Zimmer MIS Multi-Reference, Surgical Technique, Page: 21 / 48

Zimmer MIS Multi-Reference 4-in-1 Femoral Instrumentation Surgical Technique
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Option 1
MIS Notch/Chamfer
Trochlear Guide
The MIS Notch/Chamfer Trochlear
Guide consists of 2 pieces for each
size, the MIS Notch/Chamfer Guide and
the MIS Trochlear Guide. Matching sizes
must be used.
The MIS Notch/Chamfer Trochlear
Guide may be used to complete the
chamfer cuts, the trochlear groove, the
intercondylar box and to drill the peg
holes after the anterior and posterior
cuts have been made with the MIS
Femoral Finishing Guide.
After the anterior and posterior cuts
have been made, check the flexion
gap and the extension gap using the
MIS Spacer Block. Make the necessary
adjustments.
Knee in slight flexion
Position the appropriate size MIS
Notch/Chamfer Guide onto the
femur so it is flush against the
resected surfaces both distally and
anteriorly. Ensure that no soft tissue or
osteophytes interfere with instrument
positioning. Position the guide
mediolaterally (Fig. 4t).
Fig. 4t Position the MIS Notch/Chamfer
Guide flush against the femur
Fig. 4v Secure the MIS Notch/Chamfer Guide
to the femur
Fig. 4w Cut the sides and base of the
intercondylar box
Fig. 4u Insert two short headed pins or short
screws through the anterior flange
Fig. 4x Cut the anterior and posterior
chamfers
Use a reciprocating saw to cut the
sides and base of the intercondylar box
(Fig. 4w). Protect the tibia with a wide
osteotome.
Use the Patellar/Femoral Drill to drill
the femoral post holes.
Note: Do not use the LPS-Flex Femur
Peg Drill, size A, B with the MIS Notch/
Chamfer Guide as there is no stop on
the guide for this smaller drill. If using
a micro size (A, B) LPS-Flex Femoral
Component, the femoral post holes
must be drilled when the anterior and
posterior condyle cuts are made using
the appropriate size MIS Flex Femoral
Finishing Guide and the LPS-Flex
Femur Peg Drill.
Then use an oscillating saw to cut the
anterior chamfer and the posterior
chamfer (Fig. 4x).
Note: The distal mediolateral profile
of the MIS Notch/Chamfer Guides,
anterior to the tabs, can be used to
position the guide referencing the
lateral condyle.
Insert two short headed pins or short
screws through the anterior flange
of the guide to secure the guide in
position (Fig. 4u).
Knee in 90° flexion
Secure the MIS Notch/Chamfer Guide
to the femur distally with two Short
Spring Screws or 3.2mm (1/8-inch)
headed screws. Alternatively, insert two
headed pins (Fig. 4v).