Cadera Bimetric Porous

5/28/2018 Cadera Bimetric Porous

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bi-metricporous

primary hip system:

the cornerstone

of the alliance

hip system family

Bi-metric

porous primary

hip system


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alliance

X-Series

implant technology

Introducing the new Bi-MetricLateralized Primary Stem

Femoral Neck:

Unchanged since 1984, a standard Morse-type

taper with reduced AP neck dimensions facilitates

range of motion up to 154. Adapts to seven

neck lengths and accommodates a range of head

sizes: 22mm, 26mm, 28mm, 32mm and the 38mm

metal-on-metal.

Titanium:

The porous hips of the AllianceX-Series

are constructed of Ti-6Al-4V titanium alloy

to enhance bio-compatability, high fatigue

strength and a low modulus of elasticity.

Porous Coating:

A titanium alloy substrate combined with

non-interconnected, circumferential titanium

porous coating has been designed for bony ingrowth

to lock in the femoral implant and create a seal to

particulate debris migration that may help to reduce

osteolysis and improve long-term fixation.8

Interlok

Surface:Provides a roughened titanium surface

for bone ongrowth, enhancing the

potential for long-term fixation.

Tapered Feature:

Biomets philosophy incorporates a clinically

proven 3 bi-planar taper geometry. The stem

tapers 3 from the proximal shoulder to the distal

tip of the implant and from the lateral shoulder

to the medial calcar area. The taper affords greater

proximal stress off-loading and minimizes the need

to remove distal cortical bone. Each implants

distinct lateral-to-medial taper is designed to

provide physiologic proximal load transfer and

exceptional implant-to-patient fit.

Insertion Hole:

Medialized for ease

of insertion and less

interference from the

greater trochanter.


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1

FEATURES & BENEFITS OF

ALLIANCEX-SERIES IMPLANTS:

Simple Standard Instrument Sets:

Incorporating one common set of instruments, the Exacthip instruments

are used to implant all AllianceX-Series components (Figure 1). This feature

provides the surgeon with maximum flexibility and simplifies procedures for the

OR staff while reducing instrument inventory for the hospital.

AllianceX-Series Surface Coatings:

The X-Series implants offer a variety of surface finishes that promote

fixation. Biomets porous plasma sprayed components have shown

significantly lower rates of osteolysis than other circumferentially-coated

components.8,11,12,15,17

Proximal circumferential non-interconnected plasma spray works

in conjunction with the implant design for optimal bone ingrowth. A

roughened Interlokfinish provides the medium for bone ongrowth and

the smooth or polished portions of the stem is consistent with proximal

fixation.

Net-Forgings:

Net-forging technology provides a more precise fit for the implant.

The human variability associated with hand polishing is reduced,

allowing superior reproduction of the compound angles on the finished implant. In addition,

net-forgings adhere to the industrys most exacting dimension tolerances, which provide a

more consistent broach-to-implant fit.

biomet, the first company

to establish the standard

for success.

Titanium

bi-planar taper geometry

circumferential plasma

spray porous coating

unchanged philosophy:

titanium,

tapered geometry,

& plasma spray.

Figure 1 AllianceGeneral Case I


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TRADITION

AND TECHNOLOGY

The Alliancefamily of femoral components uses net-shape forgings

and advanced manufacturing technology to optimize the consistency of

multiple geometries and configurations. The foundation for the X-Series of

implants are the excellent long-term clinical results of proximal-to-distal

tapered stem geometries (Figure 1). The combined technology and

geometries have proven to meet the needs of both the patient and the

surgeon for successful cementless hip reconstruction.

Meticulous design and superior materials, combined with improvedmanufacturing techniques, have allowed for advanced concepts in femoral

components and instrumentation. Net-shape forging technology results in a

consistent and reproducible surgical technique.

This advanced technology provides a more precise envelope for

the implant, which has greatly reduced the human variability associated

with previous manufacturing methods. This technology has been integral

in the development of superior standards of performance. The X-Series implants maximize

the effectiveness of net-forging technology while maintaining the specific features that

surgeons prefer.

the X-Series of

implants blends

biomet tradition

and advanced

technology.

alliance

X-Series

implant technology

Figure 1 The Bi-MetricPorous hip system is the foundation of the technologicallyadvanced X-Series femoral components.

2

uncompromised

tradition &

technology.


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The X-Series implants are manufactured using three-dimensional CAD-CAM techniques.

Computer-aided design (CAD) and computer-aided manufacturing (CAM) have revolu-

tionized the manufacturing process (Figure 2). 3D CAD-CAM engineering technology

is superior over previous 2D CAD-CAM designs in that 2D technology allowed for

two-dimensional drawings to be designed in limited planes. Due to this limited technology,

there was a possibility for variability in the final design. New, innovative processes permit

creation of the actual implant, while eliminating manufacturing steps (Figures 3 and 4).

Recent developments in three-dimensional solid modeling technology allow for designs tobe viewed and manipulated from all angles. This technology provides accurate interpretation

of compound planes and complex implant

geometries, leading to the precise and consistent

development of femoral components and related

instrumentation (Figure 5).

3

Figure 5 Using the latest 3D CAD-CAM technology and machinery,Biomet engineers have successfully reduced tolerance issues asthey relate to the broach and implant.

Figure 2 Innovative computer-aided design (CAD)

Figure 3 Shown above (left to right) are thenear net-forging, turned taper, polishedimplant prior to porous coating, andthe final implant.

Figure 4 Shown above (left to right) arethe net-forging, turned taper,and the final implant.


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alliance

X-Series

implant technology

TITANIUM

PLASMA SPRAY

Plasma spray is a three-dimensional distribution of

randomly dispersed titanium particles (Figure 1). Biomets

proprietary plasma spray application is unique in that only

the titanium alloy powder used to create the coating is

heated, not the implants substrate. Plasma spray porouscoating is applied to the substrate of the implant at a low temperature, which preserves up to

90% of the mechanical strength of the implant.2Randomly shaped particles are flattened

upon impact with the substrate. An arbitrary distribution of pore size between 100 and 1,000

microns is generated, providing a larger contact area between the particles and the substrate.

The resulting surface is rough in contrast to the smooth surfaces of a beaded implant. Implant

stability, interface strength and contact to the bony surface area are maximized by the irregular

surface. This feature allows the implant to scrape bone into the pores during implantation,

providing solid initial fixation. In addition, the random particle dimensions result in a varied

pore size distribution. Smaller pores are important for initial fixation because they quickly fill

in with bone, promoting early osseointegration. Larger pores require a longer time to fill in

POROUS COATING VS. OSTEOLYSIS

0

10

20

30

40

50

60

70

80

Sintered orDiffusionBonded

PlasmaSprayed

Sintered orDiffusionBonded

PlasmaSprayed

Ti Alloy Co-Cr Alloy

Fatigue

Strength(ksi

)at107

Cyc

les

Range of values determinedRange of values reported

Figure 2 Effect of the porous coating method on fatiguestrength.8

Figure 1 Above is an SEM photographat 100x magnification showingplasma spray porous coating.

4

Author Reference Hip Implant System Years Followed Osteolysis

Evans and DeLee Submitted for Publication Bi-Metric(Biomet) 510 years 0.0%

Mauerhan, et al. J. Arthroplasty, 1997 Integral(Biomet) 58 years 0.0%

McLaughlin JBJS Taperloc(Biomet) 812.5 years 6.0%

Head,et al. Orthopedics,1999 Mallory-Head(Biomet) 11 years avg. 0.0%

Rothman Orthopedics,1994 Taperloc(Biomet) 7 years 3.0%

Bourne,et al. Hip Society (March), 2001 Mallory-Head(Biomet) 1013 years 0.0%

Multi-Center Study Biomet Clinical Report, 1994 Taperloc, Mallory-Head 5 years 0.4%

Bi-Metric, Integral(Biomet) Meding, et al. AAOS(Feb.), 2001 Bi-Metric(Biomet) 1012 years 0.0%

Capello, McClain Trans. Intl Sym., 1992 Omnifit(Osteonics) 26 years 44.7%

Heekin, et al. JBJS, 1993 PCA(Howmedica) 57 years 18.0%

Woolson, Maloney J. Arthroplasty, 1992 Harris/Galante(Zimmer) 3.5 yrs. avg. follow-up 22.0%

Kim, et al. Orthop. Trans, 19923 PCA(Howmedica) 27 years 37.0%

Kim, et al. Orthop. Trans, 19923 AML(DePuy) 27 years 55.8%

Smith, Harris CORR, 1995 Harris/Galante(Zimmer) 4.5 yrs. avg. follow-up 31.0%

Engh Presentation, 1992 AML(DePuy) 7.5 yrs. avg. follow-up 28.0%

Kim, et al. CORR, 1999 AML(DePuy) 11.3 yrs. follow-up 17.0%


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and provide for long-term fixation with continued macro bone in-growth. Bony in-growth is

important for mechanical interlocking and maximum load transfer. Studies show that rough

titanium has been found to have a good propensity for encouraging adhesion of osteoblasts.18

Circumferentially coating the femoral component with plasma spray creates a barrier to

particulate debris (metallic, polyethylene or PMMA), which can trigger a macrophage response

that can initiate osteolysis.1,5,9,14Tanzer, et al., have reported that sealing the endosteum from

the pumping of debris may be the most important factor in preventing osteolysis in total hip

patients.19The lack of longitudinal pore interconnectivity creates a sealfrom this particulate debris migration, which may help to reduce osteolysis

and improve long-term fixation.7,19While other femoral components have

circumferential porous coating, it is notBiomets clinically proven

non-interconnected plasma spray.3,7,13

LATERAL OFFSET RESTORATION

In total hip reconstruction, the most effective and easily manipulated

mechanical variable available to the surgeon to optimize the biomechanics

of the hip is the offset of the prosthesis. A lateral offset option allows the

surgeon to enhance joint stability and restore normal hip function. If the potential offset

deficiency is not identified or treated, it could lead to joint instability, limp, and increased

joint reaction forces. The advantage, intra-operatively, is that it allows for adjustment of

offset and soft tissue tension without changing the neck resection level or the length of

the leg.

The X-Series implants employ two methods of achieving optimal offset restoration.

For the Integralfemoral stems, lateralization is achieved by shifting the neck geometry

of the implant medially 6mm while maintaining a constant neck shaft angle and slightly

increasing the length of the taper. The Bi-MetricX-Series addresses lateral offset by

lowering the neck angle, slightly increasing the length of the trunion, and shifting the

neck geometry medially in proportion to the stem size (Figure 3).

Figure 3 The AllianceX-Series implants offer two distinctive

design strategies for restoration of lateral offset.

5

anatomic offsets

enhance joint stability

and help restore hip

biomechanics by providing

the opportunity to tighten

soft tissue without

creating leg length

discrepancies.


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BI-METRIC

HIP SYSTEM

Since its introduction in 1984, the

Bi-MetricHip System continues to provide a

high degree of versatility and unsurpassed clinical

performance. Developed by a team of orthopedic

surgeons and engineers, the Bi-Metrichip stems major

design concept of a 3 bi-planar taper is incorporated

throughout nearly every Biomet hip system. The bi-planar taper

and distinct lateral-to-medial taper provide physiologic proximal load

transfer and preserve distal cortical bone, significantly reducing the likeli-

hood of proximal resorption.

KEY DESIGN FEATURES:

3 Bi-planar taper provides enhanced proximal stress off-loading and initial implant

stability.

Forged titanium for better biocompatibility and a lower modulus of elasticity forenhanced load transfer.

Manufactured with state-of the-art solid modeling and net-shaped forgings.

The titanium plasma spray porous coatings structure acts as a potential barrier to the

migration of particulate debris and provides rotational stability and proven long-term

fixation.

Seven neck lengths allow for accurate leg length adjustment.

Available in collared and collarless designs.

Lateralized option available for proper joint restoration.

Bi-MetricHIP stem:

Uncompromising

design

uniquely functional

reported Long-term

clinical success

bi-metric

porous primary

hip x-series system

6

ExactAllianceInstrumentation

for intraoperative flexibility.

Medialization of the insertion hole

facilitates implant insertion without

interference of the greater trochanter

(Figure 1).

Primary Results at 1012 year follow-up/100% survivorship in 105 hips17

No Osteolysis HHS Increased from an Average of 26

Preoperatively to 92 Postoperatively

No Revisions

811 year follow-up/ 100% AsepticSurvivorship in 67 hips10 3% Thigh Pain

1.5% Osteolysis No Revisions for Aseptic Loosening

515 year follow-up of 118 hips6

No Osteolysis No Thigh Pain

100% Survivorship

Figure 1 Medialized Insertion Hole


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8-Year

Postoperative

At 8-year follow-up

the patient is pain free,

walking 2 miles per day

and doing 20 flights of

stairs per day without

difficulty. Range ofmotion and gait are

normal. Follow-up X-rays

at 8-years show no osteolysis or component subsidence.

Proximal bone quality is excellent.

Immediate

Postoperative

A/P X-ray of a

Bi-Metriccollarless

component.

LATERAL OFFSET RESTORATION:The collarless Bi-MetricPrimary Porous Hip is available in a standard and

lateralized offset. In-depth studies have concluded that femurs with greater hori-

zontal offset often have a more varus neck shaft angle. As the stem size increases,

the required offset also increases.4The Bi-Metriclateralized components design is

based on this philosophy. The offset is achieved by decreasing the neck shaft angle,

medially shifting the trunion and increasing the neck length, while not affecting

leg length (Figure 2).

All of these key features work

in unison to promote gradual

off-loading of stresses from the

femoral component throughout the

entire femur (Figure 3).

Figure 3

Lat. Neck Angle

130.0

Std. Neck Angle

135.0

9mm

7mm

5mm

6mm

Figure 2 Bi-MetricStandard and Lateral Offset

Stems

Bi-MetricLateralized Offset References

Stem Size Additional

Porous Lateralized Offset

810mm 5mm

1114mm 7mm

1517mm 9mm

7

CASE STUDY: Preoperative

Patient was a 61-year

old man who had long

standing bilateral hip

arthritis that severely

limited his activities.


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INSTRUMENTATION

The ExactHip Instrumentation was designed for improved efficiency in the OR. The

system includes precision instrument designs that promote accuracy, provide reproducible

results, and complement Biomets clinically proven femoral components. Alliancefemoral

components can be implanted using only three trays: the General I Insertion case and

the Alliancesystem-specific Reamer and Broach cases (Figure 1). The broach cases can

accommodate up to 12 different neck trunions to support any Allianceimplant. Recognizable

color-coding identifies the instrumentation specific to the selected femoral component.

KEY COMPONENTS OF THE EXACT

INSTRUMENTATION ARE:

A Starter Reamerallows for the initial opening of the femoral canal.

The Offset Chiselprovides a direct view for accessing the piriformis

fossa.

Incrementally sizedMagnetic Trial Necksin standard and

lateralized offsets offer accurate intraoperative biomechanical adjust-

ment during trial reduction. Standard offset is gold while lateralized

offset trial necks are black.

System-Specific Reamerswith new markings that reference both

the greater trochanter and medial resection level.

exacthip instrumentation

offers versatility, simplicity,

and intraoperative flexibility

by providing a common

general instrument case used

in combination with the

Alliancesystem-specific

instrumentation.

General Case 1

The following ExactHip

Instrumentation cases are neededtoimplant the AllianceFamily femoral

components:

AllianceReamers

General Case II (Extraction)

Open only if needed

Alliance

X-Series/ exact

instrumentation experience

AllianceBroaches

Cylindrical Reamers

Optional

8

Figure 1 AllianceReamer and Broach Cases


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TheFemoral Inserterfacilitates implant insertion.

The AllianceFemoral Resection Guideoffers the versatility of

medial and vertical radius reference points from the greater and

lesser trochanter respectively (Figure 2). A convenient trochanter

stop assists in accurate measurement.

The Broach Handle provides solid engagement with a quick, easy

trigger locking mechanism that affords a clear view and a rapid

release. A large impaction plate provides for solid driving contact.

Broachesprovide efficient removal of cancellous bone to contour aprecise envelope for the femoral component. These newly designed

broaches are created utilizing the same data set used to produce the

implant. An innovative cutting tooth design and nitrided surfaces

provide for durability and prolonged life of the cutting edges.

X-RAY TEMPLATES:

PREOPERATIVE PLANNING

The new ExactTemplate system offers a precise technique for implant sizing

and preoperative evaluation of anatomic offset (Figure 3). Vertical and medial scales

correspond to the resection guide to aid in leg length restoration. The templates are

designed to match the color-coded

instrument case for ease of identifica-

tion and offer a table for quick offset

references (Figure 4).

Figure 4 Bi-MetricHip TemplateFigure 3 Preoperative x-ray with new Bi-MetricHipTemplate

Figure 2 AllianceResection Guide and Reamer.Vertical markings on the AllianceResectionGuide correspond to markings on the AllianceReamers for consistent, reproducible results.

9


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bi-metric

primary hip

x-series surgical technique

FEMORAL HEAD RESECTION

Using the Exacttemplates, determine the height of the femoral neck

resection above the lesser trochanter and the height of the tip of the greater

trochanter relative to the shoulder of the femoral component. The Alliance

femoral neck resection guide references these measurements intraoperatively.

Position the femoral neck resection guide parallel to the longitudinal axis of the

femoral shaft. Confirm the height of the femoral neck resection above the lesser

trochanter using the scale on the medial aspect of the resection guide relative

to the preoperative templated X-ray. The vertical scale referenced to the greatertrochanter is an additional conformation of the resection level (Figure 1). Resect

the femoral neck at this level to re-create the appropriate femoral neck length

and offset.

ACCESSING FEMORAL CANAL

The ExactOffset Chisel is used to access the piriformis fossa and to clear

a channel to accept the tapered reamers. The design provides for adequate

visualization for a lateral pathway to avoid varus positioning (Figure 2).

A Starter Reamer on a T-handle may be used to identify the femoral canal

(Figure 3).

Fig. 1

Fig. 2

Fig. 3

10

the bi-metric

femoral component

combines unmatched

clinical success with

new, innovative

instrument design.


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Fig. 8

Fig. 7

Fig. 4

REAMING FEMORAL CANAL

The AllianceExactReamers are proportionally sized tapered reamers with

blunt tips that are used to progressively enlarge the intramedullary canal to the size

estimated by preoperative templating. In determining reamer depth, the proximal

tip of the greater trochanter is used as a landmark to reference the femoral head

center in conjunction with the reference bands on the reamer shaft, femoral

resection guide, and the ExactTemplates (Figure 4). Bands along the reamer

shank reference the vertical scale on the templates and the resection guide, which

correspond to the center of the femoral head (Figure 5). For example, if the

templated vertical scale is a 10, bury the reamer until the 10mm mark on the

reamer corresponds to the top of the greater trochanter for accurate femoral depth.

Begin with a canal reamer that is 34mm smaller than the templated femoral

component. Sequentially ream the femoral canal until cortical chatter is

encountered. It is important to stay lateral and posterior with the femoral reamers

to ensure that the canal is being prepared in neutral alignment with the femoral

axis (Figure 6).

Note: It is important to be lateral in the greater trochanter when broaching and

reaming. A trochanteric reamer (Part No. 31-473192) is available to give additional

lateralization if necessary.

BROACHING PROXIMAL FEMUR

Begin the broaching process with a broach at least 23mm smaller than the

largest reamer used. Attach the broach handle to the broach by pulling back on

the trigger and locking it into place. It is important that the broach is oriented

to produce the desired femoral anteversion. Sequentially increase the size of the

broach until the templated size is reached or until the broach engages the medial

cortex and can not be placed deeper (Figure 7). With the properly sized broach

in place, the calcar can be planed flush by using the retractable calcar planer if

necessary. The calcar planer is specially designed to reach the short broach post and

prevent metal-to-metal wear of the post (Figure 8).

Fig. 5

Fig. 6

11


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bi-metric

primary hip

x-series surgical technique

TRIAL REDUCTION

To perform the trial reduction with the final broach still in place, attach the

appropriate ExactAlliancemagnetic neck trunion over the extended broach

post. The gold trunion indicates standard offset, while the black trunion represents

lateralized offset. The Exactmagnetic trunions are sized to correspond to the

appropriate broach size with the stem size clearly marked on top of the trunion

(Figure 9). Select the trial femoral head of desired diameter and neck length

(If using a collared trial, the collar should rest on the proximal femoral neck)

(Figure 10). Reduce the hip to ensure that proper leg length and joint stability

have been achieved. In performing the trial range of motion, ensure the absence

of impingement of the femoral neck on the rim of the acetabular component or

acetabular liner.

INSERTING POROUS IMPLANT

The stem corresponding to the size of the final broach is threaded onto the

femoral stem inserter. The femoral inserter handle assists in controlling rotation of

the implant and allows the implant to be placed into the femoral envelope with

the proper amount of anteversion (Figure 11). The stem should slide distally into

the canal without much resistance until the stem is 510mm proximal to the calcar.

As resistance is met, gently tap the inserter until the implant is seated. If desired,

another trial reduction can be accomplished prior to impacting the modular head

onto the stem. Provisional heads in seven neck lengths allow an additional trial

reduction using the actual implant to ensure proper leg length and stability. After

fully seating the femoral component, the appropriate modular head is impacted onto

the clean, dry taper (Figure 12).

Fig. 10

Bi-MetricTrunions:

Non-Collared and Collared Standard gold

Non-Collared Lateralized black

Fig. 11

Fig. 12

Fig. 9

12

This brochure demonstrates the surgical technique of John Cuckler, M.D., Professor and Director,Division of Orthopedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama,and Douglas E. Jessup, M.D., Richmond, Virginia.

Biomet as the manufacturer of this device, does not practice medicine and does not recommend this or anyother surgical technique for use on a specific patient. The surgeon who performs any implant procedureis responsible for determining and utilizing the appropriate techniques for implanting the prosthesis in eachindividual patient. Biomet is not responsible for selection of the appropriate surgical technique to be utilized

for an individual patient.


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13

HEAD OPTIONS

-5mm -3mm Std.

-6mm -3mm Std. +3mm +6mm +9mm +12mm

-3mm Std.

-5mm -3mm Std. +3mm +6mm

SURGEON NOTES


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14

ordering information

BI-METRICFEMORAL COMPONENT

Neck Angle Bi-MetricNon-Collared Standard: 135

Neck Angle Bi-MetricNon-Collared Lateralized: 130

Neck Angle Bi-MetricCollared: 140

Stem Stem Implant Std. Implant Lat. Implant Std. Exact

Alliance ExactAlliance

Size Length Non-Collared Non-Collared Collared Broach Tapered Reamer

7mm 115 X180307 X181307 31-400007 31-400027

8mm 120 X180308 X11-180308 X181308 31-400008 31-400028

9mm 125 X180309 X11-180309 X181309 31-400009 31-400029

10mm 130 X180310 X11-180310 X181310 31-400010 31-400030

11mm 135 X180311 X11-180311 X181311 31-400011 31-400031

12mm 140 X180312 X11-180312 X181312 31-400012 31-40003213mm 145 X180313 X11-180313 X181313 31-400013 31-400033

14mm 150 X180314 X11-180314 X181314 31-400014 31-400034

15mm 155 X180315 X11-180315 X181315 31-400015 31-400035

16mm 160 X180316 X11-180316 X181316 31-400016 31-400036

17mm 165 X180317 X11-180317 X181317 31-400017 31-400037

18mm 170 X180318 X11-180318 X181318 31-400018 31-400038

19mm 175 X180319 X11-180319 X181319 31-400019 31-400039

20mm 180 X180320 X11-180320 X181320 31-400020 31-400040

21mm 185 X180321 X11-180321 X181321 31-400021 31-400041


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ExactInstrument Cases:

ExactGeneral Case I

595100

ExactGeneral Case II

595101

AllianceSpecific Cases:

ExactAllianceBroach Case

595105

ExactAllianceTapered Reamer Case

595106

Bi-MetricTemplates:

ExactBi-MetricTemplate Non-Collared

31-400163

Exact

Bi-Metric

Template Collared31-400165

BI-METRICCOLLARED

MAGNETIC NECK TRUNIONS

BI-METRICNON-COLLARED

MAGNETIC NECK TRUNIONS

15

Standard (Gold) Lateralized (Black)

Sizes Part No. Sizes Part No.

710 31-400048 810 31-400160

1114 31-400049 1114 31-400161 1521 31-400050 1521 31-400162

Sizes Part No.

710 31-400045

1114 31-400046 1521 31-400047


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offset information

STANDARD COLLARED BI-METRIC

POROUS PRIMARY

16

Femoral OffsetHorizontal Offset

VerticalOffset

NeckL

ength

NeckAngle

Size

Stem Neck Horizontal Offset Vertical Offset Neck Length

Length Angle -6 -3 STD +3 +6 +9 +12 -6 -3 STD +3 +6 +9 +12 -6 -3 STD +3 +6 +9

7mm 115mm 140 35.1 37.1 39.0 40.9 42.9 44.8 46.7 26.6 28.9 31.2 33.5 35.8 38.1 40.4 28.4 31.4 34.4 37.4 40.4 43.

8mm 120mm 140 35.4 37.4 39.3 41.2 43.2 45.1 47.0 26.7 29.0 31.3 33.6 35.9 38.2 40.5 28.4 31.4 34.4 37.4 40.4 43.

9mm 125mm 140 35.7 37.7 39.6 41.5 43.5 45.4 47.3 26.9 29.2 31.5 33.8 36.1 38.4 40.7 28.4 31.4 34.4 37.4 40.4 43.

10mm 130mm 140 36.0 38.0 39.9 41.8 43.8 45.7 47.6 27.0 29.3 31.6 33.9 36.2 38.5 40.8 28.4 31.4 34.4 37.4 40.4 43.

11mm 135mm 140 36.3 38.3 40.2 42.1 44.1 46.0 47.9 27.1 29.4 31.7 34.0 36.3 38.6 40.9 28.4 31.4 34.4 37.4 40.4 43.

12mm 140mm 140 36.6 38.6 40.5 42.4 44.4 46.3 48.2 27.2 29.5 31.8 34.1 36.4 38.7 41.0 28.4 31.4 34.4 37.4 40.4 43.

13mm 145mm 140 36.9 38.9 40.8 42.7 44.7 46.6 48.5 27.4 29.7 32.0 34.3 36.6 38.9 41.2 28.4 31.4 34.4 37.4 40.4 43.

14mm 150mm 140 37.2 39.2 41.1 43.0 45.0 46.9 48.8 27.5 29.8 32.1 34.4 36.7 39.0 41.3 28.4 31.4 34.4 37.4 40.4 43.

15mm 155mm 140 37.5 39.5 41.4 43.3 45.3 47.2 49.1 27.6 29.9 32.2 34.5 36.8 39.1 41.4 28.4 31.4 34.4 37.4 40.4 43.

16mm 160mm 140 37.8 39.8 41.7 43.6 45.6 47.5 49.4 27.8 30.1 32.4 34.7 37.0 39.3 41.6 28.4 31.4 34.4 37.4 40.4 43.

17mm 165mm 140 38.1 40.1 42.0 43.9 45.9 47.8 49.7 27.9 30.2 32.5 34.8 37.1 39.4 41.7 28.4 31.4 34.4 37.4 40.4 43.

18mm 170mm 140 38.4 40.4 42.3 44.2 46.2 48.1 50.0 28.0 30.3 32.6 34.9 37.2 39.5 41.8 28.4 31.4 34.4 37.4 40.4 43.

19mm 175mm 140 38.7 40.7 42.6 44.5 46.5 48.4 50.3 28.2 30.5 32.8 35.1 37.4 39.7 42.0 28.4 31.4 34.4 37.4 40.4 43.

20mm 180mm 140 39.0 41.0 42.9 44.8 46.8 48.7 50.6 28.3 30.6 32.9 35.2 37.5 39.8 42.1 28.4 31.4 34.4 37.4 40.4 43.

21mm 185mm 140 39.3 41.3 43.2 45.1 47.1 49.0 50.9 28.5 30.8 33.1 35.4 37.7 40.0 42.3 28.4 31.4 34.4 37.4 40.4 43.


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STANDARD NON-COLLARED BI-METRIC

POROUS PRIMARY

LATERALIZED NON-COLLARED BI-METRICPOROUS PRIMARY

Size Stem Neck Horizontal Offset Vertical Offset Neck Length

Length Angle -6 -3 STD +3 +6 +9 +12 -6 -3 STD +3 +6 +9 +12 -6 -3 STD +3 +6 +9 +12

8mm 120mm 130 39.7 42.0 44.3 46.6 48.9 51.2 53.5 27.5 29.4 31.3 33.2 35.2 37.1 39.0 32.5 35.5 38.5 41.5 44.5 47.5 50.

9mm 125mm 130 40.0 42.3 44.6 46.9 49.2 51.5 53.8 27.6 29.5 31.5 33.4 35.3 37.2 39.2 32.5 35.5 38.5 41.5 44.5 47.5 50.

10mm 130mm 130 40.3 42.6 44.9 47.2 49.5 51.8 54.1 27.7 29.6 31.6 33.5 35.4 37.3 39.3 32.5 35.5 38.5 41.5 44.5 47.5 50.

11mm 135mm 130 42.6 44.9 47.2 49.5 51.8 54.1 56.4 27.9 29.8 31.7 33.6 35.6 37.5 39.4 33.7 36.7 39.7 42.7 45.7 48.7 51.

12mm 140mm 130 42.9 45.2 47.5 49.8 52.1 54.4 56.7 28.0 29.9 31.8 33.7 35.7 37.6 39.5 33.7 36.7 39.7 42.7 45.7 48.7 51.

13mm 145mm 130 43.2 45.5 47.8 50.1 52.4 54.7 57.0 28.1 30.0 32.0 33.9 35.8 37.7 39.7 33.7 36.7 39.7 42.7 45.7 48.7 51.

14mm 150mm 130 43.5 45.8 48.1 50.4 52.7 55.0 57.3 28.2 30.2 32.1 34.0 35.9 37.9 39.8 33.7 36.7 39.7 42.7 45.7 48.7 51.

15mm 155mm 130 45.8 48.1 50.4 52.7 55.0 57.3 59.6 28.4 30.3 32.2 34.1 36.1 38.0 39.9 34.8 37.8 40.8 43.8 46.8 49.8 52.

16mm 160mm 130 46.1 48.4 50.7 53.0 55.3 57.6 59.9 28.5 30.4 32.4 34.3 36.2 38.1 40.1 34.8 37.8 40.8 43.8 46.8 49.8 52.

17mm 165mm 130 46.4 48.7 51.0 53.3 55.6 57.9 60.2 28.6 30.6 32.5 34.4 36.4 38.3 40.2 34.8 37.8 40.8 43.8 46.8 49.8 52.

18mm 170mm 130 46.7 49.0 51.3 53.6 55.9 58.2 60.5 28.8 30.7 32.6 34.6 36.5 38.4 40.4 34.8 37.8 40.8 43.8 46.8 49.8 52.

19mm 175mm 130 47.0 49.3 51.6 53.9 56.2 58.5 60.8 28.9 30.9 32.8 34.7 36.6 38.6 40.5 34.8 37.8 40.8 43.8 46.8 49.8 52.

20mm 180mm 130 47.3 49.6 51.9 54.2 56.5 58.8 61.1 29.1 31.0 32.9 34.8 36.8 38.7 40.6 34.8 37.8 40.8 43.8 46.8 49.8 52.

21mm 185mm 130 47.6 49.9 52.2 54.5 56.8 59.1 61.4 29.2 31.1 33.1 35.0 36.9 38.8 40.8 34.8 37.8 40.8 43.8 46.8 49.8 52.

Size

Stem Neck Horizontal Offset Vertical Offset Neck Length

Length Angle -6 -3 STD +3 +6 +9 +12 -6 -3 STD +3 +6 +9 +12 -6 -3 STD +3 +6 +9 +12

7mm 115mm 135 34.8 36.9 39.0 41.1 43.2 45.4 47.5 27.0 29.1 31.2 33.3 35.5 37.6 39.7 28.8 31.8 34.8 37.8 40.8 43.8 46.

8mm 120mm 135 35.1 37.2 39.3 41.4 43.5 45.7 47.8 27.1 29.2 31.3 33.4 35.6 37.7 39.8 28.8 31.8 34.8 37.8 40.8 43.8 46.

9mm 125mm 135 35.4 37.5 39.6 41.7 43.8 46.0 48.1 27.2 29.3 31.5 33.6 35.7 37.8 39.9 28.8 31.8 34.8 37.8 40.8 43.8 46.

10mm 130mm 135 35.7 37.8 39.9 42.0 44.1 46.3 48.4 27.3 29.4 31.6 33.7 35.8 37.9 40.0 28.8 31.8 34.8 37.8 40.8 43.8 46.

11mm 135mm 135 36.0 38.1 40.2 42.3 44.4 46.6 48.7 27.5 29.6 31.7 33.8 36.0 38.1 40.2 28.8 31.8 34.8 37.8 40.8 43.8 46.

12mm 140mm 135 36.3 38.4 40.5 42.6 44.7 46.9 49.0 27.6 29.7 31.8 33.9 36.1 38.2 40.3 28.8 31.8 34.8 37.8 40.8 43.8 46.

13mm 145mm 135 36.6 38.7 40.8 42.9 45.0 47.2 49.3 27.7 29.8 32.0 34.1 36.2 38.3 40.4 28.8 31.8 34.8 37.8 40.8 43.8 46.

14mm 150mm 135 36.9 39.0 41.1 43.2 45.3 47.5 49.6 27.8 30.0 32.1 34.2 36.3 38.4 40.6 28.8 31.8 34.8 37.8 40.8 43.8 46.

15mm 155mm 135 37.2 39.3 41.4 43.5 45.6 47.8 49.9 28.0 30.1 32.2 34.3 36.5 38.6 40.7 28.8 31.8 34.8 37.8 40.8 43.8 46.

16mm 160mm 135 37.5 39.6 41.7 43.8 45.9 48.1 50.2 28.1 30.2 32.4 34.5 36.6 38.7 40.8 28.8 31.8 34.8 37.8 40.8 43.8 46.

17mm 165mm 135 37.8 39.9 42.0 44.1 46.2 48.4 50.5 28.3 30.4 32.5 34.6 36.7 38.9 41.0 28.8 31.8 34.8 37.8 40.8 43.8 46.

18mm 170mm 135 38.1 40.2 42.3 44.4 46.5 48.7 50.8 28.4 30.5 32.6 34.8 36.9 39.0 41.1 28.8 31.8 34.8 37.8 40.8 43.8 46.

19mm 175mm 135 38.4 40.5 42.6 44.7 46.8 49.0 51.1 28.5 30.7 32.8 34.9 37.0 39.1 41.3 28.8 31.8 34.8 37.8 40.8 43.8 46.

20mm 180mm 135 38.7 40.8 42.9 45.0 47.1 49.3 51.4 28.7 30.8 32.9 35.0 37.2 39.3 41.4 28.8 31.8 34.8 37.8 40.8 43.8 46.

21mm 185mm 135 39.0 41.1 43.2 45.3 47.4 49.6 51.7 28.8 30.9 33.1 35.2 37.3 39.4 41.5 28.8 31.8 34.8 37.8 40.8 43.8 46.


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P.O. Box 587, Warsaw, IN 46581-0587 574.267.6639 2002 Biomet Orthopedics, Inc. All Rights Reservedweb site: www.biomet.com eMail: [email protected]

Form No. Y-BMT-761/053102/K

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Total Hip Arthroplasty in Octogenarians.J. Bone Joint Surg., 83-A: 359, 2001.

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2001to be published inJ. Arthroplast y.

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Titanium Plasma-Spray Coated Total Hip Arthroplasty Femoral Component:

Justification for Continuance of Use. Presented at the Annual Meeting of the

AAOS, Orlando, FL, February, 1995.

Alliance, Bi-Metric, Mallory-Head, Taperloc, Exact

and Integralare trademarks of Biomet, Inc.

All other trademarks are not associated with Biomet.

14. Maloney, W.; et al.: Fibroblastic Response to Particulate Metallic Debris.

Trans. Implant Retrieval Symposium of the Society of Biomaterials, 34, 1992.

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Femoral Component. J. Bone Jo int Surg., 79-B: 900907, 1997.

17. Meding, J.B.: Minimum Ten-Year Follow-Up of a Straight-Stemmed, Plasma-

Sprayed, Titanium-Alloy, Uncemented Femoral Component. Presented at

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