You might not see a big difference.1210–15, 2005. Grübl ...® Zweymüller® Stem...osseointegration properties. • Further increase of the product range to 8 standard sizes and

You might not see a big difference. But you will when you read some of over 100 publications *

written about the Alloclassic ® Zweymüller ® Hip Stem.

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“The most important findings of our fifteen-year update are the low rate of stem revision, the low rate of radiographic signs of loosening, and the low rate of distal femoral osteolysis associated with this cementless tapered, rectangular titanium stem, which is still in use and has not been changed since 19861.”Grübl, et al: 2006

The Original Since 1979

In 2009 Zimmer® Alloclassic® Zweymüller® Hip Stem celebrates 30 years of clinical history.

You might not see a big difference at first, but you will when you read some of the more than 100 published studies demonstrating the success of this implant and its excellent primary and secondary fixation.

Since 1979, over 500,000 total hip arthroplasties have utilized the original Alloclassic Zweymüller Hip Stem, making this uncemented prosthesis one of the most widely implanted in the world. The straightforward surgical technique and the broad product range are designed to aid surgeons in their goal of providing optimum care for their patients.

The Alloclassic Zweymüller Hip Stem is the only original product with this specific design and represents a milestone in total joint replacement.

We invite you celebrate with us and to learn more about this comprehensive THA solution with long-term clinical history.

History

1979The First Implantation of the Alloclassic Zweymüller Hip Stem

The Original • Alloclassic Zweymüller SL Stem manufactured by Sulzer Medizinaltechnik is first implanted by Professor Zweymüller in Vienna on October 5, 1979.Philosophy: uncemented stem •combined with a distal fixation.Design: double taper, rectangular cross •section, proximal macrostructures, distal longitudinal grooves, proximal thinning, collar and a surface roughness of 1μm.

1983Further Development

Collar removed.•Proximal region thickened to improve •proximal press-fit.Product range increased to •7 sizes.

1985A New Material

Development of Protasul• ®-100, a Ti6AI7Nb forged alloy, with excellent osseointegration properties.Further increase of the product range to •8 standard sizes and an additional 6 sizes for special cases.Surface roughness increased from 1μm •to 3–5μm, resulting in excellent bone on-growth.Diaphyseal/metaphyseal grooves were •replaced by a thicker raised section, extending along the entire length of the stem to improve press-fit.

1986Introduction of the Step Less (SL) Concept

All sizes now form a continuous taper •and are harmonized using optimized increments.Hyperbolic curvature is patented based •on the stem’s excellent anatomical fit.Development of a new patented •extraction hole.Further expansion of the product range •to 14 standard sizes (01 to 12).

2003Optimized Range of Motion

Introduction of a slim neck design and •short taper to increase range of motion and reduce the risk of impingement and dislocation.

2004Extended Product Portfolio

Introduction of an offset version, the •Alloclassic Zweymüller SLO Stem. 4mm lateralization of the • Alloclassic Zweymüller SL Hip Stem is achieved without compromising leg length.

“In our series, cumulative survival with any femoral revision as the end point was 0.99 (95% confidence interval, 0.97 to 1.00) at ten years. Thus, our femoral implant is highly reliable2.” Grübl, et al: 2002

Design Features

➊Two offset versions provide for a better reconstruction of patient anatomy without affecting leg length

➋Easily accessible extraction hole

➌Trochanteric wing results in a high degree of rotational stability

➍Double-tapered, rectangular stem design shows excellent primary and rotational stability

➎Protasul-100 Titanium Alloy with grift-blasted surface for excellent osseointegration

➍

➎

➊➋

➌

“Our study shows that a small change in the form of the femoral implant can result in statistically significant radiological changes in bone remodelling3.”Wick & Lester, 2004

The Original Concept

Rough blasted surface provides for excellent osseointegration

Cross-section of the Zimmer Alloclassic Zweymüller Hip Stem indicates that the medullary canal is not completely filled, which helps to preserve endosteal blood supply to a large extent2

Excellent Osseointegration

Excellent primary and secondary fixationProven rotational stability

Distal fixation• Cortical press-fit due to the double-tapered shape•Rectangular cross-section for rotational stability•Trochanteric wing provides for rotational stability• Rough blasted surface encourages excellent bone •on-growth

“In summary, the implantation of the cementless Alloclassic SL stem and its osseointegration is possible in very old patients4.” Pieringer, et al: 2004

Broad Product Indications

Designed to cover a wide range of patient population and cases

Versatile Alloclassic Zweymüller SL Stem family can be used for:

Primary cases•Trauma cases•Revision cases• Young patients, 50 years-old and •younger Elderly patients, 80 years-old and •older

SL Stem SL HAC Stem SLL Stem (Step Less) (Step Less HA Coated) (Step Less Long) SLO(Step Less Offset)

“The 18-year cumulative survivorship rate of […] 95% for the stem was high, particularly since the patients were young5.”Reigstad, et al: 2008

Longterm Clinical Results

Up to 18 Years of Follow-Up for the Alloclassic Zweymüller Hip Stem

98.0%Survival rate in 89 cases at 15 years (all reasons for revisions) (Grübl, et al: 2006)1

95%Survival rate at 18 years in 47 young patients (all reasons for revisions) (Reigstad, et al: 2008)5

100%Survival rate in 78 hips at 13 years (endpoint aseptic loosening) (Pieringer, et al: 2006)7

100%Survival rate in 817 cases at 6.7 years (endpoint aseptic loosening) (Grübl, et al: 2003)9

Preoperative X-ray of a right hip withposttraumatic femoral head, asepticosteonecrosis in a 57 years old,healthy and active (Devane grade 4)female patient, 6 years after internalfixation of a Garden I femoral neckfracture.

Post-operative X-ray of an active 70-year-old female (Devane grade 3) at 12.8 years showing a stable Alloclassic Zweymüller Hip Stem in spite of a slight varus position due to a previous arthroplasty.

“With a survival rate of 100% for the Alloclassic SL stem and 98.4% for the CSF cup after 157 months (end point aseptic loosening), results using this system are among the very best, as a comparison of the recent literature shows7.” Pieringer, et al: 2006

Long-term Survival Rate Demonstrated in more than 100 Publications

Patients 80 years and older

100 % at 5.7 years (endpoint aseptic loosening)

Pieringer, et al: Z. Orthop, 20044

Younger patients (52 years and younger)

100 % at 6.3 years (endpoint aseptic loosening)

Vervest & Anderson: Hip Intern, 20058

95 % at 18 years (endpoint aseptic loosening)

Reigstadt, et al: Acta Orthopaedica, 20085

Patients with dysplastic hips

100 % at 9.3 years (endpoint aseptic loosening)

Perka, et al: JBJS Am., 20046

Bibliography

1 Grübl, et al: Cementless Total Hip Arthroplasty with the Rectangular Titanium Zweymüller Stem. A Concise Follow-up, at a Minimum of Fifteen Years of a Previous Report. JBJS Am. 88:2210–2215, 2006

2 Grübl, et al: Cementless Total Hip Arthroplasty with a Tapered, Rectangular Titanium Stem and a Threaded Cup. JBJS 84-A, Number 3, 2002

3 M. Wick, D.K Lester, Radiological changes in second- and third-generation Zweymüller stems. JBJS Br. 86-B:1108–14, 2004

4 Pieringer, et al: Radiological Appearance of the Cementless Alloclassic SL-Stem Implanted in Very Old Patients with Primary Osteoarthritis of the Hip. Z Orthop 142: 322–327, 2004

5 Ole Reigstad, Per Siewers, Magne Røkkum, Birgitte Espehaug. Excellent long-term survival of an uncemented press-fit stem and screw cup in young patients: Follow-up of 75 hips for 15-18 years, Acta Orthopaedica, 79:2, 194–202, 2008

6 Perka, et al: Developmental Hip Dysplasia Treated with Total Hip Arthroplasty with a Straight Stem and a Threaded Cup. JBJS Volume 86-A No 2, 2004

7 Pieringer, et al: Long-term Results of the Cementless Alloclassic Hip Arthroplasty System Using a 28-mm Ceramic Head. The Journal of Arthroplasty Vol. 21 No. 7, 2006

8 T.M.J.S Vervest, P.G Anderson, The Zweymüller cementless total hip prosthesis in patients aged 50 and younger. Hip International Vol. 15 No 1, 2005

9 Grübl, et al: Six to Ten-Year Results of Use of the Alloclassic Hip Prosthesis – A Multicentre Survival Analysis. Z Orthop 141: 303–308, 2003

Notes

Lit.No. 06.01677.012 – Ed. 03/2009 ZHUB

+H84406016770121/$090301C093

DisclaimerThis document is intended exclusively for physicians and is not intended for laypersons.

Information on the products and procedures contained in this document is of a general nature and does not represent and does not constitute medical advice or recommendations. Because this information does not purport to constitute any diagnostic or therapeutic statement with regard to any individual medical case, each patient must be examined and advised individually, and this document does not replace the need for such examination and/or advice in whole or in part.

Information contained in this document was gathered and compiled by medical experts and qualified Zimmer personnel. The information contained herein is accurate to the best knowledge of Zimmer and of those experts and personnel involved in its compilation. However, Zimmer does not assume any liability for the accuracy, completeness or quality of the information in this document, and Zimmer is not liable for any losses, tangible or intangible, that may be caused by the use of this information.

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