

Catalog excerpts

This publication is not intended for distribution in the USA. PRODUCT RATIONALE AND SURGICAL TECHNIQUE Distally-Interlocked Modular Femoral Reconstruction Prosthesis
Open the catalog to page 1
INTRODUCTION The REEF™ implant is based on the four following basic principles: • Distal diaphyseal anchorage • A modular system which makes it possible to adapt, at the intraoperative stage, to almost any situation encountered • Total hydroxyapatite coating to achieve biological anchorage, reconstruction and support1 CORAIL Revision • Distal interlocking screws to ensure initial mechanical stability before osteointegration takes place2,3 The REEF femoral implant is reserved for cases of major femoral deficiency (Paprosky types 3A, 3B and 4). This implant is not to be used in less severe...
Open the catalog to page 3
PRODUCT RATIONALE The REEF prosthesis is a modular femoral implant which allows flexibility during intraoperative assembly of the different components thanks to the range of available stem lengths and diameters. The REEF implant offers a customised solution for most joint reconstruction problems being faced. Primary stability is provided by virtue of a distal press-fit which is further facilitated by distal interlocking screws.2,3 The fully HA coated stem allows osteointegration throughout the stem affording long term secondary fixation.1,5,6 The REEF stem should not be used with cement....
Open the catalog to page 4
Trochanteric Component and dedicated locking screw (16 mm) Trochanteric Component and dedicated locking screw (26 mm) Anteversion Witness Marks Lateral Wings Materials The REEF range of implants are made from forged titanium alloy TiAl6V4 ELI ASTM F 136 and ISO5832-3. Hydroxyapatite Coating The REEF implant utilises the same HA coating as the well established CORAIL range which has over 25 years of clinical heritage and a minimum purity of 98% and has an average thickness of 150μm.7 Due to its bioactivity, this coating encourages bone on-growth and promotes fast and efficient...
Open the catalog to page 5
SURGICAL TECHNIQUE Preoperative planning makes it possible to: 1. Identify the lower level of the extended trochanteric osteotomy (ETO) required to fully remove the failed primary implant and any cement; this involves taking measurements in relation to several reference points (the top of the greater trochanter and the lesser trochanter, the femoral condyle, and any osteosynthesis material still in place). 2. Locate the level of implantation of the REEF stem, which can be measured from the reference point for the metaphyso-diaphyseal junction of the stem, as marked on the X-ray template,...
Open the catalog to page 6
APPROACH Extended Trochanteric Osteotomy Regardless of the initial approach selected (posterior, lateral or anterior), it is obligatory that the approach be made via the transfemoral route (Wagner technique), with a large flap that includes the greater trochanter (Figure 1) instead of a simple trochanterotomy which is insufficient to expose any existing bone lesions and explant the failed hardware. There must be no interference with the vascularisation when handling the muscles and their insertions. The distal border of the osteotomy is made using a saw, around the lateral...
Open the catalog to page 7
TRIAL IMPLANTS Once the distal diaphysis has been carefully reamed, a trial stem is selected, either of the same diameter or next size available. Stability is assessed using the following criteria: • Distal stem position with regards to height (distance between the groove on the trial stem, marking the metaphyso-diaphyseal junction, and the lower part of the flap). The distance ‘D’ is checked using the ruler (Figure 3). • Stem primary stability in both the axial and rotational planes is achieved (note: should adequate press-fit not be achieved with the original size selection, a stem of the...
Open the catalog to page 8
FINAL IMPLANTS Assembly of the Targeting Frame The final stem corresponding to the trial implant in terms of length and diameter is mounted on the corresponding targeting frame (right/left). Using the “ANTE” and “POST” marking ensure the stem is correctly orientated before assembly with the targeting frame. When assembling the final Implant & the targeting frame, ensure the locking screw of the frame is aligned and fully seated in the corresponding hole on the distal stem. In addition, the orientation ‘’key’’ on the targeting frame should seat entirely into the corresponding recess in the...
Open the catalog to page 9
FINAL IMPLANTS Distal Screw Placement If not already attached, the appropriate targeting frame (right or left) replaces the handle. It is positioned on the cone and firmly locked in place. Again, ensure both surfaces are flush and the ‘locking key’ is seating in the corresponding recess in the implant. Should any gap occur here, the offset will incurs misalignment of the drill guides and the implant holes. Holes in the targeting device are designed to accept the drill guides and drill bits used to prepare the femoral cortices for the locking screws (Figure 7). For greater precision, screw...
Open the catalog to page 10
Placement of the trial trochanteric component and wing At this point, the trial trochanteric component and wing may be re-fitted in order to confirm that the length of the limb, stability of the prosthesis and anteversion have been restored (Figure 9). Before assembling any components care must be taken to ensure both surfaces are free from any debris or fluid that could interfere with the stability and strength of the taper connection. Surfaces must be cleaned and dried before assembly and impaction. The trial locking screws are differentiated from the implantable locking screws by a laser...
Open the catalog to page 11
FINAL IMPLANTS Warning: Use only the screw supplied with the definitive trochanteric component. Do not implant the trial screws (i.e. L93507 and L93510 supplied in the same sterile packaging. (Figure 10) Femoral Head Impaction After carefully cleaning and drying the stem taper, the appropriate femoral head is positioned and lightly impacted with the dedicated impactor (L93206) to engage the taper. A final reduction of the assembly is then performed. Femoral Reconstruction Reconstruction of the femoral shaft around the final implant is then undertaken. Re-attachment of the osteotomy is...
Open the catalog to page 12All Depuy Synthes catalogs and technical brochures
-
2.0 mm LCP® Distal Ulna Plate
20 Pages
-
Building on Success
16 Pages
-
RADIUS OF CURVATURE
3 Pages
-
Introducing The Variable Angle
12 Pages
-
HEALIX Anchor™ 3.4 mm
2 Pages
-
Small Battery Drive II
4 Pages
-
HEALIX ADVANCE
4 Pages
-
3.5 mm LCP™ Medial
15 Pages
-
Titanium Sternal Fixation System
34 Pages
-
MatrixRIB®FixationSystem
86 Pages
Archived catalogs
-
2.4 mm VA LCP™
4 Pages
-
Mandible Trauma Solutions
2 Pages
-
Power line II
4 Pages
-
Concorde
28 Pages
-
LCP Intercarpal
31 Pages
-
LCS® COMPLETE™
2 Pages
-
Synthes TPLO.
8 Pages
-
SynFix-LR System
56 Pages
-
ATB Anterior Tension Band Plate
32 Pages
-
CONDUIT™
15 Pages
-
Brochure_FINAL
2 Pages
-
DePuy Synthes
81 Pages
-
Anspach
3 Pages
-
Orthopedic Foot Instruments
32 Pages
-
PINNACLE® Hip Solutions
12 Pages
-
Corail
24 Pages
-
S-ROM® NOILES™
68 Pages
-
TRI-LOCK® Product Rationale
12 Pages
-
Reclaim Surgical Technique
44 Pages
-
Speed
2 Pages
-
attune
80 Pages
-
HAMMERLOCK® 2
2 Pages
-
DePuy Glenoid Solutions
2 Pages
-
Trauma Solutions. Elbow
4 Pages
-
Polar
4 Pages
-
Alveolar Distractor.
4 Pages
-
Piezoelectric System
4 Pages
-
Air Power Line II
6 Pages
-
LCP Clavicle Hook Plate
4 Pages
-
TruMatch Pin Guides
16 Pages
-
P F N A
8 Pages
-
SKILL, DEDICATION,
16 Pages
-
Orthopaedics. Overview
20 Pages
-
DURALOC
16 Pages
-
Marathon Cemented Cup
20 Pages
-
MatrixNEURO
8 Pages
-
Anspach XMax
4 Pages
-
Anspach eMax 2 Plus
4 Pages
-
Small Electric Drive
4 Pages
-
Air Pen Drive
4 Pages
-
Colibri II
4 Pages
-
Spine
25 Pages
-
Expert Hindfoot Arthrodesis Nail
48 Pages
-
LCP Distal Fibula Plates
32 Pages
-
TomoFix
60 Pages
-
Expert Tibial Nail PROtect
16 Pages
-
Expert Tibia Nail
84 Pages
-
Sacral Bars
16 Pages
-
Pelvic C-Clamp
20 Pages
-
Low Profile Pelvic System
16 Pages
-
Proximal Femoral (Hook) Plate
24 Pages
-
LCP
24 Pages
-
PFNA
112 Pages
-
HCS 1.5, 2.4, 3.0
36 Pages
-
LCP Wrist Fusion
32 Pages
-
LCP Compact Hand
28 Pages
-
VA-LCP Elbow
48 Pages
-
Distal Radius
44 Pages
-
Olecranon
30 Pages
-
LCP Hook Plate
28 Pages
-
DHP & Olecranon
4 Pages
-
LCP S-A
4 Pages
-
Epoca
4 Pages
-
Philos
32 Pages
-
MultiLoc
68 Pages