SMR Shoulder System

	Lima SMR Portfolio Overview The clinically proven Lima SMR modular shoulder system allows the choice of shoulder prosthesis to evolve with the pathology encountered – whether it is resurfacing, fracture hemi, total shoulder, reverse shoulder or revision. Based on well proven taper locking technology a common humeral stem can be assembled with either fracture specific, anatomic specific or reverse proximal bodies depending on patient pathology. The modularity on the glenoid side is achieved using a convex titanium alloy baseplate, with central peg and initial stability provided by dual screw fixation. In a total shoulder situation a cross linked polyethylene glenoid liner locks over the metal back and articulates with the humeral head. In a reverse shoulder arrangement dual sided tapers are used to lock the eccentric or centred glenosphere to the metal back. The locking taper on humeral and glenoid side allows the postoperative revision of a total shoulder to a reverse while leaving the humeral stem and metal back glenoid implanted. Further developments to reduce notching in the reverse shoulder arrangement have resulted in the cross linked polyethylene glenosphere which reduces the amount off poly debris and therefore notching. Revision options are available for humeral and glenoid bone defects restoring motion and quality of life to the patient.

Detail Lima SMR Info

1. SMR-R - std and CTA - the SMR-R humeral resurfacing system is available in multiple sizes to match the patient anatomy and either standard or extended heads if required in a cuff deficient situation. The resurfacing heads have a Ti, plasma spray HA coating on their underside to aid fast oseointegration and resulting stability. 2 sizes of modular stem attach to the resurfacing head with taper locking technology allowing the fixation to be matched to patient size. The fully canulated instrument system allows accurate preparation of the humeral head to allow a close fit to the final implant with reduced sized reamers allowing good visibility.
   
   
2. SMR-Fracture - 3 different proximal body heights and cemented or cementless stems allow the correct height adjustment to match the fractured humerus, while suture holes in the reduced bulk body allow the surgeon to choose the most appropriate suture technique securing the tuberosities back to the stem. A range of 8 different modular eccentric adaptors allows the surgeon to custom tune the head eccentricity to get best coverage of the resected bone.
   If the tuberosities fail to unite and the head rides high, the SMR humeral implant can be changed to a reverse SMR without removing the stem.
   
   
3. SMR-Total - the anatomical press fit proximal body is assembled to the correct stem size while the multiple sized, convex glenoid plate is press fit into the bone then stabilised with 2 screws. Cross linked polyethylene glenoid liners then snap fit onto the glenoid plate to recreate the bearing surface. The system allows for revision to a reverse SMR without removing humeral stem or glenoid plate.
   
   
4. SMR-Reverse is designed to use the same cemented or cementless stems as the anatomical SMR. The reverse proximal body is available in either an HA coated primary version or a trauma version with a blasted finish and suture holes for remaining soft tissue attachment. Three thickness's of cross linked polyethylene liner are available to adjust the soft tissue tension as well as a humeral extender for when greater tension is required.
   
   The glenosphere is available in either a standard centred version or an eccentric which allows the centre of rotation to be placed lower so reducing the incidence of notching. These are connected to the metal back baseplate using double ender taper locking technology.
   
   The reverse shoulder design has been further developed to reduce the incidence of notching while preserving the clinically proven biomechanics of reverse shoulders by using cross linked polyethylene on the glenosphere and cobalt chrome on the humeral liner. This can result in the cocr liner being in contact with the scapula neck in adduction but compared to a polyethylene liner this will not generate poly debris which can lead to osteolysis. Therefore the overall factors that influence the creation of a scapula notch are reduced.
   
   The option to use either 40 mm or 44 mm polyethylene glenospheres allows a greater range of motion and joint stability than smaller glenospheres. The cut away design of the glenosphere combined with the thin titanium alloy baseplate allows these implants to be used in smaller anatomies that a traditionally larger glenosphere
   
   
5. SMR-Revision provides a series of long cemented and cementless stems to enable distal fixation in revision and bone loss cases. A modular proximal humeral replacement system is also available in severe bone loss or tumour cases. In cases of glenoid bone loss where a reverse shoulder is required a glenoid plating system that locks into the metal back is available.