| BUECHEL-PAPPAS™
INTEGRATED HIP REPLACEMENT SYSTEM – TOTAL |
Total
Hip Surgical Procedure
Acetabular
Preparation
Acetabular preparation requires the use of sequential, spherical
cheese-grater type reamers to deepen the acetabulum to the
floor (outer table of the tear drop), while retaining the
subchondral plate in the superior, weight bearing dome. Care
is taken to retain the anterior and posterior walls of the
acetabulum and use their anatomical position for proper anteversion,
while orienting the cup at 30° from the horizontal plane.
This
hip replacement system provides a hemispherical acetabular
cup that allows for precise positioning at the acetabular
floor with the ability to adjust minor valgus or version angles
by simple impaction of the acetabular cup rim. Elimination
of fixation fins, pins, or a cylindrical fixation geometry
adds to the ease of insertion of this cup.
An interference
fit of 1mm in hard bone, such as osteoarthritis, and a 2mm
interference fit in soft bone, such as rheumatoid arthritis,
allows the use of these spherical components without screws.
Screws may be used to augment fixation if bone grafts or minor
instabilities of the cup are present.
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Femoral
Preparation
A straight stem, femoral component with a 30° horizontal
calcar-loading collar is precisely matched in the proximal
triangular region of the femur and the distal cylindrical
region of the shaft to provide optimal loading of the bone
while minimizing thigh pain problems. Sequentially sized straight
reamers with a blunt tip are used to enlarge the femoral canal
to the endosteal diameter of the isthmus. Proximal femoral
rasps are then used to enlarge the upper femur, while retaining
the structural support of the calcar femoral component. If
the optimal stem and proximal dimensions differ, a modular
stem of appropriate diameter and length can be mechanically
attached by a locking-screw-taper mechanism to provide an
ideal reconstruction that loads the proximal femur and calcar
while maintaining an exact fit in the femoral isthmus.
Such
reconstructions allow immediate weight bearing to tolerance
following surgery and provide optimal loading for long term
fixation. The use of a titanium nitride (TiN) ceramic bearing
surface articulating with UHMWPe greatly improves the wear
resistance of this articulation over conventional metal-plastic
interfaces.
Smooth
cylindrical distal tips reduces distal loading and distal
thigh pain, as well as wear debris during the positioning
of the proximal fixed stem.
Convenience,
versatility, excellent long-term results, and ease of implantation
make the Buechel-Pappas stem-type total hip replacement a
superior implant choice for reconstructing the severely arthritic
hip.
Total
Hip Instruments
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