PHYSICA ZUK SURGICAL TECHNIQUE Step 3 | Check Extension and Flexion Gaps
STEP 3 CHECK EXTENSION/FLEXION GAPS
Check the extension gap by inserting the thick end of the Flexion/Extension Gap Spacer into the joint. Flex the Knee to 90° and check the flexion gap by inserting the thin end of the selected Flexion/Extension Gap Spacer into the joint (Figs. 25 and 26) . If, in both flexion and extension, the joint space is too tight to insert the selected Flexion/Extension Gap Spacer, then use a smaller Gap Spacer, or remove more tibial or femoral bone. Then use the selected Flexion/Extension Gap Spacers to recheck the gaps . If in both flexion and extension the joint space is too loose, insert progressively thicker Flexion/Extension Gap Spacers and repeat the gap checking. If tight in extension and acceptable in flexion, two options may be pursued: 1. recut proximal tibia with less tibial slope; 2. recut 1 mm - 2 mm of distal femur. NOTE: to recut 2mm on the distal femur use the recutter block [9061.10.002]. Align the recutter off the tibial surface and fix it in extension with two pins (preferably headed screws). Proceed with the +2 mm distal femur cut. (Fig. 27)
Figure 25
If tight in flexion and acceptable in extension carefully evaluate the option to increase tibial slope.
Figure 26
NOTE. Accurate verification of the flexion and extension gaps at this stage of the procedure will reduce the likelihood of a gap imbalance during the trial reduction and final implantation.
Figure 27
16 Surgical Technique PHYSICA ZUK
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