View Filing Data

Print Document View Excel Document

Document and Entity Information - USD ($)	12 Months Ended
Document and Entity Information - USD ($)	Dec. 31, 2017	Mar. 02, 2018	Jun. 30, 2017
Document And Entity Information [Abstract]
Document Type	10-K
Amendment Flag	false
Document Period End Date	Dec. 31, 2017
Document Fiscal Year Focus	2017
Document Fiscal Period Focus	FY
Trading Symbol	LMAT
Entity Registrant Name	LEMAITRE VASCULAR INC
Entity Central Index Key	0001158895
Current Fiscal Year End Date	--12-31
Entity Well-known Seasoned Issuer	No
Entity Current Reporting Status	Yes
Entity Voluntary Filers	No
Entity Filer Category	Accelerated Filer
Entity Common Stock, Shares Outstanding		19,281,268
Entity Public Float			$ 404,852,999

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Current assets:
Cash and cash equivalents	$ 19,096	$ 24,288
Short-term marketable securities	22,564
Accounts receivable, net of allowances of $349 at December 31, 2017, and $258 at December 31, 2016	15,000	13,191
Inventory and other deferred costs	21,046	19,578
Prepaid expenses and other current assets	2,605	1,970
Total current assets	80,311	59,027
Property and equipment, net	12,378	8,012
Goodwill	23,844	23,426
Other intangibles, net	8,234	9,897
Deferred tax assets	1,378	1,399
Other assets	178	163
Total assets	126,323	101,924
Current liabilities:
Accounts payable	1,543	1,217
Accrued expenses	9,770	8,804
Acquisition-related obligations	1,876	461
Total current liabilities	13,189	10,482
Deferred tax liabilities	2,176	1,941
Other long-term liabilities	1,188	2,001
Total liabilities	16,553	14,424
Stockholders' equity:
Preferred stock, $0.01 par value; authorized 3,000,000 shares; none outstanding
Common stock, $0.01 par value; authorized 37,000,000 shares; issued 20,745,041 shares at December 31, 2017, and 20,040,348 shares at December 31, 2016	207	200
Additional paid-in capital	93,127	85,378
Retained earnings	28,333	15,335
Accumulated other comprehensive loss	(2,289)	(4,583)
Treasury stock, at cost; 1,480,101 shares at December 31, 2017 and 1,452,810 shares at December 31, 2016	(9,608)	(8,830)
Total stockholders' equity	109,770	87,500
Total liabilities and stockholders' equity	$ 126,323	$ 101,924

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Statement of Financial Position [Abstract]
Accounts receivable, allowances	$ 349	$ 258
Preferred stock, par value	$ 0.01	$ 0.01
Preferred stock, shares authorized	3,000,000	3,000,000
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares authorized	37,000,000	37,000,000
Common stock, shares issued	20,745,041	20,040,348
Treasury stock, at cost	1,480,101	1,452,810

Consolidated Statements of Operations - USD ($) shares in Thousands, $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Statement [Abstract]
Net sales	$ 100,867	$ 89,151	$ 78,352
Cost of sales	30,170	26,215	24,186
Gross profit	70,697	62,936	54,166
Sales and marketing	25,948	26,105	22,780
General and administrative	17,010	14,354	14,010
Research and development	6,636	6,141	5,479
Medical device excise tax			744
Gain on divestitures			(360)
Total operating expenses	49,594	46,600	42,653
Income from operations	21,103	16,336	11,513
Other income (expense):
Interest income	179	81	13
Interest expense	(21)	(14)
Foreign currency loss	(155)	(161)	(102)
Income before income taxes	21,106	16,242	11,424
Provision for income taxes	3,929	5,652	3,666
Net income	$ 17,177	$ 10,590	$ 7,758
Earnings per share of common stock:
Basic	$ 0.91	$ 0.57	$ 0.44
Diluted	$ 0.86	$ 0.55	$ 0.42
Weighted-average shares outstanding:
Basic	18,961	18,485	17,764
Diluted	20,033	19,241	18,316
Cash dividends declared per common share	$ 0.22	$ 0.18	$ 0.16

Consolidated Statements of Comprehensive Income - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Comprehensive Income (Loss), Net of Tax, Attributable to Parent [Abstract]
Net income	$ 17,177	$ 10,590	$ 7,758
Other comprehensive income (loss):
Foreign currency translation adjustment, net	2,294	(534)	(1,684)
Total other comprehensive income (loss)	2,294	(534)	(1,684)
Comprehensive income	$ 19,471	$ 10,056	$ 6,074

Consolidated Statements of Stockholders' Equity - USD ($) $ in Thousands	Total	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive Income (Loss) [Member]	Treasury Stock [Member]
Beginning Balance at Dec. 31, 2014	$ 68,207	$ 188	$ 75,389	$ 3,248	$ (2,365)	$ (8,253)
Beginning Balance, Shares at Dec. 31, 2014		18,778,436				1,407,211
Net income	7,758			7,758
Other comprehensive income	(1,684)				(1,684)
Issuance of common stock for stock options exercised	4,836	$ 9	4,827
Issuance of common stock for stock options exercised, Shares		906,936
Vested restricted stock units	0	$ 0	0	0	0	$ 0
Vested restricted stock units, shares		62,949
Excess tax benefits from stock-based compensation awards	454		454
Stock based compensation expense	1,424		1,424
Repurchase of common stock at cost	(266)					$ (266)
Repurchase of common stock at cost, shares						23,928
Common stock cash dividend paid	(2,845)			(2,845)
Ending Balance at Dec. 31, 2015	77,884	$ 197	82,094	8,161	(4,049)	$ (8,519)
Ending Balance, Shares at Dec. 31, 2015		19,748,321				1,431,139
Net income	10,590			10,590
Other comprehensive income	(534)				(534)
Cumulative effect adjustment to retained earnings	72		165	(93)
Issuance of common stock for stock options exercised	1,442	$ 3	1,439
Issuance of common stock for stock options exercised, Shares		233,798
Vested restricted stock units	0	$ 0	0	0	0	$ 0
Vested restricted stock units, shares		58,229
Stock based compensation expense	1,680		1,680
Repurchase of common stock at cost	(311)					$ (311)
Repurchase of common stock at cost, shares						21,671
Common stock cash dividend paid	(3,323)			(3,323)
Ending Balance at Dec. 31, 2016	87,500	$ 200	85,378	15,335	(4,583)	$ (8,830)
Ending Balance, Shares at Dec. 31, 2016		20,040,348				1,452,810
Net income	17,177			17,177
Other comprehensive income	2,294				2,294
Issuance of common stock for stock options exercised	$ 5,500	$ 7	5,493
Issuance of common stock for stock options exercised, Shares	635,503	635,503
Vested restricted stock units	$ 0	$ 0	0	0	0	$ 0
Vested restricted stock units, shares		69,190
Stock based compensation expense	2,256		2,256
Repurchase of common stock at cost	(778)					$ (778)
Repurchase of common stock at cost, shares						27,291
Common stock cash dividend paid	(4,179)			(4,179)
Ending Balance at Dec. 31, 2017	$ 109,770	$ 207	$ 93,127	$ 28,333	$ (2,289)	$ (9,608)
Ending Balance, Shares at Dec. 31, 2017		20,745,041				1,480,101

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Operating activities
Net income	$ 17,177	$ 10,590	$ 7,758
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	4,055	3,591	3,394
Stock-based compensation	2,256	1,680	1,424
Fair value adjustments to contingent consideration obligations	106
Provision for doubtful accounts and allowances	230	105	182
Provision for inventory write-downs	396	362	462
Provision (benefit) for deferred income taxes	300	140	(384)
Gain on divestitures			(360)
Excess tax benefits from stock-based compensation awards			(454)
Loss on disposal of property and equipment			5
Foreign currency transaction gain	(29)	59	100
Changes in operating assets and liabilities:
Accounts receivable	(1,507)	(922)	(1,879)
Inventory and other deferred costs	(1,352)	(134)	608
Prepaid expenses and other assets	(288)	1,528	(2,035)
Accounts payable and other liabilities	1,524	(103)	2,617
Net cash provided by operating activities	22,868	16,896	11,438
Investing activities
Purchases of property and equipment	(6,417)	(2,841)	(2,273)
Payments related to acquisitions, net of cash acquired		(14,368)	(1,565)
Purchases of short-term marketable securities	(22,541)
Proceeds from divestitures, net of expenses			360
Proceeds from sale of property and equipment			15
Purchase of intellectual property		(2)	(17)
Net cash used in investing activities	(28,958)	(17,211)	(3,480)
Financing activities
Payment of deferred acquisition consideration	(463)	(385)	(1,100)
Proceeds from issuance of common stock	5,500	1,442	4,836
Purchase of treasury stock	(778)	(311)	(266)
Common stock cash dividend paid	(4,179)	(3,323)	(2,845)
Excess tax benefits from stock-based compensation awards			454
Net cash provided by (used in) financing activities	80	(2,577)	1,079
Effect of exchange rate changes on cash and cash equivalents	818	(271)	(278)
Net increase (decrease) in cash and cash equivalents	(5,192)	(3,163)	8,759
Cash and cash equivalents at beginning of year	24,288	27,451	18,692
Cash and cash equivalents at end of year	$ 19,096	$ 24,288	$ 27,451

Significant Accounting Policies and Related Matters

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Significant Accounting Policies and Related Matters

1. Significant Accounting Policies and Related Matters

Description of Business

Unless the context requires otherwise, references to LeMaitre Vascular, we, our, and us refer to LeMaitre Vascular, Inc. and our subsidiaries. We develop, manufacture, and market medical devices and implants used primarily in the field of vascular surgery. We also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. We operate in a single segment in which our principal product lines include the following: valvulotomes, balloon catheters, carotid shunts, biologic vascular patches, biologic vascular grafts, radiopaque marking tape, anastomotic clips, remote endarterectomy devices, laparoscopic cholecystectomy devices, vascular grafts, angioscopes, and powered phlebectomy devices. Our offices are located in Burlington, Massachusetts; Fox River Grove, Illinois; Vaughn, Canada; Sulzbach, Germany; Milan, Italy; Madrid, Spain; North Melbourne, Australia; Tokyo, Japan; and Shanghai, China.

Consolidation and Basis of Presentation

Our consolidated financial statements include the accounts of LeMaitre Vascular and the accounts of our wholly-owned subsidiaries, LeMaitre Vascular GmbH, LeMaitre Vascular GK, Vascutech Acquisition LLC, LeMaitre Acquisition LLC, LeMaitre Vascular SAS, LeMaitre Vascular S.r.l., LeMaitre Vascular Spain SL, LeMaitre Vascular Switzerland GmbH, LeMaitre Vascular ULC, LeMaitre Vascular AS, LeMaitre Vascular Pty Ltd, Xenotis Pty Ltd, LeMaitre Vascular, Ltd. and LeMaitre Medical Technology (Shanghai) Co. Ltd. All significant intercompany accounts and transactions have been eliminated in consolidation.

Foreign Currency Translation

Balance sheet accounts of foreign subsidiaries are translated into U.S. dollars at year-end exchange rates. Operating accounts are translated at average exchange rates for each year. Net translation gains or losses are adjusted directly to a separate component of other comprehensive income (loss) within stockholders’ equity. Foreign exchange transaction gains (losses), substantially all of which relate to intercompany activity between us and our foreign subsidiaries, are included in other income (expense) in the accompanying consolidated statements of operations.

Estimates

The preparation of financial statements in conformity with U.S. generally accepted accounting principles (GAAP) requires us to make estimates and assumptions that affect the amounts reported in our consolidated financial statements and accompanying notes. Our estimates and assumptions, including those related to bad debts, inventory and other deferred costs, intangible assets, sales returns and discounts, and income taxes are reviewed on an ongoing basis and updated as appropriate. Actual results could differ from those estimates.

Revenue Recognition

Our revenue is derived primarily from the sale of disposable or implantable devices used during vascular surgery. We sell primarily directly to hospitals and to a lesser extent to distributors, as described below, and, during the periods presented in our consolidated financial statements, entered into consigned inventory arrangements with either hospitals or distributors on a limited basis. With the recent acquisition of the RestoreFlow allograft business, we also derive revenues from the processing and cryopreservation of human tissues for implantation in patients. These revenues are recognized when services have been provided and the tissue has been shipped to the customer, provided all other revenue recognition criteria discussed in the succeeding paragraph have been met.

We recognize revenue when four basic criteria are met: (1) persuasive evidence of an arrangement exists; (2) delivery has occurred or services have been rendered; (3) the fee is fixed or determinable; and (4) collectability is reasonably assured. We assess whether the fee is fixed or determinable based on the terms of the agreement associated with the transaction. Sales transactions are based on prices that are determinable at the time the customer’s purchase order is accepted by us. Orders that are not accompanied with a purchase order are either confirmed in writing or verbally with the customer.

After the delivery of the product, there is no uncertainty about customer acceptance due to the nature of the product. There is no contingency for acceptance, warranty, or price protection. We do not recognize revenue on consigned sales until the customer notifies us that the products have been used. In order to determine whether collection is reasonably assured, we assess a number of factors, including past transaction history with the customer and the creditworthiness of the customer. If we determine that collection is not reasonably assured, we defer the recognition of revenue until collection becomes reasonably assured, which is generally upon receipt of payment. We provide for product returns at the time revenue is recognized based on our product return history.

Based on these policies, we recognize revenue, net of allowances for returns and discounts, as well as any sales and value added taxes required to be invoiced as products are shipped, based on shipping point terms, or at the time consigned inventory is consumed at which time title passes to customers. We recognize revenue net of allowances for returns and discounts, at the time of shipment of our products to our distributors. Customers returning products are entitled to full or partial credit based on the condition and timing of the return. To be accepted, a returned product must be unopened (if sterile), unadulterated, and undamaged, must have at least 18 months remaining prior to its expiration date, or twelve months for our hospital customers in Europe, and generally be returned within 30 days of shipment. These return policies apply to sales to both hospitals and distributors. The amount of products returned to us, either for exchange or credit, has not been material. Nevertheless, we provide for an allowance for future sales returns based on historical return experience. Our cost of replacing defective products has not been material and is accounted for at the time of replacement.

Research and Development Expense

Research and development costs, principally salaries, laboratory testing, and supplies, are expensed as incurred and also include royalty payments associated with licensed and acquired intellectual property.

Shipping and Handling Costs

Shipping and handling fees paid by customers are recorded within net sales, with the related expense recorded in cost of sales.

Advertising Costs

Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Advertising expense	$	305	$	378	$	428

Cash and Cash Equivalents

We consider all highly liquid instruments purchased with maturity dates of 90 days or less to be cash equivalents. Cash and cash equivalents are primarily invested in money market funds. These amounts are stated at cost, which approximates fair value.

Short-term Marketable Securities

Our short-term marketable securities are available-for-sale securities carried at fair value, with unrealized gains and losses recorded in other comprehensive income.

Concentrations of Credit Risk

Our financial instruments that are exposed to concentrations of credit risk consist primarily of cash and cash equivalents and accounts receivable. Cash equivalents represent highly liquid investments with maturities of 90 days or less at the date of purchase. Credit risk related to cash and cash equivalents are limited based on the creditworthiness of the financial institutions at which these funds are held. We maintain cash balances in several banks. Accounts located in the United States are insured by the Federal Deposit Insurance Corporation (FDIC) up to $250,000. Certain of our account balances exceed the FDIC limit. Cash balances held outside the United States totaled approximately $11.8 million as of December 31, 2017.

Our accounts receivable are with customers based in the United States and internationally. Accounts receivable generally are due within 30 to 90 days of invoice and are stated at amounts due from customers, net of an allowance for doubtful accounts and sales returns, other than in certain European markets where longer payment terms are customary and may range from 90 to 240 days. We perform ongoing credit evaluations of the financial condition of our customers and adjust credit limits based upon payment history and the current creditworthiness of the customers, as determined by a review of their current credit information. We continuously monitor aging reports, collections, and payments from customers, and maintain a provision for estimated credit losses based upon historical experience and any specific customer collection issues we identify.

We closely monitor outstanding receivables for potential collection risks, including those that may arise from economic conditions, in both the U.S. and international economies. Our European sales to government-owned or supported customers such as hospitals, distributors and agents, in Southern Europe, specifically Italy and Spain may be subject to significant payment delays due to government austerity measures impacting funding and payment practices. As of December 31, 2017 our receivables in Italy and Spain totaled $1.1 million and $0.6 million, respectively. Receivables balances with certain publicly-owned hospitals and government supported customers in these countries can accumulate over a period of time and then subsequently be settled as large lump sum payments. While we believe our allowance for doubtful accounts in these countries is adequate as of December 31, 2017, if significant changes were to occur in the payment practices of these European governments or if government funding becomes unavailable, we may not be able to collect on receivables due to us from these customers and our write offs of uncollectible amounts may increase.

We write off accounts receivable when they become uncollectible. Such credit losses have historically been within our expectations and allowances. The allowance for doubtful accounts is our best estimate of the amount of probable credit losses in our existing accounts receivable. We review our allowance for doubtful accounts on a monthly basis and all past due balances are reviewed individually for collectability. The provision for the allowance for doubtful accounts is recorded in general and administrative expenses. The following is a summary of our allowance for doubtful accounts and sales returns:


	Balance at Beginning of Period		Additions (recoveries) charged to Income		Deductions from Reserves		Balance at End of Period
	(in thousands)
Allowance for doubtful accounts and sales returns:
Year ended December 31, 2017	$	258	$	230	$	139		349
Year ended December 31, 2016		243		105		90		258
Year ended December 31, 2015		242		182		181		243

Fair Value of Financial Instruments

Our financial instruments include cash and cash equivalents, short-term marketable securities, accounts receivable and trade payables. The fair value of these instruments approximates their carrying value based upon their short-term nature or variable rates of interest. Unrealized gains and losses on our short-term marketable securities are recorded in other comprehensive income and were not material to our consolidated financial statements for the year ended December 31, 2017.

Inventory and Other Deferred Costs

Inventory and Other Deferred Costs consists of finished products, work-in-process, raw materials and costs deferred in connection with human tissue cryopreservation services of our RestoreFlow allograft business. We value inventory and other deferred costs at the lower of cost or market value. Cost includes materials, labor and manufacturing overhead and is determined using the first-in, first-out (FIFO) method. On a quarterly basis, we review inventory quantities on hand and analyze the provision for excess and obsolete inventory based primarily on product expiration dating and our estimated sales forecast, which is based on sales history and anticipated future demand. Our estimates of future product demand may not be accurate, and we may understate or overstate the provision required for excess and obsolete inventory. Accordingly, any significant unanticipated changes in demand could have a significant impact on the value of our inventory and results of operations.

Property and Equipment

Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows:


Description		Useful Life
Computers and equipment		3–5 years
Machinery and equipment		3–10 years
Leasehold improvements		The shorter of its useful life or lease term

Expenditures for maintenance and repairs are charged to operations when incurred, while additions and betterments are capitalized. When assets are retired or disposed, the asset’s original cost and related accumulated depreciation are eliminated from the accounts and any gain or loss is reflected in the statement of operations.

Valuation of Business Combinations

We assign the value of the consideration transferred to acquire a business to the tangible assets and identifiable intangible assets acquired and liabilities assumed on the basis of their fair values at the date of acquisition. We assess the fair value of assets, including intangible assets, using a variety of methods and are usually performed by an independent appraiser who measures fair value from the perspective of a market participant.

Acquisitions have been accounted for using the acquisition method, and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. Acquisition transaction costs have been recorded in general and administrative expenses, and are expensed as incurred. Allocation of the purchase price for acquisitions is based on estimates of the fair value of the net assets acquired and, for acquisitions completed within the past year, is subject to adjustment upon finalization of the purchase price allocation.

Our acquisitions have historically been made at prices above the fair value of the acquired assets, resulting in goodwill, due to expectations of synergies of combining the businesses. These synergies include use of our existing commercial infrastructure to expand sales of the acquired businesses’ products, use of the commercial infrastructure of the acquired businesses to cost-effectively expand sales of our products, and the elimination of redundant facilities, functions and staffing.

Contingent Consideration

Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income.

Impairment of Long-lived Assets

We review our long-lived assets (primarily property and equipment and intangible assets) subject to amortization quarterly to determine if any adverse conditions exist or a change in circumstances has occurred that would indicate impairment or a change in the remaining useful life. Conditions that may indicate impairment include, but are not limited to, a significant adverse change in legal factors or business climate that could affect the value of an asset, a product recall, or an adverse action or assessment by a regulator. If an impairment indicator exists, we test the intangible asset for recoverability. We record impairment losses on long-lived assets used in operations when events and circumstances indicate that the assets might be impaired and the undiscounted cash flows estimated to be generated by those assets are less than the carrying amount of those assets. Impairment is measured based on the fair market value of the affected asset using discounted cash flows.

Goodwill

Goodwill represents the amount of consideration paid in connection with business acquisitions in excess of the fair value of assets acquired and liabilities assumed. Goodwill is evaluated for impairment annually or more frequently if indicators of impairment are present or changes in circumstances suggest that an impairment may exist. We evaluate the December 31 balance of the carrying value of goodwill based on a single reporting unit annually. We perform an assessment of qualitative factors to determine if it is “more likely than not” that the fair value of our reporting unit is less than its carrying value as a basis for determining whether it is necessary to perform the two-step goodwill impairment test. The “more likely than not” threshold is defined as having a likelihood of more than 50 percent. If required, the next step of the goodwill impairment test is to determine the fair value of the reporting unit. The implied fair value of goodwill is determined on the same basis as the amount of goodwill recognized in connection with a business combination. Specifically, the fair value of a reporting unit is allocated to all of the assets and liabilities (including any unrecognized intangible assets) as if the reporting unit had been acquired in a business combination as of the date of the impairment review and as if the fair value of the reporting unit was the price paid to acquire the reporting unit. The excess of the fair value of a reporting unit over the amounts assigned to its assets and liabilities is the implied fair value of goodwill. If the carrying amount of the reporting unit goodwill exceeds the implied fair value of that goodwill, an impairment loss shall be recognized in an amount equal to that excess. We have determined that no goodwill impairment charges were required for the years ended December 31, 2017, 2016 or 2015.

Other Intangible Assets

Other intangible assets consist primarily of patents, trademarks, technology licenses, and customer relationships acquired in connection with business acquisitions and asset acquisitions and are amortized over their estimated useful lives, ranging from 1 to 13 years.

Stock-based Compensation

We recognize, as expense, the estimated fair value of stock options to employees which is determined using the Black-Scholes option pricing model. We have elected to recognize the compensation cost of all share-based awards on a straight-line basis over the vesting period of the award. In periods that we grant stock options, fair value assumptions are based on volatility, interest, dividend yield, and expected term over which the stock options will be outstanding. The computation of expected volatility is based on the historical volatility of the company’s stock. The interest rate for periods within the contractual life of the award is based on the U.S. Treasury risk-free interest rate in effect at the time of grant. Historical data on exercise patterns is the basis for estimating the expected life of an option. The expected annual dividend rate was calculated by dividing our annual dividend, based on the most recent quarterly dividend rate, by the closing stock price on the grant date.

We also issue restricted stock units (RSUs) as an additional form of equity compensation to our employees, officers, and directors, pursuant to our stockholder-approved 2006 Plan. RSUs entitle the grantee to an issuance of stock at no cost and generally vest over a period of time determined by our Board of Directors at the time of grant based upon the continued service to the company. The fair market value of the award is determined based on the number of RSUs granted and the market value of our common stock on the grant date and is amortized to expense over the period of vesting. Unvested RSUs are forfeited and canceled as of the date that employment or service to the company terminates. RSUs are settled in shares of our common stock upon vesting. We may repurchase common stock upon our employees’ vesting in RSUs in order to cover any minimum tax withholding liability as a result of the RSUs having vested.

Share-based compensation charges had in prior years been recorded net of the estimated forfeitures based upon historical forfeiture rates, and was adjusted in subsequent periods to reflect the results of actual forfeitures and vesting. In March 2016, the Financial Accounting Standards Board (“FASB”) issued a new standard that changes the accounting for certain aspects of share-based payments to employees, including a provision allowing companies to make an election to account for award forfeitures as they occur, rather than estimating them at the time of grant. We early-adopted the new guidance in the third quarter of fiscal year 2016, which required us to reflect any adjustments as of January 1, 2016, the beginning of the annual period that includes the interim period of adoption. In connection with this early adoption we made the election to account for award forfeitures as they occur, and we recorded a cumulative-effect adjustment to beginning retained earnings of $0.1 million, net of tax. Share-based compensation charges are recorded across the consolidated statement of operations based upon the grantee’s primary function.

Commitments and Contingencies

In the normal course of business, we are subject to proceedings, lawsuits, and other claims and assessments for matters related to, among other things, patent infringement, business acquisitions, employment, and product recalls. We assess the likelihood of any adverse judgments or outcomes to these matters as well as potential ranges of probable losses. A determination of the amount of reserves required, if any, for these contingencies is made after careful analysis of each individual issue. The required reserves may change in the future due to new developments in each matter or changes in approach such as a change in settlement strategy in dealing with these matters. We record charges for the losses we anticipate incurring in connection with litigation and claims against us when we conclude a loss is probable and we can reasonably estimate these losses. During the years ended December 31, 2017, 2016 and 2015, we were not subject to any material litigation or claims and assessments.

Income Taxes

We account for income taxes under the asset and liability method of accounting for income taxes. Under the asset and liability method, deferred taxes are determined based on the difference between the financial reporting and tax bases of assets and liabilities using enacted tax rates in effect in the years in which the differences are expected to reverse. The provision for income taxes includes taxes currently payable and deferred taxes resulting from the tax effects of temporary differences between the financial statement and tax bases of assets and liabilities. We maintain valuation allowances where it is more likely than not that all or a portion of a deferred tax asset will not be realized. Changes in the valuation allowances are included in our tax provision in the period of change. In determining whether a valuation allowance is warranted, we evaluate factors such as prior earnings history, expected future earnings, carry-back and carry-forward periods and tax strategies that could potentially enhance the likelihood of the realization of a deferred tax asset.

Our 2017 tax provision includes an estimate for the impact of US tax reform. The final impact of US tax reform may differ from these estimates because of changes in interpretations, analysis, and assumptions made by management, updates or changes to our transition tax calculation, and/or additional guidance that may be issued by the IRS.

We recognize, measure, present and disclose in our financial statements, uncertain tax positions that we have taken or expect to take on a tax return. We recognize in our financial statements the impact of tax positions that meet a “more likely than not” threshold, based on the technical merits of the position. The tax benefits recognized in the financial statements from such a position are measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement.

Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense.

Comprehensive Income

Comprehensive income is defined as the change in equity of a business enterprise during a period from transactions and other events and circumstances from non-owner sources. Other than reported net income, comprehensive income includes foreign currency translation adjustments, which are disclosed in the accompanying consolidated statements of comprehensive income. There were no reclassifications out of comprehensive income for the years ended December 31, 2017 and 2016.

Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $2.3 million and $4.6 million as of December 31, 2017 and 2016, respectively.

Restructuring

We record restructuring charges incurred in connection with consolidation or relocation of operations, exited business lines, reductions in force, or distributor terminations. These restructuring charges, which reflect our commitment to a termination or exit plan that will begin within twelve months, are based on estimates of the expected costs associated with site closure, legal matters, contract terminations, severance payments, or other costs directly related to the restructuring. If the actual cost incurred exceeds the estimated cost, an additional charge to earnings will result. If the actual cost is less than the estimated cost, a credit to earnings will be recognized.

Earnings per Share

We compute basic earnings per share by dividing net income available for common stockholders by the weighted average number of shares outstanding during the year. Except where the result would be anti-dilutive to net income per share, diluted earnings per share has been computed using the treasury stock method and reflects the potential vesting of restricted common stock and the potential exercise of stock options, as well as their related income tax effects.

The computation of basic and diluted net income per share is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands, except per share data)
Basic:
Net income available for common stockholders	$	17,177	$	10,590	$	7,758

Weighted average shares outstanding		18,961		18,485		17,764

Basic earnings per share	$	0.91	$	0.57	$	0.44

Diluted:
Net income available for common stockholders	$	17,177	$	10,590	$	7,758

Weighted-average shares outstanding		18,961		18,485		17,764
Common stock equivalents, if dilutive		1,072		756		552

Shares used in computing diluted earnings per common share		20,033		19,241		18,316

Diluted earnings per share	$	0.86	$	0.55	$	0.42

Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive		6		45		55

Recent Accounting Pronouncements

In January 2017, the Financial Accounting Standards Board (“FASB”) issued an accounting standards update, ASU 2017-01, which changes the definition of a business for purposes of determining whether a business has been acquired or sold. The amendment is intended to help companies evaluate whether transactions should be accounted for as acquisitions (or disposals) of assets or businesses. The new standard is effective for us beginning January 1, 2018, with early adoption permitted. The adoption of this standard is not expected to have a material impact on our financial statements.

In August 2016, the FASB issued an accounting standards update, ASU 2016-15, which changes the classification of certain cash receipts and cash payments within the statement of cash flows. The new standard is effective for us beginning January 1, 2018, with early adoption permitted. The adoption of this standard is not expected to have a material impact on our financial statements.

In February 2016, the FASB issued its new lease accounting guidance in Accounting Standards Update (ASU) No. 2016-02, Leases (Topic 842). Under the new guidance, lessees will be required to recognize the following for all leases (with the exception of short-term leases) at the commencement date: a lease liability, which is a lessee‘s obligation to make lease payments arising from a lease, measured on a discounted basis; and a right-of-use asset, which is an asset that represents the lessee’s right to use, or control the use of, a specified asset for the lease term. The new lease guidance simplifies the accounting for sale and leaseback transactions primarily because lessees must recognize lease assets and lease liabilities. Lessees will no longer be provided with a source of off-balance sheet financing. The standard is effective for public companies for fiscal years beginning after December 15, 2018, including interim periods within those fiscal years (i.e., January 1, 2019, for a calendar year entity). Early application is permitted. Lessees (for capital and operating leases) and lessors (for sales-type, direct financing, and operating leases) must apply a modified retrospective transition approach for leases existing at, or entered into after, the beginning of the earliest comparative period presented in the financial statements. The modified retrospective approach would not require any transition accounting for leases that expired before the earliest comparative period presented. Lessees and lessors may not apply a full retrospective transition approach. We have not yet determined the impact on our consolidated financial statements.

In May 2014, the FASB and the International Accounting Standards Board issued substantially converged final standards on revenue recognition. The FASB’s ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606), as amended from time to time, outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry-specific guidance. The new revenue recognition guidance becomes effective for us on January 1, 2018, with early adoption permitted on January 1, 2017. Entities have the option of using either a full retrospective or a modified approach to adopt the guidance in the ASU. Our assessment of the impact to our financial statements of adopting this standard is now complete. We engaged external consultants to assist us with our analysis, which included evaluating our standard arrangements with customers, as well as arrangements specific to certain customer bases or product offerings, and reviewing a sample of actual contracts to determine whether there are additional attributes to consider beyond our standard arrangements. We have concluded that adoption of Topic 606 will not have a material impact on our consolidated financial statements. We expect that substantially all of our revenue will continue to be recognized when products are shipped from our premises. However, there will be changes to our revenue recognition accounting policy as well as other disclosures. We have determined that we will use the modified retrospective method of adoption under which the comparative information will not be restated and will continue to be reported under the standard in effect for those periods.

Acquisitions and Divestitures

12 Months Ended

Dec. 31, 2017

Business Combinations [Abstract]

Acquisitions and Divestitures

2. Acquisitions and Divestitures

Acquisitions are accounted for using the acquisition method and the acquired companies’ results have been included in the accompanying consolidated financial statements from their respective dates of acquisition. In each case for the acquisitions disclosed below, pro forma information assuming the acquisition had occurred at the beginning of the earliest period presented is not included as the impact is immaterial.

Our acquisitions have historically been made at prices above the fair value of the acquired identifiable assets, resulting in goodwill, due to expectations of synergies that will be realized by combining businesses. These synergies include the use of our existing sales channel to expand sales of the acquired businesses’ products, consolidation of manufacturing facilities, and the leveraging of our existing administrative infrastructure.

The fair market valuations associated with these transactions fall within Level 3 (see Note 13) of the fair value hierarchy, due to the use of significant unobservable inputs to determine fair value. The fair value measurements were calculated using unobservable inputs, primarily using the income approach, specifically the discounted cash flow method. The amount and timing of future cash flows within our analysis was based on our due diligence models, most recent operational budgets, long range strategic plans and other estimates.

RestoreFlow Allografts

On November 10, 2016, we entered into an agreement to acquire the assets of Restore Flow Allografts, LLC, a provider of human vascular tissue processing and cryopreservation services, for an initial purchase price of $12 million, with three additional payments of up to $2 million each ($6 million in total), depending upon the satisfaction of certain contingencies. The first payment of $2 million is due not later than 15 days following the expiration of the 18 month period following the closing date, subject to reductions as specified in the agreement for each calendar month that certain retained employees are not employed by us due to resignation without good reason, or termination for cause, both as defined in the agreement. The portion of this payment that will be paid to retained employees and that is contingent on their continued employment, estimated at $0.9 million, is being accounted for as post-combination compensation expense rather than purchase consideration. The remaining $1.1 million that is payable to non-employee investors but that is also contingent on the continued employment of certain retained employees has been accounted for as contingent consideration, at an acquisition-date fair value of $0.9 million. This valuation reflects management’s assessment of the likelihood that the retained employees will remain employed by us, discounted at a rate of 6.1% to account risk inherent in the probability estimate as well as for the time value of money between acquisition date and the payment date. This valuation is being re-measured each reporting period until the payment requirement ends, with any adjustments reported in income from operations. For the year ended December 31, 2017, the amount of the adjustment was $0.1 million.

There are also two potential earn-out payments under the agreement. The first earn-out was calculated at 50% of the amount by which net revenue in the first 12 months following the closing exceeded $6 million, with such payout not to exceed $2 million. This milestone was not met and accordingly no amount was paid out. The second earn-out is calculated at 50% of the amount by which net revenue in the second 12 months following the closing exceeds $9 million, with such payout not to exceed $2 million. These earn-outs were accounted for as contingent consideration, at an acquisition-date fair value of $0.1 million for the two earn-outs combined. This valuation was derived by utilizing an option pricing model technique incorporating, among other inputs, management’s forecasts of future revenues, the expected volatility of revenues, and an estimated weighted average cost of capital 14.1% to account for the risk of achievement of the revenue forecasts as well as the time value of money between acquisition date and the payment date.

The RestoreFlow business derives revenue from human tissue preservation services, in particular the processing and cryopreservation of veins and arteries. By federal law, human tissues cannot be bought or sold. Therefore, the tissues we obtain and preserve are not held as inventory, and the costs we incur to procure and process vascular tissues are instead accumulated and deferred. Revenues are recognized for the provision of cryopreservation services rather than product sales.

The acquired assets included intellectual property, permits and approvals, data and records, equipment and furnishings, accounts receivable, inventory, literature, and customer and supplier information. We also assumed certain accounts payable. We accounted for the acquisition as a business combination.

The following table summarizes the purchase price allocation as of December 31, 2017:


	Allocated
	Fair Value
	(in thousands)
Accounts receivable	$	394
Deferred cryopreservation costs		2,583
Equipment and supplies		125
Accounts payable		(286	)
Intangible assets		4,544
Goodwill		5,599

Purchase price	$	12,959

The goodwill is deductible for tax purposes over 15 years.

The following table reflects the allocation of the acquired intangible assets and related estimated useful lives:


			Weighted
	Allocated		Average
	Fair Value		Useful Life
	(in thousands)
Non-compete agreements	$	180		5.0 years
Tradename		271		9.0 years
Procurement contracts		617		9.0 years
Technology		2,793		10.5 years
Customer relationships		683		12.5 years

Total intangible assets	$	4,544

The weighted-average amortization period of the acquired intangible assets was 10.3 years.

ProCol Biologic Graft

On March 18, 2016, we acquired the ProCol biologic vascular graft (“ProCol”) business for $2.7 million from Hancock Jaffe Laboratories, Inc. (HJL) and CryoLife, Inc. (CRY). HJL was the owner and manufacturer of ProCol and CRY was the exclusive distributor of the ProCol graft. CRY also owned an option to purchase the ProCol business, which we acquired from CRY. We bought finished goods inventory and other ProCol related assets from CRY for $2.0 million, which was paid in full at closing. We bought other ProCol assets from HJL for $0.7 million, 50% of which was paid at closing, 25% of which was paid in the quarter ended September 30, 2016 and the remainder of which will be paid within one year of closing. Additional consideration is payable to HJL for a three-year period following the closing, calculated at 10% of ProCol revenues. This additional consideration was initially valued at $0.3 million and is being re-measured each reporting period until the payment requirement ends, with any adjustments reported in income from operations. For the year ended December 31, 2017, the amount of the adjustment was not material to our financial statements.

Assets acquired included inventory, intellectual property and a related license, the ProCol trade name, customer lists, non-compete agreements and certain equipment and supplies. We did not assume any liabilities. We accounted for the acquisition as a business combination.

The following table summarizes the purchase price allocation as of December 31, 2017:


	Allocated
	Fair Value
	(in thousands)
Inventory	$	2,080
Manufacturing equipment and supplies		25
Intangible assets		620
Goodwill		318

Purchase price	$	3,043

The goodwill is deductible for tax purposes over 15 years.

The following table reflects the allocation of the acquired intangible assets and related estimated useful lives:


			Weighted
	Allocated		Average
	Fair Value		Useful Life
	(in thousands)
Non-compete agreement	$	84		5.0 years
Tradename		109		9.5 years
Technology		277		9.0 years
Customer relationships		150		9.0 years

Total intangible assets	$	620

The weighted-average amortization period of the acquired intangible assets was 8.6 years.

Tru-Incise Valvulotome

In May 2015, we entered into an asset purchase agreement with UreSil, LLC (UreSil) to acquire the production and distribution rights of UreSil’s Tru-Incise valvulotome for sales outside the United States for a purchase price of approximately $1.4 million. We paid $1.1 million at the closing and $0.2 million in 2016, and $0.1 million in 2017. We accounted for the acquisition as a business combination. Assets acquired included inventory and intellectual property. We did not assume any liabilities. The purchase accounting is complete.

The following table summarizes the purchase price allocation at the date of the acquisition:


	Allocated Fair Value
	(in thousands)
Inventory	$	88
Intangible assets		545
Goodwill		742

Purchase price	$	1,375

The goodwill is deductible for tax purposes over 15 years.

The following table reflects the allocation of the acquired intangible assets and related estimated useful lives:


	Allocated Fair Value		Weighted Average Useful Life
	(in thousands)
Non-compete agreement	$	120		5.0 years
Tradename license		17		3.0 years
Technology		391		7.0 years
Customer relationships		17		3.0 years

Total intangible assets	$	545

Other 2015 Items

Following the May 2015 Tru-Incise valvulotome acquisition, we entered into definitive agreements with seven UreSil distributors to terminate their distribution of the Tru-Incise valvulotome for aggregate termination fees of $0.2 million. We recorded approximately $0.2 million of intangible assets with a weighted-average amortization period of 3.0 years.

In August 2015, we entered into a definitive agreement with Grex Medical Oy (Grex), our distributor in Finland to terminate their distribution of our products, and we began selling direct to hospitals in Finland as of January 1, 2016. The agreement required us to pay approximately $0.2 million in exchange for the purchase of customer lists and a non-compete agreement.

The UnBalloon Divestiture

In July 2015, we entered into an asset sales agreement with Merit Medical Ireland Limited to sell our inventory, intellectual property, and customer lists associated with The UnBalloon non-occlusive modeling catheter product line for $0.4 million which was recognized as a gain on divestiture in the third quarter of 2015. During the year ended December 31, 2014, we had recognized an impairment charge of $0.2 million on The UnBalloon non-occlusive modeling catheter product line. Additionally, in 2014 we recognized a $0.3 million charge to cost of sales related to the non-occlusive modeling catheter inventory.

Inventory and Other Deferred Costs

12 Months Ended

Dec. 31, 2017

Text Block [Abstract]

Inventory and Other Deferred Costs

3. Inventory and Other Deferred Costs

Inventory and other deferred costs consists of the following:


	December 31, 2017		December 31, 2016
	(in thousands)
Raw materials	$	3,200	$	2,810
Work-in-process		3,745		2,489
Finished products		12,278		11,662
Other deferred costs		1,823		2,617

Total inventory and other deferred costs	$	21,046	$	19,578

We held inventory on consignment of $1.4 million and $1.1 million as of December 31, 2017 and 2016, respectively.

In connection with our recent acquisition of the RestoreFlow allograft business, other deferred costs include costs incurred for the preservation of human vascular tissues available for shipment, tissues currently in active processing, and tissues held in quarantine pending release to implantable status. By federal law, human tissues cannot be bought or sold. Therefore, the tissues we preserve are not held as inventory, and the costs we incur to procure and process vascular tissues are instead accumulated and deferred. These costs include fixed and variable overhead costs associated with the cryopreservation process, including primarily direct labor costs, tissue recovery fees, inbound freight charges, indirect materials and facilities costs. General and administrative expenses and selling expenses associated with the provision of these services are expensed as incurred.

Property and Equipment

12 Months Ended

Dec. 31, 2017

Property, Plant and Equipment [Abstract]

Property and Equipment

4. Property and Equipment

Property and equipment consists of the following:


	As of December 31,
	2017			2016
	(in thousands)
Computers and equipment	$	3,204		$	2,801
Machinery and equipment		12,223			10,331
Building and leasehold improvements		10,843			6,579

Gross property and equipment		26,270			19,711
Less accumulated depreciation		(13,892	)		(11,699	)

Property and equipment, net	$	12,378		$	8,012

Depreciation expense is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Depreciation expense	$	2,266	$	1,986	$	1,881

Goodwill and Other Intangibles

12 Months Ended

Dec. 31, 2017

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Other Intangibles

5. Goodwill and Other Intangibles

Goodwill consists of the following:


	As of December 31,
	2017		2016
Balance at beginning of year	$	23,426	$	17,789
Additions for acquisitions		—		5,660
Purchase accounting adjustments		257		—
Effects of currency exchange		161		(23	)

Balance at end of year	$	23,844	$	23,426

Other intangibles consist of the following:


	December 31, 2017						December 31, 2016
	Gross				Net		Gross				Net
	Carrying		Accumulated		Carrying		Carrying		Accumulated		Carrying
	Value		Amortization		Value		Value		Amortization		Value
	(in thousands)
Product technology and intellectual property	$	10,267	$	4,908	$	5,359	$	10,173	$	4,017	$	6,156
Trademarks, tradenames and licenses		1,948		1,468		480		1,939		1,359		580
Customer relationships		5,383		3,299		2,084		5,216		2,588		2,628
Other intangible assets		1,575		1,264		311		1,558		1,025		533

Total identifiable intangible assets	$	19,173	$	10,939	$	8,234	$	18,886	$	8,989	$	9,897

These assets are being amortized over useful lives ranging from 1 to 13 years. The weighted-average amortization period for these intangibles as of December 31, 2017, is 8.0 years. Amortization expense is included in general and administrative expense and is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Amortization expense	$	1,790	$	1,605	$	1,513

Estimated amortization expense for each of the five succeeding fiscal years, based upon the intangible assets at December 31, 2017, is as follows:


	Year ended December 31,
	2018		2019		2020		2021		2022
	(in thousands)
Amortization expense	$	1,593	$	1,394	$	1,132	$	929	$	713

- 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

Accrued Expenses and Other Long-term Liabilities

12 Months Ended

Dec. 31, 2017

Payables and Accruals [Abstract]

Accrued Expenses and Other Long-term Liabilities

6. Accrued Expenses and Other Long-term Liabilities

Accrued expenses consist of the following:


	December 31, 2017		December 31, 2016
	(in thousands)
Compensation and related taxes	$	6,494	$	6,124
Income and other taxes		703		312
Professional fees		35		122
Other		2,538		2,246

Total	$	9,770	$	8,804

Other long-term liabilities consist of the following:


	December 31, 2017		December 31, 2016
	(in thousands)
Aquisition-related liabilities	$	127	$	1,253
Deferred rent		561		394
Income taxes		321		200
Other		179		154

Total	$	1,188	$	2,001

Commitments and Contingencies

12 Months Ended

Dec. 31, 2017

Commitments and Contingencies Disclosure [Abstract]

Commitments and Contingencies

7. Commitments and Contingencies

Leases

We conduct the majority of our operations in leased facilities, which are accounted for as operating leases. Certain leases include renewal options. In addition, we lease automobiles and equipment under operating leases. There were no assets held under capital leases at December 31, 2017 and 2016.

Rent expense was as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Rent expense	$	2,190	$	1,580	$	1,506

At December 31, 2017, the minimum rental commitments under all non-cancelable operating leases with initial or remaining terms of more than one year, for each of the following fiscal years, are as follows:


			Less than		1-3		3-5		More than
Contractual obligations	Total		1 year		years		years		5 years
	(in thousands)
Operating leases	$	9,408	$	2,220	$	3,423	$	2,563	$	1,202

Purchase Commitments

As part of our normal course of business, we have purchase commitments to purchase $1.3 million of inventory through 2019. The purchase commitments for inventory are to be used in operations over the normal course of business and do not represent excess commitments or loss contracts.

Income Taxes

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Income Taxes

8. Income Taxes

Income (loss) before income taxes is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
United States	$	17,778	$	12,600	$	10,469
Foreign		3,328		3,642		955

Total	$	21,106	$	16,242	$	11,424

Certain of our foreign subsidiaries are included in the U.S. tax return as branches but are included as foreign for purposes of the table above.

The provision (benefit) for income taxes is as follows:


	Year ended December 31,
	2017			2016			2015
	(in thousands)
Current:
Federal	$	2,451		$	4,409		$	3,218
State		292			393			333
Foreign		886			710			499

		3,629			5,512			4,050
Deferred:
Federal		(268	)		197			(12	)
State		390			166			(466	)
Foreign		178			(223	)		94

		300			140			(384	)

Provision for income taxes	$	3,929		$	5,652		$	3,666

We have reviewed the tax positions taken, or to be taken, in our tax returns for all tax years currently open to examination by a taxing authority. As of December 31, 2017, the gross amount of unrecognized tax benefits exclusive of interest and penalties was $0.5 million, which may increase within the twelve months ending December 31, 2018. We remain subject to examination until the statute of limitations expires for each respective tax jurisdiction. The statute of limitations will be open with respect to these tax positions through 2025. A reconciliation of beginning and ending amount of our unrecognized tax benefits is as follows:


	2017			2016		2015
	(in thousands)
Unrecognized tax benefits at the beginning of year	$	390		$	82	$	23
Additions for tax positions of current year		83			95		—
Additions for tax positions of prior years		57			213		59
Reductions for settlements with taxing authorities.		—			—		—
Reductions for lapses of the applicable statutes of limitations		(5	)		—		—

Unrecognized tax benefits at the end of the year	$	525		$	390	$	82

Deferred taxes are attributable to the following temporary differences:


	As of December 31,
	2017			2016
	(in thousands)
Deferred tax assets:
Inventory	$	569		$	753
Net operating loss carryforwards		1,898			2,272
Tax credit carryforwards		760			491
Capital loss carryforwards		1,168			1,077
Reserves and accruals		629			655
Intangible assets		1,138			1,299
Stock options		322			585
Other		65			35

Total deferred tax assets		6,549			7,167
Deferred tax liabilities:
Property and equipment		(1,203	)		(571	)
Goodwill		(2,932	)		(3,956	)
Foreign branch deferred offset		(1,177	)		(1,374	)
Other		(44	)		(43	)

Total deferred tax liabilities		(5,356	)		(5,944	)

Net deferred tax assets before valuation allowance		1,193			1,223
Valuation allowance		(1,991	)		(1,765	)

Net deferred tax liabiltity	$	(798	)	$	(542	)

Deferred tax classification
Long-term deferred tax asset	$	1,378		$	1,399
Long-term deferred tax liability		(2,176	)		(1,941	)

Net long-term deferred tax liability	$	(798	)	$	(542	)

We elected to early adopt ASU 2016-09 during the third quarter of 2016. Consequently, we recorded excess tax benefits related to certain stock option exercises of $0.3 million and $3.7 million in 2016 and 2017 respectively. In 2015, these excess benefits were recorded to additional paid-in capital.

In 2015, we released approximately $0.4 million of valuation allowances on certain deferred assets associated with state research and development credits. In 2016, we released approximately $0.3 million of valuation allowances on deferred assets in Spain and Switzerland. In 2015 and 2016, our assessment considered evidence such as current profitability, utilization of certain available tax assets and liabilities, and projected future earnings. Based on this evidence, we concluded that it was more likely than not that we would generate sufficient pre-tax income in future periods to utilize all of these deferred tax assets for which the valuation allowance was removed. In 2017, we increased our valuation by a net $0.2 million mainly attributable to Massachusetts credit carryforwards.

As of December 31, 2017, we have provided a valuation allowance of $2.0 million for deferred tax assets primarily related to Australian net operating loss and capital loss carry forwards and Massachusetts tax credit carry forwards that are not expected to be realized. The valuation allowance against our deferred tax assets may require adjustment in the future based on changes in the mix of temporary differences, changes in tax laws, and operating performance.

Realization of our deferred tax assets is dependent on our generating sufficient taxable income in future periods. Although we believe it is more likely than not that future taxable income will be sufficient to allow us to recover substantially all of the value of our deferred tax assets remaining after we apply the valuation allowances, realization is not assured and future events could cause us to change our judgment. In the event that actual results differ from our estimates, or we adjust these estimates in the future periods, further adjustments to our valuation allowance may be recorded, which could materially impact our financial position and net income (loss) in the period of the adjustment.

As of December 31, 2017, we have net operating loss carryforwards in Australia of $2.3 million that do not expire, in France of $2.9 million that do not expire, in Spain of $1.1 million that do not expire, in Italy of $0.3 million that do not expire, in Sweden of $0.1 million that do not expire, in Norway of $0.1 million that do not expire and in Switzerland of $11,000 that begin to expire in 2021. We have a capital loss carryforward in Australia of $3.9 million that does not expire. We also have state tax credit carryforwards of approximately $1.3 million that are available to reduce future tax liabilities, which begin to expire in 2020, or can be carried forward indefinitely.

The Tax Cuts and Jobs Act (the Tax Act) was signed into law on December 22, 2017. The Tax Act changed many aspects of U.S. corporate income taxation and included reduction of the corporate income tax rate from 35% to 21%, implementation of a territorial tax system, and imposition of a tax on deemed repatriated earnings of foreign subsidiaries (the Transition Tax). Accounting for the income tax effects of the Tax Act which impact our current year tax provision has been estimated and included in our financial statements as of December 31, 2017. As a result, we recorded $0.6 million in tax expense related to the Transition Tax and recognized $1.0 million in tax benefit related to the remeasurement of deferred taxes to the 21% tax rate. In 2018, we may identify adjustments to our estimated tax provision while preparing the 2017 U.S. tax return, finalizing foreign earnings and profits calculations, or taking into account additional guidance issued by the IRS. Any such revisions will be treated in accordance with the measurement period guidance outlined in Staff Accounting Bulletin No. 118.

We historically reinvested all the undistributed earnings of our international subsidiaries. With the enactment of the Tax Act, our undistributed foreign earnings were subject to the Transition Tax. As a result, we recognized a one-time tax expense in the amount of $0.6 million. As of December 31, 2017, we had cash and cash equivalents of $19.1 million, of which $8.6 million was held by our international subsidiaries. We plan to keep these amounts permanently reinvested overseas. If these funds were repatriated, we would be required to accrue and pay additional U.S. tax (if any) and applicable non-U.S. taxes. It is not practicable to estimate the amount of deferred tax liability associated with the hypothetical repatriation of undistributed earnings.

A reconciliation of the Federal statutory rate to our effective tax rate is as follows:


	2017			2016			2015
Federal statutory rate		35.0	%		35.0	%		34.0	%
State tax, net of federal benefit		1.7	%		1.3	%		(2.1	%)
Effect of foreign taxes		(0.6	%)		(1.9	%)		1.4	%
Subpart F income		1.7	%		1.6	%		2.2	%
Valuation allowance		0.1	%		(2.6	%)		0.4	%
Foreign deferred tax liability offset		(0.2	%)		1.5	%		(0.9	%)
Manufacturing deduction		(1.5	%)		(2.5	%)		(2.8	%)
Research & development tax credits		(0.6	%)		(0.7	%)		(1.5	%)
Stock options exercises		(15.8	%)		(0.7	%)		0.6	%
Uncertain tax positions		0.6	%		2.0	%		0.6	%
Other permanent differences		1.0	%		1.2	%		1.3	%
Change in tax laws		2.9	%		0.0	%		0.0	%
Deferred tax remeasurement		(5.0	%)		0.0	%		0.0	%
Other		(0.7	%)		0.5	%		(1.1	%)

Effective tax rate		18.6	%		34.8	%		32.1	%

In 2016 the Internal Revenue Service completed an audit of our 2013 and 2014 U.S. federal tax returns. As a result of the audit we paid $0.2 million in additional federal income taxes. Additionally, the adjustment settled on for this audit resulted in an additional $0.2 million increase to our uncertain tax provisions for a state carryforward. We are not currently under audit in any other tax jurisdictions.

As of December 31, 2017, a summary of the tax years that remain subject to examination in our most significant tax jurisdictions are:


United States			2014 and forward
Foreign			2010 and forward

Stockholders' Equity

12 Months Ended

Dec. 31, 2017

Equity [Abstract]

Stockholders' Equity

9. Stockholders’ Equity

Authorized Shares

Our Certificate of Incorporation, as amended and restated from time to time, authorizes the issuance of up to 37,000,000 shares of common stock and up to 3,000,000 shares of undesignated preferred stock.

Under the terms of our certificate of incorporation, our board of directors is authorized to issue shares of the preferred stock in one or more series without stockholder approval. Our board of directors has the discretion to determine the rights, preferences, privileges and restrictions, including voting rights, dividend rights, conversion rights, redemption privileges and liquidation preferences, of each series of preferred stock. Currently, we have no shares of preferred stock outstanding.

Stock Award Plans

In May 2006 we approved a 2006 Stock Option and Incentive Plan (as subsequently amended, the 2006 Plan), which became effective upon our initial public offering. In 2010 we amended the 2006 Plan to increase the aggregate pool of available shares to 3,000,000 of common stock, and in 2015 the 2006 Plan was amended to increase the aggregate pool to 5,500,000 shares. The 2006 Plan allows for granting of incentive stock options, non-qualified stock options, stock appreciation rights, RSUs, unrestricted stock awards, and deferred stock awards to our officers, employees, directors, and consultants. Incentive stock options are required to be issued at not less than fair market value at the date of the grant and generally vest over four or five years. The term of the options is determined by our Board of Directors but in no event will exceed ten years from date of grant. In connection with the adoption of the 2006 Plan, no further option grants were permitted under any previous stock option plans and any expirations, cancellations, or terminations under the previous plans are available for issuance under the 2006 Plan. We may satisfy awards upon exercise of stock options or RSUs with either newly issued shares or treasury shares. The total number of shares currently authorized for the 2006 Plan is 7,118,003 shares, of which 1,506,797 remain available for grant as of December 31, 2017.

We have computed the fair value of employee stock options using the following weighted average assumptions:


	2017			2016			2015
Dividend yield		0.7	%		1.3	%		1.4	%
Volatility		39.1	%		34.5	%		28.6	%
Risk-free interest rate		2.2	%		1.2	%		1.8	%
Weighted average expected option term (in years)		4.6			5.5			5.6
Weighted average fair value per share of options granted	$	10.37		$	4.04		$	2.80
Aggregate intrinsic value of options exercised	$	13,086,167		$	2,391,154		$	6,534,800

A summary of option activity as of December 31, 2017 and the year then ended is presented below:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term		Aggregate Intrinsic Value
						(in years)
Balance outstanding at December 31, 2016 (1)		1,979,501		$	10.25		4.10	$	29,871,569
Granted		219,413		$	32.09
Exercised (2)		(635,503	)	$	8.65			$	13,086,167
Canceled / Expired		(27,129	)	$	11.91

Balance outstanding at December 31, 2017 (3)		1,536,282		$	13.86		4.15	$	27,771,635

Vested and exercisable at December 31, 2017 (4)		403,300		$	8.59		2.83	$	9,376,622
Expected to vest at December 31, 2017		1,132,982		$	15.74		4.62

Total		1,536,282

(1)	The aggregate intrinsic value represents the difference between the exercise price and $25.34, the closing price of our stock on December 31, 2016, for all in-the-money options outstanding.

(2)	The aggregate intrinsic value of shares exercised represents the difference between the exercise price and the closing price of our stock on the date of exercise.

(3)	The aggregate intrinsic value represents the difference between the exercise price and $31.84, the closing price of our stock on December 31, 2017, for all in-the-money options outstanding.

(4)	The aggregate intrinsic value represents the difference between the exercise price and $31.84, the closing price of our stock on December 31, 2017, for all in-the-money options vested and exercisable as of that date.

Restricted Stock Units

A summary of our RSU activity is as follows:


				Weighted
				Average
				Grant Date
	Shares			Fair Value
Balance outstanding at December 31, 2016		239,282		$	11.51
Granted		67,519		$	31.59
Vested (1)		(68,992	)	$	10.09
Canceled		(21,059	)	$	12.17

Balance outstanding at December 31, 2017		216,750		$	18.10

(1)	The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements.

The fair values of the RSUs that vested during 2017, 2016, and 2015 were $1.9 million, $0.8 million, and $0.7 million, respectively.

We repurchase shares of our common stock in order to cover any minimum tax withholding liability associated with RSU vestings. A summary of our repurchases is as follows:


	2017		2016
Shares of common stock repurchased		27,291		21,671
Average per share repurchase price	$	28.51	$	14.33
Aggregate purchase price (in thousands)	$	778	$	311

Stock-based Compensation

The components of stock-based compensation expense included in the consolidated statements of operations are as follows:


	2017		2016		2015
	(in thousands)
Stock option awards	$	1,612	$	1,116	$	992
Restricted stock units		644		564		432

Total stock-based compensation	$	2,256	$	1,680	$	1,424

Stock-based compensation is included in our statements of operations as follows:


	2017		2016		2015
	(in thousands)
Cost of sales	$	188	$	175	$	165
Sales and marketing		403		373		284
General and administrative		1,484		983		869
Research and development		181		149		106

Total stock-based compensation	$	2,256	$	1,680	$	1,424

General and administrative stock-based compensation expense for 2017 includes a charge of $0.5 million related to a stock option modification associated with the departure of our President of International Operations.

We expect to record the unamortized portion of share-based compensation expense of $8.3 million for existing stock options and RSUs outstanding at December 31, 2017, over a weighted-average period of 4.0 years.

Stock Repurchase Plan

On July 25, 2017, our Board of Directors approved a stock repurchase program under which the Company is authorized to repurchase up to $7.5 million of its common stock through transactions on the open market, in privately negotiated purchases or otherwise. This program may be suspended or discontinued at any time, and expires on the earlier of July 25, 2018 or when the authorized aggregate $7.5 million repurchase limit is reached. To date we have not made any repurchases under this program.

Dividends

In February 2011, our Board of Directors approved a policy for the payment of quarterly cash dividends on our common stock. Future declarations of quarterly dividends and the establishment of future record and payment dates are subject to approval by our Board of Directors on a quarterly basis. The dividend activity for the periods presented is as follows:


Record Date	Payment Date	Per Share Amount		Dividend Payment
				(in thousands)
Fiscal Year 2017
March 22, 2017	April 6, 2017	$	0.055	$	1,029
May 24, 2017	June 8, 2017	$	0.055	$	1,036
August 23, 2017	September 6, 2017	$	0.055	$	1,055
November 22, 2017	December 7, 2017	$	0.055	$	1,060

Fiscal Year 2016
March 21, 2016	April 4, 2016	$	0.045	$	825
May 25, 2016	June 8, 2016	$	0.045	$	829
August 22,2016	September 2, 2016	$	0.045	$	833
November 21, 2016	December 5, 2016	$	0.045	$	836

On February 15, 2018, our Board of Directors approved a quarterly cash dividend on our common stock of $0.07 per share payable on April 5, 2018, to stockholders of record at the close of business on March 22, 2018, which will total approximately $1.4 million in payments.

Profit-Sharing Plan	12 Months Ended
Profit-Sharing Plan	Dec. 31, 2017
Postemployment Benefits [Abstract]
Profit-Sharing Plan	10. Profit-Sharing Plan We offer a 401(k) profit-sharing plan (the Plan) covering eligible U.S. employees to make tax deferred contributions, a portion of which are matched by us. We may make discretionary profit sharing contributions to the Plan in an amount determined by our Board of Directors. Our contributions vest ratably over six years of employment and amounted to approximately $0.2 million, $0.1 million and $50,000 for 2017, 2016 and 2015, respectively.

Segment and Enterprise-wide Disclosures

12 Months Ended

Dec. 31, 2017

Segment Reporting [Abstract]

Segment and Enterprise-wide Disclosures

11. Segment and Enterprise-wide Disclosures

The FASB establishes standards for reporting information regarding operating segments in financial statements. Operating segments are identified as components of an enterprise that engage in business activities for which separate, discrete financial information is available and is regularly reviewed by the chief operating decision-maker in making decisions on how to allocate resources and assess performance. We view our operations and manage our business as one operating segment. No discrete operating information is prepared by us except for sales by product line and operations by legal entity for local reporting purposes.

Most of our revenues are generated in the United States, Germany, and other European countries, Canada, the United Kingdom and Japan, and substantially all of our assets are located in the United States. Net sales to unaffiliated customers by country were as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
United States	$	58,470	$	50,439	$	45,177
Germany		11,576		10,350		9,090
Other countries		30,821		28,362		24,085

Net sales	$	100,867	$	89,151	$	78,352

Total property and equipment held by geography were as follows:


	As of December 31,
	2017		2016
	(in thousands)
United States	$	10,275	$	6,116
Australia		1,639		1,535
Germany		369		279
Other countries		95		82

Total property and equipment	$	12,378	$	8,012

Supplemental Cash Flow Information

12 Months Ended

Dec. 31, 2017

Supplemental Cash Flow Elements [Abstract]

Supplemental Cash Flow Information

12. Supplemental Cash Flow Information

Supplemental disclosures of cash flow information are as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Cash paid for income taxes, net	$	3,146	$	4,231	$	4,792

Fair Value Measurements

12 Months Ended

Dec. 31, 2017

Fair Value Disclosures [Abstract]

Fair Value Measurements

13. Fair Value Measurements

The fair value accounting guidance requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories:

•

Level 1 — Quoted prices in active markets for identical assets or liabilities.

•

Level 2 — Observable inputs other than quoted prices included in Level 1, such as quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar assets and liabilities in markets that are not active; or other inputs that are observable or can be corroborated by observable market data.

•

Level 3 — Unobservable inputs that are supported by little or no market activity and that are significant to the fair value of the assets or liabilities. This includes certain pricing models, discounted cash flow methodologies and similar techniques that use significant unobservable inputs.

Level 1 assets being measured at fair value on a recurring basis as of December 31, 2017 included our short-term investment mutual fund account.

We had no Level 2 assets being measured at fair value on a recurring basis as of December 31, 2017.

As discussed in Notes 1 and 2, several of our acquisition-related assets and liabilities were measured using Level 3 techniques. During 2016, we recorded contingent liabilities associated with our acquisitions of the RestoreFlow allograft and ProCol biologic graft businesses. In the case of the Restore Flow allograft acquisition, the agreement included the potential for us to pay up to $5.1 million of additional consideration, with $1.1 million contingent on the continued employment by LeMaitre of certain retained employees, and another $4.0 million contingent on the achievement of specified levels of revenues in the first 12 and 24 months following the acquisition date. This additional consideration was initially valued in total at $1.0 million and is being re-measured each reporting period until the payment requirement ends, with any adjustments reported in income from operations. The amount attributable to the first 12 months of revenue following the acquisition date was not paid as the associated revenue metric was not achieved. In the case of ProCol, additional consideration is payable to the former shareholders for a three-year period following the closing, calculated at 10% of ProCol revenues. This additional consideration was initially valued at $0.3 million and is being re-measured each reporting period until the payment requirement ends, with any adjustments reported in income from operations. These arrangements are described more fully in Note 2. The following table provides a rollforward of the fair value of these liabilities, as determined by Level 3 unobservable inputs including management’s forecast of future revenues for these acquired businesses, as well as, in the case of the Restore Flow allograft acquisition, management’s estimate of the likelihood of continued employment of certain retained employees.


	Year ended December 31,
	2017			2016
	(in thousands)
Beginning balance	$	1,320		$	—
Additions		—			1,301
Payments		(126	)		(68	)
Change in fair value included in earnings		106			87

Ending balance	$	1,300		$	1,320

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Quarterly Financial Data (unaudited)

12 Months Ended

Dec. 31, 2017

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data (unaudited)

14. Quarterly Financial Data (unaudited)


	Three months ended
2017	March 31		June 30		September 30		December 31
	(in thousands, except per share data)
Total net sales	$	24,139	$	25,753	$	24,822	$	26,153
Gross profit		17,353		17,516		17,577		18,251
Income (loss) from operations		4,193		5,536		5,053		6,321
Net income		3,219		4,632		5,042		4,284
Earnings per share
Basic	$	0.17	$	0.25	$	0.26	$	0.22
Diluted	$	0.16	$	0.23	$	0.25	$	0.21

	Three months ended
2016	March 31		June 30		September 30		December 31
	(in thousands, except per share data)
Total net sales	$	20,258	$	22,389	$	23,216	$	23,288
Gross profit		14,356		15,367		17,019		16,194
Income (loss) from operations		3,300		3,783		5,344		3,909
Net income (loss)		2,166		2,598		3,229		2,597
Earnings per share
Basic	$	0.12	$	0.14	$	0.17	$	0.14
Diluted	$	0.11	$	0.14	$	0.17	$	0.13

Accumulated Other Comprehensive Income (Loss)

12 Months Ended

Dec. 31, 2017

Equity [Abstract]

Accumulated Other Comprehensive Income (Loss)

15. Accumulated Other Comprehensive Income (Loss)


	Year ended December 31,
	2017			2016			2015
	(in thousands)
Beginning balance	$	(4,583	)	$	(4,049	)	$	(2,365	)
Other comprehensive income (loss) before reclassifications		2,294			(534	)		(1,684	)
Amounts reclassified from accumulated other comprehensive loss		—			—			—

Ending Balance	$	(2,289	)	$	(4,583	)	$	(4,049	)

Changes to our accumulated other comprehensive loss consisted primarily of foreign currency translation for the years ended December 31, 2017, 2016 and 2015

Significant Accounting Policies and Related Matters (Policies)

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Description of Business

Description of Business

Consolidation and Basis of Presentation

Consolidation and Basis of Presentation

Foreign Currency Translation

Foreign Currency Translation

Estimates

Estimates

Revenue Recognition

Revenue Recognition

Research and Development Expense

Research and Development Expense

Shipping and Handling Costs

Shipping and Handling Costs

Shipping and handling fees paid by customers are recorded within net sales, with the related expense recorded in cost of sales.

Advertising Costs

Advertising Costs

Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Advertising expense	$	305	$	378	$	428

Cash and Cash Equivalents

Cash and Cash Equivalents

Short-term Marketable Securities

Short-term Marketable Securities

Our short-term marketable securities are available-for-sale securities carried at fair value, with unrealized gains and losses recorded in other comprehensive income.

Concentrations of Credit Risk

Concentrations of Credit Risk


	Balance at Beginning of Period		Additions (recoveries) charged to Income		Deductions from Reserves		Balance at End of Period
	(in thousands)
Allowance for doubtful accounts and sales returns:
Year ended December 31, 2017	$	258	$	230	$	139		349
Year ended December 31, 2016		243		105		90		258
Year ended December 31, 2015		242		182		181		243

Fair Value of Financial Instruments

Fair Value of Financial Instruments

Inventory and Other Deferred Costs

Inventory and Other Deferred Costs

Property and Equipment

Property and Equipment

Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows:


Description		Useful Life
Computers and equipment		3–5 years
Machinery and equipment		3–10 years
Leasehold improvements		The shorter of its useful life or lease term

Valuation of Business Combinations

Valuation of Business Combinations

Contingent Consideration

Contingent Consideration

Contingent consideration for acquisitions is recognized at the date of acquisition, based on the fair value at that date, and then re-measured periodically through adjustments to net income.

Impairment of Long-lived Assets

Impairment of Long-lived Assets

Goodwill

Goodwill

Other Intangible Assets

Other Intangible Assets

Stock-Based Compensation

Stock-based Compensation

Commitments and Contingencies

Commitments and Contingencies

Income Taxes

Income Taxes

Our policy is to classify interest and penalties related to unrecognized tax benefits as income tax expense.

Comprehensive Income

Comprehensive Income

Accumulated other comprehensive loss consisted primarily of foreign currency translation adjustment losses of $2.3 million and $4.6 million as of December 31, 2017 and 2016, respectively.

Restructuring

Restructuring

Earnings per Share

Earnings per Share

The computation of basic and diluted net income per share is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands, except per share data)
Basic:
Net income available for common stockholders	$	17,177	$	10,590	$	7,758

Weighted average shares outstanding		18,961		18,485		17,764

Basic earnings per share	$	0.91	$	0.57	$	0.44

Diluted:
Net income available for common stockholders	$	17,177	$	10,590	$	7,758

Weighted-average shares outstanding		18,961		18,485		17,764
Common stock equivalents, if dilutive		1,072		756		552

Shares used in computing diluted earnings per common share		20,033		19,241		18,316

Diluted earnings per share	$	0.86	$	0.55	$	0.42

Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive		6		45		55

Recent Accounting Pronouncements

Recent Accounting Pronouncements

Segment Reporting

Fair Value Measurement

The fair value accounting guidance requires that assets and liabilities carried at fair value be classified and disclosed in one of the following three categories:

•

Level 1 — Quoted prices in active markets for identical assets or liabilities.

•

Significant Accounting Policies and Related Matters (Tables)

12 Months Ended

Dec. 31, 2017

Accounting Policies [Abstract]

Summary of Advertising Costs

Advertising Costs

Advertising costs are expensed as incurred and are included as a component of sales and marketing expense in the accompanying consolidated statements of operations. Advertising costs are as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Advertising expense	$	305	$	378	$	428

Summary of Allowance for Doubtful Accounts and Sales Returns

The following is a summary of our allowance for doubtful accounts and sales returns:


	Balance at Beginning of Period		Additions (recoveries) charged to Income		Deductions from Reserves		Balance at End of Period
	(in thousands)
Allowance for doubtful accounts and sales returns:
Year ended December 31, 2017	$	258	$	230	$	139		349
Year ended December 31, 2016		243		105		90		258
Year ended December 31, 2015		242		182		181		243

Summary of Property and Equipment

Property and equipment are recorded at cost. Depreciation is provided over the estimated useful lives of the related assets using straight-line method as follows:


Description		Useful Life
Computers and equipment		3–5 years
Machinery and equipment		3–10 years
Leasehold improvements		The shorter of its useful life or lease term

Computation of Basic and Diluted Net Income per Share

The computation of basic and diluted net income per share is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands, except per share data)
Basic:
Net income available for common stockholders	$	17,177	$	10,590	$	7,758

Weighted average shares outstanding		18,961		18,485		17,764

Basic earnings per share	$	0.91	$	0.57	$	0.44

Diluted:
Net income available for common stockholders	$	17,177	$	10,590	$	7,758

Weighted-average shares outstanding		18,961		18,485		17,764
Common stock equivalents, if dilutive		1,072		756		552

Shares used in computing diluted earnings per common share		20,033		19,241		18,316

Diluted earnings per share	$	0.86	$	0.55	$	0.42

Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive		6		45		55

Acquisitions and Divestitures (Tables)

12 Months Ended

Dec. 31, 2017

Restore Flow Allografts [Member]

Summary of Purchase Price Allocation

The following table summarizes the purchase price allocation as of December 31, 2017:


	Allocated
	Fair Value
	(in thousands)
Accounts receivable	$	394
Deferred cryopreservation costs		2,583
Equipment and supplies		125
Accounts payable		(286	)
Intangible assets		4,544
Goodwill		5,599

Purchase price	$	12,959

Acquired Intangible Assets and Related Estimated Useful Lives

The following table reflects the allocation of the acquired intangible assets and related estimated useful lives:


			Weighted
	Allocated		Average
	Fair Value		Useful Life
	(in thousands)
Non-compete agreements	$	180		5.0 years
Tradename		271		9.0 years
Procurement contracts		617		9.0 years
Technology		2,793		10.5 years
Customer relationships		683		12.5 years

Total intangible assets	$	4,544

ProCol Biologic Graft [Member]

Summary of Purchase Price Allocation

The following table summarizes the purchase price allocation as of December 31, 2017:


	Allocated
	Fair Value
	(in thousands)
Inventory	$	2,080
Manufacturing equipment and supplies		25
Intangible assets		620
Goodwill		318

Purchase price	$	3,043

Acquired Intangible Assets and Related Estimated Useful Lives

The following table reflects the allocation of the acquired intangible assets and related estimated useful lives:


			Weighted
	Allocated		Average
	Fair Value		Useful Life
	(in thousands)
Non-compete agreement	$	84		5.0 years
Tradename		109		9.5 years
Technology		277		9.0 years
Customer relationships		150		9.0 years

Total intangible assets	$	620

Tru-Incise Valvulotome [Member]

Summary of Purchase Price Allocation

The following table summarizes the purchase price allocation at the date of the acquisition:


	Allocated Fair Value
	(in thousands)
Inventory	$	88
Intangible assets		545
Goodwill		742

Purchase price	$	1,375

Acquired Intangible Assets and Related Estimated Useful Lives

The following table reflects the allocation of the acquired intangible assets and related estimated useful lives:


	Allocated Fair Value		Weighted Average Useful Life
	(in thousands)
Non-compete agreement	$	120		5.0 years
Tradename license		17		3.0 years
Technology		391		7.0 years
Customer relationships		17		3.0 years

Total intangible assets	$	545

Inventory and Other Deferred Costs (Tables)

12 Months Ended

Dec. 31, 2017

Text Block [Abstract]

Summary of Inventory and Other Deferred Costs

Inventory and other deferred costs consists of the following:


	December 31, 2017		December 31, 2016
	(in thousands)
Raw materials	$	3,200	$	2,810
Work-in-process		3,745		2,489
Finished products		12,278		11,662
Other deferred costs		1,823		2,617

Total inventory and other deferred costs	$	21,046	$	19,578

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2017

Property, Plant and Equipment [Abstract]

Summary of Property and Equipment

Property and equipment consists of the following:


	As of December 31,
	2017			2016
	(in thousands)
Computers and equipment	$	3,204		$	2,801
Machinery and equipment		12,223			10,331
Building and leasehold improvements		10,843			6,579

Gross property and equipment		26,270			19,711
Less accumulated depreciation		(13,892	)		(11,699	)

Property and equipment, net	$	12,378		$	8,012

Depreciation Expense

Depreciation expense is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Depreciation expense	$	2,266	$	1,986	$	1,881

Goodwill and Other Intangibles (Tables)

12 Months Ended

Dec. 31, 2017

Goodwill and Intangible Assets Disclosure [Abstract]

Schedule of Goodwill

Goodwill consists of the following:


	As of December 31,
	2017		2016
Balance at beginning of year	$	23,426	$	17,789
Additions for acquisitions		—		5,660
Purchase accounting adjustments		257		—
Effects of currency exchange		161		(23	)

Balance at end of year	$	23,844	$	23,426

Components of Identifiable Intangible Assets

Other intangibles consist of the following:


	December 31, 2017						December 31, 2016
	Gross				Net		Gross				Net
	Carrying		Accumulated		Carrying		Carrying		Accumulated		Carrying
	Value		Amortization		Value		Value		Amortization		Value
	(in thousands)
Product technology and intellectual property	$	10,267	$	4,908	$	5,359	$	10,173	$	4,017	$	6,156
Trademarks, tradenames and licenses		1,948		1,468		480		1,939		1,359		580
Customer relationships		5,383		3,299		2,084		5,216		2,588		2,628
Other intangible assets		1,575		1,264		311		1,558		1,025		533

Total identifiable intangible assets	$	19,173	$	10,939	$	8,234	$	18,886	$	8,989	$	9,897

Amortization Expense Included in General and Administrative Expense

Amortization expense is included in general and administrative expense and is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Amortization expense	$	1,790	$	1,605	$	1,513

Estimated Amortization Expense for Each of Five Succeeding Fiscal Years

Estimated amortization expense for each of the five succeeding fiscal years, based upon the intangible assets at December 31, 2017, is as follows:


	Year ended December 31,
	2018		2019		2020		2021		2022
	(in thousands)
Amortization expense	$	1,593	$	1,394	$	1,132	$	929	$	713

Accrued Expenses and Other Long-term Liabilities (Tables)

12 Months Ended

Dec. 31, 2017

Payables and Accruals [Abstract]

Accrued Expenses

Accrued expenses consist of the following:


	December 31, 2017		December 31, 2016
	(in thousands)
Compensation and related taxes	$	6,494	$	6,124
Income and other taxes		703		312
Professional fees		35		122
Other		2,538		2,246

Total	$	9,770	$	8,804

Schedule of Other Long-term Liabilities

Other long-term liabilities consist of the following:


	December 31, 2017		December 31, 2016
	(in thousands)
Aquisition-related liabilities	$	127	$	1,253
Deferred rent		561		394
Income taxes		321		200
Other		179		154

Total	$	1,188	$	2,001

Commitments and Contingencies (Tables)

12 Months Ended

Dec. 31, 2017

Commitments and Contingencies Disclosure [Abstract]

Summary of Rent Expenses

Rent expense was as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Rent expense	$	2,190	$	1,580	$	1,506

Minimum Rental Commitments Under All Non-Cancelable Operating Leases With Initial or Remaining Terms of More Than One Year


			Less than		1-3		3-5		More than
Contractual obligations	Total		1 year		years		years		5 years
	(in thousands)
Operating leases	$	9,408	$	2,220	$	3,423	$	2,563	$	1,202

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2017

Income Tax Disclosure [Abstract]

Income (Loss) Before Income Taxes

Income (loss) before income taxes is as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
United States	$	17,778	$	12,600	$	10,469
Foreign		3,328		3,642		955

Total	$	21,106	$	16,242	$	11,424

The Provision (Benefit) for Income Taxes

The provision (benefit) for income taxes is as follows:


	Year ended December 31,
	2017			2016			2015
	(in thousands)
Current:
Federal	$	2,451		$	4,409		$	3,218
State		292			393			333
Foreign		886			710			499

		3,629			5,512			4,050
Deferred:
Federal		(268	)		197			(12	)
State		390			166			(466	)
Foreign		178			(223	)		94

		300			140			(384	)

Provision for income taxes	$	3,929		$	5,652		$	3,666

Reconciliation of Beginning and Ending Amount of Unrecognized Tax Benefits

A reconciliation of beginning and ending amount of our unrecognized tax benefits is as follows:


	2017			2016		2015
	(in thousands)
Unrecognized tax benefits at the beginning of year	$	390		$	82	$	23
Additions for tax positions of current year		83			95		—
Additions for tax positions of prior years		57			213		59
Reductions for settlements with taxing authorities.		—			—		—
Reductions for lapses of the applicable statutes of limitations		(5	)		—		—

Unrecognized tax benefits at the end of the year	$	525		$	390	$	82

Deferred Taxes

Deferred taxes are attributable to the following temporary differences:


	As of December 31,
	2017			2016
	(in thousands)
Deferred tax assets:
Inventory	$	569		$	753
Net operating loss carryforwards		1,898			2,272
Tax credit carryforwards		760			491
Capital loss carryforwards		1,168			1,077
Reserves and accruals		629			655
Intangible assets		1,138			1,299
Stock options		322			585
Other		65			35

Total deferred tax assets		6,549			7,167
Deferred tax liabilities:
Property and equipment		(1,203	)		(571	)
Goodwill		(2,932	)		(3,956	)
Foreign branch deferred offset		(1,177	)		(1,374	)
Other		(44	)		(43	)

Total deferred tax liabilities		(5,356	)		(5,944	)

Net deferred tax assets before valuation allowance		1,193			1,223
Valuation allowance		(1,991	)		(1,765	)

Net deferred tax liabiltity	$	(798	)	$	(542	)

Deferred tax classification
Long-term deferred tax asset	$	1,378		$	1,399
Long-term deferred tax liability		(2,176	)		(1,941	)

Net long-term deferred tax liability	$	(798	)	$	(542	)

Reconciliation of the Federal Statutory Rate to Effective Tax Rate

A reconciliation of the Federal statutory rate to our effective tax rate is as follows:


	2017			2016			2015
Federal statutory rate		35.0	%		35.0	%		34.0	%
State tax, net of federal benefit		1.7	%		1.3	%		(2.1	%)
Effect of foreign taxes		(0.6	%)		(1.9	%)		1.4	%
Subpart F income		1.7	%		1.6	%		2.2	%
Valuation allowance		0.1	%		(2.6	%)		0.4	%
Foreign deferred tax liability offset		(0.2	%)		1.5	%		(0.9	%)
Manufacturing deduction		(1.5	%)		(2.5	%)		(2.8	%)
Research & development tax credits		(0.6	%)		(0.7	%)		(1.5	%)
Stock options exercises		(15.8	%)		(0.7	%)		0.6	%
Uncertain tax positions		0.6	%		2.0	%		0.6	%
Other permanent differences		1.0	%		1.2	%		1.3	%
Change in tax laws		2.9	%		0.0	%		0.0	%
Deferred tax remeasurement		(5.0	%)		0.0	%		0.0	%
Other		(0.7	%)		0.5	%		(1.1	%)

Effective tax rate		18.6	%		34.8	%		32.1	%

Summary of Tax Years Subject to Examination in Most Significant Tax Jurisdictions

As of December 31, 2017, a summary of the tax years that remain subject to examination in our most significant tax jurisdictions are:


United States			2014 and forward
Foreign			2010 and forward

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2017

Equity [Abstract]

Fair Value of Employee Stock Options Using Weighted Average Assumptions

We have computed the fair value of employee stock options using the following weighted average assumptions:


	2017			2016			2015
Dividend yield		0.7	%		1.3	%		1.4	%
Volatility		39.1	%		34.5	%		28.6	%
Risk-free interest rate		2.2	%		1.2	%		1.8	%
Weighted average expected option term (in years)		4.6			5.5			5.6
Weighted average fair value per share of options granted	$	10.37		$	4.04		$	2.80
Aggregate intrinsic value of options exercised	$	13,086,167		$	2,391,154		$	6,534,800

Summary of Option Activity

A summary of option activity as of December 31, 2017 and the year then ended is presented below:


	Number of Shares			Weighted Average Exercise Price		Weighted Average Remaining Contractual Term		Aggregate Intrinsic Value
						(in years)
Balance outstanding at December 31, 2016 (1)		1,979,501		$	10.25		4.10	$	29,871,569
Granted		219,413		$	32.09
Exercised (2)		(635,503	)	$	8.65			$	13,086,167
Canceled / Expired		(27,129	)	$	11.91

Balance outstanding at December 31, 2017 (3)		1,536,282		$	13.86		4.15	$	27,771,635

Vested and exercisable at December 31, 2017 (4)		403,300		$	8.59		2.83	$	9,376,622
Expected to vest at December 31, 2017		1,132,982		$	15.74		4.62

Total		1,536,282

(1)	The aggregate intrinsic value represents the difference between the exercise price and $25.34, the closing price of our stock on December 31, 2016, for all in-the-money options outstanding.

(2)	The aggregate intrinsic value of shares exercised represents the difference between the exercise price and the closing price of our stock on the date of exercise.

(3)	The aggregate intrinsic value represents the difference between the exercise price and $31.84, the closing price of our stock on December 31, 2017, for all in-the-money options outstanding.

(4)	The aggregate intrinsic value represents the difference between the exercise price and $31.84, the closing price of our stock on December 31, 2017, for all in-the-money options vested and exercisable as of that date.

Summary of RSU Activity

A summary of our RSU activity is as follows:


				Weighted
				Average
				Grant Date
	Shares			Fair Value
Balance outstanding at December 31, 2016		239,282		$	11.51
Granted		67,519		$	31.59
Vested (1)		(68,992	)	$	10.09
Canceled		(21,059	)	$	12.17

Balance outstanding at December 31, 2017		216,750		$	18.10

(1)	The number of RSUs vested includes the shares that we withheld on behalf of employees to satisfy minimum statutory tax withholding requirements.

Summary of Repurchases

A summary of our repurchases is as follows:


	2017		2016
Shares of common stock repurchased		27,291		21,671
Average per share repurchase price	$	28.51	$	14.33
Aggregate purchase price (in thousands)	$	778	$	311

Share-Based Compensation Expense

The components of stock-based compensation expense included in the consolidated statements of operations are as follows:


	2017		2016		2015
	(in thousands)
Stock option awards	$	1,612	$	1,116	$	992
Restricted stock units		644		564		432

Total stock-based compensation	$	2,256	$	1,680	$	1,424

Schedule of Stock-based Compensation

Stock-based compensation is included in our statements of operations as follows:


	2017		2016		2015
	(in thousands)
Cost of sales	$	188	$	175	$	165
Sales and marketing		403		373		284
General and administrative		1,484		983		869
Research and development		181		149		106

Total stock-based compensation	$	2,256	$	1,680	$	1,424

Dividend Activity

The dividend activity for the periods presented is as follows:


Record Date	Payment Date	Per Share Amount		Dividend Payment
				(in thousands)
Fiscal Year 2017
March 22, 2017	April 6, 2017	$	0.055	$	1,029
May 24, 2017	June 8, 2017	$	0.055	$	1,036
August 23, 2017	September 6, 2017	$	0.055	$	1,055
November 22, 2017	December 7, 2017	$	0.055	$	1,060

Fiscal Year 2016
March 21, 2016	April 4, 2016	$	0.045	$	825
May 25, 2016	June 8, 2016	$	0.045	$	829
August 22,2016	September 2, 2016	$	0.045	$	833
November 21, 2016	December 5, 2016	$	0.045	$	836

Segment and Enterprise-wide Disclosures (Tables)

12 Months Ended

Dec. 31, 2017

Segment Reporting [Abstract]

Net Sales to Unaffiliated Customers by Geography

Net sales to unaffiliated customers by country were as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
United States	$	58,470	$	50,439	$	45,177
Germany		11,576		10,350		9,090
Other countries		30,821		28,362		24,085

Net sales	$	100,867	$	89,151	$	78,352

Total Property and Equipment Held by Geography

Total property and equipment held by geography were as follows:


	As of December 31,
	2017		2016
	(in thousands)
United States	$	10,275	$	6,116
Australia		1,639		1,535
Germany		369		279
Other countries		95		82

Total property and equipment	$	12,378	$	8,012

Supplemental Cash Flow Information (Tables)

12 Months Ended

Dec. 31, 2017

Supplemental Cash Flow Elements [Abstract]

Supplemental Cash Flow Information

Supplemental disclosures of cash flow information are as follows:


	Year ended December 31,
	2017		2016		2015
	(in thousands)
Cash paid for income taxes, net	$	3,146	$	4,231	$	4,792

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2017

Fair Value Disclosures [Abstract]

Rollforward of the Fair Value as Determined by Level 3

The following table provides a rollforward of the fair value of these liabilities, as determined by Level 3 unobservable inputs including management’s forecast of future revenues for these acquired businesses, as well as, in the case of the Restore Flow allograft acquisition, management’s estimate of the likelihood of continued employment of certain retained employees.


	Year ended December 31,
	2017			2016
	(in thousands)
Beginning balance	$	1,320		$	—
Additions		—			1,301
Payments		(126	)		(68	)
Change in fair value included in earnings		106			87

Ending balance	$	1,300		$	1,320

Quarterly Financial Data (unaudited) (Tables)

12 Months Ended

Dec. 31, 2017

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Data (Unaudited)


	Three months ended
2017	March 31		June 30		September 30		December 31
	(in thousands, except per share data)
Total net sales	$	24,139	$	25,753	$	24,822	$	26,153
Gross profit		17,353		17,516		17,577		18,251
Income (loss) from operations		4,193		5,536		5,053		6,321
Net income		3,219		4,632		5,042		4,284
Earnings per share
Basic	$	0.17	$	0.25	$	0.26	$	0.22
Diluted	$	0.16	$	0.23	$	0.25	$	0.21

	Three months ended
2016	March 31		June 30		September 30		December 31
	(in thousands, except per share data)
Total net sales	$	20,258	$	22,389	$	23,216	$	23,288
Gross profit		14,356		15,367		17,019		16,194
Income (loss) from operations		3,300		3,783		5,344		3,909
Net income (loss)		2,166		2,598		3,229		2,597
Earnings per share
Basic	$	0.12	$	0.14	$	0.17	$	0.14
Diluted	$	0.11	$	0.14	$	0.17	$	0.13

Accumulated Other Comprehensive Income (Loss) (Tables)

12 Months Ended

Dec. 31, 2017

Equity [Abstract]

Summary of Accumulated Other Comprehensive Income (Loss)


	Year ended December 31,
	2017			2016			2015
	(in thousands)
Beginning balance	$	(4,583	)	$	(4,049	)	$	(2,365	)
Other comprehensive income (loss) before reclassifications		2,294			(534	)		(1,684	)
Amounts reclassified from accumulated other comprehensive loss		—			—			—

Ending Balance	$	(2,289	)	$	(4,583	)	$	(4,049	)

Significant Accounting Policies and Related Matters - Additional Information (Detail) - USD ($)	3 Months Ended	12 Months Ended
	Sep. 30, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Concentration Risk [Line Items]
Remaining prior period of expiration for return of product		18 months
Remaining prior period of expiration for return of product for hospital customers		12 months
Maximum number of days for product return of shipment		30 days
Cash and cash equivalents with maturity dates		90 days
Accounts receivable		$ 15,000,000	$ 13,191,000
Percentage of goodwill impairment		50.00%
Impairment charges of goodwill		$ 0	0	$ 0
Retained earnings, net of tax	$ 100,000		72,000
Reclassification out of comprehensive income		0	0
Accumulated other comprehensive loss foreign currency translation adjustment losses		$ 2,300,000	$ 4,600,000
Commitment to a termination or exit plan		12 months
Foreign Deposits [Member]
Concentration Risk [Line Items]
Cash balances held outside United States		$ 11,800,000
Maximum [Member]
Concentration Risk [Line Items]
Cash balances insured by the FDCIC		$ 250,000
Intangible assets useful lives		13 years
Minimum [Member]
Concentration Risk [Line Items]
Intangible assets useful lives		1 year
United States [Member] \| Maximum [Member]
Concentration Risk [Line Items]
Accounts receivable due period		90 days
United States [Member] \| Minimum [Member]
Concentration Risk [Line Items]
Accounts receivable due period		30 days
Europe [Member] \| Maximum [Member]
Concentration Risk [Line Items]
Accounts receivable due period		240 days
Europe [Member] \| Minimum [Member]
Concentration Risk [Line Items]
Accounts receivable due period		90 days
Italy [Member]
Concentration Risk [Line Items]
Accounts receivable		$ 1,100,000
Spain [Member]
Concentration Risk [Line Items]
Accounts receivable		$ 600,000

Significant Accounting Policies and Related Matters - Summary of Advertising Costs (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Accounting Policies [Abstract]
Advertising expense	$ 305	$ 378	$ 428

Significant Accounting Policies and Related Matters - Summary of Allowance for Doubtful Accounts and Sales Returns (Detail) - Allowance for Doubtful Accounts and Sales Returns [Member] - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Valuation and Qualifying Accounts Disclosure [Line Items]
Balance at Beginning of Period	$ 258	$ 243	$ 242
Additions (recoveries) charged to Income	230	105	182
Deductions from Reserves	139	90	181
Balance at End of Period	$ 349	$ 258	$ 243

Significant Accounting Policies and Related Matters - Summary of Property and Equipment (Detail)	12 Months Ended
	Dec. 31, 2017
Computers and Equipment [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Useful Life	5 years
Computers and Equipment [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Useful Life	3 years
Machinery and Equipment [Member] \| Maximum [Member]
Property, Plant and Equipment [Line Items]
Useful Life	10 years
Machinery and Equipment [Member] \| Minimum [Member]
Property, Plant and Equipment [Line Items]
Useful Life	3 years
Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Estimated useful life	The shorter of its useful life or lease term

Significant Accounting Policies and Related Matters - Computation of Basic and Diluted Net Income per Share (Detail) - USD ($) $ / shares in Units, shares in Thousands, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Basic:
Net income available for common stockholders	$ 4,284	$ 5,042	$ 4,632	$ 3,219	$ 2,597	$ 3,229	$ 2,598	$ 2,166	$ 17,177	$ 10,590	$ 7,758
Weighted average shares outstanding									18,961	18,485	17,764
Basic earnings per share	$ 0.22	$ 0.26	$ 0.25	$ 0.17	$ 0.14	$ 0.17	$ 0.14	$ 0.12	$ 0.91	$ 0.57	$ 0.44
Diluted:
Net income available for common stockholders	$ 4,284	$ 5,042	$ 4,632	$ 3,219	$ 2,597	$ 3,229	$ 2,598	$ 2,166	$ 17,177	$ 10,590	$ 7,758
Weighted-average shares outstanding									18,961	18,485	17,764
Common stock equivalents, if dilutive									1,072	756	552
Shares used in computing diluted earnings per common share									20,033	19,241	18,316
Diluted earnings per share	$ 0.21	$ 0.25	$ 0.23	$ 0.16	$ 0.13	$ 0.17	$ 0.14	$ 0.11	$ 0.86	$ 0.55	$ 0.42
Shares excluded in computing diluted earnings per share as those shares would be anti-dilutive									6	45	55

Acquisitions and Divestitures - Restore Flow Allografts - Additional Information (Detail) - USD ($)		3 Months Ended								12 Months Ended
	Nov. 10, 2016	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Business Acquisition [Line Items]
Fair value adjustments to contingent consideration obligations										$ 106,000
Net revenue		$ 26,153,000	$ 24,822,000	$ 25,753,000	$ 24,139,000	$ 23,288,000	$ 23,216,000	$ 22,389,000	$ 20,258,000	$ 100,867,000	$ 89,151,000	$ 78,352,000
Weighted average useful life										8 years
Restore Flow Allografts [Member]
Business Acquisition [Line Items]
Initial purchase price	$ 12,000,000
Acquisition-related contingent consideration	$ 900,000
Additional payment description										The first payment of $2 million is due not later than 15 days following the expiration of the 18 month period following the closing date, subject to reductions as specified in the agreement for each calendar month that certain retained employees are not employed by us due to resignation without good reason, or termination for cause, both as defined in the agreement. The portion of this payment that will be paid to retained employees and that is contingent on their continued employment, estimated at $0.9 million, will be accounted for as post-combination compensation expense rather than purchase consideration. The remaining $1.1 million that is payable to non-employee investors but that is also contingent on the continued employment of certain retained employees has been accounted for as contingent consideration, at an acquisition-date fair value of $0.9 million. This valuation reflects management’s assessment of the likelihood that the retained employees will remain employed by us, discounted at a rate of 6.1% to account for risk inherent in the probability estimate as well as for the time value of money between acquisition date and the payment date. There are also two potential earn-out payments under the agreement. The first earn-out is calculated at 50% of the amount by which net revenue in the first 12 months following the closing exceeds $6 million, with such payout not to exceed $2 million. The second earn-out is calculated at 50% of the amount by which net revenue in the second 12 months following the closing exceeds $9 million, with such payout not to exceed $2 million.
Fair value inputs, discount rate	6.10%
Fair value adjustments to contingent consideration obligations										$ 100,000
Estimated weighted average cost of capital	14.10%
Maximum goodwill deductible for tax purposes										15 years
Weighted average useful life										10 years 3 months 18 days
Restore Flow Allografts [Member] \| Non-employee Investors [Member]
Business Acquisition [Line Items]
Acquisition-related contingent consideration	$ 1,100,000
Acquisition-date fair value	900,000
Restore Flow Allografts [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Acquisition-related contingent consideration	6,000,000
Contingency One [Member] \| Restore Flow Allografts [Member]
Business Acquisition [Line Items]
Acquisition-related contingent consideration	2,000,000
Earn - Outs Payment One [Member] \| Restore Flow Allografts [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Acquisition-related contingent consideration	2,000,000
Earn - Outs Payment One [Member] \| Restore Flow Allografts [Member] \| Minimum [Member]
Business Acquisition [Line Items]
Net revenue	6,000,000
Earn - Outs Payment Two [Member] \| Restore Flow Allografts [Member] \| Maximum [Member]
Business Acquisition [Line Items]
Acquisition-related contingent consideration	2,000,000
Earn - Outs Payment Two [Member] \| Restore Flow Allografts [Member] \| Minimum [Member]
Business Acquisition [Line Items]
Net revenue	9,000,000
Combined Earn-out Payment [Member] \| Restore Flow Allografts [Member]
Business Acquisition [Line Items]
Acquisition-date fair value	$ 100,000

Acquisitions and Divestitures - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016	Mar. 18, 2016	Dec. 31, 2015	May 31, 2015
Business Acquisition [Line Items]
Goodwill	$ 23,844	$ 23,426		$ 17,789
Restore Flow Allografts [Member]
Business Acquisition [Line Items]
Accounts receivable	394
Deferred cryopreservation costs	2,583
Manufacturing equipment and supplies	125
Accounts payable	(286)
Intangible assets	4,544
Goodwill	5,599
Purchase price	12,959
ProCol Biologic Graft [Member]
Business Acquisition [Line Items]
Inventory	2,080
Manufacturing equipment and supplies	25
Intangible assets	620		$ 620
Goodwill	318
Purchase price	$ 3,043
Tru-Incise Valvulotome [Member]
Business Acquisition [Line Items]
Inventory					$ 88
Intangible assets					545
Goodwill					742
Purchase price					$ 1,375

Acquisitions and Divestitures - Acquired Intangible Assets and Related Estimated Useful Lives (Detail) - USD ($) $ in Thousands		1 Months Ended	12 Months Ended
	Mar. 18, 2016	May 31, 2015	Dec. 31, 2017
Business Acquisition [Line Items]
Weighted average useful life			8 years
Restore Flow Allografts [Member]
Business Acquisition [Line Items]
Allocated fair value			$ 4,544
Weighted average useful life			10 years 3 months 18 days
Restore Flow Allografts [Member] \| Non-Compete Agreement [Member]
Business Acquisition [Line Items]
Allocated fair value			$ 180
Weighted average useful life			5 years
Restore Flow Allografts [Member] \| Trade Name [Member]
Business Acquisition [Line Items]
Allocated fair value			$ 271
Weighted average useful life			9 years
Restore Flow Allografts [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Allocated fair value			$ 683
Weighted average useful life			12 years 6 months
Restore Flow Allografts [Member] \| Procurement Contracts [Member]
Business Acquisition [Line Items]
Allocated fair value			$ 617
Weighted average useful life			9 years
Restore Flow Allografts [Member] \| Technology [Member]
Business Acquisition [Line Items]
Allocated fair value			$ 2,793
Weighted average useful life			10 years 6 months
ProCol Biologic Graft [Member]
Business Acquisition [Line Items]
Allocated fair value	$ 620		$ 620
Weighted average useful life			8 years 7 months 6 days
ProCol Biologic Graft [Member] \| Non-Compete Agreement [Member]
Business Acquisition [Line Items]
Allocated fair value	$ 84
Weighted average useful life	5 years
ProCol Biologic Graft [Member] \| Trade Name [Member]
Business Acquisition [Line Items]
Allocated fair value	$ 109
Weighted average useful life	9 years 6 months
ProCol Biologic Graft [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Allocated fair value	$ 150
Weighted average useful life	9 years
ProCol Biologic Graft [Member] \| Technology [Member]
Business Acquisition [Line Items]
Allocated fair value	$ 277
Weighted average useful life	9 years
Tru-Incise Valvulotome [Member]
Business Acquisition [Line Items]
Allocated fair value		$ 545
Tru-Incise Valvulotome [Member] \| Non-Compete Agreement [Member]
Business Acquisition [Line Items]
Allocated fair value		$ 120
Weighted average useful life		5 years
Tru-Incise Valvulotome [Member] \| Customer Relationships [Member]
Business Acquisition [Line Items]
Allocated fair value		$ 17
Weighted average useful life		3 years
Tru-Incise Valvulotome [Member] \| Tradename License [Member]
Business Acquisition [Line Items]
Allocated fair value		$ 17
Weighted average useful life		3 years
Tru-Incise Valvulotome [Member] \| Technology [Member]
Business Acquisition [Line Items]
Allocated fair value		$ 391
Weighted average useful life		7 years

Acquisitions and Divestitures - ProCol Biologic Graft - Additional Information (Detail) - USD ($) $ in Millions		12 Months Ended
	Mar. 18, 2016	Dec. 31, 2017	Mar. 31, 2017	Sep. 30, 2016
Business Acquisition [Line Items]
Weighted average useful life		8 years
ProCol Biologic Graft [Member]
Business Acquisition [Line Items]
Purchase price for acquisition of assets and rights	$ 2.7
Business combination, finished goods inventory and other related assets acquired	2.0
Business combination, other assets acquired	$ 0.7
Business combination consideration calculated, percentage of revenues	10.00%
Additional consideration initial value	$ 0.3
Payment made for assets purchased, percentage	50.00%		25.00%	25.00%
Maximum goodwill deductible for tax purposes	15 years
Weighted average useful life		8 years 7 months 6 days

Acquisitions and Divestitures - Tru-Incise Valvulotome - Additional Information (Detail) - Tru-Incise Valvulotome [Member] - USD ($) $ in Millions	1 Months Ended	12 Months Ended
	May 31, 2015	Dec. 31, 2017	Dec. 31, 2016
Business Acquisition [Line Items]
Purchase price for acquisition of assets and rights	$ 1.4
Cash paid for assets purchased	$ 1.1	$ 0.1	$ 0.2
Acquisition date of assets and rights		May 31, 2015
Maximum goodwill deductible for tax purposes	15 years

Acquisitions and Divestitures - Other 2015 Items - Additional Information (Detail) $ in Millions	1 Months Ended		12 Months Ended
	Aug. 31, 2015 USD ($)	May 31, 2015 USD ($) Agreement	Dec. 31, 2017
Business Acquisition [Line Items]
Weighted average useful life			8 years
Grex Medical Oy [Member]
Business Acquisition [Line Items]
Purchase price for acquisition of assets and rights	$ 0.2
Acquisition date of assets and rights			Jan. 01, 2016
UreSil, LLC, Distributors [Member]
Business Acquisition [Line Items]
Number of definitive agreements \| Agreement		7
Intangible assets		$ 0.2
Weighted average useful life			3 years
Purchase price for acquisition of assets and rights		$ 0.2

Acquisitions and Divestitures - The UnBalloon Divestiture - Additional Information (Detail) - USD ($) $ in Thousands	1 Months Ended	3 Months Ended	12 Months Ended
	Jul. 31, 2015	Sep. 30, 2015	Dec. 31, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Gain on divestiture			$ 360
Non-Occlusive Modeling Catheter Divestiture [Member]]
Business Acquisition [Line Items]
Impairment charges				$ 200
Charge to cost of sales				$ 300
Merit Medical Ireland Limited [Member]
Business Acquisition [Line Items]
Asset sales agreement amount	$ 400
Gain on divestiture		$ 400

Inventory and Other Deferred Costs - Summary of Inventory and Other Deferred Costs (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Inventory Disclosure [Abstract]
Raw materials	$ 3,200	$ 2,810
Work-in-process	3,745	2,489
Finished products	12,278	11,662
Other deferred costs	1,823	2,617
Total inventory and other deferred costs	$ 21,046	$ 19,578

Inventory and Other Deferred Costs - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2017	Dec. 31, 2016
Inventory Disclosure [Abstract]
Inventory on consignment	$ 1.4	$ 1.1

Property and Equipment - Summary of Property and Equipment (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Gross property and equipment	$ 26,270	$ 19,711
Less accumulated depreciation	(13,892)	(11,699)
Property and equipment, net	12,378	8,012
Computers and Equipment [Member]
Property, Plant and Equipment [Line Items]
Gross property and equipment	3,204	2,801
Machinery and Equipment [Member]
Property, Plant and Equipment [Line Items]
Gross property and equipment	12,223	10,331
Building and Leasehold Improvements [Member]
Property, Plant and Equipment [Line Items]
Gross property and equipment	$ 10,843	$ 6,579

Property and Equipment - Depreciation Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 2,266	$ 1,986	$ 1,881

Goodwill and Other Intangibles - Schedule of Goodwill (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Goodwill and Intangible Assets Disclosure [Abstract]
Balance at beginning of year	$ 23,426	$ 17,789
Additions for acquisitions		5,660
Purchase accounting adjustments	257
Effects of currency exchange	161	(23)
Balance at end of year	$ 23,844	$ 23,426

Goodwill and Other Intangibles - Components of Identifiable Intangible Assets (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	$ 19,173	$ 18,886
Accumulated Amortization	10,939	8,989
Net Carrying Value of Intangible Assets	8,234	9,897
Product Technology and Intellectual Property [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	10,267	10,173
Accumulated Amortization	4,908	4,017
Net Carrying Value of Intangible Assets	5,359	6,156
Trademarks, Tradenames and Licenses [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	1,948	1,939
Accumulated Amortization	1,468	1,359
Net Carrying Value of Intangible Assets	480	580
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	5,383	5,216
Accumulated Amortization	3,299	2,588
Net Carrying Value of Intangible Assets	2,084	2,628
Other Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Gross Carrying Value	1,575	1,558
Accumulated Amortization	1,264	1,025
Net Carrying Value of Intangible Assets	$ 311	$ 533

Goodwill and Other Intangibles - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Weighted-average amortization period for intangibles	8 years
Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible assets useful lives	13 years
Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Intangible assets useful lives	1 year

Goodwill and Other Intangibles - Amortization Expense Included in General and Administrative Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 1,790	$ 1,605	$ 1,513

Goodwill and Other Intangibles - Estimated Amortization Expense for Each of Five Succeeding Fiscal Years (Detail) $ in Thousands	Dec. 31, 2017 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense, Fiscal Year 2018	$ 1,593
Amortization expense, Fiscal Year 2019	1,394
Amortization expense, Fiscal Year 2020	1,132
Amortization expense, Fiscal Year 2021	929
Amortization expense, Fiscal Year 2022	$ 713

Accrued Expenses and Other Long-term Liabilities - Accrued Expenses (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Payables and Accruals [Abstract]
Compensation and related taxes	$ 6,494	$ 6,124
Income and other taxes	703	312
Professional fees	35	122
Other	2,538	2,246
Total	$ 9,770	$ 8,804

Accrued Expenses and Other Long-term Liabilities - Schedule of Other Long-term Liabilities (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Other Liabilities, Noncurrent [Abstract]
Aquisition-related liabilities	$ 127	$ 1,253
Deferred rent	561	394
Income taxes	321	200
Other	179	154
Total	$ 1,188	$ 2,001

Commitments and Contingencies - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Loss Contingencies [Line Items]
Commitments to purchase inventory	$ 1,300,000
Purchase commitments inventory expire year	2019
Assets Held under Capital Leases [Member]
Loss Contingencies [Line Items]
Assets held under capital leases	$ 0	$ 0

Commitments and Contingencies - Summary of Rent Expenses (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Commitments and Contingencies Disclosure [Abstract]
Rent expense	$ 2,190	$ 1,580	$ 1,506

Commitments and Contingencies - Minimum Rental Commitments Under All Non-Cancelable Operating Leases with Initial or Remaining Terms of More Than One Year (Detail) $ in Thousands	Dec. 31, 2017 USD ($)
Commitments and Contingencies Disclosure [Abstract]
Operating leases, Total	$ 9,408
Operating leases, Less than 1 year	2,220
Operating leases, 1-3 years	3,423
Operating leases, 3-5 years	2,563
Operating leases, More than 5 years	$ 1,202

Income Taxes - Income (Loss) Before Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
United States	$ 17,778	$ 12,600	$ 10,469
Foreign	3,328	3,642	955
Total	$ 21,106	$ 16,242	$ 11,424

Income Taxes - The Provision (Benefit) for Income Taxes (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Current:
Federal	$ 2,451	$ 4,409	$ 3,218
State	292	393	333
Foreign	886	710	499
Current, Total	3,629	5,512	4,050
Deferred:
Federal	(268)	197	(12)
State	390	166	(466)
Foreign	178	(223)	94
Deferred, Total	300	140	(384)
Provision for income taxes	$ 3,929	$ 5,652	$ 3,666

Income Taxes - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Tax Examination [Line Items]
Unrecognized tax benefits exclusive of interest and penalties, gross		$ 525,000	$ 390,000	$ 82,000	$ 23,000
Statute of limitations expiration period		2025
Excess tax benefits		$ 3,929,000	5,652,000	$ 3,666,000
Valuation allowances		1,991,000	1,765,000
Net operating loss carryforwards		1,898,000	2,272,000
Capital loss carryforward		$ 1,168,000	$ 1,077,000
Corporate income tax rate		35.00%	35.00%	34.00%
2017 Tax Act, one-time transition tax expense		$ 600,000
2017 Tax Act, remeasurement of deferred taxes, tax benefit		1,000,000
Cash and cash equivalents		19,096,000	$ 24,288,000	$ 27,451,000	$ 18,692,000
Scenario, Forecast [Member]
Income Tax Examination [Line Items]
Corporate income tax rate	21.00%
ASU 2016-09 [Member]
Income Tax Examination [Line Items]
Excess tax benefits		(3,700,000)	(300,000)
Domestic Tax Authority [Member] \| Internal Revenue Service (IRS) [Member]
Income Tax Examination [Line Items]
Additional income taxes paid and adjustment settled			200,000
State [Member]
Income Tax Examination [Line Items]
Tax credit carryforwards			$ 1,300,000
State tax credit carryforwards, expiration date			2020
State [Member] \| Internal Revenue Service (IRS) [Member]
Income Tax Examination [Line Items]
Additional income taxes paid and adjustment settled			$ 200,000
State [Member] \| Massachusetts [Member] \| Tax Credit Carryforwards [Member]
Income Tax Examination [Line Items]
Increase (decrease) in valuation allowance		200,000
State [Member] \| Research and Development Credits [Member] \| Deferred Tax Assets [Member]
Income Tax Examination [Line Items]
Increase (decrease) in valuation allowance				$ (400,000)
Foreign [Member] \| Spain and Switzerland [Member] \| Deferred Tax Assets [Member]
Income Tax Examination [Line Items]
Increase (decrease) in valuation allowance			(300,000)
Foreign [Member] \| Australia [Member]
Income Tax Examination [Line Items]
Net operating loss carryforwards			2,300,000
Capital loss carryforward			3,900,000
Foreign [Member] \| France [Member]
Income Tax Examination [Line Items]
Net operating loss carryforwards			2,900,000
Foreign [Member] \| Spain [Member]
Income Tax Examination [Line Items]
Net operating loss carryforwards			1,100,000
Foreign [Member] \| Italy [Member]
Income Tax Examination [Line Items]
Net operating loss carryforwards			300,000
Foreign [Member] \| Sweden [Member]
Income Tax Examination [Line Items]
Net operating loss carryforwards			100,000
Foreign [Member] \| Switzerland [Member]
Income Tax Examination [Line Items]
Net operating loss carryforwards			$ 11,000
Net operating loss carryforwards, Expiration date			2021
Foreign [Member] \| Norway [Member]
Income Tax Examination [Line Items]
Net operating loss carryforwards			$ 100,000
Subsidiaries [Member] \| International [Member]
Income Tax Examination [Line Items]
Cash and cash equivalents		$ 8,600,000

Income Taxes - Reconciliation of Beginning and Ending Amount of Unrecognized Tax Benefits (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Unrecognized tax benefits at the beginning of year	$ 390	$ 82	$ 23
Additions for tax positions of current year	83	95
Additions for tax positions of prior years	57	213	59
Reductions for settlements with taxing authorities	0
Reductions for lapses of the applicable statutes of limitations	(5)
Unrecognized tax benefits at the end of the year	$ 525	$ 390	$ 82

Income Taxes - Deferred Taxes (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Deferred tax assets:
Inventory	$ 569	$ 753
Net operating loss carryforwards	1,898	2,272
Tax credit carryforwards	760	491
Capital loss carryforwards	1,168	1,077
Reserves and accruals	629	655
Intangible assets	1,138	1,299
Stock options	322	585
Other	65	35
Total deferred tax assets	6,549	7,167
Deferred tax liabilities:
Property and equipment	(1,203)	(571)
Goodwill	(2,932)	(3,956)
Foreign branch deferred offset	(1,177)	(1,374)
Other	(44)	(43)
Total deferred tax liabilities	(5,356)	(5,944)
Net deferred tax assets before valuation allowance	1,193	1,223
Valuation allowance	(1,991)	(1,765)
Net deferred tax liability	(798)	(542)
Deferred tax classification
Long-term deferred tax asset	1,378	1,399
Long-term deferred tax liability	(2,176)	(1,941)
Net long-term deferred tax liability	$ (798)	$ (542)

Income Taxes - Reconciliation of the Federal Statutory Rate to Effective Tax Rate (Detail)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Income Tax Disclosure [Abstract]
Federal statutory rate	35.00%	35.00%	34.00%
State tax, net of federal benefit	1.70%	1.30%	(2.10%)
Effect of foreign taxes	(0.60%)	(1.90%)	1.40%
Subpart F income	1.70%	1.60%	2.20%
Valuation allowance	0.10%	(2.60%)	0.40%
Foreign deferred tax liability offset	(0.20%)	1.50%	(0.90%)
Manufacturing deduction	(1.50%)	(2.50%)	(2.80%)
Research & development tax credits	(0.60%)	(0.70%)	(1.50%)
Stock options exercises	(15.80%)	(0.70%)	0.60%
Uncertain tax positions	0.60%	2.00%	0.60%
Other permanent differences	1.00%	1.20%	1.30%
Change in tax laws	2.90%	0.00%	0.00%
Deferred tax remeasurement	(5.00%)	0.00%	0.00%
Other	(0.70%)	0.50%	(1.10%)
Effective tax rate	18.60%	34.80%	32.10%

Income Taxes - Summary of Tax Years Subject to Examination in Most Significant Tax Jurisdictions (Detail)	12 Months Ended
	Dec. 31, 2017
United States [Member]
Income Tax Examination [Line Items]
Income tax year under examination	2014 and forward
Foreign [Member]
Income Tax Examination [Line Items]
Income tax year under examination	2010 and forward

Stockholders' Equity - Additional Information (Detail) - USD ($)		12 Months Ended
	Feb. 15, 2018	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2010	Jul. 25, 2016
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Common stock, shares authorized		37,000,000	37,000,000
Preferred stock, shares authorized		3,000,000	3,000,000
Preferred stock, shares outstanding		0	0
Aggregate purchase price				5,500,000	3,000,000
Total number of shares currently authorized for stock award plans		7,118,003
Number of shares remain available for grant		1,506,797
Expected term		Not exceed ten years
Further option grants		$ 0
Fair values of RSUs, vested		1,900,000	$ 800,000	$ 700,000
Total stock-based compensation		2,256,000	$ 1,680,000	$ 1,424,000
Unamortized portion of share-based compensation expense		$ 8,300,000
RSUs outstanding over a weighted-average period		4 years
Cash dividend on common stock per share		$ 0.22	$ 0.18	$ 0.16
General and Administrative [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Total stock-based compensation		$ 1,484,000	$ 983,000	$ 869,000
General and Administrative [Member] \| President [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Total stock-based compensation		$ 500,000
Installment 1 FY 2018 [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Dividend payment date		Apr. 05, 2018
Dividend record date		Mar. 22, 2018
Installment 1 FY 2018 [Member] \| Subsequent Event [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Cash dividend on common stock per share	$ 0.07
Dividend Payment	$ 1,400,000
Maximum [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Common stock, shares authorized		37,000,000
Preferred stock, shares authorized		3,000,000
Incentive stock options vest		5 years
Minimum [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Incentive stock options vest		4 years
Stock Repurchase Program [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Stock repurchase program expiration date		Jul. 25, 2017
Stock repurchase program, Description		This program may be suspended or discontinued at any time, and expires on the earlier of July 25, 2017 or when the authorized aggregate $5.0 million repurchase limit is reached.
Share repurchases		0
Stock Repurchase Program [Member] \| Maximum [Member] \| Common Stock [Member]
Business Acquisition, Equity Interests Issued or Issuable [Line Items]
Repurchase of common stock						$ 7,500,000

Stockholders' Equity - Fair Value of Employee Stock Options Using Weighted Average Assumptions (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Equity [Abstract]
Dividend yield	0.70%	1.30%	1.40%
Volatility	39.10%	34.50%	28.60%
Risk-free interest rate	2.20%	1.20%	1.80%
Weighted average expected option term (in years)	4 years 7 months 6 days	5 years 6 months	5 years 7 months 6 days
Weighted average fair value per share of options granted	$ 10.37	$ 4.04	$ 2.80
Aggregate intrinsic value of options exercised	$ 13,086,167	$ 2,391,154	$ 6,534,800

Stockholders' Equity - Summary of Option Activity (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Equity [Abstract]
Number of Shares, Balance outstanding at beginning	1,979,501
Number of Shares, Granted	219,413
Number of Shares, Exercised	(635,503)
Number of Shares, Canceled / Expired	(27,129)
Number of Shares, Balance outstanding at ending	1,536,282	1,979,501
Number of Shares, Vested and exercisable	403,300
Number of Shares, Expected to vest	1,132,982
Number of Shares, Total	1,536,282
Weighted Average Exercise Price, Balance outstanding at beginning	$ 10.25
Weighted Average Exercise Price, Granted	32.09
Weighted Average Exercise Price, Exercised	8.65
Weighted Average Exercise Price, Canceled / Expired	11.91
Weighted Average Exercise Price, Balance outstanding at ending	13.86	$ 10.25
Weighted Average Exercise Price, Vested and exercisable	8.59
Weighted Average Exercise Price, Expected to vest	$ 15.74
Weighted Average Remaining Contractual Term	4 years 1 month 6 days	4 years 1 month 24 days
Weighted Average Remaining Contractual Term, Vested and exercisable	2 years 9 months 29 days
Weighted Average Remaining Contractual Term, Expected to vest	4 years 7 months 13 days
Aggregate Intrinsic Value, Beginning Balance outstanding	$ 29,871,569
Aggregate Intrinsic Value, Exercised	13,086,167	$ 2,391,154	$ 6,534,800
Aggregate Intrinsic Value, Ending Balance outstanding	27,771,635	$ 29,871,569
Aggregate Intrinsic Value, Vested and exercisable	$ 9,376,622

Stockholders' Equity - Summary of Option Activity (Parenthetical) (Detail) - $ / shares	Dec. 31, 2017	Dec. 31, 2016
Equity [Abstract]
Closing price of stock	$ 31.84	$ 25.34

Stockholders' Equity - Summary of RSU Activity (Detail)	12 Months Ended
Stockholders' Equity - Summary of RSU Activity (Detail)	Dec. 31, 2017 $ / shares shares
Equity [Abstract]
Balance outstanding at the beginning, Shares \| shares	239,282
Shares Granted \| shares	67,519
Shares Vested \| shares	(68,992)
Shares Canceled \| shares	(21,059)
Balance outstanding at the ending, shares \| shares	216,750
Weighted Average Granted Date Fair Value, Beginning Balance \| $ / shares	$ 11.51
Weighted Average Granted Date Fair Value, Granted \| $ / shares	31.59
Weighted Average Granted Date Fair Value, Vested \| $ / shares	10.09
Weighted Average Granted Date Fair Value, Canceled \| $ / shares	12.17
Weighted Average Granted Date Fair Value, Ending Balance \| $ / shares	$ 18.10

Stockholders' Equity - Summary of Repurchases (Detail) - Restricted Stock Units [Member] - USD ($) $ / shares in Units, $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares of common stock repurchased	27,291	21,671
Average per share repurchase price	$ 28.51	$ 14.33
Aggregate purchase price (in thousands)	$ 778	$ 311

Stockholders' Equity - Share-Based Compensation Expense (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Schedule of Trading Securities and Other Trading Assets [Line Items]
Total stock-based compensation	$ 2,256	$ 1,680	$ 1,424
Stock Option Awards [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Total stock-based compensation	1,612	1,116	992
Restricted Stock Units [Member]
Schedule of Trading Securities and Other Trading Assets [Line Items]
Total stock-based compensation	$ 644	$ 564	$ 432

Stockholders' Equity - Schedule of Stock-based Compensation (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	$ 2,256	$ 1,680	$ 1,424
Cost of Sales [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	188	175	165
Sales and Marketing [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	403	373	284
General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	1,484	983	869
Research and Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total stock-based compensation	$ 181	$ 149	$ 106

Stockholders' Equity - Dividend Activity (Detail) - USD ($) $ / shares in Units, $ in Thousands	1 Months Ended	12 Months Ended
	Feb. 28, 2011	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015	Dec. 07, 2017	Sep. 06, 2017	Jun. 08, 2017	Apr. 06, 2017	Dec. 05, 2016	Sep. 02, 2016	Jun. 08, 2016	Apr. 04, 2016
Dividends Payable [Line Items]
Per Share Amount		$ 0.22	$ 0.18	$ 0.16
Installment 1 FY 2017 [Member]
Dividends Payable [Line Items]
Record Date		Mar. 22, 2017
Payment Date		Apr. 06, 2017
Per Share Amount	$ 0.055
Dividend Payment								$ 1,029
Installment 2 FY 2017 [Member]
Dividends Payable [Line Items]
Record Date		May 24, 2017
Payment Date		Aug. 06, 2017
Per Share Amount	0.055
Dividend Payment							$ 1,036
Installment 3 FY 2017 [Member]
Dividends Payable [Line Items]
Record Date		Aug. 23, 2017
Payment Date		Jun. 09, 2017
Per Share Amount	0.055
Dividend Payment						$ 1,055
Installment 4 FY 2017 [Member]
Dividends Payable [Line Items]
Record Date		Nov. 22, 2017
Payment Date		Jul. 12, 2017
Per Share Amount	0.055
Dividend Payment					$ 1,060
Installment 1 FY 2016 [Member]
Dividends Payable [Line Items]
Record Date		Mar. 21, 2016
Payment Date		Apr. 04, 2016
Per Share Amount	0.045
Dividend Payment												$ 825
Installment 2 FY 2016 [Member]
Dividends Payable [Line Items]
Record Date		May 25, 2016
Payment Date		Jun. 08, 2016
Per Share Amount	0.045
Dividend Payment											$ 829
Installment 3 FY 2016 [Member]
Dividends Payable [Line Items]
Record Date		Aug. 22, 2016
Payment Date		Sep. 02, 2016
Per Share Amount	0.045
Dividend Payment										$ 833
Installment 4 FY 2016 [Member]
Dividends Payable [Line Items]
Record Date		Nov. 21, 2016
Payment Date		Dec. 05, 2016
Per Share Amount	$ 0.045
Dividend Payment									$ 836

Profit-Sharing Plan - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Deferred Compensation Arrangement with Individual, Excluding Share-based Payments and Postretirement Benefits [Line Items]
Vesting period of contributions	6 years
Deferred Profit Sharing [Member]
Deferred Compensation Arrangement with Individual, Excluding Share-based Payments and Postretirement Benefits [Line Items]
Contribution amount	$ 200,000	$ 100,000	$ 50,000

Segment and Enterprise-wide Disclosures - Additional Information (Detail)	12 Months Ended
	Dec. 31, 2017 Segment
Segment Reporting [Abstract]
Number of operating segments	1

Segment and Enterprise-wide Disclosures - Net Sales to Unaffiliated Customers by Geography (Detail) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Net sales	$ 26,153	$ 24,822	$ 25,753	$ 24,139	$ 23,288	$ 23,216	$ 22,389	$ 20,258	$ 100,867	$ 89,151	$ 78,352
United States [Member]
Segment Reporting Information [Line Items]
Net sales									58,470	50,439	45,177
Germany [Member]
Segment Reporting Information [Line Items]
Net sales									11,576	10,350	9,090
Other Countries [Member]
Segment Reporting Information [Line Items]
Net sales									$ 30,821	$ 28,362	$ 24,085

Segment and Enterprise-wide Disclosures - Total Property and Equipment Held by Geography (Detail) - USD ($) $ in Thousands	Dec. 31, 2017	Dec. 31, 2016
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 12,378	$ 8,012
United States [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	10,275	6,116
Australia [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	1,639	1,535
Germany [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	369	279
Other Countries [Member]
Property, Plant and Equipment [Line Items]
Total property and equipment	$ 95	$ 82

Supplemental Cash Flow Information - Supplemental Cash Flow Information (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Supplemental Cash Flow Elements [Abstract]
Cash paid for income taxes, net	$ 3,146	$ 4,231	$ 4,792

Fair Value Measurements - Additional Information (Detail) - USD ($)	Mar. 18, 2016	Dec. 31, 2017	Nov. 10, 2016
Restore Flow Allografts [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Acquisition-related contingent consideration			$ 900,000
Restore Flow Allografts [Member] \| Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Acquisition-related contingent consideration			6,000,000
Restore Flow Allografts [Member] \| Non-employee Investors [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Acquisition-related contingent consideration			1,100,000
Acquisition-date fair value			900,000
ProCol Biologic Graft [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business combination consideration calculated, percentage of revenues	10.00%
Additional consideration initial value	$ 300,000
Level 2 [Member] \| Recurring [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets measured at fair value		$ 0
Fair Value, Inputs, Level 3 [Member] \| Restore Flow Allografts [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Acquisition-date fair value			1,000,000
Fair Value, Inputs, Level 3 [Member] \| Restore Flow Allografts [Member] \| Earn Out Payment [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Acquisition-related contingent consideration			4,000,000
Fair Value, Inputs, Level 3 [Member] \| Restore Flow Allografts [Member] \| Maximum [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Acquisition-related contingent consideration			5,100,000
Fair Value, Inputs, Level 3 [Member] \| Restore Flow Allografts [Member] \| Non-employee Investors [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Acquisition-related contingent consideration			$ 1,100,000
Fair Value, Inputs, Level 3 [Member] \| ProCol Biologic Graft [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business combination consideration calculated, percentage of revenues	10.00%
Additional consideration initial value	$ 300,000

Fair Value Measurements - Rollforward of the Fair Value as Determined by Level 3 (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016
Fair Value Disclosures [Abstract]
Beginning balance	$ 1,320
Additions		$ 1,301
Payments	(126)	(68)
Change in fair value included in earnings	106	87
Ending balance	$ 1,300	$ 1,320

Quarterly Financial Data (unaudited) - Quarterly Financial Data (Unaudited) (Detail) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2017	Sep. 30, 2017	Jun. 30, 2017	Mar. 31, 2017	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Quarterly Financial Information Disclosure [Abstract]
Total net sales	$ 26,153	$ 24,822	$ 25,753	$ 24,139	$ 23,288	$ 23,216	$ 22,389	$ 20,258	$ 100,867	$ 89,151	$ 78,352
Gross profit	18,251	17,577	17,516	17,353	16,194	17,019	15,367	14,356	70,697	62,936	54,166
Income (loss) from operations	6,321	5,053	5,536	4,193	3,909	5,344	3,783	3,300	21,103	16,336	11,513
Net income (loss)	$ 4,284	$ 5,042	$ 4,632	$ 3,219	$ 2,597	$ 3,229	$ 2,598	$ 2,166	$ 17,177	$ 10,590	$ 7,758
Basic:
Basic	$ 0.22	$ 0.26	$ 0.25	$ 0.17	$ 0.14	$ 0.17	$ 0.14	$ 0.12	$ 0.91	$ 0.57	$ 0.44
Diluted	$ 0.21	$ 0.25	$ 0.23	$ 0.16	$ 0.13	$ 0.17	$ 0.14	$ 0.11	$ 0.86	$ 0.55	$ 0.42

Accumulated Other Comprehensive Loss - Summary of Accumulated Other Comprehensive Loss (Detail) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2017	Dec. 31, 2016	Dec. 31, 2015
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	$ 87,500	$ 77,884	$ 68,207
Ending Balance	109,770	87,500	77,884
Accumulated Other Comprehensive Income (Loss) [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	(4,583)	(4,049)	(2,365)
Other comprehensive income (loss) before reclassifications	2,294	(534)	(1,684)
Amounts reclassified from accumulated other comprehensive loss	0	0	0
Ending Balance	$ (2,289)	$ (4,583)	$ (4,049)