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Smith & Nephew Syncera Anthem, Хирургические техники

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Introduction

The ANTHEM™ PS Total Knee System has been designed to offer 
orthopaedic surgeons solutions to address a range of intraoperative 
situations. Proper implant function is dependant on an extensive 
and accurate surgical technique. The ORTHOMATCH™ Universal 
Instrumentation system is designed to be used with ANTHEM 
to provide an easy to use system that facilitates accurate and 
reproducible surgical outcome. The system is designed to 
accommodate either a minimally invasive or standard surgical incision 
and exposure.

While it is the designers’ objective to develop accurate, easy-to-use 
instrumentation, each surgeon must evaluate the appropriateness 
of the following technique based on his or her medical training, 
experience and the specific patient clinical evaluation.

Indications

Indications for use include rheumatoid arthritis; post-traumatic 
arthritis, osteoarthritis or degenerative arthritis; failed osteotomies or 
unicompartmental replacement. The ANTHEM PS Total Knee System is 
designed for use in patients in primary total knee replacement surgery, 
where the anterior and posterior cruciate ligaments are not fully 
functional and the collateral ligaments remain intact.

Disclaimer

The following technique guide was prepared under the guidance of 
Professor T.K. Kim, Professor D. Saris, Professor R. Tözün, Professor Y. 
Zhou, Professor A. Belooshi, Doctor M. Wadhwa, Doctor R. McLennan-
Smith and Doctor J. Duboy. It contains a summary of medical 
techniques and opinions based upon their training and expertise in 
the field, along with their knowledge of Smith & Nephew products. 
It is provided for educational and informational purposes only. Smith 
& Nephew does not provide medical advice and it is not intended 
to serve as such. It is the responsibility of the treating physician 
to determine and utilize the appropriate products and techniques 
according to their own clinical judgment for each of their patients. For 
more information on the products in this surgical technique, including 
indications for use, contraindications, effects, precautions and 
warnings, please consult the products’ Instructions for Use (IFU).

Содержание Syncera Anthem

Страница 1: ...Surgical Technique...

Страница 2: ...Korea Professor D Saris Utrecht Netherlands Professor R T z n Istanbul Turkey Professor Y Zhou Beijing China Professor A Belooshi Dubai U A E Doctor M Wadhwa Chandigarh India Doctor R McLennan Smith...

Страница 3: ...s 2 Preoperative planning 3 Femoral preparation 4 Tibial preparation 7 Femoral positioning and sizing 11 A P and chamfer resection 15 Component trialling 17 Tibial keel preparation 20 Resurfacing pate...

Страница 4: ...ent The ANTHEM PS Total Knee System is designed for use in patients in primary total knee replacement surgery where the anterior and posterior cruciate ligaments are not fully functional and the colla...

Страница 5: ...so that correct limb alignment is restored Beware of misleading angles in knees with a flexion contracture or rotated lower extremities Note Many surgeons prefer to simply select a standard angle for...

Страница 6: ...angle 3 Slide the IM T Handle rod through the valgus bushing and in to the femoral canal until the assembled valgus alignment guide touches at least one of the distal femoral condyles Figure 2 4 Conn...

Страница 7: ...ction Figure 4 8 By sliding the resection check guide angel wing in to the blade slot of the universal cutting block assess the bone resection level before performing the resection The universal cutti...

Страница 8: ...in hole to secure the universal cutting block in position Resect the distal femur using an oscillating saw Figure 7 11 Once resection complete then remove pins and the universal cutting block from the...

Страница 9: ...ng block to the 3 cut block connector with the T mark facing outwards This can be attached either centrally or medially depending on preference 3 Place the ankle clamp around the patient s ankle dista...

Страница 10: ...ting block by inserting the foot of the tibial stylus into the cutting slot of the universal cutting block 6 Adjust the resection level by lowering the universal cutting block until the tibial stylus...

Страница 11: ...the spike rod superiority while the universal cutting block remains in position with secured pins The ankle clamp and 3 cut block connector can then also be removed 10 Insert drop rod guide assembly...

Страница 12: ...y or scalpel to prevent it from affecting the assessment 13 Extend the knee to 0 degree to check mechanical axis alignment and extension gap balance Check alignment and balance with the appropriate sp...

Страница 13: ...ilizing either the Ant Ref or Post Ref holes These holes correlate with similar holes on the A P resection blocks The femoral size is indicated on either side of the femoral housing of the sizer In ad...

Страница 14: ...for more detail e Select Anterior or Posterior referencing f Pin either anterior or posterior referencing holes with trocar pins g Leave pins in place for femoral cutting block 1 Place the femoral si...

Страница 15: ...otation of the femoral component should be considered Figure 16b Note Ensure that the appropriate side is chosen when setting external rotation ie L for left and R for right 4 Once the desired externa...

Страница 16: ...e Posterior referencing Choose the next larger size ie upsize to reduce the risk of anterior notching Anterior referencing Choose the next smaller size ie downsize to avoid overstuffing the flexion sp...

Страница 17: ...se the anterior OR posterior referencing translation blocks These are designed to allow fine adjustment of the A P position of the femoral cutting block To use the translation block remove the trochar...

Страница 18: ...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 siz...

Страница 19: ...it of the trial in the trochlea and trochlea junction area to avoid any overhang 3 Secure the femoral trial to the bone using two short headed pins in the anterior flange Figure 20 4 The ANTHEM femora...

Страница 20: ...handle and impact through the collet guide until flush with the collet The chisel should be used anteriorly and then posteriorly to ensure that the full length of the PS box is prepared Remove any re...

Страница 21: ...ng both medially and laterally throughout the range of motion There should be no increase in resistance as the knee flexes from 0 to 90 If the knee is too tight try a thinner insert or resect more tib...

Страница 22: ...the femoral trial Figure 23 2 Re assess the tibial coverage size and rotation required and pin the tibial trial baseplate in place using two short headed pins Figure 24 3 Using the 11mm tibial drill...

Страница 23: ...ethod to setting tibial rotation is to use the tibia trial bullet This can be used once the central canal has been prepared but before the keel preparation With the tibial trial not pinned to the tibi...

Страница 24: ...e 25 4 Subtract 9mm from this measured thickness This is the amount of bone that will remain after resection Figure 25a 5 Set the patella resection guide for the amount of bone that should remain afte...

Страница 25: ...diameter resurfacing patella drill guide and place it onto the patella Align patella drill guide to the resected patella 8 Use the patella peg drill to drill for the three peg holes through the patel...

Страница 26: ...rfacing patellar trial onto the resected patella Use the patella caliper to reassess the patella thickness Figure 25d and 25e 11 Revert back the patella onto the femoral trial to check patella femoral...

Страница 27: ...igure 26 2 Apply generous amounts of cement to the dry underside of the baseplate keel and onto the proximal tibia and keel prep hole Figure 26 3 Use the tibial implant impactor on the modular handle...

Страница 28: ...ment that extrudes posteriorly is difficult to remove 5 Place the Femoral Implant onto the femur and use the Modular Femoral Impactor to fully seat the implant Remove excess cement Extend the knee to...

Страница 29: ...lant onto the patella and clamp into the bone Remove excess cement Figure 26e 8 Select the correct Articular Insert Implant with the appropriate thickness 9 Clear any debris from the locking mechanism...

Страница 30: ...best done when the leg is flexed to around 20 30 degrees and impacting on the anterior surface of the insert Figure 26f Note To check insert is fully seated perform a visual examination on each side...

Страница 31: ...Compenent Produt Family Sizes Femoral ANTHEM Standard PS CoCr 3 8 LT RT ANTHEM Narrow PS CoCr 1 6 LT RT GENESIS II Non porous PS CoCr 1 8 LT RT LEGION Non porous PS CoCr 2 8 LT RT LEGION Non porous Na...

Страница 32: ...Brooks Road Memphis TN 38116 Telephone 901 396 2121 Information 1 800 238 7538 Orders inquires 1 800 238 7538 www smith nephew com Trademark of Smith Nephew 2016 Smith Nephew All rights reserved 02903...

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