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15

Instruments

SECTION

7

Cemented Implantation Option

TECHNIQUE TIP 

7.B

Prior to cementing implants remove provisionals and use pulse lavage 
to remove unwanted debris from the resected bone surfaces  
and the joint space.

•

   Cement may be used to fix the Persona Trabecular Metal 

Femoral Component. After the implants have been chosen, 
make a final check to ensure that all components are 
compatible. If the resected surfaces of the femur is sclerotic, 
drill multiple holes with a small drill (2.0mm-3.2mm) to 
improve cement intrusion. The cement should have a doughy 
consistency when ready for use.

•

   With the knee in 70°-90° of flexion, retract the soft  

tissue in the desired manner. Place a layer of cement on  
the underside of the prosthesis and in the holes drilled 
in the femur. Attach the Femoral Inserter/Extractor to the 
femoral component 

(Fig. 43a & 43b)

. Insert the femoral 

component onto the distal femur by translating the 
component laterally until the lateral peg aligns with the 
drill hole in the lateral femoral condyle. Take care to avoid 
scratching the implant component surfaces. After the 
femoral component is placed on the femur and the inserter/
extractor is removed, the impaction head/inserter assembly 
can be used to implant the component onto the femur.  
If this inserter/extractor method is used, the inserter 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 

(Fig. 44)

. Use this assembly to fully seat the femoral 

implant 

(Fig. 45)

. Remove retractors, and check the medial 

and lateral sides to make sure the femoral implant is fully 
impacted distally. Remove any excess cement in a thorough 
and consistent manner.

Implant Femoral Components

Fig. 43a

Fig. 43b

Tibial Impactor 

Head

00-5901-033-00

Quick Connect 

Handle

00-5901-034-00

Femoral Impactor 

Head

00-5901-032-00

Persona

 Femoral 

Inserter/Extractor

42-5099-092-00

Persona

 Femoral 

PS Impactor Pad

42-5099-093-00

Persona

 Femoral 

CR Impactor Pad

42-5099-094-00

Persona  

Trabecular Metal 

  

PS Femoral Component 

Size 

7

 Right

42-5008-062-02

Persona  

Trabecular Metal 

  

CR Femoral Component 

Size 

7

 Right

42-5028-062-02

1. Unlock Collar

2. Insert

3. Release

4. Rotate

Fig. 45

Fig. 44

Summary of Contents for Persona Trabecular Metal Femoral Component

Page 1: ...Surgical Technique Trabecular Metal Femoral Component ...

Page 2: ...xation 2 Patient Bone Quality The Persona Trabecular Metal Femoral component should only be used on patients with good bone quality to ensure in growth will occur Stable fixation may be compromised if used on soft osteoporotic bone quality 3 Ambulation Period An uncemented total knee replacement requires a period of time to achieve stable bone growth into the Trabecular Metal material for successf...

Page 3: ...ponent than a cemented component Femoral Trial Implant Fit A fully seated femoral provisional and or implant should have no gaps anteriorly posteriorly and distally Gaps in the anterior and posterior chamfer areas are to be expected and can be filled with bone grafting if desired The Trabecular Metal material is approximately 0 5mm proud of the implant rails and has a darkened appearance If no lig...

Page 4: ...ncing Note The 2 5mm Female Hex Screws and 2 5mm Male Hex Driver should not be used in cortical bone as this may increase the incidence of stripping of the driver The chart below contains relevant information on various 3 2mm Pins Screws that are compatible with the Persona system If these screws pins are used during the procedure for instrument fixation they should be removed prior to closure as ...

Page 5: ...Femoral Alignment 1 Resect Distal Femur 3 Size Femur and Establish 5 External Rotation Complete Femoral A P 7 and Chamfer Resections CR Femoral Finishing 9 PS Femoral Finishing 11 and PS Box Preparation Implant Femoral Component 14 Persona Trabecular Metal Femoral Component Surgical Technique ...

Page 6: ...issue exposure use the 8mm IM Step Drill to make a starter hole Fig 1 Suction the canal to remove medullary contents Insert the Femoral IM Rod into the Modular T Handle Fig 2 and insert the IM rod into the femur far enough to ensure the most accurate replication of the anatomic axis then remove the T handle Fig 3 Fig 1 Fig 2 Fig 3 TECHNIQUE TIP 1 A As the symbol on the T handle indicates do not im...

Page 7: ...traction Optional Pinning Holes 5 Right Valgus Setting Retract the spring loaded button on the top of the Femoral Valgus Alignment Guide and rotate the valgus adjustment dial to the desired valgus angle and release the button to lock the valgus angle from 0 to 9 ensuring that the proper left or right setting is attained Fig 4 Place the Femoral Valgus Alignment Guide on the IM Rod against the most ...

Page 8: ...the adjustment dial to attain the desired setting Fig 9 Insert trocar tipped pins through the two standard pin holes marked 0 on the anterior surface of the cutting head Fig 10 Additional 2mm adjustments may be made by removing the cutting head from the pins and replacing the cutting head on the pins in the sets of holes marked 2 2 and 4 The markings on the cutting head indicate in millimeters the...

Page 9: ...d the implant fit properly Fig 10 After completing the cut remove pins and the cutting head Squeeze the button on the resection guide Fig 11 to release and remove the alignment guide and resection guide assembly from the cutting head The modular T handle is used to remove the IM Rod prior to the distal femoral resection Alternatively the T handle can be used to remove the IM Rod while the button o...

Page 10: ...erencing Sizer 4mm laterally from Whiteside s line to better center the drill holes for subsequent Anterior Referencing 4 in 1 Cut Guide placement due to the M L offset of the holes Hold the Anterior Referencing Sizer in place and if necessary secure the Anterior Referencing Sizer to the femur using 25mm x 3 2mm 2 5mm female hex screws Fig 15 in one or both of the holes on the lower portion of the...

Page 11: ...terior Referencing Sizer Boom telescopes proximally distally to facilitate optimal placement 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 Fig 16a Once the Anterior Referencing Sizer Boom is appropriately positioned it should be locked in place by tightening the knob at the end of the boom cl...

Page 12: ...he Resection Guide through the anterior slot of the cut guide to ensure the desired anterior resection Fig 20 If inadequate bone will be removed from the anterior cortex drill through the two holes on the face of the cut guide Fig 21a Use the Slaphammer to axially remove the cut guide Fig 22a 22b Place the next smaller sized femoral cut guide on the femur in the newly drilled posteriorized drill h...

Page 13: ... be placed on the distal femur in the anteriorized holes This will result in a 2mm anterior shift of the 4 in 1 femoral resections Verify that the desired anterior and posterior resections will be attained Fig 22a Fig 22b Fig 23 Fig 24 TECHNIQUE TIP 4 E Areas where the bone transitions from high to low density such as from cancellous to cortical bone can lead to the saw blade skiving and inconsist...

Page 14: ...he Standard femoral provisionals have intermittent cutouts around the periphery with 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 Fig 25b Care should be taken to use the appropriate Standard or Narrow implant as is related to side left or right and size based on the provisiona...

Page 15: ...ovisional Fig 28 Note Do NOT use a 48mm screw in the anterior lateral fixation hole 48mm screws are not recommended due to potential bone perforation Once 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...

Page 16: ...two profiles Standard and Narrow The Standard femoral provisionals have intermittent cutouts around the periphery with 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 Fig 31b Care should be taken to use the appropriate Standard or Narrow implant as is related to side left or righ...

Page 17: ...er on the proximal portion of the Femoral Inserter Extractor Fig 33 Alternatively if the PS Femoral Provisional is placed on the femur by hand the PS Femoral Impaction Pad inserter assembly can be used to impact the provisional into the femur If this insertion impaction method is used the inserter handle must be in the closed and locked position For additional fixation of the fully seated PS Femor...

Page 18: ...not easily seat into the PS Femoral Provisional perform clean up cuts to assure adequate bone has been removed Do NOT impact the PS Box Provisional Make sure the PS Femoral Provisional is fully seated after inserting the correct PS Box Provisional Fig 35a Fig 35b Fig 36 Drill the peg holes for the femoral implant through the PS Femoral Provisional with the NexGen 6 4mm Patella Femoral Drill Fig 37...

Page 19: ...ck Connect Handle to the Femoral Impactor Head Fig 40 Use the Femoral Impactor Head assembly to fully seat the femoral component Fig 41 Remove retractors and check the medial and lateral sides to make sure the femoral component is fully impacted distally Fig 39a Fig 39b Fig 41 Fig 42 Fig 40 Quick Connect Handle 00 5901 034 00 Femoral Impactor Head 00 5901 032 00 Persona Femoral Inserter Extractor ...

Page 20: ...re to avoid scratching the implant component surfaces After the femoral component is placed on the femur and the inserter extractor is removed the impaction head inserter assembly can be used to implant the component onto the femur If this inserter extractor method is used the inserter handle must be in the closed and locked position Ensure that soft tissue is not trapped beneath the implant Alter...

Page 21: ...ection of the Persona Knee Surgical Technique for tibial and articular surface insertion instructions If the tibial component is already in place prior to femoral component insertion take care to ensure the posterior condyles do not contact the tibial component upon impaction Fig 46a 46b Implant Femoral Components ...

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Page 24: ...constitute any diagnostic or therapeutic statement with regard to any individual medical case each patient must be examined and advised individually and this document does not replace the need for such examination and or advice in whole or in part Please refer to the package inserts for important product information including but not limited to contraindications warnings precautions and adverse ef...

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