GENESIS
`
`UHIEUHHETHEHTAL HI'IIEE S‘I’STEH
`
`
`
`ltnmw-zurmm Amumuawr IHHL‘Hum-mmm
`
` SURBIEIIEL TEEHHIDLIE
`
`WMT 1018-1
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`WMT 1018-1
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`

`

`GENESIS
`
`UlllElllIll’lillTlllEHTAL lillEE S‘lSTElIl
`
`Mum EH Ehrgr'um'fl'ufl 1PM.-
`
`_]:LrnI3:- H. Mulnflrfi. .‘ni.|].
`Elllnlcfll PIG-Emil]! u-l' ilrflmpamlim: and 51mm Malici m:
`Inuit-fill}- ul' III-Ill'fllll |:1 interim-.1] :icllml
`flfll'lnp:h.1l1'¢ Hurguim
`.I'ilalmrnu Spam: Medicine :3: Unlimited in: [Miler
`
`iii n11jngli:u11..-'I.luli:m1:1
`
`Philippe Battier. _"-1.l.‘.I.
`EJr'Il1-;:I]:I:wtli:,'fillrj.l;¢m1
`Eliltiqwe lies Ejlas
`Purim |"r:lnr_'n|:
`
`1Illi'illi:1.rn H.HE'I1I1I31.lfI'. 3-113.
`
`IiIrthmmL-cllc Emmi”
`Samara Manual-ml I-imnilnl
`Einnmm. Flm'itln
`
`fitmhm‘ £11m Emu New: Tim! fir:
`
`Phililquinrlu'r. lull]-
`firthwmalic fiilrgmn
`UlliiqllE-flflfilJ |:L5
`Paris. l-‘nmn:
`
`TABLE Elf
`
`[llllTlElHE
`
`lllLl'ii-Llll-Eljfll'l
`
`'3
`
`[High l'eliun-E. 35
`
`Surgical fidnuqm =‘l
`
`[Izltzllflg Tnfnrnmtiun
`
`2*}
`
`Hum Hum: 'l'liu1uclililqmflirlmmn I1L'ruin is maul.-
`nullnlilu Inlhu|u.-:IE1I1|::L|'-:[arm-.mlnlinl1n|||LI5tr:u:1-1I1u
`:Lunlmni' wage-Hui li'uifll'lkflll lur IEII.I Lllmmmllcnmj
`lmuflinm lll1l'IL' final :II1:1|{.*sl.~i. Illcpr-Lfl'rmll tn'utlnunl Ir-
`:Ii:ltulliu:li:lll11n_rfiu-i IJH: l:|L"L'Ill.'~ of lil'fl: .‘i||L"ElllE|L'1lH.'lll.
`
`l .lLl'HlL'IIL‘I H-I.‘l"!lLl._"-Jli.5.lJ5:'|_U:l-:': :IJ1I]'5.lLHl.—llll'l. lH|1|:r l":|.|ll.'||L‘-1"I.'|1'|l.||1|.'.
`til-SH Ffilii- in reglraunsllr:ILlI.1n:LI1HIl'HI1iltli-& hL‘FIl'h‘I'l-"Hllillill'lllh lllL'.
`
`WMT 1018-2
`
`WMT 1018-2
`
`

`

`llllltlllllHTlflll
`
`he ltezr palm to :tpltr'uc'itlltt :Il't-tilttl the
`
`asymmetric fer uplimal meander. utiiiuaetl-shalael
`
`GEHl-‘fllfi hints: Seaman is its flexibility. Frum
`
`articular inses'ts allawlnsenlmi an the left er right
`
`primary In I‘L't'ililtiln ltneeanhrcplasty. it Is
`ta,.eneeat|1.r natpnssihle tu- maertain all tiletal Is until
`
`the ltnee ls actuaJiyeptimtd. althuugh the GENESIS
`
`aha-item isan {rLJL‘lLtllbl'lll'IH dcesijtn Fer aperattcns In
`
`which "all gees :Is cttluatlul.“ it is in addressing the
`
`Unexpected that the System's fluil:i|i1}'.ii1siaesa.|1tl
`
`lit. rnaltes it remarkably ua-I'ul it: the surpecn and
`
`heneticial tn IhepatienL
`
`and between tau siae-s cl implant limes. minimiz-
`
`ing it unen1r1rs'.
`
`The rant-hating tit-sign at the cult-alt chmmium
`
`:tllm‘ it'lS'i'lI-l 1'75} fcrnta‘ttl EnIIIp-tment imeiltus
`
`minimal bcne remceai- presenting the hartl
`
`titllaciitmtlndlain-tsetselentil-teat:I'a':l::ttieu1..rlI cen-
`
`tnured lemma] anterlta' aspen: minimises.- lullellttf
`
`laminae-meat. 'l'i-‘ehslllte mutinsliateleam
`
`J'ls a un lmmpartnaaua! itnee ssstem. GJEHESIS
`
`strategically placed in the cinntuuieut ta enhance
`
`temtutlaes that utlalitt' hates sic-cit is impummt 1::
`
`cement fiaatjun at the cemptmenttcunem in ter-
`
`presents. and hune resectien In match Willl'l'tfl'l'll
`
`htflc. implant filflhillt'y is further tllasilnimtl with an
`
`siae magnet he a eiahle nptinn. The GlL‘lltfill-l
`
`anti-mtatiun lln and meduiar llaat'um peg. [ha-mi].
`
`Llnitumpat'lniei ital line: tit-sauna n'rcdulat'itt'
`
`Ila: rtflnttml Itemietn' and anatemte pesterhsr
`
`aliens the su mean In ctestraniae a hnee pnathesis
`
`mlulgdc allna- [lesiun te- Kill".
`
`that suits. the mealsul'ea-ch patient.
`
`“this liesihilley altme annitl malte GENESIS a
`system aurtlt e'cIntining. lites-taut. the dealer: LillJtL'
`GJL‘lIh-llti l.'nictanrutrt|nen1a| tinee System maltes it
`
`The tilih't-EIS tfnlcempanua-nutl timer-13.5mm
`
`incarpcrates instntmeutatian and Minimise
`
`which help pteseme heme stratit. accurately restate
`
`the hint line. 1uul ensure mesa. retinalucihle cuts
`
`an etnhnal s'EIriice let many pmcedtires. 11s asym-
`
`The instrumentatlcu cl'l‘ers tan distinct :ttl'luml'llitflfli
`
`meti'lc. tltanl em allia- Iih'ral nag-- is mete anattan l-
`
`In the sensual — minimal bane neeetimi tlllrtl I'nll
`
`calh‘ cane-EL mat is asailahle in siaes that cf'f'er
`
`hetter fit. this; retielrl :13 the WEE-fl” item the
`
`unpleasmitcheice lutataai "tarerlumg" and
`
`"uruiiahane,"
`
`The Ilhial Implants Feature an aluminum aside
`
`JtI'Il-ltiast surface wnh cement meals. a medial fin.
`:uul tthia! lasts. 1which ctu'r aceummadate earietet
`
`supplemental listuirm rmtians. 't‘ihial canaument
`lhidtlic'ts-raithnls allmratliuatnmusl'rmn 3 mm ta
`
`1?. mm in 1 mm inenanents. Mlnlmum pulse-the]—
`ene thtcl-tness is h mm. it is remnunendel that
`
`Ir-talca11aci11-‘bel'cle tlt'l llll'lg hit the final irtqtlant.
`
`fills”. a unique lemcral teaming stats" "hikes the
`
`pretatml iun let the GENESIS femur-4| L‘tn'npra amt
`
`repmducihle.eliminating the need I'ta' freehand
`
`prelutlmtim- Hatramedullanr tlhial alignment
`lnstrun letttststn also be creased Laer treat the
`
`tllil'llhllh‘ 'l'ntal tinee System.
`
`'I‘Itsestirgits'rl tecl'rntqm1Jual'nlltrars has ham
`
`tlEi-‘itlulittfl as a guide fer using the t I Ill-ll-ltllE-l
`
`tiniccmpartn'renlsd l'LllL‘t." system. it will alsn
`
`rliantmstrate that the {HEM-Eli‘s disiguctanlaintai
`
`H mm tllslal Mll'lllllll'lttl'llli he used with law activity
`
`Hurt-rim fi1 1a‘ith an ellectj're. temuduc'thle tech-
`
`patients and a tt.'I It: l3 nun unnmnent be used For
`
`nique. II can lJL" a must useful addltlen. tnyruur
`
`them-eight patients. .-'|.Etl'uargtt the tibial base is
`
`practice.
`
`In.-
`
`WMT 1018-3
`
`WMT 1018-3
`
`

`

`BESIEH FEATURES
`
`
`
`
`
`
`
`
`flan{mm-1' amError.firm and
`apart HI: minimi'flpm'mrmr
`impinge-maul}.
`
`Ami-mama" mix-“muffin.
`
`M'mmnrrmfl mm flaw.
`
`
`
`
`dmmwfl'fimmnr WWW-9
`mafia?!“ m ’39 -
`
`
`
`Mun-dry! unfl-ma‘uuflu.
`
`
`
`.‘I'ufyu'ymmffind Em! Emma-55m
`m rim I'I" FIHI'I'I'EIEE thumb- .Ffia'
`hurrah-fa. minimizingm Mr}.
`
`.Hrflubr 1‘er abhu'
`flbfm' fl:Mm
`adfimmfs n.- : mm
`incrementifrmu
`.5 mm.
`
`WMT 1018-4
`
`WMT 1018-4
`
`

`

`Three fitmefI-ra}: are neeeaeaqt
`
`-
`
`.I'I. full! htgtit amen-tumult: radjugraph at the
`Jn'm- lirnh made 914 Meters. in Fullaeighl
`heatlng tn enlmlttle the difl'erml :ti'ltl'lurt'llt. :L11tl
`
`meeltattleei extent the limb [Figure 1‘}.
`
`.-
`
`I
`
`Twe lll‘ll'lfl't-l" tit-rat's In 'u'fll'lfltalt'lil t-algus Hews
`hated it: calculate Ute littel-tmeasnt' the remain-
`lngeartiltme. mettl Ir. the magmfleatiun is at
`li'ttu {Fame 2].
`
`I'm-eight hearing ill-ray efllte lll'lil'E with a lateral
`view. In thetght healthy, and with 'l.l'|E leteeat t‘ull
`intimation. tielflmine the anterior tibial
`
`suhltetatlnit {thmeit
`
`Fmraflve tempiatts arealsalmtpi‘ul Iu E'r'nlUittE
`thesieetfl‘tl'ne implant needul For the particular
`
`SlllElIill.
`
`lEElllllllllE
`
`PREGPERHTIVE REQUIREMM
`
`A: [may by Emma Gambit H. D.
`
`ineram'e flatter flaieuleflun
`
`hfitiEfLLl 1trenpemtive lit-ray Is meeamaehletn :1
`week lfletttrl'tl'ie detects and angulardet'taflen-
`
`patient.
`
`WMT 1018-5
`
`WMT 1018-5
`
`

`

`SURGIEAi TEEHHIDHE
`
`PmEHT Peememcmn
`
`Suemuu APPRGACH
`
`Positioning
`
`Pneitiun ll1e lie-gun :1 knee suppnn In alinw easy
`Inchl | leuuun cf die ience fecm [I' in I SIT of flexlun.
`
`Surgical Incision
`
`Mule: :uitruighi [ungitudinal inclsirm llulmedirll
`1c Ihe mldllue ci'the knee mmugh the skin
`{Jr-mum: If and 5}.‘l‘th:n1uecLIl:1rllmislenis
`medial. nr'lnlerul 1when pericrmiugu lakenfl
`cmummnem replacement.
`
`ixpm‘ilmn Reheat, ul mulnlmum- the pew-[lulu] Higeuf ll1e
`nl' lhe ininl.
`
`".l
`
`mmmming tibial plateau just clmugh In Imerlu
`small "sml ll Ie" type relnLcter.:'I.n1r'I11nrem-rlemiw
`reliant! mull] Mull In nail-ml ininl reullniliu.I and
`may not gunnmiee 1l1e hymmnectinn i'll 1|1e' eml Hi
`
`Iln: surgry.
`
`Esplcmijeln
`
`Hemme a sample elflhe amnriul fluid l'nrllrldct'ifll
`
`11:11:15;
`
`[ii-mull ne cilrefully'me mudiliun-ui “1E eynm'iill
`limne.tth:111cr|iscm:uulthecmurulntcrzll c:1rtl-
`
`Methane-[11:111.mlmliun.:u+¢lruulhr—pmhing
`wlll he neemargr' 1n delenui ne lhe excel: mnelilirm
`
`WMT 1018-6
`
`WMT 1018-6
`
`

`

`Slilifilihl TEEHI'iiflllE
`
`Eflflhl: all the mteeptn'tee en the eperetlt'e elite e11
`151E Femur flittl the tibia [figure 6}.
`
`Examine the teniereieetkieiis. the mteiete
`ligaments. flidfljttl'l'l the intmetia'lthrlernflteit and
`rename :tnteriertihial tinny bleeit which maybe
`teammihle [er fleeten umtraelme.
`
`Ftenttwe die meniscus. and :my Foreign hedy.
`Eitrrieieumnt' illflftE'J'IEtEEfll'f.
`
`Tteee CUT
`
`the Ihttmmedullnt'y 'I'iltitfl fltttling Guide.
`
`Flee The h1eeet'3fl“ and. emailing he it-eey
`eeleuhttiette. merit the level at the herimnhrl eut
`dJreethr en fluhnteewlflt a eautery knfle er
`methyl-me hlue mmiterwhlle infiltrating the nudge ei‘
`
`Then.- :tre tee typeset extntriflluilary tl'hiel cutting
`guides. Date is en emlutien {If the Cartier tittitle.
`:mti fitentlterie amedifleel GENESJS [letting Guide
`WHEN-'11 in technique}. 'J'I'Ie cut is perfem'nfl airing
`the tlhlrrlejtineufthe MILL Tltee'ettt'eel cut is
`tee-Em with :t temper-eating met in The exec:
`i't-I-‘platie Feetu the 1:13: at the guide in the merit:
`made en die hune. Hemre die Cutting IGuide at The
`tequ Inn] level with till'LE er tint: lime mikes and
`begin the herleerltal cut wlth en eeeiflntlng 51m.
`
`titer-trellis die cut in the iI-t-l.|i|:ine teal-w}:
`[teqimtdleelrtrte the meeltenhzd Mia and the
`vertical eel should net-er be less than 9-3“
`
`if-‘Iierrre .F'}- ”Iljl't'l'tt‘i't-tl. there hi me when.
`
`WMT 1018-7
`
`WMT 1018-7
`
`

`

`SURGIEAL TEEHHIIJUE
`
`In the J‘I-Pjilflfll': and :mmrdlug Imm- mummy. Ila:
`culwil] have a 'i' II) “1' .H‘ slime (Realm: 51']. WI'Ien
`Ihe cut has been perfunned. check :1an wl1J1 flu.-
`cullljng gubde tn unsure Ilml The cut is in Ila: mrnxt
`
`In mew-11153:! vanes Lihla mrmffl. {he cut is
`made peqlewiim Is]: In: the meflphpma] aegis of Ihu
`IiIJlH! shall—"111i; ifipm'pemiiulhw 1:: the line im'ning
`lhe eenlemhhe spine andlhe midipert at me chard
`[Dining Ihe mining nmrkuflhe gaming mmluge
`whidl i-i emiilytiaen en the fi'unl nflhe III-my. In this
`HEB. the cutter“ Izre-sllflhflj.r ubllque going. up tu- {he
`tibial spine In I'lmclnn, hut I.II.Illl L11: WHHJ men
`Ihe knee is in extensiun.iffl1ebuw is [m lnqmrtant,
`an eelentnmf felt Lealignmfl. will heneaflery
`Ilefure 91* during 111:: fillrgerf.
`
`haF and M-LEIIJIH'IE end that theem is. [111'thin Hm.
`
`
`WMT 1018-8
`
`7
`
`WMT 1018-8
`
`

`

`Sflflfiltdl TEEHHIEIIJE
`
`Tease CUTTING
`
`I
`
`Estatet'I1-13tll.lt[:trg|.IAlignment
`
`'l‘helnlle'e-inp cheetfihes the EEITEIIJEllltllltllT
`alignnnail technique.
`
`Using the pmslmsilyspthed ml. slide the red
`fltmgii 1JiL' Itntt-sltitted tibial [tilting hleelt. The
`and is then Inserted in the attgrm'leul sleeve which
`15 attached It: the ankle clamp. after lacking the
`ankle clamp in the teen maiden, place the
`amnhlyel'er die antertureteit ulthe tihiawith the
`
`pent-um all the lthal memhly slitaJJd lieI min 1113
`center I}! the Iihla. whteli Is tituiiai 1n the center of
`dietu1ltle.'l‘a Mitre the anltle clamp. depress the
`hutten {HI L'ltlierside ntlhe anltle clamp.
`
`¥ ankleelmnpmertheanltle {Heme M}.Thedietal
`
`'HW
`
`”"3“‘5-1'
`
`"'5“
`
`I]
`[|
`F'
`1:
`3.1?
`=
`
`II—itet
`
`ll—Iflhl
`
`
`
`filigree an
`
`
`
`
`
`
`
`
`
`
`
`
`The ankle elaiiip alln-ws the sung-mi tu nll'fim the
`distal end at die alignment gal ide up ta H mm
`mean! the raeditd side 1:: allms' allgnmentumr the
`{enter at the laliJa fiat IflTsel at H mm minimtees
`die chame- lnr a Tr‘tll'llfi eu1.J~‘.:«:tehd the proximal
`]2HJI'lllJl'l at 1 he tibial aesemhhr up use: the pmsiaial
`tibia. Impact the leap, spit-u: intrr Llie presimal tlhla
`at applet inst antefinrta- the tibial spineadjust the
`[Htsitimi Itt'the distal [Kli'lim ei‘d'u; rant mfllmlillf
`until the red is paml lel lttll'tL' mid-mnmal platteet'
`the tlhla. tn ensues that the tibial eat is peniemliaai-
`Iartn the tibial axis In all |'t'lill'tl':i..
`
`The estrJtIIsluiims' alignment tawer and red can
`he Least asa metha-d al' eheeltlhp, the: SHEI'IIHEI'II-
`{lithe cutting plane Is In eta-Le rtl' edges. the distal
`H mm [ll'hltfl can be fine tuned at dtls dine tn
`
`ermlt'e WITltcl sdigliment of the [tidal :nLt Ila
`materiarslepesleut istletitetl. :eliust the pasitien eF
`the distal [HITIiI l-l1 :ti'the assembly“: the destred
`angle. llllffllfi the fillnl‘lEl‘EllllflHtll me pmsi nial
`pettifllt ed die meatihly mm the tibia. er secure the
`pusttlflrl with a 35.1 matdrilt hit In die paednutl
`
`alilitpie hule {Item-e t H.
`
`
`
`Hit-tare H
`
`WMT 1018-9
`
`WMT 1018-9
`
`

`

`SUEEIEAL TEEHHIEUE
`
`t'tttaelt Ute desired pma'intal tihial Fl'flltfi and
`tighten the stylus dawn I11: 1e. latte-led ltnnh. I-‘nttr
`diFleI'utl tilt-l let lE'rTJlfi :It'e:ttr:t.tl:thle: II]. 3. 1. :Ltttl
`{1 mm. Using thetII mm ett'lua the level of tatt will
`he etett tt-iUt the end at the at'ylte. gauge- 't'flten
`tiring [lee ,3 mm Ultr'ltlti. the [meal ttftttl i: 3 mm
`lreltt'ei Ute end til the att'ltte gattne.:u1d an en.
`
`'I'heee are [we ltalee in Ute tibial bled-t nrt either
`
`side nl' the allmttttent rttd. Insert :1 UR" 11in inte
`”lit: lenlentt ethilt fiiElL' til Ute IJ'hi:U mud :uinttlllt' it:
`fit: Ute mttlingltlnel-t tel Ute anter'iur' surface ltd the
`ttltia Hiram-e I3}. tilttjttttad 45' :Utglelttllflt un
`eiUtereide tdthe bled»; new he used [er additional
`ttaltilitt: Talte care in retract the patellar ligament
`diatallt'. tat tlt:tt it it ttttt Itttltaled he a drill-
`
`fittee Ute hind»: Isaetateelt' fitted ta Ute tihla. Ute
`
`Iil1ifl]fll}'llJ.‘i-:IJ'|IIfligfllltmllmfifllnlllfflflnll'
`temtwetl leaving thetihial trtttt'ittg Heel-z. .I'tttttdt tlte
`irflfllnll guide and adlttstittrdeaieed PEEE-flitflt-
`'I'ltt:vertie4tl+:tt1altnttldcnttte Cline tn llteattleriur
`
`emulate lljtatttent inaerttntt Mature: {5'}- ll'it
`
`:tlt11‘:Lnt Iltnl tun IitEIeItttne i_~'. gluing in he I'elt'ttttetl.
`the ltlrrclt can he aditlated tIt lemme 2 mm mmenr
`leea htttte Urieum Mt- {thee Uteettneet height at
`the mllilagltltflt I'ee1' ltwtt tvtuelt,a.:leelI d'lL'Cltl the
`ttrientatitttt nl'the flitting hlnd-z iIt the tatnm-t'algttti
`[tlmte This ezet he dune ltt' attaching, the tttttee tn
`Ilte L'tllliltglthtdt and plating :t lung uliglttltutl I‘ttltl
`Utmugh the It'P-Jt'lf'T. 'I'he mdalteuld eenterttn the
`nutter nl' tltetaite: 'ut lttttlt the manual antistagittal
`planes. lltlte :tt'ilmtatintt ttlthe cutting: ltlnelt iti
`enrt‘efl. the tibia Itt male lt.'t he cut.
`
`II-IIE'IHI
`II--lE'I—|
`Il-Ilfi”
`II--lh'-'_'t
`
`DI
`
`TI-lll’ll
`
`WMT 1018-10
`
`
`
`h'il'twre I J
`
`WMT 1018-10
`
`

`

`EUHEIEAL TEiHHIflHE
`
`Using a GH'JPEJS Saw Made and an milial-
`in; saw. cut me hum-Imam] lib-IE] [aim-nu
`{figure I5}. mumm- bind: flush
`with Ihemllinp, bll‘d-I t1: BEE-HIE a Hill
`cut.Uslng:1 recipe-mums, 51w, mail-:1:
`Im- mfljcal cm (Haw? IE). L‘ul
`mrefulhrsufl'mt fliebmmcm hemken
`nul In meme-cl: Thu: mminfng Imam can
`be mun-Ml With :1. mnyurln EIIIEFIII' sealing
`all [he libial mpunent. Iliad: UH: cut
`sufl'flce uFlhe flhiam Insure Ilia! 1|. is
`
`high Sim-E WM": 3 mp.
`
`flat mingaslmigl'll edge. Lend an].r
`
`
`
`1H
`
`WMT 1018-11
`
`WMT 1018-11
`
`

`

`.FI‘.
`
`Hit-[are i9
`
`SUREIEAi TEEHHIDUE
`
`Peernemae are THE
`
`"i‘lELiL TRIAL
`
`Using the h-P 'Iihial Sizing Device. eheeltthe h—F
`dimension of metihlal plaieau [Figure IF}-
`
`Select the meet apprepriate iihiai haae trial. There
`mesh: sizes ranging fren'i Earn-email la magnum
`Iwith the same lie-admirer medial and Lateral
`mrreiartnienis. Peeitian the haaewiii'l the straight
`part along the tibia] spine and the rim-rm eat]
`anterirrrii'. Hiram ti'Ieiit-iai htaewiiii minimum
`eeeemge and aeemerhang. ”the anteriee part at the
`trial heee alteuitl be exactly in linewitli tlieimterier
`euriieal edge. "iti'hert the trial is in place. secure its
`peeitian with me sheet 12 mm drill hitili fill? at
`the anterier hale-t U-‘ieme i'Hi. The final size I't't:1.'g.'
`he tlil'lereni team the size shown an the .I'i-F' tibial
`
`airing guide. In thai ease. you have in die-use the
`[Hill fl'l-L'iimfl whit the trial 'lll'tlill base. II the trial i5
`
`emailerthan 'll'lE! dimensitm she-1.11 an me sizing
`guide. adaptthe .I't-P peaitlen elii'le trial in beaure
`that Ii '5 net lee anteriar. if the trial is higger than
`thedimensien Shawnee the sitting guide. check if
`yen hare eutetmugh en the tibia] spine and ii pun
`
`hattemamleti the lateral tibial tfilflflj'lllflfl'i.
`
`Faeitian the tibial trial articular ineert EDPI'EIiflI'Hl-
`lag in me tibial hate elae with tliu adequate [mie-
`L'ilii'leiti.’ thieltneei. 'i'l'hereare three aieea {me far
`nee tees-es: anti flee difl'eimi fliieimeeeee ti!- mm in
`
`11mm} ti-‘igura iii]. In itflltittiil'tit‘y tight lane-t.
`exiencl 1J1e Itnee at 20' it: Elli” allleitian with slight
`trams areaigue ta epeu me Iflllil. and try again. Ii
`them is I'llill eiiflitgh mam. a thinner iieerialieultl
`he aeleettei er ti'tepctsierier caudal-e alieuld he
`rte-teetedelightie.
`
`Tl-‘l'l'irli
`
`if:
`
`era
`'-'|-'-||.|'.l
`flit-l
`
`fil-Illlfll
`lit-l
`
`WMT 1018-12
`
`ll
`
`WMT 1018-12
`
`

`

`SUEEIEAIL TEEHHIIHJE
`
`FEMDRAL PHEPARA’I‘IUN
`
`lnmierlu lumteflm mnleq'nfmefmwal mnflyle :11
`[he anterlur anltularllmit in :Htlj'lfiiflnrflilerfl lhc
`knee WHII the trial plan-nu 511'“ in place {fifimw .E'EJ'ZI-
`1fiiu'ith IhE' knee exterfladwlflmul him at Imm-
`temlnn. 11er an I11: cumhrlr: the pmiaciim uflhe
`:mlm'tur uigwfl' Ill: Lihirll imam and aha IhEpmie-c-
`11u11 a! ll'lenenterui Theflhlul inserL [‘I‘Mmmr a!
`line Ilhlni Imam ht uuttlmd lam mmfleun lhe
`plmic}. lfyullam'l my. full EflEl‘EIflJL maimhe
`mark I mm nr 2 mm mar tlulamjmjm nf ma.-
`nnharlnrudm Li'fl'u: lihiu] ins-an.
`
`Hr dfllllg 1.11.15, Ilh: HIKE-1L: mil hexmthrmw the
`writer Lrl'ihe libiul lrflandurlng the mdlflng 11mm.
`Winn flue lame l5 flexed, H115 mark may wanna]
`imam! a: men In!!! tmflfll. INTI-Mr. il 1':- 1113 ammpriv
`uh: |:tmlmilrk rmilinn {FE-EH11”: E.“ ]I_
`
`HEI11fl1fiHP‘II—‘fl'lm'lnlri1lhil.1rial ham. and EnserL Then
`
`flux 111E! lunar :I1 90'.
`
`
`
`
`I-‘Igm-u- 3r?
`
`Hymn! 3!
`
`I1
`
`WMT 1018-13
`
`WMT 1018-13
`
`

`

`SURGI'EAL TEEHHIflUE
`
`FEMURAL COMPDNENI' SHINE
`
`'I'I'Iem are 55?: Edm- Enr the Flmnntl trial. 'I'H
`
`delemflne the appropriate size. the
`
`lemme] sieinp deetee is teed. Mler
`
`eerrqiluelyremtningthe [trimmer
`esteephrtes. mitten the sizing device with
`
`lite [105th I11 eel-fleet wlflt fllelmrter
`:etpeet ullhe ulttlyilet. '1'heml1hur'fi prelenmce 15 In
`peeltlmt flre gu Ide :tlenelhe lateral :etpeet eflhe
`L'u-I'rdjlle with Ihe alltm‘itrr [lll‘l'lli'm at “H: [eat-l Hf the
`:Interipr mark. The prtrper Hire 1.II-Iill he the nne'ed'lieh
`seem: luhe 111e meet :twt'eprlntetu me emdyle
`shape. ‘t'lirhnhtlle fillflllld heptlrtrllel tn the tihiill
`eut Wl'rEl'l the knee is :rt 90" H} tflfl' pf l'lexlenn.
`
`'l'l'ILI turn-Jet Hiring :le‘ritJ-e will curmmrltl exactly
`with the anteriurrnmlt nurtle preeimlslyen the
`eenrlyle {Ii-[emf 2.2]. ”'11 hummer}; tn slightly
`eut lhe premier mndfie te [rmiiliw the Irinl imierl.
`HIEHHLIL'E Ilre fillet-mesa remm'etl and nllmv a cane
`
`elmmltug gap ltlh'rfl‘l! Ihe leek-fine marmaltlu
`enntlyhe :irul Ihe pester'ter aspect till the fixing Ill-mite.
`
`FEM'DRAL RENEE GUIDE
`
`PGSITIDNLNG
`
`Seleel 1I1e reamer guide emesperrdinp, 1e: Ihe
`Selectedlemerelsbjng gultle tfierw 3}}. There
`
`Ti-llll'll
`Ill-maul
`r.‘I-lllilrh
`
`*1 - #113
`mm
`
`are l|l1rnee runner minim ml: nne :efiime-aing ten:
`lernnral till-5E [HrSmulIIEnmIL Merliumflnrge. antl
`K-Ierrye'hlefituml. Then attach the
`warmer guide handles tel lhe black. and
`set Ill-e eurreept'I-ndJng plastteeellet en
`1Jte upper hale.
`
`
`
`
`
`
`.l-‘Jfiem'eiti
`
`| l-IH'lHl
`
`WMT 1018-14
`
`WMT 1018-14
`
`

`

`Ellllfilihi.
`
`liEHHiflUE
`
`I
`
`3"3-‘5'3
`-:_i;:
`
`Ptmiiiw the guide with the inner enlerier edge til'
`the plastic bushing plnmi ln titeenllet in line wl1J1
`111E Imifln‘lslfil made 1:111 the $111th {Pilgrim 341.
`
`Lleinglwtl l1:u1tl|es {cut one
`
`ii there is neterieugh space}
`
`plttmi retrellel ttril1e [Ilene til'
`
`the mndyle taking intu eeeuunt lite
`
`ebllqulnr you went [theme-ct. set the peeliJnIt
`__
`
`ll't' tiltingitfil Itim lung {IriII hit in: [he Lemar
`he-ie.1iiil1i|e et'iented vertically. secure I
`
`the pusttlen nl‘ tlte puitlu I.Ititlt um,- :11
`M1 :ltltli tiurtnl H mm drill bits. The guide sl'teuld
`he in perfetttemlstetnlflte unterpm'lef'lhe
`ulnlteteltie ef the with-ire. :11. lee: in the rntetl
`superinr and inl'erierpanst
`
`
`
`_
`'ll'wfl Ell
`
`FEMURfiL EWING
`
`Select the Eememl reame-r sim mnesmndlnp tn the
`pres-imply m-temiinetl Steinem] il'flt. titled the
`depth 11F resent i111; 1mu need LU mm 11.1 -i mini
`awarding tn the Ihld-flifi uFfl'te rentutnlng
`cartilage in mine: with the reannsr guide. Place
`the Liusliingintet the pesterinr petsltlen ef the
`I'e111nrttll'e11n1er puleleilretmd begin tn helm until
`lhe drill .‘llflll Irt i1] Ctuilncl. with the gum-1.:
`[Elmer-e 35}.‘|he :tppmpliete teeming depth can
`15151131 he adjuster} hg' leteening the thread
`{eludes-1111:] 11111111.- ienmretl reemer 11nd
`
`
`
`
`
`
`
`
`
`
`. placing thedepth ring hate the
`
`eImmpIiutehrmm'itfil Jxeittem
`(Hitter? 3'34}. Then lighten the
`t|1reaelmu11ler—eleueltwise
`
`[Cl secure the dqttii [minim
`
`Him in winning.
`
`
`
`Deplh Selene:
`
`Te Adjust Depth
`lJTHI'HEI'I._ Tereltt'erw
`
`
`
`.4
`
`WMT 1018-15
`
`WMT 1018-15
`
`

`

`SUHEIEfiL TEEHHIfilIE
`
`
`
`
`
`
`urn-m
`
`Runtn'elhe I'EfllTl'lEl and Ell-Ell: II'IE dqarh IJI'TJ'aE remu-
`inpr'l'he rlfi'lldefih Is remind when the Huhclmmlml
`hum: is Hurting In Meal III-mun: 35}- If {mu :1.1'E nul
`deep enuugh. ream I mm 11mm unul you I'E'Jflh Il'u:
`sfldfimdm] ham. Hui-ping 1hr: flame llficknmj. claim
`Lt'ntlmnedehria and EI'I'EI'I'E IhE hmhing luflle unher
`hale andmnu {Fimtre 3?]. Herr-aw all material and.
`__
`Rummy. mm Ihe 15.1335 DI the rimmed
`’37
`marith an maillatlng ramp. mist] or file
`Emmafll. Bnmufirermd 1mm
`refining Mus: III? :I the same deplh.
`“not. mam agam fl'mmre nfim sidu.l
`with line mm, mmriny, lhal 111:3
`rammingdeplh pmiu'm has mt
`flungztl. He mun-fill
`nut to war ream.
`
`
`
`-
`
`
`
`.F-‘J‘gum 3?
`
`
`
`I'mrre 33
`
`MT 1018-16
`
`l5
`
`WMT 1018-16
`
`

`

`SlllilSlEAL TEEHHIDUE
`
`Pameme Pamela Cars
`
`Seleet the :Elfimml'lillx [enural culling hlael: and
`limitinu llie anteriur part ellaelig.r in Ll'lE middle of
`the meal. :uflerleir palm [if the previsz man-i; male
`on fleemalyle. in a lemma. Lfi-au am 'I raise Ihe
`[Hflefiar mllinp, guide la the level Ell TJ'Ie maria,
`ell-eel: il'll'le rem-e. is antefiureneuglt. ll'nnL make
`a mere :a11erinr renew at the lee! al' Hie marl; ailh
`
`aetiml. Able. eheelz If ire-u lam: reamed panel-let
`eeleaplu'tee and :11 least eula lilele firm The
`:mkfilrflnidflfi when yea are In beta-leer: nun
`Wee LF-‘fgm'e 25?}. 'l'he iauidle elmlel he teethil
`and me iaefliriur pan is eaaellyin mated 1.1.1111 the
`|Irfleriiirmleuufrjleemrlylu
`
`'l'li'llh Ila: relreil alilerlnr edge affl'ie culling hind»:
`aliglaei nn 1i1e tide maflz. ileum the blend; will: 1am
`lmne spikes [Mn-lel'fl}. EniaJr-e That [he hlaeh 131'
`well flee-Ll 1a Ihe ennui-1e. lime culling lilac};
`nan-es [afieriai-Iy.lla:]ineterii1rmnd}'I-e
`will be ten tlllekmel lhe knee will
`be tight in fleaieai. it may lie Eulrl'ul
`in remove all mneinirig cartilage frtm'l
`Hie reflerinr emelyle het'me fifllll llfi the
`fenmmlnlulng hlaeli.
`
`
`
`
`Heme 35'
`
`Tt-fl-IHII
`
`Il-lfllfll
`
`
`
`
`fiemejfl
`
`JIE
`
`WMT 1018-17
`
`WMT 1018-17
`
`

`

`SUREIEAI TfEHIHflIJE
`
`Make flue mmHnr 11mm] cuts [Hartm- 3m
`
`HmflflB} with a nanm' {Ecillallng 511w. ‘I'hea'l.
`using: 5.2 mm drill hit,dril[ the I'M: hum-i l :11] In
`
`" firilimle the filament-alum! Femural finishing. trial
`
`.lfiwm 39E]. Rum-name [tuning hI-n-cl-I. flnlah “1:
`
`cut. If [mun and mm: “H: hum: chips.
`
`
`
`WMT 1018-18
`
`I?
`
`WMT 1018-18
`
`

`

`SUEEIEAI. TEEHHIEUE
`
`FWISI-[fl'nffi TEN.
`
`Select mwmm Emma] Finishing triflJ
`based on fl'repmriuus slums. much lhe handle. and
`impart il D11 the femur In Ihe pmlnmiy pmpumd
`holes II'figumjfl. Make certain that the 2mm
`admdnesmtmtflapfllafidammfiifimmfl}.
`Emmi-11m handle, neimert fl'leflhlat tflats.:1.nd
`
`”in."
`Ihmnln
`""3””
`
`I begintherang:urImtmru'smuizinghuts-ling, T-‘L-Hlil
`II—H—il
`
`IE
`
`WMT 1018-19
`
`WMT 1018-19
`
`

`

`
`
`SURGICAL TEEHHII‘JIJE
`
`'I‘EIALJHG
`
`The tibia! insert must remain perfectly stable
`without any tilting [mm ll" In tfirfl' ecl‘ Mlun wlflt
`111E Emit in 5'1.“ “3' ufexternal TEIIH'l'itm Gigi-twin
`In slighlflexE-un “5'1. when gnu apply name in
`[email 111nm tumulmrmuannwnt} nrin minus
`{lateral enmpmtment].d1e Penman“ :nntlyle dues not
`have to he in enntantwltl'l fl'ueuhlnlqnine
`
`In slight flexien “'51. wt: shuul-tl lune In twee: a.
`smell mmlulng Imity an Ihe stile uf flumneavlty
`1:: mid mermrreuiun pruhlmas. 1'11 Meat is
`mrate unlessym I'Imredme an emmh'e release.
`In I'uH exmfim. bemreful tu :mfiri' muffin-1mm
`between fl'hespine and the intrmfiylar nnteh
`tfleum 3-3}. [I mutant mute. open men.- nt' the
`11mm and remake, liming any reruainl'utyr
`wwphfles en the medial [1.111 at the candyle with :I.
`
`mngeur.
`
`
`
`emure EH
`
`WMT 1018-20
`
`WMT 1018-20
`
`

`

`SHEEIEAl TEEHHIDLIE
`
`M {RISES 0F TILTIHG
`
`Wid'l 1.11:: EHH l'fill'i- “111 mi lhE preclae instru-
`mentutlnnJll'ting Is nu lungs: a I'nlquent nmhiem.
`m1fiilmuld be helpful lukmaw tl'ue 5mm
`
`mui nmurfiuf tilting:
`
`
`
`pumlln [flame-35}.
`
`I. Halduul limmflmmcle: Rem Ila-e tih'ml
`
`trial and maul: fur Ilflf rerminl rug “1:111sz ur
`mum “1:11 ”my be chanting lhe trial and
`hindering gmdpmitiunlng, Mandwd; to are
`Il'ml. any remainlng mm: mrfly'lu is causing
`
`1m ntntanle LFE-wmjfi}.
`
` i. Parana Is. Hal. Replaced.- Rechazk :Lflnr replacing
`
`
`Fiat-rm 35
`
`1n.
`
`WMT 1018-21
`
`fiRm-r'jfi
`
`WMT 1018-21
`
`

`

`flymrj?
`
`
`
`
`.FIEIIM'E . i3
`
`SUEEIEAL TEEHHIHIJE
`
`i. Mumpn-am'inr Mahmlfimlmg; Ehangr d1: M"
`minim nl‘ NEW and mm: again {Firmwjfl
`
`4.1mm] Dal is Hal Flu}.-
`
`l’lntten lhe 1:th MyrtrEj'HL
`
`'i. Candy-'13: Dblicpm'y: Emmi-E II'IE Irinl and. repaailiun
`flwmflrhmmflly {ngrrefifi}-
`
`
`
`man-WEE?
`
`WMT 1018-22
`
`WMT 1018-22
`
`

`

`Sllflfilfill TEEHHifilIE
`
`E. IrIIIfirigemenl: [if the Fmidyhe en Il'ueflpine in
`i-‘elemansl-‘eree: Mmethelriellnlenrllyur
`eutmm'eefil'ie IibinJ efilne Wen: 4H}.
`
`3'. E5en1hing Leeks fined. Hui Tilting. Remains:
`lnnmue lhe premier siege el'flie Iih-inl eul nr eui
`mnre distal lenulrunrl rrm'ne chm in :Lsmeller
`
`I'enueml size {Heme 1H].
`
`Comm. eF H‘reeeeeeeenen
`
`l. Furthe venue knee. [I check may he peflmmed
`ensi I1.I rm 1|1e medial mum-Jeriliwni. Mung 111L-
`hertieeJ ween the Uhinlepirue. ehed-z [4.1 elenne
`Ilml the upper Imeflnn elf me Lrinl ineen is never trier
`lhe rlilTenmm hem-en lhe :wmlluue :mei ens-[lee]
`
`bane.
`
`2. Fur hath lhe nuns and. angue knee. leferenee lhe
`nfinniiie mn'qlflfll'ilflll :LnrJ died: in delennlne |I'1|1e
`mnlmlelernl enni Inge i5fl1iek Elmllflh. Then hTIiiie a
`needle in Iheeenterel' 111e e311] lug- lielng die
`Iihinl lri:Li.e|'Lee1ithallhe upper. :inleriur [mriinn
`nl' IJIE tried Insert Is not ever-lhe I-e'eel nFIhe
`
`
`
`
`Ifidk. [E 111: mnflege was I'Lrund
`lhin. spi ire lhe lung rreedie :It
`lhe upper le'rei nl' the
`mflflflgeflnd rlupirmnu 131i:
`leellnique.
`
`3... Fur bath lhe wuus and
`
`wllgm km‘fl, always check ihel Him! is :1
`slight lie-zit; :LI ahmll E5“ Hf flexiun nn lhe
`sldeef'lhedel'nrmiry.
`
`WMT 1018-23
`
`WMT 1018-23
`
`

`

`SUHEIEAL TEEHHIEUE
`
`Feet TtenL mp Feeeeet,
`
`Peeeeeetee
`
`If d'le trials :Lre net eefiefmn'. yen shuttle! be
`able tneeetltr ntm'e TJte pnel'flett efetther the
`[i'ltiel] plateau hr flue Fentnml finleiting lr‘l:l.l
`wttlhetlt deetmft'ng nrn' Irene. III'JI'Ien the triele
`give an eeeellfitt mJL were the Ellie] here
`pneit'tun with me er tun [Him 5mm. Haiku-fie
`the femnral handle an the melting template
`end using the [entered peg drllLtflrtll the Itnle fer
`the peg U‘Iem'e 43‘). Using. :1 name-H neeillnling
`sew. prepare The elel fer the lenterel fine taking
`intu :lE-EIJLI-Hl lltnt the nntefiur [in 15 emeller them
`
`the pneterinr which gees unlll the beginning
`el the meet pee-tenet- nut {Figure {'3’}-
`
`7MB”
`
`Heem' J2
`
`
`
`
`WMT 1018-24
`
`

`

`SURGICAL TECHHlflUE
`
`
`
`Fix. will] Huber-Emma, flu! mum nFIhi: Lilia] has:
`:Ll'El'LE emaipmiiiurl dztefrnirwtl during tl'helrials :u1l:l
`lea-ls. {in mam-Emma Ill-E: hum: is reqrhm'li lhE
`lateral bum: splice mayr mate "it trial lame plain.
`
`'I'hlmlure. ling: nnly me hme mike ulnar. in “TE tibial
`
`mine and have mte‘s amalEIm'IIJ'lnltl Ihe hunt in place
`
`during [In and 1mm pnfnufllij} Hermm Ill: TIL-mun]
`
`trl:i|W|1J1 tlflflqllirr Lane Fem. fln ll'lE! tibial iriaJ lime.
`
`prepare Iheslm Eur Ihe flrtwitl'l fl'nemmprinte fin
`
`punch {H ULI'I-i nr HWIJJ {Magma 441.
` ”fl"
`Attach the fihinl tum drill guide mum uhm trial mi
`select the mpmpriurilrlll {qum #5].
`
`*IJI'HHI
`Tl-‘Hlfl
`
`”Jilin
`
`
`
`Eli
`
`WMT 1018-25
`
`WMT 1018-25
`
`

`

`SUREIEfiL TEEHHIL’IIJE
`
`
`
`
`
`
`
`Duflng drilllng. It E mamlahw t1: chuck maul“:
`Iit'ill guide mttflinfi “Hi and in perfect mum with
`the tibial lime. The hunt dt'lll will unlgr prqmm fur
`Ihe bum murmlmt an flu: LIE'Ij-lfl'fitll'fiwfi uflhe tibial
`
`Implant Him-a2 It'd]. TF screw fixation in deslred.
`Bela: lhemhlnutlon bumflngmdflll. hut
`EJWEF} USE “HIKE-m1“ firfit.
`
`T].ij_fl|
`
`
`
`T|-':||-J|I
`
`WMT 1018-26
`
`3;
`
`WMT 1018-26
`
`

`

`SURGIEAL TEEHHlll'LIE
`
`CEMENT Peeeeemee
`
`I
`
`ileum-e femer'el end tibia] trials.
`
`..
`'M'm'
`
`Hemmre thetibi :tl trial-.5. Hefere cementing. it ie
`l1'l'll'llt3tt'lfll'll. tn elm-J»: diet the tmpient {mutating ie
`ere't'eet. 'E'Iten pleeethe cement en the Ilene. but
`den't put ere,r in tlte heee hele. Heep the pleatie enn
`er: eleheee shill] tmpeet I.Ielth the tlhl :tl impectet'.
`Hemmre enyeeeete eement.
`
`[l we ere mlltflflfifl'fll‘. remm-e the plestle cap tn
`the [mete the tlhlnl lute: end 1.:l]!t fltmugh the Item:
`eentnenent 1.In'ith the eereI-e em. Then insert the
`[IE mm ter 22 mm eenew. Fltlt'ttmlt: any remeinlltg
`een'lent
`
`11.9.4.1
`
`Te eet the ireert in plttee. elitle it between the lemerel
`eempenem and the tihith hue rutrl tee-mi; the
`metliel [em firet. Then ptleit tleeit Inlemlh' until yet:
`
`i hear1"elieI-t"ereheeI-tetnerl’eetil'ISEfllnlt[figure
`
`4.721]. In nrtler le hut-e :1I:-e1tert-iew and mtee fiance
`meet the irteert in ghee. it is eeeierte [three the knee
`in 313' nr 311'” el fleeien with :l slight fereed mlgus
`[metfittl eitleJI er Irene [Internl side]. 11' fee h:n-e :m}'
`th'flieult'y Heating the ineert. remtwe itend eheel: if
`the eenIe-JI end is atl EH1“ ermere hunt the herleente!
`
`95-55-511
`TE-‘i-H-‘J
`
`Heme
`m”
`
`Iil'e':tl en: tit-“were flit]. ][::rt|.t:nn1.-ettltt.-t.1t|witlt:t
`reeinreeetjng meet men and then. resent the lIJEETL
`
`priel Nete Fer flernenling the 'l'thie:
`
`The ten.- ttl'tJtL- titll‘nll' ietqtttuuel. t'i'ltut flLI't'II'JI'IlIlI'tg
`the tihirtl beee without it till-I'IE'FF place It flexible
`tuhe. eh'nflt Ie ellghtlyenetl Ier then the [trrt’etr'ed
`le tie. mm the drilled l'eee Itele. [lee e smell tlrill Le
`ereete sente helee en the eel tJhiel eutleeete
`
`imprut-umm-nl Immune“- Plan.- eenemt utt me
`|'|l'|.'1:|':tl'E!Ill tihiel en rfeeeentl in the [tee hele nreund
`the ineerted tube. The tree ef the slightly umlersieed
`Itle-ttietuhe :Lllmte eunent tn penetrate the heme
`amen-Ll thehree.hut|1re1'eneeernenl [rent :teetllntl-
`
`letine, under Ute hteehele-
`
`
`
`
`1‘" me #34
`it?!
`I
`
`._,
`,.
`I-teme' "’ H
`
`H1
`
`WMT 1018-27
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`WMT 1018-27
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`

`

`SUREIEAL TElHI‘iIflUE
`
`I
`
`1iir'hen cementing U'Ie tihinl hnee with n eerew. he sure
`tn enter the dfillerl here; hule eempletely whl Ie applying
`cement nu the Iihia] surface. '1'hi5vu'iiipremntninm'll
`tram migrating intn the bum hnle area and eliminate
`the chance uE :tnl't cut-111ml. :nxp. inte the ttitinl here. He
`dri Ii hnles en the tibial su rl'ane :1re neeeesnrgr' sinee lite
`CIII-I'IIIJ-Jflfilflt'l seren- prru'ltI-e-i elteugh cement
`intetdtgttutiun. ”(1115: H La»: nmnmunlul Illil the
`wee uptien he utilii-ted enh‘ with the medium
`thrnugh ititLgt'ILtltt Elie tibial limes. 'l11e n—eutuil and
`email tihiul hares shuttle] he cemented 1:t-ilhizlul the
`
`nerew nptl-un te ensure adequate eemenl emeeaee.
`
`l-'~u|' tlle Funeral E-IJIIIII'IIIHLEHL ptll n :ilIIIIIll 1t|1tuuunl [if
`eement en the Whittle, but due: nut nut tut-5 in the pee
`lenleerluetermr aspen til the I'entuntl mnelyte. Etru-
`iul I]: place the leutuml muumrI-enl Hit the prepen'tl
`eunelyle. 'I'he Fernu-ral [leg and [in will di reet the
`
`it'l'llilltll'll itlln Ilte IJI'IJIIIIFIHElllIZIII and nn'mflnlinli.
`Then tiettl
`it with the Fentnml intpudnr. lemme Ill'l'_'-'
`eateees cement- :ou then impact mun- Jtentute
`I'E'l rulinil‘qi'I Eerllenl .‘ll ul piece the legin lull ettlemtitm
`
`until the cement i5 Fully dry.
`
`filemt :uttlwneh e:u1.:ltlll}'.
`
`ClflSURE
`
`t'eritig.’ I'Iertieu'l le ulttujnerl u] ti“ tn lifl'- litethntt elteure
`uflerirt'igutinrl :IJttlSLLL'l'mtI Iwith the flexed lame
`between Lttl" unti Iii-ET. tiuture the uuntirieem lll'til.
`Curet'ully‘rqmir the mnflul [etlellttl' retainzteulum tfur
`litetlisllnnenlurtmmh‘].1't1'il1rui'eeneeu-lputeilu
`n1:tp1:ui|te,:utereiteure eitheetfit tleuuet tin nut suture
`lhe letlellnr reiinuetthuu in |:|te1".3lprte.etltln:-Ll’lw:e
`tetrmletiun drainage tubes: I'J'I'IE intm-unieu huh and
`
`the tulieraitlheututermeli' er |t|.'t1.:l-.'tr'l_1'r_'ttl :Irh'.
`
`WMT 1018-28
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`“.3.
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`WMT 1018-28
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`

`

`SUEGJffll TEIZHHIDUE
`
`FDSTDFERATME CARE
`
`The pzllientslmuld I'I-EELHIWHJE[IJI'1|1]}'|IIE:ll"-'~'Eiflhl.
`with En unhm. nn firfimt chum HIIEFH'II'EEQ'. lnilinln:
`Isometric mmmcliun nl' 1hr.- quadrlcelm and. twin
`maule- tlwnlpywhh Ii L'JJM I11:u.'l:|iu|:_ Herman.- HIE
`kl rm: er-«aal I11: Lrl'l 111:3 third {I51}- mailufiflflliwly. [1| hrtk
`the kneedrmingnu Il1utlg|1fl1dayand iniljme
`Flu-24ml therapy. [In certain imuumm phfiicnl
`[lwrnpy an}'!-i1.:l:l'|.1]l"l II'II': Fflunh EII‘ fifth d:|.1_-'. I'III'I-‘ifll
`IZI'I.‘ path-n! 1:: walk will: :er