MAKO PKA EXAMS SCRIPT QUESTIONS AND ANSWERS
GRADED A+
✔✔rotational landmark - ✔✔in transverse view:
find PCL footprint and place blue dot here
scroll until you see tubercle
adjust top arrow so it is to the medial third of the tubercle
this gives you the a/p m/l axis of tibia
✔✔tibia knee center - ✔✔coronal view- top center point
gives you proximal end of tibia mechanical axis
✔✔when checking rotational landmark in implant planning if there is too much space on
lateral side: - ✔✔move rotational landmark arrow medially
✔✔when checking rotational landmark in implant planning if there is too little space on
lateral side: - ✔✔move rotational landmark arrow laterally
✔✔how big is the cross hair - ✔✔4mm across
✔✔translational arrows move implant - ✔✔0.25mm at a time
✔✔rotational arrows move implant - ✔✔0.5 degree at a time
✔✔Medial Bicomp Tibia order - ✔✔transverse
coronal
sagittal
✔✔medial bicomp femur order - ✔✔sagittal
3D model
transverse
coronal
✔✔medial bicomp PF steps - ✔✔0) transverse view for size
1) superior lateral tip
2) trochlear groove
3) bloominsats line
4)superior medial tip
5) PF wings
6) PF to femoral implant space
✔✔lateral uni tibia order - ✔✔transverse
coronal
sagittal
, ✔✔lateral uni femur order - ✔✔3D model
sagittal
coronal
✔✔Medial bicomp PF step 0 - ✔✔look at transverse view for size
make sure there is no overhang to the medial and lateral ridges but also no more than
2mm inset to ridges
✔✔Medial bicomp PF step 1 - ✔✔superior lateral tip
click pink dot in transverse view then look in sagittal view
pink dot is highlighted - you want the tip of the implant to be split 50/50 by native bone
as best as possible
✔✔Medial bicomp PF step 2 - ✔✔trochlear groove
click deepest part of groove in transverse view then look in sagittal view
want implant to be 2mm proud of bone (measure with crosshair)
to adjust this you can anchor the superior lateral tip and add up to 5 degrees of flexion
✔✔Medial bicomp PF step 3 - ✔✔bloominsats line - radiographic landmark where
cruciate ligaments originate
look in sagittal view to find bright white line on posterior side
make sure implant is anterior to line
✔✔Medial bicomp PF step 4 - ✔✔superior medial tip
click on pink do tin transverse view then look in sagittal view
want to make sure tip of implant is touching bone
no ariballing
✔✔Medial bicomp PF step 5 - ✔✔PF wings - most important step
making sure transition zones line up perfectly so the patella can easily glide through its
range of motion
in coronal view: make sure each wing is 2mm proud of cortical bone
prioritize non diseased side
you can adjust one side by adding varus/valgus
✔✔Medial bicomp PF step 6 - ✔✔PF to femoral implant space
make sure there is 3mm of space between implants
coronal view: the two pink vertical lines are 3mm from implant
scroll through to make sure blue and green implants never cross pink lines
✔✔rotary cutting attachment parts - ✔✔cutting attachment
burr
long guard
GRADED A+
✔✔rotational landmark - ✔✔in transverse view:
find PCL footprint and place blue dot here
scroll until you see tubercle
adjust top arrow so it is to the medial third of the tubercle
this gives you the a/p m/l axis of tibia
✔✔tibia knee center - ✔✔coronal view- top center point
gives you proximal end of tibia mechanical axis
✔✔when checking rotational landmark in implant planning if there is too much space on
lateral side: - ✔✔move rotational landmark arrow medially
✔✔when checking rotational landmark in implant planning if there is too little space on
lateral side: - ✔✔move rotational landmark arrow laterally
✔✔how big is the cross hair - ✔✔4mm across
✔✔translational arrows move implant - ✔✔0.25mm at a time
✔✔rotational arrows move implant - ✔✔0.5 degree at a time
✔✔Medial Bicomp Tibia order - ✔✔transverse
coronal
sagittal
✔✔medial bicomp femur order - ✔✔sagittal
3D model
transverse
coronal
✔✔medial bicomp PF steps - ✔✔0) transverse view for size
1) superior lateral tip
2) trochlear groove
3) bloominsats line
4)superior medial tip
5) PF wings
6) PF to femoral implant space
✔✔lateral uni tibia order - ✔✔transverse
coronal
sagittal
, ✔✔lateral uni femur order - ✔✔3D model
sagittal
coronal
✔✔Medial bicomp PF step 0 - ✔✔look at transverse view for size
make sure there is no overhang to the medial and lateral ridges but also no more than
2mm inset to ridges
✔✔Medial bicomp PF step 1 - ✔✔superior lateral tip
click pink dot in transverse view then look in sagittal view
pink dot is highlighted - you want the tip of the implant to be split 50/50 by native bone
as best as possible
✔✔Medial bicomp PF step 2 - ✔✔trochlear groove
click deepest part of groove in transverse view then look in sagittal view
want implant to be 2mm proud of bone (measure with crosshair)
to adjust this you can anchor the superior lateral tip and add up to 5 degrees of flexion
✔✔Medial bicomp PF step 3 - ✔✔bloominsats line - radiographic landmark where
cruciate ligaments originate
look in sagittal view to find bright white line on posterior side
make sure implant is anterior to line
✔✔Medial bicomp PF step 4 - ✔✔superior medial tip
click on pink do tin transverse view then look in sagittal view
want to make sure tip of implant is touching bone
no ariballing
✔✔Medial bicomp PF step 5 - ✔✔PF wings - most important step
making sure transition zones line up perfectly so the patella can easily glide through its
range of motion
in coronal view: make sure each wing is 2mm proud of cortical bone
prioritize non diseased side
you can adjust one side by adding varus/valgus
✔✔Medial bicomp PF step 6 - ✔✔PF to femoral implant space
make sure there is 3mm of space between implants
coronal view: the two pink vertical lines are 3mm from implant
scroll through to make sure blue and green implants never cross pink lines
✔✔rotary cutting attachment parts - ✔✔cutting attachment
burr
long guard
