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Hip Resurfacing Market By MedPanel, Inc. November 2006

Hip Resurfacing Market By MedPanel, Inc. November 2006. Contents: Project Objectives 2 Methodology & Sample 3 Executive Summary 4-7 Detailed Findings 8-26 Current Use of Hip Replacements 9-11

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Hip Resurfacing Market By MedPanel, Inc. November 2006

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  1. Hip Resurfacing MarketBy MedPanel, Inc.November 2006

  2. Contents: • Project Objectives 2 • Methodology & Sample 3 • Executive Summary 4-7 • Detailed Findings 8-26 • Current Use of Hip Replacements 9-11 • Hard-on-Hard Bearing Hip Replacements 12-16 • Hip Resurfacing 16-26

  3. Study Objectives Primary Objective: Understand the current and future markets for hip resurfacing Specific Objectives: • Determine background information regarding current practice procedures used by the respondents • Evaluate the current uses of hard-on-hard bearing hip implants • Examine the possible future market for hip resurfacing procedures • Identify levels of risk associated with the use of hip resurfacing procedures

  4. Methodology & Sample Survey Specifics: A 10-minute self-administered survey was fielded online via MedPanel’s Web site November 13-14, 2006. Sample: The total sample comprises 50 orthopedic surgeons selected from MedPanel’s U.S. database. • To qualify, respondents were required to meet the following criteria: • Have been in practice between 2 and 30 years (mean: 16.9 years, range: 3-30) • Spend at least 75% of their professional time in clinical practice (mean: 98%)

  5. Executive Summary

  6. Executive Summary • Current Use of Hip Replacements • Over 50% of respondents currently are using primary hip implants manufactured by Johnson & Johnson and Stryker • Hard-on Hard Bearing Hip Replacements • Orthopedic surgeons indicated that 18% of their primary hip implants are hard-on-hard bearing implants • Surgeons reported a 54% increase in procedures using hard-on-hard bearing implants over the past year • 20% of respondents selected 56-60 years as the age cut-off category for hard-on-hard bearing implants • On a scale from 1-5, respondents rated somewhat favorably large-head metal-on-metal designs used for hip resurfacing; score of 3 out of 5 • 76% of respondents agreed with the statement that younger, active patients are well served by current hard-on-hard designs, emphasizing better wear, better longevity, and better stability of this design

  7. Executive Summary • Hip Resurfacing • Orthopedic surgeons said that 20% of primary hips will use a resurfacing implant five years from now • Physicians reported a somewhat moderate level of interest of their patients in hip resurfacing procedures; score of 2.7 out of 5 • Respondents stated that the availability of hip resurfacing will be somewhat influential on the decision of young patients; score of 3 out of 5 • 52% of orthopedic surgeons indicated that 10 procedures is the learning curve for the process of resurfacing • Over 50% of respondents said that hip resurfacing will make future revisions easier • 64% of respondents mentioned they are somewhat concerned about the risk of femoral neck fracture with hip resurfacing

  8. Executive Summary • Hip Resurfacing (continued) • 64% of orthopedic surgeons are somewhat concerned about the rise in systemic metal ion concentrations with metal-on-metal implants • 44% of physicians are unsure whether clinical benefits of hip resurfacing will outweigh the risks associated with it • 54% of respondents said they plan to be trained on hip resurfacing prior to availability of hip resurfacing products • Orthopedic surgeons most commonly selected Stryker as the vendor of the product to be trained on

  9. Detailed Findings

  10. Current Use of Hip Replacements

  11. Survey DetailsCurrent Use of Hip Replacements Practice Location (n=50) Hip Replacement Procedures per Year: Mean: 56 (Range: 6-150) Q1. Please select your location of practice. Q2. In a typical year, approximately how many hip replacements do you perform?

  12. Survey DetailsCurrent Use of Hip Replacements Over 50% of respondents are currently using primary hip implants manufactured by Johnson & Johnson and Stryker Hip Replacement Manufacturers (n=50) Q3. Please estimate the percentage of your primary hip implants that are from each of the following manufacturers.

  13. Hard-on-Hard Bearing Hip Replacements

  14. Survey DetailsHard-on Hard Bearing Hip Replacements Orthopedic surgeons indicated that 18% of their primary hip implants are hard-on-hard bearing implants. Respondents also indicated a 54% increase in procedures using hard-on-hard bearing implants. Change in Hard-on-Hard Bearing Use(n=50) Types of Hip Implants (n=50) N/A Q4. Please estimate the percentage of your primary hip implants that are hard-on-hard bearing implants. Q5. Over the past year, how has your proportion of procedures using hard-on-hard bearings changed?

  15. Survey DetailsHard-on Hard Bearing Hip Replacements One-fifth of respondents selected 56-60 years as the age cut-off category for hard-on-hard bearing implants. Hard-on-Hard Bearing Age Cut-Off (n=50) Years of age Q6. What is the rule of thumb age cut-off for hard-on-hard bearing implants?

  16. Survey DetailsHard-on Hard Bearing Hip Replacements On a scale from 1-5, respondents rated neutrally large-head metal-on-metal designs used for hip resurfacing, giving them the score of 3 out of 5. Overall Impression of Metal-on-Metal Bearings (n=50) Mean 3.06 Q7. Using a scale from 1 to 5, please rate your overall impression of large-head metal-on-metal designs used for hip resurfacing. “1” indicating “very skeptical” impression; “5” indicating “very favorable” impression.

  17. Survey DetailsHard-on Hard Bearing Hip Replacements 76% of respondents agreed with the statement that younger, active patients are well served by current hard-on-hard designs, emphasizing better wear, better longevity, and better stability of this design. Use of Hard-on-Hard Bearings with Young Patients (n=50) Rationale: Yes: • Better wear (12) • Last longer (7) • Better stability (2) • Saves proximal femoral bone (1) No: • Need more data (5) • No better than poly (3) • Metal debris concern (1) Q8. In your opinion, are younger, active patients well served by current hard-on-hard designs? Q9. Please explain your response.

  18. Hip Resurfacing

  19. Survey DetailsHip Resurfacing Respondents indicated that 20% of primary hips will use a resurfacing implant in 5 years. Primary Hips Using Resurfacing Implant (n=50) Q10. Please estimate the percentage of primary hips that will use a resurfacing implant at each of the following time periods.

  20. Survey DetailsHip Resurfacing Physicians reported a somewhat moderate level of interest of their patients in hip resurfacing. Patient Interest in Hip Resurfacing (n=50) Mean 2.7 Q11. Using a scale from 1 to 5, please rate the level of interest your patients have shown in hip resurfacing procedures. “1” indicating “Not at all interested” and “5” indicating “Very interested.”

  21. Survey DetailsHip Resurfacing Respondents stated that the availability of hip resurfacing will be somewhat influential on the decision of young patients, who may otherwise defer hip replacement surgery. Influence of Hip Resurfacing on Young Patient Decision to Receive Implant (n=50) Mean 3.0 Q12. Using a scale from 1 to 5, please rate how influential the availability of hip resurfacing will be on the decision of young patients, who may otherwise defer hip replacement surgery, to accelerate their decision to have the surgery. “1” indicating “Not at all influential” and “5” indicating “Very influential.”

  22. Survey DetailsHip Resurfacing 52% of orthopedic surgeons indicated that 10 procedures is the learning curve for the process of resurfacing. Learning Curve for Resurfacing (n=50) Q13. In your opinion, how long is the learning curve for the process of resurfacing?

  23. Survey DetailsHip Resurfacing Over 50% of respondents said that hip resurfacing will make future revisions easier. Impact of Resurfacing on Revision Ability (n=50) Q14. What will be the impact of hip resurfacing on the ability of the surgeon to make future revisions?

  24. Survey DetailsHip Resurfacing A majority of respondents indicated they are somewhat or very concerned about the risk of femoral neck fracture with hip resurfacing. Level of Concern About Femoral Neck Fracture with Hip Resurfacing (n=50) Q15. How concerned are you about the risk of femoral neck fracture with hip resurfacing?

  25. Survey DetailsHip Resurfacing 64% of orthopedic surgeons are somewhat concerned about the rise in systemic metal ion concentrations with metal-on-metal implants. Level of Concern About Systemic Metal Ion Concentrations with Hard-on-Hard Bearings (n=50) Q16. How concerned are you about the rise in systemic metal ion concentrations with metal-on-metal implants?

  26. Survey DetailsHip Resurfacing 44% of physicians are unsure whether clinical benefits of hip resurfacing will outweigh the risks associated with it. Will Benefits Outweigh Risks of Hip Resurfacing? (n=50) Q17. Do you believe that the clinical benefits of hip resurfacing will outweigh the risks associated with it?

  27. Survey DetailsHip Resurfacing 54% of respondents said they plan to be trained on hip resurfacing prior to availability of hip resurfacing products. Orthopedic surgeons most commonly selected Stryker as the vendor of the product to be trained on. Plans for Training in Hip Resurfacing (n=50) Vendors: (n=27) - Stryker (8) • Smith & Nephew (5) • Biomet (5) - Zimmer (4) • Depuy (4) • Johnson & Johnson (1) • Osteonics (1) • Richards (1) Q18. Do you plan to be trained on hip resurfacing prior to your primary vendor having a hip resurfacing product available? Q19. Which vendor product do you expect to be trained on?

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