Joseph Periosteal Elevator, Slightly Curved, Tips 2mm to 5mm

What the Joseph periosteal elevator is

The Joseph periosteal elevator is a hand instrument used to lift periosteum and soft tissue off cartilage and bone in nasal and facial surgery. Surgeons also call it a Joseph elevator, a Joseph nasal periosteal elevator or simply a periosteal elevator. It is made by Adas Instruments in high quality medical grade stainless steel, and it is reusable and fully autoclavable.

The blade is slightly curved and is supplied in four tip widths from 2 mm to 5 mm, so the same pattern covers a narrow caudal approach and a broad sweep over the dorsum depending on which tip is ordered.

The work an elevator does is always the same in principle. A layer of soft tissue is stuck to the cartilage or bone under it, and it has to come off in one sheet without a hole in it. Get that right and the rest of the case has a dry field and a flap that will lie back down. That is why the shape of the working end and the stiffness of the blade decide which pattern a surgeon picks up.

Key design features of the Joseph periosteal elevator

• Slightly curved blade, supplied in 2 mm, 3 mm, 4 mm and 5 mm tip widths
• The curve keeps the handle out of the way while the tip stays on the bone
• Blunt working end that raises periosteum in one sheet
• Four tip widths from one pattern, so a tray can carry two of them rather than two patterns
• Flat knurled handle for a pencil grip
• High quality medical grade stainless steel, reusable and autoclavable

The handle is flat and knurled rather than round. A flat handle tells you where the blade is facing without looking at it, and the knurling holds when a glove is wet. The shaft runs straight into the blade with no step, so there is no shoulder to catch on the rim of a nostril and nothing for protein to sit in after a case.

Joseph elevator sizes and build options

Every tip width below is one we actually ship. Imperial figures are given beside the metric because United States buyers search in inches.

Nothing is listed above that we do not hold. If a build you need is not in the table, ask, because a pattern like this is often made to order for an OEM run and a change of size is a tooling change rather than a new instrument.

Uses of the Joseph periosteal elevator by specialty

The Joseph periosteal elevator appears on the same trays across these specialties because the job is the same one each time, lifting a tissue plane cleanly off what lies under it.

Preference cards and catalogues sometimes file this pattern under the procedure rather than the pattern, so a search for a joseph elevator rhinoplasty instrument, or for a joseph nasal periosteal elevator, lands on this same blade.

The specialty name and the procedure name are both worth knowing when you order, because catalogues file this pattern under whichever of the two the buyer used. An operating room manager searches by procedure and a purchasing office searches by specialty, and they are looking for the same instrument.

Tissue planes the Joseph periosteal elevator works in

An elevator handles no suture and no needle. What decides the choice of pattern is the plane it has to open and how much force that plane takes.

Force is the part nobody writes down. Perichondrium on young cartilage lifts with almost nothing, while mucoperiosteum on bone needs a firm push and a stiff blade behind it. Match the blade to the plane and the instrument does the work instead of your wrist.

How the Joseph periosteal elevator compares with other patterns

These four sit next to each other on a nasal tray and they are not interchangeable.

Surgeons who use this pattern usually also hold the Joseph Masing septum elevator, the Tessier periosteal elevator and the Howarth septum elevator. The closest relative in the range is the Tessier periosteal elevator. For bone outside the nose the Read periosteal elevator double ended carries two widths on one shaft, and the Kleinert Kutz dissector handles the small planes of the hand.

If you are building a tray from scratch, the usual answer is two elevators rather than one. Something light for cartilage and something stiffer for bone covers almost every case.

Materials and finish

The instrument is made in high quality medical grade stainless steel. The steel itself is made to a German specification. The blade is flat ground and satin finished, which cuts glare under the lights in an operating room and keeps the working end readable against wet tissue. There is no coating to chip and nothing on the shaft to trap protein.

Stainless steel is chosen here for a reason that has nothing to do with appearance. An elevator is levered, and a levered instrument that is too hard will crack at the neck while one that is too soft will take a set and stay bent. The grade used sits between the two.

Joseph periosteal elevator care and sterilization

Rinse the instrument in cool water straight after use so blood does not dry on the blade. Clean it with a soft brush and a neutral pH enzymatic detergent, rinse in deionized water, then dry it completely. Steam autoclave at 134 degrees Celsius. Lay it in the tray so the blades do not rest against other instruments, because a bruised edge on an elevator is what tears a flap.

Look at the working end against the light before every case. A blunt end should be smooth with no flat spot and no nick, and a working edge should still sit flat on bone. An elevator that has been dropped on a tiled floor is the one that buttonholes a flap two cases later, and it costs nothing to check.

Ordering and wholesale

This pattern is supplied by Adas Instruments to hospitals, surgical distributors and OEM buyers, in single units and in bulk. The item code is AN-60.01 and it is printed in the size table above so a procurement search finds it. Backorder items dispatch in 10 to 12 working days. Every instrument carries a three year replacement against manufacturing defects.

For wholesale and OEM orders, instruments ship unpackaged in bulk or individually poly bagged, and laser marking with a distributor code or a hospital asset number is available on the shaft. Tell us the quantity and the marking you need and the quotation comes back with the lead time for that run rather than a stock figure.

Production is controlled under an ISO 13485 quality management system.

Frequently asked questions

What is a Joseph periosteal elevator used for?

It lifts periosteum off the nasal dorsum and the facial bones and raises mucoperichondrial and mucoperiosteal flaps in rhinoplasty and septoplasty. Oral and maxillofacial surgeons use the same pattern to raise full thickness mucoperiosteal flaps.

What tip widths does the Joseph elevator come in?

This pattern is supplied in 2 mm, 3 mm, 4 mm and 5 mm tips. The narrow tips suit a caudal approach and a tight plane, and the wider tips clear the dorsum faster once the plane is open.

Why is the blade slightly curved?

The curve lifts the handle away from the face while the tip stays flat on the bone. A straight blade at the same angle either lifts its tip off the bone or drives the handle into the cheek, and neither gives a clean subperiosteal plane.

Is a Joseph elevator the same as a periosteal elevator?

A Joseph elevator is one pattern of periosteal elevator. The family covers many shapes, so if you are ordering against a surgeon preference card, quote the Joseph name and the tip width rather than the family name on its own.

How do you clean and sterilize a Joseph periosteal elevator?

Rinse it in cool water straight after use, clean with a soft brush and a neutral pH enzymatic detergent, rinse in deionized water and dry it fully, then steam autoclave at 134 degrees Celsius.

Related products and categories

Surgeons who work with the Joseph periosteal elevator usually compare it against the Joseph Masing septum elevator, the Tessier periosteal elevator and the Howarth septum elevator. The whole family sits in dissectors and elevators, and this pattern is also listed under rhinoplasty instruments.