Figure 56
34
VANGUARD
X
P
Total Knee System
• Place the femoral component onto the end of the
femoral impactor and insert it manually as far as possible.
• Fully seat the component onto the femur using the
femoral impactor.
eXPert Advice: If the femoral component is not seated, the
extension gap will be decreased, therefore increasing loads
in full extension, and possibly increasing the risk for fracture
of the bone island.
• Remove excess cement in a routine manner (Figure 56).
• With the knee flexed to approximately 70 degrees,
insert the lateral tibial trial bearing by hand or using a
hemostat as the trial bearing handle was not intended to
work when placing trial bearings on the implant.
• Reduce the patella and insert the medial tibial trial bearing.
eXPert Advice: The lateral tibial bearing is easier to insert
with the medial tibial bearing absent. Once the patella
is reduced, the forces on the distal femur are minimized,
making the medial tibial bearing insertion easier.
• Make certain that both tibial bearings are fully seated
before moving the knee into full extension to avoid
possible fracture of the tibial bone island.
Note: Ensure there is no bone cement (or overhanging
bone) alongside the bone island which will inhibit the
bearing from appropriately engaging.
Femoral Component Implantation
• While mixing another 40g unit of cement, pulse lavage
and dry the femoral side again.
• As soon as the cement properties permit, apply a layer
over the entire bone-opposing surface of the appropriate
femoral component.
• Avoid contamination of the implant-cement interface.
Note: The cement should overfill the pockets on distal
and chamfer facets by 2–3 mm and on the anterior and
posterior facets by 1–2 mm.
• Apply cement to the prepared femur and pressurize
the cement, striving for penetration of 3–5 mm, with
special attention given to pressurizing cement into the
anterior facet, as seating of the implant will not
contribute much to cement penetration in this area.
• Any cement remaining proud on the posterior facet
should be scraped flush to the bone before proceeding,
so that it is not displaced and inaccessible upon seating
of the femoral component.
- 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 femoral facets.
- Cement may also be applied and pressurized manually.
Implant Reduction
Summary of Contents for VANGUARD XP
Page 1: ...Surgical Technique ...
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