Medial Rotation Knee. Forever Active. Landmark Operative Technique Supplement: No.1 All-Polyethylene Tibia (Cemented)

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Medial Rotation Knee Landmark Operative Technique Supplement: No.1 All-Polyethylene Tibia (Cemented) Physiological Stability and Mobility for the Active Knee Without Compromise Forever Active

Contents Section 1 Introduction 3 Section 2 Trial Reduction 4 Section 3 Tibia Finishing 6 Section 4 Implantation 9 Section 5 Instrumentation 10 Section 6 Sizing Chart 11 Manufactured by MatOrtho Limited 13 Mole Business Park Randalls Road Leatherhead Surrey KT22 7BA United Kingdom T: +44 (0)1372 224 200 info@matortho.com For more information visit: www.matortho.com MatOrtho Limited 2017 All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording or any information storage and retrieval system. 2 Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia

Introduction The purpose of this supplement is to describe the operative technique unique to the Medial Rotation Knee All-Polyethylene Tibia. It is supplemental to, and should be used in conjunction with, the Medial Rotation Knee Landmark Operative Technique, Part No. ML-300-007. Follow steps as described in the Medial Rotation Knee Landmark Operative Technique up to and including Step 28 before referring to this document. The steps particular to the All-Polyethylene components described here are: trial reduction (Steps 29-33), tibial finishing (Steps 34-37) and tibial component implantation (Steps 50-52). Perform all other steps as described in the Medial Rotation Knee Landmark Operative Technique, with the exception of the Tibial Assembly, Medial Rotation Knee Landmark Operative Technique Steps 46-49, which is not required for the Medial Rotation Knee All-Polyethylene Tibia. Section 1 Introduction Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia 3

Section 2 Trial Reduction Step 29 Choose the appropriate All-Poly Tibial Guide that fits the tibia without overhang. This will be the size used and need not match the femur size. Step 30 Fit the All-Poly Tibial Trial, checking for correct left or right orientation and chosen thickness. 4 Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia

Step 31 With the knee in deep flexion, use the Femoral Impactor to fit the appropriate Femoral Trial. Check the fit and position. Section 2 Trial Reduction Step 32 Test for stability in extension and flexion with the patella reduced. The knee should be stable and have only limited laxity in flexion. The Tibial Trial should find its best fit position on the tibia as a meniscal trial. Using diathermy, make location marks on the tibia and on the femur both medially and laterally of the Femoral Trial. These marks will be used to ensure correct positioning for final preparation of the femur and tibia. Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia 5

Section 3 Tibia Finishing Step 33 Pegged Femur Pin the Femoral Trial, ensuring that it remains well positioned with reference to the diathermy marks. Drill femoral peg holes to full depth using the drill marked Femur Peg. Note: do not perform this step if using a Stemmed Femur. 6 Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia

Step 34 Remove the Femoral and Tibial Trials. Place the All-Poly Tibia Guide Handle onto the All-Poly Tibia Guide and lock. Section 3 Tibia Finishing Replace the Tibia Guide, ensuring correct positioning with reference to the posterior edges, the diathermy mark and optionally using the External Alignment Rod. Pin in place. Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia 7

Section 3 Tibia Finishing Step 35 Fit the appropriate size of All-Poly Tibia Drill Guide to the handle, ensuring that both tubular drill guides are securely located in the Tibia Guide. Drill the first peg hole to depth, ensuring that the Tibia Guide maintains its position and remains flat on the tibia. Step 36 To help secure the assembly when drilling the second peg hole, an All-Poly Tibia Plug is provided to fill the drilled peg hole. Drill the second peg hole to depth, ensuring that the Tibia Guide maintains its position and remains flat on the tibia. Step 37 Remove all components and refer to the Medial Rotation Knee Landmark Operative Technique, following Steps 38-45. The All-Polyethylene Tibial components do not require pre-assembly as described in Steps 46-49 in the Medial Rotation Knee Landmark Operative Technique. This guide continues with implantation, Step 50 8 Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia

Step 50 Clean the resected bone surfaces with a bone brush or pressurised lavage. Use suction to remove the debris and liquid. Dry thoroughly. Step 51 Place bone cement on the tibial bone. The Tibial Plugs may be used to prevent cement seeping into the peg holes. Section 4 Implantation Step 52 Insert the All-Polyethylene Tibial component. Impact carefully using the correct Tibial Impactor for the all-polyethylene tibial components. Note: The anterior protrusion on the Tibial Impactor is intended to contact the anterior part of the tibial component to distribute the force and ensure the component is properly seated. Now refer to the Medial Rotation Knee Landmark Operative Technique and follow Steps 53-56 for implantation of the Femur and Patella. Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia 9

Section 5 Instrumentation 10 Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia

Section 6 Sizing Chart Note: There is no requirement to size-match components; all are compatible Medial Rotation Knee Operative Technique Supplement: All-Polyethylene Tibia 11

Supplement to: Medial Rotation Knee Landmark Operative Technique Part no. ML-300-007 Forever Active MatOrtho Limited 13 Mole Business Park Randalls Road Leatherhead Surrey KT22 7BA United Kingdom T: +44 (0)1372 224 200 info@matortho.com For more information visit: www.matortho.com 0088 Part No. ML-300-023 issue 2