*smith&nephew; EP-FIT PLUSâ¢

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Surgical Technique Note Users of minimally invasive surgical techniques, please work through the following surgical instructions additionally: posterolateral approach (Lit. No. 1426); anterolateral approach (Lit. No. 1483); anterior approach (Lit. No. 1494). Position of patient and approach Surgery is performed with the patient in an extended supine or lateral position. Surgical approach – lateral or dorsolateral – is determined on the basis of the patient data established in advance and preference of the surgeon. Removal of the femoral head An osteotomy of the femoral neck is performed in accordance with the preoperative planning for the corresponding stem system. Preparation of the acetabulum The joint capsule is opened and sufficiently resected, fully if necessary. The acetabulum is exposed to allow a good view and sufficient room for reaming instruments. 6
Assembly of the reamer The reamer is placed on the drive shaft using pressure and turned clockwise until the locking mechanism snaps in. Reaming of the acetabulum The acetabulum is reamed using a spherical original Smith & Nephew Orthopaedics AG reamer with increasing diameter until the cartilage layer is fully removed and the subchondral bone bleeds uniformly. Note It is recommended to begin with a reamer size equal to or 2 mm smaller than the head size and that reaming is continued down to the base of the fovea acetabuli (teardrop figure). As much hard sclerotic bone as possible should be removed from the pole region, but retained in the peripheral zone. It may be advisable to choose a reamer that is in relation to the cup size 1 mm larger to avoid fissures and ensure optimal seating. Excessive reaming of the periphery should at all times be avoided as this would result in a level of bone loss, especially at the anterior and posterior columns of the acetabulum, that is too high. The bone slurry that remains in the last reamer can be used to fill in the gap between the acetabulum and the implant later on. Reamers with 1 mm increments are available (see page 37). 7
Page 1: Surgical Technique *smith&nephew EP
Page 5 and 6: Foreword Shells conceived on the ba
Page 7: Case Study Preoperative Postoperati
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 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

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*smith&nephew; EP-FIT PLUSâ¢