Zimmer Biomet Avenir Complete Hip System User manual

Avenir Complete™
Hip System
Surgical Technique

Table of Contents
Pre-operative Planning............................................................................................. 4
Digital Pre-operative Planning ................................................................................. 4
Patient Positioning/Surgical Exposure .................................................................... 5
Femoral Neck Resection ........................................................................................... 5
Femoral Canal Opening............................................................................................ 6
Femoral Canal Preparation....................................................................................... 7
Calcar Preparation.................................................................................................... 7
Trial Reduction.......................................................................................................... 8
Femoral Implant Insertion ........................................................................................ 9
Head Impaction ...................................................................................................... 10
Intraoperative Stem Repositioning or Removal..................................................... 11

4 | Avenir Complete Hip System Surgical Technique
Figure 2Figure 1
Digital Pre-operative Planning
Avenir Complete Femoral System digital templates
are available through various digital template
providers. When using digital templating for
a primary Total or Hemi Hip Replacement, it is
necessary to use a magnification marker with a
known dimension. This is required to calculate
the correct magnification. As soon as the correct
magnification has been determined, the system can
be used with aiming at best deciding the correct
implant size and center of rotation (Figure 2).
Pre-operative Planning
The objectives of pre-operative planning are to
define:
• Pre-operative leg length
• Acetabular component size and position
• Femoral component size
• Femoral oset and center of rotation
The Avenir Complete Hip System provides X-ray
templates with 100%, 110%, 115%, and 120%
magnification (Figure 1).
It is recommended to use a radiographic marker
to assess the X-ray magnification and select the
appropriate template.
It is also recommended that templates are
positioned over the AP X-rays to best decide the
correct implant size and center of rotation.

5 | Avenir Complete Hip System Surgical Technique
Patient Positioning/
Surgical Exposure
The Avenir Complete femoral component can be
implanted using any of the standard approaches for
total or hemi hip replacement (Figure 3).
Figure 4Figure 3
Femoral Neck Resection
Once the femoral head is dislocated, cut the femoral
neck according to the pre-operative plan (Figure 4).
AvenirComplete_fig04
DRAFT- for review purposes only

6 | Avenir Complete Hip System Surgical Technique
Figure 7Figure 6Figure 5
Femoral Canal Opening
Identify the entry point (Figure 5a) of the femur and
carefully prepare the lateral neck with the boxed
osteotome (Figure 5).
Note: Make sure to lateralize the femoral canal
preparation.
For anterior approaches the curved canal finder is
available (Figure 6).
For lateral and posterior approaches open the
medullary cavity using the straight canal finder.
Position the awl in the axis of the femoral shaft in
order to avoid varus positioning (Figure 7).
Figure 5a

7 | Avenir Complete Hip System Surgical Technique
Figure 7
Femoral Canal Preparation
If good bone stock is present, use the Avenir
Complete starter rasp to prepare the femur.
Then, start femoral preparation with the smallest
rasp giving special attention to the native anteversion
(Figure 8). Rasp in sequential fashion and once
complete stability is achieved with the final rasp,
disengage the handle from the rasp (Figure 9).
Note: Zimmer Biomet oers dierent rasp
handle designs for dierent surgical approaches.
Figure 9 Figure 10Figure 8
Calcar Preparation
A calcar planer is available for use with the collared
implant. Once the final rasp is fully seated, place the
calcar planer over the rasp post and level the calcar
until reaching the the rasp face (Figure 10).
Note: Planing must be done with the planer in
line with the rasp post and without torquing the
rasp.
Note: Put calcar planer in motion before applying
cutting force to the calcar.

8 | Avenir Complete Hip System Surgical Technique
Figure 12Figure 11
Trial Reduction
With the final rasp in place, select the appropriate
provisional neck (Standard Oset, High Oset or
Coxa Vara) and connect it onto the rasp (Figure 11).
Color Coding – Stem Variant
Gold Standard Oset (STD)
Black High Oset (HO)
Silver Coxa Vara
Once the provisional neck is in place, select the
correct provisional head size and position it onto
the provisional neck (Figure 12). Perform the trial
reduction and if necessary repeat the procedure
with dierent head osets.
Oset Shift (Oset Management Inset)
Note: There is a 3.5 mm shift in neck lengths
between core sizes (0 to 7.5) and macro sizes
(8 to 9).
- Horizontal oset: 6 mm shift between STD and
HO or Coxa Vara.
- Vertical oset: 6 mm shift between STD or HO
and Coxa Vara.
6 mm
Vertical Oset
Oset Management
6 mm
Horizontal Oset

9 | Avenir Complete Hip System Surgical Technique
Femoral Implant Insertion
The definitive implant must correspond to the last
rasp used. Start inserting the femoral component
into the femoral canal by hand and finish with the
stem impactor (Figure 13a and 13b
).
Figure 13a Figure 13b
Make sure to drive the final implant into the femur
following the path of the prepared canal, using the
impactor until the stem is fully seated.

10 | Avenir Complete Hip System Surgical Technique
Figure 15Figure 14
Head Impaction
If desired, a further trial reduction can be completed
after implantation of the definitive femoral stem
(Figure 14).
Before impacting the final femoral head, carefully
clean and dry the taper of the stem.
Fully seat the modular head by means of firm axial
impaction utilizing the femoral head impactor and
mallet (Figure 15).

11 | Avenir Complete Hip System Surgical Technique
Intraoperative Stem
Repositioning or Removal
Should an Avenir Complete stem require removal,
only the specific extraction instrument should be
used.
Assemble the extractor adapter with the extractor
and thread it to the final implant. Pull the stem out
in line with the femoral shaft, by using the slide
hammer (Figure 16).
Figure 16

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Zimmer Biomet or its aliates unless otherwise indicated, and must
not be redistributed, duplicated or disclosed, in whole or in part,
without the express written consent of Zimmer Biomet.
This material is intended for health care professionals. Distribution to
any other recipient is prohibited.
For product information, including indications, contraindications,
warnings,precautions,potential adverseeects and patient counseling
information, see the package insert and www.zimmerbiomet.com.
Zimmer Biomet does not practice medicine. This technique was
developed in conjunction with health care professionals. This
document is intended for surgeons and is not intended for laypersons.
Each surgeon should exercise his or her own independent judgment
in the diagnosis and treatment of an individual patient, and this
information does not purport to replace the comprehensive training
surgeons have received. As with all surgical procedures, the technique
used in each case will depend on the surgeon’s medical judgment as
the best treatment for each patient. Results will vary based on health,
weight, activity and other variables. Not all patients are candidates for
this product and/or procedure.
Caution: Federal (USA) law restricts this device to sale by or on the
order of a physician. Rx only.
Check for country product clearance and reference product specific
instructions for use. Document not for distribution in France. Not
intended for surgeons practicing medicine in France.
©2018 Zimmer Biomet
Legal Manufacturer
Zimmer, Inc.
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Warsaw Indiana 46580
USA
Telephone [phone]
Legal Manufacturer
Zimmer GmbH
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Telephone +41/ (0)52 262 60 70
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www.zimmerbiomet.com
For ordering information refer to the following documents:
2067-GLBL-en Ordering Information leaflet
Products with this system are
under the design control
of various legal manufacturers.
Refer to the product labeling
of each device for the
legal manufacturer.
1624.2-GLBL-en-REV0219 MC208935