OR manual CORON - tantum AG

OR manual
CORON

tantum · OR manual CORON
2
Duo-head Acetabular cup
Head Large head
Flexibility - thanks to
the modular set up:
the best treatment for
each indiation can be
achieved through
various components.

CORON – The cemented
hip endoprosthesis by tantum
tantum · OR manual CORON
The tantum Straight Stem-Hip-Endoprosthesis-System
Years of experience and excellent clinical results with
the implantation of cemented straight stem prosthesis
led to the development of the tantum Straight Stem-
Hip-Endoprosthesis-System. The system with its modular
concept, allows individual adjustment with the
treatment of medial femoral neck fractures in elderly
patients.
System components:
– Straight Stem-Hip-Endoprosthesis, cemented, with
matt surface, 12/14mm Conus
– Head of steel, 28 mm diameter, three neck-lenghts
– Acetabular cup: of PE, cemented
– Duo-head: external shell of steel with inlay of PE,
28mm diameter.
– Large head: of steel, one neck length
Our prothesis´ stems are manufactured from high
nitrogen alloy implant steel following ISO 5832-9.
Indication
Medial femoral neck fractures, with or without coxarthrosis
in elderly patients
Recommendation of treatment
– Patients with coxarthrosis: total replacement of the
hip joint with cemented acetabular cup and stem
– Patients without coxarthrosis: duo-head with cemented
stem
– Bedridden patients: large head with cemented stem
3

tantum · OR manual CORON
Implantation of the CORON-
Hip-Endoprosthesis with
Duo-Head or Large Head
Fig. 1
Fig. 2
4
10-15°
1. Positioning and opening
The patient must be positioned supine with the affected
side slightly elevated. The approach is made by
administering a curved skin incision with the greater
trochanter at the center. This incision is then directed
towards the anterior superior iliac spine. Exposure of
the gluteus medius muscle and splitting in line with the
muscle fibers (Fig. 1).
Positioning of two Hohmann retractors ventrally and
dorsally of the femoral neck. Opening of the capsule
and resection of the ventral parts. Now the fracture
can be exposed.
2. Resection of the femoral neck
Change of the Hohmann retractors position by placing
them intraarticular. Depending on the type of fracture,
the femoral head can now be fixated and dislocated.
Measuring the head diameter with the gauge.
Osteotomy of the femoral neck in a line 1cm ventrally
of the lesser trochanter reaching in a 45° angle
towards the greater trochanter. Next, the femoral
head is removed (Fig. 2).

Fig. 3
Fig. 4
3. Preparation of the femoral shaft
tantum · OR manual CORON
Adduction and external rotation of the femur.
Opening of the medullary cavity, with a sharp spoon,
directly at the medial femoral cortex and removal of
the bone marrow as far as the femoral canal. Manual
reaming of the medullary cavitiy by using the reamers
(Pos. 13) (Fig. 3), beginning with the smallest size until
the cranial end of the reamer can be completely inserted
into the intramedullary canal aligning the femoral
neck resection.
Inserting the prosthesis and eventually verification of
the exact position with the image intensifier. Removal
of the trial prosthesis.
4. Implantation of the straight-stem-prosthesis
Insert the medullary canal plug (PE) (cement stopper,
Pos. 18) with the handle for the cement stopper (Pos.
5) into the distal medullary canal. Instead of the PEplug,
cancellous bone from the femoral head can be
used as an alternative. Preparation of the bone cement
in vacuum technique and placing an air escape tube in
the medullary canal.
Injection of the cement and insertion of the definite
prosthesis to the appropriate marking (Fig. 4). While
hardening, the cement must be pressurized with slight
pressure of the impactor (Pos. 8) on the prosthesis.
After irrigating the joint with large amounts of
Ringer´s solution, the capsule resection borders must
be finally checked for bleeding.
5

tantum · OR manual CORON
Fig. 5
Fig. 6
6
40°
5. Implantation of the Duo-Head or the Large Head
Placing the trial head (Pos. 2 and 16) (Duo-Head: middle
neck length of the trial head (Pos. 15)) in the previous
chosen size into the hip-joint (Fig. 5). If the measured
size lies between two sizes, the smaller one must
be chosen.
Trial reduction and verification of the leg length, the
range of motion and an eventual tendency for luxation.
With implantation of a Duo-Head, correction by
changing to a head with a different neck length might
be necessary, eventually, by using the wedge (Pos. 12)
for femoral heads.
Removal of the trial head and positioning of the definite
implant (Fig. 6) (Duo-Head: after placing the desired
femoral head into the Duo-Head with the Duo-
Head-forceps, Pos. 1). Placement of two Redon-drains
dorsally and laterally. Finally, closure of the wound one
layer at a time.

Implantation of the CORON-
Hip-Endoprosthesis with
cemented acetabular cup
Fig. 7
Fig. 8
10-15°
1. Positioning and opening
The patient must be positioned supine with the affected
side slightly elevated. The approach is made by
administering a curved skin incision with the greater
trochanter at the center. This incision is then directed
towards the anterior superior iliac spine. Exposure of
the gluteus medius muscle and splitting in line with the
muscle fibers (Fig. 7).
Positioning of two Hohmann retractors ventrally and
dorsally of the femoral neck. Opening of the capsule
and resection of the ventral parts. Now the fracture
can be exposed.
2. Resection of the femoral neck
tantum · OR manual CORON
Change of the Hohmann retractors position by placing
them intraarticular. Depending on the type of fracture,
the femoral head can now be fixated and dislocated.
Measuring the head diameter with the gauge.
Osteotomy of the femoral neck in a line 1cm ventrally
of the lesser trochanter reaching in a 45° angle
towards the greater trochanter. Next, the femoral
head is removed (Fig. 8).
7

tantum · OR manual CORON
Fig. 9
Fig. 10
Fig. 11
8
40°
3. Preparation of the acetabulum
Removal of the capsule in the cranial and caudal part.
In order to minimize the danger of bleeding, it is
recommended to leave the posterior part in place.
Exposure of the acetabulum with a shaped Hohmannretractor,
its tip placed behind the dorsal rim, and a
second retractor positioned on the anterior rim. Then,
resection of existing exophytes and cartilage of the
acetabulum with the reamer (Pos. 4 und 14) in the previously
selected size.
4. Implantation of the acetabular cup
Placement of the acetabular trial cup (Pos. 3 und 17) in
the previously selected size and determination of the
definite size (Fig. 9). For optimal fixation of the acetabular
cup, drilling of two to three anchoring pivots for
the bone cement cranially and medially. Irrigation of
the joint with Ringer´s solution.
Preparation of the bone cement and placement in the
acetabulum. Implantation of the PE-acetabular cup,
correctly angled, with the bent cup impactor (Pos. 6
and 7) and hardening in the exact same postion (Fig.
11). Excess cement must be cleaned off thoroughly
before the final hardening.
Finally, place armed, wet gauze into the cavity of the
acetabular cup.

Fig. 12
Fig. 13
Fig. 14
5. Preparation of the femoral shaft
Adduction and external rotation of the femur.
Opening of the medullary cavity, with a sharp spoon,
directly at the medial femoral cortex and removal of
the bone marrow as far as the femoral canal.
Automatic and manual reaming of the medullary cavitiy
by using the reamers (Pos. 13) (Fig. 12), beginning
with the smallest size until the cranial end of the reamer
can be completely inserted into the intramedullary
canal aligning the femoral neck resection.
Inserting the prosthesis and verification of the exact
position with the image intensifier.
6. Implantation of the straight-stem-prosthesis
Insert the medullary canal plug (PE) (cement stopper,
Pos. 18) with the handle for the cement stopper (Pos.
5) into the distal medullary canal. Instead of the PEplug,
cancellous bone from the femoral head can be
used as an alternative. Preparation of the bone cement
in vacuum technique and placing an air escape tube in
the medullary canal. Injection of the cement and insertion
of the definite prosthesis to the appropriate
marking (Fig. 13). While hardening, the cement must
be pressurized with slight pressure of the impactor
(Pos. 8) on the prosthesis. After irrigating the joint with
large amounts of Ringer´s solution, the capsule resections
must be finally checked for bleeding.
7. Implantation of the femoral head
tantum · Operationstechnik CORON
Placing the trial head of middle neck length (Pos. 15)
onto the straight-stem-prosthesis. Reduction of the
prosthesis into the PE acetabular cup and verification
of exact leg length and eventual tendency for luxation.
Eventual correction by changing to a head with a different
neck length (Pos. 15).
Removal of the trial head and positioning of the definite
implant (Fig. 14) using the femoral head impactor
(Pos. 9 und 10). After a last control of function, placement
of two Redon-drains dorsally and laterally.
Finally, closure of the wound one layer at a time..
9

tantum · OR manual CORON
01) 200-100 Duo-head forceps
02) 200-120 Handle for trial heads
03) 200-121 Handle for size tester
04) 200-122 Handle for cup reamer
05) 200-123 Handle for cement stopper
06) 200-124 Cup inserter, bended
07) 200-125 Head for cup inserter
08) 200-126 T-handle
09) 205-130 Hammer for straight stem
10) 205-131 Impactor for head
11) 205-132 Cap for head impactor
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CORON Instruments
12) 205-134 Wedge for head
13) Straight stem mono reamer
7.5 207-101 11.25 207-104
8.75 207-102 12.5 207-105
10.0 207-103 13.75 207-106
2002
December
14) Cup reamer
notice.
Ø 44 mm 207-111 Ø 54 mm 207-116 prior
Ø 46 mm 207-112 Ø 56 mm 207-117
Ø 48 mm 207-113 Ø 58 mm 207-118
Ø 50 mm 207-114 Ø 60 mm 207-119 without
Ø 52 mm 207-115 Ø 62 mm 207-120
occur may
15) Trial head
changes
S, Ø 28 mm, 12/14 208-120
M, Ø 28 mm, 12/14 208-121
L, Ø 28 mm, 12/14 208-122
16)
measurements.Technical
Trial head
Ø 42 mm 208-152 Ø 50 mm 208-126
Ø 44 mm 208-123 Ø 52 mm 208-127 original
Ø 46 mm 208-124 Ø 54 mm 208-128
the
Ø 48 mm 208-125 Ø 56 mm 208-129to
equivalent not
17) Size tester
and
Ø 44 mm 208-133 Ø 54 mm 208-138
Ø 46 mm 208-134 Ø 56 mm 208-139
Ø 48 mm 208-135 Ø 58 mm 208-140schematic
Ø 50 mm 208-136 Ø 60 mm 208-141
Ø 52 mm 208-137 Ø 62 mm 208-142
are shown figures
18) 102-103 Cement stopper The

CORON Components
Head, sterile
Material: steel (ISO 5832-9)
Diameter: 28 mm
Cone: 12/14 mm
Neck length Art. No.
S 102-100
M 102-101
L 102-102
Duo-head, sterile
Material:
External shell:
steel (ISO 5832-1)
Inlay: PE (ISO 5834-2)
Inlay Ø: 28 mm
Outer Ø Art. No.
42 mm 102-205
44 mm 102-206
46 mm 102-207
48 mm 102-208
Large head, sterile
Material: steel (ISO 5832-1)
Cone: 12/14 mm
Outer Ø Art. No.
40 mm 102-110
42 mm 102-111
44 mm 102-112
46 mm 102-113
48 mm 102-114
50 mm 102-115
Outer Ø Art. No.
50 mm 102-209
52 mm 102-210
54 mm 102-211
56 mm 102-212
Outer Ø Art. No.
52 mm 102-116
54 mm 102-117
56 mm 102-118
58 mm 102-119
60 mm 102-120
Straight stem, cemented, sterile
Material: steel (ISO 5832-9)
Cone: 12/14 mm
Surface: matt
Size Art. No.
7.5 102-401
8.75 102-402
10.0 102-403
11.25 102-404
12.5 102-405
13.75 102-406
Acetabular cup, cemented, sterile
Material: PE (ISO 5834-2)
Inner Ø: 28 mm
Outer Ø Art. No.
44 mm 102-300
46 mm 102-301
48 mm 102-302
50 mm 102-303
52 mm 102-304
Cement stopper, sterile
Material: PE (ISO 5834-2)
X-ray indicator: steel
Art. No. 102-103
Outer Ø Art. No.
54 mm 102-305
56 mm 102-306
58 mm 102-307
60 mm 102-308
62 mm 102-309
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tantum AG
Mühlenhof 65
D-24534 Neumünster
Telephone +49 4321-2 00 59 0
Fax +49 4321-2 00 59 19
info@tantum-ag.de