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. These instruments designed to provide confidence through solid construction, ease of use, and multiple options to address implant removal. The HP Extraction Knee Instruments complement DePuy Synthes Joint Reconstruction s comprehensive portfolio of revision implants and instruments. They are designed to address obstacles encountered during revision Total Knee Arthroplasty (TKA). The HP Extraction Knee Instruments are another example of DePuy Synthes Joint Reconstruction s 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 Product Overview HP Knee Extraction Instrumentation DePuy Synthes 1
HP Extraction Standard Removal Case 2011-03-048 Top Level: HP Revision General Extraction Top Level HP Revision Extraction Instrument Case 2011-03-048 HP Extraction 7 mm V Split 12 in 2011-03-034 HP Extraction 7 mm Reverse Curette 12 in 2011-03-035 HP Extraction Offset Chisel 2011-03-036 HP Extraction Component Impactor 2011-03-037 HP Extraction Straight Osteotome 7 mm 2011-03-038 HP Extraction Straight Osteotome 12.5 mm 2011-03-039 HP Extraction Straight Osteotome 20 mm 2011-03-040 2 DePuy Synthes HP Knee Extraction Instrumentation Product Overview
HP Extraction Standard Removal Case 2011-03-048 Bottom Level: HP Revision General Extraction Instrument Set Bottom Level Handle With Quick Coupling End (2) 2709-04-001 Small Slap Hammer 2709-04-002 Flexible Osteotome System* 2709-04-100 HP Extraction Removal Screw 8 mm 2011-03-042 HP Extraction 10 in Cement Rongeur 2011-03-044 Sterile Packed Flexible Osteotomes: Must Order Separately. *Not included with Complete Kit order. Must be ordered separately. Product Overview HP Knee Extraction Instrumentation DePuy Synthes 3
Complete Kit Code for Ordering: 2011-03-300 Complete kit code includes both the top and bottom levels of case 2011-03-048 Flexible Osteotomes must be ordered separately from the complete kit 2011-03-300. They are sold as a set of 8 or as individual parts. HP Extraction 7 mm V Split 12 in 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. Fragments of the cement can then be removed with the Cement Rongeur (2011-03-044). HP Extraction 7 mm Reverse Curette 12 in (2011-03-035) 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. 4 DePuy Synthes HP Knee Extraction Instrumentation Product Overview
Complete Kit Code for Ordering: 2011-03-300 HP Extraction Offset Chisel (2011-03-036) 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. HP Extraction Component Impactor (2011-03-037) 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 (2011-03-038, 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. Product Overview HP Knee Extraction Instrumentation DePuy Synthes 5
Complete Kit Code for Ordering: 2011-03-300 Flexible Osteotome Blades & Handle To develop a plane between and implant and bone, use the Flexible Osteotome Blades (2709-04-004 to 2709-04- 011) with the Quick-Coupling Handle (2709-04-001). 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 (2011-03-038 to 2011-03-040 previously listed). Small Slap Hammer (2709-04-002) 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 Removal Screw (2011-03-042) Use the 8 mm Removal Screw to remove polyethylene components. A ¼ in drill bit can be used to create a hole which will accept the Removal Screw. When an allpolyethylene tibial component is to be removed, the Removal Screw is threaded into the pre-drilled hole and its collar is impacted with a mallet. The Removal Screw may also be used to facilitate removal of a polyethylene tibial insert. 6 DePuy Synthes HP Knee Extraction Instrumentation Product Overview
Complete Kit Code for Ordering: 2011-03-300 HP Extraction 10 in Cement Rongeur (2011-03-044) The 10 in 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. Product Overview HP Knee Extraction Instrumentation DePuy Synthes 7
HP Extraction Sleeve Removal Case 2011-03-058 Hp Revision Sleeve Extraction Instrument Set 2011-03-200 HP Revision Sleeve Extraction Case 2011-03-058 HP Femoral Impactor/Extractor 9505-01-171 HP Slap Hammer 9505-01-308 Small Slap Hammer 2709-04-002 HP Extraction Tibial Component Remover 2011-03-045 HP Extraction MBT Sleeve Extractor 2011-03-031 HP Extraction MBT Sleeve/Tray Separator Tool 2011-03-053 HP Extraction TC3 Tuning Fork 2011-03-030 Stem Trial Extractor 86-5226 HP Extraction Stem Trial Extractor Adapter 2011-03-047 Locking Pliers 2709-03-006 HP Extraction Locking Pliers Adapter 2011-03-046 8 DePuy Synthes HP Knee Extraction Instrumentation Product Overview
Complete Kit Code for Ordering: 2011-03-200 Complete kit code includes all the instruments listed below Complete kit code includes the case (2011-03-058) and all instruments inside HP Femoral Impactor/Extractor (9505-01-171) The Universal Femoral Impactor/Extractor is designed to work with a number of different femoral components. The A/P spring loading mechanism, in conjunction with the adjustable M/L wings, allows it to fit onto any size femoral component. The Impactor/Extractor can then be locked down onto the femoral component, by turning it in a clockwise motion (to release, turn counterclockwise). The Impactor/Extractor works with the 9505-01-308 HP Slap Hammer. HP Slap Hammer (9505-01-308) The HP Slap Hammer features a quick connect end that assembles to the HP Femoral Impactor/Extractor (9505-01-171). It 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 femoral component. Small Slap Hammer (2709-04-002) 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. Product Overview HP Knee Extraction Instrumentation DePuy Synthes 9
Complete Kit Code for Ordering: 2011-03-200 HP Extraction Locking Pliers (2709-03-006) and Locking Pliers to Slap Hammer Adapter (2011-03-046) 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 (2709-04-002) can then be attached to the Locking Pliers via the Locking Pliers to Slap Hammer Adapter (2011-03-046). HP Extraction MBT Tray/Sleeve Separator (2011-03-053) The MBT Tray/Sleeve Separator is inserted in-between the inferior portion of the MBT Revision Tray and the superior portion of the MBT Revision Tibial sleeve after proper exposure has been achieved. Once impacted, the separator is designed to break the taper between the MBT Revision Tray and sleeve. This is especially useful if a 14 mm or smaller Universal stem was used with the tibial tray. If this is the case, the tibial tray and stem can be pulled out through the MBT Revision sleeve after separation. The surgeon can then work on removing the sleeve. HP Extraction TC3 Tuning Fork (2011-03-030) The HP TC3 Tuning Fork is designed to break the taper between the SIGMA TC3 Femoral Component and the Universal sleeves. The Tuning Fork can be inserted from the medial or lateral sides of the femur, between the box and femoral sleeve. It can then be impacted to disengage the taper between the femoral component and sleeve. 11 DePuy Synthes HP Knee Extraction Instrumentation Product Overview
Complete Kit Code for Ordering: 2011-03-200 Stem Trial Extractor (86-5226) and HP Extraction Stem Trial Extractor to Slap Hammer Adapter (2011-03-047) The Stem Trial Extractor threads into and removes stem trials (pilots) that have gotten stuck in the canal. The Stem Trial Extractor can also be threaded through a femoral sleeve trial into the stem trial to remove a sleeve/stem trial construct that is stuck in the femur. For additional extraction force, the Small Slap Hammer (2709-04-002) can be attached to the Stem Trial Extractor via the Stem Trial Extractor to Slap Hammer Adapter (2011-03-047). 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 two prongs are inserted through the proximal portion of the sleeve, passed all the way through the sleeve, and then out the distal end. 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 (2709-04-002) can be attached to explant the sleeve. HP Tibial Component Extractor (2011-03-045) The Tibial Component Extractor can be used to remove tibial trays, and tray constructs. If a metaphyseal sleeve is present, flexible osteotomes should be utilized to disrupt the sleeve to bone interface prior to extraction. The base of the tibial tray should be exposed with osteotomes and the poly 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 explant the entire tibial tray construct as one piece. Product Overview HP Knee Extraction Instrumentation DePuy Synthes 11
References: 1. Sharkey, P. F., MD, Lichstein, P. M., MD, MS, Shen, C., MD, Tokarski, A. T., BS, & Parvizi, J., MD, FRC. (2014). Why Are Total Knee Arthroplasties Failing Today Has Anything Changed After 10 Years? The Journal of Arthroplasty, 1774-1778. Limited Warranty and Disclaimer: DePuy Synthes products are sold with a limited warranty to the original purchaser against defects in workmanship and materials. Any other express or implied warranties, including warranties of merchantability or fitness, are hereby disclaimed. Please also refer to the package insert(s) or other labeling associated with the devices identified in this surgical technique for additional information. CAUTION: Federal Law restricts these devices to sale by or on the order of a physician. Some devices listed in this surgical technique may not have been licensed in accordance with Canadian law and may not be for sale in Canada. Please contact your sales consultant for items approved for sale in Canada. Not all products may currently be available in all markets. DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, IN 46582 USA Tel: +1 (800) 366 8143 Fax: +1 (800) 669 2530 DePuy International, Ltd. St Anthony s Road Leeds LS11 8DT England Tel: +44 (0) 113 270 0461 Symmetry Medical Manufacturing, Inc. 486 West 350 North Warsaw, Indiana 46582 USA Tel: +1 (574) 267-8700 Enztec Limited 26 Dakota Crescent Sockburn, Christchurch 8042, New Zealand 0086 www.depuysynthes.com DePuy Synthes 2014, 2017. All rights reserved. DSUS/JRC/0716/1702 04/17 The third party trademarks used herein are the trademarks of their respective owners.