Orthofix Medical (OFIX) 10-Q 31 Oct 16 2016 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2016	Oct. 28, 2016
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2016
Document Fiscal Year Focus	2,016
Document Fiscal Period Focus	Q3
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		17,826,136

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 46,824	$ 63,663
Trade accounts receivable, less allowance for doubtful accounts of $8,840 and $8,923 at September 30, 2016 and December 31, 2015, respectively	52,893	59,839
Inventories	65,013	57,563
Prepaid expenses and other current assets	20,519	31,187
Total current assets	185,249	212,252
Property, plant and equipment, net	51,861	52,306
Patents and other intangible assets, net	8,020	5,302
Goodwill	53,565	53,565
Deferred income taxes	56,222	57,306
Other long-term assets	21,136	19,491
Total assets	376,053	400,222
Current liabilities:
Trade accounts payable	14,375	16,391
Other current liabilities	68,900	65,597
Total current liabilities	83,275	81,988
Other long-term liabilities	19,598	27,923
Total liabilities	102,873	109,911
Contingencies (Note 11)
Shareholders’ equity:
Common shares $0.10 par value; 50,000,000 shares authorized; 18,036,712 and 18,659,696 issued and outstanding as of September 30, 2016 and December 31, 2015, respectively	1,804	1,866
Additional paid-in capital	208,109	232,126
Retained earnings	67,415	62,551
Accumulated other comprehensive loss	(4,148)	(6,232)
Total shareholders’ equity	273,180	290,311
Total liabilities and shareholders’ equity	$ 376,053	$ 400,222

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Statement Of Financial Position [Abstract]
Trade accounts receivable, allowance for doubtful accounts	$ 8,840	$ 8,923
Common shares, par value	$ 0.10	$ 0.10
Common shares, authorized	50,000,000	50,000,000
Common shares, issued	18,036,712	18,659,696
Common shares, outstanding	18,036,712	18,659,696

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Income Statement [Abstract]
Product sales	$ 84,997	$ 87,761	$ 261,490	$ 251,461
Marketing service fees	13,500	13,390	39,761	40,406
Net sales	98,497	101,151	301,251	291,867
Cost of sales	19,880	23,865	64,533	65,114
Gross profit	78,617	77,286	236,718	226,753
Operating expenses
Sales and marketing	41,717	46,129	132,582	133,360
General and administrative	18,581	19,348	53,341	63,423
Research and development	6,858	6,523	21,294	18,819
Restatements and related costs	691	1,147	1,481	9,276
Charges related to U.S. Government resolutions (Note 11)	1,499		14,369
Total operating expenses	69,346	73,147	223,067	224,878
Operating income	9,271	4,139	13,651	1,875
Other income and expense
Interest income (expense), net	471	(125)	320	(323)
Other (expense) income, net	(634)	(1,736)	1,346	(192)
Total other income (expense)	(163)	(1,861)	1,666	(515)
Income before income taxes	9,108	2,278	15,317	1,360
Income tax benefit (expense)	1,276	(3,066)	(6,703)	(5,808)
Net income (loss) from continuing operations	10,384	(788)	8,614	(4,448)
Discontinued operations (Note 11)
Loss from discontinued operations	(1,018)	(804)	(3,580)	(2,315)
Income tax benefit	530	221	1,258	585
Net loss from discontinued operations	(488)	(583)	(2,322)	(1,730)
Net income (loss)	$ 9,896	$ (1,371)	$ 6,292	$ (6,178)
Net income (loss) per common share—basic:
Net income (loss) from continuing operations	$ 0.57	$ (0.04)	$ 0.47	$ (0.24)
Net loss from discontinued operations	(0.02)	(0.03)	(0.13)	(0.09)
Net income (loss) per common share—basic	0.55	(0.07)	0.34	(0.33)
Net income (loss) per common share—diluted:
Net income (loss) from continuing operations	0.56	(0.04)	0.46	(0.24)
Net loss from discontinued operations	(0.02)	(0.03)	(0.12)	(0.09)
Net income (loss) per common share—diluted	$ 0.54	$ (0.07)	$ 0.34	$ (0.33)
Weighted average number of common shares:
Basic	18,091,650	18,855,533	18,238,533	18,785,696
Diluted	18,382,118	18,855,533	18,569,861	18,785,696
Other comprehensive income (loss):
Unrealized (loss) gain on derivative instruments, net of tax	$ (2)	$ (706)	$ 74	$ 230
Unrealized gain on debt securities, net of tax	3,008		539
Foreign currency translation adjustment	820	(365)	1,471	(3,666)
Comprehensive income (loss)	$ 13,722	$ (2,442)	$ 8,376	$ (9,614)

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015
Cash flows from operating activities:
Net cash provided by operating activities	$ 38,396	$ 26,539
Cash flows from investing activities:
Capital expenditures for property, plant and equipment	(12,934)	(20,980)
Capital expenditures for intangible assets	(1,327)	(219)
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	(17,874)	(31,649)
Cash flows from financing activities:
Proceeds from issuance of common shares	19,688	3,106
Tax payments for shares withheld to satisfy withholding obligations	(2,354)	(1,437)
Payment of debt issuance costs		(1,723)
Changes in restricted cash		34,424
Repurchase and retirement of common shares	(54,996)
Net cash (used in) provided by financing activities	(37,662)	34,370
Effect of exchange rate changes on cash	301	(2,381)
Net (decrease) increase in cash and cash equivalents	(16,839)	26,879
Cash and cash equivalents at the beginning of the period	63,663	36,815
Cash and cash equivalents at the end of the period	$ 46,824	$ 63,694

Nature of operations, basis of

Nature of operations, basis of presentation and recently issues accounting pronouncements	9 Months Ended
	Sep. 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 strategic business units (SBUs): BioStim, Biologics, Extremity Fixation and Spine Fixation. 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, is based on full year forecasts. Change in accounting principle for goodwill During the quarter ended September 30, 2016, the Company voluntarily changed its annual goodwill testing date from the end of the fourth quarter, December 31, to the beginning of the fourth quarter, October 1. The Company believes this change in the method of applying the accounting principle is preferable, as it will more closely align the annual impairment testing date with the most current information from the budgeting and strategic planning process and will provide management with additional time to complete its annual assessment in advance of our year-end reporting. The change will not delay, accelerate or avoid an impairment charge. This change is not applied retrospectively, as it is impracticable to do so because retrospective application would require application of significant estimates and assumptions with the use of hindsight. Accordingly, the change will be applied prospectively. Recently adopted accounting standard In March 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2016-09, Improvements to Employee Share-Based Payment Accounting. This ASU simplifies several aspects of the accounting for share-based payment transactions, including the income tax consequences, accounting for forfeitures, and classification on the statement of cash flows. During the quarter ended September 30, 2016, the Company early adopted this new accounting standard with an effective date of January 1, 2016. Under the new standard, all excess tax benefits and tax deficiencies will be recognized as income tax expense or benefit in the income statement as discrete items in the reporting period in which they occur. Recently issued accounting pronouncements In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606) 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 October 2016, the FASB issued ASU 2016-16, Intra-Entity Transfers of Assets Other Than Inventory

Inventories

Inventories	9 Months Ended
	Sep. 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) September 30, 2016 December 31, 2015 Raw materials $ 4,809 $ 4,976 Work-in-process 7,838 5,087 Finished products 48,358 42,947 Deferred cost of sales 4,008 4,553 Total inventory $ 65,013 $ 57,563

Long-term debt

Long-term debt	9 Months Ended
	Sep. 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., 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 September 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 September 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 not made any borrowings on its €5.8 million ($6.5 million and $6.3 million) available line of credit in Italy at September 30, 2016 and December 31, 2015, respectively. 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	9 Months Ended
	Sep. 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, which is designated and accounted for as a cash flow hedge, 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 September 30, 2016 Fair f (unfavorable) Balance sheet classification Cross-currency swap $ 2,247 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 September 30, Nine Months Ended September 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 Cross-currency swap unrealized (loss) gain, net of taxes $ (2 ) $ (706 ) $ 74 $ 230 Warrants unrealized loss, net of taxes $ — $ — $ — $ —

Fair value measurements

Fair value measurements	9 Months Ended
	Sep. 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) September 30, 2016 Level 1 Level 2 Level 3 Assets Collective trust funds $ 1,594 $ — $ 1,594 $ — Treasury securities 487 487 — — Certificates of deposit 452 452 — — Derivative instruments 2,247 — 2,247 — Debt securities 14,470 — — 14,470 Total $ 19,250 $ 939 $ 3,841 $ 14,470 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 provided the Company an exclusive acquire eNeura (the “Option”) during 18-month following grant the Option, which the Company elected to let expire in September 2016. 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 March 4, 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 969 Unrealized gain on debt securities 843 Balance at September 30, 2016 $ 14,470

Accumulated other comprehensive

Accumulated other comprehensive loss	9 Months Ended
	Sep. 30, 2016
Equity [Abstract]
Accumulated other comprehensive loss	6. 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 Derivatives 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 $50 — 74 — 74 Unrealized gain on debt securities, net of tax benefit of $304 — — 539 539 Foreign currency translation adjustment (1) 1,471 — — 1,471 Balance at September 30, 2016 $ (2,918 ) $ 302 $ (1,532 ) $ (4,148 ) ___________________________________________ (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	9 Months Ended
	Sep. 30, 2016
Earnings Per Share [Abstract]
Earnings per share	7. Earnings per share For the three and nine months ended September 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 income (loss) per common share computations. Three Months Ended September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Weighted average common shares-basic 18,091,650 18,855,533 18,238,533 18,785,696 Effect of dilutive securities: Unexercised stock options and employee stock purchase plan, net of treasury share repurchase 290,468 — 331,328 — Weighted average common shares-diluted 18,382,118 18,855,533 18,569,861 18,785,696 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 571,601 and 468,286 outstanding awards and options not included in the diluted earnings per share computation for the three and nine months ended September 30, 2016, because their inclusion was antidilutive. Due to the Company having a net loss from continuing operations position for the three and nine months ended September 30, 2015, there were 1,203,424 and 1,153,763 potentially dilutive shares excluded from the computation, respectively, as their effects were antidilutive.

Share-based compensation

Share-based compensation	9 Months Ended
	Sep. 30, 2016
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Share-based compensation	8. Share-based compensation All share-based compensation awards 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 $8.1 million and $12.2 million, respectively, of share-based compensation expense for the three and nine months ended September 30, 2016 and $1.9 million and $5.5 million, respectively, for the three and nine months ended September 30, 2015. On June 30, 2014, the Company granted 99,600 shares of performance-based vesting restricted stock to executive officers and certain employees. Vesting is based on achieving adjusted earnings targets in two consecutive rolling four quarter periods prior to December 31, 2017. As of September 30, 2016, the Company determined these performance-based awards were probable to vest, resulting in the recognition of $2.7 million of expense for the quarter ended September 30, 2016. Between June 30, 2015 and August 5, 2015, the Company granted 110,660 shares of performance-based vesting restricted stock, coupled with performance stock units (“PSUs”), to executive officers and certain employees. Vesting of the restricted stock is based on achieving adjusted earnings or return on invested capital targets as of and for any of the years ended December 31, 2016, 2017 or 2018. As of September 30, 2016, the Company determined these performance-based awards were probable to vest, resulting in the recognition of $2.4 million of expense for the quarter ended September 30, 2016. The PSUs, which represent the potential to receive additional shares of common stock in an amount up to 50% of the shares of restricted stock granted, are based on adjusted earnings and return on invested capital targets as of and for the year ended December 31, 2018. On July 1, 2016, the Company granted 96,245 market-based PSUs to executive officers and certain employees. The awards, if performance goals are achieved, will be settled in shares of common stock, with one share of common stock issued per PSU if targets are achieved at a 100% level. Awards may be achieved at a minimum level of 50% and a maximum level of 200%. The performance targets are based the Company’s stock achieving certain total shareholder return targets relative to specified index companies during a 3-year performance period beginning on July 1, 2016. As of September 30, 2016, approximately $0.5 million of expense has been recognized for these contingent performance units. During the three months ended September 30, 2016 and 2015, there were 181,235 and 43,326 shares, respectively, of common stock issued related to stock purchase plan issuances, stock option exercises and the vesting of restricted stock awards. During the nine months ended September 30, 2016 and 2015, there were 710,026 and 271,166 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	9 Months Ended
	Sep. 30, 2016
Income Tax Disclosure [Abstract]
Income taxes	9. Income taxes For the third quarter, the effective tax rate on continuing operations was (14.0)%, resulting in a benefit of $1.3 million, as compared to 134.6%, resulting in expense of $3.1 million, for the same period in the prior year. Excluding the impact of discrete tax items, the effective tax rate on continuing operations for the third quarter of 2016 and 2015 was 29.2% and 63.3%, respectively. For the first nine months of 2016, the effective tax rate on continuing operations was 43.8%, or $6.7 million, as compared to 427.1%, or $5.8 million, for the same period in the prior year. Excluding the impact of discrete tax items, the effective tax rate on continuing operations for the first nine months of 2016 and 2015 was 66.5% and 279.2%, respectively. During the third quarter of 2016, the Company changed its estimate relating to the deductibility of certain compensation expenses. This change in estimate reduced tax expense and increased net income from continuing operations by $2.9 million and increased earnings per share by $0.16 for both the three and nine months ended September 30, 2016. The primary factors affecting the Company’s effective tax rate for the three and nine months ended September 30, 2016, were expense categorized as “Charges related to US Government Resolutions,” which represents anticipated settlement payments with substantially no tax benefit, and the change in estimate relating to the deductibility of certain compensation expenses. Other factors affecting the Company’s effective tax rate for the three and nine months ended September 30, 2016, and 2015 were the mix of earnings among tax jurisdictions, state taxes, and current period losses in certain jurisdictions for which the Company does not currently receive a tax benefit. During the third quarter of 2015, the Internal Revenue Service commenced an examination of the Company’s federal income tax return for 2012. Further, in October 2016, the Company was notified of an examination of the Company’s federal income tax return for 2013. The Company cannot reasonably determine if these examinations will have a material impact on its financial statements and cannot predict the timing regarding resolution of these tax examinations.

Business segment information

Business segment information	9 Months Ended
	Sep. 30, 2016
Segment Reporting [Abstract]
Business segment information	10. Business segment information The Company has four 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 the Company defines 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 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 September 30, (U.S. Dollars, in thousands) 2016 2015 Change BioStim $ 42,956 $ 41,559 3.4 % Biologics 14,335 14,639 (2.1 )% Extremity Fixation 24,314 24,694 (1.5 )% Spine Fixation 16,892 20,259 (16.6 )% Total net sales $ 98,497 $ 101,151 (2.6 )% Nine Months Ended September 30, (U.S. Dollars, in thousands) 2016 2015 Change BioStim $ 128,758 $ 119,962 7.3 % Biologics 42,685 43,874 (2.7 )% Extremity Fixation 75,840 72,103 5.2 % Spine Fixation 53,968 55,928 (3.5 )% Total net sales $ 301,251 $ 291,867 3.2 % The table below presents net margin by SBU reporting segment for the three and nine months ended September 30, 2016 and 2015: Three Months Ended September 30, Nine Months Ended September 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 BioStim $ 19,996 $ 16,834 $ 54,980 $ 47,634 Biologics 6,821 6,296 19,642 19,525 Extremity Fixation 8,834 6,442 24,170 22,607 Spine Fixation 1,388 1,938 5,925 4,582 Corporate (139 ) (353 ) (581 ) (955 ) Total net margin 36,900 31,157 104,136 93,393 General and administrative 18,581 19,348 53,341 63,423 Research and development 6,858 6,523 21,294 18,819 Restatements and related costs 691 1,147 1,481 9,276 Charges related to U.S. Government resolutions 1,499 – 14,369 – Operating income $ 9,271 $ 4,139 $ 13,651 $ 1,875

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2016
Commitments And Contingencies Disclosure [Abstract]
Contingencies	1 1 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 the matters that remain pending 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. Commercial Litigation Settlement During the third quarter of 2016, the Company entered into an agreement to settle an outstanding commercial litigation matter, whereby the Company will receive a $3.0 million cash payment. 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. 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 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. SEC Investigation In connection with the initiation of the Audit Committee’s independent review, the Company 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 SEC conducted a formal investigation of these matters, and both the Company and the Audit Committee cooperated fully with the SEC. 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, and the Company previously recorded a charge in this amount during the second quarter of 2016 for this matter. 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. Deferred Prosecution Agreement and Review of Potentially 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 former 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, the Company entered into a three-year deferred prosecution agreement (“DPA”) with the DOJ and a consent to final judgment (the “Consent”) with the SEC. Under the DPA, the DOJ agreed not to pursue any criminal charges against the Company in connection with the Promeca matter if the Company complied with the terms of the DPA. The DPA took note of the Company’s 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 the Company. The DPA and the Consent collectively required, among other things that with respect to anti-bribery compliance matters the Company 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, the Company represented that it had implemented and would 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 maintaining a system of internal controls. The Company 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 potentially improper payments with respect to its Brazilian subsidiary, Orthofix do Brasil Ltda., and promptly contacted both the DOJ and the SEC Enforcement Staff to voluntarily self-report the allegations. Following the self-report, the Company cooperated fully with the DOJ’s investigation of those 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; on July 29, 2016, the DOJ filed with the court a dismissal of the underlying Promeca-related case; and, on August 1, 2016, the court entered an order granting the DOJ’s motion to dismiss such case without prejudice. The Company also fully cooperated with the SEC’s investigation of the allegations in Brazil. The Company has been engaged in discussions with the SEC Enforcement Staff regarding a resolution of the Brazil-related allegations as they relate to the SEC's jurisdiction. 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. The Company recorded a charge of $4.6 million in the second quarter of 2016, and a further charge of approximately $1.5 million in the third quarter of 2016, for this matter. However, no assurance can be given that we will be able to achieve a final, definitive resolution with the SEC on these or other terms, and the failure to resolve this matter on these or other terms could adversely affect our business and operations. Matters Related to the Company’s Former Breg Subsidiary and Possible Indemnification Obligations On May 24, 2012, the Company sold Breg to an affiliate of Water Street Healthcare Partners II, L.P. (“Water Street”) pursuant to a stock purchase agreement (the “Breg SPA”). Under the terms of the Breg SPA, upon closing of the sale, the Company and its subsidiary, Orthofix Holdings, Inc., agreed to indemnify Water Street and Breg with respect to certain specified matters, including 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 nine months of 2016 of $0.8 million as compared to $0.3 million in the first nine 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 the Company, Breg was 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 September 30, 2016, the Company has accrued $5.7 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. On October 28, 2016, the California Court of Appeal issued a ruling in Engler v. Breg, Inc. et al. , reversing in part and affirming in part the judgment entered against Breg in 2012. The Company is evaluating the ruling. 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	9 Months Ended
	Sep. 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 to date have consisted of open market transactions at prevailing market prices in accordance with the guidelines specified under Rule 10b-18 of the Exchange Act, 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 September 30, 2016, the Company repurchased 253,063 shares of common stock for $11.1 million with an average price per share of $43.90 which were all retired upon repurchase. As of September 30, 2016, there was $8.4 million remaining under this share repurchase authorization. From October 1, 2016, to October 28, 2016, the Company made additional repurchases of 211,671 shares for an amount equal to $8.4 million to complete the share repurchase plan.

Nature of operations, basis o18

Nature of operations, basis of presentation and recently issues accounting pronouncements (Policies)	9 Months Ended
	Sep. 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, is based on full year forecasts.
Change in accounting principle for goodwill	Change in accounting principle for goodwill During the quarter ended September 30, 2016, the Company voluntarily changed its annual goodwill testing date from the end of the fourth quarter, December 31, to the beginning of the fourth quarter, October 1. The Company believes this change in the method of applying the accounting principle is preferable, as it will more closely align the annual impairment testing date with the most current information from the budgeting and strategic planning process and will provide management with additional time to complete its annual assessment in advance of our year-end reporting. The change will not delay, accelerate or avoid an impairment charge. This change is not applied retrospectively, as it is impracticable to do so because retrospective application would require application of significant estimates and assumptions with the use of hindsight. Accordingly, the change will be applied prospectively.
Recently adopted accounting standard	Recently adopted accounting standard In March 2016, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) 2016-09, Improvements to Employee Share-Based Payment Accounting. This ASU simplifies several aspects of the accounting for share-based payment transactions, including the income tax consequences, accounting for forfeitures, and classification on the statement of cash flows. During the quarter ended September 30, 2016, the Company early adopted this new accounting standard with an effective date of January 1, 2016. Under the new standard, all excess tax benefits and tax deficiencies will be recognized as income tax expense or benefit in the income statement as discrete items in the reporting period in which they occur.
Recently issued accounting pronouncements	Recently issued accounting pronouncements In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606) 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 October 2016, the FASB issued ASU 2016-16, Intra-Entity Transfers of Assets Other Than Inventory

Inventories (Tables)

Inventories (Tables)	9 Months Ended
	Sep. 30, 2016
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories were as follows: (U.S. Dollars, in thousands) September 30, 2016 December 31, 2015 Raw materials $ 4,809 $ 4,976 Work-in-process 7,838 5,087 Finished products 48,358 42,947 Deferred cost of sales 4,008 4,553 Total inventory $ 65,013 $ 57,563

Derivative instruments (Tables)

Derivative instruments (Tables)	9 Months Ended
	Sep. 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, which is designated and accounted for as a cash flow hedge, 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 September 30, 2016 Fair f (unfavorable) Balance sheet classification Cross-currency swap $ 2,247 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 September 30, Nine Months Ended September 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 Cross-currency swap unrealized (loss) gain, net of taxes $ (2 ) $ (706 ) $ 74 $ 230 Warrants unrealized loss, net of taxes $ — $ — $ — $ —

Fair value measurements (Tables

Fair value measurements (Tables)	9 Months Ended
	Sep. 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) September 30, 2016 Level 1 Level 2 Level 3 Assets Collective trust funds $ 1,594 $ — $ 1,594 $ — Treasury securities 487 487 — — Certificates of deposit 452 452 — — Derivative instruments 2,247 — 2,247 — Debt securities 14,470 — — 14,470 Total $ 19,250 $ 939 $ 3,841 $ 14,470 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 969 Unrealized gain on debt securities 843 Balance at September 30, 2016 $ 14,470

Accumulated other comprehensi22

Accumulated other comprehensive loss (Tables)	9 Months Ended
	Sep. 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 Derivatives 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 $50 — 74 — 74 Unrealized gain on debt securities, net of tax benefit of $304 — — 539 539 Foreign currency translation adjustment (1) 1,471 — — 1,471 Balance at September 30, 2016 $ (2,918 ) $ 302 $ (1,532 ) $ (4,148 ) ___________________________________________ (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)	9 Months Ended
	Sep. 30, 2016
Earnings Per Share [Abstract]
Schedule of Reconciliation of Weighted Average Shares Used in Calculation of Basic and Diluted Net Income (Loss) 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 September 30, Nine Months Ended September 30, 2016 2015 2016 2015 Weighted average common shares-basic 18,091,650 18,855,533 18,238,533 18,785,696 Effect of dilutive securities: Unexercised stock options and employee stock purchase plan, net of treasury share repurchase 290,468 — 331,328 — Weighted average common shares-diluted 18,382,118 18,855,533 18,569,861 18,785,696

Business segment information (T

Business segment information (Tables)	9 Months Ended
	Sep. 30, 2016
Segment Reporting [Abstract]
Schedule of Net Sales by SBU Reporting Segment	The tables below present net sales 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 September 30, (U.S. Dollars, in thousands) 2016 2015 Change BioStim $ 42,956 $ 41,559 3.4 % Biologics 14,335 14,639 (2.1 )% Extremity Fixation 24,314 24,694 (1.5 )% Spine Fixation 16,892 20,259 (16.6 )% Total net sales $ 98,497 $ 101,151 (2.6 )% Nine Months Ended September 30, (U.S. Dollars, in thousands) 2016 2015 Change BioStim $ 128,758 $ 119,962 7.3 % Biologics 42,685 43,874 (2.7 )% Extremity Fixation 75,840 72,103 5.2 % Spine Fixation 53,968 55,928 (3.5 )% Total net sales $ 301,251 $ 291,867 3.2 %
Summary of Net Margin by SBU Reporting Segment	The table below presents net margin by SBU reporting segment for the three and nine months ended September 30, 2016 and 2015: Three Months Ended September 30, Nine Months Ended September 30, (U.S. Dollars, in thousands) 2016 2015 2016 2015 BioStim $ 19,996 $ 16,834 $ 54,980 $ 47,634 Biologics 6,821 6,296 19,642 19,525 Extremity Fixation 8,834 6,442 24,170 22,607 Spine Fixation 1,388 1,938 5,925 4,582 Corporate (139 ) (353 ) (581 ) (955 ) Total net margin 36,900 31,157 104,136 93,393 General and administrative 18,581 19,348 53,341 63,423 Research and development 6,858 6,523 21,294 18,819 Restatements and related costs 691 1,147 1,481 9,276 Charges related to U.S. Government resolutions 1,499 – 14,369 – Operating income $ 9,271 $ 4,139 $ 13,651 $ 1,875

Nature of operations, basis o25

Nature of operations, basis of presentation and recently issues accounting pronouncements - Additional Information (Detail) $ in Thousands	Jan. 01, 2016USD ($)	Sep. 30, 2016USD ($)Segment	Sep. 30, 2015USD ($)
Organization Consolidation Basis Of Presentation Business Description And Accounting Policies [Line Items]
Number of strategic business units | Segment		4
Decrease in net cash provided by financing activities		$ 37,662	$ (34,370)
Increase in net cash from operating activities		$ 38,396	26,539
ASU 2016-09 [Member]
Organization Consolidation Basis Of Presentation Business Description And Accounting Policies [Line Items]
Decrease in net cash provided by financing activities			300
Increase in net cash from operating activities			$ 300
Cumulative-effect adjustment to retained earnings	$ 1,400

Inventories - Schedule of Inven

Inventories - Schedule of Inventories (Detail) - USD ($) $ in Thousands	Sep. 30, 2016	Dec. 31, 2015
Inventory Disclosure [Abstract]
Raw materials	$ 4,809	$ 4,976
Work-in-process	7,838	5,087
Finished products	48,358	42,947
Deferred cost of sales	4,008	4,553
Total inventory	$ 65,013	$ 57,563

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2016USD ($)	Sep. 30, 2016EUR (€)	Dec. 31, 2015USD ($)	Aug. 31, 2015USD ($)
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 6,500,000	€ 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	Sep. 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)	$ 2,247	$ 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		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Cross-Currency swap [Member]
Derivative [Line Items]
Unrealized gain (loss) on derivative instruments, net of taxes	$ (2)	$ (706)	$ 74	$ 230

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Sep. 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	$ 14,470	$ 12,658
Fair Value, Measurements, Recurring [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	19,250	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	1,594	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	487	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	452	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	2,247	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	14,470	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	939	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	487	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	452	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	3,841	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	1,594	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	2,247	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	14,470	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	$ 14,470	$ 12,658

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Thousands	Mar. 04, 2015	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Sep. 30, 2016
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Accumulated temporary impairment		$ 2,500			$ 2,500
Debt Securities [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Unrealized gain (loss) on debt securities		$ 4,700	$ (3,000)	$ (800)	$ 843
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 March 4, 2019
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			9 Months Ended
	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Sep. 30, 2016
Fair Value Assets Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning balance			$ 12,658	$ 12,658
Accrued interest income				969
Unrealized gain on debt securities	$ 4,700	$ (3,000)	$ (800)	843
Ending balance	$ 14,470			$ 14,470

Accumulated Other Comprehensi33

Accumulated Other Comprehensive Loss - Components of Changes in Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			$ 290,311
Unrealized gain on derivative instruments, net of tax	$ (2)	$ (706)	74	$ 230
Unrealized gain on debt securities, net of tax	3,008		539
Foreign currency translation adjustment	820	$ (365)	1,471	$ (3,666)
Ending Balance	273,180		273,180
Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			(4,389)
Foreign currency translation adjustment			1,471
Ending Balance	(2,918)		(2,918)
Derivatives [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			228
Unrealized gain on derivative instruments, net of tax			74
Ending Balance	302		302
Debt Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			(2,071)
Unrealized gain on debt securities, net of tax			539
Ending Balance	(1,532)		(1,532)
Accumulated Other Comprehensive Loss [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance			(6,232)
Ending Balance	$ (4,148)		$ (4,148)

Accumulated Other Comprehensi34

Accumulated Other Comprehensive Loss - Components of Changes in Accumulated Other Comprehensive Loss (Parenthetical) (Detail)	9 Months Ended
	Sep. 30, 2016USD ($)
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized gain on derivative instruments, tax	$ 50,000
Unrealized gain on debt securities, tax	304,000
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
Derivatives [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized gain on derivative instruments, tax	50,000
Debt Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Unrealized gain on debt securities, tax	$ 304,000

Earnings Per Share - Schedule o

Earnings Per Share - Schedule of Reconciliation of Weighted Average Shares Used in Calculation of Basic and Diluted Net Income (Loss) Per Share (Detail) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Earnings Per Share [Abstract]
Weighted average common shares-basic	18,091,650	18,855,533	18,238,533	18,785,696
Effect of dilutive securities:
Unexercised stock options and employee stock purchase plan, net of treasury share repurchase	290,468		331,328
Weighted average common shares-diluted	18,382,118	18,855,533	18,569,861	18,785,696

Earnings Per Share - Additional

Earnings Per Share - Additional Information (Detail) - shares	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 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	571,601		468,286
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		1,203,424		1,153,763

Share-based Compensation - Addi

Share-based Compensation - Additional Information (Detail) - USD ($) $ in Millions	Jul. 01, 2016	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense recognized		$ 8.1	$ 1.9	$ 12.2	$ 5.5
Shares issued under stock purchase plan, stock option exercises and restricted stock		181,235	43,326	710,026	271,166
Performance Based [Member] | Maximum [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Percentage of restricted stock granted to issue additional common stock				50.00%
Market-Based Performance Share [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Common stock issued based on performance stock units	1
Percentage of performance to be achieved	100.00%
Performance period	3 years
Market-Based Performance Share [Member] | Maximum [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Percentage of performance to be achieved	200.00%
Market-Based Performance Share [Member] | Minimum [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Percentage of performance to be achieved	50.00%
June 30, 2014 Grant Date [Member] | Performance Based [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense recognized		$ 2.7
Non-vested shares		99,600
June 30, 2015 to August 5, 2015 Grant Date [Member] | Performance Based [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense recognized		$ 2.4
Non-vested shares		110,660
July 1, 2016 Grant Date [Member] | Market-Based Performance Share [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Non-vested shares		96,245
July 1, 2016 Grant Date [Member] | Contingent Performance Units [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Share-based compensation expense recognized		$ 0.5

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Income Tax Disclosure [Abstract]
Income tax expense (benefit)	$ (1,276)	$ 3,066	$ 6,703	$ 5,808
Income tax effective rate	(14.00%)	134.60%	43.80%	427.10%
Income tax effective rate excluding the impact of discrete charges	29.20%	63.30%	66.50%	279.20%
Increase in net income from continuing operations	$ 2,900		$ 2,900
Decrease in tax expense from continuing operations	$ (2,900)		$ (2,900)
Increased earnings per share	$ 0.16		$ 0.16

Business Segment Information -

Business Segment Information - Additional Information (Detail)	9 Months Ended
	Sep. 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		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Segment Reporting Information [Line Items]
Net Sales	$ 98,497	$ 101,151	$ 301,251	$ 291,867
Change	(2.60%)		3.20%
BioStim [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 42,956	41,559	$ 128,758	119,962
Change	3.40%		7.30%
Biologics [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 14,335	14,639	$ 42,685	43,874
Change	(2.10%)		(2.70%)
Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 24,314	24,694	$ 75,840	72,103
Change	(1.50%)		5.20%
Spine Fixation [Member]
Segment Reporting Information [Line Items]
Net Sales	$ 16,892	$ 20,259	$ 53,968	$ 55,928
Change	(16.60%)		(3.50%)

Business Segment Information 41

Business Segment Information - Summary of Net Margin by SBU Reporting Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2016	Sep. 30, 2015	Sep. 30, 2016	Sep. 30, 2015
Segment Reporting Information [Line Items]
Total net margin	$ 36,900	$ 31,157	$ 104,136	$ 93,393
General and administrative	18,581	19,348	53,341	63,423
Research and development	6,858	6,523	21,294	18,819
Restatements and related costs	691	1,147	1,481	9,276
Charges related to U.S. Government resolutions (Note 11)	1,499		14,369
Operating income	9,271	4,139	13,651	1,875
Operating Segments [Member] | BioStim [Member]
Segment Reporting Information [Line Items]
Total net margin	19,996	16,834	54,980	47,634
Operating Segments [Member] | Biologics [Member]
Segment Reporting Information [Line Items]
Total net margin	6,821	6,296	19,642	19,525
Operating Segments [Member] | Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Total net margin	8,834	6,442	24,170	22,607
Operating Segments [Member] | Spine Fixation [Member]
Segment Reporting Information [Line Items]
Total net margin	1,388	1,938	5,925	4,582
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Total net margin	(139)	(353)	(581)	(955)
Material Reconciling Items [Member]
Segment Reporting Information [Line Items]
General and administrative	18,581	19,348	53,341	63,423
Research and development	6,858	6,523	21,294	18,819
Restatements and related costs	$ 691	$ 1,147	$ 1,481	$ 9,276

Contingencies - Additional Info

Contingencies - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended			9 Months Ended	12 Months Ended
	Sep. 30, 2016	Jun. 30, 2016	Jun. 30, 2014	Sep. 30, 2016	Dec. 31, 2012	Sep. 30, 2015
Commitment And Contingencies [Line Items]
Settlement of claims, amount received (paid)	$ 3		$ (1.3)
Contingencies, settlement agreement, terms				During the third quarter of 2016, the Company entered into an agreement to settle an outstanding commercial litigation matter, whereby the Company will receive a $3.0 million cash payment.
Judgments and settlement costs	0.8			$ 0.8		$ 0.3
Discontinued operations for compensatory damages and exemplary damages	5.7			5.7
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				$ 8.3
Brazil Related Allegations [Member]
Commitment And Contingencies [Line Items]
Allegations related charge	$ 1.5	$ 4.6

Share Repurchase Plan - Additio

Share Repurchase Plan - Additional Information (Detail) - USD ($)	1 Months Ended	3 Months Ended
	Oct. 28, 2016	Sep. 30, 2016	Dec. 31, 2015
Equity Class Of Treasury Stock [Line Items]
Share repurchase program, authorized amount			$ 75,000,000
Common stock repurchased, shares		253,063
Common stock repurchased, amount		$ 11,100,000
Common stock repurchased, price per share		$ 43.90
Share repurchase program, remaining authorized amount		$ 8,400,000
Subsequent Event [Member]
Equity Class Of Treasury Stock [Line Items]
Common stock repurchased, shares	211,671
Common stock repurchased, amount	$ 8,400,000