Smith & Nephew TC-PLUS Revision, Surgical Technique, Page: 36 / 98

36
Tibial size determination
The chosen trial stem is attached to the extension for trial
stem ( Ø 8 mm ) and with the modular handle carefully
inserted into the tibial IM canal so the line marked with
«MIN.» is approximately level to the distal bone resection.
The modular handle is now removed. It is important to
avoid putting excessive pressure in the tibial IM canal.
The tibial sizer handle with the axial alignment rod
is assembled onto tibia sizer trial.
The tibial rotation is determined anatomically
statically (orientation to the tibial tuberosity and the axial
alignment rod).
After preliminary drilling with the Ø 3.2 mm drill, the
tibial sizer is fixed with at least two bone pins two bone
pins with head (25 mm or 38 mm) through the
anterior inclined holes..
The tibial sizer trial assembled with the tibial slope adapter
«3°» and the alignment bushing «8» are intramedullary
placed over the extension for trial stem ( Ø 8 mm ) and
applied onto the proximal bone resection. The tibial sizer
trial should completely cover the cortex without projecting
beyond the tibia. In case of doubt a lateral projection is
preferred, because a medial projection may cause irritation
of the pes anserinus. If the projection is not acceptable, a
smaller size should be used ( pay attention to the
combination! ). The correct tibial size is then determined.
Important
By use of tibial blocks, the corresponding blocks are to be
attached to the tibial sizer. Note the corresponding heights
(«5 mm», «10 mm» or «15 mm») and side ( «Rlat/Lmed» or
«Llat/Rmed» ). The 15mm tibial blocks are anatomically bent
M/L and posterior. Therefore, the under contour is always
a size smaller than the upper contour.
If an offset stem is required, see instructions page 39.
Setting the tibial rotation