Stryker Scorpio TS Bedienungsanleitung

corpio T Femoral Component pecifications

Resected Box Intercondylar Condylar tem

ize A/P-Med A/P-Lat M/L A/P Height Box Width Width Height*

(mm) (mm) (mm) (mm) (mm) (mm) (mm) (mm)

#3 52 54 56 35 20 17 20 42

#5 56 58 61 39 20 17 22 42

#7 60 62 66 44 23 19 24 46

#9 66 68 71 49 23 19 26 46

#11 72 72 76 53 25 21 28 48

#13 74 76 81 58 25 21 30 48

Tibial Baseplates**

77-4003 77-4005 77-4007 77-4009 77-4011

76-4103

72-4-03xx 72-4-05xx

76-4105

72-4-03xx 72-4-05xx 72-4-57xx

Crossover

76-4107

72-4-75xx 72-4-07xx 72-4-09xx

Crossover

76-4109

72-4-07xx 72-4-09xx 72-4-91xx

Crossover

76-4111

72-4-19xx 72-4-11xx

Crossover

76-4113

72-4-11xx

**Scorpio®PS Inserts may be used.

Femoral

Components

corpio T Tibial Tray pecifications

*With end cap

ize A/P M/L tem Boss

(mm) (mm) Length* (mm)

3 40 61 35

5 44 66 35

7 47 71 37

9 51 77 37

11 54 82 43

13 58 88 43

corpio T Tibial Insert pecifications

Post Post

ize A/P M/L Height Width

(mm) (mm) (mm) (mm)

3 40 61 23 16

5 44 66 23 16

7F/5T 44 66 27 18

5F/7T 47 71 23 16

7 47 71 27 18

9 51 77 27 18

11F/9T 51 77 29 20

9F/11T 54 82 27 18

11 54 82 29 20

Orthopaedics

corpio®T

Sin le Axis Revision

Knee System

A surgeon must always rely on is or er own professional clinical judgment w en deciding w et er to use a particular

product w en treating a particular patient. Stryker does not dispense medical advice and recommends t at surgeons be

trained in t e use of any particular product before using it in surgery.

T e information presented is intended to demonstrate t e breadt of Stryker product offerings. A surgeon must always

refer to t e package insert, product label and/or instructions for use before using any Stryker product. Products may not

be available in all markets because product availability is subject to t e regulatory and/or medical practices in individual

markets. Please contact your Stryker representative if you ave questions about t e availability of Stryker products in

your area.

Stryker Corporation or its divisions or ot er corporate affiliated entities own, use or ave applied for t e following

trademarks or service marks: Stryker. All ot er trademarks are trademarks of t eir respective owners or olders.

Literature Number: LSPK34 Rev. 2

MS/GS 06/11

Copyrig t © Stryker 2011

Printed in USA.

Scorpio TS

Trial Cutting Guide Surgical

Protocol

325 Corporate Drive

Ma wa , NJ 07430

t: 201 831 5000

www.stryker.com

izing Information

Scorpio Trial Cuttin Guide

*With end cap

2459_10_LSPK34_Rev2_Scorpio_Protoco _Cover_Back_012958 CVR.qxd 6/6/11 4:16 PM Page 1

Acknowledgements

Stryker Orthopaedics would like to thank

Dr. Masini for his help in developing the

Scorpio Trial Cutting Guide.

Michael A. Masini, MD

Ann Arbor Bone and Joint Surgery

St. Joseph Mercy Hospital

Ann Arbor, MI

Clinical Instructor in Orthopaedic Surgery

University of Michigan

Ann Arbor, MI

Introduction

This surgical protocol is a supplement

to the Scorpio Total Stabilizer Revision

Knee System Surgical Protocol

(Lit o. LSTS/ST).

The Scorpio Trial Cutting Guide is an

intramedullary based instrumentation

system focused on the restoration of the

joint line and proper flexion-extension

gap assessment.

Orthopaedics

Scorpio®TS

Sin le Axis Revision

Knee System

Sc rpi TS

Trial Cutting Guide Surgical Protocol

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 1

Tibial and Femoral Canal Preparation

Scorpio Trial Cuttin Guide

Tibial Preparation

Prepare the tibia following the Scorpio

Total Stabilizer Revision Knee System

Surgical Protocol (Lit. o. LSTS/ST, pages

1- 5). If an offset is needed, use the tibial

offset reamer to prepare for the tibial

offset. Insert the assembled trial into the

tibia (Figure 1 and Figure 2).

ote: The Scorpio Trial Cutting

Guide (TCG) is designed for use

with its own mating tibial insert

trial. The trial insert does not have

a post to allow for more accurate

assessment of the ligaments

during surgery.

Femoral Canal Preparation

Prepare the femoral canal to accept a

stem as described in the Scorpio Total

Stabilizer Revision Knee System Surgical

Protocol (Lit. o. LSTS/ST, page 5). If an

offset is needed, use the femoral offset

reamer to prepare for the femoral offset

(Lit. o. LSTS/ST, page 9) (Figure 3).

Figure 1 Tibial Canal Preparation Figure 2 Tibial Trial Assembly and

Insertion

Figure 3 Femoral Canal Preparation

Command T-Handle

6266-5-401

Tibial Boss/Offset Reamer

8200-0015

Reamer Depth Stop

8200-0047 80mm stem with offset

8200-0048 155mm stem with offset

Femoral Offset Reamer

8200-0095

IM Reamers

6633-9-408 8mm

6633-9-409 9mm

6633-9-410 10mm

6633-9-411 11mm

6633-9-412 12mm

6633-9-413 13mm

6633-9-414 14mm

6633-9-415 15mm

6633-9-416 16mm

6633-9-417 17mm

6633-9-418 18mm

6633-9-419 19mm

6633-9-420 20mm

6633-9-421 21mm

6633-9-422 22mm

6633-9-423 23mm

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 2

Femoral/Tibial Trial Selection

Scorpio Trial Cuttin Guide

Femoral/Tibial Trial Selection

Select the appropriate size femoral trial

cutting guide, offset adapter, and

corresponding tibial insert trial (Table 1).

Appropriate sizing can be achieved

through the use of:

• Previous operative notes

• Size of the original implant removed

• X-ray templates

The Scorpio Trial Cutting Guide (TCG)

can be assembled for either a left or right

knee. Assemble the offset adapter into the

housing of the TCG so the offset adapter

is pointing to the appropriate left or right

orientation (Figure 4).

Categ ry Sizes

Femoral Cutting Guides 3, 5, 7, 9, 11, 13

Offset Adapter 0mm, 2mm, 4mm, 6mm, 8mm

Tibial Insert Trial Sizes 3, 5, 7, 9, 11, 13

Tibial Insert Trial Thickness 10mm, 12mm, 14mm, 16mm , 18mm, 21mm, 24mm

Table 1 Trial Cutting Guide Instrument Sizes

Femoral

Cutting Guide

Figure 4 Trial Cutting Guide in “Right” Orientation

Trial Cutting Guide

8200-5003

8200-5005

8200-5007

8200-5009

8200-5011

8200-5013

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 3

Femoral/Tibial Trial Selection (continued)

Scorpio Trial Cuttin Guide

Assembly

Assemble the trial cutting guide, offset

adapter, and appropriate size trial stem

as shown (Figure 5).

A neutral offset adapter may be used

initially to construct the trial cutting

guide assembly until the need for a

femoral offset is determined.

First, assemble the trial stem to the offset

adapter, then assemble the offset adapter

into the Trial Cutting Guide housing and

secure the anterior set screw. Once “finger

tight” pressure is achieved, rotate

counterclockwise 1/2 turn to allow the

offset adapter to rotate freely. The anterior

set screw will be fully secured after the

appropriate offset and rotation is

determined (Figure 6).

ote: Rotating counterclockwise

1/2 turn will allow the offset

adapter to rotate freely without

disassembling from the Trial

Cutting Guide housing. Rotating

counterclockwise more than 1/2

turn will cause the offset adapter

to fall out of the Trial Cutting Guide

housing.

Torx Screwdriver

8200-5110

Tibial Insert Trial

T72-7-XXYY

XX = 03, 05, 07, 09, 11

YY = 10, 12, 14, 16, 18, 21, 24

Offset Adapter

8200-5100

8200-5102

8200-5104

8200-5106

8200-5108

Figure 6 Set Screw Assembly

Trial

Stem

Offset

Adapter

Trial

Cutting Guide

Trial Cutting

Guide

Housing

Set

Screw

Figure 5 Trial Cutting Guide

Assembly

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 4

Trial Cutting Guide Orientation

Scorpio Trial Cuttin Guide

ote: Femoral chamfer cuts cannot

be made with the TCG. However, if

bone loss is minimal and it is

determined that chamfer cuts are

required, the Scorpio Total

Stabilizer (TS) All-In-One Cutting

Block may be used to make

chamfer cuts (Lit. o. LSTS/ST,

Page 8).

Joint Line Restoration

Insert the TCG into the femoral canal

(Figure 7) and align the TCG medial

epicondyle (ME) scribe line reference mark

with the medial epicondyle (Figure 8). The

ME scribe line is 28mm from the distal

surface of the TCG. When the ME scribe

line is in line with the medial epicondyle,

the distal surface of the TCG will be

approximately located at the joint line.

(The joint line can also be estimated

using pre-operative radiographs and

anatomic landmarks.)

Place an initial fixation pin in the middle

of the medial slot on the TCG (Figure 9

and Figure 10). Pinning the medial slot

will fix the proximal/distal position while

allowing for slight internal and external

rotation of the TCG.

Figure 7 TCG Femoral Canal

Insertion

Figure 8 Joint Line Restoration to

Medial Epicondyle

Figure 9 Initial Fixation Pin Insertion Figure 10 Initial Fixation Pin –

Extension

Medial

ME Scribe

1/8" Headless Pins

7650-1038

Joint Line Scale

8200-0065

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 5

Trial Cutting Guide Orientation (continued)

Scorpio Trial Cuttin Guide

Femoral Offsetting

There are several ways to determine the

proper femoral offset required.

1) Start with a neutral offset and measure

or estimate the distance from the

inferior surface of the anterior flange

of the TCG to the anterior femur

(Figure 11) or,

2) Line up the femoral sizing “C” templates

with the trial stem and measure or

estimate the distance from the anterior

femur to the inferior surface of the

anterior flange of the TCG.

ote: A 4mm offset is typical for

many revision scenarios, and if an

A/P offset is not necessary, the

offset adapter may be used to

displace the femur medially or

laterally.

ote: When adjusting the offset of

the TCG, the entire offset adapter

and stem construct will be rotating.

To adjust the offset, insert the hex driver

into the distal face of the offset adapter

and rotate (Figure 12). After final offset

position has been determined, tighten the

anterior set screw to secure the offset

position on the TCG (Figure 6, page 4).

If an offset is required, record the final

position of the offset by reading the

location of the hash mark on the offset

adapter relative to the clock face on the

TCG. The clock recording will be

required when assembling the implant. If

an offset is not required, use the 0 adapter

(Figure 13).

ote: The numerical clock on the

TCG is a mirror image of the clock

face markings on the femoral trial

and final implant (Figure 14 and

Figure 14a).

Figure 11 Offset Measuring Figure 12 Trial Cutting Guide

Offsetting

Figure 13 Offset Reading Figure 14 Trial Cutting Guide and

Implant/Trial Clock Face

Figure 14A Enlarged View of Clock

Face (0=Posterior Offset)

Anterior Set Screw

Femoral Sizing Template

8200-0096 #3/5

8200-0097 #7/9

8200-0098 #11/13

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 6

Trial Cutting Guide Orientation (continued)

Scorpio Trial Cuttin Guide

Preliminary Trial Assessment

With the joint line restored and the

appropriate offset determined, a

preliminary trial assessment should be

conducted with the trial tibial

components in place (Figure 15).

Select the appropriate trial tibial insert

and place it onto the trial tibia. Select the

insert that provides varus/valgus stability

in full extension (Figure 16).

Figure 15 Preliminary Trial Assessment

Figure 16 Varus/Valgus Stability Check at Full Extension

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 7

Trial Cutting Guide Orientation (continued)

Scorpio Trial Cuttin Guide

Rotation

With the knee flexed at 90°, appropriate

external rotation can be set by

positioning the TCG on the tibial trial

insert so that it is seated with no

varus/valgus tilt. The transepicondylar

axis or Whiteside’s axis can be used to

estimate rotation as well.

A second headless fixation pin should

then be placed in the TCG’s anterior pin

hole to fix the TCG position once

rotation has been established (Figure 17).

Place as many pins as necessary to

securely fix the TCG on the distal femur.

ote: Headless pins may now be

replaced with short headed fixation

pins to facilitate joint reduction.

ote: The TCG trial inserts do not

have a post. This allows for a more

accurate assessment of the

ligaments during trialing.

Figure 17 Second Fixation Pin – Rotation

Headed Fixation Pin

7650-1136 1” Headed Pin

7650-1137 3” Headed Pin

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 8

Trial Cutting Guide Orientation (continued)

Scorpio Trial Cuttin Guide

Trial Assessment

Once the TCG is fixed to the femur, a

trial reduction may be conducted. Reduce

the extensor mechanism and patella. The

inferior pole of the patella should rest

approximately 14mm above the joint line

with the knee in 90° of flexion unless

patella baja or patella alta was present

pre-operatively. Tracking of the patella

can then be assessed (Figure 18).

ote: A suture or towel clip may be

used to facilitate reduction and

trial assessment (Figure 19).

It should be noted that the flexion gap

often feels “too loose” in the revision

situation even when the appropriately

sized femoral implant is positioned at the

joint line. Using the TCG gives the

surgeon the unique opportunity to upsize

the femoral component and offset the

next size femur to selectively fill the

flexion gap that feels “too loose.”

However, if upsizing results in poor

tracking and “overstuffing of the joint”,

the surgeon need only return to the

previous size TCG and offset.

ote: A full evaluation of stability

and range of motion can be

performed before making any

resections on the distal femur.

Adjustment of the implant position

and size is possible before making

any femoral bone cuts.

Figure 18 Preliminary Trial Reduction

Figure 19 Preliminary Trial Reduction With Suture

Suture

2459_10_LSPK34_Rev2_Scorpio_Protocol_Text_012958 txt_. xd 6/6/11 4:14 PM Page 9

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