Tri-Lock Bone Preservation Stem
|
|
- Blaise Hardy
- 5 years ago
- Views:
Transcription
1 Tri-Lock Bone Preservation Stem Clinical Results of the Tri-lock BPS Femoral Stem at One Year Follow-Up William L. Healy, M.D. Lahey Clinic Medical Center Burlington, Massachusetts Introduction Cementless femoral stems with a flat, tapered wedge design have performed with success when used in hip replacement procedures with reported ten to fifteen year survivorship from ninety-five to one hundred percent. 1-9 The Tri-lock Femoral Stem (DePuy Orthopaedics, Warsaw, Indiana) is a cementless, flat, tapered wedge femoral stem, which has been used for hip reconstructions since ,7,8,9 The clinical success of the Trilock Femoral Stem is based on a simple reproducible surgical technique that achieves initial fixation and allows long term, durable fixation. In 2008, the Tri-lock Femoral Stem was modified in order to improve the proximal geometry of the femoral stem, increase range of motion and stability of the reconstructed hip, facilitate implantation of the stem from any surgical approach, and preserve proximal femoral bone. The new Tri-lock Bone Preservation Stem (BPS) maintained the successful flat tapered wedge design, which was associated with durable fixation and clinical success. Similar to the original Tri-Lock, the Tri-lock BPS Femoral Stem was designed as a broach only femoral system. The new porous coating (Gription, DePuy Orthopaedics, Warsaw, Indiana) on the Tri-Lock BPS offers an enhanced coefficient of friction when compared to Porocoat porous coating, which is on the original Tri-Lock. The author gratefully acknowledges the contributions of Adam Rana, M.D., Jared A. Toman, M.D., and John Garfi, M.D. to this report. WLH
2 Table 1: Femoral Stem Sizes Stem Size Number Implanted Gription The length of the Tri-lock BPS Femoral Stem was shortened, and the lateral distal tip of the stem was beveled in order to facilitate implantation. This report will present the early clinical results of fiftyseven consecutive Tri-lock BPS Femoral Stems with a minimum of one year follow-up. Methods and Materials Fifty-seven Tri-lock BPS Femoral Stems were implanted in 57 hips in 56 patients who had primary hip replacement operations performed between March 2008 and April The Tri-lock BPS cohort included 34 men and 22 women. The mean age of the patients was 65.4 years with a range from 17 to 92 years. All patients presented with hip pain and limitation of function. The diagnoses for these 57 hip replacement operations included: 51 osteoarthritis, 5 rheumatoid arthritis, and 1 osteonecrosis. Proximal femoral morphology was classified by the Dorr Classification; 16 Dorr A femurs, 35 Dorr B femurs, and 6 Dorr C femurs. The mean body mass index was 27.9 with a range of 20.6 to All 57 operations were performed by one surgeon in one hospital using one surgical approach (modified direct lateral). One standardized clinical pathway was used for all patients, and one clinical team cared for all patients. All 57 hip replacement operations used the Trilock BPS Femoral Stem (DePuy Orthopaedics, Warsaw, Indiana). The most common size implanted was #5 (13 Stems); the median size implanted was #5; the smallest size implanted was #0, and the largest size implanted was #9. All stems were high offset stems. (Table 1) All hips were reconstructed with modular cobalt-chrome femoral heads, which articulated with highly crosslinked polyethylene acetabular liners (Marathon, DePuy Orthopaedics, Warsaw, Indiana). Forty-nine hips used 36 mm femoral heads and eight hips used 32 mm femoral heads. The most common femoral neck length was 8.5 mm (22 femoral heads) with a range of 1.5 mm to 15.5 mm. All hips were reconstructed with a Pinnacle acetabular cup (DePuy Orthopaedics, Warsaw, Indiana). All cups used screw fixation. The most common Pinnacle acetabular cup size used was 54 mm (20 cups). The median cup size was 54 mm, with a range from 52 mm to 64 mm. Clinical and radiographic information was collected prospectively and entered into a computerized joint replacement registry. Patient questionnaires were completed by patients without assistance from the operating surgeon or midlevel practitioner. Clinical evaluation included a 10 point visual analog pain score and the Harris Hip Score. Patients were asked to rate pain by intensity on a 10 point scale and by location of discomfort. Thigh pain was defined as pain in 2
3 the anterior thigh below the inguinal area, and pain rated 3 or greater on the 10 point scale was considered clinically significant. 10 The mean pre-operative pain score for these patients was 6.6 with a range from 1 to 10. The mean pre-operative Harris Hip Score for these patients was 51.8 with a range from 22 to 72. Radiographic evaluation was performed with a standardized anteroposterior radiograph of the pelvis and hips and a cross table lateral view of the affected hip. The radiographs of the femoral stems were evaluated for implant position, change in implant position, femoral stem subsidence, femoral stem loosening, and implant failure. Ideal implant position was defined as neutral alignment of the stem in the proximal femur with medial cortical contact at the calcar and lateral cortical contact at the lateral shoulder of the femoral stem. Clinical examination was performed at six weeks, one year, and latest follow up. Radiographic examination was performed at six weeks, 1 year, and at latest followup. The mean follow up for these patients was 1.2 years with a range from 1 to 2 years. Minimum follow up was 1 year. Results Fifty-seven primary total hip arthroplasty (THA) procedures were performed on 56 patients. All patients were available for clinical evaluation with minimum one year follow up. Fifty-six of 57 patients were available for radiographic examination with minimum one year follow up. Three complications were encountered following these 57 THA procedures. One intraoperative fracture occurred in a 55 year old male with a Dorr A femur. This was the second case in the series. The fracture was a nondisplaced crack in the calcar, which occurred during insertion of the Tri-Lock BPS femoral stem. The fracture was treated by removing the stem, applying a cerclage wire to the proximal femur proximal to the lesser trochanter, and reimplanting the same femoral component. The patient was treated with foot flat partial weight bearing for six weeks. This complication had no adverse impact on patient outcome. venous thrombosis and one patient had a pulmonary embolus. These thrombo-embolic complications were treated with no adverse impact on patient outcome. Patient reported pain using the 10 point visual analog pain scale improved significantly for all patients after THA. The pain score improved from a mean preoperative pain score of 6.6 (range 1-10) to a mean follow up pain score of 0.5 (range 0-3). Three patients reported a pain score greater than or equal to 3, which was considered clinically significant pain. Two patients reported buttock and trochanteric discomfort. One patient reported only trochanteric discomfort. All three patients were treated with an extended course of physical therapy. One patient was treated with a trochanteric injection of lidocaine/cortisone. No patient complained of thigh pain. (Table 2) Table 2: Post -op Pain Score Range Thigh Pain...0 Harris Hip Score Range Complications Intra-Operative Fracture...1 Infection...0 Dislocation...0 D.V.T....1 P.E Re-operations...0 Revisions...0 Decreased Pain: Yes (100%) No...0 Improved Function: Yes...55 (96%) No...2 Satisfied with THA: Yes...56 (98%) No...1 Two patients encountered venous thrombo-embolic disease following their THA. One patient had a deep 3
4 Table 2: Pre-op Hips Patients Mean Follow-up (years) Range Minimum... 1 Male Female Mean Age (years) Range Mean BMI Range Diagnosis OA RA... 5 Osteonecrosis... 1 Dorr Classification A B...35 C...06 Pain Score Range Harris Hip Score Range The Harris Hip Score improved significantly for all 57 patients. The mean pre-operative Harris Hip Score of 51.8 (range 22-72) improved to a mean follow up Harris Hip Score of 85.1 (range 52-96). Pain score and Harris Hip Scores were examined according to Dorr Classification. There was no clinical difference in mean pain score or mean Harris Hip Scores between Dorr Classifications (Table 3). Table 3: Results by Dorr Classification Pain Score Harris Hip Score Pre-op F/U Pre-op F/U Dorr A Dorr B Dorr C All patients were asked outcome questions regarding pain, function, and patient satisfaction. All 57 patients stated that the THA operation with a Tri-lock BPS Femoral Stem was associated with decreased pain. Fiftyfive patients (96%) stated that the THA operation with a Tri-lock BPS Femoral Stem was associated with improved function. The two patients who stated that the operation did not increase their function presented pre-operatively with a rupture of the gluteus medius and minimus muscular tendinous junction, which was discovered and repaired at the time of operation. Fifty-six patients (98%) expressed satisfaction with their THA operation with a Tri-lock BPS Femoral Stem. One patient who was not satisfied complained of a one centimeter leg length discrepancy with the operative side being long. Radiographic review was available for 56 of 57 hips at minimum one year follow up. All femoral stems were in neutral position in the femoral canal with endosteal cortical contact at the medial femoral calcar and at the lateral shoulder of the femoral stem. There was no change in implant position from the initial post-operative radiographs until the follow up radiographs. There was no subsidence of the femoral stems, no loosening of the femoral stems, and no implant failures. Discussion In this series of 57, consecutive primary THA procedures performed with a Tri-lock BPS Femoral Stem, patients generally reported pain relief and improved function as measured by a 10 point visual analog pain score and a Harris Hip Score. Radiographic evaluation noted predictable positioning of the femoral stem in the femoral canal with successful initial fixation. No thigh pain was observed in these 57 patients who were treated with Tri-lock BPS Femoral Stems with minimum one year follow up. In this regard, the Tri-lock BPS Femoral Stem compares favorably with the original Trilock Femoral Stem, which demonstrated a 5.0% incidence of thigh pain (7.0% for cobalt chrome; 3.1% for titanium). 9 One potential explanation for this improvement in thigh pain is the shortening of the Tri-lock BPS Femoral Stem, which reduces the extent of the stem in the femoral diaphysis and places more dependence on proximal metaphyseal fixation. 4
5 There was no clinical difference in mean pain scores or mean Harris Hip Scores among the three proximal femoral shapes; Dorr A, B, and C. The clinical success of the Tri-lock BPS Femoral Stem at minimum one year follow up may be attributed to its specific design features a straight collarless porous coated modular femoral stem with a flat, tapered wedge design of the intraosseous body that fits into a medial/ lateral slot created in the proximal femoral canal by hand broaching. Axial stability, rotational stability, and initial fixation are provided by wedging the femoral stem into the medial and lateral endosteal cortices. Conclusion In this preliminary series, the Tri-lock BPS Femoral Stem provided successful femoral reconstruction at a minimum one year follow up with successful clinical outcomes and a low rate of complication. On the basis of these findings, we will continue to use the Tri-lock BPS Femoral Stem, and we will re-evaluate this cohort with minimum two year follow-up. In this series, femoral stems were placed in the appropriate position in A/P and lateral planes. One potential risk for shorter femoral stems, which was not observed in this series, is placement in a slightly flexed or extended position. Flexion or extension malposition can be avoided by careful surgical technique, which broaches the proximal femur in a neutral varus/valgus and flexion/ extension position. One potential disadvantage of a flat, tapered wedge femoral stem design is the risk for proximal femoral fracture that may occur with filling of the proximal femoral metaphysis with a metal wedge. In this series, one intraoperative calcar crack was observed at the time of femoral stem implantation into a patient with a Dorr A femur. This fracture was treated with a cerclage wire, and the fracture healed without further complication. Tri-Lock BPS at One Year The strength of this preliminary report of hip replacement surgery with a Tri-lock BPS Femoral Stem is its prospective study design and its objective detailed follow up. There are two major weaknesses to this study. First, this is a preliminary report with minimum one year follow up. The results will have more credibility with a minimum two year follow up. Second, the report is presented by a member of the surgical design team for the Tri-lock BPS Femoral Stem. In an effort to avoid bias in reporting these clinical results, the data was prepared by the department s orthopaedic database coordinator, and the data was audited by two orthopaedic surgeons who have no connection to the Tri-lock BPS Femoral Stem Design Team. 5
6 References 1. Burt CF, Garvin KL, Otterberg ET, et al. A femoral component inserted without cement in total hip arthroplasty. A study of the Trilock component with average ten-year duration of follow-up. J Bone Joint Surg 1998; 80: Keisu KS, Orozco F, Sharkey PF, et al. Primary cementless total hip arthroplasty in octogenarians. Two to eleven-year follow-up. J Bone Joint Surg Am. 2001; 83-A(3):359. Erratum in: J Bone Joint Surg Am 2002 Jan; 84-A: McLaughlin JR, Lee KR. The outcome of total hip replacement in obese and non-obese patients at years. J Bone Joint Surg Br 2006;88: McLaughlin JR, Lee KR. Total hip arthroplasty with an uncemented femoral component. Excellent results at ten year follow-up. J Bone Joint Surg Br 1997; 79: Parvizi J, Keisu KS, Hozack WJ, et al. Primary total hip arthroplasty with an uncemented femoral component. A long-term study of the Taperloc stem. J Arthroplasty Feb; 19:151. William L. Healy, M.D. 6. Sakalkale DP, Eng K, Hozack WJ, et al. Minimum 10 year results of a tapered cementless hip replacement. Clin Orthop Relat Res.1999; Teloken MA, Bissett G, Hozack WJ et al. Ten to fifteen year follow-up after total hip arthroplasty with a tapered cobalt-chromium femoral component (Trilock) inserted without cement. J Bone Joint Surg Am. 2002; 84-A: Pellegrini VD Jr, Hughes SS, Evarts CM. A collarless cobalt-chrome femoral component in uncemented total hip arthroplasty. Five-to eight-year follow-up. J Bone Joint Surg Br. 1992; 74: Healy WL, Tilzey JF, Iorio R, Specht LM, Sharma S. Prospective Randomized Comparison of Cobalt- Chrome and Titanium Trilock Femoral Stems. Journal of Arthroplasty 2009; 24; Barrack RL, Paprosky W, Butler RA, et al. Patients perception of pain after total hip arthroplasty. J Arthroplasty 2000; Total Hip Prostheses, Self-Centering Hip Prostheses and Hemi-Hip Prostheses Important This Essential Product Information sheet does not include all of the information necessary for selection and use of a device. Please see full labeling for all necessary information. Intended Use/Indications Total Hip Arthroplasty (THA) is intended to provide increased patient mobility and reduce pain by replacing the damaged hip joint articulation in patients where there is evidence of sufficient sound bone to seat and support the components. THA is indicated for a severely painful and/or disabled joint from osteoarthritis, traumatic arthritis, rheumatoid arthritis or congenital hip dysplasia; avascular necrosis of the femoral head; acute traumatic fracture of the femoral head or neck; failed previous hip surgery; and certain cases of ankylosis. Self-Centering Hip Prostheses and Hemi-Hip Prostheses are intended to be used for hemi-hip arthroplasty where there is evidence of a satisfactory natural acetabulum and sufficient femoral bone to seat and support the femoral stem. Hemi-hip arthroplasty is indicated in the following conditions: Acute fracture of the femoral head or neck that cannot be reduced and treated with internal fixation; fracture dislocation of the hip that cannot be appropriately reduced and treated with internal fixation; avascular necrosis of the femoral head; non-union of femoral neck fractures; certain high subcapital and femoral neck fractures in the elderly; degenerative arthritis involving only the femoral head in which the acetabulum does not require replacement; and pathology involving only the femoral head/ neck and/or proximal femur that can be adequately treated by hemi-hip arthroplasty. Contraindications THA and hemi-hip arthroplasty are contraindicated in cases of: active local or systemic infection; loss of musculature, neuromuscular compromise or vascular deficiency in the affected limb, rendering the procedure unjustifiable; poor bone quality; Charcot s or Paget s disease; for hemi-hip arthroplasty pathological conditions of the acetabulum that preclude the use of the natural acetabulum as an appropriate articular surface. Ceramic heads are contraindicated in revision surgery when the femoral stem is not being replaced or for use with any other than a polyethylene or metal-backed polyethylene cup. In the USA and Canada, ceramic heads are not approved for use with metal inserts. Warnings and Precautions Ceramic coated femoral stem prostheses are indicated for uncemented press fit fixation. CAUTION: DO NOT USE BONE CEMENT FOR FIXATION OF A CERAMIC COATED PROSTHESIS. Components labeled for Cemented Use Only are to be implanted only with bone cement. The following conditions tend to adversely affect hip replacement implants: excessive patient weight, high levels of patient activity, likelihood of falls, poor bone stock, metabolic disorders, history of infections, severe deformities leading to impaired fixation or improper positioning, tumors of the supporting bone structures, allergic reactions to materials, tissue reactions, and disabilities of other joints. Adverse Events The following are the most frequent adverse events after hip arthroplasty: change in position of the components, loosening of components, wear or fracture of components, dislocation, infection, peripheral neuropathies, tissue reaction. 6
7 7
8 DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, IN USA Tel: +1 (800) Fax: +1 (574) DePuy Orthopaedics, Inc All rights reserved M 1210
Optimum implant geometry
Surgical Technique Optimum implant geometry Extending proven Tri-Lock heritage The original Tri-Lock was introduced in 1981. This implant was the first proximally coated tapered-wedge hip stem available
More informationCAUTION: Ceramic liners are not approved for use in the United States.
Total Hip Prostheses, Self-Centering Hip Prostheses and Hemi-Hip Prostheses IMPORTANT: This essential product information sheet does not include all of the information necessary for selection and use of
More informationSURGICAL TECHNIQUE CEMENTED & PRESS-FIT UNIFIED INSTRUMENTATION INTRAOPERATIVE FLEXIBILITY PROVEN BIOMECHANICS
SURGICAL TECHNIQUE CEMENTED & PRESS-FIT UNIFIED INSTRUMENTATION INTRAOPERATIVE FLEXIBILITY PROVEN BIOMECHANICS INTRODUCTION The Summit Tapered Hip System s comprehensive set of implants and instruments
More informationOptimizing function Maximizing survivorship Accelerating recovery
Surgical Technique Optimizing Function Maximizing Survivorship Accelerating Recovery The company believes in an approach to patient treatment that places equal importance on: Optimizing function Maximizing
More informationOptimum implant geometry
Design Rationale Optimum implant geometry Extending the proven Tri-Lock heritage The original Tri-Lock was introduced in 1981. This implant was the first proximally coated tapered-wedge hip stem available
More informationOptimum implant geometry
Design Rationale Optimum implant geometry Extending proven Tri-Lock heritage The original Tri-Lock was introduced in 1981. This implant was the first proximally coated tapered-wedge hip stem available
More informationBone Preservation Stem
TRI-LOCK Bone Preservation Stem Featuring GRIPTION Coating Surgical Technique Implant Geometry Extending the TRI-LOCK Stem heritage The original TRI-LOCK Stem was introduced in 1981. This implant was
More informationFeaturing. Technology. Product Rationale
Featuring Technology Product Rationale 2 Optimum implant geometry Extending proven TRI-LOCK heritage The original TRI-LOCK Stem was introduced in 1981. This implant was the first proximally coated tapered-wedge
More informationHIP SYSTEM SURGICAL TECHNIQUE
HIP SYSTEM SURGICAL TECHNIQUE Introduction...2 Preoperative Planning...3 Preoperative Planning...3 Templating and Radiographs...4 Determination of Leg Length Discrepancy...5 Determining Acetabular Cup
More informationSurgical Technique r5.indd 1 12/8/10 10:36 AM
Surgical Technique The science of simplicity With more than 700,000 implantations and two and a half decades of clinical success, the Corail Total Hip System now has the most extensive experience with
More informationEncina Taper Stem. Stinson Orthopedics Inc. 303 Twin Dolphin Drive, Suite 600 Redwood City, CA
Stinson Orthopedics Inc. 303 Twin Dolphin Drive, Suite 600 Redwood City, CA 94065 info@stinsonortho.com www.stinsonortho.com Table of Contents Introduction 3 Features 4 Surgical Technique 5 Preoperative
More informationEnhanced Stability Constrained Liners. Design Rationale Surgical Technique
Enhanced Stability Constrained Liners Design Rationale Surgical Technique The Pinnacle Acetabular Cup System was designed to maximize the number of options available to the surgeon, and provide those options
More informationA Contemporary Broach-Only Cementless Hip Stem: Surgical Tips and Pearls
TRI LOCK BONE PRESERVATION STEM A Contemporary Broach-Only Cementless Hip Stem: Surgical Tips and Pearls Vincent D. Pellegrini, Jr, MD Medical University of South Carolina The TRI LOCK Femoral Stem (DePuy
More informationMetha Short Hip Stem System
Metha Short Hip Stem System Accuracy That Stands Alone Aesculap Orthopaedics Metha Short Hip Stem System Designed For Anatomic Accuracy The Metha Short Hip Stem is designed for anatomic accuracy to restore
More informationBone Bangalore
Dr Suresh Annamalai MBBS, MRCS(Edn), FRCS( Tr & Orth)(Edn), FEBOT(European Board), Young Hip and Knee Fellowship(Harrogate, UK) Consultant Arthroplasty and Arthroscopic Surgeon Manipal Hospital, Whitefield,
More informationProgeny Hip Stem. Surgical Protocol and Product Specifications
Progeny Hip Stem Surgical Protocol and Product Specifications Progeny Hip Stem Introduction With emphasis on maximum stability and ease of use, the StelKast ProgenyTM Hip System provides the surgeon with
More informationTaperFill. Surgical Technique
TaperFill Surgical Technique Table of Contents Indications and Contraindications 3 TaperFill Hip Size Charts 4-5 DJO Surgical 9800 Metric Boulevard Austin, TX (800) 456-8696 www.djosurgical.com Preoperative
More informationESC. Enhanced Stability Liners. Design Rationale & Surgical Technique
ESC Enhanced Stability Liners Design Rationale & Surgical Technique Choice Without Compromise DePuy Synthes PINNACLE Hip Solutions are designed with a wide range of acetabular cup options, biological and
More informationCORAIL HIP SYSTEM DESIGN RATIONALE
CORAIL HIP SYSTEM DESIGN RATIONALE THE SCIENCE OF SIMPLICITY The advanced features of the CORAIL stem, and its bone-preserving surgical technique, have made it a great choice for minimally invasive hip
More informationRevision. Hip Stem. Surgical Protocol
U2 TM Revision Hip Stem Surgical Protocol U2 Revision Hip Stem Table of Contents Introduction... 1 Preoperative Planning... 2 Femoral Preparation... 3 Trial Reduction... 5 Implant Insertion... 6 Ordering
More informationArcos Modular Femoral Revision System
Arcos Modular Femoral Revision System Arcos System Simplify the Complex The Arcos Modular Femoral Revision System meets the demands of complex hip revision surgery by offering surgeons and OR staff the
More informationThe science of simplicity
1 Design Rationale The science of simplicity The advanced features of the Corail stem, and its bone-preserving surgical technique, have made it a great choice for minimally invasive hip surgery. More than
More informationACETABULAR CUP SURGICAL TECHNIQUE
ACETABULAR CUP SURGICAL TECHNIQUE ACETABULAR CUP DEVICE INDICATIONS FOR USE The ICONACY I-Hip total hip replacement is indicated for the following conditions: 1. A severely painful and/or disabled hip
More informationPreoperative Planning. The primary objectives of preoperative planning are to:
Preoperative Planning The primary objectives of preoperative planning are to: - Determine preoperative leg length discrepancy. - Assess acetabular component size and placement. - Determine femoral component
More informationHELIOS h i p s y s t e m
HELIOS h i p s y s t e m Design The Helios stem is a highly polished, High Nitrogen Stainless Steel (ISO5832-9) dual tapered cemented stem. The design of the stem is based on the clinically lly successful
More informationACTIS. TOTAL HIP SYSTEM Approach Active Patients with Confidence DESIGN RATIONALE
ACTIS TOTAL HIP SYSTEM Approach Active Patients with Confidence DESIGN RATIONALE APPROACH ACTIVE PATIENTS WITH CONFIDENCE The ACTIS Total Hip System is the first DePuy Synthes Companies of Johnson & Johnson
More informationTaperloc Complete Hip System. Surgical Technique
Taperloc Complete Hip System Surgical Technique One Surgeon. One Patient. Over 1 million times per year, Biomet helps one surgeon provide personalized care to one patient. The science and art of medical
More informationsimplicity THE SCIENCE OF DESIGN RATIONALE
simplicity THE SCIENCE OF DESIGN RATIONALE T H E S C I E N C E O F S I M P L I C I T Y The advanced features of the Corail stem, and its bone-preserving surgical technique, have made it a great choice
More informationTHE NATURAL FIT. Surgical Technique. Hip Knee Spine Navigation
THE NATURAL FIT Surgical Technique Hip Knee Spine Navigation MiniMAX Surgical Technique Hip Knee Spine Navigation INTRODUCTION The MiniMAX TM is a cementless anatomic stem available in 9 right sizes and
More informationApproach Patients with CONFIDENCE
Design Rationale Approach Patients with CONFIDENCE The ACTIS Total Hip System is the first DePuy Synthes stem specifically designed to be utilized with tissue sparing approaches, such as the anterior
More informationSurgical Technique. Hip System
Surgical Technique Hip System INDICATIONS FOR USE The TaperSet Hip System is designed for total or partial hip arthroplasty and is intended to be used with compatible components of the Consensus Hip System.
More informationSURGICAL TECHNIQUE. Alpine Cementless Hip Stem
SURGICAL TECHNIQUE Alpine Cementless Hip Stem The following technique is a general guide for the instrumentation of the Alpine Cementless Hip Stem. It is expected that the surgeon is already familiar with
More informationTemplating and Pre Operative Planning 2. Preparation of the Acetabulum 4. Trial Sizing and Impaction of the Shell 5.
Surgical Technique Contents Templating and Pre Operative Planning 2 Preparation of the Acetabulum 4 Trial Sizing and Impaction of the Shell 5 Cup Positioning 6 Joint Stability 7 Trial sizing and Impaction
More informationCAUTION Federal law (USA) restricts this device to sale, by or on the order of a physician.
CAUTION Federal law (USA) restricts this device to sale, by or on the order of a physician. ENGLISH Mpact 3D Metal Implants and Augments 3D Metal INSTRUCTION FOR USE Important notice: the device(s) can
More informationStinson Orthopedics Inc. 303 Twin Dolphin Drive, Suite 600 Redwood City, CA
Stinson Orthopedics Inc. 303 Twin Dolphin Drive, Suite 600 Redwood City, CA 94065 info@stinsonortho.com www.stinsonortho.com Encina HA Stem Table of Contents Introduction 3 Encina HA Stem Features 4 Surgical
More informationDePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, IN USA Tel: +1 (800) Fax: +1 (574)
References 1. Sanchez-Sotelo J, Haidukewych GJ, Boberg CJ. Hospital Cost of Dislocation After Primary Total Hip Arthroplasty. J Bone Joint Surg. 2006;88A:290-294. 2. Brodner W, Grübl A, Jankovsky R, Meisinger
More informationS U R G I C A L T E C H N I Q U E
SURGICAL TECHNIQUE RECOVERY FUNCTION SURVIVORSHIP DePuy believes in an approach to total hip replacement that places equal importance on recovery, function and survivorship. The DePuy PROXIMA Hip System
More informationAML Hip System. Design Rationale/ Surgical Technique
AML Hip System Design Rationale/ Surgical Technique Design Rationale Evolution In 1977, DePuy Synthes Companies introduced the original cementless total hip. The AML Hip launched in order to solve one
More informationKnee Revision. Portfolio
Knee Revision Portfolio I use the DePuy Revision Knee System because of its versatility. With this system I can solve nearly any situation I encounter in the OR. Dr. Thomas Fehring, OrthoCarolina Hip and
More informationFurlong H-A.C. THR System
Important Information Please read prior to use in a clinical setting. The Surgeon should be familiar with the operative technique. Caution Federal (U.S.A) law restricts this device to sale by or on the
More informationCementless Tapered Femoral Stem Surgical technique
Cementless Tapered Femoral Stem Surgical technique Contents Operative summary 4 Pre-operative planning 5 Femoral neck osteotomy 5 Femoral canal preparation 5 Intra-medullary (IM) reamer 6 Sequential rasping
More informationContinuing the Tradition. VerSys Heritage Hip System
Continuing the Tradition VerSys Heritage Hip System Heritage Following the Tradition The low-friction hip prosthesis developed by Sir John Charnley has more than a 20-year history of outstanding results.
More informationApproach Patients with Confidence
Surgical Technique Approach Patients with Confidence The ACTIS Total Hip System is the first DePuy Synthes stem specifically designed to be utilized with tissue sparing approaches, such as the anterior
More informationUTF Stem. reduced. Surgical Protocol
UTF Stem TM reduced Surgical Protocol Table of Contents Surgical Protocol Device... Preoperative Planning and Templating... Femoral Osteotomy... Femoral Canal Accessing... Canal Reaming... Canal Broaching...
More informationREVISING THE DEFICIENT PROXIMAL FEMUR
REVISING THE DEFICIENT PROXIMAL FEMUR by David Mattingly, Boston, MA Joseph McCarthy, Boston, MA Benjamin E. Bierbaum, Boston, MA Hugh P. Chandler, Boston, MA Roderick H. Turner, Boston, MA Hugh U. Cameron,
More informationBone Conserving Hip Replacement Surgical technique
MiniHip Bone Conserving Hip Replacement Surgical technique MiniHip Contents Operative summary 4 Overview 5 Pre-operative templating 6 Operative technique 7 Neck resection 7 Femoral canal preparation 7
More informationUNDERSTANDING TRADITION, MASTERING INNOVATION. Surgical Technique
UNDERSTANDING TRADITION, MASTERING INNOVATION Surgical Technique Joint Spine Sports Med MasterLoc Surgical Technique Joint Spine Sports Med INTRODUCTION This document describes the Surgical Technique for
More informationADDRESSING CLINICAL ISSUES OF CEMENTLESS HIP ARTHROPLASTY
E C H E L O N P R I M A R Y H I P S Y S T E M P R O D U C T R A T I O N A L E ADDRESSING CLINICAL ISSUES OF CEMENTLESS HIP ARTHROPLASTY Echelon Primary Total Hip System HIGH OFFSET STANDARD OFFSET Cementless
More informationMove Ahead with Confidence. Hip Replacement Solutions from DePuy Orthopaedics
Move Ahead with Confidence Hip Replacement Solutions from DePuy Orthopaedics The Healthy Hip Joint Pelvis Acetabulum (hip socket) Head of femur Neck of femur Femur (thigh bone) Head of femur in the acetabulum
More informationMetaFix. Cementless Total Hip Replacement Surgical technique
MetaFix Cementless Total Hip Replacement Surgical technique Contents Operative summary 4 Acetabular preparation 5 Pre-operative templating 5 Operative technique 6 Femoral neck osteotomy 6 Femoral canal
More informationTriboFit Hip System. Issue 3 - August 2013 English
Important Information: Please read prior to use in a clinical setting. The surgeon should be familiar with the operative technique and all the information in this insert. Description: The TriboFit Hip
More informationCementless Tapered Femoral Stem Surgical technique
Cementless Tapered Femoral Stem Surgical technique Contents Operative summary 4 Pre-operative planning 5 Femoral neck osteotomy 5 Femoral canal preparation 5 Intra-medullary (IM) reamer 6 Sequential rasping
More informationLPS SYSTEM POCKET GUIDE
LPS SYSTEM POCKET GUIDE Implants Procedural Uses Instruments & Trials L P S Limb Preservation System L P S Limb Preservation System The purpose of this document is to review the LPS (Limb Preservation
More informationTotally Hip Preservation to Revision. Gothenburg, Sweden 29 March - 1 April 2017 WEDNESDAY 29 MARCH. Arrivals THURSDAY 30 MARCH
Totally Hip 2017 Preservation to Revision Gothenburg, Sweden 29 March - 1 April 2017 WEDNESDAY 29 MARCH Arrivals THURSDAY 30 MARCH 08:00 08:30 Welcome from the Chairmen, Co Chairmen and technical intro
More informationEXTENDED TROCHANTERIC OSTEOTOMY SURGICAL TECHNIQUE FPO EXTENSIVELY COATED FIXATION
EXTENDED TROCHANTERIC OSTEOTOMY SURGICAL TECHNIQUE FPO EXTENSIVELY COATED FIXATION SINCE 1983 PREOPERATIVE PLANNING EXPLANTATION OPTIONS the cement from inside the cement canal until the bone/ cement bond
More informationFLH /11
FLH 225 04/11 This publication has been issued by: European Central Marketing Waterton Industrial Estate Bridgend, South Wales CF31 3XA, United Kingdom Tel: +44 (0)1656 655221 Fax: +44 (0)1656 645454 www.biomet.com
More informationSurgical technique MkII instrumentation
MiniHip Surgical technique MkII instrumentation Contents Operative summary 4 Overview 5 Pre-operative templating 6 Operative technique 7 1. Intra-operative templating 7 2. Neck starter awl 7 3. Curved
More informationThe Leader in Orthopaedic Innovation
The Leader in Orthopaedic Innovation Wright is a leading international manufacturer and distributor of superior, easy to use, and innovative orthopaedic implants and instrumentation. For over 50 years,
More informationUnderstanding Hip Implant Options
Understanding Hip Implant Options Cup (Socket) Bearing (Liner) Head Stem (Femur) Modern Hip Implants (Ball) Metal Femoral Head on Marathon Cross-linked Polyethylene Liner Proven materials Polyethylene
More informationPLR. Proximal Loading Revision Hip System
PLR Proximal Loading Revision Hip System The PLR splined revision stem is designed to recreate the natural stresses in the revised femur, where proximal bone may be compromised. PLR Hip System Design Considerations
More informationRECLAIM REVISION HIP SYSTEM
RECLAIM REVISION HIP SYSTEM Where Strength and Modularity Connect DESIGN RATIONALE System Overview RECLAIM Modular Revision Hip System WHERE STRENGTH & MODULARITY CONNECT 2 Offset Options Proximal Body
More informationRevision hip arthroplasty with S-ROM prosthesis: a study of clinical outcomes and implant stability
J Orthopaed Traumatol () 7:1 1 DOI 1.17/s1195--15- ORIGINAL M. El-Deen S. Zahid D.T. Miller A. Nargol R. Logishetty Revision hip arthroplasty with S-ROM prosthesis: a study of clinical outcomes and implant
More informationDESIGN RATIONALE AND SURGICAL TECHNIQUE
DESIGN RATIONALE AND SURGICAL TECHNIQUE ANCHOR PEG GLENOID DESIGN RATIONALE In total shoulder arthroplasty, most cases of clinical and radiographic loosening involve failure of the fixation of the glenoid
More informationAesculap Trilliance Triple Tapered Polished Hip Stem
Aesculap Trilliance Triple Tapered Polished Hip Stem Aesculap Orthopaedics Trilliance Triple Tapered Polished Hip Stem CONTENTS 2 Contents Page Trilliance Philosophy 4 Trilliance Design 6 Trilliance Implants
More informationCORAIL HIP SYSTEM SURGICAL TECHNIQUE
CORAIL HIP SYSTEM SURGICAL TECHNIQUE THE SCIENCE OF SIMPLICITY With 2,000,000 stems provided for patients worldwide 1 and thirty years of clinical history, the CORAIL Total Hip System now has a very extensive
More informationThis publication is not intended for distribution in the USA. SURGICAL TECHNIQUE
This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE DePuy Synthes DURALOC Surgical Technique CONTENTS Templating and Pre Operative Planning 2 Preparation of the Acetabulum
More informationFixed and Variable Geometry Total Shoulder Arthroplasty
Fixed and Variable Geometry Total Shoulder Arthroplasty RECOVERY FUNCTION SURVIVORSHIP DePuy believes in an approach to total shoulder replacement that places equal importance on recovery, function and
More informationInspiring people, Enriching lives
TM Inspiring people, Enriching lives Encore Medical, L.P. 9800 Metric Blvd. Austin, Texas 78758 512-832-9500 www.encoremed.com Encore Medical, L.P. Cat. # 0177-170 1000 12/04 rev. A Encore and Revelation
More informationDocument No Rev. B Pg. 1 of 5 Approvals / Date Title: INSTRUCTIONS FOR USE DJO SURGICAL MODULAR REVISION HIP SYSTEM AND ACETABULAR CAGE
Document No. 0400-0205 Rev. B Pg. 1 of 5 Approvals / Date Title: INSTRUCTIONS FOR USE DJO SURGICAL MODULAR REVISION HIP SYSTEM AND ACETABULAR CAGE Revision ECO Date ECO Summary of Changes Deann Rector
More information9800 Metric Blvd. Austin, Texas
rev. A Encore Orthopedics, Inc. 1998 www.encoremed.com 9800 Metric Blvd. Austin, Texas 78758 512-832-9500 1 contents How to use the Foundation Hip 1 2 Plan your approach Select your hardware Preparing
More informationApproach Patients with Confidence
Approach Patients with Confidence The is the first stem specifically designed to be utilized with tissue sparing approaches, such as the anterior approach, as well as traditional approaches. The implant
More informationasterloc Surgical Technique HIP SYSTEM UNDERSTANDING TRADITION, MASTERING INNOVATION Hip Knee Spine Navigation
asterloc HIP SYSTEM UNDERSTANDING TRADITION, MASTERING INNOVATION Surgical Technique Hip Knee Spine Navigation Masterloc Surgical Technique Hip Knee Spine Navigation INTRODUCTION This document describes
More informationOvation Hip System. Surgical Technique
Ovation Hip System Surgical Technique Ovation Hip System Surgical Technique Ovation Designing Surgeons: Andrew Petrella, M.D. Lecanto, FL Richard Vlasak, M.D. Gainesville, FL Ovation Tribute Designing
More informationSURGICAL TECHNIQUE. Protrusio Cage A COMPREHENSIVE ACETABULAR REVISION SYSTEM
SURGICAL TECHNIQUE Protrusio Cage A COMPREHENSIVE ACETABULAR REVISION SYSTEM Important: This essential product information does not include all of the information necessary for selection and use of a device.
More informationDesign Rationale. ECHELON Primary Hip System
Design Rationale ECHELON Primary Hip System ECHELON Primary Total Hip System Addressing clinical issues of cementless hip arthroplasty Cementless total hip arthroplasty has provided a proven method of
More informationTOTAL HIP REPLACEMENT: MODERN SURGERY FOR SEVERE ARTHRITIS OF THE HIP
TOTAL HIP REPLACEMENT: MODERN SURGERY FOR SEVERE ARTHRITIS OF THE HIP By John T. Dearborn, M.D. Please read this pamphlet before your visit so that we can answer any questions that you have during our
More informationThigh Pain in Primary Total Hip Arthroplasty
The Journal of Arthroplasty Vol. 19 No. 7 Suppl. 2 2004 Thigh Pain in Primary Total Hip Arthroplasty The Effects of Elastic Moduli Carlos Lavernia, MD,* Michele D Apuzzo, MD,* Victor Hernandez, MD,* and
More informationNavigation for total hip arthroplasty
Interact Surg (2008) 3: 128 134 Springer 2008 DOI 10.1007/s11610-008-0084-4 ORIGINAL ARTICLE Navigation for total hip arthroplasty O. Guyen 1,V.Pibarot 1, J. Bejui-Hugues 2,SCORGroup 1 Service de chirurgie
More informationZMR Crossover Instruments. Abbreviated Surgical Technique
ZMR Crossover Instruments Abbreviated Surgical Technique ZMR Crossover Instruments Surgical Technique Introduction ZMR Crossover Instruments facilitate the combination of any Porous Proximal Body with
More informationThis publication is not intended for distribution in the USA.
This publication is not intended for distribution in the USA. Extraction of a CORAIL Stem Surgical Technique Introduction Given the excellent long-term results of the CORAIL stem, 1,2,3 its extraction
More informationCase report: Pain L THR [ post THR 2 years; with history of trivial fall] Your Diagnosis?
Case report: Pain L THR [ post THR 2 years; with history of trivial fall] Your Diagnosis? Diagnosis: Ceramic head fracture In the 1970 s, Boutin implemented ceramic in modern total hip arthroplasty (THA).
More informationImportant notice: the device(s) can be prescribed and implanted only by a doctor legally authorized to perform this type of surgery.
rev.10 CAUTION Federal law (USA) restricts this device to sale, by or on the order of a physician. ENGLISH - EVOLIS/GMK KNEE PROSTHESIS - INSTRUCTIONS FOR USE Important notice: the device(s) can be prescribed
More informationSpecifications guide ECHELON. Hip System
Specifications guide ECHELON Hip System Primary and revision porous implants Porous coating ROUGHCOAT porous coating increases the friction between the implant and bone, improving implant stability and
More informationSurgical Technique. *smith&nephew POLARSTEM Cementless Stem System
Surgical Technique *smith&nephew POLARSTEM Cementless Stem System POLARSTEM Cementless Stem System Contents Introduction... 3 Indications... 4 Contraindications... 4 Case Studies... 5 Preoperative Planning...
More informationEVOLVING OUR HERITAGE, MEETING YOUR NEEDS. Surgical Technique
EVOLVING OUR HERITAGE, MEETING YOUR NEEDS Surgical Technique Joint Spine Sports Med Mpact DM Surgical Technique Joint Spine Sports Med INTRODUCTION The Mpact DM is part of the Mpact Acetabular System and
More informationReaching new heights. Comprehensive. Efficient. Simple.
Reaching new heights Comprehensive. Efficient. Simple. Various acetabular cup choices Compatible with the different head and liner options including VERILAST Technology Reach for proven OR efficient Instrumentation
More informationVerSys LD/Fx Cemented and Press-Fit Hip Prostheses. Surgical Technique IMAGE TO COME. Versatile solutions for total and partial hip replacement
VerSys LD/Fx Cemented and Press-Fit Hip Prostheses Surgical Technique IMAGE TO COME Versatile solutions for total and partial hip replacement VerSys LD/Fx Cemented and Press-Fit Hip Prostheses VerSys
More informationNational Joint Replacement Registry. Lay Summary 2015 Annual Report Hip and Knee Replacement
National Joint Replacement Registry Lay Summary 2015 Annual Report Hip and Knee Replacement SUPPLEMENTARY REPORT 2015 TABLE OF CONTENTS Introduction... 1 A brief history of the Registry origins... 1 The
More informationTotal Hip Replacement in Diaphyseal Aclasis: A Case Report
ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 6 Number 1 Total Hip Replacement in Diaphyseal Aclasis: A Case Report V Singh, S Carter Citation V Singh, S Carter.. The Internet Journal of
More informationCC TRIO VERSAFITCUP. Surgical Technique. each to their own. Hip Knee Spine Navigation
VERSAFITCUP CC TRIO each to their own Surgical Technique Hip Knee Spine Navigation Versafitcup CC TRIO Surgical Technique Hip Knee Spine Navigation EACH TO THEIR OWN The Versafitcup CC Trio is a range
More informationTotal Hip Arthroplasty Performed Using Conventional and Computer-Assisted, Tissue- Preserving Techniques 6
Total Hip Arthroplasty Performed Using Conventional and Computer-Assisted, Tissue- Preserving Techniques 6 Stephen B. Murphy, MD, Timo M. Ecker, MD and Moritz Tannast, MD Introduction Less invasive techniques
More informationCementless Acetabular Fixation With and Without Screws
Cementless Acetabular Fixation With and Without Screws Analysis of Stability and Migration The Journal of Arthroplasty Vol. 25 No. 2 2010 Richard Iorio, MD,* Brian Puskas, MD,y William L. Healy, MD,* John
More informationProduct Rationale. Where Strength and Modularity Connect
Product Rationale Where Strength and Modularity Connect 2 ReClaim Modular Revision Hip System Advanced Strength 1 Advanced Strength Over 600 million cycles of testing 1 Advanced Fixation Advanced Instrumentation
More informationThe proven, simple solution. CPT 12/14 Hip System
The proven, simple solution CPT 12/14 Hip System Primary CPT Hip The proven, simple solution 5mm The collarless, polished, doubletaper design concept used in the CPT 12/14 Hip System has proven itself
More informationZMR CROSSOVER INSTRUMENTS AND SURGICAL TECHNIQUE. Surgical Technique for Revision Hip Arthroplasty
ZMR CROSSOVER INSTRUMENTS AND SURGICAL TECHNIQUE Surgical Technique for Revision Hip Arthroplasty A MULTITUDE OF OPTIONS Several fixation options are offered within the ZMR Hip System. Spout, Cone, and
More informationClinical Evaluation Surgical Technique
Clinical Evaluation Surgical Technique Table of Contents EMPERION Specifications 3 EMPERION Surgical Technique 9 EMPERION Catalog 18 Nota Bene: This technique description herein is made available to the
More informationTotal Hip Replacement
Please contactmethroughthegoldcoasthospitaswityouhaveanyproblemsafteryoursurgery. Dr. Benjamin Hewitt Orthopaedic Surgeon Total Hip Replacement The hip joint is a ball and socket joint that connects the
More informationIntegra. Titan Modular Shoulder System, 2.5
Titan Modular Shoulder System, 2.5 Limit uncertainty with a shoulder implant system that redefines modularity, addresses multiple indications, and allows for reproducible results. Titan Modular Shoulder
More informationTHE P.F.C. SIGMA FEMORAL ADAPTER. Surgical Technique
THE P.F.C. SIGMA FEMORAL ADAPTER Surgical Technique Contents P.F.C. Sigma Femoral Adapter and Revision Knee Surgery Introduction 2 Preoperative Planning 2 Overview 3 Surgical Technique Preparation of the
More information