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Persona The Personalized Knee Surgical Technique
Persona The Personalized Knee Surgical Technique
Introduction............................................................................................................... 2
Constraint Options
Preoperative Planning
Surgical Approach
Patient Preparation
Magnet Usage
Symbols
Screw/Pin Information
Implant Components............................................................................................... 43
Tibial Plate
Femoral Component
Bearing
Patellar Component
All-Polyethylene Patella
Close Incision........................................................................................................... 46
Surgeon Notes and Tips
Appendix A............................................................................................................... 47
2 Degrees Valgus Recut Guide
2 Degrees Varus Recut Guide
Appendix B............................................................................................................... 49
Spacer Block Technique
Appendix D.............................................................................................................. 66
Compatibility Charts
Surgical Technique
2 | Persona The Personalized Knee Surgical Technique
Introduction
Successful total knee arthroplasty depends in part on The CR femoral provisionals and components can
re-establishment of normal lower extremity alignment, be used when the PCL is sacrificed or deficient and
proper implant design and orientation, secure implant removed, if used with either a MC or ultracongruent
fixation, and adequate soft tissue balancing and (UC) bearing provisionals and components.
stability. Persona The Personalized Knee is designed to
help the surgeon accomplish these goals by combining Also, posterior stabilized (PS) femoral provisionals and
alignment accuracy with a simple, straight-forward components can be used with the PS or constrained
technique. posterior stabilized (CPS) bearings provisionals and
components when the PCL is deficient and removed.
T he instruments and technique assist the surgeon in
restoring the center of the hip, knee, and ankle to lie PS femoral components cannot be used with CR, MC,
in a straight line, establishing a neutral mechanical or UC bearings and CR femoral components cannot be
axis. The femoral and tibial components are used with PS or CPS bearings.
oriented perpendicular to this axis. Femoral rotation The CPS bearings can be used to provide moderate
is determined using the posterior condyles, the varus\valgus constraint in patients to facilitate soft
epicondylar axis, or Whiteside’s line as a reference. tissue balance and stability. The CPS bearings shall
The instruments enable accurate cuts to ensure robust be used with cemented non-porous femoral and tibial
component fixation. components only. Additional information for this
A wide variety of component sizes, shapes, and product may be found in the Constrained Posterior
constraint options allow for optimized component fit Stabilized (CPS) Surgical Technique (97-5026-072-00).
and soft tissue balancing. The femur, tibia, and patella The MC, UC, PS, and CPS implants can be used in
are prepared independently, and can be cut in any the following situations, depending on the degree
sequence using the principle of measured resection of the deformity, the stability of the ligaments, and
(removing enough bone to allow replacement by the the quality of the bone. The surgeon is responsible
prosthesis). Adjustment cuts may be needed later. The for assessing whether a more constraining implant/
anterior referencing technique uses the anterior cortex system or revision implant/system is necessary.
to set the A/P position of the femoral component. The
posterior condyle cut is variable. Marked valgus deformity – requiring PCL
1.
and lateral soft tissue release.
Introduction (cont.)
Patient Preparation
Note: The MC components can be used with or To prepare the limb for total knee arthroplasty,
without the PCL present. The UC, PS, and CPS adequate muscle relaxation is required. The
components should not be used if the PCL is anesthesiologist should adjust the medication based
present. on the patient’s habitus and weight, and administer
to induce adequate muscle paralysis for a minimum
Please refer to the package inserts for complete of 30-40 minutes. It is imperative that the muscle
product information, including contraindications, relaxant be injected prior to inflation of the tourniquet.
warnings, precautions, and adverse effects. Alternatively, spinal or epidural anesthesia should
produce adequate muscle relaxation. If desired, apply
a proximal thigh tourniquet and inflate it with the
Preoperative Planning knee in hyperflexion to maximize that portion of the
Obtain 36 inch or 53 inch standing anteroposterior quadriceps that is below the level of the tourniquet.
and lateral radiographs of the extremity, as well as a Once the patient is draped and prepped on the
sunrise view of the patella. The entire femur should operating table, determine the landmarks for the
be visualized to rule out any structural abnormalities, surgical incision.
as the distal femoral cut will be referenced from an
intramedullary rod in the medullary canal.
Surgical Approach
The surgeon can choose a midvastus approach, a
subvastus approach, or a parapatellar medial
arthrotomy. Also, depending on surgeon preference,
the patella can be either everted or subluxed. The
femur, tibia, and patella are prepared independently,
and can be cut in any sequence using the principle of
measured resection (removing enough bone to allow
replacement by the prosthesis).
4 | Persona The Personalized Knee Surgical Technique
Introduction (cont.)
Magnet Usage
Warning: Some instruments in the Persona System
contain magnets. All Persona Magnetic Instruments
should be kept at a safe distance from a patient’s
active implantable medical device(s) (i.e. pacemaker).
These types of devices may be adversely affected by
magnets. Instruments containing magnets should be
kept on an appropriate table or stand when not in use
at the surgical site.
Symbols
Symbols have been established for the following:
Left Right Varus/Valgus
• Left
• Right
• Standard
• Inset Only
• Anterior Referencing
• Lock
Lock Unlock
• Unlock
• Cemented
Cemented Stemmed Narrow
• Stemmed
• Narrow
5 | Persona The Personalized Knee Surgical Technique
Introduction (cont.)
Screw/Pin Information
The chart below contains relevant information on various 3.2 mm
screws/pins that are compatible with the Persona System. If these
screws/pins are used during the procedure for instrument fixation,
they should be removed prior to closure as they are NOT implantable.
25 mm Shorthead Non-Sterile 1 No
Holding Pin
00-5977-056-03 Multi Pin Puller
00-5901-022-00
* The 2.5 mm female hex screws and 2.5 mm male hex driver should not be used in cortical bone,
as this may increase the incidence of stripping of the driver.
6 | Persona The Personalized Knee Surgical Technique
1. Pull
Caution
Marking
2. Insert
Figure 3
Figure 1
Rotate Dial
2. Rotate
1. Press
Figure 2 Figure 4
Persona 8 mm IM Rod Persona Modular Handle Persona Valgus Alignment Guide Persona Adjustable Resection Tower
42-5099-002-00 42-5099-014-00 42-5099-004-00 42-5099-008-00
7 | Persona The Personalized Knee Surgical Technique
2. Insert 1. Unlock
Figure 6a
Lock
Figure 5 Figure 6b
Persona 8 mm IM Rod Persona Modular Handle Persona Valgus Alignment Persona Adjustable Persona 0° Distal Cut Guide Persona 9 mm Distal
42-5099-002-00 42-5099-014-00 Guide Resection Tower 42-5099-010-00 Resection Plate
42-5099-004-00 42-5099-008-00 42-5099-015-09
8 | Persona The Personalized Knee Surgical Technique
8 mm IM Step Drill Persona 8 mm IM Rod Persona Modular Handle Persona Valgus Alignment Guide Persona Adjustable Resection Tower
00-5978-014-00 42-5099-002-00 42-5099-014-00 42-5099-004-00 42-5099-008-00
Figure 9
Rotate Dial
"Click"
Figure 10 Figure 11
Persona 8 mm IM Rod Persona Modular Handle Persona Valgus Alignment Guide Persona Adjustable Resection Tower
42-5099-002-00 42-5099-014-00 42-5099-004-00 42-5099-008-00
Persona 0° Distal Cut Guide Persona Drop Rod Adapter Alignment Rod with Coupler
42-5099-010-00 42-5399-006-00 00-5785-080-00
10 | Persona The Personalized Knee Surgical Technique
1. Unlock
2. Pull
Figure 12 Figure 13
Persona 8 mm IM Rod Persona Modular Handle Persona Valgus Alignment Guide Persona Adjustable Resection Tower
42-5099-002-00 42-5099-014-00 42-5099-004-00 42-5099-008-00
Persona 0° Distal Cut Guide 3.2 mm x 75 mm Trocar Tipped Drill Pin Pin Screw Inserter
42-5099-010-00 (2.5 mm hex) 00-5901-021-00
00-5901-020-00
11 | Persona The Personalized Knee Surgical Technique
Figure 15a
Figure 14
Figure 15b
R
emove all pins and the cut guide.
Persona 0° Distal Cut Guide 3.2 mm x 75 mm Trocar Tipped Drill Pin Pin Screw Inserter Resection Guide Multi Pin Puller
42-5099-010-00 (2.5 mm hex) 00-5901-021-00 00-5977-084-00 00-5901-022-00
00-5901-020-00
12 | Persona The Personalized Knee Surgical Technique
5. Insert
1. Lift
4. Push
6. Release
2. Insert Rod
1. Push
3. Release
Figure 16 Figure 17
Persona EM Proximal Tube Persona EM Distal Rod Persona EM Ankle Clamp Persona Tibial Cut Guide Persona Tibial Cut Guide
42-5399-001-00 42-5399-002-00 42-5399-003-00 Left - 3° Left - 7°
42-5399-051-03 42-5399-051-07
13 | Persona The Personalized Knee Surgical Technique
Clockwise
Height Adjustment
Shorten Lengthen
Counter
Varus/Valgus Adjustment
Clockwise
Slope Adjustment
Figure 18 Figure 19
Persona Tibial Cut Guide Persona Tibial Cut Guide Persona Tibial Cut Guide Persona Tibial Cut Guide
Right - 3° Right - 7° Universal - 3° Right - 7°
42-5399-052-03 42-5399-052-07 42-5399-050-03 42-5399-050-07
14 | Persona The Personalized Knee Surgical Technique
Figure 20a
5 mm
AP Axis
Persona EM Proximal Tube Persona EM Distal Rod Persona EM Ankle Clamp 3.2 mm Drill
42-5399-001-00 42-5399-002-00 42-5399-003-00 00-5120-085-00
3.2 mm x 75 mm Trocar Tipped Drill Pin Pin Screw Inserter Persona Tibial Cut Guide
(2.5 mm hex) 00-5901-021-00 Right - 7°
00-5901-020-00 42-5399-052-07
15 | Persona The Personalized Knee Surgical Technique
2. Insert
1. Push
3. Release
Figure 22 Figure 23
Figure 26
Persona Tibial Stylus - 2/10 mm Persona Drop Rod Adapter 75 mm x 3.2 mm Trocar Resection Guide
42-5399-005-00 42-5399-006-00 Tipped Drill Pin (2.5 mm hex) 00-5977-084-00
00-5901-020-00
Pin/Screw Inserter Alignment Rod with Coupler Persona Tibial Cut Guide Right - 7°
00-5901-021-00 00-5785-080-00 42-5399-052-07
17 | Persona The Personalized Knee Surgical Technique
2. Translate
1. Lift
Figure 29 Figure 31
Locking Pin
Symbol
Persona Tibial Cut Guide Right - 7° 75 mm x 3.2 mm Trocar Tipped Pin/Screw Inserter Multi Pin Puller
42-5399-052-07 Drill Pin (2.5 mm hex) 00-5901-021-00 00-5901-022-00
00-5901-020-00
18 | Persona The Personalized Knee Surgical Technique
Persona Tibial Cut Guide Persona Tibial Cut Guide Persona Tibial Cut Guide 75 mm x 3.2 mm Trocar Multi Pin Puller
Right - 7° Universal - 3° Universal - 7° Tipped Drill Pin (2.5 mm hex) 00-5901-022-00
42-5399-052-07 42-5399-050-03 42-5399-050-07 00-5901-020-00
Side
Designation
Figure 37
Figure 36 Figure 38
Persona Anterior Referencing Sizer 2.5 mm Male Hex Driver 25 mm x 2.5 mm Female Hex Screw
42-5099-088-10 42-5099-025-00 42-5099-025-25
20 | Persona The Personalized Knee Surgical Technique
Size 7 e 12
Siz
Size 1
25 mm x 2.5 mm 3.2 mm Drill 2.5 mm Male Hex Driver Persona Anterior Referencing Sizer
Female Hex Screw 00-5120-085-00 42-5099-025-00 42-5099-088-10
42-5099-025-25
21 | Persona The Personalized Knee Surgical Technique
Figure 40 Figure 41
Figure 44b
Figure 42
Figure 44a
3. Extract
1. Insert 2. Rotate
Figure 45b
Figure 43
Figure 45a
3. Extract
Figure 46
2. Rotate
1
Figure 48b
3
1. Insert
75 mm x 3.2 mm Trocar Tipped Pin/Screw Inserter Multi Pin Puller Persona Slaphammer Persona Anterior Referencing
Drill Pin (2.5 mm hex) 00-5901-021-00 00-5901-022-00 42-5099-037-00 4-in-1 Cut Guide - Size 7
0-5901-020-00 42-5099-085-62
24 | Persona The Personalized Knee Surgical Technique
3. Release
2. Insert
Figure 49a
Persona Tibial Sizing Plate Handle Persona Cemented Tibial Multi Pin Puller Alignment Rod with Coupler 2.5 mm Male Hex Driver
42-5399-017-00 Sizing Plate Size F Right 00-5901-022-00 00-5785-080-00 42-5099-025-00
42-5399-075-02
25 | Persona The Personalized Knee Surgical Technique
Persona Cemented Tibial Drill, 15.7 mm Persona Cemented Tibial Drill Guide - 15.7 mm
42-5399-018-10 42-5399-020-00
26 | Persona The Personalized Knee Surgical Technique
Depress
Slide
Figure 52
Figure 53 Figure 54
Persona Tibial Sizing Plate Handle Persona Cemented Tibial Persona Cemented Persona Cemented Tibial Persona Cemented Tibial
42-5399-017-00 Sizing Plate Size F Right Tibial Drill, 15.7 mm Drill Guide - 15.7 mm Drill Stop Collar, 15.7 mm
42-5399-075-02 42-5399-018-10 42-5399-020-00 42-5399-019-00
27 | Persona The Personalized Knee Surgical Technique
Insert
Figure 58
Figure 60
** The 29 mm and 32 mm patellae must be inset when used with sizes
10–12 Persona PS femoral components.
Figure 59 Figure 61
2. Depress
1. Squeeze
Figure 65
Figure 67
2. Depress
1. Squeeze
Figure 66 Figure 68
NexGen Patella Peg Drill Guide Patella Clamp NexGen 6.4 mm Patella/Femoral Drill
Sizes 29, 32, 35, 38, 41 00-5903-020-00 00-5120-052-01
00-5903-023-29/41
31 | Persona The Personalized Knee Surgical Technique
Release Lever
Narrow Cutouts
Alignment Arrows
Persona Femoral Inserter/Extractor Persona Femoral CR Impactor Pad Persona CR Femoral Provisional Size 7 Right
42-5099-092-00 42-5099-094-00 42-5027-062-02
32 | Persona The Personalized Knee Surgical Technique
Pinch to
release
Figure 71 Figure 73
2. Rotate
3. Extract
1. Insert
Figure 72 Figure 74
25 mm x 2.5 mm NexGen 6.4 mm Patella/ Persona Slaphammer 2.5 mm Male Hex Driver NexGen 4.4mm Femoral Drill for size
Female Hex Screw Femoral Drill 42-5099-037-00 42-5099-025-00 1 and 2 Femoral Provisionals
42-5099-025-25 00-5120-052-01 00-5965-009-00
33 | Persona The Personalized Knee Surgical Technique
Release Lever
Alignment Arrows
Persona Femoral Inserter/Extractor Persona Femoral PS Impactor Pad Persona PS-CPS Femoral Provisional Size 7 Right
42-5099-092-00 42-5099-093-00 42-5047-062-02
34 | Persona The Personalized Knee Surgical Technique
Figure 78a
Figure 76
Pinch to
release
PS Femoral Finishing
and PS Box Preparation (cont.)
Technique Tip: Do not impact the anterior flange Alternatively, if the PS femoral provisional is placed
of the PS femoral provisional. Do not impact the on the femur by hand, the femoral inserter/extractor
medial or lateral aspects or the release lever of the handle must be in the closed and locked position
femoral inserter/extractor. prior to engaging the PS femoral provisional. Then the
femoral inserter/extractor can be used to impact the
emove any posterior osteophytes or overhanging
R provisional onto the femur. For additional fixation of the
bone on the femur to facilitate maximum knee flexion. fully seated PS femoral provisional, insert the 25 mm
Attach the femoral inserter/extractor to the correct x 3.2 mm screw (2.5 mm female hex) with the 2.5 mm
PS femoral provisional by inserting the hook on the male hex driver through the hole in the lateral anterior
femoral inserter/extractor arm into the lateral notch in flange of the PS femoral provisional (Figure 78a).
the PS femoral provisional and close the handle on the
femoral inserter/extractor to secure the PS femoral By hand, insert and hold the correct-sized PS box
provisional (Figure 76). cut guide into the anterior holes of the PS femoral
provisional (Figure 78b). For additional fixation of the
Place the correct PS femoral provisional onto the fully seated PS box cut guide, insert the 25 mm x 3.2
femur in the desired medial/lateral position. Impact mm screw (2.5 mm female hex) with the 2.5 mm male
the end of the femoral inserter/extractor handle to hex driver through one of the holes in the PS box cut
fully seat the PS femoral provisional onto the femur guide. Separate PS box cut guides exist for the PS
(Figure 77). To remove the femoral inserter/extractor femoral provisional for sizes 1–2, 3–5, 6–9, and 10–12.
from the PS femoral provisional, pinch the release
lever while pulling out/down (Figure 77).
Persona Femoral Persona Femoral PS Persona PS-CPS Femoral 2.5 mm Male Hex Driver 25 mm x 2.5 mm Persona PS Box
Inserter/Extractor Impactor Pad Provisional Size 7 Right 42-5099-025-00 Female Hex Screw Cut Guide 6-9
42-5099-092-00 42-5099-093-00 42-5047-062-02 42-5099-025-25 42-5099-060-03
35 | Persona The Personalized Knee Surgical Technique
PS Femoral Finishing
and PS Box Preparation (cont.)
Technique Tip: Do not impact the PS box cut guide After completing the anterior-to-posterior box cut,
into the provisional. make the vertical wall cuts for the PS notch cuts by
resting the saw blade in a parallel manner against
Make the anterior to posterior PS box cut with a the interior sidewalls of the PS femoral provisional
1.27 mm (0.050 inch) thick, ½ inch wide oscillating or (Figure 79b).
reciprocating saw blade, by resting the saw blade in
a parallel manner on the front surface of the PS box
cut guide. Avoid undercutting the medial and lateral
condyles. This is particularly important for smaller
femurs (Figure 79a).
Persona PS-CPS Femoral Persona PS Box Cut Guide 6-9 2.5 mm Male Hex Driver 25 mm x 2.5 mm
Provisional Size 7 Right 42-5099-060-03 42-5099-025-00 Female Hex Screw
42-5047-062-02 42-5099-025-25
36 | Persona The Personalized Knee Surgical Technique
Figure 80
PS Femoral Finishing
and PS Box Preparation (cont.)
Technique Tip: Keep blades against the support Technique Tip: If the appropriately sized PS box
features of the cut guide and femoral provisional to provisionals does not easily seat into the PS femoral
ensure adequate bone resection. The cut planes (A/P provisional, perform clean up cuts to assure
and vertical) extend below the top of the PS cam. adequate bone has been removed. Do NOT impact
the PS box provisional. Make sure the PS femoral
Technique Tip: Align the raised bumps on the provisional is fully seated after inserting the correct
exterior side walls of the box provisional with the PS box provisional.
grooves in the interior sidewalls of the femoral
provisional.
2.5 mm Male Hex Driver 25 mm x 2.5 mm Persona PS Box Cut Persona PS-CPS Box Provisional
42-5099-025-00 Female Hex Screw Guide 6-9 Size 6-7 Right
42-5099-025-25 42-5099-060-03 42-5047-007-12
37 | Persona The Personalized Knee Surgical Technique
1. Remove
3. Rotate
4. Extract
2. Insert
Figure 81 Figure 82
PS Femoral Finishing
and PS Box Preparation (cont.)
Technique Tip: Ensure the shoulder of drill is Technique Tip: Ensure oval hole of the femoral
seated at bottom of the femoral provisional provisional is free of debris prior to inserting
counterbore. slaphammer.
rill the pegs holes for the size 3 through 12 femoral
D Technique Tip: If trialing with TASP leave femoral
implants through the PS femoral provisionals with the provisional in place until trialing is complete.
NexGen 6.4 mm Patella/Femoral Drill (Figure 81). The
size 1 and 2 femoral components do not have pegs thus Technique Tip: Do not impact the anterior flange
drilling is not required for those sizes. Remove the screw of the PS femoral provisional for removal, as this
from the anterior flange in the PS femoral provisional. may damage the PS femoral provisional.
Remove the PS box provisional. The slaphammer
can be used to remove size 3 through 12 PS femoral
provisionals (Figure 82). Rotate the slaphammer a ¼
turn outward. For size 1 and 2 PS femoral provisionals
the slaphammer can be inserted into the notch on the
medial or lateral side of the provisional. Alternatively,
the femoral inserter/extractor can be re-attached to
the PS femoral provisional to remove it from the bone. If
necessary, insert the slaphammer in the extraction hole
of the femoral inserter/extractor to facilitate removal.
NexGen 6.4 mm 2.5 mm Male Hex Driver 25 mm x 2.5 mm Persona PS-CPS Box Persona Slaphammer Persona PS-CPS Femoral
Patella/Femoral Drill 42-5099-025-00 Female Hex Screw Provisional Size 6-7 Right 42-5099-037-00 Provisional Size 7 Right
00-5120-052-01 42-5099-025-25 42-5047-007-12 42-5047-062-02
38 | Persona The Personalized Knee Surgical Technique
Quick Connect Handle Tibial Impactor Head Persona Stemmed Tibial Persona Femoral Persona Cemented Tibial Persona Femoral CR
00-5901-034-00 00-5901-033-00 Provisional Size F Right Inserter/Extractor Sizing Plate Size F Right Impactor Pad
42-5321-075-02 42-5099-092-00 42-5399-075-02 42-5099-094-00
Persona CR Femoral Persona Femoral PS Persona PS-CPS Box Persona PS-CPS Femoral Standard All-Poly Tibial Provisional Extractor
Provisional Size 7 Right Impactor Pad Provisional Size 6-7 Right Provisional Size 7 Right Patella Provisional, 00-5977-017-00
42-5027-062-02 42-5099-093-00 42-5047-007-12 42-5047-062-02 Size 35 mm x 9 mm
00-5971-065-35
39 | Persona The Personalized Knee Surgical Technique
Pin Slots
Pins
Persona TASP Top Persona TASP Top Right Persona TASP Top Right Persona TASP Top Right Persona TASP Right EF Persona TASP Right
Right CR 3-11/EF Medial Congruent 6-7/EF Ultracongruent 4-11/EF PS 6-9/EF +0 Bottom EF +6 Bottom
42-5270-005-10 42-5271-007-10 42-5272-005-10 42-5274-007-10 42-5270-005-05 42-5270-005-15
40 | Persona The Personalized Knee Surgical Technique
> 30 degrees
1. Depress
3. Release 2. Insert
5-15 degrees
Persona TASP Right Persona TASP Top Right Persona TASP Top Right Persona TASP Top Right Persona Tibial Sizing Persona TASP Shim EF
EF +6 Bottom Ultracongruent 4-11/EF CR 3-11/EF Medial Congruent 6-7/EF Plate Handle 10 mm
42-5270-005-15 42-5272-005-10 42-5270-005-10 42-5271-007-10 42-5399-017-00 42-5279-005-00
41 | Persona The Personalized Knee Surgical Technique
11 mm
14 mm
12 mm
Figure 87d *Shared Sizing - A and B, C and D, E and F, G and H Cemented Tibial Sizing Plates
have common TASP Tops, Bottoms and Shims respectively.
Figure 88
Persona TASP Right Persona TASP Top Right Persona TASP Top Right Persona TASP Top Right Persona Tibial Sizing
EF +6 Bottom Ultracongruent 4-11/EF CR 3-11/EF Medial Congruent 6-7/EF Plate Handle
42-5270-005-15 42-5272-005-10 42-5270-005-10 42-5271-007-10 42-5399-017-00
Figure 89
1. Unlock Collar
3. Release
2. Insert
4. Rotate
Figure 90 Figure 91
Standard All-Poly Patella Quick Connect Handle Tibial Impactor Head Persona Cemented Stemmed
Provisional, Size 35 mm x 9 mm 00-5901-034-00 00-5901-033-00 Tibial Plate Sizes F Right
00-5971-065-35 42-5320-075-02
44 | Persona The Personalized Knee Surgical Technique
Figure 94
1. Unlock Collar
3. Release
Figure 92a
1.
2.
2. Insert
4. Rotate
Persona Femoral Persona Femoral PS Persona Femoral CR Persona CR Femoral Persona PS Femoral
Inserter/Extractor Impactor Pad Impactor Pad Component Size 7 Right Component Size 7 Right
42-5099-092-00 42-5099-093-00 42-5099-094-00 42-5026-062-02 42-5006-062-02
45 | Persona The Personalized Knee Surgical Technique
Persona UC Tibial Articular Persona PS Tibial Articular Persona Articular Surface Inserter Articular Surface Removal Instrument
Component Size 4-11/EF Right Component Size 6-9/EF Right 42-5299-001-00 00-5977-021-00
42-5212-005-10 42-5214-007-10
46 | Persona The Personalized Knee Surgical Technique
Figure 98
Appendix A
If a valgus correction cut is needed, place the valgus Perform resection, remove trocar tipped pins, and the
recut guide on the resected tibial plateau by attaching valgus recut guide (Figure 100).
the alignment rod with coupler and the NexGen PRI
Alignment Adaptor. Align with the medial 1/3 of the
tubercle. Once it has been determined that the desired
correction cut will be attained, slide the medial portion
of the valgus recut guide so it is flush with the medial
portion of the tibial cortex to provide a planar recut of
the tibia. Affix with 3.2 mm trocar tipped pins using the
pin and screw inserter.
Alignment Rod with Coupler 2° Valgus Recut Guide NexGen PRI Alignment Adapter
00-5785-080-00 00-5901-090-00 00-5901-086-00
Pin/Screw Inserter Persona Drop Rod Adapter Persona Tibial Cut Guide Right - 7° 75 mm x 3.2 mm Trocar Tipped Drill Pin
00-5901-021-00 42-5399-006-00 42-5399-052-07 (2.5 mm hex)
00-5901-020-00
NX APPENDIX
SECTION
Insert the alignment adapter into the recut guide. Place the Insert the alignment adapter into the recut guide. Place the
alignment rod into the alignment adapter and verify the alignment rod into the alignment adapter and verify the
desired alignment. (Fig. 101) Remove the alignment adapter desired alignment. (Fig. 101) Remove the alignment adapter
and alignment rods, perform resection, remove the trocar-tipped and alignment rods, perform resection, remove the trocar-tipped
pins and the guide. pins and the guide.
Insert the Persona Drop Rod Adapter into the tibial cut Technique Tip: The fixation holes for the varus
guide. Place the alignment rod with coupler into the recut guide are at oblique angles to improve fixation
drop rod adaptor and assess the cut (Figure 101). of the guide.
Tibial Cut Guide, Pin/Screw Inserter 3.2mm x 75mm Multi Pin Puller Tibial Cut Guide, Pin/Screw Inserter 3.2mm x 75mm Multi Pin Puller
0°, Standard
00-5901-079-00
If a varus correction cut is needed, place the varus
00-5901-021-00 Trocar Tipped
Drill Pin (2.5 hex)
00-5901-022-00 0°, Standard
00-5901-079-00
00-5901-021-00 Trocar Tipped
Drill Pin (2.5 hex)
erform resection, remove trocar tipped pins, and the
P
00-5901-022-00
00-5901-020-00
recut guide on the resected39tibial plateau by attaching
00-5901-020-00
varus recut guide (Figure 102).
the alignment rod with coupler and the NexGen PRI
Alignment Adaptor. Align with the medial 1/3 of the
tubercle. Once it has been determined that the desired
correction cut will be attained, slide the lateral portion
of the varus recut guide so it is flush with the lateral
portion of the tibial cortex to provide a planar recut of
the tibia. Affix with 3.2 mm trocar tipped pins using the
pin and screw inserter.
Alignment Rod with Coupler 2° Valgus Recut Guide NexGen PRI Alignment Adapter
00-5785-080-00 00-5901-090-00 00-5901-086-00
Pin/Screw Inserter Persona Drop Rod Adapter Persona Tibial Cut Guide Right - 7° 75 mm x 3.2 mm Trocar Tipped Drill Pin
00-5901-021-00 42-5399-006-00 42-5399-052-07 (2.5 mm hex)
00-5901-020-00
49 | Persona The Personalized Knee Surgical Technique
Appendix B
Appendix B (cont.)
Extension
Flexion Tight OK Loose
Tight 1 2 3
OK 4 5 6
Loose 7 8 9
Figure 105
Appendix B (cont.)
Extension
Flexion Tight OK Loose
Tight 1 2 3
OK 4 5 6
Loose 7 8 9
Figure 106
2. Insert
Figure 107
Figure 109
Lock
2. Insert 1. Unlock
Persona 8 mm IM Rod Persona Modular Handle Persona 5° Valgus Persona Fixed Resection Tower Persona 0° Distal Cut Guide
42-5099-002-00 42-5099-014-00 Alignment Guide 42-5099-006-00 42-5099-010-00
42-5099-005-05
54 | Persona The Personalized Knee Surgical Technique
8 mm IM Step Drill Persona 8 mm IM Rod Persona Modular Handle Persona 5° Valgus Persona Fixed Resection Tower Persona 0° Distal Cut Guide
00-5978-014-00 42-5099-002-00 42-5099-014-00 Alignment Guide 42-5099-006-00 42-5099-010-00
42-5099-005-05
55 | Persona The Personalized Knee Surgical Technique
1. Unlock
2. Pull
Persona 8 mm IM Rod Persona Modular Handle Persona 5° Valgus Persona Fixed Persona 0° Distal Cut Guide
42-5099-002-00 42-5099-014-00 Alignment Guide Resection Tower 42-5099-010-00
42-5099-005-05 42-5099-006-00
Persona Drop Rod Adapter Alignment Rod with Coupler 3.2 mm x 75 mm Trocar Tipped Pin/Screw Inserter
42-5399-006-00 00-5785-080-00 Drill Pin (2.5 mm hex) 00-5901-021-00
00-5901-020-00
56 | Persona The Personalized Knee Surgical Technique
Side Designation
Figure 119
Figure 121
Figure 124
Shift Block
Prior to performing the four facet cuts with the 4-in-1 Technique Tip: The Persona Shift Block is only to
cut guide, determine whether the position of the block be used with the Persona 4-in-1 Cut Guides.
anterior to posterior and external rotation is sufficient.
If adjustment is needed, remove the 4-in-1 cut guide Technique Tip: Do not impact or torque the shift
block while inserting or drilling.
from the femur and insert the shift block using the
same holes in the distal face of the femur (Figure 123).
Persona Shift Block 3.2 mm Drill Persona Anterior Referencing 4-in-1 Cut Guide - Size 7
42-5099-085-10 00-5120-085-00 42-5099-085-62
61 | Persona The Personalized Knee Surgical Technique
Insert
Figure 129
Unlock
Optional
Pinning
2. Rotate Holes
1. Retract 3. Release
Retraction
Oblique
Hole
Figure 134
Figure 136b
Figure 135
Squeeze to
Unlock
Remove
Squeeze the button on the distal femoral resection Technique Tip: Check the flatness of the distal
guide (Figure 137) to release and remove the femoral femoral cut with a flat surface, such as the top of
valgus alignment guide and distal femoral resection one of the tibial cut guides. If necessary, modify the
guide assembly from the cutting head. The modular distal femoral surface so that it is completely flat.
T-handle is used to remove the IM rod, prior to the This is extremely important for the placement of
distal femoral resection. subsequent guides and for proper fit of the implant.
Alternatively, the modular T-handle can be used to After completing the cut, remove pins and the
remove the IM rod while the button on the distal femoral cutting head.
resection guide is squeezed to facilitate rapid removal
of the IM rod, the femoral valgus alignment guide and
3.2 mm x 75 mm Trocar Tipped Pin/Screw Inserter Multi Pin Puller Persona Slaphammer Femoral IM Rod Modular T-Handle
Drill Pin (2.5 mm hex) 00-5901-021-00 00-5901-022-00 42-5099-037-00 00-5901-060-00 00-5901-061-00
00-5901-020-00
65 | Persona The Personalized Knee Surgical Technique
Figure 139 Figure 140 Figure 141 Figure 142 Figure 143
Implant Components
Attached Tibial Plate Inserter
Depress the lever of the tibial inserter to extend the To release the inserter from the implant, depress
metal distal tab (Figure 139). Insert the tab into the the lever on the tibial inserter. The handle will move
implant’s dovetails on the central portion of the tibial in a superior direction away from the tibial implant
implant. Slide the tibial inserter posteriorly until the tab (Figure 142). Tilt the handle posteriorly to disengage the
engages the dovetails (Figure 140). Release the lever to distal tab of the inserter from the plate (Figure 143).
secure the tibial inserter to the tibial implant. Ensure the
tibial inserter is seated flush to the proximal surface of Thoroughly remove any excess cement in a consistent
the tibial implant (Figure 141). manner. Allow the cement to fully cure before performing
a trial ROM or inserting the bearing.
Sublux the tibia anteriorly to allow adequate clearance
to insert the tibial implant into the prepared bone. Do
not apply substances other than bone cement to the
tibial implant (i.e. do not dip implant into antibiotics or
other substances). Keep the implant clean and free of
debris prior to cementing. Place a layer of cement on the
underside of the tibial baseplate, around the keel, on the
resected tibial surface, and in the tibial IM canal.
Position the tibial plate onto the tibia and use the tibial
inserter to impact it until fully seated.
Persona CR Femur Used On NexGen CR/CR Flex Bearing (Modular, Fixed Bearing)
Persona CR Femoral Size
All compatibility above applies only to the following NexGen CR/CR-Flex Bearings: 90-5970-XXX-XX, 00/90-5952-XXXX-XX
*The A-E Micro / 5-6 NexGen CR/CR-Flex Bearing is only available in Japan, and only in the 00-5952-041-XX family.
This information is also available in the Persona Femoral Component package insert.
All compatibility above applies only to the following NexGen Trabecular Metal Monoblocks: 00-5886-04X-XX
This information is also available in the Persona Femoral Component package insert.
69 | Persona The Personalized Knee Surgical Technique
All compatibility above applies only to the following NexGen LPS-Flex Bearings: 00-5960-XXX-XX, 00-5962-XXX-XX, 00-5964-XXX-XX
*The E / 1-2 & G / 3-4 bearings are only available in the 00-5962-XXX-XX family.
This information is also available in the Persona Femoral Component package insert.
70 | Persona The Personalized Knee Surgical Technique
Persona PS Femur Used On NexGen LPS Monoblock Tibia (Trabecular Metal Monoblock)
Persona PS Femoral Size
All compatibility above applies only to the following NexGen Trabecular Metal Monoblocks: 00-5886-05X-XX, 00-5886-06X-XX, 00-5886-07X-XX
This information is also available in the Persona Femoral Component package insert.
71 | Persona The Personalized Knee Surgical Technique
Notes
72 | Persona The Personalized Knee Surgical Technique
Notes
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This material is intended for health care professionals. Distribution to any
other recipient is prohibited.
For product information, including indications, contraindications,
warnings, precautions, potential adverse effects and patient counseling
information, see the package insert and zimmerbiomet.com.
Zimmer Biomet does not practice medicine. This technique was
developed in conjunction with [a] health care professional[s]. This
document is intended for surgeons and is not intended for laypersons.
Each surgeon should exercise his or her own independent judgment in
the diagnosis and treatment of an individual patient, and this information
does not purport to replace the comprehensive training surgeons have
received. As with all surgical procedures, the technique used in each case
will depend on the surgeon’s medical judgment as the best treatment
for each patient. Results will vary based on health, weight, activity and
other variables. Not all patients are candidates for this product and/or
procedure.
Check for country product clearances and reference product specific
instructions for use. Not for distribution in France.
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is not valid unless there is a CE
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