HP Knee Extraction Instrumentation. Product Overview

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Sabrina Woods
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1 HP Knee Extraction Instrumentation Product Overview

The HP Extraction Knee Instruments complement the DePuy Orthopaedics comprehensive portfolio of revision implants and instruments.

3 HP Extraction Knee Instruments DePuy Orthopaedics is working with Symmetry Medical * to distribute Advanced Knee Extraction instruments. These instruments provide confidence through solid construction, ease of use, and multiple options to address implant removal. The HP Extraction Knee Instruments complement the DePuy Orthopaedics comprehensive portfolio of revision implants and instruments. They are designed to address obstacles encountered during revision TKA (Total Knee Arthroplasty). The HP Extraction Knee Instruments are another example of DePuy Orthopaedics commitment to providing implants and instruments that address two of the biggest reasons for revision knee failure: loosening and instability. 1 Addressing Loosening with Rotating Platform Addressing Instability with Metaphyseal Sleeves *Manufacturer: Symmetry Medical, Inc North State Road 15, Warsaw, IN 46582, USA 1

4 HP Extraction Standard Removal Case Top Level: HP Revision General Extraction Instrument Set Top Level HP Revision Extraction Instrument Case HP Extraction 7 mm V Split 305 mm HP Extraction 7 mm Reverse Curette 305 mm HP Extraction Offset Chisel HP Extraction Component Impactor HP Extraction Straight Osteotome 7 mm HP Extraction Straight Osteotome 12.5 mm HP Extraction Straight Osteotome 20 mm

5 Bottom Level: HP Revision General Extraction Instrument Set Bottom Level Handle With Quick Coupling End (2) Small Slap Hammer Flexible Osteotome System HP Extraction Removal Screw 8 mm HP Extraction 254 mm Cement Rongeur

HP Extraction 7 mm V Split 305 mm Osteotome (2011-03-034) Use the 7 mm V Osteotome to fragment bone cement remaining in the proximal tibia after removal of the tibial component.

6 HP Extraction 7 mm V Split 305 mm Osteotome ( ) Use the 7 mm V Osteotome to fragment bone cement remaining in the proximal tibia after removal of the tibial component. HP Extraction 7 mm Reverse Curette 305 mm ( ) Use the 7 mm Reverse Curette to hook cement fragments in the proximal tibia after removal of the tibial component. The 7 mm Reverse Curette can also be used to scrape the distal femoral canal after removal of the femoral component. HP Extraction Offset Chisel ( ) Use the Offset Chisel to develop a plane between the femoral component and the bone cement in the intercondylar notch. This instrument may also be used to chip away bone cement in the posterior region of the proximal tibia and around the patellar component. 4

7 HP Extraction Component Impactor ( ) A Component Impactor is provided to assist in removal of either a femoral or tibial component after the components have been loosened. HP Extraction Straight Osteotomes ( , 039, & 040) Three Straight Osteotomes are provided to develop a plane between an implant and the bone cement and to fragment the bone cement. They have widths of 7 mm, 12.5 mm, and 20 mm respectively. 5

Flexible Osteotome Blades & Handle With the Quick-Coupling Handle (2709-04-001) to develop a plane, use the Flexible Osteotome Blades (2709-04-004 to 2709-04-011) between an implant and bone.

If these actions are necessary, use the Straight Osteotomes (2011-03-038 to 2011-03-40 listed above).

8 Flexible Osteotome Blades & Handle With the Quick-Coupling Handle ( ) to develop a plane, use the Flexible Osteotome Blades ( to ) between an implant and bone. There are four blade widths 8 mm, 10 mm, 12 mm, and 20 mm. These osteotomes are not rigid enough to pry and wedge. If these actions are necessary, use the Straight Osteotomes ( to listed above). Small Slap Hammer ( ) The Small Slap Hammer can be used if the flexible Osteotomes get stuck. The Slap Hammer can be attached to the Quick Coupling Handle to extract the Flexible Osteotomes. HP Extraction 8 mm Extraction Screw ( ) Use the 8 mm Extraction Screw to remove polyethylene components. A 6.4 mm drill bit can be used to create a hole which will accept the Extraction Screw. When an all-polyethylene tibial component is to be removed, the Extraction Screw is threaded into the pre-drilled hole and its collar is impacted with a mallet. The Extraction Screw may also be used to facilitate removal of a polyethylene tibial insert. 6

9 HP Extraction 254 mm Cement Rongeur ( ) The 254 mm Cement Rongeur is used to extract cement in the tibial and femoral canal after the components have been removed. The long, narrow arm is able to reach deep into both canals. The handle can be then be pressed together to cinch the arm s mouth together to remove cement that is difficult to access. 7

10 HP Extraction Sleeve Removal Case HP Revision Sleeve Extraction Instrument Set HP Revision Sleeve Extraction Case HP Femoral Impactor/Extractor HP Slap Hammer Small Slap Hammer HP Extraction Tibial Component Remover HP Extraction MBT Sleeve Extractor HP Extraction MBT Sleeve/Tray Separator Tool HP Extraction TC3 Tuning Fork Stem Trial Extractor HP Extraction Stem Trial Extractor Adapter Locking Pliers HP Extraction Vice Grips Adapter

HP Femoral Impactor/Extractor (9505-01-171)* The Universal Femoral Impactor/Extractor is designed to work with LCS and SIGMA femurs.

The Impactor/Extractor can then be locked down onto the femoral component, by turning it in a clockwise motion (to release turn counter clockwise).

*This instrument is for extraction of the trials not for implants HP Slap Hammer (9505-01-308) The HP Slap Hammer features a quick connect end that assembles to the HP Femoral Impactor/ Extractor

11 HP Femoral Impactor/Extractor ( )* The Universal Femoral Impactor/Extractor is designed to work with LCS and SIGMA femurs. The A/P spring loading mechanism, in conjunction with the adjustable M/L wings, allows it to fit onto any size LCS and SIGMA femoral component. The Impactor/Extractor can then be locked down onto the femoral component, by turning it in a clockwise motion (to release turn counter clockwise). The Impactor/Extractor works with the HP Slap Hammer. *This instrument is for extraction of the trials not for implants HP Slap Hammer ( ) The HP Slap Hammer features a quick connect end that assembles to the HP Femoral Impactor/ Extractor ( ). It also has an ergonomic handle and a modified slide bar to allow the surgeon to slap the component out, or put varus/valgus torque on the femur. Locking Pliers ( ) and HP Extraction Locking Pliers Adapter to Slap Hammer Adaptor ( ) Among many uses, the Locking Pliers are helpful in removing femoral sleeve trials or implants. The vice grips can be locked onto the distal portion of a femoral sleeve (if the sleeve is an implant, Osteotomes need to be used to get access to the sleeve). The Small Slap Hammer ( ) can then be attached to the Locking Pliers via the Locking Pliers Adapter ( ). 9

HP Extraction MBT Tray/Sleeve Separator (2011-03-053) The MBT Tray/Sleeve Separator is inserted in between the inferior portion of the MBT Tray and the superior portion of the MBT Tray sleeve after

This is especially useful if a 14 mm or small universal stem was used with the tibia. If this is the case, the tibia and stem can be pulled out through the MBT sleeve after separation.

12 HP Extraction MBT Tray/Sleeve Separator ( ) The MBT Tray/Sleeve Separator is inserted in between the inferior portion of the MBT Tray and the superior portion of the MBT Tray sleeve after proper exposure has been achieved. Once impacted, the separator is designed to break the taper between the MBT tray and MBT sleeve. This is especially useful if a 14 mm or small universal stem was used with the tibia. If this is the case, the tibia and stem can be pulled out through the MBT sleeve after separation. Then the surgeon can work on removing the sleeve. HP Extraction TC3 Tuning Fork ( ) The HP TC3 Tuning Fork is designed to break the morse taper between the TC3 femoral component and the universal sleeve. The Tuning Fork can be inserted into the medial or lateral portion box, between the box and femoral component. It can then be impacted to disengage the taper between the femur and sleeve. Stem Trial Extractor ( ) and HP Extraction Stem Trial Extractor to Slap Hammer Adapter ( ) The Stem Trial Extractor threads into and removes stem trials (pilots) that have become stuck in the femoral canal. The Stem Trial Extractor can also be threaded through a sleeve into the stem trial (or pilot) to remove a sleeve/ stem trial construct that is stuck in the femur. For additional extraction force, the Small Slap Hammer ( ) can be attached to the stem trial extractor via the stem trial to Slap Hammer Adaptor ( ). 10

HP Extraction MBT Sleeve Remover (2011-03-031) The MBT Sleeve Remover is used to remove sleeves trials or implants that are stuck in the tibial canal.

The handle is then turned clockwise to open up the prongs and engage the prongs steps on the distal aspect of the sleeve.

HP Tibial Component Extractor (2011-03-045) The Tibial Component Extractor can be used to remove tibial trays, trays and stems, or trays, stems, and sleeves that are fixed together.

13 HP Extraction MBT Sleeve Remover ( ) The MBT Sleeve Remover is used to remove sleeves trials or implants that are stuck in the tibial canal. The two prongs are inserted through the proximal portion of the sleeve, passed all the way through the sleeve, and then out the other side. The handle is then turned clockwise to open up the prongs and engage the prongs steps on the distal aspect of the sleeve. To aid in removal, the Small Slap Hammer ( ) can be attached to impact the sleeve out. HP Tibial Component Extractor ( ) The Tibial Component Extractor can be used to remove tibial trays, trays and stems, or trays, stems, and sleeves that are fixed together. The base of the tibial tray should first be exposed with Osteotomes and the polyethylene insert removed from the tray. Once exposed, the tibial component extractor prongs are inserted below the base of the tray. The locking screw is then tightened down onto the superior portion of the tray. The Small Slap Hammer is then attached and used to impact the entire tibial tray construct out as one piece. HP Tibial Component Extractor Replacement Straight Blades ( ) and Offset Blades ( ) and Replacement Tibial Component Extractor Hex Wrench ( ) The tibial component blades come in two options: Standard and Offset. The Offset Blades work with the MBT tray, MBT revision tray system, and other systems with wide/broad keels. The blades come with screws that are threaded to the extractor ( ). If screws are lost, a replacement set of blades must be ordered. The screws are tightened down using the L shaped hex wrench. 11

14 HP Extraction Sleeve Removal Case HP Extraction Standard Removal Case HP Extraction 7 mm V Split 305 mm HP Extraction 7 mm Reverse Curette 305 mm HP Extraction Offset Chisel HP Extraction Component Impactor HP Extraction Straight Osteotome 7 mm HP Extraction Straight Osteotome 12.5 mm HP Extraction Straight Osteotome 20 mm HP Extraction Removal Screw 8 mm HP Extraction 25 mm Cement Rongeur Flex Osteotome Delivery System Handle with Quick Coupling End (2) Small Slap Hammer HP Extraction Sleeve Removal Case HP Extraction Tibial Component Remover HP Extraction Locking Pliers Adapter HP Extraction Stem Trial Removal Adaptor HP Extractor MBT Tray/Sleeve Separator HP Slap Hammer Small Slap Hammer Locking Pliers HP Extraction TC3 Tuning Fork HP Extraction MBT Sleeve Remover Stem Trial Extractor HP Femoral Impactor/Extractor * Thin Osteotome Blade, 8 mm x 76 mm Thin Osteotome Blade, 10 mm x 76 mm Thin Osteotome Blade,12 mm x 76 mm Thin Osteotome Blade, 20 mm x 76 mm Thin Osteotome Blade, Curved End, 12 mm Thin Osteotome Blade, Curved End, 20 mm Thin Osteotome Blade, 8 mm x 127 mm Thin Osteotome Blade, 10 mm x 127 mm Replacement Codes HP Extract Tib Rem Bld Straight HP Extract Tib Rem Bld Offset HP Extract Tib Rem Hex Offset *Manufacturer: Enztec Ltd, 26 Dakota Crescent, Sockburn, Christchurch 8004, New Zealand

16 References 1. Mulhall KJ, Callaghan JJ et al. Current Etiologies and Modes of Failure in Total Knee Arthroplasty Revision. Clinical Orthopaedics and Related Research ;446: This publication is not intended for distribution in the USA. 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, IN USA Tel: +1 (800) Fax: +1 (574) 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 version 2 Issued: 11/12 CA#DPEM/ORT/1112/0359

HP KNEE EXTRACTION Instrumentation. Product Overview

HP KNEE EXTRACTION Instrumentation Product Overview HP Extraction Knee Instruments DePuy Synthes Joint Reconstruction is working with Symmetry Medical to distribute Advanced Knee Extraction instruments.