DEPUY SYNTHES JOINT RECONSTRUCTION PATIENT EDUCATION SEMINAR Welcome! 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 hip pain and treatment options will be followed by a question-and-answer session. Today s presentation is sponsored by DePuy Synthes Joint Reconstruction
AGENDA How your hip works & why it hurts Hip replacement basics What patients have to say Your questions Pelvis Hip socket (Acetabulum) Leg bone (Femur) Ball (Femoral head) 2 2
Michael Patney D.O. Coastal Orthopedics 904-269-1930 3
B.A. in Biology at Temple University, Doctorate in Osteopathy at Philadelphia College of Osteopathic Medicine, Orthopaedic Surgery Residency at BiCounty Community Hospital. Board certified in Orthopaedic surgery by the American Osteopathic Board of Orthopedic Surgery (AOBOS). Appointed multiple positions throughout career: Chief Surgical Resident, Chief of General Orthopaedic Division, Assistant Clinical Professor, Chief of Adult Reconstruction Division, Medical Director of Orthopedics Inpatient Unit. Staff privileges at St. Vincent s MC Clay, St. Vincent s MC Southside and Memorial Hospital Jacksonville, Surgcenter of Orange Park. 4
WHAT DO YOU THINK? 1. How many people in the United States undergo hip replacement surgery each year? a) 80,000 b) 325,000 c) 650,000 2. What disease is the leading cause of disability in the U.S.? a) Heart Disease b) Diabetes c) Arthritis 5
HOW YOUR HIP WORKS Anatomy of the Hip Ball-and-socket joint Ball (femoral head) at the end of the leg bone (femur) Hip socket (or acetabulum) holds the ball 6 6
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 and possibly throbbing and deformity 1. Landers, S. Another reason to exercise for those with arthritis. American Medical Association website. 2005. Available at: http://www.ama-assn.org/amednews/2005/05/02/hlsc0502.htm. 7
WHAT S CAUSING YOUR PAIN? Healthy Hip The end of each bone in the joint is covered with cartilage, acting as a cushion so the joint functions without pain Diseased Hip (osteoarthritis) Wear and tear deteriorates natural cushion, leading to bone-on-bone contact, soreness and swelling 8
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 or up into the low back? 9
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 relief 1 Little or no pain Excruciating, debilitating pain 1.2008 DePuy Synthes Joint Reconstruction Hip Attitudes & Usage Study. 10
HOW CAN YOUR PAIN BE TREATED? Water Therapy Soaking, hot packs Exercise & physical therapy Good for weight loss Medications Analgesics Anti-Inflammatories Injections Steroids 11
HIP REPLACEMENT Implants replace damaged surfaces Helps relieve pain and improve mobility In 2011, more than 325,000 people in the United States had a total hip replacement 1 1. 2012 Premier, Inc. 12
WHAT IS HIP REPLACEMENT? Ball Liner A surgical procedure that removes and replaces diseased joint surfaces with implants Stem 13
HOW DOES IT WORK? Diseased area in hip socket removed & re-shaped New cup secured in socket Liner placed within cup Stem inserted in leg bone (femur) Ball is placed on the stem Ball placed in cup 14
HOW DOES IT WORK? Pre-op Post-op FPO istockphoto $12-18 9799592 15
ANTERIOR APPROACH 16 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 bones Results in a faster and more complete return to function Allows for the surgery to be done as an outpatient.
TRADITIONAL SURGERY Patients typically lie on their side Incision on side or back of leg Surgeon detaches muscles, disrupts tissue Surgeon relies on post-operative x-ray to check component placement and leg length 17
ANTERIOR APPROACH Patients lie on back Incision on front of leg No detachment of muscles, minimal disruption of tissue Surgeon can check component placement & leg length during procedure 18
POTENTIAL BENEFITS OF THE ANTERIOR APPROACH Less trauma to the body Smaller incision Potentially less pain Less tissue disruption, may lead to faster rehabilitation Fewer restrictions during recovery 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, 2010. 19 Comparison of functional outcomes after Anterior Approach (211 patients) with Anterolateral/Traditional (259 patients).
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 hip replacement is right for you 20
WHICH BEARING IS RIGHT FOR YOU? When choosing a bearing, your surgeon will consider: Range of motion Stability Wear characteristics Lifestyle Age, weight & gender Severity of disease Your surgeon will work with you to choose materials that are right for you. 21
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 interact DePuy Synthes Joint Reconstruction bearing options: Metal-on-plastic (polyethylene) Ceramic-on-plastic (polyethylene) Ceramic-on-ceramic 22
SHOULD YOU WAIT TO REPLACE YOUR HIP? Assess your pain and ability to function Do you have difficulty sleeping or performing basic functions (shopping or walking up the stairs)? Does medication no longer provide relief? Consult your physician Early diagnosis and treatment are important 1 Delaying may lower your quality of life 2 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. 23
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 hip replacement is right for you 24
WHAT OTHER PATIENTS HAVE TO SAY Please note: As with any medical treatment, individual results may vary. Only an orthopaedic surgeon can determine whether an orthopaedic implant is an appropriate course of treatment. There are potential risks, and recovery takes time. The performance of the new joint depends on weight, activity level, age and other factors. 25
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. 1 90% said they were able to participate in their favorite activities. 1 One study has shown that PINNACLE Hips have a 95.8% success rate 9 years after surgery. 2 26 1.DePuy Hip Pain: A&U/Segmentation. Final Report January 2008. Data on file. 2.Multi-center PINNACLE Acetabular Cup System Outcomes Study, Kaplan-Meier survivorship results. Abstract submitted June 1, 2012 for 2013 AAOS Meeting.
SUMMARY The leading cause of hip pain is osteoarthritis Osteoarthritis is degenerative -it won t get better and may get worse Early diagnosis and treatment of osteoarthritis are important Hip replacement helps relieve pain and improve mobility Your surgeon will help choose the right implant for you 27
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 28
QUESTIONS? Michael Patney D.O., Coastal Orthopaedics Orange Park location: 1715 Eagle Harbor Parkway, Suite B Fleming Island, FL 32003 Jacksonville location: 4131 University Boulevard South, Building 15 Jacksonville, FL 32216 Phone: 904-269-1930 Website: coastalorthopedicsjax.com 23
THANK YOU! To find out more about hip pain and the treatment options available, visit: www.depuysynthes.com www.hipreplacement.com www.aaos.org 30 DePuy Synthes Joint Reconstruction, a division of DOI 2013 The third-party trademarks used herein are trademarks of their respective owners. 3/2013