Figure 52
31
• Avoid contamination of the implant-cement interface.
• The cement should just overfill the pockets on
underside of the tray, up to 1 mm proud posteriorly and
2 mm anteriorly.
eXPert Advice: For ease of tibial bearing implantation, it is
important to not apply cement to the sides of the tibial tray
that will face the bone island.
• Apply cement to the tibia and pressurize the cement,
striving for penetration of 3 to 5 mm.
- Use of a cement gun/cartridge equipped with a
pressurizing nozzle is recommended to deliver
and pressurize cement into the prepared holes
and across the flat surface (Figure 52).
- Or, cement may be applied manually and pressed
forcefully into the bone using a 1/2 inch (12.7mm),
or wider, flat osteotome.
Note: Be careful not to apply cement to the sides of the
bone island.
Tibial Tray Implantation
with Intact/Functioning ACL
• If a tourniquet above the knee is not already in use,
place and/or inflate throughout preparation of bone for
cementation, as well as mixing, application and hardening
of bone cement.
• Perforate cancellous bone on the tibial side of the
knee by drilling or punching an array of 2 mm holes,
2–3 mm deep, spaced 5 to 8 mm apart to improve
cement penetration.
• If the femoral side is dense or sclerotic, perforate it as well.
• Cleanse all cement-receiving bone surfaces thoroughly
using pulse lavage.
• Dry with a clean, dry lap sponge.
• Mix a single 40g unit of cement.
Note: Use of a vacuum mixing cartridge is recommended
as well as application of new gloves.
• As soon as the cement properties permit, apply a thin
layer over the entire underside of the tibial component.
Implant Reduction
Summary of Contents for VANGUARD XP
Page 1: ...Surgical Technique ...
Page 39: ......
