Total Net Revenues and Total Net Property, Plant and Equipment by Geographic Region (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended													12 Months Ended
	Dec. 31, 2013	Sep. 30, 2013	Jun. 30, 2013	Mar. 31, 2013		Dec. 31, 2012		Sep. 30, 2012		Jun. 30, 2012		Mar. 31, 2012		Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011
Segment Reporting Information [Line Items]
Net revenues	$ 450,539	$ 413,796	$ 420,059	$ 411,877	[1]	$ 419,056	[2]	$ 368,054	[2]	$ 383,332	[2]	$ 380,567	[1],[2]	$ 1,696,271	$ 1,551,009	$ 1,492,528
Property, plant and equipment, net	325,900					297,945								325,900	297,945	251,912
United States
Segment Reporting Information [Line Items]
Net revenues														844,884	789,771	762,957
Property, plant and equipment, net	203,985					180,833								203,985	180,833	159,042
Other Americas
Segment Reporting Information [Line Items]
Net revenues														57,656	53,665	55,228
Property, plant and equipment, net	12,350					12,828								12,350	12,828	12,492
Germany
Segment Reporting Information [Line Items]
Net revenues														133,598	123,355	128,072
Property, plant and equipment, net	12,135					12,197								12,135	12,197	8,549
Other Europe
Segment Reporting Information [Line Items]
Net revenues														438,567	393,627	403,274
Property, plant and equipment, net	61,891					58,843								61,891	58,843	53,775
All Other
Segment Reporting Information [Line Items]
Net revenues														221,566	190,591	142,997
Property, plant and equipment, net	$ 35,539					$ 33,244								$ 35,539	$ 33,244	$ 18,054

[1] Amounts for the first quarter 2012 include a pretax goodwill impairment charge of $332.1 million, or $315.1 million net of tax. See Note 7 to the consolidated financial statements.

[2] Amounts reflect the retrospective impact of reporting the orthopedic business as discontinued operations. See Note 18 to the consolidated financial statements.