Operative Technique - Implamed · INTRODUCTION The Optetrak® Rotating Bearing Knee gives you the...

Operative TechniqueAddendum to:

Cruciate Retained/ Posterior Stabilized Operative Technique

Operative Technique

RBKROTATING BEARING KNEE

™

It’s not just a road we’re on, it’s a trail we’re blazing.

The Right Track

©20

08 E

xact

ech,

Inc.

• IS

O 13

485

Certi

fied

INTRODUCTION

The Optetrak® Rotating Bearing Knee gives you the best of both

worlds — the benefits of a fixed and a mobile bearing knee in one

unique system. The fixed, proximal bearing surface allows for 145

degrees of flexion while maintaining Optetrak’s proven optimized con-

gruency. The lower bearing features a patented “wave” design for

rotational freedom and predictable kinematics. These two articulating

surfaces work together to maintain proper alignment and minimize

contact stress.

The following surgical technique is an addendum to the Optetrak Comprehensive Operative Technique Cruciate Retaining/ Posterior Stabilized.

Figure 1 Templating with the RBK Trial Tibial Plate

Figure 2 Templating with the

Standard Trial Tibial Tray

Table 1 Compatibility chart

between the femoral size and the tibial size

Hi-Flex™ Femoral size

RBK™ Tibial insert size

RBK™ Tibial tray size

RBK™ Trial tibial plate

RBK™ Trial tibial stem

Implant or instrument Implant Instrument

1F 1F1F/1T 1F/1T

1T – 2T1F/2T 1F/2T

2F 2F

2F/1T 2F/1T

2F/2T 2F/2T

2F/3T 2F/3T 3T – 4T

3F 3F

3F/2T 3F/2T 1T – 2T

3F/3T 3F/3T

3T – 4T3F/4T 3F/4T

4F 4F

4F/3T 4F/3T

4F/4T 4F/4T

4F/5T 4F/5T 5T

5F 5F5F/4T 5F/4T 3T – 4T

5F/5T 5F/5T 5T

1

Implant note

The Optetrak® Hi-Flex™ RBK™ uses the stan-

dard Hi-Flex femoral component. Hi-Flex

fixed bearing tibial components should be

available if this option is required. Included in

the Hi-Flex tibial components are the Hi-Flex

inserts and the standard tibial trays. The size

1 Delta tibial tray implant and trial must be

included when a fixed bearing Hi-Flex option

is needed.

preparatIon of the femurThe femur is prepared with the Optetrak

instrumentation according to the standard

operative technique.

Note: The Hi-Flex femoral component requires

a Hi-Flex Notch Resection Guide.

preparatIon of the tIbIa anD the patellaThe tibia and patella are prepared according

to the standard operative technique.

preparatIon of the tIbIaTIBIAl TemPlATIng

The cut tibial surface should be sized using the

rbK trial tibial plate (Figure 1) or the Standard

trial tibial tray (Figure 2). For a given size of

femoral component, the surgeon has a choice

of three tray sizes. These include the same

nominal size as the femoral component, one

size larger and one size smaller (Table 1).

Figure 3 RBK Trial Tibial Insert and Trial Tibial Plate

Figure 4 Trial Reduction

2

tIbIal tray poSItIonThe trial tibial plate defined previously should

be placed on the resected tibia. In addition,

one of the four tibial insert thicknesses (9mm,

11mm, 13mm or 15mm) is placed on the trial

tibial plate (Figure 3).

trIal reDuctIonA trial reduction may be performed at this

time to assess the stability of the trial tibial

insert (Figure 4).

Note: the motion of the trial tibial insert

relative to the trial tibial plate is constrained

only by the wave.

Figure 5 Tibial rotational positioning

Figure 6 Standard Trial Tibial

Tray positioning

3

tIbIal poSItIonIngTibial tray rotation should be referenced by a

mark on the anterior surface of the tibial bone

(Figure 5).

fInal tIbIal preparatIon anD trIalThe Standard Tibial Tray Trial should now be

positioned on the resected tibia. The center

of the Tibial Tray Trial is aligned with the

previous mark on the tibia and pinned in

place (Figure 6).

Continue the tibial preparation as described in

the standard surgical technique.

Figure 7 RBK Trial Tibial Plate Assembly

4

trIal tIbIal plate aSSemblyThe rbK trial tibial Stem should now be

attached to the RBK Trial Tibial Plate selected

in the previous step. Choose one of three

cemented or cementless trial stems that cor-

responds with the plate size by matching

the “T” number, ie plate size 3F/2T use stem

size 1T-2T. Trial stem is inserted into the trial

tibial plate and rotated 45 degrees clockwise

(Figure 7).

Figure 8 Tibial Fin Preparation

Figure 9 Trial Tibial Insert

Assembly

5

tIbIal fIn preparatIon The rbK tibial Impactor should be inserted

through the Trial Tibial Plate and screwed

into the Trial Tibial Stem. The RBK Trial Tibial

assembly should be inserted into the previously

prepared tibial canal and impact until fully

seated to complete the bone preparation

(Figure 8). minimal force is required to create

additional room for the RBK component.

trIal tIbIal InSert aSSembly The trial modular peg can be screwed into the

bottom side of the previously selected trial

tibial Insert (Figure 9).

Figure 10 Trial Tibial Insert Placement

Figure 11 Final Trial Reduction

6

trIal tIbIal InSert placementThe Trial Insert assembly is placed into the

Trial Tibial assembly (Figure 10).

fInal trIal reDuctIonThe knee should be assessed for stability in

both extension and flexion (Figure 11).

Figure 12 Tibial Tray Implantation

7

fInal rbK tIbIal tray ImplantatIonThe Tibial Impactor may be used to implant

the final tibial prosthesis (Figure 12). If

using the cemented design, cement should be

applied to the under side of the tray and to the

bone. If using the press-fit design, cement is

not required. The tibial tray should be inserted

by hand into the prepared canal. The tray may

now be seated by placing the Tibial Impactor

on the proximal surface and impacted with a

mallet.

fInal tIbIal proStheSIS ImplantatIonContinue preparation of the knee as described

in the standard surgical technique.

For additional device information, refer to the Exactech Optetrak Comprehensive Knee System – Instructions for Use.

For further product information, please contact Customer Service, Exactech, Inc. 2320 NW 66th Court, Gainesville, Florida 32653-1630, USA. (352) 377-1140, (800) 392-2832 or FAX (352) 378-2617.

Authorized European RepresentativeMediMark® Europe11, rue Emile Zola B.P. 233238033 Grenoble Cedex 2France

OpTeTRak RBk ImplaNTs & INsTRUmeNTs sCOpe

8

264-21-09 RBK PS Hi-Flex Tibial Insert, Size 1, 9mm264-21-11 RBK PS Hi-Flex Tibial Insert, Size 1, 11mm264-21-13 RBK PS Hi-Flex Tibial Insert, Size 1, 13mm264-21-15 RBK PS Hi-Flex Tibial Insert, Size 1, 15mm





260-04-21 RBK Downsized Finned Tibial Tray, Cemented, Size 2F/1T260-04-32 RBK Downsized Finned Tibial Tray, Cemented, Size 3F/2T260-04-43 RBK Downsized Finned Tibial Tray, Cemented, Size 4F/3T260-04-54 RBK Downsized Finned Tibial Tray, Cemented, Size 5F/4T

262-04-21 RBK Downsized Finned Tibial Tray, Cementless, Size 2F/1T262-04-32 RBK Downsized Finned Tibial Tray, Cementless, Size 3F/2T262-04-43 RBK Downsized Finned Tibial Tray, Cementless, Size 4F/3T262-04-54 RBK Downsized Finned Tibial Tray, Cementless, Size 5F/4T

260-04-11 RBK Size to Size Finned Tibial Tray, Cemented, Size 1F/1T260-04-22 RBK Size to Size Finned Tibial Tray, Cemented, Size 2F/2T260-04-33 RBK Size to Size Finned Tibial Tray, Cemented, Size 3F/3T260-04-44 RBK Size to Size Finned Tibial Tray, Cemented, Size 4F/4T260-04-55 RBK Size to Size Finned Tibial Tray, Cemented, Size 5F/5T

262-04-11 RBK Size to Size Finned Tibial Tray, Cementless, Size 1F/1T262-04-22 RBK Size to Size Finned Tibial Tray, Cementless, Size 2F/2T262-04-33 RBK Size to Size Finned Tibial Tray, Cementless, Size 3F/3T262-04-44 RBK Size to Size Finned Tibial Tray, Cementless, Size 4F/4T262-04-55 RBK Size to Size Finned Tibial Tray, Cementless, Size 5F/5T

260-04-12 RBK Upsize Finned Tibial Tray, Cemented, Size 1F/2T260-04-23 RBK Upsize Finned Tibial Tray, Cemented, Size 2F/3T260-04-34 RBK Upsize Finned Tibial Tray, Cemented, Size 3F/4T260-04-45 RBK Upsize Finned Tibial Tray, Cemented, Size 4F/5T

262-04-12 RBK Upsize Finned Tibial Tray, Cementless, Size 1F/2T262-04-23 RBK Upsize Finned Tibial Tray, Cementless, Size 2F/3T262-04-34 RBK Upsize Finned Tibial Tray, Cementless, Size 3F/4T262-04-45 RBK Upsize Finned Tibial Tray, Cementless, Size 4F/5T

265-21-09 RBK PS Hi-Flex Trial Tibial Insert, Size 1, 9mm265-21-11 RBK PS Hi-Flex Trial Tibial Insert, Size 1, 11mm265-21-13 RBK PS Hi-Flex Trial Tibial Insert, Size 1, 13mm265-21-15 RBK PS Hi-Flex Trial Tibial Insert, Size 1, 15mm





261-05-21 RBK Trial Downsized Tibial Tray, Size 2F/1T261-05-32 RBK Trial Downsized Tibial Tray, Size 3F/2T261-05-43 RBK Trial Downsized Tibial Tray, Size 4F/3T261-05-54 RBK Trial Downsized Tibial Tray, Size 5F/4T

261-05-11 RBK Trial Size to Size Tibial Tray, Size 1F/1T261-05-22 RBK Trial Size to Size Tibial Tray, Size 2F/2T261-05-33 RBK Trial Size to Size Tibial Tray, Size 3F/3T261-05-44 RBK Trial Size to Size Tibial Tray, Size 4F/4T261-05-55 RBK Trial Size to Size Tibial Tray, Size 5F/5T

261-05-12 RBK Trial Upsize Tibial Tray, Size 1F/2T261-05-23 RBK Trail Upsize Tibial Tray, Size 2F/3T261-05-34 RBK Trial Upsize Tibial Tray, Size 3F/4T261-05-45 RBK Trial Upsize Tibial Tray, Size 4F/5T

261-30-12 RBK Trial Tibial Tray Fin/Broach, Cemented, Size 1T/2T261-30-34 RBK Trial Tibial Tray Fin/Broach, Cemented, Size 3T/4T261-30-56 RBK Trial Tibial Tray Fin/Broach, Cemented, Size 5T/6T

263-30-12 RBK Trial Tibial Tray Fin/Broach, Cementless, Size 1T/2T263-30-34 RBK Trial Tibial Tray Fin/Broach, Cementless, Size 3T/4T263-30-56 RBK Trial Tibial Tray Fin/Broach, Cementless Size 5T/6T

261-03-00 RBK Impactor Handle

261-03-06 RBK Trial Impactor

261-00-00 Trial Tibial Insert Universal Peg

261-31-00 Complete Instrument Case

Not available for sale iN the UNited states

Patent WO 2005/009298 and other patents pending

352-377-1140 1-800-EXACTECHwww.exac.com

©20

08 E

xact

ech,

Inc.

• IS

O 13

485

Certi

fied

712-18-30 Rev. B RBK Operative Technique 0608

Operative Technique - Implamed · INTRODUCTION The Optetrak® Rotating Bearing Knee gives you the...

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