LPS SYSTEM POCKET GUIDEsynthes.vo.llnwd.net/o16/LLNWMB8/US Mobile/Synthes... · ®PFC ®SIGMA Patella Componentsand Misc. Replacement Components 96-0110 32 mm 3-Peg Round/Dome Patella

ImplantsProcedural UsesInstruments & Trials

Limb Preservation System

L P S

LPS™

SYSTEM POCKET GUIDE

The purpose of this document is to review

the LPS™ (Limb Preservation System) and

provide details for material composition,

dimensional characteristics, the use of the

implant components and some examples of

how the components are assembled to address

various surgical needs. The LPS instruments

are reviewed to provide information regarding

their use. A checklist of other instruments

and/or implants that are integrated for the

procedural uses is also covered.

Limb Preservation System

L P S

3

Implants

IMPLANTS

Proximal Femoral Body Replacement Components......... 4

Segmental Components ............................................... 6

Total Femoral Segmental Component ........................... 8

Intercalary Segmental Component ................................ 8

Distal Femoral Replacement Components ..................... 10

Stem Extension Components ........................................ 12

Proximal Tibial Replacement Component ...................... 16

MBT Revision Tray........................................................ 18

LPS Universal Tibial Hinge Insert Bearing ....................... 22

S-ROM® NOILES™ Rotating Hinge Femoral Component .. 24

Metaphyseal Sleeves .................................................... 26

4

PROXIMAL FEMORAL BODY REPLACEMENT COMPONENTS

Standard Body Style

Trochanteric Build-Up Body Style

Body Height70 mm

(using +1.5 mm head)

Offset38 mm

5

MATERIAL

• Titanium alloy with POROCOAT® Porous Coating

FEATURES

• Standard and trochanteric build-up styles

• Neutral and 15 degrees (left and right)

• Suture holes

• Anti-rotation tabs

• 90 mm minimum resection

• 70 mm body + 20 mm stem collar (to the + 1.5 mm head center)

• 38 mm offset (using a +1.5 mm head)

• ARTICUL/EZE® neck taper

• 135 degree neck/shaft angle

• Female component taper

USE

• Replaces proximal femoral bone

• Mates with segmental components, total femoral segmental components, LPS stem extension components, and universal metaphyseal sleeves

1987-10-105 Standard Body, Neutral

1987-10-205 Trochanter Body, Neutral

1987-11-105 Standard Body, Left, 15 Degrees

1987-11-205 Trochanter Body, Left, 15 Degrees

1987-12-105 Standard Body, Right, 15 Degrees

1987-12-205 Trochanter Body, Right, 15 Degrees

Ordering Information

Cat. No. Description

PROXIMAL FEMORAL BODY REPLACEMENT COMPONENTS

6

SEGMENTAL COMPONENTS

Length

7

MATERIAL

• Titanium alloy

FEATURES

• 25, 30, 35, 40, 45, 65, 85, 105 and 125 mm lengths

• One male and one female taper

• Anti-rotation tabs and slots

USE

• “Connectors” of the LPS System.

• Mates with all LPS components, including the LPS femoral to sleeve adapter

• Replaces missing shaft bone in 5 mm increments to adjust leg length

1987-07-025 25 mm length

1987-07-030 30 mm length

1987-07-035 35 mm length

1987-07-040 40 mm length

1987-07-045 45 mm length

1987-07-065 65 mm length

1987-07-085 85 mm length

1987-07-105 105 mm length

1987-07-125 125 mm length

Ordering Information Cat. No. Description

SEGMENTAL COMPONENTS

8

TOTAL FEMORALSEGMENTAL COMPONENT

INTERCALARY SEGMENTAL COMPONENT

55 mm Length

55 mm Length

9

MATERIAL

• Titanium alloy

FEATURES

• 55 mm length

• Two male tapers

• Anti-rotation slots

USE

• Needed for total femoral replacement construct

• Replaces missing shaft bone

• Mates with segmental, proximal femoral or distal femoral components

1987-08-055 55 mm length


TOTAL FEMORAL SEGMENTAL COMPONENT

MATERIAL

• Titanium alloy

FEATURES

• 55 mm length• Two female tapers• Anti-rotation tabs

USE

• Replaces midshaft bone

• Connects with segmental components and LPS stem extensions

1987-09-055 55 mm length


INTERCALARY SEGMENTAL COMPONENT

10

DISTAL FEMORAL REPLACEMENT COMPONENTS

X-small60 mmHeight

XX-small50 mmHeight

53 mm A/P, X-small48 mm A/P, XX-small

66 mm M/L, X-small56 mm M/L, XX-small

11

MATERIAL• Cobalt Chrome alloy

FEATURES• 70/80 mm minimum resection

• 50/60 mm component height to articular surface + 20 mm stem collar when using LPS stems

• 50/60 mm minimum resection when using metaphyseal sleeves• Utilizes SIGMA® Patella• Female taper with anti-rotation tabs • Anatomic (right and left)• X-small and XX-small size for soft tissue closure• Cobalt Chrome hinge pin allows for easy insertion with secure

locking (packaged with the femur)

USE• Replaces missing distal femur• Compatible with segmental components, total segmental

components, LPS stem extensions, and universal metaphyseal sleeves

• Assembles with the LPS Universal Tibial Hinge insert bearing to connect with the MBT Revision Tray or the LPS proximal tibial replacement components

• Load share design between hinge pin bushings and plateau bearing surface

• Allows for 5 degrees of hyperextension and 140 degrees of flexion

• Intended for cemented use only• Femoral component and tibial insert must match size for size


DISTAL FEMORAL REPLACEMENT COMPONENTS

1987-13-111 Left, XX-small

1987-14-111 Right, XX-small

1987-13-105 Left, X-small

1987-14-105 Right, X-small

PFC® SIGMA® Patella Components and Misc. Replacement Components

96-0110 32 mm 3-Peg Round/Dome Patella




1987-17-000 Distal femoral poly bumper replacement

1987-15-000 XX-small replacement hinge pin

62-1640 X-small/small replacement hinge pin

12

STEM EXTENSION COMPONENTS

20 mm Collar Height

Stem Length

Bevel

13

MATERIAL

• Cobalt Chrome alloy

FEATURES

• Cemented and porous options

• Straight (100 and 125 mm) and bowed (150 and 200 mm)

• All stems have a porous collar, 20 mm height

• Male taper with anti-rotation slots

• Proximal stem bevel for enhanced fit

• Porous stems utilize POROCOAT Porous Coating with bullet tip

• Cemented stems have flutes for enhanced cement fixation

• Trials are 0.5 mm undersized relative to the implant

USE

• Provides fixation into remaining host bone

• Stems mate with segmental, intercalary, proximal femoral, distal femoral and proximal tibial replacement components

Cemented Stems

9-17 mm diameters

(1 mm increments)

100, 125, 150 and 200 mm lengths*

Porous Stems

10.5-18.5 mm diameters

(1 mm increments)

100, 125, 150 and 200 mm lengths*

*See pages 14 and 15 for details

14

1987-25-109 9 mm diameter x 100 mm length










1987-26-109 10.5 mm diameter x 100 mm length












CEMENTED STEMS (STRAIGHT)

POROUS STEMS (STRAIGHT)

15

























POROUS STEMS (BOWED)

CEMENTED STEMS (BOWED)

16

PROXIMAL TIBIAL REPLACEMENT COMPONENT

73 mmHeight

66 mm M/L, X-small

17

MATERIAL


FEATURES

• 105 mm minimum resection

• 73 mm component + 12 mm bearing insert + 20 mm collar

• Female taper with anti-rotation tabs

• Highly polished plateau articulation surface

• Anterior suture holes

• POROCOAT Porous Coating

USE

• Replaces missing proximal tibial bone

• Mates with segmental components and LPS stem extensions

• Accepts the LPS Universal Tibial Hinge insert bearing to connect with the S-ROM NOILES rotating hinge femoral component or the LPS distal femoral replacement component

• Intended for cemented use only

1987-21-105 LPS, X-small


PROXIMAL TIBIAL REPLACEMENT COMPONENT

18

MBT REVISION TRAY

19

MATERIAL


FEATURES

• Tibial tray baseplate 5 is mm thick

• Mates with metaphyseal sleeves (29, 37, 45, 53 and 61 mm options)

• Mates with modular step wedges (5, 10 and 15 mm thicknesses)

• Mates with universal press-fit stems

• Titanium alloy

• 75, 115 and 150 mm lengths in 10-24 mm diameters

• Mates with SIGMA cemented stems

• Titanium alloy

• 30, 60, 90, 120 and 150 mm lengths in 13 mm diameter

• 30, 60 and 90 mm lengths in 15 mm diameter

• Thick tray options available in 15 and 25 mm thicknesses, sizes 2, 3 and 4

USE

• Resurfacing of tibia in distal femoral and total femoral replacement procedures

• Accepts the LPS Universal Tibial Hinge insert bearing to connect with the LPS distal femoral replacement component or the S-ROM NOILES rotating hinge femoral component

• Intended for cemented use only

20

MBT REVISION TRAY (CONT.)

21

1294-35-110 1 59 mm M/L x 39 mm A/P

1294-35-115 1.5 62 mm M/L x 41 mm A/P

1294-35-120 2 65 mm M/L x 43 mm A/P

1294-35-125 2.5 67 mm M/L x 44 mm A/P

1294-35-130 3 70 mm M/L x 46 mm A/P

1294-35-140 4 75 mm M/L x 49 mm A/P

1294-35-150 5 81 mm M/L x 53 mm A/P

1294-35-160 6 87 mm M/L x 57 mm A/P

1294-35-215 2 MBT Rev Thick Tray Size 2, 15 mm






Ordering Information Cat. No. Cemented Size Description

Ordering Information Cat. No. Cemented Size Description

MBT REVISION TRAY

MBT REVISION THICK TRAY

22

LPS UNIVERSAL TIBIAL HINGE INSERT BEARING

Parallel Sides

S-ROM NOILES ArticularGeometry

Cobalt Chrome Core

23

MATERIAL

• Forged Cobalt Chrome pin for enhanced strength

FEATURES

• Polyethylene bushings mate with hinge pin

• Flat anterior surface with hyperextension stop

• XX-small, X-small, small and medium sizes

• 12, 14, 16, 18, 21, 23, 26, 28 and 31 mm plateau bearing thickness

USE

• Provides stability for missing ligaments

• Hinge provides stability in flexion and extension and acts as a pivot point for distal femoral internal and external rotation

• Mates with the LPS distal femoral replacement component or the S-ROM NOILES rotating hinge femoral component and the MBT Revision Tray or the LPS proximal tibial replacement component

• Femoral Component and tibial insert must match size for size

1987-27-012 XX-small, 12 mm

1987-27-014 XX-small, 14 mm

1987-27-016 XX-small, 16 mm

1987-27-018 XX-small, 18 mm

1987-27-021 XX-small, 21 mm

1987-27-023 XX-small, 23 mm

1987-27-112 X-small, 12 mm

1987-27-114 X-small, 14 mm

1987-27-116 X-small, 16 mm

1987-27-118 X-small, 18 mm

1987-27-121 X-small, 21 mm

1987-27-123 X-small, 23 mm

1987-27-126 X-small, 26 mm

1987-27-128 X-small, 28 mm

1987-27-131 X-small, 31 mm

1987-27-212 Small, 12 mm

1987-27-214 Small, 14 mm

1987-27-216 Small, 16 mm

1987-27-218 Small, 18 mm

1987-27-221 Small, 21 mm

1987-27-223 Small, 23 mm

1987-27-226 Small, 26 mm

1987-27-228 Small, 28 mm

1987-27-231 Small, 31 mm

1987-27-312 Medium, 12 mm

1987-27-314 Medium, 14 mm

1987-27-316 Medium, 16 mm

1987-27-318 Medium, 18 mm

1987-27-321 Medium, 21 mm

1987-27-323 Medium, 23 mm

1987-27-326 Medium, 26 mm

1987-27-328 Medium, 28 mm

1987-27-331 Medium, 31 mm


LPS UNIVERSAL TIBIAL HINGE INSERT BEARING

24

S-ROM NOILES ROTATING HINGE FEMORAL COMPONENT

25

MATERIAL• Cobalt Chrome alloy

FEATURES• Three sizes (X-small, small and medium)• Anatomic (left and right)• Six degrees of hyperextension with polyethylene bumper stop• Load share design between hinge pin bushings and plateau

bearing surface• Posterior hinge point for maximum flexion• Cobalt Chrome hinge pin• Mates with universal femoral metaphyseal sleeves

(20, 31, 34, 40 and 46 mm options)

USE• Assembles with the LPS proximal tibial replacement

component or the MBT Revision Tray components using the LPS Universal Tibial Hinge insert bearing

• Intended for cemented use only• Use with S-ROM patella

62-3421L X-small, 66 mm M/L x 58 mm A/P, left

62-3421R X-small, 66 mm M/L x 58 mm A/P, right

62-3411L Small, 66 mm M/L x 62 mm A/P, left

62-3411R Small, 66 mm M/L x 62 mm A/P, right

62-3401L Medium, 71 mm M/L x 66 mm A/P, left

62-3401R Medium, 71 mm M/L x 66 mm A/P, right

S-ROM Patella Components

62-1630 30 mm Patellar Dome





S-ROM NOILES ROTATING HINGE FEMORAL COMPONENT

26

METAPHYSEAL SLEEVES

27

MATERIAL

• Titanium with clinically proven POROCOAT Porous Coating

FEATURES

• Five tibial sleeve sizes: 29, 37, 45, 53, and 61 mm • Five femoral sleeve sizes: 20 (cemented only), 31, 34, 40 and

46 mm (fully or distally porous)• Femoral sleeves are compatible with SIGMA, LCS®, S-ROM

NOILES and LPS knee systems• LPS distal femoral to sleeve adapter available in 0, 5, and

10mm lengths to increase distal offset• Tibial sleeves are compatible with the MBT Revision Tray and

MBT Revision Thick Trays• Accepts universal press-fit and SIMGA cemented stems

USE

• Employs Wolff’s Law to progressively load the bone with its stepped design

• Provides rotational stability to help prevent component loosening

• Same straightforward surgical technique at every level of constraint

1294-54-000 MBT Revision Porous Tibial Sleeve, 29 mm

1294-54-140 MBT Revision Cemented Tibial Sleeve, 29 mm





1294-53-205 Universal Femoral Sleeve - Cemented, 20 mm

1294-53-215 Universal Femoral Sleeve - Distally Porous, 31 mm

1294-53-216 Universal Femoral Sleeve - Fully Porous, 31 mm







1987-06-000 LPS Femoral to Sleeve Adapter +0 mm




Cat. No. Description

METAPHYSEAL SLEEVES AND ADAPTERS

28

29

Procedural Uses

PROCEDURAL USES

Proximal Femoral Replacement ....................................................... 30

Proximal Tibial Replacement ........................................................... 32

Total Femoral Replacement ............................................................. 34

Midshaft Replacement ..................................................................... 36

Distal Femoral Replacement ............................................................ 38

In this section, the five major lower extremity procedural uses and the instruments and implants needed to prepare for a case are reviewed. In addition, the instruments and implants that integrate with the LPS System are included for a total overview.

30

PROXIMAL FEMORAL REPLACEMENT

Note: Acetabular options: Unipolar heads, bipolar cups, fixed cups, cages, etc., are options dependent on the surgeon’s needs or preferences from the DePuy Synthes Joint Reconstruction* hip product portfolio. Do not use or mix other manufacturer’s implants with the LPS implants. Remember to have the appropriate instrumentation to support the acetabular option chosen. These implants and instruments need to be obtained for the case. They are not sent automatically with an LPS order.

Proc

edur

al U

ses

31

The LPS System offers flexibility to address a variety of difficult surgical situations in cases where there is the need for replacement due to the significant loss of proximal femoral bone.

In a proximal femoral replacement case, a proximal femoral replacement body, segmental component(s) and a stem extension are generally used.

The proximal femoral replacement body offers the option of neutral or 15 degrees of built-in anteversion depending on the need in surgery. The proximal femoral body with trochanteric build-up is an option with shortened abductors.

The length of segmental component(s) used depends upon the amount of missing bone that needs to be replaced with metal. The stem size used will depend upon the remaining bone diameter and length needed to provide adequate stability and fixation in the host bone. The construct’s minimum resection is 90 mm (using a +1.5 mm femoral head).

791 B LPS Calcar/Bevel Reamer Set

792 B LPS Component Trial Set

793 B LPS Straight Stem Trial Set

794 B LPS Bowed Stem Trial Set

795 B LPS Instrument Set

797 B LPS Proximal Tibial and Femoral Trial Set

Not Available through DePuy ExpressCare Straight Reamers (7-21 mm)

Not Available through DePuy ExpressCare Flexible Reamers (9-20.5 mm)

Instrument Ordering Information

DePuy ExpressCare Set No. Description


780 A LPS Cemented Straight Stem Set

781 A LPS Cemented Bowed Stem Set

782 A LPS POROCOAT Straight Stem Set

783 A LPS POROCOAT Bowed Stem Set

784 A LPS Proximal Femoral Body Set, Neutral/Left

785 A LPS Proximal Femoral Body Set, Neutral/Right

788 A LPS Segmental Component Set

Implant Ordering Information



32

PROXIMAL TIBIAL REPLACEMENT

33

The LPS System provides the surgical latitude needed to address the replacement of significant proximal tibial bone loss.

Proximal tibial replacement generally uses a proximal tibial replacement component, possibly a segmental component and an LPS stem extension. The S-ROM NOILES rotating hinge femoral component articulates with the LPS proximal tibial replacement component that uses the LPS Universal Tibial Hinge insert bearing.

The need for LPS segmental component(s) depends upon the amount of missing bone that needs to be replaced with metal. The stem size used will depend upon the remaining bone diameter and length needed to provide adequate stability and fixation in the host bone. The S-ROM NOILES rotating hinge femoral component requires the use of a sleeve and stem. The construct’s minimal tibial resection is 105 mm (when using a 12 mm bearing insert).





796 B LPS Tibial Trial Set



KN 981 B S-ROM Hinge Femoral Instrument Set*

KN 982 B S-ROM Hinge Common Instrument Set*

*If using S-ROM hinge femoral implants

Instrument Ordering Information DePuy ExpressCare Set No. Description


KN 489 A Universal Fluted Stems

KN 490 A Universal Femoral Sleeves - Distally Porous

KN 491 A Universal Femoral Sleeves - Fully Porous

KN 974 A S-ROM Hinge Femoral Components


782 A LPS Porous Straight Stem Set

786 A LPS Distal Femoral Set, Left

787 A LPS Distal Femoral Set, Right


789 A LPS Proximal Tibial Replacement

799 A LPS Univesal Hinged Insert Set

Implant Ordering Information DePuy ExpressCare Set No. Description


34

TOTAL FEMORAL REPLACEMENT

Note: Acetabular options: Unipolar heads, bipolar cups, fixed cups, cages, etc., are options dependent on the surgeon’s needs orpreferences from the DePuy Synthes Joint Reconstruction hip product portfolio. Do not use or mix other manufacturer’s implants with the LPS implants. Remember to have the appropriate instru-mentation to support the acetabular option chosen. These implants and instruments need to be obtained for the case. They are not sent automatically with an LPS order.

35

With a total femoral replacement, the entire femur is replaced by the prosthetic construct. This femoral construct articulates with a tibial component through a hinged insert connection.

A total femoral replacement utilizes the proximal femoral replacement body, a total femoral segmental component, the segmental component(s) and the distal femoral replacement component. The MBT Revision Tray is recommended on the tibial side with the option to use sleeves and stems.





Not Available through DePuy ExpressCare MBT Revision Prep

Not Available through DePuy ExpressCare MBT Revision Stem Trials

Not Available through DePuy ExpressCare MBT Revision Reamers

Not Available through DePuy ExpressCare MBT Revision Tray Trials/Wedge Instruments







784 A LPS Proximal Femoral Body Set, Neutral Left

785 A LPS Proximal Femoral Body Set, Neutral Right

786 A LPS Distal Femoral Replacement Set, Left

787 A LPS Distal Femoral Replacement Set, Right


799 A LPS Universal Hinged Insert Set

382 A MBT Revision Trays/Step Wedges, Size 6

383 A MBT Revision Thick Trays, Sizes 2-4

385 A MBT Revision Trays, Sizes 2-5

386 A MBT Revision Sleeves

387 A MBT Revision Step Wedges, Sizes 2-5

389 A MBT Revision Trays/Step Wedges, Sizes 1-1.5


36

MIDSHAFT REPLACEMENT

37

The LPS System addresses the replacement of significant midshaft femoral bone loss.

With midshaft bone loss, use the 55 mm intercalary segmental component with two stem extensions to “bridge the gap” of missing bone. If additional length is needed in the midshaft area, a segmental component can be used to make up for the missing bone. The diameter, type and length of the LPS stem extension used depends upon the remaining bone diameter, quality and stability needed with appropriate length. The construct’s minimum resection length is 95 mm.



793 B(2) LPS Straight Stem Trial Set*






780 A(2) LPS Cemented Straight Stem Set**

782 A(2) LPS Porous Straight Stem Set**


*Note: Need to order two sets of straight stem trials.**Note: Need to order two sets of straight stem implants.




38

DISTAL FEMORAL REPLACEMENT

39

The LPS System provides the options to address replacement of significant distal femoral bone loss.

A distal femoral replacement uses the distal femoral replacement component, the segmental component(s) and an LPS stem extension. Surgeons also have the option to use universal femoral metaphyseal sleeves for additional fixation. The MBT Revision Tray provides multiple options for use on the tibial side. Use the LPS Universal Tibial Hinge insert bearing with the MBT Revision Tray.

The length of segmental component(s) used depends upon the amount of missing bone that needs to be replaced with metal. The stem size used will depend upon the remaining bone diameter and length needed to provide adequate stability. The distal femoral minimum resection is 70 mm when using LPS stems and 50 mm when using universal femoral metaphyseal sleeves.






796 B LPS Proximal Tibial Trial Set


798 B LPS Metaphyseal Instrument Set


Not Available through DePuy ExpressCare Flexible Reamers (9-20.5 mm)

Not Available through DePuy ExpressCare MBT Revision Tray Prep

Not Available through DePuy ExpressCare MBT Revision Stem Trials

Not Available through DePuy ExpressCare MBT Revision Reamers

Not Available through DePuy ExpressCare MBT Revision Tray Trials/Wedge Instruments

Not Available through DePuy ExpressCare Femoral Adapter Instrument Set




40






782 A LPS POROCOAT Straight Stem Set

783 A LPS POROCOAT Bowed Stem Set




799 A LPS Universal Hinged Insert Set







KN 463 A SIGMA Cemented Stems

KN 489 A Universal Stems

798 A LPS Metaphyseal Sleeve Set

41

Instruments/Trials

INSTRUMENTS/TRIALS

LPS Calcar Planer and Bevel Reamer Set ......................................... 42 Bevel Reamer .............................................................................. 43 Calcar Planer ............................................................................... 44 Assembled Reamer ..................................................................... 45

LPS Component Trial Set.................................................................. 48

LPS Component Trial Set Instruments .............................................. 48 Proximal Femoral Body Replacement Trial ................................. 49 Segmental Component Trial ....................................................... 50 Distal Femoral Replacement Trial ............................................... 51 Total Femoral Segmental Component Trial ................................. 52 Intercalary Segmental Component Trial ...................................... 53 Segmental Stack Chart ................................................................ 54

LPS Straight Stem and Bowed Stem Trial Sets ................................. 57 Cemented Stem (Trial Use) ......................................................... 57 Porous Stem (Trial Use) .............................................................. 58 LPS Ream and Trial Chart ........................................................... 58

LPS Instrument Set ........................................................................... 59 Universal Handle with Quick Release and Femoral Driver .......... 60 Impaction Cap............................................................................. 60 Disassembly Tool ........................................................................ 61 Assembly Stand .......................................................................... 61 Inserter/Extractor (Version Guide and Slap Handle) .................... 62 Ruler ........................................................................................... 62

LPS Tibial Trial Set ........................................................................... 64 Tibial Hinge Insert Trial and Tibial Post Trial .............................. 65 LPS Metaphyseal Sleeve Set ....................................................... 66

The LPS System instrumentation provides the ability to prepare the remaining host bone, perform trial assessment and reduction, and assemble and insert the modular construct. This section reviews the sterilization case layout of the instruments and provides an overview of the individual instruments.

42

LPS CALCAR PLANER AND BEVEL REAMER SET

The calcar planer and bevel reamer case contains instruments designed to prepare the resected bone for acceptance of the stem extension.

Inst

rum

ents

/Tria

ls

Ordering Information Express Care No. Description Quantity

791 B LPS Calcar/Bevel Reamer Sterilization 1 Case Complete

Top Tray

Cat. No. Description Quantity

2987-70-001 LPS Calcar Planer, Small 1

2987-70-002 LPS Calcar Planer, Large 1

2987-70-090 LPS Bevel Reamer Insert, 9 mm 1

2987-70-095 LPS Bevel Reamer Insert, 9.5 mm 1












LPS CALCAR/BEVEL REAMER SET

43

CALCAR PLANER AND BEVEL REAMER

• Bevel reamers have pilots in .5 mm increments to assist in centering the bevel reamer in the canal.

Top Tray (cont.)















LPS CALCAR/BEVEL REAMER SET (CONT.)

44

ASSEMBLED REAMER

• The calcar planer and bevel reamer are assembled together to prepare for a flat cut and a bevel angle of the medullary canal of the resected bone.

• For a porous stem extension, begin reaming with the calcar/bevel reamer two to three sizes below the chosen implant size. The final bevel reamer must match the final stem extension. For example, if using a 15.5 mm stem extension the final bevel reamer with pilot should be 15.5 mm. This allows for a slight press-fit of the stem extension bevel.

• For a cemented stem extension, begin the calcar/bevel reaming two to three sizes below the final intermedullary (I.M.) ream size. For example, if an 11 mm stem is chosen with a 2 mm cement mantle, the final I.M. reamer will be 15 mm. The final calcar/bevel reamer will be 15 mm. This allows for a cement mantle around the stem extension bevel.

45

LPS COMPONENT TRIAL SET

The component trial case contains some of the trials needed to prepare a trial construct for assessment prior to the final implant assembly. This instrument case contains all the segmental, proximal femoral body, distal femoral replacement and femoral head trials.

Ordering Information Express Care No. Description Quantity


792 B LPS Component Trial 1 Sterilization Case Complete

46

Top Tray

2987-07-025 LPS Segmental Component Trial 25 mm 2









2987-08-055 LPS Total Femoral Segmental Trail, 55 mm 1

2987-09-055 LPS Intercalary Component Trial, 55 mm 1

2987-13-105 Distal Femoral Component, 1 Left, X-small Trial

2987-13-111 Distal Femoral Component, 1 Left, XX-small Trial

2987-14-105 Distal Femoral Component, 1 Right, X-small Trial

2987-14-111 Distal Femoral Component, 1 Right, XX-small Trial


47


Bottom Tray

2987-10-105 LPS Proximal Femoral Body 1 Neutral Standard Trial

2987-10-205 LPS Proximal Femoral Body 1 Neutral Trochanter Trial

2987-11-105 LPS Proximal Femoral Body Left, 1 15 mm diameter, Standard Trial

2987-11-205 LPS Proximal Femoral Body Left, 1 15 mm diameter, Trochanter Trial

2987-12-105 LPS Proximal Femoral Body Right, 1 15 mm diameter, Standard Trial

2987-12-205 LPS Proximal Femoral Body Left, 1 15 mm diameter, Trochanter Trial

2530-69-000 ARTICUL/EZE Femoral Head Trial 1 22.225 +4 mm

2530-70-000 ARTICUL/EZE Femoral Head Trial 1 22.225 +7 mm

2530-81-000 ARTICUL/EZE Femoral Head Trial 28 +1.5 mm 1

2530-82-000 ARTICUL/EZE Femoral Head Trial 28 +5 mm 1









48


PROXIMAL FEMORAL BODY REPLACEMENT TRIAL

Proximal femoral body trials replicate the implant and are used in trial reduction to assess leg length, offset and joint stability. The six femoral body trials mirror the system implants. The trials accept ARTICUL/EZE femoral trial heads and segmental and stem trials as needed.

49

SEGMENTAL COMPONENT TRIALS

Segmental component trials help plan the amount of missing bone that needs to be replaced by the prosthesis or adjustment of leg length. The nine segmental component trial sizes match the nine implant sizes (25, 30, 35, 40, 45, 65, 85, 105 and 125 mm lengths). The segmental trials offer the ability to provide 5 mm increments of adjustment with single components or through a stacking combination.


50


DISTAL FEMORAL REPLACEMENT TRIAL

These trial components match the distal femoral replacement implant, allowing for trial reduction. The left and right components accept the LPS Universal Tibial Hinge insert bearing trials, segmental, total, femoral to sleeve adapter trials, or LPS stem trials as needed.

51


TOTAL FEMORAL SEGMENTAL COMPONENT TRIAL

This trial matches the 55 mm total femoral segmental component. It is used when performing a total femoral replacement trial reduction.

52

INTERCALARY SEGMENTAL COMPONENT TRIAL

The 55 mm intercalary segmental trial is used to assess replacement bone in a midshaft tumor replacement. It is used with two LPS stem extension trials to assess leg length. Segmental trials are used to assess more extensive midshaft bone loss if needed.


53

25 25

30 30

35 35

40 40

45 45

50 25 + 25

55 25 + 30

60 25 + 35

65 65

70 25 + 45 or 30 + 40

75 30 + 45 or 35 + 40

80 35 + 45

85 85

90 25 + 65

95 30 + 65

100 35 + 65

105 105

110 25 + 85 or 45 + 65

115 30 + 85

120 35 + 85

125 125

130 25 + 105 or 45 + 85

135 30 + 105

140 35 + 105

145 40 + 105

150 25 + 125 or 45 + 105

155 30 + 125

160 35 + 125

165 40 + 125

170 45 + 125

175 125 + 25 + 25

180 125 + 25 + 30

190 125 + 65

195 125 + 25 + 45

200 125 + 35 + 40

205 125 + 35 + 45

210 125 + 85

215 125 + 25 + 65

220 125 + 30 + 65

225 125 + 35 + 65

230 125 + 105

235 125 + 25 + 85

240 125 + 30 + 85

245 125 + 35 + 85

250 125 + 40 + 85

Remaining LPS Segmental Gap Components

Remaining LPS Segmental Gap Components

SEGMENTAL STACK CHART

PROCEDURE

The chart below provides a quick reference to choose the segmental component(s) needed to replace the missing bone gap.

Minimum resection length

Proximal Femoral Replacement 90 mm (70 mm femoral body with 1.5 mm head center + 20 mm stem collar)

Distal Femoral Replacement with LPS Stems

70 mm (50 mm distal femoral component + 20 mm stem collar)

Distal Femoral Replacement with Metaphyseal Sleeves

50 mm (using XX-Small femur) 60 mm (using X-Small femur)

Proximal Tibial Replacement 105 mm (73 mm tibial component + 12 mm insert bearing +20 mm stem collar)

Midshaft Tumor Replacement 95 mm (55 mm intercalary segment length + two 20 mm stem collars)

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LPS STRAIGHT STEM AND BOWED STEM TRIAL SETS

The straight stem trial components are available in 1 mm increments from 9 to 19 mm in diameter and 100 and 125 mm lengths that correspond to the implants. The bowed stem trials are available in 1 mm increments from 11-19 mm in diameter and 150 and 200 mm in lengths that correspond to the implants. The trial’s purpose is to assess fit and provide for the ability to perform a construct trial reduction. Choose trials based on the implant options selected and the last reamed size.

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LPS STRAIGHT STEM TRIAL SET

793 B LPS Straight Stem Trial 1 Sterilization Case Complete

Top Tray

2987-25-109 9 x 100 mm Stem Extension Trial, Straight 1






Bottom Tray











Express Care No. Description Quantity

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LPS BOWED STEM TRIAL SET

794 B LPS Bowed Stem Trial 1 Sterilization Case Complete

Top Tray

2987-15-211 11 x 150 mm Stem Extension Trial Bowed 1









Bottom Tray













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LPS STRAIGHT STEM AND BOWED STEM TRIAL SETS

CEMENTED STEM (TRIAL USE)

If using a cemented stem, the appropriate trial can be used to assess the cement mantle. For example, if the last reamed size is 15 mm, use a 13 mm trial if a 1 mm circumferential mantle is being evaluated or use an 11 mm trial if a 2 mm circumferential mantle is being evaluated. For trial reduction purposes, if a 15 mm reamer was last used, use a 15 mm trial for the trial reduction to prevent spinning of the stem extension in the canal.

POROUS STEM (TRIAL USE)

If using a porous stem, the reaming technique determines the appropriate trial. All porous stems are in 1 mm increments. Since the typical protocol is to underream by .5 mm, the trial used would correspond to the last reamer used. For example, if using a 13.5 mm porous stem and 13 mm was the last reamer used, select a 13 mm trial for the trial reduction. This allows for trial stability without compromising the prepared bone.

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* Trial diameters are 0.25 to 0.50 mm less than stated to allow for clearance in the intermedullary canal.

The following chart shows reamer-to-trial implant suggestions.

Implant

ReamDiameter

(mm)

Trial*Diameter

(mm)

Cemented Stem with 1 mm mantle/side

Cemented Stem with 2 mm mantle/side

Porous Stemwith .5 mmunderream

9 9 N/A N/A N/A

10 10 N/A N/A 10.5 mm

11 11 9 mm N/A 11.5 mm

12 12 10 mm N/A 12.5 mm

13 13 11 mm 9 mm 13.5 mm

14 14 12 mm 10 mm 14.5 mm

15 15 13 mm 11 mm 15.5 mm

16 16 14 mm 12 mm 16.5 mm

17 17 15 mm 13 mm 17.5 mm

18 18 16 mm 14 mm 18.5 mm

19 19 17 mm 15 mm N/A

LPS REAM AND TRIAL CHART

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This instrument case contains the LPS inserter/extractor (including the version guide and slap handle) the assembly stand and related items; and ruler and femoral impactor with driver.


LPS INSTRUMENT SET

795 B LPS Instrument Sterilization 1 Case Complete

Tray Contents

2987-71-000 LPS Disassembly Tool 1

2987-72-010 LPS Distal Femoral Assembly Stand 1

2987-72-020 LPS Proximal Femoral Assembly Stand 1

2987-72-025 LPS Assembly Base 1

2987-72-030 LPS Inserter/Extractor 1

2987-72-035 LPS Version Guide 1

2987-72-040 LPS Slap Handle 1

2987-72-045 LPS Extractor Moreland Adapter 1

2987-72-050 LPS Ruler 1

6338-01 S-ROM Tibial Driver 1

6338-02 S-ROM Femoral Driver 1

6338-05A S-ROM Impaction Cap 1

6338-06A S-ROM Universal Handle Quick Release 1

LPS INSTRUMENT SET

ExpressCare Description Quantity


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UNIVERSAL HANDLE WITH QUICK RELEASE AND TIBIAL/FEMORAL DRIVER

The universal handle is connected to the tibial femoral driver and used when impacting the tibial femoral replacement construct into the remaining host bone.

IMPACTION CAP

Use the impaction cap to cover the end of the stem extension when impacting the component into a construct. Be sure to remove the impaction cap before implantation.

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ASSEMBLY STAND

The assembly stand is made up of the assembly base, distal femoral assembly stand and proximal femoral assembly stand. The assembly stand provides a method of holding a proximal femoral or distal femoral replacement construct when impacting the tapers.

DISASSEMBLY TOOL

Use this instrument to separate the morse taper connection of the components. The disassembly tool fits into the anti-rotation slot areas of the assemblies. The tool has a flat and a half-moon shape that keys into the anti-rotation slot geometry of the implants. Once secure in the slots, squeeze the handle and push the handle down to loosen the taper junction. Do not reuse implants once they are disassembled due to possible damage or scratches on the tapers.

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RULER

The stainless steel ruler is 500 mm (19.5 in.) in length and assists in planning the resection level. It is used to approximate the gap of missing bone following resection.

INSERTER/EXTRACTER (VERSION GUIDE AND SLAP HANDLE)

This instrument is used to insert a proximal femoral construct. Thread the inserter into the proximal body shoulder and use the version guide to assist in the construct orientation. This instrument also acts as an extractor by threading into a stem extension. The slap handle is used to provide extraction force.

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This instrument case contains the proximal tibial replacement and insert trial components for trial reduction.

LPS TIBIAL TRIAL SET

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796 B LPS Tibial Trial 1 Sterilization Case Complete

Top Tray

2178-63-132 MBT Revision Trial Post 1 2987-22-000 LPS Tibial Hinge Trial Post Adapter 1 2987-22-012 LPS Tibial Insert Trial, XX-Small, 12 mm 1 2987-22-014 LPS Tibial Insert Trial, XX-Small, 14 mm 1 2987-22-016 LPS Tibial Insert Trial, XX-Small, 16 mm 1 2987-22-018 LPS Tibial Insert Trial, XX-Small, 18 mm 1 2987-22-021 LPS Tibial Insert Trial, XX-Small, 21 mm 1 2987-22-023 LPS Tibial Insert Trial, XX-Small, 23 mm 1 2987-22-131 LPS Tibial Insert Trial, X-Small, 31 mm 1 2987-22-231 LPS Tibial Insert Trial, Small, 31 mm 1 2987-22-331 LPS Tibial Insert Trial, Medium, 31 mm 1

Bottom Tray

2987-22-112 LPS Tibial Insert Trial, X-Small, 12 mm 1 2987-22-114 LPS Tibial Insert Trial, X-Small, 14 mm 1 2987-22-116 LPS Tibial Insert Trial, X-Small, 16 mm 1 2987-22-118 LPS Tibial Insert Trial, X-Small, 18 mm 1 2987-22-121 LPS Tibial Insert Trial, X-Small, 21 mm 1 2987-22-123 LPS Tibial Insert Trial, X-Small, 23 mm 1 2987-22-126 LPS Tibial Insert Trial, X-Small, 26 mm 1 2987-22-128 LPS Tibial Insert Trial, X-Small, 28 mm 1 2987-22-212 LPS Tibial Insert Trial, Small, 12 mm 1 2987-22-214 LPS Tibial Insert Trial, Small, 14 mm 1 2987-22-216 LPS Tibial Insert Trial, Small, 16 mm 1 2987-22-218 LPS Tibial Insert Trial, Small, 18 mm 1 2987-22-221 LPS Tibial Insert Trial, Small, 21 mm 1 2987-22-223 LPS Tibial Insert Trial, Small, 23 mm 1 2987-22-226 LPS Tibial Insert Trial, Small, 26 mm 1 2987-22-228 LPS Tibial Insert Trial, Small, 28 mm 1 2987-22-312 LPS Tibial Insert Trial, Medium, 12 mm 1 2987-22-314 LPS Tibial Insert Trial, Medium, 14 mm 1 2987-22-316 LPS Tibial Insert Trial, Medium, 16 mm 1 2987-22-318 LPS Tibial Insert Trial, Medium, 18 mm 1 2987-22-321 LPS Tibial Insert Trial, Medium, 21 mm 1 2987-22-323 LPS Tibial Insert Trial, Medium, 23 mm 1 2987-22-326 LPS Tibial Insert Trial, Medium, 26 mm 1 2987-22-328 LPS Tibial Insert Trial, Medium, 28 mm 1



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TIBIAL HINGE INSERT TRIAL, TIBIAL POST TRIAL AND HINGE PIN TRIAL

The tibial hinge insert trial is available in four sizes and nine thicknesses. Trials include a tibial hinge insert, tibial post and trial hinge pin used with the proximal tibial replacement component trial or MBT Revision Tray trial depending on the need. This trial also mates with the LPS distal femoral replacement component trial or the S-ROM NOILES rotating hinge femoral component trial based on the surgical situation. The tibial hinge insert trials allow for assessment of the joint line, leg length and joint stability when performing a trial range of motion. The hinge pin trial secures the tibial hinge insert trial to the chosen distal femoral trial.


Tibial Post Trial

Tibial Hinge Insert Trial

Hinge Pin Trialhinge pin trial

tibial hinge insert trial

tibial post trial

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The LPS metaphyseal sleeve instrument case contains the trial instruments necessary for using a metaphyseal sleeve for a distal femoral replacement case. Instruments include sleeve adapters.


LPS METAPHYSEAL SLEEVE SET

798 B LPS Metaphyseal Sleeve Case 1

Tray Contents

2987-04-000 Metaphyseal Sleeve Removal Tool 1

2987-06-000 LPS Femoral to Sleeve Adapter Trial, +0 mm 1



2178-63-135 Revision Femoral Stem/Adapter Clamp 1



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LPS PROXIMAL TIBIAL AND FEMORAL TRIAL SET

This instrument case contains the proximal tibial and proximal femoral trial components.

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LPS PROXIMAL TIBIAL AND FEMORAL TRIAL SET

797 B LPS Proximal Tibial and Femoral Case 1

Tray Contents

2987-10-105 LPS Proximal Femoral Body, Neutral Standard Trial

2987-10-205 LPS Proximal Femoral Body, Neutral Trochanter Trial

2987-11-105 LPS Proximal Femoral Body, Left Standard Trial,

15 degree anteversion

2987-11-205 LPS Proximal Femoral Body, Left Trochanter Trial,


2987-12-105 LPS Proximal Femoral Body, Right Standard Trial,


2987-12-205 LPS Proximal Femoral Body, Left Trochanter Trial,


2987-21-105 LPS Proximal Tibial Replacement Trial, X-Small

2987-40-025 Implant to Trial Adapter, 25 mm





2530-81-000 ARTICUL/EZE Grooved Ball Trial, 28 mm, +1.5 degree

2530-82-000 ARTICUL/EZE Grooved Ball Trial, 28 mm, +5 degree




2530-91-000 ARTICUL/EZE Grooved Ball Trial, 32 mm, +1 degre





2531-50-000 ARTICUL/EZE Grooved Ball Trial, 36 mm, -2 degree








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PROXIMAL TIBIAL REPLACEMENT TRIAL

The proximal tibial replacement trial replicates the proximal tibial replacement component and is used to assess fit and for trial reduction utilizing the trial construct. It is used with the stem extension trials and segmental components if needed due to extensive bone loss.


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LPS METAPHYSEAL SLEEVE INSTRUMENTATION SET

Top Tray






2178-63-135 Revision Femoral Stem/Adapter Clamp 1

2987-04-000 Metaphyseal Sleeve Removal Tool 1


798B

LPS METAPHYSEAL SLEEVE INSTRUMENTATION SET

LPS Metaphyseal Sleeve Instrumentation Case

1

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Below is a complete listing of DePuy ExpressCare set numbers for The LPS System. Please refer to the guide for special set numbers needed for the various proce-dural uses.


Set No. Description

LPS TOTAL DEPUY EXPRESSCARE SET NUMBER LISTING








798 B LPS Metaphyseal Sleeve Instruments

KN 463 B SIGMA Cemented Stem Instruments

KN 981 B S-ROM Hinge Femoral Instrument Set

KN 982 B S-ROM Hinge Common Instrument Set


Set No. Description



782 A LPS Porous Straight Stem Set

783 A LPS Porous Bowed Stem Set

784 A LPS Proximal Femoral Body Set, Neutral Left

785 A LPS Proximal Femoral Body Set, Neutral Right




789 A LPS Proximal Replacement

798 A LPS Metaphyseal Sleeve Set

799 A LPS Universal Hinged Insert trials Set







KN 463 A SIGMA Cemented Stems


KN 490 A Universal Femoral Sleeves - Distally Porous

KN 491 A Universal Femoral Sleeves - Fully Porous

KN 974 A S-ROM Hinge Femoral Components

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Consult the package insert for complete product information.

LPS™ (Limb Preservation System)

Important:This Essential Product Information sheet does not include all of the information necessary for selection and use of a device. Please see full labeling for all necessary information.

DescriptionThe DePuy LPS Limb Preservation System is designed for the replacement of the mid-shaft portion of the femur, proximal, distal and/or total femur, and proximal tibia. The DePuy LPS system offers a variety of component options (including, but not limited to, proximal femoral bodies, segmental components, distal femoral components, femoral stems, tibial stems, proximal tibial components, hinged tibial insert bearings, metaphyseal sleeves, and adapters). The components, which can be used in conjunction with certain components from other systems, are for treatment of patients presenting bone loss and deformity associ-ated with bone tumors resection, trauma, infection, and difficult revision arthroplasty. A total femoral replacement is possible in those cases where no part of the femur can be salvaged.

IndicationsThe DePuy LPS is intended for use in replacement of the mid-shaft portion of the femur, proximal, distal and/or total femur, and proximal tibia, especially in cases that require extensive resection and replacement. Specific diagnostic indications for use include:

• malignant tumors (e.g., osteosarcomas, chondrosarcomas, giant cell tumors, bone tumors) requiring extensive resec-tion and replacement;

• patient conditions of noninflammatory degenerative joint disease (NIDJD), e.g. avascular necrosis, osteoarthritis, and inflammatory joint disease (IJD), e.g., rheumatoid arthritis, requiring extensive resection and replacement;

• revision cases for a failed previous prosthesis requiring extensive resection and replacement;

• severe trauma requiring extensive resection and replacement.

The LPS is also intended for use in bone loss post-infection, where the surgeon has elected to excise the bone and replace-ment is required.

The S-ROM tibial tray and the non-porous coated straight and bowed stems are intended for cemented use only.

The porous-coated metaphyseal sleeves are intended for either cemented or cementless applications.

Contraindications:1. Active local or systemic infection.2. Loss of bone or musculature, osteoporosis, neuromuscular

compromise or vascular deficiency in the affected limb in sufficient degree to render the procedure unjustifiable (e.g., absence of musculoligamentous supporting struc-tures, joint neuropathy).

Note: Diabetes, at present, has not been established as a con-traindication. However, because of the increased risk for compli-cations such as infection, slow wound-healing, etc., the physician should carefully consider the advisability of knee replacement in the severely diabetic patient.

Warnings and PrecautionsComponents labeled for “Cemented Use Only” are to be implanted only with bone cement. The following conditions tend to impose severe loading on the affected extremity thereby plac-ing the patient at higher risk of failure of the prosthesis: obesity or excessive patient weight, manual labor, active sports participa-tion, high levels of patient activity, likelihood of falls, alcohol or drug addiction, tumors of the supporting bone structures, other disabilities, as appropriate.

Adverse EventsThe following are the most frequent adverse events after a pros-thetic implant surgery: change in position of the components, loosening, bending, cracking, fracture, deformation or wear of one or more of the components, fatigue fractures, infection, tissue reaction to implant materials or wear debris; pain, disloca-tion, subluxation, flexion contracture, decreased range of motion, lengthening or shortening of leg caused by improper positioning or possible loss of limb if complications occur, looseness or wear of components; fractures of the femur or tibia, cardiovascular disorders, thromboembolic disease, myositis ossificans, especially in males with hypertrophic arthritis, limited preoperative range of motion and/or previous myositis and possible loss of limb if complications occur.

DePuy Orthopaedics, Inc.700 Orthopaedic DriveWarsaw, IN 46582T. +1 (800) 366-8143

www.depuysynthes.com

© DePuy Synthes Joint Reconstruction, a division of DOI 2014. All rights reserved. 0612-35-050 (Rev. 6) EO 6/14

* DePuy Synthes Joint Reconstruction is a division of DePuy Orthopaedics, Inc.

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