18,084	)		—			(18,084	)		1,580			(16,504	)
	Net loss		$	(19,822	)	$	—		$	(19,822	)	$	986		$	(18,836	)
	Net income (loss) per common share:
	Basic:
	Net loss from continuing operations		$	(1.00	)	$	—		$	(1.00	)	$	0.09		$	(0.91	)
	Net loss		$	(1.10	)	$	—		$	(1.10	)	$	0.06		$	(1.04	)
	Diluted:
Net loss from continuing operations		$	(1.00	)	$	—		$	(1.00	)	$	0.09		$	(0.91	)
Net loss		$	(1.10	)	$	—		$	(1.10	)	$	0.06		$	(1.04	)
		4th Quarter
2013
Net sales		$	106,143		$	—		$	106,143		$	(257	)	$	105,886
Cost of sales			32,517			—			32,517			1,606			34,123
Gross profit			73,626			—			73,626			(1,863	)		71,763
Operating expense			80,004			—			80,004			1,838			81,842
Operating loss			(6,378	)		—			(6,378	)		(3,701	)		(10,079	)
Net loss from continuing operations			(8,564	)		—			(8,564	)		(1,075	)		(9,639	)
Net loss		$	(7,876	)	$	—		$	(7,876	)	$	(2,536	)	$	(10,412	)
Net income (loss) per common share:
Basic:
Net loss from continuing operations		$	(0.47	)	$	—		$	(0.47	)	$	(0.06	)	$	(0.53	)
Net loss		$	(0.43	)	$	—		$	(0.43	)	$	(0.15	)	$	(0.58	)
Diluted:
Net loss from continuing operations		$	(0.47	)	$	—		$	(0.47	)	$	(0.06	)	$	(0.53	)
Net loss		$	(0.43	)	$	—		$	(0.43	)	$	(0.15	)	$	(0.58	)
Condensed Consolidated Statement of Operations
(U.S. Dollars, in thousands, except per share data)
		As Reported			Original			As Originally			Further			Restated
		in the 2012			Restatement			Restated in			Restatement
		Form 10-K			Adjustments			the 2012			Adjustments
		Prior to						Form 10-K/A
		Original
		Restatement
		1st Quarter
2012
Net sales		$	116,041		$	(7,105	)	$	108,936		$	(1,773	)	$	107,163
Cost of sales			21,939			(561	)		21,378			2,767			24,145
Gross profit			94,102			(6,544	)		87,558			(4,540	)		83,018
Operating expense			71,671			(2,033	)		69,638			(1,409	)		68,229
Operating income			22,431			(4,511	)		17,920			(3,131	)		14,789
Net income from continuing operations			12,215			(3,618	)		8,597			(1,727	)		6,870
Net income		$	12,016		$	(2,609	)	$	9,407		$	(2,058	)	$	7,349
Net income (loss) per common share:
Basic:
Net income from continuing operations		$	0.65		$	(0.19	)	$	0.46		$	(0.09	)	$	0.37
Net income		$	0.64		$	(0.14	)	$	0.5		$	(0.11	)	$	0.39
Diluted:
Net income from continuing operations		$	0.64		$	(0.19	)	$	0.45		$	(0.09	)	$	0.36
Net income		$	0.63		$	(0.14	)	$	0.49		$	(0.11	)	$	0.38
		2nd Quarter
2012
Net sales		$	119,492		$	(6,069	)	$	113,423		$	(1,822	)	$	111,601
Cost of sales			23,676			3,871			27,547			(2,604	)		24,943
Gross profit			95,816			(9,940	)		85,876			782			86,658
Operating expense			75,251			(3,673	)		71,578			(1,542	)		70,036
Operating income			20,565			(6,267	)		14,298			2,324			16,622
Net income from continuing operations			13,967			(4,097	)		9,870			1,551			11,421
Net income		$	11,205		$	(3,951	)	$	7,254		$	1,548		$	8,802
Net income (loss) per common share:
Basic:
Net income from continuing operations		$	0.74		$	(0.22	)	$	0.52		$	0.09		$	0.61
Net income		$	0.59		$	(0.21	)	$	0.38		$	0.09		$	0.47
Diluted:
Net income from continuing operations		$	0.73		$	(0.22	)	$	0.51		$	0.08		$	0.59
Net income		$	0.58		$	(0.21	)	$	0.37		$	0.09		$	0.46
Condensed Consolidated Statement of Operations
(U.S. Dollars, in thousands, except per share data)
		As Reported			Original			As Originally			Further			Restated
		in the 2012			Restatement			Restated in			Restatement
		Form 10-K			Adjustments			the 2012			Adjustments
		Prior to						Form 10-K/A
		Original
		Restatement
		3rd Quarter
2012
Net sales		$	114,752		$	(6,895	)	$	107,857		$	(2,039	)	$	105,818
Cost of sales			22,373			2,011			24,384			503			24,887
Gross profit			92,379			(8,906	)		83,473			(2,542	)		80,931
Operating expense			70,846			(6,178	)		64,668			(680	)		63,988
Operating income			21,533			(2,728	)		18,805			(1,862	)		16,943
Net income from continuing operations			13,118			(2,544	)		10,574			(1,262	)		9,312
Net income		$	7,560		$	(2,544	)	$	5,016		$	(1,269	)	$	3,747
Net income (loss) per common share:
Basic:
Net income from continuing operations		$	0.69		$	(0.14	)	$	0.55		$	(0.06	)	$	0.49
Net income		$	0.4		$	(0.14	)	$	0.26		$	(0.06	)	$	0.2
Diluted:
Net income from continuing operations		$	0.67		$	(0.13	)	$	0.54		$	(0.06	)	$	0.48
Net income		$	0.39		$	(0.14	)	$	0.25		$	(0.06	)	$	0.19
		4th Quarter
2012
Net sales		$	112,035		$	5,330		$	117,365		$	(1,758	)	$	115,607
Cost of sales			18,504			6,440			24,944			1,807			26,751
Gross profit			93,531			(1,110	)		92,421			(3,565	)		88,856
Operating expense			69,050			(2,242	)		66,808			(4,470	)		62,338
Operating income			24,481			1,132			25,613			905			26,518
Net income from continuing operations			14,636			1,373			16,009			1,509			17,518
Net income		$	20,514		$	647		$	21,161		$	1,793		$	22,954
Net income (loss) per common share:
Basic:
Net income from continuing operations		$	0.76		$	0.07		$	0.83		$	0.08		$	0.91
Net income		$	1.06		$	0.04		$	1.1		$	0.09		$	1.19
Diluted:
Net income from continuing operations		$	0.74		$	0.07		$	0.81		$	0.08		$	0.89
Net income		$	1.04		$	0.03		$	1.07		$	0.1		$	1.17
Condensed Consolidated Balance Sheets
(U.S. Dollars, in thousands, except share and per share data)		Originally			Original			Originally			Further			Restated
		Reported in			Restatement			Restated in			Restatement
		2013			Adjustments			2013			Adjustments
		Form 10-Q						Form 10-Q/A
		1st Quarter
2013
Total assets		$	503,380		$	(27,622	)	$	475,758		$	(11,605	)	$	464,153
Total liabilities			101,212			1,154			102,366			812			103,178
Total shareholders’ equity			402,168			(28,776	)		373,392			(12,417	)		360,975
Total liabilities and shareholders’ equity		$	503,380		$	(27,622	)	$	475,758		$	(11,605	)	$	464,153
		Originally			Original			Originally			Further			Restated
		Reported in			Restatement			Reported in			Restatement
		2013			Adjustments			2013			Adjustments
		Form 10-K						Form 10-K
		2nd Quarter
2013
Total assets		$	459,450		$	—		$	459,450		$	(13,129	)	$	446,321
Total liabilities			114,223			—			114,223			(48	)		114,175
Total shareholders’ equity			345,227			—			345,227			(13,081	)		332,146
Total liabilities and shareholders’ equity		$	459,450		$	—		$	459,450		$	(13,129	)	$	446,321
		3rd Quarter
2013
Total assets		$	430,058		$	—		$	430,058		$	(14,534	)	$	415,524
Total liabilities			111,001			—			111,001			(2,470	)		108,531
Total shareholders’ equity			319,057			—			319,057			(12,064	)		306,993
Total liabilities and shareholders’ equity		$	430,058		$	—		$	430,058		$	(14,534	)	$	415,524
		4th Quarter
2013
Total assets		$	423,182		$	—		$	423,182		$	(11,207	)	$	411,975
Total liabilities			112,688			—			112,688			3,424			116,112
Total shareholders’ equity			310,494			—			310,494			(14,631	)		295,863
Total liabilities and shareholders’ equity		$	423,182		$	—		$	423,182		$	(11,207	)	$	411,975
Condensed Consolidated Balance Sheets
(U.S. Dollars, in thousands, except share and per share data)		As Reported			Original			As Originally			Further			Restated
		in the 2012			Restatement			Restated in			Restatement
		Form 10-K			Adjustments			the 2012			Adjustments
		Prior to						Form 10-K/A
		Original
		Restatement
		1st Quarter
2012
Total assets		$	707,586		$	(13,480	)	$	694,106		$	(13,510	)	$	680,596
Total liabilities			369,178			12,556			381,734			317			382,051
Total shareholders’ equity			338,408			(26,036	)		312,372			(13,827	)		298,545
Total liabilities and shareholders’ equity		$	707,586		$	(13,480	)	$	694,106		$	(13,510	)	$	680,596
		2nd Quarter
2012
Total assets		$	553,320		$	(22,925	)	$	530,395		$	(9,547	)	$	520,848
Total liabilities			199,104			6,092			205,196			2,731			207,927
Total shareholders’ equity			354,216			(29,017	)		325,199			(12,278	)		312,921
Total liabilities and shareholders’ equity		$	553,320		$	(22,925	)	$	530,395		$	(9,547	)	$	520,848
		3rd Quarter
2012
Total assets		$	565,073		$	(25,507	)	$	539,566		$	(11,392	)	$	528,174
Total liabilities			187,463			6,136			193,599			2,156			195,755
Total shareholders’ equity			377,610			(31,643	)		345,967			(13,548	)		332,419
Total liabilities and shareholders’ equity		$	565,073		$	(25,507	)	$	539,566		$	(11,392	)	$	528,174
		4th Quarter
2012
Total assets		$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
Total liabilities			105,183			(118	)		105,065			3,042			108,107
Total shareholders’ equity			399,098			(31,266	)		367,832			(11,393	)		356,439
Total liabilities and shareholders’ equity		$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
Note: The sum of the quarterly earnings per share may not equal the full year amount, as the computations of the weighted average number of common shares outstanding for each quarter and full year are performed independently.
There were no material impacts to the consolidated statements of cash flows for the restated interim quarterly periods contained within the fiscal years ended December 31, 2013 and 2012 that are not representative of the changes presented in the consolidated statements of cash flows for the years ended December 31, 2013 and 2012. See Note 2 “Original and Further Restatement of the Consolidated Financial Statements.”

Subsequent_events

Subsequent events	12 Months Ended
	Dec. 31, 2013
Subsequent Events [Abstract]
Subsequent events	23	Subsequent events
	On August 14, 2014 the Lenders and the Company entered into a subsequent Limited Waiver which was extended on September 30, 2014, January 15, 2015 and February 26, 2015 (the “Subsequent Limited Waivers”). Under the Subsequent Limited Waivers, the Lenders collectively waived requirements under the Credit Agreement that the Company deliver quarterly financial statements with respect to the fiscal quarters ended June 30, 2014 and September 30, 2014, and related financial covenant certificates, until the earlier of (i) March 31, 2015 or (ii) the date that is one day after such financial statements are publicly filed or released. The Subsequent Limited Waivers also extend the date by which the Company is required to provide certain 2014 fiscal year financial statements until the earlier of (i) one business day following the date that the Company files its Annual Report on Form 10-K for the fiscal year ended December 31, 2014 or (ii) April 30, 2015. In addition, the Subsequent Limited Waivers provided that the Further Restatement would not constitute a default or event of default provided that within one business day after the public release or filing of such restated financial statements, the Company delivered corrected financial statements and compliance certificates with respect to such restated periods and immediately paid any additional interest and other fees that would have been owed had applicable interest and fees originally been calculated based on the restated financial statements.
	In January 2015, the Company completed the sale of its Tempus™ Cervical Plate product line, which was part of the Company’s Spine Fixation SBU. The sale included the transfer of net assets of $2.1 million, consisting of intellectual property and the associated inventory, in exchange for consideration of $4.8 million in cash.
	On March 4, 2015, the Company entered into an Option Agreement (the “Option Agreement”) with eNeura, Inc. (“eNeura”), a privately held medical technology company that is developing devices for the treatment of migraines. The Option Agreement provides the Company with an exclusive option to acquire eNeura (the “Option”) during the 18-month period following the grant of the Option. In consideration for the Option, (i) the Company paid a non-refundable $250,000 fee to eNeura, and (ii) eNeura issued a Convertible Promissory Note (the “eNeura Note”) to the Company. The principal amount of the eNeura Note is $15,000,000 and interest will accrue at 8%. The eNeura Note will mature on the earlier of (i) March 4, 2019, or (ii) consummation of the acquisition (as described below), unless converted or prepaid at an earlier date. The Company will be entitled to designate one representative for appointment to the board of directors of eNeura during the 18-month option period. Pursuant to an Agreement and Plan of Merger between the Company, eNeura and certain other parties, if the Company exercises the Option to acquire eNeura, the Company will pay to former eNeura shareholders $65 million (subject to certain positive or negative adjustments based on the assets and liabilities of eNeura). In addition, during the 4-year period following the closing of such acquisition, the Company may be required to pay additional cash consideration to eNeura shareholders upon the satisfaction of certain milestones.

Schedule_1Condensed_Financial_

Schedule 1-Condensed Financial Information of Registrant Orthofix International N.V.	12 Months Ended
	Dec. 31, 2013
Condensed Financial Information of Parent Company Only Disclosure [Abstract]
Schedule 1-Condensed Financial Information of Registrant Orthofix International N.V.	Schedule 1—Condensed Financial Information of Registrant Orthofix International N.V.
	Condensed Balance Sheets (unaudited)
	(U.S. Dollars in thousands)		December 31,			December 31,
			2013			2012
			(Restated)			(Restated)
	Assets
	Current assets:
	Cash and cash equivalents		$	1,426		$	7,392
	Prepaid expenses and other current assets			670			534
	Total current assets			2,096			7,926
	Other long term assets			—			15
	Investments in and amounts due from subsidiaries and affiliates			308,173			357,811
	Total assets		$	310,269		$	365,752
	Liabilities and shareholder’s equity
	Current liabilities		$	6,295		$	1,202
	Long-term liabilities			8,111			8,111
	Shareholder’s equity:
	Common stock			1,810			1,934
	Additional paid in capital			216,653			246,306
	Accumulated earnings			73,897			102,709
	Accumulated other comprehensive income			3,503			5,490
				295,863			356,439
	Total liabilities and shareholder’s equity		$	310,269		$	365,752
	See accompanying notes to condensed financial statements.
	Orthofix International N.V.
	Schedule 1—Condensed Financial Information of Registrant Orthofix International N.V.
	Condensed Statements of Operations (unaudited)
	(U.S. Dollars in thousands)		Year Ended			Year Ended			Year Ended
			December 31,			December 31,			December 31,
			2013			2012			2011
			(Restated)			(Restated)			(Restated)
	(Expenses) income:
	General and administrative		$	(16,641	)	$	(7,700	)	$	(11,134	)
	Equity in earnings of investments in subsidiaries and affiliates			(12,494	)		50,331			(5,884	)
	Other, net			323			24			7
	(Loss) income before income taxes			(28,812	)		42,655			(17,011	)
	Income tax benefit (expense)			—			197			(687	)
	Net (loss) income		$	(28,812	)	$	42,852		$	(17,698	)
	See accompanying notes to condensed financial statements.
	Orthofix International N.V.
	Schedule 1—Condensed Financial Information of Registrant Orthofix International N.V.
	Condensed Statement of Cash Flows (unaudited)
	(U.S. Dollars in thousands)		Year Ended			Year Ended			Year Ended
			December 31,			December 31,			December 31,
			2013			2012			2011
			(Restated)			(Restated)			(Restated)
	Net (loss) income		$	(28,812	)	$	42,852		$	(17,698	)
	Equity in earnings of (loss) investments in subsidiaries and affiliates			12,494			(50,331	)		5,884
	Cash (used in) provided by other operating activities			468			(6,811	)		3,429
	Net cash used in operating activities			(15,850	)		(14,290	)		(8,385	)
	Cash flows from investing activities:
	Distributions and amounts received from subsidiaries			53,389			12,564			5,875
	Capital expenditures			—			—			—
	Net cash provided by investing activities			53,389			12,564			5,875
	Cash flows from financing activities:
	Net proceeds from issuance of common stock			3,450			25,586			20,113
	Repurchase of treasury shares			(39,494	)		—			—
	Contributions to subsidiaries and affiliates			(7,543	)		(36,921	)		(2,789	)
	Tax benefit on exercise of stock options			82			1,020			1,737
	Net cash (used in) provided by financing activities			(43,505	)		(10,315	)		19,061
	Net (decrease) increase in cash and cash equivalents			(5,966	)		(12,041	)		16,551
	Cash and cash equivalents at the beginning of the year			7,392			19,433			2,882
	Cash and cash equivalents at the end of the year		$	1,426		$	7,392		$	19,433
	See accompanying notes to condensed financial statements.
Orthofix International N.V.
Schedule 1—Condensed Financial Information of Registrant Orthofix International N.V.
Notes to Condensed Financial Statements (unaudited)
1	Background and basis of presentation
These condensed parent company financial statements have been prepared in accordance with Rule 12-04, Schedule 1 of Regulation S-X, as the restricted net assets of Orthofix Holdings, Inc. and its subsidiaries exceed 25% of the consolidated net assets of Orthofix International N.V. and its subsidiaries (the “Company”). This information should be read in conjunction with the Company’s consolidated financial statements included elsewhere in this filing.
2	Restricted net assets of subsidiaries
Certain of the Company’s subsidiaries have restrictions on their ability to pay dividends or make intercompany loans and advances pursuant to their financing arrangements. The amount of restricted net assets the Company’s subsidiaries held at December 31, 2013 and 2012 was approximately $168.5 million and $194.5 million, respectively. Such restrictions are on net assets of Orthofix Holdings, Inc. and its subsidiaries.
3	Commitments, contingencies and long-term obligations
For a discussion of the Company’s commitments, contingencies and long term obligations under its senior secured credit facility, see Note 9, Note 12 and Note 17 of the Company’s consolidated financial statements.
4	Dividends from subsidiaries
Orthofix International N.V. did not receive cash dividends in 2013 or 2012.

Schedule_2Valuation_and_Qualif

Schedule 2-Valuation and Qualifying Accounts	12 Months Ended
	Dec. 31, 2013
Valuation and Qualifying Accounts [Abstract]
Schedule 2-Valuation and Qualifying Accounts	Schedule 2—Valuation and Qualifying Accounts
	For the years ended December 31, 2013, 2012 and 2011:
						Additions
	(U.S. Dollars in thousands)		Balance at			Charged to			Charged			Deductions/			Balance at
	Provisions from assets to which they apply:		beginning			cost and			(credited)			Other			end of year
			of year			expenses			to other
									accounts
	2013 (Restated)
	Allowance for doubtful accounts receivable		$	6,673		$	4,590			—		$	(2,152	)	$	9,111
	Deferred tax valuation allowance			26,361			5,411			—			—			31,772
	2012 (Restated)
	Allowance for doubtful accounts receivable		$	6,184		$	2,027		$	(13	)	$	(1,525	)	$	6,673
	Deferred tax valuation allowance			19,124			7,237			—			—			26,361
	2011 (Restated)
	Allowance for doubtful accounts receivable		$	6,784	(1)	$	4,523		$	—		$	(5,123	)	$	6,184
	Deferred tax valuation allowance			21,023			(1,899	)		—			—			19,124
	-1	Balance at beginning of year includes a $242 thousand increase in allowance for doubtful accounts for an error correction recorded in the Further Restatement.

Summary_of_significant_account1

Summary of significant accounting policies (Policies)	12 Months Ended
	Dec. 31, 2013
Accounting Policies [Abstract]
Basis of consolidation	(a)	Basis of consolidation
	The consolidated financial statements include the financial statements of the Company and its wholly owned and majority-owned subsidiaries and entities over which the Company has control. All intercompany accounts and transactions are eliminated in consolidation.
Reclassifications	(b) Reclassifications
	The Company has reclassified certain line items to conform to the current year presentation. The reclassifications have no effect on previously reported net earnings or shareholders’ equity.
Use of estimates in preparation of financial statements	(c)	Use of estimates in preparation of financial statements
	The preparation of financial statements in conformity with United States generally accepted accounting principles (“U.S. GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. On an ongoing basis, we evaluate these estimates, including those related to contractual allowances, doubtful accounts, inventories, potential intangible assets and goodwill impairment, income taxes, and share-based compensation. We base our estimates on historical experience, future expectations and on other relevant assumptions that are believed to be reasonable under the circumstances, the results of which form the basis for making judgments about the carrying values of assets and liabilities that are not readily apparent from other sources. Actual results could differ from those estimates.
Foreign currency translation	(d)	Foreign currency translation
	The financial statements for operations outside the United States are generally maintained in their local currency. All foreign currency denominated balance sheet accounts, except shareholders’ equity, are translated to U.S. dollars at year end exchange rates and revenue and expense items are translated at weighted average rates of exchange prevailing during the year. Gains and (losses) resulting from the translation of foreign currency are recorded in the accumulated other comprehensive income component of shareholders’ equity. Transactional foreign currency gains and (losses), including those generated from intercompany operations, are included in other expense, net and were $0.5 million loss, $0.4 million loss and $1.7 million loss for the years ended December 31, 2013, 2012 and 2011, respectively.
Cash and cash equivalents	(e) Cash and cash equivalents
	The Company considers all highly liquid investments with an original maturity of three months or less at the date of purchase to be cash equivalents.
Restricted cash	(f) Restricted cash
	Restricted cash consists of cash held at certain subsidiaries, the distribution or transfer of which to Orthofix International N.V. (the “Parent”) or other subsidiaries that are not parties to the credit facility described in Note 9 is restricted. The senior secured credit facility restricts the Parent and subsidiaries that are not parties to the facility from access to cash held by Orthofix Holdings, Inc. and its subsidiaries. All credit party subsidiaries have access to this cash for operational and debt repayment purposes.
Market risk	(g) Market risk
	In the ordinary course of business, the Company is exposed to the impact of changes in interest rates and foreign currency fluctuations. The Company’s objective is to limit the impact of such movements on earnings and cash flows. In order to achieve this objective, the Company seeks to balance its non-U.S. dollar denominated income and expenditures. During 2013, 2012 and 2011, the Company made use of a foreign currency swap agreement to manage cash flow exposure generated from foreign currency fluctuations.
	The Company generally does not require collateral on trade receivables.
Inventories	(h) Inventories
	Inventories are valued at the lower of cost or estimated net realizable value, after provision for excess, obsolete or impaired items which is reviewed and updated on a periodic basis by management. For inventory procured or produced, whether internally or through contract manufacturing arrangements, at our manufacturing facility in Italy, cost is determined on a weighted-average basis, which approximates the first-in, first-out (“FIFO”) method, due to the high turn-over rate of inventory at this location. For inventory procured or produced, whether internally or through contract manufacturing arrangements, at our manufacturing facility in Texas, standard costs, which approximates actual cost on the FIFO method, is used to value inventory. Standard costs are reviewed annually by management, or more often in the event circumstances indicate a change in cost has occurred. The valuation of work-in-process, finished products, field inventory and consignment inventory includes the cost of materials, labor and other production costs. Field inventory represents immediately saleable finished products inventory that is in the possession of the Company’s direct sales representatives. Consignment inventory represents immediately saleable finished products located at third party customers, such as distributors and hospitals.
Long-lived assets, including intangibles	(i)	Long-lived assets, including intangibles
	Property, plant and equipment is stated at cost less accumulated depreciation. Costs include all expenditures necessary to place the asset in service, including freight and sales and use taxes. Plant equipment also includes instrumentation held by customers and is generally used to facilitate the implantation of the Company’s products, the associated cost and accumulated depreciation as of December 31, 2013 was $56.7 million and ($35.4 million), respectively. Depreciation is computed on a straight-line basis over the useful lives of the assets. Depreciation of leasehold improvements is computed over the shorter of the lease term or the useful life of the asset. The useful lives are as follows:
			Years
	Buildings			25 to 33
	Plant equipment and instrumentation			2 to 10
	Furniture and fixtures			4 to 8
	Expenditures for maintenance and repairs and minor renewals and improvements, which do not extend the lives of the respective assets, are expensed as incurred. All other expenditures for renewals and improvements are capitalized. The assets and related accumulated depreciation are adjusted for property retirements and disposals, with the resulting gain or loss included in operations. Fully depreciated assets remain in the accounts until retired from service.
	Patents and other intangible assets are recorded at cost, or when acquired as a part of a business combination at estimated fair value. These assets primarily include patents and other technology agreements (“developed technologies”) and trademarks. Identifiable intangible assets which are considered definite lived are amortized over their useful lives using a method of amortization that reflects the pattern in which the economic benefit of the intangible assets is consumed. The Company’s weighted average amortization period for developed technologies is 11 years.
	Intangible and long-lived assets with definite lives, such as developed technologies, are tested for impairment if any adverse conditions exist or change in circumstances have occurred that would indicate impairment or a change in the remaining useful life. If an impairment indicator exists, the Company tests the intangible asset for recoverability. For purposes of the recoverability test, the Company groups its intangible assets with other assets and liabilities at the lowest level of identifiable cash flows if the intangible asset does not generate cash flows independent of other assets and liabilities. If the carrying value of the intangible asset (asset group) exceeds the undiscounted cash flows expected to result from the use and eventual disposition of the intangible asset (asset group), the Company will write the carrying value down to the fair value in the period identified.
	The Company generally calculates fair value of indefinite-lived intangible assets as the present value of estimated future cash flows. In determining the estimated future cash flows associated with intangible assets, the Company uses estimates and assumptions about future revenue contributions, cost structures and remaining useful lives of the asset (asset group). The use of alternative assumptions, including estimated cash flows, discount rates, and alternative estimated remaining useful lives could result in different calculations of impairment.
Goodwill	(j)	Goodwill
	The Company tests goodwill at least annually for impairment. The Company tests more frequently if indicators are present or changes in circumstances suggest that impairment may exist. These indicators include, among others, declines in sales, earnings or cash flows, or the development of a material adverse change in the business climate. The Company assesses goodwill for impairment at the reporting unit level, which is defined as an operating segment or one level below an operating segment, referred to as a reporting unit. The Company has identified four reporting units, which are consistent with the Company’s reporting segments: BioStim, Biologics, Extremity Fixation, and Spine Fixation.
	In order to calculate the respective carrying values, the Company initially recorded goodwill based on the purchase price allocation performed at the time of acquisition. Corporate assets and liabilities that directly relate to a reporting unit’s operations are ascribed directly to that reporting unit. Corporate assets and liabilities that are not directly related to a specific reporting unit, but from which the reporting unit benefits, are allocated based on the respective contribution measure of each reporting unit. Effective July 1, 2013, the Company re-aligned its reporting units and consequently reallocated the carrying value of goodwill from its previous reporting units to its new reporting units based on the relative fair value of each new reporting unit to total enterprise value at July 1, 2013.
	As a result of the Company’s change in reporting structure, the Company allocated goodwill to each reporting unit, and subsequently evaluated each reporting unit for possible impairment of goodwill, as there were indicators of impairment when completing a qualitative analysis. The result of this analysis was a full impairment of the goodwill allocated to the Extremity Fixation and Spine Fixation reportable units, totaling $19.2 million.
	The Company’s annual goodwill impairment analysis, which was performed qualitatively during the fourth quarter of 2013, did not result in any additional impairment charge.
Derivative instruments	(k) Derivative instruments
	The Company manages its exposure to fluctuating cash flows resulting from changes in interest rates and foreign exchange within the consolidated financial statements according to its hedging policy. Under the policy, the Company may engage in non-leveraged transactions involving various financial derivative instruments to manage exposed positions. The policy requires the Company to formally document the relationship between the hedging instrument and hedged item, as well as its risk-management objective and strategy for undertaking the hedge transaction. For instruments designated as a cash flow hedge, the Company formally assesses (both at the hedge’s inception and on an ongoing basis) whether the derivative that is used in the hedging transaction has been effective in offsetting changes in the cash flows of the hedged item and whether such derivative may be expected to remain effective in future periods. If it is determined that a derivative is not (or has ceased to be) effective as a hedge, the Company will discontinue the related hedge accounting prospectively. Such a determination would be made when (1) the derivative is no longer effective in offsetting changes in the cash flows of the hedged item; (2) the derivative expires or is sold, terminated or exercised; or (3) management determines that designating the derivative as a hedging instrument is no longer appropriate. Ineffective portions of changes in the fair value of cash flow hedges are recognized in earnings.
	The Company records all derivatives as either assets or liabilities on the balance sheet at their respective fair values. For a cash flow hedge, the effective portion of the derivative’s change in fair value (i.e. gains or losses) is initially reported as a component of other comprehensive income, net of related taxes, and subsequently reclassified into net earnings when the hedged exposure is no longer effective.
	The Company utilizes a cross currency swap to manage its foreign currency exposure related to a portion of the Company’s intercompany receivable of a U.S. dollar functional currency subsidiary that is denominated in Euro. The cross currency swap has been accounted for as a cash flow hedge in accordance with ASC Topic 815, Derivatives and Hedging.
Accumulated other comprehensive income	(l)	Accumulated other comprehensive income
	Accumulated other comprehensive income is comprised of foreign currency translation adjustments and the effective portion of the gain (loss) on the Company’s cross-currency swap, which is designated and accounted for as a cash flow hedge (see Note 10) and the unrealized gain (loss) on warrants. The components of and changes in accumulated other comprehensive income are as follows:
	(U.S. Dollars in thousands)		Foreign Currency			Change in			Accumulated Other
			Translation			Fair Value			Comprehensive
			Adjustments						Income
	Balance at December 31, 2011 (Restated)		$	4,228		$	(132	)	$	4,096
	Unrealized gain on cross-currency swaps, net of taxes of $153			—			263			263
	Foreign currency translation adjustment (1)			1,131			—			1,131
	Balance at December 31, 2012 (Restated)			5,359			131			5,490
	Unrealized loss on cross-currency swaps, net of tax benefit of $164			—			(278	)		(278	)
	Unrealized gain (loss) on warrants			—			(1	)		(1	)
	Foreign currency translation adjustment (1)			(1,708	)		—			(1,708	)
	Balance at December 31, 2013 (Restated)		$	3,651		$	(148	)	$	3,503
	-1	As the cash generally remains permanently invested in the non U.S. dollar denominated foreign subsidiaries, no deferred taxes are recognized on the related foreign currency translation adjustment.
Revenue recognition and accounts receivable	(m)	Revenue recognition and accounts receivable
	Commercial revenue is related to the sale of the Company’s implant products, generally representing hospital customers. Revenues are recognized when these products have been utilized and a confirming purchase order has been received from the hospital.
	Revenue is derived from third-party payors, including commercial insurance carriers, health maintenance organizations, preferred provider organizations and governmental payors such as Medicare, in connection with the sale of our stimulation products. Revenue is recognized when the stimulation product is placed on or implanted in and accepted by the patient. Amounts paid by these third-party payors are generally based on fixed or allowable reimbursement rates. These revenues are recorded at the expected or pre-authorized reimbursement rates, net of any contractual allowances or adjustments. Certain billings are subject to review by the third-party payors and may be subject to adjustment.
	For distributor revenue, which is related primarily to implant products, the Company recognizes revenue either on a sell-in or sell-through basis depending on the specific circumstances of the distributor. In some cases the Company recognizes distributor revenue as title and risk of loss passes at either shipment from the Company’s facilities or receipt at the distributor’s facility, assuming all other revenue recognition criteria has been achieved (the “sell-in method”). Based on the results of the Independent Review, the Company determined in some cases the revenue recognition criteria for distributor sales were not satisfied at the time of shipment or receipt; specifically, the existence of extra-contractual terms or arrangements caused the Company not to meet the fixed or determinable criteria for revenue recognition in some cases, and in others collectability had not been established. In situations where we are unable to satisfy the requirements to recognize revenue on the sell-in method, we recognize revenue relating to distributor arrangements once the product is delivered to the end customer (the “sell-through method”). Because the Company does not have reliable information about when its distributors sell the product through to end customers, the Company uses cash collection from distributors as a basis for revenue recognition under the sell-through method. Although in many cases the Company is legally entitled to the accounts receivable at the time of shipment, the Company has not recognized accounts receivables or any corresponding deferred revenues associated with distributor transactions for which revenue is recognized on the sell-through method. Effective April 1, 2013, all distributor revenue is recognized on the sell-through basis.
	For distributors on the sell-in method prior to April 1, 2013, cost of sales is recognized upon shipment. For sell-through distributors, whose revenue is recognized upon cash receipt, the Company considers whether to match the related cost of sales expense with revenue or to recognize expense upon shipment. In making this assessment, the Company considers the financial viability of its distributors based on their creditworthiness to determine if collectability of amounts sufficient to realize the costs of the products shipped is reasonably assured at the time of shipment to these distributors. In instances where the distributor is determined to be financially viable, the Company defers the costs of sales until the revenue is recognized.
	Biologics revenue is primarily related to a collaborative arrangement with MTF. In 2008, the Company entered into a collaborative arrangement with MTF to develop and commercialize Trinity Evolution®, a stem cell-based bone growth biologic matrix. With the development process completed in 2009, the Company and MTF operated under the terms of a separate commercialization agreement. Under the terms of the 10-year agreement, MTF sourced the tissue, processed it to create the bone growth matrix, packaged and delivered it to the customer in accordance with orders received from the Company. The Company has exclusive global marketing rights for Trinity Evolution® as well as non-exclusive marketing rights for other products, and receives marketing fees from MTF based on total sales. These marketing fees are recorded on a net basis within net sales and were $48.1 million, $46.5 million and $36.8 million in 2013, 2012 and 2011, respectively. On January 10, 2012, the Company announced that it had reached an agreement with MTF to both co-develop and commercialize a new technology for use in bone grafting applications and to expand MTF’s Trinity Evolution® processing capacity. The amendment amends the term of the existing agreement until the later of (i) 15 years after the date that certain development milestones were achieved under the existing agreement (which occurred during 2010) or (ii) the date that certain licensing arrangements between the Company and NuVasive, Inc. expire. MTF is considered the primary obligor in these arrangements and therefore the Company recognizes these marketing service fees on a net basis upon shipment of the product to the customer.
	Revenues exclude any value added or other local taxes, intercompany sales and trade discounts. Shipping and handling costs are included in cost of sales.
	The process for estimating the ultimate collection of accounts receivable involves significant assumptions and judgments. Historical collection and payor reimbursement experience is an integral part of the estimation process related to reserves for doubtful accounts and the establishment of contractual allowances. Accounts receivable are analyzed on a quarterly basis to assess the adequacy of both reserves for doubtful accounts and contractual allowances. Revisions in allowances for doubtful accounts estimates are recorded as an adjustment to bad debt expense within sales and marketing expenses, and contractual allowances are recorded as an adjustment to revenue. These estimates are periodically tested against actual collection experience.
Sale of accounts receivable	(n) Sale of accounts receivable
	The Company will generally sell receivables from certain Italian hospitals each year. The estimated related fee for 2013 and 2012 was $0.8 million and $0.6 million, respectively, which is recorded as interest expense. Trade accounts receivables sold without recourse are removed from the balance sheet at the time of sale.
Share-based compensation	(o) Share-based compensation
	The fair value of service-based stock options are determined using the Black-Scholes valuation model. Such value is recognized as expense over the service period net of estimated forfeitures.
	The fair value of market-based stock options are determined at the date of the grant using the Monte Carlo valuation methodology. Such value is recognized as expense over the requisite service period adjusted for estimated forfeitures for each separately vesting tranche of the award. The Monte Carlo methodology that we use to estimate the fair value of market-based options incorporates into the valuation the possibility that the market condition may not be satisfied.
	The expected term of options granted is estimated based on a number of factors, including the vesting and expiration terms of the award, historical employee exercise behavior for both options that are currently outstanding and options that have been exercised or are expired, the historical volatility of the Company’s common stock and an employee’s average length of service. The risk-free interest rate is determined based upon a constant U.S. Treasury security rate with a contractual life that approximates the expected term of the option award. Management estimates expected volatility based on the historical volatility of the Company’s stock. The compensation expense recognized for all equity-based awards is net of estimated forfeitures. Forfeitures are estimated based on an analysis of actual option forfeitures.
Advertising costs	(p) Advertising costs
	The Company expenses all advertising costs as incurred. Advertising expense included in sales and marketing expense for the years ended December 31, 2013, 2012 and 2011 was $0.2 million, $0.3 million and $0.5 million, respectively.
Research and development costs	(q) Research and development costs
	Expenditures related to the collaborative arrangement with MTF are expensed based on the terms of the related agreement. Milestone payments made to MTF in 2013 and 2012 totaled $2.5 million and $3.0 million, respectively. There were no milestone payments made to MTF in 2011. Expenditures for other research and development are expensed as incurred.
Income taxes	(r) Income taxes
	The Company is subject to income taxes in both the U.S. and foreign jurisdictions, and uses estimates in determining the provision for income taxes. The Company accounts for income taxes using the asset and liability method for accounting and reporting for income taxes. Under this method, deferred tax assets and liabilities are recognized based on temporary differences between the financial reporting and income tax basis of assets and liabilities using statutory rates. This process requires that the Company project the current tax liability and estimate the deferred tax assets and liabilities, including net operating loss and tax credit carry forwards. In assessing the need for a valuation allowance, the Company has considered the recent operating results, future taxable income projections and all prudent and feasible tax planning strategies.
	The Company accounts for uncertain tax positions in accordance with ASC 740, Income Taxes, which contains a two-step approach to recognizing and measuring uncertain tax positions. The first step is to evaluate the tax position taken or expected to be taken in a tax return by determining if the weight of available evidence indicates that it is more likely than not that, on an evaluation of the technical merits, the tax position will be sustained on audit, including resolution of any related appeals or litigation processes. The second step is to measure the tax benefit as the largest amount that is more than 50% likely to be realized upon ultimate settlement. The Company reevaluates income tax positions periodically to consider factors such as changes in facts or circumstances, changes in or interpretations of tax law, effectively settled issues under audit, and new audit activity. Such a change in recognition or measurement would result in recognition of a tax benefit or an additional charge to the tax provision.
	The Company includes imputed interest and any applicable penalties related to tax issues as part of income tax expense in our consolidated financial statements.
Net income (loss) per common share	(s) Net income (loss) per common share
	Net income (loss) per common share—basic is computed using the weighted average number of common shares outstanding during each of the respective years. Net income (loss) per common share—diluted is computed using the weighted average number of common and common equivalent shares outstanding during each of the respective years using the “treasury stock” method, if dilutive. Common equivalent shares represent the dilutive effect of the assumed exercise of outstanding share options (see Note 20). The only differences between basic and diluted shares result from the assumed exercise of certain outstanding share options.
Financial instruments and concentration of credit risk	(t) Financial instruments and concentration of credit risk
	Financial instruments that could subject the Company to a concentration of credit risk consist primarily of cash and cash equivalents and accounts receivable. Generally, the cash is held at large financial institutions and our cash equivalents consist of highly liquid money market funds. The Company performs ongoing credit evaluations of the customers, generally does not require collateral and maintain a reserve for potential credit losses. The Company believes that a concentration of credit risk related to the accounts receivable is limited because the customers are geographically dispersed and the end users are diversified across several industries.
	Net sales to our customers and distributors based in Europe were approximately $52 million in 2013 which results in a substantial portion of our trade accounts receivable balance as of December 31, 2013. It is at least reasonably possible that changes in global economic conditions and/or local operating and economic conditions in the regions these distributors operate, or other factors, could affect the future realization of these accounts receivable balances.
Recently issued accounting standards	(u) Recently issued accounting standards
	In July 2013, the Financial Accounting Standards Board (“FASB”), issued Accounting Standards Update (“ASU”) No. 2013-11, Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward, A Similar Tax Loss, or a Tax Credit Carryforward Exists. The authoritative guidance concludes that, under certain circumstances, unrecognized tax benefits should be presented in the financial statements as a reduction to a deferred tax asset for a net operating loss carryforward, a similar tax loss, or a tax credit carryforward. We adopted this guidance early, as permitted, for the fiscal year ended December 31, 2013. The adoption of this guidance did not have a material effect on our consolidated financial statements.
	In February 2013, the FASB issued ASU No. 2013-02, Comprehensive Income (Topic 220): Reporting of Amounts Reclassified Out of Accumulated Other Comprehensive Income. The standard requires presentation (either in a single note or parenthetically on the face of the financial statements) of the effect of significant amounts reclassified from each component of accumulated other comprehensive income based on its source and the income statement line items affected by the reclassification. If a component is not required to be reclassified to net income in its entirety, a cross reference to the related footnote for additional information is required. The amendments are effective prospectively for reporting periods beginning after December 15, 2013. The adoption of this guidance did not have a material effect on our consolidated financial statements.
	On June 16, 2011, the FASB issued ASU No. 2011-05, Presentation of Comprehensive Income. This ASU eliminates the current option to present other comprehensive income and its components in the statement of changes in shareholders’ equity and increases the prominence of other comprehensive income in the statements by providing an alternative to present the components of net income and comprehensive income as either one continuous or two separate but consecutive financial statements. Companies are also required to present reclassification adjustments for items that are reclassified from other comprehensive income to net income within these statements. This standard is to be applied retrospectively and is effective for fiscal years beginning after December 15, 2011 with early adoption permitted. The Company adopted this ASU as of March 31, 2012 and it did not have a material impact on the Company’s consolidated financial statements.

Summary_of_significant_account2

Summary of significant accounting policies (Tables)	12 Months Ended
	Dec. 31, 2013
Accounting Policies [Abstract]
Schedule of Useful Lives	The useful lives are as follows:
			Years
	Buildings			25 to 33
	Plant equipment and instrumentation			2 to 10
	Furniture and fixtures			4 to 8
Components of Changes in Accumulated Other Comprehensive Income	The components of and changes in accumulated other comprehensive income are as follows:
	(U.S. Dollars in thousands)		Foreign Currency			Change in			Accumulated Other
			Translation			Fair Value			Comprehensive
			Adjustments						Income
	Balance at December 31, 2011 (Restated)		$	4,228		$	(132	)	$	4,096
	Unrealized gain on cross-currency swaps, net of taxes of $153			—			263			263
	Foreign currency translation adjustment (1)			1,131			—			1,131
	Balance at December 31, 2012 (Restated)			5,359			131			5,490
	Unrealized loss on cross-currency swaps, net of tax benefit of $164			—			(278	)		(278	)
	Unrealized gain (loss) on warrants			—			(1	)		(1	)
	Foreign currency translation adjustment (1)			(1,708	)		—			(1,708	)
	Balance at December 31, 2013 (Restated)		$	3,651		$	(148	)	$	3,503
	-1	As the cash generally remains permanently invested in the non U.S. dollar denominated foreign subsidiaries, no deferred taxes are recognized on the related foreign currency translation adjustment.

Original_and_Further_Restateme1

Original and Further Restatement of the Consolidated Financial Statements (Tables)	12 Months Ended
	Dec. 31, 2013
Text Block [Abstract]
Effects of Original Restatement and Further Restatement to Previously Filed Consolidated Income Statements	The tables below show the effects of the Original Restatement for each of the fiscal years ended December 31, 2012 and 2011, as well as the effects of the Further Restatement for each of the fiscal years ended December 31, 2013, 2012 and 2011. In each case, the tax effect of the adjustments is estimated based on the Company’s estimated tax rate.
		Year Ended December 31, 2013
					Further Restatement Adjustments by Category
	(U.S. Dollars, in thousands)	Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Reported			Self-Pay			Timing			Receivable			Profit									Restatement
					Revenue						Reserve												Adjustments
	Net sales	$	400,534		$	(2,242	)	$	—		$	(582	)	$	—		$	—		$	(99	)	$	(2,923	)	$	397,611
	Cost of sales		102,300			—			—			—			1,090			3,688			(166	)		4,612			106,912
	Gross profit		298,234			(2,242	)		—			(582	)		(1,090	)		(3,688	)		67			(7,535	)		290,699
	Operating expenses
	Sales and marketing		176,581			(2,242	)		1,455			122			—			—			(448	)		(1,113	)		175,468
	General and administrative		65,147			—			—			—			—			—			(317	)		(317	)		64,830
	Research and development		26,768			—			—			—			—			—			—			—			26,768
	Amortization of intangible assets		2,687			—			—			—			—			—			—			—			2,687
	Costs related to the accounting review and restatement		12,945			—			—			—			—			—			—			—			12,945
	Impairment of Goodwill		19,193			—			—			—			—			—			—			—			19,193
			303,321			(2,242	)		1,455			122			—			—			(765	)		(1,430	)		301,891
	Operating (loss) income		(5,087	)		—			(1,455	)		(704	)		(1,090	)		(3,688	)		832			(6,105	)		(11,192	)
	Other income and (expense)		295			—			—			—			—			—			294			294			589
	Loss before income taxes		(4,792	)		—			(1,455	)		(704	)		(1,090	)		(3,688	)		1,126			(5,811	)		(10,603	)
	Income tax expense		(10,116	)		—			509			246			381			1,290			88			2,514			(7,602	)
	Net loss from continuing operations	$	(14,908	)	$	—		$	(946	)	$	(458	)	$	(709	)	$	(2,398	)	$	1,214		$	(3,297	)	$	(18,205	)
		Year Ended December 31, 2012
					Original Restatement Adjustments by Category
	(U.S. Dollars, in thousands)	As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
		in the 2012			Revenue			Reserves									Restatement			Restated in
		Form 10-K															Adjustments			2012
		Prior to																		Form 10-K/A
		Original
		Restatement
	Net sales	$	462,320		$	(14,777	)	$	—		$	—		$	38		$	(14,739	)	$	447,581
	Cost of sales		86,492			(2,032	)		5,647			8,190			(44	)		11,761			98,253
	Gross profit		375,828			(12,745	)		(5,647	)		(8,190	)		82			(26,500	)		349,328
	Operating expenses
	Sales and marketing		200,343			(6,629	)		—			(8,190	)		1,607			(13,212	)		187,131
	General and administrative		53,827			(2	)		—			—			(434	)		(436	)		53,391
	Research and development		28,577			—			—			—			—			—			28,577
	Amortization of intangible assets		2,098			—			—			—			200			200			2,298
	Charges related to U.S. Government resolutions		1,973			—			—			—			(678	)		(678	)		1,295
			286,818			(6,631	)		—			(8,190	)		695			(14,126	)		272,692
	Operating income		89,010			(6,114	)		(5,647	)		—			(613	)		(12,374	)		76,636
	Other income and (expense)		(6,282	)		—			—			—			(166	)		(166	)		(6,448	)
	Income before income taxes		82,728			(6,114	)		(5,647	)		—			(779	)		(12,540	)		70,188
	Income tax expense		(28,792	)		1,782			1,645			—			227			3,654			(25,138	)
	Net income from continuing operations	$	53,936		$	(4,332	)	$	(4,002	)	$	—		$	(552	)	$	(8,886	)	$	45,050
		Year Ended December 31, 2012
					Further Restatement Adjustments by Category
	(U.S. Dollars, in thousands)	As Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Restated in			Self-Pay			Timing			Receivable			Profit									Restatement
		2012			Revenue						Reserve												Adjustments
		Form 10-K/A
	Net sales	$	447,581		$	(9,049	)	$	—		$	1,653		$	—		$	—		$	4		$	(7,392	)	$	440,189
	Cost of sales		98,253			—			—			—			207			1,774			492			2,473			100,726
	Gross profit		349,328			(9,049	)		—			1,653			(207	)		(1,774	)		(488	)	$	(9,865	)		339,463
	Operating expenses
	Sales and marketing		187,131			(9,049	)		1,097			(408	)		—			—			—		$	(8,360	)		178,771
	General and administrative		53,391			—			—			—			—			—			259			259			53,650
	Research and development		28,577			—			—			—			—			—			—			—			28,577
	Amortization of intangible assets		2,298			—			—			—			—			—			—			—			2,298
	Charges related to U.S. Government resolutions		1,295			—			—			—			—			—			—			—			1,295
			272,692			(9,049	)		1,097			(408	)		—			—			259			(8,101	)		264,591
	Operating income		76,636			—			(1,097	)		2,061			(207	)		(1,774	)		(747	)		(1,764	)		74,872
	Other income and (expense)		(6,448	)		—			—			—			—			—			641			641		$	(5,807	)
	Income before income taxes		70,188			—			(1,097	)		2,061			(207	)		(1,774	)		(106	)		(1,123	)		69,065
Income tax expense		(25,138	)		—			384			(721	)		72			621			838			1,194		$	(23,944	)
Net income from continuing operations	$	45,050		$	—		$	(713	)	$	1,340		$	(135	)	$	(1,153	)	$	732		$	71		$	45,121
	Year Ended December 31, 2011
				Original Restatement Adjustments by Category
(U.S. Dollars, in thousands)	As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
	in the 2012			Revenue			Reserves									Restatement			Restated in
	Form 10-K															Adjustments			2012
	Prior to																		Form 10-K/A
	Original
	Restatement
Net sales	$	470,121		$	(29,135	)	$	—		$	—		$	985		$	(28,150	)	$	441,971
Cost of sales		92,619			(8,289	)		3,377			7,713			107			2,908			95,527
Gross profit		377,502			(20,846	)		(3,377	)		(7,713	)		878			(31,058	)		346,444
Operating expenses
Sales and marketing		200,145			(1,216	)		—			(7,713	)		2,295			(6,634	)		193,511
General and administrative		64,374			—			—			—			107			107			64,481
Research and development		22,861			—			—			—			—			—			22,861
Amortization of intangible assets		2,350			—			—			—			200			200			2,550
Charges related to U.S. Government resolutions		56,463			—			—			—			678			678			57,141
		346,193			(1,216	)		—			(7,713	)		3,280			(5,649	)		340,544
Operating income		31,309			(19,630	)		(3,377	)		—			(2,402	)		(25,409	)		5,900
Other income and (expense)		(11,868	)		—			—			—			3,915			3,915			(7,953	)
Income (loss) before income taxes		19,441			(19,630	)		(3,377	)		—			1,513			(21,494	)		(2,053	)
Income tax expense		(21,181	)		6,408			1,102			—			(494	)		7,016			(14,165	)
Net loss from continuing operations	$	(1,740	)	$	(13,222	)	$	(2,275	)	$	—		$	1,019		$	(14,478	)	$	(16,218	)
	Year Ended December 31, 2011
				Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)	As Originally			Co-Pay and			Bad Debt			Accounts			Intercompany			Inventory			Other			Total Further			Restated
	Restated in			Self-Pay			Timing			Receivable			Profit									Restatement
	2012			Revenue						Reserve												Adjustments
	Form 10-K/A
Net sales	$	441,971		$	(5,960	)	$	—		$	(439	)	$	—		$	—		$	(53	)	$	(6,452	)	$	435,519
Cost of sales		95,527			—			—			—			253			321			314			888			96,415
Gross profit		346,444			(5,960	)		—			(439	)		(253	)		(321	)		(367	)		(7,340	)		339,104
Operating expenses
Sales and marketing		193,511			(5,960	)		(2,143	)		(252	)		—			—			—			(8,355	)		185,156
General and administrative		64,481			—			—			—			—			—			304			304			64,785
Research and development		22,861			—			—			—			—			—			—			—			22,861
Amortization of intangible assets		2,550			—			—			—			—			—			—			—			2,550
Charges related to U.S. Government resolutions		57,141			—			—			—			—			—			—			—			57,141
		340,544			(5,960	)		(2,143	)		(252	)		—			—			304			(8,051	)		332,493
Operating income		5,900			—			2,143			(187	)		(253	)		(321	)		(671	)		711			6,611
Other income and (expense)		(7,953	)		—			—			—			—			—			(21	)		(21	)		(7,974	)
Loss before income taxes		(2,053	)		—			2,143			(187	)		(253	)		(321	)		(692	)		690			(1,363	)
Income tax expense		(14,165	)		—			(752	)		66			89			113			206			(278	)		(14,443	)
Net loss from continuing operations	$	(16,218	)	$	—		$	1,391		$	(121	)	$	(164	)	$	(208	)	$	(486	)	$	412		$	(15,806	)
Effects of Original Restatement and Further Restatement on Consolidated Balance Sheet	The effects of the Further Restatement on the Company’s consolidated balance sheet as of December 31, 2013 are as follows:
		As of December 31, 2013
	(U.S. Dollars, in thousands except share and per share data)	Originally			Further			Restated
		Reported in			Restatement
		2013			Adjustments
		Form 10-K
	Assets
	Current assets:
	Cash and cash equivalents	$	30,486		$	(1,562	)	$	28,924
	Restricted cash		23,761			—			23,761
	Trade accounts receivable, less allowances of $9,111		75,567			(4,756	)		70,811
	Inventories		90,577			(17,899	)		72,678
	Deferred income taxes		33,947			6,052			39,999
	Prepaid expenses and other current assets		25,906			3,027			28,933
	Total current assets		280,244			(15,138	)		265,106
	Property, plant and equipment, net		54,606			(234	)		54,372
	Patents and other intangible assets, net		9,046			—			9,046
	Goodwill		53,565			—			53,565
	Deferred income taxes		18,336			4,058			22,394
	Other long-term assets		7,385			107			7,492
	Total assets	$	423,182		$	(11,207	)	$	411,975
	Liabilities and shareholders’ equity
	Current liabilities:
	Trade accounts payable	$	20,674		$	—		$	20,674
	Other current liabilities		46,146			3,530			49,676
	Total current liabilities		66,820			3,530			70,350
	Long-term debt		20,000			—			20,000
	Deferred income taxes		13,132			(106	)		13,026
	Other long-term liabilities		12,736			—			12,736
	Total liabilities		112,688			3,424			116,112
	Contingencies (Note 17)
	Shareholders’ equity
	Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 issued and outstanding		1,810			—			1,810
	Additional paid-in capital		216,653			—			216,653
	Retained earnings		89,332			(15,435	)		73,897
	Accumulated other comprehensive income		2,699			804			3,503
	Total shareholders’ equity		310,494			(14,631	)		295,863
	Total liabilities and shareholders’ equity	$	423,182		$	(11,207	)	$	411,975
	The effects of the Original Restatement and the Further Restatement on the Company’s consolidated balance sheet as of December 31, 2012 are as follows:
		As of December 31, 2012
	(U.S. Dollars, in thousands except share and per share data)	As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in the			Restatement
		10-K Prior to			Adjustments			2012			Adjustments
		Original						Form 10-K/A
		Restatement
	Assets
	Current assets:
	Cash and cash equivalents	$	31,055		$	—		$	31,055		$	(288	)	$	30,767
	Restricted cash		21,314			—			21,314			—			21,314
	Trade accounts receivable, less allowances of $6,673		150,316			(43,004	)		107,312			(3,510	)		103,802
	Inventories		88,744			(5,371	)		83,373			(13,560	)		69,813
	Deferred income taxes		16,959			16,491			33,450			5,037			38,487
	Prepaid expenses and other current assets		32,056			2,023			34,079			2,370			36,449
	Total current assets		340,444			(29,861	)		310,583			(9,951	)		300,632
	Property, plant and equipment, net		51,362			2,473			53,835			(1,042	)		52,793
	Patents and other intangible assets, net		6,880			410			7,290			—			7,290
	Goodwill		74,388			—			74,388			—			74,388
	Deferred income taxes		19,904			(1,023	)		18,881			2,642			21,523
	Other long-term assets		11,303			(3,383	)		7,920			—			7,920
	Total assets	$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
	Liabilities and shareholders’ equity
	Current liabilities:
	Bank borrowings	$	16		$	—		$	16		$	—		$	16
	Trade accounts payable		21,812			763			22,575			—			22,575
Other current liabilities		46,969			(7,375	)		39,594			3,148			42,742
Total current liabilities		68,797			(6,612	)		62,185			3,148			65,333
Long-term debt		20,000			—			20,000			—			20,000
Deferred income taxes		11,456			—			11,456			(106	)		11,350
Other long-term liabilities		4,930			6,494			11,424			—			11,424
Total liabilities		105,183			(118	)		105,065			3,042			108,107
Contingencies (Note 17)
Shareholders’ equity
Common shares $0.10 par value; 50,000,000 shares authorized; 19,339,329 issued and outstanding		1,934			—			1,934			—			1,934
Additional paid-in capital		246,111			195			246,306			—			246,306
Retained earnings		148,549			(33,702	)		114,847			(12,138	)		102,709
Accumulated other comprehensive income		2,504			2,241			4,745			745			5,490
Total shareholders’ equity		399,098			(31,266	)		367,832			(11,393	)		356,439
Total liabilities and shareholders’ equity	$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
Effects of Original Restatement and Further Restatement of Consolidated Statement of Operations and Comprehensive Income (Loss)	The effects of the Further Restatement on the Company’s consolidated statement of operations and comprehensive income for the year ended December 31, 2013 are as follows:
		Year Ended December 31, 2013
	(U.S. Dollars, in thousands, except share and per share data)	Originally			Further			Restated
		Reported in 2013			Restatement
		Form 10-K			Adjustments
	Product sales	$	352,796		$	(3,244	)	$	349,552
	Marketing service fees		47,738			321			48,059
	Net sales		400,534			(2,923	)		397,611
	Cost of sales		102,300			4,612			106,912
	Gross profit		298,234			(7,535	)		290,699
	Operating expenses
	Sales and marketing		176,581			(1,113	)		175,468
	General and administrative		65,147			(317	)		64,830
	Research and development		26,768			—			26,768
	Amortization of intangible assets		2,687			—			2,687
	Costs related to the accounting review and restatement		12,945			—			12,945
	Impairment of Goodwill		19,193			—			19,193
			303,321			(1,430	)		301,891
	Operating loss		(5,087	)		(6,105	)		(11,192	)
	Other income and (expense)
	Interest expense, net		(1,925	)		98			(1,827	)
	Other expense		2,220			196			2,416
			295			294			589
	Loss before income taxes		(4,792	)		(5,811	)		(10,603	)
	Income tax expense		(10,116	)		2,514			(7,602	)
	Net loss from continuing operations		(14,908	)		(3,297	)		(18,205	)
	Discontinued operations (Note 16)
	Loss from discontinued operations		(15,510	)		—			(15,510	)
	Income tax benefit (expense)		4,903			—			4,903
	Net loss from discontinued operations		(10,607	)		—			(10,607	)
	Net loss	$	(25,515	)	$	(3,297	)	$	(28,812	)
	Net loss per common share—basic:
	Net loss from continuing operations	$	(0.80	)	$	(0.17	)	$	(0.97	)
	Net loss from discontinued operations		(0.57	)		—			(0.57	)
	Net loss per common share—basic	$	(1.37	)	$	(0.17	)	$	(1.54	)
	Net loss per common share—diluted:
	Net loss from continuing operations	$	(0.80	)	$	(0.17	)	$	(0.97	)
	Net loss from discontinued operations		(0.57	)		—			(0.57	)
	Net loss per common share—diluted	$	(1.37	)	$	(0.17	)	$	(1.54	)
	Weighted average number of common shares:
	Basic		18,697,228			—			18,697,228
	Diluted		18,697,228			—			18,697,228
	Other comprehensive loss, before tax:
	Translation adjustment	$	(1,768	)	$	60		$	(1,708	)
	Unrealized gain on derivative instrument		(442	)		(1	)		(443	)
	Other comprehensive loss, before tax		(2,210	)		59			(2,151	)
	Income tax expense related to components of other comprehensive income		164			—			164
	Other comprehensive loss, net of tax		(2,046	)		59			(1,987	)
	Comprehensive loss	$	(27,561	)	$	(3,238	)	$	(30,799	)
	The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of operations and comprehensive income for the year ended December 31, 2012 are as follows:
		Year Ended December 31, 2012
	(U.S. Dollars, in thousands, except share and per share data)	As Reported in the			Original			As Originally			Further			Restated
		2012 Form 10-K			Restatement			Restated in the			Restatement
		Prior to Original			Adjustments			2012			Adjustments
		Restatement						Form 10-K/A
	Product sales	$	415,850		$	(14,811	)	$	401,039		$	(7,392	)	$	393,647
	Marketing service fees		46,470			72			46,542			—			46,542
	Net sales		462,320			(14,739	)		447,581			(7,392	)		440,189
	Cost of sales		86,492			11,761			98,253			2,473			100,726
	Gross profit		375,828			(26,500	)		349,328			(9,865	)		339,463
	Operating expenses
	Sales and marketing		200,343			(13,212	)		187,131			(8,360	)		178,771
	General and administrative		53,827			(436	)		53,391			259			53,650
	Research and development		28,577			—			28,577			—			28,577
Amortization of intangible assets		2,098			200			2,298			—			2,298
Charges related to U.S. Government resolutions (Note 17)		1,973			(678	)		1,295			—			1,295
		286,818			(14,126	)		272,692			(8,101	)		264,591
Operating income		89,010			(12,374	)		76,636			(1,764	)		74,872
Other income and (expense)
Interest expense, net		(4,577	)		(166	)		(4,743	)		582			(4,161	)
Other expense		(1,705	)		—			(1,705	)		59			(1,646	)
		(6,282	)		(166	)		(6,448	)		641			(5,807	)
Income before income taxes		82,728			(12,540	)		70,188			(1,123	)		69,065
Income tax expense		(28,792	)		3,654			(25,138	)		1,194			(23,944	)
Net income from continuing operations		53,936			(8,886	)		45,050			71			45,121
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.,		1,345			—			1,345			—			1,345
Loss from discontinued operations		(4,012	)		1,018			(2,994	)		(500	)		(3,494	)
Income tax benefit (expense)		26			(589	)		(563	)		443			(120	)
Net loss from discontinued operations		(2,641	)		429			(2,212	)		(57	)		(2,269	)
Net income	$	51,295		$	(8,457	)	$	42,838		$	14		$	42,852
Net income (loss) per common share—basic:
Net income from continuing operations	$	2.84		$	(0.47	)	$	2.37		$	0.01		$	2.38
Net loss from discontinued operations		(0.14	)		0.02			(0.12	)		—			(0.12	)
Net income per common share—basic	$	2.7		$	(0.45	)	$	2.25		$	0.01		$	2.26
Net income (loss) per common share—diluted:
Net income from continuing operations	$	2.78		$	(0.46	)	$	2.32		$	0.01		$	2.33
Net loss from discontinued operations		(0.14	)		0.03			(0.11	)		(0.01	)		(0.12	)
Net income per common share—diluted:	$	2.64		$	(0.43	)	$	2.21		$	0		$	2.21
Weighted average number of common shares:
Basic		18,977,263			—			18,977,263			—			18,977,263
Diluted		19,390,413			—			19,390,413			—			19,390,413
Other comprehensive income, before tax:
Translation adjustment	$	480		$	288		$	768		$	363		$	1,131
Unrealized gain on derivative instrument		416			—			416			—			416
Other comprehensive income, before tax		896			288			1,184			363			1,547
Income tax expense related to components of other comprehensive income		(153	)		—			(153	)		—			(153	)
Other comprehensive income, net of tax		743			288			1,031			363			1,394
Comprehensive income	$	52,038		$	(8,169	)	$	43,869		$	377		$	44,246
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of operations and comprehensive loss for the year ended December 31, 2011 are as follows:
	Year Ended December 31, 2011
(U.S. Dollars, in thousands, except share and per share data)	As Reported in the			Original			As Originally			Further			Restated
	2012 Form 10-K			Restatement			Restated in the			Restatement
	Prior to Original			Adjustments			2012			Adjustments
	Restatement						Form 10-K/A
Product sales	$	432,975		$	(27,828	)	$	405,147			(6,452	)	$	398,695
Marketing service fees		37,146			(322	)		36,824			—			36,824
Net sales		470,121			(28,150	)		441,971			(6,452	)		435,519
Cost of sales		92,619			2,908			95,527			888			96,415
Gross profit		377,502			(31,058	)		346,444			(7,340	)		339,104
Operating expenses
Sales and marketing		200,145			(6,634	)		193,511			(8,355	)		185,156
General and administrative		64,374			107			64,481			304			64,785
Research and development		22,861			—			22,861			—			22,861
Amortization of intangible assets		2,350			200			2,550			—			2,550
Charges related to U.S. Government resolutions (Note 17)		56,463			678			57,141			—			57,141
		346,193			(5,649	)		340,544			(8,051	)		332,493
Operating income		31,309			(25,409	)		5,900			711			6,611
Other income and (expense)
Interest expense, net		(9,456	)		3,915			(5,541	)		100			(5,441	)
Other expense		(2,412	)		—			(2,412	)		(121	)		(2,533	)
		(11,868	)		3,915			(7,953	)		(21	)		(7,974	)
Income (loss) before income taxes		19,441			(21,494	)		(2,053	)		690			(1,363	)
Income tax expense		(21,181	)		7,016			(14,165	)		(278	)		(14,443	)
Net loss from continuing operations		(1,740	)		(14,478	)		(16,218	)		412			(15,806	)
Discontinued operations (Note 16)
Income (loss) from discontinued operations		1,263			(3,968	)		(2,705	)		—			(2,705	)
Income tax (expense) benefit		(596	)		1,409			813			—			813
Net income (loss) from discontinued operations		667			(2,559	)		(1,892	)		—			(1,892	)
Net loss	$	(1,073	)	$	(17,037	)	$	(18,110	)		412		$	(17,698	)
Net (loss) income per common share—basic:
Net loss from continuing operations	$	(0.10	)	$	(0.79	)	$	(0.89	)	$	0.02		$	(0.87	)
Net income (loss) from discontinued operations		0.04			(0.14	)		(0.10	)		—			(0.10	)
Net loss per common share—basic	$	(0.06	)	$	(0.93	)	$	(0.99	)	$	0.02		$	(0.97	)
Net (loss) income per common share—diluted:
Net loss from continuing operations	$	(0.10	)	$	(0.79	)	$	(0.89	)	$	0.02		$	(0.87	)
Net income (loss) from discontinued operations		0.04			(0.14	)		(0.10	)		—			(0.10	)
Net loss per common share—diluted:	$	(0.06	)	$	(0.93	)	$	(0.99	)	$	0.02		$	(0.97	)
Weighted average number of common shares:
Basic		18,219,343			—			18,219,343			—			18,219,343
Diluted		18,219,343			—			18,219,343			—			18,219,343
Other comprehensive loss, before tax:
Translation adjustment	$	(3,192	)	$	913		$	(2,279	)	$	382		$	(1,897	)
Unrealized loss on derivative instrument		(693	)		—			(693	)		—			(693	)
Other comprehensive loss, before tax		(3,885	)		913			(2,972	)		382			(2,590	)
Income tax benefit related to components of other comprehensive income		256			—			256			—			256
Other comprehensive loss, net of tax		(3,629	)		913			(2,716	)		382			(2,334	)
Comprehensive loss	$	(4,702	)	$	(16,124	)	$	(20,826	)		794		$	(20,032	)
Effects of Original Restatement and Further Restatement on Consolidated Cash Flow	The effects of Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2013 are as follows:
	(U.S. Dollars, in thousands)	Year Ended December 31, 2013
		Originally			Further			Restated
		Reported in			Restatement
		2013			Adjustments
		Form 10-K
	Cash flows from operating activities:
	Net loss	$	(25,515	)	$	(3,297	)	$	(28,812	)
	Adjustments to reconcile net loss to net cash provided by operating activities:
	Depreciation and amortization		22,659			163			22,822
	Amortization of debt costs		720			—			720
	Amortization of exclusivity agreements		1,546			—			1,546
	Provision for doubtful accounts		6,003			(1,413	)		4,590
	Deferred income taxes		(1,986	)		4,815			2,829
	Share-based compensation		6,267			—			6,267
	Impairment of goodwill		19,193			—			19,193
	Gain on sale of Breg, Inc., net of tax		—			—			—
	Excess income tax benefit on employee stock-based awards		(82	)		—			(82	)
	Income tax benefit (expense) on employee stock-based awards		795			(795	)		—
	Other		4,442			94			4,536
	Changes in operating assets and liabilities, net of effect of dispositions:
	Trade accounts receivable		25,747			2,815			28,562
	Inventories		(6,626	)		3,413			(3,213	)
	Escrow receivable		—			—			—
	Prepaid expenses and other current assets		6,791			1,973			8,764
	Trade accounts payable		(2,280	)		—			(2,280	)
	Charges related to U.S. Government resolutions		—			—			—
	Other current liabilities		8,018			(1,049	)		6,969
	Other long-term assets		2,750			(8,079	)		(5,329	)
	Other long-term liabilities		(1,561	)		1,521			(40	)
	Net cash provided by operating activities		66,881			161			67,042
	Cash flows from investing activities:
	Capital expenditures for property, plant and equipment		(24,787	)		—			(24,787	)
	Capital expenditures for intangible assets		(4,891	)		—			(4,891	)
	Purchase of other investments		—			(1,374	)		(1,374	)
	Net proceeds from sale of Breg, Inc.		—			—			—
	Net cash (used in) provided by investing activities		(29,678	)		(1,374	)		(31,052	)
	Cash flows from financing activities:
	Net proceeds from issuance of common shares		3,450			—			3,450
	Payment of refinancing fees and debt issuance costs		—			—			—
	Repayments of long-term debt		(16	)		—			(16	)
	Repayment of bank borrowings, net		—			—			—
	Changes in restricted cash		(2,375	)		—			(2,375	)
	Purchase of common stock		(39,494	)		—			(39,494	)
	Cash payment for purchase of minority interest in subsidiary		—			—			—
	Excess income tax benefit on employee stock-based awards		82			—			82
	Net cash used in financing activities		(38,353	)		—			(38,353	)
	Effect of exchange rate changes on cash		581			(61	)		520
	Net (decrease) increase in cash and cash equivalents		(569	)		(1,274	)		(1,843	)
	Cash and cash equivalents at the beginning of the year		31,055			(288	)		30,767
	Cash and cash equivalents at the end of the year	$	30,486		$	(1,562	)	$	28,924
	Supplemental disclosure of cash flow information:
	Cash paid during the year for:
	Interest	$	2,046		$	—		$	2,046
	Income taxes	$	8,773		$	—		$	8,773
	The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2012 are as follows:
	(U.S. Dollars, in thousands)	Year Ended December 31, 2012
		As Reported in			Original			As Originally			Further			Restated
		the 2012 Form			Restatement			Restated in			Restatement
		10-K Prior to			Adjustments			the 2012			Adjustments
		Original						Form 10-K/A
		Restatement
	Cash flows from operating activities:
	Net income	$	51,295		$	(8,457	)	$	42,838		$	14		$	42,852
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		20,261			319			20,580			152			20,732
Amortization of debt costs		1,737			—			1,737			—			1,737
Amortization of exclusivity agreements		1,289			—			1,289			—			1,289
Provision for doubtful accounts		13,302			(2,730	)		10,572			(8,360	)		2,212
Deferred income taxes		871			(2,123	)		(1,252	)		5,023			3,771
Share-based compensation		6,303			—			6,303			—			6,303
Impairment of goodwill		—			—			—			—			—
Gain on sale of Breg, Inc, net of tax		(1,345	)		—			(1,345	)		—			(1,345	)
Excess income tax benefit on employee stock-based awards		—			(1,020	)		(1,020	)		—			(1,020	)
Income tax benefit on employee-stock-based awards		—			2,910			2,910			(2,910	)		—
Other		2,125			2,011			4,136			662			4,798
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable		(31,600	)		13,162			(18,438	)		7,310			(11,128	)
Inventories		(6,341	)		3,846			(2,495	)		2,111			(384	)
Escrow receivable		41,537			—			41,537			—			41,537
Prepaid expenses and other current assets		(6,191	)		(9,386	)		(15,577	)		1,002			(14,575	)
Trade accounts payable		5,554			(979	)		4,575			—			4,575
Charges related to U.S. Government resolutions		(82,500	)		(678	)		(83,178	)		—			(83,178	)
Other current liabilities		(2,842	)		(2,887	)		(5,729	)		490			(5,239	)
Other long-term assets		(2,114	)		4,241			2,127			(5,518	)		(3,391	)
Other long-term liabilities		(135	)		751			616			—			616
Net cash provided by operating activities		11,206			(1,020	)		10,186			(24	)		10,162
Cash flows from investing activities:
Capital expenditures for property, plant and equipment		(27,994	)		—			(27,994	)		—			(27,994	)
Capital expenditures for intangible assets		(780	)		—			(780	)		—			(780	)
Purchase of other investments		—			—			—			(714	)		(714	)
Proceeds from sale of other investments		—			—			—			878			878
Net proceeds from sale of Breg Inc.		153,773			—			153,773			—			153,773
Net cash provided by (used in) investing activities		124,999			—			124,999			164			125,163
Cash flows from financing activities:
Net proceeds from issuance of common shares		25,586			—			25,586			—			25,586
Payment of refinancing fees and debt issuance costs		—			—			—			—			—
Repayments of long-term debt		(188,695	)		—			(188,695	)		—			(188,695	)
Proceeds of bank borrowings, net		(1,297	)		—			(1,297	)		—			(1,297	)
Changes in restricted cash		25,799			—			25,799			—			25,799
Cash payment for purchase of minority interest in subsidiary		—			—			—			—			—
Excess income tax benefit on employee stock-based awards		—			1,020			1,020			—			1,020
Net cash used in financing activities		(138,607	)		1,020			(137,587	)		—			(137,587	)
Effect of exchange rates changes on cash		250			—			250			36			286
Net increase (decrease) in cash and cash equivalents		(2,152	)		—			(2,152	)		176			(1,976	)
Cash and cash equivalents at the beginning of the year		33,207			—			33,207			(464	)		32,743
Cash and cash equivalents at the end of the year	$	31,055		$	—		$	31,055		$	(288	)	$	30,767
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest	$	4,569		$	—		$	4,569		$	—		$	4,569
Income taxes	$	18,268		$	—		$	18,268		$	—		$	18,268
The effects of the Original Restatement and the Further Restatement on the Company’s consolidated statement of cash flows for the year ended December 31, 2011 are as follows:
(U.S. Dollars, in thousands)	Year Ended December 31, 2011
	As Reported in			Original			As Originally			Further			Restated
	the 2012 Form			Restatement			Restated in			Restatement
	10-K Prior to			Adjustments			the 2012			Adjustments
	Original						Form 10-K/A
	Restatement
Cash flows from operating activities:
Net loss	$	(1,073	)	$	(17,037	)	$	(18,110	)	$	412		$	(17,698	)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization		22,776			241			23,017			165			23,182
Amortization of debt costs		1,239			—			1,239			—			1,239
Amortization of exclusivity agreements		374			—			374			—			374
Provision for doubtful accounts		11,532			1,404			12,936			(8,356	)		4,580
Deferred income taxes		936			(988	)		(52	)		(13,889	)		(13,941	)
Share-based compensation		6,648			—			6,648			—			6,648
Impairment of goodwill		—			—			—			—			—
Gain on sale of Breg, Inc, net of tax		—			—			—			—			—
Excess income tax benefit on employee stock-based awards		(1,737	)		—			(1,737	)		—			(1,737	)
Income tax benefit on employee-stock-based awards		—			—			—			—			—
Other		4,906			(415	)		4,491			(2,193	)		2,298
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable		(25,818	)		26,111			293			6,352			6,645
Inventories		(8,349	)		(4,275	)		(12,624	)		(81	)		(12,705	)
Escrow receivable		(32,562	)		—			(32,562	)		—			(32,562	)
Prepaid expenses and other current assets		(4,057	)		6,886			2,829			(447	)		2,382
Trade accounts payable		576			1,746			2,322			—			2,322
Charges related to U.S. Government resolutions		88,463			638			89,101			—			89,101
Other current liabilities		3,384			(1,965	)		1,419			2,097			3,516
Other long-term assets		(1,588	)		(16,093	)		(17,681	)		15,364			(2,317	)
Other long-term liabilities		(869	)		3,747			2,878			525			3,403
Net cash provided by operating activities		64,781			—			64,781			(51	)		64,730
Cash flows from investing activities:
Capital expenditures for property, plant and equipment		(24,965	)		—			(24,965	)		—			(24,965	)
Capital expenditures for intangible assets		(793	)		—			(793	)		—			(793	)
Payment made in connection with acquisition		(5,250	)		—			(5,250	)		—			(5,250	)
Purchase of other investments		—			—			—			(468	)		(468	)
Net cash provided by (used in) investing activities		(31,008	)		—			(31,008	)		(468	)		(31,476	)
Cash flows from financing activities:
Net proceeds from issuance of common shares		20,113			—			20,113			—			20,113
Payment of refinancing fees and debt issuance costs		(758	)		—			(758	)		—			(758	)
Repayments of long-term debt		(7,500	)		—			(7,500	)		—			(7,500	)
Proceeds of bank borrowings, net		(2,561	)		—			(2,561	)		—			(2,561	)
Changes in restricted cash		(24,178	)		—			(24,178	)		—			(24,178	)
Cash payment for purchase of minority interest in subsidiary		(517	)		—			(517	)		—			(517	)
Excess income tax benefit on employee stock-based awards		1,737			—			1,737			—			1,737
Net cash used in financing activities		(13,664	)		—			(13,664	)		—			(13,664	)
Effect of exchange rates changes on cash		(463	)		—			(463	)		55			(408	)
Net increase (decrease) in cash and cash equivalents		19,646			—			19,646			(464	)		19,182
Cash and cash equivalents at the beginning of the year		13,561			—			13,561			—			13,561
Cash and cash equivalents at the end of the year	$	33,207		$	—		$	33,207		$	(464	)	$	32,743
Supplemental disclosure of cash flow information:
Cash paid during the year for:
Interest	$	17,088		$	—		$	17,088		$	—		$	17,088
Income taxes	$	26,227		$	—		$	26,227		$	—		$	26,227
Effects of Original Restatement and Further Restatement on Consolidated Shareholders' Equity	The results of the Further Restatement adjustments to the Company’s previously filed consolidated shareholders’ equity as of January 1, 2011, by category as discussed above under the subheadings “Bad Debt Timing Adjustments”, “Accounts Receivable Reserves”, “Intercompany Profit Adjustments”, “Piece Parts Inventory”, “Inventory Reserves” and “Other Adjustments” are summarized in the table below.
		Cumulative Adjustments to Shareholders’ Equity at
		January 1, 2011
		(U.S. Dollars, in thousands)
	Further Restatement Adjustments by Category	Further Restatement			Further			Total Cumulative
	Increase (decrease) to Retained earnings	Adjustments for			Restatement			Adjustments
		Years ended			Adjustments to			through
		December 31, 2009			Year ended			December 31, 2010
		and Prior			December 31, 2010
	Bad debt timing adjustments	$	—		$	409		$	409
	Accounts receivable reserves		(4,383	)		(1,037	)		(5,420	)
	Intercompany profit adjustments		(812	)		(203	)		(1,015	)
	Inventory existence		(68	)		(16	)		(84	)
	Inventory reserves		(13,352	)		2,581			(10,771	)
	Other adjustments		(1,426	)		(285	)		(1,711	)
	Income tax benefit (expense)		7,416			(1,388	)		6,028
	Retained earnings decrease	$	(12,625	)	$	61		$	(12,564	)

Inventories_Tables

Inventories (Tables)	12 Months Ended
	Dec. 31, 2013
Inventory Disclosure [Abstract]
Schedule of Inventories
		December 31,
	(U.S. Dollars in thousands)	2013		2012
		(Restated)		(Restated)
	Raw materials	$	6,515	$	7,623
	Work-in-process		6,606		7,886
	Finished products		28,291		22,236
	Field inventory		21,312		17,061
	Consignment inventory		2,388		4,235
	Deferred cost of sales		7,566		10,772
		$	72,678	$	69,813

Property_plant_and_equipment_T

Property, plant and equipment (Tables)	12 Months Ended
	Dec. 31, 2013
Property, Plant and Equipment [Abstract]
Schedule of Property Plant and Equipment
		December 31,
	(U.S. Dollars in thousands)	2013			2012
		(Restated)			(Restated)
	Cost
	Buildings	$	4,075		$	3,911
	Plant, equipment and instrumentation		133,427			121,370
	Furniture and fixtures		5,872			5,567
			143,374			130,848
	Accumulated depreciation		(89,002	)		(78,055	)
		$	54,372		$	52,793

Patents_and_other_intangible_a1

Patents and other intangible assets (Tables)	12 Months Ended
	Dec. 31, 2013
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Patents and Other Intangible Assets
		December 31,
	(U.S. Dollars in thousands)	2013			2012
					(Restated)
	Cost
	Patents and licenses	$	42,568		$	38,905
	Trademarks—definite lived		620			657
			43,188			39,562
	Accumulated amortization
	Patents and licenses		(33,688	)		(31,845	)
	Trademarks—definite lived		(454	)		(427	)
			(34,142	)		(32,272	)
	Patents and other intangible assets, net	$	9,046		$	7,290

Goodwill_Tables

Goodwill (Tables)	12 Months Ended
	Dec. 31, 2013
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Changes in Net Carrying Amount of Goodwill	The following table presents the changes in the net carrying value of goodwill by reportable segment as well as the reallocation as of July 1, 2013 in conjunction with our change in reportable segments. (See Note 1 “Summary of significant accounting policies”):
	(U.S. Dollars in thousands)	Spine			Orthopedics			BioStim		Biologics		Extremity			Spine Fixation			Total
												Fixation
	At December 31, 2011	$	41,419		$	31,675		$	—	$	—	$	—		$	—		$	73,094
	Foreign currency		145			1,149			—		—		—			—			1,294
	At December 31, 2012		41,564			32,824			—		—		—			—			74,388
	Foreign currency		(163	)		(1,467	)		—		—		—			—			(1,630	)
	At June 30, 2013		41,401			31,357			—		—		—			—			72,758
	Reallocation at July 1, 2013		(41,401	)		(31,357	)		42,678		10,887		9,825			9,368			—
	Impairment		—			—			—		—		(9,825	)		(9,368	)		(19,193	)
	At December 31, 2013	$	—		$	—		$	42,678	$	10,887	$	—		$	—		$	53,565

Other_current_liabilities_Tabl

Other current liabilities (Tables)	12 Months Ended
	Dec. 31, 2013
Payables and Accruals [Abstract]
Summary of Other Current Liabilities	(U.S. Dollars in thousands)	2013		2012
		(Restated)		(Restated)
	Accrued expenses	$	18,903	$	11,710
	Salaries, bonuses, commissions and related taxes payable		16,598		17,915
	Accrued legal expenses		10,292		8,496
	Other payables		3,883		4,621
		$	49,676	$	42,742

Derivative_instruments_Tables

Derivative instruments (Tables)	12 Months Ended
	Dec. 31, 2013
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Schedule of Fair Values of Derivative Instruments	The tables below disclose the types of derivative instruments the Company owns, the classifications and fair values of these instruments within the balance sheet, and the amount of gain (loss) recognized in other comprehensive income (loss) (“OCI”) or net income (loss).
	(U.S. Dollars, in thousands)	Fair value: favorable			Balance sheet location
		(unfavorable)
	As of December 31, 2013
	Cross-currency swap	$	(1,036	)	Other long-term liabilities
	Warrants	$	107		Other long-term assets
	As of December 31, 2012
	Cross-currency swap	$	305		Other long-term assets
	Warrants	$	—		Other long-term assets
Schedule of Gain (Loss) Recognized on Derivative Instruments
		For the year ended
		December 31,
	(U.S. Dollars in thousands)	2013			2012		2011
	Cross-currency swap and warrants gain (loss) recorded in other comprehensive income (loss), net of taxes	$	(279	)	$	263	$	(437	)

Fair_value_measurements_Tables

Fair value measurements (Tables)	12 Months Ended
	Dec. 31, 2013
Fair Value Disclosures [Abstract]
Schedule of Financial Assets and Liabilities Recorded at Fair Value on Recurring Basis	The fair value of the Company’s financial assets and liabilities on a recurring basis were as follows:
	(U.S. Dollars in thousands)		Balance			Level 1		Level 2			Level 3
			December 31,
			2013
			(Restated1)
	Assets
	Collective trust funds		$	1,667		$		$	1,667		$	—
	Treasury securities			660			660					—
	Certificates of deposit			1,562			1,562		—			—
	Derivative securities			107			—		107			—
	Total		$	3,996		$	2,222	$	1,774		$	—
	Liabilities
	Deferred compensation plan		$	(2,506	)	$	—	$	(2,506	)	$	—
	Derivative securities			(1,036	)		—		(1,036	)		—
	Total		$	(3,542	)	$	—	$	(3,542	)	$	—
	(U.S. Dollars in thousands)		Balance			Level 1		Level 2			Level 3
			December 31,
			2012
			(Restated1)
	Assets
	Collective trust funds		$	1,513		$		$	1,513		$	—
	Treasury securities			624			624					—
	Certificates of deposit			288			288		—			—
	Derivative securities			305			—		305			—
	Total		$	2,730		$	912	$	1,818		$	—
	Liabilities
	Deferred compensation plan		$	(2,320	)	$	—	$	(2,320	)	$	—
	Total		$	(2,320	)	$	—	$	(2,320	)	$	—
	1)	The Company has changed the presentation to breakout and provide more description of assets and to include financial instruments not previously included in the table above.

Commitments_Tables

Commitments (Tables)	12 Months Ended
	Dec. 31, 2013
Commitments and Contingencies Disclosure [Abstract]
Schedule of Future Minimum Lease Payments Under Operating Leases, Net of Amount to be Received Under Sub Leases	Future minimum lease payments under operating leases, net of amounts to be received under sub-leases, as of December 31, 2013 are as follows:
	(U.S. Dollars in thousands)
	2014	$	4,342
	2015		4,107
	2016		3,713
	2017		2,974
	2018		2,846
	Thereafter		3,049
	Total	$	21,031

Business_segment_information_T

Business segment information (Tables)	12 Months Ended
	Dec. 31, 2013
Segment Reporting [Abstract]
Schedule of External Net Sales by SBU Reporting Segment	External Net Sales by SBU:
	The table below presents external net sales for continuing operations by SBU reporting segment. Net sales include product sales and marketing service fees.
		External Net Sales by SBU
		Year ended December 31,
	(U.S. Dollars in thousands)	2013						2012						2011
		Net Sales			Percent of			Net Sales			Percent of			Net Sales		Percent of
					Total Net						Total Net					Total Net
					Sales						Sales					Sales
		(Restated)						(Restated)						(Restated)
	BioStim	$	145,085			36	%	$	174,562			40	%	$	181,736		42	%
	Biologics		53,746			14	%		53,731			12	%		42,910		10	%
	Extremity Fixation		103,359			26	%		112,011			25	%		119,504		27	%
	Spine Fixation		95,421			24	%		99,885			23	%		91,368		21	%
	Total Net Sales	$	397,611			100	%	$	440,189			100	%	$	435,519		100	%
Summary of Net Margin, Defined as Gross Profit Less Sales And Marketing Expenses from Continuing Operations by SBU Reporting Segment	The table below presents net margin, defined as gross profit less sales and marketing expenses from continuing operations by SBU reporting segment:
	Net Margin by SBU	Year Ended December 31,
	(U.S. Dollars in thousands)	2013			2012			2011
		(Restated)			(Restated)			(Restated)
	Net Margin
	BioStim	$	63,847		$	88,788		$	92,860
	Biologics		24,794			23,589			18,978
	Extremity Fixation		23,704			34,554			30,773
	Spine Fixation		4,329			15,256			13,037
	Corporate		(1,443	)		(1,495	)		(1,700	)
	Total net margin	$	115,231		$	160,692		$	153,948
	General & administrative		64,830			53,650			64,785
	Research and development		26,768			28,577			22,861
	Amortization of intangible assets		2,687			2,298			2,550
	Costs related to the accounting review and restatement		12,945			—			—
	Impairment of goodwill		19,193			—			—
	Charges related to U.S. Government resolutions		—			1,295			57,141
	Operating (loss) income	$	(11,192	)	$	74,872		$	6,611
Schedule of Depreciation and Amortization by SBU Reporting Segment	The table below presents external net sales for continuing operations by SBU reporting segment. Net sales include product sales and marketing service fees.
		External Net Sales by SBU
		Year ended December 31,
	(U.S. Dollars in thousands)	2013						2012						2011
		Net Sales			Percent of			Net Sales			Percent of			Net Sales		Percent of
					Total Net						Total Net					Total Net
					Sales						Sales					Sales
		(Restated)						(Restated)						(Restated)
	BioStim	$	145,085			36	%	$	174,562			40	%	$	181,736		42	%
	Biologics		53,746			14	%		53,731			12	%		42,911		10	%
	Extremity Fixation		103,359			26	%		112,011			25	%		119,504		27	%
	Spine Fixation		95,421			24	%		99,885			23	%		91,368		21	%
	Total Net Sales	$	397,611			100	%	$	440,189			100	%	$	435,519		100	%
Summary of Net Sales by Geographic Destination	The following geographic data includes net sales by geographic destination:
	(U.S. Dollars in thousands)	2013			2012			2011
		(Restated)			(Restated)			(Restated)
	U.S.	$	293,032		$	327,228		$	322,186
	Italy		16,755			18,742			17,447
	U.K.		10,002			8,431			8,206
	Brazil		26,786			31,166			34,424
	Others		51,036			54,622			53,256
	Total net sales	$	397,611		$	440,189		$	435,519
Analysis of Property, Plant and Equipment of Reporting Segments by Geographic Area	Analysis of property, plant and equipment by geographic area:
	(U.S. Dollars in thousands)	2013			2012
		(Restated)			(Restated)
	U.S.	$	39,287		$	38,504
	Italy		8,150			7,625
	U.K.		1,871			1,402
	Brazil		3,210			3,421
	Others		1,854			1,841
	Total	$	54,372		$	52,793

Income_taxes_Tables

Income taxes (Tables)	12 Months Ended
	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Schedule of Income from Continuing Operations Before Provision for Income Taxes	Income from continuing operations before provision for income taxes consisted of:
		Year Ended
		December 31,
	(US$ in thousands)	2013			2012			2011
		(Restated)			(Restated)			(Restated)
	U.S.	$	(3,546	)	$	56,210		$	4,730
	Non-U.S.		(7,057	)		12,855			(6,093	)
	Total income before taxes	$	(10,603	)	$	69,065		$	(1,363	)
Schedule of Provision for (Benefit from) Income Taxes on Continuing Operations	The provision for (benefit from) income taxes on continuing operations in the accompanying consolidated statements of operations consists of the following:
		Year Ended
		December 31,
	(US$ in thousands)	2013			2012			2011
		(Restated)			(Restated)			(Restated)
	U.S.
	Current	$	2,465		$	16,982		$	26,273
	Deferred		4,013			2,675			(13,241	)
	Total U.S		6,478			19,657			13,032
	Non-U.S.
	Current		2,308			3,191			2,111
	Deferred		(1,184	)		1,096			(700	)
			1,124			4,287			1,411
	Total tax expense	$	7,602		$	23,944		$	14,443
Schedule of Tax Effects of Significant Temporary Differences Comprising Deferred Tax Assets and Liabilities	The tax effects of the significant temporary differences, which comprise the deferred tax assets and liabilities, are as follows:
	(US$ in thousands)	2013			2012
		(Restated)			(Restated)
	Intangible assets and goodwill	$	4,798		$	5,338
	Inventories and related reserves		20,769			19,626
	Deferred revenue and cost of goods sold		11,577			12,336
	Other accruals and reserves		4,778			6,149
	Accrued compensation		3,942			3,791
	Allowance for doubtful accounts		2,040			1,542
	Accrued interest		18,063			17,995
	Net operating loss carryforwards		34,979			27,231
	Other, net		893			590
			101,839			94,598
	Valuation allowance		(31,772	)		(26,361	)
	Deferred tax asset	$	70,067		$	68,237
	Withholding taxes		(13,026	)		(11,351	)
	Property, plant and equipment		(7,674	)		(8,226	)
	Deferred tax liability		(20,700	)		(19,577	)
	Net deferred tax assets	$	49,367		$	48,660
	Reported as:
	Current deferred tax assets		39,999			38,487
	Non-current deferred tax assets		22,394			21,523
	Current deferred tax liability		—			—
	Non-current deferred tax liability		(13,026	)		(11,350	)
	Net deferred tax assets	$	49,367		$	48,660
Schedule of Effective Income Tax Rate Reconciliation for Continuing Operations	The rate reconciliation for continuing operations presented below is based on the U.S. federal income tax rate, rather than the parent company’s country of domicile tax rate. Management believes, given the large proportion of taxable income earned in the United States, such disclosure is more meaningful.
	(US$ in thousands, except percentages)	2013						2012						2011
		Amount			Percent			Amount			Percent			Amount			Percent
		(Restated)			(Restated)			(Restated)			(Restated)			(Restated)			(Restated)
	Statutory U.S. federal income tax rate	$	(3,711	)		35	%	$	24,179			35	%	$	(477	)		35	%
	State taxes, net		2,039			(19.2	)%		2,536			3.7	%		1,809			(132.7	)%
	Foreign rate differential		(510	)		4.8	%		(2,894	)		(4.2	)%		1,549			(113.6	)%
	Valuation allowance—foreign losses		3,913			(36.9	)%		6,189			9	%		4,924			361.3	%
	Italian subsidiary intangible		(2,288	)		21.6	%		(2,214	)		(3.2	)%		(2,421	)		177.6	%
	Goodwill impairment		6,452			(60.9	)%		—			—			—			—
	Domestic manufacturing deduction		(233	)		2.2	%		(1,567	)		(2.3	)%		(1,703	)		125	%
	Withholding taxes		1,676			(15.8	)%		1,679			2.4	%		1,676			(123.0	)%
	Settlement of U.S. Government resolutions		—			—			(1,260	)		(1.8	)%		9,520			(698.5	)%
	Other items, net		264			(2.5	)%		(2,704	)		(3.9	)%		(434	)		31.9	%
	Income tax expense/effective rate	$	7,602			(71.7	)%	$	23,944			34.7	%	$	14,443			(1,059.6	)%
Schedule of Gross Unrecognized Tax Benefits (Excluding Interest and Penalties)	A reconciliation of the gross unrecognized tax benefits (excluding interest and penalties) for the years ended December 31, 2013 and December 31, 2012 follows:
	(US$ in thousands)	2013			2012
		(Restated)			(Restated)
	Balance as of January 1,	$	1,189		$	610
	Additions for current year tax positions		183			793
	Decreases for prior year tax positions		(12	)		(106	)
	Settlements of prior year tax positions		(560	)		—
	Expiration of statutes		(77	)		(108	)
	Balance as of December 31,	$	723		$	1,189

Sale_of_Breg_and_Disposition_o1

Sale of Breg and Disposition of Sports Medicine SBU (Tables)	12 Months Ended
	Dec. 31, 2013
Discontinued Operations and Disposal Groups [Abstract]
Schedule of Information Related to Sale of Breg	The following table presents the value of the asset disposition, proceeds received, net of various working capital adjustments and indebtedness and net gain on sale of Breg as shown in the condensed consolidated statement of operations for the year ended December 31, 2012.
	(U.S. Dollars in thousands)	Total
	Cash proceeds	$	157,500
	Less:
	Working Capital		(7,093	)
	Transaction related expenses		(4,276	)
	Fair value of indemnification		(2,000	)
	Tangible assets		(8,309	)
	Intangible assets		(28,164	)
	Goodwill		(106,200	)
	Gain on sale of Breg		1,458
	Income tax expense		(113	)
	Gain on sale of Breg, net of taxes	$	1,345

Sharebased_compensation_plans_

Share-based compensation plans (Tables)	12 Months Ended
	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Schedule of Share-Based Compensation by Line Item in Consolidated Statements of Operations	The following table shows the detail of share-based compensation by line item in the consolidated statements of operations for the years ended December 31, 2013, 2012 and 2011 and the assumptions for each of these years in which grants were awarded:
	(U.S. Dollars in thousands, except assumptions)	Year Ended			Year Ended			Year Ended
		December 31,			December 31,			December 31,
		2013			2012			2011
	Cost of sales	$	104		$	592		$	153
	Sales and marketing		1,444			1,550			2,031
	General and administrative		4,483			4,023			4,322
	Research and development		236			138			142
	Total	$	6,267		$	6,303		$	6,648
Schedule of Share-based Payment Award, Valuation Assumptions	Assumptions:
	Expected term		5.00 years			4.50 years			4.58 years
	Expected volatility		32.1% – 50.8	%		50.9% – 51.8	%		49.6% – 49.9	%
	Risk free interest rate		0.58% – 1.52	%		0.76% – 0.84	%		.90% – 2.26	%
	Dividend rate		—			—			—
	Weighted average fair value of options granted during the year	$	10.83		$	16.99		$	14.21
Schedule of Stock Option Activity	Summaries of the status of the Company’s stock option plans as of December 31, 2013 and 2012 and changes during the year ended December 31, 2013 are presented below:
		Options			Weighted Average			Weighted
					Exercise Price			Average
								Remaining
								Contractual
								Term
	Outstanding at December 31, 2012		1,945,955		$	34.5
	Granted		466,250		$	28.51
	Exercised		(79,949	)	$	23.25
	Forfeited		(408,077	)	$	36.33
	Outstanding at December 31, 2013		1,924,179		$	33.12			4.41
	Vested and expected to vest at December 31, 2013		1,839,383		$	33.5			4.17
	Options exercisable at December 31, 2013		1,367,269		$	34.35			2.89
Schedule of Stock Options Outstanding and Exercisable by Price Range	Outstanding and exercisable by price range as of December 31, 2013
		Options Outstanding									Options Exercisable
	Range of Exercise Prices	Number			Weighted			Weighted			Number		Weighted
		Outstanding			Average			Average			Exercisable		Average
					Remaining			Exercise					Exercise
					Contractual			Price					Price
					Life
	$10.42 – $21.78		232,250			9.31		$	20.79			16,000	$	13.31
	$22.75 – $25.05		326,166			4.1		$	24.73			306,166	$	24.84
	$26.79 – $28.95		230,000			4.79		$	28.45			170,000	$	28.65
	$29.23 – $37.36		225,168			5.1		$	33.14			169,839	$	32.41
	$37.76 – $38.11		230,975			1.69		$	37.99			230,975	$	37.99
	$38.40 – $40.27		351,354			3.17		$	39.76			174,355	$	39.77
	$41.33 – $43.04		178,633			2.84		$	41.66			150,301	$	41.72
	$44.87 – $45.84		140,133			3.05		$	45.02			140,133	$	45.02
	$50.50 – $50.50		2,000			3.01		$	50.5			2,000	$	50.5
	$50.99 – $50.99		7,500			3.04		$	50.99			7,500	$	50.99
	$10.42 – $50.99		1,924,179			4.41		$	33.12			1,367,269	$	34.35
Schedule of Changes in Restricted Stock	A summary of the status of our restricted stock as of December 31, 2013 and 2012 and changes during the year ended December 31, 2013 are presented below:
		Shares			Weighted
					Average Grant
					Date Fair Value
	Non-vested as of December 31, 2012		160,831		$	38.34
	Granted		269,791		$	27.09
	Vested		(62,948	)	$	36.58
	Cancelled		(80,970	)	$	38.8
	Non-vested as of December 31, 2013		286,704		$	28.01

Earnings_per_share_Tables

Earnings per share (Tables)	12 Months Ended
	Dec. 31, 2013
Earnings Per Share [Abstract]
Schedule of Reconciliation of Weighted Average Shares Used in Calculation of Basic and Diluted Earnings Per Share	The following is a reconciliation of the weighted average shares used in the basic and diluted net income (loss) per common share computations.
		Year Ended December 31,
		2013		2012		2011
	Weighted average common shares-basic		18,697,228		18,977,263		18,219,343
	Effect of diluted securities:
	Unexercised stock options net of treasury share repurchase		—		413,150		—
	Weighted average common shares-diluted		18,697,228		19,390,413		18,219,343

Quarterly_financial_data_unaud1

Quarterly financial data (unaudited) (Tables)	12 Months Ended
	Dec. 31, 2013
Quarterly Financial Information Disclosure [Abstract]
Condensed Consolidated Statement of Operations	Condensed Consolidated Statement of Operations
	(U.S. Dollars, in thousands, except per share data)
		Originally			Original			Originally			Further			Restated
		Reported in			Restatement			Reported in			Restatement
		2013			Adjustments			2013			Adjustments
		Form 10-Q						Form 10-Q/A
		1st Quarter
	2013
	Net sales	$	100,254		$	3,119		$	103,373		$	(1,094	)	$	102,279
	Cost of sales		22,699			2,918			25,617			224			25,841
	Gross profit		77,555			201			77,756			(1,318	)		76,438
	Operating expense		73,531			(3,862	)		69,669			701			70,370
	Operating income		4,024			4,063			8,087			(2,019	)		6,068
	Net income from continuing operations		4,908			2,702			7,610			(1,684	)		5,926
	Net income	$	2,116		$	2,384		$	4,500		$	(1,053	)	$	3,447
	Net income (loss) per common share:
	Basic:
	Net income from continuing operations	$	0.25		$	0.14		$	0.39		$	(0.08	)	$	0.31
	Net income	$	0.11		$	0.12		$	0.23		$	(0.05	)	$	0.18
	Diluted:
	Net income from continuing operations	$	0.25		$	0.14		$	0.39		$	(0.09	)	$	0.3
	Net income	$	0.11		$	0.12		$	0.23		$	(0.05	)	$	0.18
		Originally			Original			Originally			Further			Restated
		Reported in			Restatement			Reported in			Restatement
		2013			Adjustments			2013			Adjustments
		Form 10-K						Form 10-K
		2nd Quarter
	2013
	Net sales	$	98,280		$	—		$	98,280		$	(640	)	$	97,640
	Cost of sales		20,246			—			20,246			1,638			21,884
	Gross profit		78,034			—			78,034			(2,278	)		75,756
	Operating expense		69,230			—			69,230			(394	)		68,836
	Operating income		8,804			—			8,804			(1,884	)		6,920
	Net income from continuing operations		4,130			—			4,130			(2,118	)		2,012
	Net loss	$	(2,317	)	$	—		$	(2,317	)	$	(694	)	$	(3,011	)
	Net income (loss) per common share:
	Basic:
	Net income from continuing operations	$	0.22		$	—		$	0.22		$	(0.11	)	$	0.11
	Net loss	$	(0.12	)	$	—		$	(0.12	)	$	(0.04	)	$	(0.16	)
	Diluted:
	Net income from continuing operations	$	0.21		$	—		$	0.21		$	(0.11	)	$	0.1
	Net loss	$	(0.12	)	$	—		$	(0.12	)	$	(0.04	)	$	(0.16	)
	Condensed Consolidated Statement of Operations
	(U.S. Dollars, in thousands, except per share data)
		Originally			Original			Originally			Further			Restated
		Reported in			Restatement			Reported in			Restatement
		2013			Adjustments			2013			Adjustments
		Form 10-K						Form 10-K
		3rd Quarter
	2013
	Net sales	$	92,738		$	—		$	92,738		$	(932	)	$	91,806
	Cost of sales		23,920			—			23,920			1,144			25,064
	Gross profit		68,818			—			68,818			(2,076	)		66,742
	Operating expense		84,418			—			84,418			(3,575	)		80,843
	Operating loss		(15,600	)		—			(15,600	)		1,499			(14,101	)
	Net loss from continuing operations		(18,084	)		—			(18,084	)		1,580			(16,504	)
	Net loss	$	(19,822	)	$	—		$	(19,822	)	$	986		$	(18,836	)
	Net income (loss) per common share:
	Basic:
	Net loss from continuing operations	$	(1.00	)	$	—		$	(1.00	)	$	0.09		$	(0.91	)
	Net loss	$	(1.10	)	$	—		$	(1.10	)	$	0.06		$	(1.04	)
	Diluted:
	Net loss from continuing operations	$	(1.00	)	$	—		$	(1.00	)	$	0.09		$	(0.91	)
	Net loss	$	(1.10	)	$	—		$	(1.10	)	$	0.06		$	(1.04	)
	4th Quarter
2013
Net sales	$	106,143		$	—		$	106,143		$	(257	)	$	105,886
Cost of sales		32,517			—			32,517			1,606			34,123
Gross profit		73,626			—			73,626			(1,863	)		71,763
Operating expense		80,004			—			80,004			1,838			81,842
Operating loss		(6,378	)		—			(6,378	)		(3,701	)		(10,079	)
Net loss from continuing operations		(8,564	)		—			(8,564	)		(1,075	)		(9,639	)
Net loss	$	(7,876	)	$	—		$	(7,876	)	$	(2,536	)	$	(10,412	)
Net income (loss) per common share:
Basic:
Net loss from continuing operations	$	(0.47	)	$	—		$	(0.47	)	$	(0.06	)	$	(0.53	)
Net loss	$	(0.43	)	$	—		$	(0.43	)	$	(0.15	)	$	(0.58	)
Diluted:
Net loss from continuing operations	$	(0.47	)	$	—		$	(0.47	)	$	(0.06	)	$	(0.53	)
Net loss	$	(0.43	)	$	—		$	(0.43	)	$	(0.15	)	$	(0.58	)
Condensed Consolidated Statement of Operations
(U.S. Dollars, in thousands, except per share data)
	As Reported			Original			As Originally			Further			Restated
	in the 2012			Restatement			Restated in			Restatement
	Form 10-K			Adjustments			the 2012			Adjustments
	Prior to						Form 10-K/A
	Original
	Restatement
	1st Quarter
2012
Net sales	$	116,041		$	(7,105	)	$	108,936		$	(1,773	)	$	107,163
Cost of sales		21,939			(561	)		21,378			2,767			24,145
Gross profit		94,102			(6,544	)		87,558			(4,540	)		83,018
Operating expense		71,671			(2,033	)		69,638			(1,409	)		68,229
Operating income		22,431			(4,511	)		17,920			(3,131	)		14,789
Net income from continuing operations		12,215			(3,618	)		8,597			(1,727	)		6,870
Net income	$	12,016		$	(2,609	)	$	9,407		$	(2,058	)	$	7,349
Net income (loss) per common share:
Basic:
Net income from continuing operations	$	0.65		$	(0.19	)	$	0.46		$	(0.09	)	$	0.37
Net income	$	0.64		$	(0.14	)	$	0.5		$	(0.11	)	$	0.39
Diluted:
Net income from continuing operations	$	0.64		$	(0.19	)	$	0.45		$	(0.09	)	$	0.36
Net income	$	0.63		$	(0.14	)	$	0.49		$	(0.11	)	$	0.38
	2nd Quarter
2012
Net sales	$	119,492		$	(6,069	)	$	113,423		$	(1,822	)	$	111,601
Cost of sales		23,676			3,871			27,547			(2,604	)		24,943
Gross profit		95,816			(9,940	)		85,876			782			86,658
Operating expense		75,251			(3,673	)		71,578			(1,542	)		70,036
Operating income		20,565			(6,267	)		14,298			2,324			16,622
Net income from continuing operations		13,967			(4,097	)		9,870			1,551			11,421
Net income	$	11,205		$	(3,951	)	$	7,254		$	1,548		$	8,802
Net income (loss) per common share:
Basic:
Net income from continuing operations	$	0.74		$	(0.22	)	$	0.52		$	0.09		$	0.61
Net income	$	0.59		$	(0.21	)	$	0.38		$	0.09		$	0.47
Diluted:
Net income from continuing operations	$	0.73		$	(0.22	)	$	0.51		$	0.08		$	0.59
Net income	$	0.58		$	(0.21	)	$	0.37		$	0.09		$	0.46
Condensed Consolidated Statement of Operations
(U.S. Dollars, in thousands, except per share data)
	As Reported			Original			As Originally			Further			Restated
	in the 2012			Restatement			Restated in			Restatement
	Form 10-K			Adjustments			the 2012			Adjustments
	Prior to						Form 10-K/A
	Original
	Restatement
	3rd Quarter
2012
Net sales	$	114,752		$	(6,895	)	$	107,857		$	(2,039	)	$	105,818
Cost of sales		22,373			2,011			24,384			503			24,887
Gross profit		92,379			(8,906	)		83,473			(2,542	)		80,931
Operating expense		70,846			(6,178	)		64,668			(680	)		63,988
Operating income		21,533			(2,728	)		18,805			(1,862	)		16,943
Net income from continuing operations		13,118			(2,544	)		10,574			(1,262	)		9,312
Net income	$	7,560		$	(2,544	)	$	5,016		$	(1,269	)	$	3,747
Net income (loss) per common share:
Basic:
Net income from continuing operations	$	0.69		$	(0.14	)	$	0.55		$	(0.06	)	$	0.49
Net income	$	0.4		$	(0.14	)	$	0.26		$	(0.06	)	$	0.2
Diluted:
Net income from continuing operations	$	0.67		$	(0.13	)	$	0.54		$	(0.06	)	$	0.48
Net income	$	0.39		$	(0.14	)	$	0.25		$	(0.06	)	$	0.19
	4th Quarter
2012
Net sales	$	112,035		$	5,330		$	117,365		$	(1,758	)	$	115,607
Cost of sales		18,504			6,440			24,944			1,807			26,751
Gross profit		93,531			(1,110	)		92,421			(3,565	)		88,856
Operating expense		69,050			(2,242	)		66,808			(4,470	)		62,338
Operating income		24,481			1,132			25,613			905			26,518
Net income from continuing operations		14,636			1,373			16,009			1,509			17,518
Net income	$	20,514		$	647		$	21,161		$	1,793		$	22,954
Net income (loss) per common share:
Basic:
Net income from continuing operations	$	0.76		$	0.07		$	0.83		$	0.08		$	0.91
Net income	$	1.06		$	0.04		$	1.1		$	0.09		$	1.19
Diluted:
Net income from continuing operations	$	0.74		$	0.07		$	0.81		$	0.08		$	0.89
Net income	$	1.04		$	0.03		$	1.07		$	0.1		$	1.17
Condensed Consolidated Balance Sheets	Condensed Consolidated Balance Sheets
	(U.S. Dollars, in thousands, except share and per share data)	Originally			Original			Originally			Further			Restated
		Reported in			Restatement			Restated in			Restatement
		2013			Adjustments			2013			Adjustments
		Form 10-Q						Form 10-Q/A
		1st Quarter
	2013
	Total assets	$	503,380		$	(27,622	)	$	475,758		$	(11,605	)	$	464,153
	Total liabilities		101,212			1,154			102,366			812			103,178
	Total shareholders’ equity		402,168			(28,776	)		373,392			(12,417	)		360,975
	Total liabilities and shareholders’ equity	$	503,380		$	(27,622	)	$	475,758		$	(11,605	)	$	464,153
		Originally			Original			Originally			Further			Restated
		Reported in			Restatement			Reported in			Restatement
		2013			Adjustments			2013			Adjustments
		Form 10-K						Form 10-K
		2nd Quarter
	2013
	Total assets	$	459,450		$	—		$	459,450		$	(13,129	)	$	446,321
	Total liabilities		114,223			—			114,223			(48	)		114,175
	Total shareholders’ equity		345,227			—			345,227			(13,081	)		332,146
	Total liabilities and shareholders’ equity	$	459,450		$	—		$	459,450		$	(13,129	)	$	446,321
		3rd Quarter
	2013
	Total assets	$	430,058		$	—		$	430,058		$	(14,534	)	$	415,524
	Total liabilities		111,001			—			111,001			(2,470	)		108,531
	Total shareholders’ equity		319,057			—			319,057			(12,064	)		306,993
	Total liabilities and shareholders’ equity	$	430,058		$	—		$	430,058		$	(14,534	)	$	415,524
		4th Quarter
	2013
	Total assets	$	423,182		$	—		$	423,182		$	(11,207	)	$	411,975
	Total liabilities		112,688			—			112,688			3,424			116,112
	Total shareholders’ equity		310,494			—			310,494			(14,631	)		295,863
	Total liabilities and shareholders’ equity	$	423,182		$	—		$	423,182		$	(11,207	)	$	411,975
	Condensed Consolidated Balance Sheets
	(U.S. Dollars, in thousands, except share and per share data)	As Reported			Original			As Originally			Further			Restated
		in the 2012			Restatement			Restated in			Restatement
		Form 10-K			Adjustments			the 2012			Adjustments
		Prior to						Form 10-K/A
		Original
		Restatement
		1st Quarter
	2012
	Total assets	$	707,586		$	(13,480	)	$	694,106		$	(13,510	)	$	680,596
	Total liabilities		369,178			12,556			381,734			317			382,051
	Total shareholders’ equity		338,408			(26,036	)		312,372			(13,827	)		298,545
	Total liabilities and shareholders’ equity	$	707,586		$	(13,480	)	$	694,106		$	(13,510	)	$	680,596
		2nd Quarter
	2012
	Total assets	$	553,320		$	(22,925	)	$	530,395		$	(9,547	)	$	520,848
	Total liabilities		199,104			6,092			205,196			2,731			207,927
	Total shareholders’ equity		354,216			(29,017	)		325,199			(12,278	)		312,921
	Total liabilities and shareholders’ equity	$	553,320		$	(22,925	)	$	530,395		$	(9,547	)	$	520,848
		3rd Quarter
	2012
	Total assets	$	565,073		$	(25,507	)	$	539,566		$	(11,392	)	$	528,174
	Total liabilities		187,463			6,136			193,599			2,156			195,755
	Total shareholders’ equity		377,610			(31,643	)		345,967			(13,548	)		332,419
	Total liabilities and shareholders’ equity	$	565,073		$	(25,507	)	$	539,566		$	(11,392	)	$	528,174
		4th Quarter
	2012
	Total assets	$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546
	Total liabilities		105,183			(118	)		105,065			3,042			108,107
	Total shareholders’ equity		399,098			(31,266	)		367,832			(11,393	)		356,439
	Total liabilities and shareholders’ equity	$	504,281		$	(31,384	)	$	472,897		$	(8,351	)	$	464,546

Recovered_Sheet1

Summary of Significant Accounting Policies - Additional Information (Detail) (USD $)	3 Months Ended								6 Months Ended	12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2009
										Unit
Foreign Currency Translation [Line Items]
Transactional foreign currency gains and (losses), including those generated from intercompany operations										($500,000)	($400,000)	($1,700,000)
Property plant and equipment, gross	143,374,000				130,848,000				143,374,000	143,374,000	130,848,000
Property plant and equipment, accumulated depreciation	35,400,000								35,400,000	35,400,000
Number of reporting units										4
Impairment of goodwill									19,193,000	19,193,000
Estimated related fee										800,000	600,000
Advertising expense										200,000	300,000	500,000
Net sales	105,886,000	91,806,000	97,640,000	102,279,000	115,607,000	105,818,000	111,601,000	107,163,000		397,611,000	440,189,000	435,519,000
Musculoskeletal Transplant Foundation ("MTF") [Member]
Foreign Currency Translation [Line Items]
Expenditures for other research and development										2,500,000	3,000,000	0
Customers and Distributors Based in Europe [Member]
Foreign Currency Translation [Line Items]
Net sales										52,000,000
Collaborative Arrangement [Member] | Musculoskeletal Transplant Foundation ("MTF") [Member]
Foreign Currency Translation [Line Items]
Period of agreement with MTF													10 years
Extended Period of existing agreement with MTF										15 years
Marketing fee										48,100,000	46,500,000	36,800,000
Spine Fixation and our Extremity Fixation reportable units [Member]
Foreign Currency Translation [Line Items]
Impairment of goodwill		$19,200,000								$19,200,000
Developed Technology [Member]
Foreign Currency Translation [Line Items]
Weighted average amortization period ( in years)										11 years

Recovered_Sheet2

Summary of Significant Accounting Policies - Schedule of Useful Lives (Detail)	12 Months Ended
	Dec. 31, 2013
Minimum [Member] | Buildings [Member]
Foreign Currency Translation [Line Items]
Useful life, in years	25 years
Minimum [Member] | Plant equipment and instrumentation [Member]
Foreign Currency Translation [Line Items]
Useful life, in years	2 years
Minimum [Member] | Furniture and fixtures [Member]
Foreign Currency Translation [Line Items]
Useful life, in years	4 years
Maximum [Member] | Buildings [Member]
Foreign Currency Translation [Line Items]
Useful life, in years	33 years
Maximum [Member] | Plant equipment and instrumentation [Member]
Foreign Currency Translation [Line Items]
Useful life, in years	10 years
Maximum [Member] | Furniture and fixtures [Member]
Foreign Currency Translation [Line Items]
Useful life, in years	8 years

Recovered_Sheet3

Summary of Significant Accounting Policies - Components of Changes in Accumulated Other Comprehensive Income (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	$5,490
Unrealized gain (loss) on cross-currency swaps, net of taxes (benefit)	-279	263	-437
Foreign currency translation adjustment	-1,708	1,131	-1,897
Ending Balance	3,503	5,490
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	5,359	4,228
Foreign currency translation adjustment	-1,708	1,131
Ending Balance	3,651	5,359
Change in Fair Value [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	131	-132
Unrealized gain (loss) on cross-currency swaps, net of taxes (benefit)	-278	263
Unrealized gain (loss) on warrants	-1
Ending Balance	-148	131
Accumulated Other Comprehensive Income [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	5,490	4,096
Unrealized gain (loss) on cross-currency swaps, net of taxes (benefit)	-279	263	-437
Unrealized gain (loss) on warrants	-1
Foreign currency translation adjustment	-1,708	1,131	-1,897
Ending Balance	$3,503	$5,490	$4,096

Summary_of_Significant_Account3

Summary of Significant Accounting Policies - Components of Changes in Accumulated Other Comprehensive Income (Parenthetical) (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain (loss) on cross-currency swaps, taxes (benefit)	($164,000)	$153,000	($256,000)
Deferred taxes recognized on related foreign currency translation adjustment	-1,184,000	1,096,000	-700,000
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Deferred taxes recognized on related foreign currency translation adjustment	0	0
Change in Fair Value [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain (loss) on cross-currency swaps, taxes (benefit)	-164,000	153,000
Accumulated Other Comprehensive Income [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain (loss) on cross-currency swaps, taxes (benefit)	($164,000)	$153,000

Original_and_Further_Restateme2

Original and Further Restatement of the Consolidated Financial Statements - Additional Information (Detail) (USD $)	3 Months Ended								12 Months Ended			1 Months Ended			6 Months Ended	3 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Sep. 30, 2012	Jun. 30, 2012	31-May-12	Jun. 30, 2012	Mar. 31, 2014
									Facilities
Increase (Decrease) in net sales										($14,700,000)	($28,200,000)
Increase (Decrease) in net income from continuing operations										-8,900,000	-14,500,000
Net sales	105,886,000	91,806,000	97,640,000	102,279,000	115,607,000	105,818,000	111,601,000	107,163,000	397,611,000	440,189,000	435,519,000
Increase (Decrease) in accounts receivable									-28,562,000	11,128,000	-6,645,000
Increase (Decease) in inventory									3,213,000	384,000	12,705,000
Adjustment to reclassify interest expenses											3,900,000
Repayment of debt obligation									16,000	188,695,000	7,500,000
Sales and marketing expense									175,468,000	178,771,000	185,156,000
Number of manufacturing facilities									2
Increase (Decrease) in Income Taxes									-1,700,000	-1,200,000	200,000
Revolving Credit Facility [Member]
Repayment of debt obligation									57,500,000			20,000,000	20,000,000	57,500,000
Term Loan Facility [Member]
Repayment of debt obligation									87,500,000					87,500,000
Inventory Reserve [Member]
Increase (Decease) in inventory										-14,800,000
Increase (Decrease) in inventory reserve															1,200,000
Restatement Adjustments [Member]
Increase (Decrease) in accounts receivable									-4,800,000
Increase (Decease) in inventory									-17,900,000
Sales and marketing expense									2,200,000	9,000,000	6,000,000
Increase (Decrease) in assets									-11,200,000
Increase (Decrease) in income tax expense									-500,000	-1,100,000
Increase (Decrease) in Deferred income tax									6,000,000
Restatement Adjustments [Member] | Bad Debt Timing [Member]
Increase (Decrease) in accounts receivable										1,500,000
Sales and marketing expense									1,500,000	1,100,000	2,100,000
Restatement Adjustments [Member] | Other Adjustments [Member]
Increase (Decease) in inventory									-2,600,000	-1,500,000
Increase (Decrease) in cost of sales									1,100,000	200,000	300,000
Restatement Adjustments [Member] | Discontinued Operations [Member]
Interest expenses classified under discontinued operations										500,000
Restatement Adjustments [Member] | Accounts Receivable Reserve [Member]
Increase (Decrease) in accounts receivable									-4,200,000	-3,500,000
Increase (Decrease) in assets									-700,000	-200,000	2,100,000
Restatement Adjustments [Member] | Inventory Reserve [Member]
Increase (Decease) in inventory									-14,400,000	-11,800,000
Increase (Decrease) in cost of sales									3,200,000	1,500,000	100,000
Restatement Adjustments [Member] | Inventory Existence [Member]
Increase (Decease) in inventory									-1,000,000	-600,000
Increase (Decrease) in cost of sales									400,000	300,000	200,000
Subsequent Event [Member]
Increase (Decrease) in Income Taxes																-1,900,000
Distributor Revenue [Member]
Distributors that did not meet the fixed or determinable or collectability revenue recognition criteria									4
Number of distributer terminated									2
Sales return										3,300,000	4,100,000
Increase (Decrease) in accounts receivable										-41,300,000
Increase (Decease) in inventory										11,000,000
Distributor Revenue [Member] | Previously Reported [Member]
Net sales										$462,000,000	$470,000,000
Distributor Revenue [Member] | Minimum [Member]
Percentage of net sales									11.00%
Distributor Revenue [Member] | Maximum [Member]
Percentage of net sales									13.00%

Original_and_Further_Restateme3

Original and Further Restatement of the Consolidated Financial Statements - Effects of Original Restatement and Further Restatement to Previously Filed Consolidated Income Statements (Detail) (USD $)	3 Months Ended								6 Months Ended	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Net sales	$105,886	$91,806	$97,640	$102,279	$115,607	$105,818	$111,601	$107,163		$397,611	$440,189	$435,519
Cost of sales	34,123	25,064	21,884	25,841	26,751	24,887	24,943	24,145		106,912	100,726	96,415
Gross profit	71,763	66,742	75,756	76,438	88,856	80,931	86,658	83,018		290,699	339,463	339,104
Operating expenses
Sales and marketing										175,468	178,771	185,156
General and administrative										64,830	53,650	64,785
Research and development										26,768	28,577	22,861
Amortization of intangible assets										2,687	2,298	2,550
Costs related to the accounting review and restatement										12,945
Charges related to U.S. Government resolutions											1,295	57,141
Impairment of goodwill									19,193	19,193
Total operation expenses	81,842	80,843	68,836	70,370	62,338	63,988	70,036	68,229		301,891	264,591	332,493
Operating (loss) income	-10,079	-14,101	6,920	6,068	26,518	16,943	16,622	14,789		-11,192	74,872	6,611
Other income and (expense)										589	-5,807	-7,974
(Loss) before income taxes										-10,603	69,065	-1,363
Income tax expense										-7,602	-23,944	-14,443	6,028
Net income (loss) from continuing operations	-9,639	-16,504	2,012	5,926	17,518	9,312	11,421	6,870		-18,205	45,121	-15,806
As Originally Restated in the 2012 Form 10-K/A [Member]
Net sales					117,365	107,857	113,423				447,581	441,971
Cost of sales					24,944	24,384	27,547				98,253	95,527
Gross profit					92,421	83,473	85,876				349,328	346,444
Operating expenses
Sales and marketing											187,131	193,511
General and administrative											53,391	64,481
Research and development											28,577	22,861
Amortization of intangible assets											2,298	2,550
Charges related to U.S. Government resolutions											1,295	57,141
Total operation expenses					66,808	64,668	71,578				272,692	340,544
Operating (loss) income					25,613	18,805	14,298				76,636	5,900
Other income and (expense)											-6,448	-7,953
(Loss) before income taxes											-70,188	-2,053
Income tax expense											-25,138	-14,165
Net income (loss) from continuing operations					16,009	10,574	9,870				45,050	-16,218
As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Net sales					112,035	114,752	119,492	116,041			462,320	470,121
Cost of sales					18,504	22,373	23,676	21,939			86,492	92,619
Gross profit					93,531	92,379	95,816	94,102			375,828	377,502
Operating expenses
Sales and marketing											200,343	200,145
General and administrative											53,827	64,374
Research and development											28,577	22,861
Amortization of intangible assets											2,098	2,350
Charges related to U.S. Government resolutions											1,973	56,463
Total operation expenses					69,050	70,846	75,251	71,671			286,818	346,193
Operating (loss) income					24,481	21,533	20,565	22,431			89,010	31,309
Other income and (expense)											-6,282	-11,868
(Loss) before income taxes											82,728	19,441
Income tax expense											-28,792	-21,181
Net income (loss) from continuing operations					14,636	13,118	13,967	12,215			53,936	-1,740
Further Restatement [Member]
Net sales										397,611	438,532	435,519
Cost of sales										106,912	100,726	96,415
Gross profit										290,699	339,463	339,104
Operating expenses
Sales and marketing										175,468	178,771	185,156
General and administrative										64,830	53,650	64,785
Research and development										26,768	28,577	22,861
Amortization of intangible assets										2,687	2,298	2,550
Costs related to the accounting review and restatement										12,945
Charges related to U.S. Government resolutions											1,295	57,141
Impairment of goodwill										19,193
Total operation expenses										301,891	264,591	332,493
Operating (loss) income										-11,192	74,872	6,611
Other income and (expense)										589	-5,807	-7,974
(Loss) before income taxes										-10,603	69,065	-1,363
Income tax expense										-7,602	-23,944	14,443
Net income (loss) from continuing operations										-18,205	45,121	-15,806
Further Restatement [Member] | As Originally Restated in the 2012 Form 10-K/A [Member]
Net sales										400,534	447,581	441,971
Cost of sales										102,300	98,253	95,527
Gross profit										298,234	349,328	346,444
Operating expenses
Sales and marketing										176,581	187,131	193,511
General and administrative										65,147	53,391	64,481
Research and development										26,768	28,577	22,861
Amortization of intangible assets										2,687	2,298	2,550
Costs related to the accounting review and restatement										12,945
Charges related to U.S. Government resolutions											1,295	57,141
Impairment of goodwill										19,193
Total operation expenses										303,321	272,692	340,544
Operating (loss) income										-5,087	76,636	5,900
Other income and (expense)										295	-6,448	-7,953
(Loss) before income taxes										-4,792	70,188	-2,053
Income tax expense										-10,116	-25,138	-14,165
Net income (loss) from continuing operations										-14,908	45,050	-16,218
Further Restatement [Member] | Co-Pay and Self-Pay Revenue [Member]
Net sales										-2,242	-9,049	-5,960
Cost of sales
Gross profit										-2,242	-9,049	-5,960
Operating expenses
Sales and marketing										-2,242	-9,049	-5,960
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions
Impairment of goodwill
Total operation expenses										-2,242	-9,049	-5,960
Operating (loss) income
Other income and (expense)
(Loss) before income taxes
Income tax expense
Net income (loss) from continuing operations
Further Restatement [Member] | Bad Debt Timing [Member]
Net sales
Cost of sales
Gross profit
Operating expenses
Sales and marketing										1,455	1,097	-2,143
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions
Impairment of goodwill
Total operation expenses										1,455	1,097	-2,143
Operating (loss) income										-1,455	-1,097	2,143
Other income and (expense)
(Loss) before income taxes										-1,455	-1,097	2,143
Income tax expense										509	384	-752
Net income (loss) from continuing operations										-946	-713	1,391
Further Restatement [Member] | Accounts Receivable Reserve [Member]
Net sales										-582	1,653	-439
Cost of sales
Gross profit										-582	1,653	-439
Operating expenses
Sales and marketing										122	-408	-252
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions
Impairment of goodwill
Total operation expenses										122	-408	-252
Operating (loss) income										-704	2,061	-187
Other income and (expense)
(Loss) before income taxes										-704	2,061	-187
Income tax expense										246	-721	66
Net income (loss) from continuing operations										-458	1,340	-121
Further Restatement [Member] | Intercompany Profit [Member]
Net sales
Cost of sales										1,090	207	253
Gross profit										-1,090	-207	-253
Operating expenses
Sales and marketing
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions
Impairment of goodwill
Total operation expenses
Operating (loss) income										-1,090	-207	-253
Other income and (expense)
(Loss) before income taxes										-1,090	-207	-253
Income tax expense										381	72	89
Net income (loss) from continuing operations										-709	-135	-164
Further Restatement [Member] | Inventory [Member]
Net sales
Cost of sales										3,688	1,774	321
Gross profit										-3,688	-1,774	-321
Operating expenses
Sales and marketing
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions
Impairment of goodwill
Total operation expenses
Operating (loss) income										-3,688	-1,774	-321
Other income and (expense)
(Loss) before income taxes										-3,688	-1,774	-321
Income tax expense										1,290	621	113
Net income (loss) from continuing operations										-2,398	-1,153	-208
Further Restatement [Member] | Total Adjustments [Member]
Net sales										-2,923	-9,049	-6,452
Cost of sales										4,612	2,473	888
Gross profit										-7,535	-9,865	-7,340
Operating expenses
Sales and marketing										-1,113	-8,360	-8,355
General and administrative										-317	259	304
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions
Impairment of goodwill
Total operation expenses										-1,430	-8,101	-8,051
Operating (loss) income										-6,105	-1,764	711
Other income and (expense)										294	641	-21
(Loss) before income taxes										-5,811	-1,123	690
Income tax expense										2,514	1,194	-278
Net income (loss) from continuing operations										-3,297	71	412
Further Restatement [Member] | Other Adjustments [Member]
Net sales										-99	4	-53
Cost of sales										-166	492	314
Gross profit										67	-488	-367
Operating expenses
Sales and marketing										-448
General and administrative										-317	259	304
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions
Impairment of goodwill
Total operation expenses										-765	259	304
Operating (loss) income										832	-747	-671
Other income and (expense)										294	641	-21
(Loss) before income taxes										-1,126	-106	-692
Income tax expense										88	838	206
Net income (loss) from continuing operations										1,214	732	-486
Original Restatement [Member]
Net sales											447,581	441,971
Cost of sales											98,253	95,527
Gross profit											349,328	346,444
Operating expenses
Sales and marketing											187,131	193,511
General and administrative											53,391	64,481
Research and development											28,577	22,861
Amortization of intangible assets											2,298	2,550
Charges related to U.S. Government resolutions											1,295	57,141
Total operation expenses											272,692	340,544
Operating (loss) income											76,636	5,900
Other income and (expense)											-6,448	-7,953
(Loss) before income taxes											70,188	-2,053
Income tax expense											-25,138	-14,165
Net income (loss) from continuing operations											45,050	-16,218
Original Restatement [Member] | Distributor Revenue [Member]
Net sales											-14,777	-29,135
Cost of sales											-2,032	-8,289
Gross profit											-12,745	-20,846
Operating expenses
Sales and marketing											-6,629	-1,216
General and administrative											-2
Research and development
Amortization of intangible assets
Charges related to U.S. Government resolutions
Total operation expenses											-6,631	-1,216
Operating (loss) income											-6,114	-19,630
Other income and (expense)
(Loss) before income taxes											-6,114	-19,630
Income tax expense											1,782	6,408
Net income (loss) from continuing operations											-4,332	-13,222
Original Restatement [Member] | Inventory Reserves [Member]
Net sales
Cost of sales											5,647	3,377
Gross profit											-5,647	-3,377
Operating expenses
Sales and marketing
General and administrative
Research and development
Amortization of intangible assets
Charges related to U.S. Government resolutions
Total operation expenses
Operating (loss) income											-5,647	-3,377
Other income and (expense)
(Loss) before income taxes											-5,647	-3,377
Income tax expense											1,645	1,102
Net income (loss) from continuing operations											-4,002	-2,275
Original Restatement [Member] | Total Adjustments [Member]
Net sales											-14,739	-28,150
Cost of sales											11,761	2,908
Gross profit											-26,500	-31,058
Operating expenses
Sales and marketing											-13,212	-6,634
General and administrative											-436	107
Research and development
Amortization of intangible assets											200
Charges related to U.S. Government resolutions											-678	678
Total operation expenses											-14,126	-5,649
Operating (loss) income											-12,374	-25,409
Other income and (expense)											-166	3,915
(Loss) before income taxes											-12,540	-21,494
Income tax expense											3,654	7,016
Net income (loss) from continuing operations											-8,886	-14,478
Original Restatement [Member] | As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Net sales											462,320	470,121
Cost of sales											86,492	92,619
Gross profit											375,828	377,502
Operating expenses
Sales and marketing											200,343	200,145
General and administrative											53,827	64,374
Research and development											28,577	22,861
Amortization of intangible assets											2,098	2,350
Charges related to U.S. Government resolutions											1,973	56,463
Total operation expenses											286,818	346,193
Operating (loss) income											89,010	31,309
Other income and (expense)											-6,282	-11,868
(Loss) before income taxes											82,728	19,441
Income tax expense											-28,792	-21,181
Net income (loss) from continuing operations											53,936	-1,740
Original Restatement [Member] | Other Adjustments [Member]
Net sales											38	985
Cost of sales											-44	107
Gross profit											82	878
Operating expenses
Sales and marketing											1,607	2,295
General and administrative											-434	107
Research and development
Amortization of intangible assets											200	200
Charges related to U.S. Government resolutions											-678	678
Total operation expenses											695	3,280
Operating (loss) income											-613	-2,402
Other income and (expense)											-166	3,915
(Loss) before income taxes											-779	1,513
Income tax expense											227	-494
Net income (loss) from continuing operations											-552	1,019
Original Restatement [Member] | Royalties [Member]
Net sales
Cost of sales											8,190	7,713
Gross profit											-8,190	-7,713
Operating expenses
Sales and marketing											-8,190	-7,713
General and administrative
Research and development
Amortization of intangible assets
Charges related to U.S. Government resolutions
Total operation expenses											-8,190	-7,713
Operating (loss) income
Other income and (expense)
(Loss) before income taxes
Income tax expense
Net income (loss) from continuing operations

Original_and_Further_Restateme4

Original and Further Restatement of the Consolidated Financial Statements - Effects of Original Restatement and Further Restatement on Consolidated Balance Sheet (Detail) (USD $)	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$28,924				$30,767				$32,743	$13,561
Restricted cash	23,761				21,314
Trade accounts receivable, less allowances	70,811				103,802
Inventories	72,678				69,813
Deferred income taxes	39,999				38,487
Prepaid expenses and other current assets	28,933				36,449
Total current assets	265,106				300,632
Property, plant and equipment, net	54,372				52,793
Patents and other intangible assets, net	9,046				7,290
Goodwill	53,565		72,758		74,388				73,094
Deferred income taxes	22,394				21,523
Other long-term assets	7,492				7,920
Total assets	411,975	415,524	446,321	464,153	464,546	528,174	520,848	680,596
Current liabilities:
Bank borrowings					16
Trade accounts payable	20,674				22,575
Other current liabilities	49,676				42,742
Total current liabilities	70,350				65,333
Long-term debt	20,000				20,000
Deferred income taxes	13,026				11,350
Other long-term liabilities	12,736				11,424
Total liabilities	116,112	108,531	114,175	103,178	108,107	195,755	207,927	382,051
Contingencies (Note 17)
Shareholders' equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of December 31, 2013 and 2012, respectively	1,810				1,934
Additional paid-in capital	216,653				246,306
Retained earnings	73,897				102,709
Accumulated other comprehensive income	3,503				5,490
Total shareholders' equity	295,863	306,993	332,146	360,975	356,439	332,419	312,921	298,545	280,304
Total liabilities and shareholders' equity	411,975	415,524	446,321	464,153	464,546	528,174	520,848	680,596
Originally Reported [Member]
Current assets:
Cash and cash equivalents	30,486				31,055
Restricted cash	23,761
Trade accounts receivable, less allowances	75,567
Inventories	90,577
Deferred income taxes	33,947
Prepaid expenses and other current assets	25,906
Total current assets	280,244
Property, plant and equipment, net	54,606
Patents and other intangible assets, net	9,046
Goodwill	53,565
Deferred income taxes	18,336
Other long-term assets	7,385
Total assets	423,182	430,058	459,450
Current liabilities:
Trade accounts payable	20,674
Other current liabilities	46,146
Total current liabilities	66,820
Long-term debt	20,000
Deferred income taxes	13,132
Other long-term liabilities	12,736
Total liabilities	112,688	111,001	114,223
Contingencies (Note 17)
Shareholders' equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of December 31, 2013 and 2012, respectively	1,810
Additional paid-in capital	216,653
Retained earnings	89,332
Accumulated other comprehensive income	2,699
Total shareholders' equity	310,494	319,057	345,227
Total liabilities and shareholders' equity	423,182	430,058	459,450
Further Restatement Adjustments [Member]
Current assets:
Cash and cash equivalents	-1,562				-288				-464
Restricted cash
Trade accounts receivable, less allowances	-4,756				-3,510
Inventories	-17,899				-13,560
Deferred income taxes	6,052				5,037
Prepaid expenses and other current assets	3,027				-2,370
Total current assets	-15,138				-9,951
Property, plant and equipment, net	-234				-1,042
Patents and other intangible assets, net
Goodwill
Deferred income taxes	4,058				2,642
Other long-term assets	107
Total assets	-11,207	-14,534	-13,129	-11,605	-8,351	-11,392	-9,547	-13,510
Current liabilities:
Bank borrowings
Trade accounts payable
Other current liabilities	3,530				3,148
Total current liabilities	3,530				3,148
Long-term debt
Deferred income taxes	-106				-106
Other long-term liabilities
Total liabilities	3,424	-2,470	-48	812	3,042	2,156	2,731	317
Contingencies (Note 17)
Shareholders' equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of December 31, 2013 and 2012, respectively
Additional paid-in capital
Retained earnings	-15,435				-12,138
Accumulated other comprehensive income	804				745
Total shareholders' equity	-14,631	-12,064	-13,081	-12,417	-11,393	-13,548	-12,278	-13,827
Total liabilities and shareholders' equity	-11,207	-14,534	-13,129	-11,605	-8,351	-11,392	-9,547	-13,510
As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Current assets:
Cash and cash equivalents					31,055				33,207	13,561
Restricted cash					21,314
Trade accounts receivable, less allowances					150,316
Inventories					88,744
Deferred income taxes					16,959
Prepaid expenses and other current assets					32,056
Total current assets					340,444
Property, plant and equipment, net					51,362
Patents and other intangible assets, net					6,880
Goodwill					74,388
Deferred income taxes					19,904
Other long-term assets					11,303
Total assets					504,281	565,073	553,320	707,586
Current liabilities:
Bank borrowings					16
Trade accounts payable					21,812
Other current liabilities					46,969
Total current liabilities					68,797
Long-term debt					20,000
Deferred income taxes					11,456
Other long-term liabilities					4,930
Total liabilities					105,183	187,463	199,104	369,178
Contingencies (Note 17)
Shareholders' equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of December 31, 2013 and 2012, respectively					1,934
Additional paid-in capital					246,111
Retained earnings					148,549
Accumulated other comprehensive income					2,504
Total shareholders' equity					399,098	377,610	354,216	338,408
Total liabilities and shareholders' equity					504,281	565,073	553,320	707,586
Original Restatement Adjustments [Member]
Current assets:
Cash and cash equivalents
Restricted cash
Trade accounts receivable, less allowances					-43,004
Inventories					-5,371
Deferred income taxes					16,491
Prepaid expenses and other current assets					2,023
Total current assets					-29,861
Property, plant and equipment, net					2,473
Patents and other intangible assets, net					410
Goodwill
Deferred income taxes					-1,023
Other long-term assets					-3,383
Total assets	0	0	0	-27,622	-31,384	-25,507	-22,925	-13,480
Current liabilities:
Bank borrowings
Trade accounts payable					763
Other current liabilities					-7,375
Total current liabilities					-6,612
Long-term debt
Deferred income taxes
Other long-term liabilities					6,494
Total liabilities	0	0	0	1,154	-118	6,136	6,092	12,556
Contingencies (Note 17)
Shareholders' equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of December 31, 2013 and 2012, respectively
Additional paid-in capital					195
Retained earnings					-33,702
Accumulated other comprehensive income					2,241
Total shareholders' equity	0	0	0	-28,776	-31,266	-31,643	-29,017	-26,036
Total liabilities and shareholders' equity	0	0	0	-27,622	-31,384	-25,507	-22,925	-13,480
As Originally Restated in the 2012 Form 10-K/A [Member]
Current assets:
Cash and cash equivalents					31,055				33,207	13,561
Restricted cash					21,314
Trade accounts receivable, less allowances					107,312
Inventories					83,373
Deferred income taxes					33,450
Prepaid expenses and other current assets					34,079
Total current assets					310,583
Property, plant and equipment, net					53,835
Patents and other intangible assets, net					7,290
Goodwill					74,388
Deferred income taxes					18,881
Other long-term assets					7,920
Total assets					472,897	539,566	530,395	694,106
Current liabilities:
Bank borrowings					16
Trade accounts payable					22,575
Other current liabilities					39,594
Total current liabilities					62,185
Long-term debt					20,000
Deferred income taxes					11,456
Other long-term liabilities					11,424
Total liabilities					105,065	193,599	205,196	381,734
Contingencies (Note 17)
Shareholders' equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 and 19,339,329 issued and outstanding as of December 31, 2013 and 2012, respectively					1,934
Additional paid-in capital					246,306
Retained earnings					114,847
Accumulated other comprehensive income					4,745
Total shareholders' equity					367,832	345,967	325,199	312,372
Total liabilities and shareholders' equity					$472,897	$539,566	$530,395	$694,106

Original_and_Further_Restateme5

Original and Further Restatement of the Consolidated Financial Statements - Effects of Original Restatement and Further Restatement on Consolidated Balance Sheet (Parenthetical) (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, except Share data, unless otherwise specified
Trade accounts receivable, allowances	$9,111	$6,673
Common shares, par value	$0.10	$0.10
Common shares, authorized	50,000,000	50,000,000
Common shares, issued	18,102,335	19,339,329
Common shares, outstanding	18,102,335	19,339,329
Originally Reported [Member]
Trade accounts receivable, allowances	9,111
Common shares, par value	$0.10
Common shares, authorized	50,000,000
Common shares, issued	18,102,335
Common shares, outstanding	18,102,335
Further Restatement Adjustments [Member]
Trade accounts receivable, allowances	9,111	6,673
As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Trade accounts receivable, allowances		6,673
Common shares, par value		$0.10
Common shares, authorized		50,000,000
Common shares, issued		19,339,329
Common shares, outstanding		19,339,329
Original Restatement Adjustments [Member]
Trade accounts receivable, allowances		6,673
As Originally Restated in the 2012 Form 10-K/A [Member]
Trade accounts receivable, allowances		$6,673

Original_and_Further_Restateme6

Original and Further Restatement of the Consolidated Financial Statements - Effects of Original Restatement and Further Restatement of Consolidated Statement of Operations and Comprehensive Income (Loss) (Detail) (USD $)	3 Months Ended								6 Months Ended	12 Months Ended
In Thousands, except Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Product sales										$349,552	$393,647	$398,695
Marketing service fees										48,059	46,542	36,824
Net sales	105,886	91,806	97,640	102,279	115,607	105,818	111,601	107,163		397,611	440,189	435,519
Cost of sales	34,123	25,064	21,884	25,841	26,751	24,887	24,943	24,145		106,912	100,726	96,415
Gross profit	71,763	66,742	75,756	76,438	88,856	80,931	86,658	83,018		290,699	339,463	339,104
Operating expenses
Sales and marketing										175,468	178,771	185,156
General and administrative										64,830	53,650	64,785
Research and development										26,768	28,577	22,861
Amortization of intangible assets										2,687	2,298	2,550
Costs related to the accounting review and restatement										12,945
Charges related to U.S. Government resolutions (Note 17)											1,295	57,141
Impairment of goodwill									19,193	19,193
Total operating expenses	81,842	80,843	68,836	70,370	62,338	63,988	70,036	68,229		301,891	264,591	332,493
Operating (loss) income	-10,079	-14,101	6,920	6,068	26,518	16,943	16,622	14,789		-11,192	74,872	6,611
Other income and (expense)
Interest expense, net										-1,827	-4,161	-5,441
Other expense										2,416	-1,646	-2,533
Total other income (expense)										589	-5,807	-7,974
(Loss) income before income taxes										-10,603	69,065	-1,363
Income tax expense										-7,602	-23,944	-14,443	6,028
Net income (loss) from continuing operations	-9,639	-16,504	2,012	5,926	17,518	9,312	11,421	6,870		-18,205	45,121	-15,806
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.											1,345
Income (loss) from discontinued operations										-15,510	-3,494	-2,705
Income tax (expense) benefit										4,903	-120	813
Net income (loss) from discontinued operations										-10,607	-2,269	-1,892
Net income										-28,812	42,852	-17,698
Net (loss) income per common share-basic:
Net income from continuing operations	($0.53)	($0.91)	$0.11	$0.31	$0.91	$0.49	$0.61	$0.37		($0.97)	$2.38	($0.87)
Net income (loss) from discontinued operations										($0.57)	($0.12)	($0.10)
Net income per common share-basic	($0.58)	($1.04)	($0.16)	$0.18	$1.19	$0.20	$0.47	$0.39		($1.54)	$2.26	($0.97)
Net (loss) income per common share-diluted:
Net income from continuing operations	($0.53)	($0.91)	$0.10	$0.30	$0.89	$0.48	$0.59	$0.36		($0.97)	$2.33	($0.87)
Net income (loss) from discontinued operations										($0.57)	($0.12)	($0.10)
Net income per common share-diluted:	($0.58)	($1.04)	($0.16)	$0.18	$1.17	$0.19	$0.46	$0.38		($1.54)	$2.21	($0.97)
Weighted average number of common shares:
Basic										18,697,228	18,977,263	18,219,343
Diluted										18,697,228	19,390,413	18,219,343
Other comprehensive income, before tax:
Translation adjustment										-1,708	1,131	-1,897
Unrealized gain on derivative instrument										-443	416	-693
Other comprehensive income, before tax										-2,151	1,547	-2,590
Income tax expense related to components of other comprehensive income	164				-153				164	164	-153	256
Other comprehensive income, net of tax										-1,987	1,394	-2,334
Comprehensive income										-30,799	44,246	-20,032
As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Product sales											415,850	432,975
Marketing service fees											46,470	37,146
Net sales					112,035	114,752	119,492	116,041			462,320	470,121
Cost of sales					18,504	22,373	23,676	21,939			86,492	92,619
Gross profit					93,531	92,379	95,816	94,102			375,828	377,502
Operating expenses
Sales and marketing											200,343	200,145
General and administrative											53,827	64,374
Research and development											28,577	22,861
Amortization of intangible assets											2,098	2,350
Charges related to U.S. Government resolutions (Note 17)											1,973	56,463
Total operating expenses					69,050	70,846	75,251	71,671			286,818	346,193
Operating (loss) income					24,481	21,533	20,565	22,431			89,010	31,309
Other income and (expense)
Interest expense, net											-4,577	-9,456
Other expense											-1,705	-2,412
Total other income (expense)											-6,282	-11,868
(Loss) income before income taxes											82,728	19,441
Income tax expense											-28,792	-21,181
Net income (loss) from continuing operations					14,636	13,118	13,967	12,215			53,936	-1,740
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.											1,345
Income (loss) from discontinued operations											-4,012	1,263
Income tax (expense) benefit											26	-596
Net income (loss) from discontinued operations											-2,641	667
Net income											51,295	-1,073
Net (loss) income per common share-basic:
Net income from continuing operations					$0.76	$0.69	$0.74	$0.65			$2.84	($0.10)
Net income (loss) from discontinued operations											($0.14)	$0.04
Net income per common share-basic					$1.06	$0.40	$0.59	$0.64			$2.70	($0.06)
Net (loss) income per common share-diluted:
Net income from continuing operations					$0.74	$0.67	$0.73	$0.64			$2.78	($0.10)
Net income (loss) from discontinued operations											($0.14)	$0.04
Net income per common share-diluted:					$1.04	$0.39	$0.58	$0.63			$2.64	($0.06)
Weighted average number of common shares:
Basic											18,977,263	18,219,343
Diluted											19,390,413	18,219,343
Other comprehensive income, before tax:
Translation adjustment											480	-3,192
Unrealized gain on derivative instrument											416	-693
Other comprehensive income, before tax											896	-3,885
Income tax expense related to components of other comprehensive income					-153						-153	256
Other comprehensive income, net of tax											743	-3,629
Comprehensive income											52,038	-4,702
Original Restatement Adjustments [Member]
Product sales											-14,811	-27,828
Marketing service fees											72	-322
Net sales				3,119	5,330	-6,895	-6,069	-7,105			-14,739	-28,150
Cost of sales				2,918	6,440	2,011	3,871	-561			11,761	2,908
Gross profit				201	-1,110	-8,906	-9,940	-6,544			-26,500	-31,058
Operating expenses
Sales and marketing											-13,212	-6,634
General and administrative											-436	107
Research and development
Amortization of intangible assets											200	200
Charges related to U.S. Government resolutions (Note 17)											-678	678
Total operating expenses				-3,862	-2,242	-6,178	-3,673	-2,033			-14,126	-5,649
Operating (loss) income				4,063	1,132	-2,728	-6,267	-4,511			-12,374	-25,409
Other income and (expense)
Interest expense, net											-166	3,915
Other expense
Total other income (expense)											-166	3,915
(Loss) income before income taxes											-12,540	-21,494
Income tax expense											3,654	7,016
Net income (loss) from continuing operations				2,702	1,373	-2,544	-4,097	-3,618			-8,886	-14,478
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.
Income (loss) from discontinued operations											1,018	-3,968
Income tax (expense) benefit											-589	1,409
Net income (loss) from discontinued operations											429	-2,559
Net income											-8,457	-17,037
Net (loss) income per common share-basic:
Net income from continuing operations				$0.14	$0.07	($0.14)	($0.22)	($0.19)			($0.47)	($0.79)
Net income (loss) from discontinued operations											$0.02	($0.14)
Net income per common share-basic				$0.12	$0.04	($0.14)	($0.21)	($0.14)			($0.45)	($0.93)
Net (loss) income per common share-diluted:
Net income from continuing operations				$0.14	$0.07	($0.13)	($0.22)	($0.19)			($0.46)	($0.79)
Net income (loss) from discontinued operations											$0.03	($0.14)
Net income per common share-diluted:				$0.12	$0.03	($0.14)	($0.21)	($0.14)			($0.43)	($0.93)
Weighted average number of common shares:
Basic
Diluted
Other comprehensive income, before tax:
Translation adjustment											288	913
Unrealized gain on derivative instrument
Other comprehensive income, before tax											288	913
Income tax expense related to components of other comprehensive income
Other comprehensive income, net of tax											288	913
Comprehensive income											-8,169	-16,124
As Originally Restated in the 2012 Form 10-K/A [Member]
Product sales											401,039	405,147
Marketing service fees											46,542	36,824
Net sales					117,365	107,857	113,423				447,581	441,971
Cost of sales					24,944	24,384	27,547				98,253	95,527
Gross profit					92,421	83,473	85,876				349,328	346,444
Operating expenses
Sales and marketing											187,131	193,511
General and administrative											53,391	64,481
Research and development											28,577	22,861
Amortization of intangible assets											2,298	2,550
Charges related to U.S. Government resolutions (Note 17)											1,295	57,141
Total operating expenses					66,808	64,668	71,578				272,692	340,544
Operating (loss) income					25,613	18,805	14,298				76,636	5,900
Other income and (expense)
Interest expense, net											-4,743	-5,541
Other expense											-1,705	-2,412
Total other income (expense)											-6,448	-7,953
(Loss) income before income taxes											-70,188	-2,053
Income tax expense											-25,138	-14,165
Net income (loss) from continuing operations					16,009	10,574	9,870				45,050	-16,218
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.											1,345
Income (loss) from discontinued operations											-2,994	-2,705
Income tax (expense) benefit											-563	813
Net income (loss) from discontinued operations											-2,212	-1,892
Net income											-42,838	-18,110
Net (loss) income per common share-basic:
Net income from continuing operations					$0.83	$0.55	$0.52				$2.37	($0.89)
Net income (loss) from discontinued operations											($0.12)	($0.10)
Net income per common share-basic					$1.10	$0.26	$0.38				$2.25	($0.99)
Net (loss) income per common share-diluted:
Net income from continuing operations					$0.81	$0.54	$0.51				$2.32	($0.89)
Net income (loss) from discontinued operations											($0.11)	($0.10)
Net income per common share-diluted:					$1.07	$0.25	$0.37				$2.21	($0.99)
Weighted average number of common shares:
Basic											18,977,263	18,219,343
Diluted											19,390,413	18,219,343
Other comprehensive income, before tax:
Translation adjustment											768	-2,279
Unrealized gain on derivative instrument											416	-693
Other comprehensive income, before tax											1,184	-2,972
Income tax expense related to components of other comprehensive income					-153						-153	256
Other comprehensive income, net of tax											1,031	-2,716
Comprehensive income											43,869	-20,826
Further Restatement Adjustments [Member]
Product sales										-3,244	-7,392	-6,452
Marketing service fees										321
Net sales	-257	-932	-640	-1,094	-1,758	-2,039	-1,822	-1,773		-2,923	-7,392	-6,452
Cost of sales	1,606	1,144	1,638	224	1,807	503	-2,604	2,767		4,612	2,473	888
Gross profit	-1,863	-2,076	-2,278	-1,318	-3,565	-2,542	782	-4,540		-7,535	-9,865	-7,340
Operating expenses
Sales and marketing										-1,113	-8,360	-8,355
General and administrative										-317	259	304
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Charges related to U.S. Government resolutions (Note 17)
Impairment of goodwill
Total operating expenses	1,838	-3,575	-394	701	-4,470	-680	-1,542	-1,409		-1,430	-8,101	-8,051
Operating (loss) income	-3,701	1,499	-1,884	-2,019	905	-1,862	2,324	-3,131		-6,105	-1,764	711
Other income and (expense)
Interest expense, net										98	582	100
Other expense										196	59	-121
Total other income (expense)										294	641	-21
(Loss) income before income taxes										-5,811	-1,123	690
Income tax expense										2,514	1,194	-278	-1,388	7,416
Net income (loss) from continuing operations	-1,075	1,580	-2,118	-1,684	1,509	-1,262	1,551	-1,727		-3,297	71	412
Discontinued operations (Note 16)
Gain on sale of Breg, Inc.
Income (loss) from discontinued operations											-500
Income tax (expense) benefit											443
Net income (loss) from discontinued operations											-57
Net income										-3,297	14	412
Net (loss) income per common share-basic:
Net income from continuing operations	($0.06)	$0.09	($0.11)	($0.08)	$0.08	($0.06)	$0.09	($0.09)		($0.17)	$0.01	$0.02
Net income (loss) from discontinued operations
Net income per common share-basic	($0.15)	$0.06	($0.04)	($0.05)	$0.09	($0.06)	$0.09	($0.11)		($0.17)	$0.01	$0.02
Net (loss) income per common share-diluted:
Net income from continuing operations	($0.06)	$0.09	($0.11)	($0.09)	$0.08	($0.06)	$0.08	($0.09)		($0.17)	$0.01	$0.02
Net income (loss) from discontinued operations											($0.01)
Net income per common share-diluted:	($0.15)	$0.06	($0.04)	($0.05)	$0.10	($0.06)	$0.09	($0.11)		($0.17)	$0	$0.02
Weighted average number of common shares:
Basic
Diluted
Other comprehensive income, before tax:
Translation adjustment										60	363	382
Unrealized gain on derivative instrument										-1
Other comprehensive income, before tax										59	363	382
Income tax expense related to components of other comprehensive income
Other comprehensive income, net of tax										59	363	382
Comprehensive income										-3,238	377	794
Originally Reported in 2013 Form 10-K [Member]
Product sales										352,796
Marketing service fees										47,738
Net sales	106,143	92,738	98,280							400,534
Cost of sales	32,517	23,920	20,246							102,300
Gross profit	73,626	68,818	78,034							298,234
Operating expenses
Sales and marketing										176,581
General and administrative										65,147
Research and development										26,768
Amortization of intangible assets										2,687
Costs related to the accounting review and restatement										12,945
Impairment of goodwill										19,193
Total operating expenses	80,004	84,418	69,230							303,321
Operating (loss) income	-6,378	-15,600	8,804							-5,087
Other income and (expense)
Interest expense, net										-1,925
Other expense										2,220
Total other income (expense)										295
(Loss) income before income taxes										-4,792
Income tax expense										-10,116
Net income (loss) from continuing operations	-8,564	-18,084	4,130							-14,908
Discontinued operations (Note 16)
Income (loss) from discontinued operations										-15,510
Income tax (expense) benefit										4,903
Net income (loss) from discontinued operations										-10,607
Net income										-25,515
Net (loss) income per common share-basic:
Net income from continuing operations	($0.47)	($1)	$0.22							($0.80)
Net income (loss) from discontinued operations										($0.57)
Net income per common share-basic	($0.43)	($1.10)	($0.12)							($1.37)
Net (loss) income per common share-diluted:
Net income from continuing operations	($0.47)	($1)	$0.21							($0.80)
Net income (loss) from discontinued operations										($0.57)
Net income per common share-diluted:	($0.43)	($1.10)	($0.12)							($1.37)
Weighted average number of common shares:
Basic										18,697,228
Diluted										18,697,228
Other comprehensive income, before tax:
Translation adjustment										-1,768
Unrealized gain on derivative instrument										-442
Other comprehensive income, before tax										-2,210
Income tax expense related to components of other comprehensive income	164								164	164
Other comprehensive income, net of tax										-2,046
Comprehensive income										($27,561)

Original_and_Further_Restateme7

Original and Further Restatement of the Consolidated Financial Statements - Effects of Original Restatement and Further Restatement on Consolidated Cash Flow (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Cash flows from operating activities:
Net income (loss)	($28,812)	$42,852	($17,698)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	22,822	20,732	23,182
Amortization of debt costs	720	1,737	1,239
Amortization of exclusivity agreements	1,546	1,289	374
Provision for doubtful accounts	4,590	2,212	4,580
Deferred income taxes	2,829	3,771	-13,941
Share-based compensation	6,267	6,303	6,648
Impairment of goodwill	19,193
Gain on sale of Breg, Inc, net of tax.		-1,345
Excess income tax benefit on employee stock-based awards	-82	-1,020	-1,737
Income tax benefit (expense) on employee stock-based awards
Other	4,536	4,798	2,298
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable	28,562	-11,128	6,645
Inventories	-3,213	-384	-12,705
Escrow receivable		41,537	-32,562
Prepaid expenses and other current assets	8,764	-14,575	2,382
Trade accounts payable	-2,280	4,575	2,322
Charges related to U.S. Government resolutions		-83,178	89,101
Other current liabilities	6,969	-5,239	3,516
Other long-term assets	-5,329	-3,391	-2,317
Other long-term liabilities	-40	616	3,403
Net cash provided by operating activities	67,042	10,162	64,730
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	-24,787	-27,994	-24,965
Capital expenditures for intangible assets	-4,891	-780	-793
Payment made in connection with acquisition			-5,250
Purchase of other investments	-1,374	-714	-468
Proceeds from sale of other investments		878
Net proceeds from sale of Breg Inc.		153,773
Net cash (used in) provided by investing activities	-31,052	125,163	-31,476
Cash flows from financing activities:
Net proceeds from issuance of common shares	3,450	25,586	20,113
Payment of refinancing fees and debt issuance costs			-758
Repayments of long-term debt	-16	-188,695	-7,500
Proceeds from (repayment of) bank borrowings, net		-1,297	-2,561
Changes in restricted cash	-2,375	25,799	-24,178
Purchase of common stock	-39,494
Cash payment for purchase of minority interest in subsidiary			-517
Excess income tax benefit on employee stock-based awards	82	1,020	1,737
Net cash used in financing activities	-38,353	-137,587	-13,664
Effect of exchange rates changes on cash	520	286	-408
Net (decrease) increase in cash and cash equivalents	-1,843	-1,976	19,182
Cash and cash equivalents at the beginning of the year	30,767	32,743	13,561
Cash and cash equivalents at the end of the year	28,924	30,767	32,743
Cash paid during the year for:
Interest	2,046	4,569	17,088
Income taxes	8,773	18,268	26,227
Originally Reported [Member]
Cash flows from operating activities:
Net income (loss)	-25,515
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	22,659
Amortization of debt costs	720
Amortization of exclusivity agreements	1,546
Provision for doubtful accounts	6,003
Deferred income taxes	-1,986
Share-based compensation	6,267
Impairment of goodwill	19,193
Gain on sale of Breg, Inc, net of tax.
Excess income tax benefit on employee stock-based awards	-82
Income tax benefit (expense) on employee stock-based awards	795
Other	4,442
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable	25,747
Inventories	-6,626
Escrow receivable
Prepaid expenses and other current assets	6,791
Trade accounts payable	-2,280
Charges related to U.S. Government resolutions
Other current liabilities	8,018
Other long-term assets	2,750
Other long-term liabilities	-1,561
Net cash provided by operating activities	66,881
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	-24,787
Capital expenditures for intangible assets	-4,891
Purchase of other investments
Net proceeds from sale of Breg Inc.
Net cash (used in) provided by investing activities	-29,678
Cash flows from financing activities:
Net proceeds from issuance of common shares	3,450
Payment of refinancing fees and debt issuance costs
Repayments of long-term debt	-16
Proceeds from (repayment of) bank borrowings, net
Changes in restricted cash	-2,375
Purchase of common stock	-39,494
Cash payment for purchase of minority interest in subsidiary
Excess income tax benefit on employee stock-based awards	82
Net cash used in financing activities	-38,353
Effect of exchange rates changes on cash	581
Net (decrease) increase in cash and cash equivalents	-569
Cash and cash equivalents at the beginning of the year	31,055
Cash and cash equivalents at the end of the year	30,486
Cash paid during the year for:
Interest	2,046
Income taxes	8,773
Further Restatement Adjustments [Member]
Cash flows from operating activities:
Net income (loss)	-3,297	14	412
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	163	152	165
Amortization of debt costs
Amortization of exclusivity agreements
Provision for doubtful accounts	-1,413	-8,360	-8,356
Deferred income taxes	4,815	5,023	-13,889
Share-based compensation
Impairment of goodwill
Gain on sale of Breg, Inc, net of tax.
Excess income tax benefit on employee stock-based awards
Income tax benefit (expense) on employee stock-based awards	-795	-2,910
Other	94	662	-2,193
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable	2,815	7,310	6,352
Inventories	3,413	2,111	-81
Escrow receivable
Prepaid expenses and other current assets	-1,973	1,002	-447
Trade accounts payable
Charges related to U.S. Government resolutions
Other current liabilities	-1,049	490	2,097
Other long-term assets	-8,079	-5,518	15,364
Other long-term liabilities	1,521		525
Net cash provided by operating activities	161	-24	-51
Cash flows from investing activities:
Capital expenditures for property, plant and equipment
Capital expenditures for intangible assets
Purchase of other investments	-1,374	-714	-468
Proceeds from sale of other investments		878
Net proceeds from sale of Breg Inc.
Net cash (used in) provided by investing activities	-1,374	164	-468
Cash flows from financing activities:
Net proceeds from issuance of common shares
Payment of refinancing fees and debt issuance costs
Repayments of long-term debt
Proceeds from (repayment of) bank borrowings, net
Changes in restricted cash
Purchase of common stock
Cash payment for purchase of minority interest in subsidiary
Excess income tax benefit on employee stock-based awards
Net cash used in financing activities
Effect of exchange rates changes on cash	-61	36	55
Net (decrease) increase in cash and cash equivalents	-1,274	176	-464
Cash and cash equivalents at the beginning of the year	-288	-464
Cash and cash equivalents at the end of the year	-1,562	-288	-464
Cash paid during the year for:
Interest
Income taxes
As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Cash flows from operating activities:
Net income (loss)		51,295	-1,073
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization		20,261	22,776
Amortization of debt costs		1,737	1,239
Amortization of exclusivity agreements		1,289	374
Provision for doubtful accounts		13,302	11,532
Deferred income taxes		871	936
Share-based compensation		6,303	6,648
Gain on sale of Breg, Inc, net of tax.		-1,345
Excess income tax benefit on employee stock-based awards			-1,737
Other		2,125	4,906
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable		-31,600	-25,818
Inventories		-6,341	-8,349
Escrow receivable		41,537	-32,562
Prepaid expenses and other current assets		-6,191	-4,057
Trade accounts payable		5,554	576
Charges related to U.S. Government resolutions		-82,500	88,463
Other current liabilities		-2,842	3,384
Other long-term assets		-2,114	-1,588
Other long-term liabilities		-135	-869
Net cash provided by operating activities		11,206	64,781
Cash flows from investing activities:
Capital expenditures for property, plant and equipment		-27,994	-24,965
Capital expenditures for intangible assets		-780	-793
Payment made in connection with acquisition			-5,250
Net proceeds from sale of Breg Inc.		153,773
Net cash (used in) provided by investing activities		124,999	-31,008
Cash flows from financing activities:
Net proceeds from issuance of common shares		25,586	20,113
Payment of refinancing fees and debt issuance costs			-758
Repayments of long-term debt		-188,695	-7,500
Proceeds from (repayment of) bank borrowings, net		-1,297	-2,561
Changes in restricted cash		25,799	-24,178
Cash payment for purchase of minority interest in subsidiary			-517
Excess income tax benefit on employee stock-based awards			1,737
Net cash used in financing activities		-138,607	-13,664
Effect of exchange rates changes on cash		250	-463
Net (decrease) increase in cash and cash equivalents		-2,152	19,646
Cash and cash equivalents at the beginning of the year		33,207	13,561
Cash and cash equivalents at the end of the year		31,055	33,207
Cash paid during the year for:
Interest		4,569	17,088
Income taxes		18,268	26,227
Original Restatement Adjustments [Member]
Cash flows from operating activities:
Net income (loss)		-8,457	-17,037
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization		319	241
Provision for doubtful accounts		-2,730	1,404
Deferred income taxes		-2,123	-988
Gain on sale of Breg, Inc, net of tax.
Income tax benefit (expense) on employee stock-based awards		2,910
Other		2,011	-415
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable		13,162	26,111
Inventories		3,846	-4,275
Prepaid expenses and other current assets		-9,386	6,886
Trade accounts payable		-979	1,746
Charges related to U.S. Government resolutions		-678	-638
Other current liabilities		-2,887	-1,965
Other long-term assets		4,241	-16,093
Other long-term liabilities		751	3,747
Net cash provided by operating activities		-1,020
Cash flows from financing activities:
Excess income tax benefit on employee stock-based awards		1,020
Net cash used in financing activities		1,020
Cash and cash equivalents at the beginning of the year
Cash and cash equivalents at the end of the year
As Originally Restated in the 2012 Form 10-K/A [Member]
Cash flows from operating activities:
Net income (loss)		42,838	-18,110
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization		20,580	23,017
Amortization of debt costs		1,737	1,239
Amortization of exclusivity agreements		1,289	374
Provision for doubtful accounts		10,572	12,936
Deferred income taxes		-1,252	-52
Share-based compensation		6,303	6,648
Gain on sale of Breg, Inc, net of tax.		-1,345
Excess income tax benefit on employee stock-based awards		-1,020	-1,737
Income tax benefit (expense) on employee stock-based awards		2,910
Other		4,136	4,491
Changes in operating assets and liabilities, net of effect of dispositions:
Trade accounts receivable		-18,438	293
Inventories		-2,495	-12,624
Escrow receivable		41,537	-32,562
Prepaid expenses and other current assets		-15,577	2,829
Trade accounts payable		4,575	2,322
Charges related to U.S. Government resolutions		-83,178	89,101
Other current liabilities		-5,729	1,419
Other long-term assets		2,127	-17,681
Other long-term liabilities		616	2,878
Net cash provided by operating activities		10,186	64,781
Cash flows from investing activities:
Capital expenditures for property, plant and equipment		-27,994	-24,965
Capital expenditures for intangible assets		-780	-793
Payment made in connection with acquisition			-5,250
Net proceeds from sale of Breg Inc.		153,773
Net cash (used in) provided by investing activities		124,999	-31,008
Cash flows from financing activities:
Net proceeds from issuance of common shares		25,586	20,113
Payment of refinancing fees and debt issuance costs			-758
Repayments of long-term debt		-188,695	-7,500
Proceeds from (repayment of) bank borrowings, net		-1,297	-2,561
Changes in restricted cash		25,799	-24,178
Cash payment for purchase of minority interest in subsidiary			-517
Excess income tax benefit on employee stock-based awards		1,020	1,737
Net cash used in financing activities		-137,587	-13,664
Effect of exchange rates changes on cash		250	-463
Net (decrease) increase in cash and cash equivalents		-2,152	19,646
Cash and cash equivalents at the beginning of the year		33,207	13,561
Cash and cash equivalents at the end of the year		31,055	33,207
Cash paid during the year for:
Interest		4,569	17,088
Income taxes		$18,268	$26,227

Original_and_Further_Restateme8

Original and Further Restatement of the Consolidated Financial Statements - Effects of Original Restatement and Further Restatement on Consolidated Shareholders' Equity (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010	Dec. 31, 2009
Income tax benefit (expense)	($7,602)	($23,944)	($14,443)	$6,028
Retained earnings increase (decrease)				-12,564
Bad Debt Timing [Member]
Retained earnings increase (decrease)				409
Accounts Receivable Reserve [Member]
Retained earnings increase (decrease)				-5,420
Other Adjustments [Member]
Retained earnings increase (decrease)				-1,015
Inventory Existence [Member]
Retained earnings increase (decrease)				-84
Inventory Reserve [Member]
Retained earnings increase (decrease)				-10,771
Other Adjustments [Member]
Retained earnings increase (decrease)				-1,711
Further Restatement Adjustments [Member]
Income tax benefit (expense)	2,514	1,194	-278	-1,388	7,416
Retained earnings increase (decrease)				61	-12,625
Further Restatement Adjustments [Member] | Bad Debt Timing [Member]
Retained earnings increase (decrease)				409
Further Restatement Adjustments [Member] | Accounts Receivable Reserve [Member]
Retained earnings increase (decrease)				-1,037	-4,383
Further Restatement Adjustments [Member] | Other Adjustments [Member]
Retained earnings increase (decrease)				-203	-812
Further Restatement Adjustments [Member] | Inventory Existence [Member]
Retained earnings increase (decrease)				-16	-68
Further Restatement Adjustments [Member] | Inventory Reserve [Member]
Retained earnings increase (decrease)				2,581	-13,352
Further Restatement Adjustments [Member] | Other Adjustments [Member]
Retained earnings increase (decrease)				($285)	($1,426)

Inventories_Schedule_of_Invent

Inventories - Schedule of Inventories (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Inventory Disclosure [Abstract]
Raw materials	$6,515	$7,623
Work-in-process	6,606	7,886
Finished products	28,291	22,236
Field inventory	21,312	17,061
Consignment inventory	2,388	4,235
Deferred cost of sales	7,566	10,772
Total Inventory	$72,678	$69,813

Property_Plant_and_Equipment_S

Property, Plant and Equipment - Schedule of Property,Plant and Equipment (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Property, Plant and Equipment [Line Items]
Cost	$143,374	$130,848
Accumulated depreciation	-89,002	-78,055
Total	54,372	52,793
Buildings [Member]
Property, Plant and Equipment [Line Items]
Cost	4,075	3,911
Plant equipment and instrumentation [Member]
Property, Plant and Equipment [Line Items]
Cost	133,427	121,370
Furniture and fixtures [Member]
Property, Plant and Equipment [Line Items]
Cost	$5,872	$5,567

Property_Plant_and_Equipment_A

Property, Plant and Equipment - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Property Plant and Equipment Useful Life And Values [Abstract]
Depreciation expense	$20	$15.80	$14.30

Recovered_Sheet4

Patents and Other Intangible Assets - Schedule of Patents and Other Intangibles Assets (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Finite And Indefinite Lived Intangible Assets [Line Items]
Cost	$43,188	$39,562
Accumulated amortization	-34,142	-32,272
Patents and other intangible assets, net	9,046	7,290
Patents and licenses [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Cost	42,568	38,905
Accumulated amortization	-33,688	-31,845
Trademarks-definite lived [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Cost	620	657
Accumulated amortization	($454)	($427)

Recovered_Sheet5

Patents and Other Intangible Assets - Additional Information (Detail) (USD $)	Dec. 31, 2013
In Millions, unless otherwise specified
Future Amortization expense
2014	$2.10
2015	1.8
2016	1.7
2017	1.4
2018	0.5
2019 and thereafter	$1.50

Goodwill_Schedule_of_Changes_i

Goodwill - Schedule of Changes in Net Carrying Amount of Goodwill (Detail) (USD $)	6 Months Ended		12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Jun. 30, 2013	Dec. 31, 2013	Dec. 31, 2012
Goodwill [Line Items]
Beginning balance	$72,758	$74,388	$74,388	$73,094
Reallocation
Foreign currency		-1,630		1,294
Impairment	-19,193		-19,193
Ending balance	53,565	72,758	53,565	74,388
Spine [Member]
Goodwill [Line Items]
Beginning balance	41,401	41,564	41,564	41,419
Reallocation	-41,401
Foreign currency		-163		145
Impairment
Ending balance		41,401		41,564
Orthopedics [Member]
Goodwill [Line Items]
Beginning balance	31,357	32,824	32,824	31,675
Reallocation	-31,357
Foreign currency		-1,467		1,149
Impairment
Ending balance		31,357		32,824
BioStim [Member]
Goodwill [Line Items]
Beginning balance
Reallocation	42,678
Foreign currency
Impairment
Ending balance	42,678		42,678
Biologics [Member]
Goodwill [Line Items]
Beginning balance
Reallocation	10,887
Foreign currency
Impairment
Ending balance	10,887		10,887
Extremity Fixation [Member]
Goodwill [Line Items]
Beginning balance
Reallocation	9,825
Foreign currency
Impairment	-9,825
Ending balance
Spine Fixation [Member]
Goodwill [Line Items]
Beginning balance
Reallocation	9,368
Foreign currency
Impairment	-9,368
Ending balance

Goodwill_Additional_Informatio

Goodwill - Additional Information (Detail) (USD $)	6 Months Ended	12 Months Ended		3 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Sep. 30, 2013
Goodwill [Line Items]
Impairment of goodwill	$19,193	$19,193
Spine Fixation and our Extremity Fixation reportable units [Member]
Goodwill [Line Items]
Impairment of goodwill		$19,200		$19,200

Bank_Borrowings_Additional_Inf

Bank Borrowings - Additional Information (Detail)	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2012
In Millions, unless otherwise specified	USD ($)	EUR (€)	USD ($)	EUR (€)
Equity Method Investments And Cost Method Investments [Abstract]
Amount outstanding under lines of credit	$0		$0.10
Weighted average interest rate on borrowings under lines of credit	3.70%	3.70%	3.70%	3.70%
Maximum borrowing capacity	$8	€ 5.80	$7.60	€ 5.80

Other_Current_Liabilities_Summ

Other Current Liabilities - Summary of Other Current Liabilities (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Payables and Accruals [Abstract]
Accrued expenses	$18,903	$11,710
Salaries, bonuses, commissions and related taxes payable	16,598	17,915
Accrued legal expenses	10,292	8,496
Other payables	3,883	4,621
Total	$49,676	$42,742

LongTerm_Debt_Additional_Infor

Long-Term Debt - Additional Information (Detail)

12 Months Ended

1 Months Ended

12 Months Ended

12 Months Ended

0 Months Ended

1 Months Ended

12 Months Ended

12 Months Ended

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2011

Dec. 31, 2013

Dec. 31, 2012

Sep. 30, 2012

Jun. 30, 2012

31-May-12

Dec. 31, 2013

Dec. 31, 2012

Aug. 30, 2010

Dec. 31, 2013

Dec. 31, 2012

Jan. 15, 2015

Aug. 30, 2010

31-May-12

Dec. 31, 2013

Dec. 31, 2012

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2013

Dec. 31, 2012

USD ($)

USD ($)

USD ($)

EUR (€)

EUR (€)

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Revolving Credit Facility [Member]

Subsequent Event [Member]

Term Loan Facility [Member]

Term Loan Facility [Member]

Term Loan Facility [Member]

Term Loan Facility [Member]

Term Loan Facility [Member]

New Credit Agreement [Member]

New Credit Agreement [Member]

Prior Credit Agreement [Member]

Prior Credit Agreement [Member]

USD ($)

USD ($)

USD ($)

USD ($)

USD ($)

USD ($)

LIBOR [Member]

LIBOR [Member]

Revolving Credit Facility [Member]

USD ($)

USD ($)

USD ($)

USD ($)

Base rate [Member]

LIBOR [Member]

Base rate [Member]

LIBOR [Member]

LIBOR [Member]

USD ($)

Maximum [Member]

Maximum [Member]

Maximum [Member]

Debt Instrument [Line Items]

Debt instrument term (in years)

5 years

5 years

Maximum borrowing capacity

$8,000,000

$7,600,000

€ 5,800,000

€ 5,800,000

$200,000,000

Maximum borrowing capacity

100,000,000

Maximum additional borrowing capacity available

100,000,000

Repayment of debt obligation

16,000

188,695,000

7,500,000

87,500,000

87,500,000

Repayment of debt obligation

20,000,000

20,000,000

57,500,000

57,500,000

Amount outstanding

0

100,000

20,000,000

20,000,000

Margin on variable rate

2.50%

2.50%

3.25%

2.25%

Variable rate basis

LIBOR

Effective interest rate (as a Percent)

2.70%

2.70%

Revolving credit facility due date

30-Aug-15

Amount of restricted net assets

168,500,000

194,500,000

Restricted cash

23,761,000

21,314,000

Debt issuance costs incurred

5,000,000

Write-off of debt issue costs

800,000

Deferred debt issuance costs, net

$1,100,000

$1,800,000

Derivative_Instruments_Schedul

Derivative Instruments - Schedule of Fair Values of Derivative Instruments (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Other long-term liabilities [Member] | Cross-currency swap [Member]
Derivatives, Fair Value [Line Items]
Fair value: favorable (unfavorable)	($1,036)
Other long-term assets [Member] | Cross-currency swap [Member]
Derivatives, Fair Value [Line Items]
Fair value: favorable (unfavorable)		305
Other long-term assets [Member] | Warrants [Member]
Derivatives, Fair Value [Line Items]
Fair value: favorable (unfavorable)	$107

Derivative_Instruments_Schedul1

Derivative Instruments - Schedule of Gain (Loss) Recognized on Derivative Instruments (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Derivative Instruments [Line Items]
Cross-currency swap and warrants gain (loss) recorded in other comprehensive income (loss), net of taxes	($279)	$263	($437)
Cross-currency swap and warrants [Member]
Derivative Instruments [Line Items]
Cross-currency swap and warrants gain (loss) recorded in other comprehensive income (loss), net of taxes	($279)	$263	($437)

Derivative_Instruments_Additio

Derivative Instruments - Additional Information (Detail)	12 Months Ended
Share data in Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2013	Sep. 30, 2010	Sep. 30, 2010
	Swap Agreement [Member]	Bone Biologics, Inc [Member]	Cross-currency swap [Member]	Cross-currency swap [Member]
		USD ($)	Designated as Hedging Instrument [Member]	Designated as Hedging Instrument [Member]
			Pay Euros [Member]	Receive U.S. dollars [Member]
			EUR (€)	USD ($)
Derivatives, Fair Value [Line Items]
Notional amount			€ 28,700,000	$39,000,000
Fixed rate (as a percent)			5.00%	4.64%
Swap agreement expiration date	30-Dec-16
Notes receivable net		$250,000
Number of shares for which warrants held		125
Exercise price shares on which warrant exercised		$1

Fair_Value_Measurements_Schedu

Fair Value Measurements - Schedule of Financial Assets and Liabilities Recorded at Fair Value on Recurring Basis (Detail) (Fair Value, Measurements, Recurring [Member], USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative securities	$107	$305
Assets fair value	3,996	2,730
Deferred compensation plan, Liabilities	-2,506	-2,320
Derivative securities, Liabilities	-1,036
Liabilities fair value, Total	-3,542	-2,320
Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative securities
Assets fair value	2,222	912
Deferred compensation plan, Liabilities
Liabilities fair value, Total
Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative securities	107	305
Assets fair value	1,774	1,818
Deferred compensation plan, Liabilities	-2,506	-2,320
Derivative securities, Liabilities	-1,036
Liabilities fair value, Total	-3,542	-2,320
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative securities
Assets fair value
Deferred compensation plan, Liabilities
Derivative securities, Liabilities
Liabilities fair value, Total
Collective trust funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	1,667	1,513
Collective trust funds [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value
Collective trust funds [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	1,667	1,513
Collective trust funds [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value
Treasury securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	660	624
Treasury securities [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	660	624
Treasury securities [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value
Treasury securities [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value
Certificates of deposit [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	1,562	288
Certificates of deposit [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	1,562	288
Certificates of deposit [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value
Certificates of deposit [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value

Commitments_Additional_Informa

Commitments - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Commitments and Contingencies Disclosure [Abstract]
Rent expenses	$3.40	$4.10	$4.80
Inventory purchase commitment	$3	$1.40	$1.80

Commitments_Schedule_of_Future

Commitments - Schedule of Future Minimum Lease Payments Under Operating Leases, Net of Amount to be Received Under Sub Leases (Detail) (USD $)	Dec. 31, 2013
In Thousands, unless otherwise specified
Commitments and Contingencies Disclosure [Abstract]
2014	$4,342
2015	4,107
2016	3,713
2017	2,974
2018	2,846
Thereafter	3,049
Total	$21,031

Business_Segment_Information_A

Business Segment Information - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2013
	Segment
Segment Reporting [Abstract]
Number of strategic business units	4

Business_Segment_Information_S

Business Segment Information - Schedule of External Net Sales by SBU Reporting Segment (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Sales Information [Line Items]
Percent of Total Net Sales									100.00%	100.00%	100.00%
Net sales	$105,886	$91,806	$97,640	$102,279	$115,607	$105,818	$111,601	$107,163	$397,611	$440,189	$435,519
BioStim [Member]
Sales Information [Line Items]
Percent of Total Net Sales									36.00%	40.00%	42.00%
Net sales									145,085	174,562	181,736
Biologics [Member]
Sales Information [Line Items]
Percent of Total Net Sales									14.00%	12.00%	10.00%
Net sales									53,746	53,731	42,911
Extremity Fixation [Member]
Sales Information [Line Items]
Percent of Total Net Sales									26.00%	25.00%	27.00%
Net sales									103,359	112,011	119,504
Spine Fixation [Member]
Sales Information [Line Items]
Percent of Total Net Sales									24.00%	23.00%	21.00%
Net sales									$95,421	$99,885	$91,368

Business_Segment_Information_S1

Business Segment Information - Summary of Net Margin, Defined as Gross Profit Less Sales and Marketing Expenses from Continuing Operations by SBU Reporting Segment (Detail) (USD $)	3 Months Ended								6 Months Ended	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Sales Information [Line Items]
Total net margin										$115,231	$160,692	$153,948
General and administrative										64,830	53,650	64,785
Research and development										26,768	28,577	22,861
Amortization of intangible assets										2,687	2,298	2,550
Costs related to the accounting review and restatement										12,945
Impairment of goodwill									19,193	19,193
Charges related to U.S. Government resolutions											1,295	57,141
Operating (loss) income	-10,079	-14,101	6,920	6,068	26,518	16,943	16,622	14,789		-11,192	74,872	6,611
BioStim [Member]
Sales Information [Line Items]
Impairment of goodwill
Biologics [Member]
Sales Information [Line Items]
Impairment of goodwill
Extremity Fixation [Member]
Sales Information [Line Items]
Impairment of goodwill									9,825
Spine Fixation [Member]
Sales Information [Line Items]
Impairment of goodwill									9,368
Operating Segments [Member] | BioStim [Member]
Sales Information [Line Items]
Total net margin										63,847	88,788	92,860
Operating Segments [Member] | Biologics [Member]
Sales Information [Line Items]
Total net margin										24,794	23,589	18,978
Operating Segments [Member] | Extremity Fixation [Member]
Sales Information [Line Items]
Total net margin										23,704	34,554	30,773
Operating Segments [Member] | Spine Fixation [Member]
Sales Information [Line Items]
Total net margin										4,329	15,256	13,037
Corporate, Non-Segment [Member]
Sales Information [Line Items]
Total net margin										1,443	1,495	1,700
Material Reconciling Items [Member]
Sales Information [Line Items]
General and administrative										64,830	53,650	64,785
Research and development										26,768	28,577	22,861
Amortization of intangible assets										2,687	2,298	2,550
Costs related to the accounting review and restatement										12,945
Impairment of goodwill										19,193
Charges related to U.S. Government resolutions											1,295	57,141
Operating (loss) income										($11,192)	$74,872	$6,611

Business_Segment_Information_S2

Business Segment Information - Schedule of Depreciation and Amortization by SBU Reporting Segment (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Sales Information [Line Items]
Depreciation and amortization	$22,822	$20,732	$23,182
Continuing Operations [Member]
Sales Information [Line Items]
Depreciation and amortization	22,822	18,297	17,025
Continuing Operations [Member] | BioStim [Member]
Sales Information [Line Items]
Depreciation and amortization	1,979	1,659	2,122
Continuing Operations [Member] | Biologics [Member]
Sales Information [Line Items]
Depreciation and amortization	648	567	436
Continuing Operations [Member] | Extremity Fixation [Member]
Sales Information [Line Items]
Depreciation and amortization	7,265	5,201	5,156
Continuing Operations [Member] | Spine Fixation [Member]
Sales Information [Line Items]
Depreciation and amortization	12,834	10,800	9,258
Operating Segments [Member] | Continuing Operations [Member] | Corporate [Member]
Sales Information [Line Items]
Depreciation and amortization	$96	$70	$53

Business_Segment_Information_S3

Business Segment Information - Summary of Net Sales by Geographic Destination (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Revenues from External Customers and Long-Lived Assets [Line Items]
Net sales	$105,886	$91,806	$97,640	$102,279	$115,607	$105,818	$111,601	$107,163	$397,611	$440,189	$435,519
Domestic Tax Authority [Member] | U.S. [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Net sales									293,032	327,228	322,186
Foreign Tax Authority [Member] | Italy [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Net sales									16,755	18,742	17,447
Foreign Tax Authority [Member] | U.K. [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Net sales									10,002	8,431	8,206
Foreign Tax Authority [Member] | Brazil [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Net sales									26,786	31,166	34,424
Foreign Tax Authority [Member] | Others [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Net sales									$51,036	$54,622	$53,256

Business_Segment_Information_A1

Business Segment Information - Analysis of Property, Plant and Equipment of Reporting Segments by Geographic Area (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	$54,372	$52,793
U.S. [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	39,287	38,504
Italy [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	8,150	7,625
U.K. [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	1,871	1,402
Brazil [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	3,210	3,421
Others [Member]
Revenues from External Customers and Long-Lived Assets [Line Items]
Property, plant and equipment, net	$1,854	$1,841

Income_Taxes_Schedule_of_Incom

Income Taxes - Schedule of Income from Continuing Operations Before Provision for Income Taxes (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Income Tax Disclosure [Abstract]
U.S.	($3,546)	$56,210	$4,730
Non-U.S.	-7,057	12,855	-6,093
(Loss) income before income taxes	($10,603)	$69,065	($1,363)

Income_Taxes_Schedule_of_Provi

Income Taxes - Schedule of Provision for (Benefit from) Income Taxes on Continuing Operations (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
U.S.
Current	$2,465	$16,982	$26,273
Deferred	4,013	2,675	-13,241
Total U.S	6,478	19,657	13,032
Non-U.S.
Current	2,308	3,191	2,111
Deferred	-1,184	1,096	-700
Total Non U.S	1,124	4,287	1,411
Income tax expense/effective rate	$7,602	$23,944	$14,443	($6,028)

Income_Taxes_Schedule_of_Tax_E

Income Taxes - Schedule of Tax Effects of Significant Temporary Differences Comprising Deferred Tax Assets and Liabilities (Detail) (USD $)	Dec. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Income Tax Disclosure [Abstract]
Intangible assets and goodwill	$4,798	$5,338
Inventories and related reserves	20,769	19,626
Deferred revenue and cost of goods sold	11,577	12,336
Other accruals and reserves	4,778	6,149
Accrued compensation	3,942	3,791
Allowance for doubtful accounts	2,040	1,542
Accrued interest	18,063	17,995
Net operating loss carryforwards	34,979	27,231
Other, net	893	590
Total	101,839	94,598
Valuation allowance	-31,772	-26,361
Deferred tax asset	70,067	68,237
Withholding taxes	-13,026	-11,351
Property, plant and equipment	-7,674	-8,226
Deferred tax liability	-20,700	-19,577
Net deferred tax assets	49,367	48,660
Current deferred tax assets	39,999	38,487
Non-current deferred tax assets	22,394	21,523
Current deferred tax liability
Non-current deferred tax liability	-13,026	-11,350
Net deferred tax assets	$49,367	$48,660

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	3 Months Ended	6 Months Ended	12 Months Ended
	Mar. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Components Of Income Tax Expense Benefit [Line Items]
Valuation allowance		$31,772,000	$31,772,000	$26,361,000
Net increase in valuation allowance			5,400,000
Operating loss carry forwards, state, net of tax		24,500,000	24,500,000
Operating loss carry forwards, foreign, net of tax		120,400,000	120,400,000
Impairment of goodwill		19,193,000	19,193,000
Income tax expense			7,602,000	23,944,000	14,443,000	-6,028,000
Income tax effective rate			-71.70%	34.70%	-1059.60%
Recognized tax benefit	300,000
Gross unrecognized tax benefit		700,000	700,000	1,200,000
Accrued interest and penalties related to unrecognized tax benefits		500,000	500,000	800,000
Unremitted foreign earnings		329,700,000	329,700,000	272,600,000
Total cash and cash equivalents		52,700,000	52,700,000
Cash and cash equivalents		28,924,000	28,924,000	30,767,000	32,743,000	13,561,000
U.S. Subsidiary [Member]
Components Of Income Tax Expense Benefit [Line Items]
Unremitted foreign earnings		341,300,000	341,300,000
Senior Secured Credit Agreement [Member]
Components Of Income Tax Expense Benefit [Line Items]
Restricted cash and cash equivalents		23,800,000	23,800,000
Non-U.S. Subsidiaries [Member]
Components Of Income Tax Expense Benefit [Line Items]
Cash and cash equivalents		$30,200,000	$30,200,000

Income_Taxes_Schedule_of_Effec

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation for Continuing Operations (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
Income Tax Disclosure [Abstract]
Statutory U.S. federal income tax rate	35.00%	35.00%	35.00%
State taxes, net	-19.20%	3.70%	-132.70%
Foreign rate differential	4.80%	-4.20%	-113.60%
Valuation allowance-foreign losses	-36.90%	9.00%	361.30%
Italian subsidiary intangible	21.60%	-3.20%	177.60%
Goodwill impairment	-60.90%
Domestic manufacturing deduction	2.20%	-2.30%	125.00%
Withholding taxes	-15.80%	2.40%	-123.00%
Settlement of U.S. Government resolutions		-1.80%	-698.50%
Other items, net	-2.50%	-3.90%	31.90%
Income tax expense/effective rate	-71.70%	34.70%	-1059.60%
Statutory U.S. federal income tax rate	($3,711)	$24,179	($477)
State taxes, net	2,039	2,536	1,809
Foreign rate differential	-510	-2,894	1,549
Valuation allowance-foreign losses	3,913	6,189	4,924
Italian subsidiary intangible	-2,288	-2,214	-2,421
Goodwill impairment	6,452
Domestic manufacturing deduction	-233	-1,567	-1,703
Withholding taxes	1,676	1,679	1,676
Settlement of U.S. Government resolutions		-1,260	9,520
Other items, net	264	-2,704	-434
Income tax expense/effective rate	$7,602	$23,944	$14,443	($6,028)

Income_Taxes_Schedule_of_Gross

Income Taxes - Schedule of Gross Unrecognized Tax Benefits (Excluding Interest and Penalties) (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012
Income Tax Disclosure [Abstract]
Beginning Balance	$1,189	$610
Additions for current year tax positions	183	793
Decreases for prior year tax positions	-12	-106
Settlements of prior year tax positions	-560
Expiration of statutes	-77	-108
Ending Balance	$723	$1,189

Related_parties_Additional_inf

Related parties - Additional information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2011
Related Party Transactions [Abstract]
Sales	$0.50

Sale_of_Breg_and_Disposition_o2

Sale of Breg and Disposition of Sports Medicine SBU - Additional Information (Detail) (USD $)	0 Months Ended	12 Months Ended
In Millions, unless otherwise specified	24-May-12	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Breg [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Proceeds from sale of outstanding shares of Breg	$157.50
Prepayment of outstanding company indebtedness	145
Fair value of liability			2
Period of indemnification (in years)		3 years
Obligations under guarantee		0.9	1.6
Sports Medicine [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Net sales			44	108.9
Operating income (loss)			$2.90	$1.20

Sale_of_Breg_and_Disposition_o3

Sale of Breg and Disposition of Sports Medicine SBU - Schedule of Information Related to Sale of Breg (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Less:
Gain on sale of Breg, net of taxes		$1,345,000
Breg [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Cash proceeds		157,500,000
Less:
Working Capital		-7,093,000
Transaction related expenses		-4,276,000
Fair value of indemnification		-2,000,000
Tangible assets		-8,309,000
Intangible assets		-28,164,000
Goodwill		-106,200,000
Gain on sale of Breg		1,458,000
Income tax expense		-113,000
Gain on sale of Breg, net of taxes		$1,345,000

Contingencies_Additional_Infor

Contingencies - Additional Information (Detail) (USD $)	0 Months Ended			12 Months Ended	1 Months Ended
	Oct. 29, 2012	Jun. 06, 2012	24-May-12	Dec. 31, 2013	Jul. 31, 2012	Dec. 31, 2012	Dec. 31, 2011
Commitment And Contingencies [Line Items]
Amount of fine	$7,800,000
Deferred prosecution agreement term				3 years
Amount approved to be paid under the agreement		34,200,000
Interest rate on settlement amount approved to be paid under the agreement (as a percent)				3.00%
Settlement agreement description				The Company agreed to pay $34.2 million (plus interest at a rate of 3% from May 5, 2011 through the day before payment was made)
Mandatory special assessment	400
Amount paid to settlement of claims	32,000,000
Amount used from escrow fund through acquisition of Blackstone for legal settlement	32,000,000
Charges accrued in connection with litigation			4,200,000
Judgments and settlement costs				6,700,000		6,800,000	1,800,000
Accrued judgments and settlements				2,100,000
Litigation settlement paid				4,600,000
Additional settlement costs				3,800,000
Discontinued operations for compensatory damages and exemplary damages					4,200,000
Litigation related to Promeca [Member]
Commitment And Contingencies [Line Items]
Imputed Interest settlement against the charge				5,200,000
Amount of fine				2,200,000
Litigation Related to Breg [Member]
Commitment And Contingencies [Line Items]
Compensatory damages to plaintiff					2,100,000
Exemplary damages					$7,000,000

Recovered_Sheet6

Pensions and Deferred Compensation - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Orthofix Inc 401(k) Plan [Member]
Defined Benefit Plans and Other Postretirement Benefit Plans [Line Items]
Employee contribution limit per calendar year (as a percent of compensation)	15.00%
Employer match of employee contributions of first level of eligible compensation (as a percent)	100.00%
Percentage of eligible compensation, matched by employer, level one	2.00%
Employer match of employee contributions of second level of eligible compensation (as a percent)	50.00%
Percentage of eligible compensation matched by employer, level two	4.00%
401 (k) Plans [Member]
Defined Benefit Plans and Other Postretirement Benefit Plans [Line Items]
Expenses incurred for contribution plans	$2.40	$2.50	$2.50
Defined Contribution pension plans for other International employees [Member]
Defined Benefit Plans and Other Postretirement Benefit Plans [Line Items]
Expenses incurred for contribution plans	0.7	0.7	0.8
Deferred Compensation Plan [Member]
Defined Benefit Plans and Other Postretirement Benefit Plans [Line Items]
Annual deferred compensation provision for leaving indemnity, as a percentage of total commissions earned	3.50%
Expense for deferred compensation	0.3	0.4	0.1
Deferred compensation payments	0.1	0.8
Amount of deferred compensation payable	$2.50	$2.30

Recovered_Sheet7

Share-based Compensation plans - Additional Information (Detail) (USD $)	12 Months Ended
In Millions, except Share data, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Jun. 29, 2004
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Options outstanding	1,924,179	1,945,955
Options exercisable	1,367,269
Restricted stock outstanding	286,704	160,831
Purchase price of shares equivalent to fair market value	85.00%
Shares issued under stock purchase plan	1,437,519
Unamortized compensation expense	$2.80
Weighted average remaining contractual life of exercisable options (in years)	2 years 10 months 21 days
Total intrinsic value of options exercised	0.4	7.2	4.2
Closing stock price	$22.82
Aggregate intrinsic value of options outstanding	0.5	11.2	10.8
Aggregate intrinsic value of options exercisable	0.2	9.8	8.4
Granted (in shares)	269,791
2004 LTIP Plan [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Amount of shares reserved for issuance	1,600,000			3,100,000
Options outstanding	515,917
Options exercisable	22,668
Restricted stock outstanding	279,039
Full value award limit	100,000
2004 LTIP Plan [Member] | Employees [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Award vesting period	3 years
2004 LTIP Plan [Member] | Non-Employees Director [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Number of shares approved for annual grant	5,000
2004 LTIP Plan [Member] | Minimum [Member] | Non-Employees Director [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Award vesting period	3 years
2004 LTIP Plan [Member] | Maximum [Member] | Non-Employees Director [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Award vesting period	5 years
Stock Purchase Plan [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Amount of shares reserved for issuance	1,850,000
Stock Purchase Plan [Member] | North America, South America and Asia [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Percentage of compensation eligible employees to be deducted for purchase of common stock	25.00%
Stock Purchase Plan [Member] | Minimum [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Percentage of compensation eligible employees to be deducted for purchase of common stock	1.00%
Stock Purchase Plan [Member] | Maximum [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Percentage of compensation eligible employees to be deducted for purchase of common stock	25.00%
Stock Purchase Plan [Member] | Maximum [Member] | Customers and Distributors Based in Europe [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Percentage of compensation eligible employees to be deducted for purchase of common stock	15.00%
Staff Share Option Plan [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Options outstanding	15,000
Options exercisable	15,000
Award vesting period	5 years
Award Contractual term	10 years
Staff Share Option Plan [Member] | 2004 LTIP Plan [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Options outstanding	1,243,262
Options exercisable	1,179,601
Restricted stock outstanding	7,665
Award Contractual term	10 years
Restricted Stock [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Unamortized compensation expense	$6.70
Granted (in shares)	269,791	149,500

Recovered_Sheet8

Share-based Compensation Plans - Schedule of Share-Based Compensation by Line Item in Consolidated Statements of Operations (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	$6,267	$6,303	$6,648
Cost of sales [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	104	592	153
Sales and marketing [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	1,444	1,550	2,031
General and administrative [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	4,483	4,023	4,322
Research and development [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	$236	$138	$142

Sharebased_Compensation_Plans_1

Share-based Compensation Plans - Schedule of Share-based Payment Award, Valuation Assumptions (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Expected volatility	32.10%	50.90%	49.60%
Expected volatility	50.80%	51.80%	49.90%
Expected term	5 years	4 years 6 months	4 years 6 months 29 days
Dividend rate
Weighted average fair value of options granted during the year	$10.83	$16.99	$14.21
Minimum [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Risk free interest rate	0.58%	0.76%	0.90%
Maximum [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Risk free interest rate	1.52%	0.84%	2.26%

Sharebased_Compensation_Plans_2

Share-based Compensation Plans - Schedule of Stock Option Activity (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Outstanding at the beginning of the period (in shares)	1,945,955
Granted	466,250
Exercised	-79,949
Forfeited	-408,077
Outstanding at the end of the period (in shares)	1,924,179
Vested and expected to vest	1,839,383
Options exercisable	1,367,269
Outstanding at the beginning of the period (in dollars per share)	$34.50
Granted	$28.51
Exercised	$23.25
Forfeited	$36.33
Outstanding at the end of the period (in dollars per share)	$33.12
Vested and expected to vest	$33.50
Options exercisable	$34.35
Options outstanding, weighted average remaining contractual term	4 years 4 months 28 days
Options vested and expected, weighted average remaining contractual term	4 years 2 months 1 day
Options exercisable, weighted average remaining contractual term	2 years 10 months 21 days

Sharebased_Compensation_Plans_3

Share-based Compensation Plans - Schedule of Stock Options Outstanding and Exercisable by Price Range (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013
$10.42 - $21.78 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$10.42
Exercise price, high end of range (in dollars per share)	$21.78
Number outstanding (in shares)	232,250
Weighted Average Remaining Contractual Life of options outstanding (in years)	9 years 3 months 22 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$20.79
Number Exercisable (in shares)	16,000
Weighted Average Exercise Price of options exercisable (in dollars per share)	$13.31
$22.75 - $25.05 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$22.75
Exercise price, high end of range (in dollars per share)	$25.05
Number outstanding (in shares)	326,166
Weighted Average Remaining Contractual Life of options outstanding (in years)	4 years 1 month 6 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$24.73
Number Exercisable (in shares)	306,166
Weighted Average Exercise Price of options exercisable (in dollars per share)	$24.84
$26.79 - $28.95 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$26.79
Exercise price, high end of range (in dollars per share)	$28.95
Number outstanding (in shares)	230,000
Weighted Average Remaining Contractual Life of options outstanding (in years)	4 years 9 months 15 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$28.45
Number Exercisable (in shares)	170,000
Weighted Average Exercise Price of options exercisable (in dollars per share)	$28.65
$29.23 - $37.36 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$29.23
Exercise price, high end of range (in dollars per share)	$37.36
Number outstanding (in shares)	225,168
Weighted Average Remaining Contractual Life of options outstanding (in years)	5 years 1 month 6 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$33.14
Number Exercisable (in shares)	169,839
Weighted Average Exercise Price of options exercisable (in dollars per share)	$32.41
$37.76 - $38.11 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$37.76
Exercise price, high end of range (in dollars per share)	$38.11
Number outstanding (in shares)	230,975
Weighted Average Remaining Contractual Life of options outstanding (in years)	1 year 8 months 9 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$37.99
Number Exercisable (in shares)	230,975
Weighted Average Exercise Price of options exercisable (in dollars per share)	$37.99
$38.40 - $40.27 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$38.40
Exercise price, high end of range (in dollars per share)	$40.27
Number outstanding (in shares)	351,354
Weighted Average Remaining Contractual Life of options outstanding (in years)	3 years 2 months 1 day
Weighted Average Exercise Price of options outstanding (in dollars per share)	$39.76
Number Exercisable (in shares)	174,355
Weighted Average Exercise Price of options exercisable (in dollars per share)	$39.77
$41.33 - $43.04 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$41.33
Exercise price, high end of range (in dollars per share)	$43.04
Number outstanding (in shares)	178,633
Weighted Average Remaining Contractual Life of options outstanding (in years)	2 years 10 months 2 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$41.66
Number Exercisable (in shares)	150,301
Weighted Average Exercise Price of options exercisable (in dollars per share)	$41.72
$44.87 - $45.84 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$44.87
Exercise price, high end of range (in dollars per share)	$45.84
Number outstanding (in shares)	140,133
Weighted Average Remaining Contractual Life of options outstanding (in years)	3 years 18 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$45.02
Number Exercisable (in shares)	140,133
Weighted Average Exercise Price of options exercisable (in dollars per share)	$45.02
$50.50 - $50.50 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$50.50
Exercise price, high end of range (in dollars per share)	$50.50
Number outstanding (in shares)	2,000
Weighted Average Remaining Contractual Life of options outstanding (in years)	3 years 4 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$50.50
Number Exercisable (in shares)	2,000
Weighted Average Exercise Price of options exercisable (in dollars per share)	$50.50
$50.99 - $50.99 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$50.99
Exercise price, high end of range (in dollars per share)	$50.99
Number outstanding (in shares)	7,500
Weighted Average Remaining Contractual Life of options outstanding (in years)	3 years 15 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$50.99
Number Exercisable (in shares)	7,500
Weighted Average Exercise Price of options exercisable (in dollars per share)	$50.99
$10.42 - $50.99 [Member]
Share-based Compensation, Shares Authorized under Stock Option Plans, Exercise Price Range [Line Items]
Exercise price, low end of range (in dollars per share)	$10.42
Exercise price, high end of range (in dollars per share)	$50.99
Number outstanding (in shares)	1,924,179
Weighted Average Remaining Contractual Life of options outstanding (in years)	4 years 4 months 28 days
Weighted Average Exercise Price of options outstanding (in dollars per share)	$33.12
Number Exercisable (in shares)	1,367,269
Weighted Average Exercise Price of options exercisable (in dollars per share)	$34.35

Sharebased_Compensation_Plans_4

Share-based Compensation Plans - Schedule of Changes in Restricted Stock (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Non-vested at the beginning of the period (in shares)	160,831
Granted (in shares)	269,791
Vested (in shares)	-62,948
Cancelled (in shares)	-80,970
Non-vested at the end of the period (in shares)	286,704
Non-vested at the beginning of period (in dollars per share)	$38.34
Granted (in dollars per share)	$27.09
Vested (in dollars per share)	$36.58
Cancelled (in dollars per share)	$38.80
Non-vested at the end of period (in dollars per share)	$28.01

Earnings_Per_Share_Schedule_of

Earnings Per Share - Schedule of Reconciliation of Weighted Average Shares Used in Calculation of Basic and Diluted Earnings Per Share (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Earnings Per Share [Abstract]
Weighted average common shares-basic	18,697,228	18,977,263	18,219,343
Effect of diluted securities:
Unexercised stock options net of treasury share repurchase		413,150
Weighted average common shares-diluted	18,697,228	19,390,413	18,219,343

Earnings_Per_Share_Additional_

Earnings Per Share - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Options to Purchase Common Stock [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Outstanding options not included in diluted earnings per share	1,186,259	789,650
Common Stock Equivalents [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Outstanding options not included in diluted earnings per share	101,672		344,168

Stock_Repurchase_Program_Addit

Stock Repurchase Program - Additional Information (Detail) (USD $)	0 Months Ended	12 Months Ended
	8-May-13	Dec. 31, 2013
Equity [Abstract]
Share repurchase program, authorized amount	$50,000,000
Stock repurchased amount		$39,500,000

Quarterly_Financial_Data_Conde

Quarterly Financial Data - Condensed Consolidated Statement of Operations (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Interim Reporting [Line Items]
Net sales	$105,886	$91,806	$97,640	$102,279	$115,607	$105,818	$111,601	$107,163	$397,611	$440,189	$435,519
Cost of sales	34,123	25,064	21,884	25,841	26,751	24,887	24,943	24,145	106,912	100,726	96,415
Gross profit	71,763	66,742	75,756	76,438	88,856	80,931	86,658	83,018	290,699	339,463	339,104
Operating expense	81,842	80,843	68,836	70,370	62,338	63,988	70,036	68,229	301,891	264,591	332,493
Operating (loss) income	-10,079	-14,101	6,920	6,068	26,518	16,943	16,622	14,789	-11,192	74,872	6,611
Net income (loss) from continuing operations	-9,639	-16,504	2,012	5,926	17,518	9,312	11,421	6,870	-18,205	45,121	-15,806
Net (loss) income	-10,412	-18,836	-3,011	3,447	22,954	3,747	8,802	7,349	-28,812	42,852	-17,698
Basic:
Net income (loss) from continuing operations	($0.53)	($0.91)	$0.11	$0.31	$0.91	$0.49	$0.61	$0.37	($0.97)	$2.38	($0.87)
Net income (loss)	($0.58)	($1.04)	($0.16)	$0.18	$1.19	$0.20	$0.47	$0.39	($1.54)	$2.26	($0.97)
Diluted:
Net income (loss) from continuing operations	($0.53)	($0.91)	$0.10	$0.30	$0.89	$0.48	$0.59	$0.36	($0.97)	$2.33	($0.87)
Net income (loss)	($0.58)	($1.04)	($0.16)	$0.18	$1.17	$0.19	$0.46	$0.38	($1.54)	$2.21	($0.97)
Originally Reported in 2013 Form 10-Q [Member]
Interim Reporting [Line Items]
Net sales				100,254
Cost of sales				22,699
Gross profit				77,555
Operating expense				73,531
Operating (loss) income				4,024
Net income (loss) from continuing operations				4,908
Net (loss) income				2,116
Basic:
Net income (loss) from continuing operations				$0.25
Net income (loss)				$0.11
Diluted:
Net income (loss) from continuing operations				$0.25
Net income (loss)				$0.11
Original Restatement Adjustments [Member]
Interim Reporting [Line Items]
Net sales				3,119	5,330	-6,895	-6,069	-7,105		-14,739	-28,150
Cost of sales				2,918	6,440	2,011	3,871	-561		11,761	2,908
Gross profit				201	-1,110	-8,906	-9,940	-6,544		-26,500	-31,058
Operating expense				-3,862	-2,242	-6,178	-3,673	-2,033		-14,126	-5,649
Operating (loss) income				4,063	1,132	-2,728	-6,267	-4,511		-12,374	-25,409
Net income (loss) from continuing operations				2,702	1,373	-2,544	-4,097	-3,618		-8,886	-14,478
Net (loss) income				2,384	647	-2,544	-3,951	-2,609		-8,457	-17,037
Basic:
Net income (loss) from continuing operations				$0.14	$0.07	($0.14)	($0.22)	($0.19)		($0.47)	($0.79)
Net income (loss)				$0.12	$0.04	($0.14)	($0.21)	($0.14)		($0.45)	($0.93)
Diluted:
Net income (loss) from continuing operations				$0.14	$0.07	($0.13)	($0.22)	($0.19)		($0.46)	($0.79)
Net income (loss)				$0.12	$0.03	($0.14)	($0.21)	($0.14)		($0.43)	($0.93)
Originally Reported in 2013 Form 10-Q/A [Member]
Interim Reporting [Line Items]
Net sales				103,373
Cost of sales				25,617
Gross profit				77,756
Operating expense				69,669
Operating (loss) income				8,087
Net income (loss) from continuing operations				7,610
Net (loss) income				4,500
Basic:
Net income (loss) from continuing operations				$0.39
Net income (loss)				$0.23
Diluted:
Net income (loss) from continuing operations				$0.39
Net income (loss)				$0.23
Further Restatement Adjustments [Member]
Interim Reporting [Line Items]
Net sales	-257	-932	-640	-1,094	-1,758	-2,039	-1,822	-1,773	-2,923	-7,392	-6,452
Cost of sales	1,606	1,144	1,638	224	1,807	503	-2,604	2,767	4,612	2,473	888
Gross profit	-1,863	-2,076	-2,278	-1,318	-3,565	-2,542	782	-4,540	-7,535	-9,865	-7,340
Operating expense	1,838	-3,575	-394	701	-4,470	-680	-1,542	-1,409	-1,430	-8,101	-8,051
Operating (loss) income	-3,701	1,499	-1,884	-2,019	905	-1,862	2,324	-3,131	-6,105	-1,764	711
Net income (loss) from continuing operations	-1,075	1,580	-2,118	-1,684	1,509	-1,262	1,551	-1,727	-3,297	71	412
Net (loss) income	-2,536	986	-694	-1,053	1,793	-1,269	1,548	-2,058	-3,297	14	412
Basic:
Net income (loss) from continuing operations	($0.06)	$0.09	($0.11)	($0.08)	$0.08	($0.06)	$0.09	($0.09)	($0.17)	$0.01	$0.02
Net income (loss)	($0.15)	$0.06	($0.04)	($0.05)	$0.09	($0.06)	$0.09	($0.11)	($0.17)	$0.01	$0.02
Diluted:
Net income (loss) from continuing operations	($0.06)	$0.09	($0.11)	($0.09)	$0.08	($0.06)	$0.08	($0.09)	($0.17)	$0.01	$0.02
Net income (loss)	($0.15)	$0.06	($0.04)	($0.05)	$0.10	($0.06)	$0.09	($0.11)	($0.17)	$0	$0.02
Originally Reported [Member]
Interim Reporting [Line Items]
Net sales	106,143	92,738	98,280
Cost of sales	32,517	23,920	20,246
Gross profit	73,626	68,818	78,034
Operating expense	80,004	84,418	69,230
Operating (loss) income	-6,378	-15,600	8,804
Net income (loss) from continuing operations	-8,564	-18,084	4,130
Net (loss) income	-7,876	-19,822	-2,317						-25,515
Basic:
Net income (loss) from continuing operations	($0.47)	($1)	$0.22
Net income (loss)	($0.43)	($1.10)	($0.12)
Diluted:
Net income (loss) from continuing operations	($0.47)	($1)	$0.21
Net income (loss)	($0.43)	($1.10)	($0.12)
Originally Reported in 2013 Form 10-K [Member]
Interim Reporting [Line Items]
Net sales	106,143	92,738	98,280						400,534
Cost of sales	32,517	23,920	20,246						102,300
Gross profit	73,626	68,818	78,034						298,234
Operating expense	80,004	84,418	69,230						303,321
Operating (loss) income	-6,378	-15,600	8,804						-5,087
Net income (loss) from continuing operations	-8,564	-18,084	4,130						-14,908
Net (loss) income	-7,876	-19,822	-2,317
Basic:
Net income (loss) from continuing operations	($0.47)	($1)	$0.22						($0.80)
Net income (loss)	($0.43)	($1.10)	($0.12)						($1.37)
Diluted:
Net income (loss) from continuing operations	($0.47)	($1)	$0.21						($0.80)
Net income (loss)	($0.43)	($1.10)	($0.12)						($1.37)
As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Interim Reporting [Line Items]
Net sales					112,035	114,752	119,492	116,041		462,320	470,121
Cost of sales					18,504	22,373	23,676	21,939		86,492	92,619
Gross profit					93,531	92,379	95,816	94,102		375,828	377,502
Operating expense					69,050	70,846	75,251	71,671		286,818	346,193
Operating (loss) income					24,481	21,533	20,565	22,431		89,010	31,309
Net income (loss) from continuing operations					14,636	13,118	13,967	12,215		53,936	-1,740
Net (loss) income					20,514	7,560	11,205	12,016		51,295	-1,073
Basic:
Net income (loss) from continuing operations					$0.76	$0.69	$0.74	$0.65		$2.84	($0.10)
Net income (loss)					$1.06	$0.40	$0.59	$0.64		$2.70	($0.06)
Diluted:
Net income (loss) from continuing operations					$0.74	$0.67	$0.73	$0.64		$2.78	($0.10)
Net income (loss)					$1.04	$0.39	$0.58	$0.63		$2.64	($0.06)
Originally Restated [Member]
Interim Reporting [Line Items]
Net sales								108,936
Cost of sales								21,378
Gross profit								87,558
Operating expense								69,638
Operating (loss) income								17,920
Net income (loss) from continuing operations								8,597
Net (loss) income								9,407
Basic:
Net income (loss) from continuing operations								$0.46
Net income (loss)								$0.50
Diluted:
Net income (loss) from continuing operations								$0.45
Net income (loss)								$0.49
As Originally Restated in the 2012 Form 10-K/A [Member]
Interim Reporting [Line Items]
Net sales					117,365	107,857	113,423			447,581	441,971
Cost of sales					24,944	24,384	27,547			98,253	95,527
Gross profit					92,421	83,473	85,876			349,328	346,444
Operating expense					66,808	64,668	71,578			272,692	340,544
Operating (loss) income					25,613	18,805	14,298			76,636	5,900
Net income (loss) from continuing operations					16,009	10,574	9,870			45,050	-16,218
Net (loss) income					$21,161	$5,016	$7,254			$42,838	($18,110)
Basic:
Net income (loss) from continuing operations					$0.83	$0.55	$0.52			$2.37	($0.89)
Net income (loss)					$1.10	$0.26	$0.38			$2.25	($0.99)
Diluted:
Net income (loss) from continuing operations					$0.81	$0.54	$0.51			$2.32	($0.89)
Net income (loss)					$1.07	$0.25	$0.37			$2.21	($0.99)

Quarterly_Financial_Data_Conde1

Quarterly Financial Data - Condensed Consolidated Balance Sheets (Detail) (USD $)	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2011
In Thousands, unless otherwise specified
Interim Reporting [Line Items]
Total assets	$411,975	$415,524	$446,321	$464,153	$464,546	$528,174	$520,848	$680,596
Total liabilities	116,112	108,531	114,175	103,178	108,107	195,755	207,927	382,051
Total shareholders' equity	295,863	306,993	332,146	360,975	356,439	332,419	312,921	298,545	280,304
Total liabilities and shareholders' equity	411,975	415,524	446,321	464,153	464,546	528,174	520,848	680,596
Originally Reported in 2013 Form 10-Q [Member]
Interim Reporting [Line Items]
Total assets				503,380
Total liabilities				101,212
Total shareholders' equity				402,168
Total liabilities and shareholders' equity				503,380
Original Restatement Adjustments [Member]
Interim Reporting [Line Items]
Total assets	0	0	0	-27,622	-31,384	-25,507	-22,925	-13,480
Total liabilities	0	0	0	1,154	-118	6,136	6,092	12,556
Total shareholders' equity	0	0	0	-28,776	-31,266	-31,643	-29,017	-26,036
Total liabilities and shareholders' equity	0	0	0	-27,622	-31,384	-25,507	-22,925	-13,480
Originally Restated in 2013 Form 10-Q/A [Member]
Interim Reporting [Line Items]
Total assets				475,758
Total liabilities				102,366
Total shareholders' equity				373,392
Total liabilities and shareholders' equity				475,758
Further Restatement Adjustments [Member]
Interim Reporting [Line Items]
Total assets	-11,207	-14,534	-13,129	-11,605	-8,351	-11,392	-9,547	-13,510
Total liabilities	3,424	-2,470	-48	812	3,042	2,156	2,731	317
Total shareholders' equity	-14,631	-12,064	-13,081	-12,417	-11,393	-13,548	-12,278	-13,827
Total liabilities and shareholders' equity	-11,207	-14,534	-13,129	-11,605	-8,351	-11,392	-9,547	-13,510
Originally Reported [Member]
Interim Reporting [Line Items]
Total assets	423,182	430,058	459,450
Total liabilities	112,688	111,001	114,223
Total shareholders' equity	310,494	319,057	345,227
Total liabilities and shareholders' equity	423,182	430,058	459,450
As Originally Reported in the 2013 10-Q [Member]
Interim Reporting [Line Items]
Total assets			459,450
Total liabilities			114,223
Total shareholders' equity			345,227
Total liabilities and shareholders' equity			459,450
Originally Reported in 2013 Form 10-K [Member]
Interim Reporting [Line Items]
Total assets	423,182	430,058
Total liabilities	112,688	111,001
Total shareholders' equity	310,494	319,057
Total liabilities and shareholders' equity	423,182	430,058
As Reported in the 2012 Form 10-K Prior to Original Restatement [Member]
Interim Reporting [Line Items]
Total assets					504,281	565,073	553,320	707,586
Total liabilities					105,183	187,463	199,104	369,178
Total shareholders' equity					399,098	377,610	354,216	338,408
Total liabilities and shareholders' equity					504,281	565,073	553,320	707,586
As Originally Restated in the 2012 Form 10-K/A [Member]
Interim Reporting [Line Items]
Total assets					472,897	539,566	530,395	694,106
Total liabilities					105,065	193,599	205,196	381,734
Total shareholders' equity					367,832	345,967	325,199	312,372
Total liabilities and shareholders' equity					$472,897	$539,566	$530,395	$694,106

Subsequent_events_Additional_I

Subsequent events - Additional Information (Detail) (USD $)	12 Months Ended	1 Months Ended	0 Months Ended
	Dec. 31, 2013	Jan. 31, 2015	Mar. 04, 2015
eNeura Inc [Member]
Subsequent Event [Line Items]
Maturity description of promissory note	The eNeura Note will mature on the earlier of (i) March 4, 2019, or (ii) consummation of the acquisition (as described below), unless converted or prepaid at an earlier date.
Scenario, Forecast [Member] | Tempus [Member]
Subsequent Event [Line Items]
Net sales consideration transferred		$2,100,000
Consideration in cash		4,800,000
Scenario, Forecast [Member] | eNeura Inc [Member]
Subsequent Event [Line Items]
Non-refundable fees paid			250,000
Principal amount of promissory note			15,000,000
Accrued interest on promissory note			8.00%
Amount paid to former shareholders			$65,000,000

Schedule_1_Condensed_Financial

Schedule 1- Condensed Financial Information of Registrant Orthofix International N.V. - Condensed Balance Sheets (unaudited) (Detail) (USD $)	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$28,924				$30,767				$32,743	$13,561
Prepaid expenses and other current assets	28,933				36,449
Total current assets	265,106				300,632
Other long term assets	7,492				7,920
Total assets	411,975	415,524	446,321	464,153	464,546	528,174	520,848	680,596
Liabilities and shareholder's equity
Current liabilities	70,350				65,333
Shareholders' equity:
Common stock	1,810				1,934
Additional paid in capital	216,653				246,306
Accumulated earnings	73,897				102,709
Accumulated other comprehensive income	3,503				5,490
Total shareholders' equity	295,863	306,993	332,146	360,975	356,439	332,419	312,921	298,545	280,304
Total liabilities and shareholders' equity	411,975	415,524	446,321	464,153	464,546	528,174	520,848	680,596
Orthofix International N V [Member]
Current assets:
Cash and cash equivalents	1,426				7,392				19,433	2,882
Prepaid expenses and other current assets	670				534
Total current assets	2,096				7,926
Other long term assets					15
Investments in and amounts due from subsidiaries and affiliates	308,173				357,811
Total assets	310,269				365,752
Liabilities and shareholder's equity
Current liabilities	6,295				1,202
Long-term liabilities	8,111				8,111
Shareholders' equity:
Common stock	1,810				1,934
Additional paid in capital	216,653				246,306
Accumulated earnings	73,897				102,709
Accumulated other comprehensive income	3,503				5,490
Total shareholders' equity	295,863				356,439
Total liabilities and shareholders' equity	$310,269				$365,752

Schedule_1_Condensed_Financial1

Schedule 1 - Condensed Financial Information of Registrant Orthofix International NV - Condensed Statements of Operations (unaudited) (Detail) (USD $)	3 Months Ended								12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013	Dec. 31, 2012	Sep. 30, 2012	Jun. 30, 2012	Mar. 31, 2012	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2010
(Expenses) income:
General and administrative									($64,830)	($53,650)	($64,785)
(Loss) income before income taxes									-10,603	69,065	-1,363
Income tax benefit (expense)									-7,602	-23,944	-14,443	6,028
Net (loss) income	-10,412	-18,836	-3,011	3,447	22,954	3,747	8,802	7,349	-28,812	42,852	-17,698
Orthofix International N V [Member]
(Expenses) income:
General and administrative									-16,641	-7,700	-11,134
Equity in earnings of investments in subsidiaries and affiliates									-12,494	50,331	-5,884
Other, net									323	24	7
(Loss) income before income taxes									-28,812	42,655	-17,011
Income tax benefit (expense)										197	-687
Net (loss) income									($28,812)	$42,852	($17,698)

Schedule_1_Condensed_Financial2

Schedule 1 - Condensed Financial Information of Registrant Orthofix International NV - Condensed Statement of Cash Flows (unaudited) (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Condensed Financial Statements, Captions [Line Items]
Net (loss) income	($28,812)	$42,852	($17,698)
Cash flows from investing activities:
Capital expenditures	-24,787	-27,994	-24,965
Cash flows from financing activities:
Net proceeds from issuance of common stock	3,450	25,586	20,113
Repurchase of treasury shares	-39,494
Contributions to subsidiaries and affiliates			-517
Tax benefit on exercise of stock options	82	1,020	1,737
Net (decrease) increase in cash and cash equivalents	-1,843	-1,976	19,182
Cash and cash equivalents at the beginning of the year	30,767	32,743	13,561
Cash and cash equivalents at the end of the year	28,924	30,767	32,743
Orthofix International N V [Member]
Condensed Financial Statements, Captions [Line Items]
Net (loss) income	-28,812	42,852	-17,698
Equity in earnings of (loss) investments in subsidiaries and affiliates	12,494	-50,331	5,884
Cash (used in) provided by other operating activities	468	-6,811	3,429
Net cash used in operating activities	-15,850	-14,290	-8,385
Cash flows from investing activities:
Distributions and amounts received from subsidiaries	53,389	12,564	5,875
Capital expenditures
Net cash provided by investing activities	53,389	12,564	5,875
Cash flows from financing activities:
Net proceeds from issuance of common stock	3,450	25,586	20,113
Repurchase of treasury shares	-39,494
Contributions to subsidiaries and affiliates	-7,543	-36,921	-2,789
Tax benefit on exercise of stock options	82	1,020	1,737
Net cash (used in) provided by financing activities	-43,505	-10,315	19,061
Net (decrease) increase in cash and cash equivalents	-5,966	-12,041	16,551
Cash and cash equivalents at the beginning of the year	7,392	19,433	2,882
Cash and cash equivalents at the end of the year	$1,426	$7,392	$19,433

Schedule_1_Condensed_Financial3

Schedule 1 - Condensed Financial Information of Registrant Orthofix International NV - Additional information (Detail) (USD $)	12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012
Condensed Financial Statements, Captions [Line Items]
Restricted net assets of subsidiary of the reporting entity	$168,500,000	$194,500,000
Cash dividends received from consolidated subsidiaries	0	0
Orthofix Inc [Member]
Condensed Financial Statements, Captions [Line Items]
Percent of restricted net assets of a Subsidiary to consolidated net assets of the company where condensed parent company financial statement are required	25.00%
Restricted net assets of subsidiary of the reporting entity	$168,500,000	$194,500,000

Schedule_2_Valuation_and_Quali

Schedule 2 - Valuation and Qualifying Accounts (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Allowance for doubtful accounts receivable [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at beginning of year	$6,673	$6,184	$6,784
Additions Charged to cost and expenses	4,590	2,027	4,523
Additions Charged (credited) to other accounts		-13
Deductions/ Other	-2,152	-1,525	-5,123
Balance at end of year	9,111	6,673	6,184
Deferred tax valuation allowance [Member]
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at beginning of year	26,361	19,124	21,023
Additions Charged to cost and expenses	5,411	7,237	-1,899
Balance at end of year	$31,772	$26,361	$19,124

Schedule_2_Valuation_and_Quali1

Schedule 2 - Valuation and Qualifying Accounts (Parenthetical) (Detail) (USD $)	12 Months Ended
In Thousands, unless otherwise specified	Dec. 31, 2013
Valuation and Qualifying Accounts [Abstract]
Decrease in allowance for doubtful accounts	$242