Zimmer MIS Multi-Reference, Хирургическая техника, Страница: 29 / 48

Zimmer MIS Multi-Reference 4-in-1 Femoral Instrumentation Surgical Technique
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Step Six
Check Flexion/Extension
Gaps
Use the Spacer/Alignment Guides to
check the flexion and extension gaps.
With the knee in extension, insert the
thinnest appropriate Spacer/Alignment
Guide between the resected surfaces
of the femur and tibia (Fig. 6a). Insert
the Alignment Rod into the guide and
check the alignment of the tibial
resection (Fig. 6b). If necessary insert
progressively thicker Spacer/Alignment
Guides until the proper soft tissue
tension is obtained.
Then flex the knee and check ligament
balance and joint alignment in flexion.
When using the MIS Flex Femoral
Finishing Guide, the flexion gap will
be approximately 2mm greater than
the extension gap. For example, if the
extension gap is 10mm, the flexion
gap will be 12mm. To account for this
difference, the appropriate MIS CR-Flex
Spacer Adapter or MIS LPS-Flex Spacer
Adapter (Fig. 6c) should be placed on
top of the Spacer/Alignment Guide that
was used in extension to accurately
check ligament balance in flexion.
The combined construct will equal the
total posterior condylar thickness of the
final implant.
If the tension is significantly greater
in extension than in flexion, re-cut the
distal femur using the appropriate
instrumentation. This will enlarge the
extension space.
If the tension is significantly less in
extension than in flexion, either
downsize the femur or perform
additional ligament releases.
Fig. 6a Fig. 6b Fig. 8c