Orthofix Medical (OFIX) 10-Q/A 31 Mar 15 2014 Q1 Quarterly report (amended) Financial data

Document_and_Entity_Informatio

Document and Entity Information	3 Months Ended
	Mar. 31, 2014	Mar. 27, 2015
Document And Entity Information [Abstract]
Document Type	10-Q/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-Q/A”) to its Quarterly Report on Form 10-Q for the fiscal quarter ended March 31, 2014, which was originally filed on May 8, 2014 (the “Original Form 10-Q”). 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-Q and the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2013 (the “2013 Form 10-K”) were not properly accounted for under U.S. generally accepted accounting principles (“U.S. 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 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 including those contained in the Original Form 10-K) should no longer be relied upon. This Form 10-Q/A contains restated consolidated interim financial statements for the fiscal quarters ended March 31, 2014 and 2013. Contemporaneously with the filing of this Form 10-Q/A, the Company is filing (i) an amendment to the 2013 Form 10-K (the “2013 Form 10-K/A”), which amendment contains restated consolidated financial statements for the fiscal years ended December 31, 2013, 2012 and 2011, and (ii) its delayed Quarterly Reports on Form 10-Q for the fiscal quarters ended June 30, 2014 (the “2014 Second Quarter Form 10-Q”) and September 30, 2014 (the “2014 Third Quarter Form 10-Q”), which contain restated consolidated interim financial statements for the fiscal quarters ended June 30, 2013 and September 30, 2013. The corrections of the additional errors in this Form 10-Q/A and the 2013 Form 10-K/A are referred to herein as the “Further Restatement.”
Document Period End Date	31-Mar-14
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	Q1
Trading Symbol	OFIX
Entity Registrant Name	ORTHOFIX INTERNATIONAL N V
Entity Central Index Key	884624
Current Fiscal Year End Date	-19
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		18,754,831

Condensed_Consolidated_Balance

Condensed Consolidated Balance Sheets (USD $)	Mar. 31, 2014		Dec. 31, 2013	Mar. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$25,117	[1]	$28,924	$32,874	$30,767
Restricted cash	19,270	[1]	23,761
Trade accounts receivable, less allowance for doubtful accounts of $8,841 and $9,111 at March 31, 2014 and December 31, 2013, respectively	73,447	[1]	70,811
Inventories	70,677	[1]	72,678
Deferred income taxes	40,007	[1]	39,999
Prepaid expenses and other current assets	31,050	[1]	28,933
Total current assets	259,568	[1]	265,106
Property, plant and equipment, net	52,656	[1]	54,372
Patents and other intangible assets, net	8,518	[1]	9,046
Goodwill	53,565	[1]	53,565
Deferred income taxes	22,816	[1]	22,394
Other long-term assets	6,850	[1]	7,492
Total assets	403,973	[1]	411,975
Current liabilities:
Trade accounts payable	14,022	[1]	20,674
Other current liabilities	43,700	[1]	49,676
Total current liabilities	57,722	[1]	70,350
Long-term debt	20,000	[1]	20,000
Deferred income taxes	13,201	[1]	13,026
Other long-term liabilities	12,487	[1]	12,736
Total liabilities	103,410	[1]	116,112
Contingencies (Note 16)		[1]
Shareholders' equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,365,910 and 18,102,335 issued and outstanding as of March 31, 2014 and December 31, 2013, respectively	1,836	[1]	1,810
Additional paid-in capital	223,356	[1]	216,653
Retained earnings	71,389	[1]	73,897
Accumulated other comprehensive income	3,982	[1]	3,503
Total shareholders' equity	300,563	[1]	295,863
Total liabilities and shareholders' equity	$403,973	[1]	$411,975
[1]	Unaudited

Condensed_Consolidated_Balance1

Condensed Consolidated Balance Sheets (Parenthetical) (USD $)	Mar. 31, 2014		Dec. 31, 2013
In Thousands, except Share data, unless otherwise specified
Statement of Financial Position [Abstract]
Trade accounts receivable, allowance for doubtful accounts	$8,841	[1]	$9,111
Common shares, par value	$0.10	[1]	$0.10
Common shares, authorized	50,000,000	[1]	50,000,000
Common shares, issued	18,365,910	[1]	18,102,335
Common shares, outstanding	18,365,910	[1]	18,102,335
[1]	Unaudited

Condensed_Consolidated_Stateme

Condensed Consolidated Statements of Operations and Comprehensive Income (loss) (USD $)	3 Months Ended
In Thousands, except Share data, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Income Statement [Abstract]
Product sales	$88,300	$90,241
Marketing service fees	11,714	12,038
Net sales	100,014	102,279
Cost of sales	26,773	25,841
Gross profit	73,241	76,438
Operating expenses
Sales and marketing	41,171	45,844
General and administrative	17,276	18,241
Research and development	5,933	5,741
Amortization of intangible assets	584	544
Costs related to the accounting review and restatement	8,306
Total operating expenses	73,270	70,370
Operating (loss) income	-29	6,068
Other income and expense
Interest expense, net	-468	-542
Other (expense) income	-272	4,764
Total other income (expense)	-740	4,222
(Loss) income before income taxes	-769	10,290
Income tax expense	-1,179	-4,364
Net (loss) income from continuing operations	-1,948	5,926
Discontinued operations (Note 15)
Loss from discontinued operations	-794	-3,960
Income tax benefit	234	1,481
Net loss from discontinued operations	-560	-2,479
Net (loss) income	-2,508	3,447
Net (loss) income per common share-basic:
Net (loss) income from continuing operations	($0.11)	$0.30
Net loss from discontinued operations	($0.03)	($0.12)
Net (loss) income per common share-basic	($0.14)	$0.18
Net (loss) income per common share-diluted:
Net (loss) income from continuing operations	($0.11)	$0.30
Net loss from discontinued operations	($0.03)	($0.12)
Net (loss) income per common share-diluted	($0.14)	$0.18
Weighted average number of common shares:
Basic	18,197,363	19,431,093
Diluted	18,197,363	19,691,141
Other comprehensive (loss) income:
Unrealized (loss) gain on cross-currency swap, net of tax	103	-318
Foreign currency translation adjustment	376	-2,679
Comprehensive (loss) income	($2,029)	$450

Condensed_Consolidated_Stateme1

Condensed Consolidated Statements of Cash Flows (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014		Mar. 31, 2013
Cash flows from operating activities:
Net (loss) income	($2,508)		$3,447
Adjustments to reconcile net (loss) income to net cash (used in) provided by operating activities:
Depreciation and amortization	5,746		5,067
Amortization of debt costs	180		180
Amortization of exclusivity agreements	346		311
Provision for doubtful accounts	108		1,368
Deferred income taxes	-246		-6
Share-based compensation	1,187		1,943
Excess income tax benefit on employee stock-based compensation	-29		-78
Other	14		421
Change in operating assets and liabilities:
Trade accounts receivable	-2,607		9,665
Inventories	2,487		-2,106
Prepaid expenses and other current assets	-3,464		4,843
Trade accounts payable	-6,670		-7,247
Other current liabilities	-4,606		-162
Long-term assets	130		-1,553
Long-term liabilities	-280		-1,039
Net cash (used in) provided by operating activities	-10,212		15,054
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	-3,691		-6,029
Capital expenditures for intangible assets	-46		-44
Sale of other investments	32		-506
Net cash used in investing activities	-3,705		-6,579
Cash flows from financing activities:
Net proceeds from issuance of common shares	5,542		2,143
Repayment of bank borrowings, net			-15
Changes in restricted cash	4,502		-8,141
Excess income tax benefit on employee stock-based awards	29		78
Net cash provided by (used in) financing activities	10,073		-5,935
Effect of exchange rate changes on cash	37		-433
Net (decrease) increase in cash and cash equivalents	-3,807		2,107
Cash and cash equivalents at the beginning of the period	28,924		30,767
Cash and cash equivalents at the end of the period	$25,117	[1]	$32,874
[1]	Unaudited

Summary_of_significant_account

Summary of significant accounting policies	3 Months Ended
	Mar. 31, 2014
Accounting Policies [Abstract]
Summary of significant accounting policies	1. Summary of significant accounting policies
	(a) Basis of presentation
	The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States (“U.S. GAAP”) for interim financial information and with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. Pursuant to these rules and regulations, certain information and note disclosures, normally included in financial statements prepared in accordance with U.S. GAAP, have been condensed or omitted. In the opinion of management, all adjustments (consisting of normal recurring items) considered necessary for a fair presentation have been included. Operating results for the three months ended March 31, 2014, are not necessarily indicative of the results that may be expected for the year ending December 31, 2014. The balance sheet at December 31, 2013, has been derived from the audited financial statements at that date, but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements. For further information, refer to the consolidated financial statements and notes thereto contained in the 2013 Form 10-K/A. The notes to the unaudited condensed consolidated financial statements are presented on a continuing basis unless otherwise noted.
	(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
	The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. On an ongoing basis, the Company evaluates its estimates including those related to contractual allowances, doubtful accounts, inventories, potential goodwill and intangible asset impairment, income taxes, and shared-based compensation. Actual results could differ from these estimates.
	(d) Foreign currency translation
	The financial statements for operations outside the U.S. are generally maintained in their local currency. All foreign currency denominated balance sheet accounts, except shareholders’ equity, are translated to U.S. dollars at period 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.
	(e) Collaborative agreement
	The Company receives a marketing fee through our collaboration with Musculoskeletal Transplant Foundation (“MTF”) for Trinity Evolution® and Trinity ELITE®, for which, we have exclusive marketing rights and VersaShield™ for which we have non-exclusive marketing rights. Under our agreements with MTF, MTF processes the tissues, maintains inventory, and invoices hospitals and surgery centers and other points of care for service fees, which are submitted by customers via purchase orders. MTF is considered the primary obligor in these arrangements and therefore we recognize these marketing service fees on a net basis upon shipment of the product to the customer.

Original_and_Further_Restateme

Original and Further Restatement of the Consolidated Financial Statements	3 Months Ended
	Mar. 31, 2014
Accounting Changes and Error Corrections [Abstract]
Original and Further Restatement of the Consolidated Financial Statements	2. Original and Further Restatement of the Consolidated Financial Statements
	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-Q and the Original 2013 Form 10-K were not properly accounted for under U.S. generally accepted accounting principles (“U.S. 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 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 (including those contained in the Original 2013 Form 10-K and the Original Form 10-Q) should no longer be relied upon. This Form 10-Q/A contains restated consolidated interim financial statements for the fiscal quarters ended March 31, 2014 and 2013.
	Contemporaneously with the filing of this Form 10-Q/A, the Company is filing (i) an amendment to the Original 2013 Form 10-K (the “2013 Form 10-K/A”), which amendment contains restated consolidated financial statements for the fiscal years ended December 31, 2013, 2012 and 2011, and the quarterly reporting periods contained within the fiscal years ended December 31, 2013 and 2012, and (ii) its delayed Quarterly Reports on Form 10-Q for the fiscal quarters ended June 30, 2014 (the “2014 Second Quarter Form 10-Q”) and September 30, 2014 (the “2014 Third Quarter Form 10-Q”), which contain restated consolidated interim financial statements for the fiscal quarterly and year-to-date periods ended June 30, 2013 and September 30, 2013, respectively. The corrections of the additional errors in this Form 10-Q/A and the 2013 Form 10-K/A are referred to herein as the “Further Restatement.”
	The Original 2013 Form 10-K reflected a prior restatement of the Company’s consolidated financial statements for the fiscal years ended December 31, 2012 and 2011 and the fiscal quarter ended March 31, 2013, which we refer to herein as the “Original Restatement.” For additional information regarding the Original Restatement, see the 2013 Form 10-K/A.
	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 in the 2013 Form 10-K/A and 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. Additionally, in the quarter ended March 31, 2014, there were amounts related to contractual amounts from commercial insurance carriers that were incorrectly classified to bad debt expense rather than a reduction of revenue.
	Adjustments to correct the foregoing reduce equally both the Company’s historical net sales and its sales and marketing expense by approximately $1.4 million and $1.5 million for the fiscal quarters ended March 31, 2014 and 2013, respectively. Additionally, there was $1.4 million in the fiscal quarter ended March 31, 2014 which was inappropriately classified to bad debt expense rather than a reduction of revenue, for a total reduction to bad debt and revenue of $2.8 million for the fiscal quarter ended March 31, 2014. 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 for the fiscal quarter ended March 31, 2013. There were no adjustments to the fiscal quarter ended March 31, 2014. These adjustments resulted in no impact to the accounts receivable balance as of March 31, 2014 and December 31, 2013.
	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 loss of $1.5 million for the fiscal quarter ended March 31, 2014 and a net increase in operating income of $0.4 million for the fiscal quarter ended March 31 2013.
	This adjustment resulted in a decrease in accounts receivable, net (due to an increase in reserves) as of March 31, 2014 and December 31, 2013, by $2.8 million and $4.2 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 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 $3.0 million and a decrease to cost of sales of $0.1 million for the fiscal quarters ended March 31, 2014 and 2013, respectively.
	This adjustment resulted in a decrease in inventory as of March 31, 2014 and December 31, 2013, by $5.5 million and $2.6 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 $0.2 million and $0.1 million for the fiscal quarters ended March 31, 2014 and 2013, respectively.
	These adjustments resulted in a decrease in inventory as of March 31, 2014 and December 31, 2013, by $1.2 million and $1.0 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 $2.4 million and $0.8 million for the fiscal quarters ended March 31, 2014 and 2013, respectively. These adjustments resulted in a decrease to inventory (due to an increase in reserves) as of March 31, 2014 and December 31, 2013, by $16.4 million and $14.4 million, respectively.
	Other Adjustments
	In addition to the adjustments described above, the Company is correcting certain other items. The impact of correcting these items results in a decrease to loss before income taxes of $1.6 million for the fiscal quarter ended March 31, 2014, and a decrease to income before income taxes of $0.3 million for the fiscal quarter ended March 31, 2013.
	The tables below show the effects of the Original Restatement for the fiscal quarter ended March 31, 2013, as well as the effects of the Further Restatement for each of the fiscal quarters ended March 31, 2014 and 2013. In each case, the tax effect of the adjustments is estimated based on the Company’s estimated tax rate.
		Three Months Ended March 31, 2014
					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
		in 2014			Revenue						Reserve												Adjustments
		Form 10-Q
	Net sales	$	101,342		$	(2,800	)	$	—		$	1,651		$	—		$	—		$	(179	)	$	(1,328	)	$	100,014
	Cost of sales		22,632			—			—			—			2,966			2,564			(1,389	)		4,141			26,773
	Gross profit		78,710			(2,800	)		—			1,651			(2,966	)		(2,564	)		1,210			(5,469	)		73,241
	Operating expenses
	Sales and marketing		43,871			(2,800	)		—			201			—			—			(101	)		(2,700	)		41,171
	General and administrative		17,545			—			—			—			—			—			(269	)		(269	)		17,276
	Research and development		5,939			—			—			—			—			—			(6	)		(6	)		5,933
	Amortization of intangible assets		584			—			—			—			—			—			—			—			584
	Costs related to the accounting review and restatement		8,306			—			—			—			—			—			—			—			8,306
			76,245			(2,800	)		—			201			—			—			(376	)		(2,975	)		73,270
	Operating (loss) income		2,465			—			—			1,450			(2,966	)		(2,564	)		1,586			(2,494	)		(29	)
	Other income and (expense)		(747	)		—			—			—			—			—			7			7			(740	)
	Loss before income taxes		1,718			—			—			1,450			(2,966	)		(2,564	)		1,593			(2,487	)		(769	)
	Income tax expense		(1,940	)		—			—			(508	)		1,039			898			(668	)		761			(1,179	)
	Net loss from continuing operations	$	(222	)	$	—		$	—		$	942		$	(1,927	)	$	(1,666	)	$	925		$	(1,726	)	$	(1,948	)
		Three Months Ended March 31, 2013
					Original Restatement Adjustments by Category
	(U.S. Dollars, in thousands)	As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
		in the 2013			Revenue			Reserves									Restatement			Restated in
		Form 10-Q															Adjustments			2013
		Prior to																		Form 10-Q/A
		Original
		Restatement
	Net sales	$	100,254		$	2,963		$	—		$	—		$	156		$	3,119		$	103,373
	Cost of sales		22,699			471			86			2,030			331			2,918			25,617
	Gross profit		77,555			2,492			(86	)		(2,030	)		(175	)		201			77,756
Operating expenses
Sales and marketing		48,839			(2,073	)		—			(2,030	)		318			(3,785	)		45,054
General and administrative		18,788			—			—			—			(458	)		(458	)		18,330
Research and development		5,400			—			—			—			341			341			5,741
Amortization of intangible assets		504			—			—			—			40			40			544
Charges related to U.S. Government resolutions		—			—			—			—			—			—			—
		73,531			(2,073	)		—			(2,030	)		241			(3,862	)		69,669
Operating income		4,024			4,565			(86	)		—			(416	)		4,063			8,087
Other income and (expense)		4,204			—			—			—			—			—			4,204
Income before income taxes		8,228			4,565			(86	)		—			(416	)		4,063			12,291
Income tax expense		(3,320	)		(1,529	)		29			—			139			(1,361	)		(4,681	)
Net income from continuing operations	$	4,908		$	3,036		$	(57	)	$	—		$	(277	)	$	2,702		$	7,610
	Three Months Ended March 31, 2013
				Further Restatement Adjustments by Category
(U.S. Dollars, in thousands)	As Originally			Co-Pay			Bad			Accounts			Intercompany			Inventory			Other			Total Further			Restated
	Restated in			and			Debt			Receivable			Profit									Restatement
	2013			Self-Pay			Timing			Reserve												Adjustments
	Form 10-Q/A			Revenue
Net sales	$	103,373		$	(1,453	)	$	—		$	437		$	—		$	—		$	(78	)	$	(1,094	)	$	102,279
Cost of sales		25,617			—			—			—			(120	)		820			(476	)		224			25,841
Gross profit		77,756			(1,453	)		—			437			120			(820	)		398		$	(1,318	)		76,438
Operating expenses
Sales and marketing		45,054			(1,453	)		1,455			(8	)		—			—			796			790			45,844
General and administrative		18,330			—			—			—			—			—			(89	)		(89	)		18,241
Research and development		5,741			—			—			—			—			—			—			—			5,741
Amortization of intangible assets		544			—			—			—			—			—			—			—			544
		69,669			(1,453	)		1,455			(8	)		—			—			707			701			70,370
Operating income		8,087			—			(1,455	)		445			120			(820	)		(309	)		(2,019	)		6,068
Other income and (expense)		4,204			—			—			—			—			—			18			18			4,222
Income before income taxes		12,291			—			(1,455	)		445			120			(820	)		(291	)		(2,001	)		10,290
Income tax expense		(4,681	)		—			509			(156	)		(42	)		287			(281	)		317			(4,364	)
Net income from continuing operations	$	7,610		$	—		$	(946	)	$	289		$	78		$	(533	)	$	(572	)	$	(1,684	)	$	5,926
The effects of the Further Restatement on our condensed consolidated balance sheet as of March 31, 2014 are as follows:
	As of March 31, 2014
(Unaudited, U.S. Dollars, in thousands, except share data)	Originally			Further			Restated
	Reported in			Restatement
	2014			Adjustments
	Form 10-Q
Assets
Current assets:
Cash and cash equivalents	$	26,747		$	(1,630	)	$	25,117
Restricted cash		19,270			—			19,270
Trade accounts receivable, less allowances of $8,841 at March 31, 2014		76,917			(3,470	)		73,447
Inventories		92,753			(22,076	)		70,677
Deferred income taxes		33,956			6,051			40,007
Prepaid expenses and other current assets		28,781			2,269			31,050
Total current assets		278,424			(18,856	)		259,568
Property, plant and equipment, net		52,532			124			52,656
Patents and other intangible assets, net		8,518			—			8,518
Goodwill		53,565			—			53,565
Deferred income taxes		18,758			4,058			22,816
Other long-term assets		6,743			107			6,850
Total assets	$	418,540		$	(14,567	)	$	403,973
Liabilities and shareholders’ equity
Current liabilities:
Trade accounts payable	$	14,022		$	—		$	14,022
Other current liabilities		41,467			2,233			43,700
Total current liabilities		55,489			2,233			57,722
Long-term debt		20,000			—			20,000
Deferred income taxes		13,307			(106	)		13,201
Other long-term liabilities		12,487			—			12,487
Total liabilities		101,283			2,127			103,410
Contingencies (Note 16)
Shareholders’ equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,365,910 issued and outstanding as of March 31, 2014		1,836			—			1,836
Additional paid-in capital		223,630			(274	)		223,356
Retained earnings		88,550			(17,161	)		71,389
Accumulated other comprehensive income		3,241			741			3,982
Total shareholders’ equity		317,257			(16,694	)		300,563
Total liabilities and shareholders’ equity	$	418,540		$	(14,567	)	$	403,973
The effects of the Further Restatement on our condensed consolidated balance sheet as of December 31, 2013 are as follows:
	As of December 31, 2013
(Unaudited, U.S. Dollars, in thousands, except share data)	Originally			Further			Restated
	Reported in			Restatement
	2014			Adjustments
	Form 10-Q
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 at December 31, 2013		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 16)
Shareholders’ equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 issued and outstanding as of December 31, 2013		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 Further Restatement on our condensed consolidated statement of operations and comprehensive loss for the three months ended March 31, 2014 are as follows:
	Three Months Ended March 31, 2014
(Unaudited, U.S. Dollars, in thousands, except share and per share data)	Originally			Further			Restated
	Reported in 2014			Restatement
	Form 10-Q			Adjustments
Product sales	$	89,684		$	(1,384	)	$	88,300
Marketing service fees		11,658			56			11,714
Net sales		101,342			(1,328	)		100,014
Cost of sales		22,632			4,141			26,773
Gross profit		78,710			(5,469	)		73,241
Operating expenses
Sales and marketing		43,871			(2,700	)		41,171
General and administrative		17,545			(269	)		17,276
Research and development		5,939			(6	)		5,933
Amortization of intangible assets		584			—			584
Costs related to the accounting review and restatement		8,306			—			8,306
		76,245			(2,975	)		73,270
Operating income (loss)		2,465			(2,494	)		(29	)
Other income and expense
Interest expense, net		(486	)		18			(468	)
Other (loss) income		(261	)		(11	)		(272	)
		(747	)		7			(740	)
Income (loss) before income taxes		1,718			(2,487	)		(769	)
Income tax expense		(1,940	)		761			(1,179	)
Net loss from continuing operations		(222	)		(1,726	)		(1,948	)
Discontinued operations (Note 15)
Loss from discontinued operations		(794	)		—			(794	)
Income tax benefit		234			—			234
Net loss from discontinued operations		(560	)		—			(560	)
Net loss	$	(782	)	$	(1,726	)	$	(2,508	)
Net loss per common share—basic:
Net loss from continuing operations	$	(0.01	)	$	(0.10	)	$	(0.11	)
Net loss from discontinued operations		(0.03	)		—			(0.03	)
Net loss per common share—basic	$	(0.04	)	$	(0.10	)	$	(0.14	)
Net loss per common share—diluted:
Net loss from continuing operations	$	(0.01	)	$	(0.10	)	$	(0.11	)
Net loss from discontinued operations		(0.03	)		—			(0.03	)
Net loss per common share—diluted	$	(0.04	)	$	(0.10	)	$	(0.14	)
Weighted average number of common shares:
Basic		18,197,363			—			18,197,363
Diluted		18,197,363			—			18,197,363
Other comprehensive income:
Unrealized gain (loss) on cross-currency swap, net of tax		103			—			103
Foreign currency translation adjustment		439			(63	)		376
Comprehensive loss	$	(240	)	$	(1,789	)	$	(2,029	)
The effects of the Original Restatement and the Further Restatement on our condensed consolidated statement of operations and comprehensive income (loss) for the three months ended March 31, 2013 are as follows:
	Three Months Ended March 31, 2013
(U.S. Dollars, in thousands, except share and per share data)	As Reported in the			Original			As Originally			Further			Restated
	2013 Form 10-Q			Restatement			Restated in the			Restatement
	Prior to Original			Adjustments			2013 Form 10-			Adjustments
	Restatement						Q/A
Product sales	$	88,358		$	2,978		$	91,336			(1,095	)	$	90,241
Marketing service fees		11,896			141			12,037			1			12,038
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 expenses
Sales and marketing		48,839			(3,785	)		45,054			790			45,844
General and administrative		18,788			(458	)		18,330			(89	)		18,241
Research and development		5,400			341			5,741			—			5,741
Amortization of intangible assets		504			40			544			—			544
		73,531			(3,862	)		69,669			701			70,370
Operating income		4,024			4,063			8,087			(2,019	)		6,068
Other income and (expense)
Interest expense, net		(560	)		—			(560	)		18			(542	)
Other income		4,764			—			4,764			—			4,764
		4,204			—			4,204			18			4,222
Income before income taxes		8,228			4,063			12,291			(2,001	)		10,290
Income tax expense		(3,320	)		(1,361	)		(4,681	)		317			(4,364	)
Net income from continuing operations		4,908			2,702			7,610			(1,684	)		5,926
Discontinued operations (Note 15)
Loss from discontinued operations		(4,432	)		(2	)		(4,434	)		474			(3,960	)
Income tax benefit (expense)		1,640			(316	)		1,324			157			1,481
Net loss from discontinued operations		(2,792	)		(318	)		(3,110	)		631			(2,479	)
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			(0.09	)	$	0.3
Net loss from discontinued operations		(0.14	)		(0.02	)		(0.16	)		0.04			(0.12	)
Net income per common share—basic	$	0.11		$	0.12		$	0.23			(0.05	)	$	0.18
Net income (loss) per common share—diluted:
Net income from continuing operations	$	0.25		$	0.14		$	0.39			(0.09	)	$	0.3
Net loss from discontinued operations		(0.14	)		(0.02	)		(0.16	)		0.04			(0.12	)
Net income per common share—diluted:	$	0.11		$	0.12		$	0.23			(0.05	)	$	0.18
Weighted average number of common shares:
Basic		19,431,093			—			19,431,093			—			19,431,093
Diluted		19,691,141			—			19,691,141			—			19,691,141
Other comprehensive (loss) income, before tax:
Unrealized gain on derivative instrument		(318	)		—			(318	)		—			(318	)
Translation adjustment		(2,814	)		106			(2,708	)		29			(2,679	)
Comprehensive (loss) income	$	(1,016	)	$	2,490		$	1,474		$	(1,024	)	$	450
The effects of the Further Restatement on our condensed consolidated statement of cash flows for the three months ended March 31, 2014 are as follows:
	Three Months Ended
	31-Mar-14
(Unaudited, U.S. Dollars, in thousands)	Originally			Further			Restated
	Reported in			Restatement
	2014 Form			Adjustments
	10-Q
Cash flows from operating activities:
Net loss	$	(782	)	$	(1,726	)	$	(2,508	)
Adjustments to reconcile net loss to net cash used in operating activities:
Depreciation and amortization		6,004			(258	)		5,746
Amortization of debt costs		180			—			180
Amortization of exclusivity agreements		346			—			346
Provision for doubtful accounts		2,579			(2,471	)		108
Deferred income taxes		(246	)		—			(246	)
Share-based compensation		1,461			(274	)		1,187
Excess income tax benefit on employee stock-based awards		(29	)		—			(29	)
Other		166			(152	)		14
Change in operating assets and liabilities:
Trade accounts receivable		(3,780	)		1,173			(2,607	)
Inventories		(1,690	)		4,177			2,487
Prepaid expenses and other current assets		(2,806	)		(658	)		(3,464	)
Trade accounts payable		(6,670	)		—			(6,670	)
Other current liabilities		(4,761	)		155			(4,606	)
Long-term assets		130			—			130
Long-term liabilities		(280	)		—			(280	)
Net cash used in operating activities		(10,178	)		(34	)		(10,212	)
Cash flows from investing activities:
Capital expenditures for property, plant and equipment		(3,691	)		—			(3,691	)
Capital expenditures for intangible assets		(46	)		—			(46	)
Sale of other investments		—			32			32
Net cash used in investing activities		(3,737	)		32			(3,705	)
Cash flows from financing activities:
Net proceeds from issuance of common shares		5,542			—			5,542
(Repayment of) proceeds from bank borrowings, net		—			—			—
Changes in restricted cash		4,502			—			4,502
Excess income tax benefit on employee stock-based awards		29			—			29
Net cash provided by financing activities		10,073			—			10,073
Effect of exchange rate changes on cash		103			(66	)		37
Net decrease in cash and cash equivalents		(3,739	)		(68	)		(3,807	)
Cash and cash equivalents at the beginning of the period		30,486			(1,562	)		28,924
Cash and cash equivalents at the end of the period	$	26,747		$	(1,630	)	$	25,117
The effects of the Original Restatement and the Further Restatement on our condensed consolidated statement of cash flows for the three months ended March 31, 2013 are as follows:
	Three Months Ended
	31-Mar-13
(Unaudited, U.S. Dollars, in thousands)	As Reported			Original			As Originally			Further			Restated
	in the 2013			Restatement			Restated in			Restatement
	Form 10-Q			Adjustments			the 2013			Adjustments
	Prior to						Form 10-Q/A
	Original
	Restatement
Cash flows from operating activities:
Net income	$	2,116		$	2,384		$	4,500		$	(1,053	)	$	3,447
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization		4,995			34			5,029			38			5,067
Amortization of debt costs		180			—			180			—			180
Amortization of exclusivity agreements		311			—			311			—			311
Provision for doubtful accounts		3,227			(1,853	)		1,374			(6	)		1,368
Deferred income taxes		(744	)		738			(6	)		—			(6	)
Share-based compensation		1,943			—			1,943			—			1,943
Excess income tax benefit on employee stock-based awards		(78	)		—			(78	)		—			(78	)
Other		(345	)		736			391			30			421
Change in operating assets and liabilities:
Trade accounts receivable		13,779			(5,190	)		8,589			1,076			9,665
Inventories		(4,230	)		2,130			(2,100	)		(6	)		(2,106	)
Prepaid expenses and other current assets		(179	)		2,874			2,695			2,148			4,843
Trade accounts payable		(7,242	)		(5	)		(7,247	)		—			(7,247	)
Other current liabilities		4,478			(2,408	)		2,070			(2,232	)		(162	)
Long-term assets		(2,014	)		461			(1,553	)		—			(1,553	)
Long-term liabilities		(743	)		(296	)		(1,039	)		—			(1,039	)
Net cash provided by operating activities		15,454			(395	)		15,059			(5	)		15,054
Cash flows from investing activities:
Capital expenditures for property, plant and equipment		(6,029	)		—			(6,029	)		—			(6,029	)
Capital expenditures for intangible assets		(439	)		395			(44	)		—			(44	)
Purchase of other investments		—			—			—			(506	)		(506	)
Net cash used in investing activities		(6,468	)		395			(6,073	)		(506	)		(6,579	)
Cash flows from financing activities:
Net proceeds from issuance of common shares		2,143			—			2,143			—			2,143
(Repayment of) proceeds from bank borrowings, net		(15	)		—			(15	)		—			(15	)
Changes in restricted cash		(8,141	)		—			(8,141	)		—			(8,141	)
Excess income tax benefit on employee stock-based awards		78			—			78			—			78
Net cash used in financing activities		(5,935	)		—			(5,935	)		—			(5,935	)
Effect of exchange rate changes on cash		(431	)		—			(431	)		(2	)		(433	)
Net increase in cash and cash equivalents		2,620			—			2,620			(513	)		2,107
Cash and cash equivalents at the beginning of the period		31,055			—			31,055			(288	)		30,767
Cash and cash equivalents at the end of the period	$	33,675		$	—		$	33,675			(801	)	$	32,874

Inventories

Inventories	3 Months Ended
	Mar. 31, 2014
Inventory Disclosure [Abstract]
Inventories	3. Inventories
	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.
	Work-in-process and finished products, 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 been met. Once the revenue recognition criteria have been met, both the deferred revenues and associated cost of sales are recognized.
	Inventories were as follows:
	(U.S. Dollars, in thousands)	March 31,		December 31,
		2014		2013
		(Restated)		(Restated)
	Raw materials	$	5,220	$	6,515
	Work-in-process		7,412		6,606
	Finished products		51,190		51,991
	Deferred cost of sales		6,855		7,566
	Total Inventory	$	70,677	$	72,678

Patents_and_other_intangible_a

Patents and other intangible assets	3 Months Ended
	Mar. 31, 2014
Goodwill and Intangible Assets Disclosure [Abstract]
Patents and other intangible assets	4. Patents and other intangible assets
	(U.S. Dollars, in thousands)	March 31,			December 31,
		2014			2013
	Cost
	Patents	$	34,815		$	34,820
	Trademarks — definite lived		645			620
	Licenses and other		7,748			7,748
			43,208			43,188
	Accumulated amortization
	Patents		(32,170	)		(31,739	)
	Trademarks — definite lived		(484	)		(454	)
	Licenses and other		(2,036	)		(1,949	)
			(34,690	)		(34,142	)
	Patents and other intangible assets, net	$	8,518		$	9,046

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2014
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	5. Goodwill
	As a result of the Company’s change in reporting structure in July of 2013, the Company allocated goodwill to each reporting unit, and subsequently evaluated all reporting units, including the Extremity Fixation and Spine Fixation reporting units, for the possible impairment of goodwill. The result of this evaluation was a full impairment of the goodwill allocated to our Extremity Fixation and our Spine Fixation reporting units, totaling $19.2 million. As of December 31, 2013 and March 31, 2014, accumulated impairment was $9.8 million for our Extremity Fixation reportable unit and $9.4 million for our Spine Fixation reporting unit. Our BioStim and Biologics reportable units have not been impaired. The following table presents the net carrying value of goodwill by reportable segment as of March 31, 2014 and December 31, 2013.

Bank_borrowings

Bank borrowings	3 Months Ended
	Mar. 31, 2014
Debt Disclosure [Abstract]
Bank borrowings	6. Bank borrowings
	The Company had no borrowings and an unused available line of credit of €5.8 million ($8.0 million) at both March 31, 2014 and December 31, 2013, on 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.

Longterm_debt

Long-term debt	3 Months Ended
	Mar. 31, 2014
Debt Disclosure [Abstract]
Long-term debt	7. 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.
	As of March 31, 2014, and December 31, 2013, there was $20 million outstanding under the Revolving Credit Facility. 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 March 31, 2014, and December 31, 2013, 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 March 31, 2014, and December 31, 2013, was 2.7%. Outstanding balances on the Revolving Credit Facility are due on August 30, 2015.
	Borrowings under the Revolving Credit Facility, which may be made in the future, may 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. On August 14, 2013, the Company entered into a Limited Waiver (the “Original Limited Waiver”) with the lenders under the Credit Agreement (the “Lenders”) which waived requirements under the Credit Agreement to deliver quarterly financial statements for the fiscal quarter ended on June 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. The Company was in compliance with the affirmative and negative covenants at March 31, 2014 and there were no events of default.
	In connection with the Further Restatement and the Company’s delay in filing the 2014 Second Quarter Form 10-Q, on August 14, 2014 the Company entered into a subsequent Limited Waiver with the Lenders 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. As of the date hereof, the Company has delivered the quarterly consolidated financial statements for the fiscal quarters ended June 30, 2014 and September 30, 2014, and the Company does not expect the Further Restatement to trigger any such additional interest or fees with respect to such prior periods. However, in the event that the Company does not satisfy these respective obligations under the Original Limited Waiver, the Subsequent Limited Waivers and/or the Credit Agreement, an event of default could be declared under the Credit Agreement, which could have a material adverse effect on the Company’s financial position.
	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 March 31, 2014, and December 31, 2013, is $171.1 million and $168.5 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 March 31, 2014, and December 31, 2013, was $19.3 million and $23.8 million, respectively.
	In conjunction with obtaining the Credit Facilities and the Credit Agreement, as amended, the Company incurred debt issuance costs of $5 million. These costs are being amortized using the effective interest method over the life of the Credit Facilities. As of March 31, 2014, and December 31, 2013, debt issuance costs, net of accumulated amortization, related to the Credit Agreement were $0.9 million and $1.1 million, respectively.

Derivative_instruments

Derivative instruments	3 Months Ended
	Mar. 31, 2014
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivative instruments	8. 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
	As of March 31, 2014	(unfavorable)
	Cross-currency swap	$	(1,035	)		Other long-term liabilities
	Warrants	$	107			Other long-term assets
	As of December 31, 2013
	Cross-currency swap	$	(1,036	)		Other long-term liabilities
	Warrants	$	107			Other long-term assets
		Three Months Ended
		March 31,
	(U.S. Dollars, in thousands)	2014			2013
	Cross-currency swap unrealized gain (loss) recorded in other comprehensive income (loss), net of taxes	$	103		$	(318	)
	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 March 31, 2014 and 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 detachable from the note, exercisable over a seven year period, and transferable by the holder to other parties. There was no change in fair value of the warrants for the three months ended March 31, 2014 or 2013.

Fair_value_measurements

Fair value measurements	3 Months Ended
	Mar. 31, 2014
Fair Value Disclosures [Abstract]
Fair value measurements	9. 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
			March 31,
			2014
	Assets						(Restated1)
	Collective trust funds		$	1,652		$	—	$	1,652		$	—
	Treasury securities			661			661		—			—
	Certificates of deposit			1,630			1,630		—			—
	Derivative securities			107			—		107			—
	Total		$	4,050		$	2,291	$	1,759		$	—
	Liabilities
	Deferred compensation plan		$	(1,970	)	$	—	$	(1,970	)	$	—
	Derivative securities			(1,035	)		—		(1,035	)		—
	Total		$	(3,005	)	$	—	$	(3,005	)	$	—
	(U.S. Dollars in thousands)		Balance			Level 1		Level 2			Level 3
			December 31,
			2013
	Assets						(Restated1)
	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	)	$	—
	-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.

Accumulated_other_comprehensiv

Accumulated other comprehensive income	3 Months Ended
	Mar. 31, 2014
Equity [Abstract]
Accumulated other comprehensive income	10. Accumulated other comprehensive income
	Accumulated other comprehensive income is comprised of foreign currency translation adjustments, 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 and the unrealized gain (loss) on warrants. The components of and changes in accumulated other comprehensive income were as follows:
	(U.S. Dollars, in thousands)		Foreign		Change			Accumulated
			Currency		in			Other
			Translation		Fair Value			Comprehensive
			Adjustments					Income
			(Restated)		(Restated)			(Restated)
	Balance at December 31, 2013		$	3,651	$	(148	)	$	3,503
	Unrealized gain on cross-currency swap and warrants, net of tax of $25			—		103			103
	Foreign currency translation adjustment (1)			376		—			376
	Balance at March 31, 2014		$	4,027	$	(45	)	$	3,982
	-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.

Earnings_per_share

Earnings per share	3 Months Ended
	Mar. 31, 2014
Earnings Per Share [Abstract]
Earnings per share	11. Earnings per share
	For the three months ended March 31, 2014 and 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.
		Three Months Ended
		March 31,
		2014		2013
	Weighted average common shares-basic		18,197,363		19,431,093
	Effect of dilutive securities:
	Unexercised stock options net of treasury share repurchase		—		260,048
	Weighted average common shares-diluted		18,197,363		19,691,141
	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 1,691,203 and 973,037 outstanding options not included in the diluted earnings per share computation for the three months ended March 31, 2014 and 2013, respectively, because the inclusion of these options was antidilutive.

Sharebased_compensation

Share-based compensation	3 Months Ended
	Mar. 31, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Share-based compensation	12. Share-based compensation
	All share-based compensation costs are measured at the grant date, based on the estimated fair value of the award, and are recognized as expense in the condensed consolidated statements of operations over the requisite service period.
	The following table shows the detail of share-based compensation by line item in the condensed consolidated statements of operations:
		Three Months Ended
		March 31,
	(U.S. Dollars, in thousands)	2014		2013
	Cost of sales	$	29	$	287
	Sales and marketing		444		436
	General and administrative		642		1,175
	Research and development		72		45
	Total	$	1,187	$	1,943
	For the three months ended March 31, 2014 and 2013, there were no performance requirements for share-based compensation awarded to employees. In March 2013, the Company granted options to its newly-appointed Chief Executive Officer, which vesting is based on achieving certain market prices for the Company’s common stock.
	During the three months ended March 31, 2014 and 2013, there were 263,575 and 113,965 shares, respectively, of common stock issued related to stock purchase plan issuances, stock option exercises and the vesting of restricted stock awards.

Income_taxes

Income taxes	3 Months Ended
	Mar. 31, 2014
Income Tax Disclosure [Abstract]
Income taxes	13. Income taxes
	The Company recognized a $1.2 million and $4.4 million provision for income tax which reflects an effective tax rate of (153.3)% and 42.4% on pre-tax income for the three months ended March 31, 2014 and 2013, respectively. Excluding the impact of various discrete charges, the effective tax rate on continuing operations was (68.5)% and 42.4% for the first three months of 2014 and 2013, respectively. The principal factors affecting the Company’s March 31, 2014 effective tax rate was the Company’s mix of earnings among various tax jurisdictions, state taxes, current period losses in certain jurisdictions for which the Company does not currently provide a tax benefit and variations in the customary relationship between income tax expense and pretax earnings resulting from extraordinary expenses.
	As of March 31, 2014 and December 31, 2013, the Company’s unrecognized tax benefit was $0.7 million and $0.7 million, respectively. The Company recognizes potential accrued interest and penalties related to unrecognized tax benefits in income tax expense. The Company had approximately $0.5 million and $0.5 million accrued for payment of interest and penalties as of March 31, 2014 and December 31, 2013, respectively. The entire amount of unrecognized tax benefits, including interest, would favorably impact the Company’s effective tax rate if recognized. As of March 31, 2014, the Company does not expect the amount of unrecognized tax benefits to change significantly over the next twelve months.

Business_segment_information

Business segment information	3 Months Ended
	Mar. 31, 2014
Segment Reporting [Abstract]
Business segment information	14. 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
	Biologics 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. and Puerto Rico. Our partnership with Musculoskeletal Transplant Foundation (“MTF”) allows us to exclusively market our Trinity Evolution® and Trinity ELITE® tissue forms for musculoskeletal defects to enhance bony fusion as well as VersaShield™ for which we have non-exclusive rights.
	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 direct and distributor 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 distributor 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.
	The table below presents external net sales by SBU reporting segment (amounts reported for prior periods have been reclassified to conform to our new segment reporting structure). Net sales include product sales and marketing service fees. Marketing service fees, which are recorded on a net basis, are comprised of fees earned for the marketing of Trinity Evolution®, Trinity ELITE® and Versashield™ in our Biologics segment.
		External Net Sales by SBU
		Three Months Ended March 31,
	(U.S. Dollars, in thousands)	2014			2013			Reported			Constant
								Decline			Currency
											Decline
		(Restated)			(Restated)			(Restated)			(Restated)
	BioStim	$	37,137		$	37,226			—			—
	Biologics		13,010			13,360			(3	)%		(3	)%
	Extremity Fixation		27,066			26,197			3	%		4	%
	Spine Fixation		22,801			25,496			(11	)%		(11	)%
	Total Net Sales	$	100,014		$	102,279			(2	)%		(2	)%
	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	Three Months Ended
		March 31,
	(U.S. Dollars, in thousands)	2014			2013
		(Restated)			(Restated)
	Net margin:
	BioStim	$	15,020		$	17,183
	Biologics		6,502			6,018
	Extremity Fixation		6,933			5,642
	Spine Fixation		4,059			2,176
	Corporate		(444	)		(425	)
	Total net margin		32,070			30,594
	General and administrative		17,276			18,241
	Research and development		5,933			5,741
	Amortization of intangible assets		584			544
	Costs related to the accounting review and restatement		8,306			—
	Operating (loss) income	$	(29	)	$	6,068

Sale_of_Breg

Sale of Breg	3 Months Ended
	Mar. 31, 2014
Discontinued Operations and Disposal Groups [Abstract]
Sale of Breg	15. Sale of Breg
	In 2012, the Company sold its subsidiary Breg, Inc. In connection with this sale transaction, the Company agreed to indemnify the buyer with respect to certain specified matters. The portion of the indemnification related to post closing claims related to post-closing sales of cold therapy units has created a guarantee under Accounting Standards Codification 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. The Company is amortizing the fair value of the non-contingent liability ratably over the period of indemnification, which is three years. The Company’s remaining obligations under this guarantee were approximately $0.8 million and $0.9 million as of March 31, 2014 and December 31, 2013, respectively.
	Discontinued operations for the three months ended March 31, 2014 is $0.8 million of expense related to the Company’s indemnification of certain specified matters described above.
	In addition, the Company does not accrue for estimated legal fees and other directly related costs as they are expensed as incurred.

Contingencies

Contingencies	3 Months Ended
	Mar. 31, 2014
Commitments and Contingencies Disclosure [Abstract]
Contingencies	16. Contingencies
	The Company is party to certain outstanding legal proceedings, investigations and claims. These matters are described in the 2013 Form 10-K/A. As of the end of the period covered by this report, there had been no further material developments with respect to these matters that are not described in the 2013 Form 10-K/A.

Stock_repurchase_program

Stock repurchase program	3 Months Ended
	Mar. 31, 2014
Text Block [Abstract]
Stock repurchase program	17. Stock repurchase program
	On May 8, 2013, the Company announced that its Board of Directors had authorized a share repurchase program in an amount up to $50 million. To date, the Company has made total repurchases in an amount equal to $39.5 million, all of which were made between May and July 2013.

Subsequent_events

Subsequent events	3 Months Ended
	Mar. 31, 2014
Subsequent Events [Abstract]
Subsequent events	18. 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.

Summary_of_significant_account1

Summary of significant accounting policies (Policies)	3 Months Ended
	Mar. 31, 2014
Accounting Policies [Abstract]
Basis of presentation	(a) Basis of presentation
	The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States (“U.S. GAAP”) for interim financial information and with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. Pursuant to these rules and regulations, certain information and note disclosures, normally included in financial statements prepared in accordance with U.S. GAAP, have been condensed or omitted. In the opinion of management, all adjustments (consisting of normal recurring items) considered necessary for a fair presentation have been included. Operating results for the three months ended March 31, 2014, are not necessarily indicative of the results that may be expected for the year ending December 31, 2014. The balance sheet at December 31, 2013, has been derived from the audited financial statements at that date, but does not include all of the information and footnotes required by accounting principles generally accepted in the U.S. for complete financial statements. For further information, refer to the consolidated financial statements and notes thereto contained in the 2013 Form 10-K/A. The notes to the unaudited condensed consolidated financial statements are presented on a continuing basis unless otherwise noted.
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	(c) Use of estimates
	The preparation of financial statements in conformity with U.S. GAAP requires management to make estimates and assumptions that affect the amounts reported in the financial statements and accompanying notes. On an ongoing basis, the Company evaluates its estimates including those related to contractual allowances, doubtful accounts, inventories, potential goodwill and intangible asset impairment, income taxes, and shared-based compensation. Actual results could differ from these estimates.
Foreign currency translation	(d) Foreign currency translation
	The financial statements for operations outside the U.S. are generally maintained in their local currency. All foreign currency denominated balance sheet accounts, except shareholders’ equity, are translated to U.S. dollars at period 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.
Collaborative agreement	(e) Collaborative agreement
	The Company receives a marketing fee through our collaboration with Musculoskeletal Transplant Foundation (“MTF”) for Trinity Evolution® and Trinity ELITE®, for which, we have exclusive marketing rights and VersaShield™ for which we have non-exclusive marketing rights. Under our agreements with MTF, MTF processes the tissues, maintains inventory, and invoices hospitals and surgery centers and other points of care for service fees, which are submitted by customers via purchase orders. MTF is considered the primary obligor in these arrangements and therefore we recognize these marketing service fees on a net basis upon shipment of the product to the customer.

Original_and_Further_Restateme1

Original and Further Restatement of the Consolidated Financial Statements (Tables)	3 Months Ended
	Mar. 31, 2014
Original Restatement [Member]
Schedule of Restatement to Previously Filed Consolidated Income Statements	Three Months Ended March 31, 2013
					Original Restatement Adjustments by Category
	(U.S. Dollars, in thousands)	As Reported			Distributor			Inventory			Royalties			Other			Total Original			As Originally
		in the 2013			Revenue			Reserves									Restatement			Restated in
		Form 10-Q															Adjustments			2013
		Prior to																		Form 10-Q/A
		Original
		Restatement
	Net sales	$	100,254		$	2,963		$	—		$	—		$	156		$	3,119		$	103,373
	Cost of sales		22,699			471			86			2,030			331			2,918			25,617
	Gross profit		77,555			2,492			(86	)		(2,030	)		(175	)		201			77,756
	Operating expenses
	Sales and marketing		48,839			(2,073	)		—			(2,030	)		318			(3,785	)		45,054
	General and administrative		18,788			—			—			—			(458	)		(458	)		18,330
	Research and development		5,400			—			—			—			341			341			5,741
	Amortization of intangible assets		504			—			—			—			40			40			544
	Charges related to U.S. Government resolutions		—			—			—			—			—			—			—
			73,531			(2,073	)		—			(2,030	)		241			(3,862	)		69,669
	Operating income		4,024			4,565			(86	)		—			(416	)		4,063			8,087
	Other income and (expense)		4,204			—			—			—			—			—			4,204
	Income before income taxes		8,228			4,565			(86	)		—			(416	)		4,063			12,291
	Income tax expense		(3,320	)		(1,529	)		29			—			139			(1,361	)		(4,681	)
	Net income from continuing operations	$	4,908		$	3,036		$	(57	)	$	—		$	(277	)	$	2,702		$	7,610
Further Restatement [Member]
Schedule of Restatement to Previously Filed Consolidated Income Statements	Three Months Ended March 31, 2014
					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
		in 2014			Revenue						Reserve												Adjustments
		Form 10-Q
	Net sales	$	101,342		$	(2,800	)	$	—		$	1,651		$	—		$	—		$	(179	)	$	(1,328	)	$	100,014
	Cost of sales		22,632			—			—			—			2,966			2,564			(1,389	)		4,141			26,773
	Gross profit		78,710			(2,800	)		—			1,651			(2,966	)		(2,564	)		1,210			(5,469	)		73,241
	Operating expenses
	Sales and marketing		43,871			(2,800	)		—			201			—			—			(101	)		(2,700	)		41,171
	General and administrative		17,545			—			—			—			—			—			(269	)		(269	)		17,276
	Research and development		5,939			—			—			—			—			—			(6	)		(6	)		5,933
	Amortization of intangible assets		584			—			—			—			—			—			—			—			584
	Costs related to the accounting review and restatement		8,306			—			—			—			—			—			—			—			8,306
			76,245			(2,800	)		—			201			—			—			(376	)		(2,975	)		73,270
	Operating (loss) income		2,465			—			—			1,450			(2,966	)		(2,564	)		1,586			(2,494	)		(29	)
	Other income and (expense)		(747	)		—			—			—			—			—			7			7			(740	)
	Loss before income taxes		1,718			—			—			1,450			(2,966	)		(2,564	)		1,593			(2,487	)		(769	)
	Income tax expense		(1,940	)		—			—			(508	)		1,039			898			(668	)		761			(1,179	)
	Net loss from continuing operations	$	(222	)	$	—		$	—		$	942		$	(1,927	)	$	(1,666	)	$	925		$	(1,726	)	$	(1,948	)
	Three Months Ended March 31, 2013
					Further Restatement Adjustments by Category
	(U.S. Dollars, in thousands)	As Originally			Co-Pay			Bad			Accounts			Intercompany			Inventory			Other			Total Further			Restated
		Restated in			and			Debt			Receivable			Profit									Restatement
		2013			Self-Pay			Timing			Reserve												Adjustments
		Form 10-Q/A			Revenue
	Net sales	$	103,373		$	(1,453	)	$	—		$	437		$	—		$	—		$	(78	)	$	(1,094	)	$	102,279
	Cost of sales		25,617			—			—			—			(120	)		820			(476	)		224			25,841
	Gross profit		77,756			(1,453	)		—			437			120			(820	)		398		$	(1,318	)		76,438
	Operating expenses
	Sales and marketing		45,054			(1,453	)		1,455			(8	)		—			—			796			790			45,844
	General and administrative		18,330			—			—			—			—			—			(89	)		(89	)		18,241
	Research and development		5,741			—			—			—			—			—			—			—			5,741
	Amortization of intangible assets		544			—			—			—			—			—			—			—			544
			69,669			(1,453	)		1,455			(8	)		—			—			707			701			70,370
	Operating income		8,087			—			(1,455	)		445			120			(820	)		(309	)		(2,019	)		6,068
	Other income and (expense)		4,204			—			—			—			—			—			18			18			4,222
	Income before income taxes		12,291			—			(1,455	)		445			120			(820	)		(291	)		(2,001	)		10,290
	Income tax expense		(4,681	)		—			509			(156	)		(42	)		287			(281	)		317			(4,364	)
	Net income from continuing operations	$	7,610		$	—		$	(946	)	$	289		$	78		$	(533	)	$	(572	)	$	(1,684	)	$	5,926
	T
Effects of Further Restatement on Condensed Consolidated Balance Sheet	The effects of the Further Restatement on our condensed consolidated balance sheet as of March 31, 2014 are as follows:
		As of March 31, 2014
	(Unaudited, U.S. Dollars, in thousands, except share data)	Originally			Further			Restated
		Reported in			Restatement
		2014			Adjustments
		Form 10-Q
	Assets
	Current assets:
	Cash and cash equivalents	$	26,747		$	(1,630	)	$	25,117
	Restricted cash		19,270			—			19,270
	Trade accounts receivable, less allowances of $8,841 at March 31, 2014		76,917			(3,470	)		73,447
	Inventories		92,753			(22,076	)		70,677
	Deferred income taxes		33,956			6,051			40,007
	Prepaid expenses and other current assets		28,781			2,269			31,050
	Total current assets		278,424			(18,856	)		259,568
	Property, plant and equipment, net		52,532			124			52,656
	Patents and other intangible assets, net		8,518			—			8,518
	Goodwill		53,565			—			53,565
	Deferred income taxes		18,758			4,058			22,816
	Other long-term assets		6,743			107			6,850
	Total assets	$	418,540		$	(14,567	)	$	403,973
	Liabilities and shareholders’ equity
	Current liabilities:
	Trade accounts payable	$	14,022		$	—		$	14,022
	Other current liabilities		41,467			2,233			43,700
	Total current liabilities		55,489			2,233			57,722
	Long-term debt		20,000			—			20,000
	Deferred income taxes		13,307			(106	)		13,201
	Other long-term liabilities		12,487			—			12,487
	Total liabilities		101,283			2,127			103,410
	Contingencies (Note 16)
	Shareholders’ equity:
	Common shares $0.10 par value; 50,000,000 shares authorized; 18,365,910 issued and outstanding as of March 31, 2014		1,836			—			1,836
	Additional paid-in capital		223,630			(274	)		223,356
	Retained earnings		88,550			(17,161	)		71,389
	Accumulated other comprehensive income		3,241			741			3,982
	Total shareholders’ equity		317,257			(16,694	)		300,563
	Total liabilities and shareholders’ equity	$	418,540		$	(14,567	)	$	403,973
	The effects of the Further Restatement on our condensed consolidated balance sheet as of December 31, 2013 are as follows:
		As of December 31, 2013
	(Unaudited, U.S. Dollars, in thousands, except share data)	Originally			Further			Restated
		Reported in			Restatement
		2014			Adjustments
		Form 10-Q
	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 at December 31, 2013		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 16)
Shareholders’ equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,102,335 issued and outstanding as of December 31, 2013		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
Effects of Further Restatement of Consolidated Statement of Operations and Comprehensive Income (Loss)	The effects of the Further Restatement on our condensed consolidated statement of operations and comprehensive loss for the three months ended March 31, 2014 are as follows:
		Three Months Ended March 31, 2014
	(Unaudited, U.S. Dollars, in thousands, except share and per share data)	Originally			Further			Restated
		Reported in 2014			Restatement
		Form 10-Q			Adjustments
	Product sales	$	89,684		$	(1,384	)	$	88,300
	Marketing service fees		11,658			56			11,714
	Net sales		101,342			(1,328	)		100,014
	Cost of sales		22,632			4,141			26,773
	Gross profit		78,710			(5,469	)		73,241
	Operating expenses
	Sales and marketing		43,871			(2,700	)		41,171
	General and administrative		17,545			(269	)		17,276
	Research and development		5,939			(6	)		5,933
	Amortization of intangible assets		584			—			584
	Costs related to the accounting review and restatement		8,306			—			8,306
			76,245			(2,975	)		73,270
	Operating income (loss)		2,465			(2,494	)		(29	)
	Other income and expense
	Interest expense, net		(486	)		18			(468	)
	Other (loss) income		(261	)		(11	)		(272	)
			(747	)		7			(740	)
	Income (loss) before income taxes		1,718			(2,487	)		(769	)
	Income tax expense		(1,940	)		761			(1,179	)
	Net loss from continuing operations		(222	)		(1,726	)		(1,948	)
	Discontinued operations (Note 15)
	Loss from discontinued operations		(794	)		—			(794	)
	Income tax benefit		234			—			234
	Net loss from discontinued operations		(560	)		—			(560	)
	Net loss	$	(782	)	$	(1,726	)	$	(2,508	)
	Net loss per common share—basic:
	Net loss from continuing operations	$	(0.01	)	$	(0.10	)	$	(0.11	)
	Net loss from discontinued operations		(0.03	)		—			(0.03	)
	Net loss per common share—basic	$	(0.04	)	$	(0.10	)	$	(0.14	)
	Net loss per common share—diluted:
	Net loss from continuing operations	$	(0.01	)	$	(0.10	)	$	(0.11	)
	Net loss from discontinued operations		(0.03	)		—			(0.03	)
	Net loss per common share—diluted	$	(0.04	)	$	(0.10	)	$	(0.14	)
	Weighted average number of common shares:
	Basic		18,197,363			—			18,197,363
	Diluted		18,197,363			—			18,197,363
	Other comprehensive income:
	Unrealized gain (loss) on cross-currency swap, net of tax		103			—			103
	Foreign currency translation adjustment		439			(63	)		376
	Comprehensive loss	$	(240	)	$	(1,789	)	$	(2,029	)
	The effects of the Original Restatement and the Further Restatement on our condensed consolidated statement of operations and comprehensive income (loss) for the three months ended March 31, 2013 are as follows:
		Three Months Ended March 31, 2013
	(U.S. Dollars, in thousands, except share and per share data)	As Reported in the			Original			As Originally			Further			Restated
		2013 Form 10-Q			Restatement			Restated in the			Restatement
		Prior to Original			Adjustments			2013 Form 10-			Adjustments
		Restatement						Q/A
	Product sales	$	88,358		$	2,978		$	91,336			(1,095	)	$	90,241
	Marketing service fees		11,896			141			12,037			1			12,038
	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 expenses
	Sales and marketing		48,839			(3,785	)		45,054			790			45,844
	General and administrative		18,788			(458	)		18,330			(89	)		18,241
	Research and development		5,400			341			5,741			—			5,741
	Amortization of intangible assets		504			40			544			—			544
			73,531			(3,862	)		69,669			701			70,370
	Operating income		4,024			4,063			8,087			(2,019	)		6,068
	Other income and (expense)
Interest expense, net		(560	)		—			(560	)		18			(542	)
Other income		4,764			—			4,764			—			4,764
		4,204			—			4,204			18			4,222
Income before income taxes		8,228			4,063			12,291			(2,001	)		10,290
Income tax expense		(3,320	)		(1,361	)		(4,681	)		317			(4,364	)
Net income from continuing operations		4,908			2,702			7,610			(1,684	)		5,926
Discontinued operations (Note 15)
Loss from discontinued operations		(4,432	)		(2	)		(4,434	)		474			(3,960	)
Income tax benefit (expense)		1,640			(316	)		1,324			157			1,481
Net loss from discontinued operations		(2,792	)		(318	)		(3,110	)		631			(2,479	)
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			(0.09	)	$	0.3
Net loss from discontinued operations		(0.14	)		(0.02	)		(0.16	)		0.04			(0.12	)
Net income per common share—basic	$	0.11		$	0.12		$	0.23			(0.05	)	$	0.18
Net income (loss) per common share—diluted:
Net income from continuing operations	$	0.25		$	0.14		$	0.39			(0.09	)	$	0.3
Net loss from discontinued operations		(0.14	)		(0.02	)		(0.16	)		0.04			(0.12	)
Net income per common share—diluted:	$	0.11		$	0.12		$	0.23			(0.05	)	$	0.18
Weighted average number of common shares:
Basic		19,431,093			—			19,431,093			—			19,431,093
Diluted		19,691,141			—			19,691,141			—			19,691,141
Other comprehensive (loss) income, before tax:
Unrealized gain on derivative instrument		(318	)		—			(318	)		—			(318	)
Translation adjustment		(2,814	)		106			(2,708	)		29			(2,679	)
Comprehensive (loss) income	$	(1,016	)	$	2,490		$	1,474		$	(1,024	)	$	450
Effects of Further Restatement of Condensed Consolidated Statement of Cash Flow	The effects of the Further Restatement on our condensed consolidated statement of cash flows for the three months ended March 31, 2014 are as follows:
		Three Months Ended
		31-Mar-14
	(Unaudited, U.S. Dollars, in thousands)	Originally			Further			Restated
		Reported in			Restatement
		2014 Form			Adjustments
		10-Q
	Cash flows from operating activities:
	Net loss	$	(782	)	$	(1,726	)	$	(2,508	)
	Adjustments to reconcile net loss to net cash used in operating activities:
	Depreciation and amortization		6,004			(258	)		5,746
	Amortization of debt costs		180			—			180
	Amortization of exclusivity agreements		346			—			346
	Provision for doubtful accounts		2,579			(2,471	)		108
	Deferred income taxes		(246	)		—			(246	)
	Share-based compensation		1,461			(274	)		1,187
	Excess income tax benefit on employee stock-based awards		(29	)		—			(29	)
	Other		166			(152	)		14
	Change in operating assets and liabilities:
	Trade accounts receivable		(3,780	)		1,173			(2,607	)
	Inventories		(1,690	)		4,177			2,487
	Prepaid expenses and other current assets		(2,806	)		(658	)		(3,464	)
	Trade accounts payable		(6,670	)		—			(6,670	)
	Other current liabilities		(4,761	)		155			(4,606	)
	Long-term assets		130			—			130
	Long-term liabilities		(280	)		—			(280	)
	Net cash used in operating activities		(10,178	)		(34	)		(10,212	)
	Cash flows from investing activities:
	Capital expenditures for property, plant and equipment		(3,691	)		—			(3,691	)
	Capital expenditures for intangible assets		(46	)		—			(46	)
	Sale of other investments		—			32			32
	Net cash used in investing activities		(3,737	)		32			(3,705	)
	Cash flows from financing activities:
	Net proceeds from issuance of common shares		5,542			—			5,542
	(Repayment of) proceeds from bank borrowings, net		—			—			—
	Changes in restricted cash		4,502			—			4,502
	Excess income tax benefit on employee stock-based awards		29			—			29
	Net cash provided by financing activities		10,073			—			10,073
	Effect of exchange rate changes on cash		103			(66	)		37
	Net decrease in cash and cash equivalents		(3,739	)		(68	)		(3,807	)
	Cash and cash equivalents at the beginning of the period		30,486			(1,562	)		28,924
	Cash and cash equivalents at the end of the period	$	26,747		$	(1,630	)	$	25,117
	The effects of the Original Restatement and the Further Restatement on our condensed consolidated statement of cash flows for the three months ended March 31, 2013 are as follows:
		Three Months Ended
		31-Mar-13
	(Unaudited, U.S. Dollars, in thousands)	As Reported			Original			As Originally			Further			Restated
		in the 2013			Restatement			Restated in			Restatement
		Form 10-Q			Adjustments			the 2013			Adjustments
		Prior to						Form 10-Q/A
		Original
		Restatement
	Cash flows from operating activities:
	Net income	$	2,116		$	2,384		$	4,500		$	(1,053	)	$	3,447
	Adjustments to reconcile net income to net cash provided by operating activities:
	Depreciation and amortization		4,995			34			5,029			38			5,067
	Amortization of debt costs		180			—			180			—			180
	Amortization of exclusivity agreements		311			—			311			—			311
	Provision for doubtful accounts		3,227			(1,853	)		1,374			(6	)		1,368
	Deferred income taxes		(744	)		738			(6	)		—			(6	)
	Share-based compensation		1,943			—			1,943			—			1,943
	Excess income tax benefit on employee stock-based awards		(78	)		—			(78	)		—			(78	)
	Other		(345	)		736			391			30			421
	Change in operating assets and liabilities:
	Trade accounts receivable		13,779			(5,190	)		8,589			1,076			9,665
Inventories		(4,230	)		2,130			(2,100	)		(6	)		(2,106	)
Prepaid expenses and other current assets		(179	)		2,874			2,695			2,148			4,843
Trade accounts payable		(7,242	)		(5	)		(7,247	)		—			(7,247	)
Other current liabilities		4,478			(2,408	)		2,070			(2,232	)		(162	)
Long-term assets		(2,014	)		461			(1,553	)		—			(1,553	)
Long-term liabilities		(743	)		(296	)		(1,039	)		—			(1,039	)
Net cash provided by operating activities		15,454			(395	)		15,059			(5	)		15,054
Cash flows from investing activities:
Capital expenditures for property, plant and equipment		(6,029	)		—			(6,029	)		—			(6,029	)
Capital expenditures for intangible assets		(439	)		395			(44	)		—			(44	)
Purchase of other investments		—			—			—			(506	)		(506	)
Net cash used in investing activities		(6,468	)		395			(6,073	)		(506	)		(6,579	)
Cash flows from financing activities:
Net proceeds from issuance of common shares		2,143			—			2,143			—			2,143
(Repayment of) proceeds from bank borrowings, net		(15	)		—			(15	)		—			(15	)
Changes in restricted cash		(8,141	)		—			(8,141	)		—			(8,141	)
Excess income tax benefit on employee stock-based awards		78			—			78			—			78
Net cash used in financing activities		(5,935	)		—			(5,935	)		—			(5,935	)
Effect of exchange rate changes on cash		(431	)		—			(431	)		(2	)		(433	)
Net increase in cash and cash equivalents		2,620			—			2,620			(513	)		2,107
Cash and cash equivalents at the beginning of the period		31,055			—			31,055			(288	)		30,767
Cash and cash equivalents at the end of the period	$	33,675		$	—		$	33,675			(801	)	$	32,874

Inventories_Tables

Inventories (Tables)	3 Months Ended
	Mar. 31, 2014
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories were as follows:
	(U.S. Dollars, in thousands)	March 31,		December 31,
		2014		2013
		(Restated)		(Restated)
	Raw materials	$	5,220	$	6,515
	Work-in-process		7,412		6,606
	Finished products		51,190		51,991
	Deferred cost of sales		6,855		7,566
	Total Inventory	$	70,677	$	72,678

Patents_and_other_intangible_a1

Patents and other intangible assets (Tables)	3 Months Ended
	Mar. 31, 2014
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Patents and Other Intangible Assets
	(U.S. Dollars, in thousands)	March 31,			December 31,
		2014			2013
	Cost
	Patents	$	34,815		$	34,820
	Trademarks — definite lived		645			620
	Licenses and other		7,748			7,748
			43,208			43,188
	Accumulated amortization
	Patents		(32,170	)		(31,739	)
	Trademarks — definite lived		(484	)		(454	)
	Licenses and other		(2,036	)		(1,949	)
			(34,690	)		(34,142	)
	Patents and other intangible assets, net	$	8,518		$	9,046

Goodwill_Tables

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2014
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Changes in Net Carrying Amount of Goodwill	The following table presents the net carrying value of goodwill by reportable segment as of March 31, 2014 and December 31, 2013.
	(U.S. Dollars, in thousands)	March 31,		December 31,
		2014		2013
	BioStim	$	42,678	$	42,678
	Biologics		10,887		10,887
	Total goodwill	$	53,565	$	53,565

Derivative_instruments_Tables

Derivative instruments (Tables)	3 Months Ended
	Mar. 31, 2014
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
	As of March 31, 2014	(unfavorable)
	Cross-currency swap	$	(1,035	)		Other long-term liabilities
	Warrants	$	107			Other long-term assets
	As of December 31, 2013
	Cross-currency swap	$	(1,036	)		Other long-term liabilities
	Warrants	$	107			Other long-term assets
Schedule of Gain (Loss) Recognized on Derivative Instruments
		Three Months Ended
		March 31,
	(U.S. Dollars, in thousands)	2014			2013
	Cross-currency swap unrealized gain (loss) recorded in other comprehensive income (loss), net of taxes	$	103		$	(318	)

Fair_value_measurements_Tables

Fair value measurements (Tables)	3 Months Ended
	Mar. 31, 2014
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
			March 31,
			2014
	Assets						(Restated1)
	Collective trust funds		$	1,652		$	—	$	1,652		$	—
	Treasury securities			661			661		—			—
	Certificates of deposit			1,630			1,630		—			—
	Derivative securities			107			—		107			—
	Total		$	4,050		$	2,291	$	1,759		$	—
	Liabilities
	Deferred compensation plan		$	(1,970	)	$	—	$	(1,970	)	$	—
	Derivative securities			(1,035	)		—		(1,035	)		—
	Total		$	(3,005	)	$	—	$	(3,005	)	$	—
	(U.S. Dollars in thousands)		Balance			Level 1		Level 2			Level 3
			December 31,
			2013
	Assets						(Restated1)
	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	)	$	—
	-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.

Accumulated_other_comprehensiv1

Accumulated other comprehensive income (Tables)	3 Months Ended
	Mar. 31, 2014
Equity [Abstract]
Components of Changes in Accumulated Other Comprehensive Income	The components of and changes in accumulated other comprehensive income were as follows:
	(U.S. Dollars, in thousands)		Foreign		Change			Accumulated
			Currency		in			Other
			Translation		Fair Value			Comprehensive
			Adjustments					Income
			(Restated)		(Restated)			(Restated)
	Balance at December 31, 2013		$	3,651	$	(148	)	$	3,503
	Unrealized gain on cross-currency swap and warrants, net of tax of $25			—		103			103
	Foreign currency translation adjustment (1)			376		—			376
	Balance at March 31, 2014		$	4,027	$	(45	)	$	3,982
	-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.

Earnings_per_share_Tables

Earnings per share (Tables)	3 Months Ended
	Mar. 31, 2014
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.
		Three Months Ended
		March 31,
		2014		2013
	Weighted average common shares-basic		18,197,363		19,431,093
	Effect of dilutive securities:
	Unexercised stock options net of treasury share repurchase		—		260,048
	Weighted average common shares-diluted		18,197,363		19,691,141

Sharebased_compensation_Tables

Share-based compensation (Tables)	3 Months Ended
	Mar. 31, 2014
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 condensed consolidated statements of operations:
		Three Months Ended
		March 31,
	(U.S. Dollars, in thousands)	2014		2013
	Cost of sales	$	29	$	287
	Sales and marketing		444		436
	General and administrative		642		1,175
	Research and development		72		45
	Total	$	1,187	$	1,943

Business_segment_information_T

Business segment information (Tables)	3 Months Ended
	Mar. 31, 2014
Segment Reporting [Abstract]
Schedule of External Net Sales by SBU Reporting Segment	The table below presents external net sales by SBU reporting segment (amounts reported for prior periods have been reclassified to conform to our new segment reporting structure). Net sales include product sales and marketing service fees. Marketing service fees, which are recorded on a net basis, are comprised of fees earned for the marketing of Trinity Evolution®, Trinity ELITE® and Versashield™ in our Biologics segment.
		External Net Sales by SBU
		Three Months Ended March 31,
	(U.S. Dollars, in thousands)	2014			2013			Reported			Constant
								Decline			Currency
											Decline
		(Restated)			(Restated)			(Restated)			(Restated)
	BioStim	$	37,137		$	37,226			—			—
	Biologics		13,010			13,360			(3	)%		(3	)%
	Extremity Fixation		27,066			26,197			3	%		4	%
	Spine Fixation		22,801			25,496			(11	)%		(11	)%
	Total Net Sales	$	100,014		$	102,279			(2	)%		(2	)%
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	Three Months Ended
		March 31,
	(U.S. Dollars, in thousands)	2014			2013
		(Restated)			(Restated)
	Net margin:
	BioStim	$	15,020		$	17,183
	Biologics		6,502			6,018
	Extremity Fixation		6,933			5,642
	Spine Fixation		4,059			2,176
	Corporate		(444	)		(425	)
	Total net margin		32,070			30,594
	General and administrative		17,276			18,241
	Research and development		5,933			5,741
	Amortization of intangible assets		584			544
	Costs related to the accounting review and restatement		8,306			—
	Operating (loss) income	$	(29	)	$	6,068

Original_and_Further_Restateme2

Original and Further Restatement of the Consolidated Financial Statements - Additional Information (Detail) (USD $)	3 Months Ended		0 Months Ended	12 Months Ended	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013	Dec. 31, 2013	Dec. 31, 2014	Sep. 30, 2014
	Facilities
Decrease in accounts receivables, net	$2,607,000	($9,665,000)
Number of manufacturing facilities	2
Decrease in accounts receivables	-2,487,000	2,106,000
(Loss) income before income taxes	-769,000	10,290,000
Inventory Reserves [Member]
Decrease in accounts receivables	-16,400,000		-14,400,000
Inventory Existence [Member]
Decrease in accounts receivables	-1,200,000		-1,000,000
Cost of sales [Member] | Inventory Reserves [Member]
Adjustments due to correction	2,400,000	800,000
Cost of sales [Member] | Inventory Existence [Member]
Adjustments due to correction	200,000	100,000
Co-Pay and Self-Pay Revenue [Member] | Bad Debt Expense [Member]
Reduction due to error correction	1.4
Co-Pay and Self-Pay Revenue [Member] | Bad Debt Expense And Revenue [Member]
Reduction due to error correction	2.8
Co-Pay and Self-Pay Revenue [Member] | Sales and marketing [Member]
Adjustments due to correction	1,400,000	1,500,000
Bad Debt Timing [Member] | Sales and marketing [Member]
Adjustments due to correction	0	1,500,000
Other Adjustments [Member]
(Loss) income before income taxes	-1,600,000	-300,000
Intercompany Profit [Member]
Decrease in accounts receivables	-5,500,000		-2,600,000
Intercompany Profit [Member] | Cost of sales [Member]
Adjustments due to correction	3,000,000	-100,000
Accounts Receivable Reserve [Member]
Increase (decrease) in operating income loss	-1,500,000	400,000
Decrease in accounts receivables, net	($2,800,000)			($4,200,000)
Scenario, Forecast [Member] | Inventory Existence [Member]
Percentage of field inventory counted					90.00%	90.00%

Original_and_Further_Restateme3

Original and Further Restatement of the Consolidated Financial Statements - Schedule of Restatement to Previously Filed Consolidated Income Statements (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Net sales	$100,014	$102,279
Cost of sales	26,773	25,841
Gross profit	73,241	76,438
Operating expenses
Sales and marketing	41,171	45,844
General and administrative	17,276	18,241
Research and development	5,933	5,741
Amortization of intangible assets	584	544
Costs related to the accounting review and restatement	8,306
Total operating expenses	73,270	70,370
Operating (loss) income	-29	6,068
Other income and (expense)	-740	4,222
Income (loss) before income taxes	-769	10,290
Income tax expense	-1,179	-4,364
Net (loss) income from continuing operations	-1,948	5,926
Previously Reported [Member]
Net sales		100,254
Cost of sales		22,699
Gross profit		77,555
Operating expenses
Sales and marketing		48,839
General and administrative		18,788
Research and development		5,400
Amortization of intangible assets		504
Total operating expenses		73,531
Operating (loss) income		4,024
Other income and (expense)		4,204
Income (loss) before income taxes		8,228
Income tax expense		-3,320
Net (loss) income from continuing operations		4,908
Other Adjustments [Member]
Operating expenses
Income (loss) before income taxes	-1,600	-300
Further Restatement [Member]
Net sales	100,014	102,279
Cost of sales	-26,773	-25,841
Gross profit	73,241	76,438
Operating expenses
Sales and marketing	41,171	-45,844
General and administrative	17,276	-18,241
Research and development	5,933	-5,741
Amortization of intangible assets	584	-544
Costs related to the accounting review and restatement	8,306
Total operating expenses	73,270	-70,370
Operating (loss) income	-29	6,068
Other income and (expense)	-740	4,222
Income (loss) before income taxes	-769	10,290
Income tax expense	-1,179	-4,364
Net (loss) income from continuing operations	-1,948	5,926
Further Restatement [Member] | Previously Reported [Member]
Net sales	101,342	103,373
Cost of sales	-22,632	-25,617
Gross profit	78,710	77,756
Operating expenses
Sales and marketing	43,871	-45,054
General and administrative	17,545	-18,330
Research and development	5,939	-5,741
Amortization of intangible assets	584	-544
Costs related to the accounting review and restatement	8,306
Total operating expenses	76,245	-69,669
Operating (loss) income	2,465	8,087
Other income and (expense)	-747	4,204
Income (loss) before income taxes	1,718	12,291
Income tax expense	-1,940	-4,681
Net (loss) income from continuing operations	-222	7,610
Further Restatement [Member] | Co-Pay and Self-Pay Revenue [Member]
Net sales	-2,800	-1,453
Cost of sales
Gross profit	-2,800	-1,453
Operating expenses
Sales and marketing	-2,800	1,453
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses	-2,800	1,453
Operating (loss) income
Other income and (expense)
Income (loss) before income taxes
Income tax expense
Net (loss) income from continuing operations
Further Restatement [Member] | Bad Debt Timing [Member]
Net sales
Cost of sales
Gross profit
Operating expenses
Sales and marketing		-1,455
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses		-1,455
Operating (loss) income		-1,455
Other income and (expense)
Income (loss) before income taxes		-1,455
Income tax expense		509
Net (loss) income from continuing operations		-946
Further Restatement [Member] | Accounts Receivable Reserve [Member]
Net sales	1,651	437
Cost of sales
Gross profit	1,651	437
Operating expenses
Sales and marketing	201	8
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses	201	8
Operating (loss) income	1,450	445
Other income and (expense)
Income (loss) before income taxes	1,450	445
Income tax expense	-508	-156
Net (loss) income from continuing operations	942	289
Further Restatement [Member] | Intercompany Profit [Member]
Net sales
Cost of sales	-2,966	120
Gross profit	-2,966	120
Operating expenses
Sales and marketing
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses
Operating (loss) income	-2,966	120
Other income and (expense)
Income (loss) before income taxes	-2,966	120
Income tax expense	1,039	-42
Net (loss) income from continuing operations	-1,927	78
Further Restatement [Member] | Inventory [Member]
Net sales
Cost of sales	-2,564	-820
Gross profit	-2,564	-820
Operating expenses
Sales and marketing
General and administrative
Research and development
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses
Operating (loss) income	-2,564	-820
Other income and (expense)
Income (loss) before income taxes	-2,564	-820
Income tax expense	898	287
Net (loss) income from continuing operations	-1,666	-533
Further Restatement [Member] | Other Adjustments [Member]
Net sales	-179	-78
Cost of sales	1,389	476
Gross profit	-1,210	398
Operating expenses
Sales and marketing	-101	-796
General and administrative	-269	89
Research and development	-6
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses	-376	-707
Operating (loss) income	1,586	-309
Other income and (expense)	7	18
Income (loss) before income taxes	1,593	-291
Income tax expense	-668	-281
Net (loss) income from continuing operations	925	-572
Further Restatement [Member] | Total Adjustments [Member]
Net sales	-1,328	-1,094
Cost of sales	-4,141	-224
Gross profit	-5,469	-1,318
Operating expenses
Sales and marketing	-2,700	-790
General and administrative	-269	89
Research and development	-6
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses	-2,975	-701
Operating (loss) income	-2,494	-2,019
Other income and (expense)	7	18
Income (loss) before income taxes	-2,487	-2,001
Income tax expense	761	317
Net (loss) income from continuing operations	-1,726	-1,684
Original Restatement [Member]
Net sales		103,373
Cost of sales		25,617
Gross profit		77,756
Operating expenses
Sales and marketing		45,054
General and administrative		18,330
Research and development		5,741
Amortization of intangible assets		544
Charges related to U.S. Government resolutions
Total operating expenses		69,669
Operating (loss) income		8,087
Other income and (expense)		4,204
Income (loss) before income taxes		12,291
Income tax expense		-4,681
Net (loss) income from continuing operations		7,610
Original Restatement [Member] | Royalties [Member]
Net sales
Cost of sales		2,030
Gross profit		-2,030
Operating expenses
Sales and marketing		-2,030
General and administrative
Research and development
Amortization of intangible assets
Charges related to U.S. Government resolutions
Total operating expenses		-2,030
Operating (loss) income
Other income and (expense)
Income (loss) before income taxes
Income tax expense
Net (loss) income from continuing operations
Original Restatement [Member] | Distributor Revenue [Member]
Net sales		2,963
Cost of sales		471
Gross profit		2,492
Operating expenses
Sales and marketing		-2,073
General and administrative
Research and development
Amortization of intangible assets
Charges related to U.S. Government resolutions
Total operating expenses		-2,073
Operating (loss) income		4,565
Other income and (expense)
Income (loss) before income taxes		4,565
Income tax expense		-1,529
Net (loss) income from continuing operations		3,036
Original Restatement [Member] | Inventory Reserves [Member]
Net sales
Cost of sales		86
Gross profit		-86
Operating expenses
Sales and marketing
General and administrative
Research and development
Amortization of intangible assets
Charges related to U.S. Government resolutions
Total operating expenses
Operating (loss) income		-86
Other income and (expense)
Income (loss) before income taxes		-86
Income tax expense		29
Net (loss) income from continuing operations		-57
Original Restatement [Member] | Previously Reported [Member]
Net sales		100,254
Cost of sales		22,699
Gross profit		77,555
Operating expenses
Sales and marketing		48,839
General and administrative		18,788
Research and development		5,400
Amortization of intangible assets		504
Charges related to U.S. Government resolutions
Total operating expenses		73,531
Operating (loss) income		4,024
Other income and (expense)		4,204
Income (loss) before income taxes		8,228
Income tax expense		-3,320
Net (loss) income from continuing operations		4,908
Original Restatement [Member] | Other Adjustments [Member]
Net sales		156
Cost of sales		331
Gross profit		-175
Operating expenses
Sales and marketing		318
General and administrative		-458
Research and development		341
Amortization of intangible assets		40
Charges related to U.S. Government resolutions
Total operating expenses		241
Operating (loss) income		-416
Other income and (expense)
Income (loss) before income taxes		-416
Income tax expense		139
Net (loss) income from continuing operations		-277
Original Restatement [Member] | Total Adjustments [Member]
Net sales		3,119
Cost of sales		2,918
Gross profit		201
Operating expenses
Sales and marketing		-3,785
General and administrative		-458
Research and development		341
Amortization of intangible assets		40
Charges related to U.S. Government resolutions
Total operating expenses		-3,862
Operating (loss) income		4,063
Other income and (expense)
Income (loss) before income taxes		4,063
Income tax expense		-1,361
Net (loss) income from continuing operations		$2,702

Original_and_Further_Restateme4

Original and Further Restatement of the Consolidated Financial Statements - Effects of Restatements on Condensed Consolidated Balance Sheet (Detail) (USD $)	Mar. 31, 2014		Dec. 31, 2013	Mar. 31, 2013	Dec. 31, 2012
In Thousands, unless otherwise specified
Current assets:
Cash and cash equivalents	$25,117	[1]	$28,924	$32,874	$30,767
Restricted cash	19,270	[1]	23,761
Trade accounts receivable, less allowances of $8,841 and $9,111 at March 31, 2014 and December 31, 2013, respectively	73,447	[1]	70,811
Inventories	70,677	[1]	72,678
Deferred income taxes	40,007	[1]	39,999
Prepaid expenses and other current assets	31,050	[1]	28,933
Total current assets	259,568	[1]	265,106
Property, plant and equipment, net	52,656	[1]	54,372
Patents and other intangible assets, net	8,518	[1]	9,046
Goodwill	53,565	[1]	53,565
Deferred income taxes	22,816	[1]	22,394
Other long-term assets	6,850	[1]	7,492
Total assets	403,973	[1]	411,975
Current liabilities:
Trade accounts payable	14,022	[1]	20,674
Other current liabilities	43,700	[1]	49,676
Total current liabilities	57,722	[1]	70,350
Long-term debt	20,000	[1]	20,000
Deferred income taxes	13,201	[1]	13,026
Other long-term liabilities	12,487	[1]	12,736
Total liabilities	103,410	[1]	116,112
Contingencies (Note 16)		[1]
Shareholders' equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,365,910 and 18,102,335 issued and outstanding as of March 31, 2014 and December 31, 2013, respectively	1,836	[1]	1,810
Additional paid-in capital	223,356	[1]	216,653
Retained earnings	71,389	[1]	73,897
Accumulated other comprehensive income	3,982	[1]	3,503
Total shareholders' equity	300,563	[1]	295,863
Total liabilities and shareholders' equity	403,973	[1]	411,975
Further Restatement [Member]
Current assets:
Cash and cash equivalents	25,117		28,924	32,874	30,767
Restricted cash	19,270		23,761
Trade accounts receivable, less allowances of $8,841 and $9,111 at March 31, 2014 and December 31, 2013, respectively	73,447		70,811
Inventories	70,677		72,678
Deferred income taxes	40,007		39,999
Prepaid expenses and other current assets	31,050		28,933
Total current assets	259,568		265,106
Property, plant and equipment, net	52,656		54,372
Patents and other intangible assets, net	8,518		9,046
Goodwill	53,565		53,565
Deferred income taxes	22,816		22,394
Other long-term assets	6,850		7,492
Total assets	403,973		411,975
Current liabilities:
Trade accounts payable	14,022		20,674
Other current liabilities	43,700		49,676
Total current liabilities	57,722		70,350
Long-term debt	20,000		20,000
Deferred income taxes	13,201		13,026
Other long-term liabilities	12,487		12,736
Total liabilities	103,410		116,112
Contingencies (Note 16)
Shareholders' equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,365,910 and 18,102,335 issued and outstanding as of March 31, 2014 and December 31, 2013, respectively	1,836		1,810
Additional paid-in capital	223,356		216,653
Retained earnings	71,389		73,897
Accumulated other comprehensive income	3,982		3,503
Total shareholders' equity	300,563		295,863
Total liabilities and shareholders' equity	403,973		411,975
Originally Reported [Member] | Further Restatement [Member]
Current assets:
Cash and cash equivalents	26,747		30,486	33,675	31,055
Restricted cash	19,270		23,761
Trade accounts receivable, less allowances of $8,841 and $9,111 at March 31, 2014 and December 31, 2013, respectively	76,917		75,567
Inventories	92,753		90,577
Deferred income taxes	33,956		33,947
Prepaid expenses and other current assets	28,781		25,906
Total current assets	278,424		280,244
Property, plant and equipment, net	52,532		54,606
Patents and other intangible assets, net	8,518		9,046
Goodwill	53,565		53,565
Deferred income taxes	18,758		18,336
Other long-term assets	6,743		7,385
Total assets	418,540		423,182
Current liabilities:
Trade accounts payable	14,022		20,674
Other current liabilities	41,467		46,146
Total current liabilities	55,489		66,820
Long-term debt	20,000		20,000
Deferred income taxes	13,307		13,132
Other long-term liabilities	12,487		12,736
Total liabilities	101,283		112,688
Contingencies (Note 16)
Shareholders' equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,365,910 and 18,102,335 issued and outstanding as of March 31, 2014 and December 31, 2013, respectively	1,836		1,810
Additional paid-in capital	223,630		216,653
Retained earnings	88,550		89,332
Accumulated other comprehensive income	3,241		2,699
Total shareholders' equity	317,257		310,494
Total liabilities and shareholders' equity	418,540		423,182
Further Restatement Adjustments [Member] | Further Restatement [Member]
Current assets:
Cash and cash equivalents	-1,630		-1,562	-801	-288
Restricted cash
Trade accounts receivable, less allowances of $8,841 and $9,111 at March 31, 2014 and December 31, 2013, respectively	-3,470		-4,756
Inventories	-22,076		-17,899
Deferred income taxes	6,051		6,052
Prepaid expenses and other current assets	2,269		3,027
Total current assets	-18,856		-15,138
Property, plant and equipment, net	124		-234
Patents and other intangible assets, net
Goodwill
Deferred income taxes	4,058		4,058
Other long-term assets	107		107
Total assets	-14,567		-11,207
Current liabilities:
Trade accounts payable
Other current liabilities	2,233		3,530
Total current liabilities	2,233		3,530
Long-term debt
Deferred income taxes	-106		-106
Other long-term liabilities
Total liabilities	2,127		3,424
Contingencies (Note 16)
Shareholders' equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,365,910 and 18,102,335 issued and outstanding as of March 31, 2014 and December 31, 2013, respectively
Additional paid-in capital	-274
Retained earnings	-17,161		-15,435
Accumulated other comprehensive income	741		804
Total shareholders' equity	-16,694		-14,631
Total liabilities and shareholders' equity	($14,567)		($11,207)
[1]	Unaudited

Original_and_Further_Restateme5

Original and Further Restatement of the Consolidated Financial Statements - Effects of Restatements on Condensed Consolidated Balance Sheet (Parenthetical) (Detail) (USD $)	Mar. 31, 2014		Dec. 31, 2013
In Thousands, except Share data, unless otherwise specified
Trade accounts receivable, allowances	$8,841	[1]	$9,111
Common shares, par value	$0.10	[1]	$0.10
Common shares, authorized	50,000,000	[1]	50,000,000
Common shares, issued	18,365,910	[1]	18,102,335
Common shares, outstanding	18,365,910	[1]	18,102,335
Further Restatement [Member]
Trade accounts receivable, allowances	8,841		9,111
Common shares, par value	$0.10		$0.10
Common shares, authorized	50,000,000		50,000,000
Common shares, issued	18,365,910		18,102,335
Common shares, outstanding	18,365,910		18,102,335
Originally Reported [Member] | Further Restatement [Member]
Trade accounts receivable, allowances	8,841		9,111
Common shares, par value	$0.10		$0.10
Common shares, authorized	50,000,000		50,000,000
Common shares, issued	18,365,910		18,102,335
Common shares, outstanding	18,365,910		18,102,335
Further Restatement Adjustments [Member] | Further Restatement [Member]
Trade accounts receivable, allowances	$8,841		$9,111
[1]	Unaudited

Original_and_Further_Restateme6

Original and Further Restatement of the Consolidated Financial Statements - Effects of Restatements of Condensed Consolidated Statement of Operations and Comprehensive Income (Loss) (Detail) (USD $)	3 Months Ended
In Thousands, except Share data, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Product sales	$88,300	$90,241
Marketing service fees	11,714	12,038
Net sales	100,014	102,279
Cost of sales	26,773	25,841
Gross profit	73,241	76,438
Operating expenses
Sales and marketing	41,171	45,844
General and administrative	17,276	18,241
Research and development	5,933	5,741
Amortization of intangible assets	584	544
Costs related to the accounting review and restatement	8,306
Total operating expenses	73,270	70,370
Operating (loss) income	-29	6,068
Other income and (expense)
Interest expense, net	-468	-542
Other (loss) income	-272	4,764
Total other income (expense)	-740	4,222
(Loss) income before income taxes	-769	10,290
Income tax expense	-1,179	-4,364
Net (loss) income from continuing operations	-1,948	5,926
Discontinued operations (Note 15)
Loss from discontinued operations	-794	-3,960
Income tax benefit	234	1,481
Net loss from discontinued operations	-560	-2,479
Net (loss) income	-2,508	3,447
Net income (loss) per common share-basic:
Net (loss) income from continuing operations	($0.11)	$0.30
Net loss from discontinued operations	($0.03)	($0.12)
Net (loss) income per common share-basic	($0.14)	$0.18
Net income (loss) per common share-diluted:
Net (loss) income from continuing operations	($0.11)	$0.30
Net loss from discontinued operations	($0.03)	($0.12)
Net (loss) income per common share-diluted	($0.14)	$0.18
Weighted average number of common shares:
Basic	18,197,363	19,431,093
Diluted	18,197,363	19,691,141
Other comprehensive income, before tax:
Unrealized gain (loss) on cross-currency swap, net of tax	103	-318
Unrealized gain on derivative instrument		-318
Foreign currency translation adjustment	376	-2,679
Comprehensive (loss) income	-2,029	450
Originally Reported [Member]
Product sales	89,684
Marketing service fees	11,658
Net sales	101,342
Cost of sales	22,632
Gross profit	78,710
Operating expenses
Sales and marketing	43,871
General and administrative	17,545
Research and development	5,939
Amortization of intangible assets	584
Costs related to the accounting review and restatement	8,306
Total operating expenses	76,245
Operating (loss) income	2,465
Other income and (expense)
Interest expense, net	-486
Other (loss) income	-261
Total other income (expense)	-747
(Loss) income before income taxes	1,718
Income tax expense	-1,940
Net (loss) income from continuing operations	-222
Discontinued operations (Note 15)
Loss from discontinued operations	-794
Income tax benefit	234
Net loss from discontinued operations	-560
Net (loss) income	-782
Net income (loss) per common share-basic:
Net (loss) income from continuing operations	($0.01)
Net loss from discontinued operations	($0.03)
Net (loss) income per common share-basic	($0.04)
Net income (loss) per common share-diluted:
Net (loss) income from continuing operations	($0.01)
Net loss from discontinued operations	($0.03)
Net (loss) income per common share-diluted	($0.04)
Weighted average number of common shares:
Basic	18,197,363
Diluted	18,197,363
Other comprehensive income, before tax:
Unrealized gain (loss) on cross-currency swap, net of tax	103
Foreign currency translation adjustment	439
Comprehensive (loss) income	-240
Further Restatement Adjustments [Member]
Product sales	-1,384	-1,095
Marketing service fees	56	1
Net sales	-1,328	-1,094
Cost of sales	4,141	224
Gross profit	-5,469	-1,318
Operating expenses
Sales and marketing	-2,700	790
General and administrative	-269	-89
Research and development	-6
Amortization of intangible assets
Costs related to the accounting review and restatement
Total operating expenses	-2,975	701
Operating (loss) income	-2,494	-2,019
Other income and (expense)
Interest expense, net	18	-18
Other (loss) income	-11
Total other income (expense)	7	-18
(Loss) income before income taxes	-2,487	-2,001
Income tax expense	761	317
Net (loss) income from continuing operations	-1,726	-1,684
Discontinued operations (Note 15)
Loss from discontinued operations		474
Income tax benefit		157
Net loss from discontinued operations		631
Net (loss) income	-1,726	-1,053
Net income (loss) per common share-basic:
Net (loss) income from continuing operations	($0.10)	($0.09)
Net loss from discontinued operations		$0.04
Net (loss) income per common share-basic	($0.10)	($0.05)
Net income (loss) per common share-diluted:
Net (loss) income from continuing operations	($0.10)	($0.09)
Net loss from discontinued operations		$0.04
Net (loss) income per common share-diluted	($0.10)	($0.05)
Weighted average number of common shares:
Basic
Diluted
Other comprehensive income, before tax:
Unrealized gain (loss) on cross-currency swap, net of tax
Unrealized gain on derivative instrument
Foreign currency translation adjustment	-63	29
Comprehensive (loss) income	-1,789	-1,024
Previously Reported [Member]
Product sales		88,358
Marketing service fees		11,896
Net sales		100,254
Cost of sales		22,699
Gross profit		77,555
Operating expenses
Sales and marketing		48,839
General and administrative		18,788
Research and development		5,400
Amortization of intangible assets		504
Total operating expenses		73,531
Operating (loss) income		4,024
Other income and (expense)
Interest expense, net		-560
Other (loss) income		4,764
Total other income (expense)		4,204
(Loss) income before income taxes		8,228
Income tax expense		-3,320
Net (loss) income from continuing operations		4,908
Discontinued operations (Note 15)
Loss from discontinued operations		-4,432
Income tax benefit		1,640
Net loss from discontinued operations		-2,792
Net (loss) income		2,116
Net income (loss) per common share-basic:
Net (loss) income from continuing operations		$0.25
Net loss from discontinued operations		($0.14)
Net (loss) income per common share-basic		$0.11
Net income (loss) per common share-diluted:
Net (loss) income from continuing operations		$0.25
Net loss from discontinued operations		($0.14)
Net (loss) income per common share-diluted		$0.11
Weighted average number of common shares:
Basic		19,431,093
Diluted		19,691,141
Other comprehensive income, before tax:
Unrealized gain on derivative instrument		-318
Foreign currency translation adjustment		-2,814
Comprehensive (loss) income		-1,016
Restatement Adjustments [Member]
Product sales		2,978
Marketing service fees		141
Net sales		3,119
Cost of sales		2,918
Gross profit		201
Operating expenses
Sales and marketing		-3,785
General and administrative		-458
Research and development		341
Amortization of intangible assets		40
Total operating expenses		-3,862
Operating (loss) income		4,063
Other income and (expense)
Interest expense, net
Other (loss) income
Total other income (expense)
(Loss) income before income taxes		4,063
Income tax expense		-1,361
Net (loss) income from continuing operations		2,702
Discontinued operations (Note 15)
Loss from discontinued operations		-2
Income tax benefit		-316
Net loss from discontinued operations		-318
Net (loss) income		2,384
Net income (loss) per common share-basic:
Net (loss) income from continuing operations		$0.14
Net loss from discontinued operations		($0.02)
Net (loss) income per common share-basic		$0.12
Net income (loss) per common share-diluted:
Net (loss) income from continuing operations		$0.14
Net loss from discontinued operations		($0.02)
Net (loss) income per common share-diluted		$0.12
Weighted average number of common shares:
Basic
Diluted
Other comprehensive income, before tax:
Unrealized gain on derivative instrument
Foreign currency translation adjustment		106
Comprehensive (loss) income		2,490
Original Restatement [Member]
Product sales		91,336
Marketing service fees		12,037
Net sales		103,373
Cost of sales		25,617
Gross profit		77,756
Operating expenses
Sales and marketing		45,054
General and administrative		18,330
Research and development		5,741
Amortization of intangible assets		544
Total operating expenses		69,669
Operating (loss) income		8,087
Other income and (expense)
Interest expense, net		-560
Other (loss) income		4,764
Total other income (expense)		4,204
(Loss) income before income taxes		12,291
Income tax expense		-4,681
Net (loss) income from continuing operations		7,610
Discontinued operations (Note 15)
Loss from discontinued operations		-4,434
Income tax benefit		1,324
Net loss from discontinued operations		-3,110
Net (loss) income		4,500
Net income (loss) per common share-basic:
Net (loss) income from continuing operations		$0.39
Net loss from discontinued operations		($0.16)
Net (loss) income per common share-basic		$0.23
Net income (loss) per common share-diluted:
Net (loss) income from continuing operations		$0.39
Net loss from discontinued operations		($0.16)
Net (loss) income per common share-diluted		$0.23
Weighted average number of common shares:
Basic		19,431,093
Diluted		19,691,141
Other comprehensive income, before tax:
Unrealized gain on derivative instrument		-318
Foreign currency translation adjustment		-2,708
Comprehensive (loss) income		$1,474

Original_and_Further_Restateme7

Original and Further Restatement of the Consolidated Financial Statements - Effects of Restatements of Condensed Consolidated Statement of Cash Flow (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014		Mar. 31, 2013
Cash flows from operating activities:
Net income	($2,508)		$3,447
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	5,746		5,067
Amortization of debt costs	180		180
Amortization of exclusivity agreements	346		311
Provision for doubtful accounts	108		1,368
Deferred income taxes	-246		-6
Share-based compensation	1,187		1,943
Excess income tax benefit on employee stock-based awards	-29		-78
Other	14		421
Change in operating assets and liabilities:
Trade accounts receivable	-2,607		9,665
Inventories	2,487		-2,106
Prepaid expenses and other current assets	-3,464		4,843
Trade accounts payable	-6,670		-7,247
Other current liabilities	-4,606		-162
Long-term assets	130		-1,553
Long-term liabilities	-280		-1,039
Net cash provided by operating activities	-10,212		15,054
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	-3,691		-6,029
Capital expenditures for intangible assets	-46		-44
Sale of other investments	32		-506
Net cash used in investing activities	-3,705		-6,579
Cash flows from financing activities:
Net proceeds from issuance of common shares	5,542		2,143
(Repayment of) proceeds from bank borrowings, net			-15
Changes in restricted cash	4,502		-8,141
Excess income tax benefit on employee stock-based awards	29		78
Net cash provided by financing activities	10,073		-5,935
Effect of exchange rate changes on cash	37		-433
Net decrease in cash and cash equivalents	-3,807		2,107
Cash and cash equivalents at the beginning of the period	28,924		30,767
Cash and cash equivalents at the end of the period	25,117	[1]	32,874
Originally Reported [Member]
Cash flows from operating activities:
Net income	-782
Restatement Adjustments [Member]
Cash flows from operating activities:
Net income			2,384
Original Restatement [Member]
Cash flows from operating activities:
Net income			4,500
Further Restatement Adjustments [Member]
Cash flows from operating activities:
Net income	-1,726		-1,053
Further Restatement [Member]
Cash flows from operating activities:
Net income	2,508		3,447
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	5,746		5,067
Amortization of debt costs	180		180
Amortization of exclusivity agreements	346		311
Provision for doubtful accounts	108		1,368
Deferred income taxes	-246		-6
Share-based compensation	1,187		1,943
Excess income tax benefit on employee stock-based awards	-29		-78
Other	14		421
Change in operating assets and liabilities:
Trade accounts receivable	-2,607		9,665
Inventories	2,487		-2,106
Prepaid expenses and other current assets	-3,464		4,843
Trade accounts payable	-6,670		-7,247
Other current liabilities	-4,606		-162
Long-term assets	130		-1,553
Long-term liabilities	-280		-1,039
Net cash provided by operating activities	-10,212		15,054
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	-3,691		-6,029
Capital expenditures for intangible assets	-46		-44
Sale of other investments	32
Purchase of other investments			-506
Net cash used in investing activities	-3,705		-6,579
Cash flows from financing activities:
Net proceeds from issuance of common shares	5,542		2,143
(Repayment of) proceeds from bank borrowings, net			-15
Changes in restricted cash	4,502		-8,141
Excess income tax benefit on employee stock-based awards	29		78
Net cash provided by financing activities	10,073		-5,935
Effect of exchange rate changes on cash	37		-433
Net decrease in cash and cash equivalents	-3,807		2,107
Cash and cash equivalents at the beginning of the period	28,924		30,767
Cash and cash equivalents at the end of the period	25,117		32,874
Further Restatement [Member] | Originally Reported [Member]
Cash flows from operating activities:
Net income	782		2,116
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	6,004		4,995
Amortization of debt costs	180		180
Amortization of exclusivity agreements	346		311
Provision for doubtful accounts	2,579		3,227
Deferred income taxes	-246		-744
Share-based compensation	1,461		1,943
Excess income tax benefit on employee stock-based awards	-29		-78
Other	166		-345
Change in operating assets and liabilities:
Trade accounts receivable	-3,780		13,779
Inventories	-1,690		-4,230
Prepaid expenses and other current assets	-2,806		-179
Trade accounts payable	-6,670		-7,242
Other current liabilities	-4,761		4,478
Long-term assets	130		-2,014
Long-term liabilities	-280		-743
Net cash provided by operating activities	-10,178		15,454
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	-3,691		-6,029
Capital expenditures for intangible assets	-46		-439
Net cash used in investing activities	-3,737		-6,468
Cash flows from financing activities:
Net proceeds from issuance of common shares	5,542		2,143
(Repayment of) proceeds from bank borrowings, net			-15
Changes in restricted cash	4,502		-8,141
Excess income tax benefit on employee stock-based awards	29		78
Net cash provided by financing activities	10,073		-5,935
Effect of exchange rate changes on cash	103		-431
Net decrease in cash and cash equivalents	-3,739		2,620
Cash and cash equivalents at the beginning of the period	30,486		31,055
Cash and cash equivalents at the end of the period	26,747		33,675
Further Restatement [Member] | Restatement Adjustments [Member]
Cash flows from operating activities:
Net income			2,384
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization			34
Provision for doubtful accounts			-1,853
Deferred income taxes			738
Other			736
Change in operating assets and liabilities:
Trade accounts receivable			-5,190
Inventories			2,130
Prepaid expenses and other current assets			2,874
Trade accounts payable			-5
Other current liabilities			-2,408
Long-term assets			461
Long-term liabilities			-296
Net cash provided by operating activities			-395
Cash flows from investing activities:
Capital expenditures for intangible assets			395
Net cash used in investing activities			395
Further Restatement [Member] | Original Restatement [Member]
Cash flows from operating activities:
Net income			4,500
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization			5,029
Amortization of debt costs			180
Amortization of exclusivity agreements			311
Provision for doubtful accounts			1,374
Deferred income taxes			-6
Share-based compensation			1,943
Excess income tax benefit on employee stock-based awards			-78
Other			391
Change in operating assets and liabilities:
Trade accounts receivable			8,589
Inventories			-2,100
Prepaid expenses and other current assets			2,695
Trade accounts payable			-7,247
Other current liabilities			2,070
Long-term assets			-1,553
Long-term liabilities			-1,039
Net cash provided by operating activities			15,059
Cash flows from investing activities:
Capital expenditures for property, plant and equipment			-6,029
Capital expenditures for intangible assets			-44
Net cash used in investing activities			-6,073
Cash flows from financing activities:
Net proceeds from issuance of common shares			2,143
(Repayment of) proceeds from bank borrowings, net			-15
Changes in restricted cash			-8,141
Excess income tax benefit on employee stock-based awards			78
Net cash provided by financing activities			-5,935
Effect of exchange rate changes on cash			-431
Net decrease in cash and cash equivalents			2,620
Cash and cash equivalents at the beginning of the period			31,055
Cash and cash equivalents at the end of the period			33,675
Further Restatement [Member] | Further Restatement Adjustments [Member]
Cash flows from operating activities:
Net income	1,726		-1,053
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	-258		38
Provision for doubtful accounts	-2,471		-6
Share-based compensation	-274
Other	-152		30
Change in operating assets and liabilities:
Trade accounts receivable	1,173		1,076
Inventories	4,177		-6
Prepaid expenses and other current assets	-658		2,148
Other current liabilities	155		-2,232
Net cash provided by operating activities	-34		-5
Cash flows from investing activities:
Sale of other investments	32
Purchase of other investments			-506
Net cash used in investing activities	32		-506
Cash flows from financing activities:
(Repayment of) proceeds from bank borrowings, net
Effect of exchange rate changes on cash	-66		-2
Net decrease in cash and cash equivalents	-68		-513
Cash and cash equivalents at the beginning of the period	-1,562		-288
Cash and cash equivalents at the end of the period	($1,630)		($801)
[1]	Unaudited

Inventories_Schedule_of_Invent

Inventories - Schedule of Inventories (Detail) (USD $)	Mar. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
Inventory Disclosure [Abstract]
Raw materials	$5,220		$6,515
Work-in-process	7,412		6,606
Finished products	51,190		51,991
Deferred cost of sales	6,855		7,566
Total Inventory	$70,677	[1]	$72,678
[1]	Unaudited

Recovered_Sheet1

Patents and Other Intangible Assets - Schedule of Patents and Other Intangibles Assets (Detail) (USD $)	Mar. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
Finite And Indefinite Lived Intangible Assets [Line Items]
Cost	$43,208		$43,188
Accumulated amortization	-34,690		-34,142
Patents and other intangible assets, net	8,518	[1]	9,046
Patents [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Cost	34,815		34,820
Accumulated amortization	-32,170		-31,739
Trademarks-definite lived [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Cost	645		620
Accumulated amortization	-484		-454
Licenses and other [Member]
Finite And Indefinite Lived Intangible Assets [Line Items]
Cost	7,748		7,748
Accumulated amortization	($2,036)		($1,949)
[1]	Unaudited

Goodwill_Additional_Informatio

Goodwill - Additional Information (Detail) (USD $)	1 Months Ended
In Millions, unless otherwise specified	Jul. 31, 2013	Mar. 31, 2014	Dec. 31, 2013
Goodwill [Line Items]
Impairment of goodwill	$19.20
Extremity Fixation [Member]
Goodwill [Line Items]
Accumulated impairment		9.8	9.8
Spine Fixation [Member]
Goodwill [Line Items]
Accumulated impairment		$9.40	$9.40

Goodwill_Schedule_of_Changes_i

Goodwill - Schedule of Changes in Net Carrying Amount of Goodwill (Detail) (USD $)	Mar. 31, 2014		Dec. 31, 2013
In Thousands, unless otherwise specified
Goodwill [Line Items]
Total Goodwill	$53,565	[1]	$53,565
BioStim [Member]
Goodwill [Line Items]
Total Goodwill	42,678		42,678
Biologics [Member]
Goodwill [Line Items]
Total Goodwill	$10,887		$10,887
[1]	Unaudited

Bank_Borrowings_Additional_Inf

Bank Borrowings - Additional Information (Detail)	Mar. 31, 2014	Mar. 31, 2014	Dec. 31, 2013	Dec. 31, 2013
	USD ($)	EUR (€)	USD ($)	EUR (€)
Equity Method Investments And Cost Method Investments [Abstract]
Amount outstanding under lines of credit	$0		$0
Maximum borrowing capacity	$8,000,000	€ 5,800,000	$8,000,000	€ 5,800,000

LongTerm_Debt_Additional_Infor

Long-Term Debt - Additional Information (Detail)

Mar. 31, 2014

Mar. 31, 2014

Dec. 31, 2013

Dec. 31, 2013

Mar. 31, 2014

Jan. 15, 2015

Dec. 31, 2013

Aug. 30, 2010

Mar. 31, 2014

Dec. 31, 2013

Aug. 30, 2010

Mar. 31, 2014

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

Dec. 31, 2013

Mar. 31, 2014

Dec. 31, 2013

USD ($)

EUR (€)

USD ($)

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]

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 ($)

LIBOR [Member]

LIBOR [Member]

USD ($)

USD ($)

USD ($)

Base rate [Member]

LIBOR [Member]

Base rate [Member]

LIBOR [Member]

LIBOR [Member]

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

€ 5,800,000

$8,000,000

€ 5,800,000

$200,000,000

Maximum borrowing capacity

100,000,000

Maximum additional borrowing capacity available

100,000,000

Amount outstanding

0

0

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

171,100,000

168,500,000

Restricted cash

19,270,000

[1]

23,761,000

Debt issuance costs incurred

5,000,000

Deferred debt issuance costs, net

$900,000

$1,100,000

[1]

Unaudited

Derivative_Instruments_Schedul

Derivative Instruments - Schedule of Fair Values of Derivative Instruments (Detail) (USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Other long-term liabilities [Member] | Cross-currency swap [Member]
Derivatives, Fair Value [Line Items]
Fair value: favorable (unfavorable)	($1,035)	($1,036)
Other Noncurrent Assets [Member] | Warrants [Member]
Derivatives, Fair Value [Line Items]
Fair value: favorable (unfavorable)	$107	$107

Derivative_Instruments_Schedul1

Derivative Instruments - Schedule of Gain (Loss) Recognized on Derivative Instruments (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Derivative Instruments [Line Items]
Cross-currency swap unrealized gain (loss) recorded in other comprehensive income (loss), net of taxes	$103	($318)
Cross-currency swap [Member]
Derivative Instruments [Line Items]
Cross-currency swap unrealized gain (loss) recorded in other comprehensive income (loss), net of taxes	$103	($318)

Derivative_Instruments_Additio

Derivative Instruments - Additional Information (Detail)	3 Months Ended
Share data in Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013	Sep. 30, 2010	Sep. 30, 2010
	Swap Agreement [Member]	Bone Biologics, Inc [Member]	Bone Biologics, Inc [Member]	Bone Biologics, Inc [Member]	Cross-currency swap [Member]	Cross-currency swap [Member]
		USD ($)	USD ($)		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 receivables			250,000
Number of shares held to purchase common stock		125		125
Change in fair value of warrant liability		$0	$0
Warrant issued, exercise period		7 years

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 $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	$4,050	$3,996
Deferred compensation plan, Liabilities	-1,970	-2,506
Derivative securities, Liabilities	-1,035	-1,036
Liabilities fair value, Total	-3,005	-3,542
Derivative securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	107	107
Fair Value, Inputs, Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	2,291	2,222
Derivative securities, Liabilities
Fair Value, Inputs, Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	1,759	1,774
Deferred compensation plan, Liabilities	-1,970	-2,506
Derivative securities, Liabilities	-1,035	-1,036
Liabilities fair value, Total	-3,005	-3,542
Fair Value, Inputs, Level 2 [Member] | Derivative securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	107	107
Fair Value, Inputs, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Derivative securities, Liabilities
Collective trust funds [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	1,652	1,667
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	1,652	1,667
Treasury securities [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets fair value	661	660
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	661	660
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	1,630	1,562
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	$1,630	$1,562

Accumulated_other_comprehensiv2

Accumulated other comprehensive income - Components of Changes in Accumulated Other Comprehensive Income (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014		Mar. 31, 2013	Dec. 31, 2013
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	$3,503
Unrealized gain(loss)	103		-318
Foreign currency translation adjustment	376		-2,679
Ending Balance	3,982	[1]
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	3,651
Foreign currency translation adjustment	376
Ending Balance	4,027
Change in Fair Value [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance				-148
Ending Balance	-45			-148
Change in Fair Value [Member] | Cross-currency swap and warrants [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain(loss)	103
Accumulated Other Comprehensive Income [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	3,503
Foreign currency translation adjustment	376
Ending Balance	3,982
Accumulated Other Comprehensive Income [Member] | Cross-currency swap and warrants [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain(loss)	$103
[1]	Unaudited

Accumulated_other_comprehensiv3

Accumulated other comprehensive income - Components of Changes in Accumulated Other Comprehensive Income (Parenthetical) (Detail) (USD $)	3 Months Ended
	Mar. 31, 2014
Foreign Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Deferred taxes recognized on related foreign currency translation adjustment	$0
Foreign Currency Translation Adjustments [Member] | Cross-currency swap and warrants [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain on derivative instrument, taxes (benefit)	25,000
Change in Fair Value [Member] | Cross-currency swap and warrants [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain on derivative instrument, taxes (benefit)	25,000
Accumulated Other Comprehensive Income [Member] | Cross-currency swap and warrants [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Unrealized gain on derivative instrument, taxes (benefit)	$25,000

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)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Earnings Per Share [Abstract]
Weighted average common shares-basic	18,197,363	19,431,093
Effect of dilutive securities:
Unexercised stock options net of treasury share repurchase		260,048
Weighted average common shares-diluted	18,197,363	19,691,141

Earnings_Per_Share_Additional_

Earnings Per Share - Additional Information (Detail) (Options to Purchase Common Stock [Member])	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
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	1,691,203	973,037

Sharebased_Compensation_Schedu

Share-based Compensation - Schedule of Share-Based Compensation by Line Item in Consolidated Statements of Operations (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	$1,187	$1,943
Cost of sales [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	29	287
Sales and marketing [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	444	436
General and administrative [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	642	1,175
Research and development [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share-based compensation expense	$72	$45

Sharebased_Compensation_Additi

Share-based Compensation - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Shares issued under stock purchase plan	263,575	113,965

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail) (USD $)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
Income Tax Disclosure [Abstract]
Provision for income tax	$1,179,000	$4,364,000
Income tax effective rate (as a percent)	-153.30%	42.40%
Income tax effective rate excluding the impact of the charges related to the U.S. Government resolutions (as a percent)	-68.50%	42.40%
Gross unrecognized tax benefit	700,000		700,000
Accrued interest and penalties related to unrecognized tax benefits	$500,000		$500,000

Business_Segment_Information_A

Business Segment Information - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2014
	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
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Sales Information [Line Items]
Reported Growth (as a percent)	-2.00%
Constant Currency Growth (as a percent)	-2.00%
Net sales	$100,014	$102,279
BioStim [Member]
Sales Information [Line Items]
Net sales	37,137	37,226
Biologics [Member]
Sales Information [Line Items]
Reported Growth (as a percent)	-3.00%
Constant Currency Growth (as a percent)	-3.00%
Net sales	13,010	13,360
Extremity Fixation [Member]
Sales Information [Line Items]
Reported Growth (as a percent)	3.00%
Constant Currency Growth (as a percent)	4.00%
Net sales	27,066	26,197
Spine Fixation [Member]
Sales Information [Line Items]
Reported Growth (as a percent)	-11.00%
Constant Currency Growth (as a percent)	-11.00%
Net sales	$22,801	$25,496

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
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Sales Information [Line Items]
Total net margin	$32,070	$30,594
General and administrative	17,276	18,241
Research and development	5,933	5,741
Amortization of intangible assets	584	544
Costs related to the accounting review and restatement	8,306
Operating (loss) income	-29	6,068
Operating Segments [Member] | BioStim [Member]
Sales Information [Line Items]
Total net margin	15,020	17,183
Operating Segments [Member] | Biologics [Member]
Sales Information [Line Items]
Total net margin	6,502	6,018
Operating Segments [Member] | Extremity Fixation [Member]
Sales Information [Line Items]
Total net margin	6,933	5,642
Operating Segments [Member] | Spine Fixation [Member]
Sales Information [Line Items]
Total net margin	4,059	2,176
Corporate, Non-Segment [Member]
Sales Information [Line Items]
Total net margin	444	425
Material Reconciling Items [Member]
Sales Information [Line Items]
General and administrative	17,276	18,241
Research and development	5,933	5,741
Amortization of intangible assets	584	544
Costs related to the accounting review and restatement	8,306
Operating (loss) income	($29)	$6,068

Sale_of_Breg_Additional_Inform

Sale of Breg - Additional Information (Detail) (USD $)	3 Months Ended	12 Months Ended
In Millions, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Indemnification Expense	$0.80
Orthofix Inc [Member] | Breg [Member]
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Fair value of liability	2
Period of indemnification (in years)	3 years
Obligations under guarantee	$0.80	$0.90

Stock_Repurchase_Program_Addit

Stock Repurchase Program - Additional Information (Detail) (USD $)	0 Months Ended
In Millions, unless otherwise specified	8-May-13
Equity [Abstract]
Share repurchase program, authorized amount	$50
Stock repurchased amount	$39.50

Subsequent_Events_Additional_I

Subsequent Events - Additional Information (Detail) (USD $)	3 Months Ended	1 Months Ended	0 Months Ended
	Mar. 31, 2014	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, 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