Explant®

Acetabular Cup Removal System

Surgical Technique

1Explant® Acetabular Cup Removal System Surgical Techninque

• Controlledbonedissectionatthebone-cupinterface

helpsminimizebonelossduringrevisionsurgery.

• Twobladestylesforeachcupsizefacilitateprogres-

siveremovalofthecup.

• BladescloselymatchacetabularcupODtopreserve

bonestock.

• Centeringheads,whichmatchacetabularcupID,

helpstabilizeandguidethebladesduringcutting.

Simple Procedure

Anchoredbyacenteringheadattachedtothehandle,a

stiffTruncatedBladepenetratesdenseperipheralbone

andcreatesachannel.

Afullradius,thinFullBladethenfreesthedomeofthe

cupfromboneattachment.

Minimizes Acetabular Bone Loss

2 Explant® Acetabular Cup Removal System Surgical Techninque

Determinethesizeofacetabularcuptoberemovedby

determiningitsoutsideandinsidediameters.Selectthe

bladebasedontheoutsidediameter(OD)ofthecupand

thePivotHead(22mm-36mm)basedontheinside

diameter(ID).

Note:IftheODisinbetweentheavailablebladesizes,

selectthenextlargestsize.Alternatively,iftheIDisin

betweentheavailablePivotHeadsizes,selectthenext

smallestsize.

IftheshelltobeexplantedisaLargeDiameterHeadshell

andtheinsidediameter(ID)is38mmorgreater,youmust

choosetheappropriatesizeMetasul® LDH®femoralhead

trialthatmostcloselymatchestheIDoftheshell.Place

theadapterontheExplanthandlebyscrewingitdownin

thesamemannerthatyouwouldattachthestandardpivot

heads,makingsurethatitistightenedcompletelyand

securely.Then,placetheappropriatesizedMetasul LDH

femoralheadtrialsecurelyontheadapterbypushingdown

onthetrialheadsothatthetaperontheadaptercapturesit

securely.Alightimpactionwiththepalmofthehandwillbe

enough.

Note: This should be done BEFORE attaching the osteotome

blade. Attachtheappropriatesizedosteotomebladeonthe

handleandsecurewithhexdriver.

Note:IftheODisinbetweentheavailablebladesizes,select

thenextlargestsize.Alternatively,iftheIDisinbetweenthe

availablePivotHeadorLarge Diameter HeadTrialHeadsizes,

selectthenextsmallestsize.

1Select Instrument Size

3Explant® Acetabular Cup Removal System Surgical Techninque

2Assemble BladesThreadtheselectedPivotHeadsortheExplantAdapterwith

Large Diameter HeadTrialHeadsontoeachofthetwohandles.

EnsurethePivotHeadorAdapterwithLarge Diameter Head

TrialHeadisthreadeddowntightlyonthehandletoprevent

looseningduringimpaction.SlidetheselectedTruncated

BladeandcorrespondingFullBladeovertheboltoneach

handle.UsetheTorqueWrenchwiththehexadaptertosecure

thebladetothehandle.TightenuntiltheTorqueWrench

releases.Thiswillensurethatthebladeisfullylockedin

place.

Note:Thehandleboltiscaptured.Onlyloosentheboltwith

thetorquewrenchandhexadaptor.Theboltonlyneedstobe

looseneduntilthebladeisfree.Donotcontinuetounscrew

theboltasitmaybecomeseparatedfromhandle.

Warning: Do not attempt to unscrew the Pivot Head or

Adapter with Large Diameter Head Trial Head from the handle

when the blade is still attached. The sides of the blade are

sharp and caution should be used. Instead, remove the

blades prior to the Pivot Head or Adapter with Large Diameter

Head Trial Head removal.

4 Explant® Acetabular Cup Removal System Surgical Techninque

UsetheBallImpactor, ifrequired,tosecurethe handlewithinthecup.

Assesslocationofscrewsinanyacetabularcupand

removethemtoensurenointerferencewiththeExplant

blades.Also,ensuresofttissueisclearedfromthefaceof

thecup.

UsetheTruncatedBladetoinitiatecupremoval.This

shorter,stifferbladeisdesignedtopenetratethedenser

peripheralbonearoundthecup.PlacethePivotHeador

AdapterwithLarge Diameter HeadTrialHeadwithinthe

cupIDtoguidethebladearoundthecup.UsetheBall

Impactor,ifrequired,tosecurethehandlewithinthecup.

Usingatechniqueofimpactionandaxialrotation,initiate

achannelaroundthecupperiphery.Ifthebonenearthe

rimisscleroticandtheTruncatedBladeisnotadvancing,

theExplantinstrumentcanberemovedandpreparation

initiatedwithastraightosteotome.

Note:Ifthecuplinerisdamaged,orifthecuphasanoffset

linerpreventingpropercenteringoftheosteotome,remove

thelineranduseaprovisionalinsert.

3Initiate Cup Removal

5Explant® Acetabular Cup Removal System Surgical Techninque

UsetheFullBladetofinalizethecupremoval.Thislonger,

thinnerbladeisdesignedtoreachtowardthedomeof

thecup.RepeatthetechniquedescribedfortheTruncated

Blade.Avoidapplyingtoomuchforceusingthethinblade.

Warning: Should the blade bend and impinge upon the

cup itself, excess torque could lever the cup out of the

acetabulum along with attached bone.

4Finalize Cup Removal

Afterthecuphasbeenexplanted,itisrecommended

thattheshortandlongExplantbladesusedinsurgery

bediscarded.Wearand/orotherdamagethatmay

occurduringthecupremovalcancompromisethe

blades’cuttingability.

Warning: The Explant blades are extremely sharp.

Caution must be used in handling throughout the

surgical procedure and subsequent disposal of the

blades.

5Blade Disposal

6 Explant® Acetabular Cup Removal System Surgical Techninque

Order Information

Instrumentation*

00-7001-021-00—LargeSet

ProductNo. Description Qty.00-7000-021-00 Shell Removal Instrument Set - Large00-7050-098-00 LargeOsteotomeInstrumentCase 100-7053-001-00 TorqueWrench 100-7053-002-00 TorqueWrenchAdapter,Hex3.5mm 100-7053-003-02 CurvedOsteotome,LargeHandle 200-7053-062-10 TruncatedBlade,62mmHemisphere 100-7053-064-10 TruncatedBlade,64mmHemisphere 100-7053-066-10 TruncatedBlade,66mmHemisphere 100-7053-068-10 TruncatedBlade,68mmHemisphere 100-7053-070-10 TruncatedBlade,70mmHemisphere 100-7053-072-10 TruncatedBlade,72mmHemisphere 100-7053-062-20 FullBlade,62mmHemisphere 100-7053-064-20 FullBlade,64mmHemisphere 100-7053-066-20 FullBlade,66mmHemisphere 100-7053-068-20 FullBlade,68mmHemisphere 100-7053-070-20 FullBlade,70mmHemisphere 100-7053-072-20 FullBlade,72mmHemisphere 100-7053-022-00 OsteotomePivotHead,22mm 200-7053-026-00 OsteotomePivotHead,26mm 200-7053-028-00 OsteotomePivotHead,28mm 200-7053-032-00 OsteotomePivotHead,32mm 200-7053-036-00 OsteotomePivotHead,36mm 200-7053-003-03 Explant LargeDiameterHeadAdapter 2

00- 7053-004-00 Ball Impactor (Optional)

* Bladesizingreferstotheoutsidediameterofthecupbeingremoved. Forexample,useProd.Nos.00-7053-050-10(TruncatedBlade)and 00-7053-050-20(FullBlade)fora50mmcup.

ProductNo. Description Qty.Large Diameter Head Femoral Head Trials

01.00189.381 ≥38mm 101.00189.401 ≥40mm 101.00189.421 ≥42mm 101.00189.441 ≥44mm 101.00189.461 ≥46mm 101.00189.481 ≥48mm 101.00189.501 ≥50mm 101.00189.521 ≥52mm 101.00189.541 ≥54mm 101.00189.561 ≥56mm 101.00189.581 ≥58mm 101.00189.601 ≥60mm 1

ProductNo. Description Qty.00-7000-020-00 Shell Removal Instrument Set - Small00-7050-096-00 SmallOsteotomeInstrumentCase 100-7053-001-00 TorqueWrench 100-7053-002-00 TorqueWrenchAdapter,Hex3.5mm 100-7053-003-01 CurvedOsteotome,SmallHandle 200-7053-042-10 TruncatedBlade,42mmHemisphere 100-7053-044-10 TruncatedBlade,44mmHemisphere 100-7053-046-10 TruncatedBlade,46mmHemisphere 100-7053-048-10 TruncatedBlade,48mmHemisphere 100-7053-050-10 TruncatedBlade,50mmHemisphere 100-7053-042-20 FullBlade,42mmHemisphere 100-7053-044-20 FullBlade,44mmHemisphere 100-7053-046-20 FullBlade,46mmHemisphere 100-7053-048-20 FullBlade,48mmHemisphere 100-7053-050-20 FullBlade,50mmHemisphere 100-7053-022-00 OsteotomePivotHead,22mm 200-7053-026-00 OsteotomePivotHead,26mm 200-7053-028-00 OsteotomePivotHead,28mm 200-7053-032-00 OsteotomePivotHead,32mm 200-7053-036-00 OsteotomePivotHead,36mm 200-7053-003-03 Explant LargeDiameterHeadAdapter 2

00-7000-019-00 Shell Removal Instrument Set - Medium00-7050-097-00 MediumOsteotomeInstrumentCase 100-7053-001-00 TorqueWrench 100-7053-002-00 TorqueWrenchAdapter,Hex3.5mm 100-7053-003-00 CurvedOsteotome,MediumHandle 200-7053-052-10 TruncatedBlade,52mmHemisphere 100-7053-054-10 TruncatedBlade,54mmHemisphere 100-7053-056-10 TruncatedBlade,56mmHemisphere 100-7053-058-10 TruncatedBlade,58mmHemisphere 100-7053-060-10 TruncatedBlade,60mmHemisphere 100-7053-052-20 FullBlade,52mmHemisphere 100-7053-054-20 FullBlade,54mmHemisphere 100-7053-056-20 FullBlade,56mmHemisphere 100-7053-058-20 FullBlade,58mmHemisphere 100-7053-060-20 FullBlade,60mmHemisphere 100-7053-022-00 OsteotomePivotHead,22mm 200-7053-026-00 OsteotomePivotHead,26mm 200-7053-028-00 OsteotomePivotHead,28mm 200-7053-032-00 OsteotomePivotHead,32mm 200-7053-036-00 OsteotomePivotHead,36mm 200-7053-003-03 Explant LargeDiameterHeadAdapter 2

Itisrecommendedthatbothhandlesbeassembledwiththeosteotomebladespriortocupremovaltoreducesurgerytime.(SeeStep#2)

7

8

97-7255-206-001108-H031MLPrintedinUSA©2011Zimmer,Inc.

Thisdocumentationisintendedexclusivelyforphysiciansandisnotintendedforlaypersons.Informationontheproductsandprocedurescontainedinthisdocumentisofageneralnatureanddoesnotrepresentanddoesnotconstitutemedicaladviceorrecommendations.Becausethisinformationdoesnotpurporttoconstituteanydiagnosticortherapeuticstatementwithregardtoanyindividualmedicalcase,eachpatientmustbeexaminedandadvisedindividually,andthisdocumentdoesnotreplacetheneedforsuchexaminationand/oradviceinwholeorinpart.Pleaserefertothepackageinsertsforimportantproductinformation,including,butnotlimitedto,contraindications,warnings,precautions,andadverseeffects.

ContactyourZimmerrepresentativeorvisitusatwww.zimmer.com

TheCEmarkisvalidonlyifitisalsoprintedontheproductlabel.

+H12497725520600/$110906I11