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Revision of the metal/ceramic insert Screw the extraction instrument for metal/ ceramic inserts onto the inserter/impactor (130818). Position the extraction instrument on the edge of the metal/ceramic insert with care. Fit the 3 tips into the lateral recess in the shell – they are correctly positioned when lateral torsion is not possible. Release the metal/ceramic insert by impaction of the inserter/impactor and remove it. Postoperative Treatment The treatment of the patient after surgery will depend on several factors (in particular the surgical approach, the stem prosthesis used and any attendant diseases). If the patient has a good bone quality and the primary implantation of both prosthesic components is stable, then it is recommended that the patient use walking aids for 6–12 weeks after surgery. However, the exact degree of walking assistance required will have to be decided by the physician for each individual patient. Sterilization Implants All the implants described in this Surgical Technique are sterile when they are delivered by the manufacturer. Resterilization is not allowed. Instruments System components and instruments are not sterile when they are delivered. Before use they must be cleaned by the usual methods in accordance with internal hospital regulations and sterilized in an autoclave in accordance with the legal regulations and guidelines applicable in the relevant country. (For detailed information please refer to leaflet Lit. No. 1363.) The correct settings are given in the instructions for use issued by the autoclave manufacturer. Instrument manufacturers and dealers accept no responsibility for sterilization of products by the customer. 18
References Zwartelé RE, Brand R, Doets HC Increased risk of dislocation after primary total hip arthroplasty in inflammatory arthritis – prospective observational study of 410 hips. Acta Orthop Scand, 2004; 12 Adler E, Stuchin A, Kummer FJ Stability of Press-Fit acetabular cup. J Arthroplasty, 1992; 7:295–301 Doets HC, Olsthoorn PGM, Schmotzer H Medium-term results with the Enhanced Press-Fit Cup in osteoarthrosis, rheumatoid arthritis and revision arthroplasty, 2003. Engh CA, Griffin WL, Marx CL Cementless acetabular components. J Bone Joint Surg (Br) 1990; 72B:53–59 Lachiewicz PF, Suh PB, Gilbert JA In vitro initial fixation of porous-coated acetabular total hip components. A biomechanical comparative study. J Arthroplasty, 1989; 4:201–205 Lintner F, Zweymüller K, Brand G Tissue reactions to titanium endoprostheses. J Arthroplasty, 1986; Vol. 1, No. 3:183–95 McKenzie JR, Callaghan JJ, Pedersen P, Brown TD Areas of contact and extent of gaps with implantation of oversized acetabular components in Total Hip Arthroplasty. Clin Orthop, 1984; 208:127–136 Snorrason F, Kärrholm PJ Migration of fully threaded acetabular components. A roentgen stereo-photogrammetic analysis. J Bone Joint Surg, 1990; 72B:647–652 19
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 and 18: Note To ensure that the BIOLOX ® f
Page 19: Placement of the metal insert (ME)
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

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