CUE Instrument Set (VAR-7020S) includes: CUE Humerus Template, medium VAR-7001-MCUE Humerus Template, large VAR-7001-LCUE Humerus Trial, medium VAR-7002-MCUE Humerus Trial, large VAR-7002-LCUE Humerus Implant Holder, medium VAR-7003-MCUE Humerus Implant Holder, large VAR-7003-LCUE Humerus Tamp VAR-7004CUE Humerus Drill, medium VAR-7011-MCUE Humerus Drill, large VAR-7011-LCUE Humerus Drill Stop, medium VAR-7012-MCUE Humerus Drill Stop, large VAR-7012-LCUE Ulna Trial, medium VAR-7006-MCUE Ulna Trial, large VAR-7006-LCUE Ulna Implant Holder, medium VAR-7007-MCUE Ulna Implant Holder, large VAR-7007-LCUE Ulna Drill, medium VAR-7014-MCUE Ulna Drill, large VAR-7014-LCUE Ulna Guide, medium VAR-7015-MCUE Ulna Guide, large VAR-7015-LCUE Ulna Tamp VAR-7016CUE Instrument Set Case VAR-7020C

Accessories: Cannulated Driver Handle with AO Connector VAR-13221AOCT15 Hexalobe Driver VAR-8941DHDrill Bit, 2.5 mm VAR-4160-25

Implants: CUE Humerus Implant, medium VAR-7000-MCUE Humerus Implant, large VAR-7000-LCUE Ulna Implant, medium VAR-7005-MCUE Ulna Implant, large VAR-7005-LCorkscrew FT II, 5.5 mm x 16 mm, w/three #2 FiberWire AR-1928SF-3Low Profile Screw, 3.5 mm x 24 mm, titanium AR-8935-24Low Profile Screw, 3.5 mm x 26 mm, titanium AR-8935-26Low Profile Screw, 3.5 mm x 28 mm, titanium AR-8935-28Low Profile Screw, 3.5 mm x 30 mm, titanium AR-8935-30Low Profile Screw, 3.5 mm x 32 mm, titanium AR-8935-32Low Profile Screw, 3.5 mm x 34 mm, titanium AR-8935-34Low Profile Screw, 3.5 mm x 36 mm, titanium AR-8935-36Low Profile Screw, 3.5 mm x 38 mm, titanium AR-8935-38Low Profile Screw, 3.5 mm x 40 mm, titanium AR-8935-40

Disposables: Drill Tip Guide Pin, 2.4 mm (required) AR-1250LCurved Cruciate Needle VAR-5000

ORDERING INFORMATION

Canine Unicompartmental Elbow (CUE)

SURGICAL TECHNIQUE

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 Vet Systems 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.

www.arthrexvetsystems.com...up-to-date technology

just a click away

2

1

3

Medial Approach with Epicondylar Osteotomy Option

Lever the epicondylar bone out, from proximal to distal, and elevate the flexor muscles, joint capsule and medial collateral ligament cranially and caudally (staying on bone). This will expose the cranial and caudal extents of humeral articular cartilage, radial head and ulnar notch.

A Gelpis can be used to retract the periarticular tissues, while an assistant maintains valgus and internal rotation, so that the CUE instruments can easily be placed perpendicular to the articular surfaces of the MHC and MCP.

Valgus stress and internally rotate the antebrachium over a pad or block to expose and access the medial aspect of the humeral condyle (MHC) and medial coronoid process (MCP).

4 65

©2012, Arthrex Vet Systems - a division of Arthrex Med. Instrumente GmbH. All rights reserved. VLT0006 Vers. A

U.S. PATENT NO. 6,716,234

Incise from the caudal base of the osteotomy all the way through the joint capsule, across the joint, and distally between flexor carpi ulnaris and the superficial digital flexor and caudal to the deep digital flexor.

Place a beath pin from the center of the medial epicondyle to the center of the lateral epicondyle, outline the cranial, proximal and caudal "edges" of medial epicondyle (~4-6 mm from drill bit in each direction). Place saw guide over the beath pin.

Use a sagittal saw with a small blade to "osteotomize" the epicondyle at its "edges". Angle the osteotomies so that you end up with a trapezoidal shaped section of bone. Cut into the humerus ~5 mm for each osteotomy.

Center the appropriate size Ulna Drill guide on the MCP, flush to the articular surface, and place a beath pin through the Ulna Drill to exit the caudal ridge of the ulna.

When the beath pin is properly placed, use the Ulna Drill (reamer) to create the ulnar socket. Be careful to stay aligned on beath pin when reaming. Do not get off axis or wobble.

If necessary, the Ulna Tamp is used to fully seat the Ulna Implant.

Remove the beath pin, lavage and use the Ulna Trial to determine that the ulnar socket is properly reamed. Proceed to Humerus Implant steps before placing the Ulna Implant.

Surgical Technique

Make a medial incision along cranial border of the medial head of the triceps over the epicondyle and then between the flexor carpi ulnaris and the superficial digital flexor – skin and fascia – ~1/4 of humerus and ~1/4 of antebrachium length.

Ulna Implant Humerus Implant

2 1 32

1

1

3

6

4

Cut a u-shaped incision down to bone around the medial epicondyle, with tenotomy of flexor muscles at origin, near the epicondyle.

Remove fragments, osteophytes and abnormal cartilage and bone to define borders of the MCP.

7 Final view showing Humerus and Ulna Implant in place.

Medial Approach with Tenotomy Option

Dorsal recumbency with beanbag, pad or block under the elbow

Cut the beath pins as flush as possible to the guide. Remove the Humerus Drill guide and insert the Humerus Drill Stop over the beath pins.

Use the Humerus Tamp to fully seat the Humerus Implant.

65

Place the Humerus Drill (reamer) in the Humerus Drill Stop and over the beath pins. Keep the Humerus Drill pressed firmly and flush against the articular surface. Use the reamer to fully ream the first humeral socket, flip the reamer and guide and ream the second humeral socket.

4

Place the Humerus Implant in the Humerus Implant Holder so that the bony ingrowth surface is facing out and implant into the humeral sockets.

• Oral antibiotics (cephalexin, clavamox, or similar) for 10 days• Soft-padded bandage maintained for 2 weeks minimum (can extend if sore or concerned)• Cage rest and leash walking only for a minimum of 8 weeks• Start rehabilitation at 8-12 weeks toward progressive return to function• Full athletic function not expected until 6 months postoperatively• Rechecks at 2 weeks (suture and bandage removal), 8-12 weeks (with radiographs), and 6 months (with radiographs)

Postoperative Care Recommendations

Place the appropriate size Humerus Drill guide on humeral articular surface so that it most fully covers the humeral lesion, making sure that it is flush to the articular surface and sagittally aligned.

When the drill guide is optimally positioned, drill the beath pins through the guide and at least 15 mm into the MHC, making sure to keep the drill guide pressed firmly and flush against the articular surface.

Make an incision from base ofthe U all the way through the joint capsule, across the joint, and distally between the flexor carpi ulnaris and the superficial digital flexor and caudal to the deep digital flexor.

Valgus stress and internally rotate the antebrachium over a pad or block to expose and access the medial aspect of the humeral condyle (MHC) and medial coronoid process (MCP).

After placing the Humerus Implant, you may now place the Ulna Implant in the Ulna Implant Holder. Make sure the ridges and radiographic marker are facing out and implant it into the ulnar socket.

Elevate the flexor muscles, joint capsule and medial collateral ligament cranially and caudally (staying on bone) to expose the cranial and caudal extents of the humeral articular cartilage, radial head and ulnar notch ("open the curtains").

Gelpis can be used to retract the periarticular tissues while an assistant maintains valgus and internal rotation, so the CUE instruments can easily be placed perpendicular to the articular surfaces of the MHC and MCP.

2

4 5

3

5

CUE Instrument Set (VAR-7020S) includes: CUE Humerus Template, medium VAR-7001-MCUE Humerus Template, large VAR-7001-LCUE Humerus Trial, medium VAR-7002-MCUE Humerus Trial, large VAR-7002-LCUE Humerus Implant Holder, medium VAR-7003-MCUE Humerus Implant Holder, large VAR-7003-LCUE Humerus Tamp VAR-7004CUE Humerus Drill, medium VAR-7011-MCUE Humerus Drill, large VAR-7011-LCUE Humerus Drill Stop, medium VAR-7012-MCUE Humerus Drill Stop, large VAR-7012-LCUE Ulna Trial, medium VAR-7006-MCUE Ulna Trial, large VAR-7006-LCUE Ulna Implant Holder, medium VAR-7007-MCUE Ulna Implant Holder, large VAR-7007-LCUE Ulna Drill, medium VAR-7014-MCUE Ulna Drill, large VAR-7014-LCUE Ulna Guide, medium VAR-7015-MCUE Ulna Guide, large VAR-7015-LCUE Ulna Tamp VAR-7016CUE Instrument Set Case VAR-7020C

Accessories: Cannulated Driver Handle with AO Connector VAR-13221AOCT15 Hexalobe Driver VAR-8941DHDrill Bit, 2.5 mm VAR-4160-25

Implants: CUE Humerus Implant, medium VAR-7000-MCUE Humerus Implant, large VAR-7000-LCUE Ulna Implant, medium VAR-7005-MCUE Ulna Implant, large VAR-7005-LCorkscrew FT II, 5.5 mm x 16 mm, w/three #2 FiberWire AR-1928SF-3Low Profile Screw, 3.5 mm x 24 mm, titanium AR-8935-24Low Profile Screw, 3.5 mm x 26 mm, titanium AR-8935-26Low Profile Screw, 3.5 mm x 28 mm, titanium AR-8935-28Low Profile Screw, 3.5 mm x 30 mm, titanium AR-8935-30Low Profile Screw, 3.5 mm x 32 mm, titanium AR-8935-32Low Profile Screw, 3.5 mm x 34 mm, titanium AR-8935-34Low Profile Screw, 3.5 mm x 36 mm, titanium AR-8935-36Low Profile Screw, 3.5 mm x 38 mm, titanium AR-8935-38Low Profile Screw, 3.5 mm x 40 mm, titanium AR-8935-40

Disposables: Drill Tip Guide Pin, 2.4 mm (required) AR-1250LCurved Cruciate Needle VAR-5000

ORDERING INFORMATION

Canine Unicompartmental Elbow (CUE)

SURGICAL TECHNIQUE

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 Vet Systems 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.

www.arthrexvetsystems.com...up-to-date technology

just a click away

2

1

3

Medial Approach with Epicondylar Osteotomy Option

Lever the epicondylar bone out, from proximal to distal, and elevate the flexor muscles, joint capsule and medial collateral ligament cranially and caudally (staying on bone). This will expose the cranial and caudal extents of humeral articular cartilage, radial head and ulnar notch.

A Gelpis can be used to retract the periarticular tissues, while an assistant maintains valgus and internal rotation, so that the CUE instruments can easily be placed perpendicular to the articular surfaces of the MHC and MCP.

Valgus stress and internally rotate the antebrachium over a pad or block to expose and access the medial aspect of the humeral condyle (MHC) and medial coronoid process (MCP).

4 65

©2012, Arthrex Vet Systems - a division of Arthrex Med. Instrumente GmbH. All rights reserved. VLT0006 Vers. A

U.S. PATENT NO. 6,716,234

Incise from the caudal base of the osteotomy all the way through the joint capsule, across the joint, and distally between flexor carpi ulnaris and the superficial digital flexor and caudal to the deep digital flexor.

Place a beath pin from the center of the medial epicondyle to the center of the lateral epicondyle, outline the cranial, proximal and caudal "edges" of medial epicondyle (~4-6 mm from drill bit in each direction). Place saw guide over the beath pin.

Use a sagittal saw with a small blade to "osteotomize" the epicondyle at its "edges". Angle the osteotomies so that you end up with a trapezoidal shaped section of bone. Cut into the humerus ~5 mm for each osteotomy.

Center the appropriate size Ulna Drill guide on the MCP, flush to the articular surface, and place a beath pin through the Ulna Drill to exit the caudal ridge of the ulna.

When the beath pin is properly placed, use the Ulna Drill (reamer) to create the ulnar socket. Be careful to stay aligned on beath pin when reaming. Do not get off axis or wobble.

If necessary, the Ulna Tamp is used to fully seat the Ulna Implant.

Remove the beath pin, lavage and use the Ulna Trial to determine that the ulnar socket is properly reamed. Proceed to Humerus Implant steps before placing the Ulna Implant.

Surgical Technique

Make a medial incision along cranial border of the medial head of the triceps over the epicondyle and then between the flexor carpi ulnaris and the superficial digital flexor – skin and fascia – ~1/4 of humerus and ~1/4 of antebrachium length.

Ulna Implant Humerus Implant

2 1 32

1

1

3

6

4

Cut a u-shaped incision down to bone around the medial epicondyle, with tenotomy of flexor muscles at origin, near the epicondyle.

Remove fragments, osteophytes and abnormal cartilage and bone to define borders of the MCP.

7 Final view showing Humerus and Ulna Implant in place.

Medial Approach with Tenotomy Option

Dorsal recumbency with beanbag, pad or block under the elbow

Cut the beath pins as flush as possible to the guide. Remove the Humerus Drill guide and insert the Humerus Drill Stop over the beath pins.

Use the Humerus Tamp to fully seat the Humerus Implant.

65

Place the Humerus Drill (reamer) in the Humerus Drill Stop and over the beath pins. Keep the Humerus Drill pressed firmly and flush against the articular surface. Use the reamer to fully ream the first humeral socket, flip the reamer and guide and ream the second humeral socket.

4

Place the Humerus Implant in the Humerus Implant Holder so that the bony ingrowth surface is facing out and implant into the humeral sockets.

• Oral antibiotics (cephalexin, clavamox, or similar) for 10 days• Soft-padded bandage maintained for 2 weeks minimum (can extend if sore or concerned)• Cage rest and leash walking only for a minimum of 8 weeks• Start rehabilitation at 8-12 weeks toward progressive return to function• Full athletic function not expected until 6 months postoperatively• Rechecks at 2 weeks (suture and bandage removal), 8-12 weeks (with radiographs), and 6 months (with radiographs)

Postoperative Care Recommendations

Place the appropriate size Humerus Drill guide on humeral articular surface so that it most fully covers the humeral lesion, making sure that it is flush to the articular surface and sagittally aligned.

When the drill guide is optimally positioned, drill the beath pins through the guide and at least 15 mm into the MHC, making sure to keep the drill guide pressed firmly and flush against the articular surface.

Make an incision from base ofthe U all the way through the joint capsule, across the joint, and distally between the flexor carpi ulnaris and the superficial digital flexor and caudal to the deep digital flexor.

Valgus stress and internally rotate the antebrachium over a pad or block to expose and access the medial aspect of the humeral condyle (MHC) and medial coronoid process (MCP).

After placing the Humerus Implant, you may now place the Ulna Implant in the Ulna Implant Holder. Make sure the ridges and radiographic marker are facing out and implant it into the ulnar socket.

Elevate the flexor muscles, joint capsule and medial collateral ligament cranially and caudally (staying on bone) to expose the cranial and caudal extents of the humeral articular cartilage, radial head and ulnar notch ("open the curtains").

Gelpis can be used to retract the periarticular tissues while an assistant maintains valgus and internal rotation, so the CUE instruments can easily be placed perpendicular to the articular surfaces of the MHC and MCP.

2

4 5

3

5

Center the appropriate size Ulna Drill guide on the MCP, flush to the articular surface, and place a beath pin through the Ulna Drill to exit the caudal ridge of the ulna.

When the beath pin is properly placed, use the Ulna Drill (reamer) to create the ulnar socket. Be careful to stay aligned on beath pin when reaming. Do not get off axis or wobble.

If necessary, the Ulna Tamp is used to fully seat the Ulna Implant.

Remove the beath pin, lavage and use the Ulna Trial to determine that the ulnar socket is properly reamed. Proceed to Humerus Implant steps before placing the Ulna Implant.

Surgical Technique

Make a medial incision along cranial border of the medial head of the triceps over the epicondyle and then between the flexor carpi ulnaris and the superficial digital flexor – skin and fascia – ~1/4 of humerus and ~1/4 of antebrachium length.

Ulna Implant Humerus Implant

2 1 32

1

1

3

6

4

Cut a u-shaped incision down to bone around the medial epicondyle, with tenotomy of flexor muscles at origin, near the epicondyle.

Remove fragments, osteophytes and abnormal cartilage and bone to define borders of the MCP.

7 Final view showing Humerus and Ulna Implant in place.

Medial Approach with Tenotomy Option

Dorsal recumbency with beanbag, pad or block under the elbow

Cut the beath pins as flush as possible to the guide. Remove the Humerus Drill guide and insert the Humerus Drill Stop over the beath pins.

Use the Humerus Tamp to fully seat the Humerus Implant.

65

Place the Humerus Drill (reamer) in the Humerus Drill Stop and over the beath pins. Keep the Humerus Drill pressed firmly and flush against the articular surface. Use the reamer to fully ream the first humeral socket, flip the reamer and guide and ream the second humeral socket.

4

Place the Humerus Implant in the Humerus Implant Holder so that the bony ingrowth surface is facing out and implant into the humeral sockets.

• Oral antibiotics (cephalexin, clavamox, or similar) for 10 days• Soft-padded bandage maintained for 2 weeks minimum (can extend if sore or concerned)• Cage rest and leash walking only for a minimum of 8 weeks• Start rehabilitation at 8-12 weeks toward progressive return to function• Full athletic function not expected until 6 months postoperatively• Rechecks at 2 weeks (suture and bandage removal), 8-12 weeks (with radiographs), and 6 months (with radiographs)

Postoperative Care Recommendations

Place the appropriate size Humerus Drill guide on humeral articular surface so that it most fully covers the humeral lesion, making sure that it is flush to the articular surface and sagittally aligned.

When the drill guide is optimally positioned, drill the beath pins through the guide and at least 15 mm into the MHC, making sure to keep the drill guide pressed firmly and flush against the articular surface.

Make an incision from base ofthe U all the way through the joint capsule, across the joint, and distally between the flexor carpi ulnaris and the superficial digital flexor and caudal to the deep digital flexor.

Valgus stress and internally rotate the antebrachium over a pad or block to expose and access the medial aspect of the humeral condyle (MHC) and medial coronoid process (MCP).

After placing the Humerus Implant, you may now place the Ulna Implant in the Ulna Implant Holder. Make sure the ridges and radiographic marker are facing out and implant it into the ulnar socket.

Elevate the flexor muscles, joint capsule and medial collateral ligament cranially and caudally (staying on bone) to expose the cranial and caudal extents of the humeral articular cartilage, radial head and ulnar notch ("open the curtains").

Gelpis can be used to retract the periarticular tissues while an assistant maintains valgus and internal rotation, so the CUE instruments can easily be placed perpendicular to the articular surfaces of the MHC and MCP.

2

4 5

3

5

CUE Instrument Set (VAR-7020S) includes: CUE Humerus Template, medium VAR-7001-MCUE Humerus Template, large VAR-7001-LCUE Humerus Trial, medium VAR-7002-MCUE Humerus Trial, large VAR-7002-LCUE Humerus Implant Holder, medium VAR-7003-MCUE Humerus Implant Holder, large VAR-7003-LCUE Humerus Tamp VAR-7004CUE Humerus Drill, medium VAR-7011-MCUE Humerus Drill, large VAR-7011-LCUE Humerus Drill Stop, medium VAR-7012-MCUE Humerus Drill Stop, large VAR-7012-LCUE Ulna Trial, medium VAR-7006-MCUE Ulna Trial, large VAR-7006-LCUE Ulna Implant Holder, medium VAR-7007-MCUE Ulna Implant Holder, large VAR-7007-LCUE Ulna Drill, medium VAR-7014-MCUE Ulna Drill, large VAR-7014-LCUE Ulna Guide, medium VAR-7015-MCUE Ulna Guide, large VAR-7015-LCUE Ulna Tamp VAR-7016CUE Instrument Set Case VAR-7020C

Accessories: Cannulated Driver Handle with AO Connector VAR-13221AOCT15 Hexalobe Driver VAR-8941DHDrill Bit, 2.5 mm VAR-4160-25

Implants: CUE Humerus Implant, medium VAR-7000-MCUE Humerus Implant, large VAR-7000-LCUE Ulna Implant, medium VAR-7005-MCUE Ulna Implant, large VAR-7005-LCorkscrew FT II, 5.5 mm x 16 mm, w/three #2 FiberWire AR-1928SF-3Low Profile Screw, 3.5 mm x 24 mm, titanium AR-8935-24Low Profile Screw, 3.5 mm x 26 mm, titanium AR-8935-26Low Profile Screw, 3.5 mm x 28 mm, titanium AR-8935-28Low Profile Screw, 3.5 mm x 30 mm, titanium AR-8935-30Low Profile Screw, 3.5 mm x 32 mm, titanium AR-8935-32Low Profile Screw, 3.5 mm x 34 mm, titanium AR-8935-34Low Profile Screw, 3.5 mm x 36 mm, titanium AR-8935-36Low Profile Screw, 3.5 mm x 38 mm, titanium AR-8935-38Low Profile Screw, 3.5 mm x 40 mm, titanium AR-8935-40

Disposables: Drill Tip Guide Pin, 2.4 mm (required) AR-1250LCurved Cruciate Needle VAR-5000

ORDERING INFORMATION

Canine Unicompartmental Elbow (CUE)

SURGICAL TECHNIQUE

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 Vet Systems 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.

www.arthrexvetsystems.com...up-to-date technology

just a click away

2

1

3

Medial Approach with Epicondylar Osteotomy Option

Lever the epicondylar bone out, from proximal to distal, and elevate the flexor muscles, joint capsule and medial collateral ligament cranially and caudally (staying on bone). This will expose the cranial and caudal extents of humeral articular cartilage, radial head and ulnar notch.

A Gelpis can be used to retract the periarticular tissues, while an assistant maintains valgus and internal rotation, so that the CUE instruments can easily be placed perpendicular to the articular surfaces of the MHC and MCP.

Valgus stress and internally rotate the antebrachium over a pad or block to expose and access the medial aspect of the humeral condyle (MHC) and medial coronoid process (MCP).

4 65

©2012, Arthrex Vet Systems - a division of Arthrex Med. Instrumente GmbH. All rights reserved. VLT0006 Vers. A

U.S. PATENT NO. 6,716,234

Incise from the caudal base of the osteotomy all the way through the joint capsule, across the joint, and distally between flexor carpi ulnaris and the superficial digital flexor and caudal to the deep digital flexor.

Place a beath pin from the center of the medial epicondyle to the center of the lateral epicondyle, outline the cranial, proximal and caudal "edges" of medial epicondyle (~4-6 mm from drill bit in each direction). Place saw guide over the beath pin.

Use a sagittal saw with a small blade to "osteotomize" the epicondyle at its "edges". Angle the osteotomies so that you end up with a trapezoidal shaped section of bone. Cut into the humerus ~5 mm for each osteotomy.