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smith&nephew REDAPT Surgical Technique

Revision femoral system
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Surgical Technique

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Summary of Contents for smith&nephew REDAPT

  • Page 1 Surgical Technique...
  • Page 3 REDAPT™ Revision Femoral System Surgical Technique Smith & Nephew would like to acknowledge the contributions of the following surgeons with whom we designed the REDAPT Revision Femoral System: Mathias Bostrom, MD New York, NY Fares S. Haddad, BSc MCh, FRCS...
  • Page 4 The REDAPT™ Revision Femoral System by Smith & Nephew is uniquely designed to address the challenges in today’s revision hip arthroplasty: fixation in various bone types, achievement of joint stability, predictable stem position and surgical efficiency. It all starts with ROCKTITE™ flutes which are intended to provide rock-solid distal fixation in all bone types.
  • Page 5 REDAPT™ Sleeveless Stem 12/14 Head taper Compatible with all Smith & Nephew heads • Neck Circulotrapezoidal shape for increased • range of motion 2 Offset options; Standard and High • Stem Forged Titanium tapered, fluted design with • proprietary ROCKTITE™ flutes Diameters: 12 –...
  • Page 6 Each neck is made with a 12/14 taper for use with compatible cobalt chrome, ceramic and OXINIUM™ heads. The circulotrapezoidal neck is designed for increased range of motion. The following table and illustrations show the total offset and height for each REDAPT™ stem. Offset Height...
  • Page 7 Instruments REDAPT™ instruments are designed to maximize surgical efficiency and improve accuracy and reproducibility of implant position during the procedure. This is accomplished by reaming and trialing “over the top” of the distal reamers. Distal and proximal reamers are color-coded to provide easy identification of implant sizes and reduce unnecessary instruments.
  • Page 8 Preoperative planning and templating Templating Preoperative templating accomplishes several goals. The primary goal is to determine the intended diameter and length of the revision stem and the remaining femoral bone to support the conical, fluted stem. While all revision situations are unique, in general, 5-7cm of conical reaming of distal cortical bone is desired.
  • Page 9 5-7cm and that it engages in good diaphsyeal bone. REDAPT templates are available in digital and acetate formats (Figure 3). Consult your Smith & Nephew representative for assistance in obtaining templates.
  • Page 10 Abbreviated Surgical Technique Starter ream Distal ream Proximal ream Trial Implant...

  • Page 11: Surgical Technique

    Surgical Technique The following technique should be used when implanting REDAPT Sleeveless monolithic implants. Before surgery, review instrument sets to ensure all instruments are present and working properly. Removal of a well fixed femoral stem The removal of a well fixed femoral stem can at times be accomplished using thin osteotomes starting at the proximal portion of the implant.
  • Page 12 Surgical Technique continued Neck resection technique when using the stem in a challenging primary application The femoral neck resection may need to be modified in some challenging primary applications such as angular and rotational deformity. The conical, fluted design is particularly well-suited for these cases due to the stability that is possible with this design.
  • Page 13 This color will identify available implant sizes and appropriate instrumentation for subsequent steps. The size of a REDAPT™ stem is 0.25mm greater than the equivalently sized reamer, providing a press fit of 0.25mm. The depth of the reamer is determined by...
  • Page 14 Surgical Technique continued Upon achieving desired distal fit, disengage the quick connect and power, apply a T-handle and ensure the reamer does not rotate or translate axially. Leave final distal reamer in the canal and note the size. Proximal reaming Select a proximal reamer that offers little or no resistance when placed over the shaft of the final distal reamer.
  • Page 15 The following information illustrates the approximate proximal size of each Sleeveless stem. PF Sleeveless Stem Color A dimension 12/13 PF 17.5 14/15 PF 17.5 16/17 PF 19.5 18/19 PF 21.5 20/21 PF 23.5 22/23 PF 25.5 24/25 PF 25.5 26 PF 26.5 27 PF 27.5...
  • Page 16 Surgical Technique continued Screw pops up Trial body assemblies have been designed when seated on so that when the teeth on the underside proximal spacer of the trial body mate with the teeth on the proximal spacer when initially placed. When the components are properly mated the screw on the top of the trial body pops up.
  • Page 17 Trial/Reamer removal Attach trial handle to trial removal hook (Figure 14). To remove the assembled trial components insert the trial removal hook through the cross hole of the trial body assembly (Figure 15). Using gentle force, extract the trial components superiorly, to avoid damage to surrounding tissue.
  • Page 18 Surgical Technique continued Implant assembly and insertion Attach the implant driving platform of the stem inserter to the proximal end of the stem implant (Figure 17). To attach, stand the stem inserter upright so that the threaded tip is pointed up. Ensure that the lever handle is open on the stem inserter and screw the implant onto the threaded tip as far as possible.
  • Page 19 Proximal support Once the final components are implanted, the osteotomy is reduced and secured with cables. In order to reduce the osteotomized bone fragment in its anatomic position, it may be necessary to shape the endosteal surface of the bone fragment with a curette or burr to fit against the lateral position of the femoral component.

  • Page 20: Catalog Information

    Catalog information REDAPT™ Sleeveless Revision Stems 190mm 240mm 300mm Size STD Offset Hi Offset STD Offset Hi Offset STD Offset Hi Offset 7135-4461 7135-4478 7135-4701 7135-4718 7135-4736 7135-4754 7135-4462 7135-4479 7135-4702 7135-4719 7135-4737 7135-4755 240mm 7135-4463 7135-4481 7135-4703 7135-4721 7135-4738...
  • Page 21 REDAPT Proximal Reamer #2-11S 12/13XS PF16/17 7135-5083 REDAPT Proximal Reamer #3-11M 12/13S 14/15XS PF18/19 7135-5084 REDAPT Proximal Reamer #4-11L 12/13M 14/15S 16/17XS PF20/21 7135-5085 REDAPT Proximal Reamer #5-12/13L 14/15M 16/17S 18/19XS PF22+ 7135-5086 REDAPT Proximal Reamer #6-14/15L 16/17M 18/19S 20/21XS...
  • Page 22 Instrument Sets continued REDAPT™ Common Instrument Tray Cat. No. 7135-5410 Catalog Item Description 7135-5094 Reamer Quick Connect 7135-5079 Proximal Reamer Starter And Size Pf 12/13 7136-4001 7136-4001 Canal Finder 7136-4002 Box Osteotome 7136-4006 T-Handle 7135-4631 Trial Body Assembly, Size 12-15...
  • Page 23 REDAPT™ 190mm Distal Reamer Tray Cat. No. 7135-5400 Catalog Item Description 7135-5341 Distal Reamer 190mm Size 10 7135-5342 Distal Reamer 190mm Size 11 7135-5343 Distal Reamer 190mm Size 12 7135-5344 Distal Reamer 190mm Size 13 7135-5345 Distal Reamer 190mm Size 14...
  • Page 24 Instrument Sets continued REDAPT™ 240mm Distal Reamer Tray Cat. No. 7135-5000 Catalog Item Description 7135-5001 Distal Reamer 240mm Size 10 7135-5003 Distal Reamer 240mm Size 11 7135-5005 Distal Reamer 240mm Size 12 7135-5007 Distal Reamer 240mm Size 13 7135-5009 Distal Reamer 240mm Size 14...
  • Page 25 REDAPT™ 300mm Distal Reamer Tray Cat. No. 7135-2900 Catalog Item Description 7135-5038 Distal Reamer 300mm Size 10 7135-5042 Distal Reamer 300mm Size 11 7135-5044 Distal Reamer 300mm Size 12 7135-5046 Distal Reamer 300mm Size 13 7135-5048 Distal Reamer 300mm Size 14...
  • Page 26 Instrument Sets continued REDAPT™ Proximal Reamer Tray Cat. No. 7135-5080 Catalog Item Description 7135-5081 Proximal Reamer #1 Size 11XS PF 14/15 7135-5082 Proximal Reamer #2 Size 11S 12/13XS PF 16/17 7135-5083 Proximal Reamer #3 Size 11M 12/13S 14/15XS PF 18/19...
  • Page 27 REDAPT™ 240mm Large Size Reamers Cat. No. 7135-2910 Catalog Item Description 7135-5026 Distal Reamer 240mm Size 22 7135-5028 Distal Reamer 240mm Size 23 7135-5030 Distal Reamer 240mm Size 24 7135-5032 Distal Reamer 240mm Size 25 7135-5034 Distal Reamer 240mm Size 26...
  • Page 28 Instrument Sets continued REDAPT™ 300mm Large Size Reamers Cat. No. 7135-2920 Catalog Item Description 7135-5066 Distal Reamer 300mm Size 22 7135-5068 Distal Reamer 300mm Size 23 7135-5071 Distal Reamer 300mm Size 24 7135-5073 Distal Reamer 300mm Size 25 7135-5075 Distal Reamer 300mm Size 26...
  • Page 29 REDAPT™ Extraction Tray Cat. No. 7135-5100 Catalog Item Description 7136-4036 EMPERION™ Sleeve Removal Tool 7135-5108 Stem Extractor Adaptor 7135-5107 Stem Extractor Universal Joint 7136-0919 Sleeve/Stem Separator 7135-5109 Reamer Removal Cap 7136-0920 Trial Removal Handle 7136-0917 Trial Removal Hook 7135-5107 7135-5108...
  • Page 30 Instrument Sets continued ACCORD™ Cable System Catalog Item Description 7136-0005 Instrument Set 7134-5000 Implant Set Includes: all titanium small and standard grips 3 titanium fracture management plates 12 cobalt chrome cables with clamp 12 cobalt chrome cables for grips/plates RENOVATION™ Removal Instrument Set Catalog Item Description 7136-7575...
  • Page 31 Notes: _________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________...
  • Page 32 Reference 1. Paprosky, Wayne G, Sporer, Scott M. Revision Total Hip Arthroplasty: The Limits of Fully Coated Stems. Clinical Orthopaedics and Related Research. 2003;417:203-209. Supporting healthcare professionals for over 150 years Smith & Nephew, Inc. www.smith-nephew.com 1450 Brooks Road Memphis, TN 38116 Telephone: 1-901-396-2121 Information: 1-800-821-5700 Orders and Inquiries: 1-800-238-7538...