Welcome!DePuy Orthopaedics Community

Education Seminar

Thank you for joining us! We hope today’s information will help you on a path to reducing your pain and gaining mobility.

This informational presentation about knee pain and treatment options will be followed by a

question-and-answer session.

Today’s presentation is sponsored by DePuy Orthopaedics, Inc.

Agenda

1. How your knee works & why it hurts

2. Knee replacement basics

3. What patients have to say

4. Your questions

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Thigh bone(femur)

Cartilage

Shin bone(tibia)

Kneecap(patella)

• Dr. [insert name] • [insert practice name]

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• Insert surgeon speaker’s bio

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How your knee works

Anatomy of the knee• Largest joint in body

• Referred to as a hinge joint because it allows the knee to flex & extend; while hinges can only bend and straighten, the knee has the ability to rotate (turn) & translate (glide)

• 3 bones

• Shin bone (tibia)

• Thigh bone (femur)

• Kneecap (patella)

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What’s causing your pain?

It’s estimated 70 million people in the U.S. have some form of arthritis.1 Osteoarthritis is one of the most common types. •Osteoarthritis

• Wear and tear that deteriorates the “cushion” in your joints• A degenerative condition—it won’t get better and may get worse

•Rheumatoid arthritis• An autoimmune disease that attacks the lining of joints, causing

swelling, possibly throbbing pain and deformity

1. Landers, S. Another reason to exercise for those with arthritis. American Medical Association website. <http://www.ama-assn.org/amednews/2005/05/02/hlsc0502.htm>, 2005.

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What’s causing your pain?

Healthy knee

The end of each bone in the joint is covered with cartilage, acting as a cushion so the joint functions without pain

Diseased knee (osteoarthritis)

Wear and tear deteriorates natural cushion, leading to bone-on-bone contact, soreness and swelling

Assessing your pain

• Does your knee hurt one or more days per week?

• Does the pain interfere with your sleep?

• Is it painful for you to walk more than a block?

• Are pain medications no longer working?

• Is knee pain limiting your participation in activities(e.g. family vacations or other functions)?

• Has inactivity from knee pain caused you to gain weight?

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Little or no pain

Excruciating, debilitating pain

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Assessing your pain

• Rate your pain on a scale of 1 to 5

• For most people, the tipping point is about 4 or 5— that’s when the pain becomes too difficult and they turn to a surgeon for relief1

1. 2007 DePuy Orthopaedics, Inc. Knee Attitudes & Usage Study.

Assessing your painCheck your mobilityIf you have difficulty performing any of the movements below,it may be time to talk to your doctor about next steps

WalkBend at the

hips and kneesPretend to drive:

push the gas/brakePretend to golf:

swing a club

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How can your pain be treated?

• Exercise & physical therapy

• Also good for weight loss

• Injections• Corticosteroids,

hyaluronic acid(e.g., ORTHOVISC®)

• Water therapy• Soaking, ice packs,

hot packs

• Medications• Analgesics• Corticosteroids

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ORTHOVISC® is a trademark of Anika Research, Inc.

Knee replacement

• Implants replace damaged surfaces

• Helps relieve pain and restore mobility

• Approximately 580,000 knee replacements are performed each year in the U.S.1

• One study has shown that ten years after surgery, 99.6% of patients still depend on their SIGMA® Knees with fixed bearing option in their daily lives2

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1. American Association of Orthopaedic Surgeons. Total Knee Replacement – Your Orthopaedic Connection. http://orthoinfo.aaos.org/topic.cfm?topic=a00389 Accessed April, 2011.

2. Dalury et al. Midterm results with the P.F.C. SIGMA Total Knee Arthroplasty System. The Journal of Arthroplasty Vol.23, No.2, 2008: 175-181.

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Femoral component

Tibial component

What is knee replacement?

A surgical procedure that removes and replaces diseased joint surfaces with implants

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Femoral component

Tibial component

Patellar component

Polyethylene insert

How does it work?

• Diseased areas at top of shin bone (tibia) and bottom of thigh bone (femur) are removed and reshaped

• Femoral component covers the thigh bone (femur)

• Tibial component covers the shin bone (tibia)

• Polyethylene insert placed between femoral and tibial components

• Patellar component replaces the kneecap (patella)

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Healthy knee Knee replacement

How does it work?

DePuy SIGMA® Knees

• SIGMA Knees come in a wide range of shapes, sizes and materials

• Your surgeon may be able to fit you with a SIGMA Knee designed to provide a natural feel and movement

• The SIGMA Knee is an example of a proven design that continues to evolve to meet the demands of today’s patients

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SIGMA® Fixed Bearing Knees

• Most widely used type of knee replacement in the U.S. today1

• Designed to enhance stability of the joint

• New designs and advanced materials - Helps reduce wear

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1. IMS Health

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SIGMA® Fixed Bearing Knees

SIGMA® Rotating Platform KneesDesigned to rotate as it bends, imitating your natural knee movement

• The surfaces of the knee joint roll and glide against each other as you bend. In other words, your knee naturally rotates as it bends

• Designed for patients who want to remain active since it minimizes implant wear, compared to traditional knee replacements1

• One study has shown after 20 years, 97% of patients still depend on their rotating platform knees in their daily lives2

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1. McNulty, D. et al. “In Vitro Wear Rates of Fixed-bearing and Rotating Platform Knees (Rev. 2).” 2003.2. Buechel F., et al. “Twenty Year Evaluation of Meniscal Bearing and Rotating Platform Knee Replacements.” Clinical Orthopaedics and Related Research July 2001: 41-50.

Should you wait to replace your knee?

Assess your pain and ability to function• Do you feel severe pain in your knee?• Has the pain and loss of function affected your quality of life?• Do you have difficulty sleeping or performing basic functions

(walking, driving, climbing stairs)? • Does medication no longer provide relief?

Consult your physician Early diagnosis and treatment are important1

• Delaying may lower your quality of life2

Osteoarthritis is degenerative—it won’t get better and may get worse

1. Fortin PR, et al. Outcomes of Total Hip and Knee Replacement. Arthritis & Rheumatism. 1999;42:1722-1728. 2. Fortin PR, et al. Timing of Total Joint Replacement Affects Clinical Outcomes Among Patients With

Osteoarthritis of the Hip or Knee. Arthritis & Rheumatism. 2002;46:3327-3330.

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Important safety information

• As with any medical treatment, individual results may vary

• The performance of joint replacements depends on your age, weight, activity level and other factors

• There are potential risks, and recovery takes time

• People with conditions limiting rehabilitation should not have this surgery

• Only an orthopaedic surgeon can tell if knee replacement is right for you

Summary

• The leading cause of knee pain is osteoarthritis

• Osteoarthritis is degenerative – it won’t get better and may get worse

• Early diagnosis and treatment for total knee replacement are important1

• An Arthritis Foundation® study shows knee replacement has a 90-95% rate of patient satisfaction2

• SIGMA Knees come in a wide range of shapes, sizes and materials, so your surgeon can recommend the implant that is right for you.

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Arthritis Foundation® is a trademark of The Arthritis Foundation, Inc.

1. Fortin, Paul R., et al. Outcomes of Total Hip and Knee Replacement. Arthritis & Rheumatism 42 (1999): 1722-17282. The Arthritis Foundation. <http://arthitis.org/research/Bulletin/vol5no11/Printable.htm>, 2006.

Before we take questions . . .

• Please fill out:

• Seminar Questionnaire

• Return at end of seminar

• “For More Information” Form

• Request additional information be sent to your home

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Questions?

• Insert surgeon speaker’s contact info

Thank you!

To find out more about knee pain and the treatment options available, visit:

www.kneereplacement.comwww.aaos.org

© DePuy Orthopaedics, Inc., 2011.The third party trademarks used herein are trademarks

of their respective owners.11/2011

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Additional slides

The following 2 slides are the SIGMA® Rotating Platform Flexion Knees and SIGMA®

High Performance Partial Knees module.If desired, please select the appropriate slides to include within this presentation.

REMOVE THIS SLIDE

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SIGMA® Rotating Platform Flexion Knees

Rotating Platform Flexion Knee

High Flex implant that enables deepknee flexion

• May help with everyday activities like sitting cross-legged, kneeling and squatting

• Shown to reduce implant wear by 94% over traditional knee implants1,2

1. McNulty, D. et al. “The effect of crosslinking UHMWPE on in vitro wear rates of fixed and mobile bearing knees. ASTM STO 1445.”

2. Gsell, R. et al. American Society for Testing and Materials, West Conshohocken, PA. <http://www.astm.org>, 2004.

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SIGMA® High Performance Partial Knees

High Performance Partial Knees

Can replace any of the three areas of your knee; replacing only the damaged area maintains more of your natural knee

• May be an option for more active patients who require a high degree of flexion but not total knee replacement

• Accommodates deep knee flexion, the movement needed for kneeling, squatting or sitting cross-legged

• Less invasive with potential for faster recovery than total knee replacement

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Additional slides

The following 3 slides are the TRUMATCH® Personalized Solutions module.

If desired, please select the appropriate slides to include within this presentation.

REMOVE THIS SLIDE

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TRUMATCH® Personalized Solutions

What is TRUMATCH?

• Uses advancements in technology to provide surgeons with customized instruments designed specifically for your knee anatomy

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Benefits of TRUMATCH

• Helps your surgeon achieve consistency in the placement and positioning of your knee replacement

• TRUMATCH instruments help your surgeon to obtain a precise fit of the implant. The implant helps reduce a patient’s pain and restore their mobility

• Reduces number of surgical steps and operating time

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TRUMATCH® Personalized Solutions

How does it work?• A CT scan of your leg is taken

• A 3-D model of your knee is developed

• Personalized guides are created based on your unique anatomy

• Your guides help your surgeon position and place your new knee implant

• Guides are removed by yoursurgeon prior to your new kneebeing implanted

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Additional slides

The following 3 slides are the SIGMA®

Partial Knee Alternative module.If desired, please select the appropriate slides to include within this presentation.

REMOVE THIS SLIDE

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The Partial Knee Alternative

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“Partial”

“Total”

Partial Knee Replacement

Removes only the damaged area of the knee

Uses technologically- advanced metal and plastic implants to replace the damaged area, helping to relieve pain and restore natural movement.

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Potential advantages of a Partial Knee

• Maintains more of the healthy ligaments and bone, helping to restore the natural movement during activities

• Potential for faster recovery

• Minimally invasive procedure to reduce blood loss

• Possible reduced scarring

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Unicondylar Patellofemoral

Additional slides

The following 3 slides are the

gender-specific module.

If desired, please select the appropriate slides to include within this presentation.

REMOVE THIS SLIDE

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Important considerations for women

• Osteoarthritis affects three times more women than men1

• Women are more likely than men to be disabled• The pain is more severe for women2

• Women’s knees rotate more than men’s, especially during deep bending (kneeling)3

• Current knee replacements are designed to fit the anatomies of both women and men

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1. Hawker, Gillian A., et al. "Differences Between Men and Women in the Rate of Use of Hip and Knee Arthroplasty.“The New England Journal of Medicine 342 (2000): 1016-1022

2. Harris Interactive research survey, April 20053. Hsu, Wei-Hsiu, et al. “Difference in Torsional Joint Stiffness of the Knee Between Genders.” The American Journal of Sports

Medicine Vol. 34, No. 5 (2006): 765-770.

Gender-specific implants

• All orthopaedic manufacturers have knee implant systems with sizes appropriate for both female and male patients

• Surgeons know which knee will fit each patient best, based on gender, age, size, activity levels and aspirations

• There is no clinical support of the need for gender-specific implants

• It is too early for any clinical data; won’t know results of gender-specific implant clinical studies for 10-15 years

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Gender-specific implants

• More than 60% of knee replacements have been implanted in women1

• Current knee replacement patients have a 90 to 95% satisfaction rate with the results of their surgery2

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1. American Academy of Orthopaedic Surgeons<http://www.aaos.org/wordhtml/research/stats/Hipkneefacts.htm>, 2006.

2. The Arthritis Foundation<http://www.arthritis.org/research/Bulletin/vol51no11/Printable.htm>, 2006.

Additional slides

The following 4 slides are the minimally invasive knee surgery module.

If desired, please select the appropriate slides to include within this presentation.

REMOVE THIS SLIDE

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Minimally invasive knee replacement surgery

• Minimally invasive surgery (MIS) is still very new

• SIGMA® Knees can be implanted using minimally invasive surgery

• Alignment affects:• How long your knee

replacement lasts• Long-term success

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Benefits of MIS

• Some early studies of MIS have shown some potential benefits of the surgery (when compared to traditional, “open” surgery), such as:

• Less blood loss• Potential for shorter

hospital stays• Potential for faster

recovery

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Complications of MIS

• Other studies, however, have shown several complications with the surgery, (when compared to traditional, “open” surgery), including:

• Increased number of surgical complications• Poor implant positioning• No difference in the length of recovery

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What really matters when it comes to MIS

• MIS is still relatively new

• It won’t be known for 10 to 15 years if the new techniques affect the long-term function and durability of the implant

• You should discuss with your surgeon whether MIS is an appropriate surgical course of treatment for you

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Additional slides

The following 2 slides are thecomputer-assisted surgery module.

If desired, please select the appropriate slides to include within this presentation.

REMOVE THIS SLIDE

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Computer-assisted surgery

• What is computer-assisted surgery (CAS)?

• A new approach to knee replacement

• The patient’s anatomy is simulated and displayed on a computer

• Computer provides information about where to place the components

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Potential benefits of CAS

• CAS guides surgeon in areas that are difficult to visualize

• Relays specific measurements not previously available to surgeons, such as implant alignment and angle of cuts

• Gives precise, accurate data on your specific anatomy

• Allows surgeons to make decisions about implant placement based on detailed data from the computer

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