Zimmer MIS Multi-Reference, Surgical Technique, Page: 38 / 48

Zimmer MIS Multi-Reference 4-in-1 Femoral Instrumentation Surgical Technique
36
If needed, turn adjustment knob (C) to
achieve desired rotation of the femoral
component (Fig. 9c).
Turn tension adjustment knob (D) to
increase (tighten) or decrease (loosen)
the clamping force (Fig. 9d).
Close locking handle to secure
instrument to implant or provisional
(Fig. 9e).
Align implant or provisional onto
prepared bone, impact end (H).
Open locking handle by pressing trigger
(E) to release instrument from implant
or provisional.
If preferred, the Femoral Provisional
may be positioned by hand.
Translate the Femoral Provisional
laterally until the lateral peg of the
provisional aligns with the drill hole in
the lateral femoral condyle. Push the
provisional in place beginning laterally,
then medially. Be sure that soft tissue
is not trapped beneath the provisional
component.
Knee in extension
Check to ensure that the Femoral
Provisional is flush against the resected
surface on the medial condyle. Then
retract the lateral side and check to
make sure it is flush on the lateral side.
The Femoral Provisional should be
centered mediolaterally on the
distal femur.
Attach the appropriate Tibial Articular
Surface Provisional and perform a trial
reduction. Check ligament stability in
extension and in 30°, 60°, and 90°
flexion. Attempt to distract the joint in
flexion to ensure that it will not distract.
If a posterior stabilized component is
used, hyperflex the knee and check to
make sure that the spine still engages
the cam.
Insert the Patellar Provisional onto the
resected patellar surface. Perform a
ROM to check patellar tracking.
When component position, ROM, and
joint stability have been confirmed,
remove all provisional components.
Fig. 9c
Fig. 9d
Fig. 9e
Removal of Femoral Provisional
using Optional MIS Femoral
Inserter/Extractor
Ensure (A) and (B) are still set properly
for provisional type being used (PS or
CR).
Position instrument hook under
provisional (F) (Fig. 9f).
Turn tension adjustment knob (D) to
tighten or loosen as needed.
Close locking handle (G).
Attach slaphammer (H), extract.
Surgeon Notes & Tips
• In performing the trial reduction
and during implantation of the
Femoral Provisional or prosthesis,
make certain that no portion of the
quadriceps or soft tissue is pinned
beneath the component.
Fig. 9f