Freedom®

Constrained Liner
Surgical Technique
 1 | Freedom Constrained Liner Surgical Technique

Constrained Liner Options

Freedom Standard Freedom 10 Degree Freedom +5 mm Freedom

Face Constrained Liner Constrained Liner Standard Face All-Polyethylene
Constrained Liner Constrained Liner

Product Description
The Freedom Constrained Liner System is
manufactured from AArcom® Ultra High Molecular
Weight Polyethylene and is intended for patients
that have a high risk of dislocation due to a previous
history of dislocation, severe joint laxity and/or palsy
of surrounding musculature.

With the exception of the Freedom All-Polyethylene

Liners, the Freedom Constrained Liners have a locking
ring that is compatible with any RingLoc® Acetabular
Shell design. The Freedom All-Polyethylene Liners are
designed to be cemented into an acetabular shell or
directly into the acetabulum.

Freedom Constrained Liners are only compatible

with 36 mm Freedom Modular Heads with a -6, -3,
Standard, +3, +6, or +9 neck.
2 | Freedom Constrained Liner Surgical Technique
Figure 1
Reaming and Sizing
Carefully ream the acetabulum to prepare for
placement of the acetabular shell.
Shell Insertion
Thread the acetabular inserter onto the selected
acetabular shell and place into the acetabulum
(Figure 2). Impact the shell, taking care to check for
proper anatomic positioning.
Figure 2 Figure 3
Freedom Constrained Trial Liner
Insertion
Cementless
Place the selected trial liner into the acetabular shell
(Figure 3). The trial will fit loosely around the rim table
and will loosely engage the locking ring.
Cemented
Select the trial liner that corresponds to the inner
diameter of the component being cemented into. Place
the trial liner in to the acetabular cage or prepared
acetabulum to determine the appropriate implant size
to allow for an adequate cement mantle thickness.

Figure 4
Trialing with Freedom Provisional
Heads
Determine the desired neck length and select the
appropriate modular head provisional. Locate the
small line etch on the modular head provisional and
position this line marking in the most superior position
(Figure 6). Reduce the joint by aligning the flat aspect
of the modular head provisional with the liner’s mouth
and place the joint through a full range of motion
to ensure stability, checking that there is no early
impingement (Figure 4).
Note: Never mix the implant components and the
provisional components to perform a trial reduction.
Provisionals may become attached to the implant,
and the process of forcing these components apart
can irreparably damage the implant(s).
3 | Freedom Constrained Liner Surgical Technique
Figure 5
Freedom Implant Insertion
Remove the black plug covering the mouth of the liner
using the plug remover tool; discard this plug.
Cementless
Place the liner into the acetabular shell (Figure 5).
When satisfied with placement, use the Freedom Liner
Impactor to the seat the liner into the shell.
Cemented
Mount the all-polyethylene liner onto the cup holder.
Place the all-polyethylene liner in the cemented
acetabulum paying attention to the liner inclination,
anteversion and orientation. Maintain pressure
against the cup using the pusher and apply continuous
pressure during bone cement polymerization.
4 | Freedom Constrained Liner Surgical Technique
Figure 6
Freedom 36 mm Head Placement
Select the appropriate size modular head. Clean
the femoral implant trunnion with a dry sponge.
Before impacting the modular head on the trunnion,
position the etched line on the head such that it
is located in the most superior position and is
aligned with the lateral aspect of the stem (Figure 6).
Press the modular head onto the stem and double
check that the etch is still in the most superior
position. Fully seat the modular head by means of firm
axial impaction utilizing a femoral head impactor and
mallet.
Note: Impact the modular head with at least three
firm mallet blows.
Figure 7
Reduction
Mobilize the leg so that the head is placed at the
mouth of the liner. Flex and abduct the leg until the
circumferential flat aspect of the modular head aligns
with the liner mouth. Apply firm pressure straight into
the liner until the head snaps into place. There will
often be an audible “snap” when the modular head is
fully reduced.
Ensure Full Stability
Before wound closure, ensure that the joint remains
stable and will move throughout the anticipated range
of motion without early impingement (Figure 7).
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express written consent of Zimmer Biomet.
This material is intended for health care professionals. Distribution to any
other recipient is prohibited.
For product information, including indications, contraindications,
warnings, precautions, potential adverse effects and patient counseling
information, see the package insert and www.zimmerbiomet.com.
Zimmer Biomet does not practice medicine. This technique was
developed in conjunction with a health care professional. This document
is intended for surgeons and is not intended for laypersons. Each
surgeon should exercise his or her own independent judgment in the
diagnosis and treatment of an individual patient, and this information
does not purport to replace the comprehensive training surgeons have
received. As with all surgical procedures, the technique used in each case
will depend on the surgeon’s medical judgment as the best treatment
for each patient. Results will vary based on health, weight, activity and
other variables. Not all patients are candidates for this product and/or
procedure. Caution: Federal (USA) law restricts this device to sale by or
on the order of a surgeon. Rx only.
© 2018 Zimmer Biomet.
Check for country product clearances and reference product specific
instructions for use.
Not for distribution in France.

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Biomet UK Ltd.
Waterton Industrial Estate
Bridgend, South Wales
CF31 3XA
UK

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Biomet Orthopedics
P.O. Box 587 CE mark on a surgical technique
56 E. Bell Drive is not valid unless there is a CE
Warsaw, Indiana 46581-0587 mark on the product label. For
USA individual CE mark of implants
and instrumentation, refer to the
1959.1-GLBL-en-REV0918 www.zimmerbiomet.com product label.