Echo hiP systEm - Zimmer Biomet

1 echo HIp systEm Hip fracture Surgical TEchnique Endo II Uni-polar Acetabular Component RingLoc Bi-polar Acetabular Component Knees Hips Extremities Cement and Accessories PMI TEchnology echo hip systEm 20. 50MM. 15. STANDARD. 10 +12MM. 40MM. 5 +9MM. +6MM. +3MM. 0. 30MM -3MM. -5 -6MM. -10. 20MM. 10MM. 0MM. -10MM 0. 10. -20MM. 20. -30MM. 30. -40MM. 40. -50MM. -60MM. -70MM. -80MM. -90MM. -100MM. -110MM. -120MM. -130MM. -140MM. -150MM. -160MM. -170MM. FX. 17MM X 170MM. PART NO. 12-151317. 20% OVERSIZE TO ALLOW FOR. X-RAY MAGNIFICATION. X-RAY TEMPLATE SET CAT. NO. 2007 Biomet ORTHOPEDICS, INC.

2 Biomet ORTHOPEDICS, INC., BOX 587, EAST BELL DRIVE, WARSAW, IN 46581 ALL RIGHT RESERVED. Figure 1 Figure 2. Biomet 's echo Hip systEm Offers Three . Preoperative Planning Stem Variations Preoperative templates are provided for determining echo FX Stem: Forged cobalt alloy cemented or optimal component size, femoral neck resection level and press-fit stem appropriate neck length (Figure 1). Radiographs should include a full A/P (anteroposterior) view of the pelvis echo PF Stem: Forged titanium alloy grit blasted including the proximal one-half of both femurs and a press-fit stem lateral view of the proximal half of the affected femur.

3 echo Bi-Metric Stem: PPS forged titanium alloy press-fit stem Surgical Approach Any one of the echo Hip systEm components may be The echo Hip systEm is designed to accommodate any utilized in total or hemi hip arthroplasty. standard approach based on the surgeon's experience or personal preference. Adequate exposure that allows bony landmark visualization, component alignment and thorough soft tissue assessment can contribute to more successful results (Figure 2). The echo Hip systEm was designed and developed in conjunction with Michael Berend, ; Christian Christensen, ; Philip Faris, ; Kevin Garvin, ; Douglas Jessup, ; Michael Keating, ; John Meding, and Jeffery Mokris, This hip facture surgical technique is utilized by Kevin Garvin, Biomet as the manufacturer of this device, does not practice medicine and does not recom- mend this device or technique.

4 Each surgeon is responsible for determining the appropriate device and technique to utilize on each individual patient. Figure 3 Figure 4. Resecting the Femoral Head Gauge Acetabulum A broach/provisional or the femoral resection template Sizing of the acetabulum is conducted by using may be used as a template for the femoral resection level provisional shells that are attached to the gauge handle (Figure 3). If fractured, remove the head/neck fragment (Figure 4). These provisionals are utilized for both bi-polar with a corkscrew. and uni-polar applications. You may also utilize the femoral head gauge to determine the diameter of the resected femoral head.

5 Note: Please refer to the product listing for femoral head trial size options. 1. echo hip systEm Figure 5 Figure 6. Opening Femoral Canal A hollow chisel or starter reamer can be used to open the femoral canal (Figures 5 and 6). 2. Figure 8. Figure 7 Figure 9. Reaming the Distal Femur Broaching the Proximal Femur Note: If using the fully toothed broaches, the reaming Begin broaching with the broach that is at least 2mm step may be skipped. smaller than the last reamer size used. It is important that the broach is oriented so that the medial/lateral axis of Tapered side-cutting reamers are introduced in a the broach is parallel with the anatomic medial/lateral axis sequential fashion beginning with the smallest size of the femoral neck.

6 A sequentially larger broach is used reamer and progressing until the cutting flutes encounter until ideal or templated size is reached. resistance from the endosteal wall. The reamer is advanced until the gold portion is at the level of the Example: Ream to 12mm, sequentially broach to 12mm planned medial resection or the appropriate reference (Figure 9). band is at the level of the greater trochanter based on preoperative templating (Figures 7 and 8). Note: Whether press-fitting or cementing, the echo Hip systEm component's Exact Alliance RPP broaches, which are nitrided black, must be utilized.

7 3. echo hip systEm echo PF echo Bi-Metric Lateralized echo Bi-Metric Standard echo FX Standard Figure 10 Figure 11. Planing the Calcar Trunnion Selection With the broach/provisional properly seated, the calcar To perform the trial reduction with the indwelling broach, is planed flush by using the Exact calcar planer attach the Exact echo neck trunnion onto the broach (Figure 10). post. The neck trunnions for the echo FX and echo PF. stems are offered in standard (S) offset only. The neck Note: Fully seat the spring loaded plunger over the trunnions for the echo Bi-Metric are offered in standard broach post prior to powering-up and advancing the (S) and lateralized (L) offset.

8 These trunnions are color body and blade of the planer. coded to represent offset. The gold trunnions represent standard offset while the black represents lateralized offset. The Exact trunnions are sized to correspond to the final broach. The stem size is clearly marked on the top of the trunnion (Figure 11). 4. Endo II Trial Head RingLoc Bi-Polar Trial Head Figure 12 Figure 13. For Endo II. With the appropriate neck trunnion in place, select Note: Align the circumferential flat on the RingLoc . the desired Endo II trial head and provisional shell bi-polar trial head with the desired provisional shell components.

9 Biomet offers five neck length options component. The bi-polar head will articulate within the (-6, -3, Standard, +3, and +6mm) for use with the Endo II provisional shell component. A trial reduction is carried uni-polar systEm . Assemble as shown (Figure 12). out to ensure that proper leg length and joint stability have been achieved. Note: The Endo II trial head will snap into the apical hole of the desired provisional shell component. A trial reduction is carried out to ensure that proper leg length echo Cementless Stem Insertion . and joint stability have been achieved. Select either the echo PF, echo FX or the echo .

10 Bi-Metric implant that corresponds to the last size reamer and broach used. For RingLoc Bi-polar . With the appropriate neck trunnion in place, select the Example: Ream and broach to a 12mm. Implant a size appropriate RingLoc bi-polar trial head and provisional 12mm echo PF or Bi-Metric stem. Attach implant to the shell components. Biomet offers seven neck length inserter tool and impact until the stem stops advancing. Do options (-6, -3, Standard, +3, +6, +9 and +12mm) for use not attempt to seat the stem further if it fails to advance with the RingLoc bi-polar systEm . Assemble as shown (Figure 13).