Cemented Cup System Modular Instruments Exceed AB… · 09/11/2016 · Exceed ABT Cemented Cup...
Transcript of Cemented Cup System Modular Instruments Exceed AB… · 09/11/2016 · Exceed ABT Cemented Cup...
Surgical Technique
Exceed ABT Cemented Cup System Modular Instruments
Over 1 million times per year, Biomet helps one surgeon
provide personalized care to one patient.
The science and art of medical care is to provide the right
solution for each individual patient. This requires clinical
mastery, a human connection between the surgeon and the
patient, and the right tools for each situation.
At Biomet, we strive to view our work through the eyes of
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provide as if it’s meant for a family member.
Our approach to innovation creates real solutions that assist
each surgeon in the delivery of durable personalized care
to each patient, whether that solution requires a minimally
invasive surgical technique, advanced biomaterials or a
patient-matched implant.
When one surgeon connects with one patient to provide
personalized care, the promise of medicine is fulfilled.
One Surgeon. One Patient.
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Exceed ABT Cemented Cup System Modular Instruments
ContentsSystem Overview ................................................................................................................................................... 2
Surgical Technique
Step 1.0 – Pre-operative Planning ...................................................................................................................... 6
Step 2.0 – Patient Positioning ............................................................................................................................ 7
Step 3.0 – Acetabular Preparation – Reaming ................................................................................................... 7
Step 4.0 – Acetabular Preparation – Instrument Preparation ............................................................................ 10
Step 5.0 – Acetabular Preparation – Trial Flange .............................................................................................. 12
Step 6.0 – Acetabular Preparation – Cement Fixation Holes ............................................................................ 13
Step 7.0 – Cement Preparation and Application .............................................................................................. 14
Step 8.0 – Component Insertion ...................................................................................................................... 15
8a. Combined Instruments ...................................................................................................................... 16
8b. Independent instruments ................................................................................................................... 18
8c. Cup Positioning ................................................................................................................................. 19
Step 9.0 – Femoral Component Insertion......................................................................................................... 19
Instrument Overview ........................................................................................................................................... 20
Acetabular Cemented Toolkit ............................................................................................................................. 23
Implant Codes
Flanged ............................................................................................................................................................ 25
Trial Flanges ..................................................................................................................................................... 25
Non-Flanged .................................................................................................................................................... 26
Muller ............................................................................................................................................................... 27
Modular Heads 12/14 Taper ............................................................................................................................ 28
Modular Heads Type 1 Taper ........................................................................................................................... 28
Exceed ABT Cemented Cup E1 and ArCom Sizing Charts .................................................................................... 30
The Complete Exceed ABT Family .................................................................................................................... 32
Exceed ABT Cemented Cup System Modular Instruments
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System Overview
The Exceed ABT Cemented Cup System offers a complete system of Flanged, and Non Flanged variant designs, available in both ArCom and E1 Antioxidant Infused Technology.
PMMA SpacersPre-assembled 3 mm cement spacers to maintain a minimum thickness of cement mantle and reduce therisk of bottoming out.
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Cement Flange Flexible flange aiding cement retention and pressurisation. Trimmable to allow for appropriate acetabular size matching.
X-Ray Marker wiresPre-assembled radial and circumferential titanium marker wire allows for identification of cup positioning on x-ray.
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Elongated posterior wall120 degrees of circumferential coverage, the elongated posterior wall offers additional head coverage and protection against dislocation.
Range of Head diameters28, 32, 36 and 40 mm head diameters available offering improved stability and protection against dislocation without compromising wear characteristics.
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Feature Availability
Diameter Flanged Non-Flanged Muller
ArComØ28 mm X X X
Ø32 mm X X X
E1 Antioxidant Infused TechnologyØ28 mm X X X
Ø32 mm X X X
Ø36 mm X X X
Ø40 mm X X X
Circumferential Marker Wire X X X
Radial Marker Wire X X
PMMA Spacers X X
Elongated Posterior Wall X X
Trimmable Flange X
Low Profile X
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Step 1.0 Pre-Operative Planning
Selection of the correct acetabular component is attained through careful pre-operative planning.
This can be achieved manually by means of x-ray templates, or digitally by means of a Picture Archiving and Communication System (PACS).
1a. Manual Pre-Operative PlanningX-ray templates are available for all design versions of the Exceed ABT Cemented Cups in 100%, 110%, 115% and 120% magnifications.
These templates are positioned over the AP x-rays to best decide the correct implant size, centre of rotation and to ensure a complete cement mantle is achieved.
1b. Digital Pre-operative PlanningThe Exceed ABT Cemented acetabular system digital templates are available through various digital template providers.
When using digital templating for a primary THR, it is necessary to use a magnification marker with a known dimension. This is required in order for the system to calculate the correct magnification.
As soon as the correct magnification has been determined, the system can be used to best decide the correct implant size, centre of rotation and to ensure a complete cement mantle is achieved.
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Step 2.0 Patient Positioning
The Exceed ABT Cemented cup can be implanted using any of the standard approaches for total hip arthroplasty.
In any approach the goal is to achieve a full exposure of the acetabulum and the proximal femur.
Step 3.0 Acetabulum Preparation - Reaming3a. Reamer AssemblyThe acetabular grater reamers are prepared by securely placing the reamer onto the drive shaft using the locking mechanism as demonstrated in figure 3a and described below:
1. Retract locking pins and place reamer on shaft
2. Rotate reamer to locked position
3. Release locking pins to secure
Figure 3a
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Step 3.0 Continued Acetabulum Preparation - Reaming3b. Reamer DisassemblyThe reamer is disassembled by following the steps as shown in figure 3b (ii) and described below:
1. Retract locking pins
2. Rotate reamer to release position
3. Remove from the shaft
Figure 3b (ii)Figure 3b (i)
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3c. Acetabular ReamingThe acetabular rim is identified and residual capsule, synovium and any osteophytes are removed. Gouges can be used to remove any osteophytes and identify the true acetabular floor.
Consecutive reamers are used to shape and prepare the acetabulum, ensuring that the anterior and posterior walls are not over reamed.
Figure 3c
During reaming of the acetabulum the shaft of the reamer must be orientated at 30-40° of abduction (inclination), with desired angle of anteversion, depending on the approach used.
All articular cartilage is removed and a layer of bleeding subchondral bone is exposed. Cancellous surface should be exposed wherever possible with the exception of the true medial wall.
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Figure 4a (i) Figure 4a (ii)
Step 4.0 Acetabular Preparation – Instrument Preparation4a. Introducer Handle AssemblyInserter assemblies are attached to the inserter handle to produce the complete introducer.
To assemble: The inserter assembly shaft is inserted into the barrel of the inserter handle as shown in figure 4a (i). Notches on either side of the handle thread correspond to nipples on inserter assemblies to aid the correct orientation of the introducer plate. When correct orientation is achieved, the locking nut is tightened as shown in figure 4a (ii).
N.B. Failing to locate the inserter assembly into thread notches correctly will not allow full tightening of the locking nut.
To disassemble: reverse steps shown in figures 4a (i) and (ii) to release locking nut and remove inserter assembly shaft from inserter handle.
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Step 4.0 Continued Acetabular Preparation – Instrument Preparation4b. Cup TriallingThe appropriate trial cup is selected; this is defined by the last reamer size used.i.e if ream Ø = 52 mm, trial cup = 52 mm.
The trial cup size refers to the outer diameter of the cement mantle which is assumed to be 3mm for all cup designs. In the case of Flanged and Non-Flanged cups, this is also the outer diameter of the cement spacers. For the Muller cup, if a different mantle thickness is required, please refer to pages 30-32 for true outer diameter size of the polyethylene.
The appropriate sized inserter plate is then selected based on required head size.
The inserter plate is attached to the inserter handle assembly by aligning the inserter plate open end with the open end of the inserter handle. Align the inserter plate holes with boss on the inserter handle. Then push forward to lock as shown in figure 4b (i).
The trial cup is assembled onto the cup inserter as shown in figure 4b (ii) and 4b (iii) and introduced into the acetabulum as shown in figure 4b (iv) to confirm the size of the acetabulum and to ensure it is correctly seated.
The trial cup is released by pressing the trigger on the inserter handle as shown in figure 4b (v).
Once trial has been completed, remove trial cup and inserter plate from inserter handle assembly.
Figure 4b (i)
Figure 4b (iii)Figure 4b (ii) Figure 4b (v)
Figure 4b (iv)
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Step 5.0 Acetabular Preparation – Trial FlangeFOR FLANGED CUP ONLYThe appropriate trial flange is selected corresponding with the trial cup size i.e if the trial cup = 60 mm, trial flange = 60 mm.
The trial flange is placed on the trial cup and both are applied onto the inserter handle assembly and inserter plate as shown in figure 5 (i) and introduced into the acetabulum as shown in figure 5 (ii).
The trial flange is used to assess required shape of the definitive implant flange and can be trimmed with the flange scissors. Figure 5 (iii)
The trial cup and flange are released by pressing the trigger as shown in figure 4b (v).
Once trial has been completed, remove inserter plate from inserter handle assembly.
The trial flange is then placed over the definitive implant and used as a template for trimming of the definitive implant flange with the flange scissors.
The trial flange is then removed and disposed of.
Figure 5 (i) Figure 5 (iii)
Figure 5 (ii)
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Figure 6
Step 6.0 Acetabular Preparation – Cement Fixation Holes
When appropriate reaming has been achieved, cement fixation holes can be introduced to the ilium, ischium and pubis using the stop drill to enhance cement fixation with the bone surface. Figure 6.
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Figure 7 (i)
Step 7.0 Cement Preparation and Application
N.B: Before commencing cement preparation, please ensure that you are familiar with the insertion methods described in Step 8 and that all instruments are prepared for insertion of definitive implant.
The prepared acetabular surface should be thoroughly cleaned using high pressure pulse lavage. The acetabulum should then be dried and can be packed with swabs whilst the bone cement is mixed.
The use of a high quality, high viscosity, antibiotic-loaded bone cement is recommended to reduce the risk of infection and aseptic loosening. It is also recommended to mix cement in a closed vacuum mixing system such as Optivac or Optipac to reduce cement porosity and exposure to monomer fumes.
Figure 7 (ii)
N.B: When mixing bone cement, always refer to the manufacturers recommended mixing instructions.
40g of cement should be sufficient for the average acetabulum, which is delivered as a bolus using a cement gun, figure 7 (i). Pressure should be applied and maintained to ensure micro interlock, figure 7 (ii), until cement is sufficiently doughy.
At this point the definitive implant should be inserted using the cup introducer, maintaining adequate and constant pressure and ensuring an even cement mantle is maintained.
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Step 8.0 Component Insertion
Using the pre-assembled inserter handle assembly, select the appropriate sized inserter plate for the definitive implant articulation diameter: Ø28 mm, Ø32 mm, Ø36 mm, or Ø40 mm. Figure 8 (i).
The R and L on the inserter plates correspond to either a right or left hip. When assembling the inserter plates to the inserter handle assembly ensure that the either R or L corresponds on both.
To confirm correct orientation of the plate onto the inserter assembly, tilt the assembly to either the left or right and check that the groove on the side face of the plate is aligned with the groove on the side face of the inserter assembly. For a left hip the grooves will be aligned on the left hand side and for a right hip they will be aligned on the right hand side.
The corresponding sized pusher head should then be fitted to the cup pusher handle.
The cup introducer and cup pusher have been designed to allow for two methods for cup insertion:
8a. Combined Instruments
The cup pusher and inserter handle assembly can be combined to allow for ‘continuous pressurisation’.
The continuous pressurisation method maintains pressure throughout cement curing with the cup pusher while allowing the removal of the inserter handle assembly following cup positioning. As shown in Figure 8a (i).
8b. Independent Instruments
The cup pusher head is placed on top of inserter plate requiring release of pressure to remove the inserter handle assembly. As shown in Figure 8b (i).
Figure 8 (i) Figure 8a (i) Figure 8b (i)
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Figure 8a (ii) Figure 8a (iv)
Figure 8a (iii)
Step 8.0 Continued Component Insertion8a. Combined InstrumentsThe cup pusher and cup inserter can be combined to create one instrument.
To assemble: The shaft of the pusher handle is inserted through the slot of the inserter handle assembly and inserter plate as shown in figure 8a (ii) and turned 90° to engage the pin on the top of the inserter plate as shown in figure 8a (iii).
The definitive implant is applied to the combined cup pusher and inserter handle assembly and introduced into the acetabulum, as shown in figure 8a (iv).
NB: Care should be taken to ensure the following on the flanged or non flanged implant variants: For a right hip the indented line on the front face of the implant should be positioned at 9 o’clock. For a left hip it should be positioned at 12 o’clock.
Continuous pressure is maintained using the pusher handle while positioning is achieved. Any excess cement can be removed from the acetabular tissue.
When positioning has been achieved, the inserter handle assembly can be disengaged from the cup pusher and removed whilst maintaining continuous pressure with the cup pusher.
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Figure 8a (v) Figure 8a (vii)
Figure 8a (vi)
Step 8.0 Continued Component Insertion
To disengage: Turn the pusher handle 90° to disengage the pin on the top of the inserter plate. Figure 8a (v).
Push the pusher through the slot until the head makes contact with bearing surface and maintain continuous pressure.
Release the cup by pressing the trigger on the inserter handle assembly. Leaving the trigger pressed will retain the inserter plates. Figure 8a (vi).
Figure 8a (viii)
NB: Leave the trigger lever pressed as shown in figure 8a (vi) by maintaining pressure. Leaving the trigger pressed during disengagement with the implant will prevent separation of the inserter plate. Figure 8a (vii)
Holding the pusher in position and maintaining continuous pressure, remove the cup inserter in a smooth upward motion and slide the slot away from the shaft as shown in figure 8a (vii). The cup pusher can remain in place. Figure 8a (viii).
N.B: care should be taken not to disrupt the positioning of the cup.
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Step 8.0 Continued Component Insertion8b. Independent InstrumentsSelect correct cup location head which corresponds with the size of the inserter plate. Attach the cup location head onto the inserter handle assembly and inserter plate as shown in figure 8b (ii).
The definitive implant is assembled onto the inserter handle assembly and inserted into the acetabulum.
NB: Care should be taken to ensure the following on the flanged or non flanged implant variants: For a right hip the indented line on the front face of the implant should be positioned at 9 o’clock. For a left hip it should be positioned at 12 o’clock.
The cup pusher head is placed into the recess on top of the inserter handle assembly and pressure is applied and maintained as shown in figure 8b (iii). Any excess cement can be removed from the acetabular tissue.
When positioning has been achieved, remove the cup pusher from the top of the inserter handle assembly. Release the cup by pressing the trigger on the inserter handle assembly. Remove the inserter handle assembly. Figures 8b (iv).
NB: Leave the trigger lever pressed as shown in figure 8b (iv) by maintaining pressure. Leaving the trigger pressed during disengagement with the implant will prevent separation of the inserter plate.
Replace the cup pusher into the cup and apply pressure to the bearing surface of the cup until the cement has completely cured. Figure 8b (v)
Figure 8b (ii)
Figure 8b (iv)
Figure 8b (iii)
Figure 8b (v)
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Figure 8c (i) Figure 8c (ii)
Step 8.0 Continued Component Insertion8c. Positioning The cup inserter is designed to present the cup at 45° when the shaft of the inserter is orientated at 90° to the long axis of the body as shown in figure 8c (i).
The alignment rod offers 20° of antiversion when orientated distally along the long axis of the body, i.e. with the patient lying in the lateral decubitus position, the shaft will be vertical and the alignment rod horizontal in the direction of the feet as shown in figure 8c (ii).
N.B: these alignment rods are intended to be used as a guide only
Step 9.0 Femoral Component Insertion With the cup in position, femoral component implantation can continue, allowing for trial reduction and determination of leg length.
N.B: The head diameter of any head used for a trial reduction must match the inner diameter of the acetabular cup.
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Product Label Part Number Size Description
A 31-60108102 — Exceed ABT Alignment Rod (x2 required)
B
31-60172831-60173231-60173631-601740
28 mm32 mm36 mm40mm
Exceed ABT Cemented Pusher Head Ø28 mmExceed ABT Cemented Pusher Head Ø32 mmExceed ABT Cemented Pusher Head Ø36 mmExceed ABT Cemented Pusher Head Ø40 mm
C 31-601409 — Exceed ABT Cemented Cup Inserter Handle
D
31-60174631-60174831-60175031-60175231-60175431-60175631-60175831-601760
46 mm48 mm50 mm52 mm54 mm56 mm58 mm60 mm
Exceed ABT Cemented Trial Cup Ø46 mmExceed ABT Cemented Trial Cup Ø48 mmExceed ABT Cemented Trial Cup Ø50 mmExceed ABT Cemented Trial Cup Ø52 mmExceed ABT Cemented Trial Cup Ø54 mmExceed ABT Cemented Trial Cup Ø56 mmExceed ABT Cemented Trial Cup Ø58 mmExceed ABT Cemented Trial Cup Ø60 mm
E 31-601415 — Exceed ABT Cemented Cup Flange Scissors
C
A
D
B
E
31-601720 Exceed ABT Cemented Cup Modular Instruments (Top Layer)
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Product Part Number Size Description
F 31-601710 — Exceed ABT Cemented Cup Inserter Assembly
G 31-601508 — Exceed ABT Cemented Step Drill
H 31-601414 — Exceed ABT Cemented Pusher Handle
I
31-60170431-60170531-60170631-601707
—
Exceed ABT Cemented Cup Location Head Ø28 mmExceed ABT Cemented Cup Location Head Ø32 mmExceed ABT Cemented Cup Location Head Ø36 mmExceed ABT Cemented Cup Location Head Ø40 mm
J
31-60170031-60170131-60170231-601703
—
Exceed ABT Cemented Cup Inserter Plate Ø28 mmExceed ABT Cemented Cup Inserter Plate Ø32 mmExceed ABT Cemented Cup Inserter Plate Ø36 mmExceed ABT Cemented Cup Inserter Plate Ø40 mm
Product Part Number Size Description
K 31-601536 — Exceed ABT Cemented Cup Inserter Spring
L 31-601537 — Exceed ABT Cemented Cup Piston End
31-601507 — Exceed ABT Cemented X-Ray Template Set
F
G H
I
J L
K
31-601720 Exceed ABT Cemented Cup Modular Instruments (Bottom Layer)
31-601720 Exceed ABT Cemented Cup Modular Instruments Spare Items
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Product Part Number Size Description
31-600057 12” Acetabular Reamer Driver
31-10063831-10063931-10064031-10064131-10064231-10064331-10064431-10064531-10064631-10064731-10064831-10064931-10065031-10065131-10065231-10065331-10065431-10065531-10065631-10065731-10065831-10065931-10066031-10066131-10066231-10066331-10066431-10066531-10066631-10066731-10066831-10066931-100670
38 mm39 mm40 mm41 mm42 mm43 mm44 mm45 mm46 mm47 mm48 mm49 mm50 mm51 mm52 mm53 mm54 mm55 mm56 mm57 mm58 mm59 mm60 mm61 mm62 mm63 mm64 mm65 mm66 mm67 mm68 mm69 mm70 mm
Grater Reamer Ø38 mmGrater Reamer Ø39 mmGrater Reamer Ø40 mmGrater Reamer Ø41 mmGrater Reamer Ø42 mmGrater Reamer Ø43 mmGrater Reamer Ø44 mmGrater Reamer Ø45 mmGrater Reamer Ø46 mmGrater Reamer Ø47 mmGrater Reamer Ø48 mmGrater Reamer Ø49 mmGrater Reamer Ø50 mmGrater Reamer Ø51 mmGrater Reamer Ø52 mmGrater Reamer Ø53 mmGrater Reamer Ø54 mmGrater Reamer Ø55 mmGrater Reamer Ø56 mmGrater Reamer Ø57 mmGrater Reamer Ø58 mmGrater Reamer Ø59 mmGrater Reamer Ø60 mmGrater Reamer Ø61 mmGrater Reamer Ø62 mmGrater Reamer Ø63 mmGrater Reamer Ø64 mmGrater Reamer Ø65 mmGrater Reamer Ø66 mmGrater Reamer Ø67 mmGrater Reamer Ø68 mmGrater Reamer Ø69 mmGrater Reamer Ø70 mm
31-600055 Grater Reamer Tray Assembly (1 mm Increments)
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Refobacin® is a licensed trademark from Merck KGaA, Germany
Product Part Number Size Description
4740500394
1 cartridge of 40.8 g powder1 pouch of 20 ml liquid1 cartridge of 81.6 g2 pouches of 20 ml
For two cement mixings at total hip arthroplasty
Optipac Hip Set (40 & 80)
Refobacin® Bone Cement R
47105003941 cartridge of 40.8 g powder
1 pouch of 20 ml liquid
Optipac 40
Refobacin® Bone Cement R
30039400011 sachet of 40.8 g powder 1 ampoule of 20 ml liquid Refobacin® Bone Cement R
4150
For two cement mixings, e.g. 40 g and 80 g for total hip
arthroplastyOptivac Hip Set
4161For a single mix of 20 g to 40 g
cement,Optivac S
Acetabular Cemented Toolkit
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Product Part Number Size Description
4195
Cement gun for mixing systemsLight weight delivery system made of aluminium, with a
rachet system Weight 0.79 kg
Optigun Ratchet
4232Vacuum Pump with silencer
Includes inlet hoseVacuum Pump
4236Air Hose for Vacuum Pump
5 metresAir Hose
4410 —OptiLavage Hand Unit with Biomet
(Universal) connector incl. Instrument Oil (REF 4417)
4407 Length 3 m Air Hose British Standard for 4410
4433* —End Cap OptiLavage, for Air hose
4411 and 4407
4413Tubing: length 3 m Nozzle:
length 10 cmStandard Set
4414Tubing:length 3 m
Nozzle: lengths 10 cm and 25 cm
Hip Set
4424 — Splash Shield large, conical
4324 32 mm ProCup
4316 — Acetabular Pressurizer, Ø 50 mm
4317 — Acetabular Pressurizer, Ø 57 mm
4321 — Acetabular Pressurizer, Ø 63 mm
4322 — Acetabular Pressurizer, Ø 71 mm
4327 —Handle for Acetabular Pressurizer, to
be used with 4321 and 4322
4318 —Handle for Acetabular Pressurizer, to
be used with 4316 and 4317
4319 —
Angled Handle for Acetabular Pres-surizer, compatible with all Acetabu-lar Pressurizers (4316, 4317, 4321,
4322).
Acetabular Cemented Toolkit (cont’d)
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Implant CodesFlanged Cemented Cup
E1 Flanged Cup
E1 sizeArticulation Diameter
28 32 36 40
46 EP-102846
48 EP-102848
50 EP-102850 EP-103250
52 EP-102852 EP-103252
54 EP-102854 EP-103254 EP-103654
56 EP-102856 EP-103256 EP-103656
58 EP-102858 EP-103258 EP-103658 EP-104058
60 EP-102860 EP-103260 EP-103660 EP-104060
ArCom Flanged Cup
ArCom size
Articulation Diameter
28 32
46 Only available in E1
48 AR-102848
50 AR-102850 Only available in E1
52 AR-102852 AR-103252
54 AR-102854 AR-103254
56 AR-102856 AR-103256
58 AR-102858 AR-103258
60 AR-102860 AR-103260
Cup Size 46 Head Ø28 and Cup Size 50 Head Ø32 only available in E1
Trial Flanges
Part No. Description31-601846 Exceed ABT Cemented Trial Flange Ø46mm
31-601848 Exceed ABT Cemented Trial Flange Ø48mm
31-601850 Exceed ABT Cemented Trial Flange Ø50mm
31-601852 Exceed ABT Cemented Trial Flange Ø52mm
31-601854 Exceed ABT Cemented Trial Flange Ø54mm
31-601856 Exceed ABT Cemented Trial Flange Ø56mm
31-601858 Exceed ABT Cemented Trial Flange Ø58mm
31-601860 Exceed ABT Cemented Trial Flange Ø60mm
Trial Flanges
N.B: Trial flanges are supplied individually sterile packed and are single use only.
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ArCom Non-Flanged Cup
ArCom size
Articulation Diameter
28 32
46 Only available in E1
48 AR-112848
50 AR-112850 Only available in E1
52 AR-112852 AR-113252
54 AR-112854 AR-113254
56 AR-112856 AR-113256
58 AR-112858 AR-113258
60 AR-112860 AR-113260
Cup Size 46 Head Ø28 and Cup Size 50 Head Ø32 only available in E1
E1 Non-Flanged Cup
E1 sizeArticulation Diameter
28 32 36 40
46 EP-112846
48 EP-112848
50 EP-112850 EP-113250
52 EP-112852 EP-113252
54 EP- 112854 EP-113254 EP-113654
56 EP-112856 EP-113256 EP-113656
58 EP-112858 EP-113258 EP-113658 EP-114058
60 EP-112860 EP-113260 EP-113660 EP-114060
Implant Codes (cont’d)Non-Flanged Cup
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E1 Muller Cup
E1 sizeArticulation Diameter
28 32 36 40
46 EP-122846
48 EP-122848
50 EP-122850 EP-123250
52 EP-122852 EP-123252
54 EP-122854 EP-123254 EP-123654
56 EP-122856 EP-123256 EP-123656
58 EP-122858 EP-123258 EP-123658 EP-124058
60 EP-122860 EP-123260 EP-123660 EP-124060
ArCom Muller Cup
ArCom size
Articulation Diameter
28 32
46 Only available in E1
48 AR-122848
50 AR-122850 Only available in E1
52 AR-122852 AR-123252
54 AR-122854 AR-123254
56 AR-122856 AR-123256
58 AR-122858 AR-123258
60 AR-122860 AR-123260
Cup Size 46 Head Ø28 and Cup Size 50 Head Ø32 only available in E1
Implant Codes (cont’d)Muller Cup
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Head Offset
CoCrMo Modular HeadsC2A-Delta Ceramic
Modular HeadsC2A-Delta Ceramic Option Head
Ø28 mm Ø32 mm Ø36 mm Ø40 mm Ø28 mm Ø32 mm Ø36 mm
Ø28 mm Ø32 mm Ø36 mm Ø40 mm
650-1055 650-1056 650-1057 650-1058
Option Taper Sleeves (Type 12/14)
-4 mm - 650-0882 650-0887 650-1020 - 650-0833 650-0836 -
-3.5 mm 650-0877 - - - 650-0830 - - -
-3 mm - - - - - - - 650-1060
0 mm 650-0878 650-0883 650-0888 650-1021 650-0831 650-0834 650-0837 650-1061
+3.5 mm 650-0879 - - - 650-0832 - - -
+4 mm - 650-0884 650-0889 650-1022 - 650-0835 650-0838 650-1062
+7 mm 650-0880* - - - - - - 650-1063
+8 mm - - 650-0890 650-1023 - - 650-0667 -
+12 mm - - 650-0891* 650-1024 - - - -
*= Not for use for metal on metal articulation
Head Offset
CoCrMo Modular HeadsC2A-Delta Ceramic
Modular HeadsC2A-Delta Ceramic Option Head
Ø28 mm Ø32 mm Ø36 mm Ø40 mm Ø28 mm Ø32 mm Ø36 mm
Ø28 mm Ø32 mm Ø36 mm Ø40 mm
650-1055 650-1056 650-1057 650-1058
Option Taper Sleeves (Type 1)
-6mm 650-0863 650-0870 650-0839 650-1030 - - - 650-1064
-3mm 650-0864 650-0871 650-0840 650-1031 164135 164185 650-0660 650-1065
0mm 650-0865 650-0872 650-0841 650-1032 164136 164186 650-0661 650-1066
+3mm 650-0866 650-0873 650-0842 650-1033 164137 164187 650-0662 650-1067
+6mm 650-0867 650-0874 650-0843 650-1034 - - 650-0663 650-1068
+9mm - - 650-0844 650-1035 - - - -
+12 mm - - 650-0845* 650-1036 - - - -
Modular Heads - Biomet Type 1 Taper
*= Not for use for metal on metal articulation
Implant Codes (cont’d)Modular Heads - Biomet 12/14 Taper
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Exceed ABT Cemented Cups: E1 and ArCom: True Outer Diameter Size
Product
CodeE1 Flanged Head Size Size True OD Size
Ream Size For:
3 mm Cement
Mantle
EP-102846 Exceed ABT CMTD E1 Flanged Cup 28X46 mm 28 Ø28 x 46 mm 40 mm 46
EP-102848 Exceed ABT CMTD E1 Flanged Cup 28X48 mm 28 Ø28 x 48 mm 42 mm 48
EP-102850 Exceed ABT CMTD E1 Flanged Cup 28X50 mm 28 Ø28 x 50 mm 44 mm 50
EP-102852 Exceed ABT CMTD E1 Flanged Cup 28X52 mm 28 Ø28 x 52 mm 46 mm 52
EP-102854 Exceed ABT CMTD E1 Flanged Cup 28X54 mm 28 Ø28 x 54 mm 48 mm 54
EP-102856 Exceed ABT CMTD E1 Flanged Cup 28X56 mm 28 Ø28 x 56 mm 50 mm 56
EP-102858 Exceed ABT CMTD E1 Flanged Cup 28X58 mm 28 Ø28 x 58 mm 52 mm 58
EP-102860 Exceed ABT CMTD E1 Flanged Cup 28X60 mm 28 Ø28 x 60 mm 54 mm 60
EP-103250 Exceed ABT CMTD E1 Flanged Cup 32X50 mm 32 Ø32 x 50 mm 44 mm 50
EP-103252 Exceed ABT CMTD E1 Flanged Cup 32X52 mm 32 Ø32 x 52 mm 46 mm 52
EP-103254 Exceed ABT CMTD E1 Flanged Cup 32X54 mm 32 Ø32 x 54 mm 48 mm 54
EP-103256 Exceed ABT CMTD E1 Flanged Cup 32X56 mm 32 Ø32 x 56 mm 50 mm 56
EP-103258 Exceed ABT CMTD E1 Flanged Cup 32X58 mm 32 Ø32 x 58 mm 52 mm 58
EP-103260 Exceed ABT CMTD E1 Flanged Cup 32X60 mm 32 Ø32 x 60 mm 54 mm 60
EP-103654 Exceed ABT CMTD E1 Flanged Cup 36X54 mm 36 Ø36 x 54 mm 48 mm 54
EP-103656 Exceed ABT CMTD E1 Flanged Cup 36X56 mm 36 Ø36 x 56 mm 50 mm 56
EP-103658 Exceed ABT CMTD E1 Flanged Cup 36X58 mm 36 Ø36 x 58 mm 52 mm 58
EP-103660 Exceed ABT CMTD E1 Flanged Cup 36X60 mm 36 Ø36 x 60 mm 54 mm 60
EP-104058 Exceed ABT CMTD E1 Flanged Cup 40X58 mm 40 Ø40 x 58 mm 52 mm 58
EP-104060 Exceed ABT CMTD E1 Flanged Cup 40X60 mm 40 Ø40 x 60 mm 54 mm 60
Product
CodeE1 Non Flanged Head Size Size True OD Size
Ream Size For:
3 mm Cement
Mantle
EP-112846 Exceed ABT CMTD E1 N/Flng Cup 28X46 mm 28 Ø28 x 46 mm 40 mm 46
EP-112848 Exceed ABT CMTD E1 N/Flng Cup 28X48 mm 28 Ø28 x 48 mm 42 mm 48
EP-112850 Exceed ABT CMTD E1 N/Flng Cup 28X50 mm 28 Ø28 x 50 mm 44 mm 50
EP-112852 Exceed ABT CMTD E1 N/Flng Cup 28X52 mm 28 Ø28 x 52 mm 46 mm 52
EP-112854 Exceed ABT CMTD E1 N/Flng Cup 28X54 mm 28 Ø28 x 54 mm 48 mm 54
EP-112856 Exceed ABT CMTD E1 N/Flng Cup 28X56 mm 28 Ø28 x 56 mm 50 mm 56
EP-112858 Exceed ABT CMTD E1 N/Flng Cup 28X58 mm 28 Ø28 x 58 mm 52 mm 58
EP-112860 Exceed ABT CMTD E1 N/Flng Cup 28X60 mm 28 Ø28 x 60 mm 54 mm 60
EP-113250 Exceed ABT CMTD E1 N/Flng Cup 32X50 mm 32 Ø32 x 50 mm 44 mm 50
EP-113252 Exceed ABT CMTD E1 N/Flng Cup 32X52 mm 32 Ø32 x 52 mm 46 mm 52
EP-113254 Exceed ABT CMTD E1 N/Flng Cup 32X54 mm 32 Ø32 x 54 mm 48 mm 54
EP-113256 Exceed ABT CMTD E1 N/Flng Cup 32X56 mm 32 Ø32 x 56 mm 50 mm 56
EP-113258 Exceed ABT CMTD E1 N/Flng Cup 32X58 mm 32 Ø32 x 58 mm 52 mm 58
EP-113260 Exceed ABT CMTD E1 N/Flng Cup 32X60 mm 32 Ø32 x 60 mm 54 mm 60
EP-113654 Exceed ABT CMTD E1 N/Flng Cup 36X54 mm 36 Ø36 x 54 mm 48 mm 54
EP-113656 Exceed ABT CMTD E1 N/Flng Cup 36X56 mm 36 Ø36 x 56 mm 50 mm 56
EP-113658 Exceed ABT CMTD E1 N/Flng Cup 36X58 mm 36 Ø36 x 58 mm 52 mm 58
EP-113660 Exceed ABT CMTD E1 N/Flng Cup 36X60 mm 36 Ø36 x 60 mm 54 mm 60
EP-114058 Exceed ABT CMTD E1 N/Flng Cup 40X58 mm 40 Ø40 x 58 mm 52 mm 58
EP-114060 Exceed ABT CMTD E1 N/Flng Cup 40X60 mm 40 Ø40 x 60 mm 54 mm 60
Exceed ABT Cemented Cup System Modular Instruments
30
Exceed ABT Cemented Cups: E1 and ArCom: True Outer Diameter Size (cont’d)
Product
CodeE1 Muller
Head
SizeSize
True OD
Size
Ream Size For:
3 mm
Cement
Mantle
2 mm
Cement
Mantle
0/1 mm
Cement
Mantle*
EP-122846 Exceed ABT CMTD E1 Muller Cup 28X46 mm 28 Ø28 x 46 mm 40 mm 46 44 42
EP-122848 Exceed ABT CMTD E1 Muller Cup 28X48 mm 28 Ø28 x 48 mm 42 mm 48 46 44
EP-122850 Exceed ABT CMTD E1 Muller Cup 28X50 mm 28 Ø28 x 50 mm 44 mm 50 48 46
EP-122852 Exceed ABT CMTD E1 Muller Cup 28X52 mm 28 Ø28 x 52 mm 46 mm 52 50 48
EP-122854 Exceed ABT CMTD E1 Muller Cup 28X54 mm 28 Ø28 x 54 mm 48 mm 54 52 50
EP-122856 Exceed ABT CMTD E1 Muller Cup 28X56 mm 28 Ø28 x 56 mm 50 mm 56 54 52
EP-122858 Exceed ABT CMTD E1 Muller Cup 28X58 mm 28 Ø28 x 58 mm 52 mm 58 56 54
EP-122860 Exceed ABT CMTD E1 Muller Cup 28X60 mm 28 Ø28 x 60 mm 54 mm 60 58 56
EP-123250 Exceed ABT CMTD E1 Muller Cup 32X50 mm 32 Ø32 x 50 mm 44 mm 50 48 46
EP-123252 Exceed ABT CMTD E1 Muller Cup 32X52 mm 32 Ø32 x 52 mm 46 mm 52 50 48
EP-123254 Exceed ABT CMTD E1 Muller Cup 32X54 mm 32 Ø32 x 54 mm 48 mm 54 52 50
EP-123256 Exceed ABT CMTD E1 Muller Cup 32X56 mm 32 Ø32 x 56 mm 50 mm 56 54 52
EP-123258 Exceed ABT CMTD E1 Muller Cup 32X58 mm 32 Ø32 x 58 mm 52 mm 58 56 54
EP-123260 Exceed ABT CMTD E1 Muller Cup 32X60 mm 32 Ø32 x 60 mm 54 mm 60 58 56
EP-123654 Exceed ABT CMTD E1 Muller Cup 36X54 mm 36 Ø36 x 54 mm 48 mm 54 52 50
EP-123656 Exceed ABT CMTD E1 Muller Cup 36X56 mm 36 Ø36 x 56 mm 50 mm 56 54 52
EP-123658 Exceed ABT CMTD E1 Muller Cup 36X58 mm 36 Ø36 x 58 mm 52 mm 58 56 54
EP-123660 Exceed ABT CMTD E1 Muller Cup 36X60 mm 36 Ø36 x 60 mm 54 mm 60 58 56
EP-124058 Exceed ABT CMTD E1 Muller Cup 40X58 mm 40 Ø40 x 58 mm 52 mm 58 56 54
EP-124060 Exceed ABT CMTD E1 Muller Cup 40X60 mm 40 Ø40 x 60 mm 54 mm 60 58 56
*Includes cement interdigitation
31
Exceed ABT Cemented Cups: E1 and ArCom: True Outer Diameter Size (cont’d)
Product
CodeArCom Flanged
Head
SizeSize
True OD
Size
Ream Size For:
3 mm Cement Mantle
AR-102848 Exceed ABT CMTD ArCom Flange Cup 28X48 mm 28 Ø28 x 48 mm 42 mm 48
AR-102850 Exceed ABT CMTD ArCom Flange Cup 28X50 mm 28 Ø28 x 50 mm 44 mm 50
AR-102852 Exceed ABT CMTD ArCom Flange Cup 28X52 mm 28 Ø28 x 52 mm 46 mm 52
AR-102854 Exceed ABT CMTD ArCom Flange Cup 28X54 mm 28 Ø28 x 54 mm 48 mm 54
AR-102856 Exceed ABT CMTD ArCom Flange Cup 28X56 mm 28 Ø28 x 56 mm 48 mm 56
AR-102858 Exceed ABT CMTD ArCom Flange Cup 28X58 mm 28 Ø28 x 58 mm 52 mm 58
AR-102860 Exceed ABT CMTD ArCom Flange Cup 28X60 mm 28 Ø28 x 60 mm 54 mm 60
AR-103252 Exceed ABT CMTD ArCom Flange Cup 32X52 mm 32 Ø32 x 52 mm 46 mm 52
AR-103254 Exceed ABT CMTD ArCom Flange Cup 32X54 mm 32 Ø32 x 54 mm 48 mm 54
AR-103256 Exceed ABT CMTD ArCom Flange Cup 32X56 mm 32 Ø32 x 56 mm 50 mm 56
AR-103258 Exceed ABT CMTD ArCom Flange Cup 32X58 mm 32 Ø32 x 58 mm 52 mm 58
AR-103260 Exceed ABT CMTD ArCom Flange Cup 32X60 mm 32 Ø32 x 60 mm 54 mm 60
Product
CodeArCom Non Flanged
Head
SizeSize
True OD
Size
Ream Size For:
3 mm Cement Mantle
AR-112848 Exceed ABT CMTD ArCom N/Flng Cup 28X48 mm 28 Ø28 x 48 mm 42 mm 48
AR-112850 Exceed ABT CMTD ArCom N/Flng Cup 28X50 mm 28 Ø28 x 50 mm 44 mm 50
AR-112852 Exceed ABT CMTD ArCom N/Flng Cup 28X52 mm 28 Ø28 x 52 mm 46 mm 52
AR-112854 Exceed ABT CMTD ArCom N/Flng Cup 28X54 mm 28 Ø28 x 54 mm 48 mm 54
AR-112856 Exceed ABT CMTD ArCom N/Flng Cup 28X56 mm 28 Ø28 x 56 mm 48 mm 56
AR-112858 Exceed ABT CMTD ArCom N/Flng Cup 28X58 mm 28 Ø28 x 58 mm 52 mm 58
AR-112860 Exceed ABT CMTD ArCom N/Flng Cup 28X60 mm 28 Ø28 x 60 mm 54 mm 60
AR-113252 Exceed ABT CMTD ArCom N/Flng Cup 32X52 mm 32 Ø32 x 52 mm 46 mm 52
AR-113254 Exceed ABT CMTD ArCom N/Flng Cup 32X54 mm 32 Ø32 x 54 mm 48 mm 54
AR-113256 Exceed ABT CMTD ArCom N/Flng Cup 32X56 mm 32 Ø32 x 56 mm 50 mm 56
AR-113258 Exceed ABT CMTD ArCom N/Flng Cup 32X58 mm 32 Ø32 x 58 mm 52 mm 58
AR-113260 Exceed ABT CMTD ArCom N/Flng Cup 32X60 mm 32 Ø32 x 60 mm 54 mm 60
Product
CodeArCom Muller
Head
SizeSize
True OD
Size
Ream Size For:
3 mm Cement Mantle
2 mm Cement Mantle
0/1 mm Cement Mantle*
AR-122848 Exceed ABT CMTD ArCom Muller Cup 28X48 mm 28 Ø28 x 48 mm 42 mm 48 46 44
AR-122850 Exceed ABT CMTD ArCom Muller Cup 28X50 mm 28 Ø28 x 50 mm 44 mm 50 48 46
AR-122852 Exceed ABT CMTD ArCom Muller Cup 28X52 mm 28 Ø28 x 52 mm 46 mm 52 50 48
AR-122854 Exceed ABT CMTD ArCom Muller Cup 28X54 mm 28 Ø28 x 54 mm 48 mm 54 52 50
AR-122856 Exceed ABT CMTD ArCom Muller Cup 28X56 mm 28 Ø28 x 56 mm 48 mm 56 54 52
AR-122858 Exceed ABT CMTD ArCom Muller Cup 28X58 mm 28 Ø28 x 58 mm 52 mm 58 56 54
AR-122860 Exceed ABT CMTD ArCom Muller Cup 28X60 mm 28 Ø28 x 60 mm 54 mm 60 58 56
AR-123252 Exceed ABT CMTD ArCom Muller Cup 32X52 mm 32 Ø32 x 52 mm 46 mm 52 50 48
AR-123254 Exceed ABT CMTD ArCom Muller Cup 32X54 mm 32 Ø32 x 54 mm 48 mm 54 52 50
AR-123256 Exceed ABT CMTD ArCom Muller Cup 32X56 mm 32 Ø32 x 56 mm 50 mm 56 54 52
AR-123258 Exceed ABT CMTD ArCom Muller Cup 32X58 mm 32 Ø32 x 58 mm 52 mm 58 56 54
AR-123260 Exceed ABT CMTD ArCom Muller Cup 32X60 mm 32 Ø32 x 60 mm 54 mm 60 58 56
*Includes cement interdigitation
32
The Complete Exceed ABT Family
M2A Metal Liner C2A Ceramic Liner E1 STD Liner* E1 HW Liner* E1 10˚ Liner*
M2A Metal Head C2A Ceramic Head
E1 Flanged Cemented Cup* E1 Non Flanged Cemented Cup* E1 Muller Cemented Cup*
Exceed ABT Standard TaperFit Shell
Exceed ABT 15° TaperFit Shell
Exceed ABT RingLoc-X Shell
Exceed ABT RingLoc-X Multi-Hole Shell
E1 Tapered STD Liner
*Also available in ArCom
33
Legal ManufacturerBiomet UK, Ltd.Waterton Industrial EstateBridgend, South WalesCF31 3XA UK
www.biomet.com
0086
©2013 Biomet Orthopedics • Form No. BMET0227.0-ENG • REV013013
This publication and all content, artwork, photographs, names, logos and marks contained in it are protected by copyright, trademarks and other intellectual property rights owned by Biomet or its affiliates or licensed to Biomet or its affiliates unless otherwise indicated. This material is intended for the sole use and benefit of the Biomet sales forces and physicians, it must not be used, copied or reproduced in whole or in part for any purposes other than marketing by Biomet or its authorised representatives. Any other purposes are prohibited.
Biomet does not practice medicine and does not recommend any particular orthopaedic implant or surgical technique for use on a specific patient. The surgeon who performs any implant procedure is responsible for determining and utilising the appropriate techniques for implanting prosthesis in each individual patient.
For product information, including indications, contraindications, warnings, precautions and potential adverse effects, see the package insert herein and Biomet’s website.