Step 12a

The bone is then shaped to provide a smooth transition between the anterior surface of the femur and the curved part of the condyles.This is easily done with the edge of the oscillating saw, osteotome or a bur.This is checked with the template.

Step 12b

Once a perfect fit of the template has been achieved, the femoral template is punched into position and secured using four pins. The articular surface ot the condyles on medial and lateral side should be level with the inset prosthesis.

The trochlear groove of the prosthesis is in line with the mechanical axis of it leg and not with the anatomical axis of the femur.Slight adjustment of valgus/varus is allowed to ensure a smooth junction between metal prosthesis and articular cartilage.

Step 13

The four guide holes in the template are drilled with the 4.5mm drill to accommodate the fixation studs of the implant. The template is then removed and the trial prosthesis impacted into position to provide a correct fit. The inferior stud of the femoral component is inserted first. The prosthesis is punched into position in the line of the long axis of the femur. The angle is then increased to 30º, then to 70º and finally to 90º with the second flat surface of the punch.