Orthofix Medical (OFIX) 10-Q 6 Aug 18 2018 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2018	Aug. 03, 2018
Document And Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Jun. 30, 2018
Document Fiscal Year Focus	2,018
Document Fiscal Period Focus	Q2
Trading Symbol	OFIX
Entity Registrant Name	ORTHOFIX MEDICAL INC.
Entity Central Index Key	884,624
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		18,910,949

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Current assets
Cash and cash equivalents	$ 45,686	$ 81,157
Accounts receivable, net of allowances of $8,490 and $8,405, respectively	74,397	63,437
Inventories	81,730	81,330
Prepaid expenses and other current assets	35,613	25,877
Total current assets	237,426	251,801
Property, plant and equipment, net	44,377	45,139
Intangible assets, net	51,498	10,461
Goodwill	70,747	53,565
Deferred income taxes	30,634	23,315
Other long-term assets	7,082	21,073
Total assets	441,764	405,354
Current liabilities
Accounts payable	14,453	18,111
Other current liabilities	49,486	61,295
Total current liabilities	63,939	79,406
Other long-term liabilities	57,979	29,340
Total liabilities	121,918	108,746
Contingencies (Note 6)
Shareholders’ equity
Common shares $0.10 par value; 50,000,000 shares authorized; 18,485,788 and 18,278,833 issued and outstanding as of June 30, 2018 and December 31, 2017, respectively	1,849	1,828
Additional paid-in capital	233,742	220,591
Retained earnings	79,418	70,402
Accumulated other comprehensive income	4,837	3,787
Total shareholders’ equity	319,846	296,608
Total liabilities and shareholders’ equity	$ 441,764	$ 405,354

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Statement Of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 8,490	$ 8,405
Common shares, par value	$ 0.10	$ 0.10
Common shares, authorized	50,000,000	50,000,000
Common shares, issued	18,485,788	18,278,833
Common shares, outstanding	18,485,788	18,278,833

Condensed Consolidated Statemen

Condensed Consolidated Statements of Income and Comprehensive Income - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Income Statement [Abstract]
Net sales	$ 111,547	$ 108,942	$ 220,256	$ 211,680
Cost of sales	22,835	23,177	46,982	45,758
Gross profit	88,712	85,765	173,274	165,922
Sales and marketing	51,529	50,471	101,797	99,003
General and administrative	22,268	20,409	41,752	38,691
Research and development	7,891	6,887	14,828	14,311
Operating income	7,024	7,998	14,897	13,917
Interest income (expense), net	(251)	76	(434)	121
Other income (expense), net	(4,752)	585	(1,840)	(3,763)
Income before income taxes	2,021	8,659	12,623	10,275
Income tax expense	(1,088)	(3,924)	(6,461)	(7,848)
Net income from continuing operations	933	4,735	6,162	2,427
Discontinued operations (Note 6)
Loss from discontinued operations		(1,300)	(3)	(1,827)
Income tax benefit (expense)	(8)	418	(8)	599
Net loss from discontinued operations	(8)	(882)	(11)	(1,228)
Net income	$ 925	$ 3,853	$ 6,151	$ 1,199
Net income (loss) per common share—basic
Net income from continuing operations	$ 0.05	$ 0.26	$ 0.33	$ 0.13
Net loss from discontinued operations		(0.05)		(0.06)
Net income per common share—basic	0.05	0.21	0.33	0.07
Net income (loss) per common share—diluted
Net income from continuing operations	0.05	0.26	0.32	0.13
Net loss from discontinued operations		(0.05)		(0.06)
Net income per common share—diluted	$ 0.05	$ 0.21	$ 0.32	$ 0.07
Weighted average number of common shares:
Basic	18,413,756	18,050,551	18,409,331	18,015,308
Diluted	18,835,560	18,343,038	18,811,356	18,288,050
Other comprehensive income, before tax
Unrealized gain (loss) on debt securities	$ 1,960		$ 1,960	$ (3,220)
Reclassification adjustment for loss on debt securities in net income				5,585
Currency translation adjustment	(1,175)	$ 2,648	(478)	2,882
Other comprehensive income before tax	785	2,648	1,482	5,247
Income tax related to items of other comprehensive income	(432)		(432)	(900)
Other comprehensive income, net of tax	353	2,648	1,050	4,347
Comprehensive income	$ 1,278	$ 6,501	$ 7,201	$ 5,546

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Cash Flows - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Cash flows from operating activities
Net income	$ 6,151	$ 1,199
Adjustments to reconcile net income to net cash from operating activities
Depreciation and amortization	8,923	10,447
Amortization of debt costs and other assets	592	719
Provision for doubtful accounts	(360)	820
Deferred income taxes	724	4,284
Share-based compensation	9,131	5,492
Other-than-temporary impairment on debt securities		5,585
Gain on valuation of equity securities	(1,399)
Revaluation of contingent consideration	1,109
Other	847	572
Changes in operating assets and liabilities, net of effects of acquisition
Accounts receivable	(363)	(3,787)
Inventories	5,251	(11,119)
Prepaid expenses and other current assets	71	2,199
Accounts payable	(3,847)	(950)
Other current liabilities	(14,612)	(19,407)
Other long-term assets and liabilities	814	(696)
Net cash from operating activities	13,032	(4,642)
Cash flows from investing activities
Acquisition of business, net of cash acquired	(43,749)
Capital expenditures for property, plant and equipment	(5,782)	(7,035)
Capital expenditures for intangible assets	(870)	(1,558)
Asset acquisition and other investments	(1,148)
Other investing activities		474
Net cash from investing activities	(51,549)	(8,119)
Cash flows from financing activities
Proceeds from issuance of common shares	5,416	5,282
Payments related to withholdings for share-based compensation	(1,375)	(2,851)
Payment of debt issuance costs and other financing activities	(356)
Net cash from financing activities	3,685	2,431
Effect of exchange rate changes on cash	(639)	719
Net change in cash, cash equivalents, and restricted cash	(35,471)	(9,611)
Cash, cash equivalents, and restricted cash at the beginning of the period	81,157	53,941
Cash, cash equivalents, and restricted cash at the end of the period	45,686	$ 44,330
Noncash investing activities:
Purchase of intangible assets	1,181
Contingent consideration recognized at acquisition date	$ 25,491

Business and basis of presentat

Business and basis of presentation	6 Months Ended
	Jun. 30, 2018
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Business and basis of presentation	Business and basis of presentation Orthofix Medical Inc. (previously Orthofix International N.V.), together with its subsidiaries (the “Company” or “Orthofix”) is a global medical device company focused on musculoskeletal products and therapies. 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, 2017. 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, 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.

Recently adopted accounting sta

Recently adopted accounting standards and recently issued accounting pronouncements	6 Months Ended
	Jun. 30, 2018
Accounting Changes And Error Corrections [Abstract]
Recently adopted accounting standards and recently issued accounting pronouncements	1. Recently adopted accounting standards and recently issued accounting pronouncements Adoption of accounting standards update (“ASU”) 2014-09, Revenue from Contracts with Customers (Topic 606) In May 2014, the FASB issued ASU 2014-09. Topic 606 supersedes the revenue recognition requirements in Topic 605, Revenue Recognition Adoption of ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10), and ASU 2018-03, Technical Corrections and Improvements to Financial Instruments In January 2016, the FASB issued ASU 2016-01, which was then further clarified in ASU 2018-03, in February 2018. This guidance requires entities to generally measure equity investments at fair value and recognize any changes in fair value in net income. However, for certain equity investments that do not have readily determinable fair values, the new guidance allows entities to choose to measure these investments using a new measurement alternative, which values the investments at cost, less any impairments, plus or minus changes resulting from observable price changes in orderly transactions for identical or similar investments of the same issuer. The Company prospectively adopted both ASU 2016-01 and ASU 2018-03 on January 1, 2018 and elected to use the new measurement alternative for the Company’s equity investments in Bone Biologics, Inc. (“Bone Biologics”), which have historically been held at cost. This resulted in an increase in the previously recorded value of the Company’s equity investments in Bone Biologics, which are recorded within other current assets or long term assets, of $1.6 million, or $0.09 per share before taxes, during the three months ended March 31, 2018, which is included in other income (expense). See Note 5 for further details. Adoption of ASU 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory In October 2016, the FASB issued ASU 2016-16, which reduces diversity in practice of accounting for intra-entity transfers of assets, particularly for intra-entity transfers of intellectual property. The new standard states an entity should recognize the income tax consequences of an intra-entity transfer when the transfer occurs, as opposed to historical U.S. GAAP guidance which prohibited the recognition of current and deferred income taxes for an intra-entity asset transfer until the asset had been sold to an outside party. During the third and fourth quarters of 2017, the Company executed two intra-entity asset transfers that resulted in prepaid income taxes of $8.6 million. The Company adopted this new standard using a modified retrospective approach as of January 1, 2018, which resulted in a reduction of prepaid income taxes and an increase in deferred tax assets with these changes offset by an adjustment to the Company's opening retained earnings of approximately $1.9 million. Adoption of this guidance did not have a material impact to the Company’s condensed consolidated statements of income and comprehensive income or to its condensed consolidated statements of cash flows. Adoption of ASU 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash In November 2016, the FASB issued ASU 2016-18, which reduces diversity in classification and presentation of restricted cash, including transfers between cash and restricted cash, on the statement of cash flows. Adoption of ASU 2017-01, Business Combinations (Topic 805) In January 2017, the FASB issued ASU 2017-01, which clarifies the definition of a business. This amendment states that when substantially all of the fair value of gross assets acquired is concentrated in a single identifiable asset or a group of similar identifiable assets, that the set of assets acquired is not a business, which will likely result in more acquisitions being accounted for as asset acquisitions rather than business combinations. Based upon this guidance, which the Company adopted as of January 1, 2018, the Company accounted for an acquisition during the first quarter of 2018 for approximately $1.9 million as an asset acquisition rather than a business combination, as the set of assets acquired did not meet the definition of a business. Recently issued accounting pronouncements Topic Description of Guidance Effective Date Status of Company's Evaluation 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 has established a cross-functional implementation team to analyze the impact of the standard on the Company's population of leases and to evaluate the Company's current accounting policies relating to leases. The Company is currently evaluating the impact this ASU may have on its consolidated financial statements; however, the Company expects this guidance will materially impact the Company's consolidated balance sheet, resulting in current operating lease obligations being reflected on the consolidated balance sheet. Goodwill (ASU 2017-04) Eliminates Step 2 of the current goodwill impairment test, which requires a hypothetical purchase price allocation to measure goodwill impairment. A goodwill impairment loss will instead be measured at the amount by which a reporting unit's carrying value exceeds its fair value, not to exceed the recorded amount of goodwill. Applied on a prospective basis, with early adoption permitted. January 1, 2020 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. However, the Company does not expect this ASU to have a significant impact on its financial statements or disclosures. Comprehensive income (ASU 2018-02) Allows entities to reclassify from accumulated other comprehensive income to retained earnings stranded tax effects resulting from the Tax Cuts and Jobs Act (the "Tax Act"). Applied either in the period of adoption or retrospectively to each period (or periods) in which the effect of the change in the U.S. federal corporate income tax rate in the Tax Act is recognized. January 1, 2019 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Acquisition of Spinal Kinetics,

Acquisition of Spinal Kinetics, Inc.	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Acquisition of Spinal Kinetics, Inc.	2. Acquisition of Spinal Kinetics, Inc. On March 15, 2018, the Company entered into a definitive merger agreement (the “Merger Agreement”) to acquire 100% of the outstanding stock of Spinal Kinetics Inc. (“Spinal Kinetics”), a privately held developer and manufacturer of artificial cervical and lumbar discs, to strengthen the Company’s product portfolio and fill a strategic gap in the Spine Fixation business. On April 30, 2018, the Company completed the acquisition and all outstanding shares of Spinal Kinetics’ capital stock were converted into the right to receive at the closing an aggregate of $45.0 million in net cash, subject to certain adjustments, plus potential milestone payments of up to $60.0 million in cash. The Company made the closing payments from cash on hand on April 30, 2018. The results of operations for Spinal Kinetics have been included in the Company’s financial results since the acquisition date, April 30, 2018. The acquisition date fair value of the consideration transferred was $76.1 million, which consisted of the following: (U.S. Dollars, in thousands) Fair value of consideration transferred Cash paid 50,564 Contingent consideration 25,491 Total fair value of consideration transferred 76,055 The contingent consideration consists of potential future milestone payments of up to $60.0 million in cash. The milestone payments include (i) up to $15.0 million if the U.S. Food and Drug Administration grants approval of Spinal Kinetics’ M6-C artificial disc (“the FDA Milestone”) and (ii) revenue-based milestone payments of up to $45.0 million in connection with future sales of the M6-C artificial cervical disc and the M6-L artificial lumbar disc. Milestones must be achieved within five years of April 30, 2018 to trigger applicable payments. The fair value of the contingent consideration arrangement at the acquisition date was $25.5 million and was $26.6 million as of June 30, 2018; however, the actual amount ultimately paid could be higher or lower than the fair value of the contingent consideration. The increase in fair value of $1.1 million was recorded in other expense. For additional discussion regarding the valuation of the contingent consideration, see Note 5. The following table summarizes the preliminary estimated fair values of the assets acquired and liabilities assumed at the acquisition date. A final determination of the allocation of the purchase price to assets acquired and liabilities assumed has not been made and the following should be considered preliminary. The final determination is subject to completion of the Company’s valuation of the assets acquired and liabilities assumed, which it expects to complete within one year. (U.S. Dollars, in thousands) As of April 30, 2018 Assigned Useful Life Assets acquired Cash and cash equivalents $ 6,785 Restricted cash 30 Accounts receivable 1,705 Inventories 8,175 Prepaid expenses and other current assets 315 Property, plant and equipment 2,285 Other long-term assets 320 Developed technology 12,400 10 years In-process research and development ("IPR&D") 26,800 Indefinite Tradename 100 2 years Deferred income taxes 3,483 Total identifiable assets acquired 62,398 Liabilities assumed Accounts payable $ 351 Other current liabilities 2,873 Other long-term liabilities 301 Total liabilities assumed 3,525 Goodwill 17,182 Total fair value of consideration transferred 76,055 The purchase price exceeded the fair value of the net tangible and identifiable intangible assets acquired from Spinal Kinetics. As a result, the Company recorded goodwill in connection with the acquisition. Specifically, the goodwill includes the assembled workforce and synergies associated with the combined entity. The goodwill is not expected to be deductible for tax purposes. The $17.2 million of goodwill recognized was assigned to the Spine Fixation reporting segment. The IPR&D intangible asset is considered an indefinite-lived asset until the completion or abandonment of the associated research and development efforts. Accordingly, during the development period after the acquisition, this asset is not amortized but, instead, is subject to impairment review and testing provisions. Upon completion of the IPR&D project, the Company will determine the useful life of the asset and begin amortization. The Company recognized $1.5 million and $3.0 million of acquisition related costs that were expensed during the three and six months ended June 30, 2018, respectively. These costs are included in the condensed consolidated statements of income and comprehensive income within general and administrative expenses. The following table presents the unaudited pro forma results for the six months ended June 30, 2018 and 2017, which combines the historical results of operations of Orthofix and Spinal Kinetics as though the companies had been combined as of January 1, 2017. The unaudited pro forma information is presented for informational purposes only and is not indicative of the results of operations that would have been achieved if the acquisition had taken place at such time. Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 (unaudited) (unaudited) (unaudited) (unaudited) Net sales $ 112,718 $ 112,350 $ 225,173 $ 219,163 Net income (loss) from continuing operations 2,161 2,484 7,099 (1,076 )

Inventories

Inventories	6 Months Ended
	Jun. 30, 2018
Inventory Disclosure [Abstract]
Inventories	3. Inventories Inventories were as follows: (U.S. Dollars, in thousands) June 30, 2018 December 31, 2017 Raw materials $ 9,210 $ 6,067 Work-in-process 13,502 12,487 Finished products 59,018 60,441 Deferred cost of sales — 2,335 Inventories $ 81,730 $ 81,330 Prior to the adoption of ASU 2014-09, or for all periods presented prior to January 1, 2018, deferred cost of sales resulted from certain transactions where the Company had shipped product or performed services for which all revenue recognition criteria had not yet been met. Once all revenue recognition criteria had been met, the revenue and associated cost of sales were recognized. Subsequent to the adoption of ASU 2014-09, the Company no longer has transactions which result in the recognition of deferred cost of sales. See Note 8 for further discussion of the Company’s adoption of ASU 2014-09.

Long-term debt

Long-term debt	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Long-term debt	4. Long-term debt As of June 30, 2018, the Company has no borrowings under the five year $125 million secured revolving credit facility it entered into in August 2015 with JPMorgan Chase Bank, N.A., as Administrative Agent, and certain lenders. In addition, the Company has no borrowings on its €5.8 million ($6.8 million) available line of credit in Italy as of June 30, 2018. The Company is in compliance with all required financial covenants as of June 30, 2018.

Fair value measurements

Fair value measurements	6 Months Ended
	Jun. 30, 2018
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: June 30, 2018 December 31, 2017 (U.S. Dollars, in thousands) Level 1 Level 2 Level 3 Total Total Assets Collective trust funds $ — $ 100 $ — $ 100 $ 100 Treasury securities 558 — — 558 556 Equity warrants — 289 — 289 311 Equity securities — 4,379 — 4,379 2,457 Debt security — — 18,010 18,010 16,050 Total $ 558 $ 4,768 $ 18,010 $ 23,336 $ 19,474 Liabilities Contingent consideration $ — $ — $ (26,600 ) $ (26,600 ) $ — Deferred compensation plan — (1,369 ) — (1,369 ) (1,379 ) Total $ — $ (1,369 ) $ (26,600 ) $ (27,969 ) $ (1,379 ) Equity Warrants and Securities The Company holds investments in common stock and warrants to purchase shares of common stock of Bone Biologics, Inc. (“Bone Biologics”). The Company’s common stock investments are recorded within other long-term assets while the warrants are recorded within other current assets or other long-term assets, dependent upon the expiration date. Prior to 2018, these instruments were accounted for at cost as the fair value of these instruments was not readily determinable. Effective January 1, 2018, the Company is required to measure these equity investments at fair value and recognize any changes in fair value in net income as a result of adopting ASU 2016-01. However, for certain equity investments that do not have readily determinable fair values, the new guidance allows entities to choose to measure these investments using a new measurement alternative, which values the investments at cost, less any impairments, plus or minus changes resulting from observable price changes in orderly transactions for identical or similar investments of the same issuer. The Company has elected to use the new measurement alternative for these equity investments in Bone Biologics, which resulted in an increase in the previously recorded value of the equity investments of $1.6 million, or $0.09 per share before taxes, during the three months ended March 31, 2018. These changes are classified as other income or expense. In addition, the Company made an additional investment in Bone Biologics during the first quarter of 2018, in which it purchased an additional 250,000 shares of common stock for $0.5 million. Debt Security The Company holds a debt security of eNeura, Inc., a privately held medical technology company that is developing devices for the treatment of migraines. The debt security matures on March 4, 2019 . Company As of June 30, 2018, the Company reassessed its estimate of fair value based on current financial information and other assumptions, resulting in a fair value of $18.0 million, an increase of $2.0 million when compared to the Company’s estimated fair value of the debt security as of December 31, 2017. This compares to an amortized cost basis in the debt security of $9.0 million. 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) 2018 2017 Debt security at January 1 $ 16,050 $ 12,220 Accrued interest income — — Gains or losses recorded for the period Recognized in net income — (5,585 ) Recognized in other comprehensive income 1,960 2,365 Debt security at June 30 $ 18,010 $ 9,000 Contingent Consideration The contingent consideration consists of potential future milestone payments of up to $60.0 million in cash associated with the Spinal Kinetics acquisition. The milestone payments include (i) up to $15.0 million if the U.S. Food and Drug Administration grants approval of Spinal Kinetics’ M6-C artificial disc (“the FDA Milestone”) and (ii) revenue-based milestone payments of up to $45.0 million in connection with future sales of the M6-C artificial cervical disc and the M6-L artificial lumbar disc. Milestones must be achieved within five years of April 30, 2018 to trigger applicable payments. The fair value of the contingent consideration arrangement at the acquisition date was $25.5 million and was $26.6 million as of June 30, 2018; however, the actual amount ultimately paid could be higher or lower than the fair value of the contingent consideration. The increase in fair value of $1.1 million was recorded in other expense. The Company estimated the fair value of the contingent consideration attributable to the FDA Milestone using a probability-weighted discounted cash flow model. This fair value is based on significant inputs not observable in the market and thus represents a Level 3 measurement. The key assumptions in applying the probability-weighted discounted cash flow model include the Company’s estimation of the probability and timing of obtaining FDA approval for the M6-C artificial disc. Significant changes in these assumptions could result in a significantly higher or lower fair value. The Company estimated the fair value of the potential future revenue-based milestone payments using a Monte Carlo simulation. This fair value measurement is based on significant inputs that are unobservable in the market, and thus represents a Level 3 measurement. The key assumptions in applying the Monte Carlo valuation model include the Company’s forecasted future revenues for Spinal Kinetics products, discount rate applied, and assumptions for potential volatility of the Company’s forecasted revenue. Significant changes in these assumptions could result in a significantly higher or lower fair value. The following table provides a reconciliation of the beginning and ending balances for the contingent consideration measured at fair value using significant unobservable inputs (Level 3): (U.S. Dollars, in thousands) 2018 Contingent consideration at January 1 $ — Acquisition date fair value 25,491 Increase in fair value recognized in other income (expense) 1,109 Contingent consideration at June 30 $ 26,600

Contingencies

Contingencies	6 Months Ended
	Jun. 30, 2018
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 any losses related to these matters are individually and collectively immaterial as to a possible loss and range of loss. 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. 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 were filed, mostly in California state court. In September 2014, the Company entered into a master settlement agreement resolving then pending pre-close cold therapy claims. In May 2018, Breg settled and resolved a post-close cold therapy claim in California state court, Gmeiner v. Breg, Inc. Charges incurred as a result of this indemnification obligation to Breg are reflected as discontinued operations in the condensed consolidated statements of income and comprehensive income. Italian Medical Device Payback (“IMDP”) In 2015, the Italian Parliament introduced rules for entities that supply goods and services to the Italian National Healthcare System. The healthcare law is expected to impact the business and financial reporting of companies operating in the medical technology sector that sell medical devices in Italy. A key provision of the law is a ‘payback’ measure, requiring companies selling medical devices in Italy to make payments to the Italian government if medical device expenditures exceed regional maximum ceilings. Companies are required to make payments equal to a percentage of expenditures exceeding maximum regional caps. There is considerable uncertainty about how the law will operate and what the exact timeline is for finalization. The Company’s current assessment of the IMDP involves significant judgment regarding the expected scope and actual implementation terms of the measure as the latter have not been clarified to date by Italian authorities. The Company accounts for the estimated cost of the IMDP as sales and marketing expense and as of June 30, 2018, the Company has accrued €2.8 million ($3.3 million) related to the IMDP; however, the actual liability could be higher or lower than the amount accrued once the law has been clarified by the Italian authorities.

Accumulated other comprehensive

Accumulated other comprehensive Income	6 Months Ended
	Jun. 30, 2018
Equity [Abstract]
Accumulated other comprehensive Income	7. Accumulated other comprehensive income The components of and changes in accumulated other comprehensive income were as follows: (U.S. Dollars, in thousands) Currency Translation Adjustments Debt Security Accumulated Other Comprehensive Income Balance at December 31, 2017 $ (563 ) $ 4,350 $ 3,787 Other comprehensive income (478 ) 1,960 1,482 Income taxes — (432 ) (432 ) Balance at June 30, 2018 $ (1,041 ) $ 5,878 $ 4,837

Revenue recognition and account

Revenue recognition and accounts receivable	6 Months Ended
	Jun. 30, 2018
Revenue Recognition And Accounts Receivable [Abstract]
Revenue recognition and accounts receivable	8. Revenue recognition and accounts receivable Adoption of ASU 2014-09, “Revenue from Contracts with Customers” Effective January 1, 2018, the Company adopted ASU 2014-09, Revenue from Contracts with Customers (Topic 606) The Company recorded a net increase to opening retained earnings of $4.8 million as of January 1, 2018 due to the cumulative impact of adopting Topic 606 as presented in the table below. (U.S. Dollars, in thousands) December 31, 2017 Impact of Adoption of ASC 606 January 1, 2018 Assets Current assets Cash and cash equivalents $ 81,157 $ — $ 81,157 Accounts receivable, net 63,437 8,648 72,085 Inventories 81,330 (2,338 ) 78,992 Prepaid expenses and other current assets 25,877 — 25,877 Total current assets 251,801 6,310 258,111 Deferred income taxes 23,315 (1,549 ) 21,766 Other long-term assets 130,238 — 130,238 Total assets $ 405,354 $ 4,761 $ 410,115 Liabilities and shareholders’ equity Total liabilities 108,746 — 108,746 Shareholders’ equity Common shares 1,828 — 1,828 Additional paid-in capital 220,591 — 220,591 Retained earnings 70,402 4,761 75,163 Accumulated other comprehensive income 3,787 — 3,787 Total shareholders’ equity 296,608 4,761 301,369 Total liabilities and shareholders’ equity $ 405,354 $ 4,761 $ 410,115 The impact primarily related to an increase in trade accounts receivable, net, from the Company’s stocking distributors, for which revenue was historically recognized when cash payment was received, and the recognition of previously deferred cost of sales for certain stocking distributor transactions, which were historically included within inventory. Adoption of Topic 606 had no impact to cash from or used in operating, investing, or financing activities on the condensed consolidated statement of cash flows. The table below presents the impact to the Company’s condensed consolidated statement of income for the three and six months ended June 30, 2018 as a result of the adoption of Topic 606. Three Months Ended June 30, 2018 Six Months Ended June 30, 2018 (U.S. Dollars, in thousands) Based on historical accounting under Topic 605 Impact of adoption As reported under Topic 606 Based on historical accounting under Topic 605 Impact of adoption As reported under Topic 606 Net sales $ 113,400 $ (1,853 ) $ 111,547 $ 214,762 $ 5,494 $ 220,256 Cost of sales 23,075 (240 ) 22,835 45,191 1,791 46,982 Gross profit 90,325 (1,613 ) 88,712 169,571 3,703 173,274 Sales and marketing 51,614 (85 ) 51,529 101,975 (178 ) 101,797 Other operating expenses 30,159 — 30,159 56,580 — 56,580 Operating income $ 8,552 $ (1,528 ) $ 7,024 $ 11,016 $ 3,881 $ 14,897 Income tax expense (1,694 ) 606 (1,088 ) (5,612 ) (849 ) (6,461 ) Net income from continuing operations $ 1,855 $ (922 ) $ 933 $ 3,130 $ 3,032 $ 6,162 Net income from continuing operations per common share—basic $ 0.10 $ (0.05 ) $ 0.05 $ 0.17 $ 0.16 $ 0.33 Net income from continuing operations per common share—diluted $ 0.10 $ (0.05 ) $ 0.05 $ 0.16 $ 0.16 $ 0.32 Revenue Recognition Under Topic 606 The Company accounts for a contract when there is approval and commitment from both parties, the rights of the parties are identified, payment terms are identified, the contract has commercial substance, and collectability of consideration is probable. The Company’s contracts may contain one or more performance obligations. If a contract contains more than one performance obligation, the Company allocates the total transaction price to each of the performance obligations based upon the observable standalone selling price of the promised goods or services underlying each performance obligation. The Company recognizes revenue when control of the promised goods or services is transferred to the customer, which typically occurs at a point in time upon shipment, delivery, or utilization, in an amount that reflects the consideration which the Company expects to be entitled in exchange for the promised goods or services. The amount the Company expects to be entitled to in exchange for the goods or services reflects any fixed amount stated per the contract and estimates for any variable consideration, such as discounts, to the extent that is it probable that a significant reversal of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is resolved. BioStim BioStim revenue is largely attributable to the U.S. and is comprised of third-party payor transactions and wholesale revenue. The largest portion of BioStim revenue is derived from third-party payors. This includes commercial insurance carriers, health maintenance organizations, preferred provider organizations and governmental payors such as Medicare, in connection with the sale of the Company’s stimulation products. The customer obtains control and revenue is recognized when the stimulation product is fitted to and accepted by the patient and all applicable documents that are required by the third-party payor have been obtained. Amounts paid by these third-party payors are generally based on fixed or allowable reimbursement rates. These revenues are recorded at the expected or preauthorized reimbursement rates, net of any contractual allowances or adjustments. Certain billings are subject to review by the third-party payors and may be subject to adjustment. Adoption of Topic 606 had an immaterial impact to the BioStim SBU. Wholesale revenue is related to the sale of the Company’s bone growth stimulators directly to healthcare providers. Wholesale revenues are typically recognized upon shipment and receipt of a confirming purchase order, which is when the customer obtains control of the promised goods. Extremity Fixation and Spine Fixation Extremity Fixation and Spine Fixation products are distributed world-wide, with U.S. sales largely comprised of commercial revenue and international sales derived from commercial sales and through stocking distributor arrangements. Commercial revenue is related to the sale of the Company’s internal and external fixation products, generally representing hospital customers. The customer obtains control and revenues are recognized when these products have been utilized and a confirming purchase order has been received from the hospital. Certain revenue within the Extremity Fixation and Spine Fixation SBUs are derived from stocking distributors, who purchase the Company’s products and then re-sell them directly to customers, such as hospitals. For revenue from stocking distributor arrangements, subsequent to the adoption of Topic 606 effective January 1, 2018, the Company recognizes revenue upon shipment and receipt of a confirming purchase order, which is when the distributor obtains control of the promised goods. The transaction price with stocking distributors is estimated based upon the Company’s historical collection experience with the stocking distributor. To derive this estimate, the Company analyzes twelve months of historical invoices by stocking distributor and the subsequent collections on those invoices, for a period of up to 24 months subsequent to the invoice date. This percentage, which is specific to each stocking distributor, is then used to calculate the transaction price. Cost of sales is also recorded upon transfer of control of the product to the customer. Prior to the adoption of Topic 606, or for all periods presented prior to January 1, 2018, the Company recognized revenue from stocking distributor arrangements once the product was delivered to the end customer (the “sell-through method”). Because the Company did not have reliable information about when its distributors sold the product through to end customers, the Company used cash collection from distributors as a basis for revenue recognition under the sell-through method. Although in many cases the Company was legally entitled to the accounts receivable at the time of shipment, the Company did not recognize accounts receivables or any corresponding deferred revenues at the time of shipment associated with stocking distributor transactions for which revenue was recognized on the sell-through method. The Company also considered whether to match the related cost of sales with revenue or to recognize cost of sales upon shipment. In making this assessment, the Company considered the financial viability of its stocking distributors based on their creditworthiness to determine if collectability of amounts sufficient to realize the costs of the products shipped was reasonably assured at the time of shipment to these stocking distributors. In instances where the stocking distributor was determined to be financially viable, the Company deferred the costs of sales until the revenue was recognized. Biologics Biologics revenue is largely attributable to the U.S. and is primarily related to a collaborative arrangement with MTF Biologics (“MTF”), which extends through July 28, 2027, through which the Company markets tissue for bone repair and reconstruction under the brand names Trinity Evolution and Trinity ELITE. Under the terms of the agreement, MTF sources the tissue, processes it to create the bone growth matrix, packages and delivers it to the customer in accordance with orders received from the Company. The Company has exclusive global marketing rights for the Trinity Evolution and Trinity ELITE tissues as well as non-exclusive marketing rights for other products, and receives marketing fees from MTF based on total sales. MTF is considered the primary obligor in these arrangements and therefore the Company recognizes these marketing service fees on a net basis within net sales upon shipment of the product to the customer. Adoption of Topic 606 had an immaterial impact to the Biologics SBU. Product Sales and Marketing Service Fees The table below presents net sales, which includes product sales and marketing service fees, for the three and six months ended June 30, 2018 and 2017. Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 Product sales $ 97,453 $ 93,908 $ 192,342 $ 182,309 Marketing service fees 14,094 15,034 27,914 29,371 Net sales $ 111,547 $ 108,942 $ 220,256 $ 211,680 Product sales primarily consist of the sale of bone growth stimulation devices and internal and external fixation products. Marketing service fees are received from MTF based on total sales of biologics tissues and relates solely to the Biologics SBU. Revenues exclude any value added or other local taxes, intercompany sales and trade discounts. Shipping and handling costs for products shipped to customers are included in cost of sales. Trade Accounts Receivable and Allowances Payment terms vary by the type and location of the Company’s customers and the products or services offered. The term between invoicing and when payment is due is not significant. Accounts receivable are analyzed on a quarterly basis to assess the adequacy of both reserves for doubtful accounts and contractual allowances. Revisions in allowances for doubtful accounts estimates are recorded as an adjustment to bad debt expense within sales and marketing expenses. Revisions to contractual allowances are recorded as an adjustment to net sales. The Company’s estimates are periodically tested against actual collection experience. Other Contract Assets The Company’s contract assets, excluding trade accounts receivable (“other contract assets”), largely consist of payments made to certain distributors to obtain contracts, gain access to customers in certain territories, and to provide the benefit of the exclusive distribution of Orthofix products. Other contract assets are included in other long-term assets and were $1.2 million and $1.0 million as of June 30, 2018, and December 31, 2017, respectively. Other contract assets are amortized on a straight-line basis over the term of the related contract. There were no changes to such treatment as a result of adoption of Topic 606. No impairments were incurred for other contract assets in 2018 or 2017. Further, the Company has applied the practical expedient allowed within the guidance to expense sales commissions when incurred as the amortization period would be for one year or less.

Business segment information

Business segment information	6 Months Ended
	Jun. 30, 2018
Segment Reporting [Abstract]
Business segment information	9. Business segment information The table below present net sales, which includes product sales and marketing service fees, by reporting segment: Three Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 Change BioStim $ 48,211 $ 47,174 2.2 % Spine Fixation 23,880 21,360 11.8 % Biologics 14,668 15,661 -6.3 % Extremity Fixation 24,788 24,747 0.2 % Net sales $ 111,547 $ 108,942 2.4 % Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 Change BioStim $ 94,374 $ 91,713 2.9 % Spine Fixation 44,587 40,627 9.7 % Biologics 29,003 30,648 -5.4 % Extremity Fixation 52,292 48,692 7.4 % Net sales $ 220,256 $ 211,680 4.1 % The primary metric used in managing the Company is non-GAAP net margin, which is an internal metric that the Company defines as gross profit less sales and marketing expense. The table below presents non-GAAP net margin by reporting segment: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 BioStim $ 21,298 $ 19,469 $ 40,244 $ 36,602 Spine Fixation 2,887 2,696 4,148 4,703 Biologics 6,247 6,470 12,327 12,641 Extremity Fixation 7,002 6,766 15,160 13,178 Corporate (251 ) (107 ) (402 ) (205 ) Non-GAAP net margin $ 37,183 $ 35,294 $ 71,477 $ 66,919 General and administrative 22,268 20,409 41,752 38,691 Research and development 7,891 6,887 14,828 14,311 Operating income $ 7,024 $ 7,998 $ 14,897 $ 13,917 Interest income (expense), net (251 ) 76 (434 ) 121 Other income (expense), net (4,752 ) 585 (1,840 ) (3,763 ) Income before income taxes $ 2,021 $ 8,659 $ 12,623 $ 10,275 Geographical information The table below present net sales by geographic destination for each reporting unit and for the consolidated Company: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 BioStim U.S. $ 48,202 $ 47,162 $ 94,339 $ 91,701 International 9 12 35 12 Total BioStim 48,211 47,174 94,374 91,713 Spine Fixation U.S. 18,853 18,050 36,432 34,085 International 5,027 3,310 8,155 6,542 Total Spine Fixation 23,880 21,360 44,587 40,627 Biologics U.S. 14,667 15,651 28,989 30,614 International 1 10 14 34 Total Biologics 14,668 15,661 29,003 30,648 Extremity Fixation U.S. 7,023 6,741 13,939 13,320 International 17,765 18,006 38,353 35,372 Total Extremity Fixation 24,788 24,747 52,292 48,692 Consolidated U.S. 88,745 87,604 173,699 169,720 International 22,802 21,338 46,557 41,960 Net sales $ 111,547 $ 108,942 $ 220,256 $ 211,680

Share-based compensation

Share-based compensation	6 Months Ended
	Jun. 30, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Share-based compensation	10. Share-based compensation The following tables present the detail of share-based compensation by line item in the condensed consolidated statements of income as well as by award type: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 Cost of sales $ 132 $ 137 $ 257 $ 286 Sales and marketing 473 319 922 679 General and administrative 4,249 2,005 7,294 4,107 Research and development 361 215 658 420 $ 5,215 $ 2,676 $ 9,131 $ 5,492 Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 Stock options $ 1,241 $ 523 $ 1,863 $ 1,118 Time-based restricted stock awards and units 1,789 1,239 3,236 2,531 Performance-based restricted stock awards 270 113 759 225 Performance-based and market-based restricted stock units 1,604 472 2,557 938 Stock purchase plan 311 329 716 680 $ 5,215 $ 2,676 $ 9,131 $ 5,492 During the three months ended June 30, 2018 and 2017, the Company issued 80,444 and 76,596 shares, respectively, of common stock related to stock purchase plan issuances, stock option exercises and the vesting of restricted stock awards. During the six months ended June 30, 2018 and 2017, the Company issued 206,955 and 291,275 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	6 Months Ended
	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Income taxes	11. 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 June 30, 2018 and 2017, the effective tax rate on continuing operations was 53.8% and 45.3%, respectively. For the six months ended June 30, 2018 and 2017, the effective tax rate on continuing operations was 51.2% and 76.4%, respectively. The primary factors affecting the Company’s effective tax rate for the three and six months ended June 30, 2018, were the lower U.S. statutory tax rate enacted in December 2017, 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. During the first quarter of 2018, the Internal Revenue Service concluded an examination of the Company’s federal income tax return for 2012 with no material impact on the financial statements. In November 2017, the Company was notified of an examination of its federal income tax return for 2015. The Company cannot reasonably determine if this examination, or any state and local tax examinations, will have a material impact on its financial statements and cannot predict the timing regarding resolution of these tax examinations. In the fourth quarter of 2017, the Company recorded tax expense of $8.3 million that represents what it believes is the impact of the enactment of the Tax Act. The expense was based on currently available information and interpretations, which are continuing to evolve, and as a result, the expense is considered provisional. The Company has continued to analyze additional information and guidance related to the Tax Act as supplemental legislation, regulatory guidance, or evolving technical interpretations become available. Based on supplemental legislation issued during 2018, the Company recorded a tax benefit of $0.5 million during the three and six months ended June 30, 2018, respectively. The Company will continue to refine such amounts within the measurement period as provided by Staff Accounting Bulletin No. 118 and expects to complete its analysis no later than the fourth quarter of 2018.

Earnings per share ("EPS")

Earnings per share ("EPS")	6 Months Ended
	Jun. 30, 2018
Earnings Per Share [Abstract]
Earnings per share ("EPS")	12. Earnings per share (“EPS”) The Company uses the two-class method of computing basic EPS due to the existence of non-vested restricted stock awards with nonforfeitable rights to dividends or dividend equivalents (referred to as participating securities). For the three and six months ended June 30, 2018 and 2017, no significant adjustments were made to net income 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 June 30, Six Months Ended June 30, 2018 2017 2018 2017 Weighted average common shares-basic 18,413,756 18,050,551 18,409,331 18,015,308 Effect of dilutive securities Unexercised stock options and stock purchase plan 327,171 156,109 318,047 115,560 Unvested restricted stock awards and units 94,633 136,378 83,978 157,182 Weighted average common shares-diluted 18,835,560 18,343,038 18,811,356 18,288,050 There were 413,296 and 462,146 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 June 30, 2018 and 2017, respectively, and 259,470 and 506,964 outstanding options, restricted stock, and performance-based or market-based equity awards not included in the diluted earnings per share computation for the six months ended June 30, 2018 and 2017, 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.

Subsequent Events

Subsequent Events	6 Months Ended
	Jun. 30, 2018
Subsequent Events [Abstract]
Subsequent Events	13. Subsequent events On July 31, 2018, the Company completed a change in its jurisdiction of organization from Curaçao to the State of Delaware (the “Domestication”) in accordance with the conversion procedures of Articles 304 and 305 of Book 2 of the Curaçao Civil Code and the domestication procedures of Section 388 of the Delaware General Corporation Law. The Company’s shareholders approved a proposal to adopt a shareholders’ resolution authorizing the Domestication at the Company’s 2018 Annual General Meeting of Shareholders held on July 17, 2018 (the “Annual General Meeting”) by the affirmative vote of shareholders representing an absolute majority of the outstanding common shares of the Company as of the record date for the Annual General Meeting. Upon the effectiveness of the Domestication, each common share of Orthofix International N.V. was automatically converted into one share of common stock of Orthofix Medical Inc. The Company’s common stock continues to be traded on the Nasdaq Global Select Market under the symbol “OFIX.” On July 31, 2018, the Company amended and restated its existing Credit Agreement with JPMorgan, the Administrative Agent, and the lenders party thereto pursuant to a First Amended and Restated Credit Agreement. The First Amended and Restated Credit Agreement is substantially the same as the existing Credit Agreement, except for certain amendments to, among other things, (i) effectuate the domestication of the Company from a Curaçao company to a Delaware corporation, (ii) limit the pledge by the Company and each domestic subsidiary of the Company of equity interests in their respective first tier foreign subsidiaries to 65% of the voting interests in such foreign subsidiaries, (iii) limit the guarantee and joint and several obligations of each subsidiary guarantor that is a foreign subsidiary so that such foreign subsidiary guarantors are only providing guarantees, or are jointly and severally obligated, for obligations of other foreign subsidiaries, and (iv) limit the secured obligations that are secured by collateral provided by subsidiary guarantors that are foreign subsidiaries to secured obligations of foreign subsidiaries. In addition, during July 2018, a court in a pending legal action issued an order resulting in the freezing of approximately $2.5 million in cash. Orthofix contests the underlying basis for the order.

Recently adopted accounting s20

Recently adopted accounting standards and recently issued accounting pronouncements (Policies)	6 Months Ended
	Jun. 30, 2018
Accounting Changes And Error Corrections [Abstract]
Recently adopted accounting standards and recently issued accounting pronouncements	1. Recently adopted accounting standards and recently issued accounting pronouncements Adoption of accounting standards update (“ASU”) 2014-09, Revenue from Contracts with Customers (Topic 606) In May 2014, the FASB issued ASU 2014-09. Topic 606 supersedes the revenue recognition requirements in Topic 605, Revenue Recognition Adoption of ASU 2016-01, Financial Instruments – Overall (Subtopic 825-10), and ASU 2018-03, Technical Corrections and Improvements to Financial Instruments In January 2016, the FASB issued ASU 2016-01, which was then further clarified in ASU 2018-03, in February 2018. This guidance requires entities to generally measure equity investments at fair value and recognize any changes in fair value in net income. However, for certain equity investments that do not have readily determinable fair values, the new guidance allows entities to choose to measure these investments using a new measurement alternative, which values the investments at cost, less any impairments, plus or minus changes resulting from observable price changes in orderly transactions for identical or similar investments of the same issuer. The Company prospectively adopted both ASU 2016-01 and ASU 2018-03 on January 1, 2018 and elected to use the new measurement alternative for the Company’s equity investments in Bone Biologics, Inc. (“Bone Biologics”), which have historically been held at cost. This resulted in an increase in the previously recorded value of the Company’s equity investments in Bone Biologics, which are recorded within other current assets or long term assets, of $1.6 million, or $0.09 per share before taxes, during the three months ended March 31, 2018, which is included in other income (expense). See Note 5 for further details. Adoption of ASU 2016-16, Income Taxes (Topic 740): Intra-Entity Transfers of Assets Other Than Inventory In October 2016, the FASB issued ASU 2016-16, which reduces diversity in practice of accounting for intra-entity transfers of assets, particularly for intra-entity transfers of intellectual property. The new standard states an entity should recognize the income tax consequences of an intra-entity transfer when the transfer occurs, as opposed to historical U.S. GAAP guidance which prohibited the recognition of current and deferred income taxes for an intra-entity asset transfer until the asset had been sold to an outside party. During the third and fourth quarters of 2017, the Company executed two intra-entity asset transfers that resulted in prepaid income taxes of $8.6 million. The Company adopted this new standard using a modified retrospective approach as of January 1, 2018, which resulted in a reduction of prepaid income taxes and an increase in deferred tax assets with these changes offset by an adjustment to the Company's opening retained earnings of approximately $1.9 million. Adoption of this guidance did not have a material impact to the Company’s condensed consolidated statements of income and comprehensive income or to its condensed consolidated statements of cash flows. Adoption of ASU 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash In November 2016, the FASB issued ASU 2016-18, which reduces diversity in classification and presentation of restricted cash, including transfers between cash and restricted cash, on the statement of cash flows. Adoption of ASU 2017-01, Business Combinations (Topic 805) In January 2017, the FASB issued ASU 2017-01, which clarifies the definition of a business. This amendment states that when substantially all of the fair value of gross assets acquired is concentrated in a single identifiable asset or a group of similar identifiable assets, that the set of assets acquired is not a business, which will likely result in more acquisitions being accounted for as asset acquisitions rather than business combinations. Based upon this guidance, which the Company adopted as of January 1, 2018, the Company accounted for an acquisition during the first quarter of 2018 for approximately $1.9 million as an asset acquisition rather than a business combination, as the set of assets acquired did not meet the definition of a business. Recently issued accounting pronouncements Topic Description of Guidance Effective Date Status of Company's Evaluation 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 has established a cross-functional implementation team to analyze the impact of the standard on the Company's population of leases and to evaluate the Company's current accounting policies relating to leases. The Company is currently evaluating the impact this ASU may have on its consolidated financial statements; however, the Company expects this guidance will materially impact the Company's consolidated balance sheet, resulting in current operating lease obligations being reflected on the consolidated balance sheet. Goodwill (ASU 2017-04) Eliminates Step 2 of the current goodwill impairment test, which requires a hypothetical purchase price allocation to measure goodwill impairment. A goodwill impairment loss will instead be measured at the amount by which a reporting unit's carrying value exceeds its fair value, not to exceed the recorded amount of goodwill. Applied on a prospective basis, with early adoption permitted. January 1, 2020 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements. However, the Company does not expect this ASU to have a significant impact on its financial statements or disclosures. Comprehensive income (ASU 2018-02) Allows entities to reclassify from accumulated other comprehensive income to retained earnings stranded tax effects resulting from the Tax Cuts and Jobs Act (the "Tax Act"). Applied either in the period of adoption or retrospectively to each period (or periods) in which the effect of the change in the U.S. federal corporate income tax rate in the Tax Act is recognized. January 1, 2019 The Company is currently evaluating the impact this ASU may have on its consolidated financial statements.

Acquisition of Spinal Kinetic21

Acquisition of Spinal Kinetics, Inc. (Tables)	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Schedule of Acquisition Date Fair Value of Consideration Transferred	The acquisition date fair value of the consideration transferred was $76.1 million, which consisted of the following: (U.S. Dollars, in thousands) Fair value of consideration transferred Cash paid 50,564 Contingent consideration 25,491 Total fair value of consideration transferred 76,055
Summary of Preliminary Estimated Fair Values of Assets Acquired and Liabilities Assumed	The following table summarizes the preliminary estimated fair values of the assets acquired and liabilities assumed at the acquisition date. A final determination of the allocation of the purchase price to assets acquired and liabilities assumed has not been made and the following should be considered preliminary. The final determination is subject to completion of the Company’s valuation of the assets acquired and liabilities assumed, which it expects to complete within one year. (U.S. Dollars, in thousands) As of April 30, 2018 Assigned Useful Life Assets acquired Cash and cash equivalents $ 6,785 Restricted cash 30 Accounts receivable 1,705 Inventories 8,175 Prepaid expenses and other current assets 315 Property, plant and equipment 2,285 Other long-term assets 320 Developed technology 12,400 10 years In-process research and development ("IPR&D") 26,800 Indefinite Tradename 100 2 years Deferred income taxes 3,483 Total identifiable assets acquired 62,398 Liabilities assumed Accounts payable $ 351 Other current liabilities 2,873 Other long-term liabilities 301 Total liabilities assumed 3,525 Goodwill 17,182 Total fair value of consideration transferred 76,055
Summary of Unaudited Pro forma Results	The following table presents the unaudited pro forma results for the six months ended June 30, 2018 and 2017, Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 (unaudited) (unaudited) (unaudited) (unaudited) Net sales $ 112,718 $ 112,350 $ 225,173 $ 219,163 Net income (loss) from continuing operations 2,161 2,484 7,099 (1,076 )

Inventories (Tables)

Inventories (Tables)	6 Months Ended
	Jun. 30, 2018
Inventory Disclosure [Abstract]
Schedule of Inventories	Inventories were as follows: (U.S. Dollars, in thousands) June 30, 2018 December 31, 2017 Raw materials $ 9,210 $ 6,067 Work-in-process 13,502 12,487 Finished products 59,018 60,441 Deferred cost of sales — 2,335 Inventories $ 81,730 $ 81,330

Fair value measurements (Tables

Fair value measurements (Tables)	6 Months Ended
	Jun. 30, 2018
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: June 30, 2018 December 31, 2017 (U.S. Dollars, in thousands) Level 1 Level 2 Level 3 Total Total Assets Collective trust funds $ — $ 100 $ — $ 100 $ 100 Treasury securities 558 — — 558 556 Equity warrants — 289 — 289 311 Equity securities — 4,379 — 4,379 2,457 Debt security — — 18,010 18,010 16,050 Total $ 558 $ 4,768 $ 18,010 $ 23,336 $ 19,474 Liabilities Contingent consideration $ — $ — $ (26,600 ) $ (26,600 ) $ — Deferred compensation plan — (1,369 ) — (1,369 ) (1,379 ) Total $ — $ (1,369 ) $ (26,600 ) $ (27,969 ) $ (1,379 )
Schedule of Reconciliation For Contingent Consideration Measured At Fair Value Using Significant Unobservable Inputs	The following table provides a reconciliation of the beginning and ending balances for the contingent consideration measured at fair value using significant unobservable inputs (Level 3): (U.S. Dollars, in thousands) 2018 Contingent consideration at January 1 $ — Acquisition date fair value 25,491 Increase in fair value recognized in other income (expense) 1,109 Contingent consideration at June 30 $ 26,600
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) 2018 2017 Debt security at January 1 $ 16,050 $ 12,220 Accrued interest income — — Gains or losses recorded for the period Recognized in net income — (5,585 ) Recognized in other comprehensive income 1,960 2,365 Debt security at June 30 $ 18,010 $ 9,000

Accumulated other comprehensi24

Accumulated other comprehensive Income (Tables)	6 Months Ended
	Jun. 30, 2018
Equity [Abstract]
Components of Changes in Accumulated Other Comprehensive Income (Loss)	The components of and changes in accumulated other comprehensive income were as follows: (U.S. Dollars, in thousands) Currency Translation Adjustments Debt Security Accumulated Other Comprehensive Income Balance at December 31, 2017 $ (563 ) $ 4,350 $ 3,787 Other comprehensive income (478 ) 1,960 1,482 Income taxes — (432 ) (432 ) Balance at June 30, 2018 $ (1,041 ) $ 5,878 $ 4,837

Revenue recognition and accou25

Revenue recognition and accounts receivable (Tables)	6 Months Ended
	Jun. 30, 2018
Revenue Recognition And Accounts Receivable [Abstract]
Summary of Cumulative Impact of Adoption under Topic 606	The Company recorded a net increase to opening retained earnings of $4.8 million as of January 1, 2018 due to the cumulative impact of adopting Topic 606 as presented in the table below. (U.S. Dollars, in thousands) December 31, 2017 Impact of Adoption of ASC 606 January 1, 2018 Assets Current assets Cash and cash equivalents $ 81,157 $ — $ 81,157 Accounts receivable, net 63,437 8,648 72,085 Inventories 81,330 (2,338 ) 78,992 Prepaid expenses and other current assets 25,877 — 25,877 Total current assets 251,801 6,310 258,111 Deferred income taxes 23,315 (1,549 ) 21,766 Other long-term assets 130,238 — 130,238 Total assets $ 405,354 $ 4,761 $ 410,115 Liabilities and shareholders’ equity Total liabilities 108,746 — 108,746 Shareholders’ equity Common shares 1,828 — 1,828 Additional paid-in capital 220,591 — 220,591 Retained earnings 70,402 4,761 75,163 Accumulated other comprehensive income 3,787 — 3,787 Total shareholders’ equity 296,608 4,761 301,369 Total liabilities and shareholders’ equity $ 405,354 $ 4,761 $ 410,115 The table below presents the impact to the Company’s condensed consolidated statement of income for the three and six months ended June 30, 2018 as a result of the adoption of Topic 606. Three Months Ended June 30, 2018 Six Months Ended June 30, 2018 (U.S. Dollars, in thousands) Based on historical accounting under Topic 605 Impact of adoption As reported under Topic 606 Based on historical accounting under Topic 605 Impact of adoption As reported under Topic 606 Net sales $ 113,400 $ (1,853 ) $ 111,547 $ 214,762 $ 5,494 $ 220,256 Cost of sales 23,075 (240 ) 22,835 45,191 1,791 46,982 Gross profit 90,325 (1,613 ) 88,712 169,571 3,703 173,274 Sales and marketing 51,614 (85 ) 51,529 101,975 (178 ) 101,797 Other operating expenses 30,159 — 30,159 56,580 — 56,580 Operating income $ 8,552 $ (1,528 ) $ 7,024 $ 11,016 $ 3,881 $ 14,897 Income tax expense (1,694 ) 606 (1,088 ) (5,612 ) (849 ) (6,461 ) Net income from continuing operations $ 1,855 $ (922 ) $ 933 $ 3,130 $ 3,032 $ 6,162 Net income from continuing operations per common share—basic $ 0.10 $ (0.05 ) $ 0.05 $ 0.17 $ 0.16 $ 0.33 Net income from continuing operations per common share—diluted $ 0.10 $ (0.05 ) $ 0.05 $ 0.16 $ 0.16 $ 0.32
Schedule of Net Sales	The table below presents net sales, which includes product sales and marketing service fees, for the three and six months ended June 30, 2018 and 2017. Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 Product sales $ 97,453 $ 93,908 $ 192,342 $ 182,309 Marketing service fees 14,094 15,034 27,914 29,371 Net sales $ 111,547 $ 108,942 $ 220,256 $ 211,680

Business segment information (T

Business segment information (Tables)	6 Months Ended
	Jun. 30, 2018
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 June 30, (U.S. Dollars, in thousands) 2018 2017 Change BioStim $ 48,211 $ 47,174 2.2 % Spine Fixation 23,880 21,360 11.8 % Biologics 14,668 15,661 -6.3 % Extremity Fixation 24,788 24,747 0.2 % Net sales $ 111,547 $ 108,942 2.4 % Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 Change BioStim $ 94,374 $ 91,713 2.9 % Spine Fixation 44,587 40,627 9.7 % Biologics 29,003 30,648 -5.4 % Extremity Fixation 52,292 48,692 7.4 % Net sales $ 220,256 $ 211,680 4.1 %
Summary of Non-GAAP Net Margin by Reporting Segment	The table below presents non-GAAP net margin by reporting segment: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 BioStim $ 21,298 $ 19,469 $ 40,244 $ 36,602 Spine Fixation 2,887 2,696 4,148 4,703 Biologics 6,247 6,470 12,327 12,641 Extremity Fixation 7,002 6,766 15,160 13,178 Corporate (251 ) (107 ) (402 ) (205 ) Non-GAAP net margin $ 37,183 $ 35,294 $ 71,477 $ 66,919 General and administrative 22,268 20,409 41,752 38,691 Research and development 7,891 6,887 14,828 14,311 Operating income $ 7,024 $ 7,998 $ 14,897 $ 13,917 Interest income (expense), net (251 ) 76 (434 ) 121 Other income (expense), net (4,752 ) 585 (1,840 ) (3,763 ) Income before income taxes $ 2,021 $ 8,659 $ 12,623 $ 10,275
Summary of Net Sales by Geographic Destination for Each Reporting Unit	Geographical information The table below present net sales by geographic destination for each reporting unit and for the consolidated Company: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 BioStim U.S. $ 48,202 $ 47,162 $ 94,339 $ 91,701 International 9 12 35 12 Total BioStim 48,211 47,174 94,374 91,713 Spine Fixation U.S. 18,853 18,050 36,432 34,085 International 5,027 3,310 8,155 6,542 Total Spine Fixation 23,880 21,360 44,587 40,627 Biologics U.S. 14,667 15,651 28,989 30,614 International 1 10 14 34 Total Biologics 14,668 15,661 29,003 30,648 Extremity Fixation U.S. 7,023 6,741 13,939 13,320 International 17,765 18,006 38,353 35,372 Total Extremity Fixation 24,788 24,747 52,292 48,692 Consolidated U.S. 88,745 87,604 173,699 169,720 International 22,802 21,338 46,557 41,960 Net sales $ 111,547 $ 108,942 $ 220,256 $ 211,680

Share-based compensation (Table

Share-based compensation (Tables)	6 Months Ended
	Jun. 30, 2018
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Schedule of Share-Based Compensation by Line Item in Condensed Consolidated Statements of Income	The following tables present the detail of share-based compensation by line item in the condensed consolidated statements of income as well as by award type: Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 Cost of sales $ 132 $ 137 $ 257 $ 286 Sales and marketing 473 319 922 679 General and administrative 4,249 2,005 7,294 4,107 Research and development 361 215 658 420 $ 5,215 $ 2,676 $ 9,131 $ 5,492 Three Months Ended June 30, Six Months Ended June 30, (U.S. Dollars, in thousands) 2018 2017 2018 2017 Stock options $ 1,241 $ 523 $ 1,863 $ 1,118 Time-based restricted stock awards and units 1,789 1,239 3,236 2,531 Performance-based restricted stock awards 270 113 759 225 Performance-based and market-based restricted stock units 1,604 472 2,557 938 Stock purchase plan 311 329 716 680 $ 5,215 $ 2,676 $ 9,131 $ 5,492

Earnings per share ("EPS") (Tab

Earnings per share ("EPS") (Tables)	6 Months Ended
	Jun. 30, 2018
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 June 30, Six Months Ended June 30, 2018 2017 2018 2017 Weighted average common shares-basic 18,413,756 18,050,551 18,409,331 18,015,308 Effect of dilutive securities Unexercised stock options and stock purchase plan 327,171 156,109 318,047 115,560 Unvested restricted stock awards and units 94,633 136,378 83,978 157,182 Weighted average common shares-diluted 18,835,560 18,343,038 18,811,356 18,288,050

Business and Basis of Present29

Business and Basis of Presentation - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2018Segment
Organization Consolidation And Presentation Of Financial Statements [Abstract]
Number Of Reporting Units	4

Recently Adopted Accounting S30

Recently Adopted Accounting Standards and Recently Issued Accounting Pronouncements - Additional Information (Detail) $ / shares in Units, $ in Thousands	Jan. 01, 2018USD ($)	Mar. 31, 2018USD ($)$ / shares	Jun. 30, 2018USD ($)	Dec. 31, 2017USD ($)Asset	Jun. 30, 2017USD ($)
Summary Of Significant Accounting Policies [Line Items]
Prepaid income taxes				$ 8,600
Number of assets transferred | Asset				2
Increase (decrease) in net cash from operating activities			$ 13,032		$ (4,642)
ASU 2016-01 and 2018-03 [Member]
Summary Of Significant Accounting Policies [Line Items]
Impact on remeasurement of equity investments recorded within other current assets or long term assets		$ 1,600
Impact on remeasurement of equity investments per share before taxes recorded within other income (expense) | $ / shares		$ 0.09
ASU 2016-16, as Amended [Member]
Summary Of Significant Accounting Policies [Line Items]
Cumulative-effect adjustment to retained earnings	$ 1,900
ASU 2016-18 [Member]
Summary Of Significant Accounting Policies [Line Items]
Increase (decrease) in net cash from operating activities					$ (14,400)
ASU 2017-01 [Member]
Summary Of Significant Accounting Policies [Line Items]
Assets Acquired Not Meeting The Definition of a Business		$ 1,900

Acquisition of Spinal Kinetic31

Acquisition of Spinal Kinetics, Inc. - Additional Information (Detail) - USD ($) $ in Thousands	Apr. 30, 2018	Jun. 30, 2018	Jun. 30, 2018	Jun. 30, 2018	Mar. 15, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill		$ 70,747	$ 70,747	$ 70,747		$ 53,565
Spinal Kinetics [Member]
Business Acquisition [Line Items]
Business acquisition date	Apr. 30, 2018
Business acquisition conversion of shares into net cash subject to adjustments	$ 45,000
Future milestone payments	60,000
Business acquisition, percentage of outstanding stock					100.00%
Fair value of the consideration transferred	$ 76,055
Milestone achievement period	5 years
Contingent consideration	$ 25,491	26,600	26,600	26,600
Goodwill	17,182
Acquisition related costs			1,500	3,000
Reveneue from acquisition			2,300	2,300
Net loss from Acquisition			$ 1,800	$ 1,800
Spinal Kinetics [Member] | Spine Fixation [Member]
Business Acquisition [Line Items]
Goodwill	17,200
Spinal Kinetics [Member] | Other Expense [Member]
Business Acquisition [Line Items]
Increase in the fair value of a contingent consideration		$ 1,100
Spinal Kinetics [Member] | US Food And Drug Administration [Member]
Business Acquisition [Line Items]
Future milestone payments	15,000
Spinal Kinetics [Member] | Revenue Milestone [Member]
Business Acquisition [Line Items]
Future milestone payments	45,000
Spinal Kinetics [Member] | Maximum [Member]
Business Acquisition [Line Items]
Future milestone payments	$ 60,000

Acquisition of Spinal Kinetic32

Acquisition of Spinal Kinetics, Inc. - Schedule of Acquisition Date Fair Value of Consideration Transferred (Detail) - Spinal Kinetics [Member] - USD ($) $ in Thousands	Apr. 30, 2018	Jun. 30, 2018
Fair value of consideration transferred
Cash paid	$ 50,564
Contingent consideration	25,491	$ 26,600
Total fair value of consideration transferred	$ 76,055

Acquisition of Spinal Kinetic33

Acquisition of Spinal Kinetics, Inc. - Summary of Preliminary Estimated Fair Values of Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Apr. 30, 2018	Jun. 30, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Goodwill		$ 70,747	$ 53,565
Spinal Kinetics [Member]
Business Acquisition [Line Items]
Cash and cash equivalents	$ 6,785
Restricted cash	30
Accounts receivable	1,705
Inventories	8,175
Prepaid expenses and other current assets	315
Property, plant and equipment	2,285
Other long-term assets	320
In-process research and development ("IPR&D")	26,800
Deferred income taxes	3,483
Total identifiable assets acquired	62,398
Accounts payable	351
Other current liabilities	2,873
Other long-term liabilities	301
Total liabilities assumed	3,525
Goodwill	17,182
Total fair value of consideration transferred	$ 76,055
In-process research and development ("IPR&D"), Assigned Useful Life	Indefinite
Developed Technology [Member] | Spinal Kinetics [Member]
Business Acquisition [Line Items]
Finite lived intangible assets acquired	$ 12,400
Assigned Useful Life	10 years
Tradename [Member] | Spinal Kinetics [Member]
Business Acquisition [Line Items]
Finite lived intangible assets acquired	$ 100
Assigned Useful Life	2 years

Acquisition of Spinal Kinetic34

Acquisition of Spinal Kinetics, Inc. - Summary of Unaudited Pro forma Results (Detail) - Spinal Kinetics [Member] - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Business Acquisition [Line Items]
Net sales	$ 112,718	$ 112,350	$ 225,173	$ 219,163
Net income (loss) from continuing operations	$ 2,161	$ 2,484	$ 7,099	$ (1,076)

Inventories - Schedule of Inven

Inventories - Schedule of Inventories (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017
Inventory Disclosure [Abstract]
Raw materials	$ 9,210	$ 6,067
Work-in-process	13,502	12,487
Finished products	59,018	60,441
Deferred cost of sales		2,335
Inventories	$ 81,730	$ 81,330

Long-Term Debt - Additional Inf

Long-Term Debt - Additional Information (Detail)	6 Months Ended
	Jun. 30, 2018USD ($)	Jun. 30, 2018EUR (€)	Aug. 31, 2015USD ($)
Italy [Member]
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 6,800,000	€ 5,800,000
Amount outstanding under lines of credit	$ 0
2015 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

Fair Value Measurements - Sched

Fair Value Measurements - Schedule of Financial Assets and Liabilities Measured at Fair Value on Recurring Basis (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Dec. 31, 2017	Jun. 30, 2017	Dec. 31, 2016
Debt Security [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	$ 18,010	$ 16,050	$ 9,000	$ 12,220
Fair Value, Measurements, Recurring [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	23,336	19,474
Contingent consideration	(26,600)
Deferred compensation plan, Liabilities	(1,369)	(1,379)
Liabilities fair value, Total	(27,969)	(1,379)
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	558
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	4,768
Deferred compensation plan, Liabilities	(1,369)
Liabilities fair value, Total	(1,369)
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	18,010
Contingent consideration	(26,600)
Liabilities fair value, Total	(26,600)
Fair Value, Measurements, Recurring [Member] | Collective Trust Funds [Member] | Other Noncurrent Assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	100	100
Fair Value, Measurements, Recurring [Member] | Collective Trust Funds [Member] | Fair Value, Inputs, Level 2 [Member] | Other Noncurrent Assets [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	100
Fair Value, Measurements, Recurring [Member] | Treasury Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	558	556
Fair Value, Measurements, Recurring [Member] | Treasury Securities [Member] | Fair Value, Inputs, Level 1 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	558
Fair Value, Measurements, Recurring [Member] | Equity Warrants [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	289	311
Fair Value, Measurements, Recurring [Member] | Equity Warrants [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	289
Fair Value, Measurements, Recurring [Member] | Equity Securities [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	4,379	2,457
Fair Value, Measurements, Recurring [Member] | Equity Securities [Member] | Fair Value, Inputs, Level 2 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	4,379
Fair Value, Measurements, Recurring [Member] | Debt Security [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	18,010	$ 16,050
Fair Value, Measurements, Recurring [Member] | Debt Security [Member] | Fair Value, Inputs, Level 3 [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Assets fair value	$ 18,010

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Thousands	Apr. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Jun. 30, 2018	Dec. 31, 2017	Jun. 30, 2017	Dec. 31, 2016
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Amortized cost basis in debt security		$ 9,000		$ 9,000
Spinal Kinetics [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Future milestone payments	$ 60,000
Milestone achievement period	5 years
Contingent consideration	$ 25,491	26,600		26,600
Other Expense [Member] | Spinal Kinetics [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Increase in the fair value of a contingent consideration		1,100
Maximum [Member] | Spinal Kinetics [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Future milestone payments	60,000
US Food And Drug Administration [Member] | Spinal Kinetics [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Future milestone payments	15,000
Revenue Milestone [Member] | Spinal Kinetics [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Future milestone payments	$ 45,000
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		$ 18,010		18,010	$ 16,050	$ 9,000	$ 12,220
Increase in estimated fair value of the debt security				$ 2,000
Bone Biologics Inc [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Purchase of common stock, value			$ 500
Bone Biologics Inc [Member] | Common Stock [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Purchase of stock, shares			250,000
ASU 2016-01 [Member] | Bone Biologics Inc [Member] | Equity Investments [Member]
Fair Value Assets And Liabilities Measured On Recurring And Nonrecurring Basis [Line Items]
Increase in previously recorded value of equity investments resulted from new measurement			$ 1,600
Impact on remeasurement of equity investments per share before taxes included within other income or expense			$ 0.09

Fair Value Measurements - Sch39

Fair Value Measurements - Schedule of Reconciliation of Debt Securities (Detail) - Debt Securities [Member] - Fair Value, Inputs, Level 3 [Member] - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Fair Value Assets Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Debt security, Beginning balance	$ 16,050	$ 12,220
Accrued interest income	0	0
Gains or losses recorded for the period
Recognized in net income	0	(5,585)
Recognized in other comprehensive income	1,960	2,365
Debt security, Ending balance	$ 18,010	$ 9,000

Fair Value Measurements - Sch40

Fair Value Measurements - Schedule of Reconciliation For Contingent Consideration Measured At Fair Value Using Significant Unobservable Inputs (Level 3) (Detail) - Fair Value, Inputs, Level 3 [Member] $ in Thousands	6 Months Ended
	Jun. 30, 2018USD ($)
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Acquisition date fair value	$ 25,491
Increase in fair value recognized in other income (expense)	1,109
Contingent consideration at June 30	$ 26,600

Contingencies - Additional Info

Contingencies - Additional Information (Detail) - Jun. 30, 2018 € in Millions, $ in Millions	USD ($)	EUR (€)
Commitments And Contingencies Disclosure [Abstract]
Discontinued operations obligated to make final payment to insurer	$ 1.7
Accrued liabilities	$ 3.3	€ 2.8

Accumulated Other Comprehensi42

Accumulated Other Comprehensive Income - Components of Changes in Accumulated Other Comprehensive Income (Loss) (Detail) - USD ($) $ in Thousands	3 Months Ended	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2018	Jun. 30, 2017
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance		$ 296,608
Other comprehensive income		1,482
Income taxes	$ (432)	(432)	$ (900)
Ending Balance	319,846	319,846
Currency Translation Adjustments [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance		(563)
Other comprehensive income		(478)
Ending Balance	(1,041)	(1,041)
Debt Security [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance		4,350
Other comprehensive income		1,960
Income taxes		(432)
Ending Balance	5,878	5,878
Accumulated Other Comprehensive Income (Loss) [Member]
Accumulated Other Comprehensive Income Loss [Line Items]
Beginning Balance		3,787
Ending Balance	$ 4,837	$ 4,837

Revenue Recognition and Accou43

Revenue Recognition and Accounts Receivable - Additional Information (Detail) - USD ($)	6 Months Ended	12 Months Ended
	Jun. 30, 2018	Dec. 31, 2017	Jan. 01, 2018
Other Contract Assets [Member]
Revenue Recognition And Accounts Receivable [Line Items]
Other contract assets impairment	$ 0	$ 0
Other Noncurrent Assets [Member]
Revenue Recognition And Accounts Receivable [Line Items]
Other contract assets	$ 1,200,000	$ 1,000,000
Topic 606 [Member]
Revenue Recognition And Accounts Receivable [Line Items]
Net increase to opening retained earnings due to cumulative impact of adoption			$ 4,800,000

Revenue Recognition and Accou44

Revenue Recognition and Accounts Receivable - Schedule of Net Increase to Opening Retained Earnings Due to Cumulative Impact of Adopting (Detail) - USD ($) $ in Thousands	Jun. 30, 2018	Jan. 01, 2018	Dec. 31, 2017
Current assets
Cash and cash equivalents	$ 45,686		$ 81,157
Accounts receivable, net	74,397		63,437
Inventories	81,730		81,330
Prepaid expenses and other current assets	35,613		25,877
Total current assets	237,426		251,801
Deferred income taxes	30,634		23,315
Other long-term assets	7,082		21,073
Total assets	441,764		405,354
Total liabilities	121,918		108,746
Shareholders’ equity
Common shares	1,849		1,828
Additional paid-in capital	233,742		220,591
Retained earnings	79,418		70,402
Accumulated other comprehensive income	4,837		3,787
Total shareholders’ equity	319,846		296,608
Total liabilities and shareholders’ equity	$ 441,764		405,354
Effect before Topic 606 [Member]
Current assets
Cash and cash equivalents			81,157
Accounts receivable, net			63,437
Inventories			81,330
Prepaid expenses and other current assets			25,877
Total current assets			251,801
Deferred income taxes			23,315
Other long-term assets			130,238
Total assets			405,354
Total liabilities			108,746
Shareholders’ equity
Common shares			1,828
Additional paid-in capital			220,591
Retained earnings			70,402
Accumulated other comprehensive income			3,787
Total shareholders’ equity			296,608
Total liabilities and shareholders’ equity			405,354
Topic 606 [Member]
Current assets
Cash and cash equivalents		$ 81,157
Accounts receivable, net		72,085
Inventories		78,992
Prepaid expenses and other current assets		25,877
Total current assets		258,111
Deferred income taxes		21,766
Other long-term assets		130,238
Total assets		410,115
Total liabilities		108,746
Shareholders’ equity
Common shares		1,828
Additional paid-in capital		220,591
Retained earnings		75,163
Accumulated other comprehensive income		3,787
Total shareholders’ equity		301,369
Total liabilities and shareholders’ equity		$ 410,115
Topic 606 [Member] | Impact of Adoption of ASC 606
Current assets
Accounts receivable, net			8,648
Inventories			(2,338)
Total current assets			6,310
Deferred income taxes			(1,549)
Total assets			4,761
Shareholders’ equity
Retained earnings			4,761
Total shareholders’ equity			4,761
Total liabilities and shareholders’ equity			$ 4,761

Revenue Recognition and Accou45

Revenue Recognition and Accounts Receivable - Summary of Consolidated Statement of Operations As Impact of Adoption (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenue Recognition And Accounts Receivable [Line Items]
Net sales	$ 111,547	$ 108,942	$ 220,256	$ 211,680
Cost of sales	22,835	23,177	46,982	45,758
Gross profit	88,712	85,765	173,274	165,922
Sales and marketing	51,529	50,471	101,797	99,003
Operating income	7,024	7,998	14,897	13,917
Income tax expense	(1,088)	(3,924)	(6,461)	(7,848)
Net income from continuing operations	$ 933	$ 4,735	$ 6,162	$ 2,427
Net income from continuing operations per common share—basic	$ 0.05	$ 0.26	$ 0.33	$ 0.13
Net income from continuing operations per common share—diluted	$ 0.05	$ 0.26	$ 0.32	$ 0.13
Topic 606 [Member]
Revenue Recognition And Accounts Receivable [Line Items]
Net sales	$ 111,547		$ 220,256
Cost of sales	22,835		46,982
Gross profit	88,712		173,274
Sales and marketing	51,529		101,797
Other operating expenses	30,159		56,580
Operating income	7,024		14,897
Income tax expense	(1,088)		(6,461)
Net income from continuing operations	$ 933		$ 6,162
Net income from continuing operations per common share—basic	$ 0.05		$ 0.33
Net income from continuing operations per common share—diluted	$ 0.05		$ 0.32
Topic 606 [Member] | Based on Historical Accounting under Topic 605 [Member]
Revenue Recognition And Accounts Receivable [Line Items]
Net sales	$ 113,400		$ 214,762
Cost of sales	23,075		45,191
Gross profit	90,325		169,571
Sales and marketing	51,614		101,975
Other operating expenses	30,159		56,580
Operating income	8,552		11,016
Income tax expense	(1,694)		(5,612)
Net income from continuing operations	$ 1,855		$ 3,130
Net income from continuing operations per common share—basic	$ 0.10		$ 0.17
Net income from continuing operations per common share—diluted	$ 0.10		$ 0.16
Topic 606 [Member] | Impact of Adoption of ASC 606
Revenue Recognition And Accounts Receivable [Line Items]
Net sales	$ (1,853)		$ 5,494
Cost of sales	(240)		1,791
Gross profit	(1,613)		3,703
Sales and marketing	(85)		(178)
Operating income	(1,528)		3,881
Income tax expense	606		(849)
Net income from continuing operations	$ (922)		$ 3,032
Net income from continuing operations per common share—basic	$ (0.05)		$ 0.16
Net income from continuing operations per common share—diluted	$ (0.05)		$ 0.16

Revenue Recognition and Accou46

Revenue Recognition and Accounts Receivable - Schedule of Net Sales (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenue Recognition [Abstract]
Product sales	$ 97,453	$ 93,908	$ 192,342	$ 182,309
Marketing service fees	14,094	15,034	27,914	29,371
Net sales	$ 111,547	$ 108,942	$ 220,256	$ 211,680

Business Segment Information -

Business Segment Information - Schedule of Net Sales by Reporting Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Segment Reporting Information [Line Items]
Net sales	$ 111,547	$ 108,942	$ 220,256	$ 211,680
Change	2.40%		4.10%
BioStim [Member]
Segment Reporting Information [Line Items]
Net sales	$ 48,211	47,174	$ 94,374	91,713
Change	2.20%		2.90%
Biologics [Member]
Segment Reporting Information [Line Items]
Net sales	$ 14,668	15,661	$ 29,003	30,648
Change	(6.30%)		(5.40%)
Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Net sales	$ 24,788	24,747	$ 52,292	48,692
Change	0.20%		7.40%
Spine Fixation [Member]
Segment Reporting Information [Line Items]
Net sales	$ 23,880	$ 21,360	$ 44,587	$ 40,627
Change	11.80%		9.70%

Business Segment Information 48

Business Segment Information - Summary of Non-GAAP Net Margin by Reporting Segment (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Segment Reporting Information [Line Items]
Non-GAAP net margin	$ 37,183	$ 35,294	$ 71,477	$ 66,919
General and administrative	22,268	20,409	41,752	38,691
Research and development	7,891	6,887	14,828	14,311
Operating income	7,024	7,998	14,897	13,917
Interest income (expense), net	(251)	76	(434)	121
Other income (expense), net	(4,752)	585	(1,840)	(3,763)
Income before income taxes	2,021	8,659	12,623	10,275
Operating Segments [Member] | BioStim [Member]
Segment Reporting Information [Line Items]
Non-GAAP net margin	21,298	19,469	40,244	36,602
Operating Segments [Member] | Biologics [Member]
Segment Reporting Information [Line Items]
Non-GAAP net margin	6,247	6,470	12,327	12,641
Operating Segments [Member] | Extremity Fixation [Member]
Segment Reporting Information [Line Items]
Non-GAAP net margin	7,002	6,766	15,160	13,178
Operating Segments [Member] | Spine Fixation [Member]
Segment Reporting Information [Line Items]
Non-GAAP net margin	2,887	2,696	4,148	4,703
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Non-GAAP net margin	(251)	(107)	(402)	(205)
Material Reconciling Items [Member]
Segment Reporting Information [Line Items]
General and administrative	22,268	20,409	41,752	38,691
Research and development	$ 7,891	$ 6,887	$ 14,828	$ 14,311

Business Segment Information 49

Business Segment Information - Summary of Net Sales by Geographic Destination for Each Reporting Unit (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	$ 111,547	$ 108,942	$ 220,256	$ 211,680
BioStim [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	48,211	47,174	94,374	91,713
Extremity Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	24,788	24,747	52,292	48,692
Spine Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	23,880	21,360	44,587	40,627
Biologics [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	14,668	15,661	29,003	30,648
U.S. [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	88,745	87,604	173,699	169,720
U.S. [Member] | BioStim [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	48,202	47,162	94,339	91,701
U.S. [Member] | Extremity Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	7,023	6,741	13,939	13,320
U.S. [Member] | Spine Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	18,853	18,050	36,432	34,085
U.S. [Member] | Biologics [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	14,667	15,651	28,989	30,614
International [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	22,802	21,338	46,557	41,960
International [Member] | BioStim [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	9	12	35	12
International [Member] | Extremity Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	17,765	18,006	38,353	35,372
International [Member] | Spine Fixation [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	5,027	3,310	8,155	6,542
International [Member] | Biologics [Member]
Revenues From External Customers And Long Lived Assets [Line Items]
Net sales	$ 1	$ 10	$ 14	$ 34

Share-based Compensation - Sche

Share-based Compensation - Schedule of Share-Based Compensation by Line Item in Condensed Consolidated Statements of Income (Detail) - USD ($) $ in Thousands	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	$ 5,215	$ 2,676	$ 9,131	$ 5,492
Stock options [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	1,241	523	1,863	1,118
Time-based Restricted Stock Awards and Units [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	1,789	1,239	3,236	2,531
Performance-based Restricted Stock Awards [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	270	113	759	225
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	1,604	472	2,557	938
Stock purchase plan [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	311	329	716	680
Cost of sales [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	132	137	257	286
Sales and marketing [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	473	319	922	679
General and administrative [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	4,249	2,005	7,294	4,107
Research and development [Member]
Employee Service Share-based Compensation, Allocation of Recognized Period Costs [Line Items]
Allocated share based compensation expense	$ 361	$ 215	$ 658	$ 420

Share-based Compensation - Addi

Share-based Compensation - Additional Information (Detail) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]
Shares issued under stock purchase plan, stock option exercises and restricted stock	80,444	76,596	206,955	291,275

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended			6 Months Ended
	Jun. 30, 2018	Dec. 31, 2017	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Mar. 31, 2018
Components Of Income Tax Expense Benefit [Line Items]
Income tax effective rate	53.80%		45.30%	51.20%	76.40%
Income tax expense (benefit) impact of the tax act	$ (0.5)	$ 8.3		$ (0.5)
Minimum [Member]
Components Of Income Tax Expense Benefit [Line Items]
Decrease in unrecognized tax benefits						$ 2.1
Maximum [Member]
Components Of Income Tax Expense Benefit [Line Items]
Decrease in unrecognized tax benefits						$ 4.1

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		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Earnings Per Share [Line Items]
Weighted average common shares-basic	18,413,756	18,050,551	18,409,331	18,015,308
Effect of dilutive securities
Weighted average common shares-diluted	18,835,560	18,343,038	18,811,356	18,288,050
Stock Options And Stock Purchase Plan [Member]
Effect of dilutive securities
Effect of diluted securities	327,171	156,109	318,047	115,560
Restricted Stock Units [Member]
Effect of dilutive securities
Effect of diluted securities	94,633	136,378	83,978	157,182

Earnings Per Share ("EPS") - Ad

Earnings Per Share ("EPS") - Additional Information (Detail) - shares	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
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	413,296	462,146	259,470	506,964

Subsequent Events - Additional

Subsequent Events - Additional Information (Detail) $ in Millions	Jul. 31, 2018USD ($)	Jun. 30, 2018
Subsequent Event [Line Items]
Common Stock, Conversion Basis		Upon the effectiveness of the Domestication, each common share of Orthofix International N.V. was automatically converted into one share of common stock of Orthofix Medical Inc. The Company’s common stock continues to be traded on the Nasdaq Global Select Market under the symbol “OFIX.”
Subsequent Event [Member]
Subsequent Event [Line Items]
Date of change in jurisdiction from Curaçao to the State of Delaware	Jul. 31, 2018
Common stock, share conversion ratio	1
Freezing amount in cash resulted from court pending legal action issued	$ 2.5
Subsequent Event [Member] | 2015 Credit Agreement [Member] | Revolving Credit Facility [Member]
Subsequent Event [Line Items]
Amended voting interest percentage in first tier foreign subsidiaries pledged to limit	65.00%