Surgical Technique
Ovation® Hip Stem
Designing Surgeons:
Andrew Petrella, M.D.
Richard Vlasak, M.D.
Table of Contents
Surgical Technique Overview
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, precautions, warnings and potential risks associated
with the Ovation® Hip Stem.
Device Description..........................1
Preoperative Planning....................2
Incision...............................................3
Femoral Neck Osteotomy..............3
Femoral Preparation.......................3
Trial Reduction.................................5
Femoral Component Insertion.....6
Hip Reduction...................................7
Ovation Instrument Listing............9
Ovation Implant Listing..................11
Surgical Technique Overview
1. Device Description
• Optimized neck geometry with highly polished surface
improves overall range of motion
• Available in 12 sizes with standard and extended neck
The Ovation® Hip Stem is a proven M/L taper design that
offsets to accommodate patient anatomy
accommodates multiple surgical approaches. In order to
provide options for various patient needs, the Ovation® Hip • Proximal body surface is coated with titanium plasma
spray for solid, long-term fixation
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
1. Femoral Neck Osteotomy
4. Calcar Planing
2. Femoral Preparation
5. Trial Reduction
6. Femoral Component
Insertion
• Distal body flute to more closely match bone properties
• A 132 degree neck angle is offered in both standard and
extended neck offsets
3. Broaching
7. Femoral Head
Impaction
1
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.
Figure 2: Resection Guide
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)
Part Numbers this page:
Resection Guide 201-0000
Box Osteotome 201-0004
Starter Reamer 201-0003
Large Hudson T-Handle 215-0009
Figure 3: Box Osteotome
Figure 4: Starter Reamer
Figure 1: Template overlaid on A/P radiograph
2
3
Increase the Broach size sequentially until the Broach
size matches the implant size determined during preoperative 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.
C LO S E D
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.
O PEN
Figure 6: Broach Handle
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).
Figure 8: Calcar Planar connected to Broach
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.
Figure 5: Starter Broach
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)
Part Numbers this page:
Broach Handle 201-1000
Blunt Distal Broach Size ST 201-2121
Fully Toothed Femoral Broach 201-2001 : 201-2012
4
Figure 9: Neck and Femoral Head Trials
Figure 7: Inserting Broach into Femoral Canal
Part Numbers this page:
Calcar Planar 201-3001 : 201-3002
Fully Toothed Femoral Broach 201-2001 : 201-2012
Neck Trial 201-4001 : 201-4008
Femoral Head Trial CoCr 238-2230 : 238-4009
Femoral Head Trial Ceramic 235-2810 : 235-4016
5
7. F
emoral Component
Insertion
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).
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.
8. Hip Reduction
(continued)
The 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.
Figure 11: Inserting the Stem
Figure 10: Attaching the Inserter
6
Part Numbers this page:
Stem Inserter 201-0002
Ovation Stem 101-0001 : 101-1012
Part Numbers this page:
Femoral Head Trial CoCr 238-2230 : 238-4009
Femoral Head Trial Ceramic 235-2810 : 235-4016
Ovation Stem 101-0001 : 101-1012
Femoral Head CoCr 138-2800 : 138-4060
Femoral Head Ceramic 136-2801 : 136-4004
Femoral Head Impactor 208-0340
Figure 12: Trial Reduction
Figure 13: Femoral Head Impaction
7
Ovation® Instrument Trays
201-9012A
ovat i o n t r i a l k i t
DE S CRIPT IO N
ovat i o n D IRE C T AN T ERI O R KI T
N UM BE R
item #
D E S CRI P TI ON
1
201-2101
Blunt Tip Broach Size 1
N UM B E R
item #
2
201-2102
Blunt Tip Broach Size 2
1
201-4001
Neck Trial Size 1-3 Standard
3
201-2103
Blunt Tip Broach Size 3
2
201-4002
Neck Trial Size 4-6 Standard
4
201-2104
Blunt Tip Broach Size 4
3
201-4003
Neck Trial Size 7-9 Standard
5
201-2105
Blunt Tip Broach Size 5
4
201-4004
Neck Trial Size 10-12 Standard
6
201-2106
Blunt Tip Broach Size 6
5
201-4005
Neck Trial Size 1-3 Extended
6
201-4006
Neck Trial Size 4-6 Extended
7
201-4007
Neck Trial Size 7-9 Extended
8
201-4008
Neck Trial Size 10-12 Extended
3
1
2
5
4
7
6
9
8
11
16
15
17
14
10
12
7
201-2107
Blunt Tip Broach Size 7
8
201-2108
Blunt Tip Broach Size 8
9
201-2109
Blunt Tip Broach Size 9
10
201-2110
Blunt Tip Broach Size 10
11
201-2111
Blunt Tip Broach Size 11
12
201-2112
Blunt Tip Broach Size 12
Small Calcar Planar
13
201-2120
Starter Broach
208-0300
Femoral Head Impactor
14
201-2121
Blunt Distal Broach Size ST
13
201-3002
Large Calcar Planar
15
201-2118
DAA Canal Finder
14
208-0340
40mm Femoral Head Impactor
16
201-0103
Offset Stem Inserter Left
15
215-0009
Large Hudson T-Handle
17
201-0102
Offset Stem Inserter Right
16
201-0000
Femoral Neck Resection Guide
18
201-0104
Offset Stem Inserter Neutral
17
201-3003
T-handle Calcar Reamer
19
201-0100
DAA Broach Handle Left
18
201-0001
Stem Extractor
20
201-0101
DAA Broach Handle Right
201-6012
Ovation Trial Case
21
201-2119
DAA Box Osteotome
22
201-2000
Chili Pepper Broach
201-6015
Ovation Direct Anterior Case
9
211-0013
Slap Hammer
10
201-0018
Femoral Head Extractor
11
201-3001
12
201-9011
13
18
2
16
4
18
17
6
13
8
14
10
15
1
3
5
7
9
11
12
21
19
22
20
ovat i o n P O S T ERI O R LAT ERAL KI T
N UM B E R
item #
1
201-2001
Broach Size 1
2
201-2002
Broach Size 2
3
201-2003
Broach Size 3
4
201-2004
Broach Size 4
DE S CRIPT IO N
5
201-2005
Broach Size 5
6
201-2006
Broach Size 6
7
201-2007
Broach Size 7
8
201-2008
Broach Size 8
9
201-2009
Broach Size 9
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
8
201-9015
2
14
4
13
6
14
8
15
16
17
1
3
5
7
9
10
11
12
Ovation Posterior Lateral Case
9
238-9000
10
Ovation® Implants
F EM O RAL H EA D T RIAL KI T
N UMB E R
item #
DE S CRIPT IO N
1
238-2230
Femoral Head Trial 22mm -3
2
238-2200
Femoral Head Trial 22mm +0
3
238-2203
Femoral Head Trial 22mm +3
4
238-2206
Femoral Head Trial 22mm +6
5
238-2630
Femoral Head Trial 26mm -3
6
238-2600
Femoral Head Trial 26mm +0
7
238-2603
Femoral Head Trial 26mm +3
8
238-2606
Femoral Head Trial 26mm +6
9
238-2609
Femoral Head Trial 26mm +9
10
238-2860
Femoral Head Trial 28mm -6
11
238-2830
Femoral Head Trial 28mm -3
12
238-2800
Femoral Head Trial 28mm +0
13
238-2803
Femoral Head Trial 28mm +3
14
238-2806
Femoral Head Trial 28mm +6
15
238-2809
Femoral Head Trial 28mm +9
16
238-3260
Femoral Head Trial 32mm -6
17
238-3230
Femoral Head Trial 32mm -3
18
238-3200
Femoral Head Trial 32mm +0
19
238-3203
Femoral Head Trial 32mm +3
20
238-3206
Femoral Head Trial 32mm +6
21
238-3209
Femoral Head Trial 32mm +9
22
238-3660
Femoral Head Trial 36mm -6
23
238-3630
Femoral Head Trial 36mm -3
24
238-3600
Femoral Head Trial 36mm +0
25
238-3603
Femoral Head Trial 36mm +3
26
238-3606
Femoral Head Trial 36mm +6
27
238-3609
Femoral Head Trial 36mm +9
10
1
5
11
2
6
12
3
7
13
4
8
14
9
15
16
22
17
18
28
23
24
19
20
30
35
38
36
39
40
32
27
37
31
25
26
21
29
34
33
41
42
43
44
45
sta n da r d a n d e x t e n d e d s i z e s
46
size
stem
length
proxima l
w idth ( m / l)
dista l
w idth ( a / p )
LEG
length
hori zonta l
offset
( standard)
hori zontal
offset
( e xtended)
47
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
48
Offset
Leg
Length
Proximal
Width
Stem Length
Ovation stem dimensions and offsets (all dimensions are in mm)
28
238-4060
Femoral Head Trial 40mm -6
29
238-4030
Femoral Head Trial 40mm -3
30
238-4000
Femoral Head Trial 40mm +0
31
238-4003
Femoral Head Trial 40mm +3
32
238-4006
Femoral Head Trial 40mm +6
33
238-4009
Femoral Head Trial 40mm +9
34
235-2810
Ceramic Femoral Head Trial 28mm S -5
I TE M #
35
235-2812
Ceramic Femoral Head Trial 28mm M -1
101-0001
Ovation Stem Standard Size 1
Ovat i o n H i p S t e m s
D E S CRI P TI ON
36
235-2814
Ceramic Femoral Head Trial 28mm L +2
101-0002
Ovation Stem Standard Size 2
37
235-3210
Ceramic Femoral Head Trial 32mm S -5
101-0003
Ovation Stem Standard Size 3
38
235-3212
Ceramic Femoral Head Trial 32mm M -1
101-0004
Ovation Stem Standard Size 4
39
235-3214
Ceramic Femoral Head Trial 32mm L +2
101-0005
Ovation Stem Standard Size 5
40
235-3216
Ceramic Femoral Head Trial 32mm XL +6
101-0006
Ovation Stem Standard Size 6
41
235-3610
Ceramic Femoral Head Trial 36mm S -5
101-0007
Ovation Stem Standard Size 7
42
235-3612
Ceramic Femoral Head Trial 36mm M -1
101-0008
Ovation Stem Standard Size 8
43
235-3614
Ceramic Femoral Head Trial 36mm L +2
101-0009
Ovation Stem Standard Size 9
44
235-3616
Ceramic Femoral Head Trial 36mm XL +6
101-0010
Ovation Stem Standard Size 10
45
235-4010
Ceramic Femoral Head Trial 40mm S -5
101-0011
Ovation Stem Standard Size 11
46
235-4012
Ceramic Femoral Head Trial 40mm M -1
101-0012
Ovation Stem Standard Size 12
47
235-4014
Ceramic Femoral Head Trial 40mm L +2
101-1001
Ovation Stem Extended Size 1
48
235-4016
Ceramic Femoral Head Trial 40mm XL +6
101-1002
Ovation Stem Extended Size 2
238-6000
Femoral Head Trial Case
101-1003
Ovation Stem Extended Size 3
101-1004
Ovation Stem Extended Size 4
101-1005
Ovation Stem Extended Size 5
101-1006
Ovation Stem Extended Size 6
101-1007
Ovation Stem Extended Size 7
101-1008
Ovation Stem Extended Size 8
101-1009
Ovation Stem Extended Size 9
101-1010
Ovation Stem Extended Size 10
101-1011
Ovation Stem Extended Size 11
101-1012
Ovation Stem Extended Size 12
11
B i o lox ® D e lta F e m o r a l H e a ds
I T E M#
DE S CRIPT IO N
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
136-3201
Biolox® Delta Femoral Head 32mm S -5
136-3202
Biolox® Delta Femoral Head 32mm M -1
136-3203
Biolox® Delta Femoral Head 32mm L +2
136-3204
Biolox® Delta Femoral Head 32mm XL +6
136-3601
Biolox® Delta Femoral Head 36mm S -5
136-3602
Biolox® Delta Femoral Head 36mm M -1
136-3603
Biolox® Delta Femoral Head 36mm L +2
136-3604
Biolox® Delta Femoral Head 36mm XL +6
136-4001
Biolox® Delta Femoral Head 40mm S -5
136-4002
Biolox® Delta Femoral Head 40mm M -1
136-4003
Biolox® Delta Femoral Head 40mm L +2
136-4004
Biolox® Delta Femoral Head 40mm XL +6
C o C r F e m o r a l H e a ds
I T E M#
12
DE S CRIPT IO N
138-2800
CoCr Femoral Head 28mm +0
138-2803
CoCr Femoral Head 28mm +3
138-2806
CoCr Femoral Head 28mm +6
138-2809
CoCr Femoral Head 28mm +9
138-2830
CoCr Femoral Head 28mm -3
138-2860
CoCr Femoral Head 28mm -6
138-3200
CoCr Femoral Head 32mm +0
138-3203
CoCr Femoral Head 32mm +3
138-3206
CoCr Femoral Head 32mm +6
138-3209
CoCr Femoral Head 32mm +9
138-3230
CoCr Femoral Head 32mm -3
138-3260
CoCr Femoral Head 32mm -6
138-3600
CoCr Femoral Head 36mm +0
138-3603
CoCr Femoral Head 36mm +3
138-3606
CoCr Femoral Head 36mm +6
138-3609
CoCr Femoral Head 36mm +9
138-3630
CoCr Femoral Head 36mm -3
138-3660
CoCr Femoral Head 36mm -6
138-4000
CoCr Femoral Head 40mm +0mm
138-4003
CoCr Femoral Head 40mm +3mm
138-4006
CoCr Femoral Head 40mm +6mm
138-4009
CoCr Femoral Head 40mm +9mm
138-4030
CoCr Femoral Head 40mm -3mm
138-4060
CoCr Femoral Head 40mm -6mm
12187 So. Business Park Drive
Draper, Utah 84020
801-553-9991/fax 801-553-9993
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Ortho Development Corporation
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1 0/2 01 3
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.