Cemented femoral stem - type CSC
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Cemented femoral stem - type CSC Cemented Femoral Hip Joint Components

Implant Description Surgical Technique Instrumentation Set Catalogue The cemented femoral stem – type CSC with centralizer – was designed using the latest knowledge and experience with cemented endoprostheses and the most modern technology is used during its manufacturing. Easy implantation and thorough fixation of implants are ensured when using instruments supplied by the manufacturer. The size series of stems makes it possible to solve almost every case that may occur in the first implantation of a cemented hip joint replacement. The purpose of this publication is to serve as a surgical...

Cemented femoral stem type POLDI Cemented femoral stem type CSC The cemented femoral stem type Poldi is the most used type of endoprosthesis in the Czech Republic. Over 150 thousand successful implantations since the first model line (in 1972) demonstrate unequivocally the quality and reliability of this implant. On the basis on thirty years of experience and in response to new trends in orthopaedics, the company BEZNOSKA launched in 2003 a modern cemented stem – type CSC with centralizer.

Implant Description Surgical Technique Instrumentation Set Catalogue Before any surgery of total hip joint replacement, it is necessary to make a presurgery planning that will enable us to determine the correct size of the femoral component. An X-ray picture of the pelvis and of both hip joints in A/P and axial projection must be available for the pre-operation planning in order to determine the metaphysis width. Templates supplied by the manufacturer are used for planning of size of the femoral component. To determine the correct size it is necessary to have the X-ray pictures with the...

Surgical Technique Perforator 1 shall be used only at posterior approach when the patient is positioned on his/her side (Fig. 1). At antero-lateral approach, this instrument is not used after the resection of the head. When using the perforator, the hole must be located in fossa piriformis. 2. Resection of the head The head is resected using an oscillation saw (Fig. 2). In case of a posterior approach, the head is resected only after the use of the perforator (1) and of the milling cutters 1 (4) to (8) with cylindrical stem according 3 8 to point 3. The perforator and the cutters can be...

Implant Description Surgical Technique Instrumentation Set Catalogue 3. Widening of entrance to the metaphysis part of the canal 9 A window-chisel (9) is used to widen the metaphysis part of the medullary canal under the osteotomy line (Fig. 3). The point of the chisel must run along the interior lateral surface of the cortical bone. The orientation of the chisel must keep the planned anteversion of the femoral component (10 to 15°). 4. Milling of the medullary canal Special milling cutters (3) to (8) with 3 8 cylindrical stem are used to mill the medullary canal, which facilitates...

5. Preparation of the medullary canal Preparation of the medullary canal is 10 15 carried out using a set of rasps (1) to (1) (Fig. 5). It is necessary to use always the rasp corresponding to the size of the stem to be implanted, which ensures the required thickness of the cemented covering. Finish the rasping when the osteotomy line coincides with the mark on the rasp (Fig. 6).

Implant Description Surgical Technique Instrumentation Set Catalogue 6. Preliminary test of articulation (on the rasp) Preliminary articulation into the artificial acetabular cup is carried out using a 19 22 plastic testing head (0) to (2) fixed on the cylindrical neck of the rasp (Fig. 7a). Testing heads are available in four options differing by the neck length – S, M, L, XL (Fig. 7b). To remove the rasp from the medullary canal it is necessary to fix the handle (1) 16 17 with the extractor pin (1) again on the rasp – see Fig. 6.

7. Application of bone cement 8. Insertion of femoral component Insert a cancellous or a polyethylene plug into the medullary canal using a special instrument and insert a Redon drain that removes haematoma from the distal pole of the medullary canal. Thus the close contact between cement and inner surface of cortical bone is provided for. The thickness of such a newly created casing is to be 1,5 mm (valid for size 0 or/and 1 only), which fully depends on the rasp size used. By bigger stem sizes (in a dependance upon bigger rasps used) the thickness of the cemented casing is increased to 2...

Implant Description Surgical Technique Instrumentation Set Catalogue 9. Final test of articulation (of the femoral component) The final test of articulation is carried out using a test or a polyethylene articulation insert. One of the four testing plastic heads (2) to 26 is used for this test of articulation (2) 23 (Fig. 9) and an appropriate metal or ceramic head is selected upon the test results. 10. Articulation of the endoprosthesis Final articulation is carried out using the head inserting instrument (2) (Fig. 10). 28

11. Final result of the surgery Position when the head has been articulated into the acetabular cup (Fig. 11).

Implant Description Surgical Technique Instrumentation Set Catalogue The set of instruments is placed in a one cassette allowing a clear arrangement of the instruments not only during transportation, storage and preparation, but also during the surgery. The arrangement of the instruments in the cassette corresponds to pictures in the surgical technique manual. During transportation, the cassette is placed in a container allowing sterilization. INSTRUMENTS FOR APPLICATION OF CEMENTED STEM TYPE CSC CASSETTE LAY-OUT

Instrument for insertion and adjustment of antetorsion of the stem Templates for measurement of extracted head size

Implant Description Surgical Technique Instrumentation Set Catalogue The stem of a total hip joint replacement type CSC, designated for implantation with a PMMA centralizer and with bone cement is made of quality stainless steel in accordance with the norm ISO 5832-9. The stem is supplied in six sizes and it is polished to mirrorlike gloss. The neck of the endoprosthesis ends in a 12/14 taper (EURO) with embossed surface allowing the use of ceramic heads. The CD angle is 135 degrees.