Knee Revision Reference Cardssynthes.vo.llnwd.net/o16/LLNWMB8/US Mobile/Synthes North...1.5 53 mm 57...

Limb Preservation System

L P S

Knee RevisionReference Cards

Flexion/Extension Balancing: Possible Causes and Possible SolutionsLoose Extension Tight Extension Stable Extension

Loose

Flexion

CauseFlexion and extension gaps are too large.

Possible SolutionThicker tibial insert

CauseInadequate resection of the distal femur (i.e. extension gap < flexion gap).

Possible Solution1. Recut distal femur2. Recut chamfers

CauseExtension gap < flexion gap. Can be tolerated to a small extent, but verify stability.

Possible Solution1. Increase tibial bearing thickness and resect more distal

femur.2. Upsize femoral component.

Tight

Flexion

Cause1. Extension gap > flexion gap.2. Posterior osteophytes.

Possible Solution1. Check for presence of posterior femoral osteophytes.2. Downsize femoral component.3. Cut Posterior slope on the tibia (not to exceed

10 degrees) and increase tibial bearing thickness.

CauseFlexion and extension gaps are too small.

Possible Solution1. Thinner tibial component.2. If the smallest polyethylene is still

too tight, resect more tibia.

CauseFlexion gap is too small.

Possible Solution1. Check for posterior femoral osteophytes.2. Ensure that there is no soft tissue impingement.3. Recut the tibia with a posterior slope.4. Possibly downsize femoral component.

CauseExtension gap > flexion gap.

Possible Solution Upsize the tibial components. Might be necessary to recut tibia with bigger posterior slope (not to exceed 10 degrees) to obtain full range of motion (ROM).

CauseExtension gaps are too small.

Possible SolutionRecut the distal femur and chamfers

P.F.C® SIGMA®

Posterior Stabilized, TC3, and Fixed Bearing Knee

Universal MBT Revision Tray LPS™ System LCS COMPLETE™ Revision Knee

S-ROM® NOILES™ Hinge Knee

SIGMA® PS, TC3, and FB Knee

P.F.C® SIGMA® TC3 Knee Compatibility*

P.F.C SIGMA Femoral

Augments

TC3 Femoral Component*

Note: P.F.C SIGMA PS Femoral Component has the same compatibility as the TC3 femoral component, except the PS femoral component does not work with the TC3 fixed or TC3 RP inserts.TC3,

Stabilized, Stab+

SIGMA Modular Plus Tray

P.F.C Offset Tray

SIGMA Modular

MBT Revision Sleeve or Wedge**

MBT Revision

**Sleeve or Wedge Cannot use both except for 29 mm sleeve.

MBT Tray

TC3 RP

RP PS

SIGMAFemoral Adapter

Cemented or Universal

Stems

Universal Femoral Sleeve

Cemented and

Universal Stems

Cemented and

Universal Stems

Mod.+ Wedges

Cemented and Universal Stems

Cemented and Universal Stems

Mod.+ Wedges


LCS COMPLETE™ Revision Knee


MBT Revision TrayLPS™ System Universal

SIGMA PS & TC3 Femoral Box Dimensions

P.F.C SIGMA PS FemoralSize 5Size 4Size 3Size 2.5Size 2Size 1.5

Size 6 (not available for TC3 femoral components )

Size 3

14.8 mm 20.1 mm

17.8 mm Inner BoxDimension Constant

P.F.C SIGMA TC3 Femoral

Size 3




SIGMA PS and TC3 Femoral Component Dimensions

Femoral Size A/P Dimension M/L

1.5 53 mm 57 mm

2 56 mm 60 mm

2.5 59 mm 63 mm

3 61 mm 66 mm

4 65 mm 71 mm

4N (PS Only) 66 mm 66 mm

5 69 mm 73 mm

6 (PS Only) 74 mm 78 mm





SIGMA PS and TC3 Femoral Box Heights

Box Height of SIGMA PS Femoral:

Size 1.5 14 mm

Size 2 14.8 mm

Size 2.5 14.8 mm

Size 3 14.8 mm

Size 4 16.7 mm

Size 5 18.6 mm

Size 6 19.5 mm

Box Height of SIGMA TC3 Femoral:

Size 1.5 19.1 mm

Size 2 20.1 mm

Size 2.5 20.1 mm

Size 3 20.1 mm

Size 4 21.7 mm

Size 5 23.4 mm




Posterior Stabilized & TC3

Note: P.F.C SIGMA PS Insert can be used with SIGMA TC3 Femoral Component.

P.F.C SIGMA Posterior Stabilized

P.F.C SIGMA TC3 (RP and Fixed)



MBT Revision TrayLPS™ System UniversalSIGMA® PS, TC3, and FB Knee

SIGMA PS Femoral Component

PS Femoral Component can allow for an 11 mm nail through the box.

12.97 mm

11.94 mm




Femoral Size and A/P Orientation with SIGMA Femoral Adapter/Sleeves(all dimensions are in millimeters) 1.5 Ant 1.5 Neut 1.5 Post 2 Ant 2 Neut 2 Post 2.5 Ant 2.5 Neut 2.5 Post

20 mm 0.9 2.7 4.7 1.8 3.8 5.8 2.6 4.6 6.6 31 mm 2.1 4.5 5.8 2.7 5 7 3.8 5.8 7.8 34 mm x 3.4 4.6 2.1 4.4 5.9 3.2 5.2 7 40 mm x 2.4 3.9 1.2 3.2 5.6 2 3.9 6 46 mm x 2.6 3.6 x 2.6 4.8 1.5 3.6 5.5

3 Ant 3 Neut 3 Post 4 Ant 4 Neut 4 Post 5 Ant 5 Neut 5 Post

20 mm 3.2 5.2 7.2 4.9 6.9 8.9 6.4 8.4 10.4 31 mm 4.6 6.7 8.6 6.3 8.3 10.2 7.8 9.7 11.8 34 mm 3.6 5.7 7.6 5.3 7.3 9.3 6.8 8.9 10.8 40 mm 2.7 4.6 6.5 4.2 6.1 8.1 5.6 7.6 9.6 46 mm 2.4 4.6 6.4 4.3 6.2 8.2 5.7 7.6 9.6

6 Ant 6 Neut 6 Post

20 mm 8.5 10.5 12.5 31 mm 9.9 11.9 13.9 34 mm 8.8 10.9 13 40 mm 7.8 9.9 11.8 46 mm 7.9 9.9 11.7

*Red “x” indicates incompatible.

Note: Measurements in chart indicate the distance between the anterior flange of the femoral component and the sleeve, based on the size of the component and the anteroposterior option chosen. Fields with an “x” denote that the sleeve, femoral size and offset option is not possible.





SIGMA Femoral Adapter

• Cobalt Chrome

• 5 or 7 degree valgus options

Bolt Options

• Neutral

• +/-2 mm offset

45 mm

13 mm diameter

15 mm diameter

Stem Collar Angles

17 mm x 20 mm (collar)




SIGMA Femoral Adapter

Standard (Neutral)

Bolt

Offset (+2/-2 mm)

Bolt





Reaming Depth Marks for SIGMA Femoral Adapter/Sleeve with MBT Revision Reamers

20 mm No 31 mm 40 mm PS Sleeve 34 mm 46 mm

Cemented Stems 30 mm 1 2 3

60 mm 2 3 3

90 mm 4 5 5

120 mm 4 6 6

150 mm 5 7 7

Press-fit Stems 75 mm 2 4 4

115 mm 4 5 6

150 mm 5 7 7

20 mm No 31 mm 40 mm TC3 Sleeve 34 mm 46 mm

Cemented Stems 30 mm 1 2 2

60 mm 2 3 4

90 mm 4 5 5

120 mm 4 6 6

150 mm 6 7 7

Press-fit Stems 75 mm 3 4 4

115 mm 4 5 6

150 mm 6 7 7




Assembly Rules for Femoral Augments

1. For Size 1.5 Femoral Components

• Distal augments are available in 4, 8 and 12 mm thicknesses. • Assemble the distal augments last.

2. For 4 or 8 mm distal augments:

• If using 4 or 8 mm distal augments with posterior augments, install distal augments first.

3. For 12 or 16 mm distal augments:

• Use 16 mm distal augment with TC3 femoral only. • Femoral stem is indicated. • On size 2, 2.5 or 3 femoral component, use 4 mm posterior augments. • On size 4 or 5 femoral component, may use 4 or 8 mm posterior augments. • If using with posterior augment, install posterior augment first.

4. For size 4N PS femoral component, use size 2 distal and size 2 posterior augments.

5. For size 6 PS femoral component, use size 5 distal and size 3 posterior augments.





Implant Assembly for SIGMA Femoral Adapter

Sleeve and Stem Use • Femoral adapter to femoral component • Add posterior and distal augments if necessary • Sleeve to stem • Sleeve to femoral adapter

Adapter with Stem Only • Femoral adapter to femoral component • Stem implant to femoral adapter • Add posterior and distal augments if necessary

Adapter with Sleeve Only • Femoral adapter to femoral component • Add posterior and distal augments if necessary • Sleeve to femoral adapter




SIGMA Femoral Augments Distal Posterior Augment Thickness Augment Thickness

4 mm Posterior 8 mm Posterior

4 mm Distal Yes Yes

8 mm Distal Yes Yes

12 mm Distal1,2 Size 1.5 – 5 Size 4 and 5

16 mm Distal1,2,3 Size 2 – 5 Size 4 and 5

1. If using a stem, attach the SIGMA Femoral Adapter before attaching the augments.

2. When utilizing a 12 or 16 mm distal augment, the femoral component size dictates what size posterior augment can be assembled.

3. 12 and 16 mm distal augments are indicated for use with a femoral stem.

4. 16 mm distal augments are indicated for use with TC3 femoral implant components only.

Sequence of assembly is determined by distal augment thickness





Revision Tibial Insert Options

Fixed Bearing Rotating Platform

Posterior Stabilized Posterior Stabilized 8, 10, 12.5, 15, 17.5, 10, 12.5, 15, 17.5, 20, 22.5, 25 (mm) 20, 22.5, 25 (mm)

Stabilized Plus 10, 12.5, 15, 17.5, 20, 22.5, 25, 30 (mm)

TC3 TC3 RP 10, 12.5, 15, 17.5, 10, 12.5, 15, 17.5, 20, 20, 22.5, 25, 30 (mm) 22.5, 25, 30 (mm)




PS, Stabilized Plus and TC3 Insert Dimensions

Tibial Insert System Dimension Posterior Stabilized of Constraint Stabilized Plus TC3 FB TC3 RP

Spine Width (mm) 16.3 17.4 17.2 17.3

Spine Height (mm) 19.0 19.0 23.0 23.0

M/L Movement at 0˚ (mm) 0.75 0.2 0.3 0.4

M/L Movement at 90˚ (mm) 0.75 0.2 0.3 0.4

Internal/External Rotation at 0˚ 7.5˚ 2.2˚ 4.3˚ –

Internal/External Rotation at 90˚ 7.5˚ 2.2˚ 5.4˚ –

Varus/Valgus at 0˚ N/A 1.9˚ 2.2˚ 2.0˚





SIGMA Femoral Adapter with Stem Extensions:Construct Lengths from Level of Distal Resection

P.F.C SIGMA Femoral Adapter with Press-Fit Stems(75 mm, 115 mm, 150 mm)

*TC3 Size 3 shown

P.F.C SIGMA Femoral Adapter with SIGMA Cemented Stems(30 mm, 60 mm, 90 mm, 120 mm, 150 mm)

*TC3 Size 3 shown




SIGMA Revision Fixed Bearing Knee System Compatibility

PS PS PS PS PS PS PSTC3 TC3 TC3 TC3 TC3 TC3 TC353/57 56/60 59/63 61/66 65/71 69/73 74/781.5 2 2.5 3 4 5 6

PS, Stab+TC3

PS, Stab+TC3

PS, Stab+TC3

PS, Stab+TC3

PS, Stab+TC3

PS, Stab+TC3

PS, Stab+TC3

41/611.5

43/642

45/672.5

47/713

51/764

55/835

59/896Ti

bial

Inse

rts

Sizi

ng •

A/P

/ M

/L (

mm

)

Fixed-bearing tibial inserts must match tibial trays size-to-size

Femoral Component Sizing • A/P / M/L (mm)





P.F.C Modular Tibial Trays

Available Keel M/L Size Configurations Height Keel

1.5 Mod, Mod +, Offset 38 mm 37 mm

2 Mod, Mod +, Offset 38 mm 37 mm

2.5 Mod, Mod +, Offset 38 mm 37 mm




6 Mod 48 mm 49 mm




P.F.C Offset Tibial Tray Components

Tray Size Offset

1.5 4 mm

2 4 mm

2.5 4 mm

3 4 mm

4 4.5 mm

5 4.5 mm

Offset trays are available in Left Medial / Right Lateral or Right Medial / Left Lateral configurations.

The medial or lateral nomenclature refers to the stem position.

Accepts all tibial wedges (must match size of tibial tray).





Tray/Stem Compatibility

P.F.C Modular Tibial Trays Size Size Size Size Size Size Size 1.5 2 2.5 3 4 5 6

Cemented 13 mm diameter (30 and 60 mm lengths)

Cemented tapered 13 mm diameter (90, 120, 150 mm lengths)

Cemented 15 mm diameter (30 and 60 mm lengths)

Cemented tapered 15 mm diameter (90 mm lengths)

Universal Press-Fit stems Diameters




SIGMA PatellaDescription Dim ‘A’ Dim ‘B’ Dim ‘C’ Dim ‘D’ Dim ‘E’

Inset Patella Inset, 25 mm 3.0 9.0 12.1 3.9 5.1

Inset, 28 mm 3.0 9.6 12.6 3.7 5.9

Inset, 32 mm 3.0 10.0 13.1 – –

1-Post Dome Patella Round, 28 mm 5.7 7.2 13.0 – –

Round/Oval, 32 mm 6.2 7.8 14.0 – –

Round/Oval, 35 mm 6.2 8.5 14.7 – –

Round/Oval, 38 mm 7.2 9.1 16.3 – –

Round/Oval, 41 mm 7.2 11.4 18.6 – –

3-Post Dome Patella Round/Oval, 32 mm 5.0 7.8 12.9 – –

Round/Oval, 35 mm 5.0 8.5 13.6 – –

Round/Oval, 38 mm 5.0 9.1 14.2 – –

Round/Oval, 41 mm 5.0 11.4 16.5 – –





SIGMA Patella

SIGMA Inset Patella

SIGMA 1-Post Patella

SIGMA 3-Post Patella




LCS COMPLETE™ Knee Family

LCS COMPLETE Augments

Universal Femoral Sleeves

MBT Revision Wedges

MBT Revision Sleeve

Cemented or Universal Stems

**Sleeve or Wedge Cannot use both except for 29 mm sleeve.


LCS COMPLETE Modular

LCS COMPLETE RPS RP Insert

RPS Insert

VVC Insert

LCS COMPLETE

Revision

MBT Revision Tray

MBT Revision Tray UniversalSIGMA® PS, TC3, and FB Knee



LPS™ System

LCS COMPLETE RPS Femoral ComponentsFemoral Intercondylar Box Width: LCS COMPLETE RPS Femoral Components incorporate a fixed intercondylar box that varies in interior and exterior width with each size. The box is open.

Inner Box Outer Box Box Opening Maximum Box Femoral Width (mm) Width (mm) Width (mm) Height (mm) Size (A) (B) (C) (D)

Small 13.7 17.3 19.7 19.7

Small+ 15.1 18.7 21.8 21.7

Medium 15.8 19.4 22.7 22.7

Standard 16.5 20.1 23.7 23.7

Standard+ 17.8 21.3 25.5 26.0

Large 19.2 22.7 27.4 27.7

Large+ 20.6 24.2 29.5 30.5




LCS COMPLETE Revision Femoral ComponentFemoral Intercondylar Box Width: LCS COMPLETE Revision Femoral Components incorporate a fixed inter-condylar box that varies in interior and exterior width with each size. The box is open. Inner Box Outer Box Box Opening Maximum Box Femoral Width (mm) Width (mm) Width (mm) Height (mm) Size (A) (B) (C)

Small 13.7 18.8 5.8 22.0

Small+ 15.1 20.2 8.8 24.2

Medium 15.8 20.9 10.8 25.5

Standard 16.5 21.6 12.9 26.4

Standard+ 17.8 22.9 15.1 28.4

Large 19.2 24.2 16.3 30.6

Large+ 20.6 25.7 18.5 32.9

40 mm Fixed Stem

2°

A

B

C




LPS™ System

LCS COMPLETE Femoral Component DimensionsRPSFemoral A/P M/L Distal Component Dimension* Dimension Thickness Size (mm) (mm) (mm)

Small 49.6 53.8 6.2

Small+ 54.7 59.2 6.9

Medium 57.8 61.9 7.2

Standard 60.9 64.6 7.5

Standard+ 65.4 69.6 8.1

Large 70.4 74.9 8.7

Large+ 75.8 80.6 9.4

RevisionFemoral A/P M/L Distal Component Dimension** Dimension Thickness Size (mm) (mm) (mm)

Small 49.6 53.8 6.2

Small+ 54.7 59.2 6.9

Medium 57.8 61.9 7.2

Standard 60.9 64.6 7.5

Standard+ 65.4 69.6 8.1

Large 70.4 74.9 8.7

Large+ 75.8 80.6 9.4

* A/P Dimension measured from exterior ** A/P Dimension measured from exterior




LCS COMPLETE RPS and VVC Inserts VVC RPS VVC RPS Spine Width* Spine Width* Spine Height** Spine Height** Insert Size (mm) (mm) (mm) (mm)

Small 13.4 11.5 20.8 13.9

Small+ 14.8 12.7 22.9 15.3

Medium 15.4 13.2 24.0 16.0

Standard 16.1 13.8 25.0 16.7

Standard+ 17.4 14.9 27.0 18.0

Large 18.8 15.9 28.9 19.3

Large+ 20.2 17.0 31.1 20.8

Internal/External Rotation at 0 As required

Internal/External Rotation at 90 As required

Varus/Valgus at 0 (for VVC insert) +1.25 degrees

RPS Insert

VVC Insert

* Spine width measured from thickest part of spine.

** Height taken from dwell point.




LPS™ System

LCS COMPLETE Revision Tibial Insert Options

RPS Insert Sizes 10, 12.5, 15, 17.5, 20, 22.5, 25

Insert A/P Dimension M/L Dimension Size (mm) (mm)

Small 32.7 53.2

Small+ 36.0 58.5

Medium 37.6 61.1

Standard 39.3 63.9

Standard+ 42.3 68.7

Large 45.5 73.9

Large+ 48.9 79.5

VVC Insert Sizes 10, 12.5, 15, 17.5, 20, 22.5, 25

Insert A/P Dimension M/L Dimension Size (mm) (mm)

Small 35.4 53.2

Small+ 39.0 58.5

Medium 40.7 61.1

Standard 42.5 63.9

Standard+ 45.8 68.8

Large 49.3 74.0

Large+ 53.2 79.7




LCS COMPLETE Compatibility Matrix Femoral Box Insert All LCS Femoral Type (PS) Options Patellas Augments Stem Sleeve Use

LCS COMPLETE No LCS COMPLETE, LCS® Yes No No No Primary TKA Classic

LCS RPS Yes LCS COMPLETE, LCS Yes No No, open box No Primary TKA Classic & RPS Insert

LCS COMPLETE No LCS COMPLETE Yes Yes Fixed boss No Revision TKA Modular & LCS Classic (distal and accepts posterior) universal stems

LCS COMPLETE Yes LCS COMPLETE Yes Yes Fixed 5˚ Yes Revision TKA Revision Revision VVC (distal and valgus boss and RPS, posterior) accepts LCS COMPLETE, universal stems LCS Classic




LPS™ System

Anteroposterior Chart (With Sleeve Use)

Distance between anterior flange of femoral component and sleeve

Sleeve Femoral Sizes Size Sm Sm+ Med Std Std+ Lg Lg+

20 mm 2.6 mm 2.5 mm 2.5 mm 2.5 mm 3.3 mm 4.3 mm 5.5 mm








LCS® Revision Femoral Augment Options

Sm Sm+ Med Std Std+ Lg Lg+

Distal Augments 5/10 mm 5/10 mm 5/10 mm 5/10 mm 5/10/15 mm 5/10/15 mm 5/10/15 mm

Posterior Augments 5/10 mm 5/10 mm 5/10 mm 5/10 mm 5/10 mm 5/10 mm 5/10 mm




LPS™ System

Implant Assembly for LCS Revision Knee

1. Sleeve and Stem Use • Add posterior and distal augments if necessary • Sleeve to stem • Sleeve/stem construct to femoral component

2. Stem Only • Add posterior and distal augments if necessary • Stem implant to femoral component

3. Sleeve Only • Add posterior and distal augments if necessary • Sleeve to femoral component




Universal Femoral Sleeve with Stem Construct Lengths Distance between distal Fixed Boss Femoral Box Height Femoral Sleeve part of sleeve and most Total (mm) from Stem Type & Length Length (mm) (mm) for LCS Rev STD Height (Size M/L) proximal part of box distal resection levelPress-Fit, 75 mm 40 18.9 60 mm (20) 5 mm 158.9 40 18.9 64 mm (31) 5 mm 162.9 40 18.9 68 mm (34) 5 mm 166.9 40 18.9 72 mm (40) 5 mm 170.9 40 18.9 76 mm (46) 5 mm 174.9Press-Fit, 115 mm 40 18.9 60 mm (20) 5 mm 198.9 40 18.9 64 mm (31) 5 mm 202.9 40 18.9 68 mm (34) 5 mm 206.9 40 18.9 72 mm (40) 5 mm 210.9 40 18.9 76 mm (46) 5 mm 214.9Press-Fit, 150 mm 40 18.9 60 mm (20) 5 mm 233.9 40 18.9 64 mm (31) 5 mm 237.9 40 18.9 68 mm (34) 5 mm 241.9 40 18.9 72 mm (40) 5 mm 245.9 40 18.9 76 mm (46) 5 mm 249.9Cemented, 30 mm 40 18.9 60 mm (20) 5 mm 113.9 40 18.9 64 mm (31) 5 mm 117.9 40 18.9 68 mm (34) 5 mm 121.9 40 18.9 72 mm (40) 5 mm 125.9 40 18.9 76 mm (46) 5 mm 129.9




LPS™ System

Universal Femoral Sleeve with Stem Construct Lengths Distance between distal Fixed Boss Femoral Box Height Femoral Sleeve part of sleeve and most Total (mm) from Stem Type & Length Length (mm) (mm) for LCS Rev STD Height (Size M/L) proximal part of box distal resection levelCemented, 60 mm 40 18.9 60mm (20) 5 mm 143.9 40 18.9 64 mm (31) 5 mm 147.9 40 18.9 68 mm (34) 5 mm 151.9 40 18.9 72 mm (40) 5 mm 155.9 40 18.9 76 mm (46) 5 mm 159.9Cemented Tapered, 90 mm 40 18.9 60 mm (20) 5 mm 179.9 40 18.9 64 mm (31) 5 mm 177.9 40 18.9 68 mm (34) 5 mm 181.9 40 18.9 72 mm (40) 5 mm 185.9 40 18.9 76 mm (46) 5 mm 190.9Cemented Tapered, 120 mm 40 18.9 60 mm (20) 5 mm 203.9 40 18.9 64 mm (31) 5 mm 207.9 40 18.9 68 mm (34) 5 mm 211.9 40 18.9 72 mm (40) 5 mm 215.9 40 18.9 76 mm (46) 5 mm 219.9Cemented Tapered, 150 mm 40 18.9 60 mm (20) 5 mm 233.9 40 18.9 64 mm (31) 5 mm 237.9 40 18.9 68 mm (34) 5 mm 241.9 40 18.9 72 mm (40) 5 mm 245.9 40 18.9 76 mm (46) 5 mm 249.9




Sleeve-only Construct Lengths Distance between distal Fixed Boss Femoral Box Height Femoral Sleeve part of sleeve and most Total (mm) from Stem Type & Length Length (mm) (mm) for LCS Rev STD Height (Size M/L) proximal part of box distal resection levelNA 40 18.9 60 mm (20) 5 mm 83.9NA 40 18.9 64 mm (31) 5 mm 87.9NA 40 18.9 68 mm (34) 5 mm 91.9NA 40 18.9 72 mm (40) 5 mm 95.9NA 40 18.9 76 mm (46) 5 mm 99.9

S-ROM® NOILES™ Rotating Hinge

Knee System




S-ROM WedgeMBT

Revision Wedges

MBT Revision Sleeve



**Sleeve or WedgeCannot use both except

for 29 mm sleeve.

Universal Femoral Sleeve

LPS™ Universal InsertS-ROM NRH

Femoral Component

MBT Revision Tray

S-ROM® NOILES™ Rotating Hinge Knee Compatibility




LPS™ System

S-ROM Hinge Femoral Component

Dist. Box Stem Size M/L A/P Cut Height Offset (mm) (mm) (mm) (mm) (mm)

X-Small 66 58 9.5 16 17

Small 66 62 11 16 17

Medium 71 66 12 17 18

A hinge pin is packaged with each femoral component.




LPS™ System

S-ROM NOILES Rotating Hinge Femoral Component1. Co-Cr-Mo alloy (ASTM F-75).

2. Distal femoral cut at 90 degrees, anterior resection angled 4 degrees.

3. Anterior chamfer is 45 degrees, posterior chamfer is 55 degrees.

4. The femoral boss height is a constant 47 mm. The taper is 2 degrees per side.

5. The deep patella groove is angled 7 degrees for anatomic tracking. The lateral side is raised for stability.

6. Hinge point is in the posterior quadrant for maximum flexion.

7. UHMWPE bumper sets hyperextension stop at 6 degrees.

8. Weight-bearing is shared between the hinge bearings and condyles, providing a large bearing surface and excellent varus/valgus stability.

9. Cobalt Chrome hinge pin allows for easy insertion with secure locking from medial or lateral aspect of the component. The hinge pin is packaged with the S-ROM Rotating Hinge Femoral Component.




S-ROM NOILES Rotating Hinge Femoral Augments

1. Titanium alloy construction.

2. 5 mm or 10 mm thick.

3. Width, length and chamfers to fit X-Small A/P box. One size fits all.

4. Attached with bone cement. Grooves on the femoral component contact surfaces are complimentary to the grooves in the femoral components to create a waffle pattern in the cement. Grooves on the superior surface are perpendicular to the long axis to allow cement to extrude outward.

5. Used to restore original joint as closely as possible when significant distal bone loss has occurred.




LPS™ System

LPS™ Universal Tibial Hinge Insert Assembly

Size M/L A/P

XX-Small* 55.9 39.3

X-Small 66.0 41.9

Small 66.0 44.8

Medium 70.7 48.0

Femoral Component must match size to size with insert.

Thickness: 12, 14, 16, 18, 21 and 23 mm in all sizes; 26, 28, and 31 mm only in X-Small, Small, and Medium sizes

Usable with MBT Revision/LPS Proximal Tibia only.

*XX-Small insert only compatible with XX-Small LPS Distal Femoral Component.

LPS™ System

Limb Preservation System

L P S




LPS™ System

Procedural Uses

Proximal Tibial Replacement

Proximal Femoral Replacement

Total Femoral Replacement

Distal Femoral Replacement

Midshaft Femoral Replacement




Length

Segmental Components

1987-07-025 25 mm length

1987-07-030 30 mm length

1987-07-035 35 mm length

1987-07-040 40 mm length

1987-07-045 45 mm length

1987-07-065 65 mm length

1987-07-085 85 mm length

1987-07-105 105 mm length

1987-07-125 125 mm length

Ordering Information Cat. No. Description





LPS™ System


Material • Titanium alloy

Features• 25, 30, 35, 40, 45, 65, 85, 105 and 125 mm

lengths

• One male and one female taper

• Anti-rotation tabs and slots

Use• “Connectors” of LPS System

• Mates with all LPS Components, and the distal femoral to metaphyseal sleeve adapters.

• Replaces missing shaft bone (5 mm increments) to adjust leg length




Total Femoral Segmental Component

55 mm Length

1987-08-055 55 mm length






LPS™ System


Material• Titanium alloy

Features• 55 mm length

• Two male tapers

• Anti-rotation slots

Use• Needed for total femoral replacement construct

• Replaces missing shaft bone

• Mates with segmental, proximal femoral or distal femoral components




Intercalary Segmental Component

55 mm Length

1987-09-055 55 mm length






LPS™ System


Material• Titanium alloy

Features• 55 mm length

• Two female tapers

• Anti-rotation tabs

Use• Replaces midshaft bone

• Connects with segmental components and LPS Stems




Distal Femoral Replacement Components

X-small60 mmHeight

XX-small50 mmHeight

66 mm M/L, X-small56 mm M/L, XX-small

53 mm A/P, X-small48 mm A/P, XX-small




LPS™ System

Material• Cobalt Chrome alloy

Features• 70/80 mm minimum resection

• 50/60 mm component height to articular surface + 20 mm stem collar when using LPS Stems

• 50/60 mm minimum resection when using metaphyseal sleeves (+ the LPS Femoral Sleeve Adapter and the portion of the metaphyseal sleeve that will sit proud of the bone)

• Utilizes SIGMA Patella• Female taper with anti-rotation tabs • Anatomic (right and left)• X-Small and XX-Small sizes for soft

tissue closure• Cobalt Chrome hinge pin allows for

easy insertion with secure locking from medial or lateral aspect of component

• Hinge pin packaged with the femoral component


Distal Femoral Replacement Components

1987-13-111 Left, XX-Small

1987-14-111 Right, XX-Small

1987-13-105 Left, X-Small

1987-14-105 Right, X-Small

SIGMA Patella and Replacement Components

96-0110 32 mm 3-Peg Round/Dome Patellar




1987-17-000 Distal femoral poly bumper replacement

1987-15-000 XX-Small replacement hinge pin

62-1640 X-Small/Small replacement hinge pin

• UHMWPE bumper sets hyperextension stop at 6 degrees.

Use• Replaces missing distal femur• Compatible with segmental

components, total femoral segment, LPS Stems, LPS Femoral Sleeve Adapter, and Universal femoral metaphyseal sleeves

• Assembles with the LPS Universal Tibial Hinged Insert Bearing to connect with the MBT revision tray or the LPS Proximal Tibial Replacement Components

• Load-sharing design between hinge pin bushings and plateau bearing surface

• Allows for five degrees of hyperextension with 140 degrees of flexion

• Femoral component and tibial insert must match size for size




20 mm Collar Height

Stem Length

Bevel

LPS Stems

LPS Cemented Stems

9-17 mm diameters

(1 mm increments)

100, 125, 150 and 200 mm lengths

LPS Porous Stems

10.5-18.5 mm diameters

(1 mm increments)

100, 125, 150 and 200 mm lengths




LPS™ System


Features• Cemented and porous options

• Straight (100 and 125 mm) and bowed (150 and 200 mm)

• All stems have porous collar, 20 mm height

• Male taper with anti-rotation slots

• Proximal stem bevel for enhanced fit

• Porous stems utilize Porocoat® Porous Coating with bullet tip

• Cemented stems have grooves for enhanced cement fixation

• Trials are 0.5 mm undersized relative to the implant

Use• Provides fixation into remaining host bone

• Stems mate with segmental, intercalary, proximal femoral, distal femoral and proximal tibial replacement components




LPS Stems (cont.)

1987-25-109 9 mm diameter x 100 mm length











Cemented Stems (Straight)

1987-26-109 10.5 mm diameter x 100 mm length











Porous Stems (Straight)




LPS™ System

LPS Stems (cont.)













Cemented Stems (Bowed)













Porous Stems (Bowed)




Proximal Tibial Replacement Component

66 mm M/L, X-Small

xx mm A/P

1987-21-105 size X-Small



73 mmHeight




LPS™ System



Features• 105 mm minimum resection

– 73 mm component + 12 mm bearing insert + 20 mm collar

• Female taper with anti-rotation tabs

• Highly polished plateau articulation surface

• Anterior suture holes, Porocoat Porous Coating

• Anatomical friendly

Use• Replaces missing proximal tibial bone

• Mates with segmental components and LPS Stems

• Accepts the LPS Universal Hinged Tibial Insert Bearing to connect with the S-ROM NOILES Rotating Hinge Femoral Component or the LPS Distal Femoral Replacement

• Intended for cemented use only




Metaphyseal Sleeves

1294-54-000 MBT Revision Porous Tibial Sleeve, 29 mm 1294-54-140 MBT Revision Cemented Tibial Sleeve, 29 mm 1294-54-100 MBT Revision Porous Tibial Sleeve, 37 mm 1294-54-110 MBT Revision Porous Tibial Sleeve, 45 mm 1294-54-120 MBT Revision Porous Tibial Sleeve, 53 mm 1294-54-130 MBT Revision Porous Tibial Sleeve, 61 mm 1294-53-205 Universal Femoral Sleeve - Cemented, 20 mm 1294-53-215 Universal Femoral Sleeve - Distally Porous, 31 mm 1294-53-216 Universal Femoral Sleeve - Fully Porous, 31 mm 1294-53-225 Universal Femoral Sleeve - Distally Porous, 34 mm 1294-53-226 Universal Femoral Sleeve - Fully Porous, 34 mm 1294-53-235 Universal Femoral Sleeve - Distally Porous, 40 mm 1294-53-236 Universal Femoral Sleeve - Fully Porous, 40 mm 1294-53-245 Universal Femoral Sleeve - Distally Porous, 46 mm 1294-53-246 Universal Femoral Sleeve - Fully Porous, 46 mm 1987-06-000 LPS Femoral Sleeve Adapter +0 mm 1987-06-005 LPS Femoral Sleeve Adapter +5 mm 1987-06-010 LPS Femoral Sleeve Adapter +10 mm


Metaphyseal sleeves and adapters




LPS™ System

Metaphyseal Sleeves

Material• Titanium with POROCOAT Porous Coating

Features• Five tibial sizes: 29, 37, 45, 53, and 61 mm

• Five femoral sizes: 20 (cemented only), 31, 34, 40 and 46 mm (fully or distally porous)

• Compatible with SIGMA, LCS, S-ROM and LPS (Femoral Components)

• LPS Femoral to sleeve adapters available in 0, 5, and 10 mm lengths to increase distal offset

• Tibial sleeves are compatible with the MBT revision tray and MBT revision thick trays

• Accepts universal press-fit and SIGMA Knee cemented stems

Use• Employs Wolff’s Law to progressively load the

bone with its stepped design

• Provides rotational stability to prevent component loosening

• Same, straightforward surgical technique at every level of constraint.

MBT Revision Tray




S-ROM NRH

LPS

MBT Revision Tray

SIGMA PS

SIGMA TC3

SIGMA RP PS

SIGMA TC3 RP

LCS COMPLETE

RPS

LCS COMPLETE VVC Insert

LCS COMPLETE

Revision

*Also compatible with all primary RP inserts , except ATTUNE® Primary RP Inserts

MBT Revision Tray Compatibility

LPS Universal

Insert




LPS™ System

MBT Revision Tray Dimensions

Stem Length Tray Size A/P M/L (w/o poly cap) Thickness

1 39 59.2 61.8 4.8

1.5 40.7 61.8 61.8 4.8

2 42.6 64.6 61.8 4.8

2.5 44.2 67.1 61.8 4.8

3 45.8 69.6 61.8 4.8

4 49.3 74.9 61.8 4.8

5 53.1 80.6 61.8 4.8

6 57.2 86.8 61.8 4.8

Tibia is cut at 2 Degree Posterior Slope

Stem has 2 Degree Posterior Slope




MBT Revision Tray• Cobalt Chrome

• Tray thickness is 4.8 mm.

• Can be used with MBT metaphyseal sleeves and/or MBT wedges.

Note: The 29 mm MBT sleeve is the only tibial sleeve that can be used in conjunction with MBT wedges.

• When no tibial stem is used, the tibial tray cap must be retained (comes pre-assembled with tray).

• Use the primary conical reamer (2178-63-199) when no tibial stem will be used. The reamer is end-cutting and side-cutting. If using a SIGMA Knee cemented stem, only a 13 mm diameter cemented stem should be used in conjunction with the MBT revision tray to avoid a step off at the stem/tray junction.




LPS™ System

MBT Revision Tray Compatibility with LPS/S-ROMMBT LPS LPS S-ROM S-ROM S-ROM Revision XX-Small X-Small X-Small Small Medium Trays Femoral Femoral Femoral Femoral Femoral

M/L 56.6 66.7 66.7 66.7 71.2

Size 1 59.2

Size 1.5 61.8

Size 2 64.6

Size 2.5 67.1

Size 3 69.6

Size 4 74.9

Size 5 80.6

Size 6 86.8 LPS Universal inserts must match femorals size-to-size. i.e. XX-Small = XX-Small, Small = Small, etc.Large Gold “d” signifies preferred match.




MBT Revision Tray Compatibility with LCS COMPLETE Revision Tibial Inserts

MBT Revision Trays LCS COMPLETE Revision Tibial Inserts (RPS and VVC)

Sizes Small Small+ Medium Standard Standard+ Large Large+

Size 1 (1294-35-110)

Size 1.5 (1294-35-115)

Size 2 (1294-35-120)

Size 2.5 (1294-35-125)

Size 3 (1294-35-130)

Size 4 (1294-35-140)

Size 5 (1294-35-150)

Size 6 (1294-35-160)




LPS™ System

MBT Revision Thick Trays

Catalog No. Size (mm) A/P M/L Stem Length Tray Thickness

1294-35-215 2+15 42.6 64.6 61.8 15

1294-35-225 2+25 42.6 64.6 61.8 25

1294-35-315 3+15 45.8 69.6 61.8 15

1294-35-325 3+25 45.8 69.6 61.8 25

1294-35-415 4+15 49.3 74.9 61.8 15

1294-35-425 4+25 49.3 74.9 61.8 25




MBT Thick Trays• Bony preparation same as the standard tray preparation.

• Instrumentation includes metal adapters to fit within the standard MBT Revision Tray Trials to make up either 1 or 25 mm thickness.

• Trays taper distally to match tibial anatomy by two sizes, regardless of tray thickness (15 and 25 mm).

Size Two Size Three Size Four

Proximal Size 2 Size 3 Size 4

Distal Size 0 (54.2 M/L, 37.5 A/P) Size 1 Size 2

• Utilize the same stems, sleeves and wedges as standard trays

• Stem length is the same as the MBT Revision Tray – 61.8 mm.

• Wedges can be used on all sizes, except the size two, as there are no size zero wedges.

• Sleeves can be used on the thick tray as well.

• Can only use the 29 mm sleeve in conjunction with wedges.




LPS™ System

MBT Revision Step Wedges• Cobalt Chrome

• Step wedges come in sizes 1-6.

• Thicknesses 5, 10, and 15 mm.

• May be downsized relative to tray. Ex. Size 4 tray compatible with size 3 wedges. Size 3 tray compatible with size 2.5 wedges.

• Universal – for use on medial, lateral or both sides.

Note: The 29 mm sleeve is the only sleeve which can be used in conjunction with wedges.

• Attach to the tray with screw packaged with the wedge.




MBT Revision Metaphyseal Sleeves

Cat. No. Size (mm) A/P (mm) M/L (mm) Height (mm)

1294-54-140 (cemented) 29 26 29 40

1294-54-000 29 26 29 40

1294-54-100 37 27 37 40

1294-54-110 45 27 45 40

1294-54-120 53 31 53 40

1294-54-130 61 34 61 40




LPS™ System

MBT Revision Metaphyseal Sleeves• Titanium alloy construction with POROCOAT Porous Coating covering the proximal

third of the sleeve (14.5–16.5 mm).

• Available in 29, 37, 45, 53, and 61 mm M/L dimensions. The 29 mm has a cemented and porous option.

• Sleeves have 20 degree internal or external rotational freedom.

• Any size sleeve may be used with any size tray.

• Note: Only the 29 mm sleeve can be used with wedges.

• In order to properly match rotation of the sleeve, you may do one of the following: – Use the trial to help match the rotation with the implant on the back table. – Lightly engage the sleeve onto the tray. Insert into the body, letting the sleeve find its proper seating. Pull the construct out and fully impact the sleeve on the tray. – Use the tibial view plate on top of the broach to match rotation with the implant construct.

Universal Components




Universal Press-Fit and Cemented Stems• Titanium construction.

• Can be used for both femoral and tibial applications.

• Compatible with SIGMA, LCS, S-ROM*, and LPS* Knee (*through the use of the Universal femoral sleeve).

• Press-Fit Options: – Lengths: 75, 115 and 150 mm – Diameters: 10, 12, 14, 16, 18, 20, 22 and 24 mm – Quad-slot stems. (Smallest diameter stems (10-12 mm) are not slotted.) – Bullet-tipped to reduce end-stem pain. – Slots can be oriented in any direction- attached to tray or femoral component with screw-in attachment.

• SIGMA Cemented Stems: – Lengths: 30 and 60 mm straight stems – Lengths: 90, 120, 150 mm tapered stems – Note: 15 mm SIGMA Cemented Stems should NOT be used with MBT Revision Tray or SIGMA Femoral Adapter to avoid cement ledge at stem/tray junction (tray stem is 13 mm diameter at distal end) which can make removing the stem in future revisions very difficult.




LPS™ System

Stem Extensions

Cemented Stems Diameter Length

13 mm 30 mm

13 mm 60 mm

15 mm 30 mm

15 mm 60 mm

Universal Press-Fit Stems Diameter Length

10 mm 75, 115, 150 mm

12 mm 75, 115, 150 mm

14 mm 75, 115, 150 mm

16 mm 75, 115, 150 mm

18 mm 75, 115, 150 mm

20 mm 75, 115, 150 mm

22 mm 75, 115, 150 mm

24 mm 75, 115, 150 mm

Cemented Tapered Stems Diameter* Length

13 mm 90 mm

13 mm 120 mm

13 mm 150 mm

15 mm 90 mm

*Noted dimension is at base of stem. Tapers by 4 mm towards the tip.




Universal Slotted Stem Feature Dimensions

Diameter Diameter Effective Slot Slot Over Under Size Length Length Width Flutes Flutes (mm) (mm) (mm) (mm) (mm) (mm)

75 x 10 75 N/A N/A 10 7.9

75 x 12 75 N/A N/A 12 9.7

75 x 14 75 22.9 2.3 14 11.6

75 x 16 75 29.9 3.1 16 13.4

75 x 18 75 33.5 3.9 18 15.2

75 x 20 75 36.9 4.7 20 17.0

75 x 22 75 38.8 5.1 22 18.9

75 x 24 75 38.5 5.4 24 208

115 x 10 115 N/A N/A 10 7.9

115 x 12 115 N/A N/A 12 9.7

115 x 14 115 41.5 2.3 14 11.6

115 x 16 115 52.5 3.1 16 13.4

Diameter Diameter Effective Slot Slot Over Under Size Length Length Width Flutes Flutes (mm) (mm) (mm) (mm) (mm) (mm)

115 x 18 115 58.3 3.9 18 15.2

115 x 20 115 64.0 4.7 20 17.0

115 x 22 115 67.1 5.1 22 18.9

115 x 24 115 66.9 5.4 24 20.8

150 x 10 150 N/A N/A 10 7.9

150 x 12 150 N/A N/A 12 9.7

150 x 14 150 41.5 2.3 14 11.6

150 x 16 150 52.5 3.1 16 13.4

150 x 18 150 58.3 3.9 18 15.2

150 x 20 150 64.0 4.7 20 17.1

150 x 22 150 67.1 5.1 22 18.9

150 x 24 150 66.9 5.4 24 20.8




LPS™ System

Revision Stem Reaming

MBT Rev Press Fit Trial Major Dia. Minor Dia. Major-Minor Reamer Dia. Per Side Stem Dia. Stem Description (mm) (mm) (mm) (mm) (mm) (mm)

Universal Press-Fit 10 mm 10 8 2 9.6 0.2 9.5








Note: 10 and 12 mm diameter stems contain no slots




Universal Femoral Sleeves• Titanium construction.

• Two options: distally porous and fully porous.

• Compatible with SIGMA, LCS, S-ROM and LPS Knee. Available in 20 (fully cemented), 31, 34, 40, 46 mm sleeves.

• POROCOAT Porous Coating covers the distal third of the distally porous sleeve.

• Steps are larger on the distally porous sleeve than on the fully porous sleeve.

• The asymmetrical shape is designed to fit natural flare and triangular section of the distal femoral metaphysis.

• When used without a stem, the femoral sleeve plug must be used ((assembled with the sleeve).




LPS™ System

Universal Femoral Sleeve Dimensions (Both distally and fully porous)

Sleeve (mm) A/P (mm) M/L (mm) Length (mm) Porous Coating (mm) Distal Coated Sleeve

20 22.4 22.4 67.4 no coating

31 20.1 31.0 67 23 mm

34 22.1 34.0 68.2 22 mm

40 24.6 40.1 72.2 30 mm

46 24.6 46.0 76.2 25 mm




LPS Universal Tibial Hinge Insert Bearing• Forged Cobalt Chrome pin for enhanced strength

• Polyethylene bushings mate with hinge pin

• Flat anterior surface with hyperextension stop

• Insert extension length: 46 mm

• XX-small, X-small, small and medium sizes

• 12, 14, 16, 18, 21, 23, 26, 28 and 31 mm plateau bearing thickness* *see table on next page for details

• Provides stability for missing ligaments

• Hinge provides stability in flexion and extension and acts as a pivot point for distal femoral internal and external rotation

• Mates with the LPS Distal Femoral Replacement Component or the S-ROM NOILES Rotating Hinge Femoral Component and the MBT Revision Tray or the LPS Proximal Tibial Replacement Component

• Femoral Component and tibial insert must match size for sizeParallel Sides

S-ROM NOILES Articular Geometry

Cobalt Chrome Core

46 mm




LPS™ System

1987-27-012 XX-small, 12 mm

1987-27-014 XX-small, 14 mm

1987-27-016 XX-small, 16 mm

1987-27-018 XX-small, 18 mm

1987-27-021 XX-small, 21 mm

1987-27-023 XX-small, 23 mm

1987-27-112 X-small, 12 mm

1987-27-114 X-small, 14 mm

1987-27-116 X-small, 16 mm

1987-27-118 X-small, 18 mm

1987-27-121 X-small, 21 mm

1987-27-123 X-small, 23 mm

1987-27-126 X-small, 26 mm

1987-27-128 X-small, 28 mm

1987-27-131 X-small, 31 mm

1987-27-212 Small, 12 mm

1987-27-214 Small, 14 mm

1987-27-216 Small, 16 mm

1987-27-218 Small, 18 mm

1987-27-221 Small, 21 mm

1987-27-223 Small, 23 mm

1987-27-226 Small, 26 mm

1987-27-228 Small, 28 mm

1987-27-231 Small, 31 mm

1987-27-312 Medium, 12 mm

1987-27-314 Medium, 14 mm

1987-27-316 Medium, 16 mm

1987-27-318 Medium, 18 mm

1987-27-321 Medium, 21 mm

1987-27-323 Medium, 23 mm

1987-27-326 Medium, 26 mm

1987-27-328 Medium, 28 mm

1987-27-331 Medium, 31 mm

Cat. No. Description

LPS Universal Tibial Hinge Insert Bearing

For more information about DePuy Synthes Companies products, visit our website at www.depuysynthes.com.

DSUS/JRC/0715/0921(1) 03/17

DePuy International, Ltd.St Anthony’s RoadLeeds LS11 8DTEnglandTel: +44 (0) 113 270 0461

DePuy Orthopaedics, Inc.700 Orthopaedic DriveWarsaw, IN 46582USATel: +1 (800) 366-8143Fax: +1 (574) 267-7196

www.depuysynthes.com

DePuy (Ireland)Loughbeg, RingaskiddyCo. CorkIrelandTel: + 353 21 4914 000Fax: + 353 21 4914 199

CONFIDENTIAL - FOR INTERNAL USE ONLY - DO NOT DISTRIBUTE

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