Procedural solutions to help surgeons improve patient satisfaction and surgical workflow KNEE & HIP ARTHROPLASTY

Transcription

1 Procedural solutions to help surgeons improve patient satisfaction and surgical workflow KNEE & HIP ARTHROPLASTY

2 Orthopaedic joint replacement surgeries are among the most commonly performed procedures [DAT1,DAT2] With an aging population and increasing sports injuries, the number of procedures is expected to rise, presenting providers with the challenge of driving down costs. [DAT1,DAT2] Complications, such as surgical site infections (SSIs), during these procedures can have a great economic impact due to additional hospital costs and extended hospital stays. [WHO] Loosening, instability and infection are the most common causes of total knee and hip arthroplasty failure In a systematic retrospective review of all revision total knee arthroplasties [SHA] (TKAs) performed at a centre between 2003 and 2012 (n=781): the most common reason overall for failure was loosening (39.9%) the second most common reason overall for failure was infection (27.4%), and infection was the most common reason in the early revision group, accounting for 37.6% of revisions performed <2 years after the primary procedure infection also accounted for 21.9% of revisions TKA in the late failure group Early Late Overall 20 0 Loosening infection Instability Periprosthetic Fracture Arthrofibrosis Patella Resurfacing PE Wear Patella Loosening Malalignment or Malposition Exterms or Mechanism Deficiency The Australian Orthopaedic Association National Joint Replacement Registry [AOANJRR] 2016 Annual Report includes detailed information on all revision hip procedures undertaken from September 1999 up to the end of 2015 (n = 11,907). The most common reason for revision of primary total conventional hip replacement are loosening / lysis (27.6%), followed by prosthesis dislocation (23.5%) and fracture (18.7%) The fourth most common reason is infection (17.5%) Figure HT5 Cumulative Incidence Revision Diagnosis of Primary Total Conventional Hip Replacement Note: All procedures using metal/metal prostheses with head size larger than 32mm have been excluded Cumulative Incidence 5.0% 4.0% 3.0% 2.0% Total Conventional Loosening/Lysis Prosthesis Dislocation Fracture Infection Pain 1.0% 0.0% Years Since Primary Procedure

3 Infection decreases patient quality of life and represents a major clinical and economic burden in knee and hip arthroplasty [BRU, CAR] Staphylococcus aureus is one of the leading causes of SSIs [BRU] Hip arthroplasty (median SSI rate: 2.1%; range: 0.05% to 28%) Knee arthroplasty (median SSI rate: 1.3%; range: 0.05% to 19%) S. aureus accounted for 35% of all orthopaedic surgery SSIs, of which 35.7% were specifically attributed to MRSA infections. [BRU, CAR] BURDEN OF SSIS IN HIP AND KNEE ARTHROPLASTY Length of stay (LOS) Re-admission rate Mortality Hospital costs Patient quality of life 2 to 3 fold increase 2 fold increase 1.2% to 56% over 1 year 3 fold increase Decreased Patel H, Khoury H, Girgenti D, Welner S, Yu H (2016) Burden of Surgical Site Infections Associated with Arthroplasty and the Contribution of Staphylococcus aureus. Surg Infect (Larchmt) 17 (1): Whitehouse JD, Friedman ND, Kirkland KB, Richardson WJ, Sexton DJ (2002) The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol 23 (4):

4 Johnson & Johnson Medical Our goal: to be your partner of choice across the entire patient pathway Helping improve clinical outcomes, patient experience and reduce cost

5 Intra operative solutions from exposure to closure Johnson and Johnson knee and hip solutions to promote patient satisfaction and improve surgical workflow ATTUNE Knee System An innovative, comprehensive, integrated knee system. Designed to address the clinical needs of patients, surgeons, and hospital providers around the world Extensive research and science included in the design to help improve functional outcomes for patients, performance for surgeons, and efficiency for providers One of the largest research and development projects in the history of DePuy Synthes Joint Reconstruction, combining the latest in design, kinematics, engineering and materials to deliver stability and motion FEATURES ATTUNE GRADIUS Curve GLIDERIGHT Articulation SOFCAM Contact LOGICLOCK Tibial Base intuition INSTRUMENTS BENEFITS Gradually reducing femoral radius designed to provide a smooth transition from stability to rotational freedom through a patient s range of motion. Encompasses a trochlear groove designed to accommodate patient variation and soft tissue interaction, and patellar components designed to optimise patellar tracking while maintaining bore coverage. Designed to provide a smooth engagement for gradual femoral rollback and stability in flexion, while reducing stresses transferred to the tibial spine. Patented central locking design provides the architecture for the system that optimises kinematics, while reducing backside micromotion to one of the lowest reported levels in the industry. [LEI] Combines the surgical process with intuitive and efficient instruments to allow the surgeon to balance the soft tissue and precisely control the implant position and fit for each patient. CORAIL PINNACLE Total Hip System CORAIL PINNACLE is the most widely used single company cementless construct in several registries including Australia and [NJR, AOA] the UK Using a proven, robust construct design with a strong supportive evidence base can potentially help reduce revision risk and the associated cost burden. The existing evidence highlights the excellent long-term stability and durability of the CORAIL stem and PINNACLE acetabular cup. There are over 152,000 [SDOF] documented cases included on registries worldwide with recorded survivorship up to 97.19% [NJR, AOA] and 95.1% at 10 years in UK and Australian registries, respectively The CORAIL PINNACLE hip construct can be used in multiple indications as well as standard cases, including complex primary cases and fractured neck of femurs. [KEN,SCH, VID, HAL] CORAIL PINNACLE has also demonstrated successful performance in young and high demand patients. [WAN,GRE] CORAIL and PINNACLE have both been granted 10A* ratings by the Orthopedic Data Evaluation Panel (ODEP). [ODE] More than 1 million construct combinations (cup, liner, head, stem) available within the CORAIL PINNACLE family of products The CORAIL hip system celebrated years in 2016, and in that time has been provided to over 1,800,000 patients. Over the last 15 years, the PINNACLE Acetabular Cup System has been provided to over 2,0,000 patients. COMBINATION IMPLANTATIONS YEAR 3 YEAR 5 YEAR 10 CoC 35, % (1.64% %) 2.38% (2.20% %) 4.00% (3.38% -4.74%) CoP 16, % (1.07% %) 1.90% (1.61% %) 2.81% (2.13% %) MoP 42, % (1.% %) 1.77% (1.62% % 3.16% (2.72% %) Italics signify <250 cases remained at risk at these timepoints [NJR]

6 STRATAFIX Knotless Tissue Control Device Portfolio Ethicon STRATAFIX Knotless Tissue Control Devices are available in a variety of different anchor technologies that can be used to close incisions in organs, fascia,* and skin. Triclosan-coated sutures can reduce the risk of SSI 2016 WHO Global Guidelines for the prevention of SSI suggest the use of Triclosan-coated sutures for the purpose of reducing the risk of SSI, independent of the type of surgery** [Petri dishes displaying zone of inhibition for STRATAFIX Symmetric PDS Knotless Tissue Control Device] 11 days for E. coli and 23 days for S. aureus (in vitro) STRATAFIX Knotless Tissue Control Devices with IRGACARE MP (triclosan) - the only commercially available knotless tissue control devices with antibacterial protection. TISSUE TYPE REQUIRED HOLDING STRENGTH POTENTIAL SOLUTIONS Capsule > 3 weeks Subcutaneous > 3 weeks Sub-cuticular 1 to 2 weeks Strength and security: interrupted suturing without knot-related complications [DAT3] Anchors run along length of devices to provide secure fixation with every pass In preclinical studies, cutting the STRATAFIX Symmetric PDS Knotless Tissue Control Device or the STRATAFIX Spiral Knotless Tissue Control Device in a bidirectional design did not result in tissue separation [DAT4] More consistent tension control and approximation during closure [MOR] Unique anchor design delivers multiple points of fixation to help maintain approximation along the suture line during closure Compared to traditional sutures, the devices help surgeons to easily manage tension and control approximation during closure More efficient than continuous suturing [DAT5] Anchors lock into place after each pass, eliminating the need to have an assistant follow the suture With equal strength and security, the devices can close wounds substantially faster than use of an interrupted technique [DAT5] *STRATAFIX Symmetric PDS Devices only ** Conditional recommendation with moderate quality of evidence

7 DERMABOND PRINEO System The only skin closure device to combine a topical skin adhesive with a self-adhering mesh The 22cm system uses 2 unique components allowing for uncompromising strength and wound healing [DAT6] Liquid topical skin adhesive (2-octyl cyanoacrylate) formulation sets in ~60 seconds when applied to mesh [DAT6] Flexible self-adhesive polyester mesh accelerates polymerisation of liquid adhesive and conforms to body s contours [DAT6] Proven 99% effective through 72 hours in vitro against bacteria most commonly associated with SSIs, including S. aureus, P. aeruginosa, E. coli, E. faecium, and S. epidermidis (including [ETH, DAT5] MRSA and MRSE).* Skin-holding strength superior to staples or subcuticular suture (P<.001) [DAT6]* Comparative skin holding strengths 33% stronger when compared to the average strength of staples 40% stronger when compared to the average strength of 4-0 suture 200 Mean max load (N) prior to 3 mm gap (+/- 1 mm) DERMABOND PRINEO Skin Closure System (22 cm) Skin Staples 4-0 Subcuticular Suture Patient quality of life benefits [VAN, DEC] Promotes self-care no post-surgical dressing changes required Ability to shower immediately after procedure (subject to their healthcare professionals recommendation) [DAT6] Easy mesh tape removal when wound is sufficiently healed [DAT7] [PAR, BLO, RIC] Less pain on removal versus other wound closure methods [PAR, BLO, RIC] Good cosmetic results MRSE = Methicillin-resistant Staphylococcus epidermidis * In an ex vivo study, more load in N was required to create a 3-mm gap between skin edges approximated with DERMABOND PRINEO System than with subcuticular 4-0 MONOCRYL (poliglecaprone 25) Suture or PROXIMATE Ethicon Endo-Surgery skin staples (P<.001).

8 Improving post-operative outcomes Care4Today Orthopedics Solution What is Care4Today Orthopedic Solutions? Care4Today Orthopedic Solutions is a technology-enabled, end-to-end Patient Pathway program for patients undergoing elective surgery for total hip and knee surgery. The solution is built around 3 fundamental pillars: Empower patients to take control of their own treatment and recovery Drive consistency between the Multi-disciplinary team across the entire pathway based on Enhanced Recovery principles Provide continuity of care (in and out of the hospital setting) throughout the patient journey. Why Care4Today? Care4Today Orthopedic Solutions is a proven solution with a track record of success. This solution has shown improved clinical outcomes, improved patient experience at a reduced cost. In a service evaluation with over 2000 patients, Care4Today Orthopedic solutions showed: [ISPOR] Statistically significant reduction in Length of Stay Improvement in Patient Reported Outcome Measures Improvement in Patient experience in 5 domains: satisfaction, education, confidence, expectation, and recommendation Cost Savings of approximately 250K per annum [ISPOR] Care4Today aims to deliver clinical and cost-effective care in hip and knee arthroplasty. Shorter durations of inpatient stay without a negative impact on clinical outcomes, improved patient-focused outcomes and experience, can deliver significant value, especially benefiting those with greater medical complexity and need. ATTUNE Knee System: One-year results from two worldwide studies showed improved patient reported outcomes with the ATTUNE knee compared to other leading knee systems [HWG] CORAIL PINNACLE Total Hip System: Demonstrated by patient-reported outcomes in NJR to reduce hip self-reported problems 6 months after surgery in 88.6% of patients and provide excellent or very good satisfaction in 79.1% of patients (vs 85.6% and 73.5% of all primary hips, respectively) [LEO] DERMABOND PRINEO System: New Premier data showing 12% reduction in LOS with Prineo22 and 31% reduction in discharge to non home setting [DAT8] STRATAFIX : Triclosan-coated sutures have been shown in multiple meta-analysis to reduce the risk of SSIs by 26-28% [AEA]

9 The Johnson & Johnson range of knee and hip procedural solutions: Designed to promote patient satisfaction and improve surgical workflow DERMABOND PRINEO System Skin Product code Description Mesh length EA/BX CLR22 2-octylcyanoacrylate topical skin adhesive applicator, flexible, self-adhesive polyester mesh tape dispenser 22 cm 2 ATTUNE Knee System For more information visit emea.depuysynthes.com/hcp/knee CORAIL PINNACLE Total Hip System For more information visit emea.depuysynthes.com/hcp/hip Potential STRATAFIX Device Needle Type Capsule Polymer Needle Size* Length (cm) Color Spiral PDO MH, 36 mm, 1/2 Circle 14 x x x 36 SXPD2B408 SXPD2B412 SXPD2B409 SXPD2B410 Spiral PDO 20 SXPD1B400 SXPD1B401 Spiral PDO 14 x x 24 SXPD2B401 SXPD2B402 Spiral PDO OS-6, 36 mm, 1/2 Circle Reverse Cutting 24 x 24 x SXPD2B200 SXPD2B201 Symmetric PDS 45 SXPP1A403 SXPP1A401 SXPP1A404 Symmetric PDS CT, 40 mm, 1/2 Circle 45 SXPP1A406 SXPP1A405 Spiral PDS 15 SXPP1B409 SXPP1B410 SXPP1B406 SXPP1B450 Subcuticular / Deep Dermal Polymer Needle Size* Length (cm) Color Spiral MONOCRYL PS-1, 24 mm, 3/8 Circle Reverse Cutting SXMP1B101 SXMP1B102 SXMP1B103 Undyed Spiral MONOCRYL PS-2, 19 mm, 3/8 Circle Reverse Cutting SXMP1B117 SXMP1B118 SXMP1B119 SXMP1B106 SXMP1B107 SXMP1B108 Undyed Subcutaneous/Fat Polymer Needle Size* Length (cm) Color Spiral PGA-PCL MH, 36 mm, 1/2 Circle 14 x x 36 SXMD2B400 SXMD2B401 Undyed *Sizing shown represents tensile strength.

10 Subcutaneous/Fat Polymer Needle Size* Length (cm) Color Spiral PDO MH, 36 mm, 1/2 Circle 14 x x 24 x 36 x 36 SXPD2B407 SXPD2B408 SXPD2B412 SXPD2B409 SXPD2B410 SXPD2B411 Spiral MONOCRYL SH, 26 mm, 1/2 Circle 20 SXMP1B409 Undyed Spiral MONOCRYL 45 SXMP1B412 SXMP1B413 Undyed Spiral MONOCRYL CT-2, 26 mm, 1/2 Circle 45 SXMP1B417 Undyed Spiral PDS SXPP1B411 SXPP1B412 Spiral PDS SH, 26 mm, 1/2 Circle 70 SXPP1B416 SXPP1B417 Symmetric PDS 45 SXPP1A403 Labeled as Ger PS-1. For more information, contact your Ethicon or DePuy Synthes representative. Please refer always to the Instructions for Use / Package Insert that come with the device for the most current and complete instructions. References: [DAT1] Data on file. Ethicon, Inc. Knee Procedure Volume [DAT2] Data on file. Ethicon, Inc. Hip Procedure Volume [WHO] WHO Guidelines for Safe Surgery Geneva, Switzerland: World Health Organization; [SHA] Sharkey PF, et al, Why Are Total Knee Arthroplasties Failing Today - Has Anything Changed After 10 Years?, J Arthroplasty (2014), [AOANJRR] Australian Orthopaedic Association National Joint Replacement Registry Hip Knee & Shoulder Arthroplasty Annual Report Available at: documents/10180/275066/hip%2c%20knee%20%26%20shoulder%20arthroplasty Accessed February [BRU] Bruns TB, Robinson BS et al. A new tissue adhesive for laceration repair in children. J Pediatr. 1998;132(6): [CAR] Carleo C, Singer AJ, Thode HC Jr. Effect of frequent water immersion on the rate of tissue adhesive sloughing: a randomized study. CJEM. 2005;7(6): [ULR] Ulrich SD, et al, Total hip arthroplasties: What are the reasons for revision? International Orthopaedics (SICOT) (2008) 32: [LAC] Lachiewicz PF, Soileau ES (2005) Changing indications for revision total hip arthroplasty. J Surg Orthop Adv 14(2): [CLO] Clohisy JC, Calvert G, Tull F et al (2004). Reasons for revision hip surgery: a retrospective review. Clin Orthop Relat Res (429): [WEE] Weeden SH, Paprosky WG (2002) Minimal 11-year follow-up of extensively porous-coated stems in femoral revision total hip arthroplasty. J Arthroplasty 17[4 Suppl 1]: [LIN] Lind M, Krarup N, Mikkelsen S et al (2002). Exchange impaction allografting for femoral revision hip arthroplasty: results in 87 cases after 3.6 years follow-up. J Arthroplasty 17(2): [ULL] Ullmark G, Hallin G, Nilsson O (2002) Impacted corticocancellous allografts and cement for revision of the femur component in total hip arthroplasty. J Arthroplasty 17(2): [BOH] Bohm P, Bischel O (2001) Femoral revision with the Wagner SL revision stem: evaluation of one hundred and twenty-nine revisions followed for a mean of 4.8 years. J Bone Jnt Surg Am 83-A(7): [TEM] Templeton JE, Callaghan JJ, Goetz DD et al (2001). Revision of a cemented acetabular component to a cementless acetabular component. A ten to fourteen-year follow-up study. J Bone Jnt Surg Am 83-A(11): [CRA] Crawford SA, Siney PD, Wroblewski BM (2000) Revision of failed total hip arthroplasty with a proximal femoral modular cemented stem. J Bone Jnt Surg Br 82(5): [BRU] Bruns TB, Robinson BS et al. A new tissue adhesive for laceration repair in children. J Pediatr. 1998;132(6): [CAR] Carleo C, Singer AJ, Thode HC Jr. Effect of frequent water immersion on the rate of tissue adhesive sloughing: a randomized study. CJEM. 2005;7(6): [STR] Strauss EJ, Weil WM et al. A Prospective, Randomized, Controlled Trial of 2-Octylcyanoacrylate Versus Suture Repair for Nail Bed Injuries. J Hand Surg Am. 2008;33(2): [SUN] Sun J, Chen Q-M et al. Octylcyanoacrylate versus absorbable suture in the repair of skin wound in children. Chinese J Clin Rehabilitation. 2005;19:26-29 [SWI] Switzer EF, Dinsmore RC et al. Subcuticular closure versus dermabond: A prospective randomized trial. Am Surg. 2003;69(5): [DAT3] Control Devices vs Various Products. Data on File. May DOF/AST /p3/Conclusion. [VAK] Vakil JJ, O Reilly MP et al. Knee arthrotomy repair with a continuous barbed suture: a biomechanical study. J Arthroplasty. 2011;26(5): [MOR] Moran ME, Marsh C et al. Bidirectional-barbed sutured knotless running anastomosis v classic Van Velthoven suturing in a model system. J Endourol. 2007;21(10): [LEV] Levine BR, Ting N et al. Use of a barbed suture in the closure of hip and knee arthroplasty wounds. Orthopedics. 2011;34(9):e473-e475. [EIC] Eickmann T, Quane E. Total knee arthroplasty closure with barbed sutures. J Knee Surg. 2010;23(3): [EIN] Einarsson JI, Chavan NR et al. Use of bidirectional barbed suture in laparoscopic myomectomy: evaluation of perioperative outcomes, safety, and efficacy. J Minim Invasive Gynecol. 2011;18(1): [ROD] Rodeheaver GT, Pineros-Fernandez A et al. Barbed sutures for wound closure: in vivo wound security, tissue compatibility and cosmesis measurements. In: Transactions from the th Annual Meeting of the Society for Biomaterials; Mount Laurel, NJ; p [WAR] Warner JP, Gutowski KA. Abdominoplasty with progressive tension closure using a barbed suture technique. Aesthet Surg J. 2009;29(3): [DAT4] Ethicon, AST Tissue gapping under tension of porcine cadaveric skin incisions closed with Stratafix Spiral in comparison to Monocryl in both interrupted and continuous stitching patterns. Data on File. Aug DOF/AST /p4/para13/lines1-2; p5/para1/lines1-2 [MOR] Moran2007/p1176/col2/para2. [DAT5] Ethicon, : Time Zero Tissue Holding - Competitive Claims Comparisons for STRATAFIX Knotless Tissue Control Devices vs Various Products. Data on File. May DOF/ /p8/Conclusion. [DAT6] Data on File, Ethicon Inc. (2013) DERMABOND PRINEO Skin Closure System Matrix. PRI [PAR] Parvizi D, Friedl H et al (2013). Use of 2-octyl cyanoacrylate together with a self-adhering mesh (Dermabond Prineo) for skin closure following abdominoplasty: an open, prospective, controlled, randomized, clinical study. Aesthetic Plast Surg 37 (3): [BLO] Blondeel PN, Richter D et al (2014). Evaluation of a new skin closure device in surgical incisions associated with breast procedures. Ann Plast Surg 73 (6): [SIN] Singer AJ, Chale S et al (2011). Evaluation of a novel wound closure device: a multicenter randomized controlled trial. Acad Emerg Med 18 (10): [RIC] Richter D, Stoff A et al (2012). A comparison of a new skin closure device and intradermal sutures in the closure of full-thickness surgical incisions. Plast Reconstr Surg 1 (4): [KHA] Khan RJ, Fick D et al (2006). A comparison of three methods of wound closure following arthroplasty: a prospective, randomised, controlled trial. J Bone Joint Surg Br 88 (2): [EGG] Eggers MD, Fang L et al (2011). A comparison of wound closure techniques for total knee arthroplasty. J Arthroplasty 26 (8): e [ELG] El-Gazzar Y, Smith DC et al (2013). The use of dermabond(r) as an adjunct to wound closure after total knee arthroplasty: examining immediate post-operative wound drainage. J Arthroplasty 28 (4): [SID] Siddiqui M, Bidaye A et al (2016). Wound dressing following primary total hip arthroplasty: a prospective randomised controlled trial. J Wound Care 25 (1): 40, [VAN] van Nooten F, De Cock E et al (2008). Comparing time and supplies usage associated with a new skin closure device vs. standard of care wound closure for abdominoplasty surgery in The Netherlands. International Society for Pharmacoeconomics and Outcomes Research, 11th Annual European Congress. Athens, Greece. [DEC] De Cock E, van Nooten F et al (2008). Changing the surgical wound closure management pathway: Time and supplies with PRINEO vs. standard of care for abdominoplasty surgery in Germany. International Society for Pharmacoeconomics and Outcomes Research, 11th Annual European Congress. Athens, Greece. [DAT7] Data on File, Ethicon Inc. (2007) Dirk Richter Letter Easily removed. 05/21/2007. [COR] CORAIL Unit Sales DePuy Orthopedics, Inc. [LEI] Leisinger S, Hazebrouck S et al (2011). Advanced Fixed Bearing TKA Locking Mechanism Minimizes Backside Micromotion. International Society for Technology in Arthroplasty (ISTA) Annual Meeting. [NJR] National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 13th Annual Report, Table 3.9. Available from [AOA] Australian Orthopaedic Association National Joint Replacement Registry. Annual Report. Adelaide: AOA; Available from URL: aoanjrr.sahmri. com/annual-reports Extract from Table TY1. Table TY1 Cumulative Percent Revision of Primary Total Conventional Hip Replacement Combinations with 10 Year Data (Primary Diagnosis OA). [SDOF] sales data on file, DePuy International Ltd. [KEN] Kendrick BJ1, Wilson HA et al. CORAIL uncemented hemiarthroplasty with a Cathcart head for intracapsular hip fractures Bone Joint J Nov;95-B(11): [SCH] Schaller G, Black J et al. Primary Collared Uncemented Total Hip Arthroplasties in the Elderly: A Safe and Reliable Treatment Option. The Journal of Arthroplasty (2015) [VID] Vidalain JP - The CORAIL Hip System: A Pratical approach based on 25 years of experience. 2011;Chapter 4.2.1: [HAL] Hallan G, Lie SA et al. Medium and long-term performance of 11,516 un-cemented primary femoral stems from the Norwegian arthroplasty register. Journal of Bone and Joint Surgery, 2007;89-B: and cross-linked polyethylene at minimum 10-year follow-up. J Arthroplasty Oct;29(10): [WAN] Wangen H1, Lereim P et al. Hip arthroplasty in patients younger than years: excellent ten to 16-year follow-up results with a HA-coated stem. Int Orthop Apr;32(2): [GRE] Greiner JJ, Callaghan JJ et al. Fixation and Wear With Contemporary Acetabular Components and Cross-Linked Polyethylene at 10-Years in Patients Aged 50 and Under. J Arthroplasty Sep; (9): [ODE] Orthopedic Data Evaluation Panel (ODEP) Available at: [ISPOR] 19th Annual European Congress, 29 October 2 November 2016, Austria Center Vienna, Austria, Abstract No [HWG] Hamilton WG, Brenkel I et al. Early Patient-Reported Outcomes With Primary vs Contemporary Total Knee Arthroplasty: A Comparison of Two Worldwide Multi-Center Prospective Studies. Presentation at the International Society for Technology in Arthroplasty (ISTA), Boston, MA Oct Poster Presentation & E-Poster [LEO] Leopold J.: PATIENT REPORTED OUTCOME MEASURES OF THE CORAIL/PINNACLE CONSTRUCT; NJR-NJR data from 1st April th July 2015 on DePuy products supplied for post-marketing surveillance, NJR Centre, [DAT8] Total Knee Arthroplasty Knee Procedures DERMABOND PRINEO Skin Closure System vs. Skin staples showed statistically significantly reduced length of stay (p<0.05). Data on File. Ethicon, Inc. 2. Total Knee Arthroplasty Knee Procedures DERMABOND PRINEO Skin Closure System vs. Skin staples showed statistically significantly reduced discharge rates(p<0.05). Data on File. Ethicon, Inc. 3. Total Knee Arthroplasty Knee Procedures DERMABOND PRINEO Skin Closure System vs. Skin staples showed statistically significantly reduced All-cause Readmission Rates at, 60, and 90 days. (p<0.05). Data on File. Ethicon, Inc. 4. Retrospective study using data from the Premier Inpatient Database, in Total Knee Arthroplasty procedures. N=1,942. [AEA] Apisarnthanarak et al. Triclosan-coated sutures reduce the risk of surgical site infections: a systematic review and meta-analysis. Infection Control & Hospital Epidemiology. 2015;36(2): Please always refer to the Instructions for Use / Package Insert that come with the device for the most current and complete instructions. Ethicon, Johnson & Johnson Medical Limited, PO Box 1988, Simpson Parkway, Kirkton Campus Livingston, Scotland EH54 0AB, Registered in Scotland, No SC Ethicon Endo-Surgery (Europe) GmbH EMEA