A sequenced approach to flush graft placement. GLENOID BONE LOSS SYSTEM Procedural Solution

Transcription

1 A sequenced approach to flush graft placement GLENOID BONE LOSS SYSTEM Procedural Solution

2 One comprehensive system, two ways of treating glenoid bone loss The GLENOID BONE LOSS SYSTEM provides you with a choice of technique options to suit your decision algorithm and procedural preference: Mini-open Latarjet or arthroscopically-assisted bone block procedures, both designed to help restore joint stability with a flush bone graft. A system designed to be accurate and efficient at every step, leading to optimized bone graft placement

3 Repair Option 1: Mini-Open Latarjet This system offers a streamlined set of innovative instruments designed to provide an accurate and efficient method of placing the coracoid bone graft on the anterior glenoid rim. 1 Graft prep The Coracoid Prep Tool provides the ability to securely hold, fully prepare and accurately drill the bone graft with one instrument. 2 Offset measurement To help ensure flush graft placement, the Offset Measurement Tool determines which Offset Drill Guide to use in Step 3. A measurement is taken from the center of the drilled hole to the coracoid edge that becomes aligned to the articular surface of the glenoid. Planar face that attached to the anterior glenoid. This edge will become flush with the glenoid face. 3 Anterior glenoid drilling The 7mm Offset Drill Guide corresponding with the measurement taken in Step 2 is chosen and the spade is placed flush on the glenoid. There is a 10-degree divergent angle, which the design helps to minimize breaching of the cortical surface. A 2.7mm drill is inserted into the guide and drilled through the glenoid. 4 Coracoid graft placement After using the depth gauge to determine screw length, insert the 4.0mm partially-threaded stainless steel screw partway through the coracoid and facilitate control of the graft with the 2.5mm Hex Screwdriver. Available in cannulated and solid, the screw head features an undercut that may help spread the load further away from the drill hole. The screw s undercut area may help to spread the load further from the graft s drill hole. Use an Innomed Fukuda retractor with embedded light source to pull back the humeral head to provide access and visualization inside the joint. 5 Graft alignment Using the Coracoid Grasper, pivot the graft around the inferior screw to obtain proper alignment. 6 Final fixation Once proper alignment is confirmed, drill the superior hole in the glenoid and affix the graft to the anterior glenoid, finger-tightening the screw with slight compression. The Anterior Glenoid Retractor exposes the glenoid neck to provide access and visualization. A 1.3mm Guide Pin may be placed in the inferior screw cannulation to aid in superior drill trajectory.

4 Repair Option 2: Arthroscopically-Assisted Bone Block These steps allow for a posterior arthroscopic drilling technique with the ease of anterior open approach to place the bone graft. 1 Posterior glenoid guide positioning a. Place the Half Pipe Cannula through the posterior portal to aid in sliding the hook end of the Double Glenoid Guide into position at the 3-4 o clock position. b. Place two Glenoid Guide bullets percutaneously to secure the guide by ratcheting onto the posterior glenoid. 2 Posterior glenoid drilling Place two 2.8mm sleeved drills through the bullets to drill parallel holes arthroscopically through the glenoid 10mm apart. Each drill will also exit 5mm below the cortical edge of the glenoid face. Remove the bullets and guide, leaving the drills and sleeves. 3 Bone block graft prep The bone graft may be held, prepped and drilled in the same manner as Step 1 under Mini-Open Latarjet System using the Graft Prep Tool. 4 Bone block placement and fixation Place the bone graft in a similar manner as Step 4 under Mini-Open Latarjet using the same screw and screwdriver type. The 2.8 drills and sleeves exiting the anterior glenoid help find the location of each hole with the screw. Place an optional guide pin into the sleeve for ease of screw alignment to the hole. Remove each drill and sleeve prior to screw insertion into the glenoid. Finger-tighten the screws with slight compression to ensure final fixation.

5 Coracoid Prep Tool: Hold, prep and drill graft with one instrument Parallel-action handle secures graft while being prepped Drill guide stylus is locked in place by rotating knob Drill style guide can slide along axis of coracoid to align drill holes centered over the graft Holes can be drilled 10mm or 15mm apart Distance makers on jaw at 5, 10, 15 and 20mm Posterior Glenoid Guide: One Step Closer to an Arthroscopic Approach Double Glenoid Guide with same 10mm drill offset as Coracoid Prep Tool Ratcheting bullets help to maintain position Hook to secure position on anterior glenoid

6 Ordering information Mini-Open Latarjet Disposables mm Solid Drill w/quick Connect N/A 90 Oscillating Saw Blade* mm Guide Pin (box of 6) Bone Block Disposables mm Drill and Guide Sleeve Implants for Mini-Open Latarjet and Bone Block 4.0mm Cannulated Screws with 2.5mm Hex Drive mm Cannulated Screw, 2.5mm Hex Drive x 30mm mm Cannulated Screw, 2.5mm Hex Drive x 32mm mm Cannulated Screw, 2.5mm Hex Drive x 34mm mm Cannulated Screw, 2.5mm Hex Drive x 36mm mm Cannulated Screw, 2.5mm Hex Drive x 38mm mm Cannulated Screw, 2.5mm Hex Drive x 40mm mm Cannulated Screw, 2.5mm Hex Drive x 42mm mm Cannulated Screw, 2.5mm Hex Drive x 44mm 4.0mm Solid Screws with 2.5mm Hex Drive mm Solid Screw, 2.5mm Hex Drive x 30mm mm Solid Screw, 2.5mm Hex Drive x 32mm mm Solid Screw, 2.5mm Hex Drive x 34mm mm Solid Screw, 2.5mm Hex Drive x 36mm mm Solid Screw, 2.5mm Hex Drive x 38mm mm Solid Screw, 2.5mm Hex Drive x 40mm mm Solid Screw, 2.5mm Hex Drive x 42mm mm Solid Screw, 2.5mm Hex Drive x 44mm The Smith & Nephew GLENOID BONE LOSS SYSTEM Procedural Solution Designed to offer simplicity, efficiency and reproducibility. Developed by surgeons who recognized that conventional systems often utilize cumbersome instrumentation, require complex techniques, and lack adjustability for graft placement. Our comprehensive system offers the convenience of five different retractors. Each is designed to allow optimal tissue retraction, glenoid exposure, and help minimize neurological issues during the procedure. *The 90 Saw Blade used in the Mini-Open technique must be ordered from the power system vendor used by the facility. Contact OKC Loaner for the Mini-Open Latarjet Instrument Tray Indications for Use The Smith & Nephew Partially-Threaded Screws are intended for use for internal bone fixation including fractures of the tibia, fibula, clavicle, scapula, olecranon, metacarpals, metatarsals, humerus, ulna, middle hand bones, middle foot bones, and calcaneous. Screws are additionally intended for arthrodeses and osteotomies of small bones and small joints including scaphoid and other carpal bones, metacarpals, tarsals, metatarsals, clavicle, scapula, olecranon, ulnar styloid, radial head, and radial styloid. To order these instruments, call in the U.S. or contact an authorized Smith & Nephew representative. Prior to performing this technique, consult the Instructions for Use documentation provided with individual components including indications, contraindications, warnings, cautions and instructions. Smith & Nephew, Inc. 150 Minuteman Road Andover, MA USA T US Customer Service: Trademark of Smith & Nephew Smith & Nephew. All rights reserved. Printed in USA V1 12/17 Supporting healthcare professionals for over 150 years