16
4.
Complete the anterior, posterior and chamfer cuts with
an oscillating saw. The block is designed to allow for
angling of the sawblade during the cuts.
Note: To maintain block stability, the anterior chamfer
cut should be completed last.
5.
Once all resection cuts are complete, remove the A/P
Resection Block and remaining pins from the bone.
6.
Ensure the knee is flexed to 90 degrees to check
flexion gap balance using the appropriate spacer block
and rod. There should be 1-2mm of laxity laterally only.
The aim is to have equal flexion and extension spaces
(Figure 18, 18a, and 18b).
Note: Surgical tips to achieve optimal flexion:
– Avoid posterior impingement of femoral component
by ensuring adequate size and correct posterior
condylar offset
– Excise the entire PCL attachment from the femoral
intercondylar notch with either a cautery or scalpel
as the PCL has been shown to constrain flexion
assessment
– Use a curved/offset osteotome to remove any
posterior osteophytes
– Correctly balance the flexion gap
– Prevent overhang of the femoral and tibial
components
– Ensure correct tibial slope
– Beware of the neurovascular structures at the
posterior aspect of the knee joint
Figure 18
Figure 18a
Figure 18b
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