Hip Stem - ODEVorthodevelopment.com/static/media/uploads/pdf...1 Surgical Technique Overview 1. Femoral Neck Osteotomy 2. Femoral Preparation 3. ... Femoral Head Impaction. 2. Preoperative

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Designing Surgeons: Andrew Petrella, M.D. Richard Vlasak, M.D.

The following technique is a general guide for instrumentation of the Ovation® Hip Stem. It is expected that the surgeon is already familiar with the fundamentals of Total Hip Arthroplasty (THA). Each patient represents an individual case that may require modification of the technique according to the surgeon’s judgment and experience. Please see the Ovation® Hip Stem Instructions for Use (IFU) for intended uses/indications, device description, contraindications, precau-tions, warnings and potential risks associated with the Ovation® Hip Stem.

Table of Contents

Surgical Technique Overview

Device Description..........................1Preoperative Planning....................2Incision...............................................3Femoral Neck Osteotomy..............3Femoral Preparation.......................3Trial Reduction.................................5Femoral Component Insertion.....6Hip Reduction...................................7Ovation Instrument Listing............9Ovation Implant Listing..................11

1. Device Description The Ovation® Hip Stem is a proven M/L taper design that accommodates multiple surgical approaches. In order to provide options for various patient needs, the Ovation® Hip Stem is available in a full range of sizes.

• Tapered stem design provides excellent rotational

stability and promotes 3-point fixation

• Minimal broach-only instrumentation simplifies surgical procedure

• Optimized neck geometry with highly polished surface improves overall range of motion

• Available in 12 sizes with standard and extended neck offsets to accommodate patient anatomy

• Proximal body surface is coated with titanium plasma spray for solid, long-term fixation

• Distal body flute to more closely match bone properties

• A 132 degree neck angle is offered in both standard and extended neck offsets

1

Surgical Technique Overview

1. Femoral Neck Osteotomy 2. Femoral Preparation 3. Broaching

4. Calcar Planing 5. Trial Reduction 6. Femoral Component Insertion

7. Femoral HeadImpaction

2. Preoperative Planning T e m p l aT i n g Templates with a 20% magnification are provided by Ortho Development® Corporation for use with preoperative x-rays. Preoperative templating enables the surgeon to estimate the correct implant size as well as to identify any unusual circumstances specific to the case at hand. The templates should be used with standard preoperative lateral and A/P radiographs to determine the approximate size and position of the prosthesis (Figure 1).

3. Incision In Total Hip Arthroplasty, exposure may be achieved through a multitude of methods based on each surgeon’s individual preference. The Ovation® Hip Stem may be implanted using a variety of approaches, including Anterolateral, Posterolateral or Direct Anterior.

4. Femoral Neck Osteotomy Once the femoral head and acetabulum are adequately exposed, dislocate the femur from the acetabulum. With the hip dislocated and the femoral neck adequately exposed, the Resection Guide is placed on the femur (Figure 2). The femoral neck cut is made in accordance with the preoperatively determined template level.

5. Femoral Preparation The Box Osteotome is used to access the lateral portion of the proximal femur (Figure 3). Removing the medial section of the greater trochanter with the Box Osteotome creates an opening to allow the insertion of the Starter Broaches. The opening should be sufficiently lateralized to avoid varus positioning of the stem.

Connect the Starter Reamer to the T-Handle and insert into the femur to access the distal canal (Figure 4).

(continued)

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Figure 1: Template overlaid on A/P radiograph

Figure 3: Box Osteotome

Figure 2: Resection Guide

Figure 4: Starter Reamer Part Numbers this page:Resection Guide 201-0000Box Osteotome 201-0004Starter Reamer 201-0003Large Hudson T-Handle 215-0009

Begin the sequential broaching with the Starter Broach (Figure 5). The Broach is attached to the Broach Handle by placing the post on the Broach into the Broach Handle and moving the lever into the closed position (Figure 6). Advance the Broach into the femur to the level of the neck resection (Figure 7). It is important to maintain proper alignment against the lateral cortex as this will help prevent varus positioning of the stem. Periodically withdraw the Broach during the broaching sequence to clear the broach teeth of bone fragments.

Note: Offset Broach Handles and other Direct Anterior Approach instruments are available, see page 9.

(continued)

Increase the Broach size sequentially until the Broach size matches the implant size determined during pre-operative templating, or until sufficient stability of the Broach has been achieved. Rotational stability of the Broach is tested by turning the Broach Handle back and forth. Once the final Broach size has been determined to be stable, remove the Broach Handle and leave the Broach in place for trialing.

If desired, with the final Broach inserted to the proper level, attach the Calcar Planar to a power driver and connect it to the Broach’s post (Figure 8). Advance the Calcar Planer into the bone slowly until the appropriate neck area has been prepared. Care should be taken with the Calcar Planer to ensure proper alignment and avoid over-planing as the cutting surface is aggressive.

6. Trial Reduction Select the preoperatively determined Neck Trial (standard or extended offset) and Femoral Head Trial and attach to the fully seated Broach post (Figure 9). With the trial components in place, the hip is reduced and carried through complete range of motion. Stability should be assessed during flexion, extension and internal rotation. Adjustments in neck length and/or offset may be made at this time. Once the desired result is achieved the Broach, Neck, and Femoral Head Trials are removed.

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C lOS e D O p e n

Figure 6: Broach Handle

Figure 5: Starter Broach

Figure 7: Inserting Broach into Femoral Canal

Figure 8: Calcar Planar connected to Broach

Figure 9: Neck and Femoral Head Trials

Part Numbers this page:Broach Handle 201-1000Blunt Distal Broach Size ST 201-2121Fully Toothed Femoral Broach 201-2001 : 201-2012

Part Numbers this page:Calcar Planar 201-3001 : 201-3002Fully Toothed Femoral Broach 201-2001 : 201-2012 Neck Trial 201-4001 : 201-4008 Femoral Head Trial CoCr 238-2230 : 238-4009Femoral Head Trial Ceramic 235-2810 : 235-4016

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Figure 11: Inserting the Stem

Figure 12: Trial Reduction

Figure 13: Femoral Head Impaction

Figure 10: Attaching the Inserter

7. Femoral Component Insertion

An Ovation® Hip Stem matching the last Broach size used is selected and carefully introduced into the canal until resistance is encountered. The Hip Stem Inserter attaches to the implant by inserting the tip of the impactor into the lateralized insertion hole and engaging it completely (Figure 10). Tap the Hip Stem Inserter with a mallet to advance the Stem into the femoral canal until it is fully seated to the level of the neck resection (Figure 11). The superior edge of the plasma spray coating of the stem corresponds to the top surface of the Broach.

(continued)

Once the Femoral Stem implant is in place, trial reduction may be performed once again to check for proper seating, rotation, and to ensure the appropriate femoral head neck length is selected (Figure 12). Based on the trial reduction, the appropriate Femoral Head implant is selected by matching the desired head diameter and length to the last Femoral Head Trial used. The selected Femoral Head is placed onto the taper of the stem by hand using extreme care to keep the stem taper undamaged and clean from soft tissue or bone. Lightly tap the Femoral Head with the Femoral Head Impactor until fully seated (Figure 13).

8. Hip ReductionThe hip should be reduced and taken through full range of motion. After taking the hip through full range of motion and the desired result is achieved, the wound should be closed in a standard fashion.

Note: In the rare instance where the femoral component needs to be extracted, attach the Stem Extractor tool onto the neck of the implant. Connect a slap hammer to the Stem Extractor and take care to force the implant upward in a direction in line with the femoral shaft to minimize damage to the femur.

Part Numbers this page:Stem Inserter 201-0002Ovation Stem 101-0001 : 101-1012

Part Numbers this page:Femoral Head Trial CoCr 238-2230 : 238-4009Femoral Head Trial Ceramic 235-2810 : 235-4016 Ovation Stem 101-0001 : 101-1012Femoral Head CoCr 138-2800 : 138-4060Femoral Head Ceramic 136-2801 : 136-4004Femoral Head Impactor 208-0340

2 01 - 9 01 2 a OvaT i O n T r i a l k i T

NUMBER ITEM # DESCRIPTION

1 201-4001 Neck Trial Size 1-3 Standard




5 201-4005 Neck Trial Size 1-3 Extended




9 211-0013 Slap Hammer

10 201-0018 Femoral Head Extractor

11 201-3001 Small Calcar Planar

12 208-0300 Femoral Head Impactor

13 201-3002 Large Calcar Planar

14 208-0340 40mm Femoral Head Impactor

15 215-0009 Large Hudson T-Handle

16 201-0000 Femoral Neck Resection Guide

17 201-3003 T-handle Calcar Reamer

18 201-0001 Stem Extractor

201-6012 Ovation Trial Case

1 5

2 6

3 7

4 8

9

1011

13

14 121516

1718

98

Ovation® Instrument Trays

2 01 - 9 01 1 OvaT i O n p OST e r i O r l aT e ra l k i T


1 201-2001 Broach Size 1









10 201-2010 Broach Size 10

11 201-2011 Broach Size 11

12 201-2012 Broach Size 12

13 201-2121 Blunt Distal Broach Size ST

14 201-1000 Broach Handle

15 201-0004 Box Osteotome

16 201-0003 Starter Reamer

17 201-0002 Stem Inserter

201-6011 Ovation Posterior Lateral Case

1

5

2

6

3

7

4

89

1011

13

12

14

14

15

16

17

1

5

2

6

3

7

4

89

1011

13

12

14

21

15

22

16

20

1718

19

2 01 - 9 01 5 OvaT i O n D i r eC T a n T e r i O r k i T


1 201-2101 Blunt Tip Broach Size 1












13 201-2120 Starter Broach

14 201-2121 Blunt Distal Broach Size ST

15 201-2118 DAA Canal Finder

16 201-0103 Offset Stem Inserter Left

17 201-0102 Offset Stem Inserter Right

18 201-0104 Offset Stem Inserter Neutral

19 201-0100 DAA Broach Handle Left

20 201-0101 DAA Broach Handle Right

21 201-2119 DAA Box Osteotome

22 201-2000 Chili Pepper Broach

201-6015 Ovation Direct Anterior Case

2 3 8 - 9 0 0 0 F e m O ra l H e a D T r i a l k i T


1 238-2230 Femoral Head Trial 22mm -3

2 238-2200 Femoral Head Trial 22mm +0
































34 235-2810 Ceramic Femoral Head Trial 28mm S -5

35 235-2812 Ceramic Femoral Head Trial 28mm M -1

36 235-2814 Ceramic Femoral Head Trial 28mm L +2




40 235-3216 Ceramic Femoral Head Trial 32mm XL +6









238-6000 Femoral Head Trial Case

1 5

2 6

3 7

4 8

9

10

11

13

12

14

15

16

17

19

21

18

20

22

23

24

25

27

29

30

32

3333

37

38

39

40

41 45

46

47

48

43

42

44

35

34

36

26

31

28

1110

OvaT i O n H i p ST e m S

ITEM# DESCRIPTION

101-0001 Ovation Stem Standard Size 1












101-1001 Ovation Stem Extended Size 1












STa n Da r D a n D e x T e n D e D S i z e S

SIzE STEM lENgTH

PROxIMAl wIDTH (M/l)

DISTAl wIDTH (A/P)

lEg lENgTH

HORIzONTAl OFFSET

(STANDARD)

HORIzONTAl OFFSET

(ExTENDED)

1 98 26 5 29 34 39

2 106 27 6 30 34 39

3 108 28 6 30 35 40

4 110 29 7 32 37 43

5 114 30 8 32 38 44

6 118 31 9 33 38 44

7 122 32 10 34 42 49

8 126 34 11 34 43 50

9 130 36 13 34 44 51

10 134 38 16 36 47 55

11 138 40 18 36 48 56

12 142 42 20 36 49 57

Ovation stem dimensions and offsets (all dimensions are in mm)

Ovation® Implants

Stem Length

ProximalWidth

Leg Length

O�set

B i O lOx ® D e lTa F e m O ra l H e a DS

ITEM# DESCRIPTION

136-2801 Biolox® Delta Femoral Head 28mm S -5

136-2802 Biolox® Delta Femoral Head 28mm M -1

136-2803 Biolox® Delta Femoral Head 28mm L +2




136-3204 Biolox® Delta Femoral Head 32mm XL +6









CO C r F e m O ra l H e a DS

ITEM# DESCRIPTION

138-2800 CoCr Femoral Head 28mm +0




138-2830 CoCr Femoral Head 28mm -3














138-4000 CoCr Femoral Head 40mm +0mm




138-4030 CoCr Femoral Head 40mm -3mm

138-4060 CoCr Femoral Head 40mm -6mm

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Ortho Development Corporationodev.com

12187 So. Business Park DriveDraper, Utah 84020801-553-9991/fax 801-553-9993

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Copyright © 2013 Ortho Development® Corporation. All rights reserved.

Unless otherwise indicated, all materials on these pages are copyrighted by Ortho Development Corporation. All rights reserved. No part of these pages, either text or image may be used for any purpose other than personal use. Therefore, reproduction, modification, storage in a retrieval system or retransmission, in any form or by any means, electronic, mechanical or otherwise, for reasons other than personal use, is strictly prohibited without prior written permission.

Ortho Development® Corporation designs, manufactures, and distributes orthopedic implants and related surgical instrumentation—with a specialty focus on hip and knee joint replacement, trauma fracture repair, and basic spinal fixation. Ortho was founded in 1994 and is located at the base of the Wasatch Mountains in the Salt Lake City suburb of Draper, Utah. The company has established distribution throughout the United States and Japan, along with other select international markets.

Documents

Hip Stem - ODEVorthodevelopment.com/static/media/uploads/pdf...1 Surgical Technique Overview 1. Femoral Neck Osteotomy 2. Femoral Preparation 3. ... Femoral Head Impaction. 2. Preoperative