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1 rev. A Encore Orthopedics, Inc Metric Blvd. Austin, Texas
2 1 contents How to use the Foundation Hip 1 2 Plan your approach Select your hardware Preparing for surgery and proper analysis of your patient s needs are the most important steps in preplanning your approach in helping your patient regain the freedom of activity that they had prior to this surgery. Selecting the appropriate implant and instruments to match the needs of your patient gives you the most flexibility in your approach to this surgery. Whether the patients s physical stature, bone density, or fracture site is the basis of your decision, Encore s Foundation Hip System offers the choices you require to make your decisions. Perform
3 Design Rationale The Foundation Total Hip System has been developed by enhancing proven design features and simplifying instrumentation to provide a state-of-the-art system that is easy to use. Cemented Stems The cemented stems feature: Forged femoral CoCr stems A tapered geometry designed to keep the cement mantle in constant compression. The cobra flange of both stems and normalization arches of the 460 series stem contribute to medial cement compression while improving the resistance to lateral tensile forces. Proximal centralization of the 460 series stem and distal PMMA centralizers of both stems assure a minimum 2mm cement mantle around the entire femoral stem. Porous & Press Fit Stems The Porous and press-fit titanium stems feature: A tapered geometry for physiologic proximal to distal load transfer. 132 degree neck angle A coronal slot in the larger sizes (sizes 16 and above). The 470 and 480 series stems have a proximal circumferential porous coating Distal splines for rotational stability The 440 series has a proximal circumferential grit blast texturing. 3
4 Surgical The Foundation Hip System is designed to accommodate any standard approach based on the surgeon s experience or personal preference. Adequate exposure which allows bony landmark visualization, component alignment and thorough soft tissue assessment, can contribute to more successful results Femoral Neck Resection Once the hip is dislocated, the patient s offset and neck length should be noted for reestablishing after components have been implanted. The offset is measured from the tip of the greater trochanter to the center of the femoral head (Figure 1). The neck length is measured from the tip of the lesser trochanter to the center of the head (Figure 2). The femoral neck resection can be measured proximally from the lesser trochanter based on the preoperatively templated measurement. If estimation is used for the initial neck cut without preoperative templating, the surgeon should cut at least 15mm above the lesser trochanter for a patient with a normal neck. If the patient s neck is valgus, the cut should be higher to compensate for the discrepancy. The femoral neck cut can be made by either using the osteotomy guide corresponding to the templated stem size (Figure 3) or using the femoral broach to guide the angle 5
5 Trial Reduction Calcar planing collared prosthesis The medial neck planer is then used to machine the neck area for precise fit of the stem collar. The planer should engages the rasp trunnion and the planer should be started before engaging the calcar to avoid chipping the calcar. Calcar planing insures proper seating of the prosthesis collar (Figure 9). Calcar planing is not required if collarless stem is utilized. Trial Reduction A trial reduction with modular instrumentation allows determination of motion, leg length, and stability can be performed with the broach, corresponding head/neck adapter, insert trial, and head trial (Figure 10). At this point, measurements of the offset and neck length can be compared to the preosteotomy measurements, but may need to be adjusted to insure adequate/optimal stability depending on final acetabular component seating and anteversion of the femoral stem. (If more length is needed, a longer head neck component is used. If less is needed, the rasp is removed counter sunk and more femoral neck is cut off. If less length is needed, the rasp is counter sunk and more femoral neck is cut off. If difficult version is needed, the rasp is removed, reinserted in a different version, medial neck is planed and trial reduction is carried out. The head neck trial includes five neck lengths for each head diameter.) For cemented stem, if satisfied with trial reduction, marking the calcar with Electro cartery or methylene blue for reproduction of orientation for the stem is suggested. 7
6 9 Reference Chart
CAUTION: Ceramic liners are not approved for use in the United States.
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