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Zimmer's (ZMH) latest marketing gamble rests on a simple observation: Women complain more than men do.

Or they seem to after total knee replacements, atleast. So, Zimmer has now rolled out a high-end kneetailored specifically for women.

Knee replacements boast high success rates amongboth men and women already. But "this is not marketinghype," insists Zimmer CEO Ray Elliott. "This is somegreat science."

Zimmer's new "Gender Solutions" knee hits themarket at a particularly crucial time, as devicemakers struggle to secure price increases for theirtraditional orthopedic implants and remain short on breakthrough technologies that could reshape the industry.

Like drug manufacturers before them, orthopedicdevice makers have been scrambling for new ways togrow -- and attracting some criticism in the process.The companies have been accused of developing newdevices that seem like gimmicks at best -- and healththreats at worst -- as they seek to reignite theironce highflying stocks.

Of course, Zimmer has come under fire already. Just a few years ago, the company started promoting a new minimally invasive hip-replacement surgery that led to failures and never really took off.


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New Trend

Robert Booth, a prominent orthopedic surgeon whohelped develop Zimmer's new device, foresees thebeginning of a trend.

"Women can wear men's clothing and shoes, but mostprefer clothing and shoes made for them," Boothobserves. "That's because women are shaped differentlythan men. It's the same with knees, and it makesperfect sense to design knee implants with women inmind -- particularly considering that women are by farthe majority of the knee-replacement patientpopulation."

Zimmer will begin reaching out to those women soonthrough direct-to-consumer advertising. Ultimately,the company hopes to lure more women into theoperating room -- including many who have resisted knee-replacement surgery so far -- with promises of better outcomes in the end.

Of course, Zimmer could use a new success storyright now. The device maker, which relies onorthopedic implant sales more than most, has seen itsstock punished over the past year as prices for itscore products continue to come under pressure. Thecompany is now banking on new products like GenderSolutions to accelerate sales and enable it to hit its aggressive full-year targets.

Zimmer can sell Gender Solutions at a premiumbecause it ranks as a new technology using thecompany's expensive "high-flex" knee system. But somecritics seem to wonder whether the company -- andthose that follow it -- should be going down that pathat all.

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"It is unclear how much traction they will getfrom these products," writes Leerink Swann analystJason Wittes, who has a market-perform rating onZimmer's stock. "But given the feedback thus far, wedo question whether the orthopedic companies are goingtoo far in promoting products with obvious marketingappeal but little clinical backing."

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Sparking a Debate

Already, Zimmer has managed to spark a debate.

First -- a week before Gender Solutions' scheduleddebut -- a Zimmer competitor suddenly declared that it had invented the first female-oriented knee.


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pointed to its Triathlon knee system, implanted in men and women alike, as proof.

Zimmer took the move as a compliment. After all,the company felt, Stryker had started promoting femaleknees even if it lacked a specially tailored one likeZimmer's own.

DePuy, which runs the orthopedics division of

Johnson & Johnson

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, claims that thecompany offers a superior female knee as well. Thecompany highlights its rotating-platform technology --behind the only mobile-bearing knees in the -- as "a true innovation in 'knees for women.'"



( BMET), whose recently departed CEO always shunned the marketing game, now claims to sell an ideal female knee.The company simply points to its flagship Vanguard systemas the choice implant for both sexes.

"A lot of the things being touted about the femaleknee are things we introduced in 2004 with Vanguard,"Bill Kolter, president of Biomet Orthopedics, told

last week. "I can't say that Zimmer is making bad changes because they are mimicking changes we made a couple of years ago. They're just a little later to the game."

Looking in the Mirror

Clearly, Zimmer sees itself as the trendsetterhere instead.

Sheryl Conley, chief marketing officer for thecompany, admits that some competing systems -- such as Triathlon and Vanguard -- share advances with Gender Solutions. However, she says, they lack a major gender-related improvement.

Notably, she says, those systems failed to adjustthe thickness of the implant front that causes womenso much pain. Zimmer alone has done so, she adds.

Zimmer spent five years conducting research beforethe company rolled out its own gender-specific knee.As a result, the company plans to arm itself withreams of scientific evidence as it heads out to sellits product.

"There are 1,000-and-some pages of science,"Elliott boasted at a recent investor conference."There's just nothing else in there. ... It's going tobe fun going out and selling against our competitorswho assume this is Zimmer marketing."

In the meantime, Zimmer has started ribbing thecompetition already.

"Zimmer measures potential new product success bythe level and intensity of insults from competitors,"Elliott said during the company's latest quarterlyconference call. "Gender Solutions is right up therewith highly cross-linked (polyethylene) in 1998,high-flexion knees in 2000, MIS

minimally invasive surgery hips in 2001 and MISknees in 2004."

Leading the Cause

Zimmer led the push for MIS joint replacements aswell.

But Zimmer's breakthrough surgery technique -- the two-incision hip replacement -- proved too challenging for widespread adoption and, therefore, fell short of the company's revolutionary aims. Today, only 6% to 7% of surgeons who use Zimmer implants rely on the complicated procedure.

To be fair, most Zimmer surgeons have wound upadopting other company-sponsored MIS proceduresinstead. But critics still question the soundness ofMIS joint replacements, due to possible complications,and even Zimmer's focus on that particular niche.

After all, they note, Zimmer has basically spent awhole lot of money training surgeons to use the sameold devices in a different way.

"All of these things -- MIS, computer-assistedsurgery, gender-specific knees, etc. -- are costlyextensions for Zimmer and the others," says a formersales manager who has marketed orthopedic devices forseveral major players in the past. But "none of theseproducts are actually changing market share. It's justa big 'keep up with the Joneses' game that is costingthese companies more money and slowing down theprocess of replacing joints."

Still, Zimmer clearly feels otherwise.

"We devote huge energy to innovative game-breakers-- whether it's MIS or Gender Solutions orhigh-flexion -- and we focus a lot of dollars there,"Elliott admitted last month. "We're having a lot offun with (Gender Solutions), and there actually issome great science to it. ... It will make for someunique debate in case anybody was getting boredlistening to orthopedics."