Insertion of the definitive components
Remove the PRIMA stem of the chosen size from sterile packaging and impact it into the prepared humerus using the impactor with the impactor adaptor of the chosen size (Figure 34). The retroversion may be verified by screwing the alignment rod in the marked screw holes of the impactor (0°, 20° or 30°). For a left shoulder, the mark “L” shall be visible on the front of the impactor and vice versa the mark “R” for a right shoulder. Place the PRIMA stem in the same position as the trial implant. The impactor has been designed to provide two impaction directions, along the axis of the stem and along the axis of the trial stem taper. Additionally, the impactor features a mark to visualize the PRIMA Stem axis. Stop impacting when the adaptor comes fully in contact with the resected surface. Then remove the impactor by unscrewing it from the stem. Optional during this phase, the impactor knob features a central hole for the 3.5mm hexagonal screwdriver to support the removal of the impactor from the implanted stem. Once the impactor and the adaptor are removed, the PRIMA stem will be 0.5mm protruded from the resection plane to compensate the subsidence during subsequent phases. Remove the appropriate final adaptor taper and final head from the sterile packaging. Apply the adaptor taper to the definitive stem. If an eccentric adaptor taper is used, insert it by aligning the marking with the previous marked reference (Figure 35). A safety screw is used to secure the coupling between the adaptor taper and the PRIMA stem (Figure 36).
Figure 34
Eccentric position
Figure 35
Figure 36
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