Surgical Technique micrometrics addendum
Contents
1. Connect the G shaped array on the selected tibial cutting guide and make sure that the latter is firmly attached to the micrometric positioner Under computer guidance position the assembly on the tibia close to the target position To avoid impingement during the micrometric regulation do not place the tibial cutting guide directly in contact with the bone pin A third pin without head may be used to further stabilize the support The initial position ot the assembly must be close to the target position If the initial position is not accurate the regulation of the micrometric positioner will not be enough to reach the position MIS 02 07 10 02907 10 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 5 3 NAVIGATING THE TIBIAL CUT Adjustments are pertormed by turning specitic knobs under computer assistance as shown in the picture below H cut height V varus valgus S slope K locking screw ADJUSTMENT KNOB PARAMETER RANGE CUT HEIGHT 4 mm vs the neutral position of the knob see par 5 1 VARUS VALGUS 9 vs the neutral position of the knob see par 5 1 Ore 10 vs the neutral position of the knob see par 5 1 11 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International Ed Check the corresponding real time values on screen whilst turning each knob P2. vs the neutral position of the knob see par 7 1 21 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International Check the corresponding real time values on screen while turning each knob X ga EA YSIS ANALYSS gt PROGRESSION 4 in 1 resection Set the resection parameters and accordigly navigate the resection block Estimated size Cut height O Femoral rotation Post condyles ext 0 Whiteside line int 6 Epicondyles int 6 33 22 0003 02 07 10 0201 0206 Cut height references Anterior cortex H 1 Posterior condyles H2 Femoral rotation references Whiteside s line R1 Transepicondylar axis R2 Posterior condyles line R3 To remove the Ain micrometric positioner Fix the 4in1 cutting guide by using 2 parallel pins Free the cutting block locking knob Pull up the locking lever Remove the 4in1 positioner sliding it away from the distal cutting guide An additional check may be performed e Move the cursor f3 to the picture lower right corner on screen e Press f4 to switch trom the 4in1 micrometric positioner to the 4in1 cutting guide e Assemble the G array on the 4inl cutting guide e Check the alignment of the 4in1 cutting guide on screen 22
3. 00 Aled acta International Cut Height Connect the G array in the two holes on the 4in1 micrometric positioner as shown in the picture Slide the connection plate located on the bottom of the Ain positioner into the corresponding slot on the top of the 4in1 cutting guide MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International Ed By using a screwdriver turn the locking knob 90 degrees A in the picture below to fix the connection The Ain micrometric positioner cannot be used with the software Evolis Global v 4 3 0 because it is not compatible with the 02 07 10 2101 6 and the 2 631 6 cutting guides see par 2 POSITIONING ON THE DISTAL CUT The distal cutting guide must be firmly in place in the same position it was when the distal resection was performed Slide the connection plate located on the 4in positioner into the slot on the distal guide and push the lever down to tix the connection STD MIS 02 07 10 0201 6 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 3 NAVIGATING THE ANTERIOR POSTERIOR CUTS Adjustments are pertormed by turning specific knobs under computer assistance as shown in the picture below H Cut height R External rotation REGULATING KNOB PARAMETER RANGE H CUT HEIGHT 4 mm vs the neutral position of the knob see par 7 1 ROTATION 12
4. 44 d acta 44 44 e amp soacia icro4defrics MICROMETRIC POSITIONERS USER MANUAL Ref 99 30MM 16 rev 00 Last update November 201 9 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International CAUTION Federal law USA restricts this device to sale by or on the order of physician Distributed by MEDACTA USA Inc 4725 Calle Quetzal Unit B Camarillo CA 93012 1 800 901 7836 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International TABLE OF CONTENTS La AEN I a GOT O T EO H D O 4 2 PGR oI GO HII GUIDE Vir DIR T 5 IN BR EEN Bhain reir Nrirm mrm m c m m m m mmma 6 as Foca DUNG THE WICROMEING GUIDE ON TE SURPOR Padda bin 7 Sec KS Tr te ee eer ee er eee 8 5 1 ASSEMBLING THE TIBIAL CUTTING BLOCK ON THE MICROMETRIC GUIDE 8 NN EEEE OIA A EEEE 10 NR aim A E A O T 11 ome Si ee A nn 13 6 1 ASSEMBLING THE DISTAL CUTTING GUIDE ON THE MICROMETRIC GUIDE 13 O22 Soll ONIN GAIN Iie E ni 15 OO INA OA HIG CAI ah R HTH 17 NI FO TER OR GT sa a cs 18 7 ASSEMBLING THE 4IN1 CUTTING GUIDE ON THE 4INT MICROMEIRIC GUIDE 18 T SINSIN a SR eg eeeNImmmmaN mm 20 3 NAVIGATING THE ANTERIOR POSTERIOR CUTS a aaa RAT TA ARR 21 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International SYMBOLS Throughout this manual you will find the following sym
5. I Micrometric Support Ref no 33 22 0135 Screw the micrometric support on the 3 hole socket located on the micrometric positioner MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 5 TIBIAL CUT 5 1 ASSEMBLING THE TIBIAL CUTTING BLOCK ON THE MICROMETRIC GUIDE Before fixing the micrometric positioner on the tibial cutting block set the regulation knobs at the neutral position in order to have the possibility to fine tune in both directions The reterence notches which indicate the neutral position of the three adjustment knobs are highlighted in the tigure below Varus Valgus Cut Height L Slope Ss MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International Locate the flat coupling surface on the DT micrometric positioner green in picture below and slide the selected tibial cutting block on to it It is suggested not to introduce the tibial guide up to the end of the flat surface In case of impingement between the cutting guide and the bone during the micrometrical fine tuning an additional correction is then possible by sliding the cutting block on the connection plate Finally secure the assembly by turning the locking screw A in the picture below MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 5 2 POSITIONING ON THE TIBIA
6. K Locking screw ADJUSTMENT KNOB PARAMETER RANGE CUT HEIGHT 4 mm vs the neutral position of the knob see par 6 1 VARUS VALGUS 9 vs the neutral position of the knob see par 6 1 FLEXION 10 vs the neutral position of the knob see par 6 1 17 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International Ed Check the corresponding real time values on screen whilst turning each knob PROGRESSJON Distal resection Set the resection parameters and accordigly navigate the resection block Varus 0O 091 5 Flexion D 33 22 0003 When the cut height is deemed satisfactory screw the corresponding screw K to fix the position To remove the micrometric positioner e Fix the distal cutting guide by using 2 parallel pins e Free the cutting block locking screw e Remove the pins from the micrometric support e Slide away the micrometric positioner from the distal cutting guide 7 ANTERIOR POSTERIOR CUTS 7 ASSEMBLING THE 4INI CUTTING GUIDE ON THE 4INI MICROMETRIC GUIDE Before fixing the Ain micrometric positioner on the Ain cutting block set the regulation knobs at the neutral position in order to have the possibility to tine tune in both directions The reference notches which indicate the neutral position of the two adjustment knobs are highlighted in the tigure below 18 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev
7. RE RESECTION ANATOMICAL ANALYSIS ANDMARKS PROGRESSION Tibial resection Set the resection parameters and accordigly navigate the resection block 02 07 10 0291 When the cut height is deemed satisfactory screw the corresponding screw K to fix the position To remove the micrometric positioner e Fix the tibial cutting guide by using 2 parallel pins e Free the cutting block locking screw e Remove the pins from the micrometric support e Slide away the micrometric positioner trom the tibial cutting guide 12 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 6 DISTAL CUT ASSEMBLING THE DISTAL CUTTING GUIDE ON THE MICROMETRIC GUIDE Betore tixing the micrometric positioner on the distal block set the regulation knobs at the neutral position in order to have the possibility to fine tune in both directions The reference notches which indicate the neutral position of the three adjustment knobs are highlighted in the tigure below Cut Height e Flexion Varus Valgus 13 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International Locate the flat coupling surface on the micrometric positioner highlighted in green in picture below and slide the selected distal resection block on it It is suggested not to introduce the distal block up to the end of the flat surface In case of impingement between t
8. bol The descriptions in the MSS boxes refer to instruments suitable for muscle sparing approaches This manual applies to the following software versions GMK v 4 2 2 GMK v 4 3 0 Evolis Global v 4 3 0 For different applications please contact Medacta International 1 INSTRUMENT DESCRIPTION The micrometric positioners are used to place the GMK cutting guides on the tibia and on the femur allowing a fine tuning of the cut parameters under computer assistance by turning specitic knobs The micrometric positioners are meant to be used in combination with the iMNS Medacta Navigation System The following table summarizes the commercial codes for micrometric positioners ae AISI 3 16L A Ea AISI 4208 33 22 0136 DT Micrometric Positioner ei SR AISI630 R 7 PROPILUX Gs TEFLON L aa AISI 3161 33 22 0135 DT Micrometric Support amd AISI 4208 gt AISI Sl l r AISI 4208 33 22 0137 JA in 1 Micrometric Positioner LC i AlSl630 wine fs PROPILUX Ss Ti6AIAV MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 2 MICROMEIRICS VS CUTIING GUIDES COMPATIBILITY MICROMETRICS CUTTING GUIDES GUIDES CUMNGGUDS gg ie SR E AL No 02 07 10 0111 3 Yes Wat 2 2022 No 0207 100 IR sa a ostat 0207100727 ys FEMUR sag TIR 02 07 1005 No OZ VA u 210 FEMUR 4IN1 2 2 6816 O Spar OTS 0 7 75 O20 b To be use
9. d in combination with 33 22 0135 PE Not applicable MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled a cta International Ed 3 CUTTING GUIDES SELECTION Please check the compatibility with the micrometric positioners before selecting each cutting guide PROGRESSION Guides selection The MIS distal femoral resection block 02 07 10 0065 will be used Tibia tool Distal tool 4 in 1 tool _ STD 02 07 10 2145 6 _ STD 2623 _ STD 02 07 10 2101 6 _ STD 02 07 10 0111 3 _ STD 02 07 10 0127 _ MIs 2631 6 _ MS 2 622 MIS 2 618 02 07 10 0201 6 MIS 02 07 10 0290 1 E ms 02 07 10 0065 CAS 2 637 CAS 33 22 0137 02 07 10 0291 02 07 10 0065 To navigate the GMK cutting guides by using the micrometric positioners in the Tibia Tool section select F3 and confirm FA the tibial cutting guide to be navigated in the Distal Tool section select F3 and confirm F4 the distal cutting guide to be navigated in the 4in1 Tool section select F3 and confirm F4 the option CAS 33 22 0137 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International Ed 4 ASSEMBLING THE MICROMETRIC GUIDE ON THE SUPPORT The DT micrometric support is used to tix the DT micrometric positioner on the tibia and on the femur The following components must be assembled e DI Micrometric Positioner Ref no 33 22 0136 e D
10. he cutting guide and the bone during the micrometrical fine tuning an additional correction is then possible by sliding the cutting block on the connection plate Finally secure the assembly by turning the locking screw A in the picture below 14 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 6 2 POSITIONING ON THE FEMUR Connect the G shaped array on the selected distal cutting guide and make sure that the latter is firmly attached to the micrometric positioner Under computer guidance position the assembly on the femur close to the target position To avoid impingement during the micrometric regulation do not place the tibial cutting guide directly in contact with the bone pins Green positioning on the femur L The initial position of the assembly must be close to the target position It the initial position is not accurate the regulation of the micrometric positioner will not be enough to reach the position 15 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International STD 02 07 10 0127 MIS 2 618 16 MEDACTA iMNS Micrometric positioners user manual Ref 99 30MM 16 rev 00 Aled acta International 6 3 NAVIGATING THE DISTAL CUT Adjustments are performed by turning specific knobs as shown in the picture below F Flexion H Cut height V Varus Valgus
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