S U R G I C A L T E C H N I Q U E A D D E N D U M

Peripheral Baseplate Reamer

TORNIER

AEQUALIS™ REVERSED IIShoulder System

Intended Use.......................................................................................................................................................... 2

Overview ................................................................................................................................................................. 2

General Glenoid Preparation ............................................................................................................................. 3

Technique 1: Peripheral Reaming ..................................................................................................................... 3

Technique 2: Peripheral Re-Reaming ............................................................................................................... 5

Technique 3: Revision Reaming ........................................................................................................................ 6

Instrument Set ....................................................................................................................................................... 7

Table of Contents:

INTENDED USEPlease refer to the AEQUALIS™ Reversed II Instructions for Use for a complete list of indications. Instrumentation instructions for use for the peripheral reamer instrumentation are listed in IFU-UTBI.

OVERVIEWThis technique contains instructions for the use of the Reversed II peripheral baseplate reaming system. This optional reamer system provides the surgeon with the opportunity to ream the peripheral bone recess surrounding the baseplate following implantation of the baseplate and screw components. This technique will cover three techniques:

TECHNIQUE 1: PERIPHERAL REAMINGReaming of the peripheral bone is performed after the baseplate and screws have been implanted using the peripheral reamers .Prior to baseplate reaming, only the 25 or 29mm central baseplate reamer is used.

TECHNIQUE 2: PERIPHERAL RE-REAMINGThis technique uses the peripheral reamers to perform a secondary “re-reaming” of the peripheral bone recess once the baseplate and screw components have been implanted.

TECHNIQUE 3: REVISION REAMINGThis technique uses the peripheral reamers in revision situations where a 36mm sphere is removed and replaced by a 42mm sphere. This requires reaming of the peripheral bone to prepare for the larger sphere diameter without removal of the baseplate or screws.

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TECHNIQUE 1: PERIPHERAL REAMINGThis technique performs the complete peripheral reaming step after the baseplate and screw components have been implanted. The standard AEQUALIS™ Reversed II peripheral reamer is not used in this technique. Only the central baseplate reaming step is performed prior to implantation of the baseplate and screws. This technique is described in the following steps:

Central Glenoid ReamingWith the 6mm pilot hole prepared, the central reamer is assembled to the handle based on the baseplate size chosen in the previous step (25mm or 29mm diameter). The central reaming step is performed according to the standard AEQUALIS™ Reversed II surgical technique (CAW-2145). (Figures 1 and 2)

Note: No peripheral reaming is performed at this time.

Baseplate and Screw ImplantationThe baseplate and screws are then implanted as described in the AEQUALIS™ Reversed II Surgical Technique (Figure 3).

Peripheral Bone ReamingComplete reaming of the peripheral bone is now performed. The reamer associated with the previously chosen baseplate and sphere sizes is attached to the T-Handle from the standard AEQUALIS™ Reversed II tray (MWB497).

The pilot tip on the reamer is then carefully inserted into the central hole of the implanted baseplate in alignment with the axis of the baseplate post (Figure 4).

Figure 1

Figure 2

Figure 3

Figure 4

GENERAL GLENOID PREPARATIONCentral Baseplate PreparationAll steps prior to implantation of the baseplate should be followed as they are described in the AEQUALIS™ Reversed II surgical technique (CAW-2145) using either cannulated or non-cannulated instrumentation.

This technique will describe alternative methods for preparing the bone using the AEQUALIS™ Reversed II peripheral reamers.

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Manual reaming is then performed using a back and forth reaming motion (Figure 5). Progression of the reaming should be gradual, being careful not to ream too aggressively and cause glenoid fracture.

Figure 6

Note: Reaming with the peripheral reamers must be performed manually. Do not use these reamers under power.

Note: Care should be taken not to place leverage on the reamer to avoid transferring stress onto the baseplate components.

Figure 5

Sphere ImplantationFollowing secondary reaming of the peripheral bone recess, the sphere is then implanted as described in the AEQUALIS™ Reversed II Surgical Technique (Figure 6).

To ensure proper assembly, verify that the sphere is flush with the bottom of the baseplate and the components are properly assembled.

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Note: The pie-shaped or standard peripheral reamers can be used to perform peripheral reaming of the bone.

Figure 7

Figure 8

Figure 9

Figure 10

TECHNIQUE 2: PERIPHERAL RE-REAMINGThe peripheral re-reaming technique performs all reaming steps (central and peripheral reaming steps) prior to implantation of the baseplate and screws with the standard AEQUALIS™ Reversed II instrumentation. When necessary, the peripheral reamer system allows for additional re-reaming of the peripheral bone after the baseplate and screws have been implanted. This technique is described in the following steps:

Central Glenoid ReamingWith the 6mm pilot hole prepared, the central reamer is assembled to the handle based on the baseplate size chosen in the previous step (25mm or 29mm diameter). The central reaming step is performed according to the standard AEQUALIS™ Reversed II surgical technique (CAW-2145) (Figure 7).

Peripheral Glenoid ReamingNext, the peripheral reamer is assembled to the handle based on the desired sphere size (36mm or 42mm diameter sphere). Reaming is performed until the peripheral bone recess has been created as described in the AEQUALIS™ Reversed II Surgical Technique (Figure 8).

Baseplate and Screw ImplantationThe baseplate and screws are then implanted as described in the AEQUALIS™ Reversed II Surgical Technique (Figure 9).

Secondary Peripheral Bone ReamingIf required, the peripheral reamer may be used to provide secondary reaming of the peripheral bone recess.

The reamer associated with the previously chosen baseplate and sphere sizes is attached to the T-Handle.

The pilot tip on the reamer is then carefully inserted into the central hole of the implanted baseplate in alignment with the axis of the baseplate post (Figure 10).

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Manual reaming is then performed using a back and forth reaming motion (Figure 11). Progression of the reaming should be gradual, being careful not to ream too aggressively and cause glenoid fracture.

Sphere ImplantationFollowing secondary re-reaming of the peripheral bone recess, the sphere is then implanted as described in the AEQUALIS™ Reversed II Surgical Technique (CAW-2145) (Figure 12).

To ensure proper assembly, verify that the sphere is flush with the bottom of the baseplate and the components are properly assembled.

TECHNIQUE 3: REVISION REAMINGThis technique uses the peripheral reamers in revision situations where a 36mm sphere is removed and replaced by a 42mm sphere. This requires reaming of the peripheral bone to prepare for the larger sphere diameter without removal of the baseplate or screws.

Sphere RemovalSphere removal is performed according to the standard AEQUALIS™ Reversed II surgical technique (CAW-2145) using the glenoid sphere extractor and screw.

Peripheral Glenoid ReamingThe reamer associated with the implanted baseplate and corresponding 42mm sphere is attached to the T-Handle from the standard AEQUALIS™ Reversed II tray (MWB497).

Note: Reaming with the peripheral reamers must be performed manually. Do not use these reamers under power.

Note: Care should be taken not to place leverage on the reamer to avoid transferring stress onto the baseplate components.

Note: Reaming with the peripheral reamers must be performed manually. Do not use these reamers under power.

The pilot tip on the reamer is then carefully inserted into the central hole of the implanted baseplate in alignment with the axis of the baseplate post (Figure 13).

Figure 12

Figure 11

Figure 13

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Manual reaming is then performed using a back and forth reaming motion (Figure 14). Progression of the reaming should be gradual, being careful not to ream too aggressively and cause glenoid fracture.

Sphere ImplantationFollowing reaming of the peripheral bone recess, the new sphere is then implanted as described in the AEQUALIS™ Reversed II Surgical Technique (Figure 15).

To ensure proper assembly, verify that the sphere is flush with the bottom of the baseplate and the components are properly assembled.

Note: Reaming with the peripheral reamers must be performed manually. Do not use these reamers under power.

Note: Care should be taken not to place leverage on the reamer to avoid transferring stress onto the baseplate components.

Figure 15

Figure 14

INSTRUMENTATION: 9711500

Part Number Description Qty.

9028708 Peripheral Reamer 25-36mm 1

9028709 Peripheral Reamer 25-36mm 1

9028710 Peripheral Reamer 29-36mm 1

9028711 Peripheral Reamer 29-42mm 1

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1023 Cherry RoadMemphis, TN 38117800 238 7117901 867 9971www.wright.com

10801 Nesbitt Avenue SouthBloomington, MN 55437888 867 6437952 426 7600www.tornier.com

Proper surgical procedures and techniques are the responsibility of the medical professional. This material is furnished for information purposes only. Each surgeon must evaluate the appropriateness of the material based on his or her personal medical training and experience. Prior to use of any Tornier implant system, the surgeon should refer to the product package insert for complete warnings, precautions, indications, contraindications, and adverse effects. Package inserts are also available by contacting Wright. Contact information can be found in this document and the package insert.

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CAW-5086 Rev B ECN 160814 08-Jun-2016