Enhanced Aircast Walking Brace Two key strategic opportunities: Improved product offering, providing solution for key product concerns Increased customer base and sales opportunities by training the entire Sales force on the superiority of the Aircast Walking Braces and focusing on the clinical messaging “Smart Healing with Every Step” Smart Healing With Every Step
AIRCAST WALKING BRACE : Business Overview DJO Global is the market leader in the $335M Global Walking Brace Market with 25% Market Share. In 2010, DJO generated $84M globally in Walking Brace revenue – of which Aircast accounted for more than 50% at $49M. Walking Braces are the largest revenue segment in the Bracing division. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Positioning and Value Proposition Positioning Statement Smart Healing With Every Step Value Proposition The clinically proven Aircast Walking Braces have continuously advanced the science of pneumatic healing for over 30 years. The uniquely layered aircells can be individually custom-inflated, while the multi-radius rocker sole and anatomical design promotes superior offloading for a more normal gait, allowing smart healing with every step. So what is our positioning statement? How about Smart Healing With Every Step? What does this mean? It means the clinically proven Aircast Walking Braces have continuously advanced the science of pneumatic healing for over 30 years. The uniquely layered aircells can be individually custom-inflated, while the multi-radius rocker sole and anatomical design promotes superior offloading for a more normal gait, allowing smart healing with every step. In the next few minutes I’m going to give you a better understanding of WHY Aircast is the gold standard when it comes to Walking Braces. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Product Overview (Trimmable Shell) The Aircast Walking Braces provide semi-pneumatic support with trimmable semi-rigid shell protection. Foam-filled aircells cushion the ankle for customized comfort and support. Aircast was founded on the development of the first off-the-shelf walking brace. Every Walking Brace features: Trimmable Shell – the keyword is TRIMMABLE. The Aircast Walking Brace can be trimmed all the way down to the ankle, accommodating for larger patients. So how do you trim the Aircast WB. If you are looking at the back of the Walking Brace you will see groves. These groves can be trimmed, expanding the brace to not only accommodate patients with large gastroc’s but with large ankles as well. The Ossur boot only expands in the gastroc area and in fact, doesn’t expand very well due to the design of the straps feeding through the shell. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Product Overview (Custom Inflation) The semi-rigid shell of our Walking Braces is a key component of functional management associated with our aircell technology. Aircells found in the liner do not provide better healing Single inflation port can bottom out Single inflation does not provide consistent support The semi-rigid shell of our Walking Braces is a key component of functional management associated with our aircell technology. The pulsating actions of the aircells only work when combined with the support provided by the semi-rigid shell. What this means is, the Aircast Walking Brace is the only Walking Brace on the market to house their aircells in the shell rather than the liner. The competition offers aircells found in the liner but this design does do not provide better healing. In fact, when there is only a single inflation port, the aircell can bottom out and the patient’s limb can be in contact with the rigid support of the brace. Also, if you think about it, everyone’s leg is a different size and each liner is made the exact same. Therefore, as I wrap my leg in the liner, the aircell will fit in a different location than for Steve. And as my edema reduces, then I will definitely see a shift in aircell locations. There will not be a consistent fit like the Aircast. When the foot is not properly supported, it will have a tendency to shift in the boot, resulting in shear stress and longer healing time. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Product Overview (Rocker Sole) Ossur Aircast Tennis Shoe The competitor’s brace shows the center of pressure being considerably more lateral compared to the Aircast. The Aircast Walking Braces functional force pattern mimics that of a normal gait. Richard’s Study One of the most important factors when choosing a Walking Brace is the shape and height of the rocker bottom. The Aircast rocker is composed of four sections: the heel strike section, mid-stance section, rock through section, and the toe-off section. All of these sections combine to form the proper curvature that permits normal walking for a given foot size. The Aircast Walking Braces have been optimized to offer a more natural gait to the patient, and less hip differential, which was a cause of complaint from some patients. This chart shows the difference in off-loading compared to the Ossur boot. Not only did the Richard’s study show the variance in off-loading, but the study identifies potential biomechanical issues when using the Ossur Rebound that could be causes of concern to clinicians who commonly prescribe walkers. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Product Overview (Duplex™ Technology) The combination of support with the pulsating action of the aircells promotes a faster edema reduction, thus promoting pain relief, patient compliance and faster healing. A New Concept in Fracture Immobilization Dale PA, Bronk JT, O’Sullivan ME, et al - Clinical Orthopedics and Related Research, 1993 So what is the Duplex Aircell Tehcnology? The exclusive Aircast Duplex™ Aircell Technology is found only in the XP Walking Braces combines the semi-rigid shell support with the pulsating action of the Distal and Posterior aircells. Taking the Distal aircells and overlapping them with the posterior aircell provides pulsating graduated compression during ambulation. How is this done? When walking, the aircells provide pulsating graduated compression. After walking, pressures rise gradually and stabilize as displaced fluids return. The following graph shows this during ambulation. From 0 to 10 seconds the compression is more or less steady because the individual is either standing or their foot is off the ground. As the individual goes through his/her natural gait process, the distal aircell (blue line) and the proximal aircell (purple line) start to fluctuate – causing a massaging motion the milks the edema away from the injured area. You see greater compression at “heel off” and then decreasing during “mid-stance” and “toe-off.” A great way to show this to a Dr is to inflate both the Distal and Posterior aircells. Have the Physician make a fist and put their hand/arm into the boot. As they drag their arm out of the brace, they will feel the massaging motion of the Duplex Technology. this pulsating action from the aircells promoting faster edema reduction, pain relief, patient compliance and improved healing time. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : XP Walking Brace XP Walking Brace (extra pneumatic) High Level of Support The ultimate in protection, adjustability, edema control, and durability. Main indication Stable fractures of the lower leg and ankle, Severe ankle sprains, Post-op pinning & plating procedures High level of swelling/edema Lightweight, durable semi-rigid shell provides a “total contact” fit Overlapping Duplex aircells provide intermittent pneumatic compression for edema reduction and callus formation. Most features and benefits are common to all our walking braces, but some are specific to a model The XP Walking Brace (extra pneumatic because it has 4 AIRCELLS) is the best clinical solution for lower leg and foot injuries. The XP Walker has a lightweight, durable & trimmable semi-rigid shell that helps support the limb while providing full-shell protection. Lining the shell are overlapping Duplex aircells providing intermittent pneumatic compression for edema reduction and callus formation. As I mentioned earlier – there are 4 aircells. One in the front panel, 2 Distal and 1 posterior. These 4 aircells can be custom inflated for a “total contact” fit. The XP is the closest brace on the market to a total contact cast. In fact, if compliance is an issue, on the XP walking brace, we have a Brace-Lok that provides additional compliance. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : FP Walking Brace FP Walking Brace (foam pneumatic) Moderate Level of Support Aircast’s quality, effectiveness and comfort in an economical model. Main indications Stable foot and/or ankle fracture, Severe ankle sprains, Post-operative use, Post cast removal Breathable & washable liner Custom inflated distal aircells (2) for individual fit and support The FP Walking Brace (foam pneumatic because it has a FOAM LINER) does not offer as much support as the XP Walking Brace, and does not have the duplex aircell technology that the XP Walking Brace has but it provides Aircast’s quality, effectiveness and comfort in an economical model. The FP Walker has a lightweight, durable, semi-rigid shell that supports the limb while providing protection. Housed within the shell are two adjustable distal aircells that provide compression and support the malleoli. The main indications for the FP Walking Brace are: Stable fracture of foot/ankle/lower leg Severe ankle sprain Post-operative immobilization COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : SP Walking Brace SP Walking Brace (short pneumatic) Moderate Level of Support Specifically designed for foot and ankle injuries. Main indications Metatarsal fracture, Forefoot and mid-foot injury, Acute or post-operative use, Bunionectomy, Soft tissue injury Lightweight, semi-rigid shell has a pre-inflated anterior aircell for a “total contact” fit The SP Walking Brace is the best clinical solution / option to a number of indications related to the forefoot, mid-foot and hindfoot injuries, as well as some ankle injuries. It has 3 aircells. A preinflated front panel aircell and two distal aircells. Shorter height makes it ideal when limb length or calf circumference prohibits use of a standard height walking brace COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : XP Diabetic Walker System High Level of Support Specifically designed to meet the needs of the higher risk diabetic patient. Main indications Stable foot and/or ankle fracture, Post operative use, Hindfoot and heel foot protection, Neuropathic ulcers, Soft tissue injury Regulated aircell inflation with hand bulb pressure gauge Optimized rocker sole for maximum off-loading of the diabetic foot XP Diabetic Walking Brace is the best clinical solution / option for the specific needs of diabetic patients. The XP Diabetic Walking Brace incorporates an optimized rocker sole for maximum off-loading of the diabetic foot and an innovative dual density insole to help eliminate pressure points. The combination of semi-rigid shells, full aircells and insole helps regulate shear stress. Two extra insoles (including the dual-laminate insole designed with the Impax™ Grid Technology), three stockings and one hand bulb with pressure gauge are included. Dual density insole - Impax™ Grid technology - to reduce shear stress and eliminate pressure points. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Product Enhancement Superior Breathable Liner Enhanced nylon reducing liner wear Increased foam density for better comfort Additional Velcro to mitigate liner migration in the shell Added soft binding for a more finished look Dependable Straps Ultrasonic welds Improved quality and aesthetics of straps Enhanced Aircell Structure Airtight welds Aircast Walking Braces are now available with smart enhancements from top to bottom. Our continuous improvement philosophy, NEVER STOP GETTING BETTER™, inspires us to gather insights that guide our innovation. Manufacturing processes and engineering standards vary from company to company, but only Aircast has become the gold standard. Superior Breathable Liner: Enhanced nylon reducing liner wear Increased foam density for better comfort Additional Velcro to mitigate liner migration in the shell Added soft binding for a more finished look Dependable Straps Ultrasonic welds Improved quality and aesthetics of straps Enhanced Aircell Structure Airtight welds And when it comes to premium walking braces, only Aircast is clinically-proven to promote faster healing and reduce edema. “A New Concept in Fracture Immobilization” (Paul A. Dale, MD, James T. Bronk, Michael E. O’Sullivan, F.R.C.S.I., Edmund Y. S. Chao, PhD., and Patrick J. Kelly, M.D.) Only Aircast is clinically-proven to promote faster healing and reduce edema. - A Comparison Study of Plantar Foot Pressure in a Standardized Shoe, Total Contact Cast and Prefabricated Pneumatic Walking Brace Baumhauer JF, Wervey R, McWilliams J, et al - Foot & Ankle International, 1997 COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Quality Warranty 6-Month Warranty Free from defects in materials and workmanship Repair or replace a defective product at no charge to customer We want every practitioner and every end user to feel confident about DJO Walking Braces! What does that mean? As the Market Leader of Rehabilitative Products, DJO instills confidence by providing a high quality product each and every time! Moving forward, all walking braces will include a hang-tag clarifying the Walking Brace Warranty Program. Our 6-Month Warranty is DOUBLE what Breg and DeRoyal offer. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Added Accessories Toe Cover Made of a thin polycarbonate flexible plastic material and covered with a soft, nylon foam, this accessory provides the ideal coverage for patients. Hygiene Cover This easy-to-apply cover is used to provide a hygienic environment by preventing the spread of dirt, dust and germs brought in on a patients’ Walking Brace. Weather cover coming soon . . . Also – some new additions to the line TOE COVER: This optional accessory can be adjusted to fit a patient properly unlike our competitors in which you either have to store extra SKU’s or cut the Brace to accommodate a patient. The Aircast Walking Brace Toe Cover comes in Small (fits: Ped and Small) and Large (fits: Medium, Large and XLarge) and will fit all Aircast style Walking Braces. HYGIENE COVER: This easy-to-apply cover is used to provide a hygienic environment by preventing the spread of dirt, dust and germs brought in on a patients’ Walking Brace. Available in Ped/Small, Medium/Large and XLarge. All pricing and p/n’s are found in the launch binder and/or the Marketing Materials COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Competitors Review section 6 of your Launch Binder for a breakdown of Competitors and their Walking Braces. COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Competitors (OSSUR) Soft overmolded edge prevents pressure points and conforms easily to calf shape Study identifies potential biomechanical issues when using the Ossur Rebound that could be causes of concern to clinicians who commonly prescribe walkers. “Comparison of the Kinematics, Forces, moments and Pressure when using two designs of Walker” (Richards J, The Movement Analysis Laboratory School of Public Health and Clinical Sciences UCLan Preston). Integrated pneumatic chambers and airpump inside for consistent compression Circumferential shell can be trimmed to accommodate large calves Soft overmolded joints prevent pressure points Straps in front for easier adjustment Vented shell for breathability Toe bumper for additional protection Rocker Sole: The Rebound Air Walker lacks the four sections that permit normal walking ability. Instead, patients will find that they have a “heel strike” section and a “toe-off” section with nothing in between. There is no “mid-stance” section for balance and no “rock-through” section for a more natural gait. Though the sole is made of a plastic material making the sole lighter, this material does not provide shock-absorbency and has less grip then the “rubber sole” found on the Aircast Walker. Front Bumper: Can cause an issue with patients who are in between sizes as their toes can rub. Also – if a practitioner doesn’t want the bumper – they have to order additional p/n’s which means more boots on their shelves. With the Aircast Toe Cover, the practitioner can accommodate with the adjustable accessory. Also – reminder that the toe bumper is NOT OSHA compliant. In order to be OSHA compliant the toes must be completely covered with a hard material. Straps: Both the Aircast and the Ossur Walkers have 3 straps. The Ossur Walker uses Elasticized Velcro® straps which fluctuates the leg muscles during gait and prevents a good grip around the limb, leading to shear movements. The uneven distribution of straps on the Ossur Walker will focus pressure only on the site of the strap, which can lead to “window edema” along the limb. There is also difficulty in adjusting the top strap: a patient and/or provider will need to feed the strap through the shell which is very difficult and time consuming. The Aircast evenly distributes the straps to reduce any pooling of edema. The combination of the Aircast strap locations and the front panel allow for the best circumferential compression. The pressure from the strap is distributed evenly through-out the front panel. Pump: The “single” air pump can bottom out on one side of the brace, creating pressure points as the leg will come in contact with the structure of the brace. All Aircast Walkers have multiple air chambers allowing for a true custom fit for the patient. Shell: Both the Aircast and the Ossur Walkers have the trimmable option. The Aircast Walker can be trimmed on the back shell to accommodate patients with larger calves, and still provide the added protection of our semi-rigid shells. Both Aircast and the Ossur Walkers offer the ventilated holes to promote breathability. Front panel: The semi-rigid shell used by Ossur is not strong enough to prevent buckling at the ankle area. With the addition of the “rubber” crease on the front panel, the Ossur Walker will allow the ankle to bend and prevent appropriate support. Full rocker bottom sole for enhanced gait dynamics COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Clinical Efficacy “Comparison of the Kinematics, Forces, moments and Pressure when using two designs of Walker” (Richards J, The Movement Analysis Laboratory School of Public Health and Clinical Sciences UCLan Preston). Study identifies potential biomechanical issues when using the Ossur Rebound that could be causes of concern to clinicians who commonly prescribe walkers. “A New Concept in Fracture Immobilization” (Paul A. Dale, MD, James T. Bronk, Michael E. O’Sullivan, F.R.C.S.I., Edmund Y. S. Chao, PhD., and Patrick J. Kelly, M.D.) shows the benefits of pressurized braces on healing in the lower leg. Only Aircast Walking Braces combine the benefits of aircells and semi-rigid shells, providing a superior environment promoting faster healing. “The Aircast Walking Brace versus Conventional Casting Methods” (Kalish SR, Pelcovitz N, Zawada S, et al) shows the efficacy of an Aircast Walking Brace in diminishing muscle atrophy during the length of treatment. “Pneumatic Bracing and Total Contact Casting Have Equivocal Effects on Plantar Pressure Relief” (Hartsell HD, Fellner C, Saltzman CL) indicates that our walking brace provides pressure reduction equal to a total contact cast. “A Comparison Study of Plantar Foot Pressure in a Standardized Shoe, Total Contact Cast and Prefabricated Pneumatic Walking Brace” (Baumhauer JF, Wervey R, McWilliams J, et al) shows how a pneumatic walking brace is a viable alternative for plantar ulcer treatment. It is time to change our thinking from entering a DR’s office and saying “what Walking Brace do you use?” –to– “why do you use a Walking Brace?” It is time to remember what matters when it comes to a Walking Brace. As the Walking Brace market becomes more commoditized, DJO Global needs to look for other Selling Tools to differentiate. Aircast pioneered the functional management of lower leg fractures and was built on the Clinical Efficacy of the Walking Brace. Leveraging the Aircast Walking Braces enhanced design, unique technology and superior clinical message, we are poised to continue as the market leader. The Lower Extremity Abstract (p/n 00-0735) is a compilation of the Aircast Clinical Studies simplified for everyday use. You can order this document through DJOprint. If you need a copy of a specific Clinical Study, you can purchase it on pubmed.gov (www.ncbi.nlm.nih.gov/pubmed/). COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Marketing Material Launch Package Data Sheet (P/N: 00-1060-EN) 3D Video coming soon . . . COMPANY CONFIDENTIAL
AIRCAST WALKING BRACE : Post-Launch Surveillance Post Launch Dashboard will be created and distributed to measure sales performance as well as provide useful information (i.e. Success Stories), which may help others win business in their markets. Top performing Sales Reps will also be recognized for their success. COMPANY CONFIDENTIAL
Smart Healing With Every Step QUESTIONS? COMPANY CONFIDENTIAL