PHYSICA ZUK SURGICAL TECHNIQUE Step 6 | Sizing and Finishing the Tibia
STEP 6 SIZING AND FINISHING THE TIBIA
Inspect the proximal tibial cut and remove any remaining meniscus and osteophytes, especially those interfering with the medial collateral ligament. Select the Tibial Sizer that best covers the resected proximal tibia in both the A/P and M/L dimensions. TECHNIQUE TIP. Use the resected tibial bone fragment as an aid in sizing. If necessary, a second sagittal cut can be made to allow for optimal coverage with the next larger size tibial base plate. Place the head of the Tibial Sizer on the cut surface of the tibia moving it flush against the sagittal cut. Verify the proper rotation of the sagittal cut in the transverse plane. The rotation is correct when the sizer is 90° to the coronal plane. (Fig. 43) The Tibial Sizer accommodates a Tibial Slider which facilitates measurement in the A/P dimension. (Fig. 44) Ensure the head of the Tibial Sizer rests on cortical bone near the edge of the cortex around its entire perimeter without any overhang. Pull the Tibial Slider anteriorly until the hook on the tip of the slider contacts the posterior edge of the tibia. (Fig. 45) The A/P length is indicated on the sizer handle. (Fig. 46a) An additional measurement on the slider at the tip of the sizer handle indicates the length of exposed bone posteriorly (behind the implant) with the sizer head in this particular position. (Fig. 46b)
Figure 43
Figure 44
Figure 45
TECHNIQUE TIP. Clean the edge of the bone cut with a curette or rasp so the sizer will fit flush against the cut.
Figure 46a
If the slider is used without the sizer the marks 1 to 6 on the slider indicate the A/P length of the corresponding implant. (Fig. 47)
Figure 46b
Remove the Tibial Sizer. Then remove all soft tissue debris from the popliteal region.
Figure 47
24 Surgical Technique PHYSICA ZUK
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