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The Furlong®
Hemiarthroplasty System
Contents

System Benefits 2

Company Overview 2

Furlong® Cemented Hemiarthroplasty

Design Attributes 3
Clinical Evidence 3
Implant Range 5
Operative Technique 7
Instrumentation 10

Furlong® Hydroxyapatite Ceramic Coated Hemiarthroplasty

Design Attributes 13
Clinical Evidence 13
Implant Range 15
Operative Technique 17
Instrumentation 21
System Benefits

The Furlong® Arthroplasty System

• Cemented or H-A.C. Coated stem options and bi-polar or physiological head options
provide clinical flexibility to match surgeon preference

• The fully modular system allows the surgeon to select the implants which best meet the
patients clinical needs

• Versatility of the system allows for easy conversion to a total hip construct should this be
required intra or post operatively

• Easy to use effective instrumentation designed to enhance clinical outcome

• Clinically proven1,2,3

Company Overview

• JRI Limited, established in 1970 by Mr Ronald Furlong FRCS

• Developers of the world’s first H-A.C. coated hip replacement Prosthesis

– first Furlong H-A.C. total hip replacement implanted 9 September 1985

• Market leading peer reviewed clinical results

• Dedicated orthopaedic research, development and manufacturing

2
 Furlong® Cemented Hemiarthroplasty

Design Attributes

The Furlong® cemented hemiarthroplasty stem is a Müller type femoral stem that
has been devised to incorporate the design features and clinical success of the
Furlong cemented primary modular stem which has received an ODEP rating
of 10 C

Available in 5 stem sizes, designed to ensure optimal match to patient’s anatomy

Cost effective system compared to a total hip replacement

Collarless, double tapered, polished high nitrogen stainless steel stem,

designed to facilitate accurate placement of the prosthesis in the cement mantle.

Clinical Evidence

72 Implants had been inserted into 71 different patients by 35 different

Surgeons of all grades. No dislocations in any of the 72 patients who had
bi-polar hips inserted during the study period1

Comparable with results of total hip replacement (THR) but without the risk
of dislocation1

Results are significantly better than would be expected with conventional

Hemiarthroplasty in this group of patients1

Eleven of the sixteen able to walk 1 mile before fracture were able to do so
at review. Mean follow up 32 months.1

3
A more flexible choice for you...

...a better outcome for Mary

4
 Furlong® Cemented Hemiarthroplasty

The JRI Bipolar head is pre assembled and The JRI Physiological Head is manufactured
available in 1mm increments. It has been from proven High Nitrogen Stainless Steel. This
designed specifically to minimize the risk of increases biocompatibility and provides greater
the prosthesis assuming a varus position. fatigue strength and corrosion resistance over
conventional medical grade stainless steel.

12-14 Taper allows for easy

conversion to a total hip at a later
date should this be required

The highly polished surface

finish allows for controlled
subsidence and self locking in
the cement mantle.

Based on the proven 1979

design of the Furlong® Straight
Stem. The high nitrogen stainless
steel stem is double tapered,
collarless and polished for
longevity of cement fixation.

Longer stem available to cater

for most surgical requirements.

127º

The 127º neck angle increases

stability and reduces the risk of
dislocation.

5
DESCRIPTION PRODUCT NO.
Femoral Stems (Standard Stem)
Extra Extra Small Stem 95.08.00
Extra Small Stem 95.10.00
Small Stem 95.12.00
Medium Stem 95.15.00
Large Stem 95.18.00
Femoral Stems (Long Stem)
Small Stem 95.12.25
Medium Stem 95.15.25
Large Stem 95.18.25
Bipolar Heads
40mm O/D 94.40.01
41mm O/D 94.41.01
42mm O/D 94.42.01
43mm O/D 94.43.01
44mm O/D 94.44.01
45mm O/D 94.45.01
46mm O/D 94.46.01
47mm O/D 94.47.01
48mm O/D 94.48.01
49mm O/D 94.49.01
50mm O/D 94.50.01
51mm O/D 94.51.01
52mm O/D 94.52.01
53mm O/D 94.53.01
54mm O/D 94.54.01
56mm O/D 94.56.01
58mm O/D 94.58.01
Physiological Heads
39mm O/D 93.39.01
40mm O/D 93.40.01
41mm O/D 93.41.01
42mm O/D 93.42.01
43mm O/D 93.43.01
44mm O/D 93.44.01
45mm O/D 93.45.01
46mm O/D 93.46.01
47mm O/D 93.47.01
48mm O/D 93.48.01
49mm O/D 93.49.01
50mm O/D 93.50.01
51mm O/D 93.51.01
52mm O/D 93.52.01
53mm O/D 93.53.01
54mm O/D 93.54.01
56mm O/D 93.56.01
58mm O/D 93.58.01

6
 Furlong® Cemented Hemiarthroplasty

1 2

Correct positioning of the patient, on the operating table, The femoral neck is cut 1-2cm above the lesser trochanter.
is very important and the hip joint is exposed using a (This cut can be determined by where the fracture has
preferred surgical approach for hemiarthroplasty. occurred). A trial stem can be used, if required, to help
identify where the neck cut should be and a line made
using a diathermy probe or skin marker.

3 4

The saw cut should be perpendicular to the neck and The femoral head is removed using the corkscrew. A light
the position of the tibia should be vertical while the cut tap may help engagement and purchase into the femoral
is made. head.

5 6

The femoral head size can then be estimated using the Sizing is confirmed using the trial heads and introducer.
femoral head template guide. The Labrum is best left intact but, if necessary, can be
sectioned at this point to allow the correct size head to
be selected.

7
 Operative Technique

7 8

The proximal femur is opened using the box chisel which The smallest (4-8mm tapered) intramedullary reamer,
is positioned laterally and posteriorly so that entry is in line which has a sharp tip, is mounted on the T-Handle, and
with the femoral intramedullary canal. used to expose the femoral canal. Care should be taken
with this first reamer and if bone quality is poor then the
8mm intramedullary reamer should be used first, as it has
a more rounded tip. Further straight reamers are used
increasing in 1mm size increments until an acceptable
reaming has been achieved.

9 10

The smallest rasp (extra, extra small) is used to prepare At this point, if required, the appropriate trial stem can be
the proximal femur. The large tommy bar should be carefully inserted using the stem impactor.
used to control version. If the fit of this first rasp is
unsatisfactory then repeat the procedure increasing rasp
size accordingly. Care should be taken to lateralise the
rasps as they are inserted.

11 12

The chosen trial head is screwed onto the trial prosthesis The trial stem can be removed with the use of the
and a reduction attempted. If the reduction is not possible trial stem extractor. Care must be taken to tap out
or is regarded as too tight, remove the trial prosthesis. of the femur in a neutral position to prevent possible
The neck should be resected further to permit deeper damage to the femur.
seating of the stem. Seat the rasp again and repeat the
trialing process until the reduction is stable.

8
 Operative Technique Continued

13 14

At this point a suitable size of cement restrictor or plug is The plug is then inserted into the femoral canal at a
chosen, depending on the size of the final intramedullary depth of 1–2cm beyond the distal tip of the prosthesis.
reamer used and screwed onto the introducer. The depth To remove the introducer handle turn anti-clockwise to
of insertion is determined by placing the cement plug unscrew from the plug. Do not remove the introducer
introducer alongside the trial/prosthesis. The plug is aligned handle until the plug is seated correctly at the pre-
1–2cm beyond the distal tip of the trial/prosthesis and a measured depth.
measurement taken from the markings on the introducer
handle. The lateral shoulder of the trial/prosthesis is a
good reference point. (Ref Page 10 Chart A)

15 16

The preferred cementing technique is now used. Modern Making sure the tibia is vertical, the definitive femoral
techniques recommend the use of a cement plug, lavage, stem should be inserted in neutral alignment, to ensure
drying of the femoral canal and retrograde filling with a a continuous circumferential cement mantle, using the
cement gun. stem impactor and inserted to the depth determined by
the trial prosthesis.
The depth of the stem should be determined by the
height of the centre of rotation of the femoral head on the
contralateral side. If the same size rasp, trial and definitive
stem are used then a cement mantle of approx. 1-2mm
will be obtained. Should a thicker cement mantle be
required, then a smaller size of prosthesis than the size of
the last rasp used, should be selected.

17 18

Before fitting the Bipolar or mono-polar, physiological The implant head (either bi-polar or mono-polar,
femoral head ensure that the cement is fully cured and physiological) is fitted onto the stem and impacted using
set. the femoral head impactor. A light tap is required to
engage the taper.

9
 Operative Technique

19

Finally the joint is reduced, and the wound is closed.

Furlong® Cemented Instrumentation

Chart A

Intramedullary Rasp
Reamer Size (mm) Implant Size Cement Plug (mm)

9
Extra Extra Small or 10
10
Extra Small or
11
Small 12.5
12

14 Medium or 15
16 Large 17.5 or 20

1 2

DESCRIPTION PRODUCT NO.

1 Cement Plug
Size AA 10.0mm Diameter 13.00.03
Size OA 12.5mm Diameter 13.00.04
Size OB 15.0mm Diameter 13.00.05
Size OC 17.5mm Diameter 13.00.06
Size OD 20.0mm Diameter 13.00.07
2 Cement Plug Introducer 13.00.01

10
 Furlong® Cemented Instrumentation

1 4

2
5

3
6

DESCRIPTION PRODUCT NO.

1 Trial Head Introducer 10.00.44
2 Head Impactor 10.00.47
3 Trial Stem Extractor 10.00.08
4 Box Chisel 50.99.45
5 Stem Impactor 50.99.34
6 Femoral Head Extractor 10.00.21

7 10 13

12
8
11
9

7 Intramedullary Reamers
4-8mm 14.48.61
8mm 14.61.08
9mm 14.61.09
10mm 14.61.10
11mm 14.61.11
12mm 14.61.12
13mm 14.61.13
14mm 14.61.14
16mm 14.61.16
8 Small Tommy Bar 10.08.28
9 Large Tommy Bar 10.25.28
10 Hudson Adaptor 10.00.26
11 Jacobs Adaptor 10.00.27
12 T Handle 10.00.50
13 Femoral Head Gauge 64.00.18

11
14 15

14 Trial Stems (Threaded Spigot)

Extra Extra Small 96.08.08
Extra Small 96.08.10
Small 96.08.12
Medium 96.08.15
Large 96.08.18
Small Trial Long Stem 96.25.12
Available as a
Medium Trial Long Stem 96.25.15
revision option
Large Trial Long Stem 96.25.18
15 Rasps
Extra Extra Small 50.00.14
Extra Small 50.00.15
Small 50.00.16
Medium 50.00.17
Large 50.00.18

16 17

DESCRIPTION PRODUCT NO. DESCRIPTION PRODUCT NO.

16 Bipolar Trial Heads (Black) 17 Physiological Trial Heads (White)
39mm 64.39.10
40mm 64.40.94 40mm 64.40.10
41mm 64.41.94 41mm 64.41.10
42mm 64.42.94 42mm 64.42.10
43mm 64.43.94 43mm 64.43.10
44mm 64.44.94 44mm 64.44.10
45mm 64.45.94 45mm 64.45.10
46mm 64.46.94 46mm 64.46.10
47mm 64.47.94 47mm 64.47.10
48mm 64.48.94 48mm 64.48.10
49mm 64.49.94 49mm 64.49.10
50mm 64.50.94 50mm 64.50.10
51mm 64.51.94 51mm 64.51.10
52mm 64.52.94 52mm 64.52.10
53mm 64.53.94 53mm 64.53.10
54mm 64.54.94 54mm 64.54.10
56mm 64.56.94 56mm 64.56.10
58mm 64.58.94 58mm 64.58.10

12
 Furlong® H-A.C. Hemiarthroplasty

Design Attributes

Supravit® H-A.C. coating and stem geometry are identical to the Furlong® H-A.C.
hip replacement, which has an ODEP rating of 10 A

Very impressive clinical results have shown that Supravit makes the
Furlong® H-A.C. Total Hip Replacement, possibly the most successful
uncemented hip stem4-12

Can be used on patients with osteoporotic bone13

Cost effective compared to Total Hip Replacement

Clinical Evidence

We conclude that Hemiarthroplasty with the Hydroxyapatite coated Bipolar Furlong®

prosthesis for displaced intracapsular fracture of the neck of the femur gives good mid term
results in elderly patients for return to mobility, use of mobility aids and freedom from pain2

Modularity of the head allows later conversion to total hip arthroplasty without revision
of the stem2

Use of the Hydroxyapatite–coated stem eliminates the need for cement and its attendant
risks to the cardio respiratory system in the elderly and often frail population2

The results of our study indicate that hip Hemiarthroplasty using the Furlong® H-A.C. coated
implant is associated with good functional recovery in terms of mobility and reliance on
walking aids2

The mean Clinical Rating Score was 70 ( Harris Hip Score 80.6 ). 86% had no pain and 90%
were satisfied. This prosthesis functions well in the active elderly patient with a displaced
intracapsular proximal femoral fracture3

13
A more flexible choice for you...

...a better outcome for Barbara

14
 Furlong® H-A.C. Hemiarthroplasty

The JRI Bipolar head is pre assembled and The JRI Physiological Head is manufactured
available in 1mm increments. It has been from proven High Nitrogen Stainless Steel. This
designed specifically to minimize the risk of increases biocompatibility and provides greater
the prosthesis assuming a varus position. fatigue strength and corrosion resistance over
conventional medical grade stainless steel.

12-14 Taper allows for

an easy conversion to a
total hip replacement at
a later date, should this
be required
127º

The 127º neck angle increases

stability and reduces the risk of Proven stem design of the
dislocation. Furlong® H-A.C. Total Hip
Replacement

Proximal stem geometry aids

primary fixation of the implant Fully coated with Supravit®
hydroxy-apatite ensuring
even distribution of forces
transmitted through the
prosthesis to the host bone.

The collar of the implant

helps neutral alignment of
the prosthesis.

15
DESCRIPTION PRODUCT NO.
H-A.C. Femoral Stems
9mm 97.09.00
10mm 97.10.00
11mm 97.11.00
12mm 97.12.00
13mm 97.13.00
14mm 97.14.00
16mm 97.16.00
Bipolar Heads
40mm O/D 94.40.01
41mm O/D 94.41.01
42mm O/D 94.42.01
43mm O/D 94.43.01
44mm O/D 94.44.01
45mm O/D 94.45.01
46mm O/D 94.46.01
47mm O/D 94.47.01
48mm O/D 94.48.01
49mm O/D 94.49.01
50mm O/D 94.50.01
51mm O/D 94.51.01
52mm O/D 94.52.01
53mm O/D 94.53.01
54mm O/D 94.54.01
56mm O/D 94.56.01
58mm O/D 94.58.01
Physiological Heads
39mm O/D 93.39.01
40mm O/D 93.40.01
41mm O/D 93.41.01
42mm O/D 93.42.01
43mm O/D 93.43.01
44mm O/D 93.44.01
45mm O/D 93.45.01
46mm O/D 93.46.01
47mm O/D 93.47.01
48mm O/D 93.48.01
49mm O/D 93.49.01
50mm O/D 93.50.01
51mm O/D 93.51.01
52mm O/D 93.52.01
53mm O/D 93.53.01
54mm O/D 93.54.01
56mm O/D 93.56.01
58mm O/D 93.58.01

16
 Furlong® H-A.C. Hemiarthroplasty

1 2

Correct positioning of the patient, on the operating table, The femoral neck is resected. (This cut can be determined
is very important and the hip joint is exposed using a by where the fracture has occurred). A trial stem, rasp or
preferred surgical approach for hemiarthroplasty. template can be used, if required, to help identify where
the neck cut should be and a line made using a diathermy
probe or skin marker.

3 4

The femoral head is removed using the corkscrew. A light The size of the femoral head can then be estimated
tap may help engagement and purchase into the femoral using the femoral head template guide.
head.

5 6

The actual implant head to be used (either bi-polar or The proximal femur is opened using the box chisel which
mono-polar, physiological) is determined using the trial is positioned laterally and posteriorly so that entry is in line
heads and introducer. The Labrum is best left intact but, with the femoral intramedullary canal.
if necessary, can be sectioned at this point to allow the
correct size head to be selected.

17
 Operative Technique

7 8

The smallest (4-8mm tapered) intramedullary reamer, Next the 9mm intramedullary reamer is used.
which has a sharp tip, is mounted on the T-Handle, and
used to open up the femoral canal. Care should be taken
with this first reamer and if the bone quality is poor then
the 8mm intramedullary reamer should be used first in its
place, as it has a more rounded tip.

9 10

The smallest rasp (Size 9) is used first to prepare the If the fit of this first rasp is unstable then the next size
proximal femur. The small tommy bar is used to control of intramedullary reamer is used followed by the
version. corresponding size of rasp. This ream / rasp technique is
continued until the fit of the rasp is stable.

11 12

With the correct rasp in place remove the rasp handle With the rasp still in place, the fin cutter is gently tapped
and if required, trim the neck using the calcar cutter home into the groove in the rasp with the teeth facing the
fitted onto the T-handle. greater trochanter.

18
 Furlong® H-A.C. Hemiarthroplasty

13 14

At this point, if required, the appropriate trial stem The chosen trial head is screwed onto the trial prosthesis
prosthesis can be carefully inserted using the stem and a reduction attempted. If the reduction is not possible
impactor. or is regarded as too tight, the trial prosthesis is removed
and the neck resected further to permit deeper seating
of the stem. The rasp is seated again and the trialing
process repeated until the reduction is satisfactory.

15 16

The trial stem can be removed with the use of the trial The definitive femoral stem should be inserted using
stem extractor. Care must be taken to tap the trial out the stem impactor and tapped home to the depth
of the femur in a neutral position to prevent possible determined by the trial prosthesis.
damage to the femur.

17 18

Seating of the collar on the calcar is preferred but not The implant head (either bi-polar or mono-polar,
essential. physiological) is fitted onto the stem and impacted using
the nylon femoral head impactor. A light tap is required to
engage the taper.

19
 Operative Technique Continued

19

Finally the joint is reduced and the wound is closed.

20
 Furlong® H-A.C. Instrumentation

1 4

2
5

3
6

DESCRIPTION PRODUCT NO.

1 Trial Head Introducer 10.00.44
2 Head Impactor 10.00.47
3 Trial Stem Extractor 10.00.08
4 Box Chisel 50.99.45
5 Stem Impactor 50.99.34
6 Femoral Head Extractor 10.00.21

7 13

8 12
11
9

10

7 Intramedullary Reamers
4-8mm 14.48.61
9mm 14.61.09
10mm 14.61.10
11mm 14.61.11
12mm 14.61.12
13mm 14.61.13
14mm 14.61.14
16mm 14.61.16
8 Small Tommy Bar 10.08.28
9 Small Tommy Bar 10.08.28
10 Fin Cutter 90.99.02
11 Calcar Cutter 90.00.23
12 T Handle 10.00.50
13 Femoral Head Gauge 64.00.18

21
 14 16
15

14 Trial Stems
9mm 98.08.09
10mm 98.08.10
11mm 98.08.11
12mm 98.08.12
13mm 98.08.13
14mm 98.08.14
16mm 98.08.16
15 Rasp Handle 200.02.99
16 Rasps
9mm 91.11.09
10mm 91.11.10
11mm 91.11.11
12mm 91.11.12
13mm 91.11.13
14mm 91.11.14
16mm 91.11.16

17 18

DESCRIPTION PRODUCT NO. DESCRIPTION PRODUCT NO.

17 Bipolar Trial Heads (Black) 18 Physiological Trial Heads (White)
39mm 64.39.10
40mm 64.40.94 40mm 64.40.10
41mm 64.41.94 41mm 64.41.10
42mm 64.42.94 42mm 64.42.10
43mm 64.43.94 43mm 64.43.10
44mm 64.44.94 44mm 64.44.10
45mm 64.45.94 45mm 64.45.10
46mm 64.46.94 46mm 64.46.10
47mm 64.47.94 47mm 64.47.10
48mm 64.48.94 48mm 64.48.10
49mm 64.49.94 49mm 64.49.10
50mm 64.50.94 50mm 64.50.10
51mm 64.51.94 51mm 64.51.10
52mm 64.52.94 52mm 64.52.10
53mm 64.53.94 53mm 64.53.10
54mm 64.54.94 54mm 64.54.10
56mm 64.56.94 56mm 64.56.10
58mm 64.58.94 58mm 64.58.10

22
 JRI Services/Education

• Research Funding • In service support

• Nurse Training • Consignment stock checks:

• Implants
• Factory Tours
• Instruments
• Furlong Hip Course
• PACS Digital X-Ray templates

References:
1. S Dixon et al. Cemented Bipolar Hemiarthoplasty for Displaced Intracapsular Fracture in the Mobile Active Elderly
Patient. Int. J Care Injured 2004; 35:152-156. 2. P Chandran et al. Mid Term Results of Furlong LOL Uncemented
Hip Hemiarthroplasty for Fractures of the Femoral Neck. Acta Orthop. Belg., 2006; 72:426-433. 3. R Rees et al.
The JRI Bipolar Hemiarthroplasty for the Active Patient With a Displaced Intracapsulat Proximal Femoral Fracture.
BOA 2001. 4. Survivorship of 38 cases in under 50 year olds. N.N. Shah et al J Bone Joint Surg [Br] 2009; 91-B:865-9
5. Survivorship of 331 consecutive cases. J.A.N Shepperd et al J Bone Joint Surg [Br] 2008; 90-B:27-30
6. Survivorship of 134 consecutive cases. A.A. Shetty et al J Bone Joint Surg [Br] 2005; 87-B:1050-4 7. Survivorship in
2212 cases. J.M. Buchanan, Sunderland Royal Hospital Data presented at BOA, Manchester, 26 - 28 September 2007. 8.
Sources: Fisher J, University of Leeds (UK); Pandorf T, CeramTecAG (Germany), 2006 9. Buchanan J.M. A nineteen-year
review of hydroxyapatite ceramic coated hip implants: a clinical and histological evaluation. BOA, 2007; Manchester
26-28th September 2007. 10. Raman R, David D, Eswaramoorthy V, Tiru M, Angus P; Long term results of 586 cementless
primary total hip arthroplasties using H-A.C. coated endoprosthesis: BOA ; Manchester 26-28th September 2007. 11. Escriba
I, Sancho R, Crusi X, Valera M; Hemispherical hydroxyapatite-coated cups for acetabular revision in severe bone defects: 3 to
7 year results. EFORT, Helsinki, Finland, June 4 -10th 2003. 12. Data on file. 13. Data on file – published at EFORT AOS 2008.

Wholly owned by the Furlong Research Charitable Foundation who

independently fund orthopaedic research

Joint Replacement Instrumentation Limited

18 Churchill Way, 35A Business Park, Chapeltown, Sheffield S35 2PY
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