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Arcos Broach/Calcar Proximal Body

 

Surgical Technique

Figure 2

Figure 1

Patient Positioning  
and Surgical Approach

Patient position should be determined by the 

 

surgeon’s preferred approach. The goal of the surgical 
approach is to establish adequate visualization of the 
anatomy (Figure 2).

Pre-operative Planning

When planning a hip revision utilizing the Arcos 
Modular Femoral Revision System, carefully review 
the indications and contraindications for use 
referenced within the package insert. 

The Arcos Modular Femoral Revision System is not 
designed for use in a fully unsupported proximal 
femur. Bone stock of adequate quality must be 
present and appraised at the time of surgery. The 
use of medial and/or lateral strut grafts may be 
necessary to support the taper junction in cases of 
severe proximal deficiency.

Utilizing A/P and M/L X-rays and implant templates 
will assist in determining the correct implant size, 
offset and position for a stable reconstruction 
(Figure 1). Final determination frequently cannot be 
made until the actual time of surgery. However, with 
appropriate planning, a consistent operative plan 
with alternatives can be formulated. 

Содержание Arcos Modular FemoralRevision System

Страница 1: ...Arcos Modular Femoral Revision System Broach and Calcar Proximal Bodies Surgical Technique...

Страница 2: ......

Страница 3: ...he Diaphysis 10 Trialing the Distal Stem 10 Preparation of the Metaphysis 11 Broaching the Metaphysis 12 Calcar Resection 13 Trial Reduction 14 Implant Assembly 15 Implant Insertion 16 Inserting the L...

Страница 4: ...e package insert The Arcos Modular Femoral Revision System is not designed for use in a fully unsupported proximal femur Bone stock of adequate quality must be present and appraised at the time of sur...

Страница 5: ...teotomy may be necessary if removing an extensively coated stem Sectioning the stem and utilizing trephine reamers can assist in the removal of the porous coated distal segment of a cementless stem Fi...

Страница 6: ...l the desired size A F and the 60 mm proximal body height is achieved The 60 mm etch mark of the proximal reamer should align with the tip of the greater trochanter Figure 8 Preparation of the Diaphys...

Страница 7: ...d remove the broach handle and tighten the broach s captured screw with the 3 5 mm hex driver to lock the broach into place Figure 11 Note Locking the broach and stem trial together will aid in matchi...

Страница 8: ...le to the assembled trial and insert the trial into the femur to verify it seats to the desired level Calcar Resection If utilizing the calcar proximal body implant determine the level of deficiency i...

Страница 9: ...femur Detach the broach handle from the assembled trial Trial Reduction Utilizing the modular neck and head trials perform a trial reduction of the hip and determine if the selected offset leg length...

Страница 10: ...nt Assembly With the trial still assembled in the sterile field assemble the distal stem and proximal body implants to match the orientation of the assembled trial Figure 16 Note If utilizing a slotte...

Страница 11: ...ength and stability After fully seating the femoral component impact the appropriate modular head onto the clean dry taper Inserting the Locking Screw To lock the distal and proximal body implants thr...

Страница 12: ...physis To prepare the femur for an STS distal stem select the STS reamers silver reamers for 150 mm stem length and gold reamers for a 190 mm stem length Assemble the STS reamer to the T handle and tu...

Страница 13: ...oximal femur assemble the final STS reamer into the proximal reamer and press down on the collar at the top of the proximal reamer to securely lock the two instruments together Figure 23 Ream the prox...

Страница 14: ...anteversion and the 60 mm etch mark on the broach handle is aligned with the tip of the greater trochanter Once the broach has been seated to the desired level remove the broach handle from the assemb...

Страница 15: ...the trial into the femur to verify that it seats to the desired level Calcar Resection If utilizing the calcar proximal body implant determine the level of deficiency in the proximal femur align the r...

Страница 16: ...trial and remove the trial from the femur Detach the broach handle from the assembled trial Trial Reduction Utilizing the modular neck and head trials perform a trial reduction of the hip and determin...

Страница 17: ...led implant and impact the taper junction with at least three blows of the mallet on the back table Figure 32 Implant Assembly With the trial still assembled in the sterile field assemble the distal s...

Страница 18: ...eck the security of the screw once the implant has been fully seated Implant Insertion With the proximal inserter still assembled to the implant ensure the anti rotation tabs are properly locked and i...

Страница 19: ...prior to selecting final head size and impacting the modular head onto the stem Figure 35 Provisional heads in seven neck lengths allow an additional trial reduction using the actual implant to ensur...

Страница 20: ...claw trials large or small to select the needed width Note Guide may be easier to attach before hip is reduced Attaching the Trochanteric Bolt Guide All proximal body designs accept a bolt and claw ex...

Страница 21: ...ed select the size B trochanteric bolt drill bit Selecting the correct size will prevent the drill from contacting the implant Note Bolts are available in 2 mm increments Preparing for Auxiliary Impla...

Страница 22: ...e 5 0 mm hex driver to the T handle and set to torque limiting position Preparing for Auxiliary Implant Attachment cont Advance the appropriate size drill bit through the plunger until the built in st...

Страница 23: ...ditional stability Figure 44 Note If the trochanteric bolt guide is difficult to remove unthread the trochanteric bolt by 1 2 a turn remove the guide and retighten the bolt with the T handle in torque...

Страница 24: ...ner that matches the selected proximal body height into the proximal distal inserter handle Depress the button at the top of the proximal distal inserter handle and insert the assembly rod into the in...

Страница 25: ...sired depth Figure 49 Note When a click is heard while tightening the strike plate the proximal body and distal stem are separated and cannot be locked during insertion into the femur Insertthe5 0mmhe...

Страница 26: ...ch and anti rotation handle Impact the stem to the desired depth Figure 51 Implant Assembly cont To fully engage the taper junction attach the torque wrench to the end of the proximal distal inserter...

Страница 27: ...al stem implant using the 5 0 mm hex Disengage the proximal distal inserter by pulling back on the inserter collar Figures 53 and 54 Inserter Disassembly To loosen the strike plate use the anti rotati...

Страница 28: ...epeated Inserter Disassembly cont To remove the proximal fastener utilize the taper assembly driver and unthread the proximal fastener from the proximal body implant Figure 55 Note This inserter disas...

Страница 29: ...prior to selecting final head size and impacting the modular head onto the stem Figure 58 Provisional heads in seven neck lengths allow an additional trial reduction using the actual implant to ensur...

Страница 30: ...l Body Insertion Attaching the Proximal Body to the Distal Stem Implant Once the desired offset has been chosen ensure that the taper junction on the distal stem implant is clean and dry Attach the pr...

Страница 31: ...n handle on the implant neck and tighten until 300 in lbs is indicated on the torque wrench shaft Figure 64 Insert the 5 0 mm hex driver into the top of the proximal distal inserter handle and tightly...

Страница 32: ...counter clockwise while leveraging the anti rotation handle Depress the button at the top of the proximal distal inserter handle and unthread the strike plate Figure 65 Unthread the distal fastener fr...

Страница 33: ...ge the proximal distal inserter by pulling back on the inserter collar Figure 67 To remove the proximal fastener utilize the taper assembly driver and unthread the proximal fastener from the proximal...

Страница 34: ...y from the Distal Stem Implant To disengage the proximal body implant from the distal stem remove the locking screw with the 3 5 mm hex driver and thread the taper disassembly tool that matches the pr...

Страница 35: ......

Страница 36: ...es force Distribution to any other recipient is prohibited Zimmer Biomet does not practice medicine The treating surgeon is responsible for determining the appropriate treatment technique s and produc...

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