(BQ) Part 2 book “A beginner ’s guide to total knee replacement” hass contents: Instruments for primary total knee replacement, postoperative treatment, mobilization and physiotherapy, fixed varus and valgus deformities, tricks and tips with mediolateral deformities, recurvatum deformity of the knee, and other contents. | Instruments for Primary Total Knee Replacement 253 10 Instruments for Primary Total Knee Replacement I rrespective of the implant design or brand, the instruments achieve exactly the same goals, namely: 1. Cutting the lower femur in a few degrees valgus and parallel to the floor. 2. Cutting the upper tibia neutral to floor mediolaterally but with a slight posterior slope. 3. Ensuring a proper rotational alignment during anterior, posterior and chamfer cuts of distal femur. 4. The surface and taper cuts of distal femur should exactly match the undersurface of the femoral component. 5. Adequate trials for checking all cuts and releases before implantation. 6. Instrumentation to ensure that gaps in flexion and extension are equal. 253 254 Guide to Total Knee Replacement CHARNLEY FEMORAL BROACH The intramedullary broach and alignment rod is available in different combinations from the simplest to the most complicated. This is the first instrument used and locates the long axis of the femur. The rod should be inserted deep enough into the medulla to catch the isthmus to ensure that a wrong axial identification is avoided. The distal femoral cutting guide is attached to this block. Instruments for Primary Total Knee Replacement 255 DISTAL FEMORAL CUTTING ASSEMBLY Various designs of distal cutting blocks achieve the same purpose with minor technical variations in the instrumentation. 256 Guide to Total Knee Replacement EACH SYSTEM PROVIDES A VALGUS CUT Each instrument can provide valgus cuts from 3° to 7° in small increments to tailor the cut according to the patient. Instruments for Primary Total Knee Replacement 257 BLOCK DESIGNS VARY These blocks can vary from simple Freeman and Insall designs (top and bottom) to the complex fourth generation magnetic .
