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The following technique should be used when
implanting REDAPT Sleeveless monolithic
implants. Before surgery, review instrument
sets to ensure all instruments are present and
working properly.
Removal of a well fixed femoral stem
The removal of a well fixed femoral stem can at
times be accomplished using thin osteotomes
starting at the proximal portion of the implant.
If the ingrowth region of the implant is not
abutting cortical bone, this is more likely to be
successful. Often, however, the ingrowth region
of the stem is more distal and abuts the cortical
bone and advancing an osteotome may fracture
the femur. A proximal opening osteotomy,
typically an extended trochanteric osteotomy
(ETO), greatly facilitates stem removal. Once
the stem is exposed over the lateral surface,
a saw or burring device can be used to disrupt
the anterior and posterior surfaces. The medial
surface can then be disrupted using a Gigli
saw. This maneuver may be tedious and require
multiple saws. Once this is accomplished, the
ETO is replaced to its original position and held
in place with cerclage wires or cables.
Templating is useful in determining the length
of the ETO, identifying angular deformities which
may require corrective osteotomy, or planning
removal of other retained hardware.
Surgeon tip Before performing an ETO,
reaming, trialing and inserting a new stem,
place a cable or cerclage wire slightly distal
to the osteotomy or the existing stem before
reaming, trialing and inserting the stem to
minimize risk of propagating a crack or fracture.
Surgical Technique