VERILAST™ A technology from Oxidized Zirconium with XLPE Figure HT25: Cumulative Percent Revision of Primary Total Conventional Hip Replacement by Bearing Surface (Primary Diagnosis OA) Cumulative Percent Revision Ceramic/Ceramic Ceramic/Non Cross-Linked Polyethylene Ceramic/Cross-Linked Polyethylene Metal/Metal Metal/Non Cross-Linked Polyethylene Metal/Cross-Linked Polyethylene Ceramicised Metal/Cross-Linked Polyethylene Years Since Primary Procedure Number at Risk Ceramic/Ceramic Ceramic/Non Cross-Linked Polyethylene Ceramic/Cross-Linked Polyethylene Metal/Metal Metal/Non Cross-Linked Polyethylene Metal/Cross-Linked Polyethylene Ceramicised Metal/Cross-Linked Polyethylene 0 Yrs 50533 2961 21192 19422 15949 100782 10154 1 Yr 42704 2655 16987 18852 15099 87223 8230 3 Yrs 29276 2289 10532 16582 13497 62834 5299 5 Yrs 19729 2055 6398 10952 11505 42591 3344 10 Yrs 3918 934 993 1384 4108 7736 0 12 Yrs 285 231 147 118 543 893 0 Real-Life Results In the 2013 Australian Registry, the ceramicized metal/modified polyethylene category, which includes the exclusive OXINIUM™ alloy from Smith & Nephew, had the highest survivorship of all bearing categories at five years: 98%.1 1 Australian Orthopaedic Association National Joint Replacement Registry Annual Report. Adelaide: AOA: 2013. Figure has been reproduced in exact and complete form. For a full copy of the AOA National Joint Replacement Registry report, see http://www.dmac.adelaide.edu.au/aoanjrr/publications.jsp Although the ceramicised metal/cross-linked polyethylene combination has the lowest reported cumulative percent revision at five years this result should be interpreted with caution (Tables HT22 and HT25). It is the Registry’s view that this articulation cannot be compared to other articulations as it has only been used with a small number of femoral stems and acetabular combinations from a single company. The results should not be compared due to the inability to correct for the confounding effect of the limited number of stem/acetabular combinations. Smith & Nephew, Inc 7135 Goodlett Farms Parkway Cordova, TN 38016, USA ™Trademark of Smith & Nephew. Reg. US Pat. & TM Off. Lit. Nr. 01788 Ed. 05/14 VERILAST™ A technology from Oxidized Zirconium with XLPE Ti64 CoCrMo Ti64 OxZr CoCrMo Head on Ti-6Al-4V Taper OxZr Head on Ti-6Al-4V Taper SS SS SS Head on SS Taper SS OxZr OxZr Head on SS Taper Biocompatibilty After over five Mcycles of fatigue testing in 3.5 pH solution, “the OxZr heads, coupled with Ti-6Al-4V and SS trunnions, showed the least chemical attack on either the head or the trunnion.”1 1 Pawar et al., ASMI 2004. Smith & Nephew, Inc 7135 Goodlett Farms Parkway Cordova, TN 38016, USA ™Trademark of Smith & Nephew. Reg. US Pat. & TM Off. Lit. Nr. 01788 Ed. 05/14 VERILAST™ A technology from Oxidized Zirconium with XLPE Cumulative volumetric wear comparison1 700 CoCr (32mm) against CPE Average Volume Loss (mm3) 600 500 CoCr (36mm) against 10-XLPE 400 80% 300 Reduction in volumetric wear after 7.8 million cycles 67% Reduction in volumetric wear after 45 million cycles 200 100 OxZr (36mm) against 10-XLPE 0 0 10 20 30 40 50 Cycles (million) Wear Performance VERILAST Technology for total hip arthroplasty has been tested and shown to provide superior wear performance compared to CoCrMo on highly-crosslinked polyethelene, for up to 45 million cycles. With advanced materials designed to last, VERILAST Technology helps restore patients to their active lifestyles, allowing joint pain to be addressed earlier. 1 ™Trademark of Smith & Nephew. Reg. US Pat. & TM Off. A. Parikh, P. Hill, V. Pawar and J. Sprague, “Long-term simulator wear performance of an advanced bearing technology for THA,” Orthop Res Soc, San Antionio, TX, Jan 26-29, 2013, 1028. Smith & Nephew, Inc 7135 Goodlett Farms Parkway Cordova, TN 38016, USA Lit. Nr. 01788 Ed. 05/14 VERILAST™ A technology from Oxidized Zirconium with XLPE Corrosion avoidance: Retrieval analysis CoCrMo Retrieval1 OXINIUM™ Retrieval1 • 15 year (1997-2012) retrieval analysis • Taper damage related to head material • CoCrMo heads show more corrosion and corrosion by products compared to OxZr Biocompatibilty With its biocompatible properties, due to its use of oxidized zirconium, VERILAST Technology has shown to reduce taper corrosion in total hip arthroplasty, minimizing the concern of trunnionosis. This feature makes VERILAST Technology the optimal solution for total hip arthroplasty. 1 Cartner et al ORS 2014 and Aldinger et al ISTA 2013 Smith & Nephew, Inc 7135 Goodlett Farms Parkway Cordova, TN 38016, USA ™Trademark of Smith & Nephew. Reg. US Pat. & TM Off. Lit. Nr. 01788 Ed. 05/14 VERILAST™ A technology from Oxidized Zirconium with XLPE Long term in vitro corrosion performance • 45 Mcycle wear simulation testing CoCrMo head and associated taper • 36mm heads on 12/14 Ti6Al4V taper • CoCrMo: Maximum depth of material loss at the taper ranged from 5.8 µm to 35.8 µm • OxZr: Depth of material loss at the taper was not measurable Oxidized Zirconium (OXINIUM™) head and associated taper Biocompatibilty For all OxZr heads, little or no evidence of fretting and corrosion was observed, and the depth of material loss at the taper was not measurable. The results demonstrated that the tapers for the OxZr heads are less susceptive to fretting and corrosion as compared to those for the CoCrMo heads. 1 Li et al OR‐13‐75 Smith & Nephew, Inc 7135 Goodlett Farms Parkway Cordova, TN 38016, USA ™Trademark of Smith & Nephew. Reg. US Pat. & TM Off. Lit. Nr. 01788 Ed. 05/14