THE ATTUNE® REVISION FIXED BEARING KNEE SYSTEMInstrumentation Designed to Enhance Efficiency and Versatility

Surgical Process and Key Instrument Overview

TABLE OF CONTENTS

3

Introduction

ATTUNE® Revision Fixed Bearing Knee Instrumentation and

workflows are designed to allow surgeons to address the

various clinical demands of revision total knee arthroplasty

efficiently and successfully. This surgical process and

instrument overview guide highlights the versatility of the

ATTUNE Revision Fixed Bearing Knee Instrumentation and

demonstrates the convenience of use in a surgical setting.

A surgical technique guide is also available, which provides

detailed guidelines for the preparation and implantation of

the ATTUNE Revision Fixed Bearing Knee System through a

variety of workflows.

ADDRESS VARYING CLINICAL DEMANDS

2

Introduction

Femoral WorkflowsShort Cemented Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Straight Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Offset Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Sleeve with Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10

Tibial WorkflowsShort Cemented Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12

Straight Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

Offset Press-Fit Stem Workflow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .16

Trialing and Setting RotationTrialing and Setting Rotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .18

Transferring Offset to the ImplantTransferring Tibial Offset to Implant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Transferring Femoral Offset to Implant . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

4 5

Femoral Workflows

Assemble and insert the Trial construct

SHORT CEMENTED STEM WORKFLOW

Ream using the selected Cemented Femoral Stem Reamer and Boss Reamer

3

Resect the box

1

Primary resections using the ATTUNE® Knee System INTUITION™ Instrumentation. Place the respective Cut Through Trial on the resected femur

Assemble the Reamer Tower and Bushing

21 4

5

6 7

Femoral Workflows

6

Assemble and insert the Trial construct

5

Remove the IM Adaptor Trial and perform the box resection

STRAIGHT PRESS-FIT STEM WORKFLOW

1 2 43

Assemble the Cut Through Trial and attach the Stem Trial

Assess the gapsSize the femur

Use the Canal Reamers to prepare the canal

Assemble the appropriate Stem Trial to the Femoral Boss Reamer and ream to the proper depth

8 9

Femoral Workflows

765

Attach the Reamer Guide and ream using the Offset Drill

Perform the 4-facet and box resections using the Conventional Cut Guide attachments

Assemble the Femoral Trial to the previously determined offset position and insert the Trial construct

OFFSET PRESS-FIT STEM WORKFLOW

1 2 43

Assess the 360º Offset position using the Conventional Cut Guide assembled to the Femoral Offset Guide construct

Record the Offset position

Remove the Femoral Offset Guide assembly, leaving the Conventional Cut Guide in place

Use the Canal Reamers to prepare the canal

Assemble the Distal Femoral Resection Guide and perform the distal resection

10 11

Femoral Workflows

Assemble the Femoral Trial with the Broach retained in the canal

76

Assess the gaps, remove the Broach Adaptor, and perform the 4-facet and box resections using the Conventional Cut Guide attachments

Remove the Broach Handle and assemble the Conventional Cut Guide and Broach Adaptor to the Broach retained in the femoral canal

Use the Canal Reamers to prepare the canal

1

SLEEVE WITH PRESS-FIT STEM WORKFLOW

3

Assemble the appropriate Stem Trial to the Femoral Broach Starter Reamer and ream to the proper depth

Assemble the Stem Trial, Femoral Broach and Broach Stop, and the Broach Handle and broach until rotational stability

Assemble the Distal Femoral Resection Guide and perform the distal resection

2

5

4

12

Tibial Workflows

13

Assemble and insert the Trial construct

4

SHORT CEMENTED STEM WORKFLOW

Make primary resections using the ATTUNE Knee System INTUITION Instrumentation and size the tibia

Assemble the Reamer Tower and Bushing

1 2

Ream using the Cemented Stem Reamer and Conical Reamer

3

Tibial Workflows

14

Tibial Workflows

15

Assemble and insert the Trial construct

5

Assemble and attach the IM Mount to resect the tibia

Use the Canal Reamers to prepare the canal

STRAIGHT PRESS-FIT STEM WORKFLOW

21

Use the Tibial Offset Dials to confirm that offset is not required

Assemble the appropriate Stem Trial to the Fixed Bearing Conical Reamer and ream until the top of the cutting flutes are level with the proximal resection

3 4

16

Tibial Workflows

17

Insert the Trial constructAssemble the trial to the previously determined offset position

Transferring Offsets

65

Assemble and attach the IM Mount to resect the tibia

Use the Canal Reamers to prepare the canal

OFFSET PRESS-FIT STEM WORKFLOW

Use the Tibial Offset Dials to determine appropriate size and offset

Record the offset reading for Trial assembly

Attach the Tower and Offset Bushing and ream using the Offset Drill

3 421

18

19

TRIALING AND SETTING ROTATION

Trialing and Setting Rotation

Use the corresponding Keel Punch to prepare for the Keels

Perform trial range of motion using the desired Tibial Insert Trial

Pin the Tibial Base Trial in place once rotation has been confirmed

2 31

20

Transferring Offset to the Implant

21

Transfer reading to Tibial Offset Adaptor Trial

Set Tibial Offset Guide position

TRANSFERRING TIBIAL OFFSET TO IMPLANT

21

Record Offset Adaptor Trial orientation using the Assembly Jig

Use Assembly Jig to set the final Offset Adaptor Implant position

3 4

22

Transferring Offset to the Implant

23

Set Femoral Offset Guide position Transfer reading to Femoral Offset Adaptor Trial

TRANSFERRING FEMORAL OFFSET TO IMPLANT

1 2

Use Assembly Jig to set the final Offset Adaptor Implant position

Record Offset Adaptor Trial orientation using the Assembly Jig

3 4

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