Document and Entity Information	3 Months Ended
Document and Entity Information	Mar. 31, 2014	Apr. 28, 2014
Document Documentand Entity Information [Abstract]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2014
Document Fiscal Year Focus	2014
Document Fiscal Period Focus	Q1
Trading Symbol	iart
Entity Registrant Name	INTEGRA LIFESCIENCES HOLDINGS CORP
Entity Central Index Key	0000917520
Current Fiscal Year End Date	--12-31
Entity Filer Category	Large Accelerated Filer
Entity Common Stock, Shares Outstanding		32,567,024

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS AND COMPREHENSIVE INCOME (UNAUDITED) (USD $) In Thousands, except Per Share data, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Income Statement [Abstract]
Total revenue, net	$ 215,059	$ 196,652
Costs and Expenses:
Cost of goods sold	82,383	79,612
Research and development	12,567	12,716
Selling, general and administrative	108,338	102,963
Intangible asset amortization	3,033	3,551
Total costs and expenses	206,321	198,842
Operating income (loss)	8,738	(2,190)
Interest income	62	63
Interest expense	(5,142)	(4,800)
Other income (expense), net	317	(974)
Income (loss) before income taxes	3,975	(7,901)
Income tax expense (benefit)	1,769	(1,873)
Net income (loss)	2,206	(6,028)
Basic net income per common share (in dollars per share)	$ 0.07	$ (0.22)
Diluted net income per common share (in dollars per share)	$ 0.07	$ (0.22)
Weighted average common shares outstanding (See Note 11):
Basic (in shares)	32,275	27,796
Diluted (in shares)	32,768	27,796
Comprehensive income (loss) (See Note 12)	$ 3,206	$ (12,512)

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (USD $) In Thousands, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013
Current Assets:
Cash and cash equivalents	$ 129,038	$ 120,614
Trade accounts receivable, net of allowances of $6,287 and $6,194	112,521	118,145
Inventories, net	215,232	206,919
Deferred tax assets	48,459	48,616
Prepaid expenses and other current assets	34,496	26,858
Total current assets	539,746	521,152
Property, plant and equipment, net	205,667	200,310
Intangible assets, net	429,446	197,163
Goodwill	367,649	249,764
Deferred tax assets	5,645	15,412
Other assets	7,770	8,338
Total assets	1,555,923	1,192,139
Current Liabilities:
Accounts payable, trade	46,428	50,752
Deferred revenue	4,220	4,197
Accrued compensation	28,487	28,079
Accrued expenses and other current liabilities	37,696	36,354
Total current liabilities	116,831	119,382
Long-term borrowings under senior credit facility	421,875	186,875
Long-term convertible securities	207,125	205,182
Deferred tax liabilities	94,612	2,083
Other liabilities	36,280	12,527
Total liabilities	876,723	526,049
Commitments and contingencies
Stockholders’ Equity:
Preferred Stock; no par value; 15,000 authorized shares; none outstanding	0	0
Common stock; $0.01 par value; 60,000 authorized shares; 41,449 and 41,042 issued at March 31, 2014 and December 31, 2013, respectively	415	410
Additional paid-in capital	760,817	750,918
Treasury stock, at cost; 8,903 shares at March 31, 2014 and December 31, 2013	(367,121)	(367,121)
Accumulated other comprehensive income (loss)	1,927	927
Retained earnings	283,162	280,956
Total stockholders’ equity	679,200	666,090
Total liabilities and stockholders’ equity	$ 1,555,923	$ 1,192,139

CONDENSED CONSOLIDATED BALANCE SHEETS (UNAUDITED) (Parenthetical) (USD $) In Thousands, except Per Share data, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013
Statement of Financial Position [Abstract]
Trade accounts receivable, allowances	$ 6,287	$ 6,194
Preferred Stock, par value (in dollars per share)	$ 0	$ 0
Preferred Stock, authorized shares (in shares)	15,000	15,000
Preferred Stock, outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.01	$ 0.01
Common stock, shares authorized (in shares)	60,000	60,000
Common stock, shares issued (in shares)	41,449	41,042
Treasury stock, shares (in shares)	8,903	8,903

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
OPERATING ACTIVITIES:
Net income (loss)	$ 2,206	$ (6,028)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	13,961	11,389
Non-cash impairment charges	600	0
Deferred income tax provision (benefit)	1,563	(1,055)
Amortization of debt issuance costs	608	545
Non-cash interest expense	1,666	1,610
Loss on disposal of property and equipment	0	1,865
Share-based compensation	2,471	2,072
Excess tax benefits from stock-based compensation arrangements	(541)	(23)
Changes in assets and liabilities, net of business acquisitions:
Accounts receivable	5,671	2,109
Inventories	(8,516)	(6,739)
Prepaid expenses and other current assets	(1,582)	2,704
Other non-current assets	(127)	(115)
Accounts payable, accrued expenses and other current liabilities	(4,438)	(515)
Deferred revenue	21	391
Other non-current liabilities	(2,309)	(364)
Net cash provided by operating activities	11,254	7,846
INVESTING ACTIVITIES:
Purchases of property and equipment	(11,335)	(10,853)
Sales of property and equipment	0	532
Cash used in business acquisition, net of cash acquired	(235,000)	(2,766)
Net cash used in investing activities	(246,335)	(13,087)
FINANCING ACTIVITIES:
Borrowings under senior credit facility	235,000	0
Principal payments under capital lease obligations	(122)	0
Proceeds from exercised stock options	7,755	234
Excess tax benefits from stock-based compensation arrangements	541	23
Net cash provided by financing activities	243,174	257
Effect of exchange rate changes on cash and cash equivalents	331	(2,263)
Net change in cash and cash equivalents	8,424	(7,247)
Cash and cash equivalents at beginning of period	120,614	96,938
Cash and cash equivalents at end of period	$ 129,038	$ 89,691

BASIS OF PRESENTATION

3 Months Ended

Mar. 31, 2014

Organization, Consolidation and Presentation of Financial Statements [Abstract]

BASIS OF PRESENTATION

General

The terms “we,” “our,” “us,” “Company” and “Integra” refer to Integra LifeSciences Holdings Corporation, a Delaware corporation, and its subsidiaries unless the context suggests otherwise.

In the opinion of management, the March 31, 2014 unaudited condensed consolidated financial statements contain all adjustments (consisting only of normal recurring adjustments) necessary for a fair statement of the financial position, results of operations and cash flows of the Company. Certain information and footnote disclosures normally included in financial statements prepared in accordance with generally accepted accounting principles have been condensed or omitted in accordance with the instructions to Form 10-Q and Rule 10-01 of Regulation S-X. These unaudited condensed consolidated financial statements should be read in conjunction with the Company’s consolidated financial statements for the year ended December 31, 2013 included in the Company’s Annual Report on Form 10-K. The December 31, 2013 consolidated balance sheet was derived from audited financial statements, but does not include all disclosures required by accounting principles generally accepted in the United States. Operating results for the three-month period ended March 31, 2014 are not necessarily indicative of the results to be expected for the entire year.

The preparation of consolidated financial statements in conformity with generally accepted accounting principles requires management to make estimates and assumptions that affect the reported amount of assets and liabilities, the disclosure of contingent liabilities, and the reported amounts of revenues and expenses. Significant estimates affecting amounts reported or disclosed in the consolidated financial statements include allowances for doubtful accounts receivable and sales returns and allowances, net realizable value of inventories, valuation of intangible assets including in-process research and development, amortization periods for acquired intangible assets, discount rates and estimated projected cash flows used to value and test impairments of long-lived assets and goodwill, estimates of projected cash flows and depreciation and amortization periods for long-lived assets, computation of taxes, valuation allowances recorded against deferred tax assets, the valuation of stock-based compensation, valuation of pension assets and liabilities, valuation of derivative instruments, valuation of the equity component of convertible debt instruments, valuation of contingent liabilities, the fair value of debt instruments and loss contingencies. These estimates are based on historical experience and on various other assumptions that are believed to be reasonable under the current circumstances. Actual results could differ from these estimates.

Certain amounts from the prior year’s financial statements have been reclassified in order to conform to the current year’s presentation.

Change in accounting principle

In the first quarter of 2014, the Company changed its method of accounting for the medical device excise tax (“MDET”). Prior to the change the Company recorded the MDET in inventory at the time of the first sale and then recognized the tax in cost of goods sold when the medical device was sold to the ultimate customer. Under the new method, the MDET will be recorded in selling, general and administrative expenses in the period the first sale occurs, which could be an intercompany sale.

The Company believes that this change in accounting principle is preferable as the new method provides a better comparison with the Company's industry peers, the majority of which expense the MDET at the time of the first sale.

The medical device excise tax applies to sales beginning January 1, 2013; therefore, only 2013 financial results were affected by this change. The cumulative effect of the change in the prior years is included in retained earnings as of December 31, 2013 and the comparative period for the three months ended March 31, 2013 has been revised to reflect the retrospective application of the change in accounting principle had the new method been in effect for all periods, as follows:

Condensed Consolidated Statements of Operations and Comprehensive Income:



	Three Months Ended March 31, 2013
	Originally						As
	Reported			Adjustments			Adjusted
	(In thousands, except per share amounts)
Cost of goods sold	$	80,268		$	(656	)	$	79,612
Selling, general and administrative	100,161			2,802			102,963
Income tax expense (benefit)	(1,705		)	(168		)	(1,873		)
Net income (loss)	(4,050		)	(1,978		)	(6,028		)
Basic net income (loss) per common share	$	(0.15	)				$	(0.22	)
Diluted net income (loss) per common share	(0.15		)				(0.22		)
Comprehensive income (loss)	$	(10,534	)	$	(1,978	)	$	(12,512	)

Condensed Consolidated Balance Sheets:



	December 31, 2013
	Originally					As
	Reported		Adjustments			Adjusted
	(In thousands)
Inventories	$	213,431	$	(6,512	)	$	206,919
Deferred tax assets - current	46,300		2,316			48,616
Prepaid expenses and other current assets	26,752		106			26,858
Retained earnings	285,046		(4,090		)	280,956

Condensed Consolidated Statements of Cash Flows:



	Three Months Ended March 31, 2013
	Originally						As
	Reported			Adjustments			Adjusted
	(In thousands)
Net income (loss)	$	(4,050	)	$	(1,978	)	$	(6,028	)
Inventories	(8,885		)	2,146			(6,739		)
Prepaid and other current assets	2,872			(168		)	2,704

Recently Issued Accounting Standards

On July 18, 2013, the FASB issued ASU No. 2013-11, Presentation of an Unrecognized Tax Benefit When a Net Operating Loss Carryforward, a Similar Tax Loss, or a Tax Credit Carryforward Exists. This updated guidance requires an unrecognized tax benefit to be presented in the financial statements as a reduction to a deferred tax asset for a net operating loss carryforward, similar tax loss, or a tax credit carryforward. To the extent the tax benefit is not available at the reporting date under the governing tax law or if the entity does not intend to use the deferred tax asset for such purpose, the unrecognized tax benefit should be presented as a liability and not combined with deferred tax assets. This ASU is effective for fiscal years and interim periods within those years beginning after December 15, 2013 for public entities. Early adoption is permitted. The amendments are to be applied to all unrecognized tax benefits that exist as of the effective date and may be applied retrospectively to each prior reporting period presented. The standard adoption does not have a material impact on the Company's financial statements.

In April 2014, the FASB issued amendments to guidance for reporting discontinued operations and disposals of components of an entity. The amended guidance requires that a disposal representing a strategic shift that has (or will have) a major effect on an entity’s financial results or a business activity classified as held for sale should be reported as discontinued operations. The amendments also expand the disclosure requirements for discontinued operations and add new disclosures for individually significant dispositions that do not qualify as discontinued operations. The amendments are effective prospectively for fiscal years, and interim reporting periods within those years, beginning after December 15, 2014 (early adoption is permitted only for disposals that have not been previously reported). The implementation of the amended guidance is not expected to have a material impact on our consolidated financial position or results of operations.

- Definition

The entire disclosure for organization, consolidation and basis of presentation of financial statements disclosure.

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+ Details

BUSINESS ACQUISITIONS

3 Months Ended

Mar. 31, 2014

Business Combinations [Abstract]

BUSINESS ACQUISITIONS

Confluent Surgical, Inc.

On January 15, 2014, the Company acquired all outstanding shares of Confluent Surgical, Inc., ("Confluent Surgical") - including its surgical sealant and adhesion barrier product lines - from Covidien Group S.a.r.l, ("Covidien") for an aggregate purchase price of $255.9 million. The purchase price is comprised of an initial cash payment to Covidien of $231.0 million upon the closing of the transaction, a separate prepayment of $4.0 million made under a transitional supply agreement with an affiliate of Covidien, and contingent consideration with an acquisition date fair value of $20.9 million. The potential maximum undiscounted contingent consideration of $30.0 million consists of: $25.0 million upon obtaining certain U.S. governmental approvals and $5.0 million upon obtaining certain European governmental approvals, both related to the completion of the transition of the Confluent Surgical business.

The transitional supply agreement secures the supply of the acquired products from an affiliate of Covidien until the earlier of (i) the time that the transition of the Confluent Surgical business as discussed above is compete, or (ii) the fifth anniversary of the effective date of the agreement; the agreement also contains an option to extend for another two years by providing written notice at least 180 days prior to the end of the initial five-year period. This agreement contains financial incentives to the affiliate of Covidien for the timely supply of products each fiscal quarter through the third anniversary of the agreement. The prices paid under the supply agreement are essentially flat through the third anniversary of the agreement, and then increase significantly each of the following three years. The Company also entered into a transition services agreement with an affiliate of Covidien at the closing for services such as: customer service, accounting and information technology management; clinical and regulatory affairs; manufacturing transition services; and other functions.

This acquisition complements the Company's global neurosurgery growth strategy aimed at providing a broader set of solutions for surgical procedures in the head.

The following summarizes the preliminary allocation of the purchase price based on the fair value of the assets acquired and liabilities assumed, the allocation of goodwill to the Company's reporting units has not yet been completed:



	Preliminary Purchase Price Allocation
	(Dollars in thousands)
Inventory deposit	$	4,000
Fixed assets	438
Intangible assets:			Wtd. Avg. Life
Technology product rights	239,800		20 years
Other	400		Less than 1 year
Deferred tax asset - long term	14
Goodwill	117,715
Total assets acquired	362,367
Contingent supply liability	5,891
Other	731
Deferred tax liability - long term	99,850
Net assets acquired	$	255,895

Subsequent to the acquisition date, a regulatory event occurred that resulted in the full-impairment of one of the acquired technology product rights for $0.6 million. This event was not known, or knowable, at the time of the acquisition and therefore the impairment has been included in the Company's March 31, 2014 cost of sales.

The Company accounted for the contingent supply liability by recording its fair value as a liability on the date of the acquisition based on a discounted cash-flow model. This contingent supply liability relates to contractual quarterly incentive payments that will be made to an affiliate of Covidien if certain supply minimums under the transitional supply agreement are met.

The Company accounted for the contingent consideration by recording its fair value as a liability on the date of the acquisition. The contingent consideration relates to the Company obtaining certain U.S. and European regulatory approvals. At the date of the acquisition, both of these milestones were valued using a discount rate of 2.2%, which is equivalent to the cost of debt for the estimated time horizon, and an overall probability of occurring of 95%. Accordingly, on January 15, 2014 the Company recorded a $20.9 million liability representing the initial fair value estimate of the probability weighted contingent consideration that management believes will be paid between early 2017 and late 2018. Depending on the expected timing of the estimated payments, the acquisition date fair value of the probability adjusted payments could have been $0.3 million higher or $0.4 million lower. These fair value measurements were based on significant inputs not observed in the market and thus represented a Level 3 measurement. The contingent consideration is re-measured to fair value at each reporting date until the contingency is resolved, and those changes in fair value are recognized in earnings.

The goodwill recorded in connection with this acquisition is based on (i) expected cost savings, operating synergies and other benefits expected to result from the combined operations, (ii) the value of the going-concern element of Confluent Surgical's existing business (that is, the higher rate of return on the assembled net assets versus if the Company had acquired all of the net assets separately), and (iii) intangible assets that do not qualify for separate recognition such as Confluent Surgical's assembled workforce. The goodwill acquired will not be deductible for tax purposes.

Contingent consideration

The carrying value of contingent consideration was increased during the three-months ended March 31, 2014 to reflect current period acquisitions and the change in the time value of money during the period. A reconciliation of the opening balances to the closing balances of these Level 3 measurements are as follows (dollars in thousands):



			Location in Statement of Operations
Balance as of January 1, 2014	$	1,227
Contingent consideration from Confluent Surgical acquisition	20,895
Loss from increase in fair value of contingent consideration liability	128		Selling, general and administrative
Fair value at March 31, 2014	$	22,250

Pro Forma Results

The following unaudited pro forma financial information summarizes the results of operations for the three months ended March 31, 2013 as if the Confluent Surgical acquisition completed by the Company during 2014 had been completed as of January 1, 2013. The pro forma results are based upon certain assumptions and estimates, and they give effect to actual operating results prior to the acquisition and adjustments to reflect (i) the change in interest expense, depreciation expense, and intangible asset amortization, (ii) certain external expenses related to the acquisition as if they were incurred on January 1, 2013 that will not be recurring in the post-acquisition periods, (iii) income taxes on the aforementioned adjustments at the Company’s statutory rate, and (iv) the earnings per share impact of the increase in the number of weighted average shares outstanding from the sale of registered common shares during November 2013 in anticipation of the Confluent Surgical acquisition. No effect has been given to other cost reductions or operating synergies. As a result, these pro forma results do not necessarily represent results that would have occurred if the acquisitions had taken place on the basis assumed above, nor are they indicative of the results of future combined operations.

The pro forma impact of the Confluent Surgical acquisition was not material to the 2014 consolidated operating results of the Company; therefore the pro forma impact on that period has not been included below. The pro forma results below also incorporate the impact of the change in accounting for the MDET on the 2013 results which is discussed in Note 1.



	Three Months Ended March 31, 2013
	(Dollars in thousands)
Total revenue	$	213,051
Net income (loss)	$	(5,469	)
Net income (loss) per share:
Basic	$	(0.17	)
Diluted	$	(0.17	)

- Definition

The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).

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+ Details

INVENTORIES

3 Months Ended

Mar. 31, 2014

Inventory, Net [Abstract]

INVENTORIES

Inventories, net consisted of the following:



	March 31, 2014		December 31, 2013
	(In thousands)
			(As adjusted)
Finished goods	$	131,791	$	123,786
Work in process	47,836		47,403
Raw materials	35,605		35,730
	$	215,232	$	206,919

The December 31, 2013 amounts above have been revised to correct an immaterial reclassification of certain items between work in process and raw materials.

- Definition

The entire disclosure for inventory. This may include, but is not limited to, the basis of stating inventory, the method of determining inventory cost, the major classes of inventory, and the nature of the cost elements included in inventory. If inventory is stated above cost, accrued net losses on firm purchase commitments for inventory and losses resulting from valuing inventory at the lower-of-cost-or-market may also be included. For LIFO inventory, may disclose the amount and basis for determining the excess of replacement or current cost over stated LIFO value and the effects of a LIFO quantities liquidation that impacts net income.

+ References+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS

3 Months Ended

Mar. 31, 2014

Goodwill and Intangible Assets Disclosure [Abstract]

GOODWILL AND OTHER INTANGIBLE ASSETS

The Company reviews goodwill for impairment annually during its third quarter and whenever events or changes in circumstances indicate the carrying value of goodwill may not be recoverable. The Company performed its most recent annual assessment on July 31, 2013 which resulted in a non-cash goodwill impairment charge of $46.7 million for its U.S. Spine reporting unit, which is a part of the U.S. Spine and Other reportable segment.

Changes in the carrying amount of goodwill for the three months ended March 31, 2014 were as follows:



	U.S. Neurosurgery		U.S. Instruments		U.S. Extremities		U.S. Spine and Other			International		Total
	(In thousands)
Goodwill, gross	$	95,165	$	58,033	$	61,079	$	56,325		$	25,900	$	296,502
Accumulated impairment losses							(46,738		)			(46,738		)
Goodwill at December 31, 2013	95,165		58,033		61,079		9,587			25,900		249,764
Confluent Surgical acquisition - preliminary allocation	94,315		—		—		—			23,400		117,715
Foreign currency translation	88		27		28		4			23		170
Goodwill at March 31, 2014	$	189,568	$	58,060	$	61,107	$	9,591		$	49,323	$	367,649

The components of the Company’s identifiable intangible assets were as follows:



	March 31, 2014
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	18 years	$	320,460	$	(49,607	)	$	270,853
Customer relationships	12 years	146,701		(81,926		)	64,775
Trademarks/brand names	31 years	33,601		(15,726		)	17,875
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(9,677		)	25,044
All other⁽¹⁾	4 years	4,652		(2,237		)	2,415
		$	588,619	$	(159,173	)	$	429,446



	December 31, 2013
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	12 years	$	81,238	$	(45,343	)	$	35,895
Customer relationships	12 years	146,627		(79,624		)	67,003
Trademarks/brand names	31 years	33,703		(15,648		)	18,055
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(9,305		)	25,416
All other⁽¹⁾	5 years	4,251		(1,941		)	2,310
		$	349,024	$	(151,861	)	$	197,163


⁽¹⁾	At March 31, 2014 and December 31, 2013, all other included in-process research and development ("IPR&D") of $1.4 million in both periods, which was indefinite-lived.

During the three months ended March 31, 2014, the Company recorded an impairment charge of $0.6 million in cost of goods sold related to technology assets acquired from Confluent Surgical that will no longer be sold due to a regulatory event that occurred after the acquisition date.

Based on quarter-end exchange rates, annual amortization expense (including amounts reported in cost of product revenues, but excluding any possible future amortization associated with acquired IPR&D) is expected to approximate $30.9 million in 2014, $28.8 million in 2015, $26.5 million in 2016, $24.4 million in 2017 and $24.1 million in 2018. Identifiable intangible assets are initially recorded at fair market value at the time of acquisition using an income or cost approach.

- Definition

The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final. May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.

+ References+ Details

DEBT

3 Months Ended

Mar. 31, 2014

Debt Disclosure [Abstract]

DEBT

Amended and Restated Senior Credit Agreement

On August 10, 2010, the Company entered into an amended and restated credit agreement with a syndicate of lending banks (the “Senior Credit Facility”). The Company amended the Senior Credit Facility on June 8, 2011, May 11, 2012 and June 21, 2013.

The June 8, 2011 amendment:


i.	increased the revolving credit component from $450 million to $600 million and eliminated the $150 million term loan component that existed under the original amended and restated credit agreement;


ii.	allows the Company to further increase the size of the revolving credit component by an aggregate of $200 million with additional commitments;


iii.	provides the Company with decreased borrowing rates and annual commitment fees, and provides more favorable financial covenants; and


iv.	extended the maturity date from August 10, 2015 to June 8, 2016.

On May 11, 2012, the Company entered into an amendment to the Senior Credit Facility (the “2012 Amendment”). The 2012 Amendment modified certain financial and negative covenants. The 2012 Amendment provides that the Company’s Maximum Consolidated Total Leverage Ratio (a measure of net debt to consolidated EBITDA, in each case as defined in the Senior Credit Facility, as amended) during any consecutive four quarter period should not be greater than 3.75 to 1.00 during any such period ending on December 31, 2013 (instead of March 31, 2012). In addition, when calculating consolidated EBITDA for any period, the 2012 Amendment permits the addition of certain costs and expenses in the calculation of consolidated net income for such period, to the extent deducted in the calculation of consolidated net income.

On June 21, 2013, the Company entered into an amendment to the Senior Credit Facility (the “2013 Amendment”). The 2013 Amendment modified certain financial and negative covenants and increased the Company’s Maximum Consolidated Total Leverage Ratio (a measure of net debt to consolidated EBITDA, in each case as defined in the Senior Credit Facility, as amended) to 4.25 through June 30, 2014, with a step-down to 4.00 through March 31, 2015, and then with another step-down to 3.75 thereafter. In addition, when calculating consolidated EBITDA for any period, the 2013 Amendment permits the addition of certain costs and expenses in the calculation of consolidated net income for such period, to the extent deducted in the calculation of consolidated net income. The effect of the 2013 Amendment is to increase the ability of the Company to borrow under the Senior Credit Facility during the affected periods. The Company capitalized $1.1 million of incremental financing costs in connection with the 2013 Amendment, which will be amortized through the maturity date of the Senior Credit Facility.

The Senior Credit Facility is collateralized by substantially all of the assets of the Company’s U.S. subsidiaries, excluding intangible assets. The Senior Credit Facility is subject to various financial and negative covenants and at March 31, 2014, the Company was in compliance with all such covenants.

Borrowings under the Senior Credit Facility currently bear interest, at the Company’s option, at a rate equal to (i) the Eurodollar Rate (as defined in the Senior Credit Facility, which definition has not changed) in effect from time to time plus the applicable rate (ranging from 1.00% to 1.75%) or (ii) the highest of (x) the weighted average overnight Federal funds rate, as published by the Federal Reserve Bank of New York, plus 0.5%, (y) the prime lending rate of Bank of America, N.A. or (z) the one-month Eurodollar Rate plus 1.0%. The applicable rates are based on the Company’s consolidated total leverage ratio (defined as the ratio of (a) consolidated funded indebtedness less cash in excess of $40 million that is not subject to any restriction of the use or investment thereof to (b) consolidated EBITDA) at the time of the applicable borrowing.

The Company also pays an annual commitment fee (ranging from 0.15% to 0.30%, based on the Company’s consolidated total leverage ratio) on the daily amount by which the revolving credit facility exceeds the outstanding loans and letters of credit under the credit facility.

At March 31, 2014 and December 31, 2013, there was $421.9 million and $186.9 million outstanding under the Senior Credit Facility at a weighted average interest rate of 1.7% and 2.0%, respectively. At March 31, 2014, there was approximately $178.1 million available for borrowing under the Senior Credit Facility. The fair value of outstanding borrowings under the Senior Credit Facility at March 31, 2014 was approximately $425.7 million. The fair value of the Senior Credit Facility was determined by using a discounted cash flow model based on current market interest rates available to the Company. These inputs are corroborated by observable market data for similar liabilities and therefore classified within Level 2 of the fair value hierarchy. Level 2 inputs represent inputs that are observable for the asset or liability, either directly or indirectly and are other than active market observable inputs that reflect unadjusted quoted prices for identical assets or liabilities. The Company considers the balance to be long-term in nature based on its current intent and ability to repay the borrowing outside of the next twelve-month period.

2016 Convertible Senior Notes

On June 15, 2011, the Company issued $230.0 million aggregate principal amount of its 1.625% Convertible Senior Notes due in 2016 (the “2016 Notes”). The 2016 Notes mature on December 15, 2016, and bear interest at a rate of 1.625% per annum payable semi-annually in arrears on December 15 and June 15 of each year. The portion of the debt proceeds that was classified as equity at the time of the offering was $43.2 million, an equivalent of that amount is being amortized to interest expense using the effective interest method through December 2016. The effective interest rate implicit in the liability component is 5.6%.

At March 31, 2014, the carrying amount of the liability component was $207.1 million, the remaining unamortized discount was $22.9 million, and the principal amount outstanding was $230.0 million. The fair value of the 2016 Notes at March 31, 2014 was approximately $248.6 million. At December 31, 2013, the carrying amount of the liability component was $205.2 million, the remaining unamortized discount was $24.8 million and the principal amount outstanding was $230.0 million. The fair value of the liability of the 2016 Notes was determined using a discounted cash flow model based on current market interest rates available to the Company. These inputs are corroborated by observable market data for similar liabilities and therefore classified within Level 2.

The 2016 Notes are senior, unsecured obligations of the Company, and are convertible into cash and, if applicable, shares of its common stock based on an initial conversion rate, subject to adjustment of 17.4092 shares per $1,000 principal amount of 2016 Notes (which represents an initial conversion price of approximately $57.44 per share). The Company will satisfy any conversion of the 2016 Notes with cash up to the principal amount of the 2016 Notes pursuant to the net share settlement mechanism set forth in the indenture and, with respect to any excess conversion value, with shares of the Company’s common stock. The 2016 Notes are convertible only in the following circumstances: (1) if the closing sale price of the Company’s common stock exceeds 150% of the conversion price during a period as defined in the indenture; (2) if the average trading price per $1,000 principal amount of the 2016 Notes is less than or equal to 98% of the average conversion value of the 2016 Notes during a period as defined in the indenture; (3) at any time on or after June 15, 2016; or (4) if specified corporate transactions occur. The issue price of the 2016 Notes was equal to their face amount, which is also the amount holders are entitled to receive at maturity if the 2016 Notes are not converted. As of March 31, 2014, none of these conditions existed with respect to the 2016 Notes and as a result, the 2016 Notes are classified as long term.

In connection with the issuance of the 2016 Notes, the Company entered into call transactions and warrant transactions, primarily with affiliates of the initial purchasers of such notes (the “hedge participants”). The initial strike price of the call transaction is approximately $57.44 per share, subject to customary anti-dilution adjustments. The initial strike price of the warrant transaction is approximately $70.05 per share, subject to customary anti-dilution adjustments.

Convertible Note Interest

The interest expense components of the Company’s convertible notes are as follows (net of capitalized interest amounts):



	Three Months Ended March 31,
	2014		2013
	(In thousands)
2016 Notes:
Amortization of the discount on the liability component	$	1,666	$	1,610
Cash interest related to the contractual interest coupon	801		818
Total	$	2,467	$	2,428

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References+ Details

DERIVATIVE INSTRUMENTS

3 Months Ended

Mar. 31, 2014

Derivative Instruments and Hedging Activities Disclosure [Abstract]

DERIVATIVE INSTRUMENTS

Interest Rate Hedging

The Company’s interest rate risk relates to U.S. dollar denominated variable LIBOR interest rate borrowings. The Company uses an interest rate swap derivative instrument entered into on August 10, 2010 with an effective date of December 31, 2010 to manage its earnings and cash flow exposure to changes in interest rates by converting a portion of its floating-rate debt into fixed-rate debt beginning on December 31, 2010. This interest rate swap expires on August 10, 2015.

The Company designates this derivative instrument as a cash flow hedge. The Company records the effective portion of any change in the fair value of a derivative instrument designated as a cash flow hedge as unrealized gains or losses in accumulated other comprehensive income (“AOCI”), net of tax, until the hedged item affects earnings, at which point the effective portion of any gain or loss will be reclassified to earnings. If the hedged cash flow does not occur, or if it becomes probable that it will not occur, the Company will reclassify the amount of any gain or loss on the related cash flow hedge to interest expense at that time.

The Company expects that approximately $1.7 million of pre-tax losses recorded as net in AOCI related to the interest rate hedge could be reclassified to earnings within the next twelve months.

Foreign Currency Hedging

From time to time the Company enters into foreign currency hedge contracts intended to protect the U.S. dollar value of certain forecasted foreign currency denominated transactions. The Company records the effective portion of any change in the fair value of foreign currency cash flow hedges in AOCI, net of tax, until the hedged item affects earnings. Once the related hedged item affects earnings, the Company reclassifies the effective portion of any related unrealized gain or loss on the foreign currency cash flow hedge to earnings. If the hedged forecasted transaction does not occur, or if it becomes probable that it will not occur, the Company will reclassify the amount of any gain or loss on the related cash flow hedge to earnings at that time.

The success of the Company’s hedging program depends, in part, on forecasts of certain activity denominated in euros. The Company may experience unanticipated currency exchange gains or losses to the extent that there are differences between forecasted and actual activity during periods of currency volatility. In addition, changes in currency exchange rates related to any unhedged transactions may affect its earnings and cash flows.

Counterparty Credit Risk

The Company manages its concentration of counterparty credit risk on its derivative instruments by limiting acceptable counterparties to a group of major financial institutions with investment grade credit ratings, and by actively monitoring their credit ratings and outstanding positions on an ongoing basis. Therefore, the Company considers the credit risk of the counterparties to be low. Furthermore, none of the Company’s derivative transactions are subject to collateral or other security arrangements, and none contain provisions that depend upon the Company’s credit ratings from any credit rating agency.

Fair Value of Derivative Instruments

The Company has classified all of its derivative instruments within Level 2 of the fair value hierarchy because observable inputs are available for substantially the full term of the derivative instruments. The fair value of the foreign currency forward exchange contracts related to inventory purchases is determined by comparing the forward rate as of the period end and the settlement rate specified in each contract. The fair value of the interest rate swaps was developed using a market approach based on publicly available market yield curves and the terms of the related swap. The Company performs ongoing assessments of counterparty credit risk.

The following table summarizes the fair value and presentation for derivatives designated as hedging instruments in the condensed consolidated balance sheets as of March 31, 2014 and December 31, 2013:



	Fair Value as of
Location on Balance Sheet ⁽¹⁾:	March 31, 2014		December 31, 2013
	(In thousands)
Derivatives designated as hedges — Liabilities:
Interest rate swap — Accrued expenses and other current liabilities ⁽²⁾	$	1,653	$	1,676
Interest rate swap — Other liabilities⁽²⁾	444		763
Total Derivatives designated as hedges — Liabilities	$	2,097	$	2,439


⁽¹⁾	The Company classifies derivative assets and liabilities as current based on the cash flows expected to be incurred within the following 12 months.


⁽²⁾	At March 31, 2014 and December 31, 2013, the notional amount related to the Company’s sole interest rate swap was $108.8 million and $112.5 million, respectively. In the next twelve months, the Company expects to reduce the notional amount by $15.0 million.

The following presents the effect of derivative instruments designated as cash flow hedges on the accompanying condensed consolidated statements of operations during the three months ended March 31, 2014 and 2013:



	Balance in AOCI Beginning of Quarter			Amount of Gain (Loss) Recognized in AOCI- Effective Portion			Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion			Balance in AOCI End of Quarter			Location in Statements of Operations
	(In thousands)
Three Months Ended March 31, 2014
Interest rate swap	$	(2,439	)	$	(109	)	$	(451	)	$	(2,097	)	Interest (expense)
	$	(2,439	)	$	(109	)	$	(451	)	$	(2,097	)
Three Months Ended March 31, 2013
Forward currency forward contracts	$	(34	)	$	—		$	(34	)	$	—		Cost of goods sold
Interest rate swap	(4,125		)	(9		)	(490		)	(3,644		)	Interest (expense)
	$	(4,159	)	$	(9	)	$	(524	)	$	(3,644	)

The Company recognized no gains or losses resulting from ineffectiveness of cash flow hedges during the three months ended March 31, 2014 and 2013.

- Definition

The entire disclosure for derivative instruments and hedging activities including, but not limited to, risk management strategies, non-hedging derivative instruments, assets, liabilities, revenue and expenses, and methodologies and assumptions used in determining the amounts.

+ References

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+ Details

STOCK-BASED COMPENSATION	3 Months Ended
STOCK-BASED COMPENSATION	Mar. 31, 2014
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
STOCK-BASED COMPENSATION	STOCK-BASED COMPENSATION As of March 31, 2014, the Company had stock options, restricted stock awards, performance stock awards, contract stock awards and restricted stock unit awards outstanding under three plans, the 2000 Equity Incentive Plan (the “2000 Plan”), the 2001 Equity Incentive Plan (the “2001 Plan”), and the 2003 Equity Incentive Plan (the “2003 Plan,” and collectively, the “Plans”). Stock options issued under the Plans become exercisable over specified periods, generally within four years from the date of grant for officers, directors, and employees, and generally expire six years from the grant date for employees, and from six to ten years for directors and certain executive officers. Restricted stock issued under the Plans vests over specified periods, generally three years after the date of grant. The vesting of performance stock, issued under the Plans, is subject to service and performance conditions. Stock Options As of March 31, 2014, there were approximately $2.0 million of total unrecognized compensation costs related to unvested stock options. These costs are expected to be recognized over a weighted-average period of approximately two years. There were 56,727 stock options granted during the three months ended March 31, 2014. Awards of Restricted Stock, Performance Stock and Contract Stock Performance stock, restricted stock and contract stock awards generally have requisite service periods of three years. Performance stock awards are subject to graded vesting conditions and the Company expenses their fair value over the requisite service period. The Company expenses the fair value of restricted stock and contract stock awards on a straight-line basis over the vesting period or requisite service period, whichever is shorter. As of March 31, 2014, there were approximately $21.5 million of total unrecognized compensation costs related to these unvested awards. The Company expects to recognize these costs over a weighted-average period of approximately two years. The Company granted 204,397 restricted stock awards/stock units and 74,424 performance shares during the three months ended March 31, 2014. The Company has no formal policy related to the repurchase of shares for the purpose of satisfying stock-based compensation obligations. The Company also maintains an Employee Stock Purchase Plan (the “ESPP”), which provides eligible employees with the opportunity to acquire shares of common stock at periodic intervals by means of accumulated payroll deductions. The ESPP is a non-compensatory plan based on its terms.

- Definition

The entire disclosure for compensation-related costs for equity-based compensation, which may include disclosure of policies, compensation plan details, allocation of equity compensation, incentive distributions, equity-based arrangements to obtain goods and services, deferred compensation arrangements, employee stock ownership plan details and employee stock purchase plan details.

+ References+ Details

RETIREMENT BENEFIT PLANS

3 Months Ended

Mar. 31, 2014

Defined Benefit Pension Plans and Defined Benefit Postretirement Plans Disclosure [Abstract]

RETIREMENT BENEFIT PLANS

The Company maintains defined benefit pension plans that cover employees in its manufacturing plants located in Andover, United Kingdom (the “UK Plan”) and Tuttlingen, Germany (the “Germany Plan”). The Company closed the Tuttlingen, Germany plant in December 2005. The Company did not terminate the Germany Plan, and the Company remains obligated for the accrued pension benefits related to this plan. Effective March 31, 2011, the Company froze the benefits due to the participants of the UK Plan in their entirety; this curtailment resulted in a $0.3 million reduction in the projected benefit obligations which the Company recorded on that date. The plans cover certain current and former employees.

Net periodic benefit costs for the Company’s defined benefit pension plans included the following amounts:



	Three Months Ended March 31,
	2014			2013
	(In thousands)
Interest cost	$	163		$	137
Return on plan assets	(134		)	(100		)
Net period benefit cost	$	29		$	37

The Company made $0.3 million and $0.2 million of contributions to its defined benefit pension plans during the three months ended March 31, 2014 and 2013, respectively.

INCOME TAXES

3 Months Ended

Mar. 31, 2014

Income Tax Disclosure [Abstract]

INCOME TAXES

The following table provides a summary of the Company’s effective tax rate:



	Three Months Ended March 31,
	2014		2013
			(As adjusted)
Reported tax rate	44.5	%	23.7	%

The Company’s effective income tax rates for the three months ended March 31, 2014 and 2013 were 44.5% and 23.7%, respectively.

For the three months ended March 31, 2014, the increase in the income tax rate compared to the same period in 2013 was primarily the result of discrete state income tax audit settlements of $0.6 million, as well as higher income within U.S.-based operations relative to foreign operations, which created an unfavorable effect on the effective tax rate. Additionally, the effective rate for the three months ended March 31, 2013 included an income tax benefit in France which is no longer available in 2014 because of a change in French tax law change that occurred on December 30, 2013.

For the three months ended March 31, 2013, the reduction in the income tax rate compared to the same period in 2012 was primarily the result of a change in the jurisdictional mix of year-to-date worldwide pretax income and a reinstatement of the Federal research and development credit. The Company recorded a benefit of $0.9 million in the first quarter of 2013 due to the extension of the Federal research credit by the American Taxpayer Relief Act which was signed into law at that time. The Company recorded a benefit of $0.4 million in the first quarter of 2013 for the release of tax contingency reserves. This amount is offset by an expense of $0.4 million due to a change in the German local tax rate, which was also effective that quarter.

The Company expects its effective income tax rate for the full year to be approximately 23% to 24%, resulting largely from the jurisdictional mix of pretax income in U.S.-based operations relative to foreign operations. The Company may revise this estimate in the future as additional information becomes available.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References+ Details

NET INCOME PER SHARE

3 Months Ended

Mar. 31, 2014

Earnings Per Share [Abstract]

NET INCOME PER SHARE

NET INCOME (LOSS) PER SHARE

Basic and diluted net income (loss) per share was as follows:



	Three Months Ended March 31,
	2014		2013
	(In thousands, except per share amounts)
			(as adjusted)
Basic net income (loss) per share:
Net income (loss)	$	2,206	$	(6,028	)
Weighted average common shares outstanding	32,275		27,796
Basic net income (loss) per common share	$	0.07	$	(0.22	)

Diluted net income (loss) per share:
Net income (loss)	$	2,206	$	(6,028	)

Weighted average common shares outstanding — Basic	32,275		27,796
Effect of dilutive securities:
Stock options and restricted stock	493		—
Weighted average common shares for diluted earnings per share	32,768		27,796
Diluted net income (loss) per common share	$	0.07	$	(0.22	)

At March 31, 2014 and 2013, the Company had 1.4 million and 1.7 million of outstanding stock options, respectively. The Company also has warrants outstanding relating to its 2016 Notes at March 31, 2014 and 2013. Stock options, restricted stock and warrants are included in the diluted earnings per share calculation using the treasury stock method, unless the effect of including the stock options would be anti-dilutive. For the three months ended March 31, 2014, 0.2 million of anti-dilutive stock options were excluded from the diluted earnings per share calculation. For the three months ended March 31, 2013 all stock options, restricted stock and warrants were excluded from the diluted earnings per share calculation using the treasury stock method because of their anti-dilutive effect.

- Definition

The entire disclosure for earnings per share.

+ References+ Details

COMPREHENSIVE (LOSS) INCOME

3 Months Ended

Mar. 31, 2014

Equity [Abstract]

COMPREHENSIVE (LOSS) INCOME

COMPREHENSIVE INCOME (LOSS)

Comprehensive income (loss) was as follows:



	Three Months Ended March 31,
	2014			2013
	(In thousands)
				(as adjusted)
Net income (loss)	$	2,206		$	(6,028	)
Foreign currency translation adjustment	819			(6,780		)
Change in unrealized gain on derivatives, net of tax	195			296
Pension liability adjustment, net of tax	(14		)	—
Comprehensive income (loss)	$	3,206		$	(12,512	)

Changes in Accumulated Other Comprehensive Income (Loss) by component between December 31, 2013 and March 31, 2014 are presented in the table below, net of tax:



	Gains and (Losses) on Cash Flow Hedges			Defined Benefit Pension Items			Foreign Currency Items		Total
	(In thousands)
Beginning balance	$	(1,390	)	$	(2,287	)	$	4,604	$	927
Other comprehensive income (loss) before reclassifications	(62		)	(14		)	819		743
Amounts reclassified from accumulated other comprehensive income	257			—			—		257
Net current-period other comprehensive income (loss)	195			(14		)	819		1,000
Ending balance	$	(1,195	)	$	(2,301	)	$	5,423	$	1,927

The reclassification adjustments out of Accumulated Other Comprehensive Income (Loss) during the three months ended March 31, 2014 were as follows:



Details about Accumulated Other Comprehensive Income (Loss) Components	Amount Reclassified from Accumulated Other Comprehensive Income (Loss)			Affected Line Item in the Statement where Net Income (Loss) is Presented
	(In thousands)
Gains and losses on cash flow hedges
Interest rate swap	$	(451	)	Interest (expense)
	(451		)	Total before tax
	194			Tax (expense) or benefit
	$	(257	)	Net of tax

- Definition

The entire disclosure for comprehensive income, which includes, but is not limited to, 1) the amount of income tax expense or benefit allocated to each component of other comprehensive income, including reclassification adjustments, 2) the reclassification adjustments for each classification of other comprehensive income and 3) the ending accumulated balances for each component of comprehensive income.

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-Topic 505

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-Subparagraph (SX 210.3-04)

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-Glossary Reclassification Adjustments

-URI http://asc.fasb.org/extlink&oid=6522872

+ Details

SEGMENT AND GEOGRAPHIC INFORMATION

3 Months Ended

Mar. 31, 2014

Segment Reporting [Abstract]

SEGMENT AND GEOGRAPHIC INFORMATION

The Company internally manages and reports the results of its businesses to its chief operating decision maker through five reportable segments. The five reportable segments and a description of their activities are described below:


•	The U.S. Neurosurgery segment sells a full line of products specifically for neurosurgery and critical care such as tissue ablation equipment, dural repair products, cerebral spinal fluid management devices, intracranial monitoring equipment, and cranial stabilization equipment.


•	The U.S. Instruments business sells more than 60,000 instrument patterns and surgical and lighting products to hospitals, surgery centers, and dental, podiatry, and veterinary offices.


•	The U.S. Extremities segment includes the U.S. Extremity reconstruction business, which includes such offerings as skin and wound repair, bone and joint fixation, implants in the upper and lower extremities, bone grafts and nerve and tendon repair.

•

The U.S. Spine and Other segment includes (i) the U.S. Spine business, which focuses on spinal fusion, spinal implants, and deformity correction, together with bone graft substitutes and other related medical devices that are used to enhance the repair and regeneration of bone in various types of orthopedic surgical procedures, and (ii) the Private Label business, which sells the Company’s regenerative medicine and other products to strategic partners.


•	The International segment sells similar products to those discussed above, but are managed through the following geographies: (i) Europe, Middle East and Africa, and (ii) Central/South America, Asia-Pacific and Canada.

The Corporate and other category includes (i) various legal, finance, information systems, executive, and human resource functions, (ii) brand management, (iii) share-based compensation costs, and (iv) costs related to procurement, manufacturing operations and logistics for the Company’s entire organization.

The operating results of the various reportable segments as presented are not comparable to one another because (i) certain operating segments are more dependent than others on corporate functions for unallocated general and administrative and/or operational manufacturing functions, and (ii) the Company does not allocate certain manufacturing costs and general and administrative costs to the operating segment results.

Net sales and profit by reportable segment for the three months ended March 31, 2014 and 2013 are as follows:



	Three Months Ended March 31,
	2014			2013
	(In thousands)
				(as adjusted)
Segment Net Sales
U.S. Neurosurgery	$	54,383		$	38,996
U.S. Instruments	36,720			36,948
U.S. Extremities	31,912			31,361
U.S. Spine and Other	41,067			43,548
International	50,977			45,799
Total revenues	$	215,059		$	196,652
Segment Profit
U.S. Neurosurgery	$	27,788		$	17,768
U.S. Instruments	10,481			10,084
U.S. Extremities	11,753			10,791
U.S. Spine and Other	11,977			13,213
International	17,212			12,878
Segment profit	79,211			64,734
Amortization	(3,033		)	(3,551)
Corporate and other	(67,440		)	(63,373		)
Operating income (loss)	$	8,738		$	(2,190	)

Revenue by major product category consisted of the following:



	Three Months Ended March 31,
	2014		2013
	(In thousands)
Orthopedics	$	87,239	$	90,260
Neurosurgery	84,370		63,185
Instruments	43,450		43,207
Total Revenues	$	215,059	$	196,652

The Company attributes revenues to geographic areas based on the location of the customer. There are certain revenues managed by the various U.S. segments that are generated from non-U.S. customers and therefore are included in Europe and the Rest of World revenues below. Total revenue by major geographic area consisted of the following:



	Three Months Ended March 31,
	2014		2013
	(In thousands)
United States	$	163,382	$	150,019
Europe	25,324		23,617
Rest of World	26,353		23,016
Total Revenues	$	215,059	$	196,652

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

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+ Details

COMMITMENTS AND CONTINGENCIES	3 Months Ended
COMMITMENTS AND CONTINGENCIES	Mar. 31, 2014
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	COMMITMENTS AND CONTINGENCIES In consideration for certain technology, manufacturing, distribution, and selling rights and licenses granted to the Company, the Company has agreed to pay royalties on sales of certain products that we sell. The royalty payments that the Company made under these agreements were not significant for any of the periods presented. The Company is subject to various claims, lawsuits and proceedings in the ordinary course of the Company's business, including claims by current or former employees, distributors and competitors and with respect to its products and product liability claims, lawsuits and proceedings, some of which have been settled by the Company. In the opinion of management, such claims are either adequately covered by insurance or otherwise indemnified, or are not expected, individually or in the aggregate, to result in a material adverse effect on our financial condition. However, it is possible that the Company's results of operations, financial position and cash flows in a particular period could be materially affected by these contingencies. On June 6, 2012, the Company was contacted by the United States Attorney's Office for the District of New Jersey regarding the activities of sales representatives in a single region within our Extremities Reconstruction division. The U.S. Attorney's Office is investigating the activities of three sales representatives, one of whom was a supervisor until terminated by the Company for failure to cooperate with this investigation. The activities at issue pertain to alleged improper billing of products for extremities indications. The Company has been cooperating with the U.S. Attorney's Office on a voluntary basis and is not a subject or target of an investigation at this time. In cooperating with the U.S. Attorney’s Office, the Company has responded to multiple government requests for documents and information; and in the fall of 2013 it responded to what the government currently indicated is its final request. Representatives of the Company met with the Assistant United States Attorney in charge of the matter and an agent from the Federal Bureau of Investigation on April 11, 2014, to discuss the matter, the behavior of the sales representatives in question, and the disposition of the matter as to the Company. The Company awaits word from the U.S. Attorney’s Office as to the disposition of the matter as to the Company. The Company accrues for loss contingencies when it is deemed probable that a loss has been incurred and that loss is estimable. The amounts accrued are based on the full amount of the estimated loss before considering insurance proceeds, and do not include an estimate for legal fees expected to be incurred in connection with the loss contingency. The Company consistently accrues legal fees expected to be incurred in connection with loss contingencies as those fees are incurred by outside counsel as a period cost.

- Definition

The entire disclosure for commitments and contingencies.

+ References+ Details

Subsequent Event (Notes)	3 Months Ended
Subsequent Event (Notes)	Mar. 31, 2014
Subsequent Events [Abstract]
Subsequent Events	SUBSEQUENT EVENT On April 29, 2014, the Board of Directors (the "Board") of the Company appointed Glenn G. Coleman as Corporate Vice President of the Company effective as of May 2, 2014. In addition, on April 29, 2014, the Board of the Company appointed Mr. Coleman as Corporate Vice President, Chief Financial Officer and Principal Accounting Officer effective one business day after the Company files its Form 10-Q for the quarter ended March 31, 2014 with the Securities and Exchange Commission (the “SEC”), as early as May 2, 2014 and no later than May 13, 2014. At such time that Mr. Coleman commences as Chief Financial Officer, John B. Henneman, III will cease to serve as the Company’s Chief Financial Officer and will then serve as Corporate Vice President, Chief Administrative Officer. At such time that Mr. Coleman commences as Principal Accounting Officer, Jerry Corbin will cease to serve as the Company’s Principal Accounting Officer, but Mr. Corbin will still serve as Corporate Vice President, Corporate Controller. The Company expects to incur severance obligations pursuant to Mr. Henneman’s employment agreement.

BASIS OF PRESENTATION (Tables)

3 Months Ended

Mar. 31, 2014

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of New Accounting Pronouncements and Changes in Accounting Principles

Condensed Consolidated Statements of Operations and Comprehensive Income:



	Three Months Ended March 31, 2013
	Originally						As
	Reported			Adjustments			Adjusted
	(In thousands, except per share amounts)
Cost of goods sold	$	80,268		$	(656	)	$	79,612
Selling, general and administrative	100,161			2,802			102,963
Income tax expense (benefit)	(1,705		)	(168		)	(1,873		)
Net income (loss)	(4,050		)	(1,978		)	(6,028		)
Basic net income (loss) per common share	$	(0.15	)				$	(0.22	)
Diluted net income (loss) per common share	(0.15		)				(0.22		)
Comprehensive income (loss)	$	(10,534	)	$	(1,978	)	$	(12,512	)

Condensed Consolidated Balance Sheets:



	December 31, 2013
	Originally					As
	Reported		Adjustments			Adjusted
	(In thousands)
Inventories	$	213,431	$	(6,512	)	$	206,919
Deferred tax assets - current	46,300		2,316			48,616
Prepaid expenses and other current assets	26,752		106			26,858
Retained earnings	285,046		(4,090		)	280,956

Condensed Consolidated Statements of Cash Flows:



	Three Months Ended March 31, 2013
	Originally						As
	Reported			Adjustments			Adjusted
	(In thousands)
Net income (loss)	$	(4,050	)	$	(1,978	)	$	(6,028	)
Inventories	(8,885		)	2,146			(6,739		)
Prepaid and other current assets	2,872			(168		)	2,704

- Definition

Tabular disclosure of changes in accounting principles, including adoption of new accounting pronouncements, that describes the new methods, amount and effects on financial statement line items.

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Reference 1: http://www.xbrl.org/2003/role/presentationRef

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BUSINESS ACQUISITIONS (Tables)

3 Months Ended

Mar. 31, 2014

Business Acquisition [Line Items]

Schedule of Contingent Consideration

A reconciliation of the opening balances to the closing balances of these Level 3 measurements are as follows (dollars in thousands):



			Location in Statement of Operations
Balance as of January 1, 2014	$	1,227
Contingent consideration from Confluent Surgical acquisition	20,895
Loss from increase in fair value of contingent consideration liability	128		Selling, general and administrative
Fair value at March 31, 2014	$	22,250

Confluent Surgical, Inc.

Business Acquisition [Line Items]

Pro Forma Information



	Three Months Ended March 31, 2013
	(Dollars in thousands)
Total revenue	$	213,051
Net income (loss)	$	(5,469	)
Net income (loss) per share:
Basic	$	(0.17	)
Diluted	$	(0.17	)

Schedule of Purchase Price Allocation



	Preliminary Purchase Price Allocation
	(Dollars in thousands)
Inventory deposit	$	4,000
Fixed assets	438
Intangible assets:			Wtd. Avg. Life
Technology product rights	239,800		20 years
Other	400		Less than 1 year
Deferred tax asset - long term	14
Goodwill	117,715
Total assets acquired	362,367
Contingent supply liability	5,891
Other	731
Deferred tax liability - long term	99,850
Net assets acquired	$	255,895

- Definition

Tabular disclosure of the fair value measurement of liabilities using significant unobservable inputs (Level 3), a reconciliation of the beginning and ending balances, separately presenting changes attributable to the following: (1) total gains or losses for the period (realized and unrealized), segregating those gains or losses included in earnings (or changes in net assets), and gains or losses recognized in other comprehensive income (loss) and a description of where those gains or losses included in earnings (or changes in net assets) are reported in the statement of income (or activities); (2) purchases, sales, issues, and settlements (each type disclosed separately); and (3) transfers in and transfers out of Level 3 (for example, transfers due to changes in the observability of significant inputs) by class of liability.

+ References+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS (Tables)

3 Months Ended

Mar. 31, 2014

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule Of Changes In Carrying Amount Of Goodwill

Changes in the carrying amount of goodwill for the three months ended March 31, 2014 were as follows:



	U.S. Neurosurgery		U.S. Instruments		U.S. Extremities		U.S. Spine and Other			International		Total
	(In thousands)
Goodwill, gross	$	95,165	$	58,033	$	61,079	$	56,325		$	25,900	$	296,502
Accumulated impairment losses							(46,738		)			(46,738		)
Goodwill at December 31, 2013	95,165		58,033		61,079		9,587			25,900		249,764
Confluent Surgical acquisition - preliminary allocation	94,315		—		—		—			23,400		117,715
Foreign currency translation	88		27		28		4			23		170
Goodwill at March 31, 2014	$	189,568	$	58,060	$	61,107	$	9,591		$	49,323	$	367,649

Components Of Company's Identifiable Intangible Assets

The components of the Company’s identifiable intangible assets were as follows:



	March 31, 2014
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	18 years	$	320,460	$	(49,607	)	$	270,853
Customer relationships	12 years	146,701		(81,926		)	64,775
Trademarks/brand names	31 years	33,601		(15,726		)	17,875
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(9,677		)	25,044
All other⁽¹⁾	4 years	4,652		(2,237		)	2,415
		$	588,619	$	(159,173	)	$	429,446



	December 31, 2013
	Weighted Average Life	Cost		Accumulated Amortization			Net
	(Dollars in thousands)
Completed technology	12 years	$	81,238	$	(45,343	)	$	35,895
Customer relationships	12 years	146,627		(79,624		)	67,003
Trademarks/brand names	31 years	33,703		(15,648		)	18,055
Trademarks/brand names	Indefinite	48,484		—			48,484
Supplier relationships	27 years	34,721		(9,305		)	25,416
All other⁽¹⁾	5 years	4,251		(1,941		)	2,310
		$	349,024	$	(151,861	)	$	197,163


⁽¹⁾	At March 31, 2014 and December 31, 2013, all other included in-process research and development ("IPR&D") of $1.4 million in both periods, which was indefinite-lived.

DERIVATIVE INSTRUMENTS (Tables)

3 Months Ended

Mar. 31, 2014

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Summary Of Fair Value In Balance Sheet For Derivatives Designated As Hedging Instruments



	Fair Value as of
Location on Balance Sheet ⁽¹⁾:	March 31, 2014		December 31, 2013
	(In thousands)
Derivatives designated as hedges — Liabilities:
Interest rate swap — Accrued expenses and other current liabilities ⁽²⁾	$	1,653	$	1,676
Interest rate swap — Other liabilities⁽²⁾	444		763
Total Derivatives designated as hedges — Liabilities	$	2,097	$	2,439


⁽¹⁾	The Company classifies derivative assets and liabilities as current based on the cash flows expected to be incurred within the following 12 months.


⁽²⁾	At March 31, 2014 and December 31, 2013, the notional amount related to the Company’s sole interest rate swap was $108.8 million and $112.5 million, respectively. In the next twelve months, the Company expects to reduce the notional amount by $15.0 million.

Effect Of Derivative Instruments Designated As Cash Flow Hedges On Statements Of Operations



	Balance in AOCI Beginning of Quarter			Amount of Gain (Loss) Recognized in AOCI- Effective Portion			Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion			Balance in AOCI End of Quarter			Location in Statements of Operations
	(In thousands)
Three Months Ended March 31, 2014
Interest rate swap	$	(2,439	)	$	(109	)	$	(451	)	$	(2,097	)	Interest (expense)
	$	(2,439	)	$	(109	)	$	(451	)	$	(2,097	)
Three Months Ended March 31, 2013
Forward currency forward contracts	$	(34	)	$	—		$	(34	)	$	—		Cost of goods sold
Interest rate swap	(4,125		)	(9		)	(490		)	(3,644		)	Interest (expense)
	$	(4,159	)	$	(9	)	$	(524	)	$	(3,644	)

RETIREMENT BENEFIT PLANS (Tables)

3 Months Ended

Mar. 31, 2014

Defined Benefit Pension Plans and Defined Benefit Postretirement Plans Disclosure [Abstract]

Net Periodic Benefit Costs For Defined Benefit Pension Plans

Net periodic benefit costs for the Company’s defined benefit pension plans included the following amounts:



	Three Months Ended March 31,
	2014			2013
	(In thousands)
Interest cost	$	163		$	137
Return on plan assets	(134		)	(100		)
Net period benefit cost	$	29		$	37

INCOME TAXES (Tables)

3 Months Ended

Mar. 31, 2014

Income Tax Disclosure [Abstract]

Schedule of Effective Income Tax Rate Reconciliation

The following table provides a summary of the Company’s effective tax rate:



	Three Months Ended March 31,
	2014		2013
			(As adjusted)
Reported tax rate	44.5	%	23.7	%

NET INCOME PER SHARE (Tables)

3 Months Ended

Mar. 31, 2014

Earnings Per Share [Abstract]

Basic And Diluted Net Income Per Share

Basic and diluted net income (loss) per share was as follows:



	Three Months Ended March 31,
	2014		2013
	(In thousands, except per share amounts)
			(as adjusted)
Basic net income (loss) per share:
Net income (loss)	$	2,206	$	(6,028	)
Weighted average common shares outstanding	32,275		27,796
Basic net income (loss) per common share	$	0.07	$	(0.22	)

Diluted net income (loss) per share:
Net income (loss)	$	2,206	$	(6,028	)

Weighted average common shares outstanding — Basic	32,275		27,796
Effect of dilutive securities:
Stock options and restricted stock	493		—
Weighted average common shares for diluted earnings per share	32,768		27,796
Diluted net income (loss) per common share	$	0.07	$	(0.22	)

COMPREHENSIVE (LOSS) INCOME (Tables)

3 Months Ended

Mar. 31, 2014

Equity [Abstract]

Schedule of Comprehensive (Loss) Income

Comprehensive income (loss) was as follows:



	Three Months Ended March 31,
	2014			2013
	(In thousands)
				(as adjusted)
Net income (loss)	$	2,206		$	(6,028	)
Foreign currency translation adjustment	819			(6,780		)
Change in unrealized gain on derivatives, net of tax	195			296
Pension liability adjustment, net of tax	(14		)	—
Comprehensive income (loss)	$	3,206		$	(12,512	)

Schedule of Changes in Accumulated Other Comprehensive Income by Component

Changes in Accumulated Other Comprehensive Income (Loss) by component between December 31, 2013 and March 31, 2014 are presented in the table below, net of tax:



	Gains and (Losses) on Cash Flow Hedges			Defined Benefit Pension Items			Foreign Currency Items		Total
	(In thousands)
Beginning balance	$	(1,390	)	$	(2,287	)	$	4,604	$	927
Other comprehensive income (loss) before reclassifications	(62		)	(14		)	819		743
Amounts reclassified from accumulated other comprehensive income	257			—			—		257
Net current-period other comprehensive income (loss)	195			(14		)	819		1,000
Ending balance	$	(1,195	)	$	(2,301	)	$	5,423	$	1,927

Reclassification out of Accumulated Other Comprehensive Income (Loss)

The reclassification adjustments out of Accumulated Other Comprehensive Income (Loss) during the three months ended March 31, 2014 were as follows:



Details about Accumulated Other Comprehensive Income (Loss) Components	Amount Reclassified from Accumulated Other Comprehensive Income (Loss)			Affected Line Item in the Statement where Net Income (Loss) is Presented
	(In thousands)
Gains and losses on cash flow hedges
Interest rate swap	$	(451	)	Interest (expense)
	(451		)	Total before tax
	194			Tax (expense) or benefit
	$	(257	)	Net of tax

SEGMENT AND GEOGRAPHIC INFORMATION (Tables)

3 Months Ended

Mar. 31, 2014

Segment Reporting [Abstract]

Total Revenue By Major Geographic Area

Total revenue by major geographic area consisted of the following:



	Three Months Ended March 31,
	2014		2013
	(In thousands)
United States	$	163,382	$	150,019
Europe	25,324		23,617
Rest of World	26,353		23,016
Total Revenues	$	215,059	$	196,652

Net sales and profit by reportable segment for the three months ended March 31, 2014 and 2013 are as follows:



	Three Months Ended March 31,
	2014			2013
	(In thousands)
				(as adjusted)
Segment Net Sales
U.S. Neurosurgery	$	54,383		$	38,996
U.S. Instruments	36,720			36,948
U.S. Extremities	31,912			31,361
U.S. Spine and Other	41,067			43,548
International	50,977			45,799
Total revenues	$	215,059		$	196,652
Segment Profit
U.S. Neurosurgery	$	27,788		$	17,768
U.S. Instruments	10,481			10,084
U.S. Extremities	11,753			10,791
U.S. Spine and Other	11,977			13,213
International	17,212			12,878
Segment profit	79,211			64,734
Amortization	(3,033		)	(3,551)
Corporate and other	(67,440		)	(63,373		)
Operating income (loss)	$	8,738		$	(2,190	)

Revenue by major product category consisted of the following:



	Three Months Ended March 31,
	2014		2013
	(In thousands)
Orthopedics	$	87,239	$	90,260
Neurosurgery	84,370		63,185
Instruments	43,450		43,207
Total Revenues	$	215,059	$	196,652

- Definition

Tabular disclosure of the profit or loss and total assets for each reportable segment. An entity discloses certain information on each reportable segment if the amounts (a) are included in the measure of segment profit or loss reviewed by the chief operating decision maker or (b) are otherwise regularly provided to the chief operating decision maker, even if not included in that measure of segment profit or loss.

+ References+ Details

BASIS OF PRESENTATION - Schedule of New Accounting Pronouncements and Changes in Accounting Principles (Details) (USD $) In Thousands, except Per Share data, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cost of goods sold	$ 82,383	$ 79,612
Selling, general and administrative	108,338	102,963
Income tax expense (benefit)	1,769	(1,873)
Net income (loss)	2,206	(6,028)
Earnings Per Share, Basic	$ 0.07	$ (0.22)
Earnings Per Share, Diluted	$ 0.07	$ (0.22)
Comprehensive income (loss) (See Note 12)	3,206	(12,512)
Inventories, net	215,232		206,919
Deferred tax assets	48,459		48,616
Prepaid expenses and other current assets	34,496		26,858
Retained earnings	283,162		280,956
Increase (Decrease) in Inventories	(8,516)	(6,739)
Increase (Decrease) in Prepaid Expense and Other Assets	(1,582)	2,704
Scenario, Previously Reported [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cost of goods sold		80,268
Selling, general and administrative		100,161
Income tax expense (benefit)		(1,705)
Net income (loss)		(4,050)
Earnings Per Share, Basic		$ (0.15)
Earnings Per Share, Diluted		$ (0.15)
Comprehensive income (loss) (See Note 12)		(10,534)
Inventories, net			213,431
Deferred tax assets			46,300
Prepaid expenses and other current assets			26,752
Retained earnings			285,046
Increase (Decrease) in Inventories		(8,885)
Increase (Decrease) in Prepaid Expense and Other Assets		2,872
Restatement Adjustment [Member]
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Cost of goods sold		(656)
Selling, general and administrative		2,802
Income tax expense (benefit)		(168)
Net income (loss)		(1,978)
Comprehensive income (loss) (See Note 12)		(1,978)
Inventories, net			(6,512)
Deferred tax assets			2,316
Prepaid expenses and other current assets			106
Retained earnings			(4,090)
Increase (Decrease) in Inventories		2,146
Increase (Decrease) in Prepaid Expense and Other Assets		$ (168)

BUSINESS ACQUISITIONS - Narrative (Details) (USD $)	3 Months Ended		0 Months Ended	3 Months Ended
BUSINESS ACQUISITIONS - Narrative (Details) (USD $)	Mar. 31, 2014	Mar. 31, 2013	Jan. 15, 2014 Confluent Surgical, Inc.	Mar. 31, 2014 Confluent Surgical, Inc.	Jan. 15, 2014 Confluent Surgical, Inc. Cash Consideration One	Jan. 15, 2014 Confluent Surgical, Inc. Cash Consideration Two
Business Acquisition [Line Items]
Business combination, consideration transferred			$ 255,895,000
Payments to Acquire Businesses, Payment for Business Interest			231,000,000
Payments to Acquire Businesses, Payments for Transitional Supply Agreement			4,000,000
Contingent consideration from Confluent Surgical acquisition			20,900,000
Business acquisition, additional cash consideration payable upon completion of milestones			30,000,000		25,000,000	5,000,000
Impairment of intangible assets	600,000	0		600,000
Fair value inputs, discount rate			2.20%
Fair Value Input, Probability of Event			95.00%
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, Incremental Increase in Liability			300,000
Business Combination, Contingent Consideration Arrangements, Range of Outcomes, Value, Incremental Decrease in Liability			$ 400,000

BUSINESS ACQUISITIONS - Schedule of Purchase Price Allocation (Details) (USD $) In Thousands, unless otherwise specified				3 Months Ended			3 Months Ended
	Mar. 31, 2014	Dec. 31, 2013	Jan. 15, 2014 Confluent Surgical, Inc.	Mar. 31, 2014 Confluent Surgical, Inc. Developed Technology Rights	Jan. 15, 2014 Confluent Surgical, Inc. Developed Technology Rights	Jan. 15, 2014 Confluent Surgical, Inc. Other Intangible Assets	Mar. 31, 2014 Confluent Surgical, Inc. Other Intangible Assets Maximum
Business Acquisition [Line Items]
Inventory deposit			$ 4,000
Fixed assets			438
Finite Intangible Assets					239,800	400
Deferred tax asset - long term			14
Goodwill	367,649	249,764	117,715
Total assets acquired			362,367
Contingent supply liability			5,891
Other			731
Deferred tax liability - long term			99,850
Net assets acquired			$ 255,895
Weighted average useful life				20 years			1 year

BUSINESS ACQUISITIONS - Schedule of Contingent Consideration (Details) (Level 3, Cash Consideration One, USD $) In Thousands, unless otherwise specified				3 Months Ended
	Mar. 31, 2014	Jan. 15, 2014	Dec. 31, 2013	Mar. 31, 2014 Selling, General and Administrative Expenses
Business Acquisition, Contingent Consideration [Roll Forward]
Balance as of January 1, 2014	$ 22,250		$ 1,227
Contingent consideration from Confluent Surgical acquisition		20,895
Loss from increase in fair value of contingent consideration liability				128
Fair value at March 31, 2014	$ 22,250		$ 1,227

BUSINESS ACQUISITIONS - Pro Forma Information (Details) (USD $) In Thousands, except Per Share data, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Business Acquisition [Line Items]
Total revenue, net	$ 215,059	$ 196,652
Net income (loss)	2,206	(6,028)
Earnings Per Share, Basic	$ 0.07	$ (0.22)
Earnings Per Share, Diluted	$ 0.07	$ (0.22)
Confluent Surgical, Inc.
Business Acquisition [Line Items]
Total revenue, net		213,051
Net income (loss)		$ (5,469)
Earnings Per Share, Basic		$ (0.17)
Earnings Per Share, Diluted		$ (0.17)

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 04

-Paragraph 20

-Article 9

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 230

-SubTopic 10

-Section 45

-Paragraph 28

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Reference 3: http://www.xbrl.org/2003/role/presentationRef

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-Name Accounting Standards Codification

-Glossary Other Comprehensive Income

-URI http://asc.fasb.org/extlink&oid=6519514

Reference 4: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Glossary Net Income

-URI http://asc.fasb.org/extlink&oid=6518256

Reference 5: http://www.xbrl.org/2003/role/presentationRef

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-SubTopic 10

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-Name Accounting Standards Codification

-Topic 944

-SubTopic 225

-Section S99

-Paragraph 1

-Subparagraph (SX 210.7-04.19)

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-Name Accounting Standards Codification

-Topic 225

-SubTopic 10

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-Paragraph 2

-Subparagraph (SX 210.5-03.18)

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Reference 8: http://www.xbrl.org/2003/role/presentationRef

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-Paragraph 1

-Subparagraph (SX 210.7-04.22)

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Reference 9: http://www.xbrl.org/2003/role/presentationRef

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Reference 10: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 03

-Paragraph 19

-Article 5

+ Details

INVENTORIES (Inventory, Net) (Details) (USD $) In Thousands, unless otherwise specified	Mar. 31, 2014	Dec. 31, 2013
Inventory, Net [Abstract]
Finished goods	$ 131,791	$ 123,786
Work-in process	47,836	47,403
Raw materials	35,605	35,730
Inventories, net	$ 215,232	$ 206,919

- Definition

Carrying amount, net of reserves and adjustments, as of the balance sheet date of merchandise or goods which are partially completed. This inventory is generally comprised of raw materials, labor and factory overhead costs, which require further materials, labor and overhead to be converted into finished goods, and which generally require the use of estimates to determine percentage complete and pricing.

+ References+ Details

GOODWILL AND OTHER INTANGIBLE ASSETS - Narrative (Details) (USD $)	3 Months Ended			3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Sep. 30, 2013	Mar. 31, 2014 Confluent Surgical, Inc.	Sep. 30, 2013 U.S. Spine And Other
Goodwill [Line Items]
Goodwill impairment loss					$ 46,700,000
Impairment of intangible assets	600,000	0		600,000
Annual amortization expense expected to approximate in 2014			30,900,000
Annual amortization expense expected to approximate in 2015			28,800,000
Annual amortization expense expected to approximate in 2016			26,500,000
Annual amortization expense expected to approximate in 2017			24,400,000
Annual amortization expense expected to approximate in 2018			$ 24,100,000

GOODWILL AND OTHER INTANGIBLE ASSETS - Schedule of Changes in Carrying Amount of Goodwill (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Dec. 31, 2013
Goodwill [Line Items]
Goodwill, gross		$ 296,502
Accumulated impairment losses		(46,738)
Goodwill [Roll Forward]
Goodwill at December 31, 2013	249,764
Goodwill acquired during period	117,715
Foreign currency translation	170
Goodwill at March 31, 2014	367,649
U.S. Neurosurgery
Goodwill [Line Items]
Goodwill, gross		95,165
Accumulated impairment losses
Goodwill [Roll Forward]
Goodwill at December 31, 2013	95,165
Goodwill acquired during period	94,315
Foreign currency translation	88
Goodwill at March 31, 2014	189,568
U.S. Instruments
Goodwill [Line Items]
Goodwill, gross		58,033
Accumulated impairment losses
Goodwill [Roll Forward]
Goodwill at December 31, 2013	58,033
Goodwill acquired during period	0
Foreign currency translation	27
Goodwill at March 31, 2014	58,060
U.S. Extremities
Goodwill [Line Items]
Goodwill, gross		61,079
Accumulated impairment losses
Goodwill [Roll Forward]
Goodwill at December 31, 2013	61,079
Goodwill acquired during period	0
Foreign currency translation	28
Goodwill at March 31, 2014	61,107
U.S. Spine And Other
Goodwill [Line Items]
Goodwill, gross		56,325
Accumulated impairment losses		(46,738)
Goodwill [Roll Forward]
Goodwill at December 31, 2013	9,587
Goodwill acquired during period	0
Foreign currency translation	4
Goodwill at March 31, 2014	9,591
International
Goodwill [Line Items]
Goodwill, gross		25,900
Accumulated impairment losses
Goodwill [Roll Forward]
Goodwill at December 31, 2013	25,900
Goodwill acquired during period	23,400
Foreign currency translation	23
Goodwill at March 31, 2014	$ 49,323

GOODWILL AND OTHER INTANGIBLE ASSETS - Components of Company's Identifiable Intangible Assets (Details) (USD $)
In Thousands, unless otherwise specified

3 Months Ended

12 Months Ended

Mar. 31, 2014

Dec. 31, 2013

Acquired Finite-Lived Intangible Assets [Line Items]

Cost

$ 588,619

$ 349,024

Accumulated Amortization

(159,173)

(151,861)

Net

429,446

197,163

Completed technology

Acquired Finite-Lived Intangible Assets [Line Items]

Weighted Average Life

18 years

12 years

Cost

320,460

81,238

Accumulated Amortization

(49,607)

(45,343)

Net

270,853

35,895

Customer relationships

Acquired Finite-Lived Intangible Assets [Line Items]

Weighted Average Life

12 years

Cost

146,701

146,627

Accumulated Amortization

(81,926)

(79,624)

Net

64,775

67,003

Trademarks/brand names

Acquired Finite-Lived Intangible Assets [Line Items]

Weighted Average Life

31 years

Cost

33,601

33,703

Accumulated Amortization

(15,726)

(15,648)

Net

17,875

18,055

Trademarks/brand names indefinite

Acquired Finite-Lived Intangible Assets [Line Items]

Cost

48,484

Accumulated Amortization

Net

48,484

Supplier relationships

Acquired Finite-Lived Intangible Assets [Line Items]

Weighted Average Life

27 years

Cost

34,721

Accumulated Amortization

(9,677)

(9,305)

Net

25,044

25,416

All other

Acquired Finite-Lived Intangible Assets [Line Items]

Weighted Average Life

4 years

^[1]

5 years

^[1]

Cost

4,652

^[1]

4,251

^[1]

Accumulated Amortization

(2,237)

^[1]

(1,941)

^[1]

Net

2,415

^[1]

2,310

^[1]

In Process Research and Development [Member]

Acquired Finite-Lived Intangible Assets [Line Items]

Other Indefinite-lived Intangible Assets

$ 1,419

[1]	At March 31, 2014 and December 31, 2013, all other included in-process research and development ("IPR&D") of $1.4 million in both periods, which was indefinite-lived.

DEBT - Narrative (Detail) (USD $)						0 Months Ended		9 Months Ended	0 Months Ended	9 Months Ended	0 Months Ended						0 Months Ended				0 Months Ended
DEBT - Narrative (Detail) (USD $)	Mar. 31, 2014	Dec. 31, 2013	Mar. 31, 2014 Revolving Credit Facility	Dec. 31, 2013 Revolving Credit Facility	Jun. 21, 2013 Revolving Credit Facility	Jun. 21, 2013 Revolving Credit Facility Option (ii), (x)	Jun. 21, 2013 Revolving Credit Facility Option (ii), (z)	Sep. 30, 2013 Revolving Credit Facility Minimum	Jun. 21, 2013 Revolving Credit Facility Minimum Option (i)	Sep. 30, 2013 Revolving Credit Facility Maximum	Jun. 21, 2013 Revolving Credit Facility Maximum Option (i)	Jun. 08, 2011 Revolving Credit Facility August 2010 Amendment	Jun. 08, 2011 Revolving Credit Facility June 2011 Amendment	Jun. 08, 2011 Revolving Credit Facility June 2011 Amendment Minimum	Jun. 08, 2011 Revolving Credit Facility June 2011 Amendment Maximum	May 11, 2012 Revolving Credit Facility May 2012 Amendment Maximum	Jun. 21, 2013 Revolving Credit Facility June 2013 Amendment	Jun. 21, 2013 Revolving Credit Facility June 2013 Amendment Maximum	Jun. 21, 2013 Revolving Credit Facility June 2013 Amendment Leverage Ratio after March 31, 2015	Jun. 21, 2013 Revolving Credit Facility June 2013 Amendment Maximum Levarage Ratio July 01, 2014 through March 31.2015	Jun. 15, 2011 2016 Convertible Senior Notes	Mar. 31, 2014 2016 Convertible Senior Notes	Dec. 31, 2013 2016 Convertible Senior Notes
Debt Instrument [Line Items]
Senior credit facility, maximum borrowing capacity														$ 450,000,000	$ 600,000,000
Reallocated term loan													150,000,000
Additional commitments													200,000,000
Line of credit facility, expiration date												Aug. 10, 2015	Jun. 08, 2016
Leverage ratio																3.75		4.25	3.75	4.00
Debt issuance costs																	1,100,000
Interest rates available to the Company at its option						0.50%	1.00%		1.00%		1.75%
Cash balance threshold above which excess amount is not subject to any restriction of use or investment					40,000,000
Line of credit, commitment fee percentage								0.15%		0.30%
Line of credit facility outstanding			421,900,000	186,900,000
Weighted average interest rate on debt			1.70%	2.00%
Available borrowings under senior secured revolving credit facility			178,100,000
Fair value of outstanding borrowings			425,700,000																			248,600,000
Principal amount outstanding																					230,000,000	230,000,000	230,000,000
Interest rate on debt																					1.625%
Portion of the debt proceeds that was classified as equity at the time of the offering																					43,200,000
Effective interest rate implicit in the liability component																					5.60%
Carrying amount of liability	207,125,000	205,182,000																				207,100,000	205,200,000
Unamortized discount																						22,900,000	24,800,000
Common stock based on initial conversion rate ratio (in shares)																					17.4092
Principal amount to be considered for conversion purpose																					1,000
Initial conversion price, per share																					$ 57.44
Maximum selling price of company's common stock																					150.00%
Principal amount of notes per average trading price																					$ 1,000
Maximum average conversion value of the Notes																					98.00%
Earliest conversion date																					June 15, 2016
Strike price of the call transaction (in dollars per share)																					$ 57.44
Strike price of warrant transactions (in dollars per share)																					$ 70.05

DEBT - Components of Interest Expense (Detail) (2016 Convertible Senior Notes, USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
2016 Convertible Senior Notes
Debt Instrument [Line Items]
Amortization of the discount on the liability component	$ 1,666	$ 1,610
Cash interest related to the contractual interest coupon	801	818
Total	$ 2,467	$ 2,428

DERIVATIVE INSTRUMENTS - Narrative (Detail) (USD $) In Millions, unless otherwise specified	3 Months Ended
	Mar. 31, 2014
Derivative [Line Items]
Interest rate swap expiration date	August 10, 2015
Interest Rate Swap
Derivative [Line Items]
Pretax losses expected to be reclassified from AOCI in next 12 months	$ 1.7

DERIVATIVE INSTRUMENTS - Summary of Fair Value in Balance Sheet for Derivatives Designated Hedging Instruments (Detail) (USD $)

3 Months Ended

Mar. 31, 2014

Dec. 31, 2013

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Fair value of derivative liabilities

$ 2,097,000

^[1]

$ 2,439,000

^[1]

Interest Rate Swap

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Notional amount derivative instruments

108,800,000

112,500,000

Reduction In Notional Amount Of Interest Rate Derivatives In Next Twelve Months

15,000,000

Interest Rate Swap | Accrued expenses and other current liabilities

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Fair value of derivative liabilities

1,653,000

^[1],[2]

1,676,000

^[1],[2]

Interest Rate Swap | Other liabilities

Derivative Instruments and Hedging Activities Disclosure [Line Items]

Fair value of derivative liabilities

$ 444,000

^[1],[2]

$ 763,000

^[1],[2]

[1]	The Company classifies derivative assets and liabilities as current based on the cash flows expected to be incurred within the following 12 months.
[2]	At March 31, 2014 and December 31, 2013, the notional amount related to the Company’s sole interest rate swap was $108.8 million and $112.5 million, respectively. In the next twelve months, the Company expects to reduce the notional amount by $15.0 million.

DERIVATIVE INSTRUMENTS - Effect of Derivative Instruments Designated Cash Flow Hedges on Statements of Operations (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Derivative Instruments, Gain (Loss) [Line Items]
Balance in AOCI Beginning of Period	$ (2,439)	$ (4,159)
Amount of Gain (Loss) Recognized in AOCI- Effective Portion	(109)	(9)
Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion	(451)	(524)
Balance in AOCI End of Period	(2,097)	(3,644)
Cost of goods sold \| Foreign Currency Forward Contracts
Derivative Instruments, Gain (Loss) [Line Items]
Balance in AOCI Beginning of Period		(34)
Amount of Gain (Loss) Recognized in AOCI- Effective Portion		0
Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion		(34)
Balance in AOCI End of Period		0
Interest (expense) \| Interest Rate Swap
Derivative Instruments, Gain (Loss) [Line Items]
Balance in AOCI Beginning of Period	(2,439)	(4,125)
Amount of Gain (Loss) Recognized in AOCI- Effective Portion	(109)	(9)
Amount of Gain (Loss) Reclassified from AOCI into Earnings-Effective Portion	(451)	(490)
Balance in AOCI End of Period	$ (2,097)	$ (3,644)

STOCK-BASED COMPENSATION - Narrative (Detail) (USD $) In Millions, except Share data, unless otherwise specified	3 Months Ended
	Mar. 31, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Share-based Compensation Arrangement by Share-based Payment Award, Options, Grants in Period, Net of Forfeitures	56,727
Requisite service periods of awards, in years	3 years
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options exercisable, vesting period, in years	4 years
Total unrecognized compensation costs	$ 2.0
Weighted-average period for cost recognition, in years	2 years
Restricted stock awards/stock units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock options exercisable, vesting period, in years	3 years
Total unrecognized compensation costs	$ 21.5
Weighted-average period for cost recognition, in years	2 years
Awards granted during period	204,397
Performance Shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Awards granted during period	74,424
Employee
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration Period, in years	6 years
Directors and Certain Executive Officers \| Minimum \| Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration Period, in years	6 years
Directors and Certain Executive Officers \| Maximum \| Stock Options
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Expiration Period, in years	10 years

TREASURY STOCK (Additional Information) (Detail) (USD $)	3 Months Ended	0 Months Ended
	Mar. 31, 2014	Oct. 23, 2012 October 2012 Authorization
Accelerated Share Repurchases [Line Items]
Stock repurchase program, authorized amount		$ 75,000,000
Amount available for share repurchase under this latest authorization	$ 75,000,000

RETIREMENT BENEFIT PLANS (Additional Information) (Detail) (USD $) In Millions, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2011
Defined Benefit Pension Plans and Defined Benefit Postretirement Plans Disclosure [Abstract]
Reduction in projected benefit obligations			$ 0.3
Total contributions made by the Company	$ 0.3	$ 0.2

RETIREMENT BENEFIT PLANS (Net Periodic Benefit Costs for Defined Benefit Pension Plans) (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Defined Benefit Pension Plans and Defined Benefit Postretirement Plans Disclosure [Abstract]
Interest cost	$ 163	$ 137
Return on plan assets	(134)	(100)
Net period benefit cost	$ 29	$ 37

INCOME TAXES - Narrative (Details) (USD $) In Millions, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Income Tax [Line Items]
Reported tax rate	44.50%	23.70%
Income tax reconciliation, settlements with tax authority	$ 0.6
Income tax reconciliation, tax credits, research		0.9
Income tax expense, tax benefit due to release of tax contingency reserves		0.4
Income tax expense, tax benefit due to change in local tax law		$ 0.4
Minimum
Income Tax [Line Items]
Effective tax rate estimate	23.00%
Maximum
Income Tax [Line Items]
Effective tax rate estimate	24.00%

- Definition

Amount of current state and local tax expense (benefit) pertaining to income (loss) from continuing operations.

+ References+ Details

INCOME TAXES - Summary of Effective Tax Rate (Detail)	3 Months Ended
INCOME TAXES - Summary of Effective Tax Rate (Detail)	Mar. 31, 2014	Mar. 31, 2013
Income Tax Disclosure [Abstract]
Reported tax rate	44.50%	23.70%

NET INCOME PER SHARE - Narrative (Detail) In Millions, unless otherwise specified			3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Mar. 31, 2014 Stock Compensation Plan
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Stock options, shares outstanding (in shares)	1.4	1.7
Shares excluded from computation as their effect would be anti-dilutive			0.2

- Definition

Securities (including those issuable pursuant to contingent stock agreements) that could potentially dilute basic earnings per share (EPS) or earnings per unit (EPU) in the future that were not included in the computation of diluted EPS or EPU because to do so would increase EPS or EPU amounts or decrease loss per share or unit amounts for the period presented.

+ References+ Details

NET INCOME PER SHARE - Basic and Diluted Net Income Per Share (Detail) (USD $) In Thousands, except Per Share data, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Basic net income per share:
Net income (loss)	$ 2,206	$ (6,028)
Weighted average common shares outstanding (in shares)	32,275	27,796
Basic net income per common share (in dollars per share)	$ 0.07	$ (0.22)
Diluted net income per share:
Net income (loss)	$ 2,206	$ (6,028)
Weighted average common shares outstanding (in shares)	32,275	27,796
Effect of dilutive securities:
Stock options and restricted stock (in shares)	493	0
Weighted average common shares for diluted earnings per share (in shares)	32,768	27,796
Diluted net income per common share (in dollars per share)	$ 0.07	$ (0.22)

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References+ Details

- Definition

+ References+ Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

COMPREHENSIVE (LOSS) INCOME - Schedule of Comprehensive Loss Income (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Equity [Abstract]
Net income (loss)	$ 2,206	$ (6,028)
Foreign currency translation adjustment	819	(6,780)
Change in unrealized gain on derivatives, net of tax	195	296
Pension liability adjustment, net of tax	(14)	0
Comprehensive income (loss)	$ 3,206	$ (12,512)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Amount after tax, before reclassification adjustments of gain (loss) on foreign currency translation adjustments, foreign currency transactions designated and effective as economic hedges of a net investment in a foreign entity and intra-entity foreign currency transactions that are of a long-term-investment nature.

+ References+ Details

- Definition

Amount after tax of increase (decrease) in accumulated gain (loss) from derivative instruments designated and qualifying as the effective portion of cash flow hedges and an entity's share of an equity investee's increase (decrease) in deferred hedging gain (loss).

+ References+ Details

COMPREHENSIVE (LOSS) INCOME (Schedule of Changes in Accumulated Other Comprehensive Income by Component (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	$ 927
Other comprehensive income (loss) before reclassifications	743
Amounts reclassified from accumulated other comprehensive income	257
Net current-period other comprehensive income (loss)	1,000
Ending balance	1,927
Gains and Losses on Cash Flow Hedges
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(1,390)
Other comprehensive income (loss) before reclassifications	(62)
Amounts reclassified from accumulated other comprehensive income	257
Net current-period other comprehensive income (loss)	195
Ending balance	(1,195)
Defined Benefit Pension Items
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	(2,287)
Other comprehensive income (loss) before reclassifications	(14)
Amounts reclassified from accumulated other comprehensive income	0
Net current-period other comprehensive income (loss)	(14)
Ending balance	(2,301)
Foreign Currency Items
Accumulated Other Comprehensive Income (Loss) [Roll Forward]
Beginning balance	4,604
Other comprehensive income (loss) before reclassifications	819
Amounts reclassified from accumulated other comprehensive income	0
Net current-period other comprehensive income (loss)	819
Ending balance	$ 5,423

- Definition

Accumulated change in equity from transactions and other events and circumstances from non-owner sources, net of tax effect, at period end. Excludes Net Income (Loss), and accumulated changes in equity from transactions resulting from investments by owners and distributions to owners. Includes foreign currency translation items, certain pension adjustments, unrealized gains and losses on certain investments in debt and equity securities, other than temporary impairment (OTTI) losses related to factors other than credit losses on available-for-sale and held-to-maturity debt securities that an entity does not intend to sell and it is not more likely than not that the entity will be required to sell before recovery of the amortized cost basis, as well as changes in the fair value of derivatives related to the effective portion of a designated cash flow hedge.

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COMPREHENSIVE (LOSS) INCOME (Reclassification Adjustment from AOCI) (Details) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Interest (expense)	$ (5,142)	$ (4,800)
Total before tax	3,975	(7,901)
Tax (expense) or benefit	(1,769)	1,873
Net income (loss)	2,206	(6,028)
Reclassification out of Accumulated Other Comprehensive Income \| Gains and Losses on Cash Flow Hedges
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before tax	(451)
Tax (expense) or benefit	194
Net income (loss)	(257)
Reclassification out of Accumulated Other Comprehensive Income \| Gains and Losses on Cash Flow Hedges \| Interest Rate Swap
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Interest (expense)	$ (451)

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

SEGMENT AND GEOGRAPHIC INFORMATION - Net Sales and Profit by Reportable Segment (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Segment Reporting Information [Line Items]
Revenues	$ 215,059	$ 196,652
Operating income	8,738	(2,190)
Intangible asset amortization	(3,033)	(3,551)
Operating Segments
Segment Reporting Information [Line Items]
Operating income	79,211	64,734
Operating Segments \| U.S. Neurosurgery
Segment Reporting Information [Line Items]
Revenues	54,383	38,996
Operating income	27,788	17,768
Operating Segments \| U.S. Instruments
Segment Reporting Information [Line Items]
Revenues	36,720	36,948
Operating income	10,481	10,084
Operating Segments \| U.S. Extremities
Segment Reporting Information [Line Items]
Revenues	31,912	31,361
Operating income	11,753	10,791
Operating Segments \| U.S. Spine And Other
Segment Reporting Information [Line Items]
Revenues	41,067	43,548
Operating income	11,977	13,213
Operating Segments \| International
Segment Reporting Information [Line Items]
Revenues	50,977	45,799
Operating income	17,212	12,878
Corporate, Non-Segment
Segment Reporting Information [Line Items]
Operating income	$ (67,440)	$ (63,373)

SEGMENT AND GEOGRAPHIC INFORMATION - Revenue by Major Product Category (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Revenue from External Customer [Line Items]
Revenues	$ 215,059	$ 196,652
Orthopedics
Revenue from External Customer [Line Items]
Revenues	87,239	90,260
Neurosurgery
Revenue from External Customer [Line Items]
Revenues	84,370	63,185
Instruments
Revenue from External Customer [Line Items]
Revenues	$ 43,450	$ 43,207

SEGMENT AND GEOGRAPHIC INFORMATION - Total Revenue by Major Geographic Area (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Segment Reporting Information [Line Items]
Revenues	$ 215,059	$ 196,652
United States
Segment Reporting Information [Line Items]
Revenues	163,382	150,019
Europe
Segment Reporting Information [Line Items]
Revenues	25,324	23,617
Rest of World
Segment Reporting Information [Line Items]
Revenues	$ 26,353	$ 23,016

TREASURY STOCK	3 Months Ended
TREASURY STOCK	Mar. 31, 2014
Treasury Stock Transactions, Excluding Value of Shares Reissued [Abstract]
TREASURY STOCK	TREASURY STOCK On October 23, 2012, the Company's Board of Directors authorized a repurchase of up to $75.0 million of its outstanding common stock through December 2014. The Company has not repurchased any of its outstanding shares of common stock during the three month periods ended March 31, 2014 and 2013. As of March 31, 2014, there remained $75.0 million available for repurchases under this authorization.

SEGMENT AND GEOGRAPHIC INFORMATION - Narrative (Detail)	3 Months Ended
SEGMENT AND GEOGRAPHIC INFORMATION - Narrative (Detail)	Mar. 31, 2014 Segment
Segment Reporting [Abstract]
Number of reportable segments	5