TKA -Knee Surgical Tech MindRay (1).pdf

total knee arthroplasty

1. TKA Surgical Technique
Manufacturing Center:
Wuhan Mindray Scientific Co., Ltd.
No.18,Qinglinghe Road, Hongshan District, Wuhan City,
430065 Hubei Province, P.R.China
Sales Center:
Shenzhen Mindray Bio-Medical Electronics Co., Ltd.
Mindray Building, Keji 12th Road South,High-tech Industrial Park
Nanshan, Shenzhen 518057, P.R. China
Tel:[phone] Fax:[phone]
Email:[email protected]
Website:www.mindray.com

2. Model F1 F2 F3 F4 F5
AP(mm) 53 56 59 61 65
ML(mm) 57 60 63 66 71
Name
T0 T1 T1+ T2+ T3+
AP(mm)
AP(mm)
D(mm)
41
41
32
43
43
35
45
45
38
47
47
51
51
ML(mm)
ML(mm)
H(mm)
61
61
8
64
64
8.5
67
66
9
71
71
76
76
H(mm) 8、10、12.5、15
T0 T1 T1+ T2+ T3+
AP
ML
AP
ML
ML
AP
D
H
1 2
High function anatomical fixed bearing prosthesis
Characteristics of femoral condyle component
CoCrMo material·
Highly polishing design on the surface, decrease the wear of meniscus component to make it work longer·
Excellent materials and precision machining, ensure reliability and stability of prosthesis, low wear;·
Anatomical design, accommodate Asian Human Bones·
Enhanced compatibility of femoral prosthesis, closer to the human knee joint trajectory·
the deeper, wider and smoother trochlear groove design, ensure smooth transition with condylar, and optimize patellar trajectory·
Round edge to avoid soft tissue strike and patella snap·
5°elevation in anterior condyle, 1°obliquity in posterior condyle, increase the surgery safety. ·
smooth edge, reduce chance of soft tissues impact and patellar snapping·
multiple sizes for selection•·
Characteristics of tibial plateau component
The tibial plateau component fully encompassed design, ·
with a reliable locking mechanism to meniscus prosthesis, minimizes micromotion and wear
Deep design on the tray allows thicker meniscus component ·
the three-wing design of the tibial plateau, provide excellent stability and anti rotation ability, ·
and offer better support to the plateau
Improved slot for bone cement guarantee the thickness and increase stability·
Characteristics of Meniscus prosthesis
Ultrahigh molecular weight polyethylene, moderately crosslinked, widely match with distinct femoral condyle prosthesis·
back fixed pad, optimized intercondylar bulge, strengthen Knee Joint stability·
meniscus and femoral condyle highly matched, uniform stress distribution, lower wear, provides comprehensive stability. ·
At the same time, reduce the influence on joint activity.
Cutting design in the front, protect the soft tissue and avoid damaging patellar ligament.·
Femoral condyle component
Meniscus prosthesis
Tibial plateau component
Component specifications
Meniscus Component size is same as Tibia Component
F1
57/53
F2
60/56
F3
63/59
F4
66/61
F5
71/65
T1+
66/45
T2+
71/47
T3+
76/51
T1
61/43
T0
60/41
Tibial Inserts ML/AP
Femoral Component ML/AP
Component Selection
Model
Model
Femoral condyle component specification
Meniscus prosthesis specification
Tibial plateau component specification
Patellar component specification
Patellar component

3. 1.The medullary canal is entered at the midline of
the femoral trochlea 10 mm anterior to the origin
of the PCL using a drill. The drill hole may be
enlarged appropriately to facilitate unobstructed
passage of the long intramedullary rod to the
diaphyseal isthmus
2.With the handle assembled onto the long
intramedullary rod, the rod is introduced slowly
into the canal to the level of the isthmus to
confirm unobstructed passage. The rod is fluted
to relieve intramedullary pressure and permit the
release of bone marrow. Withdraw the handle
subsequently.
3.Set appropriate valgus angle from 0°to 9°in
1°increments. Normally valgus angle is 5°-7°,6°is
commonly selected. Assemble the locating
device outrigger and fix it on the intramedullary
rod. Attach the cutting block and set 9mm
resection level.
5.Confirm the resection level by using the trial
template. -2mm and +2mm amount of bone
resection and +4mm, +8mm of resection
thickness on resection slot can be achieved by
adjusting the cutting block.
3 4
4.Steinmann pins are introduced through the
holes designated □.
First remove the long intramedullary rod then
remove the locating device outrigger by pressing
the button on it and keep the distal femur cutting
block.
9mm
Femur Osteotomy-Distal Femur
Surgical Technique Surgical Technique

4. A
B
C
10.Assemble the femoral box trial to ensure the
femoral condyle is on the right position, a mark
can be made by electrome as reference to fix the
cutting block.
11.Attach the femoral noth guide and fixed by at
least 3 steinmann pins, use femoral osteotome,
oscillating saw to perform intercondylar
resection. The femoral box trial should be put
smoothly after the resection, osteophyte should
be cleared.
6.The guide is seated flush and centred on the
prepared distal femoral surface. The stylus is
allowed to move freely within the guide and
moved proximal to the articular surface. The
stylus is passed over the anterior cortex
immediately proximal to the articular surface. At
the appropriate level where the stylus is not
impeded, turn the stylus locking knob clockwise
until tight, to fix its position.
7.The femoral sizing guide is available in two
formats:
Anterior Reference and Posterior Reference.
Anterior Reference is commonly used.
Read the number of A scaleplate to decide the
size of femoral condyle when the indicating line
is align with same mark; Where the femur
measures between sizes, “down-size” femoral
component is normally selected. Put B scaleplate
at the corresponding size, then C marked can be
referenced for the inner, out diameter of
corresponding component and the situation of
component coverage.
8.Where, as in most cases, the tibia is resected at
90° to its mechanical axis, the femoral
component is positioned in approximately 3° of
external rotation to produce flexion gap
symmetry. Insert fixation pin on the left side
marked 'LM/LL' and right side marked ' RL/RM'.
Remove the sizing guide and fixtion pin, and
leave two fixation holes.
9.The corresponding A/P chamfer cutting block
selected. Assemble the removable handles by
depressing the button and inserting the handle into
the receptacle and turning until locked into position.
The A/P chamfer cutting block is seated into the drill
holes and flush to the prepared surface. The anterior,
posterior and chamfer cuts are performed with an
5 6
Femur Osteotomy- 4 in 1 Femur Osteotomy- Intercondylar
Surgical Technique Surgical Technique
Anterior Reference

5. 7 8
12.The knee is placed in maximal flexion with the
tibia distracted anteriorly and stabilised. The
upper cutting platform is assembled and secured
onto the proximal uprod of the tibial alignment
device. A 0°, 3°,or 5°cutting block can be chosen.
The upper platform is aligned with the medial
third of the tibial tubercle and medial margin of
the lateral intercondylar eminence with the
extremities of the cutting surface against the
anterior cortex. The malleolar clamp of the tibial
alignment device is positioned immediately
proximal to the malleoli.
14.Steinmann pins are introduced through the
central holes marked with a □, the tibial
alignment device can be removed and keep the
tibial cutting block.
16.With the knee in full flexion and the tibia
subluxed anteriorly, the trial tray is assembled
to the alignment handle and placed onto the
resected tibial surface. The tray is secured with
two short fixation pins inserted. Alignment rod
can be connected with the handle to check the
rotation alignment.
17.Assemble the appropriately sized cruciform
keel punch guide and drill bushing to the tray
trial.
19.Remove the drill bushing, select
appropriate sized modular tray keel punch to
impact through the guide until the shoulder of
the punch is in contact with the guide.
18.Select matching drill and fully advanced
through the drill bushing in reverse into the
cancellous bone.
15.Attach the cutting block and fix it to the bone
to perform proximal tibia osteotomy, adjust the
osteotomy thickness by moving up and down the
cutting block to increase or decrease 2mm bone
mass.
Tibia Osteotomy- Proximal Tibia Tibia Osteotomy- Tibia Plateau
13.The outrigger of the stylus is marked non-
slotted and slotted at either end. When the tibial
resection is performed from the surface of the
block, choose the non-slotted end of the
outrigger; conversely, when the resection is
performed through the slots, choose the slotted
end of the outrigger. There is a 4 mm difference
between the top surface and the slot.
A level of 8 mm or 10 mm is suggested where
resection is based on the less involved condyle.
The level of 0 is selected where resection is based
on the more involved condyle and does not result
in excessive contralateral resection.
Adjust the stylus to the center to determine the
position of tibial cutting block.
Surgical Technique Surgical Technique

6. 23.Implant the tibia tray component
24.Implant the femoral component
25.Implant the tibia insert component. First use
the tibia inert trial to determine the final
thickness, then implant the tibia insert
component after the bone cement is set.体
9 10
20.After resection of distal femur and proximal
tibia, use the 8mm spacer block with 1mm
extension shim to measure the extension gap,
alignment rod can be used at the same time to
check if the osteotomy line is correct or not.
21.After 4 in 1 femur osteotomy, use the 8mm
spacer block to measure the flexion gap
22.After resection of distal femur and proximal
tibia, before handling tibia cannal , check the
alignment line by trials to confirm the alignment
line and gap is correct.
Gap and Force line measurement Implant component
Surgical Technique Surgical Technique

7. 11

12
Specification
Femoral Instrument Set (F16AB-PA00168)
F16AB-PA00169
F16AB-PA00170
F16AB-PA00171
F16AB-PA00172
F16AB-PA00173
F16AB-PA00174
F16AB-PA00176
F16AB-PA00177
Bone File
IM Drill
Alignment Rod
Femoral Alignment Tower
IM Rod 400mm
IM Rod Handle
Anterior Reference Guide
Distal Femoral Cutting Block
Distal Femoral Locating Device OutriggerF16AB-PA00178
F16AB-PA00179
F16AB-PA00170
P/N Name
Distal Femoral Locating Device
Steinmann Pin
/
/
/
/
/
/
/
/
/
/
/
No Qty
F16AB-PA00181 4 in 1 Cutting Guide F1 F1
F16AB-PA00182
F16AB-PA00183
F16AB-PA00184
F16AB-PA00185
F16AB-PA00186
F16AB-PA00187
F16AB-PA00188
F16AB-PA00189
4 in 1 Cutting Guide F2
4 in 1 Cutting Guide F3
4 in 1 Cutting Guide F4
4 in 1 Cutting Guide F5
Removable Handle
Tibial Retractor
Pin Puller
Femoral Impactor
F2
F3
F4
F5
/
/
/
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
1
1
1
1
1
1
1
1
1
1
8
1
1
1
1
1
2
1
1
1
Femoral Insert/ExtractF16AB-PA00190
F16AB-PA00191
F16AB-PA00192
Femoral Noth Guide F1
Femoral Noth Guide F2
/
F1
F2
F16AB-PA00193 Femoral Noth Guide F3 F3
21
22
23
24
1
1
1
1
F16AB-PA00194
F16AB-PA00195
F16AB-PA00196
Femoral Noth Guide F4
Femoral Noth Guide F5
Femoral osteotome
Femoral Box Trial F1F16AB-PA00197
F16AB-PA00198
F16AB-PA00199
Femoral Box Trial F2
Femoral Box Trial F3
F4
F5
/
F1
F2
F3
F16AB-PA00200 Femoral Box Trial F4 F4
F16AB-PA00201
F16AB-PA00202
F16AB-PA00203
Femoral Box Trial F5
Femur Trial F1 Left
Femur Trial F1 Right
F5
F1 L
F1 R
25
26
27
28
29
30
31
32
33
34
1
1
1
1
1
1
1
1
1
1
F16AB-PA00204
F16AB-PA00205
F16AB-PA00206
Femur Trial F2 Left
Femur Trial F2 Right
Femur Trial F3 Left
Femur Trial F3 RightF16AB-PA00207
F16AB-PA00208
F16AB-PA00209
Femur Trial F4 Left
Femur Trial F4 Right
F2 L
F2 R
F3 L
F3 R
F4 L
F4 R
F16AB-PA00210 Femur Trial F5 Left F5 L
F16AB-PA00211 Femur Trial F5 Right F5 R
35
36
37
38
39
40
41
42
1
1
1
1
1
1
1
1
Femoral Box Trial Screw DriverF16AB-PA00212
F16AB-PA00213
F16AB-PA00214
Pin Inserter
Universal Handle
/
/
/
F16AB-PA00215 Femoral Retractor /
F16AB-PA00216 Femoral Instrument Case /
43
44
45
46
47
1
1
1
1
1
55Total
Specification
Option(※ are Optional tools)
F16AB-PA00175 Posterior Reference Guide
P/N Name
/
No Qty
※1 1

8. 13 14
Specification
Tibial Instrument Set (F16AB-PA00217)
F16AB-PA00218
F16AB-PA00219
F16AB-PA00220
F16AB-PA00221
F16AB-PA00222
P/N Name No Qty
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
F16AB-PA00223
F16AB-PA00224
F16AB-PA00225
F16AB-PA00226
F16AB-PA00227
F16AB-PA00228
F16AB-PA00229
F16AB-PA00230
F16AB-PA00231
F16AB-PA00232
F16AB-PA00233
F16AB-PA00234
F16AB-PA00235
F16AB-PA00236
F16AB-PA00237
F16AB-PA00238
F16AB-PA00239
F16AB-PA00240
F16AB-PA00241
F16AB-PA00242
F16AB-PA00243
F16AB-PA00244
F16AB-PA00245
F16AB-PA00246
F16AB-PA00247
F16AB-PA00248
F16AB-PA00249
F16AB-PA00250
F16AB-PA00251
F16AB-PA00252
F16AB-PA00253
F16AB-PA00254
F16AB-PA00255
F16AB-PA00256
F16AB-PA00257
F16AB-PA00258
F16AB-PA00259
Tibial Insert Extractor
Tibial Retractor
Tibial Tray Inserter
Polyethylene Component Impactor
Universal Tibial Tray Impactor
Slap Hammer Attachment
Spacer Block 8mm
Spacer Block 10mm
Spacer Block 12.5mm
Spacer Block 15mm
Extension Shim 1mm
Tibial Drill Bush 0-2
Tibial Drill Bush 3
Tibial Kell Bush 0-2
Tibial Kell Bush 3
Tibial Keel Punch Guide 0-2
Tibial Keel Punch Guide 3
Tibial Drill 15mm 0-2
Tibial Drill 17mm 3
Tibial Alignment Rod
Tibial Alignment Ankle Clamp
Tibial Alignment Proximal Device
Tibial Alignment Proximal Device with Spike
Slotted Tibial Cutting Block 0°
Slotted Tibial Cutting Block 3°
Slotted Tibial Cutting Block 5°
Stylus
Tibial Tray Trial T0
Tibial Tray Trial T1
Tibial Tray Trial T1+
Tibial Tray Trial T2+
Tibial Tray Trial T3+
Tibial Trial Alignment Handle
Tibial Trial Insert Remove Tool
Endless Steinmann Pin
Tibial Insert Trial T0-8
Tibial Insert Trial T0-10
Tibial Insert Trial T0-12.5
Tibial Insert Trial T0-15
Tibial Insert Trial T1-8
Tibial Insert Trial T1-10
Tibial Insert Trial T1-12.5
/
/
/
/
/
/
8mm
10mm
12.5mm
15mm
1mm
0-2
3
0-2
3
0-2
3
0-2
3
/
/
/
/
0°
3°
5°
/
T0
T1
T1+
T2+
T3+
/
/
/
T0-8
T0-10
T0-12.5
T0-15
T1-8
T1-10
T1-12.5
Specification
F16AB-PA00465
F16AB-PA00466
F16AB-PA00467
F16AB-PA00468
F16AB-PA00498
F16AB-PA00499
F16AB-PA00500
F16AB-PA00501
F16AB-PA00044
F16AB-PA00067
F16AB-PA00410
P/N Name No Qty
F16AB-PA00385
43
44
45
46
47
48
49
50
51
52
53
54
1
1
1
1
1
1
1
1
1
1
1
1
F16AB-PA00501
F16AB-PA00044
55
56
1
1
Tibial Insert Trial T1-15
Tibial Insert Trial T1+-8
Tibial Insert Trial T1+-10
Tibial Insert Trial T1+-12.5
Tibial Insert Trial T1+-15
Tibial Insert Trial T2+-8
Tibial Insert Trial T2+-10
Tibial Insert Trial T2+-12.5
Tibial Insert Trial T2+-15
Tibial Insert Trial T3+-8
Tibial Insert Trial T3+-10
Tibial Insert Trial T3+-12.5
Tibial Insert Trial T3+-15
Tibia Instrument Case
T1-15
T1+-8
T1+-10
T1+-12.5
T1+-15
T2+-8
T2+-10
T2+-12.5
T2+-15
T3+-8
T3+-10
T3+-12.5
T3+-15
/
59Total
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
4
1
1
1
1
1
1
1