0344_12_LSNRGPR_ST_Rev6_ScorpNRG_PR_Proto_US

Scorpio

NRG

CR & PS

Single Radius Primary Knee System

Surgical Protocol

This document is intended to be used by healthcare professionals only.

Posterior Referencing

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Table of Contents

Xcelerate Instrumentation Surgical Technique

For Scorpio NRG Single Radius Primary Knee System

Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Femoral Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Femoral Intramedullary Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

Distal Femoral Resection Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .3

Distal Femoral Resection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Femoral A/P Sizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

A/P Adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .5

A/P and Chamfer Bone Cuts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6

Notch Preparation for Scorpio PS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7

Option 1: Punch Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8

Compacting Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

Option 2: Saw Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Compacting Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Femoral Trial Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Tibial Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Option 1: Extramedullary Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Tibial Resection Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Proximal Tibial Resection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15

Option 2: Intramedullary Technique - IM Rod Placement . . . . . . . . . . . . . . . . . . . .16

Rotation and Varus/Valgus Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Flexion/Extension Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Tibial Resection Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19

Proximal Tibial Resection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20

Tibial Baseplate Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

Scorpio NRG Tibial Component Sizing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

Tibial Component Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22

Tibial Keel Punching . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24

Patella Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Patella Trial Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25

Implantation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26

Tibial Component . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26

Tibial Bearing Insert Assembly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Implantation of Femoral Component . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Implantation of the Patellar Component . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Appendix 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

Scorpio NRG Tibial Punching Sequence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

Appendix 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Scorpio NRG Sizing Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Appendix 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Scorpio NRG PS Femoral Component . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Scorpio NRG PS Inserts - N2Vac . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Scorpio NRG PS Tibial Inserts - X3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Appendix 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Scorpio NRG CR Femoral Component . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Scorpio NRG CR Tibial Insert - N2Vac . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Scorpio NRG CR Tibial Insert - X3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Appendix 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Tibial Component Baseplate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Patella Component - N2Vac . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Patella Component - X3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32

Figure 1

Figure 2

Figure 3

Exposure

> Use a standard anterior mid-line incision

(Figure 1). Previous incisions may be used or

incorporated to decrease the risk of skin slough.

> Enter the capsule through a medial parapatellar

approach approximately 1cm from the medial

border of the patella.

> Incise the quadriceps mechanism longitudinally to

allow adequate patellar eversion and sufficient knee

flexion (Figure 2).

Femoral Preparation

Femoral Intramedullary Alignment

> Use 3/8" diameter drill to enter the intramedullary

canal of the femur (Figure 3).

Femoral

Preparation

Figure 4

Figure 5

Figure 6

> The drill hole is located approximately 1cm anterior

to the femoral attachment of the posterior cruciate

ligament and slightly medial to the mid-line of the

distal femur (Figure 4).

> Removal of osteophytes from the margins of the

intercondylar notch may aid identification of

landmarks.

> It is recommended that the drill hole be slightly

enlarged. This can be accomplished by toggling the

drill, using a rongeur, or inserting an axial reamer.

> Place the 5/16" T-Handle Rod through the Femoral

Alignment Guide and insert the assembly into the

intercondylar drill hole (Figure 5). Advance the rod

slowly into the intramedullary canal. A suction

source may be attached to the suction fitting on the

rod to reduce the potential for excessive canal

pressurization.

> Place the Femoral Alignment Guide in contact with

the more prominent distal femoral condyle and align

the guide by referencing the posterior condyles or the

epicondyles. The Femoral Alignment Guide can be

partially stabilized by advancing the medial and/or

lateral fixation spikes and gently impacting them into

distal bone.

> The Femoral Alignment Guide is designed for use on

either the left or right knee and can be set at any

valgus angle between 3° and 9°.

Set the instrument to the desired angle by pulling the

knob of the Femoral Alignment Guide and placing it

in the appropriate notch (Figure 6). Handles may be

attached to the sides of the guide to aid in alignment

and stabilization.

Femoral

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

3/8 " Drill Hole

Valgus Angle Setting

Pull Knob to Set

Valgus A ng le

IM Handle

Figure 7

Figure 8

Figure 9

Distal Femoral Resection Level

> The XcelerateSystem offers 8mm, 10mm and 12mm

Distal Femoral Resection Guides.

Note: Removing 8mm of distal bone corresponds

to the 8mm distal thickness of the Scorpio NRG

Femoral Components.

> Select the appropriate Distal Femoral Resection

Guide and assemble it to the Femoral Alignment

Guide by positioning the Resection Guide over the

two pegs on the alignment guide. The resection guide

is locked into place by pushing and turning the

locking knob 1⁄4 turn clockwise (Figure 7).

Note: The components shall be positioned to avoid

excessive hyperextension. Excessive femoral flexion and

tibial slope should be avoided when implanting the

components. Implant positioning resulting in excessive

hyperextension may result in premature wear and

damage to the implant.

> Prior to pinning the Distal Femoral Resection Guide

to the femur, an optional external alignment check

may be performed. Attach the Alignment Handle to

the Distal Femoral Resection Guide and insert the

Alignment Rod into the handle (Figure 8).

Alignment is correct when the rod intersects the

center of the femoral head and roughly parallels the

axis of the femur in the lateral view. Once acceptable

alignment is confirmed, remove the handle and pin

the Distal Femoral Resection Guide to the anterior

femur using two 1/8" drill pins.

> The Drill-Pin Driver can be attached directly to the

reamer, drill fitting, or a Jacob`s Chuck. The drill

pins are loaded into the driver and drilled through

the “0” set of holes on the resection guide. The pins

are automatically released from the driver as it is

pulled back.

> After the resection guide is pinned in place, the

alignment guide is removed. Release the resection

guide from the alignment guide by pushing and

rotating the locking knob 1/4 turn counter-clockwise.

Remove the IM rod, and the Distal Femoral

Alignment Guide, leaving the Distal Femoral

Resection Guide in place (Figure 9).

Note: If the “X” Pin hole is used, this pin must be

removed prior to repositioning or removing the Distal

Femoral Resection Guide.

Note: A Blade Runner may be used to further assess the

resection.

Femoral

Preparation

Femoral Alignment

Guide

Distal Femoral

Resection Guide

Locking Knob

Alignment

Handle

Alignment

Rod

“X” Pin

Holes

Figure 10

Figure 11

Figure 12

Distal Femoral Resection

> Once the resection level is determined, make the

distal femoral resection (Figure 10).

> Xcelerate Instruments are designed to provide precise

control of the sawblade during bone resections. Using

a 0.05" (1.27mm) thick saw blade produces the most

accurate resections.

> Once the distal femoral resection is complete, remove

the guide and check the cut is smooth and flat.

> Remove the 1/8" drill pins with the Pin Puller.

Femoral A/P Sizing

> The A/P Sizer is designed to set the desired

external rotation and to provide adjustment of the

anterior/posterior position when needed.

> Attach the Modular Handles to Sizer. Set the A/P

adjustment indicator to “0” (Figure 11).

> Adjust the Sizer to the desired degree of external

rotation and position the instrument flush on the flat

distal femur, sliding the feet of the Sizer under the

posterior condyles (Figure 12). Note that the medial

lateral width of the implant can be assessed by referencing

the width of the anterior portion of the sizer at each

implant size. If desired, rotation can be further adjusted

by using the Modular Handles to reference and parallel

the epicondylar axis. Tighten the locking knob.

Note: It is important that the A/P adjustment

indicator be set to zero prior to placing the A/P Sizer on

the distal femur. Failure to set the indicator to zero may

lead to incorrect sizing of the femur.

Note: Option to pin (Figure 12).

Femoral

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

1/8” Drill Pins

Distal Femoral

Resection Guide

Option to pin

Figure 13

Figure 14

Figure 15

> Snap the Femoral Stylus into position on the

anterior surface of the Sizer. Using the Blade

Runner, determine the implant size that gives the

optimum anterior fit (Figure 13).

> Place the appropriate size drill bushing into the

A/P Sizer, taking care to ensure it is correctly

oriented. Using a 1/8" drill pin, prepare the

distal peg holes.

Note: If you plan to use the Scorpio Universal

Notch block with lugs you can check your position

in the medial lateral with the A/P sizer.

A/P Adjustment

> On occasion the femur will fall between two implant

sizes. Preparing for the smaller size may potentially

notch the femur.

> Preparing for the larger size prevents notching but

may lead to overstuffing of the patello-femoral joint

(Figure 14). The A/P Sizer has been designed to

avoid both these situations by allowing the overall

position of the drill holes to be adjusted to provide

the optimum anterior resection.

> When an adjustment of the A/P sizer is necessary,

loosen the locking knob and reposition the A/P

adjustment indicator until it indicates the

“-2” position (Figure 15).

Femoral

Preparation

resection

too deep

resection

too proud

Figure 16

Figure 17

Figure 18

> This will shift the position of the peg holes 2mm

anteriorly, raising the level of the anterior resection

and preventing notching of the anterior cortex

(Figure 16). However, it will remove an additional

2mm of bone from the posterior condyles, increasing

the flexion gap. Care must be taken to properly

balance the flexion and extension gaps in this

situation.

> When the A/P Sizer is adjusted to the +2mm mark,

the level of the anterior resection is moved posteriorly

2mm. The amount of posterior bone removed is

reduced. This is useful in cases where the flexion gap

is particularly loose.

A/P and Chamfer Bone Cuts

> Assemble the Cutting Block Impactor/Extractor to

the Impaction Handle.

> Insert the two prongs of the Cutting Block

Impactor/Extractor into the two distal holes on the

cutting guide.

> Position the corresponding Femoral 4:1 Cutting

Block into the pin holes and impact until the block

is seated flush on to the distal femur. Additional

fixation can be achieved by pinning the Femoral 4:1

Cutting Block to the bone.

> Impact the Cutting Block Impactor/Extractor using a

mallet while guiding alignment of the Femoral 4:1

Cutting Block with the other hand.

> Use of a 0.05” (1.27mm) thick, 18mm wide saw blade is

recommended

> Complete the remaining four bone resections

> The recommended bone resection sequence for the

Femoral 4:1 Cutting Block is:

1. Anterior Cortex

2. Posterior Condyles

3. Posterior Chamfer

4. Anterior Chamfer

> Extract the Femoral Cutting Guide by using the Cutting

Guide Impactor/Extractor

> Do not remove the Femoral 4:1 Cutting Block from the

bone by impacting on the backside of block.

Extraction with the Cutting Block Impactor/Extractor

> Assemble the Cutting Block Impactor/Extractor to the

Impaction Handle.

> Insert the two prongs of the Impactor/Extractor into the

two distal holes on the Femoral 4:1 Cutting Block.

> Extraction can be achieved by pulling on the attached

handle. If additional force is needed, the Slaphammer may

be attached to the end of the Impaction Handle.

Note: Additional fixation support should be provided for the

cutting block to ensure block stability during disengagement

of the adapter when used on osteoporotic bone.

Femoral

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Original too deep

Anterior resection

2mm

Adjusted

resection

too proud

Impaction Handle

Cutting Block

Impactor/Extractor

Figure 19

Figure 20

Notch Preparation for Scorpio PS

> The Scorpio Universal Preparation Block Instrument

is used after completion of the five femoral bone cuts.

> Select the appropriately sized Universal Notch Block.

The block sits on the anterior, anterior chamfer and

distal cuts. The anterior geometry represents the left

and right lateral flanges of the implant of the same

size. The sides are marked LL and RL for left lateral

and right lateral, respectively.

> Position the Notch Block on the prepared distal femur,

aligning the lugs with the holes made by the Femoral

Cutting Guide. Tap into place with the mallet

(Figure 19). To further aid the positioning, if using

pegless blocks, note that the block is also the same

width as the implant of its respective size.

Note: Pins used with the size 3, 4 and 5 Notch Blocks

should be used with no more than one pin per side to

avoid the potential for the pins intersecting with each

other. Pins should be used on the contra-lateral side from

each other. For example, if a pin is placed through the

medial anterior chamfer hole, a second pin should only

be placed on the lateral side through either the chamfer

or anterior flange hole. Towel clamps may be used for

additional stability if necessary in the indicated holes on

the distal plane.

> Once the Notch Block is seated flush against the

anterior, anterior chamfer and distal cuts of the

femur, drill 1/8" headless pins through the angled

holes (“X”) on the anterior and/or anterior chamfer

surfaces of the block (there are 4 “X” holes each at

15°) (Figure 20).

> Towel clamps may be used on the medial and

lateral sides of the distal portion of the block.

It is recommended to use at least the 2 anterior pin

holes, even if towel clamps are used.

> Stryker recommends the following instructions be

used when using the Size 3 Notch Preparation Guide:

Size 3 Notch Block Notch Preparation

Pins used with the size 3 Notch Block should only

be placed in through the anterior chamfer to avoid

hitting the notch punch.

Do not place pins through the anterior flange.

Towel clamps may be used for additional stability

if necessary, in the indicated holes on the distal plane.

Femoral

Preparation

Scorpio Universal

Notch Block

Figure 21

Figure 22

Figure 23

Option 1: Punch Technique

Note: If the femoral bone is sclerotic, Option 2 (Saw

Technique) should be used for the notch preparation.

> Assemble the appropriately sized Notch Punch to the

punch handle.

> Guide the Notch Punch into the tracks on the distal

face of the Notch Block (Figure 21). The rails on the

sides of the cutting edge fit into the tracks on the

inside walls of the block.

> Using a mallet, impact the Punch until it reaches

the end-stop and is fully seated in the Notch

Block (Figure 22).

> Remove the Punch from the tracks with a Slaphammer

if necessary (Figure 23).

Note: It is not uncommon for the area of bone being

prepared to be removed by the punch at the time of

extraction. In this instance, it is still necessary to clean

out remaining soft tissue and compact.

Note: Using an osteotome or rongeur, remove the

margin of the intercondylar bone necessary to ensure

that all soft tissue is cleared from the intercondylar area

of the femur. (It is important to remove all soft tissue in

the femoral notch prior to compacting bone to avoid

future potential soft-tissue impingement).

Femoral

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Notch Punch

Slaphammer

Notch Preparation

Slaphammer Fitting

Figure 24

Figure 25

Figure 26

Compacting Technique

> Assemble the appropriately sized Notch Compactor

to the punch handle (Figure 24).

> Guide the Notch Compactor into the tracks on the

distal face of the Notch Block.

> Using a mallet impact the compactor until it reaches

the end-stop and is fully seated in the Notch Block

(Figure 25).

> Remove the Compactor from the tracks with a

Slaphammer if necessary (Figure 26).

Femoral

Preparation

Notch Punch

Slaphammer

Notch Punch

Figure 27

Figure 28

Figure 29

Option 2: Saw Technique

> Guide the pegs of the appropriately sized Notch Saw

Guide into the anterior holes on the Notch Block

(Figure 27).

> Use a narrow saw blade, osteotome, or double-edged

reciprocating saw blade and the Notch Saw Guide as

a guide to saw or cut distally through the entire depth

of the intercondylar notch (Figure 28).

> Using the inner walls of the Universal Notch Guide as

a saw guide, lay the saw blade flat against the cutting

guide and saw on it through the intercondylar notch

both medially and laterally until the cut is complete

(Figure 29).

Note: Even if the saw technique is used, you must still

perform the Notch Compacting step to confirm that

enough bone was removed to accommodate the cam

and post.

Femoral

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Notch

Saw Guide

Figure 30

Figure 31

Figure 32

Compacting Technique

> Assemble the appropriately sized Notch Compactor

to the punch handle (Figure 30).

> Guide the Notch Compactor into the tracks on the

distal face of the Notch Block. The rails on the sides

of the cutting edge fit into the tracks on the inside

walls of the block.

> Using a Mallet, impact the Compactor until it reaches

the end-stop and is fully seated in the Notch Block

(Figure 31).

> Remove the Compactor from the tracks with a

Slaphammer if necessary (Figure 32).

Femoral

Preparation

Notch Compactor

Slaphammer

Notch Punch

Figure 33

Figure 34

Femoral Trial Assessment

> Assemble the appropriate size and side (Left/Right)

PS or CR Femoral Trial to the Femoral Impactor/

Extractor.

> Impact the PS or CR Femoral Trial onto the

prepared distal femur ensuring the Femoral trial is

aligned with the distal plane.

> Remove the Femoral Impactor/Extractor and assess

the fit of the PS or CR Femoral Trial. Care must be

taken to ensure that all of the osteophytes beyond

the end of the posterior femoral condyles are

removed.

• Cruciate Retaining Knee: Attach the 1/4" Peg

Drill to the Universal Driver and create the

Femoral Distal Fixation Peg holes if using the

Pegless Trials. Use a 1/8" drill for size 3 and 4

femoral Trial. Option: After removing size 3

or 4 Femoral Trial, follow-up with 1/4 in Peg

Drill.

• Posterior Stabilized Knee: If the Peg Holes

were not prepared by using the Pegged Notch

Block, attach the 1/4" Peg Drill to the Universal

Driver and create the Femoral Distal Fixation

Peg holes. Use a 1/8" drill for size 3 and 4

femoral Trial. Option: After removing size 3

or 4 Femoral Trial, follow-up with 1/4" Peg

Drill.

Tibial Preparation

Option 1: Extramedullary Technique

> With the knee flexed, place the External Tibial

Alignment Guide on the tibial shaft. Place the

spring-loaded clamp around the distal tibia just

above the malleoli.

> Place the head of the Proximal Rod over the tibial

eminence. There should be a finger’s breadth clearance

between the proximal shaft of the alignment guide and

the anterior cortex when the head is positioned

properly. Center the proximal fixation pins over the

tibial eminence and tap in the most posterior pin first

to fix the anterior/posterior location of the head.

> Rotation is now adjusted, and then set, by anchoring

the second pin. Tighten the vertical screw to secure the

proximal shaft of the guide (Figure 34).

Femoral

Preparation

Tibial

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Proximal Shaft

Fixation Pin

Vertic a l Screw

Figure 35

Figure 36

Figure 37

> Axial alignment is achieved when the vertical

shaft of the instrument parallels the long axis of

the tibia in both the anterior/posterior and

medial/lateral adjustment thumbscrews to

facilitate alignment (Figures 35 and 36).

> Landmarks often used to obtain correct axial

alignment and rotation include:

1. Tibial Tubercle – The alignment rod usually

lies over the medial third of the tibial tubercle.

2. Second Metatarsal – The second metatarsal

generally is in line with the center of the ankle

(Figure 37).

Femoral

Preparation

External Tibial

Alignment Guide

Medial/Lateral

Adjustment Screw

Anterior/Posterior

Adjustment Screw

External Tibial

Alignment Guide

Distal

Alignment

Tibial

Preparation

Figure 38

Figure 39

Figure 40

> Once axial alignment is established, tighten the

anterior/posterior and medial/lateral adjustment

thumbscrews (Figure 38).

Tibial Resection Level

> The XcelerateSystem offers Right and Left, 0° and 5°

Tibial Resection Guides.

Note:

0 degrees of posterior slope is recommended for use

with the Scorpio PS femoral components.

5 degrees of posterior slope is recommended for use

with the Scorpio CR femoral components.

> Assemble the tibial stylus onto the Tibial Resection

Guide by depressing the button on the top of the

Tibial Stylus, inserting the stylus into either the medial

or lateral holes on the top of the Tibial Resection

Guide and releasing the button to lock the stylus into

place (Figure 39).

> Attach the Tibial Resection Guide/Tibial Stylus

assembly to the External Tibial Alignment Guide by

sliding it over the top of the proximal shaft, adjusting

the stylus to reference the desired point on the tibial

plateau (Figure 40).

Note: The components shall be positioned to avoid

excessive hyperextension. Excessive femoral flexion and

tibial slope should be avoided when implanting the

components. Implant positioning resulting in excessive

hyperextension may result in premature wear and

damage to the implant.

Tibial

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Rotational Alignment

Anterior Posterior

Adjustment Screw

Medial/Lateral

Adjustment Screw

Tibial Stylus

Locking Button

Tibial Resection

Guide

Proximal

Shaft

External Tibial

Alignment Guide

Figure 41

Figure 42

Figure 43

> The Xcelerate System offers two Tibial styli each

having two resection levels; 2mm and 8mm.

> The settings allow for a corresponding resection

of bone below the point of the stylus (i.e. the

2mm setting allows for a 2mm resection below

the point of the stylus). (Figures 41 and 42).

> Once the resection level is established, tighten

the thumbscrew on the Tibial Resection

Guide. The Tibial Stylus is removed by

depressing the button and pulling it out.

Proximal Tibial Resection

> Secure the Tibial Resection Guide to the proximal

tibia using two 1/8" drill pins, drilling through the

“0” holes.

> Loosen the thumbscrew that holds the Tibial

Resection Guide to the External Tibial Alignment

Guide.

> Loosen the vertical adjustment thumbscrew on the

shaft of the alignment guide.

> Using the Slaphammer, extract the two headed

fixation pins on the top of the alignment guide

from the proximal tibia.

> Remove the proximal shaft of the alignment guide by

sliding it up through the top of the resection guide

(Figure 43).

Tibial

Preparation

Tibial Stylus

Tibial

Resection

Guide

2mm Resection

External Tibial

Alignment Guide

Tibial Stylus

8mm Resection

Tibial

Resection

Guide

External Tibial

Alignment Guide

Tibial

Resection

Guide

Slide Proximal Shaft

up through

Resection Guide

Ver ti c al

Thumbscrew

Figure 44

Figure 45

Figure 46

> Slide the Tibial Resection Guide posteriorly until it

comes in contact with the anterior tibia.

> Placing a 1/8" drill pin through the “X” pin hole will

further secure the resection guide to the tibia.

> The Alignment Handle may be used with an

Alignment Rod, referencing the same landmarks as

outlined previously to verify proper alignment.

> Resect the plateau using a 0.05" (1.27mm) saw blade

(Figure 44).

> If desired, 2mm or 4mm of additional bone

may be resected by repositioning the guide over the

pins through the +2 or +4 holes respectively

(Figure 45).

> The Tibial Resection Guide is removed by first

sliding the guide off the two 1/8" drill pins and then

removing the pins with the Pin Puller.

Note: If the “X” Pin hole is used, this pin must be

removed prior to repositioning or removing the Tibial

Resection Guide.

Option 2: Intramedullary Technique

IM Rod Placement

> If the tibial eminence is pronounced, make

an initial cut to flatten the tibial plateau and

expose an area of cancellous bone. A 5/16"

hole is drilled in the location determined by

pre-operative X-rays (Figure 46).

> Attach the pre-determined diameter IM Rod (1/4",

3/8", or 5/16") to the T-Handle by depressing the

button to lock into place. Pre-operative X-Ray

templating will aid in the determination of the

IM Rod diameter.

Tibial

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Figure 47

Figure 48

Figure 49

> Introduce the IM Rod into the entry hole and

gradually advance it down the intramedullary canal

(Figure 47). Several steps may be taken to avoid

an increase in intramedullary pressure.

A. Advance the IM Rod slowly.

B. Rotate the IM Rod within the canal during

advancement.

C. Apply suction to the fitting on the end of the

cannulated IM Rod.

> The proximal portion of both the 1/4" and 3/8"

diameter IM Rods changes to 5/16" in diameter.

It is necessary to insert those rods so that the

diameter transition point is within the

intramedullary canal. The 5/16" diameter IM Rod

may be inserted to any depth up to the scribe

mark on the proximal shaft. Once the IM Rod is

positioned, remove the T-Handle (Figure 48).

> Intra-operative X-rays may be obtained to

confirm accurate position of the rod in the canal.

> Slide the IM Alignment Guide over the Alignment

Rod (Figure 49).

Tibial

Preparation

IM Rod

T- Handle

Diameter

Transition

Point

Headed Nail

IM Alignment Jig

IM Rod

Figure 50

Figure 51

Figure 52

Rotation and Varus/Valgus Alignment

> With the body of the IM jig resting on the

proximal tibia, correct rotational alignment is

achieved by rotating the instrument about the

IM rod so that the tibial tubercle appears

slightly lateral to the vertical mounting bar.

The headed nail is impacted, fixing rotational

alignment (Figure 50).

> Assemble the appropriate Tibial Resection Guide to

the IM Tibial Alignment Guide by sliding the Tibial

Resection Guide onto the rail of the alignment guide

and tightening the thumbscrew on the resection

guide (Figure 51).

> Attach the alignment handle to the resection guide,

and slide a long alignment rod into the alignment

handle. When correct varus/valgus alignment is

attained, the pin should be centered over the ankle

(Figure 52).

Tibial

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Mounting Bar

Headed Nail

Thumbscrew

Tibial Resection

Guide

IM Tibial

Alignment Guide

External

Alignment

Rod

Figure 53

Figure 54

Figure 55

> If varus/valgus adjustment is needed, Locking Knob

“1” is loosened. The mounting bar is pulled toward

the surgeon, and the jig is rotated until proper

varus/valgus orientation is achieved (Figure 53).

Once the alignment rod is centered over the ankle,

the Locking Knob is securely tightened.

Flexion/Extension Alignment

> If additional posterior slope is required, loosen

Locking Knob “2” and set the slope. Once the

correct slope is attained, securely tighten Locking

Knob “2” to set the final position of the jig

(Figure 54).

> Increment markings have been added to the posterior

slope adjustment FOR REFERENCE ONLY. Bear in

mind that these are reference marks only and not

indicative of an exact measurement of the posterior

slope of the tibial resection. The true slope is

dependent on many factors, including, but not

limited to, tibial anatomy, the placement of the IM

Rod, the position of the cutting block from the

anterior portion of the tibia.

Tibial Resection Level

> The Xcelerate System offers Right and Left, 0° and 5°

Tibial Resection Guides.

Note:

0 degrees of posterior slope is recommended for use

with the Scorpio PS femoral components.

5 degrees of posterior slope is recommended for use

with the Scorpio CR femoral components.

> Assemble the Tibial Stylus onto the Tibial Resection

Guide by depressing the button on the top of the

Tibial Stylus, inserting the stylus into either the

medial or lateral hole on the top of the Tibial

Resection Guide, and releasing the button to lock

the stylus into place (Figure 55).

Note: The components shall be positioned to avoid

excessive hyperextension. Excessive femoral flexion and

tibial slope should be avoided when implanting the

components. Implant positioning resulting in excessive

hyperextension may result in premature wear and

damage to the implant.

Tibial

Preparation

Alignment

Handle

Alignment

Rod

Locking

Knob “1”

Locking

Knob “2”

Tibial

Resection

Guide

Thumbscrew

Tibial

Stylus

Locking

Button

Figure 56

Figure 57

Figure 58

> Loosen the thumbscrew and position the Tibial

Stylus to reference the desired point on the tibial

plateau. Secure the IM Tibial Alignment Guide to

the Tibial IM Rod by re-tightening the thumb-

screw.

> The Xcelerate System offers two Tibial styli each

having two resection levels; 2mm and 8mm.

> The settings allow for corresponding resection of

bone below the point of the stylus (i.e. the 2mm

setting allows for a 2mm resection below the point

of the stylus) (Figures 56 and 57).

Proximal Tibial Resection

> Once the resection level is established, secure the

Tibial Resection Guide to the anterior tibia using the

1/8" drill pins, drilling through the “0” holes. Pinning

through the “X” Pin hole will further secure the

Tibial Resection Guide to the tibia (Figure 58).

Tibial

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

IM Tibial

Alignment

Guide

Locking

Screw

2mm Resection Level

Tibial

Resection

Guide

Thumbscrew

Tibial

Stylus

IM Tibial

Alignment

Guide

Locking

Screw

Tibial

Resection

Guide

Thumbscrew

Tibial

Stylus

8mm Resection Level

Tibial Stylus

IM Tibial

Alignment

Guide

1/8" Drill Pin

Tibial

Resection

Guide

Figure 59

Figure 60

> Remove the Tibial Stylus by depressing the button

and pulling the stylus out.

> Release the IM Tibial Alignment Guide from the

Tibial Resection Guide by loosening the thumbscrew

on the resection guide. Re-attach the T-Handle to the

IM Rod and extract both the IM Rod and IM Tibial

Alignment Guide together, leaving the Tibial

Resection Guide pinned in place. Resect the tibial

plateau through the slot in the Tibial Resection

Guide. Use of a 0.05" (1.27mm) sawblade is

recommended for an accurate resection (Figure 59).

> Additional bone may be resected by repositioning the

Tibial Resection Guide over the pins in the +2 or +4

holes to resect an additional 2mm or 4mm of bone

respectively (Figure 60).

> The Tibial Resection Guide is removed by first

sliding the guide off the two 1/8" drill pins and then

removing the pins with the Pin Puller.

Note: If the “X” Pin hole is used, this pin must be

removed prior to repositioning or removing the Tibial

Resection Guide.

Tibial

Preparation

Tibial

Resection

Guide

Figure 61

Figure 62

Figure 63

Tibial Baseplate Preparation

Scorpio NRG Tibial Component Sizing

> Maximally flex the knee and deliver the tibia forward.

Assemble a Tibial Trial Baseplate onto the Alignment

Handle and place it on the resected tibial plateau

(Figure 61). Choose the size that best covers the

tibial plateau.

Tibial Component Alignment

> Replace the Trial Femoral Component on the femur.

Assemble a Tibial Bearing Insert Trial to the Tibial

Trial Baseplate by first positioning it posteriorly on

the baseplate and then fully seating it anteriorly

(Figure 62). Reverse the steps to dis-assemble the

insert trial from the baseplate.

> Position the assembled insert and baseplate on the

tibial plateau and carry out a trial reduction. Assess

overall component fit, ligament stability, and joint

range of motion.

> As the joint is taken through flexion and extension,

the femoral trial component helps position the tibial

baseplate. Final position of the tibial trial is achieved

when tibiofemoral articular contact is most congruent.

This is best assessed when the knee is in extension.

> Overall leg alignment may be assessed at this time.

Re-attach the Alignment Handle to the trial baseplate

and insert two Alignment Rods into the handle. The

rods should parallel the mechanical axis of the leg in

both the coronal (A/P) and sagittal (M/L) views

(Figure 63).

Tibial Baseplate

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Alignment

Rod

Alignment parallels

the mechanical axis

Tibia Components In Place

Figure 64

Figure 65

> Once satisfactory alignment and tibial component

orientation is achieved, mark the anterior tibial

cortex in line with the reference marks on the

anterior border of the trial baseplate (Figure 64).

> Remove the trial components and dis-assemble the

trial insert from the baseplate. Reposition the Tibial

Trial Baseplate aligning the anterior reference marks

on the baseplate with the reference marks on the

anterior cortex. The baseplate is positioned flush to

the anterior tibial cortex.

> Pin the baseplate to the tibial plateau by placing two

short, headed fixation pins through a medial and lateral

hole in the baseplate (Figure 65). Pin hole selection is

not critical; however, if the anterior holes are used and

the pins are fully seated, the Tibial Bearing Insert Trial

may be re-assembled to the pinned baseplate for any

subsequent trial reductions.

Tibial Baseplate

Preparation

Baseplate Reference

Marks

Marker

Short Headed Pins

Tibial Trial

Baseplate

> Advance the punch until it seats fully on the

baseplate (Figure 68). During extraction, take care to

avoid toggle or angulation of the punch as this may

distort the bone preparation. The Quick Release

Slaphammer connects to the punches for extraction.

Figure 66

Figure 67

Figure 68

Tibial Keel Punching

> Tibial Punches are identified by keel size (3/5, 7/9,

11/13) and bone preparation (“Cement Keel”

creates an interference fit around the keel).

> The sequence of steps necessary to prepare the tibia

for the Deltafit Keel may vary depending on the bone

quality of the proximal tibia. In relatively soft bone

(i.e., rheumatoid) only one punching step with the

final tibia size/preparation punch may be required. In

normal bone, it is recommended that a smaller “Press

Fit Keel” punch be used first, followed by the final

size/preparation punch.

> In denser bone, several intermediate punching steps

may be required prior to final punching. If sequential

punching is undertaken, only “Press Fit Punches”

should be utilized until the final size is reached. If

extremely dense bone is encountered, a 3/8" Guide

Bushing may be assembled to the baseplate and a

pilot hole drilled prior to tibial punching (Figure 66).

> Assemble the Tibial Punch Tower to the baseplate by

placing the tower onto the two small locating pins on

top of the baseplate. During the subsequent tibial

punching, the tower will maintain correct position of

the punches.

> Fit the appropriate Tibial Punch into the Tibial

Punch Tower (Figure 67). See Appendix 1 - Baseplate

Preparation Table. Handles may be assembled to the

tower to aid in maintaining position and stability of

the tower/baseplate assembly during punching. A

mallet may be used to impact the punch.

Tibial Baseplate

Preparation

Patella

Preparation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Preparation of pilot drill

hole will guide bushing

Tibial Punch

Tibial

Punch

To we r

Quick

Release

Handles

Tibial Punch

is Fully Seated

Figure 69

Figure 70

Figure 71

> Once the final punch has been seated, tibial

preparation is complete (Figure 69).

Patella Preparation

> Remove all osteophytes and synovial insertions

around the patella, and measure thickness using a

caliper. After determining the depth of the cut with

a caliper, fix the stylus in the appropriate slot to the

patellar resection guide, and capture the patella

between the jaws of the saw guide. Using a 0.05"

(1.27mm) non-offset sawblade, resect the patella

(Figure 70).

Patella Trial Assessment

> Remove any residual cartilage and wash away all

debris. Place correct size Patella Trial onto the

prepared patella.

> Replace all Trials and assess patellar tracking by

taking the knee through a ROM. The patella should

track normally through the ROM without tendency

for tilting or lateral subluxation.

> Center the chosen patellar drill guide over the patella

with the handle perpendicular to the trochlear

groove. Drill three fixation holes with the appropriate

stepped drill (Figure 71).

> Prepare the resected bone surfaces for bone cement

application. See page 29 for cementing with the

Patellar Clamp.

Tibial Baseplate

Preparation

Patella

Preparation

Completed Tibial Preparation

Patellar

Resection

Guide

Stylus

Stepped Drill

Drill Guide

12 inch

5 or 7

Figure 72

Figure 73

Figure 74

Implantation

Tibial Component

> If tibial fixation is to be augmented by bone screws,

remove the polyethylene plugs in the tibial tray screw

holes prior to implantation (Figure 72).

> Assemble the Tibial Component Impactor/Extractor

to the implant. To assemble, retract the slide rod

levers and insert the “feet” into the central hole in the

tibial tray. Release the levers and tighten the knurled

thumbscrew by hand to securely engage the

Impactor/Extractor to the implant (Figure 73).

> Introduce the tibial tray into the prepared tibia and

impact it until the tray is fully seated (Figure 74).

Remove the instrument from the tray before

polymerization. Clear all excess bone cement without

disturbing the position of the implant.

Implantation

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Thumbscrew

Slide Lever

Retract side levers to

engage feet in tibial tray

Tibial Tray

Implantation

Figure 75

Figure 76

Figure 77

Tibial Bearing Insert Assembly

> Prior to assembly of the prosthetic UHMWPE

bearing insert, the trial insert may be placed in the

tibial tray to once more assess joint stability and

range of motion.

> To assemble the prosthetic bearing insert, distract

the joint and angle the insert posteriorly into the tray.

The posterior lips of the bearing insert must fit

beneath the lips on the interior, posterior tray wall.

> Snap the insert in place anteriorly (Figure 75). Hand

pressure or a light tap with a mallet is required. The

tibial bearing insert is fully seated once the metal

retaining wire locks under the barbs on the anterior,

interior surface of the wall.

Implantation of Femoral Component

> Assemble the appropriate size of left or right femoral

implant onto the Femoral Impactor/Extractor in the

same manner as the femoral trial. See Appendix 2

for Scorpio NRG PS/CR interchangeability chart.

Place the implant on the prepared femur and impact

it until fully seated (Figure 76). The Impactor/

Extractor maintains accurate position of the implant

during implantation.

Note: The components shall be positioned to avoid

excessive hyperextension. Excessive femoral flexion and

tibial slope should be avoided when implanting the

components. Implant positioning resulting in excessive

hyperextension may result in premature wear and

damage to the implant.

Implantation of the Patellar Component

> The back surface of the implant (including the

pocket) and the cut surface of the patella are covered

with a layer of cement. Cement should be interdigitated

into the fixation holes on the cut patella and the pocket

on the back of the all-plastic Patellae Components.

> The patellar clamp locks in place while the cement

hardens (Figure 77).

Closure

> After cement polymerization, thoroughly irrigate the

joint and place suction drains. Hemostasis is achieved

after deflation of the tourniquet. Close soft tissues in

the normal layered fashion.

Implantation

Tibial bearing

Insert

First engage

posteriorly then

snap into place

anteriorly

Femoral Impactor

Patellar Clamp

Appendix 1

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Appendix 1

3 Press-Fit #3/#5

Press-Fit #3/#5

Cement #3/#5

4 Press-Fit #3/#5

Press-Fit #3/#5

Cement #3/#5

5 Press-Fit #3/#5

Press-Fit #3/#5

Cement #3/#5

6 Press-Fit #3/#5

Press-Fit #3/#5

Cement #3/#5

Press-Fit #3/#5

Press-Fit #7/#9

Press-Fit #3/#5

Press-Fit #7/#9

Cement #7/#9

Press-Fit #3/#5

Press-Fit #7/#9

Press-Fit #3/#5

Press-Fit #7/#9

Cement #7/#9

Press-Fit #3/#5

Press-Fit #7/#9

Press-Fit #11/#13

Press-Fit #3/#5

Press-Fit #7/#9

Press-Fit #11/#13

Cement #11/#13

Press-Fit #3/#5

Press-Fit #7/#9

Press-Fit #11/#13

Press-Fit #3/#5

Press-Fit #7/#9

Press-Fit #11/#13

Cement #11/#13

Implant Size Press-Fit Keel Cement Keel

Scorpio NRG Tibial Punching Sequence

Appendix 2

Tibial Tibial IC Notch

Component Tray Punch (mm)

Femoral Tibial Tibial PS Notch &

Component Tray Insert Compactor

Scorpio NRG Sizing Guide

3, 4 3 3/5

5, 6 5 3/5

3, 4 3 3/5

5, 6 5 3/5

3, 4 3 3/5

5, 6 5 3/5

7 7 3/5

5, 6 5 7/9

7 7 7/9

5, 6 5 7/9

7 7 7/9

9 9 7/9

7 7 7/9

9 9 7/9

7 7 7/9

9 9 7/9

11, 13 11 7/9

9 9 11/13

11, 13 11 11/13

13 11, 13 11 11/13

3 3/5 18

4 3/5 18

5 3/5 18

6 3/5 20.1

7 7/9 20.1

9 7/9 20.1

11 11/13 22.3

13 11/13 22.3

Appendix 3

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Catalog # Catalog # Catalog # Catalog # Catalog # Thickness

Size #3 Size #5 Size #7 Size #9 Size #11

Scorpio NRG PS Tibial Insert - N2Vac

82-3-0308 82-3-0508 82-3-0708 82-3-0908 82-3-1108 8mm

82-3-0310 82-3-0510 82-3-0710 82-3-0910 82-3-1110 10mm

82-3-0312 82-3-0512 82-3-0712 82-3-0912 82-3-1112 12mm

82-3-0315 82-3-0515 82-3-0715 82-3-0915 82-3-1115 15mm

82-3-0318 82-3-0518 82-3-0718 82-3-0918 82-3-1118 18mm

82-3-0321 82-3-0521 82-3-0721 82-3-0921 82-3-1121 21mm

82-3-0324 82-3-0524 82-3-0724 82-3-0924 82-3-1124 24mm

Appendix 3

81-4403L 81-4403R #3 51mm 57mm 35mm

Non-LFIT

Waf f le

w/Lugs

81-4404L 81-4404R #4 54mm 60mm 37mm

81-4405L 81-4405R #5 56mm 62mm 39mm

81-4406L 81-4406R #6 58mm 65mm 42mm

81-4407L 81-4407R #7 61mm 67mm 44mm

81-4408L 81-4408R #8 63mm 70mm 46mm

81-4409L 81-4409R #9 65mm 72mm 49mm

81-4411L 81-4411R #11 70mm 77mm 53mm

81-4413L 81-4413R #13 75mm 82mm 58mm

Catalog # Catalog # Size A/P M/L Resected

Left Knee Right Knee A/P

Scorpio NRG PS Femoral Component

A/P

M/L

Resected

A/P

Catalog # Catalog # Catalog # Catalog # Catalog # Thickness

Size #3 Size #5 Size #7 Size #9 Size #11

Scorpio NRG PS Tibial Insert - X3

82-7-0308 82-7-0508 82-7-0708 82-7-0908 82-7-1108 8mm

82-7-0310 82-7-0510 82-7-0710 82-7-0910 82-7-1110 10mm

82-7-0312 82-7-0512 82-7-0712 82-7-0912 82-7-1112 12mm

82-7-0315 82-7-0515 82-7-0715 82-7-0915 82-7-1115 15mm

82-7-0318 82-7-0518 82-7-0718 82-7-0918 82-7-1118 18mm

82-7-0321 82-7-0521 82-7-0721 82-7-0921 82-7-1121 21mm

82-7-0324 82-7-0524 82-7-0724 82-7-0924 82-7-1124 24mm

Appendix 4

Catalog # Catalog # Catalog # Catalog # Catalog # Thickness

Size #3 Size #5 Size #7 Size #9 Size #11

Catalog # Catalog # Size A/P M/L Resected

Left Knee Right Knee A/P

Scorpio NRG CR Femoral Component

80-4403L 80-4403R #3 51mm 57mm 35mm

Non-LFIT

Waf f le

w/Lugs

80-4404L 80-4404R #4 53mm 60mm 37mm

80-4405L 80-4405R #5 55mm 62mm 39mm

80-4406L 80-4406R #6 57mm 65mm 42mm

80-4407L 80-4407R #7 60mm 67mm 44mm

80-4408L 80-4408R #8 62mm 70mm 46mm

80-4409L 80-4409R #9 64mm 72mm 49mm

80-4411L 80-4411R #11 69mm 77mm 53mm

80-4413L 80-4413R #13 74mm 82mm 58mm

Scorpio NRG CR Tibial Insert - N2Vac

82-2-0308 82-2-0508 82-2-0708 82-2-0908 82-2-1108 8mm

82-2-0310 82-2-0510 82-2-0710 82-2-0910 82-2-1110 10mm

82-2-0312 82-2-0512 82-2-0712 82-2-0912 82-2-1112 12mm

82-2-0315 82-2-0515 82-2-0715 82-2-0915 82-2-1115 15mm

82-2-0318 82-2-0518 82-2-0718 82-2-0918 82-2-1118 18mm

82-2-0321 82-2-0521 82-2-0721 82-2-0921 82-2-1121 21mm

82-2-0324 82-2-0524 82-2-0724 82-2-0924 82-2-1124 24mm

M/L

A/P

Resected

A/P

Catalog # Catalog # Catalog # Catalog # Catalog # Thickness

Size #3 Size #5 Size #7 Size #9 Size #11

Scorpio NRG CR Tibial Insert - X3

82-6-0308 82-6-0508 82-6-0708 82-6-0908 82-6-1108 8mm

82-6-0310 82-6-0510 82-6-0710 82-6-0910 82-6-1110 10mm

82-6-0312 82-6-0512 82-6-0712 82-6-0912 82-6-1112 12mm

82-6-0315 82-6-0515 82-6-0715 82-6-0915 82-6-1115 15mm

82-6-0318 82-6-0518 82-6-0718 82-6-0918 82-6-1118 18mm

82-6-0321 82-6-0521 82-6-0721 82-6-0921 82-6-1121 21mm

82-6-0324 82-6-0524 82-6-0724 82-6-0924 82-6-1124 24mm

Appendix 5

Appendix

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Deltafit Series Deltafit Series Deltafit Series Size A/P M/L Stem

PA Microstructured 7000 Waffle

with Screw Holes with Screw Holes No Screw Holes

Tibial Component Baseplate

7145-0003 7125-0003 7115-0003 #3 40mm 61mm 30mm

7125-0004 7115-0004 #4 42mm 63mm 30mm

7145-0005 7125-0005 7115-0005 #5 44mm 66mm 30mm

7125-0006 7115-0006 #6 45mm 68mm 30mm

7145-0007 7125-0007 7115-0007 #7 47mm 71mm 35mm

7145-0009 7125-0009 7115-0009 #9 51mm 77mm 35mm

7145-0011 7125-0011 7115-0011 #11 54mm 82mm 40mm

7145-0013 7125-0013 7115-0013 #13 58mm 88mm 40mm

Use screw

2030-6530-1

2030-6535-1

Use screw

2030-6530-1

2030-6535-1

Stem Length

A/P

M/L

Scorpio Scorpio Size S/I* M/L Thickness

Medialized Concentric

Dome Patella Dome Patella

Universal Size Dia. Thickness

Dome

Patella

73-0510 73-2510 #5 32mm 35mm 10mm

73-0710 73-2710 #7 34mm 38mm 10mm

73-0910 73-2910 #9 36mm 41mm 10mm

73-0110 73-2110 #11 38mm 44mm 10mm

73-3308 #3 30mm 8mm

73-3508 #5 32mm 8mm

73-3708 #7

34mm 8mm

73-3710 #7 34mm 10mm

73-3910 #9 36mm 10mm

73-3110 #11 38mm 10mm

Patella Component - N2Vac

Scorpio Scorpio Size S/I* M/L Thickness

Medialized Concentric

Dome Patella Dome Patella

Universal Size Dia. Thickness

Dome

Patella

73-20-0510 73-20-2510 #5 32mm 35mm 10mm

73-20-0710 73-20-2710 #7 34mm 38mm 10mm

73-20-0910 73-20-2910 #9 36mm 41mm 10mm

73-20-0110 73-20-2110 #11 38mm 44mm 10mm

73-20-3308 #3 30mm 8mm

73-20-3508 #5 32mm 8mm

73-20-3708 #7

34mm 8mm

73-20-3710 #7 34mm 10mm

73-20-3910 #9 36mm 10mm

73-20-3110 #11 38mm 10mm

Patella Component - X3

*S/I = Superior/Inferior

Indications

• Painful, disabling joint disease of the knee

resulting from: degenerative arthritis,

rheumatoid arthritis or post-traumatic

arthritis.

• Post-traumatic loss of knee joint

configuration and function.

• Moderate varus, valgus, or flexion

deformity in which the ligamentous

structures can be returned to adequate

function and stability.

• Revision of previous unsuccessful knee

replacement or other procedure.

Additional Indications for Posterior

Stabilized Components:

• Ligamentous instability requiring implant

bearing surface geometries with increased

constraint.

• Absent or non-functioning posterior

cruciate ligament.

Contraindications

• Any active or suspected latent infection in

or about the knee joint.

• Any mental or neuromuscular disorder

which would create an unacceptable risk of

prosthesis instability, prosthesis fixation

failure, or complications in post-operative

care.

• Bone stock compromised by disease,

infection or prior implantation, which

cannot provide adequate support and/or

fixation to the prosthesis.

• Skeletal immaturity.

• Severe instability of the knee joint

secondary to the absence of collateral

ligament integrity and function.

• Obesity. An overweight or obese patient can

produce loads on the prosthesis which can

lead to failure of the fixation of the device

or to failure of the device itself.

Warnings and Precautions:

See package insert for warnings, precautions,

adverse effects and other essential product

information.

Scorpio NRG

PR Single Radius Primary Knee System

Surgical Protocol

Notes

325 Corporate Drive

Mahwah, NJ 07430

t: 201 831 5000

www.stryker.com

A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a

particular product when treating a particular patient. Stryker does not dispense medical advice and recommends

that surgeons be trained in the use of any particular product before using it in surgery.

The information presented is intended to demonstrate the breadth of Stryker product offerings. A surgeon must

always refer to the package insert, product label and/or instructions for use before using any Stryker product.

Products may not be available in all markets because product availability is subject to the regulatory and/or

medical practices in individual markets. Please contact your Stryker representative if you have questions about

the availability of Stryker products in your area.

The products listed above are CE marked according to the Medical Device Directive 93/42/EEC. Products may

not be available in all markets because product availability is subject to the regulatory and/or medical practices

in individual markets. Please contact your Stryker representative if you have questions about the availability of

Stryker products in your area.

Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the

following trademarks or service marks: NRG, Scorpio, Stryker, X3, Xcelerate. All other trademarks are

trademarks of their respective owners or holders.

Literature Number: LSNRGPR-ST Rev. 6

MS/GS 4/12

Printed in USA