TO R N I E R
AEQUALIS REVERSED II
™
Shoulder System
SURGIC AL TECHNIQUE ADDENDUM
Peripheral Baseplate Reamer
Table of Contents:
Intended Use.......................................................................................................................................................... 2
Overview.................................................................................................................................................................. 2
General Glenoid Preparation.............................................................................................................................. 3
Technique 1: Peripheral Reaming...................................................................................................................... 3
Technique 2: Peripheral Re-Reaming................................................................................................................ 5
Technique 3: Revision Reaming......................................................................................................................... 6
Instrument Set........................................................................................................................................................ 7
INTENDED USE
Please refer to the AEQUALIS™ Reversed II Instructions for Use for a complete list of indications. Instrumentation
instructions for use for the peripheral reamer instrumentation are listed in IFU-UTBI.
OVERVIEW
This technique contains instructions for the use of the Reversed II peripheral baseplate reaming system. This
optional reamer system provides the surgeon with the opportunity to ream the peripheral bone recess surrounding
the baseplate following implantation of the baseplate and screw components. This technique will cover
three techniques:
TECHNIQUE 1: PERIPHERAL REAMING
Reaming of the peripheral bone is performed after the baseplate and screws have been implanted using the
peripheral reamers .Prior to baseplate reaming, only the 25 or 29mm central baseplate reamer is used.
TECHNIQUE 2: PERIPHERAL RE-REAMING
This technique uses the peripheral reamers to perform a secondary “re-reaming” of the peripheral bone recess
once the baseplate and screw components have been implanted.
TECHNIQUE 3: REVISION REAMING
This technique uses the peripheral reamers in revision situations where a 36mm sphere is removed and
replaced by a 42mm sphere. This requires reaming of the peripheral bone to prepare for the larger sphere
diameter without removal of the baseplate or screws.
2
GENERAL GLENOID PREPARATION
Central Baseplate Preparation
All steps prior to implantation of the baseplate should be
followed as they are described in the AEQUALIS™ Reversed II
surgical technique (CAW-2145) using either cannulated or noncannulated instrumentation.
This technique will describe alternative methods for preparing
the bone using the AEQUALIS™ Reversed II peripheral reamers.
TECHNIQUE 1: PERIPHERAL REAMING
This technique performs the complete peripheral reaming step
after the baseplate and screw components have been implanted.
The standard AEQUALIS™ Reversed II peripheral reamer is not
used in this technique. Only the central baseplate reaming step
is performed prior to implantation of the baseplate and screws.
This technique is described in the following steps:
Central Glenoid Reaming
With the 6mm pilot hole prepared, the central reamer is
assembled to the handle based on the baseplate size chosen
in the previous step (25mm or 29mm diameter). The central
reaming step is performed according to the standard
AEQUALIS™ Reversed II surgical technique (CAW-2145).
(Figures 1 and 2)
Figure 1
Note: No peripheral reaming is performed at this time.
Baseplate and Screw Implantation
The baseplate and screws are then implanted as described in the
AEQUALIS™ Reversed II Surgical Technique (Figure 3).
Figure 2
Peripheral Bone Reaming
Complete reaming of the peripheral bone is now performed.
The reamer associated with the previously chosen baseplate
and sphere sizes is attached to the T-Handle from the standard
AEQUALIS™ Reversed II tray (MWB497).
The pilot tip on the reamer is then carefully inserted into the
central hole of the implanted baseplate in alignment with the
axis of the baseplate post (Figure 4).
Figure 3
Figure 4
3
Manual reaming is then performed using a back and forth
reaming motion (Figure 5). Progression of the reaming should
be gradual, being careful not to ream too aggressively and cause
glenoid fracture.
Note: Reaming with the peripheral reamers must be
performed manually. Do not use these reamers under power.
Note: Care should be taken not to place leverage
on the reamer to avoid transferring stress onto the
baseplate components.
Figure 5
Sphere Implantation
Following secondary reaming of the peripheral bone
recess, the sphere is then implanted as described in the
AEQUALIS™ Reversed II Surgical Technique (Figure 6).
To ensure proper assembly, verify that the sphere is flush
with the bottom of the baseplate and the components are
properly assembled.
4
Figure 6
TECHNIQUE 2: PERIPHERAL RE-REAMING
The peripheral re-reaming technique performs all reaming steps
(central and peripheral reaming steps) prior to implantation of
the baseplate and screws with the standard AEQUALIS™ Reversed
II instrumentation. When necessary, the peripheral reamer
system allows for additional re-reaming of the peripheral bone
after the baseplate and screws have been implanted. This
technique is described in the following steps:
Figure 7
Central Glenoid Reaming
With the 6mm pilot hole prepared, the central reamer is
assembled to the handle based on the baseplate size chosen
in the previous step (25mm or 29mm diameter). The central
reaming step is performed according to the standard
AEQUALIS™ Reversed II surgical technique (CAW-2145) (Figure 7).
Peripheral Glenoid Reaming
Next, the peripheral reamer is assembled to the handle based
on the desired sphere size (36mm or 42mm diameter sphere).
Reaming is performed until the peripheral bone recess has
been created as described in the AEQUALIS™ Reversed II Surgical
Technique (Figure 8).
Figure 8
Note: The pie-shaped or standard peripheral reamers can be
used to perform peripheral reaming of the bone.
Baseplate and Screw Implantation
The baseplate and screws are then implanted as described in the
AEQUALIS™ Reversed II Surgical Technique (Figure 9).
Figure 9
Secondary Peripheral Bone Reaming
If required, the peripheral reamer may be used to provide
secondary reaming of the peripheral bone recess.
The reamer associated with the previously chosen baseplate and
sphere sizes is attached to the T-Handle.
The pilot tip on the reamer is then carefully inserted into the
central hole of the implanted baseplate in alignment with the
axis of the baseplate post (Figure 10).
Figure 10
5
Manual reaming is then performed using a back and forth
reaming motion (Figure 11). Progression of the reaming should
be gradual, being careful not to ream too aggressively and cause
glenoid fracture.
Note: Reaming with the peripheral reamers must be
performed manually. Do not use these reamers under power.
Note: Care should be taken not to place leverage
on the reamer to avoid transferring stress onto the
baseplate components.
Figure 11
Sphere Implantation
Following secondary re-reaming of the peripheral bone
recess, the sphere is then implanted as described in the
AEQUALIS™ Reversed II Surgical Technique (CAW-2145)
(Figure 12).
To ensure proper assembly, verify that the sphere is flush
with the bottom of the baseplate and the components are
properly assembled.
Figure 12
TECHNIQUE 3: REVISION REAMING
This technique uses the peripheral reamers in revision situations
where a 36mm sphere is removed and replaced by a 42mm
sphere. This requires reaming of the peripheral bone to prepare
for the larger sphere diameter without removal of the baseplate
or screws.
Sphere Removal
Sphere removal is performed according to the standard
AEQUALIS™ Reversed II surgical technique (CAW-2145) using the
glenoid sphere extractor and screw.
Peripheral Glenoid Reaming
The reamer associated with the implanted baseplate and
corresponding 42mm sphere is attached to the T-Handle from
the standard AEQUALIS™ Reversed II tray (MWB497).
Note: Reaming with the peripheral reamers must be
performed manually. Do not use these reamers under power.
The pilot tip on the reamer is then carefully inserted into the
central hole of the implanted baseplate in alignment with the
axis of the baseplate post (Figure 13).
6
Figure 13
Manual reaming is then performed using a back and forth
reaming motion (Figure 14). Progression of the reaming should
be gradual, being careful not to ream too aggressively and cause
glenoid fracture.
Note: Reaming with the peripheral reamers must be
performed manually. Do not use these reamers under power.
Figure 14
Note: Care should be taken not to place leverage
on the reamer to avoid transferring stress onto the
baseplate components.
Sphere Implantation
Following reaming of the peripheral bone recess, the new
sphere is then implanted as described in the AEQUALIS™
Reversed II Surgical Technique (Figure 15).
To ensure proper assembly, verify that the sphere is flush
with the bottom of the baseplate and the components are
properly assembled.
Figure 15
INSTRUMENTATION: 9711500
Part Number
Description
Qty.
9028708
Peripheral Reamer 25-36mm
1
9028709
Peripheral Reamer 25-36mm
1
9028710
Peripheral Reamer 29-36mm
1
9028711
Peripheral Reamer 29-42mm
1
7
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Bloomington, MN 55437
888 867 6437
952 426 7600
www.tornier.com
Proper surgical procedures and techniques are the responsibility of the medical professional. This material is furnished for information
purposes only. Each surgeon must evaluate the appropriateness of the material based on his or her personal medical training and
experience. Prior to use of any Tornier implant system, the surgeon should refer to the product package insert for complete warnings,
precautions, indications, contraindications, and adverse effects. Package inserts are also available by contacting Wright.
Contact information can be found in this document and the package insert.
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CAW-5086 Rev B ECN 160814 08-Jun-2016