Surgical Technique
as described by Harlan Amstutz, M.D. & Michael Mont, M.D.

Proper surgical procedures and techniques are the responsibility of the medical professional. The following guidelines are furnished for informational purposes only. Each surgeon must evaluate the appropriateness of the procedures based on his or her personal medical training and experience.

Begin by reaming the acetabulum to the appropriate size based on preoperative templating and intraoperative assessment. With the CONSERVE® Total Hip System, it is recommended to ream 1mm less than the chosen shell size for a 1mm circumferential press-fit. For example, ream to a 57mm diameter, and implant a 58mm shell.	Assemble the appropriate size bayonet impactor that matches the chosen implant size. To properly assemble the shell impactor, thread the handle (A) to the appropriate size bayonet (B).	To complete the assembly, thread the plastic head to the handle/bayonet combination.
With the bayonet impactor completely assembled, attach the correct size final shell implant to the impactor by aligning the three arms of the bayonet with the three slots in the shell implant (A).	Complete the assembly by inserting the arms of the bayonet into the shell and turning the impactor in a clockwise manner (A).	Tighten the final locking screw counter-clockwise until the plastic head bottoms out in the shell.
Align the shell and impactor to the acetabulum using standard positioning techniques. Secondary guidepins are available with the impactor handle to confirm correct placement of the acetabular shell (A). The alignment pins should be facing both parallel and perpendicular to the patient to ensure a 45° position with 15° of anteversion.	Once the shell is impacted, turn the locking screw clockwise to retract the plastic head. Then turn entire handle counterclockwise to disengage the bayonets.	With the shell in place, trial the femoral head component using the appropriate size head trial (A) and sleeve trial (B). Trial head sizes range from 36mm to 54mm in diameter, and sleeves are provided in -3.5, +0, and +3.5mm neck increments.  IMPORTANT NOTE| Always use a femoral head size 10mm smaller than the chosen shell size. For example, a 48mm femoral head should be used with a 58mm acetabular shell.
	The appropriate size femoral head is now assembled to the final stem by engaging the taper with 3 to 4 strong mallet blows on the protected femoral head.  Final motion and stability is confirmed prior to routine wound closure.
Attach the assembled trial head/sleeve combination to the appropriate size trial neck, and complete a full trial reduction to confirm excellent range of motion, joint tension, and stability. A final trial reduction may also be performed with the actual stem implant and trial head/sleeve assembly to confirm proper joint tension and stability.