*smith&nephew; EP-FIT PLUS™

Insertion of the hooded polyethylene insert using the inserter/impactor
It is recommended to insert the hooded polyethylene insert using the inserter/impactor
(130818).
The procedure for the hooded polyethylene insert and the inserting device is analogous to
the description under “Placement of the standard polyethylene insert using the inserter/
impactor”.
Note
The position of the shoulder of the hooded PE inserts can be changed in 30º increments.
Use of the BIOLOX ® forte/delta ceramic insert
Indications and contraindications
The same indications and contraindications apply to the use of the BIOLOX ® forte/delta cup
inserts as for total hip arthroplasty with other articulating surfaces.
The following additional contraindications apply to ceramic inserts:
• The inclination should not be substantially above or below the range 40–50º.
• The anteversion must not be above or below the range 10–20º.
• If the angle of inclination is below 30º or above 50º BIOLOX ® forte/delta inserts must not be
used. Smith&Nephew Orthopaedics standard and hooded PE inserts are available
for such cases.
• Ceramic cup inserts should similarly not be used for cups in a retroversion mode.
• Risk of impingement should at all times be avoided.
Implantation
A trial insert should be used before a ceramic insert is implanted. Trial heads of the
intended diameter must then be used to ensure an adequate range of motion (ROM) in all
directions and to check the stability of the joint. The artificial joint must not dislocate in
the course of movement or subluxate through impingement of the implant components or
soft tissue.
The alignment guide (130728) should always be used with BIOLOX ® forte/delta ceramic inserts
in order to obtain the necessary level of accuracy.
It is advisable to use computer-assisted navigation systems intraoperatively for documentation
and verification of the implant position and to get exact information on the ROM.
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