Acquisitions Purchase Price Allocation (Details) - USD ($) $ in Thousands	May 07, 2018	Jun. 30, 2018	Dec. 31, 2017
Business Acquisition [Line Items]
Intangible assets subject to amortization		$ 169,913
Goodwill		617,814	$ 454,612
Paragon Medical Inc [Member]
Business Acquisition [Line Items]
Cash and cash equivalents	$ 13,418
Accounts receivable	22,853
Inventories	23,606
Other current assets	937
Property, plant and equipment	69,322
Intangible assets subject to amortization	164,200	163,300
Other non-current assets	3,304
Goodwill	157,421	$ 155,600
Total assets acquired	455,061
Current liabilities	16,767
Deferred tax liability	46,713
Other non-current liabilities	620
Total liabilities assumed	64,100
Net assets acquired	$ 390,961