Stryker Brochure Plastic Coil Flex Instability Surgical Technique

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2655_09_LJPST_2_JP_TwinLoop_Flex_SP_Layout1 8/3/10 2:44 PM Page 1

™

TwinLoop FLEX

Surgical Technique Guide

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TwinLoop FLEX
Surgical Technique Guide
The TwinLoop FLEX Instrumentation
System is designed to provide easy access
along the glenoid rim during arthroscopic
instability repair. Paired with Stryker’s
TwinLoop anchors, the flexible
instrumentation is an excellent solution
for surgeons who desire simplification of
instability repair.

The TwinLoop FLEX Instrumenation
System boasts five different drill guides,
which allows for a customized solution to
approaching instability repair. All five drill
guides follow the same stepwise process
for use.

1. Arthroscopic visualization and documentation
of the labrum is preferred. In the case of a soft
ALPSA or anterior Bankart lesion, the tissue to be
repaired is identified. Prepare the glenoid rim in
the standard fashion.

Figure 1

2. The 12˚ guide is selected. The 12˚ guide is passed
through a minimum of an 8mm cannula, in
conjunction with the Bullet Tip Obturator. If so
desired, the surgeon may place the 12˚ or 25˚ guide
percutaneously with the Trocar Tip Obturator. After
entering the joint space, remove the obturator from
the guide.
Position the tip of the TwinLoop FLEX guide on the
bone such that the fish mouth firmly engages the
bone surface.
Procedure Pearls: Firmly engage the fish mouth
prior to proceeding, and pay careful attention to
preventing guide handle movement.

Figure 2

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3. Place the flexible drill down the guide to the cortical
surface of the bone. Careful attention must be paid
to stabilizing the guide while advancing the
TwinLoop FLEX Drill. Run the drill in the forward
position until the proximal step is flush with the
drill guide handle.
Procedure Pearls: Transfer the TwinLoop FLEX
inserter assembly into the surgical field using sterile
technique prior to drilling the pilot hole.

Figure 3

Procedure Pearls: Make sure to minimize changes
to the angle of the guide shaft in any plane. It may
be beneficial to have a surgical assistant operate
the drill while the surgeon stabilizes the guide or
vise versa.
Once the pilot hole is created, do not allow the fish
mouth to move with respect to the bone surface, or
the angle of the guide shaft to be changed.

4. Place the inserter down the guide and align it with
the prepared pilot hole. The vertical line on the
inserter shaft indicates suture orientation. Manually
seat the anchor in the pilot hole prior to using a
metal mallet to fully insert the anchor. When the
laser mark on the distal end of the TwinLoop FLEX
inserter shaft aligns with the laser mark on the
window of the guide, or the proximal shaft laser
mark aligns with the back end of the guide handle,
a 3mm countersink depth has been achieved.

Figure 4a

Procedure Pearls: Be sure to firmly insert the anchor
into the pilot hole by applying force to the inserter
handle with your hand prior to using a mallet to
fully insert the anchor.
Take heed of the importance of the warning on the
IFU for this step: Guide instability may result in
anchor insertion failure. Firmly grip the guide when
using the metal mallet to insert the anchor.

Figure 4b
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TwinLoop FLEX
Surgical Technique Guide
5. Unwind and disengage the suture strands from the
TwinLoop FLEX inserter. Remove the inserter by
pulling it straight out along the TwinLoop FLEX
guide handle. Avoid twisting the inserter during
removal. The sutures will pass through the inserter.
Discard the inserter, and remove the guide.
Procedure Pearls: While unwrapping the suture,
maintain the stability of the guide and inserter.
Make sure that the sutures do not remain engaged
in the inserter handle cleat during inserter removal.
This will help ensure that the sutures remain
threaded in the anchor and do not inadvertently
pull out with the inserter.

Figure 5

6. The security of the anchor in bone may now be
confirmed. The TwinLoop anchor allows for suture
sliding and static knot tying to secure the tissue to
its bone bed. Additional Twin Loop Anchors, using
the flexible drill system, are implanted as necessary
to complete the repair.

Figure 6

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Ordering Information
TwinLoop FLEX Instrumentation System
Description

Product Number

TwinLoop FLEX Drill*

3910-400-100

TwinLoop FLEX Bullet Tip Obturator

3910-400-101

TwinLoop FLEX Trocar Tip Obturator

3910-400-102

TwinLoop FLEX 12˚ Guide

3910-400-103

TwinLoop FLEX 12˚ RM Guide

3910-400-104

TwinLoop FLEX 25˚ Guide

3910-400-105

TwinLoop FLEX 25˚ RM Guide

3910-400-106

TwinLoop FLEX 0˚ Guide

3910-400-107

3.5mm PEEK TwinLoop FLEX Single Strand*

3910-405-638

* packaged in boxes of 5

Suture Sliders (packaged in boxes of 5)
Description

Product Number

Suture Slider 30˚

3910-000-100

Suture Slider 60˚

3910-000-101

Suture Slider Crescent

3910-000-102

Suture Slider 45˚ Right

3910-000-103

Suture Slider 45˚ Left

3910-000-104

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Ordering Information
Champion Shoulder Instrumentation
Description

Product Number

2.7mm Straight Suture Retriever

300-027-375

2.7mm 15˚ Suture Retriever

300-027-376

3.4mm Straight Grasper

300-034-950

3.4mm Straight Grasper w/ Ratchet

300-034-951

Champion Shoulder Instrument Sterilization Tray

3910-500-721

Stabilihook Left

3910-500-722

Stabilihook Right

3910-500-723

Cuff Hook Left

3910-500-724

Cuff Hook Right

3910-500-725

Stitch Blade

3910-500-726

Suture Manipulator

3910-500-727

Tissue Grasper with Ratchet

3910-500-728

Crochet Hook

3910-500-729

Knot Manipulator Full Loop

3910-500-730

Rasp 20˚ Up

3910-500-731

Rasp 20˚ Down

3910-500-732

Tissue Liberator Blade Up

3910-500-733

Tissue Liberator Blade Down

3910-500-734

3mm Probe

3910-500-800

5mm Probe

3910-500-850

PrepStrap Shoulder Suspension Sleeve
(packaged in boxes of 5)
Description
PrepStrap Shoulder Suspension Sleeve Kit

Product Number
3910-900-200

Aztec Shoulder Holder
Description

Product Number

Aztec Shoulder Holder

3910-900-000

Slotted Interlock Weights for Shoulder Holder

3910-900-154

To order, please contact your local Stryker Orthopaedics Branch or Agency,
or call Stryker Orthopaedics’ Customer Service Department at (877) 946-9678.

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Notes

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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.
Stryker Corporation or its divisions or other corporate affiliated entities own, use or have applied for the
following trademarks or service marks: Aztec, PrepStrap, Stryker, TwinLoop FLEX. All other trademarks are
trademarks of their respective owners or holders.
Literature Number: LJPST-3
MS/GS 08/10
Copyright © 2010 Stryker
Printed in USA



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