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Reaching Higher by Design
Extremity Solutions
TM
Discovery® Elbow
AltiVate™ Anatomic AltiVate Reverse®
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A
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Y
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A
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Alians Proximal Humerus AltiVate™ Match Point System®
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Reaching higher by design…
SO PATIENTS CAN, TOO.
At DJO Surgical, our end goal is to help patients reach their greatest altitudes. We strive to achieve
this through innovation, proven results, and clinical heritage. Our approach is to partner with surgeon
experts in the field to design systems that ultimately provide extremity solutions. DJO Surgical
Extremity Solutions are anatomic designs engineered to provide optimized function, enhanced fixation,
and flexibility and versatility to manage diering patient needs. Our aim is to reach new elevations by
providing clinicians solutions to help their patients reach higher.
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AltiVate™ Reverse® Shoulder
The anatomically-based, data-driven AltiVate Reverse system incorporates enhanced fixation technologies and precision instrumentation for superior
fit in more of your patients.
Anatomic Design with Optimized Function
Elevating the 10-year clinical success of the RSP®, the first reverse shoulder design to successfully incorporate a center of rotation (COR) lateral to the
glenoid, DJO Surgical introduces its latest Extremity Solution. The AltiVate Reverse system incorporates an optimized stem design based on anatomic
studies with CT scans for determination of shell-to-stem position as well as the ability to best match patient anatomy for anatomic total and reverse
total shoulder constructs. An anatomic 135° humeral neck-shaft angle has shown through biomechanical testing to help reduce the potential for
inferior scapular notching.1 The system remains based on a lateralized center of rotation, and the premier oering is a glenosphere with the center of
rotation closest to the anatomic center.
Medial COR
Smaller Range of Motion
A lateral COR maximizes range of
motion while reducing the potential
for inferior scapular notching.
A medial COR reduces range of
motion and creates the potential
for inferior scapular notching.
Inferior scapular notching has
been associated with poor
clinical outcomes.2
Lateral COR
Larger Range of Motion
Lateral COR
135
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Enhanced Fixation Design and Technologies
On both the glenoid and humeral side, expect improved short and long term fixation as a result of
stable initial fixation as well as ideal conditions for bony ingrowth.
P2 Porous Coating*
“Porous” porous coating that
aids in the apposition of bone for
superior in-growth results.
2000N of compression
Micromotion < 150µm
e+ Liner
Highly crosslinked vitamin E polyethylene
formulated to maintain strength and
reduce wear rates.*
Bone Graft Window
Increased press-fit and bony integration
Suture Holes
Options for simplified
and enhanced tuberosity
reduction and fixation for
fracture cases.
Fins
For rotational stability and
tuberosity reconstruction.
Instruments
Precision instrumentation caters to diering
surgeon preferences and results in a streamlined
technique. A metaphyseal-referenced approach
dictates stem position based on the fit in the
metaphysis while a diaphyseal-referenced
approach bases the stem position on the fit
in the canal. Osteotome slots and specialized
instrumentation allows for stem removal with
minimal bony disruption in a revision scenario.
Flexibility and Versatility
Implants
A wide variety of intra-operative options help
to manage complex anatomies and to achieve
the best surgical outcomes. Indications include
anatomic total, anatomic hemi, reverse total,
hemi for fracture and reverse for fracture.
Seven glenospheres with a
distinct center of rotation in
each size
Stems available in
three lengths (108mm,
175mm and 220mm) and
diameters of 6mm-18mm.
Standard and +4mm socket
inserts are available in both
conventional polyethylene and
e+™ polyethylene. An 8mm
spacer is also an option.
COR 32N
COR 44+8
COR 32-4
COR 36N
COR 40N
COR 36-4
COR 40-4
4 Peripheral Screws
for resistance to shear and torsional forces.
* The baseplate is also available with 3DMatrix and HA coating
Contoured Surface
matches the shape of the glenoid.
6.5mm Lag Screw
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Reaching Higher by Design
The data-driven design of the AltiVate™ Anatomic Shoulder System
features a short P2 coated humeral stem providing superior ingrowth
and a glenoid component with patent pending Drop-and-Go™
technology for immediate fixation. The result is a truly anatomic
reconstruction with fixation you can feel.
AltiVate™ Anatomic Shoulder
Instrumentation
The AltiVate™ Anatomic instrumentation is designed to facilitate
accurate implant placement and increase visibility of the surgical site.
The lateral fins and distal extension of the
humeral broach assist stem implant alignment
Data-Driven Design
A comprehensive dimensional CT database of humeral and glenoid
specimens was used to optimize implant design resulting in a truly
anatomic reconstruction.
Cannulated instruments provide increased
alignment during drilling and reaming of the glenoid
Innovative low profile designs and translucent materials increase function and visibility
Lateral
Fins
Distal
Extension
e+ Glenoid
Moderately crosslinked
vitamin E polyethylene
formulated to maintain
strength and reduce
wear rates.*
Drop-and-Go™
Technology
Patent pending trilobe
design provides
enhanced fixation on
the peripheral pegs.*
P2 Porous Coating
Aids in the apposition of bone
for superior in-growth results.*
Surface Finish
Optimized layout for
bone in-growth above
the metaphyseal-
diaphyseal junction and
smooth finish below
to discourage bone
on-growth.
Proximal Fins
Impart initial stability,
facilitate stem
alignment and include
suture hole options
for enhanced soft
tissue fixation.
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Turon®
Keeled Glenoid
Turon
Pegged Glenoid
AltiVate Anatomic™
Pegged Glenoid
AltiVate Anatomic Neutral Humeral Heads
AltiVate Anatomic Oset Humeral Heads
Turon Neutral Humeral Heads
Turon Oset Humeral Heads
Turon Humeral
Neck Neutral
Turon Humeral Stems
(standard and long lengths).
Turon Conversion Shell Converts the
Turon stem to a Reverse® Prosthesis
RSP® Monoblock
Hemi-Adapter
RSP Monoblock Humeral Stems (standard and long lengths)
AltiVate Reverse® Humeral Stems (standard and long lengths)
AltiVate Anatomic
Humeral Neck, Neutral
AltiVate Anatomic
Short Humeral Stems
Putting It All Together
DJO shoulder systems are designed to provide a complete and seamless
shoulder solutions platform. Conversion Modules minimize the potential
challenges of removing a well-fixed humeral stem by allowing conversion
of a primary total shoulder to a reverse shoulder and a reverse shoulder
to a hemi-arthroplasty prosthesis.
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AltiVate™ Match Point System®
Enabling surgeons to preoperatively and intraoperatively tailor shoulder arthroplasty to the patient’s unique anatomy, AltiVate Match Point System,
in conjunction with the AltiVate Reverse or Turon Anatomic shoulder implant system, allows surgeons to Aim at enhancing patient outcomes and Set
patients’ goals to Reach Higher by ensuring the surgical plan is Matched to the patient’s specific anatomy.
Aim
- at enhancing patient outcomes
• CT based 3D model
• Visualize unique anatomy
• Prepares surgeons preoperatively
Set
- patient goals to reach higher
• Virtually planned surgery
• Optimized implant position
• Based on entirety of anatomy not
visible in surgery
Matched
- to the patient’s specific anatomy
• Guide and model delivered to surgery
• Accurately reproduces plan intra operatively
• Reduces variability of conventional methods
Push Handle - gentle pressure
applied to the push handle
further stabilizes the guide while
drilling the pilot hole
Drill Cylinder - designed to replicate
the planned trajectory determined
by the surgeon through the pre-
operative planning process
Coracoid Clip - unique coracoid clip
securely attaches to the patient’s coracoid,
providing a stable and reproducible fit of the
guide to the patient‘s anatomy
Patient Identifier – unique
identification code specific for
each patient case links the guide
to the patient
Version Inclination Position
Standard Inst
3D Plan + Standard Inst
3D Plan + Transfer Device
Match Point System
0
2
4
6
8
10
12
Deviation from Plan3 (mean°)
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Anatomic Design
The Discovery Elbow System is designed to reproduce the anatomy and restore the mechanics of the elbow.
With its user-friendly instrumentation and intra-operative assembly options, this implant is suitable for
surgeons of all experience levels.
Flexibility and Versatility
Any size ulnar component can be paired with any size humeral component. The size humeral component,
however, can only be paired with the size 2.5 ulnar component.
Posterior Hinge Assembly
Allows for intraoperative assembly
23° Anterior Neck Angle
Recreates the anatomic center of rotation
Functional Laxity
7° of varus/valgus laxity
recreates trochlear function Anterior Flange
Provides torsional stability and
removes need for bone graft
Lateral Bow
Follows the anatomy
of the ulna
Hemispheric Condyles
Spread the stress out through the entire
surface area of the poly, which reduces wear
Anatomic Bow
5° of internal rotation reduces the
stresses on the collateral ligaments
AltiVate™ Discovery® Elbow System
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Anatomical
Contoured plate design
Anatomic Design Flexibility and Versatility
Asymmetrical
Left and right designs
Spaded tip
Assists in preservation
of deltoid insertion
Straight edge lines up
with bicipital groove
Easy plate positioning
Sits 1.5cm below
greater tuberosity
Minimizes conflict
with acromion
Patented Dualtec System I®
polyaxial locking fixation
• Variable angle technology for
25° (±12.5°)
• Allows for repeated insertion
and re-angulations of screw
without sacrificing its strength
Optimized proximal screw hole placement
Divergent fixed angled screws placed in
inferior half of humeral head
• Targets location of most robust bone
• Blunt-tipped screws limit protrusion
through articular surface
Five unique suture holes
for soft tissue fixation
• Accessible even after plate
attachment, so pre-loading
sutures is not required
Simple and streamlined instrumentation
• 1 tray, 1 screw size, 1 drill bit, 1 driver
25°
Alians Proximal Humerus
The Alians Proximal Humerus provides another fracture management option to the AltiVate™ Extremity
Solutions Portfolio. This fracture plate system features an anatomically contoured design with patented
polyaxial locking screw options and is paired with simple, streamlined instrumentation.
ALIANS AND DUALTEC SYSTEM I ARE
TRADEMARKS OF NEWCLIP USA.
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Proven Results
The Turon shoulder is benchmarked o of the design and principles of the Charles Neer shoulder prosthesis; and RSP is one of the most, well-published
reverse shoulders on the market with over fifty peer reviewed journal publications.
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. Gutierrez S, Comiskey C, Lou Z,
Pupello D, Frankle M. Range of
Impingement-Free Abduction
and Adduction Deficit After
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J Bone Joint Surg Am.
Dec;:.
. Simovitch RW, Zumstein MA,
Lohri E, Helmy N, Gerber C.
Predictors of scapular notching
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MA, Keppler LJ. Accuracy of
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Levy JC. Observation of initial
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Rosas S. Tuberosity healing after
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Cusick MC, Hussey MM, Steen
BM, Hartzler RU, Clark RE, Cu DJ,
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DG, Cottrell BJ, Frankle MA. Results
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2015 Apr; 24(4):621-627.
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MM, Santoni BG, Inoue N, Frankle,
MA. Glenoid subchondral bone
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Steen BM, Cabezas AS, Santoni BG,
Hussey MM, Cusick MC, Kumer AG,
Frankle MA. Outcome and value
of reverse shoulder arthroplasty
for treatment of glenohumeral
osteoarthritis: a matched cohort. J
Shoulder Elbow Surg. 2015 Mar.
Levy JC, Everding NG, Frankle MA,
Keppler LJ. Accuracy of patient-
specific guided glenoid baseplate
positioning for reverse shoulder
arthroplasty. J Shoulder Elbow Surg.
2014; 23:1563-1567.
Schwarts DG, Cottrell BJ, Teusink MJ,
Clark RE, Downes KL, Tammembaum
RS, Frankle MA. Factors that predict
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treated with reverse shoulder
arthroplasty. J Shoulder Elbow Surg.
2014 23:1289-1295.
Levy JC, Everding NG, Gil CC Jr,
Stephens S, Giveans R. Speed of
recovery after shoulder arthroplasty:
a comparison of reverse and anatomic
total shoulder arthroplasty. J Shoulder
Elbow Surg. 2014; 23:1872-1881.
Teusink M, Otto R, Cottrell B,
Frankle, MA. What is the eect of
postoperative scapular fracture
on outcomes of reverse shoulder
arthroplasty? J Shoulder Elbow Surg.
2014 June; 23(6):782-790.
Cu DJ, Pupello DR. Comparison
of hemiarthroplasty and reverse
shoulder arthroplasty for the
treatment of proximal humeral
fractures in elderly patients. J Bone
Joint Surg. 2013; 95:2050-5.
Kwon YW, Pinto VJ, Yoon J, Frankle
MA, Dunning PE, Sheikhzadeh A.
Kinematic analysis of dynamic
shoulder motion in patients with
reverse total shoulder arthroplasty.
J Shoulder Elbow Surg. 2012 Sep;
21(9):1184-90.
Willis M, Min W, Brooks JP, Mulieri
P, Walker M, Pupello D, Frankle M.
Proximal humeral malunion treated
with reverse shoulder arthroplasty.
J Shoulder Elbow Surg. 2012 Apr;
21(4):507-13.
Walker M, Willis MP, Brooks JP,
Pupello D, Mulieri PJ, Frankle MA.
The use of the reverse shoulder
arthroplasty for treatment of failed
total shoulder arthroplasty. J Shoulder
Elbow Surg. 2012 Apr; 21(4):514-22.
Clark JC, Ritchie J, Song FS,
Kissenberth MJ, Tolan SJ, Hart ND,
Hawkins RJ. Complication rates,
dislocation, pain, and postoperative
range of motion after reverse
shoulder arthroplasty in patients
with and without repair of the
subscapularis. J Shoulder Elbow Surg.
2012 Jan; 21(1):36-41.
Levy JC, Badman, B. Reverse shoulder
prosthesis for acute four-part
fracture: tuberosity fixation using a
horseshoe graft. J Orthop Trauma
2011; 25:318–324.
Walker M, Brooks J, Willis M, Frankle
M. How reverse shoulder arthroplasty
works. Clin Orthop Relat Res. 2011
Sep; 469(9):2440-51.
Cheung E, Willis M, Walker M, Clark R,
Frankle MA. Complications in reverse
total shoulder arthroplasty. J Am Acad
Orthop Surg. 2011 Jul; 19(7):439-49.
Gutiérrez S, Walker M, Willis M,
Pupello DR, Frankle MA. Eects of
tilt and glenosphere eccentricity on
baseplate/bone interface forces in a
computational model, validated by a
mechanical model, of reverse shoulder
arthroplasty. J Shoulder Elbow Surg.
2011 Jul; 20(5):732-9.
Hart ND, Clark JC, Krause W,
Kissenberth MJ, Bragg WE, Hawkins
RJ. Glenoid screw position in the
Encore reverse shoulder prosthesis:
an anatomic dissection study of
screw relationship to surrounding
structures. J Shoulder Elbow Surg.
2013; 22:814-820.
Levy JC. Avoiding cement bone
necrosis eect on tuberosity healing:
the “black-and-tan” technique. Tech
Should Surg. 2013 Sep; 14(3):81-84.
Virani NA, Cabezas A, Gutiérrez
S, Santoni BG, Otto R, Frankle M.
Reverse shoulder arthroplasty
components and surgical techniques
that restore glenohumeral motion.
J Shoulder Elbow Surg. 2013 Feb;
22(2):179-87.
Puskas B, Harreld K, Clark R, Downes
K, Virani NA, Frankle M. Isometric
strength, range of motion, and
impairment before and after total
and reverse shoulder arthroplasty. J
Shoulder Elbow Surg. 2013 Jan.
Andersen JR, Williams CD, Cain R,
Mighell M, Frankle M. Surgically
treated humeral shaft fractures
following shoulder arthroplasty. J
Bone Joint Surg Am. 2013 Jan; 95(1):9-
18.
Aonso J, Nicholson GP, Frankle MA,
Walch G, Gerber C, Garzon-Muvdi J,
McFarland EG. Complications of the
reverse prosthesis: prevention and
treatment. Instr Course Lect. 2012;
61:157-68.
Cu D, Clark R, Pupello D, Frankle M.
Reverse shoulder arthroplasty for the
treatment of rotator cu deficiency:
a concise follow-up, at a minimum of
five years, of a previous report. J Bone
Joint Surg Am. 2012 Nov; 94(21):1996-
2000.
Zavala JA, Clark JC, Kissenberth MJ,
Tolan SJ, Hawkins RJ. Management
of deep infection after reverse total
shoulder arthroplasty: a case series.
J Shoulder Elbow Surg. 2012 Oct;
21(10):1310-5.
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Proven Results - continued
Cu D, Levy JC, Gutiérrez S, Frankle
MA. Torsional stability of modular
and non-modular reverse shoulder
humeral components in a proximal
humeral bone loss model. J Shoulder
Elbow Surg. 2011 Jun; 20(4):646-51.
Harreld KL, Puskas BL, Frankle M.
Massive rotator cu tears without
arthropathy: when to consider
reverse shoulder arthroplasty. J
Bone Joint Surg Am. 2011 May 18;
93(10):973-84.
Mulieri P, Dunning P, Klein S, Pupello
D, Frankle M. Reverse shoulder
arthroplasty for the treatment of
irreparable rotator cu tear without
glenohumeral arthritis. J Bone Joint
Surg Am. 2010 Nov; 92(15):2544-56.
Holcomb JO, Hebert DJ, Mighell
MA, Dunning PE, Pupello DR, Pliner
MD, Frankle MA. Reverse shoulder
arthroplasty in patients with
rheumatoid arthritis. J Shoulder Elbow
Surg. 2010 Oct; 19(7):1076-84.
Harreld KL, Puskas BL, Andersen
J, Frankle, MA. Reverse shoulder
arthroplasty in the management of
irreparable rotator cu tears without
arthritis. JBJS Essential Surgical
Techniques, 2010 Sep; 1(2):e12 1-15.
Klein SM, Dunning P, Mulieri P,
Pupello D, Downes K, Frankle MA.
Eects of acquired glenoid bone
defects on surgical technique and
clinical outcomes in reverse shoulder
arthroplasty. J Bone Joint Surg Am.
2010 May; 92(5):1144-54.
Frankle MA, Teramoto A, Luo ZP, Levy
JC, Pupello D. Glenoid morphology
in reverse shoulder arthroplasty:
classification and surgical
implications. J Shoulder Elbow Surg.
2009 Nov-Dec; 18(6):874-85.
Holcomb JO, Cu D, Petersen SA,
Pupello DR, Frankle MA. Revision
reverse shoulder arthroplasty for
glenoid baseplate failure after primary
reverse shoulder arthroplasty. J
Shoulder Elbow Surg. 2009 Sep-Oct;
18(5):717-23.
Gutiérrez S, Luo ZP, Levy J, Frankle
MA. Arc of motion and socket depth
in reverse shoulder implants. Clin
Biomech. 2009 Jul; 24(6):473-9.
Chacon A, Virani N, Shannon R, Levy
JC, Pupello D, Frankle M. Revision
arthroplasty with use of a reverse
shoulder prosthesis-allograft
composite. J Bone Joint Surg Am.
2009 Jan; 91(1):119-27.
Gutierrez S, Levy JC, Lee WE 3rd, Luo
ZP. Hierarchy of stability factors in
reverse shoulder arthroplasty. Clin
Orthop Relat Res. 2008 466:670-676.
Cu D, Pupello D, Virani N, Levy
J, Frankle M. Reverse shoulder
arthroplasty for the treatment of
rotator cu deficiency. J Bone Joint
Surg. 2008; 90:1244-1251.
Gutiérrez S, Comiskey CA 4th, Luo
ZP, Pupello DR, Frankle MA. Range
of impingement-free abduction
and adduction deficit after reverse
shoulder arthroplasty. Hierarchy of
surgical and implant-design-related
factors. J Bone Joint Surg Am. 2008
Dec; 90(12):2606-15.
Gutiérrez S, Levy JC, Frankle MA,
Cu D, Keller TS, Pupello DR, Lee WE
3rd. Evaluation of abduction range
of motion and avoidance of inferior
scapular impingement in a reverse
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Virani NA, Harman M, Li K, Levy J,
Pupello DR, Frankle MA. In vitro and
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21.
Cu DJ, Virani NA, Levy J, Frankle
MA, Derasari A, Hines B, Pupello
DR, Cancio M, Mighell M. The
treatment of deep shoulder infection
and glenohumeral instability with
debridement, reverse shoulder
arthroplasty and postoperative
antibiotics. J Bone Joint Surg Br. 2008
Mar; 90(3):336-42.
Gutiérrez S, Levy JC, Frankle MA,
Lee WE 3rd, Keller TS, Maitland ME.
Center of rotation aects abduction
range of motion of reverse shoulder
arthroplasty. Clin Orthop and Relat
Res. 2007.
Gutiérrez S, Greiwe RM, Frankle MA,
Siegal S, Lee WE 3rd. Biomechanical
comparison of component position
and hardware failure in the reverse
shoulder prosthesis. J Shoulder
Elbow Surg. 2007 May-Jun; 16(3
Suppl):S9-S12.
Levy JC, Virani N, Pupello D, Frankle
M. Use of the reverse shoulder
prosthesis for the treatment of failed
hemiarthroplasty in patients with
glenohumeral arthritis and rotator
cu deficiency. J Bone Joint Surg Br.
2007 Feb; 89(2):189-95.
Levy J, Frankle M, Mighell M, Pupello
D. The use of the reverse shoulder
prosthesis for the treatment of
failed hemiarthroplasty for proximal
humeral fracture. J Bone Joint Surg
Am. 2007 Feb; 89(2):292-300.
Frankle M, Levy JC, Pupello D, Siegal
S, Saleem A, Mighell M, Vasey M.
The reverse shoulder prosthesis for
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with severe rotator cu deficiency. a
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J Bone Joint Surg Am. 2006 Sep; 88
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Frankle M, Siegal S, Pupello D, Saleem
A, Mighell M, Vasey M. The Reverse
Shoulder Prosthesis for glenohumeral
arthritis associated with severe
rotator cu deficiency. A minimum
two-year follow-up study of sixty
patients. J Bone Joint Surg Am. 2005
Aug; 87(8):1697-705.
Harman M, Frankle M, Vasey M,
Banks S. Initial glenoid component
fixation in “reverse” total shoulder
arthroplasty: a biomechanical
evaluation. J Shoulder Elbow Surg.
2005 Jan-Feb; 14(1 Suppl S):162S-167S.
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All rights reserved. No part of this publication may be reproduced, distributed, or transmitted
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“Attention: IP Counsel,” at the address 1430 Decision St, Vista, CA 92081.
CAUTION: Federal Law (USA) restricts this device to
sale by or on the order of a physician.
See package insert for a complete listing of indications,
contraindications, warnings, and precautions.
REV D /
* Data on file at DJO Surgical DJO Surgical I A DJO Global Company
T 800.456.8696 D 512.832.9500 F 512.834.6300
9800 Metric Blvd. I Austin, TX 78758 I U.S.A.
djosurgical.com DJO Surgical™ is a manufacturer of orthopedic implants
and does not practice medicine. Only an orthopedic
surgeon can determine what treatment is appropriate.
Individual results of total joint replacement may vary.
The life of any implant will depend on the patient’s
weight, age, activity level, and other factors.