Smith & Nephew TC-PLUS Revision, Surgical Technique

Page: 46 / 98

46
Positioning the patella clamp and patella resection
Determine patellar size using the patellar sizer. Supplied
sizes are Ø 26, Ø 29, Ø 32 and Ø 35 mm. Note that the
patellar component is implanted with a slight medial offset,
thus matching the position of the natural patellar ridge.
Small implant sizes are recommended for small patella to
enable this offset to be reproduced.
Patellar Preparation
The leg is extended. Soft tissue on the posterior surface of the patella is exposed
preserving the ligaments.
If the posterior surface of the patella is not replaced, the patella is freed
osteophytes and denerved.
The patellar instruments permit the use of the « onlay »
technique in which 10 mm of the bone are resected and
replaced by a 10 mm thick patellar implant ( if an 8 mm thick
patellar implant is planned, resect just 8 mm accordingly ).
An alternative option is the « inlay » technique, in which the
implant is partially countersunk ( 3 mm to 5 mm ). Here, the
patella is only resected approx. 7 mm to 5 mm below the
ridge. The thickness of the residual bony patella should not
be less than 12 mm. See also the
« Milling » section on page 47.
After placing the patellar cutting guide on the patellar clamp
with the ratchet, grasp the patella with the clamp. The
patellar thickness can be read from the mm scale on the
handle.
Adjust the patella osteotomy insert ( mm scale ) to the
height to be resected and resect the patella with the
oscillating saw ( 1 mm saw blade with unset teeth, see page
89 ).
Important
When resecting, ensure that the saw blade does not
wander, e.g. due to sclerotic bone sectors.
Patellar size determination