BIOMET VANGUARD XP, Руководство пользователя

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Figure 24
Fine-tune
Adjustment
Figure 25A
Figure 25B
17
Tibial Preparation
Tibial Resection with Intact/
Functional ACL (cont.)
Fine Tuning Tibial Resection Height
• Fine-tune the tibial resection level by using the height
adjustment thumb wheel (Figure 24).
eXPert Advice: Retaining the ACL tends to make the gaps
tighter than in a standard TKA. Use best judgment when
fine-tuning the resection level and when in question, take
slightly more tibial bone to avoid bone island fracture.
Option 1
• Bring the knee into extension and place the tibial
resection spacer (32-700419) tongue into the slot of the
tibial cutting block and allow the paddles to loosely rest
against the distal cut surface of the femur (Figure 25A).
• Apply traction to the leg to replicate appropriate
tension on the knee ligaments.
• Gently apply pressure to the lever toward the body
of the handle. Adequate extension space will allow
the lever to rest easily on the body of the handle. If
moderate to excessive force is needed to fully depress
the lever, adjust the depth of the tibial cutting block
to resect more tibial bone, and confirm the extension
space by easily depressing the lever to the paddle body.
• Repeat previous step at 90 degrees of flexion to ensure
that flexion and extension spaces match.
Option 2
• Bring the knee into extension and place a lamina
spreader in the medial joint space for a varus knee and
lateral joint for a valgus knee and tense the ligaments
to replicate appropriate tension.
• Place the 10 mm gap checker (32-700039) on the tibial
cut block surface on the medial side for a varus knee
and lateral side for a valgus knee and visually confirm
that there is adequate space between the gap checker
and the distal cut surface of the femur (Figure 25B).
• If the space is not adequate adjust the depth of the
tibial cutting block by using the fine tune adjustment
on the EM guide.