JOURNEY II UNI Unicompartmental Knee System

Transcription

1 Surgical Technique

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3 JOURNEY II UNI Unicompartmental Knee System Table of contents Overview of surgical flow options...3 Traditional Method...7 Joint Balancing...15 Complete Femur Resections...19 Trialing and Preparation...21 Instrument Tray Layouts...32 Unicompartmental knee implants are indicated for restoring either compartment of a knee that has been affected by the following: 1. Noninflammatory degenerative joint disease including osteoarthritis, traumatic arthritis, or avascular necrosis; 2. Correction of functional deformity; 3. Revision procedures where other treatments or devices have failed; and 4. Treatment of fractures that are unmanageable using other techniques. Unicompartmental knee implants are single use only and are intended for implantation only with bone cement. Contraindications: 1. Cases where there is poor bone stock which would make the procedure unjustifiable. 2. Active, local infection or previous intra-articular infections. 3. Mental or neurologic conditions that tend to pre-empt the patient s ability or willingness to restrict activities. 4. Neuropathic (Charcot) joint. 5. Conditions that tend to place increased loads on implants such as age, weight, and activity level, which are incompatible with a satisfactory long-term result. 6. Collateral ligament insufficiency (except in cases where a constrained knee system is indicated and used). 7. Skeletal immaturity. 8. Use of a supracondylar nail through intercondylar notch of PROFIX primary femoral components. 9. Use of slotted femoral and tibial stems without adequate bone support. Nota Bene The technique description herein is made available to the healthcare professional to illustrate the authors suggested treatment for the uncomplicated procedure. In the final analysis, the preferred treatment is that which addresses the needs of the patient. The following technique is for informational and educational purposes only. It is not intended to serve as medical advice. It is the responsibility of treating physicians 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 ZUK Unicondylar Knee, including its indications for use, contraindications, and product safety information, please refer to the product s label and the Instructions for Use packaged with the product.

4 JOURNEY II UNI Unicompartmental Knee System Femoral component Asymmetric: The implant mimics the distal condyle s normal, anatomic shape by following a 10 A/P angle. This allows the left medial component to be used on the right lateral condyle, and the right medial component to be used on the left lateral condyle. Anatomic: The implant comes in seven sizes in order to customize the fit to the patient. The shape of the sagittal J-curve is the result of extensive testing to optimize function throughout the flexion arc. The anatomic anterior mesial bevel is a design feature that further optimizes the shape by ensuring smooth patellar tracking in deep flexion. Bone interface: Three planar resections and two peg holes provide a uniform, congruent cement interface. The pegs significantly diverge from the posterior planar resection, and the posterior peg is long enough to aid in placing the component in small spaces for final implantation. The entire mating surface, including the pegs, is grit-blasted to enhance cement fixation. Versatility: Sizes 3, 4, 5, 6 and 7 all feature the exact same planar resections and peg hole locations. Once these preparations have been made, the 3 7 trials are interchangeable, and can be up- and down-sized until a decision is made for the final implant choice. Sizes 1 and 2 are also interchangeable, with slightly different cuts and peg locations than 3 7. Sizes 3 7 typically are used for 80% or more of uni cases. Tibial component Asymmetric: The left medial component can be used on the right lateral tibia, and the right medial component can be used on the left lateral tibia. Flexibility: The implant comes in six sizes, and the poly thickness increases in single millimeter increments from 8 11mm to allow for fine-tuning the fit. The all-poly version and the metal-backed version have the same instrumentation, allowing for easy intraoperative choice. The all-poly version also has a thin 7mm option. GENESIS UNI Kinematics: JOURNEY II UNI features the same proven tibia articular as GENESIS UNI/ACCURIS. This gentle conformity gives similar interchangeability and kinematics as a round on flat design with increased contact area to lower point stresses. The lack of constraint allows JOURNEY II UNI to be ACL/PCL conserving, allowing the native ligaments to control the movement of the knee. Anterior mesial lugs

5 Overview of surgical flow options Set up and balancing Traditional Method (pg. 7) 1. Set up EM Guide (pg. 7) Joint Line Referencing (pg. 15) 1. Assess joint line (pg. 15) 2. Resect Proximal Tibia (pg. 9) 2. Set up EM Guide (pg. 15) 3. Assess joint balance (pg. 10) 3. Resect proximal tibia and distal femur (pg. 16) 4. Resect distal femur (pg. 12) 4. Assess joint balance (pg. 17) 5. Complete femur resections (pg. 19) 5. Complete femur resections (pg. 19) 3

6 Overview of surgical flow options Set up and balancing (continued) Hybrid Technique* 1. Assess joint line (pg. 15) 2. Set up EM Guide (pg. 15) 3. Resect proximal tibia only (pg. 16) 4. Assess joint balance (pg. 10) 5. Resect distal femur (pg. 12) 6. Complete femur resections (pg. 19) * The Hybrid Technique is only shown here and combines steps from Joint Line Referencing and Traditional Joint Balance techniques. This technique uses the joint line referencing instruments to establish and complete tibia resection then uses joint balance method to complete femur resections. 4

7 Overview of surgical flow options Trialing and implantation Traditional Method (pg. 21) 1. Assess tibia size (page 22) Alternate Method (pg.29) 1. Femur lug prep (pg. 28) 2. Place tibia and femur trials (page 22) 2. Assess tibia size and insert thickness Trial Range of Motion (pg. 29) 3. Select insert thickness Trial range of Motion (page 24) 4. Femur Lug Prep (page 26) 3. Tibia peg prep (pg. 30) 5. Tibia Peg Prep (page 24) 4. Implantation (page 31) 6. Implantation (page 31) 5

8 JOURNEY II UNI Unicompartmental Knee System Selecting a Method Three methods for preparing joint space Traditional Measured Resection/Joint Balance (Begins page 7) Joint Line Referencing (Begins page 15) Hybrid Method (See page 4) Three types of guide to choose from 1. Uncaptured Cutting block (offered in 0, 5 and 7 ) 2. Captured 5 Cutting Block 3. Joint Line Referencing Guide Captured Block / Uncaptured Block / Uncaptured Block Uncaptured Block

9 Traditional Method Step 1: Initial EM Guide set up Initial set up of EM guide includes Varus/Valgus positioning, slope, and provisional depth. Final Resection depth may be selected by adjusting the block position with gold knob. Rimmed Pin may be used to secure Extramedullary Guide Assembly to proximal Tibia. Adjustable ankle clamp and ankle clamp adjustment rod Tibial alignment tube JOURNEY II Tibia Uprod and

10 JOURNEY II UNI Unicompartmental Knee System Traditional Method continued Step 1: Initial EM Guide set up continued Refine resection depth with Tibia Stylus (2mm, 4mm, 6mm or 8mm) Tibia stylus references cutting surface on either 5 Captured Block or any Uncaptured block (0, 5, or 7 ). Using the tibial styli Some surgeons prefer to place the resection check in the cutting slot to locate the transverse tibia resection. If it is preferred to use a stylus in order to measure the resection, two double-sided styli are offered to measure 2, 4, 6 or 8 millimeters of resection. Evaluation of deformity during preoperative planning may aid in determining which stylus to use. Tibia Stylus /

11 Step 2: Resect Proximal Tibia Additional resection may be taken using either block by unlocking adjustment screw on EM Guide and dialing down desired amount. Note: Lines on EM Guide are 2mm apart. If initial resection is made with 5º captured block, 5º uncaptured block may be used as +2mm additional resection block without unlocking alignment guide. Two oblique pin holes provided for optional additional fixation Straight Ratcheting Driver Humeral 3.5mm Hexdriver Quick connect pin Quick connect 1/8 drill

12 JOURNEY II UNI Unicompartmental Knee System Traditional Method continued Step 3: Assess joint balance With measured resection balancing technique a set of two piece gap sticks are used to assess imbalance caused by deformity. This technique is a posterior referencing technique where the distal resection is adjusted based on deformity. Insert thickness/flexion gap is established by increasing the thickness of outer rail in flexion. Extension imbalance is determined by increasing thickness of inner shim. 1. Determine flexion gap by inserting outer colored rails increasing in thickness with inner Black Shim Number 0. Spacer Rail(s) Spacer Insert Number

13 2. Once Flexion gap is established continue to use the Colored Outer Shim which best approximated the flexion gap, bring the knee into full extension and assess the extension gap. If laxity is found increase the thickness of the Inner (Black) Shim until the desired extension gap is found. The combination of colored rail from Step 1, and appropriate numbered Black shim will represent your extension gap. If extension gap is tighter than flexion gap, go to steps 3A and 4A (page 13). Do not go to step 4, page 12. Spacer Rail(s) Spacer Insert(s)

14 JOURNEY II UNI Unicompartmental Knee System Traditional Method continued Step 4: Resect Distal Femur The numbered inner shim is then replaced with the like numbered distal cutting block. Reminder: If extension gap is tighter than flexion gap, go to steps 3A and 4A (page 13). Do not go to step 4, page 12. Once the Distal block is pinned into place (two parallel pins and optional oblique pin) the outer rail may be removed to allow distal resection to be made with knee in any flexion angle. Numbered blocks will resect number listed in millimeters less than the distal implant thickness to re-establish a balanced postoperative condition. Continue to Complete Femur Resections (page 19). Spacer Rail(s) Spacer Insert(s) Distal Cutting Block(s) Distal Recut Block

15 Step 3A: Assess joint balance continued 2a. If extension gap is found to be tighter than flexion gap, decrease the outer rail thickness and continue to use Number 0 black shim. The number of rails decreased between the rail used in flexion and extension will be the amount of additional resection needed. Reminder: If extension gap is looser than flexion gap do not complete Steps 3A and 4A, return to Step 4 (page 12). Note: Colored Rail used to establish flexion space will continue to represent flexion gap Spacer Rail(s) Spacer Insert Number

16 JOURNEY II UNI Unicompartmental Knee System Traditional Method continued Step 4A: Resect Distal Femur Using the same colored shim that gave the final extension balance; replace the Number 0 Black Shim with the Number 0 Distal Cutting Block. Affix two pins through the parallel guide holes (non-oblique) in the distal cutting block as shown, then replace the Number 0 Distal Block and Gap Spacer Rail with the Femur Recut Block using the holes marked with the appropriate resection depth. Resect the distal femur. Continue to Complete Femur Resections (page 19). Spacer Rail(s) Spacer Insert Number Distal Cutting Block(s) Distal Recut Block

17 Joint Line Referencing Step 1: Remove Tibia Anterior Horn Removing anterior horn of tibia will prevent impingement of the Joint Balancing Shim. Step 2: Insert Joint Spacer Shim thickness should be selected to establish Extension Gap based on desired Joint Deformity correction. Step 3: Initial EM Guide Set Up Extra-medullary alignment guide is used to establish varus/valgus and slope angles. Adjustable ankle clamp and ankle clamp adjustment rod Tibial alignment tube JOURNEY II Tibia Uprod and Joint Line Referencing Drill Guide Symmetric Balancing Shim(s)

18 JOURNEY II UNI Unicompartmental Knee System Joint Line Referencing continued Step 3: Initial EM Guide Set Up continued Four pins drilled through Joint Line Referencing guide to establish location of Distal Femur and Proximal Tibia Cutting Blocks. Optional: To ease removal of the Joint Line Referencing Guide remove the femur pins after drilling. Step 4: Resect Distal Femur/Proximal Tibia Joint Line Referencing Distal Block (Femur Recut) and Joint line referencing tibia block (either 5 or 7 ) mate on pins placed using Joint Line Referencing Guide. Joint Line Tibia Cutting Block(s) Distal Recut Block

19 Step 5: Assess joint balance 1. Balance is established by first determining flexion gap using Colored Gap Balancing Rails and Number 0 Black Insert. 2. Once flexion gap is determined extension gap will be determined by using Colored Gap Balancing Rails and Resected Gap Check Black Insert. After both flexion and extension gaps have been assessed the thicker colored rail will determine the desired insert thickness. If the thinnest rail (7mm for All Poly/8mm for Metal Backed) will not fit in either joint space with the appropriate Black Insert additional Tibia resection will be necessary. Spacer Rail(s) Spacer Insert Number Spacer Insert Resected Gap Check

20 JOURNEY II UNI Unicompartmental Knee System Joint Line Referencing continued Step 6: Assess joint balance Scenario 1 Same Thickness Joint is balanced No additional resection needed Scenario 2 Flexion Gap Larger Additional Distal Resection needed Use Distal Recut Block or Rasp to resect additional distal femur to match flexion space. Scenario 3 Extension Gap Larger Additional Posterior Resection needed Use Rasp to resect additional posterior femur to match extension space. Spacer Rail(s) Spacer Insert Number Spacer Insert Resected Gap Check

21 Complete Femur Resections Assess femur size / Select AP Cutting Guide The size may be assessed using the 2-in-1 A-P cutting blocks. There are three variants included in the set Size 1-2 Size Size 6-7 Femur sizes 3-7 are inter-changeable and may be upsized/downsized after resections made, and lug holes drilled. Sizes 1-2 are inter-changeable and may be upsized/downsized after resections made, and lug holes drilled. The size that provides maximum bone coverage without overhang should be chosen. (In the example shown size 4 would be the optimal size.) Oversized Optimal Undersized Spacer Insert(s) Femur A-P Cutting Block(s)

22 JOURNEY II UNI Unicompartmental Knee System Complete Femur Resections continued Resect Femur Chamfer and Flex Cut A Set of Gap Stick Inserts matching color and etched thickness of the rails used in balancing is included and may be used with the A-P Cutting block as a handle and to aid in setting femoral component rotation. The shim should match the Etched thickness and color established to be the flexion gap. (If necessary the flexion gap may be re-determined by inserting outer colored rails increasing in thickness with inner Black Shim Number 0.) Once established the A-P cutting block may be guided and pinned into place and the colored insert removed to facilitate making the Posterior Chamfer and Posterior Flex Resections. * Femur lug holes may be optionally prepared at this step using A-P block (see page 28), lug holes may also be prepared at later step using Prep through femoral trials. Continue to Trialing and Preparation Traditional method (next page), or Continue to Trialing and Preparation Alternate method (page 28) Spacer Insert(s) Femur A-P Cutting Block(s)

23 Trialing and Preparation Traditional Method Assess Tibia Size Size may be assessed using either double ended sizing guide or by using trial baseplates. Select the tibia size that best covers the resected proximal tibia in both the AP and ML directions. The rasp may be utilized if necessary to remove bone from the tibia spine to achieve optimal sizing. Tibia Size/Prep

24 JOURNEY II UNI Unicompartmental Knee System Trialing and Preparation Traditional Method continued Fix Baseplate Trial Optional handle may be used to guide placement of trial. Trial is fixated by provisional fin which partially prepares bone for baseplate keel. Free impactor may be used to fully seat trial if needed. Tibia Baseplate Trial Humeral 3.5mm Hexdriver

25 Select and Insert Femoral Trial Optional handle may be used to position femoral trial. Optional screw may be used to provisionally affix femoral trial Tip: Marking the resected femur with a projection of the center line from the tibia baseplate trial may aid in M-L positioning of the femoral trial. Femur Trial Humeral 3.5mm Hexdriver x 24mm Self-Tapping Cancellous Screw

26 JOURNEY II UNI Unicompartmental Knee System Trialing and Preparation Traditional Method continued Select and Install Insert Trial Lines on femoral trial, baseplate trial, and insert trial mark the center of articulation. Tibia Insert Trial(s)

27 Trial Range of Motion Femur drill through trial shown, finishing trial may be used if femur lug holes have been prepared using A-P Block. Tip: The 2mm end of the 2-3mm gap spacer may be used to help balance the knee in flexion and extension. To use insert the spacer with knee in both flexion and extension the spacer should fit snug but not overly tight. Tibia Insert Trial(s)

28 JOURNEY II UNI Unicompartmental Knee System Trialing and Preparation Traditional Method continued Prepare Femur Lugs This step may be omitted if femur lug holes have been prepared using A-P Block Anterior drill may be provisionally left in place to hold position for posterior drill. Posterior drill may be left in place to trial range of motion. Femur Lug Drill (2X) Humeral 3.5mm Hexdriver x 24mm Self-Tapping Cancellous Screw

29 Prepare Tibia Lugs Continue to Install Implants (page 31). Tibia Lug Drill(s) Humeral 3.5mm Hexdriver

30 JOURNEY II UNI Unicompartmental Knee System Trialing and Preparation Alternative Method (Prepare Femur Lugs) Optional Step Femur Lugs may also be prepared through Femoral Trials Femur lug holes may be prepared through A-P block using Journey Uni Peg Drill establishing final implant position. If preparing lugs through A-P Block, lugs should be drilled before completing posterior and chamfer resections. JOURNEY UNI femural Lug Drill Femur A-P Cutting Block(s)

31 Step 1: Assess tibia size Select and insert femoral trial Use tibia sizers to determine baseplate size Femur drill through trial shown, finishing trial may be used if femur lug holes have been prepared using A-P Block Tibia Size/Prep

32 JOURNEY II UNI Unicompartmental Knee System Trialing and Preparation Alternative Method Step 2: Select and insert tibia trial Trial range of motion Step 3: Select and insert tibia trial Prepare tibia lugs Step 4: If femur lug holes have not been prepared please see page 26, Prepare femur lugs then proceed to Install implants (page 31). If femur lugs have been prepared proceed directly to Install implants (page 31). Tibia Size/Prep Tibia Insert Trial(s) Tibia Lug Drill(s)

33 Install implants Tip: If the resected surfaces of the tibia and/or femur are sclerotic, drill multiple holes with a small drill (2.0mm 3.2mm) to improve cement intrusion. Tibia Component To facilitate insertion, flex the knee and externally rotate tibia. Apply Cement and press the tibia baseplate onto the tibia, Press down on the posterior portion of the tibia component first to force the cement anterior, then press down on the anterior portion of the component. Use the Tibia Impactor to fully seat the tibia baseplate. If sterile gauze was used, remove it slowly from behind the tibia and use a Cement Removal tool to remove any excess cement. Femoral Component Apply cement and seat the femoral component with the femoral lugs aligned with the pre-drilled holes. Use the Femoral Impactor to fully seat the component. After the cement has cured, remove any excess cement before final placement of the tibia articular surface. Tip: Tibia trial may also be used while cement is drying before final selection and implantation of tibia articular surface. 31

34 JOURNEY II UNI Unicompartmental Knee System Tray layouts JOURNEY II UNI Tray 1 Ref. Letter Cat. No. Description A Extramedullary Alignment Rod (2 pcs) B GENESIS II Resection Check C HUMERAL 3.5mm Hexdriver D JOURNEY II UNI Tibial Uprod Left E JOURNEY II UNI Tibial Uprod Right F JOURNEY UNI Tibial Impactor G Tibial Stylus 2mm and 4mm H Tibial Stylus 6mm and 8mm I Straight Ratcheting Driver J ACCURIS Femoral Impactor K GENESIS II Adjustable Ankle Clamp And Alignment Rod (2 pcs) L GENESIS II Tibial Alignment Tube M JOURNEY UNI Femoral Lug Drill N JOURNEY UNI Femoral Alignment Peg O Joint Line Referencing Drill Guide P Symmetric Balancing Shim 1mm Q Symmetric Balancing Shim 2mm R Symmetric Balancing Shim 3mm S Symmetric Balancing Shim 4mm T Tibia Lug Drill Sz 1-2 U Tibia Lug Drill Sz 3-4 V Tibia Lug Drill Sz 5-6 W JOURNEY UNI 2-In-1 Block QC Handle X Universal Pin Driver Y Universal Pin Puller Z SPEED PIN Quick Connect AA Lane Bone Holding Forcep AB Scott Cement Curette AC Cement Curette AD JOURNEY Bone Rasp 32

35 JOURNEY II UNI Tray 1 (insert) Ref. Letter Cat. No. Description A Distal Cutting Block 6.5mm B Distal Cutting Block 5.5mm C Distal Cutting Block 4.5mm D Distal Cutting Block 3.5mm E Joint Line Tibia Cutting Block 5 F Joint Line Tibia Cutting Block 7 G Femur Recut Block (Joint Line Femur Block) H JOURNEY II UNI Insert Trial Size 1-2 8mm I JOURNEY II UNI Insert Trial Size 1-2 9mm J JOURNEY II UNI Insert Trial Size mm K JOURNEY II Uni Insert Trial Size mm L JOURNEY II UNI Insert Trial Size 3-4 8mm M JOURNEY II UNI Insert Trial Size 3-4 9mm N JOURNEY II UNI Insert Trial Size mm O JOURNEY II UNI Insert Trial Size mm P JOURNEY II UNI Insert Trial Size 5-6 8mm Q JOURNEY II UNI Insert Trial Size 5-6 9mm R JOURNEY II UNI Insert Trial Size mm S JOURNEY II UNI Insert Trial Size mm T Spacer Insert Number 0 U Spacer Insert Number 1 V Spacer Insert Number 2 W Spacer Insert Number 3 Ref. Letter Cat. No. Description X Spacer Insert Resected Gap Check Y Spacer Rail 11mm Z Spacer Rail 10mm AA Spacer Rail 9mm AB Spacer Rail 8mm AC Spacer Rail 7mm AD Spacer Insert 11mm AE Spacer Insert 10mm AF Spacer Insert 9mm AG Spacer Insert 8mm AH Spacer Insert 7mm AI Gap Spacer 33

36 JOURNEY II UNI Unicompartmental Knee System Tray layouts continued JOURNEY II UNI Tray 2 Ref. Letter Cat. No. Description A Femoral Lug Drill B X 28 Self-Tapping Cancellous Screw C JOURNEY II UNI Femoral Trial Size 1 LM/RL D JOURNEY II UNI Femoral Trial Size 2 LM/RL E JOURNEY II UNI Femoral Trial Size 3 LM/RL F JOURNEY II UNI Femoral Trial Size 4 LM/RL G JOURNEY II UNI Femoral Trial Size 5 LM/RL H JOURNEY II UNI Femoral Trial Size 6 LM/RL I JOURNEY II UNI Femoral Trial Size 7 LM/RL J JOURNEY II UNI Femoral Trial Size 1 RM/LL K JOURNEY II UNI Femoral Trial Size 2 RM/LL L JOURNEY II UNI Femoral Trial Size 3 RM/LL M JOURNEY II UNI Femoral Trial Size 4 RM/LL N JOURNEY II UNI Femoral Trial Size 5 RM/LL O JOURNEY II UNI Femoral Trial Size 6 RM/LL P JOURNEY II UNI Femoral Trial Size 7 RM/LL Q JOURNEY UNI Femoral Finishing Trial RM/LL Sz 1 R JOURNEY UNI Femoral Finishing Trial RM/LL Sz 2 S JOURNEY UNI Femoral Finishing Trial RM/LL Sz 3 T JOURNEY UNI Femoral Finishing Trial RM/LL Sz 4 U JOURNEY UNI Femoral Finishing Trial RM/LL Sz 5 V JOURNEY UNI Femoral Finishing Trial RM/LL Sz 6 W JOURNEY UNI Femoral Finishing Trial RM/LL Sz 7 X JOURNEY UNI Femoral Finishing Trial RM/LL Sz 1 Y JOURNEY UNI Femoral Finishing Trial RM/LL Sz 2 Z JOURNEY UNI Femoral Finishing Trial RM/LL Sz 3 AA JOURNEY UNI Femoral Finishing Trial RM/LL Sz 4 AB JOURNEY UNI Femoral Finishing Trial RM/LL Sz 5 AC JOURNEY UNI Femoral Finishing Trial RM/LL Sz 6 AD JOURNEY UNI Femoral Finishing Trial RM/LL Sz 7 AE Tibia Sizer Hook Ref. Letter Cat. No. Description AF In 1 Femoral Cutting Block Sz 1-2 LM/RL AG In 1 Femoral Cutting Block Sz 3-5 LM/RL AH In 1 Femoral Cutting Block Sz 6-7 LM/RL AI In 1 Femoral Cutting Block Sz 1-2 RM/LL AJ In 1 Femoral Cutting Block Sz 3-5 RM/LL AK In 1 Femoral Cutting Block Sz 6-7 RM/LL AL JOURNEY II UNI Baseplate Trial Size 1 LM/RL AM JOURNEY II UNI Baseplate Trial Size 2 LM/RL AN JOURNEY II UNI Baseplate Trial Size 3 LM/RL AO JOURNEY II UNI Baseplate Trial Size 4 LM/RL AP JOURNEY II UNI Baseplate Trial Size 5 LM/RL AQ JOURNEY II UNI Baseplate Trial Size 6 LM/RL AR JOURNEY II UNI Baseplate Trial Size 1 RM/LL AS JOURNEY II UNI Baseplate Trial Size 2 RM/LL AT JOURNEY II UNI Baseplate Trial Size 3 RM/LL AU JOURNEY II UNI Baseplate Trial Size 4 RM/LL AV JOURNEY II UNI Baseplate Trial Size 5 RM/LL AW JOURNEY II UNI Baseplate Trial Size 6 RM/LL AX JOURNEY II UNI Tibia Size/Prep 1-2 LM/RL AY JOURNEY II UNI Tibia Size/Prep 3-4 LM/RL AZ JOURNEY II UNI Tibia Size/Prep 5-6 LM/RL BA JOURNEY II UNI Tibia Size/Prep 1-2 RM/LL BB JOURNEY II UNI Tibia Size/Prep 3-4 RM/LL BC JOURNEY II UNI Tibia Size/Prep 5-6 RM/LL BD JOURNEY II UNI 5 Uncaptured Tibia Cutting Block Left BE JOURNEY II UNI 5 Uncaptured Tibia Cutting Block Right BF JOURNEY II UNI 5 Captured Tibia Cutting Block Left BG JOURNEY II UNI 5 Captured Tibia Cutting Block Right BH Uncaptured Tibia Cutting Block BI Uncaptured Tibia Cutting Block 34

37 Dimensions Tibial tray dimensions(mm) Size AP ML Femoral component dimensions(mm) Size AP HT ML DM PM mm 10 ML PM PT AP M/L HT DM DT AP A/P Articular insert interchangeability JOURNEY II UNI tibial inserts are completely interchangeable with all size JOURNEY UNI femoral components. Modular inserts come in three sizes: 1-2, 3-4, 5-6. Articular insert thickness (mm) Modular

38 JOURNEY II UNI Unicompartmental Knee System Implant sets JOURNEY UNI OXINIUM femoral Sz 1 and 7 Cat. no. Description JOURNEY UNI OXINIUM Femoral Sz 1 LM/RL JOURNEY UNI OXINIUM Femoral Sz 7 LM/RL JOURNEY UNI OXINIUM Femoral Sz 1 RM/LL JOURNEY UNI OXINIUM Femoral Sz 7 RM/LL JOURNEY UNI OXINIUM Femoral Sz 2-6 Cat. no. Description JOURNEY UNI OXINIUM Femoral Sz 2 LM/RL JOURNEY UNI OXINIUM Femoral Sz 3 LM/RL JOURNEY UNI OXINIUM Femoral Sz 4 LM/RL JOURNEY UNI OXINIUM Femoral Sz 5 LM/RL JOURNEY UNI OXINIUM Femoral Sz 6 LM/RL JOURNEY UNI OXINIUM Femoral Sz 2 RM/LL JOURNEY UNI OXINIUM Femoral Sz 3 RM/LL JOURNEY UNI OXINIUM Femoral Sz 4 RM/LL JOURNEY UNI OXINIUM Femoral Sz 5 RM/LL JOURNEY UNI OXINIUM Femoral Sz 6 RM/LL JOURNEY UNI Tibia Base LM/RL Sz 1 6 Cat. no. Description JOURNEY II UNI Tibia Baseplate Size 1 LM/Rl JOURNEY II UNI Tibia Baseplate Size 2 LM/Rl JOURNEY II UNI Tibia Baseplate Size 3 LM/RL JOURNEY II UNI Tibia Baseplate Size 4 LM/RL JOURNEY II UNI Tibia Baseplate Size 5 LM/RL JOURNEY II UNI Tibia Baseplate Size 6 LM/RL JOURNEY UNI Poly Inserts LM/RL Sz 1 6 Cat. no. Description JOURNEY II UNI Tibia XLPE Insert Size 1-2 8mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size 1-2 9mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size 3-4 8mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size 3-4 9mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size 5-6 8mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size 5-6 9mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size mm LM/RL JOURNEY II UNI Tibia XLPE Insert Size mm LM/RL JOURNEY UNI Poly Inserts RM/LL Sz 1 6 Cat. no. Description JOURNEY II UNI Tibia XLPE Insert Size 1-2 8MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size 1-2 9MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size 3-4 8MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size 3-4 9MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size 5-6 8MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size 5-6 9MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size MM RM/LL JOURNEY II UNI Tibia XLPE Insert Size MM RM/LL JOURNEY UNI Tibia Base RM/LL Sz 1 6 Cat. no. Description JOURNEY II UNI Tibia Baseplate Size 1 RM/LL JOURNEY II UNI Tibia Baseplate Size 2 RM/LL JOURNEY II UNI Tibia Baseplate Size 3 RM/LL JOURNEY II UNI Tibia Baseplate Size 4 RM/LL JOURNEY II UNI Tibia Baseplate Size 5 RM/LL JOURNEY II UNI Tibia Baseplate Size 6 RM/LL 36

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