Hip Prosthesis - Treu
Transcription
Hip Prosthesis - Treu
11 Hip, Knee and Shoulder Prosthesis 11 TREU Hip-Prosthesis Austin Moore / Thompson B% }:: 11.2 ;O!#OB#OG;*!UJJB+q*BJ;q+*+U+!;+#;O*!?+;++? BJ;q¥+OG;*!UJJB+*U+!;¦+*!J BJ;+*#+OG;*!UJJB+*!J Austin Moore Hip Prosthesis Regular Stem Order No.: Head ø mm Stem Length mm Seat Width mm 11-038 38 127 24.0 11-039 39 127 24.0 11-040 40 127 24.0 11-041 41 127 24.0 11-042 42 127 24.0 11-043 43 127 24.0 11-044 44 127 24.0 11-045 45 127 24.0 11-046 46 127 24.0 11-047 47 157 25.5 11-048 48 157 25.5 11-049 49 157 25.5 11-050 50 157 25.5 11-051 51 157 25.5 11-052 52 157 25.5 11-053 53 157 25.5 11-054 54 157 25.5 11-055 55 157 25.5 11-056 56 157 25.5 *% The Standard Austin Moore hip prosthesis is designed to use for degenerated femoral head replacement. The designed of this applience approximates the anatomical shape of femur. The fenestrated stem permits packing of bone grafts and bony ingrowth for improved ?!XY!%/"%"!+%""" !"?!!=+!!%!==X!=?!=!= of stem is provided for extracting the stem. The prostesis feature has a 135° degree stem/neck angle for an anatomic reconstruction. U % %;;""%_;&<? 11.3 ;O!#OB#UJJB+q*BJ;q+*!OBBJ;+U+U+!;+#;O*!?+;++? BJ;q¥+OG;*!UJJB+*U+!;¦+*!J BJ;+*#+OG;*!UJJB+!OBBJ;+U*!J Austin Moore Hip Prosthesis Narrow Stem Order No.: Head ø mm Stem Length mm Seat Width mm 11-138 38 140 23.0 11-139 39 140 23.0 11-140 40 140 23.0 11-141 41 140 23.0 11-142 42 140 23.0 11-143 43 140 23.0 11-144 44 140 23.0 11-145 45 140 23.0 11-146 46 140 23.0 11-147 47 152 24.0 11-148 48 152 24.0 11-149 49 152 24.0 11-150 50 152 24.0 11-151 51 152 24.0 11-152 52 152 24.0 11-153 53 152 24.0 11-154 54 152 24.0 11-155 55 152 24.0 11-156 56 152 24.0 *% The narrow stem Austin Moore hip prosthesis is designed to use when the medullary canal is to small to accept the standard Moore hip prosthesis. This prosthesis has the same features as the standard stem but is narrower then the regular stem in the medial/lateral direction. The designed of this applience approximates the anatomical shape of femur. The fenestrated stem permits packing of bone %Y+!=X% ?!XY!%/"%"! +%"""!"?!!=+!!%!==X of the prosthesis. The loop at the top fo stem is provided for extracting the stem. The prosthesis feature has a 135° degree stem/neck angle for an anatomic reconstruction. U % %;;""%_;&<? 11.4 OG;*!UJJB+q*BJ;q+* JU?+;+*!;BGU+!;O;*J!+; ]JB;O!#OB#O!#!OBBJ;+U T11-100 Complete Instrumentation Set Order No.: Instrument: 11-076 1 Moore Rasp for Standard Stem 11-078 1 Moore Rasp for Narrow Stem 11-080 1 Mortesing chisel 11-082 1 Prosthesis Extractor 11-084 1 Femural Head extractor 11-086 1 Prosthesis Driver 9-704 1 Hammer 500 gr. Standard size 11.5 *!;BGU+!;O;*J!]JBOG;*!UJJB+q*BJ;q+* 11-076 11-078 Moore Rasp for Standard Stem Moore Rasp for Narrow Stem 11-080 11-082 11-084 11-086 11-087 9-702 9-704 9-706 11.6 Mortising chisel Prosthesis extractor Femoral Head Extractor Prosthesis Driver Head Only Wheight approx: 350 g Wheight approx: 500 g ( Standard size) Wheight approx: 700 g ( For Medullary Nailing) ;qJUJ!q*BJ;q+*+U+!;+#;O*!?+;++? BJ;q¥+;qJUJ!*U+!;¦+*!J BJ;+*#+;qJUJ!+!O+BJ+U+!;+#*!J Order No.: Head ø mm Stem Length mm Neck Length B mm Neck Length B mm Seat Width D mm 11-238 38 104 26 45 27 11-239 39 104 26 45 27 11-240 40 104 26 45 27 11-241 41 104 26 45 27 11-242 42 104 26 45 27 11-243 43 104 26 45 27 11-244 44 104 26 45 27 11-245 45 104 26 45 27 11-246 46 104 26 45 27 11-247 47 104 26 45 27 11-248 48 104 26 45 27 11-249 49 104 26 45 27 11-250 50 104 26 45 27 11-251 51 104 26 45 27 11-252 52 104 26 45 27 11-253 53 104 26 45 27 11-254 54 104 26 45 27 11-255 55 104 26 45 27 11-256 56 104 26 45 27 *% Used for replacement of the degenerated femoral head. The wedge of the stem provides great resistance to rotation and its broad collar gives excellent weight distribution on the calcar. The availability of head sizes in fractional and millimeter increments offers the surgeon +%"""!"?!X%=/%;?!=!! 135° degree stem/neck angle for an anatomic reconstruction. U % %;;""%_;&<?%[;£? 11.7 THOMPSON HIP PROSTHESIS COMPLETE SET T11-102 Complete Instrumentation Set Order No.: 11.8 Instrument: 11-260 1 Thompson Rasp 11-084 1 Femoral Head Extractor 11-086 1 Prosthesis Driver 11-4606 1 Lever for dislocation of Femoral head 265 mm 11-260 11-084 11-086 11-087 11-4506 Thompson Rasp Femoral Head Extractor Prosthesis Driver Head Only Lever for dislocation of Femoral Head 265 mm 11.9 Notice: 11.10 Notice: 11.11 ;B+G*!;BGU+!;+AU|q*!;+B!O;*J!O?;BOGUO;J?JAQJB;qJO+#* O?;+!;O?;BO+)&:#Wj'( ;G;;?*!A+!;+?+]J!:W})&$) &: ;+?+]O}W})&$WW')W*!;+B!+;%`` Straight Stem - Hip System Mueller - Ritorno ller Mue no Ritor B%&:&&: 11.14 UJ#G?OB;BO*Aq;;+U\+U+!;+#UG+??+Bp ;*A+#BJ*;+UJ#G?O*B+\*U+!;¥+ MUELLER Straight Stem, cemented, Standard Steel ISO 5832/9 cone 12/14 Geradschaft, zementiert, Standard Implantatstahl ISO 5832/9, Konus 12/14 L Der Mueller Geradschaft ist eine seit Jahrzehnten bewährte Hüftendoprothese zur zementierten Verankerung. Die hohe Indikationsbreite und eine standardisierte OP - Technik mit übersichtlichem Instrumentarium zeichnen % ;"! ? @ ' $"! gute Zementanhaftung. Ein - und Ausschlagsenkungen sorgen für ein einfaches Handling. The Mueller straight stem is a hip arthroplasy compo "% ! ! =X decades. The stem is distinguished by a broad range of indication "! +! "Y % ? ! Y grooved structure enables good cement adhesion. Depressions to facilitate insertion and removal ensure ease of handling. Cat. No. J$ 11-1000 J$| 11-1002 J$ Steril Cat. No. Dimensions K 11-2340 7,50 mm Stem Length 137 mm 11-2341 10,00 mm 142 mm 11-2343 12,50 mm 147 mm 11-2345 15,00 mm 152 mm K 11.15 B MUELLER Cat. No. J$ 11-2400 7,5 mm 11-2402 10,0 mm 11-2404 12,5 mm 11-2406 15,0 mm 11-108 Order No.: 11.16 Instrument: J$ 11-2400 1 Straight stem rasp „MUELLER“ 7,5 mm 11-2402 1 Straight stem rasp „MUELLER“ 10,0 mm 11-2404 1 Straight stem rasp „MUELLER“ 12,5 mm 11-2406 1 Straight stem rasp „MUELLER“ 15,0 mm 9-676 1 Hohmann Retractor 24,0 mm 9-086 1 Anterior Retractor 22,0 mm Der Frakturkopf aus Implantatstahl der Güte ISO 5832-9 ist kombinierbar mit den Schaftmaterialien Implantatstahl ISO 5832-9, CoCrMo ISO 5832-4 und ISO 5832-12, Ti6AI4V ISO 5832-3 sowie Ti6AI7Nb ISO 5832-11. The fracture head is made of implant steel of ISO 5832-9 quality and can be combinded with the following stem materials: implant steel ISO 5832-9, CoCrMo ISO 5832-4 and ISO 5832-12, Ti6AI4V ISO 5832-3 and Ti6AI7Nb ISO 5832-11. Femoral Head for Total Hip Prostesis Implant Steel - ISO 5832/4 Cone 12/14 `!`% Size A Neck q " 11-2540 28 S 11-2541 28 M 11-2542 28 L 11-2550 32 S 11-2551 32 M 11-2552 32 L Femoral Head S Femoral Head M Femoral Head L Femoral Head S Femoral Head M Femoral Head L Femoral Head for Total Hip Prostesis T/6A/4V ISO 5832-3 `!`% Size A Neck q " 11-2540 TI 28 S 11-2541 TI 28 M 11-2542 TI 28 L 11-2550 TI 32 S 11-2551 TI 32 M 11-2552 TI 32 L Modular and Unipolar Head Implant Steel - ISO 5832/9 Cone 12/14 Der Frakturkopf eignet sich besonders für die Versorgung einer Schenkelhalsfraktur bei Patienten im hohen Alter. Durch die einfache Handhabung des Frakturkopfes kommt es zu einer niedrigen Belastung des Patienten und zur Verkürzung der Operationsdauer. Der große Durchmesser sorgt für eine hohe Luxationssicherheit, die für die schnelle Mobilisierung des Patienten von zentraler Bedeutung ist. Durch die hoch= &"! +% das natürliche Acetabulum besonders geschont. `!`% 11-2600 Size 38 mm Stainless Steel `!`% 11-2611 Size 49 11-2601 39 mm 11-2612 50 11-2602 40 mm 11-2613 51 11-2603 41 mm 11-2614 52 11-2604 42 mm 11-2615 53 11-2605 43 mm 11-2616 54 11-2606 44 mm 11-2617 55 11-2607 45 mm 11-2618 56 11-2608 46 mm 11-2619 57 11-2609 47 mm 11-2620 58 11-2610 48 mm The fracture head is suitable particular for the management of femoral head fractures in very elderly patients. Because of the ease of working with the femoral head, the stress on the patient is low and the operation duration is shortened. The large diameter safeguards against dislocation, which is of crucial importance for rapid mobilisation of the patient. The highly polished metal surface is particularly gentle on the natural acetabulum. 11.17 O+;O|G?OBG\cemented ]O!!+!\ J;Q?+\§ 11.18 ø28 ø32 øD øD U **] U **] `!`% Inner-ø Innen-ø Outer-ø Ow `!`% Inner-ø Innen-ø Outer-ø Ow 11-3070 28 mm 44 mm 11-3110 32 mm 44 mm 11-3071 28 mm 46 mm 11-3111 32 mm 46 mm 11-3072 28 mm 48 mm 11-3112 32 mm 48 mm 11-3073 28 mm 50 mm 11-3113 32 mm 50 mm 11-3074 28 mm 52 mm 11-3114 32 mm 52 mm 11-3075 28 mm 54 mm 11-3115 32 mm 54 mm 11-3076 28 mm 56 mm 11-3116 32 mm 56 mm 11-3077 28 mm 58 mm 11-3117 32 mm 58 mm 11-3078 28 mm 60 mm 11-3118 32 mm 60 mm 11-3079 28 mm 62 mm 11-3119 32 mm 62 mm 11-3080 28 mm 64 mm 11-3120 2 mm 32 64 mm 11-3081 28 mm 66 mm 3121 11-3121 32 mm 66 mm 11-3082 28 mm 68 mm 11-3122 32 mm 68 mm UJ#G?OB|*J?OBG\uncemented ;¨;+UJ#G?O*B+|*J?O*B+\§ øD2 øD1 Bipolar Head Sterile `!`% | qU # Insert 11-2660 Bipolar Head 28 42 11-2661 Bipolar Head 28 43 11-2662 Bipolar Head 28 44 11-2663 Bipolar Head 28 45 11-2664 Bipolar Head 28 46 11-2665 Bipolar Head 28 47 11-2666 Bipolar Head 28 48 11-2667 Bipolar Head 28 49 11-2668 Bipolar Head 28 50 11-2669 Bipolar Head 28 51 11-2670 Bipolar Head 28 52 11-2671 Bipolar Head 28 53 11-2672 Bipolar Head 28 54 11-2673 Bipolar Head 28 55 11-2674 Bipolar Head 28 56 11-2675 Bipolar Head 28 57 11-2676 Bipolar Head 28 58 11-2677 Bipolar Head 28 59 11-2678 Bipolar Head 28 60 11-2679 Bipolar Head 28 61 Outer 11-2720 Indikation: Placement of cup together with a femoral head on stem gives an articulated partial prosthesis. The modular outher shell is "% "% % % ! is manufactured from Ultra High Molecular Weight Polyetylene UHMWPE. Required of replace or remove the inner „C“ ring of the bipolar cup during operation. Material: UHMWPE meets ASTM F.648 and ISO 5834/2 standards. Selected for its, high degree of purity, good biotolerance, good mechanical ="%"==?&=%"% stainless steel meets ASTM F.138 - ISO 5832/1 standard. 11.19 PRESS FIT CUP, UNCEMENTED J;Q?+B+]*;\!J!*U+!;¥+ Press-Fit-Cup, ISO 5834/3; cementless, sterile `!`% # Length mm 11-2730 Press-Fit-Cup 44 Material: Surface: 11-2732 Press-Fit-Cup 46 11-2734 Press-Fit-Cup 48 11-2736 Press-Fit-Cup 50 11-2738 Press-Fit-Cup 52 11-2740 Press-Fit-Cup 54 11-2742 Press-Fit-Cup 56 `!`% Length mm 11-2744 Press-Fit-Cup 58 11-2760 20 mm 11-2746 Press-Fit-Cup 60 11-2762 25 mm 11-2748 Press-Fit-Cup 62 11-2764 30 mm 11-2750 Press-Fit-Cup 64 11-2766 35 mm 11-2752 Press-Fit-Cup 66 11-2768 40 mm 11-2754 Press-Fit-Cup 68 11-2770 45 mm Ti6AI4V (ISO 5834/3) blasted *]\ cementless ; q *]\ cementless ; q << *J'j(}$ Size 44 mm - 68 mm << *J'j(}$ A}})j Insert Standard 0° 11.20 Acetabulum Screw Self tapping Insert Dys. 10° `!`% Inner-ø Outer-ø Innen-ø Ow : `!`% Inner-ø Outer-ø Innen-ø Ow * <#<`&: 11-2800 28 mm 44 mm 11-2860 28 mm 44 mm 11-2802 28 mm 46 mm 11-2862 28 mm 46 mm 11-2804 28 mm 48 mm 11-2864 28 mm 48 mm 11-2806 28 mm 50 mm 11-2866 28 mm 50 mm 11-2808 28 mm 52 mm 11-2868 28 mm 52 mm 11-2810 28 mm 54 mm 11-2870 28 mm 54 mm 11-2812 28 mm 56 mm 11-2872 28 mm 56 mm 11-2814 28 mm 58 mm 11-2874 28 mm 58 mm 11-2816 28 mm 60 mm 11-2876 28 mm 60 mm 11-2818 28 mm 62 mm 11-2878 28 mm 62 mm 11-2820 28 mm 64 mm 11-2880 28 mm 64 mm 11-2822 28 mm 66 mm 11-2882 28 mm 66 mm 11-2824 28 mm 68 mm 11-2884 28 mm 68 mm 14-410 Flexibler Schaft Flexible shank ;=!Q ;"! +@ !' `!`% 14-420 2,5 x 35 mm 14-422 2,5 x 50 mm 14-424 2,5 x 60 mm 14-426 3,2 x 35 mm 14-428 3,2 x 50 mm `!`% ø 14-430 3,2 x 70 mm 14-440 1,5 mm 14-432 3,5 x 35 mm 14-442 2,5 mm 14-434 3,5 x 50 mm 14-444 3,5 mm 14-436 3,5 x 70 mm 14-446 4,0 mm 11.21 B+*!]JB+U+!;OA+ `!`% Diam mm Style `!`% Diam mm Style 11-3370 44 Right 11-3380 44 Left 11-3371 46 Right 11-3381 46 Left 11-3373 48 Right 11-3383 48 Left 11-3372 50 Right 11-3382 50 Left 11-3375 52 Right 11-3385 52 Left 11-3374 54 Right 11-3384 54 Left 11-3376 56 Right 11-3386 56 Left *% The reinforcement cage is indicated for cup revision with considerable osseous defects or protrusion, if it is no longer possible to achieve adequate primary stability with any other implant. The intact, resistance bone is made usable again: forces acting on the bone are spread over a large area. The reinforcement cage permits undisturbed incorporation of bone grafts. The reinforcement cage is implanted +!"²!"XY !"=!"?!X'"="Y%"%Y? !%%%%Y?!!!X ! pelvic wall. The distal nose is hammered through from the inside of the cup into the ischium. The reinforcement cage can be adapted to !Y=XY%!?!"!"%%!!"=?!"=""% into correct position. U % %;;""%_;&<?%[;£? 11.22 O+;O|G?OBBJJ]B+*!]JB+U+!;B*!A `!`% Ring Size 11-3350 44 mm 11-3352 46 mm 11-3354 48 mm 11-3356 50 mm 11-3358 52 mm 11-3360 54 mm 11-3362 56 mm 11-3364 58 mm *% Acetabular ring is indicated in total hip replacement in cases of osteoporosis, rheumatoid arthritis, acetabular roof cysts, simultaneous bone grafting, after arthrodeses and in socket revision. An acetabular reinforcement ring is also recommended in combination with polyethylene cups with low wall thickness. In revision cases with severe bone loss and protrusion, the usage of a acetabular reinforcement cage is recommended. After the preparation of the acetabulum, and acetabular ring with diameter of 4 mm smaller than the last reamer is normaly used. The implant is wedge into the acetabulum with the metal impactor. The ring is positioned correctly if its lateral rim lies !%"?[=X!!!"+!%+%!!%!X" ""?!" %+!|"""+?!=%!!%"!" woint and are inclined approximately 20 medially and posteriorly in relation to the long axis of the body. The poyethylene cup has an inclination of approximately 40 which corresponds in most cases with the position of the ring. U % %;;""%_;&<?%[;£? 11.23 *!;BGU+!;O;*J!]JB#GJq+O# 11-106 11.24 Instrumentation for Duo-Heads Cat. Number 11-5300 1 Instrument @%%%;/|&| 11-5302 2 @%%%;/|&| 11-5304 3 @%%%;/||&| 11-5306 4 @%%%;/|&| 11-5308 5 @%%%;/|&| 11-5310 6 @%%%;/|&| 115312 7 @%%%;/|&| 11-5314 8 @%%%;/|&| 11-5316 9 @%%%;/&| 11-5318 10 @%%%;/&| 11-5320 11 @%%%;/&| 11-5322 12 @%%%;/&| 11-5324 13 @%%%;/|&| 11-5326 14 @%%%;/&| 11-5328 15 @%%%;/&| 11-5330 16 @%%%;/&| 11-5332 17 @%%%;/&| 11-5334 18 @%%%;/&| 11-5336 19 @%%%;/&| 11-5338 20 Duo-Head-Forceps universal for ring assembly 11-5340 21 Duo-Head-Tester handle (curved) M8 11-5342 22 Tray with holding devices for trial Duo-Heads 11-5344 23 Instrumentation Dou - Head complete 11-4200 11-4201 11-4202 11-4210 11-4212 Cup Positioning Guide antero-lateral Cup Positioning Guide postero-lateral Cup Introducer 32 mm Plastic Cap for Cup Introducer 28 mm Plastic Cap for Cup Introducer 11-4250 11-4252 C.D.H. Brim for Cup Introducer 32 mm Brim for Cup Introducer 28 mm Brim for Cup Introducer 9-708 11.25 O+;O|G?GU]B+BQ;+U O+;O|G?GUB+OU+BQ;+U 11-3474 Set komplett Set complete |||| 11.26 11-3472 1 11-3470 1 <'$=X|| Reamer 40 - 64 mm T-Handgriff Handle for Reamer Fräserhalter mit AO Ansatz Shaft for Acetabulum Reamer O+;O|G?GU]B+BQ;+U O+;O|G?GUB+OU+BQ;+U Standard AO Ansatz Fräseraufsatz mit Schnellverschluss Reamer with quick locking device 11-3440 11-3442 11-3444 11-3446 11-3448 11-3450 11-3452 11-3454 11-3456 11-3458 11-3460 11-3462 11-3464 ø 40 mm ø 42 mm ø 44 mm ø 46 mm ø 48 mm ø 50 mm ø 52 mm ø 54 mm ø 56 mm ø 58 mm ø 60 mm ø 62 mm ø 64 mm 11-3470 11-3472 Acetabulumfräser: Die Fräseraufsätze werden schlüssellos mit dem Fräserschaft gekuppelt. Es ist nur ein Schaft für das Sytstem erforderlich. Acetabulum reamer: The reamer heads are coupled with shafts key. Only one shaft is necessary for the system. 11.27 ?O;+OG! %*!;BGU+!;#+|O+ ;BOQ!J` %|O**!;BGU+!; 11-110 Cat. Number 11.28 Instrument 11-4500 1 Curette small 9 mm, 280 mm length 11-4502 1 Curette medium 15 mm, 280 mm length 11-4504 1 Curette large 27 mm, 270 mm length 11-4520 1 Osteotome 16 mm, 310 mm length 11-4522 1 Osteotome 16 mm curved, 310 mm length 11-4528 1 Swan necked gouge 16 mm, 315 mm length 11-4512 1 Chisel for cut extraction 7,5 mm, 310 mm length 11-4506 1 Lever for dislocation of femoral 11-4538 1 Chisel for cement extraction 9 mm, 250 mm length 11-086 1 Prosthesis driver 11-4500 11-4502 11-4504 11-4506 Curette, small 9 mm / 280 mm Curette, medium 15 mm / 280 mm Curette, large 27 mm / 270 mm Lever for dislocation of Femoral Head 265 mm 11.29 11-4510 Lexer Chisel 8 mm 200 mm length 11.30 11-4512 Chisel for cup extraction 7,5 mm 310 mm length 11-4514 Lexer Chisel 20 mm 315 mm 11-4518 Straight Chisel 3 mm / 310 mm length 11-4520 Osteotome 16 mm / 310 mm length 11-4522 Curved Chisel 16 mm / 310 mm length 11-4524 11-4526 Bone Chisel, ground on one side only 12 mm / 260 mm 20 mm / 315 mm 11.31 11-4528 Swan necked Gouge 16 mm / 315 mm length 11.32 11-4530 Swan necked Gouge 25 mm / 315 mm length 11-4534 Chisel for extraction of cement 9 mm Angled 15° 330 mm 11-4536 Chisel for splitting the cement 11,5 mm / 280 mm 11-4538 Chisel for cement extraction 9 mm, negative / 280 mm 11.33 11-4540 Chisel for cement extraction 9 mm negativ / 340 mm 11.34 11-4542 Chisel for cement extraction 9 mm positiv / 400 mm ?O;+OG!&%+OB;+GB ;BOQ!J`&%B+;BO;JB 11-112 Cat. Number Instrument 11-4604 1 Sharp Bone Hook 11-4608 1 Joint Capsule Scissors 11-4610 1 Weight 1250 6R for Mueller Femoral Retractor 9-676 1 Hohmann Retractor 24 mm 11-4650 1 Mueller Femoral Retractor 26 mm Wide 9-666 1 Hohmann Retractor 43 mm Wide 9-660 1 Hohmann Retractor 18 mm Narrow 11-4652 1 Anterior Retractor 22 mm 40 mm Wide 11-4656 1 Anterior Retractor 22 mm Wide 11-4654 1 Joint Capsule Clamp 11.35 11-4550 1 11-45 111-455 4 0 11-4552 11-4554 11.36 Trochanter Tro T Tr ocha chanter Forceps Hook for Extraction of Cement Rongeur Forceps for Cement Extraction Reamer with T-Handle for cement, 330 mm length 11-4570 11-4572 11-4574 11-4576 11-4578 11-4580 11-4582 11-4584 Hand Reamer 7 mm Hand Reamer 8 mm Hand Reamer 9 mm Hand Reamer 10 mm Hand Reamer 11 mm Hand Reamer 12 mm Hand Reamer 13 mm Hand Reamer 14 mm 11-4600 11-4602 Langenbeck Retractor Volkmann Skin Retractor 38 mm 11.37 11-4604 11-4608 11-4610 Joint Capsule Scissors Weight (1250 gr) for Muller Femoral Retractor 9-676 11-4650 11.38 Sharp Bone Hook Hohmann Retractor 24 mm Muller Femoral Retractor 26 mm broad 9-666 9-660 Hohmann Retractor Wide 43 mm Hohmann Retractor Narrow 18 mm 11-4652 11-4654 11-4656 11-4658 Anterior Retractor 40 mm Joint Capsule Clamp Anterior Retractor 22 mm Anterior Retractor 22 mm with insert hole 11.39 11.40 J+BO;*J!UO!GO? U q “ r e l l e e u u q i M n „ h c e T n o i t pera O „Mueller“ Operation Technique Straight Stem Hip System with Bipolar Head or Fracture Head „Mueller“ Straight Stem Hip System with cemented Acetabulum Cup 11.41 ;BO*Aq;;+Uq*Q;+U ;Q+UG+??+Bp+U+!;+# ;;B+Gq< Years of experience and excellent clinical results with the implantation of cemented straight stem prosthesis led to the development of the TREU Straight Stem-Hip-Endoprosthesis-System. The System with its modular concept, allows individual adjustment with the treatment of medial femoral neck fractures in elderly patients. <% - Straight Stem - Hip Endoprosthesis, Implantsteel, STD, cemented, Cone 1211 4 - Straight Stem - Hip Endoprosthesis, CoCrMo, STD, cemented, Cone 1211 4 - Straight Stem - Hip Endoprosthesis, CoCrMo, MT, cemented, Cone 12114 - Femoral Head, Implantsteel, 0 28 mm or 0 32 mm, six different necklength - Femoral Head, CoCrMo, 0 28 mm or 0 32 mm, six different necklength - Femoral Head, Ti6A14V coating TiN, 0 28 mm or 0 32 mm, six different necklength - Acetabular Cup, PE, cemented for Head - 0 28 mm or 32 mm - Bipolar Head, Outer Cup Implantsteel with PE-Insert, 0 28 mm - Bipolar Head, Outer Cup CoCrMo with PE-Insert, 0 28 mm - Fracture Head Implantsteel, one necklength lndication Medial femoral neck fractures, with or without coxarthrosis in elderly patients Recommendation of treatment - Patients with coxarthrosis: total replacement of the hip joint with cemented acetabular cup and stem - Patients without coxarthrosis: duo-head with cemented stem - Bedridden patients: large head with cemented stem - Reliable calculation of duration of surgery. 11.42 ;BO*Aq;;+Uq*Q;+U *;q|*J?OBq+O#JB]BO;GB+q+O# &` The patient must be positioned supine with the affected side slightly elevated. The approach is made by administering a cuwed skin incision with the greater trochanter at the center. This incision is then directed towards the anterior superior iliac spine. Exposure of the gluteus medius muscle and splitting in +!!"{<?~?*+! retractors ventrally and dorsally of the femoral neck. Opening of the capsule and resection of the ventral parts. Now the fracture can be exposed. 2. Resection of the femoral neck Change of the Hohmann retractors position by placing them intraarticular. Depending on the type of fracture, the femoral !%"+ %%%"%?&!!% diameter with the gauge. Osteotomy of the femoral neck in a line 1cm ventrally of the lesser trochanter reaching in a 45“ angle towards the greater trochanter. Next, the femoral head is removed (Fig. 2). 11.43 ;BO*Aq;;+Uq*Q;+U *;q|*J?OBq+O#JB]BO;GB+q+O# (` Adduction and external rotation of the femur. Opening of the medullary cavity, with a sharp Spoon, directly at the medial femoral cortex and removal of the bone marrow as far as the femoral canal. Manual reaming of the medullary cavitiy by using the reamers (Pos. 13) (Fig. 3), beginning with the smallest size until the cranial end of the reamer can be completely inserted into the intramedullary canal aligning the femoral neck resection. lnserting the prosthesis and eventually X" ! " = +! ! ? Removal of the trial prosthesis. }`* Insert the medullary canal plug (PE) (cement stopper, Pos. 18) with the handle for the cement stopper (Pos. 5) into the distal medullary canal. Instead of the PE-plug, cancellous bone from the femoral head can be used as an alternative. Preparation of the bone cement in vacuum technique and placing an air escape tube in the medullary canal. lnjection !"%!%=!! appropriate marking (Fig. 4). While hardening, the cement must be pressurized with slight pressure of the impactor (Pos. 8) on the prosthesis. After irrigating the joint with large amounts of Ringer’s solution, the capsule resection borders Y"!"'%%? 11.44 ;BO*Aq;;+Uq*Q;+U *;q|*J?OBq+O#JB]BO;GB+q+O# '`* | q Fracture Head Placing the trial head (Pos. 2 and 16) (Duo-Head: middle neck length of the trial head (Pos. 15)) in the previous chosen size into the hip-joint (Fig. 5). If the measured size lies between two sizes, the smaller one must be chosen. %" % X" ! ! ! of motion and an eventual tendency for luxation. With implantation of a Duo-Head, correction by changing to a head with a different neck length might be necessary, eventually, by using the wedge (Pos. 12) for femoral heads. X!!%%=!%= (Fig. 6) (Duo-Head: after placing the desired femoral head into the Duo-Head with fhe Duo-Head-forceps, Pos. 1). Placement of two Redon-drains dorsally and laterally. Finally, closure of the wound one layer at a time. 11.45 ;BO*Aq;;+Uq*Q;+U *;q+U+!;+#O+;O|G?OB &` The patient must be positioned supine with the affected side slightly elevated. The approach is made by administering a curved skin incision with the greater trochanter at the center. This incision is then directed towards the anterior superior iliac spine. Exposure of the gluteus medius muscle and =+!!"{<?~?* two Hohmann retractors ventrally and dorsally of the femoral neck. Opening of the capsule and resection of the ventral park. Now the fracture can be exposed. 2. Resection of the femoral neck Change of the Hohmann retractors position by placing them intraarticular. Depending on the type of fracture, the femoral !%"+ %%%"%?&!!% diameter with the gauge. Osteotomy of the femoral neck in a line I cm ventrally of the lesser trochanter reaching in a 45“ angle towards the greater trochanter. Next, the femoral head is removed (Fig. 8). 11.46 ;BO*Aq;;+Uq*Q;+U *;q+U+!;+#O+;O|G?OB (` Removal of the capsule in the cranial and caudal part. In order to minimize the danger of bleeding, it is recommended to leave the posterior part in place. Exposure of the acetabulum with a shaped Hohmann-retractor, its tip placed behind the dorsal rim, and a second retractor positioned on the anterior rim. Then, resection of existing exophytes and cartilage of the acetabulum with the reamer (Pos. 4 und 14) in the previously selected size. }`* Placement of the acetabular trial cup (Pos. 3 und 17) in the =XY"%/%%!%/ {<?~?<= !""=% two to three anchoring pivots for the bone cement cranially and medially. Irrigation of the joint with Ringer’s solution. Preparation of the bone cement and placement in the acetabulum. Implantation of the PE-acetabular cup, correctly angled, with the bent cup impactor (Pos. 6 and 7) and hardening in the exact same postion (Fig. 11). Excess cement must be cleaned off thoroughly before the final hardening. Finally, place armed, wet gauze into the cavity of the acetabular cup. 11.47 ;BO*Aq;;+Uq*Q;+U *;q+U+!;+#O+;O|G?OB '` Adduction and external rotation of the femur. Opening of the medullary cavity, with a sharp Spoon, directly at the medial femoral cortex and removal of the bone marrow as far as the femoral canal. Automatic and manual reaming of the medullary cavitiy by using the reamers (Pos. 13) (Fig. 12), beginning with the smallest size until the cranial end of the reamer can be completely inserted into the intramedullary canal aligning the femoral neck resection. lnserting the prosthesis and X"! "=+!!? )`* Insert the medullary canal plug (PE) (cement stopper, Pos. 18) with the handle for the cement stopper (Pos. 5) into the distal medullary canal. Instead of the PE-plug, cancellous bone from the femoral head can be used as an alternative. Preparation of the bone cement in vacuum technique and placing an air escape tube in the medullary canal. lnjection !"%!%=!! appropriate marking (Fig. 13). While hardening, the cement must be pressurized with slight pressure of the impactor (Pos. 8) on the prosthesis. After irrigating the joint with large amounts of Ringer’s solution, the capsule resections must be Y"!"'%%? 11.48 ;BO*Aq;;+Uq*Q;+U *;q+U+!;+#O+;O|G?OB W`* Placing the trial head of middle neck length (Pos. 15) onto the straight-stem-prosthesis. Reduction of the prosthesis into ! *# " "= % X" " ! and eventual tendency for luxation. Eventual correction by changing to a head with a different neck length (Pos. 1 5). X!!%%=!%= (Fig. 14) using the femoral head impactor (Pos. 9 und 10). After a last control of function, placement of two Redon-drains dorsally and laterally. Finally, closure of the wound one layer at a time. 11.49 Straight Stem - Hip System „Ritorno“ 11.50 UJ#G?OB;BO*Aq;;+UB*;JB!Jp\;*;O! 135 135° “ O N R O T RI Dimensions (K) Stem Length 11-2422 7,00 mm 139 mm 11-2423 8,00 mm 141 mm 11-2424 9,00 mm 143 mm 11-2425 10,00 mm 145 mm 11-2426 11,25 mm 148 mm 11-2427 12,50 mm 151 mm L Cat. No. TI6A / 7NB iso 5832-11 K BJ;q+*BO Ref. Number Size (ø) 11-5150 6,25 mm 11-5152 7,50 mm 11-5154 8,75 mm 11-5156 10,00 mm 11-5158 11,25 mm 11-5160 12,50 mm UJ#G?OBBOqO!#?+ 11-5100 11.51 UJ#G?OB;BO*Aq;;+UG!+U+!;+# JU?+;+*!;BGU+!;O;*J!+; B*;JB!Jp 11-118 Ref. No.: Instrument: Pieces 11-5150 Modular Prosthesis Rasp 6,25 mm 1 11-5152 Modular Prosthesis Rasp 7,50 mm 1 11-5154 Modular Prosthesis Rasp 8,75 mm 1 Ref. No.: 11-5156 Modular Prosthesis Rasp 10,0 mm 1 11-5307 Modular Prosthesis Rasp 11,25 mm 1 Repositioning Lever Synthetic Top 1 11-5158 11-5160 Modular Prosthesis Rasp 12,50 mm 1 11-084 Femoral Head Extractor 1 11-1902 Medullary Awl Reamer 1 11-4502 Spoon Curette 1 1 11-4504 Curette 1 1 Instrument: Pieces 11-5100 Modular Rasp Handle 11-5301 Test Head ø 28 mm 12/14 S 1 11-4520 Straight Chisel 11-5303 Test Head ø 28 mm 12/14 M 1 11-4522 Curved Chisel 11-5305 Test Head ø 28 mm 12/14 L 1 11-088 Retractor MURPHY No. 1 1 11-4512 Chisel for cup extraction 1 9-666 HOHMANN Retractor No. 2 1 11.52 1 B`!`% Size A 11-5301 S 11-5303 M 11-5305 L 11-5307 Repositioning Lever synthetic top 11-084 Femoral Head Extractor 11-086 Prosthesis Driver 11-087 Head Only 11-088 Murphy Lane Bone Skid 11-089 Repositioning Lever 11-1902 Curved AWL Gebogene Öffnungsschale 11.53 11-4520 Osteotome 16 mm / 310 mm length 11-4522 Curved Chisel 16 mm / 310 mm length 11.54 11-4512 Chisel for cup extraction 7,5 mm 310 mm length 9-666 with 43 mm narrow tip Der Frakturkopf aus Implantatstahl der Güte ISO 5832-9 ist kombinierbar mit den Schaftmaterialien Implantatstahl ISO 5832-9, CoCrMo ISO 5832-4 und ISO 5832-12, Ti6AI4V ISO 5832-3 sowie Ti6AI7Nb ISO 5832-11. The fracture head is made of implant steel of ISO 5832-9 quality and can be combinded with the following stem materials: implant steel ISO 5832-9, CoCrMo ISO 5832-4 and ISO 5832-12, Ti6AI4V ISO 5832-3 and Ti6AI7Nb ISO 5832-11. Femoral Head for Total Hip Prostesis Implant Steel - ISO 5832/9 Cone 12/14 `!`% Size A Neck q " 11-2540 28 S 11-2541 28 M 11-2542 28 L 11-2550 32 S 11-2551 32 M 11-2552 32 L Femoral Head S Femoral Head M Femoral Head L Femoral Head S Femoral Head M Femoral Head L Femoral Head for Total Hip Prostesis Ti6A / 4V ISO 5832-3 `!`% Size A Neck q " 11-2540TI 28 S 11-2541TI 28 M 11-2542TI 28 L 11-2550TI 32 S 11-2551TI 32 M 11-2552TI 32 L Modular and Unipolar Head Implant Steel - ISO 5832/9 Cone 12/14 Der Frakturkopf eignet sich besonders für die Versorgung einer Schenkelhalsfraktur bei Patienten im hohen Alter. Durch die einfache Handhabung des Frakturkopfes kommt es zu einer niedrigen Belastung des Patienten und zur Verkürzung der Operationsdauer. Der große Durchmesser sorgt für eine hohe Luxationssicherheit, die für die schnelle Mobilisierung des Patienten von zentraler Bedeutung ist. Durch die hoch= &"! +% das natürliche Acetabulum besonders geschont. `!`% 11-2600 Size 38 mm Stainless Steel `!`% 11-2611 Size 49 50 11-2601 39 mm 11-2612 11-2602 40 mm 11-2613 51 11-2603 41 mm 11-2614 52 11-2604 42 mm 11-2615 53 11-2605 43 mm 11-2616 54 11-2606 44 mm 11-2617 55 11-2607 45 mm 11-2618 56 11-2608 46 mm 11-2619 57 11-2609 47 mm 11-2620 58 11-2610 48 mm The fracture head is suitable particular for the management of femoral head fractures in very elderly patients. Because of the ease of working with the femoral head, the stress on the patient is low and the operation duration is shortened. The large diameter safeguards against dislocation, which is of crucial importance for rapid mobilisation of the patient. The highly polished metal surface is particularly gentle on the natural acetabulum. 11.55 O+;O|G?OBG\cemented ]O!!+!\ J;Q?+\§ 11.56 ø28 ø32 øD øD U **] U **] `!`% Inner-ø Innen-ø Outer-ø Ow `!`% Inner-ø Innen-ø Outer-ø Ow 11-3070 28 mm 44 mm 11-3110 32 mm 44 mm 11-3071 28 mm 46 mm 11-3111 32 mm 46 mm 11-3072 28 mm 48 mm 11-3112 32 mm 48 mm 11-3073 28 mm 50 mm 11-3113 32 mm 50 mm 11-3074 28 mm 52 mm 11-3114 32 mm 52 mm 11-3075 28 mm 54 mm 11-3115 32 mm 54 mm 11-3076 28 mm 56 mm 11-3116 32 mm 56 mm 11-3077 28 mm 58 mm 11-3117 32 mm 58 mm 11-3078 28 mm 60 mm 11-3118 32 mm 60 mm 11-3079 28 mm 62 mm 11-3119 32 mm 2 mm 62 11-3080 28 mm 64 mm 11-3120 32 mm 64 mm 11-3081 28 mm 66 mm 121 11-3121 32 mm 66 mm 11-3082 28 mm 68 mm 11-3122 32 mm 68 mm UJ#G?OB|*J?OBG, uncemented ;¨;+UJ#G?O*B+|*J?O*B+\§ øD2 øD1 Sterile Bipolar Head `!`% | qU # Insert 11-2660 Bipolar Head 28 42 11-2661 Bipolar Head 28 43 11-2662 Bipolar Head 28 44 11-2663 Bipolar Head 28 45 11-2664 Bipolar Head 28 46 11-2665 Bipolar Head 28 47 11-2666 Bipolar Head 28 48 11-2667 Bipolar Head 28 49 11-2668 Bipolar Head 28 50 11-2669 Bipolar Head 28 51 11-2670 Bipolar Head 28 52 11-2671 Bipolar Head 28 53 11-2672 Bipolar Head 28 54 11-2673 Bipolar Head 28 55 11-2674 Bipolar Head 28 56 11-2675 Bipolar Head 28 57 11-2676 Bipolar Head 28 58 11-2677 Bipolar Head 28 59 11-2678 Bipolar Head 28 60 11-2679 Bipolar Head 28 61 Outer 11-2720 Required of replace or remove the inner „C“ ring of the bipolar cup during operation. Indikation: Placement of cup together with a femoral head on stem gives an articulated partial prosthesis. The modular outher shell is "% "% % % ! is manufactured from Ultra High Molecular Weight Polyetylene UHMWPE. Material: UHMWPE meets ASTM F.648 and ISO 5834/2 standards. Selected for its, high degree of purity, good biotolerance, good mechanical ="%"==?&=%"% stainless steel meets ASTM F.138 - ISO 5832/1 standard. 11.57 PRESS FIT CUP, UNCEMENTED J;Q?+B+]*;\!J!*U+!;¥+ Press-Fit-Cup, ISO 5834/3; cementless, sterile `!`% # Length mm 11-2730 Press-Fit-Cup 44 Material: Surface: 11-2732 Press-Fit-Cup 46 11-2734 Press-Fit-Cup 48 11-2736 Press-Fit-Cup 50 11-2738 Press-Fit-Cup 52 11-2740 Press-Fit-Cup 54 11-2742 Press-Fit-Cup 56 `!`% Length mm 11-2744 Press-Fit-Cup 58 11-2760 20 mm 11-2746 Press-Fit-Cup 60 11-2762 25 mm 11-2748 Press-Fit-Cup 62 11-2764 30 mm 11-2750 Press-Fit-Cup 64 11-2766 35 mm 11-2752 Press-Fit-Cup 66 11-2768 40 mm 11-2754 Press-Fit-Cup 68 11-2770 45 mm Ti6AI4V (ISO 5834/3) blasted *]\ cementless ; q *]\ cementless ; q << *J'j(}$ Size 44 mm - 68 mm << *J'j(}$ A}})j Insert Standard 0° 11.58 Acetabulum Screw Self tapping Insert Dys. 10° `!`% Inner-ø Outer-ø Innen-ø Ow : `!`% Inner-ø Outer-ø Innen-ø Ow * <#<`&: 11-2800 28 mm 44 mm 11-2860 28 mm 44 mm 11-2802 28 mm 46 mm 11-2862 28 mm 46 mm 11-2804 28 mm 48 mm 11-2864 28 mm 48 mm 11-2806 28 mm 50 mm 11-2866 28 mm 50 mm 11-2808 28 mm 52 mm 11-2868 28 mm 52 mm 11-2810 28 mm 54 mm 11-2870 28 mm 54 mm 11-2812 28 mm 56 mm 11-2872 28 mm 56 mm 11-2814 28 mm 58 mm 11-2874 28 mm 58 mm 11-2816 28 mm 60 mm 11-2876 28 mm 60 mm 11-2818 28 mm 62 mm 11-2878 28 mm 62 mm 11-2820 28 mm 64 mm 11-2880 28 mm 64 mm 11-2822 28 mm 66 mm 11-2882 28 mm 66 mm 11-2824 28 mm 68 mm 11-2884 28 mm 68 mm O+;O|G?OBBJJ]B+*!]JB+U+!;B*!A `!`% Ring Size 11-3350 44 mm 11-3352 46 mm 11-3354 48 mm 11-3356 50 mm 11-3358 52 mm 11-3360 54 mm 11-3362 56 mm 11-3364 58 mm *% Acetabular ring is indicated in total hip replacement in cases of osteoporosis, rheumatoid arthritis, acetabular roof cysts, simultaneous bone grafting, after arthrodeses and in socket revision. An acetabular reinforcement ring is also recommended in combination with polyethylene cups with low wall thickness. In revision cases with severe bone loss and protrusion, the usage of a acetabular reinforcement cage is recommended. After the preparation of the acetabulum, and acetabular ring with diameter of 4 mm smaller than the last reamer is normaly used. The implant is wedge into the acetabulum with the metal impactor. The ring is positioned correctly if its lateral rim lies !%"?[=X!!!"+!%+%!!%!X" ""?!" %+!|"""+?!=%!!%"!" woint and are inclined approximately 20 medially and posteriorly in relation to the long axis of the body. The poyethylene cup has an inclination of approximately 40 which corresponds in most cases with the position of the ring. U % %;;""%_;&<?%[;£? 11.59 B+*!]JB+U+!;OA+ `!`% Diam mm Style `!`% Diam mm Style 11-3370 44 Right 11-3380 44 Left 11-3371 46 Right 11-3381 46 Left 11-3373 48 Right 11-3383 48 Left 11-3372 50 Right 11-3382 50 Left 11-3375 52 Right 11-3385 52 Left 11-3374 54 Right 11-3384 54 Left 11-3376 56 Right 11-3386 56 Left *% The reinforcement cage is indicated for cup revision with considerable osseous defects or protrusion, if it is no longer possible to achieve adequate primary stability with any other implant. The intact, resistance bone is made usable again: forces acting on the bone are spread over a large area. The reinforcement cage permits undisturbed incorporation of bone grafts. The reinforcement cage is implanted +!"²!"XY !"=!"?!X'"="Y%"%Y? !%%%%Y?!!!X ! pelvic wall. The distal nose is hammered through from the inside of the cup into the ischium. The reinforcement cage can be adapted to !Y=XY%!?!"!"%%!!"=?!"=""% into correct position. U % %;;""%_;&<?%[;£? 11.60 *!;BGU+!;O;*J!]JB#GJq+O# 11-106 Instrumentation for Duo-Heads Cat. Number 11-5300 1 Instrument @%%%;/|&| 11-5302 2 @%%%;/|&| 11-5304 3 @%%%;/||&| 11-5306 4 @%%%;/|&| 11-5308 5 @%%%;/|&| 11-5310 6 @%%%;/|&| 115312 7 @%%%;/|&| 11-5314 8 @%%%;/|&| 11-5316 9 @%%%;/&| 11-5318 10 @%%%;/&| 11-5320 11 @%%%;/&| 11-5322 12 @%%%;/&| 11-5324 13 @%%%;/|&| 11-5326 14 @%%%;/&| 11-5328 15 @%%%;/&| 11-5330 16 @%%%;/&| 11-5332 17 @%%%;/&| 11-5334 18 @%%%;/&| 11-5336 19 @%%%;/&| 11-5338 20 Duo-Head-Forceps universal for ring assembly 11-5340 21 Duo-Head-Tester handle (curved) M8 11-5342 22 Tray with holding devices for trial Duo-Heads 11-5344 23 Instrumentation Duo - Head complete 11.61 14-410 Flexibler Schaft Flexible shank ;=!Q ;"! +@ !' `!`% 11.62 14-420 2,5 x 35 mm 14-422 2,5 x 50 mm 14-424 2,5 x 60 mm 14-426 3,2 x 35 mm 14-428 3,2 x 50 mm `!`% ø 14-430 3,2 x 70 mm 14-440 1,5 mm 14-432 3,5 x 35 mm 14-442 2,5 mm 14-434 3,5 x 50 mm 14-444 3,5 mm 14-436 3,5 x 70 mm 14-446 4,0 mm B*;JB!Jp HIP STEM CEMENTLESS Introduction Years of experience with outstanding clinical results in the implantation of Cementless straight stems led to the development of the Ritorno hip stem cementiess. 13 sizes are available in various lengths with a CCD angle of 135°. The system is equipped with a 12/14 Eurocone, "%!="%Y"+!""!%?&!%!;"/" used. The Ritorno hip stem can be combinded with many cup systems and so can be adapted individually to the patient´s anatomy. Indication µ µ µ µ µ Degenerative, post -traumatic or rheumatoid arthritis Degenerative, post - traumatic or rheumatic arthrosis Avascular necrosis or necrosis due to tumour Arthrosis as a result of congenital or acquired intra - articular or extra - articular (axial) deformities This system can also be indicated to salvage previously unsuccessful operation attempts Contraindication µ µ µ µ Acute or chronic, local or systemic infection %"Y= != Loss of the ligament apparatus Hypersensitivity to the materials employed “ O N R O T I „R 11.63 B+J+BO;*V+?O!!*!A To estimate the subsequent implant size and determine the level of resection, preoperative planning with the aid of x-ray templates is "%%{~?!"+!!=%"=Y%="="%!="! assessed beforehand. Ritorno Hip Stem cementless X-ray template of Ritorno hip stem cementless size 7 11.64 Approach to the hip joint #XY=="!!!=%%Y!=?!!%"Y =%!! surgeon has a good view of the anatomical structures and can work correctly with the instruments unobstructed. Resection of the femoral neck The resection of the femoral neck is comes out according to the preoperative planning at an angle of about 45° to the femoral axis {~? Femoral axis 45° Resect cttio ion n level Diagr gram mm m mo off resectio resection on lle evel 11.65 Opening the medullary cavity !%Y"XY=%!"XY{~?!!%==%Y%=Y?!"sequent insertion of the rasps in the direction of the femoral axis. Fracturing the greater trochanter should be avoided. Opening the medullary cavity with the gouge The gouge should be applied according to the desired anteversion of the stem. The medullary cavity opening can be widened with the ={|~? Femoral rasp for widening the medularry cavity opening 11.66 _!%Y"XY!=%=!!"""{~?;+!!=/+!"! "!%!=!%?!!=!%"%%/!/"!%?!=/ "=%!=/?!"'!!=""Y!%"? Rasping the femur If the planned rasp size or depth is not reached, this can be bewuse the rasp direction does not run parallel to the axis. In this case, space can be created proximally with the femoral rasp and further rasping then becomes possible. 11.67 Trial reduction The rasps are constructed so that they can also be used as a trial prosthesis. For reduction, the handle is removed from the rasp which remains in the femur and the test cone is put on. Trial heads are available in sizes 28 and 32 with neck lengths S to XL for checking the !%X{~? Attaching the tast cone and a trial head to the rasp 11.68 The stem size to be implanted is selected according to the last rasp employed. The implant is inserted as far as possible into the femur by !%?!=!!%%%=!+!!="%!+"!X%= {~? Implantation of the stem After the stem cone has been cleaned and dried thotoughly. the original spherical head with the desired neck length is attached according to the manufacturer’s instructions. This is followed by reduction by hand along with wound closure in layers in the way preferred by the surgeon. 11.69 NOTICE 11.70 NOTICE 11.71 ;B+G*!;BGU+!;+AU|q*!;+B!O;*J!O?;BOGUO;J?JAQJB;qJO+#* O?;+!;O?;BO+)&:#Wj'( ;G;;?*!A+!;+?+]J!:W})&$) &: ;+?+]O}W})&$WW')W*!;+B!+;%`` Synicem Bone Cements Cementos para huesos Ortopedia Knochenzemente Ciments Osseux 1 2 ZEMENTE SYNICEM @;Y"%!%$=X{`;=!&Y'='!~_'YX%%/ Fixierung von Metall- oderPastischen Prothesen an das Knochengewebe verwendet werden. BESCHEINIGTE QUALITÄT Die Zemente Synicem besitzen das Zeichen CE (Conformité Européenne), im Einklang mit den Normen ISO 9001, ISO 13485 und ISO 5833 für Acrylzemente und Kunststoffe für chirurgische Implantate. TYPEN Es gibt 6 Typen von Zementen Synicem: 4 zur Handapplikation und zur Injektionsapplikation. Synicem 1 <&A +U+!;+GBqO!#O?*LO;*J! =qV"> Q!*+U&A=A<> Die Zemente Synicem zur Handappplikation sind mit folgendem Bestreben formuliert worden: - Leichtes Mischen und sofortige Homogenität der Masse. - Lange Arbeitszeit und leichte Applikation der Masse. - Verkürzte Endphase der Polimerization mit Herabsetzung des Risikos. - Homogene Radioopazität. Synicem 1 `!`%&&'':: Die Beigabe des Antibiotikums beeinträchtigt weder die physischen Eigenschaften noch die Handhabung und die Applikation des Zementes. Langfristige Freisetzung des Antibiotikums. Hohe Gentamycinkonzentrationen im Kortikal- und Spongiobereich. - Beide Zemente werden in Blisterpackungen mit 40 g durch ETO-sterilisiertem Pulver und eine Ampulle %"!<Q' geliefert. \*! +%"!% Zemente in Blisterpackungen mit 20 g durch ETO-sterilisiertem Pulver und eine Ampulle mit 10 ml %"!<Q'? Jede Blisterpackung bietet eine dreifache Sterilitätsbarriere. `!`%&&''&: Synicem 3 <(A +U+!;+GB*!+L;*J!O?*LO;*J! =!V"> Q!*+U(A=A<> Die Zemente Synicem niedrieger Viskosität sind speziell zur Applikation mittels irgendein zugelassenes Applikationssystem mit Spritze / Pistole entwickelt worden, um folgende Vorteile anzubieten: - Schnelle Mischung und sofortige Homogenität der Masse }"!_=='%'%!%X'$ Zustandes. - Zuverlässige Retention der Prothese. - Verkürzte Endphase der Polimerization mit, Herabsetzung des Risikos von Mikrobewegungen der Prothese. - Homogene Radioopazität. Die Beigabe des Antibiotikums beeinträchtigt weder die physischen Eigenschaften noch die Handhabung und die Applikation des Zementes. Langfristige Freisetzung des Antibiotikums. Hohe Gentamycinkonzentrationen im Kortikal- und Spongiobereich. Darreichungsform Beide Zemente werden in Blisterpackungen mit 60 g durch ETO-sterilisiertem Pulver, und eine Ampulle mit 30 ml durch <Q'? Jede Blisterpackung bietet eine dreifache Sterilitätsbarriere. `!`%&&'': `!`%&&''& 3 SYNICEM CEMENTS ;Y"`%="Y""=%=%"%% ="=!! live bone. Radiopacity is achieved by micro dispersed Barium Sulfate granules. CERTIFIED QUALITY ;Y"`£¢##&#¢;#{#=~'%"=Y[;£[;£|%[;£="" acrylic resin cements for surgical implants. TYPES There are 6 types of Synicem Bone Cements available: 4 to be manually applied and 2 for syringe application. Synicem 1 <&A UO!GO?O?*O;*J!+U+!; (High Viscosity) <&A=A> Synicem Manual Application Cements were developed to achieve: - Effortless mixing: immediate homogenity of dough - Uniform dough properties during a longer working period. - Long working period with soft easy to use dough. ;!!%/=!" movements during setting. # "%"!"? - Homogeneous radiopacity. Synicem 1 Addition of antibiotic does not affect physical, mixing, handling or insertion properies of the bone cement. Extended antibiotic release. Remarkable Gentamicin concentration at spongy and cortical bone levels. Presentation - Both cements are available in blisters, containing one pouch with 40 g (ETO sterilised) powder, and one ampoule with 20 ml {%~%? _"%=!==! " ="! +! { %~ % available. Each blister provides a triple sterility barrier. `!`%&&'':: `!`%&&''&: Synicem 3 <(A <O =?<> <(A=A> Synicem Syringe Application Bone Cements were developed to be used with any approved available syringe / gun system. - Effortless mixing, providing immediate homogenity of mixture - Easy application due to an extended low viscosity period. =!="% ? ;!!%/=!" movements during setting. - Homogeneous radiopacity. Addition of antibiotic does not affect the physical, mixing handling or insertion properties of the bone cement. Extended antibiotic release. Remarkable Gentamicin concentration at spongy and cortical bone levels. Presentation Both cements are available in blisters, containing one pouch with 60 g (ETO sterilised) powder, and one ampoule with {%~%? Each blister provides a triple sterility barrier. `!`%&&''& Synicem 3 `!`%&&'': 4 CEMENTOS SYNICEM };Y""="¶"%="%%""=¤=%"%=¤cas =¤"%?}%="%%%"="%=¶"%;%`"%=%? CALIDAD CERTIFICADA Los Cementos Synicem cuentan con Marcado CE (Conformité Européenne), respondiendo a las normas ISO9001, ISO 13485 e ISO 5833 referida a cementos de resinas acrílicas para implantes quirúrgicos. TIPOS # =%;Y"|==""%Y=="%? Synicem 1 <&A +U+!;;J#+O?*O*«!UO!GO? =O > Q!*+U&A=A> };Y"%_=""¶&!% formulados para lograr: - Fácil mezclado e inmediata homogenidad de la masa. - Largo tiempo de trabajo con masa suave y fácil de aplicar. <%"%¤X%"%% micro movimientos. - Radiopacidad homogénea. Synicem 1 `!`%&&'':: #%%""==%% ¶"="Y=""%"? *%"%"? Altas concentraciones de Gentamicina en Cortical y Esponjosa. ¬ - Ambos cementos se proveen en blisters conteniendo 40 g de polvo esterilizado por ETO y una ampolla de 20 ml %¶%/%="? *"%=%%=X envase conteniendo 20 g de polvo esterilizado por ETO y una ampolla de 10 ml de líquido esterilizado por " Cada blister provee una triple barrera de esterilidad. `!`%&&''&: Synicem 3 <(A +U+!;JOBOO?*O*«!J!+B*!AO =|> Q!*+U(A=A> Los Cementos Synicem de Baja Viscodidad han sido especialmente desarrollados para ser aplicados mediante cualquier sistema aprobado de jeringa / pistola, logrando: - Rápido mezclado e inmediata homogenidad de la masa. <¤"="""=%=¶% viscoso. "%=? <%"%¤X%"% de micro movimientos. - Radiopacidad homogénea #%%""==%% ¶"="Y/"%"? *%"%"? Altas concentraciones de Gentamicina en Cortical y Esponjosa. ¬ Ambos cementos se proveen en blisters conteniendo 60 g de polvo esterilizado por ETO y una ampolla de 30 ml %¶%/%="? Cada blister provee una triple barrera de esterilidad. :`!`%&&''& Synicem 3 `!`%&&'': 5 CIMENTS SYNICEM " ;Y"%=%%=¤%"="== de prothéses métalliques ou plastiques. Ils sont tous radio-opaques avac du sulfate de baryum, micro disperse QUALITÉ CERTIFiÉE Les ciments Synicem sont élaborés conformément aux normes ISO9001, ISO 13485 á la Directive Européene 93/42/CEE et ont obtenu le marquage CE. Il existe 6 types de ciment Synicem: 4 pour application manuelle et 2 types de ciment Synicem pour application avec seringue. <&A Synicem 1 ?*A!+#+*U+!;JGBO?*O;*J!UO!G+??+ =q§> Synicem 1: Caractéristiques de manipulation excellentes. Pénétration dans l´os et tension mécanique excellentes. `!`%&&'':: <&A Incorporation d´un antibiotique, la Gentamicine, sans qu´aucune des propriétés physiques (mélange, manipulation, application et insertion), ne soit modifiée. Libération prolongée de l´antibiotique. Concentration remarquable de la Gentamicine au niveau de l´os spongieux et cortical. § - Deux ciments Synicem 1 sont présentés sous forme de doses de 40 g de poudre stérilisée par oxyde d´ethyléne %%%=? * %=!%% = sous forme de doses de 20 g de poudre stérilisée par oxyde %!Y%%%=? Ces doses sont conditionnées dans un étui contenant un blister avec triple protection pour chacun de ces élements. CIMENTS POUR APPLICATION AVEC SERINGUE (Basse viscosité) Les ciments Synicem pour application avec seringue sont de basse viscosité et possédent donc d´excellentes propriétés de %?[""%? `!`%&&'&&: Synicem 3 <(A Il présente une phase de basse viscosité qui lui confére %"===="X" seringue et pistolet. <(A Incorporation d´un antibiotique, la Gentamicine sans qu´aucune des propriétés physiques (mélange, manipulation, application et ~%}=% avec efficacité maximale dés les 15 premiers jours aprés l´insertion. Concentration remarquable de la Gentamicine au niveau de l´os spongieux et cortical. `!`%&&'': § Les deux ciments Synicem 3 sont présentés sous forme de doses de 60 g de poudre stérilisée par oxyde d´éthyléne et de 30 ml de %=? Ces doses sont conditionnées dans un étui contenant un blister avec triple protection pour chacun de ces éléments. `!`%&&''& 6