Orthofix Medical (OFIX) 10-Q 4 May 17 2017 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2017	May 01, 2017
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2017
Document Fiscal Year Focus	2,017
Document Fiscal Period Focus	Q1
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	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		18,044,335

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Current assets
Cash and cash equivalents	$ 41,652	$ 39,572
Restricted cash		14,369
Accounts receivable, net of allowances of $8,394 and $8,396, respectively	59,443	57,848
Inventories	66,271	63,346
Prepaid expenses and other current assets	19,478	19,238
Total current assets	186,844	194,373
Property, plant and equipment, net	47,962	48,916
Patents and other intangible assets, net	8,530	7,461
Goodwill	53,565	53,565
Deferred income taxes	41,431	47,325
Other long-term assets	16,413	20,463
Total assets	354,745	372,103
Current liabilities
Accounts payable	16,555	14,353
Other current liabilities	46,316	69,088
Total current liabilities	62,871	83,441
Other long-term liabilities	24,740	25,185
Total liabilities	87,611	108,626
Contingencies (Note 6)
Shareholders’ equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,042,834 and 17,828,155 issued and outstanding as of March 31, 2017 and December 31, 2016, respectively	1,804	1,783
Additional paid-in capital	208,686	204,095
Retained earnings	61,525	64,179
Accumulated other comprehensive loss	(4,881)	(6,580)
Total shareholders’ equity	267,134	263,477
Total liabilities and shareholders’ equity	$ 354,745	$ 372,103

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Statement Of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 8,394	$ 8,396
Common shares, par value	$ 0.10	$ 0.10
Common shares, authorized	50,000,000	50,000,000
Common shares, issued	18,042,834	17,828,155
Common shares, outstanding	18,042,834	17,828,155

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations and Comprehensive Income (Loss) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Income Statement [Abstract]
Net sales	$ 102,738	$ 98,679
Cost of sales	22,581	22,137
Gross profit	80,157	76,542
Sales and marketing	48,532	44,822
General and administrative	18,282	17,005
Research and development	7,424	7,640
Operating income	5,919	7,075
Interest income (expense), net	45	(38)
Other income (expense), net	(4,348)	1,833
Income before income taxes	1,616	8,870
Income tax expense	(3,924)	(4,294)
Net income (loss) from continuing operations	(2,308)	4,576
Discontinued operations (Note 6)
Loss from discontinued operations	(527)	(990)
Income tax benefit	181	254
Net loss from discontinued operations	(346)	(736)
Net income (loss)	$ (2,654)	$ 3,840
Net income (loss) per common share—basic
Net income (loss) from continuing operations	$ (0.13)	$ 0.25
Net loss from discontinued operations	(0.02)	(0.04)
Net income (loss) per common share—basic	(0.15)	0.21
Net income (loss) per common share—diluted
Net income (loss) from continuing operations	(0.13)	0.24
Net loss from discontinued operations	(0.02)	(0.04)
Net income (loss) per common share—diluted	$ (0.15)	$ 0.20
Weighted average number of common shares:
Basic	17,979,675	18,477,881
Diluted	17,979,675	18,758,751
Other comprehensive income, before tax
Unrealized gain on derivative instrument		$ 48
Unrealized loss on debt securities	$ (3,220)	(824)
Reclassification adjustment for loss on debt securities in net income	5,585
Currency translation adjustment	234	1,221
Other comprehensive income before tax	2,599	445
Income tax related to items of other comprehensive loss	(900)	275
Other comprehensive income, net of tax	1,699	720
Comprehensive income (loss)	$ (955)	$ 4,560

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Cash flows from operating activities
Net income (loss)	$ (2,654)	$ 3,840
Adjustments to reconcile net income (loss) to net cash from operating activities
Depreciation and amortization	5,075	4,873
Amortization of debt costs and other assets	360	187
Provision for doubtful accounts	532	709
Deferred income taxes	5,074	953
Share-based compensation	2,816	2,099
Other-than-temporary impairment on debt securities	5,585
Other	242	1,340
Changes in operating assets and liabilities
Restricted cash	14,369
Accounts receivable	(2,074)	3,927
Inventories	(2,750)	(1,937)
Prepaid expenses and other current assets	(203)	725
Accounts payable	1,014	(3,352)
Other current liabilities	(23,253)	(8,894)
Other long-term assets and liabilities	(663)	176
Net cash from operating activities	3,470	4,646
Cash flows from investing activities
Capital expenditures for property, plant and equipment	(3,721)	(6,083)
Capital expenditures for intangible assets	(184)	(316)
Other investing activities	474	(1,000)
Net cash from investing activities	(3,431)	(7,399)
Cash flows from financing activities
Proceeds from issuance of common shares	3,876	5,756
Payments related to withholdings for share-based compensation	(2,079)	(1,014)
Repurchase and retirement of common shares		(26,464)
Net cash from financing activities	1,797	(21,722)
Effect of exchange rate changes on cash	244	658
Net change in cash and cash equivalents	2,080	(23,817)
Cash and cash equivalents at the beginning of the period	39,572	63,663
Cash and cash equivalents at the end of the period	$ 41,652	$ 39,846

Business and basis of presentat

Business and basis of presentation	3 Months Ended
	Mar. 31, 2017
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Business and basis of presentation	Business and basis of presentation Orthofix International N.V. (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 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 Form 10-K for the year ended December 31, 2016. 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 share-based compensation. Actual results could differ from these estimates.

Recent issued accounting pronou

Recent issued accounting pronouncements	3 Months Ended
	Mar. 31, 2017
Accounting Changes And Error Corrections [Abstract]
Recently issued accounting pronouncements	1. Recently issued accounting pronouncements Topic Description of Guidance Effective Date Status of Company's Evaluation Revenue Recognition (ASU 2014-09, as amended) Requires entities to recognize revenue in a way that depicts the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled to in exchange for those goods or services. Applied either retrospectively or as a cumulative effect adjustment as of the adoption date. January 1, 2018 The Company is continuing to evaluate the impact this ASU will have on its consolidated financial statements and disclosures. The Company completed an initial impact assessment and believes adopting this ASU will materially impact the timing of revenue recognition, primarily for implant product sales to stocking distributors, which are currently accounted for using the sell-through method. Specifically, the Company believes the revenue associated with these sales will be recorded at the time of the sale instead of deferring recognition until cash is received. The Company expects to adopt this new guidance using the modified retrospective transition method. Financial Instruments (ASU 2016-01) Requires entities to measure equity investments, except in limited circumstances, at fair value and recognize any changes in fair value in net income. Applied prospectively. January 1, 2018 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. Leases (ASU 2016-02) Requires a lessee to recognize lease assets and lease liabilities for leases classified as operating leases. Applied using a modified retrospective approach. January 1, 2019 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements; however, the Company expects this guidance will result in current operating lease obligations being reflected on the consolidated balance sheet. Income Taxes (ASU 2016-16) Reduces complexity by requiring current and deferred income taxes for intra-entity asset transfers, other than inventory, to be recognized when the transfer occurs. Applied using a modified retrospective approach. January 1, 2018 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. Statement of Cash Flows (ASU 2016-18) Reduces diversity in classification and presentation of restricted cash, including transfers between cash and restricted cash, on the statement of cash flows. Applied retrospectively. January 1, 2018 The Company is currently evaluating the impact this ASU may have on its consolidated statement of cash flows.

Inventories

Inventories	3 Months Ended
	Mar. 31, 2017
Inventory Disclosure [Abstract]
Inventories	2. Inventories Inventories were as follows: (U.S. Dollars, in thousands) March 31, 2017 December 31, 2016 Raw materials $ 3,966 $ 7,978 Work-in-process 11,564 9,505 Finished products 47,109 42,434 Deferred cost of sales 3,632 3,429 $ 66,271 $ 63,346

Other current liabilities

Other current liabilities	3 Months Ended
	Mar. 31, 2017
Payables And Accruals [Abstract]
Other current liabilities	3. Other current liabilities In December 2016, the Company approved and initiated a planned restructuring, which primarily affects the Extremity Fixation SBU, to streamline costs, improve operational performance, and wind down a non-core business. The restructuring plan consists primarily of severance charges and the write-down of certain assets. The Company expects to incur total pre-tax expense of approximately $2.8 million in connection with this restructuring activity and has incurred cumulative costs to date of $1.7 million. The Company had an accrual of $1.5 million as of December 31, 2016 in other current liabilities related to the planned restructuring. In the first quarter of 2017, the Company reduced its estimate of costs to be incurred by approximately $0.2 million and made additional payments of $0.2 million, resulting in an ending accrual of $1.0 million as of March 31, 2017.

Long-term debt

Long-term debt	3 Months Ended
	Mar. 31, 2017
Debt Disclosure [Abstract]
Long-term debt	4. Long-term debt As of March 31, 2017, the Company has not made any borrowings under its five year $125 million secured revolving credit facility with JPMorgan Chase Bank, N.A., as Administrative Agent, and certain lenders party thereto. The Company has also not made any borrowings on its €5.8 million ($6.2 million) available line of credit in Italy at March 31, 2017. The Company is in compliance with all required financial covenants as of March 31, 2017.

Fair value measurements

Fair value measurements	3 Months Ended
	Mar. 31, 2017
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: March 31, 2017 December 31, 2016 (U.S. Dollars, in thousands) Level 1 Level 2 Level 3 Total Total Assets Collective trust funds $ — $ 1,583 $ — $ 1,583 $ 1,584 Treasury securities 466 — — 466 467 Certificates of deposit — — — — 468 Debt securities — — 9,000 9,000 12,220 Total $ 466 $ 1,583 $ 9,000 $ 11,049 $ 14,739 Liabilities Deferred compensation plan $ — $ (1,207 ) $ — $ (1,207 ) $ (1,452 ) Total $ — $ (1,207 ) $ — $ (1,207 ) $ (1,452 ) The fair value of the debt security, which is recorded within other long-term assets, is based upon significant unobservable inputs, including the use of a discounted cash flow model, requiring the Company As of March 31, 2017, the Company revised its estimate of fair value based on current financial information and other assumptions, resulting in a fair value of $9.0 million, a decrease of $3.2 million during the first quarter of 2017. The Company evaluated the decline in fair value to determine if the impairment was other-than-temporary. Based on this evaluation, the Company recorded an other-than-temporary impairment charge of $5.6 million before income taxes, which is recorded in other expense. In addition to the decrease in fair value, the other-than-temporary impairment includes a reclassification of the amount that was previously considered temporary and included in accumulated other comprehensive loss. 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) 2017 2016 Balance at January 1 $ 12,220 $ 12,658 Accrued interest income — 316 Gains or losses recorded for the period Recognized in net income (5,585 ) — Recognized in other comprehensive income 2,365 (824 ) Balance at March 31 $ 9,000 $ 12,150

Contingencies

Contingencies	3 Months Ended
	Mar. 31, 2017
Commitments And Contingencies Disclosure [Abstract]
Contingencies	6. Contingencies In addition to the matters described below, in the normal course of its business, the Company is involved in various lawsuits from time to time and may be subject to certain other contingencies. The Company believes losses with respect to these additional matters are individually and collectively immaterial as to a possible loss and range of loss. January 2017 SEC Settlements In January 2017, the U.S. Securities and Exchange Commission (the “SEC”) approved the Company’s offers of settlement in connection with the SEC’s investigations of accounting matters leading to the Company’s prior restatement of financial statements and the Company’s review of improper payments with respect to its subsidiary in Brazil. Both investigations were initiated in 2013 and involved matters self-reported to the SEC by the Company. The settlements approved by the SEC resolved these two matters, and included payments by the Company to the SEC of amounts previously accrued and funded into escrow by the Company during 2016. In connection with the Brazil-related settlement, the Company agreed to retain an independent compliance consultant for one year to review and test the Company’s compliance program related to the U.S. Foreign Corrupt Practices Act. Discontinued Operations – Matters Related to Breg 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”). Under the terms of the agreement, the Company indemnified 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.” One case remains 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. In September 2014, the Company entered into a master settlement agreement resolving then pending pre-close cold therapy claims. Currently pending is a cold therapy claim in which the California Supreme Court recently denied a plaintiff’s request for review resulting in the plaintiff consenting to the California Court of Appeal’s proposed reduction of an adverse July 2012 jury verdict, and a post-close cold therapy claim pending in California state court. As of March 31, 2017, the Company has an accrual of $2.4 million recorded within other current liabilities; however, the actual liability could be higher or lower than the amount accrued. Charges incurred as a result of this indemnification are reflected as discontinued operations in the condensed consolidated statements of operations.

Accumulated other comprehensive

Accumulated other comprehensive loss	3 Months Ended
	Mar. 31, 2017
Equity [Abstract]
Accumulated other comprehensive loss	7. 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 Debt Securities Accumulated Other Comprehensive Loss Balance at December 31, 2016 $ (5,115 ) $ (1,465 ) $ (6,580 ) Other comprehensive income (loss) 234 (3,220 ) (2,986 ) Income taxes — 1,223 1,223 Reclassification adjustments to: Other expense, net — 5,585 5,585 Income taxes — (2,123 ) (2,123 ) Balance at March 31, 2017 $ (4,881 ) $ — $ (4,881 )

Business segment information

Business segment information	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
Business segment information	8. Business segment information The table below present net sales, which includes product sales and marketing service fees, by reporting segment: Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 Change BioStim $ 44,539 $ 41,044 8.5 % Biologics 14,987 14,094 6.3 % Extremity Fixation 23,945 24,709 -3.1 % Spine Fixation 19,267 18,832 2.3 % Net sales $ 102,738 $ 98,679 4.1 % The primary metric used in managing the Company is net margin, which the Company defines as gross profit less sales and marketing expense. The table below presents net margin by reporting segment: Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 BioStim $ 17,133 $ 16,408 Biologics 6,171 6,104 Extremity Fixation 6,412 7,175 Spine Fixation 2,007 2,335 Corporate (98 ) (302 ) Net margin $ 31,625 $ 31,720 General and administrative 18,282 17,005 Research and development 7,424 7,640 Operating income $ 5,919 $ 7,075

Share-based compensation

Share-based compensation	3 Months Ended
	Mar. 31, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Share-based compensation	9. Share-based compensation The following tables present the detail of share-based compensation by line item in the condensed consolidated statements of operations as well as by award type: Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 Cost of sales $ 149 $ 117 Sales and marketing 360 276 General and administrative 2,102 1,558 Research and development 205 148 $ 2,816 $ 2,099 Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 Stock options $ 595 $ 475 Time-based restricted stock awards 1,292 1,308 Performance-based restricted stock awards 112 — Performance-based and market-based restricted stock units 466 — Stock purchase plan 351 316 $ 2,816 $ 2,099 During the three months ended March 31, 2017 and 2016, the Company issued 214,679 and 203,398 shares, respectively, of common stock related to stock purchase plan issuances, stock option exercises and the vesting of restricted stock awards.

Income taxes

Income taxes	3 Months Ended
	Mar. 31, 2017
Income Tax Disclosure [Abstract]
Income taxes	10. Income taxes Income tax provisions for interim periods are based on an estimated annual income tax rate, adjusted for discrete tax items. As a result, the Company’s interim effective tax rates may vary significantly from the statutory tax rate and the annual effective tax rate. For the three months ended March 31, 2017 and 2016, the effective tax rate on continuing operations was 242.8% and 48.4%, respectively. The primary factors affecting the Company’s effective tax rate for the three months ended March 31, 2017, were the method for estimating income taxes at interim periods, the mix of earnings among tax jurisdictions and current period losses in certain jurisdictions for which the Company does not currently receive a tax benefit. The Internal Revenue Service is currently conducting examinations of the Company’s federal income tax returns for 2012 and 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.

Earnings per share ("EPS")

Earnings per share ("EPS")	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Earnings per share ("EPS")	11. Earnings per share (“EPS”) For the three months ended March 31, 2017 and 2016, no adjustments were made to net income (loss) for purposes of calculating basic and diluted EPS. The following is a reconciliation of the weighted average shares used in diluted EPS computations. Three Months Ended March 31, 2017 2016 Weighted average common shares-basic 17,979,675 18,477,881 Effect of dilutive securities Unexercised stock options and stock purchase plan — 138,292 Unvested time-based restricted stock awards — 142,578 Weighted average common shares-diluted 17,979,675 18,758,751 There were 1,019,185 and 387,396 outstanding options, restricted stock, and performance-based or market-based equity awards not included in the diluted earnings per share computation for the three months ended March 31, 2017 and 2016, respectively, because inclusion of these awards was anti-dilutive or, for performance-based and market-based awards, all necessary conditions had not been satisfied by the end of the respective period.

Recent issued accounting pron18

Recent issued accounting pronouncements (Policies)	3 Months Ended
	Mar. 31, 2017
Accounting Changes And Error Corrections [Abstract]
Recently issued accounting pronouncements	1. Recently issued accounting pronouncements Topic Description of Guidance Effective Date Status of Company's Evaluation Revenue Recognition (ASU 2014-09, as amended) Requires entities to recognize revenue in a way that depicts the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled to in exchange for those goods or services. Applied either retrospectively or as a cumulative effect adjustment as of the adoption date. January 1, 2018 The Company is continuing to evaluate the impact this ASU will have on its consolidated financial statements and disclosures. The Company completed an initial impact assessment and believes adopting this ASU will materially impact the timing of revenue recognition, primarily for implant product sales to stocking distributors, which are currently accounted for using the sell-through method. Specifically, the Company believes the revenue associated with these sales will be recorded at the time of the sale instead of deferring recognition until cash is received. The Company expects to adopt this new guidance using the modified retrospective transition method. Financial Instruments (ASU 2016-01) Requires entities to measure equity investments, except in limited circumstances, at fair value and recognize any changes in fair value in net income. Applied prospectively. January 1, 2018 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. Leases (ASU 2016-02) Requires a lessee to recognize lease assets and lease liabilities for leases classified as operating leases. Applied using a modified retrospective approach. January 1, 2019 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements; however, the Company expects this guidance will result in current operating lease obligations being reflected on the consolidated balance sheet. Income Taxes (ASU 2016-16) Reduces complexity by requiring current and deferred income taxes for intra-entity asset transfers, other than inventory, to be recognized when the transfer occurs. Applied using a modified retrospective approach. January 1, 2018 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. Statement of Cash Flows (ASU 2016-18) Reduces diversity in classification and presentation of restricted cash, including transfers between cash and restricted cash, on the statement of cash flows. Applied retrospectively. January 1, 2018 The Company is currently evaluating the impact this ASU may have on its consolidated statement of cash flows.

Inventories (Tables)

Inventories (Tables)	3 Months Ended
	Mar. 31, 2017
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories were as follows: (U.S. Dollars, in thousands) March 31, 2017 December 31, 2016 Raw materials $ 3,966 $ 7,978 Work-in-process 11,564 9,505 Finished products 47,109 42,434 Deferred cost of sales 3,632 3,429 $ 66,271 $ 63,346

Fair value measurements (Tables

Fair value measurements (Tables)	3 Months Ended
	Mar. 31, 2017
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: March 31, 2017 December 31, 2016 (U.S. Dollars, in thousands) Level 1 Level 2 Level 3 Total Total Assets Collective trust funds $ — $ 1,583 $ — $ 1,583 $ 1,584 Treasury securities 466 — — 466 467 Certificates of deposit — — — — 468 Debt securities — — 9,000 9,000 12,220 Total $ 466 $ 1,583 $ 9,000 $ 11,049 $ 14,739 Liabilities Deferred compensation plan $ — $ (1,207 ) $ — $ (1,207 ) $ (1,452 ) Total $ — $ (1,207 ) $ — $ (1,207 ) $ (1,452 )
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) 2017 2016 Balance at January 1 $ 12,220 $ 12,658 Accrued interest income — 316 Gains or losses recorded for the period Recognized in net income (5,585 ) — Recognized in other comprehensive income 2,365 (824 ) Balance at March 31 $ 9,000 $ 12,150

Accumulated other comprehensi21

Accumulated other comprehensive loss (Tables)	3 Months Ended
	Mar. 31, 2017
Equity [Abstract]
Components of Changes in Accumulated Other Comprehensive Income (Loss)	The components of and changes in accumulated other comprehensive loss were as follows: (U.S. Dollars, in thousands) Currency Translation Adjustments Debt Securities Accumulated Other Comprehensive Loss Balance at December 31, 2016 $ (5,115 ) $ (1,465 ) $ (6,580 ) Other comprehensive income (loss) 234 (3,220 ) (2,986 ) Income taxes — 1,223 1,223 Reclassification adjustments to: Other expense, net — 5,585 5,585 Income taxes — (2,123 ) (2,123 ) Balance at March 31, 2017 $ (4,881 ) $ — $ (4,881 )

Business segment information (T

Business segment information (Tables)	3 Months Ended
	Mar. 31, 2017
Segment Reporting [Abstract]
Schedule of Net Sales by Reporting Segment	The table below present net sales, which includes product sales and marketing service fees, by reporting segment: Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 Change BioStim $ 44,539 $ 41,044 8.5 % Biologics 14,987 14,094 6.3 % Extremity Fixation 23,945 24,709 -3.1 % Spine Fixation 19,267 18,832 2.3 % Net sales $ 102,738 $ 98,679 4.1 %
Summary of Net Margin by Reporting Segment	The table below presents net margin by reporting segment: Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 BioStim $ 17,133 $ 16,408 Biologics 6,171 6,104 Extremity Fixation 6,412 7,175 Spine Fixation 2,007 2,335 Corporate (98 ) (302 ) Net margin $ 31,625 $ 31,720 General and administrative 18,282 17,005 Research and development 7,424 7,640 Operating income $ 5,919 $ 7,075

Share-based compensation (Table

Share-based compensation (Tables)	3 Months Ended
	Mar. 31, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Schedule of Share-Based Compensation by Line Item in Condensed Consolidated Statements of Operations	The following tables present the detail of share-based compensation by line item in the condensed consolidated statements of operations as well as by award type: Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 Cost of sales $ 149 $ 117 Sales and marketing 360 276 General and administrative 2,102 1,558 Research and development 205 148 $ 2,816 $ 2,099 Three Months Ended March 31, (U.S. Dollars, in thousands) 2017 2016 Stock options $ 595 $ 475 Time-based restricted stock awards 1,292 1,308 Performance-based restricted stock awards 112 — Performance-based and market-based restricted stock units 466 — Stock purchase plan 351 316 $ 2,816 $ 2,099

Earnings per share ("EPS") (Tab

Earnings per share ("EPS") (Tables)	3 Months Ended
	Mar. 31, 2017
Earnings Per Share [Abstract]
Schedule of Reconciliation of Weighted Average Shares Used in Diluted EPS	The following is a reconciliation of the weighted average shares used in diluted EPS computations. Three Months Ended March 31, 2017 2016 Weighted average common shares-basic 17,979,675 18,477,881 Effect of dilutive securities Unexercised stock options and stock purchase plan — 138,292 Unvested time-based restricted stock awards — 142,578 Weighted average common shares-diluted 17,979,675 18,758,751

Business and Basis of Present25

Business and Basis of Presentation - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2017Segment
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number Of Reporting Units	4

Inventories - Schedule of Inven

Inventories - Schedule of Inventories (Detail) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016
Inventory Disclosure [Abstract]
Raw materials	$ 3,966	$ 7,978
Work-in-process	11,564	9,505
Finished products	47,109	42,434
Deferred cost of sales	3,632	3,429
Total inventory	$ 66,271	$ 63,346

Other Current Liabilities - Add

Other Current Liabilities - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2017	Dec. 31, 2016
Payables And Accruals [Abstract]
Pre-tax restructuring expense	$ 2.8
Cumulative costs incurred to date on restructuring	1.7
Accrued in other current liabilities related to restructuring	1	$ 1.5
Reduction in estimated restructuring costs to be incurred	0.2
Additional payments for restructuring	$ 0.2

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail) - 3 months ended Mar. 31, 2017	USD ($)	EUR (€)
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 6,200,000	€ 5,800,000
Amount outstanding under lines of credit	$ 0
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

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Mar. 31, 2017	Dec. 31, 2016	Mar. 31, 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	$ 9,000	$ 12,220	$ 12,150	$ 12,658
Fair Value, Measurements, Recurring [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	11,049	14,739
Deferred compensation plan, Liabilities	(1,207)	(1,452)
Liabilities fair value, Total	(1,207)	(1,452)
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	1,583	1,584
Fair Value, Measurements, Recurring [Member] | Treasury Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	466	467
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		468
Fair Value, Measurements, Recurring [Member] | Debt Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	9,000	$ 12,220
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	466
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	466
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	1,583
Deferred compensation plan, Liabilities	(1,207)
Liabilities fair value, Total	(1,207)
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	1,583
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	9,000
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	$ 9,000

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016	Dec. 31, 2016	Dec. 31, 2015
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Unrealized loss on debt securities	$ 3,220	$ 824
Other-than-temporary impairment on debt securities	5,585
Debt Securities [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Fair value of debt securities	9,000	$ 12,150	$ 12,220	$ 12,658
Unrealized loss on debt securities	$ 3,200

Fair Value Measurements - Sch31

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
	Mar. 31, 2017	Mar. 31, 2016
Fair Value Assets Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning balance	$ 12,220	$ 12,658
Accrued interest income		316
Gains or losses recorded for the period
Recognized in net income	(5,585)
Recognized in other comprehensive income	2,365	(824)
Ending balance	$ 9,000	$ 12,150

Contingencies - Additional Info

Contingencies - Additional Information (Detail) - USD ($) $ in Millions	Jan. 31, 2017	Mar. 31, 2017
Commitments And Contingencies Disclosure [Abstract]
Contingencies, settlement agreement, terms	In January 2017, the U.S. Securities and Exchange Commission (the “SEC”) approved the Company’s offers of settlement in connection with the SEC’s investigations of accounting matters leading to the Company’s prior restatement of financial statements and the Company’s review of improper payments with respect to its subsidiary in Brazil. Both investigations were initiated in 2013 and involved matters self-reported to the SEC by the Company. The settlements approved by the SEC resolved these two matters, and included payments by the Company to the SEC of amounts previously accrued and funded into escrow by the Company during 2016. In connection with the Brazil-related settlement, the Company agreed to retain an independent compliance consultant for one year to review and test the Company’s compliance program related to the U.S. Foreign Corrupt Practices Act.
Discontinued operations for compensatory damages and exemplary damages		$ 2.4

Accumulated Other Comprehensi33

Accumulated Other Comprehensive Loss - Components of Changes in Accumulated Other Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance	$ 263,477
Other comprehensive income (loss)	(2,986)
Income taxes	1,223
Other expense, net	(4,348)	$ 1,833
Income taxes	3,924	$ 4,294
Ending Balance	267,134
Reclassification Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Other expense, net	5,585
Income taxes	(2,123)
Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance	(5,115)
Other comprehensive income (loss)	234
Ending Balance	(4,881)
Debt Securities [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance	(1,465)
Other comprehensive income (loss)	(3,220)
Income taxes	1,223
Debt Securities [Member] | Reclassification Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Other expense, net	5,585
Income taxes	(2,123)
Accumulated Other Comprehensive Income (Loss) [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance	(6,580)
Ending Balance	$ (4,881)

Business Segment Information -

Business Segment Information - Schedule of Net Sales by Reporting Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Segment Reporting Information [Line Items]
Net sales	$ 102,738	$ 98,679
Change	4.10%
BioStim [Member]
Segment Reporting Information [Line Items]
Net sales	$ 44,539	41,044
Change	8.50%
Biologics [Member]
Segment Reporting Information [Line Items]
Net sales	$ 14,987	14,094
Change	6.30%
Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Net sales	$ 23,945	24,709
Change	(3.10%)
Spine Fixation [Member]
Segment Reporting Information [Line Items]
Net sales	$ 19,267	$ 18,832
Change	2.30%

Business Segment Information 35

Business Segment Information - Summary of Net Margin by Reporting Segment (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Segment Reporting Information [Line Items]
Net margin	$ 31,625	$ 31,720
General and administrative	18,282	17,005
Research and development	7,424	7,640
Operating income	5,919	7,075
Operating Segments [Member] | BioStim [Member]
Segment Reporting Information [Line Items]
Net margin	17,133	16,408
Operating Segments [Member] | Biologics [Member]
Segment Reporting Information [Line Items]
Net margin	6,171	6,104
Operating Segments [Member] | Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Net margin	6,412	7,175
Operating Segments [Member] | Spine Fixation [Member]
Segment Reporting Information [Line Items]
Net margin	2,007	2,335
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Net margin	(98)	(302)
Material Reconciling Items [Member]
Segment Reporting Information [Line Items]
General and administrative	18,282	17,005
Research and development	$ 7,424	$ 7,640

Share-based Compensation - Sche

Share-based Compensation - Schedule of Share-Based Compensation by Line Item in Condensed Consolidated Statements of Operations (Detail) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	$ 2,816	$ 2,099
Stock options [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	595	475
Time-based Restricted Stock Awards [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	1,292	1,308
Performance-based Restricted Stock Awards [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	112	0
Performance-based and Market-based Restricted Stock Units [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	466
Stock purchase plan [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	351	316
Cost of sales [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	149	117
Sales and marketing [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	360	276
General and administrative [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	2,102	1,558
Research and development [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	$ 205	$ 148

Share-based Compensation - Addi

Share-based Compensation - Additional Information (Detail) - shares	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Shares issued under stock purchase plan, stock option exercises and restricted stock	214,679	203,398

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Income Tax Disclosure [Abstract]
Income tax effective rate	242.80%	48.40%

Earnings Per Share ("EPS") - Sc

Earnings Per Share ("EPS") - Schedule of Reconciliation of Weighted Average Shares Used in Diluted EPS (Detail) - shares	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Weighted average common shares-basic	17,979,675	18,477,881
Effect of dilutive securities
Weighted average common shares-diluted	17,979,675	18,758,751
Stock Options And Stock Purchase Plan [Member]
Effect of dilutive securities
Effect of diluted securities		138,292
Time-based Restricted Stock Awards [Member]
Effect of dilutive securities
Effect of diluted securities		142,578

Earnings Per Share ("EPS") - Ad

Earnings Per Share ("EPS") - Additional Information (Detail) - shares	3 Months Ended
	Mar. 31, 2017	Mar. 31, 2016
Restricted Stock And Performance Based Equity Awards [Member] | Outstanding Options [Member]
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Outstanding awards and options not included in diluted earnings per share	1,019,185	387,396