Figure 32
Figure 31
20
VANGUARD
X
P
Total Knee System
• If the medial gap checker is too tight, resect additional
tibia by removing both the threaded pins at the base of
the island and tibial cutting block pins, and dialing the
tibial universal cut block down 1 mm to 2 mm.
- Lock the vertical resection block onto the tibial cut
block aligned with the previous vertical cuts and insert
cut block pins in a hole with adequate bone stock.
If small resection level adjustment is needed, it is likely
the vertical cut slot pins will not have enough bone
stock for fixation.
- Recut the vertical cuts to the depth of the tibial cutting
block using the reciprocating saw blade.
- Recut the medial tibial plateau being extremely careful
not to undercut the bone island.
Note: When the medial extension/flexion gap is adequate,
resect the lateral tibial plateau, being extremely careful
not to undercut the tibial island.
Tibial Preparation
Tibial Resection with Intact/
Functional ACL (cont.)
Horizontal Resection (cont.)
• Check the flexion gap at 90 degrees and full extension
gap with a 10 mm medial gap checker (32-700039) to
ensure there is adequate space to prevent a bone island
fracture while trialing (Figure 31).
eXPert Advice: Always clear away any posterior
osteophytes before using the medial gap checker (32-
700039). Once clear, the 10 mm medial gap checker
should slide in and out of the cut extension space, freely.
• If the 10 mm medial gap checker has adequate clearance
and can easily be introduced into both gaps, proceed to
cut the lateral side plateau, keeping the vertical
threaded pin in place to protect from undercutting the
bone island (Figure 32).
eXPert Advice: For ease of resecting the lateral plateau,
the entire patella fat pad may need to be removed. A
retractor can also be placed behind the patellar tendon at
the base of the patella to increase exposure.
Summary of Contents for VANGUARD XP
Page 1: ...Surgical Technique ...
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