smith&nephew RT-PLUS Surgical Technique page 40

Preparing the tibial IM canal
Prepare the proximal tibial anchorage with the osteotome
and the rasp.
By using the thin narrow 10 mm chisel, the tibial cavity is pre-
liminary prepared along the internal tibial chisel guide con-
tour. This in oder to avoid bone fractures, especially with bad
bone quality. The chisel must be fl ush with the tibial chisel
guide.
Now remove the tibial chisel guide.
Notes
If sclerotic bone, the fins are especially important to be pre-
pared! They can as well be used a reference for the tibial
rotation positing.
In order to prepare the tibial trial, we recommend screwing
the trial stem onto the tibial trial at this point.
With the tibial rasp, the proximal tibial cavity is defi nitively
prepared. The rasp must be knocked in far enough to ensure
that the top of the rasp is fl ush with the (more proximal) bone
resection (or fl ush with the height of the lower plane of the
tibial sizer).
Notes
In order to avoid bone fractures, knock the rasp in carefully.
In order to protect the rasp sharp threats, perform rasping with-
out the tibial sizer if necessary. In this case, with a thin chisel or
by using an electro-cauter, the tibial anchorage fins positions
are mark on the bone in order to guide the rasp.
If both side tibial augmentation blocks are planned, it is un-
necessary to rasp down to the resection level. The rasp must
be knocked down so far that the 5mm, 10mm or 15mm line
marked on the rasp corresponds to the bone resections.
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