Zimmer Biomet NexGen MIS LPS-Flex, Руководство по хирургической технике

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NexGen MIS LPS-Flex Mobile Implant System
Surgical Technique
Step Two:
Establish Femoral Alignment
(cont.)
The standard cut plate must be attached to the
adjustable IM alignment guide for a standard distal
femoral resection (Figure 2d).
Use a hex-head screwdriver to tighten the plate (Figure
2e) on the guide prior to use. The screws must be
loosened and the plate removed for sterilization.
If preferred, remove the standard cut plate if a
significant flexion contracture exists. This will allow for
an additional 3 mm of distal femoral bone resection
(Figure 2f).
Note: The optional mini micro cut plate can be used
when templating has indicated that a micro implant
is likely. When the mini micro cut plate is attached
to the MIS adjustable IM alignment guide, one
millimeter (1 mm) less bone is removed. However, if
a significant flexion contracture exists and no plate
is attached, an additional 4 mm will be removed
compared to the distal femoral cut when the mini
micro cut plate is attached. For less bone resection,
adjustments can be made using the +2 mm/-2 mm
holes on the mini distal cut guide.
Insert the IM guide into the hole in the distal femur.
If the epicondyles are visible, the epicondylar axis
may be used as a guide in setting the orientation of
the adjustable IM alignment guide. If desired, add
the threaded handles to the guide and position the
handles relative to the epicondyles. This does not set
rotation of the femoral component, but keeps the
distal cut oriented to the final component rotation.
Once the proper orientation is achieved, impact the
IM guide until it seats on the most prominent condyle.
After impacting, check to ensure that the valgus
setting has not changed. Ensure that the guide is
contacting at least one distal condyle. This will set the
proper distal femoral resection.
Optional Technique:
An extramedullary alignment
arch and alignment rod can be used to confirm the
alignment. If this is anticipated, identify the center of
the femoral head before draping. If extramedullary
alignment will be the only mode of alignment, use a
palpable radiopaque marker in combination with an
A/P x-ray film to ensure proper location of the femoral
head.
Figure 2d
Figure 2e
Figure 2f
Standard Cut Plate
Hex-head
Screwdriver