Tibial Preparation

Tibial Resection

1. Attach the tibial stylus to the tibial block by inserting the stylus foot into the cutting slot.
2. Lower the cutting block until the stylus touches the less affected side of the tibia. This allows placement of the 9 mm articular insert. The stylus can also be used to adjust the depth of the tibia cut (adjustable to 9, 11 or 13 mm).
3. Pin the tibial cutting block to the tibia. Note that the cutting block sits along the medial half of the tibia. Insert pins first through the central holes. The medial hole may also be used to secure the tibial cutting block.
4. Remove the intramedullary alignment assembly leaving the cutting block on the anterior tibia. The extramedullary guide may be left in place.
5. Cut the tibia by first directing the blade in the posterior direction and then laterally.
6. Inspect the surface for any cortical ridges. The proximal tibia can be visualized by extending the leg, placing a laminar spreader, and retracting the patella laterally.
7. Place the leg in 90° of flexion, insert a laminar spreader and remove remnants of the medial and lateral menisci and posterior osteophytes. (Figure 16)
8. Check alignment and balance with spacer block and rod. Balance ligaments in standard fashion.