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 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. 351-1-10666 Ortho Development Corporation odev.com 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.
© Copyright 2025 ExpyDoc