Pressfit, hydroxyapatitecoated acetabular cup designs may offer a lower incidence of loosening and migration than older designs. The acetabular system in combination with stems was designed to provide greater stability, wider range of movement, longevity and address the revision in case of failures. Apr 18, 2011 trilogy acetabular system manufacturing video. The bhr acetabular cup should also be removed if movement can be detected during intraoperative assessment of component stability.
Trident tritanium acetabular system surgical protocol indications painful, disabling joint disease of the hip resulting from. We queried our institutions prospectively collected registry for a series of 771 primary thas. It has pure titanium coating cpti on top of a titanium alloy shell with an average porosity of 72%. Stryker is proud to introduce the tritanium primary acetabular system, the only advanced fixation technology manufactured from a commerciallypure titanium matrix. If a revision of an existing acetabular shell is required, the surgeons preferred technique for removing the acetabular shell should be used. Reconstruction of acetabular defects in total hip arthroplasty tha presents a great challenge to orthopaedic surgeons. The plates surgical technique figure 1 figure 2 figure 3 restoration gap shell gap shell series ii insert polyethylene acetabular cup. The use of ibg for the reconstruction of acetabular defects with and without the use of adjuvant metal meshes was described by slooff et al1. The foam is supposed encourage bone cells to attach to it and grow, thereby creating joint stability. Biomet malloryhead ringloc acetabular series prosthesis. Trident tritanium acetabular system surgical protocol.
Once the acetabulum is implanted and the shell free of debris, the liner is inserted. Description nonholed 00620203821 trabecular metal acetabular shell, 38mm, solid through i through i 00620207021 trabecular metal acetabular shell, 70mm, solid. Acetabular liners in older systems placed in a canted, nonseated position have been described, and in several cases these implants fractured in a very short time. The tritanium acetabular cup from stryker is an acetabular shell manufactured from tritanium which is a proprietary commercially pure titanium matrix. Trident tritanium acetabular system surgical protocol stryker meded. The information contained in this document is intended for healthcare professionals only. Exeter femoral stem and tritanium acetabular component stryker surgical procedure. Acetabular system surgical protocol for crossfire polyethylene and trident alumina ceramic inserts with psl ha and hemispherical acetabular shells trident psl ha acetabular shell trident hemispherical acetabular shell 040924. The benefit of a titanium mesh cup is that it has a similar modulus to bone. The trident psl acetabular system is a twopiece component design that is assembled during surgery. Stryker report the shell has 72% porosity, a coefficient of friction of 1. Trabecular titanium acetabular cups in hip revision surgery.
Single use devices intended for cementless fixation within the prepared acetabulum. Jul 07, 2009 the trident acetabular component stryker orthopaedics, mahwah, nj is a commonly used uncemented acetabular component. Chiari osteotomy or shelf augmentation of the acetabulum were used to. The tritanium acetabular shell, cleared for use under fda 510k k081171, is a hemispherical acetabular shell with a 3d surface for biological fixation, fabricated from cp ti. Dimensions related to the cup wall solid, lattice and overall. This surgical technique is a guide to preparing the acetabulum for tritanium. The median duration of followup was 6,2 yrs range, 5 to 7 yrs. Full surgical techniques for the tritanium solidback, clusterhole, and multihole shells can be found in the productspecific surgical protocols. The tritanium acetabular system provides surgeons with a highly porous ingrowth surface manufactured from a commercially pure titanium matrix. Titanium locking screw for triflange acetabular component. Clinical and radiographic outcomes with a hydroxyapatite. Tritanium primary acetabular shell study full text view.
The tritanium acetabular system provides highly porous ingrowth surface manufactured from a commercially pure titanium matrix. The pt had a total hip on the other side which was resected due to an infection and is unable to walk. Refer to table 1 for insert and shell compatibility and sizing options. Critical to this success is the polished inner shell surface. Lawsuits against medical device manufacturer stryker continue over its recalled trident hip implant system which has forced injured victims to undergo further costly and painful revision surgery. Trabecular metal acetabular revision system buttress and shim augments 7 attach the cup inserter to the rim of the selected trabecular metal revision shell. The r3 acetabular system consists of acetabular cup with a liner. Primary tritanium acetabular components are associated with a high prevalence of radiolucencies which compromise clinical function at short term followup alberto carli, md, msc, frcsc, new york, ny 36. These fractures were encountered during postoperative followup and managed by revision of the acetabular liner and ceramic head components in both the cases with uneventful outcome. Acetabular reconstruction, subtrochanteric osteotomy, crowe iv.
Gradually enlarge the acetabulum by reaming articular cartilage until a continuous surface of cancellous bone is exposed. Biomet as the manufacturer of this device, does not practice medicine. So far 30 patients were available for oneyear followup migration measurement. Acetabular system is designed to help restore kinematic function by addressing the challenges associated with primary and revision acetabular reconstruction.
Error in surgical technique causing ceramic acetabular. Manufacturer specifications malloryhead ringloc acetabular series, biomet please note. One commonly used ceramic implant is the trident system stryker orthopaedics, mahwah, nj, which has a titaniumbacked ceramic pressfit liner in a hydroxyapatitecoated, titanium alloy acetabular shell. Error in surgical technique causing ceramic acetabular liner. The only difference is the number of screw holes and the orientation of the screws. We revised to shell with a 68 mm revision cup and a 36 mm 10 deg. The procotyl l acetabular cup system provides unsurpassed surgical flexibility for shell fixation and bearing material choices.
Trident tritaniu m ace tabular system surgical protocol. Ebm, a common 3d printing technique for metal components 10. Tritanium stryker, mahwah, nj, usa is a highly porous 3dimensional 3d structure designed to mimic the trabecular morphology of natural bone. With the final prosthesis connected to acetabular cup impactorpositioner, insert shell into prepared site. Migration of trident tritanium ingrowth actebular components. Acetabular system is designed to help restore kinematic function by. The shell is built upon the design features and clinical history of the existing trident tritanium, trident ad, and trident ha hemispherical acetabular shells. The fixation of the femoral osteotomy was achieved with lcdcp titanium femoral plate. Comparison of a highly porous titanium cup tritanium and. Tritanium was developed using a similar 3d structure and was composed of a titanium coating instead of tantalum, to achieve results comparable to the trident cup. Previous studies have reported on the use and outcomes of trabecular metal acetabular augments for the reconstruction of acetabular defects.
Trident acetabular system hemispherical surgical protocol step 3b. Total hip arthroplasty for crowe type iv developmental dysplasia. If acetabular osteotomes are used, final shaping must still be achieved using the hemispherical grater. Final reaming under reaming by 1 to 2 mm of the actual trident hemispherical shell size is recommended to achieve interference fit. Table 1 summarizes migration results for both components at all timepoints up to 1 year fu. Excessive vertical orientation of the shell should be avoided as this may lead to premature wear of the ceramic material.
Acetabular preparation the acetabulum is prepared by the release and removal of soft tissue using the surgeons preferred technique to gain adequate exposure for reaming. Early to midterm results of revision hip replacement with. The amount of interference fit should be determined intraoperatively based upon the patients bone quality. Trabecular metal acetabular revision system buttress and. Running a inger around the circumference of the shell and a visual check will help determine if the liner is lush with the shell face. Plates may be bent and cut to closely conform to the bone fig. Acetabular exposure the surgeon should select the appropriate exposure. Comparative survival analysis of porous tantalum and porous titanium cups in total hip arthroplasty sumon nandi, md, lima, oh 37. This surgical technique is a guide to preparing the acetabulum for the trident psl acetabular system implants utilizing a single set of acetabular instruments. Exeter femoral stem and tritanium acetabular component stryker surgical technique with step by step instructions on orthoracle. Tritanium acetabular cup in revision hip replacement. Seating of ceramic liners in the uncemented trident. Comments about the stryker tritanium acetabular cup. Trabecular metal modular acetabular system 1 trabecular metal modular acetabular system surgical technique table of contents acetabular reaming 2 component sizing 2 provisional shell positioning and alignment 3.
We engineered our r3 acetabular cups for multiple bearing options and features that address your needs as a surgeon. Surgical technique the technique for the reflection peripheral hole and multihole hemispherical shells is similar to the technique for implantation of reflection threehole shells. Our elearning platform contains high resolution images and a certified cme of the total hip replacement. He presented to dr with a grossly loose shell described as a 54 mm psl in the operative report.
The tritanium hemispherical acetabular cup stryker, mahwah, nj is a highly porous, hemispherical, multihole design shell with a roughened surface for biologic fixation. When implanting the tritanium solid back, cluster hole, or multihole shell, it is recommended. Recently new porous metal cups, shells and augments such as the most commonly used trabecular metal7 zimmer, warsaw, in, usa components have been. Trident ii tritanium acetabular shell outcomes study. Excision of the labrum and osteophytes allows for proper visualization of the bony anatomy and improves ease of reaming. None of the equipment posted for sale on is owned by medwow, should you have any questions regarding a specific item, please direct them to the appropriate seller by making use of the available communication channels on the items page. The information contained in this document is intended for. Trabecular metal modular acetabular system 9 product information trabecular metal acetabular shells shells are available in 2mm od increments 6202shell odshell type cat. The stryker tritanium acetabular shell, which replaces a persons hip socket, is made from a titanium alloy coated with a special type of porous foam. May 24, 20 the tritanium acetabular system provides highly porous ingrowth surface manufactured from a commercially pure titanium matrix. Keep slap hammer portion of positioner vertical, and aframe or gunsight extension parallel with patients body. The use of the highly porous titaniumbased acetabular shells in revision hip surgery has been previously evaluated in relatively few studies.
Clinical and radiographic outcomes of a trabecular. Anterior supine intermuscular tha surgical technique. Comparative analysis of current 3d printed acetabular titanium. The trident acetabular system utilizes the cuttingedge total hip acetabular instrumentation.
Stryker must defend massachusetts class action lawsuit. Take care to limit the cement to this location and prevent. This surgical technique is utilized by daniel wurtz, m. This surgical technique is a guide to preparing the acetabulum for the trident. It was reported that, pt is a b 6, original operation was done in b 6. Our study evaluated the initial clinical and radiographic success of a cementless acetabular shell in a large cohort of primary total hip arthroplasty tha patients. Dec 21, 2016 trident ii tritanium acetabular shell outcomes study the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. This surgical technique is a guide to preparing the acetabulum for tritanium acetabular shells utilizing cuttingedge total hip acetabular instrumentation. Trident ii tritanium acetabular shell outcomes study the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. The shells are available in sizes 48mm80mm, and offer the option of alumina ceramic or crossfire or x3 polyethylene inserts. Inspect the linershell interface for proper seating. Mean sd values of trident ha and tritanium cup translationmm and rotation degrees at each followup moment.
According to fact that medialisation of acetabular cup decreases hip. R3 uses stiktite porous coating that is designed to enhance fixation and promote bony ingrowth. The trident tritanium shells utilize the screw hole pattern and locking mechanism from the trident acetabular system. Since 1999, orthopaedic surgeons have chosen strykers trident acetabular system for its effectiveness and track record. Class 2 device recall trident hemispherical acetabular shell.
Incidence of ceramic liner malseating in trident acetabular. Acetabular reconstruction in total hip arthroplasty. Aim of this prospective study was to evaluate midterm clinical and radiographic outcomes in total hip arthroplasty using an acetabular cup made of an innovative biomaterial, trabecular titanium, whose highly porous structure and mechanical properties have been designed to mimic those of the natural bone, thus promoting a more physiological load. Ramappa et al reported excellent early results in 43 revision cases using the titanium tritanium acetabular shell in revision tha at mean followup of 18. Surgical technique 2 chapter 2 surgical technique preparation of the acetabulum ream the acetabulum sequentially, starting with the smallest reamer that conforms to the acetabular cavity. Although the company has sought to dismiss a class action lawsuit filed against it on behalf of massachusetts residents with defective trident implants, a federal judge. Trilogy acetabular system 1 trilogy acetabular system surgical technique table of contents acetabular reaming 2 component sizing 2 positioner assembly 3 positioning and alignment 3 implant orientation 4 implant insertion 4 screw insertion 5 liner positioning 5 liner insertion 6 locking ring replacement if required 6 final reduction 7. We present early and midterm results of revision hip replacement using a tritanium acetabular shell in a consecutive single surgeon series.
It may be coupled with a polyethylene liner or a titaniumbacked ceramic pressfit liner. In all hips, the acetabular component was the dual radius trident ad shell stryker orthopaedics, mahwah, new jersey. The howmedica osteonicso universal acetabular shell positionerlmpactor assists in positioning the shell al the recommended 45 of abduction inclination and 20 anteversion refer to acetabular shell positionerlmpaetor. The r3 acetabular system continues this legacy by reducing wear on the backside of the liner by utilizing this polished counterface in the refined cup design. Trident acetabular system hemispherical surgical protocol. Listing a study does not mean it has been evaluated by the u. The liner should sit lush with the face of the shell. Multihole shells with constrained liners and big femoral heads. Trilogy acetabular system 3 positioning and alignment ensure the patient is in the correct position. The shells are manufactured from titanium alloy, the material of choice for biocompatibility. Pdf early to midterm results of revision hip replacement. Trident ii tritanium acetabular shell outcomes study full. Intended for use with the mating trident polyethylen cup inserts.
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