Stryker orthopaedics introduced its first rotating. The information contained in this document is intended for. In the past, many of these lesions were resected, and the joint was fused or the entire limb was amputated. Orthopaedics gmrs proximal femoral surgical protocol. Class 2 device recall global modular replacement system.
Do you want to use the redesigned ao sr like an app. Revision distal femoral arthroplasty with the compress. In the largest series of cemented distal femoral stems, implant survival was only 67% using aseptic loosening as the failure criteria with almost 10% of stems removed for aseptic loosening. Straight and bowed connection piece for total femur 80mm, 90mm left and right distal femoral component, pressfit stems with titanium plasma spray and. The distal femur was resected through a midline skin incision and medial parapatellar arthrotomy. Current concepts in fractures of the distal femur soucasny pohled na zlomeniny dolniho konce stehenni kosti b. Structural failures of the prosthesis are wellknown postoperative complications and have been reported for various prosthesis types. Babst department of trauma surgery, cantonal hospital lucerne, lucerne, switzerland summary this paper describes current treatment strategies of distal femoral fractures as well as their evidence based rationale. It offers guidance that you should heed, but, as with any. Tibial insert and sleeve were revised and bumper, axle and bushings replaced. Class 2 device recall gmrs proximal femoral surgical protocol. Orthopaedics gmrs proximal tibial surgical protocol table of contents introduction 2 description of the proximal tibial global modular replacement system 4 surgical protocol 7 measuring resection length 8 tibial osteotomy 9 femoral sizing 9 preparation for the mrh femoral component 10 femoral canal preparation 10 distal femoral resection 11 intramedullary alignment 12. Femur axsos 3 titanium operative technique distal lateral femur. The global modular replacement system gmrs, stryker.
The condylar plate is contoured such that distal screws will be at 90 to the midline of the shaft if the plate is. Most femoral stems, however, are straight and therefore poorly fit the anteriorly bowed curvature of the femur. Sep 22, 2015 patients with failed distal femoral megaprostheses often have bone loss that limits reconstructive options and contributes to the high failure rate of revision surgery. To address this issue, we used a short, curved, uncemented pressfit femoral stem and evaluated its shortterm outcomes after reconstruction of the distal femur. This system can replace the proximal femur, distal femur, total femur, or proximal humerus. This system, now known as the global mrs system, is manufactured by d stryker orthopedics mahwah, nj. The distal femur and the proximal tibia are common sites for primary and metastatic bone tumors. Excessive and repetitive bending is not recommended as it may weaken the plate. Orthopaedics gmrs proximal tibial surgical protocol. Modular prostheses of the distal femur were initially developed for the treatment of.
The t2 femoral nailing system offers a universal left and right nail in addition to an antegrade or retrograde approach that may reduce inventory. Orthopaedics gmrs proximal tibial surgical protocol global modular replacement system. Patients with failed distal femoral megaprostheses often have bone loss that limits reconstructive options and contributes to the high failure rate of revision surgery. Your digital gateway to expertise, education, and innovation. Mrs upper extremity surgical protocol mrs distal humerus the mrs distal humerus and ulna system is designed for a universal fit with the mrs proximal humerus system and solar ulna components.
The mets distal femoral replacement system is designed as a modular system that can be used to replace diseased or deficient bone in the distal femur. Lcp combiholes combine a dynamic compression unit dcu hole with a locking screw hole. Without using the distal targeting system, the placement of the distal locking screws is done primarily by a variety of freehand techniques, using. The departments electronic database was searched for all patients undergoing revision of total knee arthroplasty. Plate system for distal femur and proximal lateral tibia. Pdf what are the longterm results of mutars modular. Gmrs global modular replacement system clinical history is knowledge for life stryker orthopaedics introduced its first rotating hinge components in 1979, setting the stage for an astounding record of over a quarter century of validated clinical success. Stryker is one of the worlds leading medical technology companies and together with our customers, we are driven to make healthcare better. Distal femoral resection with endoprosthetic reconstruction martin malawer overview the distal femur figure 30. Anatomically precontoured low profile plates reduced soft tissue problems no need for plate contouring note. It differs from traditional stemmed prostheses because it requires only 4 to 8 cm of residual bone for.
Gmrs cemented stem options available for the growing distal femur. The polyax locked plating system is indicated for the treatment of distal femur and proximal tibia fractures. From these, all patients having distal femoral replacement for periprosthetic fracture around the distal femoral component using the stryker global modular replacement system gmrs implant were filtered. Indications and contraindications for this type of replacement are listed below. If this is done, the medullary canal should be reamed a further 2mm or 4mm in. The t2 im nailing platform offers a combination of innovation, simplicity and versatility that is designed to suit your various needs. Proximal humerus reconstruction for tumors is a relatively rare surgical procedure and it is difficult to accumulate large series in a single institution.
Distal femur distal femur with allpoly tibial component while clinical history is the foundation for the gmrs system, our. Resection length of the femur and consecutive reconstruction was. The triathlon single radius has been designed to work with the body to promote a naturallike circular motion, to help restore function and. Uncemented megaprosthesis stem fixation using scratch fit. Distal femur proximal tibia proximal femur total femur open the catalog to page 4 gmrs global modular replacement system clinical history is knowledge for life stryker orthopaedics introduced its first rotating hinge components in 1979, setting the stage for an astounding record of over a quarter century of validated clinical success. Accolade surgical protocol previously lasst adm x3 mobile bearing hip system surgical protocol for us previously lsp64 hiprestoration adm. Gmrs using clinical history to drive technology for patient satisfaction.
Patients with osteosarcoma of the distal femur have traditionally been treated with a high aboveknee amputation. A guide to the placement of this mark is the linea aspera on the posterior aspect of the femur. This article presents three cases of chronic osteomyelitis treated with a staged approach culminating in endoprosthetic reconstruction. Since its launch in 2004, more than 2 million patients have received a triathlon knee. Stryker femoral head implants with the 540 taper v40 femoral. Stryker howmedica osteonics 59 route 17 allendale, new jersey 0740 1 dec 16 2002 re. Monoaxial locking plate for treating distal femur fractures. Pdf hip abductor moment arm a mathematical analysis for. Gmrs proximal femoral surgical protocol acknowledgements stryker would like to thank all of the surgeons for their contributions in developing the global modular replacement system gmrs. We help you diagnose your distal femur case and provide detailed descriptions of how to manage this and hundreds of other pathologies. Strykers gmrs represents another significant option in.
Gmrs proximal femoral surgical protocol 2 marking anterior aspect of femur a longitudinal line representing the anterior point on the femur should now be marked distal to the resection level to aid in rotational orientation of the prosthesis figure 2. Stryker distal femoral growing prosthesis components and system. Patella kinematics have been improved by incorporating a deepened patellar track to articulate with the duracon patellae. Class 2 device recall global modular replacement system gmrs. In stable fractures, this offers the biomechanical advantage.
After the assembly is placed in neutral rotation, impact the floating spikes into the distal femur and secure the distal block with pins. The global modular replacement system gmrs, stryker corporation, mahwah, nj was used in 21 70. Gmrs distal femoral surgical protocol introduction the gmrs distal femoral components are based on over a quarter of a century of clinical history. This was revised on b6 2010, to a distal femoral gmrs component with a 19mm straight stem with 30mm stem extender. Antibiotic cement and hardware were removed, and intraoperative frozen sections were negative for acute inflammation. Two years after this surgery the pt showed on xray as having a fracture at the junction of the 4mm offset adapter and the mrh femoral boss. Proximal tibial replacement in revision knee arthroplasty. Chronic osteomyelitis involving the distal femur often results in amputation or arthrodesis. What are the longterm results of mutars modular endoprostheses for reconstruction of tumor resection of the distal femur and proximal tibia. We help you diagnose your distal femur case and provide detailed descriptions of how to manage this and hundreds of other. The introduction of chemotherapy, the advances in surgical and diagnostic techniques, and the multidisciplinary approach allowed limb salvage procedures for sarcoma with no obvious detectable differences in oncologic or functional results compared with amputation 25, 8. Femoral cadaveric specimens were thawed and cut at the distal end of the femur, at cm from the distal joint line, to e represent a distal femoral tumor resection. Our portfolio of lower extremities products includes a comprehensive array of intramedullary nails, locking plates, external fixation, and biologics. Global modular replacement system one system, one vision.
Before closure, autogenous bone graft from the resected distal femoral bone stock was placed adjacent to the bonespindle interface and held in. Krh in situations where replacement of extensive bone loss in the femur andor proximal tibia is required. The information contained in this document is intended for healthcare professionals only. This system was designed to provide modular replacements for the proximal humerus, proximal femur, total femur, distal femur, and proximal tibia and has been instrumental in the widespread adoption of endoprosthetic recon. Distal femoral reconstruction following failed total knee. Distal targeting system for gamma3 long nails and t2 recon nails in response to the request of surgeons around the world, stryker osteosynthesis has created a dedicated distal targeting system. Distal femoral reconstruction following failed total knee arthroplasty. Elliptical segmental distal femur for complete replacement of the distal femur elliptical collar designed to contact the remaining flared metaphyseal portion of the distal femoral shaft accepts any oss stem option segmental distal femoral for complete replacement of the distal femur when more than 7 cm of reconstruction is required. Stryker would like to thank the following surgeons for their contributions in devel oping the global modular replacement. Patella kinematics have been enhanced by incorporating a deepened patellar track to articulate with the duracon patellae. If distal femoral augments are required, the 10mm cutting guide slots are used.
From a populationbased implant design, a patented screwtoplate interface, and streamlined instrumentation, our focus is on creating a welldesigned plating system, giving you more time to focus on other things. Gmrs proximal femoral surgical protocol stryker meded. Stage one involved resection of infected bone and placement of an intramedullary nail spanning the bony defect between proximal femur and tibia, with antibiotic cement. Chapter 53 fractures of the distal femur china quad diaries. Strykers gmrs represents another significant option in modular replacement systems as a solution. Open reduction vs distal femoral replacement arthroplasty for comminuted distal femur fractures in the patients 70 years and older. A large stryker gmrs distal femoral endoprosthesis with a rotating hinge knee was placed and her patellar tendon was found to be partially avulsed from the tibial tubercle. Aseptic loosening rates in distal femoral endoprostheses. Stryker sent urgent product recall notification letters and product accountability forms via fedex on 12212007, return receipt requested. Preoperatively radiographs in two plans as well as standing entire limb radiographs have been taken.
Stryker orthopaedics has a long tradition of understanding surgeons clinical requirements and the growing needs of the patients. Proximal and total humerus reconstruction with the use of an. Modular distal femur brochure us stanmore implants. Uncemented, curved, short endoprosthesis stem for distal.
Utilizes gmrs small axle, small bushings and mrh bumper utilizes modular rotating hinge axle, bushings, and bumper distal femur distal femur with allpoly tibial component while clinical history is the foundation for the gmrs system, our stateoftheart technology drives the systems outstanding performance. Reconstruction was performed with the gmrs combined with the mrh. Modular knee megaendoprotheses are commonly used devices for distal femur or proximal tibia replacement in tumor surgery as well as for treatment of some periprosthetic fractures around a loose or failed total knee arthroplasty. Distal femoral replacement dfr prostheses are readily used in these circumstances, but. Unfortunately, neither study reported on reaming techniques or on stem diameter. Hip abductor moment arm a mathematical analysis for proximal femoral replacement article pdf available in journal of orthopaedic surgery and research 61. Gmrs global modular knee replacement system from stryker. Gmrs, stryker corporation, mahwah, nj was used in 21 70. The distal femur and proximal tibia are common locations for both benign and malignant bone lesions. We report on 16 patients accrual over 17 months who underwent a proximal humerus reconstruction with the use of an aortograft mesh at a large national cancer institute designated cancer center. Stryker s gmrs represents another significant option in. G3in7 the gamma3 ublade lag screw may be used with either the gamma3 trochanteric nail or the long length gamma3 nail to treat patients with highly osteoporotic bone or.
Distal femoral resection 11 intramedullary alignment 12. Module and distal femoral module of the gmrs may be used together, or with the components of the mrs, in replacement of the total femur. Limbsparing surgery for distal femoral and proximal tibial. The system is intended for use in open or percutaneous fracture fixation cases requiring open reduction internal fixation orif of closed and open fractures of the distal femur and proximal tibia, including repair of non.
The original system was developed by the senior author mm in conjunction with the engineers lead engineer george corsi at howmedica rutherford, nj. Accolade ii femoral hip system surgical technique previously lsp76 hipaccolade ii. Proximal tibial replacement in revision knee arthroplasty for non. An urgent product recall letter dated 172008, was sent to surgeons who are gmrs users, advising that the gmrs proximal femoral components are not compatible with alumina ceramic heads. Open reduction vs distal femoral replacement arthroplasty. The global modular replacement system is intended to be used with the components of the howmedica osteonics modular replacement system, the howmedica osteonics modular rotating hinge knee system andor the howmedica osteonics kinematic rotating hinge knee system in situations where replacement of extensive bone loss in the femur andor. The compress compliant prestress cps implant can reconstruct the femur even when there is little remaining bone. If a further resection is required, the cutting guide can be repositioned referencing the pins placed on the distal femur through the 2mm or 4mm pin holes on the resection guide. Distal humeral component distal end accepts bearing insert, axle bushing and axle pin and provides an. The preparation of the distal femur was made in accordance with the. Gmrs global modular replacement system distal femur technology thats designed. It offers guidance that you should heed, but, as with any such technical guide, each surgeon must consider. Structural failure of a modern knee tumor megaendoprosthesis. Distal femoral replacement in periprosthetic fracture around.
Proximal and total humerus reconstruction with the use of. Our triathlon total knee system portfolio offers you many options to treat patients needing a total knee replacement. The retrograde protection sleeve is contoured to fit the profile of the intercondylar notch. Resection length of the femur and consecutive reconstruction was chosen to be as short as possible to provide a maximum of functionality. The system consists of a smiles knee, a range of shafts in 15mm increments to suit differing lengths of resections, a range of hydroxyapatite coated and uncoated collars of different diameters. A guide to the placement of this mark is the linea aspera on the posterior aspect of the.
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