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Persona The Personalized Knee

Surgical Technique

Introduction

(cont.)

Note:

The MC components can be used with or

without the PCL present. The UC, PS, and CPS
components should not be used if the PCL is
present.

Please refer to the package inserts for complete
product information, including contraindications,
warnings, precautions, and adverse effects.

Preoperative Planning

Obtain 36 inch or 53 inch standing anteroposterior
and lateral radiographs of the extremity, as well as a
sunrise view of the patella. The entire femur should
be visualized to rule out any structural abnormalities,
as the distal femoral cut will be referenced from an
intramedullary rod in the medullary canal.

Use the template overlay (available through your
Zimmer Biomet representative) to determine the
angle between the anatomic axis and the mechanical
axis. This angle will be reproduced intraoperatively.
This surgical technique helps the surgeon ensure
that the distal femur will be cut perpendicular to the
mechanical axis and, after soft tissue balancing, will be
parallel to the resected surface of the proximal tibia.

Surgical Approach

The surgeon can choose a midvastus approach, a
subvastus approach, or a parapatellar medial
arthrotomy. Also, depending on surgeon preference,
the patella can be either everted or subluxed. The
femur, tibia, and patella are prepared independently,
and can be cut in any sequence using the principle of
measured resection (removing enough bone to allow
replacement by the prosthesis).

Patient Preparation

To prepare the limb for total knee arthroplasty,
adequate muscle relaxation is required. The
anesthesiologist should adjust the medication based
on the patient’s habitus and weight, and administer
to induce adequate muscle paralysis for a minimum
of 30-40 minutes. It is imperative that the muscle
relaxant be injected prior to inflation of the tourniquet.
Alternatively, spinal or epidural anesthesia should
produce adequate muscle relaxation. If desired, apply
a proximal thigh tourniquet and inflate it with the
knee in hyperflexion to maximize that portion of the
quadriceps that is below the level of the tourniquet.
Once the patient is draped and prepped on the
operating table, determine the landmarks for the
surgical incision.

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Summary of Contents for Persona

Page 1: ...Persona The Personalized Knee Surgical Technique ...

Page 2: ...esect Proximal Tibia 12 Assemble Extramedullary EM Alignment Guide Position Alignment Guide Set Resection Level Resect Proximal Tibia Optional Technique Size Femur and Establish External Rotation 19 Complete Femoral A P and Chamfer Resections 22 Optional Instrument Establish Size and Rotation of Tibia 24 Drill and Broach Tibia 25 Optional Technique Prepare the Patella 28 Resect the Patella 28 Fini...

Page 3: ...rgeon Notes and Tips Appendix A 47 2 Degrees Valgus Recut Guide 2 Degrees Varus Recut Guide Appendix B 49 Spacer Block Technique Appendix C Optional Instruments 52 Resect Distal Femur Fixed Distal Resection Instrument Size Femur Anterior Referencing Sizer Shift Block Resect Distal Femur PRI Distal Resection Instrument Implant Components Attached Tibial Plate Inserter Appendix D 66 Compatibility Ch...

Page 4: ...rements The use of the cruciate retaining CR femoral provisionals and components can be used with either a CR or Medial Congruent MC bearing when the posterior cruciate ligament PCL is intact The CR femoral provisionals and components can be used when the PCL is sacrificed or deficient and removed if used with either a MC or ultracongruent UC bearing provisionals and components Also posterior stab...

Page 5: ...ue balancing will be parallel to the resected surface of the proximal tibia Surgical Approach The surgeon can choose a midvastus approach a subvastus approach or a parapatellar medial arthrotomy Also depending on surgeon preference the patella can be either everted or subluxed The femur tibia and patella are prepared independently and can be cut in any sequence using the principle of measured rese...

Page 6: ...s Instruments containing magnets should be kept on an appropriate table or stand when not in use at the surgical site Symbols Symbols have been established for the following Left Right Varus Valgus Medial Lateral Standard Do not implant Not for implant Do not impact Inset Only Anterior Referencing Lock Unlock Cemented Stemmed Narrow Introduction cont Lock Unlock Medial Lateral M L Standard Std Do ...

Page 7: ...as they are NOT implantable Screw Pin Screw Pin Item Compatible Driver Shipped Sterile Non sterile Quantity per Package Single use 25 mm x 2 5 mm Female Hex Screw 42 5099 025 25 2 5 mm Male Hex Driver 42 5099 025 00 Sterile 2 Yes 75 mm x 3 2 mm Trocar Tipped Drill Pin 2 5 mm hex 00 5901 020 00 Pin Screw Inserter 00 5901 021 00 Sterile 4 Yes Hex Headed Screw 33 mm long 00 5901 035 33 Pin Screw Inse...

Page 8: ... mm resection Adjustments can be made in 1 mm increments from 10 mm to 14 mm Resect Distal Femur Assemble Adjustable Distal Resection Instrumentation Pull the lever on the modular handle and insert the IM rod Figure 1 Orientation of the IM rod will align with the polished line on the sides of the modular handle Technique Tip Alternately the IM rod may be inserted into the top of the modular handle...

Page 9: ...tion for a size 1 or 2 If the size of the femur is later determined to be 3 12 then the additional bone cut can be made using the 1 mm resection plate Insert the adjustable resection tower into the adjustable valgus guide Rotate the lock lever on the adjustable resection tower to the unlocked or in line position and fully insert into the cut guide Figure 6a Flip the lock lever to the locked or ver...

Page 10: ...t the IM rod so that the engraved lines are aligned with the epicondylar axis Figure 8a Turn the lock knob on the adjustable valgus guide clockwise to the locked position to secure orientation of the assembly Figure 8b Note Setting rotation of the adjustable valgus guide is important for creating a distal resection that matches the desired valgus angle selected It does not set the rotation of the ...

Page 11: ...er depth setting rotate the dial clockwise until a click is felt This occurs when thedialmovesfromthe 4 settingtothe 0 setting The bold 0 will be visible on the dial and the line will be aligned with the 0 mark along the shaft Figure 10 Technique Tip Confirm valgus alignment by inserting the drop rod adapter into the large holes on the anterior face of the cut guide and insert an alignment rod int...

Page 12: ...l resection system exists for users who for all patients maintain a consistent valgus angle for their distal cut For use of this instrument refer to Appendix C Optional Instruments Resect Distal Femur Fixed Distal Resection Instrument Section 1 Technique Tip Additional 2 mm adjustments may be made by using the sets of holes marked 2 2 and 4 These sets of holes indicate in millimeters the amount of...

Page 13: ...ary so that it is completely flat Remove all pins and the cut guide Optional Cutting Technique If desired the bone resection can be made from the top most distal surface of the cut guide Figure 15a The top surface of the cut guide is 4 mm from the cut slot Therefore if cutting from the top surface the position of the cut guide must be adjusted by moving the cut guide from the trocar tipped pins th...

Page 14: ...stal rod into the EM proximal tube and release the button Figure 16 Attach the selected tibial cut guide to the EM alignment guide Figure 17 1 Lift the lever on the EM proximal tube up 2 Translate the cut guide onto the top of the EM proximal tube under the locking cone 3 Push down the lever on the EM proximal tube to lock the cut guide in place Figure 16 Figure 17 3 Push Down 2 Translate 1 Lift P...

Page 15: ...nd a 3 degree guide in left right and universal non sided configurations Technique Tip It is recommended to use the 3 degree cut guide for a PS component and the 7 degree cut guide for a CR component If the UC bearing is to be used the recommended tibial cut slope is 5 7 degrees Biasing towards a flatter slope cut for the UC bearing provides an opportunity to better match flexion and extension spa...

Page 16: ...n of the proximal portion of the guide Figure 20a Note This pin will need to be removed to allow the 2 or 4 mm shifts with the cut guide Align the EM alignment guide with the mechanical axis of the tibia Figure 21a The longitudinal axis will usually lie just medial to the mid point of the tibial tubercle and be centered in line with the intercondylar eminence The distal end of the EM alignment gui...

Page 17: ...s a different resection level The 2 mm tip is used to establish the resection level from the defective tibial condyle for a minimal cut The 10 mm tip is used to establish the resection level from the least involved tibial condyle To assemble push and hold the lever on the stylus and insert the stylus into the top of the cut guide and release the lever Figure 23 The stylus rotates and telescopes to...

Page 18: ...the lever on the side of the stylus and remove To confirm alignment insert the drop rod adapter into the cut guide and insert the alignment rod into the adapter Figure 28 Figure 26 Resect Proximal Tibia cont Set Resection Level cont The2mmtipshouldrestonthedefectivetibialcondyle Figure 24 This positions the slot of the cut guide to remove 2 mm of bone below the tip of the stylus Alternatively rest...

Page 19: ... 2 and 4 The markings on the cut guide indicate in millimeters the amount of additionalboneresectionrelativetothestandardtibial resection set by the cut guide and stylus If a pin or screw was inserted into the 12 mm vertical slot it will need to be removed to make the 2 mm adjustments Once the resection level has been determined insert a 3 2 mm trocar tipped pin in the oblique hole indicated by a ...

Page 20: ...nt evaluate the flatness of the proximal tibial resection prior to drilling for the pegs Modify the cut as necessary so that it is completely flat Remove oblique pins and the tibial cut guide Technique Tip If unable to complete the resection on the lateral side of the tibia remove the cut guide extend the knee and retract the soft tissue on the lateral side If necessary use an osteotome to complet...

Page 21: ...ondylar axes of the femur The 3 degrees drill holes are rotated 3 degrees from the posterior feet and are neutral to the central sizer geometry This enables use of the A P and epicondylar axis to set rotation Side Designation Figure 36 Figure 37 Figure 38 If the 3 degrees external rotation holes are to be used to set external rotation the etched line on the sizer shouldbepositionedsoitisinlinewith...

Page 22: ...along the anterior cortex The engraved lines along the top of the boom approximate the anterior flange lengths of the size 1 7 and 12 femoral components Figure 39a Once the sizing boom is appropriately positioned it should be locked in place by tightening the knob at the end of the boom clockwise Figure 39b Technique Tip Lock boom after positioning to reduce the toggle of the boom tip This will al...

Page 23: ...ortion of the sizer are used to drill 3 2 mm holes for pegs on the anterior referencing 4 in 1 femoral cut guide Figure 41 A 3 2 mm pin may be placed in the first drilled hole to maintain an index position prior to drilling the second hole Remove the screws then remove the sizer Technique Tip The multi pin puller cannot be used to extract the screw s Technique Tip This anterior referencing sizer w...

Page 24: ...uide to assure that the desired resections will be attained If too much posterior bone will be resected the original femoral cut guide can be used Technique Tip If the 2 mm shift holes are to be used assure that the desired holes on the distal femur are used The resection guide can be used as final verification of the anticipated anterior and posterior resections Technique Tip If there is a risk o...

Page 25: ...0 in thick oscillating saw blade to complete the anterior posterior posterior chamfer and anterior chamfer resections through the cut slots Figure 47 Upon completion of the cuts use the multi pin puller to remove the oblique pins Technique Tip It is not recommended that the following headed screws are used through the oblique holes of the anterior referencing 4 in 1 cut guides as the head of the s...

Page 26: ...egrees of the axis created by the medial 1 3 of the tibial tubercle and the PCL attachment point The engraved lines on the cemented tibial sizing plate can be used to aid in establishing the desired tibial rotation Rotate the cemented tibial sizing plate to attain the desired tibial rotational alignment The notch in the lateral periphery of the sizing plate is used to establish proper position wit...

Page 27: ...d the size should not be changed If desired femoral finishing can be performed in conjunction with provisional trialing at this stage to assure that the desired range of motion and soft tissue balance can be attained with the cemented tibial sizing plate in place prior to drilling and broaching the tibia By hand place and hold the cemented tibial drill guide on the tibia cemented tibial sizing pla...

Page 28: ...s displayed in the cemented tibial drill stop collar window Figure 53 and that the cemented tibial drill stop collar is locked on the cemented tibial drill Technique Tip Verify that the cemented tibial drill stop collar is locked on the cemented tibial drill by attempting to slide the cemented tibial drill stop collar on the cemented tibial drill by hand The cemented tibial drill stop collar will ...

Page 29: ...move the cemented tibial broach from the bone Figure 57 Avoid dislodging the cemented tibial sizing plate when removing the cemented tibial broach inserter extractor handle Technique Tip Assure that no metallic debris is present on the magnetic feet of the cemented tibial broach inserter extractor handle as this may inhibit the mating with the cemented tibial sizing plate and may introduce unwante...

Page 30: ...atella instrumentation is to be used to resect the patella Refer to the sizing chart for patella dimensions Figure 59 Use a 3 2 mm drill to drill the highest portion of the medial facet perpendicular to the articular surface approximately 12 mm deep centered on the medial sagittal ridge Figure 60 This acts as a guide for proper medialization of the patella Use the patella osteotomy guide with the ...

Page 31: ...050 inch thick saw blade Figure 62 Cut the patella flat so that a smooth surface remains Technique Tip To facilitate unlocking the patella osteotomy guide from the patella apply slight gripping pressure on the handles of the patella osteotomy guide and depress the release lever to unlock the patella osteotomy guide Figure 63 Figure 62 Figure 63 Figure 64 Finish the Patella Using the NexGen Patella...

Page 32: ...ll hole with the clamp oriented so two of the holes are biased toward the medial side of the patella Figure 66 Technique Tip For hard sclerotic bone it may be necessary to impact the NexGen Patella Peg Drill Guide face to fully seat the drill guide This is necessary to assure that adequate bone removal is attained during drilling to fully seat the implant Figure 66 Figure 68 Figure 67 Figure 65 Us...

Page 33: ...th the inner dimension representing the outer profile of the narrow femoral implant and the outer dimension representing the outer profile of the standard femoral implant Figure 69b Figure 69a Figure 69b Figure 70 Femoralsizes1and2areprovidedinoneprofile narrow and femoral size 12 provided in one profile standard Thus the size 1 2 and 12 femoral provisionals do not have intermittent cutouts Care s...

Page 34: ...drill is seated at bottom of the femoral provisional counterbore If the tibia has been prepared a trial range of motion can be performed to assure proper positioning of the CR femoral provisional prior to femoral peg hole preparation Once desired medial lateral placement has been attained drill the peg holes for size 3 through 12femoralimplantsthroughtheCRfemoralprovisional with the NexGen 6 4 mm ...

Page 35: ...ral inserter extractor Figure 75a The femoral PS impactor pad is keyed so the femoral PS impactor pad may have to be rotated while placing and aligning the femoral PS impactor pad onto the femoral inserter extractor Femoralsizes3through11areprovidedintwoprofiles standard and narrow The size 3 through 11 standard femoral provisionals have intermittent cutouts around the periphery with the inner dim...

Page 36: ...al lateral position Impact the end of the femoral inserter extractor handle to fully seat the PS femoral provisional onto the femur Figure 77 To remove the femoral inserter extractor from the PS femoral provisional pinch the release lever while pulling out down Figure 77 Alternatively if the PS femoral provisional is placed on the femur by hand the femoral inserter extractor handle must be in the ...

Page 37: ...ake the anterior to posterior PS box cut with a 1 27 mm 0 050 inch thick inch wide oscillating or reciprocating saw blade by resting the saw blade in a parallel manner on the front surface of the PS box cut guide Avoid undercutting the medial and lateral condyles This is particularly important for smaller femurs Figure 79a Figure 79a Figure 79b After completing the anterior to posterior box cut ma...

Page 38: ...he PS box cut guide By hand insert the correct sized PS box provisional into the PS femoral provisional to assure that adequate bone has been removed for the implant AND for proper patella trialing Separate left and right PS box provisionals exist for sizes 1 2 3 5 6 9 and 10 12 PS femoral provisionals Figure 80 The constrained posterior stabilized CPS cut slot must be used if a CPS bearing is sel...

Page 39: ...forthosesizes Removethescrew from the anterior flange in the PS femoral provisional Remove the PS box provisional The slaphammer can be used to remove size 3 through 12 PS femoral provisionals Figure 82 Rotate the slaphammer a turn outward For size 1 and 2 PS femoral provisionals the slaphammer can be inserted into the notch on the medial or lateral side of the provisional Alternatively the femora...

Page 40: ...oral inserter exactor from the provisional With the knee in extension ensure that the provisional is flush against the resected distal surface of the femur on the medial condyle Retract the lateral side and check to make sure it is flush distally on the lateral side If preparation for patella resurfacing has been performed insert the appropriate patella provisional during the trialing phase Figure...

Page 41: ...ucts and the 6 mm bottom for 16 20 mm constructs Note TASP bottom pins are offset to prevent assembly of left TASP tops on right TASP bottoms and vice versa TechniqueTip As shown on the anterior face of the TASP top confirm the correct constraint femoral compatibility tibial size and side Technique Tip Apply gentle manual pressure without impacting the TASP construct with either a mallet or hand T...

Page 42: ... TASP top and bottom To avoid inadvertent separation maintain slight pressure between the TASP top and bottom while inserting the shim The shims are incremented by 1 mm to create TASP constructs of 10 mm 11 mm 12 mm 13 mm or 14 mm to match the implant offering The 6 mm bottoms are included for instances where the TASP construct needs tobe16mm 18mm or20mm Inthesecircumstances the 10 mm 12 mm and 14...

Page 43: ...repared tibia bone For additional fixation of the fully seated provisional insert the 25 mm x 3 2 mm screw 2 5 mm female hex with the 2 5 mm male hex driver through the two screw fixation holes in the medial and lateral compartments on the STP Note Do NOT use 48 mm screws for cemented tibial sizing plate fixation 48 mm screw are not recommended due to potential bone perforation Figure 87d Figure 8...

Page 44: ...cting the PCL If the PCL is resected either a MC or UC bearing should be used If unacceptable flexion extension gap imbalances exist refer to the Balance Flexion Extension Gaps section of Appendix B for potential options The constrained posterior stabilized CPS TASP may also be assessed if further stability is needed Additional information for this product may be found in the Constrained Posterior...

Page 45: ...idelines for cement prep including but not limited to mix work and set time Tibial Plate Sublux the tibia anteriorly to allow adequate clearance to insert the tibial implant into the prepared bone Do not apply substances other than bone cement to the tibial implant i e do not dip implant into antibiotics or other substances Keep the implant clean and free of debris prior to cementing Place a layer...

Page 46: ... If this method is used the femoral inserter extractor handle must be in the closed and locked position Ensure that soft tissue is not trapped beneath the implant Alternatively assemble the quick connect handle to the femoral impactor head Figure 93 Use this assembly to fully seat the femoral implant Figure 94 Remove retractors and check the medial and lateral sides to make sure the femoral implan...

Page 47: ...CR femoral implants are used the tibial implant should be implanted prior to the femoral implant to facilitate the removal of excess cement from the posterior aspect of the tibia prior to femoral implantation Figure 96b Figure 97 Figure 96a Technique Tip Only in vivo assembly of the ultracongruent bearing is recommended because the design of the ultracongruent bearing precludes cement removal from...

Page 48: ... to the anterior surface of the patella and the patella clamp head to the posterior surface of the implant Figure 98 Use the patella clamp to apply enough pressure to fully seat the implant on the patellar surface Remove any excess cement in a thorough and consistent manner Figure 98 Close Incision Freely irrigate the wound with the solution of choice to assureunwanteddebrisisremovedfromthejointsp...

Page 49: ... a valgus correction cut is needed place the valgus recut guide on the resected tibial plateau by attaching the alignment rod with coupler and the NexGen PRI Alignment Adaptor Align with the medial 1 3 of the tubercle Onceithasbeendeterminedthatthedesired correction cut will be attained slide the medial portion of the valgus recut guide so it is flush with the medial portion of the tibial cortex t...

Page 50: ...ure 101 If a varus correction cut is needed place the varus recut guide on the resected tibial plateau by attaching the alignment rod with coupler and the NexGen PRI Alignment Adaptor Align with the medial 1 3 of the tubercle Onceithasbeendeterminedthatthedesired correction cut will be attained slide the lateral portion of the varus recut guide so it is flush with the lateral portion of the tibial...

Page 51: ...r block physical thicknesses are 9 mm more than what are shown on the spacer blocks to represent the combined Persona distal femoral thickness and the corresponding tibial component thickness Use the spacer alignment guides or MIS spacer alignment guides to check the extension gap Insert the thinnest appropriate spacer alignment guide between the resected surfaces of the femur and tibia Figure 103...

Page 52: ...bearing may be sufficient to balance the construct Figure 105 2 If the knee is tight in flexion but acceptable in extension three options exist One option is to release the PCL either by island osteotomy or ligament release both of which lengthen the ligament If the PCL is absent change constraint to MC or UC A second option is to cement the femoral component distal to the bone cut This augmentati...

Page 53: ... a posterior release 8 If the joint is loose in flexion and acceptable in extension increasing the femoral size may equalize the gaps Alternatively moving the femoral component proximally and applying a thicker tibial bearing will equalize the gaps Another option is to fill the flexion gap with the appropriate poly and perform a posterior release to increase the extension gap 9 If a joint is symme...

Page 54: ... on the IM rod with the flat plate of the fixed valgus guide to set the IM rod at a specific length Figure 108 Figure 107 Insert the fixed resection tower into the face of the fixed valgus guide indicating the angle and side of the knee left or right Note The valgus alignment guide will resect 10 mm of distal bone The distal resection can be changed to 1 mm through 9 mm resection depth in 1 mm inc...

Page 55: ...ation cont Rotate the lock lever on the fixed resection tower to the unlocked or in line position and fully insert into the cut guide Figure 110a Appendix C Optional Instruments cont Figure 110a Figure 110b Flip the lock lever to the locked or vertical position to secure it to the cut guide Figure 110b Technique Tip The fixed resection tower is compatible with the adjustable valgus guide and the a...

Page 56: ...ection instrumentation into the IM canal far enough to ensure the most accurate replication of the anatomic axis Set the orientation of the fixed valgus guide by placing it against the most prominent distal condyle and rotating it about the IM rod so that it is aligned with the epicondylar axis Figure 112 Appendix C Optional Instruments cont Figure 111 Figure 112 Figure 113 Note Setting rotation o...

Page 57: ...d adapter Figure 114 Insert a trocar tipped pin through each of the standard pin holes marked 0 on the anterior surface of the cut guide Figure 115 Flip the lock lever on the fixed resection tower to the unlocked or in line position and pull the handle to remove the IM rod and assembled distal resection instrumentation leaving only the cut guide attached to the femur Figure 116 Figure 114 Figure 1...

Page 58: ...e flush against the posterior condyles Center the anterior referencing sizer mediolaterally Both the vertical and horizontal portions of the anterior referencing sizer provide visual cues relative to the AP and epicondylar axes of the femur to help ensure that desired external rotation is attained Figure 117 Figure 118 Note Sizer geometry is rotated 3 degrees to align to the A P and epicondylar ax...

Page 59: ...ference sizer 48 mm screws are not recommended due to potential bone perforation Figure 119 Slightly extend the knee and retract soft tissues to expose the anterior femoral cortex Clear any soft tissue from the anterior cortex Ensure that the leg is in less than 90 degrees of flexion 70 degrees 80 degrees This will decrease the tension of the patellar tendon to facilitate placement of the anterior...

Page 60: ...eferencing sizer boom and approximate the proximal position of the anterior flange of the femoral component when telescoped to the same size that has been determined by the vertical anterior referencing sizer tower Figure 121 The 3 degrees or 5 degrees holes in the midline of the A P portion of the anterior referencing sizer are used to drill 3 2 mm holes for pegs on the anterior referencing 4 in ...

Page 61: ... same holes in the distal face of the femur Figure 123 To select the method of adjustment depress button and rotate drill guide until the desired face is shown If a 2 degrees rotation is desired rotate the guide to the appropriate 2 degrees rotation face Figure 124 If an A P shift is desired rotate the guide to the appropriate 1 mm shift face Figure 125 Figure 123 Figure 125 Figure 124 Technique T...

Page 62: ...ons If additional adjustment with the shift block is desired remove it from the bone using an osteotome if necessary and replace it in the newly drilled holes and repeat the drilling process Otherwise place the 4 in 1 cut guide in the newly drilled holes Figure 127 and perform bone resections Figure 126 Figure 127 Technique Tip The shift block can be rotated 180 degrees to create new drill holes i...

Page 63: ... step drill to make a starter hole Figure 128 Suction the canal to remove medullary contents Figure 128 Figure 130 Figure 129 Insert the femoral IM rod into the modular T handle Figure 129 and insert the IM rod into the femur far enough to ensure the most accurate replication of the anatomic axis then remove the modular T handle Figure 130 Technique Tip As the symbol on the modular T handle indica...

Page 64: ...de on the IM rod against the most prominent condyle and confirm the desired valgus setting Figure 132 Figure 131 Figure 133 Appendix C Optional Instruments cont Technique Tip If the epicondyles are visible the epicondylar axis may be used as a guide in setting the orientation of the femoral valgus alignment guide This does not set the rotation of the femoral component but keeps the distal cut orie...

Page 65: ...head rests on the anterior femoral cortex Figure 135 Appendix C Optional Instruments cont Verify the desired resection setting on the distal femoral resection guide and or rotate the adjustment dial to attain the desired setting Figure 136a Insert trocar tipped pins through the two standard pin holes marked 0 on the anterior surface of the cutting head Figure 136b Additional 2 mm adjustments may b...

Page 66: ... The modular T handle is used to remove the IM rod prior to the distal femoral resection Alternatively the modular T handle can be used to removetheIMrodwhilethebuttononthedistalfemoral resection guide is squeezed to facilitate rapid removal of the IM rod the femoral valgus alignment guide and Figure 137 Figure 138 Appendix C Optional Instruments cont the distal femoral resection guide at the same...

Page 67: ...ibiotics or other substances Keep the implant clean and free of debris prior to cementing Place a layer of cement on the underside of the tibial baseplate around the keel on the resected tibial surface and in the tibial IM canal Position the tibial plate onto the tibia and use the tibial inserter to impact it until fully seated To release the inserter from the implant depress the lever on the tibi...

Page 68: ... 12 J MC Persona CR Femoral Persona MC Bearing and Tibial Compatibility Tibial Size TASP Top Bottom Color Femoral Size 1 2 3 4 5 6 7 8 9 10 11 12 A B Orange 1 2 A B 3 4 A B C D Yellow 4 5 C D 6 7 C D 8 9 C D E F Green 4 5 E F 6 7 E F 8 11 E F G H Blue 8 11 G H 12 G H J Gray 12 J UC Persona CR Femoral Persona UC Bearing and Tibial Compatibility Tibial Size TASP Top Bottom Color Femoral Size 1 2 3 4...

Page 69: ... 2 A B 3 5 A B C D Yellow 1 2 C D 3 5 C D 6 9 C D E F Green 3 5 E F 6 9 E F 10 11 E F G H Blue 6 9 G H 10 12 G H J Gray 10 12 J CPS Persona PS Femoral Persona Constrained Posterior Stabilized CPS Bearing and Tibial Compatibility Tibial Size TASP Top Bottom Color Femoral Size 1 2 3 4 5 6 7 8 9 10 11 12 A B Orange 1 2 A B 3 5 A B C D Yellow 1 2 C D 3 5 C D 6 9 C D E F Green 3 5 E F 6 9 E F 10 11 E F...

Page 70: ...970 XXX XX 00 90 5952 XXXX XX The A E Micro 5 6 NexGen CR CR Flex Bearing is only available in Japan and only in the 00 5952 041 XX family This information is also available in the Persona Femoral Component package insert Persona CR Femur Used On NexGen CR Monoblock Tibia Trabecular Metal Monoblock NexGen Tibial Size Persona CR Femoral Size 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 C H 3 4 C H 4 5 C H 5 6 ...

Page 71: ...4 5 6 7 8 9 10 11 12 1 2 AB 1 2 CD 1 2 E 1 2 3 4 AB 3 4 CD 3 4 EF 3 4 G 3 4 5 6 CD 5 6 EF 5 6 GH 5 6 7 8 EF 7 10 GH 7 10 9 10 All compatibility above applies only to the following NexGen LPS Flex Bearings 00 5960 XXX XX 00 5962 XXX XX 00 5964 XXX XX The E 1 2 G 3 4 bearings are only available in the 00 5962 XXX XX family This information is also available in the Persona Femoral Component package i...

Page 72: ...l Size 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 CD 3 EF 3 4 CD 4 EF 4 5 CD 5 EF 5 GH 5 6 EF 6 GH 6 7 EF 7 GH 7 8 GH 8 9 10 All compatibility above applies only to the following NexGen Trabecular Metal Monoblocks 00 5886 05X XX 00 5886 06X XX 00 5886 07X XX This information is also available in the Persona Femoral Component package insert Appendix D Compatibility Charts cont ...

Page 73: ...71 Persona The Personalized Knee Surgical Technique Notes ...

Page 74: ...72 Persona The Personalized Knee Surgical Technique Notes ...

Page 75: ......

Page 76: ...nded for laypersons Each surgeon should exercise his or her own independent judgment in the diagnosis and treatment of an individual patient and this information does not purport to replace the comprehensive training surgeons have received As with all surgical procedures the technique used in each case will depend on the surgeon s medical judgment as the best treatment for each patient Results wil...

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