[Insert name] Emcee representing DePuy Orthopaedics, Inc.

1. [Insert name] Emcee representing DePuy Orthopaedics, Inc.

2. Welcome! • You should have with you several forms: • Event Questionnaire –an event feedback form • Please return this to us at the end of the event • Personal Assessment Form – a self-test of your mobility • “For More Information” Form – please return this to us to request additional information about knee replacement

3. Agenda • Discuss treatment options for severe knee pain • Patient stories • Questions & answers

4. Dr. [insert name] Orthopaedic Surgeon

5. What’s the Leading Cause of Knee Pain? Osteoarthritis

6. What is Osteoarthritis? • Cartilage deteriorates and friction is created between bone surfaces. • Symptoms include: • Chronic knee pain • Knee stiffness • Difficulty with everyday activities (walking, driving, stair climbing)

7. Check Your Mobility If you have difficulty performing any of the movements below, it may be time to talk to your doctor about next steps

8. Knee Osteoarthritis Treatments Early Intervention KneeReplacement Non-surgical Treatments • Medication • Weight control • 400,000 performed yearly in the U.S. • Prescription medications • Physical therapy • Injection therapy • Orthovisc(R)

9. Knee Replacement Knee replacement surgery is the replacement of the worn and arthritic surfaces of the knee joint

10. Are You Ready for Knee Replacement? • 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? • Has inactivity from knee pain caused you to gain weight? • Can you limit activities for a few months to recover from surgery? • Are you willing to commit to work hard during rehabilitation for a successful recovery?  

11. Knee Replacement Facts • Based on a National Institute of Health (NIH) study, 85% of patients are satisfied with the results of their knee replacement surgery1 1: NIH Consensus Development Conference on Total Knee Replacement, NIH Consensus Development Program (http://www.guideline.gov/summary/summary.aspx?view_id=1&doc_id=5299)

12. But You Should Also Know… • Performance of joint replacements depends on age, weight, activity level and other factors. • There are potential risks and recovery takes time. • People with current infections or conditions limiting rehabilitation should not have this surgery. • Potential complications which could result in pain, stiffness or dislocation of the joint include: • Loosening • Fracturing • Wearing of the components

13. Knee Replacement Options • Traditional: fixed-bearing • Unique: mobile-bearing (also called Rotating Platform)

14. Unique Options inKnee Replacement • Rotating Platform Knee • Designed to rotate as it bends, imitating natural knee movement • The surfaces roll and glide against each other as the knee bends, just as your natural knee does • Designed for patients who want to remain active since it minimizes implant wear, compared to fixed-bearing knees1 • A multi-center internal study shows 97% patient satisfaction at 5 years2 1: McNulty, D. et al. “In Vitro Wear Rates of Fixed-bearing and Rotating Platform Knees (Rev. 2)” (2003) 2: DePuy Multi-Center Study (2006)

15. Why is Rotation Important?

16. Should You Delay Surgery? • Early diagnosis and treatment for total knee replacement are important1 • Delaying surgery can lower quality of life before the operation and up to two years after surgery2 • Pre-existing medical conditions may become more serious, delaying elective surgery3 • Osteoarthritis is degenerative – it won’t get better and will likely get worse! 1: Fortin, Paul R., et al. “Outcomes of Total Hip and Knee Replacement.” Arthritis & Rheumatism 42 (1999): 1722-1728 2: Fortin, Paul R., et al. “Timing of Total Joint Replacement Affects Clinical Outcomes Among Patients with Osteoarthritis of the Hip or Knee.” Arthritis & Rheumatism 46 (12) (2002): 3327-3330 3: www.jointreplacement.com

17. What to Expect With or Without Knee Replacement 1-2 months Rehabilitation 3-6 months+ Return to activities Severe pain Inability to walk any distance Medications don’t help Interrupted sleep Have Surgery Surgery is recommended Delay Surgery 1-2 months Continue to address symptoms 3-6 months+ Continued or increased pain and reduced mobility

19. Patient Testimonial Received Rotating Platform Knee Date of Surgery Insert quote

20. 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

21. How Does CAS Work? Computer calculates the best position to place the components for accurate alignment Camera searches for arrays placed on the patient via infrared signals Your anatomical information is entered into the computer through a process called registration This information is fed back to the camera and communicated to the computer

22. Potential Benefits of CAS • Guides surgeon in areas that are difficult to visualize • Relays specific measurements not previously available to surgeons • Gives precise, accurate data on your specific anatomy • Allows surgeons to make informed decisions about precise implant placement based on detailed data from the computer

23. Why Use Computer Assisted Knee Replacement Surgery? • Advanced knee replacement technology combined with widely used, clinically successful implants • Allows surgeons to be more precise when making decisions about placing knee components • Provides the surgeon with extensive information to assist with surgical decisions

24. 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 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 2005 3: 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.

25. Gender-Specific Implants • There is no clinical support of the need for gender-specific implants • It is too new for any clinical data; won’t know results of the implant for 10-15 years • All orthopaedic manufacturers have knee implant systems with sizes appropriate for both females and males • 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 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)

26. Gender Issues in Knee Replacement:The Bottom Line • Rotation is important, especially for women • Women’s knees rotate more than men’s • In deep flexion (deep knee bending) • Daily activity • Only one knee, the Rotating Platform knee, is designed to accommodate your knee’s anatomical need for rotation

27. Minimally Invasive Knee Replacement Surgery • Minimally invasive surgery (MIS) is still very new • Visibility of your knee during surgery to help ensure proper alignment is more important to the long-term success of your knee replacement than the length of your incision or even your recovery • Alignment affects: • How long your knee replacement lasts • Long-term success

28. Benefits of MIS • Some early studies of MIS have shown some benefits of the surgery (when compared to traditional, “open” surgery), such as: • Less blood loss • Shorter hospital stays • Faster recovery

29. 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

30. 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

31. Additional Slides (if applicable)

32. Event Questionnaires • Please take a moment to complete the event questionnaires • Please pick up additional information about knee replacement as you leave • Don’t forget your free gift!

33. TM Thank you for attending our event: “Restoring the Joy of Motion” Questions? For more information: Include surgeon information here www.kneereplacement.com or visit www.aaos.org