Tapered Hip System Surgical Technique Overview
Tapered Hip System Surgical Technique
Content
•
Instruments show
•
Pre-Op plan
•
Femoral Neck cut
•
Operation of Acetabular
•
Operation of Fumer
•
Reset
•
Insert
Instruments
Instruments
Instruments
Pre-Op Planning
– AP and Lateral Views
Pre-Op Planning
•
Define
- Center of Rotation
- Cup Size
- Offset
- Leg Lengt
•
Landmarks
- Ischial Tuberosity
- Greater / Lesser
Trochanter
Pre-Op Planning
•
Aim for Optimal Metaphyseal Fill
- Primary Load Transfer Area
- Primary In-growth Area
•
Diaphyseal Fill Not Critical
- Tapered Distal Geometry
Pre-Op Planning
– Lateral View
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Posterior Neck
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Anterior Metaphyseal /
Diaphyseal Junction
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Distal – Posterior
Neck Resection Guide
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Reference:
- Greater Trochanter
- Lesser Trochanter
Be Conservative Measure Calcar Level From
LT Level--1.5cm up LT
Operation of Acetabular
Start grinding the
acetabular from the
smallest acetabular file or
use a 6-8mm acetabular
file smaller than the
desired prosthesis
Note the direction of the acetabular file
Valgus 45 °& Leaning forward by 15 °
Valgus 45°
Anteverted 15°
Match of Acetabular Cup with HA coating and Reamer Domes
A 50mm reames
a 49mm cavity
A 50mm trial shell is
49mm in diameter
A 50mm acetabular shell is
51mm in diameter
Anteversion Osteotome
•
Medium Style
Version Definition
Canal Finder
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Blunt Tip
•
Side Cutting
Canal Definition
Lateraliser & Lateralising Rasp
Allows Preparation in The Medial
Aspect of the Greater Trochanter
Important for a Tapered Stem
Prevents placing stem in varus
Stay Lateral!
Tapered Reamers
Tapered Reamers
•
Reference:
‘GT’ - Greater
Trochanter
Tapered Reamers
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Reference:
‘C’ – Calcar
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Medial Aspect of the Neck Resection
Tapered Reamers
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Sharp – aggressive
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Power or hand
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Thread pulls you into the canal
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Ream incrementally
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Ream to cortical ‘chatter’
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Do not over ream
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Two sizes per reamer
S
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e
6
Broach Handle
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Quick Connect / Release
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Narrow Attachment Profile
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Version – holes provided for
Alignment Rod
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Curved Strike Plate
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Broach Icon
Broaching
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B
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!
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Assess Rotational Stability
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Evaluate Neck Resection Level
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Assess Leg Length /
Center of Rotation
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Intra-op check
Broaching
S
T
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L
A
T
E
R
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L
!
Neck Trials
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Size Etchings
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-
Lateral Aspect
- Neck Trunion
Trial head locking
ring
R
e
s
e
t
Install the appropriate neck trial and
plastic head trial to determine the
correct prosthetic position, joint
stability, range of activities and
length of the lower limbs.
Stem Insertion
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I
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!
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Initial insertion by hand, impact final 1 to 2 cm
with impactor
Stem Inserter / Impactor
•
Positive Lock
Standard
Both Offer Full Version
C
ontrol
Final Reduction
Broach Stem Relationship
•
Line to Line with the grit
blasted surface
•
Porocoat Thickness: approx
0.3 mm over the broach
envelope proximally
CASE: 38 Year Male
(Dysplasia
)
This comprehensive guide provides a detailed overview of the surgical technique involved in the Tapered Hip System. From pre-op planning to instrument usage and procedures like femoral neck cut and acetabular operation, this resource covers essential steps with accompanying images for clarity.
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Presentation Transcript
Content Instruments show Pre-Op plan Femoral Neck cut Operation of Acetabular Operation of Fumer Reset Insert
Pre-Op Planning Define - Center of Rotation - Cup Size - Offset - Leg Lengt Landmarks - Ischial Tuberosity - Greater / Lesser Trochanter
Pre-Op Planning Aim for Optimal Metaphyseal Fill - Primary Load Transfer Area - Primary In-growth Area Diaphyseal Fill Not Critical - Tapered Distal Geometry
Pre-Op Planning Lateral View Three Point Contact and Fixation is CRITICAL Posterior Neck Anterior Metaphyseal / Diaphyseal Junction Distal Posterior
Neck Resection Guide Reference: - Greater Trochanter - Lesser Trochanter Be Conservative Measure Calcar Level From LT Level--1.5cm up LT
Operation of Acetabular Start grinding the acetabular from the smallest acetabular file or use a 6-8mm acetabular file smaller than the desired prosthesis
Operation of Acetabular Anteverted 15 Valgus 45
Operation of Acetabular Select the same nominal acetabular implant as the acetabular file, pay attention to the implant angle
Match of Acetabular Cup with HA coating and Reamer Domes A 50mm reames a 49mm cavity A 50mm trial shell is 49mm in diameter A 50mm acetabular shell is 51mm in diameter
Operation of Acetabular Blue area is the safe area for the screws, the screws can help the early stability of the prosthesis, you can also choose not insert the screws.
Operation of Acetabular Placement of the liner
Anteversion Osteotome Medium Style Version Definition
Canal Finder Blunt Tip Side Cutting Canal Definition
Lateraliser & Lateralising Rasp Allows Preparation in The Medial Aspect of the Greater Trochanter Important for a Tapered Stem Prevents placing stem in varus Stay Lateral!
Tapered Reamers Reference: GT - Greater Trochanter
Tapered Reamers Reference: C Calcar Medial Aspect of the Neck Resection
Tapered Reamers Size 6 Sharp aggressive Power or hand Thread pulls you into the canal Ream incrementally Ream to cortical chatter Do not over ream Two sizes per reamer
Broach Handle Quick Connect / Release Narrow Attachment Profile Version holes provided for Alignment Rod Curved Strike Plate Broach Icon
Broaching Broach in neutral alignment. Avoid broaching in varus risk of calcar fracture! Assess Rotational Stability Evaluate Neck Resection Level Assess Leg Length / Center of Rotation Intra-op check
Broaching STAY LATERAL!
Neck Trials Size Etchings - Lateral Aspect - Neck Trunion Trial head locking ring
Reset Install the appropriate neck trial and plastic head trial to determine the correct prosthetic position, joint stability, range of activities and length of the lower limbs.
Stem Insertion Insert stem in neutral alignment. Avoid following medial curve stay lateral!. Avoids varus placement risk of calcar fracture! Initial insertion by hand, impact final 1 to 2 cm with impactor
Stem Inserter / Impactor Positive Lock Standard Both Offer Full Version Control
Broach Stem Relationship Line to Line with the grit blasted surface Porocoat Thickness: approx 0.3 mm over the broach envelope proximally
CASE: 38 Year Male (Dysplasia)
