SMR TT HYBRID GLENOID - Link Sweden

SMR TTHYBRID GLENOID

LEONARDO DA VINCI: Vitruvian Man. Study of the proportions of the human body (1490).

Limacorporate S.p.A., as manufacturer of prosthetic devices, does not practice medicine. This surgical technique brochure has been developed in consultation with an experienced surgeons team

and provides the surgeon with general guidance when implanting SMR TT Hybrid Glenoid.Proper surgical procedures and techniques are necessarily the responsibility of the medical

professional. Each surgeon must evaluate the appropriateness of the surgical technique used based on personal medical training, experience and clinical evaluation of each individual patient.

For further information about our products, please visit our web site at www.limacorporate.com

This brochure describes the SMR TT Hybrid Glenoid components. For the complete set of products and combinations of the SMR Shoulder System refer to the dedicated brochures.

Please check the codes list for the availability of products in your market.

The symbol allows to distinguish the products NOT available in the US.

SMR TT HYBRID GLENOID Surgical Technique 3

SMR TT HYBRID GLENOID SURGICAL TECHNIQUE

Index

Indications, Contraindications, Warnings and Risk Factors pag. >> 6

Introduction pag. >> 10


Glenoid Preparation pag. >> 13

Final Implant pag. >> 18

Conversion and Revision Technique pag. >> 19

INSTRUMENT SET pag. >> 29

PRODUCT CODES pag. >> 36



The SMR Shoulder System is a modular shoulder platform

that was introduced on the European market in 2002.

The system offers interchangeable components, allowing

the surgeon to choose different configuration solutions in

resurfacing, fracture replacement, total shoulder, reverse

shoulder or revision surgeries.

The SMR TT Hybrid Glenoid is a glenoid component

composed of a polyethylene baseplate connected to a

central peg made of Trabecular Titanium. The baseplate

has two peripheral pegs intended to be cemented into the

native glenoid. The SMR TT Hybrid Glenoid is available

in different sizes of baseplate and peg. In case of the

baseplate 3 sizes are available (Small, Standard and

Large), and each one is in turn provided with two radii

of curvature options (standard and low mismatch) and

different thicknesses, to allow a better soft tissue tensioning.

If an SMR TT Hybrid Glenoid is in place and revision to a

reverse prosthesis is required, the prosthesis can be revised

by removing the polyethylene baseplate, leaving the metal

peg in place and by connecting it to the SMR TT Hybrid

Glenoid Reverse Baseplate. The SMR TT Hybrid Glenoid

Reverse Baseplate is intended for uncemented use with the

addition of screws for fi xation. Refer to the IFU for complete

descriptions of indications for use.

SMR TTHYBRID GLENOID

6 Surgical Technique SMR TT HYBRID GLENOID


Indications, Contraindications, Warnings and Risk Factors

INDICATIONS

The SMR TT Hybrid Glenoid is intended for total shoulder

joint replacement in patients suffering from disability due to:

• non-infl ammatory degenerative joint disease including

osteoarthritis and avascular necrosis;

• inflammatory degenerative joint disease such as

rheumatoid arthritis;

• glenoid arthrosis without excessive glenoid bone loss:

A1, A2 and B1 according to Walch classifi cation.

The SMR Reverse Shoulder System is indicated for primary,

fracture or revision total shoulder replacement in a grossly

deficient rotator cuff with severe arthropathy (disabled

shoulder). The patient’s joint must be anatomically and

structurally suited to receive the selected implants and a

functional deltoid muscle is necessary to use the device.

The SMR TT Hybrid Glenoid Reverse Baseplate must not be

used in cases of excessive glenoid bone loss and/or when

bone graft is needed.

The peripheral pegs of the SMR TT Hybrid Glenoid are

intended for fi xation by means of cement.

SMR TT Hybrid Glenoid is intended to be used if an

anatomical prosthesis is required. If an SMR TT Hybrid

Glenoid is in place and revision to a reverse prosthesis

is required, the patient can be revised by removing the

polyethylene baseplate and connecting the SMR TT Hybrid

Glenoid Reverse Baseplate to the intact, well fi xed TT Peg.

The SMR TT Hybrid Glenoid Reverse Baseplate is intended

for uncemented use with the addition of screws for fi xation.

In both cases on the humeral side all the components of

the SMR System can be used according to the clinical case

and their indication.

Please follow the instructions for use enclosed in the product packaging.


SMR TT HYBRID GLENOID SURGICAL TECHNIQUEIndications, Contraindications, Warnings and Risk Factors

System UseAvai labi l i ty

in USAnatomic Reverse Components Mater ia l Cem Not Cem

• • SMR Stems (Cemented, Cemented Revis ion) T i6Al4V X •

• • SMR Stems (Cement less F inned, Cement less Revis ion) T i6Al4V X •

• • SMR Large Resect ion Stems T i6Al4V X

• • S MR Modular Augments T i6Al4V X •

• SMR Humeral Bodies (Trauma, F inned) T i6Al4V X X •

• • SMR Reverse Humeral Bodies T i6Al4V X X •

• • SMR Reverse HA Coated Humeral Body T i6Al4V X X

• • SMR Humeral Extension T i6Al4V X X •

• SMR Humeral Heads (Standard, CTA)CoCrMo X X •

T i6Al4V X X

• SMR Adaptor Tapers (Neutra l , Eccentr ica l ) T i6Al4V X X •

• SMR CTA Head Adaptor for Reverse Humeral Body T i6Al4V X X •

• SMR Glenospheres

CoCrMo X •

T i6Al4V X

UHMWPE X-L ima+T i6A l4V X

• SMR Connectors T i6A l4V X •

• SMR Reverse L iners

UHMWPE X X •

UHMWPE X-Lima X X

CoCrMo X X

Alumina X X

• SMR Cemented Glenoids UHMWPE X •

• SMR 3-Pegs Cemented G leno ids U H M W PE X •

UHMWPE X-Lima X

• •* SMR T T Hybr id G leno id UHMWPE+T i6Al4V+Tanta lum X X •

• SMR T T Hybr id G leno id Basep la te + Screw T i6Al4V X •

• • SMR Meta l Back G leno ids T i6Al4V+PoroT i X* X* •

T i6Al4V+PoroT i+HA X •

• • SMR T T Meta l Back Basep la te T i6Al4V X* X* •

• • SMR T T Meta l Back Peg T i6Al4V X* X* •

• SMR Meta l Back L ine r UHMWPE X* X* •

•* • SMR Bone Screws T i6Al4V X •

• SMR G leno id P la tes T i X

Mater ia l Standards

T i6A l4V ( ISO5832-3 – ASTM F1472) – CoCrMo ( ISO5832-12 – ASTM F1537 ) – T i (ASTM F67 ) – UHMWPE ( ISO5834-2 – ASTM F648) – A lumina ( ISO6474) – PoroT i Coat ing (ASTM F1580) – HA Coat ing ( ISO13779) – Tanta lum (ASTM F560 / ISO13782)



Indications, Contraindications, Warnings and Risk Factors

*NOTE:• In the US, the SMR Metal Backed Glenoid/Liner

construct, used as part of the SMR Anatomic Shoulder

Replacement, is intended for use with bone cement and

should be used without bone screws.

• The SMR Metal Backed Glenoid/Connector/Glenosphere

construct, used as part of the SMR Reverse Shoulder

replacement, is intended for uncemented use with the

addition of screws for fixation.

• If an SMR TT Hybrid Glenoid is in place and revision to a

reverse prosthesis is required, the patient can be revised

by removing the polyethylene baseplate and connecting

the SMR TT Hybrid Glenoid Reverse Baseplate to the

intact, well fi xed TT Peg. The SMR TT Hybrid Glenoid

Reverse Baseplate is intended for uncemented use with

the addition of screws for fi xation.

• The Dia. 52 and 54 mm Humeral Heads with

+ 2mm increased height cannot be coupled to the Long

Adaptor Tapers (both concentric and eccentric).

The radial mismatches on coupling between the different

sizes of the SMR TT Hybrid Glenoid and the humeral heads

of the SMR System are shown in the following table.

R[m m]

Humeral Heads R [mm]

2 0( D i a 4 0 )

2 1( D i a 42 )

2 2( D i a 4 4 )

2 3( D i a 4 6 )

24( D i a 4 8 )

2 5( D i a 5 0 )

2 6( D i a 52 )

2 7( D i a 5 4 )

Smal l Low 27 7 6 5 4 3 2 1 0

Smal l 3 2 . 5 12 . 5 11. 5 10 . 5 9 . 5 8 . 5 7. 5 6 . 5 5 . 5

Standard Low 2 9 9 8 7 6 5 4 3 2

Standard 3 5 15 14 13 12 11 10 9 8

Large Low 31 11 10 9 8 7 6 5 4

Large 37. 5 17. 5 16 . 5 15 . 5 14 . 5 13 . 5 12 . 5 11. 5 10 . 5

GL

EN

OID

S

NOTE: Red couplings: not allowed.


SMR TT HYBRID GLENOID SURGICAL TECHNIQUEIndications, Contraindications, Warnings and Risk Factors

CONTRAINDICATIONS

Absolute contraindications include:

• local or systemic infection;

• septicemia;

• persistent acute or chronic osteomyelitis;

• confirmed nerve lesion compromising shoulder joint

function;

• deltoid muscle insufficiency;

Relative contraindications include:

• vascular or nerve diseases affecting the concerned limb;

• poor bone stock (for example osteoporosis or extended

previous revision surgery) compromising the stability of

the implant;

• metabolic disorders which may impair fixation and

stability of the implant;

• any concomitant disease and dependence that might

affect the implanted prosthesis;

• metal hypersensitivity to implant materials.

RISK FACTORS

The following risk factors may result in poor results with

this prosthesis:

• overweight (elevated BMI);

• strenuous physical activities (active sports, heavy

physical work);

• fretting of modular junctions;

• incorrect implant positioning;

• muscle deficiencies;

• multiple joint disabilities;

• refusal to modify postoperative physical activities;

• patient history of infections or falls;

• systemic diseases and metabolic disorders;

• local or disseminated neoplastic diseases;

• drug therapies that adversely affect bone quality, healing,

or resistance to infection;

• drug use or alcoholism;

• marked osteoporosis or osteomalacia;

• patient’s resistance to disease generally weakened (HIV,

tumour, infections);

• severe deformity leading to impaired anchorage or

improper positioning of implants;

• osteolysis.

The shoulder must be positioned off the edge of the table to

afford unobstructed arm extension.



PREOPERATIVE PLANNING

Standard X-rays are used to assist with planning of the

operation. It is recommended to use a normal AP-view in

internal and external rotation as well as an axillary view,

Bernageau or Morrison view. It is recommended to use

a CT-Scan in fracture cases and for planning the glenoid

insertion.

If required an MRI can be used to quantify the extent of

the bone deficiency and to see the muscle/capsule quality.

In post-traumatic cases, such as in special cases of

disabling shoulder, a neurological exam is helpful for

decision making.

Templates are used in all osteoarthritic cases; they can

also be used in fracture cases but often in a limited mode,

depending on the type of fracture.

The X-ray templates provided for SMR have a 105% scale;

digital templates are available as well.

ANESTHESIA

Shoulder surgery is one of the areas in which an

understanding of the surgery and participation by the

anaesthesiologist is especially important for the outcome of

the surgery. This applies to accurate preoperative evaluation

of the patient as well as intra op techniques.

They should have a good understanding of positioning on

the operating table and postoperative pain management.

Shoulder prosthetic replacement can be performed with

regional anaesthesia combined with sedation and/or with

general anaesthesia.

The modern technique of interscalea block was introduced

by Winnie in 1970 and soon became the standard for

anaesthesia and postoperative pain management in

shoulder surgery.

Requested surgical positioning (beach chair position) must

be accurately followed by the anaesthetic staff to avoid

hypotension and consecutive brain hypoperfusion.

POSITIONING

Shoulder arthroplasty is normally performed in a “beach-

chair” position; the surgeon needs complete access to

the shoulder joint. The arm is free or stabilized by arm-

holders. The shoulder must be positioned off the edge of

the table to afford unobstructed arm extension.

The patient’s head must be supported and stabilized in

the neutral position. Nerve injury due to brachial plexus

traction during positioning and surgery must be avoided.

If possible, one assistant should stay behind the shoulder,

the second on the opposite side of the patient, so that the

surgeon has a complete anterior view of the shoulder and

can move the joint without any obstacle.

Introduction


SMR TT HYBRID GLENOID SURGICAL TECHNIQUEIntroduction

ACCESS

We recommend two types of surgical approaches to the

shoulder joint. As in every surgical procedure, the access

depends not only on diagnosis and planned surgical

treatment but also on the experience of the surgeon.

Ranges of glenohumeral motion are evaluated with the

patient under anaesthesia to confirm the preoperative

assessment and the extent of capsular release needed to

restore the ROM postoperatively.

DELTO-PECTORAL APPROACH

Anterior vertical incision, starting 1 cm laterally of the

coracoid bone, slanting towards the axillary’s pouch.

If there is a metaphysal fracture, slanting laterally towards

the deltoid insertion at the humerus. The cephalic vein is

retracted laterally with the deltoid muscle.The clavipectoral

fascia is incised along the lateral edge of the conjoined

tendon up to the coracoacromial ligament.

With the clavipectoral fascia incised, a retractor can

easily be placed over the superolateral aspect of the

humeral head to retract the deltoid. The conjoined

tendon is retracted medially.

The musculocutaneous nerve penetrates the lateral

coracobrachialis muscle 3 to 8 cm distally of the tip

of the coracoid process. The position of the axillary

nerve should be indentified along the anterior surface

of the subscapularis muscle, below the conjoined

tendon. The axillary nerve crosses the inferolateral

border of the subscapularis 3 to 5 mm medially of

its musculotendinous junction and has an intimate

anatomic relation with the inferior capsule of the

shoulder joint.

The anterior humeral circumflex artery and veins are

visualized, ligated and divided.

The subscapularis tendon is released, divided 1 cm

medially to its attachment or with some bone chip of the

lesser tuberosity. Separation of the subscapularis from

the capsule and incision of the capsule is performed

to the inferior border of the glenoid rim, protecting

the axillary nerve with a blunt retractor. Release of the

subscapularis and 360° capsular release.

Closure. In fracture cases, accurate reconstruction of the

lesser and major tuberosities by suture, bone anchors or

cerclage is reccomended.

If the long head of the biceps tendon is intact, reconstruct

also the biceps groove to avoid impingement. Closure of

delto-pectoral groove.



LATERAL (DELTOID SPLITTING) APPROACH

Begin the incision at the anterolateral tip of the acromion

and carry it distally over the deltoid muscle about 5 cm.

Define the tendinous interval on 4 to 5 cm between the

anterior and middle thirds of the deltoid; splitting the

muscle here provides an avascular approach to underlying

structures.

Incise the thin wall of the subdeltoid bursa and explore the

rotator cuff as desired by rotating and abducting the arm

to bring different parts of it into view.

Introduction


SMR TT HYBRID GLENOID SURGICAL TECHNIQUESMR TT HYBRID GLENOID SURGICAL TECHNIQUEGlenoid Preparation

� EXPOSURE OF THE GLENOID

For a correct glenoid preparation an adequate glenoid

exposure is required. The fukuda (N33) and the glenoid

retractor (I33) are included into the Glenoid set.

Any peripheral osteophytes should be removed to restore

the natural anatomic shape of the glenoid. During this

phase be careful since the axillary nerve is close to the

inferior edge of the glenoid.

INSERTION OF THE GUIDE WIRE

For the glenoid preparation use a long 2.5 mm dia. guide

wire (not included in the instrument set).

The K-Wire can be positioned in place by using the K-Wire

position jig (H33) and handle (G33) (Figure 1).

The direction taken by the guide wire will determine the

version of the glenoid component. Therefore, a preoperative

CT Scan or MRI is useful to evaluate any deformities in the

articular surface. Any corrections in the wire direction should

be made at this point, correction is more difficult once the

surface is reamed and/or the pegs are drilled.

Figure 1Figure 1



Glenoid Preparation

PREPARATION OF GLENOID SURFACE

Once the K-wire has been inserted, remove the K-wire

positioning jig and handle. Connect the glenoid reamer

(E33) of the proper size to the reamer shaft (J33) (Figure 2)

and ream the glenoid carefully (Figure 3).

Ream carefully to avoid glenoid fractures. The aim of the

reaming is just to remove the cartilage and expose the

subchondral bone rather than excessive bone removal.

Remove the reamer leaving the K-wire in place and proceed

with the preparation of the central hole by using the glenoid

drill (A77) connected to the reamer shaft (J33) (Figure 4).

Drill on the guide wire, until the reamer baseplate touches

the subchondral bone (Figure 5).

Figure 3

Figure 2

Figure 5

Figure 4



Connect the glenoid drill guide (C77) of the proper size

to the quick connection handle (B77) (Figure 6) and

introduce it into the glenoid cavity by using the K-wire as

guide (Figure 7).

The glenoid drill guide has a central peg which is intended

to fi t in the previously prepared hole in the glenoid in order

to increase the device stability.

Drill the fi rst peripheral hole by using the quick connection

drill dia. 5 mm (E77) connected to the power tools by

means of the quick connection driver (D77). Disconnect

the quick connection shaft from the drill and leave the drill

in situ (as described in the previous step) while drilling the

second hole to stabilize the jig (Figure 8).

Remove the quick connection drills, the glenoid drill guide

and the K-Wire. If required, compact the central hole by

using the compactor (G77) connected to the compactor

handle (F77).

Figure 6

Figure 7

Figure 8Figure 8



INSERTION OF THE TRIAL IMPLANT

Complete the preparation of the peripheral pegs by using

the countersink (J77) (Figure 9). The aim of this step is to

remove some bone that will otherwise make difficult the

proper seating of the final implants.

Choose the proper size of the trial glenoid (H77) according

to the clinical case and the prepared seat on the glenoid

(Figure 10).

The trial glenoids have color codes according to the

following table.

To remove the trial component use the removal pliers

(I77) by connecting them into the grooves of the trial

components.

.

Glenoid Preparation

Figure 9 Figure 10

SIZE COLOR CODE

Small Low

Small Low +2

Small

Small +2

Standard Low

Standard Low +2

Standard

Standard +2

Large Low

Large Low +2

Large

Large +2

Figure 9



INSERTION OF THE FINAL IMPLANT

Remove the SMR TT Hybrid Glenoid of the correct size

(according to the trial implant) from the sterile packaging.

Connect the central peg protector (L77) to the quick

connection handle (B77) (Figure 11) and introduce it into

the central hole (Figure 12), then remove the handle. The

aim of this step is to prevent cement penetration during the

cement compaction phase.

Place the acrylic cement in the peripheral holes

(Figure 13) and compact it by means of the cement

compactor of the proper size (K77) connected to the

compactor handle (F77) (Figure 14). The aim of this phase is

to pressurize the cement. If more compaction is required,

repeat the previous steps.

Note. Make sure that no cement is present at the interface

between glenoid face and backside of the implant.

Figure 11

Figure 12

Figure 13

Figure 14

Figure 13



Final Implant

Use the glenoid positioner (M77) of the proper size

(according to the chosen final implant) connected to the

quick connection handle (B77) to position the SMR TT

Hybrid Glenoid on the glenoid cavity (Figure 15).

Note. This instrument is not intended for impaction of the

SMR TT Hybrid Glenoid device, which is impacted in the

following step using a dedicated instrument.

Note. Be sure that the two pegs are aligned with prepared

holes filled of cement.

Disconnect the positioning device from the SMR TT

Hybrid Glenoid by sliding it anteriorly and check that the

peripheral pegs are aligned with the peripheral holes into

the glenoid. Impact the SMR TT Hybrid Glenoid by using

the glenoid pusher (O77) connected to the handle of the

glenoid impactor handle (N77) until the device is fully seated

(Figure 16).

The glenoid pushers are available in two sizes and are

color coded according to SMR TT Hybrid Glenoid radius

of curvature: grey glenoid pusher is intended to be used in

case of regular mismatches, instead the yellow one in case

of low mismatches sizes.

In case of hard bone the retentive glenoid pusher (P77) can

be used to impact the SMR TT Hybrid Glenoid. Completely

surrounding the SMR TT Hybrid Glenoid, the retentive

Figure 15 Figure 16


SMR TT HYBRID GLENOID SURGICAL TECHNIQUESMR TT HYBRID GLENOID SURGICAL TECHNIQUEConversion and Revision Technique

glenoid pusher allows to impact the component according

to his main axis, preventing impingement or misalignment

that could compromize implant proper seating in case of

hard bone.

Complete the surgical technique steps according to the

SMR Anatomic surgical technique.

POLYETHYLENE BASEPLATE REMOVAL

In the case of a conversion from anatomic to reverse, or

revision of the SMR TT Hybrid Glenoid, the first step is

to disconnect the polyethylene baseplate from the central

peg.

Connect the removal guide (A79) of the proper size to the

removal guide handle (D79) (Figure 17) and position it on the

SMR TT Hybrid Glenoid surface.

The guide has a central pin which is intended to fit into

the central hole of the polyethylene baseplate, in order to

center the guide (Figure 18).

Fix the removal guide to the baseplate by means of two

headless twisted pins (B79) (Figure 19). The pins have laser

marks to indicate the sinking. Be sure that the pins are

inserted only into the polyethylene not on the bone. Ensure

that the jig is positioned perpendicular to the glenoid

baseplate surface.

Figure 18

Figure 19

Figure 17



Conversion and Revision Technique

Remove the removal guide handle, connect the quick

connection handle (E79) and drill the central hole by

using the removal drill (C79) (Figure 20) connected to the

power tools.

The removal drill has a stopper that allows to drill the

polyethylene at the proper depth to prevent TT peg

damaging; ensure that the stopper is properly set

according to the size (thickness) of the baseplate.

Note. In the case that the polyethylene baseplate is deformed

or damaged due to in vivo wear, please proceed carefully

during the drilling phase, by verifying step-by-step if the

bottom of the peg has been reached.

To disconnect the baseplate from the TT peg (Figure 22)

remove the removal drill and screw the baseplate extractor

(F79) into the polyethylene by using the removal guide as

stopper (Figure 21).

Note. A small amount of pressure should be applied initially to

the baseplate extractor so that it engages the polyethylene.

Note. While screwing the baseplate extractor on the

baseplate, the quick connection handle can be used as

counter torque.

In case of complete revision of the SMR TT Hybrid Glenoid

move to the section dedicated to the central peg removal.

Figure 20

Figure 22

Figure 21

Figure 22

Figure 21



CONVERSION

If a reverse prosthesis is required, after the polyethylene

baseplate removal, check the stability of the central

peg before proceeding. Improper fi xation of the TT

peg could affect the stability of reverse confi guration.

If the TT peg is not stable and the tissue ingrowth is not

guaranteed, proceed with peg removal (see dedicated

section).

Note. After removal of the polyethylene baseplate, if one of

the following conditions arises move to a dedicated device,

like the TT Metal Back:

• Peg not properly seated into the cavity, that comes

out from the glenoid surface;

• Bone loss;

• Bone graft required.

Screw the guide for conversion glenoid reamer (I79) into the

TT peg (Figure 23) by means of the quick connection handle

(E79). Connect the conversion glenoid reamer (H79) to the

T-handle with Zimmer connection (G79) and carefully ream

the glenoid surface (Figure 24).

Figure 23

Ensure cement removal from

peripheral pegs holes

Figure 24





Figure 25 Figure 26

The aim of this step is to remove cement remains or some

osteophytes that can impair the proper seating of the

reverse baseplate on the TT peg. This step is mandatory

for any SMR TT Hybrid Glenoid Reverse Baseplate. The

conversion glenoid reamer has the same radius of curvature

as the reverse baseplate. This allows one to prepare the

glenoid surface so as to achieve a proper seating of the

reverse baseplate and to avoid any bone/tissue impingement

with it.

Central to the reaming phase is the guide for conversion

glenoid reamer which is connected to the peg. The guide

for conversion glenoid reamer has been developed to work

as a stopper, to allow a proper reaming and cleaning of

the glenoid surface, and to prevent possible peg damage

due to reaming phase. Once fi nished, remove the guide for

conversion glenoid reamer from the peg.

Note. After the reaming phase, before introducing the

reverse baseplate, check that the inner taper of the peg is

not damaged or scratched. If the inner taper is damaged,

proceed with peg removal (see dedicated section); if not

clean the inner taper of the peg before connecting the

reverse baseplate.

Remove the reverse baseplate from the sterile package

and introduce it by using the reverse baseplate orienter

(K79) and the glenosphere impactor extractor (Z45), which

has to be screwed into the taper of the reverse baseplate

intended to host the glenosphere (Figure 25).

Once the proper orientation has been set, impact the

system into the TT peg (Figure 26).



Note. The packaging of the reverse baseplate also includes

the safety screw needed to fix the final glenosphere. The

SMR TT Hybrid Glenoid Reverse Baseplate can be coupled

with the Hybrid Glenoid peg ONLY and not with the TT Metal

Back one. See also the warning label on the package.

Drill the seats for the fi xation screws by using the helix drill

(O33) connected to the flexible mandrel (T33).

During this step, the cement in the peripheral holes must

be removed. This step has to be performed by using the

drill guide for reverse baseplate (J79) as a guide (Figure

27), in order to be sure to provide the proper inclination

to the screws to prevent impingement against the TT peg

and the central taper of the reverse baleplate, this could

prevent proper screws insertion.

The seat of the screw head on the metal shell is spherical

and therefore the fitting direction can be chosen within

an angular range of -12°/+5°. Nevertheless, the superior

screw should be oriented toward the base of the coracoid,

while the inferior screw should point dorsally. In any case,

the screws have to be positioned in the area of maximum

bone stock to obtain a stronger fi xation.

Measure the length of the screws by using the depth

gauge (S33) and introduce them by using the screwdriver

shaft (R33) connected to the ratchet handle with Zimmer

connection (Q33) (Figure 28) and the screw pliers (P33).

Note. Do not fully tighten the first screw until the second

screw has been inserted. The screws must be tightened

once both are properly seated to guarantee the best fit of

the Reverse Baseplate on the prepared glenoid.

Figure 27 Figure 28




Note. Before proceeding with the glenophere connection,

verify the reverse baseplate stability after connection to

the peg and screw insertion. If the reverse baseplate is not

stable, remove the components (see dedicated section) and

move to a dedicated device, like the TT Metal Back

INSERTION OF THE TRIAL GLENOSPHERE

Introduce the trial glenosphere for hybrid reverse baseplate

(M79) of the chosen size by using the screwdriver shaft (R33)

connected to the ratchet handle with Zimmer connection

(Q33) to tighten the glenosphere screw (Figure 29).

Check that the screw of the trial glenosphere is completely

seated into the peg. This helps in verifying that the peg

thread has not been damaged during the removal of the

polyethylene baseplate. If it is not possible to completely

tighten the screw, proceed with the peg removal (see

dedicated section).

In terms of the eccentric trial glenosphere, the surgeon

can rotate the glenosphere on the SMR TT Hybrid Glenoid

Reverse Baseplate until the most stable position for the

new joint has been obtained.

Be sure to note the last position used for the eccentric

glenosphere and trace a reference point in order to

reproduce the correct position with the fi nal implant.

Figure 29



Figure 30 Figure 31

INSERTION OF THE FINAL GLENOSPHERE

Remove the trial glenosphere using the screwdriver and

take the correct sized fi nal glenosphere (eccentric or

concentric) from the sterile package.

Connect the glenosphere to the glenosphere impactor

orienter (N79), by screwing its internal bar to expand the

petals of the connection feature (Figure 30).

Connect the glenosphere to the reverse baseplate

(Figure 31) by tapping it into place.

Finally introduce the safety screw (included into the

packaging of the reverse baseplate) and tigthen it with the

screwdriver shaft (R33) connected to the ratchet handle

with Zimmer connection (Q33).

Refer to SMR Primary Surgical Technique for preparation

of the humerus.

Reduce the joint and carry out a fi nal assessment of joint

stability and range of motion. By palpating the axillary

nerve, the surgeon should fi nd a normal structure tension

as before surgery.




REVERSE COMPONENTS REMOVAL

GLENOSPHERE REMOVAL

In case of glenosphere removal, fi rst remove the safety

screw by using the screwdriver shaft (R33) connected to

the ratchet handle with Zimmer connection (Q33).

Connect the proper sized glenosphere extraction insert

(S79 or T79) in case of Reverse HP Glenosphere according

to the glenosphere diameter and eccentricity, to the

glenosphere extractor handle (U79) by means of the quick

connection. Connect them to the glenosphere (Figure 32

or 33 in case of Reverse HP Glenosphere) and introduce

the internal bar connected to the T-handle with Zimmer

connection (G79).

Connect the multipurpose handle (R79) to the glenosphere

extractor handle (Figure 34) which prevents load

transmission to the bone during the disconnection

phase. By screwing the internal bar, the glenosphere will

disconnect from the baseplate.

Figure 32

Figure 33

Figure 34



REVERSE BASEPLATE REMOVAL

Remove the baseplate screws, this should be performed in

a smooth manear to avoid excessive torsion on the glenoid

and/or screw damage.

Connect the reverse baseplate extractor (T79) to the

reverse baseplate (Figure 35) and screw in the internal bar

connected to the T-handle with Zimmer connection (G79).

Before disconnecting, connect the multipurpose handle

(P79) to the reverse baseplate extractor (T79) to prevent

load transmission to the bone (Figure 36).

Figure 35 Figure 36




CENTRAL PEG REMOVAL

In the case of need to remove the SMR TT Hybrid Glenoid

peg, screw the internal bar of the canulated reamer (U79)

into the implanted peg (Figure 37). Connect the T-handle

with Zimmer connection (G79) to the canulated reamer and

afterwards use the cannulated reamer to remove the peg

(Figure 38).

In the case of a revision of the Hybrid Glenoid by utilizing

the TT Metal Back, once the SMR TT Hybrid Glenoid peg

has been removed, use the K-wire positioning jig for TT peg

(V79) to introduce the K-Wire. Refer to the TT Metal Back

Surgical Technique for the implantation of the device.

Figure 37 Figure 38


SMR TT HYBRID GLENOID SURGICAL TECHNIQUEInstrument set

Ref. CODE DESCRIPTION Qty.

A13 9013.02.001 Awl 1

B13 9013.02.016 Humeral Reamer Dia. 16mm 1

C13 9013.02.141 Dia. 14 - Trial Stem with Quick Connection 1











D13 9013.02.301 Stem Extractor 1

E13 9013.02.302 Quick Connection Stem Impactor 2

F13 9095.11.201 Ratchet T-Handle with Zimmer Connection 1

G13 9095.11.251 Multipurpose Handle 1

* 9013.13.990 Instrument Tray 1

9013.13.000 ‘General’ Instrument Set for SMR Shoulder Prosthesis Set



Instrument set

* Boxes are only for transportation. Please remove the instruments and place them in appropriate sterilization trays.


A23 9013.02.303 Inserter-Extractor Handle 1

B23 9013.02.321 Anatomic Adaptor Sleeve 1

C23 9013.22.100 Humeral Head Impactor 1

D23 9013.22.200 Humeral Head Press 1

E23 9013.22.405 Trial Humeral Head Dia. 40mm 1





9013.23.000 ‘Endoprosthesis’ Instrument Set for SMR Shoulder Prosthesis




F23 9013.22.800 Head Gauge 1

G23 9013.30.011 Trial Adaptor Taper Neutral 1

G23 9013.30.016 Trial Adaptor Taper Ecc. 2mm 1



G23 9013.31.011 Trial Adaptor Taper Neutral Long 1

G23 9013.31.016 Trial Adaptor Taper Ecc. 2mm Long 1



H23 9013.50.011 Trial Humeral Body Short 1

I23 9013.50.012 Pushrod Tip for Short Humeral Body 1

H23 9013.50.021 Trial Humeral Body Medium 1

I23 9013.50.022 Pushrod Tip for Medium Humeral Body 2

H23 9013.50.031 Trial Humeral Body Long 1

I23 9013.50.032 Pushrod Tip for Long Humeral Body 1

J23 9013.50.101 Body Stopper 1

K23 9013.50.121 Multipurpose Extractor 1

L23 9013.50.165 Threaded Extractor 1

M23 9013.50.175 Universal Stem for Extractor 1

N23 9013.50.210 Allen Wrench 5mm 1

N23 9013.50.211 Allen Wrench 3.5mm 1

O23 9013.50.251 45° Stop Guide 1

P23 9013.50.303 Guide for Resection Jigs 1

Q23 9013.50.304 Anatomic Resection Jig 1

R23 9013.50.305 Sickle 1

S23 9013.50.316 Alignment Rod 1

T23 9013.52.165 Expansion Extractor 1

U23 9013.75.145 Humeral Head Trauma Ruler 1

V23 9066.15.095 Pin Ø3 x 80 mm 6

W23 9066.35.610 Extracting Plier for Trial Adaptors 1





A25 9013.21.401 Trial Humeral Head Dia.40 H13mm Neutral 1

A25 9013.21.402 Trial Humeral Head Dia.40 H13mm Ecc.2mm 1



A25 9013.21.421 Trial Humeral Head Dia.42 H13mm Neutral 1




A25 9013.21.441 Trial Humeral Head Dia.44 H14mm 1














* 9013.25.990 Transportation Tray 1

9013.25.000 SMR Variable Height Humeral Heads Instrument Set




Instrument set


9013.33.000 ‘Glenoid’ Instrument Set for SMR Shoulder Prosthesis


A33 9013.02.305 Extractor for Small-R MB Glenoid 1

A33 9013.02.310 Extractor for MB Glenoid 1

B33 9013.75.125 Glenoid Drill - Small-R 1

B33 9013.75.130 Glenoid Drill - Small/STD/Large 1

C33 9013.75.140 Cemented Glenoid Pusher 1

D33 9013.75.150 Humeral Cover Small 1

D33 9013.75.151 Humeral Cover Large 1

E33 9013.75.160 Glenoid Reamer Small 1

E33 9013.75.165 Glenoid Reamer STD 1

E33 9013.75.170 Glenoid Reamer Large 1

F33 9013.75.180 Liner Inserter 1

G33 9013.75.301 K-Wire Positioning Handle 1

H33 9013.75.315 K-Wire Positioning Jig S 0° 1

H33 9013.75.316 K-Wire Positioning Jig S 10° 1

H33 9013.75.317 K-Wire Positioning Jig S 10° ANT 1

H33 9013.75.325 K-Wire Positioning Jig STD 0° 1

H33 9013.75.326 K-Wire Positioning Jig STD 10° 1

H33 9013.75.327 K-Wire Positioning Jig STD 10° ANT 1

I33 9013.75.330 Glenoid Retractor 1

J33 9013.75.350 Reamers and Drills Shaft 1

K33 9013.75.385 Metal Back Impactor 1

L33 9013.75.386 Guide for Metal Back Impactor - Small-R 1

L33 9013.75.387 Guide for Metal Back Impactor - Small/STD/Large 1

M33 9013.75.400 Drill Guide 1

N33 9075.10.281 Fukuda 1

O33 9084.20.081 Helix Drill Dia. 3.5mm 1

O33 9084.20.086 Long Helix Drill Dia 3.5mm x 79mm 1

P33 9095.10.115 Screw Pliers 1

Q33 9095.10.227 Ratchet Handle with Zimmer Connection 1

R33 9095.10.228 Screwdriver Shaft 1

S33 9095.11.301 Depth Gauge 1

T33 9095.11.700 Flexible Mandrel 1

U33 9013.75.181 Suction Cup for Liner Inserter 2




9013.42.000 SMR Reverse HP

Ref. CODE DESCRIPTION Qt.

A42 9013.62.010 Trial Liner SHORT Dia. 44mm 1

A42 9013.62.015 Trial Liner MEDIUM Dia. 44mm 1

A42 9013.62.020 Trial Liner LONG Dia. 44mm 1

A42 9013.62.115 Trial Liner Lateralizing MEDIUM Dia. 44mm 1

A42 9013.62.120 Trial Liner Lateralizing LONG Dia. 44mm 1

B42 9013.65.010 Trial Liner SHORT Dia. 40mm 1

B42 9013.65.015 Trial Liner MEDIUM Dia. 40mm 1

B42 9013.65.020 Trial Liner LONG Dia. 40mm 1

B42 9013.65.115 Trial Liner Lateralizing MEDIUM Dia. 40mm 1

B42 9013.65.120 Trial Liner Lateralizing LONG Dia. 40mm 1

C42 9013.74.105 Guide-Screw SMALL-R Trial Glenosphere 2

D42 9013.74.120 Guide-Screw Trial Glenosphere 2

E42 9013.74.401 Trial Glenosphere Dia. 40mm 1

F42 9013.74.440 Trial Glenosphere Dia. 44mm 1

F42 9013.74.444 Trial Glenosphere Dia. 44mm Corrective 1

G42 9013.74.605 Positioner for Glenosphere Plug 1

H42 9013.74.650 Trial Glenosphere Positioner 1

9013.42.950 Instrument Tray 1



Instrument set


A43 9013.02.303 Inserter-Extractor Handle 1

B43 9013.52.022 Pushrod Tip 2

C43 9013.50.121 Multipurpose Extractor 1

D43 9013.50.165 Threaded Extractor 1

E43 9013.50.175 Universal Stem for Extractor 1

F43 9013.50.210 Allen Wrench 5mm 1

F43 9013.50.211 Allen Wrench 3.5mm 1

G43 9013.50.303 Guide for Resection Jigs 1

H43 9013.50.305 Sickle 1

I43 9013.50.316 Alignment Rod 1

J43 9013.52.002 Trial Extension for Reverse Humeral Body 1

K43 9013.52.021 Trial Reverse Humeral Body 1

L43 9013.52.304 Reverse Resection Jig - Deltopectoral Approach 1

M43 9013.52.305 Reverse Resection Jig - Lateral Approach 1

N43 9013.52.116 Guide for Conical Reamer 1

O43 9013.52.131 Conical Reamer 1

P43 9013.52.141 Reverse Adaptor Sleeve 1

Q43 9013.52.142 Reverse Prosthesis Inserter 1

R43 9013.52.165 Expansion Extractor 1

S43 9013.52.201 30° Stop Guide 1

T43 9013.60.011 STD Trial Liner 1

T43 9013.60.016 +3 Trial Liner 1

T43 9013.60.031 +6 Trial Liner 1

U43 9013.74.105 Guide Screw for S-R Trial Glenosphere 2

V43 9013.74.111 Trial Glenosphere Dia. 36mm 1

U43 9013.74.120 Guide Screw for Trial Glenosphere 2

W43 9013.74.131 Drive Shaft for Trial Glenosphere 1

X43 9013.74.141 Glenosphere Impactor-Extractor 1

Y43 9013.74.142 Ecc. Glenosphere Orienter 1

Z43 9013.76.031 Trial Ecc. Glenosphere Dia. 36mm 1

Γ43 9066.15.095 Pin Ø3 x 80 mm 6

∆43 9095.11.201 Ratchet T-Handle with Zimmer Connection 1

Ʃ43 9095.11.907 Namba Shoulder Slide 1


9013.43.000 Instrument Set for ‘Reverse’ SMR Shoulder Prosthesis



9013.77.000 SMR TT Hybrid Glenoid General Instrument Set


A77 9013.79.500 Glenoid Drill S 1

B77 9013.75.481 Quick connection Handle 1

C77 9013.79.510 Glenoid Drill Guide SMALL 1

C77 9013.79.511 Glenoid Drill Guide STD 1

C77 9013.79.512 Glenoid Drill Guide LARGE 1

D77 9013.79.215 Quick Connection Driver 1

E77 9013.79.216 Quick Connection Drill Dia. 5mm 4

F77 9013.75.370 Compactor Handle 1

G77 9013.79.505 Compactor S 1

H77 9013.79.400 Trial Glenoid SMALL LOW 1

H77 9013.79.402 Trial Glenoid SMALL LOW +2mm 1

H77 9013.79.405 Trial Glenoid SMALL 1

H77 9013.79.407 Trial Glenoid SMALL +2mm 1

H77 9013.79.410 Trial Glenoid STD LOW 1

H77 9013.79.412 Trial Glenoid STD LOW +2mm 1

H77 9013.79.415 Trial Glenoid STD 1

H77 9013.79.417 Trial Glenoid STD +2mm 1

H77 9013.79.420 Trial Glenoid LARGE LOW 1

H77 9013.79.422 Trial Glenoid LARGE LOW +2mm 1

H77 9013.79.425 Trial Glenoid LARGE 1

H77 9013.79.427 Trial Glenoid LARGE +2mm 1

I77 9013.79.226 Removal Pliers 1

J77 9013.79.520 Countersink 1

K77 9013.79.530 Cement Compactor SMALL 1

K77 9013.79.531 Cement Compactor STD 1

K77 9013.79.532 Cement Compactor LARGE 1

L77 9013.79.535 Central Peg Protector 1

M77 9013.79.540 Glenoid Positioner SMALL 1

M77 9013.79.541 Glenoid Positioner STD 1

M77 9013.79.542 Glenoid Positioner LARGE 1

N77 9013.75.141 Glenoid Impactor Handle 1

O77 9013.79.544 Glenoid Pusher 1

O77 9013.79.545 Glenoid LOW Pusher 1

P77 9013.79.546 Retentive Glenoid Pusher SMALL 1

P77 9013.79.547 Retentive Glenoid Pusher STD 1

P77 9013.79.548 Retentive Glenoid Pusher LARGE 1

O77 9013.77.990 Instrument Tray 1

* Boxes are only for transportation.

Please remove the instruments and place them in appropriate sterilization trays.


n 9013.79.501 Glenoid Drill L 1

n 9013.79.506 Compactor L 1

n 9013.79.435 Trial Glenoid SMALL - Peg L 1

n 9013.79.445 Trial Glenoid STD - Peg L 1

n 9013.79.455 Trial Glenoid LARGE - Peg L 1

n Upon Request



Product Codes

9013.79.000 SMR TT Hybrid Glenoid Revision & Conversion Instrument Set


A79 9013.79.550 Removal Guide SMALL 1

A79 9013.79.551 Removal Guide STD 1

A79 9013.79.552 Removal Guide LARGE 1

B79 9095.11.A80 Headless Twisted Pin Dia. 3x80mm 4

C79 9013.79.553 Removal Drill 1

D79 9013.79.555 Removal Guide Handle 1

E79 9013.75.481 Quick Connection Handle 1

F79 9013.79.560 Baseplate Extractor 1

G79 9095.11.200 T handle with Zimmer connection 1

H79 9013.79.561 Conversion Glenoid Reamer 1

I79 9013.79.562 Guide for Conversion Glenoid Reamer 2

J79 9013.79.563 Drill Guide for Reverse Baseplate 1

K79 9013.79.565 Reverse Baseplate Orienter 1

L79 9013.79.568 Dia. 36mm Glenosphere Reamer 1

M79 9013.79.570 Trial Glenosphere Dia. 36mm for Hybrid Reverse Baseplate 1

M79 9013.79.571 Trial Ecc. Glenosphere Dia. 36mm for Hybrid Reverse Baseplate 1

N79 9013.79.572 Trial Glenosphere HP Dia. 40mm for Hybrid Reverse Baseplate 1

O79 9013.79.575 Trial Glenosphere HP Dia. 44mm for Hybrid Reverse Baseplate 1

O79 9013.79.576 Trial Glenos. HP Dia. 44mm Corrective for Hybrid Reverse Baseplate 1

P79 9013.79.579 Glenosphere Impactor & Orienter 1

Q79 9013.79.585 Glenosphere Insertion Guide 1

R79 9095.11.251 Multipurpose Handle 1

S79 9013.79.580 Glenosphere Dia. 36mm Extraction Insert 1

S79 9013.79.581 Ecc. Glenosphere Dia. 36mm Extraction Insert 1

T79 9013.79.584 HP Glenosphere Extractor Insert 1

U79 9013.79.588 Glenosphere Extractor Handle 1

V79 9013.79.590 Reverse Baseplate Extractor 1

W79 9013.79.595 Canulated Reamer 1

X79 9013.79.596 K-Wire Positioning Jig for TT Peg 1




SMR TT HYBRID GLENOID SURGICAL TECHNIQUEProduct Codes

9013.80.000 ‘Revison+Resection’ Instrument Set for SMR Shoulder Prosthesis


A8 9013.08.134 Trial Revision Stem Dia. 13 h 150 mm 1










B8 9013.13.010 Trial Resection Stem Dia. 7 mm H50 mm 1

B8 9013.13.040 Trial Resection Stem Dia. 7 mm H80 mm 1

B8 9013.13.110 Trial Resection Stem Dia. 10 mm H50 mm 1 1

B8 9013.13.140 Trial Resection Stem Dia. 10 mm H80 mm1 1

C8 9013.13.200 Dia. 13 mm Wrench 2

D8 9013.14.020 Trial Modular Spacer H20 mm 1








Product Codes


9013.90.000 ‘CTA’ Instrument Set for SMR Shoulder Prosthesis


A9 9013.30.100 Pliers for Trial Adaptor 1

B9 9013.23.420 Trial CTA Head Dia. 42 mm 1




C9 9013.23.600 Trial Adaptor Dia. 36 mm 1



CODE DESCRIPTION Qty.

9013.62.200 SMR Ceramic Liner Impactor 1

CODE DESCRIPTION Qty.

9013.62.011 Trial Liner SHORT Dia. 44mm 1

9013.62.016 Trial Liner MEDIUM Dia. 44mm 1

9013.62.021 Trial Liner LONG Dia. 44mm 1

9013.62.116 Trial Liner Lateralizing MEDIUM Dia. 44mm 1

9013.62.121 Trial Liner Lateralizing LONG Dia. 44mm 1

9013.65.011 Trial Liner SHORT Dia. 40mm 1

9013.65.016 Trial Liner MEDIUM Dia. 40mm 1

9013.65.021 Trial Liner LONG Dia. 40mm 1

9013.65.116 Trial Liner Lateralizing MEDIUM Dia. 40mm 1

9013.65.121 Trial Liner Lateralizing LONG Dia. 40mm 1



FINNED HUMERAL BODY WITH LOCKING SCREW

Ti6Al4V 1350.15.110 Finned Humeral Body

TRAUMA HUMERAL BODIES WITH LOCKING SCREW

Ti6Al4V 1350.15.010 Medium

1350.15.020 Long

1350.15.030 Short

CEMENTED STEMS L. 80 MM

Ti6Al4V 1306.15.120 Dia. 12 mm

1306.15.140 Dia. 14 mm

1306.15.160 Dia. 16 mm

1306.15.180 Dia. 18 mm

1306.15.200 Dia. 20 mm

CEMENTLESS MINI STEMS L. 60 MM

Ti6Al4V 1304.15.110 Dia. 11 mm n

1304.15.120 Dia. 12 mm n

1304.15.130 Dia. 13 mm n

This brochure describes the complete set of products and combinations of the SMR Shoulder System. Please check the codes list for the availability of products in your market. The symbol allows to distinguish the products NOT available in the US.

n Upon Request = Not Available in the United States



Product Codes

RING

Ti6Al4V 1314.15.200 Ring

Ti6Al4V 1304.15.140 Dia. 14 mm

1304.15.150 Dia. 15 mm

1304.15.160 Dia. 16 mm

1304.15.170 Dia. 17 mm

1304.15.180 Dia. 18 mm

1304.15.190 Dia. 19 mm

1304.15.200 Dia. 20 mm

1304.15.210 Dia. 21 mm

1304.15.220 Dia. 22 mm

1304.15.230 Dia. 23 mm

1304.15.240 Dia. 24 mm

Ti6Al4V 1313.15.010 Dia. 7 mm, h 50 mm

1313.15.040 Dia. 7 mm, h 80 mm

1313.15.110 Dia. 10 mm, h 50 mm

1313.15.140 Dia. 10 mm, h 80 mm

Ti6Al4V 1314.15.020 h 20 mm

1314.15.030 h 30 mm

1314.15.040 h 40 mm

1314.15.050 h 50 mm

CEMENTLESS FINNED STEMS L. 80 MM

LARGE RESECTION STEMS

MODULAR AUGMENTS




CEMENTED REVISION STEMS

NEUTRAL ADAPTOR TAPERS

CEMENTLESS REVISION STEMS

ECCENTRICAL ADAPTOR TAPERS

Ti6Al4V 1309.15.134 Dia. 13 mm - h 150 mm

1309.15.136 Dia. 13 mm - h 180 mm

1309.15.138 Dia. 13 mm - h 210 mm n

1309.15.154 Dia. 15 mm - h 150 mm

1309.15.156 Dia. 15 mm - h 180 mm

1309.15.158 Dia. 15 mm - h 210 mm n

Ti6Al4V 1330.15.270 0 mm, Standard

1331.15.270 0 mm, Long

Ti6Al4V 1308.15.134 Dia. 13 mm - h 150 mm

1308.15.136 Dia. 13 mm - h 180 mm

1308.15.144 Dia. 14 mm - h 150 mm

1308.15.146 Dia. 14 mm - h 180 mm

1308.15.154 Dia. 15 mm - h 150 mm

1308.15.156 Dia. 15 mm - h 180 mm

1308.15.164 Dia. 16 mm - h 150 mm

1308.15.166 Dia. 16 mm - h 180 mm

Ti6Al4V STANDARD

1330.15.272 + 2 mm

1330.15.274 + 4 mm

1330.15.278 + 8 mm

LONG

1331.15.272 + 2 mm

1331.15.274 + 4 mm

1331.15.278 + 8 mm




Product Codes

CoCrMo 1322.09.400 Dia. 40 mm n

1322.09.420 Dia. 42 mm

1322.09.440 Dia. 44 mm

1322.09.460 Dia. 46 mm

1322.09.480 Dia. 48 mm

1322.09.500 Dia. 50 mm

1322.09.520 Dia. 52 mm

1322.09.540 Dia. 54 mm

CoCrMo 1322.09.501 D.50mm H16

1322.09.521 D.52mm H17

1322.09.541 D.54mm H18

1321.09.401 D.40mm H13

1321.09.402 D.40mm H13 ECC2

1321.09.404 D.40mm H13 ECC4

1321.09.407 D.40mm H13 ECC7

1321.09.421 D.42mm H13

1321.09.422 D.42mm H13 ECC2

1321.09.424 D.42mm H13 ECC4

1321.09.427 D.42mm H13 ECC7

1321.09.441 D.44mm H14

1321.09.461 D.46mm H15

1321.09.481 D.48mm H16

1324.09.401 D.40mm H17

1324.09.421 D.42mm H17

1324.09.441 D.44mm H18

1324.09.461 D.46mm H19

1324.09.481 D.48mm H20

1324.09.501 D.50mm H21

1324.09.521 D.52mm H22

1324.09.541 D.54mm H23

HUMERAL HEADS

HUMERAL HEADS WITH DIFFERENT HEIGHTS



CTA HEADS ADAPTOR FOR REVERSE HUMERAL BODY

Ti6Al4V 1352.15.200 Adaptor 36 mm for Reverse Humeral Body n

Ti6Al4V 1352.20.010 HA Coated Reverse Humeral Body

1352.15.005Short Reverse Humeral Bodyonly for inversion

n

1352.15.050 Finned Reverse Humeral Body for Trauma n

1352.15.001 Humeral Extension +9 mm

UHMWPEX-LIMA

1360.50.010 Standard

1360.50.015 +3 mm

1360.50.020 +6 mm

1361.50.010 Retentive Std. n

1361.50.015 Retentive +3 mm n

1361.50.020 Retentive +6 mm n

REVERSE HUMERAL BODIES WITH LOCKING SCREW

REVERSE LINERS 36 mm

CoCrMo 1323.09.420 Dia. 42 mm

1323.09.460 Dia. 46 mm

1323.09.500 Dia. 50 mm

1323.09.540 Dia. 54 mm

CTA HUMERAL HEADS




Product Codes

CoCrMo 1374.09.105 Glenosphere Small-R

1374.09.110 Glenosphere

1376.09.025 Eccentrical Glenosphere Small-R

1376.09.030 Eccentrical Glenosphere

CoCrMo 1374.09.111 Glenosphere

1376.09.031 Eccentrical Glenosphere

GLENOSPHERE 36 mm WITH CONNECTOR *

GLENOSPHERE 36 mm

* do not couple with Hybrid Glenoid Reverse Baseplate

CoCrMo 40 MM

1365.09.010 Short

1365.09.015 Medium

1365.09.020 Long

1365.09.115 Lateralizing Liner - Medium n

1365.09.120 Lateralizing Liner - Long n

44 MM

1362.09.010 Short

1362.09.015 Medium

1362.09.020 Long

1362.09.115 Lateralizing Liner - Medium n

1362.09.120 Lateralizing Liner - Long n

REVERSE HP LINERS

REVERSE CERAMIC LINERS 44 MM

Alumina 1362.39.015 Medium n

1362.39.020 Long n




Ti6Al4V 1374.15.305 Small-R n

1374.15.310 Small STD n

UHMWPE 1378.50.005 Small-R


1378.50.020 Small

UHMWPEX-Lima

1379.51.005 X-Small


1379.51.020 Small

1379.51.030 Large

CONNECTORS WITH SCREW *

CEMENTED GLENOIDS

CEMENTED GLENOID 3 PEGS

* Optional with 36 mm glenospheres

40 MM


44 MM


1374.50.444 Corrective Glenosphere

REVERSE HP GLENOSPHERE

UHMWPE X-LIMA+ Ti6Al4V




Product Codes

LINERS FOR METAL BACK GLENOID L1

UHMWPE 1377.50.005 Small - R

1377.50.020 Small


1377.50.030 Large n

BONE SCREWS

Ti6Al4V DIA. 6.5 MM

8420.15.010 L. 20 mm

8420.15.020 L. 25 mm

8420.15.030 L. 30 mm

8420.15.040 L. 35 mm

8420.15.050 L. 40 mm


METAL BACK GLENOID

Ti6Al4V +PoroTi + HA

1375.20.005 Small - R

1375.20.020 Small


1375.20.030 Large n



Ti6Al4V 1379.15.160 Smal


HYBRID GLENOID REVERSE BASEPLATE PLUS SCREW

HYBRID GLENOID

Ti6Al4V +UHMWPE+Tantalum

1379.59.100 Small LOW

1379.59.102 Small LOW + 2

1379.59.110 Small

1379.59.112 Small + 2

1379.59.200 Standard LOW

1379.59.202 Standard LOW + 2


1379.59.212 Standard + 2

1379.59.300 Large LOW

1379.59.302 Large LOW + 2

1379.59.310 Large

1379.59.312 Large + 2

1379.59.120 Small LOW Peg L n

1379.59.122 Small LOW + 2 Peg L n

1379.59.130 Small Peg L n

1379.59.132 Small + 2 Peg L n

1379.59.220 Standard LOW Peg L n

1379.59.222 Standard LOW + 2 Peg L n

1379.59.230 Standard Peg L n

1379.59.232 Standard + 2 Peg L n

1379.59.320 Large LOW Peg L n

1379.59.322 Large LOW + 2 Peg L n

1379.59.330 Large Peg L n

1379.59.332 Large + 2 Peg L n


NotesNotes



NotesNotesSMR TT HYBRID GLENOID SURGICAL TECHNIQUE


NotesNotes



B.1379.23.002.1 121800

limacorporate.com

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Lima CZ sroDo Zahrádek I., 157/5155 21 Praha 5 - Zličín Czech RepublicT +420 222 720 011F +420 222 723 [email protected]

Lima Deutschland GmbH Kapstadtring 1022297 Hamburg - GermanyT +49 40 6378 4640 F +49 40 6378 [email protected]

Lima Austria GmbHSeestadtstrasse 27 / Top 6-71220 Wien - AustriaT +43 (1) 2712469F +43 (1) 2712469101offi [email protected]

Lima SK s.r.o.Zvolenská cesta 1497405 Banská Bystrica - SlovakiaT +421 484 161 126 F +421 484 161 [email protected]

Lima NetherlandsHavenstraat 303115 HD SchiedamThe NetherlandsT +31 (0) 10 246 26 60F +31 (0) 10 246 26 [email protected]

Lima Implantes Portugal S.U. LdaRua Olavo D’Eça Leal Nº6 Loja-1 1600-306 Lisboa - PortugalT +35 121 727 233 7F +35 121 296 119 [email protected]

Lima Orthopaedics Australia Pty LtdUnit 1, 40 Ricketts RdMt Waverley 3149Victoria AustraliaT +61 (03) 9550 0200F +61 (03) 9543 4003limaortho.com.au

Lima Orthopaedics New Zealand Ltd20 Crummer RoadAuckland 1021New ZealandT +64 93606010F +64 93606080

Lima Orthopaedics UK LimitedUnit 1, Campus 5Third AvenueLetchworth Garden CityHerts, SG6 2JFUnited KingdomT +44 (0) 844 332 0661F +44 (0) 844 332 0662

Lima USA Inc.2001 NE Green Oaks Blvd., Suite 100 Arlington, TX 76006T +1 817-385-0777 F +1 817-385-0377

Lima Sweden ABFöretagsallén 14 BSE-184 40 ÅKERSBERGASwedenT +46 8 544 103 80F +46 8 540 862 68www.linksweden.se

Lima ItalyCentro Direzionale Milanofi oriStrada 1 - Palazzo F920090 Assago - Milano - ItalyT +39 02 57791301

Lima Korea Co. Ltd11 FL., Zero Bldg.14 Teheran Road 84 GLLGangnam Gu, Seoul 135-845, South KoreaT +82 2 538 4212F +82 2 538 0706

Lima do Brasil EIRELIAv. Sagitário 138, Sala 2707Edifi cio Torre City, Condominio Alpha Square06473-073 Barueri SPBrasilT +55 1126640620F +55 1126640621

Lima Belgium sprlAvenue Newton, 41300 Wavre - BelgiumT +32 (0) 10 888 804F +32 (0) 10 868 [email protected]

Lima Denmark ApSLyngebækgårds Allé 2 2990 Nivå - DenmarkT +45 45860028F +45 4586 0068 [email protected]

Lima Turkey Ortopedi A.S.Ekinciler Cad. Necip Fazil Sk. Pekiz Plaza N°5 D134810 Kavacik, Beykoz - Istanbul/Turkey T +90 (216) 693 1373F +90 (216) 693 [email protected]

Lima Orthopaedics South AfricaNorthlands Deco Park, Stand 32610 New Market streetDesign BoulevardNorthriding2189

Lima Polska Sp. z o.o.Ul. Łopuszańska 9502-457 WarszawaPolandT 0048 22 6312786F 0048 22 [email protected]

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SMR TT HYBRID GLENOID - Link Sweden

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