gription® tf

Transcription

gription® tf

GRIPTION TF
®
Acetabular Revision Solutions
DESIGN RATIONALE /
SURGICAL TECHNIQUE
TABLE OF CONTENTS
DESIGN RATIONALE
Introduction6
System Overview
SURGICAL TECHNIQUE
ORDERING INFORMATION
7
Advanced Material
10
Advanced Fixation
12
Increased Compatibility
17
Advanced Instrumentation
18
Key Bone Stock and Landmark Considerations
20
Acetabular Preparation
21
Implant Insertion
24
Implant Options
32
Screw Options
33
Instruments35
GRIPTION® TF Acetabular Revision Solutions Design Rationale/Surgical Technique DePuy Synthes Joint Reconstruction 3
GRIPTION TF Acetabular System
®
Filling the gap in acetabular revision surgery
Advanced
Material
Advanced
Instrumentation
Advanced
Fixation
DESIGN RATIONALE
INTRODUCTION
DePuy Synthes Joint Reconstruction’s* 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 shell
system and advanced bearing options – the result is a
potential winning solution to help restore motion for
today’s revision patient.
6 DePuy Synthes Joint Reconstruction GRIPTION® TF Acetabular Revision Solutions Design Rationale / Surgical Technique
SYSTEM OVERVIEW
AUGMENT
The GRIPTION® TF Augments are designed to act as a
defect filling implant in the case of severe bone loss in
the acetabulum.
Advanced
geometry
provides
increased
surface area
for bone
contact.
Screw holes
engineered to
maximize fixation
capability. 5.5 mm
locking or 5.0 mm
non-locking screws
can be utilized on the
outer rim.
Proprietary TRUEBOND™ Locking Slot
to help mechanically secure Augment to
acetabular shell using a PINNACLE 6.5
mm Bone Screw. Additionally bone
cement can be used along with the
screw for hybrid fixation, or cement
only can be used. See pages 10 - 11 for
more information.
Tight radius inner
diameter to achieve
precise fit with shell.
Screwhole cutaways designed
to optimize fit with PINNACLE
Shell System.
GRIPTION® TF Acetabular Revision Solutions Design Rationale / Surgical Technique DePuy Synthes Joint Reconstruction 7
SYSTEM OVERVIEW
BUTTRESS
The GRIPTION TF Buttress is designed to support the shell
in a similar manner as the Augments. It is important to
note the Buttress implant spans the defect in the
acetabulum and must be cemented to the shell.
Tapered curved surface for
ease of implantation
Screw holes for use with 5.5 mm
locking/5.0 mm nonlocking screws
Screw holes for use with
PINNACLE 6.5 mm Bone Screws.
Curved spherical radius to mate
with Acetabular Shell
Neutral, left and right configurations
available for different implant positioning
SHIM
The GRIPTION TF Shim Implants are designed
to mate with the Buttress via cement to raise the end
of the Buttress when pelvic geometries require support.
Oversized holes for clearance of
locking/non-locking screws
Available in 5, 10 and 15
degree configurations
ADVANCED MATERIAL
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 initial scratch fit.
Advanced
Material
Advanced
Instrumentation
Advanced
Fixation
Coefficient of Friction
1.02
1.00
0.98
0.96
0.94
0.92
0.90
0.88
0.86
0.84
0.82
0.04
0.02
0.0
GRIPTION TF
Material1*
Trabecular Metal™
Material2
*Note: The Coefficient of Friction for the
GRIPTION TF Material is representative
of the high end of the specification.
Competitive Comparison
Compressive
Yield Strength
Compressive
Yield Strength
Young’s Modulus
GPa
MPa
20
60
50
15
40
10
30
20
5
10
0
GRIPTION TF Trabecular
Material1
Metal™
Material3
Cortical5
Bone
Cancellous4
Bone
0
GRIPTION TF
Material1
Trabecular Metal™
Material3
ADVANCED FIXATION
CEMENTED
Advanced
Material
Advanced
Instrumentation
Advanced
Fixation
Cemented
Note: The Buttress must always be
cemented to the shell
CEMENTED, CEMENTLESS,
OR HYBRID FIXATION OPTIONS
TRUEBOND
Cementless Technology*
Prior to the availability of the GRIPTION TF Augments,
the only method of fixating the Augment to the shell
was with bone cement. The introduction of the
GRIPTION TF Augments allow surgeons to select
between cementless, cemented, and hybrid options
of Augment to shell fixation.
Cemented
Hybrid
Fixation*
*The TRUEBOND Cementless Technology and hybrid fixation is achieved
using a 6.5 mm PINNACLE Bone Screw from the shell to the augment.
ADVANCED FIXATION
LOCKING SCREW OPTION
GRIPTION TF Implants have the ability to use locking
screws to fixate Augments and Buttresses to the host
bone. The Locking Screw Mechanism helps prevent the
screw from becoming loose and backing out of the
implant. This helps eliminate the risk of compromising
fixation as a result of screw migration. In addition,
GRIPTION TF Augments allow surgeons to implant
diverging locking screws for even stronger fixation to the
host bone.
5.5 mm Locking Screws can be utilized in the inner
diameter of the augment as well as on the outer rim as
shown in the image.
When using with Buttresses, 5.5 mm Locking screws can
be utilized in the proximal four screw holes of the
Buttress.
Note: Locking Screws should not be placed in the
Truebond Locking Slot of the Augment. The
TRUEBOND Locking Slot is only compatible with a
6.5 mm PINNACLE Bone Screw.
SCREW PLACEMENT
5.0 mm non-locking screw or 5.5 mm polyaxial locking screw
6.5 mm
PINNACLE
Cancellous
Bone Screw
5.5 mm polyaxial locking screw
Note: On the 10 mm thick
augments the two outside holes
on the outer periphery are for
Threaded Headed pin
placement only. Do not place
screws through these two holes.
5.5 mm Gription TF Locking or 5.0 mm
Peripheral Non-Locking Screws
Oversized through-holes on the Shims
allow for the 5.5 mm Gription TF
Locking or the 5.0 mm Peripheral NonLocking Screws to pass through.
6.5 mm PINNACLE Bone Screws ONLY
Note: The 6.5 mm PINNACLE Bone Screw is only used in the event of Mechanical Screw Fixation of the
Augment to the Cup. This screw will go from the PINNACLE Cup into the Augment TRUEBOND Slot.
ADVANCED FIXATION
NON-LOCKING SCREW OPTION
The option is also available for 5.0 mm PINNACLE NonLocking Screws to be placed on the flat outer rim of the
augment and the proximal four screw holes of the
Buttress.
Note: Do not place PINNACLE Non-Locking Screws
in the inner diameter screw holes of the Augment.
The only time a screw is used with the TRUEBOND
Locking Slot of the Augment is for mechanical
fixation of the PINNACLE Cup to the GRIPTION TF
Augment.
INCREASED COMPATIBILITY
The DePuy Synthes Joint Reconstruction GRIPTION TF
Augments are compatible with the PINNACLE Hip
Solutions Acetabular System. The PINNACLE Hip
Solutions portfolio provides the largest selection of
advanced bearing technologies. With more implant
designs and choices than any competitive system,
surgeons won’t have to compromise when meeting the
individual needs of patients.
Deep Profile
Revision
Standard Profile Revision
Multi-Hole
Sector
100 series
ADVANCED INSTRUMENTATION
The GRIPTION TF Revision System allows surgeons to
select two methods of preparing the acetabular bone
with their choice of modular or finishing rasps.
Advanced
Material
The instruments for the GRIPTION TF System were
designed to provide ease of use and consistency for the
surgeon and OR team. The finishing rasps, modular rasps,
and accompanying PINNACLE Cup Instrumentation allow
for an increased conformity between the prepared bone
and the implant.
Advanced
Instrumentation
Advanced
Fixation
Finishing rasp
Modular rasp
Half Shell Trial
GRIPTION TF SURGICAL TECHNIQUE
RADIOGRAPHIC LANDMARKS
Radiographic landmarks can be 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.
ANATOMIC LANDMARKS
1.Acetabular teardrop – integrity of medial wall and
inferior portion of anterior and posterior column
2.Kohler’s line – integrity of medial wall and superior
anterior column
3.Ischial lysis – integrity of posterior wall
and posterior column
BONE STOCK CONSIDERATIONS
Completely supportive acetabulum:
PINNACLE Hip Solutions Shell
Partially supportive acetabulum:
PINNACLE Hip Solutions Shell
with GRIPTION TF Augments
Non-Supportive acetabulum:
PINNACLE Hip Solutions Shell with possible need for
Augment, Buttress or Cage
PRE-OPERATIVE PLANNING AND TEMPLATING
Using the standard DePuy Synthes Joint Reconstruction
PINNACLE Acetabular Shell Templates, the surgeon can
determine the approximate size of the revision shell that
may be required, including the possibility of jumbo shells
(>66 mm diameter), deep profile shells, or acetabular
Augments. Assessing the acetabular bone stock is of
great importance in helping the surgeon to anticipate the
possible structural defects that may be encountered
during the surgery.
Shell OD
Augment ID
Buttress ID
50, 52
50 mm
56 mm
54, 56
54 mm
56mm
58, 60
58 mm
62mm
62, 64
62 mm
62 mm
66, 68
66 mm
68 mm
70, 72
70 mm
68mm
AUGMENT ACETABULAR PREPARATION
Once the acetabulum has been exposed and evaluated,
preparation for the acetabular construct can begin. Start by
reaming the acetabulum with an undersized reamer at a level
that will restore the appropriate center of rotation. Ream
concentrically with progressively larger reamers – maintaining
appropriate opening abduction and anteversion. Reaming
should stop when adequate rim contact (this is dictated by the
anterior posterior dimensions of the socket) has been obtained
excluding the defect region.
At this point, the surgeon has 2 options for preparing the
acetabular defect to accept the GRIPTION TF Augment:
• Finishing Rasp (most utilized option)
• Modular Rasp
Tip: Occasionally there could be sclerotic bone
hindering seating of rasp. If this is the case a high
speed burr could be utilized to finalize.
AUGMENT ACETABULAR PREPARATION
FINISHING RASP TECHNIQUE
Once the acetabular cavity has been prepared, place the
shell trial into the prepared bed at the correct center of
rotation.
Choose the appropriately sized finishing rasp that
corresponds with your PINNACLE Shell. Start preparing
the acetabular defect by keeping the inside diameter of
the finishing rasp against the outer surface of the
acetabular trial. Rasps should only be utilized over the
shell trial and not over the final shell implant.
Note: Take care to confirm that the connections for
the Strike Plate-Handle and Power Adapter-Handle
have been fully engaged. The button feature will
return to it’s original height and an audible clicking
noise will be apparent. Rasps can be used with
Stryker® Reciprocating Power.
Advance the rasp slowly until the desired seating level is
obtained. The rasp sizes directly match the corresponding
augment trial and final implant. These rasps can be used
to judge the seating of the actual implant. If it appears
that there is not intimate bone contact with the rasp,
increasing to the next thickness of rasp may be necessary,
repeating the steps above until adequate bone contact
has been obtained. Once the defect has been prepared
satisfactorily, tap the appropriate GRIPTION TF Augment
Trial into place.
If the trial is stable, then the defect is appropriately
prepared. If adequate bone contact is not obtained,
or the trial is not stable, further preparation with larger
rasps may be needed.
Tip: For improved stability when rasping, use the
adjustable handle (2217-01-500). Further stability may
be achieved by using screws or headed drill pins in
the trial shell. Placement of the screws or headed drill
pins should be considered. Select holes so that the
screws or pins will lie within the safe quadrant. The
safe quadrant is defined by two lines from the
anterior-inferior iliac spine through the center of the
acetabulum and posterior by a line from the sciatic
notch to the center of the acetabulum.
Tip: Use the threaded
headed pins to stabilize
the augment trial.
MODULAR RASP TECHNIQUE
Once the acetabular cavity has been prepared, utilize the
half shell trial that is undersized by 1 mm from the last
reamer or acetabular trial that was used. Place the trial in
the prepared acetabular cavity at the correct center of
rotation. Attach the modular rasp to the dovetail of the
trial and advance the construct so that the rasp will
prepare the defect appropriately. Starting with the
smallest size rasp, prepare the defect utilizing
progressively larger rasps until the defect has been
satisfactorily prepared to accept the appropriate size
Augment. Rasps can be used on power with the Stryker
Rasping Power Adaptor (2217-01-517), or can be used by
hand utilizing the Rasping Strike Plate (2217-01-516).
Remove the half shell trial and insert the appropriate full
hemispherical acetabular trial. The GRIPTION TF Augment
Trial can now be placed into the defect and can be
tapped into place. If the trial is stable, the defect is
appropriately prepared. If adequate bone contact is not
realized or the trial is not stable, then further preparation
with larger rasps may be needed.
Once appropriate stability has been obtained for the
Augment trial, the definitive Augment is ready to be placed.
AUGMENT INSERTION
Once the acetabulum and acetabular defect have been
prepared to accept the acetabular shell and augment, the
surgeon can decide to first place the acetabular shell and
then the augment, or first place the augment and then the
shell. Placing the acetabular shell prior to the augment
limits access to the screw holes on the inner diameter of
the augment. In addition, at the time of insertion of the
shell and Augment, the surgeon should decide whether
cement fixation or mechanical fixation will be utilized to
attach the Augment to the acetabular shell.
ACETABULAR SHELL-FIRST TECHNIQUE
After preparation of the acetabulum and accompanying
defect has been completed, insert the acetabular shell in
accordance with the PINNACLE Acetabular Shell System
technique.
Note: Acetabular shells should be placed at a
targeted 35-45 degrees of abduction and 15-20
degrees of anteversion based on individual patient
needs and pre-op planning.
The augment can be marked with a line
in the center to represent the center of
the slot
Align the Anti -Rotational Device (ARD)
with the center line of the augment while
impacting the shell, and the slot will line
up with the screw hole.
Use an ARD whose center aligns with the
center of a screw hole. May be helpful to
mark this ARD with a pen.
ACETABULAR SHELL-FIRST
TECHNIQUE (CONTINUED)
A 6.5 mm PINNACLE Bone Screw may be placed at this
point. The surgeon should pay close attention to any shift
in position of the shell that may occur secondary to
placing and tightening down the screws. If the shell
requires placement of the Augment to provide stability of
the construct, tightening the screws before placing the
Augment may shift the shell slightly. This may cause
difficulty in placing the Augment if the acetabular defect
has been prepared in a precise manner. If a shift in
position of the acetabular shell is noted, the screws
should be backed out slightly to allow the appropriate
placement of the Augment and then re-tighten. If the
shell is stable without initial screw fixation the 6.5 mm
PINNACLE Bone Screw can be placed after the Augment
has been inserted.
Drill Bits
Screws
3.8 drill bit
6.5 mm Pinnacle Bone
Screws
5.5 mm Locking
Screws
3.2 drill bit
5.0 mm Non-Locking
Screws
Once the acetabular shell is in place, if Cemented or Hybrid
fixation is desired, place a bead of doughy cement on the
outer surface of the shell prior to placing the Augment.
The Augment inserter tip should be placed on the flat
surface of the Augment in the two center holes. The
Augment can then be tapped into place behind the
acetabular shell and into the prepared defect.
AUGMENT INSERTION
(CONTINUED)
Screw fixation of the Augment can then be performed
using the 5.5 mm locking or 5.0 mm non-locking screws.
The Threaded Headed pins can be used to help stabilize
the Augment during screw insertion if necessary.
Alternatively, the surgical assistant can stabilize the
Augment with the inserter tip until screw fixation is
obtained.
Cementless Option:
If TRUEBOND Cementless Technology fixation is desired, a
standard PINNACLE 6.5 mm Bone Screw can be placed
through the shell and fixation slot of the Augment.
Special care should be taken to ensure that the head of
the screw is fully seated within the acetabular shell.
Tip: • Care should be taken to ensure that the
PINNACLE Screw used to attach the augment
to the cup does not extend beyond the
augment into bone. If the screw extends past
the augment and into bone then there is the
potential to create a gap between the shell and
augment.
•U
se the 3.8 drill bit for the 6.5 mm cancellous
screws.
• Use the 3.8 drill bit for the 5.5 mm locking
screws.
•U
se the 3.2 drill bit (in the PINNACLE
Revision System) for the 5.0 mm non-locking
screws.
AUGMENT-FIRST TECHNIQUE
Following preparation of the acetabulum and
accompanying defect, place the acetabular augment.
Utilize the 90-degree inserter tip on the inside diameter of
the Augment. The Augment can now be impacted into
the defect or held in place with the inserter. Insert the
threaded, headed pins through the holes in the flat face
of the Augment to provide provisional fixation.
Screw fixation utilizing either 5.5 mm locking or 5.0 mm
non-locking screws can now be performed. On the
inside diameter of the Augment, only 5.5 mm
locking screws can be utilized. Special care should be
taken to ensure that the screw heads are fully seated and
flush when utilizing the inner diameter fixation holes.
Note:
• Do not attempt screw fixation through the
center TRUEBOND Slot directly into bone.
• Do not drill into the augment to alter the
shape or add additional screw holes.
• Do not attempt screw fixation in the outer
periphery of the 10 mm thick augments.
These are to be used for pin fixation only.
• Utilize either the straight or 45- degree
drills on the inner diameter screw holes
AUGMENT INSERTION
AUGMENT-FIRST TECHNIQUE
(CONTINUED)
Cemented Option:
If the cemented fixation option is desired, a bead of
doughy cement can now be placed on the inner diameter
of the Augment and the acetabular shell can be impacted
in the standard fashion. A 6.5 mm PINNACLE Bone Screw
can now be used for acetabular shell fixation.
Hybrid Option:
If the hybrid fixation option will be utilized, the shell
should be carefully positioned during impaction so that
the fixation slot of the Augment lines up with an
appropriate dome hole in the Acetabular Shell. The shell
should be impacted utilizing the standard PINNACLE
Acetabular Shell surgical technique. Once the shell is in
position, screw fixation of the shell can be carried out. An
additional 6.5 mm PINNACLE Bone Screw may be placed
through the appropriate dome hole in the shell and
through the fixation slot in the Augment. Special care
should be taken to ensure that this screw head is fully
seated within the inside diameter of the shell.
Tip: Bone wax on the tip of the inserter may assist
holding the Augment on the inserter device (optional).
BUTTRESS AND SHIM INSERTION
In some cases, the acetabular defect will require a
Buttress rather than an Augment in order to provide the
appropriate stabilization of the construct. Once this has
been determined, exposure of the iliac wing is required.
Care should be taken to avoid disruption of the vascular
structures within this area. In most cases a large elevator
can be used to subperiosteally elevate the abductor
musculature from the ilium to adequately allow
placement of the Buttress in the correct position. In
cases where exposure is difficult, it may be necessary to
perform some type of trochanteric osteotomy,
trochanteric slide, or a variant thereof, to aid in exposure
of the iliac wing in the supra-acetabular area.
Once exposure is achieved, similar to the acetabular
preparation of the Augment, the acetabulum should be
reamed to the desired diameter. At this point, if the
defect needs additional preparation for the Buttress
Implant, utilize the GRIPTION TF Rasping System in the
same manner as the Augments, or a high speed burr.
Care should be taken to ensure only necessary bone is
removed to prepare the cavity for the Buttress.
Next, a hemispherical cup trial should be inserted, to
trial alongside the corresponding Buttress trial.
Different Buttress trials should be evaluated to see
which orientation (Left, Right or Neutral) can best
address the defect.
Since pelvic geometries can differ, Shims may be
required to help position the construct as well as raise
and angulate the Buttress. In the event a Shim is
required, trial this alongside the appropriate Buttress.
The Shim trials come in three angle options, a 5°, 10°,
and 15° and can be oriented in 90 degree increments,
which snaps onto the Buttress trial for ease of use.
Tip: Select screws that are longer than the
combined thickness of the Buttress and Shim.
Care should be taken to not perforate the pelvis.
BUTTRESS AND SHIM INSERTION
Once the appropriate position of the Buttress has been
determined, the surgeon has the choice of which to
implant first: The PINNACLE Shell or the Buttress. If the
acetabular shell is placed first, it is impacted in the
standard fashion and supplemental screw fixation is
utilized at this time. If only a Buttress is to be used, a bead
of cement should now be placed on the surface of the
PINNACLE Shell which will contact the inner diameter of
the Buttress. Supplemental screw fixation with the
GRIPTION TF Locking Screws, 5.0 mm Peripheral Screws
and/or the PINNACLE Bone Screws should be used at this
time. It is recommended to use at least 2 screws if possible
for stabilization.
In the event a Shim is also used, after impacting the
PINNACLE Shell, cement the Shim and the Buttress
together outside the wound. Care should be taken to
ensure there is no cement left in between the screw holes,
and that the Shim is positioned in the same manner as
when trialing. Once the cement has cured, continue the
same steps as mentioned above, by adding a bead of
cement to the PINNACLE Shell to insert the Buttress
and/or Shim.
Note: In the event a Shim is used, cement the flat side
which has the etching, to the underside of the Buttress.
The Buttress construct can then be placed and held in
position with the knurled, threaded guide pins while screw
fixation is being performed, or alternately it can be held
manually. PINNACLE 6.5 mm Bone Screws are used in the
two distal holes of the Buttress, closest to the inner diameter.
These screw holes allow for slight divergent placement to aid
in stability and fixation. GRIPTION TF 5.5 mm Locking or the
5.0 mm Peripheral Non-Locking Screws can be used in the
proximal four holes of the Buttress. Care should be taken
when inserting the screws into the Buttress plate to avoid
potential neurovascular injury.
Note: It is recommended to use at least two screws out
of the six possible screw holes if bone allows. See the
Screw Options Chart in this Surgical Technique for
guidance.
BUTTRESS AND SHIM FIRST TECHNIQUE
After the acetabulum is reamed to the desired diameter
place the corresponding acetabular shell trial in place.
Next, trial the defect using the Buttress and/or Shim trials
to best address the defect, in a similar manner described
above. At this point, secure the acetabular trial in place
using either the angled handle along with an assistant to
hold it, or angling the headed pins to keep the shell trial
in place.
To insert the Buttress implant based on the trial that has
been completed, slide this into place against the shell
trial, and secure the implant with the headed threaded
pins while supplemental screw fixation is taking place.
Care should be taken when inserting screws to avoid
neurovascular injury.
Once the Buttress is secure, remove the acetabular shell
trial and add a bead of cement to the inner diameter of
the Buttress. Insert the final PINNACLE Shell into the
acetabulum and utilize screw fixation at this time. Care
should be taken to ensure the Buttress construct has not
moved once the PINNACLE Cup has been inserted.
IMPLANT OPTIONS
GRIPTION TF AUGMENTS
GRIPTION TF BUTTRESSES
1217-10-150
GRIPTION TF Augment size 50/52 x 10
1217-00-156 GRIPTION TF Revision Buttress 56 Neutral
1217-10-154
1217-00-256 GRIPTION TF Revision Buttress 56 Left
1217-10-158
1217-00-356 GRIPTION TF Revision Buttress 56 Right
1217-10-162
1217-10-166
1217-10-170
1217-15-250
1217-15-254
1217-15-258
1217-15-262
1217-15-266
GRIPTION TF SHIMS
1217-15-270
1217-00-105 GRIPTION TF Revision Shim, 5 Degree
1217-20-350
1217-20-354
1217-20-358
1217-20-362
1217-20-366
1217-20-370
1217-30-450
1217-30-454
1217-30-458
1217-30-462
1217-30-466
1217-30-470
SCREW OPTIONS
AUGMENT SCREW OPTIONS
MECHANICAL SCREW FIXATION OPTIONS
5.5 mm GRIPTION TF Locking Screws (Sterile)
6.5 mm PINNACLE Cancellous Screws (Sterile)
1217-25-800 GRIPTION TF Locking Screw 5.5 mm x 25 mm
1217-08-500
PINNACLE Bone Screw 6.5 mm x 8mm
1217-15-500
PINNACLE Bone Screw 6.5 mm x 15 mm
1217-20-500
1217-25-500
1217-30-500
5.0 mm Cancellous Screws (Sterile)
1257-25-000 Cancellous Non-locking Screw 5.0 mm x 25 mm
SCREW OPTIONS
BUTTRESS & SHIM SCREW OPTIONS
5.5 mm Locking Screw Options (Sterile)
1217-14-800
GRIPTION TF 5.5 mm x 14 mm Locking Screw
1217-16-800
1217-18-800
1217-20-800
1217-22-800
1217-24-800
1217-25-800
1217-30-800
MECHANICAL SCREW FIXATION OPTIONS:
BUTTRESSES ONLY
6.5 mm PINNACLE Cancellous Screw Options (Sterile)
1217-08-500 PINNACLE Cancellous Bone Screw 6.5 mm x 8 mm
1217-15-500
PINNACLE Cancellous Bone Screw 6.5 mm x 15 mm
1217-20-500
1217-25-500
1217-30-500
5.0 mm Non-Locking Screw Options (Sterile)
1257-25-000
5.0 mm x 25 mm Tapered Non-locking Screw
1257-30-000
5.0 mm x 30 mm Tapered Non-locking Screw
INSTRUMENTS
CASE ONE
Trial Case – Top Tray
2217-10-150
GRIPTION TF Augment size 50/52x10 Trial
2217-20-350
2217-10-154
2217-20-354
2217-10-158
2217-20-358
2217-10-162
2217-20-362
2217-10-166
2217-20-366
2217-10-170
2217-20-370
2217-15-250
2217-30-450
2217-15-254
2217-30-454
2217-15-258
2217-30-458
2217-15-262
2217-30-462
2217-15-266
2217-30-466
2217-15-270
2217-30-470
INSTRUMENTS
CASE ONE
Trial Case – Bottom Tray
2217-01-517
Rasping Power Adaptor
2217-01-516
Rasping Strike Plate
2217-01-503
Augment Rasping Handle
2217-01-500 Augment Adjustable Handles
CASE ONE
Trial Case – Middle Tray – GRIPTION TF Buttress and Shim Trials
2217-00-156
GRIPTION TF Buttress 56 Neutral Trial
2274-09-000
DURALOC Drill Bit 3.8 Dia 10 mm
2217-00-256
GRIPTION TF Buttress 56 Left Trial
2366-84-000
3.8 mm Drill Bit 25 mm
2217-00-356
GRIPTION TF Buttress 56 Right Trial
2274-12-000
DURALOC Drill Bit 3.8 Dia 40 mm
2217-00-162
2366-85-000
3.8 mm Drill Bit 50 mm
2217-00-262
2217-01-518
Headed Drill PINNACLE 15 mm
2217-00-362
2217-01-519
2217-00-168
2217-01-505
2217-00-268
2217-01-506
2217-00-368
2217-01-507
2217-00-105
GRIPTION TF Shim Trial 5 Degree
2217-01-508
2217-00-110
2217-01-509
2217-00-115
9505-02-071
HP Power PINNACLE Driver
2366-83-000
45-Degree Angle Drill
2217-01-501
Augment Insert Tip Top
2274-36-000
DURALOC Depth Gauge
2217-01-502
Augment Insert Tip 90 Degree
INSTRUMENTS
CASE TWO
Finishing Rasp Case
2217-10-550
Augment Finishing Rasp 50 x 10
2217-20-550
2217-10-554
2217-20-554
2217-10-558
2217-20-558
2217-10-562
2217-20-562
2217-10-566
2217-20-566
2217-10-570
2217-20-570
2217-15-550
2217-30-550
Agument Finishing Rasp 50 x 30
2217-15-554
2217-30-554
2217-15-558
2217-30-558
2217-15-562
2217-30-562
2217-15-566
2217-30-566
2217-15-570
2217-30-570
CASE THREE
Modular Rasp Case
2217-01-550
Augment Modular Rasp 50/52
2217-01-657
Half Shell Trial 57 mm
2217-01-554
2217-01-661
2217-01-558
2217-01-665
2217-01-562
2217-01-669
2217-01-566
2217-01-580
Augment Rasp +5 mm Offset
2217-01-570
2217-01-582
2217-01-649
2217-01-584
2217-01-653
REFERENCES
1. Data on file, DePuy Orthopaedics, Inc, Warsaw, IN
2. Zhang Y, Ahn PB, Fitzpatrick DC, Heiner AD, Poggie RA, Brown TD. “Interfacial frictional behavior:
cancellous bone, cortical bone, and a novel porous tantalum biomaterial.” J Musculoskel Res.
1999;3(4):245-251.
3. Zardiackas LD, Parsell DE, Dillon LD, Mitchell DW, Nunnery LA, Poggie R. “Structure, Metallurgy,
and Mechanical Properties of a Porous Tantalum Foam.“ School of Dentistry/Biomaterials, University of Mississippi Medical Center, 2000; 180-187
4. Sevilla P, Aparicio C, Planell JA, Gil FG. “Comparison of the mechanical properties between
tantalum and nickel-titanium foams implant materials for bone ingrowth applications.“ J. Alloys
and Compouds 439 (2007) 67-73.
5. Reilly, DT, Burstein, AH, Frankel, VH, “The elastic modulus for bone”, J. Biomechanics, V7, pp
271-275, 1974
Limited Warranty and Disclaimer: DePuy Synthes Joint Reconstruction products are sold with a limited warranty to the original purchaser against defects
in workmanship and materials. Any other express or implied warranties, including warranties of merchantability or fitness, are hereby disclaimed.
WARNING: In the USA, this product has labeling limitations. See package insert for complete information.
CAUTION: USA Law restricts these devices to sale by or on the order of a physician.
Not all products are currently available in all markets.
The third party trademarks used herein are the trademarks of their respective owners.
DePuy Orthopaedics, Inc.
700 Orthopaedic Drive
Warsaw, IN 46582
T. +1 (800) 366-8143
www.depuysynthes.com
*DePuy Synthes Joint Reconstruction is a division of DePuy Orthopaedics, Inc.
© DePuy Synthes 2015. All rights reserved.
DSUS/JRC/1014/0488(1) 02/15

gription® tf

Transcription

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