ReCap Product Rationale

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1 FLH /09 Biomet UK Ltd Waterton Industrial Estate Bridgend, South Wales CF31 3XA, United Kingdom Tel. +44 (0) Fax. +44 (0)

2 ReCap Product Rationale

3 A complete resurfacing system designed on sound engineering principles, tried and tested materials and clinically proven fixation methods

4 Bone Preservation Optimal Wear Characteristics/Tribology Clinically Proven Fixation Methods Intra Operative Flexibility Precise & Reproducible Instrumentation

5 Anti Rotational Fins - Additional primary fixation 3mm Wall Thickness - Greater bone preservation Porous Plasma Spray (PPS) - Twice the rotational stability of beads and clinically proven as a bone friendly in-growth surface 1-4 (HA Coated Options also available). Oversized Shell Options (+2mm) - Addresses femoral and acetabular mismatch Hemispherical Shell Design - Maximises head coverage whilst providing a secure press fit Large Implant Range - 44mm 68mm in 2 mm increments Introduction Accumulated experience has shown that wear particles of polyethylene are the principle cause of interface failure. This is particularly important in young, high activity individuals where long term fixation is needed. The time has come when the use of Metal on Metal bearings, with virtually no generation of wear debris, should be considered in such patients. Biomet s commitment to manufacturing Gold Standard Metal on Metal implants date back to 1961 with Stanmore Total Hip System. This was followed by the McKee Farrar Total Hip System and more recently with the M 2 a Hip System. In response to this Biomet, alongside Key Development Centres world-wide, have developed the ReCap Total Resurfacing System. 1. Bourne, et al.: Titanium Porous Plasma Spray Coating. CORR, No. 298, January Burt, C.F; et al.: A Femoral Component Inserted Without Cement in Total Hip Arthroplasty. JBJS, July Coathup, M.J.; et al.: A Comparison of Bone Remodeling Around Hydroxyapatite Coated, Porous-Coated and Grit-Blasted Hip Replacements Retrieved at Post- Mortem. JBJS, January Markel, D.C.; et al.: Initial Scratch Fit Stability of Acetabular Cups: Comparison of Three Porous Coating Systems. ISTA, San Diego, CA, 1997.

6 The ReCap System M2a Precision Manufacture % checked by Zygo Machine, note Tolerance levels as cast cobalt chrome head 23 degrees Head Coverage - Allowing greater range of motion Unique Internal Spherical Geometry - Allowing for more natural femoral loading patterns Interlok Surface - Clinically proven cemented surface Large Implant Range - 12 sizes (38mm-60mm) 2mm Increments Bone Preservation The ReCap Total Resurfacing System resects minimal bone both from the femur and acetabulum. This is attributed to the thin components and 2mm increment component sizing. The unique spherical femoral reaming technique employed by the system, offers some distinct advantages: The acetabular component is no different. With a wall thickness of only 3mm and again a 2mm increment component sizing, it allows minimal reaming to achieve optimal fixation. Reduces Risk of Notching Normal Femoral Loading Restoration of Normal Anatomy Reduced Risk of Dislocation

7 Optimal Wear Characteristics and Tribology Biomet had a vast understanding of what is needed to produce the optimal Metal on Metal Implant, focusing efforts on optimal materials, manufacturing tolerances and processes. As-cast materials were determined to have greater abrasive wear resistance when compared to single or multiple heat treated materials A tribological study of cobalt chromium molybdenum alloys used in metal-on-metal resurfacing hip arthroplasty, J. Cawley, J.E.P. Metcalf, A.H. Jones, T.J. Band and D.S. Skupien, Wear 255 (2003),

8 Clinically Proven Fixation Methods In determining which implant and surface coating is best for patients, many issues should be considered, including: How are initial stability and fixation achieved? To what degree will osseointegration occur, and when? Will the coating successfully inhibit debris migration? By addressing these three critical issues, Biomet s Porous Plasma Spray has achieved outstanding clinical results since its introduction in1981. At follow up, surgeons are observing results of nearly 100% Survivorship at over 10 years with implants such as the Bimetric Hip System, Taperloc Hip System. Hydroxyapatite increases the amount of in growth and attachment of bone, and will further aid in initial stability when applied on top of our clinically proven Porous Plasma Spray. 1 BiMetric Stem: 99.5% Survivorship 12 years 2 100% Survivorship 10.4 years 3 Taperloc Stem: 99.6% Survivorship 12 years 4 98% Survivorship 12 Years 5 1. Blunn, et. al. JBJS Vol. 83-B, No 1, January Eskeline et. al. Acta Orthopeadica 2006; 77 (1): Meding et. al. JBJS (A) 2004;86-A: McLaughlin et. al. JBJS(A) 2008;90: Parvizi et. al. Journal of Arhtroplasty 2004;19:No. 2:

9 As-cast materials were determined to have greater abrasive wear resistance when compared to single or multiple heat treated materials Intraoperative Flexibility In an unpredictable situation like surgery, it is comforting to know you have a number of options to deal with difficult situations. ReCap is one of the most comprehensive Systems on the Market, offering: Large Implant Range 38mm-60mm Femoral Head 2mm Increments 44mm-66mm Acetabular Cup 2mm Increments Can be used with any Biomet Stem 2mm Oversized Acetabular Cups Oversized Outer Diameter of acetabular shell To offer femoral and acetabular size mismatching. Porous Coating & HA Coating Femoral and Acetabular Components available as cemented or uncemented with HA. Modular Revision Heads Designed for easy revision to THR.

10 Precise & Reproducable Instrumentation Dedicated Instrumentation Machined to exact tolerances enabling reproducible results time after time. Sequential Surgical Technique Logical stepped surgical procedure giving the surgeon intra operative flexibility Reliable, Accuracy, Advanced Simplicity The validated KS alignment device is an efficient reproducible and reliable 1,2 tool which makes femoral pin positioning easy Designed to be used with MicroPlasty Instruments designed to be used through a minimal incision, allowing Rapid Recovery for the patient. 1. Validation of Femoral Resurfacing alignment device using computer aided navigation A Phadnis*, K Singhal, V Pitkänen, A Turner, Poster presented at the Biomet Hip Symposium Femoral Resurfacing Component position using an alignment device vs CAN A Phadnis*, K Singhal, V Pitkänen, A Turner

11 Ordering Information Implants ReCap Resurfacing Heads ReCap Femoral Instrument Tray Catalogue Number Cat. No. Description ReCap Resurfacing Head Sz 38mm ReCap Resurfacing Head Sz 40mm ReCap Resurfacing Head Sz 42mm ReCap Resurfacing Head Sz 44mm ReCap Resurfacing Head Sz 46mm ReCap Resurfacing Head Sz 48mm ReCap Resurfacing Head Sz 50mm ReCap Resurfacing Head Sz 52mm ReCap Resurfacing Head Sz 54mm ReCap Resurfacing Head Sz 56mm ReCap Resurfacing Head Sz 58mm ReCap Resurfacing Head Sz 60mm ReCap HA/Porous Coated Acetabular Components ReCap General Instrument Tray Catalogue Number ReCap Cylindrical Reamer Tray Catalogue Number Cat. No. Description ReCap PF HA/PC Acetabular Comp Ø 44/38mm ReCap PF HA/PC Acetabular Comp Ø 46/40mm ReCap PF HA/PC Acetabular Comp Ø 48/42mm ReCap PF HA/PC Acetabular Comp Ø 50/44mm ReCap PF HA/PC Acetabular Comp Ø 52/46mm ReCap PF HA/PC Acetabular Comp Ø 54/48mm ReCap PF HA/PC Acetabular Comp Ø 56/50mm ReCap PF HA/PC Acetabular Comp Ø 58/52mm ReCap PF HA/PC Acetabular Comp Ø 60/54mm ReCap PF HA/PC Acetabular Comp Ø 62/56mm ReCap PF HA/PC Acetabular Comp Ø 64/58mm ReCap PF HA/PC Acetabular Comp Ø 66/60mm ReCap Spherical Reamer Tray Catalogue Number ReCap Impaction Instrument Tray Catalogue Number ReCap Porous Coated Acetabular Components Cat. No. Description ReCap PF PC Acetabular Comp Ø 44/38mm ReCap PF PC Acetabular Comp Ø 46/40mm ReCap PF PC Acetabular Comp Ø 48/42mm ReCap PF PC Acetabular Comp Ø 50/44mm ReCap PF PC Acetabular Comp Ø 52/46mm ReCap PF PC Acetabular Comp Ø 54/48mm ReCap PF PC Acetabular Comp Ø 56/50mm ReCap PF PC Acetabular Comp Ø 58/52mm ReCap PF PC Acetabular Comp Ø 60/54mm ReCap PF PC Acetabular Comp Ø 62/56mm ReCap PF PC Acetabular Comp Ø 64/58mm ReCap PF PC Acetabular Comp Ø 66/60mm ReCap Auxiliary Tray Assembly Catalogue Number ReCap Acetabular Grater Reamer Tray Catalogue Number

12 Cementless Over-Size PC Acetabular Components Cat. No. Descriptioners ReCap OS PC Acetabular Comp 38/46mm ReCap OS PC Acetabular Comp 40/48mm ReCap OS PC Acetabular Comp 42/50mm ReCap OS PC Acetabular Comp 44/52mm ReCap OS PC Acetabular Comp 46/54mm ReCap OS PC Acetabular Comp 48/56mm ReCap OS PC Acetabular Comp 50/58mm ReCap OS PC Acetabular Comp 52/60mm ReCap OS PC Acetabular Comp 54/62mm ReCap OS PC Acetabular Comp 56/64mm ReCap OS PC Acetabular Comp 58/66mm ReCap OS PC Acetabular Comp 60/68mm Cementless Over-Size HA/PC Acetabular Components Cat. No. Descriptioners HA ReCap OS HA/PC Acetabular Comp 38/46mm HA ReCap OS HA/PC Acetabular Comp 40/48mm HA ReCap OS HA/PC Acetabular Comp 42/50mm HA ReCap OS HA/PC Acetabular Comp 44/52mm HA ReCap OS HA/PC Acetabular Comp 46/54mm HA ReCap OS HA/PC Acetabular Comp 48/56mm HA ReCap OS HA/PC Acetabular Comp 50/58mm HA ReCap OS HA/PC Acetabular Comp 52/60mm HA ReCap OS HA/PC Acetabular Comp 54/62mm HA ReCap OS HA/PC Acetabular Comp 56/64mm HA ReCap OS HA/PC Acetabular Comp 58/66mm HA ReCap OS HA/PC Acetabular Comp 60/68mm M2a-Magnum Modular Heads Cat. No. Description M2a-Magnum Modular Head Sz 38mm M2a-Magnum Modular Head Sz 40mm M2a-Magnum Modular Head Sz 42mm M2a-Magnum Modular Head Sz 44mm M2a-Magnum Modular Head Sz 46mm M2a-Magnum Modular Head Sz 48mm M2a-Magnum Modular Head Sz 50mm M2a-Magnum Modular Head Sz 52mm M2a-Magnum Modular Head Sz 54mm M2a-Magnum Modular Head Sz 56mm M2a-Magnum Modular Head Sz 58mm M2a-Magnum Modular Head Sz 60mm M2a-Magnum Modular Head 12/14 Taper Adaptors Cat. No. Descriptioners M2a-Magnum Tpr Adptr 38-40mm 2mm 12/ M2a-Magnum Tpr Adptr 38-40mm STD 12/ M2a-Magnum Tpr Adptr 38-40mm +4mm 12/ M2a-Magnum Tpr Adptr 38-40mm +8mm 12/ M2a-Magnum Tpr Adptr 42-50mm 2mm 12/ M2a-Magnum Tpr Adptr 42-50mm STD 12/ M2a-Magnum Tpr Adptr 42-50mm +4mm 12/ M2a-Magnum Tpr Adptr 42-50mm +8mm 12/ M2a-Magnum Tpr Adptr 52-60mm 2mm 12/ M2a-Magnum Tpr Adptr 52-60mm STD 12/ M2a-Magnum Tpr Adptr 52-60mm +4mm 12/ M2a-Magnum Tpr Adptr 52-60mm +8mm 12/14 M2a-Magnum Modular Head Type1 Taper Adaptors Cat. No. Description M2a-Magnum Tpr Adptr 38-40mm 6mm (T1) M2a-Magnum Tpr Adptr 38-40mm 3mm (T1) M2a-Magnum Tpr Adptr 38-40mm STD (T1) M2a-Magnum Tpr Adptr 38-40mm +3mm (T1) M2a-Magnum Tpr Adptr 38-40mm +6mm (T1) M2a-Magnum Tpr Adptr 38-40mm +9mm (T1) M2a-Magnum Tpr Adptr 42-50mm 6mm (T1) M2a-Magnum Tpr Adptr 42-50mm 3mm (T1) M2a-Magnum Tpr Adptr 42-50mm STD (T1) M2a-Magnum Tpr Adptr 42-50mm +3mm (T1) M2a-Magnum Tpr Adptr 42-50mm +6mm (T1) M2a-Magnum Tpr Adptr 42-50mm +9mm (T1) M2a-Magnum Tpr Adptr 52-60mm 6mm (T1) M2a-Magnum Tpr Adptr 52-60mm 3mm (T1) M2a-Magnum Tpr Adptr 52-60mm STD (T1) M2a-Magnum Tpr Adptr 52-60mm +3mm (T1) M2a-Magnum Tpr Adptr 52-60mm +6mm (T1) M2a-Magnum Tpr Adptr 52-60mm +9mm (T1) Instrumentation ReCap/M2a-Magnum Modular Head Tray - Catalogue Number (note: when ordering catalogue no please also order either or ) M2a-Magnum Mod Head Trial Taper Adaptor Set (12-14) Catalogue Number M2a-Magnum Mod Head Trial Taper Adaptor Set (T1) Catalogue Number

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