Constrained Posterior Stabilized (CPS) Persona® The Personalized Knee Surgical Technique

2 | Persona Constrained Posterior StabilizedSurgical Technique Constraint Options The constrained posterior stabilized (CPS) bearings can be used to provide moderate varus/valgus constraint in patients to facilitate soft tissue balance and stability. The CPS bearing provisionals and implants can only be used when the PCL is removed and should be used in conjunction with the PS femoral components. The CPS bearings are to be used with cemented nonporous femoral and tibial components only and cannot be used with the CR femoral components. The constrained posterior stabilized (CPS) bearings are designed...

3 | Persona Constrained Posterior StabilizedSurgical Technique Initial Knee Assessment Having established that additional constraint is needed as described in the Persona Primary Surgical Technique (97-5026-001-00), the following steps are used to prepare the bone for the constrained posterior stabilized (CPS) bearings. Femoral Box Cut Make the anterior to posterior CPS box cut with a 1.27 mm (0.050 inch) thick, ½ inch wide reciprocating saw blade, using the CPS cut slot. Avoid undercutting the medial and lateral condyles (Figure 1). This is particularly important for small femurs. After completing...

4 | Persona Constrained Posterior StabilizedSurgical Technique Color Coded Side Specific Shared Sizing Tibial Sizing Plate/Stemmed Tibial Provisional Bearing Tops Note: The CPS TASP components are not compatible with the CR, UC, or PS TASP components. Figure 4 CPS Tibial Bearing Provisional (TASP) Assembly As shown (Figure 4), size A and B, size C and D, size E and F, size G and H, and size J tibias share side-specific tibial bottoms, tibial tops and color, respectively. CPS TASP Assembly In addition to the markings on the parts, the same colors are used for the mating TASP tops and bottoms....

5 | Persona Constrained Posterior StabilizedSurgical Technique CPS TASP Assembly (cont.) The shims (10, 12, and 14 mm) are not side-specific. Attach the tibial sizing plate handle to the appropriate AB, CD, EF, GH or J 10 mm shim (Figure 6a). While holding the CPS TASP top and bottom together with one hand, lock the CPS TASP top and bottom together by inserting the appropriate 10 mm shim with the tibial sizing plate handle (Figure 6b). The 10 mm CPS shim will create a CPS TASP construct that matches the thickness of the thinnest tibial bearing component, 10 mm (Figures 7a and 7b). Unlike the...

6 | Persona Constrained Posterior StabilizedSurgical Technique Stemmed Tibial Provisional Insertion Steps to insert and fixate the stemmed tibial provisional can be found in the Persona Primary Surgical Technique (97-5026-001-00). Utilizing the fixation screws specified in the Persona Primary Surgical Technique will provide additional stability during trial range of motion. Insert and remove the CPS TASP construct in midflexion with the CPS box provisional in place (Figure 8). It is recommended that the thinnest CPS TASP construct (10 mm) be inserted into the joint space to perform an initial...

7 | Persona Constrained Posterior StabilizedSurgical Technique Figure 9a Use the 10–14 mm provisional lockdown screw with the +0 mm CPS TASP bottom (10–14 mm TASP construct thicknesses). Use the 16–20 mm provisional lock down screw with the +6 mm CPS TASP bottom (16–20 mm TASP construct thicknesses). CPS TASP Insertion (cont.) CPS TASP Shim Exchange The longer provisional lockdown screw should be used with CPS TASP construct thicknesses from 16–20 mm (Figures 9a and 9b). The CPS bearing implants do not require a lockdown screw. If a thicker construct is needed to appropriately fill and balance...

8 | Persona Constrained Posterior StabilizedSurgical Technique CPS TASP Shim Exchange (cont.) • Retighten the provisional lockdown screw with the 3.5 mm hex driver until the head of the provisional lockdown screw has fully seated in the countersink in the CPS TASP top. Note/Warning: Do not overtorque the provisional lockdown screw. Check ligament stability in extension and in 30, 60, and 90 degree flexion. Attempt to distract the joint in flexion to check flexion gaps. Flex the knee to peak flexion and verify that the spine still engages the cam. Insert the patellar provisional onto the resected...

9 | Persona Constrained Posterior StabilizedSurgical Technique CPS TASP Removal Disengage the provisional lockdown screw by rotating the 3.5 mm hex driver in a counterclockwise direction. With the joint in mid-flexion, attach the tibial sizing plate handle to the CPS TASP and lift proximally (Figure 11) until the CPS TASP disassociates from the tibial sizing plate, stemmed tibial provisional or stemmed cemented tibial component. Note/Warning: Do not implant the stemmed tibial provisional, CPS TASP, or provisional lockdown screws. Technique Tip: Varus/valgus forces may make it difficult to remove...

This documentation is intended exclusively for physicians and is not intended for laypersons. Information on the products and procedures contained in this document is of a general nature and does not represent and does not constitute medical advice or recommendations. Because this information does not purport to constitute any diagnostic or therapeutic statement with regard to any individual medical case, each patient must be examined and advised individually, and this document does not replace the need for such examination and/or advice in whole or in part. Please refer to the package inserts...