Step 3 Seat Femoral Component to Stabilize Knee in Extension Figure

This part is easy. The femoral component must be seated on the distal femur so that there is neither recurvatum nor a flexion contracture. If the trial components result in recurvatum, the femoral component may be seated more distally by using distal femoral augments. This will be the case in the majority of revisions in which

Femur Articular Surface The Knee
FIGURE 8.5. The point at which the femoral component meets the tibial articular surface is the joint line. The patella height is then noted.

FIGURE 8.6. With the provisional components in place the knee is brought to full extension.

bone is missing as a result of failed primary. Selecting a thicker polyethylene tibial insert instead of a distal femoral augment will unbalance the stability that had been achieved in Step 2, in which the knee was stabilized in flexion.

Rarely, the surgeon may resect additional distal femur to stabilize the knee in extension. This may occur for the knee that had failed with a fixed flexion contracture, especially if the joint line had been lowered, during the primary arthroplasty. When distal femoral resection is contemplated, check that it is not for the purpose of accommodating an inordinately thick tibial insert that is going to result in proximal joint line migration. This could be a gap mismatch.

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