6 DePuy Synthes ESC® Enhanced Stability Liners Design Rationale & Surgical Technique ESC Liner Surgical Technique Step 1 Seat the ESC Constrained Liner into the PINNACLE Hip Solutions Shell and align the ARD (anti-rotation device) tabs. The preassembled locking ring is designed to fit into the groove around the inner circumference of th Surgical Technique DURALOC® Acetabular Cup DePuy Synthes 1. Figure 1. The primary goal of total hip arthroplasty is the anatomic reconstruction of the hip joint, resulting in favourable constrained liner is in place, do not perform trial reduction. Due to the liner constraining mechanism, the trial head will. surgical technique design rationale enhanced Stability Constrained liners 4.1M0806 0608-58-000 DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, IN 4658 . lbs.) The Freedom™ Constrained Liner System offers simple instrumentation and five distinct liner options with one goal in mind: to provide the surgeon a versatil
The Depuy (Warsaw, IN) Corporation manufactures the Duraloc constrained acetabular liner, which uses a locking ring mechanism. This component is designed similarly to the SROM constrained acetabular component (Depuy/Johnson & Johnson, Warsaw, IN) The Biomet® Freedom™ Constrained Liner System is intended for use only in special situations where the patient has a high risk of dislocation due to a previous history of dislocation, severe joint laxity, and/or palsy of surrounding musculature. With the exception of the All-Poly liners PINNACLE® Hip Solutions Polyethylene Surgical Technique DePuy Synthes Companies 3 Table of Contents Surgical technique Ordering Information Introduction 4 Templating and Pre-Operative Planning 6 Surgical Approach - Anterolateral 8 Surgical Approach - Posterolateral 10 Acetabular Reaming 12 Acetabular Shell Trialing and Positioning 1 The R3 Constrained Liner Acetabular System is designed for those total hip replacement patients who suffer from or are at risk for recurrent dislocations. The R3 Constrained Liner Acetabular System will not restore function to the level expected with a normal healthy joint, and the patient should be instructed as to the limitations of the device
(B) The PINNACLE Constrained Liner System is designed to address hip instability and provide resistance to dislocation and high ranges of motion with simple, reproducible insertion instruments. Preoperative diagnoses of the 46 study subjects were hip arthritis in 4, hip fracture in 37, and avascular necrosis in 5 The PINNACLE Revision Acetabular Cup System provides Standard Profile, Deep Profile, and Multi-hole shell options for intraoperative flexibility. The PINNACLE ESC ® Constrained Liner System is designed to address hip instability and dislocation through dislocation resistance and high range of motion with simple, reproducible insertion instruments
DePuy Synthes Pinnacle AltrX (7.5 Mrad) 442 446 Statistically equivalent 204 53% Lower Force (in-lbf) Lever Out: Disassembly force required to dislodge a polyethylene liner from an acetabular shell All tests were performed with 54 mm acetabular shells and 32 mm acetabular liners * Primary identification should be made using size and letter. 5 | G7 Acetabular System Surgical Technique Freedom Constrained Sizing Chart Shell Size (mm) Head Size (mm) 28 32 36 42 A 44 46 B 32 48 C 32 50 D 36 52 E 3 In the 27 patients (29 hips), an Osteonics Omnifit Constrained Acetabular Bearing Insert (Osteonics, Allendale, NJ) was used in 24 hips, an SROM constrained liner (Depuy, Inc, Warsaw, Ind) in 4, and a Biomet constrained liner (Biomet, Inc, Warsaw, Ind) in 1. The outer diameter of the polyethylene liner averaged 54 mm (range 49-68) PINNACLE ® Hip Solutions is a modular cup system designed with a wide range of acetabular cup options, biological and mechanical fixation alternatives and advanced bearing technologies that allows surgeons the flexibility to choose intraoperatively from among the most advanced technologies available depending on their patients' individual needs The DePuy Pinnacle® Constrained Acetabular Liner described in this submission is identical to the DePuy Pinnacle® Constrained Acetabular Liner previously cleared in K052079 on October 21, 2005. There have been no design modifications to the Pinnacle Constrained Acetabular Liner. The DePuy Modular M femoral hea
J Bone in revision total hip arthroplasty. J Arthroplasty. 2003;18(7):827-833. Joint Surg Am. 2002;84-A(10):1788-1792. 30. DePuy. DePuy Pinnacle Enhanced Stability Constrained Liners, Design 2. Paterno SA, Lachiewicz PF, Kelley SS. The influence of patient-related fac- Rationale and Surgical Technique. Published in 2006 Freedom Constrained Acetabular Liners feature: 36mm head for range of motion up to 114° to reduce risk of impingement and further dislocation 3. Pre-assembled constraining ring to maximize lever-out force of the head and allow for easy assembly in-situ 1-2. Multiple liner configurations to meet the demands of chronic dislocators 1 DePuy Pinnacle Acetabular Cup System Bottom Tray Catalog # Description 2217-00-020 Alternate Bearing Suction Cup Inserter 2217-50-001 Pinnacle Constrained Liner Extractor 2217-50-010 Pinnacle Poly Extractor 1221-32-148 32 mm Cup x 48 mm Inner Diameter, +4 10° 1221-32-448 32 mm Cup x 48 mm Inner Diameter Neutral +4.
System, was developed to function temporarily as a total hip replacement (THR). It was also designed as a carrier device for local delivery of antibiotic drugs within the periprosthetic space following surgery for the explantation of an infected total hip prosthesis. This implant system acts as an articulating spacer with a structure an The S-ROM® Modular Hip System has been used successfully for more than 20 years in more than 125,000 cases, and its strength and stability have been proven in clinical and laboratory studies.1 No other modular hip system can boast 98 percent survivorship in primary hip arthroplasties.2 No other modular hip system can offe The SIGMA ® Knee System design is the most constrained device available within the P.F.C. ® SIGMA ® Knee System and is indicated for use in cases where collateral ligaments are deficient. This comprehensive system offers both a fixed bearing and rotating platform option. Additionally surgeons are able to address bone and soft tissue defects with a variety of products including augments. The PINNACLE ® Revision Acetabular Cup System aims to address the need for enhanced stability and biomechanical optimization while providing immediate and long-term fixation.. By combining revision-specific advancements with the clinical heritage of the PINNACLE Primary Acetabular Cup System, the PINNACLE Revision System provides a solution for the challenges faced in revision cases
The DePuy Prostalac Hip System is comprised of a cobalt chrome alloy core femoral component, a cobalt chrome alloy modular femoral head, a one-piece ultra-high molecular weight (UHMWPe) polyethylene acetabular component, a PMMA stem centering device and antibiotic-loaded bone cement. It is designed to provide a means for limited mobilit Constrained polyethylene liners (Poly-Dial™, DePuy Orthopaedics, Inc, Warsaw, IN) with 28-mm (n = 5) and 32-mm (n = 5) inner diameter sizes were received sterilized in vacuum-sealed packages. These components are a two-piece design consisting of a 52-mm outer diameter polyethylene liner with a neutral face offset inclination and a metal. Acetabular Cup System. The DURALOC ® Acetabular Cup is a cementless cup that was introduced in 1990 and has a 13A* ODEP rating 1. The DURALOC Cup is a dome loaded cup, which helps ensure improved liner/shell congruency, a minimum polyethylene thickness of 6mm and a secure locking mechanism. These features, combined with POROCOAT ® Porous.
constrained acetabular liner were used in the study; The trilogy Acetabular System Constrained Liner (Zimmer) was used in 8 cases, the RingLoc II Constrained (Biomet Orthopedics) was used in 9 hips, one case with Smith & Nephew liner and one hip with Duraloc Constrained Liner (DePuy). Anteroposterior an Use of dual-mobility or constrained liners in these patients is an effective technique to reduce the risk of postoperative hip dislocation. However, we do not yet know the full risks of loosening of dual-mobility and constrained liners in this obese population. Level of Evidence . Level III, therapeutic study
1. DePuy Prostalac size 4, high, short stem with a 32+9 metal 12/14 head, 43/32 semi-constraint cemented PROSTALAC liner.. Cement was three commercially available tobramycin impregnated antibiotic cement each bag with 1 g of vancomycin and 1.2 g of tobramycin for a total antibiotic dosage of 3 g of vancomycin and 6.6 g of tobramycin.
The liner extractor was utilized. Post hip replacement a routine x-ray was taken to check anatomic alignment. The x-ray showed a metallic retained surgical item which was identified as the tooth from the liner extractor. Depuy representative was present when the surgical team was informed of the retained surgical item Collateral ligament insufficiency (except in cases where a constrained knee system is indicated and used). 7. Skeletal immaturity. 8. Use of a supracondylar nail through intercondylar notch of PROFIX™ primary femoral components. 9. Use of slotted femoral and tibial stems without adequate bone support. The ACTIS® Total Hip System is the first DePuy Synthes Companies of Johnson & Johnson stem specifically designed to be utilized with tissue sparing approaches, such as the anterior approach, as well as traditional approaches. The implant and instrumentation are designed to balance ease-of-insertion and may potentially provide improved implant.
DEPUY ORTHOPAEDICS, INC. (1682) DEPUY (IRELAND) (220) DEPUY INTERNATIONAL LTD (21) Non-constrained polyethylene acetabular liner (524) Coated femoral stem prosthesis, modular (237) Rotating hinged total knee prosthesis (89) Hip internal fixation system (24) Ceramic femoral head prosthesis (19) Metallic acetabulum prosthesis (12). DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, Indiana 46582 Re: K200854 Trade/Device Name: DePuy PINNACLE Dual Mobility Liner Regulation Number: 21 CFR 888.3358 Regulation Name: Hip Joint Metal/Polymer/Metal Semi-Constrained Porous-Coated Uncemented Prosthesis Regulatory Class: Class II Product Code: LPH, LZO, ME
A constrained cup is different as it is designed to hold inherent constraint are aseptic component loosening and osteoly- the head captive within the acetabular liner by means of a locking sis, and periprosthetic fracture . mechanism This system is to be used for cemented applications. Revision Knee Surgical Technique DJO Surgical, as the manufacturer of this device, does not practice medicine and cannot recommend this or any other surgical technique for use on a specific patient. The choice of the appropriate surgical technique is the responsibility of the surgeon. Medical & Radiation Emitting Device Recalls. Class 2 Recall R3 Constrained Acetabular Liner Date Posted October 18, 2010 Recall Number Z-0082-2011 Product R3 (TM) 22 MM I.D., 58 MM O.D., CONSTRAINED LINER, UHMWPE, CO-CR, TI-6AL-4V, REF 71339158, STERILE EO, QTY 1, Smith & Nephew, Inc., Hip prosthesis acetabular component. Acetabular Liner Code Information All lot
The constrained liner (Zimmer Longevity® Constrained Liner) utilized is remarkable due to the polyethylene cutouts, leading to extended cup geometry only between the 11 and 1 o'clock position as well as the 4 and 8 o'clock position (Figure 1B). The polyethylene liner was highly cross-linked ultra high molecular weight polyethylene (UHMWPE. The R3 Acetabular System from Smith and Nephew includes no-hole and mulit-hole options, constrained liners and large bearing options. The latter include XLPE, Oxinium, CoCr, and Biolox. Liners are designed to sit flush with the rim of the shell, reducing the potential for impingement. The locking system allows repositioning of the liner 8. Yun A, Koli EN, Moreland J, Iorio R, Tilzey JF, Mesko JW, Lee GC, Froimson M. Polyethylene liner dissociation is a complication of the DePuy Pinnacle Cup: A report of 23 cases. Clin Orthop Relat Res. 2015;474:441-446 10.1007/s11999-015-4396-5
DePuy also makes revision systems, components designed to be used in revision surgeries to replace or repair artificial knees. Joint Infections. One of the more serious potential knee replacement side effects that can occur after a DePuy knee system or other artificial knee is used is a joint infection The LEGION Total Knee System is a comprehensive system designed to allow surgeons to address straightforward primary to complex revision knee arthroplasty. By virtue of its unique implant design features, proprietary materials and intuitive instrumentation, LEGION empowers surgeons to manage diverse surgical challenges and provide personalized joint care with one system, one company Late liner disassociation of a Pinnacle system acetabular component. Posted May 31, 2013 Credits: PubMed: Orthopedics. 2012 Apr;35(4):e561-5. doi: 10.3928/01477447-20120327-29
Abstract We studied the P.F.C. Sigma rotating-platform total knee arthroplasties performed during 2004 and 2005 to assess implant size variations in men versus women and size variation in. The rationale for short stems in cementless total hip arthroplasty (THA) is proximal load transfer and absence of distal fixation resulting in preserved femoral bone stock and avoidance of thigh pain Depuy that slides within the innerdiameterof the cup, locking into At 3.9-year follow-up of 29 implanted liners using this technique, survivorship was noted to be 94%. of the acetabular component is recommended. A constrained liner was used given this patient's advanced age, low functional demands, and our inability to use a trial liner. Dislocation remains a common cause of failure after total hip arthroplasty. The limitations of existing approaches to address instability have led to the development of powerfull options: constrained liners, dual mobility and large heads. These implant-related options have proven to be very efficien Constrained knee implants use a pin or screw to stiffen the post to withstand implantation of a new polyethylene liner as well as a new locking screw. Intraoperatively, the screw was apparent be- Modular Knee (AMK; Depuy, Warsaw, IN) with screw loosening of the screw locking mechanism in the tibial insert causing mas
The Pinnacle® Constrained Acetabular Liner is part of a modular system designed to of the constrained liner with the femoral head from the polyethylene liner. 4. technique brochures and videos are available from DePuy. lntraoperativ Amongst the commonly used implants, liner dissociation has been reported with the Pinnacle (DePuy), Harris-Galante (Zimmer) and Trident (Stryker) acetabular components. To the best of our knowledge, this is the first case report of PLD in an R3 (Smith & Nephew) acetabular component Hip System Logical TM. LOGICAL™ lateralised, ceramic, and constrained liner options One instrument tray - the same instruments as for the primary Logical™ shell. 0 20 40 Lever-out (in Nm) Lever-out Strength2 Stryker Trident Biomet Ring-Loc Freedom Signature Orthopaedics 22.4 13.5 38.2 max 23.9 min 20.1 Depuy Duraloc 19 LOGICAL. MDM Constrained liners X3 polyethylene Innerchange Locking Mechanism. Built on data Stability. We've got you covered. DePuy Synthes Pinnacle 32 32 36 Maximum femoral head size (mm) Dual mobility at its best Add to the inherent stability of the Trident II System with our Modular Dual Mobility (MDM) bearing option. MDM is designed to help.
The condylar constrained knee arthroplasty is used to provide a stable knee in patients with extensive bone loss demonstrating a flexion or extension gap imbalance or in patients with severe deformities with soft tissue contractures and ligamentous laxity. 1-7 Other indications include neuropathic arthropathy and rheumatoid arthritis that present with severe varus or valgus deformities Freedom - Constrained Liner (Biomet) GAP II Restoration Acetabular Cup (Stryker) GTS - Surgical Technique (Biomet) S-ROM Rotating Hinge Knee Surgical Technique (DePuy) TC-PLUS PRIMARY Primary Knee System (Smith & Nephew) Tibia TMT (Zimmer) TMT (Zimmer) TMT Cone (Zimmer On December 26, 1996, Depuy, Orthopaedics, Inc. (Depuy), submitted a PMA for the S-Rom Poly-Dial Constrained Liner. Consistent with the act and the regulations, FDA consulted with the Panel regarding the approvability of the two PMAs Example of constrained acetabular liners with locking ring mechanism. (A) Duraloc constrained system (DePuy Synthes®). (B) Trilogy Acetabular System Constrained Liner (Zimmer®) 9, 18, 21). Click for larger image Download as PowerPoint slid