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Arthrex is proud to add the Univers VaultLock® augmented glenoid and instrument system to our shoulder arthroplasty portfolio. This augmented glenoid is the only implant with a variable backside radius and 15° and 25° half-wedges, which provide subchondral bone preservation. When combined with the Eclipse™ total shoulder system, the portfolio offers comprehensive solutions for a surgeons' clinical needs.

Univers VaultLock® Augmented Glenoid

Arthroplasty Shoulder

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Univers VaultLock® Augmented Glenoid Surgical Technique Univers VaultLock® Augmented Glenoid Fluted Central Peg Immediate fixation OR efficiency Inferior Keel Decreased cortical penetration compared to inferior pegs Multiple fixation features, including reverse barbs, flutes, and central cement fenestration Superior Peg Enhanced immediate fixation Self-pressurizing design Inline Configuration Combines all advantages of pegged and keeled implants including stability and preparation ease Augmented Sizes 15° and 25° half-wedge for bone preservation Anatomic Backside Radius of Curvature (ROC) Matches glenoid poly to glenoid anatomy Bone-sparing reaming Simplified decision-making Optimized ROCs Anatomic solution with subchondral, bone-preserving design Optimized ROCs Small = 35 mm Medium = 38 mm Large = 42 mm XL = 45 mm 02 I Univers VaultLock® Augmented Glenoid Surgical Technique Glenoid Guidewire Placement Obtain complete exposure of the glenoid articular surface. Assemble the appropriately sized pin guide to the handle and place the 2.8 mm guidewire. Mark the anterior (high side) of the glenoid with a pen or electrocautery. A mark 180° opposite of this location can also be made as either of these can be used to assist in orienting instrumentation while reaming the glenoid. Note: The pin guide has small windows for making superior and inferior marks on the glenoid face (as shown). These marks can also be useful for orientation later in the procedure. 1 2 Paleo Glenoid Reaming Attach the properly sized modular VaultLock reamer to the reamer shaft and place it over the guide pin. To prepare the surface for the prosthetic glenoid, carefully ream the glenoid surface to remove cartilage while sparing subchondral bone. Univers VaultLock® Augmented Glenoid I 03 3 Neo Glenoid Reaming Select the angled reaming sleeve that matches the augment size selected. Insert the inner reamer shaft through the angled reamer sleeve (a). Couple the disposable angled reamer to the inner reamer shaft (b). A tactile coupling should be felt. Augment Color 15° Purple 25° Blue a b 04 I Univers VaultLock® Augmented Glenoid (a) 4 Insert the reaming depth stop (a) into the slots near the face of the angled reamer sleeve. This depth stop is sized to match the implant and prevents overmedializing while reaming the neo glenoid, thus aligning the neo and paleo reamed surfaces within the center of the glenoid face. 5 (b) (c) Before attaching the reamer assembly to the powered hand equipment, the orientation sleeve (b) or orientation handle (c) can be attached to help maintain rotational control while reaming. Note: If using the orientation handle (c) it is helpful to align the handle with the anterior dotted line on the angled reamer sleeve. Univers VaultLock® Augmented Glenoid I 05 6 Neo Ream Insert the angled reamer assembly over the guide pin. Rotate the reamer assembly about the pin so that the dotted line on the shaft aligns with the anterior (high side) mark on the glenoid face. 7 Ream Verification Place the ream verification guide over the guidewire. Hold the guide firmly onto the face for tactile feel, confirming the glenoid is reamed properly to mate with the backside geometry of the Univers VaultLock® augmented implant. If required, repeat the paleo and neo reaming steps. 06 I Univers VaultLock® Augmented Glenoid 8 Central Hole Prepare for the central peg hole by placing the 6 mm drill over the guide pin. Advance the drill until the positive stop reaches the glenoid surface, taking care to maintain alignment of the pin to the trajectory of the drill. 9 Superior Hole Place the drill guide into position and drill for the superior hole. Detach the drill and keep it in place to hold guide orientation. Note: Flats on the proximal edge of the drill can be used with an angled clamp to facilitate detaching. 10 Inferior Drill Use the 4.5 mm drill to prepare the 3 inferior holes. Once these holes are drilled, remove the guide from the glenoid face. Note: Insert the drill into the guide before activating it. There is a mechanical stop on the drill for depth control. Univers VaultLock® Augmented Glenoid I 07 11 Inferior Punch Place the appropriate tip on the broach. The tips are sized to match the augment angle and anatomical side (eg, 15° right). Engage the pegs of the broach into the superior and central holes. Use a mallet to advance the glenoid broach into the roughly prepared slot. Optional (inset): Alternatively, use the pegged glenoid punch to prepare the keel slot. Advance only until the shoulder of the punch is flush with the bone surface. 12 Trial Insert the Univers VaultLock® augmented glenoid trial manually or using forceps. This trial will verify backside curvature and hole depth. 08 I Univers VaultLock® Augmented Glenoid 13 Implantation Prior to cementing the glenoid, use the graft compression tool to place graft around the central peg of the implant. Graft can be obtained from the humeral head or from the reamers and drills after preparing the glenoid. Place the graft into the compression tool then clamp the tool onto the central peg and twist the implant 180°. Repeat the process so the graft fully covers the central peg. 14 Implantation Remove bone and soft-tissue debris from the glenoid with irrigation and suctioning. Hemostasis should be achieved before placing the cemented glenoid. Once the glenoid has been fully prepared, open the appropriately sized implant and press bone cement into the fenestration on the inferior keel and around the superior peg. Pack the inferior slot and superior peg hole with cement using a syringe or finger. To create adequate cement interdigitation within the glenoid vault, impact the cement into the slot and superior hole using the cement pressurizer (inset). Alternate between cementing and pressurizing until a sufficient quantity of cement has filled the glenoid vault. Prior to inserting the glenoid component, the superior hole and inferior slot should be filled with cement again. Univers VaultLock® Augmented Glenoid I 09 15 Introduce the implant with the glenoid inserter/impactor (as shown) or manually. Once the central fluted peg is initially fixed into the prepared hole, push and impact the implant into the cement-filled glenoid vault. Remove excess cement and verify complete seating of the implant. Firmly hold the glenoid component in place until the cement has cured. 10 I Univers VaultLock® Augmented Glenoid After the glenoid is implanted, prepare the humerus and implant the prosthesis per the appropriate surgical technique: Eclipse™ Total Shoulder Arthroplasty System (LT1-000009-EN) Univers™ II Total Shoulder System (LT1-0701-EN) Univers™ Apex Total Shoulder System (LT1-0702-EN) Ordering Information Implants Product Description Item Number Augmented Univers VaultLock® Glenoid, small, 15°, left AR-9107-01-15L Augmented Univers VaultLock Glenoid, small, 15°, right AR-9107-01-15R Augmented Univers VaultLock Glenoid, small, 25°, left AR-9107-01-25L Augmented Univers VaultLock Glenoid, small, 25°, right AR-9107-01-25R Augmented Univers VaultLock Glenoid, medium, 15°, left AR-9107-02-15L Augmented Univers VaultLock Glenoid, medium, 15°, right AR-9107-02-15R Augmented Univers VaultLock Glenoid, medium, 25°, left AR-9107-02-25L Augmented Univers VaultLock Glenoid, medium, 25°, right AR-9107-02-25R Augmented Univers VaultLock Glenoid, large, 15°, left AR-9107-03-15L Augmented Univers VaultLock Glenoid, large, 15°, right AR-9107-03-15R Augmented Univers VaultLock Glenoid, large, 25°, left AR-9107-03-25L Augmented Univers VaultLock Glenoid, large, 25°, right AR-9107-03-25R Disposable Instruments Product Description Item Number Angled Reamer, small AR-9275-S Angled Reamer, medium AR-9275-M Angled Reamer, large AR-9275-L DynaNite® Virtual Implant Positioning™ Glenoid Pin, nitinol, 2.8 mm AR-5400-400NS Univers™ II Pin Set AR-9207S Special Order Product Description Item Number Augmented Univers VaultLock Glenoid, extra large, 15°, right AR-9107-04-15R Augmented Univers VaultLock Glenoid, extra large, 15°, left AR-9107-04-15L Augmented Univers VaultLock Glenoid, extra large, 25°, right AR-9107-04-25R Augmented Univers VaultLock Glenoid, extra large, 25°, left AR-9107-04-25L Angled Reamer, extra large AR-9275-XL Instruments for Augmented Univers VaultLock Glenoid, extra large AR-9217AGC-XL Univers VaultLock® Augmented Glenoid I 11 1 2 3 4 5 7 6 8 10 14 16 9 11 12 13 15 17 Top Tray (AR-9217AVS) Label Description Item Number 1 2.8 mm Steinmann Pin AR-9207 2 Quick Connect Handle (qty. 2) AR-9215-1-03 3 Glove Protector (qty. 2) AR-9216-4 4 Quick Connect Drive Shaft (qty. 2) AR-9617 5 Angled Reamer Sleeve, 15 Degree AR-9297-15 Angled Reamer Sleeve, 25 Degree AR-9297-25 6.0 mm Central Drill AR-9216AG 4.5 mm Inferior Drill AR-9239AG 6.0 mm Superior Drill AR-9221AG Small Modular Reamer AR-9228AG Medium Modular Reamer AR-9229AG Large Modular Reamer AR-9230AG 8 Angled Reamer Drive Shaft AR-9676 9 Modular Handle AR-9595 10 Angled Reamer Orientation Handle AR-9678 11 Angled Reamer Depth Stop, Small AR-9298-S Angled Reamer Depth Stop, Medium AR-9298-M Angled Reamer Depth Stop, Large AR-9298-L 12 Univers VaultLock Augmented Broach AR-9233AG 13 Pegged Glenoid Punch AR-9234 14 Angled Reamer Orientation Sleeve AR-9679 15 Pegged Glenoid Pressurizer AR-9235 16 Glenoid Inserter/Impactor Handle AR-9241-2 17 Glenoid Inserter/Impactor, Small AR-9241-01 Glenoid Inserter/Impactor, Medium AR-9241-02 Glenoid Inserter/Impactor, Large AR-9241-03 6 7 12 I Univers VaultLock® Augmented Glenoid 1 2 3 4 6 7 5 Bottom Tray (AR-9217AVS) Label Description Item Number Augmented Univers VaultLock® Pin Guide, 15 Left (Small, Medium, Large) AR-9215-2AG/4AG/6AG-15L Augmented Univers VaultLock Pin Guide, 25 Left (Small, Medium, Large) AR-9215-2AG/4AG/6AG-25L Augmented Univers VaultLock Pin Guide, 15 Right (Small, Medium, Large) AR-9215-2AG/4AG/6AG-15R Augmented Univers VaultLock Pin Guide, 25 Right (Small, Medium, Large) AR-9215-2AG/4AG/6AG-25R Augmented Univers VaultLock Drill Guide, 15 Left (Small, Medium, Large) AR-9231-01AG/02AG/03AG-15L Augmented Univers VaultLock Drill Guide, 25 Left (Small, Medium, Large) AR-9231-01AG/02AG/03AG-25L Augmented Univers VaultLock Drill Guide, 15 Right (Small, Medium, Large) AR-9231-01AG/02AG/03AG-15R Augmented Univers VaultLock Drill Guide, 25 Right (Small, Medium, Large) AR-9231-01AG/02AG/03AG-25R Augmented Univers VaultLock Trial, 15 Left (Small, Medium, Large) AR-9236-01AG/02AG/03AG-15L Augmented Univers VaultLock Trial, 25 Left (Small, Medium, Large) AR-9236-01AG/02AG/03AG-25L Augmented Univers VaultLock Trial, 15 Right (Small, Medium, Large) AR-9236-01AG/02AG/03AG-15R Augmented Univers VaultLock Trial, 25 Right (Small, Medium, Large) AR-9236-01AG/02AG/03AG-25R Augmented Univers VaultLock Broach Base, 15 Left AR-9233AG-15L Augmented Univers VaultLock Broach Base, 25 Left AR-9233AG-25L Augmented Univers VaultLock Broach Base, 15 Right AR-9233AG-15R Augmented Univers VaultLock Broach Base, 25 Right AR-9233AG-25R Augmented Univers VaultLock Bone Prep Trial, Small (15, 25) AR-9236-01AG-15B/25BP Augmented Univers VaultLock Bone Prep Trial, Medium (15, 25) AR-9236-02AG-15B/25BP Augmented Univers VaultLock Bone Prep Trial, Large (15, 25) AR-9236-03AG-15B/25BP 6 Graft Compression Tool AR-9236GT 7 Glenoid Trial Forceps AR-9238 1 2 3 4 5 Univers VaultLock® Augmented Glenoid I 13 Key Dimensions a VLPT - a R1 b VLPT - b H R2 UHMWPE Glenoid Component VL AT VL ST VL SFD VL SPL VLSPD VL CFD VL CPL VL CPD VL KT VL KL VL IT Glenoid Dimensions Peg Dimensions Size H (mm) R1 (mm) R2 (mm) T1 (mm) T2 (mm) VLCPL 15.3 mm Small 33.0 8.0 11.5 4.7 5.7 VLSPL 9.0 mm Medium 36.0 9.5 13.0 4.6 5.7 VLSPL 9.0 mm Large 39.0 11.0 14.5 4.5 5.6 VLKL 8.0 mm Extra Large 42.0 12.5 16.0 4.4 5.5 VLKT 4.3 mm VLSFD 6.5 mm VLSPD 3.7 mm Augment Specific Dimensions (α=15° β=25°) Size VL AT (mm) VLPT-α (mm) VLPT-β (mm) VLCFD 7.5 mm Small 4.6 7.1 8.8 VLCPD 4.2 mm Medium 4.7 7.6 9.5 Large 5.0 8.2 10.4 Extra Large 5.2 8.8 11.2 14 I Univers VaultLock® Augmented Glenoid Radial Mismatch Eclipse™ Total Shoulder Arthroplasty System Univers VaultLock® Augmented Glenoid Head Size (mm) Small Medium Large Extra Large 37 9.9 mm 39 8.5 mm 41 7.25 mm 8.75 mm 43 6 mm 7.5 mm 9 mm 45 6 mm 7.5 mm 9 mm 47 5 mm 6.5 mm 8 mm 49 5.5 mm 7 mm 51 4.5 mm 6 mm 53 5 mm 55 4 mm Univers II™/Univers Apex Shoulder Arthroplasty System Univers VaultLock Augmented Glenoid Head Size (mm) Small 40 8.5 42 7.5 44 6.4 Medium Large Extra Large 7.9 46 6.8 48 5.7 7.2 50 4.6 6.1 52 5.3 6.8 54 4 5.5 56 4.7 Univers VaultLock® Augmented Glenoid I 15 This description of technique is provided as an educational tool and clinical aid to assist properly licensed medical professionals in the usage of specific Arthrex products. As part of this professional usage, the medical professional must use their professional judgment in making any final determinations in product usage and technique. In doing so, the medical professional should rely on their own training and experience, and should conduct a thorough review of pertinent medical literature and the product’s directions for use. Postoperative management is patient-specific and dependent on the treating professional’s assessment. Individual results will vary and not all patients will experience the same postoperative activity level and/or outcomes. View U.S. patent information at www.arthrex.com/corporate/virtual-patent-marking arthrex.com © 2022 Arthrex, Inc. All rights reserved. LT1-000205-en-US_B

Univers VaultLock® Augmented Glenoid

Patrick J. Denard, MD (Medford, OR), discusses implant selection, preoperative planning, and relevant literature regarding glenoid bone loss in shoulder arthroplasty.

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Glenoid Treatment Options: Managing Complex Morphology With Augmented Implants

Michael Kissenberth, MD (Greenville, SC), demonstrates how to use the instrumentation for sizing and placing the Univers VaultLock® augmented glenoid.&nbsp;

Animations demonstrating the features and benefits of a specific product.

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Univers VaultLock® Augmented Glenoid Cadaveric Demonstration

This animation illustrates the features and benefits of the Univers VaultLock® augmented glenoid and instrument system.

Univers VaultLock® Augmented Glenoid: Features and Benefits

A visual representation of the tray and its components that includes product number, product description, product quantity, and a tray tracking form that administrative staff can use to manage trays for the hospital and/or surgery center.

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Univers VaultLock® Augmented Glenoid XL (AR-9217AVS)

Shoulder

Patrick J. Denard, MD, (Medford, OR) demonstrates the Univers VaultLock® Glenoid System technique. The Univers VaultLock Glenoid System represents a significant step forward in glenoid design – providing both enhanced fixation and bone conserving features.

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.