ANTEA NAVICULA - Adlerortho

TM1

ANTEAPROTESI DI CAPITELLO RADIALE

NAVICULASCAPHOID PROSTHESIS

SURGICAL TECHNIQUE

TM3

Anatomically shaped for an optimal fit.

Ceramic TiNbN Coating improves implant Surface hardness and biocompatibility.

Proximal holes to stabilize the implant with an artificial ligament.

Distal stem designed to stabilize the implant into the Trapezoid.

• Made Of Titanium with TiNbN antiallergic Coating.

• Anatomically Shaped.

• 4 progressively growing sizes left and right.

• Proximally and distally stabilized.

NAVICULASCAPHOID PROSTHESIS

TM4

PRESENTATION AND CHARACTERISTICS

The Navicula system is available in 4 progressively growing Scaphoid implant sizes.It has two stabilisation devices: • Distally, a stem is moulded, to be inserted in

a hole bored into the trapezium/trapezoid;• Proximally, two holes are bored, where an

artificial SLIL ligament fixed into the Lunate bone is passed and then knotted. The knot is seated into the niche on the lateral scaphoid surface.

The correct implant size is determined using the patient scaphoid bone alongside the trial implants supplied, in order to restore the patient's normal anatomy.

TIP: if in between sizes, generally select the smaller size.

INDICATIONS

• Irreparable fracture outcomes, not suitable for any graft repair.

• Failed reconstructive surgery.• No SNAC ≥ 2, radio-carpal and midcarpal

joint preserved, no carpal collapse.

CONTRAINDICATIONS

• Carpal collapse.• SNAC > 2, radio-carpal and/or mid-carpal

joints changes or destruction.

Sz. 1 Sz. 2 Sz. 3 Sz. 4

TM55

2 • Carpus exposure with a capsular flap radially based, and scaphoid removal.

SURGICAL PROCEDURE STEPS

1 • Dorsal sinusoidal incision, Radial nerve branches isolated.

TIP: The volar ligaments and capsule MUST bepreserved, retaining a volar scaphoid bone chip.

TM6

The Scaphoid implant distal stem location hole is made using a cannulated hand instrument, perfectly matching the implant distal stem, to be inserted using the K.wire guide.

3 • Preparation of the hole to secure the implant distal stem, key for distal stability. A 2 mm K.wire is drilled into the trapezium-trapezoid midline, considering that the

correct position is the one in line with the 1st metacarpal midshaft.

TM7

4 • An anchor is inserted in the lunate bone to hold the artificial ligament (Arthrex labral tape).

5 • The ligament is then passed through the two distal holes available on the implant. NOTE: Anchor and synthetic ligament are not included in the Navicula Scaphoid Surgical Instrument Set.

TM8

6 • The distal stem is placed in the previously prepared hole in the Trapezium, the implant is then placed in situ and the ligament is progressively tensioned and finally knotted. The knot is placed into the niche carved on the lateral scaphoid surface.

TM9

The post-op X-ray control should show the restoration of the Gilula arcs, while the stem placed in the Trapezium should have a radium-Scaphoid angle < 30°.

15°

7 • The dorsal capsule is then closed with non-absorbable sutures. TIPS: capsular suture to be performed in a semi-flexed wrist position. In case of damaged capsule, use a flap of extensor retinaculum to complete or reinforce

the capsular reconstruction.

TM10

Final X-Ray controls

TM11

Code Description

3400001 NAVICULA SCAPHOID SIZE 1 LEFT




3400011 NAVICULA SCAPHOID SIZE 1 RIGHT




SIZE A B C

1 28.5 11.4 14.5

2 29.9 12.1 15.4

3 31.3 12.8 16.2

4 32.5 13.5 17.2

A

B

C

IMPLANTS

T-0033-E

Manufactured by

01 -

2021

ADLER ORTHO SpA Manufacturing Unit and main officeVia dell’Innovazione 9 20032 Cormano (Mi) Tel. +39 02 6154371 Fax +39 02 615437222www.adlerortho.com

ADLER ORTHO UKThe StablesTarvin RoadFrodsham - Cheshire - WA6 6XN Tel: +44151 329 3372

Bibliography

A.B. Swanson et al. "Scaphoid implant resection arthroplasty. Long-term results". The Journal of Arthroplasty; 1(1):47-62. 1986.A.B. Sattel, A.B. Swanson, G. De Groot Swanson: "Titanium scaphoid implant for scaphoid nonunion". Operative Techniques in Orthopaedics. Volume 2, Issue 1, pagg. 32-38, 1992.M.I. Rossello et.al.:"La sostituzione protesica dello scafoide carpale". Riv. Chir: Riab.Arto Sup. XXXI, 1, 1994.M.I. Rossello, M. Costa, M. Bertolotti: "La susticion protesica del escafoides carpiano". Rev Esp. Cir. mano N° 48,Vol. 21, 1994.M.I. Rossello, F. Moretti, G. Priano, G. Novara: "Scaphoid total arthroplasty: our 20 years experience in 71 cases". Abstract book 6th Congress IFSSH, rif. P 083, 1995.M.I. Rossello, M. Costa, V. Pizzorno: "La sostituzione protesica" Cap. 12 de "Lo scafoide" Monografia della SICM, Casa Ed. Mattioli, Parma 1997.M.I. Rossello: "Trattamento degli insuccessi nella patologia dello scafoide: le protesi”. Riv Chir Riab Mano 38 (2), 2001.O. Spingardi, M.I. Rossello: "The total scaphoid titanium arthroplasty: a 15 year experience". HAND 6;179-184, 2011.M.I. Rossello, A. Zoccolan, O. Spingardi: "Protesi totale di scafoide in titanio". Medicina e chirurgia ortopedica ricerca tecnologia innovazione, Vol. 1 , 2012.M.I. Rossello, O. Spingardi: "The total scaphoid titanium arthroplasty". Arch,.Ortop. Reum.Vol. 126, 1-3 2015.M.I. Rossello. "A case of total scaphoid titanium custom-made 3D-printed prostheses with one-year follow-up". Case Reports in Plastic Surgery and Hand Surgery. VOL. 7, NO. 1, 7–12. 2020.

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ANTEA NAVICULA - Adlerortho