smith&nephew REDAPT, Хирургическая техника, Страница: 13 / 32

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Figure 5
Figure 6
Black line on quick connect
indicates alignment of
greater trochanter or other
predetermined landmark
Distal reaming
Select the appropriate reamer for the length of
stem chosen: 190mm reamers should be used for
190mm stems, 240mm reamers should be used
for 240mm stems and 300mm reamers should
be used for 300mm stems.
Attach the quick connect to the appropriate
distal reamer (Figure 5).
Set power in forward position and ream the
distal femoral canal until desired distal fit is
achieved. Begin reaming with a distal reamer
that is at least 2mm smaller than the templated
size or a reamer that has little or no resistance.
To minimize potential risk of reaming through
the anterior cortex, direct the reamer from
anterior to posterior. Care should be taken to
avoid bone or surrounding soft tissue when
introducing reamers.
Note Do not strike the quick connect or
distal reamers.
Surgeon tip Ream until you hear cortical chatter,
the reamer contains cortical bone debris and
the reamer does not advance under firm axial
pressure. The reaming technique may be more
aggressive than with a cylindrical porous stem.
Caution Take care when handling reamers as
they are sharp and may damage surgical gloves
and soft tissue.
Progressively ream in 1mm increments. Note the
color code marked on the shaft of select distal
reamers. This color will identify available implant
sizes and appropriate instrumentation
for subsequent steps.
The size of a REDAPT™ stem is 0.25mm greater
than the equivalently sized reamer, providing
a press fit of 0.25mm.
The depth of the reamer is determined by
aligning the mark on the quick connect, which
represents the +0 head center, with the greater
trochanter (Figure 6). If the greater trochanter
is not available then an alternative anatomical
reference must be made. A ruler can be used to
measure from the distal end of the osteotomy to
the previous location of the greater trochanter.
(Ruler not included in instrument set.) Ream
consistently to the determined land mark.