GMK Sphere Calipered Kinematic Alignment Surgical Technique
14
Select the tibial slotted cutting guide which corresponds to
the operative side (left or right). Fix the slotted tibial cutting
guide to the extramedullary eyeballing superior guide using
the set screw provided (black circle). Insert the malleolar
clamp (A) into the malleolar clamp support (B). Slide the
distal part of the tibial resection guide (C) into the malleolar
clamp support. Then slide the eyeballing extramedullary
superior guide (D) into the distal part of the tibial resection
guide.
Secure the malleolar clamp around the ankle.
Position the assembly on the tibia and adjust the frontal
rotation. The mark engraved on the top of the tibial slotted
cutting guide should be aligned to anterior-posterior axis of
the lateral tibial condyle previously marked.
24.
Adjust the distance of the rods to the length of the patient’s
tibia and fix with the knob provided (grey arrow). A stylus
(F) is provided to check the tibial resection level.
OPTION
Once the tibial slotted cutting block is positioned on the
tibia, insert a pin into the central slot to fix the rotation.
Inserting this pin will still allow adjustment of the tibial
slope and varus/valgus.
Central Slot
25.
CAUTION
The cutting block does not have a built-in slope, i.e. when
the extramedullary jigs are aligned with the tibial axis, the
system provides a slope of 0°.
5.3 SETTING THE TIBIAL VARUS/VALGUS WITH
THE EXTRAMEDULLARY GUIDE
TIP
Set the varus-valgus orientation of the tibial resection
parallel to the articular surface of the native tibia
compensating for cartilage and bone wear. Translating the
malleolar clamp support 15 mm lateral sets the guide to
~ 3° varus to the tibial mechanical axis. Visually fine-tune
the varus/valgus setting of the tibial cutting guide looking
at the tibia articular surface.
26.
5.4 SETTING THE TIBIAL SLOPE WITH THE
EXTRAMEDULLARY GUIDE
Place an angel wing in the saw slot of the slotted tibial
cutting guide. Set the tibial slope by sliding the distal part
of the malleolar clamp support along the malleolar clamp
rod until the angel wing is parallel to the slope of the medial
joint line after compensating for cartilage and bone wear.
27.
It is recommended to avoid any excessive posterior slope,
and it is important to check that no anterior slope is
introduced.
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