Trial Reduction

Prior to trial reduction, posterior osteophytes on the femur are removed using a three-fourth-inch curved osteotome while lifting the femur with a bone hook. Osteophyte removal is essential for maximum knee flexion.

Stability is checked in full extension, 20 degrees of flexion, and full flexion. If the PCL is intact, slight medial and lateral laxity should be allowed. Full extension must be obtained on the operating table. The femur should track in the center of the tibial tray. If the PCL is absent, the next thicker size tibial insert must be selected. The slight flexion deformity this creates will stretch out over the first 6 months. It is suggested that the PCL be resected intentionally if the patient has more than 10 degrees varus or valgus deformity or more than a 10- to 15-degree flexion contracture preoperatively.

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