smith&nephew RT-PLUS Surgical Technique page 34

Controlling the stem position
An extramedullary reamer alignment guide,
which is attached to the reamer, can be used
to check the position of the stem in axial
alignment and depth (the end of the reamer
alignment guide corresponds to the tip of the
reamer).
Preparing the tibial stem connection
If it is reamed only to diameters Ø 10, Ø 12
or Ø 14, the stem connection recess has
to be reamed with the Ø 10/16 mm stepped
reamer until the laser marking (corresponding
to the resection level).
IM positioning and control with trial stems
The chosen trial stem is attached to the ex-
tension for trial stem (Ø 8 mm) and with the
modular handle carefully inserted into the tibial
IM canal so the line marked with PRIMARY
respectively REV. is approximately level to
the proximal bone resection. The modular
handle is now removed. It is important to avoid
putting excessive pressure in the tibial IM
canal.
Note
With too short IM guidance, the alignment may
be incorrect (varus/valgus, extension/flexion).
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