Responsible Innovation Cementless Tapered Femoral Stem Surgical technique

Contents Operative summary Pre-operative planning Femoral neck osteotomy Femoral canal preparation Sequential rasping Calcar preparation Trial reduction Stem implantation Femoral head impaction Stem extraction Ordering information

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Operative summary a. Femoral neck osteotomy b. Femoral canal preparation h. Femoral head impaction

Operative technique 2. Femoral neck osteotomy 3. Femoral canal preparation Pre-operative planning should normally be carried out, to provide an indication of stem size and neck option to restore the anatomical centre of rotation. While pre-operative templating will help define the position of the osteotomy, the neck resection guide provides additional intra-operative guidance. The guide is placed so that the long axis of the instrument is in line with the long axis of the femur, and may be secured with pins if required. Remove any pins that may have been used to secure the neck resection guide....

The T-handled reamer is used to define the neutral axis of the femoral canal. It is important to create an open pathway to the appropriate depth. This reduces the risk of distal hang-up which can lead to undersizing and improper seating of the stem. The chosen handle should be attached to the starter rasp and inserted/impacted into the femur, making sure that axial and rotational alignment is maintained at all times. Progressively larger rasps are then used to create an appropriately-sized cavity for receiving the definitive implant. The growth between adjacent rasp sizes is uniform to make sequential...

Ø40mm and Ø50mm calcar reamers are available. Locate the appropriate calcar reamer onto the spigot of the final rasp to remove excess bone from the resected neck. The calcar reamer will remove any bone that protrudes 0.25mm or more above the face of the rasp. Initiate power to the calcar reamer prior to careful engagement with the bone to prevent damage to the femur. Attach the appropriate head and neck trials to the rasp in situ and perform a trial reduction to assess stability, offset and leg length. If the leg has been lengthened so that it cannot be managed easily with the available head...

9. Femoral head impaction The final rasp size indicates the definitive implant size. Once the final rasp is removed, suction may be applied but lavage of any kind should be avoided. The stem may be inserted by hand and impacted with the non-threaded introducer (Fig. 1) or held captive by screwing on the introducer/handle assembly by hand only (Fig. 2). The tommy bar can be used to release the stem if necessary. Once the acetabular cup is implanted, but before placing the definitive head on the stem, the stem taper should be thoroughly rinsed and carefully dried to ensure that it is free from...

Stem extraction In the unlikely event that the stem needs to be removed, the extraction rod is screwed into the threaded hole on the lateral/proximal shoulder of the stem. The slotted mallet is then used to gently strike the underside of the extraction rod handle, using the cut-out feature of the mallet to guide and control the blows. Responsible Innovation

Ordering information standard tapered stem 694.0001 Size 1 Cementless 694.0002 Size 2 Cementless 694.0003 Size 3 Cementless 694.0004 Size 4 Cementless 694.0005 Size 5 Cementless 694.0006 Size 6 Cementless 694.0007 Size 7 Cementless 694.0008 Size 8 Cementless 694.0009 Size 9 Cementless 694.0010 Size 10 Cementless 694.0011 Size 11 Cementless lateralised tapered stem 694.1001 Size 1 Cementless 694.1002 Size 2 Cementless 694.1003 Size 3 Cementless 694.1004 Size 4 Cementless 694.1005 Size 5 Cementless 694.1006 Size 6 Cementless 694.1007 Size 7 Cementless 694.1008 Size 8 Cementless 694.1009 Size 9...

Sizing guide offset 50° neck length standard size 1 medial stem length (mm) lateral stem length (mm) 2 lateral stem length medial stem length Responsible Innovation

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