2 How your hip works Ball-and-socket joint Anatomy of the hipBall-and-socket jointBall (femoral head) at the end of the leg bone (femur)Hip socket (or acetabulum) holds the ball
3 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.OsteoarthritisWear and tear that deteriorates the “cushion” in your jointsA degenerative condition—it won’t get better and may get worseRheumatoid arthritisAn autoimmune disease that attacks the lining of joints, causing swelling and possibly throbbing and deformity1. Landers, S. Another reason to exercise for those with arthritis. American Medical Association website Available at:
4 What’s causing your pain? Healthy hipThe end of each bone in the joint is covered with cartilage, acting as a cushion so the joint functions without painDiseased hip (osteoarthritis)Wear and tear deteriorates natural cushion, leading to bone-on-bone contact, soreness and swelling
5 Assessing your pain Do you sometimes limp? Is it difficult to perform daily tasks—like walking, housework or tying shoes?Does pain limit your activities & lifestyle?Does one leg feel “shorter”?Do you have balance problems?Do you experience pain in the thigh, groin or buttocks?Does pain radiate to the knee?
6 Excruciating, debilitating pain Assessing your painRate your pain on a scale of 1 to 5For 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 relief1Little or no painExcruciating, debilitating pain2008 DePuy Synthes Joint Reconstruction Hip Attitudes & Usage Study.
7 How can your pain be treated? Water therapySoaking, hot packsExercise & physical therapyGood for weight lossMedicationsAnalgesicsInjectionsSteroids
8 Hip replacement Implants replace damaged surfaces Helps relieve pain and improve mobilityIn 2011, more than 325,000 people in the United States had a total hip replacement1Premier, Inc.
9 What is hip replacement? LinerBallA surgical procedure that removes and replaces diseased joint surfaces with implantsStem
10 How does it work? Diseased area in hip socket removed & re-shaped New cup secured in socketLiner placed within cupStem inserted in leg bone (femur)Ball placed in cup
11 How does it work?FPOiStockPhoto $12-18Pre-opPost-op
12 Which bearing is right for you? When choosing a bearing, your surgeon will consider:Range of motionStabilityWear characteristicsLifestyleAge, weight & genderSeverity of diseaseYour surgeon will work with you to choose materials that are right for you.
13 DEPUY SYNTHES JOINT RECONSTRUCTION HIPS OFFER SEVERAL BEARING OPTIONS What is the bearing? The bearing is the union of the ball and the cup—where moving parts of the hip implant interactDePuy Synthes Joint Reconstruction bearing options:Metal-on-plastic (polyethylene)Ceramic-on-plastic (polyethylene)Ceramic-on-ceramic
14 Should you wait to replace your hip? Assess your pain and ability to functionDo you have difficulty sleeping or performing basic functions (shopping or walking up the stairs)?Does medication no longer provide relief?Consult your physicianEarly diagnosis and treatment are important1Delaying may lower your quality of life2Osteoarthritis is degenerative—it won’t get better and may get worse1. Fortin PR, et al. Outcomes of Total Hip and Knee Replacement. Arthritis & Rheumatism. 1999;42:2. 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:
15 Important safety information As with any medical treatment, individual results may varyThe performance of joint replacements depends on your age, weight, activity level and other factorsThere are potential risks, and recovery takes timePeople with conditions limiting rehabilitation should not have this surgeryOnly an orthopaedic surgeon can tell if hip replacement is right for you
16 What other patients have to say In a recent study of 600 people who chose hip replacement:More than 96% said hip replacement enabled them to move freely and without pain.190% said they were able to participate in their favorite activities.1One study has shown that PINNACLE® Hips have a 95.8% success rate 9 years after surgery.2DePuy Hip Pain: A&U/Segmentation. Final Report January Data on file.Multi-center PINNACLE Acetabular Cup System Outcomes Study, Kaplan-Meier survivorship results. Abstract submitted June 1, 2012 for 2013 AAOS Meeting.
17 Summary The leading cause of hip pain is osteoarthritis Osteoarthritis is degenerative—it won’t get better and may get worseEarly diagnosis and treatment of osteoarthritis are importantHip replacement helps relieve pain and improve mobilityYour surgeon will help choose the right implant for you
20 Remove this slide when presenting Additional slidesThe following 5 slides are the Anterior Approach module. If desired, please include the slides with the PINNACLE® Hip Solutions presentation.Remove this slide when presenting
21 Anterior Approach What is it? Incision is made on the front (anterior) of the leg rather than the side (lateral) or back (posterior)Surgeon can work between muscles and tissues without detaching them from the hip or thigh bonesUses a high-tech table and intra-operative x-ray for precise positioning of implant
22 Traditional surgery Patients typically lie on side or front Incision on side or back of legSurgeon detaches muscles, disrupts tissueSurgeon relies on post-operative x-ray to check component placement & leg length
23 Anterior Approach Patients lie on back Incision on front of leg No detachment of muscles, minimal disruption of tissueSurgeon can check component placement & leg length during procedurehana® is a trademark of Mizuho OSI.
24 Anterior Approach History First performed in 1947 by Robert Judet in FranceSurgery performed on the “Judet” table, with the patient lying on back rather than on sideIn 2002, Dr. Joel Matta of California adopted the technique, helped develop a new table and began to teach the technique in the U.S.Today, more than 350+ DePuy trained U.S. surgeons perform the technique on this table1Data on file at DePuy Synthes Joint ReconstructionDr. Matta is a consultant for DePuy Synthes Joint Reconstruction and receives royalties as the designer of the hana® and PROfx® tables which are manufactured by Mizuho OSI.
25 Potential benefits of the Anterior Approach Less trauma to the body1Smaller incision1Potentially less pain1Less tissue disruption, may lead to faster rehabilitation1Fewer restrictions during recovery11. Bourne MH, Mariani EM. A Comparison Between Direct Anterior Surgery of the Hip (DASH) and Anterolateral (AL) Surgical Approaches to Total Hip Arthroplasty: Post-Operative Outcomes, Poster Presentation #014, AAOS, New Orleans, LA March 9-13, Comparison of functional outcomes after Anterior Approach (211 patients) with Anterolateral/Traditional (259 patients).
26 Important safety information As with any medical treatment, individual results may varyThe performance of joint replacements depends on your age, weight, activity level and other factorsThere are potential risks, and recovery takes timePeople with conditions limiting rehabilitation should not have this surgeryOnly an orthopaedic surgeon can tell if hip replacement is right for you