Triathlon Revision

Knee System

Surgical protocol Implants Instruments

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Compatibility This compatibility chart applies to the X3 inserts with catalog numbers
ending with the letter E. Please reach out to your Stryker representative for
the compatibility of other Triathlon tibial inserts.

Femoral component/ Insert type

insert compatibility
Femoral components CR CS PS PSR TS
Size matching: One up, one
down, e.g., size 5 femur with TS cemented No No 4 4 4
size 4 or 6 insert/baseplate.

Femoral component/ Patella type

patella compatibility Asymmetric Symmetric
Femoral components Asymmetric
metal-backed metal-backed
Symmetric
Size matching: Every patella
articulates with every femur TS cemented
4 4 4 4
due to a common radius across
all sizes.

Tibial insert/baseplate Insert type

compatibility
Tibial Baseplates CR CS PS PSR TS
Size matching: Size specific,
e.g., size 4 insert to be used only Cemented Universal
4 4 4 4 4
with size 4 baseplate.
  Note: TS insert can only
be used with the cemented
Universal baseplate.
  Note: PS insert trial may be
used to trial for PSR insert.

Triathlon TS Augments (for Triathlon PS and TS cemented femurs only)

Distal Augments are for use with both the medial and lateral portions of the side indicated, e.g., #4 right is used for
medial and lateral compartments on a right femur.
Posterior Augments are universal size specific, e.g., size 4 posterior augments are for the size 4 femur.
Tibial Augments are size specific and come in left medial/right lateral or right medial/left lateral configurations and are
only compatible with the cemented Universal baseplate.

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Indications and contraindications

Indications for US and Rest of World: Indications for EU, EMEA countries requiring CE
General total knee arthroplasty (TKR) indications: mark and Australia:
• Painful, disabling joint disease of the knee resulting General Primary Total Knee Arthroplasty (TKA)
from: noninflammatory degenerative joint disease Indications:
(including osteoarthritis, traumatic arthritis or • Painful, disabling joint disease of the knee resulting
avascular necrosis) rheumatoid arthritis or post- from: noninflammatory degenerative joint disease.
traumatic arthritis. • Moderate varus, valgus or flexion deformity in
• Post-traumatic loss of knee joint configuration and which the ligamentous structures can be returned to
function. adequate function and stability.
• Moderate varus, valgus or flexion deformity in Additional Indications for Triathlon Cruciate
which the ligamentous structures can be returned to Retaining (CR) cemented femoral component, CS
adequate function and stability. X3 tibial inserts, Primary Cemented Baseplate,
Universal Baseplate, Cemented Symmetric and
• Revision of previous unsuccessful knee replacement
Asymmetric X3 Polyethylene Patellar components
or other procedure.
include:
• Fracture of the distal femur and/or proximal tibia
• Revision of previous unsuccessful knee replacement
that cannot be stabilized by standard fracture
or other procedure.
management techniques.
Additional Indications for Posterior Stabilized
The Triathlon Tritanium Tibial Baseplate and (PS) Femoral component, distal fixation pegs and
Tritanium Metal-Backed Patella components are PS/PSR tibial inserts:
indicated for both uncemented and cemented use. • Revision of previous unsuccessful knee replacement
The Triathlon Total Knee System beaded and or other procedure (cemented PS femoral and PS X3
beaded with Peri-Apatite components are tibial insert only).
intended for uncemented use only. • Ligamentous instability requiring implant bearing
The Triathlon All Polyethylene tibial components surface geometries with increased constraint.
are indicated for cemented use only. • Absent or non-functioning posterior cruciate ligament.
Additional Indications for Posterior Stabilized • Severe anteroposterior instability of the knee joint.
(PS) and Total Stabilizer (TS) Components: Additional Indications for Posterior Stabilized
• Ligamentous instability requiring implant bearing (PS) Femoral components and PS/PSR tibial
surface geometries with increased constraint. inserts when used with the Triathlon Tritanium
• Absent or non-functioning posterior cruciate ligament. Baseplate:
• Ligamentous instability requiring implant bearing
• Severe anteroposterior instability of the knee joint.
surface geometries with increased constraint.
Additional indications for Total Stabilizer (TS) • Absent or non-functioning posterior cruciate
Components: ligament.
• Severe instability of the knee secondary to • Severe anteroposterior instability of the knee joint.
compromised collateral ligament integrity or function. Indications for Total Stabilizer (TS) Components
Indications for Bone Augments: (TS femoral component, TS tibial inserts and TS
• Painful, disabling joint disease of the knee secondary accessory components, including stems, extenders
to: degenerative arthritis, rheumatoid arthritis and offset adapters):
or post-traumatic arthritis, complicated by the • Revision of previous unsuccessful knee replacement
presence of bone loss. or other procedure.
• Salvage of previous unsuccessful total knee replacement The following indications apply in complex
or other surgical procedure accompanied by bone loss. primary and/or revision Total Knee Arthroplasty:
• Ligamentous instability requiring implant bearing
Additional indications for Cone Augments:
surface geometries with increased constraint.
• Severe degeneration or trauma requiring extensive
• Absent or non-functioning posterior cruciate
resection and replacement.
ligament.
• Femoral and tibial bone voids. • Severe anteroposterior instability of the knee joint.
• Metaphyseal reconstruction. • Severe instability of the knee secondary to
Triathlon Tritanium Cone Augment components are compromised collateral ligament integrity or
intended for cemented or cementless use. function.
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The Triathlon Tritanium Total Knee System Contraindications

Patellar and Tibial Baseplate components are • Any active or suspected latent infection in or about
indicated for both uncemented and cemented use the knee joint.
in primary total knee arthroplasty. • Distant foci of infection which may cause
The Triathlon Total Knee System beaded with Peri- hematogenous spread to the implant site.
Apatite components are intended for uncemented • Any mental or neuromuscular disorder which would
use only in primary total knee arthroplasty. create an unacceptable risk of prosthesis instability,
prosthesis fixation failure or complications in
The Triathlon All Polyethylene tibial components
postoperative care.
are indicated for cemented use only in primary
total knee arthroplasty. • Bone stock compromised by disease, infection or
prior implantation which cannot provide adequate
Indications for Tibial and Femoral Bone Augments: support and/or fixation to the prosthesis.
• Painful, disabling joint disease of the knee • Skeletal immaturity.
complicated by the presence of bone loss. • Severe instability of the knee joint secondary to the
• Revision of previous unsuccessful knee replacement absence of collateral ligament integrity and function.
or other procedure, accompanied by bone loss.
Indications for Cone Augments (revision only): See package insert for warnings, precautions,
• Severe degeneration requiring extensive resection and adverse effects, information for patients and
replacement. other essential product information.
• Femoral and Tibial bone voids. Before using Triathlon instrumentation, verify:
• Metaphyseal reconstruction. • Instruments have been properly disassembled
prior to cleaning and sterilization.
The Triathlon Tritanium Cone Augment components
are intended for cemented or cementless use with the • Instruments have been properly assembled
Triathlon TS Femoral component and Universal Tibial post-sterilization.
baseplate. The Cone Augments are cemented to the • Instruments have maintained design integrity.
femoral or tibial component; the bone interface may be • Proper size configurations are available.
cemented or cementless. For Instructions for Cleaning, Sterilization,
Inspection and Maintenance of Orthopaedic
Medical Devices, refer to LSTPI-B and SLI0001.

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Table of contents

Preoperative templates . . . . . . . . . . . . . . . . . . . 6 Triathlon Tritanium Cone

Exposure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 Augment preparation . . . . . . . . . . . . . . . . . . . . 28
Component removal . . . . . . . . . . . . . . . . . . . . . . . 6 Tibial preparation . . . . . . . . . . . . . . . . . . . . . . 28
Tibial preparation . . . . . . . . . . . . . . . . . . . . . . . 6 Tibial canal preparation (cones) . . . . . . . . . . 28
Tibial canal preparation . . . . . . . . . . . . . . . . . . . 6 Option 1: Reamer-based. . . . . . . . . . . . . . . . . . . 28
Proximal tibial cleanup resection . . . . . . . . . . . 7 Option 2: Stem Extender-based. . . . . . . . . . . . . 29
Tibial component sizing . . . . . . . . . . . . . . . . . . . 8 Ream depth: tibial components with cones. . . 29
Tibial template positioning . . . . . . . . . . . . . . . 8 Preliminary cone sizing . . . . . . . . . . . . . . . . . . 30
Tibial augment preparation . . . . . . . . . . . . . . . 9 Symmetric tibial cone preparation . . . . . . . 30
Augment preparation with offset Symmetric Cone trialing . . . . . . . . . . . . . . . . . 32
press-fit stem . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Options if added Cone stability is required. . . . 32
Keel preparation . . . . . . . . . . . . . . . . . . . . . . . . 10 Asymmetric Tibial Cone preparation . . . . . . 33
Offset boss reaming . . . . . . . . . . . . . . . . . . . . . 11 Sizing example. . . . . . . . . . . . . . . . . . . . . . . . . . 34
Femoral preparation . . . . . . . . . . . . . . . . . . . . 12 Asymmetric Cone trialing . . . . . . . . . . . . . . . . 36
Femoral canal preparation . . . . . . . . . . . . . . . . 12 Femoral preparation . . . . . . . . . . . . . . . . . . . . 38
Ream depth: femoral components . . . . . . . . . . 12 Intramedullary reaming for Cones . . . . . . . . 38
Distal femoral resection . . . . . . . . . . . . . . . . . . 13 Option: Stem Extender-based workflow . . . . . 38
Distal femoral deficiency evaluation Distal femoral resection . . . . . . . . . . . . . . . . . 39
and augment preparation . . . . . . . . . . . . . . . . . 14 Femoral implant sizing . . . . . . . . . . . . . . . . . . 39
Femoral sizing with templates . . . . . . . . . . . . . 14 Gap balancing . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Gap balancing . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Preliminary Cone selection and sizing . . . . . 40
Flexion and extension gap balancing . . . . . . . . 15 Option 1: Central Femoral Cone
Extension gap . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Femoral resections/offsetting/flexion Central Femoral Cone trialing . . . . . . . . . . . . 43
gap balancing . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Options if added Cone stability is required . . . 44
Offset femoral boss preparation . . . . . . . . . . . . 18 Option 2: Femoral Cone preparation . . . . . . 45
Tibial trial assembly . . . . . . . . . . . . . . . . . . . . . 20 Femoral Cone Reamer Guide assembly . . . . 46
Femoral trial assembly . . . . . . . . . . . . . . . . . . . 21 Depth and sizing guide . . . . . . . . . . . . . . . . . . 47
Tibial implant assembly . . . . . . . . . . . . . . . . . 22 Femoral Cone reaming (lobe preparation) . . . 48
Tibial Baseplate with stem: No offset . . . . . . . 22 Femoral Cone trialing . . . . . . . . . . . . . . . . . . . . 50
Tibia with Stem Extender . . . . . . . . . . . . . . . . . 23 Options if added Cone stability is required . . . 50
Tibia with offset and stem . . . . . . . . . . . . . . . . 23 TS trialing with Cone Trials . . . . . . . . . . . . . . 51
Tibial augmentation . . . . . . . . . . . . . . . . . . . . . . 24 Cone implantation (tibial cone) . . . . . . . . . . . 52
Femoral implant assembly . . . . . . . . . . . . . . . 24 Cone implantation (femoral cone) . . . . . . . . . 53
Femoral Augments . . . . . . . . . . . . . . . . . . . . . . . 24 Cone implants . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Femur with stem: No offset . . . . . . . . . . . . . . . 25 TS component implantation with
Femur with Stem Extender . . . . . . . . . . . . . . . . 25 Cone implants . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Femur with Offset Adapter . . . . . . . . . . . . . . . . 26 Cemented Stems (tibia) . . . . . . . . . . . . . . . . . . 55
Component implantation . . . . . . . . . . . . . . . . 27 Cemented Stems (femur) . . . . . . . . . . . . . . . . 55
Tibial implant implantation . . . . . . . . . . . . . . . 27 Fluted Stems (tibia) . . . . . . . . . . . . . . . . . . . . . 56
Femoral implant implantation . . . . . . . . . . . . . 27 Fluted Stems (femur) . . . . . . . . . . . . . . . . . . . . 56
Tibial Insert . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Catalog . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Stabilizer Pin . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

This publication sets forth detailed validated procedures for using the Triathlon Revision Knee System. It offers instructions
that you should heed, but, as with any such technical guide, each surgeon must consider the particular needs of each patient
and make appropriate adjustments when and as required.
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Preoperative templates
The surgeon may apply the outlines on the implant
acetate template to an X-ray image to assist in
preoperative sizing.

Exposure
A standard anterior midline incision is utilized. Any
previous incision can be used or incorporated to
decrease the risk of skin slough. (Figure 1)
The capsule is entered through a medial parapatellar
approach.

Component removal

Figure 1
When removing the components to be revised,
great care must be taken to preserve as much of the
remaining bone stock as possible and to avoid the risk
A B C of fracture of the residual bone. Bone preservation can
usually be achieved through the use of small flexible
osteotomes, saws and high-speed burring instruments.

Boss depth
groove Tibial preparation
Tibial canal preparation
Assemble the 8mm Starter Awl to either the T-handle
or power unit using the Universal Driver.
Ream the tibial intramedullary canal. (Figure 2A)
Ream to the desired depth of stem or to a length of
fixation preferred for tibial alignment. Grooves along
the shank of the reamer indicate the depth of the
Figure 2
reamer in the canal. (Figure 2D)
Progressively ream, increasing diameter in 1mm
Stem Tibia
increments until cortical chatter is achieved, and leave
50-100mm 125 the final reamer in the tibial intramedullary canal.
(Figure 2B)
100mm 150
w/offset Technical points
Tibial cone 175 1. A minimum depth of 125mm, corresponding to the
tibial boss and a 100mm stem, is recommended to
150mm 175 achieve tibial intramedullary alignment.
150mm 2. Tap the final reamer gently with a mallet to assure
200
w/offset that it is firmly seated.
Figure 2D 3. A tibial offset can be planned for by reaming an
additional 25mm, for a total of 50mm greater than
Note: the desired stem length (stem + 25mm boss +
When reaming with Stem Extenders, ream an 25mm offset).
additional 25mm or 50mm accordingly. 4. If the reamer diameter is less than 16mm, prepare
for the boss or offset of the tibial component by
reaming over the top of the IM Reamer shaft with
the Boss/Offset Reamer. (Figure 2C) Ream until the
Boss depth groove lines up to the planned resected
bone depth.
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Instrument bar

6541-4-801
Universal Driver

6543-7-508
8mm Starter Awl

6541-4-800
T-Handle Driver
Figure 3B
See Catalog
IM Reamer

6543-7-527
Figure 3A
Boss/Offset Reamer
Proximal tibial cleanup resection
Slide the Resection Guide Tower over top of the IM Reamer 6541-4-602
by depressing the finger tab as shown. (Figure 3A inset) Universal Alignment Rod
Assemble the Revision Tibial Resection Guide to the Support
6541-4-003
Arm Assembly. Slide the assembly on to the Resection Guide
Headless Pins - 3”
Tower. Set distal/proximal resection level and rotation by
depressing the finger tab on the Resection Guide Tower. 6541-4-809
Use the Stop Plate or place the Blade Runner through the Headless Pin Driver
cutting slot to determine the resection level. When the
appropriate resection level and rotational alignment have been
determined, pin the Revision Tibial Resection Guide to the 6541-4-804
proximal tibia. The Universal Alignment Rod can be used to aid Headless Pin Extractor
in setting the final component position by inserting it through
the Universal Alignment Handle and assembling the Universal
Alignment Handle to the Revision Tibial Resection Guide
(Figure 3B). 6543-7-601
Resection Guide Tower
Make a cleanup cut to produce a resected surface with a
neutral slope.
5mm and 10mm tibial augment resections can be made at this 6543-7-600
point with the Revision Tibial Resection Guide. Support Arm Assembly
Using a narrow, 15mm - wide, 0.050” thick oscillating saw
blade, make a 5mm or 10mm augment resection as appropriate. Left 6543-6-700
Using a reciprocating saw blade through the Revision Tibial Right 6543-6-701
Resection Guide, complete the sagittal augment resection. Revision Tibial Resection Guides - Slotted
(Figure 4)

6543-7-602
Stop Plate

6541-4-400
Blade Runner

6541-4-806
Universal Alignment Handle

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Technical points
The Stop Plate is calibrated to give 2mm resection.

Tip:
To help ensure easy removal of the Resection Guide
Tower and Support Arm Assembly, place pins
perpendicular to the bone.

Surgeons who prefer a non-captured cleanup cut can

use the top of the resection guide. The cleanup cut slot
and 5mm slot can then be used for 5mm and 10mm
augment resections, respectively.

Note:
The 10mm slot should not be used in this case.
Figure 4

If desired, the Support Arm Assembly, Resection

Guide Tower and IM Reamer can be removed before
completing the tibial resections. To do so, depress
the tabs on the Support Arm Assembly to disengage
it from the Revision Tibial Resection Guide. Slide the
Support Arm Assembly anterior. Depress the tab on the
Resection Guide Tower and slide it off the IM Reamer.
Use a T-handle to remove the IM Reamer.

Tibial component sizing

Size the proximal tibia with a Universal Tibial
Template placed over the reamer and onto the resected
surface of the tibia. (Figure 5)
Once sized, remove the Universal Tibial Template.

Figure 5

Tibial template positioning

Attach the Tibial Offset Bushing Guide to the appropriate
size Universal Tibial Template. Assemble the Tibial Offset
Bushing to the Tibial Offset Bushing Guide. (Figure 6)
Slide the entire assembly over the shaft of the IM Reamer.
Rotate the offset dial and translate the slider on the Tibial
Offset Bushing until optimal coverage of the proximal tibia
is achieved with the Universal Tibial Template.

Note:
If offsetting between sizes 1, 2 and 3, maximum
offset achievable is 6mm.

Figure 6

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Rotational alignment of the Universal Tibial

Template should also be determined. The
Instrument bar
Universal Alignment Rod can be used to
aid in setting the final component position. See Catalog
(Figure 7) Universal Tibial Template
Pin the Universal Tibial Template to the
proximal tibia.
Record the magnitude and position of the Left 6543-6-700
tibial offset from the Tibial Offset Bushing Right 6543-6-701
(e.g., 4mm offset at 3 o’clock). An offset may Revision Tibial Resection Guides - Slotted
not be required to attain optimal tibial
coverage. (Figure 8)
Remove the Tibial Offset Bushing Guide and 6543-2-703
Universal Tibial Template. Tibial Resection Guide Link
Use a T-handle to remove the IM Reamer. Figure 7

6541-4-515
Headed Nails - 1 1/2”

6541-4-575
Headed Nails - 3/4”
Lateral Medial Lateral

6541-4-300
Left leg Right leg Headed Nail Impactor/Extractor
Figure 8
Tibial augment preparation
6543-2-600
Augment preparation with offset press-fit stem Tibial Offset Bushing

Note:
If no augments are needed, skip to the steps outlined 6543-2-601
in the section on keel preparation on page 10. Tibial Offset Bushing Guide

If tibia augments are needed, assemble the Revision

6541-4-806
Tibial Resection Guide to the Tibial Resection Guide Link.
Universal Alignment Handle
Assemble the Tibial Resection Guide Link to the
Universal Tibial Template. Pin the Revision Tibial
Resection Guide to the proximal tibia. (Figure 9) 6541-4-602
Remove the Resection Guide Link and Universal Tibial Universal Alignment Rod
Template. Pins can be removed from the Universal
Template using the Headless Pin Extractor.

6541-4-800
T-Handle Driver

6541-2-807
Tibial Alignment Handle

Figure 9

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Make the appropriate 5mm or 10mm tibial augment

resections. (Figure 10)
Using a reciprocating saw blade through the Revision
Tibial Resection Guide, complete the sagittal augment
resection. (Figure 11)
Remove the Revision Tibial Resection Guide from the
tibia.
Assemble the appropriate Tibial Augment Trials to the
distal surface of the Universal Tibial Template.
Place the assembly on the resected tibial plateau and
using the Headed Nails/Headless Pins, re-pin the
Figure 10 Universal Tibial Template to the proximal tibia.

Technical points
Surgeons who prefer a non-captured cleanup cut can
use the top of the resection guide. The cleanup cut slot
and 5mm slot can then be used for 5mm and 10mm
augment resections, respectively.

Note:
The 10mm slot should not be used in this case.

If desired, the Support Arm Assembly, Resection

Guide Tower and IM Reamer can be removed before
completing the tibial resections. To do so, depress
the tabs on the Support Arm Assembly to disengage
it from the Revision Tibial Resection Guide. Slide the
Support Arm Assembly anterior. Depress the tab on the
Resection Guide Tower and slide it off the IM Reamer.
Figure 11 Use a T-handle to remove the IM Reamer.

Keel preparation
Assemble the appropriate size Keel Punch Guide to
the Universal Tibial Template by inserting, at a slight
angle to the top of the Universal Tibial Template, the
two locating slots toward the posterior portion of the
Universal Tibial Template. Allow the Keel Punch Guide
to sit flat on the Universal Tibial Template and push
forward on the handle to lock the Keel Punch Guide to
the Universal Tibial Template. (Figure 12)

Figure 12

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Size 4-8
Size 1-3
Instrument bar
6541-4-801
Universal Driver

Sizes 1, 2, 3 - 6541-2-013
Sizes 4, 5, 6 - 6541-2-046
Sizes 7, 8 - 6541-2-078
Keel Punch

Sizes 1, 2, 3 - 6541-2-713
Figure 13 Sizes 4, 5, 6, 7, 8 - 6541-2-748
Place the appropriate Keel Punch into the Keel Punch Guide. Keel Punch Guide
Use a mallet to impact the punch. Advance the Keel Punch
until it seats fully in the Keel Punch Guide. (Figure 14) In 6543-7-527
sclerotic bone, the use of a saw prior to the Keel Punch may be Boss/Offset Reamer
advisable.

See Catalog
Tibial Augment Trial

6541-4-003
Headless Pins - 3"

6541-4-809
Headless Pin Driver

6541-4-804
Headless Pin Extractor
Figure 14 Figure 15

To extract the Keel Punch, lift up on the Keel Punch Guide

handle and pull the handle to cantilever the Keel Punch out
of the tibia. (Figure 15) Remove the Headless Pins with the
Headless Pin Extractor (or Headed Nails with the Headed Nail
Impactor Extractor) and remove the Universal Tibial Template.

Offset boss reaming

If offset preparation is required, an additional reaming
step is needed to prepare for the offset tibial boss.
Attach the Boss Reamer to the Universal Driver. Place the Boss
Reamer into the Keel Punch Guide. Ream to the appropriate
depth marker indicated by the step on the Reamer shank (Up
to the step for Size 1-3 Keel Punch Guide and all the way to the
stop for Size 4-8 Keel Punch Guide). (Figure 13)

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Femoral preparation
Femoral canal preparation
Assemble the 8mm Starter Awl to either the T-handle
or power unit using the Universal Driver.
Ream the femoral intramedullary canal.
Ream to the desired depth of stem or length of fixation
preferred for femoral alignment. Grooves along the
shank of the reamer indicate the depth of the reamer in
the canal.
Figure 16 Progressively ream, increasing diameter in 1mm
increments until cortical chatter is achieved, and leave
the final reamer in the femoral intramedullary canal.
(Figure 16)

Technical points
1. A minimum depth of 150mm, corresponding to the
femoral boss and a 100mm stem, is recommended to
achieve femoral intramedullary alignment.
2. Tap the final reamer gently with a mallet to assure
that it is firmly seated.
3. A femoral offset can be planned for by reaming an
additional 25mm, for a total of 75mm greater than
Figure 17 the desired stem length (stem + 50mm from the
joint line to the boss + 25mm offset).
4. If the reamer diameter is less than 16mm, prepare
for the boss of the femoral component by reaming
over the top of the IM Reamer shank with the Boss/
Offset Reamer. Ream until the step on the Boss/
Offset Reamer lines up with the planned resected
bone depth. (Figure 17)

Ream depth: femoral components

Stem Femur
50-100mm 150

100mm w/offset 175

Femoral Cone 175*

150mm 200
Figure 18
150mm w/offset 225

Note:
When reaming with Stem Extenders, ream an
additional 25mm or 50mm accordingly.

*When preparing for size 7-8 Cones, ream an additional 5mm deeper to
prevent the Cone Reamer from bottoming out on the IM Reamer.

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Distal femoral resection Instrument bar

Slide the Resection Guide Tower over the top of the
IM Reamer by depressing the finger tab. Assemble the
Revision Distal Resection Guide to the Support Arm 6541-4-801
Assembly. Slide the assembly on to the Resection Guide Universal Driver
Tower. Verify that the Revision Distal Resection Guide
reads “Left” for left leg or “Right” for right leg on the 6543-7-508
side facing away from the femur. 8mm Starter Awl

Set distal/proximal resection level and orientation

by depressing the finger tab on the Resection Guide
Tower and aligning the Revision Distal Resection Guide 6541-4-800
with the medial epicondyle in order to recreate the T-Handle Driver
anatomical joint line. (Figure 19)
Pin the Revision Distal Resection Guide to the distal See Catalog
femur. IM Reamer

6543-7-527
Boss/Offset Reamer

6543-7-601
Resection Guide Tower

6543-7-600
Support Arm Assembly

6543-1-721
Revision Distal Resection Guide
Figure 19

6541-4-400
Blade Runner

6541-4-003
Headless Pins - 3"

6541-4-809
Headless Pin Driver

6541-4-804
Headless Pin Extractor

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Distal femoral deficiency evaluation and augment

preparation
Resect the distal femur. 5mm, 10mm and 15mm distal
augment resections can be made at this point with the
Revision Distal Resection Guide. (Figure 20)

Technical points
Surgeons who prefer a non-captured cleanup cut can
use the top of the Revision Distal Resection Guide. The
cleanup cut slot, 5mm and 10mm slot can then be used
for a 5, 10 and 15mm augment resections, respectively.

Note:
In this scenario, do not use the 15mm cutting slot.

Figure 20 If desired, the Support Arm Assembly, Resection Guide

Tower and IM Reamer can be removed before completing
the femoral resections. To do so, depress the tabs on the
Support Arm Assembly to disengage it from the Revision
Distal Femoral Resection Guide. Slide the Support Arm
Assembly anterior. Depress the tab on the Resection
Guide Tower and slide it off the IM Reamer. Use a
T-handle to remove the IM Reamer.

Femoral sizing with templates

To determine femoral size, match the appropriate
Femoral Sizing Templates up to the femur.
Figure 21 Note:
Pay careful attention to match the femoral size to
the planned restored joint line as opposed to flush
with the surfaces of the femur. A long engraved
line on the sagittal profile of the Femoral Sizing
Templates is designed to indicate the boss position
of the femoral component, while the shorter
engraved lines above and below are designed to
represent the boss position of the femoral component
with 2mm and 4mm anterior and posterior offsets,
respectively. In addition, along the handle of each
Femoral Sizing Template are two additional tick
marks, which are designed to represent the M/L
width of the corresponding size femoral component.
(Figure 21)

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Gap balancing Instrument bar

Flexion and extension gap balancing
Remove the intramedullary reamer from the femoral 6543-7-601
canal. Resection Guide Tower
Extension gap
Put the knee into Extension (0°). If distal femoral and/or
tibial augmentation has been prepared for, assemble the 6543-7-600
appropriate thickness of Spacer Block Augments to the Support Arm Assembly
appropriate sides of the upper and/or lower paddle of the
Adjustable Spacer Block. (Figure 22B)
The numbers on the thumbwheel are designed to 6543-1-721
correspond to the implant insert thickness. Lift the Revision Distal Resection Guide
Upper Paddle Grip to free the adjustment wheel. Align
the notch with the appropriate thickness (Figure 22A)
and assess the gap space until the appropriate insert 6541-4-400
thickness is established. Read the measurement off of the Blade Runner
knob to determine the tibial insert thickness. Remove the
Adjustable Spacer Block from the joint space.
6543-1-603
Size 1-8 Femoral Sizing Templates

6541-4-610
Adjustable Spacer Block

See Catalog
Adjustable Spacer Block Augment

Figure 22A

Figure 22B
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Femoral resections/offsetting/flexion gap

Assembly for
left femur
balancing
shown Replace the IM Reamer in the femoral canal. If distal
augments are required, assemble Distal Spacers to
the distal surface of the appropriate size All-in-One
Resection Guide corresponding to distal augmentation
resections (5, 10, 15mm).
Assemble the Femoral Offset Bushing to the appropriate
size All-in-One Resection Guide, paying careful
attention to clock in such that it reads either “Left” or
“Right” depending on which is appropriate. (Figure 24)
Slide the All-in-One Cutting Guide and Femoral Offset
Bushing over the shank of the IM Reamer. (Figure 23)

Note:
Figure 23
If Adjustable Spacer Block Augments were used to
assess extension gap, remove prior to flexion gap
assessment.

Put the knee into flexion (90°). If tibial augmentation has

been prepared for, assemble the appropriate thickness
Spacer Block Augment to lower paddle of the Adjustable
Spacer Block. Set the Adjustable Spacer Block to match
the measured extension gap. Place the Adjustable Spacer
Block between the resected proximal tibia and the posterior
surface of the All-in-One Resection Guide.
Use the upper paddle of the Adjustable Spacer Block as
reference for the restored flexion joint line. Rotate the
offset dial and slide the slider on the Femoral Offset
Bushing and adjust the internal/external rotation of the
All-in-One Cutting Block until the posterior surface of
the block is flush with the upper paddle of the Adjustable
Figure 24
Spacer Block. (Figure 24)

Note:
Vertical markings on either side of the All-in-One
Resection Guides are designed to correspond to the
M/L width of the femoral components. (Figure 25)

Once the position of the All-in-One Resection Guide is

optimized, pin it to the distal femur.
Record the magnitude and position of the femoral offset
from the Femoral Offset Bushing (e.g., 2mm offset at 12
o’clock).
Remove the Adjustable Spacer Block from the joint space.
Complete the four femoral resections as well as any
posterior augment resections using a 15mm oscillation
saw blade. (Figure 25)
Figure 25
Note:
Posterior cleanup cut is made using the outer most
posterior surface of the All-in-One Resection Guide.
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Instrument bar
See Catalog
IM Reamer

See Catalog
All-in-One Cutting Block

6543-1-005
6543-1-010
6543-1-015
Distal Spacer 5mm, 10mm and 15mm

Figure 26A

6543-1-600
Femoral Offset Bushing

6541-4-610
Adjustable Spacer Block

See Catalog
Adjustable Spacer Block Augment

Figure 26B
6541-4-400
Assemble the Revision Box Cutting Guide to the
Blade Runner
anterior of the All-in-One Resection Guide.

Tip:
For added stability, make the anterior resection and 6543-1-710
anterior chamfer cut first. Then assemble the Revision Revision Box Cutting Guide
Box Cutting Guide to the All-in-One Resection Guide.
Pin the Revision Box Cutting Guide to the bone and
complete the remaining femoral resections. 6541-4-003
Headless Pins - 3"
– Dr. Kirby Hitt
Temple, Texas
6541-4-809
Headless Pin Driver

6541-4-804
Headless Pin Extractor

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Pin the Revision Box Cutting Guide to the bone.

Using a narrow, 15mm - wide 0.050” thick oscillating
saw blade, resect for the M/L walls and score the
proximal wall of the femoral box through the Revision
Box Cutting Guide (Anterior/Posterior). (Figure 27)
Remove the Femoral Offset Bushing from the All-in-
One Resection Guide and slide it off the shaft of the IM
Reamer.
Using a T-handle, remove the IM Reamer by pulling it
through the All-in-One Resection Guide.
Using a narrow, 15mm - wide 0.050” thick oscillating
saw, score the M/L walls of the femoral box preparation
through the distal face of the All-in-One Resection
Guide. (Figure 28)

Figure 27 Note:
If the IM Reamer cannot be pulled through the All-
in-One Resection Guide, disassemble the All-in-One
Resection Guide first. With the Revision Box Cutting
Guide still pinned in place, remove the fixation pins
from the All-in-One Resection Guide. Next, remove
the All-in-One Resection Guide by pulling/tilting the
posterior end away from the distal femur.

Once the All-in-One Resection Guide is out of the way,

remove the IM Reamer and finish the box preparation
using an oscillating saw.

Figure 28
Offset femoral boss preparation
Remove the All-in-One Resection Guide assembly from
the femur, and place the Femoral Boss Preparation
Guide over the pins used for the Revision Box Cutting
Guide.
Insert the Femoral Boss Reamer Bushing into the
Femoral Boss Preparation Guide, paying careful
attention to clock it such that it reads either “Left” or
“Right” depending on which is appropriate. (Figure 29)
Place the assembly on to the distal femur and pin the
anterior flange to the femur.
Prepare for a deeper box cut through the Boss
Reamer Guide. An IM Reamer may also be utilized in
preparation for a short cemented stem.

Figure 29

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Attach the 19mm IM Reamer to the Universal Driver.

Instrument bar
Place the 19mm IM Reamer into the Femoral Boss
Reamer Bushing. Ream until the groove in the cutting
See Catalog
teeth of the 19mm IM Reamer lines up with the face
IM Reamer
of the Femoral Boss Reamer Bushing. (Figure 30) This
clears for the femoral boss in the offset position.
Remove the fixation pins and disassemble the Femoral See Catalog
Boss Preparation Guide from the femur. All-in-One Cutting Block

6543-1-600
Femoral Offset Bushing

6543-1-710
Revision Box Cutting Guide

6543-1-750
Femoral Boss Preparation Guide

6543-1-751
Femoral Boss Reamer Bushing
Figure 30

6541-4-801
Universal Driver

6541-4-003
Headless Pins - 3"

6541-4-809
Headless Pin Driver

6541-4-804
Headless Pin Extractor

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Tibial trial assembly

• Without offset: Assemble all Tibial Augment Trials
to the appropriate size Tibial Baseplate Trial. Thread
the appropriate size Stem Trial into the Tibial.
• With offset: Thread the appropriate size Stem Trial
into the appropriate Offset Adapter Trial.
Dial the rotation of the Offset Adapter Trial to the
position recorded from the Tibial Offset Bushing. Align
the scribe line on the Offset Adapter Trial to the scribe
line on the Tibial Baseplate boss and snap the Offset
Adapter Trial into the Tibial Baseplate Trial. (Figure 31)
To disassemble the Offset Adapter Trial, insert the key
on the Universal Counter Wrench into one of the three
slots in the Offset Adapter Trial as shown. (Figure 33)
Assemble the tibial trial construct to the Baseplate
Figure 31 Impactor/Extractor and impact onto the tibia. (Figure 32)
Assemble the appropriate size Tibial Insert Trial into
the Tibial Baseplate Trial.

Figure 32 Figure 33

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Femoral trial assembly Instrument bar

• Without offset: Assemble all Posterior and Distal
Femoral Augment Trials prepared for onto the
appropriate size Femoral Trial. Ensure that both See Catalog
Distal Femoral Augment Trial tabs have engaged the Baseplate Trial
undercuts of the Femoral Trial. (Figure 34)
Thread the appropriate size Stem Trial into the Femoral See Catalog
Trial. Triathlon Stem Trial

See Catalog
Note: Triathlon Stem Extender Trial
Femoral Distal Augment Trials are size specific and
are offered in 5mm, 10mm and 15mm thicknesses. See Catalog
See catalog. Triathlon Offset Adapter Trial

See Catalog
Tibial Augment Trial

6543-4-801
Universal Counter Wrench

6541-4-810
Impaction Handle
Figure 34

6541-4-805
Baseplate Impactor/Extractor

See Catalog
Triathlon TS Femoral Trial

See Catalog
Triathlon Femoral Distal
Augment Trial

See Catalog
Triathlon Femoral Posterior
Figure 35 Augment Trial
• With offset: Thread the appropriate size Stem Trial into
the appropriate size Offset Adapter Trial. (Figure 35) See Catalog
Dial the rotation of the Offset Trial to the position Triathlon TS Plus Tibial Insert Trial
recorded from the Femoral Offset Bushing. Align the
scribe line on the Offset Adapter Trial to the scribe line
on the femoral boss and snap the Offset Adapter Trial
into the Femoral Trial.
6541-4-807
To disassemble the Offset Adapter Trial, insert the key
Femoral Impactor/Extractor
on the Universal Counter Wrench into one of the three
slots in the Offset Adapter Trial as shown.
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Assemble the femoral trial construct to the Femoral

Impactor/Extractor and impact onto the femur. (Figure 36)

Figure 36
Perform the trial reduction and evaluate joint stability.
(Figure 37)

Figure 37

Tibial implant assembly

Note:
If not using a stem, re-torque the end cap to 120 in-lbs
using the Universal Torque Wrench as indicated in
Figure 38.

Tibial Baseplate with stem: No offset

Using the Universal Counter Wrench with the TIBIA
side up, hold the Baseplate in place by placing the keel
fins into the slots.
Thread the appropriate size stem into the Tibial
Baseplate boss.
Place the open face end of the Universal Torque Wrench
Figure 38 on the flats of the stem.
Tighten by pulling the wrenches together. Torque
stem to 120 in-lbs as indicated on the Universal Torque
Wrench. (Figure 38)

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Tibia with Stem Extender Instrument bar

Using the Universal Counter Wrench with the
TIBIA side up, hold the Baseplate in place by
placing the keel fins into the slots. Thread the
Stem Extender into the Tibial Baseplate boss. See Catalog
Universal Tibial Baseplate
Place the open face end of the Universal Torque
Wrench on the flats of the Stem Extender.
Tighten by pulling the wrenches together. See Catalog
Torque stem to 120 in-lbs as indicated on the Triathlon Cemented Stem
Universal Torque Wrench. (Figure 39)
Figure 39
Tibia with offset and stem See Catalog
Ensure jam nut is up against the Offset Triathlon Fluted Stem, Titanium
Adapter, exposing all of the threads.
Thread the Offset Adapter into the Baseplate
until the jam nut bottoms out on the Tibial See Catalog
Baseplate boss. Triathlon TS Offset Adapter

Time the rotation of the Offset Adapter to the

position recorded from the Tibial Offset Bushing
by turning the Offset Adapter counterclockwise See Catalog
and aligning the scribe line on the Offset Adapter Figure 40 Triathlon Stem Extender
to the scribe line corresponding clockface mark
on the Tibial Baseplate boss.
6541-4-810
Holding the Offset Adapter in place, turn the
Impaction Handle
jam nut counterclockwise and hand tighten
it against the Tibial Baseplate boss. (Figure 40)
This will hold its position for final tightening.
6543-4-803
Holding the Universal Torque Wrench in the
Offset Counter Wrench
left hand, place the open face end of the
wrench on the flats of the jam nut.
Next, holding the Offset Counter Wrench in
6543-4-818
the right hand, place the open face end of the
Universal Torque Wrench
wrench on the flats on the Offset Adapter.
Tighten by pulling the wrenches together.
Torque to 120 in-lbs as indicated on the 6543-4-801
Universal Torque Wrench. (Figure 41) Universal Counter Wrench

Figure 41
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Thread the appropriate size stem into Offset Adapter.

Now, holding the Universal Torque Wrench in the right
hand, place the open face end of the wrench on the flats
of the stem.
Hold the Offset Counter Wrench in the left hand and
place the open face end of the wrench on the flats of the
Offset Adapter.
Tighten by pulling the wrenches together. Torque
stem to 120 in-lbs as indicated on the Universal Torque
Wrench. (Figure 42)

Tibial augmentation
Assemble the 1/8” Universal Joint Hex Drive into the
Slip Torque Handle.
Place the Tibial Augment on the distal side of the
Figure 42
Universal Baseplate. Verify both pins of the Tibial
Augment are engaged into the slots on the underside of
the Universal Baseplate and that the Tibial Augment
is seated flush. Using the 1/8” Universal Joint Hex
Drive, torque the helical bolt captured within the tibial
augment until the torque driver slips, at which time
you will hear an audible click. Verify that the helical
bolt is engaged into the slot on the keel of the Universal
Baseplate. (Figure 43) Repeat on a second augment if
required on the other side.

Note:
Triathlon TS Augments are not cleared to cement
together and stack to fill voids.

Figure 43

Femoral implant assembly

Femoral Augments
Assemble the 1/8” Universal Hex Driver into the Slip
Torque Handle.
Place the Femoral Augment on the appropriate (distal or
posterior) surface of the Femoral Component.
Assemble the Augment Screw through the Femoral
Augment into the threaded hole in the Femoral
Component.
Torque the Augment Screw until the torque driver slips,
at which time you will hear an audible click. (Figure 44)
Repeat this sequence on all required femoral augments.

Note:
Figure 44
If using the largest augments, assemble the stem first.

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Femur with stem: No offset Instrument bar

Using the Universal Counter Wrench with the
FEMUR side up, hold the femoral component in
place by assembling the box into the gap. See Catalog
Thread the appropriate size stem into the Universal Tibial Baseplate
femoral component.
Place the open face end of the Universal Torque
Wrench onto the flats of the stem.
See Catalog
Tighten by pulling the wrenches together.
Triathlon Tibial Augment
Torque stem to 120 in-lbs as indicated on the
Universal Torque Wrench. (Figure 45)

See Catalog
Triathlon Cemented Stem

See Catalog
Triathlon Fluted Stem, Titanium

See Catalog
Triathlon TS Offset Adapter

See Catalog
Triathlon Stem Extender

6543-4-818
Universal Torque Wrench

Figure 45
Femur with Stem Extender 6543-4-803
Using the Universal Counter Wrench with the Femur Offset Counter Wrench
side up, hold the femur in place by placing the box into
the gap. Thread the Stem Extender into the Femoral
Component.
6541-4-825
Place the open face end of the Universal Torque Wrench Slip Torque Handle
on the flats of the Stem Extender. Tighten by pulling
the wrenches together.
Torque stem to 120 in-lbs as indicated on the Universal 6541-4-802
Torque Wrench. (Figure 46) 1/8" Hex Drive

6543-4-801
Universal Counter Wrench

See Catalog
Triathlon TS Femoral Component
Figure 46

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Femur with Offset Adapter

Ensure jam nut is up against the Offset Adapter,
exposing all threads.
Thread the Offset Adapter into the Femoral Component
until the jam nut bottoms out on the femoral boss.
(Figure 47)
Dial the rotation of the Offset Adapter to the position
recorded from the Femoral Offset Bushing by turning
the Offset Adapter counterclockwise and aligning the
tick mark on Offset Adapter to the tick mark on the
femoral boss.
Holding the Offset Adapter in place, turn the jam
nut counterclockwise and hand tighten it against
the femoral boss. This will hold the construct in the
appropriate position for final tightening.
Figure 47 Holding the Universal Torque Wrench in the left hand,
place the open face end of wrench onto the flats of the
jam nut.
Next, holding the Offset Counter Wrench in the right
hand, place the open face end of the wrench on the
flats on the Offset Adapter. (Figure 48)
Tighten by pulling the wrenches together. Torque
to 120 in-lbs as indicated on the Universal Torque
Wrench.
Thread the appropriate size stem into Offset Adapter.
Now, holding the Universal Torque Wrench in the right
hand, place the open face end of the wrench onto the
flats of the stem.
Hold the Offset Counter Wrench in the left hand and
place the open face end of the wrench on the flats of the
Offset Adapter. (Figure 49)
Figure 48
Tighten by pulling the wrenches together. Torque
Stem to 120 in-lbs as indicated on the Universal Torque
Wrench.

Figure 49

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Component implantation Instrument bar

If needed, further prepare resected bone surfaces using an osteotome,
oscillating saw or bone file.
6543-4-818
Tibial implant implantation Universal Torque Wrench

Attach the Tibial Impactor/Extractor to the Impaction Handle. Assemble the

tibial implant assembly to the Tibial Impactor/Extractor. Apply cement to the
6543-4-803
appropriate sections of the tibial implant assembly and the proximal tibia.
Offset Counter Wrench
Impact the tibial implant assembly onto the tibia until fully seated and remove
all excess cement. To further seat the baseplate, attach the Tibial Baseplate
Impactor to the Impaction Handle. Place the Tibial Baseplate Impactor on to
the Tibial Baseplate straddling the central island. Ensure the Tibial Baseplate See Catalog
Impactor sits flat on the top surface of the Tibial Baseplate. Impact until the Triathlon Cemented Stem
Tibial Baseplate is fully seated.

Femoral implant implantation

See Catalog
Attach the Femoral Impactor/Extractor to the Impaction Handle. Triathlon Fluted Stem, Titanium
Assemble the Femoral Implant Assembly to the Femoral Impactor/
Extractor. Apply cement to the appropriate sections of the Femoral
Implant Assembly and the cut surfaces of the femur. Impact the Femoral
See Catalog
Implant Assembly onto the femur until fully seated and remove all excess
Triathlon TS Offset Adapter
cement. The Femoral Impactor can be attached to the Impaction Handle
to further seat the Femoral Component onto the prepared femur.

Tibial Insert See Catalog

Triathlon Stem Extender
Prior to applying the TS Tibial Insert, the Tibial Insert Trial may be
placed on the Universal Baseplate to once more assess joint stability and
range of motion.
Attach the Tibial Insert Impactor to the Impaction Handle. Ensure that
the Universal Baseplate is completely free of debris. Angle the TS Tibial See Catalog
Insert posteriorly into the Universal Baseplate. Impact the insert to snap Triathlon TS Femoral Component
it into place anteriorly.

Stabilizer pin 6543-4-600

Stabilizer Post Impactor
Place the Insert Stabilizer Pin into Tibial Insert post “barbed” end up.
Using the Stabilizer Post Impactor, tap the Insert Stabilizer Pin down
until it is below the proximal surface of the Tibial Insert post.

Note:
The Insert Stabilizer Pin is packaged with the Tibial Insert.

Closure
After cement polymerization
and removal of all residual
cement, thoroughly irrigate the
joint. Hemostasis is achieved
after deflation of the tourniquet.
Close soft tissues in the normal,
layered fashion.

Figure 50

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Triathlon Tritanium Cone

Augment preparation
Tibial preparation
To prepare for the tibia, reference the Tibial
Resected preparation, Offset preparation and Tibial Augment
tibial level preparation sections of the protocol (Pages 6-11). The
indicator
next section specifies details for tibial preparation with
Cone usage.

Figure 51

Tibial canal preparation (cones)

Prepare the tibial canal to accept a stem as described
on page 6 of the protocol.

Option 1: Reamer-based
When using a Symmetric/Asymmetric Cone, a minimum
-OR- depth of 175mm is recommended for the IM Reamer
to facilitate accurate cone reaming and to ensure that
the flutes on the Tibial Symmetric Cone Reamer do not
interfere with the flutes on the IM Reamer.
Flush with Flush with
proximal cut augment cut Tap the final IM Reamer gently with a mallet to ensure
that it is fully seated.
Figure 52
Note:
If TS Tibial Augments are to be used, ream until the
175mm marking is flush with the augment cut. Use
the bottom of the 175mm line marking as the depth
reference. See Figure 52.

Note:
If the reamer diameter is less than 16mm, prepare
for the boss of the tibial component by reaming
over the top of the IM Reamer shaft with the Boss
Reamer. Ream until the Boss Reamer bottoms out on
the IM Reamer or until the depth groove lines up to
the planned resected tibia. (Figure 51)

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Option 2: Stem Extender-based Instrument bar

Ream to 175mm with the desired diameter IM Reamer.
Ensure that purchase into the canal has been achieved.
6543-7-508
Ream over the top of the IM Reamer with the Boss
8mm Starter Awl
Reamer. Ream until the Boss Reamer bottoms out on
the IM Reamer or until the stop collar lines up to the
planned resected bone depth. Remove both the IM
Reamer and the Boss Reamer. See Catalog
IM Reamer
Assemble the Stem Extender Shaft to the appropriate
diameter Stem Trial and place the assembly into the
canal.
Continue with tibial preparation as described in the 6543-7-527
protocol. Boss/Offset Reamer

Ream depth: tibial components with cones

6543-4-516
Stems (with cones) Depth
Stem Extender Shaft
100mm 175 (3rd groove)

100mm w/offset 175 (3rd groove)

150mm 175 (3rd groove)

150mm w/offset 200 (4th groove)

Note:
When reaming with Stem Extenders, ream an
additional 25mm or 50mm accordingly.

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Preliminary cone sizing Symmetric tibial cone preparation

Depending on the size and geometry of bone defect, either Ensure that the Tibial Symmetric Cone Reamer is being
a symmetric or asymmetric tibial cone augment may be used. This can be confirmed by checking that the reamer
selected. Inverting a contralateral leg cone trial may help shaft reads “TIBIA.”
determine bone defect, assess cone coverage and determine Grooves on the reamer specify cone size. (Figure 54)
if a symmetric or asymmetric cone is required. Reference the sizing chart to help determine appropriate
cone sizing (see chart on the next page for cone and
Note: Universal Baseplate sizing options).
Invert the Cone Trial over the resected tibial bone
and ensure that the trial is centered on the IM Note:
Reamer. (Figure 53) Centering the trial helps to Use the top line of the groove (of the desired size) as
provide proper positioning. the depth reference.

Insert the Tibial Symmetric Cone Reamer over the IM

Reamer. (Figure 55) If reaming under power, confirm that
the drill is set to ream mode before reaming begins.
Start the reamer before engaging the bone. Ream down to
the desired depth/size.

Caution:
If the bone is soft, osteopenic, fractured or sclerotic,
consider initially reaming by hand using the T-handle.

Remove both the Tibial Symmetric Cone Reamer and the IM

Reamer.
If using an augment or offset, see the next page to help
determine proper preparation depth.
Figure 53
Note:
If the cone needs to be placed in a slightly more posterior
position, remove the IM Reamer and replace it with
an IM Reamer of a smaller diameter. Place the Tibial
Symmetric Cone Reamer over the IM Reamer and gently
flex it posteriorly. Ream down to the desired depth/size.

Note:
Confirm that the Tibial Symmetric Cone Reamer is not
being hindered by the cutting surface of the flutes on the
IM Reamer. If so, the IM Reamer may need to be placed in
a more distal position.

Note:

Figure 54 Figure 55 Reamer depth increases by 5mm per size.

Figure 56
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Tibial Cone sizes

Tibial Cone sizing per
tibial baseplate. Gold Instrument bar
A B C D E
represents optimal size
Size 1 X conditions.
Size 2 X Note: Cones B, C, D and E
Size 3 X X also have an asymmetric See Catalog
Implant Size 4 X X lobed option. Cones IM Reamer
sizes smaller than those marked
Size 5 X X X
with an X are designed to
Size 6 X X X X
be compatible but need
Size 7 X X to be positioned at least
Size 8 X X 5mm deeper. If these sizes
are to be used, rotational
freedom between the See Catalog
Distal
diameter 21mm 23mm 25mm 25mm 25mm tibial implant and the Symmetric Cone Augment Trial
(OD) cone may be limited
Max with non size on size
stem dia. 17mm 19mm 21mm 21mm 21mm combinations. Trial to
(ID) assess compatibility.

6543-5-200
Tibial Symmetric Cone Reamer

-OR-

No offset With offset

Figure 57

If an Offset Adapter is to be used, advance the reamer

to the next largest Cone size. This will be 5mm deeper.
(Figure 57)
Cone sizes C, D and E (Symmetric and Asymmetric)
can only be offset according to the following clocking
orientations: 9-12 (posterior) or 12-3.

Note:
If using an Offset Adapter, trial to confirm proper
offset orientation.

Note:
Tibial Cone sizes A and B (Symmetric and
Asymmetric) are not intended for use with Offset
Adapters.

If augments are to be used, the size marking of the

Tibial Symmetric Cone Reamer will indicate where the
Cone will sit. Ream until the marking is flush with the
augment cut. (Figure 52 on page 28)

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Symmetric Cone trialing Assemble the desired Stem Trial with the Tibial Cone
Introducer, TS Impaction Handle and the selected
If bone voids are such that Asymmetric Cone Symmetric Cone Trial (100mm stem maximum).
preparation is necessary, refer to the Asymmetric Cone Tibial Cone Introducers are size specific.
Preparation section of the protocol.
Note:
Note:
Downsize the Trial Stem by 1mm.
Cone trial may be placed in the prepared bone prior
to assembling the instruments as described below.
Align the orientation key on the trial with the key
feature on the Cone Introducer. The orientation key is
located posteriorly on the trial. (Figure 58)

Note:
There is no positive lock on the Cone Trial and the
Cone Introducer. The trial may disconnect from the
introducer.

Note:
The Cone Trial can be placed into the prepared bone
before the Stem Trial and the Cone Introducer.

When inserting the Cone Trial, ensure that the anterior

rotational alignment marking on the trial is aligned with
the anterior surface marking previously determined by
the Universal Tibial Template. (Figure 59)
Figure 58
Insert the trial until it is seated at the appropriate
depth. Remove the Cone Introducer and the Stem Trial
so that only the Cone Trial remains in the void.

Caution:
Do not impact or implant the Cone Trials.

Note:
Stem Trials with product code 5560-T-XXX cannot
be used with cone augment instrumentation. This
includes trials 5560-T-112 and 5560-T-115.

Options if added Cone stability is required:

Ream to a larger Symmetric Cone (Repeat steps from the
Symmetric Cone Preparation section of the protocol).
Figure 59
Or prepare for an Asymmetric Cone (Follow the steps from
the Asymmetric Cone Preparation section of the protocol).
Or implant the Cone with cement.

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Asymmetric Tibial Cone Instrument bar

preparation
Asymmetric Cone preparation is an option for increased
6541-4-810
stability and void filling after Symmetric Cone reaming
Impaction Handle
has been completed.
Symmetric Cone preparation must be performed before
Asymmetric Cone preparation can begin. Refer to the
Symmetric Cone Preparation section of the protocol. 6543-5-231
During Asymmetric Cone preparation, be sure to properly Tibial Cone Introducer
set cone rotation to ensure proper alignment with the
Universal Baseplate.
Slide the appropriate Tibial Cone Reamer Guide over the
IM Reamer and into the prepared tibia. (Figure 60)
See Catalog
Note: Symmetric Cone Augment Trial

There are two Tibial Cone Reamer Guides. One is

designed for left medial/ right lateral use, and the other
is designed for right medial/left lateral use. See Catalog
Triathlon Stem Trial

Note:
Do not fully seat the Tibial Cone Reamer Guide until
after rotation is set. See Catalog
Tibial Cone Reamer Guide
LM/ RL
Attach the Tibial Cone Alignment Guide (Handle) to the RM/ LL
Tibial Cone Reamer Guide. (Figure 61 on page 34)

See Catalog
IM Reamer

Figure 60

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Insert the Tibial Asymmetric Cone Reamer into the Tibial

Cone Reamer Guide to assist in visualization of guide
positioning.
Select the correct reamer to match the cone size.
Slide back the bushing on the reamer and place the
reamer into the slot of the guide. (Figure 63)

-OR-

No offset With offset

Figure 61 Figure 62
Sizing example
No stem offset With stem offset
Symmetric Reamer depth (C) Symmetric Reamer depth (D)
Alignment Guide level Alignment Guide level of
of embedment (C) embedment (D)
Asymmetric lobe Reamer Asymmetric lobe Reamer size
size (C) (C)
Asymmetric implant size (C) Asymmetric implant size (C)

Figure 63
Insert the Universal Alignment Rod into the bushing on
the Tibial Cone Alignment Guide (Handle).

Note:
The Universal Alignment Rod is only intended to help
align anterior rotation markings to help ensure proper
cone positioning/rotation.

Lower the Tibial Asymmetric Cone Reamer down to the

desired location.
Use the Tibial Cone Alignment Guide (Handle) to position
the reamer and rotate the guide. The assembly can be
rotated by using the built in rotational constraints (+/- 10°).
(Figure 64)

Figure 64

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Once the desired positioning is established, move the

Universal Alignment Rod so that it aligns with the Instrument bar
anterior rotational marking previously set using the
Universal Tibial Template. This will help to ensure that
desired tibial rotation is maintained. See Catalog
Tibial Asymmetric Cone Reamer
If the Universal Alignment Rod does not line up with the
anterior marking, reduce rotation until it does so.

Note:
See Catalog
If an Offset Adapter is to be used, the Alignment
Tibial Cone Reamer Guide
Rod bushing must align within the two 5° alignment LM/ RL
markers. (Figure 64) RM/ LL

The Tibial Cone Reamer Guide has micro-flutes at its base

to maintain rotation once set. 6543-5-203
After alignment has been set, seat the Tibial Cone Reamer Tibial Cone Alignment Guide
Guide so that it sits at the same depth/size as the Tibial
Symmetric Cone Reamer. (Figure 65)

6541-4-602
Universal Alignment Rod

Figure 65

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If reaming under power, confirm that the drill is set to

ream mode before reaming begins.
Before reaming begins, ensure that the bushing is fully
engaged.

Caution:
If the bone is soft, osteopenic, fractured or sclerotic,
consider initially reaming by hand using the
T-handle.

Hold the Tibial Cone Alignment Guide (Handle) in the

previously determined location to maintain rotation.
Start the reamer before engaging the bone. Ream down to
the stop. (Figure 66)
Remove the reamer from the guide. If necessary, the Slap
Hammer can be connected to the end of the Tibial Cone
Alignment Guide to assist with guide removal.
Remove the IM Reamer.

Asymmetric Cone trialing

Note:
The Cone Trial can be placed into the prepared bone
before the Stem Trial and the Cone Introducer.

Assemble the desired Stem Trial with the Tibial Cone

Introducer, TS Impaction Handle and the selected
Asymmetric Cone Trial (100mm stem maximum).
Tibial Cone Introducers are intended for use with both
Symmetric and Asymmetric Cones.

Figure 66 Note:
Downsize the Stem Trial by 1mm.

Align the orientation key on the trial with the key feature
on the Cone Introducer. The orientation key is located
posteriorly on the trial. (Figure 67)

Note:
There is no positive lock on the Cone Trial and the
Cone Introducer. The trial may disconnect from the
introducer.

Figure 67

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Insert the trial until it is seated at the appropriate depth.

(Figure 68) Remove the Cone Introducer and the Stem
Instrument bar
Trial so that only the Cone Trial remains in the void.

6543-5-203
Caution:
Tibial Cone Alignment Guide
Do not impact or implant Cone Trials

Note: See Catalog

Stem Trials with product code 5560-T-XXX cannot Tibial Asymmetric Cone Reamer
be used with cone augment instrumentation. This
includes trials 5560-T-112 and 5560-T-115.

Options if added Cone stability is required: See Catalog

Tibial Cone Reamer Guide
Ream for a larger Asymmetric Cone (repeat steps LM/ RL
from the Asymmetric Cone Preparation section of the RM/ LL
protocol).
Or implant the Cone with cement.
6541-4-602
Universal Alignment Rod

6541-4-810
Impaction Handle

6543-5-231
Tibial Cone Introducer

See Catalog
Asymmetric Cone Augment Trial

Figure 68

See Catalog
Triathlon Stem Trial

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Femoral preparation
To prepare the femur, reference the Femoral Preparation and
Gap Balancing sections of the protocol (pages 12-21).

Intramedullary reaming for

Cones
Prepare the femoral canal to accept a stem as described on
page 12.
If not previously completed, mark femoral rotation using
epicondylar landmarks. (Figure 69)
A minimum depth of 175mm is recommended for the IM
Reamer to facilitate accurate cone reaming and to ensure
that the flutes on the Cone Reamer do not interfere with the
Figure 69
flutes on the IM Reamer.

Note:
Use the Triathlon TS sizing templates and epicondylar
markings (Figure 70) to determine if the IM Reamer
is positioned too far anteriorly. If so, flex the reamer to
attain a more posterior position (downsize the reamer if
necessary).

Note:
Figure 70 If TS Femoral Distal Augments are to be used, ream
until the 175mm marking is flush with the augment cut.
Ream depth: femoral components
Use the bottom of the 175mm line marking as the depth
Stems Femur reference.
50-100mm 150

100mm w/offset 175

Tap the final IM Reamer gently with a mallet to ensure that it
is fully seated.
Femoral Cone 175*

150mm 200 Note:

150mm w/offset 225 If the final IM Reamer diameter is less than 16mm,
prepare for the boss of the femoral component by
reaming over the top of the IM Reamer shaft with the
Note: Boss Reamer. Ream until the Boss Reamer bottoms out
When reaming with Stem Extenders, ream an on the IM Reamer or until the stop collar lines up to the
additional 25mm or 50mm accordingly. planned resected bone depth.

Option: Stem Extender-based workflow

If desired, the IM Reamer can be removed and subsequent
preparation can be based off of a Stem Trial utilizing the
required Stem Trial and the Stem Extender Shaft.
Assemble the Stem Extender Shaft to the appropriate
diameter Stem Trial and place the assembly into the canal.
Continue with femoral preparation as described in the
protocol.

*When preparing for size 7-8 Cones, ream an additional 5mm deeper to
prevent the Cone Reamer from bottoming out on the IM Reamer.

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Distal femoral resection Instrument bar

Refer to pages 13-14 for sections on Distal Femoral
Resection and Augment Preparation. See Catalog
IM Reamer
Reminder:
If TS Femoral Distal Augments are to be used, ream
until the 175mm marking is flush with the augment 6543-1-603
cut. Use the bottom of the 175mm line marking as the Size 1-8 Femoral Sizing Templates
depth reference.

Femoral implant sizing

Determine femoral implant size by using the Femoral
Sizing Templates (Figure 71) or by measuring the previous
femoral implant.
Once the proper femoral implant size has been determined,
use the sizing chart on page 40 to help determine possible
rotational constraints between the box of the TS Femoral
Component and the Central Femoral Cone.
The chart also provides sizing information for use with
posterior augments.

Figure 71

Gap balancing
For gap balancing and resections, reference pages 15-18 of
the protocol.

Note:
Femoral Cones are not intended to be used with Offset
Adapters.

Note:
Reverify femoral rotation using either the epicondylar
axis or by marking pin location from the cutting guide.

Note:
Assess the TS box cut. If necessary, remove the reamer
and complete the cuts. Ensure that the IM Reamer is
repositioned into the canal once the cuts are complete.
Gently tap the reamer to reattain proper seating. TS
box cuts should be performed before cone reaming.
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Femoral Cone sizes Preliminary Cone selection and

1
1-2 3-4 5 6 7-8
sizing
2 Depending on the size and geometry of the bone defect,
TS 3 either cone shape may be selected.
femur
size 4 Inverting a contralateral leg Cone Trial can help size the
5 bone defect, assess cone coverage and determine if a Central
6 or Femoral Cone is required.
7 • Proceed either to Option 1: Central Femoral Cone or
8 Option 2: Femoral Cone procedural steps of this protocol
Proximal
diameter 21mm 23mm 25mm 27mm 29mm Note:
(OD)
Invert the Cone Trial over the resected femoral bone
Max and ensure that the trial is centered on the IM Reamer.
stem
dia. (ID)
16mm 17mm 19mm 21mm 22mm Centering the trial helps to provide proper positioning.

Allows for ± 10° rotational freedom with 5 or 10mm

posterior augments
Option 1: Central Femoral Cone
Allows for ± 10° rotational freedom with 5mm
preparation
posterior augments only
Ensure that the Central Femoral Cone Reamer is being used.
Rotational freedom between the Cone Augment and the This can be confirmed by checking that the reamer shaft is
TS femur is limited. Trial to assess compatibility. silver in color and that the shaft reads “TS Central Femur.”
Allows for +/- 5° of rotational freedom (Figure 72)

Central Femoral
Femoral Cone Reamer
Cone Reamer

Figure 72

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Insert the Central Femoral Cone Reamer over the IM

Reamer or Stem Extender. If reaming under power,
Instrument bar
confirm that the drill is set to ream mode before reaming
begins. (Figure 73) See Catalog
Start the reamer before engaging the bone. Ream down to IM Reamer
the desired depth for bone void coverage.

6543-4-516
Stem Extender Shaft

6543-6-130
TS Central Femoral Cone Reamer

Figure 73

Caution:
If bone is soft, osteopenic, fractured or sclerotic,
consider initially reaming by hand using the T-handle.

Caution:
Stop reaming if contact with the posterior cortex of
the femur causes the Central Femoral Cone Reamer
to deflect anteriorly. (Figure 74) If bone void is not
adequately filled by the corresponding size Central
Femoral Cone, consider using a Femoral Cone (by
proceeding to option two: Femoral Cone assembly and
subsequent steps of the protocol) or use alternative
methods to fill void.

Figure 74

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To determine size of the Central Femoral Cone, utilize the

Femoral Sizing Templates. Ensure that the distal femoral cut
intersects the dot marking. The dot signifies the surface of
the resected plane. (Figure 75)

Caution:
Stop the reamer before using the Femoral Sizing
Templates.

Note:
Figure 75
Ream until the dot marking is flush with the most distal
surface of the cut. Dot marking must be directly anterior.

Note:
Confirm that the Central Femoral Cone Reamer is not
being hindered by the cutting surface of the flutes on the
IM Reamer. If so, the IM Reamer may need to be placed
in a more proximal position.

Figure 76 Note:
Dot markings on the reamer increase in depth by 5mm.

Caution:
If augment cuts have been completed, there may
be interference between the leg of the cone and
the Femoral Distal augment. In the case of a 10mm
difference between the cut surfaces (Figure 77), it is
recommended to downsize the Central Femoral cone
by one size. In the case of a 15mm difference between
the cut surfaces (Figure 78), it is recommended to
Figure 77
downsize the Central Femoral Cone by two sizes. If
this is not possible, downsize by one size and/or reduce
the thickness of the Femoral Distal Augment.

Figure 78

1-2 3-4 5 6 7-8

40mm

Figure 79
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Central Femoral Cone trialing Instrument bar

The Central Femoral Cone Trial can be placed in the
prepared bone. Assemble the desired Stem Trial with the See Catalog
corresponding Central Femoral Cone Introducer and TS IM Reamer
Impaction Handle. There are two Central Femoral Cone
introducers: One for sizes 1-4 Central Femoral Cones and
another for sizes 5-8. Ensure correct side (L or R marking) is 6543-6-128
facing anterior. 6543-6-129
[Size 1-4] Central Femoral Cone
Introducer
Note:
[Size 5-8] Central Femoral Cone
Stem Trials with product code 5560-T-XXX cannot be Introducer
used with cone augment instrumentation. This includes
trials 5560-T-112 and 5560-T-115.
See Catalog
Central Femoral Cone Augment Trial
Align the orientation keys on the Introducer with the feature
on the Cone Trial. The orientation keys are located medially
and laterally on the trial. 6541-4-810
Impaction Handle
Caution:
There is no positive lock on the Central Femoral Cone
Trial and the Cone Introducer. If inserting the Trial
on the Introducer, be aware that the Cone Trial may
disconnect from the Introducer.

Caution:
Do not impact or implant the Central Femoral Cone
Trials.

The Central Femoral Cone Trial/Implant is designed to

sit 5mm proximal to the most distal surface of the femur.
(Figure 80) If Central Femoral Cone Trial/Implant sits flush
with the distal surface, there is chance of interference with
the box of the TS Femoral Component.

Figure 80

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Confirm the depth of the Central Femoral Cone Trial by

placing the Blade Runner into the slot on the Central Femoral
Cone Introducer. Proper depth can be confirmed if the Blade
Runner contacts the distal surface of the femur. (Figure 81)
If a gap exists between the Blade Runner and the distal
surface of the femur, consider downsizing the Central Cone
or re-reaming deeper.
Confirm that the rotation of the Central Femoral Cone Trial
aligns with previous epicondylar markings. The Blade
Runner can be placed in the slot of the introducer to aid in
visualizing alignment (Figure 82).

Note:
L
Refer to compatibility chart for rotational limitations
between the Central Femoral Cone and TS Femoral
Figure 81 Component.

Figure 82

Options if added Cone stability is required:

Ream to a larger Central Femoral Cone (repeat steps from the
Femoral Cone preparation section of the protocol).
Convert to a Femoral Cone (starting at Femoral Cone Reamer
Guide assembly step of the protocol).
Implant the Central Femoral Cone with cement.

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Option 2: Femoral Cone Instrument bar

preparation
See Catalog
Ensure that the Femoral Symmetric Cone Reamer is being
IM Reamer
used. This can be confirmed by checking that the reamer
shaft is gold in color and that the shaft reads “Femur”.
Reference the Femoral Cone sizing chart to help determine
appropriate cone sizing, as well as TS femoral compatibility 6543-5-300
(See chart on the following page). Femoral Symmetric Cone Reamer

Insert the Femoral Symmetric Cone Reamer over the IM

Reamer. If reaming under power, confirm that the drill is set
See Catalog
to ream mode before reaming begins.
Triathlon Stem Trial
Start the reamer before engaging the bone. (Figure 83) Ream
down to the desired depth/size. While reaming, periodically
check the reamer depth (markings) to ensure proper 6543-6-128
6543-6-129
measurement is achieved.
[Size 1-4] Central Femoral Cone Introducer
[Size 5-8] Central Femoral Cone Introducer
Caution:
If the bone is soft, osteopenic, fractured or sclerotic, 6541-4-810
consider initially reaming by hand using the T-handle. Impaction Handle

See Catalog
Central Femoral Cone Augment Trial

6541-4-400
Blade Runner

Figure 83

Figure 84

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Femoral Cone sizes

Utilize the Femoral Sizing Templates to ensure that the
distal femoral surface intersects the dot marking. The dot
1-2 3 4 5 6 7-8
signifies the surface of the resected plane. Stop the reamer
1 before using the templates. (Figure 84 on page 45)
2

3 Note:
4 Dot markings must be directly anterior.
TS 5
femur
6 Remove both the Symmetric Femoral Cone Reamer and the
size
7
IM Reamer.
8 If augments are to be used, the dot marking of the Symmetric
Proximal
Femoral Cone Reamer will indicate where the cone will sit.
diameter 21mm 23mm 23mm 25mm 27mm 29mm Ream until the dot marking is flush with the augment cut.
(OD)
Max Note:
stem 16mm 18mm 18mm 20mm 22mm 22mm
dia. (ID)
If the Cone needs to be placed in a slightly more posterior
position, remove the IM Reamer and replace it with an
Green allows for 10mm posterior augments.
Blue allows for 5mm posterior augments. IM Reamer of a smaller diameter. Place the Symmetric
Rotational freedom between the femoral implant Femoral Cone Reamer over the IM Reamer and gently
and the Cone may be limited with non size on size flex it posteriorly. Ream down to the desired depth/size.
combinations. Trial to assess compatibility.

Note:
Confirm that the Symmetric Femoral Cone Reamer is not
being hindered by the cutting surface of the flutes on the
IM Reamer. If so, the IM Reamer may need to be placed
in a more distal position.

Note:
Reamer depth increases by 5mm between sizes.

Femoral Cone Reamer Guide

assembly
Assemble the Femoral Cone Reamer Guide with a Stem Trial
of the same diameter (or a 1mm smaller diameter) as the IM
Reamer. (Figure 85) The stem must be at least 50mm shorter
Figure 85 than the final stem (maximum 100mm Trial Stem).

Note:
The Femoral Cone Reamer Guide features dot markings
to allow for easy depth referencing.

Note:
Stem Trials with product code 5560-T-XXX cannot be
used with cone augment instrumentation. This includes
trials 5560-T-112 and 5560-T-115.

Thread the Femoral Cone Handle into the guide and confirm
positioning.
Use the Femoral Cone Handle to adjust rotation of the guide.
The handle can also be used to provide extra stability during
lobed femoral cone reaming.
Figure 86 Note:
The guide provides three handle insertion options:
lateral, medial and anterior. (Figure 86)
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Depth and sizing guide Instrument bar

Insert the Femoral Cone Reamer Guide into the IM canal.
Position the guide so that the dot markings are anterior. See Catalog
Insert the Femoral Cone Alignment Guide through IM Reamer
the Femoral Cone Reamer Guide. Slide the guide until
the alignment plate lies flush with the distal femoral
surface. (Figure 87) 6543-5-300
Femoral Symmetric Cone Reamer
Note:
The Femoral Cone Alignment Guide must be assembled
in the medial slot with the pull tab facing medially.
6543-5-301
Femoral Cone Reamer Guide

6543-5-302
Femoral Cone Handle

6543-5-303
Femoral Cone Alignment Guide

See Catalog
Triathlon Stem Trial

Figure 87

The slots in the alignment plate of the Femoral Cone

Alignment Guide must be placed parallel to the
epicondylar axis (or to the previous marks from the 4-in-1
Cutting Guide fixation pins) or parallel to the proximal
tibia cut. (Figure 88) The posterior edge of the plate can
be aligned parallel to the posterior femoral cut, if no
augments are required, to reconfirm positioning. This
will help to set femoral rotation (+/-5°).

Figure 88
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The Femoral Cone Reamer Guide has micro-flutes at its

base to maintain rotation once set.

Note:
Do not fully seat the Femoral Cone Reamer Guide
until after rotation is set. Seat the guide so that it sits
at the appropriate depth marking.

Caution:
Gently tap the Femoral Cone Reamer Guide only in
indicated area.

Caution:
Do not impact the Femoral Cone Alignment Guide.
Figure 89

Proper implant preparation can be determined by ensuring

that the anterior surface markings of the Femoral Cone
Reamer Guide and the numbers displayed on the end of the
Femoral Cone Alignment Guide match. (Figure 89)

Note:
If sizing indicators do not match, re-ream with
the Symmetric Femoral Cone Reamer and seat the
guide deeper.

Utilize the Femoral Sizing Templates to reconfirm proper

sizing.

Femoral Cone reaming

(lobe preparation)
Evaluate medial and lateral bone quality. Perform initial
reaming on the femoral section with poorer bone quality.
Use the Femoral Cone Handle to provide extra stability
during reaming.
Insert the appropriate Femoral Cone Reamer into the
Femoral Cone Reamer Guide, and ream for the first cone lobe.
Keyway is designed to prevent incorrect assembly.

Note:
Fully engage the bushing before reaming. Confirm that
the drill is set to ream mode.
Figure 90
Start the reamer before engaging the bone. Ream down to the
stop. (Figure 90)

Caution:
If the bone is soft, osteopenic, fractured or sclerotic,
consider initially reaming by hand using the T-handle.

Remove the reamer.

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Insert the correct size Femoral Cone Stabilizer into the

reamed section of the femur to further increase stability.
Instrument bar
(Figure 91) Keyway is designed to prevent incorrect
assembly.

Caution:
6543-5-303
Do not impact the Femoral Cone Stabilizer. Femoral Cone Alignment Guide

6543-5-301
Femoral Cone Reamer Guide

See Catalog
Femoral Cone Reamer

6543-5-302
Femoral Cone Handle

Figure 91

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Insert the Femoral Cone Reamer into the opposite side of the
guide and ream for the second cone lobe. (Figure 92)

Note:
Fully engage the bushing before reaming. Confirm that
the drill is set to ream mode.

Start the reamer before engaging the bone. Ream down to

the stop.

Caution:
If the bone is soft, osteopenic, fractured or sclerotic,
consider initially reaming by hand using the T-handle.

Remove the reamer.

Figure 92
Remove the Femoral Cone Reamer Guide. Use the Slap
Hammer to assist in Guide removal, if necessary. (Figure 93)

Femoral Cone trialing

The Femoral Cone Trial can be placed in the prepared bone.
Assemble the desired Stem Trial with the corresponding
Femoral Cone Introducer and TS Impaction Handle (Figure
94). There is one Femoral Cone Introducer for all sizes.

Note:
Stem Trials with product code 5560-T-XXX cannot be
used with cone augment instrumentation. This includes
trials 5560-T-112 and 5560-T-115.

Align the orientation keys on the Introducer with the feature

Figure 93 on the Cone Trial. The orientation keys are located medially
and laterally on the trial.

Caution:
There is no positive lock on the Central Femoral Cone
Trial and the Cone Introducer. If inserting the Trial on
the Introducer, be aware that the trial may disconnect
from the introducer.

Options if added cone stability is required:

Ream to a larger Femoral Cone (repeat steps from the
Femoral Cone preparation section of the protocol).
Or, implant the Cone with cement.

Figure 94

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TS trialing with Cone Trials Instrument bar

Assemble and use the Tibial Baseplate Trial to ensure
proper cone sizing/positioning. Refer to page 20 of the
protocol for Tibial Trial assembly. See Catalog
Assemble and use the Femoral Trial to ensure proper cone Femoral Cone Reamer
sizing/positioning and to verify accuracy of the femoral cuts.
Refer to page 21 of the protocol for Femoral Trial assembly.
Perform trial reduction and assess joint biomechanics.
(Figure 95) See Catalog
Femoral Cone Stabilizer

6541-4-803
Slap Hammer

6541-4-810
Impaction Handle
Figure 95

6543-5-304
Femoral Cone Introducer

See Catalog
Femoral Cone Augment Trial

See Catalog
Triathlon Stem Trial

Figure 96

Extract the TS trial components, as well as the Femoral

and Tibial Cone Trials. 6541-5-100
Use the Cone Extractor to remove the Cone Trials. Cone Extractor
(Figure 96)
Insert the extractor into the Cone Trial (jaws closed).
Squeeze the extractor handles to open the jaws. The
jaws will engage the slots within the proximal end of the
Cone Trial.
Once the jaws engage with the slots, remove the trial.
Strike the handle of the extractor to assist in removal
of the Cone Trial.

Note:
A lamina spreader (with narrow fixed pads) or a curette
(reverse angle) may also be used to remove the Cone
Trials. Insert the lamina spreader or curette into the
Cone Trial and apply back pressure.
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Cone implantation (tibial cone)

Assemble the desired Stem Trial (1mm smaller than
reamed for) with the Tibial Cone Introducer, TS Impaction
Handle and the selected Symmetric/Asymmetric Cone
Implant. (Figure 97 and 98)
Tibial Cone Introducers are size specific.
Align the orientation key on the implant with the key
feature on the Cone Introducer. The orientation key is
Figure 97 located posteriorly on the implant.

Note:
There is no positive lock on the Cone Implant and the
Cone Introducer. The implant may disconnect from
the introducer.

Note:
The Cone can be placed into the prepared bone before
the Stem Trial and the Cone Introducer.

Note:
When inserting a Symmetric Cone Implant, ensure
that the anterior rotational alignment marking on the
implant is aligned with the anterior surface marking
Figure 98 previously determined by the Universal Tibial
Template.

Gently impact the Symmetric/Asymmetric Cone Implant

and confirm that it is fully seated at the appropriate
depth.

Note:
Stem Trials with product code 5560-T-XXX cannot
be used with cone augment instrumentation. This
includes trials 5560-T-112 and 5560-T-115.

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Cone implantation (femoral cone) Instrument bar

Assemble the desired Stem Trial (1mm smaller than
reamed for) with the corresponding Central or Femoral
Cone Introducer, TS Impaction Handle and the selected
Femoral Cone Implant. (Figure 99 and 100)
There are two introducers for the Central Cones and one See Catalog
for the Femoral Cones. Triathlon Tritanium Asymmetric/
Align the orientation key on the implant with the key Symmetric Cone Augment
feature on the Cone Introducer. The orientation keys are
located medially and laterally on the implant.

Note:
There is no positive lock on the Cone Implant and the See Catalog
Cone Introducer. The implant may disconnect from the Triathlon Tritanium Femoral
introducer. Cone Augment

Note:
The Cone can be placed into the prepared bone before 6541-4-810
the Stem Trial and the Cone Introducer. Impaction Handle

Gently tap the Femoral Cone Implant and confirm that it

is fully seated at the appropriate depth.
See Catalog
Note: Tibial Cone Introducer
Stem Trials with product code 5560-T-XXX cannot be
used with cone augment instrumentation. This includes
trials 5560-T-112 and 5560-T-115.
See Catalog
Femoral Cone Introducers

See Catalog
Triathlon Stem Trial

See Catalog
Triathlon Tritanium
Figure 99
Central Femoral Cone

Figure 100 53
Triathlon Revision Knee System | Surgical protocol Home Table of contents

Cone implants
For Femoral and Tibial Trial assembly, refer to pages 20
and 21 of the protocol.
Introduce the TS Femoral and Tibial Trials.
Perform final trial reduction with the Cone implants and
evaluate joint stability.
Remove the TS trial components.

TS component implantation
with Cone implants
For assembly of Tibial and Femoral Components, refer to
pages 22-26 of the protocol.
Cone implants must be fully seated before cementing the
entire construct.

Caution:
Only use the Cone Extractor if the implant is seated
in the wrong orientation and must be repositioned
(before cementing).

Insert the extractor into the Cone Implant (jaws closed).

Ensure that the flared edges of the jaws are positioned
outside of the distal end of the cone. Squeeze the extractor
handles to open the jaws.

Figure 101 Note:

A lamina spreader (with fixed narrow pads) or a
curette (reverse angle) may also be used to remove
the Cone Implants. Insert the lamina spreader or
curette into the Cone ensuring that the ends of either
instrument are positioned outside of the distal end of
the implant. Apply back pressure.

Caution:
If the Cone Implant is extracted (before cementing),
(Figure 101) inspect the Cone for damage before
reinsertion.

See next section for component and cone cementing

techniques.

Note:
All stem implants are compatible with the cone
augments. Refer to sizing charts to see maximum
stem diameter per cone size.

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Cemented Stems (tibia) Cemented Stems (femur)

Ensure that the Cone Implant is properly seated. Ensure that the Cone Implant is properly seated.
Attach the Tibial Impactor Handle/ Extractor to the Attach the Femoral Impactor Extractor to the Impaction
Impaction Handle. Assemble the tibial implant assembly Handle. Assemble the femoral implant assembly to the
to the Tibial Impactor Handle/Extractor. Femoral Impactor/Extractor.
Assess length of the construct and determine the Assess length of the construct and determine the
appropriate cement restrictors. Insert corresponding appropriate cement restrictors. Insert corresponding
restrictor. restrictor.
Irrigate the joint and then dry. Irrigate the joint and then dry.
Mix cement. Mix cement.

Note: Note:
Cone Implants used with cemented stems will require at Cone Implants used with cemented stems will require at
least two doses without major bone voids or bones with least two doses without major bone voids or bones with
IM canals greater than 20mm to fill the cone volume and IM canals greater than 20mm to fill the cone volume and
get solid fixation to the cone. get solid fixation to the cone.

Apply a thin layer of wet cement on the underside of the Apply a thin layer of wet cement on the back of the
baseplate. Allow the cement to dough. femoral implant. Allow the cement to dough.
Use the standard cementing technique with a cement Use the standard cementing technique with a cement
gun to retrograde fill the canal and cone. gun to retrograde fill the canal and cone.
Pressurize the cement into the cone, the metaphysis and Pressurize the cement into the cone, the metaphysis and
onto the flat tibial surface. onto the cut distal femoral surfaces.
Impact the tibial implant assembly onto the tibia until Impact the femoral implant assembly onto the femur
fully seated (do so when the cement is in its doughy until fully seated (do so when the cement is in dough-
state) and remove excess cement. like state) and remove excess cement.

55
Triathlon Revision Knee System | Surgical protocol Home Table of contents

Fluted Stems (tibia) Fluted Stems (femur)

Ensure that the cone is properly seated. Ensure that the cone is properly seated.
Attach the Tibial Impactor Handle/Extractor to the Attach the Femoral Impactor Extractor to the Impaction
Impaction Handle. Assemble the tibial implant assembly Handle. Assemble the femoral implant assembly to the
to the Tibial Impactor Handle/Extractor. Femoral Impactor/ Extractor.
Irrigate the joint and then dry. Irrigate the joint and then dry.
Mix cement. Mix cement.

Note: Note:
When using Cone Implants with Fluted Stems, at least When using Cone Implants with Fluted Stems, at least
one dose of cement for Cone sizes A, B and C and two one dose of cement for Cone sizes 1-2 and 3, and two
doses for Cone sizes D and E will be required in the doses for Cone sizes 4, 5, 6 and 7-8 will be required in
absence of major bone voids. the absence of major bone voids.

When using Fluted Stems with Cone implants, wipe When using Fluted Stems with Cone implants, wipe the
the inside surface of the cone with a thin layer of wet inside surface of the cone with a thin layer of wet cement
cement (avoid cement moving distally beyond the (avoid cement moving distally beyond the superior edge
inferior edge of the cone). Apply doughy cement to the of the cone). Apply doughy cement to the back surfaces of
back surface of the baseplate, and build the cement up the assembled femoral implant, and build the cement up
along the stem implant junction proximally so that the along the stem implant junction proximally so the cement
cement can fill the full depth of the cone. can fill the full depth of the cone.
Make sure the stem tray construct has enough cement Make sure the stem tray construct has enough cement
coating the implant, with enough volume to fill the Cone coating the implant, with enough volume to fill the Cone
and cover the stem tray junction. and cover the stem tray junction.
Pressurize the cement into the flat tibial surface. Pressurize the cement onto the cut distal femoral
surfaces.
Impact the tibial implant assembly onto the tibia until
fully seated (do so when the cement is in its dough-like Impact the femoral implant assembly onto the femur
state) and remove excess cement. until fully seated (do so when the cement is in its dough-
like state) and remove excess cement.

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Triathlon Revision instruments

Catalog number Description Quantity in kit

Miscellaneous Upper Tray Kit contents

6541-4-810 Impaction Handle 2

6541-4-825 Slip Torque Handle 1
6543-7-601 Resection Guide Tower 1
6541-4-807 Femoral Impactor Extractor 1
6541-4-811 Femoral Impactor 1
6541-4-812 Tibial Baseplate Impactor 1
6541-4-813 Tibial Insert Impactor 1
6541-4-805 Tibial Baseplate Impactor Extractor 1
6543-4-516 Stem Extender Shaft 1
6541-4-806 Universal Alignment Handle 1
6543-7-600 Support Arm Assembly 1
6541-4-516 5/16" IM Rod 1
6541-4-602 Universal Alignment Rod 1
6543-4-802 1/8" Universal Hex Driver 1
6543-8-004 Miscellaneous Upper Tray 1
6541-9-000 Triathlon Case 1
Total quantity 17

Catalog number Description Quantity in kit

Miscellaneous Lower Tray Kit contents

6543-4-803 Offset Counter Wrench 1

6543-4-801 Universal Counter Wrench 1
6543-4-818 Universal Torque Wrench 1
6541-4-400 Blade Runner 1
6543-7-602 Stop Plate 1
6543-4-605 Adjustable Spacer Block Augment - 5mm 4
6543-4-610 Adjustable Spacer Block Augment - 10mm 4
6543-4-615 Adjustable Spacer Block Augment - 15mm 2
6541-4-610 Adjustable Spacer Block 1
6541-4-804 Headless Pin Extractor 1
6541-4-300 Headed Nail Impactor Extractor 1
6541-4-803 Slap Hammer 1
6541-4-515 Headed Nails - 1 1/2" 2
6541-4-575 Headed Nails - 3/4" 2
6543-8-104 Miscellaneous Lower Tray 1
6541-9-000 Triathlon Case 1
Total quantity 25

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Catalog number Description Quantity in kit

3 - 6 Tibial Prep Upper Tray Kit contents

6543-2-600 Tibial Offset Bushing 1
6543-2-601 Tibial Offset Bushing Guide 1
6543-6-700 Revision Tibial Resection Guide L - Slotted 1
6543-6-701 Revision Tibial Resection Guide R - Slotted 1
6541-2-013 Size 1-3 Keel Punch 1
6541-2-046 Size 4-6 Keel Punch 1
6541-2-603 #3 Universal Tibial Template 1
6541-2-604 #4 Universal Tibial Template 1
6541-2-605 #5 Universal Tibial Template 1
6541-2-606 #6 Universal Tibial Template 1
6541-2-713 Size 1-3 Keel Punch Guide 1
6541-2-748 Size 4-8 Keel Punch Guide 1
6541-2-807 Tibial Alignment Handle 1
6543-2-703 Tibial Resection Guide Link 1
6543-8-002 3 - 6 Tibial Prep Upper Tray 1
6541-9-000 Triathlon Case 1
Total quantity 16

Catalog number Description Quantity in kit

3 - 6 Tibial Prep Lower Tray Kit contents

5521-T-300 TS Baseplate Trials #3 1
5521-T-400 TS Baseplate Trials #4 1
5521-T-500 TS Baseplate Trials #5 1
5521-T-600 TS Baseplate Trials #6 1
5545-T-301 Tibial Augment Trial #3 LM/RL - 5mm 1
5545-T-302 Tibial Augment Trial #3 RM/LL - 5mm 1
5545-T-401 Tibial Augment Trial #4 LM/RL - 5mm 1
5545-T-402 Tibial Augment Trial #4 RM/LL - 5mm 1
5545-T-501 Tibial Augment Trial #5 LM/RL - 5mm 1
5545-T-502 Tibial Augment Trial #5 RM/LL - 5mm 1
5545-T-601 Tibial Augment Trial #6 LM/RL - 5mm 1
5545-T-602 Tibial Augment Trial #6 RM/LL - 5mm 1
5546-T-301 Tibial Augment Trial #3 LM/RL - 10mm 1
5546-T-302 Tibial Augment Trial #3 RM/LL - 10mm 1
5546-T-401 Tibial Augment Trial #4 LM/RL - 10mm 1
5546-T-402 Tibial Augment Trial #4 RM/LL - 10mm 1
5546-T-501 Tibial Augment Trial #5 LM/RL - 10mm 1
5546-T-502 Tibial Augment Trial #5 RM/LL - 10mm 1
5546-T-601 Tibial Augment Trial #6 LM/RL - 10mm 1
5546-T-602 Tibial Augment Trial #6 RM/LL - 10mm 1
5570-T-020A Triathlon Offset Adapter Trial - 2mm 1
5570-T-040A Triathlon Offset Adapter Trial - 4mm 1
5570-T-060A Triathlon Offset Adapter Trial - 6mm 1
5570-T-080A Triathlon Offset Adapter Trial - 8mm 1
6543-8-102 3 - 6 Tibial Prep Lower Tray 1
6541-9-000 Triathlon Case 1
Total quantity 26

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Triathlon Revision Knee System | Surgical protocol Home Table of contents

Catalog number Description Quantity in kit

9 - 21mm Reamer Upper Tray Kit contents

6543-7-527 Boss/Offset Reamer 1

6543-7-508 8mm Starter Awl 1
6541-4-518 1/8" Drill 1
6541-4-800 T-Handle Driver 1
6541-4-801 Universal Driver 1
6541-4-809 Headless Pin Driver 1
6541-4-003 / 6541-4-003A Headless Pins - 3" 1
6543-7-509 IM Reamer - 9mm 1
6543-7-510 IM Reamer - 10mm 1
6543-7-511 IM Reamer - 11mm 1
6543-7-512 IM Reamer - 12mm 1
6543-7-513 IM Reamer - 13mm 1
6543-7-514 IM Reamer - 14mm 1
6543-7-515 IM Reamer - 15mm 1
5560-T-112 12mm x 50mm Stem Trial 2
6543-8-001 9 - 21mm Reamer Upper Tray 1
6541-4-538 3/8" IM Drill 1
6541-9-000 Triathlon Case 1
Total quantity 19

Catalog number Description Quantity in kit

9 - 21mm Reamer Lower Tray Kit contents

6543-7-516 IM Reamer - 16mm 1

6543-7-517 IM Reamer - 17mm 1
6543-7-518 IM Reamer - 18mm 1
6543-7-519 IM Reamer - 19mm 1
6543-7-520 IM Reamer - 20mm 1
6543-7-521 IM Reamer - 21mm 1
5560-T-115 Cemented Stem Trial - 15mm x 50mm 2
5571-T-025 Triathlon Stem Extender Trial - 25mm 2
5571-T-050 Triathlon Stem Extender Trial - 50mm 2
6543-8-101 9 - 21mm Reamer Lower Tray 1
6541-9-000 Triathlon Case 1
Total quantity 14

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Triathlon Revision Knee System | Surgical protocol Home Table of contents

Catalog number Description Quantity in kit

22 - 25mm Reamers and Stem Trials Tray Kit contents

6543-7-522 IM Reamer - 22mm 1

6543-7-523 IM Reamer - 23mm 1
6543-7-524 IM Reamer - 24mm 1
6543-7-525 IM Reamer - 25mm 1
5566-T-022A Triathlon Stem Trial, 22 x 150mm 1
5566-T-023A Triathlon Stem Trial, 23 x 150mm 1
5566-T-024A Triathlon Stem Trial, 24 x 150mm 1
5566-T-025A Triathlon Stem Trial, 25 x 150mm 1
5565-T-022A Triathlon Stem Trial, 22 x 100mm 1
5565-T-023A Triathlon Stem Trial, 23 x 100mm 1
5565-T-024A Triathlon Stem Trial, 24 x 100mm 1
5565-T-025A Triathlon Stem Trial, 25 x 100mm 1
6543-8-108 22 - 25mm Reamers and Stem Trials Tray 1
6541-9-000 Triathlon Case 1
Total quantity 14

Catalog number Description Quantity in kit

3 - 6 Femoral Prep Upper Tray Kit contents

6543-1-005 Distal Spacer - 5mm 2

6543-1-010 Distal Spacer - 10mm 2
6543-1-015 Distal Spacer - 15mm 2
6543-1-600 Femoral Offset Bushing 1
6543-1-603 Size 1-8 Femoral Sizing Templates 1
6543-1-703 #3 All-in-One Cutting Block 1
6543-1-704 #4 All-in-One Cutting Block 1
6543-1-705 #5 All-in-One Cutting Block 1
6543-1-706 #6 All-in-One Cutting Block 1
6543-1-710 Revision Box Cutting Guide 1
6543-1-721 Revision Distal Resection Guide 1
6543-1-750 Femoral Boss Preparation Guide 1
6543-1-751 Femoral Boss Reamer Bushing 1
6543-4-400 Joint-Line Ruler 1
6543-8-003 3 - 6 Femoral Prep Upper Tray 1
6541-9-000 Triathlon Case 1
Total quantity 19

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Catalog number Description Quantity in kit

3 - 6 TS Plus Insert Trial Tray Kit contents

5537-T-309 Triathlon TS Plus Tibial Insert Trial #3 - 9mm 1

5537-T-311 Triathlon TS Plus Tibial Insert Trial #3 - 11mm 1
5537-T-313 Triathlon TS Plus Tibial Insert Trial #3 - 13mm 1
5537-T-316 Triathlon TS Plus Tibial Insert Trial #3 - 16mm 1
5537-T-319 Triathlon TS Plus Tibial Insert Trial #3 - 19mm 1
5537-T-322 Triathlon TS Plus Tibial Insert Trial #3 - 22mm 1
5537-T-325 Triathlon TS Plus Tibial Insert Trial #3 - 25mm 1
5537-T-328 Triathlon TS Plus Tibial Insert Trial #3 - 28mm 1
5537-T-331 Triathlon TS Plus Tibial Insert Trial #3 - 31mm 1
5537-T-409 Triathlon TS Plus Tibial Insert Trial #4 - 9mm 1
5537-T-411 Triathlon TS Plus Tibial Insert Trial #4 - 11mm 1
5537-T-413 Triathlon TS Plus Tibial Insert Trial #4 - 13mm 1
5537-T-416 Triathlon TS Plus Tibial Insert Trial #4 - 16mm 1
5537-T-419 Triathlon TS Plus Tibial Insert Trial #4 - 19mm 1
5537-T-422 Triathlon TS Plus Tibial Insert Trial #4 - 22mm 1
5537-T-425 Triathlon TS Plus Tibial Insert Trial #4 - 25mm 1
5537-T-428 Triathlon TS Plus Tibial Insert Trial #4 - 28mm 1
5537-T-431 Triathlon TS Plus Tibial Insert Trial #4 - 31mm 1
5537-T-509 Triathlon TS Plus Tibial Insert Trial #5 - 9mm 1
5537-T-511 Triathlon TS Plus Tibial Insert Trial #5 - 11mm 1
5537-T-513 Triathlon TS Plus Tibial Insert Trial #5 - 13mm 1
5537-T-516 Triathlon TS Plus Tibial Insert Trial #5 - 16mm 1
5537-T-519 Triathlon TS Plus Tibial Insert Trial #5 - 19mm 1
5537-T-522 Triathlon TS Plus Tibial Insert Trial #5 - 22mm 1
5537-T-525 Triathlon TS Plus Tibial Insert Trial #5 - 25mm 1
5537-T-528 Triathlon TS Plus Tibial Insert Trial #5 - 28mm 1
5537-T-531 Triathlon TS Plus Tibial Insert Trial #5 - 31mm 1
5537-T-609 Triathlon TS Plus Tibial Insert Trial #6 - 9mm 1
5537-T-611 Triathlon TS Plus Tibial Insert Trial #6 - 11mm 1
5537-T-613 Triathlon TS Plus Tibial Insert Trial #6 - 13mm 1
5537-T-616 Triathlon TS Plus Tibial Insert Trial #6 - 16mm 1
5537-T-619 Triathlon TS Plus Tibial Insert Trial #6 - 19mm 1
5537-T-622 Triathlon TS Plus Tibial Insert Trial #6 - 22mm 1
5537-T-625 Triathlon TS Plus Tibial Insert Trial #6 - 25mm 1
5537-T-628 Triathlon TS Plus Tibial Insert Trial #6 - 28mm 1
5537-T-631 Triathlon TS Plus Tibial Insert Trial #6 - 31mm 1
6543-8-007 3 - 6 TS Plus Insert Trial Tray 1
6541-9-000 Triathlon Case 1
Total quantity 38

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Catalog number Description Quantity in kit

1, 2, 7, 8 Upper Tray Kit contents

6543-1-702 #2 All-in-One Cutting Block 1

6543-1-707 #7 All-in-One Cutting Block 1
6541-2-078 Size 7-8 Keel Punch 1
6541-2-602 #2 Universal Tibial Template 1
6541-2-607 #7 Universal Tibial Template 1
5521-T-200 #2 Baseplate Trial 1
5521-T-700 #7 Baseplate Trial 1
5512-T-201 #2 Femoral Trial Left 1
5512-T-202 #2 Femoral Trial Right 1
5512-T-701 #7 Femoral Trial Left 1
5512-T-702 #7 Femoral Trial Right 1
5540-T-200A Triathlon Femoral Distal Augment Trial, 5mm - #2 2
5540-T-700A Triathlon Femoral Distal Augment Trial, 5mm - #7 2
5541-T-200A Triathlon Femoral Distal Augment Trial, 10mm - #2 2
5541-T-700A Triathlon Femoral Distal Augment Trial, 10mm - #7 2
5542-T-200A Triathlon Femoral Distal Augment Trial, 15mm - #2 2
5542-T-700A Triathlon Femoral Distal Augment Trial, 15mm - #7 2
5543-T-200 Triathlon Femoral Posterior Augment Trial, 5mm - #2 2
5543-T-700 Triathlon Femoral Posterior Augment Trial, 5mm - #7 2
5544-T-200 Triathlon Femoral Posterior Augment Trial, 10mm - #2 2
5544-T-700 Triathlon Femoral Posterior Augment Trial, 10mm - #7 2
5545-T-701 Tibial Augment Trial #7 LM/RL - 5mm 1
5545-T-702 Tibial Augment Trial #7 RM/LL - 5mm 1
5546-T-701 Tibial Augment Trial #7 LM/RL - 10mm 1
5546-T-702 Tibial Augment Trial #7 RM/LL - 10mm 1
5545-T-201 Tibial Augment Trial #2 LM/RL - 5mm 1
5545-T-202 Tibial Augment Trial #2 RM/LL - 5mm 1
5546-T-201 Tibial Augment Trial #2 LM/RL - 10mm 1
5546-T-202 Tibial Augment Trial #2 RM/LL - 10mm 1
6543-8-009 1, 2, 7, 8 Upper Tray 1
6541-9-000 Triathlon Case 1
Total quantity 41

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Triathlon Revision Knee System | Surgical protocol Home Table of contents

Catalog number Description Quantity in kit

1, 2, 7, 8 Lower Tray Kit contents

6543-1-701 #1 All-in-One Cutting Block 1
6543-1-708 #8 All-in-One Cutting Block 1
6541-2-601 #1 Universal Tibial Template 1
6541-2-608 #8 Universal Tibial Template 1
5521-T-800 #8 Baseplate Trial 1
5521-T-100 #1 Baseplate Trial 1
5512-T-101 #1 Femoral Trial Left 1
5512-T-102 #1 Femoral Trial Right 1
5512-T-801 #8 Femoral Trial Left 1
5512-T-802 #8 Femoral Trial Right 1
5540-T-100A Triathlon Femoral Distal Augment Trial, 5mm - #1 2
5540-T-800A Triathlon Femoral Distal Augment Trial, 5mm - #8 2
5541-T-100A Triathlon Femoral Distal Augment Trial, 10mm - #1 2
5541-T-800A Triathlon Femoral Distal Augment Trial, 10mm - #8 2
5542-T-100A Triathlon Femoral Distal Augment Trial, 15mm - #1 2
5542-T-800A Triathlon Femoral Distal Augment Trial, 15mm - #8 2
5543-T-100 Triathlon Femoral Posterior Augment Trial, 5mm - #1 2
5543-T-800 Triathlon Femoral Posterior Augment Trial, 5mm - #8 2
5544-T-100 Triathlon Femoral Posterior Augment Trial, 10mm - #1 2
5544-T-800 Triathlon Femoral Posterior Augment Trial, 10mm - #8 2
5545-T-101 Tibial Augment Trial #1 LM/RL - 5mm 1
5545-T-102 Tibial Augment Trial #1 RM/LL - 5mm 1
5546-T-101 Tibial Augment Trial #1 LM/RL - 10mm 1
5546-T-102 Tibial Augment Trial #1 RM/LL - 10mm 1
5545-T-801 Tibial Augment Trial #8 LM/RL - 5mm 1
5545-T-802 Tibial Augment Trial #8 RM/LL - 5mm 1
5546-T-801 Tibial Augment Trial #8 LM/RL - 10mm 1
5546-T-802 Tibial Augment Trial #8 RM/LL - 10mm 1
6543-8-109 1, 2, 7, 8 Lower Tray 1
6541-9-000 Triathlon Case 1
Total quantity 40

Catalog number Description Quantity in kit

7, 8 TS Max Insert Trials Tray Kit contents

5537-T-722 #7 22mm TS Plus Insert Trial 1
5537-T-725 #7 25mm TS Plus Insert Trial 1
5537-T-728 #7 28mm TS Plus Insert Trial 1
5537-T-731 #7 31mm TS Plus Insert Trial 1
5537-T-822 #8 22mm TS Plus Insert Trial 1
5537-T-825 #8 25mm TS Plus Insert Trial 1
5537-T-828 #8 28mm TS Plus Insert Trial 1
5537-T-831 #8 31mm TS Plus Insert Trial 1
6543-8-013 7, 8 TS Max Insert Trials Tray 1
6541-9-000 Triathlon Case 1
Total quantity 10

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Catalog number Description Quantity in kit

3 - 6 Femoral Prep Lower Tray Kit contents

5512-T-301 TS Femoral Trials – #3 Left 1

5512-T-302 TS Femoral Trials – #3 Right 1
5512-T-401 TS Femoral Trials – #4 Left 1
5512-T-402 TS Femoral Trials – #4 Right 1
5512-T-501 TS Femoral Trials – #5 Left 1
5512-T-502 TS Femoral Trials – #5 Right 1
5512-T-601 TS Femoral Trials – #6 Left 1
5512-T-602 TS Femoral Trials – #6 Right 1
5570-T-020A Triathlon Offset Adapter Trial - 2mm 1
5570-T-040A Triathlon Offset Adapter Trial - 4mm 1
5570-T-060A Triathlon Offset Adapter Trial - 6mm 1
5570-T-080A Triathlon Offset Adapter Trial - 8mm 1
5540-T-300A Triathlon Femoral Distal Augment Trial, 5mm - #3 2
5540-T-400A Triathlon Femoral Distal Augment Trial, 5mm - #4 2
5540-T-500A Triathlon Femoral Distal Augment Trial, 5mm - #5 2
5540-T-600A Triathlon Femoral Distal Augment Trial, 5mm - #6 2
5541-T-300A Triathlon Femoral Distal Augment Trial, 10mm - #3 2
5541-T-400A Triathlon Femoral Distal Augment Trial, 10mm - #4 2
5541-T-500A Triathlon Femoral Distal Augment Trial, 10mm - #5 2
5541-T-600A Triathlon Femoral Distal Augment Trial, 10mm - #6 2
5542-T-300A Triathlon Femoral Distal Augment Trial, 15mm - #3 2
5542-T-400A Triathlon Femoral Distal Augment Trial, 15mm - #4 2
5542-T-500A Triathlon Femoral Distal Augment Trial, 15mm - #5 2
5542-T-600A Triathlon Femoral Distal Augment Trial, 15mm - #6 2
5543-T-300 Triathlon Femoral Posterior Augment Trial, 5mm - #3 2
5543-T-400 Triathlon Femoral Posterior Augment Trial, 5mm - #4 2
5543-T-500 Triathlon Femoral Posterior Augment Trial, 5mm - #5 2
5543-T-600 Triathlon Femoral Posterior Augment Trial, 5mm - #6 2
5544-T-300 Triathlon Femoral Posterior Augment Trial, 10mm - #3 2
5544-T-400 Triathlon Femoral Posterior Augment Trial, 10mm - #4 2
5544-T-500 Triathlon Femoral Posterior Augment Trial, 10mm - #5 2
5544-T-600 Triathlon Femoral Posterior Augment Trial, 10mm - #6 2
6543-8-103 3 - 6 Femoral Prep Lower Tray 1
6541-9-000 Triathlon Case 1
Total quantity 54

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Catalog number Description Quantity in kit

9 - 21mm Stem Trial Tray Kit contents

5565-T-009A Triathlon Stem Trial, 9 x 100mm 1

5565-T-010A Triathlon Stem Trial, 10 x 100mm 1
5565-T-011A Triathlon Stem Trial, 11 x 100mm 2
5565-T-012A Triathlon Stem Trial, 12 x 100mm 2
5565-T-013A Triathlon Stem Trial, 13 x 100mm 2
5565-T-014A Triathlon Stem Trial, 14 x 100mm 2
5565-T-015A Triathlon Stem Trial, 15 x 100mm 2
5565-T-016A Triathlon Stem Trial, 16 x 100mm 2
5565-T-017A Triathlon Stem Trial, 17 x 100mm 2
5565-T-018A Triathlon Stem Trial, 18 x 100mm 2
5565-T-019A Triathlon Stem Trial, 19 x 100mm 2
5565-T-020A Triathlon Stem Trial, 20 x 100mm 2
5565-T-021A Triathlon Stem Trial, 21 x 100mm 2
5566-T-009A Triathlon Stem Trial, 9 x 150mm 1
5566-T-010A Triathlon Stem Trial, 10 x 150mm 1
5566-T-011A Triathlon Stem Trial, 11 x 150mm 2
5566-T-012A Triathlon Stem Trial, 12 x 150mm 2
5566-T-013A Triathlon Stem Trial, 13 x 150mm 2
5566-T-014A Triathlon Stem Trial, 14 x 150mm 2
5566-T-015A Triathlon Stem Trial, 15 x 150mm 2
5566-T-016A Triathlon Stem Trial, 16 x 150mm 2
5566-T-017A Triathlon Stem Trial, 17 x 150mm 2
5566-T-018A Triathlon Stem Trial, 18 x 150mm 2
5566-T-019A Triathlon Stem Trial, 19 x 150mm 2
5566-T-020A Triathlon Stem Trial, 20 x 150mm 2
5566-T-021A Triathlon Stem Trial, 21 x 150mm 2
6543-8-005 9 - 21mm Stem Trial Upper Tray 1
6543-8-105 9 - 21mm Stem Trial Lower Tray 1
6541-9-000 Triathlon Case 1
Total quantity 51

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Catalog number Description Quantity in kit

1, 2, 7, 8 TS Plus Insert Trials Tray Kit contents

5537-T-809 #8 9mm TS Plus Insert Trial 1

5537-T-811 #8 11mm TS Plus Insert Trial 1
5537-T-813 #8 13mm TS Plus Insert Trial 1
5537-T-816 #8 16mm TS Plus Insert Trial 1
5537-T-819 #8 19mm TS Plus Insert Trial 1
5537-T-709 #7 9mm TS Plus Insert Trial 1
5537-T-711 #7 11mm TS Plus Insert Trial 1
5537-T-713 #7 13mm TS Plus Insert Trial 1
5537-T-716 #7 16mm TS Plus Insert Trial 1
5537-T-719 #7 19mm TS Plus Insert Trial 1
5537-T-209 #2 9mm TS Plus Insert Trial 1
5537-T-211 #2 11mm TS Plus Insert Trial 1
5537-T-213 #2 13mm TS Plus Insert Trial 1
5537-T-216 #2 16mm TS Plus Insert Trial 1
5537-T-219 #2 19mm TS Plus Insert Trial 1
5537-T-222 #2 22mm TS Plus Insert Trial 1
5537-T-225 #2 25mm TS Plus Insert Trial 1
5537-T-228 #2 28mm TS Plus Insert Trial 1
5537-T-231 #2 31mm TS Plus Insert Trial 1
5537-T-109 #1 9mm TS Plus Insert Trial 1
5537-T-111 #1 11mm TS Plus Insert Trial 1
5537-T-113 #1 13mm TS Plus Insert Trial 1
5537-T-116 #1 16mm TS Plus Insert Trial 1
5537-T-119 #1 19mm TS Plus Insert Trial 1
5537-T-122 #1 22mm TS Plus Insert Trial 1
5537-T-125 #1 25mm TS Plus Insert Trial 1
5537-T-128 #1 28mm TS Plus Insert Trial 1
5537-T-131 #1 31mm TS Plus Insert Trial 1
6543-8-011 1, 2, 7, 8 TS Plus Insert Trials Tray 1
6541-9-000 Triathlon Case 1
Total quantity 30

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Catalog number Description

Triathlon TS Plus Tibial Insert part numbers

5537-G-109 or 5537-G-109-E TS Plus Tibial Insert - X3 Poly #1 - 9mm

5537-G-111 or 5537-G-111-E TS Plus Tibial Insert - X3 Poly #1 - 11mm
5537-G-113 or 5537-G-113-E TS Plus Tibial Insert - X3 Poly #1 - 13mm
5537-G-116 or 5537-G-116-E TS Plus Tibial Insert - X3 Poly #1 - 16mm
5537-G-119 or 5537-G-119-E TS Plus Tibial Insert - X3 Poly #1 - 19mm
5537-G-122 or 5537-G-122-E TS Plus Tibial Insert - X3 Poly #1 - 22mm
5537-G-125 or 5537-G-125-E TS Plus Tibial Insert - X3 Poly #1 - 25mm
5537-G-128 or 5537-G-128-E TS Plus Tibial Insert - X3 Poly #1 - 28mm
5537-G-131 or 5537-G-131-E TS Plus Tibial Insert - X3 Poly #1 - 31mm

5537-G-209 or 5537-G-209-E TS Plus Tibial Insert - X3 Poly #2 - 9mm

5537-G-211 or 5537-G-211-E TS Plus Tibial Insert - X3 Poly #2 - 11mm
5537-G-213 or 5537-G-213-E TS Plus Tibial Insert - X3 Poly #2 - 13mm
5537-G-216 or 5537-G-216-E TS Plus Tibial Insert - X3 Poly #2 - 16mm
5537-G-219 or 5537-G-219-E TS Plus Tibial Insert - X3 Poly #2 - 19mm
5537-G-222 or 5537-G-222-E TS Plus Tibial Insert - X3 Poly #2 - 22mm
5537-G-225 or 5537-G-225-E TS Plus Tibial Insert - X3 Poly #2 - 25mm
5537-G-228 or 5537-G-228-E TS Plus Tibial Insert - X3 Poly #2 - 28mm
5537-G-231 or 5537-G-231-E TS Plus Tibial Insert - X3 Poly #2 - 31mm

5537-G-309 or 5537-G-309-E TS Plus Tibial Insert - X3 Poly #3 - 9mm

5537-G-311 or 5537-G-311-E TS Plus Tibial Insert - X3 Poly #3 - 11mm
5537-G-313 or 5537-G-313-E TS Plus Tibial Insert - X3 Poly #3 - 13mm
5537-G-316 or 5537-G-316-E TS Plus Tibial Insert - X3 Poly #3 - 16mm
5537-G-319 or 5537-G-319-E TS Plus Tibial Insert - X3 Poly #3 - 19mm
5537-G-322 or 5537-G-322-E TS Plus Tibial Insert - X3 Poly #3 - 22mm
5537-G-325 or 5537-G-325-E TS Plus Tibial Insert - X3 Poly #3 - 25mm
5537-G-328 or 5537-G-328-E TS Plus Tibial Insert - X3 Poly #3 - 28mm
5537-G-331 or 5537-G-331-E TS Plus Tibial Insert - X3 Poly #3 - 31mm

5537-G-409 or 5537-G-409-E TS Plus Tibial Insert - X3 Poly #4 - 9mm

5537-G-411 or 5537-G-411-E TS Plus Tibial Insert - X3 Poly #4 - 11mm
5537-G-413 or 5537-G-413-E TS Plus Tibial Insert - X3 Poly #4 - 13mm
5537-G-416 or 5537-G-416-E TS Plus Tibial Insert - X3 Poly #4 - 16mm
5537-G-419 or 5537-G-419-E TS Plus Tibial Insert - X3 Poly #4 - 19mm
5537-G-422 or 5537-G-422-E TS Plus Tibial Insert - X3 Poly #4 - 22mm
5537-G-425 or 5537-G-425-E TS Plus Tibial Insert - X3 Poly #4 - 25mm
5537-G-428 or 5537-G-428-E TS Plus Tibial Insert - X3 Poly #4 - 28mm
5537-G-431 or 5537-G-431-E TS Plus Tibial Insert - X3 Poly #4 - 31mm
(Continued)

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Catalog number Description

Triathlon TS Plus Tibial Insert part numbers - continued

5537-G-509 or 5537-G-509-E TS Plus Tibial Insert - X3 Poly #5 - 9mm

5537-G-511 or 5537-G-511-E TS Plus Tibial Insert - X3 Poly #5 - 11mm
5537-G-513 or 5537-G-513-E TS Plus Tibial Insert - X3 Poly #5 - 13mm
5537-G-516 or 5537-G-516-E TS Plus Tibial Insert - X3 Poly #5 - 16mm
5537-G-519 or 5537-G-519-E TS Plus Tibial Insert - X3 Poly #5 - 19mm
5537-G-522 or 5537-G-522-E TS Plus Tibial Insert - X3 Poly #5 - 22mm
5537-G-525 or 5537-G-525-E TS Plus Tibial Insert - X3 Poly #5 - 25mm
5537-G-528 or 5537-G-528-E TS Plus Tibial Insert - X3 Poly #5 - 28mm
5537-G-531 or 5537-G-531-E TS Plus Tibial Insert - X3 Poly #5 - 31mm

5537-G-609 or 5537-G-609-E TS Plus Tibial Insert - X3 Poly #6 - 9mm

5537-G-611 or 5537-G-611-E TS Plus Tibial Insert - X3 Poly #6 - 11mm
5537-G-613 or 5537-G-613-E TS Plus Tibial Insert - X3 Poly #6 - 13mm
5537-G-616 or 5537-G-616-E TS Plus Tibial Insert - X3 Poly #6 - 16mm
5537-G-619 or 5537-G-619-E TS Plus Tibial Insert - X3 Poly #6 - 19mm
5537-G-622 or 5537-G-622-E TS Plus Tibial Insert - X3 Poly #6 - 22mm
5537-G-625 or 5537-G-625-E TS Plus Tibial Insert - X3 Poly #6 - 25mm
5537-G-628 or 5537-G-628-E TS Plus Tibial Insert - X3 Poly #6 - 28mm
5537-G-631 or 5537-G-631-E TS Plus Tibial Insert - X3 Poly #6 - 31mm

5537-G-709 or 5537-G-709-E TS Plus Tibial Insert - X3 Poly #7 - 9mm

5537-G-711 or 5537-G-711-E TS Plus Tibial Insert - X3 Poly #7 - 11mm
5537-G-713 or 5537-G-713-E TS Plus Tibial Insert - X3 Poly #7 - 13mm
5537-G-716 or 5537-G-716-E TS Plus Tibial Insert - X3 Poly #7 - 16mm
5537-G-719 or 5537-G-719-E TS Plus Tibial Insert - X3 Poly #7 - 19mm
5537-G-722 or 5537-G-722-E TS Plus Tibial Insert - X3 Poly #7 - 22mm
5537-G-725 or 5537-G-725-E TS Plus Tibial Insert - X3 Poly #7 - 25mm
5537-G-728 or 5537-G-728-E TS Plus Tibial Insert - X3 Poly #7 - 28mm
5537-G-731 or 5537-G-731-E TS Plus Tibial Insert - X3 Poly #7 - 31mm

5537-G-809 or 5537-G-809-E TS Plus Tibial Insert - X3 Poly #8 - 9mm

5537-G-811 or 5537-G-811-E TS Plus Tibial Insert - X3 Poly #8 - 11mm
5537-G-813 or 5537-G-813-E TS Plus Tibial Insert - X3 Poly #8 - 13mm
5537-G-816 or 5537-G-816-E TS Plus Tibial Insert - X3 Poly #8 - 16mm
5537-G-819 or 5537-G-819-E TS Plus Tibial Insert - X3 Poly #8 - 19mm
5537-G-822 or 5537-G-822-E TS Plus Tibial Insert - X3 Poly #8 - 22mm
5537-G-825 or 5537-G-825-E TS Plus Tibial Insert - X3 Poly #8 - 25mm
5537-G-828 or 5537-G-828-E TS Plus Tibial Insert - X3 Poly #8 - 28mm
5537-G-831 or 5537-G-831-E TS Plus Tibial Insert - X3 Poly #8 - 31mm

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Catalog number Description

Triathlon Universal Tibial Baseplate part numbers

5521-B-100 Universal Tibial Baseplate #1

5521-B-200 Universal Tibial Baseplate #2
5521-B-300 Universal Tibial Baseplate #3
5521-B-400 Universal Tibial Baseplate #4
5521-B-500 Universal Tibial Baseplate #5
5521-B-600 Universal Tibial Baseplate #6
5521-B-700 Universal Tibial Baseplate #7
5521-B-800 Universal Tibial Baseplate #8

Catalog number Description

Triathlon TS Femoral Component part numbers

5512-F-101 TS Femoral Component #1 Left

5512-F-201 TS Femoral Component #2 Left
5512-F-301 TS Femoral Component #3 Left
5512-F-401 TS Femoral Component #4 Left
5512-F-501 TS Femoral Component #5 Left
5512-F-601 TS Femoral Component #6 Left
5512-F-701 TS Femoral Component #7 Left
5512-F-801 TS Femoral Component #8 Left
5512-F-102 TS Femoral Component #1 Right
5512-F-202 TS Femoral Component #2 Right
5512-F-302 TS Femoral Component #3 Right
5512-F-402 TS Femoral Component #4 Right
5512-F-502 TS Femoral Component #5 Right
5512-F-602 TS Femoral Component #6 Right
5512-F-702 TS Femoral Component #7 Right
5512-F-802 TS Femoral Component #8 Right

Catalog number Description

Triathlon TS Stems - Cemented - part numbers

5560-S-109 Triathlon Cemented Stem 9mm x 50mm

5560-S-209 Triathlon Cemented Stem 9mm x 100mm
5560-S-309 Triathlon Cemented Stem 9mm x 150mm
5560-S-112 Triathlon Cemented Stem 12mm x 50mm
5560-S-212 Triathlon Cemented Stem 12mm x 100mm
5560-S-312 Triathlon Cemented Stem 12mm x 150mm
5560-S-115 Triathlon Cemented Stem 15mm x 50mm
5560-S-215 Triathlon Cemented Stem 15mm x 100mm
5560-S-315 Triathlon Cemented Stem 15mm x 150mm
All items are made of CoCr unless otherwise stated.

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Catalog number Description

Triathlon TS Stems - Cementless - part numbers

5565-S-010 Triathlon Fluted Stem, Titanium 10mm x 100mm

5565-S-011 Triathlon Fluted Stem, Titanium 11mm x 100mm
5565-S-012 Triathlon Fluted Stem, Titanium 12mm x 100mm
5565-S-013 Triathlon Fluted Stem, Titanium 13mm x 100mm
5565-S-014 Triathlon Fluted Stem, Titanium 14mm x 100mm
5565-S-015 Triathlon Fluted Stem, Titanium 15mm x 100mm
5565-S-016 Triathlon Fluted Stem, Titanium 16mm x 100mm
5565-S-017 Triathlon Fluted Stem, Titanium 17mm x 100mm
5565-S-018 Triathlon Fluted Stem, Titanium 18mm x 100mm
5565-S-019 Triathlon Fluted Stem, Titanium 19mm x 100mm
5565-S-020 Triathlon Fluted Stem, Titanium 20mm x 100mm
5565-S-021 Triathlon Fluted Stem, Titanium 21mm x 100mm
5565-S-022 Triathlon Fluted Stem, Titanium 22mm x 100mm
5565-S-023 Triathlon Fluted Stem, Titanium 23mm x 100mm
5565-S-024 Triathlon Fluted Stem, Titanium 24mm x 100mm
5565-S-025 Triathlon Fluted Stem, Titanium 25mm x 100mm
5566-S-010 Triathlon Fluted Stem, Titanium 10mm x 150mm
5566-S-011 Triathlon Fluted Stem, Titanium 11mm x 150mm
5566-S-012 Triathlon Fluted Stem, Titanium 12mm x 150mm
5566-S-013 Triathlon Fluted Stem, Titanium 13mm x 150mm
5566-S-014 Triathlon Fluted Stem, Titanium 14mm x 150mm
5566-S-015 Triathlon Fluted Stem, Titanium 15mm x 150mm
5566-S-016 Triathlon Fluted Stem, Titanium 16mm x 150mm
5566-S-017 Triathlon Fluted Stem, Titanium 17mm x 150mm
5566-S-018 Triathlon Fluted Stem, Titanium 18mm x 150mm
5566-S-019 Triathlon Fluted Stem, Titanium 19mm x 150mm
5566-S-020 Triathlon Fluted Stem, Titanium 20mm x 150mm
5566-S-021 Triathlon Fluted Stem, Titanium 21mm x 150mm
5566-S-022 Triathlon Fluted Stem, Titanium 22mm x 150mm
5566-S-023 Triathlon Fluted Stem, Titanium 23mm x 150mm
5566-S-024 Triathlon Fluted Stem, Titanium 24mm x 150mm
5566-S-025 Triathlon Fluted Stem, Titanium 25mm x 150mm

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Catalog number Description

Triathlon TS Tibial Augment part numbers

5545-A-101 Triathlon Tibial Augment - 5mm #1 LM/RL

5545-A-201 Triathlon Tibial Augment - 5mm #2 LM/RL
5545-A-301 Triathlon Tibial Augment - 5mm #3 LM/RL
5545-A-401 Triathlon Tibial Augment - 5mm #4 LM/RL
5545-A-501 Triathlon Tibial Augment - 5mm #5 LM/RL
5545-A-601 Triathlon Tibial Augment - 5mm #6 LM/RL
5545-A-701 Triathlon Tibial Augment - 5mm #7 LM/RL
5545-A-801 Triathlon Tibial Augment - 5mm #8 LM/RL
5545-A-102 Triathlon Tibial Augment - 5mm #1 RM/LL
5545-A-202 Triathlon Tibial Augment - 5mm #2 RM/LL
5545-A-302 Triathlon Tibial Augment - 5mm #3 RM/LL
5545-A-402 Triathlon Tibial Augment - 5mm #4 RM/LL
5545-A-502 Triathlon Tibial Augment - 5mm #5 RM/LL
5545-A-602 Triathlon Tibial Augment - 5mm #6 RM/LL
5545-A-702 Triathlon Tibial Augment - 5mm #7 RM/LL
5545-A-802 Triathlon Tibial Augment - 5mm #8 RM/LL
5546-A-101 Triathlon Tibial Augment - 10mm #1 LM/RL
5546-A-201 Triathlon Tibial Augment - 10mm #2 LM/RL
5546-A-301 Triathlon Tibial Augment - 10mm #3 LM/RL
5546-A-401 Triathlon Tibial Augment - 10mm #4 LM/RL
5546-A-501 Triathlon Tibial Augment - 10mm #5 LM/RL
5546-A-601 Triathlon Tibial Augment - 10mm #6 LM/RL
5546-A-701 Triathlon Tibial Augment - 10mm #7 LM/RL
5546-A-801 Triathlon Tibial Augment - 10mm #8 LM/RL
5546-A-102 Triathlon Tibial Augment - 10mm #1 RM/LL
5546-A-202 Triathlon Tibial Augment - 10mm #2 RM/LL
5546-A-302 Triathlon Tibial Augment - 10mm #3 RM/LL
5546-A-402 Triathlon Tibial Augment - 10mm #4 RM/LL
5546-A-502 Triathlon Tibial Augment - 10mm #5 RM/LL
5546-A-602 Triathlon Tibial Augment - 10mm #6 RM/LL
5546-A-702 Triathlon Tibial Augment - 10mm #7 RM/LL
5546-A-802 Triathlon Tibial Augment - 10mm #8 RM/LL
LM-RL = Left Medial/Right Lateral RM/LL = Right Medial/Left Lateral

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Catalog number Description

Triathlon TS Femoral Augment part numbers

5540-A-101 Triathlon Femoral Distal Augment - 5mm #1 Left

5540-A-201 Triathlon Femoral Distal Augment - 5mm #2 Left
5540-A-301 Triathlon Femoral Distal Augment - 5mm #3 Left
5540-A-401 Triathlon Femoral Distal Augment - 5mm #4 Left
5540-A-501 Triathlon Femoral Distal Augment - 5mm #5 Left
5540-A-601 Triathlon Femoral Distal Augment - 5mm #6 Left
5540-A-701 Triathlon Femoral Distal Augment - 5mm #7 Left
5540-A-801 Triathlon Femoral Distal Augment - 5mm #8 Left
5540-A-102 Triathlon Femoral Distal Augment - 5mm #1 Right
5540-A-202 Triathlon Femoral Distal Augment - 5mm #2 Right
5540-A-302 Triathlon Femoral Distal Augment - 5mm #3 Right
5540-A-402 Triathlon Femoral Distal Augment - 5mm #4 Right
5540-A-502 Triathlon Femoral Distal Augment - 5mm #5 Right
5540-A-602 Triathlon Femoral Distal Augment - 5mm #6 Right
5540-A-702 Triathlon Femoral Distal Augment - 5mm #7 Right
5540-A-802 Triathlon Femoral Distal Augment - 5mm #8 Right
5541-A-101 Triathlon Femoral Distal Augment - 10mm #1 Left
5541-A-201 Triathlon Femoral Distal Augment - 10mm #2 Left
5541-A-301 Triathlon Femoral Distal Augment - 10mm #3 Left
5541-A-401 Triathlon Femoral Distal Augment - 10mm #4 Left
5541-A-501 Triathlon Femoral Distal Augment - 10mm #5 Left
5541-A-601 Triathlon Femoral Distal Augment - 10mm #6 Left
5541-A-701 Triathlon Femoral Distal Augment - 10mm #7 Left
5541-A-801 Triathlon Femoral Distal Augment - 10mm #8 Left
5541-A-102 Triathlon Femoral Distal Augment - 10mm #1 Right
5541-A-202 Triathlon Femoral Distal Augment - 10mm #2 Right
5541-A-302 Triathlon Femoral Distal Augment - 10mm #3 Right
5541-A-402 Triathlon Femoral Distal Augment - 10mm #4 Right
5541-A-502 Triathlon Femoral Distal Augment - 10mm #5 Right
5541-A-602 Triathlon Femoral Distal Augment - 10mm #6 Right
5541-A-702 Triathlon Femoral Distal Augment - 10mm #7 Right
5541-A-802 Triathlon Femoral Distal Augment - 10mm #8 Right
(Continued)

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Catalog number Description

Triathlon TS Femoral Augment part numbers - continued

5542-A-101 Triathlon Femoral Distal Augment - 15mm #1 Left
5542-A-201 Triathlon Femoral Distal Augment - 15mm #2 Left
5542-A-301 Triathlon Femoral Distal Augment - 15mm #3 Left
5542-A-401 Triathlon Femoral Distal Augment - 15mm #4 Left
5542-A-501 Triathlon Femoral Distal Augment - 15mm #5 Left
5542-A-601 Triathlon Femoral Distal Augment - 15mm #6 Left
5542-A-701 Triathlon Femoral Distal Augment - 15mm #7 Left
5542-A-801 Triathlon Femoral Distal Augment - 15mm #8 Left
5542-A-102 Triathlon Femoral Distal Augment - 15mm #1 Right
5542-A-202 Triathlon Femoral Distal Augment - 15mm #2 Right
5542-A-302 Triathlon Femoral Distal Augment - 15mm #3 Right
5542-A-402 Triathlon Femoral Distal Augment - 15mm #4 Right
5542-A-502 Triathlon Femoral Distal Augment - 15mm #5 Right
5542-A-602 Triathlon Femoral Distal Augment - 15mm #6 Right
5542-A-702 Triathlon Femoral Distal Augment - 15mm #7 Right
5542-A-802 Triathlon Femoral Distal Augment - 15mm #8 Right
5543-A-100 Triathlon Femoral Posterior Augment, 5mm - Size 1
5543-A-200 Triathlon Femoral Posterior Augment, 5mm - Size 2
5543-A-300 Triathlon Femoral Posterior Augment, 5mm - Size 3
5543-A-400 Triathlon Femoral Posterior Augment, 5mm - Size 4
5543-A-500 Triathlon Femoral Posterior Augment, 5mm - Size 5
5543-A-600 Triathlon Femoral Posterior Augment, 5mm - Size 6
5543-A-700 Triathlon Femoral Posterior Augment, 5mm - Size 7
5543-A-800 Triathlon Femoral Posterior Augment, 5mm - Size 8
5544-A-100 Triathlon Femoral Posterior Augment, 10mm - Size 1
5544-A-200 Triathlon Femoral Posterior Augment, 10mm - Size 2
5544-A-300 Triathlon Femoral Posterior Augment, 10mm - Size 3
5544-A-400 Triathlon Femoral Posterior Augment, 10mm - Size 4
5544-A-500 Triathlon Femoral Posterior Augment, 10mm - Size 5
5544-A-600 Triathlon Femoral Posterior Augment, 10mm - Size 6
5544-A-700 Triathlon Femoral Posterior Augment, 10mm - Size 7
5544-A-800 Triathlon Femoral Posterior Augment, 10mm - Size 8

Catalog number Description

Triathlon TS Stem Extender part numbers

5571-S-025 Triathlon Stem Extender 25mm

5571-S-050 Triathlon Stem Extender 50mm

Catalog number Description

Triathlon TS Offset Adapter part numbers

5570-S-020 Triathlon TS Offset Adapter 2mm

5570-S-040 Triathlon TS Offset Adapter 4mm
5570-S-060 Triathlon TS Offset Adapter 6mm
5570-S-080 Triathlon TS Offset Adapter 8mm

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Triathlon Tritanium Cone Augment instruments

Catalog number Description Quantity in kit

Tibial Cone Upper Tray part numbers

6543-5-200 Tibial Symmetric Cone Reamer 1

6543-5-220 Tibial Asymmetric Cone Reamer Size B 1
6543-5-230 Tibial Asymmetric Cone Reamer Size C 1
6543-5-240 Tibial Asymmetric Cone Reamer Size D 1
6543-5-250 Tibial Asymmetric Cone Reamer Size E 1
6543-5-201 Tibial Cone Reamer Guide LM/RL 1
6543-5-202 Tibial Cone Reamer Guide RM/LL 1
6543-5-203 Tibial Cone Alignment Guide 1
6543-8-017 Tibial Cone Upper Tray 1

Catalog number Description Quantity in kit

Tibial Cone Lower Tray part numbers

6543-5-211 Tibial Cone Introducer Size A 1

6543-5-221 Tibial Cone Introducer Size B 1
6543-5-231 Tibial Cone Introducer Size C 1
6543-5-241 Tibial Cone Introducer Size D 1
6543-5-251 Tibial Cone Introducer Size E 1
6541-5-100 Cone Extractor 1
5549-T-110 Tibial Symmetric Cone Augment Trial Size A 1
5549-T-120 Tibial Symmetric Cone Augment Trial Size B 1
5549-T-130 Tibial Symmetric Cone Augment Trial Size C 1
5549-T-140 Tibial Symmetric Cone Augment Trial Size D 1
5549-T-150 Tibial Symmetric Cone Augment Trial Size E 1
5549-T-221 Tibial Asymmetric Cone Augment Trial Size B LM/RL 1
5549-T-222 Tibial Asymmetric Cone Augment Trial Size B RM/LL 1
5549-T-231 Tibial Asymmetric Cone Augment Trial Size C LM/RL 1
5549-T-232 Tibial Asymmetric Cone Augment Trial Size C RM/LL 1
5549-T-241 Tibial Asymmetric Cone Augment Trial Size D LM/RL 1
5549-T-242 Tibial Asymmetric Cone Augment Trial Size D RM/LL 1
5549-T-251 Tibial Asymmetric Cone Augment Trial Size E LM/RL 1
5549-T-252 Tibial Asymmetric Cone Augment Trial Size E RM/LL 1
6543-8-117 Tibial Cone Lower Tray 1
5900-8114 Stryker Case 1

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Catalog number Description Quantity in kit

Femoral Cone Prep. 1 Tray part numbers

6543-5-300 Femoral Symmetric Cone Reamer 1

6543-5-301 Femoral Cone Reamer Guide 1
6543-5-303 Femoral Cone Alignment Guide 1
6543-5-304 Femoral Cone Introducer 1
6541-5-100 Cone Extractor 1
5549-T-321 Femoral Cone Augment Trial Size 1 & 2 Left 1
5549-T-322 Femoral Cone Augment Trial Size 1 & 2 Right 1
5549-T-331 Femoral Cone Augment Trial Size 3 Left 1
5549-T-332 Femoral Cone Augment Trial Size 3 Right 1
5549-T-341 Femoral Cone Augment Trial Size 4 Left 1
5549-T-342 Femoral Cone Augment Trial Size 4 Right 1
5549-T-351 Femoral Cone Augment Trial Size 5 Left 1
5549-T-352 Femoral Cone Augment Trial Size 5 Right 1
5549-T-361 Femoral Cone Augment Trial Size 6 Left 1
5549-T-362 Femoral Cone Augment Trial Size 6 Right 1
5549-T-371 Femoral Cone Augment Trial Size 7 & 8 Left 1
5549-T-372 Femoral Cone Augment Trial Size 7 & 8 Right 1
6543-8-118 Femoral Cone Prep. 1 Tray 1
1020-9000 Single Tray Case 1

Catalog number Description Quantity in kit

Femoral Cone Prep. 2 Tray part numbers

6543-5-302 Femoral Cone Handle 1

6543-5-321 Femoral Cone Stabilizer Size 1 & 2 1
6543-5-331 Femoral Cone Stabilizer Size 3 1
6543-5-341 Femoral Cone Stabilizer Size 4 1
6543-5-351 Femoral Cone Stabilizer Size 5 1
6543-5-361 Femoral Cone Stabilizer Size 6 1
6543-5-371 Femoral Cone Stabilizer Size 7 & 8 1
6543-5-320 Femoral Cone Reamer Size 1 & 2 1
6543-5-330 Femoral Cone Reamer Size 3 1
6543-5-340 Femoral Cone Reamer Size 4 1
6543-5-350 Femoral Cone Reamer Size 5 1
6543-5-360 Femoral Cone Reamer Size 6 1
6543-5-370 Femoral Cone Reamer Size 7 & 8 1
6543-8-018 Femoral Cone Prep. 2 Tray 1
1020-9000 Single Tray Case 1

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Triathlon Revision Knee System | Surgical protocol Home Table of contents

Catalog number Description Quantity in kit

Central Femoral Cone Tray part numbers

6543-6-128 Central Femoral Cone Introducer Size 1 - 4 1

6543-6-129 Central Femoral Cone Introducer Size 5 - 8 1
6543-6-130 TS Central Femoral Cone Reamer 1
6543-6-131 Central Femoral Cone Augment Trial Size 1-2, Left 1
6543-6-132 Central Femoral Cone Augment Trial Size 1-2, Right 1
6543-6-135 Central Femoral Cone Augment Trial Size 3-4, Left 1
6543-6-136 Central Femoral Cone Augment Trial Size 3-4, Right 1
6543-6-137 Central Femoral Cone Augment Trial Size 5, Left 1
6543-6-138 Central Femoral Cone Augment Trial Size 5, Right 1
6543-6-139 Central Femoral Cone Augment Trial Size 6, Left 1
6543-6-140 Central Femoral Cone Augment Trial Size 6, Right 1
6543-6-141 Central Femoral Cone Augment Trial Size 7-8, Left 1
6543-6-142 Central Femoral Cone Augment Trial Size 7-8, Right 1
6541-5-100 Cone Extractor 1
6543-6-960 Triathlon Tritanium Central Femoral Cone Preparation Tray 1

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Triathlon Revision Knee System | Surgical protocol Home Table of contents

Triathlon Tritanium Cone Augment implants

Catalog number Description

Triathlon Tritanium Cone Augments part numbers

5549-A-110 Triathlon Tritanium Symmetric Cone Augment Size A

5549-A-120 Triathlon Tritanium Symmetric Cone Augment Size B
5549-A-130 Triathlon Tritanium Symmetric Cone Augment Size C
5549-A-140 Triathlon Tritanium Symmetric Cone Augment Size D
5549-A-150 Triathlon Tritanium Symmetric Cone Augment Size E
5549-A-221 Triathlon Tritanium Asymmetric Cone Augment Size B LM/RL
5549-A-222 Triathlon Tritanium Asymmetric Cone Augment Size B RM/LL
5549-A-231 Triathlon Tritanium Asymmetric Cone Augment Size C LM/RL
5549-A-232 Triathlon Tritanium Asymmetric Cone Augment Size C RM/LL
5549-A-241 Triathlon Tritanium Asymmetric Cone Augment Size D LM/RL
5549-A-242 Triathlon Tritanium Asymmetric Cone Augment Size D RM/LL
5549-A-251 Triathlon Tritanium Asymmetric Cone Augment Size E LM/RL
5549-A-252 Triathlon Tritanium Asymmetric Cone Augment Size E RM/LL
5549-A-321 Triathlon Tritanium Femoral Cone Augment Size 1 & 2 Left
5549-A-322 Triathlon Tritanium Femoral Cone Augment Size 1 & 2 Right
5549-A-331 Triathlon Tritanium Femoral Cone Augment Size 3 Left
5549-A-332 Triathlon Tritanium Femoral Cone Augment Size 3 Right
5549-A-341 Triathlon Tritanium Femoral Cone Augment Size 4 Left
5549-A-342 Triathlon Tritanium Femoral Cone Augment Size 4 Right
5549-A-351 Triathlon Tritanium Femoral Cone Augment Size 5 Left
5549-A-352 Triathlon Tritanium Femoral Cone Augment Size 5 Right
5549-A-361 Triathlon Tritanium Femoral Cone Augment Size 6 Left
5549-A-362 Triathlon Tritanium Femoral Cone Augment Size 6 Right
5549-A-371 Triathlon Tritanium Femoral Cone Augment Size 7 & 8 Left
5549-A-372 Triathlon Tritanium Femoral Cone Augment Size 7 & 8 Right
5549-A-621 Triathlon Tritanium Central Femoral Cone Augment Size 1&2 Left
5549-A-622 Triathlon Tritanium Central Femoral Cone Augment Size 1&2 Right
5549-A-641 Triathlon Tritanium Central Femoral Cone Augment Size 3&4 Left
5549-A-642 Triathlon Tritanium Central Femoral Cone Augment Size 3&4 Right
5549-A-651 Triathlon Tritanium Central Femoral Cone Augment Size 5 Left
5549-A-652 Triathlon Tritanium Central Femoral Cone Augment Size 5 Right
5549-A-661 Triathlon Tritanium Central Femoral Cone Augment Size 6 Left
5549-A-662 Triathlon Tritanium Central Femoral Cone Augment Size 6 Right
5549-A-671 Triathlon Tritanium Central Femoral Cone Augment Size 7&8 Left
5549-A-672 Triathlon Tritanium Central Femoral Cone Augment Size 7&8 Right
LTEMK39 Triathlon TS X-Ray Templates
LTEMK45 Triathlon Tritanium Cones X-Ray Templates

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 2797

This document is intended solely for healthcare professionals. Howmedica Osteonics Corp.
A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when 325 Corporate Drive
treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular Mahwah, NJ 07430, USA
product before using it in surgery. A subsidiary of Stryker Corporation
t: 201 831 5000
The information presented is intended to demonstrate the breadth of Stryker’s product offerings. A surgeon must always refer to the package
insert, product label and/or instructions for use before using any of Stryker’s products. Except where noted, the products depicted are CE stryker.com
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