Ceramic XLPE OPERATIVE TECHNIQUE Multi-hole

BIOLOX®delta Ceramic Liner Insertion 6 Ceramic Liner Removal Tool 7 CLP75® XLPE Liner Insertion 8 CLP75® XLPE Bearing Cup Range 9 BIOLOX®delta Ceramic Bearing Cup Range 11

Pre-operative planning for the CSF Plus acetabular cup system is available on all commonly used 2D software and in acetate. To ensure accurate templating, Anterior / Posterior and Lateral radiographs will be required with neutral leg alignment and stable pelvic tilt to help determine the implant size and positioning required to restore the patient’s natural anatomy and hip biomechanics. Be sure that the cup is well centred within the acetabulum and at an abduction angle of approximately 45°, taking into account the subchondral bone and selecting a size that is located between the superior rim...

Acetabular Preparation The acetabulum is exposed and reamed, trial cup, corresponding to the final reamer, starting with a reamer 6-8mm smaller is screwed onto the cup introducer handle (10-99-62). The trial cup is introduced into templated increments size, until the acetabulum to check for diameter and circumferential bleeding subchondral bone depth. The height of the trial cup is the is achieved (Figure 1). The final reamer same as the definitive implant, whereas the size determines the size of the definitive diameter of the trial mimics the reamer and acetabular implant, but this should be...

Acetabular Alignment The definitive acetabular cup is firmly screwed onto the cup impactor (86-99-03). There are two types of acetabular cup available; standard for use with CLP75® XLPE liners and standard for use with BIOLOX®delta ceramic liners. Note: CSF Plus Acetabular Cups for CLP75® XLPE liners come with screw hole plugs already in situ. Unscrew the apical hole plug from the definitive implant so that the cup shell can be screwed onto the impactor shaft. For standard cups only, align the cluster of 3 holes to the superior aspect of the prepared acetabulum (Figure 3). The isolated holes...

The cup is presented to the prepared acetabulum ensuring the three clustered screw holes align with the illium (Figure 6). Impact the cup firmly ensuring the orientation of the cup is maintained. An audible change of tone and tactile feedback will indicate when the cup is correctly seated. The impactor handle can be removed and the seating of the cup checked through the apical hole and/or through the screw holes (Figure 7). Should the cup be difficult to seat or the bone be sclerotic, it may be necessary to open the aperture of the acetabular rim. Lightly reaming the acetabular rim only with...

Screw Insertion In the majority of primary cases, stable primary mechanical fixation will be achieved without the need for adjunctive screws. If required, additional adjunctive fixation can be achieved with the use of cancellous bone screws to supplement primary mechanical fixation. In the case of the CSF Plus CLP75® XLPE bearing cup, remove one or more screw hole plugs. A drill guide (86-00-07) is placed carefully in the chosen screw hole, ensuring that it is fully seated. A pilot hole is made using the disposable drill bit which can be used with power or manually (Figure 8). The length of the...

BIOLOX®delta Ceramic Liner Insertion Having prepared the femur and performed a trial reduction, remove the trial liner using the liner removal forceps (50-00-37) as shown in Figure 12. The inner surface of the acetabular cup must be clean, dry and free from debris. Where a CSF Plus BIOLOX®delta Ceramic has been implanted the definitive acetabular liner is inserted into the cup by gently sliding the liner down the internal taper of the cup shell (Figures 13 and 14). Ensure that the liner is seated uniformly flush against the whole rim by gliding a finger around the rim of the cup confirming the...

Ceramic Liner Removal Tool A ceramic liner removal device is available for intra-operative and revision use (not included in the standard CSF Plus instrument trays). Align the prongs of the removal device to the corresponding slots on the periphery of the acetabular cup. The plunger can be engaged with the liner, allowing for simple removal (Figure 17). An alternative ceramic liner removal device without peripheral attachments is available as standard (240-00-02). After attaching to the cup introducer, this can be directly engaged with the liner (Figure 18).

CLP75® XLPE Liner Insertion CSF Plus CLP75® XLPE liners are available in standard (Blue trial liners) and 10° hooded (Green trial liners) variants (Figures 19 and 20). The hood of the liner can be aligned anywhere around the periphery of the cup through 360°. However, to prevent the trial liner from rotating when performing a trial reduction, a hexagonal peg is located on the rear of the trial liner, this engages within the hex of the cup impaction hole. Perform a trial reduction, checking for stability, impingement and range of motion. Remove the trial liner and prepare for the definitive liner....

CLP75® XLPE Bearing Cup Range Standard CLP75® XLPE - Liner/Head size chart Cup Shell size O.D. / Liner I.D. (mm)

Hooded CLP75® XLPE Liners

CSF Plus H-AC Cementless Cup for Biolox Delta Ceramic Bearing CSF Plus Acetabular Cup - Cancellous Bone Screw Part Number Description Cancellous Bone Screw 6.5mm Thread Diameter Length 12mm Cancellous Bone Screw 6.5mm Thread Diameter Length 15mm Cancellous Bone Screw 6.5mm Thread Diameter Length 20mm Cancellous Bone Screw 6.5mm Thread Diameter Length 25mm Cancellous Bone Screw 6.5mm Thread Diameter Length 30mm Cancellous Bone Screw 6.5mm Thread Diameter Length 35mm Cancellous Bone Screw 6.5mm Thread Diameter Length 40mm Cancellous Bone Screw 6.5mm Thread Diameter Length 45mm Cancellous Bone Screw...

JRI CoCr Femoral Heads 12/14 Taper Head-neck length / Head size (mm) Short -4 Medium 0 Long +4 X Long +8 BIOLOX®delta Ceramic Femoral Heads 12/14 Taper Head-neck length / Head size (mm) Revision Femoral Head Delta Ceramic Head-neck length / Head size (mm) Short -4 Medium 0 Long +4 X Long +8