*smith&nephew; EP-FIT PLUSâ¢
*smith&nephew; EP-FIT PLUS⢠*smith&nephew; EP-FIT PLUSâ¢
Determination of the implant size using the trial shell Screw the trial shell onto the shell inserter (130707). 2 1 An alignment guide (130728) may be used for orientation purposes relative to the cup position. The assembled alignment guide is mounted on the shell inserter with the trial shell. 10°–20° The aim is an anteversion of 10° and an inclination of 45°. Align the shell inserter in such a way that rod (1) is perpendicular to the coronal plane and rod (2) is perpendicular to the sagittal plane of the patient. If the patient is lying in the supine position (see illustration, here: using the example of a right hip), the long edge of the table can serve as an orientation guide. The trial shell is placed in the reamed acetabulum by exerting pressure on the shell inserter (but without using an impacting tool). Verification of correct seating in the acetabulum. After removal of the shell inserter the cup position and depth can be checked. The trial shell is then removed with the shell inserter screwed back in. Note In contrast to the original implants the trial shells are not oversized. If the desired degree of stability is not attained, then the depth of the bone bed has to be increased (see “Reaming of the acetabulum”) or the next largest size of trial shell chosen. 8
Implantation of the titanium shell with trial shell inserter Bone slurry from the last reaming procedure can be uniformly distributed in the acetabulum to compensate for possible gaps. Mount the shell, of predetermined size, on the shell inserter (130707). If necessary, mount the alignment guide (130728) on the shell inserter. 10°–20° Position the cup shell in the acetabulum and align the shell inserter as described in “Determination of the implant size using the trial shell”. The inclination should ideally be 40–50º and anteversion 10–20º to achieve optimum results. Final acetabular component orientation must also consider the position of the femoral implant, the stability and degree of bone coverage as well as correct softtissue tensioning, to achieve the optimal result for each patient. Any inclination of the shell greater than 50º must be avoided because of possible impingement and/or a tendency towards dislocation. It may be advantageous to use a reliable navigation system to position the cup as this would considerably improve the accuracy of positioning. If no screws are used, the cup should be orient ed with screw holes inferiorly. The implant is inserted into the acetabulum by impaction with the shell inserter and the impaction/extraction hammer (130705). Note The information on the use of ceramic, metal and PE inserts must be followed without fail (see pages 12 to 18). 9
- Page 1: Surgical Technique *smith&nephew EP
- Page 5 and 6: Foreword Shells conceived on the ba
- Page 7 and 8: Case Study Preoperative Postoperati
- Page 9: Assembly of the reamer The reamer i
- Page 13 and 14: Optionally: trial reduction using t
- Page 15 and 16: Insertion of the hooded polyethylen
- Page 17 and 18: Note To ensure that the BIOLOX ® f
- Page 19 and 20: Placement of the metal insert (ME)
- Page 21 and 22: References Zwartelé RE, Brand R, D
- Page 23 and 24: Shell Ti-plasma, multihole Art.No.
- Page 25 and 26: Note EP-FIT PLUS metal inserts must
- Page 27 and 28: Ceramic ball heads, BIOLOX ® OPTIO
- Page 29 and 30: 27
- Page 31 and 32: 29
- Page 33 and 34: 31
- Page 35 and 36: 33
- Page 37 and 38: 35
- Page 39 and 40: 37
- Page 41 and 42: 39
- Page 44: Manufacturer Smith & Nephew Orthopa
Determination of the implant size using<br />
the trial shell<br />
Screw the trial shell onto the shell inserter<br />
(130707).<br />
2<br />
1<br />
An alignment guide (130728) may be used<br />
for orientation purposes relative to the cup<br />
position. The assembled alignment guide is<br />
mounted on the shell inserter with the trial<br />
shell.<br />
10°–20°<br />
The aim is an anteversion of 10° and an inclination<br />
of 45°. Align the shell inserter in such<br />
a way that rod (1) is perpendicular to the coronal<br />
plane and rod (2) is perpendicular to<br />
the sagittal plane of the patient. If the patient<br />
is lying in the supine position (see illustration,<br />
here: using the example of a right hip), the<br />
long edge of the table can serve as an orientation<br />
guide.<br />
The trial shell is placed in the reamed acetabulum by exerting pressure on the shell inserter<br />
(but without using an impacting tool).<br />
Verification of correct seating in the acetabulum. After removal of the shell inserter the cup<br />
position and depth can be checked. The trial shell is then removed with the shell inserter<br />
screwed back in.<br />
Note<br />
In contrast to the original implants the trial shells are not oversized. If the desired degree<br />
of stability is not attained, then the depth of the bone bed has to be increased (see “Reaming<br />
of the acetabulum”) or the next largest size of trial shell chosen.<br />
8
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