Smith & Nephew Syncera Anthem Surgical Techniques Download Page 7

5

6.

 Once the universal cutting block is secured with pins, 

remove pins from valgus alignment guide and slide 
the valgus alignment guide anteriorly to fully remove it. 
Then remove the IM -handle and valgus bushing from 
the Intra-medullary canal.

7.

 Extend the knee fully and insert drop rod guide 

assembly in to the blade slot of the universal cutting 
block to check Hip Knee Mechanical Axis (HKA) before 
resection (Figure 4).

8.

 By sliding the resection check guide (angel wing) in to 

the blade slot of the universal cutting block assess the 
bone resection level before performing the resection. 
The universal cutting block pinned through the “0” 
holes will resect 9.5mm from the prominent condyle of 
the femur (Figure 5). 

9.

 If additional bone removal is desired, for example in the 

case of a fixed flexion deformity, the universal cutting 
block can be shifted superiorly by removing it from the 
pins and reinserting it onto the “+2” pin holes. This will 
result in a 11.5mm distal resection (Figure 6).

Figure 5

Figure 6

Figure 4

Summary of Contents for Syncera Anthem

Page 1: ...Surgical Technique...

Page 2: ...Korea Professor D Saris Utrecht Netherlands Professor R T z n Istanbul Turkey Professor Y Zhou Beijing China Professor A Belooshi Dubai U A E Doctor M Wadhwa Chandigarh India Doctor R McLennan Smith...

Page 3: ...s 2 Preoperative planning 3 Femoral preparation 4 Tibial preparation 7 Femoral positioning and sizing 11 A P and chamfer resection 15 Component trialling 17 Tibial keel preparation 20 Resurfacing pate...

Page 4: ...ent The ANTHEM PS Total Knee System is designed for use in patients in primary total knee replacement surgery where the anterior and posterior cruciate ligaments are not fully functional and the colla...

Page 5: ...so that correct limb alignment is restored Beware of misleading angles in knees with a flexion contracture or rotated lower extremities Note Many surgeons prefer to simply select a standard angle for...

Page 6: ...angle 3 Slide the IM T Handle rod through the valgus bushing and in to the femoral canal until the assembled valgus alignment guide touches at least one of the distal femoral condyles Figure 2 4 Conn...

Page 7: ...ction Figure 4 8 By sliding the resection check guide angel wing in to the blade slot of the universal cutting block assess the bone resection level before performing the resection The universal cutti...

Page 8: ...in hole to secure the universal cutting block in position Resect the distal femur using an oscillating saw Figure 7 11 Once resection complete then remove pins and the universal cutting block from the...

Page 9: ...ng block to the 3 cut block connector with the T mark facing outwards This can be attached either centrally or medially depending on preference 3 Place the ankle clamp around the patient s ankle dista...

Page 10: ...ting block by inserting the foot of the tibial stylus into the cutting slot of the universal cutting block 6 Adjust the resection level by lowering the universal cutting block until the tibial stylus...

Page 11: ...the spike rod superiority while the universal cutting block remains in position with secured pins The ankle clamp and 3 cut block connector can then also be removed 10 Insert drop rod guide assembly...

Page 12: ...y or scalpel to prevent it from affecting the assessment 13 Extend the knee to 0 degree to check mechanical axis alignment and extension gap balance Check alignment and balance with the appropriate sp...

Page 13: ...ilizing either the Ant Ref or Post Ref holes These holes correlate with similar holes on the A P resection blocks The femoral size is indicated on either side of the femoral housing of the sizer In ad...

Page 14: ...for more detail e Select Anterior or Posterior referencing f Pin either anterior or posterior referencing holes with trocar pins g Leave pins in place for femoral cutting block 1 Place the femoral si...

Page 15: ...otation of the femoral component should be considered Figure 16b Note Ensure that the appropriate side is chosen when setting external rotation ie L for left and R for right 4 Once the desired externa...

Page 16: ...e Posterior referencing Choose the next larger size ie upsize to reduce the risk of anterior notching Anterior referencing Choose the next smaller size ie downsize to avoid overstuffing the flexion sp...

Page 17: ...se the anterior OR posterior referencing translation blocks These are designed to allow fine adjustment of the A P position of the femoral cutting block To use the translation block remove the trochar...

Page 18: ...only The aim is to have equal flexion and extension spaces Figure 18 18a and 18b Note Surgical tips to achieve optimal flexion Avoid posterior impingement of femoral component by ensuring adequate siz...

Page 19: ...it of the trial in the trochlea and trochlea junction area to avoid any overhang 3 Secure the femoral trial to the bone using two short headed pins in the anterior flange Figure 20 4 The ANTHEM femora...

Page 20: ...handle and impact through the collet guide until flush with the collet The chisel should be used anteriorly and then posteriorly to ensure that the full length of the PS box is prepared Remove any re...

Page 21: ...ng both medially and laterally throughout the range of motion There should be no increase in resistance as the knee flexes from 0 to 90 If the knee is too tight try a thinner insert or resect more tib...

Page 22: ...the femoral trial Figure 23 2 Re assess the tibial coverage size and rotation required and pin the tibial trial baseplate in place using two short headed pins Figure 24 3 Using the 11mm tibial drill...

Page 23: ...ethod to setting tibial rotation is to use the tibia trial bullet This can be used once the central canal has been prepared but before the keel preparation With the tibial trial not pinned to the tibi...

Page 24: ...e 25 4 Subtract 9mm from this measured thickness This is the amount of bone that will remain after resection Figure 25a 5 Set the patella resection guide for the amount of bone that should remain afte...

Page 25: ...diameter resurfacing patella drill guide and place it onto the patella Align patella drill guide to the resected patella 8 Use the patella peg drill to drill for the three peg holes through the patel...

Page 26: ...rfacing patellar trial onto the resected patella Use the patella caliper to reassess the patella thickness Figure 25d and 25e 11 Revert back the patella onto the femoral trial to check patella femoral...

Page 27: ...igure 26 2 Apply generous amounts of cement to the dry underside of the baseplate keel and onto the proximal tibia and keel prep hole Figure 26 3 Use the tibial implant impactor on the modular handle...

Page 28: ...ment that extrudes posteriorly is difficult to remove 5 Place the Femoral Implant onto the femur and use the Modular Femoral Impactor to fully seat the implant Remove excess cement Extend the knee to...

Page 29: ...lant onto the patella and clamp into the bone Remove excess cement Figure 26e 8 Select the correct Articular Insert Implant with the appropriate thickness 9 Clear any debris from the locking mechanism...

Page 30: ...best done when the leg is flexed to around 20 30 degrees and impacting on the anterior surface of the insert Figure 26f Note To check insert is fully seated perform a visual examination on each side...

Page 31: ...Compenent Produt Family Sizes Femoral ANTHEM Standard PS CoCr 3 8 LT RT ANTHEM Narrow PS CoCr 1 6 LT RT GENESIS II Non porous PS CoCr 1 8 LT RT LEGION Non porous PS CoCr 2 8 LT RT LEGION Non porous Na...

Page 32: ...Brooks Road Memphis TN 38116 Telephone 901 396 2121 Information 1 800 238 7538 Orders inquires 1 800 238 7538 www smith nephew com Trademark of Smith Nephew 2016 Smith Nephew All rights reserved 02903...

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