PRESS FIT CUPPRESS FIT CUPU N C E M E N T E DSURGICAL TECHNIQUECERRAH TEKNKIMPLANTS & INSTRUMENTSMPLANTLAR VE EL ALETLERThe key inorthopaedicsciencesPress Fit CupU N C E M E N T E DSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLERIntroduction 2GiriPatient Positioning 6Hasta Pozisyonlama Acetabular Reaming 6Acetabulumun Oyulmas Cup Trialing 7Test Cupn UygulanmasCup Impaction 8Cupn YerletirilmesiScrew Fixation 10Vidann FiksasyonuInsert Impaction 11Insertn YerletirilmesiInstruments&Trays 13El Aletleri&TavalarCONTENTS/NDEKLERPress Fit CupU N C E M E N T E DIntroductionGiriPress Fit CupSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLERIn principal for all forms of arthrosis, advance wear and tear of the hip joint becauseof degeneratif, posttraumatic or rheumatoid arthritis fracture of avascular necrosis of thehead of femur. Sequelae of earlier operations such as osteosynthesis, joint reconstruction,arthrodesis, hemiarthroplastic or total hip replacement. Press-fit cup, is an acetabularimplantforuncementedfixation.ThestandardcupmadeofTi6Al4Valloywiththreedimensional interlock grit blast presents a hemispherical shape with polar deflection toenhancetheperiferydistributionofthestresseseffectingthecup.Thetitaniumcup has three holes on supero-lateral side.The screws have a spheric head and havealways a good contact with their seatings, even if the introduction angle may be different.This prevents the fratting corrosion and assures the screw stability. In spite of the differentpossible introduction angles of the screw. Choosen as the basic material was Ti6Al4V whichhas been tried and tested over many years and is outstandingly biocompatible. For thebonesidecontactsurfaceoptionalTitaniumPlasmaSpraycoatingoradditionalHydroxyapatite coating enhances initial fixation and long term bone integration. Theporosity of plasma spray is ideal for osseointegration.Esas itibariyle arthrosisin btn formlar iindir. Femur bann avascular necroisisindeolan dejeneratif, posttraumatik veya rheumatoid arthritis krklarndan kaynaklanan kalaekleminin ilerlemi anma durumlarnda kullanlr. Osteosynthesis gibi erken operasyonlarnsonrasndakalanbozukluklarnda,eklemyenidenyaplandrmalarnda,arthrodesis,hemiarthroplastic veya total kala yenilemelerinde de kullanlr. Pres-fit cup sementsizfiksasyon salayan bir acetabular implanttr. Standart cup Ti6Al4V alamndan imal edilmiolup, kabn d yzeyinde oluan basknn yzeye dalmn salamak iin kumlanarakprzl bir yzey yapsna kavuturulmutur. Titanyum kabn supero lateral tarafnda 3 adetdelik vardr. Vidalar kresel bir kafaya sahiptirler ve balang alar farkl bile olsa yuvalarylaher zaman iyi bir uyum iindedirler. Bu durum, korozyona kar koruma salar ve vidanndengeli olmasn temin eder. Temel materyal olarak Ti64Al4V seilmi ve yllarca bu materyaldenenerek ve test edilerek biyolojik olarak son derece uygun olduu kantlanmtr. Kemiktarafndaki tutunma yzeyi iin opsiyonel olarak plazma sprey kaplama veya ek olarakhydroxyapatite kaplama ilk andaki tutunmay ve uzun dnemdeki kemik entegrasyonunuar tt r r . Pl azmaspr eyi ni ngzenekl i ol uuosseoi ntegr asyoni i ni deal di r .2Please Note : This document is intended as a guide for the surgeon only. There are multipletechniquesfortheinsertionofPressFitCupUncementedand,aswithanysurgicalprocedure, a surgeon should be thoroughly trained and beware that this procedure isappropriate for the patient before proceeding.Not: Bu dokman cerrahlar iin bir klavuz niteliindedir. Press Fit Cup (sementsiz) uygulanmasiin oklu teknikler mevcuttur ve dier cerrahi ilemlerde olduu gibi cerrah derinlemesineei ti ml i ol mal vei l emi nhastayauygunol duundanemi nol mal d r .Press Fit CupU N C E M E N T E DMaterialMalzemeSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLERCertified Titanium alloy according to ASTM F.136 - ISO 5832/3. It is selected for its,modulusofelasticityclosesttothatlivingbone,highfatiquestrengthandperfectbiocompatibility.Esneklikkatsaysnncanlkemikdokuyaokyaknolmasndan,yksekyorulmadayanmndan ve mkemmel biyolojik uyumluluundan dolay ASTM F 136 - ISO 5832/3yegresertifikal titanyum alamdan imal edilmitir.DDiamD mm10220000001102200000021022000000310220000004102200000051022000000610220000007102200000081022001004610220010048102200100501022001005210220010054102200100561022001005810220010060102200200461022002004810220020050102200200521022002005410220020056102200200581022002006046485052545658603Ref. NumberRef. NumarasTiAlV-alloyTitanyum AlamGrit BlastKumlanmRef. NumberRef. NumarasTi Plasma SprayTi Plazma SpreyRef. NumberRef. NumarasTi Plasma Spray+HATi Plazma Sprey+HAPress Fit CupU N C E M E N T E DPress Fit Cup InsertMaterialMalzemeSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLERThe PE-UHMW insert is fixed into the metal acetabular cup. However, the insert canbe removed via the two slots in the rim and reused again. The press fit cup can reducethepossibilityofweardebrisfromtheinnersurfaceoftheUHMWPEcup.Itis done by machining and polishing of the inner surface. The good precision of manufactureassures more over the direct contact between the UHMWPE insert and inner surface ofthe metal cup reducing micromotions and fretting The polyethylene insert is producedwith a 10 raised rim to reduce the incident of dislocation.PE-UHMW insert metal acetabular kabn iine sabitlenmitir. Bununla birlikte, insertkenardaki iki slot kullanlarak yerinden karlabilir ve tekrar kullanlabilir. Pres-fit cupn iindePE-UHMW insert bulunmasndan dolay anma ihtimali dktr. Bu durum i yzeyin hassasbir ekilde ilenmesinden kaynaklanr. retimin bu hassasiyeti PE-UHMW ile metal kabn iyzeyiarasndakidirektkontaktankaynaklananmikrohareketleriveanmayazaltr.Pol i eti l eni nser t, k kl ar engel l emeki i n, yksel enbi r kenar asahi pti r .UHMWPE Ultra Heavy Molecular Weight Polyethylene meets ASTM F.648 and ISO5834/2 standards.Selected for its;- High degree fo purity- Good biotolerance- Good mechanical performance- Friction propertiesASTM F 648 ve ISO 5834-1/2yeuygun olarak PE-UHMWmalzemeden imal edilmitir.Bu malzemenin seilmesinin nedenleri:-Yksek saflk derecesi-yi biyolojik uyum-yi mekanik performans-Srtnebilme zelliiD28 mmRef. NumberReferans NumarasPE-UHMWInsideDiam ap1021800700110218007002102180070031021800700410218007005102180070061021800700710218007008282828282828282846485052545658604OutsideDiamD apD mmPress Fit CupU N C E M E N T E DStarex ScrewStarex VidaMaterialMalzemeSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLERIf bone quality is such that the titanium cup has to be secured with screws, specialbone screws with spheric head and cancellous thread ( 6.5 mm) are used for fixation.For fixation, flexible drill and universal joint screw driver are avaliable. The screw havealways a good contact with their seatings, even if the introduction angle may be different.This prevent the fretting corrosion and assure the screw stability.Eer kemik kalitesinden dolay titanyum kabn vidalarla sabitlenmesi gerekiyorsa,fiksasyon iin kresel kafal ve spongioz dili zel kemik vidalar (q 6,5mm) kullanlr. Sabitlemeyiyapmak iin esnek matkap ve niversal eklem torna vidas edinilebilir. Vida, giri as farklbile olsa, her zaman girdii yerle iyi bir temas iindedir. Bu srtnme kaynakl korozyonunler ve vidann dengeli olmasn temin eder.CertifiedTitaniumalloyaccordingtoASTMF.136andISO5832/3.ASTMF136veISO5832/3yagresertifikaltitanyumalam.LDRef. NumberReferans NumarasTitaniumDiamapD mmLenghtUzunlukmm10802382003108023820041080238200510802382006108023820076.56.56.56.56.525303540455Press Fit CupU N C E M E N T E DAcetabular ReamingAftertheresectionoffemoralheadandneck,theacetabulumisexposed.Femoral kafaveboynunkesi l i pkarlmasndan sonra acetabulum ortayakar.With elevators, which are anchored atthe anterior and posterior acetabular rim,thefemurandadjacentsofttissuesaredisplaced,wherebytheacetabulumbecomes accessible throughout, its entirecircumference. Using motorised accessorieswith Acetabular Reamers (Ref:10610021004-1 2 ) , Acet abul ar Reamer S haf t(Ref:10610021101) and Extraction Sleeve (Ref:10601290005), the cartilage is first removedfrom the acetabulum which is then graduallydeepened and widened.Acetabularkenarlarnarteriorveposterioruna tutturulmu ekartrler yardmylafemurveyumuakdokuyerindenkarlrbyleceacetabulumveevresikolaycaulalabilir hale gelir. Acetabular oyucuyla veacetabular oyucu aftyla (Ref:10610040001)birlikte motorize aksesuarlar kullanlarak ncekkrdak alnr sonra cihaz aamal olarak dahageniletilir ve derinletirilir.Patient PositioningHasta PozisyonlamaThe goal of the surgical approach is toestablishadequatevisualizationoftheanatomy so that the entire surgical area isexposed.Cerrahiyaklamnamacanatomikyapnn uygun grntlenmesini salamaktr.The patient should be placed in a fulllateralpositionsecuredwithpositioningdevices to ensure complete patient stability.Ananterolateralapproachviaalateralcurvi l i neari nci si oni srecommended.Hasta,btnyledengedeolacakekilde, pozisyonlama cihazyla birlikte tamlateral pozisyona getirilmelidir.SURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER6Press Fit CupU N C E M E N T E DCup TrialingTest Cupn UygulanmasThetestcup(Ref:10608211044-60)isinserted into the reamed acetabulum until itreaches the floor. The test cup should fit fairlytightly in the acetabulum; it is desirable thatlight hammer blows are needed to drive thetest cup as far as the floor of the acetabulum.Forcefuldrivinginofthetestcupmustbeavoidedespeciallywhentheboneishard,because, otherwise, there is a danger of pelvicfracture. With the test cup it is possible to checkwherherthedefinitiveimplantissufficientlysurrounded by bone.Test Cup (Ref:10608211044-60) zemineulaanakadaroyulmuacetebulumiineyerletirilir.TestCupoldukaskbirekildeacetebulumaoturmuolmaldr.Testcupnacetebulum zeminine yerletirilmesinde hafifeki darbeleri vurulabilir. Kemik eer ok sertseglbirittirmeyaplmamaldr.Yaplmasdurumunda pelvisde krk oluabilir. Test kabylabirlikte olmas gereken asl implantn boyutlartamamen anlalr.The last reamer according to the preoperative planning is turned in manually usingT-Handle (Ref:10610040001) and Acetabular reamer components, slowly and carefully,so that excessive removal of bone is avoided and an exact hemispherical inner shape isachieved in the acetabulum.Kemikartklarnnalnmasveacetabulumuniineyarmkreeklindebirekiloluturmak iin operasyon ncesi planland gibi son oyucu T-Handle (Ref:10610040001)ve acetabular kompenentler kullanlarak son derece yava ve dikkatlice dndrerek ieridoru girii salanr.SURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER7Press Fit CupU N C E M E N T E DMounting the Press Fit Cup on the setting device: the setting instrument consists ofa disc-like impactor attachment (Ref:10601351044-60) marked with the implant nominaldiameter, a long handle and a central threaded rod (Ref:10601350010). There is an invidualimpactor attachment for each Press Fit Cup size. During implantation, attention needsto be paid to matching the diameter markings on the Press Fit Cup and the impactorattachment. The Press Fit Cup is mounted on the impactor attachment and the threadedrod is screwed into the central hole of the titanium shell. Both implant and impactorattachment are marked with arrows, which must point towards each other. They shouldbeorientated before impaction in the direction of the sacro-iliac joint, e.g. in the cranio-dor sal di r ecti on, sothatthescr ewsocketsar ecor r ectl yposi ti oned.Press Fit Cupn tutucuya montaj: press fit cup tutucu implant apyla markalanmimpactor attachment (Ref:10601351044-60), uzun bir sap ve u ksmna di alm merkezrodundan (Ref:10601350010) oluur. Her ebattaki Press Fit Cup ile kullanlabilecek farklboylarda impactor attachment paralar mevcuttur. mplantasyon esnasnda Press FitCup zerindeki ap ls ve impactor attachment elemesi hususuna dikkat edilmelidir.Press Fit Cup impactor attachment zerine tutturulur ve di alm rod press fik cupnmerkez deliine doru vidalanr. mplant ve impactor attachment oklarla iaretlidir, oklarbirbirlerini iaret edecek ekilde paralar birbirine tutturulur. Yerletirme ileminden ncevidadeliklerisacro-iliaceklemidorultusuna,rneincraniodorsaldorultusunda,ynlendirilmiolmaldr.Bylecevidadelikleridzgncekonumlandrlabilirler.CupI mpact i onCupn YerletirilmesiSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER840-45Press Fit CupU N C E M E N T E DThe prepared acetabulum is lined with a thin layer of bone shavings from the lasttwo reamers, so that even small gaps between acetabulum and implant are filled withbone material. The positioning guide (Ref:10602180009) for orienting the shell is pushedon to the handle (Ref:10601350010) connected to the positioning top. For orientation ofthe cup, lateral tilt of approx. 45 is aimed for, as well as anteversion of approx. 10. Thepositioning guide has two insert nuts for the positioning bar (Ref:10602180008), to be setfor the right (R) and left (L) hip. The Press Fit Cup is then inserted into the acetabulum usingthe setting instrument, its orientation checked using the positioning guide, and just fixedwith light hammer blows so that it can be re-orientated without use of significant force.The directional arrow points toward the sacro-iliac joint.Son iki reamern kullanm srasnda kan kemik paralar ince bir tabaka halindeacatebuluma yaylr, bylece acetabulum ve implant arasndaki kk boluklar bilekemik malzemesiyle doldurulmu olur. Press fit cup ynlendirmek iin Pozisyonlama Klavuzu(Ref:10602180009) Pozisyon Verdirici kolu zerine taklr. Cupn ynlendirilmesi iin lateraleim ortalama 45, anteversion eimi de ortalama 10 derece olmaldr. PozisyonlamaKlavuzunun Pozisyonlama Bar (Ref:10601350010) iin her iki yannda yuvalar vardr vehangi tarafa taklaca sa ve sol kalaya gre ayarlanr. Sonra Press Fit Cup, tutucukullanlarak acetabulum ierisine yerletirilir ve yerletirme ilemi pozisyonlama klavuzuyladorulanr. Hafif eki darbeleriyle sabitlenir, bylece fazla g kullanlmadan yerletirilmiolur. Okun yn sacro-iliac eklemini gsterir.When the implant is oriented correctly, all three pins of the positioning guideandthe positioning bar should lie horizontally. The thinner guide pins are aligned along thebody axis. The rim of the acetabulum is, of course, also an important aid to orientation.mplantdorucayerletirildiinde,pozisyonlamaklavuzundakiadetkolvepozisyonlama bar yatay eksene paralel olarak uzanyor olmaldr. Pozisyonlama klavuzununubuklarvcutekseniboyuncayataykonumagetirilirler.Acetabulumunkenardayerletirme iin yardmc bir klavuz niteliindedir.When the orientation is confirmed, the implant is driven into the acetabulum usinga heavy hammer. Adequate impaction of the Press Fit Cup can be recognised by thechange in the sound of the hammer blows and also by the fact that the implant doesnot go in any deeper with further hammer blows, and the rim of the implant closes withthe rim of the bony acetabulum, which was previously removed along the test cup.Additionally, following removal of the setting instrument.Yerletirme ilemi tamamlannca, implant ar bir eki yardmyla acetabulumierisine aklr. Press Fit Cupn tam yerine yerleip yerlemedii eki sesindeki deiimdenanlalabilirayrcaimplantyerineyerleincenekadarvurursanzvurundahaileriyegitmeyecektir ve implantn kenarlar acatebulumda alan yuvann kenarlar ile ayn hizadaolacaktr. Bundan sonra press fit cup tutucu sklr.SURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER 9Press Fit CupU N C E M E N T E DShouldadditionalscrewfixationbenecessary, holes are drilled (Ref:10809071040-50) in the direction of the sacro-iliac joint usingthe drill guide (Ref:10608021021) and a drill withfl exi bl edri veschaft(Ref:10601361101).Eerekstravidafiksasyonugerekliise;delikler (Ref:10809071040-50), sacro-iliac eklemihizasnda olacak ekilde ve Matkap Klavuzu(Ref:10608021021), matkap veFlexible DriveSchaft(Ref:10601361101)kullanlarakdelinir.Screw FixationVidann FiksasyonuThe depth of the drilled hole in the boneismeasuredusingthescrewdepthgauge(Ref:10608031021), in order to determine thecorrectscrewlength.Followingthis,thefirstthreadpitches(about10mmdeep)forthespongiosa screw are pre-cut using the screwtap (Ref:10606001101) on a Universal Joint TapHandle. The screw is then easily inserted intothe deeper soft spongiosa layers.Doru vida uzunluunu belirlemek iindeliklerinderinliiVidaDerinliklmaleti(Ref:10608031021) ile belirlenir. Bunu takiben,spongioz vidalar iin ilk giri derinlii (yaklak10mm),UniversalJointTapTutacannzeri ndeki Vi daTap (Ref:10606001101)kullanlarak nceden alr. Bundan sonra vidayumuak spongioz tabakaya kolayca sokulabilir.Wherehightorqueisnecessaryforinsertion, it is recommended to either revert toa shorter screw or to pre-cut the thread in thebonetothemeasuredlengthusingasteelscrew. Following this, the steel screw is removedandrepl acedwi thati tani umscrew.Giri iin yksek bir dndrme kuvvetiningerekli olduu yerde, ya daha kk bir vidayadnlmesi ya da elik vida kullanlarak kemiktekiboluunbelirlenenderinliegreyenidenalmas tavsiye edilir. Bundan sonra elik vidaysknveyerinetitanyumbirvidatakn.SURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER10Press Fit CupU N C E M E N T E DWhen the screw holes are adequatelyprepared,thescrewsareinsertedinthedirection of the sacro-iliac joint and tightenedusi ngtheUni versal Joi ntScrewDri ver(Ref:10604010012).Vi dadel i k l er i uygun ek i l dehazrlandnda,vidalarsacro-iliaceklemhizasndayerletirilirveUniversalTornaVida( Ref : 10604010012) kul l an l ar aks k l r .When the screw position is correct, theflatscrewheadsarefullyrecessedintothescrewsockets,avoidingcontactwiththepolyethylene insert. The complete recessing ofthescrewheadsintothesocketscanbecheckedusi ngI nser t Cont r ol Gui de(Ref:10601361044-60) with Replacement Handle(Ref:10601361010) and Extraction Sleeve (Ref:10601290005).ThecentralpinoftheInsertControl Guide , which is inserted into the centralhole of the shell and then rotated.Dz olan vida balar tamamyla yuvalarniine gmlm duruma gelince vida konumlaruygun hale gelmi demektir. Vidalarn PolietilenI nser t i l ekesi nl i kl et emaset memesigerekmektedir.Vidabalarnn,yuvalaratamamen gmlp gmlmedii Insert KontrolKlavuzu (Ref:10601361044-60), nsert YerletiriciKol(Ref:10601361010) ve Cup Yerletirici KoluTespitParas(Ref:10601290005)yardmyladorulanabilir. Bu ilem Insert Kontrol Klavuzununmerkezindekipiminpressfitkabnmerkezdeliineyerletirilmesivebudeliketrafndadndrlmesi eklinde olur.The polyethylene insert has three smallholes on its front face, which grip the pins ofthe Screw-in Attachment (Ref:10601361028).PolietilenInsertnyzndekkdel i esahi pti rvebudel i kl erScrew-i nAttachment(Ref:10601361028)parasnnpi ml eri yl es k cakenetl enmeyeyarar.Insert ImpactionInsertn YerletirilmesiSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER 11Press Fit CupU N C E M E N T E DThe polyethylene insert is guided into the titanium shell using the setting instrument.Initially, the central polyethylene pin is inserted into the central hole of the shell. The anti-dislocation rim can be rorated in 30 steps into the desired position such that, in the finalposition, the teeth on the insert rim fit into the grooves in the titanium shell. the raised rimof the insert, which serves as protection against dislocation in extreme positions withoutload especially in low sitting positions with adducted thigh, is normally inserted in a cranio-dorsal position, i.e. at an approximately 10 oclock position for the right hip, and 2oclock for the left hip. When the desired position is achieved, the polyethylene insertis impacted into the titanium shell using the hammer, ensuring that the teeth of the insertarefullyrecessedintothegroovesinthetitaniumshell.Thisendstheimplantation.Polietilen Insert Replacement Handle (Ref:10601361010) yardmyla press fit cupierisine yerletirilir. lk olarak insertn merkezindeki polietilen knt press fit cupn merkezdeliine yerletirilir. nsertn yksek kenar knts 30 derecelik aralklarla istenilen pozisyonyakalanana kadar dndrlebilir. Son pozisyonda insertn kenarndaki dilerin press fitcuptaki karlklara oturmas gerekmektedir. nsertn ykseltilmi kenar, yklemesiz vezelliklebazoturupozisyonlarndakklarnlemekiindir.Bukenarnormalolarakcraniodorsal pozisyonda yerletirilir. rnein; ortalama sa kala iin saat 10 pozisyonundave sol kala iin saat 2 pozisyonunda. stenilen pozisyona eriildiinde polietilen insert ekikullanlarak press fit cup ierisine sktrlr. Bu ilem srasnda insertn dilerinin press fitcuptakiyuvalaratamolarakoturduunaeminolarakimplantasyonubitiriniz.SURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER12Press Fit CupU N C E M E N T E DSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER10601091011 Starex Screw Holding ForcepsStarex Vida Tutucu10601361028 Screw-in Attachment for Press Fit CupInsert Yerletirici10601361010 Replacement HandleInsert Yerletirici Kol106013510441060135104610601351048106013510501060135105210601351054106013510561060135105810601351060Impactor Attachment for Press Fit CupCup Yerletirici44 46 48 50 52 54 56 58 6010601350010 Press Fit Cup HandleCup Yerletirici Kol1060129000513tray 1tava 1tray 2tava 2tray 3tava 3Instruments & Trays/El Aletleri & TavalarExtraction SleeveCup Yerletirici Kolu Tespit ParasPress Fit CupU N C E M E N T E DSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER10604101020 Hexagonal Wrench for Press Fit CupAltgen Tornavida10604010012 Universal Joint Screw driver for Press Fit CupFleksibl Tornavida10604010010 Hexagonal Long Screw driver for Press Fit CupKortikal Tornavida10602180009 Positioning GuideYn Gsterici Pozisyon Guide10602101005 Hohmann Retractor Type 5Ekartr Hohmann - Tip 510602041002 Bone Hook BluntKemik engeli - Kt10601361110 Universal Joint Tap HandleFleksibl Tap Tutucu106082110441060821104610608211048106082110501060821105210608211054106082110561060821105810608211060 Test Cup for Press Fit CupTest Cup44464850525456586010608031021 Depth GaugeDerinlik ler10608021021 Gyroscopic Drill GuideDrill Guide10606001101 Tap for Press fit CupTap10602180008 Bar for Positioning GuideYn Gsterici Pozisyon Guide Kolu10601361101 Flexible ShaftFleksibl aft106013610441060136104610601361048106013610501060136105210601361054106013610561060136105810601361060Insert Control Guide for Press Fit CupInsert Kontrol Guide44 46 48 50 52 54 56 58 6014Press Fit CupU N C E M E N T E DSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER1080907104010809071050Drill for Press Fit CupDrill3.5x25x403.5x30x5010610040001 T- Handle106100210041061002100510610021006106100210071061002100810610021009106100210101061002101110610021012 Acetabular ReamerAcetabular oyucu 44 46 48 50 52 54 56 58 6010610021101Acetabular Reamer ShaftAcetabular oyucu aft15Press Fit CupU N C E M E N T E DSURGICAL TECHNIQUE / CERRAH TEKNKIMPLANTS & INSTRUMENTS / MPLANTLAR VE EL ALETLER16Notes/NotlarKemalpasa Cd. 7404/1 Sk. No: 3 Pinarbasi - IZMIR - TURKEYTel: +90 232 479 56 54 Fax: +90 232 479 58 27marketing@tipsan.com.tr www.tipsan.com.trRevision 03 / Printed in TURKEY - 09/10 - TIPSAN DesignThe products being manufactured by TIPSAN A.S. has been certified from SZUTEST (StrojrenskZkuebn stav)for EC certificate(CE 1015) according to Annex II. 3 and II.4of Council Directive93/42/EEC concerning medical devices