Orthofix Medical (OFIX) 10-Q 1 Aug 16 2016 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2016	Jul. 29, 2016
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q2
Trading Symbol	OFIX
Entity Registrant Name	ORTHOFIX INTERNATIONAL N V
Entity Central Index Key	884,624
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		18,124,817

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 40,482	$ 63,663
Trade accounts receivable, less allowance for doubtful accounts of $9,560 and $8,923 at June 30, 2016 and December 31, 2015, respectively	56,438	59,839
Inventories	61,334	57,563
Prepaid expenses and other current assets	19,734	31,187
Total current assets	177,988	212,252
Property, plant and equipment, net	52,499	52,306
Patents and other intangible assets, net	7,822	5,302
Goodwill	53,565	53,565
Deferred income taxes	56,443	57,306
Other long-term assets	16,421	19,491
Total assets	364,738	400,222
Current liabilities:
Trade accounts payable	13,676	16,391
Other current liabilities	63,523	65,597
Total current liabilities	77,199	81,988
Other long-term liabilities	29,308	27,923
Total liabilities	106,507	109,911
Contingencies (Note 11)
Shareholders’ equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,108,540 and 18,659,696 issued and outstanding as of June 30, 2016 and December 31, 2015, respectively	1,811	1,866
Additional paid-in capital	205,337	232,126
Retained earnings	59,057	62,551
Accumulated other comprehensive loss	(7,974)	(6,232)
Total shareholders’ equity	258,231	290,311
Total liabilities and shareholders’ equity	$ 364,738	$ 400,222

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Statement Of Financial Position [Abstract]
Trade accounts receivable, allowance for doubtful accounts	$ 9,560	$ 8,923
Common shares, par value	$ 0.10	$ 0.10
Common shares, authorized	50,000,000	50,000,000
Common shares, issued	18,108,540	18,659,696
Common shares, outstanding	18,108,540	18,659,696

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Income Statement [Abstract]
Product sales	$ 90,868	$ 86,868	$ 176,493	$ 163,700
Marketing service fees	13,207	14,086	26,261	27,016
Net sales	104,075	100,954	202,754	190,716
Cost of sales	22,515	21,910	44,651	41,249
Gross profit	81,560	79,044	158,103	149,467
Operating expenses
Sales and marketing	46,037	42,946	90,853	87,231
General and administrative	17,954	22,506	34,672	44,075
Research and development	6,792	6,451	14,428	12,296
Restatements and related costs	545	2,213	790	8,129
Charges related to U.S. Government resolutions (Note 11)	12,870		12,870
Total operating expenses	84,198	74,116	153,613	151,731
Operating (loss) income	(2,638)	4,928	4,490	(2,264)
Other income and expense
Interest (expense) income, net	(113)	74	(151)	(198)
Other income, net	147	853	1,980	1,544
Total other income (expense)	34	927	1,829	1,346
(Loss) income before income taxes	(2,604)	5,855	6,319	(918)
Income tax expense	(3,685)	(1,778)	(7,979)	(2,742)
Net (loss) income from continuing operations	(6,289)	4,077	(1,660)	(3,660)
Discontinued operations (Note 11)
Loss from discontinued operations	(1,572)	(730)	(2,562)	(1,511)
Income tax benefit	474	225	728	364
Net loss from discontinued operations	(1,098)	(505)	(1,834)	(1,147)
Net (loss) income	$ (7,387)	$ 3,572	$ (3,494)	$ (4,807)
Net income (loss) per common share—basic:
Net (loss) income from continuing operations	$ (0.35)	$ 0.22	$ (0.09)	$ (0.20)
Net loss from discontinued operations	(0.06)	(0.03)	(0.10)	(0.06)
Net (loss) income per common share—basic	(0.41)	0.19	(0.19)	(0.26)
Net income (loss) per common share—diluted:
Net (loss) income from continuing operations	(0.35)	0.21	(0.09)	(0.20)
Net loss from discontinued operations	(0.06)	(0.02)	(0.10)	(0.06)
Net (loss) income per common share—diluted	$ (0.41)	$ 0.19	$ (0.19)	$ (0.26)
Weighted average number of common shares:
Basic	18,147,681	18,769,415	18,312,781	18,750,804
Diluted	18,147,681	18,989,579	18,312,781	18,750,804
Other comprehensive income (loss):
Unrealized gain on derivative instruments, net of tax	$ 50	$ 271	$ 76	$ 936
Unrealized loss on debt securities, net of tax	(1,942)		(2,469)
Foreign currency translation adjustment	(570)	1,559	651	(3,301)
Comprehensive (loss) income	$ (9,849)	$ 5,402	$ (5,236)	$ (7,172)

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015
Cash flows from operating activities:
Net cash provided by operating activities	$ 21,268	$ 8,954
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	(9,600)	(13,493)
Capital expenditures for intangible assets	(756)	(83)
Purchases of assets and investments	(3,613)
Purchase of debt securities		(15,250)
Net proceeds from sale of assets		4,800
Net cash used in investing activities	(13,969)	(24,026)
Cash flows from financing activities:
Net proceeds from issuance of common shares	13,035	1,646
Changes in restricted cash		34,424
Repurchase and retirement of common shares	(43,885)
Excess income tax benefit on employee stock-based awards	105	54
Net cash (used in) provided by financing activities	(30,745)	36,124
Effect of exchange rate changes on cash	265	(1,921)
Net (decrease) increase in cash and cash equivalents	(23,181)	19,131
Cash and cash equivalents at the beginning of the period	63,663	36,815
Cash and cash equivalents at the end of the period	$ 40,482	$ 55,946

Nature of operations, basis of

Nature of operations, basis of presentation and recently issues accounting pronouncements	6 Months Ended
	Jun. 30, 2016
Organization Consolidation Basis Of Presentation Business Description And Accounting Policies [Abstract]
Nature of operations, basis of presentation and recently issues accounting pronouncements	1. Nature of operations, basis of presentation and recently issued accounting pronouncements Nature of operations Orthofix International N.V. (together with its subsidiaries, the “Company”) is a diversified, global medical device company focused on improving patients’ lives by providing superior reconstructive and regenerative orthopedic and spine solutions to physicians. The Company is comprised of four reportable segments: BioStim, Biologics, Extremity Fixation and Spine Fixation supported by corporate activities. 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 statement have been included. These condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and related notes contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2015 (the “2015 Form 10-K”). 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 revenue recognition, contractual allowances, doubtful accounts, inventories, potential goodwill and intangible asset impairment, fair value measurements, litigation and contingent liabilities, income taxes, and shared-based compensation. Actual results could differ from these estimates. As permitted under U.S. GAAP, interim accounting for certain expenses, including income taxes, are based on full year forecasts. Recently issued accounting pronouncements In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers In July 2015, the FASB issued ASU 2015-11, Simplifying the Measurement of Inventory In January 2016, the FASB issued ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) In March 2016, the FASB issued ASU 2016-09, Improvements to Employee Share-Based Payment Accounting

Inventories

Inventories	6 Months Ended
	Jun. 30, 2016
Inventory Disclosure [Abstract]
Inventories	2. Inventories The Company’s inventories are valued at the lower of cost or estimated net realizable value, after provision for excess or obsolete items, which is reviewed and updated on a periodic basis by management determined on a first-in, first-out basis. Work-in-process and finished products include the cost of materials, labor and other production costs. Finished products include field inventory which represents immediately saleable finished products that are in the possession of the Company’s independent sales representatives, and consignment inventory which represents immediately saleable finished products located at third party customers, such as distributors and hospitals. 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 revenues and associated cost of sales are recognized. Inventories were as follows: (U.S. Dollars, in thousands) June 30, 2016 December 31, 2015 Raw materials $ 7,070 $ 4,976 Work-in-process 9,442 5,087 Finished products 40,484 42,947 Deferred cost of sales 4,338 4,553 Total inventory $ 61,334 $ 57,563

Long-term debt

Long-term debt	6 Months Ended
	Jun. 30, 2016
Debt Disclosure [Abstract]
Long-term debt	3. Long-term debt On August 31, 2015, the Company, through certain of its subsidiaries entered into a Credit Agreement (the “Credit Agreement”) with JPMorgan Chase Bank, N.A. (“JPMorgan”), as Administrative Agent, and certain lenders party thereto. The Credit Agreement provides for a five year $125 million secured revolving credit facility (the “Facility”). As of June 30, 2016, the Company has not made any borrowings under the Credit Agreement. The Credit Agreement contains financial covenants requiring the Company to maintain, as of the last day of any fiscal quarter, a total leverage ratio of not more than 3.0 to 1.0 and an interest coverage ratio of at least 3.0 to 1.0 based upon the Company’s consolidated adjusted earnings. The Company is in compliance with all required financial covenants as of June 30, 2016. The Credit Agreement also includes events of default customary for facilities of this type, and upon the occurrence of such events of default, subject to customary cure rights, all outstanding loans under the Facility may be accelerated and/or the lenders’ commitments terminated. The Company had no borrowings and an unused available line of credit of €5.8 million ($6.4 million and $6.3 million) at June 30, 2016 and December 31, 2015, respectively, on its Italian line of credit. This unsecured line of credit provides the Company the option to borrow amounts in Italy at rates which are determined at the time of borrowing.

Derivative instruments

Derivative instruments	6 Months Ended
	Jun. 30, 2016
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Derivative instruments	4. Derivative instruments In the ordinary course of business, the Company is exposed to the impact of changes in interest rates and foreign currency fluctuations. During 2016 and 2015, the Company made use of a foreign cross-currency swap agreement to manage cash flow exposure generated from foreign currency fluctuations. 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). Any gains or losses reported in accumulated other comprehensive income are reclassified into earnings upon maturity. (U.S. Dollars, in thousands) As of June 30, 2016 Fair f (unfavorable) Balance sheet classification Cross-currency swap $ 2,374 Prepaid expenses and other current assets Warrants $ 321 Other long-term assets As of December 31, 2015 Cross-currency swap $ 2,485 Prepaid expenses and other current assets Warrants $ 321 Other long-term assets Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 Cross-currency swap unrealized gain, net of taxes $ 50 $ 267 $ 76 $ 936 Warrants unrealized loss, net of taxes $ — $ 4 $ — $ —

Fair value measurements

Fair value measurements	6 Months Ended
	Jun. 30, 2016
Fair Value Disclosures [Abstract]
Fair value measurements	5. Fair value measurements The fair value of the Company’s financial assets and liabilities measured on a recurring basis were as follows: (U.S. Dollars, in thousands) June 30, 2016 Level 1 Level 2 Level 3 Assets Collective trust funds $ 1,599 $ — $ 1,599 $ — Treasury securities 521 521 — — Certificates of deposit 443 443 — — Derivative instruments 2,374 — 2,374 — Debt securities 9,438 — — 9,438 Total $ 14,375 $ 964 $ 3,973 $ 9,438 Liabilities Deferred compensation plan $ (1,488 ) $ — $ (1,488 ) $ — Total $ (1,488 ) $ — $ (1,488 ) $ — (U.S. Dollars, in thousands) December 31, 2015 Level 1 Level 2 Level 3 Assets Collective trust funds $ 1,622 $ — $ 1,622 $ — Treasury securities 495 495 — — Certificates of deposit 337 337 — — Derivative instruments 2,485 — 2,485 — Debt securities 12,658 — — 12,658 Total $ 17,597 $ 832 $ 4,107 $ 12,658 Liabilities Deferred compensation plan $ (1,503 ) $ — $ (1,503 ) $ — Total $ (1,503 ) $ — $ (1,503 ) $ — Debt Securities On March 2015, Company Option Agreement (the “Option Agreement”) with eNeura, Inc. (“eNeura”), privately technology company devices treatment migraines. The Option Agreement provides the Company an exclusive acquire eNeura (the “Option”) during 18-month following grant the Option. consideration for the Option, (i) Company non-refundable $0.3 million fee eNeura, and eNeura issued Convertible Promissory Note “eNeura Note”) Company. The principal of the eNeura Note $15.0 million interest accrues at The eNeura Note will mature earlier (i) March 4, exercise of the Option. The investment is recorded in other long-term assets as an available for sale debt security and interest is recorded in interest income. The fair value of the debt security is based upon significant unobservable inputs, including the use of a discounted cash flows model, requiring the Company The following table provides a reconciliation of the beginning and ending balances for debt securities measured at fair value using significant unobservable inputs (Level 3): (U.S. Dollars, in thousands) Balance at December 31, 2015 $ 12,658 Accrued interest income 640 Unrealized loss on debt securities (3,860 ) Balance at June 30, 2016 $ 9,438

Accumulated other comprehensive

Accumulated other comprehensive loss	6 Months Ended
	Jun. 30, 2016
Equity [Abstract]
Accumulated other comprehensive loss	6. Accumulated other comprehensive loss Accumulated other comprehensive loss 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; the unrealized gain (loss) on warrants; and the unrealized loss on the Company’s debt securities. The components of and changes in accumulated other comprehensive loss were as follows: (U.S. Dollars, in thousands) Currency Translation Adjustments Change in Fair Value of Derivatives Change in Fair Value of Debt Securities Accumulated Other Comprehensive Loss Balance at December 31, 2015 $ (4,389 ) $ 228 $ (2,071 ) $ (6,232 ) Unrealized gain on derivative instruments, net of tax of $51 — 76 — 76 Unrealized loss on debt securities, net of tax benefit of $1,391 — — (2,469 ) (2,469 ) Foreign currency translation adjustment (1) 651 — — 651 Balance at June 30, 2016 $ (3,738 ) $ 304 $ (4,540 ) $ (7,974 ) ___________________________________________ (1) As unremitted earnings generally remain indefinitely reinvested 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	6 Months Ended
	Jun. 30, 2016
Earnings Per Share [Abstract]
Earnings per share	7. Earnings per share For the three and six months ended June 30, 2016 and 2015, no adjustments were made 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 loss per common share computations. Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Weighted average common shares-basic 18,147,681 18,769,415 18,312,781 18,750,804 Effect of dilutive securities: Unexercised stock options net of treasury share repurchase — 220,164 — — Weighted average common shares-diluted 18,147,681 18,989,579 18,312,781 18,750,804 Options to purchase shares of common stock with exercise prices in excess of the average market price of common shares and performance-based restricted stock awards deemed not probable to vest are not included in the computation of diluted earnings per share. There were 792,149 outstanding awards and options not included in the diluted earnings per share computation for the three months ended June 30, 2015, because their inclusion was antidilutive. Due to the Company having a net loss from continuing operations position for the three and six months ended June 30, 2016, there were 490,296 and 484,201 potentially dilutive shares excluded from the computation, respectively, as their effects would be antidilutive. Due to the Company having a net loss from continuing operations position for the six months ended June 30, 2015, there were 1,081,308 potentially dilutive shares excluded from the computation as their effects would be antidilutive.

Share-based compensation

Share-based compensation	6 Months Ended
	Jun. 30, 2016
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Share-based compensation	8. Share-based compensation All share-based compensation costs are measured at the grant date, based on the estimated fair value of the award, and recognized as expense in the condensed consolidated statements of operations over the requisite service period. The Company recognized $1.9 million and $3.9 million, respectively, of share-based compensation expense for the three and six months ended June 30, 2016 and $1.8 million and $3.6 million, respectively, for the three and six months ended June 30, 2015. On June 30, 2014, the Company granted 99,600 performance-based restricted share awards to officers and certain employees. Vesting is based on achieving earnings targets in two consecutive rolling four quarter periods. As of June 30, 2016, no expense has been recognized for these contingent restricted share awards. On June 30, 2015, the Company granted 68,750 performance-based restricted share awards to officers and on August 5, 2015, granted an additional 41,910 performance-based restricted share awards to other members of management. Vesting is based on achieving earnings and return on invested capital targets as of and for the years ended December 31, 2016, 2017 or 2018. As of June 30, 2016, no expense has been recognized for these contingent restricted share awards. During the three months ended June 30, 2016 and 2015, there were 325,393 and 81,974 shares, respectively, of common stock issued related to stock purchase plan issuances, stock option exercises and the vesting of restricted stock awards. During the six months ended June 30, 2016 and 2015, there were 528,791 and 227,840 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	6 Months Ended
	Jun. 30, 2016
Income Tax Disclosure [Abstract]
Income taxes	9. Income taxes For the second quarter, our effective tax rate on continuing operations was (141.5%), or $3.7 million, as compared to 30.4%, or $1.8 million, for the same period in the prior year. Excluding the impact of various discrete tax charges, the effective tax rate on continuing operations for the second quarter of 2016 and 2015 was (131.6%) and 29.6%, respectively. For the first six months of 2016, our effective tax rate on continuing operations was 126.3%, or $8.0 million, as compared to (298.7%), or $2.7 million, for the same period in the prior year. Excluding the impact of various discrete tax charges, the effective tax rate on continuing operations for the first six months of 2016 and 2015 was 119.6% and (256.6%), respectively. The primary factor affecting the Company’s effective tax rate for the three and six months ended June 30, 2016, was charges related to US Government Resolutions, which is non-deductible for tax purposes, and the impact of which is fully recognized in the second quarter. Other factors affecting the Company’s effective tax rate for the three and six months ended June 30, 2016, and June 30, 2015, were the Company’s mix of earnings among various tax jurisdictions, state taxes, and current period losses in certain jurisdictions for which the Company does not currently provide a tax benefit. During the third quarter of 2015, the Internal Revenue Service commenced an examination of our federal income tax return for 2012. The Company cannot reasonably determine if this examination will have a material impact on our financial statements and cannot predict the timing regarding resolution of this tax examination.

Business segment information

Business segment information	6 Months Ended
	Jun. 30, 2016
Segment Reporting [Abstract]
Business segment information	10. Business segment information The Company has four strategic business units (“SBUs”), which are comprised of BioStim, Biologics, Extremity Fixation, and Spine Fixation supported by corporate activities. The primary metric used 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. The tables below present net sales for continuing operations by SBU reporting segment. 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 ® ® Three Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 Reported Change BioStim $ 44,758 $ 40,703 10.0 % Biologics 14,256 15,274 (6.7 )% Extremity Fixation 26,817 25,594 4.8 % Spine Fixation 18,244 19,383 (5.9 )% Total net sales $ 104,075 $ 100,954 3.1 % Six Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 Reported Change BioStim $ 85,802 $ 78,403 9.4 % Biologics 28,350 29,235 (3.0 )% Extremity Fixation 51,526 47,409 8.7 % Spine Fixation 37,076 35,669 3.9 % Total net sales $ 202,754 $ 190,716 6.3 % The table below presents net margin, which is defined as gross profit less sales and marketing expense, by SBU reporting segment for the three and six months ended June 30, 2016 and 2015: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 Gross profit $ 81,560 $ 79,044 $ 158,103 $ 149,467 Less: Sales and marketing (46,037 ) (42,946 ) (90,853 ) (87,231 ) Total net margin $ 35,523 $ 36,098 $ 67,250 $ 62,236 BioStim 18,577 16,787 34,988 30,800 Biologics 6,719 7,285 12,823 13,229 Extremity Fixation 8,162 9,149 15,340 16,165 Spine Fixation 2,203 3,173 4,539 2,644 Corporate (138 ) (296 ) (440 ) (602 ) Total net margin 35,523 36,098 67,250 62,236 General and administrative 17,954 22,506 34,672 44,075 Research and development 6,792 6,451 14,428 12,296 Restatements and related costs 545 2,213 790 8,129 Charges related to U.S. Government resolutions 12,870 – 12,870 – Operating (loss) income $ (2,638 ) $ 4,928 $ 4,490 $ (2,264 )

Contingencies

Contingencies	6 Months Ended
	Jun. 30, 2016
Commitments And Contingencies Disclosure [Abstract]
Contingencies	11. Contingencies The Company is party to outstanding legal proceedings, investigations and claims, as previously described in (i) Part I, Item 3, “Legal Proceedings,” of the 2015 Form 10-K and (ii) note 14 to the Company’s audited consolidated financial statements filed with the 2015 Form 10-K. The Company believes that it is unlikely that the outcome of any of these matters will have a material adverse effect on it and its subsidiaries as a whole, notwithstanding that the unfavorable resolution of any matter may have a material effect on the Company’s net earnings (if any) in any particular quarter. However, the Company cannot predict with any certainty the final outcome of any of these legal proceedings, investigations (including any settlement discussions with the government seeking to resolve such investigations) or claims, and there can be no assurance that the ultimate resolution of any such matters will not have a material adverse impact on the Company’s consolidated financial position, results of operations, or cash flows. In addition to the matters described in the paragraphs below and in the 2015 Form 10-K, in the normal course of its business, the Company is involved in various lawsuits from time to time and may be subject to certain other contingencies. To the extent losses related to these contingencies are both probable and reasonably estimable, the Company accrues appropriate amounts in the accompanying financial statements and provides disclosures as to the possible range of loss in excess of the amount accrued, if such range is reasonably estimable. The Company believes losses with respect to these additional matters are individually and collectively immaterial as to a possible loss and range of loss. Matters Related to the Audit Committee’s Review and the Restatement of Certain of our Consolidated Financial Statements Audit Committee Review In July 2013, the Audit Committee of our Board of Directors began conducting an independent review, with the assistance of outside professionals, of certain accounting matters. This review resulted in a restatement of our previously filed consolidated financial statements for the fiscal years ended December 31, 2012, 2011 and 2010 and the fiscal quarter ended March 31, 2013, as well as the restatement of certain financial information for the fiscal years ended December 31, 2009, 2008 and 2007. This restatement, which we completed and filed in March 2014, is referred to herein as the “Original Restatement.” In connection with the Company’s preparation of its consolidated interim quarterly financial statements for the fiscal quarter ended June 30, 2014, the Company determined that certain entries with respect to the previously filed financial statements contained in the filings containing the Original Restatement were not properly accounted for under U.S. GAAP. As a result, the Company determined in August 2014 to restate its previously filed consolidated financial statements for the fiscal years ended December 31, 2013, 2012 and 2011 and quarterly reporting periods contained within the fiscal years ended December 31, 2013 and 2012, as well as the fiscal quarter ended March 31, 2014. This restatement, which we completed in March 2015, is referred to herein as the “Further Restatement.” SEC Investigation In connection with the initiation of the Audit Committee’s independent review, we initiated contact with the staff of the Division of Enforcement of the SEC (the “SEC Enforcement Staff”) in July 2013 to advise them of these matters. The Audit Committee and the Company, through respective counsel, have been in direct communication with the SEC Enforcement Staff regarding these matters. The SEC is conducting a formal investigation of these matters, and both the Company and the Audit Committee are cooperating fully with the SEC. We have previously provided notice concerning our communications with the SEC to the Office of Inspector General of the U.S. Department of Health and Human Services (“HHS-OIG”) pursuant to our corporate integrity agreement with HHS-OIG (which agreement is described in Item 3 of our Form 10-K for the year ended December 31, 2015). The Company is currently engaged in discussions with the SEC Enforcement Staff regarding a possible negotiated resolution of these matters as to the Company. Although such discussions remain ongoing, and any agreement reached between the SEC Enforcement Staff and the Company will be subject to approval by the full Commission, the Company has reached an agreement in principle with the SEC Enforcement Staff that any negotiated resolution will include a civil money penalty of approximately $8.3 million. Accordingly, we have recorded a charge of approximately $8.3 million during the second quarter of 2016 in connection with such amount. However, no assurance can be given that we will be able to achieve a final, definitive resolution with the SEC to resolve this matter on these or other terms, and the failure to resolve this matter on these or other terms could adversely affect our business and operations. Securities Class Action Complaint As described further in prior filings, in December 2015 the Company entered into a settlement agreement, subject to court approval, in connection with a securities class action complaint filed against the Company in the United States District Court for the Southern District of New York (Tejinder Singh v. Orthofix International N.V., et al. (No.:1:13-cv-05696-JGK)), which complaint arose out of the restatement of our prior financial statements and the matters described above. The full amount of the settlement was paid into a settlement fund by the Company’s insurer in February of 2016. On April 29, 2016, the court approved the settlement and entered final judgment, releasing all claims by class members arising out of the facts alleged in the pleadings and dismissing the action with prejudice. Deferred Prosecution Agreement and Review of Potential Improper Payments Involving Brazil Subsidiary In 2012, the Company entered into definitive agreements with the U.S. Department of Justice (the “DOJ”) and the SEC agreeing to settle a self-initiated and self-reported internal investigation of our Mexican subsidiary, Promeca S.A. de C.V. (“Promeca”), regarding non-compliance by Promeca with the U.S. Foreign Corrupt Practices Act (the “FCPA”). As part of the settlement, we entered into a three-year deferred prosecution agreement (“DPA”) with the DOJ and a consent to final judgment (the “Consent”) with the SEC. Under the DPA, the DOJ agreed not to pursue any criminal charges against us in connection with the Promeca matter if we complied with the terms of the DPA. The DPA took note of our self-reporting of this matter to the DOJ and the SEC, and of remedial measures, including the implementation of an enhanced compliance program, previously undertaken by us. The DPA and the Consent collectively required, among other things, that with respect to anti-bribery compliance matters we would continue to cooperate fully with the government in any future matters related to corrupt payments, false books and records or inadequate internal controls. In that regard, we represented that we have implemented and will continue to implement a compliance and ethics program designed to prevent and detect violations of the FCPA and other applicable anti-corruption laws, which includes a system of internal controls. We periodically reported to the government during the terms of the DPA and Consent regarding such remediation and implementation of compliance measures. In August 2013, during the terms of the DPA and Consent, the Company’s internal legal department was notified of certain allegations involving potential improper payments with respect to its Brazilian subsidiary, Orthofix do Brasil Ltda. The Company engaged outside counsel to assist in the review of these allegations, focusing on compliance with applicable anti-bribery laws, including the FCPA. Consistent with the provisions of these agreements, the Company contacted both the DOJ and the SEC Enforcement Staff in August 2013 to voluntarily self-report the Brazil-related allegations. On June 15, 2015, the Company and the DOJ agreed to extend the term of the DPA for two months (through September 17, 2015) to permit the DOJ additional time to evaluate the Company’s compliance with the internal controls and compliance undertakings in the DPA and to further investigate the Brazil-related allegations. On September 17, 2015, the DOJ extended the term of the DPA for an additional ten months (through July 17, 2016), stating that the Company’s efforts to comply with the internal controls and compliance requirements of the DPA during the first eighteen months of the DPA were insufficient. On July 17, 2016, the DPA expired. The terms of the DPA require that DOJ notify the court and file a dismissal of the underlying Promeca-related case within 30 days of such expiration. This dismissal was filed on July 28, 2016. Since the self-report regarding allegations in Brazil, the Company has cooperated fully with the DOJ’s investigation of those allegations. The Company also has fully cooperated with the SEC’s investigations of the allegations in Brazil. We are currently engaged in discussions with the SEC Enforcement Staff regarding a resolution of the Brazil-related allegations as they relate to the SEC’s jurisdiction. The Company has recorded a charge of $4.6 million in the second quarter of 2016 to establish an accrual, which the Company believes represents the minimum range of loss, in connection with a potential negotiated resolution to this matter. Based on information available at this time, the Company estimates that the final resolution to the matter could result in an additional loss of up to $1.5 million in excess of the loss accrued. The Company will continue to evaluate the accrual pending final resolution of the matter and the related settlement discussions with the government. Matters Related to the Company’s Former Breg Subsidiary and Possible Indemnification Obligations On May 24, 2012, we sold Breg to an affiliate of Water Street Healthcare Partners II, L.P. (“Water Street”) pursuant to a stock purchase agreement (the “Breg SPA”). Under the terms of the Breg SPA, upon closing of the sale, the Company and its subsidiary, Orthofix Holdings, Inc., agreed to indemnify Water Street and Breg with respect to certain specified matters, including the following: · Breg was engaged in the manufacturing and sale of local infusion pumps for pain management from 1999 to 2008. Since 2008, numerous product liability cases have been filed in the United States alleging that the local anesthetic, when dispensed by such infusion pumps inside a joint, causes a rare arthritic condition called “chondrolysis.” The Company incurred losses for settlements and judgments in connection with these matters during the first six months of 2016 of $0.5 million as compared to none in the first six months of 2015. In addition, several cases remain outstanding for which the Company currently cannot reasonably estimate the possible loss, or range of loss. · At the time of its divestiture by us, Breg was currently and had been engaged in the manufacturing and sales of motorized cold therapy units used to reduce pain and swelling. Several domestic product liability cases have been filed in recent years, mostly in California state court, alleging the use of cold therapy causes skin and/or nerve injury and seeking damages on behalf of individual plaintiffs who were allegedly injured by such units or who would not have purchased the units had they known they could be injured. In September 2014, the Company entered into a master settlement agreement resolving all pending pre-close claims. Pursuant to the terms of the settlement agreement, the Company paid approximately $1.3 million, and additional amounts owed under the settlement were paid directly by the Company’s insurance providers. These amounts paid by the Company were recorded as an expense in discontinued operations during the fiscal quarter ended June 30, 2014. Remaining cold therapy claims include a putative consumer class of individuals who did not suffer physical harm following use of the devices, and an appeal of an adverse July 2012 California jury verdict and a post-close cold therapy claim pending in California state court. As of June 30, 2016, we have accrued $5.8 million for the July 2012 verdict and post-close cold therapy liabilities; however, actual liability could be higher or lower than the amount accrued. The putative class action is at an early stage and the Company currently cannot reasonably estimate the possible loss, or range of loss. Charges incurred as a result of this indemnification are reflected as discontinued operations in our Condensed Consolidated Statements of Operations and Comprehensive Loss.

Share repurchase plan

Share repurchase plan	6 Months Ended
	Jun. 30, 2016
Stockholders Equity Note [Abstract]
Share Repurchase Plan	12. Share repurchase plan The Company’s Board of Directors authorized a share repurchase plan in the fourth quarter of 2015, authorizing the purchase of up to $75 million of the Company’s common stock through and including September 2017. Under the program, common share repurchases are expected to consist primarily of open market transactions at prevailing market prices in accordance with the guidelines specified under Rule 10b-18 of the Securities Exchange Act of 1934, as amended, though the Company may also make repurchases through block trades or privately negotiated transactions. Repurchases may be made from cash on hand, cash generated from operations, and/or borrowings under the Company’s secured revolving credit facility. The program does not obligate the Company to acquire any specific number of shares and may be discontinued at any time. During the quarter ended June 30, 2016, the Company repurchased 403,688 shares of common stock for $17.4 million with an average price per share of $43.16 which were all retired upon repurchase. As of June 30, 2016, there was $19.5 million remaining under this share repurchase authorization. From July 1, 2016, to July 29, 2016, the Company has made additional repurchases of 45,108 shares for an amount equal to $2.1 million.

Nature of operations, basis o18

Nature of operations, basis of presentation and recently issues accounting pronouncements (Policies)	6 Months Ended
	Jun. 30, 2016
Organization Consolidation Basis Of Presentation Business Description And Accounting Policies [Abstract]
Basis of presentation	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 statement have been included. These condensed consolidated financial statements should be read in conjunction with the consolidated financial statements and related notes contained in the Company’s Annual Report on Form 10-K for the year ended December 31, 2015 (the “2015 Form 10-K”). 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 revenue recognition, contractual allowances, doubtful accounts, inventories, potential goodwill and intangible asset impairment, fair value measurements, litigation and contingent liabilities, income taxes, and shared-based compensation. Actual results could differ from these estimates. As permitted under U.S. GAAP, interim accounting for certain expenses, including income taxes, are based on full year forecasts.
Recently issued accounting standards	Recently issued accounting pronouncements In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers In July 2015, the FASB issued ASU 2015-11, Simplifying the Measurement of Inventory In January 2016, the FASB issued ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10): Recognition and Measurement of Financial Assets and Financial Liabilities In February 2016, the FASB issued ASU 2016-02, Leases (Topic 842) In March 2016, the FASB issued ASU 2016-09, Improvements to Employee Share-Based Payment Accounting

Inventories (Tables)

Inventories (Tables)	6 Months Ended
	Jun. 30, 2016
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories were as follows: (U.S. Dollars, in thousands) June 30, 2016 December 31, 2015 Raw materials $ 7,070 $ 4,976 Work-in-process 9,442 5,087 Finished products 40,484 42,947 Deferred cost of sales 4,338 4,553 Total inventory $ 61,334 $ 57,563

Derivative instruments (Tables)

Derivative instruments (Tables)	6 Months Ended
	Jun. 30, 2016
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Schedule of Fair Values of Derivative Instruments	In the ordinary course of business, the Company is exposed to the impact of changes in interest rates and foreign currency fluctuations. During 2016 and 2015, the Company made use of a foreign cross-currency swap agreement to manage cash flow exposure generated from foreign currency fluctuations. 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). Any gains or losses reported in accumulated other comprehensive income are reclassified into earnings upon maturity. (U.S. Dollars, in thousands) As of June 30, 2016 Fair f (unfavorable) Balance sheet classification Cross-currency swap $ 2,374 Prepaid expenses and other current assets Warrants $ 321 Other long-term assets As of December 31, 2015 Cross-currency swap $ 2,485 Prepaid expenses and other current assets Warrants $ 321 Other long-term assets
Schedule of Gain (Loss) Recognized in Other Comprehensive Income (Loss)	Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 Cross-currency swap unrealized gain, net of taxes $ 50 $ 267 $ 76 $ 936 Warrants unrealized loss, net of taxes $ — $ 4 $ — $ —

Fair value measurements (Tables

Fair value measurements (Tables)	6 Months Ended
	Jun. 30, 2016
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis	The fair value of the Company’s financial assets and liabilities measured on a recurring basis were as follows: (U.S. Dollars, in thousands) June 30, 2016 Level 1 Level 2 Level 3 Assets Collective trust funds $ 1,599 $ — $ 1,599 $ — Treasury securities 521 521 — — Certificates of deposit 443 443 — — Derivative instruments 2,374 — 2,374 — Debt securities 9,438 — — 9,438 Total $ 14,375 $ 964 $ 3,973 $ 9,438 Liabilities Deferred compensation plan $ (1,488 ) $ — $ (1,488 ) $ — Total $ (1,488 ) $ — $ (1,488 ) $ — (U.S. Dollars, in thousands) December 31, 2015 Level 1 Level 2 Level 3 Assets Collective trust funds $ 1,622 $ — $ 1,622 $ — Treasury securities 495 495 — — Certificates of deposit 337 337 — — Derivative instruments 2,485 — 2,485 — Debt securities 12,658 — — 12,658 Total $ 17,597 $ 832 $ 4,107 $ 12,658 Liabilities Deferred compensation plan $ (1,503 ) $ — $ (1,503 ) $ — Total $ (1,503 ) $ — $ (1,503 ) $ —
Fair Value, Inputs, Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Schedule of Reconciliation of Available for Sale Debt Securities	The following table provides a reconciliation of the beginning and ending balances for debt securities measured at fair value using significant unobservable inputs (Level 3): (U.S. Dollars, in thousands) Balance at December 31, 2015 $ 12,658 Accrued interest income 640 Unrealized loss on debt securities (3,860 ) Balance at June 30, 2016 $ 9,438

Accumulated other comprehensi22

Accumulated other comprehensive loss (Tables)	6 Months Ended
	Jun. 30, 2016
Equity [Abstract]
Components of Changes in Accumulated Other Comprehensive Loss	The components of and changes in accumulated other comprehensive loss were as follows: (U.S. Dollars, in thousands) Currency Translation Adjustments Change in Fair Value of Derivatives Change in Fair Value of Debt Securities Accumulated Other Comprehensive Loss Balance at December 31, 2015 $ (4,389 ) $ 228 $ (2,071 ) $ (6,232 ) Unrealized gain on derivative instruments, net of tax of $51 — 76 — 76 Unrealized loss on debt securities, net of tax benefit of $1,391 — — (2,469 ) (2,469 ) Foreign currency translation adjustment (1) 651 — — 651 Balance at June 30, 2016 $ (3,738 ) $ 304 $ (4,540 ) $ (7,974 ) ___________________________________________ (1) As unremitted earnings generally remain indefinitely reinvested 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)	6 Months Ended
	Jun. 30, 2016
Earnings Per Share [Abstract]
Schedule of Reconciliation of Weighted Average Shares Used in Calculation of Basic and Diluted Net (Loss) Income Per Share	The following is a reconciliation of the weighted average shares used in the basic and diluted net loss per common share computations. Three Months Ended June 30, Six Months Ended June 30, 2016 2015 2016 2015 Weighted average common shares-basic 18,147,681 18,769,415 18,312,781 18,750,804 Effect of dilutive securities: Unexercised stock options net of treasury share repurchase — 220,164 — — Weighted average common shares-diluted 18,147,681 18,989,579 18,312,781 18,750,804

Business segment information (T

Business segment information (Tables)	6 Months Ended
	Jun. 30, 2016
Segment Reporting [Abstract]
Schedule of Net Sales by SBU Reporting Segment	The tables below present net sales for continuing operations by SBU reporting segment. 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 ® ® Three Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 Reported Change BioStim $ 44,758 $ 40,703 10.0 % Biologics 14,256 15,274 (6.7 )% Extremity Fixation 26,817 25,594 4.8 % Spine Fixation 18,244 19,383 (5.9 )% Total net sales $ 104,075 $ 100,954 3.1 % Six Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 Reported Change BioStim $ 85,802 $ 78,403 9.4 % Biologics 28,350 29,235 (3.0 )% Extremity Fixation 51,526 47,409 8.7 % Spine Fixation 37,076 35,669 3.9 % Total net sales $ 202,754 $ 190,716 6.3 %
Summary of Net Margin as Gross Profit Less Sales and Marketing Expense by SBU Reporting Segment	The table below presents net margin, which is defined as gross profit less sales and marketing expense, by SBU reporting segment for the three and six months ended June 30, 2016 and 2015: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 Gross profit $ 81,560 $ 79,044 $ 158,103 $ 149,467 Less: Sales and marketing (46,037 ) (42,946 ) (90,853 ) (87,231 ) Total net margin $ 35,523 $ 36,098 $ 67,250 $ 62,236 BioStim 18,577 16,787 34,988 30,800 Biologics 6,719 7,285 12,823 13,229 Extremity Fixation 8,162 9,149 15,340 16,165 Spine Fixation 2,203 3,173 4,539 2,644 Corporate (138 ) (296 ) (440 ) (602 ) Total net margin 35,523 36,098 67,250 62,236 General and administrative 17,954 22,506 34,672 44,075 Research and development 6,792 6,451 14,428 12,296 Restatements and related costs 545 2,213 790 8,129 Charges related to U.S. Government resolutions 12,870 – 12,870 – Operating (loss) income $ (2,638 ) $ 4,928 $ 4,490 $ (2,264 )

Nature of operations, basis o25

Nature of operations, basis of presentation and recently issues accounting pronouncements - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2016Segment
Organization Consolidation Basis Of Presentation Business Description And Accounting Policies [Abstract]
Number Of Reporting Units	4

Inventories - Schedule of Inven

Inventories - Schedule of Inventories (Detail) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Inventory Disclosure [Abstract]
Raw materials	$ 7,070	$ 4,976
Work-in-process	9,442	5,087
Finished products	40,484	42,947
Deferred cost of sales	4,338	4,553
Total inventory	$ 61,334	$ 57,563

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2016USD ($)	Jun. 30, 2016EUR (€)	Dec. 31, 2015USD ($)	Aug. 31, 2015USD ($)
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 6,400,000	€ 5,800,000	$ 6,300,000
Amount outstanding under lines of credit	$ 0
Credit Agreement [Member] | Revolving Credit Facility [Member]
Debt Instrument [Line Items]
Debt instrument term (in years)	5 years
Maximum borrowing capacity				$ 125,000,000
Amount outstanding under lines of credit	$ 0
Line of credit, leverage ratio				3
Line of credit, interest coverage ratio				300.00%

Derivative Instruments - Schedu

Derivative Instruments - Schedule of Fair Values of Derivative Instruments (Detail) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Prepaid expenses and other current assets [Member] | Cross-Currency swap [Member]
Derivatives Fair Value [Line Items]
Fair value: favorable (unfavorable)	$ 2,374	$ 2,485
Other long-term assets [Member] | Warrants [Member]
Derivatives Fair Value [Line Items]
Fair value: favorable (unfavorable)	$ 321	$ 321

Derivative Instruments - Sche29

Derivative Instruments - Schedule of Gain (Loss) Recognized in Other Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Cross-Currency swap [Member]
Derivative [Line Items]
Unrealized gain (loss) on derivative instruments, net of taxes	$ 50	$ 267	$ 76	$ 936
Warrants [Member]
Derivative [Line Items]
Unrealized gain (loss) on derivative instruments, net of taxes		$ 4

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2016	Dec. 31, 2015
Fair Value, Inputs, Level 3 [Member] | Debt Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	$ 9,438	$ 12,658
Fair Value, Measurements, Recurring [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	14,375	17,597
Deferred compensation plan, Liabilities	(1,488)	(1,503)
Liabilities fair value, Total	(1,488)	(1,503)
Fair Value, Measurements, Recurring [Member] | Collective Trust Funds [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	1,599	1,622
Fair Value, Measurements, Recurring [Member] | Treasury Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	521	495
Fair Value, Measurements, Recurring [Member] | Certificates of Deposit [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	443	337
Fair Value, Measurements, Recurring [Member] | Derivative Instruments [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	2,374	2,485
Fair Value, Measurements, Recurring [Member] | Debt Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	9,438	12,658
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	964	832
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Treasury Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	521	495
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 1 [Member] | Certificates of Deposit [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	443	337
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	3,973	4,107
Deferred compensation plan, Liabilities	(1,488)	(1,503)
Liabilities fair value, Total	(1,488)	(1,503)
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Collective Trust Funds [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	1,599	1,622
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 2 [Member] | Derivative Instruments [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	2,374	2,485
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	9,438	12,658
Fair Value, Measurements, Recurring [Member] | Fair Value, Inputs, Level 3 [Member] | Debt Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	$ 9,438	$ 12,658

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Thousands	Mar. 04, 2015	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2016
Debt Securities [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Unrealized loss on debt securities		$ 3,000	$ 800	$ 3,860
eNeura Note [Member] | eNeura Inc [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Non-refundable fees paid	$ 300
Accrued interest on promissory note	8.00%
Maturity description of Promissory note				The eNeura Note will mature on the earlier of (i) March 4, 2019, or (ii) exercise of the Option.
Debt Instrument, Maturity Date				Mar. 4, 2019
eNeura Note [Member] | eNeura Inc [Member] | Convertible Debt Securities
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Principal amount of promissory note	$ 15,000

Fair Value Measurements - Sch32

Fair Value Measurements - Schedule of Reconciliation of Debt Securities (Detail) - Debt Securities [Member] - Fair Value, Inputs, Level 3 [Member] - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Mar. 31, 2016	Jun. 30, 2016
Fair Value Assets Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning balance		$ 12,658	$ 12,658
Accrued interest income			640
Unrealized loss on debt securities	$ (3,000)	$ (800)	(3,860)
Ending balance	$ 9,438		$ 9,438

Accumulated Other Comprehensi33

Accumulated Other Comprehensive Loss - Components of Changes in Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			$ 290,311
Unrealized gain on derivative instruments, net of tax	$ 50	$ 271	76	$ 936
Unrealized loss on debt securities, net of tax	(1,942)		(2,469)
Foreign currency translation adjustment			651
Ending Balance	258,231		258,231
Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			(4,389)
Foreign currency translation adjustment			651
Ending Balance	(3,738)		(3,738)
Change in Fair Value of Derivatives [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			228
Unrealized gain on derivative instruments, net of tax			76
Ending Balance	304		304
Change in Fair Value of Debt Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			(2,071)
Unrealized loss on debt securities, net of tax			(2,469)
Ending Balance	(4,540)		(4,540)
Accumulated Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			(6,232)
Ending Balance	$ (7,974)		$ (7,974)

Accumulated Other Comprehensi34

Accumulated Other Comprehensive Loss - Components of Changes in Accumulated Other Comprehensive Loss (Parenthetical) (Detail)	6 Months Ended
	Jun. 30, 2016USD ($)
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized gain on derivative instruments, tax	$ 51,000
Unrealized loss on debt securities, tax	1,391,000
Deferred taxes recognized on related foreign currency translation adjustment	0
Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Deferred taxes recognized on related foreign currency translation adjustment	0
Change in Fair Value of Derivatives [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized gain on derivative instruments, tax	51,000
Change in Fair Value of Debt Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized loss on debt securities, tax	$ 1,391,000

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Reconciliation of Weighted Average Shares Used in Calculation of Basic and Diluted Net (Loss) Income Per Share (Detail) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Earnings Per Share [Abstract]
Weighted average common shares-basic	18,147,681	18,769,415	18,312,781	18,750,804
Effect of dilutive securities:
Unexercised stock options net of treasury share repurchase		220,164
Weighted average common shares-diluted	18,147,681	18,989,579	18,312,781	18,750,804

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Detail) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Options to Purchase Common Stock and Performance-Based Restricted Stock Awards [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Outstanding awards and options not included in diluted earnings per share		792,149
Common Stock Equivalents [Member] | Performance-based restricted stock [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Outstanding awards and options not included in diluted earnings per share	490,296		484,201	1,081,308

Share-based Compensation - Addi

Share-based Compensation - Additional Information (Detail) - USD ($)	Jun. 30, 2016	Aug. 05, 2015	Jun. 30, 2015	Jun. 30, 2014	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense recognized					$ 1,900,000	$ 1,800,000	$ 3,900,000	$ 3,600,000
Shares issued under stock purchase plan, stock option exercises and restricted stock					325,393	81,974	528,791	227,840
Performance Based [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense recognized	$ 0
Non-vested shares		41,910	68,750	99,600

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Income Tax Disclosure [Abstract]
Income tax expense	$ (3,685)	$ (1,778)	$ (7,979)	$ (2,742)
Income tax effective rate	141.50%	30.40%	126.30%	298.70%
Income tax effective rate excluding the impact of discrete charges	131.60%	29.60%	119.60%	256.60%

Business Segment Information -

Business Segment Information - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2016Segment
Segment Reporting [Abstract]
Number of strategic business units	4

Business Segment Information 40

Business Segment Information - Schedule of Net Sales by SBU Reporting Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Segment Reporting Information [Line Items]
Net Sales	$ 104,075	$ 100,954	$ 202,754	$ 190,716
Reported Change	3.10%		6.30%
BioStim [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 44,758	40,703	$ 85,802	78,403
Reported Change	10.00%		9.40%
Biologics [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 14,256	15,274	$ 28,350	29,235
Reported Change	(6.70%)		(3.00%)
Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 26,817	25,594	$ 51,526	47,409
Reported Change	4.80%		8.70%
Spine Fixation [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 18,244	$ 19,383	$ 37,076	$ 35,669
Reported Change	(5.90%)		3.90%

Business Segment Information 41

Business Segment Information - Summary of Net Margin as Gross Profit Less Sales and Marketing Expense by SBU Reporting Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2016	Jun. 30, 2015	Jun. 30, 2016	Jun. 30, 2015
Segment Reporting Information [Line Items]
Gross profit	$ 81,560	$ 79,044	$ 158,103	$ 149,467
Less: Sales and marketing	(46,037)	(42,946)	(90,853)	(87,231)
Total net margin	35,523	36,098	67,250	62,236
General and administrative	17,954	22,506	34,672	44,075
Research and development	6,792	6,451	14,428	12,296
Restatements and related costs	545	2,213	790	8,129
Charges related to U.S. Government resolutions (Note 11)	12,870		12,870
Operating (loss) income	(2,638)	4,928	4,490	(2,264)
Operating Segments [Member] | BioStim [Member]
Segment Reporting Information [Line Items]
Total net margin	18,577	16,787	34,988	30,800
Operating Segments [Member] | Biologics [Member]
Segment Reporting Information [Line Items]
Total net margin	6,719	7,285	12,823	13,229
Operating Segments [Member] | Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Total net margin	8,162	9,149	15,340	16,165
Operating Segments [Member] | Spine Fixation [Member]
Segment Reporting Information [Line Items]
Total net margin	2,203	3,173	4,539	2,644
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Total net margin	(138)	(296)	(440)	(602)
Material Reconciling Items [Member]
Segment Reporting Information [Line Items]
General and administrative	17,954	22,506	34,672	44,075
Research and development	6,792	6,451	14,428	12,296
Restatements and related costs	$ 545	$ 2,213	$ 790	$ 8,129

Contingencies - Additional Info

Contingencies - Additional Information (Detail) - USD ($)	3 Months Ended	6 Months Ended	12 Months Ended
	Jun. 30, 2016	Jun. 30, 2016	Dec. 31, 2012	Jun. 30, 2015
Commitment And Contingencies [Line Items]
Judgments and settlement costs	$ 500,000	$ 500,000		$ 0
Amount paid to settlement of claims		1,300,000
Discontinued operations for compensatory damages and exemplary damages	5,800,000	5,800,000
Litigation Related To Promeca [Member]
Commitment And Contingencies [Line Items]
Deferred prosecution agreement term			3 years
Sec Matter [Member]
Commitment And Contingencies [Line Items]
Charges related to U.S. Government resolutions		8,300,000
Brazil Related Allegations [Member]
Commitment And Contingencies [Line Items]
Allegations related charge	4,600,000
Brazil Related Allegations [Member] | Maximum [Member]
Commitment And Contingencies [Line Items]
Additional loss in excess of loss accrued	$ 1,500,000	$ 1,500,000

Share Repurchase Plan - Additio

Share Repurchase Plan - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended
	Jul. 29, 2016	Jun. 30, 2016	Dec. 31, 2015
Equity Class Of Treasury Stock [Line Items]
Share repurchase program, authorized amount			$ 75,000,000
Common stock repurchased, shares		403,688
Common stock repurchased, amount		$ 17,400,000
Common stock repurchased, price per share		$ 43.16
Share repurchase program, remaining authorized amount		$ 19,500,000
Subsequent Event [Member]
Equity Class Of Treasury Stock [Line Items]
Common stock repurchased, shares	45,108
Common stock repurchased, amount	$ 2,100,000