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Aesculap Univation X Surgical Technique

Unicondylar knee system
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univation
X
™
Unicondylar Knee System Surgical Technique
Aesculap Orthopaedics

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Summary of Contents for Aesculap Univation X

  • Page 1 ™ Unicondylar Knee System Surgical Technique Aesculap Orthopaedics...

  • Page 2: Table Of Contents

    univation X Unicondylar Knee System ™ Surgical Technique Table of Contents Table of Contents System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Indications, Contraindications, Warnings and Potential Risks &...

  • Page 3: System Overview

    The univation™ X Unicondylar Knee System was designed with a fixed platform to treat medial knee defects . The system offers streamlined, user-friendly instrumentation to optimize surgical time and allow for intra-operative flexibility . The univation X system is an enhanced design with efficient instrumentation to help restore natural knee kinematics .

  • Page 4: Indications, Contraindications, Warnings And Potential Risks & Precautions

    Patients unwilling or unable to follow post-operative care instructions . ■ Warnings The univation X implants are designed for single patient use only and must never be reused . As with all other orthopedic ■ implants, the univation X components should never be re-implanted under any circumstances .
  • Page 5 II. Indications, Contraindications, Warnings and Potential Risks & Precautions (continued) Precautions The univation X Unicompartmental Knee System is intended to be used by surgeons specializing in orthopedic surgery who have ™ ■ a thorough knowledge of knee arthroplasty, joint morphology and the biomechanical principles of the knee . Pre-operative assessment of the suitability of the patient’s anatomy for accepting implants is made on the basis of X-rays, CT ■...

  • Page 6: Preoperative Planning

    univation X Unicondylar Knee System ™ Surgical Technique III. Preoperative Planning Fig . 1 Fig . 2 For every knee arthroplasty, careful pre-operative X-ray The following images are required for X-ray analysis: planning is recommended . Knee joint in AP projection (Fig . 1) ■...

  • Page 7: Approach

    IV. Approach Fig . 4 Fig . 3 Medial parapatellar Arthrotomy At 90° flexion, make a paramedial skin incision from the medial edge of the patella to a point 2 to 3 cm distal of the With the knee in flexion or extension, the arthrotomy is joint line .

  • Page 8: Instrument Assembly Instructions

    univation X Unicondylar Knee System ™ Surgical Technique V. Instrument Assembly Instructions 1. Extramedullar Tibial Alignment Press and hold the button on the Turn the wheel on the tibial Press and hold the handle ■ ■ ■ bimalleolar clamp . alignment handle to the open adjustment wheel to release the position, in which it shows 'OPEN' .

  • Page 9: Femur Trial Insertion Instrument

    2. Femur Trial Holder Instrument Insert the implant holder with Place the insertion instrument Tighten the holder onto the ■ ■ ■ the thread into the sleeve of the with both pins parallel to the trial femoral trial . femoral holder . implant .

  • Page 10: Workflow Synopsis

    univation X Unicondylar Knee System ™ Surgical Technique VI. Workflow Synopsis 1 . Tibial alignment and proximal tibia resection 2 . Measuring flexion and extension gaps 3 . Femur preparation 4 . Femur anterior and posterior cuts 5 . Tibia sizing 6 .

  • Page 11: Surgical Technique

    VII. Surgical Technique Fig . 6 Fig . 5 1. Tibia Alignment Extramedullary Alignment Height Adjustment The extramedullary (EM) alignment system assembly is Using the cutting check plate, the height and posterior ■ ■ placed parallel to the front of the tibia with the leg in slope of the resection can be checked .
  • Page 12 univation X Unicondylar Knee System ™ Surgical Technique Fig . 8 Fig . 7 1. Tibia Alignment (continued) Varus-valgus Alignment Push the knob (1) on the bimalleolar clamp and slide Fasten the tibial cutting guide with two headless pins ■ ■...

  • Page 13: Tibia Resection

    Fig . 9 Fig . 10 2. Tibia Resection Step 1: Tip: The vertical/sagittal cut should The horizontal tibia cut is made either through the ■ ■ cutting guide (Fig . 9) or on top of the cutting guide not extend below the transverse/ (Fig .

  • Page 14: Measuring Flexion And Extension Gaps

    univation X Unicondylar Knee System ™ Surgical Technique Fig . 13 Fig . 12 3. Measuring Flexion and Extension Gaps Measurement with Spacers The flexion gap is measured with the spacers . Please note The minimum height for the tibial plateau and meniscus ■...
  • Page 15 Fig . 14 Fig . 15 Gap Balancing Strategies Flexion and extension gaps must be balanced for optimal Scenario Option 1 Option 2 ■ post-operative results . Flexion Gap Both resection blocks = Extension are set to ‘0’ . The The resection height can be adjusted either through the ■...

  • Page 16: Femur Preparation

    univation X Unicondylar Knee System ™ Surgical Technique Fig . 17 Fig . 16 4. Femur Preparation a. Distal Femur Cut Fasten the cutting guide with two headless pins . Be sure ■ Place the distal femur cutting guide onto the trial spacer that the cutting guide is in contact with the distal and ■...
  • Page 17 Fig . 19 Fig . 18 Femoral Sizing Before resection, remove the spacer and bring the knee It is recommended to measure the femur size on the ■ ■ to 90° flexion . X-ray . The posterior part is difficult to assess intra-operatively .

  • Page 18: Chamfer And Posterior Cuts

    univation X Unicondylar Knee System ™ Surgical Technique Fig . 21 Fig . 20 4. Femur Preparation (continued) b. Femur Chamfer and Posterior Cuts Place the 2-in-1 cutting guide onto the spacer with the Based on the tibia cut, the rotation of the femur is ■...
  • Page 19 Fig . 22 Fig . 23 The resection block is fastened with two headed pins . The Make the posterior cut first, then the chamfer cut is ■ ■ anterior pin is 30 mm long (NP585R), and the posterior made . pin is 50 mm long (NP586R) .

  • Page 20: Tibia Sizing And Preparation

    univation X Unicondylar Knee System ™ Surgical Technique Fig . 25 Fig . 24 5. Tibia Sizing and Preparation Use the hook to measure the AP dimension of the tibia Place the corresponding size tibial plate on the tibial cut . ■...
  • Page 21 Fig . 27 Fig . 26 With the longer end of the tibial hook, the tibial plateau Fixate the tibia plateau with a pin . ■ ■ should be placed even with the posterior edge of the tibia . Headed pin 50 mm NP586R, B: Pin driver NP613R, C: Acculan drill ®...
  • Page 22 univation X Unicondylar Knee System ™ Surgical Technique Fig . 29 Fig . 28 The tibial peg hole is prepared using the tibial drill . Leave The fin is prepared using a reciprocating saw, then ■ ■ the peg in place for additional stabilization . finished using the tibial osteotome .
  • Page 23 Fig . 30 Connect the fin punch to the handle and then hit it into ■ place . A: Acculan saw, B: Osteotome for tibial fin NM598R, C: Handle for impactors NM590R, D: Tibial fin punch NM599R ®...

  • Page 24: Implant Sizing And Final Preparation

    univation X Unicondylar Knee System ™ Surgical Technique Fig . 32 Fig . 31 6. Final Femur Preparation Refer to page 9 for the Femur Trial Insertion Instrument - Before drilling, align the femoral trial in the ML position ■ ■...
  • Page 25 Fig . 33 Fig . 34 Use the femoral drill pegs to prepare the two parallel peg Use the osteophyte osteotome to remove osteophytes ■ ■ holes . Leave the first drill peg in place until the second from the posterior edge for the femoral implant . peg hole is drilled .

  • Page 26: Trial Reduction And Implant Final Components

    univation X Unicondylar Knee System ™ Surgical Technique Fig . 36 Fig . 35 7. Trial Reduction and Implant Final Components For the trial reduction, the trial meniscus components Check the range of motion, the ligament tension, and the ■ ■...
  • Page 27 Fig . 38 Fig . 37 Microfracturing Remove the tibia trial . For the femur, the drill (2 .7 mm) is used to drill holes . ■ ■ Remove the femoral trial by first removing the clamp ■ then use the handle to take off the femoral trial . For unicondylar systems, a bone-preserving resection ■...

  • Page 28: Trial And Final Implant

    univation X Unicondylar Knee System ™ Surgical Technique Fig . 40 Fig . 39 8. Trial and Final Implant Final Implant The implants are implanted in the following order: All cement residue must be thoroughly removed before ■ ■ 1 . Tibia the femoral component is implanted .

  • Page 29: Cementing Technique

    9. Cementing Technique prepared surfaces and also removes bone debris that can serve as third body particles that increase polyethylene Regardless of what fixation method is utilized, it is ■ wear after surgery . The surfaces should be properly dried critical that correct techniques are employed to help prior to cementation and appropriate exposure of all avoid complications and early failure .

  • Page 30: Implants Overview

    univation X Unicondylar Knee System ™ Surgical Technique VIII. Implant Overview All dimensions are in mm . univation XF Femur Size Width Radius Distal Cut Post Cut 6 .0 5 .5 6 .5 6 .5 6 .5 6 .5 6 .5 6 .5 7 .0 7 .0...
  • Page 31 Graphic template for NM1092R NM598R univation X Osteotome for tibial fin JA455R Cover for Orthotray NM599R univation X trial instr . for tibial fin NS342R IQ Tibial alignment system handle IQ Tibial alignment system holder, NS344R bimalleolar clamp IQ Tibial alignment system holder,...
  • Page 32 X femoral alignment guide univation X 2-in-1 cutting guide NM008R NM587R univation X femoral peg drill F2/F3/F4 LM univation X trial spacer 7 & 8 mm NM651R univation X 2-in-1 cutting guide NM009R F2/F3/F4 RM univation X trial spacer 9 & 10 mm...
  • Page 33 X trial femur component F1 LM ™ NM620 7 mm NM611R univation X trial femur component F1 RM univation X meniscus trial spacer NM621 NM612R univation X trial femur component F2 LM 8 mm univation X meniscus trial spacer...
  • Page 34 univation X Unicondylar Knee System ™ Surgical Technique TF083 Tibia F (optional) Qty. Item No. Description Qty. Item No. Description NM1056R univation XF tibia trial component T1 RM NM1062R univation XF tibia trial component T1 LM NM1057R univation XF tibia trial component T2 RM NM1063R univation XF tibia trial component T2 LM NM1058R univation XF tibia trial component T3 RM NM1064R univation XF tibia trial component T3 LM...

  • Page 35: Saw Blades

    Saw Blades Thickness: 1 .27 mm ■ Connector Aesculap Aesculap Aesculap Stryker Acculan 3 Ti Acculan 3 Ti Length 90 mm Length 90 mm Length 100 mm Width 19 mm GE271SU GE241SU GE249SU GE331SU Reciprocating saw blade 75/10/1 .0/1 .2 mm Reciprocating saw blade 75/12/1 .0/1 .2 mm...
  • Page 36 univation X Unicondylar Knee System ™ Surgical Technique References Santana AE, Karimi A, Derflinger VG, Schütze A . Relating hardness-curve shapes Maistrelli GL, Antonelli L, Fornasier V, Mahomed N . Cement penetration with pulsed with deformation mechanism in TiAlN thin films indentation . Materials Science and lavage versus syringe irrigation in total knee arthroplasty .
  • Page 38 Notes...
  • Page 40 All rights reserved. Technical alterations are possible. The information provided in this leaflet is distributed by Aesculap Implant Systems, LLC for educational purposes and not for the purpose of rendering medical advice. The material in this leaflet is not instructional and should NOT be relied upon by surgeons and staff as adequate training for performing the surgeries illustrated. This brochure is intended for health care professionals and employees, not for patients.

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