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TKR: Distal Femoral Cutting Guide



- Discussion:
    - femoral cutting guide is set for the appropriate right or left valgus angulation of +5 to 7 deg (in the tall thin patient try +5 deg, & in short 
            obese patient try 7 or even +9 deg);
    - in lateral plane, this cut is perpendicular to anatomic axis of femur;
    - in coronal plane cut is at right angles to line of leg alignment & at 97 deg to the anatomic axis;
    - cutting block is assembled onto calibrated outrigger of the femoral locating device such that distal femoral resection removes the thickness
            equal to the femoral component (usually 8-9 mm) + an additional 2-3 mm;
            - adding 2-3 mm to the distal femoral cut will help compensate for any flexion contractures and will help compensate for the cement 
                   mantle (1 mm) and incomplete component seating (1 mm);
            - always be careful to avoid elvation of the joint line;
    - femoral condyles are then resected at this orientation, removing amount of bone equal in thickness to distal thickness of femoral 
            component being used

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