Tibial Preparation

Intramedullary Tibial Alignment

1. Open the tibial canal (generally 5 mm medial to the midline) with the 9.5mm drill. To determine correct placement, the hole can be made through the tibial drill guide with the 11 mm tibial collet. (A preliminary resection of the tibial spine may facilitate seating of the tibial drill guide onto the proximal tibia.)
2. Attach the correct left or right tibial cutting block to the intramedullary tibial alignment assembly and pass the intramedullary rod through the cannulated alignment sleeve on the alignment assembly.
3. Slowly insert the rod into the tibial canal.
4. Assess rotation of the intramedullary tibial alignment guide. Rotational alignment is critical due to the 3° posteriorly sloped cut. The alignment rod of the intramedullary tibial alignment assembly should align with the medial third of the tibial tubercle.
5. Impact the proximal end of the cannulated alignment sleeve to drive the distal spikes into the proximal tibia to lock rotation. (Figure 15)