JOINT RECONSTRUCTION Revision Solutions This publication is not intended for distribution in the USA.

GRIPTION® TF Augments System Overview 3 Possible Surgical Solutions 11 Surgical Technique Pre-operative Planning and Templating 13 Acetabular Preparation Finishing Rasp Technique 14 Acetabular Preparation Modular Rasp Technique 15 Implant Insertion Augment-First Technique 17 Implant Insertion Acetabular Shell-First Technique 19 Ordering Information

Filling the gap in Acetabular Revision Surgery Avanced Advanced Materials Materials Avanced Advanced Instrumentation Instrumentation Advanced Avanced Fixation Fixation Design Rationale and Surgical Technique DePuy Synthes

GRIPTION TF AUGMENTS SYSTEM OVERVIEW The GRIPTION TF Acetabular Revision System is an innovative technology for addressing bone defects in complex acetabular revision surgery. It represents the latest advances in materials, fixation and instrumentation technologies. Combined with other elements of the PINNACLE® Hip Solutions portfolio – including the leading acetabular cup system and advanced bearing options – the result is a winning solution to help restore motion for today’s revision patients. The GRIPTION TF Augments are designed to act as a defect filling implant in the case of severe bone...

ADVANCED MATERIALS The GRIPTION TF material is a completely porous structure made from commercially pure titanium. It provides a modulus of elasticity similar to bone, and a coefficient of friction that allows for an impressive initial scratch fit. Advanced Avanced Materials Materials Coefficient of Friction Bone-like Modulus of Elasticity GPa Avanced Advanced Instrumentation Instrumentation Advanced Avanced Fixation Coefficient of Friction Friction Coefficient of Bone-like ModulusModulus of Elasticity Bone-like of Elasticity Cancellous Bone Compressive Yield Strength Cortical Bone 0.82 Zimmer™...

ADVANCED FIXATION LOCKING SCREW OPTION GRIPTION TF implants have the ability to use locking screws to fixate the Augment to host bone. Locking screws help prevent the screw from becoming loose and backing out of the Augment. This minimises the risk of compromising the fixation as a result of screw migration. In addition, GRIPTION TF enables surgeons to implant diverging locking screws for even stronger fixation to the host bone. Advanced Avanced Materials Materials Avanced Advanced Instrumentation Instrumentation DePuy Synthes Design Rationale and Surgical Technique Advanced Avanced Fixation

CEMENT, CEMENTLESS OR HYBRID FIXATION OPTIONS Prior to the availability of the GRIPTION TF Augments, the recognised method of securing the Augment to the cup was with bone cement. The introduction of the GRIPTION TF Augments allow surgeons to select between cementless, cemented and hybrid options of Augment to cup fixation. TRUEBOND Cementless Technology The Truebond Cementless Technology and Hybrid fi xation is achieved by using a short 6.5mm screw through the cup into the augment. Hybrid Fixation Design Rationale and Surgical Technique DePuy Synthes

ADVANCED INSTRUMENTATION The GRIPTION TF Revision System provides specialised instruments to prepare a customised bone envelope for the GRIPTION TF implants. The GRIPTION TF Revision System allows surgeons to select from two methods of preparing the acetabular bone with their choice of modular or finishing rasps. Featuring easy connect technology, the GRIPTION TF system-specific instruments are user-friendly and innovative, making them a valuable component of your technique. Advanced Avanced Materials Materials Avanced Advanced Instrumentation Instrumentation DePuy Synthes Design Rationale and...

Finishing rasp Modular rasp GRIPTION TF  Design Rationale and Surgical Technique  DePuy Synthes

ADVANCED MODULARITY The DePuy Synthes GRIPTION TF Augments are compatible with the PINNACLE Hip Solutions Acetabular system. The PINNACLE Hip Solutions provide the largest selection of advanced bearing technologies, biological and mechanical fixation alternatives. With more implant designs and choices than any competitive system, you won’t have to compromise when meeting the individual needs of patients. Revision Deep Profile 54-72 mm DePuy Synthes Design Rationale and Surgical Technique

KEY BONE STOCK AND LANDMARK CONSIDERATIONS Radiographic landmarks are helpful in assessing the acetabular bone stock. It can also be useful to order a CT scan of the area with a metal suppression technique. A CT scan will often indicate significantly more lysis than what is apparent on plain radiographs, and can also aid in determining pelvic discontinuities or loss of structural bone. Bone Stock Considerations Completely supportive acetabulum – PINNACLE Hip Solutions Shell Partially supportive acetabulum – PINNACLE Hip Solutions Shell with GRIPTION TF Augments Non-supportive – PINNACLE Hip Solutions...

The Paprosky Classification is the most widely used acetabular defect classification.5 Type 1 • Anterior/posterior columns are intact and supportive • Greater than 70 percent of host bone to hemispherical shell contact Solution • Pinnacle GRIPTION Cup Type 2A • Anterior/posterior columns are intact and supportive • Superior migration less than 2 cm • Up to 30 percent of the cup may be uncovered superiorly Solution • Pinnacle GRIPTION Multi-hole / Revision cup Type 2B • Superior migration less than 2 cm • Anterior/posterior columns are supportive • Greater than 50 percent of host bone to hemispherical...

Type 3A • 30-60 percent of rim unsupportive • Greater than 2 cm superior migration • Less than 50 percent of host bone to hemispherical shell contact Solution • Pinnacle GRIPTION Multi-hole / Revision cup • GRIPTION TF Augment / Buttress1 Type 3B • Greater than 60 percent of rim unsupportive • Significant lysis and loss of posterior column bone stock • Risk of pelvic discontinuity Solution • Pinnacle GRIPTION Multi-hole / Revision cup • GRIPTION TF Augment / Buttress1 • Protrusio Cage GRIPTION TF Design Rationale and Surgical Technique DePuy Synthes 12 Buttress / Shims available Q4 2014.