TKA 2.0 Study Notes Quiz
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Questions and Answers

What error will occur if the spread metric used to calculate 'Hip Center' fails more than once?

  • The pelvic array is used for intra-incisional tibia bone pin placement
  • The femoral array drops out of camera view
  • The spread metric used to calculate 'Hip Center' fails more than once (correct)
  • The spread metric used to calculate 'Hip Center' fails once

Which laxity value will be saved when the user captures the example by pressing the foot pedal or selecting the 'Capture' button?

  • -4.0
  • -2.0 mm (correct)
  • 1.5
  • -25

Is it true that the user must lock the preferred plan before navigating to certain pages?

  • Only in certain conditions
  • It doesn't matter
  • False
  • True (correct)

What is the capturable flexion range for flexion laxity poses during the initial assessment?

<p>85° to 105° (D)</p> Signup and view all the answers

What happens to the 'Trialing' pose captures when the poly size is changed in the software?

<p>They are deleted due to changes in joint mechanics. (D)</p> Signup and view all the answers

Is pre-resection laxity calculated from the planned tibial resection to the planned femoral resection?

<p>False (D)</p> Signup and view all the answers

Which statement is true regarding live 'Laxity Capture' during the Trialing phase?

<p>The user is limited to live laxity capture only. (A)</p> Signup and view all the answers

What occurs when a user captures a 'Hip Center' and the spread metric fails more than once?

<p>The captured 'Hip Center' remains unless the user deletes it. (C)</p> Signup and view all the answers

What do the laxity values displayed within TKA 2.0 represent?

<p>The closest distance minus the thickness of the tibia component (C)</p> Signup and view all the answers

What warning is displayed if the user selects 'Continue' after a tibial patient landmark error?

<p>A warning on the 'Bone Registration' page will be displayed. (D)</p> Signup and view all the answers

If the Mako System cuts deeper than the implant plan, what color will it be displayed in the Bone Preparation page?

<p>Yellow (C)</p> Signup and view all the answers

What happens to the Extension Lateral Max value while capturing poses?

<p>It decreases to 0.5mm. (B)</p> Signup and view all the answers

Which warning can be displayed on the 'Bone Preparation' page if triggered during Implant Planning?

<p>Notching (A)</p> Signup and view all the answers

Which statement is incorrect regarding the user's ability to modify the implant plan during 'Trialing'?

<p>The user can only view the implant plan without modifications. (A)</p> Signup and view all the answers

What checkpoint must the surgeon pass after finishing the tibial resection before proceeding to the posterior femur resection?

<p>Femur checkpoint only (A)</p> Signup and view all the answers

What must be done if the tibial landmarks fail during the capture process?

<p>The user can proceed but must handle a displayed warning. (D)</p> Signup and view all the answers

Why might the captured 'Hip Center' affect the accuracy of tibial bone registration?

<p>It may introduce errors into the registration process. (D)</p> Signup and view all the answers

What does the 'To be cut' volume display as on the 'Bone Preparation' page?

<p>Blue (D)</p> Signup and view all the answers

Which cutoff can the surgeon access if the straight saw attachment cutter checkpoint has passed, but the software is on the tibia dropdown?

<p>Access to the anterior cut (C)</p> Signup and view all the answers

What combination of checkpoints must be passed for the distal femoral resection to occur after anterior chamfer resection?

<p>Cutter checkpoint (angled saw attachment) only (D)</p> Signup and view all the answers

What happens if the implant plan triggers the 'checkpoint near cut' warning but it is not addressed?

<p>The warning will appear on the 'Bone Preparation' page (C)</p> Signup and view all the answers

If the probe tip is within 100 mm of the tibial checkpoint, what result will the software display?

<p>Red checkpoint result preventing access (C)</p> Signup and view all the answers

After passing the straight saw attachment cutter checkpoint, what should the surgeon ensure regarding their dropdown selection?

<p>It should be set to 'Femur' (C)</p> Signup and view all the answers

Which checkpoints are required if the surgeon finishes the posterior resection and wants to make a femoral cut?

<p>Femur checkpoint only (C)</p> Signup and view all the answers

What warning is applicable only during the tensioning phase related to the flexion pose?

<p>tilt, flexion (A)</p> Signup and view all the answers

What is recommended while positioning the Mako System with Mako Park?

<p>Holster the robotic arm (D)</p> Signup and view all the answers

What do positive laxity values represent in relation to the planned components?

<p>Gap space between the planned components (C)</p> Signup and view all the answers

Which views will display the anatomic axis of the femur on the Implant Planning page if 'Display axes' is enabled?

<p>Coronal and sagittal (B)</p> Signup and view all the answers

In the capturing process of the medial slope tibial landmark, what is the first step?

<p>Place the crosshair on the center of the medial tibial plateau (C)</p> Signup and view all the answers

What will happen if the user selects the lateral malleolus on the tibia during CT landmark selection?

<p>The associated CT landmark will be cleared automatically (B)</p> Signup and view all the answers

Where should the crosshair be positioned when selecting the proximal shaft CT landmark?

<p>Below the lesser trochanter (C)</p> Signup and view all the answers

Which of the following describes the knee deformity if it is varus in extension and valgus in flexion?

<p>Varus in extension, valgus in flexion (C)</p> Signup and view all the answers

What threshold must be exceeded regarding implant overhang on the anterior flange to trigger the 'Flange tip' warning?

<p>1.00 mm (B)</p> Signup and view all the answers

Will the application allow a user to proceed to bone preparation if a 'true notching' warning is triggered?

<p>No (A)</p> Signup and view all the answers

If a surgeon has executed a 7 mm tibial resection, what will trigger the 'Implant proud of cut' warning on the tibia?

<p>0.01 mm (C)</p> Signup and view all the answers

Are warnings determined solely by the user's unique surgeon preferences?

<p>No, they are standardized (C)</p> Signup and view all the answers

Which alignment method is NOT considered an individualized alignment?

<p>Static alignment (B)</p> Signup and view all the answers

When converting a PKA 3.0 session file to a TKA 2.0 session file for a lateral uni-compartmental, what should the user ensure?

<p>Ensure access to required bone registration regions (C)</p> Signup and view all the answers

Does the 'Mid-resection balancing' workflow enable the 'Joint balancing' page?

<p>No, it enables tensioning (B)</p> Signup and view all the answers

What is the correct sequence for the user to change the 'constitutional alignment' value?

<p>In implant planning, initial assessment, and trialing (D)</p> Signup and view all the answers

What workflows does TKA 2.0 offer?

<p>'Pre-resection balancing' and 'Mid-resection balancing' (A)</p> Signup and view all the answers

Which angle is used to calculate the tibial value?

<p>Medial Proximal Tibial Angle (MPTA) (A)</p> Signup and view all the answers

If the user selects 'M/L together (one pose) in extension, what must they also select?

<p>M/L together (one pose) in flexion (A)</p> Signup and view all the answers

When intra-incisional tibia bone pin placement is chosen, how should the MICS handle be rotated?

<p>90° medial, 90° lateral, or 45° lateral (D)</p> Signup and view all the answers

When should the surgeon remove the tibial bone pins and array?

<p>Prior to stem drill / keel punch (B)</p> Signup and view all the answers

What consideration must be made if the user prefers intra-incisional bone pins on the tibia?

<p>The clamp, array, and pins must be removed prior to stem drill/keel punch (A)</p> Signup and view all the answers

What placement guideline must be followed for the tibial checkpoint during intra-incisional bone pin placement?

<p>Remains the same as TKA 1.0 guidance (D)</p> Signup and view all the answers

What notification will be triggered if a patient's constitutional alignment is set to 3° varus to 3° valgus, but the patient's measurement is 5.1 varus?

<p>A notification for exceeding the varus limit will be triggered (B)</p> Signup and view all the answers

Flashcards

Hip Center Calculation Failure

The spread metric used to calculate 'Hip Center' fails more than once during capture.

Hip Center Capture Error (Femoral Array)

The femoral array falls out of camera view while capturing 'Hip Center'.

Foot Pedal/Capture Button Laxity Value

-2.0 mm of laxity is saved if the foot pedal or Capture button is pressed.

Plan Locking Before Navigation

The user must lock the preferred surgical plan before going to Initial Assessment, Tensioning, Bone preparation, and Trialing pages.

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Initial Assessment Flexion Range

The capturable flexion range for flexion laxity poses in Initial Assessment is 85° to 105°.

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Pre-resection laxity calculation

Pre-resection laxity is calculated from the planned articulating surface of the femoral component and planing articulating surface of the tibial component, not from the planned tibial resection to the planned femoral resection.

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TKA 2.0 Laxity Value Definition

TKA 2.0 laxity values represent the closest distance between the planned tibial resection and the planned articulating surface of the femoral component, minus the tibia component thickness.

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Bone Preparation Page Warning for Mako System Cut

If the Mako System cuts too deep (compared to the implant plan), the warning is displayed yellow on the 'Bone Preparation' page.

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Poly size change in Trialing page

Changing poly size in the software alters joint mechanics, requiring new Trialing pose captures.

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Extension Lateral Max value in Trialing

In the Trialing page, the Extension Lateral Max value decreases to 0.5mm when the pose is captured.

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Trialing page live laxity capture

In the Trialing stage, only live laxity captures are allowed due to the trial nature of the joint.

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Modifying implant plan in Trialing

Users cannot balance or modify the implant plan in the "Trialing" page.

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Hip Center capture failure

If the spread metric calculation for Hip Center fails, the captured Hip Center stays, unless manually deleted.

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Continue with failed tibia landmarks

Continuing with a failed tibia landmark capture results in a warning message.

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Tibial array bump during landmark capture

A 'bump' to the tibial array is not explicitly mentioned as a result of capturing landmarks.

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Bone Registration page warning

A warning will be displayed about the problematic tibia landmarks on the 'Bone Registration' page.

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Implant Overhang Warning

The 'Flange tip' warning triggers when the implant overhang on the anterior flange exceeds 1.00 mm.

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Notching Warning

The 'True Notching' warning does not prevent a user from proceeding to bone preparation and implant planning.

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Mid-Resection and 'Implant Proud' Warning

If a surgeon performs a 7 mm tibial resection during the 'Mid-resection' workflow, the 'Implant proud of cut' warning will be triggered if the implant is even 0.01 mm higher than the cut.

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Surgeon Preferences and Warnings

Warnings are not determined by the user's individual surgeon preferences, but rather by pre-defined system parameters.

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PKA to TKA Conversion Warning

When converting a PKA 3.0 session file to TKA 2.0, ensure access to bone registration regions, particularly for medial incision, especially if the original PKA session was for a lateral uni-compartmental.

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Mid-Resection Balancing

The 'Mid-resection balancing' workflow enables the 'Tensioning' page, NOT the 'Joint balancing' page.

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Laxity Capture Options

Within the same 'Surgeon Preference' profile, it is possible to select 'Laxity Capture' for the initial assessment and then 'Ratcheted Laxity Capture' for trial stages.

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TKA 2.0 Workflows

TKA 2.0 offers two main workflows: 'Pre-resection balancing' and 'Mid-resection balancing'.

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Checkpoint Visibility

Checkpoints are displayed as yellow on the 'Bone Preparation' page only when the corresponding cut is being prepared. All checkpoints will be displayed for all cuts, but only the yellow color for the specific one being prepared.

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Femur Resection Checkpoints

To perform a posterior femur resection, the surgeon only needs to pass the Femur checkpoint.

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'To be cut' Volume

'To be cut' volume is visualized as blue on the 'Bone Preparation' page.

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Anterior Chamfer Resection Checkpoints

To perform an anterior chamfer resection, the surgeon only needs to pass the Cutter checkpoint for the angled saw attachment.

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Software Behavior for Different Dropdowns

If the straight saw attachment cutter checkpoint is passed but the dropdown is on the tibia, the software detects the probe within the femoral checkpoint and validates it. If successful, the surgeon can proceed to the anterior cut.

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Warning for Deep Cuts

If the Mako System cuts too deep during bone preparation, the warning appears in yellow on the 'Bone Preparation' page.

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Checkpoint Warning Trigger

If the implant plan triggers the 'checkpoint near cut' warning and it's not addressed, the warning will be displayed on the 'Bone Preparation' page.

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Femoral Checkpoint Validation

To proceed to the anterior femur resection, the software will detect the probe's position within the femoral checkpoint. If the probe is valid, the surgeon can proceed to the anterior cut.

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Constitutional Alignment

A type of alignment where the patient's natural bone structure and anatomy determine the ideal implant position. This alignment is not based on kinematic or mechanical considerations.

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MPTA Calculation

The calculation for 'Constitutional Alignment' uses the Medial Proximal Tibial Angle (MPTA) along with constitutional landmarks identified using the 'patch landmark methodology'.

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Tibial Array Placement?

If using intra-incisional tibial bone pins, the MICS handle needs to be rotated either 90° medial, 90° lateral, or 45° lateral.

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Tibial Array Removal?

The MPS advises removing the tibial bone pins and array before performing the stem drill / keel punch when using intra-incisional placement.

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Considerations for Intra-incisional Pins

Selecting intra-incisional tibia bone pins requires removing the clamp, array, and pins before stem drilling. Additionally, the narrow sawblade needs to be enabled in 'Surgeon Preferences'.

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Tibial Checkpoint Placement

When using intra-incisional tibia bone pin placement, the tibial checkpoint placement remains the same as TKA 1.0 guidance.

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Constitutional Alignment Notification

If constitutional alignment is selected with a range of 3° varus to 3° valgus and the calculated constitutional alignment is outside of this range, a notification is triggered.

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Tibia Landmarks and Coordinate System

The medial and lateral slope landmarks influence the tibia coordinate system and the calculation of 'Resection Landmarks'.

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Velocity Trap Warning

The 'Velocity Trap' warning appears only during the 'Tensioning' phase in the 'Flexion' pose, indicating potential ligament tension due to the weight of the limb or the use of a force input tensioning device.

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Mako Park Use in TKA 2.0

Mako Park is NOT required within TKA 2.0 to gain access to 'Bone Preparation'.

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Mako Park Instructions

During Mako Park, written guidance on how to best position the Mako System will be displayed in the information box. This is FALSE.

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Mako Park Robotic Arm Positioning

It is recommended to holster the robotic arm while positioning the Mako System with Mako Park.

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Positive Laxity Values

Positive laxity values represent the gap space between the planned components, indicating a loose joint.

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Tibial Coordinate System

The tibial coordinate system is defined by the medial malleolus, lateral malleolus, rotational landmark, and tibia knee center. This is TRUE.

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Anatomic Axis of Femur

The anatomic axis of the femur will be displayed on the Implant Planning page in both coronal and sagittal views if the preference is selected and 'Display axes' is enabled.

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Proximal Shaft CT Landmark

While selecting the proximal shaft CT landmark, the crosshair should be placed below the lesser trochanter. This is TRUE.

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Study Notes

TKA 2.0 95 Questions Study Notes

  • Flexion Laxity Pose Deletion: Max Flexion Medial Laxity decreases to 5.5mm, Live Flexion Medial Laxity to 0mm, Max Flexion Lateral Laxity to 6.5mm, and Live Flexion Lateral Laxity to 2.5mm for the case of capture. All values on the screen reset to 0mm if not this case.
  • Proximal Shaft CT Landmark: Crosshair should be below the lesser trochanter when selecting.
  • Medial Slope Tibial Landmark: First step is to align the green arrows matching the patient's native slope, then place the crosshair on the center of the medial tibial plateau.
  • Distal Shaft CT Landmark: Located at the distal aspect of the femoral shaft.
  • Trialing Flexion Range: Depends on the Final Alignment sagittal flexion angle.
  • Zeroing During Trialing: Necessary if bone arrays are bumped or the user changes the poly size on the Trialing page after a surgeon change. Also zeroing is required if the user navigates to a laxity pose before all trials are in the joint.
  • Delete Button: Used to delete captured poses, or erase the maximum achieved value if Ratcheted preference is selected. Software deletes all Trialing pose captures when the poly size changes, as joint mechanics alter values.
  • Extension Lateral Laxity Pose: Max value will decrease to 0.5mm and live laxity to 0mm.
  • Hip Center Capture Error: Error pops up if the spread metric calculation fails more than once, and not accurately registering 'Hip Center.'
  • Bone Registration Error: When capturing tibia landmarks, a warning is displayed on the Bone Registration page for failed attempts.
  • Initial Assessment Flexion Range (Laxity Poses): 85° to 105° dependent on native sagittal deformity flexion angle to ensure capsule laxity during extension pose captures (not 85° to 95°).
  • Pre-resection Laxity Calculation: Determined from the planned tibial resection to femoral resection.
  • Calculated Laxity Values (TKA 2.0): Represents the closest distance between the planned resection for both tibia and femur, minus the thickness of the component.
  • Implant Display Errors: If the Mako System cuts deep to the implant plan, it will display in red on the Bone Preparation page.
  • Checkpoint Warnings (Bone Preparation): Yellow warnings appear on the main window bone model if an implant plan has triggered a checkpoint near a cut. Warnings are determined by surgeon preference; they are displayed if the implant plan has triggered a checkpoint interaction.
  • Warning Triggered Actions: The application won't move the user on to bone preparation if the following warnings are triggered: overhang, changes after resection, flange tip, and implant proud of cut.
  • Overhang Warning: Triggered when the implant overhang exceeds a threshold; the threshold is 1.00mm for tibia and 2.70mm for the Anterior Flange.
  • Checkpoint Requirements: Surgeons may need to pass a Femur checkpoint only or cutter checkpoints if they want to go to the next step of the procedure.
  • To Be Cut Volume Color: Shown as blue in Bone Preparations page..
  • Intraoperative Warnings: Notching, Combined implant flexion, and Overhang can be triggered intra-operatively; 'Implant proud of cut' and 'Checkpoint near cut' are triggered intraoperatively.
  • Implant Size and Max Flexion: If a size 3 femur and 3 tibia plan with a 3 degree posterior slope, the maximum flexion is 7° combined (10° if tibia size is equal to or greater than femur, 8 if femur is bigger than tibia). If the user plan is 5 Femur and 4 Tibia with 0 degree slope, max flexion in the femoral component is 7 degrees.

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Description

Test your knowledge with 95 questions focused on TKA 2.0 study notes. This quiz covers critical concepts such as flexion laxity, CT landmarks, and trialing flexion range. Perfect for students and professionals involved in orthopedic practices.

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