Stryker SECUR-FIT ADVANCED Surgical Technique
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Stryker SECUR-FIT ADVANCED Surgical Technique

Femoral hip system
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Secur-Fit
ADVANceD
Femoral Hip System
Surgical
Technique
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Orthopaedics

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Summary of Contents for Stryker SECUR-FIT ADVANCED

  • Page 1 Secur-Fit ® ADVANceD Orthopaedics Femoral Hip System Surgical Technique...

  • Page 2: Table Of Contents

    tABLe OF cONteNtS Pre-Operative Planning ....... . .2 Femoral Neck Resection ....... .3 Preparing the Femoral Canal .
  • Page 3 Secur-Fit ® ADVANceD Femoral Hip System The Secur-Fit Advanced Hip Stem is intended for cementless, press-fit application. The proximal region of the stem is coated with PureFix HA over a commercially pure titanium plasma spray substrate. The Secur-Fit Advanced Hip Stem is suitable for various surgical approaches. The total system includes: • 16 Implants • Size 4 and 5 in 132° offset only • Sizes 6-12, two anatomic offset angles of 132° and 127° The stem is designed for use with Stryker V40 femoral heads and their compatible acetabular components. This publication sets forth detailed recommended procedures for using Stryker Orthopaedics devices and instruments. It offers guidance that you should need, but, as with any such technical guide, each surgeon must consider the particular needs of each patient and make appropriate adjustments when and as required.

  • Page 4: Pre-Operative Planning

    The predicted change in leg length Once the final estimated stem size and offset is determined by the and position is determined, the neck relative positioning of the center of resection level should be noted templates rotation markings on the femoral (Figure 3). This will be used as a and acetabular components. reference during intra-operative neck For example, if a given femoral resection. Secur-Fit Advanced Acetate templates component center of rotation Lit# LteM106 Acetate templates include 20% magnification. 2 Secur-Fit ADVANceD SurgicAL tecHNique ®...

  • Page 5: Femoral Neck Resection

    Scale on making the final cut. resection guide corresponds to scale on the templates 39° use the resection guide to determine resection point based on lesser trochanter 39° Neck resection angle Figure 4 instrument Secur-Fit Advanced Neck resection guide 1601-1300...

  • Page 6: Preparing The Femoral Canal

    SteP 3 PrePAriNg tHe FeMOrAL cANAL To help ensure proper final orientation of the stem, lateral bias during preparation for the implant is preferred. Retraction of A clear-out hole has been the gluteus medius and removal of placed on the back of the a portion of the lateral neck and/ Box Osteotome that allows or piriformis fossa will permit true bone chips to be removed using a curette or other Or axial introduction of the instruments instruments in an action that and implant. A Box Osteotome is does not require a force to...
  • Page 7 Medial such that the appropriate marking resection corresponding to the pre-operatively Point selected stem size correlates to the depth of the medial resection point. Figure 6 Depth markings on the Starter reamer, which correspond to the tapered reamer depth for each stem, should be aligned with the medial aspect of the resection plane. Secur-Fit Advanced Starter reamer 1601-1504...

  • Page 8: Trochanteric Reaming

    Size reAMer discretion. Standard Trochanteric Reamer 10-12 Large Trochanteric Reamer instruments Orthonomic t-Handle Secur-Fit Advanced Secur-Fit Advanced Secur-Fit Advanced 2 For 1 1101-2200 Standard trochanteric Large trochanteric reamer tapered reamer Size 5-6 reamer 1601-1531 1601-1532 1601-1556 6 Secur-Fit ® ADVANceD SurgicAL tecHNique...
  • Page 9 Due to the aggressive cutting 11-12 nature of the reamer, distal reaming should not exceed the templated size. Secur-Fit Advanced 2 For 1 Secur-Fit Advanced 2 For 1 Secur-Fit Advanced 2 For 1 tapered reamer Size 7-8 tapered reamer Size 9-10...

  • Page 10: Broaching

    Upon reaching the final size and Correct fit will be denoted by a depth of the broach, detach the change in pitch, tactile resistance, or broach handle from the broach, when the broach ceases to advance. leaving the broach fully seated in the Verify a secure fit and ensure that femoral canal. instruments Secur-Fit Advanced Broach Handle Secur-Fit Advanced Low Profile Secur-Fit Advanced Broach Size 4-12 1601-1100 Broach Handle 1601-3100 1601-10XXA 8 Secur-Fit ® ADVANceD SurgicAL tecHNique...
  • Page 11 Secur-Fit Advanced calcar Planer, Secur-Fit Advanced calcar Planer, Standard Large 1601-1400 1601-1420...

  • Page 12: Trial Reduction

    Secur-Fit Advanced Monolithic Secur-Fit Advanced Monolithic Neck trial, 132 Degree Neck trial, 127 Degree (Silver) 1601-XX132 (gold) 1601-XX127 10 Secur-Fit ®...
  • Page 13 SeLectiON OF V40 HeAD triAL ON triAL Neck Figure 13 Assemble the Neck Trial onto the broach by hand. Ensure Note that the engraving on the superior edge of the neck is visible, and ensure that the broach cavity and V40 the flat lateral edge of the neck trunnion are clear of debris prior to trial is aligned with the flat lateral assembling the neck and head trials. edge of the broach. Next, assemble a V40 Head Trial onto the Neck Trial by hand. tABLe 4: Head Compatibility HeAD HeAD Size HeAD OFFSetS...

  • Page 14: Implanting The Stem

    SteP 6 iMPLANtiNg tHe SteM OPtiON 1 OPtiON 2 The Secur-Fit Advanced Stem The Secur-Fit Advanced Stem can can be inserted by hand and then also be inserted using the Modular impacted into the bone using the Offset Quick Connect Stem inserter. Modular Stem Impactor (Figure 14). Place tip of the inserter into the The Modular Stem Impactor has a drive hole of the stem taking care to spherical tip, which is placed onto align the version tab on the inserter the drive hole of the stem. This with the slot in the stem (Figure 15). instrument allows for off-axis impac- The quick connect design provides tion of the stem. The Modular Stem the inserter with a stable spring Impactor does not connect to the connection, but it does not provide stem, and, therefore, can only be a mechanical lock. Therefore, used for final impaction of the stem. this assembly should be handled with care, as excessive shaking or motion may result in the stem Figure 14 dis-associating from the inserter.
  • Page 15 A mallet is then used to seat the stem into the canal with short, controlled strokes. The surgeon should NOT attempt to continue impacting the femoral component if visual and auditory clues indicate that the stem is firmly seated in the canal. These clues, rather than the broach seating level, should be used to determine the final seating height of the implant. Continued aggressive impaction could lead to femoral fracture. In the event that dense bone is Figure 15 encountered intra-operatively and Figure 16 compounding anatomical factors are present, the seating of the implant may not be consistent with the level of the broach due to the viscoelastic Note nature of the femoral bone. If the final seating height is undesirable, Prior to implanting the final stem the implant can be removed using and femoral head, check the the Modular Threaded Stem Inserter implants for potential damage. ensure that the final stem matches (option 3) and additional broaching the last broach used.

  • Page 16: Final Reduction

    SteP 7 FiNAL reDuctiON Figure 18 Prior to final head assembly, neck length/head offset may be re-evaluated using a V40 Head Trial. Place the Note Head Trial on to the stem neck taper and reduce the hip. Leg length equality and proper soft tissue tension are ensure that the V40 taper is clean evaluated. Remove the Head Trial and dry the implant prior to assembling the head trial or head implant trunnion with a laparotomy sponge or sterile towel. Select the appropriate corresponding V40 Femoral Head WArNiNg (CoCr, Alumina Ceramic, BIOLOX delta Ceramic) or sleeve and place it onto the dry trunnion of the femoral in no instance should any attempt stem with a slight twist. Impact the head with moderate be made to preassemble the impactions using the Modular Head impactor.

  • Page 17: Extraction

    OPtiONAL SteP: eXtrActiON Figure 19 Stem extraction A surgeon should use his or her preferred surgical exposure and technique to conduct the revision surgery adequately. A surgeon should also refer to the subsequent product’s surgical technique and instructions for use to understand all appropriate warnings, indications, contra- indications, and product compatibility. There are instruments to manage the extraction of a Secur-Fit Advanced Stem in both intraoperative and revision situations. The instrument to use is the McReynolds Distal Stem Adaptor (6260-4-090) and McReynolds Driver (6869-1-000, 6869-2-000, 6869-3-000) from the Restoration Modular Instrument System. Mcreynolds Distal Stem Adaptor WArNiNg A surgeon must take care to avoid applying excessive force to the stem while exposing the joint during revision surgery.

  • Page 18: Implant And Instrument Information

    Secur-Fit ADVANceD ® iMPLANtS tABLe 6: Secur-Fit Advanced Stem Offset Table SteM cAtALOg Neck ANgLe SteM Size SteM LeNgtH Neck LeNgtH FeMOrAL DiStAL tiP NuMBer (°) (mm) (mm) OFFSet WitH DiAMeter* +0mm HeAD (mm) (mm) 1601-06127 37.2 1601-07127 41.5 1601-08127 42.4 Secur-Fit 1601-09127 46.9 Advanced 127°...
  • Page 19 tABLe 7: Secur-Fit Advanced Compatible Femoral Heads HeAD HeAD DiAMeter (mm) OFFSet (mm) V40 BIOLOx delta -4.0, -2.7, +0, +4.0 V40 BIOLOx delta -4.0, +0, +4.0 V40 BIOLOx delta -5, -2.5, +0, +2.5, +5, +7.5 Universal Taper, BIOLOx delta Head 28, 32, 36, 40, 44 Universal Taper Sleeves – V40 stems -2.5, +0, +4 V40 CoCr +0, +3, +8 V40 CoCr -3, +0, +4, +8, +12 V40 CoCr -4, +0, +4, +8, +12 V40 CoCr -4, +0, +4, +8, +12 V40 LFIT CoCr +0, +3, +8 V40 LFIT CoCr -3, +0, +4, +8, +12...
  • Page 20 Secur-Fit ADVANceD ® iNStruMeNtAtiON 1601-5005 Secur-Fit Advanced Femoral Preparation tray 5900-8114 case 18 Secur-Fit ® ADVANceD SurgicAL tecHNique...
  • Page 22 Secur-Fit ADVANceD ® iNStruMeNtAtiON 1601-5006 Secur-Fit Advanced Procedural tray 1 20 Secur-Fit ® ADVANceD SurgicAL tecHNique...
  • Page 24 Secur-Fit ADVANceD ® iNStruMeNtAtiON 1601-5007 Secur-Fit Advanced Procedural tray 2 22 Secur-Fit ® ADVANceD SurgicAL tecHNique...
  • Page 26 NOteS...
  • Page 28 325 Corporate Drive Mahwah, New Jersey 07430 t: 201 831 5000 www.stryker.com A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery. The information presented is intended to demonstrate the breadth of Stryker product offerings. A surgeon must always refer to the package insert, product label and/or instructions for use before using any Stryker product. The products depicted are CE marked according to the Medical Device Directive 93/42/EEC. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area. Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the following trademarks or service marks: ADM, Crossfire, Exeter, Howmedica, LFIT, MDM, Osteonics, PCA, PSL, PureFix, Restoration, RimFit, Secur-Fit, Stryker, Stryker Orthopaedics, Trident, Unitrax, V40, X3. BIOLOx delta is a registered trademark of Ceramtec Ag. Literature Number: LSFFH-ST Rev.1 Copyright © 2013 Stryker Printed in USA...

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