Calcar Replacement Stem Instruments Set – Orthopedic Hip Reconstruction Surgery

The Calcar Replacement Stem Instruments Set from Peak Surgicals is a complete orthopedic instrument set in surgical-grade stainless steel, supplied in an aluminum box, designed to support the full intraoperative workflow of calcar replacement stem hip arthroplasty — covering femoral canal preparation, stem trialling, bipolar head sizing and placement, cement plug management, and femoral head extraction for revision cases. It is used by orthopedic surgeons in hospital operating theatres and surgical centers performing primary and revision hip reconstruction procedures involving significant proximal femoral bone loss.

Calcar Replacement Stems: Indication and Clinical Context

The calcar — the posteromedial cortex of the proximal femur just below the femoral neck — is a critical load-bearing region of the hip. When this region is compromised by comminuted femoral neck fracture, periprosthetic fracture, pathological bone destruction from tumor or infection, or bone loss encountered during revision hip arthroplasty, a standard femoral stem cannot achieve adequate proximal fixation. Calcar replacement stems address this by extending the implant's load-bearing geometry into the diaphyseal femur, bypassing the compromised calcar region entirely. The Calcar Replacement Stem Instruments Set provides the dedicated instrument tray required to prepare the femoral canal, size and trial the bipolar head and cement plug, and introduce and seat the calcar replacement stem accurately in these demanding surgical presentations.

Femoral Canal Preparation and Stem Introduction Instruments

The femoral preparation component of the set includes the Calcar Stem Replacement Rasps in sizes 9mm, 11mm, and 13mm (9703-0009 through 9703-0113) for progressive canal broaching to the appropriate stem diameter, the First Femoral Drills (9703-0090 through 9703-0113) for precise initial femoral canal preparation and accurate stem track establishment, the Stem Impactor (9703-0020) for controlled axial stem seating, the Offset Template (9703-0021) for determining the correct stem offset geometry relative to the patient's femoral anatomy, the T-Handle and Rod (9703-0014 and 9703-0015) for driven instrument use with rotational control, and the Hammer (9703-0018) for impaction manoeuvres. The Extraction Bar (9703-0016) provides the lever arm needed for stem removal during revision cases where the calcar replacement stem requires extraction.

Head Trialling, Bipolar Sizing, and Cup Instruments

The femoral head and bipolar instrumentation includes the Head Impactor (9703-0001) for final femoral head seating, the Femoral Head Sizing Guidelines (9703-0002) for intraoperative head size determination, and the Head Extractor (9703-0007) for femoral head removal during revision or head exchange procedures. Head Trials in sizes O28-3 (S) through O28+8 (XXL) (9703-0003 through 9703-0008) allow trialling of head offset and neck length before final head selection. The Bipolar Head Ring Forceps (9703-0010) provide secure bipolar head handling during assembly and placement, the Bipolar Cup Impactor (9703-0012) ensures accurate bipolar cup seating, and the Bipolar Head Trials in sizes O42mm through O58mm (9703-0042 through 9703-0058) allow bipolar head size confirmation before final implant fixation.

Cement Plug Instruments and Ancillary Tools

For cemented calcar replacement stem procedures, the set includes Cement Plug Trials in sizes O9mm through O18mm (9703-0209 through 9703-0218) for precise plug sizing matched to the femoral canal diameter at the intended plug level, and the Cement Plug Impactor (9703-0017) for accurate plug introduction to the correct depth within the femoral canal to contain the cement column above it. Ancillary instruments include the Chisel (9703-0022) for bone shaping or removal during calcar preparation and exposure. All instruments are organized in the included aluminum box for sterile storage, theatre transport, and instrument count during the surgical procedure.

CE Mark, ISO 13485, and FDA Certification for Orthopedic Instrument Procurement

The Calcar Replacement Stem Instruments Set is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and production consistency for orthopedic surgical instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US-based hospitals, surgical centers, and orthopedic departments requiring verified regulatory documentation for capital instrument set purchases.

Product Specifications

Frequently Asked Questions

What is a calcar replacement stem and when is it indicated?
A calcar replacement stem is a femoral hip implant designed for use when the proximal femoral calcar — the posteromedial cortical region below the femoral neck — is absent, destroyed, or otherwise unable to provide the proximal support that a standard femoral stem requires for stable fixation. Indications include comminuted femoral neck and intertrochanteric fractures with significant calcar involvement, pathological fractures from metastatic disease or primary bone tumors affecting the proximal femur, periprosthetic femoral fractures with proximal bone loss, and revision hip arthroplasty where explantation of a failed stem has left the calcar region deficient. The calcar replacement stem achieves fixation in the femoral diaphysis distal to the damaged region, restoring hip biomechanics and allowing weight-bearing rehabilitation in patients where standard primary stems would fail to achieve adequate stability.

What instrument groups are included in this set?
The set covers six functional groups: femoral canal preparation instruments (rasps 9mm–13mm, femoral drills, T-handle and rod), stem introduction and fixation instruments (stem impactor, offset template, hammer, extraction bar, chisel), femoral head instruments (head impactor, head sizing guidelines, head extractor, head trials O28-3 S through O28+8 XXL), bipolar head instruments (bipolar head ring forceps, bipolar cup impactor, bipolar head trials O42mm–O58mm), cement plug instruments (cement plug trials O9mm–O18mm, cement plug impactor), and an aluminum storage and sterilization box. Together these instruments cover the complete operative sequence from initial canal preparation through to final head or bipolar cup assembly.

Is this set suitable for both cemented and cementless calcar replacement techniques?
The set supports both cemented and cementless calcar replacement stem techniques. For cemented cases, the cement plug trials and cement plug impactor provide accurate plug sizing and placement at the distal extent of the cement mantle in the femoral canal. For cementless press-fit techniques, the rasps and femoral drills prepare the canal for the stem's direct cortical engagement without cement. The bipolar head trial range and head trial sizing tools are applicable regardless of fixation technique, allowing the surgeon to confirm bipolar head size and femoral head offset before final implant assembly in both cemented and cementless configurations.

How does this set differ from the Modular Bipolar and Total Hip Replacement Instruments Set also available from Peak Surgicals?
Both sets support hip arthroplasty procedures using bipolar head components, but they are designed for fundamentally different clinical scenarios. The Modular Bipolar and Total Hip Replacement Instruments Set is configured for standard primary hip arthroplasty — bipolar hemiarthroplasty for femoral neck fractures with intact calcar, and total hip replacement for osteoarthritis — where the proximal femur is structurally intact and a standard stem length is appropriate. The Calcar Replacement Stem Instruments Set is specifically designed for cases where the proximal femoral calcar is absent or destroyed, requiring a longer, calcar-bypassing stem design. The rasp range, femoral drill sizes, cement plug sizing instruments, and extraction bar in this set reflect the specific demands of calcar replacement surgery rather than standard primary hip reconstruction.

What certifications does this set carry?
The Calcar Replacement Stem Instruments Set is manufactured under CE Mark, ISO 13485, and FDA compliant quality standards. ISO 13485 certification confirms Peak Surgicals operates a documented quality management system covering design control, material traceability, and manufacturing consistency for orthopedic surgical instruments. CE Mark confirms conformity with European medical device regulations, and FDA compliance supports procurement for US hospitals, ambulatory surgical centers, and orthopedic departments requiring verified regulatory documentation for capital instrument set purchases.

Can individual instruments be ordered as replacements?
Individual instruments from the Calcar Replacement Stem Instruments Set are available from Peak Surgicals as replacement items using their reference numbers (e.g., 9703-0001 Head Impactor, 9703-0017 Cement Plug Impactor, 9703-0020 Stem Impactor). OEM manufacturing and custom instrument set configurations are available for hospital procurement departments and orthopedic distributors requiring modified tray layouts, specific instrument substitutions, extended size ranges, or custom packaging. Contact Peak Surgicals directly for replacement instrument pricing, OEM specifications, or institutional procurement arrangements.