Acquisitions - Additional Information (Detail) - USD ($)				3 Months Ended								12 Months Ended
	Dec. 31, 2018	May 07, 2018	Oct. 02, 2017	Dec. 31, 2018	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Aug. 09, 2018	Feb. 22, 2018
Business Acquisition [Line Items]
Contract base price		$ 375,000,000
Acquisition related costs												$ 5,871,000	$ 344,000	$ 0
Financing costs												12,900,000
Revenues				$ 199,477,000	$ 205,683,000	$ 196,349,000	$ 169,148,000	$ 156,135,000	$ 148,156,000	$ 157,947,000	$ 157,555,000	770,657,000	619,793,000	584,954,000
Sales revenue												770,657,000	619,793,000	584,954,000
Income (loss) from operations												(178,888,000)	33,114,000	34,779,000
Goodwill	$ 439,452,000			439,452,000				$ 454,612,000				439,452,000	454,612,000	$ 443,529,000
Paragon Medical
Business Acquisition [Line Items]
Acquisition percentage		100.00%
Cash payment to acquire business	390,900,000
Cash and cash equivalents	13,552,000			13,552,000		13,418,000						13,552,000
Working capital adjustment												1,400,000
Finite-lived intangibles after post acquisition amortization	155,300,000			155,300,000								155,300,000
Acquired goodwill after post acquisition currency impact	158,700,000			158,700,000								158,700,000
Goodwill, expected tax deductible amount	2,800,000			2,800,000								2,800,000
Acquisition related costs												5,400,000
Revenues												116,998,000	0
Income (loss) from operations												8,086,000	0
Goodwill	161,820,000			161,820,000		$ 157,421,000						161,820,000
NN Vandalia
Business Acquisition [Line Items]
Acquisition percentage			100.00%
Revenues												30,668,000	6,682,000
Income (loss) from operations												1,532,000
Series of Individually Immaterial Business Acquisitions
Business Acquisition [Line Items]
Cash payment to acquire business			$ 38,700,000									22,000,000
Acquisition related costs												500,000	$ 300,000
Bridgemedica, LLC
Business Acquisition [Line Items]
Acquisition percentage																100.00%
Goodwill	8,000,000			8,000,000								8,000,000
Southern California Technical Arts, Inc.
Business Acquisition [Line Items]
Acquisition percentage															100.00%
Goodwill	$ 2,800,000			$ 2,800,000								$ 2,800,000