PINNACLE REVISION CUP SYSTEM
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1 PINNACLE REVISION CUP SYSTEM This publication is not intended for distribution in the USA. DESIGN RATIONALE
2 FLEXIBILITY. PRECISION. CONFIDENCE. DePuy Synthes Joint Reconstruction is proud to offer the PINNACLE Revision Acetabular Cup System to address the need for enhanced stability and biomechanical optimisation while providing immediate and long-term fixation. The PINNACLE Revision Acetabular Cup System was designed to deliver intraoperative flexibility to address the unique challenges of revision acetabular surgery. DESIGNED IN CONSULTATION WITH: William Barrett, MD Seattle WA Daniel Berry, MD Rochester MN Gregory Brick, MD Boston MA John Callaghan, MD Iowa City IA Michael Christie, MD Nashville TN Charles Engh, MD Alexandria VA Thomas Fehring, MD Charlotte NC William Griffin, MD Charlotte NC The PINNACLE Revision Acetabular Cup System consists of the Standard Profile, Deep Profile (DPx) and a Multi-hole shell that feature: Allowance for mechanical fixation in the rim or dome Dome screw holes that can angulate up to 34 degrees designed for intraoperative flexibility and optimal bony purchase The patented VIP taper that accommodates multiple bearing options to address a wide array of patients, activity levels and demand requirements Available sizes ranging from 38 to 80 mm GRIPTION Porous Coating 1 DePuy Synthes Joint Reconstruction PINNACLE Revision Cup System Design Rationale
3 FIXATION: IMMEDIATE AND LONG-TERM Standard and Deep Profile (DPx) shells feature: A full 180-degree hemisphere for rim friction fit designed to enhance immediate cup stability Deep Profile (DPx) shells with variable, progressive lateralisation that increases with shell size to provide proper graduated proportional medial defect fill Multiple peripheral and dome screw holes for immediate fixation Superiorly clustered dome screw holes to aid bone screw positioning into the best quality host bone Peripheral screw holes for additional fixation while complementing the natural compressive loading of the acetabulum GRIPTION Porous Coating GRIPTION technology is a cementless coating specifically engineered to maintain a clinically advantageous 64% surface volume porosity and an average 220-micron pore structure. 1,2,3 This makes allowance for good tissue growth and vascularisation onto and around an implant. Combined macrotexture and microtexture topographies can provide a favourable mechanical loading environment for bone reconstitution and enable greater cell adhesion and proliferation. 5 GRIPTION coating provides a 1.2 coefficient of friction which is a substantial improvement over plasma spray coating and contemporary tantalum cementless interface. 2,4 This offers potentially improved stability and scratch fit upon implantation. PINNACLE Revision Cup System Design Rationale DePuy Synthes 2
4 OPTIONS FOR MODULARITY & BIOMECHANICS: INTRAOPERATIVE FLEXIBILITY TO MATCH YOUR PATIENT S NEED Neutral ALTRX ALTRA-LINKED Polyethylene Liners are designed to optimise the range of motion by having a wide face chamfer while keeping the femoral head s centre of rotation concentric with the outer diameter of the shell. +4 Neutral ALTRX ALTRA-LINKED Polyethylene Liners are designed to enhance hip stability, by lateralising the femoral head s centre of rotation by 4 mm. 4 mm of additional lateralisation Degree ALTRX ALTRA-LINKED Polyethylene Liners are designed to re-direct the available range of motion and optimise positioning to allow the cup, screw holes and GRIPTION Porous Coating to come into contact with the most optimal surface area of the acetabulum. Apex Peak of Angle Face (Not Lipped) Changes Cup inclination/version by 10 degrees dependent on placement of liner Lipped ALTRX ALTRA-LINKED Polyethylene Liners are designed to provide a high wall along one side of the liner to increase the jump distance in the specific area that the head must travel before dislocation can occur. Apex Lip to be positioned superior/ posterior PINNACLE DPx SHELLS Providing the ability to reproduce the correct centre of rotation The ability to reproduce the centre of rotation is further enhanced with the deep profile cup. The PINNACLE deep profile shells allow the surgeon to address soft tissue laxity through a proportionally variable offset DPx cup. DPx Cup Size (mm) Lateralisation (mm) Standard Profile Deep Profile 3 DePuy Synthes Joint Reconstruction PINNACLE Revision Cup System Design Rationale
5 ENHANCED STABILITY LINERS PINNACLE Hip Solutions are designed with a wide range of acetabular cup options, biological and mechanical fixation alternatives and advanced bearing technologies. The PINNACLE ESC Constrained Liner system helps to address hip instability and dislocation through a high range of motion. Features of the ESC Constrained Liner includes: High strength head capture Compatible with bi-polar or modular heads +4 Neutral and options GVF polyethylene for enhanced mechanical integrity Simple insertion instrumentation ARD (anti-rotational device) tabs for rotational stability. Titanium locking ring securely holds the ES C liner into the Pinnacle shell to minimise potential disassembly. Chamfered titanium constraining ring provides ease of assembly and increased stability. Ridge to aid in preventing constraining ring slippage. Progressively larger ID and head sizes to help promote increased range of motion. GVF polyethylene. Poly slits and a flex groove for ease of head insertion. PINNACLE Revision Cup System Design Rationale DePuy Synthes 4
6 ORDERING INFORMATION Acetabular Cup Style Cat No. Outer Acetabular Liner Dome Peripheral Diameter Size Required Screw Hole Screw Hole (mm) (mm) Qty. Qty. ES c Constrained Liner Cat No. Description Cat No. Description GRIPTION Multi-hole II GRIPTION Standard Profile GRIPTION Deep Profile DPx Neutral ID 48OD ID 50OD ID 52OD ID 54OD ID 56OD ID 58OD ID 60OD ID 62OD ID 64OD ID 66OD ID 68OD ID 70OD ID 72OD ID 56OD ID 58OD ID 60OD ID 62OD ID 64OD ID 66OD ID 68OD ID 70OD ID 72OD ID 74OD ID 76OD 5.0 mm Peripheral Cortical Bone Screw Cat No. Neutral Length (mm) 10 Degree ID 48OD ID 50OD ID 52OD ID 54OD ID 56OD ID 58OD ID 60OD ID 62OD ID 64OD ID 66OD ID 68OD ID 70OD ID 72OD ID 74OD ID 76OD 6.5 mm Cancellous Dome Screw Cat No. Neutral Length (mm) 5 DePuy Synthes Joint Reconstruction PINNACLE Revision Cup System Design Rationale
7
8 References 1. Bobyn JD, Pilliar RM, Cameron HU, Weatherly GC. The optimum pore size for the fixation of porous surfaced metal implants by the ingrowth of bone. Clin Orthop 1980;150: DePuy Internal Test Report: WR070146; DePuy Internal Test Report: WR070125; Published literature: No M20.5ML, Zimmer Inc, 2010 and Zimmer Holdings, Inc. Trabecular Metal Technology. Website accessed Jan 23rd 2014 at URL 5. Karageorgiou V, et al. Porosity of 3D biomaterial scaffolds and osteogenesis. Biomaterials 2005;26: DePuy Orthopaedics EMEA is a trading division of DePuy International Limited. Registered Office: St. Anthony s Road, Leeds LS11 8DT, England Registered in England No DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, Indiana USA Tel: +1 (800) Fax: +1 (574) depuysynthes.com DePuy International Ltd St Anthony s Road Leeds LS11 8DT England Tel: +44 (0) Fax: +44 (0) DePuy International Ltd. and DePuy Orthopaedics, Inc All rights reserved. CA#DPEM/ORT/0214/0001 Issued: 04/14
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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
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