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EXACTECH HIP Operative Technique

EXACTECH HIP Operative Technique
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EXACTECH HIP Operative Technique

Product catalog summary
Pre-Operative Planning
Pre-operative planning utilizes traditional templating methods to estimate offset, limb length, and stem size. Tools include an A/P radiograph, pencil, straight edge, and Alteon® Tapered Wedge Template Set. Reference points on the radiograph help reconstruct the patient's natural femoral anatomy. Limb length is determined by aligning the template with the femoral canal and marking the femoral neck cut and head center of rotation.
Operative Technique Overview
The operative technique involves femur osteotomy, femoral canal opening, femoral preparation, trial reduction, and final component placement, aiming to restore joint stability and function.
Detailed Operative Technique
Approach and Osteotomy: The surgical approach is chosen based on experience and preference. The osteotomy guide is aligned with the femur's long axis, and the femoral neck is resected at the pre-determined level.
Opening of the Femoral Canal: A Box Osteotome is used to create an entry portal into the femoral canal.
Femoral Preparation: The Broach Handle is assembled to the Broach, ensuring proper orientation. Broaching is done progressively, starting with the smallest size until stability is achieved.
Calcar Preparation (Optional): Calcar planing is performed to remove excess bone.
Trial Reduction: The appropriate Femoral Neck Trial is inserted, and a trial reduction is performed.
Final Component Placement
The final femoral stem is selected and inserted with correct alignment. The femoral head component is secured, and a final reduction is performed to check stability and range of motion.
System Specifications and Implant Ordering Information
Specifications include standard and extended offsets with various sizes and dimensions. Ordering information is provided for different stem sizes and offsets.
Indications and Contraindications for Use
Indications include use in skeletally mature individuals for hip replacement due to various conditions. Contraindications include systemic infections, inadequate bone structure, and neuromuscular disorders. Unipolar and bipolar endoprostheses are contraindicated for patients with degenerative changes in the acetabulum or pelvic fractures. Patient factors such as age, weight, or activity level that may lead to early system failure are also contraindications.
Femoral Broaches
A comprehensive list of femoral broaches is provided, including Tapered Wedge Broaches and Tapered Wedge Diamond Tooth Broaches, available in sizes 1 through 17. Special order items are marked, and caution is advised due to sharp features.
Femoral Neck Trials
Tapered Wedge Neck Trials are available in standard and extended offsets, covering sizes 1-17.
Instrument Listing
Various instruments are listed, including broach handles, modular instruments, canal entry tools, calcar planer components, and additional instruments like osteotomy guides and stem extractors. Special order items and those with sharp features are noted.
Head Trials
Femoral head trials are available with different offsets, including -3.5 mm, +0 mm, +3.5 mm, +7.5 mm, and +10 mm.
Instrument Cases & Trays
The document includes a list of instrument cases and trays, specifying outer cases and inner trays for femoral components.
Notes
The document advises consulting the Instructions for Use for detailed device information, including indications, contraindications, precautions, and warnings. It emphasizes that Exactech does not practice medicine and that the guidelines are informational, requiring surgeon discretion based on personal training and experience.
Contact Information
Exactech's global headquarters are located in Gainesville, Florida, with contact details provided for further inquiries.
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Catalog excerpts

EXACTECH HIP Operative Technique-1

Tapered Wedge Femoral Stem Primary Femoral Solutions Surgeon focused. Patient driven.TM

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EXACTECH HIP Operative Technique-3

PRE-OPERATIVE PLANNING TOOLS DETERMINATION 0F LIMB LENGTH • A/P radiograph of pelvis centered on the pubic symphysis Select and position the appropriate Alteon Tapered Wedge Template over the X-ray so the central axis of the stem aligns with the central axis of the femoral canal and one of the available femoral head options creates the desired center of rotation. The Alteon Tapered Wedge Femoral Stem is designed for mediolateral cortical engagement within the tapered portion of the proximal femoral canal. • Pencil that will not damage X-ray • Straight edge • lteon® Tapered Wedge Template Set...

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EXACTECH HIP Operative Technique-4

OPERATIVE TECHNIQUE OVERVIEW Opening of the Femoral Canal Femoral Preparation Calcar Preparation (Optional) Trial Reduction Final Component Placement

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EXACTECH HIP Operative Technique-5

DETAILED OPERATIVE TECHNIQUE The goal of the surgical approach is to establish adequate visualization in order to evaluate stability and leg length and restore kinematic function of the joint. The surgical approach of choice is based upon the degree of surgical experience and preference. This technique provides key surgical steps to implant the Alteon Tapered Wedge Femoral Stem. For key surgical steps specific to the cup, refer to the appropriate acetabular technique. Figure 2 Osteotomy of the Femur The surgical approach of choice is based upon the degree of surgical experience and preference....

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EXACTECH HIP Operative Technique-6

Broaching Broach up progressively, beginning with the smallest size. Insert the Broach into the femoral canal with the desired amount of anteversion. Alternate impaction and withdrawal of the Broach as the final size is approached. Once the maximum size Broach is axially stable, release the Broach Handle from the Broach for trialing (Figure 4). Figure 4 Femoral Preparation SURGICAL TIPS If resistance is encountered while preparing the desired stem size, drop down a broach size and rebroach. The Canal Entry Tools may also be used throughout the procedure to aid in positioning of the subsequent...

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EXACTECH HIP Operative Technique-7

FINAL COMPONENT PLACEMENT Final Stem Insertion Select the appropriate femoral stem and impact using the desired Stem Inserter ensuring correct rotational alignment, version and depth. If necessary, allow the bone to adapt to the implant as it is being impacted (Figure 7). Another trial reduction can be performed with the final femoral stem and Femoral Head Trial. Figure 7 Final Component Placement Femoral Head Impaction Clean and dry the taper of the femoral stem. Place the selected femoral head component onto the taper of the femoral stem and secure it using the Femoral Head Impactor. Place...

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EXACTECH HIP Operative Technique-8

SYSTEM SPECIFICATIONS AND IMPLANT ORDERING INFORMATION Standard Offset B C Lateral Offset with the following head lengths (mm) -3.5 E Vertical Offset with the following head lengths (mm) D Neck Length with the following head lengths (mm) Extended Offset A Size F Lateral Offset with the following head lengths (mm) -3.5 E Vertical Offset with the following head lengths (mm) G Neck Length with the following head lengths (mm) *Measured diameter vs. m/l width due to lateral relief **Items are special order; please contact your Exactech Representative to order

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EXACTECH HIP Operative Technique-9

IMPLANT ORDERING INFORMATION Stem Size Thermal Plasma Spray (TPS) Standard Offset Extended Offset • Cemented femoral stems and cemented acetabular cups are intended for cemented fixation only. • Press-fit femoral stems and acetabular cups are intended for press-fit fixation. • Femoral heads and endoprostheses are intended for use in cemented and press-fit applications. All Exactech Hip Systems are indicated for use in skeletally mature individuals undergoing primary surgery for hip replacement due to osteoarthritis, rheumatoid arthritis, osteonecrosis, post-traumatic degenerative problems of...

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EXACTECH HIP Operative Technique-10

INSTRUMENT LISTING Catalog Number Part Description Tapered Wedge Broach, Size 1† Tapered Wedge Broach, Size 2† Tapered Wedge Broach, Size 3† Tapered Wedge Broach, Size 4† Tapered Wedge Broach, Size 5† Tapered Wedge Broach, Size 6† Tapered Wedge Broach, Size 7† Tapered Wedge Broach, Size 8† Tapered Wedge Broach, Size 9† Tapered Wedge Broach, Size 10† Tapered Wedge Broach, Size 11† Tapered Wedge Broach, Size 12† Tapered Wedge Broach, Size 13† Tapered Wedge Broach, Size 14† Tapered Wedge Broach, Size 15† Tapered Wedge Broach, Size 16† Tapered Wedge Broach, Size 17† Tapered Wedge Diamond Tooth Broach,...

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EXACTECH HIP Operative Technique-11

Catalog Number Part Description BROACH HANDLES 01-003-02-0001 Broach Handle, Curved, Single-Offset 01-003-02-0003 Broach Handle, Straight 01-003-02-0004** Broach Handle, Dual Offset, Left 01-003-02-0005** Broach Handle, Dual Offset, Right MODULAR INSTRUMENTS 01-001-01-0001 Modular Stem Inserter, Straight 01-001-01-0002 Modular Stem Inserter, Offset 01-001-01-0003 Modular Stem Inserter, Threaded 01-001-03-0001 Modular Femoral Head Impactor 01-001-05-0001 Modular Box Osteotome, Straight' 01-001-05-0002** Modular Box Osteotome, Offset* 01-001-05-0003 Modular Box Osteotome, Reduced Offset'

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EXACTECH HIP Operative Technique-12

INSTRUMENT LISTING Catalog Number Part Description CANAL ENTRY TOOLS 01-001-06-0001 Modular Straight Canal Finder, Blunt† Modular Straight Canal Finder, Sharp† Curved Canal Finder, Blunt† Curved Canal Finder, Sharp† Kinked Canal Finder Canal Finder, Starter Broach Canal Finder, Lateralizing Broach+ Starter Reamer† CALCAR PLANER COMPONENTS 01-003-04-0001 Calcar Planer Assembly, Shaft Calcar Planer Blade, 1.5”† Calcar Planer Blade, 2”† Calcar Planer Bushing, Broach Post Adaptor Calcar Planer Bushing, Broach Hole Adaptor Calcar Planer Wrench Calcar Planer Wrench, long 10 ** Items are special order;...

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EXACTECH HIP Operative Technique-13

Catalog Number Part Description Tapered Wedge Osteotomy Guide 189-95-00 Tapered Wedge Femoral Stem Tapered Wedge Template Set Tapered Wedge Femoral Stem Size 7 Standard and Extended Offset Stem Extractor, Trunion Adaptor Stem Extractor, Threaded Corkscrew, Sharp† Small T-handle Femoral Head Trial, 12/14, -3.5 mm Offset Femoral Head Trial, 12/14, +0 mm Offset Femoral Head Trial, 12/14, +3.5 mm Offset Femoral Head Trial, 12/14, +7.5 mm Offset Femoral Head Trial, 12/14, +10 mm Offset INSTRUMENT CASES & TRAYS 10-111-00-0001 Instrument Outer Case, Single-Level Instrument Outer Case, Lid Alteon Tapered...

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*Prices are pre-tax. They exclude delivery charges and customs duties and do not include additional charges for installation or activation options. Prices are indicative only and may vary by country, with changes to the cost of raw materials and exchange rates.