PINNACLE REVISION CUP SYSTEM ® This publication is not intended for distribution in the USA. DESIGN RATIONALE FLEXIBILITY. PRECISION. CONFIDENCE. DePuy Synthes Joint Reconstruction is proud to offer the PINNACLE Revision Acetabular Cup System to address the need for enhanced stability and biomechanical optimisation while providing immediate and long-term fixation. The PINNACLE Revision Acetabular Cup System was designed to deliver intraoperative flexibility to address the unique challenges of revision acetabular surgery. DESIGNED IN CONSULTATION WITH: William Barrett, MD Seattle WA Michael Christie, MD Nashville TN Daniel Berry, MD Rochester MN Charles Engh, MD Alexandria VA Gregory Brick, MD Boston MA Thomas Fehring, MD Charlotte NC John Callaghan, MD Iowa City IA William Griffin, MD Charlotte NC The PINNACLE Revision Acetabular Cup System consists of the Standard Profile, Deep Profile (DPx) and a Multi-hole shell that feature: • Allowance for mechanical fixation in the rim or dome • Dome screw holes that can angulate up to 34 degrees designed for intraoperative flexibility and optimal bony purchase • The patented VIP taper that accommodates multiple bearing options to address a wide array of patients, activity levels and demand requirements • Available sizes ranging from 38 to 80 mm • GRIPTION® Porous Coating 1 DePuy Synthes Joint Reconstruction PINNACLE Revision Cup System Design Rationale FIXATION: IMMEDIATE AND LONG-TERM Standard and Deep Profile (DPx) shells feature: • A full 180-degree hemisphere for rim friction fit designed to enhance immediate cup stability • Deep Profile (DPx) shells with variable, progressive lateralisation that increases with shell size to provide proper graduated proportional medial defect fill • Multiple peripheral and dome screw holes for immediate fixation • Superiorly clustered dome screw holes to aid bone screw positioning into the best quality host bone • Peripheral screw holes for additional fixation while complementing the natural compressive loading of the acetabulum GRIPTION Porous Coating GRIPTION technology is a cementless coating specifically engineered to maintain a clinically advantageous 64% surface volume porosity and an average 220-micron pore structure.1,2,3 This makes allowance for good tissue growth and vascularisation onto and around an implant. Combined macrotexture and microtexture topographies can provide a favourable mechanical loading environment for bone reconstitution and enable greater cell adhesion and proliferation.5 GRIPTION coating provides a 1.2 coefficient of friction which is a substantial improvement over plasma spray coating and contemporary tantalum cementless interface.2,4 This offers potentially improved stability and “scratch fit” upon implantation. PINNACLE Revision Cup System Design Rationale DePuy Synthes 2 OPTIONS FOR MODULARITY & BIOMECHANICS: INTRAOPERATIVE FLEXIBILITY TO MATCH YOUR PATIENT’S NEED Neutral ALTRX® ALTRA-LINKED™ Polyethylene Liners are designed to optimise the range of motion by having a wide face chamfer while keeping the femoral head’s centre of rotation concentric with the outer diameter of the shell. +4 Neutral ALTRX ALTRA-LINKED Polyethylene Liners are designed to enhance hip stability, by lateralising the femoral head’s centre of rotation by 4 mm. +4 10 Degree ALTRX ALTRA-LINKED Polyethylene Liners are designed to re-direct the available range of motion and optimise positioning to allow the cup, screw holes and GRIPTION Porous Coating to come into contact with the most optimal surface area of the acetabulum. 4 mm of additional lateralisation Apex Changes Cup inclination/version by 10 degrees dependent on placement of liner Apex Lipped ALTRX ALTRA-LINKED Polyethylene Liners are designed to provide a high wall along one side of the liner to increase the jump distance in the specific area that the head must travel before dislocation can occur. Peak of Angle Face (Not Lipped) Lip to be positioned superior/ posterior PINNACLE DPx SHELLS Providing the ability to reproduce the correct centre of rotation The ability to reproduce the centre of rotation is further enhanced with the deep profile cup. The PINNACLE deep profile shells allow the surgeon to address soft tissue laxity through a proportionally variable offset DPx cup. DPx Cup Size (mm) Lateralisation (mm) 54-58 4 60-66 5 68-72 6 Standard Profile 3 DePuy Synthes Joint Reconstruction PINNACLE Revision Cup System Design Rationale Deep Profile ENHANCED STABILITY LINERS PINNACLE Hip Solutions are designed with a wide range of acetabular cup options, biological and mechanical fixation alternatives and advanced bearing technologies. The PINNACLE ESC™ Constrained Liner system helps to address hip instability and dislocation through a high range of motion. Features of the ESC Constrained Liner includes: • • • • • High strength head capture Compatible with bi-polar or modular heads +4 Neutral and +4 10° options GVF polyethylene for enhanced mechanical integrity Simple insertion instrumentation ARD (anti-rotational device) tabs for rotational stability. Chamfered titanium constraining ring provides ease of assembly and increased stability. Titanium locking ring securely holds the ESC liner into the Pinnacle shell to minimise potential disassembly. Ridge to aid in preventing constraining ring slippage. Progressively larger ID and head sizes to help promote increased range of motion. GVF polyethylene. Poly slits and a flex groove for ease of head insertion. PINNACLE Revision Cup System Design Rationale DePuy Synthes 4 ORDERING INFORMATION Acetabular Cup Style Cat No. Acetabular Liner Size Required (mm) Dome Screw Hole Qty. Peripheral Screw Hole Qty. GRIPTION Multi-hole II 1217-30-038 38 1217-30-040 40 1217-30-042 42 1217-30-044 44 1217-30-046 46 1217-30-048 48 1217-30-050 50 1217-30-052 52 1217-30-054 54 1217-30-056 56 1217-30-058 58 1217-30-060 60 1217-30-062 62 1217-30-064 64 1217-30-066 66 1217-30-068 68 1217-30-070 70 1217-30-072 72 38 40 42 44 46 48 50 52 54 56 58 60 62 64 66 68 70 72 5 6 6 6 6 8 10 10 12 12 12 12 12 12 12 12 12 12 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 GRIPTION Standard Profile 1217-16-054 54 1217-16-056 56 1217-16-058 58 1217-16-060 60 1217-16-062 62 1217-16-064 64 1217-16-066 66 1217-16-068 68 1217-16-070 70 1217-16-072 72 1217-16-074 74 1217-16-076 76 1217-16-078 78 1217-16-080 80 48 50 52 54 56 58 60 62 64 66 70 72 74 76 5 5 5 5 5 9 9 9 9 9 9 9 9 9 8 8 8 8 8 8 8 8 8 8 8 8 8 8 GRIPTION Deep Profile DPx 1217-17-054 54 1217-17-056 56 1217-17-058 58 1217-17-060 60 1217-17-062 62 1217-17-064 64 1217-17-066 66 1217-17-068 68 1217-17-070 70 1217-17-072 72 48 50 52 54 56 58 60 62 64 66 5 5 5 5 5 9 9 9 9 9 8 8 8 8 8 8 8 8 8 8 5 Outer Diameter (mm) ESc Constrained Liner Cat No. Description Neutral+4 1218-28-648 1218-28-650 1218-32-652 1218-32-654 1218-32-656 1218-32-658 1218-32-660 1218-32-662 1218-32-664 1218-32-666 1218-32-668 1218-32-670 1218-32-672 1218-36-656 1218-36-658 1218-36-660 1218-40-662 1218-40-664 1218-40-666 1218-40-668 1218-44-670 1218-44-672 1218-44-674 1218-44-676 28ID 48OD 28ID 50OD 32ID 52OD 32ID 54OD 32ID 56OD 32ID 58OD 32ID 60OD 32ID 62OD 32ID 64OD 32ID 66OD 32ID 68OD 32ID 70OD 32ID 72OD 36ID 56OD 36ID 58OD 36ID 60OD 40ID 62OD 40ID 64OD 40ID 66OD 40ID 68OD 44ID 70OD 44ID 72OD 44ID 74OD 44ID 76OD Cat No. Description 10 Degree +4 1218-28-748 1218-28-750 1218-32-752 1218-32-754 1218-36-756 1218-36-758 1218-36-760 1218-40-762 1218-40-764 1218-40-766 1218-40-768 1218-44-770 1218-44-772 1218-44-774 1218-44-776 28ID 48OD 28ID 50OD 32ID 52OD 32ID 54OD 36ID 56OD 36ID 58OD 36ID 60OD 40ID 62OD 40ID 64OD 40ID 66OD 40ID 68OD 44ID 70OD 44ID 72OD 44ID 74OD 44ID 76OD 5.0 mm 6.5 mm Peripheral Cortical Cancellous Dome Bone Screw Screw Cat No. Length (mm) Neutral+4 1257-25-000 1257-30-000 1257-35-000 1257-40-000 1257-45-000 1257-50-000 1257-55-000 1257-60-000 1257-65-000 25 30 35 40 45 50 55 60 65 DePuy Synthes Joint Reconstruction PINNACLE Revision Cup System Design Rationale Cat No. Length (mm) Neutral+4 1217-08-500 1217-15-500 1217-20-500 1217-25-500 1217-30-500 1217-35-500 1217-40-500 1217-45-500 1217-50-500 1217-55-500 1217-60-500 1217-65-500 1217-70-500 8 15 20 25 30 35 40 45 50 55 60 65 70 References 1. Bobyn JD, Pilliar RM, Cameron HU, Weatherly GC. The optimum pore size for the fixation of porous surfaced metal implants by the ingrowth of bone. Clin Orthop 1980;150:263-270. 2. DePuy Internal Test Report: WR070146; 2007. 3. DePuy Internal Test Report: WR070125; 2007. 4. Published literature: No.97-7255-098-00 1003-M20 .5ML, Zimmer Inc, 2010 and Zimmer Holdings, Inc. Trabecular Metal Technology. Website accessed Jan 23rd 2014 at URL http://www.zimmer.com/en-US/hcp/hip/our-science/tm-technology.jspx. 5. Karageorgiou V, et al. Porosity of 3D biomaterial scaffolds and osteogenesis. Biomaterials 2005;26:5474-91 DePuy Orthopaedics EMEA is a trading division of DePuy International Limited. Registered Office: St. Anthony’s Road, Leeds LS11 8DT, England Registered in England No. 3319712 DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, Indiana 46582 USA Tel: +1 (800) 366 8143 Fax: +1 (574) 267 7196 DePuy International Ltd St Anthony’s Road Leeds LS11 8DT England Tel: +44 (0)113 387 7800 Fax: +44 (0)113 387 7890 depuysynthes.com ©DePuy International Ltd. and DePuy Orthopaedics, Inc. 2014. All rights reserved. CA#DPEM/ORT/0214/0001 Issued: 04/14 0086