Zimmer MIS Multi-Reference, Хирургическая техника, Страница: 31 / 48

Zimmer MIS Multi-Reference 4-in-1 Femoral Instrumentation Surgical Technique
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Resect the Patella
Universal Saw Guide Technique
Apply the Universal Patellar Saw
Guide in line with the patellar tendon.
Push the patella up between the jaws
of the saw guide. Level the patella
within the saw guide jaws and use the
thumbscrew to tighten the guide.
The amount to be resected across the
top of the saw guide jaws should be
approximately the same on all sides.
Check to be sure that the 10mm gauge
does not rotate beneath the anterior
surface of the patella. If the gauge hits
the anterior surface of the patella as it
is rotated, this indicates that at least
10mm of bone stock will remain after
the cut (Fig. 7b).
Cut the patella flat so that a smooth
surface remains (Fig. 7c).
Fig. 7b
Fig. 7d
Fig. 7e
Apply the Patellar Reamer Clamp at a
90° angle to the longitudinal axis with
the Patellar Reamer Surfacing Guide
encompassing the articular surface of
the patella. Squeeze the clamp until
the anterior surface of the patella is
fully seated against the fixation plate
(Fig. 7f). Turn the clamp screw to hold
the instrument in place. The anterior
surface must fully seat upon the pins
and contact the fixation plate.
Fig. 7f
Patellar Reamer Technique
Total Surfacing Procedure
Use the Patellar Reamer Surfacing
Guides as templates to determine the
appropriate size guide and reamer.
Choose the guide which fits snugly
around the patella, using the smallest
guide possible (Fig. 7d). If the patella
is only slightly larger than the surfacing
guide in the mediolateral dimension,
use a rongeur to remove the medial
or lateral edge until the bone fits
the guide.
Insert the appropriate size Patellar
Reamer Surfacing Guide into the
Patella Reamer Clamp (Fig. 7e). Turn
the locking screw until tight.
Fig. 7c