Goodwill and Intangible Assets - Other Intangible Assets (Details) - USD ($) $ in Thousands	Mar. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	$ 129,573	$ 128,702
Accumulated Amortization	(52,469)	(49,136)
Net Carrying Amount	77,104	79,566
Other
Finite-Lived Intangible Assets [Line Items]
Accumulated Amortization	(52,469)	(49,136)
Net Carrying Amount	77,104	79,566
Patents
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	20,231	19,378
Accumulated Amortization	(5,467)	(5,012)
Net Carrying Amount	14,764	14,366
Distribution agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	8,012	8,012
Accumulated Amortization	(6,023)	(5,766)
Net Carrying Amount	1,989	2,246
License agreements
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	26,926	26,930
Accumulated Amortization	(7,941)	(7,411)
Net Carrying Amount	18,985	19,519
Trademarks
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	29,991	29,998
Accumulated Amortization	(7,298)	(6,586)
Net Carrying Amount	22,693	23,412
Covenants not to compete
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	1,028	1,028
Accumulated Amortization	(1,008)	(1,000)
Net Carrying Amount	20	28
Customer lists
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	39,965	39,936
Accumulated Amortization	(24,732)	(23,361)
Net Carrying Amount	15,233	16,575
In-process technology
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Amount	3,420	3,420
Accumulated Amortization	0	0
Net Carrying Amount	$ 3,420	$ 3,420