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5/5/2010 Bone Marrow Aspiration Iliac Crest-Posterior Approach Disclaimer The aspiration technique described is utilized by Michael Murphy, M.D. Biomet Biologics, LLC, does not practice medicine and does not recommend this technique for any specific patient. Bone Marrow Aspiration Iliac Crest-Posterior Approach Confidential. Inlended ""Iely lor Biomet Biologies Disbibutors and Sales Rep""'entatives, Bone Marrow Aspiration Iliac Crest-Posterior Approach Confidential. Intended solely for Biomet Biologics Distributors and Sales Repr""""tatiVes Bone Marrow Aspiration Iliac Crest-Posterior Approach Anatomy to avoid Anatomic Landmarks Iliac Crest • Posterior Sacroiliac Ligaments • Sciatic Nerve Posterior Superior Iliac Spine • Superior Gluteal Nerve/Artery Ilium Confidential. Intended ""Iely fO( Biomet Biologies Disbibutors and Sales Representatives, Bone Marrow Aspiration Iliac Crest-Posterior Approach Needle Insertion Confidential. Intended solely for Biomet Biologies Distributors and Sates RepresentatiVes -.-. Bone Marrow Aspiration Iliac Crest-Posterior Approach Insertion point is along posterior iliac crest within 8cm of PSIS Needle angle is approximately: 40 degrees lateral to the para-sagittal plane Insertion point 35-40 degrees inferior to the transverse plane Surgeon can adjust angle of needle within the ilium to make multiple passes ConftdentlaL Intended solely for Biome' Biologies Distributors and Sales Representatives Confidenliallntended solely for Biomet Biologics Distributors and Sales RepresentatiVes 1 5/5/2010 Bone Marrow Aspiration-Calcaneus Disclaimer The aspiration technique described is utilized by Lew Schon, M.D. Biomet BiologiCS, LLC, does not practice medicine and does not recommend this technique for any specific patient. Bone Marrow Aspiration Calcaneus A printed version of this technique is available at www.biomet.com/bio!ogics Conlldenllial. Inlended solely for Biomel Biologics Dislributors and Sales Representatives Bone Marrow Aspiration-Calcaneus Anatomical Landmarks Connde.lial. Intended solely . t} ~ J Calcaneus Biologics Distributo," and Sal.. Representativ.. Bone Marrow Aspiration-Calcaneus Anatomy to avoid , /C'~;d l . '...'~ \.. tor Blome! Sustentaculum Tali ' Insertion of achilles tendon Sural Nerve ~ Confidentlial. Inlended solely for Blome! BIologics Distributors and Sales Represenlative. Bone Marrow Aspiration-Calcaneus Needle Insertion Confidential. Intended solely tor Blome! Biologic. Distributors and Sales Representatives Bone Marrow Aspiration-Calcaneus Aspiration passages Aspiration should be performed before using a tomiquet , • Only one insertion through the _cortical bone is necessary. • 3 passages through the bone _marrow cavity can be made from _single insertion point. t t)~ • 5-1 Oml of SMA can be obtained jor each passage Make a small incision on the latetal side of the ankle, anterior to the insertion of the achilles tendon Insert SMA needle anterior to the achilles tendon and posterior to the sural nerve Actual insertion point may vary based on a individual patient's anatomy Conlideniial. Intended solely lor Blome! Biologics Distributors and Sal.. Representatives Confldenllal. tntended solely lor e;ome! Biologie. Dislributcrs and Sal.. Representaliv•• 1 5/5/2010 Bone Marrow Aspiration Proximal Tibia Disclaimer The aspiration technique described is utilized by Monica H. Schweinberger and Thomas Roukis, DPMs. This technique is described in a peer-reviewed journal, Biomet Biologics was not involved in the description of this technique. Biomet Biologics LLC, does not practice medicine and does not recommend this technique for any specific patient. Bone Marrow Aspiration Proximal Tibia Schweinberger MH, et al. J Foot Ankle Surg 2007;46(5):411-414. Confidential. Intended solely for Biomet Biologics Distributoro and Sales Representatlves Bone Marrow Aspiration Proximal Tibia Anatomic Landmarks Bone Marrow Aspiration Proximal Tibia Anatomy to avoid Medial Condyle Lateral Condyle ,~i I, .,-,+ I ft. \ Articular surface of the tibial (L~~ --~\~- plateau Insertion of Pate"arTendon '\1 1! I, ' i~ " _... Conlldentlal. Intended solely for Biorne! Biologics Dilltributo", and Sales Representalives Bone Marrow Aspiration Proximal Tibia Needle Insertion and Aspiration Confidential. Intended solely for Biomet Biologics Distributo", and Sales Representatives /" Insertion is at the anterior medial aspect of the proximal tibia metaphysis Needle should be angled down the shaft of the tibia toward the ankle Confidential. Intended solely for Biomel Biologics Diolribulo", and Sales Representatives 1 Disclaimer on Aspiration Techniques Surgeons using the BioCUETM System should be familiar with bone marrow aspiration techniques and are responsible for choosing the aspiration location(s) and method(s) appropriate for each individual patient. The surgical techniques described today and/or available at www.biomet.com/biologics are provided for general reference only. These techniques are not meant to be utilized as a substitute for aspiration training in the practice of medicine. Confidential. Intended solely for Biomet Biologics Distributors and Sales Representatives