Clinical Evaluation Surgical Technique

Transcription

Clinical Evaluation
Surgical Technique
Table of Contents
EMPERION™ Specifications
EMPERION Surgical Technique
EMPERION Catalog
3
9
18
Nota Bene: This technique description herein is made available to the healthcare professional to illustrate the author’s
suggested treatment for the uncomplicated procedure. In the final analysis, the preferred treatment is that which
addresses the needs of the patient.
2
For Clinical Evaluation only. Not for distribution.
Stems
•
•
•
•
•
•
•
•
•
Made from Titanium Alloy (Ti-6Al-4V)
Primary, standard revision and long bowed revision sizes
Neck shaft angle at 131°
Circulotrapezoidal neck for increased range of motion
Primary in standard and high offset
15° neck anteversion on bowed stem
Standard (STD) and +10 calcar revision options
Distal stem fluted, slotted, with a polished bullet tip
10mm – 12mm of bow offset
Primary Stem Options
Distal
Diameter
(mm)
Length
(mm)
Standard
Offset
(mm)
High
Offset
(mm)
Neck
Height
(mm)
11
13
15
17
19
140
150
150
160
160
34
37
37
40
40
40
45
45
50
50
26
28
28
30
30
Offset (mm)
(High Offset
Only)
Standard
Neck Height
(mm)
+10
Calcar Neck
Height (mm)
45
45
50
50
28
28
30
30
38
38
40
40
45
45
50
50
28
28
30
30
38
38
40
40
Revision Stem Options
Distal
Diameter
(mm)
Length
(mm)
Standard Revision
13
15
17
19
190
190
200
200
Long Revision Bowed
13
15
17
19
250
250
260
260
3
EMPERION™ Primary Stem Specifications
4
EMPERION™ Standard Revision Stem Specifications
5
EMPERION™ Long Revision Stem (Bowed) Specifications
6
EMPERION Specifications
Sleeves
• Titanium alloy (Ti-6Al-4V) with HA on porous coating on all sleeves
• Standard (STD) 40mm sleeve length
- Three cone sizes: S, M and L
- Three spout sizes: 1, 2 and 3
• Tall 60mm sleeve length
- Two cone sizes: M and L
- One spout size: 2
• The proximal sleeve geometry is the same for standard and tall sleeves. The only variable that is
changed is the sleeve height.
Sleeve Options
Standard
1, 2, 3
Small
1, 2, 3
1, 2, 3
Medium
Tall
Large
2
2
Note: Tall Sleeves are only
available for stem sizes
13-19 with medium and large
cones and #2 spouts.
Medium
Large
Stem
Size (mm)
Sleeve
Length
Cone
Options
Spout
Options
11
13
STD
STD
TALL
STD
TALL
STD
TALL
STD
TALL
S,M,L
S,M,L
M,L
S,M,L
M,L
S,M,L
M,L
S,M,L
M,L
1,2,3
1,2,3
2
1,2,3
2
1,2,3
2
1,2,3
2
15
17
19
7
Standard Sleeve Dimensions
Size
Additional M/L Widths
Small
Cone Dia. Spout 1 Spout 2 Spout 3
(mm)
(mm)
(mm)
(mm)
11
13
15
17
19
19
21
23
25
27
Size
Medium Additional M/L Widths
(mm)
(mm)
(mm)
(mm)
11
13
15
17
19
21
23
25
27
29
+10
+11
+12
+13
+15
+10
+11
+12
+13
+14
+14
+15
+16
+17
+18
+14
+15
+16
+17
+18
+18
+19
+20
+21
+ 22
Cone Dia.
+18
+19
+20
+21
+22
Standard
Length=40mm
Size
Large
(mm)
(mm)
(mm)
(mm)
11
13
15
17
19
23
25
27
29
31
+10
+11
+12
+13
+14
+14
+15
+16
+17
+18
M/L
Tall
Length=60mm
+18
+19
+20
+21
+22
Tall Sleeve Dimensions
Size
13
15
17
19
8
Medium
Cone Dia.
(mm)
23
25
27
29
Spout 2
(mm)
+15
+16
+17
+18
Size
13
15
17
19
Large
Cone Dia.
(mm)
25
27
29
31
Spout 2
(mm)
+15
+16
+17
+18
Emperion Surgical
EMPERION™
Surgical Technique Emperion Surgical
Technique
Technique
Preoperative Planning
Preoperative Planning
The goal of preoperative planning is to help
determine the correct stem and sleeve size, level
of femoral neck cut, and proper head and stem
offset combination.
Intraoperatively, leg length restoration can be verified
by measuring the distance between a pin in the
iliac wing and a mark on the greater trochanter
before hip dislocation. This measurement should
be recorded. It is compared later in surgery to a
measurement using the same reference points
after the implant trials are in place.
Preoperative templating requires at least an
anteroposterior radiograph of the pelvis and a
lateral radiograph of the affected hip. If the
opposite hip is unaffected by disease, it can
provide accurate sizing information for the
femoral stem.
To determine if a patient has a leg length
discrepancy, the anteroposterior radiograph should
be used. Draw a line tangential to both of the
ischia or both of the obturator foramens. This line
should extend out until it contacts the medial
cortex of cone on both femurs. If the patient’s legs
are of equal length, the line that has been drawn
will contact both femurs at the same level. If the
patient’s legs are of unequal length, the lines will
contact the femurs at different levels along the
femur. Select a reference point along the femur,
such as the bottom of the lesser trochanter. The
distance between the line that has been drawn
and the reference point on both femurs is
measured. The difference in these measurements
indicates the patient’s leg length discrepancy
(Figure 1).
Note: Using this method of templating for leg
length discrepancy assumes the patient has a
normal, symmetrical pelvis and has neutral
limb positioning.
Emperion Surgical Figure 1
Technique
Another method of leg measurement consists of
the surgeon placing the foot of the affected limb
on top of the unaffected limb. The relative position
of one knee to another is then analyzed. This
second method is slightly less accurate than the
previously mentioned technique; however, both
Figure 2
methods provide a reasonable degree of accuracy
in restoring limb length equality.
When determining which size EMPERION stem and
sleeve to use, the anteroposterior and lateral
radiographs should be templated. Using the
anteroposterior radiograph, place the femoral
templates over the proximal femur of both the
affected and unaffected hips (Figure 2). The
junction of the lateral femoral neck and greater
trochanter serves as a good reference point for
placement of the X-ray templates. Place a mark at
this junction and in the center of the femoral head.
Align the lateral shoulder of the prosthesis with
the mark at the junction. Find the appropriate stem
and sleeve that fit and fill the femur and whose
neck length matches the center of the femoral
head. It is important to check that the stem fits
properly into the femur on the lateral radiograph.
9
EMPERION™ Surgical Technique
1.Femoral Neck Osteotomy
An osteotomy guide is available for proximal bone resection. The
osteotomy guide has a vertical scale in 5mm increments to help
gauge neck height.
Using the greater trochanter or other anatomical landmark as a
reference, align the osteotomy guide and determine the location of
the appropriate resection (Figure 3).
The chart below indicates the distance from the neutral head
center to the top of the sleeve. When a +10 calcar neck is
selected, move the osteotomy guide down the femur to ensure
that sufficient bone will be removed to achieve the proper
leg length.
Once the appropriate vertical position of the osteotomy guide has
been verified, the proposed horizontal osteotomy level is marked
with a marking pen or electrocautery. The femoral osteotomy can
then be made obliquely to the desired level along the medial
aspect of the femoral neck, taking care to protect the greater
trochanter during the osteotomy (Figure 4). The additional bone left
above the osteotomy level can subsequently be resected with a
ronguer or can be left until final seating of the trial sleeve has
been accomplished, at which time a clean-up cut can be made
flush with the top of the sleeve trial.
Size
Distance from +0mm Head
Center to Top of Sleeve
11
13-15
17-19
28mm
30mm
32mm
Figure 3
Figure 4
10
2. Acetabular Preparation
The acetabulum should be prepared in the recommended fashion
for the acetablular component to be utilized according to
preoperative planning and templating.
3. Femoral Canal Preparation
For Primary:
Open the medullary canal with the box osteotome (Figure 5).
Sound the femoral canal using the canal finder and the reamer
T-handle (Figure 6).
For Revision:
Begin with a distal reamer that is 4-6mm smaller than the
templated size or a reamer that has little or no resistance.
Figure 5
NOTE: It is important to stay lateral with both the box
osteotome and canal finder. This helps ensure that femoral
reaming will be in alignment with the femoral axis.
The trochanteric reamer can be used to remove lateral bone
(Figure 7). Removing lateral bone is important for maintaining
neutral stem placement.
Figure 6
Figure 7
11
4. Femoral Distal Reaming
Revision length
reference mark
Primary and Standard Revision Stems
Rigid distal reamers in 0.5mm increments from 9-20mm are
available for primary and standard revision stems.
Primary length
reference mark
Continue to enlarge femoral canal sequentially using the proximal
reamers. Ream the canal in 0.5mm increments until the last
reamer matches the selected implant size. The actual size of
flutes is 0.5mm greater than the equivalent reamer. For example,
if you are using a 13mm stem, the distal diameter is actually
13.5mm, providing an automatic 0.5mm of press-fit. The final
reamer size may need to be adjusted based on bone quality,
anatomy and surgeon preference.
Figure 8
Use the depth marks on the reamers, which correspond to the
neutral head center of the prosthesis, to gauge the appropriate
reaming depth (Figure 8).
Long Revision Bowed Stems
Thin shaft reamers are available for the long revision bowed
stems. Ream the canal in 0.5mm increments until the reamer size
matches the selected implant size. The final reamer size may
need to be adjusted based on bone quality, anatomy and
surgeon preference.
Figure 9
Use the depth marks on the reamers, which correspond to the
neutral head center of the prosthesis, to gauge the appropriate
reaming depth (Figure 9).
NOTE: This technique is different than traditional bowed
stem techniques. Usually one will over ream by 0.5–1.0mm to
ensure that the stem will be able to pass the femoral bow
without fracturing the femur. This bowed stem is different
because it transitions into a diameter 1mm smaller just prior
to the bow (Figure 10). Therefore, when reaming line-to-line,
the canal will be over reamed by 0.5mm, with respect to the
outer diameter of the flutes, for the distal, bowed portion of
the stem. This feature will minimize the risk of fracture
during insertion.
13.5mm
12.5mm
Figure 10
12
5. Femoral Proximal Reaming
Use the proximal reamers to prepare the femur for the modular
sleeve implant. There are standard reamers available for the
standard length sleeves and tall reamers for the tall sleeves.
These reamers are sized according to cone size and
distal diameter (Figure 11).
First select the reamer with the smallest cone size that corresponds
with the distal diameter of the stem. (For example, for a size 13,
select a 13S proximal reamer.) Choose a pilot that matches the stem
diameter and assemble it to the proximal reamer. In the case that
the greater trochanter does not exist, you can reference the top of
the proximal reamer which is equivalent to the top of the sleeve,
once seated. Increase the reamer size until cortical contact is
achieved. Keep in mind that you have S, M and L options per stem
diameter. Pilot extenders may be utilized in combination with the
pilot to reach the approximate length of the revision stems.
Standard/
High Offset
+10mm
Calcar Neck
Figure 11
Standard Proximal Reamers
Reamer
Sizes
2
3
4
5
6
7
8
11S
13S-11M
15S-13M-11L
17S-15M-13L
19S-17M-15L
19M-17L
19L
Tall Proximal Reamers
Reamer
Sizes
4T
5T
6T
7T
8T
13M
15M-13L
17M-15L
19M-17L
19L
13
6. Milling of Spout for Proximal Sleeve
First select the spout cutter that corresponds to the size of the
stem you are implanting. Attach this to the miller handle assembly.
Then select the milling frame that corresponds with the last
proximal reamer that was used. The frames are labeled with both
the corresponding frame numbers and the sizes. The top of the
frame will have holes that correspond with the size of spout you
are planning to use (Figure 12). Assemble the milling body to a pilot
that matches the pilot utilized in the proximal reamer step.
Assemble the milling frame onto the milling handle assembly and
select the hole that matches the spout size of the sleeve implant
by pulling back on the gold anodized quick connect of the
T-handle.
Figure 12
Note: Tall sleeves are available for Medium and Large Cones
with only the #2 spouts.
Milling Frames
Frame No.
Sizes
2
3
4
5
6
7
8
11S
13S-11M
15S-13M-11L
17S-15M-13L
19S-17M-15L
19M-17L
19L
Figure 13
Note: Milling frame numbers will coincide with the number of
the last proximal reamer used.
Before attaching the drill, insert milling frame assembly into femur
(Figure 13). Start with the no. 1 spout and progress upward until the
spout cutter/reamer reaches cortical bone. Attach drill and start
drilling prior to inserting spout into femur. Mill spout until the frame
assembly is fully seated. You can check the seating by matching
the appropriate neck height to the greater trochanter.
Note: In the case that the greater trochanter does not exist, you
can reference the top of the major diameter of the cone which is
equivalent to the top of the sleeve, once seated (Figure 14).
Figure 14
14
7. Sleeve and Stem Trialing
First select the trial sleeve that corresponds with the correct distal
diameter, cone and spout that was reamed. Then assemble the
trial sleeve to the corresponding pilot. Pilot extenders can be
used for the long revision stems. Make sure the colors all match.
Assemble the stem inserter pommel into the threaded hole and
insert the trial assembly into the femur and use a mallet to make
sure that the trial is properly seated.
Figure 15
Select the trial neck that corresponds to the correct offset or
calcar adjustment for the implant. Sizes 13mm and 15mm, and
sizes 17mm and 19mm femoral stems share trial necks. Using the
quick connect mechanism; snap the neck into the properly sized
trial stem (Figure 15). The version of the neck can be adjusted by
pushing the button on the side of the trial neck (Figure 16).
Place the desired trial femoral head on the trial neck and reduce
the hip to assess stability and range of motion.
To remove trial assembly, screw the trial removal hook onto the
trial removal handle. The hook then inserts into the hole in the
trial neck. Using the slotted mallet, remove the trial assembly.
Figure 16
The size of the bow must be evaluated to ensure the stem will fit
properly. Bowed sounds are provided for this reason.
Screw the sound insertion handle into the threaded hole at the
proximal end of the appropriate sized bowed sound. Then insert
this into the femur to assess the bowed stem fit (Figure 17).
To remove the bowed sound, screw the sound removal handle
directly into the sound. Then carefully use a slotted mallet to
remove the sound.
Figure 17
15
8. Sleeve and Stem Implant Insertion
When implanting a stem, the sleeve should be implanted first.
The sleeve implant should be loosely inserted into the femur in
the correct position. Then insert the sleeve insertion tool into the
cone of the sleeve and use a mallet to properly seat the sleeve
(Figure 18).
To insert the stem implant, engage the tip of the stem inserter
frame and pommel assembly into the stem driver slot on the
implant and turn the pommel to thread the inserter onto the
implant (Figure 19). Fully tighten the pommel before impaction.
Figure 18
Insert the implant through the sleeve into the canal with hand
pressure and verify proper implant version. Use firm mallet blows
to seat the implant to the desired level.
NOTE: Once the implant flutes have engaged the bone, the
implant version cannot be changed without removing the
implant. The implant can be removed by using the
separation tool to separate the sleeve from the stem and
then striking the underside of the threaded stem driver with
a slotted mallet.
When implanting bowed stems, first loosely place the sleeve
implant onto the stem implant. Then advance the stem as far as
possible down the femur (Figure 20). Attach the stem inserter
frame and pommel assembly to the stem as shown for the
straight stem. Making sure the neck version and sleeve position
are correct, use firm mallet blows to seat the implant.
Figure 19
If the bowed stem stops progressing during insertion,
remove the implant and enlarge the canal with a larger size thin
shaft reamer.
NOTE: A fully seated bowed stem will be extremely
difficult to remove from the femur and may require an
osteotomy to remove.
Figure 20
16
9. Implant Trialing
Once the implant is fully seated, perform a final trial reduction
to determine appropriate neck length. Place the desired trial
femoral head on the implant and reduce the hip to assess
stability and range of motion.
10. Femoral Head Assembly
Clean and dry the taper with a sterile cloth, place the
prosthetic femoral head on the neck and firmly impact several
times with a femoral head impactor and a mallet.
17
EMPERION™ Catalog
HA Coated Sleeves
7129-1111
7129-1112
7129-1113
7129-1121
7129-1122
7129-1123
7129-1131
7129-1132
7129-1133
7129-1311
7129-1312
7129-1313
7129-1321
7129-1322
7129-1328
7129-1323
7129-1331
7129-1332
7129-1338
7129-1333
7129-1511
7129-1512
7129-1513
7129-1521
7129-1522
7129-1528
7129-1523
7129-1531
7129-1532
7129-1538
7129-1533
7129-1711
7129-1712
7129-1713
7129-1721
7129-1722
7129-1728
7129-1723
7129-1731
7129-1732
7129-1738
7129-1733
7129-1911
7129-1912
7129-1913
7129-1921
7129-1922
7129-1928
7129-1923
7129-1931
7129-1932
7129-1938
7129-1933
18
11 Sm Cone
11 Sm Cone
11 Sm Cone
11 Md Cone
11 Md Cone
11 Md Cone
11 Lg Cone
11 Lg Cone
11 Lg Cone
13 Sm Cone
13 Sm Cone
13 Sm Cone
13 Md Cone
13 Md Cone
13 Md Cone
13 Md Cone
13 Lg Cone
13 Lg Cone
13 Lg Cone
13 Lg Cone
15 Sm Cone
15 Sm Cone
15 Sm Cone
15 Md Cone
15 Md Cone
15 Md Cone
15 Md Cone
15 Lg Cone
15 Lg Cone
15 Lg Cone
15 Lg Cone
17 Sm Cone
17 Sm Cone
17 Sm Cone
17 Md Cone
17 Md Cone
17 Md Cone
17 Md Cone
17 Lg Cone
17 Lg Cone
17 Lg Cone
17 Lg Cone
19 Sm Cone
19 Sm Cone
19 Sm Cone
19 Md Cone
19 Md Cone
19 Md Cone
19 Md Cone
19 Lg Cone
19 Lg Cone
19 Lg Cone
19 Lg Cone
Polished Primary Stems
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
1 Spout
2 Spout
2 Spout Tall
3 Spout
7129-1101
7129-1102
7129-1301
7129-1302
7129-1501
7129-1502
7129-1701
7129-1702
7129-1901
7129-1902
11 Primary
11 Primary
13 Primary
13 Primary
15 Primary
15 Primary
17 Primary
17 Primary
19 Primary
19 Primary
SO
HO
SO
HO
SO
HO
SO
HO
SO
HO
Polished Standard
Revision Stems
7129-1350
7129-1351
7129-1550
7129-1551
7129-1750
7129-1751
7129-1950
7129-1951
13 Std Rev Pol
13 Std Rev Pol
15 Std Rev Pol
15 Std Rev Pol
17 Std Rev Pol
17 Std Rev Pol
19 Std Rev Pol
19 Std Rev Pol
+0
+10
+0
+10
+0
+10
+0
+10
Polished Long
Revision Stems (Bowed)
7129-1370
7129-1371
7129-1372
7129-1373
7129-1570
7129-1571
7129-1572
7129-1573
7129-1770
7129-1771
7129-1772
7129-1773
7129-1970
7129-1971
7129-1972
7129-1973
13 Lng Rev Pol
13 Lng Rev Pol
13 Lng Rev Pol
13 Lng Rev Pol
15 Lng Rev Pol
15 Lng Rev Pol
15 Lng Rev Pol
15 Lng Rev Pol
17 Lng Rev Pol
17 Lng Rev Pol
17 Lng Rev Pol
17 Lng Rev Pol
19 Lng Rev Pol
19 Lng Rev Pol
19 Lng Rev Pol
19 Lng Rev Pol
+0 L
+0 R
+10 L
+10 R
+0 L
+0 R
+10 L
+10 R
+0 L
+0 R
+10 L
+10 R
+0 L
+0 R
+10 L
+10 R
Thin Shaft Reamers
Trial Necks
7136-4990
7136-4500
7136-4510
7136-4515
7136-4520
7136-4525
7136-4530
7136-4535
7136-4540
7136-4545
7136-4550
7136-4555
7136-4560
7136-4565
7136-4570
7136-4575
7136-4580
7136-4585
7136-4590
7136-4595
7136-4600
7136-1101
7136-1102
7136-1501
7136-1502
7136-1901
7136-1902
7136-1503
7136-1903
9mm Thin Shaft Reamer
11.5mm Thin Shaft Reamer
Milling Frames
7136-0892
7136-0893
7136-0894
7136-0895
7136-0896
7136-0897
7136-0898
11S-9M Milling Frame
13S-11M-9L Milling Frame
15S-13M-11L-9XL Milling Frame
Spout Cutters
7136-0884
7136-0885
7136-0886
7136-0887
7136-0888
11
13
15
17
19
Spout Cutter
Spout Cutter
Spout Cutter
Spout Cutter
Spout Cutter
Milling Handle Assembly
7136-0720
Milling Handle Assembly
9-11
9-11
13-15
13-15
17-19
17-19
13-15
17-19
SO
HO/Std Revision
SO
HO/Std Revision
SO
HO/Std Revision
+10 Calcar
+10 Calcar
11 Sm Cone
11 Sm Cone
11 Sm Cone
11 Md Cone
11 Md Cone
11 Md Cone
11 Lg Cone
11 Lg Cone
11 Lg Cone
13 Sm Cone
13 Sm Cone
13 Sm Cone
13 Md Cone
13 Md Cone
13 Md Cone
13 Lg Cone
13 Lg Cone
13 Lg Cone
15 Sm Cone
15 Sm Cone
15 Sm Cone
15 Md Cone
15 Md Cone
15 Md Cone
15 Lg Cone
15 Lg Cone
15 Lg Cone
17 Sm Cone
17 Sm Cone
17 Sm Cone
17 Md Cone
17 Md Cone
17 Md Cone
17 Lg Cone
17 Lg Cone
17 Lg Cone
19 Sm Cone
19 Sm Cone
19 Sm Cone
19 Md Cone
19 Md Cone
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
3 Spout
1 Spout
2 Spout
Trial Sleeves
7136-1111
7136-1112
7136-1113
7136-1121
7136-1122
7136-1123
7136-1131
7136-1132
7136-1133
7136-1305
7136-1306
7136-1307
7136-1321
7136-1322
7136-1323
7136-1331
7136-1332
7136-1333
7136-1511
7136-1512
7136-1513
7136-1521
7136-1522
7136-1523
7136-1531
7136-1532
7136-1533
7136-1711
7136-1712
7136-1713
7136-1721
7136-1722
7136-1723
7136-1731
7136-1732
7136-1733
7136-1911
7136-1912
7136-1913
7136-1921
7136-1922
19
EMPERION™ Catalog
28mm Trial Femoral Heads
Trial Sleeves (continued)
7136-1923
7136-1931
7136-1932
7136-1933
19 Md Cone
19 Lg Cone
19 Lg Cone
19 Lg Cone
3 Spout
1 Spout
2 Spout
3 Spout
7135-2803
7135-2800
7135-2804
7135-2808
7135-2812
7135-2816
-3mm
+0mm
+4mm
+8mm
+12mm
+16mm
Pilots
7136-0945
7136-0946
7136-0947
7136-0948
7136-0949
11mm Pilot
13mm Pilot
15mm Pilot
17mm Pilot
19mm Pilot
Pilot Extenders
7136-0926
7136-0927
7136-0928
7136-0929
13mm Extender
15mm Extender
17mm Extender
19mm Extender
Miscellaneous Instruments
7136-4006
7136-0915
7136-0916
7136-0917
7136-0918
7136-0919
7136-0992
7136-0993
7136-0994
7136-0995
7136-0920
7136-4002
7136-3999
7136-4011
7136-4008
7163-1150
7136-4001
7136-4009
7136-4015
20
Reamer T-Handle
Osteotomy Guide
Pilot Removal Tool
Trial Removal Hook
Sleeve Insertion Tool
Sleeve/Stem separator
13mm Bowed Stem Sound
Trial Removal Handle
Box Osteotome Small \ Machined
Box Osteotome Small \ Casting
Stem Inserter Pommel
Stem Inserter Frame
Slotted Hammer
Starter Reamer
Femoral Head Impactor
Trochanteric Reamer
Distal Reamers
7136-0966
7136-0967
7136-0968
7136-0969
7136-0970
7136-0971
7136-0972
7136-0973
7136-0974
7136-0975
7136-0976
7136-0977
7136-0978
7136-0979
7136-0980
7136-0981
7136-0982
7136-0983
7136-0984
7136-0985
7136-0986
7136-0987
7136-0988
9mm Distal Reamer
9.5mm Distal Reamer
10mm Distal Reamer
10.5mm Distal Reamer
11mm Distal Reamer
12mm Distal Reamer
13mm Distal Reamer
14mm Distal Reamer
15mm Distal Reamer
16mm Distal Reamer
17mm Distal Reamer
18mm Distal Reamer
19mm Distal Reamer
20mm Distal Reamer
Standard Proximal Reamers
7136-0952
7136-0953
7136-0954
7136-0955
7136-0956
7136-0957
7136-0958
7136-0959
Reamer 1, 9S
Reamer 2, 11S-9M
Reamer 3, 13S-11M-9L
Reamer 4, 15S-13M-11L-9XL
Tall Proximal Reamers
7136-0960
7136-0961
7136-0962
7136-0963
7136-0964
Tall Reamer 1, 13M
Tall Reamer 2, 15M-13L
Tall Reamer 5, 19L
Trays
7136-0899
7136-0900
7136-0907
7136-0908
7136-0890
7136-0902
7136-0903
7136-0904
7136-0905
7136-0906
7112-9400
7112-9401
7112-9402
Milling Frame Tray
Instrument Tray
Starter Tray
Distal Reamer Tray
Proximal Reamer Tray
Trial 9-11
Trial 13-15
Trial 17-19
Thin Shaft Reamers
Bowed Trials
Double Height Case
Single Height Case
Case Lid
21
Orthopaedics
Smith & Nephew, Inc.
1450 Brooks Road
Memphis, TN 38116
USA
www.smith-nephew.com
Telephone: 901-396-2121
Information: 1-800-821-5700
Orders/Inquiries: 1-800-238-7538
™Trademark of Smith & Nephew. For Clinical Evaluation only. Not for distribution.
04/05

Clinical Evaluation Surgical Technique

Transcription

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