Name: Univers Apex OptiFit™ Surgical Technique
Uploaded: 2014-08-05T00:00:00Z
Channel: Arthrex
Description: The Univers Apex OptiFit™ system represents the evolution of our stemmed anatomic systems.

Arthroplasty Shoulder

<p>The Univers Apex OptiFit™ system represents the evolution of our stemmed anatomic systems.</p>

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AN1-00023-EN | H | Univers Apex OptiFit™ Surgical Technique

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A general overview including the relevant steps of an Arthrex surgical technique. These animations always include a voice-over explaining the process.

Eine allgemeine Übersicht, einschließlich der relevanten Schritte einer Arthrex Operationsanleitung. Diese Animationen enthalten immer Voice-Overs, die den Prozess erklären.

Operationstechnik-Animationen

Surgical Technique Animations

Visão geral incluindo as etapas relevantes de uma técnica cirúrgica Arthrex. Essas animações sempre incluem uma narração explicando o processo.

Animações de técnicas cirúrgicas

Descripción general que incluye los pasos relevantes de una técnica quirúrgica de Arthrex. Estas animaciones siempre incluyen una voz en off que explica el proceso.

Animaciones de técnicas quirúrgicas

Univers Apex OptiFit™ Surgical Technique

The humeral osteotomy is performed by either a freehand cut or with an intramedullary or extramedullary guide provided in the instrument set, taking care to maintain the patient's native articular inclination inversion. The Universe Apex OptiFit instrument set contains reamers and broaches designed to prepare the Intramedullary canal to match the stem's smaller footprint to minimize bone removal. The initial broach has an attachable version guide and version rods for proper broach orientation relative to the osteotomy broach until rotational stability is achieved and the appropriate laser marking is flush with the cut surface. Following canal preparation, a proximal humerus Protector is placed and attention is turned to glenoid preparation. There are three glenoid implants available. The universal glenoid convertible base plate. The keeled glenoid. And the VaultLock glenoid, which provides immediate press fit fixation on the central peg. The VaultLock is demonstrated here. A pin is placed in the center of the glenoid by using the pin guide. The appropriately sized VaultLock reamer is positioned over the pin, and the glenoid surface is then contoured to support the polyethylene component. The central hole is drilled with a six millimeter cannulated drill, stopping once the collar comes in contact with the glenoid surface. The glenoid drill guide is positioned by placing the central peg into the previously drilled hole. A short six millimeter drill bit is used to drill the superior peg hole. It's left in place to stabilize the guide for inferior drilling. The inferior 4.5mm drill bit is then used to prepare for the inferior keel. The glenoid brooch finalizes inferior keel. Preparation. Alternatively, the glenoid punch can be used with attention to impact just so the shoulder is flush with the reamed surface. Translucent glenoid trials are available. These provide visualization for the reamed surface while evaluating the proper orientation and fit prior to cementing the polyethylene component. The glenoid vault is cleansed and dried, followed by cement injection in the superior and inferior peg holes. A pressurizing tool is available for displacing cement throughout the vault. Bone graft can be used on the central peg. Autograft can be obtained from the native humeral head by creating a slurry with the bone graft reamer. The slurry is then placed into the graft compression tool, which is clamped around the central peg. Carefully spinning. The glenoid component on the grafting tool compresses the bone graft into the flutes of the central peg. Alternatively, a demineralized bone matrix product can be used for grafting the central peg. The VaultLock glenoid is then impacted into place. Attention is turned back to the humerus for stem implantation. The OptiFit stem has suture holes in the proximal body for soft tissue repair and subscapularis closure. The apex subscapularis repair technique takes advantage of these holes. Two holes are drilled vertically in the biceps groove for passage of the lateral suture. Limbs two. Number two FiberWire. Sutures are passed through the lateral holes, yielding four suture limbs labeled A through D from superior to inferior. A blue suture is used superiorly and TigerWire inferiorly for number two. Fiberwire sutures are passed through the medial holes, yielding eight suture limbs, labeled one through eight from superior to inferior. Blue and TigerWire. Sutures are alternated from lateral to medial limbs. C and d are passed through the inferior hole from the intramedullary canal out. Similarly, limbs A and B are passed through the superior hole from the Intramedullary canal out. All strands are held out to length on tension as the stem is impacted. Using the pointed stem impactor, followed by the angled Morse taper stem impactor, placing the trunnion flush to the osteotomy surface. The inclination inferior and version superior screws are then tightened with the torque driver. Trailheads are available to verify proper head size, head offset, shoulder motion, and stability prior to impacting the Definitiv head component. Suture limbs one through eight are evenly placed through the medial aspect of the subscapularis tendon. From superior to inferior. Your proper spacing is key to the final repair. The sutures are then tied in the following sequence one to A, eight to D, four to C. Five to B, 2 to 3 and 6 to 7. The suture color pattern is such that the first four knots are tied between similar colors, and the last two knots are tied between different colors. In addition, the last two knots are tensioned and create dynamic compression of the subscapularis tendon over the lesser tuberosity. The repair is then evaluated by externally rotating the arm with the arm abducted. The degree of external rotation achieved without stressing the repair is noted for postoperative therapy limitations. The wound is irrigated and superficial closure is performed according to the surgeon's protocol.

Univers Apex OptiFit™ Surgical Technique

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