Longevity and stability

(1)

(2)

Why dual mobility?

Longevity

and

stability

Small head diameter reduces wear – the

"LOW FRICTION" principle

Large head diameter provides

good joint stability

The combination of

these two concepts

reduces wear while

ensuring good

sta-bility with a dual

mobility design

Two concentric articulations that resist wear

and improve stability:

The small articulation, more often loaded,

preserves the polyethylene

The large articulation, loaded at the

ex-tremes of ROM, ensures stability

(3)

Overview of the concept

Since the early 1980s, the clinical effectiveness of the dual mobility

concept has been proven in terms of:

- better joint stability

- greater range of motion

In primary arthroplasty, as well as in revision or acetabular

reconstruction cases, this concept covers a range of homogeneous

implants.

HAP Quattro VPS cup

CEM Quattro cup

CEM Quattro cup /

Marc. K cross plate

(4)

Technical features that meet your needs

Retention of the implant head:

m head passes through a restriction

that is smaller than its diameter

m optimal height of polyethylene

insert which does not compromise

strength at the material's elastic

limit and avoids any plastic

deformation

Modeling of polyethylene stresses and deformation

during passage of the head

-

A long descending insert: eliminates risk of altering

diameter at restriction point

-

B shortened insert: excessive stresses cause

irreversible deformation of restriction point

A

B

Cobalt-chrome metal alloy:

m optimal rigidity of the cup

m hardness reduces risk of scratching

m sphericity maintained during entire life of implant

Porous titanium sublayer:

m vacuum-plasma sprayed to reduce risk

of weakening the implant interface

m surface roughness essential to obtain the

"anchoring volume"

x primary implant fixation

x secondary fixation through binding of

newly formed bone into the pores of the

coating

Pure hemispheric shape:

m prevents risk of damaging cam effect between

implant neck and cup edge

m compatible with preferred cup inclination to prevent

psoas impingement and risk of posterior dislocation

Insert with large descending coverage:

m long beveled edge (1)

to protect neck and preserve 3

rd

articulation (between insert and neck)

m second protective beveled edge (2)

to prevent impingement between Morse

taper and retaining rim

1

2

x200 magnification (binocular microscope)

Homogeneous layer of hydroxyapatite:

(5)

Preventing instability

Quattro VPS cup Press Fit

Dual mobility insert

HAP Quattro VPS cup

Sizes 44 to 60*

Sizes 44 to 60, Ø 22.2 and 28 mm*

Sizes 44 to 60*

*Refer to complete product reference number list

Flattened polar end

cap to avoid bottoming out

of cup and encourage

equatorial press-fit

4 tropical spikes to

prevent implant from

tipping

Bilayer coating

consisting of

vacuum-plasma sprayed (VPS)

porous titanium

underlayer and

hydroxyapatite layer

6 fins around

the equator to

provide rotational

stability

Spherical shape with

indentation for improved

clearance

The implant geometry, macrostructure and

surface finish were developed so that optimal

primary stability could be achieved without

relying on the fixation screw

Test report: Tipping resistance test for various cup

configurations (data from manufacturer)

(6)

Optimizing reconstruction

The Marc. K acetabular cross plate is a metal

reinforcement guide used during acetabular

reconstruction.

In this indication, the benefits of dual mobility cups

are indisputable because of

- reduced stress

- good stability

CEM Quattro cup

Dual mobility insert

Correspondence Marc. K cross plate with CEM Quattro cup

Marc. K acetabular cross plate

Sizes 44 to 56*

Sizes 44 to 56, Ø 22.2 and 28 mm*

Size Marc. K cross plate Quattro Quattro

Ø 22 mm Ø 28 mm

4 44 -

5 48 48

6 52 52

Sizes 4 to 6, left and right*

(7)

13001 A /

V1 / 07-13

BIBLIOGRAPHY

1. Aslanian T. Reprise de prothèse totale de hanche : contraintes et solutions industrielles. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: 2006. p. 527-544.

2. Escaré P. Le cotyle élastique sans ciment MBA : résultats de 105 implantations à 9,5 ans de recul médian. Arthroplastie totale de hanche de 1ère intention : A la recherche du « Gold Standard ». Sauramps Medical ed. Montpellier: 2011. p.327-38.

3. Connes H, Desbonnet P, Escaré P, Tricoire JL, Trouillas J. Du descellement à la migration de l’implant cotyloïdien. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: 2006. p. 181-192. 4. Long-term results of low-friction. arthroplasty of the hip performed as a primary intervention; J Bone Joint Surg Br February 1972 vol. 54-B no. 1, 61-76.

5. Prudhon JL. Présentation série rétrospective Quattro SICOT 2012 (Dubaï)

6. GUYEN MD O, SHAN CHEN Q, BEJUI-HUGUES J, J. BERRY D, Kai-Nan AN, Dual mobility hip implants: effect on hip stability, (Journées Lyonnaises de Chirurgie de la Hanche 2008)

7. Aslanian T. Les matériaux constitutifs des prothèses de hanche. Histoire, évolutions et tendances. Arthroplastie totale de hanche de 1ère intention : A la recherche du « Gold Standard ». Sauramps Medical ed. Montpellier: 2011. p.113-32.

8. Aslanian T, Raossanaly C ; Verdier R. Les fractures d’implant : rares et chères. Arthroplastie totale de hanche de 1ère intention : A la recherche du « Gold Standard ». Sauramps Medical ed. Montpellier: 2011. p.553-66. 9. Trouillas J, Verdier R. Tige fémorale anatomique sans ciment MBA : apport de la modularité. Arthroplastie totale de hanche de 1ère intention : A la recherche du « Gold Standard ». Sauramps Medical ed. Montpellier: 2011. p.211-20.

10. Tricoire JL. Le cotyle et son isthme iliaque : anatomie, anthropologie et biomécanique. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: 2006. p. 171-180.

11. Desbonnet P, Tricoire JL, Connes H, Escaré P, Trouillas J. Le cotyle à plot « Intégra » dans les reprises d’arthroplastie de hanche avec grande destruction osseuse. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: 2006. p. 379-402.

12. Trouillas J, Escaré P, Connes H, Desbonnet P. Reconstruction métaphysaire et tige anatomique – Le concept Intégra. La reprise de prothèse totale de hanche. Sauramps Médical ed. Montpellier: 2006. p. 475-502.

Dual mobility is an effective technical approach to

meet all the requirements of orthopedic surgeons

who want to ensure that the joint is stable, leg

length is equal and muscle tension is restored.

GROUPE LEPINE is committed to making all of

these needs co-exist with optimal and safe use of

these implants, based on its manufacturing

know-how (1-3), which takes into account a unique

mechanical environment, as well as a sound

published clinical follow-up (4-9).

9 rue philosophe Tabrizi Les sources Bir Mourad Rais - ALGER [email protected]

C/J.J. Tadeo Murguía N. 3 - 5 BAJO 20304 IRÚN (GUIPÚZCOA) [email protected]

79 avenue IBN SINA 10.080 RABAT - AGDAL [email protected] Via Cassanese, 100

20090 Segrate (Milano) [email protected]

175 rue Jacquard - ZI Lyon Nord 69730 Genay - FRANCE TEL. +33 (0)4 72 33 02 95 FAX +33 (0)4 72 35 96 50 www.groupe-lepine.com

(8)

Size acetabular cross Marc.K Quattro VPS Quattro VPS

Ø 22,2 mm Ø 28 mm

4 44

-5 48 48

6 52 52

HAP Quattro VPS cup

Size Ref. 44 HQCHC044 46 HQCHC046 48 HQCHC048 50 HQCHC050 52 HQCHC052 54 HQCHC054 56 HQCHC056 58 HQCHC058 60 HQCHC060

HAP Quattro cup Press Fit

Size Ref. 44 HQCPF044 46 HQCPF046 48 HQCPF048 50 HQCPF050 52 HQCPF052 54 HQCPF054 56 HQCPF056 58 HQCPF058 60 HQCPF060

Dual-mobility

liner

Size Diameter Ref.

44 22,2 HQN DP244 46 22,2 HQN DP246 48 22,2 HQN DP248 50 22,2 HQN DP250 52 22,2 HQN DP252 54 22,2 HQN DP254 56 22,2 HQN DP256 58 22,2 HQN DP258 60 22,2 HQN DP260 48 28 HQN DM848 50 28 HQN DM850 52 28 HQN DM852 54 28 HQN DM854 56 28 HQN DM856 58 28 HQN DM858 60 28 HQN DM860

Range of Quattro Cobalt-chrome cups

Marc. K. acetab cross

Size Side Ref.

4 right SI0200964 5 right SI0200965 6 right SI0200966 4 left SI0200974 5 left SI0200975 6 left SI0200976

Cortical bone screw Ø 5 mm

Length Ref.

40 SI0351340 50 SI0351350 60 SI0351360

Correspondence Marc. K acetabular cross and CEM Quattro cup

CEM Quattro cup

Size Ref. 44 HQCCC044 46 HQCCC046 48 HQCCC048 50 HQCCC050 52 HQCCC052 54 HQCCC054 56 HQCCC056 58 HQCCC058 60 HQCCC060

(9)

Size Side Ref. 4 right SA0201064 5 right SA0201065 6 right SA0201066 4 left SA0201074 5 left SA0201075 6 left SA0201076

www.groupe-lepine.com

Vacuum pump

holder, Quattro VPS

Ref. HQA VI003

Vacuum pump positionner

Ref.

HQA VI004

M10 impactor

Ref.

HQA VI002

Quattro VPS pump plate

Size Ref. 44 HQA VI044 46 HQA VI046 48 HQA VI048 50 HQA VI050 52 HQA VI052 54 HQA VI054 56 HQA VI056 58 HQA VI058 60 HQA VI060

Pump end joint

Ref. HQAJS009

M10 Impaction end

Ref. HMA TA009

Liner impactor

Ref. HQA VI011

Pump piston joint

Ref.

HQAJS011

Pump plate joint

Size Ref. 44 HQAJS028 46/48 HQAJS032 50/52 HQAJS036 54/56 HQAJS040 58/60 HQAJS044

M10 trial cup

Size Ref. 44 HL3010-144 46 HL3010-146 48 HL3010-148 50 HL3010-150 52 HL3010-152 54 HL3010-154 56 HL3010-156 58 HL3010-158 60 HL3010-160

Dual-mob trial liner

Size Diameter Ref.

44 22,2 HQA VN244 46 22,2 HQA VN246 48 22,2 HQA VN248 50 22,2 HQA VN250 52 22,2 HQA VN252 54 22,2 HQA VN254 56 22,2 HQA VN256 58 22,2 HQA VN258 60 22,2 HQA VN260 48 28 HQA VN848 50 28 HQA VN850 52 28 HQA VN852 54 28 HQA VN854 56 28 HQA VN856 58 28 HQA VN858 60 28 HQA VN860

M10 head impaction tip

Ref.

HMA TA008

Quattro VPS cup rack N1

Ref.

HQA VP003

Quattro VPS cup rack N2

Ref.

HQA VP005

Monobloc stem fork

Ref.

HQA VI010

HAP and CEM Quattro Cobalt-chrome cups

Marc. K acetabular cross plate

T handle screwdriver

HEX 3.5

Ref. SA0360007

Drill Ø 3,2 L 200

Ref. GUA FX050

A01 Bowl

Ref. UCAEC004

A01 small holes bowl

Ref.

UCAEC008

Depth gauge

Ref.

HL3010-200-07

Marc. K. trial cross

Liner impactor end

Ref.

HQA VI013

Marc. K. acetabular cross

holder

Ref. HKA PA001

A02 Bowl

Ref. UCAEC003

Universal rack H75

Ref. UCAPA001

Universal cover 534 X 249

Ref. UCACO001

N°2 mini bowl

Ref. UCAEC010