Zimmer MIS Multi-Reference, Surgical Technique, Page: 41 / 48

Zimmer MIS Multi-Reference 4-in-1 Femoral Instrumentation Surgical Technique
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Patellar Component
NexGen Primary Porous Patella with
Trabecular Metal Material
Knee in 70°-90° flexion
NOTE: If the implant post begins
to engage at an angle, the implant
should be removed and repositioned
perpendicular to the resected surface.
Insert the patella again and reclamp,
applying an even distribution of
pressure on the patellar surface.
NexGen All-polyethylene Patella
Knee in 70°-90° flexion
Apply cement to the anterior surface
and pegs of the patellar component
while in a doughy consistency. Locate
the drilled peg holes and use the
Patellar Clamp to insert and secure the
patella in place. Fully open the jaws of
the clamp and align the teeth to the
anterior surface of the patella and the
plastic ring to the posterior surface of
the implant. Use the clamp to apply a
significant amount of pressure to the
implant to fully seat the implant on the
patellar surface. Then remove excess
cement.
NOTE:
The pegged plate cannot be used
with the 17mm or thicker Net-Shape
molded or
Prolong ® Highly Crosslinked
Polyethylene articular surface.
With the Prolong Highly Crosslinked
Polyethylene Articular Surface
Component (17mm and thicker only),
the metal locking clip and screw are
packaged separately from the tibial
articular surface container, but in the
same box. Before inserting the tibial
articular surface, insert the metal
locking clip into the anterior slot of
the compartment. The rail should be
aligned with the space in the slot.
There is an arrow on the superior side
of the locking clip that indicates the
correct direction for insertion. The
purpose of the rail is to prevent the clip
from being assembled incorrectly. The
metal locking clip should glide easily
into the slot. The clip is properly seated
when a click is heard. For the molded
tibial articular surface, the metal
locking clip is preassembled into the
component.
A taper plug also can be used with
the 10mm to 14mm articular surface
components. If you plan to use a 14mm
component or the flexion and extension
Fig. 10d Insert the tibial articular surface
onto the tibial base plate.
Net-Shape Molded
Fig. 10e
Prolong Polyethylene
Tibial Articular Surface
Knee in 70°-90° flexion
Use the Articular Surface Insertion
Instrument to attach the appropriate
tibial articular surface onto the tibial
base plate (Fig. 10d).
Technique for 17mm and Thicker Tibial
Articular Surface Assemblies
A secondary locking screw is required
for the 17mm and thicker tibial
articular surface components if using
a Flex Femoral Component. Therefore,
stemmed tibial base plates with either
a stem extension or taper plug must be
used with these thicker components
(Fig. 10e). This assists in lift off
resistance at higher flexion positions.