Implanting The Mobile Bearing Hip In America
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Implanting The Mobile Bearing Hip In America

It is not uncommon for orthopaedic surgeons to use a single hip replacement implant throughout their entire careers, which is why getting surgeons to convert to a new product is so incredibly difficult.

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Orthopaedic surgeons are notoriously loyal to the products that they use to replace the hips of their patients. In fact, it is not uncommon for orthopaedic surgeons to use a single hip replacement implant throughout their entire careers, which is why getting surgeons to convert to a new product that has never been used in the United States is so incredibly difficult. That is exactly what Kwittken & Company (KCO) was charged with doing for Stryker Orthopaedics, the largest division of multinational medical device maker Stryker Corporation.

As Stryker’s agency of record for more than a decade, KCO has deep knowledge of the medical device media environment, the regulatory landscape, changing patient demographics, the issues that matter most to surgeon customers and how to reach them. As with any successful product launch, however, the key is understanding what makes a product unique and what benefits a product offers over competitive products on the market today. Prior to planning the launch strategy, KCO worked with Stryker Orthopaedics’ product engineers and hip communications team to examine its product and competitor products in granular detail and help define its unique value proposition.

While total hip replacement is one of the most successful surgical procedures performed today, dislocation remains one of the top complications of the popular procedure. To address dislocation, many of Stryker Orthopaedics’ competitors have developed designs that incorporate large head sizes (think of the ball in the hip’s ball and socket joint) and are made completely out of metal, which are stronger and more resistant to wear. One of the problems, however, with a hip joint in which a metal ball rotates against a metal socket is that over time wear debris or metal ions are released into the blood stream. Although the full effects of the release of metal ions are not known today, it has been proven that they have the potential to cause patients to develop soft tissue reactions that can lead to early implant failure and revision surgery.

The KCO team learned that Stryker Orthopaedics’ ADM (anatomic dual mobility) X3 Mobile Bearing Hip System is a revolutionary style of implant, based on a design developed in France that has not been used in the U.S. Essentially, a dual mobility hip implant has two points of articulation or movement, featuring a ball within a ball (see image in exhibits). Not only does this design enable more natural multi-directional movement and greater range of motion, it also results in less friction and lower wear rates.

By working closely with Stryker’s subject matter experts, KCO identified a critical fact that would be central to its campaign: the ADM hip helps to reduce the risk of dislocation, similar to competitor metal-on-metal products, but it does not have any of the associated risks. ADM incorporates a metal on polyethylene design, using a propriety form of highly crosslinked polyethylene that is significantly more resistant to wear than metal.

While many product launches focus on driving consumer awareness and adoption of a specific product, this launch of Stryker’s ADM X3 Mobile Bearing Hip was much more complicated. Not only was KCO tasked with driving awareness and adoption of a product by a niche, product-loyal customer group (orthopaedic surgeons), the company also needed to introduce a new category of hip replacement technology to the U.S. market and simultaneously drive reductions in the use of metal-on-metal hip implants. In order to do this successfully, KCO designed a multi-channel strategy that targeted high-impact orthoapedic trade publications in addition to regional and national consumer media outlets to help change patient sentiment.

To support the product launch and craft messages that would resonate with both industry and consumer audiences, KCO’s campaign revolved around three core themes: the clinical issues that matter the most to surgeons (implant longevity, range of motion and stability), the patient benefits of ADM (long lasting, natural movement and low risk of dislocation) and the product safety concerns about competitive metal-on-metal products.

To achieve maximum impact, the product launch was timed to coincide with the orthopaedic industry’s largest trade show—the American Academy of Orthopaedic Surgeons conference in March 2010. In the lead up to the conference, KCO worked closely with Stryker Orthopaedics’ product teams to coordinate the simultaneous trade and consumer product launches.

The trade press announcement was pushed up several days to follow directly on the heels of a series of negative New York Times articles written by medical device industry investigative reporter Barry Meier, about metal-on-metal hips and the safety concerns they raise. KCO helped to inform his reporting by sharing with him clinical studies that question the safety of metal-on-metal hip implants (see exhibits). In addition to issuing a trade press release touting the clinical benefits of Stryker’s ADM hip, KCO scheduled in-person briefings during the trade show between key trade reporters and subject matter experts to discuss the new product in more detail.

To support the consumer launch, KCO worked with Stryker Orthopaedics to set up a spokesperson strategy whereby baseball hall of famer Johnny Bench would receive Stryker’s first ADM X3 hip early in 2010. His recovery and experience with the hip were featured in a video news release (VNR) that was released and a satellite media tour (SMT) that occurred at the beginning of the conference. The consumer and trade campaigns were supplemented by ongoing, customized pitches, leveraging the spokesperson power of Johnny Bench as well as the new announcements of concerns around metal-on-metal hips, such as an MHRA (the FDA in the UK) metal-on-metal hip safety warning and the recall of a competitor’s metal-on-metal hip.

One other facet of the campaign that is crucial for the success of any medical device product launch is the careful training of all spokespeople on approved product messaging. With medical device makers in the crosshairs of FDA regulators today, loose descriptions of medical devices and associated benefits can result in serious financial and regulatory penalties. As a result, KCO media trained and prepped all of the spokespeople used in the campaign from Johnny Bench to orthopaedic surgeons and Stryker Orthopaedics subject matter experts.

KCO’s public relations efforts resulted in the ADM X3 Mobile Bearing Hip being featured in all of the key orthopaedic trade publications, including, but not limited to, Orthopedics Today, Orthopedics This Week, Orthopedic Design & Technology, Medical Device Daily, Medical Devices & Surgical Technology Week and Becker’s Orthopedic & Spine Review. The product was also featured in Investor’s Business Daily. Johnny Bench’s VNR was picked up by more than 130 local news channels, resulting in a viewership of more than 3.1 million. In addition, Johnny and his new hip were featured in a full page story in the NY Post (submission for award 81) as well as by USA Today, and FOX News’ “Manny Alvarez Show” (submission for award 79).

While we are not allowed to divulge the sales figures for individual products given that Stryker is a public company, we can certainly say that there has been a dramatic decline in the number of surgeons who use metal-on-metal hip replacement technology, and many patients are beginning to question its use in orthopaedics. This shift away from metal-on-metal hip replacement technology will undoubtedly continue to support the adoption of Stryker’s ADM X3 Mobile Bearing Hip because it is the only hip on the market to offer the benefits of reduction in dislocation risk combined with reductions in wear and more natural motion.


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