Aseptic Revision Total Knee Surgical Techniques. Andrew Ehmke, DO Chicago, IL May 5, 2018
|
|
- Morris Gibson
- 5 years ago
- Views:
Transcription
1 Aseptic Revision Total Knee Surgical Techniques Andrew Ehmke, DO Chicago, IL May 5, 2018
2 I have no disclosures relevant to this talk
3 3 Phases of Revision 1. Exposure Key to the case!! 2. Component Removal 3. Joint Reconstruction
4 Planning Understand mode of failure!!!! Advanced imaging to eval malrotation or osteolysis Exploratory surgery or revision without diagnosis have much worse outcomes Proper equipment in room ALWAYS RULE OUT INFECTION
5 Phase 1 - Exposure KEY TO CASE Use prior incision Extend proximal and distal to find subcutaneous plane MIS revision extremely difficult! Aggressive MCL release All the way around proximal tibia allows subluxation of tibia
6 Phase 1 - Exposure Remove scar/adhesions from medial and lateral gutter Free up Extensor Mechanism Retropatellar scar Debulk Quad Tendon Quad snip? Lateral release RARELY need more ( TTO, Quad Turndown)
7 Phase 1 Exposure Video
8 Phase 2 - Removal Sequence of Removal 1. Polyethylene insert 2. Femoral component 3. Tibial component 4. Patella
9 Phase 2 Removal Poly opens up working space ability to flex and extend to remove excess scar tissue and work at implants Drive Osteotome into the poly-implant interface Remove any locking pin prior Beware of screw in medium constraint constructs (eg LCCK)
10 Phase 2 Removal Femur Power Saws Very fast with minimal bone loss Sagital or Recip saw Heats up and melts cement Vibrations at implant-cement interface loosen bond Osteotomes Extraction Tools from manufacturer Back slaps Bone tamp or disimpactor Remove component with axial blows
11 Phase 2 Removal Femur Video
12 Power saws Osteotomes Extraction Tools/Bone Tamp for removal Phase 2 Removal Tibia Sublux tibia forward Flexion/External rotation Get Posterior!!! Lateral release can help to access the posterior lateral corner
13 Phase 2 Removal Tibia
14 Phase 2 Removal Patella Usually not done in aseptic revision unless gross malposition Removal with Short wide blade, saw through pegs Burr around remaining pegs
15 Phase 3 - Reconstruction 1. Flexion gap larger then extension gap 2. Joint line raised due to implant removal and subsidence of femur GOALS Restore flexion stability Restore joint line Tibia affects both gaps symmetrically Restore gaps by shifting femur as necessary Distalizing femur with augments *joint line 25mm from medial condyle* Posteriorizing femur with offset and upsizing component
16 Contained or Segmental? Metaphyseal fixation? Cone vs Sleeve Tibial and/or Femoral Phase 3 Reconstruction Assess bone loss Stem cemented or pressfit? Stem length? Bypass segmental defects or increase fixation strength
17 Phase 3 - Reconstruction Cementless Stem Fixation Must engage diaphysis with cementless! Short metaphyseal cementless stems FAIL Ream until no longer advances May need offset due to engagement of diaphysis and bow Easier to get out Don t cement in offset
18 Phase 3 Reconstruction Cemented Stem Fixation No offset Can position where needed Easy preparation Strong initial fixation No end of stem pain Antibiotic delivery Difficult to remove!
19 Phase 3 Reconstruction Metaphyseal Fixation Cone Placed independent of component Can be used with different systems (off label use) Prepared with burr or reamer Wide variety to accommodate small to large defects Sleeve Linked to component via Morse taper Good long term data Ease of preparation with broach Ability to do cementless revisions? Can fracture sclerotic bone Ability to accommodate large defects?
20 Why important? Phase 3 Reconstruction Metaphyseal Fixation Allows Ingrowth in zone 2 Large surface area for biologic ingrowth Better long term fixation? Rich vascular blood supply Morgan-Jones R. (2015) Bone Loss in Revision Total Knee Arthroplasty. In: Rodríguez-Merchán E., Oussedik S. (eds) Total Knee Arthroplasty. Springer, Cham
21 Phase 3 Reconstruction Tibial Cone Preparation
22 Phase 3 Reconstruction Femoral Cone Preparation
23 Phase 3 Reconstruction Tibial Sleeve Preparation Orthopedics Sep;29(9 Suppl):S Broach until rotationally stable Cement in real tibial construct Pressfit sleeve hold in place while cement dries Can start working on femur
24 Phase 3 Reconstruction Femoral Sleeve Preparation
25 Phase 3 Reconstruction Tibial Cuts Based off intramedullary guidance perpendicular to mechanical axis Skim cut to give flat solid platform to reference the rest of case Correct previous alignment errors and avoid new ones to tibia Effects both flexion and extension gap
26 Phase 3 - Reconstruction Distal Femur Cuts Distal Cut Freshen cut for flat platform Correct varus/valgus alignment Evaluate joint line Measure from joint line 25 mm from medial epicondyle Evaluate need for augments
27 Phase 3 Reconstruction 4 in 1 cuts Size femur Typically upsize to fill flexion gap Rotation Set rotation off epicondylar axis Set rotation of spacer block Offset Posterior to fill flexion gap Evaluate need for augments Often need posterior augments due to posterior offset of femur.
28 Phase 3 - Reconstruction Gap / Soft Tissue Balance 1. Fill flexion gap first Start with 2-4 mm posterior offset on femur Go up one size from previous component Wedge osteotome or cobb in à 1-2mm play Palpate MCL 2. Evaluate extension gap If tight à aggressive posterior capsule release àextra distal femur resection Beware excessive joint line elevation à patella baja More posterior offset or upsize component if room 3. Evaluate patella tracking
29 Phase 3 Reconstruction Balancing a Hinge When can t get control of flexion gap without grossly elevating joint line Gross medial instability Balance in Extension only Make sure no patella baja (raised joint line) Adequate external rotation to avoid patella tracking issues Number one complication of hinge Femoral and tibial metaphyseal fixation due to high implant stresses
30 Thank You!
Exposure EXPOSURE. Exposure - Incision. Extend old incision proximally Expose virgin quadriceps tendon
Exposure Aaron G Rosenberg MD Professor of Orthopedic Surgery Rush Medical College Chicago, Illinois Exposure - Incision Single incision can be used or modified Multiple longitudinal incisions favor the
More informationZimmer NexGen Trabecular Metal Tibial Tray
Zimmer NexGen Trabecular Metal Tibial Tray Surgical Technique Zimmer NexGen Trabecular Metal Tibial Tray Surgical Technique Give Bone A Solid Hold Zimmer NexGen Trabecular Metal Tibial Tray Surgical Technique
More informationEXACTECH KNEE. Operative Technique ADDENDUM. Metaphyseal Cones. Surgeon focused. Patient driven. TM
EXACTECH KNEE Operative Technique ADDENDUM Metaphyseal Cones Surgeon focused. Patient driven. TM TABLE OF CONTENTS INTRODUCTION...1 DESCRIPTION...1 DETAILED OPERATIVE TECHNIQUE Initial Preparation and
More informationSingle Axis Revision Knee System
Orthopaedics Scorpio TS Single Axis Revision Knee System Scorpio TS Trial Cutting Guide Surgical Protocol Orthopaedics Scorpio TS Single Axis Revision Knee System Scorpio TS Trial Cutting Guide Surgical
More informationZimmer NexGen RH Knee Primary/Revision. Surgical Technique
Zimmer NexGen Primary/Revision Surgical Technique Zimmer NexGen Primary/Revision Surgical Technique INTRO Introduction The NexGen Rotating Hinge Knee () is designed for revision, difficult primary, and
More informationHP Knee Extraction Instrumentation. Product Overview
HP Knee Extraction Instrumentation Product Overview HP Extraction Knee Instruments DePuy Orthopaedics is working with Symmetry Medical * to distribute Advanced Knee Extraction instruments. These instruments
More informationA novel cementless option. Zimmer NexGen Trabecular Metal Primary Patella Surgical Technique
A novel cementless option Zimmer NexGen Trabecular Metal Primary Patella Surgical Technique Zimmer Trabecular Metal Primary Patella 1 Zimmer NexGen Trabecular Metal Primary Patella Surgical Technique
More informationZimmer NexGen Rotating Hinge Knee Primary/ Revision
Zimmer NexGen Rotating Hinge Knee Primary/ Revision Surgical Technique Designed for use in revision and difficult primary surgeries 1 INTRODUCTION The NexGen Rotating Hinge Knee Components are designed
More informationTRIAL COMPONENTS SURGICAL TECHNIQUE REAMING THE TIBIAL AND FEMORAL INTRAMEDULLARY CANAL
Ref. no. 99.27.2TRIALS TRIAL COMPONENTS SURGICAL TECHNIQUE CLINICAL INDICATION This technique is indicated in the case of revisions with significant bone loss when minimal or any resection of bone is required.
More informationTrabecular Metal Primary Patella
Trabecular Metal Primary Patella NexGen Complete Knee Solution Surgical Technique Table of Contents Introduction... 2 Prepare the Patella... 2 Patella Reamer Technique... 3 Insetting Technique... 5 Universal
More informationSurgical Technique. Hinge Disassembly and Rebuild Technique
Surgical Technique Hinge Disassembly and Rebuild Technique Revision Knee Arthroplasty Surgical Technique LEGION HK Hinge Knee System Introduction The LEGION HK Hinge Knee System has been designed as an
More informationKEY CHOICES AND TECHNIQUES IN REVISION THA AND TKA Step-by-Step Decisions
KEY CHOICES AND TECHNIQUES IN REVISION THA AND TKA Step-by-Step Decisions Moderator: Panelists: Daniel J Berry, Mayo Clinic John J Callaghan William L Griffin Thomas P Vail Michael P Bolognesi Presenter
More informationU2 PSA. Revision Knee. Surgical Protocol
U2 PSA TM Revision Knee Surgical Protocol Table of Contents 1 Component Removal... 1 2 Tibial Preparation... 1 2.1 Tibial Canal Preparation... 1 2.2 Proximal Tibial Resection... 2 2.3 Non Offset Tibial
More informationExtramedullary Tibial Preparation
Surgical Technique Extramedullary Tibial Preparation Primary Total Knee Arthroplasty LEGION Total Knee System Extramedullary tibial preparation Contents Introduction...2 EM tibial highlights...3 Preoperative
More informationZimmer FuZion Instruments. Surgical Technique (Beta Version)
Zimmer FuZion Surgical Technique (Beta Version) INTRO Surgical Technique Introduction Surgical goals during total knee arthroplasty (TKA) include establishment of normal leg alignment, secure implant fixation,
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 informationANATOMIC SURGICAL TECHNIQUE. 5 in 1. Conventional instrumentation 07/11/2013
ANATOMIC SURGICAL TECHNIQUE 5 in 1 Conventional instrumentation PRO.GB.933/1.0 Octobre 2013 2 Tibial step 3 Intramedullary technique - Based on the preoperative plan, drill the medullary canal with the
More informationCONTRIBUTING SURGEON. Barry Waldman, MD Director, Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD
CONTRIBUTING SURGEON Barry Waldman, MD Director, Center for Joint Preservation and Replacement Sinai Hospital of Baltimore Baltimore, MD System Overview The EPIK Uni is designed to ease the use of the
More informationSIGMA REVISION KNEE AND M.B.T. REVISION TRAY
SIGMA REVISION KNEE AND M.B.T. REVISION TRAY SURGICAL TECHNIQUE TABLE OF CONTENTS Surgical Technique Key Surgical Steps Summary 4 SIGMA Revision Knee/M.B.T. Revision Tray Knee Surgery 6 The SIGMA Revision
More informationRotating Hinge Knee System
S-ROM NOILES Rotating Hinge Knee System Surgical Technique Table of Contents Surgical Technique Key Surgical Steps Summary 4 S-ROM NOILES Rotating Hinge Knee System 6 The S-ROM Hinge System Overview 7
More informationIntramedullary Tibial Preparation
Surgical Technique Intramedullary Tibial Preparation Primary Total Knee Arthroplasty LEGION Total Knee System Intramedullary tibial preparation Contents Introduction...2 IM tibial highlights...3 Preoperative
More informationHP 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.
More informationELEOS Limb Salvage System
ELEOS Limb Salvage System Surgical Technique Hinge Knee Replacement The ELEOS Limb Salvage System offers options for patients with significant bone loss due to cancer, trauma, or previous surgical procedures.
More informationZimmer Patient Specific Instruments. Surgical Techniques for NexGen Complete Knee Solution
Zimmer Patient Specific Instruments Surgical Techniques for NexGen Complete Knee Solution INTRO Zimmer Patient Specific Instruments Surgical Techniques for NexGen Complete Knee Solution Table of Contents
More informationDistal Cut First Femoral Preparation
Surgical Technique Distal Cut First Femoral Preparation Primary Total Knee Arthroplasty LEGION Total Knee System Femoral preparation Contents Introduction...3 DCF femoral highlights...4 Preoperative planning...6
More informationZimmer Patient Specific Instruments. Surgical Technique for Gender Solutions Natural-Knee Flex System
Zimmer Patient Specific Instruments Surgical Technique for Gender Solutions Natural-Knee Flex System TOC Zimmer Patient Specific Instruments Surgical Technique for Gender Solutions Natural-Knee Flex Table
More informationTriathlon Knee System
Triathlon Knee System Express Instruments Surgical Protocol Posterior Stabilized & Cruciate Retaining TriathlonKneeSystem Express Instruments Surgical Protocol Acknowledgments..........................................................2
More informationNEXGEN COMPLETE KNEE SOLUTION. Revision Instrumentation Surgical Technique For Legacy Knee Constrained Condylar Knee
NEXGEN COMPLETE KNEE SOLUTION Revision Instrumentation Surgical Technique For Legacy Knee Constrained Condylar Knee INTRODUCTION Revision total knee arthroplasty can be a very challenging task for any
More informationNEXGEN COMPLETE KNEE SOLUTION S A. Tibial Stem Extension & Augmentation Surgical. ATechnique
NEXGEN COMPLETE KNEE SOLUTION ATechnique Tibial Stem Extension & Augmentation Surgical INTRODUCTION The NexGen Complete Knee Solution Intramedullary Tibial Instruments have been designed to provide an
More informationThe ACL-PCL Substituting Knee. BioFoam Tibial Bases. Surgical Technique For Cementless Tibial Fixation
The CL-PCL Substituting Knee BioFoam Surgical Technique For Cementless Tibial Fixation Surgical techniques and instrument recommendations were provided by: Michael nderson, MD Milwaukee, WI G. Lynn Rasmussen,
More informationScorpio TS Single Axis Revision Knee System. Scorpio Total Stabilizer Revision Knee System Surgical Protocol
Scorpio TS Single Axis Revision Knee System Scorpio Total Stabilizer Revision Knee System Surgical Protocol Table of Contents Scorpio Total Stabilizer Revision Knee System Surgical Protocol Component
More informationUniglide. Unicompartmental Knee Replacement Mk III surgical technique
Uniglide Unicompartmental Knee Replacement Mk III surgical technique Uniglide Contents Operative summary 4 Pre-operative assessment 6 Preparation 7 Incision 7 Approach 7 Medial procedure 8 Tibial preparation
More informationNexGen Trabecular Metal Tibial Tray. Surgical Technique
NexGen Trabecular Metal Tibial Tray Surgical Technique Table of Contents Surgical Technique...2 Resect the Tibia...2 Finish the Tibia...2 Position Based Anatomic Landmarks...3 Position Based on Trial
More informationLAMINA SPREADER SURGICAL TECHNIQUE
LAMINA SPREADER SURGICAL TECHNIQUE Balanced and appropriate external rotation of the femoral component is important for tibio-femoral stability in flexion and patello-femoral tracking/function. Depending
More informationSurgical Technique. VISIONAIRE Disposable Instruments for the LEGION Total Knee System
Surgical Technique VISIONAIRE Disposable Instruments for the LEGION Total Knee System VISIONAIRE and LEGION Disposable instrument technique* Note: All disposable instruments are interchangeable with the
More informationTotal Knee Original System Primary Surgical Technique
Surgical Procedure Total Knee Original System Primary Surgical Technique Where as a total hip replacement is primarily a bony operation, a total knee replacement is primarily a soft tissue operation. Excellent
More informationNEXGEN COMPLETE KNEE SOLUTION
NEXGEN COMPLETE KNEE SOLUTION Surgical Technique for the Legacy Knee LPS-Flex Mobile Bearing Knee This device is not available for commercial distribution in the U.S. Implants and Surgical Technique developed
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 informationTHE ATTUNE REVISION ROTATING PLATFORM KNEE SYSTEM
THE ATTUNE REVISION ROTATING PLATFORM KNEE SYSTEM Instrumentation Designed to Enhance Efficiency and Versatility Surgical Process and Key Instrument Overview Introduction TABLE OF CONTENTS ADDRESS VARYING
More informationS-ROM NOILES With High Performance Revision Instruments
S-ROM NOILES With High Performance Revision Instruments This publication is not intended for distribution in the USA. SURGICAL TECHNIQUE CONTENTS Key Surgical Steps Summary 4 S-ROM NOILES Rotating Hinge
More informationZimmer NexGen Tibial Stem Extension & Augmentation. Surgical Technique IMAGE TO COME. Stem Extensions and Augments
Zimmer NexGen Tibial Stem Extension & Augmentation Surgical Technique IMAGE TO COME Stem Extensions and Augments Zimmer NexGen Tibial Stem Extension & Augmentation Surgical Technique 1 Zimmer NexGen Tibial
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 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 informationImpact of Intramedullary Reaming Depth on Establishing Femoral Canal Axis in the Sagittal Plane
Impact of Intramedullary Reaming Depth on Establishing Femoral Canal Axis in the Sagittal Plane Yifei Dai, Ph.D., Dwight Todd. Zimmer Inc, Warsaw, IN, USA. Disclosures: Y. Dai: 3A; zimmer inc. 4; zimmer
More informationANTERIOR REFERENCE NEXGEN COMPLETE KNEE SOLUTION. Multi-Reference 4-in-1 Femoral Instrumentation Anterior Reference Surgical Technique
ANTERIOR REFERENCE NEXGEN COMPLETE KNEE SOLUTION Multi-Reference 4-in-1 Femoral Instrumentation Anterior Reference Surgical Technique For NexGen Cruciate Retaining & Legacy Posterior Stabilized Knees INTRODUCTION
More informationZimmer NexGen. LPS-Flex Fixed Bearing Knee. Surgical Technique. Designed to accomodate resumption of high-flexion daily activities
Zimmer NexGen LPS-Flex Fixed Bearing Knee Surgical Technique Designed to accomodate resumption of high-flexion daily activities Zimmer NexGen LPS-Flex Fixed Bearing Knee Surgical Technique 1 Zimmer NexGen
More informationTRK REVISION KNEE Surgical Technique
1 TRK REVISION KNEE Surgical Technique 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. INTERCONDYLAR RESECTION...... page FEMORAL STEM...... page NON CEMENTED FEMORAL STEM...... page TRIAL FEMORAL COMPONENTS...... page
More informationTrabecular Metal Tibial Cone Surgical Technique
Trabecular Metal Tibial Cone Surgical Technique Provides structural support in areas of bone loss Trabecular Metal Cone 1 Zimmer Trabecular Metal Tibial Cone Surgical Technique Table of Contents Overview
More informationTOTAL KNEE ARTHROPLASTY SYSTEM
SURGICAL TECHNIQUE TOTAL KNEE ARTHROPLASTY SYSTEM 90-SRK-700000 B.0 0 Contents 1. Implant Sizing 2. Surgical Technique a. Incision and Exposure b. Distal Femoral Resection c. Tibial Resection d. Femoral
More informationZimmer MOST Options System
Zimmer MOST Options System Surgical Technique Modular Options for Severe Bone Loss and Trauma Zimmer MOST Options System Surgical Technique 1 MOST Options System Surgical Technique Developed in conjunction
More informationZimmer NexGen MIS Tibial Component. Cemented Surgical Technique IMAGE TO COME
Zimmer NexGen MIS Tibial Component Cemented Surgical Technique IMAGE TO COME Zimmer NexGen MIS Tibial Component Cemented Surgical Technique 1 Zimmer NexGen MIS Tibial Component Cemented Surgical Technique
More informationSurgical Technique. Unisyn Hip System
Surgical Technique Unisyn Hip System INDICATIONS AND USAGE Significantly impaired joints resulting from rheumatoid, osteo, and post-traumatic arthritis. Revision of failed femoral head replacement, hip
More informationELEOS Limb Salvage System
ELEOS Limb Salvage System Surgical Technique Total Femoral Replacement The ELEOS Limb Salvage System offers options for patients with significant bone loss due to cancer, trauma, or previous surgical procedures.
More informationPOSTERIOR REFERENCE NEXGEN COMPLETE KNEE SOLUTION. Multi-Reference 4-in-1 Femoral Instrumentation Posterior Reference Surgical Technique
POSTERIOR REFERENCE NEXGEN COMPLETE KNEE SOLUTION Multi-Reference 4-in-1 Femoral Instrumentation Posterior Reference Surgical Technique For NexGen Cruciate Retaining & Legacy Posterior Stabilized Knees
More informationTriathlon TS Knee System. Surgical Protocol
Triathlon TS Knee System Surgical Protocol Triathlon TS Knee System Surgical Protocol Table of Contents Acknowledgments..........................................................2 Exposure...................................................................4
More informationNexGen Legacy LPS-Flex Knee. Brochure
NexGen Legacy LPS-Flex Knee Brochure What postoperative range of motion can your TKA patients expect? For patients with the ability and desire to perform For patients with the ability high-flexion activities,
More informationPersona. The Personalized Knee. Trabecular Metal Tibia. Surgical Technique
Persona The Personalized Knee Trabecular Metal Tibia Surgical Technique Table of Contents Resect the Tibia... 4 Size and Finish the Tibia... 4 Trial Fit... 6 Component Implantation... 7 Inserter/Implant
More informationLCS COMPLETE Revision Knee System. Surgical Technique
LCS COMPLETE Revision Knee System Surgical Technique Table of Contents LCS COMPLETE Revision System Surgical Technique Introduction 2 Pre-operative Planning 2 Surgical Technique 3 Intra-operative Evaluation
More informationProfix. Total Knee System. As described by
Profix Total Knee System P R I M A R Y P R O C E D U R E As described by Leo A. Whiteside, M.D. Associate Research Professor Washington University School of Medicine Director, Biomechanical Research Laboratory
More informationResurfacing Distal Femur. Orthopaedic Salvage System
Resurfacing Distal Femur Orthopaedic Salvage System Primary Arthroplasty OSS 3cm Resurfacing Distal Femur Distal Femoral Resection Drill and ream the distal femur in the following sequence: (Figure 1)
More informationProven Gen-Flex Revision Knee System. Surgical Protocol
Proven Gen-Flex Revision Knee System Surgical Protocol Proven Gen-Flex Revision Knee System Surgeon Design Team The Proven Gen-Flex Revision Knee System Instrumentation and Surgical Protocol were developed
More informationThe power of simplicity
The power of simplicity The power of simplicity Consider the facts, and take a look at the future: Revision TKA procedures are projected to double between now and 2015. 1 Restoration of a normal joint
More informationDePuy LPS Limb Preservation System
DePuy LPS Limb Preservation System surgical techniques Significant bone loss requiring extensive reconstruction around the hip and knee is often required following the treatment of malignant bone tumors,
More informationPatient Specific Instruments. Surgical Technique
Patient Specific Instruments Surgical Technique Patient Specific Instruments Surgical Technique INTRO Introduction General Considerations Zimmer Patient Specific Instruments (PSI) are not designed for
More informationNATURAL MOTION TECHNOLOGY SURGICAL TECHNIQUE. EMPOWR 3D Knee. EMPOWR PS Knee
NATURAL MOTION TECHNOLOGY EMPOWR 3D Knee EMPOWR PS Knee SURGICAL TECHNIQUE Contents System Features.... 3 Indications and Contraindications.... 4 Surgical Snap Shot.... Preoperative Planning.... Surgical
More informationMIS Cemented Tibial Component
MIS Cemented Tibial Component NexGen Complete Knee Solution Surgical Technique Table of Contents Surgical Exposure... 2 Finish the Tibia... 2 Position Based on Anatomic Landmarks... 3 Lateral Posterior
More informationLPS SYSTEM SURGICAL TECHNIQUE
LPS SYSTEM SURGICAL TECHNIQUE Significant bone loss requiring extensive reconstruction around the hip and knee is often required following the treatment of malignant bone tumors, aggressive benign bone
More informationLCS COMPLETE SURGICAL TECHNIQUE. MILESTONE Instruments with MBT Tray Preparation
LCS COMPLETE MILESTONE Instruments with MBT Tray Preparation SURGICAL TECHNIQUE CONTENTS Preface 2 Surgical Concepts 3 Instruments 4 Surgical Technique Summary 6 Surgical Technique 8 Preparation 8 Incision
More informationConstrained Posterior Stabilized (CPS) Surgical Technique
Constrained Posterior Stabilized (CPS) Surgical Technique Constrained Posterior Stabilized (CPS) Surgical Technique INTRO Introduction The Constrained Posterior Stabilized (CPS) articular surfaces can
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 informationAnterior Cut First Surgical Technique
Anterior Cut First Surgical Technique GENESIS II Anterior Cut First Surgical Technique Table of Contents Introduction....................................... 2 Preop Planning....................................
More informationUniglide. Unicompartmental Knee Replacement Mk III surgical technique. The mobile bearing is not commercially available in the USA
Uniglide Unicompartmental Knee Replacement Mk III surgical technique The mobile bearing is not commercially available in the USA Uniglide Contents Introduction 4 Compatibility chart 7 Operative summary
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 informationRevolution. Unicompartmental Knee System
Revolution Unicompartmental Knee System While Total Knee Arthroplasty (TKA) is one of the most predictable procedures in orthopedic surgery, many patients undergoing TKA are in fact excellent candidates
More informationOrthopedic Bone Nail System - Distal Femoral Nail Surgical Technique Manual
Orthopedic Bone Nail System - Distal Femoral Nail Surgical Technique Manual Note: The surgical procedures should be performed under the guidance of qualified skilled orthopedic surgeons, and this surgical
More informationSCORE Revision. Revision Total Knee Arthroplasty Cemented. Surgical Technique With Conventional Instrumentation Primary cases
SCORE Revision Revision Total Knee Arthroplasty Cemented Surgical Technique With Conventional Instrumentation Primary cases SCORE REVISION FOR PRIMARY CASES The SCORE Revision is a revision total knee
More informationNexGen CR-Flex Fixed Bearing Knee. Surgical Technique
NexGen CR-Flex Fixed Bearing Knee Surgical Technique Table of Contents Introduction...2 Preoperative Conditioning... 3 Preoperative Planning... 3 Surgical Technique...4 Incision and Exposure... 4 Femoral
More informationSurgical Technique Final Trial Reduction and Component Implantation of
Surgical Technique Final Trial Reduction and Component Implantation of TC *smith&nephew TC-PLUS PRIMARY Mobile Bearing TC-PLUS PRIMARY Mobile Bearing Final Trial Reduction and Component Implantation of
More informationZIMMER NEXGEN CRUCIATE RETAINING (CR) AND LEGACY KNEE POSTERIOR STABILIZED (LPS) TRABECULAR METAL MONOBLOCK TIBIAS. Surgical Technique Addendum
ZIMMER NEXGEN CRUCIATE RETAINING (CR) AND LEGACY KNEE POSTERIOR STABILIZED (LPS) TRABECULAR METAL MONOBLOCK TIBIAS Surgical Technique Addendum SURGICAL TECHNIQUE FOR NEXGEN CRUCIATE RETAINING (CR) AND
More informationZenith. Total Ankle Replacement Surgical technique
Total Ankle Replacement Surgical technique Contents Operative summary 4 Pre-operative planning and templating 6 Patient positioning 6 Exposure 6 Saw blades 7 Joint line definition 7 Tibial alignment jig
More informationPRIMARY POROUS PATELLA WITH TRABECULAR METAL. Surgical Technique
PRIMARY POROUS PATELLA WITH TRABECULAR METAL Surgical Technique 1 SURGICAL TECHNIQUE FOR NEXGEN PRIMARY POROUS PATELLA * WITH TRABECULAR METAL CONTENTS PREPARE THE PATELLA............... 2 Patella Reamer
More informationConstrained Posterior Stabilized (CPS)
Constrained Posterior Stabilized (CPS) Persona The Personalized Knee Surgical Technique Table of Contents Introduction... 2 Constraint Options Initial Knee Assessment... 3 Femoral Box Cut CPS Tibial Bearing
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 informationSurgical Technique Final Trial Reduction and Component Implantation of
Surgical Technique Final Trial Reduction and Component Implantation of TC *smith&nephew TC-PLUS PRIMARY Fixed Bearing TC-PLUS PRIMARY Fixed Bearing Final Trial Reduction and Component Implantation of
More informationMRH Knee System Modular Peg Baseplate Surgical Protocol
MRH Knee System Modular Peg Baseplate Surgical Protocol Using Monogram IM Revision Instruments 4 N 4 N Modular Rotating Hinge Knee System Using Monogram IM Revision Instruments Mr C R Howie FRCS Consultant
More informationSurgical Technique i.m.a.g.e. Patient Specific Instrumentation 5-in-1
Surgical Technique i.m.a.g.e. Patient Specific Instrumentation -in- SCORE Primary Total Knee System Mobile bearing Cemented or cementless Overview of SCORE TKS Overview of SCORE TKS The SCORE TKS is a
More informationTKA Gap Planning. Supporting healthcare professionals
TKA Gap Planning The NAVIO TKA Gap Planning stage helps you adjust the plan based on gap information between the femur and tibia implants. Supporting healthcare professionals Interactive Views Four interactive
More informationZimmer Trabecular Metal Ankle Interpositional Spacer and Trabecular Metal Ankle Fusion Spacer
Zimmer Trabecular Metal Ankle Interpositional Spacer and Trabecular Metal Ankle Fusion Spacer Surgical Technique 2 Zimmer Trabecular Metal Ankle Interpositional Spacer and Trabecular Metal Ankle Fusion
More informationEffects of Posteromedial Vertical Capsulotomy on the Medial Extension Gap in Cruciate-retaining Total Knee Arthroplasty
Effects of Posteromedial Vertical Capsulotomy on the Medial Extension Gap in Cruciate-retaining Total Knee Arthroplasty Ryutaku Kaneyama, M.D., Hideaki Shiratsuchi, Kazuhiro Oinuma, MD, Yoko Miura, MD,
More information1. Pre-Operative Planning Skin Incision and Arthrotomy
Stage of Operation 1. Pre-Operative Planning --------------------------1 2. Skin Incision and Arthrotomy ------------------1 3. Femoral valgus angle confirmation ------------2 4. Distal Femur Cutting -----------------------------3
More informationS U R G I C A L T E C H N I Q U E David A. McQueen, MD Return to Menu
S U R G I C A L T E C H N I Q U E David A. McQueen, MD TOTAL KNEE INSTRUMENTS Wichita Fusion Nail Introduction...1 Preoperative Planning...2 Surgical Technique...3-8 Wichita Fusion Nail Surgical Technique
More informationSurgical Technique. VISIONAIRE FastPak Instruments for the LEGION Total Knee System
Surgical Technique VISIONAIRE FastPak Instruments for the LEGION Total Knee System VISIONAIRE FastPak for LEGION Instrument Technique* Nota Bene The technique description herein is made available to the
More informationOperative Technique. Constrained Condylar. The Right Track It s not just a road we re on, it s a trail we re blazing.
Operative Technique Constrained Condylar The Right Track It s not just a road we re on, it s a trail we re blazing. TABLE OF CONTENTS Introduction...1 Design rationale...1 operative technique Overview...2
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 informationNexGen Cruciate Retaining (CR) and Revision Instrumentation. Surgical Technique
NexGen Cruciate Retaining (CR) and Revision Instrumentation Surgical Technique Table of Contents Introduction... 4 Revision Arthroplasty... 4 Multi-Reference 4-in-1 Instrumentation System MICRO-MILL Instrumentation
More informationZimmer MIS Intramedullary Instrumentation
Zimmer MIS Intramedullary Instrumentation Surgical Technique For NexGen Cruciate Retaining & NexGen Legacy Posterior Stabilized Knees Zimmer MIS Intramedullary Instrumentation Surgical Technique Surgical
More informationTHE ATTUNE REVISION FIXED BEARING KNEE SYSTEM
THE ATTUNE REVISION FIXED BEARING KNEE SYSTEM Instrumentation Designed to Enhance Efficiency and Versatility Surgical Process and Key Instrument Overview Introduction TABLE OF CONTENTS ADDRESS VARYING
More informationNexGen LPS Fixed Bearing Knee. Surgical Technique
NexGen LPS Fixed Bearing Knee Surgical Technique Table of Contents Introduction...2 Preoperative Planning...2 Surgical Technique...3 Step One: Align the Tibia...3 MICRO-MILL Hand Piece Assembly and Usage
More information