*smith&nephew; EP-FIT PLUSâ¢
*smith&nephew; EP-FIT PLUS⢠*smith&nephew; EP-FIT PLUSâ¢
Use of the PLUSMET metal insert Indications and contraindications Basically the same indications, contraindications and recommendations applying for THR with other articulating surfaces, also apply for PLUSMET metal inserts. The following additional contraindications have to be considered for metal inserts: • Patients with chronic renal failure, renal insufficiency or on dialysis. • Patients with known allergies of any kind or occupational exposure to cobalt, Chrome or molybdenum. • If angle of inclination is below 30º or above 50º, the PLUSMET metal insert must not be used. • If angle of anteversion underruns 10º or exeeds 20º, the PLUSMET metal insert must not be used. Smith&Nephew Orthopaedics standard and hooded PE inserts are available for such cases. • If a stable reduction cannot be achieved. • If cup is positioned in a retroversion mode. Risk of impingement should at all times be avoided. Implantation A trial insert should be used before a metal insert is implanted. Trial heads of the intended diameter must then be used to ensure an adequate range of motion (ROM) in all directions of movement 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. Pressure of the neck of the prosthesis at the edge of the metal insert may cause point loads that increase the risk of abrasion. The alignment guide (130728) should always be used with PLUSMET metal 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. 16
Placement of the metal insert (ME) Proceed with the trial insert as described in “Optionally: trial reduction using trial insert”. Before insertion it must be ensured that the internal surface of the metal shell is dry and free of any contamination. Screw the adapter for ME-inserts (130989– 130993) and the impactor head onto the inserter/impactor. Attach the implant onto the adapter. Place the 3 arms of the adapter on the front face of the metal shell so that the PLUSMET metal insert is not tilting. Insert it into the shell by gently hitting the inserter/impactor. Note To impact the metal/insert only the above described adapter respectively inserter/ impactor must be used. 17
- 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 and 10: Assembly of the reamer The reamer i
- Page 11 and 12: Implantation of the titanium shell
- Page 13 and 14: Optionally: trial reduction using t
- Page 15 and 16: Insertion of the hooded polyethylen
- Page 17: Note To ensure that the BIOLOX ® f
- 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
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- Page 44: Manufacturer Smith & Nephew Orthopa
Placement of the metal insert (ME)<br />
Proceed with the trial insert as described in<br />
“Optionally: trial reduction using trial insert”.<br />
Before insertion it must be ensured that the<br />
internal surface of the metal shell is dry and<br />
free of any contamination.<br />
Screw the adapter for ME-inserts (130989–<br />
130993) and the impactor head onto the<br />
inserter/impactor.<br />
Attach the implant onto the adapter.<br />
Place the 3 arms of the adapter on the front<br />
face of the metal shell so that the PLUSMET<br />
metal insert is not tilting.<br />
Insert it into the shell by gently hitting the<br />
inserter/impactor.<br />
Note<br />
To impact the metal/insert only the above<br />
described adapter respectively inserter/<br />
impactor must be used.<br />
17
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