Acquisitions - Purchase Price Allocation (Details) - USD ($) $ in Thousands	6 Months Ended	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2018	Jun. 30, 2018	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Property, plant and equipment	$ 66,000	$ 66,000		$ 14,000
Intangible assets subject to amortization	171,113	171,113		6,900
Goodwill	439,452	439,452		$ 454,612	$ 443,529
Measurement period adjustments		5,142
Paragon Medical
Business Acquisition [Line Items]
Cash and cash equivalents	13,552	13,552	$ 13,418
Cash and cash equivalents, adjustment	134
Accounts receivable	22,132	22,132	22,853
Accounts receivable, adjustment	(721)
Inventories	23,206	23,206	23,606
Inventories, adjustment	(400)
Other current assets	1,671	1,671	937
Other current assets, adjustment	734
Property, plant and equipment	63,697	63,697	69,322
Property, plant, and equipment, adjustment	(5,625)
Intangible assets subject to amortization	163,500	163,500	164,200
Intangibles assets subject to amortization, adjustment	(700)
Other non-current assets	3,175	3,175	3,304
Other noncurrent assets, adjustment	(129)
Goodwill	161,820	161,820	157,421
Measurement period adjustments	4,399
Total assets acquired	452,753	452,753	455,061
Total assets acquired, adjustment	(2,308)
Current liabilities	17,001	17,001	16,767
Current liabilities, adjustment	234
Deferred tax liability	44,271	44,271	46,713
Deferred tax liabilities, adjustment	(2,442)
Other non-current liabilities	620	620	620
Other noncurrent liabilities, adjustment	0
Total liabilities assumed	61,892	61,892	64,100
Total liabilities assumed, adjustment	(2,208)
Net assets acquired, adjustment	(100)
Net assets acquired	$ 390,861	$ 390,861	$ 390,961