Stryker SECUR-FIT ADVANCED User manual

Surgical
Technique
Orthopaedics
SECUR-FIT®
ADVANCED
Femoral Hip System

For Instructions for Cleaning, Sterilization, Inspection and Maintenance of Orthopaedic Medical Devices, refer to LSTPI_B.
CONTRAINDICATIONS
• activeinfectionorsuspectedlatentinfectioninoraboutthe
hip joint;
• bonestockthatisinadequateforsupportorxationofthe
prosthesis;
• skeletalimmaturitypatients;and,
• anymentalorneuromusculardisorderthatwouldcreatean
unacceptableriskofinstability,prosthesisxationfailureor
complicationsinpostoperativecare.
WARNINGS AND PRECAUTIONS
Seepackageinsertforwarnings,precautions,adverseeffects
andotheressentialproductinformation.BeforeusingSecur-Fit
AdvancedSteminstrumentation,verify:
• Instrumentshavebeenproperlydisassembledpriortocleaning
and sterilization;
• Instrumentshavebeenproperlyassembledpost-sterilization;
• Instrumentshavemaintaineddesignintegrity;and,
• Propersizecongurationsareavailable.
TABLE OF CONTENTS
Pre-OperativePlanning.................................2
FemoralNeckResection................................3
PreparingtheFemoralCanal ............................4
TrochantericReaming ..................................6
Broaching...........................................8
TrialReduction ......................................10
ImplantingtheStem ..................................12
FinalReduction......................................14
Extraction ..........................................15
ImplantandInstrumentInformation. . . . . . . . . . . . . . . . . . . . . . .16
INDICATIONS
Indicationsforuseinclude:
• Noninammatorydegenerativejointdiseaseincluding
osteoarthritisandavascularnecrosis;
• Rheumatoidarthritis;
• Correctionoffunctionaldeformity;
• Revisionprocedureswhereothertreatmentsordeviceshave
failed; and,
• Nonunions,femoralneckandtrochantericfracturesofthe
proximalfemurwithheadinvolvementthatareunmanageable
usingothertechniques.
AdditionalindicationspecictouseofSecur-FitAdvancedHip
StemswithcompatibleHowmedicaOsteonicsConstrainedLiners:
• WhenthestemistobeusedwithcompatibleHowmedica
OsteonicsConstrainedLiners,thedeviceisintendedforusein
primaryorrevisionpatientsathighriskofhipdislocationdue
toahistoryofpriordislocation,boneloss,softtissuelaxity,
neuromusculardisease,orintra-operativeinstability.
Secur-FitAdvancedHipStemsareintendedforcementlessuse
onlyandareintendedfortotalandhemiarthroplastyprocedures.

TheSecur-FitAdvancedHipStemisintendedforcementless,
press-tapplication.Theproximalregionofthestemiscoated
withPureFixHAoveracommerciallypuretitaniumplasmaspray
substrate.TheSecur-FitAdvancedHipStemissuitableforvarious
surgicalapproaches.
Thetotalsystemincludes:
• 16Implants
• Size4and5in132°offsetonly
• Sizes6-12,twoanatomicoffsetanglesof132°and127°
ThestemisdesignedforusewithStrykerV40femoralheadsand
theircompatibleacetabularcomponents.
Thispublicationsetsforthdetailedrecommendedprocedures
forusingStrykerOrthopaedicsdevicesandinstruments.Itoffers
guidancethatyoushouldneed,but,aswithanysuchtechnical
guide,eachsurgeonmustconsidertheparticularneedsofeach
patientandmakeappropriateadjustmentswhenandasrequired.
Femoral Hip System
SECUR-FIT®
ADVANCED

STEP 1
-
2 SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
Pre-operativeplanningaidsinthe
determinationofprobableimplant
styleandsize.Thepre-operative
planningprocessshouldtake
qualitativeandquantitativefactors
(includingpatientbonequality,
density,andmorphology)into
considerationinordertoevaluate
and select the appropriate
instrument/implantsystemfor
the patient.
Placeanacetabulumtemplate
overtheareaontheX-ray.Besure
thatthecupiswellcenteredwithin
theacetabulumandthesizells
betweentheteardropandthe
superiorrim.Aftertemplatingthe
acetabulumforsize,markthecenter
ofrotation(representedbythegreen
dot(Figure1)).
Optimalfemoralstemt,prosthetic
necklength,angleandversion
canbemorecloselyevaluated
withtheuseofpre-operativeX-ray
analysis.Thefollowingparameters
shouldbedeterminedusinganA/P
radiograph:StemSize,Femoral
Offset,LegLength,NeckAngle,
andCenterofRotation.
TheSecur-FitAdvancedhastwo
offsetoptions:thestandardoffset
132°neckangleandthehigh
offset127°neckangle(Sizes4and
5areavailableinthe132°neck
angleonly).ChoosetheSecur-Fit
Advancedtemplateforwhichthe
stemsizeachievesmedio-lateral
corticalengagementattheproximal
two-thirdsofthestemandrecreates
the desired leg length and offset
(Figure2).Forboththe132°and
127°offsetoptions,thetemplate
hasmarkingsthatindicatethe
centerofthefemoralheadfora
range of head offset options.
The predicted change in leg length
andoffsetisdeterminedbythe
relative positioning of the center of
rotationmarkingsonthefemoral
andacetabularcomponents.
Forexample,ifagivenfemoral
componentcenterofrotation
markingissuperiortothecenterof
rotationmarkingoftheacetabular
component,leglengtheningis
predicted. The desired change in
leglengthisdeterminedbythe
radiographicleglengthinequality
thatwaspreviouslydeterminedwith
anA/Pbilaterallm.If8mmofleg
lengtheningisrequiredinorderto
equalizetheleglengths,thecenter
ofrotationmarkingofthefemoral
componentshouldbepositioned
8mmsuperiortothecenterof
rotationmarkingontheacetabular
component.Thestemsizeand
headoffsetthatmostcloselymeets
this goal is chosen. The predicted
change in offset is also considered
bycomparingtherelativemedial/
lateral position of the center of
rotationmarkingsofthefemoral
andacetabularcomponents.
Thetemplatesshouldbeusedto
estimatethenalcomponentsthat
mostcloselyrestorethenormal
offset of the patient’s hip.
Oncethenalestimatedstemsize
andpositionisdetermined,theneck
resectionlevelshouldbenoted
(Figure3).Thiswillbeusedasa
referenceduringintra-operativeneck
resection.
Figure1 Figure2 Figure3
PRE-OPERATIVE PLANNING
Templates
Secur-Fit Advanced
Acetate Templates
Lit# LTEM106
Acetate templates include 20% magnification.

STEP 2
FEMORAL NECK RESECTION
3
Aproperneckresectionlevel
directlyaffectsthenalplacement
andtofthefemoralstem.By
usingtheanatomiclandmarks
referencedduringpre-operative
X-raytemplating,thepre-planned
neckresectionismadewithan
oscillatingsawandwiththeaid
oftheNeckResectionguide.
LaytheNeckResectionGuide
onthefemur,usingthelesser
trochanter and the trochanteric
fossaaslandmarkswhenmaking
thenalcut.Careshouldbetaken
toaligntheaxislineoftheNeck
ResectionGuidetothecenteraxis
ofthefemoralshaft;thescales
onthelateralangeormedial
radiusoftheguidecanbeused
to reference the greater or lesser
trochanterrespectivelywhen
makingthenalcut.
Figure4
Scale on
Resection Guide
corresponds to
scale on the
templates
Use the Resection
Guide to determine
resection point
based on lesser
trochanter
39° Neck resection angle
Instrument
Secur-Fit Advanced Neck Resection Guide
1601-1300
39°

STEP 3
4SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
PREPARING THE FEMORAL CANAL
Figure5
A clear-out hole has been
placed on the back of the
Box Osteotome that allows
bone chips to be removed
using a curette or other OR
instruments in an action that
does not require a force to
be directed at the cutting
surface.
Tip
Tohelpensurepropernal
orientationofthestem,lateral
biasduringpreparationforthe
implantispreferred.Retractionof
thegluteusmediusandremovalof
aportionofthelateralneckand/
orpiriformisfossawillpermittrue
axialintroductionoftheinstruments
andimplant.ABoxOsteotomeis
usefulinremovingbonefromthis
area.ConnecttheBoxOsteotome
attachmenttotheModularHandle.
Useamallettostriketheendof
theModularHandlewithcareful
controlledblowstoremoveremnants
ofthesuperiorfemoralneckand
openthemedullarycanal.
Instruments
Modular Box Osteotome
1601-1210
Orthonomic Modular Handle
1020-2900
Orthonomic T-Handle
1101-2200

PREPARING THE FEMORAL CANAL DISTAL REAMING
5
Medial
Resection
Point
Depth markings on the Starter
Reamer, which correspond to the
Tapered Reamer depth for each
stem, should be aligned with the
medial aspect of the resection
plane.
Tip
Figure6
Secur-Fit Advanced Starter Reamer
1601-1504
TheStarterReamercanbeused
toenterthefemoralcanalthrough
the trochanteric fossa. The Starter
Reamerhasapointtofacilitateentry
andgraduatedmarkingsalongthe
shaftthatcorrespondtoimplant
sizes.
EnterthecanalwiththeStarter
ReamerattachedtoeitheraT-handle
orpoweredinstrument.Placethe
StarterReamerontheexposed
trochanteric fossa and proceed
downintotheshaftalongitsaxis
to the appropriate depth and align
tothecenteroftheknee.The
StarterReamershouldbeinserted
suchthattheappropriatemarking
correspondingtothepre-operatively
selectedstemsizecorrelatestothe
depthofthemedialresectionpoint.
Reamer
Depth
12
10-11
8-9
6-7
5
4

STEP 3
6SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
CONTINUED
TROCHANTERIC REAMING
Medial
Resection
Point
Instruments
Orthonomic T-Handle
1101-2200
Secur-Fit Advanced 2 For 1
Tapered Reamer Size 5-6
1601-1556
Secur-Fit Advanced
Large Trochanteric Reamer
1601-1532
Secur-Fit Advanced
Standard Trochanteric
Reamer 1601-1531
Figure7 Medial
Resection
Point
BROACH ONLY OPTION
ThefullytoothedBroachesmay
facilitatepreparationofthefemoral
canalwithouttheuseofTapered
Reamers.However,anarrow/tight
diaphysealshaft(e.g.champagne
utefemur)mayresultinbroach
resistance in the distal canal. If
resistanceisencountered,tapered
reamingisrecommendedtominimize
potentialfordistalfemoralfractures.
If the Broach does not seat at the
desiredheight,reamupwarduntilthe
Broach seats at the desired height.
Theoptiontoskipanyreamingstep
isatthediscretionofthesurgeon.
Selectandusetheappropriate
TrochantericReamertoremove
lateralproximalcorticalbone.This
willfurtherassistinestablishing
properaxialalignment.The
TrochantericReamerisavailable
in standard and large sizes. The
Reamershouldbeinsertedtoa
depthsuchthatthedistalendofthe
cuttingutesalignswiththemedial
resection point. Each Trochanteric
Reamerisdesignedtopreparefor
threestemsizes.SeeTable 1.
OPTION
ForSizes4-6,thestandard
TrochantericReamerisoptionaland
tobeusedaccordingtosurgeon’s
discretion.
TABLE 1: Recommended
TrochantericReamerSizes
STEM
SIZE
TAPERED
REAMER
7-9 StandardTrochantericReamer
10-12 LargeTrochantericReamer

Secur-Fit Advanced 2 For 1
Tapered Reamer Size 5-6
1601-1556
7 
Reamersareusedtopreparethe
canaldistallywheredensecortical
boneexists,therebyaidingin
broaching.TheTaperedReamer
shouldbeinsertedsuchthatthe
appropriatemarkingcorresponding
tothestemsizecorrelatestothe
depthofthemedialresectionpoint.
See Table 2 for a list of
recommendedreamersizesforeach
stem.
TABLE 2: RecommendedTapered
ReamerSizes
STEM
SIZE
TAPERED
REAMER
4*Starterreamermaybeused
55-6
65-6
7 7-8
87-8
9 9-10
10 9-10
11 11-12
12 11-12
Size 7
Size 8
TAPERED REAMING
Figure8
If pre-operative templating results
in an in-between size, ream to a
smaller size.
Tip
Secur-Fit Advanced 2 For 1
Tapered Reamer Size 7-8
1601-1578
Secur-Fit Advanced 2 For 1
Tapered Reamer Size 9-10
1601-1590
Secur-Fit Advanced 2 For 1
Tapered Reamer Size 11-12
1601-1512
Due to the aggressive cutting
nature of the reamer, distal
reaming should not exceed the
templated size.
Tip

Figure9
Quick
Release
Button
Locking
Hook
Broach Alignment
Tab
Locking
Arm
thebroachhasaxialandrotational
stability.Withpropercorticalcontact,
thebroachshouldnottwistor
moverelativetothefemur.Ifthereis
movement,alargersizebroachmay
beneeded.
Generally,ifabroachsinksbelowthe
leveloftheneckresection,advance
tothenextlargerbroach.Iftheneck
resectionisdeemedhigherthan
desired,removethebroachand
performanewneckresectionata
lowerlevel.
Uponreachingthenalsizeand
depthofthebroach,detachthe
broachhandlefromthebroach,
leavingthebroachfullyseatedinthe
femoralcanal.
AssembletheBroachtotheBroach
Handlebyinsertingthealignment
tabonthedistalendoftheBroach
HandleontotheBroach.Closingthe
lockingarmuntilanaudibleclickis
heardsecurestheBroachontothe
BroachHandle.
Usingamalletwithshort,controlled
strokes,beginbroachingand
sequentiallybroachupuntilthe
desiredsizeisreached.Throughout
broaching,continuetoensureneutral
alignmentofthebroachtothelong
axisofthefemur.
Correcttwillbedenotedbya
change in pitch, tactile resistance, or
whenthebroachceasestoadvance.
Verifyasecuretandensurethat
8SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
Instruments
Secur-Fit Advanced Broach Handle
1601-1100
Secur-Fit Advanced Low Profile
Broach Handle 1601-3100
Secur-Fit Advanced Broach Size 4-12
1601-10XXA
BROACHING
STEP 4

Calcarplaningcreatesanalresection
planeandangletooptimizestemt.
Therearetwocalcarplanersintheset
(standard,large).Selectthesizethat
tsthecutsurfaceoftheneck.Each
calcarplanerincludesaspring-loaded
alignmenttabthatprovidescontrolled
alignmentandengagementwiththe
broach.
Proper insertion depth of
the broach in the canal is
achieved when it seats tightly
within the canal based on
visual and auditory clues. The
surgeon’s clues to confirm
implant fixation include
increased pitch of sound
with blows to broach handle
and increased resistance to
advancement. Reliance only
on the neck cut may lead to
improper sizing, inadequate
component fixation, and
femoral fracture.
CAUTION
Figure10
9
OPTIONAL STEP: CALCAR PLANING
Initiatepowerpriortocontactingthe
femurandslowlyadvancetheCalcar
Planertowardthebroach.Alignthe
tabwithinthebroachbodyandpress
downtoplanethecalcartodesired
level.FailuretooperatetheCalcar
Planerinaccordancewiththese
instructionsmayresultindamage
tothefemur.
Secur-Fit Advanced Calcar Planer,
Standard
1601-1400
Secur-Fit Advanced Calcar Planer,
Large
1601-1420

STEP 5
TRIAL REDUCTION
10 SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
Figure11
Selectanecktrialwhichhasthe
samestemsizeandangleasthe
plannedimplantsize.Thiscanbe
determinedinthreeways.
1.Matchthestemsizeindicatedon
thefaceofthenecktrialtrunnion
withtheinsertedbroach
2.Matchtheneckanglewith
desiredstemanglebasedonthe
127°trialsbeinggold,andthe
132°trialsbeingsilver
3. Matchtheneckangleindicated
onthedistalportionofneckwith
thedesiredstemangle
Thetablebelowindicatesthe
correctnecklengthforeachsize
stem.Thesizeofthebroachdirectly
corresponds to the size of the
implant.
TABLE 3: Secur-FitAdvancedNeck
TrialsandNeckLengths(mm)
Instruments
Secur-Fit Advanced Monolithic
Neck Trial, 127 Degree
(Gold) 1601-XX127
STEM
SIZE
NECK
LENGTH
(mm)
127°
(GOLD)
NECK
LENGTH
(mm)
132°
(SILVER)
4 — 26
5 — 26
6 28 26
732 30
8 32 30
936 34
10 36 34
11 40 38
12 40 38
Neck
Length
Neck
Angle
Size
30
MM
132°
Figure12
WARNING
Image depicts
improper use
of the Secur-Fit
Advanced neck trial.
It is important to ensure
the neck trial is placed
properly onto the broach
to avoid improper ROM and
joint stability assessment.
Secur-Fit Advanced Monolithic
Neck Trial, 132 Degree
(Silver) 1601-XX132

+5mm heads are the maximum head
offset allowed for the size 4.
+12mm heads are the maximum
head offset allowed for
the size 5-12 stem.
11
SELECTION OF V40 HEAD TRIAL ON TRIAL NECK
*ForadditionalAcetabularandHeadCompatibilityinformationpleaseseepage17.
Instrument
Figure13
Ensure that the broach cavity and V40
trunnion are clear of debris prior to
assembling the neck and head trials.
Note
Head Trials with an “R” suffix are
made from a radiopaque material,
making them visible on an X-ray.
Note
HEAD HEAD SIZE HEAD OFFSETS
CoCrV40
22 +0, +3, +8
26 -3,+0,+4,+8,+12
28 -4,+0,+4,+8,+12
32 -4,+0,+4,+8,+12
36 -5,+0,+5,+10
40 -4,+0,+4,+8,+12
44 -4,+0,+4,+8,+12
AluminaV40
28 -2.7,+0,+4
32 -4,+0,+4
36 -5,+0,+5
AluminaC-Taper
(whenusedwithC-TaperSleeve–
catalog#17-0000E)
28 -2.5,+0,+5
32 -2.5,+0,+5
36 -5,+0,+5
deltaBIOLOXV40
28 -4,-2.7,+0,+4
32 -4,+0,+4
36 -5,-2.5,+0,+2.5,+5,+7.5
deltaBIOLOXC-Taper
(whenusedwithC-TaperSleeve–
catalog#17-0000E)
28 -2.5,+0,+2.5,+5
32 -2.5,+0,+2.5,+5
36 -5,-2.5,+0,+2.5,+5,+7.5
deltaBIOLOXUniversalTaper(when
usedwithUniversalTaperSleeve-
catalog#6519-T-XXXX)
28 -2.5,+0,+4
32 -2.5,+0,+4
36 -2.5,+0,+4
40 -2.5,+0,+4
44 -2.5,+0,+4
V40 Head Trial
6264-x-xxxR
AssembletheNeckTrialonto
thebroachbyhand.Ensure
thattheengravingonthesuperior
edgeoftheneckisvisible,and
theatlateraledgeoftheneck
trialisalignedwiththeatlateral
edgeofthebroach.Next,assemble
aV40HeadTrialontotheNeckTrial
byhand.
Femoralheadscomeinmultiple
offsets and are different for each
femoralheadimplantmaterial(see
Table4).Forthisreason,nalhead
materialshouldbechosenprior
totrialreduction.Offsetsaddor
subtractfromthebasenecklength
oftheimplantandhelptoachieve
the desired leg length and offset.
Performatrialreductionofthehip.
Uponconrmationoftheselected
components,removethetrialhead
andtrialneck,andreassemble
thebroachhandletothebroach.
Removethebroachfromthe
femoralcanal.Thenalbroachsize
determinesthecorrectimplantsize.
WARNING
TABLE 4: HeadCompatibility

STEP 6
IMPLANTING THE STEM
Instruments
OPTION 2
TheSecur-FitAdvancedStemcan
alsobeinsertedusingtheModular
OffsetQuickConnectSteminserter.
Place tip of the inserter into the
driveholeofthestemtakingcareto
aligntheversiontabontheinserter
withtheslotinthestem(Figure15).
Thequickconnectdesignprovides
theinserterwithastablespring
connection,butitdoesnotprovide
amechanicallock.Therefore,
thisassemblyshouldbehandled
withcare,asexcessiveshaking
ormotionmayresultinthestem
dis-associatingfromtheinserter.
OPTION 3
ThreadtheModularThreadedStem
Inserter into the drive hole on the
proximalfaceofthestem(Figure16).
Theinsertershouldbefullythreaded
andsecuredtothestempriorto
impactiontopreventdamagetothe
threadsontheimplantortheinstru-
ment.Usingtheinserter,thestem
shouldbeinsertedintothefemoral
canaluntilitstops.
Figure14
OPTION 1
TheSecur-FitAdvancedStem
canbeinsertedbyhandandthen
impactedintotheboneusingthe
ModularStemImpactor(Figure14).
TheModularStemImpactorhasa
sphericaltip,whichisplacedonto
thedriveholeofthestem.This
instrumentallowsforoff-axisimpac-
tionofthestem.TheModularStem
Impactordoesnotconnecttothe
stem,and,therefore,canonlybe
usedfornalimpactionofthestem.
12 SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
Instruments
Orthonomic Modular
Handle
1020-2900
Modular Stem Impactor
1020-1870
Modular Offset Quick Connect
Inserter
1020-1860
Modular Threaded Stem Inserter
1020-1800

13
Amalletisthenusedtoseatthe
stemintothecanalwithshort,
controlledstrokes.
ThesurgeonshouldNOTattempt
tocontinueimpactingthefemoral
componentifvisualandauditory
cluesindicatethatthestemisrmly
seatedinthecanal.Theseclues,
ratherthanthebroachseatinglevel,
shouldbeusedtodeterminethe
nalseatingheightoftheimplant.
Continuedaggressiveimpaction
couldleadtofemoralfracture.
Intheeventthatdenseboneis
encounteredintra-operativelyand
compoundinganatomicalfactorsare
present,theseatingoftheimplant
maynotbeconsistentwiththelevel
ofthebroachduetotheviscoelastic
natureofthefemoralbone.Ifthe
nalseatingheightisundesirable,
theimplantcanberemovedusing
theModularThreadedStemInserter
(option3)andadditionalbroaching
canbeperformed.Ifthestem
inserter is contacting the greater
trochanterduringinsertion,continued
impactioncouldleadtoafracture.
Figure16
Figure15
If the stem inserter is
contacting the greater
trochanter during insertion,
continued impaction could
lead to a fracture. The
surgeon should consider
using an alternate impactor.
CAUTION
Final Implant Trunnion
Neck
Angle
Stem SizeFace of a Size 8
132° Stem
Taper
Lot ID Number
(Varies from implant
to implant)
1
6
0
1
-
0
8
1
3
2
V 40
Figure17
Prior to implanting the final stem
and femoral head, check the
implants for potential damage.
Ensure that the final stem matches
the last broach used. Use the
markings on the face of the stem
trunnion to verify the stem size and
taper type.
Note

STEP 7
FINAL REDUCTION
14 SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
Priortonalheadassembly,necklength/headoffset
maybere-evaluatedusingaV40HeadTrial.Placethe
HeadTrialontothestemnecktaperandreducethehip.
Leglengthequalityandpropersofttissuetensionare
evaluated.RemovetheHeadTrialanddrytheimplant
trunnionwithalaparotomyspongeorsteriletowel.
SelecttheappropriatecorrespondingV40FemoralHead
(CoCr,AluminaCeramic,BIOLOXdeltaCeramic)or
sleeveandplaceitontothedrytrunnionofthefemoral
stemwithaslighttwist.Impacttheheadwithmoderate
impactionsusingtheModularHeadimpactor.
Verifytheheadissecureonthetrunnionafterhead
impactionbyapplyingtractiontotheheadandconrming
stabilityonthetrunnion.
WhenselectingaBIOLOXdeltaUniversalTaperCeramic
FemoralHeadforimplantationwiththeSecur-Fit
AdvancedStem,useofaV40UniversalAdaptorSleeve
isnecessary.Aftercompletingthetrialingprocess,intra-
operativelyassembletheAdaptorSleevetotheFemoral
Stemmanually.TheUniversalAdaptorSleevemustbe
fullyseatedontheStemtrunnionbeforetheHeadis
assembled.
Relocatethefemoralheadintotheacetabularcupand
re-checkthelaxityandrangeofmotion.Thesurgicalsite
isthenclosedaccordingtosurgeonpreference.
Figure18
Instruments
Instruments
Orthonomic Modular Handle
1020-2900
Head/Neck Impactor
1601-1700
V40 Head Trial
6264-x-xxxR
Ensure that the V40 taper is clean
prior to assembling the head trial or
head implant
Note
In no instance should any attempt
be made to preassemble the
Adaptor Sleeve inside the BIOLOX
delta Universal Ceramic Head. Intra-
operatively assemble the BIOLOX
delta Universal Taper Ceramic Head
onto the sleeved Femoral Stem
and set with moderate blows using
the Stem Head Impactor (1104-
1000). Care must be taken to avoid
excessive impact forces when
assembling the Ceramic Head to the
sleeved femoral component.
WARNING
Any debris that is potentially
generated must be fully lavaged
prior to wound closure.
WARNING
TABLE 5: UniversalAdaptorSleeves–Titanium
CATALOG NUMBER OFFSET (mm) TAPER
6519-T-025 -2.5 V40
6519-T-100 +0 V40
6519-T-204 +4 V40

OPTIONAL STEP: EXTRACTION
15
Figure19
McReynolds Distal Stem Adaptor
6260-4-090
McReynolds Driver
6869-1-000,
6869-2-000,
6869-3-000
McReynolds
Distal Stem
Adaptor
Stem
Extraction
A surgeon must take care to avoid
applying excessive force to the
stem while exposing the joint during
revision surgery.
WARNING
A surgeon must take care in
assessing stability so as to not
fracture the bone or create any
debris. Any debris that is potentially
generated must be fully lavaged
prior to wound closure.
WARNING
Asurgeonshouldusehisorherpreferred
surgicalexposureandtechniqueto
conducttherevisionsurgeryadequately.
Asurgeonshouldalsorefertothe
subsequentproduct’ssurgicaltechnique
andinstructionsforusetounderstandall
appropriatewarnings,indications,contra-
indications,andproductcompatibility.
Thereareinstrumentstomanagethe
extractionofaSecur-FitAdvanced
Steminbothintraoperativeandrevision
situations.Theinstrumenttouseis
theMcReynoldsDistalStemAdaptor
(6260-4-090)andMcReynoldsDriver
(6869-1-000,6869-2-000,6869-3-000)
fromtheRestorationModularInstrument
System.

16 SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
SECUR-FIT® ADVANCED
IMPLANTS
STEM CATALOG
NUMBER
NECK ANGLE
(°)
STEM SIZE STEM LENGTH
(mm)
NECK LENGTH
(mm)
FEMORAL
OFFSET WITH
+0mm HEAD
(mm)
DISTAL TIP
DIAMETER*
(mm)
Secur-Fit
Advanced127°
1601-06127 127 6 120 28 37.2 6.9
1601-07127 127 7 130 32 41.5 7.4
1601-08127 127 8 136 32 42.4 8.1
1601-09127 127 9 142 36 46.9 8.9
1601-10127 127 10 148 36 48.1 9.7
1601-11127 127 11 155 40 52.6 9.7
1601-12127 127 12 160 40 53.7 10.7
Secur-Fit
Advanced132°
1601-04132 132 4 110 26 31.5 5.1
1601-05132 132 5 115 26 32.5 6.0
1601-06132 132 6 120 26 33.6 6.9
1601-07132 132 7130 30 37.5 7.4
1601-08132 132 8 136 30 38.4 8.1
1601-09132 132 9142 34 42.6 8.9
1601-10132 132 10 148 34 43.8 9.7
1601-11132 132 11 155 38 47.9 9.7
1601-12132 132 12 160 38 49.0 10.7
+5mm heads are the maximum head
offset allowed for the size 4.
+12mm heads are the maximum
head offset allowed for
the size 5-12 stem.
WARNING
Figure20
TABLE 6: Secur-FitAdvancedStemOffsetTable
*Thedistaldiameteristakenatthelocationwherethestemtransitionsfromasquarecross-sectiontoacircularcross-section
Offset
Stem Length
N
e
c
k
A
n
g
l
e
Neck Length

17
HEAD HEAD DIAMETER (mm) OFFSET (mm)
V40BIOLOx delta 28 -4.0,-2.7,+0,+4.0
V40BIOLOx delta 32 -4.0,+0,+4.0
V40BIOLOx delta 36 -5,-2.5,+0,+2.5,+5,+7.5
Universal Taper, BIOLOx deltaHead 28, 32, 36, 40, 44
UniversalTaperSleeves–V40stems -2.5,+0,+4
V40CoCr 22 +0, +3, +8
V40CoCr 26 -3,+0,+4,+8,+12
V40CoCr 28 -4,+0,+4,+8,+12
V40CoCr 32 -4,+0,+4,+8,+12
V40LFITCoCr 22 +0, +3, +8
V40LFITCoCr 26 -3,+0,+4,+8,+12
V40LFITCoCr 28 -4,+0,+4,+8,+12
V40LFITCoCr 32 -4,+0,+4,+8,+12
V40LFITCoCr 36 -5,+0,+5,+10
V40LFITCoCr 40 -4,+0,+4,+8,+12
V40LFITCoCr 44 -4,+0,+4,+8,+12
AluminaV40Head 28 -2.7,+0,+4
AluminaV40 Head 32 -4,+0,+4
AluminaV40Head 36 -5,+0,+5
C-TaperAlumina 28, 32 -2.5,+0,+5
C-TaperAlumina 36 -5,+0,+5
C-TaperBIOLOx delta 28, 32 -2.5,+0,+2.5,+5
C-TaperBIOLOx delta 36 -5,-2.5,+0,+2.5,+5,+7.5
UnitraxV40Head 38,40-56,58,61 +0
UnitraxV40MonolithicAdaptor -4,+0,+4,+8,+12
V40/C-TaperAdaptorSleeve
TridentX3AcetabularInserts
TridentCrossreElevatedRimLiners
TridentCrossre PolyLiners,10ºor0ºprole
TridentCrossre EccentricPolyLiners,10ºor0ºprole
TridentPolyLiners,10ºor0ºprole
TridentEccentricPolyLiners
Trident Constrained Insert
CrossreSeriesIIInserts(2041C,2042C,2043C,S2301,S2302)
Series II Inserts, and Series II Eccentric Inserts
Constrained Liner
Series I Inserts
System12Inserts(StandardandCrossre)
AllPolyCup
TridentAllPolyCup
CrossreTridentAllPolyCup
UH1
CentraxBipolar
PCAAcetabularInsert
PrecisionAcetabularComponents
TridentN2/VacPolyethyleneInserts
TridentHemisphericalSolidBackShells
TridentHemisphericalPSHA
TridentHemisphericalShells(ADandAD-HA)
TridentPSLHASolidBackShells
TridentHemisphericalClusterShells
TridentPSLHAClusterShells
TridentHemisphericalMulti-HoleShells
TritaniumAcetabularShellSystem
TridentPorousTitaniumAcetabularComponents
RestorationADM
MDM
ExeterX3RimFitCup
TABLE 7: Secur-FitAdvancedCompatibleFemoralHeads
TABLE 8: Secur-FitAdvancedCompatibleAcetabularComponents

18 SECUR-FIT®ADVANCED SURGICAL TECHNIQUE
SECUR-FIT® ADVANCED
INSTRUMENTATION
1601-5005Secur-Fit Advanced Femoral Preparation Tray
5900-8114Case