LPS 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 System) and provide details for material composition, dimensional characteristics, the use of the implant components and some examples of how the components are assembled to address various surgical needs. The LPS instruments are reviewed to provide information regarding their use. A checklist of other instruments and/or implants that are integrated for the procedural uses is also covered.

IMPLANTS Proximal Femoral Body Replacement Components... 4 Segmental Components... 6 Total Femoral Segmental Component... 8 Intercalary Segmental Component... 8 Distal Femoral Replacement Components... 10 Stem Extension Components... 12 Proximal Tibial Replacement Component... 16 MBT Revision Tray... 18 LPS Universal Tibial Hinge Insert Bearing... 22 S-ROM NOILES Rotating Hinge Femoral Component... 24 Metaphyseal Sleeves... 26 Implants 3

PROXIMAL FEMORAL BODY REPLACEMENT COMPONENTS Standard Body Style Offset 38 mm Body Height 70 mm (using +1.5 mm head) Trochanteric Build-Up Body Style 4

MATERIAL Titanium alloy with POROCOAT Porous Coating FEATURES Standard and trochanteric build-up styles Neutral and 15 degrees (left and right) Suture holes Anti-rotation tabs 90 mm minimum resection 70 mm body + 20 mm stem collar (to the + 1.5 mm head center) 38 mm offset (using a +1.5 mm head) ARTICUL/EZE neck taper 135 degree neck/shaft angle Female component taper USE Replaces proximal femoral bone Mates with segmental components, total femoral segmental components, LPS stem extension components, and universal metaphyseal sleeves PROXIMAL FEMORAL BODY REPLACEMENT COMPONENTS Ordering Information Cat. No. Description 1987-10-105 Standard Body, Neutral 1987-10-205 Trochanter Body, Neutral 1987-11-105 Standard Body, Left, 15 Degrees 1987-11-205 Trochanter Body, Left, 15 Degrees 1987-12-105 Standard Body, Right, 15 Degrees 1987-12-205 Trochanter Body, Right, 15 Degrees 5

SEGMENTAL COMPONENTS Length 6

MATERIAL Titanium alloy FEATURES 25, 30, 35, 40, 45, 65, 85, 105 and 125 mm lengths One male and one female taper Anti-rotation tabs and slots USE Connectors of the LPS System. Mates with all LPS components, including the LPS femoral to sleeve adapter Replaces missing shaft bone in 5 mm increments to adjust leg length SEGMENTAL COMPONENTS Ordering Information Cat. No. Description 1987-07-025 25 mm length 1987-07-030 30 mm length 1987-07-035 35 mm length 1987-07-040 40 mm length 1987-07-045 45 mm length 1987-07-065 65 mm length 1987-07-085 85 mm length 1987-07-105 105 mm length 1987-07-125 125 mm length 7

TOTAL FEMORAL SEGMENTAL COMPONENT 55 mm Length INTERCALARY SEGMENTAL COMPONENT 55 mm Length 8

MATERIAL Titanium alloy FEATURES 55 mm length Two male tapers Anti-rotation slots USE Needed for total femoral replacement construct Replaces missing shaft bone Mates with segmental, proximal femoral or distal femoral components TOTAL FEMORAL SEGMENTAL COMPONENT Ordering Information Cat. No. Description 1987-08-055 55 mm length MATERIAL Titanium alloy FEATURES 55 mm length Two female tapers Anti-rotation tabs USE Replaces midshaft bone Connects with segmental components and LPS stem extensions INTERCALARY SEGMENTAL COMPONENT Ordering Information Cat. No. Description 1987-09-055 55 mm length 9

DISTAL FEMORAL REPLACEMENT COMPONENTS X-small 60 mm Height XX-small 50 mm Height 66 mm M/L, X-small 56 mm M/L, XX-small 10 53 mm A/P, X-small 48 mm A/P, XX-small

MATERIAL Cobalt Chrome alloy FEATURES 70/80 mm minimum resection 50/60 mm component height to articular surface + 20 mm stem collar when using LPS stems 50/60 mm minimum resection when using metaphyseal sleeves Utilizes SIGMA Patella Female taper with anti-rotation tabs Anatomic (right and left) X-small and XX-small size for soft tissue closure Cobalt Chrome hinge pin allows for easy insertion with secure locking (packaged with the femur) USE Replaces missing distal femur Compatible with segmental components, total segmental components, LPS stem extensions, and universal metaphyseal sleeves Assembles with the LPS Universal Tibial Hinge insert bearing to connect with the MBT Revision Tray or the LPS proximal tibial replacement components Load share design between hinge pin bushings and plateau bearing surface Allows for 5 degrees of hyperextension and 140 degrees of flexion Intended for cemented use only Femoral component and tibial insert must match size for size DISTAL FEMORAL REPLACEMENT COMPONENTS Ordering Information Cat. No. Description 1987-13-111 Left, XX-small 1987-14-111 Right, XX-small 1987-13-105 Left, X-small 1987-14-105 Right, X-small PFC SIGMA Patella Components and Misc. Replacement Components 96-0110 32 mm 3-Peg Round/Dome Patella 96-0111 35 mm 3-Peg Round/Dome Patella 96-0112 38 mm 3-Peg Round/Dome Patella 96-0113 41 mm 3-Peg Round/Dome Patella 1987-17-000 Distal femoral poly bumper replacement 1987-15-000 XX-small replacement hinge pin 62-1640 X-small/small replacement hinge pin 11

STEM EXTENSION COMPONENTS 20 mm Collar Height Bevel Stem Length 12

MATERIAL Cobalt Chrome alloy FEATURES Cemented and porous options Straight (100 and 125 mm) and bowed (150 and 200 mm) All stems have a porous collar, 20 mm height Male taper with anti-rotation slots Proximal stem bevel for enhanced fit Porous stems utilize POROCOAT Porous Coating with bullet tip Cemented stems have flutes for enhanced cement fixation Trials are 0.5 mm undersized relative to the implant Cemented Stems Porous Stems 9-17 mm diameters (1 mm increments) 100, 125, 150 and 200 mm lengths* 10.5-18.5 mm diameters (1 mm increments) 100, 125, 150 and 200 mm lengths* *See pages 14 and 15 for details USE Provides fixation into remaining host bone Stems mate with segmental, intercalary, proximal femoral, distal femoral and proximal tibial replacement components 13

CEMENTED STEMS (STRAIGHT) Ordering Information Cat. No. Description 1987-25-109 9 mm diameter x 100 mm length 1987-25-110 10 mm diameter x 100 mm length 1987-25-111 11 mm diameter x 100 mm length 1987-25-112 12 mm diameter x 100 mm length 1987-25-412 12 mm diameter x 125 mm length 1987-25-413 13 mm diameter x 125 mm length 1987-25-414 14 mm diameter x 125 mm length 1987-25-415 15 mm diameter x 125 mm length 1987-25-416 16 mm diameter x 125 mm length 1987-25-417 17 mm diameter x 125 mm length POROUS STEMS (STRAIGHT) Ordering Information Cat. No. Description 1987-26-109 10.5 mm diameter x 100 mm length 1987-26-110 11.5 mm diameter x 100 mm length 1987-26-111 12.5 mm diameter x 100 mm length 1987-26-112 13.5 mm diameter x 100 mm length 1987-26-412 13.5 mm diameter x 125 mm length 1987-26-413 14.5 mm diameter x 125 mm length 1987-26-414 15.5 mm diameter x 125 mm length 1987-26-415 16.5 mm diameter x 125 mm length 1987-26-416 17.5 mm diameter x 125 mm length 1987-26-417 18.5 mm diameter x 125 mm length 14

CEMENTED STEMS (BOWED) Ordering Information Cat. No. Description 1987-15-211 11 mm diameter x 150 mm length 1987-15-212 12 mm diameter x 150 mm length 1987-15-213 13 mm diameter x 150 mm length 1987-15-214 14 mm diameter x 150 mm length 1987-15-215 15 mm diameter x 150 mm length 1987-15-216 16 mm diameter x 150 mm length 1987-15-217 17 mm diameter x 150 mm length 1987-15-311 11 mm diameter x 200 mm length 1987-15-313 13 mm diameter x 200 mm length 1987-15-315 15 mm diameter x 200 mm length 1987-15-317 17 mm diameter x 200 mm length POROUS STEMS (BOWED) Ordering Information Cat. No. Description 1987-16-211 12.5 mm diameter x 150 mm length 1987-16-212 13.5 mm diameter x 150 mm length 1987-16-213 14.5 mm diameter x 150 mm length 1987-16-214 15.5 mm diameter x 150 mm length 1987-16-215 16.5 mm diameter x 150 mm length 1987-16-216 17.5 mm diameter x 150 mm length 1987-16-217 18.5 mm diameter x 150 mm length 1987-16-311 12.5 mm diameter x 200 mm length 1987-16-313 14.5 mm diameter x 200 mm length 1987-16-315 16.5 mm diameter x 200 mm length 1987-16-317 18.5 mm diameter x 200 mm length 15

PROXIMAL TIBIAL REPLACEMENT COMPONENT 66 mm M/L, X-small 73 mm Height 16

MATERIAL Cobalt Chrome alloy FEATURES 105 mm minimum resection 73 mm component + 12 mm bearing insert + 20 mm collar Female taper with anti-rotation tabs Highly polished plateau articulation surface Anterior suture holes POROCOAT Porous Coating USE Replaces missing proximal tibial bone Mates with segmental components and LPS stem extensions Accepts the LPS Universal Tibial Hinge insert bearing to connect with the S-ROM NOILES rotating hinge femoral component or the LPS distal femoral replacement component Intended for cemented use only PROXIMAL TIBIAL REPLACEMENT COMPONENT Ordering Information Cat. No. Description 1987-21-105 LPS, X-small 17

18 MBT REVISION TRAY

MATERIAL Cobalt Chrome alloy FEATURES Tibial tray baseplate 5 is mm thick Mates with metaphyseal sleeves (29, 37, 45, 53 and 61 mm options) Mates with modular step wedges (5, 10 and 15 mm thicknesses) Mates with universal press-fit stems Titanium alloy 75, 115 and 150 mm lengths in 10-24 mm diameters Mates with SIGMA cemented stems Titanium alloy 30, 60, 90, 120 and 150 mm lengths in 13 mm diameter 30, 60 and 90 mm lengths in 15 mm diameter Thick tray options available in 15 and 25 mm thicknesses, sizes 2, 3 and 4 USE Resurfacing of tibia in distal femoral and total femoral replacement procedures Accepts the LPS Universal Tibial Hinge insert bearing to connect with the LPS distal femoral replacement component or the S-ROM NOILES rotating hinge femoral component Intended for cemented use only 19

20 MBT REVISION TRAY (CONT.)

MBT REVISION TRAY Ordering Information Cat. No. Cemented Size Description 1294-35-110 1 59 mm M/L x 39 mm A/P 1294-35-115 1.5 62 mm M/L x 41 mm A/P 1294-35-120 2 65 mm M/L x 43 mm A/P 1294-35-125 2.5 67 mm M/L x 44 mm A/P 1294-35-130 3 70 mm M/L x 46 mm A/P 1294-35-140 4 75 mm M/L x 49 mm A/P 1294-35-150 5 81 mm M/L x 53 mm A/P 1294-35-160 6 87 mm M/L x 57 mm A/P MBT REVISION THICK TRAY Ordering Information Cat. No. Cemented Size Description 1294-35-215 2 MBT Rev Thick Tray Size 2, 15 mm 1294-35-225 2 MBT Rev Thick Tray Size 2, 25 mm 1294-35-315 3 MBT Rev Thick Tray Size 3, 15 mm 1294-35-325 3 MBT Rev Thick Tray Size 3, 25 mm 1294-35-415 4 MBT Rev Thick Tray Size 4, 15 mm 1294-35-425 4 MBT Rev Thick Tray Size 4, 25 mm 21

LPS UNIVERSAL TIBIAL HINGE INSERT BEARING Cobalt Chrome Core S-ROM NOILES Articular Geometry Parallel Sides 22

MATERIAL Forged Cobalt Chrome pin for enhanced strength FEATURES Polyethylene bushings mate with hinge pin Flat anterior surface with hyperextension stop XX-small, X-small, small and medium sizes 12, 14, 16, 18, 21, 23, 26, 28 and 31 mm plateau bearing thickness USE Provides stability for missing ligaments Hinge provides stability in flexion and extension and acts as a pivot point for distal femoral internal and external rotation Mates with the LPS distal femoral replacement component or the S-ROM NOILES rotating hinge femoral component and the MBT Revision Tray or the LPS proximal tibial replacement component Femoral Component and tibial insert must match size for size LPS UNIVERSAL TIBIAL HINGE INSERT BEARING Ordering Information Cat. No. Description 1987-27-012 XX-small, 12 mm 1987-27-216 Small, 16 mm 1987-27-014 XX-small, 14 mm 1987-27-218 Small, 18 mm 1987-27-016 XX-small, 16 mm 1987-27-221 Small, 21 mm 1987-27-018 XX-small, 18 mm 1987-27-223 Small, 23 mm 1987-27-021 XX-small, 21 mm 1987-27-226 Small, 26 mm 1987-27-023 XX-small, 23 mm 1987-27-228 Small, 28 mm 1987-27-112 X-small, 12 mm 1987-27-231 Small, 31 mm 1987-27-114 X-small, 14 mm 1987-27-312 Medium, 12 mm 1987-27-116 X-small, 16 mm 1987-27-314 Medium, 14 mm 1987-27-118 X-small, 18 mm 1987-27-316 Medium, 16 mm 1987-27-121 X-small, 21 mm 1987-27-318 Medium, 18 mm 1987-27-123 X-small, 23 mm 1987-27-321 Medium, 21 mm 1987-27-126 X-small, 26 mm 1987-27-323 Medium, 23 mm 1987-27-128 X-small, 28 mm 1987-27-326 Medium, 26 mm 1987-27-131 X-small, 31 mm 1987-27-328 Medium, 28 mm 1987-27-212 Small, 12 mm 1987-27-331 Medium, 31 mm 1987-27-214 Small, 14 mm 23

24 S-ROM NOILES ROTATING HINGE FEMORAL COMPONENT

MATERIAL Cobalt Chrome alloy FEATURES Three sizes (X-small, small and medium) Anatomic (left and right) Six degrees of hyperextension with polyethylene bumper stop Load share design between hinge pin bushings and plateau bearing surface Posterior hinge point for maximum flexion Cobalt Chrome hinge pin Mates with universal femoral metaphyseal sleeves (20, 31, 34, 40 and 46 mm options) USE Assembles with the LPS proximal tibial replacement component or the MBT Revision Tray components using the LPS Universal Tibial Hinge insert bearing Intended for cemented use only Use with S-ROM patella S-ROM NOILES ROTATING HINGE FEMORAL COMPONENT Ordering Information Cat. No. Description 62-3421L X-small, 66 mm M/L x 58 mm A/P, left 62-3421R X-small, 66 mm M/L x 58 mm A/P, right 62-3411L Small, 66 mm M/L x 62 mm A/P, left 62-3411R Small, 66 mm M/L x 62 mm A/P, right 62-3401L Medium, 71 mm M/L x 66 mm A/P, left 62-3401R Medium, 71 mm M/L x 66 mm A/P, right S-ROM Patella Components 62-1630 30 mm Patellar Dome 62-1632 32 mm Patellar Dome 62-1635 35 mm Patellar Dome 62-1638 38 mm Patellar Dome 25

26 METAPHYSEAL SLEEVES

MATERIAL Titanium with clinically proven POROCOAT Porous Coating FEATURES Five tibial sleeve sizes: 29, 37, 45, 53, and 61 mm Five femoral sleeve sizes: 20 (cemented only), 31, 34, 40 and 46 mm (fully or distally porous) Femoral sleeves are compatible with SIGMA, LCS, S-ROM NOILES and LPS knee systems LPS distal femoral to sleeve adapter available in 0, 5, and 10mm lengths to increase distal offset Tibial sleeves are compatible with the MBT Revision Tray and MBT Revision Thick Trays Accepts universal press-fit and SIMGA cemented stems USE Employs Wolff s Law to progressively load the bone with its stepped design Provides rotational stability to help prevent component loosening Same straightforward surgical technique at every level of constraint METAPHYSEAL SLEEVES AND ADAPTERS Ordering Information Cat. No. Description 1294-54-000 MBT Revision Porous Tibial Sleeve, 29 mm 1294-54-140 MBT Revision Cemented Tibial Sleeve, 29 mm 1294-54-100 MBT Revision Porous Tibial Sleeve, 37 mm 1294-54-110 MBT Revision Porous Tibial Sleeve, 45 mm 1294-54-120 MBT Revision Porous Tibial Sleeve, 53 mm 1294-54-130 MBT Revision Porous Tibial Sleeve, 61 mm 1294-53-205 Universal Femoral Sleeve - Cemented, 20 mm 1294-53-215 Universal Femoral Sleeve - Distally Porous, 31 mm 1294-53-216 Universal Femoral Sleeve - Fully Porous, 31 mm 1294-53-225 Universal Femoral Sleeve - Distally Porous, 34 mm 1294-53-226 Universal Femoral Sleeve - Fully Porous, 34 mm 1294-53-235 Universal Femoral Sleeve - Distally Porous, 40 mm 1294-53-236 Universal Femoral Sleeve - Fully Porous, 40 mm 1294-53-245 Universal Femoral Sleeve - Distally Porous, 46 mm 1294-53-246 Universal Femoral Sleeve - Fully Porous, 46 mm 1987-06-000 LPS Femoral to Sleeve Adapter +0 mm 1987-06-005 LPS Femoral to Sleeve Adapter +5 mm 1987-06-010 LPS Femoral to Sleeve Adapter +10 mm 27

28

In this section, the five major lower extremity procedural uses and the instruments and implants needed to prepare for a case are reviewed. In addition, the instruments and implants that integrate with the LPS System are included for a total overview. PROCEDURAL USES Proximal Femoral Replacement... 30 Proximal Tibial Replacement... 32 Total Femoral Replacement... 34 Midshaft Replacement... 36 Distal Femoral Replacement... 38 Procedural Uses 29

Procedural Uses PROXIMAL FEMORAL REPLACEMENT Note: Acetabular options: Unipolar heads, bipolar cups, fixed cups, cages, etc., are options dependent on the surgeon s needs or preferences from the DePuy Synthes Joint Reconstruction* hip product portfolio. Do not use or mix other manufacturer s implants with the LPS implants. Remember to have the appropriate instrumentation to support the acetabular option chosen. These implants and instruments need to be obtained for the case. They are not sent automatically with an LPS order. 30

The LPS System offers flexibility to address a variety of difficult surgical situations in cases where there is the need for replacement due to the significant loss of proximal femoral bone. In a proximal femoral replacement case, a proximal femoral replacement body, segmental component(s) and a stem extension are generally used. The proximal femoral replacement body offers the option of neutral or 15 degrees of built-in anteversion depending on the need in surgery. The proximal femoral body with trochanteric build-up is an option with shortened abductors. The length of segmental component(s) used depends upon the amount of missing bone that needs to be replaced with metal. The stem size used will depend upon the remaining bone diameter and length needed to provide adequate stability and fixation in the host bone. The construct s minimum resection is 90 mm (using a +1.5 mm femoral head). PROXIMAL FEMORAL REPLACEMENT Instrument Ordering Information DePuy ExpressCare Set No. Description 791 B LPS Calcar/Bevel Reamer Set 792 B LPS Component Trial Set 793 B LPS Straight Stem Trial Set 794 B LPS Bowed Stem Trial Set 795 B LPS Instrument Set 797 B LPS Proximal Tibial and Femoral Trial Set Not Available through DePuy ExpressCare Straight Reamers (7-21 mm) Not Available through DePuy ExpressCare Flexible Reamers (9-20.5 mm) PROXIMAL FEMORAL REPLACEMENT Implant Ordering Information DePuy ExpressCare Set No. Description 780 A LPS Cemented Straight Stem Set 781 A LPS Cemented Bowed Stem Set 782 A LPS POROCOAT Straight Stem Set 783 A LPS POROCOAT Bowed Stem Set 784 A LPS Proximal Femoral Body Set, Neutral/Left 785 A LPS Proximal Femoral Body Set, Neutral/Right 788 A LPS Segmental Component Set 31

32 PROXIMAL TIBIAL REPLACEMENT

The LPS System provides the surgical latitude needed to address the replacement of significant proximal tibial bone loss. Proximal tibial replacement generally uses a proximal tibial replacement component, possibly a segmental component and an LPS stem extension. The S-ROM NOILES rotating hinge femoral component articulates with the LPS proximal tibial replacement component that uses the LPS Universal Tibial Hinge insert bearing. The need for LPS segmental component(s) depends upon the amount of missing bone that needs to be replaced with metal. The stem size used will depend upon the remaining bone diameter and length needed to provide adequate stability and fixation in the host bone. The S-ROM NOILES rotating hinge femoral component requires the use of a sleeve and stem. The construct s minimal tibial resection is 105 mm (when using a 12 mm bearing insert). PROXIMAL TIBIAL REPLACEMENT Instrument Ordering Information DePuy ExpressCare Set No. Description 791 B LPS Calcar/Bevel Reamer Set 792 B LPS Component Trial Set 793 B LPS Straight Stem Trial Set 795 B LPS Instrument Set 796 B LPS Tibial Trial Set 797 B LPS Proximal Tibial and Femoral Trial Set Not Available through DePuy ExpressCare Straight Reamers (7-21 mm) KN 981 B S-ROM Hinge Femoral Instrument Set* KN 982 B S-ROM Hinge Common Instrument Set* *If using S-ROM hinge femoral implants PROXIMAL TIBIAL REPLACEMENT Implant Ordering Information DePuy ExpressCare Set No. Description KN 489 A Universal Fluted Stems KN 490 A Universal Femoral Sleeves - Distally Porous KN 491 A Universal Femoral Sleeves - Fully Porous KN 974 A S-ROM Hinge Femoral Components 780 A LPS Cemented Straight Stem Set 782 A LPS Porous Straight Stem Set 786 A LPS Distal Femoral Set, Left 787 A LPS Distal Femoral Set, Right 788 A LPS Segmental Component Set 789 A LPS Proximal Tibial Replacement 799 A LPS Univesal Hinged Insert Set 33

TOTAL FEMORAL REPLACEMENT Note: Acetabular options: Unipolar heads, bipolar cups, fixed cups, cages, etc., are options dependent on the surgeon s needs orpreferences from the DePuy Synthes Joint Reconstruction hip product portfolio. Do not use or mix other manufacturer s implants with the LPS implants. Remember to have the appropriate instrumentation to support the acetabular option chosen. These implants and instruments need to be obtained for the case. They are not sent automatically with an LPS order. 34

With a total femoral replacement, the entire femur is replaced by the prosthetic construct. This femoral construct articulates with a tibial component through a hinged insert connection. A total femoral replacement utilizes the proximal femoral replacement body, a total femoral segmental component, the segmental component(s) and the distal femoral replacement component. The MBT Revision Tray is recommended on the tibial side with the option to use sleeves and stems. TOTAL FEMORAL REPLACEMENT Instrument Ordering Information DePuy ExpressCare Set No. Description 792 B LPS Component Trial Set 795 B LPS Instrument Set 796 B LPS Tibial Trial Set 797 B LPS Proximal Tibial and Femoral Trial Set Not Available through DePuy ExpressCare MBT Revision Prep Not Available through DePuy ExpressCare MBT Revision Stem Trials Not Available through DePuy ExpressCare MBT Revision Reamers Not Available through DePuy ExpressCare MBT Revision Tray Trials/Wedge Instruments TOTAL FEMORAL REPLACEMENT Implant Ordering Information DePuy ExpressCare Set No. Description 784 A LPS Proximal Femoral Body Set, Neutral Left 785 A LPS Proximal Femoral Body Set, Neutral Right 786 A LPS Distal Femoral Replacement Set, Left 787 A LPS Distal Femoral Replacement Set, Right 788 A LPS Segmental Component Set 799 A LPS Universal Hinged Insert Set 382 A MBT Revision Trays/Step Wedges, Size 6 383 A MBT Revision Thick Trays, Sizes 2-4 385 A MBT Revision Trays, Sizes 2-5 386 A MBT Revision Sleeves 387 A MBT Revision Step Wedges, Sizes 2-5 389 A MBT Revision Trays/Step Wedges, Sizes 1-1.5 KN 489 A Universal Fluted Stems 35

36 MIDSHAFT REPLACEMENT

The LPS System addresses the replacement of significant midshaft femoral bone loss. With midshaft bone loss, use the 55 mm intercalary segmental component with two stem extensions to bridge the gap of missing bone. If additional length is needed in the midshaft area, a segmental component can be used to make up for the missing bone. The diameter, type and length of the LPS stem extension used depends upon the remaining bone diameter, quality and stability needed with appropriate length. The construct s minimum resection length is 95 mm. MIDSHAFT REPLACEMENT Instrument Ordering Information DePuy ExpressCare Set No. Description 791 B LPS Calcar/Bevel Reamer Set 792 B LPS Component Trial Set 793 B(2) LPS Straight Stem Trial Set* 795 B LPS Instrument Set Not Available through DePuy ExpressCare Straight Reamers (7-21 mm) MIDSHAFT REPLACEMENT Implant Ordering Information DePuy ExpressCare Set No. Description 780 A(2) LPS Cemented Straight Stem Set** 782 A(2) LPS Porous Straight Stem Set** 788 A LPS Segmental Component Set *Note: Need to order two sets of straight stem trials. **Note: Need to order two sets of straight stem implants. 37

38 DISTAL FEMORAL REPLACEMENT

The LPS System provides the options to address replacement of significant distal femoral bone loss. A distal femoral replacement uses the distal femoral replacement component, the segmental component(s) and an LPS stem extension. Surgeons also have the option to use universal femoral metaphyseal sleeves for additional fixation. The MBT Revision Tray provides multiple options for use on the tibial side. Use the LPS Universal Tibial Hinge insert bearing with the MBT Revision Tray. The length of segmental component(s) used depends upon the amount of missing bone that needs to be replaced with metal. The stem size used will depend upon the remaining bone diameter and length needed to provide adequate stability. The distal femoral minimum resection is 70 mm when using LPS stems and 50 mm when using universal femoral metaphyseal sleeves. DISTAL FEMORAL REPLACEMENT Instrument Ordering Information DePuy ExpressCare Set No. Description 791 B LPS Calcar/Bevel Reamer Set 792 B LPS Component Trial Set 793 B LPS Straight Stem Trial Set 794 B LPS Bowed Stem Trial Set 795 B LPS Instrument Set 796 B LPS Proximal Tibial Trial Set 797 B LPS Proximal Tibial and Femoral Trial Set 798 B LPS Metaphyseal Instrument Set Not Available through DePuy ExpressCare Straight Reamers (7-21 mm) Not Available through DePuy ExpressCare Flexible Reamers (9-20.5 mm) Not Available through DePuy ExpressCare MBT Revision Tray Prep Not Available through DePuy ExpressCare MBT Revision Stem Trials Not Available through DePuy ExpressCare MBT Revision Reamers Not Available through DePuy ExpressCare MBT Revision Tray Trials/Wedge Instruments Not Available through DePuy ExpressCare Femoral Adapter Instrument Set 39

DISTAL FEMORAL REPLACEMENT Implant Ordering Information DePuy ExpressCare Set No. Description 780 A LPS Cemented Straight Stem Set 781 A LPS Cemented Bowed Stem Set 782 A LPS POROCOAT Straight Stem Set 783 A LPS POROCOAT Bowed Stem Set 786 A LPS Distal Femoral Replacement Set, Left 787 A LPS Distal Femoral Replacement Set, Right 788 A LPS Segmental Component Set 799 A LPS Universal Hinged Insert Set 382 A MBT Revision Trays/Step Wedges, Size 6 383 A MBT Revision Thick Trays, Sizes 2-4 385 A MBT Revision Trays, Sizes 2-5 386 A MBT Revision Sleeves 387 A MBT Revision Step Wedges, Sizes 2-5 389 A MBT Revision Trays/Step Wedges, Sizes 1-1.5 KN 463 A SIGMA Cemented Stems KN 489 A Universal Stems 798 A LPS Metaphyseal Sleeve Set 40

The LPS System instrumentation provides the ability to prepare the remaining host bone, perform trial assessment and reduction, and assemble and insert the modular construct. This section reviews the sterilization case layout of the instruments and provides an overview of the individual instruments. INSTRUMENTS/TRIALS LPS Calcar Planer and Bevel Reamer Set... 42 Bevel Reamer... 43 Calcar Planer... 44 Assembled Reamer... 45 LPS Component Trial Set... 48 LPS Component Trial Set Instruments... 48 Proximal Femoral Body Replacement Trial... 49 Segmental Component Trial... 50 Distal Femoral Replacement Trial... 51 Total Femoral Segmental Component Trial... 52 Intercalary Segmental Component Trial... 53 Segmental Stack Chart... 54 LPS Straight Stem and Bowed Stem Trial Sets... 57 Cemented Stem (Trial Use)... 57 Porous Stem (Trial Use)... 58 LPS Ream and Trial Chart... 58 LPS Instrument Set... 59 Universal Handle with Quick Release and Femoral Driver... 60 Impaction Cap... 60 Disassembly Tool... 61 Assembly Stand... 61 Inserter/Extractor (Version Guide and Slap Handle)... 62 Ruler... 62 LPS Tibial Trial Set... 64 Tibial Hinge Insert Trial and Tibial Post Trial... 65 LPS Metaphyseal Sleeve Set... 66 Instruments/ Trials 41

LPS CALCAR PLANER AND BEVEL REAMER SET The calcar planer and bevel reamer case contains instruments designed to prepare the resected bone for acceptance of the stem extension. LPS CALCAR/BEVEL REAMER SET Ordering Information Express Care No. Description Quantity 791 B LPS Calcar/Bevel Reamer Sterilization 1 Case Complete Instruments/ Trials Top Tray Cat. No. Description Quantity 2987-70-001 LPS Calcar Planer, Small 1 2987-70-002 LPS Calcar Planer, Large 1 2987-70-090 LPS Bevel Reamer Insert, 9 mm 1 2987-70-095 LPS Bevel Reamer Insert, 9.5 mm 1 2987-70-100 LPS Bevel Reamer Insert, 10 mm 1 2987-70-105 LPS Bevel Reamer Insert, 10.5 mm 1 2987-70-110 LPS Bevel Reamer Insert, 11 mm 1 2987-70-115 LPS Bevel Reamer Insert, 11.5 mm 1 2987-70-120 LPS Bevel Reamer Insert, 12 mm 1 2987-70-125 LPS Bevel Reamer Insert, 12.5 mm 1 2987-70-130 LPS Bevel Reamer Insert, 13 mm 1 2987-70-135 LPS Bevel Reamer Insert, 13.5 mm 1 2987-70-140 LPS Bevel Reamer Insert, 14 mm 1 2987-70-145 LPS Bevel Reamer Insert, 14.5 mm 1 2987-70-150 LPS Bevel Reamer Insert, 15 mm 1 42

LPS CALCAR/BEVEL REAMER SET (CONT.) Top Tray (cont.) Cat. No. Description Quantity 2987-70-155 LPS Bevel Reamer Insert, 15.5 mm 1 2987-70-160 LPS Bevel Reamer Insert, 16 mm 1 2987-70-165 LPS Bevel Reamer Insert, 16.5 mm 1 2987-70-170 LPS Bevel Reamer Insert, 17 mm 1 2987-70-175 LPS Bevel Reamer Insert, 17.5 mm 1 2987-70-180 LPS Bevel Reamer Insert, 18 mm 1 2987-70-185 LPS Bevel Reamer Insert, 18.5 mm 1 2987-70-190 LPS Bevel Reamer Insert, 19 mm 1 2987-70-195 LPS Bevel Reamer Insert, 19.5 mm 1 2987-70-200 LPS Bevel Reamer Insert, 20 mm 1 2987-70-205 LPS Bevel Reamer Insert, 20.5 mm 1 2987-70-210 LPS Bevel Reamer Insert, 21 mm 1 2987-70-215 LPS Bevel Reamer Insert, 21.5 mm 1 CALCAR PLANER AND BEVEL REAMER Bevel reamers have pilots in.5 mm increments to assist in centering the bevel reamer in the canal. 43

ASSEMBLED REAMER The calcar planer and bevel reamer are assembled together to prepare for a flat cut and a bevel angle of the medullary canal of the resected bone. For a porous stem extension, begin reaming with the calcar/bevel reamer two to three sizes below the chosen implant size. The final bevel reamer must match the final stem extension. For example, if using a 15.5 mm stem extension the final bevel reamer with pilot should be 15.5 mm. This allows for a slight press-fit of the stem extension bevel. For a cemented stem extension, begin the calcar/ bevel reaming two to three sizes below the final intermedullary (I.M.) ream size. For example, if an 11 mm stem is chosen with a 2 mm cement mantle, the final I.M. reamer will be 15 mm. The final calcar/bevel reamer will be 15 mm. This allows for a cement mantle around the stem extension bevel. 44

LPS COMPONENT TRIAL SET The component trial case contains some of the trials needed to prepare a trial construct for assessment prior to the final implant assembly. This instrument case contains all the segmental, proximal femoral body, distal femoral replacement and femoral head trials. LPS COMPONENT TRIAL SET Ordering Information Express Care No. Description Quantity 792 B LPS Component Trial 1 Sterilization Case Complete 45

Top Tray Cat. No. Description Quantity 2987-07-025 LPS Segmental Component Trial 25 mm 2 2987-07-030 LPS Segmental Component Trial 30 mm 1 2987-07-035 LPS Segmental Component Trial 35 mm 1 2987-07-040 LPS Segmental Component Trial 40 mm 1 2987-07-045 LPS Segmental Component Trial 45 mm 1 2987-07-065 LPS Segmental Component Trial 65 mm 1 2987-07-085 LPS Segmental Component Trial 85 mm 1 2987-07-105 LPS Segmental Component Trial 105 mm 1 2987-07-125 LPS Segmental Component Trial 125 mm 1 2987-08-055 LPS Total Femoral Segmental Trail, 55 mm 1 2987-09-055 LPS Intercalary Component Trial, 55 mm 1 2987-13-105 Distal Femoral Component, 1 Left, X-small Trial 2987-13-111 Distal Femoral Component, 1 Left, XX-small Trial 2987-14-105 Distal Femoral Component, 1 Right, X-small Trial 2987-14-111 Distal Femoral Component, 1 Right, XX-small Trial 46

Bottom Tray Cat. No. Description Quantity 2987-10-105 LPS Proximal Femoral Body 1 Neutral Standard Trial 2987-10-205 LPS Proximal Femoral Body 1 Neutral Trochanter Trial 2987-11-105 LPS Proximal Femoral Body Left, 1 15 mm diameter, Standard Trial 2987-11-205 LPS Proximal Femoral Body Left, 1 15 mm diameter, Trochanter Trial 2987-12-105 LPS Proximal Femoral Body Right, 1 15 mm diameter, Standard Trial 2987-12-205 LPS Proximal Femoral Body Left, 1 15 mm diameter, Trochanter Trial 2530-69-000 ARTICUL/EZE Femoral Head Trial 1 22.225 +4 mm 2530-70-000 ARTICUL/EZE Femoral Head Trial 1 22.225 +7 mm 2530-81-000 ARTICUL/EZE Femoral Head Trial 28 +1.5 mm 1 2530-82-000 ARTICUL/EZE Femoral Head Trial 28 +5 mm 1 2530-83-000 ARTICUL/EZE Femoral Head Trial 28 +8.5 mm 1 2530-84-000 ARTICUL/EZE Femoral Head Trial 28 +12 mm 1 2530-85-000 ARTICUL/EZE Femoral Head Trial 28 +15.5 mm 1 2530-91-000 ARTICUL/EZE Femoral Head Trial 32 +1 mm 1 2530-92-000 ARTICUL/EZE Femoral Head Trial 32 +5 mm 1 2530-93-000 ARTICUL/EZE Femoral Head Trial 32 +9 mm 1 2530-94-000 ARTICUL/EZE Femoral Head Trial 32 +13 mm 1 2530-95-000 ARTICUL/EZE Femoral Head Trial 32 +17 mm 1 47

LPS COMPONENT TRIAL SET PROXIMAL FEMORAL BODY REPLACEMENT TRIAL Proximal femoral body trials replicate the implant and are used in trial reduction to assess leg length, offset and joint stability. The six femoral body trials mirror the system implants. The trials accept ARTICUL/EZE femoral trial heads and segmental and stem trials as needed. 48

LPS COMPONENT TRIAL SET SEGMENTAL COMPONENT TRIALS Segmental component trials help plan the amount of missing bone that needs to be replaced by the prosthesis or adjustment of leg length. The nine segmental component trial sizes match the nine implant sizes (25, 30, 35, 40, 45, 65, 85, 105 and 125 mm lengths). The segmental trials offer the ability to provide 5 mm increments of adjustment with single components or through a stacking combination. 49

LPS COMPONENT TRIAL SET DISTAL FEMORAL REPLACEMENT TRIAL These trial components match the distal femoral replacement implant, allowing for trial reduction. The left and right components accept the LPS Universal Tibial Hinge insert bearing trials, segmental, total, femoral to sleeve adapter trials, or LPS stem trials as needed. 50

LPS COMPONENT TRIAL SET TOTAL FEMORAL SEGMENTAL COMPONENT TRIAL This trial matches the 55 mm total femoral segmental component. It is used when performing a total femoral replacement trial reduction. 51

LPS COMPONENT TRIAL SET INTERCALARY SEGMENTAL COMPONENT TRIAL The 55 mm intercalary segmental trial is used to assess replacement bone in a midshaft tumor replacement. It is used with two LPS stem extension trials to assess leg length. Segmental trials are used to assess more extensive midshaft bone loss if needed. 52

The chart below provides a quick reference to choose the segmental component(s) needed to replace the missing bone gap. SEGMENTAL STACK CHART Remaining LPS Segmental Gap Components 25 25 30 30 35 35 40 40 45 45 50 25 + 25 55 25 + 30 60 25 + 35 65 65 70 25 + 45 or 30 + 40 75 30 + 45 or 35 + 40 80 35 + 45 85 85 90 25 + 65 95 30 + 65 100 35 + 65 105 105 110 25 + 85 or 45 + 65 115 30 + 85 120 35 + 85 125 125 130 25 + 105 or 45 + 85 135 30 + 105 Remaining LPS Segmental Gap Components 140 35 + 105 145 40 + 105 150 25 + 125 or 45 + 105 155 30 + 125 160 35 + 125 165 40 + 125 170 45 + 125 175 125 + 25 + 25 180 125 + 25 + 30 190 125 + 65 195 125 + 25 + 45 200 125 + 35 + 40 205 125 + 35 + 45 210 125 + 85 215 125 + 25 + 65 220 125 + 30 + 65 225 125 + 35 + 65 230 125 + 105 235 125 + 25 + 85 240 125 + 30 + 85 245 125 + 35 + 85 250 125 + 40 + 85 PROCEDURE Proximal Femoral Replacement Distal Femoral Replacement with LPS Stems Distal Femoral Replacement with Metaphyseal Sleeves Minimum resection length 90 mm (70 mm femoral body with 1.5 mm head center + 20 mm stem collar) 70 mm (50 mm distal femoral component + 20 mm stem collar) 50 mm (using XX-Small femur) 60 mm (using X-Small femur) Proximal Tibial Replacement 105 mm (73 mm tibial component + 12 mm insert bearing +20 mm stem collar) Midshaft Tumor Replacement 95 mm (55 mm intercalary segment length + two 20 mm stem collars) 53

LPS STRAIGHT STEM AND BOWED STEM TRIAL SETS The straight stem trial components are available in 1 mm increments from 9 to 19 mm in diameter and 100 and 125 mm lengths that correspond to the implants. The bowed stem trials are available in 1 mm increments from 11-19 mm in diameter and 150 and 200 mm in lengths that correspond to the implants. The trial s purpose is to assess fit and provide for the ability to perform a construct trial reduction. Choose trials based on the implant options selected and the last reamed size. 54

LPS STRAIGHT STEM TRIAL SET Ordering Information Express Care No. Description Quantity 793 B LPS Straight Stem Trial 1 Sterilization Case Complete Top Tray Cat. No. Description Quantity 2987-25-109 9 x 100 mm Stem Extension Trial, Straight 1 2987-25-110 10 x 100 mm Stem Extension Trial, Straight 1 2987-25-111 11 x 100 mm Stem Extension Trial, Straight 1 2987-25-112 12 x 100 mm Stem Extension Trial, Straight 1 2987-25-113 13 x 100 mm Stem Extension Trial, Straight 1 2987-25-114 14 x 100 mm Stem Extension Trial, Straight 1 Bottom Tray Cat. No. Description Quantity 2987-25-412 12 x 125 mm Stem Extension Trial, Straight 1 2987-25-413 13 x 125 mm Stem Extension Trial, Straight 1 2987-25-414 14 x 125 mm Stem Extension Trial, Straight 1 2987-25-415 15 x 125 mm Stem Extension Trial, Straight 1 2987-25-416 16 x 125 mm Stem Extension Trial, Straight 1 2987-25-417 17 x 125 mm Stem Extension Trial, Straight 1 2987-25-418 18 x 125 mm Stem Extension Trial, Straight 1 2987-25-419 19 x 125 mm Stem Extension Trial, Straight 1 55

LPS BOWED STEM TRIAL SET Ordering Information Express Care No. Description Quantity 794 B LPS Bowed Stem Trial 1 Sterilization Case Complete Top Tray Cat. No. Description Quantity 2987-15-211 11 x 150 mm Stem Extension Trial Bowed 1 2987-15-212 12 x 150 mm Stem Extension Trial Bowed 1 2987-15-213 13 x 150 mm Stem Extension Trial Bowed 1 2987-15-214 14 x 150 mm Stem Extension Trial Bowed 1 2987-15-215 15 x 150 mm Stem Extension Trial Bowed 1 2987-15-216 16 x 150 mm Stem Extension Trial Bowed 1 2987-15-217 17 x 150 mm Stem Extension Trial Bowed 1 2987-15-218 18 x 150 mm Stem Extension Trial Bowed 1 2987-15-219 19 x 150 mm Stem Extension Trial Bowed 1 Bottom Tray Cat. No. Description Quantity 2987-15-311 11 x 200 mm Stem Extension Trial Bowed 1 2987-15-312 12 x 200 mm Stem Extension Trial Bowed 1 2987-15-313 13 x 200 mm Stem Extension Trial Bowed 1 2987-15-314 14 x 200 mm Stem Extension Trial Bowed 1 2987-15-315 15 x 200 mm Stem Extension Trial Bowed 1 2987-15-316 16 x 200 mm Stem Extension Trial Bowed 1 2987-15-317 17 x 200 mm Stem Extension Trial Bowed 1 2987-15-318 18 x 200 mm Stem Extension Trial Bowed 1 2987-15-319 19 x 200 mm Stem Extension Trial Bowed 1 56

LPS STRAIGHT STEM AND BOWED STEM TRIAL SETS CEMENTED STEM (TRIAL USE) If using a cemented stem, the appropriate trial can be used to assess the cement mantle. For example, if the last reamed size is 15 mm, use a 13 mm trial if a 1 mm circumferential mantle is being evaluated or use an 11 mm trial if a 2 mm circumferential mantle is being evaluated. For trial reduction purposes, if a 15 mm reamer was last used, use a 15 mm trial for the trial reduction to prevent spinning of the stem extension in the canal. POROUS STEM (TRIAL USE) If using a porous stem, the reaming technique determines the appropriate trial. All porous stems are in 1 mm increments. Since the typical protocol is to underream by.5 mm, the trial used would correspond to the last reamer used. For example, if using a 13.5 mm porous stem and 13 mm was the last reamer used, select a 13 mm trial for the trial reduction. This allows for trial stability without compromising the prepared bone. 57

The following chart shows reamer-to-trial implant suggestions. LPS REAM AND TRIAL CHART Implant Ream Diameter (mm) Trial* Diameter (mm) Cemented Stem with 1 mm mantle/side Cemented Stem with 2 mm mantle/side Porous Stem with.5 mm underream 9 9 N/A N/A N/A 10 10 N/A N/A 10.5 mm 11 11 9 mm N/A 11.5 mm 12 12 10 mm N/A 12.5 mm 13 13 11 mm 9 mm 13.5 mm 14 14 12 mm 10 mm 14.5 mm 15 15 13 mm 11 mm 15.5 mm 16 16 14 mm 12 mm 16.5 mm 17 17 15 mm 13 mm 17.5 mm 18 18 16 mm 14 mm 18.5 mm 19 19 17 mm 15 mm N/A * Trial diameters are 0.25 to 0.50 mm less than stated to allow for clearance in the intermedullary canal. 58

LPS INSTRUMENT SET This instrument case contains the LPS inserter/ extractor (including the version guide and slap handle) the assembly stand and related items; and ruler and femoral impactor with driver. LPS INSTRUMENT SET Ordering Information ExpressCare Description Quantity 795 B LPS Instrument Sterilization 1 Case Complete Tray Contents Cat. No. Description Quantity 2987-71-000 LPS Disassembly Tool 1 2987-72-010 LPS Distal Femoral Assembly Stand 1 2987-72-020 LPS Proximal Femoral Assembly Stand 1 2987-72-025 LPS Assembly Base 1 2987-72-030 LPS Inserter/Extractor 1 2987-72-035 LPS Version Guide 1 2987-72-040 LPS Slap Handle 1 2987-72-045 LPS Extractor Moreland Adapter 1 2987-72-050 LPS Ruler 1 6338-01 S-ROM Tibial Driver 1 6338-02 S-ROM Femoral Driver 1 6338-05A S-ROM Impaction Cap 1 6338-06A S-ROM Universal Handle Quick Release 1 59

UNIVERSAL HANDLE WITH QUICK RELEASE AND TIBIAL/FEMORAL DRIVER The universal handle is connected to the tibial femoral driver and used when impacting the tibial femoral replacement construct into the remaining host bone. IMPACTION CAP Use the impaction cap to cover the end of the stem extension when impacting the component into a construct. Be sure to remove the impaction cap before implantation. 60

DISASSEMBLY TOOL Use this instrument to separate the morse taper connection of the components. The disassembly tool fits into the anti-rotation slot areas of the assemblies. The tool has a flat and a half-moon shape that keys into the anti-rotation slot geometry of the implants. Once secure in the slots, squeeze the handle and push the handle down to loosen the taper junction. Do not reuse implants once they are disassembled due to possible damage or scratches on the tapers. ASSEMBLY STAND The assembly stand is made up of the assembly base, distal femoral assembly stand and proximal femoral assembly stand. The assembly stand provides a method of holding a proximal femoral or distal femoral replacement construct when impacting the tapers. 61

INSERTER/EXTRACTER (VERSION GUIDE AND SLAP HANDLE) This instrument is used to insert a proximal femoral construct. Thread the inserter into the proximal body shoulder and use the version guide to assist in the construct orientation. This instrument also acts as an extractor by threading into a stem extension. The slap handle is used to provide extraction force. RULER The stainless steel ruler is 500 mm (19.5 in.) in length and assists in planning the resection level. It is used to approximate the gap of missing bone following resection. 62

LPS TIBIAL TRIAL SET This instrument case contains the proximal tibial replacement and insert trial components for trial reduction. 63

LPS TIBIAL TRIAL SET Ordering Information ExpressCare Description Quantity 796 B LPS Tibial Trial 1 Sterilization Case Complete Top Tray Cat. No. Description Quantity 2178-63-132 MBT Revision Trial Post 1 2987-22-000 LPS Tibial Hinge Trial Post Adapter 1 2987-22-012 LPS Tibial Insert Trial, XX-Small, 12 mm 1 2987-22-014 LPS Tibial Insert Trial, XX-Small, 14 mm 1 2987-22-016 LPS Tibial Insert Trial, XX-Small, 16 mm 1 2987-22-018 LPS Tibial Insert Trial, XX-Small, 18 mm 1 2987-22-021 LPS Tibial Insert Trial, XX-Small, 21 mm 1 2987-22-023 LPS Tibial Insert Trial, XX-Small, 23 mm 1 2987-22-131 LPS Tibial Insert Trial, X-Small, 31 mm 1 2987-22-231 LPS Tibial Insert Trial, Small, 31 mm 1 2987-22-331 LPS Tibial Insert Trial, Medium, 31 mm 1 Bottom Tray Cat. No. Description Quantity 2987-22-112 LPS Tibial Insert Trial, X-Small, 12 mm 1 2987-22-114 LPS Tibial Insert Trial, X-Small, 14 mm 1 2987-22-116 LPS Tibial Insert Trial, X-Small, 16 mm 1 2987-22-118 LPS Tibial Insert Trial, X-Small, 18 mm 1 2987-22-121 LPS Tibial Insert Trial, X-Small, 21 mm 1 2987-22-123 LPS Tibial Insert Trial, X-Small, 23 mm 1 2987-22-126 LPS Tibial Insert Trial, X-Small, 26 mm 1 2987-22-128 LPS Tibial Insert Trial, X-Small, 28 mm 1 2987-22-212 LPS Tibial Insert Trial, Small, 12 mm 1 2987-22-214 LPS Tibial Insert Trial, Small, 14 mm 1 2987-22-216 LPS Tibial Insert Trial, Small, 16 mm 1 2987-22-218 LPS Tibial Insert Trial, Small, 18 mm 1 2987-22-221 LPS Tibial Insert Trial, Small, 21 mm 1 2987-22-223 LPS Tibial Insert Trial, Small, 23 mm 1 2987-22-226 LPS Tibial Insert Trial, Small, 26 mm 1 2987-22-228 LPS Tibial Insert Trial, Small, 28 mm 1 2987-22-312 LPS Tibial Insert Trial, Medium, 12 mm 1 2987-22-314 LPS Tibial Insert Trial, Medium, 14 mm 1 2987-22-316 LPS Tibial Insert Trial, Medium, 16 mm 1 2987-22-318 LPS Tibial Insert Trial, Medium, 18 mm 1 2987-22-321 LPS Tibial Insert Trial, Medium, 21 mm 1 2987-22-323 LPS Tibial Insert Trial, Medium, 23 mm 1 2987-22-326 LPS Tibial Insert Trial, Medium, 26 mm 1 2987-22-328 LPS Tibial Insert Trial, Medium, 28 mm 1 64

LPS TIBIAL TRIAL SET Hinge hinge Pin pin Trial trial tibial Tibial hinge Hinge insert Insert trial Trial Tibial tibial Post post Trialtrial TIBIAL HINGE INSERT TRIAL, TIBIAL POST TRIAL AND HINGE PIN TRIAL The tibial hinge insert trial is available in four sizes and nine thicknesses. Trials include a tibial hinge insert, tibial post and trial hinge pin used with the proximal tibial replacement component trial or MBT Revision Tray trial depending on the need. This trial also mates with the LPS distal femoral replacement component trial or the S-ROM NOILES rotating hinge femoral component trial based on the surgical situation. The tibial hinge insert trials allow for assessment of the joint line, leg length and joint stability when performing a trial range of motion. The hinge pin trial secures the tibial hinge insert trial to the chosen distal femoral trial. 65

The LPS metaphyseal sleeve instrument case contains the trial instruments necessary for using a metaphyseal sleeve for a distal femoral replacement case. Instruments include sleeve adapters. LPS METAPHYSEAL SLEEVE SET Ordering Information ExpressCare Description Quantity 798 B LPS Metaphyseal Sleeve Case 1 Tray Contents Cat. No. Description Quantity 2987-04-000 Metaphyseal Sleeve Removal Tool 1 2987-06-000 LPS Femoral to Sleeve Adapter Trial, +0 mm 1 2987-06-005 LPS Femoral to Sleeve Adapter Trial, +5 mm 1 2987-06-010 LPS Femoral to Sleeve Adapter Trial, +10 mm 1 2178-63-135 Revision Femoral Stem/Adapter Clamp 1 66

LPS PROXIMAL TIBIAL AND FEMORAL TRIAL SET This instrument case contains the proximal tibial and proximal femoral trial components. 67

LPS PROXIMAL TIBIAL AND FEMORAL TRIAL SET Ordering Information ExpressCare Description Quantity 797 B LPS Proximal Tibial and Femoral Case 1 Tray Contents Cat. No. Description Quantity 2987-10-105 LPS Proximal Femoral Body, Neutral Standard Trial 2987-10-205 LPS Proximal Femoral Body, Neutral Trochanter Trial 2987-11-105 LPS Proximal Femoral Body, Left Standard Trial, 15 degree anteversion 2987-11-205 LPS Proximal Femoral Body, Left Trochanter Trial, 15 degree anteversion 2987-12-105 LPS Proximal Femoral Body, Right Standard Trial, 15 degree anteversion 2987-12-205 LPS Proximal Femoral Body, Left Trochanter Trial, 15 degree anteversion 2987-21-105 LPS Proximal Tibial Replacement Trial, X-Small 2987-40-025 Implant to Trial Adapter, 25 mm 2987-40-030 Implant to Trial Adapter, 30 mm 2987-40-035 Implant to Trial Adapter, 35 mm 2987-40-040 Implant to Trial Adapter, 40 mm 2987-40-045 Implant to Trial Adapter, 45 mm 2530-81-000 ARTICUL/EZE Grooved Ball Trial, 28 mm, +1.5 degree 2530-82-000 ARTICUL/EZE Grooved Ball Trial, 28 mm, +5 degree 2530-83-000 ARTICUL/EZE Grooved Ball Trial, 28 mm, +8.5 degree 2530-84-000 ARTICUL/EZE Grooved Ball Trial, 28 mm, +12 degree 2530-85-000 ARTICUL/EZE Grooved Ball Trial, 28 mm, +15.5 degree 2530-91-000 ARTICUL/EZE Grooved Ball Trial, 32 mm, +1 degre 2530-92-000 ARTICUL/EZE Grooved Ball Trial, 32 mm, +5 degree 2530-93-000 ARTICUL/EZE Grooved Ball Trial, 32 mm, +9 degree 2530-94-000 ARTICUL/EZE Grooved Ball Trial, 32 mm, +13 degree 2530-95-000 ARTICUL/EZE Grooved Ball Trial, 32 mm, +17 degree 2531-50-000 ARTICUL/EZE Grooved Ball Trial, 36 mm, -2 degree 2531-51-000 ARTICUL/EZE Grooved Ball Trial, 36 mm, +1.5 degree 2531-52-000 ARTICUL/EZE Grooved Ball Trial, 36 mm, +5 degree 2531-53-000 ARTICUL/EZE Grooved Ball Trial, 36 mm, +8.5 degree 2531-54-000 ARTICUL/EZE Grooved Ball Trial, 36 mm, +12 degree 2531-55-000 ARTICUL/EZE Grooved Ball Trial, 36 mm, +15.5 degree 68

LPS TIBIAL TRIAL SET PROXIMAL TIBIAL REPLACEMENT TRIAL The proximal tibial replacement trial replicates the proximal tibial replacement component and is used to assess fit and for trial reduction utilizing the trial construct. It is used with the stem extension trials and segmental components if needed due to extensive bone loss. 69

LPS METAPHYSEAL SLEEVE INSTRUMENTATION SET LPS METAPHYSEAL SLEEVE INSTRUMENTATION SET Ordering Information Express Care No. Description Quantity 798B LPS Metaphyseal Sleeve Instrumentation Case 1 Top Tray Cat. No. Description Quantity 2987-06-000 LPS Femoral to Sleeve Adapter Trial, +0 mm 1 2987-06-005 LPS Femoral to Sleeve Adapter Trial, +5 mm 1 2987-06-010 LPS Femoral to Sleeve Adapter Trial, +10 mm 1 2178-63-135 Revision Femoral Stem/Adapter Clamp 1 2987-04-000 Metaphyseal Sleeve Removal Tool 1 70

Below is a complete listing of DePuy ExpressCare set numbers for The LPS System. Please refer to the guide for special set numbers needed for the various procedural uses. LPS TOTAL DEPUY EXPRESSCARE SET NUMBER LISTING Instrument Ordering Information Set No. Description 791 B LPS Calcar/Bevel Reamer Set 792 B LPS Component Trial Set 793 B LPS Straight Stem Trial Set 794 B LPS Bowed Stem Trial Set 795 B LPS Instrument Set 796 B LPS Tibial Trial Set 797 B LPS Proximal Tibial and Femoral Trial Set 798 B LPS Metaphyseal Sleeve Instruments KN 463 B SIGMA Cemented Stem Instruments KN 981 B S-ROM Hinge Femoral Instrument Set KN 982 B S-ROM Hinge Common Instrument Set Implant Ordering Information Set No. Description 780 A LPS Cemented Straight Stem Set 781 A LPS Cemented Bowed Stem Set 782 A LPS Porous Straight Stem Set 783 A LPS Porous Bowed Stem Set 784 A LPS Proximal Femoral Body Set, Neutral Left 785 A LPS Proximal Femoral Body Set, Neutral Right 786 A LPS Distal Femoral Replacement Set, Left 787 A LPS Distal Femoral Replacement Set, Right 788 A LPS Segmental Component Set 789 A LPS Proximal Replacement 798 A LPS Metaphyseal Sleeve Set 799 A LPS Universal Hinged Insert trials Set 382 A MBT Revision Trays/Step Wedges, Size 6 383 A MBT Revision Thick Trays, Sizes 2-4 385 A MBT Revision Trays, Sizes 2-5 386 A MBT Revision Sleeves 387 A MBT Revision Step Wedges, Sizes 2-5 389 A MBT Revision Trays/Step Wedges, Sizes 1-1.5 KN 463 A SIGMA Cemented Stems KN 489 A Universal Fluted Stems KN 490 A Universal Femoral Sleeves - Distally Porous KN 491 A Universal Femoral Sleeves - Fully Porous KN 974 A S-ROM Hinge Femoral Components 71

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