the attune revision fixed bearing knee system · offset is not required fixed bearing conical...
TRANSCRIPT
THE ATTUNE® REVISION FIXED BEARING KNEE SYSTEMInstrumentation Designed to Enhance Efficiency and Versatility
Surgical Process and Key Instrument Overview
TABLE OF CONTENTS
2
Introduction
Femoral WorkflowsShort Cemented Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Straight Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Offset Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Sleeve with Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Tibial WorkflowsShort Cemented Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
Straight Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14
Offset Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16
Trialing and Setting RotationTrialing and Setting Rotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18
Transferring Offset to the ImplantTransferring Tibial Offset to Implant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Transferring Femoral Offset to Implant . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
3
Introduction
ATTUNE® Revision Fixed Bearing Knee Instrumentation and
workflows are designed to allow surgeons to address the
various clinical demands of revision total knee arthroplasty
efficiently and successfully. This surgical process and
instrument overview guide highlights the versatility of the
ATTUNE Revision Fixed Bearing Knee Instrumentation and
demonstrates the convenience of use in a surgical setting.
A surgical technique guide is also available, which provides
detailed guidelines for the preparation and implantation of
the ATTUNE Revision Fixed Bearing Knee System through a
variety of workflows.
ADDRESS VARYING CLINICAL DEMANDS
4
Assemble and insert the Trial construct
SHORT CEMENTED STEM WORKFLOW
1
Primary resections using the ATTUNE® Knee System INTUITION™ Instrumentation. Place the respective Cut Through Trial on the resected femur
Assemble the Reamer Tower and Bushing
21
5
5
Femoral Workflows
SHORT CEMENTED STEM WORKFLOW
Ream using the selected Cemented Femoral Stem Reamer and Boss Reamer
3
Resect the box
4
6
6
Assemble and insert the Trial construct
5
Remove the IM Adaptor Trial and perform the box resection
STRAIGHT PRESS-FIT STEM WORKFLOW
1 2
Size the femur
Use the Canal Reamers to prepare the canal
Assemble the appropriate Stem Trial to the Femoral Boss Reamer and ream to the proper depth
7
Femoral Workflows
STRAIGHT PRESS-FIT STEM WORKFLOW
43
Assemble the Cut Through Trial and attach the Stem Trial
Assess the gaps
8
65
Attach the Reamer Guide and ream using the Offset Drill
Perform the 4-facet and box resections using the Conventional Cut Guide attachments
OFFSET PRESS-FIT STEM WORKFLOW
1 2
Use the Canal Reamers to prepare the canal
Assemble the Distal Femoral Resection Guide and perform the distal resection
9
Femoral Workflows
7
Assemble the Femoral Trial to the previously determined offset position and insert the Trial construct
OFFSET PRESS-FIT STEM WORKFLOW
43
Assess the 360º Offset position using the Conventional Cut Guide assembled to the Femoral Offset Guide construct
Record the Offset position
Remove the Femoral Offset Guide assembly, leaving the Conventional Cut Guide in place
10
6
Assess the gaps, remove the Broach Adaptor, and perform the 4-facet and box resections using the Conventional Cut Guide attachments
Remove the Broach Handle and assemble the Conventional Cut Guide and Broach Adaptor to the Broach retained in the femoral canal
Use the Canal Reamers to prepare the canal
1
SLEEVE WITH PRESS-FIT STEM WORKFLOW
Assemble the Distal Femoral Resection Guide and perform the distal resection
2
5
11
Femoral Workflows
Assemble the Femoral Trial with the Broach retained in the canal
7
SLEEVE WITH PRESS-FIT STEM WORKFLOW
3
Assemble the appropriate Stem Trial to the Femoral Broach Starter Reamer and ream to the proper depth
Assemble the Stem Trial, Femoral Broach and Broach Stop, and the Broach Handle and broach until rotational stability
4
12
SHORT CEMENTED STEM WORKFLOW
Make primary resections using the ATTUNE Knee System INTUITION Instrumentation and size the tibia
Assemble the Reamer Tower and Bushing
1 2
Tibial Workflows
13
Assemble and insert the Trial construct
4
SHORT CEMENTED STEM WORKFLOW
Ream using the Cemented Stem Reamer and Conical Reamer
3
Tibial Workflows
14
Assemble and insert the Trial construct
5
Assemble and attach the IM Mount to resect the tibia
Use the Canal Reamers to prepare the canal
STRAIGHT PRESS-FIT STEM WORKFLOW
21
Tibial Workflows
15
STRAIGHT PRESS-FIT STEM WORKFLOW
Use the Tibial Offset Dials to confirm that offset is not required
Assemble the appropriate Stem Trial to the Fixed Bearing Conical Reamer and ream until the top of the cutting flutes are level with the proximal resection
3 4
16
Insert the Trial constructAssemble the trial to the previously determined offset position
Transferring Offsets
65
Assemble and attach the IM Mount to resect the tibia
Use the Canal Reamers to prepare the canal
OFFSET PRESS-FIT STEM WORKFLOW
21
Tibial Workflows
17
OFFSET PRESS-FIT STEM WORKFLOW
Use the Tibial Offset Dials to determine appropriate size and offset
Record the offset reading for Trial assembly
Attach the Tower and Offset Bushing and ream using the Offset Drill
3 4
18
TRIALING AND SETTING ROTATION
Perform trial range of motion using the desired Tibial Insert Trial
Pin the Tibial Base Trial in place once rotation has been confirmed
21
19
TRIALING AND SETTING ROTATION
Trialing and Setting Rotation
Use the corresponding Keel Punch to prepare for the Keels
3
20
Transfer reading to Tibial Offset Adaptor Trial
Set Tibial Offset Guide position
TRANSFERRING TIBIAL OFFSET TO IMPLANT
21
Transferring Offset to the Implant
21
Record Offset Adaptor Trial orientation using the Assembly Jig
Use Assembly Jig to set the final Offset Adaptor Implant position
3 4
22
Set Femoral Offset Guide position Transfer reading to Femoral Offset Adaptor Trial
TRANSFERRING FEMORAL OFFSET TO IMPLANT
1 2
Transferring Offset to the Implant
23
Use Assembly Jig to set the final Offset Adaptor Implant position
Record Offset Adaptor Trial orientation using the Assembly Jig
3 4
DePuy Orthopaedics, Inc.700 Orthopaedic DriveWarsaw, IN 46582USATel: +1 (800) 366 8143Fax: +1 (574) 669 2530
www.jnjmedicaldevices.com
The third party trademarks used herein are the trademarks of their respective owners .© DePuy Synthes 2017, 2018 . All rights reserved .122156-190829 DSUS/EM
DePuy (Ireland)Loughbeg, RingaskiddyCo . Cork, IrelandTel: +35 (321) 491 4000Fax: +35 (321) 491 4199
DePuy International LtdSt Anthony’s RoadLeeds, LS11 8DTEnglandTel: +44 (0) 113 270 0461