Smith & Nephew TC-PLUS Revision, Surgical Technique, Page: 43 / 98

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After the A/P and facet resections the chisel guide
is positioned on the femoral reamer guide and fixed in
place with a retaining screw.
The proximal limit of the box is accurately defined first
with the femoral box chisel.
Po sterior-Stabilized
Option
In the case of complete insufficiency of the posterior cruciate ligament or if it is cut during
surgery, e.g. with bending contractures greater than 30°, dorsal instability in
bending position is possible.
A posterior-stabilized model (PS) for cemented application is available as compensation. It
includes a revision femoral component which includes a box in the intercondylar
region designed to accept a PS tibial insert with a higher pin. The movement of the
femoral box on
the tibial pin in bending results in the physiological roll-back
and prevents displacement of the femoral-tibial contact point in the ventral direction (to
the tibia).
SURGICAL TECHNIQUE FOR PS KNEE REPLACEMENT
The PS case is also used for the posterior-stabilized type (PS). Preparation of the
demur for receiving the box requires a box saw guide with the femoral box chisel and
the drill with the PS stop.
Important
To prevent unwanted fractures in the femoral condyle during preparation of the tibia
(
by Hohman support ), the femoral box and the femoral anchorage can also be prepared
at the end after preparation of the tibia.
Preparing the femoral box