Zimmer ® M/L Taper Hip Prosthesis with Kinectiv® Technology ® Case Studies with Kinectiv Technology

The following clinical cases show how the M/L Taper with Kinectiv Technology provides superior intraoperative flexibility and range of head centers to help surgeons address a wide range of patient anatomy and clinical situations. Case Study 1 — Leg length Clinical Situation: Higher neck cut than templated, results in a higher stem position than planned, lengthening the leg. Current Treatment: With traditional stems, surgeons may remove more bone with a lower neck cut or resort to shorter head length. Implications: Adjustments can be time-consuming or result in decreased stability. Kinectiv Solution:...

Case Study 3 — Valgus anatomy Clinical Situation: atient with a valgus neck anatomy. P Neck implant distribution Current Treatment: With traditional stems, surgeons may use a longer head length to restore patient leg length. Implications: Challenge in reconstructing the valgus neck anatomy with conventional stems: • hanging head length to lengthen the leg also C increases femoral offset. • linical considerations of excessive offset include C 2 trochanteric bursitis and patient dissatisfaction. Kinectiv Solution: Allows the surgeon to • Fit the stem in the femur at the desired level • Achieve...

Leg Length Adjustment Clinical Information Age Gender Preoperative Diagnosis Operative Side Procedure Implant Information 59 Male Osteoarthritis Left MIS Posterior Acetabular Cup (Size) Femoral Implant (Size) Femoral Head Implant Kinectiv Neck

Trilogy® Acetabular Cluster Holed Shell (60mm)

M/L Taper with Kinectiv Technology (Size 13.5)

CoCr Femoral Head 40mm, +0 +0 Leg Length/Extended Offset (G neck)* * 0 Leg Length/Extended Offset (G Neck) selected intraoperatively to optimize leg length without affecting + offset — see post-operative conclusions

Case Study 1 — Conclusions Case study 1 postoperative x-ray Summary • emplated to +4 leg length/Extended offset T neck implant (C neck) • lightly higher neck osteotomy than templated S • mplant +0 leg length/Extended offset neck (G neck) I to decrease leg length without affecting offset Conclusion • ntraoperative flexibility to readily respond to implant I position and optimize hip reconstruction

Varus Neck Clinical Information Age Gender Preoperative Diagnosis Operative Side Procedure Implant Information 73 Female Osteoarthritis Left MIS Anterior Supine Acetabular Cup (Size) Femoral Implant (Size) Femoral Head Implant Kinectiv Neck

Durom® Acetabular Shell (56mm)

Metasul ® LDH® 50mm, +0 +8 Leg Length/Reduced Offset (X neck)

Case Study 2 — Conclusions Case study 2 postoperative x-ray • Varus neck and small femoral anatomy • Implant X Neck-4 leg length/Extra extended offset (X neck) to optimize offset without • Broad range of head centers allows surgeon to efficiently reconstruct hip kinematics in challenging anatomical situations Surgeon Survey UrtrHWfl E<[Mlirt Short CHkrh [«,t;r ftjius) Antwutfon HlpFr*c1uif Anatomical Condition

Valgus Neck Clinical Information Age Gender Preoperative Diagnosis Operative Side Procedure Implant Information 59 Male Osteoarthritis Right MIS Posterior Acetabular Cup (Size) Femoral Implant (Size) Femoral Head Implant Kinectiv Neck

Trabecular Metal ™ Modular Acetabular Cup (50mm)

item Number

Ceramic Femoral Head 32mm, +0 -4 Leg Length/Extra Extended Offset (X neck)

Case Study 3 — Conclusions Case study 3 postoperative x-ray Head center data • Valgus neck anatomy • mplant +8 leg length/Reduced offset (X Neck) I to achieve leg length without excessive offset Conclusion • road range of head centers allows surgeon to B match patient’s anatomy • arus/valgus neck implants account for 28% V of implantations Male Female Zimmer M/L Taper with Kinectiv Technology +0mm head centers Plotting head height and offset reveals the wide range 3 of head center locations among men and women.

Anteverted Neck Clinical Information Age Gender Preoperative Diagnosis Operative Side Procedure Implant Information 63 Female Osteoarthritis Right MIS Posterior Acetabular Cup (Size) Femoral Implant (Size) Femoral Head Implant Kinectiv Neck

Trilogy Acetabular Cluster Holed Shell (58mm)

Ceramic Biolox®†† Femoral Head 36mm, +0 +4 Leg Length/Extended Offset (CC neck)* * xtended offset and anteverted neck (CC neck) selected intraoperatively to optimize joint stability without E changing leg length †† T rademark of CeramTec AG

Case Study 4 — Conclusions Case study 4 postoperative x-ray Summary • emplated to +4 leg length/Standard offset (G Neck) T • ip contracture limits internal rotation for pre-op x-ray templating H • eck version not fully appreciated until neck N osteotomy is performed • mplant +4 leg length/Extended I offset/Anteverted (CC Neck) to optimize offset and range of motion without affecting leg length Conclusion • ndependent offset adjustment to optimize stability I without affecting leg length • nteverted/retroverted neck to optimize stem fit in femur A and total version of hip reconstruction for desired...

To address today’s clinical situations Case study 1: eg length L Case study 2: Varus neck anatomy Case study 3: Valgus neck anatomy Case study 4: ersion V the solution is The Zimmer M/L Taper Hip Prosthesis with Kinectiv Technology which provides the intraoperative flexibility to help the surgeon restore the natural hip joint center by addressing leg length, offset, and version independently. The broad array of neck options efficiently targets a wide range of patient anatomies. Data on file at Zimmer. Iorio R, Healy, WL, Warren PD, Appleby D. Lateral trochanteric pain following primary total...