BIOMET VANGUARD XP, Manual

Page: 23 / 40

Figure 33 Figure 35
Figure 34
21
Tibial Resection with Intact/
Functional ACL (cont.)
Anterior Bone Island Resection
• Identify the insertion of the ACL fibers and mark the
anterior edge with a marking pen. Use the mark to guide
the anterior bone removal.
eXPert Advice: It is acceptable for the anterior bone to be
removed right back to the anterior edge of the ACL insertion.
If, after the anterior bone is clipped, the bone fragment is still
attached via some ACL fibers, the bony fragment should be
removed by cutting the fibers; not by pulling the fragment and
tearing the fibers.
• It is important to remove adequate anterior bone to
position the tibial implant for adequate posterior coverage.
• Markings on the anterior tibial island rongeur (32-700375)
represent the range of tibial implant sizes. Confirm the cut
position by aligning the rongeur to both pen markings
near the ACL base as well as implant markings on
the rongeur.
• Keeping the rongeur flat against the cutting surface,
remove the central anterior tibial bone to the resection
level of the tibial plateau (Figure 33).
Note: While cutting the bone section, place a hand over
the area to keep it from projecting upward.
• To round the island corners, place the anterior island
rongeur on top of the tibial cut block at a near 45 degree
angle and slightly trim corners of the anterior bone
island (Figure 34).
• Using the flat rasp (32-700376), fine-tune the resected
tibia to ensure flatness and to remove any rough edges
around the tibial island by using the tibial universal cut
block as a reference (Figure 35).
eXPert Advice: While rasping, be careful not to apply
torque to the tibial island as fracture of the bone island
may occur.
Tibial Preparation