AL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR ALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI PO IS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT AR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA OLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROST GHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH OTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPO RT- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- B ESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAI NIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS M- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP RAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI PO IS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT AR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA OLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROST GHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS M- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP RAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI PO IS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT AR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA OLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROST GHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS M- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP RAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS M- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP RAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH OTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPO RT- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- B ESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAI NIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS M- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP RAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS M- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP RAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS M- BI POLARHEADS- SUPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP RAIGHT- TOTAL HIP PROSTHESSIS- ARTHROM- BI POLARHEADS- SUPRA ART- CALCAR UPRA ART- CALCAR- A UNIPOLAR HEADS- STRAIGHT- TOTAL HIP PROSTHESSIS- ARTH catalog table of contents Suprart 1 3 5 11 features set detail surgical technique Straight Volumed Modular 21 23 27 features set detail surgical technique Calcar 37 39 43 features set detail surgical technique Arthrom 53 55 59 features set detail surgical technique A. Unipolar Head 73 set detail Bipolar Head 77 set detail Total Hip Prosthesis 81 87 set detail surgical technique SUPRART 1 SUPRART 1 Made of CoCrMo Cemented or cementless application 135º neck <ngle Sterile packaging 12/14 tapering joint 6 mm to 16 mm, 1 mm diameter increment 11 different length options Tapering distal part Tapering structure and round distal end, ensure a proper replacement and total hold to the medulla. It can be applied as cemented or cementless with coated or uncoated options. Supra Art Stem Porous coating, Hydroxyapatite coating or double (PC+HA) coating options are available. Body diameter options from 6 mm to 16 mm are available. 3 B E C D A Diameter (mm) Stem Length (mm) (A) Offset (mm) (B) Neck Length (mm) (C) Neck Shaft Angle (º) (D) Neck Stem Length (mm) (E) 6 7 8 9 10 11 12 13 14 15 16 114.5 117 122.5 130 135 137 140 145 148 152 157 39.5 40.5 41.5 42 43 43.5 43.5 44 44 44.5 45 32 32 32 32 32 32 32 32 32 32 32 135 135 135 135 135 135 135 135 135 135 135 19 19 19 19 19 19 19 19 19 19 19 4 Instruments tray 1 No Code 1 2 3 4 5 6 7 8 00000504200 01192200024 01192000005 01193001009 01015000000 01192000030 01192000003 01193000023 01170000013 5 5 3 Barcode Description 8699931023992 8698673497450 8698673490390 8699931028140 8698673494480 8698673494268 8698673496231 8698673493780 8680858425303 1.DESIGN TRAY INSTRUMENT NT RASP HOLDER BOX CHISEL BONE HAMMER - LARGE ROTATION CONTROLLED STEM IMPACTOR STEM IMPACTOR ANTEVERSION ROD T QUICK HANDLE PLUG HOLDER FOR SUPRA ART-1 STEM 6 8 4 Qty. 2 1 1 1 1 1 1 1 1 1 1 7 tray 2 No Code Cementless Cemented 9 Barcode Description 00000504400 01163000607 01163000809 01163001011 01163001213 01163001415 01163001600 8680858419081 8680858431397 8680858431403 8680858431410 8680858431427 8680858431434 8680858431441 4.DESIGN TRAY FOR SUPRA ART REAMERS SUPRA ART-1 CEMENTED 6-7 MM REAMER SUPRA ART-1 CEMENTED 8-9 MM REAMER SUPRA ART-1 CEMENTED 10-11 MM REAMER SUPRA ART-1 CEMENTED 12-13 MM REAMER SUPRA ART-1 CEMENTED 14-15 MM REAMER SUPRA ART-1 CEMENTED 16 MM REAMER Qty. 1 1 1 1 1 1 01173000607 01173000809 01173001011 01173001213 01173001415 01173001600 8680858431762 8680858431779 8680858431786 8680858431793 8680858431809 8680858431816 SUPRA ART-1 PC&HA 6-7 MM REAMER SUPRA ART-1 PC&HA 8-9 MM REAMER SUPRA ART-1 PC&HA 10-11 MM REAMER SUPRA ART-1 PC&HA 12-13 MM REAMER SUPRA ART-1 PC&HA 14-15 MM REAMER SUPRA ART-1 PC&HA 16 MM REAMER 1 1 1 1 1 1 9 6 tray 3 No Code 10 00000502300 01163700060 01163700070 01163700080 01163700090 01163700100 01163700110 01163700120 01163700130 01163700140 01163700150 01163700160 10 7 Barcode 8699931023985 8680858431540 8680858431557 8680858431564 8680858431571 8680858431588 8680858431595 8680858431601 8680858431618 8680858431625 8680858431632 8680858431649 Description TRAY (545X255X40 MM) FOR SUPRA 2-STRAIGHT RASPS RASP FOR SUPRA ART-1 CEMENTED Ø 6 MM RASP FOR SUPRA ART-1 CEMENTED Ø 7 MM RASP FOR SUPRA ART-1 CEMENTED Ø 8 MM RASP FOR SUPRA ART-1 CEMENTED Ø 9 MM RASP FOR SUPRA ART-1 CEMENTED Ø 10 MM RASP FOR SUPRA ART-1 CEMENTED Ø 11 MM RASP FOR SUPRA ART-1 CEMENTED Ø 12 MM RASP FOR SUPRA ART-1 CEMENTED Ø 13 MM RASP FOR SUPRA ART-1 CEMENTED Ø 14 MM RASP FOR SUPRA ART-1 CEMENTED Ø 15 MM RASP FOR SUPRA ART-1 CEMENTED Ø 16 MM Qty. 1 1 1 1 1 1 1 1 1 1 1 tray 4 No Code 11 00000504300 01163800060 01163800070 01163800080 01163800090 01163800100 01163800110 01163800120 01163800130 01163800140 01163800150 01163800160 Barcode Description 8699931024005 8680858431656 8680858431663 8680858431670 8680858431687 8680858431694 8680858431700 8680858431717 8680858431724 8680858431731 8680858431748 8680858431755 5. DESIGN TRAY FOR SUPRA ART RASP RASP FOR SUPRA ART-1 PC&HA 6 MM RASP FOR SUPRA ART-1 PC&HA 7 MM RASP FOR SUPRA ART-1 PC&HA 8 MM RASP FOR SUPRA ART-1 PC&HA 9 MM RASP FOR SUPRA ART-1 PC&HA 10 MM RASP FOR SUPRA ART-1 PC&HA 11 MM RASP FOR SUPRA ART-1 PC&HA 12 MM RASP FOR SUPRA ART-1 PC&HA13 MM RASP FOR SUPRA ART-1 PC&HA14 MM RASP FOR SUPRA ART-1 PC&HA 15 MM RASP FOR SUPRA ART-1 PC&HA 16 MM Qty. 1 1 1 1 1 1 1 1 1 1 1 11 8 9 Code Barcode Description Cemented Stem 11730101206 11730101207 11730101208 11730101209 11730101210 11730101211 11730101212 11730101213 11730101214 11730101215 11730101216 8680858427932 8680858427949 8680858427956 8680858427963 8680858427970 8680858427987 8680858427994 8680858428007 8680858428014 8680858428021 8680858428038 SUPRA ART-1 STEM SANDBLASTED 6 MM SUPRA ART-1 STEM SANDBLASTED 7 MM SUPRA ART-1 STEM SANDBLASTED 8 MM SUPRA ART-1 STEM SANDBLASTED 9 MM SUPRA ART-1 STEM SANDBLASTED 10 MM SUPRA ART-1 STEM SANDBLASTED 11 MM SUPRA ART-1 STEM SANDBLASTED 12 MM SUPRA ART-1 STEM SANDBLASTED 13 MM SUPRA ART-1 STEM SANDBLASTED 14 MM SUPRA ART-1 STEM SANDBLASTED 15 MM SUPRA ART-1 STEM SANDBLASTED 16 MM PC&HA Stem 11730901206 11730901207 11730901208 11730901209 11730901210 11730901211 11730901212 11730901213 11730901214 11730901215 11730901216 8698673447424 8698673447431 8698673447448 8698673447455 8698673447462 8698673447479 8698673447486 8698673447493 8698673447509 8698673447516 8680858420711 SUPRA ART-1 STEM PC&HA 6 MM SUPRA ART-1 STEM PC&HA 7 MM SUPRA ART-1 STEM PC&HA 8 MM SUPRA ART-1 STEM PC&HA 9 MM SUPRA ART-1 STEM PC&HA 10 MM SUPRA ART-1 STEM PC&HA 11 MM SUPRA ART-1 STEM PC&HA 12 MM SUPRA ART-1 STEM PC&HA 13 MM SUPRA ART-1 STEM PC&HA 14 MM SUPRA ART-1 STEM PC&HA 15 MM SUPRA ART-1 STEM PC&HA 16 MM Centraliser 11870000110 11870000125 11870000140 11870000155 11870000170 8698673432680 8698673432697 8698673432703 8698673432710 8698673432727 CENTRALISER 11 MM CENTRALISER 12.5 MM CENTRALISER 14 MM CENTRALISER 15.5 MM CENTRALISER 17 MM Plug X-Ray Ring Implants 11770000015 11770000018 11770000029 8698673431515 8698673431522 8698673431508 PLUG X - RAY RING (7.5-11 MM STEMS) PLUG X - RAY RING (11-13.5 MM STEMS) PLUG X - RAY RING (13.5-15 MM STEMS) 10 Surgical Technique 1 FEMORAL HEAD OSTEOTOMY Osteotomy is made over 1.5-2 cm of trochanter minor to the femoral shaft with the angle of 45°. Femoral head which is cut before is pulled out from acetabulum by Femoral Head Extractor. 2 FEMORAL HEAD MEASUREMENT The width of the cut femoral head is determined by Femoral Head Measuring Device. 3 ACCESS TO MEDULLA CANAL Access to the medullary cavity from osteotomy line is obtained with Box Chiesel. Note: Please pay attention to femoral head anteversion. 11 4 CARVING OPERATION FOR FEMORAL STEM Entry is made from piriformis fossa to medulla by the starting reamer. It is carved until reaching to the proper canal width by a Reamer which is assembled to T Quick Handle from trochanteric tip to femoral shaft. Note: To make the reamer choice, the smallest size should be tried in the beginning and the size should be increased gradually. The last reamer size demonstrates the stem size. 5 RASPING Rasping operation (considering anteversion) is started with the smallest Rasp which is assembled to NT Rasp Holder. The rasping operation is performed until ending line on proximal area of the rasp. The rasping operation is proceeded until attaining sufficient bone strength by incremental lengths. The recent used rasp determines the Body (Stem) length. Note: Different rasps are used for Cemented and Cementless applications. Please refer to pg 14 for application with A. Unipolar Head. Please refer to pg 17 for application with Bipolar Head. 12 A. Unipolar Head Application 6 A. UNIPOLAR TRIAL Width of A.Unipolar Trial is determined by femoral head measurement (Section 2). Then A.Unipolar Trial is fixed to A.Unipolar Trial Holder and the suitability with acetabulum is tested. 7 RING SIZE DETERMINATION After designating the size of A.Unipolar Trial, it is placed onto A.Unipolar Ring Trial which is held to the rasp in order to determine the suitability of the ring size. 8 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 13 9 REMOVING RING TRIAL From the Rasp The Ring Trial which is fixed to the Rasp is extracted by Stem Ring Extractor as in the figure. Rotate the instrument until trials are extracted. From the A.Unipolar Trial The Ring Trial which is fixed to A.Unipolar Trial is extracted by A.Unipolar Ring Extractor as in the figure. Rotate the instrument until the ring is extracted. 10 PLACEMENT OF THE STEM Stem is positioned considering anteversion angle by Rotation Controlled Stem Impactor fixed rotation controlled Anteversion Rod. 14 11 HAMMERING STEM In cementless applications, the Stem Impactor ensures an exact placement of the stem. 12 A. UNIPOLAR HEAD FIXING A.Unipolar Head which is placed onto A.Unipolar Ring is fixed by hammering the Femoral Head Impactor. 15 Bipolar Head Application 6 BIPOLAR TRIAL The width of Bipolar Trial Head is determined (Section 2). It is fixed to Bipolar Trial Head Holder and the suitability with acetabulum is tested. 7 MODULAR HEAD SIZE DETERMINATION After designating the size of Bipolar Trial Head, it is placed onto Modular Trial Head which is held to the rasp in order to determine the suitability of the ring size. 8 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 16 9 MODULAR TRIAL HEAD EXTREACTION Modular Trial Head which is fixed to rasp is extracted by Modular Head Extractor as in the figure. Rotate the instrument until the trials are extracted. 10 PLACEMENT OF THE STEM Stem is positioned considering anteversion angle by Rotation Controlled Stem Impactor fixed rotation controlled Anteversion Rod. 11 HAMMERING STEM In cementless applications, the Stem Impactor ensures an exact placement of the stem. 17 12 MODULAR HEAD FIXING Size of the Modular Head is determined with the help of trials. It is hammered by Modular Head Impactor. 13 BIPOLAR HEAD PLACEMENT The Segman is extracted from Bipolar Head by Bipolar Insert Ring Forceps then Bipolar Head placed into Modular Head and pushed until ‘click’ sound is heard. The extracted Segman is placed again. 18 straight VOLUMED MODULAR STEM straight VOLUMED MODULAR STEM Made of CrNi For cemented applications 135º neck angle Sterile packaging 12/14 tapering joint 5 different diameter options Tapering distal part It has proven its reliability with many surgeries. It is used in cemented applications. Tapering structure ensures positionning on the neutral axis. It settles into femur according to three point principle. Diameter options are 7.5 mm, 10 mm, 11 mm, 12.5 mm and 15 mm. 21 B E C D A F Diameter (mm) Stem Length (mm) (A) Offset (mm) (B) Neck Length (mm) (C) Neck Shaft Angle (º) (D) Neck Stem Length (mm) (E) Plug Set Length (mm) (F) 7.5 10 11 12.5 15 138 142 145 147 152 37 37 37 37 37 27 27 27 27 27 135 135 135 135 135 11 11 11 11 11 116 119.5 123 125 130 22 Instruments tray 1 No Code 1 2 3 4 5 6 7 8 00000504200 01170000011 01192200024 01192000005 01193001009 01015000000 01192000030 01192000003 01193000023 6 23 5 Barcode Description 8699931023992 8680858425280 8698673497450 8698673490390 8699931028140 8698673494480 8698673494268 8698673496231 8698673493780 1.DESIGN TRAY INSTRUMENT PLUG HOLDER FOR STRAIGHT STEM RASP HOLDER BOX CHISEL BONE HAMMER - LARGE ROTATION CONTROLLED STEM IMPACTOR STEM IMPACTOR ANTEVERSION ROD T QUICK HANDLE 1 7 4 Qty. 2 8 1 1 1 1 1 1 1 1 3 tray 2 No Code 00000504100 9 01025100750 01025101000 01025101100 01025101250 01025101500 10 01011300075 00580280150 9 Barcode Description 8680858431229 8698673494213 8698673494251 8698673494244 8698673494237 8698673494220 8699931009750 8698673498174 2.DESIGN TRAY FOR STRAIGHT STEM RASP RASP FOR STRAIGHT STEM 7.5 MM RASP FOR STRAIGHT STEM 10 MM RASP FOR STRAIGHT STEM 11 MM RASP FOR STRAIGHT STEM 12.5 MM RASP FOR STRAIGHT STEM 15 MM REAMER FOR VOLUMED MODULAR STEM Ø 7.5 MM CONTAINER 560X270X150 MM Qty. 1 1 1 1 1 1 10 24 25 Code Barcode Description Stem 10112221275 10112221210 10112221211 10112221212 10112221215 8698673434141 8698673434103 8698673434110 8698673434127 8698673434134 VOLUMED MODULAR STEM STAINLESS STEEL 7.5 MM VOLUMED MODULAR STEM STAINLESS STEEL 10 MM VOLUMED MODULAR STEM STAINLESS STEEL 11 MM VOLUMED MODULAR STEM STAINLESS STEEL 12.5 MM VOLUMED MODULAR STEM STAINLESS STEEL 15 MM Centraliser 11870000110 11870000125 11870000140 11870000155 11870000170 8698673432680 8698673432697 8698673432703 8698673432710 8698673432727 CENTRALISER 11 MM CENTRALISER 12.5 MM CENTRALISER 14 MM CENTRALISER 15.5 MM CENTRALISER 17 MM Plug X-Ray Ring Implants 11770000015 11770000018 11770000029 8698673431515 8698673431522 8698673431508 PLUG X - RAY RING (7.5-11 MM STEMS) PLUG X - RAY RING (11-13.5 MM STEMS) PLUG X - RAY RING (13.5-15 MM STEMS) 26 Surgical Technique 1 FEMORAL HEAD OSTEOTOMY Osteotomy is made over 1.5-2 cm of trochanter minor to the femoral shaft with 45° of angle. The cut femoral head, is pulled out from acetabulum by Femoral Head Extractor. 2 FEMORAL HEAD MEASUREMENT The width of the femoral head is determined by Femoral Head Measuring Device. 3 ACCESS TO MEDULLA CANAL Access to the medullary cavity from osteotomy line is obtained with Box Chiesel. Note: Please pay attention to femoral head anteversion. 27 4 CARVING OPERATION FOR FEMORAL STEM Entry is made from piriformis fossa to medulla by the starting reamer. It is carved until attaining proper canal width by a Reamer which is fixed to T Quick Handle from trochanteric tip to femoral shaft - until enough bone resistance is detected-. Note: To make the reamer choice, the smallest size should be tried in the beginning and the size should be increased gradually. The last reamer size demonstrates the stem size. 5 RASPING Rasping operation (considering anteversion) is started with the smallest Rasp which is fixed to NT Rasp Holder. The rasping operation is performed until reaching to the ending line on proximal area of the rasp. The rasping operation is proceeded until attaining sufficient bone strength by increasing lengths gradually. The recent used Rasp determines the Body (Stem) length. Please refer to pg 29 for application with A. Unipolar Head. Please refer to pg 32 for application with Bipolar Head. 28 A. Unipolar Head Application 6 A. UNIPOLAR TRIAL Width of A.Unipolar Trial is determined by femoral head measurement (Section 2). Then A.Unipolar Trial is fixed to A.Unipolar Trial Holder and the suitability with acetabulum is tested. 7 RING SIZE DETERMINATION After designating the size of A.Unipolar Head Trial, it is placed onto A.Unipolar Ring Trial which is held to the rasp in order to determine the suitable ring size. 8 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 29 9 REMOVING RING TRIAL From the Rasp The Ring Trial which is fixed to the Rasp is extracted by Stem Ring Extractor as in the figure. Rotate the instrument until trials are extracted. From the A.Unipolar Trial The Ring Trial which is fixed to A.Unipolar Trial is extracted by A.Unipolar Ring Extractor as in the figure. Rotate the instrument until the ring is extracted. 10 PLUG PLACEMENT Before the cement application, medulla is closed with a Plug which is assembled to Plug Holder. Plug Holder is pushed until marked part which indicates the stem length. 30 11 STEM PLACEMENT Centraliser placed to distal part of the Stem. The Stem is positioned considering anteversion angle using rotation controlled Stem Impactor which is fixed to rotation controlled Anteversion Rod. 12 A. UNIPOLAR HEAD FIXING After designating the width of A.Unipolar Ring by using the trials, it is placed onto A.Unipolar Head. Then A.Unipolar Head is fixed by hammering the Femoral Head Impactor. 31 Bipolar Head Application 6 BIPOLAR TRIAL The width of Bipolar Trial Head is determined (Section 2). It is fixed to Bipolar Trial Head Holder and the suitability with acetabulum is tested. 7 MODULAR HEAD SIZE DETERMINATION After designating the size of Bipolar Trial Head, it is placed onto Modular Trial Head which is held to the rasp in order to determine the suitability of the ring size. 8 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 32 9 MODULAR TRIAL HEAD EXTRACTION Modular Trial Head which is fixed to Rasp is extracted by Modular Head Extractor as in the figure. Rotate the instrument until the trials are extracted. 10 PLUG PLACEMENT Before the cement application, medulla is closed with a Plug which is assembled to Plug Holder. Plug Holder is pushed until marked part which indicates the stem length. 11 STEM PLACEMENT Centraliser placed to distal part of the Stem. The Stem is positioned considering anteversion angle using rotation controlled Stem Impactor which is fixed to rotation controlled Anteversion Rod. 33 12 MODULAR HEAD FIXING After designating the size of Modular Head by using the trials, it is hammered by Modular Head Impactor. 13 BIPOLAR HEAD PLACEMENT The Segman is extracted from Bipolar Head by Bipolar Insert Ring Forceps then Bipolar Head placed into Modular Head and pushed until ‘click’ sound is heard. The extracted Segman is placed again. 34 calcar calcar Made of CoCrMo Cemented or cementless application Double coating (PC+HA) as cementless stem 135º neck angle Sterile packaging 12/14 tapering joint Diameter options from10 mm to 18 mm with 2 mm increment 3 length options Tapering distal part Designed to be used in cases of bone loss in the proximal femur, unstable fractures and nonunion of the fracture. It ensures rotational and axial stability by settling properly with its tapering structure. Holes in the body enables passing of the cables, wires and sutures that ensure safe and stable fixation. Diameter options are 10 mm, 12 mm, 14 mm, 16 mm, 18 mm. Length options are 25 mm, 35 mm, 45 mm. It can be applied cementless with coated options. Double coating options -Porous+Hydroxyapatite- are available for cementless applications. 37 B E C G D A F Diameter Stem (mm) Length (mm) (A) 10x25 10x35 10x45 12x25 12x35 12x45 14x25 14x35 14x45 16x25 16x35 16x45 18x25 18x35 18x45 175 175 175 175 175 175 175 175 175 175 175 175 175 175 175 Offset (mm) (B) 39.5 39.5 39.5 41.3 41.3 41.3 43.6 43.6 43.6 43.1 43.1 43.1 43.4 43.4 43.4 Neck Length (mm) (C) 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 31.2 Neck Shaft Angle (º) (D) Neck Stem Length (mm) (E) Plug Set Length (mm) (F) Calcar Length (mm) (G) 135 135 135 135 135 135 135 135 135 135 135 135 135 135 135 14.1 14.1 14.1 15.1 15.1 15.1 16.1 16.1 16.1 17 17 17 18.2 18.2 18.2 150 140 130 150 140 130 150 140 130 150 140 130 150 140 130 25 35 45 25 35 45 25 35 45 25 35 45 25 35 45 38 Instruments tray 1 No Code 1 2 3 4 5 6 7 8 00000504200 01170000010 01192200024 01192000005 01193001009 01015000000 01192000030 01192000003 01193000023 6 39 4 Barcode Description 8699931023992 8698673494787 8698673497450 8698673490390 8699931028140 8698673494480 8698673494268 8698673496231 8698673493780 1.DESIGN TRAY INSTRUMENT PLUG HOLDER FOR CALCAR STEM RASP HOLDER BOX CHISEL BONE HAMMER - LARGE ROTATION CONTROLLED STEM IMPACTOR STEM IMPACTOR ANTEVERSION ROD T QUICK HANDLE 1 7 5 Qty. 3 2 1 1 1 1 1 1 1 1 8 tray 2 No Code 9 501400 01095000010 01095000012 01095000014 01095000018 01095000018 Barcode Description 8680858431182 8698673496576 8698673496583 8698673496590 8680858419760 8680858419760 2.DESIGN TRAY FOR CALCAR REAMERS REAMER FOR CALCAR Ø 10 MM REAMER FOR CALCAR Ø 12 MM REAMER FOR CALCAR Ø 14 MM REAMER FOR CALCAR Ø 16 MM REAMER FOR CALCAR Ø 18 MM Qty. 1 1 1 1 1 9 40 tray 3 Resection Marker Cementless Cemented No Code 10 00000501300 01091250010 01091250012 01091250014 01091250016 01091250018 Description 8699931023978 8698673495647 8698673495654 8698673495654 8698673496613 8680858419739 3.DESIGN TRAY FOR CALCAR RASP RASP FOR CALCAR REP. STEM COCRMO 10X25 MM RASP FOR CALCAR REP. STEM COCRMO 12X25 MM RASP FOR CALCAR REP. STEM COCRMO 14X25 MM RASP FOR CALCAR REP. STEM COCRMO 16X25 MM RASP FOR CALCAR REP. STEM COCRMO 18X25 MM Qty. 1 1 1 1 1 1 11 01091000110 01091000112 01091000114 01091000116 01091000118 8698673465091 8698673465107 8698673465114 8680858419722 8698673465121 RASP FOR CALCAR REP. STEM CEMENTLESS Ø 10 MM RASP FOR CALCAR REP. STEM CEMENTLESS Ø 12 MM RASP FOR CALCAR REP. STEM CEMENTLESS Ø 14 MM RASP FOR CALCAR REP. STEM CEMENTLESS Ø 16 MM RASP FOR CALCAR REP. STEM CEMENTLESS Ø 18 MM 1 1 1 1 1 12 01091100001 01091100002 8699931009682 8680858431366 CALCAR RESECTION MARKER 10-12 CALCAR RESECTION MARKER 14-16- 18 1 1 00580280150 8698673498174 CONTAINER 580X280X150 MM 12 41 Barcode 10 11 Implants Description 10932501210 10933501210 10934501210 10932501212 10933501212 10934501212 10932501214 10933501214 10934501214 10932501216 10933501216 10934501216 10932501218 10933501218 10934501218 8698673434158 8698673434165 8698673434172 8698673434189 8698673434196 8698673434202 8698673434219 8698673434226 8698673434233 8698673434240 8698673434257 8698673434264 8680858408320 8680858408337 8680858408344 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 10X25 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 10X35 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 10X45 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 12X25 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 12X35 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 12X45 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 14X25 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 14X35 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 14X45 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 16X25 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 16X35 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 16X45 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 18X25 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 18X35 CALCAR REP. STEM COCRMO-CEMENTED-SANDBLASTED 18X45 10970000100 10970000120 10970000140 10970000160 10970000180 8698673434448 8698673434455 8698673434462 8698673434479 8680858428779 CENTRALISER FOR CALCAR COCRMO 10 MM CENTRALISER FOR CALCAR COCRMO 12 MM CENTRALISER FOR CALCAR COCRMO 14 MM CENTRALISER FOR CALCAR COCRMO 16 MM CENTRALISER FOR CALCAR COCRMO 18 MM 11770000015 11770000024 11770000029 8698673431515 8698673431522 8698673431508 PLUG X - RAY RING (7.5-11 MM STEMS) PLUG X - RAY RING (11-13.5 MM STEMS) PLUG X - RAY RING (13.5-15 MM STEMS) CoCrMo Cemented Stem CoCrMo Cementless Stem CALCAR REP. STEM COCRMO PC+HA COATED 10X25 MM CALCAR REP. STEM COCRMO PC+HA COATED 10X35 MM CALCAR REP. STEM COCRMO PC+HA COATED 10X45 MM CALCAR REP. STEM COCRMO PC+HA COATED 12X25 MM CALCAR REP. STEM COCRMO PC+HA COATED 12X35 MM CALCAR REP. STEM COCRMO PC+HA COATED 12X45 MM CALCAR REP. STEM COCRMO PC+HA COATED 14X25 MM CALCAR REP. STEM COCRMO PC+HA COATED 14X35 MM CALCAR REP. STEM COCRMO PC+HA COATED 14X45 MM CALCAR REP. STEM COCRMO PC+HA COATED 16X25 MM CALCAR REP. STEM COCRMO PC+HA COATED 16X35 MM CALCAR REP. STEM COCRMO PC+HA COATED 16X45 MM CALCAR REP. STEM COCRMO PC+HA COATED 18X25 MM CALCAR REP. STEM COCRMO PC+HA COATED 18X35 MM CALCAR REP. STEM COCRMO PC+HA COATED 18X45 MM Centraliser Barcode 8698673443143 8698673443150 8698673443167 8698673443174 8698673443181 8698673443198 8698673443204 8698673443211 8698673443228 8698673443235 8698673443242 8698673443259 8680858424757 8680858424764 8680858424771 Plug X-Ray Ring Code 10932591210 10933591210 10934591210 10932591212 10933591212 10934591212 10932591214 10933591214 10934591214 10932591216 10933591216 10934591216 10932591218 10933591218 10934591218 42 Surgical Technique 1 FEMORAL HEAD OSTEOTOMY 1st osteotomy is made to the femoral shaft over 1.5-2 cm of trochanter minor with the angle of 90°. If the trochanter exists, the 2nd osteotomy is made endlong to the first cut from the trochanter tip. The cut femoral head is removed from acetabulum by Femoral Head Extractor. 2 FEMORAL HEAD MEASUREMENT The width of the cut femural head is determined by Femoral Head Measuring Device. 3 ACCESS TO MEDULLA CANAL Access to the medullary cavity from osteotomy line is obtained with Box Chiesel. Note: Please pay attention to femoral head anteversion. 43 4 CARVING OPERATION FOR FEMORAL STEM Entry is made from piriformis fossa to medulla by the starting reamer. It is carved until reaching to the proper canal width by a Reamer which is assembled to T Quick Handle from trochanteric tip to femoral shaft. Note: To make the reamer choice, the smallest size should be tried in the beginning and the size should be increased gradually. The last reamer size demonstrates the stem size. 5 RASPING Rasping operation (considering anteversion) is started with the smallest Rasp which is fixed to NT Rasp Holder. Before rasping, the suitable Calcar Resection Marker to the calcar length is fixed to the rasp. The rasping operation is proceeded until attaining sufficient bone strength by using incremental lengths. The recent used Rasp determines the Stem length. Note: Different rasps are used for Cemented and Cementless applications. Please refer to pg 45 for application with A. Unipolar Head. Please refer to pg 48 for application with Bipolar Head. 44 A. Unipolar Head Application 6 A. UNIPOLAR TRIAL Width of A.Unipolar Trial is determined by femoral head measurement (Section 2). Then A.Unipolar Trial is fixed to A.Unipolar Trial Holder and the suitability with acetabulum is tested. 7 RING SIZE DETERMINATION After designating the size of A.Unipolar Trial, it is placed onto A.Unipolar Ring Trial which is held to the rasp in order to determine the suitability of the ring size. 8 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 45 9 REMOVING RING TRIAL From the Rasp The Ring Trial which is fixed to the Rasp is extracted by Stem Ring Extractor as in the figure. Please rotate the instrument until trials are extracted. From the A.Unipolar Trial The Ring Trial which is fixed to A.Unipolar Trial is extracted by A.Unipolar Ring Extractor as in the figure. Please rotate the instrument until the ring is extracted. 10 PLUG PLACEMENT for Cemented Applications Before the application of cement, the medulla is closed by Plug which is assembled to the Plug Holder. The Plug Holder is advanced until the marked part that indicates stem length. 46 11 PLACEMENT OF THE STEM Centraliser for Calcar fixed to distal part of the Stem. The Stem is fixed to Rotation Controlled Stem Impactor which is fixed to rotation controlled Anteversion Rod and it is positioned considering anteversion angle. In cemented applications, position of the stem is kept constant until the cement is solidified. 11 HAMMERING OF STEM In cementless applications, the Stem Impactor ensures an exact placement of the stem. 12 A. UNIPOLAR HEAD FIXING A.Unipolar Head which is placed onto A.Unipolar Ring -after designating the size by trials- is hammered and fixed by Femoral Head Impactor. 47 Bipolar Head Application 6 BIPOLAR TRIAL The width of Bipolar Trial Head is determined (Section 2). It is fixed to Bipolar Trial Head Holder and the suitability with acetabulum is tested. 7 MODULAR HEAD SIZE DETERMINATION After designating the size of Bipolar Trial Head, it is placed onto Modular Trial Head which is held to the rasp in order to determine the suitability of the Modular Head size. 8 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 48 9 MODULAR TRIAL HEAD EXTRACTION Modular Trial Head which is fixed to Rasp is extracted by Modular Trial Head Extractor as in the figure. Please rotate the instrument until the trials are extracted. 10 PLUG PLACEMENT for Cemented Applications Before the application of cement, the medulla is closed by Plug which is assembled to the Plug Holder. The Plug Holder is advanced until the marked part that indicates stem length. 11 PLACEMENT OF THE STEM Centraliser for Calcar fixed to distal part of the Stem. The Stem is fixed to Rotation Controlled Stem Impactor which is fixed to rotation controlled Anteversion Rod and it is positioned considering anteversion angle. In cemented applications, position of the stem is kept constant until the cement is solidified. 49 12 HAMMERING STEM In cementless applications, the Stem Impactor ensures an exact placement of the stem. 13 MODULAR HEAD FIXING After designating the size of Modular Head by trials, it is hammered by Modular Head Impactor. 14 BIPOLAR HEAD PLACEMENT The Segman is extracted from Bipolar Head by Bipolar Insert Ring Forceps then Bipolar Head placed into Modular Head and pushed until ‘click’ sound is heard. The extracted Segman is placed again. APPLICATION WITH THE CABLE SYSTEM By means of holes in proximal of the stem, the trochanter fractures are fixed with a cable system. 50 ARTHROM ® ARTHROM ® Made of titanium alloy Suitable design for femoral anterior anatomy 135˚ neck angle 14 different stem size 6 different body size 84 different combination Antirotational stem shape Application with cable system Uncoated, Porous (PC), Hydroxyapatite (HA) and double coated (PC+HA) stem options It could be used safely even in cases with unstable trochanter. Compatible distal design to femoral anterior anatomy. 3 different length options and 7 different diameter options for the stem; 2 different width options and 4 different length options exist for the body to ensure compatibility to different bone structures. Star shaped stem ensures antirotational feature and total fit to the bone. Cable system can be applied by means of holes in the body. Uncoated, Porous (PC), Hydroxyapatite (HA) and double coating (PC+HA) options are available. 53 Implants 12029006045 12029006055 12029006065 12029007555 12029007565 12029007575 8680858416875 8680858416646 8680858416653 8680858416660 8680858416677 8680858416684 ARTHROM BODY POROUS SMALL 45 ARTHROM BODY POROUS SMALL 55 ARTHROM BODY POROUS SMALL 65 ARTHROM BODY POROUS STAND. 55 ARTHROM BODY POROUS STAND. 65 ARTHROM BODY POROUS STAND. 75 12021013100 12021013140 12021114100 12021114140 12021215100 12021215014 12021316100 12021316014 8680858412464 8680858412471 8680858412488 8680858412495 8680858412501 8680858412518 8680858412525 8680858412532 ARTHROM STEM NARROW JUNCTION PC+HA 13X100 ARTHROM STEM NARROW JUNCTION PC+HA 13X140 ARTHROM STEM NARROW JUNCTION PC+HA 14X100 ARTHROM STEM NARROW JUNCTION PC+HA 14X140 ARTHROM STEM NARROW JUNCTION PC+HA 15X100 ARTHROM STEM NARROW JUNCTION PC+HA 15X140 ARTHROM STEM NARROW JUNCTION PC+HA 16X100 ARTHROM STEM NARROW JUNCTION PC+HA 16X140 12021316180 12021417140 12021518140 12021518180 12021720140 12021720180 8680858412402 8680858412419 8680858412426 8680858412433 8680858412440 8680858412457 ARTHROM STEM LARGE JUNCTION PC+HA 16X180 ARTHROM STEM LARGE JUNCTION PC+HA 17X140 ARTHROM STEM LARGE JUNCTION PC+HA 18X140 ARTHROM STEM LARGE JUNCTION PC+HA 18X180 ARTHROM STEM LARGE JUNCTION PC+HA 20X140 ARTHROM STEM LARGE JUNCTION PC+HA 20X180 54 Instruments tray 1 No Code 1 2 3 4 00000109100 01192000005 02061401310 02061401411 02061401512 02061401613 02061401714 02061801613 02061401815 02061402017 02061000200 02061000300 02010300045 01193000023 00560270180 Barcode Description 8680858419197 8698673490390 8680858406531 8680858406296 8680858406319 8680858406333 8680858406357 8680858406340 8680858406364 8680858406371 8680858416301 8680858416318 8680858417315 8698673493780 8699931023152 ARTHROM 1. DESIGN TRAY BOX CHISEL REAMER ARTHROM STEM 13X140 MM REAMER ARTHROM STEM 14X140 MM REAMER ARTHROM STEM 15X140 MM REAMER ARTHROM STEM 16X140 MM REAMER ARTHROM STEM 17X140 MM REAMER ARTHROM STEM 16X180 MM REAMER ARTHROM STEM 18X180 MM REAMER ARTHROM STEM 20X180 MM ARTHROM BODY REAMER STANDART 55-65-75 MM ARTHROM BODY REAMER SMALL 55-65 MM ARTHROM BODY REAMER SMALL 45 MM T QUICK HANDLE CONTAINER 560X270X180 MM 3 55 2 Qty. 1 4 1 1 1 1 1 1 1 1 1 1 1 1 1 tray 2 No Code 5 6 7 8 00000109200 02062295575 02062296575 02062297575 02062394560 02062395560 02062396560 02050000110 01193001009 02050001011 12022000200 12022000245 8 Barcode 8680858419203 8680858406234 8680858406258 8680858406265 8680858416295 8680858406227 8680858406241 8680858416271 8699931028140 8680858416325 8680858416332 8680858416349 6 Description ARTHROM 2.DESIGN TRAY RASP ARTHROM BODY PC&HA STD. 55 MM RASP ARTHROM BODY PC&HA STD. 65 MM RASP ARTHROM BODY PC&HA STD. 75 MM RASP ARTHROM BODY PC&HA SMALL 45 MM RASP ARTHROM BODY PC&HA SMALL 55 MM RASP ARTHROM BODY PC&HA SMALL 65 MM ARTHROM RASP HOLDER BONE HAMMER - LARGE ARTHROM SCREW BOX ARTHROM JUNCTION BOLT STANDARD ARTHROM JUNCTION BOLD (45 MM BODY) 5 Qty. 1 1 1 1 1 1 1 1 1 3 3 7 56 tray 3 No Code 00000109300 9 02022394560 02022395560 02022396560 02022295575 02023296575 02023297575 10 02020910100 02020910140 02020911100 02020911140 02020912100 02020912140 02020913100 02020913140 01212016180 02020914100 02020915140 01212018180 02020917140 01212020180 Barcode 8680858419210 8680858416363 8680858405978 8680858405992 8680858405985 8680858406005 8680858406012 8680858416479 8680858416486 8680858416493 8680858416509 8680858416516 8680858416523 8680858416530 8680858416547 8680858430727 8680858416554 8680858416561 8680858430734 8680858416578 8680858430741 Description ARTHROM 3.DESIGN TRAY ARTHROM BODY TRIAL PC&HA SMALL 45 MM ARTHROM BODY TRIAL PC&HA SMALL 55 MM ARTHROM BODY TRIAL PC&HA SMALL 65 MM ARTHROM BODY TRIAL PC&HA STD. 55 MM ARTHROM BODY TRIAL PC&HA STD. 65 MM ARTHROM BODY TRIAL PC&HA STD. 75 MM ARTHROM TRIAL STEM PC&HA 13X100 MM ARTHROM TRIAL STEM PC&HA 13X140 MM ARTHROM TRIAL STEM PC&HA 14X100 MM ARTHROM TRIAL STEM PC&HA 14X140 MM ARTHROM TRIAL STEM PC&HA 15X100 MM ARTHROM TRIAL STEM PC&HA 15X140 MM ARTHROM TRIAL STEM PC&HA 16X100 MM ARTHROM TRIAL STEM PC&HA 16X140 MM ARTHROM TRIAL STEM PC&HA 16X180 MM ARTHROM TRIAL STEM PC&HA 17X140 MM ARTHROM TRIAL STEM PC&HA 18X140 MM ARTHROM TRIAL STEM PC&HA 18X180 MM ARTHROM TRIAL STEM PC&HA 20X140 MM ARTHROM TRIAL STEM PC&HA 20X180 MM 9 57 10 Qty. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 tray 4 No Code 11 12 13 14 15 16 17 18 19 20 00000109400 02065000020 02065000030 02051000010 02062400001 02055010100 02050050012 02050010121 02050010212 02520000050 02055000105 16 15 Barcode 8680858419227 8680858406401 8680858406418 8680858416387 8680858416394 8680858416400 8680858416417 8680858416424 8680858416431 8680858417308 8680858416370 17 Description ARTHROM 4.DESIGN TRAY ARTHROM STEM INSERTER ARTHROM BODY & STEM INSERTER ARTHROM BODY & STEM INSERTER INNER PART ARTHROM SYSTEM EXTRACTOR ARTHROM STEM BODY SEPARATOR TORQUE T HANDLE 5 MM 12 NM TORQUE ANTI-ROTATION INSTRUMENT ANTI ROTATION INSTRUMENT HANDLE STEM IMPACTOR PIN ARTHROM T SCREW DRIVER Ø 5 MM Qty. 1 1 1 1 1 1 1 1 1 1 12 13 18 11 19 20 14 58 Surgical Technique 1 FEMORAL HEAD OSTEOTOMY Osteotomy is made over 1.5-2 cm of trochanter minor to the femoral shaft with the angle of 45°. Femoral head which is cut before is removed from acetabulum by Femoral Head Extractor. 2 FEMORAL HEAD MEASUREMENT The width of the removed femoral head is determined by Femoral Head Measuring Device. 3 ACCESS TO MEDULLA CANAL Access to the medullary cavity from osteotomy line is obtained with Box Chiesel. Note: Please pay attention to femoral head anteversion. 59 4 CARVING OPERATION FOR FEMORAL STEM Entry is made from piriformis fossa to medulla by the starting reamer. It is carved until attaining a proper canal width by a Reamer which is fixed to T Quick Handle from trochanteric tip to femoral shaft - until enough bone resistance is detected-. Note: To make the reamer choice, the smallest size should be tried in the beginning and the size should be increased gradually. The last reamer size demonstrates the stem size. 5 DETERMINING STEM SIZE AND BODY SIZE A marked part behind the threaded part of the reamer demonstrates the body size and the stem size, in patients with trochanter major. A marked part on the thread corresponding to the trochanter minor, demonstrates the stem length in patients with unstable trochanter major. 6 CARVING OPERATION FOR ARTHROM BODY It is carved until attaining a proper canal width by Arthrom Body Reamer which is fixed to T Quick Handle from trochanteric tip to femur shaft- until enough bone resistance is detected-. To make the reamer choice, the smallest size should be tried at the beginning and the size should be increased gradually. The last reamer size demonstrates the stem size. The marked part corresponding to the trochanter tip demonstrates body size as in the figure (Because of a reamer specific to 45 mm body, there is one mark on it). 60 7 RASPING Rasping operation (considering anteversion) is started with the smallest rasp (Rasp Arthrom Body) which is fixed to Arthrom Rasp Holder. The rasping operation is continued until enough bone resistance is detected by increasing lengths gradually. The recent tried Rasp determines the Arthrom Body length. 8.a PLACEMENT OF ARTHROM TRIAL STEM After designating the length of Arthrom Trial Stem by the reamer, it is fixed to Arthrom Stem Inserter. Arrow mark on the Arthrom Stem Inserter could be adjusted to indicate cut part at distal of the stem. So, the direction can be followed while the stem is in the bone. Note: The cut part should be adjusted to the anterior part of the femoral shaft. 8.a PLACEMENT OF THE BODY TRIAL The Arthrom Body Trial which is fixed to Arthrom Body&Stem Inserter is placed to Stem considering anteversion then hammered and fixed with using Arthrom Junction Bolt. 61 8.b PLACEMENT OF THE BODY TRIAL AND THE STEM Cut part of Arthrom Trial Stem is adjusted towards anterior, neck of Arthrom Body Trial is adjusted considering anteversion. They are united and fixed by screwing. Trials which are fixed to Body Stem Inserter with an inner part are placed to the femur. Separation of the Body and Stem To separate the body and stem, Arthrom Stem Body Separator is assembled to the body as in the figure and rotated until separation. Please refer to pg 63 for application with A. Unipolar Head. Please refer to pg 66 for application with Bipolar Head. 62 A. Unipolar Head Application 9 A. UNIPOLAR TRIAL Width of A.Unipolar Trial is determined by femoral head measurement (Section 2). Then A.Unipolar Trial is fixed to A.Unipolar Trial Holder and the suitability with acetabulum is tested. 10 RING SIZE DETERMINATION After designating the size of A.Unipolar Trial, it is placed onto A.Unipolar Ring Trial which is held to the Arthrom Body Trial in order to determine the suitability of the ring size. 11 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 63 12 REMOVING RING TRIAL From the Body Trial The Ring Trial which is fixed to the body trial is extracted by Stem Ring Extractor as in the figure. Please rotate the instrument until trials are extracted. From the A. Unipolar Trial The Ring Trial which is fixed to A.Unipolar Trial is extracted by A.Unipolar Ring Extractor as in the figure. Please rotate the instrument until the ring is extracted. 13.a PLACEMENT OF THE STEM The Arthrom Stem which its length is determined by the trials is fixed to Arthrom Stem Inserter. Arrow mark on the Stem Inserter can be adjusted to indicate the cut part at distal of the stem. So, the direction can be followed while the stem is in the bone. The cut part should be adjusted so as to correspond anterior part of the femoral shaft. 64 13.a PLACEMENT OF THE BODY Body which is fixed to Stem Body Inserter is placed into stem considering anteversion and hammered. The stem is fixed to the body with a Junction Bolt using Antirotation Instrument Handle, Torque Anti-Rotation Instrument and Torque T Handle 5 mm 12 Nm as in the figure and pushed until ‘click’ sound is heard. Note: Junction bolt of 45 mm body is different. 13.b PLACEMENT OF BODY AND STEM The cut part of Arthrom Stem which is adjusted towards anterior, and the neck of Arthrom Body which is adjusted considering anteversion are combined. The stem is fixed to the body with Arthrom Junction Bolt using Antirotation Instrument Handle, Torque Anti-Rotation Instrument and Torque T Handle 5 mm 12 Nm and the bolt is pushed until ‘click’ sound is heard. Arthrom Body&Stem Inserter Part is fixed to Body Stem Inserter. Then the Arthrom Body is fixed to Body Stem Inserter. The stem is placed to the femur and hammered. Note: Junction bolt of 45 mm body is different. 14 A.UNIPOLAR HEAD FIXING A.Unipolar Head which is placed onto A.Unipolar Ring is fixed to the Arhtrom Body by hammering the Femoral Head Impactor. 65 Bipolar Head Application 9 BIPOLAR TRIAL The width of Bipolar Trial Head is determined (Section 2). It is fixed to Bipolar Trial Head Holder and the suitability with acetabulum is tested. 10 MODULAR HEAD SIZE DETERMINATION After designating the size of Bipolar Trial Head, it is placed onto Modular Trial Head which is held to the Arthrom Body Trial in order to determine the suitability of the ring size. 11 MOTION TEST After the trial insertions, the leg motion is controlled to test the size suitability. 66 12 MODULAR HEAD TRIAL EXTRACTION The Modular Trial Head which is fixed to the body trial is extracted by Modular Trial Head Extractor as in the figure. Please rotate the instrument until the trials are extracted. 13.a PLACEMENT OF THE ARTHROM STEM The Arthrom Stem which its length is determined by the trials is fixed to Arthrom Stem Inserter. Arrow mark on the Stem Inserter can be adjusted to indicate the cut part at distal of the stem. So, the direction can be followed while the stem is in the bone. The cut part should be adjusted so as to correspond anterior part of the femoral shaft. 13.a PLACEMENT OF THE ARTHROM BODY Body which is fixed to Stem Body Inserter is placed into stem considering anteversion and hammered. The stem is fixed to the body with a Junction Bolt using Antirotation Instrument Handle, Torque Anti-Rotation Instrument and Torque T Handle 5 mm 12 Nm as in the figure and pushed until ‘click’ sound is heard. Note: Junction bolt of 45 mm body is different. 67 13.b PLACEMENT OF THE ARTHROM BODY AND STEM The cut part of Arthrom Stem which is adjusted towards anterior and the neck of Arthrom Body which is adjusted considering anteversion are combined. The stem is fixed to the body with Arthrom Junction Bolt using Antirotation Instrument Handle, Torque Anti-Rotation Instrument and Torque T Handle 5 mm 12 Nm and the bolt is pushed until ‘click’ sound is heard. Arthrom Body&Stem Inserter Part is fixed to Body Stem Inserter. Then the Arthrom Body is fixed to Body Stem Inserter. The stem is placed to the femur and hammered. Note: Junction bolt of 45 mm body is different. 14 MODULAR HEAD FIXING After designating the size of Modular Head by using the trials, it is fixed to Arthrom Body by Modular Head Impactor. 15 BIPOLAR HEAD PLACEMENT The Segman is extracted from Bipolar Head by Bipolar Insert Ring Forceps then Bipolar Head placed into Modular Head and pushed until ‘click’ sound is heard. The extracted Segman is replaced again. 68 Application with the Cable System By means of holes on the Arthrom Body, the trochanter fractures can be fixed with a cable system. 69 70 A. UNIPOLAR HEAD Instruments No Code 1 2 3 4 5 6 7 8 9 00000501100 01192000010 01190000101 01195000010 01192000011 01192000039 01192000038 01191001416 01071160060 01071160030 01071160000 01071160003 01071160006 01071150040 01071150042 01071150044 01071150046 01071150048 01071150050 01071150052 01071150054 01071150056 8 73 6 Barcode Description 8699931023954 8698673495401 8699931030990 8698673496262 8698673495395 8698673438484 8698673438408 8699931023237 8698673438446 8698673438415 8698673438422 8698673438439 8698673438453 8698673438316 8698673438323 8698673438330 8698673438347 8698673438354 8698673438361 8698673438378 8698673438385 8698673438392 1.DESIGN TRAY FEMORAL HEAD EXTRACTOR FEMORAL HEAD MEASUR.DEVICE BIPOLAR INSERT RING FORCEPS FEMORAL HEAD IMPACTOR STEM RING EXTRACTOR A. UNIPOLAR RING EXTRACTOR A.UNIPOLAR TRIAL HOLDER (12\14-14\16) A. UNIPOLAR RING TRIAL X LARGE A. UNIPOLAR RING TRIAL LARGE A. UNIPOLAR RING TRIAL MEDIUM A. UNIPOLAR RING TRIAL SMALL A. UNIPOLAR RING TRIAL X SMALL A. UNIPOLAR TRIAL 40 MM A. UNIPOLAR TRIAL 42 MM A. UNIPOLAR TRIAL 44 MM A. UNIPOLAR TRIAL 46 MM A. UNIPOLAR TRIAL 48 MM A. UNIPOLAR TRIAL 50 MM A. UNIPOLAR TRIAL 52 MM A. UNIPOLAR TRIAL 54 MM A. UNIPOLAR TRIAL 56 MM 7 4 3 Qty. 5 2 9 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Code Barcode Description A.Unipolar Head Steel 10711501240 10711501242 10711501244 10711501246 10711501248 10711501250 10711501252 10711501254 10711501256 8698673437531 8698673437555 8698673437579 8698673437593 8698673437616 8698673437630 8698673437654 8698673437678 8698673437692 A. UNIPOLAR HEAD STEEL 40 MM 12-14 A. UNIPOLAR HEAD STEEL 42 MM 12-14 A. UNIPOLAR HEAD STEEL 44 MM 12-14 A. UNIPOLAR HEAD STEEL 46 MM 12-14 A. UNIPOLAR HEAD STEEL 48 MM 12-14 A. UNIPOLAR HEAD STEEL 50 MM 12-14 A. UNIPOLAR HEAD STEEL 52 MM 12-14 A. UNIPOLAR HEAD STEEL 54 MM 12-14 A. UNIPOLAR HEAD STEEL 56 MM 12-14 1 1 1 1 1 1 1 1 1 A.Unipolar Ring Steel 10711600006 10711600003 10711600000 10711600030 10711600060 8698673437722 8698673437715 8698673437708 8698673437739 8698673437746 A. UNIPOLAR RING STEEL 12-14 X SMALL A. UNIPOLAR RING STEEL 12-14 SMALL A. UNIPOLAR RING STEEL 12-14 MEDIUM A. UNIPOLAR RING STEEL 12-14 LARGE A. UNIPOLAR RING STEEL 12-14 X LARGE 1 1 1 1 1 A.Unipolar Ring Titanium Implants Qty. 10721600006 10721600003 10721600000 10721600030 10721600060 8698673437777 8698673437760 8698673437753 8698673437784 8698673437791 A. UNIPOLAR RING TITANIUM 12-14 X SMALL A. UNIPOLAR RING TITANIUM 12-14 SMALL A. UNIPOLAR RING TITANIUM 12-14 MEDIUM A. UNIPOLAR RING TITANIUM 12-14 LARGE A. UNIPOLAR RING TITANIUM 12-14 X LARGE 1 1 1 1 1 74 BIPOLAR HEAD Instruments No Code 1 2 3 4 5 6 7 8 9 00000501100 01192000010 01190000101 01195000010 01152000101 01152000102 01194000010 01194420040 01194440040 01194460040 01194480040 01194500040 01194520040 01194540040 01194560040 01194600000 01192800118 01192800218 01192800318 01192800418 01192800518 8 9 77 Barcode 8699931023954 8698673495401 8699931030990 8698673496262 8680858414895 8680858414901 8698673496378 8698673496286 8698673497689 8698673496293 8698673496309 8698673496316 8698673496323 8698673496330 8698673496347 8680858419791 8698673496385 8698673495517 8698673495500 8698673495494 8698673495524 4 6 3 Description Qty. 1.DESIGN TRAY FEMORAL HEAD EXTRACTOR FEMORAL HEAD MEASUR.DEVICE BIPOLAR INSERT RING FORCEPS MODULAR HEAD IMPACTOR MODULAR TRIAL HEAD EXTRACTOR BIPOLAR TRIAL HEAD HOLDER BIPOLAR TRIAL HEAD 42 MM BIPOLAR TRIAL HEAD 44 MM BIPOLAR TRIAL HEAD 46 MM BIPOLAR TRIAL HEAD 48 MM BIPOLAR TRIAL HEAD 50 MM BIPOLAR TRIAL HEAD 52 MM BIPOLAR TRIAL HEAD 54 MM BIPOLAR TRIAL HEAD 56 MM SEGMAN FOR BIPOLAR TRIAL HEAD 28 MM TRIAL HEAD X SMALL 28 MM TRIAL HEAD SMALL 28 MM TRIAL HEAD MEDIUM 28 MM TRIAL HEAD LONG 28 MM TRIAL HEAD X LONG 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 1 1 1 1 1 7 5 1 Code Barcode Description CoCrMo Bipolar Head 11137002840 11137002842 11137002844 11137002846 11137002848 11137002850 11137002852 11137002854 11137002856 11137002858 11137002860 8699931020793 8698673432734 8698673432741 8698673432758 8698673432765 8698673432772 8698673432789 8698673432796 8698673432802 8698673432819 8699931003932 BIPOLAR HEAD COCRMO 28X40 MM BIPOLAR HEAD COCRMO 28X42 MM BIPOLAR HEAD COCRMO 28X44 MM BIPOLAR HEAD COCRMO 28X46 MM BIPOLAR HEAD COCRMO 28X48 MM BIPOLAR HEAD COCRMO 28X50 MM BIPOLAR HEAD COCRMO 28X52 MM BIPOLAR HEAD COCRMO 28X54 MM BIPOLAR HEAD COCRMO 28X56 MM BIPOLAR HEAD COCRMO 28X58 MM BIPOLAR HEAD COCRMO 28X60 MM CoCrMo Modular Head 10730001228 10730051228 10730101228 10730151228 10730201228 8698673431058 8698673431041 8698673431034 8698673431065 8698673434042 MODULAR HEAD COCRMO 28 MM X SMALL 12-14 MODULAR HEAD COCRMO 28 MM SMALL 12-14 MODULAR HEAD COCRMO 28 MM MEDIUM 12-14 MODULAR HEAD COCRMO 28 MM LONG 12-14 MODULAR HEAD COCRMO 28 MM XLONG 12-14 CrNi Bipolar Head 11117002840 11117002842 11117002844 11117002846 11117002848 11117002850 11117002852 11117002854 11117002856 11117002858 11117002860 8698673432826 8698673432833 8698673432840 8698673432857 8698673432864 8698673432871 8698673432888 8698673432895 8698673432901 8698673432918 8698673484818 BIPOLAR HEAD CRNI 28X40 MM BIPOLAR HEAD CRNI 28X42 MM BIPOLAR HEAD CRNI 28X44 MM BIPOLAR HEAD CRNI 28X46 MM BIPOLAR HEAD CRNI 28X48 MM BIPOLAR HEAD CRNI 28X50 MM BIPOLAR HEAD CRNI 28X52 MM BIPOLAR HEAD CRNI 28X54 MM BIPOLAR HEAD CRNI 28X56 MM BIPOLAR HEAD CRNI 28X58 MM BIPOLAR HEAD CRNI 28X60 MM * 1 1 1 1 1 1 1 1 * * CrNi Modular Head Implants Qty. 10710001228 10710051228 10710101228 10710151228 10710201228 8698673431171 8698673431157 8698673431140 8698673431133 8698673431164 MODULAR HEAD CRNI 28 MM X SMALL 12-14 MODULAR HEAD CRNI 28 MM SMALL 12-14 MODULAR HEAD CRNI 28 MM MEDIUM 12-14 MODULAR HEAD CRNI 28 MM LONG 12-14 MODULAR HEAD CRNI 28 MM X LARGE 12-14 1 1 1 1 1 * 1 1 1 1 1 1 1 1 * * 1 1 1 1 1 *optional 78 total HIP prOSTHESIS Cemented Instruments 81 Code Barcode Description Qty. 00000505100 01193000144 01193000146 01193000148 01193000150 01193000152 01193000154 01193000156 01193000158 01193000160 01107002844 01107002846 01107002848 01107002850 01107002852 01107002854 01107002856 01107002858 01107002860 01152000109 01193000023 01192000110 8699931024012 8699931023268 8699931023275 8699931023282 8699931023299 8699931023305 8699931023312 8699931023329 8699931023336 8699931023343 8698673495890 8698673495906 8698673495913 8698673495920 8698673495937 8698673495944 8698673495951 8698673495968 8698673495975 8698673496019 8698673493780 8698673495982 TRAY 1 FOR PRESS FITS ACETABULAR REAMER CEMENTED 44 MM ACETABULAR REAMER CEMENTED 46 MM ACETABULAR REAMER CEMENTED 48 MM ACETABULAR REAMER CEMENTED 50 MM ACETABULAR REAMER CEMENTED 52 MM ACETABULAR REAMER CEMENTED 54 MM ACETABULAR REAMER CEMENTED 56 MM ACETABULAR REAMER CEMENTED 58 MM ACETABULAR REAMER CEMENTED 60 MM ACETABULAR CUP TRIAL 44 MM ACETABULAR CUP TRIAL 46 MM ACETABULAR CUP TRIAL 48 MM ACETABULAR CUP TRIAL 50 MM ACETABULAR CUP TRIAL 52 MM ACETABULAR CUP TRIAL 54 MM ACETABULAR CUP TRIAL 56 MM ACETABULAR CUP TRIAL 58 MM ACETABULAR CUP TRIAL 60 MM ACETABULAR REAMER HOLDER T QUICK HANDLE ACETABULAR TRIAL HOLDER 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 00000501100 01212000111 01192000112 01192000010 01190000101 01152000101 01152000102 01192800118 01192800218 01192800318 01192800418 01192800518 8699931023954 8680858419098 8698673495869 8698673495401 8699931030990 8680858414895 8680858414901 8698673496385 8698673495517 8698673495500 8698673495494 8698673495524 TRAY (545X255X40 MM) FOR BIPOLAR HEADS ACETABULAR CUP POSITIONING DEVICE ACETABULAR CUP INSERTER FEMORAL HEAD EXTRACTOR FEMORAL HEAD MEASUR.DEVICE MODULAR HEAD IMPACTOR MODULAR TRIAL HEAD EXTRACTOR 28 MM TRIAL HEAD XSMALL 28 MM TRIAL HEAD SMALL 28 MM TRIAL HEAD MEDIUM 28 MM TRIAL HEAD LONG 28 MM TRIAL HEAD XLONG 1 1 1 1 1 1 1 1 1 1 1 1 00560270150 8699931010275 CONTAINER 560X270X150 MM Cemented Barcode Description 011070002844 011070002846 011070002848 011070002850 011070002852 011070002854 011070002856 011070002858 011070002860 8698673432925 8698673432932 8698673432949 8698673432956 8698673432963 8698673432970 8698673432987 8698673432994 8698673433007 ACETABULAR CUP 0° 28X44 MM ACETABULAR CUP 0° 28X46 MM ACETABULAR CUP 0° 28X48 MM ACETABULAR CUP 0° 28X50 MM ACETABULAR CUP 0° 28X52 MM ACETABULAR CUP 0° 28X54 MM ACETABULAR CUP 0° 28X56 MM ACETABULAR CUP 0° 28X58 MM ACETABULAR CUP 0° 28X60 MM 1 1 1 1 1 1 1 1 1 Acetabular Cup 10° 011070102844 011070102846 011070102848 011070102850 011070102852 011070102854 011070102856 011070102858 011070102860 8698673433014 8698673433021 8698673433090 8698673433038 8698673433045 8698673433052 8698673433069 8698673433076 8698673433083 ACETABULAR CUP 10°28X44 MM ACETABULAR CUP 10°28X46 MM ACETABULAR CUP 10°28X48 MM ACETABULAR CUP 10°28X50 MM ACETABULAR CUP 10°28X52 MM ACETABULAR CUP 10°28X54 MM ACETABULAR CUP 10°28X56 MM ACETABULAR CUP 10°28X58 MM ACETABULAR CUP 10°28X60 MM 1 1 1 1 1 1 1 1 1 010730001228 010730051228 010730101228 010730151228 010730201228 8698673431058 8698673431041 8698673431034 8698673431065 8698673434042 MODULAR HEAD COCRMO 28 MM X SMALL 12-14 MODULAR HEAD COCRMO 28 MM SMALL 12-14 MODULAR HEAD COCRMO 28 MM MEDIUM 12-14 MODULAR HEAD COCRMO 28 MM LONG 12-14 MODULAR HEAD COCRMO 28 MM XLONG 12-14 1 1 1 1 1 Acetabular Cup 0° Code CoCrMo Moduler Head Implants Qty. 82 Cementless Instruments No Code 1 2 3 4 00000505100 01193000044 01193000046 01193000048 01193000050 01193000052 01193000054 01193000056 01193000058 01193000060 01192440021 01192460021 01192480021 01192500021 01192520021 01192540021 01192560021 01192580021 01192600021 01152000109 01193000023 2 83 Barcode Description 8699931024012 8698673496040 8698673496057 8698673496064 8698673496071 8698673496088 8698673496095 8698673496101 8698673497672 8698673496125 8698673494763 8698673494756 8698673494749 8698673494732 8698673494725 8698673494718 8698673494701 8698673494695 8698673494688 8698673496019 8698673493780 TRAY 1 FOR PRESS FITS ACETABULAR REAMER CEMENTLESS 44 MM ACETABULAR REAMER CEMENTLESS 46 MM ACETABULAR REAMER CEMENTLESS 48 MM ACETABULAR REAMER CEMENTLESS 50 MM ACETABULAR REAMER CEMENTLESS 52 MM ACETABULAR REAMER CEMENTLESS 54 MM ACETABULAR REAMER CEMENTLESS 56 MM ACETABULAR REAMER CEMENTLESS 58 MM ACETABULAR REAMER CEMENTLESS 60 MM PRESFIT TRIAL HEAD 44 MM PRESFIT TRIAL HEAD 46 MM PRESFIT TRIAL HEAD 48 MM PRESFIT TRIAL HEAD 50 MM PRESFIT TRIAL HEAD 52 MM PRESFIT TRIAL HEAD 54 MM PRESFIT TRIAL HEAD 56 MM PRESFIT TRIAL HEAD 58 MM PRESFIT TRIAL HEAD 60 MM ACETABULAR REAMER HOLDER T QUICK HANDLE 3 Qty. 4 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 Cementless Instruments No Code 5 6 7 8 9 10 11 12 13 00000505200 00000507100 01135004460 01135104460 01135014460 01137004400 01137004650 01137005256 01137005860 01192800118 01192800218 01192800318 01192800418 01192800518 01192000010 01190000101 01152000102 01152000101 10 Barcode Description 8699931024029 8680858433551 8680858433568 8680858433605 8680858433575 8680858433513 8680858433520 8680858433537 8680858433544 8698673496385 8698673495517 8698673495500 8698673495494 8698673495524 8698673495401 8699931030990 8680858414901 8680858414895 TRAY 2 FOR PRESS FITS INSERT TRIAL BOX 0° INSERT HOLDER 10° INSERT HOLDER INSERT TRIAL HOLDER INSERT FOR ANAT. PRESS FIT CUP TRIAL INSERT FOR ANAT. PRESS FIT CUP TRIAL INSERT FOR ANAT. PRESS FIT CUP TRIAL INSERT FOR ANAT. PRESS FIT CUP TRIAL 28 MM TRIAL HEAD XSMALL 28 MM TRIAL HEAD SMALL 28 MM TRIAL HEAD MEDIUM 28 MM TRIAL HEAD LONG 28 MM TRIAL HEAD XLONG FEMORAL HEAD EXTRACTOR FEMORAL HEAD MEASUR.DEVICE MODULAR TRIAL HEAD EXTRACTOR MODULAR HEAD IMPACTOR 7 8 13 Qty. 12 11 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 44 MM 46-48-50MM 52-54-56MM 58-60 MM 6 5 9 84 Cementless Instruments No Code 00000505300 14 01135024460 15 02231220025 02231225025 02231230025 02231235025 02231240025 02231245025 16 01192000013 17 01192000034 18 02020818035 19 02010101002 20 01212000112 21 02271011060 22 01192000008 23 01192000006 24 00000507200 25 21221200065 21221250065 21221300065 21221350065 21221400065 21221450065 26 03020000115 27 21221700000 00560270150 Barcode Description 8699931024036 8680858433582 8698673473188 8698673473195 8698673473201 8698673473218 8698673473225 8698673473232 8698673495371 8698673493544 8680858427468 8698673493308 8680858419258 8680858431922 8698673495784 8698673495456 8680858433599 8698673433106 8698673433113 8698673433120 8698673433137 8698673433144 8698673433151 8698673493353 8698673433410 8699931010275 TRAY 3 FOR PRESS FITS INSERT TRIAL EXTRACTOR QUICK DRILL 20 MM QUICK DRILL 25 MM QUICK DRILL 30 MM QUICK DRILL 35 MM QUICK DRILL 40 MM QUICK DRILL 45 MM FLEXIBLE DRILL HOLDER UNIVERSAL SCREW DRIVER 3.5 SCREW DRIVER QUICK TIP Ø3.5X8X180 MM SOFT SCREW DRIVER QUICK LARGE PRESS FIT CUP INSERTER POSITIONING PIN DRILL GUIDE ACETABULAR DEPTH GAUGE ACETABULUM SCREW BOX ACETABULUM SCREW SELFT CANCEL. 20 MM ACETABULUM SCREW SELFT CANCEL. 25 MM ACETABULUM SCREW SELFT CANCEL. 30 MM ACETABULUM SCREW SELFT CANCEL. 35 MM ACETABULUM SCREW SELFT CANCEL. 40 MM ACETABULUM SCREW SELFT CANCEL. 45 MM PENSET PRESS FIT CUP SCREW CONTAINER 560X270X150 MM 14 22 17 18 16 23 85 15 Qty. 19 20 21 26 24 25 27 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 3 3 3 3 3 3 1 4 Cementless Code Barcode Description Insert 11370004400 11370004650 11370005256 11370005860 11370104400 11370104650 11370105256 11370105860 8680858420476 8680858420483 8680858420490 8680858420506 8680858420513 8680858420520 8680858420537 8680858420544 INSERT FOR ANAT. PRESS FIT CUP 0° 44 MM UHMWPE INSERT FOR ANAT. PRESS FIT CUP 0° 46-48-50 MM UHMWPE INSERT FOR ANAT. PRESS FIT CUP 0° 52-54-56 MM UHMWPE INSERT FOR ANAT. PRESS FIT CUP 0° 58-60 MM UHMWPE INSERT FOR ANAT. PRESS FIT CUP 10° 44 MM UHMWPE INSERT FOR ANAT. PRESS FIT CUP 10° 46-48-50 MM UHMWPE INSERT FOR ANAT. PRESS FIT CUP 10° 52-54-56 MM UHMWPE INSERT FOR ANAT. PRESS FIT CUP 10° 58-60 MM UHMWPE 1 1 1 1 1 1 1 1 Press Fit Cup 11224000044 11224000046 11224000048 11224000050 11224000052 11224000054 11224000056 11224000058 11224000060 8680858420384 8680858420391 8680858420407 8680858420414 8680858420421 8680858420438 8680858420445 8680858420452 8680858420469 ANAT. PRESS FIT CUP PC & HA COATED 44 MM ANAT. PRESS FIT CUP PC & HA COATED 46 MM ANAT. PRESS FIT CUP PC & HA COATED 48 MM ANAT. PRESS FIT CUP PC & HA COATED 50 MM ANAT. PRESS FIT CUP PC & HA COATED 52 MM ANAT. PRESS FIT CUP PC & HA COATED 54 MM ANAT. PRESS FIT CUP PC & HA COATED 56 MM ANAT. PRESS FIT CUP PC & HA COATED 58 MM ANAT. PRESS FIT CUP PC & HA COATED 60 MM 1 1 1 1 1 1 1 1 1 CoCrMo Moduler Head 10730001228 10730051228 10730101228 10730151228 10730201228 8698673431058 8698673431041 8698673431034 8698673431065 8698673434042 MODULAR HEAD COCRMO 28 MM X SMALL 12-14 MODULAR HEAD COCRMO 28 MM SMALL 12-14 MODULAR HEAD COCRMO 28 MM MEDIUM 12-14 MODULAR HEAD COCRMO 28 MM LONG 12-14 MODULAR HEAD COCRMO 28 MM XLONG 12-14 1 1 1 1 1 CrNi Moduler Head Implants Qty. 10710001228 10710051228 10710101228 10710151228 10710201228 8698673431171 8698673431157 8698673431140 8698673431133 8698673431164 MODULAR HEAD CRNI 28 MM X SMALL 12-14 MODULAR HEAD CRNI 28 MM SMALL 12-14 MODULAR HEAD CRNI 28 MM MEDIUM 12-14 MODULAR HEAD CRNI 28 MM LONG 12-14 MODULAR HEAD CRNI 28 MM XLARGE 12-14 1 1 1 1 1 86 Surgical Technique 1 FEMORAL HEAD OSTEOTOMY Osteotomy is made over 1.5-2 cm of trochanter minor toward the femoral shaft with the angle of 45°. Femoral head which is cut before, removed from acetabulum by the Femoral Head Extractor. 2 RASPING Acetabulum is started to reaming by the smallest Acetabulum Reamer considering the anteversion. Reaming is continued by increasing reamer sizes until blood clots are seen on subchondral bone. Rasps and trials of Acetabular Cup (Cemented System) and Press Fit Cup (Cementless System) are in different sizes. 3 TRIAL After the carving operation, the size of the acetabulum is controlled with the recent used of the trial reamer size. 87 4.a PLACEMENT OF ACETABULAR CUP (Cemented) Cement is dressed into the acetabulum until ensuring the thickness of 2 mm. Positioning Pins are fixed to the Acetabular Cup Inserter. Acetabular Cup is positioned according to 45° of abduction. 45° When upper Positioning Pin is vertical to the ground, acetabular cup should be in 12° anterior flexion position. It is hold stable until the cement becomes harden. The excessive cement spilled over from the edge is cleaned. Following drying of the cement, it is continued with Modular Trial Head. 12° 4.b 45° PLACEMENT OF PRESS FIT CUP (Cementless) Positioning Pins are assembled to Press Fit Cup Inserter which is positioned according to 45° abduction. 88 When the upper Positioning Pin becomes vertical to the ground, Press Fit Cup should be in 12° flexion position towards anterior. 12° 5 DRILLING The screw way is opened using Flexible Drill with the help of Drill Guide to fix Press Fit Cup which is already in the proper position. 6 MEASUREMENT OF SCREW LENGTH Screw length is determined by using the drill length or Acetabular Depth Gauge. 7 LOCKING The suitable screw is screwed by using Universal Screw Driver 3.5. The screw settlement should be done carefully to the screw holes. In case of a disjointedness, Insert for Anat. Pres Fit Cup will not settle to the Press Fit Cup. Please pay attention to not to tighten screws excessively. Lastly, the hole in the middle is closed by using Press Fit Cup Screw. 89 Press Fit Cup Screw 8 INSERT AND MODULAR HEAD TRIAL Proper modular head size is determined with the help of Modular Trial Head by fixing the Insert Trial. 9 INSERT TRIAL EXTRACTION After determination of modular head size, Insert Trial is extracted by Insert Trial Extractor. 10 INSERT FIXATION Insert Holder and Insert are fixed to Acetabular Cup. Femoral stem is inserted according to the technique. The femoral head is placed on the stem. After hip reduction, the compatibility of the prosthesis is tested through the range of joint motion. The stability and leg lengths are examined as well. 90 Warning: This descriptive catalog is not sufficient as being unaided for proper use of the products intraoperatively. It is highly recommended that implantation and instrument sets must be used by a surgeon who is trained-experienced about the product performances and usage. 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