AGILIS Ti - Por ACETABULAR SYSTEM. Surgical Technique

Transcription

1 AGILIS Ti - Por ACETABULAR SYSTEM Surgical Technique

2 Indications Impactor Handle Assembly The Agilis Ti-Por system is indicated for all patients whose indication is the cementless implant, with particular reference to cases in which there is a bone tissue with good mechanical quality and to patients with high functional expectations. The modular impactor Agilis Ti-Por has 5 colored ends corresponding to the 5 diameters of the articular heads compatible with the system. The surgeon will make the final choice of the system to be used according on his clinical experience and the situation found intra-operatively. Notes of sirurgical technique Acetabular Preparation The surgeon can evaluate preoperatively the size of the cup to be used and its ideal position, to restore the centre of rotation and prevent excessive bone sacrifices, with the aid of transparencies, available also in digital format. The acetabulum is prepared removing the periacetabular capsular tissue residue and the sclerotic bone using hemispherical reamer with diameter gradually increasing (Fig.1) Note: The terminals may be coupled to the handle in a fixed position. To ensure an easy and reliable fixing between the two components the operator must ensure that the semicircle in relief situated around the threaded end of the terminal rests well on the cylindrical terminal having a central fixing screw on the tip of the modular handle. The operator must take care to avoid damaging the medial wall of the acetabulum sinking too much the hemispherical reamers in the cranial direction. For this it may be useful to achieve the desired level of medialization already with the first reamer (the smallest) and then simply use the following reamers to remove the pathologic tissue without a more extensive circumferential milling depth. Fig. 1 Fig. 3a The reaming operation will stop when exposed healthy subchondral bone. The surgeon has available a set of hemispherical trial cups to verify the accuracy of the preparation done. (Fig. 2). Fig. 2 To carry out this calibration correctly, use a trial cup size corresponding to the diameter of the last hemispheric reamer used. In fact the Agilis Ti-Por cup has an hemispherical shape with a diameter of 1 mm higher than the nominal one identifying the size of each system. The Operator must choose the terminal corresponding to the size of the cup to be implanted and secure it to the handle using the appropriate tightening key. (Fig. 3a and 3b) Fig. 3b In this way the use of a final cup having the same diameter of the last reamer used, guarantees a 1 mm press-fit.

3 Locking of the system on the impactor handle The edge of the cup Agilis Ti-Por is characterized by three notches distributed at 120 from each other (fig.4a). Each terminal of the impactor has three peripheral hooks also positioned at 120 from each other (Fig. 4b). The cup can be locked on the impactor thanks to the interlocking of the hooks inside the peripheral notches. (Fig. 4c) Orientation of the cup In the case of cups fitted with couplings ceramic / ceramic with large diameter heads, such as the Agilis Ti-Por, it is appropriate to supply the system with adequate coverage, that means reduce the verticality. It is therefore recommended to impact the acetabular prosthesis Agilis Ti-Por following a 35 inclination and 10 anteversion angle. 35 Positioning of the cup Fig.4a It is possible to mount on the impactor handle a module with landmarks appropriately angled to help the operator to provide the correct inclination and anteversion of the implant. (Fig. 6). The operator can now impact the cup in situ. (Fig.7) Fig.4c Fig.4b Fig. 6 The cup must be supported on the terminal already fixed to the impactor handle, taking care to center the notches on the edges of the system on the hooks of the peripheral terminal itself. Fig. 7 The implant is then locked on the impactor turning it clockwise until the hooks are not going to stop. (Fig 5a and 5b) Fig.5a Fig.5b Once positioned the cup, the impactor tool can be easily released from the acetabular system by gently rotating the handle counterclockwise (Fig. 8) Fig. 8

4 Characteristics and Sizes AGILIS Ti-POR is an uncemented monoblock hemispherical acetabulum designed to articulate with ceramic heads of large diameter. The metal cup is made directly from powders of titanium, and is characterized by three-dimensional Ti-Por surface designed to improve the primary fixation of the system and to maximize the osseointegration. The cup is available in 13 sizes (from 42mm to 66mm with 2mm increments) divided into 5 groups according to the diameter of the heads with which they can articulate. The smallest cup (42mm) is already able to accept a 32mm ceramic heads. Agilis Ti-Por Cup Size Head Diameter Agilis Ti-Por Instrumentation Set IC00804 Pin for cup impactor 2 Pz 6 IC09100 Handle for trial cups 1 pz 2 IC18000 Agilis Ti-Por Curved Modular impactor 1 Pz 7 IC18400 Agilis Ti-Por impactor Tip assembly GR.K 1 Pz IC18410 Agilis Ti-Por impactor Tip assembly GR. W 1 Pz IC18420 Agilis Ti-Por impactor Tip assembly GR. X 1 Pz 3 IC18430 Agilis Ti-Por impactor Tip assembly GR. Y 1 Pz IC18440 Agilis Ti-Por impactor Tip assembly GR. Z 1 Pz IC16000 Cup positioner reference modulus 1 Pz 1 IH44000 Trial Head D. 44mm Short 1 Pz IH44100 Trial Head D. 44mm Medium 1 Pz IH44200 Trial Head D. 44mm Long 1 Pz 5 IH48000 Trial Head D. 48mm Short 1 Pz IH48100 Trial Head D. 48mm Medium 1 Pz IH48200 Trial Head D. 48mm Long 1 Pz IP54200 Agilis Ti-Por Trial cup 42mm 1 Pz IP54400 Agilis Ti-Por Trial cup 44mm 1 Pz IP54600 Agilis Ti-Por Trial cup 46mm 1 Pz IP54800 Agilis Ti-Por Trial cup 48mm 1 Pz IP55000 Agilis Ti-Por Trial cup 50mm 1 Pz IP55200 Agilis Ti-Por Trial cup 52mm 1 Pz IP55400 Agilis Ti-Por Trial cup 54mm 1 Pz IP55600 Agilis Ti-Por Trial cup 56mm 1 Pz IP55800 Agilis Ti-Por Trial cup 58mm 1 Pz IP56000 Agilis Ti-Por Trial cup 60mm 1 Pz IP56200 Agilis Ti-Por Trial cup 62mm 1 Pz IP56400 Agilis Ti-Por Trial cup 64mm 1 Pz IP56600 Agilis Ti-Por Trial cup 66mm 1 Pz IC18100 Screwdriver L75 CH5 1 Pz 8 IF00100 IF00200 IF00300 IF00400 IF00500 IF00600 IF00700 IF00800 IF00900 IF01000 IF01100 IF01200 IF01300 IF02000 IF03000 Acetabular Reamer, Ø42mm Acetabular Reamer, Ø44mm Acetabular Reamer, Ø46mm Acetabular Reamer, Ø48mm Acetabular Reamer, Ø50mm Acetabular Reamer, Ø52mm Acetabular Reamer, Ø54mm Acetabular Reamer, Ø56mm Acetabular Reamer, Ø58mm Acetabular Reamer, Ø60mm Acetabular Reamer, Ø62mm Acetabular Reamer, Ø64mm Acetabular Reamer, Ø66mm Acetabular Reamer handle Acetabular Reamers Tray

5 Adler Ortho srl Via dell Innovazione Cormano, Italy Tel Fax T0009-E-00 luglio 2012 Agilis Ti-Por Implants Agilis Ti-Por Cup Size 42 mm For 32 mm heads Agilis Ti-Por Cup Size 44 mm For 32 mm heads Agilis Ti-Por Cup Size 46 mm For 36 mm heads Agilis Ti-Por Cup Size 48 mm For 36 mm heads Agilis Ti-Por Cup Size 50 mm For 40 mm heads Agilis Ti-Por Cup Size 52 mm For 40 mm heads Agilis Ti-Por Cup Size 54 mm For 44 mm heads Agilis Ti-Por Cup Size 56 mm For 44 mm heads Agilis Ti-Por Cup Size 58 mm For 48 mm heads Agilis Ti-Por Cup Size 60 mm For 48 mm heads Agilis Ti-Por Cup Size 62 mm For 48 mm heads Agilis Ti-Por Cup Size 64 mm For 48 mm heads Agilis Ti-Por Cup Size 66 mm For 48 mm heads Delta Ceramic Head 12/14 DIAM 32 SHORT Delta Ceramic Head 12/14 DIAM 32 MEDIUM Delta Ceramic Head 12/14 DIAM 32 LONG Delta Ceramic Head 12/14 DIAM 36 SHORT Delta Ceramic Head 12/14 DIAM 36 MEDIUM Delta Ceramic Head 12/14 DIAM 36 LONG Delta Ceramic Head 12/14 DIAM 40 SHORT Delta Ceramic Head 12/14 DIAM 40 MEDIUM Delta Ceramic Head 12/14 DIAM 40 LONG Delta Ceramic Head 12/14 DIAM 44 SHORT Delta Ceramic Head 12/14 DIAM 44 MEDIUM Delta Ceramic Head 12/14 DIAM 44 LONG Delta Ceramic Modular Head DIAM Modular Sleeve 12/14 Inner Taper SHORT Modular Sleeve 12/14 Inner Taper MEDIUM Modular Sleeve 12/14 Inner Taper LONG Modular Sleeve 12/14 Inner Taper EXTRA - LONG